On the mode of action of iron and the relative value of its salts in the treatment of anaemia / by George Herschell.

  • Herschell, George Arieh, 1856-1914.
Date:
[1895]
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Licence: Public Domain Mark

Credit: On the mode of action of iron and the relative value of its salts in the treatment of anaemia / by George Herschell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    chlorosis. He reports four cases, of which the following is an abstract:— Case i.—Improvement in haemoglobin 28% in 24 days, with 12 grains of iron altogether during the duration of the treatment in divided doses. Case 2. — Improvement in haemoglobin 32% in 24 days with 6 grains of iron. Case 3.—Improvement in haemoglobin 30% in 26 days with 9-5 grains. Case 4.—Improvement 26°/0 in 32 days with 11 grains of iron. To quote his own words:—The evidence, therefore, is overwhelming that iron will cure some forms of anaemia without ever having had the opportunity of stimulating the alimentary canal. Bunge's theory was briefly as follows :—He held that iron could not be absorbed from the alimentary canal in an inorganic state. That the quantity of iron in a healthy body was kept up to normal by the absorption of organic iron from the food. That in cases of chlorosis the sulphuretted hydrogen and alkaline sulphides formed in the intestine during the process of digestion combined with the organic iron of the food, converted it into insoluble sulphide, and thus prevented its absorption. He believed that when inorganic iron was given in medicine it used up the free sulphuretted hydrogen and sulphides, and thus allowed the organically combined iron of the food to have an opportunity of being absorbed. Stockman has proved that this theory is erroneous by the simple method of administering ready-made sulphide of iron to anaemic patients, and providing that it should reach the intestine unchanged by enclosing it in capsules of keratin, a substance which is not acted on by the gastric juice. This sulphide obviously could not take up any more H,,S, and as all the patients rapidly recovered it was evident that Bunge's theory could not stand, and that the iron must really have been absorbed into the system. What happens to the different preparations of iron when they are taken into the body by the mouth ? The following extracts from the authoritative textbook of Mitchell Bruce* may be taken to fairly represent the teaching of the schools :— In the stomach all the salts of iron whatever their nature are converted into the chloride, and do not combine with the acid albuminates like some of the other metals (p. 84). Iron very slowly enters the circulation along the whole * Materia Medica and Therapeutics, 1889.—Cassell & Company.