William Hunter discusses the subject of anemia and its treatment at considerable length in the “Index of Treatment,” Ed. 6, pp. 17–37, and gives many prescriptions containing iron for use under different conditions; and while it is unnecessary to reproduce all of these here, a few may be given in order to suggest suitable methods of prescribing iron when it cannot be given in sufficient amounts in the food.
In chlorosis Hunter advises that that form of iron which experience has shown to be least disturbing to the patient’s stomach should be used, and he suggests separate stomachic mixtures to be used simultaneously, not mixed with the iron itself. When constipation exists—and this is a very common accompaniment of chlorosis—he gives the following aperient iron combination:
| Gm. or c.c. | ||||
| ℞ | Ferrous sulphate | │25 | gr. iv | |
Magnesium sulphate | 4 | │ | Ʒ i | |
Aromatic sulphuric acid | │5 | ♏ vii | ||
Tincture of ginger | │7 | ♏ x | ||
Compound infusion of gentian (B. P.) q. s., ad | 30 | │ | ℥ i | |
This, constituting a single dose, is to be taken twice daily—at 11 a. m. and 6 p. m. A little compound tincture of gentian and water may be used in place of the compound infusion of the British Pharmacopeia. He modifies this somewhat as occasion demands by using sodium sulphate and adding sodium bicarbonate (which converts the sulphate of iron into ferrous carbonate) and adds 10 minims of spirit of chloroform to act as a stomachic.
Hunter also suggests the use of pills of aloes and iron in place of the mixture described above, and when constipation has been corrected, the aloes may be omitted and the pill of ferrous carbonate alone may be used for the iron. Hunter’s comment regarding this pill is, “very satisfactory.”
The same form of iron is available in the compound iron mixture, formerly official, which Hunter says is exceedingly good. In this country the compound solution of iron and ammonium acetate, Basham’s mixture, so called, has long enjoyed a wide reputation as causing very little disturbance of the stomach, and the homely tincture of ferric chlorid is probably useful in a large majority of cases in which the stomach is not especially irritable.
We may say with assurance that one of the forms suggested here will suffice for practically every case in which it is necessary to reinforce the amount of iron available in the food by some pharmaceutical preparation. If these do not satisfy your requirements, consult a really competent pharmacist and enlist his aid in devising a mixture especially suited to your individual patient.—(From the Journal A. M. A., Dec. 29, 1917.)