7. Treatment of Pneumonia by Restoratives

1865 American Journal of the Medical Sciences  
to that of iodine, with which it ought not, therefore, to be therapeutically asso¬ ciated, unless it is intended to counteract the effects of the latter. -Brit, and For. Med.-Chir. Rev., Jan. 1865. 6. On the Action of the Tincture of PercKloride of Iron in the Cure of Renal and Urinary Affections.-Dr. Arthur Hill Hassall relates (Lancet, Dec. 31, 1864) some very interesting observations on this subject. " There are few remedies," he observes, " more frequently prescribed in the treatment of
more » ... he treatment of renal and urinary affections than is the tincture of perchloride of iron, formerly called muriated tincture of iron. The value of that remedy in a variety of such eases is undoubted, as in the albuminuria of Bright's disease, in hemorrhage from the kidney, bladder, or urethra, in spasmodic stricture, &c. " The tincture of the perchloride of iron consists of two atoms of iron in com¬ bination with three of chlorine, dissolved in water to which rectified spirit has been added ; and it possesses the properties of an astringent, tonic, and styptic, coagulating blood or albumen with which it is brought into contact, and con¬ stringing the vessels and tissues to which it is applied. " Now, this astringent property is just that which a remedy ought to possess to be useful in the cases above referred to, and by it, it is usually supposed, it exerts its beneficial action; and certainly nothing would appear to be more plausible and more natural than this explanation. " Having, after the administration of this remedy, repeatedly tested the urine for the purpose of detecting in it the presence of iron, and having failed to dis¬ cover the faintest trace of the metal, I was led to doubt the correctness of this view, and wp.s induced to institute some experiments, in order to put the matter to the proof. " To a patient, T. L--, labouring under an habitual urinary discharge, I administered for the period of more than a week a drachm of the tincture thrice daily: but, although I tested the urine on several occasions, in no instance could I detect the smallest trace of iron, notwithstanding that a pint of the urine was evaporated to a small bulk before being examined. To a patient now in the Royal Free Hospital, Charles S-, who is suffering from an extravasation of blood, three drachms of the tincture were administered on two consecutive days. The whole of the urine passed in the twenty-four hours of each day was collected, a pint of each sample evaporated to a small bulk, and tested as before, but with a similar negative result. " Lastly, I myself took in the conrse of a day three drachms of the tincture; the urine passed in the twenty-four hours being collected and analyzed, not only on the day on which the medicine was taken, but on the preceding and succeed¬ ing days. Still no iron was found. " I could enumerate several other instances in which iron had been taken and the urine analyzed without even traces of the metal being subsequently dis¬ covered. The examples, however, 1 have quoted are sufficient to show that the tincture of perchloride of iron does not produce its beneficial effects, as gene¬ rally supposed, in restraining the amount of albumen or of blood discharged from the kidney or other portion of the genito-urinary mucous track by coming in contact with the seat of the lesion and by its action as an astringent. " How, then, does this remedy act? That much of the iron contained in the sesquichloride does not find its way into the circulation at all, but escapes from the system with the undigested portions of the food, is certain ; the black dis¬ coloration of the feces under the use of this tincture, and indeed, I believe, un¬ der all the preparations of iron, is well known, the colour being due to a com¬ bination of the iron with a portion of the sulphur of the food-sulphuret of iron being thus formed. It might therefore be very plausibly presumed that while the greater part of the iron is thus thrown off by the bowels without having been absorbed at all, the hydrochloric acid, being set free, enters the circulation, is eliminated by the kidneys, and so comes in contact with the seat of lesion ; and that it is to the acid, and not to the iron, that the benefit is to be attributed. But if this view be correct, it is capable of being substantiated by experiment; and with this object I administered to two persons drachm doses, repeated thrice daily, of the perchloride; the urine of the twenty-four hours being col-
doi:10.1097/00000441-186504000-00033 fatcat:rshfcrrvn5dqfmgxxfkb5shmnm