The Treatment of Chlorosis by Iron and some Other Drugs

Abstract

THIs metal has a certain reputation as a hmematinic.In this country it is never given alone for such purposes, but very frequently as compound syrups of the phosphates and hypophosphites, in which manganese is always present as an adjuvant to the iron.In France and Germany it is used to some extent.Most of the standard textbooks either deny its efficacy or speak very doubtfully regarding it.although Binz states that many experienced clinicians believe it to be a valuable aid to iron in the treatment of anwmia, and that for this reason the sulphate of manganese is included in the German Pharmacopoeia.Bartholow also says: "There is no doubt its combination with iron much increases the efficacy of the latter."A glance at its history will show us on what foundation rests such reputation as it may have.The black oxide (MnO,) was first used by Brdra in Italy (1822) in atonic diarrheea.and as an emmenagogue and antichlorotic.Ktlgler3' (1838) recommends it as useful in scrofulosis.The former seems to have used it quite empirically- the latter from an idea that workers in manganese were exempt from scrofula.Various chemists have found traces of it in the bones, gall stones, liver, gastric juice, blood (Wurzer, 1830), and other tissues of man.Both in man and animals its presence seems to be purely accidental, that is to say, it is not an essential component of any tissue or organ, but is derived from vegetable food, which in turn gets it from the soil.Marchessaux (1844), Millon,60 and Riche"' have confirmed its presence in human blood.Renewed interest in the matter arose from the researches of Hannon,62 P6trequin,53 and Burin du Buisson,5' who claimed that manganese is an essential and constant constituent of the blood of man, that it is present in the corpuscles only, and that its administration is essential for the complete recovery of many cases of aniemia.Hannon, indeed, de- scribes three varieties of anaemia: (1) where iron is deficient;(2) where manganese is deficient; (3) where both are deficient.The results of Petrequin, of Burin du Buisson, and oi several others are completely vitiated by the fact that they always gave iron along with the manganese, and often in four times larger quantity.Hannon, however, gave mangasnese alone with asserted good results.On the other hand Gl6nard ,5 examining the blood of forty persons in good health who were bled " in the ordinary course," found in one only a trace of manganese, and as he found none in the blood of a man- ganese miner, he argues that it cannot be absorbed by any channel.Kobert and Cahn have proved that manganese salts given by the mouth are not absorbed.The traces found in the tissues and urine sometimes must be due to its presence in our food.Dr. Broadbent6I treated seven cases of anaemia with it, and believes that it has a certain value.Three of these were anuemic children suffering from ascarides, porrigo, vaginitis, and other complications.Their recovery may be fairly ascribed to treatment directed to cure the complications, rather than to any action of manganese on the bloodi.