Iron was not regarded as of special medicinal value by the ancients.
The alleged administration of the rust of iron by Melampus was
apparently looked upon as a miracle, and though this instance is often
quoted as the earliest record of ferruginous treatment, it does not
appear to have been copied. Classical allusions, such as that of the
rust of the spear of Telephus being employed to heal the wounds which
the weapon had inflicted, which is referred to by Homer, can hardly be
treated as evidences of the surgical skill of that period. Iron is not
mentioned as a remedial agent by Hippocrates, but Dioscorides refers to
its astringent property, and on this account recommends it in uterine
hæmorrhage. He states that it will prevent conception; it subsequently
acquired the opposite reputation. The same authority, as well as
Celsus, Pliny, and others, allude to a practice of quenching a red-hot
iron in wine or water in order to produce a remedy for dysentery, weak
stomachs, or enlargement of the spleen.
The later Latin physicians made very little use of iron or its
compounds. Oribasius and Aetius write of the uses of its oxide
outwardly in the treatment of ulcers, and Alexander of Tralles
prescribes both an infusion and the metal in substance for a scirrhus
of the spleen. He was probably the earliest physician who discovered
its value as a deobstruent. Rhazes, the Arab, gave it in substance, and
in several combined forms, but Avicenna regarded iron as a dangerous
drug, and suggested that, if any had been accidentally taken, some
loadstone should be administered to counteract any evil consequences.
Vitriol (sulphate of iron and sulphate of copper) was the iron medicine
most in use up to the sixteenth century; but it was not given with
the special intention of giving iron. Paracelsus had great faith in
the Arcanum Vitrioli, which, indeed, appears to have been sulphur. He
also introduced the use of the magnet, but only externally. It was in
the century after him that the salts of Mars came into general medical
use. In the course of the seventeenth and eighteenth centuries the
preparations of iron became very numerous. Iron filings brought into an
alcohol, that is very finely powdered, were much employed, sometimes
alone and sometimes saccharated, or combined with sugar candy. Crocus
martis was the sesquioxide, æthiops martial was the black oxide,
and flores martis, made by subliming iron filings and sal ammoniac,
yielding an ammoniated chloride of iron, was included in the several
British pharmacopœias of the eighteenth century.
The association of iron with Mars probably influenced the early
chemical physicians in their adoption of iron salts in anæmic
complaints, and as general tonics. The undoubted effect of iron
remedies in chlorotic disease was naturally observed, and the
reputation of the metal was established for the treatment of this
condition long before it was discovered that iron is an invariable
constituent of the human body. When this physiological fact came to be
recognised it was supposed that the action of iron salts was explained;
but, in fact, the investigations of the last century have only tended
to make this theory doubtful.
It is known that in health the proportion of iron in the body is fairly
constant. An average man’s blood contains about 38 grains, almost all
of which is contained in the hæmoglobin. He requires from one to two
grains every day to make up for waste, and this he gets in the meat and
vegetable food which he absorbs. The vegetables obtain iron from the
soil, and animals acquire it from the corn, roots, or grasses which
they eat. So far as is known it is from these sources only that human
beings assimilate the iron they require. It is very doubtful whether
a particle of the iron administered in any of the multitudinous forms
which pharmacy provides is retained. A noted modern physiologist,
Kletzinsky, says “From all the hundredweights of iron given to anæmics
and chlorotics during centuries not a single blood corpuscle has
been formed.” For all that there is no medical practitioner of any
considerable experience who has not found directly beneficial results
follow the administration of these medicines in such cases.
To Sydenham and Willis, two of the most famous physicians of the
seventeenth century, the general employment of iron as a medicine may
be traced. Sydenham, in his treatise on hysteric diseases, which, he
says, are occasioned by the animal spirits being not rightly disposed,
and not as some supposed by the corruption of the blood with the
menstrual fluid, points out that the treatment must be directed to
the strengthening of the blood, for that is the fountain and origin
of the spirits. In cachexies, loss of appetite, chlorosis, and in
all diseases which we describe as anæmic, he recommends that if the
patient is strong enough recourse should be had first to bleeding,
this to be followed by a thirty days’ course of chalybeate medicine.
Then he describes, much the same as modern treatises do, how rapidly
iron quickens the pulses, and freshens the pale countenances. In his
experience he has found that it is better to give it in substance than
in any of the preparations, “for busy chemists make this as well as
other excellent medicines worse rather than better by their perverse
and over officious diligence” (Pechey’s translation). He advises 8
grains of steel filings made into two pills with extract of wormwood to
be taken early in the morning and at 5 p.m. for thirty days; a draught
of wormwood wine to follow each dose. “Next to the steel in substance,”
he adds, “I choose the syrup of it prepared with filings of steel
or iron infused in cold Rhenish wine till the wine is sufficiently
impregnated, and afterwards strained and boiled to the consistence of a
syrup with a sufficient quantity of sugar.”
[Illustration: DR. THOMAS SYDENHAM. 1624-1689.
(Originator of Sydenham’s Laudanum.)
]
Dr. Willis had a secret preparation of iron of which Dr. Walter Harris,
physician in ordinary to Charles II, in “Pharmacologia Anti-Empirica”
(1683), writes:--“The best preparation of any that iron can yield us
is a secret of Dr. Willis. It has hitherto been a great secret and
sold at a great price. It was known as Dr. Willis’s Preparation of
Steel.” Dr. Harris thinks it will not be an unacceptable service to
the public to communicate this masterpiece of that eminent and ever
famous man. “It was no strained stately magistery, no sublimation or
salification, no calcined crocus, and no chemical mystery; but an easy
and a natural way of opening this hard body that it may open ours.” It
was given particularly for the removal of obstructions. The formula
was equal parts of iron filings and crude tartar powdered and mixed
with water in a damp mass in a glazed earthen vessel. This was to be
dried over a slow fire or in the sun; wetted and dried again; and this
process repeated four or five times. It might be given in white wine,
or made into a syrup, or into pills, electuary, or lozenges. Dr. Willis
preferred the crude tartar because the cream of tartar sold by the
druggists was generally a cheat, often combined with alum. The crude
could be bought at 6d. to 8d. per lb. In the apothecaries’ shops cream
of tartar was sold at 3s. to 3s. 6d. per lb.
[Illustration: THOMAS WILLIS, M.D. 1621-1675.]
Quincy (1724), who frequently offers explanations of the exact way in
which medicines exercise their remedial power, thus scientifically
describes the action of iron in removing obstructions:--“Mechanics
teach nothing more plainly than that the momenta of all percussions
are as the rectangles under the gravities and celerities of the moving
bodies. By how much more gravity then a metalline particle has more
than any other particle in the Blood, if their celerities are equal,
by so much the greater will the stroke of the metalline particle be
against everything that stands in its way than of any other not so
heavy; and therefore will any Obstruction in the Glands and Capillaries
be sooner removed by such particles than by those which are lighter.
This is a way of reasoning that is plain to the meanest Capacity.”
Tartarised iron has always been a favourite form for its
administration. The Balls of Mars (boules de Mars, or boules de
Nancy), still a popular medicine in France, are a tartarised iron
prepared by a complicated process. First, a decoction of vulnerary
species is made from 12 parts of water and 2 of the species. This is
strained and poured on 12 parts of pure iron filings in powder. The
mixture is evaporated to dryness and powdered. On this powder another
decoction, 18 of water and 3 of species, is poured, and 12 parts of
red tartar added. This compound is evaporated to the consistence of a
firm paste, and a third decoction, 35 water and 5 species, is added
to 25 of the paste and 25 of red tartar. This is evaporated to the
proper consistence to make balls, which are usually about 1 oz. or 2
oz. in weight. They are kept to dry and then wrapped in wrapper. They
are taken in doses of 4 to 5 grains much as Blaud’s pills are taken
here. Sometimes the balls are dipped in water until a brown colour is
imparted to the liquid. This water is also used as an application to
bruises.
Mistura Ferri Composita was adopted in the P.L., 1809, from the formula
of his anti-hectic mixture which Dr. Moses Griffith, of Colchester,
had published thirty or forty years previously. Paris quotes it as a
successful instance of a medical combination which could not receive
the sanction of chemical law; and he testifies to the opposition
offered on that ground to its official acceptance, but adds that
subsequent inquiry had proved that the chemical decompositions which
constituted the objections to its use were in fact the causes of its
utility. It yields a protocarbonate of iron in suspension, and a
sulphate of potash in solution. The compound of iron is in the state in
which it is most active.
As evidence of the faith in ferruginous waters as tonics of the
generative system, Phillips quotes from the thesis of Dr. Jacques, of
Paris, a curious marriage contract said to have been common at one time
among the burghers of Frankfort to the effect that their wives should
not visit the iron springs of Schwalbach more than twice in their lives
for fear of being too fruitful. The story looks suspiciously like an
advertisement of Schwalbach.
Tincture of perchloride of iron acquired its reputation in the 18th
century from the secret medicines known as La Mothe’s “gouttes d’or,”
and Bestucheff’s Nerve Tincture (see page 321). The formula of the
latter, published by the Academy of Medicine of St. Petersburg, was
corrected by Klaproth, and under various names and in different forms
found its way into all the pharmacopœias. Klaproth’s process was to
dissolve powdered iron in a mixture of muriatic acid 3, and nitric acid
1; evaporate to dryness, and then leave the mass to deliquesce to a
brown liquor. Mix this with twice its weight of sulphuric ether. The
saturated ethereal solution to be mixed with twice its volume of spirit
of wine, and kept in small bottles exposed to light until the liquid
acquired the proper golden tint. A similar preparation is retained in
the French Codex under the title of ethereal-alcoholic tincture of
muriate of iron.
Reduced Iron, or Iron reduced by hydrogen, was first prepared by
Theodore Quevenne, chief pharmacist of the Hôpital de la Charité,
about the year 1854. Pharmacological experiments were made with it by
himself in association with Dr. Miquelard. It was believed at first
that the metallic iron obtained by the process described, which was to
heat the hydrated oxide of iron in a porcelain tube to dull red, and
then to pass a current of hydrogen through the tube, was absolutely
pure, and from experiments on dogs they came to the conclusion that the
metal in this form was more assimilable than any of its salts. It had
besides the advantage of being almost tasteless. Quevenne’s treatise
describing the process and the experiments was published in 1854 under
the title of “Action physiologique et therapeutique des ferrugineux.”
Later investigations, while supporting the original opinion to a great
extent as to the assimilability of the reduced iron, established that
the product is not and cannot be pure. Dusart showed in 1884 that the
proportion of actual iron could not exceed 87 per cent., and was not
likely to be more than 84 per cent. Oxides, and carbonates of iron
were inevitable, while sulphur, arsenic, phosphorus, and silicon were
probable contaminations from the gas.
Citrate of Iron in scales was introduced by Beral, of Paris, in 1831.
His formula is given in the _Pharm. Jnl._, vol. I, p. 594.
Syrup of Phosphate of Iron was introduced in a paper read to the
Medical Society of London in 1851 by Dr. Routh, and Mr. Greenish
subsequently described to the Pharmaceutical Society the process by
which it was prepared. The formula was afterwards improved by Mr. Gale,
and his process was adopted in the B.P. It has since been modified.
A solution of iodide of iron was first employed in medicine in this
country by Dr. A. T. Thomson some time in the ’30’s of the nineteenth
century. It was introduced into the London and Edinburgh Pharmacopœias
in the form of a solid salt, and in the latter also in the form of
a solution. Neither of those preparations could be preserved from
decomposition, and the first suggestion of a syrup appears to have
been made in Buchner’s Repertorium in 1839, and soon after by other
experimenters. Dr. Thomson gave a formula for a syrup of iodide of iron
to one of the earliest meetings of the Pharmaceutical Society in 1841,
reported in the first volume of the _Pharm. Jnl._