Charles D. F. (Charles Douglas Fergusson) Phillips.

Materia medica and therapeutics, inorganic substances; (Volume 2) online

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IRON, Fe 2 6N0 3 ,=484.

PREPARATION, etc. By dissolving iron wire in nitric acid, and dilut-
ing to the proper strength, and a sp. gr. of 1.107. It is a clear solution
of reddish-brown color, acid and astringent.



LIQUOR FERRI PERSULPHATIS SOLUTION OF PERSULPHATE OF

IRON, Fe 2 3S0 4> 400.

PREPARATION, etc. By boiling a solution of the proto-sulphate with
some additional sulphuric and some nitric acid. A dense solution of
reddish-brown color; very astringent.



IRCWT. 133

FERR1 SULPHAS SULPHATE OF IRON, FeSO 4 7H 2 O.

The proto-sulphate of iron is the salt from which the greater number
of the other, compounds are prepared. Three forms of it are officinal
ferri sulphas (green vitriol), ferri sulphas exsiccata, and ferri sulphas
granulata.

PREPARATION. By dissolving iron wire in dilute sulphuric acid, and
crystallizing.

CHARACTERS. The sulphate occurs in oblique rhombic prisms, of
greenish-blue color and very styptic taste, soluble in water, insoluble in
spirit. Exposed to air, it absorbs oxygen and turns brown from forma-
tion of ferric sulphate: if the crystals be rich green in color, some ferric
oxide is present, but if nearly free from any ferric salt, the precipitate
with yellow prussiate of potash will be nearly white. The crystals efflo-
resce slightly in dry air; at 238 F. they lose most of their water of crys-
tallization, and at 400 only one atom of water is retained, and the salt
becomes a yellowish-gray powder.

Ferri Stdphas Exsiccata Dried Sulphate of Iron (FeSO 4 H 2 O).
This does not alter on exposure, and is not gritty: 3 gr. are equal to 5
gr. of the crystallized salt.

FERRI SULPHAS GRANULATA GRANULATED SULPHATE OF IRON.

PREPARATIONS By filtering a boiling solution of ordinary sulphate
into cold rectified spirit, constantly stirring.

CHARACTERS. Occurs in small green granules which are stable, and
if carefully dried retain their properties many years.

TINCTURA FERRI ACETATIS TINCTURE OF ACETATE OF IRON.

PREPARATION. By adding an alcoholic solution of acetate of potash
to one of persulphate of iron, agitating for an hour, and filtering from
the precipitate of sulphate of potash, which is insoluble in spirit.

CHARACTERS. A deep-red liquid which is apt to decompose and be-
come muddy; its taste is not unpleasant, and its degree of astringency
moderate.



FERRI CARBONA8 SACCHARATASACCHARATED CARBONATE OF

IRON, FeCO 3 ,=116.

PREPARATION. By adding carbonate of ammonium to ferrous sulphate,
each salt being dissolved in boiling water, so as to avoid the presence of
air; the precipitate is collected, washed, and rubbed with sugar.

CHARACTERS. The precipitate is at first white, then green and finally



134 MATERIA MEDIC A AND THERAPEUTICS.

becomes red from absorption of oxygen and formation of ferric oxide.
There is no ferric carbonate, but what is often sold as carbonate is a brown
ferric oxyhydrate containing only a trace of the desired salt, which is
very unstable and prone to oxidation; to preserve it from this as far as
possible, it is rubbed up with sugar.

FERRI 10DID UM- IODIDE OF IRON, Fel a ,=310.

PREPARATION. By heating together iron wire with twice its weight
of iodine, and eight times its weight of water, until the solution becomes
colorless; it is then filtered and evaporated to solidity.

CHARACTERS. A crystalline, green substance with a tinge of brown,
containing about 18 per cent, water of crystallization and a little oxide of
iron, without odor, deliquescent, soluble in equal parts of water, forming
a greenish solution which very readily absorbs oxygen, and changes into
free iodine and ferric peroxide. It is decomposed also by heat, emitting
colored vapors of iodine; the altered solution may, however, be restored
by warming with more iodine and iron, and may be preserved in strength
by keeping a piece of iron in it; so that as iodine is liberated, it can re-
combine to iodide. Syrup will preserve to a great extent, and it is in the
form of syrup that it is most frequently ordered (v. p. 179); it is incom-
patible with alkalies and their carbonates.

A Bromide of Iron is prepared similarly by direct combination, and
is sometimes prescribed, but is not yet officinal.

FERRI ARSENIAS ARSENIATE OF IRON, Fe 3 A S2 O 8 , =446.

PREPARATION. From a solution of sulphate by the addition of a mixed
solution of arseniate, and of acetate of soda: the precipitate is filtered
and dried at a low temperature to avoid oxidation. In this process,
arseniate of iron, sulphate of soda, and free acetic acid are formed;
without the acetate of soda, free sulphuric acid would be present, and
this would dissolve the iron salt: the decomposition is complex.

CHARACTERS. Arseniate of iron is an amorphous powder, white when
first formed, but becoming gray or greenish-blue from absorption of oxy-
gen: insoluble in water; soluble in hydrochloric acid. Thrown on live
coals it evolves the garlic odor of arsenic, and is essentially an arsenical
remedy, for the quantity of iron in any admissible dose is insignificant.

FERRI PHOSPHAS PHOSPHATE OF IRON, Fe 3 P a O 8 , =358.

PREPARATION. By a process analogous to that for the arseniate; sul-
phate of iron is precipitated by phosphate of soda, some acetate of soda
being also added to neutralize any free sulphuric acid that would be



IKON. 135

liberated from the iron salt. The precipitate is dried at low temperature
to prevent oxidation.

CHARACTERS. A slate-blue amorphous powder, almost tasteless, in-
soluble in water, soluble in acids.

Syrupus Ferri Phosphatis (v. p. 180 ).

Another group of iron compounds may be made of the scaly prepara-
tions, which are compounds of the metal and often of some other drug in
addition, with a vegetable acid, such as tartaric or citric acid.

FERRUM TARTARATITMTARTARATED IRON.

PREPARATION. Freshly precipitated peroxide of iron is dissolved in
solution of acid tartarate of potash and allowed to stand for twenty-four
hours, concentrated at a moderate temperature, and poured, when of
syrupy consistence, on flat plates to solidify.

CHARACTERS. Occurs in dark garnet-colored scales; soluble in water,
sparingly so in spirit. If boiled with potash or soda it deposits peroxide
of iron, but is distinguished from the ammonio-citrate by not evolving
ammonia under the same conditions, and also by leaving an alkaline ash.

FERRI ET AMMONIA CITRAS CITRATE OF IRON AND AMMONIA.

PREPARATION. By dissolving freshly precipitated peroxide of iron
.in citric acid with heat, adding ammonia to neutralization, evaporating
to consistence of syrup, and then drying in thin layers on plates.

CHARACTERS. Occurs in transparent ruby-red scales, of sweet astrin-
gent taste and slightly acid reaction, soluble in water, almost insoluble in
spirit. If boiled with soda or potash, it evolves ammonia, but alkaline
carbonates do not readily decompose it, and it may, therefore, be given
with them in effervescence with citric acid: the iron salt should be put
into the acid solution.

FERRI ET qUINI^l CITRAS CITRATE OF IRON AND QUININE.



PREPARATION. By dissolving freshly precipitated peroxide of iron
and quinine in solution of citric acid, adding ammonia and evaporating
to dryness at moderate temperature. The product is a triple citrate of
iron, quinine, and ammonium, and contains both a ferrous and a ferric
compound.

CHARACTERS AND TESTS. Occurs in greenish-yellow scales which be-
come darker by age; they are at first deliquescent and very soluble in
cold water, but become less so on exposure to light; it has a chalybeate,
and at the same time a bitter taste. It should contain 20 per cent, of
Fe 2 O s , and 16 per cent, of quinia, but the proportion of the latter varies,



136 MATEKIA MEDIC A AND THERAPEUTICS.

falling sometimes to 4 per cent. The solution is slightly acid: soda pre-
cipitates the reddish-brown peroxide Fe 3 O 3 , and ammonia a white deposit
of quinia.

The citrate of quinine with iron and zinc, and with iron and strychnia,
and many other double compounds, have also been prepared in granular
effervescent form.

ABSOBPTION AND ELIMINATION. If, in former times, the absorption
of any medicine was commonly denied, with us the absorption of all is
now commonly accepted as a necessary condition of their acting on the
system, and yet the absorption of medicinal doses of iron has been doubted
by some eminent men, and mainly because chemists, after giving the
drug to animals, have often failed to detect an increased quantity of it
in the vena portae, and have sometimes failed to find any in the urine.

On appeal to the clinical evidence of improved color and tone after
the use of iron, the objectors attribute such results to a local tonic action
upon the gastric mucous membrane leading to improved digestion; but
besides that iron salts have often rather a contrary effect, it would not,
in any case, account for all that we see, nor for the chemical changes
produced in the blood. It seems more reasonable to allow that the medi-
cine, which we can prove to be, to some extent, soluble in the gastric
fluids, should be really absorbed, at least to the extent of its solubility.
From most articles of diet certainly traces of iron are absorbed, as we
know from detecting the metal in the blood and tissues: if there be some
failure in the supply, or in its assimilation, then color and strength fail,
(just as when iron is removed from a soil, white vegetables and chlorotic
oats spring up from it), and conversely health and color usually return
when suitable ferric preparations are added to the nutriment or to the
soil. Definite facts in proof of absorption are such as the following:
Tiedemann and Gmelin administered to a horse about 6 dr. of sulphate
of iron, and found an increased amount of the metal in blood from the
splenic and hepatic veins, and in some experiments, in the lymph also.
Manghini recorded a distinct increase in the amount of iron in the blood of
dogs when he added the metal to their food (Bayle: " Biblio. de Therap.,"
v., iv.). Wohler, though he failed to detect iron in the urine after giving
various preparations of it to animals, yet succeeded in detecting it by
means of tincture of galls in the urine of patients taking chalybeate wa-
ters; he also noted its occasional presence in calculi and in urinary sedi-
ments (Treviranus : Zeitschrift, vol. i., 1824, p. 302). Quevenne, in
his careful and admirable memoir, says that only a minute quantity can
be detected in normal urine, but that after medicinal doses the amount
is increased slightly: in the bile and faeces the increase is greater (Bou-
chardat: Archives de Physiol., etc., No. 2, October, 1854). Schroff found
that when small doses were given to animals, elimination by the kidneys
was evident, and began sooner, and continued longer, than after larger



137

doses; he recorded also the curious fact (and Becquerel corroborated
him), that even during the use of equal and continued doses, the amount
passed in the urine was subject to much fluctuation, implying- that that
secretion was not the best gauge of absorption. Bence Jones speaks of
detecting iron in the urine within ten minutes of the administration of a
soluble salt, also of the rapid diffusion of another portion of it into the
textures and corpuscles (Lectures, Medical Times, ii., 18GO, p. 245), and
Delioux de Savignac affirms that it may be readily and frequently found
in all the secretions ( Gazette Med. de Paris, April 25, 1874). Bistrow
verified the presence of nearly double the ordinary amount of iron in the
milk of a goat after the administration of 15 to 40 gr. of lactate of iron;
elimination of increased amount began in the milk forty-eight hours after
giving the dose, implying a slow absorption or long detention in the tis-
sues (Husemann). In Dr. Marcet's classical case of a man who had swal-
lowed several knives, particles found in the bile were attracted by the
magnet, and that liquid contained more than double the normal amount
of iron (" Philos. Trans.," xii.).

More modern observations are those of Rabuteau, who passed through
a tube varying amounts of protochloride of iron into the stomach of dogs,
which were killed a few hours afterward; the stomach was found to con-
tain only a small amount of the compound, the intestine somewhat more,
but the greater part had passed into the blood, which was found on anal-
ysis to contain, in these cases, distinctly more iron than under ordinary
conditions (Journal de Therapeutique, 1875).' In another series of ex-
periments he injected the same salt directly into a vein; it did not cause
coagulation on the contrary, it increased the fluidity of the blood, and
yet no increased amount of iron was found in the urine. The greater
part of what was injected passed away by the intestine, proving again
that failure to find the metal in the urine is no proof of its non-absorption
into the blood; similarly, the protoxide was injected in large doses by
Papi, and was found unchanged in bile and faeces, but not at all in urine
(Husemann).

I cannot doubt that a true absorption of iron compounds occurs from
the gastro-intestinal mucous membrane, though it may be often partial
and incomplete, and is certainly rather slow and limited: it varies accord-
ing to the preparation used, the reaction of gastric juices, and the state
of the stomach as to food, etc. Woronichin showed that while chloride
of sodium promoted the assimilation of iron, chloride of potassium much
increased its elimination ( Wiener Med. Wbch., ii., 1868), and Brucke de-
monstrated in rabbits, that after a certain period the system, or more ac-
curately the corpuscles, became so charged with the substance that it was
no longer retained in the tissues, but passed almost wholly in the urine
(Husemann).

With reference to the absorption of iron from the cellular tissue, C.



138 MATERIA MEDICA AND THERAPEUTICS.

Bernard performed a well-known experiment, injecting ferro-cyanide of
potassium into the thigh of an animal, and solution of lactate of iron into
its neck; the spot in the thigh remained unchanged in color, but the neck
quickly showed blue, 'imply ing that the cyanide had been taken into the
circulation, and so reached the iron, but the lactate of iron had not trav-
elled to the cyanide. Soluble salts, however, are certainly absorbed from
wounds, and from the bared skin (Husemann), and recently, good effects
have been obtained from hypodermic injection of a double salt (pyrophos-
phate and citrate) " in pernicious anaemia," after failure of ordinary
means (Huguenin: Schmidt's Jahrb., Bd. clxxiii., 1877). The observa-
tions of Hamburger as to the absorptive powers of the vagina (tampons
soaked in iron solution being introduced into it) were vitiated by his con-
fining analyses to the urine elimination by that secretion being, as we
have seen, very uncertain and he could come to no definite conclusion
(Prager Vierteljahrschrift, 1876, p. 145).

If doubts have been expressed as to the fact of iron absorption, there
has been still more controversy as to the mode in which it is effected,
and this, indeed, may differ according to the preparation employed.
The finely divided metal, " reduced iron," is first oxidized by the help of
water (for if the compound contain any sulphur, disengaged hydrogen
makes itself evident as a sulphuret in eructations). The protoxide and
the carbonate, themselves not soluble enough for absorption, are ren-
dered so by the hydrochloric acid of the gastric juice (as evidenced by
experiments with the gastric juice of dogs) ; the protochloride does not
coagulate albumen, and is readily absorbed. The sesquioxide becomes
first perchloride and then protochloride, and is absorbed as such (Rabu-
teau).

It was formerly held that all proto-salts became quickly changed in
the system into per-salts, because this change so readily occurs outside
the body, but various conditions will prevent or even invert it. Thus,
Quevenne notes that a natural protocarbonate remains as such in many
mineral waters that per-salts are reduced by alkaline tartrates, by
charcoal, or simply by cold and that the ethereal " tincture of steel " is
rendered colorless and reduced to protochloride by mere exposure to
the air and light. Stenhouse found the per-salts to be reduced by or-
ganic substances generally, and 0. Bernard, after injecting a per-salt
into the jugular vein, recovered only a proto-salt from the urine. In
short, it is probable that if iron exists at all in the system as a per-salt it
is only for a time, and under the temporary influence of an increased
amount of oxygen; its rapid change from one condition of oxidation to
another is possibly in accord with a general law of the organism (Que-
venne).

Salts of the organic acids, the citrates, lactates, and tartrates, may be
absorbed directly into the blood, the acid becoming quickly oxidized or



IRON. 139

" burnt off," and the metallic base left free to combine with the blood
constituents. Rabuteau suggests that a carbonate of iron may be
formed, as are carbonates of the alkalies after administration of alkaline
citrates, etc.

The potassio-tartrate or tartarized iron has seemed to be more readily
assimilated than any other preparation (Leras, Mialhe). The iodide of
iron exhibits the properties of iodine rather than of the metal, and has
proved more irritating than simple iron compounds. The whole of the
iodine has been found eliminated in the urine after a few days, while but
little of the iron has passed out (Quevenne, Melsens), proving that com-
plete separation of the constituents occurs in the system.

Salts of the mineral acids the chloride, nitrate, and sulphate if
given so diluted as not seriously to constringe the gastric membrane,
nor to coagulate albumen, may be absorbed directly into the blood, and
much more quickly than the metallic preparations. (Mialhe suggests that
the blood-alkalies combine with, or neutralize, the acids so as to leave
the metal free for oxidation or combination.) Stronger solutions must,
for their first effect, coagulate the albuminous material they meet with
in the stomach. Mitscherlich found a " proto-albuminate " of iron in the
stomach of rabbits; but, within certain limits, this compound is soluble
both in excess of the iron solution, and in fresh quantities of albumen.
Gubler, indeed, recommends it as a good form for administration, being
both active and non-irritant. It has been generally held that this com-
pound of iron was absorbed and circulated as a per-albuminate, but, accord-
ing to Dietl, proto-albuminates are much more soluble than the per-salts
(Schmidt's Jahrb., 1874); the same has been said of proto-chlorides, but
practically both forms are available. The precipitates formed by per-salts
with albumen are soluble under various conditions; using 1^ part of ferric
chloride to an albuminous solution, H. Rose found the precipitate dissolve
in an excess of the salt, and when quite fresh, even the " blood-alkalies "
dissolved it. When albumen came into contact with weak iron prepara-
tions a few drops of weak acid, or sometimes of alkali, were enough to
help solution in the gastric juice (Dietl). As qualifying the observation
of Lersch that albumen could supply the place of acids as a solvent for
iron in the gastric juice, Dietl found that iron albuminate was soluble in
soda solutions, that iron phospho-albuminate was soluble in contact with
phosphate of soda, and that alkaline phosphates generally favored the
absorption of iron salts after they had become albuminates (Schmidt, loc.
cit.).

It is probable that iron is not only absorbed as an albuminate, but
eliminated mainly by membranes having albuminous secretions, such as
mucous and serous membranes. Dr. Ringer refers to experiments in
which, after being injected into the blood, most of the iron was detected
on the mucous lining of the intestine, the bronchi, the gall and urinary



140 MATERIA MEDIC A AND THERAPEUTICS.

bladder, and the serous membrane of pericardium, etc. Gubler relies on
such facts to explain the astringent action of iron on various parts distant
from the stomach, reasoning that the metal becomes separated by such
secreting surfaces from the albumen with which it has been combined,
and then recovers and exerts its natural astringency (cf. vol. i., p. 228).

To resume: of the three groups of preparations the first comprising
the reduced metal and carbonate; the second, astringent acid soluble
compounds; and the third, soluble non-astringent ones all are suscepti-
ble of absorption under favorable conditions, the first comparatively
slowly, the second (when diluted) quickly, and the third group to a
medium extent. This fact becomes of importance in guiding our choice
of a preparation in different maladies. Of either group a certain pro-
portion, according to the dose, the condition of the stomach, etc., may
remain unacted upon, and consequently unabsorbed, and pass into the
intestine mechanically mingled with the food; at this stage some further
proportion is absorbed under the influence of fats (Mialhe), or of alkaline
secretions, or of bile. It has long been recognized that the bile contains
a relatively large proportion of iron, and Lusanna argued that the greater
part, if not all, of the administered metal passed only into the portal cir-
culation from the mesenteric vein, and was eliminated by the bile. More
recently the fact has been used as an argument to show that the effete
blood-corpuscles are broken up in the liver, and furnish to the bile its
large proportion; thus, Dr. Young, after many analyses, fixing .0065 as
the amount of iron contained in the 100 grammes of human bile, calculated
it to represent 6.63 grammes of corpuscles (Journal of Anatomy and Phy-
siology, 1871). However it be, iron is largely eliminated in that secretion,
but any amount that passes through the intestine is liable to be changed
into tannate or sulphide, and so to color blackish the fecal mass; if this
be of ordinary consistence, its external surface, which is alkaline, will be
found more deeply stained than the inner part, which is slightly acid
(Quevenne). In suckling children, the coloration will not occur, and if
the salt be very completely absorbed, as are small doses of proto-chloride
(Rabuteau), or of tartrate (Stille), it will not be noticed for some days, or
until the system is saturated. Again, if the iron pass without any as-
similation, it is also said not to color the stools, so that this effect has
been considered, though I believe incorrectly, some guide to' the absorp-
tion of the drug (Kraus, in Ranking, i., 1872, p. 272).

PHYSIOLOGICAL ACTION (EXTERNAL). Compounds of iron- with the
mineral acids act as caustics, irritants, or simple astringents, according to
the kind and strength of preparation used; they are also, to some extent,
antiseptic. A caustic, destructive action is exerted by the solid per-
chloride, especially upon raw surfaces or mucous membranes, but it is not
so deep or thorough as that of the mineral acids alone, because of the
rapid coagulation of albumen. The astringent effect of dilute prepara-



IRON. 141

tions is explained partly by such coagulation, and partly by the constric-
tion of capillaries induced.

Kulischer has made curious experiments to test the comparative effects
of certain astringents and heemostatics; having divided some blood-ves-
sels in the limbs of frogs, he stayed the bleeding with different astringents
applied for various lengths of time, and then injected liquid into the
larger blood-vessels, and calculated the amount of force required to re-
open those that had been divided and closed; from his results he con-
cluded that of iron solutions a strength of 30 per cent, gave the best re-
sults, and the good effect was proportioned rather to such strength than
to the duration of its application (Schmidt's Jahrb., Bd. clxix., 1876).
Some researches by Rosenstirn upon the same subject, though conducted
in a different manner, show also how much the action is dependent upon
a definite strength of solution, and enable us to compare the effect of iron
with that of other astringents. He examined and measured, under the
microscope, the amount of contraction of blood-vessels in a frog's mesen-
tery after application of 10 per cent, solutions of nitrate of siver, acetate
of lead, and perchloride of iron, and the last acted not at all; he then
used 50 per cent, solutions, and found the iron one very effective it nar-
rowed both veins and arteries at the place of application, arrested circu-
lation, and acted as a true styptic on the blood itself; the adjacent ves-



Online LibraryCharles D. F. (Charles Douglas Fergusson) PhillipsMateria medica and therapeutics, inorganic substances; (Volume 2) → online text (page 17 of 40)