FERRUM METALLICUM–FERRUM REDACTUM.
Introduction
The old school dose of this preparation is, grains 1/2-2.
The method of preparing iron by hydrogen, as we read in the Am. Hom. Phar., comprises three stages :
“1. The preparation of a pure ferric hydrate from ferric chloride, drying and powdering the same;
“2. Submitting the ferric hydrate at a red heat to the reduction action of a continuous stream of pure hydrogen gas as long as vapor of water comes off;
“3. And finally continuing the stream of Hydrogen until the reduced iron has cooled.”
Ferrum was first proved by Hahnemann.
To quote from the Handbook, “Iron acts chiefly on the blood, producing more rapid oxydation, with rise of temperature; at first an increase of red color (or of red corpuscles), but subsequently a diminution of red corpuscles and profound anaemia.”
We use iron in cases of anaemia and so do the old school, and because it is considered by so many as the panacea in all anaemic conditions, I ask your indulgence for a few minutes to consider the position of the two schools in the administration of iron.
We, as homoeopaths, practice according to what we believe to be a law of cure, Similia Similibus Curantur (let likes be treated by likes, or as Dunham puts it: “Sick persons should be treated by drugs which produce in the healthy, symptoms similar to those of the sick persons”).
If this is a law, it is necessarily universal in its application and not subject to change. We cannot accept it in one pathological state and reject in it another; to be a law it must be inflexible and apply to all curative diseases, including anaemia.
The old school, on the contrary, not having a law to guide them, are constantly changing their practice and that change, I believe, will cause them to approach nearer and nearer to homoeopathic methods; only, until they accept our law of cure they will reap but partial benefits, for they practice for the most part empirically, or because some one has found a drug of benefit in a certain disease the remainder of the school will use that drug in a disease having the same name irrespective of the differential symptoms.
We all know that in health a mixed diet contains sufficient iron for all purposes of the human economy, and if iron other than found in food is needed, there is something wrong. (It is estimated that in the entire body there are three grams, or 46.3 grains, of metallic iron.)
We also know that, when the old school give iron, but a very small portion of it can enter the systemic circulation and that most of it is eliminated by the liver into the bile, by the intestinal tract and by the kidneys.
The position held by the old school may be best seen by quoting from some of their authors. Prof. Tirard, in a recent lecture at King’s College, London says: “For many years there has been a growing dissatisfaction with our resources for the treatment of anaemia, and efforts have frequently been made to discover some form of treatment which should possess active properties and at the same time be free from the constipating effects so often produced by many of the preparations of iron. It has long been recognized that the beneficial effects of iron salts and preparations could not be measured by the amount administered, and that an increase in the amount is almost certainly followed by the production of some form of digestive trouble.
“With the astringent or ferric salts, troublesome constipation might follow an attempt to employ full doses, or there might be loss of appetite, nausea, or unpleasant eructations, when non-astringent forms of iron or feebly- astringent ferrous salts have been administered. These considerations led to the ready acceptance of any researches or theories which should explain the frequent failure of the employment of the inorganic forms of iron.”
The theories that are advanced by the old school for the employment of iron in anaemia are many and various, and change as the years bring new books upon the market. Some authors seem to reason on the idea of brute force, and if they can only keep the stomach from rebelling, even if they have, as Ringer says, to “humor the stomach by changing occasionally the preparation of iron,” enough will be forced down the patient so that the system will be unable to eliminate it all and some will have to be taken up into the circulation.
The following from the Bartholow is of interest and it may prove an incentive to study and work out our cases of anaemia if we hope to effect a cure. “The physiological action is iron is not limited merely to the construction of red blood. When there is no intolerance to its presence in the stomach it promotes the appetite and invigorates the digestion and it is the opinion of some eminent authorities that the chief use of iron as a remedy, even in anaemia, is to promote the digestive function. Practical physicians are familiar with the fact that iron improves but little, if at all, the condition of the anaemia, when it does not increase the desire for food and the ability to digest it.
“In anaemia iron is given with two objects: to furnish the needed material to the blood; to increase the energy of the primary assimilation. To accomplish the first object, small doses – one or two grains – of reduced iron are most suitable. The second object is best obtained by large doses of the most astringent preparations which the patient’s stomach will tolerate.”
“The homoeopathic principle,” says Farrington, in speaking of anaemia, “is to correct the defective supply of haematin which lies back of the want of iron in the blood. This deficiency is due not to want of iron in the food taken, but to want of power on the part of the system to assimilate it,” and why the system lacks this power and what it needs in order to regain it, we ask each individual case to tell us by the symptoms that it presents for our interpretation.
Symptoms
In cases requiring Ferrum we find profound prostration and emaciation, usually with restlessness (160) and general relief from walking slowly (10); cannot keep quiet, but feels worse from any active effort. There is a general over-sensitiveness to pain (148) and to a greater or less extent a “general haemorrhagic diathesis” (Hering).
The face is pale, often puffy, but with tendency to easy flushing of head and face from the slightest emotion of pleasure or distress, which gives the appearance “of false plethora” (Lilienthal), or what Dr. S. Weir Mitchell has described as “fat anaemia.” There is liability to violent headaches (93); the hands and feet are often swollen and the extremities are generally cold (71).
Mentally, Ferrum is useful in melancholia or hypochondriasis in anaemic or chlorotic women, with gloomy forebodings and easy irritability.
In the head we have the so-called congestive headaches (102), with violent beating (104) and hammering, and flushed face. In these throbbing headaches (102), which are due to anaemic conditions or to loss of blood, there is extreme sensitiveness to all external impressions (95) and the pain is greatly worse by any sudden motion (96) or by noise (96). The pain generally begins and in one temple or on one side of the heat and may involve the whole head; sometimes the skull feels as if it would burst open (104). With the hot and throbbing head, there are generally cold extremities, which are always noticed, says Hughes, in “congestive headaches following large losses of blood.”
In exophthalmic goitre (83) we would think of Ferrum when the trouble was due to suppressed menstruation and associated with violent palpitation (112), extreme sensitiveness and great nervousness.
The Ferrum patient may have ravenous hunger (119) which sometimes alternates with loss of appetite, or there is absolute disgust for food, especially for meat, which is vomited. We frequently find a feeling of sinking or goneness in the stomach (179), but with no benefit from eating, on account of the diarrhoea that all nourishment causes (57).
In the diarrhoea calling for Ferrum the stools contain undigested food (60), they are, as a rule, painless and worse from eating or drinking (57), and with frequent movements at night. Associated with the diarrhoea there is generally unnatural hunger, with aggravation from satisfying it, easy flushing of the face, great weakness and exhausting sweats.
Ferrum is useful for chronic diarrhoea (58), painless, watery and gushing (59), aggravation at night, and associated with coldness of the extremities and great prostration (58). It is to be thought of as a valuable as well as a neglected remedy in colliquative diarrhoea of phthisis (60), where it seems impossible to obtain any benefit from food as it passes right through and undigested. In the diarrhoea of teething children (58) we have painless, undigested stools (60) followed by great exhaustion (58); sometimes associated with vomiting, both diarrhoea and vomiting coming on immediately after nursing.
It has proved of value in nocturnal enuresis (198) as well as in diurnal, the child wetting himself even while walking.
