1.  Blaud’s pills are very much used.  The formula follows: 

Dried Sulphate of Iron    2 drams
Carbonate of Potash       2 drams
Syrup                     Sufficient

Mix thoroughly, and make forty-eight pills.  Take one to three pills, three times a day after meals.

2.  Fowler’s solution of arsenic is also very good remedy; three to four drops three times a day.  It must be watched for bad symptoms and should only be taken under a physician’s supervision.

Diet.—­This should be good and varied to suit the special taste, and as the stomach and bowels are usually disordered such food should be chosen as will best agree.  Diet plays a very important part.

Pernicious anaemia.—­This is characterized by great decrease of the red cells of the blood with a relatively high color index and the presence of large number of germs.  The causes are unknown.

Condition.—­The body is not emaciated.  A lemon color of the skin is usually present.  The muscles are a dark red, but all the other organs are pale and fatty.  The heart is large and fatty.  The liver and spleen are normal in size, or only slightly enlarged with an excess of iron in the pigment.  The red cells may fall to one-fifth or less of the normal number.  The rich properties of the blood are fearfully decreased.

Symptoms.—­Stomach and bowels, dyspepsia, nausea and vomiting, or constipation, may precede other symptoms or they may last throughout the case.  The onset is gradual and unknown, with gradually increasing weary feeling, paleness and some difficulty in breathing and palpitation of the heart on exertion.  There is paleness of the skin and the mucous membranes, the lips look pale, no color.  The paleness becomes extreme, the skin often having a lemon yellow tint.  The muscles are flabby; the ankles are swollen, you can see the arteries beat.  Hemorrhages may occur into the skin, mucous membrane and retina of the eye.  Nervous symptoms are not common.  The pallor and weakness become extreme, sometimes with intervals of improvement and death usually occurs.  The following is Addison’s description given by Dr. Osler: 

[Blood and ductless glands 251]

It makes its approach in so slow and insidious a manner that the patient can hardly fix a date to the earliest feeling of that languor which is shortly to become extreme.  The countenance gets pale, and white of the eyes become pearly, the general frame flabby rather than wasted.  The pulse perhaps larger, but remarkably soft and compressible, and occasionally with a slight jerk, especially under the slightest excitement.  There is an increasing indisposition to exertion, with an uncomfortable feeling of faintness or breathlessness in attempting it; the heart is readily made to palpitate; the whole surface of the body presents a blanched, smooth and waxy appearance; the lips, gums and tongue seem bloodless, the flabbiness of