Studies on the retention of iron in childhood.

The efficacy of iron therapy in nutritional anaemia, which has been shown to be of such common occurrence in infants and adults (Mackay"6; Faber6; Davidson et al'; Fullerton') is apparently dependent on the administration of large doses of iron if given orally (Heath"; Witts"). In this connection it is interesting to recall that the use of large doses was first advocated in 1832 by Blaud'. Only a small amount of the iron ingested goes to the formation of haemoglobin and there has been much speculation as to the reason why it has to be given in such large doses, and as to the fate of the remainder of the iron which has not been utilized in haemoglobin building. That the body can store large amounts of iron has been shown by Reznikoff, Toscani and Fullarton24, who found that, after the administratioin of phenylhydrazine hydrochloride to a case of polycythaemia, there was a blood destruction equivalent to 21 grammes of iron without any extra excretion of this metal. Ramage and Sheldon2", recovered as much as 50 grammes of iron from the tissues in a case of haemochromatosis. The necessity for the use of massive doses of inorganic iron salts has until recently caused many workers to doubt if iron deficiency is the sole factor in the etiology of the nutritional anaemias (Whipple and RobscheitRobins30). Heath, Strauss and Castle'2 showed that the parenteral administration of iron in inorganic form resulted in 100 per cent. utilization, and because of this Fullerton8 sees no reason to postulate the existence of another factor, and suggests that the necessity for large doses is dependent, among other things, upon imperfect absorption. There are, however, few observations regarding the absorption of iron, and the importance of further investigation on its fate after ingestion is obvious. With a view to throwing some light on this problem, a series of iron-balance studies has been conducted on in-patients at the Royal Hospital for Sick Children in Glasgow.