Medical Uses

Theory would suggest the internal employment of permanganate of potassa in all the diseases which are supposed to be connected with deficient oxidation, or with putrefactive tendencies; such as the lower forms of fever, diphtheria, scarlatina, erysipelas, purulent infection, carbuncle, hospital gangrene, etc.; but further experience is necessary to prove its usefulness, internally, in these affections. it has been proposed as a remedy for foul breath; and, when this proceeds from the contents of the stomach, or from decayed teeth, it will probably prove useful, employed in the former case internally, and in the latter as a mouth-wash; but, when the affection depends on processes outside of the prime viae, its peculiar oxidizing power could scarcely prove available, as this would no doubt be exhausted by the organic matters of the stomach or bowels before it could be absorbed. As a local application, it has sometimes proved useful by its gently stimulant and alterative, independently of its disinfecting properties, in diseased surfaces, whether ulcerous, diphtheric, or simply suppurative. Dr. Louis Mackall, of Georgetown, D. C., after having long treated diphtheria in the ordinary methods, with unsatisfactory results, was induced to have recourse to the permanganate, both internally and locally to the pseudomembranous patches, and with the most flattering success. He deems it an almost sovereign remedy in all cases in which the exudation has not penetrated the larynx; and, in three instances, he has seen recoveries where this latter event had taken place. For a child often or twelve years old, he uses as a local application to the patches a solution of one drachm in a pint of water, and gives internally, every three hours, a teaspoonful of a solution containing a drachm of the salt in a pint and a half of water. For a very young child he uses a solution of half this strength. He never saw any unpleasant effects from its internal employment; and as a local remedy has found it less distressing than any other that he had employed. (Am. Journ. of Med. Sci., Jan. 1865, p. 81.) Dr. J. G. Rich, of Canada, has met with extraordinary success with the remedy in the treatment of gonorrhoea. After having purged the patient, he injects three times a day a solution of the permanganate containing six grains in a fluidounce of water. Out of 64 cases, he failed with this treatment in only two. if the case is treated in the earliest stage, from three to six injections are sufficient to effect a cure; and in none had he occasion to continue the treatment beyond the fourth day. (Edin. Med. Journ., Sept. 1864, p. 259; from the Canada Lancet.) But it is as a disinfectant that it displays the most extraordinary powers.

Use as a Disinfectant. For this purpose, it is used either as a local application to diseased surfaces, or with a view to the disinfection of the air, or of foul materials, liquid or solid, without the body. For purifying foul air it is thought to be less effective than the gaseous disinfectants, or those which, though liquid or solid, are nevertheless volatile. This is to a certain extent true; but, as I know from frequent trial, a solution, and even a very weak solution, may be used very efficiently. Simply sprinkled by the fingers, in the air of an apartment rendered offensive by foul exhalations from cancerous and other unhealthy ulcers, it will often quickly sweeten it; and, if diffused in the form of spray by means of an atomizer, it will act scarcely less efficiently than if in the gaseous state; and so weak a solution may be employed for this purpose as to leave a scarcely perceptible stain on objects present.

In reference to its disinfectant influence in disease, it may be employed in all cases of ulcerous, gangrenous, diphtheric, or suppurative affection attended with an offensive odour. it has been much and successfully used in hospital gangrene, and gangrenous wounds and ulcers. in cancerous ulcers it is extremely serviceable in correcting the offensive odour, and is for this purpose preferable to any other application that I have ever tried. it should not only be applied carefully to the surface of the ulcer itself; but a piece of patent lint, more or less saturated with it, should be placed outside of the immediate dressing, so as to arrest the foul emanations before reaching the air. in fetid abscesses, and in offensive suppuration of the mucous surfaces, as in ozaena, otirrhoea, and leucorrhoea, and in diphtheric exudations wherever seated, it is one of the most efficient remedies, being used in all these diseases, when in narrow passages, by means of injection.

With a view to a caustic as well as deodorizing effect, as sometimes in hospital gangrene, it may be applied either in the solid state, in the form of powder sprinkled over the surface, or in that of concentrated solution. For disinfectant purposes, as well as for its stimulant and alterative action, an aqueous solution should be used varying in strength according to circumstances, care being always taken that the water is entirely free from organic impurities; distilled water being preferable.

The British Pharmacopoeia directs a standard Solution (Liquor Potassae Permanganatis) containing four grains in a fluidounce. For the mildest effects one grain to each fluidounce is sufficient; this quantity may be doubled when a more decided impression is to be made; and for application to gangrenous surfaces, diphtheric patches, and very feeble and indolent ulcers, the officinal strength may be greatly increased; from ten to twenty grains to the fluidounce being now admissible, or even required. For injection into diseased passages, and for gargles, one or two grains to the fluidounce will answer to begin with. Solutions of about the same strength may be employed for dressings to be applied over those in contact with the diseased surface, and of half the strength, or even less, for deodorizing apartments by means of the atomizer. For washing the hands, to free them from offensive odour acquired in the per formance of various surgical offices, for deodorizing sponges, etc., the weakest solution above mentioned will answer, even though much diluted.* For the application to limited accessible surfaces, an ordinary hair-pencil will answer; but, being soon injured by the solution, it will require frequent renewal. A pencil of fine glass or amianthus would be preferable. For internal use, the permanganate may be given in the dose of half a grain or a grain several times a day.

* The only objection to permanganate of potassa as a deodorizer is the density of its colour, and the stain consequently left by it on the dressings, clothing, furniture, etc.; but I have found that a solution, so dilute as to leave a scarcely perceptible stain, will serve to deodorize the air of a chamber when very finely distributed through it; and any discoloration produced may readily be removed by solution of oxalic acid.