This section is from the "A Practical Treatise On Materia Medica And Therapeutics" book, by Roberts Bartholow. Also available from Amazon: A Practical Treatise On Materia Medica And Therapeutics
This salt is a very powerful oxidizing agent, and yields up its oxygen readily in the form of ozone. Its use as an internal and external remedy is based on this chemical fact. That it parts with its oxygen so readily is held by some to demonstrate its entire inutility when administered by the stomach. Although it must instantly be decomposed on reaching the stomach, there are satisfactory reasons for believing that it exerts a favorable influence on certain diseases in which, theoretically considered, it may be indicated. The author has seen marked advantage from its use in the dyspepsia and flatulence so constantly attendant on obesity. It has also appeared to be very serviceable as a remedy for an abnormal and excessive deposition of fat. In the so-called uric-acid diathesis it favors the conversion of uric acid into urea, and thus prevents the formation of uric-acid calculi. Pain in the lumbar region, frequent micturition, acid urine, much brick-dust sediment, and intestinal indigestion, are associated symptoms relieved by the permanganate. Under the same conditions, it is probable acute rheumatism is developed, and to the action of the permanganate as an oxidizing agent is attributable the benefit which is sometimes obtained from its use in this disease. In scarlatina and diphtheria the permanganate is used with undoubted benefit, applied to the throat and taken by the stomach. In erysipelas, puerperal fever, septicaemia, it has been given with advantage. Lately it has been used with success as a remedy for the bites of venomous snakes and other animal poisons, applied locally and given internally (Lacerda).
Recent trials have shown that this agent is effective against other forms of poisoning as well as that of the snake. It has been used with success in morphine poisoning, even when the poison has been absorbed and is acting on the system at large. As experiment has proved that it forms chemical combinations with alkaloids and renders them inactive, this property explains its utility when the poison is directly accessible. In cases of opium, coca, or other narcotic poisoning, when the toxic agent is yet retained in the stomach, its local action can be relied on to destroy or inhibit the poison and thus prevent systemic action. The stomach-pump having been used, the cavity should be well washed out with the permanganate solution—one or two grains to the ounce of water. Besides this local action, the evidence is conclusive that it possesses antidotal power against the systemic effects. Injected subcutaneously, it is asserted that it completely antagonizes the morphine, one grain being effective against the same amount of the narcotic. It acts in a similar manner against cocaine, and, we may well suppose, against atropine and strychnine, and other organic alkaloids. It is difficult to conceive of such remote and systemic effects, when the remarkable facility with which it parts with its oxygen in the presence of organic matter is remembered. It is known, however, that injected in the neighborhood poisoned by snake-bite, the action of the poison is arrested.
Drs. Ringer and Murrell have found it an effective remedy in the treatment of amenorrhoea, one or two grains being given in pill form three times a day. Since the publication of this discovery, many cases confirming its truth have been reported from all quarters. Recently it has been affirmed that the salts of manganese possess this property in common, and that it is not a special endowment of permanganate. The author can not but regard this as doubtful, since he has not obtained the same results from the other manganese preparations, although recognizing the desirability of having less irritating agents for the purpose. The dose of three to five grains recommended by Drs. Ringer and Murrell can be taken by few patients—if any—without experiencing very considerable gastric disturbance.
The mode of administering permanganate in the condition of amenorrhcea has much importance, since it is usually necessary to give the largest doses that can be taken without causing so much gastric disturbance as to compel its suspension. The best form in which to prescribe it is probably the compressed pellets containing one or two grains of the salt. A large draught of water that has been recently distilled, or, better, that has been boiled and filtered, should immediately follow the pellet—for free dilution in the stomach will not only promote absorption, but will lessen the action on the mucous membrane. The rapidity with which the color of a permanganate solution will be discharged in common river-water has been much exaggerated; the author ascertained that, when added to a vessel of the Schuylkill water, no appreciable change took place in a half-hour. Further, when a solution made by dissolving a compressed pellet in ordinary river-water is put into urine, the color is not at once discharged, but an interval of several minutes elapses before the change is completed.
That the large proportion of active oxygen present in the permanganate contributes to the therapeutical action can hardly be denied, and that it is an element in the action on the organs of menstruation must be admitted also. The author, therefore, advises the use of permanganate of potassium in amenorrhoea, rather than the salts of manganese, although the latter may be used when the former can not be borne. The remedy should be administered during the week preceding the time of the menstrual flow, and the dose given must be small, with the necessary frequency, so that about ten grains be received each day. When the other salts of manganese are substituted, such combinations as the following will be found useful: Rx Ferri sulph. exsic., mangani sulph. exsic, ậậ. Эj ; ext. aloes, gr. iv; ext. ignatiae vel nucis vomicae, gr. v. M. Ft. pil. no. xx. Sig.: One pill three times a day. The amount of manganese in this prescription can be trebled if need be. Rx Ferri et mangani carb. sacch., 3 ij. Ft. pulv. xx. Sig.: One powder three times a day. This latter remedy is especially commended because of its remedial value and of the ease with which it is administered, since it is almost tasteless.
The value of permanganate of potassium in amenorrhoea having been confirmed by Lvaff (Russia), Vargunin was induced to try it in cases of dysmenorrhoea characterized by scanty flow, and a general condition of anaemia. The result justified the a priori judgment, and equally fortunate cases have been reported by others since. It is a necessary condition for the successful use of permanganate in these affections that the state of the patient be that of depression, anaemia, or chlorosis, and that the organs concerned in the menstrual function be wanting in activity. Congestion or inflammation of the pelvic organs is a positive contraindication.
It should not be forgotten that pills containing permanganate of potassium in some combinations are explosive. There is, however, no actual necessity for combinations of this kind.
Among the important uses of permanganate of potassa are its external applications as a disinfectant. It is a deodorizer as well as a disinfectant. It is very frequently used ( 3 j—Oj) to correct the fetor of cancer, ulcers, caries, abscesses, etc. It is used as an injection, or in the form of spray, to destroy the odor of the discharges and to alter the morbid action, in cases of ozoena, otorrhoea, etc. It is an elegant toilet preparation (gr. j — oz j) for destroying the odor of a foul breath, the smell of the axilla, and the fetor of the sweat of the feet. See "Antiseptics" for further information.
Recently solutions of permanganate of potassium have been employed successfully in the treatment of dysentery. Among the cases thus benefited have been the formidable cases of dysentery coming from South Africa. Dr. Bennett (" Lancet," December 21, 1901) reports the cure of many cases of "asylum dysentery" in this way. For this purpose a "weak solution" is made use of to irrigate the bowel morning and evening, and this, it is reported, had "seldom to be used after the second day." This method is applicable also to any case of diarrhoea accompanied by straining.
 
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