SOME REMARKS ON THE VALUE 
OF 
Permanganate of Potassium 
IN 
AMENORRHCEA. 
By EDMUND J. DOERING, M. I)., Chicago. 
[inaugural Thesis, read before the Chicago Gynecological Society, March'JOth, 1885.] 
C 11 I C A G O: 
Clark & Longley, Printers, 
1885. SOME REMARKS ON THE VALUE 
OF 
Permanganate of Potassium 
IN 
AMENORRHCEA. 
By EDMUND J. DOERING, M. D., Chicag<\. 
[Inaugural Thesis, read before the Chicago Gynecological Society, March 20th, 1885.] 
Although several years have elapsed since Drs. Ringer and 
Murrell first introduced permanganate of potash, as an emraen- 
agogue, to the profession, there is yet a feeling of uncertainty 
as to its true value. I presume this is partly due to the 
difficulty of determining in any given case, whether the reap- 
pearance of the menses is due to the remedy given or due to 
natural causes; and on the other hand, one or two failures 
with a new remedy will generally cause the physician to 
abandon its further use. It is therefore only by carefully con- 
ducted clinical observations, and by the accumulated experi- 
ence of those who have given this remedy a fair trial, that it 
can be finally determined whether permanganate of potash is 
or is not an efficient emmenagogue. According to the U. S. 
Pharmacopoeia, permanganate of potash occurs in deep-purple, Doering—Permanganate of Potassium. 
[April 
2 
violet, or nearly black needle-shaped rhombic prisms of a 
metallic lustre, permanent in the air, odorless, having a sweet, 
afterward disagreeable, astringent taste, and a neutral reaction. 
It is soluble, with the exception of a scanty brown residue, in 
twenty parts of water at 590 Fahr. and in three parts of boiling 
water. 
It is remarkable for the quantity of oxygen which it con- 
tains and for the readiness with which it yields it up, and upon 
this chemical fact its use is based, both as an internal and 
external remedy. On the other hand, this very fact is claimed 
by chemists as an absolute proof that it is utterly useless when 
administered by the stomach. 
Bartholow, who has great faith in this drug, claims that, 
although it parts with great readiness with its oxygen, this 
readiness is not sufficiently great to prevent the distribution ot 
this gas into the blood. His opponents deny this, and argue 
that the organic matter contained in the stomach and mucous 
membranes is sufficient to appropriate the oxygen of the salt 
and thus prevent its entrance into the circulation. 
Desiring further light upon this matter, I requested Professor 
N. Gray Bartlett, the well-known chemist, to give his views, 
which he courteously consented to do. His opinion is as 
follows: 
“From the readiness with which the permanganate of pots- 
sium is decomposed by organic compounds, it would seem to 
be ineligible for internal use. When so administered, it is 
immediately brought in contact, in the stomach, with a rela- 
tively large amount of organic matter, and must, necessarily, 
be very rapidly destroyed, the manganese of the permanganate 
separating, in all probability, in the form of the hydrated 
manganese dioxide. The latter compound is an active oxidiz- 
ing agent, and is possibly capable of exercising in the economy 
the oxidizing function which has been ascribed to the perman- 
ganate of potassium. It would seem rational, therefore, antic- 1885.] 
Doering—Permanganate of Potassium. 
3 
ipating the change which follows the administration of the 
permanganate, to substitute for the latter the hydrated man- 
ganese dioxide, which can readily be prepared in a state of 
purity for medicinal use.” 
Whatever view may be adopted of the chemical changes 
which the permanganate undergoes in the human economy, the 
main question is as to its therapeutical value. Professor Thomas, 
in a recent address to the New York State Medical Associa- 
tion, says: “ Permanganate of potash, as an excitant of the 
menstrual flow, is, I think, the best emmenagogue which has 
yet been discovered. Drs. Ringer and Murrell recommend 
this remedy in amenorrhcea, depending on torpor, anaemia and 
deficient activity of the menstrual apparatus, it being contra- 
indicated when acute congestion or a general condition of 
sthenic reaction exists. They recommend it to be given in 
doses of one grain first, to be gradually increased to two 
grains four times a day, as near as possible to the regular date 
of menstruation, and continued for three or four days. I may 
say, right here, that in every case in which I have admin- 
istered the drug in this manner, it has proven useless. I have 
given the permanganate of potash a careful trial, having used 
it in about thirty cases of amenorrhoea, depending on anaemia 
and general atony of the sexual apparatus. Of this number, 
I have eliminated about one-half, in the subjoined table, the 
action of the remedy not having been satisfactory, from various 
causes, such as inattention to the general directions, want of 
perseverance in taking the medicine, etc., so that the actual 
number of cases on which my conclusions are based, is nar- 
rowed down to fourteen, in each of which, however, the cause 
of the amenorrhcea was entirely clear, the remedy carefully and 
continuously given, and the effect closely observed. In order 
to be brief, I have grouped these cases in the following table, 
instead of giving the history of each case at length: Case. 
Age. 
Single 
or 
Cause 
of 
Length of 
time 
Remedy, 
How 
Results. 
Remarks. 
Married. 
Amenorrhcea. 
Catamenia abs. 
Administered. 
I. 
16 
S. 
Anaemia. 
4 months. 
1 gr. 3 p. d. 
Failure. 
Remedy given for one week at date of expected 
menstruation for two consecutive months. Menses 
appeared finely under a course of iron tonics. 
II. 
S. 
Anaemia. 
2 months. 
1 gr. 4 p. d. 
Failure. 
Similar result as above. 
III. 
19 
s. 
Anaemia. 
3 months. 
“ “ 
Failure. 
44 44 
IV. 
26 
M. 
General atony. 
3 months. 
2 gr. 3 P- d- 
Success. 
Remedy taken for three weeks. 
V. 
20 
M. 
Anaem. fr. nursing. 
4 months. 
“ “ 
Success. 
“ “ one month. 
VI. 
40 
S. 
General atony. 
3 months. 
2 gr. 3 P- d. 
Failure. 
( Remedy taken every alternate week for six weeks, 
■j Three weeks after discontinuing remedy, menses 
( appeared. 
VII 
17 
s. 
U 44 
2 months. 
1 gr. 3 p. d. 
Failure. 
Remedy given at expected period for two months. 
VIII. 
18 
S. 
Anaemia. 
2 months. 
2 gr. 3 p. d. 
Success. 
Remedy taken for two weeks. 
IX. 
29 
M. 
General atony. 
3 months. 
2 gr. 3 p. d. 
Later, 
4 gr- 3 P- d. 
Success. 
- 
Three weeks, two grains three times a day—no re- 
sult. Finally, four grains three times a dav, suc- 
cessful in one week. Next period again missed. At 
the expected period following, the drug given in four 
grain doses for one week, successful. Since then, 
period regular. 
X. 
18 
S. 
Anaemia. 
5 months. 
2 gr. 3 p. d. 
Success. 
Remedy given two weeks. 
XI. 
32 
M. 
Gen.atony fr.nurs’g. 
2 months. 
3 gr. 3 p. d. 
Success. 
“ “ 
XII. 
21 
S. 
Anaemia. 
6 months. 
1 gr. 3 p. d. 
Failure. 
( Remedy given two weeks at two different periods, 
•j Suspicion of phthisis. Later, iron and cod liver oil, 
( successful. 
XIII. 
32 
M. 
G. a. in obese person. 
2 months. 
2 gr. 3 P- d. 
Success. 
Remedy given every alternate week for six weeks. 
XIV. 
25 
M. 
Anaemia 
following 
nursing. 
3 months. 
2 gr. 3 P- d. 
Later, 
4 gr- 3 P- d. 
Success. 
The large dose proved successful, after ten days’ ad- 
( ministration. 1885.] 
Doering—Permanganate of Potassium. 
5 
Note.—In all but two of the above cases, the remedy occa- 
sioned more or less epigastric pain, substernal pressure and 
colicky pains. 
Conclusions.—I. Permanganate of potash, in doses of from 
two to four grains, is an efficient emmenagogue, if adminis- 
tered for a period of not less than two weeks. 
II. Its administration in doses large enough to be effectual is 
accompanied by severe pain, which frequently necessitates a 
discontinuance of the remedy, and hence impairs its value as 
an emmenagogue. 
III. The most efficient method of administering the drug is 
in capsules, taken midway between meals, and followed by 
large draughts of some pure mineral water, like silurian. 
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