Dose.—The dose of sulphate of manganese in works on materia medica (grs. x. to grs. xv.), is very much too large, and will cause irritation of the stomach and intestinal canal. In my practice I have found grain doses to give the best results, sometimes lessening them to one-half grain, and sometimes increasing to three grains.
Specific Indications.—The dropsy that follows long continued use of liquor; dropsy with a full pulse, and sense of oppression in epigastrium, with oppressed breathing, and inability to lie down.
Therapeutic Action.—"In experiments upon animals, when given in large doses it causes vomiting and gastro-intestinal inflammation; injected into the veins it causes vomiting and purging, dyspnoea, rapid exhaustion, paralysis, and death." In doses of grs. v. to grs. x. it produces catharsis and not unfrequently increased secretion of bile. Yet I think it should never be employed to obtain its cathartic action, because of the danger of gastro-intestinal irritation and inflammation, the small dose answering every purpose.
When first used in medicine it was thought to belong to the class "hematics," or blood makers, having a similar action to iron. This opinion, however, has not been sustained, and in consequence the remedy has fallen into disuse. I believe, however, that the failure to obtain good results was due to the large dose employed, and that when the small dose is used it will be found to favor blood-making.
I employ the sulphate of manganese in the treatment of dropsy with most excellent results. Sometimes I use it to supplement the apocynum, and sometimes alone. In ascites, if the dropsical accumulation is large, the water should be drawn off with a trocar, and then the remedy given.
I have tried it to a limited extent in hepatic engorgement with tumid abdomen, and if the cases are properly selected, I think it will prove a valuable remedy. It is in these cases—enlargement of the liver and spleen, tumid and pendulous abdomen, and torpor of the digestive and blood-making organs—that it exerts its influence in improving blood-making.