[Reprinted from The Medical News, January 6, 1894.] 
A NOTE AS TO THE USE OF OXALIC ACID 
AS .AN EMMENAGOGUE. 
By FRANK W. TALLEY, M.D., 
OF PHILADELPHIA J 
INSTRUCTOR IN GYNHCOLOGY, PHILADELPHIA POLYCLINIC. 
The use of oxalic acid in the treatment of amenorrhea 
was first suggested by Dr. F. Paulet, and afterward in- 
troduced into American literature by Dr. A. W. Marsh 
in an article in the Therapeutic Gazette, March, 1891. 
It is recommended that the drug be administered in 
half-grain doses, repeated every four hours, and it is 
described as a safe and efficient emmenagogue. 
During the past twelve months I have used it with 
very gratifying results in a series of cases of amenorrhea 
presenting themselves for treatment at the Polyclinic 
and at the Pennsylvania Hospital. While I value oxalic 
acid as an emmenagogue, I cannot entirely subscribe to 
the conclusions drawn by Dr. Bloom in his article in 
The Medical News of October 14, 1893. While an 
efficient emmenagogue and a capable abortifacient, 
oxalic acid is not to be regarded as a perfectly safe 
drug. I have in the last month met with a case in 
which toxic symptoms followed the ingestion of three 
doses of half a grain each repeated at about four-hour 
intervals. The patient was an anemic girl, twenty-two 
years of age, who gave a history of scanty menstrua- 
tion and a complete cessation of her periods for three 
months. The uterus was not enlarged nor were there 
any of the signs of pregnancy. She was placed upon 
oxalic acid in half-grain doses, which she was directed 2 
to take after meals, largely diluted with water. After 
the third dose she was seized with vomiting, pain in the 
epigastrium, and became completely prostrated. The 
pulse was weak and rapid, and the extremities cold. 
She was placed in bed, external heat was applied, and 
the symptoms of collapse were soon overcome. She 
then complained of cramp-like pain in the hypogastrium 
and back. These symptoms were followed by an erup- 
tion upon the arms, trunk, and legs, resembling that of 
hives, which was still present seven days later and was 
attended with considerable itching. The symptoms 
gradually diminished in severity, the gastric symptoms 
being the most pronounced. 
The action of oxalic acid seems to be directly as a 
stimulant to the uterine mucous membrane. It is, 
therefore, applicable to the treatment of amenorrhea of 
the anemic as well as of the plethoric type. Upon the 
pregnant uterus oxalic acid is capable of producing 
powerful uterine contractions which terminate in the 
expulsion of the product of conception. This was ob- 
served in two cases of early physiologic amenorrhea 
to which oxalic acid had been administered, the diag- 
nosis of pregnancy not having been made. 
Considering the fact, therefore, that oxalic acid, even 
when administered in fractional doses, is capable of 
producing toxic symptoms, and bearing in mind its 
powerful abortifacient properties, we should be guarded 
in recommending it as a safe remedy. I consider it a 
valuable drug in the treatment of amenorrhea, but one 
that should be given guardedly, carefully watched, and 
only prescribed when the diagnosis of pregnancy has 
been excluded.