AMMON-ACET – Acetate of Ammonia. Spiritus Mindereri.
RATIONALE OF ITS ACTION
The experience with this medicine is almost wholly clinical. It is usually regarded as refrigerant and diaphoretic. Externally, it has been applied as a lotion and collyrium. Dierbach regards it as the only specific diaphoretic remedy, with the exception of Dover’s powders; he regards it as one of the most powerful and certain remedies for the promotion of transpiration and perspiration. It is a very great favorite, and an unusually frequently used remedy in the dominant school, being used almost universally for the production of crises through the skin in febrile diseases, although it is less useful in the commencement of severe attacks when the fever and inflammation are violent, than when these have already somewhat abated and a skin-crisis is about to occur, or, as Wendt says, when there is a cutis mollis et tractabilis. As it is not competent to the removal of any severe febrile or inflammatory disease, it is only used in the milder forms of synochal, irritative, typhoid fevers, and rheumatic fevers, and then generally has to be aided by other remedies; in gastric and bilious fevers, after sufficient evacuations are supposed to have been effected; but more especially in catarrhal rheumatic fevers, as these are supposed to be attended with check of perspiration. It has also been used in rheumatic anginas, rheumatic pleurisies and pneumonias; in exanthematic fevers, such as measles, scarlet fever, and small- pox, to aid the outbreak of the eruption when this is retarded. In dropsy, from checked perspiration, or injury of the skin, such as occurs after scarlet fever and in Bright’s disease.- J.C.P.
On account of its ammoniacal basis, it is supposed to approach somewhat in its action that of the exciting or stimulating remedies, although it causes so little heat of the skin and activity of the pulse that it has been regarded as the most excellent diaphoreticum non calidum; but still it is regarded as better adapted to feeble constitutions, and to typhoid and debilitated states then most other allopathic antiphlogistic remedies. On the other hand, the neutralization of the Ammonia by means of the Acetic-acid, renders it somewhat similar in its action to that of the neutral salts, although it is not so depressing and debilitating. Again, like Vinegar and some other acids, it is supposed to exert a peculiar action upon the biliary and urinary organs.- J.C.P.
ON THE NERVOUS SYSTEM.
Nerves of Motion. This remedy is supposed not to exert the same irritating action upon the spinal system and nerves of motion which the other ammoniacal remedies are known to do. Thus, Christison says that the second group of the order of alkaline poisons, including Ammonia, with its salts and the Sulphuret of Potassa, have a double action on the system; for, beside their local effects, they produce through the medium of the blood a disorder of some part of the nervous system closely resembling tetanus.
Nerves of Sensation. With the exception of the relief of pain in dysmenorrhoea, the Acetate of Ammonia is not known to act specifically upon the nerves of sensation; but, as dysmenorrhoea often depends upon the congestion of a womb which has not a sufficient outlet, and Acetate of Ammonia causes scantiness of menstruation, it may relieve the pain merely by lessening the congestion.
Ganglionic Nerves. It is supposed that this remedy acts more decidedly upon the ganglionic nervous system, especially that portion of the great sympathetic nerve which controls the functions of the arterial system, than upon any other portion of the nervous system.
VASCULAR SYSTEM.
Heart and Arteries. Sobernheim says it causes some increased heat of the skin, together with a quicker, fuller, and more undulating pulse; but that these phenomena cease on the breaking out of the perspiration which it is the specific action of the remedy to cause.
VENOUS SYSTEM We have no absolute proof of any action upon this system, although some authors think that it acts upon the portal system and biliary organs, like Vinegar and the Muriate of Ammonia.
GLANDULAR SYSTEM Vogt supposes that it acts specifically upon the lymphatic system, like the Muriate of Ammonia.
CLINICAL REMARKS
In febrile and inflammatory affections, and exanthemata, those medicines which determine freely to the skin are best calculated to afford relief. Of these, none will generally answer the purpose more uniformly than liquor Ammonium-aceticum. It also forms a good auxiliary to more specific measures. In inflammatory dropsy, Dr. Todd found liquor Ammonium-aceticum a very valuable sudorific, particularly when alternated with small doses of Tartar-emetic.
The solution of Acetate of Ammonia is a valuable diaphoretic, much employed in the dominant school in febrile and inflammatory diseases. The late Dr. A. T. Thomson used it as a lotion, with good effect, in porrigo affecting the scalp. It is sometimes used externally as a discutient, and Mr. Brande speaks of it as an excellent application in mumps, when applied hot on a piece of flannel. In tonsillitis, liquor Ammonium-aceticum will be found very useful.
In the hydrocele of children it is strongly recommended by Dr. Maushner, applied by means of compresses kept constantly moist. In dysmenorrhoea it has been strongly advised by Cloquet and Patin; they found it very successful in relieving the paroxysms of pain. Kopp praises this remedy very highly, as a palliative in dysmenorrhoea; he gives a tea or dessertspoonful every hour, from the commencement of the pain until its relief; it only palliates, but is not severe in its action, and does not produce secondary affections.
In dysmenorrhoea, Colombat says, with the view of producing a more rapid sedative action upon the uterus, and to overcome the painful tormina which accompany the discharge, we may give from forty to seventy drops of spiritus Mindereri, in a glass of plain or sweetened water at two doses. It allays the pain, and in that way facilitates the flow of the menses; the first dose should be given as soon as the malaise and uterine pains are felt, and the second in a half-hour; if the symptoms do not improve, a third dose may be given, but with some reserve, in order to avoid what sometimes results from it, a diminution in the quantity of the flow.- J.C.P.
In Menorrhagia and Organic Diseases of the Womb. A married lady, aged thirty-four, who had been much reduced by profuse menstruation, had had all the signs of consumption and organic disease of the womb for two years. She had lancinating pains in the womb, decided increase in the size and hardness of the organ, with ulceration, and profuse discharge of sanious, very offensive pus, mixed with shreds of organic matter and black coagulae. Walking and sitting were very painful; and all her sufferings were much increased at the monthly period; the abdomen then became exceedingly tense and painful, so that the slightest touch could not be borne; the lancinating pains became so incessant as to deprive her of all rest, and led, in the course of a few days, to a state of exhaustion which was only interrupted by frequent convulsive shocks and loud cries. At the end of five or six days of suffering, profuse menstruation would occur, and relieve her from her intense suffering, but plunge her into a highly dangerous state of exhaustion.
After the use of all other means, forty-drop doses of spirits Mindereri were given on the second day of a monthly period, when all her sufferings had reached their height; the pains abated rapidly, and ceased entirely in twenty minutes, and the menses became less abundant.
Henceforth, thirty or forty drops would always relieve the lancinating pains, and control, although not entirely abate the haemorrhage. The next monthly periods occurred without much suffering, and the flow was decidedly lessened. Examination by touch and speculum proved that the womb had lessened in size, the ulcerations had also improved, and some of them seemed on the point of cicatrizing; the discharge was less abundant and offensive, and she could sit and walk without pain.
Case A lady, aged thirty-two, had suffered with frequent menstruation,
and so abundant that she became decidedly weaker and thinner; she also had a habitual dry cough, oppression of the chest, nausea, vomiting, and poor digestion; finally the menses occurred as often as twice a month, leaving her only four or five free days, and all her other symptoms were aggravated; spiritus Mindereri was given in twenty-drop doses, night, and morning, followed by gradual diminution of the haemorrhages, so that in three months the menses occurred only regularly once a month, and lasted only four days the other symptoms also disappeared gradually, with the exception of the cough, which was also much better.
Case A lady, aged thirty-seven, subject to profuse menstruation, lasting for ten or twelve days, followed by leucorrhoea, had had six miscarriages, followed by dangerous haemorrhages; these were succeeded by dry cough, attended with oppression of the chest, increasing in intensity with the metrorrhagia, which at one time lasted for three months, attended with heat in the genitals, extending through the whole abdomen, increase of cough, oppression, loss of appetite, nausea, vomiting, emaciation, and daily loss of strength. Finally, her face became earthen, eyes dull, emaciation great, skin hot and dry; pulse frequent, small, and thread-like; cough dry and frequent; oppression constant; burning heat in the abdomen, entire loss of appetite, obstinate constipation, violent pain in the epigastrium and between the shoulders, burning thirst, constant nausea, and frequent vomiting of mucous matters; the lower portion of the abdomen was tense and very painful. The neck of the womb was hot, soft, much enlarged, and sensitive, and the slightest touch caused bleeding; with all these sufferings she had an incessant inclination for coition. Spirits Mindereri was given, in forty-drop doses, three times a day; in three days the haemorrhage had lessened three-fourths, with entire relief from the accompanying symptoms; the sexual inclination had also almost ceased. On examination, after six weeks’ treatment, she was found almost natural in size; and in three months she recovered her former flesh, strength, and health.
