AM.CARB. Carbonate of Ammonia. Sub-carbonate of Ammonia. Volatile Salts. Salts of Hartshorn. Baker’s Salt. See Hahnemann’s “Chronic Diseases,” Vol. II. Duration of action: forty days in some chronic affections.
Am-mur., Arnica, Arsenicum, Belladonna, Bryonia, China, Ferrum, Graphites, Hepar, Kali., Lachesis, Lauroc., Lycopodium, Mang., Nux-v., Phosph., Pulsatilla, Rhus., Silicea, Staphysagria, Sulphur
Arnica, Camph., Hepar
RATIONALE OF ITS ACTION
Carbonate of Ammonia is formed during the putrefaction or destructive distillation of these organic substances which contain nitrogen. The anhydrous neutral carbonate can only be obtained by bringing together dry carbonic-acid and ammoniacal gases.
It is supposed to prevent the coagulation of the blood, and retain it in a liquid state. If this be true, it must prove a valuable remedy in those maladies which are accompanied by a crude condition of the blood and an unusual tendency to decomposition of this fluid. Theoretically, we should commend it in typhus, malignant scarlatina malignant erysipelas, and disease of a similar character. It is readily absorbed into the blood, and appears to act specifically upon the nervous system, especially upon the vertebral column. Its action is nearly the same when injected into the veins. In the first place, its effects are chiefly manifested upon the ganglionic and true spinal systems; then we observe its effects upon the circulation, respiration, secretions, and the muscular fibres. It is not, like Opium and alcoholic stimulants, a diffusible stimulant, and its effects are more transient than these substances. According to Billing, it is a “local stimulant, and as such excites momentarily the action of the heart, through the solar plexus. It immediately unites with animal acids, and then circulates, or is diffused, not as a diffusible stimulant, but as a saline sedative. It therefore performs the double office of a temporary local stimulant to the stomach and heart, and a sedative to inflamed capillaries elsewhere.” Carbonate of Ammonia is a stimulant, excitant, diaphoretic, powerful ant-acid, and anti- spasmodic; in large doses, emetic; and under some circumstances, expectorant.
Injected into the veins it causes convulsions. Internally it has caused gastric inflammation with tetanic convulsions, the body ultimately becoming curved, with the head bent backwards. (Opisthotonos). Wibmer found one and one-half grains to cause no particular effect upon himself; three grains increased the pulse from 68 to 72, with throbbing headache; six to twelve grains usually, but not constantly, caused increased frequency of pulse, with disorder of brain, manifested by pain, heaviness, throbbing, secretion of bronchial mucus, was extra-ordinary. Pereira gave fifteen grains, three times a day for two months, with no other effect than suspending epileptic fits during this time.
Huxham has detailed a remarkable case, illustrative of the ill effects resulting from the long-continued use of it. A gentleman had so habituated himself to the use of vast quantities of it that at length he could eat it in a very astonishing manner, as other people eat sugar or carraway seeds. The consequence was, he brought on hectic fever; vast haemorrhages from the intestines, nose, and gums; every one of his teeth dropped out, and he could in consequence eat nothing solid, he wasted vastly in flesh, and his muscles became as soft and flabby as those of a new-born infant, he broke out all over his body in pustules; his urine was always excessively high-colored, turbid, and very fetid; he finally died in the highest degree of marasmus.
Vogt assumes that it causes a more active metamorphosis and liquefaction in the vegetative organs, viz.: increased secretion from the skin; more ready loosening of mucus from the bronchi; more profuse secretion of urine, with simultaneous absorption of lymphatic fluids from internal parts; increase and hastening of the menses; increased flow of bile; but the most marked of all is its action on the skin; so that the ammoniac remedies have always been considered as excellent diaphoretica; and next in its action upon the lymphatic, vascular, and glandular systems, whence it is regarded as a fluidizing, absorption-hastening, and resolvent remedy for the organs of these systems.- J.C.P.
In larger doses it causes stimulation to the point of overheating, whence heat and congestion have generally been regarded as signs of too great irritation from Ammonia; its expanding and dissolving powers then also become evident; excessive and very profuse perspirations set in; also greater secretions of mucus, more profuse flow of urine, and, in general, more hasty and active metamorphoses, with great inclination to excessive expansion and liquefaction. This fluidizing action may become excessive, overbalance the formative power, and cause inclination to solution and decomposition; we see this not only in the profuse secretions which it causes, but in the undermining of all the assimilative processes, viz.: in the destruction of digestion, in the solution of the chyle and blood, the want of contractile power, the diminution of organic cohesion in all parts in short, by the occurrence of a true scorbutic state; yet it is advised in affections of the intestinal mucous membrane, viz.: in gastric fever, in mucous inflammations, and in chronic mucous states with formation of viscid slime, in diarrhoeas, and dysentery.- J.C.P.
GENERAL EFFECTS ON THE NERVOUS SYSTEM
That the principal action of Ammonia is first manifested upon the ganglionic and true spinal systems is evident from the spasmodic actions which it induces, and from the increased activity of the circulation, respiration, and the secretions. It does not affect the brain like Opium and alcoholic stimulants, but appears to impress specifically the vertebral column. Among the effects of large doses, convulsions have sometimes been observed.
Nerves of Sensation. It produces temporarily increased heat of the skin and a tendency to perspiration. Indeed it exalts momentarily the sensibility of all the organs, especially upon the sentient extremities of the nerves, and upon the capillaries. It causes much itching of the scalp, and of the whole surface of the body. From its stimulating effect upon the nerves and capillaries, it has been often employed in low forms of typhus, scarlatina, and other maladies characterized by depressed nervous and vascular power.
Nerves of Motion. It probably acts more specifically or powerfully upon the nerves of motion than upon those of sensation; it not only causes increased capability for muscular exertion, and a state in which all the nervous functions are executed with greater facility, but all the salts of Ammonia cause convulsions.
Great Sympathetic Nerve. By its specific action upon the solar plexus, it rouses into augmented activity, temporarily, the heart, stomach, and lungs. Under its influence the activity of nearly every organ of the body is for a short time increased. Thus we have an increase of perspiration, of urine, of mucous secretions, and a temporary increase of muscular power.
ON THE VASCULAR SYSTEM Blood. It is speedily absorbed into the blood, and exercises the remarkable power of inducing a more liquid state of this fluid. It counteracts all tendency to crudeness, coagulation, or decomposition of the blood, and on this account affords a reasonable ground for supposing that it may prove useful in some diseases which are accompanied by, or eventuate in blood- deteriorations. According to Billing, “it immediately unites with animal acids, and then circulates, or is diffused, not as a diffusible stimulant, but as a saline sedative. It therefore performs the double operation of a temporary local stimulant to the stomach and heart, and a sedative to inflamed capillaries elsewhere.” In cases of poisoning by this substance, sanguineous effusions are found in various parts of the body.
Physical Effects of Ammonia on the Blood. Hufeland observed that the officinal, and probably all the salts of Ammonia, have the property, to a greater or less degree, of dissolving the blood- corpuscles, even to the nucleus, although slowly, and the protein textures generally. Whether they are thus endowed of themselves, or whether it is in virtue of Ammonia set free from the alkali of the blood, is a question; but, at all events, it has been ascertained that free Ammonia is not essential to these effects. When blood is combined with an ammoniacal salt, it acquires, generally, a brighter red; but this soon passes into a brownish-red hue; it does not coagulate, but forms at best a loose, semi-fluid cruor; the corpuscules begin to disappear, and the whole becomes more limpid. Blood thus decomposed, progressively evolves distinct traces of Ammonia. It is very probable that we may partially explain, upon chemical grounds (solution and disengagement of Ammonia), why large doses of the Ammonia act as poisons, and smaller doses, long continued, induce a scorbutic condition. Yet the same salt, judiciously exhibited, furnishes a valuable stimulant to the secretory and excretory apparatus.
It causes a sensation of congestion to the end of the nose, blowing out of blood from, and bleeding from the nose after eating. We do not see that it causes vomiting of blood, and
doubt whether it has any specific tendency to do this; it may, however, act chemically and corrosively upon the stomach, and thus cause haemorrhage from it, as it induces inflammation of the stomach, even when introduced into the cellular tissue. As for haemorrhoids, it causes great swelling and protrusion of piles, with pain, discharge of blood from the rectum during and after stool. As for haemoptysis, it causes cough, with mucous or muco- sanguineous expectoration, coughing up of blood, with burning and heaviness upon the chest, shortness of breath, redness and heat of the face, nausea, anxiety and trembling of the whole body. As for apoplexia-pulmonum, it causes congestion to the chest. great heaviness upon the chest with pain, heaviness upon the chest, as if from accumulation of blood. It is very decidedly homoeopathic to purpura-haemorrhagica.
Heart and Arteries. By its action on the nervous system, it augments temporarily the muscular force of the entire organism. Through its local action upon the solar plexus, it stimulates into increased activity the heart and arteries. This augmented action is of but short duration, not excessive, and therefore not usually followed by any reaction of a depressing character. This effect of Ammonia upon the circulation is accomplished in- dependently of any action upon the brain.
FEVER Frequent chilliness towards evening, frequent paroxysms of feverish chilliness, blueness of the hands and nails, chattering of teeth, and shaking; sometimes these symptoms are followed by nightly heat, with sensitiveness to cold; nausea, thirst, oppression of the chest, with stitches in the left side, tearing in the forehead, and dullness of the head, alternate redness and paleness of the cheeks, pressure at the stomach, with disposition to eructations, accompanied by a violent coryza and sleeplessness, for several days, during the catamenia. Feverish heat in the head, with cold feet. Continual night-sweats.
In scarlet fever, the Sesqui-carbonate is a very valuable remedy. It has been strongly advised by Mr. Wilkinson, who has employed it successfully in above two hundred cases. He does not depend, he states, upon its diuretic, nor diaphoretic qualities, but believes that it possesses the power of increasing the strength of the arterial action, at the same time that it diminishes its frequency; that it supports the vis-vitae, without increasing the heat and irritability of the system, and by such means counteracts the tendency in scarlatina-anginosa and scarlatina-maligna, to ulceration and sloughing, and all the other evils attending it.
In Austria, during an epidemic of scarlet-fever, commencing in April, 1841, Dr. J. Fischer treated 112 cases by Ammonium-carb., aided by occasional applications of cold water to the head; of which 105 recovered, and 7 cases terminated fatally. The seven fatal cases were: two of hydrothorax, one case of angina gangraenosa; the four remaining came under treatment at a very late date, suffering from violent disturbance of the brain.
In acute glanders, it proved successful in a case which came under the care of Mr. Wilkinson. Ammonia is evidently homoeopathic to some varieties of fever and ague, and also to hectic fever, when the chills and sweats are predominant.
In lepra and psoriasis, Mr. Cazenave successfully employs this salt. In syphilitic eruptions, Dr. Schedel states that he has seen this salt succeed when mercurials have failed. The remedy, he adds, is certainly disagreeable at first, and often causes nausea, but with a little patience the stomach is soon brought to bear it. In erysipelas, occurring in debilitated subjects, it proves highly useful. Dr. Watson observes that, after a preliminary purgation, he commences its uses and, generally speaking, a large proportion of his cases recover.
In rubeola, urticaria, roseola, erythema, and in other diseases of the same class, Mr. Wilkinson also bears witness to the value of the Sesqui-carbonate. He states that for the last seventeen years he has administered this remedy, and that he has not only never lost a patient in the above diseases, but has never had a case of the kind that has even appeared dangerous, or that has given him a moment’s anxiety.
In scrofula, the late Dr. Armstrong found that those cases attended by much debility, a languid state of the circulation, and deficient cutaneous secretions, were much benefitted by the use of this remedy.
In puerperal insanity, when great debility exists, together with defective subcutaneous circulation and cold extremities, the Carbonate of Ammonium, in alternation with Camphor, may be given every third hour with advantage.
In mercurial erethism no internal remedy is more to be trusted than the Sesqui-carbonate, in conjunction with Camphor and other stimulants.
In the nervous, excitable, anxious, and tremulous conditions which often follow abuses of alcoholic stimulants and opiates, this is a remedy of considerable power. It is also useful in similar conditions arising from undue mental excitements, such as grief, excessive anxiety,. Cases of delirium tremens have been said to have been cured with Carb-ammon. alone, but Wood says, over absolute drunkenness it has no control whatever; but, in slight disorder from alcoholic drinks, it occasionally gives relief. In sick headache with excess of acid in the stomach it is often useful. In those sudden cases of collapse, and loss of consciousness, which, if the patient survive, must be followed by febrile reaction or inflammation, it is admirably adapted; and, from the absence of and special stimulating action on the brain, to those cases in which the reaction is likely to be attended with inflammation or greater vascular excitement of the brain. Instances of this kind not unfrequently occur in the cold stage of febrile diseases, in collapse from concussion of the brain, and prostration from any sudden shock.- J.C.P.
In typhoid and scarlet fever, accompanied by a general prostration of the forces, with a dull and stupid intellectual state, alternating occasionally with transient flushes of mental exhilaration, this medicine is quite appropriate. Under such circumstances we are in the habit of prescribing the first trituration.
A case of epistaxis is related by Dr. Chapman, in a young woman, represented as anaemic, reduced in flesh, very pallid, and very dejected. She was twenty-two or twenty-three years of age, and had been subject for several years to repeated and copious bleedings from the nose. The only characteristic symptom that was mentioned in the letter of consultation, for the choice of a remedy for epistaxis, was, that it was brought on by washing the face and hands in the morning. Ammon-carb., 3, was sent to her, and, after a few doses, the bleeding ceased and recurred no more; she also recovered strength, flesh, spirits, and color. The cure was permanent.- F.G.S.
Dr. Chapman also relates a case of critical epistaxis, caused, it was supposed, by latent measles, to which the patient had been exposed some three months previously. The epistaxis continued to occur daily for a few days to an alarming extent. On the fourth day he complained of a severe pain in the forehead, and a sensation as if the brain was forcing itself out just above the nose. About a grain of the third trituration of Ammon-carb. was administered. One of his serious bleedings had occurred just before. In three or four hours after he was covered with measles, and a few doses of Pulsatilla sufficed to effect a cure.- F.G.S.
Mr. Wallace states that he has seen some very severe cases of cancrum-oris cured by the internal use of this remedy. He advises the strong Nitric-acid as a local application at the same time. A liberal diet should be allowed.
In acidity of the primae-viae, heartburn, and flatulence, particularly when occurring in cases of atonic dyspepsia, or in hysterical females the Carbonate of Ammonia proves very efficacious. It may be repeated if necessary.
In drunkenness, after the stomach has been emptied, the Sesqui carbonate may be given internally with advantage. Its application to the nostrils is also beneficial.
In dyspeptic complaints, accompanied by preternatural acidity of the stomach, and flatulence, without inflammation, a properly- diluted solution of Ammonia may be employed, with a two-fold objects that of neutralizing the free acid, and of stimulating the stomach. It must be remembered that the healthy secretions of the stomach are of an acid nature, and that the constant use of Ammonia, or any other alkali, must ultimately be attended with injurious consequences, more especially to the digestive functions. While, therefore, the occasional employment of alkalis may be serviceable, their long-continued use must ultimately prove deleterious.
It has a specific action upon the lining membrane of the kidneys, bladder, and urethra.
A case of diabetes is reported in Frank’s Magazine as cured by Ammonium-carb., in a lady, aged forty-eight, past menstruating. Symptoms: Violent thirst, dryness of the skin, constant chilliness, emaciation, oedema of the feet, with gradually increasing ascites, passing from fifteen of twenty quarts of urine daily, of a greenish color, clear and without smell, appetite voracious. The length of time in effecting the cure not mentioned. In cases of urinary calculi, in which the urine is acid, and alkalis are indicated, especially if the constitution is much debilitated, the Carbonate of Ammonia is the most preferable alkali for administration. At the same time that it corrects the acid diathesis, it determines to the skin, and gives a stimulus to the system generally.
In chronic bronchitis, and catarrhal affections occurring in debilitated constitutions, this salt will be found serviceable. It is also very useful in that form of catarrh which Laennec designates as “suffocative.”
In the advanced stages of croup, the Sesqui-carbonate has been prescribed as a stimulant, expectorant, and occasionally as an emetic in order to promote the discharge of effused lymph. When the patient is greatly debilitated, it may prove useful, but some caution is necessary in its use.
In those forms of asthma arising from, and connected with disease of the heart, Dr. Hope states that he has derived more benefit from this salt than from any other remedy. In a very obstinate case, which resisted all other means, the alternation of Ammonium-sesqui-carb. and Antim-tart. afforded great relief.
In pneumonia, in the advanced stages, when the inflammatory symptoms have subsided, and it becomes of importance to promote expectoration, Dr. Williams states that he has seen this indication well answered by the Sesqui-carbonate of Ammonia in doses of five grains or more, every two or three hours, as the urgency of the case may require. He advises its exhibition in alternation with infus. Senegae, and with five to ten drop doses of tincture Lobelia-inflatae.
It acts specifically upon the mucous membrane of the bronchi, and their ramifications through the lungs, augmenting the secretion, and giving rise to a congested sensation in this structure. It also stimulates temporarily the lungs, increases the number of respirations, and causes slight dyspnoea and some uneasiness of this organ.
It is an excellent remedy against very troublesome dry or moist short coughs, day and night, with irritation of the bronchial membrane and its ramifications, and of the substance of the lungs, with dyspnoea after the slightest exertion, stitching pains through the sides of the chest, palpitation of the heart, accelerated respirations, worse on ascending stairs; or from exertion of any kind, a general feeling of malaise.
In advanced stages of pneumonia, when the lungs are approaching a paralytic condition, with a general loss of vital energy, this is a remedy of great value. It tends to re-establish the impaired vitality, and, by promoting expectoration, and imparting to the pulmonary structures increased activity, it not unfrequently induces a permanent improvements of all the symptoms.
Ammonium-carbonicum is homoeopathic to one form of hydrothorax, and occasionally will cure it when the disease has advanced to that stage where the effusion becomes general, as shown by oedema of the lower extremities, enlargement of the abdomen,.
HAHNEMANN. “Ammonium-carbonicum has been found useful in the following affections: “Fearfulness; disobedience; want of docility; loathing of life; uneasiness in the evening; attacks of anxiety; anxiety, with weakness; diminution of the thinking faculty; vertigo, when sitting or reading; chronic headache; headache as if something would get out at the forehead; headache, with nausea; hammering headache; falling off of the hair; dry pus on the eye-lids; burning and feeling of coldness in the eyes; dimness of sight, with a sense as of waving before the eyes; black points and streaks of light covering before the eyes; cataract of the crystalline lens; shortsightedness; hardness of hearing, accompanied by suppuration, and itching of the ear; humming and tingling before the ears; itching of the nose; pustules in the nose; bleeding at the nose, early in the morning, when washing; summer freckles; tearings, extending from the left upper lip across the cheek as far as the ear; cracking in the articulation of the jaw, when chewing; chronic looseness of the teeth; sore throat, like rawness of the throat; soreness of the throat; swelling of the inner mouth; eructations tasting of the ingesta, either food or drink; bitter taste in the mouth, especially after a meal; rawness and burning of the oesophagus from below upwards, after a meal; headache after a meal; nausea after a meal; vertiginous giddiness during a meal; unconquerable desire to eat sugar; thirst; want of appetite in the morning, sour eructations; heartburn; eructations and vomiting; pain at the stomach; spasm of the stomach; contractive pain in the pit of the stomach, when stretching one’s self; burning pain in the liver; boring stitches in the liver, in the evening, when sitting; uneasiness in the abdomen; painful concussion in the hypogastrium, when setting the foot down in walking; costiveness; difficulty of passing the stools; colic, with diarrhoea; blood with the stools; discharge of blood from the rectum (flowing haemorrhoids); itching of the anus; varices of the rectum; nightly micturition; pollutions; (deficiency of the sexual desire); scanty menses, sterility, with scanty menses; menses too short and scanty; menses too early; during the menses, she experiences a pressure upon the genital organs, cutting in the abdomen, tearing in the back and the genital organs, these symptoms obliging her to lie down; watery discharge from the uterus; leucorrhoea; profuse, acrid, corrosive leucorrhoea; chronic dryness of the nose; chronic coryza; dry coryza; shortness of breath; asthma; cough; cough with hoarseness, the body being warm; caused by titillation in the throat, with discharge; cough by day; cough at night; stitches in the small of the back when coughing; burning in the chest from below upwards; tearings, beginning at the upper left side of the chest, and extending as far as the shoulder-joint; stitches in the fleshy part of the chest; goitre, swelling of the cervical glands, accompanied by an itching eruption of the face and body; pain in the nape of the neck; rigidity of the arms and fingers, they becoming cold and insensible, at night, early in the morning, and when closing the hands in seizing something; pain if the wrist- joint, which had been sprained sometime ago; swelling of the fingers, when letting the arms hang down; the fingers go to sleep; great lassitude in the lower extremities; drawing pains in the legs, when sitting; stitches in the heel; sweating of the feet; swelling of the feet; cramp in the sole of the feet; pain as from a sprain in the ball of the big toe, at night when in bed; burning in the hands and feet; feeling of weakness in the limbs, when walking in the open air; disinclination to walking; drawing and tension in the small of the back, in the back and in the joints curvature of the bones; warts; burning stitches and tearings in the corns; drowsiness by day; sleeplessness at night; nightmare on falling asleep; feverish heat in the head, with cold feet; evening chills; sweat.