ACTION ON BLOOD
Traces of ammonia are found as split-products in the erythrocytes. The lipoid solubility of ammonia explains their great hemolytic property which is characteristically potentiated in combination with saponin. From direct contact with ammonia, the blood at first becomes dark red, then through destruction of the red blood corpuscles, there is lacking and finally a rubyred. Such blood effects can appear only in very acute flooding with ammonia. But typical symptoms of intoxication find accord in the homoeopathic drug picture of ammonium preparations with septic and scorbutic states with a tendency to bleeding.
Finally, diverse but not characteristic digestive disturbances are observed as chronic effects of prolonged contact with ammonia or ammonium carbonate.
VOLATILITY OF PREPARATIONS
With all ammonium preparations, fresh preparations are important, especially in the fluid ones, because they easily yield ammonia. Mostly is this the case with ammonia water (ammonium causticum) which dissociates electrically only to 4 per cent (NH3 in H2O <-> NH4 Plus OH -) and is only hydrolytically dissolved and constantly gives off ammonia. It is similar with the combinations of ammonia with weak acids as in ammonium carb. (NH4) 2Co3. For this reason, especially in the lower potencies, triturations are preferred, as Hahnemann also advised. Somewhat more stable is ammon. mur., salmiac, NH4Cl. The bromide and the iodide require, on account of their easy destructibility, fresh preparation, for they yield ammonia, bromine, and iodine, all of which escape into the air.
AMMONIUM CAUSTICUM
Ammonium causticum adapts itself only for the attaining of the most acute ammonium actions: as an analeptic with collapse symptoms; in hemolytic manifestations with bleeding; as an antidote in snake bite, which also provokes hemolysis with central nerve actions; in acute inflammations of the larynx and throat with accumulations of mucus, if swelling and exudation cause suffocative phenomena or spasm of the glottis; under certain conditions also in diphtheria- but always with great caution because the poisonous and therapeutic actions lie close to each other.
The late effect of ammonia, especially aphonia, great exhaustion and muscle weakness, pains in the shoulder and thigh muscles, are less two edged indications, and flexor cramps have also been reported. Even if the simile relationship is quite obvious, still the practical use of ammonium causticum in homoeopathy is quite rare because of its stormy and rapidly transient effect.
AMMONIUM CARBONICUM
Exactly as potassium and sodium hydroxides are unsuitable for therapeutic purposes and the carbonates are much more useful for more prolonged acting alkalies, so is this the case with ammonium carbonicum, the preparation which unfolds the ammonium effects most extensively and clearly. The complex ion, ammonium, behaves entirely as a simple alkali ion. The slight stability, great volatility, and its role in the body physiologically limited to the destructive phase, give it an accent in contradistinction to sodium and potassium, that the action is more transient, toxic and less constitutional.
CONSTITUTION
In this respect ammonium carb. shares the general alkali constitution: relaxed fibre, tendency to corpulence, always tired and fatigued, slow manner or reaction or defective power of reaction; weak heart, labored croupy breathing, downcast, particularly around the menstrual period, in which headache, toothache occur with diarrhea on the first day and which are usually too frequent, too profuse and of dark clotted blood. The tendency to bleeding of dark blood (from the mucous membranes) is to be especially stressed in ammon. carb. in connection with its hemolytic properties.
Just as outspoken as with the other alkalies is the hydrogenoid constitution of ammon. carb.: great sensitivity to cold and water (from the latter, bodily uncleanliness, which appears as a clinical report), easy chilling, aggravation before damp (and stormy) weather, from the use of water in any form.
GENERAL ACTIONS
To this is added, more incidentally, a depressed, anxious frame of mind, ill humor in bad (stormy) weather, mental distraction, poor memory, errors in speaking and writing or counting; sleepiness during the day, at night fearful, awakening from sleep.
The headaches have little characteristic, a feeling of heaviness and beating as well as a sensation as if the brain were loose in the cranium having been reported; it is relieved by external pressure and in warm rooms, but these are insufficiently verified; the aggravation before and during the period has already been mentioned. (There has been reported an aggravation of the headache in evening and morning; this last aggravation after sleep seems to prevail with stupefaction and symptoms and weakness and make ammon. carb. resemble lachesis).
This constitutional weakness, slight ability for effort, expresses itself in asthenopia and the appearance of spots before the eyes when the eyes are strained. The fatigue and lassitude in the extremities and in the musculature in general in the provings proceed up to paresis and painfulness: heaviness and paretic weakness of the arms, the arms and fingers, which morning and night feel dead and stiff on grasping; trembling of the hands; cramps and numbness in the fingers; pains of fatigue in the hip and thighs, especially in the morning in bed; spasms in the feet and calves; heaviness and great weakness in the legs, many drawing, tearing and crushing pains in the extremities are a few of the reports. Although they have no great therapeutic significance for ammon. carb. itself, they indicate the involvement of the locomotor apparatus as an incidental trend of ammon. carb. actions. There is a failure of the musculature, which on the one side tends toward paralysis (in which respect one should compare the toxic after- effects), on the other side to many so-called rheumatic pains wherein the cold and moisture sensitivity of ammon. carb. cooperates casually. The physiologic excretion of ammonia in muscle and nerve activity perhaps creates bridge for understanding. This trend of action is more significant therapeutically for the employment of causticum.
The defective power of reaction as a basic trend of the ammonium carb. picture permits the agent to be perceived in homoeopathy as well as a type of analeptic, and is the basis of its reputation in adynamic states with fever, for example pneumonia with low temperature, dulness and apathy when the patient is too weak to cough and expectorate,, and shows rales and cyanosis. Also in malignant scarlet fever with adynamic symptoms the remedy is recommended when eruption comes on to partial development because of the defective power of reaction. A scarlatiniform type of eruption is described in the Hahnemannian provings. Also erysipelas in old weak people with cerebral symptoms, dulness and stupor, is mentioned.
The toxic action on the blood is combined with this adynamia and terminates in hemolysis. The picture is not peculiarly specific but there exists a great tendency to dark, fluid hemorrhages, that is, impaired coagulation; appearance of vari-colored spots in the skin, blood-flecked sputum, easily bleeding gums like those of scurvy, bleeding from hemorrhoids, with the menses early, profuse and dark, epistaxis in the morning on washing. This last indication of a milder nature is used most. As a warning of irritative of manifestations in the skin is severe itching with burning vesicles and pustules after scratching, likewise severe itching and burning in the anus are cited.
ACTION ON THE RESPIRATORY ORGANS
From this picture of general actions is removed the main organ direction of ammonium carb.: on the respiratory organs. The inflammatory manifestations, which may extend from the nose to the bronchioles and pulmonary alveoli, characterize themselves as far as ammonium carb. is concerned through the early disturbance or failure of central regulatory functions (respiratory or vasomotor center) frequently in association with defective equalization or compensation of the respiratory embarrassment by the muscle weakness of the heart. For the pneumonia (that is, usually bronchopneumonia) the adynamic state with very embarrassed, rapid, noisy respiration, proceeding to pulmonary edema and collapse, have already been mentioned. In this threatening state of failure of the respiratory regulation functions, one can make use of the very acute action and active ammonium iodide (fresh preparation!). Also for the suffocative feeling from the larynx, the simultaneous linking through the iodine is often preferred, for example also in the presence of goiter.
The cough of ammonium carb. whether it is conditioned through laryngitis, tracheitis, or bronchitis, is quickly combined with dyspnea, feeling of suffocation, sensations of fatigue, weakness, and heaviness in the chest, audible palpitation, anxiety, often cold sweat, trembling, inability to speak, and lachrymation. Universal is the nocturnal aggravation, especially toward three in the morning. This time of aggravation agrees with that of kali carb. and is the time of highest physiologic demand in the vagal division of the vegetative system. The patient awakens at this time with an attack of irritative coughing, dyspnea and cardiac weakness or palpitation.
Leeser, a Consultant Physician at the Stuttgart Homeopathic Hospital and a member of the German Central Society of Homeopathic Physicians, fled Germany in 1933 after being expelled by the German Medical Association. In England Otto Leeser joined the staff of the Royal London Homeopathic Hospital. He returned to Germany in the 1950s to run the Robert Bosch Homeopathic Hospital in Stuttgart, but died shortly after.
Otto Leeser wrote Textbook of Homeopathic Materia Medica, Leesers Lehrbuch der Homöopathie, Actionsand Medicinal use of Snake Venoms, Solanaceae, The Contribution of Homeopathy to the Development of Medicine, Homeopathy and chemotherapy, and many articles submitted to The British Homeopathic Journal,