Carbonate of Ammonia. (NH4)2CO3. Solution in distilled water.
INTRODUCTION
CARBONATE OF AMMONIA gives off ammonia freely, and the effects of pure ammonia or of ammonia in solution are the same as from the carbonate, only stronger.
Ordinary smelling salts consist of carbonate of ammonia reinforced by strong ammonia and scented with oil of lavender,
&c.
Aromatic spirits of ammonia (sal volatile) consists of carbonated of ammonia, ammonia and several volatile oils dissolved in alcohol.
PATHOGENESIS.
Owing to its volatility ammonia penetrates the tissues rapidly and is therefore less corrosive than the fixed alkalis, potash and soda. In poisoning by strong ammonia we get its local action on the nose, mouth and throat, and the action of the fumes on the larynx and bronchi. These parts are reddened, swollen and inflamed, the mouth and throat sore, and swallowing becomes impossible. The mucous membranes of the larynx and bronchi are inflamed and swollen, so much so as possibly to cause asphyxia, but if this does not happen there are extreme dyspnoea, rattling in the trachea, and expectoration of blood or bloody mucus. The face and nostrils are red and burning, the capillaries distended, the veins turgid and livid, and red patches occur on the skin, especially of the forearms and inner surface of the arms. Post-mortem examination shows the epidermis over these patches detached and the cellular tissue beneath them infiltrated with serum. The stomach is irritated and reflex vomiting occurs, often of blood. There are extremely foetid, liquid stools of deep red colour, evidently of blood. The blood is liquid, coagulates slowly and imperfectly. The irritation of the mucous membranes caused by ammonia produces reflex stimulation of the vasomotor centre with resulting contraction of the arterioles and increased blood-pressure, while the respirations become deeper and fuller. The heart may be temporarily slowed by reflex inhibition through the vagus. In experiments on animals tetanic convulsions were produced by a reflex action on the spinal cord,. as is the case with strychnia, but differing from the tetanus caused by strychnia in that the tetanic convulsion is not repeated. The secretion of the mucous glands of the bronchi and of the sweat glands is increased.
After absorption, ammonia and its carbonate are rapidly changed into urea, and do not render the blood more alkaline as the fixed alkalis do. The increased urea is excreted in the urine and promotes diuresis.
PROVINGS.
Head.-Passing on to the less violent effects of smaller doses we notice a feeling of distension in the head, throbbing and pressure in the forehead, as though it would burst, and burning pains in the vertex and fore part of the head. Sometimes there is a sensation of looseness in “the brain” as if it fell to the side toward which the head is inclined. The headache is worse in the morning and is increased by clenching the teeth. There is a sensation of warmth in the head and face.
Eyes.-Frequently sparks dart before the eyes, with the headache. A large black speck comes before the eyes after straining them and a “live blood” sensation in the lids may occur.
The face is mottled with red patches, and pimples appear. The alae nasi are swollen and sore, and epistaxis occurs, especially on washing in the morning. A stuffy coryza comes on which is worse at night. The nose and lips are dry, and yellow painful vesicles appear between the lip and lower canines.
Digestion.-The mouth is red and sore, the gums are swollen, tender and bleeding, and there is a painful erosion in the middle of the dorsum of the tongue. There are aching and a feeling of warmth at the epigastrium with inclination to vomit and thirst for beer. The abdomen is painfully distended by much foetid flatus; diarrhoea of offensive, liquid, blood-stained stools follows, and there are piles which protrude after stool.
Respiration.-Dryness and burning occur in the throat and a scraping sensation with inclination to cough and increased secretion of mucus in the trachea, accompanied with aching pain in the chest and shootings beside the left nipple.
Urine.-Increased frequency of micturition occurs and the urine is muddy, increased in quantity and of offensive odour.
Circulation.-Palpitation is present, associated with faintness, a palpitation which seems to the patient to be audible and which is made worse by any movement.
The menses, under the influence of ammon, carb., are premature, too profuse, of dark blood and are associated with copious diarrhoea on the first day, with great prostration, toothache, and a deep-seated, sore sensation in the pelvic viscera.
The skin is the seat of unhealthy boils, pimples and blotches or of red, mottled spots. They are made worse by bathing. There are itching and blotches in all the limbs. Boils are seen, most often on the upper thighs and nates. A burning sensation occurs in the clefts of the fingers and is followed by a collection of pus under the epidermis. There are darting, itching and burning of the feet, especially of the big toes, as from chilblains. General prostration is present, with all the above symptoms.
Fever,.-Rigors also often occur, accompanied with transient heats, mostly of the face. With his sore throat and coryza the patient is chilly and is worse out of doors. There are foetid or sour perspirations.
Mentally he is ill-humoured, gloomy, dissatisfied, over- sensitive as to what people say about him, sad and disposed to weep.
Sleep is disturbed, especially during the first part of the night, and distressing dreams of spectres of dying and of danger occur, from which the patient wakes anxious and in perspiration. In the daytime somnolence accompanies many of the conditions.
Pains, as of fatigue, especially in the hip-joint and the lower extremities, with great prostration and low temperature, are a feature.
THERAPEUTICS.
CARBONATE OF AMMONIA has its chief remedial sphere in adynamic conditions, in toxaemia, when there is great prostration and the blood is dark and fluid from deficiency in coagulation and haemorrhages result. It is a remedy for fevers that present this picture, such as malignant scarlet fever, erysipelas in old debilitated persons with associated cerebral symptoms resembling a drunken stupor, and in the resolution stage of pneumonia, when the patient’s consciousness is dulled, he is too weak or too lethargic to cough and expel the sputum, and is in danger of suffocation; coarse rattling rales, besotted, hot face and cyanosis are present at the same time.
Less dangerous complaints for which carbonate of ammonia is useful are nose bleeding, occurring usually while washing in the morning; toothache, coming at every menstrual period, worse in the evening on going to bed, and from warm water in the mouth; piles that bleed at every menstruation; exhausting menses that are premature, profuse and accompanied with diarrhoea and bleeding piles and a sensation of soreness in the pelvic viscera; debilitated heart with palpitation and dyspnoea on any exertion; asthmatic dyspnoea, that is worse in a warm room and better in the open air; stuffy colds which necessitate an open mouth during sleep, from which the patient wakes feeling suffocated; headaches, mainly frontal, that are full and bursting and worse on waking in the morning (lach.); boils and carbuncles occurring in the course of serious internal disease, and which are unhealthy, foetid and slow in their progress; and finally, gout in the big toes and pains in the heels.
Complaints are most often on the right side.
In more material doses carbonate of ammonia has been used externally as a rubefacient, and by inhalation, usually as smelling salts, in fainting or collapse, in which cases it acts by stimulating the medullary centres which raise the blood pressure. It has also been used as a mild stomachic stimulant to get rid of flatulence, and is temporarily very efficient for this purpose, and in bronchitis to render the bronchial secretions more fluid and thus aid their expulsion. It has been much used in snake bite, the poison in which in its action on the system it resembles in many respects.
LEADING INDICATIONS.
1) Offensiveness of sweat, urine and stool.
2) Turgid veins and cyanosis. Acridity of secretions,
3) Haemorrhages in depressed conditions of the well system. Blood black and fluid, not coagulating well.
4) Fevers in which there is toxaemia and great prostration. Malignant scarlatina.
5) Scorbutic conditions evidenced by epistaxis, bleeding from the gums and from the anus.
6) Pustules and boils that are indolent and have acrid discharges.
7) Delicate women of lymphatic temperament who faint easily.
AGGRAVATION:
From cold, open-air, washing, damp weather, at night, especially 3 a.m., waking from sleep (lach.), in the morning, during menstruation, exertion.
AMELIORATION:
From external pressure, lying on the affected side, warm room (except toothache and asthma), dry air.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,