Ammonium Causticum (Ammonia)

Chemical formula, NHg. Common name. Hartshorn spirits. Preparation, Solution of the gas in water.

Authorities. Toxicological (1, Wibraer, proving, Buchner's Repertorium ; 2, Better, Hufeland's Journal, 78; 3, Christian, Gaz. d. Saute; 4, Schlegel, Material, etc., 1801; 5, Mankiewicz, Virch. Archiv., 45; 6, Winter, Med.- Chir. Cent. Bl., took 8 drachms; 7, Iff, Lancet, 49; 8, Br. J. of Ham., 21 ; 9, Souchard, in N. A. J. of H., 17 ; 10, Imbert-Gourbeyre, J. d. Chim. Med., 1854; 11, Gaz. d. Hop., in N. Z. f. H. K., 17; 12, Watson, Times, 1845, "Guano Fumes;" 13, Wibmer, Effects of Inhalation ; 14, Cattell, in B. J. of Horn., 11).

Mind

The patient, perfectly comprehending his condition, resigns himself to despair

Remarkable timidity

His intellect was clear

Unconscious

Head

Slight confusion in the head, with rumbling in the abdomen (in six minutes)

Slight confusion in the head, with pressure in tl temples, ceasing almost entirely in ten minutes (in a quarter of an hour)

Sensation as if the brain protruded at the centre, forward, and on both sides, and the skull was quartered, but without pain and without confusion of the head

The forehead, where the bloodvessels are full of blood, feels hot to the touch

Pressure in the frontal region, with feeling as if the head would split, but without pain, which lasts a few minutes (in seven minutes)

Slight pressure at the occiput, lasting ten minutes (in half an hour)

Eyes

Eyes red, shining

The eyes sunken; the pupil widely dilated

Lachrymation

Ears

Deafness,'-.

Nose

Peculiar redness of skin over nose and frontal sinuses

A watery fluid runs at intervals from the nasal cavities, and the air is completely excluded from them

Face

The face is altered

The expression was anxious

The whole expression of his face showed the greatest anguish

Extremely pale face, expressive of the greatest suffering,l

Face always very red during the febrile exacerbations, I

His distorted features had red spots

His lips were rather swollen

Lower lip swollen to three times its normal size

Small black coating on the middle of the lower lip,l

The mucous membrane of the lips and nose was destroyed

Mouth p. 284

Teeth clenched

The surface of the tongue is white

The tongue appeared deprived of its epithelium; only on solitary places could some white membrane still be seen, acid nearly the whole fauces showed the same state

Curled pieces of white skin are detached from the tongue and throat, and those parts appear red,l

The tongue, the palate, and the entire oesophagus, as far as visible, are whitish and partly covered with blisters

Burning and scraping at the root of the tongue and posterior portion of the oesophagus (while swallowing the medicine)

Small black coating on the tip of the t()ague,l

The entire buccal cavity, the mouth, the tongue, and probably a great part of the oesophagus and stomach, are raw, denuded of epithelium

The mucous membrane of the mouth, and all the visible parts of the throat, were dark-red, swollen, and tender; the epithelium was detached in different places

The penetrating smell of Ammonia was still clearly perceptible in his breath, although he had taken so much vinegar

From mouth and nose flowed a large quantity of bloody fluid

Profuse bloody salivation

Foaming from mouth

Throat p. 284

Throat externally red, and the soft parts swollen

Burning pain in throat

Burning pain from the mouth to the region of the stomach

Burning heat at the throat

Burning pain at throat and stomach

Lancinating and scraping sensation at the throat (immediately after taking the medicine)

Scraping at the throat (when swallowing the medicine)

Deep redness of the velum, its pillars, the tonsils, and the posterior wall of the pharynx

The uvula is contracted and covered with white raucous

- The tonsils appear scarcely at all enlarged

The posterior wall of the pharynx, and the epiglottis, were deeply reddened, and like the mouth, with most intense pain in the throat

Dryness in oesophagus

Great difficulty in swallowing

Could scarcely swallow

He swallowed with difficulty some vinegar and water, but it seemed to relieve him

After two hours of great anxiety, the patient complained mostly of his throat, as swallowing was still nearly impossible

Stomach p. 284

Very urgent thirst,l

Thirst

Very urgent thirst, with difficult deglutition

He is consumed with thirst, and yet is unable to get down a drop of liquid

Thirst very strong, without the power to swallow

Eructations which do not smell of Ammonia (soon after taking the medicine)

Constant mucous vomiting

He passes an immense quantity of mucus from the mouth

He throws up by the mouth and nostrils quantities of a whitish fluid which burns wherever it touches, and smells like sal volatile liniment

He immediately screamed and was very sick, bringing uf) at first stringy mucus of a light color, and then some more dark

Vomiting blood

The right hand automatically pointed in the stomach region

He was allowed to get up on the fifteenth, but the next day a hearty meal gave him very great pain

Heartburn

There was burning pain in the track of the oesophagus, none in the stomach itself, but its region was tender on pressure

Epigastrium swollen and tender

Great sensitiveness of the epigastric region; very small pulse, with shiverings (at 4 p.m.)

Abdomen p. 284

Great pain and tenderness in left hypochondrium and at epigastrium

There was no abdominal distension

The abdomen was soft

Rumbling in abdomen,-

Inexpressible pains in the upper part of the intestinal tube

Pains in lower abdomen, back, and sacral region

Stool and Anus p. 285

Spasmodic contraction of the rectum ; an injection spouted forcibly from the rectum as soon as thrown up/.

The vomiting is followed by several stools, which cause a violent burning at the anus

Solid stool (he has already had the usual morning evacuation), ■with cessation of the confusion of the head (in six minutes)

Copious hemorrhagic stools

Bloody stools, very frequent

Evacuation of some pints of clear blood, with excessive tenesmus

The poison was taken March 7th, but his bowels did not act till the 12th, and then only after a purgative

Suppression of a chronic looseness of the bowels,°

Urinary Organs p. 285

Scanty, red urine

The urine was alkaline and dark-yellow

Urine smelling of aramonia

Next day, the urine contained a good deal of sediment, consisting of urates

Sexual Organs p. 285

The menses, hitherto always regular, are fifteen days too early, and very profuse

Respiratory Organs p. 285

Slight, rather coarse mucous rules were heard in the larynx and trachea

He had a constant tickling in larynx, ■with pain in epigastrium

For several days, he suffered from a bronchitis, with profuse expectoration, but it took nearly a week till his voice returned, and he regained his strength only by slow degrees

Speech fatiguing, interrupted

The voice was low and weak, speech fatiguing and interrupted, on account of the condition of the respiratory function

She could hardly speak, because the effort to do so fatigued her exceedingly, and caused pain in the chest

The voice was rough, weak, and hoarse

Dull, hoarse voice

Weak and indistinct voice

Voice deep, weak

Speech wanting

Obstinate cough

Cough, with copious mucous expectoration

Cough and much expectoration, especially after drinking

Cough, with profuse mucous expectoration, and excited by drinking

When he tries to drink, severe cough, with expectoration of slimy masses

The cough and expectoration are especially excited by the contact of liquids with the back of the mouth ; only a very little passes into the oesophagus

Spasmodic cough, lasting an hour, during which he expectorates a great quantity of membrane

He hawked and expectorated continually, although doing so gave him great pain

Bloody expectoration,'l

Respiration heavy and rattling

Every respiration produces a kind of rattling noise

The breathing harsh, hurried, and somewhat obstructed

Respiration difficult

* Very great difficulty in breathing

Great difficulty in breathing

Difficult, quick, stertorous breathing,l

Was aroused from sleep by a suffocative feeling

Spasm of the glottis; death from asphyxia

Chest p. 285

Continuous mucous rattling in chest

The chest-sounds were normal

Pain in the whole chest, with suffocative anguish

Inclination to draw a long breath, which is prevented by a violent pain in the chest towards the back, evidently in the oesophageal region

-Great oppression and want of air,l

Extreme oppression of the chest, with increased rattling and threatened suffocation

Lung-catarrh

The pra^cordial region is distended and painful

Extremely violent anguish at the prsecordia, with great oppression of the chest

Heart and Pulse p. 285

Fuhe small, weak, rapid

Small, frequent, and weak pulse,l

Very small and moderately frequent pulse, but it increases in frequency from hour to hour

The pulse was quickened five beats per minute (usual rate 70); it was also somewhat hard

Pulse so slow and intermittent that it was difficult to count it, as were also the beats of the heart

Pulse 60, small and hard

Pulse weak, irregular

Small, depressed, scarcely perceptible pulse

Upper Extremities p. 286

Convulsive twitches of right arm

Generalities p. 286

State of irritation and of extraordinary suffering

In the evening, the patient was greatly excited; pulse quite small and very quick, with increased oppression

After a venesection, the patient got more quiet, and the bloody expectoration ceased

Motorial power intact

He had perfect sensibility, and not much distress of countenance

Great weakness

Great debility

Great prostration

Remarkable exhaustion; his muscular strength is diminished to a degree not proportioned to the duration of the disease

On trying for the first time to get out of bed, he was unable to stand on his legs, and at the least effort, he trembled violently

Bleedings from the mouth, nose, eyes, ears, which cause faintness

Skin p. 286

The skin was pale, cold, and had lost its elasticity

The application of a blister plaster takes off the skin, but does not excite the secretion of serura

Erysipelas

Skin hot, not dry

Hot, dry skin

Dry skin, I

Cutaneous sensibility intact

Fever p. 286

Heat in chest and at stomach

Sleep and Dreams p. 286

Sleepless night,l

Very restless night,l

Conditions p. 286

Aggravation.

(Evening), Great excitement, etc.

(After drinkwg), Cough, etc.

(After hearty meal), Great pain in stomach.

Amelioration p. 286

(Solid stool), Confusion of the head.

(After venesection), More quiet, etc.

( Vinegar and water). Seemed to relieve him.