Ammonium Causticum

Authorities. 15, E. P. Walking, Lancet, 1846 (1), p. 385, a woman, ret. twenty-four years, took a quantity of liquid Ammonia; 16, J. W. Trotter, Lancet, 1852 (1), p. 261, P. W., ret. thirty-six years, took 1 ounce hartshorn in milk, afterwards he took copious draughts of warm water; 17, Dr. Barclay, Med. Times and Gaz., 1853 (2), p. 554, a girl, aged nineteen years, when faint from fright had some hartshorn given her; 18, H. W. Reed, M.D., ibid., 1855, p. 59, a man, ret. thirty-five years, swallowed at one draught 3 drachms each of strong Ammonia and Ammonia sesquicarb.; 19, A. Patterson, M.D., Edinb. Med. Journ.,vol. iii, 1857-8, p. 236, a man took 1 ounce into his mouth, but probably none of it reached his stomach; 20, John E. Bean, M.D., Pacific Med. and Surg. Journ., June, 1867, p. 13, Dr. John H. Pike swallowed some “ Liq. Ammon, fort.,” death after twentyone hours ; (21 to 27 from Tardieu); 21, Dr. Pellarin, Union Med., 1857, effects of a large dose ; 22, Prof. Foussagrives, ibid., poisoning by 30 grams; 23, Dr. Chapplain, Archives du Med., 1845, p. 84; 24, Gaz. Med. du Saute, 21 Mai, 1816; 25, M. Potain, Union Med., 1862, t. 12, p. 119; 26, M. General; 27, M. Albert Robin, Journ. de Therap. Ire aim.. No. 5, p. 194 ; 28, Dr. F. R. Quinton, Lancet, 1876 (1), p. 280, a man, set. fortyfourth years, swallowed about 5 or 6 drachms liquor Ammon., death in thirtytwo hours; 29, Dr. W. Dyson, Med. Times and Gaz., 1878 (1), p. 85, a child, set. twenty months, swallowed a quantity of strong Ammonia, death ; 30. Mr. Gillam, ibid. f2), p. 706, T. B., set. sixty-four years, swallowed half a pint of liquor Ammonia.

—Mental despondency,**^.—Extreme anguish,**®.—Anguish, with suffocation and constriction of the throat,**®.—Insensibility,*®.—Comatose,**®.

Mind p. 287

Yellowish chemosis of the eyes

Intense yellow discoloration of the conjunctiva

Eves spasmodically turned up, and eyelids closed

Pupils dilated

Pupils dilated and eyes inverted

Pupils contracted

Profuse accumulation of serous liquid from the nasal fossae

Face p. 287

Face pale

Face pale, eyes haggard, injected, and lids swollen

Face flushed

Upper part of the face of a violet-red color, lower part blanched

Aspect anxious (in two hours)

Lips and tongue red and denuded

Lips cyanotic

Lips livid

Mouth p. 287

Tongue dry

Mouth open

Profuse albuminous, viscid, bloody secretion pouring from mouth and nares

Inside of his upper lip, tongue, roof of mouth, and fauces were white, and other parts excoriated

Inside of mouth, tongue, and fauces, as far as visible, red, raw, and fierylooking. When asked where pain was seated, he pointed to pomum Adams, under the left ear (in two hours)

Intense and excruciating burning in the mouth, oesophagus, and stomach

Salivation profuse

Profuse salivation

Enormous secretion of limpid mucus from the salivary glands and mucous membrane of the pharynx, etc., not less than three liters of liquid a day (wonderfully controlled by Chlorate of potassium)

Loss of speech

Throat p. 287

Hawking of frothy mucus (in four hours)

Horrible pains in the throat, and especially in the epigastric region

Intense burning pain and feeling of suffocation (immediately)

Deglutition painful

Great difficulty in swallowing

Deglutition impossible

Stomach p. 287

Great thirst

Ineffectual efforts at vomiting

Vomiting

Persistent vomiting

Vomited some blood

Vomiting of bloody matter

He vomited a quantity of matter like soapsuds

Severe pain in stomach

Horrible pain in the stomach

Severe pain over the epigastric region, increased by pressure (second day)

Epigastrium excessively painful on pressure

He felt as if he were on fire from his stomach to his mouth

Abdomen p. 287

Excessive pain in the abdomen

Stool p. 287

Involuntary stools

Voided large quantities of blood per anum

Stools profuse, liquid, red, extremely fetid, evidently consisting of a large amount of disorganized blood

Urinary Organs p. 287

Incontinence of urine

Urine suppressed

(Albuminuria); the urine contained up to two grams of Albumen daily

Urine high-colored and thick, with an abundant heavy lateritious elimination

Respiratory Organs p. 287

Trachea spasmodically rising and falling

(Edema of the glottis

Voice very feeble

Voice husky

Complete loss of voice

Sonorous, moist cough, resembling a suffocative catarrh, with tracheal rales

Cough and expectoration provoked by anything getting into the throat, so that it was almost impossible to get liquid into the oesophagus/

Profuse expectoration of niucus/

Respiration rapid

Hoarse croaking respiration

Respiration stertorous

Breathing stertorous, with strong odor of Ammonia,™.

Breathing stridulous (in two hours)

Gasping for breath

Suffocation,™.

insupportable suffocation

Chest p. 288

Mucous rales in chest,™.

Intense cutting pain opposite fifth and sixth cervical vertebrae, at the bottom of the pharynx (in twelve hours)

Heart and Pulse p. 288

Tumultuous action of the heart,™.

Carotids beating violently

Pulse very rapid and feeble,™.

Pulse small, 112,’®.

Pulse 100 (in two hours)

Pulse small, rapid,™ ™.

Pulse small,™.

Pulse feeble,™.

Pulse slow, very irregular,™.

Upper Extremities p. 288

Nails violet,™.

Generalities p. 288

As soon as she had drank it, she fell back insensible, apparently (to those with her) as if choked. In four hours she had revived somewhat, but complained of severe burning pain down her throat, in the epigastrium, and left hypochondrium, each of which parts were tender on pressure ; pulse 53, small; voice a feeble whisper ; great debility; countenance anxious; choking sensation on swallowing; pupils widely dilated ;■ breathing difficult; tongue coated with white fur, painful and tender; two or three patches of its mucous membrane pulled off; three convulsive twitches of the right arm at different times during my visit

Almost immediately became conscious of severe pain in the stomach. In an hour or two became sick and vomited some blood; luematemesis to a greater or less extent continued for three days. In eight weeks she became much emaciated, complained of constant vomiting, with a weak and frequent pulse, a sort of hectic flush on the cheeks, and great prostration. Latterly the vomiting became more constant and severe, her pulse was sensibly feebler, and she became more emaciated from day to day; the eyes sunken, the tongue foul; she complained of headache, and was so weak that she was scarcely able to turn in bed. The bowels were confined throughout. She ultimately died of starvation

Face pale, anxious, qnd covered with clammy sweat, extremities cold, pulse 140, and very feeble ; mouth and throat very red and inflamed-looking. He complained of burning pain in his throat, with difficulty of swallowing, and a feeling of impending suffocation ; his voice was reduced to a whisper, and his breathing noisy, frequent, aud laborious; all the voluntary muscles of respiration seemed to be exerted to get air into the chest; occasionally he vomited mucus slightly tinged with blood (after one hour). Quantities of tenacious mucus collected in the throat aud induced fits of coughing aud sickness (first night),™.

Three white patches on the tongue, and one or two on the inner side of the cheeks ; none visible on the tonsils or pharynx, but considerable congestion of the mucous membrane of these parts. Deglutition exceedingly difficult. Frequent occurrence of vomiting; respiration rapid and shallow, accompanied by laryngeal and tracheal tales; free passage of air into the chest; cyanosis slight (after one hour). Signs of interference with the entrance of air into the lungs more marked, but not considerable. Rales distinctly heard all over the back and chest (after eleven hours). Unconscious; eyes half open ; pupils moderately contracted and equal. Convulsions came on during the night, aud were now frequently recurring (after twenty-three hours)

Semiconscious ; pupils widely dilated, and his breathing noisy and hurried; pulse very rapid; sweating profusely. He complained of great pain in the abdomen, aud vomited a quantity-of blood, mucus, aud shreds of mucous membrane (in five hours) ; hoarse and in a heavy drowsy condition ; face dusky and skin dry ; temperature 100.8°; pulse 130; again vomited blood and mucus (in ten hours). His lips are much swollen, the tongue very dry, and the mucous membrane of the mouth is partly eroded. The fauces are extremely congested and almost meet in the middle line; the mucous membrane looks oedematous, softened, and inflamed. There is great pain and tenderness of the abdomen on the slightest pressure. Tympanitis is marked. Has twice vomited blood since the night, and complains of burning pain in the throat and at the pit of the stomach. 11 P.M., much worse and is becoming comatose. There is great dyspnoea ; respiration about 66 in the minute; pulse 180. Incessant retching till death (second day)

Beating the bedclothes with his hands (in two hours)

Severe tremors

Extreme prostration

Severe cramps

Violent muscular pain, especially in the thighs

Skin p. 289

Erythematous spots in different parts of the body, especially along the lymphatics; the spots are red, bordered by a yellowish zone

Scarlatina-uke redness of the lips and mucous membrane of the mouth and tongue, as though the epithelium were peeled off

Several rosaceous spots on the internal and anterior surface of the forearms; these red spots increased in number on the next day, and covered the whole inner surface of the arm, generally following the course of the lymphatics

Fever p. 289

General coldness

Surface rather cold

Coldness of the surfaeeand extremities

Cold skin, especially in the extremities

Extremities cold (in two hours),'® ®, etc.

Profuse perspiration

Cold sweats