Ammonium carbonicum

Lecture LXIV — The Ammonium Preparations — Ammonium carb., Ammonium mur. and Ammonium phos.

Ammonium Carbonicum.

f Arnica, Antimonium tart.

Belladonna, Apis, Lachesis.

Ammonium carb. { A A _ , _ Arsenicum, Aurum, Carbo veg., Curare.

Conium, Senega, Kali bi., Calcarea ostr.

(Camphor.

^ \ Arnica.

< Lachesis.

We will first study Ammonium carb. Let me call your attention to the fact that the Carbonate ofAmmonia may be antidoted by Camphor; and some of its symptoms by Arnica.

Despite the apparent resemblance between Carbonate of Ammonia and Lachesis, these two drugs have been found to be inimical. Ammonium carb. may be studied from its action on the blood. As I have already said, its prolonged use produces a scorbutic condition. The vital powers are weakened. Haemorrhages of dark fluid blood appear. There is degeneration of blood tissue. The muscles become soft and flabby. The teeth loosen and the gums ulcerate. With these scorbutic symptoms, there is developed also a hectic form of fever. I now take up the indications for Ammonium card, in uraemia. These symptoms which I am about to give you are very important. They are not only characteristic of A??i?nonium carb. in ursemia, but also in any other disease in which this remedy may be indicated. We may find them present in scarlatina with decomposition of the blood, and also in heart disease. Now for the symptoms: you will find Ammonium carb. indicated for somnolence or drowsiness with rattling of large bubbles in the lungs, grasping at flocks, bluish or purplish hue of the lips from lack of oxygen in the blood, and brownish color to the tongue. You recognize in these symptoms some condition of blood-poisoning from the presence of carbonic acid. This may be in ursemia, or it may be in catarrh of the lungs, or in any other disease in which there is deficient oxygenation. The nearest analogues here are Antimonium iartaricum, Carbo veg. and Arse?iicu?n. A similar condition obtains in Arnica in typhoid states when the patients are drowsy and heavy, and fall asleep while answering questions.

With the symptoms just enumerated you can remember Am??io?iium carb. for oedema of the lungs or emphysema.

Ammonium carb. is also of use in poisoning by charcoal fumes. Arnica is sometimes of use in these cases, as is also Bovista. Still another use we may make of Ammonium ca?'b.

, and one, too, that would hardly suggest itself to you, is in the beginning of cerebrospinal meningitis. Sometimes, in the beginning of this disease, the patient is stricken down by the violence of the poison and falls into a stupid, non-reactive state. He is cold, and the surface of the body is cyanotic. The pulse is very weak. In just such cases you should give Ammonium carb., which will bring about reaction. Then you may select some more specific remedy which will cure the trouble. I would now like to mention the action of Ammonium carb. on the heart. This drug is useful in dilatation of that organ. The patient suffers when ascending a height, as when going up stairs or up a hill. He also suffers intolerably in a warm room. He frequently has cough which is accompanied by bloody sputum. There is palpitation of the heart with dyspnoea and retraction of the epigastrium. You may also find cyanotic symptoms present.

Ammonium carb. is also indicated in pneumonia when there is great debility, together with symptoms pointing to the formation of heart clot.

It is also indicated in chronic bronchitis with atony of the bronchial tubes, which favors emphysema. There are copious accumulation of mucus in the lungs, dilatation of the bronchial tubes, and oedema pulmonum. The patient in these cases is weak and sluggish in his movements, coughs continually, but raises either not at all or with great difficulty. Drowsiness, or even some delirium with muttering, may be present.

Another use we may make of Ammonium carb. is in scarlatina. It is undoubtedly a useful remedy in the treatment of this disease, even when of a rather malignant type. We find that it produces a rash resembling that of scarlatina, but which is, however, of a miliary character. The throat is swollen internally and externally with enlargement of the glands externally, and with bluish or dark red swelling of the tonsils. The neck externally is engorged, that is, there is, in addition to the swelling of the cervical lymphatics, inflammation of the cellular tissue. The nose is often obstructed, particularly at night, causing the child to start from its sleep as if smothering. Frequently it has to lie with its mouth wide open in order to breathe. The child is drowsy, and may even go into a stupid sleep. We frequently find, too, an enlargement of the right parotid gland.

Let us now study some of the concordant remedies of Ammonium carb. in this disease. First of all Belladonna. Between this remedy and Ammonium carb. the resemblance is only apparent. Both remedies have right side of the throat affected, bright red rash, scarlatina and drowsiness. But the distinction between the two lies in this: there is in Ammonium carb. a miliary eruption on the skin, which Belladonna has not. The throat in Ammonium carb. is of a darker red than in Belladonna y and the drowsiness is more complete. The drowsiness of the latter remedy alternates with either wildness or starting from sleep, or restless delirium or crying out in sleep. In Ammonium carb. the patient is in a state of simple somnolence. The starting from sleep is not from irritation of the brain, but from stoppage of the child's breathing.

There is some resemblance between Ammonium carb. and Apisyin that both remedies have miliary rash, and both are indicated in low types of scarlatina with somnolence. Apis has, however, more dropr sical symptoms. Whenever it is the remedy, you will find puffiness of the throat and oedema of the uvula. But you will also find inflammation or irritation of the meninges of the brain in Apis, as indicated by the sudden shrill crying of the child. This is a sudden shriek, and not a mere start as if frightened. There is rolling of the head in the pillow.

Lachesis, though apparently similar to Ammonium carb. in scarlatina, is really inimical to that remedy. It resembles A?nmonium carb. in the blueness of the surface, in the somnolence, in the engorgement of the neck and in the dark red or bluish swelling of the throat. Lachesis has almost always, if not always, that extreme sensitiveness of the surface, so that the patient cannot bear to have anything touch the neck. Then, too, Lachesis affects more the left side and Ammonium carb. the right. This sensitiveness of Lachesis is not the same kind of soreness that you find in other remedies, as in Apis. This symptom is here due to a hypersesthetic condition of the spinal nerves ramifying through the affected part. Firm pressure does not aggravate, although a light touch will.

Rhus tox. is similar to Ammonium carb. , in that both remedies have dark throat and both have drowsiness. It is the left parotid gland that is most likely to be affected under Rhus; with Ammonium carb., it is the right. There is more restlessness under Rhus. Next, the action of Ammonium carb. on the mucous membranes. This remedy is useful in nasal catarrh. The nose is stopped up at night; the patient wakens gasping for breath. He is worse at three or four o'clock a. m. The cough is dry and tickling, associated with hoarseness, and with a great deal of oppression from mucus in the chest. The nostrils are sore and raw, and sometimes, in children, there is a discharge of bluish-colored mucus. This symptom is also found under Kali bichromicum, Natrum arsenicosum, Arundo Maurit., Ammonium muriaticum and Ambragrisea. At times the coryza is scalding, excoriating the upper lip, with burning in the throat and along the trachea. There is a feeling as of a lump in the throat. Dry night cough comes, which seems to threaten suffocation; copious flow of saliva, with consequent expectoration; beating like a pulse in the chest. Ammonium carb. is particularly suited to winter catarrhs. The sputum is slimy and contains specks of blood.

Its near relative, Ammonium muriaticum, will be considered presently. It is similar in these catarrhs. Differentially the Carbonate curescatarrhs, worse in winter, nose stopped up, worse at night, awakening the patient from sleep, gasping for breath, worse three to four a. m. Cough dry, tickling, hoarseness, chest oppressed with mucus. The Muriate causes stoppage of one nostril; both stopped up at night; nostrils sore and raw; discharge of bluish mucus or scalding coryza, severe burning in the throat, etc.

In the three a. m. aggravation of Ammonium card., you may compare the Kali salts.

In this catarrh, with stoppage of the nose, excoriating discharge and rawness down the sternum, there are a few drugs which I would have you compare. One of these is the Ammonium causticum, which is one of the best remedies in the whole materia medica for aphonia, with burning rawness in the throat.

Causticum and Carbo veg. are very similar to Ammonium carb. in this rawness and burning down the sternum.

Laurocerasus has that expectoration containing little specks of blood.

Ammonium carb. has also been used for sprains when the injured joint is hot and painful; it follows Arnica.

Here you may compare Sulphuric acid and Ammonium mur.