The elements of materia medica and therapeutics (Volume 1).

  • Pereira, Jonathan, 1804-1853.
Date:
1843
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Licence: Public Domain Mark

Credit: The elements of materia medica and therapeutics (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    the pleura. From the convulsions it may be inferred, that in these instances the (gray matter of the) spinal marrow was specifically affected. y. On Man. *«.. Local Effects.—In the concentrated form the local action of liquor ammoniae is exceedingly energetic. Applied to the skin, it causes pain, redness, vesication, and destruction of the part; thus acting, first as a rubefacient, then as a vesicant, and lastly as a caustic or corrosive. Its emanations are also irritant: when they come in contact with the conjunctival membrane, a flow of tears is the result; when inhaled, their powerful action on the air-passages is well known. Persons in syncope are observed to be almost immediately raised from a death-like state, merely by inhaling the vapour of this solution. In cases of insensibility it must be employed with great caution; for, if used injudiciously, serious, or even fatal, consequences may result. Nysten (Chnstison, Treatise on Poisons.) tells us that a physician, for some years subject to epilepsy, was found by his servant in a fit. In order to rouse his master, the latter applied a handkerchief, moistened with this solution, to his nose, so assidulously, that he brought on bronchitis, of which the patient died on the third day. In the Edin- burgh Medical and Surgical Journal, there is the report of the case of a lad whose death was produced, or at least hastened, by an attendant applying, •« with such unwearied but destructive benevolence, ammonia to the nose, that suffoca- tion had almost resulted. Dyspnoea, with severe pain in the throat, immediately succeeded, and death took place 48 hours afterwards. A French physician also suffered ulceration of the mouth, and violent pulmonary catarrh, in consequence of the excessive use of ammonia, given as an antidote for hydrocyanic acid. More recently, another case of poisoning by the vapour of ammonia has been pub- lished. (Journal de Chimie Medicate, t. vi. p. 499, 2de Ser.) It arose from the accidental bursting of carboy of liquor ammoniae. The mucous membrane of the nose and lips was destroyed. The tongue was deprived of its epithelium, and a large quantity of sanguineous froth escaped from the mouth. The respira- tion was so difficult, that suffocation was feared. The pulse was feeble, irre- gular, and frequent. There were no convulsions. Bronchitis supervened, but the patient recovered. When the solution of ammonia is swallowed in large doses, it acts as a power- fully corrosive poison; but modern well-marked cases of poisoning by it in the human subject are wanting. However, it is very evident that violent inflamma- . tion of all that part of the alimentary canal with which the poison may be in contact, would be the result, and that if much were taken, decomposition of the part might be expected. When swallowed in a very dilute form, and in small quantity, the local phenomena are not very marked, and the effect of the sub- stance is then seen in the affection of the general system. The chemical action of ammonia on the tissues is analogous to that of potash, hereafter to be described. /3/3. Remote Effects.—The remote effects may be investigated under two heads, according as they are produced by small or large doses. In small or therapeutic doses, such as we are accustomed to employ in the treatment of diseases, am- monia acts as a stimulant, excitant, or calefacient. It produces a sensation of warmth in the mouth, throat, and epigastrium, frequently attended with eructa- tions. A temporary excitement of the vascular system succeeds, but this quickly subsides. The heat of the skin is sometimes increased, and there is a tendency to sweating, which, if promoted by the use of warm diluents and clothing, fre- quently terminates in copious perspiration. But the skin is not the only secreting organ stimulated to increased exertion; we observe the kidneys produce more urine, and frequently the quantity of bronchial mucus is increased. The nervous svstem is also affected, and the activity of its functions heightened. Wibmer (Die Wirkung, &c. Bd. i. S. 123.) made several experiments on himself, and from them it appears that ammonia affects the head, sometimes causing oppres- sion, or a sense of fulness, but no pain. The increased capability of muscular