R. Mond (Miinchener med. Woch., No. 14, '96).
Ovarian treatment, administered under the form of dried powder of the ovaries of heifers, in the dose of 4 or 5 grains daily, is not dangerous. In order to net it should he continued for some months; it is indicated in amenorrhcea, chloranwmia, artificial menopause due to removal of the genital organs, and acci dents of the normal menopause.
Touvenaint (Revue des Sci. Med. en France et it l'Etranger, Jan. 15, '96).
Extract of ovaries found especially valuable in amenorrhwa attending chlo rosis among a large number of cases in which it was tried. Muret (Revue ned. de la Suisse Rom., July, '97).
AMMONIA.—Ammonia is a transpar ent, colorless gas very acrid to the taste and giving a markedly alkaline reaction. It is made, in large quantities, from coal gas, by heating the ammoniacal liquor with calcium hydrate, then conducting the gas through tubes containing char coal. It may also be obtained by heating a mixture of dry slaked lime with chlo ride of ammonium. It evaporates with exceeding rapidity. It is very soluble in water.
Dose and Preparations.—The prepara tion used in medicine is a strong solu tion, or water of ammonia, the aqua ammonia fortior, U. S. P., which con tains 28 per cent., by weight, of gas; it is used mainly as a vesicant. A weaker solution (hartshorn), the aqua ammonia, U. S. P., is more generally employed, and contains 10 per cent. of the gas by weight.
Liniment of ammonia: composed of water of ammonia, 30 parts; cottonseed oil, 70 parts.
Camphorated liniment of ammonia: composed of water of ammonia, 30 parts; camphor-liniment, 70 parts.
Aromatic spirit of ammonia: composed of carbonate of ammonia, 40 parts; water of ammonia, 100 parts; oil of lemon, 12 parts; oil of lavender-flowers, 1 part; al cohol, 700 parts; water enough to make 1000 parts. Dose, 30 to 60 minims.
Spirit of ammonia: an alcoholic, col orless solution containing 10 per cent., by weight, of the gas. Dose, 10 to 30 minims.
Foetid spirit of ammonia: composed of 1 part of asafoetida to 21 parts of spirit of ammonia. Dose, drachm.
Ointment of ammonia: composed of 17 parts of water of ammonia, 32 parts of lard, and 2 parts of oil of sweet almonds.
Physiological Action.—Ammonia is a most powerful irritant to the tissues; if the exposure be long, local death and sloughing ensue. Inhaled it may also produce rapid death by cedema of the glottis or spasm. Moderate inhalations cause bronchitis, or at least tracheitis. Upon the nervous system it acts as a spinal excitant, increasing reflex action and spinal activity. Applied directly to a nerve, either motor or sensory, it par alyzes it; in very weak solution it seems to increase its functional activity. The circulation is increased to a great extent: the pulse-rate, pulse-force, and arterial pressure being due to stimulation of the accelerator nerves of the heart. The force of the action of the ventricles is much increased, and this, in turn, in creases arterial pressure. In moderate amounts ammonia does not change the blood, but in poisonous quantities it causes it to cease absorbing oxygen. The
rate of respiration is increased by stim ulation of the respiratory centre; the respiratory movements become not only more full, but more rapid. Inhaled in small amounts, it causes the same action to a smaller degree. When large amounts are taken, ammonia is eliminated by the breath, is burnt up in the system, and is excreted in the urine.
Special research showing that the elim ination of this gas by the lungs is doubt ful. Paul Billet (Revue Med. de la Suisse Rom., June 20, July 20. '93).
Ammonia exercises a depressing action on the liver, producing an increase in the amount of iron and a diminution in gly cogcn. T. Lauder Brunton and S. Dele pine (Proceedings of the Royal Soc., No. 334, '94).
Ammonia Poisoning.—True poisonous effects are rarely observed, the intense caustic action of ammonia upon the mucous membranes of the mouth and throat causing the liquid to be coughed out almost immediately in the majority of instances. Spasm of the glottis and oedema may cause death. If the liquid is swallowed the mucous layer of the (esophagus becomes acutely inflamed, softened, and ulcerated, and stricture of the oesophagus usually follows.
Treatment of Ammonia The antidotes are vinegar and lime-juice. Bland liquids—such as oil or milk— should be given, and stimulants—such as strong coffee—should be administered by rectal injection if the patient is un able to swallow. Hypodermic injections of ether or digitalis are valuable to sus tain cardiac action if there is marked depression or shock.
Therapeutics.—ASPHYIIA, COLLAPSE, AND SHOCK.—In asphyxia, whatever be its origin, ammonia is a valuable agent, taken internally and simultaneously in haled. During the latter procedure, how ever, care should be taken to not spill the liquid into the mouth or nose of the patient, which is likely to occur when he is in the recumbent position. Serious in jury has followed accidents of this kind. In collapse and heart-failure, from 10 minims to a drachm of the water of am monia, mixed with G drachms of sterilized water, may be injected into a vein.
Hypodermic inject ion of aromatic spirit of ammonia valuable in asphyxia and allied conditions. Case of mimic convulsions following scarlet fever, in which respiration and pulsation had apparently ceased; the injection of 1 drachm above the cardiac region caused the patient to return to consciousness four consecutive times. Then used in other cases, including one of gas poison ing. The aromatic spirit of ammonia should always be diluted in order to pre vent sloughing of the tissues in the vicinity of the injection. A. J. C. Saunier (St. Thomas's Hosp. Reports, London, June 1, '94).
In infants, the stage of collapse occur ring in summer diarrhoea may also be counteracted with a few drops of ammo nia occasionally administered.
In extreme stupor Fischer sometimes gives 3 drops of aromatic spirit of am monia, with 10 drops of water. (Post graduate, Sept., '92).