AMMONIUM CARBONICUM - Indicated for asphyxia from charcoal fume
-GEORGE VITHOULKAS
Generalities
Ammonium carbonicum is a remedy that is indicated in constitutions which have difficulty in oxygenating the blood; this is the first remedy indicated for asphyxia from charcoal fumes. It is one of the best remedies for emphysema with cyanosis. The circulation becomes sluggish.
This remedy will be indicated when there is a defective reaction to severe febrile diseases, such as typhoid fever, diphtheria, malignant scarlet fever, erysipelas, etc., especially when several incorrect remedies have been prescribed, confusing the case and leaving the patient looking exhausted and almost pulseless with a weak heart.
The remedy should be remembered in cases of cerebrospinal meningitis when the patient is first striken by the disease, falling into a semi-comatose state. The body is cold, the pulse very weak, the surface of the body cyanotic. This remedy will help to establish a reaction.
Another general characteristic of this remedy is a tendency to hemorrhages of dark blood, sometimes black, that will not coagulate.
Ammonium carbonicum cases are very much aggravated by cold and wet weather and by stormy or cloudy conditions, with the exception of the dyspnea, which is very much aggravated in a warm room. In a warm room they become pale and so much worse that they have to sit down and avoid any movement at all. Walking outside in cold air makes them feel terrible; they will avoid it at any cost.
Water seems to aggravate these patients considerably. They are averse to bodily contact with anything wet; consequently they do not like to wash and sometimes avoid bathing so assiduously that they become a significant problem for others living with them.
Women are aggravated during the menses, and many have to stay in bed during this period. Symptoms resembling cholera, with constant diarrhea and vomiting, may arise during the menses. Hysterical women with a tendency to faint.
There is also aggravation from motion, from chewing or pressing the teeth together, and from bending down. The time of greatest aggravation is between 3 and 4 a.m. , leading to ready confusion with Kali carbonicum in cases involving lung pathology. There is amelioration by lying down, especially on the abdomen, and by becoming warm in bed. Better lying on the painful side.
Vertigo
Vertigo on reading in a sitting position, in the morning or the evening.
Head
Pulsating, beating, throbbing headaches, mostly in the forehead, after dinner; after eating; while riding in cold air. Congestive headaches during wet weather, aggravated by walking in the open air. The most characteristic headache is a pressive one situated at the root of the nose which gives the impression as if the forehead would burst. A warm room ameliorates a pulsating sensation in the head. The headaches are worse when stepping and in the morning on waking, better with pressure and in a warm room. Headache with nausea.
Sensation as if the brain would ooze out through the forehead and eyes. The brain seems loose. When biting the teeth together or when chewing, there are shocks which pass through the head, eyes, ears and nose.
Eye
Burning of the eyes with aversion to light. Sensation as if there were sand in the eyes. Right eye feels as if bathed in hot water. Eye strain. After strain, muscular asthenopia. Pain in the eyes, better from afternoon sleep. Lids become swollen, dry and cracked from the excoriating fluid discharged from the eyes. Eyes bloodshot with lachrymation.
Vision
Sparks before the eyes at night; on waking. Double vision. Large black spots float before the eyes after sewing. Cataract of right eye.
Ear/hearing
Discharge of acrid fluid from the ears. Shocks through ears, eyes and nose when biting teeth together or chewing.
Painful sensibility, increased in deaf ear. Hardness of hearing.
Nose
Coryza in hysterical females and old people with discharge of sharp, acrid, burning water. Stoppage at night; cannot breathe at all through the nose; the nostrils are completely blocked.
Epistaxis, mostly from the left nostril, when washing the hands and face, and also after eating. Tip of nose congested. When stooping, the blood rushes to the tip of nose, causing it to become red.
Face
The face becomes heated when talking about an exciting subject, also when eating. Tetters (skin eruption) around the mouth. Hard swelling of the cheek. Boils and pustules during the menses. The corners of the mouth are sore, cracked and burn; at the same time the middle of the lips are cracked because of an acrid saliva. Boils and pustules during the menses. Cyanosis of the lips, across the nose, and even of the fingertips in cases of acute pulmonary edema or pneumonia.
Mouth
Redness and inflammation of the inner mouth and pharynx. Sensation as if the mouth were swollen. Swelling internally of the cheeks. Food tastes metallic. Taste sour; metallic. Great dryness of the mouth and throat. Vesicles on the tongue. Cracking of the jaw on chewing.
Teeth
Drawing pain in the teeth during menses. Tearing pain when biting the teeth together. Toothache. Pressing teeth together sends shocks through the head, eyes and ears.
Throat
The tonsils are highly inflamed and look almost bluish-purple. Gangrenous ulceration of the tonsils with great general exhaustion. There are varying degrees of throat inflammation ranging from simple sore throats to severe inflammations with purple fauces, swelling, ulcerations and bleeding; there are also putrid inflammations, especially in cases of scarlatina or diphtheria. The glands of the throat and neck swell, becoming large and lumpy. In diphtheria, the child gasps for breath and starts from sleep; this happens again and again, as soon as the child falls asleep.
The picture of this remedy in throat and skin affections is very similar to that of Lachesis, a remedy which is inimical to Ammonium carbonicum because of such similarities. In reality, however, it is very difficult to confuse these two remedies, so divergent are their overall pictures.
Stomach
Suppressed eructations. Eructations. Flatulent dyspepsia. Pain in the epigastrium, like a constant weight, worse after eating, especially meat. Pressure ameliorates cramping, griping, constricting pain in the stomach. Pressing pain in the stomach from clothing. Tenderness and pain in the pit of the stomach, with heartburn. Constrictive pain in the pit of the stomach, with heartburn, nausea, waterbrash and chilliness; better lying down and better pressure.
Great appetite, but easily satisfied. No relish of food. Desire for sugar. Aversion to milk. Much thirst, especially when eating.
Abdomen
Cramping, griping pain in cold air. Shooting pains in the liver area. Noises and pain in the abdomen. Elastic swelling in the groin, like a flatulent hernia.
Rectum
Diarrhea acrid; burns the anus. Constipation, difficult evacuation. Bleeding piles; worse during menses. Protruding piles, worse after stool, better lying down. Itching of anus. Lying on the back ameliorates the pain in the rectum. Painful tenesmus during menses.
Stool
Stools difficult, hard and knotty. Discharge of blood before and after stool.
Urinary
Frequent desire; involuntary urination at night. Tenesmus of bladder. Urine bloody and fetid. Sand-white sediment.
Genitalia-male
Ammonium carbonicum males are sensitive to sexual impressions, leading to masturbation; sometimes there is violent sexual desire without erections or erections without desire. Seminal emissions, even after coition. Itching and pain of the scrotum and spermatic cords.
Genitalia-female
Cholera-like symptoms (diarrhea and vomiting) at the beginning of the menses. Irritation of the clitoris with hysterical reactions in young women. Copious menses from riding in cold air. Menstrual flow is increased while standing. Menses frequent and profuse, with clotted, black blood. Reserved during menses.
Itching, swelling and burning of pudendum. Leucorrhea -- burning, acrid, watery. Aversion to the other sex; aversion to coition.
Larynx and trachea
Saltish mucus in larynx. Tickling in air passages after 3 a.m. Hoarseness.
Respiration
Difficult respiration because of pulmonary edema. Cases of older people with a history of continuous colds, coryza, bronchitis and, finally, dyspnea, asthma and emphysema. When this remedy is given in this last stage, it will palliate but not really cure.
Kent writes, "This remedy is full of catarrhal symptoms and cough, with much rattling of mucus in the chest, and air passages. Oppression of breathing, a catarrhal dyspnea. Especially is this remedy useful, when the symptoms agree, in hypostatic congestion of the lungs, a filling up of the chest with mucus which is difficult to expel... Old people who suffer from catarrh of the chest have an aggravation at 3 a.m. , with the palpitation and prostration, waking up at that hour with cold sweat and dyspnea."
There is a great accumulation of serous fluid in the lungs, with strong rales and ronchii; the fluid cannot be expectorated due to a general weakness of the patient. Another good description is provided by Hering, "Sputa thin, foamy; adynamic state, with rattling of large bubbles in the chest. Bronchitis in the aged... Cough with spitting of blood, previous sweet taste and great dyspnea, with stitches in small of back and pit of stomach."
Open air ameliorates the asthmatic respiration; a warm room aggravates. Difficult respiration in a warm room; he becomes deathly pale and must remain quiet. Dry, hacking cough, which is worse after midnight and at 3 a.m. Stitching pain in right side of chest on stooping.
Back
Pain between scapulae during menses. Drawing pain between scapulae during menses.
Extremities
Convulsions in the upper limbs, drawing limbs backward. Cramps in leg, in region of tibia. Cramps in calves and soles.
Fullness in the veins of the hand after washing in cold water. Panaritum. The finger is extremely inflamed, with deep-seated periosteal pain and redness, which extends up the arm. Hands cold and blue; distended veins.
Inflammation of first toe, repeated inflammations after injury. Pain in left first toe. Pain in first toe, in evening, in bed. Pain in jerking knee. Tearing in joints, relieved by heat of bed; inclination to stretch limbs. Chronic effects of sprains.
Skin
Clinical
Respiratory
Cough. Asthma. Emphysema. Asphyxia, suffocation from charcoal fumes. Bronchitis. Acute pulmonary edema.
Heart
Angina pectoris. Enlargement of the heart. Heart failure. High blood pressure.
General
Pains from dislocations. Pains in bones. Sprains. Pain in sternum. Toothache. Enuresis. Hemorrhoids. Bursting headaches. Cataract. Rickets. Uremia. Parotitis. Bleeding tendency from everywhere. Blood changes rapid. Due to degeneration of blood tissue, the hemorrhages are characterized by dark, clotted blood.
Skin and mucosa
Erysipelas. Measles. Miliary eruptions. Sensitive gums. Scarlatina. Whitlow.
Causation
Poisoning from charcoal fumes, from pollution of the atmosphere with exhaust gases.
Relationships
Compare: the Ammonias, Antimonium tartaricum, Carbo vegetabilis, Kali carbonicum, Arsenicum, Lachesis.
Remedies that follow well: Belladonna, Bryonia, Lycopodium, Pulsatilla, Phosphorus, Rhus toxicodendron, Sepia, Sulphur and Veratrum album.
Antidotes
It antidotes: Rhus poisoning, stings of insects, poisoning from charcoal fumes.
It is antidoted by: Arnica, Camphor and Hepar sulphuris; vegetable acids and fixed oils.
Inimical: Lachesis, sweets and warm food.
Dosage
From 12c to 1m.
Generalities
Ammonium carbonicum is a remedy that is indicated in constitutions which have difficulty in oxygenating the blood; this is the first remedy indicated for asphyxia from charcoal fumes. It is one of the best remedies for emphysema with cyanosis. The circulation becomes sluggish.
This remedy will be indicated when there is a defective reaction to severe febrile diseases, such as typhoid fever, diphtheria, malignant scarlet fever, erysipelas, etc., especially when several incorrect remedies have been prescribed, confusing the case and leaving the patient looking exhausted and almost pulseless with a weak heart.
The remedy should be remembered in cases of cerebrospinal meningitis when the patient is first striken by the disease, falling into a semi-comatose state. The body is cold, the pulse very weak, the surface of the body cyanotic. This remedy will help to establish a reaction.
Another general characteristic of this remedy is a tendency to hemorrhages of dark blood, sometimes black, that will not coagulate.
Ammonium carbonicum cases are very much aggravated by cold and wet weather and by stormy or cloudy conditions, with the exception of the dyspnea, which is very much aggravated in a warm room. In a warm room they become pale and so much worse that they have to sit down and avoid any movement at all. Walking outside in cold air makes them feel terrible; they will avoid it at any cost.
Water seems to aggravate these patients considerably. They are averse to bodily contact with anything wet; consequently they do not like to wash and sometimes avoid bathing so assiduously that they become a significant problem for others living with them.
Women are aggravated during the menses, and many have to stay in bed during this period. Symptoms resembling cholera, with constant diarrhea and vomiting, may arise during the menses. Hysterical women with a tendency to faint.
There is also aggravation from motion, from chewing or pressing the teeth together, and from bending down. The time of greatest aggravation is between 3 and 4 a.m. , leading to ready confusion with Kali carbonicum in cases involving lung pathology. There is amelioration by lying down, especially on the abdomen, and by becoming warm in bed. Better lying on the painful side.
Vertigo
Vertigo on reading in a sitting position, in the morning or the evening.
Head
Pulsating, beating, throbbing headaches, mostly in the forehead, after dinner; after eating; while riding in cold air. Congestive headaches during wet weather, aggravated by walking in the open air. The most characteristic headache is a pressive one situated at the root of the nose which gives the impression as if the forehead would burst. A warm room ameliorates a pulsating sensation in the head. The headaches are worse when stepping and in the morning on waking, better with pressure and in a warm room. Headache with nausea.
Sensation as if the brain would ooze out through the forehead and eyes. The brain seems loose. When biting the teeth together or when chewing, there are shocks which pass through the head, eyes, ears and nose.
Eye
Burning of the eyes with aversion to light. Sensation as if there were sand in the eyes. Right eye feels as if bathed in hot water. Eye strain. After strain, muscular asthenopia. Pain in the eyes, better from afternoon sleep. Lids become swollen, dry and cracked from the excoriating fluid discharged from the eyes. Eyes bloodshot with lachrymation.
Vision
Sparks before the eyes at night; on waking. Double vision. Large black spots float before the eyes after sewing. Cataract of right eye.
Ear/hearing
Discharge of acrid fluid from the ears. Shocks through ears, eyes and nose when biting teeth together or chewing.
Painful sensibility, increased in deaf ear. Hardness of hearing.
Nose
Coryza in hysterical females and old people with discharge of sharp, acrid, burning water. Stoppage at night; cannot breathe at all through the nose; the nostrils are completely blocked.
Epistaxis, mostly from the left nostril, when washing the hands and face, and also after eating. Tip of nose congested. When stooping, the blood rushes to the tip of nose, causing it to become red.
Face
The face becomes heated when talking about an exciting subject, also when eating. Tetters (skin eruption) around the mouth. Hard swelling of the cheek. Boils and pustules during the menses. The corners of the mouth are sore, cracked and burn; at the same time the middle of the lips are cracked because of an acrid saliva. Boils and pustules during the menses. Cyanosis of the lips, across the nose, and even of the fingertips in cases of acute pulmonary edema or pneumonia.
Mouth
Redness and inflammation of the inner mouth and pharynx. Sensation as if the mouth were swollen. Swelling internally of the cheeks. Food tastes metallic. Taste sour; metallic. Great dryness of the mouth and throat. Vesicles on the tongue. Cracking of the jaw on chewing.
Teeth
Drawing pain in the teeth during menses. Tearing pain when biting the teeth together. Toothache. Pressing teeth together sends shocks through the head, eyes and ears.
Throat
The tonsils are highly inflamed and look almost bluish-purple. Gangrenous ulceration of the tonsils with great general exhaustion. There are varying degrees of throat inflammation ranging from simple sore throats to severe inflammations with purple fauces, swelling, ulcerations and bleeding; there are also putrid inflammations, especially in cases of scarlatina or diphtheria. The glands of the throat and neck swell, becoming large and lumpy. In diphtheria, the child gasps for breath and starts from sleep; this happens again and again, as soon as the child falls asleep.
The picture of this remedy in throat and skin affections is very similar to that of Lachesis, a remedy which is inimical to Ammonium carbonicum because of such similarities. In reality, however, it is very difficult to confuse these two remedies, so divergent are their overall pictures.
Stomach
Suppressed eructations. Eructations. Flatulent dyspepsia. Pain in the epigastrium, like a constant weight, worse after eating, especially meat. Pressure ameliorates cramping, griping, constricting pain in the stomach. Pressing pain in the stomach from clothing. Tenderness and pain in the pit of the stomach, with heartburn. Constrictive pain in the pit of the stomach, with heartburn, nausea, waterbrash and chilliness; better lying down and better pressure.
Great appetite, but easily satisfied. No relish of food. Desire for sugar. Aversion to milk. Much thirst, especially when eating.
Abdomen
Cramping, griping pain in cold air. Shooting pains in the liver area. Noises and pain in the abdomen. Elastic swelling in the groin, like a flatulent hernia.
Rectum
Diarrhea acrid; burns the anus. Constipation, difficult evacuation. Bleeding piles; worse during menses. Protruding piles, worse after stool, better lying down. Itching of anus. Lying on the back ameliorates the pain in the rectum. Painful tenesmus during menses.
Stool
Stools difficult, hard and knotty. Discharge of blood before and after stool.
Urinary
Frequent desire; involuntary urination at night. Tenesmus of bladder. Urine bloody and fetid. Sand-white sediment.
Genitalia-male
Ammonium carbonicum males are sensitive to sexual impressions, leading to masturbation; sometimes there is violent sexual desire without erections or erections without desire. Seminal emissions, even after coition. Itching and pain of the scrotum and spermatic cords.
Genitalia-female
Cholera-like symptoms (diarrhea and vomiting) at the beginning of the menses. Irritation of the clitoris with hysterical reactions in young women. Copious menses from riding in cold air. Menstrual flow is increased while standing. Menses frequent and profuse, with clotted, black blood. Reserved during menses.
Itching, swelling and burning of pudendum. Leucorrhea -- burning, acrid, watery. Aversion to the other sex; aversion to coition.
Larynx and trachea
Saltish mucus in larynx. Tickling in air passages after 3 a.m. Hoarseness.
Respiration
Difficult respiration because of pulmonary edema. Cases of older people with a history of continuous colds, coryza, bronchitis and, finally, dyspnea, asthma and emphysema. When this remedy is given in this last stage, it will palliate but not really cure.
Kent writes, "This remedy is full of catarrhal symptoms and cough, with much rattling of mucus in the chest, and air passages. Oppression of breathing, a catarrhal dyspnea. Especially is this remedy useful, when the symptoms agree, in hypostatic congestion of the lungs, a filling up of the chest with mucus which is difficult to expel... Old people who suffer from catarrh of the chest have an aggravation at 3 a.m. , with the palpitation and prostration, waking up at that hour with cold sweat and dyspnea."
There is a great accumulation of serous fluid in the lungs, with strong rales and ronchii; the fluid cannot be expectorated due to a general weakness of the patient. Another good description is provided by Hering, "Sputa thin, foamy; adynamic state, with rattling of large bubbles in the chest. Bronchitis in the aged... Cough with spitting of blood, previous sweet taste and great dyspnea, with stitches in small of back and pit of stomach."
Open air ameliorates the asthmatic respiration; a warm room aggravates. Difficult respiration in a warm room; he becomes deathly pale and must remain quiet. Dry, hacking cough, which is worse after midnight and at 3 a.m. Stitching pain in right side of chest on stooping.
Back
Pain between scapulae during menses. Drawing pain between scapulae during menses.
Extremities
Convulsions in the upper limbs, drawing limbs backward. Cramps in leg, in region of tibia. Cramps in calves and soles.
Fullness in the veins of the hand after washing in cold water. Panaritum. The finger is extremely inflamed, with deep-seated periosteal pain and redness, which extends up the arm. Hands cold and blue; distended veins.
Inflammation of first toe, repeated inflammations after injury. Pain in left first toe. Pain in first toe, in evening, in bed. Pain in jerking knee. Tearing in joints, relieved by heat of bed; inclination to stretch limbs. Chronic effects of sprains.
Skin
Clinical
Respiratory
Cough. Asthma. Emphysema. Asphyxia, suffocation from charcoal fumes. Bronchitis. Acute pulmonary edema.
Heart
Angina pectoris. Enlargement of the heart. Heart failure. High blood pressure.
General
Pains from dislocations. Pains in bones. Sprains. Pain in sternum. Toothache. Enuresis. Hemorrhoids. Bursting headaches. Cataract. Rickets. Uremia. Parotitis. Bleeding tendency from everywhere. Blood changes rapid. Due to degeneration of blood tissue, the hemorrhages are characterized by dark, clotted blood.
Skin and mucosa
Erysipelas. Measles. Miliary eruptions. Sensitive gums. Scarlatina. Whitlow.
Causation
Poisoning from charcoal fumes, from pollution of the atmosphere with exhaust gases.
Relationships
Compare: the Ammonias, Antimonium tartaricum, Carbo vegetabilis, Kali carbonicum, Arsenicum, Lachesis.
Remedies that follow well: Belladonna, Bryonia, Lycopodium, Pulsatilla, Phosphorus, Rhus toxicodendron, Sepia, Sulphur and Veratrum album.
Antidotes
It antidotes: Rhus poisoning, stings of insects, poisoning from charcoal fumes.
It is antidoted by: Arnica, Camphor and Hepar sulphuris; vegetable acids and fixed oils.
Inimical: Lachesis, sweets and warm food.
Dosage
From 12c to 1m.
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