No. XI.] APPENDIX. 197 



but as such a case has not occurred in my own practice for a long period 

 I am unable to speak practically upon the matter.* 



In old-standing cases of asthma, especially in those in which the 

 medical man considers that the internal use of the sesquicarbonate of 

 ammonia is indispensable, in which the extremities are cold, the pulse 

 feeble, and the general vital powers depressed, the local application of 

 ammonia is particularly grateful, the patients feeling, as they describe it, 

 a glow after its exhibition, and the warmth first imparted to the lungs 

 extending by degrees over their whole system. 



In cases where the patient feels a peculiar sense of contraction upon 

 passing into cold atmospheres, as though the lungs resisted the intrusion 

 of so unpleasant an agent, the inhalation of ammonia seems to quiet the 

 spasmodic action, relieve the breathing, and give a comfort to the whole 

 chest, which is delightful to the feelings of the sufferer. 



Perhaps it is almost needless to notice that this remedy would be 

 deleterious when either special organs or the general system are attacked 

 with acute inflammation, for there is but little doubt that the ammoniacal 

 vapour is a decided stimulus, first locally in those parts with which, it 

 comes in contact, and, secondly, on the system in general, by its absorp- 

 tion into the circulation. As a stimulating agent it must obey the laws of 

 stimulants generally. It should not, therefore, be employed when the part 

 with which it comes in contact is inflamed, nor when a dry parched 

 tongue, a full pulse, and a dry skin, denote a feverish system. In all 

 chronic cases, or even occasionally with acute cases, with a feeble circula- 

 tion, in fact, whenever the system is depressed, and stimulants are advi- 

 sable, the inhalation of ammonia may be used with the greatest advantage 

 and comfort to the patient. 



I have made inquiries of those who have to deal with large quantities 

 of ammonia, and are necessarily exposed to the inconvenience of a large 

 escape of gas, but cannot find that even with extensive exposure it ever 

 exercises poisonous or deleterious effects, nor does K-amazzini, in his 

 curious little treatise on tradesmen's diseases, notice its action. 



Not alone to the relief and cure of diseases is ammonia capable of 

 lending its aid as a remedial agent, for it is an invaluable and effectual 

 antidote to certain direct and powerful poisons. One of these poisons, the 

 effects of which it thus counteracts, is bromine. This volatile fluid is per- 

 haps one of the most deadly poisons with which we are acquainted. It 

 lowers the circulation with great rapidity, and makes the action of the 

 heart irregular, and unfortunately, from its volatile nature, cannot well be 

 used without considerable escape. Its hurtful action on the animal 

 economy is instantly counteracted by the vapour of ammonia, for when 

 the two gases meet, dense white fumes are produced, when bromine pro- 

 bably ceases to exert its baneful influence, or at any rate only to a much 



* The inhalation of ammonia might, perhaps, also perform the same good 

 offices to syphilitic ulceration of the throat as cinnabar fumigation is known 

 usually to effect. The use of the cinnabar, however, may be so much dispensed 

 with by the antimonial and antimonio-ferruginous treatment which I have 

 recorded (' Med. Gaz.'), that the ammonia has not been used in any of these 

 cases ; but should further information be obtained upon this point, it will be the 

 subject of a future communication. 



