Ammonium causticum

 Chemical formula, NH3.
 Preparation: Solution of the gas in water.

 Mind.
 The patient, perfectly comprehending his condition, resigns himself to despair.
 Remarkable timidity.
 His intellect was clear.
 Unconscious.

 Head.
 Slight confusion in the head, with rumbling in the abdomen (in six minutes).
 Slight confusion in the head, with pressure in the temples, ceasing almost entirely in ten minutes (in a quarter of an hour).
 Sensation as if the brain protruded at the centre, forward, and on both sides, and the skull was quartered, but without pain and without confusion of the head.
 The forehead, where the blood vessels are full of blood, feels hot to the touch.
 Pressure in the frontal region, with feeling as if the head would split, but without pain, which lasts a few minutes (in seven minutes).
 Slight pressure at the occiput, lasting ten minutes (in half an hour).
 Eyes.
 Eyes red, shining.
 The eyes sunken; the pupil widely dilated.
 Lachrymation.
 Ears.
 Deafness.
 Nose.
 Peculiar redness of skin over nose and frontal sinuses.
 Coryza.
 A watery fluid runs at intervals from the nasal cavities, and the air is completely excluded from them.
 Face.
 The face is altered.
 The expression was anxious.
 The whole expression of his face showed the greatest anguish.
 Extremely pale face, expressive of the greatest suffering.
 Face always very red during the febrile exacerbations.
 His distorted features had red spots.
 His lips were rather swollen.
 Lower lip swollen to three times it normal size.
 Small black coating on the middle of the lower lip.
 The mucous membrane of the lips and nose was destroyed.

 Teeth clenched.
 The surface of the tongue is white.
 The tongue appeared deprived of its epithelium; only on solitary places could some white membrane still be seen, and nearly the whole fauces showed the same state.
 Curled pieces of white skin are detached from the tongue and throat, and those parts appear red.
 The tongue, the palate, and the entire oesophagus, as far as visible, are whitish and partly covered with blisters.
 Burning and scraping at the root of the tongue and posterior portion of the oesophagus (while swallowing the medicine).
 Small black coating on the tip of the tongue.
 The entire buccal cavity, the mouth, the tongue, and probably a great part of the oesophagus and stomach, are raw, denuded of epithelium.
 The mucous membrane of the mouth, and all the visible parts of the throat, were dark-red, swollen, and tender; the epithelium was detached in different places.
 The penetrating smell of Ammonia was still clearly perceptible in his breath, although he had taken so much vinegar.
 From mouth and nose flowed a large quantity of bloody fluid.
 Profuse bloody salivation.
 Foaming from mouth.
 Throat.
 Throat externally red, and the soft parts swollen.
 Burning pain in throat.
 Burning pain from the mouth to the region of the stomach.
 Burning heat at the throat.
 Burning pain at throat and stomach.
 Lancinating and scraping sensation at the throat (immediately after taking the medicine).
 Scraping at the throat (when swallowing the medicine).
 Deep redness of the velum, its pillars, the tonsils, and the posterior wall of the pharynx.
 The uvula is contracted and covered with white mucus.
 The tonsils appear scarcely at all enlarged.
 The posterior wall of the pharynx, and the epiglottis, were deeply reddened, and like the mouth, with most intense pain in the throat.
 Dryness in oesophagus.
 Great difficulty in swallowing.
 Could scarcely swallow.
 He swallowed with difficulty some vinegar and water, but it seemed to relieve him.
 After two hours of great anxiety, the patient complained mostly of his throat, as swallowing was still nearly impossible.

 Very urgent thirst.
 Thirst.
 Very urgent thirst, with difficult deglutition.
 He is consumed with thirst, and yet is unable to get down a drop of liquid.
 Thirst very strong, without the power to swallow.
 Eructations which do not smell of Ammonia (soon after taking the medicine).
 Constant mucous vomiting.
 He passes an immense quantity of mucus from the mouth.
 He throws up by the mouth and nostrils quantities of a whitish fluid which burns wherever it touches, and smells like sal volatile liniment.
 He immediately screamed and was very sick, bring up at first stringy mucus of a light color, and them some more dark.
 Vomiting blood.
 The right hand automatically pointed in the stomach region.
 He was allowed to get up on the fifteenth, but the next day a hearty meal gave him very great pain.
 Heartburn.
 There was burning pain in the track of oesophagus, none in the stomach itself, but its region was tender on pressure.
 Epigastrium swollen and tender.
 Great sensitiveness of the epigastric region; very small pulse, with shivering (at 4 P.M).
 Abdomen.
 Great pain and tenderness in left hypochondrium and at epigastrium.
 There was no abdominal distension.
 The abdomen was soft.
 Rumbling in abdomen.
 Inexpressible pains in the upper part of the intestinal tube.
 Pains in lower abdomen, back, and sacral region.
 Stool and Anus.
 Spasmodic contraction of the rectum; an injection spouted forcibly from the rectum as soon as thrown up.
 The vomiting is followed by several stools, which cause a violent burning at the anus.
 Solid stool (he has already had the usual morning evacuation), with cessation of the confusion of the head (in six minutes).
 Copious hemorrhagic stools.
 Bloody stools, very frequent.
 Evacuation of some pints of clear blood, with excessive tenesmus.
 The poison was taken March 7th, but his bowels did not act till the 12th, and then only after a purgative.
 Suppression of a chronic looseness of the bowels.

 Scanty, red urine.
 The urine was alkaline and dark-yellow.
 Urine smelling of ammonia.
 Next day, the urine contained a good deal of sediment, consisting of urates.
 Sexual Organs.
 The menses, hitherto always regular, are fifteen days too early, and very profuse.

 Slight, rather coarse mucous rales were heard in the larynx and trachea.
 He had a constant tickling in larynx, with pain in epigastrium.
 For several days, he suffered from a bronchitis, with profuse expectoration, but it took nearly a week till his voice returned, and he regained his strength only by slow degrees.
 Speech fatiguing, interrupted.
 The voice was low and weak, speech fatiguing and interrupted, on account of the condition of the respiratory function.
 She could hardly speak, because the effort to do so fatigued her exceedingly, and caused pain in the chest, The voice was rough, weak and hoarse.
 Dull, hoarse voice.
 Weak and indistinct voice.
 Voice deep, weak.
 Speech wanting.
 Obstinate cough.
 Cough, with copious mucous expectoration.
 Cough and much expectoration, especially after drinking.
 Cough, with profuse mucous expectoration, and excited by drinking.
 When he tries to drink, severe cough, with expectoration of slimy masses.
 The cough and expectoration are especially excited by the contact of liquids with the back of the mouth; only a very little passes into the oesophagus.
 Spasmodic cough, lasting an hour, during which he expectorates a great quantity of membrane.
 He hawked and expectorated continually, although doing so gave him great pain.
 Blood expectoration.
 Respiration heavy and rattling.
 Every respiration produces a kind of rattling noise.
 The breathing harsh, hurried, and somewhat obstructed.
 Respiration difficult.
 Very great difficulty in breathing.
 Great difficulty in breathing.
 Difficult, quick, stertorous breathing.
 Was aroused from sleep by a suffocative feeling.
 Spasm of the glottis; death from asphyxia.
 Chest.
 Continuous mucous rattling in chest.
 The chest-sounds were normal.
 Pain in the whole chest, with suffocative anguish.
 Inclination to draw a long breath, which is prevented by a violent pain in the chest towards the back, evidently in the oesophageal region.
 Great oppression and want of air.
 Extreme oppression of the chest, with increased rattling and threatened suffocation.
 Lung-catarrh.
 The praecordial region is distended and painful.
 Extremely violent anguish at the praecordia, with great oppression of the chest.

 Pulse small, weak, rapid.
 Small, frequent, and weak pulse.
 Very small and moderately frequent pulse, but it increases in frequency from hour to hour.
 The pulse was quickened five beats per minute (usual rate 70); it was also somewhat hard.
 Pulse so slow and intermittent that it was difficult to count it, as were also the beats of the heart.
 Pulse 60, small and hard.
 Pulse weak, irregular.
 Small, depressed, scarcely perceptible pulse.

 Convulsive twitches of right arm.

 State of irritation and of extraordinary suffering.
 In the evening, the patient was greatly excited; pulse quite small and very quick, with increased oppression.
 After a venesection, the patient got more quiet, and the blood expectoration ceased. Motorial power intact.
 He had perfect sensibility, and not much distress of countenance.
 Great weakness.
 Great debility.
 Great prostration.
 Remarkable exhaustion; his muscular strength is diminished to a degree and not proportioned to the duration of the disease.
 On trying for the first time to get out of bed, he was unable to stand on his legs, and at the least effort, he trembled violently.
 Bleeding from the mouth, nose, eyes, ears, which cause faintness.

 Skin.
 The skin was pale, cold, and had lost its elasticity.
 The application of a blister plaster takes off the skin, but does not excite the secretion of serum.
 Erysipelas.
 Skin hot, not dry.
 Hot, dry skin.
 Dry skin.
 Cutaneous sensibility intact.

 Heat in chest and at stomach.

 Sleepless night.
 Very restless night.

 Conditions. Aggravation.
 (Evening), Great excitement, etc.
 (After drinking), сough, etc.
 (After hearty meal), Great pain in stomach.
 Amelioration.
 (Solid stool), сonfusion of the head.
 (After venesection), More quiet, etc.
 (Vinegar and water), Seemed to relieve him.

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