Ammonium picricum

Volume I — Appendix

(Carbazotate of Ammonia.)

Description. — The Picrate of Ammonia is a yellow crystalline salt, very soluble in water, but sparingly so in alcohol. It is very bitter, and stains organic matters yellow.

Preparations. — Trituration, or alcoholic tinctures.

(No Proving.)

° Intermittent fever. 0 Bilious headache. ° Cerebro-spinal headache.

Volume II — Special Therapeutics

Several years ago a fragmentary proving of Picric acid was presented to the homoeopathic school. It had some very prominent and characteristic symptoms, mainly of the head, which led me to think it would prove a very useful remedy. But, notwithstanding an extensive theoretical analysis of its symptoms by one whom our school then supposed to be a man of science, the use of Picric acid has not justified the deductions and therapeutic indications based on the aforesaid analysis. The history of the use of this acid is somew7hat similar to that of Bromine. Bromine has some very suggestive cerebral symptoms, but it "was never used with any success as a curative agent in cerebral affections. But when its acid was united with alkalies, forming Bromides, those salts at once took high rank in diseases of the brain and nerve-centres. So I predict it will be with Picric acid, that the picrates will prove more useful than the acid.

The study of the provings of Picric acid and the cases of poisoning from the picrates, apparently indicate that the primary effects are to cause congestion of the brain and spinal cord. This congestion is not of an active sthenic character like that caused by Glonoin and Belladonna, but of an asthenic or passive nature. Concomitant with this asthenic congestion it inaugurates an injurious effect on the red corpuscles of the blood, so that when the secondary effects appear they take the form of cerebrasthenia and neurasthenia, with general (pernicious) anaemia. Acting upon this theory, I have used the Picrate of ammonia for several years in a class of diseases, ranged under a nomenclature now quite popular, having names such as mentioned above.

I will briefly mention the disorders in which I have found it efficient : (1.) In passive congestion or stasis of the brain, especially the medulla and cerebellum and cerebro-spinal centres, especially when due to dissipation, exhaustion from mental or physical labor, or both combined. The special symptoms indicating its use are, heavy pressive pains in the back of the head and neck (occiput and mastoid region), and also on the sides of the head to the temples

• Written for the Illinois State Homoeopathic Medical Society, 1879.

and eyes. The face is somewhat flushed, a dark, dusky color, and some unnatural heat in the head. The mind is obtuse, heavy, and indisposed to mental labor, and the whole body is in the same condition. The heaviness of the legs is quite noticeable, as is also the peculiar abnormal turgescence and irritation of the sexual organs. It may even be indicated in some of the primary stages of “ cerebrospinal fever,” so-called. Not only in acute attacks, having the above symptoms, but in many cases of chronic headache have I found it curative. The dose I have found most efficient for these symptoms and condition ranges from the 6th to 10th of Picric acid, and the 3d to 6th of Picrate of ammonia. Larger doses might aggravate, because these are primary symptoms. (2.) In cerebr asthenia, neurasthenia, and anaemia, with profound asthenia and semi-paralysis or paresis of the whole physical and mental organism, with symptoms somewhat resembling its primary ones, but conditions widely different. Picric acid and the picrates are among our most valuable medicines. Among the most characteristic symptoms of cerebrasthenia are: Headache and confusion of mind from intellectual effort; stupid, heavy slumber, which does not refresh ; also headaches from going into public meetings, from going shopping, or on a journey. All these symptoms and the condition itself are readily removed by the use of Picrate of ammonia in doses of the j^-g-th of a grain, four times a day, for weeks. I have never seen any unpleasant effects from its continued use.

In headache having a kind of periodicity this remedy acts very satisfactorily. Bilious, nervous, and even gastric headaches are apt to recur every four, seven, or fourteen days, and often once a month in women, just before or after the menses. Unless some other remedy is specially indicated I have lately prescribed Picrate of ammonia, and with very happy results. The symptoms which yield to its administration are quite similar to those of Sanguinaria, Cimicifuga, Chelidonium, Solanum, and even Pulsatilla. If, with the headaches I have mentioned, we find chlorosis or anaemia, the Picrate of iron can be substituted for the Ammonium salt /with great advantage.

Several years ago the Picrate of ammonia was praised for its antiperiodic power in the treatment of malarious intermittent fevers. But it was used so indiscriminately by the old school that

not coming up to their expectations it has been abandoned by them. There are, however, many allopaths who pronounce it excellent in a certain class of old interm ittents, probably those which have been maltreated with Quinine, and have a Quinine cachexia ingrafted upon the malarial. The picrates, like Arnica and Sulphur, are among our best antidotes of the Quinine cachexia, and they also correspond closely to the profound neurasthenia and anaemia caused by chronic malarial poisoning. During my residence in a malarial district, many years ago, I saw many cases which, were I to meet them now, I should treat with the Pierate of ammonia, and expect to cure them.

Among the protean forms of chronic ague are the periodic headaches, which strongly resemble those which the picrates cure. In some foreign journals I have seen mention of the alleged good effects of this drug in diphtheria. It was used internally and topically as a gargle. A study of the symptoms of Picric acid show considerable resemblance between some of the initial symptoms of diphtheria and that poison. Its profoundly prostrating effect on the nerve-centres remind one of those nervous lesions which often follow diphtheritic diseases.

It has been used successfully in whooping-cough. Last winter I cured several obstinate and distressing cases, both in adults and children. The treatment of whooping-cough has not covered homoeopathy with glory, notwithstanding Dunham’s excellent monograph. I am sorry to say I have never seen any brilliant curative results from remedies selected after his plan, any more than from remedies selected from Boenninghausen’s plan in the treatment of ague.

In some of the above cases of pertussis I gave disks moistened with Picrate of ammonia with results which surprised me. The paroxysms grew less in violence and in the frequency of recurrence, and in a few days disappeared nearly altogether. Before closing I will mention a method of administration of this salt which is superior to ordinary methods. It has such an intense bitter taste, so pungent and persistent, that even in the third attenuation it is quite repulsive to most patients.

The manufactured sugar-coated pilules are very eligible when

we wish to give it in doses of one-fourth, one-half, or one grain, as is sometimes required in chronic agues. But in most cases these doses are too large. The triturations are the worst form in which we can prescribe it, unless we use as high as 3C and upward. The mother tincture should be made by adding one drachm of the salt to an ounce of pure Alcohol. It will not take up all that quantity, but we have a definite saturated tincture of about onefiftieth of a grain to each drop. This should be run up to the third or sixth. My favorite preparation is the tincture for adults and the lx for children. For the administration of the tincture I prefer the disk, a delicate lozenge composed of Sugar of milk and Albumen. They are insoluble in pure Alcohol, and each will contain just about two drops of liquid. Ordinary pellets answer very well as vehicles for the higher dilutions. In illustration of the action of this drug in some obscure disorders of the cerebro-spinal centres, it may be of value to mention a few cases treated with it.

Case I. — A middle-aged woman, short, stout, and florid, troubled with acne and retarded menstruation, had been treated unsuccessfully for years for a kind of sick headache presenting the following symptoms : Every six or eight days she would wake in the morning with a violent pain in the occipital region, heaviness of the head, and vertigo when rising. This pain increased on getting up, and it extended over the sides of the head to the temples and eyes. In the afternoon nausea and vomiting of sour bilious matters occurred. Sepia, Iris, Sang., Nux and Bryonia had been tried with but little relief. I prescribed disks, saturated with the tincture of Picrate of ammonia, one every six hours, and every two hours during the pain. In six weeks she reported only one attack of headache during that time, and that a mild one. Several similar cases have since been treated successfully in the same manner.

Case II. — A physician in Wisconsin applied to me for a supposed affection of the heart. On physical examination I found no abnormal conditions, except a feeble impulse and occasional intermission. The history of the case was peculiar. Several years before I saw him his horse ran away, throwing him out of his carriage, when he received a blow on the back of his head. He was also badly frightened, but his injury was not severe enough to prevent his repairing his carriage and driving home. But he observed in a few days that on turning over in bed, or stooping, or any sudden motion, he would be seized with a “ wild feeling ” in the occiput, a trembling beating of the heart, with intermittent action, great alarm, and anxiety of mind. He became very melancholy and thought he could not live- long. He had been treated by several of our school without benefit. I at first gave him Arnica and Aconite, each in the 3d, and afterward in the 30th. I also tried Nux, Conium, and Digitalis, but he received no benefit. He then took Picric acid 6th, with some slight amelioration, but improved rapidly under the use of Picrate of ammonia tincture, one disk (two drops) three times a day. My last report from him was that for the first time in years he felt quite free from all his unpleasant symptoms.

In Intermittent Fever , (Ague), the Picrate has been used with considerable success by many Western physicians. It is claimed that in -g and J grain doses every two or four hours it will arrest the paroxysm in a large proportion of cases, and that the tendency to return is not as great as under Quinia. It has been given successfully as a prophylactic. My experience in malarial fevers has shown me that many severe cases, in fact whole epidemics, present symptoms very similar to the symptoms of Picric acid and the picrates. In such cases, therefore, will they be found best indicated and most successful. Dr. Dillenbough writes to the “Medical Times” that he finds the Picrate useful in 'pertussis. Soon after reading his article I had several obstinate cases in adults. I gave them the 1* dilution, five-drop doses, and the result was very favorable. It seemed to arrest the severity of the paroxysms at once.