Although ammonia is seldom taken long enough in medical practice to directly affect nutrition, there is evidence that its continued use will produce debilitating effects like other alkalies - as indeed might be expected from its influence on the blood. Cazenave has reported pallor, anorexia, debility, and emaciation; and Huxham, a case in which hectic, hemorrhage, and general marasmus followed upon the habitual eating of ammonia carbonate (Essay on Fevers). Prout noted a great increase in the amount of urea excreted under citrate of ammonia, taken for dyspepsia, and the same thing has been recorded in cases of debility with irritable bladder, and pale urine of low sp. gr. (Medical Times, ii., 1863). Rabuteau, however, as the result of experiments on himself in health with 75 gr. of citrate daily, found that urea was slightly diminished, and also sulphates, but that phosphates were much increased in amount. Richardson maintains that ammonia suspends oxidation, and checks formation of all downward products of albumen, and retards nutrition (Medical Times, i., 1862, ii., 1866). There are not many observations on this point, but according to Lange, ammonia carbonate may itself furnish, by decomposition, an additional quantity of urea.

Under the chloride, however, urea is distinctly increased, and oxidation of tissue rendered more active.

The iodide and bromide of ammonium exert the absorbent and sedative effects of alkaline bromides generally; if anything, they are more active and less depressing than the corresponding salts of soda and potash.

Synergists

Diffusible stimulants, heat, and, according to Gubler, opium and iodine. Both Gull and Paget have pointed out that ammonia aids the action of iodide of potassium, and it has been asserted that 5 gr. of the latter, with 3 gr. of ammon. carb., is equivalent to 8 gr. of the iodide alone (British Medical Journal, i., 1874). Volatile ammonia assists also the action of anti-spasmodics, such as valerian, castor, etc. Other alkalies and bases assist its antacid power.

Antagonists - Incompatibles

Cold, emollient drinks, quinine, tannin, interfere with the action of ammonia, and are "dynamic antidotes" (Gubler).

Incompatibles are acids and fixed alkalies, salts of iron (except the tartarated iron), calomel, lead salts, etc. Freely diluted, ammonia and its carbonate may be used as antidotes to mineral acids. Christison, Pereira, and others, consider them also antidotal to prussic acid: they certainly have dynamic effects, opposite in character to those of the acid, though they do not chemically neutralize it: they antagonize also the toxic effects of alcohol, and in some degree those of animal poisons.

Therapeutical Action (External)