 |
| Nitroglycerine |
Glon.
Keep your head and heart going the right direction
and you’ll not have to worry about your feet.
[McKenzie]
Signs
Nitroglycerin. Glyceryl trinitrate. Glonoin.
CHEMISTRY Nitroglycerin is an explosive liquid which was first made by Ascanio Sobrero in 1846 by treating glycerol with a mixture of nitric and sulphuric acid. The reaction which follows is highly exothermic, i.e. it generates heat and will result in an explosion of nitroglycerin unless the mixture is cooled while the reaction is taking place. It is a pale, yellow, oily liquid with a sweet burning taste, producing headache on tasting. It is soluble in alcohol but insoluble in water. Hering gave it the name “glonoinum” in allusion to its components: “Glycyl-Oxyd and Nitrogen Oxygen.”
EXPLOSIVE Nitroglycerin is extremely sensitive to the slightest jolt, impact or friction and in the early days, when impure nitroglycerin was used, it was very difficult to predict under which conditions nitroglycerin would explode. This highly explosive substance became one of the very first man-made drugs. Alfred Nobel was the first to produce nitroglycerin on an industrial scale. By mixing nitroglycerin with an inert binder, silica, Nobel produced a paste, which he called dynamite, that could be kneaded and shaped into rods. Like many nitrogen compounds, nitroglycerin is light-sensitive. It is the speed of the decomposition reaction which makes nitroglycerin such a violent explosive. It is decomposed almost instantaneously by a supersonic shock wave passing through the material. This instantaneous destruction of all the molecules in the sample is called a detonation, and the rapid expansion of hot gases that results is what causes the destructive blast.
TOXICITY Toxic effects may occur by ingestion, inhalation of dust or absorption through intact skin. Acute poisoning occurs especially in industrial workers; it includes nausea, vomiting, abdominal cramps, headache, mental confusion, delirium, bradycardia, breathing difficulties, paralysis, convulsions, methaemoglobinaemia and cyanosis, circulatory collapse, death. Chronic poisoning is characterised by severe headache, hallucinations, and skin rashes. Alcohol aggravates symptoms; it may cause low blood pressure and circulatory collapse. ‘Monday morning sickness’ is a common symptom among workers in explosives factories. During the week tolerance to the effects of nitrates develops quickly, but this wears off after a brief nitrate-free interval [weekend], so that the symptoms reappear on Mondays.
MEDICINE Nitroglycerin dilates blood vessels by relaxing the smooth muscles surrounding them. lt was originally believed that nitrates and nitrites dilated coronary blood vessels, thereby increasing blood flow to the heart. It is now believed that atherosclerosis limits coronary dilation and that the benefits of nitrates and nitrites result from dilation of arterioles and veins in the periphery. The resulting reduction in preload and to a lesser extent in afterload decreases the work load of the heart and lowers myocardial oxygen demand. Short-acting nitroglycerin preparations act within seconds to relieve acute symptoms of angina pectoris. Nitroglycerin is used to treat or prevent chest pain in people with angina pectoris and to treat instances of congestive heart failure.
SIDE EFFECTS The most common side effects of nitroglycerin preparations are [transient but severe] headaches and dizziness. Other adverse reactions include postural syncope, reflex tachycardia, hypotension, nausea and vomiting, allergic reaction, muscle twitching, diaphoresis. Contraindications for its use are: hypersensitivity, hypotension, head injury and cerebral haemorrhage.
NOBEL Alfred Nobel [1833-1896] has 355 inventions to his name and yet the theme of his life was explosives, in particular nitroglycerin and dynamite. The first to produce nitroglycerin on an industrial scale, it was nitroglycerin where his life was all about: he made his fortune with it, got sick from it, was treated with it, and died from it. After his father went bankrupt and left Russia, Alfred stayed and started experimenting with nitroglycerin. He became the first to control its detonation, by using a wooden cap filled with gunpowder as a detonator. This was in 1862. Alfred developed a method to manufacture nitroglycerin, which he called “sprängolja” [explosive oil], and set up a factory in Stockholm with his brothers. September 1864 the whole factory blew up, causing the death of his youngest brother, Emil, and four other workers. Experiments and production now continued on a barge. More and more orders for nitroglycerin came in, but opposition to the ‘mad scientist’ grew as well. Explosives were developed further by Nobel, first as a more powerful form of dynamite, blasting gelatine, and later as one of the first nitroglycerin smokeless powders, ballistite. Nobel ran his international business from his palace-like house in Paris. He thought that peace could only be achieved if the strongest countries had enough [explosive] power to destroy each other. He thought about ‘terror balance’ before the word was even invented. Some say that this and the later established Nobel Prize were only ways for him to ease a bad conscience. In 1894 he bought the weapon factory Bofors, close to Karlskoga, Sweden, where he built a brand-new laboratory. He had great plans, such as making ‘flying rockets’ [torpedoes’], a camera to record moving pictures, etc. But Nobel was in bad health: he suffered from nitroglycerin headaches and had a heart condition for which his physicians prescribed nitroglycerin, a whim of fate he himself wrote about with great irony. On December 10, 1896 he died from a cerebral haemorrhage, leaving a fortune of 33 million Swedish kronor in trust to establish the Nobel Prizes. In his will he had specified that the awards should annually be made “to those who, during the preceding year, shall have conferred the greatest benefit on mankind” in the fields of Physics, Chemistry, Physiology or Medicine, Literature, and Peace. A sixth award, the Prize for Economic Sciences, was added in 1969 by the Bank of Sweden. 1
PROVINGS •• [1] Hering introduced the drug and made a compilation of the provings; method: tincture, 1c, 2c, 1x, 2x; mostly single doses, with short-lasting effects.
•• [2] Dudgeon – 18 provers, 1853; method: 1-2 drops of saturated solution or of 1x.
1 Lindqvist, Historien om Sverige, Ånga och dynamit [Steam and Dynamite]; Stockholm 1999.
Affinity
BRAIN. VASOMOTOR NERVES [CIRCULATION; HEAD (forehead); HEART]. Mastoids. Respiration. * Right side.
Modalities
Worse: HEAT [on HEAD; overheating; of SUN, lamp, etc.; HOT WEATHER]. MOTION [SHAKING; JAR; stooping; injury]. Wine. Suppressed menses. Weight of hat. Haircut. Ascending.
Better: Open air. Elevating head. Cool things. Pressure. Cold applications.
Comparisons
c COMMON SYMPTOMS OF AMYLENUM NITROSUM AND GLONOINUM
The nitrites, like the amyl nitrite used as ‘poppers’ for recreation, have the same basic effects as nitroglycerin. Nitrites were first synthesized and used medically in 1857, but due to their short-lasting and unreliable effect were soon replaced by nitroglycerin. Related to the dilation of blood vessels, the side effects of nitrates and nitrites are common and consistent. For recreational use, these drugs are regarded for their psychological effects, such as removal of inhibitions, skin sensitivity, and a sense of exhilaration and acceleration before sexual orgasm. There is a rather common visual disturbance consisting of a bright yellow spot with purple radiations. Some people use these drugs not for the mental effects but for their muscle-relaxing properties to permit anal intercourse. Since the advent of the nitroglycerin patch for continuous administration of the drug to heart patients, many people have been continuously exposed to nitroglycerin and have developed tolerance to it. 1
1 Kuhn, Swartzwelder and Wilson, Buzzed.
Main symptoms
M Confusion due to congestion.
Loses his way in well-known streets [but remembers other things well].
• “As he returned home through the streets, after the headache, everything seemed strange to him, not as familiar as usual; he was obliged to look about him every few moments to convince himself of being in the right street; it seemed to him as if the houses were not in their right places, on the same route that he had passed over at least four times a day for years.” [Allen] ”
• The way home seemed three times longer than usual.” [Hughes]
G Tendency to SUDDEN and VIOLENT irregularities of the circulation.
G CONGESTION; UPWARD RUSHES of BLOOD.
Flushes of heat UPWARDS.
No way back:
• “Head throbbing and bursting, especially above ears and at temples, and I experienced a choking sensation as if a ligature were tied round my neck, which kept the blood from returning from the head.” [Hughes]
G < WARM AIR. < WARM STOVE. G < Exposure to SUN. Ailments since a sunstroke. G FULL feeling internally. G Flushes of heat during menopause [and nausea and vertigo]; also during menses. G Epilepsy preceded by violent, pulsating headache. < Warm room. Followed by unconsciousness, and froth at the mouth. And Face alternately pale and bright red. P Vertigo and pulsating pain in head and flushing of face. P WAVES of terrible, bursting, pulsating HEADACHE. Sensation as if head is enlarged, distended, or smaller. As if standing on head. GRASPS / PRESSES the head to stop the pounding sensation. • “Can’t bear any heat about the head; can’t walk in the sun; must walk in the shade or carry an umbrella.” [Guernsey] P Headache – pulsating pain alternating between TEMPLES. Veins of temples distended. P Frontal headache. When looking long at anything. < Moving or shaking head sideways. [This modality occurred in three provers.] P Headache from overheating in the sun or from SUNSTROKE. Distressing after-effects of sunstroke. • “Sunstroke: face pale, full round pulse, laboured respiration, eyes fixed, cerebral vomiting, white tongue, sinking at the pit of the stomach.” [Dewey] P Red, injected, hot eyes during headache, with wild expression and STARING. P Basedow’s disease. And Pulsating carotids, violent palpitation, bursting headache and rush of blood to face. P Cardiac pains, radiate to all parts, toward arms. P Blood surging back and forth from HEAD to HEART. Rubrics Mind Ailments from quarrelling [1]. Aversion, to husband and children [2]. Confusion, knows not where he is [3], loses his way in well-known streets [3]. Delusions, distances are enlarged [1], objects are enlarged [1], he were hanging with his head downward [1/1], he will become insane [1]. Dwells, long forgotten offences come back to him [1/1]. Fear, of open spaces, during menopause [2/1], from sensation of swelling of throat [2]. Doesn’t recognize anyone [2]. Time appears longer, passes too slowly [3]. Vertigo Riding in a carriage > [1]. From sunlight and heat [2]. After tea > [1/1].
Head
Congestion, alternating with congestion to heart [2; Calc-ar.*]; at every throb of heart [2; Cimic.]. Enlarged sensation, during menses [2]. Holds head with hands [1; Ferr.*]. Sensation as if skull were lifted up [1]. Pain, begins with the warm weather [1].
Eye
As if eyes were falling out [1]. Pain, eyes as if being pulled out [2]. Staring, during headache [3].
Vision
Colours, black spots during headache [2], black spots on turning quickly [2/1], black spots with vertigo [2]. Hemiopia, right half lost [1]. Objects seem small [2].
Face
Heat, during palpitation [2]. Sensation of swelling, lower lip [1/1].
Mouth
Sensation as if tongue were enlarged [1]. Taste, of pine-wood [1/1].
Throat
Choking, with headache [2/1]. Constant disposition to swallow, at night [1].
Stomach
Flushes of heat, extending to head [2]. Vomiting, after coffee [1].
Abdomen
Flushes of heat rise from hypochondria [1].
Urine
Copious, during headache [2].
Female
Menses, scanty, < physical and mental exertion [2]. Chest Palpitation, > motion [1], during pains [1], > walking [1].
Limbs
Sudden heat of hands [1]; heat of soles of feet, uncovers them [1]. Pulsation, hands, on touching anything [1/1]; fingertips [1]. Sensation as if tied, wrist [1], with lame feeling in arm [1*]. Trembling, hands, during headache [1].
Sleep
Disturbed, by dryness of mouth and thirst [1*], by visions of innumerable multitudes of heads, with comical expressions of features [1*].
Dreams
Homesickness [2].
Perspiration
During headache [1].
Generals
Pain, appears suddenly [2], extending upward [2]. Warm stove < [3]. * Repertory additions [Hughes]. Food Aversion: [1]: Wine. Desire: [2]: Cold drinks; smoking. [1]: Alcohol. Worse: [2]: Wine. [1]: Coffee; peaches. Better: [1]: Coffee; tea; wine.