Smelling salts

File:First aid ammonia inhalant capsules.jpg

Two capsules of smelling salts from a first-aid kit. A thin inner glass tube contains alcohol and ammonia; the outer layer is cotton and netting. When crushed, the liquid is released into the cotton, while the glass shards are retained inside. The ammonia-soaked cotton is waved in front of the nose for the treatment of fainting.

Smelling salts, also known as ammonia inhalants, spirit of hartshorn, or sal volatile, are chemical compounds used as stimulants to restore consciousness after fainting.<ref name="BJSM" />

Usage

The usual active compound is ammonium carbonate—a colorless-to-white, crystalline solid ((NH₄)₂CO₃).<ref name="BJSM" /> Because most modern solutions are mixed with water, they should properly be called "aromatic spirits of ammonia".<ref name="BJSM" /> Modern solutions may also contain other products to perfume or act in conjunction with the ammonia, such as lavender oil or eucalyptus oil.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Historically, smelling salts have been used on people feeling faint,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="scifun">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> or who have fainted. They are usually administered by others but may be self-administered.

Smelling salts are often used on athletes who have been dazed or knocked unconscious to restore consciousness and mental alertness.<ref name="BJSM" /> Smelling salts are now banned in most boxing competitions because of the concern that their effect could mask a more serious injury.<ref name="goodchild-donaldson">Template:Cite journal</ref>

They are also used as a form of stimulant in athletic competitions (such as powerlifting, strong man, rugby and ice hockey) to "wake up" competitors to perform better.<ref name="BJSM" /><ref name="BBC1" /> In 2005, Michael Strahan estimated that 70–80% of National Football League players were using smelling salts as stimulants.<ref name="FTU">Template:Cite news</ref>

History

File:M0354 1951-23-102 2.jpg

Flask with smelling salts, used for reviving dental patients after a procedure. French, 18th century.

Smelling salts have been used since Roman times and are mentioned in the writings of Pliny as Hammoniacus sal.<ref name=BJSM>Template:Cite journal</ref> Evidence exists of use in the 13th century by alchemists as sal ammoniac.<ref name=BJSM/> In the 14th-century "The Canon's Yeoman's Tale", one of Chaucer's The Canterbury Tales, an alchemist purports to use sal armonyak.<ref name="prewitt">Template:Cite magazine</ref> In the 17th century, the distillation of an ammonia solution from shavings of harts' (deer) horns and hooves led to the alternative name for smelling salts as spirit or salt of hartshorn.<ref name=BJSM/>

They were widely used in Victorian Britain to revive fainting women, and in some areas, constables would carry a container of them for that purpose.<ref>Template:Cite news</ref> At that time, smelling salts were commonly dissolved with perfume in vinegar or alcohol and soaked onto a sponge, which was then carried on the person in a decorative container called a vinaigrette.<ref name="Sampson Mordan">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The sal volatile appears several times in Dickens' novel Nicholas Nickleby.

The use of smelling salts was widely recommended during the Second World War, with all workplaces advised by the British Red Cross and St. John Ambulance to keep smelling salts in their first aid boxes.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Physiological action

File:Rembrandt van Rijn - Unconscious Patient (Allegory of Smell) - RR-111 - Leiden Collection.jpg

Rembrandt's Unconscious Patient (Allegory of Smell) shows a woman using smelling salts to revive a man who has fainted at the hands of a barber-surgeon.

Solid ammonium carbonate and ammonium bicarbonate salts partly dissociate to form Template:Chem, Template:Chem and Template:Chem vapour as follows:

The smelling salts release ammonia (Template:Chem) gas, which triggers an inhalation reflex. It causes the muscles that control breathing to work faster by irritating the mucous membranes of the nose and lungs.<ref name=BBC1>Template:Cite news</ref>

Fainting can be caused by excessive parasympathetic and vagal activity that slows the heart and decreases perfusion of the brain.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The sympathetic irritant effect is exploited to counteract these vagal parasympathetic effects and thereby reverse the faint.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Risks

Exposure to ammonia gas in large concentrations for prolonged periods is toxic and can be fatal.<ref name="BJSM" /><ref name="scifun" /> If a high concentration of ammonia is inhaled too close to the nostril, it might burn the nasal or oral mucosa. The suggested distance is Template:Convert.<ref name="BJSM" />

The use of ammonia smelling salts to revive people injured during sport is not recommended because it may inhibit or delay a proper and thorough neurological assessment by a healthcare professional,<ref name="BJSM" /> such as after concussions when hospitalization may be advisable, and some governing bodies recommend specifically against it.<ref name="thefa">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The irritant nature of smelling salts means that they can exacerbate any pre-existing cervical spine injury by causing reflex withdrawal away from them, although this has been found to be a result of holding the smelling salts closer to the nose than recommended.<ref name="BJSM" />