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Smelling salts
Smelling salts
Smelling salts
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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.[1]

The usual active compound is ammonium carbonate—a colorless-to-white, crystalline solid ((NH4)2CO3).[1] Since most modern solutions are mixed with water, they may also be called aromatic spirits of ammonia.[1] Modern solutions may also contain other products to perfume or act in conjunction with the ammonia, such as lavender oil or eucalyptus oil.[2]

Use

[edit]

Historically, smelling salts have been used on people feeling faint,[3][4][5] or who have fainted. Others usually administer them, but they may also be self-administered.

Smelling salts are often used on athletes who have been dazed or knocked unconscious to restore consciousness and mental alertness.[1] Smelling salts are now banned in most boxing competitions because of the concern that their effect could mask a more serious injury.[6]

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.[1][7] In 2005, Michael Strahan estimated that 70–80% of NFL players were using smelling salts as stimulants.[8]

History

[edit]
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.[1] Evidence exists of use in the 13th century by alchemists as sal ammoniac.[1] In the 14th-century "The Canon's Yeoman's Tale", one of Chaucer's The Canterbury Tales, an alchemist purports to use sal armonyak.[9] 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.[1]

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.[10] 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.[11][12] 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.[13]

Physiological action

[edit]
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 NH
3, CO
2 and H
2O vapour as follows:

(NH4)2CO3 → 2 NH3 + CO2 + H2O
NH4HCO3 → NH3 + CO2 + H2O

The smelling salts release ammonia (NH
3) 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.[7]

Fainting can be caused by excessive parasympathetic and vagal activity that slows the heart and decreases perfusion of the brain.[14] The sympathetic irritant effect is exploited to counteract these vagal parasympathetic effects and thereby reverse the faint.[15]

Risks

[edit]

Exposure to ammonia gas in large concentrations for prolonged periods is toxic and can be fatal.[1][5] 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 10–15 centimetres (4–6 in).[1]

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,[1] such as after concussions when hospitalization may be advisable, and some governing bodies recommend specifically against it.[16] 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 is a result of holding the smelling salts closer to the nose than recommended.[1] The National Football League banned teams from providing smelling salts to players in 2025, though the use of smelling salts itself was still permitted.[17]

References

[edit]
[edit]
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Smelling salts

View on Grokipedia
from Grokipedia
Smelling salts are chemical preparations, typically consisting of mixed with or diluted in and , that release pungent vapors when sniffed to stimulate and revive individuals from fainting or syncope. These inhalants, also known as ammonia inhalants or aromatic spirits of , have been used since ancient times, with references dating back to the Roman era as "Hammoniacus sal" described by Pliny, evolving through medieval alchemical uses as "sal ammoniac" and 17th-century production from distilled (deer shavings) into perfumed forms popularized in the Victorian period for treating swooning, particularly among women in corseted attire. Historically employed as a folk remedy for fainting by irritating the nasal membranes and triggering a reflexive that boosts oxygen to the and activates the for an surge, smelling salts fell out of routine medical favor by the in favor of simpler interventions like elevation of the legs. In modern contexts, they are considered unapproved new drugs by the FDA, which has issued warnings against their use for , and are primarily used by athletes in high-impact such as football, hockey, and —where many NFL players have employed them—to heighten before performance or after impacts, though as of August 2025 the NFL has banned teams from providing them due to safety concerns; evidence for ergogenic benefits is limited to minor improvements in repeated high-intensity efforts like the , with no enhancement in single maximal sprints. Contemporary formulations often contain about 15% alongside essential oils like lavender or for scent, delivered in crushable ampoules or packets. Despite their stimulant effects, smelling salts carry risks including respiratory irritation, coughing, allergic reactions such as , potential chemical burns to nasal passages or skin from overuse, and the critical danger of masking symptoms by inducing a that delays diagnosis of . They are not addictive but are not recommended for general use due to these hazards and lack of proven long-term or beyond transient arousal.

Composition and Preparation

Chemical Composition

Traditional smelling salts are primarily composed of , a white crystalline solid with the (NH4)2CO3(NH_4)_2CO_3, which serves as the . This compound decomposes upon exposure to air or moisture, releasing ammonia gas (NH3NH_3), (CO2CO_2), and , as represented by the equation: (NH4)2CO3→2NH3+CO2+H2O(NH_4)_2CO_3 \rightarrow 2NH_3 + CO_2 + H_2O In historical formulations, was often mixed with perfumes or essential oils to mask the pungent odor, and it was commonly referred to as "spirit of ," an early name derived from its production via of animal horns. Modern variants of smelling salts typically consist of aqueous solutions, containing 15-20% (NH3NH_3) dissolved in , which provides a more stable and readily deployable form compared to the solid carbonate. These solutions may include added scents such as lavender or oils to reduce the harshness of the smell. Contemporary formulations often incorporate inactive components like alcohol () at concentrations of 35-40% for enhanced stability and , ensuring the product remains effective without rapid degradation.

Preparation Methods

Traditional preparation of smelling salts typically involved apothecaries manually mixing crystals with water or alcohol, often incorporating perfumes for , and allowing the solution to stand or evaporate to form crystallized solids or pearls suitable for crushing and . This process relied on the decomposition of to release gas upon exposure to air or moisture. In modern industrial production, smelling salts are manufactured by dissolving gas—produced via the Haber-Bosch process—into or under controlled temperature and pressure conditions to create solutions of precise concentration, which are then flavored with essential oils such as lavender or . These solutions are filled into small ampoules, sealed, and sometimes surrounded by absorbent material like for safe handling and immediate release upon breakage, or applied to pre-soaked pads for portable use. Smelling salts are produced in several forms to suit different applications: solid pearls or powders of that release when crushed; liquid inhalants contained in breakable vials; or fabric pads pre-impregnated with for quick activation without tools. in production emphasizes maintaining concentrations within safe limits, such as approximately 15% in ampoule inhalants or 1.7–2.1% total in aromatic spirits, to ensure effective stimulation while minimizing risks of severe mucosal . Manufacturers conduct assays for purity, stability, and gas release to meet pharmaceutical standards.

History

Origins and Early Use

The origins of smelling salts trace back to ancient practices where various irritant substances were inhaled to restore consciousness and treat ailments like fainting or . The ancient Romans knew of , referred to as "Hammoniacus sal," as described by in his . These early ammonia-based compounds laid the groundwork for later formulations, though the specific compound —derived from the of deer antler shavings, known as —was not isolated until the . Ammonia solutions, including sal ammoniac, appear in 13th-century European alchemical texts for their reviving properties. By the , the process had become more refined, producing "spirit of ," a volatile used in early to counteract and nervous disorders. Early physicians in the alchemical endorsed such ammonia-based inhalants as aromatic waters for rousing the faint, marking a shift toward chemical remedies in . In the , smelling salts gained popularity in under the name "sal volatile," an aromatic preparation often scented with lavender or , primarily to treat fainting spells and "female hysterics" among the upper classes. These episodes were common in refined society, prompting women to carry vials for immediate revival. Beyond medical use, sal volatile played a cultural role in theaters and social gatherings, where it combated the "vapors"—a period term for fatigue, anxiety, or nervous exhaustion—allowing participants to endure long performances or tense interactions.

Evolution in Medicine and Society

In the 19th century, smelling salts gained prominence in medical practice, particularly following the introduction of anesthesia in the mid-1800s, when they were routinely used in hospitals to hasten patients' recovery from unconsciousness by stimulating the respiratory reflex through ammonia inhalation. Physicians employed them to treat various conditions, including shock, respiratory depression, and fainting during childbirth, integrating them into standard protocols as a quick revival aid. This era also saw their societal embedding as a staple for Victorian women, who carried ornate vials—often scented with perfumes or vinegar—as "ladies' remedies" to counteract fainting spells attributed to tight corsets, emotional stress, or social expectations of fragility. By the mid-, smelling salts began to decline in formal as advancements like intravenous drugs and provided safer, more effective alternatives for managing fainting and , rendering ammonia inhalants obsolete in clinical settings. Despite this medical fade, their use revived in culture during the late , with athletes in leagues like the and NHL adopting them for heightened . This shift reflected a broader cultural transition from medical necessity to performance enhancement, though scientific evidence for ergogenic benefits remains limited to specific high-intensity scenarios. Societally, smelling salts evolved from symbols of Victorian decorum—frequently portrayed in literature and early films as tools to revive swooning heroines—to modern over-the-counter commodities available at supplement stores and online retailers for athletic or everyday arousal boosts. Media depictions, such as in classic cinema scenes of fainting and revival, perpetuated their nostalgic image while highlighting gender norms of the era. Regulatory developments underscored this change; ammonia inhalants were classified as non-prescription items by the FDA for fainting treatment, though recent warnings target unapproved variants marketed for energy without proven safety data. Safety concerns over masking concussion symptoms led to restrictions in some sports, including longstanding bans in professional boxing since the mid-20th century.

Mechanism of Action

Physiological Effects

When ammonia gas from smelling salts is inhaled, it immediately irritates the , activating chemoreceptors in the trigeminal and olfactory nerves. This irritation triggers a reflexive gasp or response, which sharply increases oxygen intake and heightens alertness by stimulating the . The sensory response is rapid, occurring within seconds of exposure. The activation of the leads to cardiovascular changes, including a brief elevation in , known as . Earlier studies reported a temporary increase in due to reflex in peripheral vessels, but more recent research indicates no significant change. These effects enhance overall but are short-lived. Respiratory stimulation occurs as the prompts an increased rate to expel the irritant, which in turn improves cerebral blood flow through of . This enhanced oxygenation supports heightened mental acuity during the response. The physiological effects of smelling salts typically peak within seconds to a minute of and last 1 to 5 minutes, after which the body returns to baseline.

Biochemical Processes

The ammonia gas released from smelling salts interacts with the moisture in the , undergoing a reaction that produces ions and ions, thereby creating a basic environment that irritates the chemoreceptors in the . \ceNH3+H2O−>NH4++OH−\ce{NH3 + H2O -> NH4+ + OH-} This chemical irritation primarily stimulates polymodal nociceptive neurons associated with the (cranial nerve V), which detect irritants and relay sensory signals from the nasal passages to the in the . The activated trigeminal afferents trigger a pathway, where signals project to the respiratory and vasomotor centers in the , eliciting an inhalation reflex that enhances respiratory drive. The brainstem integration subsequently activates the , prompting the adrenal glands to release adrenaline (epinephrine) into the bloodstream as part of the . Parallel to adrenaline release, the sympathetic activation elevates norepinephrine levels in nervous system, promoting heightened arousal and vigilance by enhancing neural signaling at adrenergic receptors without requiring direct penetration of into the . This surge amplifies the overall stimulatory effect, focusing the response on peripheral and autonomic pathways rather than central olfactory processing.

Uses

Medical Applications

Smelling salts, primarily in the form of inhalants, have historically been employed in clinical settings to revive patients experiencing syncope, or fainting, particularly vasovagal syncope, by stimulating through of the nasal and pulmonary membranes. Their use has been noted in emergency rooms and ambulances for rapid restoration of consciousness in cases of transient loss due to or reflex-mediated events, though modern protocols favor simpler interventions and they are not routinely recommended. In 2024, the U.S. (FDA) warned against unapproved inhalant products marketed for or energy, classifying them as unapproved drugs with potential health risks. Protocols for administration, when used, involve supervised of the ammonia vapor for 10-15 seconds, with the held approximately 10-15 cm from the patient's to minimize direct mucosal . In , smelling salts are not recommended as a first-line intervention for , where (CPR) and take precedence, as they do not address underlying cardiac or . Some regional EMS guidelines explicitly advise against their routine use for assessing levels, citing non-diagnostic value. Their medical role is supported largely by anecdotal evidence dating to the 1800s, with limited randomized controlled trials (RCTs) evaluating efficacy. Historical medical texts, such as 19th-century editions of the Dispensatory of the United States, list ammonia-based smelling salts as an analeptic, or restorative stimulant, for reflex arousal in cases of faintness. Evidence indicates transient cardiorespiratory stimulation that may aid recovery from vasovagal syncope in some cases, but emphasizes the absence of robust evidence for sustained therapeutic effects. This reflex arousal stems from irritation triggering increased respiratory and heart rates, as detailed in physiological mechanisms.

Sports and Athletic Use

Smelling salts, also known as inhalants, are commonly employed in high-impact sports such as in the (), powerlifting, and to counteract fatigue, enhance focus, or revive athletes from a post-knockout daze. In the , players have historically used them to achieve a quick mental boost before plays or during huddles, with estimates indicating widespread adoption among 70-80% of athletes as of 2017. Powerlifters often inhale them immediately prior to maximal lifts, such as deadlifts or bench presses, to trigger an adrenaline response that sharpens concentration and combats perceived exhaustion. In , they were traditionally administered after knockouts to restore consciousness, though their role has diminished due to regulatory changes. Athletes typically administer smelling salts by snapping open small ampoules or capsules containing ammonia carbonate and holding them under the nose for a brief, intense inhalation, often during team huddles in football or right before gripping the bar in powerlifting. This practice gained prominence in professional sports starting in the late 20th century, with NFL players like Michael Strahan noting their increasing use since the 1990s for clearing mental fog before high-stakes moments. Similarly, in powerlifting competitions, the ritual has become a staple for psyching up, providing an immediate sensory jolt that athletes describe as invigorating. Endorsements from prominent figures, such as NFL tight end George Kittle, who expressed strong attachment to the substance amid recent policy shifts, underscore its entrenched role in athletic routines. Athletes report anecdotal benefits from smelling salts, including heightened focus, increased , and a temporary surge in that aids in overcoming during intense efforts. However, reveals no significant ergogenic advantages, particularly in single maximal strength efforts like those in or football plays; a 2023 review in Sports Health concluded that benefits are limited to repeated high-intensity bouts, with no enhancement in performance such as deadlifts. Studies, including those examining peak power output, support this, attributing perceived gains to psychological rather than physiological improvements. The cultural significance of smelling salts extends to , where performers like athletes incorporate them into pre-match rituals for dramatic hype and revival effects. Controversies have arisen over their safety, leading to restrictions in various leagues; for instance, most organizations banned them decades ago due to concerns over masking injuries, while high school sports associations in the began explicitly prohibiting their use to prevent potential health risks among young athletes. In the , a 2025 policy update barred teams from supplying smelling salts, citing their potential to obscure symptoms, though players may still use personal supplies.

Risks and Safety

Potential Side Effects

The use of smelling salts, which release gas, can lead to acute irritation of the and mucous membranes upon . Common immediate reactions include nasal burning, excessive tearing, and coughing, as the irritates sensory nerves in the and eyes. In rare instances, direct skin contact with concentrated forms may cause chemical burns, particularly if the substance is mishandled or broken open improperly. Systemic effects may occur shortly after use, including headaches, , , and , resulting from the reflexive increase in and . The can also induce , potentially leading to or fainting in susceptible individuals. These symptoms typically resolve quickly but can be more pronounced in those with pre-existing sensitivities. Overuse or repeated exposure carries risks of medium-term respiratory , with documented cases linking chronic to bronchitis-like symptoms or . A notable allergic reaction in a powerlifter involved , wheezing, , and periorbital shortly after use, requiring treatment with epinephrine and antihistamines. Recent FDA reports from 2024 highlight similar respiratory issues, including airway constriction and , in consumers of unapproved inhalants. Overall incidence of severe adverse effects remains low, with FDA data show 6 adverse event reports in 2022, 26 in 2023, and 2 as of August 2024, indicating low but varying annual reports; incidence rates among users are unknown due to lack of comprehensive usage data. however, risks appear elevated in unsupervised athletic contexts where frequent or improper application is common.

Contraindications and Precautions

Smelling salts, primarily composed of compounds, are contraindicated for individuals with or other chronic respiratory conditions, as the irritant vapors can trigger , exacerbate breathing difficulties, and potentially lead to severe airway constriction. Pregnant individuals should avoid exposure to smelling salts due to insufficient data on the safety of during , with recommendations to minimize unnecessary chemical exposures. Children, particularly those under 2 years of age, are at heightened risk of irritation and adverse reactions, and use is generally not advised without medical supervision. To minimize risks, smelling salts should be limited to 1-2 brief inhalations per use, held at a safe distance from the to avoid excessive irritation. They must be avoided in cases of head trauma or suspected , as the stimulating effect can mask symptoms and complicate injury assessment, potentially leading to worsened outcomes. For storage, keep them in a cool, dry place at , sealed in their original container and away from heat sources or moisture to prevent premature decomposition and maintain potency. Guidelines for in-flight medical care, endorsed by the American College of Emergency Physicians, recommend against including inhalants in kits due to limited evidence of benefit and potential for harm. In general emergency settings, safer revival methods are prioritized. In , organizations like the NCAA permit smelling salts as they are not listed among banned substances, but usage is monitored to ensure it does not contribute to injury oversight or overuse. As of August 2025, the has advised against the use of smelling salts due to potential risks highlighted by FDA warnings. Safer alternatives include for medical revival in cases of syncope or low alertness, which provides respiratory support without irritants. For milder stimulation in sports or daily use, menthol-based inhalers, such as those containing and essential oils, offer a non-ammonia option to enhance focus and breathing without the risks of chemical irritation.

References

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