When I was young I remember attending soccer and rugby matches at which a player might suffer a knock to the head and pass out. The medical team would then open a small bottle of smelling salts under the player’s nose to bring them round. What were smelling salts and how did they work – if indeed they had a genuine effect? You never hear of people using them today.
• Smelling salts are essentially crystals, which on contact with water release pungent ammonia gas. The bottle held the reagents in separate compartments and was designed so the crystals would be wetted on opening. The effect is genuine: as the player inhales, the ammonia irritates their nostrils, triggering two physiological responses that help revive them. First, irritation of the nasal lining (and windpipe if deeply inhaled) triggers a sharp intake and exhalation of breath, drawing in more air and increasing oxygenation of the blood. This reflex occurs even when fully unconscious. The irritation also sparks heightened activity of the sympathetic nervous system, raising heart rate and blood pressure, increasing blood flow to the brain. The face-slapping used to revive boxer Rocky Balboa in the Rocky movies similarly worked through irritation.
Ammonia is both toxic and corrosive, and above a certain concentration lethal, but smelling salts provide doses well below injurious levels. In sport, they were used not only on the field but also in the boxing ring on knocked-out fighters. Their use was banned by the International Boxing Union in the 1950s and is discouraged by the English Football Association, because an athlete’s outward immediate recovery makes it hard to assess the severity of brain trauma and the risk of ensuing complications, while their recoil on whiffing the salts could exacerbate any upper spine injury – or indeed cause it.
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“Ammonia is both toxic and corrosive, and above a certain concentration it is lethal”
Though their use is now rare, smelling salts figure in many a Victorian novel where a lady has swooned on hearing shocking news, and more recently police on the beat in the UK sometimes carried a bottle, just in case.
Nowadays when goading someone to wake up, we just tell them to smell the coffee.
Len Winokur, Leeds, UK