When a person, unaccustomed to the use of tobacco, takes it even in small quantities, the effect above mentioned is deepened into vertigo, nausea, and often vomiting, with feelings of epigastric uneasiness, general weakness, universal muscular relaxation, depression of the pulse, coolness of the surface, faintness, etc., which are anything but agreeable, and which are obviously the result of a sedative operation. After a few trials, however, the susceptibility of the nervous centres is diminished, and only the slighter effects above referred to are experienced.

* There is reason, however, to believe that the effects of tobacco itself are somewhat different from those of the empyreumatic oil resulting from its igneous decomposition. Thus, in the experiments of Brodie on the lower animals, while infusion of tobacco caused death by immediate prostration, leaving the heart flaccid, distended with blood, and with entire loss of contractility, the empyreumatic oil appeared to act like the stimulant narcotics, causing death by suspending respiration, while the heart continued to act after all other signs of life had ceased. it follows, therefore, that the smoking of tobacco ought to have effects somewhat different from those of the narcotic used in other modes; as in the act of smoking the empyreumatic oil is always produced, and, along with the volatilized nicotia, enters with the smoke. This idea receives confirmation from experiments made by Dr. Edward Smith, of London, on the effects produced by smoking on the pulse. Carefully eliminating all other influences from the experiments than that of the tobacco smoke, he found the pulse to be always accelerated by smoking, and in one instance from 741/2 in the minute to 106; six or seven minutes elapsing after the commencement of the smoking before any effect whatever was experienced. [Med. T. and Gaz., March, 1863, p. 292.) The probability is that the pure empyreumatic oil is a stimulant narcotic, somewhat analogous to alcohol and opium in its action; but that, as obtained by the destructive distillation of tobacco, and as existing in tobacco smoke, it is always mixed with more or less nicotia, which is a powerful nervous sedative; and that, consequently, in the effects of tobacco smoking, we have a mingling of two different influences, one stimulant, and the other sedative; while, administered in any other mode, tobacco is purely sedative. (Note to the third edition.)

There appears to me to be a considerable analogy between the influences which produce sea-sickness and the operation of tobacco. The first impression of the vessel, gently moving over the waves, is of the same soothing and tranquillizing character, with the same peculiar cerebral sensation; but, in the unaccustomed, this is soon aggravated into vertigo, nausea, and vomiting, with all the anxiety, epigastric distress, and sense of general weakness, that characterize the action of tobacco.

Poisonous Effects

Tobacco often produces alarming effects in overdoses, and has in many instances caused death. This rarely happens from the medicine taken into the stomach, because it is speedily rejected by vomiting. But death has often resulted from its exhibition by the rectum in the form of infusion, and Desault witnessed fatal effects from the smoke administered in the same way. A case is on record in which the juice of the fresh leaves, applied to the head of a boy of eight years, for the cure of tinea capitis, caused death in three hours; and alarming symptoms have frequently followed the application of the medicine, in various forms, to wounds and ulcerated or abraded surfaces. A man, wishing to evade the revenue laws in France, crossed the border with a quantity of leaves wrapped about his body. Perspiration was induced, and the tobacco, moistened, acted with such force on the system as to endanger fatal prostration. (Comptes Rendus, Juillet 11, 1864.) The smoking of tobacco in great excess has also proved fatal.

The symptoms produced by over-doses of tobacco are excessive and distressing nausea and vomiting, with frequent retching and a sense of sinking at the epigastrium; occasionally purgation; giddiness, mental confusion, dimness or perversion of vision, and sometimes delirium; muscular weakness, tremors of the limbs, and universal relaxation; feelings of faintness, with great depression of the pulse, which is sometimes slow, sometimes frequent, but always small, extremely weak, and irregular; paleness and coldness of the surface, with cold sweats; and, towards the close of fatal cases, paralysis, drowsiness or torpor, universal prostration, and sometimes, though rarely, convulsions before death. The fatal result may be very speedy, having sometimes occurred in less than an hour, though more frequently after several hours.

In the treatment of poisoning by tobacco, the first indication is to remove the cause. Hence, if it has been swallowed, the stomach should be washed out by demulcent drinks; if administered by the rectum, this should be evacuated by a large purgative enema; if applied to the surface, it should be immediately removed, and the surface cleansed. Opiates should be administered by the mouth or the rectum, a sinapism applied to the epigastrium, and heated rubefacients to the extremities; and, if the prostration is very great, recourse should be had to the alcoholic and ammoniacal stimulants.

Effects of Habitual Use. The habitual use of tobacco by smoking, chewing, or snuffing, if indulged in moderately, is not generally productive of any obvious injury to the health; but, in some individuals of nervous temperaments, or great susceptibility of the nervous system, it cannot be employed even in small quantities without disadvantage. In excess, I have no doubt that it is often very injurious, greatly impairing the vigour of the nervous system and of the health generally, and probably shortening life, if not directly, at least by rendering the system less able to resist noxious agents. The effects most frequently induced are dyspepsia, defective nutrition, paleness and emaciation, general debility, and various nervous disorders, of which the most frequent are palpitations of the heart, hypochondriacal feelings, and neuralgic pains, especially of the head and eyes. Angina pectoris and amaurosis have been ascribed to the same cause.* Very great habitual excess seems to be capable of directly inducing a condition, similar to that induced by the omission of alcoholic drinks in the case of the drunkard; a condition prominently marked by muscular tremors, obstinate wakefulness, and hallucinations. The late Professor Chapman informed me that he had witnessed several cases of delirium resulting from tobacco, closely resembling delirium tremens, which ceased upon the omission of the drug. This fact very strongly illustrates the opposite effects of tobacco and alcohol; a condition being produced by the direct influence of the one, very analogous if not identical with that resulting from the omission of the other. Even insanity has been ascribed to the abuse of tobacco; and M. Mercier believes, from his own experience, that it has a depressing influence on the generative function. (B. and F. Medico-chir.

* Amaurosis. M. Sichel thinks that the abuse of tobacco is apt to produce feebleness of vision and of memory; and states that few persons who have long been in the habit of smoking more than five drachms of tobacco daily, escape without some evidences of the failures referred to. Mr. Wordsworth, of London, having had under his observation a case in which the excessive use of tobacco was attended with amaurosis, connected with a partial white atrophy of the optic nerve-disc, was disposed to believe that this affection of the eye was one of the effects of the abuse of this narcotic. The idea was strengthened by the occurrence of other cases of a similar bearing, and by the consideration, moreover, that amaurosis with atrophy of the optic nerve is much more common in men than women. (Med. Times and Gaz., April, 1863, p. 344.) But it will be perceived that this opinion is little more than conjectural; for the excessive use of tobacco is so common, that there is probably no disease which might not be found coincident with it in the same case. Besides, atrophy of the optic nerve is generally associated with organic disease in the brain, as effusion, tumours, etc., and the action of tobacco is purely functional; being, perhaps, almost never attended with serious organic change; certainly not with incurable diseases, such as this variety of amaurosis is admitted by Mr. Wordsworth himself to be. Moreover, Mr. Ernest, of London, states that he has examined the eyes of great numbers of inveterate smokers, and found no case in which even the trace of a tendency to white atrophy of the optic nerve could be seen. (Ibid., Aug. 1863, p. 141.)-Note to the third edition.

Rev., July, 1863, p. 205.) Snuffing appears to be less injurious to the general health than either smoking or chewing; but there can be no doubt that it is more or less hurtful in excess, and at all events it is apt to occasion diminished susceptibility of the sense of smell, and a disagreeable alteration of the voice. From the liver of an inveterate snuff-taker, examined after death by M. Morin, a substance was extracted believed to be nicotia, as it had the sensible properties of that principle. {Med. Times and Gaz., Jan. 1862, p. 41; from the Presse Beige.)