1875. Therapeutic Uses

In Dropsical Affections, Tobacco was strongly recommended by Dr. Fowler.* He employed an infusion (Leaves j., Boiling Water Oj.; macerate one hour; add Rectified Spirit of Wine fij.), in doses of gutt. xxx., three times a day, at the commencement; and gradually increased the dose until it augmented the urine and produced sickness, when it was discontinued. Dr. Darwell states that, thus used, it appeared to him particularly useful; more so, when the Dropsy arose from disease of the liver and spleen, than from the heart and lungs. He adds, that he never saw any ill effects resulting from its use. It is, notwithstanding, a dangerous remedy, and inferior to many others of a safer character.

1876. In Ileus, Dry Belly-ache, Tobacco enemas have the sanction of Sydenham, Heberden, and other high authorities. Dr. Abercrombie considers them of most general utility in all the forms and stages of Ileus. He observes, "It should be given at first with much caution; perhaps not more than 15 grains, infused for ten minutes in f vj. of boiling water. After an interval of half an hour, if no effect be produced, it may be repeated in the quantity of 20 grains; and so on, until such effects are produced in slight giddiness and muscular relaxation, as show that its peculiar action is taking place in the system. It may be repeated at intervals of one or two hours, a great many times, if the case do not yield speedily. With the precautions now mentioned," he adds, " I have never seen any unpleasant effect result from the free use of this powerful remedy." From the fatal effects which have resulted occasionally from Tobacco enemas, this treatment has never come into general use. In Colica Pic-tonum, the same treatment has been advised. Dr. Graves proposes, as a substitute for the enema in the above cases, to apply to the abdomen compresses soaked in a strong decoction of Tobacco leaves. It is less speedy, but is stated to be equally efficacious.

1877. In Strangulated Hernia, Tobacco enemas were formerly much employed with a view of relaxing the muscular system, and facilitating the reduction of the hernia. It is an extremely uncertain and dangerous remedy, and should only be had recourse to when every other means have failed. Mr. Liston § remarks, " that the employment of the supposed remedy cannot be too strongly reprobated; its effects are most severe and unmanageable; the state of collapse is most complete and alarming; and it is often difficult, if not impossible, to bring the patient out of it, - to procure reaction." "I have often," he adds, "seen it fail, and have witnessed the operation afterwards performed on the patients, who were at the time without pulsation, from whom

* Med. Reports on the Effects of Tobacco, &c, 1785. Cyc. Pract. Med., vol. i. p. 648.

Pathology of the Intestinal Ca nal, p. 144.

§ Elements of Surgery, part iii. p. 31.

no blood flowed after the incisions, and who never rallied, but sunk rapidly." According to the experience of Velpeau, it succeeds once in twenty-five times.