In habitual constipation, due to a relaxed state of the muscular layer of the bowel, five minims of the wine of tobacco, administered at bedtime, will not infrequently afford relief.

Impaction of the caecum, colica pictonum, sometimes intussusception, and strangulated hernia, may be overcome by a tobacco-enema It must be borne in mind, however, that this is an expedient not free from danger. Numerous deaths have been caused by it, and Dr. Copeland reports one instance in which thirty grains by enema proved fatal. Of the official infusion ( 3 j—Oj) it is not safe to use more than four ounces, or fifteen grains; and this quantity may be expected to produce most depressing nausea. It must be urged in favor of this remedy that it has, in very unfavorable cases, proved exceedingly effective. It is especially adapted to cases in which obstruction has occurred from paresis of the muscular layer of the bowel (impacted caecum, typhlitis, painter's colic).

Tobacco is one of the antispasmodic remedies used in the treatment of spasmodic asthma, and the paroxysms of difficult breathing in emphysema. It enters as a constituent in various pastilles and cigarettes employed in these maladies. Asthmatics, unaccustomed to the use of tobacco, are sometimes relieved by smoking a cigar or pipe, but the effect is lost by habitual use. Laryngismus stridulus may be quickly arrested by a snuff-plaster to the neck—an effective but dangerous domestic remedy. Obstinate hiccough, or singultus, may be cured by five-minim doses of wine of tobacco, but we possess other useful remedies, less dangerous and less unpleasant in action.

We possess no remedy more effective in the treatment of tetanus than tobacco. It may be used in the form of an enema, commencing with four ounces of the infusion, and regulating the quantity to be administered and the time of administration by the effect produced. Minim-doses of the alkaloid may be given every two hours by the stomach, or two minims by the rectum (Haughton). When it acts favorably, it relaxes the trismus so that nutriment may be taken, and suspends the tonic convulsions. Care must be used not to introduce a lethal quantity, and produce death by asphyxia. The author has known the wine of tobacco to be used successfully in a severe case of tetanus, the quantity administered being regulated by the effect of the remedy on the convulsions.

The experiments of Haughton having demonstrated an antagonism between nicotine and strychnine, he proposed the use of nicotine in strychnine-poisoning, and cases have occurred in which it proved entirely successful, As the effects of nicotine are so nearly instantaneous, the stomach administration—if the spasms do not prevent—will suffice, but rectal and even hypodermatic injections may be resorted to if necessary. The following formula of Erlenmeyer may be used for the subcutaneous injection in strychnine-poisoning and in tetanus: Rx Nicotinae, gr. ss; aquae destil., 3 ij. M. Sig.: Ten minims contain 1/24 of a grain. The cases of strychnine-poisoning in which tobacco was used successfully were treated by the infusion.

Tobacco was formerly employed in the treatment of dropsy. It is adapted to those cases in which digitalis is now used. It promotes free diuresis, and is at the same time laxative—effects especially serviceable in cardiac dropsy. It is, however, so disagreeable in action that few practitioners have the temerity to prescribe it, and few patients are willing to swallow it.

There is no doubt that excessive use of tobacco lessens the venereal appetite. Slightly nauseating doses of the wine of tobacco will check chordee and priapism. Satyriasis is effectively quenched in tobacco-nausea. Nocturnal pollutions, due to repletion and to continence, are also usually suspended by the use of this remedy; but it is, unfortunately, so horribly depressing that the remedy may be justly considered the greater evil.

Local Uses of Tobacco

So many unfortunate accidents have resulted from the external application of tobacco, that its use in this way is rarely justifiable. The infusion and an ointment have been employed with success in tinea, scabies, prurigo, pityriasis, etc. An injection of tobacco will destroy ascarides, but it is unsafe. Other and more manageable remedies have entirely taken the place of tobacco in the local diseases above named.

Authorities referred to:

Benham, Dr. W. T. On the Action of Nicotine. West Riding Lunatic Asylum Reports, vol. iv, p. 307.

Blatin, M. le Dr. Recherches Phys. et Clin, sur la Nicotine et la Tabac. Gaz. dee Hộpitaux, 1870, p. 221

Copland, Dr. Dictionary of Practical Medicine, article Colic, vol. i, p. 443.

Curling, Mr. T. B. A Treatise on Tetanus, London, 1836.

Erlenmeyer, Dr. A, Die subcutanen Injectionen der Arzneimittel, 3. Auflage, p. 85.

Fluckiger and Hanbury. Pharmacographia, English edition, p. 418.

Haughton, Rev. Prof. Dublin Hospital Gazette, December, 1856, and Dublin Quarterly Journal, August, 1862, p. 172.

Hermann, Dr. L. Handbuch der exper. Toxicologie, p. 318.

Husemann, Dr. Theodor. Handbuch der gesammten Arzneimittellehre, zweiter Band, p. 1142.

Hirschmann, Dr. Abstract in Bull. Gen. de Thérap., lxv, p. 561.

Hirt, Dr. Ludwig. Die Krankheiten der Arbeiter, erster Theil, p. 156, et seq.

Nasse, Dr. 0. Centralblatt für die med. Wissensch., 1865, p. 785.

Tardieu, A. Diet. d' Hygiéne, deuxiéme édition, 1862, article Tabac, p. 229, ei seq.

Taylor, Dr. A. S. On Poisons, third English edition, p. 803.

Tscheschichin. Arch, für Anatomie und Physiologie, 1866, p. 151.

Traube, Dr. L. As quoted by Hermann.

Uspensky, P. Arch. für Anat. und Physiologie, 1868, p. 522.

Van Praag, Dr. L. Arch für Anat. und Physiologie, viii, p. 56.

Von Basch und Oser. Wiener medicinische Jahrbücher, 1872, p. 387.