PHYSIOLOGICAL POSITION OF TOBACCO. 171 



also a common result of chronic, nicotism. A very distinguished 

 Parisian physician had hands which shook so much that he could not 

 write. Whenever he remained without tobacco for any length of 

 time, these tremblings disappeared. Another case mentioned by 

 Blatin is noteworthy. A man of forty-five years consulted him re- 

 specting violent and numerous attacks of vertigo. When he felt 

 one of them approaching, he was obliged to lie down wherever he 

 might be, in order to avoid falling. In the country, where he had 

 plenty of exercise, they were less frequent than in the town, where his 

 occupation was sedentary. Cessation from tobacco and a tonic regi- 

 men quickly restored him. 



A physician of fifty-two was afflicted with similar disagreeable 

 symptom's, and was also cured by abstinence. Habit had become so 

 strong that he could not resist at times the temptation to slight indul- 

 gence. Finding that these returns to tobacco were immediately fol- 

 lowed by his old painful attacks, he renounced it forever. 



The circulatory system presents in chronic nicotism similar symp- 

 toms to those found in acute poisoning. The most noticeable of these 

 is the intermittent pulse, of which many cases have been collected by 

 Decaisne and others. 



Decaisne speaks of narcotism of the heart, but Blatin does not 

 consider the action to be directly upon that organ, but considers the 

 effects described to result from an irregular relaxation of the ganglia 

 of the great sympathetic nerve. 



When a person suffering from intermittent pulse was carefully ex- 

 amined, Blatin found the stoppage in the heart's beat followed a series 

 of apparently normal movements. The systole and diastole succeeded 

 in due regularity, and nothing in the play of the central organ indi- 

 cated trouble, when the heart suddenly stopped in diastole, sometimes 

 for the space of three arterial pulsations. When it awakens from this 

 syncope its action is abnormally quick, as if it wished to make up for 

 the lost time, and force the mass of blood across the organs at one 

 stroke. But, with force insufficient for this purpose, it is exhausted in 

 fruitless efforts, hesitates, wavers, acquires fresh power, commences 

 again, now violent, now feeble, and fulfils very imperfectly the duties 

 which it should perform. Gradually it calms ; a foreign element seems 

 to appease the tumult, the heart again becomes regular. The expla- 

 nation appears to be that the irritation of the sympathetic nerve stops 

 short the movements of the heart, and thus causes the intermittence ; 

 then the susceptibility of the nerve is lessened or paralyzed, and the 

 cardiac functions are left to the sole direction of the auto-motor gan- 

 glia ; hence the disordered beats, which decrease as the nervous force 

 coming afresh from the pneumogastric moderates and regularizes it. 



From intermittent pulse to angina pectoris the distance is not far. 

 That tobacco may produce all the usual symptoms of that painful dis- 

 ease has been abundantly shown by Beau. To the cases which he has 



