TOBACCO AND THE TOBACCO HABIT. 675 



venience ; and there are some who are able to smoke just before 

 sitting down at the table. Smoking generally dulls the appetite 

 and gives relief against the pains of hunger. But after eating the 

 desire to smoke becomes irresistible. This is the psychological 

 moment ; and the pleasure we feel then is more intense than at 

 any other time in the day. The pipe or the cigar is a condition of 

 good digestion for some smokers, but in others it produces gas- 

 tric troubles. Nervous people, those who lead a too sedentary life, 

 and office men, especially if they have the habit of smoking before 

 meals, gradually lose their appetite, and acquire instead of it a 

 painful anxiety and nausea. Others suffer from pyrosis. There 

 are smokers who can not light a cigar at some hours in the day 

 without having the feeling of hot iron that marks that affection. 

 Nearly all excessive smokers are dyspeptics ; and the fact is 

 explained by the excess of salivation and the diminution of the 

 gastric juice and of the functional energy of the stomach. Next 

 after the digestive troubles, the most common affections touch the 

 respiratory organs and the heart. Granular pharyngitis is very 

 common among persons who smoke to excess. The irritation of 

 the pharynx is often communicated to the larynx, and there results 

 a peculiar dry cough. Others feel a temporary oppression in the 

 evening after having smoked during the day. A special form of 

 asthma has been mentioned as caused by the abuse of tobacco ; 

 but cases of it must be very rare, for I have never observed it, 

 though I have passed my life among smokers. Affections of the 

 heart are more frequent. Some doctors assert that one fourth of 

 the smokers are afflicted with palpitations and irregularities of 

 the pulse. I do not know where such observations have been 

 made, but I have never seen any cases of the kind. I, as well as 

 other doctors, have met cases of angina pectoris, chiefly among 

 persons who passed their lives in an atmosphere saturated with 

 tobacco, and among those who have swallowed the smoke of their 

 cigars, and have not been surprised at them, because the smoke 

 then enters into the lesser ramifications of the bronchial vessels, 

 where it impresses directly the finest nervous threads of the lungs 

 and the heart, and its action induces the spasms of suffocation that 

 constitute that terrible disease. These symptoms are at first fleet- 

 ing, and rarely mortal ; but, if the patient does not abandon his 

 habit, they occur more frequently, and become more grave till 

 death ensues in one of them. Disasters from breathing an atmos- 

 phere saturated with tobacco-smoke seem more liable to occur with 

 children than with grown persons. Staying in smoking-rooms, 

 where the smoke is sometimes so thick that one can hardly see 

 from one end of the room to the other, is dangerous to persons sub- 

 ject to palpitations, even though they do not smoke. Dr. Vallin 

 has cited three facts conclusive as to this point, one of which re- 



