civ Journal of Comparative Neurology. 



but it can never be perfectly immunized — no period of tolerance is 

 long enough to exclude the final appearance of intoxication. It is 

 a fact that many smokers reach old age, but it is probably equally 

 true that many people do not live to old age because they are 

 smokers. 



The disturbances of nicotinism may be observed in almost all or- 

 gans of the body. On the skin we see itching and erythema; the 

 nerves of taste are blunted; in the throat a.n angina granulosa devel- 

 ops; leukoplakia is probably a consequence of the abuse of tobacco; 

 loss of appetite, fullness and pain in the epigastrium are quite com- 

 mon, as is matutinal vomiting and disturbed function of the intestine; 

 the secretion of urine is usually increased ; in smoking women dis- 

 turbances of menstruation are the rule ; in female cigar-makers abor- 

 tion appears to be frequent ; diminished sexual appetite and power, 

 even impotency, have been observed. 



The most frequent pathological effect of nicotine is a disturb- 

 ance of the actio;i of the heart, palpitations, rapid heart-beat, inter- 

 missions, praecordial anxiety, weakness, fainting spells and collapse. 

 Sclerosis of the coronary arteries, hypertrophy of the left ventricle, 

 perhaps myocarditis and fatty degeneration of the heart seems to be 

 favored by the abuse of tobacco. The smoking of cigars, and more 

 so of cigarettes, produces an irritation of the nasal mucous membrane 

 (the so-called vasomotor catarrh) and diminishes olfactory sensibility. 

 There usually is chronic hyperaemia of the epiglottis and larynx, some- 

 times even of the trachea and bronchi. 



The use of tobacco in any form may produce disturbances of the 

 sight. This may be favored by general debility, excessive heat, men- 

 tal overwork, etc. The most common form of optic disturbance is 

 bilateral nicotine amblyopia. There usually is central disturbance of 

 the field of vision, a central horizontal elliptic scotoma for red and 

 green, sometimes also for blue, in a lesser degree; the external limits 

 of the field of vision are normal, as a rule. 



In the auditory organ a swelling of the tubes and congestion of 

 the tympanum is often observed in higher degrees of nicotinism ; also 

 paresis of the auditory nerves or the disturbances consequent upon 

 this, such as noises in the ears, etc. 



The functions of the central nervous system may be affected too. 

 It has been observed that in higher schools the non-smokers get along 

 better than the smokers, and that children from nine to fifteen years 

 that were addicted to smoking, showed dimished intelligence, laziness 

 and a craving for spirits. Adult persons given to excess in smoking 



