486 The Physiological Position of Tobacco. [October, 
thrice daily. The vomitings which were noticed at first 
soon ceased, the action of the heart became extremely 
irregular, the circulation grew daily feebler, digestion 
became difficult, appetite diminished, they were subject 
alternately to diarrhcea and constipation, the mucous mem- 
brane of mouth and pharynx soon became so dry that deglu- 
tition was very difficult, the gums swelled, the teeth loosened, 
and some of them fell out. These and other symptoms 
preceded paralysis of the posterior extremities, blindness, 
deafness, and death from sheer exhaustion. ‘Their autopsy 
showed the heart to be pale, soft, slightly atrophied, the 
blood poor in the red globules, fluid, and deprived of fibrine. 
A closely parallel case in a human subject is given. 
Brigitte V., a married woman, of 46 years, having lost one 
of her children, took to tobacco as a consoler. She snuffed, 
smoked, and chewed, spending about 2 francs weekly for 
tobacco. When Dr. Le Briert was called, her voice was 
rough, not a word could be distinguished, respiration was 
difficult, pulse feeble and intermittent, the heart beat with 
difficulty, the pupil dilated and insensible to the light, 
hearing defective, but not absolutely lost, swallowing 
difficult, &c., &c. Next day she died, all her organs being 
in a manner paralysed by the influence of tobacco. 
The rough voice of snuff-takers, and the ‘‘ smoker’s sore 
throat,” are also due to the influence of tobacco. Some 
smokers occasionally spit blood, often immediately after 
going to bed, and this affection may be confounded with 
true hemoptysis. 
M. Blatin regards all these local affections as trifling, 
when compared with the gradual saturation of the system 
with nicotine, which, accumulating in the tissues, waits for 
the opportunity, varying, according to individual habits and 
constitution, of declaring its poisonous nature. 
The trembling, which is one of the usual symptoms of 
acute, is 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 note- 
worthy. A man of 45 years consulted him respecting 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 regimen quickly restored him. 
