S4 
He would be practically unfitted for work but for the steadying effect of 
tokazco. It acted as a sedative. Why not prevent the reaction and make 
the use of tobacco unnecessary? When you point out these things you knoek 
the props from under the tobacco argument. Doctors are notorious smokers. 
When they meet, especially at a banquet, the air is usually full of smoke, 
so full that you can not see across the room. Naturally those who do not 
smoke stay away, as they do from other ‘‘smokers.”’ 
In a general way in youth and up to middle age individuals may be 
grouped under three classes according to the blood pressure—low, medium 
or high, under unsanitary city conditions. At middle age and after there 
are really only two groups, those with a low pressure and those with a high 
pressure. Ordinarily we speak of the action of tobacco on man; in reality 
it is the reaction of man to tobacco. When the low pressure individual is 
exposed to tobacco smoke his pressure declines still more, his pulse may be- 
come imperceptible, he feels bad, and he gets out: He is a victim of tobacco- 
sis. On the other hand is the high blood pressure individual: To him 
tobacco smoke may act as a sedative, it lowers the tension, he feels better. 
He is the one who attends “‘smokers;” he does not object to tobacco.. But 
as a rule he does not realize the significance of high blood pressure and the 
danger he is in, how his very life hangs on a thread.* 
Moreover mental changes are marked. The low pressure man is stupefied 
by tobacco smoke, he can not think. The bright things he might have said 
come to him the next day. On the other hand the high blood pressure man 
whose mind is constantly running riot is steadied. Such a statement taken 
without the context might be considered as a plea for the use of tobacco! 
How do these two elasses, the high and the low pressure, react from the 
standpoint of coniosis under infected dust conditions and without tobacco 
effects, say in the poorly ventilated church, as during the closed door season 
when some leave early because they feel bad? As a general rule those who 
leave “deathly pale” are low pressure with the pressure still further reduced, 
while those who go out with flushed face are high pressure, with the pressure 
heightened. We thus see the two-sided effect of bad air, air with infected dust. 
*In my searen for original data L have questioned many physicians, including both 
smokers and non-smokers, as well as an occasional chewer. Strange to relate | have 
met men whom I suspected to have a high blood pressure who refused to have the 
pressure taken; they preferred to live on in ignorance and smoke. The average phy- 
sician knows as little about the effeet of tobacco as the man on the street who has no 
education and in whom one does not expect any matured opinion. 
