350 



Lee 



Tliese protocols are typical of the effect of tobacco smoke on man 

 They may be divided into three groups : the first including those in which 

 the smoker was a novice ; the second, the group of moderate smokers ; and 

 the third, the group containing the " excessive smokers." 



In the case of the novice there is always an initial rise of blood-pressure 

 very shortly after the inhalation has well started^ and lasting half an hour 

 or perhaps even a shorter time. The height to which the blood-pressure 



Fig. 5, 





120 

 115 

 110 



Time. 



68 68 68 



68 68 68 68 Pulse. 



rises above the normal varies, but is usually from 10 to 20 mm. Hg. This 

 effect is associated with some quickening of the pulse ; for example, in 

 protocol 2 the increase is from 72 to 80, and in 3 from 84 to 106. 



At first the smoker has no unpleasant symptoms, but rather a feeling 

 of well-being and exhilaration. As the smoking continues, however, a 

 sudden change occurs in the blood-pressure, which begins to fall rapidly, 



120 

 115 



no 



105 

 100 



Time. 



67 64 64 64 64 60 59 59 60 60 Pulse. 



SO that, as in the case shown in protocol 2, there may be a fall of 50 mm. 

 Hg within five minutes. 



When the smoker, though a novice, is less affected by the inhalation, as 

 in protocol 3, the fall, though vstill rapid in onset, does not so closely 

 resemble a crisis as in experiment 2. This fall in blood - pressure is 

 associated with all the symptoms characteristic of shock or collapse. 

 The face becomes pale, the skin is covered with a clammy sweat, there is 

 general weakness of all the muscles, faintness, shallow respirations, and a 

 slow and feeble pulse ; sometimes nausea or vomiting may be present, and 



