26 tobacco: it% use and abuse. 



be prejudicial to his health, and proves, if he had a will 

 to relinquish the pipe or cigar, he would find a wai/. 

 Teh's best argument to use in dealing with the obstinate 

 prejudices of such people, is to tell them, that an accv- 

 dental attack of a new disease can sa/eli/ and at once 

 occasion the total withdrawal of tobacco without pro- 

 ducing any bad consequences. It is scarcely possible to 

 cure either syphilis or gonorrhoea, if the patient continue 

 to indulge in smoking tobacco. 



14. When tobacco is too much indulged in, it pro- 

 duces, both locally and constitutional^ the most dire 

 effects. Locally, smoking causes ulceration of the lips, 

 tongue,* gums, mucous membrane of the mouth or 

 cheeks, tonsils, velum, and even pharynx. Many, from 

 smoking, produce carcinomatous ulceration of the lower 

 or upper lip, or its commissure, requiring excision of the 

 diseased structure. One individual, a captain of the 

 Indian navy, fell a victim under my care (from smoking 

 Cherouts). When I first saw him, he had ulceration 

 of the mucous membrane of his left cheek, extending 

 backwards to the tonsil and pharynx of the same side, 

 having all the characteristic appearances of carcinoma. 

 The disease resisted every variety of treatment. Inter- 

 nally — alteratives and mild diet; externally — fomenta- 

 tions, poultices, a solution of honey and w^ter, and nitric 

 acid. From this case, and other instances, it would ap- 

 pear that the cigar induces carcinoma just as readily aa 

 the cutty-pipe. It would seem that the pungent oil of 

 the tobacco, combined with the heat, constitutes the ex« 



* See Chapter III., p. 132. 



