PRACTICAL OBSERVATIONS. 33 



those nmcli addicted to smoking, in whom a cigar is 

 never out of the mouth ; but I have witnessed it also to 

 occur in the snuflfer of the plant. It is denoted by head- 

 ache, want of sleep, or rather restless nights, and occa- 

 sionally flushing of the couatenance. The worst case I 

 have had under my care was a foreigner, who travelled 

 for a manufacturer of cigars — he was at the same time 

 fearfully nervous. He had a red, swollen countenance, 

 as if he combined the bottle with his smoking, but this 

 he assured me he never did — the tobacco was enough 

 for him. I inserted an issue or seton in the nape of his 

 neck, purged him with calomel and aloes, put him on as 

 low a diet as he would permit, confined him to the 

 house, and entreated him to smoke as few cigars as pos- 

 sible. In a fortnight the congestion of the brain was 

 subdued, and then he was allowed gradually more and 

 more nourishing diet and exercise in the open air. He 

 returned to Edinburgh in two years after in good health 

 but still nervous even from the moderate use of cigars. 

 He said that he had tried to give them up altogether, 

 but that he had found that impracticable — a difficulty 

 connected, no doubt, with his avocation. 



27. Apoplexy has been taken notice of by several 

 authors, supervening to the smoking of tobacco : also to 

 the immoderate use of snufi^as related by Morgagni; 

 likewise in the EjyhemnndesWes Curieux de la Noturey 

 and in the Journal d'Allemagne for 1830, page 179. 

 The treatment here is the same as that for congestion 

 of the brain. 



28. The form of palsy produced by excessive smoking 

 is generally hemiplegia, and it is almost always incura- 







