114 tobacco: its use and abuse. 



modic action of the orbicularis muscle of the eye, expe- 

 rienced, together with intolerance of light, on awaking 

 from sleep in the m^orning. 



" I think the frontal sinuses do not escape ; for I find 

 that one of the symptoms, very constantly experienced 

 after excessive smoking, is a heavy, dull ache, precisely 

 in the region of these sinuses. But descending along 

 the alimentary canal, we come to the stomach, and here 

 we find the results to be, in extreme cases, the symptoms 

 of gastritis. There is pain and tenderness on pressure 

 of the epigastrium, anorexia, nausea on taking food, 

 and a constant sensation of sickliness, and desire to 

 expectorate. 



" The action of the heart and lungs is impaired by 

 the influence of the narcotic on the nervous system, but 

 a morbid state of the larynx, trachea, and lungs, results 

 from the direct action of the smoke. The voice is ob- 

 served to be rendered hoarser, and with a deeper tone; 

 sometimes a short cough results ; and in one case that 

 came under my notice, ulceration of the cartilages of 

 the larynx was, I felt quite certain, a consequence of 

 excessive use of tobacco. This individual had originally 

 contracted the habit of smoking when a sailor, and it 

 had become so inveterate, that he literally was never 

 without a pipe in his mouth except when eating or 

 Bleeping. If he awoke in the night he lighted his pipe; 

 the moment he finished a meal he did the same. It is 

 only in extreme cases like this that the inference can be 

 fairly made as to the morbid results of the habit, because 

 there are so many other causes of disease to be estimated 

 fct the same time. This particular instance has^ how- 



