8 TOBACCO, INSANITY AND NERVOUSNESS. 



precipitated by excessive use of tobacco. I know, however, 

 of instances where the last named disease, or " softening 

 of the brain," as it is called by the lay-public, could not be 

 referred to any other cause but tobacco. 



That the majority of the insane smoke or chew is too 

 well known to deserve special mention. Some alienists 

 have been of the opinion that this habit ought not to be 

 discouraged, that it has a calming and pacifying effect 

 especially on the chronic insane. I believe this to be the 

 case in some of the secondary dements, but ordinarily, 

 though calming at first, it has an exciting effect later on. 

 True, if the temporary contentment resulting from the 

 gratification of the craving of the patient is looked upon as 

 the action of tobacco, I agree that its effects are calming. 

 But this quieting down, in my opinion, takes place on the 

 same principle that a child gets quiet and stops crying when 

 its wish, even though most unreasonable, is gratified. The 

 rule is, that smoking causes or prolongs excitement in the 

 insane. Many become absolutely unmanageable as soon as 

 they touch tobacco. They get quarrelsome, tease and 

 molest their fellow-patients and render themselves obnox- 

 ious generally. 



That tobacco really does cause insanity is evidenced by 

 the magic effect seen in some cases after the discontinu- 

 ance of the drug, when the patient's condition is still 

 such that he is not wholly inaccessible to reason and has 

 will power enough to abandon the habit. Thus I have 

 seen that beginning melancholia with suicidal impulses, 

 hallucinations of various kinds, forced actions, besides, the 

 precursory symptoms of insanity, such as insomnia, crying 

 spells, praecordial anxiety, fears of impending evil, " that 

 something is going to happen," impotency, vertigo, begin- 

 ning impairment of memory and judging power, and even 

 the lowering of the moral tone, all of which, and a host of 

 other symptoms were attributable to chronic tobacco- 



