TOBACCO, INSANITY AND NERVOUSNESS. 7 



that tobacco was gradually undermining his own mind 

 and body, although his wife and his friends knew and 

 saw it. 



But it is not only in the young, that the use of tobacco is 

 followed with such disastrous effects. Smoking or chew- 

 ing, when commenced in the period of manhood, and even 

 at the time it generally does least harm, after middle age, 

 will tell on the mind if excessively indulged in. Is it to be 

 wondered at, that a drug which, until tolerance is estab- 

 lished, has such potent and palpable effects as to produce 

 loss of co-ordination and unspeakable malaise, and after the 

 organism has become used to it, is capable of setting up 

 the well-known heart disturbances, amblyopia and even 

 amaurosis — which, in short, possesses the characteristic 

 qualities of a powerful nerve poison, is it a wonder if such 

 drug, when, in spite'of the warnings on the part of various 

 organs, excessively and persistently used, finally produces 

 one or the other form of insanity? A drug that can, as 

 has been demonstrated, cause organic changes of the optic 

 nerve, w T hich, I hardly need mention it, is, in reality, not 

 a nerve, but a protrusion of elongation of the brain itself 

 must certainly be capable of injuriously influencing 

 other and functionally higher, parts of the organ of the 

 mind. 



Dr. Kjelberg read before the section of Neurology and 

 Psychiatry of the last International Congress, a paper in 

 which he described a nicotine-psychosis, well marked by def- 

 inite symptoms and stages. I have never seen the clinical 

 picture as drawn by this observer, but it always seemed 

 to me that whenever tobacco entered at all as a factor in a 

 case of insanity, it was the immediate cause, vivifying, 

 uniting and condensing, as it were, the dormant morbid 

 elements which predisposed the individual to mental dis- 

 turbance. Thus I have seen melancholia, more often 

 mania, and very frequently general paresis hastened and 



