TOBACCO AND ITS EFFECTS. IO3 



use of tobacco." Another regards " the constant use of 

 tobacco as the source of a chronic inflammation of the 

 throat and fauces, that can never be misunderstood by an 

 experienced eye." 



" I have seen ulceration of the hps in those addicted to 

 constant use of tobacco, which was traceable directly 

 thereto ; in not a few cases catarrh was present, mani- 

 fested by a nasal sound in talking, due to the thickening of 

 the lining membrane of the nose and its appendages." 



" I have met- with many cases of congestion of the 

 pharyngeal mucous membrane, sometimes extending to 

 the ear and sometimes to the larynx, producing hoarseness. 

 It would seem that the pungent oil of the tobacco, volatil- 

 ized by the heat, constitutes the exciting cause — at least 

 I have always found such diseased condition difficult to 

 reach except by requiring the unconditional surrender of 

 its use ; usually thereafter treatment has been easy and 

 successful." 



" I have observed that in some cases smoking has pro- 

 duced eczema of the nasal mucous membrane, and chronic 

 conjunctivitis. I have also seen irritable cough, and, in a 

 few instances, violent heart-disturbance and gastric irrita- 

 tion, all of which have disappeared upon stopping the use 

 of tobacco." 



Question 6. " Have any cases of the following diseases 

 come under your observation, which you beUeve to have 

 been caused by the use of tobacco : {a) Ulceration of the 

 lips ; ij?) epithelical cancer of the lips or mouth ; {c) any 

 local disease of the tongue, gums, tonsils, pharynx, &c. ? 

 If so, give particulars." 



The replies to this question may be arranged as follows : 

 {a) eighty-one per cent answer yes; {b) fifty-nine per 



