TABACUM.

Nicotiana tabacum, Linn.

Natural order , Solanaceæ.

Common name , Tobacco.

Preparation , Tincture of the leaves.

Authorities. ( 1 to 3 , from Hartlaub and Trinks).

1 , Nenning; 2 , Schreter; 3 , Hausbrand, Hufeland's Journ., vol. 45, part 4, p. 109, observed in a nurse from a clyster containing 2 ounces of native Tobacco; ( 4 to 31 , Seidel's collection, A. H. Z., 12, 150); 4 , effects of 10 drops of tincture on himself; 4 a , 20 drops of tincture; 4 b , 30 drops; 4 c , 40 drops; 4 d , 60 drops; 5 , E., a healthy girl, took 5 drops of tincture; 6 , L., a healthy young woman, took 2 drops of tincture; 7 , Fowler, Med. Rep., London, 1785, effects of Tobacco; 8 , Hildebrandt, Hufeland's Journ., vol. 15, p. 160, effects of application of leaves to chest and abdomen; 9 , Murray, Arzneivorrath, vol. 1, p. 624; 10 , Muller, Bad. Annal. für Heilk., vol. 4, p. 92; 11 , Voigtel, Arzneimittel, 1817; 12 , Gesner, Epistol., effects on nose and mouth of smoking the leaves; 13 , Gessner, Arzn., in Schwaben, 1, 194; 14 , Marrigues, Vandemond, Rec. Periodic, vol. 7, p. 68, effects of smoking; 15 , Vidocq, Miscel., 1828, 12, 376; 16 , Mombert, Hufeland's Journ., 1833, effects of injection in a man, æt. seventy years, for a scrotal hernia which had to be operated on; 17 , Chantourelle, Archiv. Gén. de Med., 1832, injection of 1 1/2 ounces in a man; 18 , Gemelin, Geschichte der Pflanzengifte, 1770, Halle Gifte Histoire, 1787; 19 , Dove, Duncan, Med. Corr., Dec. 2d, vol. 8; 20 , Garnel, Med. Comment for the Year 1791; 21 , O'Brien, Dublin Hosp. Rep., 1832, effects of injection; 22 , Ephem. Nat. Cur., Dec. 2d, Ann. 3, obs. 108, p. 62, effects of external application of the juice to a wound; 23 , Stevenson, Alston's Mat. Med., vol. 2, 160, application of juice to an ulcer; 24 , Diemenbrock, Tract. de Peste, p. 294; 25 , Pitschaft, Hufeland's Journ., 1832; 26 , Horn, Arzneimittel, 1805; 27 , Chornel, Usuelles, 10, 184; 28 , Brandis, Archiv., 25, 1, 97, effects of a clyster; 29 , Grahl, Hufeland's Journ., 71, 4, 100; 30 , Hellwig, Obs. Phys. Med., p. 45; 31 , Ephem. Nat. Cur., Dec. 2d, Ann. 10, p. 222; 32 , P. Grant, Med. Comment., 1786, a man and his wife anointed their bodies with a strong infusion to prevent the itch; 33 to 35 , Cany, Recueil de Mem. de Med., 1816 (Frank's Mag., 3, 855), effects on men of attempting to save burning Tobacco; 36 , same, effects on a woman; 37 , Marshall Hall, M.D., Edin. Med. and Surg. Journ., 1816, p. 11, J. H., æt. nineteen years, unaccustomed to smoking, smoked one, and a part of a second pipe, and swallowed the saliva; 38 , Dr. Truchsess, Med. Corr. Blatt., vol. 6, p. 339 (Horn, Archiv., 16, pr. 3, p. 94), a girl, æt. ten years, had a crust upon the scalp, to which was applied powdered Tobacco; 39 , G. G. Sigmond, M.D., Lancet, 1837 (1), 150, a young man made an external application for the itch; 40 , Richard, from Thorer (Journ. de Chim. Méd., 1839), a woman took an injection of an infusion; 41 , Krauss, Würt. Corr. Blatt., 1840 (Frank's Mag., 2, 169), a girl took an injection of an infusion for worms; 42 , Schmidtmann, Hufeland's Journ., 1840 (Frank's Mag., 1, 812), effects of excessive smoking; 43 , Gaz. Méd. de Paris (A. H. Z., 21, 28), effects of an injection of 45 grams of an infusion; 44 , same, effects of an infusion; ( 45 to 51 , Dr. Riemer Schneider, De Herb a Nicotine, 1840 (A. H. Z., 19, 10); 45 , a man, æt. twenty-four years, took in ten days 1 ounce of tincture of fresh leaves of Nict. rustica, and within eight days 2 ounces of essence; 46 , a prover, æt. twenty-three years, took within eight days 2 ounces of essence; 47 , K., æt. twenty-five years, took 1 ounce of essence in ten days; 48 , another, æt. twenty-nine years, took 4 ounces of essence in eight days; 49 , S., æt. twenty-two years, took 2 ounces of essence in eight days; 50 , G., æt. twenty-eight years, took the essence for ten days; 51 , E., æt. twenty-six years, took 5 ounces of essence in fourteen days; 52 , B. M. Tavignot, Revue Med., Dec., 1840 (Brit. and For. Med.-Chir. Rev., 1841 (2), p. 562), a man, æt. fifty-five years, suffering from dysuria and enlarged prostate, took an injection of a decoction of 12 grains of Tobacco in 6 ounces of water, death; 53 , Curtis, Treatise on the Eyes (Bost. Med. and Surg. Journ., 26, 1842, p. 258), effects of excessive smoking on a young man; 54 , Eitner, Encyclop. des Sci. Med. Mag., 1843 (Am. Journ. Med. Sci., 1844 (1), p. 231); 55 , Dr. Meyern, Casper's Woch., 1844 (Hom. Vjs., 6, 104), a woman, æt. fifty years, made an external application of the leaves; 55 a , Westrumb, Rust's Mag., vol. 42, 464, a man rubbed the juice into a wound on the hand; ( 56 to 64 , A. B. Shipman, Bostom Med. and Surg. Journ., vol. 31, 1844).

56 , a young man smoked, chewed, and snuffed freely; 57 , a sister of same, æt. thirty-nine years, had smoked and snuffed for fifteen years; 58 , S. E., æt. forty years; 59 , C. P., æt. forty-three years, had chewed for twenty years; 60 , S. C., æt. sixty-three years, had chewed for thirty-eight years; 61 , S. J., æt. fifty-four years, had used Tobacco for ten years; 62 , A. C., æt. twenty-seven years, had chewed for four years; 63 , Mr. H., æt. thirty years, had used Tobacco for fifteen years; 64 , J. S., æt. forty years, often used a pound a week; 65 , B. B. A., ibid., general effect; 66 , Bost. Med. and Surg. Journ., 33, 1845, p. 101, report of French Acad. of Med. of effects on workmen; 67 , Dr. Chapman, Diseases of the Viscera (Lond. Med. Gaz., new ser., vol. 1, 1845, p. 981), effects of excessive chewing, smoking, and snuffing; 68 , Melier, S. J., 95, 41, effects on workmen in Tobacco; 69 , R. H. Allnatt, M.D., Lond. Med. Gaz., 1845 (1), p. 237, effects of chewing on a young man; 70 , M. Bertini, Giornale delle Sci. Med. della Soc. Med. Chir. di Torino (Med. Times, vol. 13, 1846, p. 326), a child, æt. four years and a half, was given an enema prepared with part of a cigar; 71 , Peter Eade, Lancet, 1849 (2), p. 480, a girl, æt. eighteen years, for constipation, took an injection of about 3 drachms of common shag Tobacco boiled in 1/2 pint of water, death in an hour and a half; 72 , Bost. Med. and Surg. Journ., vol. 43, p. 474, effects of excessive smoking on an old man; , R. A. Kimlock, M.D., Charleston Med. Journ. and Rev., vol. 5, 1850, p. 450, a woman, æt. twenty-eight years, had "chewed snuff" for six years; , Howison, Foreign Scenes (Brit. Journ. of Hom., 8, 1850, p. 24), Mr. H. embarked on a sloop laden with Tobacco; , J. L. Levison, Med. Times, vol. 21, 1850, p. 27, effects on the teeth; , Innhauser, Wien. Zeit., 1851 (S. J., 71, 356), effects on cigarmakers; , Dr. Deutsch, Preuss. Verein Zeit., 1851 (S. J., 70, 27), a man suffering from tapeworm, took 1 ounce of fluid extract; , same, a young woman smoked and swallowed a piece of a cigar for toothache; , Hjorth, Gaz. des Hôp., 1852, (S. J., 76, 311), a woman, suffering from irregular intermittent fever, took an infusion in milk; , W. A. Weaks, M.D., Bost. Med. and Surg. Journ., vol. 47, 1852, p. 461, a child, æt. seven days, took two tablespoonfuls of water impregnated with Tobacco-smoke, death in eight hours and a half; , Dr. J. W. Corson, Bost. Med. and Surg. Journ., vol. 49, p. 518, effects of chewing and swallowing the juice; , Dr. Polko, Preuss. Verein Zeit., 1854 (S. J., 86, p. 31), a man applied the leaves to the lower extremities for rheumatism; , David Skae, M.D., Edin. Med. and Surg. Journ., 1855-6, p. 643, a maniac, æt. twenty-six years, swallowed over 1/2 ounce of the crude. ( to , quoted by Levi, Charleston Med. Journ., vol. 11, 1856, p. 843); , Etmuller; , Richard Morton; , Leroy d'Etiolles; , W. A. Hammond, M.D., Am. Journ. Med. Sci., 1856 (2), p. 315, unaccustomed to smoking, smoked 150 grains after each meal; , same, second experiment, the bread and meat each reduced, 6 ounces daily; , Dr. Reil, Journ. für Pharmakodynamik, vol. 1, 1857, p. 568, poisoning of a family of three persons by coffee containing Tobacco; , same, a woman, æt. fifty-six years; , I. N. Kerlin, M.D., Med. and Surg. Rep., vol. 10, 1857, a lad, æt. eighteen years accustomed to the use of Tobacco, swallowed 30 grains of the leaf. ( to , Dr. A. Teste, Journ. de la Soc. Gall., 2d ser., vol. 3, p. 401.); , effects on workers in Tobacco; , a soldier, who smoked thirty pipes daily; , a gentleman, who smoked seven or eight cigars daily; , a man, æt. sixty years, an almost incessant smoker; , a man, who had left off the use of Tobacco for fifteen or twenty years, staid a few minutes in a room where others were smoking; , symptoms in a man, æt. forty-three years, all of which disappeared after leaving off smoking; , effects on Dr. Teste himself; , Gaz. Med. Italian (Journ. de Chim. Méd., 1859), a man, affected with herpes in the beard, applied the oil; , Dr. Osborne, Dublin Quart. Journ., 1860 (2), p. 291; , Brit. Journ. of Hom., 18, 1860, p. 681, a man, æt. forty-six, smoked one or two cigars every evening.

100 to 103 , M. Beau, La presse Méd. Belge, July 1862 (Brit. and For.-Med. Chir. Rev., 1862 (2), p. 537); 100 , a gentleman, æt. sixty years, smoked the greater part of the day; 101 , a doctor, æt. thirty-five years, smoked cigarettes excessively; 102 , another doctor, æt. fifty years, smoked continually; 103 , a man, æt. thirty years, smoked cigarettes continually; 104 to 106 , same, Med. Circ., August 27th, 1862 (Brit. Journ. of Hom., 20, 1862, p. 685); 104 , a physician; 105 , a merchant smoked cigarettes excessively; 106 , a healthy and vigorous man, æt. seventy-five years; 107 , Clemens, Deutsch Clinic, 1862 (S. J., 156, 16), effects of excessive smoking; 108 , another case; 109 , P. J. Farnsworth M.D., Am. Med. Times, vol. 5, 1862, p. 189, Mr. L., æt. thirty-five years, smoked excessively; ( 110 to 112 a , E. Smith, M.D., Lancet, 1863 (1), p. 292, effects on the pulse.); 110 , Mr. D., smoked a pipe, drawing the smoke through water; 110 a , second experiment by same, where the smoke was not drawn through water; 110 b , same, smoked seven minutes; 110 c , smoked in greater volume; 110 d , smoked faster three minutes and recharged the pipe; , effect on Dr. H.; , same, smoked the strongest bird's-eye Tobacco; , Dr. R. smoked a cigar; , same, smoked the strongest bird's-eye Tobacco; , J. C. Wadsworth, Lancet, 1863 (2), p. 95, W. A., æt. twenty-one years, smoked 1 pound or 1 1/2 pounds a week; , same, J. M., æt. thirty-six years, used Tobacco excessively; , G. A., æt. twenty years, has smoked eight or nine years, now smokes 1/2 ounce of strong Tobacco every day; , M. Bernard, Comptes Rendus, 1864 (Brit. and For. Med.-Chir. Rev., 1864 (2), p. 531), a man enveloped his whole skin in the leaves to evade the payment of duty; , Dr. Le Briert, Gaz. des Hôp. (Edin. Med. Journ., 1864 (2), 171), a woman, æt. forty-five years, had eaten about two francs' worth a week for several years; , M. Decaisne, Med. Times and Gaz., 1864 (1), p. 671, effects of smoking; , Med. Times and Gaz., 1864 (2), p. 559, a man died from the effects of chewing and swallowing the juice of roll Tobacco; , Dr. Majer, Würt. Corr. Blatt., 1864, effects of smoking four Kentucky cigars; , Walter Scott, M.D., Med. Mirror (Dublin Med. Press, new ser., vol. 10, 1864, p. 588), Richard Edmondson, æt. seventeen years, smoked two pipes of bird's-eye and chewed about 1/3 ounce of Limerick roll Tobacco, swallowing the spittle; , Dr. Henry Kennedy, ibid., vol. 9, 1864, p. 226, a man æt. thirty-four years, an excessive smoker; , Dr. Royston, Med. Circular, vol. 25, 1864, p. 381, effects of excessive smoking; , Dr. Charles Drysdale, ibid., p. 380, effects of excessive smoking, such as 3/4 ounce daily; , same, a young man smoked 1/2 ounce daily; , Marchant, Journ. de Brux., 1865 (S. J., 127), poisoning by sucking the juice from an old pipe; , Wien. Med. Press, 1866 (N. Z. für H. K., 13, 112), effects of chewing a cigar of Tobacco rust; , T. H. Babbington, M.D., Dublin Journ., 1866 (2), p. 545, Patrick Collier, æt. thirty years, poisoned by exposure to fumes of roated Tobacco and excessive use of the weed; , Ritter, Med. Corr. Blatt. Würt., vol. 38, p. 5, a man, æt. sixty-three years, who had smoked excessively since fourteen years old, now smoked Hungarian Tobacco in a meerschaum several times daily for six months, besides several cigars each day; , Dr. L. Scotten, Virchow's Archiv., 1868 (North Am. Journ. of Hom., 17, p. 469), an officer smoked excessively; , same, second case; , Mr. Curgensen, Med. Circular, vol. 25, 1869, p. 380, effects of excessive smoking; , Maurice G. Evans, M.D., Lancet, June 19th, 1869, a boy, æt. seven years, for ringworm on the neck, had applied to it the ashes scraped from interior of a much-used pipe and mixed with oil; the ashes could have been held on the point of a penknife; , Bull. Gén. de Thér., June, 1869 (New York Journ. of Hom., vol. 2, 1874, p. 533), a lotion of Tobacco was used as a wash to cure itch; , Lembke, N. Z. für H. K. 12, 97, repeated doses of 5, 10, 15, and 20 drops of tincture, and 30 to 40 drops of Aqua nicotine; , S. Swan, North Am. Journ. of Hom., new ser., vol. 1, 1870, p. 253, a man used a paper of fine-cut Tobacco every day, with some cigars; , same, general statement; , J. H. P. Frost, Hahn. Month., vol. 5, 1870, p. 409, a physician used Tobacco over thirty years; , Reymond, Ann. d'Ocul., 1871 (S. J., 151, 312), abuse of Tobacco; , Carl Muller, Am. Hom. Obs., 1871, p. 561, a man, æt. twenty-four, a confirmed devotee to Tobacco, smoked a "splendidly colored cutty" three times in succession while in bed; , James W. Allan, Lancet, 1871 (2), p. 663, a woman applied the leaves to an ulceration on her legs; , T. F. Allen, Hahn. Month., vol. 8, 1872, p. 22, a man, æt. thirty-five years, had used Tobacco immoderately for several years; , Dr. Miller, Hahn. Month., vol. 7, 1872, p. 531, general effects; , same, a French physician investigated the effects of habitual smoking upon thirty-eight boys between the ages of nine and fifteen years; , Hahn. Month., vol. 7, p. 288, effects on children; , Dr. Goullon, Jr., A. H. Z., 84, 66, effects of smoking a cigar in the evening; , H. N. Dunnell, M.D., Med. Union, vol. 1, 1873, p. 227, a German, æt. forty-three years, took 15 drops on an empty stomach, death in about ten minutes; , U. V. Miller, North Am. Journ. of Hom., new ser., vol. 4, 1874, p. 86, C. T., æt. twenty-seven, has for three years observed effects on himself of smoking; , B. W. Richardson, M.D., Brit. and For. Med.-Chir. Rev., 1875 (2), p. 234, a man smoked in less than twelve hours forty cigarettes and fourteen good cigars; ( to , E. B. Morgan, Brit. Med. Journ., 1875 (2), p. 487, three persons poisoned by water from a well in which Tobacco had been placed); , a man, æt. fifty-five years; , death of a boy æt. four years; , a girl æt. six years; , E. W. Berridge, U. S. Med. Invest., new ser., vol. 1, 1875, p. 100, took 77 pilules 1000 (Jen.) at 10.50 A.M. and at 11 P.M.; , same, effects on Mr. --- of smoking; , Prof. Chevallier, Journ. de Chim. Méd. (New Remedies, 1875), a young man smoked twelve cigars, death; , Dr. Yeldman, Brit. Journ. of Hom., vol. 33, 1875, p. 508, effects of attempting to learn to smoke; , effects of excessive smoking on a man; , effects of excessive smoking on a young man; , Ravoth, from the Swedish, Lundahl, "Tabac est Gift," Berlin, 1875; , Forsius, ibid., effects of excessive smoking; ( to , Foussard, De l'Empoisonnement a la Nicotine et le Tabac, Paris, 1876); , symptoms of acute poisoning; , Mackenzie; , Foussard, Madame N. took an infusion; , Rabateau, Med. Gaz., vol. 10, poisoning by an injection; , same, effects of smoking cigars; , E. W. Berridge, M.D., Am. Journ. of Hom. Mat. Med., vol. 9, 1876, p. 244, effects of smoking on Mr. ---; , J. N. Bigelow, M.D., New York Med. Journ., vol. 23, 1876, p. 399, T. S., æt. twenty-six years, had smoked excessively from the age of twelve; , G. H. De Wolfe, M.D., Lancet, 1876 (2), p. 811, G. H. smoked six pipes before breakfast, and continued smoking all day, using small dirty pipes; , W. W. Van Valzah, M.D., Phila. Med. Times, 1877 (1), p. 271, a man took Tobacco to relieve constipation; , Brit. Med. Journ., 1877 (2), p. 419, a boy, æt. four years, blew soap-bubbles with an old wooden pipe, death on the fourth day; , Mr. Nettleship, Med. Times and Gaz., 1877 (2), p. 434, William W., æt. fifty-three years, a heavy smoker; , W. K., æt. fifty years, a heavy smoker; , John H., æt. sixty-six years, a heavy smoker; , William E., æt. fifty-two years, a smoker; , Jonathan Hutchinson, Med.-Chir. Trans., 1867, p. 411 (Ophth. Hosp. Rep., 1871, p. 172, and 1876, p. 463), cases of amaurosis, supposed to be due to Tobacco; , Hemptel's Mat. Med., vol. 2, p. 675, a girl, æt. twenty-three years, who had the itch, made a decoction of 3 ounces of the leaves, with which she soaked compresses, and wrapped them around her leg in the evening.

MIND

• Emotional.
• Quiet delirium, murmuring to himself, 17.
• He went to sleep in the cabin, which was full of large packages of tobacco, but was harassed by wild and frightful dreams, and suddenly awaked about midnight, bathed in a cold dew, and totally unable to speak or move. He knew, however, perfectly where he was, and recollected everything that had occurred the preceding day; he could not make any bodily effort whatever, and tried in vain to get up, or change his position. The watch on deck struck four bells , and he counted them, though it seemed to him as if he did not hear the beat, but received the vibration through his body. About this time a seaman came into the cabin with a light, and carried away an hour-glass without observing the sufferer. Shortly after a pane of glass was broken in the skylight, and he saw the fragments of glass drop on the floor. These circumstances which really occurred, are mentioned to show that Mr. H. experienced real sensations, and was not still under the influence of perturbed dreams. His inability to move was not accompanied by any pain or uneasiness, but he felt as if the principle of life had entirely departed from his frame. At length he became totally insensible, and continued so till an increase of wind made the sea a little rough, which caused the vessel to roll. The motion, he supposes, had the effect of awakening him from his trance, and he contrived somehow or other go get up and go on deck. His memory was totally lost for about a quarter of an hour; he knew that he was in a ship, but nothing more. While in this state he observed a man drawing water from the sea in buckets, and requested him to pour one on his head. On the seaman doing so, all his faculties were immediately restored, and he acquired a most vivid recollection of a vast variety of ideas and events which appeared to have passed through his mind, and to have occupied him during the time of his supposed insensibility, 74.
• By loud calling and vigorous shaking, he was aroused from his comatose condition, when he began in a high state of nervous excitement to cry, "Oh, my head! Oh, my head!" at the same time clutching his forehead with his hands, and staring wildly about him. At one time, in great trepidation, he begged that some imaginary bottles should be taken out of the room; indeed, his conduct and appearance at this time were not unlike one suffering with delirium tremens, 89.
• After a time the patient changed from a state of stupor into one of wild intoxication, started up in bed with ridiculous, foolish talking, accompanied by convulsive movements and spasms of the facial muscles, 34.
• Complete intoxication, 33.
• Felt as if intoxicated with spirituous liquor (after one hour), .

HEAD

• Vertigo and Confusion.
• Head confused, 47, 48. [80.]
• Great confusion of the head, 50, 51.
• Confusion, long continued, 11.
• *Vertigo, 7, 8, 9, 10, 11 , etc.
• Excessive vertigo (after half an hour, and second and fourth days), 2.
• Vertigo and intoxication, 12.
• Vertigo, with some colic, 7.
• Frequent paroxysms of vertigo, 158.
• Vertigo and fulness of the head, 56.
• Vertigo, with no steadiness of the body, 4c.
• Vertigo on motion, 131. [90.]
• Vertigo on every attempt to rise, 77.
• Vertigo, so that she could not rise up, 88.
• Vertigo, with qualmishness in the stomach (fifth day), 2.
• Vertigo, which amounted to loss of consciousness, 3.
• Vertigo, as from intoxication (first and second day), 2.
• Vertigo, a turning in a circle with pressive headache in the forehead and temples, 1.
• Frequent attacks of vertigo, which caused staggering and falling, while everything seemed to turn round, 137.
• Vertigo, everything about him seemed to move from right to left, or from above downward, and then the reverse, 158.
• Vertigo; it seems as if the whole room were turning about in a circle, and she does not dare to rise from her seat for fear of reeling (after a quarter of an hour), 2.
• Vertigo on entering the house after walking in the open air, with nausea and inclination to eructate; the nausea increases in a warm room, so that she is obliged to go into the open air, when she vomits the food eaten at noon, 1. [100.]
• Dizzy and reeling (after five minutes), 2.
• Dizziness and physical prostration, soon, 4a.
• Reeling, 13.

EYE

• Objective.
• Dark redness around the eyes, 88.
• Eyes staring, 17, 41, 166.
• Eyes fixed, 70.
• Eyes turned upward, 88.
• Sparkling eyes, 33.
• Eyes sunken and seeming small, 34.
• Eyes lost their brilliancy, 37.
• Eyes listless and heavy, 69.
• Eye had a haggard appearance, 117. [190.]
• The eyes are dejected, without brilliancy, deeply sunk in the orbit, 95.
• Eyes closed, 80.
• Closure of the eyes and photophobia, 3.
• Injected eyes, 160.
• Eyes highly injected cornea vascular and semiopaque, 56.
• Cornea dim, covered with mucus, 127.
• Redness of the cornea, with some photophobia; if she looks towards the light she is obliged to close the eyes (second day), 2.
• Decided exophthalmus in consequence of the weakness of the recti muscles, 138.
• The ophthamoscope demonstrates an atropic condition of both optic nerves, the inner (apparent) half of each, seen in the reversed image, being quite white and non vascular; the outer part being redder, and more vascular than normal, 115.
• An examination of the numerous cases reported by Dr. Hutchinson reveals the following conditions common to all the cases; white or gray atrophy of the optic nerve (in a few cases the color was bluish-white), commencing at the outer part of the disk, usually with a sharply-defined margin and with diminishing size of retinal vessels; in a few cases there were signs of congestion, and in two cases neuritis with indistinct outline of disk. In some cases the centre of disk was found depressed and atrophied. It is noteworthy that the left eye became first affected and was more affected than the right in nearly every case. The vision failed suddenly in a few, rapidly in many; in others the progress of the disease was fitful. Some complained of flashes of light, others of fog, but most simply of indistinctness of vision. As the atrophy advanced the pupils dilated and became insensible to light; and in a few cases divergence of the eyes ensued, 174. [200.]
• By means of the ophthalmoscope, both optic nerves appear of brilliant white color, their areas being enlarged, and their outlines clearly defined, .

EAR

• The ears are red and burning hot (first day), 2.
• Tearing in front of and beneath the right ear (second day), 1.
• Sticking behind the left ear, with somewhat hard red swelling (sixth day), 2.
• Pains within the ear, on touching the outer ear (sixth day), 2.
• Violent earache twelve months ago, with giddiness and overpowering sleepiness, 174.
• Painful gnawing in the right ear (after five minutes), 1.
• Some painful tearing in the right ear (first day), 1.
• Jerking tearing in the right ear and in front of it, externally (second day), 1.
• Fine tearing and sticking in the lobule of the right ear, 1. [290.]
• Tickling in the ears (third day), 2.
• Sticking in the ears, during music (fifth day), 2.
• Stitches in the ears, especially in the open air (second day), 2.
• Stitches in the ears (first, third, fourth, fifth, sixth, and ninth days), 2.
• Sensation as if something stopped the ears (second day), 2.
• Ears seem stopped, especially the right (third and fourth days), 4a.
• Hearing.
• Hyperæsthesia of the acousticus against music and loud talking, 131.
• Sensitive to the slightest noise, 139.
• Deafness not complete, but hearing very dull, 117.
• Noise in ears occasionally, 167. [300.]
• After sunset, indoors, fluttering in right ear, both heard and felt (first day), 152.
• Ringing in the ears, 40.
• Roaring in the ears, 2, 78, 96, 126.
• Roaring and rushing in the ears, 42.
• Roaring in the ears for several days, especially in the morning, 4a, 4b.
• Humming in the ears, aggravated by loud noise or by going into the open air, for several days, 4a.

NOSE

• Ulceration of the nose, 159.
• Sneezing several times, after which the head felt freer (fourth day), 2.
• Constant desire to sneeze, 164.
• Fluent catarrh (first, second, fourth, and fifth days), 2. [310.]
• Fluent catarrh, with acute smell (fourth day), 2.
• Dry catarrh (third day), 2.
• Constant discharge of watery mucus from the nose, 36.
• Twelve had frequent epistaxis, 143.
• Bleeding from the nose and lungs, 76.
• Nose stopped (third and eighth days), 2.
• Dryness of the nose, 1, 76.
• Sensation of pressure and formication in the Schneiderian membrane, 48.
• Drawing pain in both angles of the lower jaw (third day), 2.
• Crawling in the nostrils (fourth day), 2. [320.]
• Burning under the nose, as from violent fluent coryza (tenth day), 2.
• Sudden burning in the left nostril (first day), 1.
• Smell.
• Hyperæsthesia of the olfactories, especially against tobacco and cologne water, 131.
• Very acute fine smell in the morning (second day), 2.
• Diminished smell (first and third days), 2.
• Smell very weak; but she is very sensitive to the odor of wine, so that from an empty wineglass, standing in the room, she became almost befogged (fourth day), 2.

FACE

• Objective.
• Muscles of the left side of the face permanently contracted, as in apoplexy, 17.
• Face emaciated, pale, and stupid-looking, 117.
• Expression of the countenance that of stupefaction, 70.
• Altered expression of face, etc., 94. [330.]
• Features pinched and contorted, 106.
• Austere gloomy expression, as if indifferent to everything on account of being exceedingly discouraged, 95.
• Expression stupid, 107, 108.
• Features drawn, 105.
• Features sunken (third day), 121.*
• Countenance indicating lassitude and exhaustion, 140.
• Anæmic or cachectic look, 109.
• A peculiar alteration of the complexion; this is not a mere want of color, an ordinary pallor; it is a dullish gray appearance of the face, partaking both of a chlorotic tinge, and of that belonging to certain cachexias. It imparts to the countenance a characteristic look by which a practiced eye can recognize those who have been engaged beyond a certain length of time in the manufacture of tobacco; for it must be remarked that this facial aspect is only to be observed in the case of veteran workers, 90.
• Pale face, 93, 95.*
• Face very pale, 32, 35a.* [340.]
• Face deathly pale, 10, 175.*
• *Deathly paleness with the nausea, 1.
• Face pale and contracted, 70.*
• *Face pale, collapsed, covered with cold sweat, 88.
• Looks pale and depressed, 122.
• Pale face, with drawn features and deeply sunken eyes, surrounded by blue rings, 77.*

MOUTH

• Teeth.
• Chattering of the teeth from cold, in the evening (fifth day), 2.
• Lips drawn back, showing the teeth, which were covered with dark sordes (third day), 121.
• Caries of all the teeth, 139.
• Teeth good, but dirty and stained, 167.
• Toothache, continuing until nearly all the teeth were lost, 139.
• Violent drawing-tearing toothache in the upper teeth, extending towards the forehead (eighth day), 2. [380.]
• Drawing pain in the upper teeth, disappearing on pressing on the cheeks (third day), 2.
• Sharp tearing in the teeth of the right lower jaw (after half an hour), 1.
• Toothache becomes intolerable, 4.
• Sudden violent toothache, with heat of the face and dizziness, 3.
• When biting upon hollow teeth a sticking in them (third day), 2.
• Violent, persistent, throbbing toothache, in several hollow teeth, 6.
• In a vast number of extreme cases of smoking, when those who have indulged in such excess have had what has been called toothache, their sufferings have been great, yet in most instances I have observed that the crowns of the teeth seemed perfect, excepting that the enamel appeared to be altered in structure and color, and, therefore, I directed my special attention to the state of the fangs, and found them, in all such cases, denuded of their periosteum being rough at the extremities, as if rasped; whilst the color of the fangs themselves resembled horn, being of a darker hue than healthy dentine, and of a porous appearance, differing materially from the usual dense substance which envelops them. In consequence, therefore, of the active absorption going on, the affected teeth act as extraneous bodies and produce much local irritation. Hence I am led to the inference that tobacco affects the teeth themselves, and that the affection must not be confounded with their injury induced by the acidity often caused by stomach derangement, resulting from an inveterate habit of smoking. The symptoms of the "smoker's disease" are as follows: More or less uneasy sensations about the crown of the teeth, which gradually extends to the fangs; at this stage of the disorder, if the teeth are touched, there is a tenderness experienced, and if bitten on in this condition, a sudden and most painful sensation is experienced; as the disease proceeds, the patient seems cognizant of the immediate seat of the disease, the agonizing pain being confined to the bottom of the alveolar process of the affected tooth or teeth, which is attended with a palpable throbbing, or, as an unscientific patient expressed it, a "jumping pain." The most distressing symptoms are felt under vicissitudes of climate; in great and sudden changes from heat to cold, or ; or after drinking spirits and water, wine, beer, or any other alcoholic stimulants; in other words, the teeth, under this affection, suffer from anything that accelerates the circulation. Among many of my most intelligent patients, when there happened to be a space (from previous extraction) between the affected teeth, they have described their sensation as if a series of galvanic or electric shocks continually passed from tooth to tooth, and tired at last by this continued disturbance, they have had the offenders forcibly removed, .

THROAT

• Hawking of mucus (first day), 2.
• Much tenacious mucus in the throat (ninth day), 2.
• Tenacious mucus in the throat, which cannot he raised, 1.
• Choking, 64, 133.
• Nocturnal attacks of tightness of the throat, with palpitation and neuralgic pains in the neck, 104.
• Sore feeling in the right side of the pharynx when not swallowing, 1.
• Irritation to cough and scratching in the throat (second day), 2.
• Frequent irritation in the throat and larynx, exciting violent fits of dry cough, chiefly at night, 92. [450.]
• Scraping in the throat, 88.
• Scraping and pressure in the throat and larynx, 48.
• Scraping in the throat the whole afternoon (second day), 2.
• The throat is so scraping and dry that she can scarcely swallow (second day), 2.
• Rawness and scraping in the throat (soon), 1.
• Dryness of the throat, 2, 126.
• Throat parched, 150.
• Throat dry and irritable, 167.
• Pressure in the throat as if something were sticking in it (second day), 2.
• Tickling and raw feeling in the throat, 1. [460.]
• Tickling in the throat, rising up and provoking frequent cough (after half an hour), 1.
• A crawling sensation in the throat, which is painful on swallowing, 1.
• Transient stinging sensation of heat in the pharynx, soon, 7.
• Uvula and Tonsils.
• Uvula œdematous, 164.
• Catarrhal inflammation of the tonsils, 50.
• Tonsils enlarged, 167, 109.
• Fauces.
• Diffused redness and dryness of the fauces and roof of the mouth, 157.
• Redness of fauces, 109.

STOMACH

• Appetite and Thirst.
• Increased appetite (first day), 2, 45, 46, 51, 92.
• Appetite inordinate, 109.
• Ravenous appetite, 30, 147.
• Incessant hunger, if she eats nothing she is nauseated (sixteenth, seventeenth, and eighteenth days), 2.
• Immediately after vomiting, he can again eat with appetite, 1.
• Paroxysms of canine hunger, 92.
• Appetite, but cannot eat, 95.
• The desire for food was not nearly so great as in the experiment without Tobacco, neither was there so great a degree of debility, 87a. [490.]
• She has neither hunger nor appetite, and the food at noon disgusts her, 1.
• Appetite failed several months before sight, 174.
• Smoking just before eating diminished the appetite, 9.
• Appetite bad, in the morning, 174.
• Loss of appetite, 10, 36, 42 , etc.
• Appetite diminished somewhat and had lost much flesh, 174.
• Appetite and digestion gone, 87.
• Twenty-three had a strong appetite for alcoholic drinks, 143.
• Anorexia, 66, 79, 91.
• Thirst, 36.* [500.]
• Increased thirst, 1.
• Violent thirst, 42 ; in the evening (fourth day), 2.
• Great thirst, especially at night, 136.
• Great thirst, but could not drink much at a time, 32.
• Frequent drinking of only small quantities of water, 77.
• A morbid craving for stimulants and narcotics, 142.
• No thirst; water will not go down (twelfth day), 2.

ABDOMEN

• Hypochondria.
• Liver enlarged, 167. [640.]
• Acute inflammation of the liver after an extraordinary bout of smoking, 123.
• Pressure in the hypochondria (first day), 2.
• Stitches in the hypochondria (first and seventh days), 2.
• Sensitiveness of the entire gastric region to slight pressure. But the real seat of pain was the left hypochondria, immediately below the heart. Slight pressure relieved it temporarily, it never ceased entirely, but came on in paroxysms, mostly excited by motion, though it would also take place, albeit only at long intervals, in a state of complete rest. The patient described this pain as being an exaggeration of that which is felt in the region of the spleen after running too long, 93.
• When pressing upon the hepatic region pain extending to the pit of the stomach (tenth day), 2.
• Stitches in the hepatic region relieved by stooping, could not stretch out on account of it (tenth day), 2.
• Stitches in the hepatic region (fourth day), 2.
• Several times stitches in the hepatic region under the last ribs, towards evening (first day), 2.
• Fine stitches as with a needle in the liver, aggravated by breathing (first day), 2.
• When walking, stitches in the liver, which extend toward the pit of the stomach (tenth day), 2. [650.]
• Burning sticking externally in the left hypochondriac region (after five minutes), 2.
• Umbilicus and Sides.
• Painful retraction of the navel, especially on stooping, 1.
• Cramplike pain in the umbilical region, 1.
• Cutting pain about the navel (fifth day), 2.
• Pressive pain in the umbilical region with cramplike retraction of the navel, 1.
• Pressive sensation beneath the right short ribs, as if a heavy weight were lying there, the place is also painful to touch, 2.
• Digging and pressive feeling in the umbilical region, 1.
• A pressive, painful feeling in the region of the kidneys, 1.
• Stitches beneath the right short ribs (fourth day), 2.

RECTUM AND ANUS

• Burning pain in the anus after the stool, 1.
• Itching in the anus, 48.
• Repeated ineffectual urging to stool, followed by a hard evacuation several hours after the usual time, 4d.
• Tenesmus and violent pain in the small of the back during stool, though the evacuation was soft (fourth day), 2.
• Frequent urging to stool in the morning (eighth day), 2. [710.]
• Desire for stool with frequent tenesmus in the rectum (after four minutes), 2.
• Violent straining at stool with pressure as if the fæces were retained, yet the stool was soft, 2.
• Straining and violent burning in the anus during stool (eleventh day), 2.
• Frequent desire for stool, but always a scanty evacuation, preceded and followed by sore pain in the abdomen (second day), 1.

STOOL

• Diarrhœa.
• Diarrhœa, 9, 11 , etc.
• Profuse diarrhœa, 76, 162.
• At intervals, violent diarrhœa, accompanied with severe gripings, lasting sometimes several days, and followed by constipation, 92.
• The diarrhœa was not like that produced by tobacco in the provings; it was urgent watery, painless ; one movement on rising in the morning, and four or five before reaching his office, and no more till next morning ; cured in two weeks, 136.
• After one or two years the symptoms of chronic poisoning begin with serous diarrhœa, followed by a peculiar change in the color of the face, which becomes a pale gray; the blood becomes very thin, and passive congestions occur, 68.
• He was subject, for eighteen months, to severe attacks of diarrhœa, which almost invariably came on at night, about 2 A.M. On discontinuing the use of tobacco, these attacks ceased, 72. [720.]
• Simultaneously with the convulsive attack, he was purged to a most unusual and extraordinary extent, the whole bed and floor around it being flooded, as it were, with the discharges, which consisted of feculent matter of a dark greenish-brown color, 83.
• Diarrhœa with vomiting and delirium (after two hours), 97.
• Involuntary evacuations, 54.
• Involuntary evacuations at times of both urine and fæces, 108.
• Bowels very loose, especially in the morning; generally has to rise from bed about 4 A.M., in consequence of a call to stool, and he has frequently two or three evacuations before breakfast also; the motions are of a good color, only thin, 99.
• Purging several times (second and third days), 2.
• Purging and emission of flatus immediately after eating (fourth day), 2.
• Purging three times with sore pain in the anus (fourth day), 2.
• Purging with colic (fourth day), 2.
• Five diarrhœa-like stools at night, with burning and tenesmus in the anus (seventh day), 1. [730.]
• Liquid, very offensive evacuation, followed by tenesmus, 1.
• Green, slimy diarrhœa with tenesmus, .

URINARY ORGANS

• Kidneys and Bladder.
• Pressive pain in the region of the kidneys before urinating, 51.
• Paralysis of the bladder and rectum, 68.
• Urethra.
• The orifice of the urethra is inflamed and agglutinated (eighth day), 2. [770.]
• Burning and tickling in the urethra, soon, followed by an emission at night, 50.
• Burning in the urethra when urinating, 42.
• Burning-itching pain in the urethra after urinating (eighth day), 2.
• Prickling in the urethra during micturition, 48.
• Itching in the urethra before urinating, 51.
• Micturition and Urine.
• Frequent desire to urinate, 5.
• Constant desire to urinate, 134, 139.
• Pressing desire to evacuate the bladder and bowels, 78.
• Desire to urinate, with or without vertigo, 7.
• Frequent and increased, evacuation of urine, which was once passed involuntarily at night, 46. [780.]
• Urine evacuated more frequently than usual, at times involuntary dribbling, 48.
• Urine passed involuntarily, 117.
• Increased discharge of urine, 7, 19, 20 , etc.
• Increased evacuation of red, offensive, ammoniacal urine, 45.
• Increased secretion of urine, from small doses, 26.
• Copious secretion of pale urine, 47.
• Urine pale, increased in quantity, so that he was frequently obliged to rise at night to urinate, with almost incontinence of urine, 49.
• Increased evacuation of yellowish-red urine, 1.
• Suppression of urine, 40.
• Quantity of urine small and dark in color, specific gravity 1025, acid reaction; deposits urates and mucus, no albumen or sugar, 167. [790.]

SEXUAL ORGANS

• Male.
• Genital organs flabby, 107.
• Erections towards morning (first day), 2.
• Many erections without voluptuous sensation (second day), 2.
• Discharge of prostatic fluid (eighth day), 2.
• Some crawling in the glans penis, 2. [800.]
• Varicocele, 174.
• Emissions, 47.
• Nocturnal emissions, 46, 174.
• Emission at night, without waking (eighth day), 2.
• No erections or sexual desires, 109.
• Female.
• Discharge of a few drops of liquid like mat water from the vagina, fourteen days after the menses (second day), 2.
• The menses, which were delayed about one day, came on more profusely than usual (first day), 1.
• Derangement of the catamenia, 57.

RESPIRATORY ORGANS

• Constrictive pain in the larynx, 45.
• Terrible tickling in the larynx, with alteration of the voice, 164. [810.]
• Irritation of the upper part of the trachea, followed by expectoration, 46.
• Voice.
• Voice weak, 167.
• Voice feeble and low, 128.
• Voice hoarse, 47, 78.
• Cough and Expectoration.
• Almost constant cough, with sensation of burning in the larynx, 36.
• Dry cough (second, third, seventh, and thirteenth days), 2 ; towards evening, 4d.
• Dry cough the whole morning, with a stitch in the pit of the stomach (twelfth day), 2.
• Dry short cough, 159.
• A dry cough, which soon became frightfully severe; a genuine whooping-cough, continuing night and day, only intermitting during a meal, 96.
• At times tickling cough, 76. [820.]
• Cough and hiccough at the same time, as if she would suffocate, lasting a quarter of an hour (tenth day), 2.
• Cough, with dark sputa, 167.
• Hæmoptysis; she had raised several ounces of blood and mucus this morning; she had now a cough and continued to expectorate small quantities of blood; on close examination the matter expectorated was found to contain numerous dark particles diffused through it; in some spots several of these had coalesced and formed large masses, although she had not touched snuff for four days; the next day the hæmorrhage had gradually lessened, but the snuff was still diffused through what was brought up, and continued so the whole of this day and the next. I ascertained that the attempt to introduce a spoonful of snuff into the mouth has, from the first, been frequently followed by a convulsive cough. Her friend from whom she learned the habit is troubled with a constant cough, and has become emaciated and weakly, 73.
• (Expectoration of gray mucus, in the morning), (second day), 2.
• Respiration.
• Respiration very free and more easy than usual, 50.
• Respiration very rapid, short, or at times slow and deep, apparently omitting entirely at times, .

CHEST

• Smoking of tobacco tends to render the lungs flaccid, and to bring on a true marasmus, 85.
• Various diseases of the chest, 9.
• Oppression of the chest, relieved by deep breathing, 1.
• The chest is oppressed, constricted; cannot take a deep breath, associated with a feeling of apprehension and anxiety; she cannot rid herself of the thought that some misfortune would happen to her (third day), 2.
• Oppression at the chest great, 64.
• Very violent constriction of the chest (tenth day), 2.*
• Constriction across front of upper chest, dyspnœa and disposition to take a full inspiration, with the darting pain extending from the heart to the vertex, 147. [870.]
• On a Saturday an attack of angina supervenes, of half an hour's duration; a second fit recurs next day, and he is found dead in his bed on the Monday morning, 106.
• On taking a deep breath, it seemed as if the chest were too tight (second day), 2.*
• One evening, while smoking, he was seized suddenly with violent pain in the chest, as if he had been squeezed by a vice; his pulse was insensible. The attack lasted ten minutes, 103.
• After seven years was suddenly seized with intense pain in the chest, gasping for breath, and a sensation as if a crowbar were pressed tightly from the right breast to the left, till it came and twisted in a knot round the heart, which now stopped deathly still for a minute, and then leaped like a dozen frogs . After two hours of deathlike suffering, the attack ceased, and ever after the heart missed every fourth beat . For the next twenty-seven years, continued to suffer milder attacks like the above, lasting from one to several minutes, as often as two or three times a day or night. After the discontinuance of tobacco the attacks ceased, 81.
• The smoker feels a pain, dull, and although not acute, yet distressing, from the constant sense of oppression which attends it. Its seat is behind the breast bone, and rather tending to the left side. It is neither aggravated nor diminished by full inspiration, nor by any change of posture; comes on usually in the afternoon, but irrespectively of meals, and sometimes increases in severity during the night, so as to interfere with sleep, yet almost completely vanished before morning, and this without appreciable disturbance of the circulation, respiration, or digestion, .

HEART AND PULSE

• Præcordia.
• Three had heart disease, 143.
• They very generally thought they had idiopathic heart disease; complained of pain and soreness in the region of the heart, and they could not lie very long on the left side, at night, 142.
• Heart disease is very common among tobacco provers, 142.
• Præcordial oppression, 108.
• Suddenly seized in the evening with violent præcordial anxiety, followed by complete sleeplessness and springing from bed, 108.
• Suffered chiefly at night from paroxysms of præcordial oppression, with palpitation and pain between the shoulders, 105.*
• One morning was suddenly seized with pain in the region of the heart, with transversal constriction in the upper part of the chest. He could neither walk nor speak; the pulse was insensible; the hands cold; the attack continued half an hour, 101.
• Darting pain, extending from the heart upwards to the vertex, and sensation of constriction across front of upper chest, with dyspnœa and disposition to take a full inspiration, 147 . [The cardiac and thoracic pains were probably an aggravation of symptoms caused by partial suppression of a habitually profuse and offensive footsweat.] [910.]
• Aching pains in cardiac region, generally worse at night, with frequent intermission of the pulse and of the heart's action, 137.
• Slight disturbance at the heart, 96.
• Heart's Action.
• Both sounds of heart clear, but the action was relaxed and occasionally intermittent, 148.
• The heart sounds were muffled and seemed to almost run into each other, 166.
• Systolic murmur in aortic area and in course of large vessels, 167.
• On applying the hand over the cardiac region, the impulse conveyed to it was of marked peculiarity, much resembling, as was conceived at the time, the purring tremor, or fremissement cataire of French writers, which is likely to accompany aortic regurgitation, 89.
• Sounds of the heart inaudible, and its movements scarcely felt (after three days), 121.
• *Palpitation, , , , etc.

NECK AND BACK

• Neck.
• Stiff neck, so that he could not turn the head to the right side (eighth day), 2.
• *Neuralgic pains in the neck, with the tightness of the throat, 104.
• Burning and tension in the skin of the right side of the neck (second day), 1.
• Great heaviness and pain in the nape of the neck, so that he was obliged to remove the neckerchief (first day), 2.
• Back.
• Tenderness of the spine along its whole length, the more especially in the cervical and lumbar regions, 57.
• Pain between the shoulders, with the præcordial oppression, 105.
• Burning beneath the scapula (second day), 2.
• Stitches in the right scapula (fourth day), 2.
• Dull pain in the middle of the spine, with bruised feeling over the body, especially in the upper extremities, in the morning, 4. [990.]
• Pain in the small of the back and loins , especially after sitting, 4, 4a, 4b, 4c.
• Intolerable pain in the small of the back, greatly aggravated while sitting and lying, 4d.
• Pain in the small of the back, constrictive, especially violent after a stool (fourth day), 2.
• Pressive pain in the lumbar region on rising from a seat and on beginning to walk, disappearing on walking, 1.
• Beating pain in the region of the sacrum, in the evening (first day), 4.

EXTREMITIES

• Extremities outstretched, relaxed, powerless, with almost incessant trembling and frequent convulsive twitchings, 77.
• Trembling of the limbs, 38, 48, 55a, 82.
• Trembling of arms and hands, 147.
• Rigidity of the limbs, 36, 57.
• Limbs began to be very stiff (second day), 121. [1000.]
• Paralysis and relaxation of the limbs, 34.
• Cataleptic condition of the arms and legs; if a leg or arm were extended or flexed or uplifted, it would retain that position for at least five minutes, or until it was reduced to a more comfortable posture, 66.
• Great weakness and trembling of the hands and feet (first day), 2.
• Weariness and prostration of the limbs, 1.
• Complete loss of power of the upper and lower extremities, 168.
• Limbs relaxed, 33.
• A feeling as if the fingers were longer when smoking Tobacco in a pipe, after about three inspirations of it; if he continues smoking, he feels as if he had lost the use of his legs from knees downwards; can smoke a cigar in open air, but if he smokes half of one indoors, his calves feel as if they did not belong to him, and as if they were dropping away, 165.
• Pain in all the limbs, 42.

SUPERIOR EXTREMITIES

• The arms bound over the chest, 37.
• Constant inclination to stretch the arm (second day), 2. [1010.]
• The right arm seems paralyzed, as with cramp (twelfth day), 2.
• The left arm is completely powerless and painful (third day), 2.
• Severe spasmodic contractions in his arms and hands, 32.
• Tension in the left arm, especially in the elbow (first day), 2.
• Pain in the arm on raising it (first day), 2.
• Drawing pain in a spot as large as a half dollar on the left arm, as if an ulcer would form (fourth day), 2.
• Shoulder.
• Pulsation beneath the right shoulder (first day), 2.
• Stitches and drawing in the left shoulder (second day), 2.
• Elbow.
• A drawing pain in the elbow on turning the forearm (first day), 2.
• Sticking pains in the elbows, on account of which he could not quickly stretch out the right arm (second day), 2.
• Forearm. [1020.]
• Pain, as from a sprain, in the right forearm, especially in the elbow, with painful stitches immediately on every exertion (third day), 2.
• Tearing in the tendons of the left forearm towards the hand, and then in the elbow (second day), 1.
• Hands.
• Hands joined, and in a state of rigid contraction, 37.
• Trembling of the hands (first day), 2, 76, 107, 149.
• Trembling of the hands and tongue, 78.
• His hand trembles much when he holds it out, 99.
• Weakness of the hands (first day), 2.
• The hands seem paralyzed and cold, followed by burning and fuzziness of the tips of the fingers and difficult mobility, with coldness and chilliness of the body (eighth day), 2.
• Drawing, paralytic, spasmodic pain in the right hand, extending to the elbow (fifth day), .

GENERALITIES

• Consumption, 9. [1070.]
• "The pernicious effects of Tobacco upon children are incontestable. The use of Tobacco causes pallor, chloro-anæmia, palpitation, and troubles of digestion. The anæmia is incurable as long as the habit is continued. Children addicted to Tobacco are of inferior intelligence, and have a taste more or less pronounced for strong drink. Those who drop the habit before the production of any organic lesion recover perfectly," 144.
• Twenty-seven presented marked symptoms of nicotine poisoning, 143.
• The habitual use doubtless causes a physical and mental deterioration of the race. One's offspring are more liable to possess a delicate constitution, because this abuse produces undue excitement, and hence exhaustion of nervous force in the patient, and statistics conclusively show that such indulgence predisposes the next generation to various cerebral affections, 142.
• Feeling of increased vigor in the muscles, with disinclination for the slightest movement (soon), 4.
• Entire system flaccid, pallid, 80.
• Walks literally bent double, pressing both hands over the region of the spleen, and groaning at every step, 93.
• Blood thin; red corpuscles scattered, non-confluent and crenated, 167.
• Eight had decided deterioration of the blood, 143.
• Emaciation, 61, 69, 109. [1080.]
• An advanced state of marasmus, 91.
• Rapid emaciation, 76, 122.
• Loses flesh, especially on the back; the cheeks also become wasted (after ten days), 2.
• Began to emaciate and grow pallid, 58.
• She is emaciated; all her clothes are too loose (twelfth day), 2.
• Average weight of body 225.79 pounds (for five days before smoking); 225.86 pounds (for five days while smoking), 87.
• Average weight of body 224.77 pounds (for five days before smoking); 223.62 (for five days while smoking), 87a.
• The hands were doubled into a fist and tightly drawn across the chest; the fingers could not be outstretched nor the arm moved; the muscles of the chest and arms felt hard, with vibrating contractions of different fibres, 127.
• I always had a strong appetite for Tobacco, so that nothing but absolute necessity could ever have induced me to undertake to break up the habit, but for a year I found the symptoms gradually increasing in violence and frequency. I used Gentian as an antidote or substitute; its bitterness temporarily destroyed the everlasting craving for Tobacco. The first night after reforming, I jerked so that I could not sleep, jerked all over, and something seemed to draw my left shoulder down irresistibly. A dose of Ignatia immediately relieved me of these symptoms, and I slept well the remainder of the night; one slight jerking since is all. Now I can lie very well on either side. Can go upstairs or over a bridge quite comfortably. Better as to pulse and cardiac pain. No more vertigo. Can hardly observe any numbness of orbicularis oris. Sleep well. No bad dreams: Appetite good. Strength improving. Temper better than usual, .

SKIN

• Objective.
• Jaundice, 9, 134.
• Cases of jaundice in healthy young men, 124.
• Skin pallid and presented an anæmic appearance, 166.
• The skin gradually assumes a peculiar grayish tinge, which may be said to occupy a medium between the paleness of chlorosis and that of other cachexiæ, 66. [1200.]
• Increased turgescence of the skin, with violent itching and slight general perspiration, 50.
• Increased turgescence of the skin, with itching and slight perspiration, 51.
• Skin livid, covered with cold sweat, 160.
• Red itching eruption over the whole back (after five days), 1.
• Red spots on the face (first day), 2.
• Red spots on the right shoulder, with burning when touched (tenth day), 2.
• Many pimples on the forehead, with itching, which is relieved for a short time by rubbing (third day), 2.
• Itching pimples on the small of the back and fingers (after eleven days), 2.
• Itching pimples on the chest (third day), 2.
• Papular eruption, 50. [1210.]
• Pustular eruption on the nape of the neck and upper extremities, 49.
• Gritty elevations on both cheeks, beneath the eyes, perceptible only on touch (first day), 2.
• Small itching blisters on the body, surrounded by red areolæ, and filled with yellow liquid, with sore pain on touch (after five days), 2.
• Dryness of the skin, 11.
• Subjective.
• Increased vulnerability of the skin, so that the slightest wound or abrasion is followed by a high grade of inflammation, 50.
• Trembling sensation in the skin as though it were being torn, 145.
• Formication of the left lower extremities from the knee to the toes (third day), 2.
• Violent itching, 77.
• Violent itching of the whole surface, 136.

SLEEP

• Sleepiness.
• Much yawning (second, third, fourth, and fifth days), 2.
• Yawning and sleepiness after dinner (first day), 1, 2.
• Much yawning after dinner (first day), 2.
• Drowsy, 37, 121.
• Sleepiness (after one and a half hours), 2, 9, 11, 45, 174.
• Great inclination to sleep, 1. [1230.]
• Very sleepy towards evening (third and fourth days), 2.
• Promotes sleep, 7.
• Sleepiness in the house, which disappears in the open air (second day), 2.
• Sleepiness, associated with heat and restlessness, 7.
• Sleepy in the forenoon; he also slept for a short time (first day), 2.
• She was sleepy immediately after dinner, and slept for an hour, and even then could not arouse herself until after violent palpitation (fourth day), 2.
• She woke before midnight and soon fell asleep again (first day), 1.
• Stupefying, but not refreshing sleep at night, 4.
• Sleep, stupefaction, and profuse perspiration, 24.
• Deep sleep, followed by copious perspiration, 11. [1240.]
• Sound sleep at night (second and fifth days), 2.
• Sleep heavy, with irregular rattling respiration, from which he could not be awakened; at the same time the face and back were covered with cold sweat, eyes open and staring, features drawn; by long-continued shaking and calling the patient was momentarily aroused to consciousness; he took a cup of peppermint tea and then fell down in a most profound faint, with pale face, cold sweat, staring, sunken eyes, surrounded by blue margins, dilated and insensible pupils the lower jaw dropped, the extremities relaxed, powerless, 120.
• Cannot be wakened or aroused in the morning (second, third, and ninth days), 2.
• Sleeplessness.
• Sleeplessness, 72, 57, 60 , etc.

FEVER

• Chilliness.
• Chilliness, 92.
• Chilliness, with shivering in the open air (first day), 2. [1270.]
• Chilliness, with cold sweat (after two hours), 97.*
• Chilliness from 5 to 7 P.M.; about 6 o'clock associated with thirst (first day), 1.
• Violent shaking chill in the evening in bed, 4d.
• Violent shaking chill, with inclination to stretch, in the evening (first day), 4d.
• Shaking chill over the whole body every evening, 2.
• Shivering, with yawning and stretching of the arms (after four minutes), 2.
• Shivering over the whole body (after a quarter of an hour), 2.
• Shivering over the whole body, flushes of heat (first day), 2.
• Shivering immediately after eating, which lasted nearly the whole afternoon, and frequently alternated with heat, without thirst; during the coldness she perspired constantly under the arms (first day), 2.
• She complained of coldness and shivering in the morning in the open air (second day), 2. [1280.]
• Shivering, with shaking all day, and towards evening sweat in the palms of the hands (second day), 2.
• Shivering the whole day, and pressive pain between the shoulders (third day), 2.
• Shivering nearly the whole day (seventh day), 2.
• Febrile shivering and chilliness (eleventh day), 2.
• Slight shivering, 48.
• Gooseflesh all day (first day), 2.
• Cold skin, 77, 183.*
• Whole body icy cold, streaming with cold sweat, 78.
• Pale and cold, 78.
• Coldness, with creeping heat, without thirst (after two hours), 2. [1290.]
• A sense of excessive coldness, 134.
• Coldness and shivering in the evening (fourth day), 2.
• Skin cold, covered with clammy sweat, 128.

CONDITIONS

• Aggravation.
• ( Morning ), Diarrhœa; dull pain in middle of spine.
• ( Afternoon ), Apprehension; anxiety; pain in chest.
• ( Evening ), Chilliness.
• ( Night ), When alone, anxiety; irritation in throat, causing cough; pain in pit of stomach; on going to sleep, shocks at epigastrium; pain in cardiac region.
• ( Open air ), Stitches in ears; humming in ears.
• ( Breathing ), Stitches in liver.
• ( Deep breathing ), Rumbling and gurgling in abdomen; stitches in chest.
• ( Great cold ), The symptoms.
• ( During dinner ), Pressure on right side of head.
• ( After dinner ), Heaviness of head.
• ( Eating ), Pressure in vertex; pressure in cardiac orifice of stomach.
• ( After eating ), Loud eructations; pain in stomach; clawing in stomach.
• ( On entering house, after walking ), Vertigo.
• ( Great heat ), The symptoms.
• ( In the house ), Sleepiness.
• ( Looking intently ), Lachrymation.
• ( Laughing ), Stitch in articulation of jaw.
• ( Lying ), Pain small of back.
• ( Lying on left side ), Palpitation.
• ( Motion ), Vertigo; headache; drawing pain in eyeballs and temples; vomiting; pain in left hypochondrium.
• ( Moving eyes ), Pressive sensation in them.
• ( Music ), Sticking.
• ( Loud noise ), Humming in ears.
• ( During rest ), Sticking in right side of chest.
• ( Riding ), The symptoms.

SUPPLEMENT: TABACUM. Authorities.

176 , B. C. Brodie, Pharm. Journ., 2d Ser., vol. ii, 1860-1, p. 237, effects of smoking; 177 , Wm. O'Neill, M.D., Lancet, 1879 (1), p. 296, Mrs. A., æt. forty years, applied chopped tobacco to a bleeding wound.

• Extremely prostrated, pulse scarcely to be felt, skin pale, cold, and wet, with a profuse clammy perspiration. The pupils of the eyes were dilated, and in a faint whisper she complained of dizziness, of dimness of sight, and of confusion of thought, also suffered from severe pain in abdomen, constant nausea, and vomiting, 177.
• Almost the worst case of neuralgia that ever came under my observation; the pains were universal and never absent; but during the night they were especially intense, so as almost wholly to prevent sleep, 176.