DERANGEMENT OF THE DIGESTIVE SYTEM.
Most of the great systems of the body suffer from the effects of tobacco smoke, but of all systems the digestive is the one most affected. The tongue of the confirmed smoker is rarely clean, the appetite rarely perfect. The mucous membrane of the mouth, tongue, and throat is often much irritated, the salivary glands are excited to profuse secretion, and the tonsils are often rendered large and irritable. The mucous membrane of the stomach is ir ritated and secretes its digestive fluids 'irregularly, with frequent excretion of acrid fluid which causes heartburn, eructation, and general debility. The muscular fibres of the stomach are also influenced, losing their tone and activity. The food, therefore, in a confirmed smoker seldom passes through complete digestion, and constipation and irregular action of the bowels are the conse quences. On the whole dyspepsia may be said to be the malady of the confirmed smoker, and the terms "smoker's sore throat," "smoker's tongue," "smoker's salivation," are too familiar. When the smoker is not cleanly in his habits a deposit of an earthy kind takes place, on the teeth, from the saliva, salivary calculus.
Cancer of the lips or tongue has not unfrequently been con nected with smoking, and the cancer of the lip at the point where the pipe presses has often been observed as the spot from which epithelial cancer takes its rise. I have no doubt that the irritation produced by the stem of the pipe does excite epithelial cancer in persons predisposed to that affection, but I do not think there is sufficient evidence to show that tobacco smoke itself is an exciting cause of cancer.
Derangement of the Circulatory System.
Tobacco smoke does not, I believe, produce organic disease of the heart or other parts of the circulatory system, but it renders the blood unnaturally fluid, it injures the red blood corpuscles, and it greatly disturbs the action of the heart and of the arteries. It creates palpitation of the heart, irregular motion, intermittency, and, in extreme instances, cardiac breathlessness, attended by acute pain or spasm through the chest. It causes constriction of the blood-vessels of the minute circulation, paleness of the face, and Derangement of the Respiratory System.
The action of the smoke of tobacco on the mucous lining of the bronchial passages is to produce much irritation, attended often with cough and expectoration. At the same time, considering how large a surface in the lungs is immediately exposed to the vapor, it is remarkable that the irritation should be so limited as it really is. I have often been obliged to prohibit smokers who suffer from bronchial irritation the indulgence of the pipe, but I could not say that I have ever known organic disease of the lungs to spring from smoking. I have entered largely in another place into the ques tion whether pulmonary consumption and bronchitis are directly caused by the action of tobacco, and I think I have conclusively shown that they are not. At the same time I am convinced that when either of these diseases is present smoking adds to the mis chief. This is particularly true in regard to consumption, for smoking interferes with the due oxidation of blood and promotes indigestion, both of which derangements are favorable to the de velopment of the inherited affection.
Derangements of the Nervous System.
The opponents of tobacco unite in the expression of opinion that tobacco smoke seriously affects the nervous function, and even produces nervous diseases, such as apoplexy and paralysis. In one remarkable and exceptional instance I witnessed in a man fatal symptoms which had been induced purely from excessive smoking. In this instance death came on from a paralysis, involving, I may say, the whole nervous system, for all the motor powers, voluntary and involuntary, together with the mental powers, collapsed. As a rule, however, tobacco smoke does not produce structural or organic nervous change, although it keeps the nervous system in a continual state of irritability and debility. It also creates giddi ness and unsteadiness in some persons, vertigo; and, without any doubt, it dulls while it seems to soothe the mental faculties. It causes also irritability of temper and a craving for itself which amounts too often to a kind of mental disorder. Through the sympathetic nervous system tobacco acts on the glandular system, exciting over-secretion followed by an impaired secreting power. I do not accredit the hypothesis that tobacco smoking is a cause of insanity.
Derangements of the Sensory Systems.
There can be no doubt that smoking produces serious func tional derangement of the senses. It markedly impairs the senses of taste and smell, and probably renders less accurate the sense of touch. But the senses most seriously influenced by it are those of hearing and sight.
The specific effect of smoking on the sense of hearing is indi cated by a confusion of sounds, with a difficulty in appreciating sounds that are very soft or unusually loud. This causes the affected person to ask questions with respect to articulate sounds which by others are distinctly heard. When this symptom is pre sented it is usually followed by that of a sudden sharp ringing in the ears, which may be excited, at one time, by a slight external noise, and, at other times, without any noise at all. These symp toms are often long continued in smokers, but happily pass away, as a general rule, when the habit is discontinued.
On the sense of sight tobacco smoking produces, indisputably, phenomena of a serious character. In moderate smokers the sight is often perplexed. Letters become confused in reading, luminous specks float before the eyes, deep-seated pain is felt in the eyes, and the vision is, at times, attended with irritability, as if the sight could not be firmly fixed on an object. In inveterate smokers the pupils are unnaturally dilated, and when the light is very strong the vision is imperfect.
The best evidence that the tobacco is acting injuriously on the sense of sight is supplied when there is a long retention of images on the sensorium after the eye is withdrawn from them. This when long continued indicates that the retina or nervous screen is becoming affected, and the symptoms which follow are gener ally indicative of steady impairment of vision under all conditions. In time there is produced a disease which is called " tobacco amaurosis," one of the most determinate forms of blindness when completely established. In this instance the habit of tobacco smoking produces a distinct organic or structural disease.
Effects of Smoking on the Young.
From what is written above it will be seen that tobacco plays an important part in the role of induced diseases. I have spoken so far of its effects on adults only. In the young those effects are infinitely more serious. In them smoking checks nutrition, bodily development, and mental development, to such an extent that if a community of youths of both sexes were trained to early smoking, and if marriage were confined to them, an inferior race of men and women, compared with what is now existing, would, of neces sity, be born. To the credit of our women this experiment is not being carried out.
Effects of Tobacco taken as Snuff.
Indulgence in tobacco in the form of snuff has now consider ably decreased, but the habit, when it is carried out, is, decisively, productive of injurious effects. Many of the results attributable to smoking are produced by snuff, especially those which are ex erted on the throat and on the digestive and nervous systems. Profuse snuff-takers are, as a rule, always dyspeptic, for the par ticles of the snuff pass down into the back of the throat and are swallowed, so that the direct action of the poison on the stomach is brought about. I have seen confirmed indigestion, injected throat, irritative cough, and vertigo, with other nervous phenom ena, induced by the inhalation of tobacco as snuff, and I have once known further poisonous results from the action of lead with which the snuff was adulterated.