Tabacum

Nicotiana tabacum, Linn.

Natural order, Solanaceae.

Common name, Tobacco.

Preparation, Tincture of the leaves.

Authorities. (1 to 3 from Hartlaub and Trinks.) 1, Kenning ; 2, Schroeder; 3, Husband, 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 6, 30 drops; 4c, 40 drops; 4d, 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, Hildebrand, 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. fur Heilk., vol. 4, p. 92; 11, Voigtel, Arzneimittel, 1817; 12, Gesner, Epistol., effects on nose and mouth of smoking the leaves; 13, Lesser, Arzn., in Schwaben, 1, 194 ; 14, Marriages, Vandemond, Rec. Periodic, vol. 7, p. 68, effects of

■f Usually clammy or greasy sweat. smoking; 15, Vidocq, Miscel., 1828, 12, 376; 16, Moment, Hufeland's Journ., 1833, effects of injection in a man, set. seventy years, for a scrotal hernia which had to be operated on ; 17, Chantourelle, Archiv. Gen. de Med., 1832, injection of 1^ ounces in a man ; 18, Gmelin, Geschichte der Pflanzengifte, 1770, Halle Gifte History, 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, Dimenbrock, Tract, de Peste, p. 294; 25, Pitschaft, Hufeland's Journ., 1832; 26, Horn, Arzneimittel, 1805; 27, Cornel, Usuelles, 10, 184; 28, Brandies, Archiv., 25, 1, 97, effects of a clyster; 29, Grahl, Hufeland's Journ., 71, 4, 100; 30, Helbig, Obs. Phvs. 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, set. 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, set. ten years, had a crust upon the scalp, to which was applied powdered Tobacco; 39, G. G. ttigmond, M.D., Lancet, 1837 (1), 150, a young man made an external application for the itch ; 40, Richard, from Thore (Journ. de Chim. Med., 1839), a woman took an injection of an infusion ; 41, Krauss, Wurt. Corr. Blatt., 1840 (Frank's Mag., 2, 169), a girl took au injection of an infusion for worms; 42, Schmidtmann, Hufeland's Journ., 1840 (Frank's Mag., 1, 812), effects of excessive smoking; 43, Gaz. Med. de Paris (A. H. Z., 21, 28), effects of au injection of 45 grams of an infusion ; 44, same, effects of an infusion. 45 to 51, Dr. Riemer Schneider, De Herba Nicotine, 1840 (A. H. Z., 19, 10). 45, a man, set. 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, set. twenty-three years, took within eight days 2 ounces of essence; 47, K., set. twenty-five years, took 1 ounce of essence in ten days; 48, another, set. twenty-nine years, took 4 ounces of essence in eight days; 49, S., set. twenty-two years, took 2 ounces of essence in eight days ; 50, G., set. twenty-eight years, took the essence for ten days; 51, E., set. twentysix 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, set. 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, Either, Encvclop. des Sci. Med. Mag., 1843 (Am. Journ. Med. Sci., 1844 (1), p. 231) ; 55, Dr. Meyern, Casper's Woch., 1844 (Horn. Vjs., 6, 104), a woman, set. 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, Boston Med. and Surg. Journ., vol. 31, 1844.) 56, a young man smoked, chewed, and snuffed freely ; 57, a sister of same, set. thirty-nine years, had smoked and snuffed for fifteen years ; 58, S. E., set. forty years ; 59, C. P., set. forty-three years, had chewed for twenty years; 60, S. C, set. sixty-three years, had chewed for thirty-eight years ; 61, S. J., set. fifty-four years, had used Tobacco for ten years; 62, A. C, aet. twenty-seven years, had chewed for four years; 63, Mr. H., aet. thirty years, had used Tobacco for fifteen years; 64, J. S., set. 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 (Loud. 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., Loud. Med. Gaz., 1845(1), p. 237, effects of chewing on a young man ; 70, M. Beating, Giornale delle Sci. Med. della Sac. Med.-Chir. di Torino (Med. Times, vol. 13, 1846, p. 326), a child, set. four years and a half, was given an enema prepared with part of a cigar; 71, Peter Made, Lancet, 1849 (2), p. 480, a girl, aet. eighteen years, for constipation, took an injection of about 3 drachms of common shag Tobacco boiled in i 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 ; 73, R. A. Hemlock, M.D., Charleston Med. Journ. and Rev., vol. 5, 1850, p. 450, a woman, aet. twenty-eight years, had "chewed snuff" for six years ; 74, Poison, Foreign Scenes (Brit. Journ. of Horn., 8, 1850, p. 24), Mr. H. embarked on a sloop laden with Tobacco; 75, J. L. Levison, Med. Times, vol. 21, 1850, p. 27, effects on the teeth ; 76, Innhauser, Wien. Zeit., 1851 (S. J., 71, 356), effects on cigarmakers ; 77, Dr. Deutsche, Preuss. Vereiu Zeit., 1851 (S. J., 70, 27), a man, suffering from tapeworm, took 1 ounce of fluid extract; 78, same, a young woman smoked and swallowed a piece of a cigar for toothache; 79, Hjortb, Gaz. des Hop., 1852 (S. J., 76, 311), a woman, suffering from irregular intermittent fever, took an infusion in milk ; 80, W. A. Weaks, M.D., Bost. Med. and Surg. Journ., vol. 47, 1852, p. 461, a child, aet. seven days, took two tablespoonfuls of water impregnated with Tobacco-smoke, death in eight hours and a half; 81, Dr. J. W. Carson, Bost. Med. and Surg. Journ., vol. 49, p. 518, effects of chewing and swallowing the juice; 82, Dr. Polko, Preuss. Vermin Zeit., 1854 (S. J., 86, p. 31), a man applied the leaves to the lower extremities for rheumatism ; 83, David Sake, M.D., Edin. Med. and Surg. Journ., 1855-6, p. 643, a maniac, aet twenty-six years, swallowed over ^ ounce of the crude. (84 to 86 quoted by Levi, Charleston Med. Journ., vol. 11, 1856, p. 843.) 84, Muller; 85, Richard Morton ; 86, Leroy d'Etiolles ; 87, W. A. Hammond, M.D., Am. Jouin. Med. Sci., 1856 (2), p. 315, unaccustomed to smoking, smoked 150 grains after each meal ; 87 a, same, second experiment, the bread and meat each reduced, 6 ounces daily ; 88, Dr. Reil, Journ. fur Pharmakodynamik, vol. 1, 1857, p. 568, poisoning of a family of three persons by coffee containing Tobacco ; 88a, same, a woman, aet. fifty six years; 89, I. N. Berlin, M.D., Med. and Surg. Rep., vol. 10, 1857, a lad, aet. eighteen years, accustomed to the use of Tobacco, swallowed 30 grains of the leaf. (90 to 97, Dr. A. Teste, Journ. de la Sac. Gall., 2d ser., vol. 3, p. 401.) 90, effects on workers in Tobacco ; 91, a soldier, who smoked thirty pipes daily ; 92, a gentleman, who smoked seven or eight cigars daily; 93, a man, aet. sixty years, an almost incessant smoker; 94, 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; 95, symptoms in a man, aet. forty-three years, all of which disappeared after leaving off smoking; 96, effects on Dr. Teste himself; 97, Gaz. Med. Italian (Journ. de Chim. Med., 1859), a man, affected with herpes in the beard, applied the oil; 98, Dr. Borne, Dublin Quart. Journ., 1860 (2), p. 291; 99, Brit. Journ. of Horn., 18, 1860, p. 681, a man, set. forty-six, smoked one or two cigars every evening. 100 to 103, M. Beau, La Presse Med. Beige, July, 1862 (Brit, and For. Med.-Chir. Rev., 1862 (2), p. 537) ; 100, a gentleman, pet. sixty years, smoked the greater part of the day; 101, a doctor, set. thirty-five years, smoked cigarettes excessively; 102, another doctor, set. fifty years, smoked continually; 103, a man, set. thirty years, smoked cigarettes continually. 104 to 106, same, Med. Circ, August 27th, 1862 (Brit. Journ. of Horn., 20, 1862, p. 685). 104, a physician ; 105, a merchant smoked cigarettes excessively; 106, a healthy and vigorous man, set. seventy-five years; 107, Clement," Deutsche 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., set. thirty five years, smoked excessively. (110 to 112a, E. Smith, M.D., Lancet, 1863 (1), p. 292, effects ou the pulse.) 110, Mr. D., smoked a pipe, drawing the smoke through water; 110a, second experiment by same, where the smoke was not drawn through water; 110 6, same, smoked seven minutes; 110c, smoked in greater volume; 110 d, smoked faster three minutes and recharged the pipe; 111, effect on Dr. H. ; 111a, same, smoked the strongest bird's-eye Tobacco ; 112, Dr. R., smoked a cigar; 112 a, same, smoked the strongest bird's-eye Tobacco; 113, J. C. Wads worth, Lancet, 1863 (2), p. 95, W. A., set, twenty-one years, smoked 1 pound or 1J pounds a week; 114, same, J. M., set. thirty-six years, used Tobacco excessively ; 115, G. A., set. twenty years, has smoked eight or nine years, now smokes \ ounce of strong Tobacco every day ; 116, 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; 117, Dr. Le Brier, Gaz. des Hop. (Edin. Med. Journ., 1864 (2), 171), a woman, set. forty-five years, had eaten about two francs' worth a week for several years ; 118, M. Decline, Med. Times and Gaz., 1864 (1), p. 671, effects of smoking; 119, Med. Times and Gaz., 1864 (2), p. 559, a man died from the effects of chewing and swallowing the juice of roll Tobacco; 120, Dr. Major, Wiirt. Corr. Blatt., 1864, effects of smoking four Kentucky cigars; 121, Walter Scott, M.D., Med. Mirror (Dublin Med. Press, new ser., vol. 10, 1864, p. 588), Richard Edmondsou, set. seventeen years, smoked two pipes of birdseye and chewed about h ounce of Limerick roll Tobacco, swallowing the spittle; 122, Dr. Henry Kennedy, ibid., vol. 9, 1864, p. 226, a man, fet. thirty-four years, an excessive smoker; 123, Dr. Boston, Med. Circular, vol. 25, 1864, p. 381, effects of excessive smoking; 124, Dr. Charles Drysdale, ibid., p. 380, effects of excessive smoking, such as f ounce daily; 125, same, a young man smoked ? ounce daily; 126, Marchaut, Journ. de Brux., 1865 (S. J., 127), poisoning bv sucking the juice from au old pipe; 127, Wien. Med. Press, 1866 (N. Z. fur H. K., i3, 112), effects of chewing a cigar of Tobacco rust; 128, T. H. Babbington, M.D., Dublin Journ., 1866 (2), p. 545, Patrick Collier, set. thirty years, poisoned by exposure to fumes of roasted Tobacco and excessive use of the weed ; 129, Ritter, Med. Corr. Blatt. Wiirt., vol. 38, p. 5, a man, set. 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 ; 130, Dr. L. Scotten, Virchow's Archiv., 1868 (North Am. Journ. of Horn., 17, p. 469), an officer smoked excessively; 131, same, second case; 132, Mr. Curgensen, Med. Circular, vol. 25, 1869, p. 380, effects of excessive smoking; 133, Maurice G. Evans, M.D., Lancet, June 19th, 1869, a boy, set. 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; 134, Bull. Gen. de Ther., June, 1869 (New York Journ. of Horn., vol. 2, 1874, p. 533), a lotion of Tobacco was used as a wash to cure itch ; 135, Lembke, N. Z. fur H. K., 12, 97, repeated doses of 5, 10, 15, and 20 drops of tincture, and 30 to 40 drops of Aqua nicotine; 136, S. Swan, North Am. Journ. of Horn., new ser., vol. 1, 1870, p. 253, a man used a paper of fine-cut Tobacco everyday, with some cigars; 136 a, same, general statement; 137, J. H. P. Frost, Hahn. Month., vol. 5, 1870, p. 409, a physician used Tobacco over thirty years; 138, Raymond, Ann. d'Ocul., 1871 (S. J., 151, 312), abuse of Tobacco; 139, Carl Muller, Am. Horn. Obs., 1871, p. 561, a man, set. twentyfour, a confirmed devotee to Tobacco, smoked a "splendidly colored cutty" three times in succession while in bed; 140, James W. Allan, Lancet, 1871 (2), p. 663, a woman applied the leaves to an ulceration on her legs; 141, T. F. Allen, Hahn. Month., vol. 8, 1872, p. 22, a man, set. thirty-five years, had used Tobacco immoderately for several years; 142, Dr. Miller, Hahn. Month., vol. 7, 1872, p. 531, general effects; 143, same, a French physician investigated the effects of habitual smoking upon thirty-eight boys between the ages of nine and fifteen years; 144, Hahn. Month., vol. 7, p. 288, effects on children ; 145, Dr. Goullon, Jr., A. H. Z., 84, 66, effects of smoking a cigar in the evening; 146, H. N. Unwell, M.D., Med. Union, vol. 1, 1873, p. 227, a German, set. forty-three years, took 15 drops on an empty stomach, death in about ten minutes; 147, U. V. Miller, North Am. Journ. of Horn., new ser., vol. 4, 1874, p. 86, C. T., set. twenty-seven, has for three years observed effects on himself of smoking; 148, 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. (149 to 151, E. B. Morgan, Brit. Med. Journ., 1875 (2), p. 487, three persons poisoned by water from a well in which Tobacco had been placed.) 149, a man, set. fifty-five years; 150, death of a boy set. four years; 151, a girl set. six years; 152, 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.; 153, same, effects on Mr. of smoking; 154, Prof. Chevalier, Journ. de Chim. Med. (New Remedies, 1875), a young man smoked twelve cigars, death ; 155, Dr. Yeldman, Brit. Journ. of Horn., vol. 33, 1875, p. 508, effects of attempting to learn to smoke; 156, effects of excessive smoking on a man; 157, effects of excessive smoking on a young man ; 158, Ravoth,from the Swedish, Lundahl, " Tabac est Gift," Berlin, 1875; 159, Forsius, ibid., effects of excessive smoking. (160 to 164, Foussard, De rEmpoisonnement a la Nicotine et la Tabac, Paris, 1876 ) 160, symptoms of acute poisoning; 161, Mackenzie ; 162. Foussard, Madame N. took an infusion ; 163, Rabateau, Med. Gaz., vol. 10, poisoning by an in jection ; 164, same, effects of smoking cigars; 165, E. W. Berridge, M.D., Am. Journ. of Horn. Mat. Med., vol. 9, 1876, p. 244, effects of smoking on Mr. ; 166, J. N. Bigelow, M.D., New York Med. Journ., vol. 23, 1876, p. 399, T. S., set. twenty-six years, had smoked excessively from the age of twelve; 167, G. H. De Wolf, M.D., Lancet, 1876 (2), p. 811, G. H. smoked six pipes before breakfast, and continued smoking all day, using small dirty pipes; 168, W. W. Van Valzah, M.D., Phila. Med. Times, 1877 (1), p. 271, a man took Tobacco to relieve constipation ; 169, Brit. Med. Journ., 1877 (2), p. 419, a boy, set. four years, blew soap-bubbles with an old wooden pipe, death on the fourth day; 170, Mr. Nettleship, Med. Times and Gaz., 1877 (2), p. 434, William W., set. fifty-three years, a heavy smoker; 171, W. K., set. fifty year?, a heavy smoker; 172, John H., set, sixty-six years, a heavy smoker; 173, William E., set. fifty-two years, a smoker; 174, 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 ; 175, Hempel's Mat. Med., vol. 2, p. 675, a girl, set. 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 p. 472

Emotional. Quiet delirium, murmuring to himself

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 to 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

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

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

Complete intoxication

Felt as if intoxicated with spirituous liquor (after one hour)

Extreme agitation

Intoxication for more than twenty-four hours

(The Mexican priests incite courage and bravery by means of an ointment of tobacco)

Great joyfulness and talkativeness, as from intoxication (first day)

Frequent laughter without cause

She sings the whole day (twelfth day)

Joyful and lively, second and third days

She is very lively and jolly, danced about on one leg for joy, and laughs without reason nearly all day (first day)

He was queer for days after, the principal symptom being weak and irritable pulse

Misanthropy

Very morose and fretful (first day)

Despondency

Low spirits, want of resolution and general hypochondriasis

Gloom, hypochondria, apprehensions of sudden death

Most profound gloom, constant fear of death, yet attempting suicide

Nervous and hypochondriac

Psychical alteration and hypochondria in a high degree

Hypochondria in a high degree

Extremely hypochondriac mood (first day ),4a 4b.

Anxiety,9 11 160.

Anxiety and sickness (woman)

Anxiety on being alone at night

Anxiety with very depressed, melancholy thoughts while walking (third day)

Uneasiness and anxiety in the afternoon, as if some misfortune would occur (tenth day)

Apprehensive and insensible

Apprehensive towards evening, several days

Apprehension and anxiety occurred several afternoons, and were relieved by weeping

Apprehensive, faint-hearted, and despondent, with nausea; she thought she would die, which disappeared after vomiting, after dinner

Great apprehension with oppression of the chest, and a very despondent, sad mood, as if he apprehended some misfortune, preceded by inclination to vomit; relieved by weeping (first day)

Apprehension, anxiety, and despondency, as if she dreaded death, at 4 p.m., two days in succession

Terrible apprehensions of immediate death

Despondent, joyless mood

Discouragement

His maimer is nervous, restless, and uneasy; he looks as though he were frightened, and confesses to a feeling of anxiety without any cause for it

From having been one of the most healthy and fearless of men, he had become sick all over, and as timid as a girl ; he could not even present a petition in Congress, much less say a word concerning it ; though he had long been a practicing lawyer, and had served much in a legislative body. By any ordinary noise, he was startled or thrown into tremulousness, and afraid to be alone at night. During the narrative of his sufferings, his aspect approached the haggard wildness of distemperature

Evenness and mildness of temper, notwithstanding he felt very uneasy about his health

111 humor,45 47 48 51.

Irritability, i0 60.

He was incapacitated for business of any kind, weak, irresolute, and despondent

Completely indifferent, would not answer, immovable

Intellectual. Indolent (firstly)

Disinclined to work (second day)

Dread of work,40 47, etc.

Psychical uneasiness

Exalted action of the brain ; copious flow of ideas; during this sort of intellectual paroxysm, which often continues all night long, leaving me in the morning wornout and sick, I would conceive and elaborate about twenty undertakings, of which probably not one would ever come to light

Mind dull

She feels dull, cannot rightly collect her thoughts (fourth day)

Difficulty in concentrating his mind for any length of time on one subject.

Confusion of ideas,41 126 149.

Understanding transiently confused

The primary effects of tobacco on my constitution exactly corresponded with the secondary effects of coffee, viz., turpitude of the cerebral functions; confusion of ideas, and lack of words to express them

She is unable to grasp an idea, something else constantly occurs to her and crowds out the former thought, with heaviness and dulness of the head, all of which disappears after vomiting, after dinner

Twenty-three manifested serious derangements of the intellectual faculties

Loss of intellectual power

Memory has failed of late

Stupefaction,10 11 37, etc.

Profound stupor

He no longer recognized his surroundings ; when spoken to he understood, but the answers he endeavored to make were only unintelligible sounds

Lost consciousness for a moment ; he screamed out that smokers must go out of the room, though no one was smoking, that the fumes took away his breath, etc. ; immediately afterwards he became -quiet, but talked incessantly and irrationally, with open, staring eyes, spoke of events in his past life, then returned to consciousness

Completely dumb and insensible

Complete loss of consciousness,10 89, etc.

Unconscious as if in a faint

Became senseless and unconscious, without apparent respiration

Fell unconscious to the ground

She fell to the ground unconscious, with stoppage of the respiration and scarcely perceptible pulse

Complete insensibility to pinching and sticking

Complete unconsciousness with appearance of quiet sleep

The child lay in a soporous condition with the eyes half closed, with a staring look, dilated pupils, with violent trembling of the limbs, rapid respiration, violent beating of the heart and carotids, extreme thirst, profuse- sweat, and cold extremities (after twenty-four hours)

Coma,31 80 160 169.

The person seemed in a comatose condition for some moments, then he was roused by the pain, but uttered no complaint, but made violent automatic movements, rose, walked a few steps as if intoxicated, and threw himself upon the bed and tossed about

Profound narcotism, stupor

Fell into a comatose state and died

Head p. 474

Vertigo and Confusion. Head confused

Great confusion of the head

Confusion, long continued

* Vertigo, 7 8 9 10 n, etc.

Excessive vertigo (after half an hour, and second and fourth days)

Vertigo and intoxication

Vertigo, with some colic

Frequent paroxysms of vertigo

Vertigo and fulness of the head

Vertigo, with no steadiness of the bodv

Vertigo on motion

Vertigo on every attempt to rise

-Vertigo, so that she could not rise up

Vertigo, with quan illness in the stomach (fifth day)

Vertigo, which amounted to loss of consciousness

Vertigo, as from intoxication (first and second day)

Vertigo, a turning in a circle with pressive headache in the forehead and temples

Frequent attacks of vertigo, which caused staggering and falling, while everything seemed to turn round

Vertigo, everything about him seemed to move from right to left, or from above downward, find then the reverse

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)

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

Dizzy and reeling (after five minutes)

Dizziness and physical prostration, soon

Reeling

Reeling in the morning after rising from bed (eleventh day)

The girl walked about as if intoxicated

Slight giddiness and occasional headache at the time the eyes began to fail

Giddiness in occiput

General Head. Head thrown back, amounting almost to opisthotonos

Slight tremulous motion of the head while reading (after a quarter of an hour),4b.

Slight trembling of the head and hands

Apoplexy

Congestions to the head

Frequent congestions to the head and chest

Much congestion of blood and flushing of heat towards the head (first day)

Heaviness of the head

Heaviness of the head on stooping (after half an hour)

Feeling of heaviness in the head after dinner

Head heavy and dull

Heaviness of the head, she could scarcely hold it up (first day)

Great heaviness of the head ; it constantly sinks forward (first day)

Dulness and confusion of the head

Dulness of the head, with dull pressure on the root of the. nose, with sensation as if the ears were stopped

* Headache? 11 36 3S, etc.

Headache xvith vertigo

Woke with headache and pressure in the vertex aud temples, which lasted nearly all day (fourth day)

Violent headache in the morning on moving, as if something were shaking within the head, relieved during rest (second day)

Severe headache for three or four months

Headache towards evening, as if both temples were compressed (seventh to tenth day)

Headache with a feeling of slight throbbing in both temples

Pain in head and eyes

Violent headache

Whilst passing his urine, was attacked with sudden and most violent pain in the head, followed immediately by vomiting; the pain was so violent he screamed for assistance

Acute and persistent headache

Dull headache, especially in the forehead, aggravated by motion, after dinner,4b.

Violent headache, especially drawing in the left half of the forehead and through the left eye,4e.

* The headache is relieved, in the open air

Compressive pains in the head, especially in the occiput (third day)

Oppression of the head, as though the whole world were resting upon him, with weakness

Rising sensation like an aura about his head

Sensation of rush of blood to the head

■ Shocks in the head, followed by a sensation as if a rush of blood took place to the head

Roaring in the head

Complained much of head and throat, and the former was thrown back

Some deep stitches in the head, extending towards the vertex (third day)

Forehead. Contraction in the muscles of the forehead (first day)

Supraorbital headache

Frontal headache, as if the brain were compressed ; the pain is aggravated by inclining the head towards the painful side

Pressive pain in the forehead

Pressive pains in the forehead or vertex

Pressive headache above the eyes (after five minutes) ; also, with flickering before the eyes, worse on walking (after one hour)

Pressive headache above the eyes with heat of the head (after one hour)

Pressive headache the whole afternoon, especially above the right eye (second day)

Sensation as if the anterior portion of the brain were pressed backward from the forehead

Dull pressive pain in the forehead and root of the nose

Dull pressive pain, deep in the frontal region

Pain in forehead

Stitches extending from the forehead to the occiput ; they disappeared in the open air, but if he stood still, they returned ; they ceased entirely on lying down (second day)

Temples. Pressive contraction iu the temples (after a quarter of an hour)

Pressure in the temples lasting ten days (after four days)

Alternating pressure and sticking in the temples (first day)

Some pain iu temple where symptoms begun

A drawing, sticking pain, extending from the left temple over the forehead towards the vertex (first day)

Stitches in left temple (after two minutes, and first and third days).2.

Sore stitches in the temples (second day)

Vertex and Pa rietals. A pressure on the vertex as if some one was pressing upon it with a board (first day)

Violent pressive headache in the vertex (after three minutes and afterwards)

Violent internal pressure in the vertex immediately after eating (first day)

Pressive pain on the vertex, at times associated with stitching

Stitches in the vertex for ten days, frequently recurring (after four days)

Pain in both sides of the head as if broken (after one and a half hours)

Pain in the right parietal bone on pressing on it (first day)

Pressive pain in the parietal bones in the morning on waking, which disappeared on rising (sixth day)

Pressure in the right side of the head during dinner

A sticking pain in the parietal bone, extending towards the occiput on walking rapidly (first day)

Stitches in the left side of the head (fifth day)

Occiput. Pressure in the occiput (fourth and fifth day)

Pressive headache extending from the occiput to the temples

External Head. Much hair falls out on combing (fifth and sixth days)

Burning on the head, followed by formication, loss of appetite, violent sticking in the ears, then by coldness with shivering (eighth day)

Formication above the left temple (second day)

Violent itching of the scalp in a room filled with tobacco-smoke

Eyes p. 476

Objective. Dark redness around the eyes

Eyes staring,17 41166

Eyeg fixed

Eyes turned upward

Sparkling eyes

Eyes sunken and seeming small

Eyes lost their brilliancy

Eye listless and heavy

Eye had a haggard appearance

The eyes are dejected, without brilliancy, deeply sunk in the orbit

Eyes closed

Closure of the eyes and photophobia

Injected eyes

Eyes highly injected, cornea vascular and semiopaque

Cornea dim, covered with mucus

Redness of the cornea, with some photophobia ; if she looks towards the light she is obliged to close the eyes (second day)

Decided exophthalmus in consequence of the weakness of the recti muscles

The ophthalmoscope 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

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 di^k. In sorns cases the centre of di:-k 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

By means of the ophthalmoscope, both optic nerves appear of brilliant white color, their areas being enlarged, and their outlines clearly defined

The fundus of each eye seems quite normal, with the exception of the optic discs, which appear too large, and irregularly circular, the tissue being quite of tendinous whiteness

Subject ice. Tight tension and drawing, extending from the left eye down into the upper jaw (first day)

The eyes are painful, as after long weeping (first day)

Pain in the eyes and flickering, on looking intently at an object (second day)

Pressure in the right eye, which extended into the occiput (eighth day)

Pressive sensation in the eyes, especially on moving them

Pressure in the eyes

Feeling as if a hair were in the right eye, towards evening (fourteenth day)

Heat in the eyes, with lachrymation (fifth day)

Burning in the eyes

Burning in the eyes, in the evening, while reading

Some stitches in the left eye, after a few minutes

A kind of burning, with a sensation of coldness in the eye (first day)

Orbit. Numbness of orbicularis oris. (frequently immediately after taking a chew of tobacco)

Pressive sensation, deep in the orbits, with weakness of the eyes and vertigo

Dull pain in the base of the orbits, with redness of the eyes

Sticking above the right eye, extending from the outer margin of the eyebrow to the inner, into the orbit (first day)

Some fine stitches in the upper part of the orbit (first day)

The orbits are heated (first day)

Lachrymation. Lachrymation

Lachrymation, on looking intently at anything (second day)

Lid. Squinting, when trying to read

Twitching of the left upper lid (after one hour),4b.

Eyelids in persistent motion, half voluntary

Eyelids granular

Contraction of the lids, with a biting pain in the eyeballs (after seven minutes)

Contraction of the lids and lachrymation (first day)

Spasmodic contraction of the lids and masseter muscles ; inability to open the mouth

Violent itching in the inner canthus of the right eye, with burning after rubbing (after half an hour)

Conjunctiva. Great injection of the conjunctiva

Conjunctiva injected

Frequent sensation of a foreign body in the conjunctiva, apparently caused by the irritating action of the smoke

Ball, Pressure in the eyeballs (after two hours)

Violent digging-drawing pains in the eyeballs and temporal regions, aggravated by motion, with distended vessels and increased throbbing in them

Heat in the eyeball (after five minutes)

Pupil. Pupils dilated, 10 40 88, etc.

Pupils dilated, fixed, and staring

Both pupils are rather large, but the motion of the irides are active

Both pupils rather large, and motions of the irides sluggish

Pupils considerably dilated and not much influenced by light

Pupils greatly dilated,41 55» 148.

Pupils greatly dilated and insensible,™ 117 n9.

Pupils unnaturally dilated, on the approach of light

Pupils fully dilated and quite insensible to the light of a candle held close to the eye (third day)

Pupils irregularly dilated

Contraction of the pupils,50 51 180.

Pupils much contracted

Pupils contracted, irresponsive to light

Pupils decidedly contracted, but slightly sensitive to light

The right pupil exceedingly contracted ; the left was much larger than usual, and had lost its circular form ; both were unaffected on the approach of light

Vision. Vision weak

Dimness before the eyes, as from mucus (first day)

Indistinct vision for some minutes (twelfth day)

Objects are not seen as distinctly as usual (second day)

Obscuration of vision,6-.

Eyesight affected, m.

Sight failing for six weeks, being alike in the two eyes. Vision = 16 Jager ; not improved by glasses

For an uncertain time he has noticed his sight to be gradually failing, until now it has become so imperfect that he is unable to attend to his business

For a long period his sight has gradually failed, till he can only see to read, for a short time, characters of one-third of an inch

About nine months since his sight began to fail, and has continued to get worse to the present time. He can only see to read No. 18 test-type (canon) with his left eye, and with the right, No. 16 (two-line great primer), word by word ; and distant objects are equally indistinct

Sight tailing slightly for twelve mouths, the defect being most apparent in a bright light (? central scotoma). With his glasses he could, however, still read the newspaper; but his distant vision, unaided by glasses, was only 40 Snellen, at fifteen feet. Optic discs definitely pale at their temporal portion ; no other changes

Complained of failure of sight for three months, and in particular that "things looked black (probably central scotoma). Sight did not vary on different ways. Vision

right, letters of Jager and 50 Snellen, barely at twenty feet. Slight hypermetropia, but sight not improved by glasses. Optic discs pale at the temporal portion ; no other changes. The physiological cup very large in each, and iu one eye spontaneous pulsation of the vein

Complained for three years past that he had been unable to find suitable spectacles. The sight had failed grade. ally, but he believed that it had remained stationary for about six months prior to his admission. Vision, without glasses, each eye = 18 Juger, and not 200 Snellen, at twenty feet. Pupils active, the left rather larger than the right. Is using strong glasses (+ 5), but they are of little service. Optic discs definitely pale all over, but much more so on the yellow spot side. No other changes, unless a slight mistiness of the retina around the discs

Vision ; nothing in the distance. Discs decidedly whiter at the outer than at the inner part. Dimness came on suddenly ; as he was walking a lot of gnats seemed to come before the sight;" sight has not got much worse since that time

Vision -J^. O. Ds. congested and somewhat swollen and slightly hazy ; vessels not obscured

Failure began six years ago ; right failed two or three weeks before left. It began as if a large drop of water was before the eye; this increased in size; also a floating muscle before each. Discs rather pale, left universally, right only on yellow-spot side

Amblyopia, accompanied by intolerance of light, especially blue. Very slight pressure on eyeballs makes vision worse

She becomes almost blind for a few minutes, towards evening; it seems as though a veil were before the eyes ; on rubbing the eyes it becomes worse (third day)

His sight was so imperfect that he could not see small objects, even when near him

Blindness almost complete

Darkness before the eyes

Vanishing of sight

Vanishing of vision, on looking at a white object

Complains of seeing double whenever he uses the smallest amount of tobacco ; he says that in ten minutes after smoking a part of a segar, or after chewing a little tobacco, he begins to see double, and a kind of dimness or confusion of sight, as if black dots filled his visual field comes on. When he abstains from tobacco for awhile he improves, and his vision becomes single and clear. The tobacco condition is always aggravated, in a very marked degree, by any kind of stimulant. I found, on examining him, vision in each eye -y^. Insufficiency of the internal recti, so that behind a screen there is a divergence of one and a half lines. Double vision for distant objects; monocular vision for near objects; cannot diverge both eyes on it. Optic disk pale, partly atrophied, eye otherwise normal

Increased presbyopia

Flickering before the eyes (first day)

Fog before the vision, 12ti.

Black spots before the eyes

More black points than usual before the eyes, on looking (first day)

The disturbance of vision resulting from the abuse of tobacco cannot be distinguished from that caused by alcoholic drinks ; we find an irregular, variable irritation and irritability of the retina, sometimes central scotoma, with improved vision in the dark ; diminished extent of accommodation (one of the first symptoms) ; at times increased intraocular pressure ; pupils moderately dilated and sluggish

Ears p. 478

The ears are red and burning hot (first day)

Tearing in front of and beneath the right ear (second day)

Sticking behind the left ear, with somewhat hard red swelling (sixth day)

Pains within the ear, on touching the outer ear (sixth day)

Violent earache twelve months ago, with giddiness and overpowering sleepiness

Painful gnawing in the right ear (after five minutes)

Some painful tearing in the right ear (first day)

Jerking tearing in the right ear and in front of it, externally (second day)

Fine tearing and sticking in the lobule of the right ear

Tickling in the ears (third day)

Sticking in the ears, during music (fifth day)

Stitches in the ears, especially in the open air (second day)

Stitches in the ears (first, third, fourth, fifth, sixth, and ninth days)

Sensation as if something stopped the ears (second day)

Ears seem stopped, especially the right (third and fourth days)

Jleftfiiif/. Hyperesthesia of the acousticus against music and loud talking

Sensitive to the slightest noise

Deafness not complete, but hearing very dull

Noise in ears occasionally

After sunset, indoors, fluttering in right ear, both heard and felt (first day)

Ringing in the ears

Roaring in the ears,2 78 "6126.

Roaring and rushing in the ears

Roaring in the ears for several days, especially in the morning,4* 4b.

Humming in the ears, aggravated by loud noise or by going into the open air, for several days,4a.

Nose p. 479

Ulceration of the nose

Sneezing several times, after which the head felt freer (fourth day)

Constant desire to sneeze

Fluent catarrh (first, second, fourth, and fifth days)

Fluent catarrh, with acute smell (fourth day)

Dry catarrh (third day)

Constant discharge of watery mucus from the nose

Twelve had frequent epistaxis

Bleeding from the nose and lungs

Nose stopped (third and eighth days)

Dryness of the nose

Sensation of pressure and formication in the Schneiderian membrane

Drawing pain in both angles of the lower jaw (third day)

Crawling in the nostrils (fourth day)

Burning under the nose, as from violent fluent coryza (tenth day)

Sudden burning in the left nostril (first day)

Smell. Hyperesthesia of the olfactories, especially against tobacco and cologne water

Very acute fine smell, in the morning (second day)

Diminished smell (first and third days)

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)

Face p. 479

Objective. Muscles of the left side of the face permanently contracted, as in apoplexy

Face emaciated, pale, and stupid-looking

Expression of the countenance that of stupefaction

Altered expression of face, etc.,94.

Features pinched and contorted

Austere gloomy expression, as if indifferent to everything on account of being exceedingly discouraged

Expression stupid

Features drawn

* Features sunken (third day)

Countenance indicating lassitude and exhaustion

Anemic or cachectic look

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

* Pale /ace

* Face very pale,™ 55a.

* Face deathly pale

* Deathl'y paleness with the nausea

Face pale and contracted

* Face pale, collapsed, covered with cold sweat

Looks pale and depressed

* Pale face, with drawn features and deeply sunken eyes, surrounded by blue rings

Suddenly became pale, with lividity of the lips, and all the appearances indicating syncope

Sickly-looking, thin, and pale as a ghost

Pale-gray color of the face

Wan, or rather yellowish complexion, resembling the carcinomatous physiognomy

Face red and swollen

Face alternately red and earthy pale

Dark-red face

Countenance suffused with a deep livid color

Face brownish red

Face slightly reddish brown

Face bluish and drawn

Face violet

Subjective Violent tearing in the bones of the face and teeth, in the evening (fifth day)

Very transient feeling through the middle of the face, as though dead (after eight hours)

Chech's. Cheek sallow and sunken

Circumscribed redness of the cheeks, especially of the left; this symptom was so prominent that his wife could always tell by it when he had been smoking to excess

Lips. Owing to the smoking of tobacco, cancer of the lip presents itself in twenty-seven times out of a hundred cases among men, and one and a half in a hundred among women

Lips cracked, painful (eighth day)

Upper lip rough and dry, with burning sensation (tenth day)

The lips are livid

Lips pale and bloodless

Lips pale

tipper lip feels elongated (after smoking half a segar, indoors)

Chin. Contraction of the jaws

Violent contraction of both jaws

Lower jaw dropped

Painful drawing in the right side of the lower jaw (second day)

A stitch in the articulation of the jaw, when laughing (third day)

Mouth p. 480

Teeth. Chattering of the teeth from cold, iu the evening (fifth day)

Lips drawn back, showing the teeth, which were covered with dark sordes (third day)

Caries of all the teeth

Teeth good, but dirty and stained

Toothache, continuing until nearly all the teeth were lost

Violent drawing-tearing toothache in the upper teeth, extending towards the forehead (eighth day)

Drawing pain in the upper teeth, disappearing on pressing on the cheeks (third day)

Sharp tearing in the teeth of the right lower jaw (after half an hour)

Toothache becomes intolerable

Sudden violent toothache, with heat of the face and dizziness

When biting upon hollow teeth a sticking in them (third day)

Violent, persistent, throbbing toothache, in several hollow teeth

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, aud, therefore, I directed my special attention to the state of the fangs, and found them, iu 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 vice versa; 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

Gums. Gums pale and parched

Drawing in the gum (fourth day)

Tongue. Tongue tremulous, red and dry

Constant trembling of the tongue and extremities

Tongue pale, trembling constantly

Tongue entirely covered with a thick brown-yellow coat, very adherent and smooth, notwithstanding the prominence of the papillae

Yellowish tongue, not coated

Tongue thickly furred

Tongue coated

Tongue dry and dark red in color

Tongue dry and white

His tongue, without being furred, is whitish, and trembles

Tongue red and dry

Tongue dry, parched, and covered with a blackish-brown crust (third day)

Dryness of the tongue and lips

Fine stitches in the tongue, soon

Alienation of taste of tongue, with sensation as if the back of the tongue were filled with the settlings of his pipe; day and night this taste persecuted him ; mixed itself up with his food and drink

Tongue feels swollen, so that in speaking his words run into each other (after smoking half a cigar, indoors)

General Mouth. Corners of the mouth sore (after second and fourth days)

* Frothing from the mouth?3.

The breath and the cutaneous secretion oppressively charged with the odor of tobacco

Swollen glands under the tongue, painful to external touch (eighth day)

Four had ulceration of the mucous membrane of the mouth

Yellowish mucus from the mouth

* The mouth is full of white tenacious mucus which must be frequently expectorated

Dryness of the whole mouth, with violent thirst

Dry mouth

Great dryness of the mouth

Burning in the mouth and throat, soon,4* bc d.

Burning-scraping warmth in the throat and oesophagus, extending to the stomach

Great hyperemia of the mucous membrane of the mouth and pharynx ; pharynx covered with granulations, with dryness, and a varnished appearance

Saliva Salivation

* Constant t profuse ptyalism

* Increased secretion of saliva

* Accumulation of saliva in the mouth?1.

* Spits much

* Constant running of thin watery saliva from the mouth

Taste. Taste bad

Bad taste in the mouth, as of burnt milk

Bad insipid taste, in the morning, as from disordered stomach (second day)

Mouth insipid, in the morning (second day)

Flat slimy taste, in the morning (third day)

Everything tastes sour (third day)

Sour taste in the mouth (third and sixth days)

Water tastes as if mixed with wine (third day)

A very bitter taste in the mouth (tenth day)

Bitter taste in the mouth, in the morning after waking (fifth day)

In December, 1856, after having, perhaps, for some time, smoked more than usual, I perceived in my mouth a disagreeable taste, like that of rancid oil, which lasted for eight days, ceasing only during a meal, and returning an hour after, in spite of all efforts to remove or disguise it. At the end of a few weeks, a yellowish spot appeared on the edge of the tongue. This spot, which at first was the size of a half-dime, looked exactly as if a piece of dried lichen had been planted there. It seemed as though I could detect, by sucking at it, that here was the immediate cause of the bad taste in my mouth. It grew a little larger by slow degrees. Soon another sim ilar spot appeared on the arches of the palate

Speech. Speech difficult

While reading he cannot articulate; he reads very indistinctly, quite contrary to habit (first day)

Speech faltering, and mind uncertain

Speech difficult and unintelligible

Power of speech wanting

The patient could speak only in a low tone and in a broken manner, and complained of exhaustion, confusion of the head, and a mouldy taste of tobacco

Almost speechless; her voice was hoarse and she could only murmur some inarticulate sounds

Throat p. 482

Hawking of mucus (first day)

Much tenacious mucus in the throat (ninth day)

Tenacious mucus in the throat, which cannot be raised

Choking

Nocturnal attacks of tightness of the throat, with palpitation and neuralgic pains in the neck

Sore feeling in the right side of the pharynx when not swallowing

Irritation to cough and scratching in the throat (second day)

Frequent irritation in the throat and larynx, exciting violent fits of dry cough, chiefly at night

Scraping in the throat

Scraping and pressure in the throat and larynx

Scraping in the throat the whole afternoon (second day)

The throat is so scraping and dry that she can scarcely swallow (second day)

Rawness and scraping in the throat (soon)

Dryness of the throat

Throat parched

Throat dry and irritable

Pressure in the throat as if something were sticking in it (second day)

Tickling and raw feeling in the throat

Tickling in the throat, rising up and provoking frequent cough (after half an hour)

A crawling sensation in the throat, which is painful on swallowing

Transient stinging sensation of heat in the pharynx, soon

Uvula and Tonsils. Uvula cedematous

Catarrhal iufiammatiou of the tonsils

Tonsils enlarged,167 m.

Fauces. Diffused redness and dryness of the fauces and roof of the mouth

Redness of fauces

Pharynx and (Esophagus. Pain in the pharynx on swallowing

Rawness and scraping in the pharynx

Biting and scraping in the pharynx (immediately)

Scraping and burning in the pharynx

Burning in the pharynx,45 46 00.

Heat in the pharynx after swallowing

Periodic sensation of a plug in the oesophagus, with constant dull pressure

Pressive pain in the lower part of the oesophagus on swallowing food (after three hours)

Swallowing. Swallowing very painful, owing to spasms of the throat

At times great difficulty in swallowing (after three days)

Swallowing was very difficult, even a small quantity was swallowed with the greatest effort

Deglutition difficult (impossible, except when the article to be swallowed was placed low in the throat)

Unable to swallow,119 u

External Throat. Tensive pain in the submaxillary glands, with a feeling as if swollen, and as though the lower jaw had lost its mobility, soon

Stomach p. 482

Appetite find Thirst. Increased appetite (first day),2 45 46 51 92.

Appetite inordinate

Ravenous appetite

Incessant hunger; if she eats nothing she is nauseated (sixteenth, seventeenth, and eighteenth days)

Immediately after vomiting, he can again eat with appetite

Paroxysms of canine hunger

Appetite, but cannot eat

The desire for food was not nearly so great as in the experiment without Tobacco, neither was there so great a degree of debility ,8?a.

She has neither hunger nor appetite, and the food at noon disgusts her

Appetite failed several months before sight

Smoking just before eating diminished the appetite

Appetite bad, in the morning

Loss of appetite,10 36 42, etc.

Appetite diminished somewhat and had lost much flesh

Appetite and digestion gone

Twenty-three had a strong appetite for alcoholic drinks

Anorexia,66 79 91.

* Thirst

Increased thirst

Violent thirst,42; in the evening (fourth day)

Great thirst, especially at night

Great thirst, but could not drink much at a time

Frequent drinking of only small quantities of water

A morbid craving for stimulants and narcotics

No thirst ; water will not go down (twelfth day)

Almost no thirst (usually she drinks a great deal), (first and second days)

Aversion to drinking water (second and fourth days)

No thirst

Eructations. Eructations

Several eructations (after half an hour),V

Constant eructations

Frequent eructations, with pain in the epigastric region

Frequent empty eructations (first day)

Frequent eructations tasting of the food (first day)

Frequent eructations, nausea, and qualmishness (first day)

Regurgitations of small quantities of food

Sour hot eructations, in the morning (third day)

Acid eructations,56 57 5S.

Very loud eructations all day, especially after eating (third day)

Inclined to eructate,4c.

Hiccough, Hiccough (first and second days),2 55 166.

Spasmodic hiccough (tenth day )

Heartburn. Heartburn

Heartburn, rising from the stomach into the throat (fourth day)

JSrausea and Vomiting *Nausea,9 10 n, etc.

Nausea, rising up from the pit of the stomach

Nausea and griping in the abdomen (first day)

Nausea, with stitches in the left temple (second day)

Became suddenly nauseated, and soon vomited freely

Constant nausea

Incessant nausea and frequent vomiting™.

* Feels exactly as if seasick ; has the same vertigo, with nausea, coming in paroxysms, during which the body is covered with a cold sweat

* Great nausea, amounting almost to faintness, which disappears in the open air (second hour)

* When sitting quietly she feels rather well, but if she moves in the least she is excessively nauseated

The stomach feels unsettled (first day)

Qualmish, with pressure in the stomach (first day)

Complained of faintness and feeling sick (in half an hour)

Nausea, with inclination to eructate, followed by relief of the oppression of the pit of the stomach

* Qualmish nausea (second day)

Is nauseated, in the morning on rising (second day)

Nausea, with accumulation of water, soon

Nausea, and irrational talking for an hour

Qualmishness, in the morning, on hawking up mucus, with insipid taste in the mouth (eighth day)

Sick and drowsy (after one hour)

Nausea, and inclination to vomit

Retching and vomiting (man)

Violent retching and vomiting

Nausea and violent vomiting; vomiting of a large quantity of blood, afterwards vomiting of mucus three times

Ineffectual inclination to vomit and eructate, soon

* Violent efforts to vomit™.

Gulping efforts at emesis

Retching

* Nausea and vomiting,17 43 82 160.

Nausea and violent vomiting

* Vomiting,7 8, etc.

Vomited often, at first

Constant vomiting

Violent vomiting,22 23 88.

Vomiting of whitish mucus

Spasmodic vomiting

Nearly incessant vomiting all night

Vomiting and diarrhoea

Violent vomiting, with anxiety and great weakness

Vomiting following pain in the head

So long as he sits still he can always keep from vomiting, but as soon as he moves he begins to vomit again

Violent vomiting, followed by retching

Violent vomiting from irritation in the larynx

* Sometimes vomiting, in the morning, even before breakfast; vomiting of watery liquid, sometimes insipid, sometimes bitter

Vomiting of only water, with which it becomes green and yellow before the eyes

* Easy vomiting of sour liquid (after one hour)

Vomiting of a sour liquid, with mucus, followed by great relief (third day)

Sour and slimy vomiting, with considerable effort, in the morning (eighth day)

Vomiting of blood

A good deal of bloody vomiting, two or three times repeated

Vomiting of a mass of liquid in one long stream

The stomach frequently refused to retain the food

Immediately after purging affected with sickness, and vomited a large quantity of brownish fluid, mixed with fragments of what was immediately recognized, by its color and appearance, to be cut cavendish Tobacco

Persistent efforts to vomit

Generally, relief from vomiting

Stomach. Distension of the epigastrium

Dyspepsia

Dyspeptic and hypochondriac

Dyspepsia, more or less for ten years, attended with nervous palpitation and acidity, hypochondriasis, and epigastric sinking

Severe indigestion

Food did not digest well

Sinking at the pit of the stomach,58 6* 60.

Sinking at the epigastrium for many years

Sudden sinking at the pit of the stomach and faintness, which obliged him to lie down in the field,*1

Disturbance of the gastric functions

* Weakness of the stomach 175.

Weakness of the stomach for a long time after vomiting

Faint feeling at the stomach from fasting a short time

* Sensation of relaxation of the stomach, with some nausea (second day)

Gastrodynia

Gastralgia

Placed his hands to the pit of the stomach, frequently drawing up his legs, as if he suffered great pain in the abdomen (after three days)

Pain in the stomach

Painful sensations at the pit of the stomach

Painfulness of the epigastric region

Violent pains in the stomach

Constant indefinite pain in the pit of the stomach, always worse at night, at times accompanied by pulsation and anxiety

Two or three hours after every meal, however light, excessive pains in the stomach, followed by vomiting

Excessive pain in the stomach and intestines

Pit of the stomach sensitive to pressure

The next morning he had a pain in the stomach, as if he had swallowed something which was too large. He could hardly eat breakfast, deglutition gave him so much pain. He points to the epigastrium when locating the pain. He says it is as if at a certain spot the bolus was forced through too small an opening, and when the food is once in the stomach, it occasions a bursting or distensive pain. Fluids occasion a similar pain, but not so intense. Warm drinks occasion less suffering than cold while swallowing, but their presence in the stomach somewhat alleviates the burning pain. He also observes, on taking a full inspiration, a stitchlike sharp but not acute pain, which extends from the epigastrium directly backwards to the spine. This sensation feels as if it would be relieved by an eructation, but it is not. Twenty-four hours afterwards, he was afraid to eat or drink because of the pain. He has never had anything like this before ; all that he has ever noticed from the use of Tobacco was a sense of sinking at the epigastrium

Epigastric region painful to pressure

Pressure in the stomach

Sensation of a hard substance in the stomach, with nausea.76.

Pressive sensation in the stomach

Pressure in the region of the cardiac orifice of the stomach while eating

Slight pressure in the pit of the stomach during and after dinner,4b.

Spasmodic pressure in the region of the cardiac orifice of the stomach, soon,44a.

Constrictive pain in the stomach after eating (eighth day)

Pinching at the stomach immediately after a meal, shortly followed by a diarrhoeic stool, which habitually occurred three or four times a day

Violent clawing in the stomach after eating (eighth day)

Feeling as if the stomach would turn over (first day)

Cramp in the stomach (second and sixth days)

Twisting movement in the pit of the stomach, with inclination to vomit ; lachrymation, and accumulation of water in the mouth, for a quarter of an hour,4c.

Shocks at the epigastrium

Shocks at the epigastrium when going to sleep, but after awhile in the daytime, with profuse perspiration

Shocks at the epigastrium, coming on at the first hour of slumber, which were repeated several times in the course of the night, and often in the. morning before breakfast

Shocks at the epigastrium at night, on first going to sleep, which started him up in great agitation and alarm

Shocks at the epigastrium to such a degree that his -leep was a succession of starts, which nearly wore him out; at the end of two years they came upon him during the day ; he described them as like shocks of electricity

Shocks at the epigastrium, with a sinking sensation at the pit of the stomach

A shock in the epigastrium which started him in great alarm from his sleep, repeated several times in the night, and as often as he fell into a slumber

Cardialgia

Burning in the stomach (after a quarter of an hour)

Burning in the epigastric region and frequent eructations

Great burning in the stomach

Heat in the epigastrium or abdomen

Sensation of warmth in the stomach

Feeling of coldness in the stomach and inclination to vomit

Feeling of coldness in the stomach and along the spine

Stitches in the pit of the stomach (fourth and twelfth days)

Stitches in the pit of the stomach, extending through the back (seventh day)

Violent stitches above the pit of the stomach, less during rest (second day)

Discomfort in the stomach

Abdomen p. 485

Hypochondria. Liver enlarged

Acute inflammation of the liver after an extraordinary bout of smoking

Pressure in the hypochondria (first day)

Stitches in the hypochondria (first and seventh days)

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)

Stitches in the hepatic region relieved by stooping, could not stretch out on account of it (tenth day)

Stitches in the hepatic region (fourth day)

Several times stitches in the hepatic region under the last ribs, towards evening (.first day)

Fine stitches as with a needle in the liver, aggravated by breathing (first day)

When walking, stitches in the liver, which extend toward the pit of the stomach (tenth day)

Burning sticking externally in the left hypochondriac region (after five minutes)

Umbilicus and Sides. Painful retraction of the navel, especially on stooping

Cramplike pain in the umbilical region

Cutting pain about the navel (fifth day)

Pressive pain in the umbilical region with cramplike retraction of the navel

Pressive sensation beneath the right short ribs, as if a heavy weight were lying there, the place is also painful to touch

Digging and pressive feeling in the umbilical region

A pressive, painful feeling in the region of the kidneys

Stitches beneath the right short ribs (fourth day)

Sharp stitches in the right flank (second day )

General Abdomen. Abdomen distended

Abdomen excessively swollen, hard, tense, very painful to the slightest touch

Belly retracted

Abdomen contracted

Retracted abdomen with rumbling

Flatulence and nausea

Frequent movements of flatus with pain in the abdomen, followed by diarrhoea with tenesmus, in the evening (seventh day)

Rumbling in the abdomen

Rumbling in the transverse colon

Rumbling in the colon and inclination to stool

Rumbling, gurgling, and griping about the abdomen (first day)

Rumbling and gurgling in the abdomen on deep breathing, lasting eight days

Rumbling in the abdomen, and a feeling of coldness over the whole body

Very violent, almost incessant rumbling in the abdomen the whole afternoon, while taking a walk (tenth day)

Pain in the abdomen

Pain in the abdomen with distension

Frightful pains in the abdomen

Considerable looseness, and pain in lower part of abdomen (woman)

Repeated attacks of what he called "biliousness pain in the bowels, and purging

Severe pain in bowels, their action was arrested, necessitating the use of enemata

Frightful pain in the abdomen, a violent burning which caused loud cries, the pains afterwards involved the whole abdomen, especially the epigastrium

Violent contractions in the muscles of the abdomen

She woke after midnight with sensitiveness in the abdomen, so that she could scarcely be touched without internal pain, followed by a soft stool with relief of the pain ; at 4 a.m. the same symptoms were renewed (first day)

The entire abdomen, but more especially the pit of the stomach and the hepatic region, are so sensitive that the pressure of his uniform tuuic is intolerable

Some months after, ceasing to smoke, I was induced to smoke incessantly, during a nine-hours journey in the company of smokers, and in consequence, the taste of rancid oil returned, with such intensity, that it would have turned my stomach, had it not been disguised by the same means which had excited it. On approaching Paris, I felt some slight lancinations in the hypochondria, which I scarcely noticed. Feeling as if the abdomen was larger than usual ; and on the other hand, while it was the seat of a dull pain, little increased by pressure, it was as if paralyzed ; I touched it, and my hands alone were sensitive of the contact. I noticed also a difficulty in articulation, resulting from a kind of numbness, hitherto quite unfelt, not only of the tongue, but of the muscles of the cheeks and lower jaw, which were affected with a slight, nervous agitation when I tried to speak. These last symptoms, however, which I attributed to fatigue, ceased for the most part on my arrival at home. It was then 8 p.m. ; I had an excellent appetite, my dinner awaited me, and I took my seat at the table with extreme pleasure. The soup seemed excellent, it doubtless was so, but alas! I was unable to enjoy it. I had taken scarcely three or four spoonfuls when a sudden, piercing, indescribable pain, so excessive as to make me cry out, forced me to drop my spoon, and throw myself back in my chair, pale as a corpse, bathed in a cold sweat, breathless, as if in the agonies of death. Judge how my family were terrified ! The disorder had broken out so suddenly and with such violence, that I had not the chance to utter a word, and only my hands clasped over the stomach served to point out the seat of my suffering. However, I succeeded, with some difficulty, in getting into bed. I was covered with hot cloths, which were renewed every minute, and greatly relieved me. I felt my pulse

it was never quieter; I pressed hard on the stomach and abdomen, they scarcely felt it. A quarter of an hour passed, my appetite i*eturued, I was hungry, very hungry, and without quitting my bed (very fortunately, as it turned out) I resumed my dinner, which seemed to have been interrupted by a horrible nightmare. So incredible, so rapid a change, caused the friends who surrounded me to smile amid their recent tears ; they brought me the wing of a fowl. I eagerly swallowed a few mouthfuls ; it was too much, a hundred times too much. The pain has got me again

it is terrible ! I have had extracted in my time a big molar, whose root had grown to the lower jaw, and which broke twice under the dentist's turnkey. In 1849 I had cholera so badly that I was blue all over, as my venerable friend Dr. Peters can testify, who kindly attended me at the time. Well, I boldly declare that the pain I am now speaking of was worse than either. A horrible night it was, that night of February 21st, 1858. First, I vomited (but only by taking tepid water and tickling the uvula), a little food mingled with a very bitter fluid. It seemed to me that this vomiting relieved me by bringing out the sweat which marked the height and turningpoint of the attacks. These lasted altogether from twenty to thirty minutes, becoming rather longer towards morning. Each of them was over in from one to three minutes, during which I could only keep from crying aloud by prodigious efforts of will. They were accompanied neither with nausea nor colic, and excited neither stools nor urination, but yielded in every case to a very copious sweating, which usually marked the close of a paroxysm. After the cessation of one attack I felt remarkably easy. Then my lace, a moment before greatly altered and of a cadaverous pallor, regained its color and natural expression, and I had no more pain anywhere. During the 22d, I had three of these attacks, in the daytime. The first one took me (I believing myself cured) when I was away from home, but only a few steps from it. Fortunately a carriage was standing at my door. I beckoned to the driver, and he came to my help before I fainted in the street. On the 23d, I was well and without an attack, thanks to lying in bed, and the strictest diet, despite a very sharp appetite. On the 24th, after a very good night and feeling admirably, I took a few spoonfuls of chocolate, and went out in a carriage. But scarcely had ten minutes passed when I felt another attack coming on, and returned home quite desperate. 25th and 26th, strict diet, rest in bed, and no attack. 27th, chicken-broth ; I could sit up a little; felt same wandering pains in the sides, but no decided attack. Three. days after, I returned to my usual diet and mode of life. The tongue, which was loaded after the forced vomiting, is still a little yellow at the root. The pulse, which for eight days had continued quite regular (even in the most violent of the paroxysms) is still a little slower than usual ; but this I attribute to deprivation of food. No trace of pain. The stools are normal, and there has been no constipation. March 5th, having felt very well for five days, I tried to smoke a segar, and immediately, that is, after the third and fourth puff, felt sharp, characteristic pain in the pit of the stomach ; rancid taste in the mouth ; sweat on the forehead ; an attack was impending, which would certainly have occurred if I had gone on smoking

Colic,40 1461 8S.

Colic, in the morning (fifth day)

Colic, as from a purge, towards evening (eighth day)

Violent colic

Colic and diarrhoea

Colic, followed by violent cramp in the stomach, great nausea and salivation (tenth day)

Movements about the abdomen as if diarrhoea would come on (first day)

Griping in the abdomen (first and fourth days)

Griping and rumbling in the abdomen for twelve days (after four days)

Griping in the abdomen, followed by clawing pain in the stomach (fourth day)

Pinching and griping in the abdomen

Shocks in the bowels at night when first getting into a drowse; at length they came on in the daytime, with epigastric sinking, costiveness and general dyspepsia

Pressure in the upper abdomen

A feeling of weight and distension in the abdomen

Tearing in the abdomen at night (eighth day)

A number of sudden fine stitches in the whole abdomen (after half an hour)

Heat in the intestinal canal

Hypogastrium and Iliac Region. Violent pressive pain in the lower abdomen with nausea and inclination to vomit

Violent pressive pains in the lower abdomen with chilliness of the whole body

Pressive pain in the lower abdomen with relief from emission of flatus

Sensation of powerlessness in the right groin (fifth day)

Rectum and Anus p. 488

Burning pain in the anus after the stool

Itching in the anus

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)

Frequent urging to stool in the morning (eighth day)

Desire for stool with frequent tenesmus in the rectum (after four minutes)

Violent straining at stool with pressure as if the faeces were retained, yet the stool was soft

Straining and violent burning in the anus during stool (eleventh day)

Frequent desire for stool, but always a scanty evacuation, preceded and followed by sore pain in the abdomen (second day)

Stool p. 488

Diarrhoea. Diarrhoea,911, etc.

Profuse diarrhoea,76 ,62.

At intervals, violent diarrhoea, accompanied with severe gripings, lasting sometimes several days, and followed by constipation

The diarrhoea 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

After one or two years the symptoms of chronic poisoning begin with serous diarrhoea, 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

He was subject, for eighteen months, to severe attacks of diarrhoea, which almost invariably came on at night, about 2 a.m. On discontinuing the use of tobacco, these attacks ceased

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

Diarrhoea with vomiting and delirium (after two hours)

Involuntary evacuations

Involuntary evacuations at times of both urine and faeces

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

Purging several times (second and third days)

Purging and emission of flatus immediately after eating (fourth day)

Purging three times with sore pain in the anus (fourth day)

Purging with colic (fourth day)

Five diarrhoea-like stools at night, with burning and tenesmus in the anus (seventh day)

Liquid, very offensive evacuation, followed by tenesmus

Green, slimy diarrhoea with tenesmus

Frequent thin evacuations

Thin evacuation of the bowels, increased in quantity

Stool at the usual time, and rather thinner than usual (first day)

Stool softer than usual, ,9.

Frequent pasty stools

Involuntary thin stools

Habitual soft and often diarrhoeic stools

A very sudden, almost involuntary pasty yellow-green evacuation, followed by tenesmus

Stool pasty, increased in quantity, frequently slimy, with emission of flatus

Stool softer than usual, after large doses

Black, fetid stools

Several stools

Two thin stools with some colic

It depresses the action of a purge upon the colon

Stool only after thirty-six hours, harder than usual, and of a dark color

Frequent involuntary and unconscious evacuation of bloody and watery faeces and watery urine

Two soft stools at night (second day)

Two soft stools within two hours, followed by internal sensitiveness of the abdomen (second day)

Two small soft stools in the evening, followed by straining for a long time (second day)

* Stoo!s resembling those of cholera

The fasces, resembling the excrements of sheep, had for long only been passed after the use of enemata and purgatives; at first, on the contrary, purging had been present

Let an individual smoke half a segar in the morning, soon after breakfast, and almost before he has finished, he will have an urgent desire for an alvine dejection

Stools irregular

Stool indolent, with at times diarrhoea, associated with great weakness of the sphincter ani

Average weight of feces, 8.10 ounces (for five days before smoking) ; 8.09 ounces (for five days while smoking)

Average weight of fseces, 6.04 ounces (for five days before smoking) ; 4.52 ounces (for five days while smoking)

Constipation. Constipation,42 57, etc.

The stool usually daily, omitted for two days

Absence of stool, contrary to habit (first day)

No stool (fourth to seventh day)

The evacuation that usually occurred in the morning, now took place towards evening, and was harder than usual

Inclined to constipation at times

Habitual constipation, worse when the patient is worse in other respects; never has diarrhoea

Unrelenting constipated bowels

Obstinate constipation, changing at times to diarrhoea

Urinary Organs p. 489

Kidneys and Bladder. Pressive pain in the region of the kidneys before urinating

Paralysis of the bladder and rectum

Urethra. The orifice of the urethra is inflamed and agglutinated (eighth day)

Burning and tickling in the urethra, soon, followed by an emission at night

Burning in the urethra when urinating

Burning-itching pain in the urethra after urinating (eighth day)

Prickling in the urethra during micturition

Itching in the urethra before urinating

Micturition and Urine. Frequent desire to urinate

Constant desire to urinate

Pressing desire to evacuate the bladder and bowels

Desire to urinate, with or without vertigo

Frequent and increased evacuation of urine, which was once passed involuntarily at night

Urine evacuated more frequently than usual, at times involuntary dribbling

Urine passed involuntarily

Increased discharge of urine,1 19 20, etc.

Increased evacuation of red, offensive, ammoniacal urine

Increased secretion of urine, from small doses

Copious secretion of pale urine

Urine pale, increased in quantity, so that he was frequently obliged to rise at night to urinate, with almost incontinence of urine

Increased evacuation of yellowish-red urine

Suppression of urine

Quantity of urine small and dark in color, specific gravity 1025, acid reaction ; deposits urates and mucus, no albumen or sugar

Albuminuria (second day)

Urine dark red, smelling of tobacco

Urine clear, lemon yellow, more copious than usual, 4b 4fi.

Average quantity of urine, 41.69 fluid ounces; free acid, 27.86 grains; urea, 657.69 grains ; uric acid, 12.83 grains; chlorine, 148.81 grains; phosphoric acid, 56.18 grains; sulphuric acid, 36.92 grains (for five days before smoking) ; average quantity of urine, 39.82 fluid ounces ; free acid, 32.89 grains ; urea, 615.32 grains ; uric acid, 18.71 grains; chlorine, 125.77 grains ; phosphoric acid, 80.01 grains; sulphuric acid, 41.33 grains (for five days while smoking)

Average quantity of urine, 38.85 fluid ounces ; free acid, 24.64 grains; urea, 610.50 grains ; uric acid, 10.53 grains; chlorine, 129.55 grains ; phosphoric acid, 44.23 grains ; sulphuric acid, 31.66 grains (for five days before smoking) ; average quantity of urine, 37.34 fluid ounces; free acid, 27.67 grains; urea, 547.96 grains; uric acid, 15.05 grains; chlorine, 114.55 grains ; phosphoric acid, 74.46 grains ; sulphuric acid, 40.01 grains (for five days while smoking)

Sexual Organs p. 490

Male. Genital organs flabby

Erections towards morning (first day)

Many erections without voluptuous sensation (second day)

Discharge of prostatic fluid (eighth day)

Some crawling in the glans penis

Varicocele

Emissions

Nocturnal emissions

Emission at night, without waking (eighth day)

No erections or sexual desires

Female. Discharge of a few drops of liquid like meat-water from the vagina, fourteen days after the menses (second day)

The menses, which were delayed about one day, came on more profusely than usual (first day)

Derangement of the catamenia

Respiratory Organs p. 490

Constrictive pain in the larynx

Terrible tickling in the larynx, with alteration of the voice

Irritation of the upper part of the trachea, followed by expectoration

Voice. Voice weak

Voice feeble and low

Voice hoarse

Cough anil JEocpectoratiOfl. Almost constant cough, with sensation of burning in the larynx

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)

Dry short cough

A dry cough, which soon became frightfully severe ; a genuine whooping-cough, continuing night and day, only intermitting during a meal

At times tickling cough

Cough and hiccough at the same time, as if she would suffocate, lasting a quarter of an hour ( tenth day )

Cough, with dark sputa

Haemoptysis ; 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 haemorrhage 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

(Expectoration of gray mucus, in the morning), (second day)

Respiration. Respiration very free and more easy than usual

Respiration very rapid, short, or at times slow and deep, apparently omitting entirely at times

Rapid difficult respiration

Quick breathing (woman)

Respiration spasmodic, deep, 6 per minute

Prolonged respiration (after fifty minutes)

Respiration slow

Breathing slow and stertorous

Respiration slow and regular

Slow respiration, sinking to 8 in a minute, interrupted by continual yawning

Respiration slow, the thorax scarcely expanded

Respiratory movements irregular and sighing

His wind, as he called it, became so short that he was compelled to give up active exercise

(When he bends towards the left side and presses he can breathe more easily)

Stertorous respiration

Breathing stertorous, the cheeks flopping with each expiration

Respiration anxious, moaning, deep, and difficult

Very feeble respiration

Difficult respiration?3 40 551 .

Respiration difficult, sighing

Difficult respiration, with a hoarse voice, for a long time after the poisoning

Sudden difficulty of breathing

Laborious breathing

Oppression of breathing

Dyspnoea

Dyspnoea, drew long sighs

Moaned frequently (after third day)

Feeling as though he would suffocate

Paroxysms of suffocation, from which he frequently awoke with the most frightful anxiety

Attacks of suffocation

Asphyxia and syncope

Dyspnoea to a very great degree (man)

Dyspncea, from almost constant sibilant rules, and which was very troublesome

Great dyspnoea, palpitation, and distress in cardiac region, on going upstairs or ascending any eminence

They almost invariably experienced great dyspncea on ascending

Average weight of carbonic acid expired, 11616.46 grains (for five days before smoking); 11664.50 grains (for five days while smoking)

Average weight of carbonic acid expired, 10456.53 grains (for five days before smoking) ; 10458.27 grains (for five days while smoking)

Average weight of aqueous vapor expired, 4884.66 grains (for five days before smoking) ; 4585.20 grains (for five days while smoking)

Average weight of aqueous vapor expired, 4449.45 grains (for five days before smoking) ; 4289.51 grains (for five days while smoking)

Chest p. 491

Smoking of tobacco tends to render the lungs flaccid, and to bring on a true marasmus

Various diseases of the chest

Oppression of the chest, relieved by deep breathing

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)

Oppression at the chest great

* Very violent constriction of the chest (tenth day)

Constriction across front of upper chest, dyspnoea and disposition to take a full inspiration, with the darting pain extending from the heart to the vertex

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

* On taking a deep breath, it seemed as if the chest were too tight (second day)

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

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 rigid bread 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

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

Flitting pains in the chest

When taking a deep breath it seems as if the intercostal muscles were being cut to pieces from the front towards the back ; worse when touched ; the pain brought tears to the eyes (first day)

Pain, like a soreness in the chest, during rest (twelfth day)

Shocks in the chest and region of the heart; at first always in the night, but after awhile in the daytime, with rushing of blood to the head, which would momentarily deprive him of consciousness

Anxiety, beginning in the chest and precordial region

Pressure in the chest, with anxiety

Pressure and stitches in the chest (second day)

Stitches in the chest, on taking a deep breath (fourth and eighth days)

Many transient stitches, extending from before backward, through the chest, aggravated by deep breathing

Stitches in the side and chest, on breathing, with great weakness of the head, as if intoxicated, and flickering before the eyes, so that he could not distinguish objects far off (first day)

Front and, Sides. Pain in the sternum, as if a knife were sticking into it (after five minutes)

Pressure beneath the sternum (fifth day)

Pressure on the sternum, as if something heavy were lying upon it (third day)

Stitches beneath the sternum, with impossibility to take a deep breath (first day)

Stitches beneath the sternum, on deep breathing (fourth day)

Fine stitches in the middle of the chest, extending to the sternum

Dull pains in the sides, which seem to alternate with sore throat

Great pain and distress in the left side of chest, especially around the precordial region

Stitches in the right side of the chest, on talking (fourth day)

Stitches in the right side of the chest (fourth day)

Sharp stitches in the right side of the chest, near the axilla, relieved by inspiration (after half an hour)

Sore sticking in the right side of the chest, worse during rest (third day)

Some stitches beneath the right short ribs, with tightness of the chest

Some stitches beneath the left short ribs (third day)

3£(linwiw. A violent sore pain in the right female mamma, with a feeling as if the nipple itself were bitten off (twelfth day)

Great oppression at breast (woman)

A burning stitch beneath the left breast (first day)

Heart and Pulse p. 492

Prwcordia. Three had heart disease

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

Heart disease is very common among tobacco-provers

Precordial oppression

Suddenly seized in the evening with violent precordial anxiety, followed by complete sleeplessness and springing from bed

Suffered chiefly at night from paroxysms of precordial oppression, with palpitation and pain between the shoulders

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

Darting pain, extending from the heart upwards to the vertex, and sensation of constriction across front of upper chest, with dyspnoea and disposition to take a full inspiration,147.f

Aching pains iu cardiac region, generally worse at night, with frequent intermission of the pulse and of the heart's action

Slight disturbance at the heart

Heart's Action. Both sounds of heart clear, but the action was relaxed and occasionally intermittent

The heart-sounds were muffled and seemed to almost run into each other

Systolic murmur in aortic ireland in course of large vessels

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 catarrh of French writers, which is likely to accompany aortic regurgitation

Sounds of the heart inaudible, and its movements scarcely felt (after three days)

* Palpitation,56 57 58, etc.

Palpitation and pain in cardiac region

Palpitation while lying in bed on the left side, which ceases on turning to the right side (twelfth day)

For some time he suffered from palpitation, with pain and constriction of the chest, which came on in the form of an attack either in the evening or night; afterwards a similar attack from inhaling the fumes

Palpitation with the tightness of the throat

For about a month, during the night he frequently had attacks of palpitation, with oppression and pains about his shoulders

Strong pulsation of the temporal arteries

Violent palpitation (third and fourth days)

Violent palpitation all night

Most distressing palpitation of the heart

Heart beating so violently that he is compelled to give up active exercise

Heart beat somewhat irregularly, with a slight anaemic murmur

The heart beat very irregularly ; this was evinced by palpitation and tremulous motion of the organ, especially when lying upon the left side

Beat of the heart weak, slow, intermittent

Beat of the heart weak and intermittent

* Heart's action very feeble

Heart scarcely beat

Heart perfectly paralyzed

The most powerful influence seemed to be exerted on the heart's action

Ptllse. Pulse rapid

Violent pulse

Pulse more rapid by 10 beats, and fuller (soon),4h.

Pulse small and very frequent

Pulse small, rapid, irregular

Pulse averaged 85 (before experiment) ; 92 (during experiment)

Full, hard, rapid pulse

Pulse quick and feeble

Small, hard, rapid pulse

Pulse full, slow

Pulse slightly compressible and perfectly regular, at barely 60,93.

Man's pulse hard and quick

* Pulse soft, full, and feeble

While he sits, the pulse beats but 48 in a minute. It is large and full to the finger, under which it passes slowly, and readily compresses; any movement at once increases the beats, and more than occurs in the healthy state

Woman's pulse rather soft, but frequent

* Pulse slow, 45,43 ; 50 to 60,107.

Very slow pulse

* Pu/se small, 82,60 108.

Pulse 60, regular, small, and weak

Pulse 48, and small

Pulse very slow and weak

Extremely weak, small pulse.116.

Pulse small, slow, 34,551 51.

Pulse remarkably slow, scarcely perceptible, intermittent for fifteen seconds

Pulse small and intermittent, 78, 105.

Slow and intermittent pulse

* Pulse small and weak

Mind p. 493

'p^g pU]se becomes small and weak, the skin cold, and covered with clammy sweat

Frequent intermission of the pulse and of the heart's action, with the pains in the cardiac region

Among eighty-eight inveterate smokers, there were twenty-one instances of marked intermittence of the pulse, occurring in men from 27 to 42 years of age

Pulse irregular, variable, and intermittent; at one time 136 per minute, and in a short time thereafter down to 38 per minute

Basis, 74| pulsations: Six minutes, 81, 81, 81, 83, 82, 82 ; average 81.6. Seventeen minutes, 85, 89, 89, 93, 96, 90, 94, 94, 93, 92, 93, 95, 95, 96, 94, 97, 93 ; average 93,110.

Basis, 74^ pulsations: Six minutes, 79,77,80, 78,78,77; average 78.1. Seven minutes, 83, 87, 88, 94, 98, 102, 102; average 93.4. Eight minutes, 105, 105, 104, 105, 105, 107, 107, 110; average 106. After smoking eleven minutes, 112, 108, 107, 101, 101, 100, 100, 100, 100, 98, 91,110

Smoking seven minutes, 76, 75, 79, 79, 76, 78, 82. Smoking ceased ten minutes, 81, 88, 81, 83, 82, 84, 83, 83, 80, 82,110b.

Basis, 70£ pulsations : Six minutes, 68, 70, 71, 70, 72, 74 ; average 70.8. Six minutes, 76, 77, 86, 89, 91, 94 ; average 85.5. Four minutes, 98, 95, 96, 95,110c.

Smoked fast three minutes, 94, 94, 96. Pipe recharged, 87, 93, 96, 96, 96,1,0d.

Basis, 82 pulsations : 85, 85, 84, 80, 94, 94 (one missed), 84, 84, 88, 89, 86,111.

Basis, 65 pulsations : Seven minutes, 64, 64, 64, 65, 67, 64, 65 ; average 64.7. Seven minutes, 70, 70, 70, 71, 74, 68, 71 ; average 70.5. Five minutes, 76, 77, 77, 81, 81; average 78.4,11,a.

Basis, 84 pulsations: 84, 84, 85, 84, 86, 84, 83, 85, 86, 84, 87, 86

Basis, 73 pulsations: Ten minutes, 76, 75, 73, 74, 71, 74, 71, 74, 73, 73 ; average 73.4. Six minutes, 77, 79, 81, 87 (missed one), 74, 75 ; average 77.1,1121.

Pulse not perceptible at wrist, and action of heart scarcely so in precordial region

Pulse almost imperceptible, very small, intermittent, extremely slow, 45, n.

Pulse scarcely perceptible, 83,u9 150.

No pulse at the wrist (third day)

Pulseless (after fifty minutes)

Neck and Back p. 494

Week. Stiff neck, so that he could not turn the head to the right side (eighth day)

Neuralgic pains in the neck, with the tightness of the throat

Burning and tension in the skin of the right side of the neck (second day)

Great heaviness and pain in the nape of the neck, so that he was obliged to remove the neckerchief (first day)

Back. Tenderness of the spine along its whole length, the more especially in the cervical and lumbar regions

Pain between the shoulders, with the praecordial oppression

Burning beneath the scapula (second day)

Stitches in the right scapula (fourth day)

Dull pain in the middle of the spine, with bruised feeling over the body, especially in the upper extremities, in the morning

Pain in the small of the baric and loins, especially after sitting,4 41 b c.

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)

Pressive pain in the lumbar region on rising from a seat and on beginning to walk, disappearing on walking

Beating pain in the region of the sacrum, in the evening (first day)

Upper Extremities p. 494

Extremities outstretched, relaxed, powerless, with almost incessant trembling and frequent convulsive twitchings

Trembling of the limbs,38 48 55

Trembling of arms and hands

Rigidity of the limbs

Limbs began to be very stiff (second day)

Paralysis and relaxation of the limbs

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

Great weakness and trembling of the hands and feet (first day)

Weariness and prostration of the limbs

Complete loss of power of the upper and lower extremities

Limbs relaxed

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

Pain in all the limbs

Superior Extremities p. 494

The arms bound over the chest

Constant inclination to stretch the arm (second day)

The right arm seems paralyzed, as with cramp (twelfth day)

The left arm is completely powerless and painful (third day)

Severe spasmodic contractions in his anus and hands

Tension in the left arm, especially in the elbow (first day)

Pain in the arm on raising it (first day)

Drawing pain in a spot as large as a half dollar on the left arm, as if an ulcer would form (fourth day)

SJiOiilder. Pulsation beneath the right shoulder (first day )

Stitches and drawing in the left shoulder (second day)

Elbow. A drawing pain in the elbow on turning the forearm (first day)

Sticking pains in the elbows, on account of which he could not quickly stretch out the right arm (second day)

Forearm. Pain, as from a sprain, in the right forearm, especially in the elbow, with painful stitches immediately on every exertion (third day)

Tearing in the tendons of the left forearm towards the hand, and then in the elbow (second day)

■ Hands. Hands joined, and in a state of rigid contraction

Trembling of the hands (first day),2 T6 107 149.

Trembling of the hands and tongue.78.

His hand trembles much when he holds it out

Weakness of the hands (first day)

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)

Drawing, paralytic, spasmodic pain in the right hand, extending to the elbow (fifth day)

Sticking and tearing in the right hand (after ten minutes)

Fingers. Fingers somewhat swollen (sixteenth, seventeenth, and eighteenth days)

Twitching of one finger

Cramp, and a feeling of formication, in the three first fingers of the left hand (third day)

Cramp in various fingers (after two hours, and on washing in the morning), (second, third, aud fourth days)

Frequent painful tearing in the whole little finger (second day)

Gait shuffling

Had the gait of an old man

Tottering iu his gait (after half an hour)

Stiffness of the lower extremities and of the spine

Uneasiness in the lower extremities

A kind of paralysis or excessive weakness of the lower extremities, so that at last the patient is obliged to sit or lie down, with loss of sensation and more or less weakness of all the special senses

Complete loss of power over lower extremities

Hip and Thigh. Dull pressive pain in the hips and kneejoints

Stitches iu the right hip, towards evening (third day)

Pain on pressing upon the right gluteal muscles (second day),4c.

Sticking in aud above the gluteal muscles (first day),4b.

Pain and tension in the gluteal and femoral muscles, as after a long walk (third day),4c.

Drawing in the thighs (ninth day)

Stitches in the left thigh, between the shoulders aud beneath the sternum (eighth day)

Knee. Knees tottered, and he appeared scarcely able to support his emaciated body

Stitches on bending the knees, pressure iu them during rest (first day)

Cracking in the knees when walking (first day)

Cramp in the knee (eighth day)

Stitches in the hollows of the knees (fourth day)

Frightful burning in the knee, and when touched, a feeling as if pins were in it (eleventh day)

Leg. Paralyzed feeling, as if asleep below the knee (fifth day)

Tension from the knees to the feet when walking (third day)

Weakness of the legs and feet (third and fourth days)

Tearing externally ou the left tibia

Tearing down the left calf (first day)

Pressive pain in the left ankle

Jerking of tendo Achillis, aud of other muscles, mostly at night, with restlessness and sleeplessness

Foot. Trembling, or rather shaking of the feet for a long time (first day)

Great weakness, as if the feet were paralyzed ; could scarcely go upstairs (first day)

Paralyzed feeling in the right foot (first day)

Burning on the side of the sole of the foot, as from a glowing hot iron, most violent towards evening (second day)

Jerking tearing on the back of the left foot (first day)

Toes. Cramp from the toes into the knee (first day)

Acute pain in the balls of the toes of the left foot, so that he could not step upon it as usual (sixth day)

Generalities p. 495

Consumption

Gout

The pernicious effects of Tobacco upon children are incontestable. The use of Tobacco causes pallor, chloro-anemia, palpitation, and troubles of digestion. The anaemia 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 Ul.

Twenty-seven presented marked symptoms of nicotine poisoning

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

Feeling of increased vigor in the muscles, with disinclination for the slightest movement (soon)

Entire system flaccid, pallid

Walks literally bent double, pressing both hands over the region of the spleen, and groaning at every step

Blood thin ; red corpuscles scattered, non-confluent, and crenated

Eight had decided deterioration of the blood

Emaciation,61 69 109.

An advanced stage of marasmus

Rapid emaciation

Loses flesh, especially on the back; the cheeks also become wasted (after ten days)

Began to emaciate and grow pallid

She is emaciated ; all her clothes are too loose (twelfth day)

Average weight of body 225.79 pounds (for five days before smoking) ; 225.86 pounds (for five days while smoking)

Average weight of body 224.77 pounds (for five days before smoking); 223.62 (for five days while smoking)

The hands were doubled iu to 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

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

I was called and saw him in less than ten minutes after he had taken it. Upon entering the room, I noticed two short inspirations, and all was ended. From the statements of the family, he had convulsions immediately after drinking the poison, and sank to the floor. I found him lying upon his left side, mouth and jaws wide open, with the tongue protruding ; lips, tongue, and inside of mouth of a dark-blue color; eyelids open ; pupil of the eye contracted to the size of a pin's head. General appearance of a man who had been suddenly struck dead. Petechia? all over the body, with spots of ecchymosis in places. Rigor mortis very great

Epilepsy

Muscles rigid

Paralysis

A fit of hemiplegia eight years ago

Twitching of the muscles

Jerking in the whole body, with pulsation in the head and palpitation (fourth day)

Tremblings

Trembling greatly

Trembling of all the muscles,10 41 134.

After having lain in bed for three hours, she felt a shudder throughout her whole body, which was followed by nausea and violent vomiting, with convulsions in the arms, lower limbs, and even in the muscles of the back; these convulsions had continued from 1 to 4 a.m.,175.

Trembling of the whole body, with the nausea

Trembling of the head and hands, with great excitement, like intoxication, after dinner (first day)

Whole frame shook with strong tremors

Nervous tremors

Spasmodic contractions of single muscles

Constant jactitating movements of the muscles

Whole body affected with spasmodic contraction

In a state of continuous muscular tremor, and when he moved across the room to reach his bed, his legs seemed bent or bowed, as if he were permanently deformed, which, however, was not the case. He had evidently lost the full use of the muscles of the lower extremities, and he climbed into bed with considerable difficulty. When he reclined in the bed, a continual movement of the muscles of the arms and legs was kept up, and the facial muscles moved occasionally in an involuntary manner

Great nervous excitement, accompanied by irregular action of the muscles, more particularly of the eyelids, mouth, and upper extremities, which lasted for about two hours after each occasion of using this substance. These sensations were succeeded by a pleasant feeling of ease and contentment, which lasted about two hours

Hysteric tremors, with convulsive twitching of the flexor muscles of the whole body, accompanied by an agonized apprehension of some rapidly approaching physical catastrophe, the result of which would be death. He would clutch the arm of any bystander and beseech him to save his life, to relieve him from the great precordial distress and threatening suffocation. This fear was, in some subsequent attacks, the cause of prolonged mental and bodily excitement. Conversation, rapid walking, or any violent motion of the attendants, would provoke this spasmodic attack, and produce great nervous irritability. His disposition, from being amiable, became fretful and peevish

General convulsive trembling

Convulsions,14 27 70, etc.

Convulsions, followed by death

Spasmodic convulsions

Violent spasms, with great rattling (after two minutes)

Violent convulsions, followed by death

Convulsions, the head firmly drawn back, with rigidity of the muscles of the posterior part of the neck (third day); there were constantly returning rigid tetanic spasms, the muscles of the back being principally affected, till death, a week after he chewed the Tobacco

Violent involuntary contraction of all the muscles, with appearance of frightful pain; constantly placed the hand upon the abdomen and tore at the penis forcibly

Convulsive movements of the arms, then of the legs, and afterwards of the whole body, which progressively augmented during six or seven minutes, and were succeeded by extreme prostration

General convulsions, with bending forward of the body and stretching of the limbs, with subdued cries, on account of the pain in the stomach

Frightful convulsions, with rigidity of the limbs and violent contractions of the muscles of the abdomen ; bending backward of the body ; distended bloodvessels on the head

In half an hour violently convulsed, the flexor muscles of the upper and lower extremities being rigidly and spasmodically contracted, so as to contract the limbs forcibly against the body

Tetaniform convulsions

Clonic convulsions, which produced great muscular agitation, particularly of the extremities ; the teeth w-ere grit together, hands tightly clenched, legs flexed and extended in rapid alternation

The next morning he always had a spasmodic attack, was constantly obliged to stretch the limbs and yawn, with a sensation of rolling through the chest, abdomen, and calves, followed by a feeling of leaden heaviness of the feet

The general effects upon the system were almost identical with those previously described as resulting

Skin p. 497

32 from the former use of Tobacco ; there was the same nervous excitement, trembling, wakefulness, but in a somewhat less degree

Slightly convulsed (in one hour)

Disturbance of motility

Complete rigidity of the muscles

He felt decidedly uncomfortable at the end of the eighth, and when he had finished the ninth, he was attacked by giddiness and shiverings ; these symptoms became worse after the tenth cigar ; he refused to leave off smoking, and was then attacked by severe pain in the bowels and vomiting, and died in the night

* General debility,31' 91 92 u

General sick feeling

Great debility and emaciation

* Weakness,36 46, etc.

Weakness and indolence

Weak, nervous, and timid

Weakness, paleness, dilated pupils (second day)

Very weak and languid

General relaxation of the whole body, with rough and warm palms of the hands (soon)

Weakness towards evening, and on moving part, immediate shivering and coldness between the shoulders, with dizziness and stitches in the temples, forehead, and vertex (first day)

Muscular weakness so great that any movement was very difficult

Weaker in the forenoon than in the afternoon (first day)

General feeling as if he were losing all his strength all over body (after smoking half a cigar indoors)

Lost strength very rapidly

Inclination to lie down, yet when he goes to bed he cannot close his eyes to sleep

Aversion to work (first day)

Disinclination for physical effort

Aversion to moving about

Reflex and motor functions weak

Muscles weak and flabby

Relaxation of the whole body

Excessive languor

Lassitude and debility of the voluntary muscles, with vertigo on motion

Feeling of great exhaustion

Prostration**33130.

Profound prostration

Excessive prostration all night

Complete prostration, motionless, and apparently insensible

Nervous excitability

Nervous and shaky ou smoking

Smoking makes him nervous if he exceeds his usual amount

Very nervous for several years, especially after smoking, in the morning

Restlessness,43 121 160.

Great restlessness

Restlessness and sleeplessness, with the jerking of the muscles

* Restlessness, requiring continual change of place,™6.

Restless and excited condition

Restlessness drives her from place to place, with constant sighing (tenth day)

Vertigo when standing and sitting, at last becoming painful; frequently obliged to change his position, and when standing, was frequently obliged to stand upon one foot and frequently change the position of the body, to lean or support the body in some way ; while sitting, was obliged to stretch out or bend up the feet and move them back and forth ; while reading, the arm speedily became fatigued from holding the book, at times associated with stitching in the fingers, especially in the thumbs; even in bed was frequently obliged to change the position, and also while asleep I became very restless, so that the sleep was frequently interrupted, and was often weary in the morning. Following this, there was complete loss of power of co-ordination of antagonistic muscles, so that while standing, the knees gave way, or on sitting down, I fell with my full weight on the chair. I became unable to draw my clothes on to my limbs without supporting myself. At times the gait became slow and shuffling, the steps short, scarcely raising the feet from the ground, so that I frequently stumbled and became weary ; it was especially difficult to go upstairs, especially if the steps were high ; such an ascent caused anxiety and dread of falling backward, so that I went with the body bent forward. This was associated with transient attacks of vertigo while walking in the open air, especially on suddenly looking upward, also with great weakness and speedy fatigue, without confusion of the head and without difficulty in performing mental labor, with at times nosebleed without apparent cause. One evening, while sitting, as usual, drinking beer and smoking, there was a sudden peculiar creeping chill along the back with general weakness ; this was ascribed to a draft of air, so that I changed my place, but the symptom was repeated from time to time, with such aversion to my cigar, that I threw it away and went home. On my way home, I was attacked with a dull pressive headache on the lower portion of the frontal bone; while undressing, on going to bed, I was attacked with a shaking chill, soon followed by dry heat, and afterwards perspiration ; the sleep which followed was interrupted by vivid dreams, from which I awoke with perspiration pouring from the whole body, greatly exhausted, and with head confused ; on rising in the morning, I had a dull distressing headache in the frontal region, as though there were an actual pressure from above downward within the skull; the headache was completely relieved by a horizontal position ; this was associated with thirst, a coated tongue, and loss of appetite. On attempting to walk, I had pains in the loins, small of the back, and nape of the neck ; the gait was slow and anxious, accompanied by vertigo and a terrible pressing headache ; when walking, my left foot frequently failed to make a step, as do soldiers on changing the step. In the afternoon there was considerable bleeding of the left nostril, with some relief to the headache, but later, in the evening, on attempting to make some visits, the pressive headache became worse, and concentrated in the left side ; this, however, disappeared on going to bed, in the evening, but the sleep was filled with vivid dreams. The next morning the headache returned, was concentrated in the left side, with great weakness, thirst, and loss of appetite, and with no inclination to smoke; haemorrhage from the left nostril returned, and lasted for a quarter of an hour, consisting of black blood. To-day my gait was very unsteady, tottering, and assisted by a cane. The urine was increased in quantity, and of a deep yellowish-brown color. On the subsequent day there were, in addition, tearing pains in the temporal muscles, the epistaxis recurred, the blood being thick, dark, tenacious. This condition continued unabated for some time, after which it gradually improved until perfectly good health returned, with less desire for Tobacco and with greatly lessened use of it

In the course of an hour a patient has been seen to sit on every chair in the room, recline in various positions on sofas, armchairs, bed, or floor, sit on the edge of the table, and give, as a reason, that no place or position seemed comfortable, and he was compelled by an irresistible restlessness to this constant change, 136».

Inclined to faint

Faintness,11 14 etc.

Sudden faintings

Quite collapsed, with cold sweats (in one hour)

Frequent attacks of faintness

Attacks of syncope and unconsciousness

Violent syncope

Profound collapse, with pale face, with cold sweat

Hyperesthesia of different nervous branches

Anaesthesia more or less complete, especially of the left side of the extremities and of the tip of the tongue

General numbness

General numbness, commencing first in tips of fingers, toes, and tongue

Complete loss of sensation, of voluntary motion, and of respiration

Feeling as though the blood were circulating more rapidly and violently (soon),4

Inability to lie on the left side ; it caused so much pain and palpitation

Painful cramp

Cramps and twitching

Different neuralgias, as of the N. pudendum ext., awakening him from good refreshing sleep, at 4 a.m., with painful erections and strangury, and passing off about noon after micturating a watery urine six or eight times ; of the plexus cceliacus, with continual sour eructations ; of the fifth left intercostal nerve; of the right plexus brachialis; as soon as one neuralgia ceases, another starts in its place

Drawing pains over the whole body

Violent pressive pain, with uneasiness of the whole body and anxious perspiration

Dread of motion

During low barometer, and when the wind blows, the pains return, and they can only sometimes be relieved by hot applications to the stomach, by lying oil the back, and by a strict diet (notwithstanding his good appetite), during two, three, or four days

Aggravation of all the symptoms from great heat, great cold, and especially from stormy weather

Aggravation by walking, riding in a carriage, and especially from the jarring of a railway train

The left side of the body suffers more than the right

She feels better in the open air

Skin p. 500

Objective. Jaundice

Cases of jaundice in healthy young men

Skin pallid and presented an anaemic appearance

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 cachexia

Increased turgescence of the skin, with violent itching and slight general perspiration

Increased turgescence of the skin, with itching and slight perspiration

Skin livid, covered with cold sweat

Red itching eruption over the whole back (after five days)

Red spots on the face (first day)

Red spots on the right shoulder, with burning when touched (tenth day)

Many pimples on the forehead, with itching, which is relieved for a short time by rubbing (third day)

Itching pimples on the small of the back and fingers (after eleven days)

Itching pimples on the chest (third day)

Papular eruption

Pustular eruption on the nape of the neck and upper extremities

Gritty elevations on both cheeks, beneath the eyes, perceptible only on touch (first day)

Small itching blisters on the body, surrounded by red areolae, and filled with yellow liquid, with sore pain on touch (after five days)

Dryness of the skin

Subjective. Increased vulnerability of the skin, so that the slightest wound or abrasion is followed by a high grade of inflammation

Trembling sensation in the skin as though it were being torn

Formication of the left lower extremities from the knee to the toes (third day)

Violent itching

Violent itching of the whole surface

Itching, here and there on the body, provoking scratching, and afterwards disappearing (third day)

Frequent itching, as from fleas, on the face, in the evening (second day)

Itching on the right hypochondriac region

Itching, as from fleas, on the arm and neck (third day)

Itching on the thighs

Sleep p. 500

Sleepiness. Much yawning (second, third, fourth, and fifth days)

Yawning and sleepiness after dinner (first day)

Much yawning after dinner (first day)

Drowsy

Sleepiness (after one and a half hours),2 9 11 45 174.

Great inclination to sleep

Very sleepy towards evening (third and fourth days)

Promotes sleep

Sleepiness in the house, which disappears in the open air (second day)

Sleepiness, associated with heat and restlessness

Sleepy in the forenoon ; he also slept for a short time (first day)

She was sleepy immediately after dinner, and slept for an hour, and even then could not arouse herself until after violent palpitation (fourth day)

She woke before midnight and soon fell asleep again (first day)

Stupefying, but not refreshing sleep at night

Sleep, stupefaction, and profuse perspiration.24.

Deep sleep, followed by copious perspiration

Sound sleep at night (second and fifth days)

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 aud 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

Cannot be wakened or aroused in the morning (second, third, and ninth days)

Sleeplessness. Sleeplessness,72 57 60, etc.

Could not fall asleep in the evening, could not wake in the morning (third day)

Light slumbers, often interrupted, sometimes without apparent cause, but more frequently by cough and colic

Restless sleep,47 6t.

Sleeping badly and eating badly, when sight began to fail

Uneasy sleep at night, with coldness and tossing about the bed (ninth day)

Restless sleep at night, frequent waking on account of pain in the left wrist and ankle

Restless sleep with anxious dreams

Sleepless and restless at night, and were often favored in sleep with dreams of snakes and other frightful visions

Starting from his early slumber with a shock through the epigastrium, and sometimes through the chest

Frightened during slumber (first day)

Awoke several times at night (first and second day)

During the first part of the night there was wakefulness, but this was always followed by sound sleep, which continued till the hour for rising

Ten had disturbed sleep

Sleep bad, and disturbed by dreams

Startings, when first falling into a slumber

Dreams. Sleep disturbed by many dreams

Sleep broken by the most horrid imagery, in the shape of frightful dreams, for more than a year

Dreams that she wished to talk and could not, on account of her excessively large tongue, which extended out of her mouth and up to her nose; she tried to cry out and could not, thereupon wept and was inconsolable, until at last she woke in anxiety (a kind of nightmare), (first day)1.

Uneasy dreams

Dreams disturbing sleep

Painful dream that a tooth had fallen out

Anxious dream of fire (first day)

Frightful dreams

Frightful dreams, dreams generally of snakes, apprehension of death, etc.,137.

Fever p. 501

Chilliness. Chilliness

Chilliness, with shivering in the open air (first day)

* Chilliness, with cold sweat (after two hours)

Chilliness from 5 to 7 p.m.; about 6 oclock associated with thirst (first day)

Violent shaking chill in the evening in bed,4d.

Violent shaking chill, with inclination to stretch, in the evening (first day)

Shaking chill over the whole body every evening

Shivering, with yawning and stretching of the arms (after four minutes)

Shivering over the whole body (after a quarter of an hour)

Shivering over the whole body, flushes of heat (first day)

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)

She complained of coldness aud shivering in the morning in the open air (second day)

Shivering, with shaking all day, and towards evening sweat in the palms of the hands (second day)

Shivering the whole day, and pressive pain between the shoulders (third day)

Shivering nearly the whole day (seventh day)

Febrile shivering and chilliness (eleventh day)

Slight shivering

Gooseflesh all day (first day)

* Cold skin

Whole body icy cold, streaming with cold sweat

Pale and cold

Coldness, with creeping heat, without thirst (after two hours)

A sense of excessive coldness

Coldness and shivering in the evening (fourth day)

Skin cold, covered with clammy sweat

Complete absence of warmth, extremities cold and blue

Internal coldness, with hot face, with one time cold, at another warm, sweaty hands, without thirst (fourth day)

Surface of body cool (96° Tahr.), clammy perspiring

Temperature 97.2°,167.

Skin cold, especially on the extremities

Cold, moist nose

Limbs cold and bluish

Cold extremities,10 etc.

The left hand is cold, the right hot (twelfth day)

Icy-cold legs, with heat of the body (first day)

The feet are icy cold from the knees to the toes, with burning in the thighs, and much heat (third day)

Icy coldness of the feet ; she could not get them warm in bed the whole night (first day)

Cold feet (first and second day)

Heat. Violent fever, with general intoxication for three or four days

Extraordinary heat

Heat and restlessness

Heat and perspiration

Heat and sensation of dryness, increasing from minute to minute (first day)

Increased external warmth, with an internal sensation of shivering and prostration, with disinclination for the slightest work (soon),4b.

Flushing heat after the vomiting

Warm body, with icy-cold bands (fifth day)

Increased warmth, especially noticed in the palms (after a few minutes)

Sensation of warmth over the whole body

Temperature high

Temperature ranged from 98° to 99.5° Tahr.,166.

Skin hot and drv; temperature in the axilla, 103.40,151.

Very dry, hot skin

Orgasm of blood

Heat of the head and face, with burning iu the chet ks (soon)

Heat in the head (first and second days)

Face hot, bright red

Sudden, very transient mounting of heat into the head (soon)

Glowing heat in the right cheek, while the left was pale (first and sixth days)

Heat and redness of the left cheek, without thirst (first day)

Rising of heat into the face (first day)

Sweat. Perspiration

Profuse perspiration

Profuse perspiration before midnight, as if soaked with water, with the odor of tobacco,4d.

Profuse perspiration on the head and chest

General copious perspiration

While engaged in light occupation, streams of perspiration ran down his face

The whole skin, except the forehead, cold, covered with trickling perspiration

Cold perspiration for some days

* Cold perspiration,11 22 116, etc.

* Cold sweat covered the whole body

Cold sweats all night

* Cold, clammy sweats,55 89 167.

Viscous sweating

Nightsweats (first day)

Profuse perspiration of the head,5o

Cold sweat on the forehead

Cold perspiration on the face

* Cold sweat on the hands (after three hours)

Perspiration apparently diminished

The cutaneous transpiration, whether from the diminished temperature of the atmosphere, or as an effect of the Tobacco, was very sensibly lessened in quantity

Conditions p. 502

Aggravation.

(Horning), Diarrhoea; 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 iu 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 in 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.

(Biding), The symptoms.

(On rising), Vertigo.

(Sitting), Pain in small of back.

(Stimulants), Double vision.

(Stooping), Heaviness of head ; stitches in hepatic region ; retraction of navel.

(Talking), Stitches in right side of chest.

(Before urinating), Stitches in urethra.

(On urinating), Burning in urethra ; prickling in urethra.

( Walking), Flickering before eyes ; the symptoms.

(Stormy weather), The symptoms.

Amelioration p. 503

(Open air), Headache; stitches in forehead; the symptoms.

(Deep breathing), Oppression of chest.

(Inspiration), Stitches in right side of chest.

(Pressing cheeks), Drawing pain in teeth.

(Weeping), Apprehension.

Footnotes p. 492

† The cardiac and thoracic pains were probably an aggravation of symptoms caused by partial suppression of a habitually profuse and offensive footsweat.