A few years ago, a business man about forty years of age entered my office evidently in a state of considerable excitement. Without stopping to seat himself, he said in a voice trembling with emotion,
"Doctor, I am told that I have myocarditis (tobacco heart), with casts and albumin, and my physician will not promise me more than a year and a half or two years to live. Now I want you to tell me how to live so I can have ten years more in which to develop my business.
"I am head of a business enterprise which I induced my friends to invest in several years ago and thus far it has brought no returns. Development has been slower than we expected and it will take ten years more to make it a real success which will insure my friends a good return for their investments. I am absolutely indispensable to the business. If I fail, the whole thing will fail and my friends will lose every dollar of their money. I must have more time, then I shall "make good" and everybody will be happy. Tell me, doctor, how I can keep on my feet for just ten years more. I'll do anything you say, eat anything you order, follow any rules you may lay down to the letter.
"I've stopped smoking, of course. I stopped at once when I found what it was doing to me. I never would have smoked one cigar if I had known that it was harmful. Now I've stopped. I'll soon be all right, won't I? Now, just tell me what I can do to live ten years more and make my business a success."
As the speaker paused, he leaned forward in his chair and with an expression of anxiety and eager expectation, awaited an answer. I could only say to
"My dear sir, we will do our utmost for you, but the trouble is, your safety margin is used up, your reserve is gone. Your heart, liver and kidneys have carried such a heavy burden, done so much overwork for years that they are worn out. Your blood-vessels are hardened and shrunken, greatly increasing the work of the heart, while the heart is degenerated and weakened, the usual effects of nicotine; and so a vicious circle is formed. You are like a man whose once great bank balance of millions has been reduced by extravagance to a few cents. His fortune is gone. Economy and reform will not bring it back. We will do our best for you. But with heart and kidneys both so badly damaged, there is little on which to base an extended life expectancy."
As I hesitated, seeking to find some word which would convey a little ray of hope for a despairing soul facing an awful tragedy, the man read my thoughts, and saw there was no hope.
He sprang from his chair for a moment and strode back and forth in my office, pulling his hair out by the roots. Suddenly, he paused a few seconds, then, with a look of mingled terror, despair and indignation, he rushed at me, and shaking his clenched fist close in my face, he fairly shrieked,
"But I've stopped smoking. I'll never touch it again. I'll soon be all right, won't I, with careful living? I can't leave my business. It will go to smash and ruin my friends who trusted me. Doctor, you must keep me going somehow. If you can't give me ten years, make it five. I can do something in five years. Make it five, Doctor. I must live long enough to make good and save my friends from loss."
"Why didn't I know this before? Why didn't somebody tell me what tobacco would do to a man? I never dreamed there was any harm in it.
Doctors smoke, preachers smoke; everybody smokes; I thought, of course, it must be harmless. If I had even dreamed that tobacco would injure my health or my business, I would have cut my throat as soon as I would have smoked. Why didn't I know this before?"
With this shaking, screaming, figure before me, with blazing eyes glaring at me, I felt myself shriveling to a shred, a contemptible, cowardly wretch. I quailed and cowed before those piercing eyes.
Here was a man who had lost his chance "to make good," because he was ignorant of the subtle power of nicotine to destroy men and business. And he evidently felt that I was responsible for his undoing, because I had known and had not informed him.
I feared his judgment was just. A sense of guilt overshadowed me. I determined to try to make amends. Hence this book.
Tobacco, in its various forms, is one of the most mischievous of all drugs. There is perhaps no other drug which injures the body in so many ways and so universally as does tobacco. Some drugs offer a small degree of compensation for the evil effects which they produce; but tobacco has not a single redeeming feature and gives nothing in return for the $1,500,000,000 which it costs the nation annually, besides the 10,000 lives which it probably destroys.
It has long been known to medical men, chemists and pharmacists, that tobacco is one of the most deadly of all the many poisonous plants known to the botanist. Aside from its use by the devotees of the drug, practically its only use by man is for the killing of parasites on livestock, and the destructive pests, both animal and vegetable, which attack our orchards, gardens, and greenhouses.
To please men and to kill parasites are the only uses of tobacco—its ultimate effects are the same in both cases.
How marvelous the ability to so camouflage its venom that millions of men are made to believe harmless a weed which almost every other living creature than man, great and small, recognizes and avoids as a baneful poison!
Alcoholism, the opium habit and tobaccoism, are a trio of poison habits which have been weighty handicaps to human progress during the last three centuries. In the United States, the subtle spell of opium has been broken by restrictive legislation; the grip of the rum demon has been loosened by the Prohibition Amendment to the Constitution, but the tobacco habit [addiction] still maintains its strangle-hold and many millions of victims of tobaccoism daily burn incense to the smoke god. The battle against alcoholism was won by a campaign of education, the foundation for which was laid by that historic
body of eminent men of science, "The Committee of Fifty." When subjected to the searching scrutiny of these competent and conscientious investigators and tried in the crucible of laboratory research, every one of the pseudo virtues of alcohol vanished in smoke and out of the crucible rose a spectre of suich forbidding aspect, that alcohol, thus stripped of its camouflage, stood naked before the world the hideous demon that it is; and the men and women by when civilization must be saved, if it is saved, set going the campaign of education which culminated in the achievement of a constitutional foundation for prohibition, one of the greatest steps of progress toward Race Betterment ever made.
Tobacco has not yet been fully tried before the bar of science. But the tribunal has been prepared and the gathering of evidence has begun and when the final verdict is rendered, it will appear that tobacco is evil and only evil; that as a drug it is far more deadly than alcohol, killing in a dose a thousand times smaller, and that it does not possess a single one of the quasi merits of alcohol. No one even suggests that tobacco is a remedy for collapse, a food, a prop for the weak or an antidote for snake-bite, the plausible apologies for alcohol which so long deceived the public as to its real character.
Now that the brewer and the saloon have been eliminated, the time has come for a campaign against those kindred enemies of the race, the tobacconist and the smoking-room. It will doubtless be a long and hitter fight; but victory will be the final result, for civilization must be rescued from these destroying forces. This end will be attained only by scientific research and the patient education of the rising generation. Already progress is being made. A "Committee to Study the Tobacco Problem," comprising some of the ablest scientists in the world, has been organized and has begun the work of collecting and sifting the evidence which has already been developed and has set to work some of the world's most expert physiologists, chemists, psychologists,
educators, statisticians and other scientific experts in well-equipped laboratories, delving into every phase of the tobacco question. In due time their findings will be published and one more enemy of the race will stand before the public with its real character revealed, condemned by such authoritative evidence as cannot be impeached. But the writer feels that what is already indisputably known makes possible a very certain forecast of what the ultimate verdict will be.
The following most interesting statement made in his annual address as retiring president of the American Academy of Engineers by Dr. J. A. L. Waddell, D. S. C., D. E., LL.D., is one of the clearest and most significant pronouncements against tobacco which has appeared from non-medical scientific sources (Scientific Monthly, July, 1918):
"While the efforts of certain scientists to prohibit (prevent?) the use of tobacco have proved a failure, as far as the populace is concerned, they have succeeded in convincing thinking men that the effect of nicotine in the system is to reduce materially one's mental acumen; consequently, a very large percentage of the scientists and engineers of today do not use the weed. As a direct result of this there is a small but quite appreciable augmenting of their individual output." (Italics ours).
Evidently the campaign against the tobacco plague is making progress. Men of the training and standing of Dr. Waddell do not make random or ill-considered statements. Dr. Waddell gives us the results of his observations of the habits of scientists and engineers, men whose professional duties are most exacting and often exhausting. It is most encouraging to know that "a very large percentage" of these men of unusual knowledge, as well as highest intelligence, the leaders in scientific progress, are convinced of the evils of tobaccoism and "do not use the weed.'*
"This observation is quite in harmony with that of Dr. William Mayo, the eminent surgeon, who on one occasion when entertaining a company of surgeons in his home re-
marked, "It is customary, as we all know, to pass around cigars after dinner, but I shall not do it. I do not smoke, and I do not approve of smoking. If you will notice you will see that the practice is going out among the ablest surgeons, the men at the top. No surgeon can afford to smoke."
When the whole truth is known about tobacco, and every man, woman and child in this great Republic has been made acquainted with the appalling facts about this noisome weed, the vocation of the tobacconist will become as unsavory as that of the saloonist, and in clue time an enlightened society will purge itself of this unclean and hateful thing.
In compiling the facts and experimental observations which modern scientific research has developed in relation to tobacco, free use has been made of the numerous books and other contributions on this subject which have appeared in recent times. Of the scores of authorities consulted, the writer is especially indebted to a most valuable treatise by [Dr. Abel] Gy, of Paris, "L'Intoxication par le Tabac [(Paris: Masson et Cie, 1913)]," in which is summarized much of the most important data which scientific inquiry has developed.
October, 1921. J.H.K.
Preface to the Seond Edition
The cordial reception given this little work which has created so soon a demand for a second edition, is doubtless attributable to the growing appreciation by the public of the immense harm being done by the tobacco habit and the necessity for a campaign to counteract the baneful influence of the insidious tobacco propaganda which is flooding the whole world.
Battle Creek, July, 1923. J.H.K.
|Preface to the Second Edition||10|
|A Brief History of the Tobacco Habit||13|
|The Recent Rapid Growth of the Tobacco Habit||15|
|The Properties of Tobacco||17|
|The Composition of Tobacco Smoke||18|
|Nicotine Not Destroyed in Smoking||18|
|Tobacco More Poisonous Than Deadly Nightshade||21|
|Poisonous Effects of Tobacco on Plants||21|
|Tobacco Intoxicated Plants||22|
|Effects of Tobacco Upon Micro-Organisms||25|
|Tobacco Deadly to Animals||25|
|Tobacco a Virulent Poison to Man||32|
|Poison in the Old Pipe||34|
|Is Nicotine Absorbed?||34|
|Dose of Nicotine Fatal to Man||35|
|The Toxicity of Oriental Tobaccos||37|
|Does the Body Become Immune to Tobacco?||37|
|How Tobacco Disorders Digestion||40|
|The Effect of Tobacco upon the Intestine||42|
|Smoking Destroys Appetite||43|
|The Damage Tobacco Does to the Liver||45|
|The Destructive Effects of Tobacco upon the Lungs||49|
|Smoking Leads to Consumption||51|
|Destructive Changes in the Heart|
and Blood-Vessels Caused by Nicotine
|Degeneration of the Large Arteries||58|
|The Smoker's Heart||58|
|Smoking Causes High Blood-Pressure||60|
|Tobacco Angina Pectoris||63|
|The Old Smoker's Heart||67|
|The Destructive Effects of Tobacco on the Blood||71|
|Tobacco and Bright's Disease||72|
|Effects of Tobacco upon the Brain and Nerves||77|
|Tobacco a Possible Cause of Insanity||78|
|Loss of Word Memory||83|
|Tobacco Lessens Efficiency||86|
|Why Athletes in Training Do Not Smoke||95|
|All Experts Avoid Tobacco||97|
|Football Players Avoid Tobacco||98|
|The Evil Effects of Tobacco upon Nutrition||103|
|Tobacco Destroys the Sex Glands|
and Hinders Reproduction
|The Effects of Tobacco upon Growth||106|
|Tobacco No Protection Against Infection,
But the Reverse
|Tobacco a Cause of Acne||112|
|Tobacco a Cause of Diabetes||112|
|The Smoker's Legacy||113|
|Tobacco a Cause of Race Degeneracy||117|
|Tobacco and Longevity||118|
|Women Smoke Less than Men and Live Longer||119|
|Use of Tobacco by Women||120|
|Tobacco a Real Narcotic||124|
|Tobacco-Using a Drug Habit||125|
|Tobacco-Using Leads to Alcoholic Intemperance||125|
|The Moral Effects of Tobacco-Using||128|
|The Enormous Economic Waste from Tobacco||133|
|Apologies for the Tobacco Habit||135|
|Does a Man Need Soothing?||135|
|Recent Scientific Researches||139|
|Gas Poisoning from Tobacco Smoke||139|
|The Effects of Tobacco Upon Non-Smokers||143|
|How to Stop Smoking||150|
A Brief History of the Tobacco Habit
Tobacco was used by the American aborigines in connection with certain religious ceremonies. There is no evidence that it ever was used so generally and freely by the Indians as by the present inhabitants of this country.
Columbus saw the first smokers when he discovered America. Ramon Pane, a monk who accompanied Columbus on his second voyage, observed the practice of snuff-taking, and the practice of chewing was noted by a party of Spanish explorers in 1502 when approaching South America.
Ralph Lane, the first governor of Virginia, was the first English smoker. He presented a pipe and tobacco to Sir Walter Raleigh, who soon acquired the habit and started in England a vice which has become a menace to the future of the human race. Historians tell us that Raleigh smoked a pipe just before he ascended the scaffold. It is certainly a pity that his vice did not perish with him.
The white race has made no original discoveries in methods of using tobacco. Smoking, chewing. snuff-taking, are all poison habits borrowed from the ignorant savages who once peopled the Western Hemisphere.
Sir Walter Raleigh helped to create a demand for the weed by smoking or "drinking" tobacco, as it was then called, in public and private.
King James beheaded Sir Walter for treason and tried to stop the use of tobacco by means of a "counter blaste" in which he condemned tobacco-using as "A custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs, and in the black, stinking fume thereof, nearest resembling the horrible Stygian smoke of the pit that is bottomless."
Tobacco was extolled as the panacea for all human ills. A veritable tobacco "craze" seized the country. In London there were more than seven thousand tobacco shops.
King James, by royal edict opposed the practice, but the shrewd business methods of the promoters of the tobacco traffic kept the practice alive.
King James evidently had a very healthy aversion to the weed. He declared, "Surely, smoke becomes a kitchen far better than a dining chamber."
The spread of the practice during the 17th century was so rapid that numerous sovereigns thought it necessary to make efforts to suppress it. The Sultan of Turkey (Amurath IV.), prohibited smoking and condemned smokers to death. In Russia (Michel III.) smokers were punished by cutting off their noses. The Shah of Persia (Abbas II.) made equally stringent laws against tobacco, and Pope Urban VIII. anathematized smoking in church.
In spite of the opposition of King James and his successors, Charles I. and Charles II., the culture and use of tobacco increased until the tobacco plantations in the colonies exceeded in size all other crops together. The habit grew during the period of the commonwealth, and even Cromwell smoked. At Eton the boys had lessons in smoking every morning and a pupil was "Soundly whipped because he refused to smoke."
In the time of Queen Anne, snuff-taking was introduced. The soldiers returning from the Peninsular war brought in the practice of cigar smoking and in like manner the cigarette habit returned with the army from the Crimea.
Some of the Puritans smoked, but the Quakers always opposed the use of the weed, and the Wesleyan conference forbade its preachers to smoke, chew or take snuff as early as 1795.
The cigarette habit was introduced into this country by foreign visitors to the Centennial Exhibition in 1876, since which time it has spread with astonishing rapidity among all classes, especially the young.
The Recent Rapid Growth of the Tobacco Habit.
Within the last quarter of a century, the growth of the tobacco habit in all parts of the world, and particularly in the United States, has been phenomenal.
The world's production of tobacco was in 1894, 1,560,000,000 pounds; 1913, 2,722,000,000 pounds.
Increase, 1,162,000,000 pounds or an increase of 74 per cent in 19 years.
In the United States the production of tobacco was in 1894, 360,000,000 pounds; 1914, 1,034,000,000 pounds; 1930, 1,508,000,000 pounds, an increase in 26 years of 319 per cent.
The per capita consumption of tobacco in the United States in 1880 was 80 ounces; in 1914, it was 112 ounces, and in 1920, about 180 ounces.
The following table compiled by the Census Bureau shows the enormous increase of the cigarette habit in ten years as shown by the number manufacured:
The above figures show an increase of more than 59,000,000,000 cigarettes in 38 years or nearly 2,000 per cent, an unparalleled example of rapidity in the spread of a disease-producing vice. Continued increase at the same rate will produce in the year 1930. seventeen cigarettes daily for every one of the 115 million men, women and children now living under the American flag.
Of the 62,000.000,000 cigarettes manufactured in 1920, 46,000.000,000 were consumed in this country (Department of Commerce), or 460 cigarettes for every man, woman and child in the United States.
The Properties of Tobacco
The several varieties of tobacco differ greatly in the amount of nicotine which they contain, as shown by the following table published by the American Druggist:
Nicotine Content of Different Tobaccos
From the above it appears that the nicotine content of tobacco varies between 1 and 9 per cent. according to the variety of tobacco. In general, pipe tobacco contains the most nicotine.
|American Chewing Leaf|| .93
|Syrian Tobacco Leaf||1.09
|Chinese Tobacco Leaf||1.90
|Turkish Coarse Cut||2.50
|Golden Virginia (whole strips)||2.50
|Gold Flake Virginia||2.50
|Navy Cut (light)||2.53
|Navy Cut (dark)||3.64
|Best "Bird's Eye"||3.93
|Best Shag (a)||4.90
|Cut Cavandish (b)||4.97
|Best Shag (b)||5.00
|Algerian Tobacco (a)||8.81
|French Grown Tobacco||8.71
|Algerian Tobacco (b)||8.90|
The average nicotine content of all tobaccos is probably about 3 per cent. The billion pounds of tobacco raised in the United States annually, contains, then, 20 to 30 million pounds of nicotine, each drop of which carried death-dealing properties second only to those of prussic acid, the deadliest of drugs.
The Composition of Tobacco Smoke.
The burning of tobacco in pipe, cigar or cigarette, gives rise to various substances which are not originally found in the tobacco leaf. According to Dr. J. Dixon Mann, F.R.C.P. (British Medical Journal, 1908) tobacco smoke contains a formidable 1ist of poisons among which are the following:
The United States Dispensatory notes in addition to the above
|Pyridine bases||Carbon Monoxide
Three other poisons, pyrrol, formic aldehyde and furfurol are mentioned by Arnold.
Nicotine Not Destroyed in Smoking.
It thus appears that tobacco smoke contains not less than nineteen poisons, every one of which is capable
of producing deadly effects. Several of these, nicotine, prussic acid, carbon monoxide and pyridine are deadly in very small doses so that the smoker cannot possibly escape their toxic effects. To these poisons are attributable the various destructive effects upon heart, lungs, liver, kidneys and other bodily organs that are described in succeeding chapters.
The idea generally held that the nicotine is practically destroyed so that little of the poison is absorbed has been shown to be an error. The London Lancet, one of the leading medical journals of the world, a few years ago made a careful study of the composition of tobacco smoke as determined by improved methods of chemical analysis. It was found that tobacco smoke always contained nicotine, the amount varying with the variety of tobacco and the mode of using. Some tobaccos gave off in the smoke only 10 per cent of their nicotine content, while the smoke of others contained four-fifths of the total nicotine present. Pipe smoke contained most nicotine, sometimes more than 2 per cent. Cigar smoke contained less and the cigarette least.
Cavendish smoke contains more than 4.00 per cent of nicotine and Perique 5.3 per cent.
But the cigarette was found to contain another active poison, furfurol, which though less active than nicotine is fifty times as toxic as alcohol (Lancet). In very minute doses it produces staggering, trembling and twitching. Larger doses
produce convulsions resembling those of epilepsy and muscular paralysis. So what the cigarette lacks in nicotine it makes up in furfurol.
Furfurol is the characteristic ingredient of bad whisky. It is highly pungent and acts as a powerful irritant to the mucous membrane of the throat. There is as much of this poisonous furfurol in the smoke of one Virginia cigarette as in two ounces of whiskey. (Lancet.)
It is interesting to note that the symptoms characteristic of furfurol tally closely with those which result from cigarette smoking. (Lancet )
The British Medical Journal has shown that cigar smoke contains less nicotine than pipe smoke because the nicotine is condensed in the stump. Analysis shows that a cigar stump contains five times the original amount of nicotine. After the first half of the cigar has been smoked, the remaining half contains most of the nicotine of the whole and further smoking results in the inhalation of much nicotine.
Carbon monoxide and ammonia are other poisons found in very appreciable quantities in tobacco smoke. The first named is a highly active blood poison; it damages the red cells of the blood and thus produces a condition akin to suffocation.
Acrolein, a highly irritating poison, is produced by the burning of cigarette paper.
A cigarette weighing one gram gives off, when smoked, more than half a grain of nicotine, half
Experiment Showing the Dwarfing Effect of
Tobacco Smoke upon Plant Growth (Molisch)
a grain of ammonia, and one-seventh of a grain of pyridin.
An ounce of tobacco produces, when smoked, one-fifth pint of carbon monoxide.
Tobacco smoke contains one-sixteenth of 1 per cent. of formaldehyde, according to Dr. Arnold (London Lancet).
According to Dr. Spitzka, the smoker of cigarettes who "inhales," may absorb so much as 79 per cent. of the nicotine of the smoke, which in turn may contain half or even more of the nicotine content of the tobacco, besides pyridine, carbon monoxide and other worse poisons.
Tobacco More Poisonous Than Deadly Nightshade.
Deadly nightshade belongs to the same botanical class of plants, but is less poisonous than tobacco; yet who would think of smoking this noxious weed.
The habitual smoker lives in a chimney, or rather, he himself becomes a part of a chimney in which is burned a poisonous weed.
In view of the above facts it is evident that every package of cigarettes ought to bear a skull and cross bones and should be marked "deaidly poison" like "Rough on Rats" and other deadly drugs.
Poisonous Effects of Tobacco on Plants.
In an article published in Die Umschau a few years ago (1911), Prof. Mölisch, an eminent scien-
tific authority, summarized the results of an exhaustive research upon the effects of tobacco smoke upon growing plants. We quote the following condensed summary of these interesting observations from the Scientific American Supplement (Sept. 23, 1911):
Tobacco Intoxicated Plants
"Very young seedlings of peas (Vicia Sativa), about one-tenth-inch high, were placed on a piece of tulle, which was stretched over the mouth of a jar so nearly filled with water that most of the roots were immersed, while the stem and seed leaves were above the cloth. A large beaker glass of more than one gallon capacity was inverted over the jar, with its mouth resting on a plate and sealed by a shallow layer of water. The operation of covering the jar with the beaker was conducted in front of an open window, in order to fill the vessel with pure air. The beaker was then slightly tipped and three mouthfuls of tobacco smoke were blown into it through a bent glass tube. Another jar similarly planted and covered, but not smoked, served as an object of comparison. Both beakers with their contents were covered with zinc covers which completely excluded the light, and were kept in the green-house at a temperature of 60 to 65 deg. F. Six days later the two Jars presented the appearance shown (see cut) in which the injurious effect of the tobacco smoke is startlingly evident.
"The plants in the left hand jar, which had been exposed to the smoke, were greatly stunted and their thick stalks grew obliquely, horizontally, or even downward, while their buds showed scarcely a trace of the red tint of anthocyan which tinged most of the buds of the plants which had grown in pure air.
"When the seedlings are grown in water, a single mouthful of tobacco smoke is sufficient to produce a marked effect and, what is more surprising, if the beaker is filled with tobacco smoke, rinsed with water, allowed to stand 24 hours, and then filled with pure air and inverted over the young plants, an appreciable effect is produced by the vaporisation of ingredients of the tobacco smoke which have condensed on the inner surface of the beaker and have not been removed by washing.
"Very similar results were obtained with seedlings of peas, pumpkins and beans. The accompanying cuts show the enormous effect upon the growth of these plants.
"The experiments show plainly that tobacco smoke greatly diminishes the length and increases the thickness of the stem, and destroys its natural negative geotropism. i.e., its tendency to grow vertically upward. The smoked seedlings often assume a horizontal or inclined position, an appearance quite similar to that observed by Nel-
jubow and Richter in young plants growing in laboratory air.
It is probable that the toxic effects of tobacco smoke upon plants was not due to nicotine, but to pyridin, sulphuretted hydrogen and carbon monoxide, which are found in the smoke of all varieties of tobacco and in about the same proportions, and which must act as injuriously upon human beings as upon plants, and especially upon young children and infants.
"The effect of laboratory air upon plants has been attributed, probably correctly, to traces of illuminating gas and the products of its combustion. Tobacco smoke unquestionably exerts a similar effect and in future experimentation with plants more attention must be paid to this influence.
"The fact that greenhouse plants are apparently not injured by fumigation is due to the circumstance that the influence of the tobacco smoke is usually exerted only for a night, after which the house is thoroughly ventilated, and that the damp walls and soil purify the air by absorbing the smoke.
"But in ill-ventilated rooms in which tobacco is often smoked in large quantities, and in which no such rapid absorption takes place, plants must suffer greatly. The peculiar morbid appearance exhibited by plants growing in dwellings, restaurants and shop windows is due partly to darkness, dust, and dryness, and partly to impurities derived from illuminating gas and tobacco smoke."
Effects of Tobacco upon Micro-Organisms
It is interesting to note that certain forms of plant life, bacteria, are even more susceptible to the poisonous effects of tobacco than are higher plants. Mölisch found that:
"The rapid influence of tobacco smoke on bacteria is especially evident in luminous bacteria. A piece of filter paper three inches square is moistened with a few drops of a strongly luminous bouillon culture of the marine bacterium Pseudomonas lucifera. In a dark room the round spot formed by the liquid appears brightly luminous to an eye accustomed to the darkness. If the paper is placed in a glass box containing a little tobacco smoke, and observed in a dark room, the spot usually becomes invisible within less than one minute, although a similar preparation in pure air continues to shine with undiminished brightness for an hour or more. If, immediately after the disappearance of the light, the paper is removed from the smoke box and placed in pure sea water, the luminosity usually returns in a minute or two. In this case the tobacco smoke acts similarly to ether or chloroform, by exerting an immediate and temporary narcotic effect upon the bacteria, but it does not kill them, and so has no value as a disinfectant."
Tobacco Deadly to Animals.
Mölisch experimented upon low forms of animal life and found that tobacco exerts a more deadly
influence upon these organisms than upon plants. He devised a cell by means of which the micro-organisms contained in a suspended drop of water can be observed under the microscope, while exposed to the direct influence of tobacco smoke. The cell is fumigated only once at the beginning of the experiment. In these conditions the motions of certain species of amœba begin to flag in from five to ten minutes. The organisms assume a spherical form, protrude hyaline processes, and finally fall to pieces about thirty minutes after exposure to tobacco smoke. The stemless bell animalcule (Vorticella) ceases swimming after fifteen minutes' exposure and continues merely to move its cilia, and dies in two or three hours.
The learned editor of the Scientific American very justly adds: "If the living substance of plants and of minute animals is so strongly affected by very small doses of tobacco smoke it is hardly credible that saturation of the mouth and the organs of respiration with tobacco smoke, continued many years, can be entirely free from injurious effects."
That tobacco is a poison to animals has long been known. A decoction of tobacco is used [as insecticide] to destroy lice and other parisites which infest sheep and cattle. Sometimes the careless use of the drug for this purpose leads to death of the animals.
Greenhouse men burn tobacco in their propagating houses to kill green flies and other para-
sites. The destruction of parasites is the one useful service which tobacco is capable of rendering as was facetiously pointed out by Dr. H. W. Wiley in Good Housekeeping.
"When old Hans Schmidt, who was acknowledged to be the meanest man in the neighborhood, had been placed in the grave, and the audience, according to the good old Pennsylvania custom, had waited long for some good neighbor to say something good of him so that the grave might be filled, Gustave Schultz ended the embarrassment by walking to the edge of the grave, taking off his hat, and saying, 'Well, I can say joost one good ting about Hans, he wuzzn't always as mean as he wuz sometimes.' So can I say one good thing about tobacco: A decoction of tobacco is speedy death to lice and ticks and makes an ideal dip for pigs and poultry."
The British Medical Journal reports that tobacco leaves have been successfully used as a protective against plague-infected fleas in India.
Dr. Pidduck states that leaches die instantly when made to suck the blood of smokers.
Bees, flies and other insects are quickly killed by directing upon them a stream of tobacco smoke.
A drop of nicotine on the shaven skin of a rabbit will produce death in a short time.
According to Traube a minute quantity of nicotine injected into the jugular vein of an animal, caused the blood pressure to rise to two and one-half times the normal after first dropping.
The Journal of the American Medical Association says (May, 1917):
"Experimental research has confirmed that tobacco may induce a tendency to convulsions in animals. A number of research workers have recently reported cellular changes in the cortex of rabbits and guinea-pigs long submitted to slow tobacco intoxication."
Two French scientists, M. M. Fleig and de Visme, have been experimenting on the effects of tobacco in various forms, when administered to dogs, rabbits, rats and guinea-pigs.
The effect of causing a dog to inhale the smoke of tobacco was found to be to cause first a marked fall, then a great rise in blood pressure, great contraction of the vessels of the kidneys and a dilatation of the vessels of the brain. The intensity of the effects produced was in proportion to the amount of nicotine contained in the tobacco.
According to Vibert, the cat and the rabbit are killed by one-sixth of a drop, a dog one-half drop to two drops.
According to Leblanc a horse is killed in four minutes by eight drops.
Planas showed that the poisonous properties of nicotine are very rapidly and strongly manifested when it is applied to the rectum or to the conjunctiva.
According to Guinier, death occurs most rapidly after application of the poison to the trachea.
A glass rod dipped in nicotine was applied to the throat of each of three young cats. The effects were the same in each. Within six seconds the cats suffered from dyspnea and dragged the hind legs. Then general convulsions occurred. The sphincters were relaxed, froth appeared at the mouth, and at the end of fifteen seconds death occurred.
Claude Bernard showed that one drop of nicotine applied to the cornea of an animal is sufficient to produce instant death.
One drop of nicotine was applied to the eye of a white mouse and the eye of a sparrow. Both animals died instantly.
Ritchie of William and Mary College reports the following observation:
"Two young guinea-pigs that were made to inhale tobacco smoke from the fourth day after birth weighed on the forty-fourth day, 174 and 169 grams (5.8 and 6.6 ounces), respectively, instead of 330 grams (11 ounces), which is the normal weight of guinea-pigs at that age. On the forty-fourth day, one of them died; the other was not subjected to any further inhalations; nevertheless, at the end of the third month, its weight was only 295 grams (9.8 ounces), instead of the normal weight, namely, 485 grams (16.2 ounces)."
"Jebrofsky, a Russian investigator, by the use of an ingenious apparatus, compelled rabbits to smoke cigarette tobacco for a period of six to
eight hours daily. Two animals died within a month, and showed changes in the nerve ganglia of the heart. Others established a tolerance similar to that exhibited by human beings who become habitual smokers, but upon being killed at the end of five months, degenerative changes similar to those produced by the injection of nicotine were found, viz., hardening of the blood-vessels. Loss in weight was also observed. There seems to be little doubt that tobacco smoke poisoning is chiefly nicotine-poisoning." (Fisk.)
But even as a dip for tick-infested cattle, tobacco is not always harmless. A Western farmer reported to the writer tliat he lost six highly valuable cows because the man in charge of the "dipping" made the decoction double strength to make sure of good results. One of the animals died in the dipping tank. All the rest died within an hour. The tobacco performed its function efficiently. It is a good killer.
Gouget (La Presse Médical, 1906) gave to rabbits small doses of a 10 per cent infusion of tobacco which probably contained about one-half of 1 per cent of nicotine. Many of the rabbits died within a few weeks. The rabbits suffered convulsions and their blood vessels were degenerated.
Adler and Heusel gave rabbits nicotine in quarter grain doses. Degenerative changes in the aorta were noted after 18 to 25 doses. Lime was
deposited in the walls of the large vessels and in some cases small aneurisms appeared.
In general, animal experiments have shown that tobacco is a cardiovascular poison.
Noel, Le Bon and others have shown that the toxicity of tobacco depends less upon the nicotine, its principal alkaloid, than upon the numerous other substances which are produced by the burning of tobacco. These authors have shown that tobacco smoke contains a crowd of noxious products. Le Bon isolated collidine and showed that one-twentieth of a drop of collidine is sufficient to quickly kill a frog, with symptoms of paralysis. "One cannot breathe the vapor of collidine even for a few seconds without experiencing muscular weakness and vertigo."
According to the same physiologist, the nausea, vomiting and headache produced by smoke are the result of the action of prussic acid. Prussic acid is found in tobacco in the proportion of three to eight milligrams (1/25 to 1/8 grain) in 100 grams (3½ ozs.) of tobacco.
Vohl and Eulenberg believe that most of the symptoms produced by tobacco smoke are due to prussic acid and collidine.
Grenant killed a dog with tobacco smoke. He found the blood showing all the characteristics present in poisoning by carbon monoxide.
Dudley attributed the effects of cigarette smoking to the same cause, carbon monoxide. Dudley
also claimed that carbon monoxide is the most poisonous substance found in tobacco smoke.
Marcelet has shown that one gram of tobacco (15 grains) in the form of a cigarette produces 20 to 80 centimeters (1 to 5 cubic inches) of carbon monoxide. A smoker who consumes 20 grams (2/3 ounce) of tobacco a day produces 1,600 to 2,180 cubic centimeters (100 to 125 cubic inches) of the gas.
The general conclusions drawn from the observations made in recent years is that the intoxication due to smoking is attributable not alone to the natural poisons of tobacco, but to tobacco smoke; that is, to the poisons produced by the combustion of tobacco.
Tobacco a Virulent Poison to Man
Wood's Materia Medica (1860) states that instances of death are on record from taking a decoction of one-half dram of tobacco. The fatal dose of nicotine was probably half a grain to a grain. Wood also states that fatal results have followed smoking and even the introduction of smoke into the rectum to excite bowel action.
An absolutely dispassionate, coldly scientific, impartial testimony comes from a standard work on "Materia Medica and Therapeutics" by John V. Shoemaker, A.M., M.D., a leading physician of Philadelphia and one of the world's most eminent authorities on the effects of drugs, who says:
"Tobacco is an acro-narcotic poison, acting energetically, in small doses, upon persons unaccustomed to its use. It is a nauseating emetic, being accompanied by great muscular relaxation; the respiration and circulation are depressed, the temperature lowered, and the surface becomes cold and moistened with perspiration. * * * The nervous system is early affected by the drug. The motor nerves are paralysed progresssively from the periphery to the central organs. The spinal and central nerves become affected, and inco-ordination, a staggering gait, and vertigo are prominent symptoms of its toxic action. Finally, collapse and death may occur from paralysis of the heart or of the respiration. Poisoning has also followed the application of tobacco leaves to a wound."
Says the London Lancet, "No smoker can be a well man."
Said Professor [Samuel] Solly [1805-1871], an eminent London surgeon:
"The profession has no idea of the ignorance of the public regarding the nature of tobacco; even intelligent, well-educated men stare in astonishment when you tell them that tobacco is one of the most powerful poisons we possess. Now is this right? Has the medical profession done its duty? Ought we not as a body to have told the public that of all our poisons it is the most insidious, uncertain, and in full doses the most deadly?"
"Nicotine is not the only poisonous substance present in tobacco, nor, bad as it is, is it the worst
ingredient in the deadly drug. Carbon monoxide gas, prussic acid, and furfurol are some of the other poisons of tobacco. Some investigations of
the London Lancet show that the most injurious forms of smoking are not those in which nicotine prevails, but. those in which there is a larger proportion of the irritant aldehydes, particularly the aldehyde furfurol, a substance to which many attribute the injurious effects of cheap liquors, and which is commonly distinctive of the smoke from cheap Virginia cigarettes."
Books by Dr. Solly
The Human Brain: Its Configuration, Structure, Development, and Physiology (London: Longman, Rees, Orme, Brown, Green and Longman, 1836)
The Human Brain: Its Structure, Physiology and Diseases, With a Description of the Typical Forms of Brain in the Animal Kingdom (London, Longman, Brown, Green and Longmans, 1847)
The Human Brain: Its Structure, Physiology and Diseases, With a Description of the Typical Forms of Brain in the Animal Kingdom (Philadelphia, Lea and Blanchard, 1848)
The Human Brain: Its Structure, Physiology and Diseases, With a Description of the Typical Forms of Brain in the Animal Kingdom. From the 2d London ed. (Philadelphia: Lea and Blanchard, 1848)
Surgical Experiences, The Substance of Clinical Lectures (London, Hardwicke, 1865)
Poison in the Old Pipe.
The British Medical Journal calls attention to the fact that if a smoker
"resumes the use of a pipe which he has let alone for several weeks, and in which the tobacco juice has become completely dried, he may imbibe a sufficient dose of the poison to cause vertigo accompanied by nausea, sometimes with diarrhea, cold sweats, palpitation, headache, and, above all, by a sense of burning and dryness in the mouth and throat."
The insidious mischiefs wrought by tobacco are usually attributed to almost every cause but the right one.
Is Nicotine Absorbed?
Nicotine is readily soluble in water and hence is easily absorbed. The rapidity with which it is taken into the body and distributed by the blood is shown by the suddenness with which pallor,
nausea and faintness take possession of the boy who for the first time essays to smoke a cigar. Another evidence is afforded by the strong tobacco odor which emanates from the breath and skin of a tobacco user for many hours after the smoking of a single pipe or cigar.
The mucous lining of the nose, mouth, lungs and air passages presents a very extensive absorbing surface, an area of 800 to 2,000 square feet, over which the whole volume of the blood is spread out every three minutes.
It has been shown that one-half of the nicotine inhaled is absorbed. A man who smokes an ounce of tobacco daily may absorb seven to ten grains of nicotine and probably in some instances more.
Dose of Nicotine Fatal to Man.
According to Dr. Copeland, authority on poisons death has been produced by an enema containing less than a grain of nicotine.
Melsens asserts that the smoke from half an ounce of tobacco contains a fatal dose of nicotine
A case is on record (Ann d'Hygiène, 1861) in which a murder was committed by forcing nicotine into the victim's mouth. Death occurred in three to five minutes.
Krocker reports that one thirty-second of a drop produced giddiness, nausea, vomiting, feeble pulse, intense muscular weakness, difficult breathing, cold extremities, partial loss of consciousness and other symptoms of impending collapse.
A man who committed suicide by taking nicotine into the mouth, dropped instantly to the floor insensible and died in three minutes.
It is generally held that one drop of nicotine is the fatal dose for man. (Gy.)
The usual effects of the first pipe or cigar afford all the evidence needed to establish the status of tobacco as a poison. The fact that these symptoms soon disappear if one continues to use the drug is no evidence that the drug ceases to produce poisonous effects. The so-called "tolerance" established is simply a cessation of the reflex protest. The insidious mischief to heart, blood-vessels, lungs, liver and kidneys continues.
Gy of Paris, undertook a few years ago, very extensive experiments to determine the facts with reference to denicotinized and distoxicated tobaccos. He showed in a paper presented to the Société de Biologie that 4 c.c. (60 drops) of a maceration of Sweet Caporal, or 5 c.c. (75 drops) of distoxicated tobacco, would produce death. Two c.c. (30 drops) of a maceration of ordinary Caporal tobacco is a fatal dose.
Sweet Caporal is half as toxic as ordinary Caporal. Five parts of distoxicated tobacco produces the same effect as four parts of Sweet Caporal.
Gy showed that the effects of denicotinized tobaccos upon the stomach, liver, kidneys, lungs
and nerves are essentially the same as other tobacco, though their toxicity may be slightly reduced.
M. Lesieur, who made a careful study of this subject, said, "We tliink it gives the smoker a false sense of security to place on sale a toxic product under the name of denicotinized tobacco, tobacco which contains dangerous doses of nicotine." And Vitoux says that denicotimzed tobaccos offer, instead of security against toxic symptoms, a veritable danger because of their reputation for innocuity.
The Toxicity of Oriental Tobaccos.
In the study of Oriental tobaccos, supposed to be less toxic than ordinary brands, [Dr. Abel] Gy found that they possess no special advantages. They produce a very pronounced asthenia (prostration). This was noticed particularly in rabbits.
One subject remained in a state of stupor for several hours, which led to investigation to ascertain whether opium was present. It was not found present, although all Oriental tobaccos may not be free from opium.
Does the Body Become Immune to Tobacco?
It is well-known that the body rapidly acquires a tolerance for tobacco as for opium and other narcotics. Most smokers doubtless entertain the idea that tolerance means immunity; that is, that when no unpleasant effects are felt, no harm is
being done. It is true that there are poisons to which the body may be by training made immune. Such are snake venoms, some poisons produced by bacteria, and various organic poisons. The body may be gradually trained to make antidotes for these poisons, and thus render them inert and harmless; but it was proved by [Dr. Abel] Gy, a French physiologist, that nicotine does not belong to this class.
[Ed. Note: Examples of Initial
Reactions to First Smoking]
After some use of the drug the body ceases to remonstrate by acute and distressing symptoms, but the mischievous effects continue, steadily, insiduously destroying the fine machinery of the body until heart, blood vessels, liver, kidneys, and other vital organs are so badly damaged that the vital functions can no longer proceed in a regular and normal fashion and then a medical examination reveals the fact, not that the subject has begun to suffer from nicotine poison, but that his body has been ruined by it. Every cell of the body, every tissue and every fibre, has been damaged. The vital reserve has been exhausted, the defenses of the body have been broken down and the living machine is irreparably injured. It may be possible to patch it up sufficiently to keep it going for a few years, but a large share of its working capacity, its efficiency, has been used up in carrying unnatural and unnecessary burdens and cannot he replaced.
Dr. [Abel] Gy fully demonstrated that no antitoxin is developed in the blood as the result of using
tobacco. This experiment was made: A rabbit was given full doses of tobacco infusion for several months. The serum from the blood of this rabbit was then injected into the peritoneal cavity of another rabbit. A quarter of an hour later a dose of tobacco infusion sufficient to kill a rabbit in two minutes was given. The effects were just the same as in the animals which had not received the serum. The conclusion is drawn from this experiment that chronic tobacco intoxication does not give to the serum of the individual or of the animal any antitoxic properties. The apparent tolerance is due simply to the fact that the immediate reaction is less violent.
The first effects of the inhalation of tobacco smoke appear only the first time the inhalations are made; but a study of the effects of tobacco upon the heart and blood vessels by delicate instruments shows that in spite of the tolerance the usual reactions occur; that is, tolerance does not necessarily imply the absence of reaction, but simply the absence of intolerance. Tolerance means simply the tolerance of reaction.
|Ed. Note. See books by Dr. Abel Gy:
Le Tabagisme, Étude Expérimentale et Clinique (Paris: G. Steinheil, 1909)
L'Intoxication par le Tabac (Paris: Masson et Cie, 1913)
How Tobacco Disorders Digestion
That tobacco smoking affects the stomach is not a new idea to any smoker who recalls the effects of his first cigar. The nausea and vomiting which the novice experiences, clearly indicate the disturbing influence of the filthy weed.
Evidently tobacco arrests and paralyzes the normal processes of digestion and even reverses the action of the stomach as seen in vomiting.
The pernicious effects of tobacco begin in the mouth. The salivary glands of the smoker are so exhausted that the saliva loses, to a large degree, its power to digest starch, its normal function. The nicotine and empyreumatic oils in the smoke blunt the sensibility of the nerves of taste and smell and so destroy the gustatory reflex and lessen the formation of "appetite juice," which Pavlov showed to be essential to normal digestion.
Tobacco in small quantities has no effect upon the saliva, but in large doses interferes with its action. This has been shown by [Dr. Abel] Gy and Calcaterra.
Roger has shown that there is a close relation between the functions of the salivary glands and the pancreas.
These facts explain the gastro-intestinal disorders and the disturbances of assimilation which are seen very commonly in smokers.
Tobacco, by incessant irritation, predisposes to mucous plaques and cancer. On this account syphilitics are forbidden to smoke.
Tobacco smoking unquestionably encourages cancer of the lip by maintaining chronic irritation.
Granular pharyngitis and catarrh of the throat, sensibility to cold and dryness of the throat, are symptoms commonly observed in smokers.
Huchard calls attention to the effects of tobacco on the diaphragm, causing hiccough.
The paralyzing effect of tobacco upon the stomach is well shown in the abolition of hunger. The Turk takes opium to abate the pangs of hunger when food is not attainable. Sailors and others use tobacco for the same purpose. (Combe.)
Cannon and Carlson have shown that the sensation of hunger is associated with contractions of the stomach, the so-called "pangs" of hunger. Tobacco abolishes these contractions by paralysing the stomach arid in this way destroys the sensation of hunger. This fact has been established by Carlson, who showed that in old smokers as well as those not accustomed to use tobacco, hunger pains and gastric contractions cease under the influence of smoking. Carlson's observations were made on a man with a large gastric fistula like that of Alexis St. Martin, and on specially trained subjects.
Cramer proved that smoking slows the movements of the stomach.
Pouchkine concluded that tobacco increases the quantity of gastric juice, but lessens its acidity, lowering the proportion of hydrochloric acid and diminishing the activity of the rennet, ferment, and so does not aid digestion hut hinders it.
Osler observed loss of appetite in dogs dosed with nicotine.
Tobacco smoke passed through a solution of pepsin or gastric juice lessens the rapidity of the action of pepsin. The addition of an infusion of tobacco to gastric juice produces a still more marked injurious effect.
Nicotine causes exaggeration of peristalsis and may give rise to diarrhea.
Persons who smoke in the morning before breakfast, even very moderately, are likely to suffer from gastric symptoms, while others who smoke only after meals, to a much greater extent escape.
The prolonged use of tobacco contributes in a very marked way to the development of gastric disturbances
Cramer reports finding complete absence of gastric acid in old smokers.
The Effect of Tobacco Upon the Intestine.
Laurent reports the following case: A man 27 years of age, robust physique, began smoking
cigarettes at the age of 23 years. It took him a long time to become accustomed to their use. At the end of six months he suffered with diarrhea, which resisted all treatment. He stopped smoking, and in less than eight days was well. Fifteen days afterwards he again began smoking, and the diarrhea reappeared at once. He repeated this experiment four times with just the same results.
Another case reported by the same author: A student of 23 years, habitually of good health, had never experienced any digestive trouble. Had good appetite, and bowels normal. When this young man, who did not smoke, found himself in an atmosphere saturated with tobacco smoke, he was seized at once with diarrhea, which did not stop so long as he continued to inhale the tobacco smoke.
Smoking Destroys Appetite.
More than forty years ago Hammond called attention to the fact that the use of tobacco lessened the consumption of food. On this account it was claimed to be a means of economizing food. To this argument the writer urged the unanswerable argument that life is due to tissue change. Without change, without consumption of energy, there is vital stagnation. The less activity, the less life. Anything that lessens tissue change, the
assimilation and disassimilation of food, lessens life.
Lord Rhondda, the British Food Controller, is reported as saying in defense of tobacco for the army, "Men would eat a great deal more if they did not have tobacco." Doubtless this is true; and they would accomplish "a great deal more." And the Sunsaid, in promoting its pernicious Tobacco Fund:
"It used to he said against tobacco and coffee that they were devils because they killed the appetite for food. Now, for the same reason, they are angels. Heroes drink a cup of Rio, grab a cigarette and go over the top."
It has not been shown that tobacco and coffee make better soldiers. Whisky was once thought to he necessary for the fighting man. In the Great War, the American soldier fought without spirits and certainly showed no inferiority to either the English Tommies who were well supplied with rum, or the Germans who were fairly inundated with beer. And there were many soldiers who did not smoke and showed superiority in marching and fighting power to those who did, as many officers will testify. General Miles, a well seasoned soldier, is a non-smoker, and during the war stated to the writer that he regarded tobacco as an enemy to the soldier. The general stated that he abandoned the cigar when he saw
General Grant in the last stages of smoker's cancer of the throat.
It is evident then, that tobacco can be in no way an aid to digestion. Its influence can be only in a high degree detrimental. The notion that an after-dinner cigar aids digestion is wholly without scientific foundation.
The deleterious effects of tobacco upon digestion are doubtless in part due to its effect upon the sympathetic nerves.
Pouchkine has shown that tobacco lessens the secretion of gastric acid (HCl) by the stomach and the activity of the gastric juice and so greatly hinders digestion.
The Damage Tobacco Does to The Liver.
The first pipe or cigar would probably prove a fatal dose [Ed. Note: Examples: Dr. Thorn and Dr. Jackson] , except for the fact that the liver possesses a remarkable function by means of which it is able to destroy the poisonous properties of the nicotine and other poisons derived from tobacco.
This distoxicating power of the liver resides in its cells. Alcohol, creasote, morphia, the poisons produced by putrefactive bacteria, in fact, all organic poisons, are acted upon by these wonderful cells in such a way as to destroy or very greatly decrease their pernicious qualities.
It is for this reason that when a drug is given by hypodermic injection only half as large a dose is required to produce a given effect as when
given by the mouth. When injected under the skin the poison enters the circulation at once; when taken by the mouth, most of the drug passes through the liver and is distoxicated by it. Even when injected under the skin the poison is largely captured by the liver and destroyed, although more slowly and less completely.
This wonderful distoxicating power of the liver was demonstrated by Roger, a pupil of the famous Bouchard, many years ago.
The experiments of Roger, Charrin, and others, brought to light the curious fact that this distoxicating power of the liver is much greater after a meal than before, and led to the demonstration of the important part played by sugar or starch in the liver function. After a meal rich in farinaceous foods, the liver cells are well filled with an animal starch known as glycogcn, which is known to be essential for the distoxicating activity of the liver.
This physiological fact explains the observation of Brooks that "there is a universal and well founded belief that the use of tobacco on a full stomach is less likely to produce symptoms than on an empty stomach."
If the liver were able to destroy all the nicotine imbibed by smokers and to continue to do so for an indefinite period of time, the smoker might indulge his pipe with impunity and without stint. Indeed, some smokers seem to possess an almost unlimited liver capacity and to be able to distoxi-
Normal Liver Tobacco-Destroyed Liver
cate almost unlimited quantities of nicotine They are blessed with wonderful livers and are able not only to smoke almost constantly, hut to drink quantities of whiskey, to indulge their appetites without restraint, and yet maintain a marvelous degree of efficiency and manifest an astounding ability to resist the ravages of time.
These men owe their unusual tolerance of tobacco and other poisons to the fact that they possess extraordinary livers which are able to do double or quadruple duty as poison destroyer That they cannot be cited as proof that tobacco is harmless, is clearly enough shown by the fact that for every one possessed of this unusual tolerance to poisons because of his extraordinary endowment with capacity for poison destruction, there are many hundreds who demonstrate their lack of this unusual natural protection by succumbing to the poison habit at an early age.
It must be remembered, also, that the liver plays a highly important part in the process of digestion It works over and refines, so to speak, the crude products of gastric and intestinal digestion. When compelled to devote its energies to the destruction of nicotine, it cannot do the work of digestion properly. Crude and waste elements accumulate in the blood and tissues, and are eliminated in lessened quantity. This accounts in part for the lessened endurance of smokers.
It is difficult to demonstrate the effects of tobacco upon the liver, because the human liver is exposed to so many other possible causes of injury.
Stern (1907) thinks that tobacco may produce elementary glycosuria, and that a mild diabetes may be aggravated by the use of cigarettes. He even attributes certain cases of diabetes to nicotine poisoning.
Graziani showed that tobacco causes changes in the liver, particularly hemorrhages and areas of necrosis (death of tissue).
Adler showed at the end of two months enlargement of the liver and infiltrations indicating the beginning of sclerosis. These conditions were increased at the end of four months. The connective tissue was dense. Fatty degeneration was also present.
Fatty and sclerotic changes in the liver have been noted by [Dr. Abel] Gy and others in experiments upon animals as the result of chronic nicotine poisoning.
The Destructive Effects of
Tobacco upon the Lungs
The lining of the air tubes and cells of the lungs presents an extraordinarily extensive absorbing surface, about 1000 square feet of surface under which a volume of blood equal to all the blood m the body courses every minute. Through the extremely delicate covering of this "respiratory field", gases of all sorts pass into the blood with the greatest facility. So rapid is this absorption that nicotine or any other poison introduced into the body in gaseous form enters the blood and saturates the tissues far more quickly than when introduced in liquid form into the stomach or by hypodermic injection.
A single cigarette may contain a grain of nicotine, at least half of which enters the lungs and in part, at least, the blood. A cigar contains three or more times as much tobacco as the cigarette, hut less nicotine is absorbed because the smoke is not inhaled.
Besides the nicotine there are all the other poisonous products which are always present in smoke, creasote, pyridine, Prussic acid, furfurol. The complacency with which smokers and sometimes nonsmokers, ladies, perhaps, often sit for hours in a room the air of which is blue with tobacco smoke, is an evidence of the blunting effect of nicotine upon the normal sensibilities. Smoke from any other source
would not he tolerated. Yet smoke is smoke, and tobacco smoke does not differ essentially from other smoke except by the addition of nicotine, and other poisons much worse than those of ordinary smoke.
The well known irritating effects of smoke upon the respiratory membranes easily explain the injurious effects from tobacco smoke observed in the throats of smokers.
Smoker's sore throat is a condition very familiar to throat specialists. The highly irritating and injurious effects of tobacco smoke in cases of chronic disease of the throat and lungs from other causes is also well known. So long as the patient continues to smoke his throat maladies are incurable; but from the moment he lays aside his pipe or cigar, recovery begins.
It is largely through the injury inflicted upon the naso-pharyngeal mucous membriane that smoking impairs the hearing and the sense of smell.
Sir Morell Mackenzie, the famous London throat specialist, is quoted by a London author as saying that:
"In considering the evils produced by smoking, it should be borne in mind that there are two bad qualities contained in the fumes of tobacco. The one is the poisonous nicotine, and the other is the high temperature of the burning tobacco. The cigarette, which is so much in vogue nowadays, is most certainly the worst form of indulgence, people being tempted to smoke all day long. and easily ac-
customing themselves to inhale the fumes into their lungs, and thus saturating their blood with the poison."
And again, "Unfortunately it is not necessary to smoke to be a victim of tobacco. Many persons find their neighbors' pipes or cigars very trying, and, for a person with a delicate throat, exposure to an atmosphere laden with the fumes of tobacco is even worse than smoking."
Smoking Leads to Consumption.
The unusual liability of cigar workers to tuberculosis or lung consumption has long been noted. Attention has even been called to the danger of contracting the disease through the use of cigars by reason of the liability of infection through handling by persons suffering from the disease.
In a paper read by the author by request before the National Association of Life Underwriters, at its meeting in New York City (1918), attention was called to certain statistical facts which seem to show that tobacco is a potent factor in causing pulmonary tuberculosis in men. It was shown that for every 100 females who die of tuberculosis, there are 137 male decedents, an excess of 37 per cent, although the excess of males in the population is only 2 per cent.
It was further shown that,
"Up to the period of 25 years, however, the female decedents are greatly in excess of the males, show-
ing 122 female deaths to 100 males. Beginning with the twenty-fifth year, however, the figures are reversed, the disparity steadily increasing to a maximum of 243 male decadents to 100 female decedents at the age period of 50-54 years.
"The average for the entire period from 25-70 years is 166 male deaths from lung tuberculosis to each 100 female deaths.
"There certainly must be some definite reason for this very great preponderance of male decedents from an infectious disease. That the male constitution is not more susceptible than the female is shown by the preponderance of female decedents during the first twenty-five years of life, the period of greatest susceptibility to infectious disease. In 1915, between the years of 35-70, male deaths exceeded female deaths to the enormous number of 14,791, or one-fourth of the total number of decedents. During this period, one-fourth of the total number of deaths were due to lung tuberculosis.
"Another point which should be mentioned in this connection is the fact that in certain parts of the country, Michigan, for example, while tuberculosis on the whole is decreasing, the decrease is due wholly to the lessened mortality of females from this disease, since the mortality of males is actually increasing.
"The fact that lung tuberculosis is increasing in males is very significant when associated with another fact; namely, the enormous increase in the
"Diseased (Calcified) Arteries Tubercular Lung (X-ray)
consumption of tobacco, especially in the form of cigarettes, within the last few years. The increase of tuberculosis in man runs parallel with the increase of the consumption of tobacco."
The Fourth and Fifth Reports of the Phipps Institute of Philadelphia for the study and treatment of tuberculosis present strong evidence of the damaging influence of tobacco in the battle against this most dangerous enemy of human life. The "Fourth Report" (1907) says,—
"We have merely evidence as to the influence of tobacco on the development and mortality of tuberculosis and not upon implantation. The preposterous claim that has been made that tobacco is a preventive of tuberculosis implantation can not be maintained in the presence of the statistics of a large number of tobacco users who have developed tuberculosis. More than two-thirds of the males who applied for treatment used tobacco in one form or another. The statistics here given, if they have any meaning at all, would seem to indicate that the use of tobacco has a predisposing influence for the implantation of tuberculosis. In fact, the extensive use of tobacco by males may be one of the explanations why tuberculosis is at present so much more prevalent among males than among females.
"The damaging influence of tobacco in tuberculosis is probably exercised through the circulation. Tobacco undoubtedly depresses the heart and interferes to some extent with vigorous circulation. It is generally conceded that anything that depresses the cir-
culation interferes with nutrition and consequently predisposes to tuberculosis both in implantation and development."
The Fifth Report (1908) gives us the following most significant facts which have never been invalidated or disputed:
"We now have statistics for two years on the use of tobacco. During the fourth year 73.01% of the males used tobacco and 26.98% did not use it. For the current year (Feb. 1, 1907, to Feb. 1, 1908) 78.95% used it and 21.04% did not use it. During the fourth year 61.80% smoked only, 8.38% chewed only, and 29.81% both smoked and chewed. During the current year 63.77% smoked only, 7.18% chewed only, and 29.01% both smoked and chewed.
"As with alcohol, so with tobacco, the mortality was much greater among those who used it than among those who did not use it. During the fourth year 18.58% of those who used tobacco died, as compared with 5.15% of those who did not use it; and during the current year 15.30% of those who used tobacco over those who did not use it is as great as the excessive mortality among those who used alcohol over those who did not use it.
"Alcohol and tobacco give no protection against tuberculosis, as has been claimed by some people. The striking preponderance of mortality among patients who used alcohol and tobacco as compared with those who did not use them, moreover, warrants abstinence on the part of all who are suffering from tuberculosis in active form."
Dr. Wright of St. Mary's Hospital, London, found that nicotine greatly lowers the tuberculo-opsonic index, one of the most delicate means of measuring the resistance of the body to the tubercle bacillus. In one case reported by Wright, that of a cigarette smoker, the index was reduced to zero. The patient died three weeks later.
Dr. Webb, a famous lung specialist, of Colorado Springs, observed in the examination of thousands of soldiers at the various camps during the war, that cigarette smoking is an active cause of chronic bronchitis. He reported the finding of "ronchi'' in the lungs of nearly all smokers. Ronchi mean irritation, and irritation means low resistance, an open door to tuberculosis.
Tobacco asthma is well known (Gy [pp 58-59]).
|Ed. Note. See books by Dr. Abel Gy:
Le Tabagisme, Étude Expérimentale et Clinique (Paris: G. Steinheil, 1909)
L'Intoxication par le Tabac (Paris: Masson et Cie, 1913)
Destructive Changes in the Heart
and Blood-Vessels Caused by Nicotine
Adler and Hensel (1906) injected 15 deci-milligrams of 1 to 200 solution of Merck's nicotine intraenously (1/12 of a cigarette 1/40 of a grain). After 18 injections marked changes in the aorta made their appearance. These changes involved the entire aorta to the ileac bifurcation. They became most marked after 38 to 50 injections.
Gebrowsky and Papadia (1907) observed similar changes in the aorta.
Gy observed that the effects of nicotine are less marked than those of tobacco for the reason that nicotine does not represent all the poisons found either in tobacco or tobacco smoke.
Boveri observed atheroma of the aorta and hypertrophy of the suprarenal capsules (degeneration of the kidney).
Bylac obtained identical results and observed also aneurisms of the aorta and calcareous plaques (arteriosclerosis) in a rabbit weighing two kilograms, which was given in the course of 38 days, 35 c. c. of a 10 per cent infusion of tobacco by intravenous injection.
Lesieur (1907) observed lesions of the aorta as the result of subcutaneous injections of infusions of
French and English tobaccos. The alheroma (calcereous degeneration) was most often found at the arch of the aorta.
The appearance of these lesions is always the same, whether produced by lead, tobacco, adrenalin, oxalic acid or digitalis.
The atheroma is, according to Josué, a process of defense. There is first a simple thickening of the elastic and muscular tissues of the artery. Later degeneration occurs because of disturbance of the circulation.
Claude Bernard made a microscopic study of the effects of nicotine upon the blood-vessels of a frog's foot. He found that the vessels contracted so strongly that they were completely emptied of blood.
Lauder Brunton and others have shown that nicotine is a powerful vasoconstrictor.
The violent chill sometimes observed in guinea-pigs after injections with infusion of tobacco, were thought by Claude Bernard to be the same sort of effect as that produced by the ligature of an artery in preventing blond from entering a muscle in causing trembling of the muscle.
Fleig and de Visme have shown that tobacco, no matter in what way introduced, always causes a formidable elevation of blood pressure. This is due to the direct action of nicotine upon the muscular walls of the vessels. Later, this vasoconstriction is followed by a paralytic vasodilatation.
Gy observed changes in the arteries in two cases as the result of the use of Caporal tobacco.
Boveri produced atheroma in 10 rabbits out of 16.
Degeneration of the Large Arteries.
Baylac obtained the same results in 5 rabbits out of 8; Gebrowsky in 7 rabbits out of 9.
Hypertrophy of the heart is a natural result of the raised blood-pressure.
Examination of the heart tissue showed, in dogs (Favarger), degeneration of the heart muscle.
Gebrowsky found lesions of the ganglia of the heart.
Brooks made postmortem examinations of fifty-four tobacco users and found damaged heart muscles in nearly every case. Fatty and fibroid degeneration and brown atrophy were most common.
The Smoker's Heart.
There are three characteristic symptoms of tobacco heart, one or all of which may be present; viz., pain, shortness of breath, rapid and often irregular heart action.
The heart is a muscle. The blood vessels are muscular tubes connected with the heart. The heart and blood-vessels may be properly regarded as one organ, having for its function the distribution of the blood to the tissues and the renewal of tissue wastes.
The task performed by the heart is much greater than is generally realized. It expends one-tenth of
the whole bodily output of energy in lifting the 120 foot tons which constitute the average day's work of the heart.
The heart is a pump, the arteries the distributing pipes, the veins, the return pipes. When the arteries are contracted or obstructed, the work of the heart is increased and the blood-pressure is raised.
The heart is controlled by nerves which give to it a rhythmic movement and regulate its action to suit the needs of the tissues.
The blood-vessels are also controlled by nerves which regulate their size and their activity. A constant adjustment of the work of the heart is necessary to meet the changing conditions of the blood vessels. Upon the constant and regular action of this finely adjusted mechanism, all the processes of life depend.
Old age is essentially due to the wearing out of the heart and blood-vessels. An eminent French physiologist very truly said, "A man is as old as his arteries."
The effect of tobacco upon the heart has been most carefully studied by many physiologists. All authorities agree that tobacco is a heart poison. A very small dose increases the work of the heart by contracting the arteries and raising the blood pressure. This effect is produced not only in beginners but in old smokers. It is the result of the influence of tobacco upon the nerves which control the heart and blood-vessels.
Smoking Causes High Blood-Pressure
Numerous observations by thoroughly competent investigators have demonstrated the injurious effects of tobacco upon blood-pressure. The normal hlood-pressure is about 120. It is not uncommon to find the blood-pressure of smokers 160-180, and not infrequently pressures of 200-250 or more are observed in smokers. A very definite proof that tobacco is a cause of this high blood-pressure is to be found in the fact that the pressure promptly drops and to a very considerable extent when smoking is discontinued.
Tobacco always raises the blood-pressure. In an experiment upon a younp man, an habitual smoker, it was found that the blood-pressure rose twenty five points in twenty minutes after he had smoked three cigarettes. An hour elapsed before the b1ood-pressure returned to normal. It is thus evident that smokers who repeat the indulgence several times a day, in so doing keep the blood-pressure constantly above normal.
"Both in frogs and mammals," says Sir Lauder Brunton, "nicotine produces, first convulsions and then paralysis. * * * In mammals it causes a slowing of the heart with enormous rise of blood-pressure."
A single cigarette or cigar causes a rise of ten to fifteen points in the blood-pressure (Brooks, Jane way). This means an increase in the work of the heart amounting to more than ten per cent. That is, the heart has to lift daily 132-foot tons instead of 120,—twelve tons of energy thrown away. This loss (estimated for the whole time) amounts to one per cent of the whole energy of the body.
Normal Pulse—Each Vertical Line Represents A Heart Beat
Irregular Pulse of Tobacco Hear
Of course a single cigar will not produce a permanent effect, but after some years the habitual smoker's blood-pressure is permanently raised and not ten to twenty points only, but fifty, seventy-five, and even a hundred points. The work of the heart is doubled or more than doubled.
The electrocardiograph is an instrument of extreme delicacy by which morbid conditions of the heart may be detected and studied through a graphic record of the electrical currents generated during the action of the heart. The accompanying cuts show the normal sphygmograph tracing and that of a smoker suffering from myocarditis due to tobacco.
Claude Bernard, the great French physiologist, was first to notice the contraction of the blood-vessels caused by nicotine. Bruce, Miller, Hooker, Hirschfelder, all noted the same. The effects are the same on beginners and old smokers (Brooks).
M. Julin (Zeit. f. Exp. Path u. Therap., Berlin, 1913) called attention to the fact that smoking always raises the diastolic pressure. This point is highly important. The diastolic pressure represents the work the heart has to do to open its valves and before it can send any blood into the arteries. The higher the diastolic pulse the more energy the heart must waste. The rise is due to contraction of the small arteries caused by the nicotine circulating in the blood.
Said the late Dr. Janeway, an authority on blood-pressure:
"Tobacco, or its alkaloid nicotine, has a powerful action on the circulation. Nicotine, in less than overwhelming dose, produces an immense augmentation of blood-pressure in animals, due to stimulation of both central and peripheral vaso-motor mechanisms (Cushney). Cook and Briggs have called attention to the temporary elevation of arterial tension during smoking. They found it most marked when a strong cigar or old pipe is used, and continuing an hour or more after the smoke is ended.
"Dr. John, in the clinic of Volhard at Dortmund, made a study of the influence of tobacco smoking on the circulation. His blood-pressure measure ments indicate that the smoking of two 'medium' cigars evokes characteristic alterations in arterial pressure in typical cases. Even during the act of smoking there may be evidence of rise in diastolic pressure, and the effect may persist as long as two hours. Eight or ten Russian cigarettes give a result comparable with two 'medium' cigars.
"These experiments confirm the impression that nicotine can produce vascular alterations in the sense of sclerotic changes. We may argue as we will that habitual smokers have consumed extraordinary quantities of tobacco over long periods without signs of vascular change, but we are in duty bound to take cognizance of careful blood-pressure measurements. 'Indifference to scientific evidence is an intolerable attitude.'" (Jour. A. M. A., 1914).
Boveri gave nicotine to rabbits for eighty-four days and found hardening of the blood-vessels.
Cases have been observed in man in which there seems to have been no evident cause for an extensive arteriosclerosis other than excessive smoking." (Jour. A. M. A., 1909).
Tobacco Angina Pectoris.
Angina pectoris, a highly painful disease of the heart, is due to constriction of the vessels of the heart itself.
Tobacco causes temporary constriction of the vessels with the pain and other agonising symptoms characteristic of angina pectoris.
A similar contraction of the arteries of the arm and legs as well as of the pancreas has been noted, and an eminent Vienna physician has recently pointed out that contraction of the vessels of the intestines and other abdominal organs, with extreme pain, may be due to the same cause.
These anginal pains sometimes appear with the first cigar (Brooks), but usually develop later.
The heart nerves do not become accustomed to the drug by use, but on the contrary, become sensitized so that the poisonous effects are produced by smaller doses than at first. Brooks relates a case in which a heavy smoker had become so sensitized that he could not enter a room containing tobacco smoke without being seized with an anginal attack.
The anginal attacks produced by tobacco have proved fatal (Huchard).
Irregularity of the pulse is one of the characteristics of "smoker's heart." This is believed to be due to contraction of the arteries of the heart.
Authors have recognized for a long time the existence in smokers of such symptoms as neuralgia and angina pectoris.
Huchard cites a case of a man of 42 years, an officer, previously in excellent health. No alcoholic excess. No disease. He had smoked since he was 18 years old and for 20 years had smoked from 30 to 60 cigarettes a day of Caporal tobacco. He died suddenly after breakfast one morning. The post-mortem showed death to have been due to an attack of angina of the chest induced by smoking.
Huchard reports another case of a physician of 28 years who smoked continuously, lighting one cigar from the preceding one. He began suffering from attacks of angina, which came on every night during sleep, producing a sensation of sudden suffocation with restriction of the cbest, and pain running into the left arm. He was frightened at these attacks and stopped smoking. Within a month the attacks disappeared and did not return.
According to Hucbard, these attacks are due to spasm or sclerosis of the arteries of the heart.
Heart symptoms due to tobacco are often encountered in smokers. The symptoms are especially produced by fatigue and are most likely to show
themselves in old smokers; they may appear whether tobacco has been used in excess or not. The most prominent symptoms are vertigo, malaise, sleeplessness, slow pulse, sometimes inttemittent pulse. These symptoms are often very distinct, sometimes continuing for a year or two after the use of tobacco is suspended.
Chapman, of England, long ago (1802) described as "tobacco heart" a hypertrophy and dilation of the heart due to tobacco. The action of tobacco upon the blood-vessels is not less marked than its effect upon the heart.
Huchard and Robin held that the changes in the blood-vessels are the result of the increased blood pressure.
Smoking not only encourages changes in the blood-vessels but aggravates the effects of various other causes which may be in operation.
Eid (1900) observed, during a visit to Corsica, numerous cases of aortic lesions in persons who bad been great smokers. In two of them suppression of tobacco brought complete disappearance of the heart symptoms.
Disorders of the blood-vessels due to tobacco poisoning are much more frequent than heart troubles. In these cases the affected person may feel in his legs after a few steps various pains, such as sensations of weight, of ants crawling, cramps, and heaviness. Sometimes the feet and legs become white, at other times the color of wine. There is no
change in the reflexes or in sensibility. The pulse is small and frequently cannot be felt at the tibial arteries. The patient is suddenly obliged to stop when walking. After a little while the pain ceases and he can go on. Soon all the symptoms reappear. These symptoms, which often coincide with other signs of arteriosclerosis may be confined to one limb, usually the left leg. At length dry gangrene may occur in a toe or the entire foot. Sometimes the symptoms are less pronounced. A single artery may be affected without the nutrition of the whole limb being disturbed.
The cause of these symptoms is easily understood. Tobacco produces spasm of the arteries, which diminishes the blood supply. This hindrance is hardly perceptible when the limbs are in repose. When an increased supply of blood is required by exercise, the deficiency nf blood appears, with intermittent claudication. One step farther and the more advanced symptoms appear.
Dr. Willy Meyer has recently recorded numerous observations which seem to show very conclusively that the use of tobacco is the chief cause of this condition commonly known as "intermittent claudication "
The fact that this disease, also known as thromboangutis obliterans, is practically unknown in women, is held by Dr. Meyer to be strongly confirmatory of his view that smoking is the principal cause of the disease. He regards the pyridine of tobacco smoke as second only to nicotine in its baneful effects.
Red and White Blood Cell
Of all the causes of this form of angiosclerosis, tobacco is the most frequent. In 45 cases observed, Erb found only 7 who would not confess to having smoked. Thirteen smoked moderately, 10 smoked much, and 15 smoked excessively.
The Old Smoker's Heart.
That the effects of tobacco upon the heart are not lessened by use, is well shown by the observations of J. W. Payne and G. A. Dowling (Fisher and Berry), who found that smokers have constantly a higher pulse rate than non-smokers, due to weakening of the heart muscles.
Another evidence of heart weakness in smokers was the fact that after exercise the pulse rate returned much more slowly tn the pre-exercise rate. For example, in smokers the pulse rate did not return to normal at the end of fifteen minutes after exercise, whereas in non-smokers the average time was only five minutes.
"That soldiers in this war smoke to excess is, I think, unquestionable; and in the treatment of 'irritable heart' the limitation of pipe and cigarette smoking should, I submit, constitute a leading item." Kenneth Macleod, Brit. Med. Journal
Dr. Osler (Lancet, 1910) calls attention to the increase of angina pectoris, the result of the rapid growth of the tobacco habit in women in recent years.
Dr. Osler states that death may occur from tobacco angina pectoris and cites the cases of three of his friends, apparently strong, healthy men, incessant smokers, all of whom died suddenly from the effects of tobacco on the nerves of the heart.
Huchard and others believe that tobacco angina pectoris may be due to arteriosclerosis of the arteries of the heart produced by the continued action of nicotine.
Says J. Rochard:"I have met cases of angina pectoris chiefly among persons living in an atmosphere of tobacco smoke."
Among the irregularities mentioned as due to tobacco are extrasystole (extra beat), palpitation, and "heart block," a condition in which the auricles and ventricles of the heart beat at a different rate (