Does not this word describe accurately the state of mind produced by excessive smoking?

Am I correct in my opinion that a part of the British nation is silently, heedlessly, blindly, drifting into a state of hebetude, idleness and decrepitude? Am I correct in thinking that the propheac words of Mr. Solly, which he wrote fifty years ago, have proved true? "I believe, if

the habit of smoking in England advances as it has done in the last ten or twelve years, that the English character will lose that combintion of energy and solidity which has hitherto distinguished it, and that England will sink in the scale of nations."

Mr. [Samuel] Solly was an eminent surgeon in his day, and a Fellow of the Royal Society. He could not shut his eyes to the evil effects of the tobacco habit, and he tried to influence his professional brothers to speak the truth as far as they could of the different diseases resulting from smoking.

His efforts were successful in rousing great interest, and a vast amount of reliable evidence was recorded in the pages of The Lancet. The fact that these letters were written fifty years ago does not detract from their value. They bear the stamp of careful enquiry and sincerity, and are the experience of men who practised medicine in different parts of our empire. Many of them had been smokers and experienced in themselves unpleasant symptoms, hence they wisely gave it up. When they emerged from darkness into light, they hastened to spread the truth, to prevent others groping in darkness.

I still rejoice at my own liberation from the delusion that tobacco is a panacea for all the ills of life. I am convinced that smoking is a hindrance to the full enjoyment and exercise of the faculties of mind and body. What is the verdict of many an honest smoker? I have heard many smokers express deep regret at being slaves to the habit, confessing its uselessness and its expense, and other drawbacks.

Tobacco tends to make the bread-winner dull of intellect, disinclined for hard work, feeble of digestion, short-winded, short-sighted, dry in the throat, and often thirsting for intoxicating drink. So the unfortunate man has to supply his craving for tobacco and drink before he satisfy the claim of his wife and children. The wife and children are deprived of necessary food and clothing and become feeble and debilitated, if not actually victims to disease. We cannot eradicate disease entirely, but we acknowledge that a great many diseases are preventable, and certainly those which are induced by tobacco and alcohol are preventable

The medical profession has, at last, roused itself to warn the public about the dangers of excessive drinking, and at last it recognises that the value of alcohol as medicine

The evils of tobacco inebriety are truthfully described by Dr. Crothers in his work on "Morphinism and Narcomanias from other Drugs," published by Saunders & Co., London, 1902, he writes thus: "The tobacco addiction is usually associated with alcohol or other drugs, hence the tobacco disability is seldom considered. In reality, tobacco is a narcotic poison, and its use is not only dangerous, but it is certain to be followed with debility, mental perversion and exhaustion. Statistics show that students and brain workers who use tobacco have less vigour, both mental and physical, and are more liable to disease."

I maintain that the education of a medical man is not complete if he fails to realize the harm of smoking. The subject should be taught in all medical schools as a part of the curriculum. It is unreasonable to expect greater knowledge among the laity than medical men. We must lead the way, teach the truth, and show our consistency by acting up to our knowledge. Who can deny the truth of the evidence contained in the pages of The Lancet which I have quoted? The fact that a few men can smoke without harmful consequences, does not prove that it is beneficial to them. No man is justified in playing with poison. I am convinced that the smoker has less resisting power to disease than others.

My opinion is corroborated by the results of the experiments of [zoologist and bacteriologist Élie] Metchnikoff [1845-1916], who has discovered that the white corpuscles of the blood, which he calls phagocytes, eat up intrusive bacteria and other germs, and are the chief means in warding off disease; so that the man or animal who has the normal quantity of healthy active phagocytes is immune, that is to say, he cannot be effectively attacked by disease germs.

Metchnikoff's conclusion is that the phagocytes in our bodies should be stimulated in their activity, in order to

What about the old belief that smoking was a safeguard against infection? It was based on a want of knowledge, and it was a capital excuse for those who liked tobacco. The light of scientific investigation has come to our help, and clearly indicates the dangers of tobacco and other narcotics in rendering the phagocytes inefficient for their physiological functions. We owe a debt of gratitude to Metchnikoff for his discoveries. There is now no excuse for using tobacco, except for simple indulgence, as a form of mental intoxication. Whether it is dear at the price is a matter of opinion. Chacun à son goût.

This consideration opens up an important question for medical officers in the Army and Navy. Ought they not to avoid smoking, and teach their men to do the same? It is a serious question and demands instant attention.

We want an efficient army and navy to protect our country, our colonies, our Indian empire and our commerce.

We need efficient, clear-headed, far-seeing statesmen and legislators to govern wisely.

We need ministers of religion to set an example of the Christian life, aind to show us the advantage of leading a "godly, righteous, and sober life."

We need medical men who will live up to the spirit of the ancient Hippocrates, and warn their patients against "anything harmful and mischievous."

We need parents and teachers to persuade boys, girls, young men and women to avoid the smoking mania.

We need a long pull, a strong pull, and a pull all together, to save the rising generation from falling victims to a big snare and delusion.

Does smoking promote frivolity of mind? I think no

A dreamy reverie takes the place of manly activity. The discipline and simplicity of early days is forgotten in the clouds of tobacco, and the man who was once in serious earnest in his work may become frivolous, capricious and lethargic.

Look at the countries of Europe now, mostly absorbed in frivolous amusements, and doing little to help the oppressed, or to relieve the sufferings of humanity. The whole body is sick, but the frivolous take no heed. "Let us eat and drink and smoke and enjoy ourselves" is the guiding principle of the multitude. Frivolity must be considered a disease of the mind.

We want healthy minds and bodies, and I ask how can one reasonably expect to be strong, vigorous, and contented who perpetually imbibe a narcotic poison which stupifies the brain? I am quite certain that smoking does cause forgetfulness and stupidity, and I am of opinion that many serious accidents are the result of temporary oblivion, the immediate result of narcotic poison.

Seeing that tobacco obscures the reason and the intellectual powers, it may be answerable for the want of chivalry, and the want of religion, which we deplore among the Christian nations of Europe and America. It is obvious that forgetfulness is a common result of smoking. I notice it every day of my life. The young men who are smokers are most forgetful, even in the ordinary affairs of business. Many notes of warning have been recently uttered by thoughtful men of various schools, but the people heed them not. The only remedy is to teach the rising generation to abstain from tobacco.

I dread touching on this subject, for I consider that the day when I began to smoke was the most unfortunate day in my whole life. I have often testified to the injurious effect it had on me, morally, mentally and physically. I

I decline to describe the sufferings I endured, and the painful struggles of conscience; it is enough for me to say that I am fully convinced that tobacco can become a quencher of the Holy Spirit in a man. I may mention one of the ill effects I experienced from tobacco, viz., occasional loss of sleep after smoking a cigar; only those who have been deprived of a good night's sleep can appreciate its value. Natural sleep is the most precious medicine Nature can give. Art can supply no substitute. This proves that tobacco has a disturbing or exciting action on the brain, resulting from the weak action of the heart, and not to the direct action of tobacco on the nerve cells of the brain.

Insomnia is one of the evils of the day, and is often the result of excessive brain work and anxiety. Can tobacco be recommended as an antidote for a weary, overworked brain? My prescription would be—rest, and food, and fresh air, together with entire abstinence from alcohol and tobacco.

How does tobacco affect a married man in his home? Under the influence of tobacco he becomes lazy, and disinclined for any exertion. He is tempted to shirk many little domestic duties which he might perform, but he hopes his wife will save him all trouble and let him enjoy his reverie. He is no comfort to his wife, and she gets little sympathy from him. Her life becomes one long dreary never-ending task; if sickness attacks the children, all the responsibility is thrust on her shoulders; if the husband is out of work, the wife must go out as a charwoman to provide bread for the husband and children. The willing horse does all the work, but she must be a strong woman if her health will stand such a heavy strain. I think this is no exceptional case: I see so many pale, haggard, thin, care-worn, wrinkled, and yet young women, and I wonder what are the causes, and I think I have pointed out one, at least. Not only is the poor wife overworked all day, but she is liable to be poisoned by night by the exhalations of nicotine which rise from the skin and the lungs of her husband. Then she has headache, faintness, and giddiness, but no one

It is nobody's business to trace disease to its original causes, unless the general practitioner undertakes it. As a rule he has little time for such an enquiry, or feels that it is useless.

I have heard medical men argue that smoking cannot be one of the chief causes of insanity because the asylums have more female inmates than male. I ask if it is unreasonable to suggest that the gross and brutal selfishness on the part of a husband is not calculated to cause insanity in the wife?

Nothing is more difficult than to trace mental disease or insanity to its true origin; there is, however, only too much evidence to show that excessive smoking has often caused insanity. Experience teaches that the mental condition of a husband influences that of his wife: if he is cheerful, hopeful and contented, it helps the wife to be like him; on the other hand, when the husband is morose, dull, idle, or fond of drink and tobacco, he exerts a bad influence over the wife. Hence, the husband who abuses himself with tobacco and alcohol will ultimately destroy his wife's health and happiness. An unhealthy woman is unable to rear healthy children, even in a good environment, and this, I believe, is the explanation of the excessive amount of disease amongst the children of the rich and poor in the countries of Great Britain, Europe and America. Sickly children are always peevish and fretful, and when the parents get weary of their crying they give them sweets to pacify them. A craving for sweets is acquired early in life, and prevents the proper nourishment of the child. The sickly and stunted children that now crowd the schools of this country are a source of grave anxiety to all thoughtful people.

The report of the Inter-Departmental Committee on Physical Deterioration contains ample evidence of the widespread evil of alcoholic excess among men and women, both as a cause of disease and poverty. The evils of juvenile smoking in checking growth were emphasized by Professor Cunningham, but no inquiries were made as to the evils of excessive smoking among adults. This is a serious omission, as superficial observers are apt to conclude that smoking is a harmless pastime. In my opinion it is a

It always seems illogical to suggest or assert that smoking is harmful before the age of twenty-one, and harmless after that age. I have never received an explanation on this point.

It puzzles me to know how boys will be prevented from smoking and injuring their prospects so long as they see their parents and teachers set such store on it. I was speaking to a man lately, and he said, "smoking is the only pleasure I have in life." Are there not many like him?

When I was in London two years ago I noticed a number of "unemployed" sitting contentedly on the seats and parapets on the Thames Embankment. The majority had their pipes in their mouths and their hands in their pockets, and they did not look eager for work. Now everyone knows that tobacco is not food, but the craving for a smoke is so strong in some men that they are content to starve their stomachs in order to satisfy the craving for a whiff of poison. Such men soon fall victims to consumption and other diseases.

All observers are agreed that the chief factor in causing disease are over-crowding in small tenements, female factory labour, and want of proper care of infants and children. We must not be content with these statements, but we must inquire how it happens that these people are living under such conditions. Why are they so poor that they cannot afford to pay the rent of a nice cottage?

In too many cases their poverty is caused by their indulgence in tobacco and strong drink. What proof can I give of this statentent? Is there any village or town so poor that it cannot support one or more public houses and many tobacconists? The very poorest districts can pay for these injurious luxuries.

The law takes care of the property of youths under twenty-one, and does not allow a minor to have control of his property, he is placed under guardians: why does not the law also take an equal care for the health of his body? The most critical time of a lad's life is just after leaving school; if he forms bad habits then he may never be able to regain his self-reapect; he needs guidance, help, and protection till he reaches the age of twenty-one. Do fathers and mothers always realize their responsibilities?

Have we traced the craving for alcohol to its origin? It is not a natural craving, it is acquired. In my experience non-smokers hardly ever become drunkards, while nearly all drunkards are smokers.

I am of opinion that the only way to check intemperance is to persuade the lads of our country to pledge themselves to abstain from tobacco and alcohol until they reach the age of twenty-one. Does this suggestion seem impossible? by no means, if the Christian men and women combine and determine to organize societies all over the country to effect this purpose; the majority of lads will see that it is for their good and gladly give the pledge. I appeal to all those who love and serve our Lord Jesus Christ to help in this work.

The words of the poet [Henry Wadsworth] Longfellow [1807-1882] must be our watchword and our motto:

It will be a hard fight to reclaim our lads for purity and sobriety, but "if God be for us, who can be against us?"

IT is my opinion, that many diseases which are now ascribed to alcohol, are really due to tobacco. It seems strange that the medical teachers should fail to see the connection between tobacco and the ever increasing disorders of the nervous system, the arterial system, the digestive system and the pulmonary system. Last, but not least, are the disorders of the sexual system which occur in the male and the female. When the costs and penalties of the tobacco habit are fully and fairly considered, we must certainly agree with the opinion of the late Sir B. Ward Richardson, M.D., "that smoking is a doubtful pleasure with a certain penalty."

I have heard many arguments from all sorts of men, and many ingenious excuses for a puff, but the only one that meets my approval is the case of a man with a scolding wife, who goes out of doors to look at the stars and smoke a pipe to keep his wife at a safe distance. I plead specially with medical men, because they are trusted by the public to speak the truth, the whole truth, and nothing but the truth, in all matters which concern the health. We are not compelled to denounce the use of alcoholic beverages in moderation, but we ought to denounce every drug habit as highly dangerous.

I regard the smoking of tobacco as the most universal and pernicious of all drug habits. It is instructive to trace the origin of the tobacco habit, and compare it with the origin of the alcoholic habit. Wine is mentioned frequently in the Holy Scriptures, and our Lord, by a miracle at

To disobey is to dishonour. I know of many young men of great promise, and of excellent character, who after beginning to smoke, have come to utter grief, and brought sorrow and shame on their parents. When I lived in London I was intimate with five young men, all brothers, well educated men, with good prospects; four of them began to smoke, and one by one they died off, having accomplished nothing to their credit. Tobacco and drink were the causes of their downfall. The only one of that family, now alive, refrained from smoking, and he is an active, clever, and prosperous mnan. There is nothing more distressing than to see a man become a wreck through his own folly. I know these young men acted contrary to the wishes of their father, for I know he hated smoking. The habits of his sons were a source of great grief to him.

There are some people who try to argue that tobacco is good for some, and bad for others. Every medical man knows that tobacco contains a deadly poison called nicotine. If a man swallows a few drops of nicotine, he will fall down insensible at once, and probably die from the effects in a few minutes.

Some men argue that smoking is not forbidden in the Bible. I think that the Sixth Commandment is applicable, "Thou shalt do no murder." There are different ways of committing murder; there is the sudden murder, and the slow murder. If a man takes frequent whiffs of poisonous smoke, he is shortening his life, therefore he is killing himself by slow degrees; this is murder by slow processes. There is a great uncertainty about the effects of tobacco; sometimes

We know that God has great respect for human life. Cain was banished for killing his brother Abel [Genesis 4:8-12]. The answer which went up from the first murderer is often repeated in our own day,

What answer does our Lord give to this question; he answers,

It seems to me, thefore, it is the duty of all who know the evil effects of smoking, to do all they can to warn those who are ignorant. Every man knows that smoking is particularly detrimental to boys under twenty-one. It will stop their growth, weaken their minds, and make them short-winded and weak. Do boys know all this?

Now I venture to say, if men and women would combine and use their authority, the boys could soon be reduced to obedience. It requires a little patient remonstrance, and a few words of kind warning.

I cannot imagine why boys smoke, it is very unpleasant. No one would dream of climbing on the roof of a house and holding his head over a chimney and breathing the smoke, and yet coal smoke is less poisonous than tobacco smoke.

The only explanation I can give is, that we have a great idol in this land called Fashion. Fashion is stronger than the King. Fashion is an autocratic tyrant, his subjects are slaves, and are not allowed to think for themselves or choose between right and wrong. This is not right; we are the children of God, and we must not let Fashion rule over us. God alone should rule over us; He should be our supreme Ruler, and we should disregard the fashion of the world when it is contrary to God's laws. I am quite convinced that smoking poison cannot be pleasing in God's sight.

There are many popular delusions about tobacco; many people believe that tobacco keeps off the infection of disease. I don't believe it for a moment. That is an old-fashioned belief. With regard to boys, it spoils them for cricket, football, and all athletic sports. Is there anything manly in it? Does it require any skill or courage to smoke cigarettes? No! any fool can smoke and lounge about.

I am a practical man, and know it is impossible to stamp out all diseases, or to prevent accidents, but there is no reason why we should actually go to the cost of spending millions of money on two things which we know produce,

I now make an earnest appeal to my professional brethren in all parts of the British empire to take a forward step at once, and set the example of self-denial and abstinence from all hurtful things. Let us show to the world that we regard alcoholic beverages merely as luxuries, which should rarely be indulged in, if at all, and also let us speak the truth about the dangers of all drug habits, such as tobacco, opium, morphia, cocaine, Indian hemp, &c. &c.

I have no desire to dictate to the members of my profession who have learnt to regard the daily use of tobacco as a necessity, but I do wish to remind them that the habit has frequently induced physiological discord in the human body, and turned a healthy man into an incurable invalid. I cannot hope to write a complete history of the diseases caused by tobacco, for there is not an organ or tissue of the body which is not liable to disease from the poisons which enter the blood; but I hope to write enough to awaken an interest in the importance of tracing all illnesses and diseases to their true sources. This branch of medicine is called Etiology; it is difficult, but may be acquired by experience. It is highly useful to the practitioner who is often puzzled to explain the origin of an illness.

The object of Education is the Training of the Mental Faculties to discriminate between good and evil, truth and falsehood, to help us to avoid evil habits. An intelligent man can always give a sound reason for his opinions and actions. I have frequently asked men who smoke to explain what advantages they derive from the use of tobacco. I have never yet had a satisfactory explanation. The usual answer is:

That amounts to a confession of its uselessness. Why should a man smoke and inhale poison to pass away the time? God has made us for higher and nobler purposes than puffing tobacco smoke into our nostrils and lungs. Do we intend to educate our boys to seek comfort in tobacco, rather than in the sympathy and friendship of the Great Physician? If that is our purpose we should be consistent, and instead of offering

I maintain that every medical man should be conversant with the diseases caused by tobacco smoking, and should use his best endeavours to save humanity from the slavery and dangers of narcotism. I am fully convinced that tobacco smoking has come to be the source of many of the evils which now afflict us, and I believe it promotes a craving for strong drink. My feelings prompted me to read a paper on this subject before the State Medicine Section of the British Medical Association at the Annual Meetings held at Exeter in 1907. There was a poor attendance, and I was requested to cut short my address before I had been ten minutes on my feet, as some members wished to catch a train to attend a luncheon party at a distance. I urged the importance of promoting definite teaching of the evil effects of tobacco in all medical schools, and that an effort should be made throughout the Empire to save the rising generation from acquiring the smoking habit. I called special attention to the intimate connection between the use of tobacco and mental disorder, proving that tobacco is a frequent cause of insanity.

I can only characterise the discussion which followed the reading of my address as frivolous and puerile and utterly unworthy of the Association. After making further efforts to procure a sub-committee to inquire into the diseases caused by tobacco and meeting with no support, I lost confidence in the principles and practice of the Association and withdrew my name from the roll of members. I determined henceforth to carry on a crusade against tobacco by God's help alone, trusting to the guidance of the Holy Spirit.

When I realize how many members of the learned professions have become slaves to tobacco, and that the Church and Medicine and the Law suffer from tobacco blindness, I tremble, lest the love of tobacco, which stands for narcotism, should be able to destroy our Church and Nation. If seventy per cent. of the Church and Nation use tobacco, then it follows that the same number of people are liable to tobacco paralysis and other evils which promote decay and disease. I believe that over seventy per cent. of men between the ages of

The two following letters from medical men show that the "medical conscience" is awake at home and in Canada in at least two men:

I wrote and thanked Dr. Playter for his letter, and I was obliged to inform him that he was under a false impression, as I had completely failed to persuade the executive of the British Medical Association to take any steps to promote efficient teaching as to the diseases caused by tobacco smoking, or to utter any manifesto to the public, as to the dangers of the habit.

The following is a newspaper report of what transpired in the State Medicine section, when I read my address. I had barely ten minutes for the task, as the section was eager to catch an early train for a luncheon party at a distance. Several members treated the subject as a joke. The address was widely reported in the lay-papers, but was omitted from the British Medical Journal:

I felt indignant at the apathy of the Association with regard to a habit which promotes disease and inefficiency, and I sent in my resignation and ceased to be a member. I consider inaction in such a matter amounts to blood-guiltiness and is a professional scandal.

How can the medical profession be militant or triumphant, when seventy per cent. of her members are indulging in the pleasures of narcotism and making their bodies unholy and filthy, and offering prayers which stink of tobacco? Is it not awful presumption for a nation, from the highest to the lowest, to prostitute itself by tobacco debauchery, and then profess to be servants of Jesus Christ—the preacher of righteousness, holiness, and purity. How can a man who is a slave to tobacco repeat the lines of that beautiful hymn?

And yet I fear that many choir boys and other boys who sang these words with true joy in their early days have insensibly lost the desire to abide with Christ, owing to the action of a narcotic poison, paralysing the mental faculties, and creating a strong craving for tobacco which often kills the man's spiritual nature.

There are many smokers who require the comfort of a pipe during the night, and who are so selfish as to indulge their habit, to the annoyance of the wife, who cannot have pure air to breathe. Such a man may be said to look at his pipe as he goes to bed, saymg, "Abide with me when night is nigh," and he dies with his pipe (and not his Bible) on the chair at his bed-side.

A very important medico-legal question arises as to the correct way of certifying the death of a man who has been an habitual smoker. If it is certain that the deceased has died from disease caused by the use of tobacco, or that disease was aggravated by it, then the duty of the doctor is to state the fact on the death certificate. I have only felt justified in one case in certifying death due to tobacco. A better plan would be to pass a law to compel the medical attendant to fill up a special form, stating whether the deceased had ever used tobacco, and if so, to what extent, specifying the number of years, and the nature and form in which it was used, whether cigarettes, cigars, pipe tobacco, chewing or snuffing. Such a fund of information, when published, might cause people to think seriously on the sin of self-intoxication.

No one would wish to see a true epitaph over the grave of a smoker in the following style:

I once attended an inveterate smoker during his last illness, and I felt grieved, for he had been a hard-working man, and probably had never been taught by his betters to avoid tobacco. Surely it is the duty of medical men to inform the whole nation that tobacco smoking is destroying the life, both moral and physical of the nation.

I know of three things which a Christian man and woman should fear.

These are the enemies of civilisation; they are dangerous enemies, but though they combine their forces with the king of hell, they cannot wreck the ship in which the Master of earth and heaven is resting at the helm.

I honestly believe that the majority of medical men view the habit of smoking with disapproval, but are too much engrossed in their particular duties to devote suffcient time to make a full enquiry as to the evil consequences. Perhaps some think that the habit is so deeply rooted that any attempt to check it would be useless and a waste of time. I know some men would not be convinced they were injuring themselves if an Archangel were to warn them, but some smokers are open to argument and to reason, and in justice they can demand our sympathy and help.

In this matter of smoking it seems as if the profession as a whole had gone to sleep for half a century [Ed. Note: i.e., since the 1857 Lancet series], and now finds that the habit is so popular and so universal,

If the habit were not dangerous to life we could adopt a neutral attitude in our public capacity, and content ourselves with advising our private patients, and hoping in course of time that the mass of the people would smoke less and less, and finally drop it entirely.

It is my opinion that the evil is so great as to constitute a national danger. Therefore I appeal to the patriotism of the members of our noble profession to go forward and help to educate the people.

Will not some of the Medical Societies undertake to give public lectures on health and training, with special reference to the abuse of alcohol and tobacco? I believe that those medical men who smoke are thereby unconsciously lessening their moral power and influence over their patters. We should remember that a patient is not merely an animal, but that he is a compound of the divine and human, and though the latter is the part which mostly needs our attention, we shall have more power to improve the body by working through the higher nature, that is the soul and mind.

I believe that the greatest danger of smoking is the effect on the mind, acting through the nervous system. It has been frequently observed that the highest honours in schools and colleges are usually won by the non-smokers.

Men who smoke cigarettes are liable to frontal headache, loss of memory, loss of appetite and palpitation of the heart, also tremor of the hands and melancbolia. Excessive smoking occasionally leads to acute homicidal mania, delirium tremens, or chronic insanity.

Charles James Russell, M.D., was born in the United States of America, February 25th, 1830, remained at home with his mother (his father having died when his son was nine months old), who was a godly woman, fully alive to the many rocks and shoals so often met with while navigating the ocean of life, and took great care in teaching her only charge to box well his compass, and hold fast the tiller in all kinds of weather.

At four and a half years of age he became a Sabbath School scholar, and a member of the Juvenile Temperance Society (connected with the Sunday School), which held its meeting on the first Monday in every month. At these meetings all kinds of alcoholic drinks, and the use of tobacco in any and every form were denounced; and they were taught that a simple life was the most conducive to health, longevity and success in fighting the battle of life.

Dr. Russell having, during the whole of his life, adhered most strictly to those early teachings, is one of the few octogenarians who have lived a strenuous life, and been true to his convictions. One peculiar feature in the Doctor's early life, was his fondness for the company of

From a very early period in his child-life, he was taught that change of occupation was recreation, and he found it a noble lesson, and opened to his mind new fields of interest and profit, and most perfectly solved the problem of "nothing-to-do"; for every occupation brought with it a burning desire to undertake some new subject, included in the catalogue of "always do something," and always let that something be something good and something well done.

At the age of sixteen he began to read medicine, left the Bible Class for the teacher's chair and social work; at the same time, continued those studies necessary to enable him to reach the higher standard required for his medical education, the profession of bis choice. But, he states, he was not long in learning that the medical profession brought him in close contact and relation to the inner social life of all classes of society, and that to be a successful physician and surgeon he must study the nature of every social problem that would in any way influence his success as a medical man, a citizen, and a philanthropist. On a close investigation of these problems he found, from his standpoint, that the medical practitioner held a most unique position in society. First at the birth of life, and last at the ebb and end of the vital forces, he could look along the tortuous way of life and find something at every crook and turn to engage his attention, something to do for his patients, for the community in which he lived, and as much for his King and Country.

Having finished his course of study, and five years as an assistant to two eminent medical men, where large opportunities were afforded him to acquire a practical knowledge of his profession, and spending years in walking three different hospitals—one in America, one in Scotland, and one in France (the Hotel Dieu Paris),—he took minor degrees in Scotland in 1848, and the M.D. in America in 1876. Since 1876 he has conducted his professional and social work at the same time, feeling that as society is at present constituted, they are inseparable.

The Doctor is a popular public speaker; hundreds of thousands have listened to his addresses on many phases of the many social questions that are engaging the attention of the public mind. On one occasion it is said that in an audience

The Doctor also read a most interesting paper on narcotics before the British Anti-Tobacco, and Anti-Narcotic League at Manchester, of which he was then, and is now a member. He was a member of the Grand Lodge of the I.O.G.T., and held office in that body, and still continues a Good Templar in New Zealand; and a year ago he was made a member of the Royal Society of Arts, London, founded 1754.

In 1880 the Doctor removed to New Zealand, where he still conducts a large practice, and spends much time in delivering courses of lectures on health and kindred subjects, which are largely attended and highly appreciated. He is patron, vice-patron, president, vice-president, chairman, councillor, or member of more than thirty associations and societies, and a few weeks ago he was elected by an unusually large majority, to a seat on the Board of Education for the Central District of North Canterbury.

The Doctor is looked upon as a genial, liberal, good-hearted philanthropist, proud to be identified with every phase of true social reform. He has the courage of his belief, and is not afraid to give expession to his convictions, and treats the most delicate social questions in a most lucid and pleasant manner, and in such a way as to give no offence to the most fastidious. He has just ordered 25,000 tracts and literature, upon the evils of alcoholic drinks and tobacco, for free circulation through the city and suburbs of Christchurch; this looks very much like "good business," and I wish him, his friends, and their noble work, every success.

I am informed that notwithstanding his advanced age (81 years), he works night and day professionally as well as socially, has his five senses almost perfect, and his work

THE evils of Tobacco smoking have been fully recognised by certain members of the medical profession in France, who have issued a useful magazine for the last thirty-five years, describing the diseases caused thereby.

This society offered a prize of one thousand francs for the best essay on the effects of tobacco on the health of men of letters and its influence on the future of French literature. Dr. [Maurice de] Fleury [1860-1931] gained the prize. At the time he wrote his essay he was a smoker. Soon after, he found himself suffering from dyspepsia, which he attributed to tobacco, so he wisely gave up smoking and soon got rid of dyspepsia. He has written a most interesting book, called "Medicine and the Mind," from which I have taken the following extracts:

• Victor Hugo [1802-1885] considers smoking injurious to the intellect; he said, "thought became reverie."

• One author stated, "the cigarette is only dreaming and resignation, a deadly pastime, completely useless."

• Another wrote, "tobacco changes manly projects into reverie."

• Dumas wrote, "I gave up tobacco when I found it caused me giddiness." "In my belief tobacco with alcohol is the most formidable adversary of intellect."

• J. Barbier wrote, "I have been a great smoker, and I narrowly escaped paying for that deplorable and delicious habit with my

life. By degrees the beating of the heart became irregular, a few more cigars and it would have stopped. The elimination of the nicotine was slow, it took more than a year to get rid of its effects."
• One writer said he had brought on angina pectoris by smoking, and that soon after he ceased smoking, he recovered.

• Another author wrote, "I am not a doctor; all I can tell you is that after having smoked for forty years I had to renounce that pleasant intoxication which was leading me too fast to the grave."

• Another wrote, "I was in fact a great smoker, and I found it hard to renounce tobacco. But I was absolutely constrained to do so, some years ago, by the increase of certain nervous complications, which I had for a long time time refused to attribute to nicotine, and which in reality had no other cause. 1 was forced to yield to a conviction of the truth when these nervous affections, gastric vertigo among the number, became more frequent and intolerable."

Dr. Fleury was not a bigot, he was a smoker until he began to suffer in health, and when he found tobacco was poisoning his blood he wisely gave it up. After a full enquiry about the work accomplished by smokers and non-smokers, he came to the conclusion that the latter accomplished far better work than the former. As examples of fine intellects among non-smokers, he mentions [Johann Wolfgang von] Goethe the German poet [1749-1832], Victor Hugo [1802-1885], [Honoré] Balzac [1799-1850], [Jules] Michelet [1798-1874], and [Alexandre] Dumas the elder [1802-1870].

I will now take leave of Dr. Fleury, wishing his book may be the means of spreading a desire to know the real effects of tobacco among all civilized people.

I will now introduce the reader to an American physician, Dr. W. S. Hall, M.D., a professor of physiology. He has written a personal letter to young men which was published in the School Physiology Journal.

It begins thus:

It seems clear to me that Dr. Hall's experiment proved the truth of Dr. Fleury's conclusion that the "nicotine poisoning turns manly projects into reverie and promotes

• Is not the boy smoker more liable to the habit of masturbation than others?

• Is not the smoker of eighteen or twenty-one years of age more likely to get a girl into trouble than others?

• Can the smoker control all the passions, such as jealousy, anger, revenge, etc., as well as others?

• Is it not possible that careful enquiry into the history of many criminals would prove that the crimes were committed while they were under the influence of nicotine?

It has been stated that quite eighty per cent. of the 15,000 youths who are detained to-day in the prisons, reformatories, or industrial schools of the London district are cigarette smokers.

The head-master of a Glasgow elementary school stated he had seen many cases of frequent sickness and moral weakness from cigarette smoking. He had succeeded in curing the beginners, but others were incurable. Here are particulars of two boys:

(1st) "Frequently sick, lazy, gets more backward in his work every day, impossible to get him to remember his lessons. Says he has tried to stop smoking but cannot."

(2nd) "This boy before smoking was of average intelligence. The change in him has been very noticeable day by day. He cannot fix his attention on anything for more than two or three moments, from morning to night he seems to be in a state of lethargy."

Many employers of labour refuse to engage boys who smoke. Many juvenile smokers have been guilty of stealing cigarettes and other things. School teachers, and all those who have charge of boys, declare that smoking prevents boys making progress in their studies and renders them unable to excel in athletics. Moreover

I recently heard of a gentleman of considerable ability, who had distinguished himself at one of the Universities, who smoked to excess and gradually lost his self-respect and that of his friends. Ultimately he wandered about the country and became a tramp. Poison, absorbed day by day for many years, weakened his intellect, until there was no trace of the original man.

The present age is anxious for an improvement in health. The majority of thoughtful people have become alarmed at the spread of nervous disorders and other signs of degeneration in our midst. Who can count the number of men who have paid an awful penalty for their love of tobacco? How many men have become insane though tobacco? God only knows! How many women have been driven mad by the cruelty of their husbands who loved their pipes and beer better than their wives and children?

There can be no doubt that smoking tobacco causes loss of nervous energy and leads to many serious diseases. Its effect on the heart is known to all practitioners. Cases of painful palpitation from cigarette smoking are common among men, women, and boys.

A gentleman in this town, who is under thirty years of age, smoked for some years, and then he found his wind was getting short, he then stopped smoking and he recovered.

An extract from Dr. Clifford Allbutt's System of Medicine may interest my readers; he writes as follows:

It is a fact that men who lead active lives and are of a robust constitution, and who do not drink to excess, may smoke tobacco habitually for many years without any greater suffering than occasional attacks of dyspepsia or palpitation of the heart. This immunity may continue to the age of fifty or sixty, and therefore they feel quite sure smoking is not injurious to health, and they are not backward in talking of their achievements, hence they spread a belief among young boys that tobacco must be a boon to mankind.

Physiologists are aware that various functions are not so easily performed as people advance in years, for example, the processes of digestion are less perfect, and the action of the kidneys and skin, whereby the products of tobacco are eliminated, are more easily checked by sudden changes of weather. Hence after middle life there is a great danger of these poisonous products being retained in the system until, without warning, alarming symptoms of poisoning suddenly occur. A man may feel well on rising from bed, and may start for business as usual; he may incur some unusual exertion or some unexpected worry; the heart flutters and he falls to the ground without any warning. Sudden death from sudden failure of the heart, associated with fatty degeneration, is not uncommon among plethoric men over fifty years of age.

I will now relate a remarkable case published by an American doctor.

Some superstitions die hard. I would gladly make a personal sacrifice to help my fellow creatures to avoid a habit that survives under a false reputation of being a peace-maker.

Has it ever been proved by diplomatists to act as a peace-maker between nations?

Has it ever prevented litigation?

Has it cemented the marriage bond, and lessened the number of divorce cases?

Has it promoted peace and goodwill between capital and labour?

Has it promoted peace between the rival political parties in Great Britain?

Has it promoted peace between the rival religious bodies in Christendom?

Did it prevent war between the northern and southern States of America, or between Great Britain and the Boers?

The following statement has been made by my friend, Mr. Colbeck, who served in the Army 1859-1882:

The Surgeon General of the United States Navy has recommended in his last Annual Report, that an order be issued by the Navy Department, forbidding the use of cigarettes by all person in the Navy under twenty-one years of age.

I was told by an English officer who went through the whole of the last Boer war, that his men occasionally suffered from thirst while on the march to such an extent, that they could not resist sinking from dirty pools of water. It is my opinion that the smoking habit itself produces thirst, and I think it probable that the men would not have suffered in this way had they been non-smokers. By drinking dirty water they contracted enteric fever. By smoking tobacco they created an unnatural thirst. I have been told that some men used to smoke over an ounce of tobacco a day.

One of the Naval medical reports contains the following :

An Army pensioner has lately informed me, that he has been a non-smoker all his life, as had been his father and his grandfather, that, although most of the soldiers smoked when he was in the regiment, he never hankered (sic) after "the weed," saw no good to come from the pipe, and that its use certainly incurred an expense which ended in smoke. When on active service in the Field (the Zulu War and the Transvaal, 1878-1879), he observed while on the march, that when a "halt" was ordered, there was an immediate rush to the river banks or to pools for drinks of water, and he could not help but notice the fact that these rushes were made by the smokers, and rarely by the non-smokers; this occurred at every halt, and he therefore came to the conclusion that such inextinguishable thirst arose from "dry throats," certainly caused by tobacco. He added: Some of the pools at which the men drank were certainly very far indeed from being clean or free from insects. One pool, he recollects, had the carcase of a dead bullock partly submerged in it. The Officers, both commissioned and non-commissioned, did their utmost to restrain the men from drinking such foul water, pointing out the danger, probable results, etc., but the intense thirst had to be, and was assuaged as he has stated.

Many years ago the soldiers in a regiment were informed that they were all to be examined by the medical officer to see if all were fit for active service. As the time approached for the examination, one of the men set to work to smoke a pipe, and he smoked vigorously until he was called forward. The doctor discovered that his heart was acting irregularly and quicker than should be in health,

The aggregate consumption of tobacco in England and Wales, from 1702 to 1709, was 11,260,659 lbs. a year.

We can trace the growth of this habit from one generation to another, making slaves of free-born Britons, causing thirst and disease of various forms, causing poverty and shortening life, promoting paralysis and insanity.

A habit fostered by the professors of divinity, law, and medicine, regardless of the warnings of numerous medical men and others who desired to preserve their fellow creatures from acquiring the worst of all drug habits, the smoking of tobacco.

It is an alarming fact that the tobacco consumed in the year 1908 contained 2,700,810 lbs. of nicotine. Surely there is cause for wonder and gratitude that we have not been wiped out as a nation, when we remember that five drops of nicotine introduced to the mouth of a man will cause sudden death.

THE true aim of the medical profession is to promote Hygiene. No medical writers of the present day recommend the habit of smoking; but all those who refer to it are compelled to admit it leads to sickness and disease, and affects the moral nature of man besides the physical nature.

The evil effects of inhaling nicotine vapour through the nose and lungs are well known. The smoking of tobacco in badly ventilated rooms and in houses is far more injurious than smoking in the open air, because in the former case the atmosphere becomes highly charged with carbon monoxide gas, which takes the place of oxygen. Hence, the atmosphere does not contain the proper proportion of oxygen, and those who inspire the atmosphere, starve their blood of oxygen and introduce carbon monoxide into the hemoglobin of the blood.

Directly a poisonous atmosphere is inhaled into the mouth and lungs, the blood becomes poisoned. The process of oxidation is impeded owing to the presence of poisons in the hæmoglobin of the red corpuscles of the blood. The blood is the source of all our vital forces, and we require an abundance of pure air to preserve the purity of the blood.

The lungs are the organs by which oxygen is conveyed to the blood and by which impure gases are eliminated from the blood. The lungs are like sponges to a certain extent, because they absorb whatever gases come in contact with their lining membranes. They absorb foul air as readily as pure air. The person who is placed in an atmosphere of tobacco smoke cannot avoid breathing the poisonous gases present in the air. It is certainly

In consequence of the frequency with which the smoking of tobacco is associated with the abuse of alcohol, the symptoms of tobacco poisoning, which are insidious, are often overlooked, or are attributed to other causes, such as gout, rheumatism, over pressure of work, or the abuse of alcohol. It is easy to trace the connection between an over dose of alcohol and the disturbance which follows, but the action of tobacco is slower and more insidious, and it often happens that a certain toleration becomes established, which means that the various organs perform their functions well enough to persuade the smoker that "all is well," and that he can smoke without harm. The truth is that the loss of one per cent. of vital energy every few months escapes observation.

As the amount of tobacco smoked increases, there will consequently be a progressive loss of vigour from year to year, which may be apparent to every one but the smoker. Tobacco often deceives the user into a false sense of security. No part of the body can escape a poison that is circulating in the blood day and night. The nervous system suffers and the muscles become tremulous. But the heart is the chief sufferer in the beginner and the confirmed smoker.

CASE 1.—A man, age 55, who was an abstainer from alcohol and a steady man, living wisely in all respects, except that he smoked and chewed tobacco, came to see me on January 27th, 1908. He had been at work until two days ago, when he fell ill. At first he vomited and felt pains in the back. I found the pulse weak, 128, he was shaky and unfit for work. I put him on his club and gave him medicine. He came again on February 3rd, heart sounds were feeble, pharynx injected, urine thick. He promised to give up smoking. On February 5th, after walking one mile, the pulse was 112, he complained of weakness in legs, vertigo, palpitation, and nausea. It was evident he was suffering from mild influenza, plus chronic tobacco poisoning; he remained under treatment for three months, abstaining entirely from tobacco. The heart gradually recovered its tone. On April 29th pulse was 96; he

Case 2.—In November, 1905, I was consulted by a man, age 28, a mechanic, he was very pale, his eyes were dull and restless, tongue red, his expression was sad, his hands were tremulous, he complained of loss of memory and inability to calculate figures, etc., he said he had never tasted alcoholic drinks, he was in the habit of smoking half-a-pound of ship tobacco in a week. I urged him to reduce the quantity, he admitted that my advice was right, but expressed a fear that he could not overcome the craving, nor has he done so yet.

Case 3.—On January 11th, 1908, a man, age 54, fell ill and was obliged to rest in bed. He was formerly in the Royal Navy, he had been in regular work and never drank to excess, he had been smoking half-an-ounce of ship tobacco a day for many years, he was fat and pale, heart sounds feeble, impulse feeble, he suffered from pains in the arms and shoulders. On January 16th he was no better. On January 21st, tongue was coated brown, the systolic sound was short and feeble, and the second sound feeble, pulse irregular. He was suffering from influenza, com­plicated with a "tobacco heart." His illness was of a catarrhal nature and resembled mild influenza, and might have been thrown off in three days if his blood had been free from the poison of tobacco. His disability lasted over three weeks.

Case 4.—A young man of healthy appearance, age 25, a carpenter, came to see me, saying he had recently fainted in the early morning, immediately after rising from bed. This happened twice within a short time. I found no sign of disease, and on questioning him as to his habits I found he was a cigarette smoker. I advised him to break off the habit. Such cases as this occur to most practitioners, and they prove that the heart is liable to serious disturbance, even in strong men. This man took my advice and has since been in good health.

Case 5.—In October, 1906, I attended an old man who had smoked one ounce of tobacco daily for many years, he suffered from chronic heart disease, associated with a weak pulse that was usually 130, he died at the age of 72 from want of digestive power and gradual heart failure. He had the symptoms of fatty degeneration of the heart.

Case 6.—I first examined this patient four years ago, he was then 31, a tall man. He began to smoke at 17; he entered the Marines; he enjoyed good health for many years. At the age of 30 he was discharged from the Service on account of heart disease; he was told by the doctors that he would not live long. After a period of rest he improved, and was able to do light work for several years. I found he was suffering from hypertrophy of the left ventricle, with a loud mitral bruit. The compensation was efficient and he did not suffer much inconvenience. I advised him to stop smoking and drinking, but he preferred to follow his [abulia] inclinations. Two years later he had trouble and attempted suicide. Three months ago he had severe influenza which brought on locomotor ataxy and an increase in dilatation of the heart, producing general dropsy. This case appears to be entirely due to tobacco poisoning, as the man had no illness and was never injured by over-work.

Case 7.—This man is now 58 years of age. He entered the Navy in his youth; he had fever on the West Coast of Africa. After four years service, he was invalided home. He was a patient in the Naval Hospital for a long period for incipient phthisis. While in the Navy, he used to smoke 4 ozs. a week. While in the hospital, he was allowed to smoke as much as he liked. At the time he did not suspect his illness was the result of tobacco smoking. For several years after his discharge he suffered from chronic cough, and was able to earn his living as a porter. He then married, and had a family. He used to drink to excess sometimes, up to the age of 38. One day he was running up steps, when he suddenly turned faint; a doctor saw him, and diagnosed dilatation of the heart. From that time, he gave up alcohol and tobacco. He slowly recovered his health, and returned to work. Four years ago he had asthma and bronchitis, and was laid up several weeks; since then he has wheeled a barrow with vegetables up and down the hills of Torquay. He has one son and three daughters. He began to recover health when he gave up alcohol and tobacco.

Case 8.—Marasmus and anæmia in a young man, caused by smoking.

R. B. was the son of a man described as Case 21, Chapter XI. in this book. I took his history on 14th July, 1910, he was 27; his father and paternal grandfather died of

At the age of 22 he was unfit for work, owing to pains in the chest and shortness of breath. From that time he did nothing but eat, sleep, and smoke "fags," he had no liking for beer or spirits; he was content to sit by the fire and smoke, and read the sporting papers.

During the fits he lay quiet until he recovered, except for a slight quiver of the mouth. His loss of strength and vigour was gradual. Present condition (July 14th), eyes are dull and lifeless; the face of a greenish yellow colour, the body is the same colour; cheeks sunken, body emaciated. He has a vacant expression, and appears indifferent to all things. He has now become obstinate, he refuses to put on a clean shirt, and refuses to go to bed; he has not eaten food for several days; he answered my questions in a vacant way; he seemed in a constant dream; he spat up frothy fluid from his stomach; gums soft and swollen, tongue yellow. The following day I was sent for and found him in a fit; he went off quietly while seated in a chair.

On my arrival, he appeared lifeless and motionless; respirations were not perceptible, the only sign of life was the pulse, which was regular. As he recovered, he was asked to drink some brandy and water, but he refused saying, "What good is brandy to me." I examined his chest, and found shallow respiration, but no evidence of tubercular disease; body greatly emaciated.

He remained in bed from that time till his death; he never asked for a cigarette again; he tried to take food, but his stomach was in a state of catarrh. From that time, his mind improved, and he was docile, and took his medicine; his gums were swollen and painful. He slept a good deal.

July 15. Pulse bounding 96, no cough, no spitting or eructation, unable to take food and very weak.

July 16. Weaker.

July 18. Had a fit, and was unconscious for half an hour, occasional vomiting and diarrhœa.

July 19. Weaker. Pulse 120, Temp. 102°.

"	20. Mind wanders.
"	21. Temp. 103.4°.
"	31. He died.

There is no doubt the blood was in a diseased condition from constant inhaling of cigarette smoke. His first medical attendant associated the fits with tobacco, and advised him to stop smoking. He was not subject to fits in infancy, and if he had avoided tobacco he might have enjoyed good health. I certified his death as due to "Wasting and Atrophy from cigarette smoking."

Case 9.—A naval pensioner, age 63, has smoked to excess for many years. Never had an acute illness; he has gradually become prematurely decayed, his tissues are atrophied, face shrunken, eyes dull, back feeble and bent; all his limbs are tremulous—too feeble to walk. There is an indolent ulcer on the nose that never heals; it forms a dry scab, which is renewed from time to time. At the age of 64 he had a severe apoplectic fit and died.

Case 10.—The following case will show the close connection between smoking and cancer, and also the danger of breathing an atmosphere of tobacco smoke. It is my opinion that excessive smoking on the part of a male parent will cause congenital debility in his offspring.

I will relate a case in point, and I have no hesitation in stating that the children inherited weak constitutions from their father, because the mother had a sound constitution, and is still in the enjoyment of good health.

The father was a business man who lived near London and went into the City on business every day. He became a heavy smoker; his wife bore three sons and two daughters. The eldest son caught diphtheria at the age of 4 and died in a few days. The second son joined the volunteers, and contracted enteric fever and died. The father developed cancer of the rectum, and was confined to the house; he used to smoke day and night to lull the pain; his youngest son used to sit in the same room with him, and began to suffer in his throat from the irritation of the tobacco smoke. In a short time he developed

There is no doubt in my mind that smokers are more liable to cancer than others; it is also my opinion that the only women who suffer from cancer are the wives or daughters of men who have indulged to excess in tobacco. The youngest son of this gentleman spent much of his time in the room where his father used to smoke. Does not tobacco smoke set up irritation in the throat and lungs and often lead to consumption?

Case 11.—Reported in the Rochester paper, August 17th, 1907. "An inquest was held at the Military Hospital, Sheerness, before Mr. G. B. Harris, County Coroner, on A. B. Howels, aged 29 years, a sapper in the Royal Engineers. On Sunday night deceased was in the cook­house cleaning the floor. All of a sudden, he said, 'Good God!' and fell forward on the broom he was using. He gasped two or three times and expired. The deceased was an excessive smoker of cigarettes, and Dr. Vincent Legge told the coroner and jury that this had possibly affected the heart. The jury returned a verdict that death was due to sudden heart failure."

Case 12.—Reported in the Sheffield Telegraph, November 4, 1907.—"John Cairns, a fitters' labourer, 23, although warned by his doctor that cigarette smoking was doing him serious physical harm, was such a slave to the habit that he only desisted from the excess for a few days. While he was hurrying to fetch a doctor to attend his sister he fell dead in the street. At the inquest the jury's verdict was based on the medical opinion that death was immediately due to violent emotional excitement, aggravated by excessive cigarette smoking."

Case 13.—Reported in the Liverpool Post, November 12, 1907. "At Lytham, yesterday, Tom Smith, about 36 years of age, tripe dealer, had just finished his dinner of fish and potatoes, when he complained of feeling sick. He sat on the couch and died immediately. He was an inveterate smoker of cigarettes, and had been warned to give up the practice by a doctor as recently as last week."

Case 14.—Reported in the Daily Express, May 5, 1906. "A coroner's jury decided at Gilmorton, near Lutterworth, yesterday, that the death from syncope on the previous

Case 15.—Insanity caused by cigarette smoking. "It was the cigarettes drove my boy mad. He never drank, he used no drugs, his habits were in other respects good." This statement was recently made in a continental city by the father of the boy, who was adjudged insane. For the past year he had done no work, but sat by the hour smoking and reading.

Case 16.—Reported in the Whitby Gazette: "At an inquest at Hull, J. Prickett, 14, fell down in the street and died before he could be taken into the infirmary. The mother said he was a heavy smoker of cigarettes, and had commenced at the age of ten or earlier. Dr. Smith, house surgeon at the infirmary, said the heart of the deceased showed disease of the aortic valve, and death was due to heart failure." The jury found that the boy died from "natural causes." Who will explain the meaning of this verdict? The true verdict should have been "Death directly or indirectly caused or aggravated by tobacco poisoning."—H. H. T.

Case 17.—Reported from Shrewsbury: "An extraordinary case, demonstrating the dangers of cigarette smoking has occurred at Shrewsbury. A boy, age 14, smoked two cigarettes on his way to work and swallowed the smoke to escape detection. The boy was taken ill at the workshop and was induced to lie down. A short time afterwards he lost the use of all his limbs and the body became quite cold. Medical aid was summoned, and the lad was found to be suffering from heart failure."

Case 18.—Reported in a newspaper as follows:

"Some sensation was caused at Alfreston by the discovery of the body of Henry Lee, 27, a jockey, by the side of the road, and at the inquest which was held, evidence was given which gave rise to comments on the evils of cigarette smoking. Mr. Taylor said that the deceased lodged at his house, he never knew anything wrong with his heart, he was a great [addicted] smoker. Mr. Wallis, a medical practitioner, said he made a post-mortem examination of the deceased and found that the cause of death was syncope from

Case 19.—Reported in a newspaper: "A schoolboy at Halifax, aged 11, died recently, and the verdict of the coroner's jury was 'poisoned by nicotine.' After smoking several cigarettes on Saturday afternoon, he became sick on Sunday, and died on Monday after partial paralysis had set in."

Case 20.—Reported in the Dundee Telegraph, February 4th,1908.

"A boy seven years old has died very suddenly after sickness. Medical aid was summoned when the boy became ill, and the doctor stated that death was due to 'cigarette smoking.'"

Case 21.—Reported in the News of the World, December 23rd, 1906.

"Sensational statements of the growing evil of cigarette smoking amongst schoolboys were made at a meeting of the South Shields Education Committee. It was reported that a scholar named Wood, age 12, had died, and that his illness was attributed to cigarette smoking. Another scholar, age 13, was under medical treatment, and he had the character of being an inveterate smoker. The Rev. Holmes said that in his delirium in his last hours, the only thing which seemed to occupy the thoughts of the boy Wood was smoking. He asked for cigarettes and matches and made the motions of striking matches and lighting cigarettes."

Case 22.—Death of a country gentleman, age 56, reported in The Lancet, March, 1857, by Thomas Hawksley, M.D.

This case is too long to report in full. The deceased had taken a journey the day he died, and called to see a friend; he was shown into the drawing room. When his friend entered the room, the deceased was lying dead. Death was attributed to tobacco poisoning and heart failure by the doctors who made the post-mortem examination.

Case 23.—A sad fate recently overtook a gentleman, a smoker, who lived in Torquay. He was middle aged. One day he went out shooting rabbits. While walking up a hill, he suddenly fell on his face, and expired in a few minutes. He had not walked half a mile when his death occurred.

I will now report a case which happened recently in London:—

Case 24.—Mr. Schroeder, Coroner, held an inquest at St. Pancras on Mr. B. Castellotte, aged 66, a well-known dental surgeon, of Wimpole Street, Cavendish Square, W., who died at Euston Station on Tuesday. A daughter stated that her father had spent three weeks at Ryde, and she noticed that he avoided hills, and that his breathing was affected. He was a very great smoker of cigars and tobacco, but she did not know that he had suffered from nicotine poisoning. A porter at Euston said he found the deceased on the platform with a cigar near him. He died a few seconds later. Dr. Lewis Evans stated that Mr. Castellotte was an excessive smoker, and smoked strong [ndian cigars. The witness warned him about the evil consequences, and knew that he was practically killing himself by it. He was strongly of opinion that the case was one of nicotine poisoning.

At the adjourned inquest, a son of Mr. Castellotte stated that his father had been an excessive smoker from boyhood. He could live on smoke, and did not take very much food. Dr. Edwin Hollings, who was called to see Mr. Castellotte at Euston Station, said he found nothing to suggest nicotine poisoning. A non-smoker might have exactly the same symptoms as the deceased. Dr. J. Thompson, who made the post-mortem, said that he had never come across a case of nicotine poisoning, and he believed it was mythical. A smoker who smoked excessively got nicotine poisoning, in the sense that it interfered with his digestion, upset his liver, and made him ill. He believed in the present case there was not the slightest doubt that excessive smoking produced depression of the heart, which acted fatally on a heart already diseased. The jury returned a verdict of "death from natural causes."

This is certainly a very sad ending to the life of an educated man, brought up and living in a Christian land.

The habit was first acquired by the natural tendency of the boy to imitate men: perhaps he imitated his father, his school master, his clergyman, or his doctor. When the habit had become strong and the ill effects were visible, he was warned by a medical man that he was killing himself.

The warning came too late. The habit was too strong. The habit, which was at first a silken thread, had become a chain of iron, too strong to be thrown off. The man's will was overpowered by the fatal narcotic. He lived with a mill-stone around his neck. Day by day the fatal poison was indulged in—the poisoned heart at length gave way while he was travelling. Had he died in bed, there would probably have been no inquest. May this case be a warning to men, and teach them that Nature must suffer when man presumes to introduce a narcotic poison into his system. Who will venture to say how many lives are being spoiled in Christian England in our own day?

Everyone who reads the newspaper must notice that a larger proportion of men than women die of sudden heart failure. If the majority of women lived easy and comfortable lives compared with the men, we should explain their comparative freedom from sudden heart failure to that fact, viz., less liability to exertion and over-work. But the fact is that women in these days are not only called upon to endure the risks of motherhood, but are often required to be "bread winners." Their lives are arduous beyond those of men, but they are less liable to sudden death from heart failure. There can be no doubt that disorders of the heart, often ending in sudden failure and death, are more common among men who smoke than among those who do not. Therefore, sudden deaths from heart failure are more common among men than women.

IT is obvious that our habits should be regulated by the light of our medical knowledge. We should not "follow a multitude to do evil" [Proverbs]. When we see our fellow creatures being led astray into evil habits we should point out their errors and urge them to follow the better way. [Leviticus]. Are not these words addressed to all Christians, high and low, learned and unlearned?

I ask if it is honourable for the members of the British Medical Association to be silent on the dangers of the tobacco habit? If all the diseases which result from tobacco were clearly recognized and diagnosed as dependent on tobacco there would be a mass of evidence that would stagger humanity.

I am writing from the experience I have gained as a general practitioner. We have drifted into a terrible abyss of mental and bodily diseases; health and peace of mind are being lost to an ever increasing number of people, while the returns of the Registrar-General bear witness to an ever increasing

I have set myself a gigantic task, to enquire into the effects of tobacco smoking, and I will prove that the wives of heavy smokers do not produce as many healthy children as the wives of non-smokers; and also that male children are becoming actually fewer than female children among the wives of smokers. It is common both in hospital and in private practice to meet with patients suffering from a complication of diseases, and it is of no use trying to ascertain whether such illness is due chiefly to alcohol or tobaco.

In order to study the pathology of the tobacco habit in relation to the functions of generation, it is necessary to take notes of the conditions of smokers, and their wives and children at every age, regarding their moral, mental, and physical states. The information thus obtained would be of no value, except it could be compared with a healthy standard. Such a standard can be secured by taking notes concerning the moral, mental, and physical states of married men at all ages, who are healthy in all respects, and live under similar sanitary conditions and are of the same social state as the others, but differ from them in being non-smokers.

We shall never be able to recognize the causes of disease until we take a census on a scientific plan. My method of taking a complete history of a married couple will be explained in chapters 10 and 11. I separated the histories of smokers from the of non-smokers, and I was then able to prove that the wives of smokers suffered from a high degree of sterility, and from a larger number of abortions and other defects than the wives of non-smokers. Who can trace the remote effects of the tobacco habit on the system of a man who commences smoking at the period of puberty or soon after, and continues it through the whole of his married life to his death? Such knowledge can only be gained by the family doctor who attends the wife in all her confinements, and watches the growth of all the children to maturity.

Every branch of medical science must be founded on carefully recorded observations, conducted by competent observers for a long period, and must include sufficient cases illustrating similar facts, in order to draw safe conclusions. It is necessary that the social state and

I have collected the following histories in the course of my visits to my patients. They are all taken concerning mothers past the age of child-bearing, with two exceptions. In such an enquiry it is desirable, when possible, to ascertain the average quantity of tobacco used by each man. There are a few men who smoke a pipe only when opening a foul drain, who do not use more than one or two ounces a year, and there are others who only smoke on rare occasions to appear sociable. Such moderate use of tobacco cannot injure the blood permanently, and therefore I class them with the non-smokers.

I have classified my cases under the following heads:—

Class 1. Non-smokers.

Class 2. Smokers.

All the cases in classes 1 and 2 are among my patients. They are masons, painters, carpenters, plumbers, gardeners, ex-soldiers and sailors, cab drivers agents, small shop-keepers, builders, labourers, etc. I have not selected my cases, or tried to prove that non-smokers never meet with sickness, and are always fertile, and that all the diseases in the world are the result of tobacco smoking. My sole aim is to find the truth, and to dispel the illusion that smoking is a harmless pastime and a gentlemanly accomplishment.

I have since learnt that one man, Case 13 in Class 1, was at one time of his life an habitual smoker, and some of Class 1 were probably the sons of smokers, while some of the wives of the same class were the daughters of

Therefore I regard my thirty-eight cases of non-smokers as below a stanard of perfection, but still the best that can be obtained in an age when the smoking habit is nearly universal. It is, however, many degrees better than Class 2.

I wish the reader to observe that the environment and occupations of my people are good and healthy, most of them are in the open air all day.

I will now invite the reader to study the thirty-eight histories of non-smokers' families:—

CASE 1.—A. C. is a man who may be classed as a non-smoker; he rarely touches alcohol; is now 59, and looks healthy and robust; has often been employed opening defective drains, and has never suffered illness therefrom; nor has he been laid up with sickness for a singJe day since his marriage; his father was a sailor and a non-smoker. A. C. married at 22 a healthy woman, aged 21, who was a native of Dartmoor; her mother died of asthma at 85. When the wife was pregnant with her fifth child, she was obliged to go out as a charwoman, as her husband was out of work; she continued to work up to within three days of her confinement. She bore the following children:

• 1. Girl, living and married, aged 35.

• 2. Girl,      "               "

• 3. Boy, in the Navy.

• 4. Boy, now living.

• 5. Girl, now married, and has one son.

• 6. Girl, living and healthy.

• 7. Girl,     "               "

• 8. Girl,     "               "      aged 18.

These eight children were born within seventeen years, they were all fed at the breast, and they are all living and healthy. The mother had no miscarriages, no abscesses, and no illnesses connected with her confinements; no twins. The children were all devoted to their home. Mrs. C. died at 56 from asthma and bronchitis, brought on by hard work, and by nursing a sick daughter day and night. She was a good woman, and was my patient in her last illness. This may be reckoned as a first-class family history, as each confinement ran a normal course from beginning to end, and all the children grew up healthy in all respects, morally and physically.

CASE 2.—This is a remarkable history for the regular alternate births of boys and girls, all of whom are now living and healthy but one, who died. N. is a cab-driver; his father and mother are living and healthy; he has had no illness; he is a good husband and father; an abstainer from alcohol and tobacco, and is 52 years of age; his wife is a fine healthy woman, and is 47, but her family history is not good; her father was a heavy drinker and smoker, and was removed to an asylum, where he died; her mother died at 61 of cancer of the œsophagus, or stomach. Mrs. N. learnt dress-making in London, at the age of 13. At the age of 17 she was admitted to St. George's Hospital for gastric ulcer; she was married in Torquay, in December, 1883, at the age of 21; her husband was 25; she has had a happy married life, and enjoyed good health; Her husband had small wages, but he managed to provide a doctor for his wife in most of her confinements. Their family is as follows:

• 1. Girl, born 3rd October, 1885.

• 2. Boy, born 3rd November, 1887.

• 3. Girl, born 16th November, 1889.

• 4. Boy, born 26th October, 1891. Died at 13 months.

• 5. Girl, born 22nd December, 1893.

• 6. Boy, born 28th May, 1896.

• 7. Girl, born 10th May, 1898.

• 8. Boy, born 29th October, 1900.

• 9. Girl, born 8th September, 1903.

• 10. Boy, born 7th January, 1906.

She was attended by a midwife in her third confinement,

(pp 86-89)

• 6. Boy, born two years after the last; he died of meningitis at 6 years.

• 7. Boy, born two and a half years after the last.

• 8. Boy, born two years and nine months after the last.

• 9. Boy, born three years after the last.

The mother was 42 when the last child was born; all the children were breast fed. Total: eight boys (one died forty-eight hours from birth), one girl living.

One miscarriage; no abscess of breast. She was careful not to strain herself in her third and following conceptions, and she went to the full time. All the children had measles and whooping cough and made good recoveries. The mother is now 53, and has recently recovered from acute tuberculosis of the lungs, leaving a vomica. She is now able to walk a mile, and is almost free from cough. This proves she has a great amount of vitality; her father is a non-smoker, and is now 80; her mother died at 77. It is certain she inherited a strong nature, and has treated herself wisely; she has worked hard to earn money by dressmaking; she is very thin. This family is a credit to the parents, who are intelligent and thrifty.

CASE 9.—F. is a non-smoker, age 70, never used tobacco, and has not tasted alcohol for 28 years; he served 15 years in the Navy; his father was a very active man, and worked hard up to a few weeks before his death at the age of 77. By his first wife he had ten children, five boys and five girls, no miscarriages. One girl died at 2 years. Seven children are married and doing well. One son is a Baptist minister, and one is an officer in the Salvation Army; his wife died of internal inflammation at 42. By his second wife he had two children, both boys.

CASE 10.—I obtained the following history from the widow, who is between 50 and 60; her fathher died suddenly at the age of 60; his wife bore five sons and five daughters. Mrs. Q. was married at the age of 23; her husband was 25; he was a ganger on the railway. At the age of 45 he suffered from giddiness; he consulted his doctor, who advised him to smoke [Ed. Note: malpractice]. He had never smoked before, but he acted on the advice. Each pipe he smoked caused nausea and perspiration; he continued at his work. One day as he was returning home from work, he fell down

• 1. Boy, was a strong babe.

• 2. Boy          "          "

• 3. Girl          "          "

• 4. Boy          "          "

• 5. Boy          "          "

• 6. Boy          "          "

• 7. Boy          "          "

• 8. Girl          "          "

They are all living. She had no miscarriages.

CASE 11.—The husband is a good-tempered man, with a fresh colour and rather stout; his wife has borne the following children:

• 1. Boy.

• 2. Boy.

• 3. Girl.
  She then ceased bearing for seven years.

• 4. Boy.

• 5. Boy.

• 6. Boy.

They all had measles and whooping-cough; they are above the average in weight and height; all were breast-fed. Between the third and fourth children she miscarried from the effects of a strain; all living and healthy.

CASE 12.—Mrs. C. has brought up eleven children; one died at 18 of acute tuberculosis; the others are healthy; five sons and six daughters. The husband gave up smoking just before the birth of the first child; in order that he might be a good example to his family he has never smoked since, and has been a total abstainer from alcohol for twenty-eight years. I know one daughter and one son; they are tall, healthy, and above the average in intellect and physique.

CASE 13.—Part life non-smoker. The husband is a gardener, the son of a heavy smoker; his usual beverage is a glass of beer at dinner; his wife is fat and good-tempered. She has borne the following children:

• 1. Boy.

• 2. Boy, became a soldier.

(pp 92-101)

CASE 1.—Mrs. P. is a thin, wiry widow about 60; her father died of phthisis six months after her birth; she married at the age of 19; her husband was a few years older; he was often out of work for long periods; she suffered many hardships and did rough work when able; her husband did not smoke till he was 25, and began the habit at a doctor's advice. She bore the following children:

• 1. Boy, born December, 1862, died of phthisis at 30.

• 2. Girl     "             "       1864, married a healthy man; she had two sons, one died of phthisis.

• 3. Boy, born July, 1866.

• 4. Girl      "    March 1869, married, has two tuberculous children.

• 5. Boy, born May, 1871.

• 6. Girl,     "    "    1873

• 7. Boy,     "    "    1875.

• 8. Boy       "   July, 1877, became insane at 25.

• 9. Girl       "   May, 1879.

• 10. Girl      "  July, 1884.

• 11. }Twins, Boy, born March 1886, died at birth from injury.
  
• 12. } Boy, became cigarette smoker; now 21, suffering from incipient phthisis.

The daughters are anæmic; their father died of decline at 63; he was a sober, steady man. The wife suffered from an abscess of left breast when suckling her third child. When pregnant with her seventh child and near her term, an abscess formed in right breast. The paternal grandfather of these children was a heavy drinker and died of alcoholism. He probably transmitted a feeble constitution to his son, who begat twelve delicate children and died of decline at 63. One grandson died recently of phthisis, which he inherited from his mother; two other grandchildren by the fourth daughter also show tuberculous disease in the glands. The children in this list inherited an alcoholic taint from the grandfather, and a tobacco taint from the father; fortunately, they had good blood from the mother, who was in all respects a good mother; she had easy confinements.

CASE 2.—Mrs. U. is a large woman of calm temper; she married at 22 and is now 50; her husband is 51; he smoked an ounce of tobacco daily for many years; was never "a drinker." She suffered much in her first pregnancy; her feet and legs were swollen; she bore the following children:

• 1. } Twin boys, still-born,
  
• 2. } one a foot presentation.

• 3. Boy, tedious confinement, instruments used.

• 4. Boy, died of fits at end of first year.

• 5. Girl, now living, placenta adherent; metritis followed.

• 6. Boy, now living.

• 7. Girl,    "      "

• 8. Girl, anæmic.

• 9. Boy, still-born.

• 10. Girl, now living.

All children were breast-fed the full time. The mother has been almost "teetotal" and enjoyed good health before marriage. The father has been steady and sober, though not teetotal. Many years ago he got an inflamed wound on his leg from the pressure of his boot, he neglected to secure medical aid and the wound became so deep that it was necessary to amputate the leg. At the age of 46 he became blind in both eyes from cataract; he underwent operation. The wife has been in a feeble state of body

CASE 3.—The father is sober and industrious; he looks haggard and care-worn; he is a heavy smoker; he works in a bakehouse; his wife is a good-tempered, active little woman, who does not take alcohol; she has borne the following:

• 1. Girl.

• 2. Boy, suffered from partial infantile paralysis in one leg.

• 3. Boy, died under 5 years of "consumptive bowels."

• 4. Girl.

• 5. Boy.

• 6. Girl, died of measles at

• 7. Girl.

• 8. Boy.

• 9. Boy.

• 10. Girl, died of measles at 15th month.

• 11. Boy.

• 12. Girl, died of diphtheria.

The mother is healthy and strong; she never miscarried; no abscess of breast. The youngest boy has a weak heart and is anæmic. The high mortality of the children is evidence of feeble vitality.

CASE 4.—The husband is about 54; an hotel bus conductor; he looks as if he indulged freely in beer; he smokes in his home every night in his wife's company; his wife is 48; they have been married 26 years. Her first conception ended in a miscarriage at the second month,

(pp 106-115)

4. Girl, who was born in 1904.

5. Boy, horn in 1909.

Mrs. Y. inherits a neurotic taint from her grandfather and from her father, who was a heavy smoker and also an abuser of alcohol; she is strictly temperate.

Case 20.—The father is 40; has been leading a healthy open-air life for many years; he is pale and rather fat; he often suffers from pharyngitis, the result of tobacco smoke; he is a life-long abstainer from alcohol. He began to smoke tobacco at the age of 30 at the advice of his doctor; in the course of time he consumed as much as an ounce a day. At the time of his marriage he was 21 and his wife 22. They had five children within twelve years:

Case 21.—B. was a labourer who married a healthy woman, age 19; he smoked heavily. His wife bore the following children:

She had easy confinements, and no miscarriage; she

I have attended three members of this family for fatal illnesses, and know the constitutions of the children, and that of their mother; she is still a healthy woman, well nourished, and good tempered. It appears to me that the three children last born had less vigour than the first seven, as the father's health at the time of impregnation was in a feeble state, the result of many years' indulgence in tobacco. The first seven children were strong, and survived the period of puberty.

This case is an instructive one, because it shows that the sons inherited a craving for tobacco; they all took to smoking early; one died of phthisis at 23, and another died of atrophy and anaemia at 25 (vide Case 8, chapter 9, page 73).

Case 22.—Mrs. 8., a good-tempered, broad-chested fat woman, over 50; was born on Dartmoor and brought up to country life; her father was a non-smoker, lived to 70; her mother lived to 90. Mrs. S. married at 26 to a plasterer, age 31; he smoked a lot, two ounces or more a week; he was not a strong man; he had a weak heart and died at 50. She bore the following children:

1. Boy, now living and healthy.

2. Boy, killed by an accident at 6 years while at play.

3. Boy, got cold and died of consumptive bowels at 6.

4. Boy, now living, but not robust.

5. Girl,	now healthy.	}
		}
6. Girl	"	} All were breast-fed.
		}
7. Girl	"	}

She had two miscarriages; she thinks these were caused by lifting heavy weights; she had to go out to work when her husband was ill.

Case 23.—Mrs. F. is an active, healthy widow, about 60; she was married at 21; her husband was a coachman; he used to smoke a pipe regularly; he died of cancer of the mouth at 52; she bore the following children:

1. Boy, became a coachman.

2. Girl, living and healthy (married).

3. Girl, died of scarlet fever over 5 years.

4. Boy, died of scarlet fever under 5 years.

(pp 118-135)

In this chapter I shall review and compare the two Abstracts based on the complete genealogical histories of thirty-eight fathers non-smokers, and fifty-seven fathers smokers. I will then offer my opinion as to the cause, or causes, of the defects in Class 2 when compared with Class 1.

The average number of children to each family is over 7. The usual way of expressing the ratio of the sexes in official reports of birth-rates is to show the number of males born to every 1,000 females born.

The ratio in this [Ed. Note: non-smoker] Class is 1,137 M. to 1,000 F. at birth. This Class shows a high degree of fertility and a good proportion of male and female infants.

The defects of the birth-rates among smokers are most perplexing when they are thus revealed. We find the wives of smokers were unable to produce as many male infants as the wives of non-smokers, but by some law which we cannot explain, they were unduly fertile in female births. The inability to produce a normal number of males is a serious defect, and constitutes a measure of sterility affecting the male sex; but the evil is intensified, being associated with an actually abnormal number of females. This deficiency of male infants is accurately represented thus: for every 1,000 females born, there were only 870 males; compare this with Class 1, 1,137 M. to 1,000 F.

Everyone will admit that this is an abnormal ratio of the sexs and constitutes a morbid state. It is highly desirable, if possible, to learn whether the defect originates in the fathers or in the mothers.

I can confidently state that there was no difference whatever in the physical or mental condition of the mothers of Class 2, from those in Class 1; they are of the same race; they lived in the same town, under the same conditions; subject to the same privations and accidents, and derived their food and drink from the same sources; they were, in all respects, as healthy as those in Class 1 before marriage. If the defect did not arise among the mothers, it must have arisen among the fathers. The fathers in Class 2 are of the same race and were in all conditions, like those of Class 1, except one; they smoked tobacco habitually, some indeed of them using an ounce a day.

These defects cannot be attributed to chance or local peculiarities, to idiocyncrasy or consanguinity, for the marriage customs are similar in both Classes. I have taken great care in preparing my Tables, and I feel convinced that there was an initial poisoning of the ova of Class 2, which so acted as to cause an inversion of the ratio of sexes at birth, leading to an excess of female over male births.

I have discovered that the families in which the excess of females is highest belonged generally to the heaviest smokers. This series of cases points to the existence of a [Ed. Note: natural] law, that the wives of heavy smokers cannot produce a

When an ovum is fertilized, conception or impregnation occurs. It is possible to calculate the total number of impregnations in each Class by first taking the number of live-born children in each Class, and adding all the miscarriages and still-born infants together; the aggregate will show the total number of conceptions, and the proportion of fœtuses which died before reaching maturity.

This Table shows that the wives of the smokers had 185 more conceptions than the wives of the non-smokers, but that owing to a higher rate of mortality in the fœtuses, they had a lower birth rate of mature infants, the deficiency being 509 infants. If virility is defined as as the power of procreating children, then this Table clearly indicates that the men in Class 2 possessed less virility than Class 1. The number of live-born children is regarded as the proof of virility. Class 1 had the higher birth-rate, therefore it is correct to assume [Ed. Note: conclude] that the class of smokers had lost some degree of virility.

This Table clearly shows that the low birth-rate among the wives of the smokers was not due to want of fertility among the wives, as they had a larger number of conceptions than the wives of the non-smokers.

In order to avoid confusion, I will define these terms. I have adopted the terms as they are used in "Playfair's Book on Midwifery." He [W. S. Playfair (1836-1903)] used the terms miscarriage and abortion as synonymous. He wrote as follows:

I find it impossible to follow this rule with absolute accuracy in taking histories, because women always calculate the stages of pregnancy by months and not by weeks. A woman usually remembers the month at which she has miscarried, and my histories usually give the period by months. A woman will know whether she has lost a child at the sixth or seventh month, but she will probably describe the loss in both cases as miscarriage, though the latter, according to [Playfair's] classification, should be termed a premature birth.

In the case of dead-born infants, it is of no consequence from my point of view, whether the death occurred at the sixth month or the seventh month. In the former case, it should be classed as an abortion, and in the latter as a still-born male or female. The distinction between the two classes is abitrary, and only adopted for purposes of classification. I shall now drop the use of the word miscarriage and keep to the word abortion.

The number of abortions which occur in the general population [Ed Note: meaning, England, 1912] can never be reckoned. No record is kept in this country of abortions or still-born infants. The latter are officially recorded in France and many other countries. Some interesting facts may be obtained by a comparison of the number of abortions and dead-born children among the wives of the non-smokers and smokers.

As there is no object to be gained by discussing the causes of abortion and still-birth separately, I shall include both in one Table, and discuss the causes of both in one enquiry.

Table 7 proves that the wives of the non-smokers had a loss of fœtal lives equal to a rate of 604 in 1,000 wives; and that the wives of smokers had a loss of fœtal lives equal to a rate of 1,298 in 1,000 wives. How can the excess among the latter be explained?

The wives in Class 2 were as healthy as those in Class 1 before marriage; they were on a par with the wives in Class 1, in all respects but one; they were exposed to the poison of tobacco, directly and indirectly, being the wives of smokers. Non of the husbands in Class 2 were in any respects inferior to those in Glass 1, except as a consequence of indulgence in tobacco.

The Medical and also the Lay reader may perhaps be astonished that I should attribute the great excess of fœtal mortality in Class 2 as the direct consequence of the action of tobacco on the developing ovum; this excess is so very large that it indicates a very large amount of poison in this Class 2. We can only speculate as to the

There is no reason to consider that the fœtal losses in Class 1 are above the average among a class of non-smokers. My knowledge of husbands in Class 1 enables me to exclude syphilis, tubercle, alcohol, and lead-poisoning as possible factors. As they were, in all respects, healthy men, I do not consider any of these losses as due to paternal defects; I am, therefore, bound to consider all the fœtal losses in Class 1 as due to causes affecting the mothers; I can exclude syphilis, alcohol, tubercle, and lead-poisoning as possible factors among the mothers; thus leaving a large class of well-known causes as factors, such as incidental illness, exhaustion from overwork, want of food, prolonged lactation, anxiety, grief or mental emotion, and lastly, excessive coitus.

I have thus explained the various possuble causes of the loss of fœtal lives among the wives of non-smokers. If in Class 1 maternal influences, such as I have indicated, caused a loss of 604 fœtal lives, it is reasonable to assume that similar maternal influences might also cause a similar fœtal death-rate among the wives of smokers.

If then I assume that the wives of Class 2 were responsible for the deaths of 604 fœtuses, and no more, I must assume that the fathers were responsible for the balance or excess, viz., 694. This calculation may appear to be speculative, but it is not really so. The father must protect the wife as far as he can from all anxiety and privation, and he must provide good food and an abundance of pure air; he must protect her from exposure to sewer gas, from all poisonous vapours, and especially from an atmosphere of tobacco smoke; he should also abstain from smoking, lest the emanations from his body should poison the air of the bedroom, or lest his perspiration should be absorbed by his wife.

When it can be proved that the father was in perfect health, and that his blood was free from any trace of organic or inorganic poison at the time of impregnation, then it follows that any disease conveyed to the fœtus must have been transmitted through maternal blood.

If the mother becomes ill after impregnation, from infectious disease such as measles, scarlet fever, enteric fever, etc., the disease is transmitted to the ovum, and it is aborted. The growth of the ovum from the time of impregnation to its separation from the womb is entirely dependent on the mother. If the mother has not sufficient oxygen in her blood for the requirement of the fœtus, it will be asphyxiated. If convulsive movements occur in the fœtus from this cause, they might set up reflex uterine action, and bring on premature labour. Nature might be able to save the child's life if labour were rapid. The need for oxygen must be ever increasing with the growth of the fœtus; and if the fœtus should absorb nicotine with the oxygen, and this should accumulate in its blood, chronic poisoning of the fœtus would take place.

How are we to account for the great difference in the fœtal mortally of the two classes? Are we to assume that the wives of Class 2 were more exposed to illness, privation, and accident than those of Class 1? Certainly not!

In all fairness, the mothers of Class 2 can only be credited with the same number of losses as the wives in Class 1, because they were subject to the same risks, and were on a par with them in all respects but one—the women in Class 2 were the wives of smokers, and therefore I state my conviction, that the tobacco poison must be credited with the number of fœtal deaths in Class 2, beyond those in Class 1.

I need not pause now to enquire as to the channels by which the poison can be conveyed, it may be

• by initial intoxication of ovum,

• through fertilisation by means of poisonous semen, or it may be

• by intoxication of embryo by tobacco conveyed in the maternal blood.

My theory with regard to the danger of pregnant women being poisoned with tobacco may be scoffed at, but we are here dealing with facts; and there is no denying this fact, that the wives of the smokers had twice as many dead fœtuses as the wives of the non-smokers.

It would be useless to speculate whether the ova we are discussing were poisoned by the spermatozoa, or at a later stage of development by the presence of nicotine in the mother's blood; the fact has been proved that the wives

Table 8 shows the excess of abortions over still-births in both Classes per 1,000 wives:

Table 9 shows the per-centage of abortions and still-births in both classes for every 100 live-births:

The object of preparing this Table is to show the excess of abortions in Class 2 above the still-births in the same Class. What is the cause of the abortions in Class 2 being nearly three times more than those in Class 1? I consider that more than half of the abortions in Class 2 occurred in the first three months of pregnancy and were due to a diseased condition of the ovum or its coverings, caused by the poison of nicotine and want of oxygen.

These tables will furnish an indication of the relative strength and resisting power to disease, inherent in the children of the two classes. These tables show the number of children who died in the first four years of life.

I have prepared the following tables for the purposes of comparison:

These Tables show a higher mortality among the children of the smokers in both sexes. It will be observed that the mortality is higher among males than females in Class 1. The ratio may be represented thus.

Table showing the aggregate mortality of the two Classes:

These Tables cannot be compared with those of "Infantile Mortality," which only include the first twelve months of life.

The histories show that the wives of the smokers had more difficulties and complications from faulty presentation than the wives of non-smokers. The development of the human ovum is the most delicate and wonderful of all the works of nature, and it is in this function where the evil results of the tobacco habit are most in evidence. The faintest trace of syphilitic poison in the seed of the male is enough to cause the early death of the ovum.

The poison of nicotine is so intense that a faint trace of it in the semen is enough to cause the death of the ovum at an early period, but if the fœtus survives and is ready to be born, it undergoes special risks at birth. Philologists have performed experiments on animals, and they have proved that nicotine, when applied to ends of nerves connected with uterus, causes the uterus to contract violently and remain in a state of spasm for a long period.

I believe that nicotine in the blood of a woman in the time of her confinement may cause irregular contraction of the os, or what is known as hour glass contraction, which causes great difficulty, and often requires the use of instruments and of chloroform [anesthetic] to relax the spasm.

I have prepared an abstract to show the number of abnormal or difficult confinements in every 1,000 confinements.

I will now compare the cases of abscess of the breast in the two classes.

There were only three cases among the wives of 38 non-smokers; there were 15 among the wives of 57 smokers. The former class is equal to a rate of 80 per 1,000 wives, and the latter is equal to a rate of 263 per 1,000 wives.

These abcesses were a serious hindrance to lactation; about 5 per cent. occurred during pregnancy, while 95 per cent. occurred during lactation. The Table shows that the wives of non-smokers are liable to abscess at the rate of 80 in 1,000 women who are suckling. The causes are various, such as infection from an abrasion of the nipple, constitutional illness, injury or exposure to cold; women freely run out of door partly uncovered and get a chill that leads to abscess. If these natural causes account for 80 per 1,000 in Class 1, how do we account for Class 2 having a rate of 263 per 1,000 wives?

It appears reasonable to assume that the wives in both Classes ran equal risks in all respects from the causes I have mentioned, but the wives in Class 2 ran the risk of inhaling the poison of tobacco in the atmosphere, and the risk of absorbing it by the use of dirty towels or by washing their husband's dirty linen, etc.

The causes of abscess in the two Classes may be tabulated thus

It is well-known that a man who suffers from constitutional syphilis, usually transmits the disease to the embryo, the poison being conveyed in the spermatozoa. Diseased ova are frequently aborted. Those which grow to maturity show signs of disease at birth. It is also known that men whose blood is poisoned, either by alcohol or lead, transmit a taint or defect to each embryo; these poisons may lead to the death of the embryo, causing abortion. If the embryo survive and is born alive, it will be feeble and perhaps diseased. I have carefully excluded all poisonous agents in these cases except tobacco, and therefore it is my duty to declare that I honestly believe my histories prove a serious amount of disease affecting the generative functions of the married people in the class of smokers from poison in the seed of the males.

I will try to illustrate my line of reasoning by a parable from Nature.

If a farmer has two kinds of wheat, and sows them separately in the same kind of soil and on the same day, he will expect both crops to be equally good, if he believes both kinds of seed are equally good, but if one crop is good and the other bad, he will be certain that the bad crop was the product of bad seed. He cannot attribute the defect to bad soil or bad weather, because he has evidence in the good crop that the soil and weather were favourable, therefore he can trace the cause of the failure to the bad quality of the seed.

I have followed this line of argument in tracing the causes of the excess of defects in Class 2 when compared with Class 1, and have traced the source of the evil to the tobacco poison in the seed of the fathers.

If we assume that the children of smokers and non-smokers have equal vitality at birth, we should expect them to have an equal death-rate in the first four years of existence, but we find a marked difference; the mortality rate in 1,000 children of non-smokers was 153, and that

In the seventh section of Table X., dealing with the mortality rates of the live-born infants, I have shown that the death-rate among the male children of non-smokers was higher than that of female children of the same Class. This proves a less amount of vitality among sons than daughters; this is not limited to the two Classes I am dealing with, it is characteristic of the whole population, with, perhaps, a few exceptions. I regret to note this weakness among the sons of non-smokers.

I cannot believe that the Creator originally created males of inferior physique to females. Then this weakness has been acquired by our male ancestors' habits, and I presume that the forefathers of the Class of non-smokers had indulged in tobacco, and so transmitted the defect among the male line more strongly than along the female line.

All the Abstracts of smokers clearly prove that males suffer to a greater extent than females.

The record and defects in Class 2 show clearly that there is some poison at work that is not present in Class 1. I invite inquiry and discussion, for I do not consider myself infallible, but these records will, I hope, stimulate other practitioners to take family histories on similar lines, and publish their results. Science is ever seeking for truth in all that concerns the comfort and health of the human race.

It is an axiom that "health is the first wealth," and I sadly fear that in the hurry of modern times, health

IT is unsatisfactory to investigate cases in which the husbands have indulged in both alcohol and tobacco, unless accurate information can be supplied as to the exact amount of tobacco and alcohol consumed by each. I regret I have not a larger series of Cases of this Class, and I offer these as a small contribution to an important subject, hoping I shall induce others to pursue the subject.

It is an interesting question to ascertain whether chewing of tobacco is quite so harmful as smoking. The chewer does not produce carbon monoxide gas, and therefore he escapes one deadly product which assails the smoker. Case 10 is that of a man who chewed for many years and never smoked.

CASE 1.—This is the family of a man who was only a moderate smoker, and indulged in alcbhol to excess occasionally.

• 1. Boy, healthy, died of fever abroad.

• 2. Boy, living.

• 3. Boy.

• 4. Girl, living.

• 5. Boy,    "

• 6. Boy,    "

• After an interval of nine years she bore:

  7. Girl.

(pp 154-159)

There were 9 still-born children to 10 wives, equal to a rate of 900 to 1,000 wives (or 118 to 1,000 live-born). This compares badly with Class 1 with 210, and Class 2 with 263 still-born to 1,000 wives.

Abortions: there were 6, equal to 600 in 1,000 wives (or 79 to 1,000 live-born). Compare this with Class 1, 391, and Class 2, 1,035 abortions to 1,000 wives.

The worst feature in this Class is the large number of still-born infants, being three times more than in Class 2, one woman having seven in succession at the seventh month. These latter may have been cases of premature birth, partly due to asphyxia of the fœtus, and partly to nervous influences acting on the mother and promoting general irritability of the nervous system.

The number of abortions is slightly above Class 1, but not nearly so bad as Class 2. While the number of conceptions is higher than in either Class, thus:

Class 3 had the largest number of conceptions, the largest number of fcetal losses, and the largest number of living children. The chief point of interest in this Class is that the male infants are in good proportion to the females, though not to the same degree of excess as in Class 1. It is possible that the alcohol used by these men helped to eliminate the nicotine and other products from their bodies, and was an antidote. Anyhow they showed no sterility, and had a normal excess of male infants.

In attempting to collect further records of children born to non-smokers and smokers fqr the purposes of comparison, I frankly confess that I have chosen the best of the former, and the worst of the latter, consequently the contrast between the two series is great.

The cases of non-smokers, which I have collected and arranged in this Chapter, belong chiefly to the past generation. I had no opportunity of getting information as to abortions or still-births, or other details.

I have been able to trace the histories of some families through three generations; and thus I have proved that the healthiest young people are those who have non-smoking ancestors; they have good eyesight, well-shaped jaws, well-balanced minds, and are well developed.

Case 3.—William B. was born of industrious and healthy parents; he grew up an honest man of great ability and established a large business; he had great energy of mind and body and was of a strong constitution; he never smoked; he amassed a fortune and was truly liberal; he was three times Mayor of Chester; he had

Case 7.—The Rev. Jeremiah Scholefield, born in 1764, obtained a fellowship at Trinity College, Oxford, which he resigned to get married; he then became the Rector of Barton-on-the-Heath, which he retained till his death at the age of 85; he always enjoyed good health and fulfilled his parochial duties up to his last illness; he had good teeth and a fresh colour in his old age; his wife bore four sons and fiv« daughters, who inherited their father's fine mental, moral, and physical qualities; he was never a smoker. Four daughters died at the following ages: 75, 50, 72 and 92, while the youngest daughter is now in good health and spirits and possesses a keen intellect, a good memory, good sight, and a good appetite; she is now in her 90th year; her father was 70 years old at the time of her birth.

Case 8.—Son of the latter; became a clergyman; a non-smoker; he enjoyed excellent health until he got blood poisoning, which ended fatally; he died at 68; he married a delicate lady who bore eighteen living children, eight sons and ten daughter, including three sets of twins. There were also five miscarriages and one still-born child, making a total of twenty-four pregnancies. Fourteen grew up strong and intelligent; all the sons did well. They were a happy family, though not rich; the widow is still living and has all her faculties.

Case 9.—Another son of Case 7; was Captain in the Royal Navy and was a non-smoker; his wife bore four sons and four daughters.

Case 10.—Was Vicar of a country parish, was no smoker, and used alcohol sparingly. He and his wife were healthy; she bore four sons, including twins, and one daughter. He retained all his faculties, and took Sunday duty up to the age of 90, when he died of acute bronchitis. His wife lived to 86.

CASE 11.—The eldest son of the latter became a clergyman, he was no smoker. His wife bore five sons, no daughters.

Case 12.—A twin son of Case 10, became an officer in the Royal Engineers, he is a non-smoker and almost teetotal; his wife bore seven sons and one daughter. One son died, and four entered the Army.

Cases 10, 11 and 12 had an aggregate of sixteen sons and two daughters. Such a ratio, eight to one, is an unusually high record.

Case 13.—A boy of a good Scotch family, one of a family of thirteen, born 1786. He entered the Navy at the age of 14; was first stationed in the West Indies, and next in China; afterwards he was engaged in active service for many years, and was promoted for gallantry. He was twice married but had no child; he never smoked and was strictly temperate in all things; he enjoyed good health to the age of 90, when he died of senile decay. One of his ancestors, who was twice married, had twenty children by his first wife, and nineteen by the second wife; they were jocularly spoken of as "The Thirty-nine Articles"; tradition says the father was not a smoker.

Case 14.—A gentleman, aged 86; he has never smoked; he has good eyesight. He and his wife are both healthy, and enjoy a long walk together when the weather permits; they have one son and one daughter.

Case 15.—The history of a business man who owned a paper mill in Yorkshire; he possessed good health and spirits up to the age of 80, and worked hard in his public and private duties up to that age. He was no smoker, and almost teetotal for many years; he was born in 1819, and married in 1847. His wife was five years younger; they had nine children, as follows:

• 1. Son, still-born, born July, 1848.

• 2. Daughter, born January, 1850.

• 3. Son, born September, 1851.

• 4. Daughter, born February, 1854, died 1868.

• 5. Son, born August, 1855, died aged 8 days.

• 6. Daughter, born June, 1859.

• 7. Daughter, born March, 1861.

• 8. Son, born May, 1863; he became a smoker. He died of heart-disease, aged 39. He was strictly temperate.

• 9. Son, born May, 1866.

The mother died, age 60, she was an invalid, more or less, since the birth of her last child. The father died of cerebral hæmorrhage at the age of 82.

Case 16.—F. was the second son of a merchant and freeman of the city of London. He succeeded his father in the business; was born in 1812; he never smoked tobacco, and was often heard to state that neither his father nor his grandfather smoked. He was a moderate drinker; he married at 28; his wife was then 24; she bore two sons and one daughter. F. re-married, and by his second wife had five boys and three girls: total children seven sons and four daughters. F.'s eldest son, a non-smoker, served in the Army and is now living, age 70; an active and healthy man, with good sight and no trace of baldness.

Case 17.—The record of a working-man now living in Manchester, who is a life-long abstainer from alcohol and tobacco. One of his sons gained a scholarship at Owen's College, and afterwards received a medical training at Edinburgh University, where he gained the degrees of M.B. and Ch.B. He is now stationed in India, and is occupied in Medical Mission Work.

Case 25.—A gardener, born in 1835; has never been a smoker; never had a serious illness. He is now 76 years of age; he has good eyesight; he is strong and active; a good workman, and is above the average in intellect.

Case 26.—A cab driver in Torquay for many years; a life-long abstainer from alcohol and tobacco. At the age of 57 he was in good health; height 5ft. 10 in., weight 10 stone 4 lbs.; his wife was healthy; they had four sons and no daughters. His sons took advantage of their opportunities for education and did well after leaving school. The shortest of them was 5ft. 9in., the tallest 6ft. 3in.

The wives of twenty-seven non-smokers bore 197 children, consisting of 123 males and 74 females.

The ratio of the sexes at hirth is 1,662 M. to 1,000 F. This is much higher than in Class 1. The ratio of males to females may be regarded as ideal or superlative. When both the male and female rates are normal, then the difference becomes an actual excess, and not a relative excess. If the whole population of England and Wales could produce male and female infants at these rates, the balance of the sexes might be speedily restored, and the happiness and prosperity of home life also be restored.

(pp 170-171)

Class 5 is composed of two different classes of men, those who belong to the professions forming the first 31 Cases, and working-men forming the last 20. The latter class usually marry early in life; they live active lives, and are usually in a good state of health at the time of marriage; they usually marry for love, and have fewer anxieties and responsibities than the professional men—for these reasons they have a higher fertility rate. Marriage among men in the professional class is now often deferred so the age of 30, or even later, for want of means to support a wife. I do not attribute the low rate of fertility as a direct consequence, except in the case of men who commenced their married lives, much the worse in consequence of many years indulgence in tobacco. It is quite obvious that the older the woman is at the time of marriage, the less chance there is of many children.

Table to show fertility rates:

The above Table shows that the male fertility rate reaches low water mark in the professional class, being six times lower than the working class. The relative loss of males being 83 per cent., the relative loss of females being 35 per cent.

The wives of the professional class have a relative deficiency of 4,708 infants. The great excess of females in each class, is the clearest indication that the wives of smokers cannot produce male and female infants in the natural ratio, because they cannot produce males in excess of females. The histories of the non-smokers always show an excess of males.

The serious deficiency of males in both classes is clearly proved by the following figures:

Ratio of males to females at birth

A deficiency of male births is thus clearly proved to be a common defect among the wives of smokers.

I wish to call particular attention to one peculiarity in the female fertility rate in Class 2. It is abnormally high; it is not only 473 higher than the male birth-rate of the same Class, thus causing a. relative excess of 474 female infants; but when compared with the female birth-rate of Class 1, it shows an actual excess of 219 female infants. This is a strange fact, and suggests the thought that this over-fecundity in female infants is the result of the low fecundity in male infants.

It seems as if Nature, baulked in one direction, showed her reproductive power in another direction, with the result of a large excess of female infants above the normal. It is evidence of a high degree of reproductive power in the wives of this Class, wilich was not present in the wives of Class 5. It illustrates the far-reaching effects of tampering with the laws of the Creator. See Tables II. and IV., Chapter XII.

I have now demonstrated a large excess of females in both classes of smokers, and I have shown that there is an excess of males in both classes of non-smokers.

The ratio of the sexes in these Classes can be plainly demonstrated:

Final comparison of the combined Classes of non-smokers with those of smokers in rates for 1,000 wives:

This Table proves that the rate of loss to 1,000 wives of smokers is 2,025 infants. We may assume that thesis a similar loss in every 1,000 wives of smokers in the general population. Whether the loss is the result of absolute sterility or of abortions, matters not so far as vital statistics are concerned. It means a large loss of life which might and ought to be prevented in a civilized country.

It is an axiom in physics that there can be no effect without a cause; it is also an axiom of nature that there must be a cause for every effect. For every disease there must be a cause; for every defect there must be a cause. We may start with the simple fact recorded in the book of Genesis:

No intelligent person can doubt the truth of this statement. The evidence of the harmony that exists in nature is evidence of the supernatural skill and wisdom of the Unseen Creator and Architect. Day and night succeed each other year by year, the daylight varying in length according to the season of the year.

There are some men who are so narrow-minded as to think that modern men have discovered science, and that it supplies all our needs. Science is but the revelation of the laws by which God controls all living creatures. The object of legitimate science is to help man to live in harmony with the laws of the Creator. There is always a danger of exceeding our duties in our search for knowledge, and we must never break any of God's laws in our search for knowledge. God has revealed to men of this generation many of His laws, which we call science, which were unknown to the men of the last generation. Some people of the present day seem

God has revealed many of the hidden causes of disease to the servants of Christ, and the medical art now flourishes in the foremost countries that profess Christianity. These histories reveal the awful consequences of what follows the abuse of tobacco among married men.

Thank God there are some men who are fully alive to the evils of the tobacco habit. A book has recently been written by Mr. James Pyper, M.A., Principal of Belfast Mercantile College. He asks the question, "Is tobacco smoking not suicide and murder?" These pages give a true answer, and show it is race suicide. The first recorded commandment to the human race was, "Be fruitful, and multiply, and replenish the earth."—Gen. i. 28.

God is dishonoured by self-inflicted imperfections on any of His own children, and what will He do to save the people of this land from the effects of the annual consumption of ninety million pounds of tobacco? He will not perform miracles [Ed. Note: [Deut. 6:16; Matt. 4:7; and Luke 4:12 allusion] to restore health and fertility to those who have wilfully poisoned themselves by a weed grown in foreign countries.

Not only do the smokers suffer, but their wives and children suffer to the third and fourth generations, and ultimately become extinct.

The non-smokers show a good rate of fertility, and show no signs of degeneration. The race of smokers is slowly and certainly degenerating and approaching extinction. Many observers have noticed that the girls of the present day are stronger and taller than those of the last generation, while the men are smaller and weaker.

I admit this may be true among the children of smokers, and I regard it as a result of that habit. My histories have shown that the males in Class 2 were not only fewer in number than females in that Class, but that they had less vitality, as was proved by the higher rate of mortality. Thus the male race is being exterminated at a quicker rate than the female.

It is needless to insist that the defects which have been exposed in these two Classes of smokers must also exist among the general Class of smokers according to the amount of tobacco used. These

Assuming that the proportion of fœtal losses to live-born infants in the general population is in the same ratio as in the combined Classes 1 and 2 (non-smokers and smokers), then, by taking this ratio as our standard, we can estimate the probable number of abortions and still-born infants in the whole number of births for one year. First, add the total number of live-born children in Classes 1 and 2 together, and then add together the total number of fœtal losses in these two classes, divide the former by the latter, and we ascertain that there is one fœtal loss to every seven living children. The figures on which I make my estimate are given here:

This represents a rate of one dead fœtus to seven live-born children.

The Registrar General [Ed. Note: census data] states the total number of legitimate and illegitimate children born in 1909 to be 914,472; we can now estimate the probable number of fœtal losses for this number of live births by the above ratio.

Divide the total number of births in England and Wales by 7, this gives the number of abortions as 130,638. I believe this figure is below the mark for the reason that my combined Class 1 and 2 contains a larger number of non-smokers than the general population, it must, therefore, be better and should have a lower ratio.

I find on reference to Jewett's "Practice of Obstetrics" that Hegar estimated the average to be one abortion or still-born infant in every eight or ten live-born infants; and other authorities estimated one in every five or six; I think the latter is nearer the mark. But surely the

I will now proceed to calculate the number of fœtal losses in the general population, which may be traced to general causes (independent of tobacco), and, secondly, the number of abortions entirely caused by tobacco.

I will first assume that the whole population consists entirely of non-smokers, and that the ratio of fatal losses to living infants is the same as in Class 1.

I will next assume that the whole population consists entirely of smokers, and that the ratio of fœtal losses to living infants is the same as in Class 2.

Then I will compare the two rates of fœtal losses, and the difference will represent the number of abortions and still-born infants caused by the abuse of tobacco.

In Class 1 there were twenty-three fœtal losses to 280 living infants; a ratio of one in twelve.

In Class 2 there were seventy-four fœtal losses to 391 living infants; a rate of one in five.

If the proportion of fœtal losses to the number of live-born infants in the whole population be in the same ratio as Class 1, the fœtal losses would be 76,206 to 914,472 living infants.

But, if the proportion of fœtal losses to the number of live-born infants in the whole population be in the same ratio as Class 2, the fœtal losses would be 182,894 to 914,472 living infants.

This Table is an estimate based on data, provided by my histories of the Classes 1 and 2. It shows that if the whole population of England and Wales consisted of non-smokers, the fœtal losses would be 76,206 in a year; and, secondly, it shows that if the whole population consisted of smokers the fœtal losses would be 182,894 in a year.

Is it not time that Official record should be kept of these serious losses?

We have now in theory taken a census of two Classes of people, resembling each other in all respects except that one Class abstained from tobacco, and the other Class smoked tobacco habitually.

We may now safely assume [conclude] the abortions in the former class were due to a variety of causes not associated with tobacco.

We may also assume that the latter Class was liable to a similar number of abortions as the former Class, due to general causes not associated with tobacco, while any balance or surplus in latter Class must be attributed entirely to the influence of tobacco.

The difference between the two Classes is 106,688 abortions and still-born infants.

If this large number of abortions were the only result of the abuse of tobacco, it would be a terrible proof of the evil of the habit, and ought to suffice to convince every right-minded man to regard the habit as barbarous and suicidal [murderous].

If my estimate is correct, the abstinence of tobacco for a whole year through the country would produce an increase in the births, and would raise the botal to over one million, thus [see replacement tables, page 248]:

I have clearly demonstrated by the Table in Chapter XII. that the wives of smokers are more liable to abort than

"abortion occurs most frequently in the third month. It is especially liable to take place at the menstrual periods. It is very probable that this greater frequency at this period is due to the fact that at this time important changes are taking place in the attachment between the ovum and the uterine wall. It is the period of the formation of the placenta. The chorionic villi situated on the periphery of the ovum undergo atrophy, while those situated in contact with the uterine wall (the decidua serotina) become hypertrophied."

Women usually blame themselves for abortions, because they are not aware that the abuse of tobacco on the part of the husband often leads to the early death of the ovum from atrophy of the chorionic villi, etc. Some trivial illness is then blamed for the miscarriage, and the original cause is never suspected.

Before concluding this painful inquiry I must call attention to the danger to the mother after an ordinary abortion. Local disease often originates, and, rarely, death may ensue. The average mortality in England to one million living women was stated to be:

These returns are probably below the actual number.

DR. Hurteau, physician to the factory at Paris, stated that the workers were peculiarly liable to congestions. Kortial observed that women who worked in the tobacco factories were very liable to abortions. Nicotine has been found in the amniotic fluid surrounding the fœtus. It is also affirmed that the milk of women who work in the factories has a strong smell of tobacco. Buck also states that sexual development is retarded in young girls who enter tobacco factories, while the married women have very small families, average to each from three to four. Buck, author of "Hygiene and Public Health," also stated "when persons begin to work in the tobacco factories, they almost invariably suffer from headache, nausea and vomiting; they pass sleepless nights, and are troubled with diarrhœa. These symptoms are more common in females than males, and indicate poisoning with nicotine."

The late Dr. C. R. Drysdale, of London, observed that young boys and girls who were engaged as workers in the tobacco factories in London frequently suffered in health. The employers frequently denied these ill effects.

The following account has been rendered by Dr. Kostral, Physician to the Royal tobacco factory of Iglan, near Vienna.

We may infer from these facts that pregnant women, and those who are suckling their children, should not be exposed to tobacco smoke.

At the International Congress against the abuse of tobacco, Dr. Drysdale spoke of the injury done to the heart's action by smoking, and to the frequency with which smokers and chewers become affected with blindness. The use of tobacco was very deadening to the intellect.

A Turkish Medical man, Dr. Omer Bey, observed that in Turkey: "It was not alcoholism that caused injury to health, but tobacco. It kills the individual person, the race, and enervates the country. Nicotism in my country is what alcoholism is in France, and morphinism is in eastern Asia. In Turkey, people do not drink, thanks to the abstinence enjoined by the Koran, but they smoke everywhere and for ever; it is for this reason that we may conclude that nicotism is a question more important in my native land than alcoholism."

These observations of Dr. Kostral prove that pregnant women are peculiarly liable to be poisoned by inhaling an atmosphere full of tobacco dust. He reported that the milk of those suckling their infants was poisoned with tobacco, and proved fatal to the children. He also reported that tha mothers often suffered from inflammation of the breasts.

I would call the reader's attention to the fact already mentioned in Chapter XII, that the rate of abscess of breast among 1,000 wives of non-smokers was 80, while among the wives of smokers it was 268. I have also shown that the wives of non-smokers had 394 miscarriages, and the wives of smokers 1,035 miscarriages to 1,000 wives. These facts justify me in classing tobacco among the poisons which produce abortion and abscess of the breast. The evidence of these independent observers confirms the accuracy of my conclusions deduced from my histories.

Dr. Playfair writes as follows: "Important as are the causes of abortion, arising from some morbid condition of the ovum, they are not more so than those which depend on the maternal state; and it is to be observed that the former are often indirect causes produced by primary maternal changes. Many of these maternal causes act by causing hyperæmia of the uterus, which leads to

It is my own opinion that a pregnant woman should never be exposed to the risk of inhaling or absorbing tobacco smoke, lest it should injure the fœtus. [Ed. Note: See also p 238.]

It is dangerous for a pregnant woman to be in a room where a person is smoking, or has been recently smoking. In the latter case small quantities of nicotine, which have been condensed on the walls, may still be present in the atmosphere for many hours. [Ed. Note: In fact, we now know that ambient TTS lingers longer, about two weeks.]

A French chemist has recently demonstrated that one gramme of tobacco smoked in cigarette form yielded 20 to 80 cubic centimetres of carbon monoxide gas, and in pipe form 53 to 100 cubic centimetres. This gas is a deadly poison, and is readily absorbed by the blood, forming a definite chemical compound with the hæmoglobin, which prevents the oxidation of the blood. Breathing an atmosphere containing even so little as .07 per cent. has very deleterious effects. There is also an excess of carbonic acid gas in tobacco smoke.

A woman is not always at liberty to leave a room which contains [second-hand] tobacco smoke when she feels the bad effects of the poisonous atmosphere, consequently her blood becomes highly charged with poison, and if she is pregnant the fœtus probably receives the poison into its blood.

• If the dose be small, it may retard development of the whole body, or set up disease of the brain or some general nervous disorder.

• If the dose be large it may set up convulsive movements, which may set up hæmorrhage and end in abortion.

The action of tobacco dust on the unborn infants is clearly proved by the records of Dr. Kostral. Out of 506 births which took place, 206 children died soon after birth, of which 101 died of brain disease with convulsions. Tobacco is known to be a brain poison, and it appears that the children of the mothers who work in the tobacco factories are born of feeble vitality, poisoned by tobacco. The evidence contained in my histories proves the low vitality of the children of smokers. The rate of mortality for 1,000 children of non-smokers is 153, the rate for smokers is 227. Dr. Kostral's rate of mortality is 407 to 1,000 living infants.

Dr. Etienne, of Nancy, made notes of the infants deposited at the Creche, belonging to the mothers who worked at tobacco factories. He had 98 children under observation. He classified them into five groups.

• First, came infants entirely breast-fed by the mothers who kept away from the tobacco factory, and

• secondly infants similarly reared whilst the mother continued to work there.

• The third class included infants exclusively breast-fed at first, and afterwards reared exclusively by the bottle;

• the fourth consisting of infants more irregularly reared by the mother, the bottle, and the wet nurse.

• Lastly, came the fifth class, infants brought up exclusively and from the first on the bottle.

On the other hand, as might be expected, the first class comes out best of all. Of course, in any working population, especially in factories, the child does best if the mother is allowed a holiday when she nurses it, but the extreme contrast between the mortality in the first two classes, in both of which the child was exclusively fed by the mother, plainly shows that tobacco is especially prejudicial to the infant.

The remaining Classes show rather a high mortality, but fall far below the second Class. The third, fourth, and fifth Classes include all the infants of tobacco factory women, which were fed artificially or by wet nurses, whilst the mothers returned to work; but the mortality was higher than what might be expected in artificially-reared babies in factory towns, and that mortality, we know, is very high, even in districts far from tobacco works.

In the interests of the population, a serious question in France, Dr. Etienne recommends that work women should be forbidden to suckle their children when actively employed, but should be allowed a holiday [Ed. Note: modern term, 'family leave'] of at least one month after delivery, in order to nurse their infants, since at the end of that time the latter can be reared artificially with comparative safety. Vide British Medical Journal, p. 1,094, Vol. 1, l898.

Marriage is defined as the act of uniting a man and a woman for life; it is a contract both civil and religious by which the parties engage to live together in mutual affection and fidelity till death shall separate them. It was instituted by God for the purple of preventing the promiscuous intercourse of the sexes, for promoting domestic felicity, and for securing the maintenance and education of children.

The importance of marriage cannot be over-estimated in relation to the husband and wife; marriage either makes or mars the fortunes of a man and a woman. The welfare of a nation depends on the number of good and fruitful marriages. People make a mistake if they consider the first duty of a man is to make money or gain knowledge and position. The first command from the Creator to man which has been recorded referred to marriage. "And God blessed them, and God said unto them, Be fruitful and multiply and replenish the earth and subdue it " (Genesis i.) We learn from Holy Scripture that

An essential condition for normal fertility is, that the husband and wife be in good health at the time of marriage, which means that their blood must be normal in quality and quantity, and free from any trace of poison, such as tobacco, alcohol, opium, lead, &c.

There is a tendency in modern times, among some medical men to regard the sterility of a married couple as due to a defect of the wife alone; this is obviously an error of judgment. In order that a married couple can produce a healthy child, it is absolutely necessary that the blood of both parents be in a healthy condition, and also that the organs concerned in generation be capable of performing their functions. It is also necessary that the wife should live under healthy conditions during the whole period of pregnancy; otherwise the ovum could become diseased and might die, in which case it would be thrown off.

Most married people desire to have children, and it may be regarded as a natural and healthy instinct, one that should be encouraged. We are distinctly told that marriage was ordained for the procreation of children. If a woman does not desire motherhood she has no right to become a wife, unless as an old man's companion. God uses no compulsion—there is no commandment that every man must take a wife, because such is not required. The desire to possess a wife develops natunally in most healthy men.

It is, however, most important to observe that God requires every man to use his best efforts to preserve his health, not only for man's personal happiness, but that in order, in the event of his entering the married state, he may procreate healthy, vigorous and perfect children, with healthy moral instincts. Should not every youth at the age of puberty be encouraged to live a pure and healthy life, and to maintain the purity of his blood, by living in a pure air when possible, careful in his diet, and avoiding tobacco, and all excess in alcoholic beverages? The age of puberty should be a period of preparation for matrimony in both sexes.

I do not approve of our present system of keeping men at college after they have attained the age of 21, unless they can at the same time enter matrimony. It is the

The causes of sterility and feeble fertility have been chiefly studied by two classes of medical men, those who have made a speciality of the diseases of the male organs of generation, and those who have been gynecologists or specialists in the diseases of the female organs of generation. There is a general belief that excessive smoking produces impotency in the male. A striking instance of this was recorded by Dr. Tyrrel in The Lancet, vol. I., 1857. It occurred in a newly married man; he recovered potency when he abstained from tobacco, but when he resumed smoking the impotency returned.

The following statement will be found in Curling's work on "Diseases of the Testis."