Common name: Tobacco.
Nicotiana tabacum, Linn.
Natural order: Solanaceae.
Preparation: Tincture of the leaves.
Emotional. Quiet delirium, murmuring to herself. He went to sleep in the cabin, which was full of large packages of tobacco, but was harassed by wild and frightful dreams, and suddenly awaked about midnight, bathed in a cold dew, and totally unable to speak or move. He knew, however, perfectly where he was, and recollected everything that had occurred the preceding day; he could not make any bodily effort whatever, and tried in vain to get up, or change his position. p73 The watch on deck struck four bells, and he counted them, though it seemed to him as if he did not hear the beat, but received the vibration through his body. About this time a seaman came into the cabin with a light, and carried away an hour-glass without observing the sufferer.
Shortly after a pane of glass was broken in the skylight, and he saw the fragments of glass drop on the floor. These circumstances which really occurred, are mentioned to show that Mr. H. experienced real sensations, and was not still under the influence of perturbed dreams. His inability to move was not accompanied by any pain or uneasiness, but he felt as if the principle of life had entirely departed from his frame. At length he became totally insensible, and continued so till an increase of wind made the sea a little rough, which caused the vessel to roll. The motion, he supposes, had the effect of awakening him from his trance, and he contrived somehow or other to get up and go on deck. His memory was totally lost for about a quarter of an hour; he knew that he was in a ship, but nothing more. While in this state he observed a man drawing water from the sea in buckets, and requested him to pour one on his head.
On the seaman doing so, all his faculties were immediately restored, and he acquired a most vivid recollection of a vast variety of ideas and events which appeared to have passed through his mind, and to have occupied him during the time of his supposed insensibility. By loud calling and vigorous shaking, he was aroused from his comatose condition, when he began in a high state of nervous excitement to cry, “Oh, my head! Oh, my head!” at the same time clutching his forehead with his hands, and staring wildly about him. At one time, in great trepidation, he begged that some imaginary bottles should be taken out of the room; indeed; his conduct and appearance at this time were not unlike one suffering with delirium tremens. After a time the patient changed from a state of stupor into one of wild intoxication, started up in bed with ridiculous, foolish talking, accompanied by convulsive movements and spasms of the facial muscles. Complete intoxication. Felt as if intoxicated with spirituous liquid (after one hour). Extreme agitation.
Intoxication for more than twenty-four hours. (The Mexican priests incite courage and bravery by means of an ointment of tobacco). Great joyfulness and talkativeness, as from intoxication (first day). Frequent laughter without cause. She sings the whole day (twelfth day). Joyful and lively, second and third days. She is very lively and jolly, danced about on one leg for joy, and laughs without reason nearly all day (first day). He was queer for days after, the principal symptom being weak and irritable pulse. Misanthropy. Very morose and fretful (first day). Despondency. Low spirits, want of resolution and general hypochondriasis. Gloom, hypochondria, apprehensions of sudden death. Most profound gloom, constant fear of death, yet attempting suicide. Nervous and hypochondriac. Psychical alternation and hypochondria in a high degree. Hypochondria in a high degree. Extremely hypochondriac mood (first day). Anxiety.
Anxiety and sickness (woman). Anxiety on being alone at night.
Anxiety with very depressed, melancholy thoughts while walking (third day). Uneasiness and anxiety in the afternoon, as if some misfortune would occur (tenth day). Apprehensive and insensible.
Apprehensive towards evening, several days. Apprehension and anxiety occurred several afternoon, and were relieved by weeping.
Apprehensive, faint-hearted, and despondent, with nausea; she thought she would die, which disappeared after vomiting, after dinner. Great apprehension with oppression of the chest, and a very despondent, sad mood, as if he apprehended some misfortune, preceded by inclination to vomit; relieved by weeping (first day). Apprehension, anxiety, and despondency, as if she dreaded death, at 4 P.M., two days in succession. Terrible apprehension of immediate death. Despondent, joyless mood. Discouragement.
His manner is nervous, restless, and uneasy; he looks as though he were frightened, and confesses to a feeling of anxiety without any cause for it. From having been one of the most healthy and fearless of men, he had become sick all over, and as timid as a girl; he could not even present a petition in Congress, much less say a work concerning it; though he had long been a practicing lawyer, and had served much in a legislative body. By any ordinary noise, he was startled or thrown into tremulousness, and afraid to be alone at night. During the narrative of his sufferings, his aspect approached the haggard wildness of his temperature. Evenness and mildness of temper, notwithstanding he felt very uneasy about his health. Ill humor. Irritability. He was incapacitated for business of any kind, weak, irresolute, and despondent. Completely indifferent, would not answer, immovable.
Intellectual. Indolent (first day). Disinclined to work (second day). Dread of work, etc. Psychical uneasiness. Exalted action of the brain; copious flow of ideas; during this sort of intellectual paroxysms, which often continues all night long, leaving me in the morning worn-out and sick, I would conceive and elaborate about twenty undertakings, of which probably not one would ever come to light. Mind dull. She feels dull, cannot rightly collect her thoughts (fourth day). Difficulty in concentrating his mind for any length of time on one subject.
Confusion of ideas. Understanding transiently confused. The primary effects of tobacco on my constitution exactly corresponded with the secondary effects of coffee, viz., turpitude of the cerebral functions; confusion of ideas, and lack of words to express them. She is unable to grasp an idea, something else constantly occurs to her and crowds out the former thought, with heaviness and dulness of the head, all of which disappears after vomiting, after dinner. Twenty-three manifested serious derangements of the intellectual faculties. Loss of intellectual power. Memory has failed of late. Stupefaction, etc. Profound stupor. He no longer recognized his surroundings; when spoken to he understood, but the answers he endeavored to make were only unintelligible sounds. Lost consciousness for a moment; he screamed out that smoker must go out of the room, though no one was smoking, that the fumes took away his breath, etc.; immediately afterwards he became quiet, but talked incessantly and irrationally, with open, star-ing eye, spoke of events in his past life, then returned to consciousness.
Completely dumb and insensible. Complete loss of consciousness, etc. Unconscious as if in a faint. Became senseless and unconscious, without apparent respiration. Fell unconscious to the ground. She fell to the ground unconscious, with stoppage of the respiration and scarcely perceptible pulse. Complete insensibility to pinching and sticking. Complete unconsciousness with appearance of quite sleep. The child lay in a soporous condition with the eyes half closed, with a staring look, dilated pupils, with violent trembling of the limbs, rapid respiration, violent beating of the heart and carotids, extreme thirst, profuse, sweat, and cold extremities (after twenty-four hours). Coma. The person seemed in a comatose condition for some moments, then he was roused by the pain, but uttered no complaint, but made violent automatic movements, rose, walked a few steps as if intoxicated, and threw himself upon the bed and tossed about. Profound narcotism, stupor. Fell into a comatose state and died.
Vertigo and Confusion. Head confused. Great confusion of the head. Confusion, long continued. Vertigo, etc. Excessive vertigo (after half an hour, and second and fourth days).
Vertigo and intoxication. Vertigo, with some colic. Frequent paroxysms of vertigo. Vertigo and fullness of the head.
Vertigo, with no steadiness of the body. Vertigo on motion.
Vertigo on every attempt to rise. Vertigo so that she could not rise up. Vertigo, with qualmishness in the stomach (fifth day).
Vertigo, which amounted to loss of consciousness. Vertigo, as from intoxication (first and second day). Vertigo, a turning in a circle with pressive headache in the forehead and temples.
Frequent attacks of vertigo, which caused staggering and falling, while everything seemed to turn round. Vertigo, everything about him seemed to move from right to left, or from above downward, and then the reverse. Vertigo; it seems as if the whole room were turning about in a circle, and she does not dare to rise from her seat for fear of reeling (after a quarter of an hour).
Vertigo on entering the house after walking in the open air, with nausea and inclination to eructate; the nausea increases in a warm room, so that she is obliged to go into the open air, when she vomits the food eaten at once. Dizzy and reeling (after five minutes). Dizziness and physical prostration, soon. Reeling.
Reeling in the morning after rising from bed (eleventh day). The girl walked about as if intoxicated. Slight giddiness and occasional headache at the time the eyes began to fail.
Giddiness in occiput. General Head. Head thrown back, amounting almost to opisthotonos. Slight tremulous motion of the head while reading (after a quarter of an hour). Slight trembling of the head and hands. Apoplexy. Congestions to the head.
Frequent congestions to the head and chest. Much congestion of blood and flushing of heat towards the head (first day). Heaviness of the head. Heaviness of the head on stooping (after half an hour). Feeling of heaviness in the head after dinner.
Head heavy and dull. Heaviness of the head, she could scarcely hold it up (first day). Great heaviness of the head; it constantly sinks forward (first day). Dulness and confusion of the head. Dulness of the head, with dull pressure on the root of the nose, with sensation as if the ears were stopped. Headache, etc. Headache with vertigo. Woke with headache and pressure in the vertex and temples, which lasted nearly all day (fourth day). Violent headache in the morning on moving, as if something were shaking within the head, relieved during rest (second day). Severe headache for three or four months.
Headache towards evening, as if both temples were compressed (seventh to tenth day). Headache with a feeling of slight throbbing in both temples. Pain in head and eyes. Violent headache. Whilst passing his urine, was attacked with most sudden and violent pain in head, followed immediately by vomiting; the pain was so violent he screamed for assistance.
Acute and persistent headache. Dull headache, especially in the forehead, aggravated by motion, after dinner. Violent headache, especially drawing in the left half of the forehead and through the left eye. The headache is relieved in the open air.
Compressive pains in the head, especially in the occiput (third day). Oppression of the head, as though the whole world were resting upon him, with weakness. Rising sensation like an aura about his head. Sensation of rush of blood to the head. Shocks in the head, followed by a sensation as if a rush of blood took place to the head. Roaring in the head. Complained much of head and throat, and the former was thrown back. Some deep stitches in the head, extending towards the vertex (third day). Forehead.
Contraction in the muscles of the forehead (first day).
Supraorbital headache. Frontal headache, as if the brain were compressed; the pain is aggravated by inclining the head towards the painful side. Pressive pain in the forehead. Pressive pains in the forehead or vertex. Pressive headache above the eyes (after five minutes); also, with flickering before the eyes, worse on walking (after one hour). Pressive headache about the eyes with heat of the head (after one hour). Pressive headache the whole afternoon, especially above the right eye (second day).
Sensation as if the anterior portion of the brain were pressed backward from the forehead. Dull pressive pain in the forehead and root of the nose. Dull pressive pain, deep in the frontal region. Pain in forehead. Stitches extending from the forehead to the occiput; the disappeared in the open air, but if he stood still, they returned; they ceased entirely on lying down (second day). Temples. Pressive contraction in the temples (after a quarter of an hour). Pressure in the temples lasting ten days (after four days). Alternating pressure and sticking in the temples (first day). Some pain in the temples where symptoms began. A drawing, sticking pain, extending from the left temple over the forehead towards the vertex (first day). Stitches in the left temple (after two minutes, and first and third days).
Sore stitches in the temples (second day). Vertex and Parietals.
A pressure on the vertex as if someone was pressing upon it with a board (first day). Violent pressive headache in the vertex (after three minutes and afterwards). Violent internal pressure in the vertex immediately after eating (first day). Pressive pain on the vertex, at times associated with sticking. Stitches in the vertex for ten days, frequently recurring (after four days). Pain in both sides of the head as if broken (after one and a half hours). Pain in the right parietal bone on pressing on it (first day). Pressive pain in the parietal bones in the morning on waking, which disappeared on rising (sixth day).
Pressure in the right side of the head during dinner. A sticking pain in the parietal bone, extending towards the occiput on walking rapidly (first day). Stitches in the left side of the head (fifth day). Occiput. Pressure in the occiput (fourth and fifth day). Pressive headache extending from the occiput to the temples. External Head. Much hair falls out on combing (fifth and sixth days). Burning on the head, followed by formication, loss of appetite, violent sticking in the ears, then by coldness with shivering (eighth day). Formication above the left temple (second day). Violent itching of the scalp in a room filled with tobacco-smoke.
Objective. Dark redness around the eyes. Eyes staring. Eyes fixed. Eyes turned upward. Sparkling eyes. Eyes sunken and seeming small. Eyes lost their brilliancy. Eye listless and heavy. Eye had a haggard appearance. The eyes are dejected, without brilliancy, deeply sunk in the orbit. Eyes closed.
Closure of the eyes and photophobia. Injected eyes. Eyes highly injected, cornea vascular and semi opaque. Cornea dim, covered with mucus. Redness of the cornea, with some photophobia; if she looks towards the light she is obliged to close the eyes (second day). Decided exophthalmus in consequence of the weakness of the recti muscles. The ophthalmoscope demonstrates an atopic condition of both optic nerves, the inner (apparent) half of each, seen in the reversed image, being quite white and non-vascular; the outer part being redder, and more vascular than normal. A examination of the numerous cases reported by Dr. Hutchinson reveals the following conditions common to all the cases; white or gray atrophy of the optic nerve (in a few cases the color was bluish-white), commencing at the outer part of the disk, usually with a sharply defined margin and diminishing size of retinal vessels; in a few cases there signs of congestion, and in two cases neuritis with indistinct outline of disk. In some cases the center of disk was found depressed and atrophied. It is noteworthy that the left eye became first affected and was more affected than the right in nearly every case. The vision failed suddenly in a few, rapidly in many; and in others the progress of the disease was fitful. Some complained of flashes of light, others of fog, but most simply of indistinctness of vision. As the atrophy advanced the pupils dilated and became insensible to light; and in a few cases divergence of the eyes ensued. By means of the ophthalmoscope, both optic nerves appear of brilliant white color, their areas being enlarged, and their outlines clearly defined. The fundus of each eye seems quite normal, with the exceptions of the optic discs, which appear too large, and irregularly circular, the tissue being quite of tendinous whiteness. Subjective. Tight tension and drawing, extending from the left eye down into the upper jaw (first day). The eyes are painful, as after long weeping (first day). Pain in the eyes and flickering, on looking intently at an object (second day).
Pressure in the right eye, which extended into the occiput (eighth day). Pressive sensation in the eyes, especially on moving them. Pressure in the eyes. Feeling as if a hair were in the right eye, towards evening (fourteenth day). Heat in the eyes, with lachrymation (fifth day). Burning in the eyes.
Burning in the eyes, in the evening, while reading. Some stitches in the left eye, after a few minutes. A kind of burning, with a sensation of coldness in the eye (first day).
Orbit. Numbness of orbicularis oris (frequently immediately after taking a chew of tobacco). Pressive sensation, deep in the orbits, with weakness of the eyes and vertigo. Dull pain in the base of the orbits, with redness of the eyes. Sticking above the right eye, extending from the outer margin of the eyebrow to the inner, into the orbit (first day). Some fine stitches in the upper part of the orbit (first day). The orbits are heated (first day). Lachrymation. Lachrymation. Lachrymation, on looking intently at anything (second day). Lid. Squinting, when trying to read. Twitching of the upper lid (after one hour).
Eyelids in persistent motion, half voluntary. Eyelids granular.
Contraction of the lids, with a biting pain in the eyeballs (after seven minutes). Contraction of the lids and lachrymation (first day). Spasmodic contraction of the lids and masseter muscles; inability to open the mouth. Violent itching in the inner canthus of the right eye, with burning after rubbing (after half an hour). Conjunctiva. Great injection of the conjunctiva. Conjunctiva injected. Frequent sensation of a foreign body in the conjunctiva, apparently caused by the irritating action of the smoke. Ball. Pressure in the eyeballs (after two hours). Violent digging-drawing pains in the eyeballs and temporal regions, aggravated by motion, with distended vessels and increased throbbing in them. Pupil. Pupils dilated, etc. Pupils dilated, fixed, and staring. Both pupils are rather large, but the motion of the irides are active. Both pupils rather large, and motion of the irides sluggish. Pupils considerably dilated and not influenced by light. Pupils greatly dilated. Pupils greatly dilated and insensible. Pupils unnaturally dilated, on the approach of light. Pupils fully dilated and quite insensible to the light of a candle held close to the eye (third day). Pupils irregularly dilated. Contraction of the pupils. Pupils much contracted. Pupils contracted, irresponsive to light. Pupils decidedly contracted, but slightly sensitive to light. The right pupil exceedingly contracted; the left was much larger than the usual, and had lost its circular form; both were unaffected on the approach of light. Vision.
Vision weak. Dimness before the eyes, as from mucus (first day).
Indistinct vision for some minutes (twelfth day). Objects are not seen as distinctly as usual (second day). Obscuration of vision. Eyesight affected. Slight failing for six weeks, being alike in the two eyes. Vision 16 Jager; not improved by glasses.
For an uncertain time he has noticed his sight to be gradually failing, until now it has become so imperfect that he is unable to p73 attend to his business. For a long period his sight has gradually failed, till he can only see to read, for a short time, characters of one-third of an inch. About nine months since his sight began to fail, and has continued to get worse to the present time. He can only see to read No. 18 test-type (canon) with his left eye, and with the right No. 16 (two-line great primer), word by word; and distant objects are equally indistinct. Sight failing slightly for twelve months, the defect being most apparent in a bright light (? central scotoma). With his glasses he could, however, still read the newspaper; but his distant vision, unaided by glasses, was only 40 Snellen, at fifteen feet. Optic discs definitely pale at higher temporal portion; no other changes. Complained of failure of sight for three months, and in particular that “things looked black” (probably central scotoma). Sight did not vary on different ways. Vision – right, letters of Jager and 50 Snellen, barely at twenty feet. Slight hypermetropia, but sight not improved by glasses. Optic discs pale at the temporal portion; no other changes. The physiological cup very large in each, and in one eye spontaneous pulsation of the vein. Complained for three years past that he had been unable to find suitable spectacles.
The sight had failed gradually, but he believed that it had remained stationary for about six months prior to his admission.
Vision, without glasses, each eye 18 Jager, and not 200 Snellen, at twenty feet. Pupils active, the left rather larger than the right. Is using strong glasses (Plus 5), but they are of little service. Optic discs definitely pale all over, but much more so on the yellow-spot side. No other changes, unless a slight mistiness of the retina around the discs. Vision 1/20; nothing in the distance. Discs decidedly whiter at the outer than at the inner part. Dimness came on suddenly; as he was walking, “a lot of gnats seemed to come before the sight,” sight has not got much worse since that time. Vision 20/200 O. Ds. congested and somewhat swollen and slightly hazy; vessels not obscured.
Failure began six years ago; right failed two or three weeks before left. It began as if a large drop of water was before the eye; this increased in size; also a floating muscae before each.
Discs rather pale, left universally, right only on yellow-spot side. Amblyopia, accompanied by intolerance of light, especially blue. Very slight pressure on eyeballs makes vision worse. She becomes almost blind for a few minutes, towards evening; it seems as though a veil were before the eyes; on rubbing the eyes it becomes worse (third day). His sight was so imperfect that he could not see small objects, even when near him. Blindness almost complete. Darkness before the eyes. Vanishing of sight.
Vanishing of vision, on looking at a white object. Complains of seeing double whenever he uses the smallest amount of tobacco; he says that in ten minutes after smoking a part of a cigar, or after chewing a little tobacco, he begins to see double, and a kind of dimness or confusion of sight, as if black dots filled his visual field comes on. When he abstains from tobacco for awhile he improves, and his vision becomes single and clear. The tobacco condition is always aggravated, in a very marked degree, by any kind of stimulant. I found, on examining him, vision in each eye 21/ 100. Insufficiency of the internal recti, so that behind the screen there is a divergence of one and a half lines. Double vision for distant objects; monocular vision for near objects; cannot diverge both eyes on it. Optic disk pale, partly atrophied, eye otherwise normal. Increased presbyopia.
Flickering before the yes (first day). Fog before the vision.
Black spots before the eyes. More black points than usual before the eyes, on looking (first day). The disturbance of vision resulting from the abuse of tobacco cannot be distinguished from that caused by alcoholic drinks; we find an irregular, variable irritation and irritability of the retina, sometimes central scotoma, with improved vision in the dark; diminished extent of accommodation (one of the first symptoms); at times increased intraocular pressure; pupils moderately dilated and sluggish.
The ears are red and burning hot (first day). Tearing in front of and beneath the right ear (second day). Sticking behind the left ear, with somewhat hard red swelling (sixth day). Pains within the ear, on touching the outer ear (sixth day). Violent earache twelve months ago, with giddiness and overpowering sleepiness. Painful gnawing in the right ear (after five minutes). Some painful tearing in the right ear (first day).
Jerking tearing in the right ear and in front of it, externally (second day). Fine tearing and sticking in the lobule of the right ear. Tickling in the ears (third day). Sticking in the ears, especially in the open air (second day). Stitches in the ears (first, third, fourth, fifth, sixth, and ninth days).
Sensation as if something stopped the ears (second day). Ears seemed stopped, especially the right (third and fourth days).
Hearing. Hyperaesthesia of the acousticus against music and loud talking. Sensitive to the slightest noise. Deafness not complete, but hearing very dull. Noise in ears occasionally.
After sunset, indoors, fluttering in right ear, both heard and felt (first day). Ringing in the ears. Roaring in the ears.
Roaring and rushing in the ears. Roaring in the ears for several days, especially in the morning. Humming in the ears, aggravated by loud noise or by going into the open air, for several days.
Ulceration of the nose. Sneezing several times, after which the head felt freer (fourth day). Constant desire to sneeze. Fluent catarrh (first, second, fourth, and fifth days). Fluent catarrh, with acute smell (fourth day). Dry catarrh (third day).
Constant discharge of watery mucus from the nose. Twelve had frequent epistaxis. Bleeding from the nose and lungs. Nose stopped (third and eighth days). Dryness of the nose. Sensation of pressure and formication in the Schneiderian membrane.
Drawing pain in both angles of the lower jaw (third day).
Crawling in the nostrils (fourth day). Burning under the nose, as from violent fluent coryza (tenth day). Sudden burning in the left nostril (first day). Smell. Hyperaesthesia of the olfactories, especially against tobacco and cologne water. Very acute fine smell, in the morning (second day). Diminished smell first and third days). Smell very weak; but she is very sensitive to the odor of wine so that from an empty wineglass, standing in the room, she became almost befogged (fourth day).
Objective. Muscles of the left side of the face permanently contracted, as in apoplexy. Face emaciated, pale and stupid- looking. Expression of the countenance that of stupefaction.
Altered expression of face, etc. Features pinched and contorted.
Austere gloomy expression, as if indifferent to every thing on account of being exceedingly discouraged. Expression stupid.
Features drawn. Features sunken (third day). Countenance indicating lassitude and exhaustion. Anaemic or cachectic. A peculiar alteration of the complexion; this is not a mere want of color, an ordinary pallor; it is a dullish gray appearance of the face, partaking both of a chlorotic tinge, and of that be-longing to certain cachexias. It imparts to the countenance a characteristic look by which a practiced eye can recognize those who have been engaged beyond a certain length of time in the manufacture of tobacco; for it must be remarked that this facial aspect is only to be observed in the case of veteran workers. Pale face. Face very pale. Face deathly pale. Deathly paleness with the nausea. Face pale and contracted. Face pale, collapsed, covered with cold sweat. Looks pale and depressed. Pale face, with drawn features and deeply sunken eyes, surround-ed blue rings. Suddenly became pale, with lividity of the lips, and all the appearances indicating syncope.