The basic pathology and specific treatment of diphtheria, typhoid, zymotic, septic, scorbutic, and putrescent diseases generally

Front matter

3AS1C PATH

OLOC

IFIC TREATMENT

Preface

In the following pages I have endeavored to present a general summary of the basic pathology and specific treatment of some of the most formidable and destructive diseases that afflict and destroy mankind and the lower animals, for they are directly linked in one continuous pathological as well as physiological chain of life. I have therein tried to show that all the varied and complex diseases classed as scorbutic, necrsemic, typhoid, zymotic, septic, infectious, malarial, gangrenous, putrescent, and allied affections, by whatever name designated, from the simplest to the most malignant, are dependent upon, or complicated with, one common basic, alkaline, pathogenic factor, mostly the volatile organic alkali — Ammonia, incidental to all forms of life, and differing only in quantity and the constitutional and local manifestations and complications arising from diverse aetiological and pathological conditions, yet underlying and intensifying them all, and thus often complicating and rendering more severe every form of disease, even of the simplest kind, for the successful treatment of which, this primal morbific factor must be decomposed, neutralized, or removed, which can usually be readily effected by acidulous, antalkaline, resolving, and counteracting agents, thus simplifying the hygienic and therapeutic problems in general, and giving more definiteness and certainty to sanitation and therapeutics, or both preventive and curative medicine.

Thus, the recognition and subversion, or neutralization and elimination of this one common alkaline factor of disease, pestilence, and death, inherent in the vital economy, as well as derived from extraneous sources, cannot fail to improve the health and greatly facilitate the prevention and resolution or cure of disease of all kinds, especially those typhoid, septic, zymotic, contagious and malignant maladies directly occasioned thereby, that so largely endanger and destroy the lives of human beings and the inferior creatures. With the special agents for this purpose, I have also briefly considered its collateral relations and morbific complications, with the particular remedies and measures indicated for the prevention and treatment of these diseases, both simple and complex.

I have thus embodied in general, the results of my own observations, experience, and studies thereon, with confirmatory evidence from other sources, believing them to be correct and in direct accord with science and truth. But as individual observation, experience, and effort are necessarily limited, I present them for the serious consideration of the medical profession, and the severest practical test to which they can be put in every way in hospitals and sanitaria for the sick, as well as in private practice, and in quarantine, and elsewhere throughout the world, for preventive and curative purposes ; believing that both directly and indirectly their practical application will result in great good in the prevention and cure of some of the most malignant and devastating diseases, with the minor "ills to which flesh is heir," that so sorely scourge and destroy human beings with the inferior forms of life.

As it would, of course, require a large volume to treat of these subjects in extenso, I have merely presented a general outline of the main points and basic principles of the most practical importance in a hygienic and therapeutic point of view, to more directly concentrate attention thereon and better enable sanitarians and physicians to avert, counteract, and resolve these morbific plagues with their concomitant evils.

Philadelphia, November 15, 1883.

Contents

Page

Preface, 3

I. Introduction, 7

Introduction

The treatment of diphtheria, typhoid, zymotic, scorbutic, septic, putrescent and correlative diseases, like all other morbid states, must necessarily be based upon their basic and true pathology, and although a knowledge of this is most desirable for the greatest certainty in the application of remedial measures, yet, independent thereof, much practical information of therapeusis may be acquired by enlightened observation, experiment, and practice, as well as the more purely empirical and tentative treatment, or the casual juvantia and lsedentia, especially if supplemented with logical induction and deduction, and this too, even when the aetiology and pathology of any disease is most obscure and undetermined, as shown for instance, in the empirical discovery of the very general specific effects of cinchona bark with its principal alkaloid, quinia, in the prevention and cure of

m intermittent and other malarial fevers, though the materies morbi and pathology thereof are so indefinite and occult.

The same holds true in diphtheria with other zymotic and septic diseases, for though their precise aetiology and pathology may not be fully known, yet a definite amount of information thereon has been practically acquired, while clinical experience teaches certain truths with regard to their successful treatment based upon scientific principles and practice as well as empirical effort and unenlightened observation, so that these latter are not to be entirely disregarded, as they sometimes afford valuable data for accurate induction and correct treatment. But in the meantime, while the exact aetiology, pathology and treatment of these formidable diseases are still so largely sub judice, reasoning in a scientific spirit, based upon personal and professional, with general observation and experience, cannot fail to greatly aid in the solution of these truly vital problems.

In scientific medicine theory precedes and directs practice; while in empirical effort practice precedes intelligent thought, and is but tentative and experimental at the best, as it can only prove accidentally useful and of most value when carefully conducted in an inductive spirit, but if at random, without due discretion and judgment, will ensue in hap-hazard and destructive rather than in beneficent results. Hence, the most extensive experience without due thought and reflection is but reckless empiricism and usually more injurious than beneficial, for truly "if experience is not directed by theory it is blind," says Bacon, and necessarily more or less confusing if not misleading, as is often exemplified in the empirical treatment of disease and all other matters. Indeed, purely empirical experience is like a lamp without a light, it is an inert or dead fact that has the basis but not the principle of light within it, yet which when lighted illuminates everything around it and enables those that can see to direct their work and movements with the greatest precision and certainty, instead of otherwise floundering about in the dark tentatively and often injuriously or even destructively to themselves, things and persons about them. Thus theory is a light and compass that enlightens and directs practice, and establishes a scientific and positive, for an empirical and doubtful art of hygiene and therapeutics in the prevention and treatment of disease. In fact then, for scientific accuracy and positive certainty, theory, thought or deduction must precede practice in medicine as in every other branch of knowledge having the slightest claims to the title of science and scientific art; pure empiricism being but a series of blind or random experiments that maims and kills oftener than cures, and long before even logical induction will guide to correct practice. Indeed, it is only by the union of the two co-ordinate systems of induction and deduction that the highest results can be secured so as to develop a true science and art of medicine — culminating in hygiene and therapeutics, the ultimate expression thereof. Legitimate deduction will as surely lead aright to correct conclusions, practice, and discoveries in medicine as it directed Leverrier to the knowledge and discovery of a new planet, and it matters not whether the medical any more than the astronomical discoverer is the practical demonstrator of his own cognitions, the truth and honor are the same in either instance. Hence, from

B facts to principles, and from theory to practice, should be the rule in medicine as in all other branches of science, to insure a scientific art of sanitation and rational methodus medendi, or true system of preventive and curative medicine.

But as in general, both inductively and deductively, individual thought, investigation and experience must necessarily be limited, it is usually far better to regard the combined observations, experience, experiments, and cognitions of the many as most apt to lead to correct conclusions and practice. Therefore, taking as a basis the observations, experience and knowledge in general, with my own limited investigations and cognitions thereon, I venture to present the following views respecting the aetiology, pathology, prevention and treatment of diphtheria, typhus, cholera, zymotic, septic, infectious, scorbutic, putrescent, mephitic, colliquative and cognate diseases generally, believing them to be founded upon truth and the immutable laws of nature, hence must necessarily be correct and successful in the degree that they are properly applied. With a view then to a clearer exposition of the specific means for the prevention and treatment thereof, I will first briefly present a general outline of the basic source and proximate — if not often the immediate — cause of these destructive maladies as manifested in their etiology and pathology, from the standpoint of my own observations, experience and studies, with confirmatory evidence from other sources.

II. Etiology And Pathology

While in general, abnormal departures from the normal standard of health are spontaneous from various non-specific intrinsic and extraneous causes, in some there are more immediate special exciting influences or specific contagia, vet in all these varied though correlative maladies there seems to be one common basic morbific factor, promotive of the inception and malignancy of the diverse scorbutic, zymotic, septic, putrescent, contagious, colliquative, adynamic and cognate diseases generally, both constitutional and local. This may be engendered within or be introduced from without the vital economy, or be abnormally increased therein by both. It is of an alkaline nature, resulting from general organic transformation and decomposition in both plants and animals, and without which the specific contagium or exciting cause in each case, whatever it may be, could not develop and act upon the living organism with such intensity and deadly effect as usual in zymotic, infectious and septic diseases, while in some it may be the sole pathogenic factor developing spontaneously various scorbutic, toxic, putrescent and adynamic diseases of a milder type which are, however, the basis of the more malignant and contagious diseases, the intensity, variety and complications thereof depending upon its quantity. It is thus in fact a veritable fons et origo mali, and gives the type of malignancy to all diseases, local as well as general. This is strikingly manifested in scurvy, purpura, necrseniia and typhus, as well as in all other septic and infectious diseases arising from the ordinary conditions of life, notably erysipelas, which may be idiopathic or be excited by the slightest bruise or scratch whenever the susceptibility or superalkaline condition of the blood and system exists.

This is likewise the case in ship, and doubtless also in yellow, congestive, malarial, and all other malignant fevers, with diphtheria, the exanthemata and the scorbutic type, necrsemic tendency, putrid, typhoid, infectious, and dissolutive crasis of diseases generally, as all the symptoms thereof point to this general basic superalkaline condition of the blood and economy, while investigation has demonstrated it to a certain extent. This common basic morbific alkaline agent of all such diseases is the well-known organic alkali — Ammonia, which is being constantly engendered spontaneously within the living organism from the combination of its constituent elements in the chemical reactions and normal disintegration of the components of the body, and often in excess from heat, undue effort and other active causes of organic decomposition, as well as excessive accumulation therein from its abnormal retention within the vital economy. It may also be more or less freely introduced from without the system by imbibition in impure water, and the direct inhalation of its vapor extraneously engendered, or its evolution from various malarious, decomposing and putrefying substances, as it is highly volatile, especially when influenced by heat and moisture, which are so active in tropical climates and warm weather, and in close, hot and moist places everywhere.

Thus, in general, in all these varied scorbutic, typhoid, zymotic, septic, pyretic, malarial, infectious, putrescent, colliquative, and allied diseases, there is this one common basic, underlying and omnipresent morbific factor of an excess of the volatile organic alkali — Ammonia, either generated or retained unduly within, or introduced from without the body, or all combined according to circumstances, of itself engendering and superinducing a scorbutic, necrsemic, colliquative, pyrexial, phlegmonous, typhoid, mephitic, infectious, and malignant type of disease. This ammonsemia or superalkaline condition of the blood and system, thus induces an undue solution and fluidity of the liquids, and softening of the solids of the body, with scorbutic, necraemic, toxic, septic, phlogistic, febrile, contagious, adynamic, and decomposing conditions, and tendency to serous and albuminous states and defluxions, congestions, haemorrhages, inflammations, eruptions and other local lesions, as well as constitutional disorders of a mixed sthenic and asthenic type, and of a putrescent, infectious, gangrenous, dissolving and disorganizing character, especially manifested in typhus, ship, yellow, congestive, bilious, enteric, puerperal and other low fevers, with small-pox, scarlatina, measles, diphtheria, angina maligna, apthae and gangrene of mouth, throat, lungs and other parts, anthrax and carbunculoid affections, erysipelas, inflammation and abscess of liver, haematemesis, hematuria, albuminuria, anasarca, lencorrhoea, diarrhoea, choleraic, suppurative, and other serous, haemorrhagic, lymphoidal, catarrhal and purulent fluxes, with adynamic, febrile and malignant forms of typhoid, zymotic, septic, contagious, mephitic and colliquative diseases generally, which are specially manifested according to complicating circumstances.

That this ammoniacal and superalkaline condition of the blood and system is a potent underlying morbific factor, and an active exciting, as well as predisposing cause of all such diseases is manifest from all their correlative phenomena and general nature, though it has also been largely demonstrated by observation and experience, as well as by practical therapeutics, a brief outline of which I will present in confirmation thereof, with a view to their direct application to the prevention and curative treatment of these toxical, disorganizing, contagious, pestiferous, and destructive maladies, with the minor scorbutic and mephitic disorders.

Thus, according to Dr. Waring {Practical Therapeutics), "Hufeland observes that the officinal and probably all the salts of ammonia have the property to a greater or less degree of dissolving the blood-corpuscles, although slowly, and the protean textures generally. When blood is combined w r ith an ammoniacal salt, it acquires generally a brighter red, but this soon passes into a brownish red hue; it does not coagulate, but forms at best, a loose semifluid cruor, the corpuscles begin to disappear, and the whole becomes more limpid. Blood thus decomposed, progressively evolves distinct traces of ammonia. It is very probable that we may partially explain, upon chemical grounds (solution and disengagement of ammonia), why large doses of hydrochlorate of ammonia act as poisons, and smaller doses, long continued, induce a scorbutic condition. Yet the same salt, judiciously exhibited, furnishes a valuable stimulant to the secretory and excretory apparatus. That chemical attraction is inadequate to account for the therapeutic and poisonous quality of the hydrochlorate is obvious, inasmuch as it exercises a general action, and induces inflammation of the stomach even when introduced into the subcutaneous cellular tissue.

" Dr. B. W. Richardson has confirmed the statement that the effect of the addition of ammonia to freshly drawn blood, is to prevent coagulation, and to destroy and alter the blood globules. In this respect the action of ammonia resembles that of the fixed alkalies. When ammonia or its carbonate is administered for some time to animals or man, the effect is to modify the blood-corpuscles; they become easily soluble, crenate at the edge, many-sided, colorless, transparent, collapsed, and loosely agglomerated, but not in rolls; and the blood when drawn, or after death, is absolutely fluid or loosely coagulated. These changes in the blood, he thinks, correspond closely with those observed by Jenner in the blood of patients suffering from typhus fevers. By making animals breathe or swallow ammonia, Dr. Richardson has been able to induce a condition resembling the typhoid in man. A superalkaline condition of the blood from the presence of an excess of ammonia is observed in yellow and typhus fevers, and other diseases of the typhoid type, and in cases where the function of the kidney is suppressed. In such conditions, therefore, he believes that the administration of ammonia and other alkalies is contraindicated. The ammoniacal condition of the blood is recognized by the ammoniacal condition of the breath, tested by a rod dipped in hydrochloric acid/'

But, better still, even before ammonia can be thus detected in the breath by the scorbutic condition of the blood itself, and the general appearance of the tongue and lips, or mucous membrane- of the interior of the mouth, which have a diffused reddish-brown, purplish or dark cerulean hue, as if the blood was imcornpletely oxidized, and the red corpuscles collapsed with their coloring matter diffused through the serum. This ammoniacal or superalkaline condition of the blood is also often manifest in the countenance and general surface of the body, especially in the hands and feet, sometimes to a very marked degree, though a similar scorbutic state may likewise result from an excess of the fixed alkalies, particularly from potassium and its salts.

Moreover, Dr. Richardson found that "the presence of ammonia effectually arrested the oxidation of various substances, and even prevented the action of ozone. Believing that by an extension of the same law, animal substances exposed to ammonia could be prevented from putrefaction, he kept blood and portions of tissues in contact with simple ammoniacal vapor, and with results which were most remarkable. Blood in an ordinary stoppered bottle, if charged with ammonia so as to give a faint ammoniacal odor, would retain its freshness and many of its properties for years. Animal structures in like manner placed, even so as to be massed together in bottles containing ammonia vapor, would retain their freshness apparently for an unlimited time

11 The last point to which Dr. Richardson drew attention was the cause of the antiseptic power of ammonia. Ammonia, being a product of decomposition, had been looked on commonly as a substance provoking decomposition. But ammonia was truly the most powerful antiseptic known ; it acted catalytically, by preventing the action of oxygen with oxidizable bodies. . . . . .

" In conclusion, the results presented tended to throw a light on the influence of the ammonia, as the producing causes of some diseases, and as the curative remedies in other diseases. The same rule that pertained to dead pertained to living organic matter. Hence, long exposure to ammoniacal vapor, by arresting oxidation, produced extreme anaemia and a low depraved condition of the system altogether, with reduced respiration, reduced appetite, reduced muscular power, and reduced energy. On the other hand, in cases where a rapid oxidation of the body was being determined, attended with increase of heat and rapid disintegration of tissue, the administration of ammonia, by arresting these changes, became, in judicious hands, the most powerful and effective of remedies. It checked decomposition by its action on oxygen ; it held the blood fluid by its solvent power as an alkali; and, being volatile, it inflicted no immediate injuries on the structures of the body." — British Medical Journal and Dublin Medical Press.

Yet, ammonia in excess is a powerful caustic and irritant, as well as solvent, while its volatility disseminates it rapidly throughout the system, dissolving and disintegrating the blood corpuscles, exciting, irritating and inflaming the heart and vessels with all the other organs and structures of the body, disorganizing the fluids and solids of the vital economy, and actively promoting dissolution and death as often manifested in ammoniacal and stinking blood, urine and other fluids, with corresponding abnormities, so that for medicinal purposes it has to be given carefully in moderate doses. Hence, while it may preserve dead animal structure, it devitalizes living tissue, and disorders and arrests life action. As the presence of ammonia in excess prevents due oxidation of the living as well as dead blood and tissues, it thereby in the proportion of its accumulation or quantity in the body, subverts normal arterialization, hsematosis, nutrition and chemico-organic or vital metamorphosis generally, while by its solvent, irritant, and volatile properties, it causes abnormal liquefaction, excitement, deterioration and disorder of the components, structure and functions of the living organism, thus predisposing and giving rise to numerous and varied diseases of a mixed inflammatory, septic, infectious and adynamic character, both constitutional and local, according to concurring and complicating circumstances, so frequently manifested in typhus, yellow, puerperal, enteric and other asthenic fevers, diphtheria, angina maligna, erysipelas and correlative phlegmasia, w^ith haemorrhages, albuminous, serous, choleraic and other defluxijus, mephitic, malignant, infectious, and colliquative diseases generally.

Besides the constant spontaneous evolution of ammonia in the body from the direct union of its elements in the normal chemico-organic processes of the living economy, it may be, and often is, abnormally increased by undue retention therein, as well as by various inherent and extraneous agencies, until a state of ammonsemia ensues, which, according to its degree of intensity and concurring circumstances of climate, season, weather, temperature, moisture, pestilential and other agencies, occupation, exposure, alimentation, conditions, habits and modes of life, becomes an active predisposing and exciting cause of, with the minor ills, some of the most malignant and pestiferous diseases that afflict and destroy mankind with the lower forms of life.

Thus, in addition to its internal chemico- vital sour c :- - , ammonia may be introduced from without the by imbibition or inspiration from decomposing organic matter, or from its artificial evolution as is bo common and profuse in that pernicious miasm — tobacco smoke, which is diffused s<:» freely everywhere throughout the world, on land and sea, in ships and houses, in hamlet and palace, city and country, indoors and outdoors, in every country and clime. - that scarcely any one can be free from its forced involuntary inhalation and baneful effects. Moreover, with the volatile ammoi therein, tobacco smoke contains those most r tent narcotic poisons — nicotia. nicotianin, collndine and other active sedatives, which also deteriorate the blood and depress the nervous and general system, thereby strongly predis] sing to, and causing adynamic, scorbutic, septic, infectious, mephitic and colliquative diseases, to which men, women and children are thus so freely exj everywhere

having their nostrils, throats, air p: ind lungs

irritated, and their blood and bodies frequen saturated with the noxious fumes of tobacco, in addition to other active causes of disease and d< :he separate and combined influence of which sickens, disables and destroys myriads of human beings.

Tiiat tobacco is a potent acro-narcotic and prolific source of ammonia with other morbid and

baneful agents, and its use or exposure _ :• its noxious fumes largely introduces it and them into the system, thereby irritating the nares, mouth, pharynx, air passages, lungs, and heart, corrupting the blood, vitiating the humors, perverting the secretions, depressing the nervous, muscular, mental, and vital energies, and poisoning the entire economy, ample evidence is afforded everywhere, and much scientific testimony could be adduced in proof thereof, but we will merely present the following of more immediate practical relation to the subject of discussion :

Thus, Dr. Headland states (Action of Medicine), "The vapor of burning tobacco contains carbonate of ammonia in considerable quantity. This must necessarily be absorbed to a large extent by the mucous surfaces of the mouth and lungs of smokers" (and likewise of those obliged to inhale it). "Regarded in this point of view, the practice of smoking when continued, may be looked upon in the same light as a course of alkaline medication. It may be attended with the same risk or advantage. It must be illsuited to those in whom there is a tendency to alkalinity of the humors, and better adapted to the case of those gouty or dyspeptic subjects with whom the contrary obtains. But of course the therapeutic action of the nicotia and other volatile principles of tobacco must be separately taken into account." (p. 143.)

" The smoke of tobacco contains its alkaloid nicotia. This is a powerful poison. If it were allowed to accumulate in the blood the act of smoking would probably be fatal. It is certainly absorbed to some extent, but it passes quickly into the urine where it may be detected by simple chemical tests. Even the small quantity at one time in the system will produce a very marked intoxication in some persons. It is only not a poison because slowly taken into the system in small amounts and eliminated pari passu. Dr. Paris has plausibly conjectured that nicotia may be the fc juice of cursed Hebanon' mentioned in 'Hamlet. 5

"The careful experiments of Dr. Snow appear to have established the fact that the volatile inebriants are powerful in inverse proportion to their solubility : also that whether inhaled or absorbed from the stomach their action obeys very closely the following law; complete narcotism is established as soon as the blood has dissolved one fifty-sixth part of the quantity it is capable of holding in solution. 5 ' (p. 269.)

Dr. B. W. Richardson presents in the Medical Times and Gazette, the following summary of the noxious effects of tobacco: "1. The effects that result from smoking are due to different agents imbibed by the smoker, viz., carbonic acid, ammonia, nicotine, a volatile empyreumatic substance, and a bitter extract. The more common effects are traceable to the carbonic acid and ammonia; the rarer and more severe to the nicotine, the empyreumatic substance, and the extract. 2. The effects produced are very transitory,* the poisons finding a ready exit from the body. 3. All the evils of smoking are functional in character, and no confirmed smoker can ever be said, so long as he indulges in the habit, to be well; it does not follow, however, that he is becoming the subject of organic and fatal disease because he smokes.f 4. Smoking produces disturbances: (a) in the blood, causing undue fluidity and change in the red corpuscles; (6) on the stomach, giving rise to debility, nausea, and, in extreme cases, sickness; (c) on the heart, producing

* Sometimes, however, they are severe and and persistent ; from a slight exposure to the fumes of tobacco I have known them to continue for days and produce very serious illness and prolonged invalidism.

f Although it is a frequent result thereof, as seen in cancer of lip, ulceration of throat, disease of heart, brain, kidney, etc.

debility of that organ and irregular action ;* (d) on the organs of sense, causing in the extreme degree dilatation of the pupils of the eye, confusion of vision, bright lines, luminous or cobweb specks, and long retention of images on the retina, with other and analogous symtoms affecting the ear, viz., inability clearly to define sounds, and the annoyance of a sharp, ringing, sound like a whistle or a bell ; (e) on the brain, suspending the waste of that organ, and oppressing it if it be duly nourished, but soothing it if it be exhausted; (/) on the nervous filaments and sympathetic or organic nerves, leading to deficient power in them, and to over-secretion in those surfaces — glands — over which the nerves exert a controlling force; (g) on the mucous membrane of the mouth, causing enlargement and soreness of the tonsils (smoker's sore-throat), redness, dryness, and occasional peeling off of the membrane, and either unnatural firmness or contraction and sponginess of the gums; (Ji) on the bronchial surface of the lungs when that is already irritable, sustaining the irritation, and increasing the cough. 5. The statements to the effect that tobacco smoke causes specific diseases, such as insanity, epilepsy, St. Vitus' dance, apoplex}^, organic diseases of the heart, cancer and consumption, and chronic bronchitis have been made without any sufficient evidence or reference to facts; all such statements are devoid of truth, and can never accomplish the object which those who offer them have in view.f 6. As the human body

* With sometimes neuralgia and spasm of the heart, angina pectoris, paralysis, and sudden death.

f Nevertheless, ample evidence of the truth of such could be adduced if space permitted, some of which we will present, with others the writer can testify to its production of neuralgia, insanity, organic as well as functional disease of the heart, bronchitis, consumption, haemoptysis and correlative affections.

is maintained alive and in full vigor by its capacity, within certain well defined limits, to absorb and apply oxygen, as the process of oxidation is most active and most required in those periods of life when the structures of the body are attaining their full development, and as tobacco smoke possesses the power of arresting such oxidation, the habit of smoking is most deleterious to the young, causing in them impairment of growth, premature manhood and physical degradation,"

The evils of tobacco are not, however, thus so exclusively limited to the young, but extends to all of every age and both sexes, subject to its noxious influence by its use in every form and manner or exposure to its poisonous fumes.

In a paper upon the subject {Georgia Medical and Surgical Encyclopedia), Dr. Hollified thus notices some of the evil effects of tobacco upon the human system. " Tobacco effects the system by producing weakness, languidness, vomiting, vertigo, stupor, giddiness, paralysis, nervousness, and great debility, with often fatal prostration. It also acts upon the nervous and circulatory systems to an extent that is both terrifying and alarming, often causing death. When chewed or rubbed it exerts a great influence upon the mucous membrane of the mouth, and also upon the salivary glands, the sublingual and submaxillary, causing them to secrete a larger amount of saliva than nature intended them to do, or than- is necessary for the purpose of accomplishing the duties assigned them, thus robbing the system of a portion of its fluids which are required for the healthy maintenance of its animal functions, merely for the gratification of a. morbid appetite. The sense of taste is generally perverted or greatly impaired in all those who either rub or chew the noxious weed.

" When tobacco is smoked it acts as an irritant, and frequently a portion of the smoke is carried into the lungs rendering the air breathed hot and impure. It then acts as a sedative upon the circulation, and often irritates the lining membrane of the air-cells in the lungs, which brings on inflammation, laying broad and deep the seeds of disease which may in time hurry its victim to an early grave. Death has resulted from the inhalation of the smoke," and blindness has been occasioned by it in the case of a gentlemen addicted to smoking, whose sight repeatedly improved when he relinquished the habit. But this " was too strong; at last he gave way to it entirely, and in 1855 was almost totally blind, being only able to distinguish night from day, becoming according to his own acknowledgment, at the early age of twenty-eight years, a victim to the immoderate use of tobacco."