Part 3

The confidence of an enlightened community has assigned to you, as guardians of the dearest interests of society, an elevated and highly responsible rank among those who labor to promote the great cause of human happiness. Your influence in the medical councils of this great and flourishing State, gives a lasting effect to your deliberations, and stamps a value on those productions which you are pleased to approve. While the opinions of other men are often exhibited and forgotten with the occasion which gave them birth, those of the physician continue not unfrequently to affect at least the physical welfare of the world, after his "dust has returned to the earth as it was, and his spirit has gone to God who gave it." In view of this momentous truth, an humble attempt will now be made, in discharge of the duty assigned me, to examine the cause of some of the "ills which flesh is heir to."

I regard this principle as an axiom, that whatever conduces to augment the sum of human happiness, must be an object of solicitude to the conscientious and intelligent physician. He will be anxious that his fellow citizens should be sober, peaceable, and virtuous; that they should be industrious, frugal, and prosperous. Whatever will produce such results should receive the decided approbation of every benevolent member of the Faculty. It follows, of course, that whatever has an opposite tendency should meet his frown. Pursuing this principle, you have condemned the use of ardent spirits, unless sickness demands their application as a medicine.

The physical evils resulting from intemperance were eloquently exhibited in the address, presented by your committee, during the last year. That address, with its accompanying resolutions, now exerts a beneficial influence through a widely extended community. We are cheered by the kind wishes and prayers of the friends of good order, in our efforts to destroy that vice which has not only "walked" through our country "in darkness," but "wasted at noon-day." But while we exult in the triumph of correct principles on this subject, do not other vicious indulgences demand our attention? Should we slumber over the mischiefs resulting from such indulgences, while the public look to us as pioneers who should trace out the pathway to health and happiness, and demand from us both precepts and examples of sobriety and virtue? Unfortunately, in all our attempts to abolish practices prejudicial to the best interests of man, we are compelled, in the outset, to encounter our own inveterate habits--habits which rise up in mutiny against reformation, and with clamorous note forbid us to proceed. Are we so fortunate as to be free from their influence ourselves, we look around and see our friends bound in chains, from which we should rejoice to deliver them; but we fear, perhaps, to make an experiment which may rouse their passions, rather than convince their understandings.

Who can count the multitudes yearly consigned to the tomb, by the indulgence of a fastidious and unnatural appetite? Headaches, flatulencies, cholics, dyspepsias, palsies, apoplexies, and death, pursue the Epicurean train, as ravens follow the march of an armed host, to prey on those who fall in the "battle of the warrior, with their garments rolled in blood." The truth of this statement will not be questioned. Yet where is the physician, possessing sufficient moral courage to raise his voice against the system of modern cookery? Should it be thought, that, as medical men have given no more encouragement to that system than any other class in society, they are not bound to use any extraordinary exertions to produce a change; still a wide field is left open to benevolent action in reference to those things, the influence of which is injurious to mankind.

Gentlemen--there is a baneful habit, diffused, like the atmosphere, through all classes, and affecting all the ramifications of society. And this habit owes much of its prevalence to the advice and example of respectable physicians. We indulge the hope, from the great increase of medical knowledge, that the time will soon arrive, when persons disposed to vicious indulgence will be unable to entrench themselves behind our professional advice. I am aware that I tread on dangerous ground, in attempting to investigate the propriety of a practice which has been introduced and approved by a large portion of the members of this respectable Society. You may start at the suggestion, and regard it as unworthy of your notice. Let me hope, however, that you will suspend your opinions, while I endeavor to present the natural history, chemical composition, and medical properties of one of our most deadly narcotics--the Tabaci Folia, Nicotiana Tabacum, i. e. tobacco. If in the prosecution of this inquiry, we shall be able to discover the great and injurious effects which the use of this poisonous plant produces on the constitution, I shall be excused, if I urge this subject on your consideration with more than ordinary importunity.

I. NATURAL HISTORY.

"This plant was unknown in Europe until after the discovery of America by the Spaniards, and was first carried to England by Sir Francis Drake, A. D. 1560. The natives of this continent call it petun; those of the islands, yoli. The Spaniards, who gave it the name of tobacco, took that name from Tabaco, a province in Yucatan, where they first found it, and first learned its use. Some contend that it derives its name from Tobago, one of the Caribbee Islands, discovered by Columbus, in 1498." It received the name tobacco from Hernandez de Toledo, who first sent it to Spain and Portugal.

The botanic description of this plant may be found in most works on the science of botany: and therefore I shall not detain you with it at this time. The plant, while growing exhibits a very beautiful appearance, but is so extremely nauseous, that in all the variety of insects, only one is found to feed upon it. This is a worm "sui generis," the mode of its propagation being entirely unknown; and from its being the only living creature (man excepted) that will devour this plant, it is called "tobacco worm."

II. SENSIBLE QUALITIES.

It is of a yellowish green color; it has a strong, narcotic, and foetid odor, with a bitter and extremely acrid taste.

III. CHEMICAL COMPOSITION.

"Mucilage, albumen, or gluten, extractive, a bitter principle, an essential oil, nitrate of potass, which occasions its deflagration, muriate of potass, and a peculiar proximate principle, upon which the virtues of the plant are supposed to depend, and which has therefore been named Nicotin. This peculiar principle is considered by some, as approaching the essential oil in its properties. It is colorless, has an acrid taste, and the peculiar smell of tobacco; and occasions violent sneezing. With alcohol and water it forms a colorless solution, from which it is precipitated by a tincture of galls. Tobacco yields its active matter to water and proof spirit, but most perfectly to the latter; long boiling weakens its powers. A most powerful oil may be obtained by distillation, and separating it from the surface of the water on which it floats."

IV. MEDICAL PROPERTIES.

These are considered to be those of a powerful narcotic, antispasmodic, emetic, cathartic, sudorific, and diuretic.

"As a narcotic, it is endued with the most energetic, poisonous properties, producing, when administered even in small doses, severe nausea and vomiting, cold sweats, universal tremors, with extreme muscular debility." From its exerting a peculiar action on the nervous system, as ascertained by the well directed experiments of Mr. Brodie, it powerfully controls the action of the heart and arteries, producing invariably a weak, tremulous pulse, with all the apparent symptoms of approaching death. And so different is its operation from that of other narcotics, that it actually operates with more destructive efficacy, when used by way of injection, than when applied either to the skin, or when taken into the stomach.

From what has been said of its narcotic powers, you, Gentlemen, will readily infer its virtue as an article of medicine. If we wish, at any time, to prostrate the powers of life in the most sudden and awful manner, we have but to administer a dose of tobacco, and our object is accomplished. Hence its use in obstinate constipation, in cholic, in the iliac passion, and in stranguary.

As it is conceded that its efficacy as an antispasmodic depends upon its power to prostrate every vestige of tone and elasticity in the muscular fibre, prudence would dictate that it should be used with the utmost circumspection, when the system had been previously exhausted by the disease, or by the antecedent method of cure. Melancholy instances are on record, of the fatal effects of this medicine when administered without this caution, both as an internal remedy, and as an external application in cutaneous diseases. Two instances will suffice.

"A medical practitioner," says Paris, "after repeated trials to reduce a strangulated hernia, injected an infusion of tobacco, and shortly after sent the patient in a carriage to the Westminster Hospital, for the purpose of undergoing the operation; but the unfortunate man arrived only a few minutes before he expired."

"I knew a woman," says the same learned author, "who applied to the heads of three of her children, afflicted with scald-head, an ointment composed of snuff and butter; but what was the poor woman's surprise, to find them immediately seized with vertigo, violent vomiting, fainting, and convulsions."

We next come to its effects as an emetic. "As such," says Professor Chapman, "tobacco claims our attention. Cullen and many others opposed its use, on account of the harshness of its operation. Certainly it exceeds all others in the promptness, violence, and permanence of its impressions. But these very qualities, unpleasant as they are, enhance its value in many cases."

"Tobacco seems especially to be adapted to the evacuation of some poisons; and it has this advantage, that it acts with equal certainty and expedition, when applied to the region of the stomach in the form of a poultice, as when internally administered." Professor Barton says, he had recourse to an application of the moistened leaves of this plant to the region of the stomach, with complete success, to expel an inordinate quantity of laudanum, in a case where the most active emetics, in the largest doses, were resorted to in vain. But most poisons, particularly the corrosive, are attended with so much exhaustion, that it would seem perilous to administer tobacco, lest by its own depressing effects, the powers of vitality might be irrecoverably extinguished. In many instances, however, it appears that it may be administered in small doses with safety and advantage.

We are informed by a respectable writer, that while at the Cape of Good Hope, he had a number of Hottentots, with intermittent fever, under his care. Having few medicines, he resorted to tobacco, and found six grains of snuff as effectual in exciting vomiting, as two of Tartar emetic.

By many it is preferred in minute doses, as a nauseating medicine. Thus administered, it has succeeded in subduing some of the most violent symptoms of the most furious cases of mania; and where it cannot be given by the mouth, from the obstinacy of the patient, it may with equal benefit be applied in the form of a poultice.

As a cathartic, tobacco is entitled to notice. "Some physicians have been in the habit of prescribing this powerful substance not only for the more dangerous cases of incarcerated hernia, but in all cases of obstinate constipation, from whatever cause produced. To relieve these painful diseases, it has been usually given in the form of a clyster, regulating the dose to the age, circumstances, and strength of the patient; and it is affirmed to have proved, in many instances, very effectual, and to possess the confidence of practitioners."

I was informed by a learned and ingenious friend, that, having an obstinate case of ascaris lumbricoides in his own family, after repeated unsuccessful efforts to dislodge the worms, he at last had recourse to this potent remedy, a poultice of which he applied to the region of the stomach. The worms were almost instantaneously expelled, but with very alarming symptoms, and a complete prostration of the patient. From these circumstances, we should be led to conclude, that its efficacy as a vermifuge defends either upon its narcotic properties, or upon its sudden and powerful effect as a cathartic.

Its effects as a sternutatory, i. e. as exciting to sneeze, are known to all. If applied to the nostrils, in the form of a powder or snuff, it produces violent and repeated sneezing, with a slight degree of vertigo. The violent agitation produced in this way, together with a copious discharge from the nostrils, often relieves catarrh, headache, and incipient opthalmia or inflammation of the eyes. But habit soon blunts the sensibility of the organs, and much positive injury follows the habitual use of snuff. It has been a popular remedy in many places for the cure of scald-head, psora, and most other cutaneous eruptions. It has also been applied for cleansing ulcers, and for the removal of indolent tumors. But the dreadful effects produced by it when absorbed into the system, have induced most medical men to abandon it altogether, and prescribe a more safe application.

Though it is said, by Dr. Brailsford, to be a sudorific of considerable efficacy, I am in possession of no facts which go to support such a conclusion, unless indeed it be the fact, that it in an eminent degree brings on that cold perspiration of which we have spoken, and which is, in many instances, the immediate precursor of death.

But of all others, its diuretic properties have been the most lauded. Dr. Fowler was the first to bring them extensively into notice. In dropsy, dysury, gravel, and nephritis calculosa or inflammation of the kidneys, the infusion and tincture were given by him with astonishing success. In spasmodic asthma, the same distinguished physician found it to afford relief.