to paralysis and insensibility; respiration is impeded, the pulse declines to a mere thread, and the patient dies in syncope.
When the patient resists the attack, as is most frequently the case, the evolution of the symptoms described above is arrested, and the sufferer comes out of his comatose condition with a violent headache, extreme weakness, and a gastric disturbance which it requires a considerable time to allay.
The effects produced by the habitual use of tobacco differ according to the way it is consumed. They have not been much observed except among smokers, who are most noticed because of their number. Then their habit is open; the smoke goes everywhere, and it causes inconvenience to others; while the more discreet snuff-taker can hide his snuff-box, and annoys with the smell of tobacco only those who come too near him.
Beginners at snuff-taking require, like smokers, an apprenticeship. They begin by sneezing; then the mucous membrane of the nasal fossæ becomes accustomed to the drug, is palled, and even finds itself pleasantly tickled by the ammoniacal piquancy and nicotian perfume of the virulent powder. At last it becomes thick, and with intemperate snuff-takers perceives odors only feebly. It becomes sometimes the seat of a chronic inflammation which extends to the pharynx and produces a slight dry and characteristic cough. Snuff-takers are told of who have suffered from eruptions, ulcerations, and polypi; others have become deaf; but such cases are so rare and their etiology is so doubtful that serious account need not be taken of them.
The only phenomenon peculiar to nicotine often observed among snuff-takers is a rhythmic trembling of the hands, not like that of old men or that of drunkards, but which is observed likewise in excessive smokers. A single case is mentioned by Dr. Bean of angina pectoris in a patient who was addicted to an excessive use of snuff. But a solitary case is not important in the consideration of a habit so general, and there is no need of pursuing a fugitive enemy. Snuff-taking is condemned by fashion, from whose decrees there is no appeal. Those of hygiene are not so imperative.
Smoking is charged by its opponents with injuring the health and debasing the mind. The former part of the charge has a measure of foundation. There is certainly nothing hygienic in the habit. All are acquainted with the troubles that ensue on the first effort to smoke. There are nauseas, soon followed by vomiting, headache, vertigo, and a condition resembling sea-sickness, and much like the earlier phenomena of acute poisoning by tobacco. These troubles soon pass away, and after a few succeeding efforts the smoker accustoms himself to the action of the smoke. When the habit is once acquired, smokers feel no further incon-
