Tabacum

The drugs composing this group of remedies present great symp- tomatic similarity. The first three remedies on the list are continually in use, even in an average practice. There is scarcely a symptom of one of them which cannot be found under one of the others. The resemblances are, in fact, perplexingly similar.

I have arranged the remedies on the board, not botanically, but rather according to their medicinal relations. For instance, the first four on the list attack prominently the brain and have narcotic prop- erties; they are, therefore, placed in one group. Then we have Tabacum, which also has narcotic properties, but which acts also on other parts of the body besides the brain. Next comes Dulcamara, which contains a small quantity of Solanine, and is only slightly nar- cotic. A large quantity of this drug would be required to develop the soporific effects which can be obtained from Stramonium or Hyoscya- mus. Lastly, we have Capsicum, which is decidedly irritant or acrid. Placed on the skin, it acts as a blister or counter-irritant. It has pos- sibly some narcotic effects, but it differs almost entirely from the other members of the group.

The resemblances between the first three members of the group are so. great, in fact the drugs are so nearly " idem,'" that it is not well to follow one with the other. There are some symptoms of Belladonna and Hyoscyamus which are opposite, not so much in the phraseology in which they are expressed, for they may read almost exactly alike, but

SOLANACE^E.

in the fact that they are results acting in opposite directions; conse- quently, they sometimes serve to antidote each other. Especially is this true of the skin symptoms.

Tabacum contains several active ingredients, the most important of which is Nicotine. Ever since smoking was an " art," attempts have been made to get rid of this Nicotine. Every one acknowledges that it has a serious effect on the body. There are three groups of symp- toms which may follow the use of tobacco. The primary symptoms are the well-known gastric symptoms, deathly nausea and vomiting. The patient is deathly pale, does not care whether he lives or dies. Sometimes cold sweat breaks out on the body. The secondary effects are more remote, coming months or even years after using the weed, and these are dyspepsia, amblyopia and also some symptoms of the heart.

These symptoms of the heart I would have you remember. If they are not caused by tobacco, Tabacum will be a very valuable remedy in their cure. I refer especially to dilated heart when these symptoms are present: there are frequent pallor, with lividity of the face; diar- rhoea, alternating with constipation; palpitation when lying on the left side; muscse volitantes, tinnitus aurium and dry cough, which is cardiac in its origin; paroxysms of suffocation, with tightness across the upper part of the chest; feeble and irregular pulse; pains like those of angina pectoris shoot from the heart down the left arm or up into the neck, and involve different plexuses of nerves; the extremi- ties are cold and covered with a clammy sweat. Another symptom that may come as a secondary symptom of tobacco is neuralgia of the face. This symptom, when thus caused, is curable by Sepia, as is also the dyspepsia.

Impotence also follows tobacco, and often yields to Lycopodhmi.

The tertiary effects of tobacco include apoplexy.

Tobacco, in its effect on the gastric organs, very much resembles Hydrocyanic acid, Veratrum and Camphor. For instance, we find it indicated in cholera, when the nausea and cold sweat persist after Veratrum, Secale or Camphor has stopped the diarrhoea. This nausea is accompanied by burning heat about the abdomen, the rest of the

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body being cold. The patient persists in uncovering the ab- domen.

I would remark here that this kind of sickness suggests Tabacum in renal colic or in strangulated hernia. There are this deathly nausea and sickness, with slimy stool, from irritation of the bowels.

The resemblance to Hydrocyanic acid is found in asphyxia. The latter drug acts upon the medulla, and, hence, upon the heart through the pneumogastric nerves. Consequently, the symptoms you would expect it to produce are those of the heart and lungs. We find it pro- ducing convulsions, with drawing at the nape of the neck from irrita- tion at the base of the brain. Along with this, respiration is irregu- lar or gasping, and there is great distress about the heart, with re- peated weak ' ' spells ' ' and coldness and blueness of the surface of the body. It is well to remember this fact in ursemic convulsions when the medula is affected. Hydrocyanic acid is then our only hope.

Tabacum is used as an antidote to the bad effects of Cicuta virosa.

The primary effects of tobacco are generally relieved by Ipecac.

Nux vomica is indicated for the bad taste in the mouth and the head- ache worse in the morning from excessive smoking.

It is said that Plantago major produces a distaste for tobacco. I have seen one or two patients who, after taking it, supposed they had contracted a dislike to tobacco.