Tabacum : Some guiding
symptoms.
By Henry Clay Allen
Presented by Sylvain Cazalet
Dr Henry
Clay Allen
(1836-1909)Of American habitat.
Tobacco belongs to the natural order Solanaccæ,
that vast genus which gives the deadly Belladonna.
Dulcamara. Hyoscyamus and Stramonium
on the one hand, and the esculent potato, egg-plant and the tomato on
the other. The mountain goat and the tobacco worm eat the green plant,
and the discovery of its narcotic properties by man has certainly been
of doubtful benefit-we might almost say a calamity to the race. Although
extensively proved in the crude, in the form of tinctures, clusters,
local applications, injections, olfactions, chewing and smoking- the
Encyclopædia, devoting 32 pages and giving 177 authorities as the basis
of its pathogenesis-yet there is no drug in the Materia Medica whose
careful proving with the alternations will reap a richer harvest than Tabacum.From the indiscriminate
use, misuse or abuse, this valuable narcotic occupies a most anomalous
position as a therapeutic agent. So many medical men are users of it in
some form that they are prone to overlook its physiological effects as a
disease-producing factor in the ailments of their patients, possibly for
the reason given by Cowper :“That all men
think all men mortal but themselves.” As a natural result of this
failure to recognize the disease-producing cause, there are many
failures to cure otherwise curable affections, until a functional
disturbance terminates in an organic lesion. For this reason we shall
first consider the following :
Antidotes :
Narcotics generally palliate the symptoms they produce. This rule is so
universal that it might almost be considered a law. If the symptoms are
palliated or promptly relieved by smoking a cigar or chewing tobacco, it
is proof positive that they are to be attributed to the drug. The coffee
or tea headache, neuralgia or nervousness are promptly relieved by a cup
of coffee or tea. And so of all the rest. In my practice I have for many
years found the potentized drug to be not only the best antidote for
chronic tobacco poisoning, but very often one of the curative remedies.
Furthermore, as in cases where patients are suffering from drug effects
of Opium, the potentized remedy will act promptly either as the antidote
or curative, even though the patient be saturated with the crude drug.
As tobacco affects no two persons in exactly the same manner, it
necessarily follows that there is no universal antidote for the
constitutional effects of the drug, the symptoms must be antidoted as
met with in each individual case by the simillimum. Tabacum 200
(Dunham), 500 to 1000 (B. & T.) is the remedy I most frequently use
with which to begin the treatment of the chronic effects of
tobacco ; and usually with the most happy results. But it must not
be repeated too frequently.For the congestive
headache from excessive smoking, Belladonna.
Glonoine ; for the occipital headache from excessive
use, Gelsemium ; for constant
nausea and obstinate vomiting. Ipecacuanha
or Lobelia ; for the bad
effects of excessive chewing, Arsenicum ;
for gastric disturbances next morning after smoking, especially in
beginners, Nux vomica ; for
attacks of violent palpitation, Lachesis,
Phosphorus ; for toothache Clematis,
Plantago ; for dyspepsia, hepatic troubles, nervousness,
neuralgia of right side of the head and face. Sepia, Tabacum, for the periodic “bilious
attacks” from moderate or excessive use of tobacco, Bryonia ; for impotence from excessive
smoking, Lycopodium, Staphysagria ;
Caladium, Belladonna, Plantago, Quassia and Tabacum 200 have,
each in its place, relieved the terrible craving for it, producing in
some cases complete aversion for months and sometimes for life. But
whatever the antidote be, the use of the drug must be abandoned ere its
effects can be permanently cured.
Modalities :
Aggravation. Paleness, coldness, deathly nausea and vomiting worse from
least bodily movement ; palpitation, angina pectoris, attacks worse
at night ; all the symptoms and especially the head ; by great
heat, or a close, warm room ; skin symptoms, by heat of bed ;
palpitation, lying on left side.
Amelioration :
Open
air, all the symptoms and especially the head ; deep inspiration
and weeping, the terrible apprehension and thoracic oppression ;
walking, the pain in back.The symptoms occur
paroxysmal, predominate on the left side, and like Pulsatilla and Kali-bi.,
are constantly changing.
Mind :
Confusion of ideas ; slow perception. Great difficulty in
concentrating his mind for any length of time on one subject. Cannot
listen to a lecture, or fully comprehend what he hears. Cannot study or
read, or understand what is read. Despondent, gloomy, fearful,
apprehensive of sudden death yet attempting suicide, and with this fear,
anxiety, apprehension there is combined great cowardice or timidity
about any business undertaking, no matter how frequently he has
transacted it before. Very forgetful. Cannot bear to be alone night or
day on account of anxiety. With each nervous, attack, a terrible
apprehension of sudden death. “From a bold, healthy, fearless man,
he had become weak, nervous, irresolute, and as timid as a child.”
He is easily startled or thrown into a nervous paroxysm by any ordinary
noise or confusion. An intoxicated feeling as from spirituous liquor is
frequently complained of. Children often become idiotic.Diseases which
originate in cerebral irritation, followed by or attended with marked
gastric symptoms as a consequence, not cause, find their true remedy in
Tabacum if the symptoms correspond.Dr. Guernsey
says : “I have frequently prescribed it most successfully for
those medical students, who had worked hard and smoked much while at
their studies, but finally could not hear with comprehension nor study
any longer.” I have myself successfully prescribed it for similar
conditions in patients who were not medical students.No drug in the Materia
Medica corresponds more closely with the condition of so-called nervous
prostration or nervous exhaustion, brain fag, and loss of intellectual
power among literary, professional and business men than Tabacum. The following case, taken from the
Encyclopædia. Vol. IX, page 473, the result of excessive chewing,
smoking and snuffing is not infrequently met with in practice :“from having been
one of the most healthy and fearless of men, he had becomes sick all
over and as a timid as a girl” he could not even present a petition
in Congress, much less say a word 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 and thrown into tremulousness and afraid
to be atone at night. During the narrative of his sufferings, his aspect
approached the haggard wildness of distemperature.That Tabacum blunts the intellectual faculties,
producing mental dullness and a general stupid indifference, is shown by
many observers, and smoking does this quite as if not more, effectually
than chewing. That it produces mental derangement, amounting to
irresponsibility and complete insanity, has been denied by many writers,
yet the unfortunate records of the asylums of Massachusetts and
Pennsylvania, with the isolated cases reported from time to time in our
periodical literature, appear to confirm the terrible fact. The
despondency, gloom, anxiety, apprehension and fear of sudden death are
characteristic.
Head :
While the symptoms of the mind are more characteristic of the chronic
form of poisoning, these of the head mark with greater clearness the
primary action of the drug. Here, too, we find the modalities running
through the entire group and forming the “red strand” of the
rope. Desire for cold air, better in the open air, better out of doors,
is a condition constantly met with in affections of the head. (Arg. nit., Pulsatilla).
Vertigo, excessive, so
great cannot rise up, with deathly pale face. Head is so heavy it can
hardly be held up. Headache with severe vertigo, worse indoors, better
in open air. -Hahnemann.Sick headache,
beginning in early morning and gradually increasing, becomes intolerable
by noon ; greatly aggravated by light and noise, and attended with
deathly nausea and terrible vomiting. I have relieved, permanently, many
cases of sick headache in ladies by antidoting tobacco and prohibiting
smoking in the house.“always think of
tobacco for total loss of consciousness, or coma, attended with extreme
pallor and cold sweat ; pulse small, weak, almost
imperceptible.”“Persons attacked
with weak, faint spells fall to the ground, nearly or quite unconscious,
break out with cold perspiration, and become deathly pale. They are
picked up and resuscitated, when sooner or later the same scene
recurs.” -Guernsey.“Bilious
headache :” the head feels heavy, stupid, dull ; constant
vertigo on motion ; confusion of mind so that mental labor is
almost impossible ; great weakness, bad taste, loss of appetite,
constipation.
Eyes :
The
effect on the organ of vision is pronounced, and though occultists are
not united in the exact symptomatology of the affection, they agree that
it produces various forms of defective vision, chiefly of a functional
character. Amblyopia and amaurosis are the two most common variations
from the normal standard. The eye is listless, heavy, loses its
brilliancy, deeply sunken in the orbit. The globes are injected, cornea
vascular, dim and covered with mucus, must wipe it frequently. Confused
sight, double vision, widely dilated pupils, and quite insensible to
light of candle held close to the eye. Vision dim, indistinct, almost
amounting to blindness. Dr. Hutchinson’s numerous examinations (London
Hospital reports 64) reveal the following conditions common to all
cases. “White or gray atrophy of the optic nerve, commencing at the
outer part of disk, usually with a sharply-defined margin, and with
diminishing size of retinal vessels, in a few cases neuritis, with
indistinct outline of disk. In some cases the centre of disk was found
depressed and atrophied. The left eye was first and most affected in
nearly every case. Vision failed suddenly in a few, rapidly in many,
while in others the course was fitful. Some had flashes of light, others
fog, but the majority had simply indistinct vision. As the atrophy
advanced, the pupils dilated and became insensible to light.”De Weeker says, tobacco
and alcohol combined cause amblyopia, but he is not convinced that the
evidence is clear on tobacco alone. Yet a tobacco amblyopia is
recognized in all modern text books on the eye.The symptoms and
evidence of its effect on vision might be indefinitely extended. My
object is to direct the attention of the general practitioner to the
fact that in all cases of defective vision in tobacco-users he should
carefully scrutinize the case and compare the symptoms with the
pathogenesis of the drug. If satisfied of the possibility of the cause,
try the antidotal action of the potentized drug before relinquishing the
case as hopeless or turning him over to the allopathic oculist. Tabacum 200 will sometimes clear up the eye
like magic.
Ears :
Red and burning hot. Sensation as it something closed the ears. Nervous
deafness. Sensitive to slightest noise. Neuralgic earache. Roaring,
rushing, hissing, ringing in the ears, all cleared up by going into cold
air. (Compare Quinine). Also very often cleared up rapidly by smoking a
strong cigar in those accustomed to the use of the weed.
Nose :
Epistaxis in smokers. Catarrh. Coryza. Continued paroxysms of sneezing
for weeks, with a crawling sensation in nares (sensation of squirming in
nostril as of a small worm, in hay fever,
Natrum mur.). It is simply impossible to cure the catarrhal
affections of tobacco-users without antidoting the drug or securing its
discontinuance. I have found Tabacum very effective in some cases of hay
fever. I have relieved some severe cases of epistaxis in business men of
sedentary habits by the use of the indicated remedy-very often Tabacum 200. When the attacks occur early in
the morning, from 3 to 6 o’clock, hæmorrhage profuse, bright red,
accompanied by vertigo and fainting, Tabacum is followed well by Nux vomica or Bryonia. The olfactory function
is often seriously impaired and sometimes entirety lost.
Face :
The Tabacum face is always
characteristic. It is pale, deathly pale ; often cold, collapsed
and covered with cold sweat. (Compare Ver.
alb.). The features are pinched, drawn, distorted ; eyes
deeply sunken and surrounded by blue rings, and terrible tearing
neuralgic pains in bones of face and teeth.
Mouth :
The
lips become dry, sensitive, cracked or swollen, and often pale and
bloodless. According to Leroy d’Etiolles, cancer of the lip is found in
twenty-seven out of a hundred tobacco smokers in men, and one and a half
in a hundred among women.The saliva is increased
and the taste perverted, in the morning the tobacco user complains of a
bad taste, or it may be flat, slimy, bitter, like rancid oil. He is sure
he is “bilious”, and this condition is often a precursor of
“a bilious attack,” the direct of the drug.For these symptoms of
the lips and mouth and the “bilious attacks” of tobacco users
I have found Bryonia the most
frequently indicated and effective remedy I have ever used. Dr. Guernsey
says :“I have cured many
of these cases with Bryonia, which I
know is a great antidote of some forms of tobacco poisoning.”
Dr Carroll
DunhamDunham
says :“For the bilious
attacks so common in persons who have for many years have accustomed to
take frequent doses of Calomel or blue mas for headache and biliousness.
Bryonia is, in the majority of cases, the remedy. If early resorted to,
it will break up the attack ; and a repetition rarely fails to
destroy a tendency to its recurrence.”It is for this
“bilious condition,” the result of direct drug action, of
tobacco proving or tobacco poisoning, that Bryonia is so effective when
it corresponds to the case.The mouth is often full
of tenacious, viscid mucus, which sometimes extends to the throat ;
it is difficult to detach, yet must be frequently expectorated, and
causes a constant hawking. The pharynx is dry as if burnt, and there is
a sensation of rawness and constant scraping.Teeth become stained
and dirty ; violent drawing, rending, jumping toothache, which
becomes intolerable. Caries of the teeth. For this tobacco odontalgia, Clematis or Plantago
have done the best work for me. The latter is characterized by the most
intense nervous restlessness, which has served to distinguish them.
Stomach :
Appetite may be greatly increased with constant, craving hunger and
nausea if the hunger be not satisfied ; or, what is still more
frequently found, diminished appetite with disgust for food. Eructations
of food in mouthfuls ; hot, sour or bitter fluids ; loud,
noisy incessant belchings. There is a sensation of coldness of stomach
like Calcarea., Camphor., Colchicum :
a weakness, faintness, sinking and relaxation at pit of stomach.Nausea and vomiting as
soon as he begins to move ; vomiting of pregnancy in morning on
first waking ; seasickness, deathly paleness, coldness, worse from
least movement, better on deck in open air. The gastric symptoms usually
are promptly relieved by smoking or chewing but patient “knows it
is not caused by tobacco because a cigar affords such prompt
relief.”
Abdomen :
Severe colic pains in paroxysms ; loud and constant rumbling of
flatulence ; tympanitic distension. Pains are aggravated by eating,
yet he is so hungry he must eat. Painful contraction of abdominal
muscles in paroxysms ; retraction of navel.
Stool :
Alternate constipation and diarrhœa. (Nux.,
Op., Verat.). Morning diarrhœa, sudden and painless, watery,
(Aloe. Sulph.) papescent, green or
yellowish-green slimy stool, sometimes with tenderness and tenesmus and
often with large quantities of flatus. (Aloe). Cholera
morbus ; characteristic stool and vomiting ; body and
extremities cold and bathed in cold sweat ; abdomen hot, cannot
bear any clothing on abdomen ; fainting, sinking, collapse (Secale).
The cholera morbus
attacks of tobacco are as liable to occur in winter as summer, and
appear to be an aggravated form of the periodical “bilious
attacks.” Tabacum 200 usually
affords prompt relief when Veratrum and other remedies fail. Obstinate
constipation ; stool in hard round balls and evacuated with great
difficulty (Opium and Plumbum). Opium
200 often cures the tobacco constipation.
Urine :
Profuse, watery or high colored and scanty. Renal colic ; terrible
pains along course of right ureter (Lyc.
-of left side, Berb., Kali-c.) ;
with deathly nausea, pale face, fainting, cold sweats and great
exhaustion. I have found Berberis or
Tabacum the remedy for this nephritic colic. If a tobacco user, I first
give Tabacum.
Heart :
(Pulse, etc.) : Its action in the cardiac region is very
pronounced. On the central organ of the circulation and on the muscular
coat of the large arteries the chief force of the drug seems to be
expended. Here it destroys the elasticity of the muscular walls and as a
consequence renders them liable to aneurismal distention. Many of the
cases of sudden death in tobacco users occur from heart collapse or
rupture of an aneurism. The irritable heart is often subject to attacks
of violent palpitation, suffocation, faintness at night when lying on
left side ; is relieved by turning to right.Angina pectoris ;
sudden precordial anguish ; attack usually at night ; legs
tremble, cannot walk with angina pectoris. Pulse : may be full and
quick ; small, weak and irregular, intermittent, soft, feeble and
extremely slow.Dr. Troitski
contributes the following conclusions to the Annales d’Hygiène :In non-smokers of
average constitutions, the mean temperature of the twenty-four hours
amounts to 36.76°C. (or about 98°F.), and the pulse rate 72.9. In
smokers the temperature reaches 37.02°C (98.6°F), and the pulse rate
89.9. Tobacco-smoking, therefore, raises the temperature .26°C and the
pulse-rate 16. In persons of feeble .26°C and the pulse-rate 16. In
persons of feeble constitutions the temperature rises .43°C, and the
pulse-rate 11.9 Taking a mean, tobacco may be said to raise the
temperature .29°C (nearly 1°F.), and to increase the cardiac
pulsations by 12.7. Representing the normal temperature at 1000 in
non-smokers, it rises to 1008 ; and, whereas the pulse of the
former may be taken at 1000, that of the smoker is 1180. It is by
increasing cardiac pulsations that tobacco has such an injurious effect
on some constitutions.
Tabacum
is
most frequently indicated in commencing the treatment of these heart
troubles, is followed well by Digitalis,
Gelsemium, Arsenicum or Convallaria. but these cases can
never be permanently cured until the cause be removed.
Skin :
Eczematous and herpetic eruptions on various parts of the body,
especially on the extremities, groin or perineum. The eruption is
greatly aggravated by warmth of bed, is compelled to throw off the
clothes because the heat of bed becomes intolerable (like Mercury,
Secale-reverse of Arsenic). Herpes and eczema are often produced by
excessive use of tobacco. I have relieved some terrible cases by
detecting and stopping the cause.
Dr H.N. GuernseyDr. H. N. Guernsey
relates the following cases :About ten years ago a
gentleman from Washington called on me. He was utterly unfit for
business ; thin, weak, had no appetite ; slept badly, had no
confidence in his abilities, and could find no one to help him. He had
been a great smoker of tobacco, but now smoked very little ; did
not care for it much. A few doses of Tabacum
made a new man of him in every way in a very short time. For over nine
years past he has enjoyed perfect health, and is conducting an immense
business.Recently an aged
gentleman called on me to obtain relief from an intolerable itching in
his legs. He had been for years a great tobacco chewier. This rash has
troubled him much at night for years ; the only relief obtained is
to lie with his feet and legs uncovered. The cold air stops the itching.
Tabacum 200 quite cured him for a long time, but he would not stop
chewing, and the red, itching rash has returned.
Source :
Medical Advance, 1886.
Copyright © Sylvain
Cazalet 2001
