Transcriber's Note: Minor typographical errors have been corrected
without note. Irregularities and inconsistencies in the text have been
retained as printed.
Words printed in italics are noted with underscores: _italics_.
The cover of this ebook was created by the transcriber and is hereby
placed in the public domain.
TOBACCO AND ALCOHOL
_I. IT DOES PAY TO SMOKE._
_II. THE COMING MAN WILL DRINK WINE._
BY
JOHN FISKE, M.A., LL.B.
--"_Quæres a me lector amabilis quod plerique sciscitantur laudemne an
vero damnem tabaci usum? Respondeo tabacum optimum esse. Tu mi lector
tabaco utere non abutere._"--MAGNENUS Exercitationes de Tabaco,
_Ticino_, 1658.
NEW YORK:
LEYPOLDT & HOLT.
1869.
ENTERED ACCORDING TO ACT OF CONGRESS, IN THE YEAR 1868, BY
LEYPOLDT & HOLT,
IN THE CLERK'S OFFICE OF THE DISTRICT COURT FOR THE SOUTHERN
DISTRICT OF NEW YORK.
Stereotyped by LITTLE, RENNIE & CO.,
430 Broome St., New York.
PREFACE.
Five weeks ago to-day the idea of writing an essay upon the
physiological effects of Tobacco and Alcohol had never occurred to us.
Nevertheless, the study of physiology and pathology--especially as
relating to the action of narcotic-stimulants upon nutrition--has for
several years afforded us, from time to time, agreeable recreation.
And being called upon, in the discharge of a regularly-recurring duty,
to review Mr. Parton's book entitled "Smoking and Drinking," it seemed
worth while, in justice to the subject, to go on writing,--until the
present volume was the result.
This essay is therefore to be regarded as a review article, rewritten
and separately published. It is nothing more, as regards either the
time and thought directly bestowed upon it, or the completeness with
which it treats the subject. Bearing this in mind, the reader will
understand the somewhat fantastic sub-titles of the book, and the
presence of a number of citations and comments which would ordinarily
be neither essential nor desirable in a serious discussion. Had we
been writing a systematic treatise, with the object of stating
exhaustively our theory of the action of Tobacco and Alcohol, we
should have found it needful to be far more abstruse and technical;
and we should certainly have had no occasion whatever to mention Mr.
Parton's name. As it is, the ideal requirements of a complete
statement have been subordinated--though by no means sacrificed--to
the obvious desideratum of making a summary at once generally
intelligible and briefly conclusive.
The materials used especially in the preparation of this volume were
the following:
Anstie: Stimulants and Narcotics. Philadelphia, 1865.
Lallemand, Duroy, et Perrin: Du Rôle de l'Alcool et des Anesthésiques.
Paris, 1860.
Baudot: De la Destruction de l'Alcool dans l'Organisme. Union
Médicale, Nov. et Déc., 1863.
Bouchardat et Sandras: De la Digestion des Boissons Alcooliques.
Annales de Chimie et de Physique, 1847, tom. XXI.
Duchek: Ueber das Verhalten des Alkohols im thierischen Organismus.
Vierteljahrschrift für die praktische Heilkunde. Prague, 1833.
Von Bibra: Die Narkotischen Genussmittel und der Mensch. Nürnberg,
1855.
And the works of Taylor, Orfila, Christison, and Pereira, on Materia
Medica and Poisons; of Flint, Dalton, Dunglison, Draper, Carpenter,
Liebig, Lehmann, and Moleschott, on general Physiology; several of the
special works on Tobacco mentioned in the Appendix; and the current
medical journals.
OXFORD STREET, CAMBRIDGE, _November 23, 1868_.
TOBACCO AND ALCOHOL
I.
IT DOES PAY TO SMOKE.
Mr. James Parton having abandoned the habit of smoking, has lately
entered upon the task of persuading the rest of mankind to abandon
it also.[1] His "victory over himself"--to use the favourite
expression--would be incomplete unless followed up by a victory over
others; and he therefore desists for a season from his congenial
labours in panegyrizing Aaron Burr, B. +F. Butler, and other popular
heroes, in order that he may briefly descant upon the evil characters
of tobacco and its kindred stimulants. Some of the sophisms and
exaggerations which he has brought into play while doing so, invite
attention before we attempt what he did not attempt at all--to state
squarely and honestly the latest conclusions of science on the
subject.
[1] Smoking and Drinking. By James Parton. Boston, Ticknor &
Fields, 1868. 12mo, pp. 151.
According to Mr. Parton, tobacco is responsible for nearly all the
ills which in modern times have afflicted humanity. As will be seen,
he makes no half-way work of the matter. He must have the whole loaf,
or he will not touch a crumb. He scorns all carefully-limited,
compromising, philosophical statements of the case. Whatever the
verdict of science may turn out to be, he _knows_ that no good ever
did come, ever does come, or ever will come, from the use of tobacco.
All bad things which tobacco can do, as well as all bad things which
it cannot do--all probable, possible, improbable, impossible,
inconceivable, and nonsensical evil results--are by Mr. Parton
indiscriminately lumped together and laid at its door. It is simply a
diabolical poison which, since he has happily eschewed the use of it,
had better be at once extirpated from the face of the earth. Of all
this, Mr. Parton is so very sure that he evidently thinks any
reasoning on the subject quite superfluous and out of place.
The paucity of his arguments is, however, compensated by the multitude
and hardihood of his assertions. A sailor, he says, should not smoke;
for "why should he go round this beautiful world drugged?" Note the
_petitio principii_ in the use of the word "drugged." That the smoker
is, in the bad sense of the word, drugging himself, is the very point
to be determined; but Mr. Parton feels so sure that he substitutes
a sly question-begging participle for a conscientious course of
investigation. With nine readers out of ten this takes just as well;
and then it is so much easier and safer, you know. Neither should
soldiers smoke, for the glare of their pipes may enable some hostile
picket to take deadly aim at them. Moreover, a "forward car," in which
a crowd of smoking veterans are returning from the seat of war, is a
disgusting place. And "that two and two make four is not a truth more
unquestionably certain than that smoking does diminish a soldier's
power of endurance, and does make him more susceptible to imaginary
dangers." (p. 17.) This statement, by the way, is an excellent
specimen of Mr. Parton's favourite style of assertion. He does not
say that his private opinion on this complex question in nervous
physiology is well supported by observation, experiment and deduction.
He does not say that there is at least a preponderance of evidence in
its favour. He does not call it as probable as any opinion on such an
intricate matter can ever be. But he says "it is as unquestionably
certain as that two and two make four." Nothing less will satisfy him.
Let it no longer be said that, in the difficult science of physiology,
absolute certainty is not attainable!
Then again, the soldier should not smoke, because he ought always to
be in training; and no Harvard oarsman needs to be told "that smoking
reduces the tone of the system and diminishes all the forces of the
body--he _knows_ it." The profound physiological knowledge of the
average Harvard under-graduate it would perhaps seem ungracious to
question; but upon this point, be it said with due reverence, doctors
disagree. We have known athletes who told a different story. Waiving
argument for the present, however, we go on presenting Mr. Parton's
"certainties." One of these is that every man should be kept all his
life in what prizefighters call "condition," which term Mr. Parton
supposes to mean "the natural state of the body, uncontaminated by
poison, and unimpaired by indolence or excess." Awhile ago we had
"drugs," now we have "poison," but not a syllable of argument to show
that either term is properly applicable to tobacco. But Mr. Parton's
romantic idea of the state of the body which accompanies training is
one which is likely to amuse, if it does not edify, the physiologist.
So far from "condition" being the "natural (i.e. healthy) state of the
body," it is an extremely unnatural state. It is a condition which
generally exhausts a man by the time he is thirty-five years old,
rendering him what prizefighters call "stale." It is not "natural," or
normal, for the powers either of the muscular or of the nervous system
to be kept constantly at the maximum. What our minds and bodies need
is intermittent, rhythmical activity. "In books and work and healthful
play," not "in work and work and work alway," should our earlier and
later years be passed; and a man who is always training for a boatrace
is no more likely to hold out in the plenitude of his powers than a
man who is always studying sixteen hours a day. The only reason why
our boys at Yale and Harvard are sometimes permanently benefited by
their extravagant athleticism is that they usually leave off before it
is too late, and begin to live more normally. For the blood to be
continually determined toward the muscles, and for the stomach to be
continually digesting none but concentrated food, is a state of things
by no means favourable to a normal rate and distribution of nutritive
action; and it is upon this normal rate and distribution of nutrition
that life, health and strength depend. It is as assisting this process
that we shall presently show the temperate use of tobacco to be
beneficial. Mr. Parton's idea well illustrates the spirit of that
species of "radical" philosophy which holds its own opinions as
absolutely and universally, not as relatively and partially, true;
which, consequently, is incapable of seeing that one man's meat may be
another man's poison, and which is unable to steer safely by Scylla
without turning the helm so far as to pitch head foremost into
Charybdis. Mr. Parton sees that athletic exercise is healthful, and he
jumps at once to the conclusion that every man should always and in
all circumstances keep himself in training. Such was not the theory of
the ancient Athenians: [Greek: mêdhen agan] was their principle of
life,--the principle by virtue of which they made themselves competent
to instruct mankind.
Having thus said his say about muscular men, Mr. Parton goes on to
declare that smoking is a barbarism. "There is something in the
practice that allies a man with barbarians, and constantly tends to
make him think and talk like a barbarian." We suppose Mr. Parton must
_know_ this; for he does not attempt to prove it, unless indeed he
considers a rather stupid anecdote to be proof. He tells us how he
listened for an hour or so to half a dozen Yale students in one of the
public rooms of a New-Haven hotel, talking with a stable-keeper about
boat-racing. They swore horribly; and of course Mr. Parton believes
that if they had not been smokers they would neither have used profane
language nor have condescended to talk with stable-keepers. _Sancta
simplicitas!_
"We must admit, too, I think, that smoking dulls a man's sense of the
rights of others. Horace Greeley is accustomed to sum up his opinions
upon this branch of the subject by saying: 'When a man begins to
smoke, he immediately becomes a hog.'" Our keen enjoyment of Mr.
Greeley's lightness of touch and refined delicacy of expression should
not be allowed to blind us to the possible incompleteness of his
generalization. What! Milton a hog? Locke, Addison, Scott, Thackeray,
Robert Hall, Christopher North--hogs?
And then smoking is an expensive habit. If a man smoke ten cigars
daily, at twenty cents each, his smoking will cost him from seven to
eight hundred dollars a year. This dark view of the case needs to be
enlivened by a little contrast. "While at Cambridge the other day,
looking about among the ancient barracks in which the students live, I
had the curiosity to ask concerning the salaries of the professors in
Harvard College." Probably he inquired of a _Goody_, or of one of the
_Pocos_ who are to be found earning bread by the sweat of their brows
in the neighbourhood of these venerable shanties, for it seems they
told him that the professors were paid fifteen or eighteen hundred
dollars a year. Had he taken the trouble to step into the steward's
office, he might have learned that they are paid three thousand
dollars a year. Such is the truly artistic way in which Mr. Parton
makes contrasts--$1500 _per annum_ for a professor, $800 for cigars!
Therefore, it does not pay to smoke.
Smoking, moreover, makes men slaves. The Turks and Persians are great
smokers, and they live under a despotic form of government. Q.E.D. The
extreme liberality of Oriental institutions _before_ the introduction
of tobacco Mr. Parton probably thinks so well known as not to require
mention. But still worse, the Turks and Persians are great despisers
of women; and this is evidently because they smoke. For woman and
tobacco are natural enemies. The most perfect of men, the
"highly-groomed" Goethe--as Mr. Parton elegantly calls him--loved
women and hated tobacco. This aspect of the question is really a
serious one. Tobacco, says our reformer, is woman's rival,--and her
successful rival; therefore she hates it. For as Mr. Parton, with
profound insight into the mysteries of the feminine character, gravely
observes, "women do not disapprove their rivals; they hate them." This
"ridiculous brown leaf," then, is not only in general the cause of all
evil, but in particular it is the foe of woman. "It takes off the edge
of virility"!![2] It makes us regard woman from the Black Crook point
of view. If it had not been for tobacco, that wretched phantasmagoria
would not have had a run of a dozen nights. "Science" justifies this
conjecture, and even if it did not, Mr. Parton intimates that he
should make it. Doubtless!
[2] When we first read this remark, we took it for a mere
burst of impassioned rhetoric; but on second thoughts, it
appears to have a meaning. Another knight-errant in
physiology charges tobacco with producing "giddiness,
sickness, vomiting, vitiated taste of the mouth, loose
bowels, diseased liver, congestion of the brain, apoplexy,
palsy, mania, loss of memory, amaurosis, deafness,
nervousness, _emasculation_, and cowardice." Lizars, _On
Tobacco_, p. 29. A goodly array of bugbears, quite aptly
illustrating the remark of one of our medical professors,
that hygienic reformers, in the length of their lists of
imaginary diseases, are excelled only by the itinerant
charlatans who vend panaceas. There is, however, no
scientific foundation for the statement that tobacco "takes
off the edge of virility." The reader who is interested in
this question may consult Orfila, _Toxicologie_, tom. II. p.
527; _Annales d'Hygiène_, tom. XXXVIII.; and a Memoir by
Laycock in the _London Medical Gazette_, 1846, tom. III.
One bit of Mr. Parton's philosophy still calls for brief comment. He
wishes to speak of the general tendency of the poor man's pipe; and he
means to say "that it tends to make him satisfied with a lot which it
is his chief and immediate duty to alleviate,--he ought to hate and
loathe his tenement-house home." A fine specimen of the dyspeptic
philosophy of radicalism! Despise all you have got, because you cannot
have something better. We believe it is sometimes described as the
philosophy of progress. There can of course be no doubt that Mr.
Parton's hod-carrier will work all the better next day, if he only
spends the night in fretting and getting peevish over his
"tenement-house home."
Such then, in sum and substance, is our reformer's indictment against
tobacco. It lowers the tone of our systems, and it makes us contented;
it wastes money, it allies us with barbarians, and it transforms
us--_mira quadam metamorphosi_--into swine. Goethe, therefore, did not
smoke, the Coming Man will not smoke, and General Grant, with tardy
repentance, "has reduced his daily allowance of cigars." And as for
Mr. Buckle, the author of an able book which Mr. Parton rather too
enthusiastically calls "the most valuable work of this century,"--if
Mr. Buckle had but lived, he would doubtless have inserted a chapter
in his "History," in which tobacco would have been ranked with
theology, as one of the obstacles to civilization.
Throughout Mr. Parton's rhapsody, the main question, the question
chiefly interesting to every one who smokes or wishes to smoke, is
uniformly slurred over. Upon the question whether it is unhealthy to
smoke, the Encyclopædias which Mr. Parton has consulted do not appear
to have helped him to an answer. Yet this is a point which, in making
up our minds about the profitableness of smoking, must not be taken
for granted, but scientifically tested.
What, then, does physiology say about this notion--rather widespread
in countries over which Puritanism has passed--that the use of tobacco
is necessarily or usually injurious to health? Simply that it is a
popular delusion--a delusion which even a moderate acquaintance with
the first principles of modern physiology cannot fail to dissipate.
Nay, more; if our interpretation shall prove to be correct, it goes
still further. It says that smoking, so far from being detrimental to
health, is, in the great majority of cases, where excess is avoided,
beneficial to health; in short, that the careful and temperate smoker
is, other things equal, likely to be more vigorous, more cheerful, and
more capable of prolonged effort than the man who never smokes.
We do not pretend to _know_ all this, nor are we "as certain of it as
that two and two make four." Such certainty, though desirable, is not
to be had in complex physiological questions. But we set down these
propositions as being, so far as we can make out, in the present state
of science, the verdict of physiology in the matter. Future inquiry
may reverse that verdict; but as the physiologic evidence now stands,
there is a quite appreciable preponderance in favor of the practice of
smoking. Such was our own conclusion long before we had ever known, or
cared to know, the taste of a cigar or pipe; and such it remains after
eight years' experience in smoking. We shall endeavor concisely to
present the _rationale_ of the matter, dealing with some general
doctrines likely to assist us both now and later, when we come to
speak of alcohol.
We do not suppose it necessary to overhaul and quote all that the
illustrious Pereira, in his "Materia Medica,"[3] and Messrs. Johnston
and Lewes, in their deservedly popular books, have said about the
physiologic action of tobacco. Their works may easily be consulted by
any one who is interested in the subject; and their verdict is in the
main confined to the general proposition that, from the temperate use
of tobacco in smoking, no deleterious results have ever been proved to
follow. More modern and far more elaborate data for forming an opinion
are to be found in the great treatise of Dr. Anstie, on "Stimulants
and Narcotics," which we shall make the basis of the following
argument.[4]
[3] "I am not acquainted with any well-ascertained ill
effects resulting from the habitual practice of
smoking."--Pereira, _Materia Medica_, vol. ii., p. 1431.
Tobacco "is used in immense quantities over the whole world
as an article of luxury, without any bad effect having ever
been clearly traced to it."--Christison on _Poisons_, p.
730. These two short sentences, from such consummate masters
of their science as Christison and Pereira, should far more
than outweigh all the volumes of ignorant denunciation which
have been written by crammers, smatterers, and puritanical
reformers, from King James down.
[4] Only a basis, however. The argument as applied to
tobacco, though a necessary corollary from Dr. Anstie's
doctrines, is in no sense Dr. Anstie's argument. We are
ourselves solely responsible for it.
In the first place, we want some precise definition of the quite
vaguely understood word, "narcotic." What is a narcotic? _A narcotic
is any poison which, when taken in sufficient quantities into the
system, produces death by paralysis._ The tyro in physiology knows
that death must start either from the lungs, the heart, or the nervous
system. Now a narcotic is anything which, in due quantity, kills by
killing the nervous system. When death is caused by too great a
proportion of carbonic acid in the air, it begins at the lungs; but
when it is caused by a dose of prussic acid, it begins at the medulla
oblongata, the death of which causes the heart and lungs to stop
acting. Prussic acid is, therefore, a narcotic; and so are strychnine,
belladonna, aconite, nicotine, sulphuric ether, chloroform, alcohol,
opium, thorn-apple, betel, hop, lettuce, tea, coffee, coca, hemp,
chocolate, and many other substances. All these, taken in requisite
doses, will kill by paralysis; and all of them, taken in lesser but
considerable doses, will induce a state of the nerves known as
narcosis, which is nothing more nor less than incipient paralysis.
Every man who smokes tobacco, or drinks tea or coffee, until his hands
are tremulous and his stomach-nerves slightly depressed, has just
started on the road to paralysis: he may never travel farther on it,
but he has at least turned the corner. Every man who drinks ale, wine,
or spirit until his face is flushed and his forehead moist, has
slightly paralyzed himself. Alcoholic drunkenness is paralysis. The
mental and emotional excitement, falsely called exaltation, is due,
not to stimulation, but to paralysis of the cerebrum. The unsteady
gait and groping motion of the hands are due to paralysis of the
cerebellum. The feverish pulse and irregular respiration are due to
paralysis of the medulla oblongata. The flushed face and tremulous,
distressed stomach, are due to paralysis of the sympathetic ganglia.
And when a person is "dead-drunk," his inability to perform the
ordinary reflex acts of locomotion and grasping is due in part to
paralysis of the spinal centres. The coma, or so-called sleep of
drunkenness, is perfectly distinct from true reparative sleep, being
the result of serious paralysis of the cerebrum, and closely allied to
delirium.[5] Now, what we have stated in detail concerning alcohol is
also true of tobacco. A fatal dose of nicotine kills, just like
prussic acid, by paralyzing the medulla, and thus stopping the heart's
beating. The ordinary narcotic dose does not produce such notable
effects as the dose of alcohol, because it is hardly possible to take
enough of it. Excessive smoking does not make a man maudlin, but it
causes restless wakefulness, which is a symptom of cerebral paralysis,
and is liable, in rare cases, to end in coma. Its action on the
cerebellum and spinal cord cannot be readily stated; but its effect on
the medulla and sympathetic is most notable, being seen in depression
or feeble acceleration of the pulse, trembling, nausea of the stomach,
and torpidity of the liver and intestines. Nearly or quite all of
these effects producible by tobacco, are producible also, in even a
heightened degree, by narcotic doses of tea and coffee. A concentrated
dose of tea will produce a paralytic shock; and a single cup of very
strong coffee is sometimes enough to cause alarming disorder in the
heart's action. All these narcotic effects, we repeat, are instances
of paralytic depression. _In no case are they instances of stimulus
followed by reaction; but whenever a narcotic dose is taken, the
depressive paralytic action begins as soon as the dose is absorbed by
the blood-vessels_. The cheerful and maudlin drunkard is not under
the action of stimulus. His rapid, irregular, excited mental action is
no more entitled to be called "exaltation" than is the delirium of
typhoid fever. In the one case and in the other, we have not
stimulation but depression of the vitality of the cerebrum; in both
cases, the nutrition is seriously impaired; in both cases, molecular
disorganization of the nerve-material is predominant.
[5] Sleep is caused by a diminution of blood in the
cerebrum; stupor and delirium, as well as _insomnia_, or
nocturnal wakefulness, are probably caused by excess of
blood in the cerebrum. We feel sleepy after a heavy meal,
because the stomach, intestines and liver appropriate blood
which would ordinarily be sent to the brain. But after a
drunken debauch, a man sinks in stupor because the brain is
partially congested. The blood rushes to the paralyzed part,
just as it rushes to an inflamed part; and in the paralysis,
as in the inflammation, nutrition and the products of
nutrition are lowered. The habitual drunkard lowers the
quality of his nervous system, and impairs its
sensitiveness,--hence the necessity of increasing the dose.
It will be seen, therefore, that it is not the function of a
narcotic, as such, to induce sleep, though in a vast number
of cases it may induce stupor. The headache felt on awaking
from stupor, is the index of impaired nutrition, quite the
reverse of the vigor felt on arising from sleep.
So much concerning narcotics has been established, with vast and
profound learning, by Dr. Anstie. No doubt, by this time, the reader
is beginning to rub his eyes and ask, Is this the way in which you are
going to show that smoking is beneficial? You define tobacco as a
poison which causes paralysis, and then assure us that it pays to
smoke! It is true, this has at first sight a paradoxical look; but as
the reader proceeds further, he will see that we are not indulging
either in paradoxes or in sophisms. We wish him to take nothing for
granted, but merely to follow attentively our exposition of the case.
We have indeed called tobacco a poison,--and so it is, if taken in
narcotic doses. We have accused it of producing paralysis,--and so it
does, when taken in adequate narcotic doses. We would now call
attention to a property of narcotics, which is well enough known to
all physiologists, but is usually quite misapprehended or ignored by
popular writers on alcohol and tobacco.[6] We allude to the fact that
narcotics, when taken in certain small quantities, do not behave as
narcotics, but as _stimulants_; and that they will in such cases
produce the exact reverse of a narcotic effect. Instead of lowering
nutrition, they will raise it; instead of paralyzing, they will
invigorate. Taken in a stimulant dose, tobacco is not only not a
producer, it is an averter, of paralysis. It is not only not a poison,
but it is a healthful, reparatory stimulus.
[6] Mr. Lizars (On _Tobacco_, p. 54) has the impudence to
cite Pereira (vol. ii. p. 1426) as an opponent of smoking,
because he calls nicotine a deadly poison! And on p. 58 he
similarly misrepresents Johnston. This is the way in which
popular writers contrive to marshal an array of scientific
authorities on their side. In the case of tobacco, however,
it is difficult to find physiologists who will justify the
popular clamour. They have a way of taking the opposite
view; and when Mr. Lizars cannot get rid of them in any
other way, he insinuates that all writings in favour of
tobacco "have been _got up_ from more than questionable
motives." (p. 137.) This is in the richest vein of what, for
want of a better word, we have called radicalism; and may be
compared with Mr. Parton's belief that physicians recommend
alcoholic drinks because they like to fatten on human
suffering! (_Smoking and Drinking_, p. 56.)
It is desirable that this point should be thoroughly understood before
we advance a step farther. Here is the _pons asinorum_ in the study of
narcotics, but it must be crossed if we would get at the truth
concerning alcohol and tobacco. Alcohol is a poison, says the
teetotaler, who means well, but has not studied the human organism;
alcohol is a poison, and once a poison always a poison. Nothing can
seem more logical or reasonable, so long as one knows nothing about
the subject. A quart of brandy is admitted to be poison; is not,
therefore, a spoonful of brandy also poison? We reply, by no means.
Physiological questions are not to be settled by formal logic. Here
the quantity is the all-essential element to be taken into the
account. Common salt, in large doses, is a virulent poison; in lesser
doses it is a powerful emetic; in small doses it is a gentle
stimulant, and an article of food absolutely essential to the
maintenance of life. In the spirit of the teetotaler's logic, then, it
may be asked, If a pound of salt is a poison, is not a grain of salt
also a poison? We reply, call it what you please, you cannot support
life without it. So from the poisonous character of the quart of
brandy, the poisonous character of the spoonful is by no means a
legitimate inference. The evil effects of the small dose are to be
ascertained by experiment, not to be taken for granted. Logic is
useful in the hands of those who understand the subject they reason
about; but in other hands it sometimes leads to queer results. It was
logic that used up the one-hoss shay.
The general principle to guide us here is that of Claude Bernard, that
whatever substance or action, in due amount, tends to improve
nutrition, may, in excessive amount, tend to damage nutrition. In the
vast majority of cases the difference between food and poison, between
beneficent and malignant action, is only a difference of quantity.
Oxygen is the all-important stimulus, without which nutrition could
not be carried on for a moment. It constitutes about one-fifth of our
atmospheric air. Let us now step into an atmosphere of pure oxygen,
and we shall speedily rue such a radical proceeding. We shall live so
fast that waste will soon get ahead of repair, and our strength will
be utterly exhausted. The effect of sunlight on the optic nerve is to
stimulate the medulla, and increase thereby the vigor of the
circulation. But too intense a glare produces blindness and dizziness.
The carpenter's thumb, by friction against the tools he uses, becomes
over-nourished and tough; but if the friction be too continuous, there
is lowered nutrition and inflammation. Moderate exercise enlarges the
muscles; exercise carried beyond the point of fatigue wastes them. The
stale prize-fighter and the overworked farmer are, from a physical
point of view, pitiable specimens of manhood. A due amount of rich
food strengthens the system and renders it superior to disease; an
excessive amount of rich food weakens the system, and opens the door
for all manner of aches and ailments. A pinch of mustard, eaten with
meat, stimulates the lining of the stomach, and probably aids
digestion; but a mustard poultice lowers the vitality of any part to
which it is applied. Moderate emotional excitement is a healthful
stimulus, both to mind and body; but intense and prolonged excitement
is liable to produce delirium, mania, or paralysis. _Ne quid nimis_,
therefore, the maxim of the wise epicurean, is also the golden rule of
hygiene. If you would keep a sound mind in a sound body, do not rush
to extremes. Steer cautiously between Scylla and Charybdis, and do not
get wrecked upon the one or swallowed up in the other.
Few persons who have not been specially educated in science have ever
learned this great lesson of Materia Medica, "that everything depends
on the size of the dose." It is not merely that a small dose will
often produce effects differing in degree from those produced by a
large dose; nor is it merely that the small dose will often produce an
effect differing in kind from that of the large dose; but it is that
the small dose will often produce effects diametrically opposite and
antagonistic to those of the large dose. The small dose may even serve
as a partial antidote to the large dose. The adage concerning the hair
of the dog that has bitten us, embodies the empirical wisdom of our
ancestors on this subject. Especially is this true of all the
substances classed as narcotics. In doses of a certain size, they, one
and all, produce effects exactly the reverse of narcotic. If anything
is entitled to be called a deadly narcotic poison, it is strychnia,
which, by paralyzing the spinal cord, induces tetanic convulsions: yet
minute doses of strychnia have been used with signal success in the
cure of hemiplegic paralysis. In teething children, the pressure upon
the dental branches of the trigeminal nerve sometimes causes an
irritation so great as partly to paralyze the medulla, inducing clonic
convulsions, and perhaps death by interference with the heart's
action.[7] In these cases, alcohol has been frequently used with
notable efficacy, averting as it does the paralysis of the medulla.
Epileptic fits, choreic convulsions, and muscular spasms--such as
colic, and spasmodic asthma--are also often relieved by the tonic or
anti-paralytic action of alcohol. And how often has the temperate
smoker, after some occasion of distressing excitement, his limbs and
viscera trembling, his nerves "all unstrung," or incipiently
paralyzed,--how often has the temperate smoker found his whole system
soothed and quieted, and the steadiness of his nerves restored, by a
single pipe of tobacco! That this is due to its action as a
counteracter of paralysis is shown by the fact that tobacco has been
successfully used in tetanus,[8] in spasm of _rima glottidis_,[9]
in spasmodic asthma,[10] and in epilepsy.[11] For these phenomena
physiology has but one explanation. They are due to the fact that
narcotics, in small doses, either nourish, or facilitate the normal
nutrition of the nervous system. They restore its equilibrium,
enabling it, with diminished effort, to discharge its natural
functions. And anything which performs this office is, in modern
physiology, called a _stimulant_.
[7] Clendon, _On the Causes of the Evils of Infant
Dentition_.
[8] Curling, _On Tetanus_, p. 168; Earle, in _Med. Chir.
Trans._, vol. vi., p. 92; and O'Beirne, in _Dublin Hospital
Reports_, vols. i. and ii.
[9] Wood, _U.S. Dispensatory_.
[10] Sigmond, in _Lancet_, vol. ii., p. 253.
[11] Currie, _Med. Rep._, vol. i., p. 163.
Here then we have obtained an important amendment of our notion of a
narcotic. A narcotic is a substance which, taken in the requisite
dose, causes paralysis. But we have seen that by diminishing the dose
we at last reach a point where the narcotic entirely ceases to act as
a narcotic and becomes a stimulant. What then is a stimulant? There is
a prejudice afloat which interferes with the proper apprehension of
this word. People call alcohol, indiscriminately, a stimulant; and
when a man gets drunk, he is incorrectly said to be stimulating
himself; stimulants are therefore looked at askance, as things which
demoralize. The reader is already in a position to know better than
this. He sees already that it is not stimulus but narcosis which is
ruining the drunkard. Nevertheless, that he may understand thoroughly
what a stimulant is, we must give further explanation and
illustration.
Food and stimulus are the two great, equally essential factors or
co-efficients in the process of nutrition. We mean by this, that in
order to nourish your system and make good its daily waste, you need
both food and stimulus. You must have both, or you cannot support
life. Day by day, in every act of life, be it in the acts of working
and thinking which go on consciously, or be it in the acts of
digestion and respiration which go on unconsciously, in the mere
keeping ourselves alive, we are continually using up and rendering
worthless the materials of which our bodies are composed. We use up
tissue as an engine uses up fuel; and we therefore need constant
coaling. Tissue once used is no better than ashes; it must be
excreted, and food must be taken to form new tissue. Now the wonderful
process by which digested food is taken up from the blood by the
tissues--each tissue taking just what will serve it and no more,
muscle-making stuff to muscle, bone-making stuff to bone, nerve-making
stuff to nerve--is called assimilation, nutrition, or repair. It is
according as waste or repair predominates that we are feeble or
strong, useless or efficient. When repair is greatly in excess, as it
usually is in childhood and youth, we grow. When waste is greatly in
excess, we die of consumption, gangrene, or starvation. When the daily
repair slightly outweighs the daily waste, we are healthy and
vigorous. When the daily repair is not quite enough to replace the
daily waste, we are feeble, easily wearied, and liable to be assailed
by some illness.
Now, in order to carry on this great process of nutrition, we have
said that food and stimulus are equally indispensable. We must have
food or we can have nothing to assimilate; but we must also have
stimulus, or no assimilation will take place. _The unstimulated tissue
will not assimilate food._ The nutritive material rushes by it,
unsought for and unappropriated, and no repair takes place. There are
some people whom no amount of eating will build up: what they need is
not more food, but more nerve stimulus; they doubtless eat already
more than their tissues are able to assimilate. In pulmonary
consumption, the chief monster which we have to fight against is
impaired nutrition, the tubercles being only a secondary and
derivative symptom.[12] The problem before us, in dealing with
consumption, is to improve nutrition, to make the tissues assimilate
food. And to this end we prescribe, for example, whisky and milk--a
food which easily reaches the tissues, and a stimulant which urges
them to take up the food sent to them. We define, therefore, a
stimulant as _any substance which, brought to bear in proper
quantities upon the nervous system, facilitates nutrition_.
[12] Indeed, there are many fatal cases in which tubercles
never appear. See Niemeyer on _Pulmonary Phthïsis_.
At the head of all stimulants stands oxygen, concerning which, for
further illustration, we shall quote the following passage from Dr.
Anstie:
"It needs but a glance at the vital condition of different populations
in any country to arrive at a tolerably correct idea of the virtues of
oxygen as a promoter of health and a curer of disease. If we compare
the physical condition of the inhabitants of a London alley, an
agricultural village, and a breezy sea-side hamlet, we shall recognize
the truth of the description which assigns to it the same therapeutic
action as is exercised by drugs, to which the name of stimulant seems
more naturally applicable than to such a familiar agent as one which
we are constantly breathing in the common air. A child that has been
bred in a London cellar may be taken to possess a constitution which
is a type of all the evil tendencies which our stimulants are intended
to obviate.... It is highly suggestive to find that that very same
quiet and perfect action of the vital functions, without undue waste,
without pain, and without excessive material growth, is precisely what
we produce, when we produce any useful effect, by the administration
of stimulants, though, as might be expected, our artificial means are
weak and uncertain in their operation, compared with the great natural
stimulus of life."[13]
[13] _Stimulants and Narcotics_, p. 144.
Stimulus implies no undue exaltation of the activity of any part of
the organism. In complete health all parts of the body should work
together in unhindered co-operation. Any undue exaltation of a
particular function--excessive brain-action, excessive muscular-nutrition,
excessive deposit of fat--is a symptom of lowered life, in which the
co-ordinating control of the whole system over its several parts is
diminished. Stimulus, on the other hand, implies an increase of the
co-ordinating and controlling power. Dr. Anstie therefore recommends
that the word "overstimulation" be disused, as unphilosophical and
self-contradictory.
In yet one further particular, current notions need to be rectified
before we can proceed. _In no case is the action of a stimulant
followed by a depressive reaction._ This seems at first like a
paradox. Physiologists have in times past maintained the contrary; and
some have even ventured to apply to the phænomena of stimulation the
dynamic law that "action and reaction are equal and opposite." But in
physiology we shall not be helped much by the theorems of mechanics.
In no case is the stimulus followed by any other "recoil" than that
which is implied in the mere gradual cessation of its action, just as
in the case of food which has been eaten, assimilated, and used up. We
quote the following from Dr. Anstie:--"We often hear the effects of
strong irritation of the skin, or the mucous surfaces, quoted as an
example of the way in which action and reaction follow each other. The
immediate effect of such treatment (it is said) is to quicken the
circulation and improve the vital condition of the part, but its
_ultimate_ result is a complete stagnation of the vital activities in
the irritated tissues. The real explanation of the matter is, however,
very different. Mild stimulation of the skin (as by friction, warm
liniments, &c.) has no tendency to produce subsequent depression; nor
has mild stimulation of the mucous membranes (as by the mustard we eat
with our roast beef). But the application of an irritant strong enough
to produce a morbid depression at all, produces it _from the first_.
Thus the cantharidine of a blister has no sooner become absorbed
through the epidermis than it _at once_ deprives a certain area of
tissue of its vitality to a considerable extent, as is explained by
the researches of Mr. Lister.... Here is no stimulation first and
depressive recoil afterward, but unmitigated depression from the
first."[14] "What has been commonly spoken of as the _recoil_ from the
stimulant action of a true narcotic is, in fact, simply the advent of
narcosis owing to a large impregnation of the blood with the agent
after the occurrence of stimulation, owing to a small one. Thus a man
drinking four ounces or six ounces of brandy gradually, has not in
reality taken a truly narcotic dose till perhaps half the evening has
worn away; previously to that he has not been 'indulging in narcotism'
at all; nor, had he stopped then, would any after depression have
followed, for he might have taken no more than two ounces of brandy,
equal perhaps to one ounce of alcohol. But he chose to swallow the
extra two ounces or four ounces, thus impregnating his blood with a
narcotic mixture capable of acting upon nervous tissue so as to render
it incapable of performing its proper functions. _The narcosis has no
relation to the stimulation but one of accidental sequence. This is
proved by the fact that in cases where a narcotic dose is absorbed
with great rapidity, no signs of preliminary stimulation occur._"[15]
[14] _Stimulants and Narcotics_, p. 148.
[15] Id. p. 224.
This disposes of the popular objection to stimulants--based upon the
long-exploded theories of vitalistic physiology[16]--that every
stimulus is followed by a reaction. It is seen that when a man feels
ill and depressed after the use of alcohol or tobacco, it is because
he has not stimulated but narcotized himself. We challenge any person,
not hopelessly dyspeptic, to produce from his own experience any
genuine instance of physical or mental depression as the result of a
half-pint of pure wine taken with his dinner,[17] or of one or two
pipes of mild tobacco smoked after it.
[16] "The origin of the belief that stimulation is
necessarily followed by a depressive recoil is obviously to
be found in the old vitalistic ideas. It is our old
acquaintance, the Archæus, whose exhaustion, after his
violent efforts in resentment of the goadings which he has
endured, is represented in modern phraseology by the term
'depressive reaction.' This idea once being firmly
established in the medical mind, the change from professed
vitalism to dynamical explanations of physiology has not
materially shaken its hold." Id. p. 146. An interesting
example of the way in which quite obsolete and forgotten
theories will continue clandestinely to influence men's
conclusions. The subject is well treated by Lemoine, _Le
Vitalisme et l'Animisme de Stahl_. Paris, 1864.
[17] "From good wine, in moderate quantities, there is no
reaction whatever."--Brinton, _Treatise on Food and
Digestion_.
Let us not, however, indulge in sweeping statements. We have expressed
ourselves with caution, but a still further limitation needs to be
made. There are a few persons who are never stimulated, but always
poisonously depressed, by certain particular narcotics. There are a
few persons--ourselves among the number--in whom a very temperate dose
of coffee will often give rise to well-defined symptoms of narcosis.
There are others in whom even the smallest quantity of alcoholic
liquor will produce giddiness and flushing of the face. And there are
still others upon whom tobacco, no matter how minute the dose, acts as
a narcotic poison. But such cases are extremely rare; and it is
needless to urge that such persons should conscientiously refrain,
once and always, from the use of the narcotic which thus injuriously
affects them. Our friendly challenge, above given, is addressed to the
vast majority of people; and thus limited, it may be allowed to stand.
We have now defined a narcotic; we have seen that narcotics, in
certain doses, will act as stimulants, and we have defined a
stimulant. Until one's ideas upon these points are rendered precise,
there is little hope of understanding the ordinary healthy action
either of tobacco or of alcohol. But the reader who has followed us
thus far will find himself sufficiently prepared for the special
inquiry into the stimulant effects of these substances. Confining
ourselves, for the present, to tobacco, we shall find that by
assisting the nutritive reparatory process, it conforms throughout to
the definition of a true stimulant.
What do we do to ourselves when we smoke a cigar or pipe? In the first
place, we stimulate, or increase the normal molecular activity of,
the sympathetic system of nerves. By so doing we slightly increase
the secretion of saliva, and of the gastric,[18] pancreatic, and
intestinal juices. We accomplish these all-important secretory actions
with a smaller discharge of nerve force: we economize nerve force in
digestion. And by this we mean to say that we perform the work of
digesting food just as well as before, and still have more of the
co-ordinating and controlling nerve-power left with which to perform
the other functions of life. Thus at the outset tobacco exhibits
itself as an _economizer of life_. Such is the inevitable inference
from its stimulant action on the sympathetic. From the distribution of
the sympathetic fibres, we deem it a fair inference that the
bile-secreting function of the liver is also facilitated; but of this
there is less direct evidence.[19] We can now understand why a pipe or
cigar dissipates the feeling of heaviness ensuing upon a dinner, or
other hearty meal; and when we recollect how instant is the relief, we
can form some notion of the amount of nerve-force which is thus
liberated from the task of digestion. We are thus also reminded of the
hygienic rule that smoking must be done after eating, and not, in
ordinary cases, upon an empty stomach. If we smoke when the stomach is
empty and quiescent, the stimulated secretion of the alimentary juices
is physiologically wasteful; and, moreover, the much more rapid
absorption of nicotine by the blood-vessels increases the liability to
narcotic effects. It is upon this very principle that the same amount
of wine may stimulate at dinner, but narcotize when taken in the
forenoon.
[18] "It is a positive fact that the gastric secretion can
at any time be produced by simply stimulating the salivary
glands with tobacco."--Lewes, _Physiology of Common Life_,
vol. i. p. 192. The gastric secretion is also stimulated by
the action of tobacco on the pneumogastric or eighth pair of
nerves.