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Updated: May 22, 2025
In serious pain morphin becomes a life saver. While a number of causes of true cardiac pain may be eliminated by improvement in any loss of compensation, by improvement of the heart tone, by more or less recovery from myocardial or endocardial inflammation, and by the withdrawal of nicotin, which may cause cardiac pains, still, true angina pectoris once occurring is likely to be caused by a progressive, incurable condition, and the attacks will become more frequent until the final one.
The old chewer, safe in the blunted irritability of the salivary glands, can continue his practice all night, if he be so infatuated, without inconvenience. In masticating tobacco, nicotin and nicotianin are rolled about in the mouth with the quid, but are not probably so quickly absorbed as when in the gaseous state.
Other products developed during combustion are carbon monoxid gas, a minute amount of prussic acid and in some varieties a considerable amount of furfurol, a poison. From any one cigar or cigaret but little nicotin is absorbed, else the user would be poisoned. It is generally considered that the best tobacco comes from Cuba, and in the United States from Virginia.
Though peculiar soils and dressings may impart a greater aroma and richness to the plant, by the variations in the quantity of nicotianin, as compared with the other organic elements, yet we are inclined to think that the diminished proportion of nicotin in the best varieties in the cause of their superior flavor to the rank Northern tobaccoes, and that it is mainly because they are milder that they are most esteemed.
Some years ago investigation was made by Torrence, of the Illinois State Reformatory, in which there were 278 boys between the ages of 10 and 15 years. Ninety-two percent of these boys had the habit of smoking cigaretes, and 85 percent were classed as cigarete fiends. The most important action of nicotin is on the circulation.
The nicotin is doing two things for him that are serious: first, it is raising his blood pressure, and second, it will sooner or later weaken his heart, which may be weakened by the high blood pressure alone.
These men may add weight from the age of 40 on, or they may be thin and wiry. Besides the hypertension there is likely to be a too sturdily acting heart, which is often hypertrophied, and there is an accentuated closure of the aortic valve. There may be dizziness, or no head symptoms at all. Nicotin is likely to be an etiologic factor in this class.
It is probable that the tobacco-chewer, by putting fifty grains of the "Solace," "Honey-Dew," or "Cavendish" into his mouth for the purpose of mastication, introduces at the same time from one to four grains of nicotin with it, according to the quality of the tobacco he uses. It is not probable that anything like this amount is absorbed into the system. Nature protects itself by salivation.
So, too, the cigar improves with age, because a certain amount of nicotin evaporates and escapes. Taste in cigars varies, however, from the Austrian government article, a very rank "long-nine," with a straw running through the centre to improve its suction, to the Cuban cigarrito, whose ethereal proportions three whiffs will exhaust.
If it is due to a toxemia from intestinal disturbance, that may readily be remedied. If due to nicotin, it need not again occur from that reason, and perhaps the damage caused by the nicotin may be removed. Any organic kidney trouble must, of course, be managed according to its seriousness, and if there is hypertension without any serious lesion, the treatment should be directed toward its relief.
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