1911 The Lancet  
Hygiene of Tobacco-smoking. IN a paper on tobacco-smoking published in a recent number of the Orvosok Lapja Dr. Pekanovics described some of the injurious effects of this practice. He said that besides nicotine, tobacco-smoke contained nicotianine, collidine, and other pyridine derivatives, acids, resins, carbon dioxide, hydrocyanic acid, and ammoniacal salts. Two drops of nicotine placed on a dog's tongue produced in succession efforts to swallow, great weakness, convulsions, and death in less
more » ... , and death in less than a minute ; eight drops of it were sufficient to kill a horse. Tobacco contained from 2 to 8 per cent. of nicotine, and M. Le Bon, a French observer, has determined that though most of this was changed in smoking it was converted into other pyridine bodies which were just as poisonous. Dr. Pekanovics found that these bodies did not condense to any great extent in the warm mouth, and were mostly exhaled, so that the physiological effect of ordinary smoking was not very marked. Susceptible persons might, however, be much affected by breathing the air of a room in which there was much tobacco-smoke. The action of nicotine had been shown by the investigations of Petit to be intermediate between that of the bromides and of digitalis. It soothed the nervous system, but caused a powerful and rapid contraction of the vessels and a rise in blood-pressure. Among its dangers, therefore, one of the best known was angina pectoris, perhaps due to spasm of the coronary arteries. Through prolonged use it promoted the development of arteriosclerosis. Tobacco was a "habit-drug," like opium, cocaine, and alcohol, and its devotee lost the force of will necessary to stop the habit, though he knew it was harming him. Tobacco-smoke had apparently no bactericidal action on any micro-organisms present in the lungs. One of the first effects of an overdose was nausea, and prolonged smoking was a distinct factor in the production of digestive troubles. Short-sightedness in School Children. Dr. Bogdan has given in the Orovsok Lapja an account of his examination of 200 school text-books from a sanitary point of view. He has here drawn particular attention to the fact, already established by many prominent investigators, that short-sightedness in children either originated or developed in connexion with school education. The chief causative agency was, in fact, to be found in too prolonged reading, writing, and drawing, whereby visual accommodation as well as convergence were greatly fatigued. Undue strain of the muscles of accommodation caused an active hyperæmia; the return flow of the venous circulation was greatly hindered, there was an increase of the intra-ocular pressure, and the sclerotic was gradually stretched. Too strong convergence worked even greater harm for the eye in various ways. It must also be observed that in some of the children short-sightedness was hereditary, and they became affected much sooner than their healthy comrades. In addition to the above causes producing short-sightedness, mention must be made of insufficient admission of light in many schools ; a similar remark applied to unsuitable desks and other school furniture. As regards the influence of books on the eyesight, Dr. Bogdan insisted that paper should not have a glossy surface, for under artificial light a surface of this kind prevented the eye from seeing well and necessitated moving the book to and fro, as well as frequent changes in the position of the head. Again, the paper should be thick enough to prevent the printing of the next page from obtruding itself upon the reader's eye. A few authorities have recommended yellow paper, but the majority were in favour of white paper, which gave a better contrast between the printed matter and the background. A Case of Rhinophyma. An interesting case of this rather rare condition, in which i operation was followed bV remarkably good results, was reported by Dr. Imre Fischer at a meeting of the Nagyvdrad Medical Society on Oct. lst. The patient was a man aged 65 years. There was no history of injury. Some years ago he had what was probably an attack of acne rosacea in which the nose and the adjacent borders of the cheeks were most prominently affected. This was followed by a nodular growth of the nose which involved all of that organ except the upper fourth. The growth gave rise to no pain. Breathing was not interfered with, but the projecting mass caused much difficulty in eating. The operation consisted in the making of an elliptical incision with removal of the enclosed part followed by shaving of the growth on each side. Contrary to expectation there was very little hæmorrhage. The cosmetic result was very good, an interesting point being that over the area where the growth was simply shaved off skin of normal appearance has been reproduced instead of scar tissue ; this was chiefly due to the fact that after the removal of the growth the whole surface was touched with a pencil of carbonic acid snow. Histological examination of the removed tissue showed it to be a soft fibroma of the skin with conspicuous distension and possibly hyperplasia of the sebaceous glands. Treatment of Epilepsy. Dr. Rene Berkovics recommends the double bromide of rubidium and ammonium in the treatment of epilepsy; he has seen decidedly better results with this salt than with other bromides. The action is in the main the same, since the rubidium does not exercise any specific effect. The daily dose is 4 to 7 grammes ; 4 or 5 grammes given at night are an excellent hypnotic. Oct. 28th.
doi:10.1016/s0140-6736(01)42172-6 fatcat:uluqvjd47ba2dgvswxh5gca3iu