Accidents have occurred from children playing with old pipes. In 1877[358] a child, aged three, used for an hour an old tobacco-pipe, and blew soap bubbles with it. Symptoms of poisoning soon showed themselves, and the child died in three days.
[358] Pharm. Journ. [3], 377, 1877.
Tobacco-juice, as expressed or distilled by the heat developed in the usual method of smoking, is very poisonous. Sonnenschein relates the case of a drunken student, who was given a dram to drink, into which his fellows had poured the juice from their pipes. The result was fatal. Death from smoking is not unknown.[359] Helwig saw death follow in the case of two brothers, who smoked seventeen and eighteen German pipefuls of tobacco. Marshall Hall[360] records the case of a young man, nineteen years of age, who, after learning to smoke for two days, attempted two consecutive pipes. He suffered from very serious symptoms, and did not completely recover for several days. Gordon has also recorded severe poisoning from the consecutive smoking of nine cigars. The external application of the leaf may, as already shown in the case of the horse, produce all the effects of the internal administration of nicotine. The old instance, related by Hildebrand, of the illness of a whole squadron of hussars who attempted to smuggle tobacco by concealing the leaf next to their skin, is well known, and is supported by several recent and similar cases. The common practice of the peasantry, in many parts of England, of applying tobacco to stop the bleeding of wounds, and also as a sort of poultice to local swellings, has certainly its dangers. The symptoms—whether nicotine has been taken by absorption through the broken or unbroken skin, by the bowel, by absorption through smoking, or by the expressed juice, or the consumption of the leaf itself—show no very great difference, save in the question of time. Pure nicotine acts with as great a rapidity as prussic acid; while if, so to speak, it is entangled in tobacco, it takes more time to be separated and absorbed; besides which, nicotine, taken in the concentrated condition, is a strong enough base to have slight caustic effects, and thus leaves some local evidences of its presence. In order to investigate the effects of pure nicotine, Dworzak and Heinrich made auto-experiments, beginning with 1 mgrm. This small dose produced unpleasant sensations in the mouth and throat, salivation, and a peculiar feeling spreading from the region of the stomach to the fingers and toes. With 2 mgrms. there was headache, giddiness, numbness, disturbances of vision, torpor, dulness of hearing, and quickened respirations. With 3 to 4 mgrms., in about forty minutes there was a great feeling of faintness, intense depression, weakness, with pallid face and cold extremities, sickness, and purging. One experimenter had shivering of the extremities and cramps of the muscles of the back, with difficult breathing. The second suffered from muscular weakness, fainting, fits of shivering, and creeping sensations about the arms. In two or three hours the severer effects passed away, but recovery was not complete for two or three days. It is therefore evident, from these experiments and from other cases, that excessive muscular prostration, difficult breathing, tetanic cramps, diarrhœa, and vomiting, with irregular pulse, represent both tobacco and nicotine poisoning. The rapidly-fatal result of pure nicotine has been already mentioned; but with tobacco-poisoning the case may terminate lethally in eighteen minutes. This rapid termination is unusual, with children it is commonly about an hour and a half, although in the case previously mentioned, death did not take place for two days.
[359] The question as to whether there is much nicotine in tobacco-smoke cannot be considered settled; but it is probable that most of the poisonous symptoms produced are referable to the pyridene bases of the general formula (CnH2n-5N). Vohl and Eulenberg (Arch. Pharmac., 2, cxlvi. p. 130) made some very careful experiments on the smoke of strong tobacco, burnt both in pipes and also in cigars. The method adopted was to draw the smoke first through potash, and then through dilute sulphuric acid. The potash absorbed prussic acid, hydric sulphide, formic, acetic, propionic, butyric, valeric, and carbolic acids; while in the acid the bases were fixed, and these were found to consist of the whole series of pyridene bases, from pyridene (C5H5N), boil. point 117°, picoline (C6H7N), boil. point 133°, lutidine (C7H9N), boil. point 154°, upwards. When smoked in pipes, the chief yield was pyridene; when in cigars, collidine (C8H11N); and in general, pipe-smoking was found to produce a greater number of volatile bases. The action of these bases has been investigated by several observers. They all have a special action on the organism, and all show an increase in physiological activity as the series is ascended. The lowest produce merely excitement from irritation of the encephalic nervous centres, and the highest, paralysis of those centres. Death proceeds from gradual failure of the respiratory movements, leading to asphyxia—(Kendrick and Dewar, Proc. Roy. Soc., xxii. 442; xxiii. 290). The most recent experimental work is that of A. Gautier; he found that tobacco smoked in a pipe produced basic compounds, a large quantity of nicotine, and a higher homologue of nicotine, C11H16N2, which pre-exists in tobacco leaves, and a base C6H9NO, which seems to be a hydrate of picoline—(Compt. Rend., t. cxv. p. 992, 993). The derivatives of the pyridene series are also active. The methiodides strongly excite the brain and paralyse the extremities. A similar but more energetic action is exerted by the ethyl and allyl derivatives; the iodyallyl derivatives are strong poisons. Methylic pyridene carboxylate is almost inactive, but the corresponding ammonium salt gives rise to symptoms resembling epilepsy—(Ramsay, Phil. Mag., v. 4, 241). One member of the pyridene series β-lutidine has been elaborately investigated by C. Greville Williams and W. H. Waters—(Proc. Roy. Soc., vol. xxxii. p. 162, 1881). They conclude that it affects the heart profoundly, causing an increase in its tonicity, but the action is almost confined to the ventricles. The auricles are but little affected, and continue to beat after the ventricles have stopped. The rate of the heart’s beat is slowed, and the inhibitory power of the vagus arrested. By its action on the nervous cells of the spinal cord, it in the first place lengthens the time of reflex action, and then arrests that function. Finally, they point out that it is antagonistic to strychnine, and may be successfully employed to arrest the action of strychnine on the spinal cord.
[360] Edin. Med. and Surg. Jour., xii., 1816.