The origin of the use of tobacco is usually ascribed to the New World. There is no doubt that immediately subsequent to the discovery of America, the use of tobacco spread over the world, and that its employment by Sir Walter Raleigh made it fashionable. It is certain, however, that the Romans and Irish employed pipes for smoking long ere the Christian era (Fig. [1]), but the substances smoked were not tobacco but dried aromatic leaves. The English before Columbus (Fig. [2]) did the same. In Western Asia historic botanical evidence leaves no doubt that tobacco was indigenous. Tobacco from the East hence probably encountered tobacco from the West, both currents meeting in Asia Minor. As with alcohol and opium the statistic method generally adopted proves fallacious when applied to the degenerative effects of tobacco. Study of its effects on the individual is needed to determine its effects on the race. The most careful researches show that the typical effects occur as a rule after long-continued use of tobacco, sometimes not until twenty years or more. While many smokers reach old age, many fail to live to old age because they are smokers. The skin is the subject of itching and reddening, the nerves of taste are blunted, and patches develop in the throat; loss of appetite, epigastric fulness, pain, vomiting, and disturbance of bowel function are common. Menstrual disturbance occurs in women. In female cigar-makers abortion and pluriparity are frequent. The sexual appetite is impaired and sometimes sterility and impotence occur; also disturbed heart action, palpitation, rapid and intermitting pulse, precordial anxiety, weakness, faintness and collapse, with sclerosis of the coronary arteries of the heart and left ventricular hypertrophy. Cigars and cigarettes produce irritation of the nose, mucous membrane, diminished smell, chronic hyperæmia of the epiglottis and larynx, and sometimes of the trachea and bronchi predisposing to consumption. Nicotine amblyopia, or sight weakness, is common, with central disturbances of the field of vision and with colour-weakness of sight. Often there is disorder of the ear tubes and congestion of drum, with loss of power of the hearing nerves, and consequent noises in the ear. The central nervous system is affected. In high schools, non-smokers get on better than smokers. Children from 9 to 15 years of age exhibit less intelligence, laziness, or other degenerative tendencies. Adults have head-pressure, sleeplessness, or drowsy stupor, depression, apathy, and dizziness. There may also be ataxic symptoms, paretic weakness of bowel and bladder, trembling and spasms. Tobacco insanities are comparatively rare in smokers, but are common in snuffers and still oftener in chewers.[157] In the precursory stage, which lasts about three months, there is general uneasiness, restlessness, anxiety, sleeplessness, and mental depression, often of a religious type. After this occurs precordial anxiety, and finally the psychosis proper consisting of three stages: 1. Hallucinations of all senses, suicidal tendency, depression of spirits, attacks of fright with tendency to violence and sleeplessness. 2. Exhilaration, slight emotional exaltation, agreeable hallucinations after from two to four weeks’ relaxation, again followed by excitement. 3. The intervals between exaltation and depression diminish, the patient becomes irritable, but otherwise not alive to his surroundings, and perception and attention are lessened. The patient may be cured in five or six months if he stop tobacco during the first stage. In a year or so he may recover during the second stage. After the third stage the disease is frequently incurable. As the patient often becomes (especially by the use of the cigarette) an habitué ere puberty, the proper development and balance of the sexual and intellectual system is checked. These patients break down mentally and physically between 14 and 25. The moral delinquencies, other than sexual, are often an especial tendency to forgery and deceit of parents. Frequently the insanity of puberty (hebephrenia) is precipitated by tobacco. The cigarette, if used moderately, may be a sedative, but as used is a stimulant, and is often made of spoiled tobacco, resembling in reaction morphine, and on animals acting in a somewhat similar manner. As tobacco turns the salivary glands (which are concerned in digestion of starch) into excretory glands, it leads to imperfect digestion of starch, to consequent irregular fermentation in the bowel, thus at once furnishing a culture medium for microbes, to form more violent toxins from, and also creating leucomaines, to interfere especially with a nervous system overstimulated by nicotine. This is one great reason why those who snuff and chew tobacco more frequently become insane from tobacco than smokers, albeit these last are not exempt.
Statistics from the female employés of the Spanish, French, Cuban, and American tobacco factories, while defective and somewhat vitiated by the co-existence of other conditions producing degeneracy, support the opinion that the maternal tobacco habit (whether intentional or the result of an atmosphere consequent on occupation) is the cause of frequent miscarriage, of high infantile mortality, of defective children, and of infantile convulsions.[158]
Tobacco, therefore, in its influence on the paternal and maternal organism, exhausts the nervous system so that an acquired neurosis results in such a way as to be transmissible.
Professional tea-tasters have long been known to suffer from nervous symptoms; very early in the practice of their occupation the head pressure symptoms of neurasthenia occur. Tremor also occurs early. While changes in the optic nerve have not been demonstrated beyond a doubt, still eye disorders have been observed in the pauper tea-drinkers of the United States and in the tea-tasters of Russia, thus indicating that similar changes to those produced by tobacco and alcohol are likely to occur in the optic nerve from tea. Bullard[159] has found that tea has a cumulative effect. In his experience toxic effects are not produced by less than five cups daily. The symptoms manifested are those of nervous excitement resembling hysteria, at times almost amounting to fury; nervous dyspepsia; rapid and irregular heart action; neuralgia of the heart; helmet-like sensation on the head, and tenderness along the spine. James Wood,[160] of Brooklyn, found that 10 per cent. of those under treatment at the city hospitals exhibited similar symptoms. Of these 69 per cent. were females. Every symptom ascribed by Bullard to tea was found by Wood in his cases, who also found that the women manifested irregularities in menstruation of neurasthenic or hysteria type. He has found these symptoms to be produced by one-half of the quantity of tea charged with these effects by Bullard. The Lancet[161] several years ago, from an editorial analysis of the effects of tea-tippling, took the position that in no small degree nervous symptoms occurring in children during infancy were due to the practice of the mothers, both of the working and society class, indulging in the excessive use of tea, the excess being judged by its effects on the individual and not by the amount taken. Convulsions and resultant infantile paralysis were frequently noticed among the children of these tea-tipplers. Observations among the factory population and the workers in the clothing sweating-shops show that tea neurasthenia, presenting all the ordinary symptoms of nervous exhaustion, is especially common among these. It is evident that tea produces a grave form of neurasthenia readily transmissible to descendants. In addition to its effects directly upon the nervous system, tea tends to check both stomach and bowel digestion, and thus increases the self-poisoning which is so prominent a cause, consequence, and aggravation of these nervous conditions.
Coffee exerts a very similar action to that of tea, albeit the nervous symptoms produced by it are usually secondary to the disturbances of the stomach and bowel digestion. Coffee produces tremor, insomnia, nervous dyspepsia, and helmet sensations. With the exception of certain districts of the United States, coffee abuse is not carried to such an extent as tea, albeit in these, as in some portions of Germany, the habit is an excessive one. The conditions described result in Germany as frequently as they do in the United States. Mendel[162] finds that in Germany coffee inebriety is increasing and supplanting alcohol. Profound depression with sleeplessness and frequent vertex headache are early symptoms. Strong coffee will remove these temporarily, but it soon loses its effects, and they recur. There is much tremor, especially of the hands. The heart’s action is rapid and irregular. Nervous dyspepsia is frequent. L. Bremer, of St. Louis, Mo., has observed similar conditions among both Germans and Americans there.
While coca took its place only recently among the toxic causes of degeneracy, it was old as a factor in the degeneration of the Peruvian long ere the discovery of America by Columbus. Forty-three years ago Johnston[163] wrote that even Europeans in different parts of Peru had fallen into the coca habit long practised by the Indians. A confirmed chewer of coca is called a coquero, and he becomes more thoroughly a slave to the leaf than the inveterate drunkard is to alcohol. Sometimes the coquero is overtaken by an irresistible craving, and betakes himself for days together to the woods, and there indulges unrestrainedly in coca. Young men of the best families of Peru are considered incurable when addicted to this extreme degree of excess. They abandon white society, and live in the woods or in Indian villages. In Peru the term white coquero has the same sense as irreclaimable drunken tramp. The inveterate coquero has an unsteady gait, yellow skin, quivering lips, hesitant speech, and general apathy. The drug has assumed an unusual prominence in the field of degeneracy since the discovery of its alkaloid, cocaine. Since then there has sprung into existence in both Europe and the English-speaking countries the world over, a habit which, while much over-estimated, is undoubtedly growing, and aggravating as well as producing degeneracy. Many of the cases reported as due to cocaine are, however, chargeable to the desire of the hysteric or neurasthenic to secure a new sensation, or the desire on the part of the opium or whisky habitué to try a dodge for forgiveness by friends. The habit is very frequently induced by patent medicines taken to cure catarrh by the neurasthenic, or to cure nervousness by hysterics as well. As the deformities of the nose passages predispose to what is called “catarrh,” patent medicines for local application containing cocaine are frequently employed in the treatment of this supposed constitutional disease, with the result of aggravating the original degeneracy. As the youth under the stress of puberty frequently ascribes all his ills to catarrh, he also employs very frequently snuffs containing cocaine, and has his nervous condition much aggravated thereby. Among the nostrums urged in the newspapers and magazines for this condition, so often resultant on nerve stress, is a certain notorious snuff containing 3 per cent. of cocaine. From the description given by Johnson of the coquero there can be no doubt but tramps, errabund lunatics, and paupers result from this habit, to give birth to degenerates in the next generation.
Lead has been found to produce in those exposed to its fumes a systemic nervous exhaustion, characterised by local paralysis about the wrist as well as the general symptoms of profound systemic nerve tire. This may result, as Tanquerel des Planches[164] pointed out nearly half a century ago, in acute insanity of the confusional type followed very often by forms of mental disorder of a chronic type resembling paretic dementia. In some cases the patient recovers from the acute insanity to suffer thereafter from epilepsy. In other cases, as Kiernan has shown,[165] an irritable suspicional condition results, in which the patient may live for years, marry, and leave offspring. This last condition and the epileptic are the most dangerous as to the production of degeneracy. As has already been pointed out, the women employed in the pottery factories in Germany suffer according to Rennert[166] from a form of lead poisoning which produces decidedly degenerative effects upon the offspring. These women had frequent abortions, often produced deaf-mutes, and very frequently macrocephalic children.
Brass workers suffer from a very similar nervous condition to that produced by lead. Hogden,[167] of Birmingham, called attention to the grave forms of nervous exhaustion produced among brass-workers. The period during which the patient is able to pursue the occupation without breaking down is longer than that of the lead workers. Women, like men, are exposed to this condition. The chief effect produced, so far as offspring have been observed, is chiefly frequent abortions and infantile paralysis.
The occupations employing mercury, whether mining, mirror-making, or gilding, produce forms of systemic nervous exhaustion in which the most marked symptom (but less important from a sanitary standpoint) is a tremor amounting at times almost to shaking-palsy. Like all other systemic nervous exhaustions, the mercurial one may appear as degeneracy in the offspring. The employment of women in match factories and tenement house sweating shops is growing. The chief toxic effect of phosphorus is not the localised jaw necrosis. This is but an evidence of the progressive system saturation with phosphorus. It bears the same relation to the more dangerous effects of phosphorus that “blue gum” does to the systemic effects of lead.
Every condition arising from a toxic cause capable of producing profound systemic nervous exhaustion in the ancestor, and especially the ancestress, is likely to be transmitted as degeneracy to the descendant. Undoubtedly with the growing tendency of woman to pass from the ill-paid work of the seamstress to the better paid but dangerous occupations, a certain seeming increase in degeneracy must result.