Richmond planet. [volume] (Richmond, Va.) 1883-1938, 1904-08-27
TOBACCO DEAFNESS.
Views of Wyatt Wingrave. NJ. d., Ply.
sician and Pathologist to Lon
don Throat and Ear Hospital.

We SduHOt ldll TO nave observed thu
rapidly increasing consumption of to
Oacco. which is not only beyond Al
proposition to the increase of popula
non. but promises to extend to a sill
greater degree ana. further. that lis
oVer-n0ulSence ESPECIALLY by Youths
IS likely TO be responsible for serious
morold changes, some of which are
pl immediate interest to us in one do
partment of our work. It's resnonsi.
putty for serious morbid visual cbanoes
mas been fully established. and observ.
ing the frequent occurrences of deaf.
ness IN those suffering with tobacco
dtnolyopla. it occurred to me that the
association might be more than coinci.
GENITAL This prompted a careful exam.
NATION Of such cases.
Deafness, due to tobacco smoking
may be conveniently classified in three
groups according to their etiology:
~ Mechanical or pneumatic; C2) irri
tatiVe or catarrhal; (3) toxic or nerve
deafness.
% Mechanical This has its origin
IN the habit of smoking a tightly packed
pipe cigar or cigarette. especially in
those suffering with nasal obstruction
A violent minus or negative naso.
pharyngeal pressure is exerted with
each inspiration. not only upon the
EuStachlan tubes but also upon the
olooo and lymph vessels of the parts sc
ieadlng TO hyperaemia, upon whose
symptoms and treatment we need moi
dwell
~ Irritative or Catarrhal. This form
Is very familiar in the early morning
cough and eXpectoration of habitual
smokers. 1t is caused by the chemical
and mechanical irritation of the smoke
on the mucous membrane, extending
along the EUstachian tube. and inducing
also hypertrophic changes.
% Toxic or Nerve Deafness. This is
due to the gradual accumulation of GER
tain toxins of tobacco in the system
Whatever the actual poison may be.
whether picrO toxin. nicotine. or any
other, it is found. as a rule. in largest
amounts in the darkest. strongest and
cheapest tobaccos. g. E., cut plug. cut
caNenoish. shay. etc. also in cigars of
the maduro strength, oriental as we'll
as occidental. This poison is undoubt-
edly cumulative since complete absti-
nence is essential to effectine anv per-
manent Improvement: mere reduction
in the quantity consumed or of its
strength generally proves unsatisfac-
tory
The effect of tobacco toxin upon the
cardio-vascular system is familiar to
all of us. Also its influence upon the
"astro-intestinal tract. which may be
responsible for the production of further
toxins. But its most striking effect is
upon the nervous system as exempIi-
fed In tobacco amblyopia. n disease
characterized by degeneration of certain
bundles of the optic nerve. known as
the papillomacular -scotoma-
characterized prominently by the loss
III appreciation Of the visual red waves
Does the auditory nerve present a SINH
lar degeneration? Although at present
we have no definite histolocical evil
dence. the fact that there was marked
deficiency i'm the appreciation of low
tones in 80 per cent. of the cases record
ed is preSumptive evidence i'm favor OF
there being some seleCtive degeneration
at work in the auditory as In the optic
nerve
The effects of the toxins may posi-
bly, be terminal and central, but thes-
are questions which also demand care
ful and extensive observations. both
hlstological and clinical. The cases
which | have examined are Il in num-
| Der They are those of typica! nerve
deafness" for which no cause other
than tobacco abuse could be found. TIC
save time ] give YOU brief abstract OF
their chief features
Ages. With regard 20 age. eight oc-
| Cured between - and 30 and nine oc-
CURED between IS and 81.
Tobacco. They all smoked very
strong tobacco or cigars or cigarettes
and in large quantities.
Deafness. They were all subjects o
\ symmetrical nerve deafness; an appre-
citation OF low tones was deficient II
| eight; tiEnitus and vertigo being eener
ally we'll marked
| Nision-There was marked impair
ment Of color seEse-red. in II. of which
four had well-Gefned scotoma
Treatment. Treatment consisted o
complete abstinence from tobacco. il
every form, with the ADMINISTRATION o
strychnia, quinine or bromides.
Results. Quinine, bromides, separate
| ly or combined. afforded no appreciate
effect. but strychnia pushed to full dose
n proved more successful; three sever
cases We're completely cured in eight
nine and twelve months, respectively
nine showed marked Improvement; tw,
improved only slowly, and two refuset
| to continue treatment. That the i'm
| proVement was in a great measure du
TO arrest Of smoking was shown in sew
eral cases, which always pelapsed o.
resuming the habit, although strychni
was persisted with. Improvement wa
again marked on abstaining from to
bacco.
In conclusion, allow me to emphasiz
the following points:
, l. That they were we'll marked case
of nerve deafness (unattributable [
other causes) occurring in heavy smoI
ers.
g That the loss of low tones in :