To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Foremost among recorded encephalitis epidemics was the global pandemic of encephalitis lethargica that emerged in and from Europe during the last years of the Great War and occurred in successive waves throughout the world during the following decade. Although the diagnosis of encephalitis lethargica is sometimes applied to sporadically occurring cases of inflammation of the brain having a strong lethargic or stuporous aspect, this discussion focuses upon the encephalitis pandemic that accompanied and followed the 1918 influenza pandemic.
Clinical Manifestations and Pathology
Clinically, encephalitis lethargica was characterized by diffuse involvement of the brain and spinal cord, producing practically the entire range of the signs and symptoms of neurological disease. Sometimes occurring in close conjunction with respiratory-spread influenza, but more often after a long interval, encephalitis patients developed an illness usually characterized by the triad signs of fever, lethargy, and disturbances of eye movement, along with a broad range of other signs and symptoms. These included headache, tremor, weakness, depression, delirium, convulsions, the inability to articulate ideas, coordinate movements, or recognize the importance of sensory stimuli, as well as psychosis and stupor. Oculogyric crisis (eyeballs fixed in one position for a period of time) and other disorders of eye movement, the most frequent sign of localized damage to the nervous system, were present in three-fourths of the cases. Lethargy, another common symptom, in some patients lasted only a few days, but in others it persisted for weeks and months or until death from comatose respiratory failure. Not infrequently, spasmodic twitching and severe psychic and behavior changes persisted long after the acute illness.
The term tobaccosis in this essay denotes, collectively, all diseases resulting from the smoking, chewing, and snuffing of tobacco and from the breathing of tobacco smoke. They include cancers of the mouth, nasopharynx, larynx, trachea, bronchi, lungs, esophagus, stomach, liver, pancreas, kidney, bladder, prostate, and cervix, as well as leukemia. They also include atherosclerosis of the cardiovascular system – coronary heart disease (with ischemia and infarction), cardiomyopathy, aortic and other aneurysms, cerebrovascular hemorrhages and blockages; renal failure and peripheral vascular disease; emphysema and chronic obstructive pulmonary diseases; peptic ulcer disease and regional ileitis; cirrhosis of the liver; immunological deficiencies and failures of endocrine and metabolic functions; and fetal diseases and perinatal disabilities.
Tobaccosis is the foremost plague of the twentieth century and thus joins the most fearsome plagues that devastated humanity during this millennium such as the Black Death, smallpox, malaria, yellow fever, Asiatic cholera, and tuberculosis. But unlike microparasitic plagues, whose victims experienced pathognomonic disease manifestations within days or weeks of exposure, tobaccosis is an extraordinarily insidious disease entity of long latency resulting from exposure to tobacco for many years or decades and manifested by increased occurrence of any of a broad spectrum of neoplastic and degenerative diseases ordinarily associated with advanced age. Thus, the powerfully malignant nature and magnitude of the tobaccosis pandemic went largely undetected during the first four centuries of its global march; and it is only late in the fifth century of the post-Columbian world’s exposure to tobacco that the extent of tobacco’s depredations is being fully revealed.
Email your librarian or administrator to recommend adding this to your organisation's collection.