Nicotine may not be the dominant pathogenic agent in tobacco and many symptoms commonly attributed to this agent may in reality be chronic allergic reactions to tobacco proteins (or to bacterial proteins developed during the process of fermentation). Sulzberger1 and his colleagues of the Montefiore Hospital, New York, have published data which do not prove that nicotine is without injurious effects but which do serve to call attention to a possibility thus far overlooked in theoretical and practical toxicological research.
Sulzberger's conclusions were drawn from a study of reactivity of the skin to various tobacco products. Tests made by the patch method on fifty-eight healthy nonsmokers, for example, showed 16 per cent with a hereditary or acquired sensitivity to tobacco extract. Similar tests with ninety-five healthy smokers showed 36 per cent with the same cutaneous sensitivity. A parallel study of seventy-three patients with cardiovascular disease exclusive of thrombo-angiitis obliterans
TOBACCO ALLERGY. JAMA. 1933;101(7):527–528. doi:10.1001/jama.1933.02740320037011
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