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September 24, 1887


JAMA. 1887;IX(13):415. doi:10.1001/jama.1887.02400120031011

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Dear Sir:  —A gentleman 39 years old, weight 170 lbs., occupation a guide roller, came into my office this evening for examination for life insurance. I was smoking a cigar. He politely asked me to desist from smoking whilst he was in the office, as he would not hold himself responsible for what might occur. I quit smoking and raised the windows to let the offensive smoke pass out. He stated that the smoke first caused an intense pain over both eyes, causing him to knit his brows; then he became, as he termed it, cranky, and would fight with his best friend. After this cranky condition lasted for a time he became sick at the stomach, and would throw up the contents of his stomach, after which he would have to lie down. He further stated that his mother had the same idiosyncrasy with regard to tobacco smoke, and

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