Smoking
The Guild News, March 1941, pages 7 & 8
"Pernicious Weed!"
For thy sake, tobacco, I/Would do anything but die.--Charles Lamb
To smoke or not to smoke? That is the moot question.
Whenever two or more persons are gathered together, the conversation is likely to go something like this:
"Smoking doesn't hurt me a bit." . . . "I cut it out two months ago and I never felt better in my life." . . . "My doctor won't stand for smoking." . . . "Well, my doctor will."
The Guild News, always the public servant, decided to go to headquarters. The following are the independent opinions of seven Saranac Lake tuberculosis specialists:
Dr. Edward R. Baldwin doesn't smoke says, "As to the influence of tobacco smoke on tuberculosis, the opinions have varied from complete abstinence, as the only safe procedure for tuberculosis patients, to moderate indulgence. "Unquestionably, some physicians are inclined to permit smoking because they, themselves, smoke, and many specialists who have the disease themselves, continue to use tobacco. Personally, I have always tried to be rational in advice in the matter of smoking. Each individual should be advised according to his condition. If a patient has an involvement of the larynx, it seems entirely obvious that added irritation from smoking would be contraindicated. On the other hand, patients who have very little cough and expectoration are not at all likely to be harmfully influenced by three to five cigarettes a day, or a couple of cigars, or frequent use of the pipe. To summarize, a wise doctor is the one who treats each patient as a separate problem."
Dr. Baldwin doesn't smoke.
Dr. Francis B. Trudeau advises the reduction, or elimination, of smoking in two types of cases: all throat cases, and cases with highly positive sputum, where there is the danger of throat infection. In connection with the latter, he explains that coughing may cause an abrasion over which the sputum is constantly passing, increasing the danger of infection. Some people have a cigarette cough, Dr. Trudeau says. That cough is not good for the tuberculosis patient. If cigarettes are eliminated, at least that part of his cough which is due to smoking is eliminated. The corollary is that others have a cough which is exaggerated by the use of tobacco. Then, too, smoking must be eliminated. To have a bad cough, Dr. Trudeau says, is about as strenuous as climbing Baker Mountain. He does not believe, however, that smoking has any detrimental effect on the disease of the lung itself. Where there is neither a throat condition, nor the danger of it, he advocates the reduction of the normal amount of smoking, until the patient is down to a cigarette after each meal. He finds most patients co-operative in reducing or eliminating the use of tobacco, and says that some like to do so on an organized schedule.
Dr. Trudeau smokes cigarettes.
Dr. J. Woods Price finds the problem of advising patients on the use of tobacco a constant and important one. Where there is a cough, or where the appetite is noticeably affected, smoking should be eliminated, he feels. When neither of these conditions is present, and smoking means anything to the patient, he thinks the moderate use of tobacco is justifiable. The majority of patients expect that tobacco will be eliminated, and it is his opinion that it is easier for the patient to cut out smoking altogether, than to reduce it gradually. He regards six cigarettes a day as a moderate number. Dr. Price recalls that when he came to Trudeau Sanatorium in 1904, the smoking of cigarettes on the grounds was prohibited. All smoking was banned in the cottages, but a pipe or cigar might be smoked in the open-air pavilion after meals. The pavilion stood on the site of the present Recreation Pavilion, and was exposed to the four winds. Came the war, the soldier with his fag, and the woman smoker, and moderation was almost a thing of the past. Dr. Price never smoked in his own office, he says, until after the war. Men occasionally asked if they might smoke. But the woman smoker changed all that. With ashes fluttering all over the waiting room, Dr. Price finally installed ash trays, and now once in a while enjoys a smoke himself in his own office.
Dr. Price smokes cigarettes and cigars.
Dr. D. M. Brumfiel has no objection to an occasional smoke, providing it doesn't do one of three things: cause a cough, induce a lack of appetite or interfere with the relaxation of the patient. Smoking in excess is bad for anyone, and it doesn't take a doctor to tell you so, Dr. Brumfiel says. It keeps the nervous system jacked-up, and interferes with rest and appetite. Although he has no objection to an occasional smoke, especially after meals, he feels that in cases where the patient can do so without too much nervous shock, he should take advantage of his period of curing to eliminate nicotine from his system. He likes the idea of converting cigarette smokers into pipe smokers, says that while learning, they principally smoke matches anyway, and though getting less tobacco, they have the same psychological satisfaction.
Dr. Brumfiel smokes a pipe and cigarettes.
Dr. Henry Leetch says the use of tobacco is a drug habit, and that nobody has to ask a doctor if it's good for the human body. However, he's pretty lenient, and in cases where there is no throat infection, nor loss of appetite, he thinks six to ten cigarettes a day do very little harm. The new patient, Dr. Leetch feels, coming here with his life temporarily disrupted, and his emotions disturbed, suffers less from the moderate use of tobacco than from its withdrawal. In his first period of extreme nervousness, it is an unnecessary hardship, he thinks, to completely eliminate tobacco.
Dr. Leetch rolls his own cigarettes, and occasionally smokes a pipe.
Dr. John N. Hayes states that "smoking is under dreadful fire these days both in diseases of the lungs and heart." The longer he treats tuberculosis cases, the more desirable he thinks it is that smoking be eliminated. In curing tuberculosis, a great deal of self-discipline is required, he says. Since few people can smoke in moderation, it is an all or nothing proposition. Discontinue the habit, is his advice to patients. Tobacco is an irritant to the throat and produces cough and expectoration. All doctors advise their patients to control the cough, which shakes the lung and does not allow it proper rest. Why then, he asks, use tobacco, which may be expected to aggravate or induce cough? He also says that it is human, on the part of the patient who has made a recovery, to attribute any cough he may develop to the use of tobacco. With tobacco eliminated, the cough becomes a symptom with which the experienced patient will know how to deal.
Dr. Hayes smokes cigarettes.
Dr. Hugh M. Kinghorn advises all patients to completely eliminate tobacco, not only during their period of curing, but afterward, when they have returned to normal health. "The cough that is induced by the use of tobacco masks symptoms," Dr. Kinghorn says. "The patient who has recovered, and is home and at work, may develop a cough. If he is a smoker, he is quite likely to call it a cigarette cough, and to ignore the symptoms. We not only want to cure the patient; we want to keep him well." Smoking is especially dangerous in diseases of the larynx, or mouth, Dr. Kinghorn says. While ill, the patient should cut out the use of all tobacco, but upon recovery, if he feels he must smoke, Dr. Kinghorn thinks a cigar or pipe might be permitted occasionally, providing they are not inhaled. He has no use for cigarettes. Smoking them he describes as "a dirty habit." He commented that "if young women only knew how much it detracts from their charm, and how unpleasant a thing is this reeking from tobacco smoke, they would eliminate it." Why not break a habit? he asks, that has helped to exaggerate a disease.
Dr. Kinghorn smokes cigars, which he does not inhale. There are no ash trays in his office.
All of which proves that Saranac Lake specialists are most obliging. If you want Little Willie to cut out smoking, you'll know whom to consult; and if you're Little Willie, with a fondness for the weed, pick your man.
Dr. Edward Welles smoked cigarettes, as a photo on his page will attest.
Dr. Leroy Gardner smoked a pipe.
SARANAC, 1937-1940
A Memoir of "The Cure" in the Adirondacks
by Richard Ray
Smoking cigarettes was a habit acquired at 15, attending high school, learning to drink beer and dance among other things I hadn't done in a town of 2,000 at age 13 or 14. Smoking was not considered a serious health problem in the mid '30s.
Sanatorium rules were fifty or more years ahead of the times where smoking was concerned. Buildings were mostly off limits to cigarettes. Smoking was frowned on but the only proscription was against smoking in bed. The danger of setting fire to the bedclothes by dropping hot ashes was certainly considered more important than danger to a patient's lungs, so Ray Brook would permit patients to smoke only in the fully tiled shower-bathroom-toilet areas -- or outside the buildings.
Somewhere during that long bed-bound year of 1939 I gave in to temptation and put together a handmade hookah to sneak some late-night, low risk smokes. Though I had a bad case of nerves each night I smoked, I managed to go undetected and might have continued the action until someone caught me, except that one morning I forgot that the glass by my bedside still held the same water that had recently filtered the smoke of a cigarette and I swallowed a gulp. And that tasted so bad I didn't even dream about cigarettes until I could get on my feet again.
But nicotine held me in bondage for many more years of chasing the cure. When the surgeon general, in 1958, proved that smoking cigarettes was a major cause of lung cancer, I finally managed to give up the habit.
[There's a photo of the author on page 46, standing outdoors at Ray Brook Sanatorium in pajamas and robe, "stepping outside for a cigarette."]
