Medical Marijuana Historical Record
On the Preparations of the Indian Hemp, or Gunjah
from Transactions of the Medical and Physical Society of
Bengal, by W.B. O'Shaugnessy, M.D. (Calcutta: 1838-1840, pp.
421-461)
On the Preparations of the Indian Hemp,
or Gunjah
(CANNABIS INDICA); THEIR EFFECTS ON THE ANIMAL SYSTEM IN HEALTH, AND THEIR UTILITY IN THE TREATMENT OF TETANUS AND OTHER CONVULSIVE DISEASES
(CANNABIS INDICA); THEIR EFFECTS ON THE ANIMAL SYSTEM IN HEALTH, AND THEIR UTILITY IN THE TREATMENT OF TETANUS AND OTHER CONVULSIVE DISEASES
Presented October, 1839.
By W.B. O'Shaugnessy, M.D., Assistant-Surgeon, and
Professor of Chemistry, &c. In the Medical College of
Calcutta.
The narcotic effects of Hemp are popularly known in the south
of Africa, South America, Turkey, Egypt, Asia Minor, India, and
the adjacent territories of the Malays, Burmese, and Siamese. In
all these countries Hemp is used in various forms, by the
dissipated and depraved, as the ready agent of pleasing
intoxication. In the popular medicine of these nations, we find
it extensively employed for a multitude of affections. But in
Western Europe, its use either as a stimulant or as a remedy, is
equally unknown. With the exception of the trial, as a frolic, of
the Egyptian 'Hasheesh,' by a few youths in Marseilles, and of
the clinical use of the wine of Hemp by Mahneman, as shewn in a
subsequent extract, I have been unable to trace any notice of the
employment of this drug in Europe.
Much difference of opinion exists on the question,
whether the Hemp so abundant in Europe, even in the high northern
latitudes, is identical in specific characters with the Hemp of
Asia Minor and Hindostan. The extraordinary symptoms produced by
the latter depend on a resinous secretion with which it abounds
and which seems totally absent in the European kind. As the
closest physical resemblance or even identity exists between both
plants, difference of climate seems to me more than sufficient to
account for the absence of the resinous secretion, and consequent
want of narcotic power in that indigenous in colder
countries.
In the subsequent article I first endeavour to
present an adequate view of what has been recorded of the early
history, the popular uses and employment in medicine of this
powerful and valuable substance. I then proceed to notice several
experiment which I have instituted on animals, with the view to
ascertain its effects on the healthy system; and, lastly, I
submit an abstract of the clinical details of the treatment of
several patients afflicted with hydrophobia, tetanus, and other
convulsive disorders, in which a preparation of Hemp was employed
with results which seem to me to warrant our anticipating from
its more extensive and impartial use no inconsiderable addition
to the resources of the physician.
In the historical and statistical department of
the subject, I owe my cordial thanks for most valuable assistance
to the distinguished traveller, the Syed Keramut Ali, Mootawulee
of the Hooghly Imambarrah, and also the Hakim Mirza Abdul Rhazes
of Teheran, who have furnished me with interesting details
regarding the consumption of Hemp in Caudahar, Cabul, and the
countries between the Indus and Herat. The Pundit Modoosudun
Goopto has favoured me with notices of the remarks on these drugs
in the early Sanscrit authors on Materia Medica; -- to the
celebrated Kamalakantha Vidyadanka, the Pundit of the Asiatic
Society, I have also to record my acknowledgments; -- Mr. DaCosta
has obligingly supplied me with copious notes from the
'Mukzun-ul-Udwieh,' and other Persian and Hindee systems of
Materia Medica. For information relative to the varieties of the
drug, and its consumption in bengal, Mr. McCann, the Deputy
Superintendent of Police, deserves my thanks; -- and lastly, to
Dr. Goodeve, to Mr. Richard O'Shaughnessy, to the late Dr. Bain,
to Mr. O'Brien of the Native Hospital, and Nobinchunder Mitter,
one of my clinical clerks, I am indebted for the clinical details
with which they have enriched the subject.
Botanical characters, chemical properties, production.
Botanical Description -- Assuming with Lindley and other
eminent writers that the
Cannabis sativa and
Indica are identical, we find that the plant is dioecious,
annual, about three feet high, covered over with a fine
pubescence; the stem is erect, branched, bright green, angular;
leaves alternate or opposite, on long weak petioles; digitate,
scabrous, with linear, lanceolate, sharply serrated leaflets,
tapering into a long, smooth, entire point; stipules subulate;
clusters of flowers axillary, with subulate braces; males lax and
drooping, branched and leafless at base; females erect, simple
and leafy at the base. [Male] Calyx downy, five parted,
imbricated. Stamens five; anthers large and pendulous. [Female]
Calyx covered with brown glands. Ovary roundish, with pendulous
ovule, and two long filiform glandular stigmas; achenium ovate,
one seeded. --
v. Lindley's Flora Medica, p. 299.
The fibres of the stems are long and extremely
tenacious, so as to afford the best tissue for cordage, thus
constituting the material for one of the most important branches
of European manufactures.
The seed is simply albuminous and oily, and is
devoid of all narcotic properties.
Chemical Properties -- In certain seasons, and in warm
countries, a resinous juice exudes, and concretes on the leaves,
slender stem, and flowers; the mode of removing this juice will
be subsequently detailed. Separated and in masses it constitutes
the
Churrus[1] of Nipal and Hindostan, and to this the type,
or basis of all the Hemp preparations, are the powers of these
drugs attributable.
The resin of the Hemp is very soluble in alcohol
and ether; partially soluble in alkaline; insoluble in acid
solutions; when pure, of a blackish grey colour; hard at 90
degrees; softens at higher temperatures, and fuses readily; --
soluble in the fixed and in several volatile oils. Its odour is
fragrant and narcotic; taste slightly warm, bitterish, and
acrid.
The dried Hemp plant which has flowered, and
from which the resin has not been removed, is called
Gunjah. It sells from twelve annas to one rupee seer, in
the Calcutta bazars, and yields to alcohol twenty per 100 of
resinous extract, composed of the resin (
churrus) and green colouring matter (
Chloro-phille). Distilled with a large quantity of water,
traces of essential oil pass over, and the distilled liquor has
the powerful narcotic odour of the plant. The
gunjah is sold for smoking chiefly. The bundles of
gunjah are about two feet long, and three inches in
diameter, and contain 24 to 36 plants. The colour is dusky green
-- the odour agreeably narcotic -- the whole plant resinous and
adhesive to the touch. The larger leaves and capsules without the
stalks, are called
'Bangh Subjee or Sidhee.' They are used for making an
intoxicating drink, for smoking, and in the conserve or
confection termed
Majoon.
Bang is cheaper than
gunjah, and though less powerful, is sold at such a low
price, that for one pice enough can be purchased to intoxicate an
experienced person.
According to Mr. McCann's notes, the
gunjah consumed in Bengal is chiefly brought from
Mirzapúr and Ghazeepore, being extensively cultivated
near Gwalior and in Tirboot. The natives cut the plant when in
flower, allow it to dry for three days, and then lay it in
bundles, averaging one seer weight each, which are distributed to
the licensed dealers. The best kind are brought from Gwalior and
Bhurtpore, and it is also cultivated of good quality in a few
gardens around Calcutta. In Jessore, I am informed, the drug is
produced of excellent quality, and to a very considerable extent
of cultivation.
In Central India and the Saugor territory, and in
Nipal,
churrus is collected during the hot season, in the
following singular manner: -- Men clad in leathern dresses run
through the Hemp-fields, brushing through the plant with all
possible violence; the soft resin adheres to the leather, is
subsequently scraped off, and kneaded into balls, which sell from
five to six rupees the seer. A still finer kind, the
momeea or waxen
churrus, is collected by the hand in Nipal and sells for
nearly double the price of the ordinary kind. In Nipal, Dr.
McKinnon informs me, the leathern attire is dispensed with, and
the resin is gathered on the skins of naked coolies. In Persia,
it is stated by Mirza Abdool Rhazes that the
churrus is prepared by pressing the resinous plants on
coarse cloths, and then scraping it from these, and melting it in
a pot with a little warm water. He considers the
churrus of Herat as the best and most powerful of all the
varieties of the drug.
Popular uses.
The preparations of Hemp are used for the purpose
of intoxication as follow:
Sidhee,
subjee, and
bang (synonymous) are used with water as a drink, which is
thus prepared. About three tola weight, 540 troy grains, are well
washed with cold water, then rubbed to powder, mixed with black
pepper, cucumber and melon seeds, sugar, half a pint of milk, and
an equal quantity of water. This is considered sufficient to
intoxicate an habituated person. Half the quantity is enough for
a novice. This composition is chiefly used by the Mahomedans of
the better classes.
Another recipe is as follows:
The same quantity of
sidhee is washed and ground, mixed with black pepper, and
a quart of cold water added. This is drank at one sitting. This
is the favorite beverage of the Hindus who practice this vice,
especially the Birjobassies, and many of the rajpootana
soldiery.
From either of these beverages intoxication will
ensue in half an hour. Almost invariably the inebriation is of
the most cheerful kind, causing the person to sing and dance, to
eat food with great relish, and to see aphrodisiac enjoyments. In
persons of quarrelsome disposition it occasions, as might be
expected, an exasperation of their natural tendency. The
intoxication lasts about three hours, when sleep supervenes. No
nausea or sickness of stomach succeeds, nor are the bowels at all
affected, next day there is slight giddiness and vascularity of
the eyes, but no other symptom worth recording.
Gunjah is used for smoking alone -- one rupee weight, 180
grains, and a little dried tobacco are rubbed together in the
palm of the hand with a few drops of water. This suffices for
three persons. A little tobacco is placed in the pipe first, then
a layer of the prepared
gunjah, then more tobacco, and the fire above all.
Four or five persons usually join in this debauch.
The hookah is passed round, and each person takes a single
draught. Intoxication ensues almost instantly, and from one
draught to the unaccustomed -- within half an hour, and after
four or five inspirations to those more practised in the vice.
The effects differ from those occasioned by the
sidhee. Heaviness, laziness, and agreeable reveries ensue,
but the person can be readily roused, and is able to discharge
routine occupations, such as pulling the punkab, waiting at
table, &c.
The
Majoon, or Hemp confection, is a compound of sugar,
butter, flour, milk and
sidhee or
bang. The process has been repeatedly performed before me
by Ameer, the proprietor of a celebrated place of resort for Hemp
devotees in Calcutta, and who is considered the best artist in
his profession. Four ounces of
sidhee, and an equal quantity of
ghee are placed in an earthen or well-tinned vessel, a
pint of water added, and the whole warmed over a charcoal fire.
The mixture is constantly stirred until the water all boils away,
which is known by the crackling noise of the melted butter on the
sides of the vessel. The mixture is then removed from the fire,
squeezed through cloth while hot -- by which an oleaginous
solution of the active principles and colouring matter of the
Hemp is obtained -- and the leaves, fibres, &c. remaining on
the cloth are thrown away.
The green oily solution soon concretes into a
buttery mass, and is then well washed by the hand with soft
water, so long as the water becomes coloured. The colouring
matter and an extractive substance are thus removed, and a very
pale green mass, of the consistence of simple ointment, remains.
The washings are thrown away: Ameer says that these are
intoxicating, and produce constriction of the throat, great pain,
and very disagreeable and dangerous symptoms.
The operator then takes 2 lbs. of sugar, and
adding a little water, places it in a pipkin over the fire. When
the sugar dissolves and froths, two ounces of milk are added; a
thick scum rises and is removed; more milk and a little water are
added from time to time, and the boiling continued about an hour,
the solution being carefully stirred until it becomes an adhesive
clear syrup, ready to solidify on a cold surface; four ounces of
tyre (new milk dried before the sun) in fine powder, are now
stirred in, and lastly the prepared butter of Hemp is introduced,
brisk stirring being continued for a few minutes. A few drops of
attur of roses are then quickly sprinkled in, and the mixture
poured from the pipkin on a flat cold dish or slab. The mass
concretes immediately into a thin cake, which is divided into
small lozenge-shaped pieces. A seer thus prepared sells for four
rupees: one drachm by weight will intoxicate a beginner; three
drachms one experienced in its use: the taste is sweet, and the
odour very agreeable.
Ameer states that there are seven or eight
majoon makers in Calcutta -- that sometimes, by special
order of customers, he introduces stramonium seeds, but never
nux-vomica; that all classes of persons, including the lower
Portugese, or 'Kala Feringhees,' and especially their females,
consume the drug; that it is most fascinating in its effects,
producing extatic happiness, a persuasion of high rank, a
sensation of flying -- voracious appetite, and intense
aphrodisiac desire. He denies that its continued use leads to
madness, impotence, or to the numerous evil consequences
described by the Arabic and Persian physicians. Although I
disbelieve Ameer's statements on this point, his description of
the immediate effect of
majoon is strictly and accurately correct.
Most carnivorous animals eat it greedily, and very
soon experience its narcotic effects, becoming ludicrously drunk,
but seldom suffering any worse consequences.
Historical details -- Notice of Hemp, and its popular uses by the Sanscrit, Arabic, and Persian writers.
The preceding notice suffices to explain the
subsequent historical and medicinal details. I premise the
historical, in order to shew the exact state of our knowledge of
the subject, when I attempted an investigation.
Although the most eminent of the Arabic and
Persian authors concur in referring the origin of the practice of
Hemp intoxications to the natives of Hindoostan, it is remarkable
that few traces can be detected of the prevalence of the vice at
any early period in India.
The Pundit Modoosudun Gooptu finds that 'Tajni
guntu,' a standard treatise on Materia Medica, which he estimates
vaguely at 600 years' date, gives a clear account of this agent.
Its synonyms are '
Bijoya,' '
Ujoya,' and '
Joya,' names which mean promoters of success; '
Brijputta,' or the strengthener, or the strong-leaved; '
Chapola,' the causer of a reeling gait; '
Ununda,' or laughter moving; '
Hursini,' the exciter of sexual desire. Its effects on man
are described as excitant, heating astringent. It is added that
it 'destroys phlegm, expels flatulence, induces costiveness,
sharpens the memory, increases eloquence, excites the appetite,
and acts as a general tonic.'
The 'Rajbulubha,' a Sanscrit treatise of rather
later date, alludes to the use of Hemp in gonorrhoea, and repeats
the statements of the 'Rajniguntu.' In the Hindu Tantra, or a
religious treatise, teaching peculiar and mystical formulae and
rites for the worship of the deities, it is said moreover, that
sidhee is more intoxicating that wine.
In the celebrated 'Susruta,' which is perhaps the
most ancient of all Hindy medical works, it is written that
persons labouring under catarrh should, with other remedies, use
internally the
bijoya or
sidhee. The effects however are not described.
The learned Kamalakantha Vidyalanka has traced
notice of Hemp in the 5th chapter of
Menu, where Brahmins are prohibited to use the following
substances,
plandoo or onions;
gunjara or
gunjah; and such condiments as have strong and pungent
scents.
The Persian and Arabic writers are however far
more voluminous and precise in their accounts of these
fascinating preparations. In the 1st vol. of De Sacy's
'Crestomathie Arabe,' we find an extremely interesting summary of
the writings of Takim Eddin Makrizi on this subject. Lane has
noticed it too with his usual ability in his admirable work 'The
Modern Egyptians.' From these two sources, the MS. notes of the
Syed Keramut Ali and Mr. DaCosta, and a curious paper
communicated by our friend Mirza Abdool Rhazes, a most
intelligent Persian Physician, the following epitome is
compiled.
Makrizi treats of the Hemp in his glowing
description of the celebrated Canton de la Timbaliere, or ancient
pleasure grounds, in the vicinity of Cairo. This quarter, after
many vicissitudes, is now a heap of ruins. In it was situated a
cultivated valley named Djoneina, which we are informed was the
theatre of all conceivable abominations. It was famous above all
for the sale of the
Hasheeha, a drug still greedily consumed by the dregs of
the populace, and from the consumption of which sprung the
excesses which led to the name of 'Assassin,' being given to the
Saracens in the Holy Wars. The history of the drug the author
treats of thus: The oldest work in which Hemp is noticed is a
treatise by Hasan, who states that in the year 658 (Mahometan
era), the Sheikh Djafar Shirazi, a monk of the order of Haider,
learnt from his master the history of the discovery of Hemp.
Haider, the chief of ascetics and self-chasteners, lived in rigid
privation on a mountain between Nishabor and Romah, where he
established a monastery of Fakirs. Ten years he had spent in this
retreat, without leaving it for a moment, till one burning
summer's day, when he departed alone to the fields. On his return
an air of joy and gaiety was imprinted on his countenance; he
received the visits of his brethren, and encouraged their
conversation. On being questioned, he stated that struck by the
aspect of a plant which danced in the heat as if with joy, while
all the rest of the vegetable creation was torpid, he had
gathered and eaten of its leaves. He led his companions to the
spot, all ate, and all were similarly excited. A tincture of the
Hemp leaf in wine or spirit seems to have been the favorite
formula in which the Sheikh Haider indulged himself. An Arab poet
sings of Haider's
emerald cup; an evident allusion to the rich green
colour of the tincture of the drug. The Sheikh survived the
discovery ten years, subsisting chiefly on this herb, and on his
death his disciples by his desire planted it in an arbour about
his tomb.
From this saintly sepulcher the knowledge of the
effects of Hemp is stated to have spread into Khorasan. In
Chaldea it was unknown until 728, during the reign of the Khalif
Mostansir Billah: the kings of Drmus and Bahrein then introduced
it into Chaldea, Syria, Egypt, and Turkey.
In Khorasan, however, it seems that the date of
the use of Hemp is considered to be far prior to Haider's era.
Biraslan, an Indian pilgrim, the contemporary of
Cosröes,[2] is believed to have introduced and
diffused the custom through Khorasan and Yemen. In proof of the
great antiquity of the practice, certain passages in the works of
Hippocrates may be cited, in which some of its properties are
clearly described; but the difficulty of deciding whether the
passages be spurious or genuine renders the fact of little value.
Dioscorides (lib. ij. cap. 169) describes Hemp, but metely
notices the emollient properties of its seeds -- its intoxicating
effects must consequently be regarded as unknown to the Greeks
prior to his era, which is generally agreed to be about the
second century of the Christian epoch, and somewhat subsequent to
the life time of Pliny.
In the narrative of Makrizi we also learn that
oxymel and acids are the most powerful antidotes to the effect of
this narcotic; next to these, emetics, cold bathing, and sleep;
and we are further told that it possesses diuretic, astringent,
and specially aphrodisiac properties. Ibn Beitar was the first to
record its tendency to produce mental derangement, and he even
states that it occasionally proves fatal.
In 780 M.E. very severe ordinances were passed in
Egypt against the practice: the Djoneina garden was rooted up,
and all those convicted of the use of the drug were subjected to
the extraction of their teeth; but in 799 the custom
reestablished itself with more than original vigor. Makrizi draws
an expressive picture of the evils this vice then inflicted on
its votaries -- 'As its consequence, general corruption of
sentiments and manners ensued, modesty disappeared, every base
and evil passion was openly indulged in, and nobility of external
form alone remained to these infatuated beings.'
Medicinal properties assigned to Hemp by the ancient Arabian and Persian writers, and by modern European authors.
In the preceding notice of Makrizi's writings on
this subject, we have confined ourselves chiefly to historical
details, excluding descriptions of supposed medicinal effects.
The Mukzun-ul-Udwieh and the Persian MS. in our possession,
inform us as to the properties which the ancient physicians
attributed to this powerful narcotic.
In Mr. DaCosta's MS. version of the chapter on
Hemp in the Mukzun-ul-Udwieh,
churrus, we are informed, if smoked through a pipe, causes
torpor and intoxication, and often proves fatal to the smoker;
three kinds are noticed, the
garden,
wild and
mountain, of which the last is deemed the strongest -- the
seeds are called
sheaduna or
shaldaneh in Persia. These are said to be 'a compound of
opposite qualities, cold and dry in the third degree; that is to
say, stimulant and sedative, imparting at first a gentle reviving
heat, and then a considerable refrigerant effect.'
The contrary qualities of the plant, its stimulant
and sedative effects, are prominently dwelt on. 'They at first
exhilirate the spirits, cause cheerfulness, give colour to the
complexion, bring on intoxication, excite the imagination into
the most rapturous ideas, produce thirst, increase appetite,
excite concupiscence. Afterwards the sedative effects begin to
preside, the spirits sink, the vision darkens and weakens; and
madness, melancholy fearfulness, dropsy, and such like
distempers, are the sequel -- and the seminal secretions dry up.
These effects are increased by sweets, and combatted by
acids.'
The author of the
Mukzun-ul-Udwieh, further informs us --
'The leaves make a good snuff for deterging the
brain; the juice of the leaves applied to the head as a wash,
removes dandrin and vermin; drops of the juice thrown into the
ear allay pain, and destroy worms or insects. It checks
diarrhoea; is useful in gonorrhoea; restrains seminal secretions,
and is diuretic. The bark has a similar effect.'
'The powder is recommended as an external
application to fresh wounds and sores, and for causing
granulations; a poultice of the boiled root and leaves for
discussing inflammations, and cure of erysipelas, and for
allaying neuralgic pains. The dried leaves bruised and spread on
a castor oil leaf cure hydrocele and swelled testes. The
dose, internally, is one
direm or 48 grains. The antidotes are emetics, cow's milk,
hot water, and sorrel wine.'
Alluding to its popular uses, the author dwells on
the eventual evil consequences of the indulgence; -- weakness of
the digestive organs first ensues, followed by flatulency,
indigestion, swelling of the limbs and face, change of
complexion, diminution of sexual vigor, loss of teeth, heaviness,
cowardice, depraved and wicked ideas, scepticism in religious
tenet; licentiousness and ungodliness are also enumerated in the
catalogue of deplorable results.
The medicinal properties of Hemp, in various forms
are the subject of some interesting notes by Mirza Abdool Rhazes.
'It produces a ravenous appetite and constipation, arrests the
secretions, except that of the liver, excites wild imagining,
especially a sensation of ascending, forgetfulness of all that
happened during its use, and such mental exaltation, that
the beholders attribute it to supernatural
inspiration.'
Mirza Abdool considers Hemp to be a powerful
exciter of the flow of bile, and relates cases of its efficacy in
restoring appetite -- of its utility as an external application
as a poultice with milk, in relieving haemorrhoids -- and
internally in gonorrhoea to the extent of a quarter drachm of
bangh. He states also that the habitual smokers of Gunjah
generally die of diseases of the lungs, dropsy, and anasarca --
'so do the eaters of
majoon and smokers of
sidhee, but at a later period. The inexperienced on first
taking it are often senseless for a day, some go mad, others are
known to die.'
In the 35th chapter of the 5th vol. of Rumphius
Herbarium Amboinense, p. 208, Ed. Amsterd. A.D. 1695, we find a
long and very good account of this drug, illustrated by two
excellent plates. The sub-joined is an epitome of Rumphius'
article.
Rumphius first describes botanically the male and
female Hemp plants, of which he gives two admirable drawings. He
assigns the upper provinces of India as its
habitat, and states it to be cultivated in Java and
Amboyna. He then notices very briefly the exciting effects
ascribed to the leaf, and to mixtures thereof with spices,
camphor, and opium. He alludes doubtingly to its alleged
aphrodisiac powers, and states that the kind of mental excitement
it produces depends on the temperament of the consumer. He quotes
a passage from Galen lib. i. (de aliment. occult.) in which it is
asserted that in that great writer's time it was customary to
give Hemp seed to the guests at banquets as promoters of hilarity
and enjoyment. Rumphius adds, that the Mahomedans in his
neighborhood frequently sought for the male plant from his garden
to be given to persons afflicted with virulent gonorrhoea, and
with asthma, or the infection, what is popularly called,
'stitches in the side.'
He tells us, moreover, that the powdered leaves
check diarrhoea, are stomachic, cure the malady named
Pitao, and moderate excessive secretion of bile. He
mentions the use of Hemp smoke as an enema in strangulated
hernia, and of the leaves as an antidote to poisoning by
orpiment. Lastly, he notices in two subsequent chapters varieties
of Hemp which he terms the
gunjah sativa and
gunjah agrestis. In the
Hortus Malabaricus Rheede's article on the Hemp is a
mere outline of Rumphius's statements.
Among modern European writers, the only
information we could trace on the medicinal use of Hemp
in Europe, is the recent work of Ness v. Esenbeck, from
which the following is an extract kindly supplied by Dr. Wallich:
--
'The fresh herb of the Hemp has a very powerful
and unpleasant narcotic smell, and is used in the East in
combination with opium, in the preparation of intoxicating
potions, &c. It is probable that the
nepenthe of the ancients was prepared from the leaves of
this plant. Many physicians, Hahnemann among them, prescribe the
vinous extract in various nervous disorders, where opium and
hyoscyamus used to be employed, being less heating and devoid of
bitterness.'[3]
No information as to the medicinal effect of Hemp
exists in the standard work on Materia Medica, to which I have
access. Soubeiran, Feé, Merat and de Lens in their
admirable dictionary; Chevalier and Richard, Roques (Phytographie
Medicale); Ratier and Henry (Pharmacopée Francaise);
and the Dictionnaire des Sciences Medicales -- are all equally
silent on the subject.
In
Ainslie's Materia Indica, 2d vol., we find three
notices of the plant and its preparations.
At page 39 'Banghie,' (
Tamul) with the Persian and Hindee synonymes of 'Beng' and
'Subjee,' is described as an intoxicating liquor prepared with
the leaves of the
Gunjah or Hemp plant.
Under the head
Gunjah, Ainslie gives numerous synonymes, and tells that
the leaves are sometimes prescribed in cases of diarrhoea; and in
conjunction with turmeric, onions, and warm gingilie oil are made
into an unction for painful protruded piles. Dr. Ainslie also
gives a brief view of the popular uses, and botanical
peculiarities of the plant.
Majoon lastly is described by Dr. Ainslie, page 176, as a
preparation of sugar, milk, ghee, poppy seeds, flowers of the
datura, powder of nux-vomica, and sugar. The true
majoon however, as prepared in Bengal, contains neither
datura, or nux-vomica. I have already described the process by
which it has been manufactured before me.
In the
Journal de Pharmacie, the most complete magazine in
existence on all pharmaceutical subjects, we find Hemp noticed in
several volumes. In the Bulletin de Pharmacie t.v.a. 1810, p.
400, we find it briefly described by M. Rouyer, apothecary to
Napoleon, and member of the Egyptian scientific commission, in a
paper on the popular remedies of Egypt. With the leaves and tops,
he tells us, collected before ripening, the Egyptians prepare a
conserve, which serves as the base of the
berch, the
diasmouk, and the
bernaouy. Hemp leaves reduced to powder, and incorporated
with honey, or stirred with water, constitute the
berch of the poor classes.
The same work also, (Bulletin vol. 1. p. 523, x.
1809,) contains a very brief notice on the intoxicating
preparations of Hemp, read by M. De Sacy before the Institute of
France in July, 1809. M. De Sacy's subsequent analysis of
Makrizi, of which I have given an outline, is however much more
rich in details than the article in the Bulletin.
Such was the amount of preliminary information
before me, by which I was guided in my subsequent attempts to
gain more accurate knowledge of the action, powers, and possible
medical applications of this extraordinary agent.
There was sufficient to to show that Hemp
possessed in small doses an extraordinary power of stimulating
the digestive organs, exciting the cerebral system, of acting
also on the generative apparatus. Larger doses, again, were shewn
by the historical statements to induce insensibility, or to act
as a powerful sedative. The influence of the drug in allaying
pain was equally manifest in all the memoirs referred to. As to
the evil sequelae so unanimously dwelt on by all writers; these
did not appear to me so numerous, so immediate, or so formidable,
as many which may be clearly traced to over-indulgence in other
powerful stimulants, or narcotics, viz. alcohol, opium, or
tobacco.
The dose in which the Hemp preparations might be
administered, constituted of course one of the first objects of
inquiry. Ibn Beitar had mentioned a
direm, or 48 grains of
churrus; but this dose seemed to me so enormous, that I
deemed it expedient to proceed with much smaller quantities. How
fortunate was this caution, the sequel will sufficiently
denote.
Experiments of the author -- Inferences as to the action of the drug on animals and man.
An extensive series of experiments on animals, was
in the first place undertaken, among which the following may be
cited:
Expt. 1. -- Ten grains of Nipalese
churrus, dissolved in spirit, were given to a
middling-sized dog. In half an hour he became stupid and sleepy,
dozing at intervals, starting up, wagging his tail, as if
extremely contented; he ate some food greedily; on being called
to, he staggered to and fro, and his face assumed a look of utter
helpless drunkenness. These symptoms lasted about two hours, and
then gradually passed away; in six hours he was perfectly well
and lively.
Expt. 2. -- One drachm of
majoon was given to a small-sized dog; he ate it with
great delight, and in twenty minutes was ridiculously drunk; in
four hours his symptoms passed away, also without harm.
Expt. 3, 4, & 5 -- Three kids had ten grains each of
the alcoholic extract of
gunjah. In one no effect was produced; in the second there
was much heaviness and some inability to move; in the third a
marked alteration of countenance was conspicuous, but no further
effect.
Expt. 6. -- Twenty grains were given, dissolved in a
little spirit, to a dog of very small size. In a quarter of an
hour he was intoxicated; in half an hour he had great difficulty
of movement; in an hour he had lost all power over the hinder
extremities, which were rather stiff but flexible; sensibility
did not seem to be impaired, and the circulation was natural. He
readily acknowledged calls by an attempt to rise ue. In four
hours he was quite well.
In none of these, or several other experiments,
was there the least indication of pain, or any degree of
convulsive movement observed.
It seems needless to dwell on the details of each
experiment; suffice it to say that they led to one remarkable
result. -- That while carnivorous animals, and fish, dogs, cats,
swine, vultures, crows, and adjutants, invariably and speedily
exhibited the intoxicating influence of the drug, the
graminivorous, such as the horse, deer, monkey, goat, sheep, and
cow, experienced but trivial effects from any dose we
administered.
Encouraged by these results, no hesitation could
be felt as to the perfect safety of giving the resin of Hemp an
extensive trial in the cases in which its apparent powers
promised the greatest degree of utility.
Cases of Rheumatism treated by Hemp
The first cases selected were two of acute
rheumatism, and one of that disease in the chronic form. In the
two former but little relief had been derived from a fair trial
of antiphlogistic measures, and Dover's powder with antimonials
-- In the last case sarsaparilla at first, and subsequently the
Hemides-mus Indicus, with warm baths, had been tried without
advantage.
On the 6th of November, 1838, one grain of the
resin of Hemp was administered in solution at 2
P.M. to each of these three
patients.
At 4
P.M. it was reported that one was becoming very
talkative, was singing songs, calling loudly for an extra supply
of food, and declaring himself in perfect health. The other two
patients remained unaffected.
At 6
P.M. I received a report to the same effect, but
stating that the first patient was now falling
asleep.
At 8
P.M. I was alarmed by an emergent note from
Nobinchunder Mitter, the clinical clerk on duty, desiring my
immediate attendance at the Hospital, as the patient's symptoms
were very peculiar and formidable. I went to the Hospital without
delay, and found him lying on his cot quite insensible, but
breathing with perfect regularity, his pulse and skin natural,
and the pupils freely contractile on the approach of
light.
Alarmed and pained beyond description at such a
state of things, I hurried to the other patients, found one
asleep, the third awake, intelligent, and free from any symptoms
of intoxication or alarm.
Returning then to the first, an emetic was
directed to be prepared, and while waiting for it, I chanced to
lift up the patient's arm. The professional reader will judge of
my astonishment, when I found that it remained in the posture in
which I placed it. It required but a very brief examination of
the limbs to find that the patient had, by the influence of this
narcotic, been thrown into that strange and most extraordinary of
all nervous conditions, into that state what so few have seen,
and the existence of which so many still discredit -- the genuine
catalepsy of the nosologist.
It had been my good fortune years before to have
witnessed two unequivocal cases of this disorder. One occurred in
the female clinical ward in Edinburgh, under Dr. Duncan's
treatment, and was reported by myself for the
Lancet in 1828. The second took place in 1831, in a
family with whom I resided in London. The case was witnessed by
Dr. Silver, Mr. George Mills, and several other professional
friends. In both these cases the cataleptic state was established
in full perfection, and in both the paroxysm ran on each occasion
a regular course, and terminated suddenly without any evil
consequence.
To return to our patient. We raised him to a
sitting posture, and placed his arms and limbs in every
imaginable attitude. A waxen figure could not be more pliant, or
more stationery in each position, no matter how contrary to the
natural influence of gravity on the part.
To all impressions he was meanwhile almost
insensible; he made no sign of understanding questions; could not
be aroused. A sinapism to the epigastrium caused no sign of pain.
The pharynx and its coadjutor muscles acted freely in the
deglutition of stimulant remedies which I thought it advisable to
administer, although the manifest cataleptic state had freed me
altogether of the anxiety under which I before laboured.
The second patient had meanwhile been roused by
the noise in the ward, and seemed vastly amused at the strange
aspect of the statue-like attitudes in which the first patient
had been placed, when on a sudden he uttered a loud peal of
laughter, and exclaimed that four spirits were springing with his
bed into the air. In vain we attempted to pacify him, his
laughter became momentarily more and more incontrollable. We now
observed that the limbs were rather rigid, and in a few minutes
more his arms or legs could be bent, and would remain in any
desired position. A strong stimulant drink was immediately given,
and a sinapism applied. Of the latter he made no complaint, but
his intoxication led him to such noisy exclamations, that we had
to remove him to a separate room; here he soon became tranquil,
his limbs in less than an hour gained their natural condition,
and in two hours he experienced himself perfectly well, and
excessively hungry.
The first patient continued cataleptic till 1
P.M., when consciousness and voluntary motion
quickly returned, and by 2
A.M. he was exactly in the same state as the
second patient.
The third man experienced no effect whatever, and
on further inquiry, it was found that he was habituated to the
use of
gunjah in the pipe.
On the following day it gave me much pleasure to
find that both individuals, above mentioned, were not only
uninjured by the narcotic, but much relieved of their rheumatism;
they were discharged quite cured in three days after.
The fourth case of trial was an old muscular
cooly, a rheumatic malingerer, and to him half a grain of Hemp
resin was given in a little spirit. The first day's report will
suffice for all. -- In two hours the old gentleman became
talkative and musical, told several stories, and sang songs to a
circle of highly delighted auditors; ate the dinners of two
persons subscribed for him in the ward, sought also for other
luxuries we can scarcely venture to allude to, and finally fell
soundly asleep, and so continued till the following morning. On
the noonday visit, he expressed himself free from headache, or
any other unpleasant sequel, and begged hard for a repetition of
the medicine, in which he was indulged for a few days and then
discharged.
In several cases of acute and chronic rheumatism
admitted about this time, half-grain doses of the resin were
given, with closely analogous effects; -- alleviation of pain in
most -- remarkable increase of appetite in all -- unequivocal
aphrodisia, and great mental cheerfulness. In no one case did
these effects proceed to delirium, or was there any tendency to
quarrelling. The disposition developed was uniform in all, and in
one was the headache or sickness of stomach a sequela of the
excitement.
Case of Hydrophobia.
A case now occurred in which the influence of a
narcotic, capable either of cheering or of inducing harmless
insensibility, would be fraught with blessings to the wretched
patient.
On the 22nd November, at 9
A.M., a note in English was handed to me by my
servant, entreating my assistance for the Hakim Abdullah, then at
my gate, who had been bitten by a rabid dog, three weeks before,
and who feared that the miserable consequences of the bite
already had commenced. I found the poor man in a carriage, he was
perfectly composed, though quite convinced of the desperate
nature ofhis case. He told me that the evening before, on passing
near a tank, he started in alarm, and since then was unable to
swallow liquid. His eye was restless, suspicious, and wild; his
features anxious, his pulse 125, his skin bedewed with cold
moisture; he stated nevertheless that he wished for food and felt
well; a small red and painful cicatrix existed on the left
fore-arm.
He was immediately removed to the Hospital, where
I accompanied him. By his own desire water was brought near his
lips; -- never can I forget the indescribable horrors of the
paroxysm which ensued. It abated in about three minutes, and
morbid thirst still goading the unhappy man, he besought his
servant to apply a moistened cloth to his lips. Intelligent and
brave, he determinately awaited the contact of the cloth, and for
a few seconds, though in appalling agony, permitted some drops to
trickle on his tongue, -- but then ensued a second struggle,
which, with a due share of the callousness of my profession, I
could not stand by to contemplate.
Two grains of Hemp resin in a soft pillular mass
were ordered every hour; after the third dose he stated that he
felt commencing intoxication -- he now chatted cheerfully on his
case, and displayed great intelligence and experience in the
treatment of the very disease with which he was visited. He
talked calmly of drinking, but said it was in vain to try -- but
he could suck an orange; this was brought to him, and he
succeeded in swallowing the juice without any difficulty.
The Hemp was continued till the sixth dose, when
he fell asleep and had some hours' rest. Early the ensuing
morning, however, Mr. Siddons, my assistant, was called up to
him, and found him in a state of tumultuous agony and excitement:
tortured by thirst he attempted to drink, -- but I will spare the
reader the details of the horrors which ensued.
The Hemp was again repeated, and again by the
third dose the cheering alleviation of the previous day was
witnessed. He ate a piece of sugar-cane, and again swallowed the
juice -- he partook freely of some moistened rice, and permitted
a purgative enema to be administered. His pulse was nearly
natural, the skin natural in every respect. His countenance was
happy. On
one subject only was he incoherent, and even here was
manifested the powerful and peculiar influence of the narcotic.
He spoke in raptures of the inmates of his
zenana and his anxiety to be with them. We ascertained
however that he had no such establishment.
Four days thus passed away, the doses of Hemp
being continued. When he fell asleep, on waking the paroxysms
returned, but were again almost immediately assuaged as at first.
Meanwhile purgative enemata were employed, and he partook freely
of solid food, and once drank water without the least suffering.
But about 3
P.M. of the fifth day he sunk into profound
stupor, the breathing slightly stertorous; in this state he
continued, and without further struggle, death terminated his
sufferings at 4
A.M. of the 27th November.
Reviewing the preceding summary of this
interesting case, it seems evident that at least one advantage
was gained from the use of the remedy; -- the awful malady was
stripped of its horrors; if not less fatal than before, it was
reduced to less than the scale of suffering which precedes death
from most ordinary diseases. It must be remembered too that in
the first case ever so treated, I possessed no data to guide me
as to the dose or manner of administration of the drug. The
remarkable cases of tetanus detailed in the sequel, throw light
on these important points, and will lead in future cases to the
unhesitating administration of much larger quantities than at
first I ventured to employ. I am not however rash enough to
indulge the hope which involuntarily forces itself upon me, that
we will ever from this narcotic derive an effectual remedy, for
even a solitary case of this disease -- but next to cure, the
physician will perhaps esteem the means which enable him 'to
strew the path to the tomb with flower,' and to divest of its
specific terrors the most dreadful malady to which mankind
is exposed.
While the preceding case was under treatment, and
exciting the utmost interest in the school, several pupils
commenced experiments on themselves, to ascertain the effects of
the drug. In all, the state of the pulse was noted before taking
a dose, and subsequently the effects were observed by two pupils
of much intelligence. The result of several trials was, that in
as small doses as the quarter of a grain, after an average
interval of one hour, the pulse was increased in fulness and
frequency; the surface of the body glowed; the appetite became
extraordinary; vivid ideas crowded the mind; unusual loquacity
occurred; and with scarcely any exception, great aphrodisia was
experienced.
In one pupil, Dionath Dhur, a retiring lad of very
quiet habits, ten drops of the tincture, equal to a grain of the
resin, induced in twenty minutes the most amusing effects I ever
witnessed. A shout of laughter ushered in the symptoms, and a
transitory state of cataleptic rigidity occurred for two or three
minutes. Summoned to witness the effects, we found him enacting
the part of a Raja giving orders to his couriers; he could
recognize none of his fellow-students or acquaintances; all to
his mind seemed as his own condition; he spoke of many years
having passed since his student's days; described his teachers
and friends with a piquancy which a dramatist would envy;
detailed the adventures of an imaginary series of years, his
travels, his attainment of wealth and power. He entered on
discussions on religious, scientific, and political topics, with
astonishing eloquence, and disclosed an extent of knowledge,
reasoning, and a ready apposite wit, which those who knew him
best were altogether unprepared for. For three hours and upwards
he maintained the character he at first assumed, and with a
degree of ease and dignity perfectly becoming his high situation.
A scene more interesting it would be difficult to imagine. It
terminated nearly as rapidly as it commenced, and no headache,
sickness, or other unpleasant symptom followed the innocent
excess.
In the symptoms above described we are unavoidably
led to trace a close resemblance to the effects produced by the
reputed inspiration of the Delphic Oracles -- perhaps it would
not be very erroneous to conclude, that it was referable to the
same kind of excitement.
Use in Cholera.
An epidemic cholera prevailing at this period, two
of the students administered the tincture of Hemp in several
cases of that disease, and cures were daily reported by its
alleged efficacy. Dr. Goodeve was thus led to try it in several
cases, and his report was in the highest degree favourable. The
diarrhoea was in every instance checked, and the stimulating
effect of the drug clearly manifested. The Durwan of the College,
an athletic Rajpoot, was attacked, and came under my treatment
after he had been ill seven hours; he was pulseless, cold, and in
a state of imminent danger; the characteristic evacuations
streaming from him without effort -- half a grain of the Hemp
resin was given, and in twenty minutes the pulse returned, the
skin became warm, the purging ceased, and he fell asleep. In an
hour he was cataleptic, and continued so for several hours. In
the morning he was perfectly well, and at his duty as
usual.
It is but fair to state, however, that the
character of the epidemic was not at the time malignant. I admit
the cases to be inconclusive, but I conceive them to be
promising, and that they deserve the close attention of the
practitioner.
Use in Tetanus
I now proceed to notice a class of most important
uses, in which the results obtained are of the character which
warrants me in regarding the powers of the remedy as
satisfactorily and incontrovertibly established. I allude to its
use in the treatment of traumatic
tetanus, or lock-jaw, next to hydrophobia, perhaps the
most intractable and agonizing of the whole catalogue of human
maladies.
The first case of this disease treated by Hemp was
that of Ramjan Khan, aet. 30, admitted to the College Hospital on
the 13th of December, 1838, for a sloughing ulcer on the back of
the left hand. Five days previously a native empiric had applied
a red hot
gool (the mixture of charcoal and tobacco used in the
hookah) to the back of the left wrist, as a remedy for chronic
dysentery and spleen. The patient's brother was similarly
cauterized on the same day. In both sloughing took place down to
the tendons. Symptoms of tetanus occurred on the 24th of
December. The brother who had refused to avail himself of
European aid had been seized with tetanus at his ownh ome four
days previously, and died after three days' illness. On the 26th
December, spasms set in and recurred at intervals of a few
minutes; the muscles of the abdomen, neck, and jaw, became
firmly, and permanently contracted. Large doses of opium with
calomel having been administered for some hours, without the
least alleviation of symptoms, and his case having on
consultation been pronounced completely hopeless, I obtained Dr.
Egerton's permission to subject the poor man to the trial of the
Hemp resin. Two grains were first given at 2
1/2 P.M., dissolved in a little spirit. In half an
hour the patient felt giffy; at 5
P.M. his eyes were closed, he felt sleepy, and
expressed himself much intoxicated.
He slept at intervals during the night, but on
waking had convulsive attacks.
On the 27th, two grains were given every third
hour -- (a purgative enema was also administered, which operated
three times); the stiffness of the muscles became much less
towards evening, but the spasms returned at intervals as before.
Pulse and skin natural.
28th. -- Improved; is lethargic but intelligent.
Spasms occasionally recur, but at much longer intervals, and in
less severity.
29th. -- Dose of Hemp increased to three grains
every second hour. Symptoms moderating.
30. -- Much intoxicated; continues to
improve.
1st January 1839. A Hemp cataplasm applied to the
ulcer, and internal use of remedy continued; towards evening was
much improved; no permanent rigidity; had passed two
dysenteric stools.
2nd Morning report. Has passed a good night, and seems
much better. Hemp continued.
Evening report. Doing remarkably well.
3rd, 4th, and 5th. -- Continues to improve. Hemp
resin in two grain doses every 5th hour.
6th, 5
A.M. Feverish; skin hot; pulse quick; all tetanic
symptoms gone; passing mucous and bloody stools; leeches to
abdomen; starch and opium enema, with three grains acetate of
lead, every second hour; tepid sponging to the body; Hemp
omitted.
7th, 6
A.M. Still feverish; stools frequent, mucous;
abdomen tender on pressure. No appetite. The ulcer sloughy,
ragged, and offensive. Opium and acetate of lead continued.
Abdomen leeched. Sore dressed with water. At noon there was
slight rigidity of abdominal muscles; Hemp resumed. At 3
P.M. became intoxicated and hungry, ulcer
extremely dry, foul, and abominably foetid; towards evening
rigidity ceased. Hemp discontinued.
From this day the tetanus may be considered to
have ceased altogether, but the dysenteric symptoms continued,
despite of the use of opium and acetate of lead; the ulcer too
proved utterly intractable. Some improvement in the dysenteric
symptoms occurred from the 10th to the 15th, when natural stools
were passed; he seemed gaining strength, but the wound was in no
wise improved, the slough on the contrary threatened to spread,
and two metacarpal bones lay loose in the centre of the sore; on
consultation it was agreed to amputate the arm, but to this the
patient peremptorily objected. The mortification now spread
rapidly, and to our infinite regret, he died of exhausion on the
night of the 23rd January.
An unprejudiced review of the preceding details
exhibits the sedative powers of the remedy in the most favourable
light; and although the patient died, it must be remembered that
it was of a different disease, over which it is not presumed that
Hemp possesses the least power.
The second case was that of Chunoo Syce, (treated
by Mr. O'Brien at the Native Hospital) in whom tetanus supervened
on the 11th December, after an injury from the kick of a horse.
After an ineffectual trial of turpentine and castor oil in large
doses, two grain doses of Hemp resin were given on the 26th
November. He consumed in all 134 grains of the resin, and left
the Hospital cured on the 28th December.
Third case.
Huroo, a female aged 25, admitted to the Native Hospital
on 16th December; had tetanus for the three previous days, the
sequel of a cut on the left elbow received a fortnight before.
Symptoms violent on admission. Turpentine and castor oil given
repeatedly without effect; on the 16th and 17th, three grains of
Hemp resin were given at bed-time. On the morning of the 18th she
was found in a state of complete catalepsy, and remained so until
evening, when she became sensible, and a tetanic paroxysm
recurred. Hemp resumed, and continued in two grain doses every
fourth hour. From this time till the third hour tetanic symptoms
returned. She subsequently took a grain twice daily till the 8th
of February, when she left the Hospital quite well.
Mr. O'Brien has since used the Hemp resin in five
cases, of which four were admitted in a perfectly hopeless state.
He employed the remedy in
ten grain doses dissolved in spirit. The effect he
describes as almost immediate relaxation of the convulsive
tendency. Of Mr. O'Brien's eight cases, four have
recovered.
In the Police Hospital of Calcutta, the late Dr.
Bain has used the remedy in three cases of traumatic tetanus, of
these one has died and two recovered.
A very remarkable case has recently occurred in
the practice of my cousin, Mr. Richard O'Shaughnessy. The patient
was a Jew, aged 30, attacked with tetanus during the progress of
a sloughing sore of the scrotum, the sequel of a neglected
hydrocele. Three grain doses were used every second hour, with
the effect of inducing intoxication, and suspending the symptoms.
The patient has recovered perfectly, and now enjoys excellent
health. The details of this case are given as a companion article
to this paper.
Besides the preceding cases I have heard of two of
puerperal trismus thus treated in native females. Both terminated
fatally, an event which cannot discredit the remedy, when it is
remembered that the Hindoo native females of all ranks are placed
during, and subsequent to their confinement, in a cell within
which large logs of wood are kept constantly ignited. The
temperature of these dens I have found to exceed 130 of
Fahrenheit's scale.
The preceding facts are offered to the
professional reader with unfeigned diffidence, and to the
inferences I feel disposed to derive from the consideration. To
me they seem unequivocally to shew, that when given
boldly, and in large doses, the resin of Hemp is capable
of arresting effectually the progress of this formidable disease,
and in a large proportion of cases of effecting a perfect
cure.
The facts are such at least as justify the hope
that the virtues of the drug may be widely and severely tested in
the multitudes of these appalling cases which present themselves
in all Indian Hospitals.
Case of Infantile Convulsions
A very interesting case of this disease has
recently occurred in my private practice; the particulars of
which I have the permission of the family to insert in this
paper.
A female infant, 40 days old, the child of Mr. and
Mrs. J.L. of Calcutta, on the 10th Septembet, had a slight attack
of convulsions, which recurred chiefly at night for about a
fortnight, and for which the usual purgative, warm baths, and a
few doses of calomel and chalk were given without effect. On the
23rd the convulsive paroxysms became very severe and the bowels
being but little deranged, two leeches were applied to the head.
Leeches, purgatives, and opiates were alternately resorted to,
and without the slightest benefit up to the 30th of
September.
On that day the attacks were almost unceasing and
amounted to regular tetanic paroxysms. The child had moreover
completely lost appetite, and was emaciating rapidly.[4]
I had by this exhausted all the usual methods of
treatment, and the child was apparently in a sinking
state.
Under these circumstances I stated to the parents
the results of the experiments I had made with the Hemp, and my
conviction that it would relieve their infant, if relief could
possibly be obtained.
They gladly consented to the trial, and a single
drop of the spiritous tincture, equal to the one-twentieth part
of a grain in weight, was placed on the child's tongue at 10
P.M. No immediate effect was perceptible, and in
an hour and a half two drops more were given. The infant fell
asleep in a few minutes, and slept soundly till 4
P.M. when she awoke, screamed for food,
took the breast freely, and fell asleep again. At 9
A.M., 1st October, I found the child fast asleep,
but easily roused; the pulse, countenance and skin perfectly
natural. In this drowsy state she continued for four days totally
free from convulsive symptoms in any form. (During this time the
bowels were frequently spontaneously relieved, and the appetite
returned to the natural degree.)
October 4th. At 1
A.M. convulsions returned, and continued at
intervals during the day; five drop doses of the tincture were
given hourly. Up to midnight there were thirty fits, and
forty-four drops of the tincture of Hemp were ineffectually
given.
October 5th. Paroxysms continued during the night; at 11
A.M. it was found that the tincture in use during
the preceding days had been kept by the servants in a small
bottle with a paper stopper; that the spirit had evaporated, and
the whole of the resin settled on the sides of the phial. The
infant had in fact been taking drops of 'water' during the
preceding day.
A new preparation was given in three drop doses
during the 5th and 6th, and increased to eight drops; with the
effect of diminishing the violence though not of preventing the
return of the paroxysm.
On the 7th, I met Dr. Nicholson in consultation,
and despairing of a cure from the Hemp, it was agreed to intermit
its use, to apply a mustard poultice to the epigastrium, and to
give a dose of castor oil and turpentine. The child, however,
rapidly became worse, and at 2
P.M. a tetanic spasm set in, which lasted without
intermission till 6 1/2
P.M. A cold bath was given without solution of the
spasm -- the Hemp was therefore again resorted to, and the dose
of 30 drops, equal to 1 1/2 grains of the resin, given at
once.
Immediately after this dose was given the limbs
relaxed, the little patient fell fast asleep, and so continued
for thirteen hours. While asleep, she was evidently under the
narcotic influence of the drug.
On the 8th October, at 4
A.M., there was a severe fit, and from this hour
to ten at night 25 fits occurred and 130 drops of the tincture
were given in 80 drop doses, equal to 15 grains of the resin. It
was now manifestly a struggle between the disease and the remedy,
but at 10
P.M. she was again narcoticized, and from that
hour no fit returned.
On the three following days there was considerable
griping, and on administering large doses of almond oil, several
small dark green lumps of the Hemp resin were voided, which gave
effectual relief. The child is now (23rd November) in the
enjoyment of robust health, and has regained her natural plump
and happy appearance.
In reviewing this case several very remarkable
circumstances present themselves. At first we find three drops,
or one twentieth of a grain, causing profound narcoticism;
subsequently we find 130 drops daily required to produce the same
effect. The severity of the symptoms doubtless must be taken
chiefly into account, in endeavouring to explain this
circumstance. It was too soon for habit to gain ascendancy over
the narcotic powers of the drug. Should the disease ever recur,
it will be a matter of much interest to notice the quantity of
the tincture requisite to afford relief. The reader will remember
that this infant was but sixty days old when 130 drops were given
in one day, of the same preparation of which ten drops had
intoxicated the student Dinonath Dhur, who took the drug for
experiment. 130 drops are equal again to 15 grains of the resin,
one grain of which occasioned profound trance (or catalepsy) in
two men labouring under rheumatism.
Delirium occasioned by continued Hemp inebriation.
Before quitting this subject, it is desirable to
notice the singular form of delirium which the incautious use of
the Hemp preparations often occasions, especially among young men
first commencing the practice. Several such cases have presented
themselves to my notice. They are as peculiar as the 'delirium
tremens,' which succeeds the prolonged abuse of spiritous
liquors, but are quite distinct from any other species of
delirium with which I am acquainted.
This state is at once recognized by the strange
balancing gait of the patient's; a contant rubbing of the hands;
perpetual giggling; and a propensity to caress and chafe the feet
of all bystanders of whatever rank. The eye wears an expression
of cunning and merriment which can scarcely be mistaken. In a few
cases, the patients are violent; in many highly aphrodisiac; in
all that I have seen, voraciously hungry. There is no increased
heat or frequency of circulation, or any appearance of
inflammation or congestion, and the skin and general functions
are in a perfectly natural state.
A blister to the nape of the neck, leeches to the
temples, and nauseating doses of tartar emetic with saline
purgatives have rapidly dispelled the symptoms in all the cases I
have met with, and have restored the patient to perfect
health.
The preceding cases constitute an abstract of my
experience on this subject, and which has led me to the belief
that in Hemp the profession has gained an anti-convulsive remedy
of the greatest value. Entertaining this conviction, be it true
or false, I deem it my duty to publish it without any avoidable
delay in order that the most extensive and the speediest trial
may be given to the proposed remedy. I repeat what I have already
stated in a previous paper -- that were individual reputation my
object, I would let years pass by, and hundreds of cases
accumulate before publication, and in publishing I would enter
into every kind of elaborate detail. But the object I have
proposed to myself in the inquiries is of a very different kind.
To gather together a few strong facts, to ascertain the limits
which cannot be passed without danger, and then pointing out
these to the profession, to leave their body to prosecute and
decide on the subject of discussion, such seems to me the fittest
mode of attempting to explore the medical resources which an
untried Materia Medica may contain.
It may be useful to add a formula for making the
preparation which I have employed.
The
resinous extract is prepared by boiling the rich, adhesive
tops of the dried
gunjah in spirit (Sp. gr. 835,) until all the resin is
dissolved. The tincture thus obtained is evaporated to dryness in
a vessel placed over a pot of boiling water. The extract softens
at a gentle heat, and can be made into pills without any
addition.
The
tincture is prepared by dissolving 3 grains of the extract
in one drachm of proof spirit.
Doses, &c. -- In
Tetanus a drachm of the tincture every half hour until the
paroxysms cease, or catalepsy is induced. In
Hydrophobia I would recommend the resin in soft pills, to
the extent of ten to twenty grains to be chewed by the patient,
and repeated according to the effect. In
Cholera ten drops of the tincture every half hour will be
often found to check the vomiting and purging, and bring back the
warmth of the surface; -- my experience would lead me to prefer
small doses of the remedy in order to excite rather than
narcotise the patient.
Footnotes:
- For very fine specimens of churrus, I have to express my thanks to Dr. Campbell, late assistant Resident at Nipal.
- By this term is probably meant the first of the Sassanian dynasty, to whom the epithet of 'Khusrow' or Cosroes, equivalent to Kaiser, Caesar, or Czar, has been applied in many generations. This dynasty endured from A.D. 202 to A.D. 635 -- vide note 50 to Lane's translation of the Arabian Nights, vol. ii, p. 226.
- Handbuch der Medicin. und Pharmac. Botanik, von F. Nees von. Estabeck et Dr. Carl Ebermaier, vol. 1, p. 338.
- The nurse, I should have mentioned, was changed early in the illness, and change of air resorted to on the river, but in vain.