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.


  BY

  W. B. O’SHAUGHNESSY, M.D.,

  BENGAL ARMY,

  Late Professor of Chemistry and Materia Medica in the Medical College
  of Calcutta.


  LONDON:

  PRINTED BY S. TAYLOR, 6, CHANDOS-STREET, STRAND.

  [Reprinted from the Transactions of the Medical Society of Calcutta,
  1838; and from the Provincial Medical Journal, 1843.]




INDIAN HEMP, &c.


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 a pleasing intoxication. In the
popular medicine of these nations, we find it extensively employed
for a multitude of affections, especially those in which spasm or
neuralgic pain are the prominent symptoms. 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 Hahnemann, as shown 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 high northern latitudes, is identical
in specific characters with the hemp of Asia Minor and India. 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. 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 experiments 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 to the Hakim Mirza Abdul Razes of Teheran, who have furnished
me with interesting details regarding the consumption of hemp in
Candahar, Cabul, and the countries between the Indus and Herat. The
Pandit Moodoosudun Gootu has favored me with notices of the statements
regarding hemp in the early Sanscrit authors on materia medica; to
the celebrated Kamalakantha Vidyalanka, the Pandit 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 the medical gentlemen named in the sequel, I feel much
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 diœcious, 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 bractes; males lax and drooping,
branched and leafless at base; females erect, simple and leafy at the
base. Calyx downy, five parted, imbricated. Stamens five; anthers large
and pendulous. Calyx covered with brown glands. Ovary roundish with
pendulous ovule, and two long filiform glandular stigmas; achenium
ovate, one seeded.--_Vide 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 stems, 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 soluble in alcohol and æther; partially
soluble in alkaline, insoluble in acid solutions; when pure, of a
blackish grey color; hard at 90°; softens at higher temperatures, and
fuses readily; soluble in the fixed and in several volatile oils. Its
odor 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 for 1s. 6d. to 2s. for 2
lbs. in the Calcutta bazaars, and yields to alcohol twenty per 100 of
resinous extract, composed of the resin (_churrus_), and green coloring
matter (_chlorophylle_). Distilled with a large quantity of water or
spirit, traces of essential oil pass over, and the distilled liquor
has the powerful narcotic odor of the plant. The _gunjah_ is sold for
smoking chiefly. The bundles of _gunjah_ are about two feet long and
four inches in diameter, and contain twenty-four plants. The color is
dusky green; the odor agreeably narcotic; the whole plant resinous and
adhesive to the touch.

The larger leaves and capsules, without the stalks, are called “_bang_,
_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 less than a half-penny enough can be purchased to
intoxicate an “experienced” person.

According to Mr. McCann’s notes, the _gunjah_ consumed in Bengal is
chiefly brought from Mirzapore and Ghazeepore, being extensively
cultivated near Gwalior and in Tirhoot. The natives cut the plant when
in flower, allow it to dry for three days, and then lay it in bundles
averaging two pounds weight each, which are distributed to the licensed
dealers. The best kinds are brought from Gwalior and Bhurtpore, and it
is also cultivated, of good quality, in a few gardens round 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, and is
subsequently scraped off and kneaded into balls, which sell from 10s.
to 12s. for 2 lbs. 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 Abdul Razes that the
_churrus_ is prepared by pressing the resinous plant 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
follows:--

_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 dried and 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 class.

Another recipe is as follows:--

The same quantity of _sidhee_ is washed, dried, 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
seek aphrodisiac enjoyments. In persons of a 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 the stomach succeeds, nor are the
bowels at all affected; next day there is slight giddiness and much
vascularity of the eyes, but no other symptom worth recording.

_Gunjah_ is used for smoking only: 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 punkah, 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_ (clarified butter) 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 coloring 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 colored. The coloring 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 two pounds 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 uttur 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. Thus prepared it sells for 8s. the 2 lbs;
one drachm, by weight, will intoxicate a beginner; three drachms one
experienced in its use. The taste is sweet, and the odor 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 Portuguese 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 effects 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--Notices of Hemp and its 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 show the
exact state of our knowledge of the subject, when I attempted its
investigation.

Although the most eminent of the Arabic and Persian authors concur
in referring the origin of the practice of hemp intoxication to the
natives of Hindostan, it is remarkable that few traces can be detected
of the prevalence of the vice at any early period in India.

The Pandit Moodoosudun Gooptu finds that the “Rajniguntu,” a standard
treatise on materia medica, which he estimates vaguely at 600
years date, gives a clear account of this agent. Its synonymes 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 the
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 gonorrhœa, and repeats the statements of the
“Rajniguntu.” In the Hindu Tantra, a religious treatise, teaching
peculiar and mystical formulæ and rites for the worship of the deities,
it is said, moreover, that _sidhee_ is more intoxicating than wine.

In the celebrated “Susruta,” which is perhaps the most ancient of all
Hindu medical works, it is written, that persons laboring under catarrh
should, with other remedies, use internally the _bijoya_ or _sidhee_.
The effects, however, are not described.

The learned Kamalakantha Vidyalanka has traced a notice of hemp in
the 5th chapter of _Menu_, where Brahmins are prohibited to use the
following substances--_palandoo_ or onions, _gunjara_ or _gunjah_, and
such condiments as have strong and pungent scents.

The Arabic and Persian 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 Abdul Razes, 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, the 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_, which is
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, M.
E. the Sheikh Djafar Shirazi, a monk of the order of Haider, learned
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 Ramah, 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 favourite 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, and subsisted
chiefly on this herb, and on his death his disciples by his desire
planted it in an arbour about his tomb.

From this saintly sepulchre the knowledge of the effects of hemp is
stated to have spread into Khorasan. In Chaldea it was unknown until
728 M. E. during the reign of the Khalif Mostansir Billah; the kings of
Ormus 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 merely 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 effects of this narcotic; next to these,
emetics, cold bathing, and sleep; and we are further told that it
possesses diuretic, astringent, and especially 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 re-established 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 _sheadana_ 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 exhilarate the
spirits, cause cheerfulness, give color 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 combated 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 dandriff and vermin;
drops of the juice thrown into the ear allay pain and destroy worms or
insects. It checks diarrhœa, is useful in gonorrhœa, 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 forty-eight 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 tenets, 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 Abdul Razes. “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 happens during its use, and such
mental exultation, that _the beholders attribute it to supernatural
inspiration_.”

Mirza Abdul 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 hæmorrhoids, and internally in gonorrhœa. A quarter of a
drachm of _bangh_ is given in water as the dose in gonorrhœa. 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 volume of “Rumphius’ Herbarium
Amboinense,” p. 208, Ed. Amsterd. A.D. 1695, we find a long and very
good account of the hemp, illustrated by two excellent plates. The
subjoined 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. facult.), 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 a promoter of hilarity and enjoyment. Rumphius adds, that
the Mahomedáns in his neighbourhood frequently sought for the male
plant from his garden, to be given to persons afflicted with virulent
gonorrhœa and with asthma, or the affection which is popularly called
“stitches in the side.” He tells us, moreover, that the powdered leaves
check diarrhœa, 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 the 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
echo of Rumphius’ statements.

Among modern European writers the only information I could trace on the
_medicinal_ use of hemp _in Europe_, is in the recent work of Nees 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_ effects of hemp exists in the
standard works 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 (Pharmacopeé
Française); and the Dictionnaire des Sciences Medicales, are all
equally silent on the subject.

In “Ainslie’s Materia Indica,” 2nd vol., we find three notices of this
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
us that the leaves are sometimes prescribed in cases of diarrhœa; 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 characters 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 nor 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. i., p. 523, A. 1809) contains a very brief notice of
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
copious in details than the article in the Bulletin.

Professor Royle in his admirable work, entitled “Illustrations of the
Botany, &c. of the Himalayas,” p. 334, gives a very brief notice of the
synonymes and epithets of the hemp resin, and mentions its intoxicating
properties, but affords us no information on its medicinal effects.


_Experiments by the Author--Inferences as to the Action of the Drug on
Animals and Man._

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 medicinal applications of this
remarkable agent.

There was sufficient to show that hemp possesses, 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 shown 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 sequelæ 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 forty-eight 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.

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 and 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.

_Expts._ 3, 4, and 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 up. 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 exhibited the intoxicating influence of the drug,
the graminivorous, such as the horse,[4] 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. Catalepsy produced by one grain._

The first cases selected were two of acute rheumatism and one of that
disease in the chronic form, occurring among the patients in the
Clinical Hospital of the Medical College. In the two former but little
relief had been derived from a fair trial of antiphlogistic measures,
and of Dover’s powder with antimonials; in the last case, sarsaparilla
at first, and subsequently the Hemidesmus Indicus with warm baths had
been tried without advantage.

On the 6th November, 1838, one grain of the resin of hemp was
administered in solution, at two, p.m., to each of these three patients.

At four, 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 six, p.m., I received a report to the same effect, but stating that
the first patient was now falling asleep.

At eight, 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 which 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. This case was witnessed by Dr.
Silver, Mr. G. Mills, and several other professional friends. In both
these cases the cataleptic state was established in full perfection,
and in both the paroxysm 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 stationary 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 the 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
labored.

The second patient had meanwhile been roused by the noise in the ward,
and seemed vastly amused at the strange aspect and 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 represented himself to be perfectly well and excessively hungry.

The first patient continued cataleptic till one, a.m., when
consciousness and voluntary motion quickly returned, and by two, 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 the
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 cooley, 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 noon-day
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 none was headache or sickness of stomach a sequel 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 eight, 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 of his 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 in a metallic vessel,
which he grasped, and 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 ladies 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 three, p.m., of the fifth day he
sunk into a profound stupor, the breathing slightly stertorous; in this
state he continued, and without further struggle death terminated his
sufferings at four, a.m., on the 27th of 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 this, 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 flowers,” 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 a quarter of a grain 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, Dinonath Dhur, a retiring lad of excellent habits, ten
drops of the tincture, equal to a quarter of 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 Rajah
giving orders to his courtiers; he could recognise none of his fellow
students or acquaintances; all to his mind seemed as altered 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, reading,
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 suddenly 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 favorable. The diarrhœa was in every instance checked, and the
stimulating effects 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 due
attention of the practitioner.

Since this passage was written in 1838, the tincture of hemp has been
used in a great number of cases, both European and native, in the
hospital of the Medical College. I know no remedy equal to it as a
general and steady stimulant when given to _Europeans_ in half drachm
doses during the tractable stage of this disease. I have known the
pulse and heat return and the purging checked by a single dose. It
allays vomiting much more certainly than the opium preparations, and
is not more likely than these to lead to cerebral congestion on the
cessation of cholera symptoms. The cheering effect on the patient’s
spirits is not the least benefit this remedy confers.

In _native_ cases much less advantage was obtained; nearly all this
class of patients were old gunjah smokers.


_Use in Tetanus._

I now proceed to notice a class of most important cases, 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 agonising of the whole catalogue of human maladies.

The first case of this disease treated by hemp was that of Ramjan
Khan, aged thirty, 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 cauterised 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 own home 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 jaws 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 Mr. Egerton’s permission to subject the poor man to the trial
of the hemp resin. Two grains were first given at half past two, p.m.,
dissolved in a little spirit. In half an hour the patient felt giddy;
at five, 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.

28. Improved; is lethargic but intelligent; spasms occasionally occur,
but at much longer intervals, and in less severity.

29. Dose of hemp increased to three grains every second hour. Symptoms
moderating.

30. Much intoxicated; continues to improve.

January 1, 1839. A hemp cataplasm applied to the ulcer, and internal
use of remedy continued. Towards evening was much improved; spasms
trivial; no permanent rigidity; had passed two _dysenteric stools_.

2. Morning report: Had passed a good night, and seems much better.
Evening report: Doing remarkably well.

3, 4, and 5. Continues to improve. Hemp resin in two grain doses every
fifth hour.

6. Five, p.m.--Feverish; skin hot; pulse quick; all tetanic symptoms
gone; passing mucous and bloody stools. Leeches to abdomen; a starch
and opium enema with three grains of acetate of lead every second hour;
tepid sponging to the body; hemp omitted.

7. Six, 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 three, p.m., became intoxicated and hungry; ulcer extremely
dry, foul, and abominably fœtid; 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 exhaustion on the
night of the 23rd of January.

An unprejudiced review of the preceding details exhibits the sedative
powers of the remedy in the most favorable light; and, although the
patient died, it must be remembered that it was of a different disease,
over which it is not presumed that the 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
of 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 16th of December. He
consumed in all 134 grains of the resin, and left the hospital cured on
the 28th of December.

_Third case._--Huroo, a female, aged twenty-five, admitted to the
Native Hospital on the 16th of 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. She
subsequently took a grain twice daily till the 8th of February, when
she left the hospital apparently 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 muscles and interruption of the
convulsive tendency. Of Mr. O’Brien’s seven 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 thirty,
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.

Beside the preceding cases I have heard of two of puerperal trismus
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 120° of Fahrenheit’s scale.

A curious coincidental proof of the value of hemp in these cases has
very recently come to my notice. In the appendix to Sir James Murray’s
“Medical Essays,” p. 16, dated Dublin 1837, occurs the following
passage:--“Having written the substance of these pages (Sir James’s
work) to my brother, then assistant-surgeon of the 60th Rifles, at
the Cape of Good Hope, he mentioned that a plant called _dyka_, or
wild hemp, which grows on the eastern coast of Africa, is used by the
natives for this purpose (the relief of puerperal convulsions), and
that they all, male and female, smoke it to bring on perfect relaxation
and relief from pain and spasm of any kind during its relaxing
influence.”

The preceding facts are offered to the professional reader with
unfeigned diffidence as to the inferences I feel disposed to derive
from their consideration. To me they seem unequivocally to show 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.

Messrs. Hughes and Templar, eminent veterinary surgeons of Calcutta,
have used the hemp resin in five cases of horses suffering from
tetanus; of these three have recovered. Dr. Sawyers, of the medical
board, has cured a pony similarly affected.

Drs. Esdaile and Macrae have used the hemp with success; the former
in a case of tetanus; the latter in one of convulsions from neuralgia
of the testis, which had resisted every other remedy, and for which
the removal of the organ had been decided on. In the “London Medical
Gazette” Mr. Lewis gives a case of tetanus in which the hemp was used
with great relief to the symptoms, although it did not effect a cure.


_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, forty days old, the child of Mr. and Mrs. J. L., of
Calcutta, on the 10th of September had a slight attack of convulsions,
which recurred chiefly at night for about a fortnight, and for which
the usual purgatives--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.[5]

I had by this time 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 spirituous
tincture, equal to the one-twentieth part of a grain of extract, was
placed on the child’s tongue at ten, 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 four, p.m.,
when she awoke, screamed for food, _took the breast freely_, and fell
asleep again. At nine, a.m., 1st of 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 4. At one, 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.

5. Paroxysms continued during the night. At eleven, a.m., it was found
that the tincture in use during the preceding days had been kept by the
servant in a small bottle with a paper stopper; that the spirit had
evaporated and the whole of the resin had settled on the sides of the
phial. The infant had in fact been taking drops of mere 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 two,
p.m., a tetanic spasm set in, which lasted without intermission till
half-past six, p.m. A cold bath was tried without solution of the
spasm; the hemp was, therefore, again resorted to, and a dose of thirty
drops, equal to one and a half 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 peculiar influence of the drug.

On the 8th October, at four, a.m., there was a severe fit, and from
this hour to ten at night twenty-five fits occurred, and 130 drops of
the tincture were given in thirty drop doses. It was now manifestly a
struggle between the disease and the remedy; but at ten, p.m., she was
again narcotised, 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 hemp resin were voided, which gave effectual relief. The child is
now (December 17) 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 three-twentieths of a
grain, causing profound narcotism, 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 ascendency 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.


_Use in Delirium Tremens._

I have given the tincture of hemp an extensive trial in this disease,
and have had much reason to be gratified with its effects. In
action it resembles opium and wine, but is much more certain than
these remedies. I have no hesitation in saying, that in the cases in
which the opium treatment is applicable, hemp will be found far more
effectual. The changed state of mind it produces is truly wonderful.
From the appalling terror which generally predominates, the patient
soon passes into a state of cheerfulness, often of boisterous mirth,
and soon sinks into a happy sleep. Of course there are many cases in
which this, or any other, narcotic should not be employed.


_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 who try it for the first
time. Several such cases have presented themselves to my notice. They
are as peculiar as the “delirium tremens” which succeeds the prolonged
abuse of spirituous liquors, but are quite distinct from any other
species of delirium with which I am acquainted.

This state is at once recognised by the strange balancing gait of the
patient, a constant 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 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.


_Conclusion._

The preceding cases constitute an abstract of my experience on this
subject, and constitute the grounds of my 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
mere 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 these 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 them to prosecute and decide on the subject of discussion,
such seems to me the fittest mode of attempting to explore the
medicinal resources which an untried remedy may afford.

It may be useful to add a formula for making the preparations 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 by
distillation, or 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 the extract in spirit of 835°
density.

_Doses, &c._--In _tetanus_ a drachm of the tincture every half hour
until the paroxysms cease, or catalepsy or narcotism is induced. In
_hydrophobia_ I 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_, thirty drops of the tincture every half
hour will be often found to check the vomiting and purging, and bring
back warmth to the surface. My experience would here lead me to prefer
_small_ doses of the remedy in order to excite rather than narcotise
the patient.

I have only further to add, that since the substance of the preceding
memoir was first published, numerous cases have come to my knowledge
in which the _churrus_, or resin prepared by the natives for smoking,
has been used with little effect. This was the case in some experiments
made by Dr. Pereira with _churrus_ which I sent him myself. Age and
adulteration have been probably both concerned in rendering this
substance inactive. But with the alcoholic extract made from the tops
in the way I recommend, the practitioner has only to feel his way, and
increase the dose till he produces intoxication as the test of the
remedy having taken effect.

Of all powerful narcotics it is the safest to use with boldness and
decision.

I have given Mr. Squire, of Oxford-street, a large supply of the
gunjah, and that gentleman has kindly promised me to place a sufficient
quantity of the extract at the disposal of any hospital physician or
surgeon who may desire to employ the remedy. My object is to have it
extensively and exactly tested without favor or prejudice, for the
experience of four years has established the conviction in my mind,
that we possess no remedy at all equal to this in anti-convulsive and
anti-neuralgic power.

 (_Date of Reprint_) London, January, 1843.


FOOTNOTES:

[1] For very fine specimens of _churrus_, I have to express my thanks
to Dr. Campbell, late political resident at Nipal.

[2] By this term is probably meant the first of the Sassanian dynasty,
to whom the epithet of “Khusrow” or Cosroes, equivalent to Kȧiser,
Cæsar, or Czar, has been applied in many generations. This dynasty
endured from A.D. 202 to A.D. 636.--_Vide note 50 to Lane’s Translation
of the Arabian Nights_, _vol._ ii. p. 226.

[3] Handbuch der Medicin und Pharmac. Botanik, von F. Ness von Esenbeck
und Dr. Carl Ebermaier, vol. i, p. 338.

[4] Although I observed no effect from two drachms of hemp resin given
to a horse, Messrs. Hughes and Templar, of Calcutta, have since cured
four horses of traumatic tetanus by giving half-pint doses of the
tincture.--W. B. O’S.

[5] The nurse, I should have mentioned, was changed early in the
illness, and change of air resorted to on the river, but in vain.




INDIAN HEMP.

TO THE EDITORS OF THE PROVINCIAL MEDICAL JOURNAL.


GENTLEMEN,--With reference to my paper on the Indian Hemp, lately
inserted in your Journal, I trust I may be permitted to disclaim any
wish to advance these preparations as specifics in the treatment of
tetanus, or in spasmodic diseases generally. That hemp possesses great,
indeed extraordinary, anti-convulsive power, I feel assured from
numerous facts which I have myself observed, and which others have also
witnessed. The cases of the six horses affected by traumatic tetanus,
recorded in my paper, of which four recovered, are almost enough
by themselves to convince any unprejudiced person of the energy and
promise of this drug.

Many failures must be expected at first, from the salutary caution
all good practitioners must observe in the doses of a remedy with
which they are not practically familiar. On this point I have further
to remark that in a case of traumatic tetanus, now under treatment,
fifteen grain doses of the resin have been given every second or third
hour, and of these doses five taken before narcotism was induced.

In cases of tetanus, I consider no trial of the drug at all conclusive,
unless it has been pushed to the extent of inducing stupor and
insensibility.

Too much importance has been attached by commentators on my paper to
the occurrence of _catalepsy_ as an effect of this drug; catalepsy I
have witnessed unequivocally in many cases, but the effect is not an
universal one; I have seen it produced by ten drops of the tincture,
and by one grain of the resin. But, on the other hand, I have given
fifty grains in one day to a tetanic patient without any such effect
being observable.

It seems quite evident, from the experiments made by Mr. Ley and Dr.
Pereira, that much larger doses must be used in this country than
those we found sufficient in India. The cause of this is possibly
to be traced to molecular chemical changes taking place by age in
the constituents of the drug, and analogous to those familiar to the
profession in the case of hemlock and its active principle.

The tincture, made by dissolving the extract in spirit, I consider the
best form of the drug for use in tetanic cases--or the resin may be
made into an emulsion, by trituration with a little flour, carbonate
of soda, and mucilage. The soda tends to dissolve the resin, and its
use is in accordance with the precepts of the ancient Eastern writers,
who prescribed hemp with alkaline substances, and used acids in various
forms (such as oxymel and sorrel wine) to counteract its effects when
taken in overdoses.

In conclusion, I venture to refer to the very interesting cases lately
published by Mr. Ley, in the Provincial Medical Journal. Another
memoir from the same able pen, will, I understand, soon appear, and
will afford ample evidence of the therapeutic value of this agent.
Mr. Ley informs me that of the _anti-convulsive_ power of the hemp he
entertains no doubt. This is the great, the valuable result to look
for; all else is comparatively of but little importance. On some minor
points Mr. Ley’s results differ from mine. This must be regarded but
as a proof of the accuracy of his observations--that he is recording
faithfully what he sees, and is not merely treading in the footsteps of
another.

  I am, Gentlemen,
  Your faithful servant,
  W. B. O’SHAUGHNESSY, M.D.

  London, Feb. 8, 1843.

P.S.--I would take the liberty of inviting experimentalists to the
repetition on the hemp resin of the processes for preparing conia and
nicotina--namely by distillation with caustic potash or soda and water,
receiving the distilled liquid in dilute acid, and redistilling this
with an excess of alkali, as before. My departure from India interfered
with my trial of this process, and I think it likely to lead to
valuable results.


  LONDON:
  S. Taylor, Printer, 6, Chandos street, Covent-garden.




Transcriber’s Notes

A few very minor mistakes in punctuation and spelling were fixed.