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also be remembered that it is difficult to examine
a maniac's eyes. But the pupils are certainly not
dilated as with belladonna, nor contracted to a pin
point as with opium.
In these cases of acute mania ganja may be
the exciting cause with another cause as predis-
posing. Transient mania cannot easily be dis-
tinguished from hemp drug mania; but one gets
accustomed to the physiognomy of a case of
ganja intoxication, by which you recognize the
case as one of more than probable ganja mania.
The chief points are the extreme vehemence of
the symptoms and the alert, excited appearance as
of keen intelligence, which is very difficult to
describe; and there is the history of ganja. Cases
of transient mania occurring in Europe are, how-
ever, characterized by extreme violence and
homicidal mania; and I do not think there is
any one symptom by which cases of transient
mania could be distinguished from hemp drug
mania. These cases in Europe are very often
associated with the use of alcohol. They are
attended with homicidal impulses. I am not
aware of their occurring in any one class of society.
There is in regard to hemp drug mania an ab-
sence of any typical symptom. In any indivi-
dual case the diagnosis would depend on the
history of ganja; but in a series of cases you would
anticipate the ganja history, that is, the experience
of a series of cases would lead one to predicate
ganja; but this would be more or less of an
assumption—a provisional diagnosis, which would
not be regarded as certain or final without a
history. But in the absence of history it would
go down in asylum records as "probably ganja."
The use of dhatura may give rise to acute
mania of this character. You could distinguish
it by the dilatation of the pupil, which is wanting
in ganja. Dhatura is more soporific than ganja.
(2) The chronic mania due to ganja could not
be diagnosed apart from history. But still there
is a general character given to an Indian asylum
by the number of chronic ganja cases, which, I
believe, is peculiar. This character is given by
the large number of happy attitudinizing and
singing lunatics, the majority of whom are ganja
cases. We also have patients presenting similar
appearance in English asylums; but the character
given to an English asylum is given by the melan-
cholics. But the character of the Indian asylum
is given by the chairomaniacs or light-hearted
maniacs. I cannot say whether this character is
found among the asylums of Southern India, where
insanity is much less attributed to ganja and the
drug is less known. It is possible that this differ-
ence of character between English and Indian
asylums may be due in part to the difference of
character between the two races. But I do not
accept this as an adequate explanation in view
of the fact that so many of this special class re-
cover entirely in India. The large number of re-
coveries is in the ganja members of this class and
is due to the deprivation of the drug.
(3) The cases that have gone on to dementia
have nothing typical about them.
In all of these three classes there may be a
predisposing cause, just as in alcoholic insanity
there is frequently a predisposing cause; and the
one class often follows on the other, viz., chronic
on acute mania, and dementia on chronic mania.
It may be quite true that in some insanity cases
a tendency to insanity may have made a man take
to ganja as to any other stimulant; but that does
not militate against what I have stated; for the
ganja is that which leads in these cases to the
immediate outbreak of insanity.
In regard to the procedure in recording the
cause of insanity, the lunatic comes into the asylum
with a descriptive roll in which the cause of in-
sanity is recorded by the police. This is by no
means trustworthy. The inquiry is made by the
police. I have myself seen an inquiry going on
in which a constable was filling in the papers from
the statements of the lunatic himself, the man
being at the time insane. This may be exceptional,
but I have seen it. In any case I distrust
this descriptive roll. Besides this we have (but
only in criminal cases) the judgment, in which
the point is frequently raised and discussed as
part of the defence. Besides this, there is the
mark on the hand and thumb of the ganja smoker,
which, if present, immediately distinguishes him
as a habitual smoker. Then we have frequently
some time in the course of his incarceration an op-
portunity of interrogating his friends who come to
see him, and finally we have the confession of the
lunatic himself on his recovery that he used the
drug. These remarks apply chiefly to the cases of
criminal lunatics, because of the effect of the asso-
ciation of ganja with their case on the subsequent
treatment. We do not take the same pains in
regard to non-criminal lunatics. My recollection
is that these subsequent discoveries would alter.
the entries in the asylum books from which the
annual statements were compiled. This was my
practice. Any information which I was thus able
to get subsequently would have its effect on the
entries in statement VII. That is to say, the
cause of insanity was not determined once and for
all from the descriptive rolls when the lunatics
came into the asylum. This statement refers to
all lunatics, though the inquiries would probably
be more careful in the case of criminal lunatics.
I am speaking from memory.
I have heard read the statement of Ramesh
Chandra Sib (witness No. 131). He is a
thoroughly truthful and trustworthy man. I
think his statement may be more safely taken
than mine in regard to the entries he has all along
made as to cause and the annual statements
compiled therefrom. I suppose I must be
mistaken, though I have a recollection of
correspondence about alterations in the state-
ments from reclassification. These may have been
in regard to type. There was no discussion of
cause in any annual report written by me from
Dacca, nor any formal discussion in writing. It
has been distinctly the habit in the Dacca Asylum
and elsewhere to put down the insanity as due to
ganja in any case where the descriptive roll
mentioned ganja at all as having been used by
the man. This would be done if the entry under
heading No. 9 showed that the man was
"addicted to ganja," even though No. 10 showed
"cause unknown." The only reason is that we
jump at any possible cause and put it down. We
should do this without inquiring as to the extent
of use. It is impossible to get at this. Of
course this would only be done if there was no
other cause mentioned. I do not think that it is
fair thus to attribute insanity to ganja in the
case of all smokers. It appears, then, that the
statement No. VII is based on the descriptive
rolls, modified so as to have ganja shown as the
cause in every case where the descriptive rolls
show that the man used the drug and no other
cause is given. These descriptive rolls are not
reliable. The figures, then, are not to be accepted
as absolutely representing the proportion of