269
nal lunatics. I was also the author of the rules
drawn up by the Committee of 1888 regarding the
disposal of criminal lunatics. I have no other
experience of insanity apart from this and no
special training in the subject. I have visited
asylums at home, but never held charge of one.
In my practice outside of lunatic asylums my
experience is confined to very few cases—only two
or three in the whole course of my service—of
ganja intoxication brought to hospital.
I have had no experience of any diseases attri-
butable to ganja. My experience has been chiefly
in Eastern Bengal, where ganja is largely consum-
ed, and I have often travelled for days together
with boatmen who used ganja regularly in a
moderate way. Nothing in their appearance or
demeanour showed this. I have only known it
because I have been informed. There is one ex-
ception, my own darwan, in whom I frequently
see what I believe to be the effects of ganja. He
is loud and excited in demeanour. That is the
only effect.
He both smokes and drinks hemp.
He is in thoroughly good health (except that he
has elephantiasis) and is quite trustworthy. In
regard to literature regarding the effects of the
hemp drugs, I know only the ordinary literature
that everybody knows. I know of no special liter-
ature dealing with the subject. In regard to
insanity, there is no reference at any length to
ganja or hemp as a cause of insanity in any
literature I know.
I have made a large number of post-mortem ex-
aminations in cases of lunatics whose insanity was
believed to be due to ganja and who died in
the asylums. I did not make these examinations
with a view of studying the effects of ganja, but
in the ordinary course of duty. I found no patho-
logical change that could be attributed to ganja.
There are always changes in the brains of lunatics;
but the ganja cases did not seem to me to differ
from other cases. The most frequent changes are
shrinkage of the brain generally, want of sym-
metry of the two sides of the brain, effusions of
serum to fill up the space left by the shrunken
brain, and I think diminution in the thickness of
the grey matter. These are the appearances which
occur in cases of chronic insanity.
The acute
mania which I believe to characterize ganja
insanity is never fatal in my experience. The
appearances found in the chronic ganja cases are
those that are found in other cases of secondary
insanity from whatever cause it may have origin-
ated. I have never made any minute microsco-
pical examination of the brains in such cases;
and I think it most improbable, in our present
state of knowledge of the structure of nerve cells,
that any distinctive appearances would be detected
by the microscope.
With regard to chronic insanity caused by alco-
holism, certain changes would be recognizable
especially in the connective tissues surrounding
the nerve cells for the reason that alcohol is a
tissue poison. Ganja is not believed to be a tissue
poison. This has not been investigated, but it is
like other vegetable poisons which do not act on
the tissues generally. Examples of this are
dhatura and belladonna, which leave no anatomi-
cal change behind so far as is known: no anatomi-
cal changes have been traced to them.
I must have examined the brains of ganja smok-
ers who were not insane, as I have made many
post-mortem examinations in Eastern Bengal.
But I cannot refer to any in particular. I have
not met with any changes which I have been able
to recognize.
There is no literature on the pathological effects
of the drug that I know of.
I have made no physiological experiments on ani-
mals and know of none. I have no knowledge
of the physiological effects of the drugs apart
from the clinical effects.
My experience is practically confined to smok-
ing. I know that the drug produces intoxication
when smoked. The symptoms produced are
entirely referable to cerebral excitation, to excite-
ment of the brain cells. This entirely predominates
over any soporific effect which it is said to possess
and which is subsequent to the excitation and is
of short duration. I would expect to find certain
pathological changes in a brain examined in such
a case; but I have never had an opportunity of
examining one. I would expect to find hyperæmia
of the brain (increase of circulation) such as is
found when excitement is produced by any other
cause and of which there are symptoms in a man's
appearance. This is all. These conditions would
pass of. In a case where this has occurred for
the first time or at infrequent intervals, I should
expect the brain to return to an apparently per-
fectly normal condition. I say so because the
brain functions become perfectly normal and leave
no trace of anything of the kind. On the other
hand, if I had this condition of hyperæmia long
continued by repeated exhibition of the drug, I
should expect to find chronic changes. They
would be of the kind I described earlier. They
would lead to atrophy, to shrinkage, and such
grave nutritive changes, not distinguishable from
those produced by cerebral excitation of other
kinds except perhaps alcoholic.
Alcohol irritates the whole elements of which
the brain is composed, the tissues in which the
nerve cells and nerve fibres are embedded, as well
as these elements themselves: whereas ganja and
other vegetable excitants apparently confine their
action to the nerve elements: but I say all this
subject to correction, which may come as the
result of more careful pathological research.
Question 27.—My experience of the beneficial
effects of the drugs is practically confined to these
boatmen, and I am quoting rather the belief on
which they take the drug. I have hardly suffi-
cient grounds for forming an opinion of my own
except that I have been struck with the extraordi-
nary endurance of these men. These are the only
class of labourers with whom I have intimate
acquaintance. In that part of answer No. 44
which deals with this subject also I am rather
quoting the generally received opinion on this
point than expressing any established opinion of
my own.
Question 31.—The basis of my opinion that
the moderate use of ganja does not readily deve-
lop into the excessive is my having lived long in
a district where the drug is largely used and
having known only very rarely cases of excess.
I have no continuous observations of individuals
to record. But I base my statement on the
general impression derived from observing the
population, and seeing so few excessive consumers.
I should cease to call smoking moderate when it
began to affect the man's demeanour. That
would be my definition of moderate smoking.
Question 35.—The opinion here expressed that
alcohol is worse than ganja is regarding the