292
Confinement of the patient with removal of the
exciting cause generally brings about rapid cure.
Delirium is a prominent feature. There are other
general features which it is difficult to put into
words, and which experience alone can teach one,
just as one recognizes a face without knowing exact-
ly why. One recognizes ganja insanity intuitively.
All the symptoms I have described may be
present in other kinds of insanity, but one judges
by the combination of them. If the symptoms
were present without any history, I should not
like to make a certain diagnosis of toxic insanity;
but I might make a probable diagnosis, subject
to further information, and probably should be
right, on account of my experience. It is essen-
tial to have a history for a certain diagnosis. The
attack of ganja insanity may last weeks or
months; but it is common to find patients
brought as raving lunatics recovered when they
reach the asylum. If the attack lasted from 12
to 15 months, the fact would shake my diagnosis,
unless there were history of previous attacks and
gradual degeneration from ganja. I have ex-
amined brains in cases of hemp drug insanity, and
have discovered no abnormal appearances, which
could be attributed to the effect of the hemp.
I cannot say that I should expect to find any
such appearances in cases of temporary insanity.
I do not remember to have made post mortem
of any person permanently insane from the hemp
drug. Such cases are very sure.
The statement made by Ramesh Chandra Sib
on the 19th instant has been read to me, and de-
scribes accurately the procedure followed in the
asylum in regard to cause. I do not approve of
entering ganja as the cause of insanity merely on
the ground that the insane is known to have used
the drug, because it must be misleading when
ganja is so commonly used. But this is an accu-
rate statement of the procedure. Therefore the
entry of cause in Statement VII of the annual
report is based exclusively on the descriptive rolls.
I do not consider that the descriptive rolls contain
information which is reliable, but they help us in
making up our minds. They do not afford a satis-
factory basis for judging scientifically of the con-
nection between hemp drugs and insanity.
I have studied the cases admitted to the asylum
in 1892, and I put in a note about them—(Note
attached).
As to the effects of ganja generally, I should
say that until I began to study the question with
a view to give evidence before the Commission,
although I had a vague notion that ganja-smoking
was prevalent among the lower classes in Bengal,
I had no idea that the practice was as common as
I have since found it to be.
Before July 1893, when I began to enquire into
the matter, my experience of the effects of hemp
drugs was limited to the cases of insane persons
whose insanity was attributed to their use; and
as in many of these cases I satisfied myself that
the insanity was really so caused, I naturally ac-
quired a prejudice against the habit. But when,
on enquiry, I found that hemp drugs were so
widely used, and in the majority of cases with the
beneficial results I have detailed in my evidence
before the Commission, my views as to their evil
effects were greatly modified.
Appendix.
Note on cases of insanity attributed to the use
of hemp drugs admitted into the Dacca Lunatic
Asylum during 1892, put in by Dr. Cobb.
1. Charan Dass.—There is no reason to suppose
that ganja was the cause of this man's insanity,
except the entry in his descriptive roll, in which
it is stated that he was "addicted to ganja," and
a remark by Dr. Wise in 1872, that "he is a
stupid fellow, who brightens up when ganja is
mentioned."
The history of his case is not that of a ganja
maniac, and the post-mortem appearances suggest
chronic degenerative changes in the central nervous
system.
2. Dayal Bass Bairagi.—I have no doubt that
this was a case of temporary insanity induced
by smoking ganja. He is example No. I in the
evidence which I have already given.
The history of the gradual supervention of his
insanity under the increasing doses of ganja and
his rapid recovery when confined are instructive.
The fact that his father was a ganja smoker is
worthy of notice. These facts I discovered in
careful personal examination of the man.
3. Baishna C. Saha.—There is no evidence of
his being a ganja smoker beyond the entry in his
descriptive roll that he was addicted to ganja
and spirits.
The case was evidently one of simple mania.
4. Uzir Ali Sha.—The evidence of ganja-smok-
ing in this case is very untrustworthy. It is
vaguely stated in his descriptive roll that he was
formerly addicted to ganja. The case was pro-
bably one of simple mania.
5. Swarup Kaibarta.—There is not the slight-
est reason for supposing ganja-smoking to have
been the cause of this man's insanity other than
the entry in his descriptive roll. On the con-
trary, the case presents all the characteristics of
simple melancholia.
6. Sekh Waris.—This man was found to be
quite sane on admission into the asylum. There is
not a particle of evidence to support the view that
ganja caused his insanity, if he ever was insane.
7. Durga Charan Changa.—This is undoubtedly
a case of recurrent mania. Beyond a vague refer-
ence to ganja-smoking in his descriptive roll, there
is no reason to attribute his insanity to a toxic
cause.
8. Madhab Ram Deo.—This patient's insanity
is definitely attributed to the use of ganja in his
descriptive roll, but I think it is extremely doubt-
ful if the drug had anything to do with it.
9. Gagan Chanar Chathati.—This is a doubtful
toxic case. It is stated in the descriptive rol
that he was addicted to ganja and spirits.
10. Garua.—There is no evidence of ganja being
the cause of insanity, except the fact stated in the
descriptive roll that he was "addicted to ganja."
11. Narayan Dass.—This man is an up-country
fakir, and was known to be an excessive ganja
smoker, and he does not deny the fact. The
whole history of his case leads me to the conclusion
that ganja was the exciting cause of his insanity.
12. Monubar Mohanta.—The entry in the de-
scriptive roll and the medical certificate that the
"lunatic is addicted to ganja" are the only reasons
for supposing this to be a case of toxic insanity.
In view of the fact as shown by the papers that
this man's relatives were not known and nothing
else was known of his case, the above entries are
of less weight than they would otherwise have
been.
13. Narayan Nawa.—This appears to be a case
of insanity induced by the use of ganja.