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ful than either whether it is eaten or smoked. I
know of no organic change taking place in the
human system from opium. The difference be-
tween hemp drugs (except bhang) and opium is one
of degree : the excessive use of ganja or charas
being more deleterious than opium. I think bhang
is probably, if possible, less deleterious than opium.
I think that the opium and hemp drug habits are
about equally practised. Therefore the Colaba
Asylum statistics seem to bear out my view ; for the
admissions from hemp drugs are set down as higher
than the opium cases. The alcoholic habit also is
not extensively practised by natives. I speak only
of Bombay. There the use of opium and hemp
drugs is more general among the natives than
that of alcohol. I have no statistics, but give my
own opinion only. The admissions to the asylum
are from other parts of the country (principally
Bombay and the surrounding talukas); but my
remarks regarding the people generally are con--
fined to Bombay. I cannot say whether all the
mill hands drink. I cannot give detailed statis--
tics of different classes. I have only stated my
general impression that there are more hemp drug
than alcohol consumers in Bombay. I refer to
hemp drugs taken as a whole. Those who in a
year take hemp drugs are more numerous than
those who take alcohol ; but I think that the habi--
tual consumers of alcohol are more numerous than
the habitual consumers
o f h a m p d r u g s . G a n j a i s h a b i t u a l l y c o n s u m e d , b h a n g ( a s a r u l e ) m o r e
occasionally and by a large number of the popula--
tion on festive occasions.
Question 46.—When a man is received in the
asylum, papers in forms A and C are received
with him. This constitutes all the information we
receive as to previous history in respect to cause.
Form C is all we have. The medical certificate
form A usually deals with symptoms only and does
not deal with cause. I find that form C is signed
as a rule by the medical officer who examines the
patient. He gets his information from various
sources, generally from the patient's friends, from
personal observation, or any other source available.
I have been Civil Surgeon. My experience was
that I got the information regarding cause from
the friends or from the police. Very often I had
cases where no friends came. In such cases
I t r u s t e d t o t h e p o l i c e o r w h e r e v e r I c o u l d g e t
m y in
f o r m a t i o n .
At the asylum we supplement this informa-
- t i o n b y e n q u i r y f r o m t h e p a t i e n t ' s f r i e n d s w h e n
they visit the asylum. That is, when no cause is
previouly assigned, or where a cause has been
given and we are able from the friends to elicit the
true facts of the case. We very seldom change
an entry of cause already trade from the inform--
ation of the friends. The entry in our register
is made immediately on the patient's admission.
The case is written up then, and the cause is entered.
The patient is not kept under observation before
entering cause, if any cause is given in the form.
Friends come to visit insanes in the large majority
of cases. when the patients are from the city of
Bombay, but not generally otherwise. Any time
between sunrise and sunset visits may be paid ;
but generally between one and four. Generally,
therefore, the inquiries from friends are made by
the senior apothecary (in my absence). He has
no instructions, except that he is to make the
inquiries where the entry in regard to cause is
blank. He works at his own discretion. If the
patient's friends alleged the ganja habit, that
would be enough to make the entry of ganja as
the cause, if we had no definite particulars as to cause from the officer signing the forms. The
apothecary would differentiate between the
moderate and excessive use of the drug ; but if
only the moderate use were alleged, we would
probably enter that cause if no other cause were
elicited. This has been generally the practice.
There is no record of the enquiry except the mere
entry of cause.
I think that if dhatura were used to increase
intoxication (vide answer 29 ( b ), that though
generally similar in effect to ganja, it would have
a stronger effect in inducing acute maniacal symp--
toms, but not in predisposing to permanent
insanity. I do not think its effects are taken
into account either in the police inquiry or by the
apothecary. I do not think that ganja either
predisposes to permanent insanity, though it
produces symptoms of acute mania. I do not
think that a case due to ganja would be differen--
tiated from a dhatura case except from the history.
The symptoms are much the same. Dilatation
of pupils is generally absent, I think, in hemp
drugs cases, otherwise there is no differentiation
of symptoms. The redness of conjunctiva is also
mentioned, and I have, I think, noticed it, though
I have not paid attention to these symptoms
until recently. I mean it is only in habitual
consumers in excess that you have this dull eye
with red and congested conjunctiva. I do not
mean that this is a symptom of acute mania from
hemp drugs. In transient mania you also get
dilated pupils ; but I doubt if they would be so
much dilated as in dhatura. In transient mania
also the symptoms are of short duration. Without
a history I think it would be difficult to diagnose
between the form of insanity known as transient
mania and dhatura insanity. I would not say
impossible. Taking hemp drug insanity, dhatura
insanity and transient mania, they all resemble
each other : to differentiate them would require
previous history and (if possible) pumping out
of the contents of the stomach. I have once or
oftener as Civil Surgeon of Dhulia pumped out
the contents of the stomach. That was for treat--
ment, not for diagnosis, as I was already in
possession of the facts showing that the cases
were dhatura poisoning. I have conducted post--
mortem examinations in the asylum on deaths in
the asylum. Of course we cannot do it if friends
object. I have never seen tissue changes in the
brain, but I cannot remember any death of a hemp
d r u g c a s e i n w h i c h I l o o k e d f o r p a t h o l o g i c a l
changes m the brain. I cannot refer to a case.
I have never heard (I may add) of such changes.
I have consulted the pathologist at the Grant
Medical College ; and he also has found no such
cases, and is unaware that such changes exist.
T a k i n g t h e i m p o r t a n t p l a c e t h a t h i s t o r y b o l d s i n
the diagnosis of cause, I think that we have a
very unsatisfactory basis. The history is often
unreliable. Thus even ganja taken for relief
against what is causing insanity may be entered
as
the cause. We do the best we can; and where
a man is given to ganja-smoking, I think it
should be put down in the absence of other known
cause ; for there we have a tangible fact. I think
there is no doubt that ganja in excess does cause
transient insanity. I refer only to the excessive
use. As a scientific basis of any theory of the
connection between insanity and hemp drugs,
these histories are unreliable, but they are useful
in giving a clue in respect to treatment.
I take of the 1892 cases, No. 4, Damodhar.
Here I have history (on further inquiry) of ganja,
bhang and majum; but nothing was noticed until
V o l . v i i .
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