294

I disagree altogether with him as to his attri-
buting insanity to ganja on the mere statement
that the man uses the drug. I have no satisfac-
tory evidence of cases of true permanent insanity
due to the use of ganja. And in any case to put
insanity down to the drug without knowing the
amount used, the time during which the habit
existed, and the previous history of the man is
quite wrong.

I quite agree with the Assistant Surgeon as to
the great difficulty of satisfactorily ascertaining
the cause of insanity in the cases we have to deal
with.

I have no personal experience of the physiolo-
gical action of hemp drugs on the human subject.
The best account of the action of the drug I know
is in H. C. Wood's "Therapeutics." It is an
American work. I am not acquainted with any
literature dealing with hemp drug insanity. I
have had experience of hemp drug intoxication.
I treated every case in the Medical College
Hospital for about eight years when I was Re-
sident Physician and Professor of Pathology.
There were not very many. The symptoms I
observed were analogous to alcoholic intoxication.
But the excitement was more intense, the patient
livelier (not so soon comatose as in alcohol) and
the excitement lasted longer. Alcohol causes
intoxication by poisoning the centres. They are
first stimulated; and stimulation beyond a certain
extent ends in exhaustion. Hence the comatose
condition. Suppose the stimulation is frequently
repeated by repeated doses of alcohol, you have an
overgrowth of the coarser elements; and these
coarser elements finally replace the highly organ-
ised elements. The physical and mental effects
following this alteration would be a dementia
preceded by a period of irritation. This period of
irritation would have as symptoms change of
disposition, grandiosity in ideas, fits of depression
alternating with fits of exaltation, and the other
symptoms of alcoholic insanity. Chronic alco-
holism may thus produce an overthrow of mental
equilibrium.

As to hemp drug intoxication, I suppose that
in the early stages of hemp drug intoxication there
is congestion of brain. This is my supposition.
I have no pathological experience for that. I
have not, personally, experience of the stimula-
tion of the centres in alcoholism; but the condi-
tion of the brain is well known. To a certain
extent the condition of the brain in the early
stages of alcoholism could be ascertained by
naked eye inspection without the miscroscope.
I have examined ganja smokers' brains. I
examined the other day (since I knew that I was
required to give evidence here) the brain of a man
said to have been a smoker for many years. He
died suddenly in a factory of phthisis and was
sent in. The brain and the membranes were per-
fectly healthy. I know nothing of the man

except that the police reported that for many
years he had been a ganja smoker. I made naked
eye inspection and did not use a microscope.
Against this I had a case of a man "addicted to
drink for some years" whom I examined a month
ago post mortem. In his brain the membranes
were opaque, thickened, and the convolutions of
the brain shrunken; and there was an excessive
quantity of brain fluid. It was a typical drunk-
ard's brain. There was no insanity. He had
died suddenly of some other cause and was sent
in by the police, as in the other case. I knew
nothing of either this man or the other except
through the police report. I knew nothing of the
extent of the habit in either case except what the
police said.

I have no evidence of what the frequent stimu-
lation of the brain caused by ganja would result in.
I cannot argue by analogy with alcohol; for there
is nothing that I know to show that ganja is an
irritant of the same class as alcohol. The evidence
wanting is pathological evidence founded on facts
observed after the experimental exhibition of these
drugs on the lower animals.

The position I assume then is this, that I admit
the analogy between alcoholic and ganja intoxi-
cation as regards the general symptoms. These
symptoms are due to the action of alcohol on the
brain. It is possible, I admit by analogy, that
the symptoms in ganja intoxication are produced
by the action of the drug on the brain. In the
case of alcohol it is well ascertained that the re-
peated exhibition of alcohol leads to grave structural
changes, which sometimes give rise to certain
mental and physical symptoms. In the case of
hemp drugs, I will not admit that repeated or long
continued stimulation of the brain will produce
any structural changes in the brain because there
is no pathological evidence; and the facts are, as
far as my experience goes, dead against it. I have
examined the brains of many persons who were
said to be addicted to ganja and have discovered
no structural changes. I did not use the micro-
scope, and can only speak to coarse structural chan-
ges. As far as I have read, too, there is nothing
about these changes in books on pathology. Hemp
drugs are never mentioned among the causes of
structural changes in the brain.

In the case of insanity from grief or other so-
called moral cause there need be no structural
changes that are apparent in the brain. Such
changes are found occasionally, but they are not
found in many cases. But in respect to insanity
following a physical cause, I should assuredly
expect changes, and that they would be visible
structural changes. The established physical causes
are such as alcohol, syphilis, injuries. These are
very few compared with the great mass of mental
disease. I know nothing of dhatura as a cause of
insanity.

112. Evidence of SURGEON-CAPTAIN J. H. TULL WALSH, Superintendent, Lunatic
                                                      Asylums, Calcutta.

Finding it somewhat difficult to reply to the
questions given in Chapter VI, with sufficient
fullness in the space allotted, I take the liberty
of stating my opinions on some of the points
raised in that chapter in the following report:—

Commencing with question 39, I may state
that having been unable to obtain subjects for
comparative experiments, I have no actual know-
ledge of the comparative effects produced by
different preparations of the hemp drugs. The
Hospital Assistant attached to the Native Lunatic
Asylum informs me, however, that it is generally