300

cured during five years (1888-1892) varied from
3 to 10 months, and many of these were kept
under observation for some time after they had
been pronounced sane. Of the 108 cases
admitted more than half recovered very quickly,
and this points to some cause easily removable.
These figures include a few re-admissions of persons
previously treated for insanity, due to the abuse
of hemp drugs (Ex. 9, 12, 16). With regard to
the patients who do not recover, I think they
probably represent, as pointed out by Dr. Wise
(Ex. 10.), a number of insane persons who may or
may not have used hemp drugs.

As to my personal knowledge of the effects of
hemp drugs, I have already given instances to the
members of the Commission who visited the
Dullunda Asylum on the 14th and 18th of August
1893. It would serve no useful purpose to quote
the cases again.

In conclusion I think it may be fairly stated:—

1.  That hemp drugs are very largely used
throughout Bengal, smoked as ganja and charas;
drunk as bhang and siddhi or eaten as majum.
The smoking of charas and the eating of majum
are not common.

2.   Among healthy persons ganja, smoked alone
with tobacco or with a very small addition of
dhatura (two or three seeds), produces a condition
varying from mild exhilaration to marked intoxi-
cation. The violent intoxicating effects are less
marked, or not seen at all, in persons having a
regular and wholesome supply of food (Ex. 21).
Much the same may be said of bhang, etc.

3.   Among persons of weak mind or with a
marked neurotic tendency even a moderate quan-
tity of hemp drugs may so increase the insanity
evident or latent as to make such persons violent,
morose or melancholy according to the neuropathy
with which we start. The presence of adultera-
tions, such as dhatura, will increase these effects.

4.  Abuse of hemp drugs, especially when adul-
terated with dhatura, will produce, even in healthy
persons, a very violent intoxication simulating
mania, or may lead to a morose melancholic
condition with outbreaks of irritability. These
conditions are generally of short duration and the
patient ultimately recovers. So common is abso-
lute recovery that I think when a patient, confined
in an asylum for the treatment of insanity said to
be due to the abuse of hemp drugs, does not recover
within 10 months, the drugs were possibly only
the exciting cause, and that we are dealing with an
individual who was either insane previous to his
use of intoxicating drugs, or with one in whom
latent insanity has been roused into activity by
the irritating effects of excess of ganja, bhang, etc.

Further Statement put in by DR. WALSH.

As regards the post mortem appearances in cases
where the insanity has been ascribed to the abuse
of hemp drugs, I find that from the beginning
of 1890 to the present time four deaths have
occurred among supposed "ganja-insanes."

1. Ratigen Gossain, aged 31; admitted into
the Dullanda Asylum 5th May 1890. Was
violent, dangerous and dirty in habits, but fairly
coherent at times. He did not improve; and
though the acute maniacal stage passed off, he
remained always silly, demented, dirty in habits
and somewhat uncertain. In his descriptive roll
he was stated to have been insane for 13 years.
The paroxysm of mania which caused him to be
shut up in the Dullanda Asylum in May 1890

was possibly excited by abuse of hemp drugs;
but I think there can be little doubt that the
abuse of hemp drugs was not the original cause
of his insanity. A more careful search into the
history of such cases is desirable. In 1893 his
bodily health became very bad, though no marked
symptoms of disease were noted. He died on
the morning of the 26th March 1893.

Post mortem.—Feet and legs œdematous; body
very thin and emaciated; about 4 pints of serous
fluid in the peritoneal cavity. Heart small, and
muscular tissue somewhat pale; valves normal.
Lungs signs of old pleurisy and adhesions over
right lung; lung tissue normal; left lung not
adherent. Some hypostatic congestion at the
bases of lungs. Liver contracted; Glisson's cap-
sule generally thickened and increased fibrous
tissue shewing signs of cirrhosis. Spleen hard;
otherwise normal. Kidneys: right kidney pale
and undergoing fatty degeneration. Pyramids
apparently healthy; capsule thicker than usual,
but not adherent; left kidney as right. In-
testines generally very pale; one or two congest-
ed or faintly ulcerated patches (the man had
passed some round worms in February 1893) in
the small intestines; no entozoa.

Brain.—No thickening of the meninges and no
signs of meningitis; brain tissue somewhat soft
but otherwise normal; no hœmorrhages or local
changes; grey matter in normal proportion.

Weight of organs.—Brain, 49 oz.; right lung,
14 oz.; left lung, 131/2 oz.; heart, 5 oz.; liver,
22 oz.; spleen 6½ oz.; right kidney, 3 oz.; left
kidney, 21/2 oz.

Cause of death; cirrhosis of liver and anæmia.

As regards this and subsequent cases I must
mention that no microscopic examinations were
made. The Superintendent rarely has the neces-
sary leisure for such important work, while his
assistants do not possess the necessary knowledge
of histology and technical microscopy.

2.   Mougla alias Mohomed Syed, aged 45; admit-
ted 22nd June 1892. Said to have been insane for
four months and his insanity was stated to be due
to "ganja smoking."

There was nothing very noticeable about his case.
He was in bad physical health, and died on the 22nd
August from the results of a bad attack of dysen-
tery. His brother removed the body and declined
to allow a post mortem examination to be made.

3.   Mihir Lal De, aged 22; said to have been
insane for eleven months; cause ascribed "ganja-
smoking." Was convicted of theft and sent to
Hughli Jail, where his insanity became marked
and led to his transfer to an asylum. Remarks
on certificate of insanity:—"(1) General vacancy
of appearance; (2) uncleanliness in habits; (3) de-
structiveness of Jail property; (4) at times silent,
muttering fits; (5) occasionally boisterous, inco-
herency of speech." The man while in the Dullanda
Asylum, into which he was admitted on the 30th
September 1892, was melancholic, sometimes with
mild outbursts of excitement or weeping. The
case did not improve. He died of cholera on the
4th January 1893.

Post mortem.—Body well nourished; rigor mortis
slight in upper extremities; well-established in
lower.

Brain.—Weight 43 oz.; both membranes and
substance of brain congested; lateral ventricles
contained a very small quantity of fluid. Brain
substance firm. Heart weighed 8 oz.; chambers
of both sides contained dark blood and clots;