246 REPORT OF THE INDIAN HEMP DRUGS COMMISSION, 1893-94. [CH. XII.

In 17 out of 98 cases only is information recorded as to the nature of the
onset of the symptoms; in eight it may be described "sudden;" in six as
"gradual" or "slow"; and in three as "insidious." As a rule no detailed in-
formation is ascertainable regarding the nature of the premonitory symptoms
or their duration. "Headache" has been mentioned, but beyond that there are
no clinical symptoms. Sometimes alteration in habit is alluded to, but more
frequently attention has first been drawn to the mental condition by some
insane, violent, or destructive act which has led to the individual being sent
to a medical officer for observation. Regarding the state of the general bodily
health on admission into asylums, in 35 cases it is described as "good," in
20 "fair," in 8 "indifferent," in 6 "bad," in 3 "weak" or "very weak," and
in the remaining cases no information is recorded. As a rule no records are kept
of the form or measurements of the head, general physical features are not
recorded, and thermometrical observations do not usually appear to be made.
The facial expression is as a rule not described, and in three instances
only is it referred to as "vacant." The appearance of a "ganja wart" on
the palm is mentioned by one Superintendent. The gait is as a rule
not described. Abnormalities or signs of disease of the sexual organs are not
usually mentioned. The condition of the circulatory and respiratory systems
are not as a rule recorded. Under the digestive system it may be mentioned
that in fifteen cases food was refused, necessitating forcible feeding. No informa-
tion as a rule is available regarding the glandular system, state of the skin, or
character of the urine. Under the muscular system "tremor" has been referred
to and "muscular twitchings like chorea." But such features as power of
"grasp" of hands or reaction to electric stimulus are not mentioned. Under the
nervous system—sight, hearing, taste, and smell—no systematic observations
appear to be recorded; in only one asylum was there any record regarding the
state of the pupils; in one asylum redness of the conjunctiva was mentioned;
and in one asylum the eyes are described as "red." The conditions of nervous
sensibility, hyperæsthesia and anæsthesia, do not appear to have received
attention; and in one asylum only are reflex phenomena mentioned.

Regarding mental symptoms. In fifty-six cases incoherence of language is
mentioned, in seven uncommunicativeness, in seven silentness, in nine talkative-
ness, in twelve muttering, and in twenty-two abusiveness or obscenity of language;
in four cases the patients were "excited," in three roaring, in twenty-four noisy,
in twelve restless, and in thirty-one sleepless. In seven cases there were symp-
toms of "exaltation," in thirteen quarrelsomeness, in twenty-nine destructiveness,
twenty-five were homicidal, twelve suicidal—frequently the same case exhibited
both tendencies—and thirty-six violent. In twelve cases there was laughter, in
two dancing, in one absurd postures, and fourteen were either sad, crying, or
moaning. Forty-six were dirty or filthy in their habits, twenty-one were indecent,
in twenty-four there were delusions, and in four cases the patients are described
as "childish."

The alteration in symptoms in the asylum was in some cases very rapid,
so rapid in some instances as to be almost immediate. In others the progress
towards sanity was slower; in some there were relapses, with occasional outbursts
of violence; while others from being violent and abusive became melancholic or
quiet and silly, or drifted into a condition of dementia.