HYPNOTICA: SOPORIFICS

Insomnia is one of the worst evils from which mankind can suffer. It is always a calamity, whether the victim be a worker who during the day attends to his business or an idle pleasure-seeker. Woe to the unhappy wretch tortured by this evil who lies awake till morning on his hard or soft couch. But those too in whom mental overwork has excited the cerebral functions so that sleep refuses to come, or whose eyes will not close for fear of the coming mom, those whose unbalanced soul vibrates convulsively or whose conscience banishes sleep in self-accusation, all vainly look forward for many a long night to the realization of Egmont's words:

Sweet sleep, thou comest like a pure joy of thine own accord, without supplication of prayer. Thou dissolvest the knots of grave thoughts, thou interweavest pictures of sorrow and of joy; the course of internal harmony flows without an obstacle, and lulled in agreeable frenzy we sink and cease to be.

And how often in the darkness of sleepless nights is not the sad and sighing complaint sounded unto eternity that sleep might favour those who hour after hour vainly expect the appearance of dawn? How grievous is the cry of Shakespeare's King Henry IV:
. . . 0 sleep, 0 gentle sleep,
Nature's soft nurse, how have I frighted thee, That thou no more wilt weight my eyelids down And steep my senses in forgetfulness? .. .
0 thou dull god, why liest thou with the vile
In loathsome beds, and leav'st the kingly couch A watch-case or a common 'Lamm-bell? .. . Canst thou, 0 partial sleep, give thy repose?

Mental and physical fatigue finally demand aid at any price.
What remedies do we possess against the waves of restlessness of the brain? King Xerxes of old, when he could not sleep one night, had the chronicle of the empire read to him in order to become fatigued. His sleeplessness brought the highest royal honours to Mordechai, salvation to the Jews of the empire, and to Haman the gallows. It is unlikely that Xerxes slept that night! Sometimes indeed the reading of a very dull book is a remedy; medical books written by regular professors of the faculty are especially liable to produce sleep. As a rule, persons who suffer from insomnia have recourse not to mental remedies but to chemical substances.
The physical and mental consequences of the latter have been the subject of research which informs us that the satisfaction of the need for sleep by their means has in many cases led to a permanent craving for them. Those who use them can hardly wait for the evening in order to be transferred from the life of reality to that of dreams. It is, furthermore, certain that the toleration of a prolonged use of hypnotics depends upon the brain constitution of the individual, the chemical composition of the hypnotic, and the chemical relationship between the elements of the brain and the drug. The differences of toleration are under these circumstances very considerable. No devotee of sporific remedies remains immune, in the long run, from harmful effects. Even if these effects are felt scarcely or not at all, they are always present to a greater or lesser degree as the price paid for sleep, in the form of nervous disorders or other morbid states which result from abuse, and on examination do not fail to be discovered. In the following pages I describe some of the hypnotics which have become more popular and which are most frequently abused. The results of my observations may without restriction be extended to other substances used for the same purpose but not mentioned in this book.
Efforts to restrict the abuse of narcotic substances encounter a serious obstacle in the activities of certain manufacturers of chemical products who have at their disposal a whole staff of medical and even philological advisers. The propaganda litreature of these firms, which is constantly changed, and even written in Latin with quotations from Roman poets, endeavours to influence medical men and to cause them to prescribe the soporifics in question, which are always untruthfully declared to be non-poisonous or of a "considerable degree of nontoxicity."

The consequences are apt to be very serious if, thus disguised, dangerous substances which powerfully influence the brain fall into the hands of persons suffering from insomnia who have once tasted the charm of sleep produced ad libitum, and would at all costs retain it. There is no hypnotic whose use is harmless, and medical men should take this to heart in order to prevent the increase of the already widespread evil of soporific consumption. Profiteering may flourish elsewhere, but in this sphere it is apt to give rise to injurious poison-blossoms.

CHLORAL
Many of the motives which lead to the application and abuse of morphia coincide with those which give rise to the employment of chloral. Fortunately the latter is fairly rare, for chloral has virtually been erased from the list of medicaments; it is unpleasant to take, and the injurious consequences of its habitual use are too well known. Soon after its introduction into therapeutics the avarice of traders and others interested in its application produced many chloralists. Many of these applaud the harmlessness of the drug even after prolonged application; they are like the drunkard who glorifies alcohol as the source of all delights. A tendency exists to become habituated to chloral, as with every other narcotic substance. In some cases habituation and increase of the dose do not take place so rapidly as with morphia. There are, however, many proofs that such persons have a passionate craving for chloral, i.e. that the substance has taken the place of a normal excitant. There is no doubt that chloral is far more dangerous than morphia in this respect, not only because it is liable to call forth serious disturbances in the central organs, but also because there is the possibility of sudden death from paralysis of the heart. In many cases of sudden death this real cause is not diagnosed. The doses consumed daily amount in some cases to 15-20 gr. The combination of chloral with morphia also occurs. The following description depicts the effects of chloral.
In some chloralists the face becomes very red, almost purple; others exhibit a lurid discoloured appearance soon after ingestion of the substance. The eyeballs frequently grow yellowish, the skin is covered with spots, blood-spots, papular eruptions, etc. The fingers are ulcerated and the finger-nails spoilt. The general condition of health suffers. A feeling of intense cold, fatigue, and faintness, is accompanied by gastro-intestinal disorders, indigestion, and a considerable degree of emaciation. Habitual use is also said to occasion spasms of the bladder and other urinary troubles, weakness and palpitation of the heart, respiratory disturbances, pneumonia, and occasionally gangrene from pressure. The sexual impulse is generally lacking and troubles of menstruation occur. In addition to these symptoms, pains in the limbs, often also in the back and in the joints, increased cutaneous sensibility, formication, weakness of the legs, facial paralysis, etc., frequently appear in some combination or other.
Chloralists are, like morphinists, morally weak and incapable of renouncing their passion. Their insomnia is often increased by abuse of the narcotic. The mental faculties are enfeebled so that the behavior of some of them is childish and stupid. Their memory is affected, and in the advanced stages they become mentally and physically unfit. In many cases an exaggerated nervousness appears in the foreground. The patient is a prey to an incessant haste and restlessness which prevents him from staying in the same place even for a moment. From this state to real mental disease is only a step. In chloralists a state of raving madness, delirium and hallucination, have been observed. Morbid states of melancholia together with prostration, general weakness, cachectic appearance, refusal to take food, and suicidal intentions occur. The mental disposition of the subjects grows more and more sombre and they became misanthropes. Suicides as a result of chloralism are probably more frequent than has been assumed. They must be directly attributed to chloral since it creates a false mental disposition. A chloralist once attempted suicide with an excessive dose of chloral. He was cured from the acute symptoms, but remained an idiot.
Among the motor disturbances due to chloral, trembling of the hands and the head, ataxic walking, epileptoid convulsions with or without mental derangement may be observed. Convulsions with unconsciousness frequently occurred in a devotee of morphia and chloral. Between the crises he remained in a state of sleep from which he could be awakened. If the application of chloral was suspended unconsciousness disappeared, but weakness of memory and temporary mental confusion remained. Another often had hallucinations and was always in a state of mental depression. One day he fell down in an epileptic fit.

The mental disease with which Nietzsche was affected is attributed to the hyper-productivity of his brain and to the continually increasing rapidity of his thinking as well as the use of chloral. I consider the latter circumstance particularly aggravating. His mind was so incessantly active that he found no sleep at night. Physicians recommended chloral for the foolish reason that this product is quite harmless. He took immediate doses of the drug, and in this way at least accelerated his mental ruin.
Gutzkow became a slave of the drug in the same manner, for he suffered from obstinate insomnia. One night in December, 1878, after having taken a dose of chloral he upset the light in a state of torpor and set fire to his bed. He never awoke again.
The cure of chloralism is attempted in the same manner as in morphinism, has the same consequences, and as regards success is just as futile as the latter. The gradual or rapid withdrawal of the drug, with or without the administration of small doses of morphia, always shows the severity of the detrimental effects which chloral has had on the economy of the organism, especially the brain. Generally violent excitation, excessive restlessness, states of fury, and raving with hallucinatory madness on a foundation of extreme depression occur. In one case the patient was almost exclusively tormented with hallucinations of hearing. In spite of the administration of morphia and alcohol in another patient, four days after deprivation extreme agitation and a mania for destruction occurred together with hallucinations of sight which lasted forty-eight hours. Trembling continued after the disappearance of the hallucinations. Complete retrogression of these states of excitation may take place after a few days, or sometimes not till weeks have passed. Pains and twitching in the legs, especially the thighs and the calves, weakness and alternating frequency of the pulse, attacks of cardiac weakness, diarrhoea, twitching of the facial muscles, trembling of the tongue, stammering speech are more frequent symptoms.

VERONAL
This substance may also become the object of habitual use which is not rarely accompanied by a progressive increase in the size of the doses. Like all toxins that act on the brain, it produces a euphoric state. A morphinist had for two months taken 4 gr. of veronal per day, i.e. 250 gr. in all. This sufficed to call forth motor incoordination, weakness, tottering gait, drawling, muttering speech, and on the mental side a stimulation of the imagination and a state of euphoric gaiety as in inebriety. In those cases where the abuse has been more prolonged the symptoms are far more serious. The individual sensibility of different subjects to veronal plays an extremely important part in deciding the form of the disturbances of the organic functions produced by the drug. These troubles appear even if the daily dose does not exceed 0.5 gr. If the subject is very sensitive, disorders of metabolism, rapid emaciation, haematic disturbances will soon be observed. In the blood an unpleasant decomposition-product of the colouring matter, haematoporphyrin, is formed, which passes into the urine. In one case veronal gave rise to these symptoms after six months' use.
Certain nervous persons who suffer from insomnia experience an urgent desire for a further application of the drug even if the initial doses medically prescribed already give rise to alarm signals in the form of drowsiness in the daytime, motor disturbances, etc. A young hysterical girl considered these symptoms as negligible and procured veronal on old prescriptions which finally she took in daily doses of 1 to 2 gr. for eleven and a half months. She spent seven months in bed with progressive loss of strength and nausea. She suffered from extreme excitation, slight confusional illusions, defects of memory, and tottering gait. After admission to a hospital more serious disturbances of consciousness occurred, interrupted by lucid intervals, and after eleven days unilateral twitching of the face, immobility of the pupil, and general convulsions supervened. She died during an attack of these convulsions. Disease and death were without doubt due to veronalism.
I do not think that veronalists are rare.

PARALDEHYDE
The inclination of many persons to take narcotics renders the abuse of paraldehyde quite natural. Patients have been observed who took 35 to 40 gr. of the substance per day, sometimes even more. One of them continued the abuse for over a year. A man has been known to reach in the course of twenty-six months a weekly dose of 480 gr. The symptoms produced are similar to those of chronic alcoholism: emaciation and anaemia, fever in the evening, constipation and flatulence accompanied by voracity, irregular activity of the heart and palpitations, albuminuria, hallucinations of hearing and sight with illusions or delirium tremens, defects of memory and intelligence, disturbances of speech, a feeling of stupor or anxiety and excitement, muscular weakness, trembling of the tongue, face and hands, uncertain gait, restlessness, and paraesthesia. In spite of cautious withdrawal, deliria with convulsions similar to epilepsy are apt to occur. A lady, who after using morphia and chloral had become addicted to paraldehyde and was unable to sleep without the substance, became agitated, depressed, suffered neuralgic pains, and collapsed if deprivation of the drug only lasted for a few hours. Menstruation had ceased and a cure was impossible.

SULPHONAL
After reading the preceding pages it will not seem surprising that man has become addicted to this substance also and finds pleasure in its use. Its abuse inevitably produces organic modifications, especially alterations in the blood, where haematoporphyrin is formed from oxyhaemoglobin. Symptoms of paralysis of the limbs and trunk have also been ascertained, and in the intellectual sphere, weakness of memory, somnolence, disorders of speech, etc. A withdrawal cure after three to five months' abuse produced faintness and motor disturbances.

POTASSIUM BROMIDE
On account of the cheapness of potassium bromide and the facility with which it can be procured, the over-worked who suffer from insomnia make use of it and soon become slaves to it, as does the morphinist to morphia.' Indeed many persons lie with respect to its use, in the same way as morphinists, and positive proofs are frequently necessary to obtain a confession. Abuse increases with use, so that various disorders of health occur. The substance does not, however, produce a euphoric state.
The bromide salt spreads throughout the organism. The brain retains considerable amounts. If a woman employs the drug before or during pregnancy her child is apt to suffer from bromine poisoning. A newly-born child of this description was emaciated, the skin hung loosely like an empty sack round the thighs, the face had a senile appearance and was of a bluish colour. The infant slept incessantly and only awaked in the morning and at night for a few short moments. Later on grave dermatitis occurred similar to that which frequently affects consumers of bromides, and which is apt to develop into nodulous and ulcerous formations.
The limits of individual sensibility are very wide here also. Habituation to bromides gradually produces an attenuation of their action. The symptoms of habitual use are frequently the following: reduction of the sexual impulse, troubles of the respiratory and cardiac apparatus, a peculiar fixed expressionless stare, and especially disturbances of the functions of the brain, such as apathy, weakness of memory and understanding, etc. This mental depression is often accompanied by motor weakness and disturbances of co-ordination. Occasionally a state of excitation appears instead of depression. Unpleasant consequences are also liable to occur after deprivation.

Bromural
Habituation to this substance may likewise be induced by gradually increasing the dosage. The symptoms observed are disorders of speech and of the reflexes, interference with temporal and spatial perception, and insecure gait.

KAVA KAVA
The immense island world of the Pacific attracts the attention of the anthropologist perhaps to a greater degree than the continental territories. For it leads us among other things to ask the following questions. Has nature in her marvellous creativeness endowed man with some narcotic plant whose effects may be agreeably experienced? Have the inhabitants of these distant islands surrounded by the mighty ocean, who lead so bare an existence on their small fragment of the earth, been instinctively led to the discovery of substances capable of raising even them above the daily monotony of a crude existence and supplying sensations of a wholly different state of well-being? The existence and use on these islands of piper methysticum, which I was the first to investigate,' answer these questions in the affirmative. I also found confirmation of a fact to which I have repeatedly alluded when speaking of the development of the use of such substances: namely, that there is no obstacle which can arrest the spread of a narcotic, not even the sea with its menacing dangers for the natives of these islands. Not men alone, but the ocean itself yields to the power of narcotics. Kava-Kava or piper methysticum is characteristic of Oceania, i.e. all those intertropical swarms of islands which are spread over an area of 66 million square kilometres. Who taught the natives to employ the plant in the manner in which they use it, which is the best possible way? An insoluble problem, like many others in this sphere.
Piper methysticum is a carefully cultivated piperaceous plant with several varieties. It is called kava, kava-kava, ava, or yangona. It may be found at an altitude of 500 to 304 metres above sea-level and is a picturesque, shrub-like plant which grows in thick bushes. The character of its slow growth is similar to that of bamboo.
The most important part of the plant is the root. It is knotty, thick, and provided with sarmentous radicles up to 1.8 metres in length, which are sometimes threadlike in their extremities. When fresh it is greyish-green, in a dried state greyish-brown, and weighs between 1 and 2 kilogrammes in the fresh state. After removal of the bark a network of ligneous formation appears, partly filled with a soft and yellowish cellular substance. The section of the fresh plant is yellowish-white, greyish-white, lemon-coloured or pink, according to the variety. The central part of the root is soft with a few ligneous bundles. The substance contained in the ligneous bundles is soft, spongy, and can easily be scratched out with the finger-nail.

Where and how Kava-Kava is drunk
In the Australian Archipelago, which extends over nearly 20 degrees of latitude, live two groups of aborigines. The former, the Melanesians or Papuans, have dark skin and woolly hair. They inhabit the area bounded on the north by New Guinea, the Louisiade Archipelago, the Solomon Islands, the New-Britain Archipelago, to which New Caledonia and the Loyalty Islands in the south are attached; on the east by the New Hebrides, the St. Cruz Islands, the Fiji group, and far to the south, New Zealand, whose population, however, does not belong to this group. The second ethnical group is that of the Polynesians and Micronesians, with light-coloured skin and lank hair. They inhabit the outer girdle of the islands above mentioned, and the others scattered in the Pacific, the Caroline Islands, the Marianne, Gilbert, Samoa, Tonga, and Marquesas Islands, the Society Islands, the Fortunate Islands, the Hervey, the Austral, and the Paumotu Islands. The existence and use of kava-kava is said to be confined to the islands inhabited by the light-coloured aborigines, and not to occur at all in the group inhabited by Papuasians. Such a division cannot be accepted, for the use of kava-kava in New Guinea, which is mainly populated by Papuans, is beyond question, whereas its existence has not been proved on the Tokelau Islands and others whose natives are light-skinned.
My investigations as to the geographical extension of piper methysticum and its use have led to the following results:
It occurs in New Guinea. Miklouho-Maclay once sent me a report on an inebriating beverage, keu, which all the male inhabitants prepared from piper methysticum on festive occasions. Its use, however, was only permitted to persons of a certain age. This custom exists not only on the Maclay Coast, Astrolabe Bay, and Finch Bay, but also on the Fly River, and probably extends far to the east and north. In the Carolines many plantations of the plant have been destroyed by the missionaries, and the use of kava-kava has greatly diminished. It still exists, however, in the Solomon Islands. The plant grows in New Caledonia but is not used there. In the New Hebrides the consumption of kava-kava is practised beside that of betel. Kava-kava is drunk on Tanno, Erromango and Meli, and farther to the east in Rotuma and the Futuna Islands. The Fiji Islanders use it, and the natives of the Tonga Islands take it every morning. Girls crush the root between stones. On Samoa it is consumed in moderation. It is cultivated there in such amounts that it is exported. In 1908 34,350 kilos, and in 1909, although an earthquake had destroyed a part of the plantations, 16,299 kilos, were exported. On Wallis (Uvea), where an excellent variety of the plant occurs, the missionaries have abolished its use. It also occurs in the Cook Archipelago and in the Tubuai Islands. In the Society Islands the plant was cultivated in Cook's time (1768). At the present day the cultivation of the plant on Tahiti has completely ceased. Even in the year 1830 it was hardly possible to procure a single specimen. Some natives do not even know its name. In the interior of Tahiti, sporadic specimens, stunted and with poor stems, have been observed, as well as on Raiatea and Moorea. Kava-Kava also occurs in the Tuamotu Islands and the Marquesas Archipelago. In the latter it is cultivated and employed a great deal. It occurs in nearly all the eleven islands which this group comprises.
There are still kava-kava plantations on the Sandwich Islands. It seems, however, that the dissemination and use of the plant have given way in favour of alcoholic beverages.
The geographical boundaries of the occurrence and use of kava are therefore with a few exceptions confined to the islands in the intertropical zone, from 23 ° north latitude to 23° south latitude and from 135° east longitude to 130° west longitude.

Preparation and Use of Kava-Kava
Kava was intimately interwoven with the social, religious, and political life of the South Sea Islanders. It accompanied them on all their peaceful and war-like enterprises, whether in common or individual, and played a prominent part in all the joyous or sad events of life. It is therefore not surprising that the first explorers of those islands spoke in detail of the plant and its use. Moreover the sorcerers and medicine-men among the natives highly valued kava because it acts very rapidly after ingestion not only as a euphoric but also as an anodyne.
The missionaries did all they could to suppress the use of kava, probably not to the benefit of the natives. The violent campaign against kava by the Presbyterian missionaries cannot be justified in the least. It bears witness to the gross ignorance of the missionaries, who have made many a mistake elsewhere. Reason, hide thy face! The Anglican mission was less hostile to kava. There is no doubt whatever, that the physical and moral state of the natives has been, and is, far more damaged by the use of alcohol than by the consumption of kava. The missions are right in pointing out that crime and misery appeared in Tahiti together with the spread of drunkenness. The substitution for the use of kava of the almighty alcohol had already begun at the opening of the last century. The natives acquired a knowledge of the preparation of alcohol from fermented sugar-containing material which has given rise locally to the use of indigenous products of this kind. On the Marquesas Islands, for instance, spirits are obtained from fermented coco-nut milk.
Before the arrival of the missionaries the kava plantation was divided into three parts. The first and best was reserved for the evil gods; it was taboo, i.e. sacrosanct. The second was reserved for the Atu, the gods of sleep, and the third belonged to the family. Here also, as with many other narcotic substances which I have described, an intimate connection with religious conceptions may be observed. At the present day the part reserved for the gods has generally been abolished. In Samoa and the Wallis Islands alone some families still consecrate a few feet of land to the old gods. On some of the last-mentioned islands, however, there are kava fields which belong to the community and in which every family has a share.
The drinking of kava often takes place to celebrate a festival. The planting of trees, for instance, is celebrated by a kava feast. Kava is consumed when palavering with other tribes, during the discussion of public affairs, in society, and when entertaining guests in order to experience agreeable sensations. It is also used as a sedative medicament to give repose to the diseased or fatigued organism. In some islands it is consumed as a daily beverage, like our tea or coffee. On some of the scattered islands of the Pacific Ocean the natives receive Europeans and wait upon them with kava. Cook saw the natives drink the drug several times during the morning. The Samoans always take kava before meals and never after, and some of the elder folk drink a cup of the beverage before breakfast. Occasionally, kava feasts take place at night by the light of torches. In Wailevu these festivals were customary in honor of the foreigners. Some ardent kava-drinkers imbibe the beverage six to eight times a day. There are many Europeans living on these islands who frequently make use of the drug. The inferior classes of whites on the Fiji Islands must be counted among those. In good society it is considered as a sign of respectability to refrain from using kava.
In the New Hebrides there are said to exist public-houses for kava orgies, generally situated near a banana tree. At sunrise the men repair to these places for a cup of kava. In the Samoa Islands a public square in the neighbourhood of a banana tree serves for the same purpose. In other islands perhaps any but is chosen with this end in view. The ceremonies which accompany the preparation and drinking of kava differ in the various groups of islands, and are sometimes even dissimilar in different districts of one and the same island. For instance, in the mountainous parts of the Fiji Islands the tune of the meke chants sung when brewing yangona and the movements of the bodies of the singers as they accompany their airs are quite different from those customary on the coast. In some parts the ceremonies are the same as in ancient times. In other places the levelling influence of civilization which has invaded these islands has only allowed the pleasure of drinking to be retained. The ceremonies have been shortened or abolished. The Samoans at public kava feasts pray to the gods for health, long life, a good harvest, and success in war. Generally women are not present at these feasts. However, in Samoa and other islands both women and men have been seen to participate. In Waja (to the west of Viti Levu) the women are said to have their own kava societies, similar to those on Tonga.
Old or young roots are cleaned and cut into suitable pieces after the bark has been removed. The root is then masticated. This method, which is the most general, is the primitive Tonga method, whereas the crushing of the root between stones, the Fiji method, is hardly in use. The individuals chosen for the process of mastication first clean their hands and their mouths. Usually they are young men and boys with good teeth, but the females also assist. On the Fiji Islands when a kava feast without ceremonies is celebrated, the root is masticated by girls who serve it while singing. Solemnly and slowly the root is chewed until the substance is fine and fibrous. It is not permitted to swallow any of the juice, which accumulates in the mouth.
The method employed in these islands by many whites and half-breeds, which consists in scraping the root on a grater without mastication and chewing it or merely macerating it with water, is said not to furnish a beverage of such good quality. It is even said that an infusion of scraped kava in water and masticated kava are as dissimilar in their effects as currant wine and champagne. Two mouthfuls of the substance generally suffice for one person. As soon as mastication is accomplished, the chewed lumps are placed in a wooden bowl made in one piece, which holds from 2 to 6 litres, and sufficient water is added. The man in charge of the bowl then stirs the liquid with his hands for a few minutes. From the moment that the water is poured into the bowl the ceremonial commences. This differs on the various islands and has not yet been completely abandoned. There is a solemn appeal to the gods, the departed spirits, etc. The extracted vegetable residue is removed after the water has been in contact with the masticated kava for a sufficient time. Each native has his own receptacle, usually the 'half of an empty coconut, which is filled with the prepared kava beverage and drunk to the accompaniment of special rites.
In appearance kava resembles an infusion of coffee with milk. It is of a dirty greyish-brown or greyish-white colour, especially when stirred, by reason of the fine greyish-yellow detritus of the root, which is not removed by the process of filtration practised by the natives. If little of this residue is present, or if the islanders pour the kava into their vessels after allowing it to settle, the liquid has a light or dark brown colour. The taste differs with the mode of preparation. It may be insipid or very bitter, aromatic or biting, soapy or astringent. The reason for the difference in taste lies in the degree of accuracy with which the insoluble residue of the root is separated from the fluid. The latter contains only a very small amount of the active and sapid substances in solution. The presence of resin is of the greatest importance. The more resin there is, the most intensive the taste. The natives do not seem to grow accustomed to the peculiar taste of the beverage, for Cook saw them grimace as they took it and afterwards shake themselves.

The Active Substances of Kava and their Action
Until my own researches began, it was generally assumed that the secret of the action of kava lay in its mode of preparation. It was said that during mastication the saliva transformed the starch of the root into sugar, and that this by fermentation turned into alcohol. I have proved this opinion false in every respect. This has not prevented several writers in their ignorance from reproducing this nonsense at a later date.
The only active principle of kava is a resinous substance which is found in the root accompanied by the crystalline and non-active methysticin (Kavalin), that is if,- methysticin, a substance which I called yangonin (the crystalline anhydrous methylic ester of yangona acid) and a lactone with the formula C15l.-11404. By a special process I have been enabled to split this resin up into two components, a- and f3kava-resin, of which the former had a more powerful action on the human body. The a-resin has the property, like cocaine, of
anaesthetizing the mucous membranes and also the eye. Otherwise both resins are similar in action. A carefully prepared kava beverage taken in small quantity occasioned only slight and agreeable modifications of sensibility. In this form it is a stimulating beverage after the imbibition whereof hardships can be endured more easily. It refreshes the fatigued body and brightens and sharpens the intellectual faculties. Appetite is augmented, especially if it is taken half an hour before meals. Some travellers prefer it to champagne, but believe that its effects are only fully experienced in hot climates. If enough of the active principle is ingested peculiar narcotic phenomena appear. In the first report of Cook's travels it is stated that some of the crew had drunk of the beverage, and that effects were observed similar to those of a large dose of a spirituous liquor or of opium.
After doses that are not too strong a state of happy carelessness, content, and well-being appears without any physical or mental excitation. It is a real euphoric state which is accompanied by an increased muscular efficiency. At the beginning speech is fluent and lively and the hearing becomes more sensible to subtle impressions. Kava has a soothing effect. Those who drink it are never choleric, angry, aggressive and noisy, as in the case of alcohol. Both natives and whites look upon it as a sedative in case of accidents. Reason and consciousness remain unaffected. After the consumption of greater quantities, however, the limbs become weary, the muscles seem to be out of control of the will, the gait is slow and unsteady, and the subject appears half drunk. An urgent desire to lie down manifests itself. The eye sees objects before it but is unable to identify them with exactness. In the same way the ears hear everything, but the individual is unable to account for what he hears. Everything becomes more and more diffuse. The drinker succumbs to fatigue, and experiences a desire to sleep which is stronger than all other impressions. He becomes somnolent and finally falls asleep. Many Europeans have themselves experienced this action of kava which paralyses the senses like magic and finally leads to deep sleep. Frequently a state of somnolent torpor accompanied by incoherent dreams and occasionally erotic visions remains without sleep supervening.
The sleep is similar to that produced by alcohol, out of which the individual can be awakened only with difficulty. If moderate quantities have been consumed it occurs twenty to thirty minutes later, and lasts from two to eight hours according to the degree of habituation of the subject. If the beverage is concentrated, i.e. contains a large amount of the resinous components of kava, intoxication comes on much more rapidly. The drinkers are found lying in the very places where they have been drinking. Occasionally a short state of nervous trembling occurs before they fall asleep. No excitation precedes these symptoms.
The strongest kava is prepared in Rotuma. The natives amuse themselves by intoxicating the sailors who come on shore to such a degree that they are unable to stand or walk and have to be carried on board.
It will be readily understood that Europeans who have had the opportunity of experiencing the agreeable effects of kava, frequently make use of the beverage. Many reports certify that even educated Europeans can only with difficulty break off the habit of regular kava-drinking after they have found pleasure in its consumption. Many whites in a socially inferior position may be seen in the Fiji Islands in a state of kava inebriety. No injurious consequences of any importance have been established.
As regards its moral influence on the subject, this mania is like all other passions of a similar nature, morphinism, alcoholism, etc. The kava-drinker is incessantly tormented with the craving for his favourite beverage, which he cannot prepare for himself. It is a repugnant spectacle to see old and white-haired people, degenerate through prolonged abuse of the drug, going from house to house in order to beg for freshly prepared kava and often meeting with a refusal. Mental weakness has also been stated to follow from kavaism. It is said that old kava habitués have red, inflamed, bloodshot eyes, dull, bleary, and diminished in their functions. They become extremely emaciated, their hands tremble, and finally they cannot lift the drinking vessel to their mouths. Numerous cutaneous diseases of the natives of the South Seas, especially a kind of scaly eruption which results in a parchment-like state of the skin, have been attributed to the abuse of kava. I do not, however, consider it probable that kava is the original cause of these affections.

KANNA
Under the name of kanna (channa), Kolbe more than 200 years ago designated a plant whose root he found used by the Hottentots as a means of enjoyment. They chewed it and kept it in their mouths for some time, thus becoming excited and intoxicated. "Their animal spirits were awakened, their eyes sparkled and their faces manifested laughter and gaiety. Thousands of delightsome ideas appeared, and a pleasant jollity which enabled them to be amused by the simplest jests. By taking the substance to excess they lost consciousness and fell into terrible delirium."
At the present day the name channa designates certain species of mesembryanthemum, for instance M. expansum and M. tortuosum (kaugoed) , which occur in the hinterland of the Cape of Good Hope, especially on the dry Karroo plateau, and also in Namaqualand, etc. The root, leaves, and trunk of these mesembryanthema are crushed and the resulting material chewed and smoked. Mesembryanthemum tortuosum contains an alkaloid with a sedative action, a vegetable substance which in frogs gives rise to paralysis and the arrest of respiration, and in rabbits to convulsions. It is said that 5 gr. of the drug produce a state of torpor in man.
It is impossible that these plants should produce the phenomena which Kolbe attributed to kanna. He probably confused their effects with those of Indian hemp, to which the Hottentots are passionately addicted. The results experimentally achieved reveal pharmacological properties of such little importance that it is inconceivable why the Hottentots should have used the plant. We are confronted with a gap in our knowledge which for the present cannot be filled. There are other plants in those countries, for instance sclerocarya caffra and sclerocarya schweinfurthi, which have an intoxicating action and are used for this purpose.