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AUTO-OBSERVATIONS BY PHYSICIANS

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Reports - The Problem of Cannabis

Drug Abuse

Auto-observations by physicians certainly arouse much interest; for example the account given by Carstairs.    Prevailed upon to share in the Brahmin group's potations on two occasions, "he experienced the time distortion, the tumbling rush of ideas, the intensified significance of sights, sounds and tastes, and more strongly than anything else, the feeling of existing on two planes at once.    His body sat or lay in a state of voluptuous indifference to its surroundings, while consciousness alternated between a timeless trance-like state and a painful strugele to keep awake, to keep on observing, and acting (in this case, to keep on writing down notes on his introspective experiences). It became clear to him, in retrospect, that throughout the intoxication his bias of personality, and perhaps his less conscious fears of surrendering to a dreamlike state, resisted the somatic pull of the drug; and yet he was able to enter sufficiently into the fringe of the real ecstasy to quicken his future appreciation of what the experience meant to those who welcomed and valued

Moreover, the recognition of his own fear and repudiation of the state opened Carstairs' eyes, as he explains, to two possibilities: (a) that other Western observers might have shared his own reluctance, if not inability, fully to submit to -thi5 intoxication; and (b) that to Hindus, "with their different cultural heritage and personality bias", the experience might represent something different, at once less frightening and more congenial.

Some experiment with physicians, dental surgeons and pare-medical personnel of a medical clinic in Rio de Janeiro have been described.(37) In the first experiment with 7 persons, one or two marihuana cigarettes containing 1.56 g each were given, mixed with placebos made from maize awns. As the marihuana had been stored for a long time, only 1 person Showed any mental disturbance.

The experiment was then repeated in the same place, with fresh drug sent by air. The cigarettes contained this time 2.82 g of the drug.    Six of the 9 persons concerned showed signs of mental disturbance. Objective symptoms were revealed in the following order of frequency: tachycardia and high pulse rate in 8 of the persons under observation; abnormal reasoning in 41 serious conjunctival irritation in 41 a state of excitation in 4, affected pupils in 3, restlessness in 3, lachrymation in 2, sweating in 1, ambulatory delirium in 1, mental confusion in 1, irritability in 1. Subjective symptoms occurred in the following order of frequency: burning sensation in the throat 111 bitter taste 8, giddiness and "dopiness" 7, paresthesia 5, change of character 5, disorders of the circulation 5, sleepiness 4, euphoria 3, thirst 3, insensibility of the tip of the tongue 3, anxiety 3, giddiness 2, feeling of drunkenness 2, desire to laugh 2, "a pleasant smoke" 21 "resinous flavour" 2, furring of the tongue 2, buzzing noises 2, feeling of absurdity, sleep-walking, imminent deat headache, walking delirium, 1 (and other, minor symptoms in some cases).

The symptoms started within the first ten minutes and persisted for from threeto twenty-three hours.

From further observations -made by Parreiras during a journey to the northern states-of Brazil, On 120 persons of different social classes, the majority of them workmen, it was concluded that in about two-thirds of them the smoking of maconha caused psychic disturbances/ ranging from exaggerated and forced laughter to hallucinations, psyehoses, aggression and murder. The same proportion of two-thirds was also found three years earlier in 46 cases observed by Cardoso.

This might be the right place to give a warnipgthat care should be taken not to held cannabis responsible, in the absence of satisfactory proof, for psychological symptoms apparently the same as those caused by this drug. Hillenbrand, far instance, quotes from the memoirs of C. L. Schleich a story according to which hashish was injected (!) at a students' club in the small university town of Greifswald in Northern Germany at the end of the last century. This does not sound very probable.'

Recently - in 1952 - D. McI. Johnson explained the symptoms of bread poisoning observed at Pont-Saint-Esprit as being "an epidemic of intoxication mania" caused by cannabis. Apart from a few psychotic symptoms of a general character which the author discovered when visiting the village six months later, no valid proof for his conjecture was given. The clinical picture, described in detail,(19)does not agree with cannabis symptomatology.. Moreover, it has been stated by the government authorities responsible for narcotic affairs that most probably a fluid fungicide drug for the impregnation of flour sacks had been sDilled inadvertently on the floor and had soaked into the contents of the sacks.