(Indian Hemp.)

Definition. - The dried flowering tops of the pistillate plant of Cannabis sativa L., grown in the East Indies and gathered while the fruits are as yet undeveloped and carrying the whole of their natural resin.

Description and Properties. - The article of commerce consists of bundles of a few flowers, the branches and bracts, and nearly ripe fruit, the whole more or less agglutinated by a resinous exudation. Of a brownish-green color, peculiar narcotic odor, and slightly acrid taste. The exact composition of cannabis is not known. It is an extremely variable drug, and plants in different countries display great diversity in amount of active constituents. It is thought that only the tropical varieties are effective.

The active constituents are not yet definitely isolated. They exist in a mixture of resins and volatile oils, termed for convenience only Cannabinol; but no one body that may be said to possess the pharmacological characters of the crude drug has yet been positively determined as to its chemical structure.

The crude drug is commonly called in India "gunjah." "Bhang," "siddhi," or "hashish," the term usually employed - from whose toxic effects, frequently inciting to murder, is said to be derived our word "assassin" - is another form of cannabis appearing as the Arabian confection prepared by mixing aromatics with fruits and dried leaves.

Dose.- 2-5 grains (0.12-0.3 Gm.).

Official Preparations

Extrctum Cnnabis ndicae - Extrcti Cannabis ndicae - Extract of Indian Cannabis. - Dose, 1/4-1 grain (0.015-0.06 Gm.) [1/5 grain (0.01 Gm.), U. S. P.],

Fluidextrctum Cannabis Indicae - Fluidextrcti Cannabis Indicae - Fluid-extract of Indian Cannabis. - Dose, 2-5 minims (0.12-0.3 Cc).

Tinctra Cannabis ndicae (10 per cent.) - Tinctrae Cannabis ndicae - Tincture of Indian Cannabis. - Dose, 5-20 minims (0.3-1.2 Cc).

Antagonists and Incompatibles. - Strychnine, caustic alkalies, acids, and aqueous preparations are pharmaceutical incompatibles, precipitating the resin.

Synergists. - Alcoholics, ether, bromides, cocaine, and members of the present group enhance its cerebral effects.

Physiological Action. - Externally and Locally. - Its local action on the skin is nil.

Internally. - Digestive System. - It is slightly sedative to the stomach, in many persons appearing to promote the appetite and aid digestion. Its use is not followed by constipation or other gastro-intestinal disturbance.

Circulatory System. - A slight acceleration of the pulse is noticeable under full doses.

Nervous System. - In moderate-sized doses after half to one hour there is a marked stimulation of the cerebral activities. The flow of ideas is heightened. Imagination is quickened and in certain types of individuals there may be hallucinations of sight, of hearing, of touch, etc. These are for the most part accompanied by a dreamy state of beatitude, atypical euphoria, comparable in some degree to the euphoria of alcohol or opium. Certain psychological peculiarities are often noted in the mental exaltation. Double consciousness, or sense of divided consciousness, is common, and there is usually a loss of space and time relations. The peripheral nerves of touch and pain are affected, both of these sensations being dulled. There may be heightened reflex irritability in the cord.

Respiratory System. - No marked or uniform action upon the respiration has been observed, it being at times quickened and again retarded.

Absorption and Elimination. - Cannabis is slowly eliminated, though in what manner is unknown, the effects of the drug sometimes persisting for twenty-four or thirty-six hours. Of all the secretions, the urine alone is affected, the amount being increased.

Temperature. - Cannabis has no direct depressing action upon temperature, which, however, may rise during the period of excitation, and be diminished somewhat during sleep.

Eye. - The drug differs from opium in that it dilates the pupil and produces exaggerated vision.

Uterus. - It is considered to be a powerful uterine stimulant, and like properties are usually ascribed to it as an aphrodisiac, though its effect upon sexual desire is not always manifest. It undoubtedly increases the energy of the uterus, though possessing no power to inaugurate uterine contractions when once suspended.

Poisoning. - Large doses of cannabis Indica are wont to produce toxic effects, but these are rarely fatal even in large doses. Cardiac failure is thought to precede respiratory paralysis.

The after-effects of hashish indulgence vary with the physiological and mental peculiarities of the individual. As a rule, they are not disagreeable, though it requires time to eradicate the effects of the poison. Death directly attributable to the drug has not been recorded.

Treatment of Acute Poisoning. - Among antidotes, lemon-juice, coffee, and tobacco have been favorably mentioned. The best treatment appears to be similar to that adopted in cases of chloral- and opium-poisoning.

Chronic poisoning induces a characteristic series of mental symptoms. The effects of continued indulgence, according to the Makhzan-el-Adwiya, an early treatise, are "weakness of the digestive organs, followed by flatulency, indigestion, swellings of the limbs and face, changes in complexion, diminution of sexual vigor, loss of teeth, heaviness, cowardice, depraved and wicked ideas." The most common effect, however, is the development of insanities which have been known for many years. A number of types are described. Temporary intoxication is the state commonly seen in the hashish cafes of the Orient. The patient represents a medium condition between an alcoholic and an opium intoxication. Hashish delirium represents a severer grade comparable to delirium tremens. The patients are restless and sleepless and chatter unendlessly. Acute maniacal excitement is also found. The patient runs amuck, but may also be melancholic. Chronic mania and dementia represent terminal stages. The mania is usually a happy mania. The dementia is of a classical organic type. A further form of the cannabino-mania needs characterization. He is the shiftless never-do-well - a liar and thief, quite comparable with the degenerated alcoholic, opium, or cocaine habitues.

Therapeutics. - Externally and Locally. - Cannabis is very seldom used locally.

Internally. - Cannabis has been discarded as a remedy in many disorders for which it was formerly used. It is, however, still employed to a considerable extent as a hypnotic in melancholia and mania and for its analgesic action in neuralgia and pruritus.

Cannabis Indica is of service in functional impotence, its action in this disorder being aided by combining it with ergot and nux vomica.

It is a valuable adjuvant to cough-mixtures intended to relieve tickling or irritation of the throat, as well as to quiet the excessive cough of bronchitis or phthisis, being superior to opium in this respect, since it disturbs the stomach less and does not produce constipation.

It has been used in spasm of the bladder, and in gonorrhea and chordee it has been found to be a most valuable remedy.

In considering the therapeutics of cannabis Indica reference should be made to its efficacy in migraine and headache, particularly those present at the menopause. Although as a remedy for the former disorder cannabis has been largely superseded by the adoption of antipyrine and agents of its class, the old use of tincture of gelsemium, combined with tincture of cannabis, serves an important purpose in aborting the distressing attacks of migraine. It is useful as a mild hypnotic in insomnia from exhaustion with pain, and is often efficient in severe tic douloureux.

Administration. - The extract should be given in pill form; the tincture and fiuidextract, in an alcoholic menstruum. As has been already intimated, different samples vary greatly in strength; it is therefore best to begin with the minimum dose until the force and quality of the preparation be ascertained.

It is advisable to prescribe invariably the preparations of that particular manufacture which experience has shown to produce samples of uniform strength.