Description Of The Hashish Experience

[Jacob Bell]

BY R.P. WALTON, M.D. Ph.D.

At about the same period as the more imaginative descriptions
by the French voluptuaries and the American adventurers
were composed, various members of the medical
profession and otherwise scientifically trained people
observed and reported the effects of hashish on themselves,
their friends and their patients. This general display of interest
was occasioned by the sudden prominence of Indian
hemp as a medicinal agent. The therapeutic applicability of
this drug had been advocated by Aubert-Roche in 1839, by
O'Shaughnessy in 1843 and by Moreau de Tours in 1845.
Each of these physicians contributed descriptions of the
pharmacologic and what might be called the psychopharmacologic
effects.
Moreau de Tours made numerous experiments on himself,
normal individuals and patients. He reported that with smaller
doses of dawamesc, a person does not feel particularly
different and only experiences a mild feeling of expansion.
With larger doses there is a marked euphoria, slight pressure
in the temples and upper cranium, retarded breathing,
slightly accelerated pulse, a feeling of warmth over the whole
body with the exception of the feet which are usually cold
and a heaviness and numbness of the hands and arms. With
still larger doses, there are choreic movements, ringing in the
ears, and a feeling of oppression in the region of the heart.
Subjectively there is no such effect. There is a development
of tonic spasms, particularly of the flexors, all with short or
long intermissions. There are numerous psychologic phenomena
such as a feeling of lust without sexual excitation, an
indescribable feeling of peace, happiness and delight, a
distorted, a powerfully heightened effect of music, fixed
ideas and delusional convictions which change rapidly, irresistible
impulses and illusions and hallucinations which are
closely allied to insanity.
Rech, in 1847, reported the effects of hashish administered
to a number of young interns. Three main types of
effects were obtained: (1) a disturbance of digestive functions;
(2) purely nervous effects; and (3) confusion of mental
faculties. The first manifested itself as a loss in appetite,
dryness of the mouth, burning thirst, pain in the epigastrium
and inclination to vomit with sometimes outright vomiting.
These effects pass off rapidly and are of subordinate importance
with respect to another symptom, namely, a coldness
in the extremities. The second group of effects includes involuntary
contractions, a disturbance of locomotion, a feeling of
paralysis and a convulsive laughter, which is sometimes
disagreeable but more often is pleasant. In one case the lower
extremities seemed to be as heavy as lead and nailed to the
floor, another felt a heaviness in all extremities and felt as if
he were walking in snow. The purely mental effects lasted
longer and were most prominent. The subjects could not
converse rationally, ideas displaced one another without
relationship, memory and the sense of passing time were
extinguished. Imagination was intensely stimulated; the most
brilliant ideas flashed by; some had hallucinations and
thought they were transformed. A deep torpor gradually set
in. Of all the intellectual capacities, the power of comprehension
remained in the most normal state.
Donovan took large doses of extracts made from hemp
plants grown near Dublin. No effects were obtained. However,
ten drops of the tincture of Cannabis in&a from
Calcutta caused marked effects. The walls of the room
seemed to move in on him. His thoughts came more slowly
and finally were extinguished. This condition lasted for two
hours after which he recovered and manifested a strong
appetite.
Clarke had substituted cannabis for morphine in a case of
mania. The first dose from a renewed supply produced
marked depression with cyanosis. Some of the same sample
was taken by the author who had a typical hashish experience,
also accompanied by cyanosis and by partial paralysis
of the left arm De Luca was prompted by curiosity to swallow two to
three grains of a sugary paste containing hashish recently
brought from the Orient. Effects began in a quarter of an
hour and prevented him from continuing work. Movements
seemed to progress from without to the interior of the body.
There was a sensation of things entering through the fingers
and proceeding directly to the brain. These sensations were
not unpleasant and did not seem to derange intellectual faculties.
Space seemed greatly exaggerated, there were sensations
of walking on air and of great superiority to other
people. Ideas passed with great rapidity and seemed to be
very clear and exact. The effect lasted about four hours.
Ideas then began to come more slowly, distances diminished,
nervous movements disappeared and finally the only thing
noticeable was that the lips were not as moist as usual.
H. C. Wood, Jr., of Philadelphia, was chiefly interested in
determining if there was any activity in American grown
cannabis. He made an alcoholic extract from male plants
grown for fiber purposes in Lexington, Kentucky. An
estimated twenty to thirty grains of this extract were
ingested at 4:30 P.M. Apparently forgetting or disregarding
this fact, he went on a professional call and at 7:00 P.M.,
while attending a patient, the effects suddenly became evident.
By 7: 30 the feeling of hilarity had rapidly increased.
It was not a sensuous feeling, in the ordinary meaning
of the term . . . It did not come from without; it was
not connected with any passion or sense. It was simply a
feeling of inner joyousness; the heart seemed bouyant
beyond all trouble; the whole system felt as though all
sense of fatigue were forever banished; the mind gladly
ran riot, free constantly to leap from one idea to
another, apparently unbound from its ordinary laws. I
was disposed to laugh; to make comic gestures __ . There
was nothing like wild delirium, nor any hallucinations
that I can remember. . . I think it was about eight
o'clock, when I began to have a feeling of numbness in
my limbs, also a sense of general uneasiness and unrest,
and a fear lest I had taken an overdose. I now constantly
walked about the house, my skin to myself was warm,
in fact my whole surface felt flushed; my mouth and
throat were very dry; my legs put on a strange, foreign
feeling, as though they were not part of my body. I
counted my pulse and found it 120, quite full and
strong . . . My legs felt as though they were waxen pillars
underneath me . . . I began to have marked "spells,"
periods when all connection seemed to be severed
between the external world and myself . . . The duration
of these to me were very great, although they really
lasted but from a few seconds to a minute or two . _ .
The periods of unconsciousness became at once longer
and more frequent, and during their absence intellection
was more imperfect, although when thoroughly roused,
I thought I reasoned and judged clearly. The oppressive
feeling of impending death became more intense . . .
Under the influence of an emetic I vomited freely
without nausea and without much relief. . . When I
awoke early in the morning, my mind was at first clear,
but in a few minutes the paroxysms, similar to those of
the evening, came on again, and recurred at more or less
brief intervals until late in the afternoon. All of the day
there was marked anesthesia of the skin. At no time was
there any marked aphrodisiac feelings produced. There
was a marked increase of the urinary secretion. There
were no after-effects, such as nausea, headache or
constipation.
A Dr. Thomas, who was called, reported that zinc sulphate
produced free emesis in fifteen minutes and after that the
pulse rate fell from 136 to 104 and the warmth of the skin
was restored. The mental state was not affected by the
emetic.
Another, and evidently more potent, extract was
subsequently prepared from the same Kentucky hemp.
Three-quarters of a grain of this resin produced effects but of
a much milder sort than the original experience. There were
no marked periods of unconsciousness but only a feeling of
hilarity, a prolongation of time and a total inability to fix the
attention except for short periods. A friend took one grain of
this same resin and experienced approximately the same
effects. In addition, however, he became ravenously hungry,
ate excessively and experienced a marked degree of sexual
excitement which lasted several days.
Kuykendall had administered cannabis frequently in neuralgia and obtained only the exhilarating effects. However, in
an experimental trial on himself, terrifying sensations were
experienced. The intoxication reached its greatest intensity in
about one and a half hours and lasted about six hours.
Wiltshire had a patient who expressed reluctance at taking
any further doses of cannabis because the first produced
peculiar sensations. In order to reassure her of the innocence
of this drug, he took fifteen drops of the fluid extract and
was surprised to be affected by the typical hashish sensations.
I remember perfectly well all the phenomena that
were produced; even when I was engrossed with the idea
that death was at my door . . . Felt much intoxicated,
body growing larger; indescribable sounds came to my
ears; imagined that the blasts of old winter were lashing
at my windows and walls. Reason good; memory heightened
. . . A feeling of aphrodisia possessed me; fast upon
this comes a feeling of alarm and restlessness . . . My
heart now began to beat fearfully, thought it would
leave its walls. Moments seemed hours . . . Head now
felt as though it would burst. Consciousness of my corporeal
existence had somewhat left me, though I could
see, and feel with my hand my lower extremities, as in
perfect health, but expressed to my physician that I had
better not go to sleep, for fear I would not awake . . _ At
one time I could feel a sense of tremor passing over my
body . . . I began to improve and walked around the
room with a feeling of delightful calmness, and with
thoughts so pleasant that I remarked to my friends,
"this is true ecstasy."
The writings of Bayard Taylor prompted Duncan to try
cannabis on his patients. Since no effects were obtained, the
preparation was considered worthless and, to establish this
more certainly, he took three teaspoonsful of the tincture.
Four hours later, typical effects were manifested.
I was so giddy that I could not stand still, and the
damned in the infernal regions could have felt no more
agonizing terrors. My skin was burning up with heat,
pulse so fast that I could hardly count it, and a general
paralysis taking possession of my whole person, more
especially my stomach . . . The most intense headache
accompanying the other symptoms. I was in this condition
about three hours, having several times concluded
I was dying, with not altogether the most comfortable
feelings, being decidedly in doubt as to my final destiny,
disposed rather to view myself as lost. At the expiration
of three hours, the pulse became normal, the skin cool
and moist, and the paralysis gradually wore off. Then of
all the happy mortals that ever existed, I was the most
supremely so. I saw the most beatific visions, the most
beautiful women, angelic in their mental and physical
configurations. If all the gold of Solomon's Temple had
been offered me, I would not then have relinquished my
perfect happiness and mutual repose counterbalancing
the exciting experience of the previous three hours.
These mental hallucinations lasted, I suppose, four to
five hours. Then came the reactionary feeling, dull,
heavy headache for forty-eight hours; uncertain in gait,
and terrible mental confusion . . . Whilst I would not be
without the experience gained, relative to its action, I
would not for the same length of time undergo similar
doubts and feats, to say nothing of the unpleasant after
effects.
An English physician, who preferred to remain anonymous,
reported some self-experiments in which he took
doses of one-fourth to two grains of the extract without
effect. Likewise, a dose of one dram of the tincture produced
no effect. Some months later, a fresh specimen of tincture
was obtained and one dram of this was taken.
The effect this time was quick and alarming. In
fifteen minutes I was unable to walk, shook all over, and
felt my mind in a whirl with fast-flowing, grand, or
grotesque ideas of a more or less constantly unpleasant
nature, and all tinctured by an undercurrent of restlessness
and anxiety; occasionally, for a brief interval, I
would suddenly drop, so to speak, into my normal state,
and be able to think clearly about my condition, only to
soon relapse into the same condition of wild and more
or less painfully vague and intense perverted mental
action. This condition lasted two or three hours and
then gradually passed into a deep sleep, from which I
awoke the next morning feeling none the worse for my
somewhat rash experiment.
Von Mering made a number of experiments with an
extract of charas resin and described, in summary, the condition
which is ordinarily produced. According to him the
extremities are heavy and without sensation, there are muscle
tremors, ringing in the ears, difficulty in hearing, defective
perception, a feeling of heat or cold in the head, vertigo,
flashes before the eyes, dryness of the mouth and a feeling of
oppression and anxiety. After this a very pleasant phase of
the effects develops. The subject becomes hilarious, laughs
very loudly, phantasies move rapidly; sensory delusions are
manifested and visions come and go in quick succession.
Consciousness is retained. Illusions are present if the eyes are
closed; but disappear when they are opened. In this state
most individuals sleep for hours. Side actions of headache
and vertigo are infrequent. Bowel movements are not
affected; appetite is distinctly increased. The pulse is usually
accelerated in the beginning. The pupils are dilated during the
hashish effects. With some individuals there is a muscular
rigidity.
The observations which Marshall carried out on himself
were unique in one particular, i.e., he was the first to use the
vacuum distilled product termed "cannabinol." "With doses
of twenty mgm., the first symptom was usually loss of power
for mental work. A typical condition of mental exhaustion
set in. Sentences could not be conceived except by powerful
efforts, and these were not often forthcoming. . . After
intermediate doses (fifty mgm.) the ability to work was lost
altogether . . . Pleasurable tingling in the limbs, very slight
ataxia and other symptoms similar to those obtained after
larger doses were present. Time passed quickly. Sleepiness
was sometimes but not always present. As an early symptom,
a peculiar indistinctness of the periphery of the visual field
occurred, and later it was found that the point of regard was
made to travel with difficulty, as along the line of a page.
Depression usually continued throughout the following
day . _ . After a large dose of cannabinol my own pulse
increased in frequency. Constipation was rarely present.
Salivation was not usually observed, dryness of the mouth
being a more constant symptom . . . A most interesting condition,
after large doses, is the occurrence, alternateIy, of loss
of control and lucid intervals. The crude drug seemed to
produce more excitment than pure cannabinol." This latter is
attributed possibly to the associated terpenes in the crude
drug.
Binet-Sangle, along with a companion and in the presence
of an observer, swallowed 0.2 grams of a pill of extract of
hashish. The effects became manifest in about half an hour.
There was intense thirst, the saliva had a peculiar taste, the
head seemed full and there was a peculiar restlessness.
Voluntary movements were uncertain and almost ataxic. On
the other hand, tactile sensibility seemed to be more acute.
Objects, when viewed directly seemed enormously exaggerated,
but in the peripheral field of vision they were of
normal dimensions, i.e., there was a sort of "macropsie
centrale." The perception of space was also distorted. Sounds
were extraordinarily intensified and caused painful sensations.
Suggestive ideas became so vivid they amounted
almost to hallucinations. There were spells of laughter usually
preceded by ecstatic emotions. Fatigue and confused mental
processes persisted into the next day. The companion experienced
marked respiratory depression, congestion in the face,
transitory muscular incoordination, visual hallucinations and
intermittent spasms of laughter.
Robinson tried the fluid extract on himself and his friends
and recounted the effects with special emphasis on the
ludicrous aspects of the experiences. Manifestations particularly
noted were uncontrolIabIe laughter, the revival of
previous ideas, a lost sense of time, euphoria, erotic sensations,
occasional nausea, a double sense of consciousness,
alternating sensations of lightness and heaviness and, most
prominently, a feeling of immense geniality and mirth,
accompanied by sentiments of the most expansive good will.
One of the subjects awoke the next morning with a ravenous
appetite which was attributed as much to the great expenditure
of energy in laughing as to any direct effects of the
drug.
Burr has recorded the experiences which he and a fellow
interne had when under the influence of hashish. At 7: 30 P.M.
he took sixty minims of Parke-Davis' tincture of Cannabis
indica after having eaten an hour and a half previously. At
10:00 he noticed that he couldn't tell the difference between
an ace and a club and couldn't see to read because his eyes
were so widely dilated. His mouth became dry; he became
intensely thirsty and drank three quarts of water during the
evening. At lo:30 he suffered a general convulsion which
lasted three minutes. He felt well; his speech was not
affected. The convulsion resembled an attack of hysteria. He
had a pronounced feeling of well-being and was supremely
happy in a quiet, mentally unexcited way. He was not
boisterous or noisy and was able to describe his sensations
clearly. There was no increase in intellectual power. Sex ideas
were entirely absent and he said that Venus herself couldn't
have tempted him. After the first convulsion he became very
hungry and ate a whole cold chicken, a large loaf of bread
and some butter. He had six convulsions in four hours; they
were all like the first and ended abruptly. The convulsions
appeared willful in that he willed to convulse; he knew that
he was throwing his arms about, that he was writhing like a
snake, acting like a clown, making silly grimaces. But he
could not will to do otherwise. He could restrain a convulsion
for a few minutes, but soon the will to convulse overcame the
will to inhibit. At 11:00 P.M. ideas of time became prolonged.
One minute seemed like twenty. This distortion wasn't due
to a rapidity of ideas; it wasn't due to ennui. He had some
feeling of space enlargement and also had ideas of double
consciousness. He was himself, yet was somebody else, sitting
in a boat floating through the sky amid pink clouds. This was
his only hallucination; it occurred about six times, and lasted
about a minute each time. At ~:~OA.M. he became drowsy and
went to bed. He got up five hours later and went to work.
Throughout the day he felt comfortably tired. He was
dreamy, had a sense of unreality, and was unable to keep his
attention concentrated on any long conversation. During the
experiment there was no change in respiratory rate. His pulse
was 100. He passed large quantities of dilute urine. There was
no tactile anesthesia, no paresthesia and no loss of power in
the limbs.
Four days later his friend took the same dose of the same
drug from the same bottle. His symptoms were quite different.
Two hours after swallowing the drug he was suddenly
seized with a sense of death by suffocation. This hallucination
lasted for four minutes. Similar seizures came on every
twenty minutes for about three hours. There was no disturbance
of the pulse or the respiration. Even when he thought
he was suffocating, his breathing was quiet and regular. He
had no other symptoms and went to sleep three hours later.
Schneider took three cc. of the fluid extract of Cunn.
indica experienced mental effects in ten to twenty minutes
and intense apprehension in thirty minutes. After one hour,
quite suddenly there is developed an indescribable feeling
of exaltation and of grandeur. The words "fine,"
"superfine" and "grand" come to my mind as being
applicable to the feeling. This indescribable feeling is
purely subjective. Self-consciousness is completely annihilated
for the time being. The concepts time, place
and space have vanished. The confines of my room are
no longer existent. I say to myself, "If this drug can
produce such marvellous effects, I will certainly take it
often! "
The feeling of exaltation came in waves. The mouth and
lips were dry. An hour and a half after taking the drug:
I am capable of anything and everything. No task
would be too great, no problem too difficult. The
exalted feeling is wholly indescribable and appears to be
general and all-inclusive. [During the next three hours]
the feeling of supreme exaltation and grandeur continues
for varying degrees. The idea of oneness with all
nature and with the entire universe seems to take hold.
There is no material body or personality . . . The skin is
now moist but the mouth continues dry. I have momentary
visions or glimpses of vast beautiful landscapes,
showing wonderful color effects . . . I do not visualize
persons nor do persons play any part in the mental
imagery . . . There is a marvellous color imagery, blue,
purples and old gold predominating with most delicate
shading effects . . . Beautiful gardens filled with flowers
appear. Again, grotesque monsters of ever-varying forms
and without producing any terrifying effects . . . I regret
that others cannot share with me this feeling of wellbeing
. . _ Evidently sleep gradually set in and continued
undisturbed until the usual rising time. No special
sensation on rising. Feeling, if anything, more than
usually refreshed. All of the sensations recorded above
have completely vanished. The recollections of the
experiences are however very clear and vivid. Mouth
continued dry until morning. No after effects of any
kind. The action of the kidneys is increased but no
effects as to the intestinal tract.
Six days later, a second dose was taken which did not
produce any distinct mental exaltation or feeling of grandeur.
Color and form imagery were poorly developed as compared
to the first test. Months later, a third dose which was
identical with the first, did not produce any feeling of
exaltation and grandeur. The color imagery, though, was
specially marked. The next day there was a slight feeling of
nausea.
One month later, eight cc. of the original fluid extract
were taken. The idea of a dual nature and the color imagery
were not as marked as before and there were none of the
feelings of exaltation and grandeur.
Probably for a period of not less than six hours I
suffer from nightmare. I am convinced that the end has
arrived and that I cannot recover.
Dizziness and nausea develop and some nausea persists into
the next day.
Among others who have similarly experienced and described
the hashish episode may be mentioned Ragsky,
Judie, Hamburg, Bell, Owen, Campbell, von Schroff, Polli,
Richet, Beane, Renz, Williams, and Lange.
The therapeutic exploitation of Indian hemp in Europe Object
and America, which dates from about 1840, correspondingly gayhyi,9
resulted in a great many instances of individuals suffering a
hashish experience which was wholly unexpected and often
undesired. There are several general factors responsible for
the high degree of variability in cannabis effects-and these
are further augmented when the drug is given to invalids. The
patient's condition itself is subject to more than ordinary
variations. We have repeatedly seen that animals in poor
condition are more severely affected by this type of drug
than healthy animals and this parallel is hardly needed in
order to emphasize the fact that debilitated patients are
much more likely to respond unfavorably than normal
individuals. The collection of descriptions which follows is
characterized by a high proportion of cases in which there
was marked motor and sensory depression. The effects on
consciousness were predominantly the agonizing sort rather
than the euphoric. The case of a patient receiving an
unexpected overdose represents one of the least favorable
conditions of mental preparation, and it is generally recognized
that the state of mental preparation for a hashish
episode is an important determining factor in the character of
the resulting cerebral effects.
The dosages taken by these individuals usually are given in
specific terms but these have only a casual bearing on the
actual dosage of active material. Bioassays of any degree of
reliability were not introduced before 1900 and satisfactory
chemical assays have not yet been introduced. Accordingly,
the dosages which were administered have only an approximate
significance in terms of any standardized activity.
One of the first to describe a case of this sort was Brown.
He was called to see a druggist's clerk who had taken six
grains of the solid extract in installments. About three and
one-half hours after the first dose he became nervous and
dizzy, felt an irresistible inclination to run, a great desire to
urinate, great thirst. Spasms supervened, during which, at
times the flexors and extensors, at times the abductors and
adductors of the whole body were thrown into violent
alternate action. The spasms increased in severity and frequency
for half an hour and then gradually diminished after
emesis had been induced. The spasms were unaccompanied
by pain but did produce a sense of weariness. At no time was
there delirium or loss of consciousness. The symptoms lasted
in severity about an hour, then gradually diminished.
Twenty-four hours later the desire for constant motion and
occasional slight spasm persisted but soon passed away.
Kelly administered thirty mg. of the extract to a woman of
sixty who had severe rheumatic pains. She experienced a
marked reaction, her fingers became icy cold and benumbed.
She heard noises and had visions of objects before her eyes.
The phenomena passed away in a few hours. The dose was
later repeated with the same result.
Strange was called to see a phthisical patient who had
accidentally been given an overdose of the extract. Three
hours after taking the extract, the patient had suffered such a
marked reaction that he was thought to be dying.
There was complete superficial anesthesia, the patient
declaring that he could touch nothing. He felt as if dead;
could scarcely recognize anything. He had intense dread
of death; a frightened countenance; the pupils were
dilated, but contracted slightly to light. Vomiting,
which was not present, was induced by mustard and
water, and the green extract came up with the mucus of
the stomach. During the whole time, I was cheered by
the fact that the pulse did not fail, nor was there any
clammy perspiration.
The patient fell asleep after two hours and next morning ate
a ravenous breakfast.
Mary Hungerford had been taking small doses of Indian
hemp without any appreciable effects. A very large dose was
then taken which produced near unconsciousness in a short
time. There was a much exaggerated appreciation of sight,
motion and sound.
It was not only death I feared with a wild, unreasoning
terror, but there was a fearful expectation of
judgment, which must, I think, be like the torture of
Iost souls . . . In place of my lost senses I had a
marvelously keen sixth sense or power, which I can only
describe as an intense superhuman consciousness that in
some way embraced all the fine and went immeasurably
beyond . . . As time went on, and my dropping through
space continued, I became filled with the most profound
loneliness.
These effects persisted for a considerable length of time.
Sticker administered Cannabinon in about thirty cases
with no particular after effects except in the instance of a
young man who took 0.1 gram of the drug. Effects began in
one-half hour. There was intense anxiety and depression with
a tonic-clonic twitching of muscles of the extremities.
Shortly after that there was complete paralysis of the
motility of the extremities. During the next few hours there
were several long periods of psychic exaltation. He went to
work the next morning but there were minor residual effects
for some time. Using this same preparation, "Cannabinon,"
Richter, Buchwald, and Pusinelli have similarly observed
cases in which the ordinary doses of 0.1 to 0.3 grams caused
alarming symptoms.
Seifert reported the case of a patient who took 0.1 grams
"Balsamum Cann. Indica" and became violently delirious
with residual effects which lasted several days.
Hamaker was called in to see a young physician who had
taken forty-one drops of Squibb's fluid extract of Cam.
indica with the idea of testing the quality of the medicine. He
was walking on the floor excitedly, laughing and talking
continuously, but not incoherently. At times he would cry,
and then suddenly change to laughing. He was abnormally
irritable and said he felt as if he were "rattling around among
the centuries." There were redness of the eyes and profuse
lachrymation, with a fast pulse. He subsequently became
drowsy and afterwards reported that during the beginning of
the experience he had a feeling of dread of danger which had
passed off quickly.
Prentiss reported the case of a dentist suffering from an
irritable cough who took five drops of a Parke Davis "liquid
preparation" in installments. The effects became manifest in
two hours. He became oblivious to all surroundings, excessively
happy and, after potassium bromide was administered,
eventually fell asleep. The next morning he reported that all
the sensations were agreeable and in no way accompanied by
unpleasant emotions. The effect came on in waves until he
lost himself.
He was moving through space with lightning speed,
and in his path were clouds of the most beautiful,
ever-changing colors, and when he touched them each
one played a beautiful tune.
Windscheid observed a twenty-eight-year-old healthy male
who took about three grams of extract of Cann. indica within
a period of two and one-quarter hours. After two and
one-half hours, he was suddenly seized with a feeling of
apprehension, intense excitement with exalted ideas and
hallucinations. An hour and a half later he became apathetic
and extremely thirsty. Windscheid found him with dilated
pupils, hyperesthesia and tremors, particularly in the extremities.
The pulse of 172 was weak but regular. On the following
day, only mild hallucinations were experienced, the pulse was
120, he was hyperesthetic and had heightened skin and
patellar reflexes and reactive pupils. After an apathetic period
of eight days he was about normal. This was considered a
case of special resistance to an enormous dose.
Winter reported a case of poisoning in a fifty-seven-yearold
woman who was healthy but of weak constitution. The
patient had taken increasing doses (20 to 300 mg.) of the
extract to combat the pain of trigeminal neuralgia. Then for
several weeks she had taken three doses each day of 0.3
grams each, without any disturbing effects. On stopping the
medication for two days and starting again on the third with
one dose of 0.3 grams, marked depression set in after a few
hours. The patient became weak and somnolent, did not
respond to questioning, reflexes were absent and pupils were
dilated. After an hour, the patient recovered to some extent
but later relapsed to an excitable, delirious state followed by
despondency and weeping. After two hours of such condition
she fell into a deep sleep and awoke the next morning with
only a little dullness and very slight recollection of the
experience.
Geiser reported that seven minims of a fluid preparation of
cannabis produced severe effects in an elderly woman suffering
from malarial cachexia. There were none of the usual
hallucinations but there was a marked exhibition of deafness,
labored breathing, weak pulse and alternating loss of consciousness.
The drug had been given to relieve migraine.
Fischlowitz was called to attend a physician who had
taken one teaspoonful of the fluid extract of Cannabis indica
in order to relieve a troublesome cystitis. He had fallen asleep
but awoke with unpleasant dreams one-half hour after taking
the drug. He thought he had slept for hours, and had a feeling
of tingling all over his body, especially around the angles of
his jaws and in the region of his stomach. He soon developed
a happy frame of mind and became quite garrulous. He
complained of the tingling and uneasiness in his limbs, said
his legs were as heavy as lead and that when walking he felt as
if wading through feathers. His throat felt parched, the
conjunctivae were reddened, the pulse ranged from 100 to
118 and the respiration was very rapid. Four hours after
taking the drug he fell asleep and awoke the next day with no
residue other than a frontal headache.
Minter reports an instance of a prescription containing
Indian hemp which was taken regularly for about a month
with no symptoms other than drowsiness after the first three
doses. On taking the last dose, however, the patient had
severe effects which began in a few minutes. The impressions
and hallucinations were of an unpleasant sort. After a restless
night, the patient awoke with a very vivid recollection of his
experience.
Sawtelle administered twenty-five drops of fluid extract of
Cannabis indica in installments to a well-developed, middleaged
man suffering from a severe occipital neuralgia. On
visiting him that night, he found the neuralgia was relieved
but that the patient was in a state of increased mental and
motor activity, which was soon followed by partial delirium
and hallucinations. The pupils were dilated. The hallucinations
were of a jovial character. The patient talked freely and
pleasantly, and when relating some incident he would burst
into laughter. He first thought the ceiling was falling and
placed himself in position for protection by extending his
arms and calling loudly for help. He then moved his bed to
the opposite side of the ward and imagined he saw pieces of
timber floating in space about him. He left his bed and went
to a corner of the ward where he became intensely excited
over what he took to be a fight between a large and a small
dog. After watching the imaginary fight for a few moments,
he returned to the bed and remarked that the large dog had
torn the small one into pieces and expressed sympathy for
the small dog. At first he attempted to leave the room
through a window and it was necessary to restrain him.
Symptoms continued for three days. From the first the pulse
was full and strong, respiration normal; during the night he
was troubled with erection of the penis. There was slight
anesthesia of the lower extremities and the patient complained
of weakness of the legs for several days after the
other effects of the drug had passed off.
Atlee prescribed ten minim doses of tincture of Cann.
indica for a twelve-year-old boy, suffering from headache. He
took one dose of the prescription and, in a few minutes, said
he felt a burning pain in the pit of his stomach and soon
became strange in his manner saying that his legs were
humping about, that he heard a ticking like a watch, that he
saw the room on fire, saw pictures falling down, etc.
Examination showed a weak pulse with a rate of 120 and
dilated pupils which reacted sluggishly to light. He was given
two drams of brandy and ten grains of citric acid in syrup of
lemon. A blister was applied to the nape of the neck. He soon
began to revive, his color improved and, in about two hours
and a half had recovered, his headache was gone and he was
able to walk home. The same dose of tincture was given to
another child the same morning with no ill effects.
Baxter-Tyrie was called in to see a young lady who had
first taken three half-grain pills of Indian hemp for the relief
of headache. When these had caused no apparent effect she
had concluded that the preparation was a "fraud" and, to
demonstrate her conviction, had proceeded to swallow nine
more of the same pills. When observed four hours later, she
was in a state in which fits of laughter and incoherent ravings
alternated with comparatively lucid intervals. She complained
of various hallucinations and delusions, chief of which were a
complete perversion of the relations of time and a loss of
identity. She was now herself, now again a different individual,
and the modifications of her behaviour in relation to
her dual personality were grotesque. Coffee and strychnine
were administered and she was entirely normal the following
day.
Bicknell reports a case in which three grains of an English
extract produced effects which were most distinguished by
convulsive movements and opisthotonos. The opisthotonos
was later relieved only by violent friction over the affected
parts. At no time was there fear or foreboding of a fatal
result.
Benedict reports having seen about twenty cases of intoxication
attributable to variations in susceptibility, voluntary
increase or repetition of dose by patients.
The sole symptom of intoxication has been anxiety
and subjective feeling of danger from the drug.
Downer was called in to see a young girl who had
introduced tobacco dust into her nose after the manner of
taking snuff. (The tobacco was subsequently shown to
contain Cannabis in&a.) The girl became frankly intoxicated,
talked incoherently and giggled in a fatuous manner.
She could not move her lower limbs, the feet and lower legs
being completely anesthetic and there was a general paresthesia.
She was oblivious to her surroundings unless well shaken,
when she took some notice and would answer questions.
After the administration of an emetic and coffee she slowly
improved.
Baker-Bates has recently reported an instance from
England in which a young man grew hemp in his garden and
several times smoked the dried leaves and tops. He experienced
mild symptoms which included loss of sense of time
and space, vivid dreams or hallucinations and subsequent
drowsiness.
Incredulous about his experiences, his fiancee, aged
twenty-two, smoked-and to some extent inhaledabout
two-thirds of a cigarette, made from the top of a
fruiting plant. This was at about 1O:lO P.M.. Soon
afterwards she fell asleep and a few minutes later, on
being disturbed, she awoke with a start and exhibited
apprehension. The eyes were bright, the hands were
twitching, and she appeared intoxicated; she asked
where she was-probably deceived by hallucinationsbut
seemed happy. At about lo:25 P.M. she was taken
for a short walk, which was interrupted by outbursts of
laughter and of affection; her speech became slurred
from dryness of the mouth and her gait increasingly
unsteady. At lo:30 P.M. she was taken to a doctor and
the history explained; he recorded that she was pale, but
able to stand and walk although feeling dizzy; she was
very excited and talkative and made stiff purposeless
movements with her hands; her state was highly emotional,
even amorous, towards her companion; at one
moment gay, she was next anxious and said she felt
"enclosed"; she exaggerated the passage of time and was
confused about spatial dimensions; her tongue and
mouth felt parched and words were pronounced with
difficulty, while sentences lapsed into incoherencies; the
eyelids were half closed; the pupils dilated, but reacted
to light; the pulse was rapid, but strong. She was
transferred by police ambulance to the casualty depart
ment of the Liverpool Stanley Hospital where she
arrived at 11 P.M. in a collapsed condition. Her symptoms
at that time were loss of power in the legs and
inability to stand; dizziness, dryness of the mouth, and
palpitation; and lengthened estimation of the passage of
time. She believed her condition had lasted many hours
and, although fully conscious of her existence, she
imagined she was "outside her own body," enclosed in a
small space, and surrounded by a mist from which she
could not escape. This imaginary mist did not impair her
vision for distant objects. On further examination
speech was found to be confused, rambling, and often
inarticulate. She was unable to stand steadily or without
support, and showed great incoordination in the movements
of the hands. There was tachycardia (140 per
minute) and also marked inspiratory dyspnoea. No
other abnormality was found. Following general treatment
for shock the patient recovered in nine hours and
there were no sequelae except severe headache.
Approximately forty more case reports of this type are
listed in the indexes of the Surgeon General's Office and of
Schmidt's Jahrbticher. Most of these appeared at fairly
regular intervals during the period 1840 to 1900 and, in this
respect, closely paralleled the therapeutic popularity of the
drug.
Within the last decade the hashish episode has been sub- Psyc@ric
jetted to extensive analyses in several of the most prominent ~~~~~~ Of
psychiatric clinics. This series of studies has included a sort of experience.
merging of the ancient "hashish" and the current "marihuana."
While both are essentially the same, there are differences
of degree which at times seem to make almost qualitative
differences in the resulting picture. "Marihuana"
consists of the dried tops and leaves of American Cannabis,
which ordinarily is not so rich in active resin as the same
plant grown in Asia and Africa. "Anascha" is the term applied
to the drug in Asia Minor and, more recently, in Russia
and, apparently, is quantitatively of about the same degree of
activity as marihuana. The manner of use in both cases is
almost exclusively by smoking in the form of cigarettes. The
ancient "hashish" on the other hand was usually swallowed
or, when smoked, was not smoked in cigarettes. Recently
"hashish" smoking in the cigarette form has become prevalent
in Greece, and in this case the term seems to include
both the plant and the resinous exudate.
Of the modern psychiatric studies, the earliest were from
clinical groups in Utrecht, Munich and Heidelberg, each of
which used an orally ingested form of the drug. The later
studies in Russia, Greece and the United States were directly
concerned with the more current preparations which are
smoked in cigarettes. An additional distinction of these later
studies is that the chronic effects were investigated in considerable
detail.
Fraenkel and Joel made numerous experiments with normal
individuals, their dosages being one hundred mg. of the
extract of Cann. indica (Parke Davis). Their observations and
conclusions may be summarized as follows:
One of the first indications that the drug has begun to act
is an oppressive foreboding and feeling of apprehension;
something strange and inescapable seems to approach. Activities
cease, the feeling of impotence and anxiety becomes
overpowering.
When the intoxicated subject surrenders to this new
authority, he soon comes to feel even more imprisoned and
oppressed by conceptions, ideas, words, actions, emotions
and outbursts which no longer seem to belong to him. Images
and series of images, long-buried recollections appear, whole
scenes and situations project into the present. They excite
first interest, sometimes pleasure, finally, since they cannot
be controlled or stopped, torture and exhaustion. The subject
is astounded and overwhelmed by all that takes place and by
what he says and thinks. His laughter, all his expressions
happen to him like happenings from the outside world. He
passes through experiences which seem to amount to supernatural
revelations. All these oppressive forces cannot be
dispelled by simply saying "This is not reality it is only the
effects of a drug." The character of the delusions, for
example, cannot be evolved at will; one recognizes that they
are hashish phenomena, yet they remain unaltered. These
delusions are mostly illusionary transformations of the outer
world, which at first had become very strange and singular.
The room widens itself, the floor slopes precipitously, atmospheric
sensations develop; vapors and fogginess cloud the air;
colors become brighter and more luminous; objects become
more attractive or, again, they may become grotesque and
menacing. Tormenting doubts of the reality of things assert
themselves. It is remarkable what variations take place in all
animate things; they assume expressions of mask-like fixity
and lifelessness. Physiognomies turn to gypsum, wax, and
ivory. True hallucinations are rarely experienced. In the
haptic sphere there often develops a disintegration of the
feeling of the body's coherence. There are also dynamic sensations
such as that of being hurled through space as by a
powerful centrifugal force. All this is accomplished not as a
continuous development but rather as a continuous change
between the dreaming and waking state, a lasting, finally exhausting
alternation between completely different regions of
consciousness; this sinking or this emerging can take place in
the middle of a sentence. For the comprehension of the
intoxification-episode, this precipitous change is of great significance.
The dream-like phases have an influence on the
often grotesque over-evaluation of periods of time, which
likewise is a characteristic hashish phenomenon. The mood
and affectivity vary according to the consciousness of compulsion,
the restriction of activity and the frequently resulting
feeling of defencelessness and dependence. Or there may
develop a simple feeling of well-being, which can increase to a
state of blissful euphoria and ecstatic rapture. An agonising
combination of incompatibles, which often exists in the way
of thoughts and opinions, can also dominate the affectivity
and introduce moods of affective perplexity and disintegration.
The intoxicated subject usually reports in a form which
varies considerably from the normal. The associations become
difficult because of the frequent sharp separation of
each recollection from that which preceded. Conceptions
cannot be expressed well in words, the situation can become
so dominated by an irrepressible mirth that the hashish-eater
for minutes at a time is capable of nothing but laughter. Even
his other types of expression, facial appearance, gestures, and
his whole motor behavior are changed. Contracture states
alternate with periods of increased motility, bizarre movements
and sudden outbursts. The recollection of the intoxication
is particularly clear. Among the bodily symptoms may
be mentioned, dry throat, coughing, occasionally increased
blood pressure. Fatigue in the usual sense does not develop.
Frequently there is a marked feeling of hunger, and considerable
quantities of food are consumed with a pleasure not
ordinarily experienced, in spite of the tongue being coated
and dry. Objective sensibility is not disturbed. That hashish
does not cause any local anesthesia is considered to have been
previously emphasized. Aphrodisiac effects are lacking.
At the suggestion of Professor Straub, Kant and Krapf in
the Psychiatric Clinic at Munich made a series of selfobservations
with hashish. Doses corresponding to three to
nine grams of "Herba Cannabis Indica" were used in the
experiments. This medication was prepared by Gayer who
extracted the crude drug and then absorbed the potent
extract on chocolate powder. The activity of this preparation
was previously defined in terms of the amount producing
cornea1 anesthesia in a rabbit. The lowest orally administered
dose of the crude drug producing this effect in rabbits
corresponded to three grams per kilo. This dose of three
grams was also found to be the smallest dose producing
recognizable effects in human subjects. Some chocolate
tablets containing no drug were used in these human experiments
as a control against auto-suggestion. In general, neurologic
disturbances were not observed nor was there any
depression of surface sensibilities as might have been expected
from preceding descriptions. Further, aphrodisiac
effects were not experienced. With large doses there was
fatigue, thirst, vomiting, vertigo and collapse phenomena
with a soft and arrhythmic pulse. Taking hashish stimulated
the appetite but never produced intense hunger.
In one person, recognizable effects usually began in thirty
to forty-five minutes, while a distinct clouding of the consciousness
did not begin until fifty to seventy-five minutes.
With the other subject, initial effects were recognized in
eighty-five to one hundred five minutes and the first change
in the state of consciousness in ninety to one hundred
eighty-five minutes. Effects appeared more quickly with the
larger doses. Disturbances of consciousness were manifested
by a feeling of "the superficiality of things," "a stupid
feeling," "a slowing of thoughts." The subject declared
"things go away from me, they are taken from me," "I must
speak rapidly else I will forget what I mean to say," "a veil of
smoke is drawn over the brain," "I can't remove myself from
this condition without forcing my will," "I forget everything
except the last sentence." There was a subjective feeling of
obliviousness. With some exceptions the mood was one of
pronounced euphoria. The subjects felt very well disposed to
things in general and had an expanded sense of selfappreciation.
Between spells of laughter, the subjects sometimes
became sensitive and seemed to dread the recurrence of
the laughing spell. With large doses the feeling of intoxication
expressed itself in an agonizing fear of death.
The inclination to motor activity was much increased. "It
felt as if all joints of the body were freshly lubricated." The
subjects mimicked common movements such as riding or
dancing. The capacities of critical perception were dulled.
There was a marked over-estimation of the passage of time.
Impressions of light and sound seemed extraordinarily exaggerated.
The light from a table lamp blinded the eyes and
ordinary noises, such as the ticking of a clock, resounded
loudly. An inconclusive but suggestive experiment indicated
that the actual threshhold of sound stimuli was lowered;
steps in an adjoining room, which were imperceptible to
other people, were heard and counted correctly.
Illusionary misconceptions developed. "I see now that you
have become much more square. Now you have a very
sharp-pointed chin." The flow of imagination at the height of
the experiment was slowed. "I have the feeling that ideas can
come very rapidly, however, they do not come at all."
There were crawling sensations in the legs, which seemed
to become alternately light and heavy. Sensations of heat
coursed in waves from the feet to the head or seemed to
locate in specific organs. These sensations along with a slight
feeling of numbness were the first subjective symptoms of
drug action. These elementary phenomena, which are purely
body sensations, produce a much more complex effect when
they become multiplied. These body sensations constitute
the primary basis of the experience.
Taste sensations were experienced by only one of the
subjects and then only with the larger nine-gram dose. Sweet,
salty and metallic tastes were experienced. Visual phenomena
were also experienced. In some cases the subject became
suspicious, irritable and easily provoked to a dangerous
degree of aggressiveness. One of the subjects attacked his
colleague with a knife and had to be locked up for a time.
Straub, in describing the typical hashish effects, used one
of the experiments by this group as an example. In this case,
the experimenter had taken a dose corresponding to six
grams of the crude drug. The first effects were felt in
forty-five minutes. The eyes became moist, the lids heavy and
there was an uncomfortable sort of fatigue. He broke out in
spells of uncontrollable laughter. The extremities seemed to
have no weight and to be of exaggerated length. Corresponding
to the increasing euphoria, the personality seemed to
divide into individuals, one critically rational and the other of
a fantastic spiritual character. The senses seemed more acute.
Scientific problems seemed to be solved instantly in front of
his eyes. Visions in bright, harmonious colors moved before
him. This rapturous state seemed to last for many hours. In
spite of this condition, there also existed, at times, an almost
normal degree of rational consciousness. After four hours
there was marked hunger and food was taken. During the
remainder of the day there was some mental confusion. The
following day there was not the slightest after-effect.
Kant subsequently extended his observations with these
preparations to nine manic-depressives and ten schizophrenic
women, The drug produced tachycardia, dryness of the
mouth, heaviness of the limbs, a feeling of warmth and
paresthesias. The effects only varied in degree from those he
had observed in himself.
Meggendorfer about the same time also contributed a
discussion of cannabis psychoses.
The series of studies from the Utrecht and Munich clinics
were followed shortly afterward by a similar series from the
Heidelberg clinic. The dosages in this latter series were
considered much higher and, correspondingly, the degree of
narcosis and psychopathological phenomena were more intense.
"Cannabinol," prepared by a commercial firm, was
used in oral doses of one hundred mg. in about thirty
"selbstversuchen." This dose, according to Marx, contained
forty of the "cornea1 units" defined by Gayer. According to
this comparison, the dose of one hundred mg. of "Cannabinol"
represented forty times as much activity as that which
gives a human subject clearly recognizable effects, and this
would clearly be a tremendous dose. The possibility of such
an extraordinarily large dose actually acting on the nervous
system, is opposed by various other considerations. For
instance, the highly purified preparation may possibly under
go more destruction in the alimentary canal than an equally
active crude preparation; there is no very convincing evidence
that the "Cannabinol" made by commercial houses at this
date was to be considered so much more potent than the
"Cannabinol" of Wood, Spivey and Easterfield. Marshall
working with this latter preparation, found that twenty mg.
was the minimal oral dose producing recognizable effects in
man. Accordingly, the doses of the Heidelberg group may be
considered as large doses but possibly not so large as the
comparative figures would imply. Relatively severe effects
were obtained, such as pronounced states of apprehension,
somnolence and collapse. Metabolic studies made at the same
time indicated "fundamental functional disturbances" which
were considered to be a new observation in this type of
study.
Disturbances of thought caused by the drug were classified
by Beringer according to three general types: (1) a disturbance
within the higher complex processes which are responsible
for integrated conception as a whole; (2) a disturbance
of the ability to retain memories; (3) a disturbance of the
flow of thought, or disconnection of thought ("Gedankenabreissen").
The hashish phenomena were compared with
various psychotic states and with mescalin intoxication.
V. Bayer proposed and explained a schematic division of
the motor phenomena. Three main types were recognizable
in these experiments : (1) movements similar to normal
expressive movements, representing elation, ecstasy or apprehension,
frequently with excessive exaggeration; (2) movements
which originate in a primary change of the motor
apparatus, that is, an impulse excess or an inhibition of the
motor apparatus-and they are only later filled with meaning
and expression; (3) movements which were actuated at more
peripheral points and were not associated with the higher
center of consciousness. Typical of this group, are myoclonic
movements which take place in special sets of muscles,
choreiform restlessness, and also, the pseudo-cataleptic effects
in the limbs. This latter uncomfortable condition was
produced in three of the thirty hashish experiments.
Marx made numerous observations of body changes. One
group of symptoms, suggesting a febrile syndrome, included a
rise in body temperature and pulse frequency. Circulation
velocity and venous pressures were frequently increased
Dryness of the mouth and throat simulated an-opine effects.
The eyes were characteristically glazed as in febrile patients
and there was a marked injection of the conjunctival vessels.
This latter is referred to as a recognized symptom in the
Orient. The hands and feet were cold and moist. Blood
concentration took place, hemoglobin values sometimes rising
as high as 50 percent. The fact that this often accompanied
a marked diuresis was considered very unusual.
Hydrogen-ion concentration and carbon dioxide combining
power of the plasma did not show any remarkable variations.
Significant hypoglycemic changes were described.
Stringaris, also of the Heidelberg clinic, had occasion to
study a large number of persons in Greece who were addicted
to the smoking of hashish. Skliar and Iwanow, at the
Psychiatric Clinic in Astrachan, Russia, have similarly studied
cases of "Anascha" smoking in Russia.
Stringaris reported that the acute intoxication is characterized
by euphoria, increased motor activity, excitability,
talkativeness, laughter and appetite. Hallucinatory and delusional
experiences were frequent. Occasionally, especially in
persons who suffer from chronic addiction, depression instead
of euphoria occurred. A considerable number of the
addicts declared that the drug is a sexual stimulant. Libido is
increased both during the action of the drug and during the
intervals between doses.
Skliar and Iwanow carefully studied the intoxication phenomena
after administering the drug to fifty-two cases, most
of whom were chronic "Anaschisten." The number of individuals
showing the individual typical symptoms has been
recorded. For instance, fifteen noticed a lightness in the head
at the beginning; six noticed tinnitus and nausea; four,
clouding of vision; four, thirst; two, heaviness in the legs and
arms; five, palpitation; seventeen, increased appetite; thirtyfour,
a calm and pleasant euphoria; thirty-two, laughed;
seven, a depressed, anxious condition; six, moderate motor
phenomena; twenty-two, inclination to reveries; four, disturbance
of personality-consciousness, etc. True hallucinations
of the special senses, such as vision, hearing taste and smell
were not common. There was macropsy in twelve cases,
micropsy in two cases. Functions of the sense organs in
several cases were intensified and in other cases diminished.
In eight cases, there was excitement which passed over into
sleep. This is more usual with the neophytes than with
chronic users. Other distinctions between the neophyte and
the experienced user were noted. The neophyte usually is
ecstatically euphoric, laughs loudly and has an increased
appetite and thirst. A subject, who has taken it for, say two
years, is much more repressed in his laughter and general
boisterousness.
Objective symptoms were glazed eyes, red eyelids, hyperemit
conjunctivae, tremors of the tongue and extended
fingers, increased patellar reflexes, marked palpitation, and
accelerated pulse. These observations were considered to
resemble in general the classic descriptions of Baudelaire,
Gautier, Moreau de Tours, Joel and Fraenkel, Schroff and
Freusberg, but certain differences were pointed out. The
hashish effects are considered more pronounced than those
with anascha. With hashish the laughter is more violent and
unrestrained. Consciousness is much more affected with
hashish and the fantastic illusions and pseudo-hallucinations
are more frequent and vivid. Also with hashish there are true
hallucinations of sight and hearing, which are lacking altogether
with anascha. The disturbance of time sense is considerably
greater with hashish. Particularly distinctive with
hashish is the disintegration of personality and the resolving
of the individual into the environment and all nature at large,
which phenomena are infrequent or very slight with anascha.
These distinctions are considered only quantitative rather
than qualitative. Anascha is obviously a mild form of hashish
(and smoking is a means of ingestion permitting smaller
systemic dosage). Also, the mentality and character of these
subjects varied considerably from that of the writers and
scientists who were the subjects for the classic descriptions.
Further, the age range of these subjects was low, seven to
twenty-five years ! When larger doses of anascha were given
the effects resembled in intensity the hashish effects.
Dontas and Zis also made careful observations of the
immediate effects of hashish smoking. The hashish they used
evidently corresponded to the resinous exudate rather than
the crude plant. Their studies were primarily concerned with
the physiologic changes and included good comparisons of
the effects on normal individuals and on those habituated to
the use of the drug. Medical students in the University of
Athens were used as normal subjects. After several minutes
they experienced a dryness of the mouth and pharynx and
were seized with a violent cough which at times became
spasmodic. The face became red and there was a feeling of
warmth. Very often there was a bitter taste and the saliva
became thick. The respiratory movements became irregular,
the pulse was accelerated and increased ten to fifty pulsations
per minute. Blood pressure was usually diminished. Often
there was vertigo, nausea, and vomiting. The subjects always
felt a general weakness and numbness in the extremities.
Sometimes there was a general or partial muscular trembling
with a rapid rhythm which was periodically accelerated; at
other times the trembling was myoclonic. Almost always
there was a marked increase of the tendinous reflexes.
Throughout the experience, the intelligence remained clear.
If the person continued to smoke, psychic phenomena
appeared. Frequently there were cataleptic phenomena. In
the beginning, the smokers experienced a muscular relaxation
and a pleasant torpor. They avoided all movement, fixed
their eyes, had the air of thinking profoundly and experienced
hallucinations which for the most part were agreeable
and which rendered them happy and gay. Later if the subject
continued to smoke, the psychic phenomena were accentuated,
the hallucinations and paresthesias took on a general
character. One of the students thought that he was flying in
space, another thought his feet had become very large while
at the same time his pipe had become microscopic. Another
thought that the wall of a nearby house was a lake surrounded
with trees. Suddenly thinking he was being mocked
he attacked the assistants. Such symptoms were always very
transitory. Several minutes after the subject had ceased to
smoke, the psychic phenomena disappeared, the other
symptoms disappeared later and in the course of several
hours they were no longer recognizable.
When smoking a stronger preparation from Serbia, one student,
among other usual symptoms, was seized with a general
muscular trembling followed by a tonic contraction of the
extensor muscles of the fingers of both hands. His fingers
remained in extension for five minutes.
Another series of experiments was made on subjects who
had smoked hashish for one to four years. All of them
showed an augmentation of reflexes, pallor, fixity of expres
sion, nervousness and variability of moods. Deprived of
hashish they became nervous and despondent and their
attitude belligerent. After smoking, they became gay and
talkative. These individuals smoked hashish almost every day,
sometimes by cigarettes but most frequently by narghile. *
When studying such cases in the laboratory and comparing
them with subjects unaccustomed to hashish, it was noted
that the nervous phenomena were less marked although there
was a distinct augmentation of reflexes.
Dreury recently described an instance of marihuana
psychosis with sexual stimulation and marked schizophrenic
coloring.
Marihuana smoking as a social problem and as a subject for
psychiatric analysis has been similarly studied by Bromberg, a
psychiatrist at Bellevue Hospital. According to him, the chief
effect of smoking is an intoxication of transitory nature and
relatively uniform symptomatology. A period of anxiety is
developed in ten to thirty minutes and is associated with
restlessness and hyperactivity. A few minutes of this and the
subject begins to feel more calm, develops a definite euphoria,
becomes talkative, exhilarated and filled with a vivid
sense of happiness.
Walking becomes effortless. The paresthesias and
changes in bodily sensations help to give an astounding
feeling of lightness to the limbs and body. Elation
continues: he laughs uncontrollably and explosively for
brief periods of time without at times the slightest
provocation: if there is a reason it quickly fades, the
point of the joke is lost immediately. Speech is rapid,
flighty, the subject has the impression that his conversation
is witty, brilliant; ideas flow quickly. Conclusions
to questions seem to appear ready-formed and surprising
in their clarity. The feeling of clarity is, of course,
spurious: it is merely a subjective feeling. When the user
wishes to explain what he has thought, there is only
confusion. The rapid flow of ideas gives the impression
of brilliance of thought and observation. The flighty
ideas are not deep enough to form an engram that can
be recollected-hence the confusion on trying to remem-
ber what was thought. The smoker is seized with the
desire to impart his experiences to others; he wishes in
some way to transmit the glory and the thrill. Activities
speed up tremendously and time is slow in passing:
there is a feeling of changed reality. Sex excitement
consists in the fact that the sexual objects in his
environment become extraordinarily desirable. At the
stage (about twenty to thirty minutes after starting) he
may begin to have visual hallucinations which may start
as misinterpretations and illusions. Characteristically
there are at first flashes of light of amorphous forms of
vivid color which evolve and develop into geometric
figures, shapes, human faces, and pictures of great
complexity. The depth of the color and its unusually
arresting tone strike the subject. After a longer or
shorter time, lasting up to two hours, the smoker
becomes drowsy, falls into a dreamless sleep and
awakens with no physiologic after-effects and with a
clear memory of what had happened during the intoxication.
Bromberg himself smoked two marihuana cigarettes within
forty minutes and experienced a pronounced lightness in the
head immediately after the second. In general, the sensations
experienced were typical.
New thoughts seem to come from the background
with a startling clarity and speed. The imagery I have is
so luminously clear it stands out in the background like
sharply cut figures in a frieze.
The uniform symptomatology of cannabis links up
the psychotic states, the experimental findings and the
effects obtained by the casual user. From a clinical view
point the importance of this symptomatology is that
when it occurs in a mental picture (such as a schizophrenia
with toxic features) it can be recognized as such
because of its almost specific distortion of the clinical
picture. The relationship of the personality reaction to
the physiological changes due to the drug in the resulting
clinical picture becomes obvious in studying mental
reactions where marihuana is a factor.
The cases of intoxication are considered to fall into three
clinical categories as follows: (1) Intoxications illustrating
any or all of the characteristic symptoms; (2) reactive states
to these features of the intoxication; (3) toxic psychoses
which seem usually to be the admixture of the toxic effects
of the drug to a basic cyclothymic (manic-depressive) or
schizophrenic reaction.
Eleven illustrative cases are given in considerable detail.
The first group consisted of three negroes who had been
smoking "reefers." Two of them had appealed to the police
when they became alarmed at their peculiar sensations; the
third had been taken in custody by police after he was seen
following women in the park. Excitement, disorientation,
visual hallucinations and sexual excitement characterized
these cases. All were discharged in one to several days with
no evidence of psychosis. A second group of two cases
illustrated mental reactions to the changed somatic sensations
which the patient experienced. Suicidal impulses and homosexual
tendencies characterized both cases. The third group
comprised cases of psychotic conditions in which marihuana
intoxication provided a characteristic coloring to the mental
picture.
Fraenkel studied the hashish intoxication according to a
scheme of psychiatric analysis based on the Rorschach test.
This test involves the interpretation of ink spots and is
considered to show the particular direction of the .variations
of emotion. For instance, in some cases sexual emotivity is
manifested, in other cases the maternal instincts. Subjects
under the influence of hashish, in interpreting images, attribute
an abnormally significant importance to details. The
detail tends to break its boundaries, it tends to emancipation.
Accordingly, it ceases to be a detail. Interpretations of detail
are collectively reduced and, in turn, changed in character. It
no longer simply stimulates affectivity, it becomes epic in
character.


Source: Description Of The Hashish Experience