CH. XII.] REPORT OF THE INDIAN HEMP DRUGS COMMISSION, 1893-94. 247

Post-mortem examinations.

534. The cause of death in the nine fatal cases was as follows: One
general debility, one cholera, two dysentery, one
leprosy, one heart disease, one diarrhœa, one dropsy
and old age, and one no cause assigned. In five of these cases no post-mortem
examination appears to have been made; in the four in which it was conducted,
the condition of the brain is not specially noted in three, while in one case—death
from cholera—the following note is made: "Weight 43 oz.; both membranes and
substance of brain congested, and lateral ventricles contained a very small quantity
of fluid. Brain substance firm." As to the results of post mortem examinations in
alleged ganja cases, therefore, the evidence is purely negative as to any even
coarse brain changes being present. It may be remarked, however, that as a rule
when autopsies have been conducted in asylums, it has been solely with the object
of ascertaining the cause of death and not for purposes of pathological research.
In most cases the brain does not appear to have been examined, and, when it
has been examined, the information recorded is so meagre and superficial as to
be valueless.

Diagnosis of hemp drug insanity.

535. Reviewing the mode of incidence so far as it can be ascertained, the
type, general symptoms, and duration of cases in
which the mental balance has been alleged to have
been overthrown by the use of hemp drugs, the question arises are there any symp-
toms pathognomonic of the condition generally known as hemp drug insanity, and
on what does the evidence rest that the use of these drugs may induce mental aber-
ration ? The evidence obtained by the Commission appears to indicate that in the
cases of alleged hemp drug insanity which find their way into asylums, there are no
typical features in the premonitory symptoms and no pathognomonic symptoms
in the insane condition on which to base a determination of causation. The
mode of incidence, the premonitory symptoms, and the symptoms of the insane
state are practically the same in cases in which these drugs have never been used
as in instances in which the mental equipoise has been accepted as being disturbed
by their employment. The type of hemp drug insanity is mania, though in the
subsequent history of a few cases there appears to be divergence from the type.
The mania may be acute or chronic. The majority of medical witnesses who have
studied the subject are clearly of opinion that there is nothing typical in the
symptomatology of hemp drug mania to distinguish it from mania due to other
causes. But at the same time several express an opinion that the symptoms are
of shorter duration in hemp drug mania than in mania due to other causes.
Besides this pretty generally accepted view that short duration is a diagnostic
mark of hemp drug insanity, one or two witnesses are inclined to think that there
are other characteristic symptoms. Dr. Cobb (Bengal witness No. 110) in his
oral evidence states: "There is nothing very typical in the symptoms, but still
ganja insanity has points of distinction from other kinds of insanity. It is very
temporary. Confinement of the patient with removal of the exciting cause gen-
erally brings about rapid cure. Delirium is a prominent feature. There are other
general features which it is difficult to put into words, and which experience alone
can teach.........One recognizes ganja insanity intuitively. All the symptoms
I have described may be present in other kinds of insanity, but one judges by the
combination of them." Dr. Crombie (Bengal witness No. 104) in the appendix
to his written evidence states: "I refer to the peculiar characters of this form