252 REPORT OF THE INDIAN HEMP DRUGS COMMISSION, 1893-94. [CH. XII.
(c)Cases in which
the drug has been used for a considerable period, and
then given rise to mania of shorter or longer duration, or cases
in
which the symptoms of hemp drug delirium do not completely
subside, but pass on into a state of mania usually curable,
and
thus indicating the probable absence of anatomical lesions—
hemp drug mania.
The evidence, though by
no means clear and decisive, is perhaps sufficient
to justify the presumption of an analogy such as is above
indicated; and cases
which have come before the Commission have seemed to divide
themselves into
these three classes. At the same time it must be pointed out that
the sharp line
of demarcation in symptoms which separates alcoholic intoxication
from delirium
tremens does not separate the intoxication and delirium produced by
hemp drugs.
Further, in regard to what has been said about hemp drug mania, it
may be noted
that it is not improbable, though it has not been established by
evidence, that
prolonged abuse of the drugs may give rise in some cases to
definite brain lesions
resulting in a progressive weakening of all the faculties leading
to dementia.
Legrain's description of
poisons
of the mind.
538. Hemp drugs have been
classed among the "poisons of the mind," and it
may be of interest, as
throwing a good deal of light on
the whole subject and explaining the different modes
in which "intoxications" may give rise to altered mental states, to
allude briefly
to the manner in which mental poisons are presumed to act. M.
Legrain, in Hack
Tuke's Dictionary of Psychological Medicine, defines mental poisons
as including
all substances, whatever may be their origin and nature, which are
capable of
exercising a marked action on the intellectual processes, either by
disordering
them or by suspending them completely for a moment or longer. He
then goes on
to describe their action at length in a passage which may be
summarized as follows.
Poisons of the mind act primarily to a greater or less extent on
the cerebral cells.
Almost all substances introduced into the organism modify the
cerebral processes,
this being due to the delicacy of the organization of the nervous
system, which,
like all complicated mechanism, is extremely vulnerable. The brain
as the termi-
nus of all sensations, and as the regulator of even the most minute
cellular
functions, has to bear the brunt of attacks, even the slightest,
directed against
the vital equilibrium, and has also to re-act in order to
re-establish this equili-
brium. In every intoxication, in addition to the cerebral re-action
due to the effect
of the poison itself, there are other re-actions requiring as many
reflexes for the
defence of the body, and closely connected with the impressions
which
the sensorium receives, of modifications of nutrition, or of
changes which
take place in other organs under the influence of the poison. These
re-
actions are the symptoms common to every intoxication. The
cerebral
re-actions which take place under the more direct influence of the
toxic sub-
stance are of two kinds—they may be diffused, general, and
undefined, and
expressed by vague symptoms, indicating a lesion of the brain as a
whole; or they
are well-defined, clear, and localized, indicating that the poison
affects one special
centre of the brain to the exclusion of all others. Special
derangements may also
occur in addition to those of the brain. In spite of the great
dissimilarity of
the substances which are capable of producing cerebral
intoxication, there are
nevertheless certain clinical features common to all. We might even
say that
there are no intellectual disorders more pathognomonic of one
poison than of
another. The artificial insanity produced by toxic substances is
nothing but the