301

valves healthy. Liver weighed 35 oz; gall blad-
der full of bile, normal. Spleen weighed 8 oz.,
slightly enlarged; right kidney 2½ oz., left kidney
2½ oz., slightly congested; capsule easily separated.
Bladder contracted and empty. Intestines: con-
gestions all along both small and large intestines,
except portions of upper and lower ends. Small
intestines contained thin, yellow offensive fluid;
large intestines thicker, darker and larger quantity
of fluid than the small intestines. No worms.
Lungs both adherent to chest walls; gorged
with dark blood.

4. Bolai Chand Dey, aged 27; addicted to
excess in ganja and alcohol for 18 months. Sent
to the Dullanda Asylum 20th May 1893. Re-
marks on certificate of lunacy:—Talks incohe-
rently. Is at times violent. Is at times very
boisterous. He is indecent and dirty in his habits.
Has a biting propensity.

On admission to the asylum the man was noisy
and violent, sleepless, and refused food. Treat-
ment with sulphonal and morphia calmed him
somewhat, but he passed into a state of low deli-
rium and died at 5 P.M. on the 23rd of May. He
was removed to the hospital on admission.

Post mortem.—Body well nourished; rigor mor-
tis well marked. Lungs, both congested. Right
lung 39 oz., left lung 26 oz. Heart 10 oz., nor-
mal; valves healthy. Ante-mortem clot of small
size found in the right ventricle passing into the
pulmonary arteries. Liver 57 oz., congested;
otherwise normal. Spleen 6 oz., normal. Both
kidneys (right 5 oz., left 5½ oz.) congested; cap-
sule easily removed. Intestines slightly congested
throughout. No ulcers or parasites.

Brain 46 oz.; membranes deeply congested;
sinuses full of dark blood; brain also congested.
Punctœ well marked; no other signs of disease or
any lesions of brain substance.

The cause of death appeared to be in this case
acute meningitis. The following notes are taken
from his hospital bed-head ticket:—Temperature
on admission 99° F.; violent and excited; strug-
gled when fed and became unconscious with
shallow respiration. Ice was applied to his head
and a castor-oil enema given, and the man re-
covered consciousness after a few minutes. His
conjunctivæ were congested and his pupils con-
tracted. His temperature rose to 102° F. The
enema acted and brought away lots of scyballæ.
He remained in a somewhat comatose condition
from the evening of the 20th, and on the 21st was
treated with bromide of potassium, ice to the head
and ice water enemata. On the evening of the
21st his temperature had gone down to 100° F.
On the 22nd his condition seemed somewhat better.
Temperature 99.6° F.; took some food and spoke,
but was incoherent and delirious; sordes on teeth;
at 12 A.M. the temperature rose to 102° F.
Quinine and antepyrine were added to the bromide
mixture and slowly the pyrexia abated; at 3 P.M.
the temperature was 101.8° F.; at 8 P.M. 99.6° F.
On the 23rd the temperature again rose to 102.4°
F.; pulse soft and compressible; breathing difficult;
the patient died about 4-45 or 5 P.M.

The symptoms all pointed to meningitis and the
congested state of the vessels of the brain and
membranes prove, I think, that the diagnosis was
correct. The question now arises as to a cause.
Was it ganja or alcohol, or the two combined ?
Could there be any other cause ? I am inclined to
think that this was a case of delirium tremens
with pyrexia, and that ganja, if used, may or may
not have added to the violence and excitement
present on admission to the asylum. I am bound,
however, to record certain other features connected
with this case.

When the patient was admitted, the Hospital
Assistant who examined his body found the follow-
ing wounds and contusions on him:—(1) Contused
wound about 4 inches long on the right shoulder;
(2) circular contusion right upper arm; (3) five
contused wounds varying from 1½ to 3 inches on
the back of the left shoulder; (4) one contused
wound about 1½ inches long on the left elbow; (5)
six irregular bruises on the back; (6) bruises on
the right side of the abdomen and another on the
left thigh; (7) a small swelling over the left
parietal eminence. How he came by these injuries
(some looked like contusions and abrasions from
ropes) I cannot say, but he had evidently at some
time received a blow on the head, and this might
be succeeded by congestion of the brain and may
have increased the gravity of his condition.

As regards the general appearance of the various
organs of the body, and especially with regard to
coarse lesions of the brain, these cases show
nothing which could be ascribed to the action of
ganja more than to other causes present. It is
probable that as the insanity produced by ganja
is never very prolonged, the hyperæmia occurring
during the stage of excitement leaves no per-
manent mark on the brain tissue or membranes.

                      Oral evidence.

My length of service is ten years, six years of
which have been in civil employ in Bengal. I
have been Superintendent of the Bhawanipur cum
Dullanda Asylums for two and a half years. I
have had no special training in insanity beyond
that acquired by a student attending his lectures
in London. Apart from my asylum experience
and my knowledge of the tincture of Cannabis
indica as used in medicine and the two experi-
ments with bhang related in the Journal of Medi-
cal Science for January 1894, I have no know-
ledge of the effects of hemp drugs.

As to literature, there are O'Saughnessy's
Bengal Dispensatory, the Records of Macnamara's
Experiments, brief and casual references to hemp
drugs in works on insanity, and so on; but I
know of no work in which hemp drug insanity
is systematically treated.

In regard to dhatura, the Hospital Assistant,
Trailakyanath Banerji, had told me, what I had
heard from others, including lunatics, that it was
customary to mix two or three seeds of dhatura
with ganja for their use by smokers who use the
drug to excess. I asked the Hospital Assistant
to obtain me a sample of the mixture as actually
sold to be smoked in this way. He brought me a
small packet, and said he had bought it in the
bazar in the shop. The packet contained just
enough to fill one chillum and be one smoke for
a person accustomed to this use. It contained
dhatura seed. There were two seeds so far as I
remember. It was shown as given to me to a
Committee of this Commission at the asylum.

A man named Tulsi Malak was brought into
the asylum on 13th August last. He was not
insane when admitted. He told me that he had
purchased a mixture of dhatura and bhang to use
it in a debauch with some fakirs. The result
was insensibility, in which he went into a shop,
where he was found sleeping and arrested. He
was certified insane by the Civil Surgeon of
Barrackpur and sent into Dullanda. This is also
a case showing the preparation of this mixture for
sale.