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Two cases of Poisoning by Cannabis Indica

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One night at the beginning of this year, about 11: 30 P.M. a
young gentleman rang me up, and asked me to go as quickly
as possible to see his two brothers, who, he said, were both
suffering from some poison. I at once asked, what kind of
poison-was it opium? My young friend could only remember
that his brothers had spoken of a drug which had a name like
"Hash." I at once suspected "cannabis indica," or "Hashish,"
so I hurriedly looked at one or two medical books to refresh
my memory as to symptoms and treatment in such a case of
poisoning. On the way to the house I met a medical friend
(Dr. C.), who had been sent for as the nearest medical man,
and he was now on his way to bring me as quickly as possible
to the patients. He had just left the patients, and he said to
me he did not think there was any danger to life, though they
were greatly excited, and were evidently suffering from the
effects of a large dose of cannabis indica, or Indian hemp.
These facts he had gathered from what he heard from one of
the patients a few minutes before our meeting.
As I was well acquainted with both patients, I had great
hopes I should soon find out all about the drug they had
taken; and if the drug was Indian hemp, it would be comforting
to tell them there was little or no danger from it. I
requested Dr. C. to accompany me to the house of the
patients, in case help would be needed.
The patients were brothers, A. and B. A. was twenty-two
years of age, a medical student in his third year; B. was
twenty years of age, an art student, quite a philosopher in his
way, and of a highly strung and sensitive nature. Both were
tall, powerful fellows, nearly six feet in height. On entering
the dining-room, where our patients were, we saw an extraordinary
sight. A. and B. were only partially dressed. A. was
hanging tightly on to B., who was rushing round the diningroom
table in a very excited state, wildly throwing about his
arms and singing in a most jovial manner. They were alone in
the room when we entered. A. was evidently doing his best to
control B., both were panting for breath, while B. was singing
out loudly in a most excited manner. A. looked pale and
depressed, as if overweighted by some sense of heavy responsibility.
Both in mind and body B. was in a state of extraordinary
excitement. He appeared as if he could not talk fast
enough, and as if his arms and legs were acting automatically,
while A. hung like a dead-weight on the back of his brother,
doing his best to control the awful restlessness. As Dr. C. and
I entered the dining-room, B. was rushing wildly round the
room, and A., in an almost exhausted condition, was hanging
as a dead-weight on the back of his brother with his arms
clasped tightly round his body. Dr. C. went quietly to an
arm-chair and sat down, while I went up towards the
brothers, who at once recognised me, and seemed to be wild
with joy at my appearance on the scene.
The younger brother, B., threw his arms round me in a
loving embrace, and spoke most kindly and even tenderly to
me; and then all of a sudden he began to quote poetry, and in
an excited manner asked me which poet I liked best, naming
several, one after another-the brother A. calmly looking on,
and regaining his breath after the recent struggles. A perfect
torrent of words and poetic sentences was showered on to
my face in this moment of excitement, and then B. rushed
off again round the table, with his brother after him,
endeavouring to control him, as before.
I also did my best to control A., making the mistake of
trying to argue with him as to such foolish conduct. This
seemed to excite B. very much, and he made a rush at Dr. C.
as if to strike him, and it required all my own power and that
of A. to calm B. I then went upon the opposite plan, and
agreed with A. in everything, and gradually B. became less
excited. I then gave Dr. C. the hint to slip quietly out of the
room, and told him to get the young brother to go off at
once for a cab, as I had made up my mind that both patients
would be better for a night in the Infirmary.
It is necessary here to state that the parents of our patients
were at this time in the country, after an attack of influenza,
for a change of air, and that the only relative in the house
besides the youngest boy was a sister, who at this particular
hour was fast asleep, and happily unconscious, in a room at
the very top of the house.
As soon as Dr. C. left the house and the young boy had
gone for a cab, I thought of an emetic for my patients. I
could not find mustard; but I had in my pocket a bottle of
ipecacuanha wine, a large dessert-spoonful of which I persuaded
B. to swallow. As it was nearly two hours since the
drug had been swallowed, I had little hopes that an emetic
would do good, and it was not possible for me to give an
antidote to cannabis indica. I therefore decided to stay with
my patients until I could safely get them to bed, either in
their own house or in the Infirmary. For a full quarter of an
hour after this our time was spent in rushing round the room,
accompanying B. as he dashed about his arms and legs, and as
he talked and sang and quoted poetry incessantly. A. looked
quite tired out. He was quite conscious, and able to talk
sensibly regarding the situation; but it was impossible to get
B. to do anything else than dance and sing and talk. I saw an
open penknife on the dining-room table when I entered the
room at first; this I took possession of. At last we heard the
cab drive up to the front door. It was now snowing hard, and
the air was very cold. A. put on his coat and cap, and after
some trouble we managed to get B. to put on his coat and
hat, and then with a rush we all bundled into the cab, and I
told the cabman to drive rapidly to the Infirmary. A. and I
got B. into a corner of the cab, where we partly held him
down, for fits of excitement came upon him at simple suggestions,
and it was most difficult to prevent him from
becoming violent. Fortunately B. and I were great friends,
and my plan of humouring and agreeing with him had a
soothing effect upon him.
After what seemed a terribly long journey, we at last
reached the Infirmary at about 1 A.M., in the midst of a heavy
snow-storm, and we at once went into the medical waitingroom
and rang up the resident medical officer.
During our journey to the Infirmary, A. was very
depressed. His head hung down, and I saw him continually
feeling his pulse; and he frequently asked me if he was going
to die. On the other hand, B. was very lively during the
journey-songs and poetic quotations would come out, in
spite of a tendency to yawn occasionally. I rather thought
the dessert-spoonful of ipecacuanha wine was now nauseating
him slightly, but he did not vomit. The medical officer was
greatly puzzled by B.'s symptoms, and began questioning
him. This greatly excited B., who went at the doctor. The
latter quickly retreated to a corner of the room, while A. and
I took possession of B. once more.
The doctor told us there were no private wards to be had,
and that the only beds vacant for such a case were in the D.T.
Ward. This was rather trying to my patients, especially to A.
but B. was still quite jovial, and did not seem to care about
anything as long as he could sing and talk.
Up to this time I had a difficulty in seeing into B.'s eyes. I
now saw that his pupils were widely dilated, and I found that
his pulse was rapid and small.
I left my patients in the care of a strong male nurse in the
D.T. Ward. Next morning at lo:30 I called at the Infirmary,
but found that my patients had left that excellent institution,
the D.T. Ward, at 9:30 A.M., and had reached home in time
for breakfast with their astonished and wondering sister, who
had so peacefully slept through the previous night, in blissful
ignorance of all that had occurred in the dining-room
between the hours of 10 P.M. and 1 A.M.
The elder of the two patients, A.-the medical student-has
written a description of his experiences, which I now append.
An Experience under Haschish, or "A Night Out. "-With a
view to experiencing the wonderful dreams said to be produced
by haschish, or cannabis indica, my brother and I on
three successive occasions took doses of that drug. On the
first occasion we took twenty-five minims of the tincture.
This produced no effect on my brother, but, on the other
hand, I began to feel somewhat hysterical. Hoping that it
would produce the desired effect, I went to bed. After about
half an hour's sleep, I awoke trembling all over. I soon, however,
went to sleep again, and there was no further result.
On the second occasion (a week later), we took over forty
minims. My brother chose as a fitting subject to excite the
dreamy, imaginative state of which we were in quest, De
Quincey's famous "Confessions," from which he read aloud.
I soon found myself totally unable to follow him, and was
seized with uncontrollable convulsions of laughter, in which
my brother joined, although he seemed to have more control
over himself than I had. I soon went to bed. My brother
followed two hours later in an extremely nervous condition,
and frightened like a child in the dark. We neither of us
experienced the dreams we had anticipated.
After a three weeks' interval, we tried a third time, taking
on this occasion over ninety minims. My brother, taking the
dose after me, drank in all probability a considerable amount
of sediment, although there was still some of the drug left in
the bottle when he had finished.
In about twenty minutes we both began to feel exhilarated,
the dose, as before, having a greater effect upon me. I
felt decidedly pleased with myself, and versatile. My brother
failed to follow my erratic criticisms on some of Beardsley's
weird drawings, at which we were looking. Then one o,f the
figures before me began to nod and whirl round. Suddenly I
felt myself carried away as it were by a whirlwind, and finally
lose consciousness. Here I must quote my brother's account
of what happened at this moment.
"Scarcely had my brother," he writes, "recovered from his
hysterics when he sprang up with appalling suddenness,
upsetting everything, and shouting exultingly, 'Hurrah! I'm
off!' Almost instantaneously he became unnaturally serious,
and began muttering, 'We've done a damned foolish thing, a
damned foolish thing! ' all the while stamping up and down
the room, striking and kicking out with his arms and legs as if
struggling with some invisible antagonist."
The next thing I remember after regaining consciousness
was the room heaving up and down. I was standing, trembling
from head to foot, clutching my brother. First it seemed I
was towering above him; then he in his turn overtopped me.
With each upheaval of the room I felt we were growing worse
and worse. It was a nightmare in its most horrible phase-a
feeling that we were drifting into an irrevocable madness. I
felt as if I was at the mercy of some supernatural force,
which was sweeping through my brain, keeping me in a
breathless state of suspension. Everything-time, objectsseemed
to be rushing past me. I was nerved to the extremest
limit of excitement. Would this force suddenly break itself up
and play havoc with my brain, urging me to the very verge of
insanity? It was as if a mesmerist was compelling his unhappy
victim to perform some act of hopeless madness. What was
going to happen next? Should we indeed commit some senseless
deed, which we were powerless to prevent? This growing
sense of responsibility made me think of putting ourselves
into the hands of a policeman; but before I could formulate
such an idea into words, everything again became blank.
When I again recovered consciousness, it gradually dawned
upon me that possibly I alone was mad. It took some time to
convince myself that this was really the case. My brother
assured me that he was sane, and this gave me an immense
relief. There was now somebody to look after me. I was in
safe hands, in case I should attempt anything foolish. I now
realised in a forcible yet dim sort of way the necessity of
controlling myself. The importance of not arousing the
inmates of the house was the predominant idea throughout
my subsequent actions that night. I took an exultant pleasure
in grinding my teeth, clenching my hands, striding up and
down the room, in the endeavour to prevent the fit which
every moment I was anticipating. Sometimes I would stand
still, quivering from head to foot. Presently I heard my
brother mention "mustard," which I must have unknowingly
suggested to him, with the idea that a vomit would help
matters. We failed to discover any. Then I remembered some
morphine tabloids which I had upstairs with my hypodermic.
This my brother went to fetch; but, feeling that I should be
unable to control myself in his absence, I followed behind. I
found the tabloids, and took them in my hand, and then
again all was a blank. The next thing I remember was swallowing
spoonfuls of salt, in the hope that this would make
me vomit. Meanwhile my brother had awakened my youngest
brother, and, on emerging from the pantry, I heard him
giving him orders to fetch a doctor. In the middle of his
directions he broke into an insane fit of laughter. This completely
mystified my youngest brother, who had previously
witnessed my own strange behaviour, and thought than in
any case his other brother would be in his right senses.
At this juncture we returned to the dining-room. The
sudden outburst of insane laughter on my brother's part
somewhat sobered me. Was be also going mad? I realised now
the increased horror of the situation. Every now and then he
would burst out into laughter. It seemed to me an absolute
necessity that, if he was going to abandon himself to the
wiles of the drug, I should keep control over my actions.
About this time I felt my limbs contracting. In my excitement
I pictured myself assuming that posture of opisthotonos.
I rubbed my calves, stamped up and down the room,
opened my pen-knife and dug it into my hand. My brother,
however, in one of his intervals of sanity, not approving of
my possessing a knife, endeavoured to take it from me; but
before he could do so all again became a blank-this time for
both of us. Strange and absurdly silly ideas now began to pass
through our minds, one after the other. We related stories to
each other, never failing to laugh at the conclusion of each,
however much they might be lacking in wit. In fact we were
immensely pleased with ourselves. There was a general feeling
of cleverness in the air, exhilaration. Subsequently I noticed
my brother getting more noisy, even pugnacious. I had to
laugh now at his jokes, fearing there might be an unfriendly
rupture between us if I did not. It was all-important that
there should be no outbreak of hostilities between us. He
now developed an insane desire to peep out of the windows,
and see if people were watching us from the street. Then,
imagining he heard whispers outside the room, he would rush
off to the kitchen banisters and peer downstairs to see if the
servants were listening to us. This irritated me intensely; I
thought it quite unnecessary. Then he would begin marching
round the dining-room table, waving his arms, striking absurd
attitudes, and singing in a low voice.
Then perhaps there would be an interval of relative sanity.
Thinking we heard steps outside, we would rush to the halldoor
to see if the doctor had arrived; or else he would again
go up to the window or peer down the kitchen stairs,
returning eventually to the dining-room and resuming his
march round the table. Now, instead of singing and preaching
sotto vote, he would get louder and louder. In vain I imitated
him in whispers, in the endeavour to make him follow my
example, so as not to arouse the household. He could not
control himself. At last the doctor arrived. I implored him to
give us morphia; but, after deliberating for somme time, he
decided to fetch our medical attendant. I besought him not
to leave us alone, dreading that we might go totally mad
during his absence. However, he decided to leave us.
The doctor once gone, my brother again returned to his
interminable march round the table. Sometimes he would get
more boisterous and hit me about in a good-natured way. I
meekly submitted to this, laughed, and pretended to enjoy it,
knowing that it was best to humour him. Once or twice I was
foolish enough not to fall in with his insane ideas, and then
he would go for me in earnest. After that I disagreed with
him no more, and he returned to his everlasting promenade.
How many times we walked round that table I should not
like to say. Of this period my brother writes: "I have an
impression that throughout the evening we spoke to each
other in husky whispers; and I can remember vividly how
strangely our natural voices sounded when, on one or two
occasions, we spoke aloud. The sound was as of voices
coming from another and far-distant world."
The drug was now exerting a very different effect on me. I
began to feel extremely depressed and weary. I felt as if some
magnetic force was dragging me to the ground. My limbs
were heavy and aching. I gazed in despair at my brother, who
still, as idiotic as ever, was waving his arms, imagining himself
at the head of some triumphal procession. How long this
dreary comedy lasted I do not know-it seemed to me hours.
I dared not now go to the door and look out, fearing my
brother might stampede upstairs or out into the street. At
last our medical attendant, Dr. Foulis, arrived. He immediately
took in the situation. My brother took to him at once,
shook hands, and probed him with good-natured jokes,-
"Swinburne is the poet I like-Rossetti: now what do you
think of Tennyson, doctor?"
It now dawned upon me that perhaps this escapade was
going to end in death, and a most vivid picture presented
itself to my mind. It was a picture showing Virgil and Dante
standing on a rocky ridge overhanging a deep abyss, whence
are issuing multitudes of lost souls on their way to Hades. I
imagined myself standing on that ridge watching the
unending and evermoving throng passing out of sight. Above
me there seemed to be an irresistible force, dragging me most
unwillingly from that spot. I told the doctor that I felt in the
presence of death-that feeling described by patients who
suffer from angina pectoris. The doctor assured that the drug
seldom proved fatal. This annoyed me extremely. I felt a
craving to linger over the scene of the picture, thinking that I
might possibly participate in it. Eventually the doctor told
me that he was going to take us off to the Hospital. While
waiting for the cab, the doctor gave my brother a considerable
dose of vin. ipecac., which, however, never acted. He
subsequently examined his pupils and found them widely
dilated; the pulse was rapid and full; mine was rapid, but
weak. At last the cab arrived. My brother made but little
difficulty about entering. "During the whole time," my
brother says, "that I was under the influence of the drug, I
felt nothing but merriment and elation. The only exception
to this was on hearing that I was to be taken to the Infirmary,
when I felt like a criminal being dragged off to prison,
humiliated and fearful."
Once in the cab I experienced intense relief, the necessity
for that rigid control having vanished, my brother could now
give vent to his feelings without any disastrous consequences.
In fact, he had somewhat quieted down. He seemed to have
passed the most acute stage.
We entered the Hospital gates a little before one o'clock,
i.e., two and a half hours after having taken the drug. It gave
me rather a shock at first to know that I was to be an inmate
of the famous D.T. Ward, but I soon entered into the novelty
of the situation. I must say that I felt at first rather like a
condemned criminal being conducted to his cell. Whilst
waiting in the corridor outside the ward, my brother
suddenly made a rush at me, and there we stood clasping
each other's arms, gazing at each other half stupefied, and
engaging in a half-hearted struggle-an exact reproduction of
that characteristic picture of two drunkards struggling
together, neither of them being any the worse for the
My brother was soon after taken off by the keeper and
given a bath. Finding that the water sustained its normal tint,
the attendant remarked cheerily, "You don't want much of a
bath, you don't!" at which my brother was duly flattered. I
was not even offered a bath. We were then handed over to
the nurse. I am afraid she did not look upon us in a very
favourable light, although I tried to impress upon her that it
was an extremely interesting experience. Indeed, it was with
difficulty that I could persuade anyone that we had not been
taking the common drink. Lastly, our names and addresses
were taken. My brother was under the impression that we
ought to give false ones, but gave himself away by telling me
so at the top of his voice. "Matthew," he said in answer to
the nurse. "Nonsense," she replied. "Matthew Prior-
Matthew, Mark, Luke, and John went"- In the end I had to
answer for him.
Finally, thoroughly tired out, I sank into a doze. Sometimes
I would hear my brother singing to himself, as pleased
and contented as ever. I saw the resident pass round on his
nightly round, and then succumbed to sleep.
The effect of the drug lasted for three or four days, during
which time we were in an extremely unstable state of mind,
and had to keep a constant guard over our actions. On the
afternoon of the following day, my brother had another
attack. "I became restless," he writes, "wandered about the
house, and finally shut myself into the drawing-room, where
I danced and sang for my own delectation in front of the
looking-glass. Mixed with my merriment was a sinister vision
of my brother coming back, raving mad, from a concert to
which he had gone that afternoon. I pictured to myself the
door being suddenly flung open, and my brother standing at
the doorway with flaming eyes; and I knew if this happened I
should rush at him with murderous intent."
The following is the account of his dreams, on falling to
sleep at the Infirmary:-"Upon falling to sleep I experienced
the most exquisite dreams. The sky was scintillating with
delicate colours, rapidly succeeding one another. Then came
shifting landscapes of unimaginable beauty, following fast
upon each other, and all too quickly disappearing."
Such was the unexpected sequel brought about by a
draught of that green liquid. I remember saying at the time
how extremely suggestive it was-suggestive perhaps of some
magic potion. I compared it to the crimson wine with which
Circe intoxicated and beguiled away her unwary guests. Certainly,
it seemed to me that there was some definite yet
unfamiliar force which had taken temporary possession of
my body, and was expending itself on my nervous
mechanism, producing a state of molecular unrest which at
any moment might culminate in a nerve storm. So real and
persistent was this presence, that I should like to believe the
drug to have acted in the following manner, that it so altered
the relation of the molecules to one another in the nerve
ceils, by the increased influx of the blood to the brain, that
they became capable of receiving waves of vibrations (thus
producing the feeling described), which normally pass
through the brain without exerting any influence over it. It
was a most ludicrous and, under different circumstances,
might have been a most enjoyable experience. The imperative
necessity that ever weighed most heavily upon us-that of
keeping ourselves under control-and the trouble we entailed
on those who attended us, prevented this.
I think the following points to be of some considerable
interest: -
First, the different ways in which the drug expended itself
on my brother and myself. Our ages are respectively twenty
and twenty-two. In my brother's case the onset of his period
of excitement was postponed for some little time and was
gradual in character. Also his lysis, if I might so call it, was
more prolonged than mine. Then the occurrence of his outbreak
on the following day. Lastly, his pupils remained
dilated for at least four days after the taking of the drug. I
think that all the above facts may be accounted for by the
fact that his dose contained much of the resinous material
undissolved, forming a sediment at the bottom of the bottle.
His dose, therefore, took some time in being absorbed by the
stomach, and some of the resin may even have remained
undissolved until the day following, thus accounting for his
second outbreak.
In comparing my own case with his, the onset was much
sooner, and was almost instantaneous, reaching its climax at
once. Later, this stage of excitement gave way to one of
extreme mental depression. This state of mental depression
stands out in striking contrast to that of my brother's, which
was one of levity throughout the evening. I was able to
experience the numbing effect of the drug whilst digging the
knife into my hand. There were no dreams in my case. And,
secondly, in neither of us did the drug produce its reputed
aphrodisiac action.

Source: Two cases of Poisoning by Cannabis Indica
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