THE HASHISCH HABIT.
CHAPTER XII.
HASHISCH INTOXICATION.
A common practice in some of the far Eastern countries—hashisch taking—is comparatively rare among the people of civilized nations. Here, as there, the practice is not one of steady, daily intoxication with this drug, but it, more like alcohol, is resorted to at certain times, when the system seems especially to crave it, or the temptation is offered. In this it differs materially from the practice of opium or morphia taking. In point of continual craving, we might, I think, arrange these drugs in the following order: Morphine or opium, chloral, hashisch, alcohol.
It would seem that, as the more intense is the daily or hourly craving for a stimulant or narcotic, the easier it is to permanently destroy that craving when the habit is once broken. Thus a short struggle of from four to eight days will, in the majority of instances, cure the opium patient, while with alcohol or hashisch, less so with chloral, the desire seems to be latent and to crop out at odd times, and under peculiar circumstances. Once the desire is fully satisfied, then it remains quiescent for a shorter or longer period, to again show itself in its original, or with increased intensity, at a later date. Hence it is that it is so very difficult to permanently cure dipsomania. With the opium or morphine habituè, the desire at first, certain symptoms at a later date, come to the surface and demand a renewal of the drug saturation as soon as the effect of the last dose passes away.
We must differentiate between a diseased mental condition that imperatively calls for some narcotic or stimulant, and that craving for these substances that is only developed after their prolonged use, and which did not exist before their use was begun. Both conditions are those of disease; the one always existing, the other springing from the prolonged use of the substance to which they become addicted. Be it distinctly understood that where, throughout this book, I have used the word “habit,” I have meant an abnormal appetite or condition, calling for the use of narcotics or stimulants, that either existed before or was produced by the use of the substance in question.
There are those who use hashisch steadily the year round, as many of our countrymen use alcohol; but this is due more to moral depravity than to any special morbid craving for the substance used.
Were we able to procure a thoroughly reliable extract of hemp in this country, and did physicians use it as freely, as carelessly, and in as large doses, as they are using opium, morphine and chloral, hashisch takers would be more common.
Known in English-speaking countries as Indian Hemp or Cannabis Indica, it is called Hashisch by the Arabians, Gunjah and Churrus by the inhabitants of India, Bust or Sheera by the Egyptians, Dagga or Dacha by the Hottentots, El Mogen by the Moors. This is the solid extract. Bangue, Bang or Bendji is the spirituous extract.[102]
Our pharmacopœia offers a tincture of Cannabis Indica, every drachm of which represents fully three grains of the extract. Some of our manufacturing chemists prepare a fluid extract, and a fairly though not thoroughly reliable extract of hemp is manufactured by the English.
The English extract is that usually employed for medicinal purposes, and for the production of intoxication.
The only habituè that I have known was a woman, thirty-eight years of age, who consumed, daily, nine grains of the English extract. She would roll it up into a little lump, knead it for some time between the fingers, and then placing it in the bowl of a common clay pipe, partly filled with tobacco, light it, and inhale the smoke. This was done twice daily, about four and a half grains being used at a time. Sometimes she would go a week at a time—at least so she said—without using any; but I suspect that on those days when she did not smoke it, she used it by the stomach.
She was of an intensely nervous temperament, formerly addicted to the excessive use of alcoholic stimulants; of sallow complexion, dull eyes, pupils always widely dilated, pulse slow and irregular, occasionally intermitting a beat; heart sounds feeble, body poorly nourished, skin dry, bowels usually loose, appetite poor, and urine scanty and high colored, but free from casts, albumen or sugar. She had been using the drug in this way about eighteen months, and found it necessary to occasionally increase her doses. She complained, especially in the morning, when waking from her almost cataleptic state, of intense pain in the left side of the head, and along the course of the sciatic nerve of the same side.
She began to use the drug through curiosity, having read of its peculiar effects, and being extremely desirous of finding something to supply the place of the alcohol, to which she had become a slave.
When not under the influence of the drug her intellect was dull and sluggish, and her temper, at times, bad and unreasoning. During the night, when most completely under the influence of hemp, her dreams were highly pleasurable; she seeming to live in a different world, a thought being answered by its accomplishment, a wish by its fulfillment; distances were traversed in a few seconds; feasts, marked by plenty and variety, the food on dishes of gold, studded with diamonds and other precious stones, were set before her. Everything was done on a scale of magnificence. At times the dreams partook of a highly lascivious character. She assured me that she seemed to be living a double life—the one the real, the other that produced by the hemp. In the latter the incidents of one night’s dreams seemed to follow as regularly, and the characters to be as real, as the incidents and people of every day life.
There was one peculiarity: if she took a little more than her usual allowance of the drug, she found her dreams of an entirely different nature; not pleasant, but inexpressibly horrible, new faces and new scenes taking the place of the usual ones, the thread of her dream romance being suddenly snapped. The same thing occurred, though not so markedly, if she took less than the usual amount.
Before commencing the use of this drug she was in fair health, stout, and when not under the influence of liquor, bright and cheerful.
She passed entirely away from my observation, and I have never since been able to learn what became of her, though I heard once that she had died, how or when I do not know.
I once saw her in one of those deep sleeps produced by hashisch, and noted that there seemed to be complete anæsthesia, deep snoring respiration, thirteen to the minute, dilated and irregular pupils, purplish congestion of the face and conjunctivæ, and a spasmodic twitching of the left eyelid that lasted all the time I was with her—two hours.
She was possessed of some money, and was very highly educated. She claimed to be the widow of an English army surgeon.
In the morning she rarely smoked all that was put in the pipe, and never enough to put her to sleep. Occasionally she added a little opium to the hemp. She was a mental and bodily wreck. Her gait was tottering, and sometimes she would be forced to go in a direction opposite to that in which she desired to move.
She expressed no desire to be broken of her vice, saying often that if she wished it she could stop without any trouble. I regret exceedingly that her temper and many peculiarities would not permit my studying her case more closely. The urine examined was obtained by catheterization during the semi-cataleptic spell already spoken of.
The mental effect of this drug has been variously described by different authors. Thus, Calkins[103] says:—
“The mental condition is an ideal existence, the most vivid, the most fascinating. Time and space both seem to have expanded by an enormous magnification; pigmies have swelled to giants, mountains have grown out of molehills, days have enlarged to years and ages. De Moria in wending his way one evening to the opera house, seemed to himself to have been three years in traversing the corridor. De Saulcy having once fallen into a state of insensibility following upon incoherent dreamings, fancied he had lived meanwhile a hundred years. Rapidity as well as intensity of thought is a noticeable phenomenon. De Lucca, after swallowing a dose of the paste, saw, as in a flitting panorama, the various events of his entire life, all proceeding in orderly succession, though he was powerless in the attempt to arrest and detain a single one of them for a more deliberate contemplation. Memory is sometimes very singularly modified nevertheless, there being perhaps a forgetfulness, not of the object, but of its name proper, or the series of events that transpired during the paroxysm may have passed away into a total oblivion.
“The normal mental condition is that of an exuberant enjoyance rather than the opposite, that of melancholy and depression, though the transition from the one state to the other may be as extreme as it is swift. Oftener the subject is kept revolving in a delirious whirl of hallucinatory emotions, when images the most grotesque and illusions the drollest and most fantastic crowd along, one upon another, with a celerity almost transcending thought. (Mirza Abdúl Roussac.)
“Command over the will is maintainable, but temporarily only. As self-control declines the mind is swayed by the mere fortuitous vagaries of the fancy; and now it is that the dominant characteristic or mental proclivity has its real apocalypsis. The outward expression may reveal itself under a show of complacency and contentment in view of things around, or suspicion, distrust, or querulousness of disposition may work to the surface, or may be, a lordly hauteur that exacts an unquestioning homage from the ‘profanum vulgus’ by virtue of an affected superiority over common mortals, is the ruling idea of the hour; or peradventure, the erotic impulses may, for the time, overshadow and disguise all others.
“Amid the ever-shifting spectacular scene the sense of personal identity is never perhaps entirely lost, but there does arise in very rare instances the notion of a duality of existence; not the Persian idea precisely, that of two souls occupying one and the same body in a joint stock association, as it were (the doctrine as alluded to by Xenophon, in the story of the beautiful Panthea), but rather the idea of one and the same soul in a duplication or bipartation else, and present in two bodies.”
Many persons who have put themselves once or twice under the influence of this drug claim that no such pleasant effects, but rather torturing and horrible conditions are produced. The results when the drug is taken in this way, like those produced by tobacco on boys who smoke for the first time, should not be taken as a true estimate of the results obtained by the continued use of either.
A curious, interesting and valuable experiment was made upon himself by Dr. H. C. Wood, of Philadelphia, who is especially qualified to undertake and record the results of such an observation.
He says[104]:—
“When given in full doses, cannabis Indica produces a feeling of exhilaration, with a condition of reverie, and a train of mental and nervous phenomena, which varies very much according to the temperament or idiosyncrasies of the subject, and very probably also, to some extent, according to the nature of his surroundings. The sensations are generally spoken of as very pleasurable; often beautiful visions float before the eyes, and a sense of ecstacy fills the whole being; sometimes the venereal appetites are greatly excited; sometimes loud laughter, constant giggling, and other indications of mirth are present. Some years since, in experimenting with the American extract, I took a very large dose, and in the essay upon the subject (Proceedings of the American Philosophical Society, 1869, vol. xi. p. 226), the result was described as follows:—
“About half-past four P.M., September 23, I took most of the extract. No immediate symptoms were produced. About seven P.M. a professional call was requested, and, forgetting all about the hemp, I went out and saw my patient. While writing the prescription I became perfectly oblivious to surrounding objects, but went on writing, without any check to or deviation from the ordinary series of mental acts connected with the process, at least that I am aware of. When the recipe was finished, I suddenly recollected where I was, and, looking up, saw my patient sitting quietly before me. The conviction was irresistible that I had sat thus many minutes, perhaps hours, and directly the idea fastened itself that the hemp had commenced to act, and had thrown me into a trance-like state of considerable duration, during which I had been stupidly sitting before my wondering patient. I hastily arose and apologized for remaining so long, but was assured I had only been a very few minutes. About seven and a half P.M. I returned home. I was by this time quite excited, and the feeling of hilarity now rapidly increased. It was not a sensuous feeling, in the ordinary meaning of the term; it was not merely an intellectual excitation; it was a sort of bien-être—the very opposite to malaise. 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 buoyant 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; one very frequently recurrent fancy was to imitate with the arms the motions of a fiddler, and with the lips the tune he was supposed to be playing. There was nothing like wild delirium, nor any hallucinations that I remember. At no time had I any visions, or at least any that I can now call to mind; but a person who was with me at that time states that once I raised my head and exclaimed, ‘Oh, the mountains! the mountains!’ While I was performing the various antics already alluded to, I knew very well I was acting exceedingly foolishly, but could not control myself. 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 a part of my body. I counted my pulse and found it one hundred and twenty, quite full and strong. A foreboding, an undefined, horrible fear, as of impending death, now commenced to creep over me; in haste I sent for medical aid. The curious sensations in my limbs increased. My legs felt as though they were waxen pillars beneath me. I remember feeling them with my hand and finding them, as I thought, at least, very firm, the muscles all in a state of tonic contraction. About eight o’clock I began to have marked ‘spells’—periods when all connection seemed to be severed between the external world and myself. I might be said to have been unconscious during these times, in so far that I was oblivious to all external objects, but on coming out of one it was not a blank, dreamless void, upon which I looked back, a mere empty space, but rather a period of active but aimless life. I do not think there was any connected thought in them; they seemed simply wild reveries, without any binding cord—each a mere chaos of disjointed ideas. The mind seemed freed from its ordinary laws of association, so that it passed from idea to idea, as it were, perfectly at random. The duration of these spells, to me, was very great, although they really lasted but a few seconds to a minute or two. Indeed, I now entirely lost my power of measuring time. Seconds seemed hours; minutes seemed days; hours seemed infinite. Still I was perfectly conscious during the intermissions between the paroxysms. I would look at my watch, and then, after an hour or two, as I thought, would look again, and find that scarcely five minutes had elapsed. I would gaze at its face in deep disgust, the minute-hand seemingly motionless, as though graven in the face itself; the laggard second-hand moving slowly, so slowly it appeared a hopeless task to watch during its whole infinite round of a minute, and always would I give it up in despair before the sixty seconds had elapsed. Occasionally, when my mind was most lucid, there was in it a sort of duplex action in regard to the duration of time. I would think to myself, it has been so long since a certain event—an hour, for example, since the doctor came; and then reason would say, no, it has been only a few minutes; your thoughts or feelings are caused by the hemp. Nevertheless, I was not able to shake off this sense of the almost indefinite prolongation of time, even for a minute. The paroxysms already alluded to were not accompanied with muscular relaxation. About a quarter before nine o’clock I was standing at the door, anxiously watching for the doctor, and when the spells would come on I would remain standing, leaning slightly, perhaps, against the doorway. After awhile I saw a man approaching, whom I took to be the doctor. The sound of his steps told me he was walking very rapidly, and he was under a gas-lamp, not more than one-fourth of a square distant, yet he appeared a vast distance away, and a corresponding time approaching. This was the only occasion in which I noticed an exaggeration of distance; in the room it was not perceptible. My extremities now began to grow cold, and I went into the house. I do not remember further, until I was aroused by the doctor shaking or calling me. Then intellection seemed pretty good. I narrated what I had done and suffered, and told the doctor my opinion was that an emetic was indicated, both to remove any of the extract still remaining in my stomach, and also to arouse the nervous system. I further suggested our going into the office, as more suitable than the parlor, where we then were. There was at this time a very marked sense of numbness in my limbs, and what the doctor said was a hard pinch produced no pain. When I attempted to walk up-stairs my legs seemed as though their lower halves were made of lead. After this there were no new symptoms, only an intensifying of those already mentioned. The periods of unconsciousness became at once longer and more frequent, and during their absence intellection was more imperfect, although when thoroughly aroused I thought I reasoned and judged clearly. The oppressive feeling of impending death became more intense. It was horrible. Each paroxysm would seem to have been the longest I had suffered; as I came out of it a voice seemed constantly saying, ‘You are getting worse; your paroxysms are growing longer and deeper; they will overmaster you; you will die.’ A sense of personal antagonism between my will power, as affected by the drug, grew very strong. I felt as though my only chance was to struggle against these paroxysms—that I must constantly arouse myself by an effort of will; and that effort was made with infinite toil and pain. I felt as if some evil spirit had control of the whole of me, except the will power, and was in determined conflict with that, the last citadel of my being. I have never experienced anything like the fearful sense of almost hopeless anguish and utter weariness which was upon me. Once or twice during a paroxysm I had what might be called nightmare sensations; I felt myself mounting upward, expanding, dilating, dissolving into the wide confines of space, overwhelmed by a horrible, rending, unutterable despair. Then, with tremendous effort, I seemed to shake this off, and to start up with the shuddering thought, next time you will not be able to throw this off, and what then? Under the influence of an emetic I vomited freely, without nausea, and without much relief. About midnight, at the suggestion of the doctors, I went up-stairs to bed. My legs and feet seemed heavy, I could scarcely move them, and it was as much as I could do to walk with help. I have no recollection whatever of being undressed, but am told I went immediately to sleep. 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 anæsthesia of the skin. At no time were there any aphrodisiac feelings produced. There was a marked increase of the urinary secretion. There were no after effects, such as nausea, headache, or constipation of the bowels.
“The sense of prolongation of time which I experienced was to me very remarkable, but is not uncommon in these cases. It is evidently due to the immense rapidity of the succession of ideas. The mind, without doubt, measures time by the duration of its own processes, and when an infinitude of ideas arise before it in the time usually occupied by a few, time becomes infinitely prolonged to the mind. It is a lifetime in the minute. A very common mental phenomenon, not yet mentioned, is a condition of double consciousness, a sense of having two existences, of being at the same time one’s self and somebody else.”
Pleasurable as may be the stage of excitement or intoxication, fascinating as may be the dreams that follow, the evil effect upon the body is rapid and decisive.
Wasting of the muscles, sallowness of the skin, hebetude of the mind, interference with coördination, failure of the appetite, convulsive seizures, loss of strength, and idiotic offspring, seem, from all accounts, to be the uniform result of the long continued use of this drug.
CHAPTER XIII.
CONCLUSIONS.
A careful study of the facts presented in the foregoing chapters teach us several lessons well worth considering, and suggest certain cautions and reforms that are greatly needed.
From the abundant evidence upon this point I think we must conclude that the abuse or habitual use of narcotics is steadily upon the increase, especially the subcutaneous use of morphine; that these drugs are, in the majority of instances, first taken to relieve pain, and not for simple gratification of a morbid appetite; and that the drug used and the manner of using it is in consonance with the prevalent medical practice of the time in which the habituè lives.
There are two classes especially blamable for this—the physicians and the druggists. In the early history of the use of the hypodermic syringe the danger of contracting the habit through its frequent use was not recognized, and the physician was not then to blame. At the present time, however, knowing fully the dangers incident to its use, the physician is criminally careless in placing the instrument in the hands of the patient or her friends for their use. If he does not appreciate the full extent of the danger, he is culpably ignorant, and certainly deserving of punishment.
The deaths, and dangerous accidents, and the spread of the continued use of narcotics, is due, to a great extent, to the druggists, who, in many cases, sell the drug without a physician’s prescription, and without any reasonable excuse on the part of the patient, in direct violation of the law. Chloral is sold to men just recovering from a spree; prescriptions containing large amounts of these drugs are renewed for patients for whom they were not originally given; the druggist himself often prescribes a mixture of chloral, morphine and bromide of potassium, for repentant drunkards, or for patients suffering from insomnia.
When spoken to about this matter, they coolly excuse their practices with the remark that “if we don’t do it, some other druggist will; and why should we lose the money.” The laws relating to the sale of poisons are loose and inefficient, the practice rotten, and the statute really a dead letter. Dangerous and even fatal consequences[105] are not, then, so much to be wondered at.
Another matter in this connection needs attention, viz: the lying pretensions of a few charlatans, notably in the West, who, by specious advertisements and deceitful lies, induce the victims to these habits to buy their medicines, or come under their care for treatment. Their so-called specifics are simply preparations of opium or morphine, and their treatment is based upon the plan of substituting one form of the drug for another.
These sharpers are utterly without conscience, and do not scruple to prey upon and undermine the health of their victims, in order to gain a few dollars. It is about time that the people found out that honest, honorable and trustworthy physicians, who have only the good of the patient at heart, do not advertise. It is a shameful fact that the religious press tolerates the advertisements of these charlatans in their columns. As a rule, the vilest advertisements are to be found in these newspapers. Owing to the moral weight supposed to be carried by these sheets, owing to their large circulation among the people, who look upon every word therein contained as truth, these announcements and endorsements do the people an infinite amount of harm. Can it be that the financial “backers” of these papers overrule the scruples of the religious editor? If so, while a good investment financially, it must be a very poor one morally.
I have emphasized the fact that the continued use of chloral is not so liable to end in the formation of a habit, as is the prolonged use of morphia or opium; not that physicians may exercise less care and discrimination in its employment, for the danger is sufficiently great, but simply to refute the statements of some men who are gone wild upon the subject of habituation and inebriety, and who suggest measures for reform, and plans for restraint and treatment, as impracticable and impossible as their statements are whimsical and truthless.
Finally, be it distinctly understood, that many of the symptoms enumerated as occurring in both the morphine and chloral habituès, but especially the latter, are only found where the drug has been used in large amount, or for a long time. Every symptom will, moreover, be modified somewhat by the systemic peculiarities of each patient.
The “mixed” habits, so called, where patients are using two or more narcotics at one time, have not been discussed separately, as they possess no distinctive characters, and the physician who understands the prominent points of each will have no trouble in detecting and treating these cases.