Since this passage was written in 1838, the tincture of hemp has been used in a great number of cases, both European and native, in the hospital of the Medical College. I know no remedy equal to it as a general and steady stimulant when given to Europeans in half drachm doses during the tractable stage of this disease. I have known the pulse and heat return and the purging checked by a single dose. It allays vomiting much more certainly than the opium preparations, and is not more likely than these to lead to cerebral congestion on the cessation of cholera symptoms. The cheering effect on the patient’s spirits is not the least benefit this remedy confers.
In native cases much less advantage was obtained; nearly all this class of patients were old gunjah smokers.
Use in Tetanus.
I now proceed to notice a class of most important cases, in which the results obtained are of the character which warrants me in regarding the powers of the remedy as satisfactorily and incontrovertibly established. I allude to its use in the treatment of traumatic tetanus, or lock-jaw, next to hydrophobia, perhaps the most intractable and agonising of the whole catalogue of human maladies.
The first case of this disease treated by hemp was that of Ramjan Khan, aged thirty, admitted to the College Hospital, on the 13th of December, 1838, for a sloughing ulcer on the back of the left hand. Five days previously a native empiric had applied a red hot gool (the mixture of charcoal and tobacco used in the hookah) to the back of the left wrist, as a remedy for chronic dysentery and spleen. The patient’s brother was similarly cauterised on the same day. In both sloughing took place down to the tendons. Symptoms of tetanus occurred on the 24th of December. The brother, who had refused to avail himself of European aid, had been seized with tetanus at his own home four days previously, and died after three days’ illness. On the 26th December spasms set in, and recurred at intervals of a few minutes; the muscles of the abdomen, neck, and jaws became firmly and permanently contracted. Large doses of opium with calomel having been administered for some hours, without the least alleviation of symptoms, and his case having on consultation been pronounced completely hopeless, I obtained Mr. Egerton’s permission to subject the poor man to the trial of the hemp resin. Two grains were first given at half past two, p.m., dissolved in a little spirit. In half an hour the patient felt giddy; at five, p.m., his eyes were closed, he felt sleepy, and expressed himself much intoxicated.
He slept at intervals during the night, but on waking had convulsive attacks.
On the 27th, two grains were given every third hour (a purgative enema was also administered, which operated three times); the stiffness of the muscles became much less towards evening, but the spasms returned at intervals as before; pulse and skin natural.
28. Improved; is lethargic but intelligent; spasms occasionally occur, but at much longer intervals, and in less severity.
29. Dose of hemp increased to three grains every second hour. Symptoms moderating.
30. Much intoxicated; continues to improve.