The Use of the Cannabis Drugs in India

Title

The Use of the Cannabis Drugs in India

Details

Author: I. C. Chopra, R. N. Chopra
Pages: 4 to 29
Creation Date: 1957/01/01

The Use of the Cannabis Drugs in India

Dr I. C. Chopra Pharmacologist
Col. Sir R. N. Chopra Director, Drug Research Laboratory, Jammu and Kashmir (India), Member of thc Expert Advisory Panel on Addiction-producing Drugs of the World Health Organization.

		Page			Page
I.	General considerations. Production of cannabis and its preparations	4	VI.	Causes leading to habitual use of cannabis	16
II.	Active principles of cannabis drugs-modes of consumption	6	VII.	Effect of habitual use of cannabis drugs on the individual	19
III.	Uses of cannabis in India	9	VIII.	Public health and social aspects of the habitual use of cannabis	22
IV.	Cannabis in Indian indigenous medicine	11	IX.	Physiological aspects of the habitual use of cannabis. Individual and racial variations	25
V.	Habitual use of cannabis for euphoric and intoxicating purposes - extent of the habit - its decline	13	X.	Control of production, possession and sale of cannabis drugs	28

CHAPTER I

General considerations. Production of cannabis and its preparations

Cannabis Plant

The cannabis drugs commonly used in India are derived from the flowers, leaves (and the resinous matter derived therefrom), fruit, young twigs and bark of the stem of the plant Cannabis sativa Linn. of the family Cannabinaceae. At one time, Cannabis indica Lamk. was considered as a distinct species, but the Indian plant has now been reduced to Cannabis sativa Linn. Even the plant growing under different climatic conditions in the vast Indo-Pakistan sub-continent shows remarkable variations in appearance; those variations at first may give the impression of separate species.

The plant has a widespread natural distribution in Asia and is found growing in abundance in the territories to the south of the Caspian Sea, in Siberia, in the Kirghiz desert in Russian Turkistan, in central and southern Russia and along the lower slopes of the Caucasus mountains. In China, where probably it is indigenous on the lower mountain tracts, it has been known since the sixth century B.C. It grows in an almost wild state in Iran.

In India the plant is found growing wild throughout the Himalayan foothills and the adjoining plains, from Kashmir in the west to Assam in the east. It has become acclimatized to the plains of India and grows even in the warm climate of southern India, producing its narcotic principles.

It is interesting to note that the cannabis plant and a few other plants such as the potato, tobacco and the poppy seem to have the capacity for growing with equal luxuriance under any climatic conditions. With the change of climate and the consequent alteration in the conditions of growth, however, some of the important characters of the plant are changed or modified. Thus in Europe, the cannabis plant produces a valuable fibre while showing little or no tendency to produce the narcotic principle, which, in Asia, constitutes its chief value. On the mountain tracts of upper India, the cannabis plant yields a fairly good fibre, but in Kashmir and Ladakh, its narcotic principles become much more predominant. When the plant is cultivated in the plains of India, the cannabis resin which constitutes charas is not generally secreted; but the young female flowers and shoots show a tendency to develop the narcotic principle instead, and these constitute the ganja of India. In other parts of India again, the narcotic property is often not developed in the cannabis plant until the fruits are mature.

The plant grows wild in the following states: Assam, Bihar, Madras, Uttar Pradesh, Punjab, West Bengal, Jammu & Kashmir, Patiala and East Punjba States Union, Rajasthan. Travancore-Cochin, Himachal Pradesh, Manipur and Tripura. The states where there is no wild growth include Bombay, Kutch, Madhya Pradesh, Orissa, Hyderabad, Mysore, Saurasthra, Ajmer, Coorg, Delhi, Andhra, Bhopal, Vindhya Pradesh and the Andaman and Nicobar Islands. On account of the widely scattered habitat of the plant, it is not possible to arrive at any reliable estimate of the total area under it. The wild growth appears to be less prevalent in the western and southern parts of the country. It is most luxuriant along the southern slopes of the Himalayas and along the eastern border of Assam up to an altitude of 10,000 feet above sea level.

Cultivation of the Cannabis Plant

Though the cannabis plant grows wild in many parts of India, it has to be properly cultivated in order to obtain for commercial purposes its fibre or its narcotic principles, as the case may be. For a good growth of the cannabis plant a rich, friable loamy soil, moist but not shady, is selected. The soil is amply manured with stable-yard manure rich in cow dung. When the plant is cultivated for the production of ganja, the soil is repeatedly ploughed and prepared into ridges one foot high and one foot apart. Seeds are sown on bright or sunny days in August. Seedlings are usually 6-12 inches high when they are ready for transplanting by the end of September. Trimming of the plants begins in November and consists of lopping off the lower branches so as to favour the upward growth of the shoots. All weeds are removed, and when the plants begin to form flowers, the services of an expert known as a "ganja doctor" (" Paddar" or "Parak-dar ") are requested. He goes through the field cutting down all staminate (male) plants, leaving what are colloquially known as "madi" (female) plants.

This operation is of the greatest importance in preventing seed formation. The presence of even a few staminate plants in the field may suffice to damage the entire crop, since in that case fertilization of the female plants takes place and most of the flowers run to seed. The ganja yielded by such plants is of poor quality and scarcely saleable. The female plants come to maturity about the beginning of January, but the ganja is not fully developed till a month later. The crop intended to be made into what is technically known as "flat ganja" is reaped a few days earlier than that for " round ganja ". The Indian Hemp-Drug Commission (1893-94) reported that the total area under cultivation for narcotic purposes did not exceed 6,000 acres. By 1935-36, however, this area had been reduced to only about 1,600 acres, and at present such cultivation has been further reduced to about 800 acres.

The cannabis drugs are used in India in three main forms - bhang, ganja and charas. Bhang is composed of the matured leaves and, in some parts of India, also the fruit of the cannabis plant. Ganja is derived from the flowering tops of female plants and twigs, which are covered with resinous exudation. Charas is the resinous exudation secreted by the leaves, young twigs, bark of stem and even the young fruit of the female cannabis plant.

1. Bhang

Bhang consists of the dried matured leaves and flowering shoots of both female and male plants, wild or cultivated. The inclusion of male plants and male flower-heads in the manufacture of bhang is of no special advantage, as the male flowers contain very little of the active principle. In fact, Prain, the famous botanist, stated that male flower-heads and shoots were excluded from the specimens of bhang he examined. There is little doubt, however, that in case of ordinary bazaar samples, male flowers are also included. Judging from the crude methods of collection and preparations in use, which consist simply of drying the plants and striking them against a block of wood so as to separate the leaves from them, a satisfactory separation of the male and female flowers is hardly to be expected. Apart from this, the refuse that collects on the kneading floor during the preparation of ganja is often also mixed with the bhang commonly sold in excise shops.

The narcotic principle in the plant develops only when it matures, reaching its maximum at about the time of flowering and then gradually declining and beginning to disappear when the leaves and flowers turn yellow. For the manufacture of good bhang, therefore, the leaves should be separated when they are just mature and when there are no signs of decay or withering. The time of collection varies in different localities, but generally the months of May and June in the plains, and July and early August in the hills are considered best.

2. Ganja

Ganja consists of the dried flowering tops of the cultivated female cannabis plant, which become coated with a resinous exudation, chiefly from the glandular hairs, in consequence of being deprived of the opportunity of setting seed. As the female plants begin to form flowers, all the large leaves on the stem and branches are also removed. The smaller leaves and the bracts of inflorescence become agglutinated into a mass called ganja. Fresh excise ganja has a rust-green colour with a characteristic odour. The material thus collected is further treated to form the ganja of commerce which appears in two forms : flat ganja and round ganja.

For the manufacture of flat ganja, the plants are cut about six inches from the ground and exposed to the sun for a few hours. The stems which do not bear flower-heads are then cut off and the flower-heads are laid on the grass and left overnight to the action of the dew. The following morning the plants are sorted into bundles and arranged in a ring on a mat with heads directed towards the centre and overlapping each other. Treading and kneading are then commenced and continued till the narcotic resin is pressed firmly among the flowers in the desired form. Fresh bundles are placed over those which have already been pressed, and the treading is repeated. This goes on till the ring rises to about one foot in height, the whole mass being then pressed together. The flowering twigs are removed from the stocks and beaten so as to shake off any redundant fruit or leaves which may be left. These twigs are then rearranged in a fresh circle so that the twigs from the top are brought down to the bottom and the whole process is repeated. On the following day, the whole sequence of operations is repeated again and again till the resin and flowers consolidate into a flat mass near the apex of the twigs. The mass thus prepared constitutes flat ganja

Round ganja

After the useless twigs and leaves have been rejected, the flowering tops are placed on the ground in a straight line below a bamboo pole fixed horizontally in such a way that the treaders can rest their arms and support themselves while treading or trampling. The plant is rolled so that the resinous material collects near the apex to form a sausage-like mass. The rolling is repeated several times; then each twig is picked up and trimmed separately. When the resin loosens, it is moulded into the desired form.

Chur or Rora Ganja

This is a third variety of ganja which is prepared from either flat or round ganja. Perfectly dry flat or round ganja is boiled in such a manner that the homogeneous mass is broken up into loose fragments of resinous matter. The fragments are usually distinct and do not stick to each other. This preparation resembles charas more closely than ganja and is believed to be more potent.

3. Charas

Charas is the resinous matter collected from the leaves and flowering tops and constitutes the active principle of the plant. As sold in this country, charas is a greenish mass with a peculiar characteristic odour. When kept for some time it turns to a brownish-grey colour, becomes hard and friable and loses most of its narcotic activity.

Although the cannabis plant when cultivated in tropical regions such as India, Africa and Malaya, is rich in narcotic principles, it seldom yields sufficient resin to be collected as charas. Charas is sometimes collected on the plateaus of central Asia and the southern Himalayas (Nepal), but both the yield and the quality are poor. The highest yield and best quality of charas resin are obtained from plants grown in Yarkand in Chinese Turkistan in central Asia. In that area there is an extensive natural growth of the plant at altitudes of 3,000 to 5,000 ft. above sea level, and it is also cultivated. The plant flourishes and reaches a height of 8 to 10 ft. It matures during the months of September and October, when on the top of each plant appear big tufts of flowers which are collected. The female flower heads are first dried, then broken and crushed between the hands into a powder which is passed through sieves so that it attains the fineness and consistency of sand or sawdust. This powder, which is still green, is stored in bags made of rawhide for four to five months during the winter. At the onset of hot weather, the material is taken out and exposed to the sun for a short time-sufficient to allow the resin to melt. It is stored again in hide bags of 10-14 lb. capacity. After a few days the agglutinated mass is again taken out and kneaded well by means of wooden rods so that a certain amount of oily matter appears on its surface. The process of kneading is continued till each bag yields about one to two pounds of oil. At this stage charas is transferred into new hide bags and is ready for distribution and sale.

Until recent years, the major part of the charas produced in Chinese Turkistan found its way into India through Leh in Kashmir, and was one of the important articles of trade between central Asia and India. This, however, is no longer the case, as the import of charas into India was entirely prohibited by the Government of India nearly two decades ago. The consumption of cannabis resin (charas) is prohibited everywhere in India. A certain amount of charas is, however, smuggled through the northern frontier and finds its way into India although a very strict watch is kept.[1] A certain amount is also prepared clandestinely from the cannabis plants growing in some hill areas of India and Nepal and finds its way into various contiguous states.

Area under Cultivation for Production of Ganja and Charas

(Hectares)

1893-94	1934-35	1950	1954
2,400 approx.	640 approx.	236.5	184

The states in which the cannabis plant is allowed to be cultivated at present are:

State	Area in hectares
Bihar	20
Orissa	6
West Bengal	60
Hyderabad	9
Madhya Bharat	71
Mysore	16

CHAPTER II

Active principles of cannabis drugs: Modes of consumption

Nature of the Narcotic Principles

Wood et al (1896) obtained the following constituents from genuine Yarkand charas:

1.5% of a terpene (C ₁₀H ₁₅), boiling point 165°C.
1.75% of a sesquiterpene (C ₁₅H ₂₄), boiling point 258-259°C.
A small amount of a paraffin hydrocarbon, melting point 64°C and
A toxic red oil, yield about 33% of the total, which set to a semi-solid mass on keeping.

This oil was insoluble in water but soluble in alcohol, ether, benzene and other organic solvents. It gave mono-acetyl and monobenzoyl derivatives and was termed cannabinol. It was considered to be the active principle of the drug. In a later paper (1899), the same authors showed that the cannabinol isolated was not a pure compound, but a mixture of at least two compounds having similar physical characters. They retained the name cannabinol for the pure compound C ₂₁H ₂₆O ₂which was obtained by hydrolysing the crystalline acetyl derivative (m.p. 75°C). Bauer (1927) concluded that cannabinol (crude) was not an ester, acid, aldehyde, ketone or phenol, but probably of the nature of a polyterpene. Other workers have obtained resins with apparently constant boiling point from cannabis and named these cannabinol, giving slightly varying formulae. Cahn (1931) analysed several different samples of hashish of uncertain origin and in every case obtained the same results which were confirmed when compared with cannabis resin of known Indian origin. His work corroborated that of Wood et al, according to which the term cannabinol should be applied only to the substance obtained from the acetyl derivative of m.p. 75°C and the resin with an apparently constant boiling point should be termed crude cannabinol. The resinous substance contained in cannabis is therefore considered the principle responsible for its physiological activity. The resin probably contains a number of compounds, one of which is cannabinol (Cahn) which is probably the active principle. Various formulae have been suggested for cannabinol, but the chemical constitution of this substance has not yet been finally determined. The presence of a substance of alkaloidal nature was suspected, but not confirmed.

Deterioration of the Narcotic Principle

There is no doubt that the narcotic principle of cannabis drugs deteriorates with age. The popular belief is that cannabis drugs retain their potency for a period of at least two years without appreciable loss. The experience of the excise authorities in the plains of India is that ganja retains most of its activity for one year, and during the second year it begins gradually to lose its potency until it becomes quite useless and unsaleable at the end of two years. According to Dixon, ganja exposed to the air and sunlight markedly depreciated in six months while a control sample, sealed and in the dark, was not particularly affected. The retention of physiological activity of the three types of cannabis drugs largely depends on the climate and on the care exercised during storage. Bhang is not as susceptible to deterioration as ganja and may keep in fairly good condition for three to four years, if not directly exposed to sun and air. This comparatively slow deterioration of bhang is reflected in the subjective symptoms complained of by bhang consumers, according to whom freshly collected bhang is very "heating and intoxicating ". Bhang stored for two years or more is "mildly stimulating and pleasure-giving ", and it is this particular type which is specially desired when joyful occasions are to be celebrated. Bhang kept for more than three years is used only as a soothing and cooling drink during the hot season and is generally considered to be devoid of practically all intoxicating properties. This opinion, apparently the result of long observations, may have a scientific basis. Bioassays carried out in Eli Lilly Company's laboratories showed that dry samples of cannabis lost activity at the rate of 1.0% per month over a period of five years. The dry drug in sealed containers did not retain activity appreciably longer.

With regard to charas, which was always an imported commodity, the opinion was that it was very potent during the first year, after which it gradually lost its activity until the fourth year, when it practically became inert and useless. Charas deteriorates rapidly when exposed to heat and moisture.

Modes of Consumption

Charas and ganja are mostly smoked, while bhang in India is always taken by mouth either in the form of a beverage or a confection. A number of preparations of ganja for oral consumption are, however, also used in various parts of the country.

Bhang Beverages. - Beverages made from bhang are known under different names in different parts of India. They are called thandai, siddhi, sawi and sukhe in the Punjab and Uttar Pradesh. In Bombay and central India they are generally known as bhang, ghota, or pang; in Bengal, sidhi; in Rajasthan and Madhya Pradesh, dudhii; in south India ramras or ram rasain.

The simplest bhang beverage consists of a drink made by pounding bhang leaves with a little black pepper and sugar, and diluting with water·to the desired strength. Various kinds of special beverages are prepared by the middle and well-to-do classes by the addition of almonds, sugar, iced milk, curds, etc. A number of other ingredients are often added to improve the taste and also possibly with the idea of enhancing the euphoric effect of the beverage. Among these ingredients, aniseed, ajawan, cucumber, melon and poppy seeds, rose petals, saffron, cloves, cardamom and musk are the most common. Pistachio nuts, asafoetida, liquorice, senna leaves and extracts derived from various other herbs are not infrequently added. Fruit juices such as those derived from pomegranate, date-palm and bael-fruit and also coco-nut milk form ingredients of such drinks. Besides improving the taste, these spices and flavourings are popularly believed to counteract the harmful effects of the regular use of cannabis drugs.

Ganja is sometimes employed in place of bhang in the preparation of these beverages. This practice is uncommon in northern India, but is often resorted to in Madras and Orissa, where the usual distinction between bhang and ganja is lost and the name "bhang" stands for any preparation of cannabis taken by mouth.

Bhang leaves are sometimes chewed for their sedative effects. This is done particularly at times when it is inconvenient for the habitué to prepare the beverage, as, for example, when travelling. During cold weather, when the system does not require large quantities of fluid or in the case of mendicants (sadhus and fakirs) who cannot afford the expense of preparing the beverage, the chewing of leaves may be substituted for the beverage. On festive occasions bhang may be incorporated in a variety of sweetmeats. Ice-cream containing bhang is also sometimes available in large towns during the hot weather.

Some of the special preparations of bhang and ganja commonly used in various parts of India for oral consumption are briefly described.

Majun. - This is a special type of confection on the preparation of which bhang or, very occasionally, ganja, is either heated in a little ghee (clarified butter) or boiled in water. The active resin, which is lighter, floats to the surface in the form of a green, jelly-like substance. This greenish scum is separated, then mixed with sugar and heated over a fire to form a paste which on settling is cut into small pieces. This majun is eaten either on the same day or within a few days of its preparation. In some parts of the country, notably in Madras and Mysore, the mode of preparation of this confection differs slightly. Powdered ganja is boiled in syrup of jaggery, and strained through a cloth. The residue is fried in ghee and various other ingredients such as black pepper, almonds and saffron are added to it, partly for flavouring purposes and partly to enhance its intoxicating properties.

Halwa. - Bhang or ganja is boiled in a jaggery syrup and filtered. The residue is discarded and the filtrate, which contains the active principles of cannabis, is used for preparing halwa in the usual manner with flour and ghee. This preparation is commonly used in southern India.

Curry. - Bhang curries are still used in some parts of India. The bhang leaves are powdered on a curry pounding stone in the same way as ordinary curry ingredients and used in preparing curries of various kinds, though it is difficult to say whether in the prolonged cooking involved, much of the activity of the drug is retained.

Churum. - Though formerly widely used in Madras and Mysore, this preparation is now rarely met with. Ganja is boiled in water till it forms a thick paste, which is strained through cloth. The whole mass is ground to a fine powder to which sugar and ghee are added. This preparation keeps for several months without spoiling or going rancid.

Besides these, there are special preparations which are prepared in Madras from Ganja:

Pillai legiyam - Ganja fried in ghee, strained, and mixed with sugar.
Purnadhi legiyam - Ganja washed several times in hot water, dried, powdered and mixed with ghee and sugar, dry ginger, pepper and spices.
Majiyam - A kind of fire-dried and powdered majun prepared from ganja and with palmyra jaggery, spices, and even added plantains.
Purnadhi - Ganja, dried ginger, sittarattai (lesser galingale), black pepper, nutmeg, cloves, mace, kurva, pattai, cinnamon, aniseed, liquorice, cumin, rose-buds, surat avari, gallnut, ghee and sugar, pounded together and heated over a fire till they take the consistency of a thick jelly. One-eighth of this is said to be ganja (excluding ghee and sugar).

Smoking of Cannabis. - Ganja and charas are commonly smoked. The equipment for smoking differs in various parts of the country, most widely used being a simple earthenware chillum similar to that used by the poorer classes for smoking tobacco, resembling a funnel with a wide base and a long neck. In addition to this, the smoker must have a brazier, a pair of tongs and a piece of cloth to be wrapped round the neck of the funnel. The method is simple. The ganja is first moistened with a little water to soften it and is then placed in the palm of the left hand and kneaded with the thumb and forefinger of the right hand to a pulpy mass. An amount of tobacco, a little less than the ganja, is then placed inside the chillum, the prepared ganja being placed on top of it. The usual practice is to put the kneaded ganja (or charas) between two thin pieces of broken earthenware, thus preventing the rapid combustion of the drug by the ignited charcoal and helping to reduce the temperature of the smoke, which might otherwise be too hot. A piece of glowing charcoal or smouldering cow-dung cake is placed with a pair of tongs on the chillum thus prepared. A piece of moistened cloth is then wrapped round the neck of the chillum, which is held between the palms of the hands. The mouth is applied to the opening formed between the thumb and forefinger of the right hand and the smoke is inhaled deeply into the lungs. The smoke is retained in the lungs for as long as possible and is then allowed to escape slowly through the nostrils, the mouth being kept shut. The longer the smoke is retained, the more potent are the effects obtained. Experienced smokers are able to retain the smoke for quite a long time.

Apart from the chillum method of smoking described above, ganja and charas are also smoked in the ordinary hookah or hubble-bubble, in which the smoke is allowed to bubble through water before being inhaled. It is the method commonly employed in the frontier districts of Pakistan and in West Punjab. Cigarettes containing bhang have recently been introduced in certain towns, but this practice is uncommon. Both bhang and charas are occasionally smoked in an ordinary tobacco pipe, but this method is not popular.

Charas is smoked in more or less the same way as ganja, except that it is usually warmed a little in the early stages and is mixed with approximately double its quantity of tobacco before being put in the chillum. Charas is generally considered to be a stronger preparation and therefore a smaller quantity of the drug is used or there must be a larger company to smoke it. Besides ganja and charas, bhang leaves are also smoked. This practice is, however, rare and exists only amongst the poorer classes who cannot afford to buy ganja or charas.

Although bhang, ganja and charas are preparations from the same cannabis plant, they differ in the amount of narcotic principles they contain. The physiological effects produced by all these are similar, though differing remarkably in their degree of potency. While bhang is usually taken by the mouth in the form of a powder or a drink, ganja and charas are mostly smoked. The effects produced by ganja when taken by mouth are prolonged and more lasting than when smoked. By the latter method the effects appear much more rapidly and intensely and pass off more quickly. Ganja is nearly four to five times more potent than bhang. The effects produced by the smoking of ganja are approximately twice as strong as in the taking of bhang internally. The effects produced by the smoking of charas are even stronger than those produced by ganja. When these drugs are taken as a food complement it is usually by smoking. The common practice of those who take ganja habitually is to take a few whiffs after a meal or after the day's work is done and when they are tired, in order to overcome the sense of fatigue. Such a use seldom leads to abuse and apparently does little harm. When used as an intoxicant and as a deliriant in large doses, these drugs, especially bhang and its preparations, impair digestion and produce nervous and mental symptoms which may bring into prominence some acquired or inherited mental weakness of the individual.

Admixture of Cannabis Drugs with Other Substances.-An important characteristic of the habitual use of cannabis drugs which needs emphasis at this stage is the tendency of the habitués to mix it with other substances before eating or smoking. Besides the use of simple flavouring agents already described, cannabis drugs are sometimes fortified with other active ingredients such as tobacco, alcohol, dhatura, opium and seeds of nux vomica. The presence of tobacco in the chillum along with ganja or charas presumably helps the drug to burn slowly and dilutes the smoke, rendering it less harmful and possibly also more pleasant and soothing. Veteran smokers who desire intense effects generally prefer to smoke the drug by itself, unmixed with tobacco. Dhatura is commonly used by addicts of long standing to increase the narcotic effects of cannabis. Less frequently, the juice of ak ( Calotropis gigantea), bamboo shoots, opium, arsenic and strychnine are added. Sometimes copper coins are boiled along with ganja or bhang leaves, as the decoction thus prepared is believed to possess tonic and blood-purifying properties. The addition of alcohol to cannabis beverages is not particularly common, though in certain parts of Baluchistan a drink called madra, containing dhatura, opium, bhang and alcohol used to be a popular intoxicant. In the Sholapur district of Bombay state, an alcoholic drink called boja used to be prepared by fermenting jowar grains to which cannabis and seeds of nux vomica were added.

(a) Modes of Indulgence.-Unlike opium and cocaine eaters, who generally seek solitude in order to indulge in these drugs, the cannabis habitués (both drinkers and smokers) prefer to smoke or drink in company. For this purpose they assemble (in certain places) in the afternoons or evenings; the morning doses, when they are needed, are usually taken at home. In some of the Hindu and Sikh temples and Mohammedan shrines in different parts of India, bhang is taken, much after the fashion of punch, from a common bowl. Even up to the present day, at the occasion of some festivals, a large iron vessel full of a bhang drink is sometimes kept for public consumption. It is rare to find habitués indulging in these drugs without company, except in the form of pills or sweets or at other occasions when company is not available. Our experience is that even those who have bought their own supplies always enjoy them in company if possible. It is a well known fact that there are certain meeting places of Mohammedan fakirs (takyas or dehras), as they are called, in almost every large town in northern India where the cannabis addicts congregate for this purpose.

In the case of charas and ganja, the chillum is handed round from one to the other, each person usually inhaling deeply the smoke until dazed before passing it on. Their object is to get a sense of well-being, all present combine to make the sitting as pleasant as possible, and social and caste distinctions disappear. When questioned as to the quantities of the drugs used, they state that two or three annas' worth of the drug can produce the required effects, or nasha. Although in most of the states there are at present no legal restrictions to indulging in bhang and ganja in company, there is little doubt that these parties are regarded with disfavour generally: such meetings lead young men to acquire the habit, and habitués will not infrequently commit petty thefts so as to obtain money with which to get a smoke.

The method of consumption is adapted to the effects desired. Smoking brings about an intense intoxication of a short duration (from a half to one hour) starting almost immediately after indulgence, and as the effect passes off there is a great desire for a repetition. Consumption by the mouth produces a milder effect lasting two to three hours or longer, and is usually adopted by those who wish a mild and prolonged euphoria- for example, the working-class habitués during the hot months in the plains of India. Intense intoxication is necessary to produce aphrodisia or a state of mind wherein all sense of relativity of time and space is abolished; for this people indulge in ganja and charas. In the large series of cases of cannabis habitués studied by Chopra & Chopra (1939) not more than 35% were smokers, and the remaining 65% took the drug by mouth in the form of beverage or preparations.

CHAPTER III Uses of cannabis in India

Cannabis drugs have been used in India from very early times in order to overcome fatigue and worry, for the production of euphoria and to give courage to warriors in time of stress.

The present use of these drugs in India runs in three main channels:

Medicinal and quasi-medicinal use.
Use in connexion with religious and social customs.
Euphoric purposes.

Medicinal and Quasi-medicinal Uses

(a) Cannabis in Western Medicine.-The introduction of cannabis into modern western medicine may be traced back to the period when Napoleon's expeditionary forces occupied Egypt. The members of the scientific commission which accompanied this army were greatly impressed by the local reputation of the drug, and began to use it extensively in the French Army for its pain-relieving and sedative effects. In India, O'Shaughnessy (1839) tried cannabis as a sedative for the central nervous system in such diseases as tetanus, hydrophobia, rheumatism, chorea and convulsions in children. Clinical trials carried out by physicians on Indian patients at that time showed it to be a" useful anodyne, hypnotic and antispasmodic next only in value to opium ". Later it was used on patients undergoing surgical operations and it was shown that the drug undoubtedly had mild anaesthetic and some pain-relieving properties. During the period that followed the report of these early observers, cannabis was used for its analgesic and hypnotic effects in such affections as asthma, neuralgia, tinnitus, dysmenorrhoea, muscular and joint pains, etc. It was also used to relieve the lightning pains of tabes, formication, numbness, paraesthesia, convulsions, etc. Cannabis euphoria as a means of combating mental conditions of a depressive character proved successful in some cases. On account of its diuretic and sedative properties a decoction of cannabis leaves was used in the treatment of cystitis and urethritis. Preparations of cannabis also found a place in the British Pharmacopoeia and were used quite extensively at one time in the practice of western medicine in this country. For the last twenty or thirty years, however, their use has gradually declined. The main reason appears to be that cannabis preparations deteriorate rapidly and their potency was thus variable and uncertain. During the last decade or so cannabis preparations have not figured at all in the practice of western medicine in India. We have recently made inquiries from some of the large hospitals attached to the medical colleges and other institutes and our belief has been confirmed that cannabis is hardly used in the practice of modern medicine in this country at the present time. Most of the eminent physicians to whom inquiries were addressed said that they have neither used nor are willing to use cannabis preparations in their practice. Cannabis has been excluded from the British Pharmacopoeia and has also been deleted from the B.P. Codex. It was still official, however, in the Indian Pharmacopoeia of 1954 and two preparations (a liquid extract and a tincture) are listed.

Cannabis undoubtedly has remarkable therapeutic properties. Unfortunately its chemistry is still not quite clear. It is possible that studies, particularly on the synthetic variations which might be produced from it, may bring out advantages to be derived from its use as a therapeutic agent. In contrast with opium and its derivatives, the drug has no constipating action, it does not depress the respiratory centre; and there is little or no liability to addiction formation.

(b) Uses in Veterinary Medicine.-For diseases of cattle, cannabis leaves are frequently used mixed with such ingredients as spices, salt or sugar candy. A decoction is made by boiling cannabis leaves, and a certain amount of sugar is added to make a slightly sweetened drink readily acceptable to the cattle. Sometimes the animals are exposed to the fumes of burning leaves in the hope that the smoke will be absorbed through the lungs and produce its effects. The smoke produced by burning cannabis plants is used as a disinfectant for sheepfolds. Ganja is considered to be a good remedy against intestinal worms and" foot sore" disease. It is often administered to bullocks as a tonic, to relieve fatigue and to impart additional staying power. Pills containing ganja or charas and also opium and arsenic which can be administered with bran or grass, are made for this purpose. Bhang is sometimes used to increase the flow of milk in cows and also to keep them under control if they are troublesome at milking-time. On account of its supposed aphrodisiac properties bhang or ganja is occasionally given to mares shortly before they are mated. Bhang mixed with salt is often administered to cattle as a household remedy, as a preventive against diarrhoea which is a common occurrence in India among cattle during the monsoon months. Such use is largely based on hearsay and tradition. The sedative effects of cannabis are used in this country in veterinary work.

(c) Cannabis as a Household Remedy.-Cannabis preparations are popularly used as household remedies in the treatment of many minor ailments. A mild beverage made from bhang leaves is believed to sharpen the appetite and help the digestion. Religious mendicants who roam throughout India often carry bhang with them and use it for all sorts of gastrointestinal and rheumatic troubles from which they frequently suffer on account of exposure to inclement weather. They also recommend it to the ignorant and credulous people in rural areas for these ailments. Cannabis is also largely used for its soothing effects by those exposed to severe physical and mental strain. It was commonly used as a smoke and as a drink for its supposed prophylactic Value in malarial regions. Bhang beverages form one of the popular household remedies for gonorrhoea and dysuria. On account of their mild diuretic and sedative properties these drinks probably give a certain amount of symptomatic relief. Likewise, the use of bhang in dysmenorrhoea, asthma and other spasmodic conditions is quite common among the ignorant masses in rural areas. A poultice made from the powdered leaves is applied to sores and open wounds to stimulate healing. Warm poultices are also applied to inflamed piles, and fumigation with smoke from burning ganja or bhang is reputed to relieve the pain. A poultice made from fresh leaves is a common household remedy for painful affections of the eyes, conjunctivitis, swollen joints, orchitis and other acute inflammatory conditions. A fragment of charas is often placed in the cavity of a carried tooth to relieve toothache.

The belief regarding the stimulant effects of cannabis on the sexual organs has existed for a long time among a section of the population. In moderate doses cannabis is believed to promote sexual desire, and it is not an uncommon practice among the younger newly married folk to drink beverages and eat sweets containing bhang. Among profligate women and prostitutes, bhang sherbet used to be a popular drink in the course of the evening when their paramours visited them. This practice has, however, been replaced by the use of alcohol. Whether bhang in doses in which it is taken produces any stimulant effect at all on the sexual faculties is not clear. According to the physiological data obtained, it is possible that cannabis by its action on the higher centres of the brain may excite ideas or possibly desire of a sexual nature. No experimental data, however, are available to show that cannabis has any specific action on the lower sexual centres in the spinal cord or a direct effect on these organs.

The dry leaves powdered, mixed with sugar and well fried in ghee with black pepper or poppy seeds added, form a household remedy for the treatment of chronic diarrhoea and dysentery. About half a dram of dried tender leaves mixed with a little sugar and black pepper powder is also used in rural areas in the treatment of acute or chronic diarrhoea. Combined with asafoetida it is given in hysterical conditions.

A poultice made by boiling bhang leaves is applied to inflamed piles or inflamed skin surfaces. Powder made from dried leaves is applied to fresh wounds to ease pain and promote healing.

Certain special preparations are occasionally indulged in for aphrodisiac and euphoric purposes. Some are made at home from the plant growing wild. Some are prepared by Hakims and Vaidyas, and there is a large demand for them. Among those commonly used nowadays may be mentioned jate phaladya churna, jayanal rasa, madananda modka, kamesh-wri modka. These preparations are frequently used by both young and middle-aged individuals for stimulating sexual desire and prolonging the sexual act.

Uses in Connexion with Religious and Social Customs

The cannabis plant is regarded by the Hindus as holy, and the origin of this conception can be traced to the Vedic period. In the Atharva Veda, the plant is described as a sacred grass, and the guardian angel of mankind is supposed to residein its leaves. According to one legend, the cannabis plant is believed to have been brought out from the ocean by the God Shiva, when all the gods churned it in order to extract "nectar" from it. According to another account, the "nectar" dropped on the earth from heaven and the carmabis plant sprang up from it. These accounts regarding its origin have naturally given bhang a unique position amongst credulous Indian folk, and often cannabis is mentioned with reverence and included among objects which are believed to bring luck. Indeed, such was the popularity of this plant that to meet a man carrying bhang was regarded as an omen of success; similarly, cannabis plant in a dream was regarded as being lucky. Much of the sanctity attached to bhang is put down to its supposed properties of" clearing the head and stimulating the brain to think ".

Cannabis drugs are often taken by ascetics and religious mendicants to overcome hunger and thirst, and under its influence they can go without food for a number of days. These drugs are further believed to help those who are religiously inclined in concentrating on the Supreme Being. It is probable that on account of these supposed effects, bhang has played an important part in many of the rituals performed in some of the Hindu temples. Though there is hardly any mention of the use of cannabis in the Shastras, the Tantras, which are a later production, abound in references regarding the use of bhang in many religious ceremonies. On Shivratri or the Shiva's Night, drinks containing bhang are poured on the "Shivalinga" all night. Classes such as Banias and Bhatias offer richly spiced bhang to Baldev, elder brother of Lord Krishna, and all the devotees present during the ceremony partake of it. The orthodox high-class Hindus, who are forbidden the use of alcohol, are allowed to drink bhang sherbet after a fast. Some of the old records from Rajasthan show that "sidhi" or bhang was often drunk in order to propitiate Shiva in time of war. It is stated that the Rajputs used to drink bhang as a stimulant to courage at the time of battle when courageous deeds had to be performed against their enemies.

In Bengal, for instance, the custom still persists among certain classes of offering a beverage prepared from the leaves of the cannabis plant to the various family members and to guests present on the last day of Durga Puja (Vijaya Dasmi) which is the biggest Hindu festival in that state. In Tara-keshwar temple in Bengal, ganja is used as an offering on the Shivratri (Shiva's Night). Less commonly, it is used in other religious festivals such as Trinath Puja, a religious ceremony observed also by certain Mohammedan sects in a slightly different form. In Puff (Orissa) one of the greatest places of Hindu pilgrimage in India, ganja and bhang are largely used by the attendants and worshippers of the god Jagannath. In the Uttar Pradesh, where Durga Puja is observed in a manner similar to that in Bengal, the use of bhang is not so much in vogue. It is also taken by certain classes on the occasion of the Holi and Dewali festivals, marriage ceremonies and other family festivities. Among the Sikhs, the use of bhang as a beverage was quite common twenty or thirty years ago, and these beverages were freely distributed to devotees visiting some of their religious places and shrines. Drinking of bhang is also in vogue in !Kajputana at the festival of Kama (Indian Cupid) by the Rajputs of Bondil. In central India, ghota is used among the lower classes at the time of different festivals. Shiva worshippers in Bombay generally use ganja, while the Marwaris and merchant classes, who belong to such religious sects as the Jains, use bhang on festive occasions. In Madras state, the use of cannabis drugs on religious and social occasions is less common than in other states. Assam is the only state where bhang is practically not used at all at present, probably because of the prevalence there of the use of opium.

To certain sects of Mohammedans, the plant is an embodiment of the spirit of the prophet Khizer Elijah, the patron saint of water (" Khizer " means "green colour of the drink made from bhang "). Many Hindustani poets, especially Nasir, have immortalized bhang by eulogizing it in their poems. The drug is mentioned by some Mohammedan poets as "warak-al-khiyal" or "fancy's leaf". In Persian literature it is known by various names such as "joy-giver ", "sky flier", "heavenly guide", "poor man's heaven ", "soother of grief", etc. The Mohammedan fakirs revere bhang as the "giver of long life" and they consider that it frees them from worldly bonds, and induces communion with the divine spirit.

The use of cannabis in connexion with religious and social practices is still met with in almost all the states of India among the lower strata of the population, though to a much lesser extent now than in the past. Brahman priests of Mathura, Brindaban and some other well-known places of pilgrimage are notoriously addicted to the use of bhang even now.

From the foregoing description it is evident that the use of cannabis drugs in social and religious customs among certain classes is still in vogue, though it has considerably decreased during the last two or three decades. Even today a religious mendicant smoking ganja is not only tolerated, but is looked upon with some veneration by ignorant people and is even considered to possess supernatural powers of healing disease and infirmities. Sects of sanyasia mahantas, mantra-data gurus or religious preceptors are held in great respect although they indulge freely in cannabis drugs. In fact, making them an offering of cannabis is considered an act of piety.

The enormous influence that cannabis and its associations had on the mind of the credulous and ignorant classes in India and the tradition that was built up around it can thus be easily imagined.

CHAPTER IV Cannabis in Indian indigenous medicine

Historical and General

Reference to cannabis drugs is found in the classical literature as well as in old medical works of many countries in the world. In Indian literature the earliest reference to the word " bhang " occurs in the Atharva Veda, which, according to western scholars, dates as far back as 2000 to 1400 B.C. Whether the term was used at that time to mean only a particular species of a sacred grass, or the true cannabis plant, is an open question. The reference to the flowers of plant as bhang in the works of Panini ( circa 300 B.C.), however, appears to be fairly reliable evidence that probably the true cannabis plant was meant. There appears to be no doubt that the cannabis plant was believed by the ancient Aryan settlers of India to possess sedative, cooling and febrifuge properties.

The first mention of the use of bhang as a medicine occurs in the works of Susrata, believed to have been written in the sixth or seventh century where it is described as an anti-phlegmatic. In the tenth century the narcotic and pain-relieving properties of the plant seem already to have been recognized, and in the fourteenth century these were certainly well known, as they are frequently mentioned in the dramatic literature of that period. The occurrence of such names as "vijaya" (unconquered), "virapatia" (hero-leaved), "ganja ", "capta" (light-hearted), "ananda" (joy), "trilok kamaya" (desired in the three worlds), and "harshini" (the rejoicers) indicate amply that the intoxicating and pleasure-giving properties of the drug were well known. The other names for bhang occurring in the books of Hindu medicine are: ranjika, bhanga, tandra krit, bahuvidini, madini, madika and madu.

Cannabis in the Ayurvedic Medicine

In Susruta, the well-known treatise on Hindu medicine, cannabis leaves are recommended along with a number of other drugs as antiphlegmatic, as a remedy for catarrh accom- panied by diarrhoea, and as a cure for biliary fever. In Rajanirghanta, edited by Narahari Pandita (A.D. 300) and again published in A.D. 1500, a detailed description was given of the cannabis plant and its medicinal properties. The drug is described as astringent and soothing, and is also credited with the power of dissolving phlegm, relieving flatulence, reducing costiveness, sharpening the memory and exciting the appetite. In Sarangadhara Samhita, a medical treatise believed to have been written during the Mohammedan period, the drug is mentioned as a general stimulant. In Dhurtasamagama (A.D. 1500), ganja is described as a soporific which "corrects derangements of humours and produces a healthy appetite, sharpens the wit and act as an aphrodisiac ". In Bhavaprakash (A.D. 1600), cannabis is mentioned as "antiphlegmatic, pungent, astringent and digestive ". On account of its marked narcotic properties it was probably also used as an anaesthetic, sometimes combined with alcohol, by the ancient Indian and Chinese surgeons. Cannabis is also considered to have an aphrodisiac action by the Hakims and Vaidyas and a number of preparations are mentioned in the books of these systems for this purpose.

In the Ayurvedic or Hindu medicine the properties of cannabis are described as follows:

^{Paphahari: Promotes loosening, separation and the elimination of phlegm.}

^{Grahini: Promotes retention and binds the bowels.}

^{Pachani: Promotes digestion.}

^{Ushna: Promotes heat.}

^{Pitala: Excites the flow of bile.}

^{Mada-vardhani: Promotes talkativeness or releases the volitional restraint of speech.}

^{Moda-vardhani: Promotes happiness.}

^{Vag-vardhani: Stimulates the digestive fire.}

^{Dipani: Stimulates appetite.}

^{Ruchya: Promotes taste.}

^{Nidraprada: Hypnotic.}

A perusal of what has been said above will show that cannabis was quite an important drug of the old Hindu materia medica. On account of its undoubtedly potent medicinal properties in the fresh and the dried forms, it was utilized in the treatment of various diseases met with at that time, both as a curative and as a palliative. Even at the present time it is extensively used by the Ayurvedic practitioners.

Cannabis in Mohammedan Medicine

In the early literature of Arabian and Persian medicine, cannabis is frequently mentioned. The earliest reference occurs in a treatise by Hassan in A.D. 658. An interesting anecdote of the discovery of the cannabis plant records the story of a monk who, after eating leaves of the plant to appease his hunger, felt an extraordinary feeling of exhilaration: the peculiar properties of the leaves gradually became known, and ultimately a decoction prepared by soaking hemp leaves in wine or spirit became the favourite drink of the Haider sect to which this monk belonged.

In the Arabian Nights, there are frequent references to cannabis under the old name " benj ". The Arabic benj and the Persian name beng are so closely related phonetically to the Sanskrit bhanga that there is a strong presumption of their origin from the latter source. The Greek name " kannabia " and the Latin name " cannabis " probably owe their origin to the Arabic " kinnab " or " konnat ", which means hemp. The term " hasish " in Arabic signifies a green intoxicating liquid containing cannabis. The Hebrew word " sesha ", meaning flux, is apparently a kindred derivative. It would thus appear that the knowledge about cannabis must have originated first with the Hindus, passing subsequently to the Arabs, the Persians and the Jews.

Rumphius (A.D. 1095), in the Herbarium amboinence, stated that Mohammedans frequently use the male cannabis plants against gonorrhoea and asthma and in the treatment of a condition popularly called " stitch in the side ". He also adds that the powdered cannabis leaves are stomachic and check diarrhoea and excessive biliary secretion. He mentions the use of cannabis as an enema in strangulated hernia, and as an antidote in poisoning with orpiment. In Makhsanul aldawaiya, the well-known Arabic book on materia medica, the author dwells on the wonderful properties of the cannabis plant. It is said that bhang is one of the best of God's gifts, it is " a cordial, a bile absorber, and an appetizer, and its moderate use prolongs life. It quickens the fancy, deepens thought and sharpens judgment ". The chief qualifies attributed to cannabis are therefore those of a stimulant as well as of a sedative. The oil expressed from the cannabis seeds is known as kandiryak and is used in Kashmir as well as in certain parts of the Punjab for external application against rheumatic pains.

In Tibbi or Mohammedan medicine the properties of cannabis are as follows:

^{Madakari: Promotes insanity.}

^{Shukra-stambhan: Promotes retention and the control over ejaculation.}

^{Murchakaraka: Causes the loss of consciousness.}

^{Hritdaurbalya-karaka: Causes the weakness of heart.}

^{Vedanastapani: Analgesic.}

^{Virya-shodhan: Inhibits the secretion of semen.}

Cannabis in the Practice of Indigenous Medicine in India

Bhang and ganja are prescribed extensively by Hakims and Vaidyas in bowel complaints and are recommended as appetizers, as nervous stimulants and as a source of great staying-power under conditions of severe exertion or fatigue. Pulverized dried leaves are used as snuff " for clearing the brain ". The juice extracted from the leaves is applied to the head to remove dandruff and vermin. Dropped into the ear it is said to allay pain. It is also believed to destroy worms. It cheks the discharge from the intestines in diarrhoeal conditions and also the urethral discharge in gonorrhoea. A powder made from dried leaves and bark applied to fresh wounds and sores is believed to promote granulation. A poultice made by boiling the roots and leaves of the cannabis plant is applied locally to inflamed surfaces such as erysipelas, haemorrhoids, etc. as an anodyne and sedative. It is believed to be useful in various forms of neuralgia, from which people in India suffer frequently. The pulverized leaves are given internally in doses of 40 grains.

Externally, a poultice of the fresh bruised leaves is used in affections of the eye accompanied by photophobia. Spread on castor-oil leaf, it is applied to relieve pain and swelling of orchitis and is believed to be a cure for hydrocele.

The concentrated resin exudate (resinous matters) extracted from the leaves and flowering tops of agglutinated spikes of cannabis, and known as nasha or charas, which contain the active principle of the drug, is used to produce sleep in conditions of insomnia, in which opium is contra-indicated. It is considered valuable in preventing and curing sick-headaches, neuralgias and migraine (malarial and periodical) and an excellent remedy in the treatment of acute maniacal conditions. It is considered a sovereign remedy for relieving pain in dysmenorrhoea and menorrhagia, and against dysurea. Since it does not produce loss of appetite and constipation as opium does, it is often used in place of that drug. Practitioners of indigenous medicine in India use it in the treatment of tetanus, heat stroke and cough, and as an antispasmodic in asthma and whooping cough. The dose of the extract is from ? to 2 grains, repeated if necessary two or three times a day. In case of chronic colic the administration of 1 to 2 grains of the extract in combination with ? grain of ipecacuanha root bark powder is considered useful.

Numerous concoctions of bhang are described and used. These are, as their names imply, considered aphrodisiac and are used in chronic bowel complaints and nervous debility. Most of these contain a number of supposed tonic and reputed aphrodisiac substances in small quantities, and a quantity of bhang equal in weight to all the other ingredients together, with the addition of sugar, honey and the usual aromatics. Majun would be a neater substitute for these complicated preparations.

The following preparations containing cannabis are used in the indigenous medicine at the present time:

	Name of preparation	Disease against which used
1.	Madnanand modak	Tonic with aphrodisiac action.
2.	Trailokya vijaya vati	Mania, renal colic, dysmenorrhoea.
3.	Jatiphaladi jog	Dyspepsia, bronchitis and sprue type of chronic diarrhoea.
4.	Lai chourna	ditto
5.	Vijayableh	ditto
6.	Grahni shardool	Diarrhoea, dysentery and fever.
7.	Brehat myka ch.	Coryza, cough, piles, diarrhoea, dysentery and sprue.
8.	Gangadhar ch.	Diarrhoea, sprue, fever, cough, coryza.
9.	Swalp nayaka ch.	Chronic diarrhoea (sprue type).
10.	Mundyadi vatika.	ditto
11.	Kamashwar modak	Asthma, cough, piles, indigestion, debility.
12.	Madan modak	ditto
13.	Agni kumar modak	Asthma, cough, gout, sprue.
14.	Jatiphaladi vati	Diarrhoea, cough, acidity, piles, sprue.
15.	Kumari asava	Cough, piles, tumor or swelling in abdomen.
16.	Laxmi vilas (nardya)	Fever.
17.	Trailokya samohan	Tonic with aphrodisiac action.
18.	Madhya nayika ch	Diarrhoea, cough, asthma, colic, gout and piles.

To summarize the situation with regard to the use of cannabis in Indian indigenous medicine at the present time, it may be said that it was and still is fairly extensively used in both the Ayurvedic (Hindu) and Tibbi (Mohammedan) systems of medicine as an anodyne, hypnotic, analgesic and antispasmodic, and as a remedy for external application to piles. It is also used in the treatment of dysmemorhoea, rheumatism, chronic diarrhoea of the sprue type, gonorrhoea, malaria and mental diseases on the advice of itinerant practitioners of indigenous medicine as well as quacks who roam about the country. For medicinal purposes the drug is administered by mouth and hardly ever by smoking.

The use of cannabis drugs in indigenous medicine has greatly declined during recent years for two reasons-firstly, because of the rapid deteriorations of the potency of cannabis drugs in storage, the specimens available on the market being often inert and quite useless; secondly, because a number of potent and effective drugs of the type used in western medicine are now available on the market and are used quite extensively by the practitioners of indigenous medicine in place of cannabis, for their anodyne, sedative and hypnotic effects. In the rural areas of India, however, the practitioners of indigenous medicine still use cannabis quite extensively in their practice

CHAPTER V Habitual use of cannabis for euphoric and intoxicating purposes - extent of the habit - its decline

Cannabis drugs are reputed to alleviate fatigue and also to increase staying power in severe physical stress. In India, fishermen, boatmen, laundrymen and farmers, who daily have to spend long hours in rivers, tanks and waterlogged fields, often resort to cannabis in some form, in the belief that it will give them a certain amount of protection against catching cold. Mendicants who roam about aimlessly in different parts of India and pilgrims who have to do long marches often use cannabis either occasionally or habitually. Sadhus and fakirs visiting religious shrines usually carry some bhang or ganja with them and often take it. It is not an uncommon sight to see them sitting in a circle and enjoying a smoke of ganja in the vicinity of a temple or a mosque. Labourers who have to do hard physical work use cannabis in small quantities to alleviate the sense of fatigue, depression and sometimes hunger. A common practice amongst labourers engaged on building or excavation work is to have a few pulls at a ganja pipe or to drink a glass of bhang towards the evening. This produces a sense of well-being, relieves fatigue, stimulates the appetite, and induces, a feeling of mild stimulation, which enables the worker to bear more cheerfully the strain and perhaps the monotony of the daily routine of life. The low cost and easy availability of these drugs are important factors in their use by the working classes, whose economic condition is low in this country. Cannabis drugs are perhaps the only narcotic drugs which fall comfortably within their meagre means, and they make use of them as occasion arises. A dose worth an anna or two (1 to 2 U.S. cents) is often sufficient for producing the desired effect in a few individuals.

Cannabis drugs are also sometimes used to induce a state of intoxication which will excite emotion and give a sense of bravado so that daring acts may be committed. We already mentioned the fact that the Rajput warriors, during their frequent encounters with the Mohammedan invaders in the old days, used to indulge in bhang to banish fear and nervousness. This practice is met with even now in connexion with wrestling contests and athletic sports and games entailing great physical effort and endurance. Robbers and dacoits also use these drugs when undertaking hazardous exploits. Indulgence in cannabis drugs, unlike alcohol, rarely brings the habitué into a state of extreme intoxication where he loses entire control over himself. As a rule, the intoxication produced is of a mild nature, and those who indulge in it habitually can carry on their ordinary vocations for long periods and do not become a burden to society or even a social nuisance.

The use of cannabis for euphoric and intoxicant purposes, although quite common twenty to thirty years ago, has gradually declined, and at the present time it is almost entirely confined to the lower strata of society. Amongst the upper and middle classes, the use of cannabis is nowadays considered to be derogatory, in spite of the fact that the practice was held in great esteem in ancient India, and early literature is full of references to the virtues of this drug. This change in outlook with regard to indulgence in cannabis is not difficult to understand. One reason is that cannabis drugs are popular with the lower strata of society, which contain a large number of undesirable and criminal elements, and the well-to-do and respectable classes are giving them up on account of this association. Another and perhaps a more important reason for the decline of the use of cannabis as a euphoric is probably traceable to the peculiar blunting of the sense of relativity produced by the drug, whereby the idea of time and space may be lost. By affecting the higher nervous pathways concerned in the balanced co-ordination of time and space, cannabis, unlike other drugs which produce euphoria, is more likely to place the habitué in an awkward position and bring him into ridicule. Behaviour problems are also known to arise commonly with the use of cannabis. These lapses naturally become immediately apparent in social and club life and make the company of such persons undesirable. The upper and. middle classes, therefore, abstain from the use of these drugs as far as possible. Whatever may be the reasons for it, statistical data undoubtedly show a marked decrease in the consumption of cannabis drugs during recent years, especially among the upper classes.

Abuses of Cannabis Drugs

Cannabis preparations are rarely employed to produce a state of intoxication so intense that the individual may lose all control over himself. Although their habitual use is common in India, these drugs are not often indulged in to such an extent as to constitute a definite abuse and menace. The deliberate abuse of bhang is met with almost entirely among certain classes of religious mendicants in this country, their main purpose being to get into a state of frenzy which, according to their traditional ideas, induces mental concentration and communion with God. Such a frenzied state is used as a cloak for impressing the credulous illiterate masses and creating in them a sort of religious fervour. A large number of religious fanatics in temples and in places of pilgrimage undoubtedly indulge in the use of cannabis habitually, and the addiction is sometimes of a very long standing, large doses being taken.

Others prone to abuse cannabis are to be found in the nomadic classes, living in small camps by the roadside and exposed to all conditions of inclement weather.

It is commonly believed that bhang drinking is relatively less harmful than the practice of smoking ganja and charas. There appears to be a good deal of truth in this popular belief. Although the use of bhang as a cooling beverage is common in many parts of India, cases of excessive indulgence are not frequent and instances of frank abuse and harmful effects following therefrom are as a rule uncommon. This, of course, does not mean that bhang does not produce any deleterious effects on the system. Impairment of digestion is a common symptom in bhang drinkers of long standing, who take excessive quantities. This naturally results in injury to their general health and vitality. There is a definite and demonstrable stimulation of the cerebral and medullary centres, but this is seldom intense, and the harm done is therefore comparatively small.

The smoking of ganja and charas, on the other hand, although affecting the digestion to a lesser extent, brings about a state of intense intoxication as a result of its action on the higher centres of the brain, and, if the abuse is continued for a considerable time, may lead to mental derangement, behaviour problems, crime and insanity. These habits, therefore, constitute an important social problem in India. Moreover, ganja and charas are possibly more likely to produce intense addiction than bhang. Habitual use of bhang can be discontinued without much trouble, but withdrawal from the ganja and charas habits, in our experience, is more difficult to achieve, and is sometimes accompanied by unpleasant symptoms, though they are negligible compared with those associated with withdrawal from opiates and even cocaine.

Total Consumption of Cannabis for all Purposes in India

It will be interesting now to consider the present extent of the use of cannabis drugs in India as a whole, for all purposes to which reference has been made heretofore. The only reliable figures we have in this connexion are those obtained from the excise departments of various states of India. They are given below and are the sum total of the figures supplied by various states to the Central Government.

Total Consumption of Cannabis Drugs in India

1912-13	1934-35	1950	1954
1,993,592 lb.	1,031,496 lb.	983,565 lb.	924,051 lb.
(906,178 kg.)	(468,862 kg.)	(447,075 kg.)	(420,007 kg.)

The total consumption of cannabis drugs of all description in 1912-13 was 1,993,592 lb. (906,178 kg.) and in 1934-35 it amounted to 1,031,496 lb. (468,862 kg.) in what was then known as British India (excluding the former princely states where there was no excise control). The figures for 1950 are 983,565 lb. (447,075 kg.) and for 1954, 924,051 lb. (420,007 kg.) including the former princely states - which have now ceased to exist as such - exclusive of what is now Pakistan. It would appear, therefore, that the use of these drugs has been considerably reduced during the past three or four decades.

Uttar Pradesh showed the largest quantity of cannabis consumption in 1934-35 - i.e., 287,926 lb.; next in order came the Punjab of pre-partition days with 180,020 lb., Madras with 89,172 lb., then Bihar and Orissa with 85,468 lb., and Bombay with 79,566 lb.

These figures do not, however, represent the whole truth. The amount of cannabis taken directly from the wild growth is not inconsiderable, and this has not been taken into consideration, as no figures are available and it is even difficult to make an approximate guess. It may be argued that this source was also available in 1934-35, but against this it may be stated that because of the general administrative measures taken to reduce the consumption of cannabis during recent years (since 1934-35) and of the increase in price of the excise product, habitual consumers have in all probability resorted more and more to this source during recent years. We will refer to this in chapter X.

Extent of the Cannabis Habit. - The total consumption of cannabis in the form of bhang, ganja and charas according to excise returns was 1,031,496 lb. in 1943-35, in what was then known as British India, and this worked out to approximately 4.24 lb. per 1,000 population per annum (census 1931). The figures for the same area for 1912-13 worked out at 15 lb. per 1,000 population per annum. The incidence of the habit as estimated by Chopra & Chopra (1939) after extensive studies in the field ranged between 0.5% and 1.0% of the population of the sub-continent. The largest number of habitual users were in Uttar Pradesh, the Punjab, Madras, Bengal, Bihar and Bombay, in order of incidence. In these areas the habitual use was not restricted to any particular community, but was largely found in the lower strata of society, extending even to the middle classes. Incidence of the habit was highest in Sind and contiguous areas of Rajasthan, with a consumption of 35.12 lb. per 1,000 of population per annum.

A study of the excise figures of the sale of cannabis preparations showed clearly that the consumption of these drugs in India generally declined from 1912-13 onwards and by 1934-35 had fallen to almost half of what it was two decades previously. It was also shown that the incidence of the habitual use of cannabis in the country as a whole in 1953-54 had come down to almost one-fourth of what it had been in 1899-1900. The reduction was steadily progressive except during the decade 1910-20 (World War I). The higher incidence, then, may be ascribed to the war-time and post-war conditions which followed, as the areas which showed such rises were those where the population was most affected by the war. There have certainly been no indications of extension of the use of these drugs even up to the, present time (1956) as shown by our recent investigations. It was also concluded that the cause of decline of the habit was undoubtedly the tightening of government control - a substantial reduction of the area under cannabis cultivation and a great increase in price due to higher excise duty.

The incidence of the habitual use of cannabis was higher in urban than in rural areas. Large industrial towns or large agricultural centres, as a rule, have a large labour population in poor economic circumstances. They have to work very hard, and they usually indulge in these drugs because they are cheap. Thus in large industrial towns such as Calcutta, Bombay, Madras, Ahmedabad and Kanpur the consumption was high on account of the large number of labourers residing there. Such was also the case in large coal-mining areas, because working hours were long and tedious, and social, hygienic and economic conditions were such as to lead to the use and even abuse of narcotic and euphoric drugs. Religious centres and important places of pilgrimage also showed a high incidence in the use of cannabis owing to the presence of numerous mendicants who assemble in such places for various reasons.

On the other hand there were large areas in the country where the use of cannabis was non-existent, next to areas where habitual use ran very high. Instances of occasional use of cannabis are not so common at the present time in connexion with social and religious customs, and as a rule little or no cannabis preparations are used among the middle and upper classes on any such occasions.

It is also clear that the three preparations of cannabis drugs - i.e., bhang, ganja and charas were used till about 1934-35, when the import of charas was entirely stopped by the Government of India. An account of excise figures for 1934-35 is given below.

The use of these three preparations showed considerable variations in different parts of the country. Charas was mainly used in the northern and western parts of India, the Frontier Province (of pre-partition days), the Punjab, Sind, Rajasthan and to a lesser extent in the large towns such as Bombay, Calcutta and Delhi. Ganja was largely used in Madras, Bengal, Bihar and Orissa, Bombay, Uttar Pradesh and Madhya Bharat. Bhang was used extensively in Uttar Pradesh, the Punjab, Sind, Rajasthan and Bengal. After the import of charas was stopped and its use banned, its place was taken by ganja; though appreciable quantities of charas are still prepared clandestinely in certain hill areas where cannabis grows wild profusely, and some is also smuggled into various states.

If we study the figures of recent consumption of bhang and ganja (charas having been officially eliminated), it will be seen that the consumption of these drugs in India taken as a whole shows a definite decrease, particularly in recent years. The latest figures available for 1954 show that it is less than it was in 1934-35.

	1934-35	1954
	(Pounds)	(Pounds)
Bhang	584,332	128,407
Ganja	324,306	795,608
Charas	122,858	-
	1,031,496	924,015

It will thus be seen that the position has considerably changed for the better during recent years in the country as a whole.

Dosage and Number of Addicts.-It is very difficult to form an accurate idea of the number of persons habituated to cannabis drugs, as there are many occasional consumers and there is no registration of addicts. Besides, many of the addicts use cannabis obtained from the natural growth which occurs profusely in many states in India. It is only possible, therefore, to form a very rough estimate of the number of addicts from the total amount of the three preparations consumed and the average dose taken.

The average daily dose of bhang, ganja and charas was carefully worked out by Chopra & Chopra (1939) in a study of more than 1,400 habitual users. It is approximately as follows:

	Grains
Bhang	20
Ganja	18
Charas	15

Assuming that the whole amount was used for euphoric purposes and for habitual consumption (the amount used for medicinal and quasi-medicinal purposes being small), the number of cannabis addicts in the whole of British India in the year 1939-40 worked out to be nearly one million if the cannabis preparations issued by the excise authorities of different states were considered. From our acquaintance with the situation all over the country, we know that the actual amount of the drug obtained from illicit sources-for example, by smuggling or from spontaneous growth-which can be or is utilized for habitual use, is by no means negligible. The total number, therefore, must be considerably more than one million.

Types of cannabis addict. -There is nothing inherent in the make-up of a normal individual in this country that draws him towards the habitual use of narcotic drugs. The basic factor underlying habitual use and addiction is almost always some defect or abnormality in the mental make-up of the individual. The causes leading to drug addiction are practically identical all over the world. The reasons for which the habit is started are psychological and are sufficiently convincing to the addict himself: he intentionally carries on the habit in spite of being aware of its dire consequences. We were often told by addicts that they were taking cannabis for no other reason than that, having once started the use of the drug for some ailment or other, they could not feel normal without it. Life seemed brighter to them under the influence of the drug and their surroundings became more congenial and pleasant. The majority of the addicts met with in India are fortunately not of the vicious type.

The type of people habitually taking cannabis in India and the purposes for which it is taken are given below. They can be divided into four main groups.

Group I. This group consists of persons belonging to the poorer classes, such as labourers, domestic servants, etc. These people are the principal consumers of ganja (and also charas if they can get it). They take these as food accessories in order to relieve fatigue after their work and for mild euphoric effects to relieve the monotony of their daily vocations and existence. They necessarily stick to small doses and as a rule they are able to carry on with their ordinary work. They suffer little or no injury to their general health from the habitual use of the drug.

Group II. This is composed of those individuals who use cannabis in the same way as opium for its narcotic effects. The members of this group are idlers and persons mentally below average who take to the habitual use of cannabis in order to induce a state of oblivion or to overcome feelings of inferiority and the sense of inhibition. Ganja and charas are mostly used by this group and the damage to their health is more perceptible than in the case of group I

Group III. This includes those individuals who use cannabis, in order to obtain stimulant effects combined with intoxicating effects, in the same way as alcohol. This practice exists mostly amongst the idle and the rich who wish to seek pleasure and new sensations, often of a sexual nature. Such a use, prolonged and carried to excess, is apt to cause injury to the gastro-intestinal tract resulting in dyspepsia and impairment of vitality and general health, and later in damage to their nervous system. Sometimes other potent drugs such as nux vomica and dhatura are also mixed by addicts to fortify themselves to perpetrate acts of violence.

Group IV. This group consists mostly of religious mendicants (sadhus and fakirs) and the priestly classes. Cannabis drugs are used in all forms by them in order to overcome the feeling of hunger and to help them to concentrate on religious and meditational objectives.

Sometimes cannabis drugs are also used by the unaccustomed to excite passion and emotion.

CHAPTER VI Causes leading to the habitual use of cannabis

In India taken as a whole it would appear that the smoking of charas was more prevalent among the Muslims, while the habitual use of ganja was more common among the Hindus. This, we consider, was mainly a question of availability, as charas was more easily available in the north, where the predominant population is Muslim, while ganja was available in the south, where the population is mostly Hindu. Bhang was and still is largely used by the Hindus and the Sikhs. Since 1935, the use of charas has been prohibited. The habitual use of bhang or any other cannabis preparation is very uncommon - we may even say rare - among the female sex. Heredity or family history does not appear to play any part in contracting the habit.

Chopra & Chopra (1939), in their analytical studies of addicts, worked out the causes leading to the habitual use of cannabis drugs. They concluded that a past history of nervous disease and the personality of the addict are factors which appear to have some bearing on the formation of the habit. In this group, nearly 50 per cent had a neurotic temperament or had suffered from some nervous disease in the past. Insomnia was commonly described by the habitués as an important cause for starting the habit. A large number of the addicts had irritable and easily excitable temperaments before they took to cannabis; others had hysterical symptoms, were hypochondriacs and gave histories of having suffered from all sorts of ailments. These people generally asserted that they definitely improved after the use of cannabis. It was also shown that ganja and charas were used more by persons suffering from an inferiority complex and by those who possessed nervous and hysterical temperaments. Bhang appeared to be a favourite with those who were suffering from insomnia. Persons of excitable or irritable temperament are more prone to use ganja and charas than bhang, because of their immediate soothing effects. The age between 20 and 40 years appears to be the period of life when the individual generally falls a prey to the cannabis habit; the incidence generally declines after 40 years of age and it is very rare to find an individual starting the habit after he is 50 or 55. There also appears to be little doubt that younger persons have a stronger tendency to fall a prey to ganja and charas than to bhang, which is regarded as a drug possessing milder effects more suitable for older people. In India, addiction to cannabis in persons under 20 years and above 60 years of age is negligible; the incidence is highest between the ages of 21 and 40 years.

Occupation and Vocation

Addiction to cannabis is common among religious mendicants in India, who lead a lazy and idle life and do not work; they form about 30% of this group. About 25% belong to labouring and artisan classes such as blacksmiths, carpenters, tailors, etc. The habitual use of cannabis is more common among the lower uneducated classes than among cultured and educated classes. Sadhus, fakirs and hackney-carriage drivers are more prone to use ganja, while bhang is used by the priestly classes, landowners and agriculturists.

Association and Example

It has been observed that cannabis addicts always try to persuade their friends and acquaintances to try these drugs by attributing all sorts of wonderful properties to them. Cannabis addicts frequently collect in places of pilgrimage all over India and thus form nests where the drug habit flourishes and from where it extends to other places. Most of the addicts stated that their first introduction to cannabis was in the company of a religious mendicant or a fellow worker who had used it for a number of years. The novices are told of the wonderful sensations and stimulating effects which would accrue if they indulged in the drug, and thus a desire is created in their minds to experience these sensations for themselves. These drugs were cheap and easily procurable and at first are supplied gratis; but late on, as the individual develops a liking for the indulgence, the habit is established and he buys some for himself. In a number of cases the habit results from the example of a parent or some other relative or a servant who is addicted. There appears to be no doubt that the ready availability of cannabis in this country is an important factor in the formation of the habit. In about 25% of addicts, association or example is the main factor responsible for the starting of the habit; this was particularly the case with ganja and charas.

Religious Factors, Emotion, etc.

The popular belief that cannabis drugs help in the concentration of mind towards meditation on the Supreme Being or on some other religious subjects has been responsible for starting its habitual use in quite a large number of cases among those who are religiously inclined. Mendicants, fakirs and the priestly classes are initiated to the use of cannabis mostly on account of such beliefs. The presence of a comparatively large number of cannabis addicts in places of pilgrimage such as Benares, Allahabad, Muttra, Hardwar, etc., is no doubt largely due to this factor. The preparation commonly used for this purpose is bhang. Ganja is less frequently used, though religious mendicants and fakirs, who go about naked except for a loincloth, often smoke it, as it renders them less sensitive to cold.

The frequent use of these drugs in connexion with various religious and social customs was directly responsible for the habitual use in about 20% in this group. A further analysis shows that for these purposes bhang is more popular than ganja or charas.

Euphoria and Pleasure

About 17% in this group started the habit on account of the euphoric and sedative effects of cannabis. It may be noted here that the important predisposing causes of addiction are related to the constitutional make-up of the individual. A nervous person is more prone to use narcotic drugs habitually than one with a stable mental equilibrium. This means that those with mild psychic disorders or those with a faulty personality or an impaired mental make-up constitute a large proportion of the habitués. In approaching the solution of the problem of drug addiction one must take into consideration the mental and hygienic factors involved. Most of the addicts we studied could be divided into two main groups.

Weak-minded phlegmatic persons, mentally dull and deficient individuals. - In some of them there was a family history of insanity, neurosis, or addiction to some narcotic drug. These individuals are in many instances unable to stand the daily stress of life, and this is the reason why they take to a drink of bhang or a few whiffs of ganja, especially when they feel tired towards the evening, in order to enable them to carry on their daily routine of life without feeling undue strain. A close scrutiny showed that this class of habitué did not take to the use of cannabis for sexual or vicious purposes, but merely for obtaining mild stimulation or euphoria in order to go through life with a less disturbed mind. Such a feeling could be more easily and expeditiously obtained from ganja and charas than from bhang. The euphoric factor is undoubtedly more prominent in the case of opium and cocaine habits, but it also plays an important part in producing habituation to cannabis drugs. About 22% in this group stated that they were irritable and depressed, but became self-confident and cheerful and were able to face the world with fortitude and composure after they took to cannabis.
Irritable, nervous and hypersensitive individuals. - These persons form a smaller group. They are easily upset and irritated by small worries which normal individuals would ignore. They require some sort of sedative or narcotic which would soothe them and make them forget their worries, and give them a restful sleep and a quiet life. There were, in this group, people who were irritable and quarrelsome and who became docile and gentle after they took to the use of one of the cannabis preparations.

As a Prophylactic against Disease

We have observed elsewhere that the presence of disease or ailment is an important factor in producing the opium habit. It may be stated here that this is not such an important factor in producing addiction to cannabis drugs (8%). This observation may appear to be strange in view of the widespread use of cannabis as a household remedy. There appears to be no doubt that, although bhang is commonly used to ameliorate the symptoms produced by various diseases, it seldom leads to habit formation in the same sense as opium does, and that its use is very often discontinued suddenly without much inconvenience. Occasional use of cannabis for dyspepsia, pain, insomnia, etc., rarely leads to habit formation. A further study of the history of persons who started the habit on account of some disease showed that such individuals had a definite nervous diathesis, and many of them were individuals of neurotic temperament.

A study of the histories of many of the addicts showed that important precipitating or immediate causes of addiction were related to previous use of these drugs in the treatment of some ailment, to self-medication for the relief of pain, to recourse during emotional stress, and to association with other confirmed addicts. Repetition of the dose developed into craving for the drug, and gradually there developed in such individuals habitual use and increased tolerance which led to increase of dosage.

Further, the number of individuals who used cannabis on account of disease was greater in the case of bhang than in the case of ganja. The reason is probably that bhang, being easily available and having a milder action, forms an ingredient of medicinal preparations used against dyspepsia and asthma and is used as an anti-spasmodic, more frequently than ganja and charas. Cannabis has been used both by practitioners of indigenous medicine and by people in rural areas as a household remedy in prophylaxis and treatment of the following disease conditions.

In dyspepsia and as food accessory. - In this series about 30% of individuals used cannabis as a stomachic and an appetizer. Charas and ganja were more often used for this purpose than bhang. A smoke after a meal is often regarded as being beneficial in dyspepsia. Bhang is commonly used against dyspepsia resulting from a change of climate, in a form called "pani lag" by the sadhus and fakirs who roam about; in fact, it forms one of the important items of their small kitbag. The general belief, as already stated, is that cannabis sharpens the appetite and helps digestion.
To relieve pain. - Cannabis is believed to be one of the oldest popular analgesics in India and is commonly employed for the relief of pain. This appeared to be the cause of the habit formation in more than 20% of this group. Bhang was more frequently used for relief of pain than ganja and charas.
Rheumatism. - Pains of a rheumatic nature are common among the large rural population, and these drugs were and are still considered beneficial against rheumatism and allied conditions. About 20% took cannabis for this reason. For this purpose, ganja and bhang are commonly used and are taken both internally and applied locally. When taken internally, cannabis acts as an analgesic as well as a diuretic, both actions being considered very desirable in this condition. Locally, bhang leaves are applied in the form of a poultice to inflamed joints and are said to give much relief. Fumigation of the joint with ganja and charas smoke is believed to be beneficial in acutely inflamed joints.
Dysentery and diarrhoea of sprue type. - Cannabis has been frequently used as a household remedy against dysentery and diarrhoea of sprue type, and in this group more than 12% believed in its prophylactic as well as curative value. Such use is much more popular in the case of bhang than of ganja and charas.
Malaria.-Cannabis has been used as a prophylactic against malaria in the sub-montane and Terai tracts of the Uttar Pradesh state, where it grows profusely in a state of nature. Bhang is believed to be more effective than ganja, and a drink of siddioften allays the general feeling of restlessness occurring in malarial fevers. The diaphoretic and diuretic properties help in bringing down the fever. In this group about 7% took to the drug for this purpose.
Piles.-Bhang is used as a common household remedy for haemorrhoids, and it is employed internally as a drink and, especially when they are inflamed externally, in the form of a poultice. Fumigation with smoke of ganja or charas is also used as a local sedative in this condition. In this group nearly 7% gave the history of having used these drugs as a means of relief for piles.
Nervous diseases.-The use of cannabis in nervous affections is mentioned in the literature of indigenous medicine. Only 7% in this group appreciated its value in this connexion, and most of them used bhang, while a small number used ganja and charas. This lends support to the view that drinking bhang has more of a soothing and sedative effect than smoking ganja and charas, which practice gives rise to a feeling of general stimulation and mental excitement.
Epilepsy and hysteria.-(Less than 1%.) Owing to its general sedative effects, cannabis has also been used as a household remedy to decrease the intensity and number of epileptic fits. It is also used sometimes in the treatment of hysteria in combination with asafoetida.
Gonorrhoea and other genito-urinary diseases.-An infusion or a drink prepared by pounding cannabis leaves forms a popular household remedy for gonorrhoea and other painful conditions of the urethra. In the present group about 5% used bhang with beneficial effects in urethritis. Bhang, besides having a diuretic, anti-spasmodic, and analgesic effect is believed to have a certain amount of antiseptic action also during its excretion in urine.
Cholera.-Cannabis is sometimes used as a prophylactic and also as a household remedy in the treatment of cholera. In this group about 4% used it for this purpose, ganja and bhang being equally employed.

As a Substitute for Alcohol, Opium and other Drug Habits

It is commonly believed by the laity that it is not difficult to replace the habitual use of expensive cocaine, opium, and alcohol with the cheaper cannabis drugs. It is also thought that there is less likelihood of forming such an intense habit with cannabis drugs. This belief has been responsible for the habitual use of cannabis in quite a number (12%) of instances, especially in rural areas. Often these addictions remained and the habitual use of cannabis was super-imposed.

Association with other Drug Addicts

In nearly 60% of cases in this group, association with other addicts was the cause of the habit.

Habitual use of alcohol as well as opium along with cannabis drugs occurred in about 9% of the cases in this group.

It will also be seen that the necessity of supplementing habitual use of cannabis with other forms of addiction is felt more in the case of bhang than other cannabis preparations. This is probably due to its milder effects.

Sexual Factors

Cannabis drugs are perhaps the cheapest and most easily procurable of all narcotic drugs that have been taken by mankind with the idea of obtaining pleasurable sensation and stimulation of their sexual appetite. We have made a reference to this aspect elsewhere.

Nearly 11% in this group, mostly young people between the age of 20 and 30 years, started the habit in order to enjoy the alleged sexual effect of these drugs.

To relieve Fatigue, Worry and Strain

These factors play an important part in the formation of the cannabis drug habit. A few whiffs of ganja smoke or a little beverage made from bhang will remove the sensation of fatigue and hunger for the time being, and will give a feeling of self-satisfaction and forgetfulness. For this purpose these drugs are generally taken towards the evening, after the day's work is done. As the effects of a single dose last for a comparatively short time in the case of ganja and charas, there is a keen desire to repeat the dose.

Cannabis drugs in small doses are believed by the people to stimulate physical energy. Those who have to deal with labour forces in tea-gardens, ricefields and wheatfields in India, know the value of mild narcotics such as cannabis and even small doses of opium for those who have to do hard physical work and are exposed to inclement weather. It has been our experience that in the Punjab and some other states the use of ganja and bhang increases during the harvest season by about 50%.

Miscellaneous Causes:-Indulgence for the Sake of Curiosity, Thrill, Bravado, etc.

We have already stated that, cannabis drugs being cheap and easily available, they are commonly used by the lower classes. Sexual vice and dissipation are not infrequent among them, and many individuals are anxious to find new avenues of pleasure-giving sensations. Some well-to-do persons also take to these drugs because their reaction to pleasure is dulled and they want something to stimulate it so as to appreciate and enjoy those pleasurable sensations to which they have become insensitive, probably through a long and continued abuse of such narcotic drugs as cocaine, alcohol and opium. The individuals who start the use of cannabis drugs on account of pleasure, curiosity, etc., are mostly met with in large towns amongst the artisan class. Their work is monotonous; their environmental conditions are unhygienic; and they develop the habitual use of these drugs for want of healthy recreation. About 5% in this group were idle and rich and indulged in cannabis drugs simply for the sake of having something to make life worth living.

Daily Dosage.-The daily dose of cannabis drugs taken by addicts varied from a few grains to a few hundred grains a day. About 34% took 21 to 45 grains a day, and 66% up to about 90 grains.

So far as the three preparations, viz., bhang, ganja and charas, are concerned the majority of those taking bhang keep to a dose not exceeding 45 grains a day, while in case of ganja and charas the majority generally take doses exceeding 45 grains a day. It would appear, therefore, that those who indulge in bhang generally keep to smaller doses than those indulging in ganja and charas. It would also appear that those who take bhang habitually seldom go to excesses such as those using ganja and charas are capable of reaching. The reason for this is not far to seek. Bhang is used by the poor and the well-to-do alike in many states as a mild narcotic and as a food accessory, and an attempt is always made to keep the dose on the moderate side. Ganja and charas are used largely for their euphoric and aphrodisiac effects, and less frequently for producing a state of intoxication, under the influence of which daring acts such as robbery, etc., may be committed. The tendency is, therefore, towards larger doses, so that maximum effects are obtained.

Frequency of Indulgence.-Frequency of indulgence depends upon several factors. Usually these drugs are taken only once a day-generally towards the evening, when the individual feels tired after the day's work. The frequency, however, depends also upon the mode of consumption. Smoking, as has been previously stated, produces an effect that is intense but of short duration. Hence those drugs that are indulged in by smoking are likely to be repeated more often than those that are taken by the mouth and produce a more lasting effect. It has been observed that ganja and charas are repeated more frequently than bhang. Even so, nearly 40% indulged in smoking once a day, and about the same number twice a day, about 15% thrice a day. About 5% to 6% were occasional smokers.

Duration of the Habit.-Study of the series brings out the interesting fact that the habit when once formed may last for 20 to 25 years or more, but in the majority of cases from 11 to 20 years. Beyond 25 years the use of these drugs was continued only in rare instances, possibly owing to the fact that the continued use of cannabis drugs injures the organism and the consumer falls a prey to some intercurrent disease which carries him off before reaching old age. Further, it was observed that in the case of ganja and charas the duration of the habit never exceeded 35 years, showing that these are more injurious than bhang.

To summarize what has been said with regard to the causes leading to the habitual use of cannabis preparations, it will be observed that in quite a large number of cases quasi-medical use of this drug was responsible for the formation of the habit. Many of the habitués started using the drug as a household remedy for some ailment with which they were afflicted. Association with and example of other addicts, religious and emotional factors, euphoric and pleasure-giving effects, hard work and thrill were some of the other important causes which started off the addiction to cannabis.

CHAPTER VII Effect of habitual use of cannabis drugs on the individual

Chopra & Chopra (1939) carefully analysed the statements of persons who took cannabis drugs habitually, with a view to determining to what extent, if any, the general health is affected by such an indulgence. In about 52% of the habitués in a series of over 1,238 cases, no ill effects whatever were admitted. In about 25%, the health was believed to be affected to a minor degree and in about 15%, to a marked degree. There were, on the other hand, about 10% of habitués who stated that their general health improved after they took to cannabis drugs. This last group were mostly persons habituated to the use of bhang and were taking small doses not exceeding 10 grains a day. These studies also revealed that the evil effects were admitted more frequently by those smoking ganja and charas habitually than in case of those taking bhang by the mouth. Futher analysis showed that the adverse effects were admitted to be more pronounced with higher dosage.

It was apparent from these studies that health does not as a rule suffer when cannabis drugs are taken in doses below 20 grains daily; further increase in the dosage is attended with deleterious effects and in the very few cases of consumption in high doses exceeding 180 grains a day there is often a rapid and serious damage to health.

General Physical Effects

Moderate habitual use of ganja or charas by smoking may or may not be attended with harmful effects and in the case of bhang there is ample evidence that no apparent harm may result if it is taken in small quantities. Of all the preparations of cannabis, bhang is popularly believed to be the least harmful, and our own observations are in accord with this view. According to the Indian Hemp Drug Commission (1893-1894), bhang was considered as a refreshing beverage corresponding to beer in England and moderate indulgence in it was attended with less injurious consequences than similar consumption of alcohol in Europe. This view was corroborated by the above-mentioned studies of a large number of persons who took bhang habitually and is borne out by our own obser- vations. People drinking bhang habitually, but in moderate quantities, are, unlike other drug addicts, robust and physically well built, and moderate habitual use of bhang does not appear to lead to malnutrition. On the contrary, appetite appears to be stimulated. When loss in weight occurred, it was probably due to some other pernicious drugs such as opium, cocaine or alcohol being taken also. In a certain number of cases from the well-to-do and priestly classes, an atonic condition of the voluntary muscles of the body was observed. Such individuals were flabby, and therefore had a tendency to become obese. Bhang habitués taking excessive doses generally show a sleepy countenance, and they often have a vacant look and red eyes.

Confirmed ganja and charas smokers, especially those taking large doses, often exhibit signs of a deteriorated health. The excessive smokers are thin and emaciated, with a sallow or muddy complexion and dull grey eyes, often bloodshot. Excessive smoking also produces chronic catarrhal laryngitis, and considerable bronchial irritation may result from the deep inhalation of the smoke.

Excessive dosage of these drugs repeated daily upsets the alimentary and excretory systems. Appetite declines and food is not properly assimilated. The addicts may lose weight rapidly and may suffer from general cachexia; the skin becomes pale and dry and is often covered with scales; the nails and the teeth decay and the hair, which is frequently affected, becomes dry and loses its lustre. The general bodily nutrition suffers, because the money which should be spent for the purpose of procuring wholesome and nutritious food is used to buy the drug. Impairment of vitality results, which makes the system unable to resist intercurrent diseases. Generally such habitués are also more sensitive than ordinary people to changes in the weather.

The effects produced on different organs of the body were also studied. More than 50% of the habitués had a healthy look and did not show any apparent untoward effects produced by the habit.

Conjunctivitis was a very prominent symptom in the majority of addicts (72.13%). This varied from slight turgescence to congestion of a marked degree. The congestion persists even after the actual stage of intoxication is terminated. After many years of indulgence, the conjunctiva as a whole assumes a somewhat dull appearance, but the active congestion persists in the origin of the transverse ciliary vessels. The yellow discolouration is probably due to the deposition of a yellow pigment after the active congestion subsides. This is a very important sign by which addiction to cannabis drugs, particularly ganja and charas smoking, can be diagnosed. The congestion of the transverse ciliary vessels may persist for many years after the drug has been completely withheld. The authors have observed this sign in almost all the mental cases in Indian Mental Hospital at Ranchi who gave a history of prolonged indulgence in cannabis drugs, even after five to ten years' stay in the hospital where they had no chances of indulgence in these drugs.

Action on the Respiratory Tract

The belief that smoking of ganja and charas wards off attacks of bronchitis and asthma exists only in a few localities. On the contrary, it is believed in many parts that habitual smoking of cannabis brings about these very conditions.

The inhalation of vapour of pyridine is believed to be beneficial in asthma, and tobacco smoking has been recommended in this condition because it contains pyridine compounds. Irrespective, therefore, of the products yielded by the burning of cannabis, any form of smoke containing pyridine compounds may have a soothing effect in bronchitis and asthma. Long-continued smoking, whether of ganja or of any other substance, however, produces deposition of finely divided carbonaceous matter in the bronchioles, and the presence of other irritating substances in the smoke ultimately produces local irritation of the bronchial mucous membrane leading to increased secretion and resulting in the condition known as chronic bronchitis of ganja and charas smokers. It is not fair, therefore, to put on cannabis the entire responsibility for producing these conditions.

The inhalation of ganja smoke may, in the early stages, act as a pulmonary sedative by diminishing the flow of mucus. But if the use is excessive and prolonged, it leads to chronic irritation resulting in copious secretion from the respiratory mucosa. Further, it should also be remembered that in India these drugs are rarely smoked by themselves, but are very often mixed with tobacco. The only difference is that in the act of inhaling the smoke, considerable force is used in the case of cannabis, so that a large volume of smoke is inhaled as deeply into the lungs as possible, which is not often the case with ordinary tobacco smoking. The composition of smoke has been shown to vary according to the amount of air admitted during smoking for combustion of the material. In the case of tobacco, for example, the process of oxidization has been shown to be somewhat more complete in the case of cigar than in the case of pipe smoking. Pyridine is present in larger quantities when the combustion is low, as when tobacco is smoked in a pipe. But when ganja or charas is smoked along with tobacco in a pipe, other aromatic hydrocarbons are formed besides pyridine. The exact nature and action of these hydrocarbons formed during the process of dry distillation which occurs during the smoking of a pipe is not known, but the pyridine bases are believed to act as depressants to the respiratory centre and may thus act as pulmonary sedatives.

Next to the central nervous system cannabis drugs appear to affect most severely the respiratory system. In this series, nearly 40% of cases suffered from some disorder of the respiratory tract. Chronic sore throat and pharyngitis are common among the habitués. Even after a drink of bhang a feeling of constriction and hoarseness in the throat is observed which in some cases may lead to a certain amount of difficulty in speaking. When cannabis is smoked along with tobacco, there is always some irritation and congestion of the buccal and pharyngeal mucous membrane. The incidence of chronic bronchitis and emphysema is very high among those who smoke ganja, and typical asthma-like attacks may occur.

The incidence of tuberculosis of the lungs is also high amongst the people who smoke ganja and charas. The high rate of tuberculosis among the habitués may be due to economic reasons, as the majority belong to poor classes, ill-nourished and living under bad hygienic conditions in overcrowded places. Chances of contagion may also be increased by the common pipe (chillum), through which cannabis is usually smoked in company.

Digestive Troubles

In small doses, cannabis drugs, especially bhang, are believed to sharpen the appetite, improve taste, and help digestion. Our inquiries from sadhus or religious mendicants who were using large quantities of cannabis drugs showed that charas and ganja smoking inhibits the hunger contractions of the stomach. The peristaltic movements of the stomach and intestine are not affected by moderate doses, but when the drug is taken in large quantities and for prolonged periods, these are paralysed and the digestive processes are seriously impaired. Offensive breath, chronic pharyngitis, pyorrhoea alveolaris and furred tongue are common among the habitués of cannabis drugs, especially the smokers. These effects are probably due to the continuous irritation of the buccal and gastric mucosa caused by the smoke. The common symptoms are loss of appetite, flatulent dyspepsia and alternating attacks of diarrhoea and constipation due to chronic catarrh of the gastro-intestinal tract, all of which eventually lead to general emaciation. Diarrhoea, in fact, is one of the very common sequelae of the habitual use of these drugs.

General Nutrition

In those taking cannabis drugs habitually in large doses, loss of weight commonly occurs. A certain amount of anaemia is also observed. Apart from the digestive and respiratory disturbances, the loss in weight may be due to defective nutrition, as a large proportion of the meagre earnings of the addicts, whose economic condition is low, is spent for the drug and not for healthy and nourishing food.

Blood Pressure

Blood pressure records before and after a smoke of ganja and charas show that systolic blood pressure rises slowly in the experienced addicts to the extent of 20 mm to 300 mm of mercury after smoking. In unexperienced persons a few pulls of a ganja or charas pipe may produce a sharp rise of blood pressure (20 to 30 mm) followed by a rapid fall with the onset of symptoms of intoxication. In the latter group, symptoms of collapse may be produced, the blood pressure remaining low for a considerable time.

Effects on the Central Nervous System

Habitual use of cannabis drugs mainly affects the central nervous system. These effects are of two kinds:

Temporary effects-i.e., those that are present only when the person is actually under the influence of the drug.
Permanent effects-i.e., the sequelae of the prolonged use of these drugs.

(a) Temporary Effects.

Soon after taking a moderate dose by the mouth, the pulse increases somewhat in fulness and frequency, the face becomes flushed and there is a feeling of warmth all over the body; the appetite becomes sharpened and there is a tendency to talk. In some instances aphrodisiac sensations are experienced. The sensation of pain is definitely dulled, and there is a feeling of partial anaesthesia all over the body. The pupils are slightly dilated.

With larger doses the above symptoms become more pronounced, the pulse becomes rapid and sometimes irregular at first and slow afterwards. The temperature varies according to whether the individual is excited or depressed. This stage is usually followed by drowsiness and deep sleep.

Ganja and charas smoking :- The immediate effect of moderate doses in habitual smokers is the initial feeling of anxiety and restlessness, followed by a refreshing and stimulating feeling. The sense of fatigue is alleviated, pleasurable sensations are experienced, so that the consumer is happy and congenial with everybody. Restlessness is removed and there is a tranquillizing effect on the nervous system which induces forgetfulness of all worries.

The effects in many cases are attended with hallucinations of sight, hearing and general sensibility. The senses become hyper-acute and more subtle. Disturbance of the sensations of taste and smell may also occur during the later stages. Deep sleep generally follows, in the majority of cases, an hour or more after indulgence.

There are individuals amongst ganja and charas smokers on whom the effect of intoxication is quite different from that ordinarily obtained. They lose all sense of proportion and become irresponsible. They may commit very dangerous acts, even murder.

Bhang or sidhi drinking :- Bhang is somewhat extensively used for occasional indulgence and for so-called religious purposes; its symptomatology therefore deserves special mention. The effects produced by the drug are more lasting than those produced by smoking of ganja and charas. With moderate doses the individual feels cheerful, the appetite is sharpened, the sense of time and space is disturbed. There is an increased acuity of hearing, and sound appears to be tremendously magnified; ordinary light appears very brillant. Sometimes sensory perceptions-e.g., of skin-may be depressed. With some people there is a sensation of forgetfulness and relief from worries and troubles of life. Others get good sleep after the day's hard work; still others feel active and interested in life and their surroundings after the dose. A sense of euphoria occurs after charas and ganja and also after bhang. This usually consists of a mildly pleasant sensation, but rarely leads to a state of rapturous ecstasy. In some, exactly the opposite effects may occur, with a deep sense of apprehension and terrifying agony.

Most bhang addicts, after a regular dose, become emotional; the control of the higher centres is lost and the sense of judgement is impaired to an appreciable degree. The state of intoxication generally lasts from three to five hours and then sleep supervenes. The addict, on waking next morning, does not experience any marked nausea or vomiting, nor are the bowels affected (constipated) as with other intoxicants-particularly of the opium group-although some of the addicts complain of slight dizziness and congestion of the eyes and of a feeling of heaviness in the head.

Duration of Effects. Ganja and Charas Smoking.-Smoking produces its effects more rapidly than does consumption by the mouth because by the latter method the absorption of the resin, which is combined with large quantities of colloidal matter, is considerably delayed from the gastro-intestinal tract. With pure resin, absorption is of course much quicker. According to Russell, in the case of ganja smoking, the mental effects appear within three to five minutes, while in the case of charas they may appear with the first pull from the pipe ( chillum). This is in accordance with our own observations. In the case of ganja the effects last from half an hour to one hour or even longer-in the case of charas from 15 to 20 minutes. With bhang the symptoms may set in from 20 to 30 minutes, or may be delayed and may last from two to twelve hours.

(b) Permanent Effects

Mental Effects.-Mental injury is more likely to occur in the case of those individuals who take large doses for prolonged periods.

The effects of different preparations are interesting. Emotional character and judgment are affected more in the case of ganja and charas. Bhang habitués are also more peevish and hypochondriacal than those indulging in ganja and charas. The incidence of gross injuries to the central nervous system, such as insanity and moral depravity, appears to be more frequent amongst the ganja and charas smokers than with the bhang drinkers. Epileptic fits, on the other hand, occur more frequently among the bhang-habitués.

Effects on Sleep.-According to our observations (see also Chopra & Chopra (1939)), sleep is more disturbed in the case of ganja and charas addicts and little or not at all in the case of those addicted to bhang. This may be due to the fact that bhang as a sedative has a mild and prolonged action, while ganja and charas have rapid and intense effects appearing after smoking, in which euphoria and stimulation are more pronounced for a short time.

Sexual Factors.-Prior to the introduction of the cocaine habit in this country, cannabis drugs were commonly used for sexual purposes. Between the First and the Second World War, cocaine had largely replaced cannabis drugs, particularly among prostitutes and their paramours. During recent years, on account of cocaine's being scarce, cannabis drugs were again used to a considerable extent for sexual stimulation by the lower and middle classes. The effect of cannabis drugs is a temporary stimulation of the psychic areas, and mental excitement resulting from this gives the semblance of aphrodisiac effects, particularly in those individuals who are sexually inclined.

Cannabis drugs have been commonly used in India for their aphrodisiac effects. Some even believe that they restore sexual power in case of impotence and for this reason they have found their way to, and are used in, houses of ill fame somewhat as alcohol is used in western countries. On the other hand, saintly people who wish to renounce wordly pleasure use cannabis drugs for suppressing sexual desires.

Studies by early British workers showed that cannabis does not in itself possess any aphrodisiac action; it merely induces a condition of partial delirium in which orientals may possibly have visions of a sexual nature and try to give a sexual direction to the mental disturbances which are produced, especially when the cannabis used is mixed with such drugs as musk, amber, cantharides, etc. O'Shaughnessy, on the other hand, speaks of the drug as acting on the "generative apparatus ", and experiments which he carried out in India indicate that, with aphrodisia, scarcely any exception was experienced after the administration of the extract containing physiologically active principles of cannabis drugs. Such is not our experience. In our series of cases only 10.42% of habituals used the drug as an aphrodisiac, there being more ganja and charas smokers than bhang users.

The use of cannabis as a stimulant in order to assist in the execution of daring acts has been mentioned. Like alcohol, it depresses the higher cerebral centres; the removal of their control gives a free course to the predominant desires of animal nature and a semblance of strength and courage. In our view the alleged aphrodisiac action of cannabis drugs, stimulant as well as depressant, seems to be merely its indirect effect as apparent stimulant of the lower centres by removing the control which the higher centres exercise over them. The variable sexual effects can also be explained by the action of the drugs on the higher centres. People with low morals concentrate their thoughts on sexual pleasures and objects of sexual love, while people with religious and saintly tendencies concentrate their thoughts away from such things. The stimulant or depressant sexual effects would thus appear to be purely psychical phenomena in both cases.

Ganja and charas are considered to be more potent sexual excitants than bhang. In those who indulge in these drugs excessively, sexual faculties are undoubtedly depressed in due course of time.

Fecundity.-Chopra & Chopra (1939) studied the effect of habitual indulgence in cannabis drugs on fecundity and concluded that the fecundity rate in those who indulge habitually in cannabis is lower than normal, but higher than in opium addicts. The percentage of sterile marriages is also higher in those who indulge in these drugs habitually and excessively.

CHAPTER VIII Public health and social aspects of the habitual use of cannabis

The use of bhang is not considered to be as disreputable as that of cocaine or alcohol, or as opium smoking. The disapproval of ganja may be due to the fact that it is a cheap intoxicating drug generally used by the lower and often the criminal classes. Bhang, which is used by the comparatively well-to-do people, is not regarded with such disfavour, and is not objected to so strongly as are ganja and charas.

It is believed by a large section of the population in India that addicts to cannabis drugs-especially those who smoke them-are not people of good character and should not be associated with. They are considered to be undesirable neighbours as they are believed to be criminally inclined. We can say from our experience of work in the field that habitual consumers of cannabis, especially bhang, are not generally so offensive and undesirable neighbours as habitual drunkards. Generally the former are timid and rarely commit acts of violence, either premeditated or on the spur of the moment, when under the effects of the drug. They are bad neighbours in the sense that they set a bad example of indulgence in these drugs; many of them have unhygienic habits and cough and spit indiscriminately everywhere.

Cannabis and Mental Derangements

The popular belief in India has been that excessive and prolonged indulgence in cannabis drugs leads to certain forms of mental disorders and to violent crime. The conclusions of the Indian Hemp Drug Commission (1893-94) were not quite in accordance with this belief. The Commission considered that "Moderate use of these drugs produced no injurious effect except in persons with a markedly neurotic diathesis. Excessive use indicates and intensifies mental instability. Moderate use produces no moral injury whatsoever." Ewens (1904) expressed the opinion that the form of mental disease classified in India as toxic insanity has a direct relation to the excessive use of cannabis drugs. Robertson-Milne (1906) and Dhunjibhoy (1927) came to a similar conclusion. None of these workers, however, had studied the bearing of the habitual use of these drugs on the incidence of crime in India.

Chopra & co-workers (1942) made an attempt to clarify the part played by narcotic poisons in general and cannabis in particular in producing mental instability leading to what is termed toxic mischief and crime in this country. These authors in the first instance based their observations on the large number of cases of addiction to cannabis drugs studied by Chopra & Chopra (1939). They also took into consideration the large number of addicts to opium (Chopra, R. N., 1928) and cocaine (Chopra & Chopra 1931) in India. Besides this, investigations were also carried out in almost all the mental hospitals in India, where inmates suffering from toxic insanity were examined from time to time and kept under observation for a number of years. The histories of most of the discharged cases of toxic insanity were also critically studied.

The cases in which cannabis preparations were the apparent cause of insanity were studied individually, and attempts were made to obtain all possible information from the patients themselves and other sources in order to determine if the facts elicited were reasonably correct. All doubtful cases were eliminated. In this way the authors collected reliable data concerning 600 cases of insanity attributable to cannabis drugs admitted into various mental hospitals in the country.

There is no doubt that cannabis, like other intoxicants or nerve poisons, gives rise to an altered state of mind which may in certain cases simulate mania. It is well known that cannabis has a marked effect on the intellectual processes, which become irregular or even partially or totally suspended. It has been established that the higher centres of the brain, which develop later than others, are more prone to the influence of narcotic and euphoric drugs, the general effects on the brain being euphoria, dizziness, exhilaration and a feeling of relief from the strains and stresses of life.

The localized and specialized effects of these drugs affect special centres of the brain and are different in the case of each drug. Thus each drug is apt to cause certain special symptoms or derangement of the mental faculties in addition to its general effect. It is apparent that despite great dissimilarity between the effects of the different narcotic and euphoric substances, there are certain features which are common to all. For this reason it is difficult to give a definite picture of the symptomatology of toxic insanity attributable to cannabis alone. Mental derangement resulting from the use of toxic substances is nothing but a reaction on the part of cerebral cells whose regular activity is either held in abeyance or perverted partially or totally. There is a relaxation of control of the higher centres which allows the lower centres to come under the influence of the external abnormal excitations, which may be different from the usual stimulation. This reaction may be observed in one or more parts of the central nervous system, leading to difference in symptoms produced. All types of insanity resulting from intoxication through any drug are characterized by certain general symptoms, such as excitation of the organs of thought, sense of intoxication and incoherent ideas in the individual. Persons with psychopathic and neurotic tendencies appear to be more easily affected than normal, healthy individuals with stable nervous systems. Besides, there are other factors of importance which have to be considered in evaluating the effects of cannabis drugs on an individual. These are the degrees of education, reasoning, judgment, dosage, mode of administration of the drug, etc. All these factors may modify the symptoms and effects.

Excessive indulgence in cannabis is apt to produce in healthy individuals and more so in susceptible individuals, mental confusion which may lead to delusions with restlessness and disordered movements. Intellectual impairment as well as disorientation may show itself in various ways, such as weakening of moral sense, habit of telling lies, prostitution, theft, etc. The addict may become egotistic and unreliable, and may have recourse to theft, pilfering, sex perversions and other disgraceful practices. Sometimes indulgence may release subconscious impulses and lead to violent crime.

Indulgence in cannabis drugs often results in illusions, delusions and hallucinations. In young individuals, hallucinations of a pleasant and sexual nature sometimes form the chief attraction in the use of these drugs. These hallucinations depend upon the personality and subconscious trend of the habitués mind. A person with a religious trend of mind may imagine himself to be a messiah, a messenger of God or a prophet, while a person with loose morals may imagine himself in the lap of his beloved. The hallucinations and delusions in the case of cannabis are largely visual and auditory. These are mostly transitory, but in more susceptible individuals may assume a chronic form resembling paraphrenia. Delusions of a persecutory nature are dangerous and frequently lead to homicide, the power of discrimination being lost through a lack of control by the higher centres. A study of the records of criminal cases, especially murder cases, in various jails and mental hospitals revealed, however, that in only a very few instances (1% to 2%) temporary or permanent mental derangement induced by cannabis drugs was directly responsible for a crime.

Cannabis and Insanity

A survey was carried out of the toxic insanity cases in all the important Indian mental hospitals between 1928 and 1939. During that period, frequent visits were paid to these institutions and many cases were examined from time to time and individually studied. Keeping in view the physiological and pathological changes and the symptoms observed and those already on record in the history sheets, an attempt was made to study the mental disorders resulting from the use of cannabis drugs. A series of 600 cases of toxic insanity referred to above were thus collected for study with a definite history of indulgence in the use of cannabis drugs.

The first thing observed was that acute mental disorders attributable to the use of cannabis drugs were much more frequent than chronic conditions.

1. Acute Disorders.-Most of the narcotic poisons, and especially cannabis drugs, produce disorders of a temporary nature which disappear without leaving any trace. The effects are limited to slight excitement or depression of faculties, or to a short interval of intoxication and sometimes to profound narcosis. Complete recovery, however, occurs in most of these cases. The duration and nature of the symptoms may vary according to the disposition of the individual and the dosage. The acute stage, if recovery should follow, does not last more than a few days or a few weeks. Acute toxic insanity is a secondary insanity which may simulate all forms of insanity. It may differ not only in the case of two different drugs, but also with one and the same drug. It is temporary and may be cured with the elimination of the poison from the body. Besides the generally accepted view that a short duration is diagnostic of cannabis insanity, this form differs in other ways from other types of mental disorders. General care of the patient and withdrawal of the drug lead to rapid recovery. In regard to the different diagnostic symptoms, delirium frequently occurs. Acute mental derangements due to cannabis drugs are marked by extreme vehemence of the mania. Mental, moral and muscular manifestations are more pronounced, and differ from those seen in the case of alcohol and other drugs. The individual looks confused and excited, and has bright, shining eyes which are almost always heavily congested. He shouts, vociferates, sighs, walks quickly up and down or round his cell, and shakes the door out of its fastenings. If at liberty, he is violent, aggressive, and may run amock. These symptoms are not so pronounced in other forms of mania. Instances are on record where the patient in this state of excitement got hold of a weapon and committed murder without any reason or provocation. The attack, however, was usually of short duration, being limited to a few days. Later, in most cases there was perfect recovery, but the patient was quite oblivious of the events which took place during the period of intoxication.

The following conditions were met with under this category.

Acute confusional insanity (37%). This condition was most common and probably resulted from a general derangement of the cerebral functions after taking the poison.
Maniacal conditions of expansive forms (7.5%). These were characterized by erotic ideas of self-gratification and exaggeration of personality.
Melancholia and depressive mania (13.2%). This condition depends upon the type of individuality and temperament of the addict. Those with a sad, morose disposition were more prone to this type of disorder after the use of cannabis drugs. A true melancholia following the use of cannabis is rare, but very often the mixed types of cases which result are labelled as "maniacal depressive".
Delusional and hallucinatory type of insanity (12.5%). The delusions were of self-agrandizement; the tendency to suicide was very rare, but homicidal acts by cannabis maniacs were not uncommon.

2. Chronic Disorders.-Chronic voluntary intoxication may also lead to mental disorders. The course of symptoms may depend on the habits of the individual, on the individual's reactions and on the dosage. The chronic form does not generally establish itself from the very beginning. There are at first acute phenomena which may reproduce themselves a number of times without, however, preventing chronicity from establishing itself. These acute symptoms are nothing but a recurring picture of the original attack which appears again and again in the course of the disease. The two essential kinds of symptom are the irresistible desire for the poison, with the periodical recurrence of the acute or subacute symptoms, and the progressive decay of mental faculties. The acute symptoms correspond to temporary saturation of the body with the poison, while chronic symptoms are the expression of definite anatomical injury to the brain which gradually results from the effects of the drug. The prolonged abuse of the poison thus gives rise to progressive weakening of all the faculties of the brain, eventually leading to dementia.

The insanity produced by a long-continued and excessive indulgence in ganja or charas has also certain symptoms and points of its own. The patients are hilarious and full of sense of well-being; they are, as a rule, good-natured and trustworthy, and recover in a large proportion of cases when admitted to a hospital and after the drugs have been withdrawn. Relapses, however, are quite common.

In the present series 60 cases, or 10%, showed relapses, and it was found that relapses were more common between the ages of 20 to 30 and 41 to 50 years.

Dementia secondary to cannabis drugs. This condition was rather rare and occurred in only 3.33% of cases in this series.
Schizophrenia. This was present in 5% of cases.
Chronic toxic mania. This disorder was found to be much more prevalent than the other two. It was present in 15% of cases in this series.

Analytical study of these 600 cases of cannabis insanity revealed that, though it was comparatively easy to elicit the history of cannabis habit from such patients, it was often difficult to ascertain whether this narcotic was the primary cause of insanity or indulgence in it was only secondary to the existing mental disorder. It is well recognized that persons with an unstable nervous system and those suffering from mental disorders are more prone to drug habits and particularly to excesses, than normal, healthy individuals. The former two groups very often indulge in intoxicants with undue or unwarranted freedom, and thereby precipitate the course and aggravate the symptoms of the actual disease. All cases with doubtful history were rejected and only those cases where a definite authentic history of cannabis indulgence could be found were considered. These cases consisted of two main groups:

Unmixed cases in which the cannabis habit was found to be the only elicitable cause of insanity; 400 out of 600 belonged to this group.
Mixed cases in which other factors such as heredity, predisposition, or indulgence in other intoxicants were also present in addition to indulgence in cannabis drugs. Co-association of other intoxicants along with cannabis naturally increases the frequency of insanity. In this series history of indulgence in alcohol, dhatura and opium was quite frequent. It is logical to think that the simultaneous use of these narcotics, which are also cerebral poisons, would further upset the equilibrium by their cumulative effects.

It was also shown that the most common age at which an attack is likely to occur is from 15 to 30 years. The next common period is between 31 and 40 years, after which the incidence falls gradually, till it is only 1% after 60 years. The information regarding the duration of the period of insanity was either unreliable or not available.

To recapitulate briefly, it may be said that the cerebral centres are responsible for keeping in check the lower centres upon which the behaviour of an individual depends. Cannabis preparations and other narcotic and euphoric drugs depress the higher centres to begin with. Moderate interference with these may not be dangerous and sometimes may even be helpful, as for instance in removing inferiority complexes and temperamental difficulties. With frequent repetitions of the dose, however, harm is likely to result through prolonged inhibition of the higher faculties of the mind, and this may lead to permanent changes in character and even to the production of such conditions as megalomania, irritability, boastfulness, etc. Fits of aggressive mania are not infrequently observed after indulgence in cannabis, particularly by smoking. Impulses of a suicidal and morbid nature have been known to occur with drugs such as bhang, especially when taken in large doses, and particularly during a period of mental depression. The higher centres, when kept under constant repression, undoubtedly suffer; they are the first to succumb to the action of these drugs. The lower centres also suffer through over-action, but these are more resistant and do not show signs of degeneration till late. The studies carried out in mental hospitals and in prisons show that not infrequently addiction to cannabis preparations was the immediate cause of a sudden crime such as murder.

Deliberate heavy indulgence in cannabis by religious mendicants to induce a state of frenzy in order to impress the onlookers with their supernatural powers is frequently met with in India. Frenzy is also deliberately induced to enable the subject to carry out enterprises of a difficult and dangerous nature, either planned beforehand or only decided upon on the spur of the moment.

A milder condition is sometimes induced by criminals to enable them to keep up their courage while committing offences such as dacoities, etc. Though they differ in degree, yet the two uses are essentially similar. In the first instance it may be followed by murder, while in the second by robbery, theft and the like. The frenzied state is more likely to be induced by a cumulative effect of repeated doses of cannabis drugs than by a single dose.

There is a popular belief amongst the laity that indulgence in cannabis drugs is a common cause of insanity. The experience of the present authors is that the moderate use of these drugs does not lead to insanity in the majority of individuals unless some predisposing factor is present. The willpower and self-reliance of the addicts may be weakened, as is usually the case with drug habits, but the character and mental faculties of those taking small and moderate doses remain practically normal. The social disfavour and boycott of the addicts in certain parts of the country where the use of cannabis is not common makes it difficult for them to lead a normal life. The latter may bring about unfavourable changes in their character and gradual mental and moral deterioration, and those who might have been otherwise law-abiding citizens may break the law. In this way they become outcasts and idlers. Those who use charas and ganja habitually are as a rule compelled to associate with persons of low moral character in order to enjoy the indulgence in company.

Cannabis and Crime

As regards the relationship between the habitual use of cannabis drugs and crime, there are instances of criminal acts committed under the effects of these drugs especially after smoking ganja or charas, under grave provocation or in cold blood and with premeditation. Such instances do not necessarily prove any definite relationship between the use of cannabis and crime. Indulgence in alcohol, too, undoubtedly gives rise to a feeling of bravado and courage by depressing the higher controlling cerebral centres, and there are many instances in which it has led to crimes of a very grave nature. So far as cannabis is concerned, however, the situation has to be viewed from a different angle. Cannabis drugs are cheap and are generally used by the poorer classes who belong to the lower strata of society, to which most of the criminals in India belong. This may be an explanation of the fact that proportionately more consumers of cannabis, especially ganja and charas smokers, are found among bad characters than among the general population.

It should also be remembered that the habitual use of cannabis drugs impoverishes the addict, whose income is generally small. He spends a large portion of his meagre earnings on the "dope ", and in consequence he has very little money left to obtain the daily necessities of life. This may lead him to commit thefts and other crimes of a similar nature. This, however, does not mean that the use of cannabis preparations is entirely responsible for his misbehaviour.

So far as premeditated crime is concerned, particularly that of a violent nature, the role of cannabis in our experience is quite distinctive. In some cases these drugs not only do not lead to it, but actually act as deterrents. We have already observed that one of the important actions of these drugs is to quieten and stupefy the individual so that there is no tendency to violence, as is not infrequently found in cases of alcoholic intoxication. The result of continued and excessive use of these drugs in our experience in India is to make the individual timid rather than to lead him to commit violent crimes. Our opinion in this respect, based on a very careful study of a large series of persons taking these drugs habitually, is that the tendency of the drugs appears to be to develop or bring into evidence the natural disposition of the consumer and to emphasize his true character and peculiarities. For example, if he is inclined to be lazy and easy-going, he will be quiet and restful, but if he is irritable or excitable he may, if interfered with, become violent.

In the large number of habitual users studied by us, 6.24% had been convicted once and 7.92% more than once. The figures for conviction are of course very much higher than those usually met with amongst the general population in India. It will also be observed that the number of those who had been convicted, in this group, is much larger in the case of ganja and charas users than in the case of bhang consumers. The former are often quarrelsome and do not heed the consequence of their deeds. The reason no doubt is that the effects produced by smoking are rapid and more intense on the higher intellectual faculties than when the drugs are taken orally. Besides, ganja and charas are used more by the lower strata of society, which include a higher proportion of habitual criminals.

Use of Cannabis for Homicidal and Suicidal Purposes.-It has already been remarked that cannabis has been used by criminals for two purposes-firstly to fortify themselves to commit premeditated crimes, and secondly to enable them to endure unusual fatigue or exposure to inclement weather and to stimulate them for extra exertion; in both cases the drugs are used by those who have been indulging in them habitually.

Cannabis drugs have not been used for suicidal or homicidal purposes in the same way as opium. The obvious reason is that the lethal dose is much too large. It has been stated that sometimes these are used for stupefying people with the object of robbing them. It is doubtful if a deep enough stupefaction can be effected with these drugs, except in those who are not accustomed to take them habitually, and very often dhatura has to be mixed to obtain the desired effects.

Another difficulty in the way of using these drugs, especially ganja and charas, is that they can readily be detected by their characteristic and penetrating smell, and therefore it is difficult to mix them with tobacco or other substances for the purpose of smoking, without detection. It is, however, possible to utilize them for stupefying individuals who are not addicted to their use, by secretly mixing them with more potent drugs such as dhatura. Cases have been reported where prostitutes were stupefied in this manner and robbed of their ornaments. Children are sometimes decoyed and offered sweetmeats containing cannabis preparations to make them insensible and to rob them of their ornaments. Generally speaking, because of the difficulty of their administration without detection and their uncertain action, these drugs are seldom resorted to for such purposes.

CHAPTER IX Physiological aspects of the habitual use of cannabis. Individual and racial variations

Physiological Considerations

We have already referred to the great variability in the physiological activity of cannabis preparations which were previously included in the British Pharmacopoeia and are still official in the Indian Pharmacopoeia, 1954. On account of the rapid deterioration of the active principles, particularly in galenical preparations, large variations in potency occur in a short time. This has been amply demonstrated by the biological assays of a large number of preparations which have been carried out in our own laboratories from time to time. This is one of the main reasons why, in spite of the remarkable narcotic properties of cannabis, it is not used in the practice of western medicine at the present time, even in India. It is, however, still extensively used in the practice of indigenous systems of medicine and for quasi-medical purposes by people in the rural areas.

Chopra & Chopra (1939) carried out a series of experiments on animals and men to determine the physiological effects produced by cannabis preparations, with a view to investigate the variations in its physiological activity as well as to determine the nature of the habit formation produced by it. When the drug was given orally to animals such as cats and dogs, the effects appeared within three-quarters of an hour to one hour. Immediately after the drug was administered the animal showed signs of uneasiness and a preference for darkness and gave occasionally a piercing cry. In dogs, the early symptoms were those of excitement, the animals becoming more active and sometimes barking loudly. The mental disposition of these animals also showed a marked change. The cats, usually afraid of dogs, lost all sense of fear and repulsion. The dogs became more docile and affectionate and did not show their usual antipathy to cats when put together with them. As the effects developed, the signs of restlessness became more pronounced. The heart-beat became rapid, there was salivation and sometimes vomiting and defaecation. The premonitary symptoms developed into more active symptoms. The animals now exhibited uneasy movement and experienced difficulty in maintaining equilibrium. On standing they showed the peculiar to-and-fro swaying movements of the body which are characteristic of intoxication with cannabis. The drug appeared to produce symptoms of uncoordination of muscular actions which may have resulted partly from disturbance of sensation and partly from interference with the reflex muscular mechanism owing to the direct effect of the drug on the spinal centres. Finally there followed the stage of depression and sleep which varied with the dose administered and lasted several hours.

From these experiments it appeared that the effect of cannabis on the central nervous system could be divided into three stages; the primary stage of stimulation and excitement, followed by the second stage of general depression and anaesthesia and thirdly the stage of general excitement which occurred only in the case of large and perhaps toxic doses. There was no clear line of demarcation between the different stages (the one merged imperceptibly into the other). These stages are also recognizable in man when cannabis drugs are taken. The third stage, comprising a period of secondary stimulation, is not so distinctly marked and is often overlooked in the case of small and moderate doses.

Development of Addiction and Tolerance in Animals and Man

The effects of repeated administration of these drugs for prolonged periods were studied on monkeys, cats and albino rats. In these animals slight tolerance appeared to be developed and the animals showed a certain amount of liking for the drug after they had become habituated to its use by repeated administrations extending over a period of four to six weeks. In monkeys the desire for repeating the dose and the abstinence symptoms produced by the drug were mildly appreciable; these were not nearly so intense as is the case with animals to whom opiates were repeatedly administered. In cats and albino rats repeated administration of cannabis produced irritability and development of mild abstinence symptoms which were insignificant as compared with those occurring after morphine and cocaine.

Our own observations on the large series of persons who took cannabis drugs habitually agree with the experimental observations on animals. In contrast to other narcotic drugs, we found that the necessity for increase of dosage in order to produce the same effects subsequently was only rarely observed in those who took cannabis drugs habitually. The tolerance developed both in animals and man was generally slight, if any, and was in no way comparable to that tolerance developed to opiates. Its occurrence was observed only in those individuals who took excessive doses, after its prolonged use. Even then it was hardly appreciable when cannabis was taken orally, but sometimes occurred when it was smoked. The acute mental distress such as occurs in case of opiates during the withdrawal period was not nearly so marked. This probably accounts for the fact that in spite of the widespread use of cannabis drugs in India, there are hardly any reports of real addiction to the drug in the same way as there are to opium.

In the course of the studies on the treatment of opium addicts we were deeply impressed by the intensity of withdrawal symptoms, which were so very difficult to control even under hospital conditions. Special techniques had to be devised to overcome these abstinence symptoms and to make them bearable to the addict under treatment. In the case of cannabis drugs, however, even habitual use, over a long period, of bhang taken orally could be suddenly cut off without much difficulty and without production of any abstinence symptoms. In those who indulged in these drugs by smoking for a long time, difficulties sometimes arose upon withdrawal of the drug. These were, moreover, mild and could be easily overcome and hospitalization was not necessary. We are therefore justified in concluding that cannabis drugs do not produce real addiction in the sense opiates do. These observations confirm the views expressed by Chevers (1870) and Dhanjibhouy (1928).

Individual Variation in the Effect of Cannabis

(a) In Animals.-One of the most striking features with regard to cannabis drugs is the extreme variability of their physiological action in different individuals of the same species. Equal quantities of the same preparation administered to two similar animals of the same weight and under almost identical conditions may produce depression in one case and stimulation in the other. The effects also vary according to the species of the animals under observation. We have already referred to the change of disposition in cats and dogs under the effects of cannabis. The variability of results in the same species of animals was amply demonstrated by experiments on cats and monkeys.

In lower animals such as rabbits, rats and guinea pigs, even comparatively large doses of cannabis drugs produced none of the reactions produced in higher animals (monkeys, cats and dogs).

(b) In Man.-It would appear that the effect produced by the same specimen of the drug in man varied a good deal in different individuals. This was distinctly shown in experiments on ten Indian volunteers, two of whom were doctors who kept careful notes of their experiences. In the first instance, although the dose was less, it produced a much more marked effect. This may be due to the fact that in experiment 1 the subject was not used to alcohol or to any narcotic drug, while the subject in experiment 2 was used to alcohol in moderate doses. The effects on the doctor who was not used to alcohol or to narcotic drug were mental depression, anxiety, apprehension of death, slight slowing of the heart and increase in the respiratory rate, these effects being followed by a transitory feeling of exaltation, succeeded by a sense of duality, loss of self-control, slight muscular incoordination, and hallucinations of sight and hearing. Dreamless sleep followed. With the doctor who was accustomed to alcohol in moderate amounts, a bigger dose of cannabis produced less intense effects. There was a sensation of well-being, general intoxication and disturbed sleep; there being no feeling of duality. Sleep was more natural and prolonged in the0 first case, whilst it was disturbed in the second case.

Among some volunteers cannabis tended to produce listlessness and gave rise to amnesia and forgetfulness, whilst in others it had a marked effect upon the imaginative faculties, but the lower faculties did not seem to be affected. We have also observed that individuals may react differently to cannabis after head injuries or following upon special nervous and mental strains.

Smoking of Cannabis by Occasional Users.-Ganja and charas were smoked in chillum (earthenware pipe) and hookah by a series of inhabituated persons in our presence. The following is a brief summary of the effects observed.

Immediately after taking a pull at the pipe there was such intense irritation of the throat that the smoking had sometimes to be abandoned. After a few pulls there was a feeling of dryness of the mouth, giving rise to a feeling of thirst, sweating, and dizziness in the head. This was immediately followed by hallucinations of sight and hearing and general sensibility. The ideas of time and of space became somewhat hazy. The appetite decreased and the sleep which followed was disturbed.

Smoking of Cannabis by Habitual Smokers.-One hundred habitual cannabis smokers were made to smoke the drug. They described the symptoms as follows:

"Sense of well-being"; "I have done things to-day which I usually dislike, but which I rather enjoyed doing to-day";

"Nothing seemed impossible to accomplish"; "I assumed a cool and composed attitude and forgot all mental worries";

"I behaved in a childish and foolish manner"; "Sense of fatigue disappeared and feelings of happiness experienced";

"I feel like laughing"; "My head is dizzy"; "I feel like taking more food"; "The world is gay around me";

"I feel inclined to work"; "I am a friend of all and have no enemy in this world."

Briefly it may be said that there are individuals amongst ganja and charas smokers on whom the effect of intoxication is quite different from that ordinarily obtained, and that there is no euphoria. Sometimes they remain sitting in a fixed pose with their lower lip hanging down and a continuous nervous shivering may shake their bodies. Some, however, mutter senseless phrases after violent attacks of coughing. Sometimes, they pass into a state of inebriety and ecstasy, leap and dance about until they faint from utter exhaustion. Finally, there are individuals who after imbibing large quantities of cannabis preparations (orally or by smoking) manifest no stimulation stage but go directly to the stage of depression, drowsiness and sleep from the very beginning. They may sit in a squatting position apathetically in a corner meditating in silence, wholly indifferent to their surroundings. Some burst occasionally into a peal of shrill laughter, while others only grin placidly to themselves.

A careful analysis of the effects produced in this series of 100 regular cannabis smokers showed that 74 felt a definite sense of euphoria and exhilaration, only 12 felt depressed, 39 wanted to work, and 60 became more talkative. The appetite was increased in 58 per cent of the cases.

When questioned regarding their mental efficiency, 30% stated that it was increased, 10% felt that it was diminished, and the remaining 60% said it did not affect them either way.

The study of reaction to fatigue under the influence of cannabis drugs is also interesting. It would appear that 60% felt that fatigue was relieved, in 20% it was not affected either way, and in the same number the sense of fatigue was actually enhanced. The variability in the effects observed appeared to be clue to the mental disposition of the individuals.

Diuretic and Other Effects.-Diuresis attributable to cannabis has been observed by some western observers, but none of the series of habitués studied by the present writers in India, particularly referred to this aspect. We have no experimental data in this connexion ourselves, but an eminent authority like W. E. Dixon (1899) observed no change in urinary secretion in his human experiments. It is possible that direct renal irritation on account of the terpene character of the drug may explain the occasional instances of diuresis observed.

We have already referred to the aphrodisiac effects of cannabis which undoubtedly occurred in quite a number of habitués in the series studied. Thirst was not commonly observed. Ravenous appetite and desire for sweets were frequently observed. No observations were, however, made by us with regard to the presence of hypoglycaemia and its role in producing these symptoms.

Analgesic, Sedative and Hypnotic Effect.-In animal experiments we have observed definite sedative and hypnotic effects in cannabis. Taken as an analgesic it is undoubtedly inferior to the opiates, but it has quite marked .analgesic properties and, what is more important, none of the undesirable effects of the opiates. Its particular utility in combating neuralgias of all descriptions, headaches, migraine and dysmenorrhea was appreciated by practitioners of western and indigenous medicine in India. The latter still make use of this drug for relief of pain due to diverse causes, and even labour pains in women. They also use it largely as a sedative and hypnotic in various diseases. In appropriate doses it produces, without the preliminary excitement observed in animals, sleep which is sound and lasts for several hours. In India, although it was used quite extensively in the practice of medicine in former days, there is no evidence to indicate that it was abused as a medicinal agent or to show that its medicinal use led to the formation of habit (addiction).

Toxicity of Cannabis Drugs.-Experiments were performed to determine the minimum fatal dose of cannabis drugs in cats when administered orally. In the cases of bhang, ganja and charas this worked out to be 10 g., 8 g. and 3 g. per kg. of body weight respectively. Toxicity of charas is thus more than twice that of ganja and more than three times that of bhang. These quantities are approximate, but are of interest so far as their relative values are concerned.

Racial Variations

There is a common impression in the West that inhabitants of eastern countries are more prone than those of western countries to be attracted by narcotic drugs such as opium, cannabis and others leading to habit formation. This idea has, however, been considerably modified in the light of work carried out during recent years. It is now generally admitted that the habitual use of narcotic drugs is an international problem, and eastern and western people are equally liable to contract drug habits irrespective of race, caste or creed. The use of cannabis drugs would appear to be more prevalent in eastern countries, particularly among the inhabitants of tropical climes, where these drugs are more easily available, and also possibly because the strains and stresses of life are greater, because of climatic and economic factors. The remarkable attraction shown in western countries during recent years to the smoking of cannabis (marihuana) shows that racial factors are not important in that respect. There are of course minor variations: for example, it has been observed that Europeans who smoke cannabis frequently exhibit an abnormal desire for movement and with very large doses convulsions may occur. Some individuals may even run about the room; a host of wild, nonsensical ideas are let loose in their brain and impulsively expressed by outbursts of active muscular movements-literally, fits of laughter or of crying. On the other hand there are individuals who after taking cannabis manifest no stimulation stage, but go to the stage of depression, drowsiness and sleep from the very beginning. Such conditions, in our opinion, are not peculiar to any race, but occur among Indians just as much as among western people.

Although we personally have no experience about it, from the description we have read there appears to be no great difference in the general effects produced by cannabis on the Indian and western peoples. It may, however, be stated that in our experience in India, extending over many years, we have not come across such extreme cases of cannabis habit such as those of Baudelaire (1860) or Ludlow (1857). Such cases may be considered exceptional even among western people.

CHAPTER X Control of production, possession and sale of cannabis drugs

In view of the importance of cannabis as a narcotic and euphoric and in view of its extensive use by the people in this country the Government of India instituted a strict control over the production, possession and sale of cannabis drugs many years ago.

Although no statistics are available, from the numerous popular stories that are current among the people, it would appear that the habitual use of cannabis existed on a much more extensive scale in India in the past centuries than at the present time. In the time of the Moguls, cannabis was grown and its preparations were manufactured to a greater or lesser extent throughout the country, without restriction. The plant was grown by the people for their own domestic use, or was gathered from the natural growths in areas where it occurred. The British Government of India appreciated the injurious effects produced by the habitual use of cannabis and adopted measures to discourage its use as an intoxicant. In 1881 an Act was passed (Act XXII of 1881) restricting the use of these drugs. Later in 1893, a Hemp Drug Commission was appointed to go into the whole question of the use of cannabis by the people. On recommendations of this commission, Act XII of 1896 was passed enabling the Government to exercise absolute control on the cultivation of the cannabis plant and on the preparation, import, export, and transport of drugs therefrom. The Act laid down that cultivation could only be permitted in certain places under licence and proper supervision, while it was absolutely prohibited in others. Collection of the plant growing in a state of nature was restricted and controlled, and the import in any form was prohibited except by certain specified routes. All the products were stored in bonded warehouses from which they were issued to licensed vendors after adequate duty had been imposed and levied. The jurisdiction of the Act was gradually applied to all parts of India.

Having thus provided the necessary legislative sanction, the Government of India, in a circular letter No. 1925-S.R. dated 30 April 1896, enunciated the general lines of policy which provincial governments should bear in mind in improving local excise systems. In regard to ganja and charas, it was laid down:

That the cultivation of the cannabis plant in British India for the preparation of these drugs should be restricted as soon as possible, the production of ganja and the import of charas being, however, permitted under proper control and restrictions;
That all ganja and charas should on production or import into any state, be liable to a direct quantitative duty, such duty being paid on issue for consumption from the bonded warehouses where the drugs were to be stored, but to remain the property of the cultivators, dealers, or importers; and
That the drugs should be allowed to be freely carried, under suitable restrictions, but without payment of duty, from one warehouse to another within the same or into another province, the duty being realized therefrom on issue from the warehouse for retail sale in the province of consumption.

Spontaneous Wild Growth

We have already referred to the wild growth of the cannabis plant over extensive areas in the country. It was considered that no attempt should be made to extirpate the spontaneous growth; in fact it would have been an impossible undertaking because of the vastness of the areas in which the cannabis plant occurs. No restrictions were placed on the use of the wild plant in the green state or on its manipulation for the manufacture of fibre. The collection of bhang from wild or self-grown plants by wholesale and retail vendors for the purpose of sale was only permitted under licence in Punjab and Uttar Pradesh and the transport of bhang so collected was carefully regulated and restricted. Even for the production of hemp fibre and hemp seed, the cultivation of the cannabis plant is strictly limited to the Punjab, Uttar Pradesh (especially districts of Almora, Garhwal and Nainital) and Jammu and Kashmir.

National Legal Provisions for Control of the Cannabis Plant and its Resinous Products.1

This is done under the Dangerous Drugs Act, 1930 (ii of 1930). There is no national provision to regulate the cultivation, production, sale, possession, consumption of interstate import and export of hemp (cannabis) as defined in the Dangerous Drugs Act, 1930. These are regulated under respective state laws. The state governments have been empowered under this Act to make rules permitting and regulating the inter-state import and export from the territories under their administration, the transport, possession and sale of manufactured drugs (which include medicinal cannabis). The manufacture and compounding of cannabis extract and tincture and of preparations containing them is prohibited, except under Rule 6 of the Central Drugs Rules, 1934, subject to the control of the chief excise authority of the state and under licence.

¹India is a party to the International Opium Convention of 1925, which contains previsions relating to the international control of cannabis, its derivatives and preparations.

International Trade in the Cannabis Plant and its Resinous Products.-The system of export authorizations and import certificates and the special arrangements set forth in chapter IV of the 1925 Convention are applied in India. Exports of cannabis products by sea must be made through the ports of Bombay, Calcutta or Madras. Authorizations for export by land and sea are also issued by state governments. Special authorizations may be granted by the collector of customs at any port from which a ship leaves India, for the export of cannabis required in his opinion for bona fide use on the ship by the crew or by the passengers.

Illicit Trade in Cannabis Drugs.-The Government of India has decided that from 31 March 1959 no opium will be available through excise vendor shops for oral consumption in India. From that date, opium will be available only for strictly medical and scientific purposes. As regards ganja and bhang, ganja did not present the same serious problem as opium did, as there is no true addiction to it as is the case with opiates. Several states have already banned the use of ganja without difficulty. It is therefore not necessary to register addicts and provide for the gradual reduction in the consumption of cannabis, as was done in the case of opium. Besides, it would not be possible to do away with the consumption of cannabis altogether, at least for some time, in view of the fact that bhang is commonly used in certain states at religious and social functions. When imports of charas were stopped, consumption of ganja and bhang increased a good deal. If the increase was not officially recorded, it was because illicit consumption prevailed. In all countries, smugglers, lured by the extravagant rewards that their nefarious trade offers, try to foil the efforts of the governments to protect the health, physical and mental, of the population. The narcotic problem is therefore an international one. Gangs of international traffickers exist and shift their operations from country to country wherever the government control is ineffective. Seizures from merchant vessels and civil aircraft provide evidence of smuggling between countries. Nationally, India's contribution has been greatly satisfying and its policy of control of opium through government monopoly has been accepted as a model. The aim of the Government of India is that ganja and bhang must go the way of opium, in due course.

The quantities of cannabis products seized in the illicit traffic give an indication of the extent of smuggling which is going on. Figure of seizures from 1950 to 1954 in India are available and are given below. In this all the three preparations-i.e., bhang, ganja and charas-are found. In the case of bhang and ganja the illicit traffic is extensive, because these drugs are manufactured from the wild plant; the figures for charas are remarkable.

Quantities of Cannabis Products seized in the Illicit Traffic

	1950	1951	1952	1953	1954
Bhang and ganja	10,538 lb.	23,164 lb.	34,808 lb.	35,394 lb.	41,543 lb.
	(4,790 kg.)	(10,529 kg.)	(15,822 kg.)	(16,088 kg.)	(18,883 kg.)
Charas	42 lb.	257 lb.	763 lb.	1,030 lb.	794 lb.
	(19 kg.)	(117 kg.)	(347 kg.)	(468 kg.)	(361 kg.)

Experienced security officers place the seizures at 2 to 5% of the quantity which actually gets through. From this a rough estimate can be made of the amount actually smuggled through.

^001p000

¹See: "The surprising extinction of the charas traffic"; Bulletin on Narcotics. V: 1, 1953. [Editor's note.]CHAPTER II

REFERENCES

CHEVERS, N., 1870, A manual of medical jurisprudence for India , Thacker Spink & Co., Calcutta.
Government of India, 1893-94, Indian Hemp Drugs Commission Report.
DIXON, W. E., 1899, Pharmacology of Cannabis indica, Brit. Med. Jour ., vol. 2.
EWENES, G. F. W., 1904, Ind. Med. Gaz ., 39, p. 401.
ROBERTSON MILNE, C. J., 1906, Ind. Med. Gaz ., 41, p. 129.
ECKLER, C. R., 1917, Deterioration of Crude Indian Cannabis, Jour. Am. Pharm. Assoc ., vol. 6.
DHUNJIBOY, J. F., 1927, Transaction F.E.A.T.M., 7th Congress, Calcutta, 1, p. 400.
CHOPRA, R. N., 1928, The Present position of the Opium habit in India, Ind. Jour. Med. Res ., 16, No. 2, Oct. 389.
CHOPRA, R. N. & CHOPRA, G. S., 1931, Cocaine Habit in India, Ind. Jour. Med. Res ., 18, No. 3, Jan.
LEWEN, L., 1931, Phantastica. Narcotics and stimulating Drugs . Kegan Paul, Trench & Co., London.
CHOPRA, R. N. & CHOPRA, G, S., 1935, Opium Habit in India. Studies of the physical & Mental effects produced by Opium addiction , Ind. Jour. Med. Res ., 23.2.Oct., 359.
CHOPRA, R. N., 1935, Drug Addiction in India and its treatment, Ind. Med. Gaz ., 70, No. 3, March 121.
CHOPRA, R. N. & CHOPRA, G. S., 1938, The Opium Smoking habit in India and present position of the Opium smoking habit in India, Parts I, II, III, Ind. Med. Gaz ., 73, Nos. 2, 3, 4 (Feb. Mar. Ap.)
WALTON, R. P., 1938, Marihuana, J. B. Lippincott Co., New York.
CHOPRA, R. N. & CHOPRA, G. S., 1939, The present position of Hemp Drugs. Addiction in India, Ind. Jour. Med. Res ., Memoir,No. 31.
CHOPRA, R. N., 1940, Use of Hemp Drugs in India, Ind. Med. Gaz , 75, No. 6, June.
CHOPRA, R. N., CHOPRA, G. S. & CHOPRA, I. C., 1942, Cannabis sativa in relation to Mental diseases and Crime in India, Ind. Jour. Med. Res ., 30.1. Jan.
CHOPRA, R. N. & CHOPRA, I. C., 1955, Bulletin on Narcotics (United Nations), vol. 7, No. 3-4.
United Nations Economic and Social Council, 1956, Commission on Narcotic Drugs, 11th session, doc.: E/CN/7/286/Add.12.

United Nations

Office on Drugs and Crime

The Use of the Cannabis Drugs in India

Title

Details

The Use of the Cannabis Drugs in India

Table of Contents

Area under Cultivation for Production of Ganja and Charas

(Hectares)

Total Consumption of Cannabis Drugs in India

Quantities of Cannabis Products seized in the Illicit Traffic

REFERENCES