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cataleptic rigidity occurred for two or three minutes. Summoned to I witness the effects, I found him enacting the part of a Raja giving orders to his courtiers; he could recognize none of his fellow students or acquaintances; all to his mind seemed as altered as his own condition; he spoke of many years having passed since his student's I days; described his teachers and friends with a piquancy which a dramatist would envy; detailed the adventures of an imaginary series of years, his travels, his attainment of wealth and power. He entered on discussions on religious, scientific, and political topics, with astonishing eloquence, and disclosed an extent of knowledge, reading, and a ready apposite wit, which those who knew him best were altogether unprepared for. For three hours and upwards he maintained the character he at first assumed, and with a degree of ease and dignity perfectly becoming his high situation. A scene more interesting it would be difficult to imagine. It terminated nearly as rapidly as it commenced, and no headache, sickness, or other unpleasant symptom followed the innocent excess.
In the symptoms above described we are unavoidably led to trace a close resemblance to the effects produced by the reputed inspiration of the Delphic Oracles-perhaps it would not be very erroneous to conclude, that it was referable to the same kind of excitement.
Use in Cholera.
An epidemic cholera prevailing at this period, two of the students administered the tincture of Hemp in several cases of that disease, and cures were daily reported by its alleged efficacy. Dr. Goodeve was thus led to try it in several cases, and his report was in the highest degree favorable. The diarrhoea was in every instance checked, and the stimulating effects of the drug clearly manifested. The Durwan of the College, an athletic Rajpoot, was attacked, and came under my treatment after he had been ill seven hours; he was pulseless, cold, and in a state of imminent danger, the characteristic evacuations streaming from him without effort-half a grain of the Hemp resin was given, and in twenty minutes the pulse returned, the skin became warm, the purging ceased, and he fell asleep. In an hour he was cataleptic, and continued so for several hours. In the morning he was perfectly well and at his duty as usual.
It is but fair to state, however, that the character of the epidemic was not at the time malignant. I admit the cases to be inconclusive, but I conceive them to be promising, and that they deserve the due attention of the practitioner.*
I now proceed to notice a class of most important cases, in which the results obtained are of the character which warrants me in regarding the powers of the remedy as satisfactorily and incontrovertably established. I allude to its use in the treatment of traumatic tetanus, or lock-jaw, next to hydrophobia, perhaps the most intractable and agonizing of the whole catalogue of human maladies.
The first case of this disease treated by Hemp was that of Ramjan Khan, æt: 30, admitted to the College Hospital on the 13th December 1838, for a sloughing ulcer on the back of the left hand. Five days previously a native empiric had applied a red hot gool (the mixture of charcoal and tobacco used in the hookah) to the back of the left wrist, as a remedy for chronic dysentery and spleen. The patient's brother was similarly cauterized on the same day. In both sloughing took place down to the tendons. Symptoms of tetanus occurred on the 24th December. The brother who had refused to avail himself of European aid, had been seized with tetanus at his own home four days previously, and died after three days illness. On the 26th of December spasms set in, and recurred at intervals of a few minutes; the muscles of the abdomen, neck, and jaws, became firmly and permanently contracted. Large doses of opium with calomel having been administered for some hours, without the least alleviation of symptoms, and his case having on consultation been pronounced completely hopeless, I obtained Dr. Egerton's permission to subject the poor man to the trial of the Hemp resin. Two grains were first given at 2 P. M., dissolved in a little spirit. In half an hour the patient felt giddy, at 5 P. M. his eyes were closed, he felt sleepy, and expressed himself much intoxicated.
He slept at intervals during the night, but on waking had convulsive attacks.
Since this paper was read at the Medical Society a severe epidemic cholera has broken out in Calcutta. I have treated seven cases in the Medical College Hospital, and in all the pulse and warmth returned from the use of this remedy. Five recovered, but all passed through a fever stage.-W. B. O'S.
On the 27th, two grains were given every third hour, (a purgative enema was also administered, which operated three times) the stiffness of the muscles became much less towards evening, but the spasms returned at intervals as before. Pulse and skin natural.
28th.-Improved; is lethargic but intelligent. Spasms occasionally recur, but at much longer intervals, and in less severity.
29th.-Dose of Hemp increased to three grains every second hour. Symptoms moderating.
30th.-Much intoxicated, continues to improve.
1st January, 1839-A Hemp cataplasm applied to the ulcer, and internal use of remedy continued; towards evening was much improved; spasms trivial, no permanent rigidity, Dysentery has returned. 2nd.-Morning report. Has passed a good night, and seems much better. Hemp continued. Evening report. Doing remarkably well. 3rd, 4th, and 5th.-Continues to improve. Hemp resin in two grain doses every fifth hour.
6th.-5 P. M. Feverish, skin hot, pulse quick, all tetanic symptoms gone. Dysentery urgent.
From this day the tetanus may be considered to have ceased altogether, but the dysenteric symptoms continued, despite of the use of opium and acetate of lead; the ulcer too proved utterly intractable. Some improvement in the dysenteric symptoms occurred from the 10th to the 15th. He seemed gaining strength, but the wound was in no wise improved, the slough on the contrary threatened to spread, and two metacarpal bones lay loose in the centre of the sore; on consultation it was agreed to amputate the arm, but to this the patient peremptorily objected. The mortification now spread rapidly, and to our infinite regret he died of exhaustion on the night of the 23rd January.
An unprejudiced review of the preceding details exhibits the sedative powers of the remedy in the most favorable light; and although the patient died, it must be remembered that it was of a different disease, over which it is not presumed that the Hemp possesses the least power.
The second case was that of Chunoo Syce, (treated by Mr. O'Brien at the Native Hospital) in whom tetanus supervened on the 11th December, after an injury from the kick of a horse. After an ineffectual trial of turpentine and castor oil in large doses, two grain doses of Hemp resin were given on the 26th November. He consumed in all 134 grains of the resin, and left the Hospital cured on the 28th December.
Third case. Huroo, a female, æt: 25, admitted to the Native Hospital on 16th December, had tetanus for the three previous days, the sequel of a cut on the left elbow received a fortnight before. Symptoms violent on admission. Turpentine and castor oil given repeatedly without effect; on the 16th and 17th, three grains of Hemp resin were given at bed-time. On the morning of the 18th she was found in a state of complete catalepsy, and remained so until evening, when she became sensible, and a tetanic paroxysm recurred. resumed, and continued in two grain doses every fourth hour. this time till the third hour tetanic symptoms returned. She subsequently took a grain twice daily till the 8th of February, when she left the Hospital apparently quite well.
Mr. O'Brien has since used the Hemp resin in five cases, of which four were admitted in a perfectly hopeless state. He employed the remedy in ten grain doses dissolved in spirit. The effect he describes as almost immediate relaxation of the muscles and interruption of the convulsive tendency. Of Mr. O'Brien's seven cases, four have recovered.
In the Police Hospital of Calcutta, the late Dr. Bain has used the remedy in three cases of traumatic tetanus, of these one has died and two recovered.
A very remarkable case has recently occurred in the practice of my cousin, Mr. Richard O'Shaughnessy. The patient was a Jew, æt: 30, attacked with tetanus during the progress of a sloughing sore of the scrotum, the sequel of a neglected hydrocele. Three grain doses were used every second hour, with the effect of inducing intoxication and suspending the symptoms. The patient has recovered perfectly, and now enjoys excellent health.
Besides the preceding cases I have heard of two of puerperal trismus thus treated in native females. Both terminated fatally, an event, which cannot discredit the remedy, when it is remembered that the Hindoo native females of all ranks are placed during and subsequent to their confinement in a cell within which large logs of wood are kept constantly ignited. The temperature of these dens I have found to exceed 120° of Fahrenheit's scale.
The preceding facts are offered to the professional reader with unfeigned diffidence, as to the inferences I feel disposed to derive from their consideration. To me they seem unequivocally to shew, that when given boldly and in large doses, the resin of Hemp is capable of
arresting effectually the progress of this formidable disease, and in a large proportion of cases of effecting a perfect cure.
The facts are such at least as justify the hope that the virtues of the drug may be widely and severely tested in the multitudes of these appalling cases which present themselves in all Indian Hospitals.
Delirium occasioned by continued Hemp Inebriation.
Before quitting this subject, it is desirable to notice the singular form of delirium which the incautious use of the Hemp preparations often occasions, especially among young men who try it for the first time. Several such cases have presented themselves to my notice. They are as peculiar as the "delirium tremens," which succeeds the prolonged abuse of spirituous liquors, but are quite distinct from any other species of delirium with which I am acquainted.
This state is at once recognized by the strange balancing gait of the patient, a constant rubbing of the hands, perpetual giggling, and a propensity to caress and chafe the feet of all bystanders of whatever rank. The eye wears an expression of cunning and merriment which can scarcely be mistaken. In a few cases, the patients are violent; in many, highly aphrodisiac; in all that I have seen, voraciously hungry. There is no increased heat or frequency of circulation, or any appearance of inflammation or congestion, and the skin and general functions are in a natural state.
A blister to the nape of the neck, leeches to the temples, and nauseating doses of tartar emetic with saline purgatives have rapidly dispelled the symptoms in all the cases I have met with, and have restored the patient to perfect health.
The preceding cases constitute an abstract of my experience on this subject, and which has led me to the belief that in Hemp the profession has gained an anti-convulsive remedy of the greatest value. Entertaining this conviction, be it true or false, I deem it my duty to publish it without any avoidable delay, in order that the most extensive and the speediest trial may be given to the proposed remedy. I repeat what I have already stated in a previous paper-that were individual reputation my object, I would let years pass by, and hundreds of cases accumulate before publication; and in publishing I would enter into every kind of elaborate detail. But the object I have proposed to myself in these inquiries is of a very different kind. To gather together a few strong facts, to ascertain the limits which cannot