Cannabis

CANNABIS
   The dried flowering tops of the female plant of Cannabis sativa, Linné, or the variety indica, Lamarck (Nat. Ord. Cannabinaceae). Asia, East Indies, and cultivated in other parts of the world, notably in the United States. Common Names: Guaza, Ganjah, Gunjah, Ganga; Indian Hemp (Cannabis indica) when derived from the Indian plant. Principal Constituents.—Not well determined. The following have been noted: Cannabin, an active brown resin, and cannabinon, a soft resin. Preparation.—Specific Medicine Cannabis. Dose, 1/2 to 10 drops. Specific Indications.—Marked nervous depression; irritation of the genito-urinary tract; burning, frequent micturition; painful micturition, with tenesmus; scalding urine; ardor urinae; wakefulness in fevers; insomnia, with brief periods of sleep, disturbed by unpleasant dreams; spasmodic and painful conditions, with depression; mental illusions; hallucinations; cerebral anemia from spasm of cerebral vessels; palpitation of the heart, with sharp, stitching pain; and menstrual headache, with great nervous depression. Action.—The principal seat of action of cannabis is upon the intellectual part of the cerebrum. In many respects its effects parallel those of opium and its chief alkaloid. Without doubt it is the most perfect psychic stimulant known to medicine. Certain Orientals become addicts to it, consuming it in the form they call haschisch (whence comes the term assassin), and under its influence many crimes and offenses have been committed, as well as with it. Eastern potentates are said to have dosed their fanatic followers with it. It produces an agreeable semi-delirium taking on the character of a sense of well-being and exhilaration-a state highly coveted by its devotees, who call it loftily “the increaser of pleasure,” “the laughter mover,” “the cementer of friendship,” and “the cause of a reeling gait”- all indicative of its physiologic influence. These haschisch debauches are joyful affairs, and while usually devoid of injurious consequences, may be followed by catalepsy and depressive and maniacal insanity, from which, however, the victim recovers fully in time. In some respects the effects of cannabis on the nervous system are peculiar. It causes an apparently contradictory, consentaneous stage of stimulation and depression-a state somewhat simulated by morphine. The sensations that follow the effects of cannabis vary greatly with the temperament and the peculiarities of the patient, and with his environment. Almost invariably they are pleasurable. An emotional state of happiness even to ecstacy is experienced, with an endless procession of beautiful visions coming and going, and over which the patient indulges in merriment and even hilarity. So pleasurable becomes his sensations that he may break into boisterous laughter and antics of a ridiculous character, the nature of which he fully comprehends, but is wholly unable to prevent. Gradually passing into a dream-like stage, he talks, volubly, brilliantly, with everrecurring changes of topic, little coherence of thought, and a perverted judgment. His imagination carries him into ludicrous ideas and strange actions, he has notions of grandeur and greatness, and moments are exaggerated into æons of time. He lives a “life-time in a minute.” Endless phantasms of beauty and delight pass before his distorted mental vision. A singular peculiarity is a state of “double consciousness” or dual personality which possesses him in which he imagines he is both himself and some one else, and he behaves accordingly. He becomes affectionate to the extreme, both to himself and to others, and altogether he is a very happy individual leading a very full and infinitely extended life. Finally drowsiness overtakes him and he drops into a heavy sleep, which may last for hours, and from which he awakens with no other discomfort than a ravenous hunger. In this last stage the pupils are dilated, muscular power in abeyance, and partial anesthesia prevails. While the ultimate effects of the drug in some result in tremor, great weakness, loss of appetite and convulsions, no deaths have been known to occur in man from this drug. The effect upon Caucasians is less pronounced than that described, which is experienced chiefly by Orientals. In the former the stage of exhilaration and phantasmagoric inebriation may be very brief or entirely absent, the patient passing successively through heaviness and numbness of the limbs, heat in the head, giddiness, a pleasurable pricking of the whole body, drowsiness, and deep sleep. With some individuals pressure upon the skin is said to excite a sense of burning, and the subsequent anesthesia may become so profound that the patient, when standing, is not conscious of contact with the ground. One young man to whom we administered cannabis amused himself by repeatedly jumping over the foot of his bed, laughing with great glee over his capers. Therapy.—The therapeutic effects of cannabis vary under different conditions. It stimulates in depression and sedates when there is irritation. It lessens pain-especially spasmodic pain-allays spasm, improves the appetite, causes a feeling of contentment and rest, and produces sleep. If pushed too rapidly or in too large doses, exhilaration of spirits, inebriation with phantasms, illusory delirium, and sometimes strong aphrodisia precede sleep. A peculiarity in many individuals taking cannabis is the voracious appetite induced. The effects of cannabis are far less powerful and less disturbing to the general system than those of opium, and it does not, like the latter, restrain the secretions nor produce itching. If anything the urine is increased by cannabis and constipation does not occur. The keynote indication for cannabis is marked depression of the nervous system usually with insomnia. Secondly, it allays irritation of the urino-genital tract and relieves pain. For the first condition it is invaluable in more or less painful conditions in which opium see¹

COPAIBA^COOF2
   An oleoresin derived from species of Copaiba growing in South America. Dose, 5 to 30 drops. Description.—A viscid, pale-yellow or brownish-yellow liquid, without or with a faint fluorescence (green), and having a bitter, acrid, and persistent taste, and a distinctive aroma. Soluble in chloroform, ether, dehydrated alcohol, and volatile or fixed oils; partly soluble in alcohol; insoluble in water. Specific Indications.—Vesical pressure and tenesmus, frequent urging to urinate, the urine passing in drops; itching, burning or smarting in the urethra after urinating; urethral mucoid discharges; laryngeal irritation; cough, with thick tenacious sputum, accompanied by loud rales. Action.—Copaiba is a stimulating antiseptic when applied to the skin and mucosa. Small doses taken internally act as a stimulant and antiseptic diuretic. It restrains excessive mucous discharges. When swallowed it causes gastric warmth, unpleasant eructations, and sometimes nausea and vomiting. Continued use impairs the digestive processes. It is readily absorbed, imparting its odor and bitterness to the secretions. While apparently eliminated by all the emunctories, it is chiefly passed in the urine in company with glycouronic acid. Large doses occasion gastroenteritis and haematuria. A transient measleslike eruption on the skin, with unpleasant formication and itching, or an erythematous, urticarial or bullous outbreak may occur from its use. It is not determined whether this is due to elimination-irritation, or to gastric disturbances produced by the drug. Therapy.—External. Copaiba is sometimes applied to frost-bites and chilblains, sore nipples, old ulcers, and anal fissures, and to fistulous tracts to soften hardened edges and surfaces; also in sluggish chronic skin affections when a stimulating antiseptic action is desired. Internal. Copaiba is a remedy for excessive mucous discharges after the subsidence of acute inflammation. For this purpose it is rarely used in chronic bronchitis, especially when coincident with a catarrhal condition of the bladder. It is of much value in intractable gonorrhea in the male to reawaken a dormant infection and recreate the active symptoms, after which the smaller doses are used to restrain the discharge and antisepticize the membranes. It should never be used in the acute inflammatory stage of gonorrhea, with pronounced urethral irritation and profuse secretion. This stage should be treated with Rx. Specific Medicine Aconite, 10 drops; Specific Medicines Gelsemium and Cannabis, one fluidrachm each; Simple Syrup, enough to make 4 fluidounces. Mix. Sig.: One teaspoonful every 3 hours. Having used the required local application, and rendered the urine bland by the use of small doses of sodium bicarbonate well diluted, employ the following after the acute phase has subsided: Rx Copaiba, 1 fluidrachm; Alcohol, 1 fluidounce. Mix. Dose, 5 to 10 drops in sugar and water 4 times a day. If chronic or unduly prolonged use the following: Rx. Copaiba and Spirit of Nitrous Ether, 1/2 fluidounce each; Liquor Potassae and Essence of Cinnamon, 1 fluidrachm each; Mucilage of Acacia and Simple Syrup, 1 fluidounce each. Mix. Sig.: One teaspoonful after each meal. Copaiba only helps gonorrhea when brought in direct contact with the parts affected, as it does when passed in the urine. For this reason it is more effectual in the male than the female in whom at least a part of the infection is vaginal. It is also less valuable by injection than when used internally. The foregoing treatment is Locke’s method, and is adapted to otherwise unconquerable cases. Most cases of gonorrhea are now readily cured by more modern means.¹