CO129-396 - Public Offices - 1912 — Page 479

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APPENDIX VII.

Note by the Hon'ble Surgeon General C. P. Lubis, C.S.I., M.D., LM.S. Director-General, Indian Medical Service, dated 27th June 1911, on the result of the recent medical enquiry about the drug habit. (Paragraph 14 of Despatch,)

As suggested by Mr. Brunyate, I have consulted various medical officers of experience and Superintendents of Jails and Lunatic Asylums, and I

put up below a selected series of their replies; also a statement of the causes of toxio insanity in lunatic asylums in India.

2. These reports clearly bring out the following points :--

(a) That Opium-eating can scarcely be considered a vice so far as Indians are conecrued. Its evil effects are most noticeable in Burma, and there the majority of the victims are Chinese. and after them the Burmese, but amongst the latter it is ebiefly used by the men from the hills-Kachines, Chines and Shans. Opium-smoking is regarded by Indians as a vice, and is, therefore, very rarely indulged in and then only in secret. The hypodermic injection of morphia is also very rare and is confined chiefly to Europeans and Eurasians.

Opium, as taken in moleration by the average Indian, is eaten as a stimulant, much in the same way that the British workman consumes his pint of beer or his richer neighbour his glass of port. Or else it is taken as a prophylactic against malaria; for the relief of pain; or to check the excretion of sugar in diabetes. As regards its use in malaria, it must be remembered that Indian opium contains a relatively largo proportion of Anarcotine, which is a valuable remedy in the treatment of that disense.

All the evidence goes to show that when consumed in moderate quantities (2 annas or less) it has no ill effects and this coincides with my own experience. Like Colonel Calvert, I have rarely seen it produce evil results except in a few decadents and members of the criminal classes. Like alcohol it only becomes an evil when taken in excess, but it differs from alcobol, as pointed out by Colonel Calvert, in one important respect the moderate opium ester can attend to his business and behave as a gentleman, whereas the alcoholic is a dangerous beast.

Another important point is that the average opium eater, having once fixed his dose, will often keep to it for years without increasing it, whereas the victim of alcohol and cocaine goes en constantly increasing it.

Major Jagoe Shaw's letter deserves especial attention as showing that opium, whether eaten or smoked, is never a cause or even an exciting cause of insanity, but that its continued aut excessive use leads to a condition of malnutrition which predisposes to insanity from any other exciting causes, just as it does to certain microbic infections especially tuberculosis. In this connection, please see Dr. Fink's report and that of Major Barry. There can be no doubt that, when large quantities of opium are taken for the relief of pain or checking of cough, although it lessens the suffering it lowers the patient's power of res stance and tends to hasten death; but I do not agree with Major Barry that it is ever the cause of tuberculosis or dysentery-be has, I think, confused cause with effect.

(6) Cocaine is a far greater national danger than opium. One important point as regards Once a man has contracted the cocaine

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its use is that there is no fixed dose. habit, he spends every farthing he can get on the drug and he rapidly becomes a mental and physical wreek. The babit is greatly on the increase especially amongst young men of the student class under 20 years of age. Fink also reports that it is used by pro-titutes suffering from venereal disease to prevent pain during sexual intercourse. Dr. Childe states that, whereas very little opium or morphia is consumed in Bombay, cocaine is largely used chiefly as an aphrodisiae and that it is doing far more harm than opium, whilst some opium traders affirm that they sell twice as much cocaine as opium, and Major Shaw considers that, either alone or combined with morphia, it is largely respon- sible for the increase of mental cases in his asylum. Colonel Calvert, too expresses his opinion that the effects of cocaine are infinitely worse than anything he has ever seen with opium. I entirely agree with this opinion. During my five years in Calcutta I saw many very sad cases amongst growing lads, and 1 regard this drug as being a grave menace to the future race. I believe it to be a potent factor in the spread of sedition, and to be responsible for many a criminal action or murderous outrage.

3. It is a very true saying "better the devil you know than the devil you don't know," and I fear that, if great restrictions are put upon the sale of opium, the only result. will be to drive the people to ibe more extensive use of alcohol, cocaine and Indian hemp-all of which are infinitely more deleterious in their effects than opium as consumell by the average Indian.

4. In this connexiou the table of the causes of insanity, which I put up below, is very instructive. It shows that 10 per cent of the cases are due to hemp in its various forms, 3:35 per cent to alcohol and only 046 per cent to opium,

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