see also: The History of the Intoxicant Use of Marihuana
The oldest known therapeutic description Of cannabis was by the Emperor Shen-Nung in the 28th century B.C. in China, where the plant had long been grown for fiber. He prescribed cannabis for beri-beri, constipation, "female weakness," gout, malaria, rheumatism and absentmindedness (Bloomquist, 1968: 19).
In Egypt, in the 20th century B.C., cannabis was used to treat sore eyes. Additional medical usage was not reported until much later. India Prior to the 10th century B.C., bhang, a cannabis preparation, was used as an anesthetic and antiphlegmatic in India. In the second century A.D., a Chinese physician, Hoa-Tho, prescribed it as an analgesic in surgical procedures (Mikuriya, 1969: 34). From the 10th century B.C. up to 1945 (and even to the present time), cannabis has been used in India to treat a wide variety of human maladies.
The drug is highly regarded by some medical practitioners in that country. The religious use of cannabis in India is thought to have preceded its medical use (Blum and Associates, II, 1969: 73; Snyder, 1970: 125). The religious use of cannabis is to help "the user to free his mind from worldly distractions and to concentrate on the Supreme Being" (Barber, 1970: 80).
Cannabis is used in Hindu and Sikh temples and at Mohammedan shrines. Besides using the drug as an aid to meditation, it is also used to overcome hunger and thirst by the religious mendicants. In Nepal, it is distributed on certain feast days at the temples of all Shiva followers (Blum & Associates, 1969, 11: 63). The Hindus spoke of the drug as the "heavenly guide," "the soother of grief." Considered holy, it was described as a sacred grass during the Vedic period (Fort, 1969: 15).
A reference to cannabis in Hindu scriptures is the following:To the Hindu the hemp plant is holy. A guardian lives in bhang ... Bhang is the joy giver, the sky filer, the heavenly guide, the poor man's heaven, the soother of grief ... No god or man is as good as the religious drinker of Mang. The students of the scriptures of Benares are given bhang before they sit to study. At Benares, Ujjain and other holy places, yogis take deep draughts of Mang that they may center their thoughts on the Eternal . . . By the help of Mang ascetics pass days without food or drink. The supporting power of Mang has brought many a Hindu family safe through the miseries of famine (Snyder, 1970: 125).
In ancient Greece, cannabis was used as a remedy for earache, edema, and inflammation (Robinson, 1946: 382-383).
Cannabis was used in Africa to restore appetite and to relieve pain of hemorrhoids, its antiseptic uses were also known to certain African native tribes (O'Shaughnessy, 1842: 431). Various other uses, in a number of countries, included the treatment of tetanus, hydrophobia, delirium tremens, infantile convulsions, neuralgia and other nervous disorders, cholera, menorrhagia, rheumatism, hay fever, asthma, skin diseases, and protracted labor during childbirth.
The 19th Century
Documents of the 19th century report on the use of cannabis to control diarrhea in cholera and to stimulate appetite. In his reports of the late 1830's and early 1840's, O'Shaughnessy (1842: 431) stated that tetanus could be arrested and cured when treated with extra large doses of cannabis.
John Bell, M.D., Boston, reported enthusiastically in 1857, about the effects of cannabis in the control of mental and emotional disorders as opposed to the use of "moral discipline" to restrain the mentally ill. Similarly, in 1858, Moureau. de Tours reported several case histories of manic and depressive disorders treated with hashish (Walton, 1938: 3).
The Ohio State Medical Society's Committee on Cannabis Indica, convened in 1860, reported that their respondents claimed cannabis successfully treated neuralgic pain, dysmenorhea, uterine hemorrhage, hysteria, delirium tremens, mania, palsy, whooping cough, infantile convulsions, asthma, gonorrhea, nervous rheumatism, chronic bronchitis, muscular spasms, tetanus, epilepsy and appetite stimulation (McMeens, 1860: 1). The India Hemp Commission (1894: 174) likewise was informed of similar medicinal uses for cannabis.
Specific reports included the use of cannabis as an analgesic, a restorer of energy, a hemostat, an ecbolic, and an antidiaretic. Cannabis was also mentioned as an aid in treating hay fever, cholera, dysentery, gonorrhea, diabetes, impotence, urinary incontinence, swelling of the testicles, granulation of open sores, and chronic ulcers. Other beneficial effects attributed to cannabis were prevention of insomnia, relief of anxiety, protection against cholera, alleviation of hunger and as an aid to concentration of attention.
Medical uses in the 20th Century
Despite the fact that marihuana was made illegal in the United States in 1937, research has continued on the medical uses of marihuana. The findings include various possible medical applications of cannabis and its chemical derivatives.
One of the most recent and interesting findings (Frank, 1972) concerns the effect of cannabis in reducing intraocular pressure. It was found that as the dose of marihuana increased, the pressure within the eye decreased by up to 30%. This occurred in normal persons as well as in those with glaucoma, a disease of the eye in which increased intraocular pressure may cause blindness. Much more research is necessary in connection with this experimental clinical finding before final judgment can be passed on such a possible therapeutic value.
During the past 20 years in western medicine, marihuana has been assigned antibiotic activity; as a result, several studies relating to this possibility have been undertaken. H. B. M. Murphy (1963: 20) reported investigations in Eastern Europe. He stated that "it is alleged to be active against gram positive organisms at 1/100,000 dilution, but to be largely inactivated by plasma, so that prospects for its use appear to be, confined to E. N. T. (ear, nose and throat) and skin infections."
Dr. J. Kabelikovi (1952: 500-503) and his coworkers carried out tests on rats, which were similar to tests carried out with penicillin in vitro. The alcohol extract of cannabis was bacterially effective against many gram-positive and one gram-negative microorganisms. It was also found that a paste form of external application was successful.
According to Kabelikovi, "from a study of 2,000 herbs by Czechoslovakian scientists it was found that cannabis indica (the Indian Hemp) was the most promising in the realm of antibiotics." In a 1959 publication of Pharmacie, Krejci stated: "From the flowering tips and leaves of hemp, cannabis sativa var indica bred in Middle Europe, were extracted a phenol and an acid fraction. From the acid fraction, two acids were obtained, of which one preserved its antibiotic properties" (p. 349).
In another Czechoslovakian publication, Krejci (1961: 1351-1353) referred to two additional samples with antibiotic activity. Sample I in Fig. 1 has been sufficiently identified as cannabidiolic acid and sample 9 as cannabidiol. Both fractions show antibiotic activity. The results of tests lead us to conclude that the antibacterial action of cannabis sativa is not identical to the hashish effect found, for example, in tetrahydrocannabinol. However, it was established that cannabis sativa is effective as an antibiotic for local infections.
Kabelik, Krejci, and Santavy (1960: 13) include in "Cannabis as a Medicant" the various microorganisms against which cannabis is effective. Proof could be furnished that the cannabis extracts produce a very satisfactory antibacterial effect upon the following microbes: staphylococcus pyogenes aureus, steptococcus alpha haemolyticus, streptococcus beta haemolyticus, enterococcus, diplococcus pneumonia, B. anthracis, and corynebacterium diptheriae i.e., all of them gram-positive microorganisms. Noteworthy is the effect upon staphylococcus aureaus strains, which are resistant to penicillin and to other antibiotics. These authors also mentioned that E. coli (gramnegative bacteria) were tested and found to be resistant to the cannabis extract.
One of the conclusions was "the possibility of utilizing the antibiotics locally without any danger of producing resistant strains to other antibiotics administered at the same time throughout treatment" (Kabelik, et al., 1960: 13). Veliky and Genest in "Suspension Culture of Cannabis Sativa," (1970) reported that "the ethanol extract of cultured cells exhibited antibiotic activity against Bacillus megatherium, staphlococcus aureaus and escherichia coli" (p. 493).
Other reports said that "a pronounced antibiotic effect has been observed in South America, where fresh leaves, after being ground, are used as a poultice for furuncles, and in folk medicine in Europe for treatment of erysipelas" (Kabelik, et al., 1960: 8). This section on the -antibiotic uses of cannabis concludes with a summary of several reports from various countries. In Pharmacopee Arabe: "The ground-up seeds are mixed with bread for people with tuberculosis" (Andrews and Vinkenoog, 1967: 145). In Czechoslovakia: "A preparation from seed pulp was . . . introduced by Sirek to act as a roborant diet in treatment of tuberculosis" (Kabelik, 1960: 8). "In Southern Rhodesia the plant is used as an African remedy for malaria, anthrax, sepsis, black water fever, dysentery, blood-poisoning, tropical quinine-malarial haemoglobinuria, and a wart medicine" (Watt, 1961: 13).
In Argentina: Cannabis is considered a real panacea for tetanus, colic, gastralgia, swelling of the liver, gonorrhoea, sterility, impotency, abortion, tuberculosis of the lungs and asthma ... even the root-bark has been collected in spring, and employed as a febrifuge, tonic, for treatment of dysentery and gastralgia, either pulverized or in form of decoctions. The root when ground and applied to burns is said to relieve pain. Oil from the seeds has been frequently used even in treatment of cancer . . . (Kabelik, 1960: 8).
In 1949, Davis and Ramsey reported a study of the effect of THC on epileptic children. "The demonstration of anticonvulsant activity of the tetrahydrocannabinol (THC) congeners by laboratory tests (Loewe and Goodman, Federation Proc., 6: 3521 1947) prompted clinical trial in five institutionalized epileptic children" (David and Ramsey, 1949: 284-285). Of these five children, all had severe symptomatic grand mal epilepsy with mental retardation; three also had cerebral palsy; and three had focal seizure activity. The EEG tracings were reported to be grossly abnormal in all five children. The results after treatment with homologues of THC, were reported as follows: Three children-responded at least as well as to previous therapy. Fourth child-almost completely seizure free. Fifth child-entirely seizure free. As a result of their study, David and Ramsey (1949: 284-285) felt that "the cannabinols herein reported deserve further trial in non-institutionalized epileptics."
Dr. Vansim of Edgewood Arsenal has written in a recently published book "Psychotomimetic Drugs," that the synthetic preparations of cannabis are of interest. There are three areas where they may be of definite use in medicine (Efron, 1969: 333-334). One concerns the use of a cannabis analogue which Dr. Walter S. Loewe reported very effective in preventing grand mal seizures if given in small doses. The second use refers to cannabis as an antidepressant. Straub (Walton, 1938: 3), Adams (1942: 726-727), and Stockings (1947, 920-922) point to the possible use of cannabis and cannabis analogues in relieving dysphoria in depressed patients.
Other authors (Parker and Wrigley, 1950: 278-279) had lesser success but recommended further research in this field. A report from London in 1968 suggests that cannabis treats the symptoms and not the cause by focusing the user's attention on his anxieties and pains without helping him to resolve them (Report by the Advisory Committee, 1968: 11). The third use is described by Douthwaite, who used hashish in 1947 "for reducing of anxiety and tension in patients with duodenal ulcer" (Pond, 1948: 279). A report in a 1965 issue of Medical News ("Cardiac Glycocides," p. 6) suggests cannabis as treatment for a specific form of malignancy. Cannabis is recognized as an appetite stimulant, which suggests that the drug might be useful in the treatment of pathological loss of appetite known as anorexia nervosa (Grinspoon, 1969: 21).
Similar symptoms exist in terminal cancer patients who, when treated with cannabis over a short period of time, demonstrated stimulation of appetite, euphoria, increased sense of well-being, mild analgesia and an indifference to pain which reduced the need for opiates (DHEW, 1971: 11).
Cannabis has been recently proposed as an adjunct in the treatment of alcoholics and drug addicts. Roger Adams (1942: 726-727) and Todd Mikuriya (1970a: 187-191) noted that the substitution of smoked cannabis for alcohol may have rehabilitative value for certain alcoholics. Regarding the use of cannabis analogue in the treatment of drug, alcohol and depressive state withdrawal, Thompson and Proctor (1953: 520523) report the following: Depressive States: 20 cases of neurotic depression-4 improved (20%) 6 cases of psychotic depression-none improved (00%) Post-Alcoholic Cases: 70 cases--59 reported clinical alleviation of symptoms (84%) Drug Cases: 6 cases of barbiturate addiction-4 reported amelioration of symptoms (66%) 4 cases of dilaudid addiction-3 reported alleviation (75%) 2 cases of pantopan and one paregoric addiction-all reported smooth withdrawal (100%) 12 cases of Demerol addiction-10 withdrawals in one week (83%) 6 cases of morphine addiction-2 withdrawals without unpleasant symptoms (33%)
The doctors concluded that "Pyrahexyl (a synthetic cannabis-like drug) and related compounds are beneficial in the treatment of withdrawal symptoms from the use of alcohol to a marked degree, and in the treatment of withdrawal symptoms from the use of opiates to a less marked, but still significant degree" (Thompson & Proctor, 1953:520-523). Drs. Allentuck and Bowman (1942) undertook a study of the use of marihuana in the morphine abstinence syndrome. They stated: A series of cases were selected from among drug addicts undergoing treatment. . . . Comparative results were chartered for the gradual withdrawal, total withdrawal, and marihuana derivative substitution, as methods of treatment. . . . 49 subjects were studied. The results in general, although still inconclusive, suggest that the marihuana substitution method ameliorated or eliminated (the symptoms) sooner, the patient was in a better frame of mind, his spirits elevated, his physical condition was more rapidly rehabilitated, and he expressed a wish to resume his occupation sooner (p. 250).
In his study of the medical application of cannabis for Mayor LaGuardia's committee, Dr. Samuel Allentuck reported "favorable results in treating withdrawal of opiate addicts with tetrahydrocannabinol (THC), a powerful purified product of the hemp plants" (Mikuriya, 1969: 38). Roger Adams' detailed studies, as reported by Dr. C. K. Himmelsbach in his 1944 article "Treatment of the Morphine Abstinence Syndrome with a Synthetic Cannabis-Like Compound" (1944:26), indicated that "withdrawal manifestations were considered to be mild.
The reported therapeutic value of marihuana was attributed to improved appetite, greater sleep, euphoria, and a reduction of the intensity or elimination of abstinence phenomena." Himmelsbach, however, had lesser success when he studied the effect of a "pyrahexyl" compound on the morphine abstinence syndrome, as noted by his conclusions that: (1) Pyrahexyl compound appears to possess considerable cannabis-like effect when administered orally, but little or none when given intramuscularly. (2) When given by mouth In definitely effective amounts pyrahexyl compound had no appreciable ameliorative effect on the opiate abstinence syndrome (P. 29).
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