“I’ve recently completely changed my mind about vaporizing technology. It is a marvelous experience to inhale the essence of pure vaporized Cannabis flower, and vaporizing is so far superior to smoking that I feel like an idiot I was so blindly opinionated for so long without simply trying it.”
Both my parents smoked cigarettes, and I loved the smell of tobacco and the rituals surrounding it. The click of my Dad’s Zippo lighter as he flipped it open, the aroma of lighter fluid, then the scratch of the wheel and the muted whoosh of flame, followed by Dad’s first eager puff and long, slow, savory exhale. Cigarettes were actually real tobacco in those days, and their aroma was literally intoxicating to me. So naturally I began smoking too when I was pretty young.
I first discovered Marijuana when I was seventeen, and fell in love with the tastes and smells of those first strains to hit the streets of California – Acapulco Gold and Oaxacan Purple, and the mysterious Panama Red that occasionally drifted up from Florida. Of course, most of what we got was Mexican Smash – leaves, stems and the occasional beetle glued together with Coca Cola – but it was still great smoke as long as you were young and stupid and had no taste. The Marijuana we took huge risks and paid big money for in 1960 you couldn’t give away today, and rightfully so.
However, beginning in my 50’s it was clear that smoking was damaging my health, as was drinking, so I gradually phased both (mostly) out of my life. I did enjoy the occasional bud that floated my way out of the inherent kindness of the universe, and when I would find myself near a promising bar I wouldn’t deny myself the pleasure of a good margarita. But by & large I tried to become much more moderate, and even in moderation I was finding the experience of drinking and smoking was losing its appeal.
Moderation is a great thing – in moderation – and now that I find myself newly settled back in Oregon I am delighted to be able to walk into great little gourmet Cannabis shops and select a gram of bud from a strain I’ve never tried before. For a small party we had a few weeks back and I bought a Cannabis Tasting Flight, a gram each of the budtenders six favorite top shelf Sativa/Indica selections, the same way I would have for a Wine or Tequila Flight. How pleasant to be able to enjoy Cannabis as a normal part of life without the tinge of paranoia that was always (quite rationally) present.
But what adds so much to my pleasure in trying out all these new strains is that I don’t have to smoke any more. I’ve found that I can vaporize a pinch of dried flower in an efficient little device and enjoy this particular strain’s unique flavors and aromas along with whatever body and mind effects I’m looking for in a particular strain.
Nobody has to be old to enjoy the benefits of vaporizing whole Cannabis flowers, but if you are getting on in years like I am and want to be able to enjoy the medicinal and recreational benefits of Cannabis without the toxic side-effects of smoke, as I do, then you’re going to really appreciate the new whole flower vaporizing technology that’s out there. For me, it’s so superior to smoking the divine weed in any kind of pipe that I am never going back.
Don’t get me wrong – I love smoke. All kinds. Always have. I miss the days of walking out to the airplane across the tarmac, inhaling the jet fuel and diesel equipment fumes that smelled like freedom. Around campfires I would always take the downwind spot and enjoy inhaling the clouds of burning wood and charring meat. I couldn’t get enough of trains and train stations, and once underway I always spent as much time as possible between the cars enjoying the motion, the sounds, and the smells of the smoke trailing back from the diesel engines far ahead. Pulling out of Tokyo harbor in 1949 on an old Navy troopship carrying hundreds of military women & children back to America, the air full of salt, fish, garbage, oil and diesel, the whole ship vibrating beneath my feet and great clouds of bunker fuel fumes coming from the smokestacks and from the hard-revving tugs alongside – I was in little kid heaven.
I have to admit that for years I held a lot of ill-informed opinions about vaping, and I still don’t like the idea of inhaling the vapors of chemically-processed anything, even supposedly “natural” Cannabis products like Wax & Shatter. In retrospect it looks to me like vaporizing technology, or at least vaporizer marketing, skipped right past whole dried Cannabis flowers and went straight to more easily manufactured and standardized but potentially lethal products, and huge numbers of people went along without thinking.
Unfortunately too much of the Cannabis industry seems to have fallen into this trap. Although hundreds of growers are producing thousands of beautiful, flavorful, exotic strains of Cannabis, most shops price and sell these flowers based on their THC levels without regard for taste and smell, mind/body effects like creativity or couchlock, or therapeutic effects like sleep initiation or appetite stimulation. It is as if fine wines were being sold primarily for their alcohol content, on the premise that nobody cared about enjoying them any other way.
Out of an enormous worldwide market for cheap addictive chemicals in sleek little devices has come the shadow world of unregulated vaping compounds packaged in colorful, toy-like electronic inhalers. I’m afraid that a lot of people are being conned into inhaling vapors of cheap industrial chemicals from China and India in totally unregulated compounds disguised with clever names and fruity flavors. I’m concerned that many of these folks are going to have deep regrets sooner rather than later. I would not be surprised at all to see epidemiologists soon begin announcing the discovery of a mysterious multi-symptom epidemic of irreversible neurological damage among young people that will ultimately be traced to vaping these clever little toys filled with whatever industrial chemicals the device manufacturer thinks will kick ass.
In whatever terrible ways that onrushing tragedy may evolve, I’ve recently completely changed my mind about vaporizing pure Cannabis flower. It is not only a marvelous experience in itself, but it is so far superior to smoking that I feel like an idiot I was so blindly opinionated for so long without simply trying it. I’m writing this post because I’ve come to believe that vaporizing dry Cannabis flower may be the best medical and recreational option for many people my age – let’s just say someone who’s well into those golden years.
Older people who want to enjoy Cannabis as part of a lifestyle or who find that Cannabis is a helpful medication need to discover that vaporizing Cannabis flowers is a smoke-free option with real advantages. For one thing, your body isn’t being subjected to Cannabis smoke, which in addition to the good stuff like THC also contains concentrated particles of carcinogenic soot as well as carcinogenic combustion gasses. Smoke itself, any smoke, is full of substances and chemicals created by combustion that are known to lead directly to horrible diseases. That’s true of any smoke coming from any combusted organic matter – Cannabis, cigarettes, backyard grills, fireplaces or campfires.
I’ve found vaporizers easy to use – at least my device is simplicity itself and if it lasts over a couple of years I’ll consider it a worthwhile buy. All I have to do is to pinch off a bit of Cannabis flower and put it into the small ceramic chamber, tamp it down and then put the mouthpiece back on, tap in the code and wait a few seconds for the digital readout to show me that the chamber is at 400 degrees, and then draw in a stream of almost invisible vapor.
My first hit of fresh Cannabis flower vapor is exactly like the first long sip of a cold beer on a hot day – I know there won’t be a better sip in the whole bottle. All of the volatile, delicate flavors and aromas of the flower come across fresh and intact in that first sip of vapor. Everything that follows, while enjoyable and pleasant, can never equal that first rush of magical molecules.
I find that if I stop after the first hit of vapor (I wish I were inclined to do so more often), I am already close to where I want to be, and I find that I need only a few tokes on the vaporizer to enjoy the same results that would otherwise take a whole bowl or joint. I like that I am not subjecting my increasingly aging body to the toxic stress of smoke just so that I can enjoy being high and receiving the health benefits of Cannabis.
Whether you are medicating with Cannabis, or simply relaxing with a bud after a long day, by using a vaporizer you will be able to do so discreetly, cleanly, and without the toxic side effects of smoke. Vaporizing is an especially nice way to use Cannabis as a sleep aid because your body doesn’t have to deal with the toxic effects of smoke in order to get the beneficial effects of the vaporized THC and CBD. Just fire up the vaporizer, take a clean, sweet hit, lie back, relax and drift off to sleep. It’s especially nice not to have to worry about choking your partner with a bedroom full of smoke at 2 AM just because you’ve woken up and need a hit to get back to sleep.
Another real advantage of using a vaporizer is that your environment isn’t permeated by stale smoke. As delightful as those first hits of fresh bud are, a Cannabis smoker’s living space quickly gets as nasty as any cigarette smoker’s cave. Stale smoke is just stale smoke, no matter how delightful its origins. But with a vaporizer, especially if you only take the first few puffs when the vapor is so pure that it is practically invisible, there is almost no lingering odor to disturb others or to betray you to the smoke Nazis that seem to be on patrol everywhere these days.
Bottom line – if you’re getting on in years and haven’t tried vaporizing Cannabis flowers as an alternative to smoking then you owe it to yourself to have the experience. It may open up new possibilities in areas of fun and pleasure that you thought were fading away, and it will certainly make using Cannabis for your health, vitality and medical needs a lot cleaner and more private.
But perhaps the best reason of all to vaporize is that smoking is now a relic of the past, just like living in caves – people have loved the essence of Cannabis since the dawn of time, and for thousands of years we had to inhale smoke to enjoy that essence (except for bhang, of course), and so we all went ahead, fired it up, lay back and watched the shadows dancing on the walls of the cave. Now that vaporizing technology has arrived we don’t have to smoke to enjoy and benefit from Cannabis, and I for one am happy to leave those delightful but poisonous clouds far behind in the cave where they belong.
The Cannabis Cure For Headaches
You may already know that Cannabis has been recognized throughout human history as a safe & effective treatment for headaches. But even if you already know that Cannabis is a remarkable treatment for many kinds of headaches, I’ve been reading a research paper on this topic that is worth a bit of study no matter how familiar you are with medical Cannabis.
This research study, published in a peer-reviewed medical journal and authored by prominent Southern California physicians and psychiatrists, gets around the US government’s deliberate failure to fund studies that might show Cannabis is an effective natural medicine by examining the ancient & past historical record in detail, as well as by looking at credible contemporary reports and analyses.
It is written in easily understood, layman’s language and cites historical sources like Assyrian manuscripts dating around 2000 BC, the ancient Greek physician Dioscorides, the 9th Century Arabic medical encyclopedia “Al-Aq-rabadhin Al-Saghir”, and Persian medical texts from the 10th through the 17th Centuries. Most relevant to today’s environment, the researchers also cite clinical literature showing wide-spread medical use of Cannabis for headaches in the 1800’s in Europe and America.
This research study focuses on the four main types of headache: migraines, tension-type headaches, cluster headaches, and medication-overuse headaches. The authors find that headache is a major public health concern, with enormous individual and social costs estimated at $14.4 billion annually, due mainly to decreased quality of life, decreased productivity and crippling disability. Each year, nearly 50% of the US population experiences major headaches, including migraine (10%), tension-type headache (38%), and chronic daily headache (3%).
Women are 200-300% more likely than men to experience migraine and 125% more likely to experience tension-type headache, which may explain to some degree why the government could care less about headache research. As most people know, any disease that affects mainly women and minorities typically gets the shaft from our government unless strong advocacy forces the issue.
Some of the most powerful evidence for the effectiveness of Cannabis in treating and curing headaches of all kinds comes from clinical publications in 19th Century America and Europe. According to the authors “Clinical publications between 1839 and 1937 provide valuable insights into the most effective practices, challenges, and benefits during an era when cannabis was commonly used to treat headache.”
They continue, “Historical sources indicate that cannabis was used as an effective prophylactic and abortive treatment for headache disorders. Although dosing varied among physicians, most prescribed alcohol extractions of the drug in the range of ¼ to ½ grain (16–32 mg). This dose was likely chosen to minimize the effects of intoxication while also providing effective therapeutic relief. Other providers suggested that doses should be progressively increased until modest effects of intoxication were felt. For prophylactic treatment, these doses were usually administered two to three times daily for weeks or even months. Acute treatment often involved higher doses taken as needed and, in some cases, smoked cannabis was recommended.”
As so often happens, non-medical people suffering from a disease are way ahead of the doctors in seeking out treatments and cures, and the millions of Americans and Europeans who suffer from headaches today are no exception. Even though the usefulness of Cannabis for treating headaches has been well-established for centuries, and even though the US government makes it a crime to treat yourself with Cannabis, millions of people have been risking jail (before the growing success of the Cannabis legalization movement) to use Cannabis as a medicine, and they already know that it works even in the absence of official “proof”.
The authors discuss how both doctors and patients are already “proving” that Cannabis works in states where it is now legal. For example, in a passage on the current state of Cannabis treatment in California, the authors note that:
“Many individuals are currently using cannabis for the treatment of migraine and headache with positive results. In a survey of nine California clinics … 40.7% patients self-reported that cannabis had therapeutic benefits for headaches and migraines. In another California survey of 7525 patients, 8.43% of patients reported that they were using medical cannabis to treat migraines. Another survey of 1430 patients found that 9% of patients were using medical cannabis to treat migraines.”
The authors further report that “One retrospective study described 121 patients who received cannabis for migraine treatment, among whom 85.1% of these patients reported a reduction in migraine frequency. The mean number of migraines at the initial visit was 10.4, falling to 4.6 at follow-up visits after cannabis treatment. Moreover, 11.6% of the patients found that, when smoked, cannabis could effectively arrest the generation of a migraine.”
In today’s environment there are plenty of choices of strains of Cannabis that are well-known to be specifically helpful for relief of headache, regardless of the absence of clinical research. In Cannabis-legal states you can depend on the team comprised of a trusted medical professional and your local medical Cannabis dispensary to provide you with good information on your treatment options.
In states where Cannabis is not yet legal, patients who have to resort to the “black market” can inform themselves on what to look for through on-line resources like https://leafly.com, a trustworthy provider of both medical and recreational strain information. Then it’s a matter of buying from someone who can be trusted to sell you exactly what they claim they are selling you, to ensure that you are getting a headache-specific Cannabis strain.
Fortunately, many of the most common “black market” strains are known to be therapeutic for headache, although online Cannabis advice-givers seem to focus almost exclusively on Migraines and ignore making recommendations for tension headaches, cluster headaches, and medication-overuse headaches.
Among the commonly available strains that are also widely recommended for Migraines are Northern Lights, OG Kush, Blue Dream, Lemon Kush, and several low-THC, high-CBD strains that are not as universally available including Charlotte’s Web, CBD, Harlequin and Remedy. Always seek the most reliable source for your medical Cannabis, and stay aware of the fact that growers of the same strain vary widely in their attention to healthful growing practices. The OG Kush that one Dispensary offers will not be the same that others offer, and one Dispensary’s bud may be responsibly grown while the grower for another Dispensary may be a chem-head. Especially if you’re vaporizing flower to deal with headache – the best way, I’ve found – it pays to avoid Cannabis that may have pesticide residues and stick with dependable sources.
What if there were a natural medicine that could control Huntington’s Chorea, as well as chorea stemming from other non-genetic diseases and conditions, and perhaps arrest the progression?
What if instead of having to take a medicine that may force you to think about suicide, as so many chorea victims do, you could take the extract of a simple flower and re-discover how good life is without chorea?
What if the medical profession published numerous medical journal articles about this natural medicine 150 or so years ago, when it was a standard successful treatment for chorea?
And finally, what if for the last 80 years or so the combined power of the US government and Pig Pharma corporations had made possession of this natural medicine grounds for slamming you in prison for a long, long time? That would be – let’s see, what’s the opposite of “Awesome”?
Huntington’s disease is a neuro-degenerative disease and most common inherited cause of chorea. Other non-inherited causes of chorea are show in the graphic above.
Chorea is characterized by brief, semi-directed, irregular movements that are not repetitive or rhythmic, but appear to flow from one muscle to the next. When chorea is serious, slight movements will become thrashing motions.
The characteristic movements of chorea often include twisting and writhing. Walking may become difficult because of uncontrollable body postures and leg movements.
Unlike ataxia, which affects the quality of voluntary movements, or Parkinsonism, which is a inhibition of voluntary movements, the movements of chorea occur involuntarily, without any conscious effort to move a limb, an extremity (hands or feet), the head or neck, or any other part of the body. Because all movements associated with chorea are involuntary, it is classified as a hyperkinetic movement disorder.
The only answers that Pig Pharma has for Chorea are treatments, not cures. One of the most commonly prescribed “medicines” is tetrabenazine. Among the risks associated with tetrabenazine’s use are: sedation, fatigue, insomnia, akathisia, anxiety and nausea. Oh, and also tetrabenazine increases the risk of depression and suicidal thoughts and behavior in people afflicted with Huntington’s disease. So it doesn’t cure you, but it may make you decide to kill yourself. Nice drug. All the other Pig Pharma answers to Huntington’s Disease pose similar risks and do not cure Chorea.
In fairness, it is important to point out that one of the following reported cases of someone with chorea who was healed by Cannabis, was a young girl who had suffered from a bout of rheumatic fever a month prior to the onset of Chorea. It is well-established (in 2018) that one type of Chorea, Sydenham’s chorea, occurs as a complication of streptococcal infection, and that twenty percent of children and adolescents with rheumatic fever who are left untreated with antibiotics develop Sydenham’s chorea as a complication. So it is possible, even likely, that what Dr. Douglas is describing is a strep infection leading to Chorea – in other words, a sub-set of Chorea. However, since Cannabis is not an antibiotic, it seems unlikely that in this case being described its beneficial use in the treatment of Chorea would be confined to this single sub-set of the disease. Plus the instance of this young girl is only one of many Cannabis chorea cures that are described in this medical journal article from 1869.
Fortunately for people suffering from Huntington’s today, in most places Cannabis is available for self-treatment, and in the more advanced states there are even physicians who have bothered to learn and build on what their colleagues discovered 150 years ago, ignoring the poisons being pushed by Pig Pharma.
Here is one example of what has been known and withheld from those who suffer for eight generations. The research isn’t perfect, and the doctor is very much trapped in many of the false assumptions of his day, but he is clear on one thing – Cannabis is a powerful natural medicine that is safe and effective for treating neurological diseases like Chorea.
By Dr. Douglas F.R.G.P.E.
Vice-President of the Medico-Chirurgical Society of Edinburgh
February 4th, 1869
THE USE OF INDIAN HEMP IN CHOREA
The value of Indian hemp as a therapeutic agent is well established, but a singular difficulty has been experienced in securing for it the confidence to which it is evidently entitled. Without attempting to explain or to excuse this difficulty, I propose to illustrate what appears to me one of its most useful applications.
The negative virtues of the drug are amongst its chief merits. Dr. Russell Reynolds, who writes one of the most recent, and one of the best expositions of the value of this remedy, tells us, as the result of a manifestly practical and thoughtful experience, that it is a soporific, anodyne and antispasmodic; and that it relieves pain and spasm: that it does not leave behind it headache nor vertigo; nor does it impair the appetite nor confine the bowels. These important virtues accord with anything I have seen of its action; nor have I met with any annoyance in practice from its peculiar action on the emotional or intellectual state of the sick. We are apt to be deterred from the use of a remedy by such pictures of its more peculiar actions, as are given of the abuse of the drug in countries where it is resorted to as a means of intoxication, and of its action in the cases of patients who under its use became tortured by ocular illusions and spectres of horrible form.
I do not doubt that such effects result from the use of the drug; but, in prescribing it, I have not met with them, and I am disposed to think that they are to be avoided even more certainly than we can guard against the unpleasant effects of opium.
As in the case of other useful drugs, the contradictory and extreme views of the efficacy and certainty of its therapeutic action, urged by writers of high authority, have retarded confidence in cannabis Indica; and indeed its applications to disease seem scarcely to have been investigated with the reliance which its demonstrated energy would justify. It is now many years since Dr. Dominic Corrigan published a series of cases which underwent cure in the course of four or five weeks, mainly by the use of the cannabis Indica, in doses of five minims of the tincture, increased to twenty-five: one of the cases, being of ten years standing, was cured in a month. (Archives of Medicine. Edited by Lionel S. Beale, M.B. Vol. ii. London Medical Times, 1845.)
One cannot resist the impression that other elements in the treatment, besides the administration of the cannabis, had need to be taken into account in the explanation of such cures; and moreover, before the actual value of the drug in such cases can be determined, a minute statement of the clinical and pathological relations of each case would be required i.e., how far the case might be one of chorea arising in connexion with rheumatism, struma, cerebral or spinal disease, or in connexion with some more temporary source of irritation in the system, as from derangement of the digestive or of the generative or other functions.
Again, we find Dr. Wilks of Guy’s Hospital arguing that, because fifty remedies have been found to cure such a disease as chorea, it may be safely left to itself. Accordingly, Dr. Wilks, admitting the usefulness of Dr. Hughes favourite and useful remedy, rhubarb steeped in port wine, prescribes to his patients the syrup of orange, that students may witness the spontaneous cure of the disease; and his patients, like Dr Corrigan’s, left the hospital cured in about a month.
Nevertheless, whatever preference we may have for a medicine expectant, that permits the sick to recover, over the heroic measures, whose advocates claim to have cured the patients who escape out of their hands, thoughtful practitioners will not be prevented from inquiring into the nature and the extent of special therapeutic actions by the scepticism of doubters nor by the rash generalizations of hasty observers.
Jane Williamson, aged 13, was admitted into the Chalmers Hospital under my care on the 15th of October last. She had the look of previously good health, and she was well nourished, but not robust. At the date of her admission, she presented the awkward gesture and the grimace of established chorea, though not severe in its degree. Temperature was natural; pulse 90, rather small; there was slight rheumatic pain of the knees and elbows, and an excited state of the heart’s action. The urine was loaded with lithates, it was normal in density, about 30 oz. in twenty-four hours. The bowels were easily regulated.
The treatment, in the first instance, consisted in the administration of a solution of the acetate of potash, with infusion of digitalis, and four minims of Fowler’s solution thrice a day.
The history of her previous illness given by herself and her friends was that, about a month previously, she was taken with a not intense attack of rheumatic fever. She suffered a good deal from the state of the larger joints; no symptom of cardiac inflammation appeared to have existed, but, for about a fortnight preceding her admission, she presented choreal action, gradually increasing indegree and affecting the extremities and face. . .
During the days immediately succeeding her admission, a rapid change occurred in the degree of the choreal movements, and in the state of the heart’s action. The latter became so disturbed, feeble, and excited, with feeble arterial pulse, as to cause serious anxiety for the safety of the patient, and at the same time the choreic agitation increased with such violent restlessness and 1 oiling in bed that excoriation occurred over the sacrum and both nates, while contortion of the features and tossing of the extremities, especially when their movement was attempted, continued excessive, the articular effects of rheumatism decreased, temperature became more natural, and urine healthy, but the bowels became torpid. The arsenic was persevered with, and a few 30-grain doses of bromide of potassium were given. Each dose was followed by a short period of quiescence, but, on the 20th, the excitement of the heart’s action became so alarming that 25-minim doses of tincture of Indian hemp were administered, followed by apparently marked, but only transient abatement of the spasmodic movement, which, as Dr. Hogg, the resident physician, reported, seemed to recur subsequently with increased and distressing severity.
On the following day, that is, the sixth of her residence in the Hospital, her condition seemed desperate, chiefly on account of the protracted and uncontrollable hurry of the heart’s action. She was ordered to have six minims of the tincture of cannabis every hour, the arsenic and other remedies being intermitted. The bowels were now well regulated, the excoriations of the back and nates had increased so as to form superficial sloughs of considerable extent, the pulse was small and so rapid as not to be counted, and the heart’s action was still feeble, rapid, and disturbed. She had four ounces of brandy per day. On the following day, having had twenty doses of the tincture, there was marked and increasing improvement. The violence of the tossing and rolling had diminished materially, though still it was necessary to have her secured in bed to prevent her falling or rolling over. From this time till the 15th day of her residence in the hospital, the tincture was administered from hour to hour, and she continued to make daily and progressive improvement. At that date (the 28th) she had been free of all the more violent spasmodic movements for two days and the heart’s action was quiet, pulse about 80, appetite good, bowels regular. She still presented a degree of the peculiar grimace, with awkwardness in protruding the tongue and in movement of the arms and hands. There was great mental lethargy, with languor and exhaustion, which made it impossible for her to be out of bed.
The tincture of hemp was now discontinued, and arsenical solution in four-minim doses resumed.
The subsequent progress of the case, though tedious, and so far disappointing, may be told in a few sentences. On the 1st of November, and on several occasions during the rest of that month, there occurred a renewal of the choreal state, which had not indeed absolutely disappeared, though it was often so trivial and even absent as to encourage the hope of an early recovery. Arsenic was perseveringly employed, with a carefully-regulated diet and general management, but on each occasion, of which three were noted, when an exacerbation of the choreic condition arose, a marked abatement of the muscular action resulted from the administration of small and hourly-repeated doses of tincture of hemp, relief sometimes arising so speedily as within six or eight hours. On one occasion the improvement was not decided for three or four days.
In the beginning of December, rheumatic symptoms recurred with slight febrile action and articular pains and renewal of choreic agitation. At the same time, marked excitement of the heart’s action was renewed, and now, for the first time, a faint soft diastolic murmur, indicative of aortic regurgitation, was with difficulty perceived. A weak solution of acetate and nitrate of potash was administered, and grain doses of opium four or five times in twenty-four hours. Pain arid fever abated, but not the spasmodic movement, and on the third day afterwards six-minim doses of tincture of hemp were given every two hours, followed by an immediate decrease of the chorea, which at once declined to its slightest degree in two or three days.
The patient now presented more marked indications of returning health. The state of mental lethargy into which she had early lapsed was now passing off; her appetite was revived, and on the 20th December she was able to be out of bed and to walk with assistance. Small doses of the iodide of potassium with the infusion of quassia were given, and improvement went on uninterruptedly; she did not, however, cast off the choreic jerk and awkwardness till the second week of January 1869. She has since had a very comfortable convalescence, but the diastolic murmur noted above continues strongly developed.
In the remarks I have to offer on this case, I confine myself to the points which illustrate the value and application of cannabis Indica in the treatment of choreal spasm. It is well said by Dr. Hughes, that each case of chorea, like each case of every other disease, should be separately studied; and though it may be regarded as one of a class, should still be viewed as a distinct individual of the class. In the case of my patient, the general characteristics of the attack point it out as an example of a large class of cases in which acute rheumatism constitutes the primary and originating source of chorea, while its special features simply declare the degree of chorea, with its repeated recurrences, and the unusual violence of agitation, to have been more than ordinarily severe, without any such personal or inherited constitutional peculiarity as exists in certain forms of this and of other nervous diseases.
Connected with the severity of the chorea, an inquiry of some difficulty arises out of the condition of the heart, particularly its disturbed action in the early stage, and the endocarditic lesion which occurred later, and which declared its presence only with the renewed rheumatic attack in the beginning of December. At the time of her admission and subsequently, notwithstanding the extra-ordinary hurry of the heart’s action, I persuaded myself that there was no organic nor inflammatory lesion, and I came to the conclusion that the severity of the choreic state had extended to the heart. The evidences of endocarditis subsequently developed cast doubt on my view of the previously choreic state of the heart; and there does not appear to be any means of solving the question beyond the opinion of those who saw the patient.
It certainly seems unlikely that endocarditis capable of causing such extreme disturbance of the heart’s action should have existed, unaccompanied from the outset by other indications of its presence.
This point possesses some interest in connexion with the view advanced by Dr. Russell Reynolds, that Indian hemp has been of no service in those affections of mind, sensation, or motility, which are simply functional in their character, or, at all events, have no established morbid anatomy. On the other hand, that it has afforded notable relief in cases where organic disease existed.
I do not agree with this view, but it would be beside my object to discuss it here. On the supposition, however, that the view is a sound one, it suggests that, in my patient, the organic lesion had originated in the heart at an early stage of the attack, and, consequently, the beneficial effects of the cannabis were so readily exerted. On the whole, the conclusion is a fair one, that endocarditis was present earlier than appeared; though still, I cling to the view that the disturbed action was, in the first instance, functional and choreic.
The practical interest of my case, however, consists in the illustration it affords of the special use and application of cannabis in the treatment of choreal spasm, and of the mode in which the remedy may be administered in many cases, if not in all. I have already remarked on the mistake, as it seems to me, of looking for general curative results in this or in any disease from the mere general application of special therapeutic observation or experience.
I think the cases and cures of chorea by tincture of hemp reported, to whlch I have referred, illustrate the fallacy of such reasonings; but, on the other hand, the case of my patient suggests that there is a special, and perhaps a frequently useful, application of the drug in such circumstances. The impression which the case leaves on my mind is, that cannabis has a peculiar value and power in controlling the irregular movements of chorea, which ever and again are terribly distressing, and possibly even dangerous, to the patient; and it would be of no small moment to determine the extent and limit of its influence, and to ascertain whether or not choreic action, even in slighter cases, might not be moderated by this remedy.
The result of repeated trial in my patient seems to show, on the one hand, that the violence of choreal action was speedily moderated; and the protracted duration of the case, on the other hand, makes it sufficiently evident that the virtue of the remedy did not reach farther in the direction of removal and radical cure of the disease. This points to an important question in the treatment of chorea, which has been mooted by many writers on the subject, viz., how far the chorea is to be dealt with as an independent condition, and how far its treatment and removal will be best achieved by the treatment of the diseased state out of which it has sprung?
I think that systematic writers and clinical lecturers have dealt with the subject of chorea too much as an independent disease, and that the late Dr. Babington, of London, in his justly-admired paper on chorea, indicated a sound and philosophic principle, when he advised that when the disease has arisen by metastasis of rheumatism, it should be treated in the same way as pericarditis is treated.
Recognising, then, the principle that our chief aim in the treatment is to combat the constitutional state, or the local disease in connexion with which the chorea has arisen, I conclude farther, from the case I have read, that an important aim must sometimes, if not at all times, be to allay the severity of the choreal state by the use of cannabis, or by other means. On this point, I cannot resist quoting from M. Trousseau his earnest utterances in the behalf of tartar emetic as a means of subduing the violence of choreal agitation: “Unfortunately,”says that learned physician, “there are cases in which the convulsive agitation is of such violence that all known means are without avail, and the physician too often sees poor young girls perish miserably, the skin rubbed and deeply ulcerated by incessant friction, that no appliance can obviate.
But surely, in such circumstances, cannabis Indica is a far more appropriate remedy than tartar emetic, affording, as M. Trousseau adds, “if though only in exceptional cases, a chance of success where we appeared impotent.”
The limit of the therapeutic action of cannabis Indica in these cases is incidentally indicated, with a thoroughly practical wisdom, by Dr Williams and by Dr Walshe. So long ago as in 1843, Dr Williams is reported to have said, in the course of a discussion, that he had found it “ relieves chorea during its exhibition, but without radical effect on the disease.”
In 1849, Dr Walshe, in a clinical lecture, says: “Not only was its sedative effect marked in degree, but it was almost immediate in point of time, leaving no doubt on my mind as to the reality of its influence.”
The recurrent attacks of chorea in the case of my patient afforded the means of direct illustration of the efficacy of the drug in subduing the choreal state. for repeatedly the same result was witnessed in the speedy and more or less complete subsidence of the agitation under the use of the remedy, and the decided effect produced on the heart’s action tends to confirm me in the impression that the disturbed state of that organ was largely choreal.
As to the mode of administering the remedy, small and frequent doses proved both safe and effective, and great advantage appeared to arise from increasing the frequency of the dose rather than its amount. Believing, as I do, that cannabis Indica is a remedial agent of value in many and various maladies, I am prepared to recommend this mode of seeking its effects by frequent rather than by larger doses at longer intervals. Such a mode of prescribing it has not been usual; but I find, quoted from an American source, the account of a case of hiccup treated in this way by eight-drop doses of a fluid extract, administered hour by hour, in which recovery from an attack that had defied treatment for five days took place in a few hours.
I have brought this case under the notice of the Medico-Chirurgical Society, not on account of any novelty in its history, nor on account of any conclusions it very positively points to, but simply to bring anew to the light of day an important therapeutic fact, which seemed like to be buried in the pages of undisturbed magazines, and which, probably, has an important application, not only to distressing and dangerous cases of chorea, but even to slight and ordinary cases, as well as to cases of other spasmodic diseases, such as hiccup, irritable heart, asthma, tetanus, and the like.
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