Sept., 1932J CHLORAL HYDRATE DRUG HABIT : CHOPRA & SINGH CHOPRA 481

certain parts of the Punjab. This is not the outcome of the use of the drug in the treatment Original Articles of insomnia, but is due to entirely different causes. Until a few years ago in that province potable country-made spirits were allowed to CHLORAL HYDRATE AND PARALDE' be sold to retail dealers in bulk and the vendors HYDE AS DRUGS OF ADDICTION bottled the liquor themselves. Some of these ingenious people conceived the idea of diluting R. N. m.d. By CHOPRA, m.a., (Cantab.) the spirit and adding small quantities of chloral I.M.S. LIEUTENANT-COLONEL, hydrate to make up for the loss in its potency and which would result from dilution. The know- GURBAKHSH SINGH CHOPRA, m.b., b.s. ledge that the drug had hypnotic and narcotic was obtained from the (Drug Addiction Inquiry, Indian Research Fund effects undoubtedly Association) medical profession and compounders work- in It was further learnt that Series No. 15 ing dispensaries. the effects chloral hydrate in many Chloral produced by hydrate and paraldehyde belong to resemble those by alcohol, the of ways produced group drugs known as soporifics or especially when the latter is taken in large The chief use of hypnotics. this class of drugs quantities. When the two articles are taken is in the treatment of one insomnia, of the together they act in a manner synergistic to worst evils of modern times from which man- each other and in this way the effect of either kind can suffer. The physical and mental drug is largely increased. This knowledge, of are consequences sleeplessness such that the combined with the fact that chloral hydrate sufferers are driven to the use of frequent can be bought of any of the pharmaceutical hypnotic drugs, which in many cases leads to chemists at about Re. 1-12 to Rs. 2 per pound a or addiction. permanent craving without any restriction whatsoever to its sale, Louis Lewin (1931) in his well-known work has led to the abuse of the drug described in to Pkantastica has drawn attention addiction this paper. The addition of a drachm or two to this group of drugs which include chloral, added would easily make up for the removal veronal, paraldehyde, suiphonal, potassium of a substantial portion of the liquor from the bromide and bromural. Most of the cases bottle, the quantity being made up with water. referred to by him were patients who suffered Sometimes small quantities of chloral are added from were to take the insomnia who advised without any dilution of the liquor, to make the drug by a physician. Instead of giving their effects more potent in order to get a wider sale patients rational treatment, i.e., investigating among a particular class of customer. Recently, fully the causes leading to sleeplessness and the Excise Department have stopped the sale removing them, medical men often resort to the of spirit in bulk to the retail vendors and all easier course of giving powerful chemical sub- the liquor has to be sold in sealed bottles. stances with a soporific action. Again, certain This form of adulteration is, therefore, no manufacturers of medicinal drugs employ on. longer possible. Government have also prohi- their staff medical men and others who carry bited the licensees of liquor shops to keep on an extensive propaganda by advertise- chloral hydrate in the. licensed premises. ments in the medical as well as in the The to have lay press. By broadcasting literature extolling idea, however, appears lingered the wonderful sleep-producing and non-toxic and has reached the public in some of the effects of these drugs, they influence both the districts where the use of country spirits is very the medical profession and the public. In this way prevalent among population. This is dangerous substances belonging to this class, particularly the case with the central districts the are which have a powerful effect on the central of Punjab which largely populated Sikhs. to nervous system, fall into the hands of the with Owing the rise in price of the sufferers direct. country liquor, these people, who take the liquor not for the The incidence of addiction to chloral hydrate purpose of light stimulation?as is the case in western countries?but with the outside India is apparently rare, as only occa- a of intoxication sionally is a case reported. Although by object getting pronounced effects, found could not careful and searching enquiry a few cases of they get sufficient quantities of the drink with the means at their this habit may be collected, especially in modern disposal. cities in various parts of the world, there is no They, therefore, conceived the idea of them- selves quantities of chloral to evidence of any extensive prevalence amongst adding hydrate the in order to the desired effect. the masses. It is probable that on account of liquor get the its unpleasant its irritant effects on the They procured drug without difficulty and taste, small gastro-intestinal tract and its liability to produce quantities added to the potion gave them satisfaction. So the cutaneous eruptions, addiction to chloral has closely did they find effects of the mixture resembled the effects of the not spread in the same way as have the cocaine itself that chloral in these or the opium habits. Habitual use of chloral liquor hydrate parts is well known the hydrate, however, has been found to exist in among liquor-drinking 482 THE INDIAN MEDICAL GAZETTE [Sept., 1932

1 population as sukhi-sharab' or dry liquor. although apparently the source of supply was This state of affairs first came to our notice similar. This may be due to medication of several years ago when we were studying the the beverage, but we have no evidence to con- opium habit in that area. At that time, how- firm this. The excise authorities of other ever, we thought that such use of chloral provinces have not detected any specific hydrate was rare. instances of such adulteration, although in one case in Madras chloral was detected in a D. R. i.m.s., Chemical Major Thomas, examined the excise Examiner to the Punjab Government, in a specimen by laboratory. Whether the evil exists at or there letter dated the 13th September, 1931, pointed present not, is at rate of the extended use of out to this Government that a number of cases any danger chloral and other similar for adultera- of were in certain parts of drugs poisoning occurring tion of alcoholic and the Excise the These cases came in beverages Punjab. mostly of various should be bunches and were usually the outcome of drink- Departments provinces aware of it. ing bouts with liquor adulterated with chloral hydrate. Major Thomas suggested that chloral Chloral habit.?With the advent of many hydrate and butyl chloral hydrate might be new hypnotic drugs, chloral hydrate has been brought under the category of narcotic and virtually erased from the list of medicaments dangerous drugs, and their free and indiscri- in many western countries. This is due to the minate sale to the public might be prohibited. fact that not only has the drug an unpleasant We have, therefore, paid special attention to taste and produces unpleasant effects, but it this subject and have recently investigated has a marked tendency to habit formation, the various facts in connection with the use of injurious consequences of which are too well chloral hydrate, both for adulteration of known. On account of its low price chloral alcoholic beverages as well as its use as a drug hydrate is still largely used in India and its of addiction. So far as the Punjab is concerned action and uses are well known to the profes- we have found that, although adulteration of sions of medicine and pharmacy. Although liquor on a large scale has been discontinued, there is little doubt that many of the liquor the use of the drug by the liquor drinker drinkers have used chloral hydrate at one time for adulterating his own potion to enhance or other in the central districts of the Punjab, its effects is fairly common and is well the confirmed chloral hydrate addicts do not known in certain parts of the central form more than about 5 per cent, of the total districts. Our enquiries show that a number number of the liquor-drinking population. of people who habitually take liquor in large Many of them are afraid to use the drug quantities have resorted to adulterating it with because of poisoning. Outside the small area chloral hydrate. Originally the idea was to mentioned above, the Punjab appears to be at add it to the liquor to increase its effects, when present free from the abuse. on account of high price they could not afford Modes of administration.?(i) Chloral to buy sufficient quantities. Some have used hydrate is sometimes taken mixed with alco- the so that it has resulted in drug frequently holic drinks. When indulged in in this way the formation of a habit, and unless it is added it becomes absorbed into the system very to the potion satisfaction is not obtained. quickly, its action is produced in a shorter time These persons have literally become addicts. and the effects of the drug are enhanced. The Although the use of the drug is kept very ready solubility of chloral in alcohol increases secret, we found it to be fairly prevalent in its absorption into the circulation to an enor- certain parts of Ferozepore and Ludhiana mous extent. As chloral is a powerful drug, districts. This is borne out by the fact that this method of taking it is not only harmful we were able without much difficulty to collect but dangerous. If the quantity ingested ex- and study forty cases of this form of addiction ceeds a certain limit death may result from the to a chloral in less than month. We are very depressant action of the drug on the heart and grateful to Major Thomas for giving us faci- paralysis of the organ. The margin between lities to study his records and for giving us the the dose producing the physiological effects details of cases of poisoning which have come desired by the addict and the dose producing to him for analysis. toxic symptoms is very small. A number of As regards the similar abuse of chloral in fatalities have actually occurred in these areas other parts of India, so far as our information and have been reported by the Chemical goes, the evil does not appear to exist at present. Examiner to the Punjab Government. We have, however, found indications that in (ii) The more common method of taking India and central in the Madras Presidency the drug is by dissolving it in a little water and toddy is possibly adulterated with chloral drinking it. It is also sometimes put in hot hydrate or some similar drug in order to give tea and milk, but this is uncommon. When it it increased potency. Instances have come to is dissolved in water it has a bitter aromatic the notice of the excise authorities of people taste, resembling more or less the biting taste liking the beverage supplied by certain shops of the country liquor. It is, therefore, some- because it was much more potent than others, times flavoured with essences to give it a Sept., 1932] CHLORAL HYDRATE DRUG HABIT : CHOPRA & SINGH CHOPRA 483

pleasant smell and taste. As it takes some 1. First and the most important reason for time for the drug to be absorbed the actual the use of the drug is as a substitute for alcohol intoxication effects are not produced till half or for enhancing the narcotic effects of alcohol. or an hour more after administration. It is a In the series of forty cases studied by us, 47.5 common practice for two or more persons to sit per cent, started the habit with this object. together in the evening and take the drug, they Alcoholic drinks, we have pointed out, are drink a potion and then take some meat or becoming more and more expensive on account tasty food between drinks in much the same of increase in the excise duty. For an average way as is done with alcohol. Those who can- consumer of that class the cost has become too not afford delicacies may take pickles or some high to allow the daily consumption of a suffi- other salted eatables to take off its taste from cient dose to produce the effects he desires. the mouth. The reduction in the number of licensed shops Analysis of 40 cases of chloral hydrate addiction studied in Ludhiana and Ferozepore

Present age of Causation. Ages to start. Duration. addicts.

? 8 s? a> d> O H ,

Dose. "Sh ?' 0) O S rCj 'p a_ * 2 eS ce5 a rB >. O fl H ?

1-30 gr. 11 4 1 7 4 1

31-40 gr. 5 4 2 4 2 ]

41 and 5 2 1 1 up.

Total 19 6 21 10 18 12 11

Percen- 47.5 35.0 15.0 52.5 25.0 7.5 45.0 30.0 17.5 5.0 17.5 15.0 20.0 27 .l 10.0 2.5 ta

Dose.?When the narcotic use of this drug has further made liquor less accessible. It is was first learnt and people started taking the a well-established fact that as time goes on drug habitually, they did not know the safe the habitue has to increase the quantity of limits within which they could keep the dosage liquor in order to get intoxication. He, there- to obtain its effects and at the same time avoid fore, looks for a cheap and easily available toxic symptoms. The result was that some- substitute. In old days bhang (Cannabis of times large doses were taken and severe toxic indica) and post (unlanced capsules this symptoms, such as loss of consciousness last- P. somniferum) served purpose quite well, ing for varying periods, and even fatalities but even these have become expensive and difficult to Chloral on the occurred. Further experience appears to have procure. hydrate and made them more cautious and they now appear other hand is cheap easily obtainable from to keep within the safe dosage, though even any druggist's shop. The addition of a small will a now fatalities occasionally occur. A reference quantity of chloral hydrate make little to the table will show that in our series the alcohol go a long way. daily dose varied from 10 to 60 grains. In the The special attraction of this drug appears to be its of 40 addicts studied by us, 47.5 per cent, took power setting up effects which from 10 to 30 grains, 32.5 per cent, from 31 resemble intoxication. It produces a state of to 40 grains, and only 20 per cent, took above mental and physical depression followed by 40 grains daily.- sleep, which to the addict is like the feelings Etiology.?The causes which lead to such use and sensations produced by alcohol taken in of chloral hydrate do not differ essentially from large quantities. The aim of liquor drinkers those leading to the opium habit. Chloral in India, we have already said, is to attain a hydrate, however, is taken more for its narcotic state of intoxication and forgetfulness. The and sedative effects and less for its sexual and senior author has met a number of cases where pleasurable effects which form the main attrac- the sole idea of the person taking liquor was to tion in the case of drugs like cocaine. The attain a state of oblivion. Such people drink habit of taking chloral is mainly attributed to half a bottle or even a bottle of country liquor three causes :? without dilution in one draft in order to induce 484 THE INDIAN MEDICAL GAZETTE [Sept., 1932

cent, started it in the third and fourth a state of torpor, in which they may remain per decade of life. for the following 24 hours or even longer. It is the loss of perception and memory and the As regards the present age of addicts a dulling of all bodily sensations which is the aim similar state of affairs was evident, as many of these individuals and not merely a mild as 75.0 per cent, were between the ages of 21 excitement or depression of higher areas. and 40. The addiction would appear to be Alcohol and opium produce such. an advanced common between 21 and 40; above 40 years state only after very large doses, and it takes of age and below 20 it is very uncommon. a longer time to attain it. With chloral hydrate, Duration.?A perusal of the figures given in such a state sets in with comparatively small the table shows that the addiction is of recent doses, in a much shorter time, and with little origin, the oldest case recorded was not much cost. more than of 10 years duration. It would 2. Curiosity and association.?As with other appear that the drug has been more used during drug addictions, association with addicts is the last 7 or 8 years than formerly. responsible for setting up the habit in quite a Symptoms and effects.?The following des- large number of individuals. It is a well- cription of the subjective and objective known fact that persons addicted to drugs are symptoms produced in those who take chloral and in the habit of persuading their friends hydrate habitually has been prepared from a associates to try new drugs which have been study of forty cases analysed in the table. their latest experience. We have records of Immediately after taking the drug (whether cases where chloral has been the an given by dissolved in alcoholic drink or in pure water) habitue to a friend without the latter's know- there is a feeling of constriction and warmth ledge. The potent effects produced excited in the throat, and later in the epigastrium, curiosity, and repetition of this a few times led somewhat similar to that produced by country to the discovery of the drug and formation of liquors. Fifteen to thirty minutes after inges- the habit. tion there is a transitory sensation of warmth Some individuals have also been tempted to all over the body, flushing of the face and try the drug out of sheer curiosity, but in the heaviness of the head which is probably due to majority of cases the first experience proved peripheral vaso-dilatation. The eyes are con- too much for them to repeat it. We have met gested and the eyelids feel heavy and droop. with this type of case in Amritsar and Gurdas- The patient feels dull and sluggish, and as a pore districts. A small number who are of rule in an hour or so sleep sets in; this is often neurotic disposition and are, therefore, prone sound and uninterrupted and usually lasts from to habit formation may be tempted to repeat 9 to 12 hours. Many of the persons taking it the experiment. They get over the unpleasant in moderate doses experience no other effects, preliminary effects and finally form a habit. but some have a mild feeling of weakness, People belonging to this group are generally asthenia and depression. In them there may young neurotic individuals between the ages of also be disinclination to do physical or mental 20 and 30 years. work both when under the influence of the and when from the 3. Insomnia, fatigue and worry, physical and drug awakening sleep. mental disturbances, irritability and hyper- In some of the addicts the sleep usual after a dose does not in excitability were responsible for 17.5 per cent, set immediately. In them of the cases of addiction in our series. The there is much dulling of perception, resembling chief use of chloral hydrate in medicine is in that produced by large quantities of alcohol. the treatment of insomnia and as a sedative, We were informed by many addicts, who had in and injudicious prescribing may lead to habit indulged chloral hydrate, alcohol and formation. It may be mentioned here that of opium, that the effects of taking a dose of late years the practitioners of indigenous chloral closely resemble those produced by medicine in India and some itinerent quacks taking large doses of alcohol. The main differ- also are beginning to appreciate the superior ence is that the preliminary excitement, which value of many of the drugs used in the western gives a feeling of euphoria to liquor drinkers system and have begun to prescribe and dis- and sometimes a tendency to rowdiness and pense potent medicines, particularly those whose bravado, is entirely absent. The chloral addict sale is not restricted by regulations. Chloral 'is often morose and is not socially inclined. hydrate is one of the largest used of these Unlike a person under the effect of alcohol, he medicines. It is difficult to say to what extent is not talkative and likes to be quiet. Sleep such indiscriminate use of the drug has led to finally comes on and he does not wake for habit formation but there is certainly great many hours. danger of it. When the addict gets up after 9 to 12 hours feels has a somewhat Age to start and present age of addicts.? he depressed, yawns, A study of the table will show that in the heavy head and wishes to sleep again. The majority of cases the habit was started before sleep is not of as refreshing a character as natural He looks is reluctant the age of forty years, as many as 92.5 per sleep. depressed, cent, falling in this category. Of these 77.5 to do any work and eagerly awaits the evening Sept., 1932] CHLORAL HYDRATE DRUG HABIT : CHOPRA & SINGH CHOPRA 485

considerable The look close. The eyes remain congested all day, the period. eyes sleepy. is more or less loss of eyelids droop, there is loss of appetite, the There appetite, the breath is offensive and the is coated. The tongue is coated with a thick fur and the bowels tongue remain constipated. habitues are very often dull, and the judgment and memory are impaired. In some cases there Rarely, the chloral addict does not get the is a general sense of asthenia all over the body usual sleep at all, if he takes a especially and there is a disinclination to make any smaller dose than that to which he is accus- exertion. The heart is often tomed. Under these circumstances he feels physical involved, and some of our patients complained of a sink- miserable, becomes restless and irritable. He ing feeling in the chest and of palpitations. may get palpitation of the heart and in some The addicts are to respiratory cases there is a sensation of cold and susceptible shivering catarrh with signs of impaired respiratory all over the body. We have not seen any cases function. The prolonged use of large doses going to a condition of delirium in our series leads to chronic congestion of the liver and as has been described by other observers. The lungs and to fatty degeneration of the heart. addict may feel so miserable that he may have Two of our patients complained of formication recourse to another dose, perhaps a larger one, over the arms, which was relieved by pressure. in the hope of getting into a state of somno- We have not come across any case of facial lence. The sleep generally comes, but if it does paralysis as described by Lewin, or of involve- not, as sometimes happens, the repetition of ment of any cranial or other nerves. We have doses may produce fatal results. Through the not met with any cases of tremors of the hands courtesy of Major D. R. i.m.s., we have Thomas, or head or of dementia. This may be due to been able to record a case where the wife of a the fact that the addiction is of recent origin European official was prescribed this drug and in this country and that these are the effects formed a habit after its frequent use. She produced after prolonged use of the drug. The increased the dose gradually on her own account drug certainly affects the higher psychological and succumbed to During finally poisoning. centres and the chloralist becomes a weakling; the 24 hours her death she took more preceding he shrinks from and becomes than 180 of the responsibility grains drug. unreliable. Lewin has described papular eruptions, blood Chloral habit and other habits.?Addic- spots on the skin, ulcerated fingers and spoilt drug tion to cocaine and chloral in nails, spasms of the bladder and urinary opium, hydrate India differ a deal from each other as troubles, and pressure gangrene occurring great the causative factors and effects. The among chloralists, but we have not come across regards senior author has shown that the these conditions in our series. Possibly these (1928) opium habit in this is common are accompaniments of larger doses taken for country among persons of a who need relief from prolonged periods, or this may occur only in quiet disposition some ailment or from susceptible individuals. Pain in the limbs and the worry, strain and stress of life. It is met with in in the back were also uncommon in our series. generally per- sons in the fourth decade of life or later. It All the addicts were uniformly of opinion is an addiction more of rural areas in northern that chloral hydrate is sexually a depressant a new of drug. The addicts feel no desire for sex com- India, although lately type young addict is to be met with in the cities. It panionship while under its influence and after has also been shown that the cocaine habit its prolonged use a condition of sexual neuras- (1931) occurs of licentious who are thenia and impotency is undoubtedly produced. among people type in search of enjoyment, and need constant When a has taken a toxic e.g., person dose, excitement and sexual pleasure. It is 60 or the following train mainly grains thereabouts, an addiction of young adults and is met of is The rarely symptoms usually produced. patient with after the fourth decade of life. Alcohol soon becomes and falls into a deep drowsy addiction may occur at but the from which he cannot be roused by any age age sleep at which the incidence is is between or external the face is highest shouting by stimuli, 25 and 45 years. Addicts come from all classes flushed and the contracted. In the later pupils and vocations of and to both rural the become stertorous, life, belong stages breathing may and urban areas. The chloral habit is and the pulse weak and irregular; the blood generally a secondary addiction and occurs among those pressure is often high; the body surface is cold addicted to alcohol or opium. It is common in and sometimes a sweat may occur. drenching the third and fourth decades of life. We have not met with any instance where excessive doses caused vomiting and diarrhoea. With regard to the dose, the increase in the case of chloral is not so as in the The deep sleep may end in coma and death. hydrate rapid case of and because Physical effects.?The habitue is usually a opium cocaine, probably tolerance with the former is not shallow, thin, spare and anaemic looking in- drug developed and the toxic limit is reached very dividual; the conjunctivae may be congested quickly. In our series of cases we did not find any of the and sometimes have a yellowish tinge. He habitues a for this looks sad and melancholic, especially if he has showing passionate craving as is the case with and resorted to the abuse of the drug for a drug opium cocaine. 486 THE INDIAN MEDICAL GAZETTE [Sept.; 1932

Chloral hydrate never gives rise to a feeling entirely absent. It depresses from the begin- of euphoria or takes the place of a normal ning, and narcosis and deep sleep are produced excitant. It never produces any agreeable by comparatively small doses. If narcosis is reveries, as are experienced after the use of not produced the habitue becomes miserable, hemp drugs. Chloral is said to produce its irritable, and resorts to larger doses which may harm by causing inaccuracy of mental judg- be repeated. and even delusions have been ment, reported. 4. The modes of administration of the drug, So far as the effects on the are con- system the of the the age at which chloral is far the most etiology addiction, cerned, hydrate by the habit is started, its duration and the objec- of all the drugs of in that dangerous addiction, tive and symptoms produced, as it is liable to serious effects on the subjective produce determined a of 40 cases, are and death from of by study important organs paralysis described. the heart. The habit is harmful and It Paraldehyde habit.?The habitual use of 5. dangerous. more to paraldehyde has also been recorded by Lewin is liable produce pathological changes in the and fatal results and according to him is confined to persons organs immediately than other of addiction used in this who are inclined to take narcotics. This drug any drug habit is very uncommon in this country, country. although cases have been recorded among 6. The mental, moral and physical degene- medical men and compounders working in dis- ration produced by this addiction are more pensaries. There is a case on record of a pronounced than with the common drugs of compounder who used to drink paraldehyde addiction in India. regularly wherever he was employed. The 7. The is and is habit continued for six years and he finally drug cheap easily procur- no over the sale of this died of severe anaemia and general dropsy. able, there is control in India at the time. These This case was seen by one of us, the symptoms drug present and effects produced by the drug appeared to factors are largely responsible for the spread of its use the masses in those be very much like those produced by chloral amongst hydrate. Another case was that of a sub- localities. assistant who was a successful surgeon quite 8. Habitual use of paraldehyde is known in and who took the for 3 to 4 practitioner, drug this country, but it is very uncommon. years regularly and finally died of pneumonia. 9. There is a danger of the use of chloral Summary and discussion hydrate for adulteration of alcoholic beverages of the further of 1. The addiction to chloral hydrate is of being extended and spread the chloral habit. The of indi- recent origin. Although the occasional use of practitioners medicine and the itinerant are chloral as a substitute for alcohol is known in genous quacks the almost all the districts of the Punjab where the beginning to prescribe drug. of the Sikh is percentage population high, In I would like to Louis addiction to this is at conclusion, quote drug confined, present, Lewin's remarks about this class of drug. He to a very limited area in the central districts ' There is no whose use is harm- of the The says, hypnotic Punjab (Ludhiana, Ferozepore). and medical men should take this to heart addicts are between the of 21 and less, mostly ages in order to the increase of the 40 and in the of cases are also prevent already years, majority evil of addicted to alcohol or widespread soporific consumption\ opium. The authorities in this country can do much 2. Addiction to chloral hydrate in India to help in this direction by bringing the sale differs from that in and in Europe America of such drugs as chloral hydrate, butyl chloral, that in the latter countries it is the physician paraldehyde, sulphonal, bromural, etc., under who is for the responsible producing habit, a more strict control. At present any one can whereas in habitual use of India the this drug buy these drugs and this has led to an abuse. is mainly among liquor drinkers who want its intoxicating effects. They start by putting it in their potion to strengthen the effects of the References and in this obtain intoxication at a drink, way Chopra, R. N. (1928). The Present Position of the small cost. a number of them a Among per- Opium Habit in India. Indian Journ. Med. Res., manent habit is established, and they become Vol. XVI, p. 389. addicts. Chopra, R. N., and Chopra, G. S. (1931). Cocaine 3. The effects produced by chloral hydrate Habit in India. Ibid., Vol. XVIII, p. 1013. of differ from those other drugs of addiction, Lewin, L. (1931). Phantastica: Narcotic and Stimu- such as alcohol and cocaine, in that there is lating Drugs. London: Kegan Paul, Trench, Trubner no preliminary stage of stimulation and excite- and Co., Ltd. ment; the pleasurable or euphoric effects, there- Thomas, D. R. (1930). Report of the Chemical fore, resulting from the use of the drug are Examiner to Government, Punjab.