One of the most important questions about cannabis is the consequences, if any, of
prolonged use. Since conclusive experiments in humans have not yet been performed, we must
rely on clinical evidence or on objective examination of subjective experiences recorded
in the literature. One of the best reports extant, because of its scope and keen
observation and because it relates the subjective effects of cannabis to chronic use and
psychological dependence, was given 114 years ago by the young American Fitz Hugh Ludlow
(1857) in the autobiography The Hasheesh Eater. The present paper examines Ludlow's
experiences and their relevance to current knowledge and interests about cannabis.
Ludlow was an intelligent, sensitive and imaginative youth of 16 when he discovered
cannabis in the local drug store where he had already experimented with ether, chloroform.
opium and "....the whole gamut of queer agents within my reach" (p.17). But
cannabis exerted a special fascination and so he used it intensely for the next three or
four years. He wrote The Hasheesh Eater as part of a withdrawal program and
published It anonymously when he was 21 years old.
PERCEPTUAL EFFECTS
Ludlow made several trials with Cannabis indica extract, ingesting increasing doses of
it, but experienced no effects. Finally he took 30 grains, and three hours later suddenly
realized he was under the influence of hashish:
"My first emotion was one of uncontrollable terror - a sense of getting something
which I had not bargained for" (p.20).
The reaction lasted several hours and consisted of a sequence of well structured
hallucinations,[2] mostly visual and auditory. This was perceived as a strange awesome
subjective state which, however, he was able to conceal from others. He became acutely
aware of his heart beat and of every detail of his circulation. This caused increasing
anxiety, until he thought death was imminent:
"I gave myself up for lost, since judgment, which still sat unimpaired above my
perverted senses, argued that congestion must take place in a few moments, and close the
drama with my death" (p.27).
Episodes of panic are common complications of the use of hallucinogens, especially by
novices. Becker (1967) has suggested they may be related to uncertainty and anxiety about
the drug effects when the setting does not provide reassurance and guidance.
After being reassured by a physician, Ludlow went to bed and then experienced the
ecstatic part of the reaction:
"I am borne aloft upon the glory of sound. I neat in a trance among the burning
choir of the seraphim" (p.36).
When he awoke he was glad to realize this was not another hallucination:
"it was like returning from an eternity spent in loneliness among the palaces of
strangers" (p.43).
He also noted distortion of perception, a sense of splitting of the self. repeated
interruption of the abnormal state by periods of lucidity, and a lack of hangover. With
respect to time and space he says:
"Now...l experienced that vast change which hasheesh makes in all measurements of
time. The first word of the reply [to a question he had been asked] occupied a period
sufficient for the action of a drama.... And now, with time, space expanded also... the
whole atmosphere seemed ductile, and spun endlessly out into great spaces surrounding me
on every side" (p.22).
These feelings, which were interpreted mystically as the achievement of eternity and
immortality, became an important factor in his strong fascination with the drug. The sense
of duality of the self, and the emergence of periods of lucidity, are eloquently
expressed:
"One portion of me was whirled unresistingly along the track of this tremendous
experience, the other sat looking down from a height upon its double, observing,
reasoning, and serenely weighing all the phenomena"(p.23).
"Ever and anon I returned from my dreams into consciousness." (p.24).
In addition to over a dozen subjective experiences, Ludlow gives an objective
description of four selected cannabis reactions in friends upon whom he experimented. From
them a composite picture of the effects of cannabis emerges. The only physical features
noted consistently are thirst and freedom from hangover symptoms. He considered the
intense thirst and other physical sensations to be due at least partly to enhanced
perception:
"Hasheesh... magnifies the smallest sensation till it occupies immense boundaries.
The hasheesh-eater who drinks during his highest state of exaltation almost invariably
supposes that he is swallowing interminable floods, and imagines his throat an abyss which
is becoming gorged by the sea" (p.73).
He referred to the related phenomenon of synesthesia as "the interchange of
senses."
"Thus the hasheesh eater knows what it is to be burned by salt fire, to smell
colors, to see sounds, and, much more frequently, to see feelings"
(p.149).
The quantitative and qualitative alterations of perception are undoubtedly linked to
the other psychological phenomena of the reaction and to the influence of emotional set
and setting on them. Ludlow was aware of the significance of the latter.
"Light," he says, "is a necessity to him, even when sleeping; it must tinge
his visions, or they assume a hue as sombre as the banks of Styx" (p.67). He also
found that the presence of a sympathetic: friend "prevented any undercurrent of
horror from breaking up through my delightful tides of vision" (p.203).
Enhanced suggestion, auto-suggestion and empathy all influenced the quality of the
experience:
"it is possible for a man of imaginative mind, by mere suggestions of rich veins
of thought, to lead a companion in the hasheesh state through visions of incomparable
delight" (p.55).
Through autosuggestion he could direct his visions almost at will by concentrating on a
particular subject before ingesting cannabis. He describes an instance of empathy in which
he shared the experiences of an intoxicated friend when he himself was undrugged, and vice
versa. He notes, however, that at the height of the reaction the subject becomes
refractory to suggestion.
These phenomena relate to the manner in which the personality integrates the
experience. Ludlow also described depersonalization, manifested as grotesque body
distortions, dissociation of body and mind, and assumption of a multiple personality. In
one instance, forgotten childhood memories were recalled. Ludlow realized the relation
between some of these phenomena and those seen in psychotic states:
"The hasheesh state, in its intensest forms, is generally one of the wildest
insanity. By this I do not mean to say that the hasheesh-eater... necessarily loses his
self control, or wanders among the incoherent dreams of a lawless fancy, for neither of
these propositions is true" (p.164).
The beginner, he noted, finds it almost impossible to control his behavior under the
influence of the drug, but this becomes gradually feasible and eventually a habit.
At the cognitive level he observed speeding-up of thought processes and the subjective
sense of great intellectual ability, "be its result true or false" (p.167).
He also gives an interesting example of the apparent influence of cannabis on objective
musical performance. A friend, while intoxicated, mimicked the sound of a bugle and
"played in my hearing a strain of his own impromptu composition so beautiful that it
would have done credit to any player upon wind instruments that ever obtained
celebrity" (p.117).
AFFECTIVE REACTIONS
The affect attached to Ludlow's fantasies ranged from marked euphoria to intense
anxiety. Occasionally the euphoria was related simply to humorous situations, and it is
evident that he understood the discrepancy between his subjective state and objective
reality:
"Every gesture of the figures that passed before me told me more of raillery than
tongue could utter... not the faintest stroke of humor in look or manner escaped me, and I
no doubt often committed that most gross error in any man, laughing when my neighbors saw
fit not to be moved" (p.169).
More frequently the euphoria was related to intensely pleasurable esthetic experiences
and to feelings of omnipotence and omniscience:
"My powers became superhuman; my knowledge covered the universe; my scope of sight
was infinite" (p.96). "All strange things in mind, which had before been my
perplexity, were explained - all vexed questions solved. The springs of suffering and of
joy, the action of the human will, memory, every complex fact of being, stood forth before
me in a clarity of revealing which would have been the sublimity of happiness" (p.
138).
Omnipotence was consistently expressed as a state of mystical identification with God
which gradually gave rise to conflict. In one instance he both destroyed and rcsuscitated
Him. This was accompanied by strong feelings of guilt and by punishnlent, retlected in the
increasing frequency and intensity of terrifying episodes and progressive loss of
pleasure:
"At length the reasons of my punirhment were shown me... I was told, `Thou hast
lifted thyself above humanity to peer into the speechless secrets before thy time; and
thou shalt be smitten - smitten - smitten'" (p.189).
The anxiety is often expressed as self-annihilation or death fantasies:
"I felt myself weeping, and ran to a looking-glass to observe the appearance of my
eyes. They were pouring forth streams of blood! And now a sudden hemorrhage took place
within me; my heart had dissolved, and from my lips the blood was breaking also"
(p.134).
Ludlow interpreted the hashish reaction in terms similar to those employed by
contemporary advocates of the use of psychedelic drugs. The drug, he felt, revealed
unknown areas of the mind which were often disclosed in symbolic fashion, and allowed for
otherwise inaccessible insights:
"in the hasheesh-eater a virtual change of worlds has taken place.... Truth has no
become expanded, but his vision has grown telescopic.... To his neighbor in the natural
state he turns to give expression to his visions, but finds that to him the symbols which
convey the apocalypse to his own mind are meaningless, because, in our ordinary life, the
thoughts which they convey have no existence; their two planes are utterly different"
(p. 148).
Ludlow, however, eventually reached the conclusion that the use of drugs was the wrong
pathway to these discoveries:
"...the soul at last pays a most bitter price for all its ecstasies; moreover, the
use of (cannabis) is not the proper means of gaining any insight" (p.91).
He believed that involvement in social causes, and esthetic appreciation of nature and
art, satisfied the same needs in a healthier way, and felt that destruction of the natural
environment increased man's need for drugs.
A very significant factor contributing to Ludlow's ultimate attitude was his eventual
loss of control over the use of hashish. This question will be considered after a brief
description of some relevant pharmacological points.
PHARMACOLOGICAL CONSIDERATIONS
Ludlow consistently talked of "hasheesh," but in fact he took the solid
extract of Cannabis indica which was roughly twice as potent as the crude resin and ten
times as potent as marijuana. A rough calculation shows that his intake was equivalent to
about 6 or 7 marijuana cigarettes per dose, i.e., at the hallucinatory rather than at the
euphoriant level prevalent ino contemporary North Amencan use. Medical literature of the
19th century contains many case reports of hallucinatory reactions after much smaller
doses. A few representative cases are' those described by Beckler (1886), Gardner (1852),
Kelly (1883), Kuykendall (1875), Minter (1896), and Ruelle (1897). Moreover, smoking
cannabis may differ from ingestion of the whole extract with respect to both the quality
and quantity of the active principles absorbed (Joachimoglu, 1965). Effects begin almost
immediately after smoking but are delayed one hour or more following ingestion. Lastly,
oral intake does not allow for the fine graduation of intake possible by smoking, so that
the chances of overdosage are far greater. All these factors, but particularly the
habitual intake of high doses of a very potent preparation, must be kept in mind in
assessing Ludlow's acute reactions and the strength of his eventual dependence.
Ludlow observed that the intensity of effect depended on the dose. He stated, however,
that there was no need to increase the dose on continued use. Indeed, initially the
reverse was true:
"Unlike all other stimuli with which I am acquainted, hasheesh, instead of
requiring to be increased in quantity as existence in its use proceeds, demands rather a
diminution, seeming to leave, at the return of the natural state... an unconsumed capital
of exaltation for the next indulgence to set up business upon" (p.104).
The nature of this well recognized phenomenon, recently referred to as "reverse
tolerance" (Well et al., 1968), is unclear. There are several possible
interpretations. Repeated use of cannabis might lead to a reduction of emotional
inhibitions and facilitation of conscious recognition of the subjective effects (Becker,
1958). Alternatively, there might be "pharmacological sensitization" to the drug
(Weil et al., 1968). This term might include an unexplained enhancement of sensitivity of
the receptors as a result of the first dose, saturation of inactive binding sites in
plasma and elsewhere, or induced increase in metabolic conversion of tetrahydrocannabinol
to more active substances (Mechoulam, 1970). Finally, in smoking cannabis, the
inexperienced user might not inhale deeply enough and therefore absorb only part of the
dose. The fact that Ludlow observed the same phenomenon after ingestion makes this
explanation less likely.
He also emphasized a related but not generally recognized phenomenon, i.e., if a second
dose of the extract, no matter how small, was taken before the effects of the first had
completely subsided, the reaction was extremely intense and unpleasurable.
Persistence and recurrence of effects in the undrugged state were also described:
"Returning to consciousness, he did not, however, recover from the more moderate
hasheesh effects for months. The nervous thrills... reappeared to him at intervals, and
his dreams constantly wore a hasheesh tint" (p.122).
This resembles recent descriptions of spontaneous recurrence of acute effects of
cannabis (Keeler et al., 1968) and LSD (Smart and Bateman, 1967). Ludlow provided some
evidence for a psychological rather than a pharmacological explanation in his statement
that, after months of complete withdrawal:
"...Even in perfect consciousness, I believed I was still dreaming, and to this
day I have so little lost the memory of that one demoniac toll, that, while writing these
lines. I have put my hand to my forehead, hearing and feeling something, through the mere
imagination, which was an echo of the original pang" (p.201).
A potentially significant observation was that normal dreaming disappeared during
chronic use of the drug:
"...although, previously to acquiring the habit, I never slept without some dream
more or less vivid, during the whole progress of the hasheesh life my rest was absolutely
dreamless. The visions of the drug entirely supplanted those of nature" (p.242).
Edes (1893) and Stockings (1947) have reported similar effects. Klüver (1966) has
described the same phenomenon with mescaline, but it has received very little attention in
the cannabis literature.
Ludlow was also well aware of the intra- and inter-individual variability of effects.
About the former he said:
"At two different times, when body and mind are apparently in precisely analogous
states, when all circumstances, exterior and interior, do not differ tangibly in the
smallest respect, the same dose of the same preparations of hasheesh will frequently
produce diametrically opposite effects. Still further, I have taken at one time a pill of
thirty grains, which hardly gave a perceptible phenomenon, and at another, when my dose
had been but half that quantity, I have suffered the agonies of a martyr, or rejoiced in a
perfect phrensy" (p.66).
Many writers who have commented on the marked variability of cannabis effects have
failed to distinguish between the highly variable specific content and affective character
of the experience, and the relatively constant basic processes of perceptual modification.
In the quotation above, Ludlow was differentiating clearly between intensity and affective
character of the effect. He also recognized that subjects with different temperaments
tended to react differently:
"...upon persons of the highest nervous and sanguine temperanlents hasheesh has
tile strongest effect; on those of the bilious occasionally almost as powerful a one;
while lymphatic constitutions are scarcely influenced at all except in some physical
manner, such as vertigo, nausea, coma, or muscular rigidity" (p.123).
DEPENDENCE
Ludlow's account contains most of the elements that characterize the contemporary
notion of cannabis dependence (Eddy et al., 1965). His initial motive was a general
curiosity about psychoactive drugs very similar to the attitude of some contemporary
users. It is significant, however, that he found the cannabis "high" far more
attractive than those of ether, chloroform, or opium. It was the very quality of his
reaction - not sensual but "of the most exalted ideal nature" that led him to
subsequent experiments. At the same time it satisfied his passive tendencies:
"I had now a way of gratifying it [his passion tor travelling] I which comported
both with indolence and economy.... For the humble sum of six cents I might purchase an
excursion ticket over all the earth" (p.64).
This vicarious satisfaction was gradually reinforced to the point that it eventually
replaced "...all other excitement" (p.101).
His major rationalization for repeating the experience many times was the idea that he
was conducting research:
"Moreover, through many ecstasies and many pains, I still supposed that I was only
making experiments" (P. 101).
Nevertheless, he realized that the habit was becoming increasingly difficult to
control:
"At what precise time in my experience I began to doubt the drug being, with me,
so much a mere experiment as a fascinating indulgence, I do not now recollect. It may be
that the fact of its ascendancy gradually dawned upon me; but at any rate, whenever the
suspicion became definite, I dismissed it by so varying the manner of the enjoyment as to
persuade myself that it was experimental still" (p.153).
He went on "experimenting" until he was in a state of almost continuous
intoxication, noting that on continued use "the effect of every successive indulgence
grows more perduring until the hitherto isolated experiences become tangent to each
other" (p98).
The compulsive need for cannabis and the increasingly terrifying experiences made
Ludlow decide to give the drug up altogether. Various attempts at gradual or complete
withdrawal were unsuccessful. For several weeks he mangaged on about half his usual dose,
and experienced milder effects:
"I sat in solitude, with closed eyes, enjoying the tranquil procession of images,
especially those of scenery, which I could dispel at will, since they did not reach the
reality of hallucination" (p.220).
But maintaining this regimen was difficult:
"The utmost that could be done was to keep the bolus from exceeding fifteen
grains. From ten and five, which at times I tried, there was an insensible sliding back to
the larger allowance, and even there my mind rebelled at the restriction" (p.227).
In these circumstances Ludlow got help and encouragement from the author of an article in Putnam's Magazine who
claimed to have successfully broken the cannabis habit. To make the definitive break, he
accepted a position as school teacher in a town where cannabis was not available. Complete
withdrawal was characterized by intense craving for cannabis, spontaneous recurrence of
the nightmarish features of the drug reaction "with a vividness only less than
amounting to hallucination" (p.213) and profound depression but no physical symptoms.
The depression was expressed as withdrawal into the self - "an abhorrence of speech
or action except toward the fewest possible persons, possessed me" (p.240) - and by
suicidal ideas. Ludlow describes his despondency thus:
"My troubles were not merely negative, simply regrets for something which was
lost, but a loathing, a fear, a hate of something which was. The very existence of the
outer world seemed a base mockery, a cruel sham" (p.240).
He began to dream again during sleep, but the content was not normal. The dreams
"mirrored the sights and echoed the voices of the former hasheesh life" (p.243).
They, as well as the cannabis-like episodes during the day, were heavily loaded with
anxiety.
The intensity of the craving subsided gradually over the next few months, but there
were occasions of "absolute struggle" brought about by various stimuli,
including tobacco deprivation:
"To defer for an hour the nicotine indulgence was to bring on a longing for the
cannabine which was actual pain" (p.261).
The need for visions was satisfied by such ingenious procedures as blowing soap bubbles
where he "found some faint actualization of [his] remembered hasheesh sky"
(p.262), building exotic structures with his books and, most effectively, by reenacting
his cannabis experience in writing:
"From this reproduction of the past... I gained a double benefit, the pleasure of
appeasing the fascination without increasing it, and the salutary review of abominable
horrors without any more than the echo of a pang" (p.264).
He tried substituting opium but gave it up for fear of developing a strong dependence,
of being unable to conceal its effects, and of being ridiculed as a "Coleridge le
petit" or a "De Quincey in the second edition" (p.282). He was indeed
subsequently called "a minor De Quincey" (Bragman,
1925). But most importantly, he found the effect of opium "invariably bad."
Finally, Ludlow resorted to a sympathetic and understanding physician whom he saw
almost daily for several months. Ludlow considered this crucial, since it significantly
contributed to lifting his depression and thus enabled him to mobilize his own resources
towards his rehabilitation:
"...when my own life had become to me a vague and meaningless abstraction, by
participation with his thought and sympathy I somehow gradually drew into it an injected
energy which made its juiceless pulses throb again, and awoke me out of the lethargy into
which I was sinking deeper every day" (p.252).
THE SIGNIFICANCE OF LUDLOW'S REPORT
From this examination of The Hasheesh Eater it is evident that Ludlow
recognized, with remarkable insight, most of the characteristic subjective effects of
cannabis. He also noted, and interpreted essentially correctly, such pharmacological
points as the relation of dose to effect, inter- and intra-individual variations in
response, and the influence of set and setting. Most importantly, perhaps, he recorded the
development of his dependence on cannabis more comprehensively and astutely than anyone to
date. The initial motives - including features of his own personality and temperament -
the constant rationalization, compulsive use despite obvious untoward effects, the
progression to a state of almost continuous intoxication, the inability to reduce his dose
gradually, and the intense craving and depression after abrupt withdrawal, are all clearly
described. Ludlow recognized also the lack of physical symptoms during withdrawal, and the
difference from opium withdrawal in this respect.
With the benefit of hindsight, we can also identify in Ludlow's account a number of
other features consistent with present knowledge, but which even scientists of his day
could not possibly have known. For example, the initial change in tolerance, the continuum
between euphoria and hallucinations (Isbell et al., 1967), the differentiation between the
hallucinatory process and the affective reactions to it, the relation between spontaneous
and drug-induced perceptual changes, the similarity between the effects of cannabis and
those of other hallucinogens, the attempts at drug substitution therapy (opium, tobacco),
and the role of psychotherapy and of abreactive writing, are all in keeping with
contemporary thought. These points permit the modern reader to feel even greater
confidence in the extraordinary accuracy and perceptiveness of Ludlow's record.
This analysis, however, is not intended merely to arouse the reader's admiration for
Ludlow. Its purpose is to emphasize two important benefits which contemporary
investigators may gain from careful reading of older literature, including some
nonscientific writings such as Ludlow's. The first consists of ideas for new research
arising from seemingly minor observations recorded in them. An example is Ludlow's
observation that dream activity ceased completely during the period of cannabis use and
returned after withdrawal. In view of the importance of dreaming in the normal mental
economy, this point deserves objective study by recording of paradoxical sleep (Oswald,
1966). Another example is the inference from Ludlow's account, that the strength of
dependence is related both to the intensity and quality of subjective effects, and the
potency of the preparation used. This is relevant to the comparisons between marijuana,
hashish and pure tetrahydrocannabinols. If the more potent substances become readily
available, the question of dependence may assume greater importance, and careful
investigation of experience in India (Chopra and Chopra, 1957), North Africa (Bouquet,
1950, 1951), and elsewhere would be desirable.
The second benefit offered by this literature is the wealth of observations which it
provides as raw material for objective analysis. Ludlow's book, for example, contains over
35,000 words of vived description of the imagery, phantasy, and transcendental nature of
his drug experiences, which has barely been touched on here. This material, together with
that of other authors, lends itself for a systematic exanlination such as that of Kl¨ver
(1966) on the perceptual effects of mescaline. Some workers in this field have taken the
extreme view that none of the older literature is now relevant because it originated in
other societies, or was not based on modern prilrciples of experimental design. Really
striking findings, such as Claude Bernard's discovery of glycogen. do not require
statistical evaluation. Moreover, evidence can be of different types. Modern experimental
and statistical methods are of unquestionable value, but it must not be forgotten that
they have limitations. Because of the influence of set and setting on subjective effects
of cannabis and other drugs, "neutral laboratory conditions" may be quite
inappropriate for the study of emotional reactions which occur in the more usual
circumstances of drug use. Much more valuable information on this aspect is likely to be
provided by clinical and allied approaches, such as the examination of verbal reports of
thoughts and emotions as they were experienced. An excellent resumé of much of this
literature can be found in Chapter 6 of Walton's monograph (1938), which is also a most
useful source of references. It is the perceptive, introspective and articulate creative
writers - such as Ludlow, Baudelaire, and Huxley - who can best communicate such
experiences. To dismiss their writings as excessively imaginative and atypical, is to
waste valuable material which deserves interpretation in the light of contemporary
neurophysiology, psychology and psychiatry.
This paper is an attempt to show the merits of a re-examination of the older literature
in the course of contemporary research. A knowledge of past achievements and thought can
help to avoid useless repetition, and provide valuable clues for future work. It is worth
recalling thatMoreau (1845) used cannabis in elaborating the concept of the model
psychosis, over a century before modern investigators rediscovered the idea. As Santayana
(1954) has remarked, "Those who do not remember the past are condemned to repeat
it."
The author thanks Dr. H. Kalant for his detailed discussions and major assistance in
the preparation of the manuscript, and Dr. H. Brill and Mr. R.E. Popham for their valuable
suggestions.
