Despite the fact that marihuana was made illegal in the United States in 1937, research has continued on the medical uses of marihuana. The findings include various possible medical applications of cannabis and its chemical derivatives.

One of the most recent and interesting findings (Frank, 1972) concerns the effect of cannabis in reducing intraocular pressure. It was found that as the dose of marihuana increased, the pressure within the eye decreased by up to 30%. This occurred in normal persons as well as in those with glaucoma, a disease of the eye in which increased intraocular pressure may cause blindness. Much more research is necessary in connection with this experimental clinical finding before final judgment can be passed on such a possible therapeutic value.

During the past 20 years in western medicine, marihuana has been assigned antibiotic activity; as a result, several studies relating to this possibility have been undertaken. H. B. M. Murphy (1963: 20) reported investigations in Eastern Europe. He stated that "it is alleged to be active against gram positive organisms at 1/100,000 dilution, but to be largely inactivated by plasma, so that prospects for its use appear to be, confined to E. N. T. (ear, nose and throat) and skin infections."

Dr. J. Kabelikovi (1952: 500-503) and his coworkers carried out tests on rats, which were similar to tests carried out with penicillin in vitro. The alcohol extract of cannabis was bacterially effective against many gram-positive and one gram-negative microorganisms. It was also found that a paste form of external application was successful. According to Kabelikovi, "from a study of 2,000 herbs by Czechoslovakian scientists it was found that cannabis indica (the Indian Hemp) was the most promising in the realm of antibiotics."

In a 1959 publication of Pharmacie, Krejci stated: "From the flowering tips and leaves of hemp, cannabis sativa var indica bred in Middle Europe, were extracted a phenol and an acid fraction. From the acid fraction, two acids were obtained, of which one preserved its antibiotic properties" (p. 349). In another Czechoslovakian publication, Krejci (1961: 1351-1353) referred to two additional samples with antibiotic activity.

Sample I in Fig. 1 has been sufficiently identified as cannabidiolic acid and sample 9 as cannabidiol. Both fractions show antibiotic activity. The results of tests lead us to conclude that the antibacterial action of cannabis sativa is not identical to the hashish effect found, for example, in tetrahydrocannabinol. However, it was established that cannabis sativa is effective as an antibiotic for local infections.

Kabelik, Krejci, and Santavy (1960: 13) include in "Cannabis as a Medicant" the various microorganisms against which cannabis is effective.

Proof could be furnished that the cannabis extracts produce a very satisfactory antibacterial effect upon the following microbes: staphylococcus pyogenes aureus, steptococcus alpha haemolyticus, streptococcus beta haemolyticus, enterococcus, diplococcus pneumonia, B. anthracis, and corynebacterium diptheriae i.e., all of them gram-positive microorganisms. Noteworthy is the effect upon staphylococcus aureaus strains, which are resistant to penicillin and to other antibiotics.

These authors also mentioned that E. coli (gramnegative bacteria) were tested and found to be resistant to the cannabis extract. One of the conclusions was "the possibility of utilizing the antibiotics locally without any danger of producing resistant strains to other antibiotics administered at the same time throughout treatment" (Kabelik, et al., 1960: 13).

Veliky and Genest in "Suspension Culture of Cannabis Sativa," (1970) reported that "the ethanol extract of cultured cells exhibited antibiotic activity against Bacillus megatherium, staphlococcus aureaus and escherichia coli" (p. 493).

Other reports said that "a pronounced antibiotic effect has been observed in South America, where fresh leaves, after being ground, are used as a poultice for furuncles, and in folk medicine in Europe for treatment of erysipelas" (Kabelik, et al., 1960: 8).

This section on the -antibiotic uses of cannabis concludes with a summary of several reports from various countries. In Pharmacopee Arabe: "The ground-up seeds are mixed with bread for people with tuberculosis" (Andrews and Vinkenoog, 1967: 145). In Czechoslovakia: "A preparation from seed pulp was . . . introduced by Sirek to act as a roborant diet in treatment of tuberculosis" (Kabelik, 1960: 8). "In Southern Rhodesia the plant is used as an African remedy for malaria, anthrax, sepsis, black water fever, dysentery, blood-poisoning, tropical quinine-malarial haemoglobinuria, and a wart medicine" (Watt, 1961: 13). In Argentina:

Cannabis is considered a real panacea for tetanus, colic, gastralgia, swelling of the liver, gonorrhoea, sterility, impotency, abortion, tuberculosis of the lungs and asthma ... even the root-bark has been collected in spring, and employed as a febrifuge, tonic, for treatment of dysentery and gastralgia, either pulverized or in form of decoctions. The root when ground and applied to burns is said to relieve pain. Oil from the seeds has been frequently used even in treatment of cancer . . . (Kabelik, 1960: 8).

In 1949, Davis and Ramsey reported a study of the effect of THC on epileptic children. "The demonstration of anticonvulsant activity of the tetrahydrocannabinol (THC) congeners by laboratory tests (Loewe and Goodman, Federation Proc., 6: 3521 1947) prompted clinical trial in five institutionalized epileptic children" (David and Ramsey, 1949: 284-285). Of these five children, all had severe symptomatic grand mal epilepsy with mental retardation; three also had cerebral palsy; and three had focal seizure activity. The EEG tracings were reported to be grossly abnormal in all five children. The results after treatment with homologues of THC, were reported as follows:

Three children-responded at least as well as to previous therapy.

Fourth child-almost completely seizure free. Fifth child-entirely seizure free.

As a result of their study, David and Ramsey (1949: 284-285) felt that "the cannabinols herein reported deserve further trial in non-institutionalized epileptics."

Dr. Vansim of Edgewood Arsenal has written in a recently published book "Psychotomimetic Drugs," that the synthetic preparations of cannabis are of interest. There are three areas where they may be of definite use in medicine (Efron, 1969: 333-334). One concerns the use of a cannabis analogue which Dr. Walter S. Loewe reported very effective in preventing grand mal seizures if given in small doses.

The second use refers to cannabis as an antidepressant. Straub (Walton, 1938: 3), Adams (1942: 726-727), and Stockings (1947, 920-922) point to the possible use of cannabis and cannabis analogues in relieving dysphoria in depressed patients. Other authors (Parker and Wrigley, 1950: 278-279) had lesser success but recommended further research in this field.

A report from London in 1968 suggests that cannabis treats the symptoms and not the cause by focusing the user's attention on his anxieties and pains without helping him to resolve them (Report by the Advisory Committee, 1968: 11).

The third use is described by Douthwaite, who used hashish in 1947 "for reducing of anxiety and tension in patients with duodenal ulcer" (Pond, 1948: 279).

A report in a 1965 issue of Medical News ("Cardiac Glycocides," p. 6) suggests cannabis as treatment for a specific form of malignancy.

Cannabis is recognized as an appetite stimulant, which suggests that the drug might be useful in the treatment of pathological loss of appetite known as anorexia nervosa (Grinspoon, 1969: 21). Similar symptoms exist in terminal cancer patients who, when treated with cannabis over a short period of time, demonstrated stimulation of appetite, euphoria, increased sense of well-being, mild analgesia and an indifference to pain which reduced the need for opiates (DHEW, 1971: 11).

Cannabis has been recently proposed as an adjunct in the treatment of alcoholics and drug addicts. Roger Adams (1942: 726-727) and Todd Mikuriya (1970a: 187-191) noted that the substitution of smoked cannabis for alcohol may have rehabilitative value for certain alcoholics.

Regarding the use of cannabis analogue in the treatment of drug, alcohol and depressive state withdrawal, Thompson and Proctor (1953: 520523) report the following:

Depressive States:

20 cases of neurotic depression-4 improved (20%)

6 cases of psychotic depression-none improved (00%)

Post-Alcoholic Cases:

70 cases--59 reported clinical alleviation of symptoms (84%)

Drug Cases:

6 cases of barbiturate addiction-4 reported amelioration of symptoms (66%)

4 cases of dilaudid addiction-3 reported alleviation (75%)

2 cases of pantopan and one paregoric addiction-all reported smooth withdrawal (100%)

12 cases of Demerol addiction-10 withdrawals in one week (83%)

6 cases of morphine addiction-2 withdrawals without unpleasant symptoms (33%)

The doctors concluded that "Pyrahexyl (a synthetic cannabis-like drug) and related compounds are beneficial in the treatment of withdrawal symptoms from the use of alcohol to a marked degree, and in the treatment of withdrawal symptoms from the use of opiates to a less marked, but still significant degree" (Thompson & Proctor, 1953:520-523).

Drs. Allentuck and Bowman (1942) undertook a study of the use of marihuana in the morphine abstinence syndrome. They stated:

A series of cases were selected from among drug addicts undergoing treatment. . . . Comparative results were chartered for the gradual withdrawal, total withdrawal, and marihuana derivative substitution, as methods of treatment. . . . 49 subjects were studied. The results in general, although still inconclusive, suggest that the marihuana substitution method ameliorated or eliminated (the symptoms) sooner, the patient was in a better frame of mind, his spirits elevated, his physical condition was more rapidly rehabilitated, and he expressed a wish to resume his occupation sooner (p. 250).

In his study of the medical application of cannabis for Mayor LaGuardia's committee, Dr. Samuel Allentuck reported "favorable results in treating withdrawal of opiate addicts with tetrahydrocannabinol (THC), a powerful purified product of the hemp plants" (Mikuriya, 1969: 38).

Roger Adams' detailed studies, as reported by Dr. C. K. Himmelsbach in his 1944 article "Treatment of the Morphine Abstinence Syndrome with a Synthetic Cannabis-Like Compound" (1944:26), indicated that "withdrawal manifestations were considered to be mild. The reported therapeutic value of marihuana was attributed to improved appetite, greater sleep, euphoria, and a reduction of the intensity or elimination of abstinence phenomena." Himmelsbach, however, had lesser success when he studied the effect of a "pyrahexyl" compound on the morphine abstinence syndrome, as noted by his conclusions that:

(1) Pyrahexyl compound appears to possess considerable cannabis-like effect when administered orally, but little or none when given intramuscularly.

(2) When given by mouth In definitely effective amounts pyrahexyl compound had no appreciable ameliorative effect on the opiate abstinence syndrome (P. 29).

The New York City Mayor LaGuardia's Committee on Marihuana (1944: 147-148) reported two possible therapeutic applications of marihuana:

The first is the typical euphoria-producing action which might be applicable in the treatment of various types of mental depression; the second is the rather unique property which results in the stimulation of appetite. In the light of this evidence and in view of the fact that there is a lack of any substantial Indication of dependence on the drug, It was reasoned that marihuana might be useful in alleviating the withdrawal symptoms in drug addicts. However, the studies here described were not sufficiently complete to establish the value of such treatment . . . .

A study was then undertaken at Riker's Island (N.Y.) Penitentiary involving 56 morphine or heroin addicted inmates. Two groups were equally matched according to age, physical condition, length and intensity of habit, etc. One group received no treatment or Magendie's solution, and the other received 15 mg. of THC and/or placebo.

"The impression was gained that those who received tetrahydrocannabinol had less severe withdrawal symptoms than those who received no treatment or who were treated with Magendie's solution" the report stated. However, the report further said that this alleged therapeutic use of marihuana should be "investigated under completely controlled conditions" before meaningful conclusions can be developed (New York City Mayor, AU: 147-148).

Some reports indicate that cannabis helps relieve labor pains. Such uses are reported among native tribes in South Africa and Southern Rhodesia: "The Suto tribe fumigates the parturient woman to relieve pain;"the Sotho women of Basutoland "are reported as smoking cannabis to stupefy themselves during childbirth," and have also been known to "administer the ground-up achene with bread or mealiepap to a child during weaning" (Watt, 1962:13).

The use of cannabis in the treatment of leprosy has been described in a 1939 dictionary of Malayan medicine: "Seeds of Hydnocarpus anthelmintim ... form the basis of the Tai Foon Chee treatment of leprosy. After crushing and sieving, they are mixed with cannabis indica in the proportion of two parts of the seeds to one of Indian hemp" (Andrews and Vinkenoog, 1967: 146). Likewise, Watt and Breyer-Brandwijk quote Pappe that "the early colonist employed a decoction in the treatment of chronic cutaneous eruptions, possibly in leprosy (Andrews and Vinkenoog, 1967: 146).

Kabelik, Krejci, and Santavy have reported favorable results "in stornatitis aphtosa, gingivitis, and in paradentoses with a mouthwash of the following composition: Tinct. Cannabis 20.0, Tinct. Chamomillae, Tinct. jernmarum populi (or another tan for example, Tinct. Gallarum) aa 10.0 to be applied in the form of sprays or linaments to the inside of the mouth" (Kabelik et al., 1960: 13).

In reference to the use of cannabis, Chopra and Chopra (1957: 12-13) listed some preparations used in the practice of indigenous medicine in India in 1957. They summarize their article "The Use of the Cannabis Drugs in India" (1957: 12-13) by saying:

. . . with regard to the use of cannabis in Indian indigenous medicine at the present time, it may be said that It was and still is fairly extensively used in both the Ayurvedle (Hindu) and Tibbi (Mohammedan) systems of medicine as an anodyne, hypnotic, analgesic and antispasmodic, and as a remedy for external application to piles. It is also used in the treatment of dysmennorhoea, rheumatism, chronic diarrhoea of the sprue type, gonorrhoea, malaria and mental diseases on the advice of itinerant practitioners of Indigenous medicine as well as quacks who roam about the country. For medicinal purposes the drug is administered by mouth and hardly ever by smoking.

The use of cannabis drugs in indigenous medicine has greatly declined during recent years for two reasons-firstly, because of the rapid deterioration of the potency of cannabis drugs in storage, the specimens available on the market being often Inert and quite useless; secondly, because a number of potent and effective drugs of the type used In western medicine are now available on the market and are used quite extensively by the practitioners of indigenous medicine in place of cannabis, for the anodyne, sedative and hypnotic effects. In the rural areas of India, however, the practitioners of indigenous medicine still use cannabis quite extensively In their practice.

The same article lists a variety of uses in which cannabis is employed therapeutically in veterinary medicine.

Dr. R. N. Chopra (1940: 361) reports the following medicinal household uses of Indian Hemp:

The hemp drugs are popularly used as household remedies in the amelioration of many minor ailments. A mild beverage made from bhang leaves is believed to sharpen appetite and to help digestion. Indian hemp Is commonly used as a smoke and as a drink for its supposed prophylactic value against marihuana in malarious tracts. Bhang beverages form one of the popular household remedies for gonorrhoea and dysuria. On account of their mild diuretic and sedative properties these drinks probably give a certain amount of symptomatic relief. Likewise, the use of bhang for dysmenorrhea, asthma, and other spasmodic conditions is not uncommon. A poultice made from fresh leaves is a common household remedy for painful affections of the eyes, conjunctivitis, swollen joints, orchitis, and other acute inflammatory conditions.
Tuberculosis, anthrax, tetanus, and menstrual cramps are among the miscellaneous medical uses of cannabis reported. Reports from Mexico indicate the use of marihuana smoking "to relax and to endure heat and fatigue" (Mikuriya, 1969: 37).

Kabelik et al. (1960: 13) also discuss other varied uses of cannabis.

In human therapy the best results have been obtained with the following medicaments combined with substances derived from cannabis: dusting powder together with boric acid (otitis), ointment (staphylococcus infected wounds, staphylodermia and so on), ear drops (otitis chron.), alcohol solutions with glycerine (treatment of rhagades on the nipples of nursing women-prevention of staphylococcic mastitis,) aqueous emulsions (sinusitis), dentin powder with the IRC (Isolated Resin from Cannabis) (caries). The preparations mentioned above have been already tested clinically, and will eventually be made available for production. . . . the experiments made in clinical practice, particularly in stomatology, otorhinolaryngology, gynecology, dermatology, phisiology, with some pharmaceutical preparations containing antibacterial substances from cannabis have been reported. Attention has been drawn to the advantageous utilization of the active substances from cannabis in veterinary medicine, and particularly in preventive medicine for anthropozoonoses.

Murphy (1963: 20) refers to an article by Lang, "Treatment of Acute Appendicitis with a Mixture of Ma Jen," which says "the drug has apparently been used in China for the treatment of appendicitis." The Xosa tribe in South Africa "employs it for treatment of inflammation of the feet" (Kabelik et al., 1960: 7), while the Mfengu and Hottentot use the plant as a snake-bite remedy (Watt, 1962: 13).

Other therapeutic uses attributed to marihuana are for the treatment of migraine headaches, as an analgesic, and as a hypnotic. Hollister (1971: 28) stated that "other uses which have been proposed for marihuana include the treatment of epilepsy, as prophylaxis for attacks of migraine or facial neuralgia, or as a sexual stimulant."