France has forgotten its golden age of medical cannabis

David A. Guba, Jr. is a professor and historian of cannabis in modern France.

Last summer, France's Agence Nationale de Sécurité du Médicament (ANSM) gave the go-ahead for experimentation with medical cannabis, which is illegal in France. since 1953.

Many are those who hailed this initiative, which represents an important first step towards rational, public health-oriented regulation of cannabis. The ANSM has also welcomed an effort to gather «the first French data on the efficacy and safety» of cannabis for medical treatments.

That's all well and good. However, when it comes to cannabis, French medicine seems to be suffering from historical amnesia. This experiment will not be the first to produce scientific data on medical cannabis in France. Far from it.

«A drug not to be neglected»

During the my research on the history of intoxicants in modern France, I discovered that in the mid-19th century, Paris functioned as the epicenter of an international movement to medicalize hashish, an intoxicant made from the pressed resin of cannabis plants.

Many pharmacists and doctors working in France at the time believed hashish to be a dangerous, exotic intoxicant from the «Orient», the Arab-Muslim world, which could be tamed by science and safely used against the most frightening diseases of the time.

From the late 1830s onwards, they prepared and sold edible products, hashish-based pastilles and tinctures (alcohol infused with hash), and even «medicinal cigarettes» for the treatment of asthma in pharmacies across the country.

During the 1840s and 1850s, dozens of French pharmacists staked their careers on the hashish, The company has published dissertations, monographs and articles in peer-reviewed journals on its medicinal and scientific benefits.

French epidemiologist Louis-Rémy Aubert-Roche has published a treaty in 1840 in which he explained how hashish, administered as a small foodstuff called «dawamesk» taken with coffee, successfully cured plague in seven of the 11 patients treated in Alexandria and Cairo hospitals during the 1834-1835 epidemic. An anti-contagionist at a time when germs had not yet been discovered, Aubert-Roche, like most doctors at the time, was convinced that plague was a non-communicable disease of the central nervous system that spread to humans via a «miasma» or bad air in unhygienic, poorly ventilated areas.

Aubert-Roche therefore believed, confusing symptomatic relief with a chance of cure, that hashish intoxication excited the central nervous system and counteracted the effects of the plague. Plague,« he wrote, »is a disease of the nerves. Hashish, a substance acting on the nervous system, gave me the best results. I believe, therefore, that it is a medicine not to be neglected."

Reefer madness

Physician Jacques-Joseph Moreau de Tours, organizer of the famous Club des Hachichins in Paris in the 1840s, has also proclaimed dawamesk homeopathic miracle drug for the treatment of mental illness. Moreau believed that madness was caused by damage to the brain. He was also convinced that hashish counteracted the effects.

Moreau reported in his 1845 book «Du Hachisch et l'aliénation mentale» that he had treated seven mentally ill patients at the Hôpital Bicêtre in central Paris with hashish. Moreau wasn't totally off the mark: today, cannabis-based medicines are available on the market. are prescribed for depression, anxiety, PTSD and bipolar disorder.

Despite the small sample size, a number of U.S. doctors, from United Kingdom, of Germany and Italy published favorable accounts of Moreau's work on hashish in the late 1840s and 1850s. This discovery was even described as « of great importance to the civilized world« .

The Dye War

Although French and foreign doctors described dawamesk as a miracle cure, they also complained about the inability to standardize doses due to the variation in potency of different cannabis plants. They also wrote about the challenges posed by tampering with dawamesk, which was exported from North Africa and often combined with other psychoactive plant extracts.

In the early 1830s, several doctors and pharmacists of the British Empire tried to solve these problems by dissolving hashish in alcohol to produce a tincture. In the middle of the decade, French practitioners followed suit. They developed and marketed their own hashish tinctures for French patients. Parisian pharmacist Edmond de Courtive, for example, named his preparation «Hachischine» after the famous Muslim murderers often associated with hashish in French culture.

The popularity of hashish tincture grew rapidly in France in the late 1840s, reaching its peak in 1848. It was then that pharmacist Joseph-Bernard Gastinel and Edmond De Courtive became embroiled in a legal battle over a patent, then known as «droit de priorité», to manufacture the tincture using a particular distillation method. The «Gastinel Affair», as it was called in the press, had a major impact. caused an uproar in French medical circles and occupied the pages of Parisian newspapers and magazines for much of the autumn.

To defend his patent, Gastinel sent two colleagues to plead his case before the French Academy of Medicine in October 1848. One of the doctors, Willemin, said that Gastinel had not only devised the distillation method for the tincture in question, but that his tincture could cure cholera, then considered a nerve disease.

Although Willemin was unable to convince the Académie of Gastinel's right of priority, he did convince Parisian doctors to adopt hashish tincture as a treatment for cholera.

Parisian doctors were quick to put Willemin's theory to the test. A cholera epidemic broke out in the city's suburbs a few months later. But when hashish tincture failed to cure the 7,000 or so Parisians killed by the «blue death», physicians had less and less confidence in the miracle drug.

Over the following decades, hashish tincture fell into disrepute: the anti-contagionist medical theories that had underpinned the use of the drug against plague and cholera gave way to germ theory and a new understanding of epidemic diseases and their treatment. During the same period, French Algerian doctors increasingly pointed to the use of hashish as a key cause of insanity and criminality among native Muslims, a diagnosis they dubbed «folie haschischique» or hashish-induced psychosis. Heralded as a miracle drug a few decades earlier, by the end of the 19th century the drug had become an «oriental poison».

Lessons for today

These earlier attempts to medicalize hashish in 19th-century France offer doctors, public health officials and policymakers several important insights as they strive to bring cannabis-based medicines back onto the French market.

First, they must work to disassociate cannabis-based intoxicants and medicines from colonial notions of «oriental» origin and Muslim violence, which ironically underpinned the rise and fall of hashish as a medicine in nineteenth-century France. As the specialist Dorothy Roberts astutely explained in his 2015 TED talk, «racial medicine is bad medicine, poor science and a false interpretation of humanity».

Doctors and patients must also have reasonable expectations of the benefits of medical cannabis, and not over-promise and then under-deliver, as was the case with hachichin during the cholera epidemic of 1848-1849.

And they should bear in mind that medical knowledge is developing gradually, and that basing the medical virtues of cannabis on disputed theories could ultimately reduce its chances of success, as was the case with hashish after the obsolescence of anti-contagionism in the 1860s.

But if France were to embrace its colonial past, reform its prohibitionist policies and make room for medical cannabis experimentation, it could perhaps once again become a world leader in this new medical cannabis movement.

This article is republished from The Conversation under a Creative Commons license. Read the original article here.