BOOK REVIEWS
Cocame-lts History, Uses and Effects, by RICHARD ASH-
LEY St Martm’s Press New York, 1975 232 pp $795
The author revlewed the hterature on cocame He also
noted ins own biases m the Preface He beheves that drug
experts select facts wluch support their own preJudlces He
also (correctly) IS not Impressed by authorltatlve state-
ments which ignore facts Fmally, he states that he beheves
that llhclt drugs should be legahzed and controlled m the
way that alcohol 1s regulated The book thus provides an
mterestmg overvlew of cocame but 1s wrltten m such a
way that the author’s liberal views on cocame regulation
are often m evidence
Ashley accurately states that cocame 1s not a narcotic
drug It 1s a stimulant and euphorlant Physlcal depen-
dence and tolerance do not occur although psychologuzal
dependence certamly does WIthdrawal symptoms do not
usually occur One exception to this 1s the “cocame blues”
which some regular users report after stopping the drug
The author also lists some of the psychoactlve and phy-
slologlcal effects of cocame Most experts report euphoria,
increased energy. sexual stimulation and decreased fatigue
and appetite The drug also increases the SubJectlve feeling
01 muscular strength, has a vasoconstrlctlve action, m-
creases body temperature and dries the mucous mem-
branes Adverse reactIons include central nervous system
stimulation with tremors and convulsions, cardiac failure,
anxiety and msomma Evidently parancna and hallucma-
tions are rare The latter. when they occur, are usually
of the tactile variety The most common reaction 1s a
tender nose among those who “snort” the drug
The book gives a lively history of cocaine from its
growth m Bohvla and Peru to its consumption there, as
well as elsewhere The early experlmentatlon of Freud 1s
recounted, as 1s the discovery of the usefulness of cocame
as an ophthalmological anesthetlc by Keller The mclusion
of cocame m cola dnnks and patent medlcmes, particularly
m the late 19th century also makes interesting readmg
I found the book to be intriguing as well as irritating
What was good was very good The reader will have to
Judge for hlmself as to the merits of legalizing cocaine and
controllmg it m the way that alcohol 1s regulated
McLean HospIral, CHESTER SWETT, JR
Harvard Medical School,
Belmont, MA, U S A
Ganjain Jamaica,by VERA RUBIN and LAMBROS COMITAS
Mouton The Hague, 1975 205 pp No price given
The book summarizes the findmgs of research studies of
marlJuana use m Jamaica One proJect mvolved mtervlews
and observations carried out li the naturahstlc settings
of selected rural and urban areas The findings indicated
that 60-70”, of the lower class rural population ingest
ganJa (mtermedlate strength marlJuana) m some form For
such users there was no evidence that there IS reliance
on other types of drugs and no escalation to the use of
narcotics Alcohol use has also remamed at a low level
Also the use of ganJa was not related to crime (except
for the crimes of growmg selhng and using ganJa) The
55
patterns of use were stable and appeared to have been
a part of the culture for many years (ganJd complex)
Laboratory studies showed only one interesting finding
which was a trend of mild functional hypoxia among
heavy, long-term chronic smokers Since tobacco and ganJa
are usually smoked as a nnxture, it was not possible to
sort out the relative contrlbutlon of the substances m pro-
ducmg the results There were no significant differences
between users and controls with respect to chromosome
damage, brain damage, or psychlatnc problems
Although its production and use 1s illegal. ganJa IS a
part of everyday life for the many people who grow, sell
and consume the plant A poor man can make a little
extra money by being mvolved m the cultlvatmg or selhng
A sphff (cigarette) containing tobacco as well as marlJuana
1s usually smoked socially However, many people, partlcu-
larly women and children, drmk a ganJa tea m private
Sometimes a smoker has a bad first experience and decides
not to continue smoking He 1s then excused by the smok-
mg group with the excuse that “he doesn’t have the head
for it” Those who habitually smoke beheve that ganJa
“bramlfies” them and keeps them healthy
This book 1s a significant contrtbutlon to our knowledge
of marlJuana use One of Its great pluses 1s the fact that
part of the proJect was carried out via field observattons
Thus, the patterns of use m the naturahstlc settmg could
be well documented GanJa consumption 1s endemic as a
part of the culture and appears to be used as an energizer
The facts that there was no progression to other drug use
and no amotlvatlonal syndrome are heartening The labor-
atory proJect came up with no findings of slgmficance save
one (functional hypoxia among chrome users who smoked
a mixture of ganJa and tobacco) The paucity of untoward
results 1s also encouraging On balance, this scientific study
provided a good, ObJective documentation of ganJa use via
field observation, and provided data to show that pro-
longed use has little effect on the parameters measured
m the laboratory
McLean Hoqtal, CHESTER SWEIT,JR
Harvard Me&Cal School,
Belmont, MA, US A
Gehandicapten wel Geteld. (Study of the Physically Handi-
capped Persons in the Netherlands). Centraal bureau voor
statlstlek, StaatsmtgeveriJ, Den Haag, 1974 46 pp f 7 50
In many countries there 1s a lack of mformatlon about
the number and percentage of physically handicapped per-
sons Three Mmlstrles have carried out a survey to obtain
information on this SubJect
In this study a good solution was found for the problem
of defining “physically handicapped” (one can have a
physical disorder without bemg handicapped, and vice
versa) only those persons wth one or more functional
hmitatlons, together with a physical deviation, were con-
sidered handicapped FunctIonal hmltations are dlstur-
bances m the working of legs, arms/hands, eyes, ears.
speech, stamina (mainly heart/lungs), urmatmg. defecatmg.
epllepsy/eqmhbrmm, or other body potentials However,
the decision not to consider those persons who are both
physically and mentally handicapped IS questlonable