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                  <text>'l'-‘Ww-'2-m r.

.

..._

I.

,. ,

September 30, 1977
John C, Kramer, M.D.
California College of Medicine

Irvine, California

vawllw

Dear John,
n

.

study
have re—read your suggestions regarding a hashish
following
the
with
comfortable
a number of times, and now feel
comments.

I

related
classification of four classes of hashish
It
nature
in
How
occur
many types
psychoses is a theoretic one.
that
possible
is
answering.
It
is this latter question which needs
Spuief and other
Chopra,
and
that
exist,
psychoses
the different
astute enough
been
have
example)
observers (Knight in Jamaica, for
to do so. It
failed
have
to describe them whenﬁiestern observers
all) these
(or
Do
any
is this latter point that needs follow—up.
in users ?
exist
mental states
The

T

theoretic types of hashish related

who
suggestion, that of finding individuals
and re-exposing them
have recovered fram a cannabis related psychosis the question: Cann
to
to hashish, is a good way of getting an answer
mental state 7 But, what

The second

cannabis inhalation precipitate an altered
individuals to a pathogen
of the ethics of exposing presumed 'sensitive'
be
built in to protect
could
How about the safety ? What safeguards
?
even if the acute
And,
a subject who becomes psychotic (again)
complains of
the
what
patient
if
episode is treated successfully,
?

recurrences ('flashbacks')
I would
As for the 'backtracking' pf Souief and Chopra,
that hashish
not assume that they have given up any of theirandopinions
that theta are a
psychoses,
is dangerous, that it precipitates
and euphoria
stimulation
variety of mental states, from transient
of hashish
result
a
as
which
occur
to a schizophreniform psychosis not unique for others subscribe as
are
use. In this opinion, they
assuredly, and my co-worker, Stefania
H.
Brill
and
C.
Miras
strongly:
that needs checking. Since we
probably. It is precisely this issue
whose psychsiisits
are unable to define a population of psychotics
those patients whom
of
study
perhaps a
directly related to cannabis,
Hence, the suggestion to
others see as related would be more useful.
happened to Martin
examine patients with Chopra or Souief. (Whatever
psychoses
Keeler-- he has described a series of cannabis precipitated

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John C. Kramer, M.D.

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September 30, 1997

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in students in South Carolina 7).
similar issue is developing about the use of another
'hallucinegen', khat. Khat is a plant derivative which is chewed
by the natives of Abyssinia, Sudna and Arabia for its 'stimulation'.
A

I

it

described, khat is used much as we use a coffee
break-- a relief in a set of monotonous chores. The plant is pro—
scribed in these countries. One member of our faculty, Professor
Krikorian, is a national expert and has urged me to undertake a
study of its pharmacology, physiology and to go with him (after
the present wars are settled) to Abyssinia. You may want to look
up what you can find first, and if the matter interests you, I
As

have heard

will send

.

you my

file.

,_...v..,,.e.

begun a volume on convulsive therapy, and that
is keeping me busy. The EEG studies are going well, and I now have
one good clinical unit at the VA which seems able to do good work.
Mostly with schizophrenic veterans, a complex group to assess. But
the work is interesting.

I have

$7,,

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“mm-mm"

Thanks

Arr

some

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interest.

My

for your ideas. I
best regards.

hope the responses are of

""V-m7m'

Sincerely yours,

r—w—m-

"W-‘W'v‘el‘f'

Fink, M.D.
Professor of Psychiatry

Max
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