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"BRAIN REST."

By J. LEONARD CORNING, M.D., New York.

Published by G. P. PUTNAM'S SONS.


"The preparation of Coca known as 'Vin Mariani' is the one to which I
resort in meeting the exigencies incident to excessive and habitual
worry and functional brain trouble.

"Of 'Vin Mariani' I need hardly speak, as the medical profession is
already well aware of its virtues. Of all tonic preparations ever
introduced to the notice of the profession, this is undoubtedly the
most potent for good in the treatment of exhaustive and irritative
conditions of the central nervous system.

"Mr. Angelo Mariani has spent many years in the careful study of the
Coca plant, and as a result his preparations are unrivaled. The medical
profession certainly owes a debt of gratitude to this gentleman for his
valuable labors in this direction."

[Illustration: BRANCH OF COCA PLANT,

Showing Leaf, Flower and Seed.

(Specimen from hot-houses of M. Mariani, Neuilly, France.)]




          COCA

         AND ITS

 Therapeutic Application


           BY

      ANGELO MARIANI


    WITH ILLUSTRATIONS


     Third Edition.


        NEW YORK
 J. N. Jaros, 52 W. 15th St

         1896.




The following pages are inscribed and respectfully dedicated to the
medical profession, as a token of appreciation for the kind aid ever
extended to me in my efforts to popularize that valuable addition to
therapeutics, "Erythroxylon Coca."

      ANGELO MARIANI.

  41 Boulevard Haussmann,
  Paris, France.




TO THE MEDICAL PROFESSION.


The physiological studies, researches, designs, etc., are made at
our laboratory, Neuilly s/Seine, France, where, in connection with
hot-houses, the study and cultivation of the Coca plant is carried on
under my personal supervision, and am pleased to say have succeeded
in producing large quantities of Coca plants, in all stages of growth
and of various species, under all conditions of planting, by seeds,
transplantation and grafting, all results being carefully watched and
recorded.

I hereby extend the most cordial invitation to the medical profession
and shall be happy to receive the visit of physicians who may be
interested in the subject.

Respectfully,

      ANGELO MARIANI.

  41 Boulevard Haussmann,
  Paris, France.

[Illustration: OUTLINE OF COCA PLANT.

(Showing leaves and seeds. Nos. 1 and 2, Coca leaves seen by
transmitted light.)]


All illustrations in this volume have been specially prepared for this
work, and are from original drawings from life by M. Mariani.




[Illustration]




INTRODUCTION.


Each race has its fashions and fancies. The Indian munches the betel;
the Chinaman woos with passion the brutalizing intoxication of opium;
the European occupies his idle hours or employs his leisure ones in
smoking, chewing or snuffing tobacco. Guided by a happier instinct,
the native of South America has adopted Coca. When young, he robs his
father of it; later on, he devotes his first savings to its purchase.
Without it he would fear vertigo on the summit of the Andes, and weaken
at his severe labor in the mines. It is with him everywhere; even in
his sleep he keeps his precious quid in his mouth.

But should Coca be regarded merely as a masticatory? And must we
accept as irrevocable the decision of certain therapeutists: "Cocaine,
worthless; Coca, superfluous drug"?[1]

For several years laryngologists such as: Fauvel, of France; Morell
Mackenzie and Lennox Browne, of England; and Elsberg, of America, had
undertaken the defense of Coca.

Under such patronage Coca and its preparations were not slow in
becoming popular.

Charles Fauvel was the first to make use of it as a general tonic,
having a special action on the larynx; and to make known its anæsthetic
and analgesic qualities.

Coca was further recommended, as it were empirically, against
stomatitis, gingivitis, gastric disturbances, and phthisis (Rabuteau),
_Eléments de thérapeutique et de pharmacologie_.

Although striking effects were obtained from this valuable medicine,
its full worth was yet unknown and there was diversity of opinion as to
its mode of action, until the communications of Köller, of Vienna, on
Coca and Cocaine, appeared in 1884.

These interesting publications led to such general discussion among
medical men, that nearly every one eagerly followed the work, and
watched the splendid results obtained by the Viennese physician (now
Professor of Ophthalmology in New York Polyclinic).

It is found that studies made of the active principles of Coca
have entirely corroborated our previsions, and probably no subject
has received greater attention than have the virtues of this
little Peruvian shrub, formerly looked upon in Europe with so much
indifference.

The scientific study of the principles of Coca may be considered
as completed; and we believe that the time has arrived in which to
summarize data regarding this therapeutic agent, so that the employment
of our preparations may be based on positive clinical experience.

The aim of this modest work is to offer to the medical profession a
short account of the history of Coca, and of the investigations which
it has called forth up to the present day.

We propose to divide our subject into five parts.

1ST. We will describe the botanical character of Coca, and also speak
of its culture and the mode of gathering it.

2D. Its history, its properties and uses.

3D. The physiological researches made in the domain of Coca, devoting a
special chapter to Cocaine.

4TH. Its therapeutic application.

Finally we will quote some general conclusions and explanations
regarding the method of using our different preparations, based on
observations made by competent physicians in Europe and America.

[Illustration]

[Illustration: SPECIMEN OF THE COCA SHRUB.

(Grown in a Hot-house by Mr. Mariani showing general frail condition of
the leaf.)]




[Illustration]




CHAPTER I.

ERYTHROXYLON COCA,

ITS BOTANICAL CHARACTER.


Coca is indigenous to South America. The different botanists disagree
as to which exact family it should be assigned. Linnæus, De Candolle,
Payer, Raymundi of Lima, Huntk, and others, place it in the family
of the _Erythroxyleæ_, of which there exists but one genus, the
_Erythroxylon_, while Jussien adopts another classification and places
it in the family of the _Malpighiaceæ_ (_genus Sethia_). Lamarck, on
the contrary, believes that this plant should be classed among the
family of Nerprem (Rhamneæ).

_Erythroxylon Coca_ is a shrub which reaches a height of from six to
nine feet and the stem is of about the thickness of a finger. In our
climate it cannot thrive except in a hot-house, and there its height
does not exceed one metre.

The root, rather thick, shows multiple and uniform divisions; its trunk
is covered with a ridged bark, rugged, nearly always glabrous, and of a
whitish color. Its boughs and branches, rather numerous, are alternant,
sometimes covered with thorns when the plant is cultivated in a soil
which is not well adapted to it.

The leaves, which fall spontaneously at the end of each season, are
alternate, petiolate, with double intra-accillary stipules at the base.
In shape they are elliptical-lanceolate, their size varying according
to the nature of the plant or of the soil in which it grows.

The leaf of Coca gathered in Peru, of which we give two figures of the
natural size, is generally larger and thicker than the leaf of the
Bolivian Coca. It is also richer in the alkaloid, consequently much
more bitter.

The Coca leaf from Bolivia, smaller than the Peruvian leaf, is as much
esteemed as the latter, although it contains less of the alkaloid.
It possesses so exquisite and so soft an aroma, indeed, that the
_coqueros_ seek it in preference to any other.

[Illustration: LEAVES OF PERUVIAN COCA, NATURAL SIZE

  A. Upper surface of the leaf.

  B. Lower surface of the leaf, showing the longitudinal projections of
   the two sides of the midrib.]

The Coca leaves of Brazil and Colombia are much smaller than those of
Peru and Bolivia. Their color is much paler. Containing but traces of
the alkaloid they are not bitter, and possess a pleasant, but very
volatile aroma.

One of the most important characteristics of the Coca leaf is the
disposition of its nervures; parallel with the midrib two longitudinal
projections are to be seen, which, starting from the base of the leaf,
extend in a gentle curve to its point.

[Illustration: LEAVES OF BOLIVIAN COCA, NATURAL SIZE.

(Lower surface.)]

The upper surface of these leaves is of a beautiful green tint; the
lower surface of a paler green, except, however, near the midrib. At
this point, there is a strip of green darker than the rest, which
becomes brown in the withered leaves.

[Illustration: LEAF OF COCA OF COLOMBIA, NATURAL SIZE.]

The flowers, small, regular and hermaphrodite, white or greenish
yellow, are found either alone or in groups in little bunches of cyme
at the axil of the leaves or bracts, which take their place on certain
branches. The disposition into cymes is that most commonly met with.
They are supported by a slender pedicel, somewhat inflated at the top,
the length of which does not exceed one centimetre.

[Illustration: NERVURES OF THE LEAF OF PERUVIAN COCA, SEEN BY
TRANSMITTED LIGHT. NATURAL SIZE.]

The sepals, joined at the base and lanceolated, are of a green tint
with a whitish top. The petals, half a centimetre in length, pointed,
concave inside and yellowish white, exhale a rather pleasant odor. They
are provided with an exterior appendage, of the same color and of the
same consistency, surmounted on each side with an ascending fimbriated
leaf, irregularly triangular in shape. The stamens, at first joined in
a tube for one-third of their length, afterward separate into white
subulated strings, provided with an obtuse ovoid anther which extends
a little beyond the petals. The ovary is ovoid in shape and green in
color, thickening at the top into a yellowish glandular tissue. The
style which rises above it separates into three diverging branches,
provided with orbicular papilliform bodies at their extremity,
obliquely inserted into the slender patina.

[Illustration: Seeds of Coca.]

The fruit is a drupe of an elongated ovoid form, being a little more
than a centimetre in length, of a reddish color when fresh, and having
a tender, thickish pulp inclosing a seed. This seed shows longitudinal
furrows and alternate vertical projections which make its division
irregularly hexagonal. When the fruit is dried, the skin assumes a
brownish color, shrivels up and molds itself on the protuberances and
irregularities of the seed.


CULTIVATION OF COCA.

_Erythroxylon Coca_ appears to have come originally from Peru, and from
there its cultivation was carried into Bolivia, Ecuador, New Grenada,
and Brazil, in a word, throughout the entire torrid zone of South
America.

For some time, as a result of the extended consumption of Coca
and for a still stronger reason, now that the day is at hand when
the consumption of Coca will assume greater proportions, numerous
plantations of Coca trees have been laid out in regions where that
shrub was formerly unknown. We take pleasure in recording that these
attempts have proved successful in the Antilles, thanks to the
disinterested sacrifices of our friend, Dr. Bétancès. It is also with
pleasure that we present anew an interesting communication made by the
learned doctor to the "Société d'Acclimatation de France" as appeared
in the _Revue Diplomatique_, 17th of March, 1888.

[Illustration: BRANCH OF COCA. NATURAL SIZE.

Sent by Monseigneur de Mereño, Archbishop of San Domingo, to Dr.
Bétancès, Paris.]

"Dr. Bétancès has succeeded in acclimatizing Coca in the Antilles. At
considerable expense and after numerous shipments of seeds and the
transportation of plants (this with the greatest difficulty) to Porto
Rico and San Domingo, Dr. Bétancès had the pleasure of receiving a fine
branch of Coca in full bloom, which was sent to him by Monseigneur
Mereño, Archbishop of San Domingo. This twig, which the members of
the Society were enabled to examine, excited the most lively curiosity
and won the commendation of M. Geoffroy Saint-Hilaire. It was raised
from a plant which had been only eighteen months under cultivation."

"In Porto Rico the plant reaches a greater height than in Peru.

"A box filled with beautiful leaves has also been received by Dr.
Bétancès and forwarded to Mr. Mariani. This also came from Monseigneur
Mereño.

"It is therefore evident that the plant can be cultivated in the
Antilles and that it may become a source of wealth to that country."

Plantations like this would probably thrive in Corsica or Algeria,
countries where the temperature at certain points is somewhat analogous
to that of the tropics.

It is a fact that this shrub does not attain its complete development
except in countries where the mean temperature is from fifteen to
eighteen degrees centigrade.

But heat does not suffice; great humidity is also necessary to
Coca. Therefore it is met with principally on the sides of hills
and at the bottom of wooded valleys which abound on both sides of
the Cordillieras. Unfortunately, these regions are rather distant
from the coast and they are, furthermore, devoid of easy means of
communication; it is above all to this particular cause, the difficulty
of transportation, that we must attribute the relatively high price of
Coca leaves.

The cultivation of Coca trees is begun by sowing the seed in beds
called _Almazigos_. As soon as the plant appears it is protected from
the heat of the sun by means of screens and matting; when it reaches a
height of from 40 to 50 centimetres, it is transferred to furrows 18
centimetres in length by 7 in depth, care being taken that each plant
is separated from its neighbor by a distance of a foot.

During the first year maize is sown in the interspaces, rapidly
overreaching the shrub, and taking the place of the screens and mats.

The growth of the shrub is rather rapid, reaching its full height in
about five years. But the time when it becomes productive precedes
that at which it attains its complete height by about 3½ years after
being planted. After that, when the season has been especially damp, it
yields as often as four times a year.

[Illustration: BRANCH OF COCA, as grown in a hot-house.]

Attempts have been made to acclimatize it in Europe, but so far
without success. As early as 1869 the cultivation of it was tried
in the Botanical Garden of Hyères, but no satisfactory result was
obtained. We presented, in 1872, two samples to the appreciative and
learned director of the Garden of Acclimatization of Paris, M. Geoffroy
Saint-Hilaire, and notwithstanding all the care taken of the young
plants, they failed to reach their full growth. Several frail Coca
plants may be seen in the conservatories of the _Jardin des Plantes de
Paris_, in the Botanical Gardens of London, of Brussels, etc., likewise
at several great horticulturists' of Gand, notably Van Houten's. As may
be seen by the large colored engraving[2] and by the branch engraved
above, these specimens of _Erythroxylon Coca_ are very far from giving
an idea of the plant growing in the open air, in a soil and under a
temperature that are favorable to its development, as shown by the
leaves of Peruvian Coca, illustrated above, and which come from one of
the newest _haciendas_ of Santa-Anna, belonging to M. M.-P. Concha,
bordering on the territory of a savage tribe of Antis or Campas, on the
Urubanba river, which joins the Amazon in latitude 12° S., longitude
75° W.


GATHERING OF COCA.

The plant begins to yield when it is about a year and a half old.

The leaf is the only part of the plant used.

It should be gathered in dry weather; this is entrusted generally to
women, and simply consists in plucking each leaf with the fingers.

The leaves are received into aprons, carefully carried under sheds, to
shelter them from the rain and dampness, dried, and then packed.

We quote from the _Voyage dans la région du Titicaca_, by Paul
Marcoy, the following passage ("Tour of the World," May, 1877): "Of
all the valleys of the Carabaya group, Ituata is the one where Coca
is cultivated on the largest scale. They were then at the height of
the work, peons and peonnes were following each other through the
plantations of the shrub, so dear to the natives that a decree of 1825
placed it in the crown of the arms of Peru, alongside of the vicunia
and cornucopia, or horn-of-plenty. Men and women carried a cloth slung
across the shoulders in which were placed the leaves, as they gathered
them one by one. These leaves, spread out on large awnings, were
exposed to the sun for two or three days, then packed up in bags of
about one metre in size, and sent off to all parts of the territory.

"This gathering of the Coca is just such an occasion for rejoicing
for the natives of the valleys, as reaping-time and harvests are for
our peasants. On the day when the gathering of the leaves is finished
both sexes that have taken part in the work assemble and celebrate, in
dances and libations, the pleasure they experience in having finished
their labors."

In 1851, the annual production of Bolivia was estimated to be more
than 400,000 certos (600,000 kilogrammes) of Coca leaves, of which
three-quarters came from the province of Yungas.

[Illustration:

  38 days after planting.      40 days.      51 days.

  65 days.      68 days.      71 days.

Observation of Growing Seeds in Hot-houses of M. Mariani.]

[Illustration: ERYTHROXYLON COCA.

(Specimen of a branch grown in hot-houses of Mr. Mariani.)]

[Illustration: COCA PLANT Obtained by transplanting; eight months.

(Hot-houses of Mariani.)]

[Illustration: COCA PLANT Obtained from seed; eight months.

(Hot-houses of Mariani.)]




[Illustration]




CHAPTER II.

HISTORY OF COCA.


Coca has been known from time immemorial in South America. At the time
when Pizarro landed on the Peruvian coast, the leaf of Coca was held
in great esteem among the natives; it was considered to be a divine
plant, a living representation of the Deity, a fetish of wonderful and
supernatural qualities, and the fields where it grew were reverenced as
sanctuaries. Not everybody was allowed to make use of it; its use was
the privilege of the nobles and of the priests, and among the greatest
rewards that the sovereign could give his subjects, the privilege of
chewing Coca leaves was most highly esteemed.

However strange such a superstition may appear, it is indisputable,
and all authors that have published the account of the conquest of the
Indies corroborate it. It will suffice for us to quote the testimony
of Joseph Acosta, who says in every letter, of his natural and moral
history of the Indies, of the East as well as of the West, published in
1653:

"The Indians esteem it highly, and during the reign of the Incas, the
common people were not allowed to use Coca without the permission of
the Governor."

[Illustration: NATIVES OF COLOMBIA CHEWING COCA.]

The disappearance of the empire of the Incas, far from diminishing
the importance of Coca, on the contrary gave a very much greater
scope to its popularity. The natives profited by their freedom
from the restrictions imposed by the native rulers in regard to the
consumption of Coca, and soon the use of this leaf became so common
that it has been compared by every one interested in the question to
the use of tobacco by us; and, as it has justly been added, without
its objections. There is no more likelihood of seeing a smoker embark
without his tobacco than an Indian begin work or undertake a journey
unless his _chuspa_ (pouch) is full of Coca leaves. Three or four times
a day he sits down, takes some leaves, puts them one by one into his
mouth and rolls them into an _aculio_ (quid), adding a little _llipta_
(lime), which he takes from his ever-present _poporo_. The _poporo_
is a little gourd, bored at the mouth on the upper part, in which the
Indian keeps his _llipta_. This _llipta_ is a white powder composed of
ashes of vegetables and of calcined shells pulverized, with which the
consumers of Coca have been accustomed, from the most remote times, to
season their quid. It is, really, an alkaline substance intended to
isolate the different principles of the leaf and to make the action of
the Coca more prompt.

Among those inhabitants of South America, with whom the use of Coca did
not extend to the lower classes until after the reign of the Incas,
and who reserved for themselves, as we have seen, the right of chewing
the Coca leaves, the consumption of Coca by children is strictly
prohibited. They do not indulge in this luxury except in secret, and
it appears to them all the sweeter because it is forbidden. But nearly
always their breath, charged with the tell-tale odor of Coca, betrays
them on approaching their parents, and the latter make them pay for the
pleasure which they have stolen, and to which they are not entitled
until they are of age, with very severe punishment. Only when they have
grown up will they be allowed to chew Coca and to carry the _poporo_,
which they do not relinquish even in the grave.

On coming of age the young Indian is consigned to an old woman, who
keeps him a few hours in her hut to initiate him in the mysteries of
man's estate.

After this ceremony she gives him the _chuspa_ (Coca pouch), invests
him with the _poporo_ and consecrates him a _coquero_. One should see
with what pride the young Indian leaves the threshold of the sacred
cabin, which he entered as a child scarcely a few hours before and from
which he departs a man, that is to say, carrying the _chuspa_ and the
_poporo_, and able to chew with impunity, before the old people, this
precious leaf which had been forbidden him until then.

No happiness is comparable to his! See with what an important air he
draws forth the Coca leaves from his _chuspa_, as he rolls them in his
fingers to make a large quid of them, which he carries to his mouth,
moistens delightingly with saliva, and places under his jaws and
against his cheeks. He is seen holding carefully in his right hand the
little stick, the extremity of which he is going to moisten by putting
it into his mouth, and which he will dip into the _poporo_ in order
that the _llipta_ may adhere to its moistened part.

He carefully carries the part of his little stick covered with _llipta_
to his quid, and thus performs the operation of mixing the alkaline
powder with the masticated leaf. It is at this moment that the quid of
Coca affords the young adult the most delightful sensation. His jaws
munch it slowly, his tongue collects and rolls it up against the left
cheek, all the _papillæ_ of his mouth refresh themselves deliciously
with the soothing and aromatic juices of the precious leaf, and by the
slow and measured motions of deglutition, he carries with delight the
precious juice into the pharynx and thence to the stomach. While he is
accomplishing this important operation, his eyes swim with beatitude,
over his entire countenance is diffused an expression of content and
unutterable joy, and his right hand slowly turns the little stick
around the upper part of the _poporo_, where are deposited little by
little the particles of _llipta_ and masticated Coca, which on leaving
his mouth adhere to its extremity.

The only occupation of the first days of the adult is the much-loved
quid of Coca and the encrusting of his gourd, which we cannot do better
than compare to the coating of the pipe, with this difference that
our confirmed smokers blacken hundreds of their pipes during their
existence, while the Indian encrusts only one gourd in his whole life;
so that by the thickness of the crust formed around a _poporo_, it is
possible to judge the age of its owner. This crust, which hardly ever
exceeds the thickness of a ring on the _poporo_ of a young Indian, ends
by reaching the dimension of the pileus of a large mushroom on the
_poporo_ of an old man.

The crust is produced by the particles of Coca and _llipta_ mixed with
saliva which are deposited little by little about the mouth of the
_poporo_ by smearing with the stick.

These deposits are brought about in an almost imperceptible manner. It
is only after some months that the surface of the _poporo_, on which
the chewer continually turns the little stick, becomes covered with a
hardly perceptible layer of calcareous substance; at the end of two or
three years the superimposed layers form a ring which grows larger from
year to year, and which finally attains the thickness we have spoken of
above.

[Illustration: Small stick for extracting the Llipta from the poporo.]

[Illustration: 1. Poporo of a youth.]

[Illustration: 2. Poporo of a man in his prime.]

[Illustration: 3. Poporo of an old man.]

As we have said before, the Indian never parts with his _poporo_, let
him be awake or asleep, at home or on his travels, the _poporo_ is
always attached to his belt. An Indian would part with all he holds
most dear in the world, all, except his _poporo_.

We have the rare and good fortune to possess a _poporo_, of which we
give a picture (fig. 3). It is, we believe, the only specimen existing
in Europe. We owe it to the kindness of M. Gauguet, who has made
numerous voyages to Colombia, where he has been able to establish so
much sympathy among the natives that one of their old chiefs, who was
specially indebted, did not fear to depart from all custom and to
incur the contempt of his companions, by offering him, as a pledge of
friendship, the object to which he attached the greatest value—his
_poporo_![3]

Thus the great importance that an Indian attaches to Coca is easily
shown. It should be recognized, moreover, that the first conquerors of
the country did not fail to countenance the passion of the vanquished
for the national plant. In fact, they quickly recognized that the habit
of consuming Coca might become an excellent source of revenue; and
Garcillasco de la Véga, a half-breed of the first generation, tells us
that in his time a part of the impost was paid to the conqueror in the
form of Coca leaves. The benefits which were derived from the traffic
in this plant were such that at a certain time the revenues of the
bishop and of the canons of the cathedral of Cuzco came from the tithe
on these leaves.

There was, moreover, another object in favoring the use of Coca among
the Indians. The latter were treated, as is known, as if they were
beasts of burden, and their oppressors were not slow to recognize the
fact that they furnished much better labor when they consumed Coca.

We shall see, further on, that the recognition of this fact, the
correctness of which cannot be disputed, and which served to excite
the rapacity of the conquering savages of that time, has become to-day
the means of furnishing one of the most valuable aids to contemporary
therapeutics.

The particular favor in which the plant was held in the beginning
of the conquest, was destined to suffer some disturbance. In the
seventeenth century, for example, the religious quibbles regaining the
ascendancy in public affairs, some sedate theologians pretended that
Coca was an aliment, and that under this name the use of it should be
prohibited to young people and before the communion. The question was
vigorously contested, and there is no doubt that the consumption of
Coca would have sustained a very decided blow had not Prince don Alonzo
de la Pina Montenegro declared that the plant contained no alimentary
principle. This point we shall presently consider from a scientific
point of view.

Although the inhabitants of the Indies attach so much importance to the
use of Coca, this product can not be acclimatized in our hemisphere,
and our fathers who took up the use of tobacco with so much eagerness
remained indifferent to Coca. Perhaps this indifference should be
attributed to the exaggerations of the first importers, who coming to
Europe still imbued with the legends gathered in the New World ascribed
supernatural qualities to the new plant. The exaggeration of these
statements soon became apparent. From this it was only a step to a
denial even of its existence. And thus, for more than two centuries, we
were deprived of the advantages to be derived from the judicious use of
the plant.

It should not be believed, however, that the various writers during
these two centuries remained entirely silent regarding Coca. The study
of the properties of the plant was still a field of research for a
number of learned men, small, it is true, but they well knew that side
by side with fiction, which they rejected, there was a reality that it
were better to accept.

We further observe, that Claude Duret, a magistrate of Moulins, who
wrote a book, printed in 1605, on _The Marvellous and Wonderful Plants
in Nature_, mentions Coca as one of the most worthy to figure in his
colleccion.

Nicholas Monardes in the _General History of Plants_, published in
Lyons in 1653, calls attention likewise to the properties of Coca.

In the seventeenth century, l'abbé Longuerue, who was a theologian, an
historian, and a philologist, speaking of the Spanish colonies in South
America, says, in regard to the mines explored in Peru: "The negroes
can not work in the mines, they all die. Hardly any but the natives
are able to endure this labor, and then it is necessary to relieve
them frequently and that they should chew Coca, without which the
quicksilver vapors would kill them."

Linnæus says that Coca possesses: "the penetrating aroma of vegetable
stimulants, the astricting and fortifying virtues of an astringent,
the antispasmodic qualities of bitters, and the mucilaginous nutritive
properties of analeptics or of alimentary plants. This leaf," he
continues, "exhibits with energy its action on all parts of the animal
economy: _Olido in nervos, sapido in fibras utroque in fluido_."

Father don Antonio Julian wrote: "This plant is a preventive against
many diseases, a restorative of lost strength, and is capable of
prolonging human life. It is sincerely to be regretted that so many
poor families do not possess this preventive of hunger and thirst;
that so many employees and laborers should be deprived of this means
of maintaining their strength in the midst of continuous toil; that
so many old and young men engaged in the arduous task of study and
the accomplishment of their undertakings are unable to derive the
beneficial results of this plant to guard against the exhaustion of
the vital spirits, debility of the brain, and weakness of the stomach,
which are frequent results of continuous study."

Böerhaave (_Inst. phys._ § 68), states that: "the saliva charged with
all the bitter and mucilaginous principles of Coca carries to the
stomach, in addition to vital strength, a veritable nutritive which,
digested and converted into an abundant and nutritious chyle, enters
into the circulation and is converted into the material necessary to
sustain the human economy."

We shall not stop to quote the different writings of observers who have
interested themselves in Coca. It may be inferred from the preceding
statements that Coca possesses this particular character, viz., of
enabling those who make use of it to withstand the greatest fatigue.
Men employed in hard work in mines, couriers obliged to traverse
mountainous countries difficult of travel without being able to take
much rest, in a word, persons subject to overwork in every way, all
agree in recognizing the strengthening and nerve-fortifying action
of Coca. It supports them, economizes their forces, prevents their
succumbing to lassitude—in short, augments their vitality.

When the Indian has a good supply of Coca he undertakes, without the
slightest fear, the most difficult and longest voyages, even into
fever-stricken countries.

When he passes before an _apachecta_ (a quadrangular mound which
the natives raise on the sides of the roads at certain points for a
halting-place), the Indian divests himself of his wraps, takes his quid
of Coca from his mouth, always after having previously exhausted it,
and, in order to draw down upon it the blessing of Pachacamac, their
sovereign master of the world, he throws it against the consecrated
hillock. Thus, that which particularly characterizes these kinds of
_tumuli_ are the green splashes of Coca with which they are literally
covered.

The name of _coqueros_ is given to the chewers of Coca. It seems that
this plant procured for them dreams like those to which hachisch gives
rise.

In native therapeutics, this plant is used to dress ulcers and all
kinds of sores. The Indians also use it to combat asthma, jaundice,
colic, etc.

Coca is consumed chiefly in Peru, Bolivia, Colombia, and Brazil. Since
1863—the time from which our first efforts to popularize it date—its
use has rapidly become general, and it may be stated that to-day it is
known and used in all civilized countries.

[Illustration]




[Illustration]




CHAPTER III.

PHYSIOLOGY OF COCA.


It is to empiricism and that alone that we owe our first knowledge
of the physiological action of Coca. There is nothing surprising in
that, for empiricism is nothing more, in reality, than unconscious
observation.

The Indians, who from time immemorial consumed so great a quantity
of Coca leaves, did not do so merely from religious sentiment which
deified the leaves of Coca, they well knew that they would derive great
benefit from its use; they knew it only too well, since it is to that
cause that we must attribute the legendary accounts given by the first
authors who wrote on Coca.

This veneration for Coca arose, as we have seen, from its wonderful
qualities. There are indeed, in this direction, some truly
extraordinary accounts which should not be dismissed without notice, as
they are given in good faith.

Unanué, of Lima, relates that at the siege of La Paz, Bolivia, in 1781,
only those inhabitants who had taken Coca were able to endure hunger
and fatigue. Nearly all of the soldiers perished, deprived, as they
were of food and overcome by forced marches, except those who had taken
the precaution to provide themselves with Coca leaves.

It must not be believed that this prolonged fast, sustained by the
use of Coca, wastes the strength and is injurious to the appetite.
Indeed, according to the statement of all authors, the Indians who pass
an entire day without eating, notwithstanding the hardship of forced
marches, content themselves with chewing Coca leaves, and eat very
heartily in the evening.

"The Indians who accompanied me on my voyage," says Weddel, "chewed
Coca leaves all day, neither drinking, eating, nor showing any signs of
fatigue. But at evening they replenished their stomachs like men who
were completely famished, and I can assure you that I have sometimes
seen them devour at one meal more aliment than I could have consumed
in two days." We will see, further on, that it is in exciting the
cerebro-medullary and nervous muscular functions, in part, and partly
in producing a soothing effect on the mucous membrane of the stomach,
that Coca produces these wonderful results in the conservation of
energy without the tortures of hunger, notwithstanding the deprivation
of aliment.

After this abstract of the well-known and recognized properties of Coca
leaves, we will proceed to the medical study undertaken regarding this
subject.

In 1850 Niemann discovered the active principle of the leaves of Coca,
to which he gave the name of Cocaine, though, in fact, the discovery of
this alkaloid should be attributed to Gardeke, who had separated it in
1855 under the name of _Erythroxyline_.

The work of Demarle appeared in that same year, on "The Coca of
Peru"[4], in which he pointed out certain properties attributed by him
to the alkaloid that the leaves of the plant contained, and which he
studied. He remarked, among other things, the dilatation of the pupils,
which he had noticed in his own case after having taken a dose of
Coca; the absence of taste for a greater or less length of time after
crushing some leaves with his teeth and letting them remain in the
mouth.

Mantegazza has studied the effect of Coca and, according to this
author, it acts as a stimulant on the nervous system, the respiration,
and the circulation.

A dose of fifteen to twenty grammes of Coca produces an increase of
the heart-beat, increasing pulse, and finally a rise in temperature.
Mantegazza observed on himself that, under the influence of such a
dose, his pulse increased from 65 to 124. Moreno, who repeated the same
experiment, obtained similar results. The temperature and respiration
are increased in the same proportion as the circulation.

The same dose, or even a weaker one, produces a remarkably stimulating
effect on the nervous system. It is from this stimulating effect that
Coca makes one more active and vigorous and enables those to accomplish
more work who, without it, would soon be overcome with more or less
fatigue. The use of larger doses (60 grammes for example) has caused
intoxication, accompanied by sensation of happiness, which makes
everything appear under a favorable aspect. Mantegazza, who experienced
this intoxication, describes his sensations in an animated style, which
recalls that of the Oriental legends: "Borne on the wings of two Coca
leaves, I flew about in the spaces of 77,438 worlds, one more splendid
than another. I prefer a life of ten years with Coca to one of a
hundred thousand without it. It seemed to me that I was separated from
the whole world, and I beheld the strangest images, most beautiful in
color and in form that can be imagined."

In 1868, Moreno y Maïz made some researches into the physiological
action of Cocaine, and explained them in an interesting thesis which he
read before the Faculty of Paris[5].

At about the same time, Lippmann, of Strasbourg, devoted his labors
to the same subject, but his investigations did not yield the same
results. He says that he could not establish the anæsthetic properties
of the plant.[6]

After Moreno y Maïz, Dr. Gazeau[7], in 1870, studied the stimulating
effect of Coca on nutrition, and found that it increased the pulse
and respiration, assisted digestion, increased urinary excretion, and
strengthened the nervous system. This author arrived at the conclusion
that Coca prolongs life and promotes muscular energy. He advises its
use, locally, for stomatitis, gingivitis, aphthous ulceration, and
generally for painful and difficult digestion, gastric disturbance in
phthisis, and also for obesity.

It was Charles Fauvel who first described the anæsthetizing effect of
Coca on the pharyngeal mucous membrane[8]. Thanks to this circumstance,
he has been able to derive much benefit from the use of Coca in
granular pharyngitis which is generally unaffected by any other kind of
treatment.

Fauvel further showed that the stimulating effect which Coca exercises
on all the muscles of the economy, appears to manifest itself specially
on all the muscles of the larynx. Hence his apt qualification of the
drug, "a tensor _par excellence_ of the vocal cords."

In 1880, Von Arep published the results of his physiological researches
with Cocaine. He spoke of its double effect on the nervous extremities
and on the central nervous system.

We approach, on leaving this epoch, the really scientific era, that is
to say, that of physiological experiments.

All the experiments having been made with Cocaine, we shall speak of it
in the next chapter, which will be devoted exclusively to the study of
this alkaloid.

Before closing, we will mention that it has been claimed frequently
that Coca was aphrodisiac. The fact that the Peruvian Venus was
represented as holding in her hand a leaf of Coca, was suggested as
a proof in support of this opinion. Dr. Unanué speaks of "certain
coqueros, eighty years of age and over, and yet capable of such prowess
as young men in the prime of life would be proud of."

Let us here add that the so-called unhappy consequences of the abuse
of Coca are really much more rare than those produced even by tobacco,
alcohol or opium.

The constant use of reasonable doses of Coca appears to produce a
diametrically opposite effect, and the authors, who have had occasion
to see a great number of Coca consumers, report cases of astonishing
longevity among the Indian coqueros (Tschudy, Campbell, Mantegazza,
Unanué). They add that these instances are far from being exceptional.


COCAINE.

I.—A CHEMICAL STUDY.[9]

Cocaine is a crystallized alkaloid which Niemann, a pupil of Prof.
Wœhler, succeeded in extracting, in 1859, from some leaves of
_Erythroxylon Coca_ and to which he gave the following formula:

  C³² H² O Az O²

Before it was known to him, Wackenroder, Johnston, Gardeke and Maclagan
analyzed this plant without succeeding in the isolation of its active
principle.

Some important works undertaken on this subject by Lassen, Humann and
R. Pérey are also quoted.

_Properties._—Cocaine is colorless, odorless, and bitter to the taste.
It crystallizes in the shape of oblique rhomboid prisms of from four to
six facets.

It is very soluble in water, less soluble in alcohol, and absolutely
insoluble in ether. It does not vaporize below 98°, but if the
temperature is greatly increased it is decomposed. It possesses a
strongly alkaline reaction.

United with acids it forms salts which are very difficult to
crystallize.

Those which have been obtained from it are: the salicylate, oxalate,
hydrobromide, sulphate, acetate, and finally the hydrochlorate, which
forms an exception to the general rule, and is obtained more easily in
the crystalline form than any other.

The solutions of the salts of Cocaine are precipitated by the caustic
alkalies, carbonate of sodium, carbonate of ammonium, the alkaline
bicarbonates, the bichloride of mercury, the protochloride of tin,
bichloride of platinum, and by ammonia, which, added in excess,
redissolves the precipitate formed by it. Iodine water, iodized
potassium iodide, and picric acid precipitate the solutions of salts
of Cocaine. When Cocaine is heated to 100° in a sealed tube with
concentrated hydrochloric acid, it separates into benzoic acid and a
new base, for which M. Wœhler has proposed the name of _Ecgonine_.
Lassen has discovered another nitrogenous base resulting from the
separation of Cocaine—_hygrine_.

_Preparation._—The process used by Niemann for obtaining Cocaine is as
follows:

This chemist digested Coca leaves, cut into very small pieces, in
alcohol (at 55°), for several days, adding sulphuric acid. The tincture
which resulted from this operation was separated by expression,
filtered, and treated with slaked lime. The liquid, which was primarily
of a greenish-brown, was both divested of a part of its chlorophyll and
also of a certain waxy substance. Niemann then neutralized this with
sulphuric acid and evaporated it over a water-bath. The residue was
then treated with water, which caused the separation of the rest of the
chlorophyll and of the sulphate of Cocaine that it contained, and which
was precipitated by means of the carbonate of sodium. He separated it
finally with ether and purified it by several re-crystallizations in
alcohol. This process was modified by Lassen, who precipitated the
aqueous solution with the subacetate of lead.

In this way he was able to obtain about six grammes of Cocaine from a
kilogramme of Coca leaves.

Moreno y Maïz proposed a third process. He mixed intimately, slaked
lime with finely-pulverized Coca leaves, letting the mixture stand for
nearly twenty-four hours, in order that the lime might react suitably
on the alkaloid, imitating in that, the Indian who mixes with his quid
the _llipta_, of which we have already spoken. He afterward lixiviates
it with alcohol at 40°.


II.—PHYSICAL STUDY.

We have reviewed the works of the different authors who occupied
themselves with Coca; their various labors, although very interesting,
did not reach the famous discovery of local anæsthesia, and it is to
Köller, of Vienna[10], that the honor belongs of having brought to
light the remarkable effect of Cocaine when applied to the conjunctival
membrane.

This soon awakened general curiosity. From all quarters came works on
the subject. Reuss, Kœnigstein, Jellinck, Schrotter, Knapp and others
hastened to give to the profession the result of their researches.

In France enthusiasm was not less strong, nor less prompt, all those
whom this discovery interested undertook a series of experiments with
Cocaine[11].

Among the first experimenters we must mention specially, Prof. Panas,
Prof. Vulpian, Prof. Dujardin-Beaumetz, Dr. Terrier, Dr. Trousseau, Dr.
Dehenne.

Prof. Panas reports in a communication made by him to the Académie de
Médecine[12] what he has observed.

He states, besides, that in nearly all respects his personal
investigations are confirmatory of those made by Köller.

About five minutes after a few drops of a solution of hydrochloride of
Cocaine composed of 0.5 gramme of that salt to a gramme of distilled
water have been instilled into the eye, anæsthesia of the conjunctival
mucous membrane of the cornea begins to manifest itself and reaches the
deep parts in about fifteen or twenty minutes if the instillations are
repeated every five minutes.

At the same time there is a certain amount of mydriasis, but this
is less pronounced than that produced by atropine. This pupillary
dilatation, which is more perceptible in young subjects and not in
glaucomatous states, lasts, at least, for twenty-four hours. With that
occurs a slight paralysis of the ciliary muscle.

"On account of this," says Professor Panas, "Cocaine should be placed
among the slightly mydriatic substances of which the passing effect
might be utilized for ophthalmoscopic explorations of the fundus of the
eye, under the same head as, and better than, homatropine."

According to M. Dujardin-Beaumetz, Cocaine not only deadens
sensibility, but it can further be utilized with morphinomaniacs as
a substitute for morphine without presenting the objections of the
latter substance; and he adds that subcutaneous injections made with
this alkaloid are not irritating (_Bulletin de l'Académie de Médecine_,
session of the 18th of November, 1884).

Prof. Vulpian, at the outset, communicated to the Académie des
Sciences the results of his interesting physiological researches with
the chlorhydrate of Cocaine.

M. Vulpian, after observing similar anæsthetic and analgesic effects
on the eye in animals as already shown in man, resulting from an
instillation between the eyelids of a few drops of solution of
hydrochlorate of Cocaine, and also perceiving under these conditions
the mydriatic action of the salt, noticed a protrusion of the ocular
globe when he injected 0.10 centigramme of hydrochloride of Cocaine
of a one to one hundred aqueous solution into the saphenous vein of
a non-curarized dog, and that it occurred almost immediately after
throwing the liquid into the vessel. Instantly the eyelids were seen to
separate and the pupillary orifice to enlarge. "This," says he, "is an
effect which exactly recalls the results of faradization of the upper
extremity of the cervical sympathetic nerve cut transversely."

Complete anæsthesia of the two transparent corneæ existed in this case.

Prof. Grasset, of Montpelier, almost at the same time as Vulpian,
observed the same effects of Cocaine, but a greater persistency in the
phenomena of insensibility following the intravenous injection of the
solution of hydrochloride of Cocaine.

At about that time, Dr. Laborde, of the Académie de Médecine, treated
still more deeply of the action of Cocaine in three successive notes to
the Société de Biologie (Nov. 22d and 29th and Dec. 27th, 1884). This
learned physiologist studied the analgesic action generally resulting
from subcutaneous injections of 0.03 of hydrochloride of Cocaine, in
three doses, in the guinea-pig. He saw it at the same time produce a
general hyper-excitability which irresistibly forced the animal to
move, and even produced epileptic convulsions; the general analgesic
state lasted for more than forty-eight hours.

M. Laborde, in attributing the secondary peripheric analgesia of
intravenous or subcutaneous injections of hydrochlorate of Cocaine to
the cerebral insusceptibility to pain, unconsciously made Cocaine a
general anæsthetic.

Prof. Arloing (1885, _Mémoire Soc. Biologie_) has undertaken many
experiments for demonstrating that Cocaine is not a general anæsthetic.

In his experiments, the learned physiologist of Lyons confirmed the
results obtained by Vulpian as to the modifications occasioned by
Cocaine of the arterial pressure; he saw, like his predecessors,
the excito-medullary and convulsary effect of large doses of
Cocaine and the increase of the salivary secretion, and in regard
to its cerebro-spinal effect, he compared it to strychnine. General
analgesia did not occur except from fatal doses or when accompanied by
convulsions. The hydrochlorate of Cocaine, according to M. Arloing,
produces and can produce nothing but local anæsthesia by temporarily
changing the physical properties of the protoplasm of the terminal and
fibrillary nervous elements easily accessible to medicinal agents in
the cornea and mucous surfaces.

We will presently show that the several learned men who have been
engaged in investigating the mechanism of action of the active
principles of Coca were by no means in accord as regards the _modus
agendi_ of Cocaine in the production of local anæsthesia.

While M. Dujardin-Beaumetz likens the local anæsthetic action of
Cocaine to that of cold, and while M. Laborde considers that it
produces a diminished blood supply by the vaso-constrictor action of
the great sympathetic nervous system, M. Arloing, on the contrary,
explains it by a local action on the nervous protoplasm.

Moreover, in 1886, Schilling, a supporter of the vascular theory,
advised inhalations of nine drops of nitrite of amyl, in three doses,
inhalations which caused dilatation of the vessels, to revive patients
poisoned with injections of Cocaine hydrochlorate.

In repeating these experiments in the laboratory, Dr. Laffont has
succeeded little by little in enlarging his field of experiments, and
finally has given to the Académie de Médecine (session of the 4th of
January, 1888), a complete and definitive account of the action of the
active principles of Coca on the different functions of the economy.
This work of original researches and criticism of previous works will
serve to explain the methodical and rational use of our preparations
in the list of the different diseases where our former previsions had
already led us to advise them.

In an earlier work (Comptes-rendus, _Société de Biologie_, Dec. 3,
1887), Dr. Laffont, studying the action of Cocaine on the great
sympathetic nervous system, found that under the action of the active
principle of Coca the functions of all the constrictor fibres of the
great sympathetic nerve were increased.

The stomach contracts.

The intestines undergo an augmentation in peristalsis and borborygmi
are heard.

The bladder invariably contracts, as M. Laborde has also seen.

The orbital capsule of the eye (smooth muscle) propels the eye-ball
forward.

The pupil is dilated.

In a word, all the smooth-fibred muscles or muscles of organic life,
subordinate to the great sympathetic nervous system constrictor,
undergo an augmentation of functional activity.

In a second essay (Comptes-rendus, _Société de Biologie_, Dec. 17,
1887), the same experimenter studied more particularly the mechanism of
the local or general analgesic action of Cocaine, and, like M. Arloing,
as opposed to M. Laborde, he found that the cerebral perceptibility was
not deadened, by a physiological dose, but on the contrary, increased.

The action of Cocaine on the nervous system is not exerted by the
intervention of vascular constriction; it is a generalized exciting
action, and a state of peripheric non-receptivity of external
impressions[13] in the nervous extremities of the sensory nerves and
the nerves of general sensation.

Cocaine, according to M. Laffont, is not the antagonist of curare, as
M. Laborde describes it, but quite the contrary, a particular curare,
acting like it on the periphery, and not affecting the nervous centers,
the functional action of which is exaggerated thereby.

M. le docteur Beugniès-Corbeau describes fully in the _Revue
hebdomadaire de Thérapeutique générale et thermale_, the internal
effects of Coca, until now so obscure, and in regard to which no
concrete doctrine had been formulated until M. le docteur Laffont
presented to the Académie de Médecine his researches. He shows that
Coca, from its active principles, should have these entirely distinct
actions:

1º Action on the protoplasm of the nervous extremities of the
sensory nerves and on the nerves of general sensibility, producing
non-transmissibility to the nerves of painful and even sensorized
impressions, in a large dose;

2º Excito-functional action on the cerebro-spinal nervous centers,
producing an augmentation of intellectual and muscular activity;

3º Excito-functional action on the great sympathetic constrictor
nerve, consequently an exaltation of the functional action of all the
non-striated muscles or muscles of organic life, which are subordinate
to it.

Considering these distinct properties of the active principles of
Coca, M. Laffont explains the long-recognized virtues of Coca, in that
they conserve the natural forces, notwithstanding the withdrawal of
aliments, in the following manner: "The exciting cerebro-medullary
action of these principles causes an increase of the intellectual
and physical activity, at the same time that the analgesic action on
the extremities of the sensitive and sensory nerves, prevents the
pangs of hunger, and consequently the accompanying moral and physical
depression."

From another point of view, M. Laffont adds, that the dynamogenic
action of the active principles of Coca on the smooth-fibered muscles
"indicates its use in the list of atonic gastro-intestinal diseases,
flatulent dyspepsia, dilatation of the stomach, paresis of the
intestines, of the bladder, etc."

It is impossible for us to recount here all the trials which have been
made with Cocaine; we will only quote the names of Dr. Deneffe, Dr.
Charpentier, Dr. Morell Mackenzie, Dr. Lennox Browne, Dr. Sajous, Dr.
J. Leonard Corning, Dr. Beverly Robinson, Dr. Louis Elsberg, Dr. W.
Oliver Moore, Dr. Vincenzo Cozzolino, Dr. Abadie, Dr. Galezowski, Dr.
Meyer, Dr. de Wecker, Dr. Doléris, Dr. David Colombe, Dr. Rigolet, and
Dr. Brasseur, the majority of whom have studied this question from an
ocular, therapeutical, obstetrical, dental, and laryngological point of
view.

[Illustration]




[Illustration]




CHAPTER IV.

THERAPEUTIC ACTION OF COCA.


Now that we understand the physiological properties of Coca and
Cocaine, we come to the study of the different morbid states in which
these substances may be usefully employed.


DISEASES OF THE MOUTH.

Gazeau advises the use of Coca for inflammations of the mouth and
gums. Pain is assuaged, ptyalism removed, and the inflammation itself
favorably influenced. He cites, in support of his opinion, the use
which the Peruvians make of it in affections of the mouth, and mentions
cases of mercurial stomatitis treated with this agent and cured in a
short time, in his practice.

Demarle[14], before him, expressed himself thus: "I have used Coca for
mercurial stomatitis. The affection disappeared on the third day of
treatment; nothing else had been administered."

In cases where the gums are soft, fungous, ulcerated, or bleeding, and
these changes depend on local or constitutional conditions, Coca is
equally indicated. Gazeau prefers it even to potassium chlorate.

According to Dr. Colombe[15], Coca is a potent factor in the treatment
of syphilis.[16] "It is demonstrated that potassium iodide and
potassium chlorate undergo double decomposition in the system, and thus
interfere with each other's action. Coca, substituted for the chlorate
under such circumstances, would not be open to the same objection. It
would find its application, therefore, when the mixed treatment is
found necessary."


DISEASES OF THE THROAT, PHARYNX AND THE LARYNX.

As regards the _anginæ_, the acute inflammations of the larynx and
pharynx, we might repeat what has been said about inflammations of the
mouth. In particular, the pain, so violent in certain _anginæ_, calls
for this method of treatment. The same is true of the dysphagia which
accompanies them.

Charles Fauvel first recognized the virtues of Coca in the tingling of
follicular _angina_ and the laryngeal pains of tuberculous subjects. In
those cases he specifies Mariani's extract of Coca leaves in preference
to solutions of Cocaine, which sometimes give rise to symptoms of
poisoning.

Dr. Rouquette[17] relates a case of tubercular laryngitis in which
symptoms of poisoning showed themselves as early as the third day; the
parts had been painted twice a day with a five-per-cent solution of
Cocaine.

Dr. Paul Legendre has quite recently mentioned anew the danger that
may result from a too free use of Cocaine[18]. The case was that of
an interne of the hospitals attacked with diphtheria who, in order
that he might the better bear the spraying with caustics, had his
throat painted with a solution of Cocaine. Toward the seventh day he
experienced very grave symptoms of poisoning, and the painting had to
be suspended.

It is better, in cases of this sort, to prescribe extract of Coca,
which answers the same purposes without the attendant danger of Cocaine.

One of the greatest triumphs of extract of Coca is assuredly its action
in dysphagia and in the vomiting of consumptives, as also in the
vomiting of pregnancy. The first two complications are of the gravest
kind, for they condemn to starvation patients whose only chance of
safety lies in the activity of the digestive organs (Ch. Fauvel and
Coupard).


DISEASES OF THE STOMACH.

Authors who have given attention to Coca speak very highly of its
employment in gastralgia and tardy and laborious digestion.

Demarle says on this subject: "Personally, I have found the use of
Coca, either before or after eating, excellent for gastrodynia and
pyrosis, to which I am subject; hardly have I swallowed the first bit
of saliva when the whole unpleasant feeling disappears."

Mantegazza speaks of its use in the same strain. The cephalic
congestion which accompanies his digestion is relieved; he can work
after eating without feeling any uneasiness.

Dr. Ch. Gazeau (_Thèse pour le Doctorat_, Paris, 1870, Parent, édit.,
pp. 61 _et seq._) thus sums up the physiological action of Coca: "On
the stomach, slight excitation, anæsthesia, and probably an increase
of the secretion of gastric juice; on the intestines, an increase of
the intestinal secretions, etc. These manifold physiological effects
upon the digestive tube unite in a specific action, so to speak, in the
numerous functional troubles, so varied and so ill-understood, of the
organs that compose it."

The same author cites a great number of cases of this sort in which
Coca "has never failed to exert an admirable action, often even
marvelous." And he concludes (page 65): "It seems to me useless to
bring forward more examples; these are enough to justify this positive
general conclusion: Coca is the remedy _par excellence_ for diseases of
the digestive tube."

Beugniès-Corbeau[19] prescribes it in chloro-anæmia, not only for
gastralgia, but for the frequent desire to eat which patients feel,
disappearing as soon as the first mouthful has been taken, only to
return a little while afterward.

Prof. O. Réveil ends his article on Coca as follows: "Much remains to
be done in the physiological and clinical study of Coca; it is known
that it acts on the motor and sensory nervous system. This substance is
destined some day to take an important rank in therapeutics."

In irritability and various affections of the cerebral centers, Dr. J.
Leonard Corning makes use of Coca, which he prefers to the bromides.

In a very remarkable essay on _Erythroxylon Coca_, published at
Ixelles, in 1885, a perusal of which we urge upon all who are
interested in the study of Coca, Dr. A. Feigneau says (page 61):

"There can be no mistake that, to a certain extent, Coca stimulates the
cerebra-spinal activity by suspending or retarding the destruction of
tissue in the economy, and that its action may modify the functions of
the nervous centers, provided there are no such contra-indications to
its use as active congestion, inflammation, or organic changes in these
organs."

"Consequently it would be indicated under all circumstances where a
nervous affection seemed to depend upon a state of ataxia."

"In irritations of the spinal cord, in mental aberration accompanied by
melancholia, as well as against idiopathic convulsions (Mantegazza) and
nervous paraplegia."

Dr. Beverley Robinson considers the Vin Mariani as a cardiac tonic[20]:

"On several occasions, when digitalis has proved to be useless
or injurious, I have had very excellent results from caffeine or
convallaria. Certainly, the latter drug is more easily tolerated by a
sensitive stomach than digitalis is; and whenever the nervous supply
of the heart is especially implicated, I believe that I secure more
quieting effects from its employment. Among well known cardiac tonics
and stimulants for obtaining temporary good effects, at least, I know
of no drug quite equal to Coca. Given in the form of wine or fluid
extract, it does much, at times, to restore the heart-muscle to its
former tone. I have obtained the best effects from the use of Mariani's
wine. From personal information given me by this reliable pharmacist,
these results are attributable to the excellent quality of the Coca
leaves and of the wine which he uses in its manufacture."

In cases of morphinomania, Dr. Dujardin-Beaumetz has pointed out the
advantage to be obtained with the Vin Mariani, and, following him, Dr.
Palmer, of Louisville, and Dr. Sigmaux Treux, of Vienna, have obtained
excellent results with this therapeutic agent. Further on, we give a
case of Dr. Villeneuve's, showing the cure of a morphinomaniac by the
combined use of the Vin and the Pâte (Mariani).

Dr. H. Libermann recommends the use of Coca, in the form of Vin
Mariani, against morphinomania, nicotinism and alcoholism.

"In _general diseases_ it is to the stimulating properties of the plant
that recourse is oftenest had. These properties make it the tonic _par
excellence_ whenever the object is to build up a system that has been
enfeebled from any cause. Its preparations, accordingly, may be ordered
in convalescence from all grave fevers, in anæmia and chloro-anæmia,
in all diathetic or cachætic conditions, whatever may have been their
original cause (chronic rheumatism, gout, genito-urinary affection,
cancer, etc.), in short, in all cases where the system is debilitated
from any cause whatever."

But it is, above all, in diseases that have a depressing action on the
nervous system that the effect of Coca is truly marvelous. Gubler, in
his _Commentaires de thérapeutique_, shows himself its warm champion.
"Coca," says he, "very much like tea and coffee, lends to the nervous
system the force with which it is charged, after the manner of a
fulminate, but with this difference, that it yields it gradually and
not all at once."

The theory of the _fulminates_, invented by M. Gubler, tallies so well
with observed facts, that Mantegazza, without generalizing and without
pretending to form a theory, but limiting himself to describing by
simile what he had seen, truer probably than he himself supposed, said:
"Under the influence of Coca, it seems that a new force is gradually
introduced into our organism, like water into a sponge." (A. Dechambre.)

This opinion has been corroborated by all authors who have given
attention to the question, and it may be looked upon as one of the
least contestible in therapeutics.

We will add, what is quite important, that as a tonic Coca has been
found far superior to cinchona, iron, strychnine, etc. Everybody knows
their astringent action, which makes them give rise to such obstinate
constipation that there are patients in whom it is often necessary
to suspend their use. There is no such objection to Coca; it never
constipates, and practically its use may be continued indefinitely.

[Illustration: COCA LEAVES.

(Branch in natural state.)]




[Illustration]




CHAPTER V.

OUR VARIOUS PREPARATIONS OF COCA.


Immediately after the importation of the Coca leaf into Europe, we
conceived the plan, the outcome of the request of many physicians, of
making preparations from Coca. _Vin Mariani._—_Elixir Mariani._—_Pâte
Mariani._—_Thé Mariani._—_Pastilles Mariani_, etc. (The author's name
was kindly added to his preparations by the medical profession, who had
recognized the superiority of his products.)

These different preparations had been used by our greatest
practitioners long before the discovery, or rather the application of
Cocaine.

The results obtained were marvelous, and the innumerable letters which
were addressed to us by physicians who experimented with and used our
products and rendered accounts in the medical journals in all parts of
the world, would fill several large volumes.[21]

Under the esteemed patronage of our greatest medical celebrities,
our preparations are known all over the world; they have reached all
classes of society and everywhere, in the large cities as in the small
villages, men, women, children, in fact, convalescents of all ages
now know the name of the salutary plant, which it is and has been our
effort to popularize, though strictly so according to the code of
medical ethics and by those channels approved of by the entire medical
profession.

We shall now consider the different ways in which we use Coca, and
which under the well-known forms of _vin_, _élixir_, _pâte_, and of
_thé Mariani_, have received such universal recognition. We will show
incidentally the esteem in which these preparations are held by the
highest medical authorities.


VIN MARIANI.

This is the first of the preparations of Coca and the one most
generally adopted; to the tonic and stimulant action of the drug there
is added that of a choice quality of wine.

Vin Mariani contains the soluble parts of the Coca plant. The
combination of Coca, with the tannin and the slight traces of iron
which this wine naturally contains, is pronounced the most efficacious
of tonics.

The fresh Coca leaves that we employ, after careful selection, come
from three different sources and are of incomparable quality. It is
this that gives to our _wine_ that special taste and agreeable aroma
which renders it so acceptable to the sick.

It is likewise to the combination and preparing of these three
varieties of Coca leaf in our wine that we can attribute this important
fact: during more than thirty years, no matter in how large doses
taken, _Vin Mariani_ has never produced _cocainism_, nor any other
unpleasant effects.[22]

_Vin Mariani_ is a diffusible tonic, the action of which is immediate.
This action, instead of being localized on a single organ, the stomach,
spreads to the whole system. Taken into the circulation, it awakens in
its course the retarded functions of every organ, and this is owing to
the presence in our preparation of the volatile principles of the plant.

Unlike other tonics, the astringent properties of which lead at length
to heat and constipation, _Vin Mariani_ does not produce any disorder
of the digestive functions; it stimulates them, exerts a refreshing
action on the gastric mucous membrane, and on that account so
advantageously replaces the preparations of cinchona, iron, strychnine,
etc.

"There is," says Dr. Mallez, "a form of anæmia to which the attention
of physicians has not yet been called, and which yields marvelously to
the employment of _Vin Mariani_; we allude to that state of profound
depression of the economy, of extremely marked impoverishment of the
blood, which also results from the prolonged abuse of balsamics in the
treatment of diseases of the urinary passages.

"The number of persons who, attacked with blennorrhagia, use cubebs,
copaiba, turpentine, etc., to a deplorable extent is considerable. So
true is this that, out of a hundred young dyspeptics, we may affirm
without fear of being in error that at least forty of them have become
so by the use of balsamics.

"In like manner, the number of patients affected with urinary gravel
whom the prolonged and excessive use of the agents just mentioned, has
rendered dyspeptic and then neuropathic is enormous. Like the former,
they owe the profound disorder of their digestive functions to the
immoderate use of resins and oleo-resins.

"It is of the first importance, therefore, to relieve these persons
by making them take, after having given them light laxatives and
some preparations intended to strengthen the stomach, not iron, not
cinchona, not, as we have said above, local tonics, which would be of
little if any use, but diffusible tonics, that is to say, those that
act upon the local condition and at the same time upon the general
condition, and which, moreover, do not constipate.

"It is here that _Vin Mariani_, proves its great advantage and
succeeds where other tonics have failed, in stimulating the functions
of the stomach. On the one hand by the small quantity of tannin
which it contains, on the other through the active principles of
Coca, associated with the wine, which serves as a vehicle, exciting
the vitality of each organ separately, not, however, without having
previously exerted its vivifying action on the mucous membrane of the
stomach itself." (_Gazette des Hopitaux_, Nov. 23, 1877.)

The analgesic properties of _Vin Mariani_ have received a happy
application in clinical laryngoscopy by Dr. Ch. Fauvel. This eminent
specialist has made use of it for the past twenty-six years with
unvarying success in all affections of the laryngeal mucous membrane,
the air passages, and the vocal organs. In granular angina it takes the
place of the topical medication and cauterizations which are so often
injurious when they are used indiscriminately and to excess.

The employment of _Vin Mariani_ rapidly relieves patients of the
feeling of heat and tingling which is one of the most annoying symptoms
of this very common disease of the throat. (_Gazette des Hopitaux_, May
12, 1877.)

Dr. Beverley Robinson recommends _Vin Mariani_ as a heart tonic.

Dr. W. H. Pancoast says that _Vin Mariani_ is a valuable preparation
and a tonic of the highest merit.

Dr. Jules Bouvyer, of Cauteretz, employs it with success in certain
affections of the larynx as an adjuvant to the sulphurous treatment.

In 1875, in his _Traitement rationnel de la phthisie pulmonaire_, Dr.
de Pietra Santa said, page 394:

"Among the most renowned practitioners of Paris, Péan, Barth, G. Sée,
and Cabrol have promptly adopted the preparations of Coca. Ch. Fauvel
prescribes it in affections of the respiratory passages. It is in these
diseases that I, too, have had occasion to advise its daily use in the
most convenient, the most agreeable, and the most active form—that of
the _Vin Tonique de Mariani_."

Thus has been realized Réveil's prediction: "This substance (Coca) is
destined to take an important rank in therapeutics."

In the _Revue de Thérapeutique médicaux-chirurgicale_, June 11, 1876,
page 381. Bibliographie: _Dictionnaire Encyclopédique des sciences
médicales_, par A. Dechambre, Dr. H. Cottin thus closes his article:

"In France, we are using a great deal of Coca wine, and it is tending
to take the place of all other tonic wines; it is borne a longer time
by the stomach and is more agreeable to the palate. M. Mariani has
contributed much to the popularization of Coca by the perfection of his
preparations, _vin_, _thé élixir_ and _pâte_. These are the forms at
present most employed."

Dr. Chapusot, of Paris, thus sums up his personal observations: "A
claret-glass of this wine has always been enough to make me forget
hunger and to sustain my strength; I have felt a grateful warmth and a
general exaltation of the economy; the digestion of the following meal
has always been easier than if I had not taken the _Vin Mariani_, and,
although I had not such a ravenous appetite as if I had gone without
it, I ate a good deal, the stomach appearing stronger and more active."

It was Dr. Ch. Fauvel who gave our wine the very striking and exact
title of "Tensor of the vocal cords." He says: "Thanks to _Vin
Mariani_, I have been able to restore the voice of many lyric artists
who would have been unable without this potent agent to give their
performances."

Dr. J. Leonard Corning, in _Brain Exhaustion_, New York, 1884, pages
78 and 112, says: "Of all the medicaments that I employ in the very
numerous cases of irritability, _Vin Mariani_ has rendered the greatest
service. I do not except even the bromides, for this preparation
of Coca possesses the calmative properties of those salts without
producing the unpleasant depression which characterizes them."

The same author continues:

"The _Vin Mariani_ is the remedy _par excellence_ for _ennui_. At the
same time it produces a fortifying action on the cerebral center and
gives rise to a decided sensation of well-being."

Dr. Morell Mackenzie, London, advises the _Vin Mariani_ as a stimulant
and tonic, and uses it especially with speakers and singers.

  19 Harley Street,
  Cavendish Square, W., London.

 GENTLEMEN:—I have much pleasure in stating that I have used the
 _Vin Mariani_ for many years, and consider it a valuable stimulant,
 particularly serviceable in the cases of vocalists.

  Yours faithfully,

  MORELL MACKENZIE, M. D.

Professor Sajous, of Philadelphia, who has experimented with _Vin
Mariani_ in troubles of the vocal organs, has obtained excellent
results from its use, and he advises it, not only as a restorative of
the voice, but as a general tonic.

Dr. Libermann, Surgeon-in-Chief, French Army, communicates his
experience, as follows:

"I have the honor to inform you of the results which I have obtained in
my long career of military practice from the use of _Vin Mariani_.

"I have used it with great success for profound anæmia resulting from
long and tedious campaigns in hot countries, and accompanied, as is
nearly always the case, by gastro-intestinal irritation with loss of
appetite and dyspepsia. Two or three Bordeaux-glasses of _Vin Mariani_
daily, removed that condition quite rapidly, by restoring the appetite
and the tolerance of the stomach for a tonic aliment.

"I have also employed it in cases, happily rare in our army, of
chronic alcoholism resulting from the abuse of brandy, absinthe or
strong liquors. The _Vin Mariani_ produced all the excitement sought
by drinkers, but had at the same time a sedative influence on their
nervous systems. I have frequently seen hardened drinkers renounce
their fatal habit and return to a healthy condition.

"I have also used _Vin Mariani_ to save smokers of exaggerated habits,
from nicotinism. A few glasses of _Vin Mariani_ taken in small doses,
either pure or mixed with water, acted as a substitute for pipes and
cigars, because the smokers found in it the cerebral excitement which
they sought in tobacco, wholly preserving their intellectual faculties.

"I have also employed it with success for chronic bronchitis and
pulmonary phthisis. _Vin Mariani_ increases the appetite and diminishes
the cough in these two morbid states.

"To combat the cough I give it mixed with water in the form of tisane,
a Bordeaux-glass of _Mariani_ in a glass of hot water.

"Besides I have used it to the greatest advantage in convalescence from
typhoid fever, when no wine, not even Bordeaux, was retained by the
stomach on account of gastric irritation which is the rule after fevers
of this nature.

"Although I have confined myself to giving but a rapid glance at the
results that I have obtained, I have the statistics, which I keep in
reserve should they be needed.

"I can certify that _Vin Mariani_ is the most powerful weapon that can
be put in the hands of military physicians to combat the diseases, the
infirmities, and even the vicious habits engendered by camp life and
the servitude of military existence."

Dr. Villeneuve, among other cases of morphinomania conquered by the
combined use of the _pâte_ and the _Vin Mariani_, communicated to us in
1884 the following observation:

"M. X...., barrister, 32 years of age, five years ago began to use
morphine preparations as a remedy against a very alarming chronic
bronchitis and granulations in the throat, which were irritated
constantly by cigarette smoking.

"The patient at first only used morphine, but his physicians committed
the imprudence of treating him by hypodermic injection. A notable
change for the better was produced during the first month, but,
unfortunately, abuse succeeded promptly the use of the medicament—so
much so that when I commenced to treat the patient, he was taking daily
from 1 gramme 50 centigrammes to 1 gramme 80 centigrammes of morphine
hypodermically. When he was four hours without his dose there appeared
insomnia, hallucinations and delirium; constipation lasting sometimes
for fifteen days, which brought on in the spring a very alarming
perityphlitis, jerking of the muscles, sudden frights, dyspepsia, and
at last frightful congestion of the face whenever he drank a drop of
wine or brandy.

"After a month's treatment I had succeeded in reducing the daily doses
without causing alarming symptoms; the physiological functions seemed
to awaken again. However, the congestion and especially the dyspepsia
was very grave, and the cough which had been suppressed by morphine
returned. It was then that I treated my patient with phosphate of lime,
the _pâte_ and the _Vin Mariani_. Lacking his habitual stimulant, he
was plunged in a semi-coma from which he could not always be relieved
with weaker daily doses of morphine.

"The danger I feared most was a relapse of bronchitis, and that the
cough and expectoration might end fatally. But in about a week,
during which he took ten doses of _Pâte de Coca_ daily, the cough
became less fatiguing and disappeared entirely in about twenty days.
The patient then commenced to take small doses of _Vin Mariani_ (two
Madeira-glasses a day). At first congestion appeared, but little by
little, as digestion became more easy, my patient, who on account of
his profound anæmia could not tolerate any table wines, took at first
a small glass, then two, then three glasses at a meal. Now he can go
and take his dinner in town, which he had not been able to do for three
years; he regained his former vigor, is able to undertake anew his
occupations, and has entirely given up his morphine habit."

We will conclude our quotations, already too numerous, with an article
by Dr. Scaglia, published in 1877 in the _Gazette des Hopitaux_: "La
Coca et ses propriétés thérapeutiques."

"In anæmia, connected with chronic pulmonary affections without
fever, and in anæmia accompanied by gastralgia, _Vin Mariani_ has an
excellent effect. Its stimulating properties can also be admirably
made use of in those intermediate states of impaired health which are
not yet anæmia, but must in the end become so; physical or mental
overwork, the cerebral weakness due to excess of work or pleasure; the
exhaustion from which the inhabitants of large cities suffer through
irregularities of diet and imperfect hygiene owing to their positions
and surroundings.

"_Vin Mariani_ is unquestionably of benefit to people of sedentary
habits worn out by work, to convalescents who, from a prolonged
confinement in bed, have lost muscular strength, to patients suffering
from diabetes or Bright's disease, whose muscles have lost their
elasticity and vigor.

"Let us add that the taste of _Vin Mariani_ is exquisite, that it is in
no way suggestive of drugs, and that its use is acceptable to the most
fastidious."

Ordinary Dose—Two or three claret-glassfuls daily, half an hour before
or immediately after eating.

COCA GROG.—By mixing a wineglassful of _Vin Mariani_ with half a
glassful of boiling water, sweetened to the taste, we get a grog of
exquisite flavor, and capable of rendering the greatest services
whenever an immediate effect is desired in severe cases of cold,
attended by convulsive coughing. (As prescribed by Dr. Libermann, Dr.
Cyrus Edson and others, recorded in the medical journals during the
grip epidemics.)


ELIXIR MARIANI.

The _Elixir Mariani_ is more alcoholic, very agreeable to the taste,
and three times as highly charged with the aromatic principles of the
Coca leaf as the _Vin Mariani_; therefore it should be taken in doses
of a liqueur glassful, in the morning upon rising, and after the two
principal meals.

It may be used clear or mixed with water, in nearly all cases where the
_Vin Mariani_ is used. Its tonic and eminently digestive properties and
its special aroma, at once mild and penetrating, make it an agreeable
liqueur, very much esteemed by gourmets and persons who are careful
about their health.

A small glass of the _Elixir Mariani_ taken after a meal, spreads a
gentle warmth through the stomach and calls forth an abundant secretion
of gastric juice, which mixes with the food and facilitates digestion.

For travelers, hunters, and in general all who walk much and who are
exposed to fatigue, to dampness, and to fog, the use of the _Elixir
Mariani_ may be recommended and will render admirable service, because
of the tone and strength that it gives to the stomach and to the
muscles.

Dr. Collins, _Révue de Thérapeutique_, observes that this liqueur acts
"heroically" in anæmia, chlorosis and rickets.

Dr. Ch. Fauvel, Dr. Conqueret, Dr. Villeneuve, Dr. Chapusot, Dr.
Odin, Dr. Cintrat and others declare as the result of their clinical
observations that the _Elixir Mariani_ exerts a "masterly action" in
granular pharyngitis, quinsy, and albuminuria, and that its stimulating
properties on the whole nervous system cannot be denied.

Dr. J. Leonard Corning, of New York, recommends the _Elixir Mariani_ as
a strengthener of the brain.

"As a remedy in _sea-sickness_, the _Elixir Mariani_ has always
given excellent results."—Dr. Slant, Dr. Letellier, Dr. Trossat, Dr.
Derrecagaix.

The _Elixir Mariani_ is generally prescribed in doses of a
liqueur-glassful after the principal meals. Mixed with cold water,
in the proportion of two liqueur-glassfuls to a tumbler of water, it
constitutes a very strengthening and pleasant drink.


PÂTE MARIANI (LOZENGES OF COCA).

Tonic and pectoral, _Pâte Mariani_ is a Lozenge very agreeable to the
taste, which is prescribed daily with the greatest success by throat
specialists for obstinate coughs, granular catarrh of the throat, and
the various inflammations of the digestive and respiratory passages.
Composed only of clarified gum, sugar and Coca, without a trace of
opium or of any narcotic substances, it may be taken without danger at
any hour of the day and in any quantity, without fear of its disturbing
the digestion, since, on the contrary, it can only aid it. From six to
ten of the Lozenges daily are the usual dose, but more may be taken if
necessary.

Its beneficial action is due to the happy combination of the emolient
properties of pure gum-arabic and the tonic, astringent and analgesic
properties of Coca.

"_Pâte Mariani_ has a powerful tonic action on the larynx, and,
like _Vin Mariani_, it is invaluable in cases of aphonia caused by
feebleness or relaxation of the vocal cords. This property is of
special advantage to singers and orators. _Pâte Mariani_ is a very
valuable substitute in granular catarrh of the throat and throat
affections in general, for chlorate of potassium pastilles and the
various lozenges containing opium, etc., the _Pâte Mariani_ is more
agreeable to the taste and produces anæsthetic and soothing effects."
(_Gazette des Hopitaux._)


PASTILLES MARIANI (COCA AND COCAINE).

The _Pastilles Mariani_ are used in the same cases as the _Pâte_, from
which they differ only by the addition of two milligrammes of Cocaine
hydrochlorate to each pastille.

Their action is much more intense and more rapid than that of the plain
Coca Lozenges.

The paroxysms of cough which are so frequent and so annoying to those
who smoke tobacco to excess, are overcome as if by enchantment by the
use of a few pastilles.

Dose—Four to eight daily. This amount, however, may be exceeded, at the
discretion of the physicians.


THÉ MARIANI, OR CONCENTRATED EXTRACT OF COCA (TEA MARIANI).

As its name indicates, Mariani's concentrated extract of Coca, or _Thé
Mariani_, contains within a small bulk all the active principles of the
Coca leaf. This extract, prepared in special apparatuses which prevent
all alteration and preserve all its properties and all its aroma,
answers entirely in the various modes of using Coca and constitutes a
most scrupulously exact preparation in dose, the most convenient and
the most active that could be desired.

_Thé Mariani_ is capable of indefinite preservation and easy of
transportation; it renders great service to persons who make mountain
ascensions, fatiguing marches, or long journeys through unhealthy
countries, and in fact in whatever may be called fatiguing work or
pleasure.

_Thé Mariani_ may be taken in the dose of from three to six
teaspoonfuls in the course of the day, clear, or mixed with brandy,
wine, water or milk, etc., hot or cold, in the latter cases sweetened
to taste, if desired.

COCA TEA OR INFUSION.—A teaspoonful of the _Thé Mariani_, added to a
cup of hot water, sweetened to the taste, with or without the addition
of cream or milk, makes a very agreeable drink, more digestive, more
tonic, and less exciting than coffee or tea, while possessing in
a higher degree the tonic and stimulating properties of those two
substances.

It is in this form that Coca is especially used in Peru and Bolivia,
where it is preferred to the Chinese tea.

Persons who drink Chinese tea at meals may advantageously substitute
the _Thé Mariani_ for it.

For patients who cannot generally take milk, it is advisable to add
_Thé Mariani_. Excellent results will be obtained.

COCA GARGLES AND SPRAYS.—Independently of its tonic and reconstituent
action, Coca possesses anæsthetic and soothing properties that have
been observed and made use of in practice by laryngologists in the form
of a spray, in the proportion of a teaspoonful of _Thé Mariani_ to half
a glassful of warm water.

An ambulance physician of Tonkin, who has experimented with _Thé
Mariani_, sends the following note:

"_Thé Mariani_ has rendered us real service during expeditions as well
as in hospital practice; on the march it makes with boiled water,
with or without the addition of sugar, a very agreeable, tonic and
stimulating drink; a veritable reserve food, it takes the place of
alcoholic drinks and insufficiency of food, and aids the men in bearing
the most distressing fatigue. The water of swamps, rivers or ditches,
mixed with a few spoonfuls of _Thé Mariani_, could be drank without any
inconvenience, and assuaged thirst.

"_Thé Mariani_ stimulates the appetite, overcomes atony of the
digestive organs, and prevents and combats diarrhœa efficiently.

"Mixed in small quantity with fresh or condensed milk, it gives it
an agreeable taste and causes it to be borne by the most delicate
stomachs; hence it becomes a valuable adjuvant in the treatment of the
endemic dysenteries and diarrhœas of tropical countries.

"Finally, its exclusive use, even its excessive use for several days,
has not seemed to us to exert any injurious influence on the system,
as the abuse of coffee or of alcoholic drinks had certainly done under
like circumstances."

Dr. Fordyce Barker, Dr. J. H. Douglas, Dr. Henry B. Sands and Dr. Geo.
F. Shrady have authorized us to make known that it was due to _Thé
Mariani_, added to milk (in the proportion of a teaspoonful of the
_Thé_ to a cup of milk), that they were able to nourish Gen. Grant,
the ex-President, when he was unable to support any other food. By
this means they succeeded in prolonging the life of their illustrious
patient for several months.

Coca taken in infusion gave excellent results to Tschudy while he was
sojourning in the valley of the Puna, the highest in Bolivia, which
has given its name to the disease of mountain sickness, known in Peru
by the name _Mal de Puna_, also designated by the words _sorroche_,
_veta_ and _mareo_; this last term shows clearly enough the analogy
which exists between sea-sickness and the influence of great altitudes
on the human body. Experience has proved the usefulness of Coca against
dyspnœa and vomiting, so that the Indians who make ascensions always
carry a stock of Coca with them. Dr. Tschudy found himself comfortable
by the use of it while hunting in those valleys, at a height of ten to
twelve thousand feet above the sea.

Dr. Salemi, of Nice, gives an account of a case of epilepsy in a woman,
38 years of age, cured by the daily and prolonged use of _Thé Mariani_,
given in increasing doses (ten drops daily at first and eighty drops
daily at the end of a month). This case is not an isolated one.


IMPORTANT CAUTION.

Owing to the success obtained by our preparations of Coca for many
years, imitators and counterfeiters have dared to apply to their own
valueless productions the observations made with our special products.
These occurrences, often repeated, have given rise to protests
from many physicians, among others Dr. W. Oliver Moore, Sir Morell
Mackenzie, Dr. Ch. Fauvel.

  _To the Editor of the New York Medical Journal_:

 SIR: In your issue of January 3, 1885, page 19, in a report of a
 paper read before the New York Medical Society, on "The Physiological
 and Therapeutical Effects of the Coca Leaf and its Alkaloid,"
 occurs the following: "For over twenty years Dr. Fauvel has used
 it, both internally in the form of _Vin Mariani_, and also by local
 applications to the pharynx and larynx in spray or by brush, in
 the form of a fluid extract, or, more recently, of a concentrated
 non-alcoholic preparation more of the nature of a cordial (prepared by
 Mariani & Co.)."

 Several manufacturers of Coca preparations have taken occasion to
 quote from this paper, each in turn substituting the name of _his own_
 production instead of the one mentioned in the original.

 As the preparations of Coca mentioned in my paper were personally
 tested and found to be the best of a large number experimented with, I
 wish to call attention to these misquotations and substitutions.

  Very truly,

  W. OLIVER MOORE, M.D.

*** We have taken the trouble to compare the report of Dr. Moore's
remarks with the little book on Coca prepared by M. Mariani, and with
the circulars issued by a number of manufacturers of Coca preparations;
and we certainly think that some of these manufacturers have taken
an unwarrantable liberty in appropriating work that evidently cost M.
Mariani a good deal of time and no little outlay of money.—EDITOR _N.
Y. Medical Journal_.

  _New York Medical Journal_, October 24, 1885.

 "In another column we publish a letter from Dr. W. Oliver Moore,
 calling attention to an injustice that certain competing pharmacists
 have practiced toward Messrs. Mariani & Co., in 'pirating' published
 records of the successful use of the Mariani preparations of Coca,
 and at the same time craftily making these records appear to apply to
 their own preparations. It is very much to be regretted that a house
 that has been so punctilious in avoiding even the semblance of any
 offense against the courtesy of trade should have been treated in this
 shabby way by some rival manufacturers."

  31 Rue Guénégaud, Paris, Dec. 8, 1887.

  _To the Editor of the New York Medical Journal_:

 SIR—Will you kindly have it announced in your journal, in justice
 to myself before the medical profession, that the various notices
 appearing in journals and circulars quoting my name in connection with
 Coca are entirely false and in every respect a prevarication? The
 only preparation of Coca employed by me with undoubted and uniform
 success has been the so well-known _Vin Mariani_, which, since 1865,
 I have had occasion to prescribe daily in my _clinique_, as well as
 in private practice. My opinion of this valuable medicament has,
 during many years, been frequently made known for the benefit of the
 profession in various writings, and it is but just to this worthy
 preparation that it receive all the honor due it. I thank you for
 compliance with my request.

  CH. FAUVEL, M.D.

Continued compliment is paid M. Mariani for the maintained high standard
and excellence of his preparations, by the numerous honorable mentions
and indorsements by the members of the medical profession and those
who have occasion to use his Coca preparations; latterly through the
following awards:

Gold Medal and Silver Medal from the Académie Nationale de France; Gold
Medal and a Grand Diploma of Honor from the Wine Exhibit of Bordeaux,
France; Gold Medal and a Diploma of Honor at the Hygienic Exhibit
at Amsterdam, Holland, and a Gold Medal and Diploma at Leamington,
England, the jury surnaming his _Vin Mariani_, "Wine for Athletes."

N. B.—Professional bicyclists and athletes, after careful trials of
ours and preparations of others, among which the Cafeine. Theobromine,
Kola, pseudo-Cafeine or Kolamine (Knebel), Maté, etc., invariably
give the preference to our Coca preparation. Messrs. Dubois, Lucas,
Vigneaux, Echalié, André Henry, Imans, Buffel, and many others have
attested to the vast superiority of Coca Mariani over all other tonics
(dynamogéniques).

We request those physicians, who kindly place confidence in our
preparations, to prescribe them under the name of _Mariani_, and to
insist that their prescriptions be scrupulously executed.




[Illustration: PLATE I]

PLATE I.

TRANSVERSE SECTION OF A YOUNG BRANCH; PRIMARY FORMATIONS.

(See Plate III., Figure 3.)


 _Ec._, Bark formed of an epidermis _Ep._, of a parenchyma (pulp) well
        developed with some oxaliferous cellules _C. o._ On the section
        is seen a bundle of libero-ligneous stipulaires _F. s._

 _F. p._, Fibres pericycliques.

 _Li._, Liber, with oxaliferous cellules _C. o._

 _B._, Wood.

 _Mo._, Pulpy pith containing cellules of ligneous dotted partitions
        _C. l._, and oxaliferous cellules. The cortical and medullary
        pulp contain in their cellules numberless grains of starch,
        which are not indicated in this plate.


[Illustration: PLATE II.

  FIG. 1      FIG. 2]

PLATE II.

Fig. 1—TRANSVERSE SECTION OF AN AGED STEM; SECONDARY FORMATIONS.

Fig. 2—LONGITUDINAL SECTION OF SAME STEM.

Bark formed of a corky and pulpy cortical of a secondary origin. The
primary bark exfoliates itself at a very early stage.

The pulp contains some oxaliferous cellules and some grains of starch.

The wood contains some veins and a considerable quantity of fibres with
thick and dotted partitions. The marrow remains always pulpy and with
lignified cellules.


[Illustration: PLATE III.

FIG. 1

FIG. 3

FIG. 4]

PLATE III.

Fig. 1—TRANSVERSE SECTION OF A PRIMARY ROOT.

  _A. p._, Heaped layer.

  _A. s._, Corky layer.

  _Ec._, Pithy bark.

  _End._, Endoderm; the thickening of the lateral partitions of its
          cellules is very apparent.

  _P._, Pericycle formed of a single layer of cellules.

  _T. c._, Conjunctive tissue or pith.

  _B._, Ligneous fasciculous; there are two to the diameter.

  _L._, Liberian fasciculous; there are two to the diameter,
        perpendicular to the preceding.


Fig. 2—TRANSVERSE SECTION OF A ROOT; SECONDARY FORMATIONS.

  _L. s._, Cork, secondary.

  _Ec. s._, Bark, secondary; the primary formations are exfoliate.

  _L._, Liber.

  _F. l._, Ligneous fibres in large numbers and meatus.

  _V._, Veins of wood, dotted.

  _R. m._, Medullary radius.

  _M. s._, Pith which has become entirely sclerotic.


Fig. 3—SCHEMATIC SECTION OF A YOUNG BRANCH.

  _Ec._, Bark.

  _F. f._, Foliated fasciculous not yet separated from the central
           cylinder.

  _F. s._, Fasciculous stipulaire.

  _Mo._, Pith.

  _Z. g._, Generating zone libero-ligneous.


Fig. 4—GRAINS OF STARCH OF THE SEED.

(Maximum dimensions: 22 to 24 p. × 15 to 18 p.)


[Illustration: PLATE IV.]

PLATE IV.

Fig. 1—FOLIATION. TRANSVERSE SECTION OF A LEAF NOT YET UNROLLED,
SHOWING THE TWO LONGITUDINAL JUTTINGS WHICH FORM THE FALSE NERVURES OF
THE COCA LEAF.

  _F. i._, Lower surface.
  _F. S._, Upper surface.
  _N. p._, Principal nervure.
  _F. n._, False nervures.


Fig. 2—TRANSVERSE SECTION OF ONE OF THE JUTTINGS.

  _E. s._, Upper epidermis.
  _E. i._, Lower epidermis.
  _F. n._, False nervure.


Fig. 3—LOWER EPIDERMIS OF THE LEAF AT THE FALSE NERVURE _F. n._, WHICH
IS FORMED OF LENGTHENED CELLULES WITHOUT STOMATUM _S._, STOMATUM _P._,
EPIDERMIC PAPILLOUS CELLULES.


Fig. 4—TRANSVERSE SECTION OF A LEAF ENTIRELY DEVELOPED.

  _E. s._, Upper epidermis.
  _E. i._, Lower epidermis.
  _P._, Parenchyme foliate.
  _C. p._, Palissadique cellules.
  _C. s._, Sclerotic cellules.
  _L. a._, Air-conveying cell.
  _F. l. l._, Fasciculous libero-ligneous.


Fig. 5—SCHEMATIC SECTION OF A PETIOL NEAR THE BASE.


Fig. 6—EXTREMITY OF A BRANCH SHOWING THE STIPULES OF THE LEAVES.


Fig. 7—TWO STIPULES CONNECTED, SEEN FROM THE BRANCHED SURFACE.


[Illustration: PLATE V.]

PLATE V.

Fig. 1—RIPE SEED; THE THREE STYLES AND THE STAMENS ARE STILL ADHERENT.


Fig. 2—LONGITUDINAL SECTION OF SAME.

  _T. g._, Tegument of the seed.
  _A._, Amylaceous albumen.
  _R._, Embryo rootlet.
  _C._, Cotyledons.


Fig. 3—SCHEMATIC SECTION OF THE HALF-DEVELOPED SEED.

  _P. c._, Carpellary pulp.
  _C. a._, Abortive carpelle.
  _T. o._, Tegument ovarium.
  _A. a._, Amylaceous albumen.
  _C. e._, Embryo cotyledons.
  _N. t._, Nervure of tegument of the ovule.


Fig. 4—TRANSVERSE SCHEMATIC SECTION OF A COTYLEDON.


Fig. 5—FLORAL BUD.


Fig. 6—AN EXPANDED FLOWER.


Fig. 7—THE SAME, SEEN FROM UNDERNEATH.


Fig. 8—TWO PETALS, ONE SEEN FROM UNDERNEATH, THE OTHER SEEN SIDEWAYS
AND SHOWING THE APPENDIX WHICH FORMS THE CROWN.


Fig. 9—THE ATTACHED 10 STAMENS; THE EPIPETALS ARE LARGER THAN THE
EPISEPALS.


Fig. 10—AN ANTHER AND THREAD OF STAMEN.


Fig. 11—POLLEN SEEDS.

(Dimensions: 35 p. × 28 p.)


Fig. 12—STYLE AND STIGMATE.


Fig. 13—FLORAL DIAGRAM.

The floral formula is: [5 S] + 5 P + [10 E] - [3 C].




We are justified in saying: Never has anything been so highly
recommended and every trial proves its excellence.

[Illustration: _"Mariani Bottle," showing Shape and Label._

Size of Regular Bottle, half litre (about 17 ounces).]

[Illustration: _"Mariani Bottle," showing Outside Wrapper._

Never sold in bulk—to guard against substitution.]

VIN MARIANI

_Nourishes_ = _Fortifies_

_Refreshes_

_Aids Digestion_ = _Strengthens the System_.

Unequaled as a tonic-stimulant for fatigued or overworked Body and
Brain.

Prevents Malaria, Influenza and Wasting Diseases.

 We cannot aim to gain support for our preparation through cheapness;
 we give a uniform, effective and honest article, and respectfully ask
 personal testing of =Vin Mariani= strictly on its own merits. Thus the
 medical profession can judge whether =Vin Mariani= is deserving of the
 unequaled reputation it has earned throughout the world during more
 than 30 years.

 Inferior, so-called Coca preparations (variable solutions of Cocaine
 and cheap wines), which have been proven worthless, even harmful in
 effect, bring into discredit and destroy confidence in a valuable drug.

We therefore particularly caution to specify always "VIN MARIANI," thus
we can guarantee invariable satisfaction to physician and patient.




FOOTNOTES

[1] Nothnagel et Rossbach, _Nouveaux Éléments de Thérapeutique_.

[2] This cut represents the Coca shrub presented by Mr. A. Mariani to
the Paris Botanical Gardens.

[3] Mr. Mariani has presented to the Academy of Medicine a plaster cast
of this very _poporo_, in his possession.

[4] Dr. Demarle, _Essay on Peruvian Coca_, _Thèse de Paris_, 1862.

[5] Moreno y Maïz, _Thèse de Paris_, 1868.

[6] Lippmann, _Thèse de Strasbourg_, 1868.

[7] Gazeau, _Thèse de Paris_, 1870.

[8] _Gazette des Hopitaux_, Paris, March 12, 1877.

[9] Rigolet. _Thèse de Paris_, 1885.

[10] Soc. imp. royale des médecins de Vienne, Oct. 17, 1884.

[11] Rigolet, _Thèse de Paris_, 1888.

[12] M. Panas. Communication à l'Acad. de Médecine, November, 1884.

[13] Dr. Laffont. _Etude physiologique sur la Coca et les sels de Coca._

[14] _Thèse de Paris_, 1862.

[15] _Thèse de Paris_, 1885.

[16] _Bumstead and Taylor on Venereal Diseases._

[17] _Thérapeutique contemporaine_, January, 1888.

[18] _Concours Médical_ Aug. 11, 1888.

[19] _Bulletin gen. de Thérap._ 1884.

[20] "Heart-strain and Weak Heart," _N. Y. Medical Record_, Feb. 26,
page 238.

[21] We have on file upward of 7,000 endorsements from leading
practitioners, all coinciding as to the great aid rendered by _Vin
Mariani_ as a tonic-stimulant.

[22] It has been repeatedly proven that the many worthless, so-called
Coca preparations are nothing more than variable solutions of Cocaine
in inferior grades of wines or other liquids, shamefully prepared by
unscrupulous or ignorant persons, whereby, in addition to the harmful
effects they produce, also bring into discredit a really useful drug.


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TRANSCRIBER'S NOTES


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