Transcriber’s Notes

Obvious typographical errors have been silently corrected. Variations
in hyphenation and accents have been standardised but all other
spelling and punctuation remains unchanged.

Italics are represented thus _italic_, bold thus =bold=.




[Illustration: 1. ERYTHROXYLON COCA. 2. BACK OF LEAF (_Full size_.) 3.
FLOWER (_enlarged_.) 4. FRUIT.]


                         COCA AND COCAINE:

                          THEIR HISTORY,
                    MEDICAL AND ECONOMIC USES,
                                AND
                      MEDICINAL PREPARATIONS.

                                BY
                    WILLIAM MARTINDALE, F.C.S.

         _Late Examiner of the Pharmaceutical Society, and
  Late Teacher of Pharmacy and Demonstrator of Materia Medica at
                       University College._

                        JOINT AUTHOR OF THE
                       “EXTRA PHARMACOPŒIA.”

                         _SECOND EDITION._

                              LONDON:
               H. K. LEWIS, 136, GOWER STREET, W.C.
                               1892.


                              LONDON:
               PRINTED AT 74-76, GREAT QUEEN STREET,
                       LINCOLN’S-INN-FIELDS.




                     PREFACE TO THE FIRST EDITION.


I have been induced to compile this brochure, as supplementary to the
short description of Coca given in the “Extra Pharmacopœia,” on account
of the attention this plant, and its alkaloid Cocaine, have excited
during the past eighteen months.

Although made known to us soon after the conquest of Peru by
Pizarro—more than three centuries ago—the accounts travellers have
given of Coca have only received about the same credence, and been
treated with about the same reverence as we pay to a myth. We have
considered the writers as having been overcredulous, as in some cases
they undoubtedly were. It was thought the use of the leaves by the
Indians of Peru was only that of a masticatory, which simply increased
the flow of saliva. We looked upon its so-called nutritive properties,
or rather its hunger and thirst-appeasing effects, as well as its power
to ward off fatigue and relieve oppressive respiration during mountain
ascents, as superstitions unworthy of more attention than the betel-nut
mastication practised in India. The surgical uses of Cocaine as a local
anæsthetic have, however, to some extent dispelled these illusions, and
we have been more ready to receive the accounts of early as well as
recent travellers, thinking “there may be something in them.” I have
endeavoured to reproduce what many have written, as much as possible in
their own words, or translations of them.

The old habit of Coca chewing has clung to the Peruvian Indians after
their “power, civilisation, language, alphabets, writings, and even
old religions have disappeared,” says Johnston,[1] “the common-life
customs and the bodily features of the people have alone survived.” By
him Coca is classed among the “Narcotics we indulge in,” along with
Tobacco, Hop, Poppy and Lettuce, Indian Hemp, Areca or Betel-nut,
Ava or Kava, Red Thorn Apple (_Datura sanguinea_) fruit, also in
use among the Indians of the Andes, Siberian Fungus or Fly Agaric
(_Amanita muscaria_), and Sweet Gale (_Myrica Gale_), formerly used to
give bitterness and strength to the fermented liquors of the ancient
Britons. But physiologists have more recently classed it with Tea,
Coffee, Maté, Kola Nut, and Cocoa—the Theine- (Methyl-Theobromine) and
Theobromine-yielding plants—although Cocaine has no chemical alliance
with these principles. As a beverage to substitute for tea or coffee, a
decoction or an infusion of Coca is worthy of attention at the present
time. The Indian use of it in moderation seems to prolong life, without
much need of sleep or food, or even the desire for these, although
in excess it has, no doubt, a degrading effect. A taste for infusion
or decoction of Coca or its pharmaceutical preparations is easily
acquired; if a good sample of leaves be used it is not even at first
disagreeable.

 [Footnote 1: “Chemistry of Common Life,” Vol. ii., p. 398.]

As the plant admits of easy acclimatisation, and yields annually
several crops of leaves, should it come into more extended use it is
probable that its cultivation in suitable localities in mountainous
parts of India, Ceylon, and Jamaica will prove a profitable enterprise
to planters now commencing the growth of it.

       *       *       *       *       *

The following abbreviations are used:—

 B.M.J. for _British Medical Journal_; L. for _The Lancet_; M.R.
 for _The London Medical Record_; M.T.G. for _The Medical Times and
 Gazette_; Off. for _Official_—in the _British Pharmacopæia_; P.J. for
 _Pharmaceutical Journal_; Pr. for _The Practitioner_.

My thanks are due to my colleague, Dr. Wynn Westcott, for valuable
assistance and aid in abstracting some of the references.

  WM. MARTINDALE.

  NEW CAVENDISH ST., W.
  _March, 1886._




                    PREFACE TO THE SECOND EDITION.


The text has been revised; the views of physiologists, therapeutists,
oculists, and surgeons generally have been brought up to date; those
of chemists of the constitution of Cocaine have been epitomized, and
pharmaceutical and chemical notes have been added on the modes of
dispensing and testing the purity of Hydrochlorate of Cocaine. Being
printed in larger type than the first edition, I trust it may be more
acceptable to general medical readers.

  W. M.

 _January, 1892._




                               CONTENTS.


                                                                    PAGE
  PREFACE                                                            iii

  INTRODUCTION                                                         1


                              CHAPTER I.

  EARLY HISTORY                                                        2

 The accounts given by Cieza de Leon, Nicholas Monardes, Augostin de
 Zarate, and Joseph Acosta.


                              CHAPTER II.

  SUPERSTITIONS IN REGARD TO COCA                                      5

 Mode of use by the Incas—Von Tschudi on its use in Peru—Pöppig on
 its use as a viaticum in Huanuco—Effects produced by the Spanish
 conquest of Peru—Condemnation of its use—Owners of mines encourage its
 use—Continued increase in production.


                             CHAPTER III.

  COCA IN LITERATURE                                                   8

 Unnoticed by modern pharmacologists—Extract from Abraham Cowley, the
 poet.


                              CHAPTER IV.

  ACCOUNTS OF MODERN TRAVELLERS                                       10

 Von Tschudi, “Travels in Peru”—The custom of masticating
 Coca—Facilitates mountain ascents and any hard labour—Pöppig on
 average yield—Intemperate use of Coca—Coca-craving among the
 Peruvians—Sufferings of _coqueros_.


                              CHAPTER V.

  DR. WEDDELL’S ACCOUNT                                               15

 Mode of cultivation—Amount of crop—Suitable soils—Mode of collection
 and drying—Mode of use by Peruvians—Description of the leaves—Effects
 of the leaves—Relief of hunger, a nutriment, effects of habit.


                              CHAPTER VI.

  SCHERZER, FUENTES, AND OTHERS, ON COCA                              24

 Carl Scherzer’s narrative—Fuentes on its value to miners, travellers,
 and those exposed to wet and cold—Flores on its use by the Indians
 of Bolivia—Martius on its use in Brazil—R. Spruce on its use on the
 Amazon—Fitzroy Cole describes its use in Peru.


                             CHAPTER VII.

  THE CULTIVATION OF COCA                                             28

 Dr. Rusby on its modern cultivation in Bolivia—Quality of the
 leaves—The harvest—Diseases of the Coca-plants—Mode of drying and
 exporting the leaves—Probable results of the exportation of the
 culture to Mexico, East and West Indies, and Jamaica.

                             CHAPTER VIII.

  DR. MANTEGAZZA’S EXPERIMENTS                                        37

 Résumé of its uses and abuse in Peru—Personal experiments—Summary of
 results.


                              CHAPTER IX.

  BOTANICAL SOURCE AND DESCRIPTION                                    42

 Synonyms, habitat—Description of the plant—Description of
 chromo-lithograph frontispiece—Practical hints on choosing
 leaves—Deterioration by exposure and keeping.


                              CHAPTER X.

  COCA IN COMMERCE                                                    46

 Report by Hon. R. Gibbs, U.S. Minister—Mode of importation into Europe.


                              CHAPTER XI.

  USE OF COCA AS A RESTORATIVE                                        48

 Resembles Tea in its action—Apt to cause insomnia—Taste, and effects
 of its use in infusion.


                             CHAPTER XII.

  PHARMACEUTICAL PREPARATIONS                                         50

 Elixir—Extractum Liquidum—Extractum—Infusum—Pastillus
 Extracti—Vinum—Coca Wine.


                             CHAPTER XIII.

  MEDICAL USES AND REFERENCES                                         52

 Tonic effects—Relief of fatigue—Relief of various diseases and
 symptoms—Coca-craving—Topical effects—Abstracts from the medical
 journals.


                             CHAPTER XIV.

  COCAINE AND ITS SALTS                                               54

 Cocaina—Chemical constitution—Mode of preparation—Tests and
 solubilities—Bougies—Ceratum—Collodium—Emplastrum—Oleatum Oleum cum
 Cocainâ—Suppositories—Pessaries—Tabellæ—Unguentum—Vaselinum—Cocainæ
 Citras—Cocainæ Hydrobromas—Cocainæ Hydrochloras—Buginaria—Injectio
 Hypodermica—Lamellæ—Liquor—Pastillus—Pilula—Tabloids—Trochisci—Cocainæ
 Salicylas—Dentifricium.


                              CHAPTER XV.

  USES OF COCAINE                                                     61

 Local anæsthetic effects—Mydriatic effects, surgical uses—Toxic
 effects, its mode of action—Diseases for which it is useful.


                             CHAPTER XVI.

  MEDICAL NOTES AND REFERENCES                                        69




[Illustration: Decoration]




                             INTRODUCTION.


The medical interest which has centred in Cocaine as a local anæsthetic
during the last few years, has gradually become diffused as “public
opinion,” the more so, of late, as it has been recommended as a remedy
for sea-sickness, from which Britons all more or less suffer on leaving
our seagirt home; otherwise, internally, Cocaine has been but little
used compared with its probably extended use in the future, when its
effects are better known. This now important alkaloid is obtained from
the leaves of _Erythroxylon Coca_, Lamarck, a shrub cultivated on the
eastern slopes and plateaux of the Andes, chiefly in Bolivia and Peru,
but also in the Argentine Republic, Ecuador, United States of Colombia,
and Central America, as far north as San Salvador, and latterly in
Java, Ceylon, and some parts of British India.




                           COCA AND COCAINE.


                              CHAPTER I.

                            EARLY HISTORY.


The earliest accounts extant of Coca are contained in the writings of
the historians who treat of the Spanish conquests in South America
in the sixteenth century, and of Spanish travellers and Jesuit
missionaries who followed in their wake.

Pedro de Cieza de Leon thus writes,[2] (A.D. 1532 to 1550):—

 “I have observed in all parts of the _West Indies_, where I have been,
 that the natives delight in holding herbs, roots, or twigs of trees in
 their mouths. Thus, in the territory of _Antiocha_, they use a small
 Herb called _Coca_, and other sorts in the province of _Arma_. In
 those of _Quimbaya_ and _Anzerma_, they cut twigs off a sort of tender
 middling trees, which are always green, wherewith they are incessantly
 rubbing their teeth. In most parts about _Cali_ and _Popayan_, they
 hold in their mouths the aforesaid small _Coca_, with a composition
 they keep in little calabashes, or else a sort of earth, like lime.
 Throughout all _Peru_, from the time they rise in the morning till
 they go to bed at night, they are never without this _Coca_ in their
 mouths. The reason some _Indians_, to whom I put the question, gave me
 for so doing, was, that it made them insensible of hunger, and added
 to their strength and vigour. Something there may be in it, yet I am
 rather of opinion it is only an ill habit, and fit for such people as
 they are.

 “This _Coca_ is planted on the Mountains _Andes_, from _Guamanga_,
 to the town of _La Plata_, where it grows up to little trees, which
 they cherish and nurse up carefully, that they may bear those leaves,
 resembling our Myrtle. They dry them in the sun, and then lay them
 in long narrow baskets, each of them holding about a quarter of a
 hundredweight. So highly was this Coca valued in Peru, in the years
 1548, ’49, ’50, and ’51, that I believe no plant in the world, except
 Spice, could equal it; for at that time most of the plantations
 about _Cuzco_, _La Paz_, and _La Plata_ yielded some 80, some 60,
 some 40,000 pieces-of-eight a year, more or less, and all in _Coca_;
 and whoever had lands assigned him first reckoned how many baskets
 of _Coca_ they yielded. In fine, it was more esteemed than the best
 wheat. They carried it to sell at the mines of _Potosi_; and so many
 fell to planting, that it is now much fallen in the price, but will
 always be valued. Several _Spaniards_ got estates by buying and
 selling of _Coca_, or bartering for it in the Indian markets.”

 [Footnote 2: “The Seventeen Years’ Travels of Pedro de Cieza de Leon
 through the Mighty Kingdom of Peru,” chap. lxxxiii. p. 211 (English
 Translation, London, 1709).]

Nicholas Monardes,[3] a Spanish physician of the sixteenth century,
also quotes Pedro de Cieza de Leon more fully from his Commentaries
“on Peruvian Things” under the heading of Betre (Betel), “History of
Aromatics,” book i., with annotations:—

 [Footnote 3: “Simplicium Medicamentorum ex novo orbe delectorum quorum
 in Medicina usus est Historia.” liber iii. Antwerp, 1582 (translated
 from the Latin edition of Carolus Clusius). I have been unable to
 refer to the original “History of Aromatics” by Cieza, and corroborate
 the statements here made in regard to mastiche, tobacco, and oyster
 shells.]

 “This plant Coca has been celebrated for many years among the Indians,
 and they sow and cultivate it with much care and industry, because
 they all apply it daily to their use and pleasure.

 “It is indeed of the height of two outstretched arms; its leaves
 somewhat like those of Myrtle, but larger and more succulent, and
 green (and they have, as it were, drawn in the middle of them another
 leaf of similar shape); its fruit collected together in a cluster,
 which like Myrtle fruit becomes red when ripening, and of the same
 size, and when quite ripe it is black in colour. When the time of the
 harvest of the leaves arrives, they are collected in baskets with
 other things to make them dry, that they may be better preserved, and
 may be carried to other places. For from their native mountains they
 are carried to other mountainous parts for the sake of trade, and
 are exchanged for other goods, such as clothes and flocks, salt and
 other articles, which stand to these people in the position of money.
 The seed is enclosed in mastiche, and removed from thence is sown
 elsewhere in well-cultivated earth in drills or rows, just as we sow
 the pea or the bean.

 “Its use for many purposes is common among the Indians, for it is a
 necessary to them when on a journey, and they also use it when in
 their homes for their enjoyment, and in this manner—they burn the
 shells of oysters and other shells, and thus make the lime into a
 powder, then they grind up the Coca leaves with their teeth, this they
 mix with the powder of the burnt shells, and thus mingle both at once,
 but the quantity of lime, however, must be less than the amount of
 leaf; from this mass they prepare small balls or lozenges, and expose
 them to dry.

 “When they require to use these, they take one little ball into the
 mouth, and suck it, turning it now this way now that way as long as
 they can retain it; one being consumed, they take another, and then a
 third, proceeding thus the whole time they have need during their long
 journeys, especially if they are in neighbourhoods where neither bread
 nor water are plentiful, because they assert that by this suction
 of these little balls their thirst is removed, and their strength
 preserved.

 “If, on the other hand, they desire to use the Coca for the sake of
 enjoyment, they use it alone, turning it over and over in the mouth,
 until all its properties are exhausted, then they take more. But, if
 their purpose is to be inebriated, or to be taken to some extent out
 of themselves as if by mental alienation, they mix the leaves of Coca
 with those of Tobacco, and chew and suck them simultaneously; by this
 means they find themselves with their reason lost to them, and are
 like drunken men, and they experience thence very great pleasure.
 Wonder at this matter is not wanting, when these Indians are observed
 to be in this state of delight and deprivation of mind and sense, for
 they do indeed use Tobacco and Coca together for this purpose, or even
 Tobacco alone, as we describe in the second volume of this history.”

Augostin de Zarate[4] says:—

 “In certain valleys, among the mountains, the heat is marvellous, and
 there groweth a certain herb called Coca, which the Indians do esteem
 more than gold or silver; the leaves thereof are like unto Zumake
 (sumach), the virtue of this herb found by experience is that any man
 having these leaves in his mouth hath never hunger nor thirst.”

Joseph Acosta,[5] the Jesuit, describes the use of Coca by the natives
of Peru, and says:—

 “For my part, and to say the truth, I am persuaded that it is not pure
 imagination; but, on the contrary, I hold that it gives strength and
 courage to the Indians; for one sees the effect of it, which cannot be
 attributed to imagination, as in travelling without food during many
 days with a handful of Coca and other similar agents.”

 [Footnote 4: “Strange and delectable history of the Discovery of Peru”
 (translated T. Nichols, 1581, from the Spanish of 1555, book i. chap.
 viii.).]

 [Footnote 5: “Natural History of the Indies,” (translated into Latin
 by R. R. Cauxois, 1600) from the Spanish of 1590, book v. chap. xxii.]




                              CHAPTER II.

                   SUPERSTITIONS IN REGARD TO COCA.


The employment of Coca as a masticatory goes back to the time of the
first Incas, being used in their religious rites as an offering to the
sun; the sacrificing priest never consulted the oracles without holding
some Coca leaves in his mouth, and throwing some into the fire which
consumed the victims. It was reserved for this use, and for that of the
monarch and those who for services rendered had become worthy of the
honour of partaking of it with their sovereign.

Von Tschudi[6] says:—“By the Peruvian Indians the Coca plant is
regarded as something sacred and mysterious, and it sustained an
important part in the religion of the Incas. In all ceremonies, whether
religious or warlike, it was introduced for producing smoke at the
great offerings, or as the sacrifice itself.”

[Footnote 6: Travels in Peru, 1838 to 1842, p. 454. London: 1847.]

 “During divine worship the priests chewed Coca leaves, and unless
 they were supplied with them, it was believed that the favour of the
 gods could not be propitiated. It was also deemed necessary that the
 supplicator for divine grace should approach the priests with an
 _acullico_ (or quid) in his mouth. It was believed that any business
 undertaken without the benediction of Coca leaves could not prosper,
 and to the shrub itself worship was rendered. During an interval of
 more than three hundred years Christianity has not been able to subdue
 this deep-rooted idolatry, for everywhere we find traces of belief
 in the mysterious powers of this plant. The excavators in the mines
 of Cerro de Pasco throw chewed Coca on hard veins of metal, in the
 belief that it softens the ore and renders it more easy to work. The
 origin of this custom is easily explained, when it is recollected
 that in the time of the Incas it was believed that the _Coyas_—the
 deities of metals—rendered the mountains impenetrable if they were not
 propitiated by the odour of Coca. The Indians, even at the present
 time, put Coca leaves into the mouths of dead persons, to secure to
 them a favourable reception on their entrance into another world;
 and when a Peruvian Indian on a journey falls in with a mummy, he,
 with timid reverence, presents to it some Coca leaves as his pious
 offering.”

The reliance, Pöppig says, on its extraordinary virtues among the
Peruvian Indians is so strong that, in the Huanuco Province, they
believe that if a dying man can taste a leaf placed on the tongue, it
is a sure sign of his future happiness.[7]

 [Footnote 7: Quoted in Markham’s Travels in Peru and India. London,
 1862.]

After the Spanish conquest the cultivation of Coca much increased for
a time, as described by Pedro de Cieza and Garcilasso de la Vega, the
Inca historian (who spells its name as Cuca); the latter and Acosta
exalted its virtues, yet some fanatics proposed to proscribe its
use, and root up the plants, because it had been used in the ancient
superstitions, and its cultivation took the Indians away from their
other work. The reverence rendered by the natives to it induced the
Spaniards to believe that it possessed some demoniacal influence.
“The second Council of Lima, consisting of bishops from all parts
of South America,” therefore “condemned the use of Coca in 1567.
It was described ‘as a worthless object, fitted for the misuse and
superstition of the Indians;’ and a royal decree of October 18, 1569,
expressly declares that the notion entertained by the natives is an
illusion of the devil.” In addition, numerous complaints were made to
the home government, who espoused the cause of the Indians, the latter
having been driven from the high Andes and employed by forced labour in
its cultivation in the Cocals, situated on moist, warm slopes. This was
a change of climate which proved fatal to their health. The Peruvian
mine owners were the first to discover the importance of _chacchar_, or
Coca-chewing, in assisting the Indians to go through their excessive
labour, and they, together with the plantation owners, became the most
earnest defenders of Coca. The consequence was that in defiance of
royal and ecclesiastical ordinances (like tobacco after King James’s
“Counterblast”) its use rather increased than diminished. One of the
warmest advocates of the plant was the Jesuit Don Antonio Julian,
who, in a work entitled “Perla de America,” laments that Coca is not
introduced into Europe instead of tea and coffee. “It is,” he observes,
“melancholy to reflect that the poor of Europe cannot obtain this
preservative against hunger and thirst; that our working people are not
supported by this strengthening plant in their long-continued labours.”

Under Don Francisco de Toledo, Viceroy of Peru, the cultivation
continued, conditionally on voluntary and well-paid labourers only
being employed in the Cocals. At this period of its prosperity, which
is much exceeded at the present day, in the mines of Cerro de Potosi
alone, Dr. Weddell, the quinologist, says it was consumed to the extent
of one million kilogrammes (2,204,860 lbs. Eng.) annually. But after
this the culture of Coca greatly decreased, as, owing to the hardships
endured by the Indians tending its growth and to other occupations,
their race suffered a great depopulation.




                             CHAPTER III.

                          COCA IN LITERATURE.


Coca has not been official in any but the last Codex, and last United
States, British, Austrian, Belgian, and Chilian Pharmacopœias, and
although mentioned by Guibourt and tried by Sir Robert Christison upon
himself (see p. 53), it is not mentioned by such pharmacologists as
Quincy, Pereira, or Hanbury. As a theme for the poet, Milton, who drew
many of his similes from tropical plants and scenery, appears not to
have known of it, as he does not mention it. Abraham Cowley, later, in
his Book V. of Plants, makes Bacchus fill Omelichilus[8] “a bowl with
juice from grape,” but

 [Footnote 8: “An American Godling;” the names of others follow.]

    “He unaccustom’d to the acid juice
    Storm’d and with blows had answer’d the abuse,
    But fear’d t’engage the _European_ Guest,
    Whose Strength and Courage had subdu’d the _East_.
    He therefore chooses a less dang’rous Fray,
    And summons all his Country’s Plants away:
    Forthwith in decent Order they appear,
    And various Fruits on various Branches wear.
    Like _Amazons_ they stand in painted Arms,
    _Coca_ alone appeared with little Charms,
    Yet led the Van, our scoffing Venus scorn’d
    The shrub-like tree, and with no Fruit adorn’d,
    The _Indian_ Plants, said she, are like to speed
    In this dispute of the most fertile Breed,
    Who choose a _Dwarf_ and Eunuch for their head;
    Our Gods laugh’d out aloud at what she said,
    Pachamama defends her darling Tree,
    And said the wanton Goddess was too free;
    You only know the fruitfulness of Lust,
    And therefore here your judgment is unjust,
    Your skill in other off-springs we may trust,
    With those Chast tribes that no distinction know
    Of Sex, your Province nothing has to do.
    Of all the Plants that any soil does bear,
    This Tree in Fruits the richest does appear,
    It bears the best, and bears ’em all the year.
    Ev’n now with Fruits ’tis stored—why laugh you yet
    Behold how thick with Leaves it is beset,
    Each Leaf is Fruit, and such substantial fare,
    No Fruit beside to rival it will dare.
    Mov’d with his Country’s coming Fate (whose Soil
    Must for her Treasures be exposed to spoil)
    Our _Varicocha_ first this _Coca_ sent,
    Endow’d with Leaves of wond’rous Nourishment,
    Whose Juice Succ’d in, and to the Stomach tak’n
    Long Hunger and long Labour can sustain;
    From which our faint and weary Bodies find
    More Succour, more they cheer the drooping Mind,
    Than can your _Bacchus_ and your _Ceres_ joined.
    Three Leaves supply for six days’ march afford.
    The _Quitoita_ with this Provision stor’d
    Can pass the vast and cloudy Andes o’er.
    The dreadful _Andes_ plac’d ’twixt Winter’s store
    Of Winds, Rains, Snow, and that more humble Earth,
    That gave the small but valiant _Coca_ Birth;
    This Champion that makes warlike _Venus_ Mirth.
    Nor _Coca_ only useful art at home,
    A famous Merchandize thou art become;
    A thousand _Paci_ and _Vicugni_ groan,
    Yearly beneath thy Loads, and for thy Sake alone
    The spacious World’s to us by Commerce known.
    Thus spake the Goddess, (on her painted Skin
    Were figures wrought) and next calls _Hovia_[9] in,
    That for its stony Fruit may be despis’d,
    But for its Virtue next to _Coca_ priz’d
    Her shade by wondrous Influence can compose,
    And lock the Senses in such sweet Repose,
    That oft the Natives of a distant Soil
    Long Journeys take of voluntary Toil,
    Only to sleep beneath her Branches’ shade:
    Where in transporting Dreams entranc’d they lye,
    And quite forget the _Spaniards’_ Tyranny.”

 [Footnote 9: I have not been able to identify this plant; if intended
 to be anything more than a creature of the poet’s imagination, it
 probably yielded a sedative drug known two centuries ago, which is now
 lost to us.]




                              CHAPTER IV.

                    ACCOUNTS OF MODERN TRAVELLERS.


All the mountain Indians,[10] Von Tschudi states, are addicted more
or less to the practice of masticating Coca. Each man consumes, on
an average, between an ounce and an ounce and a half per day, and
on festival days about double that quantity. The owners of mines and
plantations allow their labourers to suspend their work three times a
day for the _chacchar_ or masticating operation, which usually occupies
upwards of a quarter of an hour; and after that they smoke a paper
cigar, which they allege crowns the zest of the Coca mastication. The
Coca leaves, he says, are taken deliberately one by one, stillness and
repose being indispensable to their full enjoyment. No urging of the
traveller will interrupt the Indian in this meal,—the servant would
leave his master if prohibited the use of Coca—he would rather miss
food. In a state of silent abstraction the leaves are first masticated
into a small ball or _acullico_, a thin slip of damp wood is then
thrust into the _ishcupuru_ or gourd, containing lime, and when drawn
out, some portion of the powder it contains adheres. The _acullico_,
or ball of masticated Coca leaves is, whilst still lying in the mouth,
punctured with this slip of wood, until the lime mixing with it
(setting free its alkaloid), gives it a proper relish, and the abundant
flow of saliva thus excited is partly expectorated (? see Weddell, p.
19) and partly swallowed. When the ball ceases to emit juice, it is
thrown away, and a new one is formed by the mastication of a fresh
mouthful of Coca leaves. In Cerro de Pasco, and in places still farther
south, the Indians use instead of unslaked lime a preparation of the
pungent ashes of the Quinoa (_Chenopodium Quinoa_, L). This preparation
is called _Llucta_ or _Llipta_. In using it a piece is broken off and
masticated along with the _acullico_. In some regions the _Llipta_ is
made from the musa root.

 [Footnote 10: Travels in Peru, by J. J. Von Tschudi. London: 1847, p.
 450.]

The Indians maintain that Coca is the best preventive of that
difficulty of respiration felt in the rapid ascents of the Cordilleras
and the Puna. “Of this fact,” says Von Tschudi,[11] “I was fully
convinced by my own experience. I speak here, not of the mastication of
the leaves, but of their decoction taken as a beverage.”

 [Footnote 11: Op. cit. p. 454.]

 “When I was in the Puna, at the height of fourteen thousand feet
 above the level of the sea, I drank always before going out to hunt,
 a strong infusion of Coca leaves. I could then, during the whole day,
 climb the heights and follow the swift-footed wild animals, without
 experiencing any greater difficulty of breathing than I should have
 felt in similar rapid movements on the coast. Moreover, I did not
 suffer from the symptoms of cerebral excitement or uneasiness which
 other travellers have experienced. The reason, perhaps, is, that I
 only drank the decoction on the cold Puna, where the nervous system
 is far less susceptible than in the climate of the forests beneath.
 However, I always felt a sense of great satiety after taking the Coca
 infusion, and I did not feel a desire for my next meal until after the
 time at which I usually took it.”

He also says:—

 “A cholo of Huarai, named Hatan Huamang, was employed by me in very
 laborious digging. During the five days and nights he was in my
 service he never tasted any food, and took only two hours’ sleep each
 night. But at intervals of two and a half or three hours he regularly
 chewed about half an ounce of Coca leaves, and he kept an _acullico_
 continually in his mouth. I was constantly beside him, and therefore
 I had the opportunity of closely observing him. The work for which I
 engaged him being finished, he accompanied me on a two days’ journey
 of twenty-three leagues across the level heights. Though on foot, he
 kept up with the pace of my mule, and halted only for the _chacchar_.
 On leaving me, he declared he would willingly engage himself again for
 the same amount of work, and that he would go through it without food,
 if I would but allow him a sufficient supply of coca. The village
 priest assured me that this man was sixty-two years of age, and that
 he had never known him to be ill in his life.”

In this account we cannot but conclude that the traveller’s credulity
was imposed on. He further adds:—

 “Setting aside all extravagant and visionary notions on the subject,
 I am clearly of opinion that the moderate use of Coca is not merely
 innoxious, but that it may even be very conducive to health.”

He instances cases “by no means singular,” of longevity among the
Indians of individuals who had attained the great age of 130 years,
under its use.

Pöppig[12] says the average yield of a Cocal or Coca plantation is
about 800 lbs. of dry leaves per English acre. When nearly dry, he
says, they emit an odour similar to mellilot, or the new-mown hay odour
of _Anthoxanthum odoratum_ (probably due to coumarin), which causes
headache to strangers. If not perfectly dry when packed they heat and
ferment, and become inert and useless, especially to the manufacturer
of Cocaine.

 [Footnote 12: Companion to _Bot. Mag._, 1835, i. 161, translated from
 “Reise im Chile, Peru und auf dem Amazon Ström, 1827 to 1832.”]

Both Pöppig and Von Tschudi give a doleful account of the intemperate
use of Coca by the inveterate _coquero_, as he is called,—his bad
breath, pale lips and gums, greenish and stumpy teeth, and an ugly
black mark at the angles of his mouth, his unsteady gait, yellow skin,
dim and sunken eyes encircled by a purple ring, his quivering lips, and
his general apathy—all bear evidence of the baneful effects of the Coca
when taken in excess. He prefers solitude, and, when a slave to his
cravings, he will often take himself for days together to the silence
of the woods to indulge unrestrained the use of the leaf. The habit
must be very seducing, as, though long stigmatised and very generally
considered as a degrading, purely Indian vice, many white Peruvians
at Lima and elsewhere retire daily at stated times to chew Coca. Even
Europeans, Von Tschudi says, have fallen into the habit. Both he and
Pöppig mention instances of white _coqueros_ of good Peruvian families
who were addicted to the vice. One is described by Pöppig who became
averse to any exertion; city life and its restraints were hateful
to him; he lived in a miserable hut; once a month, at least, when
irresistibly seized with the passion he would disappear into the forest
and be lost for many days, after which he would emerge sick, powerless,
and altered.

 “He was of use to me,” he says, “as a good and eager sportsman, and
 by liberally supplying him with such fine gunpowder as he could
 not obtain by purchase, I soon gained his perfect confidence and
 goodwill. His disposition was generally kind, but any remonstrance
 against his vice would throw him into an ungovernable rage. He has
 frequently assured me in confidential moments that he would rather,
 as he has done for months together, live alone in the midst of some
 Coca shrubs in the most solitary spot in the wilderness, depending for
 support on his fishing-line and gun than return home to his family
 at Huanuco. His description of the lovely visions that appeared to
 him in the forest at night, and of his delicious sensation at such
 moments, had in it something truly awful. When it rained he used to
 cover his half-naked body with the soddened leaves that had fallen
 from the trees, and he assured me that when this wretched substitute
 for raiment was brought to steam by the warmth of his person, that he
 could lie thus enveloped for hours without experiencing inconvenience
 or cold.”

Such isolated cases, in some respects at least parallel, in inveterate
drunkards, are occasionally met with in this country. _Coqueros_ become
afflicted with a peculiar disease. Pöppig says:—

 “The natives of the cold and dry districts of the Andes are more
 addicted to the consumption of Coca than those of the close forests,
 where, undoubtedly, other stimulants do but take its place. Weakness
 in the digestive organs, ... increasing continually in a greater or
 less degree, first attacks the unfortunate _coquero_. This complaint,
 which is called _opilacion_, may be trifling in the beginning, but
 soon attains an alarming height. Then come bilious obstructions,
 attended with all those thousand painful symptoms which are so
 much aggravated by tropical climate. Jaundice and derangement of
 the nervous system follow, along with pains in the head, and such
 prostration of strength that the patient speedily loses all appetite;
 the hue of the whites assumes a leaden colour, and a total inability
 to sleep ensues, which aggravates the mental depression of the unhappy
 individual, who, in spite of all his ills, cannot relinquish the use
 of the herb to which he owes his sufferings, but craves brandy in
 addition. The appetite becomes quite irregular, sometimes failing
 altogether, and sometimes assuming a wolfish voracity, especially for
 animal food. Thus do years of misery drag on, succeeded at length by a
 painful death.”

Later, Dr. Weddell, however, who travelled where Coca was most in use,
saw no results from its use at all bearing comparison with these just
narrated. He gives the following interesting detailed account of the
growth, cultivation, and use of Coca from personal observation.




                              CHAPTER V.

                      DR. WEDDELL’S ACCOUNT.[13]


 “The cultivation of _Erythoxylon Coca_, as carried on in Bolivia in
 the present day, does not appear to differ from that which prevailed
 previous to the conquest; and the province of Yungas de la Paz is
 that which, since the Spanish occupation, seems to have supported
 the most considerable plantations. All the slopes of the mountains,
 below an elevation of 2,200 mètres [7,217 feet], are literally covered
 with them, and the traveller has continually in view the factories or
 _haciendas_ where the leaf is prepared for the purposes of trade.

 [Footnote 13: _Pharm. Journ._ 1854, pp. 162-4, 213-5, translated from
 Dr. Weddell’s “Voyage dans le nord de la Bolivie.” Paris: 1853, 8vo.
 ch. xxix.]

 “The _Coca_ shrub is propagated from seed. For this purpose the seeds,
 immediately after gathering, are scattered on the surface of the
 light and frequently watered soil of a little nursery (_almaciga_),
 where they come up generally at the end of ten or fifteen days. The
 waterings are continued, and should the sun strike the young plants
 too violently, they are sheltered with mats.

 “The following year the shrubs, whose height is already from 40 to 50
 centimètres [16 to 20 inches] are transplanted into a plot of ground
 specially prepared for them and called a _cocal_. The arrangement of
 these plantations is much more complicated than that of an ordinary
 plantation, and varies according to the inclination of the surface.
 When the _cocal_ occupies the slope of a mountain, which is the usual
 case, the cultivator forms a series of narrow steps, each intended for
 a single row of shrubs, and the more elevated (consequently the less
 numerous) as the surface is more steep. They are generally supported
 by little stone walls, which serve not merely to contain the earth
 and prevent its drying, but also to protect the stem and roots of the
 young shrubs from the too direct influence of the solar rays, by means
 of the projection which they form above the level of the soil.

 “Where the ground is level, they make, instead of steps or terraces,
 simple furrows (_uachos_) in a straight line, and separated from one
 another by little walls of well-moulded earth, called _umachas_, at
 the foot of each of which is planted a row of the shrubs, more or less
 far apart from each other.

 “At the end of a year and a half the plant affords its first crop, and
 from this period to the age of forty years or more it continues to
 yield a supply. Instances are cited of _Coca_ plantations which have
 existed for nearly a century, and which still produce. Nevertheless,
 the greatest abundance of leaves is obtained from plants of from three
 to six years of age. When the trees run up too much, the produce is
 less than when they spread; they are therefore pruned in some cases to
 favour an increase in breadth, which, however, is never considerable,
 as the form of the shrub is irregular. The average height of the wild
 plant appears to be about 2 mètres, but in cultivation it is generally
 allowed to attain but 1 mètre [39 inches].

 “The first gathering which takes place in a Coca plantation is at the
 expense of only the lower leaves of the shrubs, and it is therefore
 called _quita calzon_.[14] The leaves of which this gathering consists
 are larger and more coriaceous than those of subsequent collections,
 and also have less flavour. They are mostly consumed on the spot. All
 the other gatherings go by the name of _mitas_, and take place three
 times, or exceptionally, four times per annum. The most abundant
 harvest is that occurring in March—that is, immediately after the
 rains; this is the _mita de marzo_. The most scanty is that which
 takes place at the end of June or beginning of July, and which is
 called _mita de San Juan_. The third, named _mita de Santos_, is made
 in October or November.

 [Footnote 14: From _quitar_, to take away, and _calzon_, pantaloon.]

 “The watering of the Coca plantations greatly increases their
 productiveness. Forty days are then sufficient, I have been told, for
 naked shrubs to become covered with new leaves; but these leaves are
 not equal in their properties to those produced without irrigation;
 their colour also is less deep, and they frequently blacken in drying.
 Artificial watering is needful, moreover, only during the dry season,
 and the cultivators who have the means of employing it realise nearly
 always four, and sometimes even five, crops in the year. This is
 particularly the case in the districts of Irupana, where there are
 facilities for obtaining water that do not exist elsewhere.

 “I have examined the soil in which _Coca_ is cultivated, and almost
 everywhere have found it composed of sandy, argillaceous earth,
 softish to the touch; it originates in the decay of the schists which
 form the chief geological feature of these mountains. The soil of the
 Coca plantation is, in one word, formed of what we call primitive or
 normal earth, but it is naturally mixed with an abundance of angular
 fragments of unaltered schist which, if not removed, would interfere
 with the growth of the roots. This is therefore done by the cultivator
 while preparing the furrows for the reception of the shrubs, the
 stones being employed for the little walls before spoken of; indeed,
 these little walls, or _umachas_, are often formed entirely of the
 stones thus met with. I need hardly say that it is to the greater or
 less perfection to which this preliminary operation is carried, and to
 the labours incurred subsequently in stirring up the soil from time
 to time, and in keeping it free from weeds, that the _haciendero_
 owes the abundance of his crops. The last operation I have mentioned
 is especially needful while the shrubs are young. The weeding, which
 is regularly performed after each crop has been collected, is called
 _mazi_.

 “The collection of the leaves of the _Erythroxylon_ is performed much
 in the same way as that of tea. It is, in general, women and children
 that are employed upon this operation, which is all the easier from
 the presence of the little walls separating the furrows of the
 plantation. The gatherer squats down, and, holding with one hand the
 branch she wishes to pluck, removes with the other all the leaves,
 often one by one. The leaves are deposited in a cloth, which each
 Indian carries with her, and afterwards collected in sacks or some
 other recipients to be carried from the plantation.

 “Nothing is now easier than the preparation of the _Coca_. The leaves
 are carried from the plantation to the house, or _casa de hacienda_,
 where they are spread out in the sun, in little courts constructed
 especially for the purpose, and the floors of which are formed of
 slabs of black schist (_pizara_); if the weather is fine, they are
 left there until completely dry, which takes place without their shape
 becoming altered. They are then packed with strong pressure into bags
 made of the sheath of the banana leaf, strengthened with an outer
 covering of coarse woollen canvas. The bales thus formed contain,
 on an average, twenty-four pounds of leaves, and go by the name of
 _cestos_. The _tambor_ is a bale of double the size of the _cesto_,
 whose price at La Paz varies from 4½ to 6 piastres” (18s. to 24s.).[15]

 [Footnote 15: “As it is easily damaged by damp in transit, the only
 absolute security is to have it soldered in tin or zinc, enclosed
 in wood; such packages generally contain two tambores, or about a
 Spanish quintal of 100 pounds. Although shipped from many ports along
 the whole coast, the principal port in Peru seems to be Salaverry,
 the port of entry to Truxillo, and the principal port for Bolivia is
 Arica, Mollendo being now closed by the civil war in Peru.”—Squibb’s
 Ephemeris, ii. 792.]

 “The Peruvian ordinarily keeps his Coca in a little bag called
 _chuspa_, which he carries suspended at his side, and which he places
 in front whenever he intends to renew his _chique_, which he does
 at regular intervals, even when travelling. The Indian who prepares
 himself to _acullicar_, _i.e._ to chew, in the first place sets
 himself as perfectly at ease as circumstances permit. If he has a
 burden, he lays it down; he seats himself; then, putting his _chuspa_
 on his knees, he draws from it one by one the leaves which are to
 constitute his fresh ‘quid.’ The attention which he gives to this
 operation is worthy of remark. The complaisance with which the Indian
 buries his hand in the leaves of a well-filled _chuspa_, the regret he
 seems to experience when the bag is nearly empty, deserve observation;
 for these little points prove, as I shall have occasion to repeat
 further on, that to the Indian the use of Coca is a real source of
 enjoyment and not the simple consequence of want.

 “As the Indian deposits the leaves in his mouth he wets them by
 turning them over with the tongue, forming them into a sort of little
 ball, which he places against the cheek as a sailor does his tobacco.
 This done, he takes from his _chuspa_ a little box which generally
 accompanies the Coca, and removes from it a very small quantity of
 an alkaline paste, called _llipta_, which is the ordinary condiment
 to the leaf. The _llipta_ which the Peruvians, and especially the
 Bolivians, are in the habit of using, is made of the ashes of the
 Quinoa (_Chenopodium Quinoa_) or of those of the common _Cereus_. The
 ashes of several other plants, however, are used for the same purpose,
 they are often sold in the markets in the form of little flat cakes.
 In some parts of America lime is substituted for them.

 “From the constancy with which the Indians employ an alkali with the
 Coca, one might presume that it favours the solution of the active
 matter of the leaf; but on this head we know nothing positive. Others
 have said that the _llipta_ was intended to neutralise the acid of the
 leaf; but it is easy to convince oneself that the Coca contains no
 principle of this nature in appreciable quantity.

 “The leaves of the _Erythroxylon_ approach in shape and size those
 of tea, but they have never the dentated margin; on the under side,
 a prominent and curved line on each side of the midrib serves to
 distinguish them from most other leaves known. When dried well, they
 are of a very pale green, deeper on the upper than on the under
 side; their odour is then agreeable, and even analogous to that of
 tea. When, on the contrary, the Coca has been dried less perfectly,
 this agreeable aroma is hardly perceptible, or rather is overpowered
 by a pungent odour, _sui generis_, recalling the abominable smell
 exhaled by the breath of the masticators of Coca, which is, in fact,
 this odour in a concentrated state. This _bouquet_, if I may so term
 it, is very perceptible on tasting the Coca, and serves, according
 to its abundance, in indicating its quality. On the other hand, in
 a concentrated infusion, and still more so in a decoction, it is a
 bitterness mixed with something styptic that more particularly strikes
 the palate.

 “As to the immediate physiological effects of this infusion,
 frequently-repeated trials enable me to assert that they are in
 general limited to a slight excitement, succeeded in most cases by
 some degree of sleeplessness.

 “The questions relative to the effects resulting from the use of Coca
 are less easily determined; we may begin, nevertheless, by stating
 that an immense majority of authors, both ancient and modern, who have
 written on the subject, have agreed in attributing to the Coca-leaf
 thus employed, virtues whose well-ascertained existence would warrant
 it being placed among the more beneficial products of the vegetable
 kingdom; and such would doubtless remain the admitted opinion, had not
 a modern traveller (Pöppig) completely shaken it by supporting an
 opposite view, that is to say, in attributing to Coca very pernicious
 effects, comparable, in fact, to those brought about by the excessive
 use of opium.

 “Such assertions, in the presence of reports so opposite as those
 I have cited, may well cause some astonishment. Individuals are,
 however, not wanting, who give us to understand that, if this
 traveller had not trusted too implicitly to the accounts of
 ill-informed persons, he had erred, at least, in too much generalising
 exceptional facts. For my part, I may say, that the researches that
 I have been able to make on the subject, in localities where the
 Coca is most in use, have shown me that the mastication of the leaf
 does sometimes produce evil consequences among Europeans who have
 not accustomed themselves to it from youth; and, in two or three
 cases, I have thought I could attribute to the abuse of this practice
 a peculiar aberration of the intellectual faculties indicated by
 hallucinations. But, in the countries which I have visited, on no
 occasion have I seen the results to reach the point instanced by M.
 Pöppig.

 “Let us now examine what are the beneficial properties attributable
 to Coca. Of these the most remarkable is undeniably its reputed power
 of sustaining the strength in the absence of any other nutriment.
 The facts on which this opinion rests have been asserted by so many
 credible persons, that scepticism must be carried very far to throw
 over it a doubt; it appears to me, however, that opinions may vary
 according to the interpretation of the same facts.

 “One of two things is certain, either the Coca contains some nutritive
 principle which directly sustains the strength, or it does not contain
 it, and therefore simply _deceives_ hunger, while acting on the system
 as an excitement.

 “As to the existence of a nutritive principle in Coca, I am far from
 wishing to deny it; analysis, indeed, shows the existence in the
 leaf, and especially in its active principle, of a notable quantity
 of nitrogen together with assimilable carbonised products; but the
 proportion of these substances is so small compared with the total
 mass of the leaf, and especially with the quantity of it that the
 Indian consumes in a given time, that they can hardly be taken into
 consideration. Moreover, I can affirm very positively that Coca, as
 it is taken habitually, does _not_ satiate hunger. This is a fact of
 which I have convinced myself by daily experience. The Indians who
 accompanied me on my journey chewed Coca during the whole day; but,
 evening arrived, they filled their stomachs like fasting men, and I
 am certain I have seen one devour as much food at a single meal as I
 should have consumed during two days. The Indian of the Cordillera is
 like the vulture of his mountains; when provisions abound, he gorges
 himself greedily; when they are scarce, his robust nature enables
 him to content himself with very little. The use of Coca assists, it
 may be, to support the abstinence; but we must have cases far more
 conclusive than those which I have witnessed to convince me that it
 plays a part more important than that which I attribute to it. I will,
 however, add to what I have before said of the _llipta_, that this
 alkaline substance may also contribute, by its direct influence on the
 secretions of the stomach, to allay the requirements of that organ.

 “The action of Coca is then, in my opinion, confined to an excitement,
 but an excitement of a peculiar kind, which I consider as very
 different from that resulting from the use of most of the ordinary
 excitants, and especially of alcohol. Brandy gives strength, as all
 know; but who does not know also that the ‘gift’ is but a _loan_ made
 out at the expense of strength reserved for the future? The action of
 this agent, though powerful, is transient. The stimulus produced by
 mastication of the leaf of the _Erythroxylon_ is, on the contrary,
 slow and sustained, characters which it owes, doubtless, in great part
 to the manner of its employment, since an infusion of Coca acts very
 differently from the leaf taken in the ordinary way. It will be said
 that tea and coffee, whose effects appear to have more analogy with
 those of Coca, would perhaps produce analogous results if taken in the
 same manner. I do not believe such would be the case. Tea and coffee
 (coffee in particular) act specially on the brain, on which they
 produce an antisoporific effect, but too well known to those who are
 not in their habitual use. But Coca, while producing a little of this
 effect, when taken in large doses, as I have often experienced in my
 own person, does not act perceptibly upon the brain in small doses. To
 account for the ordinary effects of the leaf, one must then suppose
 that its action, instead of being localised, as in the case of tea
 and coffee, is diffused, and bears upon the nervous system generally,
 producing upon it a sustained stimulus, well suited to impart to those
 who are under its influence that support which has been erroneously
 attributed to peculiar nutritive properties.

 “Finally, I think that in the fidelity of the Indian to the use of
 Coca, as with some smokers and their pipes, much is due to habit;
 and it is, I think, essential not to lose sight of the fact, that
 the force of habit must have an influence all the more powerful,
 since the habit in question is almost the only one he retains of past
 times, and that now, as then, he attaches to the use of the Coca-leaf
 superstitious ideas, which, to his imagination, must at least treble
 the greatness of the benefits he derives from it. Lastly, that in the
 mastication of Coca he finds the sole distraction that breaks the
 incomparable monotony of his existence.”

Dr. Weddell supposes that the word _Coca_ comes from the Aymara
(Indian) _Khoka_, signifying _the tree_ or _plant_, just as the shrub
producing Paraguay Tea (_Ilex Paraguayensis_) is called _la Yerba_,
i.e., _the plant_. Botanical specimens were first sent by Joseph de
Jussieu to his brother in 1750; these Antoine Laurent de Jussieu
referred to the genus _Erythroxylon_, and finally they served as types
for Lamarck to give the plant his designation, _Erythroxylon Coca_, in
the _Encyclopédie Méthodique_.




                              CHAPTER VI.

                SCHERZER, FUENTES, AND OTHERS, ON COCA.


Carl Scherzer, who brought the supplies to Europe from which Niemann
and Lossen, under Wöhler, first isolated Cocaine, narrates the
following:[16]—

 [Footnote 16: “The Voyage of the Novara,” by Carl Scherzer, vol. iii.
 p. 402, London, 1863.]

 “A Scotchman named Campbell, who was settled as a merchant at Tacna
 in Bolivia, and with whom I travelled to Europe from Lima, informed
 me that a few years before, being engaged upon matters of urgent
 business, he had performed in one day a distance of 90 English miles
 on mule-back, and throughout that long distance had been accompanied
 by an Aymara Indian, who kept up easily with the mule, without other
 refreshment than a few grains of roasted maize and Coca leaves, which,
 mingled with undissolved chalk (? slaked lime), he chewed incessantly.
 On reaching the station where he had to pass the night, Mr. Campbell,
 though mounted on an excellent animal, found himself greatly fatigued;
 the guide, on the other hand, after he had stood on his head for a few
 minutes,[17] and had drunk a glass of brandy, set off without further
 delay on his homeward journey!

 [Footnote 17: A custom, Scherzer says, of these Indians after long and
 fatiguing marches, which seems to be the result of an instinct, and
 teaches them how best to mitigate the pressure of the blood.]

 “In April, 1859, Mr. Campbell despatched a native from La Paz to
 Tacna, a distance of 249 English miles, which the Indian accomplished
 in four days. He rested one day at Tacna, and set off the following
 morning on his return journey, in the course of which he had to cross
 a path 13,000 feet in height. It would seem that, throughout the
 whole of this immense journey on foot, he followed the Indian custom
 of taking no other sustenance than a little roasted maize and Coca
 leaves, which he carried in a little pouch at his side, and chewed
 from time to time.

 “The mail goes four times a month from La Paz to Tacna, and usually
 weighs 25 lb., which the courier carries on his back, and delivers
 within some five or six days, without other nourishment than that
 already specified.”

 According to Senor Fuentes,[18] “the incontestable facts which
 experience affords as to the virtues of Coca may be divided into two
 classes, those relating to healthy persons, and those concerning
 ailing or sickly individuals. It has been admitted that the Indians of
 the mountains, who, among the natives of Peru, are most given to the
 use of Coca, are these who endure the hardest labour, such as:—

 [Footnote 18: _Chemist and Druggist_, 1876, p. 155. Notes on Coca
 Leaf, by P. L. Simmonds, abstracted from “Mémoire sur le Coca de
 Pérou.” Par Manuel A. Fuentes (de Lima).]

 “1. Mining operations. The mines are almost all situated in the
 coldest parts of the Cordilleras. There the Indians work night and
 day, the pickaxe or the shovel in their hand, to detach the minerals,
 which they carry on their shoulders through long and deep subterranean
 passages, or they stamp with their feet masses of mineral from which
 they have to extract the metal. All the rest they get during this
 incessant toil is to lie down, turn by turn, on a skin covered with a
 poncho to snatch a few moments of repose, and to chew their portion of
 Coca leaf.

 “2. The postal service. Bearing a case of letters on their shoulders,
 they may be seen undertaking with celerity journeys of hundreds
 of miles, traversing, to shorten their route, deserts and rugged
 Cordilleras. These unfortunate Indians suffer from all the injuries of
 the rarefied air, which exercises a most severe effect on a half-naked
 man, obliged to traverse the rocks and deserts of the sierras or
 mountainous regions. His only shelter and chance of repose, when
 snow-storms surprise him or fatigue overcomes him, is to take refuge
 in some cavern or under some projection of rock, where, reclining on
 the frozen ground, he snatches a few hours of sleep.

 “3. The occupation of shepherd. The Indian generally pastures his
 wool-bearing animals of the alpaca tribe on the bleak pampas, which
 produce scarcely anything but a coarse kind of grass, called locally
 ‘hichu.’ The rigour of the climate renders these mountain shepherds as
 black as Ethiopians.

 “4. Irrigation. When the Indians are obliged to water their fields
 during the night, in the middle of the rigours of winter, and on the
 most elevated plateaux, they are often many hours knee-deep in water,
 and exposed like their comrades to the cutting blast of a cold and
 penetrating wind.

 “For resisting all these fatigues and the inclemencies of the seasons,
 the Indians have no other food than a handful of maize, a few
 potatoes, and their pouch of Coca leaves. They never eat flesh unless
 it is given them, which is rarely, as they respect the lives of their
 flocks as their own.

 “Dr. Ignacio Flores having seen an Indian of the tribe of the Canaris,
 who was employed in the postal service between Chuquisaca and La Paz
 in Bolivia, that is a distance of over 100 leagues, with no other
 provision with him than a few grains of roasted maize, a few cakes
 of chuno, or frost-dried potatoes, not weighing together two pounds,
 and his bag of Coca leaves, declared that there was not a monk or
 hermit in the world so austere or abstinent. This frugality, and this
 hardihood to fatigue, the very recital of which makes one shudder,
 have been attributed by many not to the use of Coca, but to the
 training and education, as it were, of the Indians. This assertion,
 however, may be easily rejected by having regard to the following
 facts:—

 “1. The Indian has naturally a voracious appetite whenever he is
 brought into contact with any one generous enough to feed him.

 “2. A great many Spaniards, who could not support the labour of the
 mines and the inclemency of the Cordillera, having taken to the
 regular use of Coca, have forthwith acquired the Herculean force of
 the Indians.

 “3. When the natives give up the use of Coca, and change their
 ordinary food system, they lose that ancient vigour and power which
 enabled them to resist fatigue and the inclemency of the weather.

 “4. Notwithstanding the rigorous prevention of the use of Coca in
 Tucuman, the habit of chewing the leaf is clandestinely practised,
 because it is alone found to give to the muleteers the power of
 resisting the rigours of the icy plateaux of Lipes, and of prolonged
 night watches to prevent the mules they are transporting to Peru from
 straying.

 “5. During the prolonged siege which the rebel Indians carried on in
 1781 against the town of La Paz in Bolivia, the inhabitants had no
 other food left than leather, unclean animals, &c., and having to
 watch at night in the trenches during a rigorous winter to repulse the
 attacks of the Indians, a great many took to the use of Coca, as the
 only means of averting this horrible famine.

 “Passing now to the beneficial effects of Coca on the sick and
 invalid, facts which, Senor Fuentes asserts, experience has confirmed;
 it is said to strengthen the gums and preserve the teeth. Taken in the
 form of an infusion, like tea, it excites perspiration and soothes
 those who suffer from asthma. Taken either in infusion or chewed, it
 assists the functions of the stomach, removes obstructions, and cures
 gripes or colic. Applied externally in friction or plasters, it allays
 rheumatic pains caused by the cold.

 “Our author further asserts that it cures intermittent fevers in the
 dose of a teaspoonful of sulphate of cocaine(?), and is a protection
 against syphilis. This last allegation is probable, seeing that an
 Indian is rarely met with afflicted with venereal diseases, so common
 among whites and negroes.”

In Western Brazil a preparation of the Coca leaf in powder is known as
Ypadú or Ipadú. Martius says[19] “the powder of the dried leaves is
notable from its wonderful effect on the nervous system, especially on
the brain, as has been lately observed, and it should be received into
the treasures of materia medica.”

 [Footnote 19: “Systema Materia Medica Vegetabilis Braziliensis,” by C.
 F. P. de Martius. Leipsic: 1843.]

By R. Spruce,[20] Ipadú is described as he saw it used on the banks
of the Rio Negro, an affluent of the Amazon; the powdered roasted(?)
Coca leaves are mixed with a little tapioca and the ashes of Imbaúba
(_Cecropia peltata_, &c.). He says:—“With a chew of Ipadú in his cheek
an Indian will go two or three days” without food, and without “having
any feeling or desire to sleep.”

The “quid of Coca” is frequently mentioned by Squier,[21] a recent
American traveller in Peru, but he gives no details of its cultivation
or use.

Fitzroy Cole[22] also describes the use of Coca in terms similar to
those of Weddell, but he confounds it with _Theobroma Cacao_, which
yields Cocoa. He says:—“The incredible fatigue endured by the Peruvian
infantry on very spare diet, but with the regular use of Coca, the
laborious toil of the Indian miner under similar circumstances
throughout a long series of years, certainly afford sufficient ground
for attributing to these Coca leaves the quality, not only of a
temporary stimulant, but also of a strong nutritive principle.”

 [Footnote 20: “Journal of a Voyage on the Amazon and Rio Negro,”
 Hooker’s Journal of Botany, Vol. v., 1853, p. 212.]

 [Footnote 21: “Peru, Incidents of Travel and Exploration in the Land
 of the Incas.” London: 1877.]

 [Footnote 22: “The Peruvians at Home,” by Geo. R. Fitzroy Cole.
 London: 1884.]



                             CHAPTER VII.

                     THE CULTIVATION OF COCA.[23]

 [Footnote 23: From the _Therapeutic Gazette_ (Detroit), January, 1886,
 p. 14, and _Pharm. Journ._, 1886, p. 705.]

The most recent account of the cultivation of Coca is given by Henry H.
Rusby, M.D., who, for more than two months, was engaged in the study
of the Coca plant and its products in the districts of Bolivia which
produce the best quality of leaves. He says:—

 “For the details concerning cultivation here presented I am chiefly
 indebted to Mr. Oscar Lohse, one of the most intelligent cultivators
 in this country, and proprietor of the Finca of San Antonio, two
 leagues from the town of Caroica, Yungas.

 “The district of Caroica may be considered as fitly representing the
 remainder of Yungas, and Yungas as representing the principal Coca
 districts of this republic. The conditions of soil and climate may be
 briefly stated. Proceeding eastward from La Paz, itself somewhat more
 than ten thousand feet[24] above the sea, for a distance of four or
 five leagues, we reach the summit of the pass over the easternmost
 cordillera of the Andes, this cordillera having an average elevation
 in this immediate district of perhaps sixteen thousand feet. This
 ridge, always more or less snow-covered, cuts off a large portion of
 the westward-bound clouds, which are either precipitated in the form
 of rain before reaching the summit, or arriving there, are deposited
 in the form of snow, and then returned by means of rivulets to the
 valleys, chiefly of the eastern slope. It should be noted that in
 Northern Peru and Ecuador this cordillera is higher than here, so that
 the eastern slope in those regions is more profusely and regularly
 watered than here. From this pass, had we a direct road, we could
 travel in half a day, so steep is the descent, to the banks of the
 Caroica River, having an altitude of only two thousand four hundred
 feet. When we have descended to six thousand four hundred feet we
 should meet with our first Coca plantations, and after passing the two
 thousand foot level we should have left them principally or entirely
 behind. Within this four or five thousand feet, then, lie the cocales
 of Bolivia. No description can convey a perfect idea of the steepness
 of this luxuriant slope. Travel, entirely by riding-animals, is
 extremely difficult. There are only occasional places where we can
 readily leave the road, and here plantations are established. The
 hedge of coffee-plants at the roadside proves on examination to be the
 uppermost row of a plantation; and as we peer down among the shrubs
 we marvel that anyone can preserve his footing while cultivating or
 collecting the coffee. The scenery is, of course, magnificent, and
 of a different type, I should think, from that of any other part of
 the world. The mountains are too young to have lost to a great extent
 their ragged outline, yet softness is imparted by the richness of the
 vegetation. We stand among the coca plants and distinctly see another
 cocal nearly four thousand feet below us.

 [Footnote 24: “I have given altitudes and measurements approximately
 in English feet. By the Spanish measurements the altitudes are much
 greater.”]

 “The cultivated plants of the coca district are coffee, rice, cacao,
 sugar cane, tobacco, maize, cotton (the arborescent species), sweet
 potatoes, yuccas, and the ordinary garden vegetables. The principal
 fruits are oranges, bananas, cocoanuts, lemons (sweet and sour),
 citrons, grapes, chirimoyas, alligator pears, tumbas, pomegranates,
 grenadillas, figs, papayas, lukmas, melons, and pineapples, the last
 just introduced.

 “The soil in such a broken country is, of course, very diversified,
 ranging from a very light decomposed shale or sandstone to a heavy
 blue or chiefly yellow clay.

 “The rainy season begins in October, and continues until May or June.
 During this time the rains are copious and almost constant. During the
 succeeding two months there is scarcely a drop of rain, and during the
 next two there are only occasional showers.

 “Such are the conditions under which the Coca grows in this section.

 “When we come now to consider the methods of cultivation here adopted,
 we must be cautious about accepting them as the best, merely because
 they are generally followed here. It is to be remembered that the
 Bolivian system of agriculture has not received the attention that it
 should have had, and that it is very probable that reforms might be
 introduced in present methods.

 “Nor is it proper to proceed concerning Coca-culture without a few
 words concerning what is meant by the ‘best quality’ of Coca-leaves.
 To a manufacturing chemist the best quality would mean the quality
 that would yield the largest percentage of crystallizable cocaine,
 obtainable in the easiest manner, while the same Coca might be
 considered for domestic consumption as representing one of the lower
 grades. It is highly probable that the amount of cocaine forms no
 element in the Indian’s estimate of the quality of Coca, no more than
 the percentage of nicotine establishes the quality of a particular
 grade of tobacco. Coca-leaves are classed in general by the Indians
 as ‘hajas dulces’ (sweet leaves) and ‘hajas amargas’ (bitter leaves).
 The former are made sweet by the abundance of alkaloids other than
 cocaine. While it is true that a greater abundance of these alkaloids
 is usually accompanied by a larger percentage of cocaine also, yet
 the variation in the amount of the latter is not so great as in the
 former; so that while in the sweet leaves the bitter taste of the
 cocaine is masked by the presence of the other alkaloids, in the
 bitter leaves its flavour is the predominant one. The presence, then,
 of these _sweet alkaloids_, as we may call them, translating the
 simple and expressive term of the Indians, determines the domestic
 value of the Coca, and all that is known of the best methods of
 cultivation is based on the production of the highest percentage of
 these alkaloids.[25] Experience may determine that for manufacturing
 purposes a very different line of principles of culture should be
 followed.

 “I have made a large number of assays tending towards elevations,
 soils, exposures, seasons, ages of plants, and of leaves, different
 varieties, wild and domestic, different parts of the plant, and
 various modes of drying and packing. The results will be embodied
 in a future monograph, mere passing references being made to them
 for the present. I have about concluded that the percentage of the
 sweet alkaloids varies inversely as the amount and continuousness of
 moisture that the plant receives. Thus, the Peruvian, Ecuadorian,
 and Brazilian Coca, which, as I have stated, is much more copiously
 and regularly watered than the Bolivian, is markedly inferior,
 so that Bolivia regularly exports about one-eighth of her crop to
 those countries. I am inclined to think that the greater breadth
 and thinness of the northern leaf may be partly due to the greater
 water-supply and the consequent greater degree of evaporation. Again,
 the Indian always seeks the Coca grown at the higher elevations, where
 the humidity is much less and more irregular than in the districts
 along the rivers. We are thus obliged, for reasons to be elaborated
 in the future, to regard these alkaloids as preserving a sort of a
 balance of moisture, by which the plant stores up during the wet
 weather a concentrated supply of water, which may be very slowly
 yielded up during a time of need.

 [Footnote 25: “It is desirable that there should be a more precise
 definition of the peculiarities here referred to.—ED. PH. J.”]

 “Having thus chosen a high altitude, the next thing is to select a
 soil. A rivalry exists between a yellow clay and a hill-side soil rich
 in vegetable matter. My assays have yielded the best results (as to
 total alkaloids) from soils of the latter class, and I am inclined to
 think that those who prefer the former soil do so because it yields a
 somewhat larger crop.

 “The ground for the nursery-bed is prepared during the latter part
 of the dry season by breaking it up very thoroughly to the depth of
 a foot or more. The fruits mature during the early part of the rainy
 season, December and January. They are red, and consist of a fleshy
 outer portion and a shell-like inner portion, which encloses the
 single seed. These people suppose that the germ cannot escape from the
 shell if planted in its natural condition, and they have continued for
 hundreds of years to deposit the seeds as soon as gathered in a shaded
 place, in layers an inch or more deep, and covered with a thin layer
 of decaying leaves, or similar substance. The heat generated by the
 decomposition of the fleshy pericarp serves to induce germination, and
 the embryo bursts from its bony covering. This growth unites them in
 from eight to fourteen days into a solid mass, which is broken up into
 small pieces and planted in furrows in the nursery. In this process
 very many of the sprouts are broken off and the plants destroyed. Mr.
 Lohse has adopted the plan of sowing the seeds broadcast as soon as
 gathered, and covering with a little earth, or, better, a layer of
 banana leaves or decaying vegetable matter. Germination requires from
 eight to twelve days longer, but all the plants are saved. In either
 case, a covering of brush or straw must be placed over the nursery,
 at first only three or four inches above the surface, and elevated to
 six or seven inches, as the plants grow. Usually this elevation is
 repeated once more.

 “All this taking place during the rainy season, the plants have
 reached a good size before the advent of the dry weather, and so do
 not call for any artificial water-supply. Advantage is taken of the
 ensuing dry season to clear the land and prepare the ground for the
 new cocal. On the manner in which this is done depends much of the
 future well-being of the plants. The ground should be thoroughly
 powdered to the depth of two, and, if possible, three feet, all roots
 and large stones being removed. On these steep slopes it is necessary
 to terrace, the terraces being supported by stone walls, the stones
 laid dry. The width of the terraces, according to the slope, varies
 from several feet, with a number of rows of plants, to much less than
 the height of the wall, only a single row of plants being admissible.
 It is here generally believed that shade tends to the production of
 the best quality of leaves; so the cocales are planted thickly with a
 small broad-topped leguminous tree related to the St. John’s bread,
 but whose name I cannot at this moment recall. There is no doubt
 that this is a mistake. I have made repeated comparative assays of
 shade-grown and sun-grown leaves from adjoining plants, and invariably
 found the latter much richer in total alkaloids. I judge the custom
 to have arisen from two considerations. There is, as I have stated,
 a period of two or three months when the plants receive no rain, and
 then these trees afford a protection from the fierce heat. Secondly,
 shade conduces to the production of a large, smooth, beautiful leaf,
 of elegant colour, and thus adds to the _appearance_ of the product.
 The terraces being thus prepared, on the advent of the permanent rainy
 season, the plants, now from 8 to 12 inches high, are transplanted,
 being set from one-half to six inches apart, according to the ideas
 of the haciendero. From this time until the first leaves are picked,
 the greatest care must be taken to keep the soil thoroughly stirred
 and free from weeds. The plants having been transferred in October
 or November of one year, the first picking is made in March or April
 of the second following year, one year and a half from the time
 of transplanting, or two and one-half from the seeds. In case an
 insufficient space has been prepared, the remaining plants are often
 left until the following year, and then transplanted, the operation
 being much more dangerous to the life of the plants.

 “The chief danger of picking the leaves earlier than the period
 indicated above is not the strain upon the vitality of the young
 plant, as many of the leaves drop off themselves, but because it is
 almost impossible to avoid breaking off the very tender tips of the
 twigs, the result being fatal to many plants. Immediately after this
 first picking, fresh leaves develop with great rapidity, and in July
 or August of the same year the plant flowers for the first time. The
 lovely white flowers, if undisturbed, remain from three to six days;
 but from the very first they are dislodged by the slightest jar, the
 corolla falling entire, although it is morphologically polypetalous.
 The fruit ripens in December and January.

 “During the first few years the percentage of alkaloid increases
 rapidly, reaching its maximum at or before the age of ten years. At
 the age of twenty it begins to diminish, but with extreme slowness,
 so that the plants are practically in their prime up to the age of
 thirty-five or forty. It is probable that the decline is then due
 rather to the exhaustion of the soil than of the vitality of the
 plant. Fertilisation of the soil has never been resorted to. It is
 probable, as suggested by Mr. Lohse, that as much can be done for the
 Coca in this way as has been done for other plants.

 “A Coca harvest is called a _mita_, an Indian word meaning a division
 or drawing of lots, and there are from three to five in a year,
 according to the season. The time of picking is determined solely
 by the condition of the leaves. When they have become mature they
 turn yellow if in the dry season, and brown if in the rainy, and
 within eight days at the outside will fall to the ground and be
 lost. As soon as the mita is over, the ground is cleared from weeds,
 and, under an ignorant notion that further cleaning is injurious, is
 left undisturbed until after the next mita. But Mr. Lohse has tried
 the plan of keeping the ground clean, with the result, thus far,
 of receiving the next crop in little more than one-half the time
 required by his neighbours. No irrigation is resorted to during the
 dry season. Although it is possible that good might result, at least
 to the welfare of the plant and the size of the crop, I suspect that
 after a long time an abundant and steady supply of water would result
 in a decrease in the amount of alkaloids. Mr. Lohse has tried the
 experiment of mulching at the end of the wet season with a few inches
 of banana leaves or other refuse, with excellent effect upon the
 plants during the succeeding dry season.

 “This plant is subject to only two diseases of any importance. The
 first is taja, which I suppose to be the result of a fungus which
 attacks the undeveloped leaves and tender twigs. It is said by some
 to be caused by careless picking, in which the twigs are broken. By
 others it is said to result from the planting of seeds taken from
 young plants. The only remedy is to remove and burn the diseased
 portions. The second disease, if such it can be called, is the ravages
 of a caterpillar called “ulo,” which makes its appearance in December,
 and destroys the crop so quickly that it admits of no remedy.

 “The method of picking and drying the Coca has been so often and so
 well described of late that it is not necessary to dwell upon it.
 Coca picking is a profession to which the children are trained from a
 tender age. The leaves are picked singly, both hands being employed
 with a rapid alternating motion, which strips a twig in an instant.
 Great care is taken to avoid breaking the twigs, and the young leaves
 are not picked. Little sacks are tied about the waist, or the women’s
 aprons are pinned or sewn into the required form. They are then
 transferred to larger sacks, which must be filled and emptied with
 great promptness, or the leaves will become heated and turn black.

 “The price here paid for picking is a Bolivian dollar, equal to about
 seventy-one cents United States currency, or three shillings English,
 for each thirty pounds, which, when dry, will weigh about twelve
 pounds.

 “The leaves are exposed to a hot sun upon a pavement of nicely-fitted
 flat stones, and stirred occasionally until dry. Under the most
 favourable conditions the drying is accomplished in about three
 hours. About the Coca place are built the storage and packing sheds.
 These are furnished with very broad doors, and men are in constant
 attendance to sweep the Coca with brush-brooms through these broad
 portals at the slightest indication of rain. A very few drops of rain
 are sufficient to decolorise and ruin the sale of the Coca, though it
 is my impression that such decolorisation, if produced by but little
 rain, is no indication of loss of cocaine. During the first few days
 that the dry Coca lies within the storage-sheds it undergoes a slight
 sweating process.

 “When I come now to speak of the best methods of packing the Coca
 for export, it is fair to say that nothing definite is known. Such
 Coca as has reached Europe or the United States in good condition has
 done so purely by accident; for, perhaps, the very next lot, dried,
 packed, and shipped as nearly as possible in the same manner, has
 arrived entirely ruined. I have tried many methods, and as often as I
 had thought that the secret was discovered, my hopes have resulted in
 disappointment.

 “As regards the exportation of the culture of Coca, the experiment
 has been tried, I believe, but once. Several years since, Mr. F. L.
 Steinart, of La Paz, shipped a small quantity of seeds _viâ_ London to
 Ceylon, and during the past season the first products were shipped to
 London and sold at a high price. Seeds for export should be exposed
 for several days to a hot sun, so as to rapidly dry the fleshy
 exterior, which thus forms a protection to the germ within.

 “It is my opinion that the Coca-plant is adapted for culture in
 many countries where it is now unknown. Among the countries where
 it would be well to experiment with it are Guatemala, Mexico, the
 East and West Indies, India, Southern China, portions of Africa, and
 possibly of Italy. It is doubtful if it would grow in any portion of
 the United States. Requiring an average temperature of at least 70°,
 the only districts at all suited would be Florida and Southern Texas;
 and it is highly probable that proximity to the sea-coast at so low
 an altitude would prove fatal. Nor would irrigation prove adequate in
 those countries possessing a long dry season. The plants must not only
 have an abundant supply of water at the roots; they must be bathed in
 a humid atmosphere for the greater portion of the year. But from what
 I have read of some of the countries above named, I am confident that
 the plant would there find a congenial home. Jamaica offers especially
 hopeful conditions.”




                             CHAPTER VIII.

                DR. MANTEGAZZA’S EXPERIMENTS WITH COCA.


Dr. Paolo Mantegazza, of Milan, who practised for many years in South
America, thus writes of Coca:—[26]

 [Footnote 26: _Pharm. Journ._, 1860, p. 616, ex _Oesterreichische
 Zeitschrift für Praktische Heiikunde_, Nov. 4, 1859.]

 “The Erythroxylon Coca, a plant which grows in moist and woody
 regions on the eastern slopes of the Andes, is highly valued by the
 inhabitants of Peru, Chili, and Bolivia, not only as a medicine, but
 also as an article of food; and serves with them as a substitute
 for the tea, coffee, betel, tobacco, haschisch, and opium used by
 other nations. Its culture, upon which, since the time of Pizarro’s
 conquest, much care has been bestowed, has recently increased to
 such a degree, that in the year 1856 the revenue of the Republic of
 Bolivia, from the sale of this herb, amounted to thirteen millions of
 francs—a very large sum if compared with the small number of consumers
 (800,000). According to the account of M. Pöppig and of other well
 known travellers, the natives use the dried leaves of the Coca-plant
 either by themselves or in combination with a highly-alkaline
 substance called _llipta_, which is prepared from roasted potatoes
 and the ashes of different other plants; they masticate them like the
 Malays and the inhabitants of the Indian Archipelago do the calcined
 leaves of the _Chavica Betle_. The use of this masticatory, which is
 considered a great delicacy, is not, however, confined to the rich;
 on the contrary, it is particularly among the hard-working Indians
 that the Coca enjoys a high reputation as a nutriment and restorative,
 and its use is considered absolutely essential for the endurance of
 fatigue and exertion, so that a labourer, in making his contract, has
 a view not only to wages, but to the amount of Coca to be furnished.
 The Inca, who lives at a height of seven to fifteen thousand feet
 above the level of the sea, and whose meagre fare consists principally
 of maize, some dried meat, and potatoes of bad quality, believes that
 he can sustain his strength solely by the use of Coca; the porter,
 who carries the mail, and accompanies the traveller over the roughest
 roads at the quick pace of the mule, invigorates and strengthens
 himself by chewing Coca; the Indian, who works half-naked in the
 silver and quicksilver mines, looks upon this plant as an ambrosia
 capable of imparting new life, and of stimulating to new exertions.
 It is not surprising, under such circumstances, that this article
 should be very much abused, and that the evil of intemperance in the
 use of Coca, known as coquear, should be quite as prevailing among
 the natives of those districts as intemperance in the use of tobacco,
 alcoholic liquors, and opium is among other nations. They intoxicate
 themselves for several weeks, hide in the deepest forests in order
 not to be disturbed in their enjoyment, and not rarely return home to
 their family suffering from delirium or decided idiocy.”

 ‘Be it that the praised efficacy of the plant is merely the
 effect of fancy or tradition, or that the plant really contains
 a powerful principle unknown to science, the solution of this
 mystery is certainly a worthy theme for scientific enquiry, and
 the investigations of Dr. Mantegazza deserve, therefore, our full
 attention.

 ‘The child and the feeble old man seize with equal eagerness the
 leaves of the wonderful herb, and find in it indemnification for all
 suffering and misery.

 ‘Dr. Mantegazza observed that the chewing of a drachm of the leaves
 of the Coca increased salivation, giving at first a somewhat bitter,
 and afterwards an aromatic, taste in the mouth, and a feeling of
 comfort in the stomach, as after a frugal meal eaten with good
 appetite. After a second and third dose, a slight burning sensation
 in the mouth and pharynx, and an increase of thirst were noticed;
 digestion seemed to be more rapidly performed, and the fæces lost
 their stercoraceous smell, the peculiar odour of the juice of the
 Coca becoming perceptible in them. On using the Coca for several
 days, the author observed on himself as well as on other individuals
 a circumscribed erythema, an eruption around the eyelids resembling
 pityriasis; from time to time a not unpleasant pricking and itching
 of the skin was felt. An infusion of the leaves, taken internally,
 was found to increase the frequency of the pulse in a considerable
 degree. In making observations on the frequency of the pulse, the
 author was very careful to consider all the conditions which might
 influence it; he found that, the temperature of the air being the same
 and the liquids being heated to an equal degree, an infusion of Coca
 will increase the action of the heart four times its normal standard,
 while cocoa, tea, coffee, and warm water only double it. By taking
 an infusion prepared from three drachms of the leaves a feverish
 condition was produced, with increased heat of the skin, palpitation
 of the heart, seeing of flashes, headache, and vertigo; the pulse
 rose from seventy to one hundred and thirty-four. A peculiar roaring
 noise in the ear, a desire to run about at large, and an apparent
 enlargement of the intellectual horizon indicated that the specific
 influence upon the brain had commenced. A peculiar, hardly describable
 feeling of increased strength, agility, and impulse to exertion
 follows; it is the first symptom of the intoxication, which is,
 however, quite different from the exaltation produced by alcoholics.
 While the latter manifests itself by increased but irregular action
 of the muscles, the individual intoxicated by Coca feels but a
 gradually-augmented vigour, and a desire to spend this newly-acquired
 strength in active labour. After some time the intellectual sphere
 participates in this general exaltation, while the sensibility seems
 to be hardly influenced; the effect is thus quite different from
 that produced by coffee, and resembles in some degree that of opium.
 Dr. Mantegazza could, in this excited condition, write with ease and
 regularity. After he had taken four drachms he was seized with the
 peculiar feeling of being isolated from the external world, and with
 an irresistible inclination to gymnastic exercise, so that he, who in
 his normal condition carefully avoided the latter, jumped with ease
 upon the writing-table without breaking the lamp or other objects
 upon it. After this a state of torpidity came on, accompanied by a
 feeling of intense comfort, consciousness being all the time perfectly
 clear, and by an instinctive wish not to move a limb during the whole
 day, not even a finger. During this sensation sleep sets in, attended
 by odd and rapidly-changing dreams; it may last a whole day without
 leaving a feeling of debility or indisposition of any kind. The author
 increased the dose to eighteen drachms in one day; his pulse rose in
 consequence of it to one hundred and thirty-four, and, in the moment
 when delirium was most intense, he described his feelings to several
 of his colleagues, who observed him, in the following written words:
 ‘_Iddio è ingiusto perche ho fatto l’uomo incapace di poter vivere
 sempre cocheando_’ (this is the expression for intoxication by Coca).
 ‘_Io preferiscto una vita di 10 anni con Coca che un di 1,000,000
 secoli senza Coca._’ After three hours of sleep Dr. Mantegazza
 recovered completely from this intoxication, and could immediately
 follow his daily occupation without the least indisposition—on the
 contrary, even with unusual facility. He had abstained for forty
 hours from food of any kind, and the meals then taken were very well
 digested. From this fact, the author finds it explainable that the
 Indians employed as carriers of the mail are able to do without food
 for three to four days, provided they are sufficiently supplied with
 Coca.

 ‘From these experiments, made repeatedly on himself and on other
 individuals, Dr. Mantegazza draws the following conclusions:—

 ‘1. The leaves of the Coca, chewed or taken in a weak infusion, have
 a stimulating effect upon the nerves of the stomach, and thereby
 facilitate digestion very much. 2. In a large dose Coca increases the
 animal heat and augments the frequency of the pulse, and consequently
 of respiration. 3. In a medium dose (three to four drachms), it
 excites the nervous system in such a manner that the movements of the
 muscles are made with greater ease; then it produces a calming effect.
 4. Used in a large dose, it causes delirium, hallucinations, and
 finally congestion of the brain.

 ‘The most prominent property of Coca, which is hardly to be found
 in any other remedy, consists in the exalting effect it produces,
 calling out the power of the organism without leaving afterwards
 any sign of debility. The Coca is in this respect one of the most
 powerful nervines and analeptics. These experiments, as well as the
 circumstance that the natives have used the Coca from the earliest
 period as a remedy in dyspepsia, flatulency, and colic, have induced
 Dr. Mantegazza, and several of his colleagues, in South America and
 Europe, to employ the leaves of the Coca in a variety of cases, partly
 as masticatory, partly in powder, as infusion, as alcoholico-aqueous
 extract in the dose of ten to fifteen grains in pills, and as
 clyster. Dr. Mantegazza has used Coca with most excellent results
 in dyspepsia, gastralgia, and enteralgia; he employed it not less
 frequently in cases of great debility following typhus fever, scurvy,
 anæmic conditions, &c., and in hysteria and hypochondriasis, even if
 the latter had increased to weariness of life. The Coca might also be
 employed with great benefit in mental diseases where some physicians
 prescribe opium. Of its sedative effect in spinal irritation,
 idiopathic convulsions, nervous erethism, the author has fully
 convinced himself. He proposes its use in the highest dose in cases of
 hydrophobia and tetanus. It is a popular opinion that the Coca is a
 reliable aphrodisiac; the author has, however, observed only two cases
 in which a decided influence upon the sexual system was perceived.

 ‘Dr. Mantegazza, finally, recommends this remarkable plant, which
 could be easily introduced into trade, to the profession for further
 physiological and therapeutical experiments, and adds the full history
 of eighteen cases by which the medicinal virtues of the remedy are
 proved to satisfaction.’




                              CHAPTER IX.

                   BOTANICAL SOURCE AND DESCRIPTION.

 _Erythroxylon Coca_, Lam. Syn. _Khoka_, Aymara; _Cuca_, Peruvian;
 _Coca_, Spanish; _Ypadú or Ipadú_, Tupin (Brazilian).


By recent botanical authorities, the genus Erythroxylon is classed in
the natural order _Linacæ_, tribe _Erythroxyleæ_. The genus contains
a number of tropical plants growing principally in South America,
the West India Islands, Madagascar, Mauritius, and some in India and
Ceylon. The folding of the leaf in its vernation, which causes the
peculiar marked line on each side of the midrib, is characteristic of
many of the species. One has large leaves eight or nine inches long.
Lindley thus describes the Coca plant and genus:—

                             ERYTHROXYLON.

 “Calyx 5-parted, 5-angled at the base. Styles 3, distinct from the
 very base, not consolidated. Cultivated on the Andes of Peru from
 2,000 to 9,000 feet above the sea.”

 “Erythroxylon du Pérou, _Erythroxylon Coca_. _Erythroxylon foliis
 ovatis acutis subtrilincatis, ramulis crebre tuberculosis._
 ‘Encyclopèdie Méthodique Botanique,’ tome ii. Lamarck. Paris: 1786,
 393.”

 “Leaves alternate, 1½ to 2 inches long, membranous, flat, opaque,
 acute at both ends, the apex almost mucronate; quite entire,
 dark green above, pale beneath, 3-nerved in the middle, with
 fine connecting veins. Petiole 2-4 lines long, with a pair of
 intra-petiolary ovate-lanceolate brown acute stipules, upon the back
 of the outside of which, indeed, the petiole is articulated, and from
 which the leaf readily falls away, leaving the branches scaly with the
 persistent stipules. Flowers numerous, in fascicles from the branches
 where the leaves have fallen away, bracteated. Peduncles about as long
 as the flower, sharply angled. Calyx 5-cleft; segments acute. Petals
 alternate with the calycine segments, oblong, concave, wavy, with a
 lacerated and much plaited membrane arising from within and above the
 base. Stamens 10; filaments longer than the pistil, combined below
 into a rather short cylindrical tube. Ovary oval. Styles 3, about as
 long as the ovary. Stigmas thickened. Fruit a 1-seeded, oblong drupe,
 in a dry state obscurely furrowed. Nut of the same shape and furrowed.
 A powerful stimulant of the nervous system, affecting it in a manner
 analogous to opium. Less violent in its effects than that drug, but
 more permanent in its action.”

The chromo-lithograph Frontispiece is from a water-colour, by Mr. J.
Allen, of the plant in flower at Kew.

1. Sprig of Erythroxylon Coca.

2. Back of Leaf (full size).

3. Flower (enlarged).

4. Fruit.

The leaves vary much in shape on the same plant even, the upper and
lower are different, and, probably owing to much cultivation and
numerous varieties, the dried leaves in commerce are very variable
in size and appearance, shape and colour, as well as state of
preservation. They are usually one to two inches long, but large
varieties are often four or five inches long. They are oval oblong,
but some are ovate, while others are obovate, entire on the margin,
sometimes acuminate, but usually blunt and emarginate, and often with
an apiculus in the notch at the apex; rather thin, smooth, with a
prominent midrib, and on each side a curved line running from the base
to the apex. The fresh leaves are paler in colour beneath, and a bloom
on the surface gives them a dichroic appearance; in one direction the
upper surface appears yellowish green, whilst if looked at direct it is
dark green. The dried leaves have a slight odour of tea, and a somewhat
grass-like, bitter, aromatic taste; in colour they vary from a pale
bright green, changing to a yellowish green (North Peruvian or Truxillo
and Huanuco varieties)—this is smaller, thinner, and much broken—to a
dull brownish olive (Bolivian variety), this is larger, broader, and
a thicker leaf, not broken, paler in colour beneath; the inner curved
lines from base to apex are very marked on this, but only faintly on
the Truxillo variety, in some leaves hardly discernible. These two
varieties shade off into each other. The Truxillo variety is imported
principally from Salaverry, and, according to Hesse, is the product of
_Erythroxylon Coca_, var. _Novo-granatense_, Dyer. The variety from
Southern Peru is, he says, exported _viâ_ Lima, that from Bolivia from
Arica and Mollendo. Huanuco and Cusca cocas are known in the markets as
coming from provinces adjacent to these towns, where commercial houses
have their headquarters. Some of the Coca finds its way to Europe
through Para, the port at the mouth of the Amazon.

Hesse says he obtains from these South American Cocas, 0·7 to 0·9
per cent. of alkaloids, of which the greater part consists of
crystallizable cocaine in the broad-leaved variety, and about one-half
in the narrow-leaved or Truxiilo Coca.—P.J. 1891, 1109.

In selecting them, care should be taken that they have not fermented
or become fusty—they may appear of a good green colour, yet have a
mouldy taste. The leaves are also collected from wild plants which have
strayed from cultivation. The original habitat of the Coca plant is
not known; it has been acclimatised in Java, Ceylon, and some parts of
India.

Burck attributes the plant cultivated in British India to a new
species—_Erythroxylon Bolivianum_, Burck—and that cultivated in Java to
a distinct variety, _E. Coca_, var. _Spruceanum_. The Cocas from these
sources, as well as from Ceylon, have not proved satisfactory in their
yield of cocaine. According to Hesse, the alkaloids accompanying it
considerably preponderate, the base frequently consisting principally
of cinnamyl-ecgonine methyl ester.—P.J. 1891, 760, 1109.

The uses of the Coca leaf in Bolivia and Peru have been described
by many travellers, who have seen it chewed, as has been before
mentioned. From two to eight or twelve drachms or more is used daily,
in conjunction with the ashes of the quinoa plant or with lime, as
a remedy for, or preventive against, the effects of extraordinary
physical exertion, to relieve the difficulty of respiration in
ascending mountains, and to appease hunger, thirst, and fatigue. The
leaves contain the crystalline alkaloid, Cocaine (See page 54). They
are said to be most active when freshly dried, and are much used by
the native Indians, miners, travellers, and others. The benumbing
effect on the tongue—dulling its sensibility—I find is much greater
on chewing a fresh living leaf than that produced by a number of
dried leaves. “The average duration,” says Markham,[27] “of Coca in
a sound state on the coast is about five months, after which time it
is said to lose flavour, and is rejected by the Indians as worthless.”
It cannot be kept in stock for any length of time without suffering
deterioration, unless it be either stored in air-tight cases in a cool
and perfectly dry place, or kept in its original compressed packages;
like hops detached from the “pocket,” it is said to lose its aroma.
“The Peruvians,”[28] says Pöppig, “are of opinion that too much heat
deprives even the best Coca of the active principle, that a warm
climate will spoil the ‘Coca del Dia’ (that dried in one day) in ten
months, whilst it continues good for a year and a half in the cold and
dry districts of the Andes.”

 [Footnote 27: “Travels in Peru and India.” London: 1862, p. 237.]

 [Footnote 28: _Op. cit._, p. 168.]




                              CHAPTER X.

                           COCA IN COMMERCE.


The Hon. Richard Gibbs, U.S. minister to Bolivia, for some years
resident at La Paz, gives a similar account to that of Weddell of the
cultivation of Coca at the present day.[29] He says the consumers of
Coca, both in Peru and in Bolivia, are the native races; the whites
seldom use it, except as an infusion, and then the first water is
thrown away as being too strong. The habitual consumers of it know
nothing of toothache, and have their teeth in good condition to a
great age. The Peruvian Government, he states, records and taxes a
production of over 15,000,000 lbs., and the Bolivian Government about
7,000,000 lbs. annually; of the latter about 55 per cent. is consumed
in Bolivia; the Argentine Republic and Chili about 15 per cent. each;
Peru, 10 per cent.; while about 5 per cent. is exported to Europe and
the United States. As “Coca is very easily damaged by the combined
effects of heat and moisture, it is, therefore, always stored in dry,
cool warehouses, and rarely handled or transported in damp weather or
during the rainy season. The rainy season is from January to April,
and, therefore, that stored on the west side of the coast range is
alone available for export during the rainy season. When exported it
is said that it usually starts in very good condition, and will reach
its destination in the same condition if carried in a cool, dry place.
Such transportation is always stipulated for on bills of lading, but
the proper precautions are generally neglected, and hence the worthless
condition in which it is often seen.”

 [Footnote 29: Squibb’s Ephemeris, vol. ii. p. 790.]

Of the Coca imported into London, Liverpool, Havre, and Hamburg, some
comes in tin-lined cases containing two tambores, but most of the
large leaves (Bolivian variety) still arrive in rough canvas bales,
generally lined with waterproof tarpaulin, and weighing from 120 to
150 lbs. each, two of which form a load for a mule for transportation
through mountain passes or across the Andes for exportation. The bales
usually contain three, or sometimes only two, tightly packed tambores,
each weighing about 40 or 45 lbs. These latter have a canvas covering
over a banana leaf lining. Other bales contain from six to nine smaller
packages of about 16 to 20 lbs. each, wrapped round with a coarse
woollen fabric and large dock-like leaves. The small leaves (North
Peruvian) are usually either in closely-packed bales, containing 2 or
3 hundredweights, covered with canvas, then with tarpaulin, and again
with canvas, or else in loosely packed canvas “beds” about 6 feet
square by 1½ to 2 feet thick, containing brick-shaped packages, wrapped
in pieces of banana leaf, weighing from 1 to 3 lbs. each, and measuring
about 5 inches by 5 inches, and from 12 to 18 inches in length. The
larger leaves at times arrive in bales containing similar packages.

Cowley (quoted p. 9) seems to have been gifted with second sight, and
referred to the commerce of the present day; until a few years ago
it was quite unknown in the London drug market: even yet no reliable
statistics of our imports are obtainable.




                              CHAPTER XI.

              USE OF COCA AS A RESTORATIVE AND BEVERAGE.


Notwithstanding the scepticism expressed in Weddell’s last sentence
quoted (p. 23), and his attributing much of the effects said to be
produced by Coca on the Indians to the force of habit, Markham (_Op.
cit._) regards it as the least injurious and the most soothing and
invigorating of all the narcotics used by man, and Dr. Archibald
Smith (“Peru as it is,” London: 1839) states, that Coca, when fresh
and good, and used in moderate quantity, increases nervous energy,
removes drowsiness, enlivens the spirits, and enables the Indian to
bear cold, wet, great bodily exertion, and even want of food, to a
surprising degree, with apparent ease and impunity; though it is
said, if taken to excess, to occasion tremor in the limbs, and even
a gloomy sort of mania. Such dire effects, he considers, must be of
rare occurrence, since, after living for years in constant intercourse
with persons accustomed to frequent Coca plantations, and with Indian
_yanacones_ or labourers, all of whom, whether old or young, masticated
the favourite leaf, he never witnessed a single instance in which the
chewer was affected with mania or tremor.

Whether, in Europe, it will ever share the field of favour with tea,
coffee, and cocoa, and become a common beverage, is doubtful. It
certainly is worthy of the attention of students who have a tendency to
become drowsy. An infusion, 1 in 50 of distilled water, has a bitterish
grass-like taste—much the same flavour as the selected tea supplied
at the Chinese kiosk during the Fisheries Exhibition, 1884. It may be
taken after meals as a refresher; it is not unpalatable; if sweetened,
with milk or a slice of lemon added, or infused with tea, it may be
taken as an ordinary cup of tea. The writer finds that a teacupful,
taken hot, produces a slight diaphoretic action, quickened circulation,
slight fulness in the head, buoyancy of spirits, and wakefulness; on
one occasion, taken late, this was succeeded by rather restless sleep.
It produces more cerebral action than tea or coffee. Johnson, in his
“Chemistry of Common Life,” says we may dismiss those fears of the Coca
leaf which old Spanish prejudices awakened, and which representations
like those of Pöppig have tended to perpetuate in Europe. There is
no good reason why it should not be tried among ourselves. That Coca
dilated the pupils of the eye was noticed by Von Tschudi. He says,
“After partaking of a strong infusion of Coca, or the mastication of a
great quantity of it, the eye seems unable to bear light, and there is
a marked distension of the pupil, and, when taken to the utmost excess,
it never, like opium, causes a total alienation of the mental powers,
or induces sleep; but, like opium, it excites the sensibility of the
brain, and the repeated excitement occasioned by its intemperate use
after a series of years wears out mental vigour and activity.”

Weddell and others, from the sleeplessness induced by an infusion
of Coca, thought that it might contain Theine, but neither he nor
Professor Frémy were able to isolate it, although he held that an
active bitter principle, which it had not been possible for them
to obtain in crystals, was contained in the leaves. The isolation,
since, of Cocaine, an alkaloid possessing such curious properties,
and the accounts of the use of Coca just narrated, show that the
effects attributed to it are more than imagination and the “force of
habit.” Whether it does more than deceive or lull hunger, thirst, and
fatigue, and how it acts in these respects, are subjects still to be
investigated. The effect which travellers have noticed it has on the
respiration at high elevations cannot be imaginary. Under the influence
of Coca, it has been said, it appears that a new force gradually
introduces itself into our organism, as water into a sponge. Gubler
thinks that as with tea, caffeine, and theobromine, Coca brings to the
nervous system the strength with which it is charged in the manner of
a _fulminate_, with the difference, that it only yields it slowly, not
all at once.




                             CHAPTER XII.

                     PHARMACEUTICAL PREPARATIONS.


=Elixir Cocæ.=—1 in 6 of Simple Elixir.

_Dose._—1 to 4 drachms in water is a palatable preparation.

=Extractum Cocæ Liquidum= (_Off._).


_Syn._—EXTRACTUM ERYTHROXYLI FLUIDUM, U.S.

_Dose._—½ to 2 drachms.

Coca leaves are exhausted by percolation with proof spirit, the second
part of percolate concentrated and dissolved in the first portion, and
the strength adjusted so that 1 ounce=1 of leaves; this preparation
contains all the properties of the leaf. If freed from the coca wax
it is miscible with water and more palatable, and, so purified, if
added to port, sherry, or burgundy, in the proportion of half a
teaspoonful to a wineglassful (about an ounce to a bottle), it forms an
exhilarating mental stimulant.

By distilling off the spirit and concentrating by evaporation, a solid
semi-alcoholic preparation is obtained about four times the strength of
the above, known as:—


=Extractum Cocæ.=

_Dose._—2 to 15 grains or more, in pills or pastils.


=Infusum Cocæ.=—1 in 50 of boiling water.

Taken hot like tea with milk and sugar, or with a slice of lemon, it
forms a refreshing beverage. In tonsillitis it may be used warm as a
gargle.


=Pastillus Cocæ Extracti, Coca Pastils.=—2½ grains of the extract in
each.

_Dose._—One every two or three hours.

Coca pastils are good; cocaine cured case of asthma of 15 years’
standing; recommended for hay fever, spasmodic asthma, and post-nasal
catarrh.—M.P.C. ii./85,320.


=Vinum Cocæ.=—About 1 in 8 of Sherry.

_Dose._—One to two tablespoonfuls, diluted with wine or water.

This is strongly medicated, it must contain half a grain of alkaloid in
the ounce, else it cannot be sold without a license.


=Coca Wine= in a more palatable and popular form, about 1 in 20 or 30
of a sweet red wine, is also prepared, and in doses of a wineglassful
it forms an agreeable, exhilarating beverage.

Wine of Coca checks vomiting of irritable stomach.—L. ii./85,1078.




                             CHAPTER XIII.

                     MEDICAL USES AND REFERENCES.


Coca has been praised as a nervine and muscular tonic, preventing
waste of tissue, appeasing hunger and thirst, relieving fatigue, and
aiding free respiration, and as being useful in various diseases of
the digestive and respiratory organs. It is said to be specially
useful in many forms of asthma, chronic bronchitis, obstinate cough,
phthisis, and general debility; in gastric derangements, owing to its
slight astringency, it seems to give more tone to the stomach than
the mere anæsthetic action of the Cocaine it contains would produce
locally; it is recommended for indigestion, gastralgia, gastrodynia,
nausea, sickness, distaste for food, is given to relieve pain, nausea,
vomiting, or discomfort caused by excess in either eating or drinking
or by pregnancy, and as a cure for morphine and alcohol craving. In
using it for this in America it is said in some cases to have produced
“Coca Craving.”

Coca is also said to cause mental exhilaration, to overcome diffidence
or bashfulness in company, and to be an excitant of the vital
functions. It has been used in melancholia, in cases of inordinate
hunger or thirst, such as occur in some forms of diabetes, and in cases
of generative debility. Locally, a solution of the extract in water has
been used as a pigment in irritated, inflamed, and granular conditions
of the larynx and pharynx.

The pastils have been used similarly for loss of voice due to weakness
or relaxation of the vocal cords. Topically these preparations act as
astringent sedatives without deranging the stomach. Externally, Coca
may be made into poultices, or a plaster made with the extract combined
with resin or soap plaster may be applied for rheumatism, lumbago, &c.
The leaves are sometimes smoked to relieve asthma.

The leaves are chewed to appease hunger and support strength, in the
absence of food, and used generally for the stimulant and narcotic
effects of tobacco and alcohol.—Pr. xvi. 467.

Coca-leaves as an inhalation, or smoked in a pipe, have a decided
effect on bronchial spasm.—L. i./76,520.

Is of use to steady the nerves of excitable persons—to a sportsman
in shooting, for example; to give endurance, is used by travellers
in Bolivia and Peru, and to counteract the effect of rarefied air on
mountains.—L. ii./76,449.

Historical and botanical account of the plant and its uses; the result
of a series of experiments on its use was most unsatisfactory, although
the drug was given in every variety of ways, under all circumstances,
and at all hours of the day.—L. i./76,631,664.

Two ascents of Ben Voirlich, under the influence of, respectively, 60
and 90 grains, done with ease by Sir Robert Christison. By the use
of Coca, hunger and thirst are suspended, but eventually appetite
and digestion are unaffected; the mental faculties are not affected
after great bodily fatigue, except by freeing them from dulness and
drowsiness.—B.M.J. i./76,527; P.J. 1876,883.

Twelve athletes, during a game, chewed, without lime or ashes, from
60 to 90 grains; at first in some, dryness was felt, and relieved by
washing the mouth; then followed a feeling of invigoration, so that
fatigue was wholly or in great part resisted; the pulse increased in
frequency, and perspiration augmented. Save exhilaration of spirits,
no mental effects were noticed or disagreeable effects realised.—P.J.
1877,221.

A party climbing Mont Blanc, each chewing 80 grains of Coca during ten
hours, were much relieved from thirst by its use. They drank no water,
tea, or coffee, and but a limited amount of wine, yet Coca enabled them
to make the trip with comparative comfort.—M.T.G. ii./82,165.

It enables a greater amount of fatigue to be borne with less
nourishment, and lessens the difficulty of respiration in ascending
mountain sides. Tea made from it has much the taste of green tea, and
is much more effectual in keeping people awake.—Markham’s Peruvian
Bark, p. 152.

In France, Bouchardat states it has rendered most valuable therapeutic
service, almost equal to cinchona bark. It is a stimulant to the
nervous and muscular systems, and ranks with tea and coffee; it
prevents the rapid waste of tissue, and enables the consumer to go a
long time without food.—B.M.J. i./76,486.

Use in walking feats.—B.M.J. i./76,335,361,387,518,519,750,752.

The leaves are neither nutritive nor tonic; it is in their anæsthetic
properties, developed by chewing the leaves with lime or plant ash, the
Indian finds the numbing effect on the mucous membrane of the stomach
that he seeks.—P.J. 1885,266.

Fluid extract of Coca relieved hæmorrhage from bowel when given
internally.—Pr. xxxv.401. And gives great relief in gastralgia.—M.P.C.
ii./87,479.

Report on the Coca alkaloids.—B.M.J. i./89,1043,1108,1158.




                             CHAPTER XIV.

                        COCAINE AND ITS SALTS.


=COCAINA=, Cocaine.

_Dose._—¹⁄₂₀ to 1 grain, in a pill or tablet.

This now important alkaloid, obtained from Coca, was first isolated
by Niemann in 1860. From analysis he gave it the formula of C₃₂H₂₀NO₈
(old notation), but Lossen in 1862 assigned it the now accepted formula
of C₁₇H₂₁NO₄₁ (new notation). It crystallizes in shining monoclinic
prisms, and requires 700 or more parts of water to dissolve it;
according to Dr. Paul, it takes upwards of 1,300 parts; it dissolves
more readily in hot water, but rapidly undergoes decomposition, forming
an acid solution which contains benzoyl-ecgonine, ecgonine, and
benzoate of cocaine, which do not separate upon cooling. It is also
soluble in alcohol (about 1 in 20), freely so in chloroform, ether
(about 1 in 3), oil of cloves, and many other volatile oils, and 1
in 10 respectively of melted vaseline, castor oil, and other fixed
oils. The latter solutions have proved serviceable in eye cases. The
following are also ready solvents, each taking up about 1 of it in 3
parts: benzol, toluol, and amylic alcohol; of petroleum spirit about 25
parts are required, much less if hot; from this solution, also from hot
alcohol, wood spirit, acetone and chloroform it readily crystallizes on
cooling. It is almost tasteless, but produces a tingling numbness on
the tongue, and local anæsthetic action on all mucous membrane. Good
Coca leaves yield 0.5 per cent. or more of Cocaine, but the average
is less—if fermented, often _nil_. Cocaine seems to be very sensitive
to chemical and physical action, and readily yields derivatives. In
working the dried leaves the following compounds are also met with,
Hygrine (a volatile alkaloid), Benzoyl-Ecgonine and Ecgonine, Cocamine
and Cocaidine, accompanied by Coca-tannin and Coca-wax. All the Coca
alkaloids, according to Hesse,[30] are derived from ecgonine methyl
ester, and the ecgonine itself from pyridine. Cocaine is the most
important, whilst the others, so far as is known, do not appear to be
distinctly noxious, but at the same time they are inferior to Cocaine
in anæsthetic properties. Ecgonine (together with benzoic acid and
methyl alcohol) may also be obtained as a derivative from Cocaine when
the latter is heated with hydrochloric acid, thus:—

  C₁₇H₂₁NO₄ + 2H₂O = C₉H₁₅NO₃ + C₇H₆O₂ + CH₄O
   Cocaine.  Water. Ecgonine.  Benzoic  Methyl
                               Acid.    Alcohol.

 [Footnote 30: A Study of Coca Leaves and their Alkaloids:—P.J. 1891,
 1109, 1129, 101.]

Dr. W. Merck, by operation with hydrochloric acid on benzoyl-ecgonine,
a by-product obtained in the manufacture of, and probably a derivative
from Cocaine, converted this into benzoic acid and ecgonine, thus:—

   C₁₆H₂₁NO₄ = C₉H₁₅NO₃ + C₇H₆O₂
   Benzoyl-   Ecgonine.  Benzoic Acid.
  Ecgonine.

With this substance also, he, as well as Skraup, has made Cocaine
synthetically by heating in a tube to 100° C., a mixture of
benzoyl-ecgonine, iodide of methyl, and methyl alcohol; the excess
of the two latter is driven off by heat and the Cocaine extracted as
a syrupy hydriodate; from the salt is produced pure Cocaine, melting
at 98° C. and answering all other tests. (Ber. D. Chem. Ges. 1885,
2264.) Dr. Merck has also made the synthesis from anhydrous ecgonine by
combining it with benzoic acid and iodide of methyl.—_Ib._ 2952.

As atropine can be saponified by the action of alkalies into tropic
acid and tropine, and as Cocaine and atropine act on the eye as
mydriatics, Dr. Einhorn has demonstrated their chemical relationship
by converting anhydrous ecgonine into tropidine (the anhydride of
tropine), from which it only differs in containing the carboxyl group
in place of an atom of hydrogen.

On combining Cocaine with benzoic acid, benzoyl-ecgonine appears to be
formed—the aqueous solution of these is not precipitated by ammonia.

Cocaine is prepared by treating powdered coca leaves with a solution
of carbonate of sodium, drying the mixture and exhausting it with
petroleum spirit. The latter, which dissolves the cocaine with very
little colouring matter, is agitated with very dilute hydrochloric
acid, the petroleum is decanted and the cocaine precipitated from the
aqueous solution by adding carbonate of sodium again. The precipitate
is separated by shaking with ether, which on evaporation yields
crystals of almost pure Cocaine. Most of the Cocaine now used is
manufactured in a crude form in Lima, and imported from Callao. It
yields about 85 per cent. of pure alkaloid, and is recrystallized or
converted into the hydrochlorate after its arrival in Europe.

No coloration is produced by dissolving pure Cocaine or its
hydrochlorate in cold concentrated sulphuric acid; with the salt,
effervescence occurs, owing to hydrochloric acid gas being set free.
Some samples give a faint evanescent yellow coloration, and others
give a magenta tinge which gradually passes to a brownish yellow, and
eventually the solution becomes almost colourless.

If Cocaine or a salt be moistened with nitric acid, evaporated
to dryness, and a drop of alcoholic caustic potash added, a
characteristic peppermint odour is developed.—P.J. 1890, 162.

Report on action of ecgonine, benzoyl-ecgonine, and cocamine.—Th. Gaz.
Oct. 1889, 698.

As pure Cocaine (the alkaloid) is soluble in fats and oils, and its
salts are not, it should always be used when it has to be combined with
fatty or oily substances, for use externally, _e.g._:—


=Bougies of Cocaine.= ½ grain each or more, with cacao-butter.

Are useful in painful affections of the urethra.


=Ceratum Cocainæ.= 1 in 30 of petroleum cerate.

Is useful in burns, scalds, urticaria, pruritus, &c.


=Collodium Cocainæ.= 2 per cent. in flexible collodion.

Allays the itching, and is a cure for inflamed chilblains.


=Emplastrum Cocainæ.= 1 dissolved in 50 of lead plaster heated in a
 water bath.

Useful for intercostal neuralgia, sciatica, tender corns, bruises, &c.


=Oleatum Cocainæ.=

A saturated solution of the alkaloid in oleic acid; heated, one part
will dissolve in two parts of oleic acid; it may be further diluted
with oleic acid or oil. Has not proved so satisfactory a preparation as


=Oleum cum Cocaina.=

A 2 per cent. solution, more or less, if ordered, in almond oil, is
mostly used. This is useful for earache. For the eye a 2 per cent.
solution in castor oil is used; for catheters, a solution in equal
parts castor and almond oils does well, it is viscid, and does not
congeal in winter.


=Suppositories= and =Pessaries of Cocaine= have ½ grain (or more, if
 ordered) in each with cacao-butter.


=Tabellæ Cocainæ=, Cocaine Tablets. ¹⁄₂₀ grain in each, with chocolate
 (or more, if ordered).

_Dose._—1 every quarter, half-hour, or hour, quickly eaten and
swallowed. Useful for sea-sickness, chloroform or alcohol sickness,
sickness of pregnancy, &c.


=Unguentum Cocainæ.= 1 in 30 of lard or lanoline (more or less, if
 ordered). Cocaine is soluble 1 in 2 of anhydrous lanoline if gently
 warmed.

Useful where absorption is required, as in facial neuralgia, shingles,
eczema, erysipelas, urticaria, and pruritus.


=Vaselinum Cocainæ.= 4 per cent. (more or less, if ordered).

Suitable for the eye; is very bland; also for smearing catheters,
burns, scalds, &c.


=Cocainæ Citras=, Citrate of Cocaine.

_Dose._—¹⁄₂₀ to 1 grain or more.

Is in deliquescent small white crystals; used by dentists.


=Cocainæ Hydrobromas=, Hydrobromate of Cocaine.

_Dose._—¹⁄₂₀ to 1 grain, in a pill or solution. Is a stable salt, in
odourless, small, white, hard, acicular crystals.


=Cocainæ Hydrochloras=, Hydrochlorate of Cocaine (_Off._).

_Off. Dose._—⅕ to 1 grain, but less and more may be given, in aqueous
solution, pill, or pastil.

This salt has been most used: if pure it is in hard, colourless, short,
acicular, granular-looking crystals, or, now more frequently met with,
in light, shining, lamellar crystals, free from odour and almost
tasteless; being soluble in half its weight of water, the tingling
numbness and local anæsthesia which it produces on the tongue are more
intense than that produced by pure cocaine.

Freely soluble in spirit and in glycerine, insoluble in ether, fats,
and oils, and therefore it is not so compatible with them. This salt
will crystallize with two molecules (9·5 per cent.) of water, but the
anhydrous salt alone is official. It dissolves with effervescence but
without colour in cold sulphuric acid (_see_ Cocaine, p. 56), but chars
if heated. Ignited in the air, it burns without residue. Its aqueous
solution gives a white precipitate with carbonate of ammonium, soluble
in excess. If one drop of solution of permanganate of potassium, B.P.,
be added to a solution of 1 grain of it in a drachm of distilled
water, acidulated with three drops of diluted sulphuric acid, the
bright deep colour of the solution, if kept covered, should not change
during half an hour, indicating absence of other alkaloids of Coca, or
any other organic matter. The salt should not only be in good crystals,
but should yield a distinctly crystalline precipitate of pure cocaine
within three minutes, when 1 grain of it is dissolved in 2 ounces
of distilled water, and six to eight drops of solution of ammonia,
B.P., are added and well stirred. The precipitate redissolves after
twenty-four hours or more, the cocaine being converted into methyl
alcohol and benzoyl-ecgonine.—P.J. 1888, 783. If a trace be mixed with
a minute quantity of calomel and breathed upon, the mixture assumes a
black colour. This will only answer with the salts of cocaine, not with
the alkaloid itself.

As with an aqueous solution of sulphate of atropine, so with an aqueous
solution of hydrochlorate of cocaine, some samples seem prone to
grow fungi, while others will not. Evil results having followed the
application of Cocaine as a local anæsthetic in several dental and
eye operations, the bad effects have been attributed to these fungoid
growths. Whether due to these, to impurity of the salt, or to the
condition or idiosyncrasy of the patient, is not clear. Three London
surgeons who have used it very largely inform me they have never seen
any untoward results from its use in simple aqueous solution. Various
modes of keeping the solution free from fungi have been suggested;
carbolic, boric, and benzoic acids, perchloride of mercury, thymol,
camphor, and chloroform have been added to check their growth; a half
to one per cent. of boric acid has been particularly recommended,
but it is of little use, as an aqueous solution of boric acid itself
sometimes grows a fungus; chloroform is probably unobjectionable except
for eye drops. Perchloride of mercury is useless, as it forms a double
salt with the Cocaine. But salicylic acid has been found to be the most
effective, and its addition is now ordered in the official solution.
(See p. 60.)

_The brush applying it should not be dipped in the stock solution._


=Buginaria Cocainæ Hydrochloratis=, NASAL BOUGIES OF HYDROCHLORATE OF
 COCAINE.

One-sixth of a grain in each with gelato-glycerine basis. Useful in hay
fever, sometimes combined with ¹⁄₁₂₀ grain of Sulphate of Atropine in
each.


=Injectio Cocainæ Hydrochloratis Hypodermica.= 1 in 20.

_Dose._—2 to 10 minims. For sciatica and many local affections acts
better than morphine.


=Hypodermic Lamels= are prepared containing ¼ grain in each.


=Lamellæ Cocainæ, Discs of Cocaine= (_Off._).

Discs of gelatine, each containing ¹⁄₂₀₀ grain of hydrochlorate of
Cocaine. These should be prepared in an atmosphere carefully freed
from dust and germs of fungi and disease. Also prepared containing
¹⁄₅₀ grain in each, and in combination with Atropine, Homatropine, and
Physostigmine.


=Liquor Cocainæ Hydrochloratis= (_Off._) 10 per cent. SOLUTION OF
 HYDROCHLORATE OF COCAINE.[31]

_Dose._—2 to 10 minims. Hydrochlorate of Cocaine 100, Salicylic Acid
1½, Boiling Distilled Water to produce 1,000 fluid parts when cold.

 [Footnote 31: This forms a stable 10 per cent. solution, which
 for the use of oculists may be diluted to a 2 per cent. solution,
 and still remain free from tendency to develop fungoid growths.
 The salicylic acid remains as free acid in the mixture, as with
 perchloride of iron it gives a more permanent violet coloration than
 the so-called salicylate of cocaine. The official solution may be used
 as an application for producing local anæsthesia or for hypodermic
 injection, for which purpose it is found to be unirritating. A
 solution up to the strength of 50 per cent. may be prepared in
 salicylic acid solution of the above strength, which is nearly
 saturated.]


=Pastillus Cocainæ Hydrochloratis.= ¹⁄₂₀ grain in each (to ⅒ or ⅕
 grain, or more if ordered).

Useful in allaying irritation of the throat and hoarseness. They
invigorate the vocal organs of singers and public speakers.


=Pastillus Cocainæ et Morphinæ= contains ¹⁄₃₀ grain Cocaine and ¹⁄₆₀
 grain morphine. Useful for coughs.


=Pilula Cocainæ Hydrochloratis.= ⅕ grain in each (or more, if
 ordered), with sugar of milk and syrup _q.s._ to make a grain pill.


=Tabloids of Hydrochlorate of Cocaine.= ⅒ and ⅙ grain each.

Are prepared for hypodermic injection.


=Trochisci Cocainæ Hydrochloratis.= ¹⁄₁₂ grain in each. Used for
 similar purposes to the pastils.


=Cocainæ Salicylas.=

_Dose._—⅕ to 1 grain or more.

Is in minute snow-white crystals, slightly deliquescent, and is
recommended for the use of oculists, as it forms a solution which keeps
well.

In spasmodic asthma the hypodermic injection of a good dose (6 grains)
at the beginning, relieves the attack.—B.M.J. ii./86,117.


=Dentifricium Cocainæ.=

  Phosphate of Calcium (dry), 2 ounces.
  Orris, in powder,           1 ounce.
  Myrrh, in powder,          30 grains.

Mix, and add in solution:—

  Cocaine,                    1½  ”
  Oil of Eucalyptus,         12 minims.

Triturate well together and add ammoniacal solution of carmine, 15
minims. Mix well and sift.

Said to be useful for toothache and spongy gums.

Cocaine and its salts, although selling at one time as high as 3s. 6d.
per grain, are now reduced to a very moderate price.




                              CHAPTER XV.

                           USES OF COCAINE.


The curious property cocaine possesses of producing local anæsthesia
was even noted by the discoverer of the alkaloid—Niemann, who, so
far back as 1860, wrote: “It produces temporary insensibility on
the part of the tongue with which it comes in contact” (Watts’s
Dict., 1st Edition, i. 1059, _ex_ “Ann. Ch. Pharm.” cxiv. 215). This
interesting fact lay dormant until in 1884, Herr Koller, a medical
student in Vienna, was led to test the local anæsthetic action of
the hydrochlorate of the alkaloid, on account of the effect he had
witnessed when cocaine in solution was pencilled upon the pharynx to
render it less susceptible in laryngoscopic examination. A vial of the
solution was given by Herr Koller to Dr. Brettauer, of Trieste, who,
on Sept. 15th, 1884, demonstrated its properties at the meeting of the
Ophthalmological Congress in Heidelberg. Several experiments were made
with the two per cent. solution, which showed that when two drops of
the liquid were placed upon the surface of the normal cornea, and the
application repeated after an interval of ten minutes, at the end of
ten minutes more, the sensibility of the cornea was so far diminished
that it could be pressed with a probe; the cornea and the surface of
the eyeball and eyelids adjoining could be rubbed; a speculum could be
inserted and the lids widely separated, the conjunctiva could even be
seized with fixation forceps, and the eye moved in various directions
without causing the patient notable discomfort.

Besides rendering the superficial structures of the eye anæsthetic,
it is a mydriatic, and produces paralysis of the accommodation, which
passes off sooner than the dilatation of the pupil; this does not at
longest last more than twelve hours. The sensitiveness of the iris is
less affected than that of the surface of the eye. The great excellence
of cocaine consists in the limitation of its action to the tissues to
which it is applied. No doubt, other symptoms at a distance do result
from the external application of the anæsthetic, but they are, for the
most part, insignificant and free from dangerous consequences. In some
measure cocaine may be compared with curare. The one agent paralyses
the termination of the sensory nerves, whilst the other paralyses the
termination of the motor nerves. Cocaine would seem to act in a manner
the reverse of aconite. When applied to a mucous membrane, it has
probably a constricting action on the vessels, produces a blanching of
the part, and simultaneously a deadening of the nervous excitability
which passes into a complete state of anæsthesia; its effect, however,
does not sink deeply into the adjacent tissues, nor does it last long.
This surface application is sufficient to render painless the use of a
caustic, the passage of catheters and lithotrites, or the performance
of operations which do not involve the more deeply-seated tissues.
Such operations as the opening of abscesses and buboes, the removal of
small tumours, require the surface anæsthesia to be supplemented by
two or more hypodermic injections, of a quarter of a grain in each,
of the hydrochlorate in close contiguity to the part to be operated
on. Injected hypodermically, the aqueous solutions of its salts deaden
sensibility around the puncture, so that the deep prick of a pin is
not felt—the surrounding part is reddened, but after thirty minutes it
resumes its normal condition; injected locally, is more useful than
morphine in relieving sciatica. Although solutions of it are little
absorbed by the skin—even a chloroform solution is scarcely at all
absorbed—yet the application of an ointment of the pure alkaloid, made
with lard, or an oily solution of it, to a surface will remove the pain
of inflammation, as in eczema or erysipelas, or the pain of facial
neuralgia or shingles, and the irritation of urticaria or pruritus.
Burns and scalds should first be brushed over with a 4 per cent.
aqueous solution of the hydrochlorate, and the pure alkaloid combined
with carron oil (Linimentum Calcis), petroleum cerate, or boric acid
ointment, afterwards applied on cotton wool or lint. Combined with
boric acid ointment, also, it may be used for fissured nipples, or
for these and stings and bites of insects an aqueous solution may be
applied. The irritability of inflamed mucous surfaces, as in hay-fever,
influenza, coryza, bronchitis, spasmodic asthma, laryngitis, and
pharyngitis, is much relieved by the spray of a watery solution of
a cocaine salt. In obstetrics, its local application relieves the
pain of the dilating os uteri, and diminishes the sensibility of the
perinæum whilst being dilated in first labours; rents of the perinæum
may be stitched up almost painlessly under its action, and under its
influence many minor gynæcological operations are much facilitated by
the ability to insert needles and make small incisions without pain.
The spasmodic and painful affections of the vagina, causing dyspareunia
and vaginismus, may be minimised by vaginal injections of a quarter
of a grain of cocaine in 1 per cent. oily solutions. In dentistry,
it is useful in toothache; it deadens the sensibility of exposed
pulp. The pure alkaloid is preferable to the salts for this purpose,
because, being only slightly soluble in water, it is less liable to
be washed away by the saliva. If a little be inserted in the cavity
of a carious tooth and covered with a plug of mastic solution, all
pain is obtunded for a considerable time. A strong solution in oil of
cloves is also useful. In preparing the cavity, previous to filling,
the sensitiveness of the dentine is more effectively treated by using
a salt of cocaine—either the hydrochlorate or citrate; the latter has
been recommended, as it can be formed into a pellet with the fingers
and pressed into the cavity, but it is not so rich in true alkaloid
as the hydrochlorate; yet, either of these is absorbed more quickly
than the alkaloid itself, which, as before said, is more suitable for
plugging a cavity for some length of time. Before using arsenical paste
to destroy the nerve when exposed, if about a quarter of a grain of a
cocaine salt be inserted into the cavity, after partially clearing,
it will anæsthetize the pulp in about five minutes, and enable the
operator thoroughly to open the cavity and expose the pulp directly
to the action of the arsenical paste without pain to the patient. In
extraction, if a dose be hypodermically injected into the gum on each
side at the base of the tooth, after waiting about five minutes this
may be done almost painlessly, and, if a 50 per cent. aqueous solution
of the hydrochlorate be painted on the surrounding gum, the first pain
of inserting the forceps is annulled. The eye, ear, throat, mouth,
tongue, pharynx, nose, larynx, trachea, urethra, vagina, os uteri,
anus, rectum, and, in fact, the whole mucous membrane, as well as cut
surfaces and open sores, are affected by it, but the true skin is less
so.

Solutions of hydrochlorate of cocaine have been employed topically
in excision of the tonsils, cauterizing the turbinated tissue of the
nose, painting chancres previous to the application of nitric acid or
other caustics, opening abscesses, removing polypi, and many cases
of iridectomy and operation for cataract, squint, and the removal of
foreign bodies from the eye. For the eye an aqueous solution of the
hydrochlorate of cocaine of mostly 2, but sometimes 4, per cent. is
used, and for other purposes from 4 to 20 or even 50 per cent.; of the
weaker solutions it is necessary to repeat the application three to
five times, at intervals of three to five minutes. No operation should
be commenced within at least ten minutes of the first application.
Injurious effects, either local or constitutional, rarely follow
its use. Its action commences in three minutes, increases from ten
to twenty minutes, and mostly disappears within half an hour. The
anæsthesia may be prolonged by applying an Esmarch’s bandage round the
site of injection.

_Uses of Cocaine, and cautions on its employment; a summary of the
experiences of fifty-two surgeons in the United States._ In minor
surgery—is of value in all operations where circulation can be
temporarily arrested in order to prevent undue absorption. A fresh
solution should be employed, of strength not exceeding 4 per cent.
Caution is required when the circulation cannot be controlled. Is of
little use as a local anæsthetic in anal work, such as fistula. In
genito-urinary surgery must be used with care, as it is in this class
of cases that untoward effects have been most marked; the solution
should not remain in contact with mucous surface more than a few
moments. In gynæcological work it is of limited service, as general
anæsthesia is mostly to be preferred. For ophthalmic surgery, Cocaine
is the anæsthetic _par excellence_; in no other department of surgery
is its use so widespread and its application so entirely satisfactory.
It is suitable for all operations on the eyeball, except iridectomy for
acute glaucoma, and enucleation; as it causes dryness of the epithelium
it should not be used long prior to operation. Is of great value in
nasal, aural, and throat operations.—Th. Gaz. Aug. 1891, 518.

=Chloroform and Cocaine Anæsthesia= (_combined_).—Chloroform is
given, 1 to 3 drachms, with an Esmarch’s mask, and from ½ to ¾
grain of cocaine, in 3 to 5 per cent. solution, injected into the
part. Less chloroform suffices, vomiting is rare, and depression on
waking slighter than chloroform alone produces.—L ii./88,220; B.M.J.
ii/88,903. Th. Gaz. Sept. 1888, 630; Oct. 686; Dec. 849.

Equal parts of an 8 per cent. solution and liquor atropinæ sulphatis
form an effective remedy for all painful and inflamed conditions of the
eye; and half a grain of pilocarpine nitrate, added to 1 drachm of a 4
per cent. solution, produces anæsthesia without in the least disturbing
the accommodation.—Whitla.

As regards the toxic properties of cocaine, its effects appear to be
mild and not cumulative. It causes cessation of respiration,—small
doses have an exhilarating effect on the nerve-centres and other parts
of the nervous system. In a case of attempted suicide by an apothecary,
a dose of 1.5 grammes (23 grains) seemed to have no seriously injurious
effect.—Varge’s “Zeitschr.” v.f. 11, 5, p. 222, 1863.

A writer in the _British and Colonial Druggist_, Feb., 1885, p. 36,
thus describes the effect of a full dose:—

“Inasmuch as the writer—whose nervous system is of an almost
unfortunate degree of sensitiveness—has taken doses of the
hydrochlorate, equivalent, in the aggregate, to no less than 32 grains
of cocaine itself within the space of three hours, without (as the
present lines sufficiently prove) a fatal result following, this
remarkable body cannot fairly be classed among the poisonous alkaloids.
Among the chief symptoms induced were increased cerebral activity
mounting at intervals into the region of delirium, the latter tendency
always subservient to a powerful effort of the will. This continued
for five hours, the heart action and breathing being meanwhile
slightly increased, but not to any painful extent. At first the
muscular powers appeared to be enhanced, heavier weights being lifted
without undue stress than is ordinarily the case, while the reflective
faculties—as instanced by ability to read and form conclusions upon
novel scientific matter—seemed stimulated. An hour after the entire
quantity named had been taken, the sensibility of the limbs to external
influences—which had gradually diminished from the first—became
materially lowered, and neither pinches, pricks, nor slight burns with
a heated wire could be felt upon the fleshy portions of the arms or
legs. The trunk, however, never lost its sensibility to pain in any
marked degree.

“Slight convulsive movements and a sensation of bodily torpor
succeeded, giving way about the eighth hour to considerable somnolency.
No special desire, or distaste, for food was noticeable, but sleep
overcame all other symptoms between ten and eleven hours from the
commencement, and continued for thirteen hours afterwards; a slight
feeling of dizziness was experienced on waking, but this gradually wore
off, and had entirely disappeared twenty-four hours later.”

By physiologists, it had been supposed that cocaine would have
properties allied to, if not identical with, caffeine, theme, or
theobromine, in the manner that these themselves are allied. But,
chemically, cocaine is quite distinct; it is much less soluble in water
than caffeine; it is a strong base, which caffeine is not, and its
chemical constitution and derivatives are quite distinct from those of
caffeine. As a medicine, the coca leaf has been more used in France and
America than in England.

Opinions are at present divided as to whether the anæsthesia produced
by Cocaine is the result of vasomotor disturbance—the small vessels are
caused to contract by its application, and the nervous filaments are
doubtless anæmic—or whether Cocaine acts directly as a paralyser on
the nervous endings, whether of sensibility, or touch, or of special
sense, since it removes the power of taste and smell, as well as the
perception of touch and pain. When Cocaine is administered in such
a dose and manner as to affect the whole system, the brain seems to
become excited, the heart stimulated, and blood and pressure increased.
Poisonous doses kill by asphyxia, the breathing becoming arrested and
the heart failing in diastole; but this has not yet been observed in
man, the dose necessary to produce this effect being very large; 20
grains have been taken without very serious result. It diminishes all
the secretions, and, although the intestinal movements are slightly
stimulated at first, larger doses or continued use cause sluggish
action, dyspepsia, and constipation. Tissue change is lessened, and the
amount of urea is similarly diminished; the temperature seems to be
somewhat higher than normal; albuminuria has been found to follow its
use, and sugar has been found in the urine. The kidneys are probably
the special means of its elimination. With regard to its action on
muscular fibre nothing is known, observers being completely at variance
in their opinions.—Buxton, in Ringer’s “Therapeutics,” 12th edition.

“Brown-Séquard regards the effect as a new sample of inhibitory action,
his experiments convincing him that Cocaine acts through the medium of
the peripheral nerves on the nervous centres, which react in bringing
about inhibition of sensibility. The phenomena which result from the
injection of Cocaine at the level of the larynx, he finds to be the
same as those which are consecutive to the application of a jet of
carbonic acid on the mucous membrane of that organ. Two minutes after
the injection there is a generalised anæsthesia and an analgesia of
the different wounds made on the body of the animal. The cutaneous
anæsthesia lasts only a few minutes, but the analgesia of the wounds
persists even till the following day. If fresh wounds are made, these,
far from being analgesic, become, on the contrary, hyperalgesic. That
which proved that Cocaine acts on the nervous centres, and particularly
on the cerebellum, is that injections of this substance produced
sometimes a rolling motion to the side opposite to the injection,
and at others a turning motion. Evidence of the inhibitory action
is offered by another of Brown-Séquard’s experiments: when the dose
of Cocaine injected was large enough to produce convulsions, it was
sufficient to pull or forcibly flex the toes to immediately stop
the convulsions. In animals which died under these conditions the
temperature of the body after death was as high as 44°·4 C, or 111°·6
F.”—Brown-Séquard in Prosser James’ “Guide to New B.P.”

In Vienna, Cocaine has been recommended for use internally in cases of
great exhaustion, such as loss of blood, sunstroke, or diarrhœa, also
by mouth or hypodermically as a cure for morphine and alcohol craving.
Morphine and Cocaine appear to be mutually antagonistic. Cocaine has
been used in some cases of melancholia and insomnia; it also possesses
aphrodisiac properties. It was likewise found to lessen the desire
for sleep and feeling of hunger, and to be a stimulant which quickly
increases and sustains, in a harmless manner, the physical powers of
the body, such as are required in long marches, mountain ascents, &c.,
in dose of ¾ to 1½ grains.

Cocaine is a stomachic, useful after excess either in eating or
drinking, in distaste for food, in sea-sickness and vomiting of
pregnancy, or from other causes; it also improves the condition of the
stomach in atonic indigestion and nervous affections of this organ, as
well as in phthisis and cachectic cases, especially those arising from
the use of mercury.




CHAPTER XVI.

MEDICAL NOTES AND REFERENCES.


Cocaine is a mydriatic; slightly raises the temperature, quickens
respiration, and pulse is more frequent; by long use, sleep is longer
and more profound. Improves nutrition, useful in insomnia and simple
melancholia.—M.R. 1883, 86.

Eleven successful cases, including three of operation for cataract,
one double iridectomy, one removal of tumour from lid, and three for
convergent strabismus. In cases of intolerance of light it acts like
magic.—L. ii./84,911.

In papillomata of larynx, interior painted with 20 per cent. solution
of hydrochlorate of Cocaine once, in five minutes was able to introduce
the forceps four times and remove large portions of tumours without
patient experiencing any pain or subsequent shock.—L. ii./84,912.

In quinsy, a 20 per cent. solution useful to paint fauces.—Pr. xli. 47.

Coca and Cocaine are said to have a deleterious action on the voice,
slackening and deadening the vocal cords through the paralysis of
the extensor muscles. The aphony produced is painless.—Th. Gaz. May,
1889,353.

Physiological effects on the eye.—L. ii./84,911.

Seven eye cases under its influence.—Med. Rec. (N. Y.) 1884,510.

Use in the nasal cavity, cotton wool soaked in 2 per cent. solution
applied at the end of a probe in over forty cases, including
hypertrophy of the nasal mucous membrane (twenty-seven cases
cauterized), acute coryza, nasal polypus and hay-fever, all having
marked swelling of the nasal mucous membrane, both from chronic and
acute causes; in every case there was complete subsidence of the
turgescence of the membrane and the sinuses were emptied of their
blood.—Med. Rec. (N.Y.) 1884,533.

Cocaine solution applied to a blistered surface anæsthetizes the
part.—B.M.J. i./85,300.

Solution painted on or injected into piles relieves the pain of
operating on them.—B.M.J. i./85,227.

References to its surgical use as a local anæsthetic:—L. ii./84,608
(ophthalmic), 683 (ophthalmic), 936 (laryngeal), 975 (ophthalmic),
975 (nasal), 992 (ophthalmic), 1022 (physiological action), 1023
(ophthalmic and aural), 1068 (ophthalmic), 1097 (ophthalmic), 1123
(ophthalmic and dental), 1167 (circumcision and catheter passing);
L. i./85,86 (uterine, vaginal, and oral), 123 (in tenesmus), 130
(on mucous membranes), 168 (dental), 220 (rectal), 226,315 (minor
surgery), 965 (ophthalmic), 1033 (fistulas, canals), 1067 (ophthalmic),
1097 (nasal), 1112 (ophthalmic); B.M.J. ii/84,761 (ophthalmic),
1074 (laryngeal), 1132, 1142,1143,1249,1256 (ophthalmic), 1133
(dysphagia), 1188 (throat and nose), 1255 (laryngoscopic), 1256
(midwifery and tinnitus); B.M.J. i./85,45,77,134,145,863 (effects
on the eye); B.M.J. i./85,24,36,77,235,286,456,792,1266 (ophthalmic
surgery); B.M.J. i./85,36,47,209,456,479 (nose and larynx); B.M.J.
i./85,377 (cancer); B.M.J. i./85,227,653,994 (rectal operations);
B.M.J. i./85,17,36,47,361,994 (vagina and urethra); B.M.J.
i./85,17,24,36,69,736,926 (in dentistry); B.M.J. i./85,402 (for
scalds); B.M.J. ii./85,396 (tumour of lip removed); B.M.J. ii./85,1060
(removal of ingrowing toe-nail); L. ii./85,829; Th. Gaz., June, 1890,
415 (preceding iodine injection in hydrocele); B.M.J. ii./86,413
(dilatation of urethra); B.M.J. ii./88,491; i./8,1113 (minor surgery);
B.M.J. i./89,943 (circumcision).

Translation of Carl Koller’s report of the earliest observations on the
use of cocaine and its salts as local anæsthetics.—L. ii./84,990.

Hydrochlorate of cocaine, 20 per cent. solution allowed nitric acid to
be applied to the tongue without pain.—L. ii./84,1023.

In skin diseases, relieves the inflammation in eczema and acne and the
irritation of urticaria.—L. i. 85,76.

Fungoid growths in aqueous solutions of salts of cocaine and other
alkaloids.—L. i./80,224,315,504,597,647.

Physiological action.—L. i/85,439; i./88,1041; B.M.J. ii./84,1313;
i./85,17,97,863.

Summary of its pharmacy.—L. i./85,488.

Checks hæmorrhage from lips and gums in purpura.—L. i./85,581; Pr.
xxxiv. 450.

Chemical researches by Paul.—P.J. 1888,781; B.M.J. i./88,709.

Hay fever relieved by solution applied locally to nose and eyes.—L.
i./85,925: L. ii./85,50,99,123,232,820; B.M.J. i./85,1084,1291;
ii./86,18; i./88,1329.

For moles, warts, &c., about 6 grains of cocaine to a drachm of nitric
acid applied once or twice a day with the point of the rod of an acid
bottle is painless; a ring of melted wax should be put round the mole
first.—L. i./85,1052.

Résumé of action and uses.—B.M.J. ii/84,1081,1132 B.M.J. i./85,36; Pr.
xxxiv. 56.

In senile gangrene, the intense pain of, relieved by a 4 per cent.
solution on contiguous parts.—B.M.J. i./85,653.

In coryza, 4 per cent. solution useful applied on cotton wool.—B.M.J.
i./85,430,1084.

The mydriatic effects on the iris, and on the tension of the eyeball,
caused by its local application.—B.M.J. i./85,1303.

The painless removal of urethral caruncles.—B.M.J. ii./85,153; and of
epithelioma.—L. i./87,56.

In obstetrics, several valuable applications.—Pr. xxxiv. 65; L.
ii./87,754, 1061; ii./90,474.

The oleate is useless, except for sores on penis and anus.—Pr. xxxiv.
451.

Hypodermic injections apt to be followed by faintness.—Pr. xxxiv. 450.

Gonorrhœa, acute, 2 per cent. solution injected relieves the pain.—Pr.
xxxiv. 222.

Rectal and prostatic pains relieved by ½-grain suppositories.—Pr.
xxxiv. 128.

Summary of its effects on the eye, viz., dilatation of pupils,
constriction of small peripheral vessels, paralysis of accommodation,
and enlargement of the palpebral fissure; the effect is local only,
by paralysing the endings of the sensory nerves, and irritating the
sympathetic nerves.—Pr. xxxiv. 1.

Dysmenorrhœa, the pain of, removed by painting the cervix with 4 per
cent. solution.—B.M.J. ii/85,399.

After lithotrity, ½ an ounce of 4 per cent. solution injected for
painless removal of fragments.—Pr. xxxiv. 128.

In labour pain attending the dilatation of the os in primiparæ relieved
by painting the os and cervix with 12 per cent. solution.—B.M.J.
ii./85,473.

In supra-orbital neuralgia, a 10 or 20 per cent. solution in oil of
cloves rubbed into the part affords immediate relief; with summary of
its medical uses.—Pr. xxxiv. 59; M.R. 1884,516.

In sea-sickness, several cases, ¹⁄₁₆ grain doses every two or three
hours in aqueous solution were successful. A girl of 18 had been sick
24 hours before it was tried; she had a double dose every half-hour
with “truly magical effect.”—L. ii./85,451; B.M.J. ii./85,627.

German and Russian recommendations of its use in sea sickness.—L.
ii./85,912.

Sea sickness effectually checked by two lozenges each containing ¹⁄₁₂
grain of hydrochlorate of cocaine taken when first threatened, and two
more in twenty minutes. One grain doses in solution also effectual.—P.
J. 1886,712.—B.M.J. ii./87,1236.

Thimble-shaped pessaries, composed of cocaine and oil of theobroma,
relieved the pains of the first stage of labour, when inserted into the
dilated os uteri. B.M.J. ii./85,1140,1159.

Morphine habit of three years’ standing, 8½ grains taken during three
days was successful in curing.—B.M.J. ii./85,1112. Counteracting
effects unsatisfactory.—L. i./89,287.

Poisonous effects attributed to local use in fourteen eye cases and
three hypodermic injections.—B.M.J. ii./85,983.

Vaginismus, ointment and pessaries of cocaine useful.—B.M.J.
ii./88,720,817; B.M.J. Supp. ii./90,30; Relief temporary only.—B.M.J.
ii./88,790.

Cases of fainting when solution of cocaine salt was applied to the
eye.—B.M.J. ii./85,1060; i./86,67. Also after hypodermic injection.—Pr.
xxxiv. 450.

In eye operations, the diminished elasticity produced by cocaine may be
a source of inconvenience.—L. ii./85,1158.

Dangers from use of cocaine in eye cases supposed to be due to
decomposition accompanying fungoid growth. Graefe recommends the
cocaine salt to be dissolved in solution of mercuric chloride 1 in
20,000.—L. ii./85,863,996,1070,1119,1167; B.M.J. ii./85,971,1184.

Cocaine craving, 5 to 7 drachms per day of 4 per cent. solution caused
a state of system allied to delirium tremens.—L. ii./85,732.

Facial neuralgia relieved by quarter of a grain of salicylate of
cocaine—L. ii./85,733.

Hydrocele, medical cure of, a preliminary injection of cocaine solution
before the injection of iodine recommended.—L. ii./85,829.

Earache, a 2 per cent. solution of the hydrochlorate on wool is
useful.—B.M.J. i./86,87.

Toe-nail ingrowing, removal of, local injections should precede.—B.M.J.
ii./85,1060.

Larynx painted with 20 per cent. solution, a state of spasm was caused
which required chloroform to subside it.—L. ii./85,946.

Whooping-cough, 15 to 20 per cent. solution a valuable pigment to
the larynx.—B.M.J. ii./85,981,992. Also in spray with glycerine.—L.
ii./89,1098.

For removal of a pile, after bathing it with hot water, some dry
hydrochlorate was dusted over it, and one grain injected into its
base; in 10 minutes after on applying the clamp and cautery, it was
painlessly removed; the patient was next day able to attend his
business; also found useful in many minor operations.—L. i./86,527.

General résumé of its effects and uses. B.M.J. i./86,527,574.

Thigh successfully amputated under the influence of cocaine, 1 per
cent. solution injected into the skin and a half per cent. solution
into the deeper parts; only during the sawing of the bone did the man
complain of pain.—L. i./86,561 _ex Med. Jour._ N.Y., Feb. 20th.

Angina pectoris, ½ grain three times a day.—L. ii./86,459.

Morphine and nitrite of amyl are the best antidotes.—B.M.J. i./88,757.

Vomiting of pregnancy relieved by internal use.—L. ii./87,754, and for
sore nipples, 1061; B.M.J. ii./87,94.

Camphor 5, chloral 5, cocaine hydrochlorate 1, warmed, form an oily
liquid which cures toothache.—L. ii./86,324.

Slight pains especially spasmodic, relieved by injection of a 20 per
cent. solution into urethra.—L. i./88,871.

Painless tooth extraction if a 15 per cent. solution be injected into
the gum.—B.M.J. ii./86,601.

In dentistry is of doubtful advantage, there is some danger, the gums
do not absorb it.—L. ii./86,1190.

Two cases of poisonous symptoms following the injection of one grain
in 20 minims into gums, in tooth extraction.—L. i./88,872. Another
case.—Pr. xli. 288.

Lithotrity rendered painless by the injection of 16 grains dissolved
in 12 ounces of warm water into the bladder.—B.M.J. i./88,972.

Several cases of dangerous symptoms following its use in surgery.—L.
i./87,780; St. Thomas Hosp. Rep. vol. xv.

Thirty cases of danger narrated, chiefly following its hypodermic
use.—Th. Gaz. Jan. 1888, 16.

Cases of toxic action; from urethral injection of 12 grains,—Pr.
xli./369; from vesical injection,—B.M.J. i./89,373; from rectal
injection,—L. ii./89,656; from hypodermic injections—B.M.J. i. 89,382;
L. ii./88,715; i./89,274; from internal use, 20 grains accidentally
swallowed,—L. i./89,292; 4 grains in child of 4 years,—Th. Gaz. Jan.
1889,26; other cases,—B.M.J. i./89,382; Th. Gaz. June 1888,373.

Résumé of poisoning cases; more than ¾ grain should not be injected
at once. Opium and morphine useless as antidotes; chloroform or
ether inhalation recommended to prevent respiratory tetanus.—B.M.J.
i./89,311. Toxic effects counteracted by ammonia.—L. i./88,394;
ii./88,715; ii./89,1126.

Erosis after hypodermic injection.—Pr. xliii./449.

Against indiscriminate use, and formation of cocaine habit.—B.M.J.
i./89,973.[32]

 [Footnote 32: Cases of danger from cocaine have generally occurred
 from its quick absorption in hypodermic use, especially in dental
 operations. Those who have applied it otherwise most freely recognise
 little danger. In a large experience of the drug, I have not met with
 a case in which the so-called “Cocaine habit” has been formed.]

Best antidote is amyl nitrite.—B.M.J. i./88,757.

Pleurisy relieved by local hypodermic injection of ⅕ to ¼ grain.—B.M.J.
ii./88,76.

In diabetes, after codeine treatment, cocaine, ¼ grain doses given;
overcame obstinate constipation, and ataxic gait disappeared.—L.
ii./89,735.

Pruritus, several cases relieved by cocaine 2 per cent. in oil of
theobroma.—B.M.J. ii./89,194.

A successful anæsthetic in skin-grafting; the vitality of tissue is
unaffected by its use.—B.M.J. ii./90,113; Pr. xlv. 295.

The morning sickness following hypodermic injections of morphine
is prevented by combining ½ grain cocaine with the morphine
solution.—B.M.J. i./90,1367.

Useful in psoriasis of tongue, used before a meal averts pain from
passage of food; in painful affections of stomach, affords relief and
averts vomiting, as that of pregnancy; in pruritus ani and itching skin
diseases; and as an anal injection checks diarrhœa and straining of
dysentery.—Ringer’s “Therapeutics,” 12th Edition.

Cocaine adopted to relieve morphine craving led to extreme cocaine
abuse.—L. ii./90,424.

The addition of phenol to hypodermic solution, 1 part to 30, preserves
the solution, increases anæsthetic action, and diminishes risk of toxic
symptoms following its use. B.M.J. ii./90,94.

Resorcin prevents cocaine poisoning; value of both drugs enhanced by
combination.—B.M.J. ii./90,506.

A 2 per cent. solution recommended in preference to stronger, as
it appears to be more quickly absorbed. An overdose usually causes
quick pulse, rise of temperature, dilatation of pupil, anorexia,
and insomnia. This last yields best to chloral, but requires large
doses.—L. ii./91,663.

Successful case of laparotomy under cocaine; 12 minims of 20 per cent.
solution used.—B. M. J. ii./90, 1022.

Amputation of wrist under cocaine; no shock.—B. M. J., Supp. i./91,202.

Cystitis arising from cantharides blistering not prevented by camphor;
intolerable pain, unalleviated by morphine, attended fresh blistering,
but ceased instantly on the introduction into the prostatic urethra of
15 minims of 1 per cent. solution of cocaine hydrochlorate. The pain
recurred in three and a half hours, but yielded at once to ten minims
of the solution, and did not return.—L. ii./91,1351.

Cocaine decidedly useful in sea-sickness. In crossing Channel two
ladies, usually ill, were kept free from the horrid feeling, one by
taking six and the other three, ⅒ grain doses.—Mrs. Fenwick-Miller, in
Ladies’ Column, _Illustrated London News_, August 27, 1891.


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