Coca

Volume II — Main text

COCA .

Erythroxylon Còca, Lam. Coca leaves. Nat. Ord., Erythroxylaceæ. I. Provings.- 1 . Dr. RAUCH, æt. 45, tall, thin,strong, and healthy. Oct. 31st, 1855, at 7 a.m., took 3 dr. of 2x dil. In 20 m. borborygmus, flatulent discharge, and stool earlier and looser than usual ; at 8.45 passing stitches in 1. side, increased by deep breathing ; at 9.30 constriction of chest, succeeded by fulness in and below epigastrium. All symptoms disappeared after dinner, but pulse was weak and quicker than usual until n. Nov. 2nd.-Took 5 dr. of Ix dil. at 7 a.m. In

5 m. borborygmus and flatulent discharge came on ; stool soft but at normal time ; borborygmus, &c., continued into afternoon ; since 9 a.m. pulse small, quick, and weak ; craving for food earlier than usual, though

epigastric region felt full. 4th.-5 dr. of 2x at 7 a.m. Frequent sneezing and urging to stool prematurely, but other symptoms did not appear. 7th .- 10 dr. at 6 a.m. At 6.30 borborygmus ; nothing else. 8th.-15 dr. at 9 a.m. Borborygmus ; slight giddiness (objects revolving) on going into open air for an h. [On 9th and 10th, cough with thick, whitish-yellow expectoration, and on 11th and 12th severe attacks of flatulent colic, both dubious results of medicine, of which no more was taken.-EDS.] (Cl. MÜLLER's provings, Hom. Viertelj., vii, 4, 443.) 2. Dr. REICHENBACH, æt. 35, slender and delicate, liable to headache and feverish attacks after any exertion, which, however, soon pass off. July 1st, 1855.-At 6 a.m. took 10 dr. of2x dil. At 8 giddiness on climbing steep staircase followed by one loose stool. On 2nd took to dr. , and on 3rd 25 dr. without effect. 4th.-At 7 a.m., 25 dr. of Ix. At 7.30, giddiness for h., relieved by rest and a glass of wine. In e. felt sleepy very early, but could not sleep ; was wakeful in bed, and felt heat with throbbing of temporal arteries till midnight. Next d. very irritable, chilly ; in e. weak and tired. 6th. At 6 a.m., 10 dr. oftinct. At 8, feeling in head of great exhaustion ; flashing before eyes like distant lightning. 7th.-Sat up till 3 a.m. writing letters, then, after coffee, took 10 dr. Felt extraordinarily well, lively, and ready for work till noon ; in e. same flashes as yesterday. 8th.-At 4 a.m., on returning from an accouchement took 25 dr. At 4.15, much exhausted and sleepy ; at 5.30 could hardly keep eyes open ; after coffee for 1 h. much brighter, but then great weariness so that he could hardly get through his work ; beer had no influence ; in e. flashes as before. Went early to bed, but was sleepless, and burdened by thoughts , also shivery. Rose at 11 , and worked till 2 a.m. perfectly awake ; then quiet sleep. 9th.-Abstained from coffee. Very great weariness ; eyes painful ; white specks before them, so that book he was reading appeared marked ; little appetite, slimy taste. Quite overcome with sleep during dinner, and did not awake for an h., when specks had disappeared, but on attempting to read drawing in occiput was felt extending to temples, lasting all afternoon. At n. profound sleep. 10th.-Giddy and weary ; involuntary quick stepping when walking, head inclined forward with fear of falling. Little appetite for meal. P.m., fever and great weakness, relieved by wine. Weary in e., but sleepless in bed. At 11 p.m. took 10 dr. After temporary sleepiness great wakefulness till 4 a.m., then quiet sleep till 7. 11th.-Lively and strong all d. Took 10 dr. in e. Sleepless n. Very poorly all next d., but slept soundly,and on 13th felt well. On 14th took, early, 25 dr. No effect save spoiled taste at breakfast. 23rd.-Took 65 dr. before dinner. Giddiness, whirling in head. On going out after dinner white specks and bright serpentine lines before eyes, with great weariness for an h.; then pressive headache on r. side and in occiput, with giddiness and chilliness . These symptoms disappeared towards e.; then indigestion with tasteless eructations, nausea, and great weariness. In h. after going to bed became wakeful and lively, with shivering, giddiness, and fever, crowding of thoughts and solicitude. Sleeplessness till 2 a.m., ending in sweating, rest, and sleep.

Awoke early ; liquid stool and indigestion. P.m., faintness, pain in occiput. 25th.-Diarrhea and loss ofappetite. P.m., same as yesterday, but with shivering and slight fever. 26th.-Poor appetite, soon satiated ; coated tongue and slimy taste, with a little fever. Occipital headache p.m. with fever. 27th.-Two loose stools without other symptoms save weakness. On Oct. 11th took 25 dr. of a fresh tinct. Pressing pain in r. cheek-bone. 12th.-50 dr. Giddiness, pressure in occiput. P.m., headache, as if catarrhal, with cold feet and unusual urging to stool. 13th.-More headache with shivering. 14th.- 60dr. in m. P.m., weariness with giddiness and headache (forehead and occiput), and shivering. 15th.-Slight headache p.m., with some shivering. 16th.-Unusual urging to stool, but no diarrhea ; otherwise quite well. ( Ibid.) 3. Dr. KALLENBACH, æt 27, in good health. Having taken on several occasions at intervals of some d. small doses of 5-10 dr. of tinct., he observed nothing more than humming of ears. On May 16th, at noon, took 50 dr. Feeling of deafness in both ears (as if something had happened there), but he still heard as clearly as before ; audible pulsations in both ears, singing in 1. 17th.-Still feeling of deafness. On reading aloud, feeling as if membrana tympani were pressed outward by the sounds, or as if they reached ear only through a thick medium. Pulsation and humming in both ears, in forenoon. By e. all symptoms had disappeared, but there was cracking in ears on empty deglutition. (Ibid.) 4: a. Dr. C. MÜLLER.-In good health,buthas some emphysema, causing slight dyspnea and palpitation at times. But slightly sensitive to medicinal action. Oct. 28th, 1853.-Masticated halfaleaf. 29th. -In forenoon much oppression on chest and dyspnea, especially on ascending. P.m., unusual sense of fulness in stomach, abdomen, and chest, with eructation, and no inclination or ability for work. 30th.- In m. 2 dr. of tinct. In forenoon same dyspnea. Nov. Ist.- In m. 3 dr. Less dyspnea than before, and on 2nd and 3rd, no med. being taken, less than usual. Felt very hungry at II a.m., and ate dinner with much appetite, of which I had not been conscious while taking drug. b. June 30th, 1855.-Took 5 dr. of tinct. at 8 a.m. In I h. much eructation, lasting 2 h., but accompanied with unusual freedom in breathing, and inclination to walk fast and far ; yawning and sleepiness when sitting. Great appetite from II ; after 12 singular feeling of emptiness of stomach and abdomen, and in walking painful contractive sensation in stomach, and near it on 1. pain like a splenic stitch. Ate much more than usual at dinner and supper without subsequent fulness. Great sleepiness towards 5 p.m. for an hour. July Ist.- On waking after a comfortable n. sense of dryness in throat, which , on swallowing, felt as if swollen, disappearing in 10 m. At 8 a.m., 10 dr. Towards 9 same sensation in the throat for 2 h., recurring in e.; uvula actually swollen. After 10 borborygmus, emptiness, and hunger, stitches in spleen ; these last also recurring in e. while walking, obliging him to stand still for 10 m. Appetite as before. 2nd.-After good n. throat as before, and same splenic pain for 5 m. Throughout d. pain-

ful lameness in 4th and 5th fingers of r. hand, especially on stretching them out or grasping anything, without external tenderness. Dysphagia, though less, continued all d. During next d. throat almost well, but fingers were same, and firmer pressure brought out some tenderness . On 4th, fingers right, throat nearly so. On 5th, well. On 6th, early, took 30 dr. In 10 m. slight eructations, followed by slight attack of giddiness when walking, with sensation as if body were drawn towards r. side, lasting some m. Inh. slight dyspnea and oppression on ascending stairs, recurring in e. whilst walking slowly, with former affection of uvula. Later, whilst sitting, an almost painful weight on chest, with constant necessity to inspire very deeply ; extraordinary weariness after a moderate walk. Dyspnea even when in bed, and palpitation, with same weariness. 7th.-On waking early, same pain in throat, with dyspnea and distension of stomach. At 8 a.m. , 40 dr. In 10 m. frequent yawning, continuing all forenoon ; in 25 m. vertigo on sitting down and again on rising ; constant dyspnea on exertion, with craving for deep inspiration, as if to breathe away something. Momentary darkness before eyes about 11 ; a hearty meal with good appetite at noon; woke from siesta with sudden jerk ; pain in throat much less. Towards 4 p.m., black specks flying before eyes ; two stools to-day (most unusual). 8th .-Scarcely any dyspnea, but great weakness and weariness in forenoon. 9th.-Well. 10th .-At 8 a.m. , 60 dr. Towards 9, yawning, but no sleepiness, in open (warm) air ; between II and 12, in cool room, felt very sleepy and head ached, both, however, disappearing on again going into open air. I1th.-On awaking, pain in muscles of forearm, on edge of radius, on moving it or on pressure, as if from a violent blow ; pain lasted throughout d., and was very violent, but there was nothing to be seen. 12th.-Still pain in arm on pressure, but none on motion ; bad taste on waking, poor appetite ; fulness of stomach with continual urging to eructate for 3 h., recurring after dinner, and lasting till e. c. Sept 25th, 1856.-Masticated two leaves in m. On walking in forenoon had weight in chest with dyspnea, and occasionally painful pressure in chest affecting breathing much less. 26th.-Recurrence of uneasiness in uvula, which next d. had become pain, rather severe when swallowing ; sense of swelling increased towards e., when there was decided elongation and reddening of uvula and its vicinity. Pain in throat went off gradually during following d. d. Oct. 16th.-Took early 10 dr. of tinct. In h. tasteless eructations, surprising inactivity all forenoon, heavy, even sleepy, with frequent yawning. 17th.-Lachrymation of r. eye on waking, slight reddening of conjunctiva and lids at inner angle ; slight mucous discharge from both eyes all d. In forenoon surprisingly fresh, lively, and inclined to walk. ( Ibid.) 5. R. H-, æt. 26, in good health save for occasional slight attacks of wandering rheumatism, and a papular eruption on back of hand. On Oct. 1st, 1856, at 6 a.m., masticated four or five leaves for 15 m. In 10 m. had scintillations before eyes ; while writing, letters seemed to swim together on paper, and he seemed to be using two pens ; feeling At gradually came as of knocking above eyes ; great tingling in ears .

8, rather severe headache, sense ofdryness in throat, great humming in ears ; vision is now clear. At 10, headache better, still heaviness in head and ringing in ears ; oppressed feeling in chest ; great nausea after breakfast. Food not relished at dinner. At 6 p.m., severe vomiting, twice, of watery mucus, without bitter or acid taste ; after that strong taste as ofleaves ; urine dark brown. No stool to-day, in spite of several attempts ; was awoke at II at n. with desire for one, which proved firm and abundant. 2nd.-At 7 a.m., masticated two leaves. In 10 m. symptoms as yesterday, but headache less violent ; heart beats strongly with oppression of chest ; no nausea. 3rd.-Same mastication, and same symptoms of eyes, ears, and head. Much constipated with abdominal uneasiness. Again palpitation for 6 or 10 m. 4th.- Masticated one leaf at 6.45 a.m. At 8, usual symptoms, but slighter. From noon toothache in hollow tooth. Bowels moved at 3 and 6. 5th. On account of violent toothache masticated no more leaves. Bowels moved at 8 p.m. 6th.-Toothache gradually went away, and bowels moved at 10 p.m. 7th.-At 6.45 a.m., masticated five leaves. At 7.15, found it impossible to continue reading, letters running together ; fiery points passed downwards before eyes; dulness of head. At 9, violent headache directly above eyes ; great ringing in ears, with deafness ; no appetite for breakfast. At I p.m., head still very heavy ; very great palpitation. Dinner not relished ; feeling as if he would vomit ; great thirst ; feet as if filled with lead. At 6.30, violent vomiting of awatery mucous substance followed by taste of leaves ; great anxiety ; all d. roaring in ears and sparks before eyes. At 9.30, great weariness ; bowels unrelieved to-day ; urine small in quantity and of dark-brown colour. 8th.-Did not sleep much; bad taste in mouth, with great thirst ; head still dull and confused. At 5 p.m., first motion for 39 h., hard and knotty. At midnight awoke with urgent desire for evacuation, but without result. 9th.-From 9 p.m. masticated four leaves, and while doing so went to bed. In 10 m. pressure in eyes ; coloured vision ; sparks pass downwards before eyes ; great anxiety and palpitation ; broke out into copious perspiration ; violent headache over eyes ; great nausea. At 11.30, vomited twice, with after-taste of leaves. Fell asleep towards 1, but was extremely restless, waking at least six times before 3 ; also bad dreams and constant perspiration. Tolerable sleep 3-7. 1oth.- Rose with great dulness in head, as after a debauch ; no appetite ; coated tongue, and bad taste. No stool to-day. 11th.-Masticated two leaves, with same effect on eyes, ears, head, heart, and abdomen ; also great thirst. In e. bowels moved, first time for 41 h. On undressing next e. discovered on inner thigh a number of small red pimples ; they itched dreadfully during n., so that he scratched till blood came. At 7 a.m., two more leaves, with usual results. Costive stool at 8 p.m.; continued itching and fresh pimples. 14th.-Same ; abdomen greatly distended. 15th and 16th.-No med. Feels well ; bowels regular ; no fresh pimples, and old ones do not itch so much. 17th.-Two more leaves with usual results ; fresh pimples behind knees and horrible itching. [Writing Nov. 1st, prover states that he has since been uncommonly free from rheumatism, and that the old eruption on hand is greatly improved.] ( Ibid.)

1. H. PEKAREK, æt. 9, a healthy, lively, and clever child. Proved a tinct. prepared from leavesdried 17 years ago. On Dec. 3rd took 10 and on 4th 15 dr. without effect. On 5th, 15 dr. In e. groaned (unconsciously) whilst writing. Drank lager beer without subsequent nocturnal enuresis which ordinarily occurs. 6th.-15 dr. In e., while writing, some irregular or heavy breathing. At 10.30, uneasy turning in bed, and repeated raising ofarm under head ; indistinct talking during sleep ; on a light being brought in, woke and stared with dilated pupils, and was a long time before she came to herself (all this abnormal) . In m. confusion of head, disappearing after toilet and breakfast. Took 15 dr. At 10, headache, going off after dinner, somewhat listless and tired in e. (Ibid.) 7. a. I made experiments with the infusion, which was of an insipid, grassy taste. When taken in e. it caused great uneasiness, discomfort, and sleeplessness ; but in m. its action was much milder, causing loss ofappetite. b. Dr. Archibald Smith once used infusion in place of tea, but felt in such a state of nervous excitement that he did not repeat the experiment. (POPPIG, quoted in Ibid.) 10. Dr. STOKES, Dec. 9th, 1857, took at 6 p.m. 10 dr. of tinct. in water. During e., hearing became painfully acute, brain excited, and there was somewhat painful pressure on sides ofhead. In bed, pillows felt hard to neck and head ; and, though very sleepy, he turned and twisted about all n., and woke tired and heavy next d., with aching shoulders. Dreams were of great activity. In n. and next m. mouth and palate felt as if burned with pepper. 10th.-In e. took same dose, and had same painful constriction round head and dreamy excited state in n. 11th .-Repeated dose m., noon, and e. In e. buoyant and elated. Indisposed for food all d.; n. again dreamy and restless. 12th.-Same dose at 10.30 a.m. Stool 3 h. late, and less easy than usual, as if from dryness of rectum. Appetite still diminished and n. dreamy. 13th.- 10 dr. again. Stool as yesterday. After this digestion, aptitude for work and power of muscles became extraordinarily good, and continued SO. He took no more med.; but sleep continued full of active troubled dreams, notwithstanding which he awoke lively and vigorous every m., for about 10 d. afterwards, when effects of proving faded away. (Monthly Hom. Rev., iii, 163.) 11. The warm infusion in small doses produces effects very much like those of ordinary tea, and, taken in larger quantities, agitation and inability to sleep. In cold infusion, it heightens arterial tension. (MÓRENO Y MAIZ, Pract., i, 234.) 12. Dr. LILIENTHAL, æt. 54, took 4 dr. of tinct. at 2 p.m., and half a teaspoonful at 4 p.m. and at midnight. At 4, fulness of head, as after wine, and dull pain over 1. temple ; at 7, vertigo, with dulness in forehead, after a relished dinner ; at 9, lazy and sleepy, indisposed to read ; soon after midnight dose, sense of compression in region of short ribs ; restless sleep, awake off and on the whole n . For next d. or two fulness in forehead, as if it were heavier than rest of brain. On 4th d. took half a teaspoonful at 7 and 9 a.m., whole at 2 p.m. Brain so muddled that he cannot read intelligently ; slight pressing pain in 1.

temple, with dulness of head ; palpitation ; stitches running towards bowels, and in afternoon 4 mushy stools, without pain. On 5th and 6th d. stools natural. On 6th d., at 5 p.m., a teaspoonful. Fulness and pressive pain in forehead, though near open window, worse towards 9 p.m. On 7th d. took teaspoonful of tinct. at 5, and of 3rd dil . at 7 p.m. Plagued all d. with desire for stool, and sulphuretted hydrogen flatulence ; fulness and tension in forehead with slight shooting in r. temple, and dull feeling over whole brain, headache increased (especially over r. eye) in e., with burning of eyes ; slight stitches in r. chest, near sternum, about 4th rib ; general restlessness ; feels tired and weary, though not sleepy, must exert himself not to shut eyes ; every symptom passed off at 9 p.m., on being called into open air. On 9th d. took teaspoonful of3rd, and had recurrence of frontal tension,with disposition to close eyes as before. On 10th and 11th d. took frequent drop doses of 30th without effect. (HERING'S Mat. Medica, i.) 13. ADELAIDE WILLIAMS, M.D., took small doses of tinct. for 2 d. without effect. On 3rd d., 20 dr. Felt stimulated after increased dose ; constipation ; fine stitches in urethra before micturition. On 4th d. took teaspoonful doses of tinct., and from 6th to 11th d. drank freely of strong infusion. On 8th, recurrence of stitches, and on 9th, of constipation. On 10th, hoarseness, with tickling in upper trachea, and some cough ; menses, 2 d. late, came on at noon, very profuse during n., not in steady flow as usual, but in gushes, waking her from sound sleep. On this d. and next, r. temporal headache in m., sharp on first rising, and all d. on looking up; pain darts from temple in straight line to vertex, leaving sore feeling behind ; same part hurts on coughing. Without date, slept all n., but very restless and dreaming, and in all her dreams much hurried. (Ibid.) 14. SARAH A. FERGUSON, M.D., took a strong infusion in tea- or tablespoonful dose one or more times a d. for 8 d. (none on 5th d.). On Ist d., after I h. dull frontal headache, relieved somewhat on walking a mile, returning on coming indoors, with heavy feeling of eyelids, and lasted (from 9 a.m.) till setting of sun, when it was followed by a state of mental exhilaration. On 2nd d., from 7 to 10 a.m., " felt like work ;" after that dull frontal headache for rest of d. On 3rd and 4th d., same headache, relieved after eating, and leaving at sunset. On 5th d., same headache, relieved by open air; heavy eyelids ; burning redness of cheeks, first 1. then r., with white spot in centre of latter ; weary, no inclination to work. On 8th d., mental depression . (Ibid.) 15. DR. G. W. POPE on several occasions took strong decoction, or chewed and swallowed a handful of leaves. Either was followed by a total disinclination to eat or sleep for 12-24 h. according to quantity taken. If taken in afternoon, he would pass n. in reading or writing, and felt no fatigue in m. (Ibid.) 16. It has long since been remarked by the oldest observers that by the regular employment of the coca the Indians (of Peru) require very little nourishment, and with a double quantity scarcely need anything at all in order to execute with ease the most laborious undertakings. (VON TSCHUDI, quoted in Ibid.)

1. After chewing a drachm of the leaves : increased saliva ; bitter, afterwards aromatic taste ; feeling of comfort in stomach as after a good dinner. After the 2nd or 3rd dose, slight burning in mouth and fauces with increased thirst ; the digestion seemed to take place quickly, the fæces gradually lose their stercoraceous smell. After employing it on self and others for several d. there occurred circumscribed erythema, an exanthem like pityriasis round eyelids ; next disagreeable prickling and itching here and there on skin. Under the use of an infusion of the leaves, the pulse gradually grew quicker, the heart's activity was increased fourfold. After taking an infusion ofZiij of the leaves there occurred a febrile state with elevated temperature of skin, palpitation of heart, vision of sparks, headache and vertigo. Pulse rose from 70 to 134, peculiar rushing noise in ears, desire for open air, expansion of sphere of vision, a peculiar indescribable feeling of increased strength, agility and desire for work, which soon gave place to an exaltation like that caused by alcohol. But though thus mentally excited he could writewith fluencyand regularity. When he had taken 4 drachms there came on a peculiar feeling of isolation from the outer world, and great inclination to do feats of strength, so that though in his normal state he carefully avoided anything like gymnastic exercises, he now leaped up on his desk with cat-like agility without upsetting anything on the desk. There then came on a kind of rigidity, but with a feeling of blissful comfort, the consciousness remaining perfect, and he felt a great wish to pass the whole d. without moving so much as a finger. Then he slept and had a succession of grotesque dreams lasting all d. without leaving any feeling of weakness or dysphoria. He increased the dose to 18 drachms in a d., when his pulse was up to 134, and in his delirium he wrote down: " God is unjust because He has made man incapable of living always under the influence of coca. I would prefer to live ten years with coca than 10,000 centuries without it." A sleep of 3 h. restored him completely, and he could immediately pursue his daily duties without the slightest feeling of illness, but, on the contrary, with unusual ease. He passed 40 h. without taking the slightest nourishment, and then he ate his dinner, and digested it perfectly. In 2 cases he observed a marked increase of the sexual powers. (MONTE- GAZZA, On the Hygienic and Medicinal Value of Coca in South America, Hom.18. F- Vierteljahrsch., took fromxi, Feb. 203.) 24th to March 8th daily 1 or 2 small cups of infusion of leaves, I or 2 h. before or soon after a meal. After the dose felt peculiarly comfortable, and slight warmth all over body which came from stomach. Pulse slightly quickened from 1 to 3 h. Urine acid, smelt of sweat; fæces not fetid. (He suffers habitually from slow digestion, megrim, distension of abdomen, pressure and tension in hypochondrium after eating, loss of appetite, thickly furred tongue, and bad taste in m. All these symptoms disappeared while taking the med.). He was cheerful and disposed for mental work. sleep undisturbed, felt refreshed in m., which is not usually the case. Excesses in diet were not followed by any discomfort when he took a cup of the infusion before or after. (Jos. FRANKL, Zeitsch. d. Ges. d. Aerzte in Wien, 1860, 13, 14).

2. Dr. ISAAC OОтт observed his urine on a regulardiet for 5d.,during which his health was excellent, and then took on 1 d. 3j, on 4 following zij of coca leaves at each of his three meals . " On comparison of the averages of each 5 d., we find that the addition of the coca decreased the quantity ofurine 47.60 centimetres ; of the urea, 20101 grm.; of chloride of sodium, 3.4167 grm.; of sulphuric acid, 2948 grm.; of free acid, 6945 grm.; and increased our weight lb., and the phosphoric acid in the urine 0090 grm. During the period of these last experiments our sleep was somewhat disturbed, with frequent headache, and slightly diminished appetite. Microscopically, we found in the urine an abundance of octohedral crystals of oxalate of lime of all sizes, which were got rid of by filtration ; but on micro-chemical examination of the leaves, we found quadratic crystals, soluble in hydrochloric acid, but not in acetic, which we believe to be oxalate of lime crystals, and the source of those in the urine." (Phil. Med. Times, i, 56. ) II. Poisonings.-All who habitually chew the coca have an extremely disagreeable perspiration, an offensive breath, pale lips and gums, blunt teeth, and a disgusting blackish corner of the mouth. The inveterate chewers, the so-called Coqueros, are recognised at the first glance by their tottering gait ; flaccid greyish-yellow skin; hollow, dull eyes, surrounded by bluish-brown circles ; quivering lips ; incoherent discourse and dull apathetic manner. Their character is mistrustful, irresolute, malicious ; they become aged when scarcely entered upon maturity ; and should they attain old age there is imbecility. Timidity causes them to flee the society of their fellow-men, and seek concealment in gloomy woods or lonely dwellings, where they give themselves up for days together to the passionate enjoyment of the leaves. Then their excited imaginations conjure up the most wonderful visions, at one time consisting of incredibly beautiful and delightful forms, at another, however, of the most horrid figures. They crouch in a corner, with eyes staring and fixed on the ground, the automaton-like movement of the hand as it places the coca in the mouth, followed by the mechanical mastication, alone indicating that consciousness exists. Sometimes a hollow groan is forced from the breast, probably when the excited imagination conjures up its scenes of horror, which can as little be scared away as the pleasant dreams at other times. b. The Indians, by the continued use of coca, suffer from intolerance of light, attended with a surprising dilatation of the pupils. This is markedly seen among the Coqueros on returning from their solitary indulgence. I have produced the same symptoms by dropping into the eye a strong decoction of the leaves. (VON TSCHUDI, loc. cit.) 2. Debility of the digestive organs is the first symptom which attacks the Coqueros ; at first it seems to be slight uneasiness, and may then be confounded with indigestion, but it soon reaches a frightful intensity. Bilious affections now make their appearance, with their numerous tormenting sufferings common under a tropical sky ; ofthese constipation is of so frequent occurrence that from its prominence in the disorder this has been called " epilacion." When jaundice occurs, indications gradually follow which show more clearly the shattered condition of

the nervous system ; the patient complains of headache and similar sufferings, gets weaker,can scarcely take any food,and quickly becomes emaciated. This state is often succeeded by a kind of anæmia ; the bilious tint gives way to a leaden colour (in whites). An insufferable sleeplessness sets in, which in fact affects even those who do not take the coca in excess. The appetite is extremely irregular, for the aversion to all food is often suddenly followed by an insatiable craving, especially for animal food. Partial edematous swellings arise, and subsequently terminate in ascites ; while the aching of the limbs is for a short time relieved by the appearance of furunculi. The disposition ofthe patient is very changeable ; he is usually very wayward, and often yields to an unbridled passion for brandy. The effect of his excesses on the mind, independent of this, is great ; the passion for solitude is injurious ; and though the mental faculties may not suffer so much as from alcohol, the moral consequences are very similar. (POPPIG, loc. cit.)

Volume IV — Appendix

COCA.

(See vol. ii, p. a6i.)

I. 20. A singular statement respecting the effect of C. on the voice has been made by Dr. Sandras before the Societe de Medecine pratique. He says all C. preparations and cocaine, used either through atomizers or in infusions and inhalations, have a disastrous action on the voice of singers. It is a great mistake, he thinks, to go on repeating that C. sharpens and strengthens the vocal cords, since, on the contrary, it will slacken and deaden them through the paralysis of the extensor muscles, as many singers have found to their cost. To better illustrate the truth of his averment. Dr. S. stopped speaking for a moment, and before the meeting drank a tablespoonful of " coca wine/' swallowing it slowly

5S6

and by small portions. Now speaking again, his voice sounded mud altered for the worse ; the words were husky, low, and scarcely audible, {Med. Counselor^ Nov., 1889.)