CHAPTER VIII

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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.’

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