The dried leaves of Erythroxylon Coca, Lamarck, and its varieties. (Nat. Ord. Erythroxylaceae.) South American Andes-Peru, Bolivia, and Chili. Dose, 60 to 240 grains.
Common Name: Coca.
Preparation.—Fluidextractum Coca, Fluidextract of Coca. Dose, 5 to 30 minims.
Specific Indications.—Defective innervation, with dizziness; impaired digestion; pain in back of the head, and fatigue; gastric pain; inordinate hunger and thirst; exhaustion during convalescence from long illness.
Action and Therapy.—The action of coca depends very largely upon the cocaine it contains, therefore the physiological effects are recorded under that subject. From time immemorial the people of the Andes, particularly in Peru, Bolivia, and Chili, have used coca leaves as other nations use stimulating table beverages; and when undergoing long journeys and hard work the natives are accustomed to chew the leaves with lime or some other alkaline substance, in order to endure hunger and fatigue, which it enables them to do with remarkable certainty. These uses of the plant led to its adoption into medicine as a remedy for neurasthenia and other disorders, with nervous weakness and muscular debility.
Coca is a remedy to be used temporarily only for defective innervation. Though the appetite is apparently normal, digestion is imperfect, and there is an associated occipital and post-cervical pain, dizziness, and inability to stand for any great length of time. The mental faculties are sluggish and tired-brain fag-and thinking is difficult and despondency a common condition. If there is gastric pain or discomfort it is relieved by coca probably through the obtunding power of cocaine upon the nerve filaments of the stomach. As compared with cocaine this power is feeble, as is coca in all its effects, still there is sufficient of the alkaloidal influence exerted to make coca a remedy to be used with great circumspection. In nervous debility it may be carefully employed for a brief period, especially in convalescence from exhausting fevers and other diseases in which a persistent nervous depression follows. While of some value in chorea and repeated attacks of hysteria, it should not be used when any other agent can be made to serve the purpose. In fact, there is no more wisdom or justification in employing coca preparations for simple functional maladies because of mere nervous discomfort than there would be in prescribing opium for similar purposes. Both lead to pernicious habits, with a train of miseries to which the victim finally succumbs.
An occasional dose of 10 to 15 drops of the fluidextract will sometimes overcome insomnia caused by gloom and worry, and very rarely it helps one over an attack of asthma. It may be used for any length of time desired in gastric carcinoma to relieve the irritability and pain. Its chief use, if employed at all, will be for very temporary exhibition in the debility following fevers, or for a more prolonged use in advanced phthisis, to give rest, quiet gastric irritability, and aid breathing. For all prolonged states of mental depression, as neurasthenia, hypochondria, melancholia, depressive insanity, etc., its administration should not be encouraged, and as a remedy for the opium and other drug habits it has no place in medicine on account of the habit-forming dangers of coca itself.
To sum up some of the beneficial results of temporary coca medication would be to include its influence as a circulatory and respiratory stimulant, a restorative of strength after exhaustive acute diseases or operations, in-sudden nervous exhaustion and insomnia, in painful indigestion, headache from exhaustion, and in migraine. In all of these it should be used for but short periods, and any symptoms of cocainism should be a warning to cease its administration. The fluid medicines may be used in moderate doses. The habit of using coca wines is but a mild form of cocaino-alcoholic tippling.
The Eclectic Materia Medica, Pharmacology and Therapeutics, 1922, was written by Harvey Wickes Felter, M.D.