Coca (The Divine Plant of the Incas)
(A longer monograph by Lloyd can be found at: http://www.swsbm.com/ManualsOther/Coca.pdf)
Erythroxylon coca is a tree native to the eastern slopes of the Andes, where, especially in Bolivia, large plantations are cultivated. The leaves have been highly valued, from the earliest records, by the natives of Peru, Chili, and Bolivia, by whom the tree was called "The Divine Plant of the Incas." In 1569, Monardes (447), of Seville, published an article on the drug, reproduced, 1577, in London. (Dowdeswell (196a).) This is among the first references to the drug in print, known to us, and it was followed by the botanical description, by Clusius (153), in 1605.
The history of coca, in its many phases, is most exhaustively presented by several travelers and authors, a large illustrated work of near 600 pages by W. Golden Mortimer, M. D., under the title Peru. History of Coca, being of exceeding interest (451a).
That coca was honored in their sacred ceremonies by the natives of the lands producing it, is evidenced by the following "recital" (451a), addressed to the sovereign:
Oh, mighty lord, son of the Sun and of the Incas, thy fathers, thou who knoweth of the bounties which have been granted thy people, let me recall the blessings of the divine Coca which thy privileged subjects are permitted to enjoy through thy progenitors, the sun, the moon, the earth, and the boundless hills.
A plant so regarded necessarily fell under the adverse criticism of the devoutly religious, early Spanish explorers, who naturally directed their efforts against everything that, in their opinion, constituted a part of heathen worship and diverted the natives from the true God. This is shown by the following quotation from Mortimer:
In 1569 the Spanish audience at Lima, composed of bishops from all parts of South America, denounced Coca because, as they asserted, it was a pernicious leaf, the chewing of which the Indians supposed gave them strength, and was hence: "Un delusio del demonio."
In this connection the following quotation will indicate how distasteful are the methods of the natives, even yet, to those whose first duty consists in suppressing such ceremonies as are therein described:
When the period for departure (on a dangerous journey.—L.) actually arrives, the Indians throw Coca in the air, just as did the Incan priests of old, to propitiate the gods of the mountains, who, presumably, do not wish their domains invaded.
The native Indian use of coca was exhibited where it was necessary for men to make the most exhausting physical effort, as the Indian "runners" of the Andes, carrying with them a modicum of food or other burdens. A few coca leaves sufficed as a hunger pacifier, and upon this as a basis the runners underwent the most exhausting and exacting journeys. It was accepted by observing travelers that the leaves, being chewed, would yield an abundance of "vital strength." The endurance of people thus employing the drug is noted also by the Jesuit Father Bias Valera (656d) under the name Cuca. After observing the methods of the Jesuit explorers, he writes as follows:
It may be gathered how powerful the Cuca is in its effect on the laborer, from the fact that the Indians who use it become stronger and much more satisfied, and work all day without eating.
Notwithstanding all this, fortified by repeated experiences of travelers, the world of scientific medicine ignored, or even ridiculed, the drug, until its emphatic introduction in the latter part of the last century (about 1870, in England), forced those concerned in authoritative medicine to give it some recognition. Numerous experimentations on its composition had been made by Dr. Weddell, in 1850 (671), and others, succeeding as well as preceding that date, who tried vainly to discover an energetic constituent of the drug. It was at first believed that the leaves owed their inherent qualities (if they had any, which was questioned) to some volatile principle, a supposition that proved a fallacy, other than in the discovery of the volatile base named by them hydrine, which did not at all represent coca and which is no longer mentioned. However, the persistent reports concerning the use of coca and its reputed powers as an empirical substance that was creeping into the use of practicing physicians, led such chemists as Hesse, Niemann, Stanislas, Martin, Maisch, Lossin, Woehler, and many others, to repeated chemical examinations of the drug and its qualities, resulting in a number of products, such as coca-wax, coca-tannic acid, and even of several alkaloidal bases, including one named cocaine, this alkaloid being discovered in 1860 by Niemann, an assistant in the laboratory of Professor Woehler, of Gottingen, Germany.
But notwithstanding the identification, half a century ago, of its now well-known alkaloid, coca was long thereafter "authoritatively" considered as inert, or simply a mild stimulant, like tea. Its alleged properties were deemed legendary and imaginary, its alkaloid similar to caffeine, both in constitution and qualities. This view prevailed until Roller, in 1884, confounded the professional world, as well as that of science, by announcing the marvelous qualities of cocaine as a local anesthetic. In this connection we may further anticipate by saying that previous investigators of coca had already employed the physiological method of injecting the alkaloid cocaine into the veins of the lower animals, as well as the utilization of other scientific methods of determining its value, such "authoritative" investigations being accepted as conclusive evidence of the fact that coca, other than as a mild stimulant, like tea or coffee, was worthless and inert, and that its alkaloid, cocaine, was similar in effect to caffeine. Physicians using coca were thus becoming subjects of ridicule, as being incapable of judging a remedy's qualities; pharmacists making preparations of the drug were tinctured with the odium of being concerned in a fraud, while the natives who employed it in their daily life, as well as travelers impressed thereby, were regarded as being involved in ignorance and imbued with superstitious imaginings. Into these classes were thrust such men as Poeppig, von Tschudi, Scherzer, Stevenson, Weddell, Spruce, Markham, and others, scientists and travelers, who spoke from personal observation or experience. Although other pessimists contributed in the same direction, the most authoritative investigations to discredit coca appeared in the London Lancet, 1876 (106a), and in the Gdinburgh Medical Journal, Vol. XIX, 1873 (55b), which may be summarized as follows:
G. F. Dowdeswell, B. A., of London, England, being conversant with the record of coca and much interested in the subject, determined to establish its position unquestionably, by personal experimentation in a scientific way. With this object, he made a careful study of the record of coca (i96a) and its reputed action. He took pains to credit those who had previously made reports, describing in detail the processes of the native coca users, and including the experiments of Dr. Alexander Bennett, 1873 (55b), in which the physiological action of cocaine on frogs, mice, and rabbits gave no therapeutic promise of individual characteristic other than the suggestion that it paralleled caffeine, theine, and theobromine, the summary (Bennett) being as follows:
When we compare this cocaine with theine, caffeine, and guarana, we find that if it is not identical with these substances, it is intimately related to them in chemical composition; (p. 324).
The investigator had not enough cocaine to give completely its action on temperature and the glandular secretions, but adds that (p.235) (55b), as compared with caffeine, theine, and so forth, "in every other respect cocaine had similar action," thus giving it no quality of its own (55b).
Having reviewed the literature on coca (including Bennett's physiological investigations on cocaine), Dowdeswell first obtained specimens of the drug, of unquestioned quality. He then interested in his work such authorities as Ringer (who furnished instruments of "perfectly accurate results") and the conspicuous Professor Murrell, of University College. The preparations employed were made by the well-known English chemist Mr. Garrard, referred to by Dowdeswell as follows:
All of which were well prepared by Mr. Garrard, of University College Hospital, who has taken much interest in the subject, and who has also very successfully obtained the alkaloid and the volatile constituent of the leaf, and is still continuing an investigation of its pharmaceutical properties, for which his skillful preparations of other previously unknown alkaloids, as of jaborandi, eminently qualify him.
The preparations made by Garrard were not only such as paralleled the products of the native users of coca, but also included others, suggested by his own chemical and pharmaceutical knowledge. The experimentation considered, in detail, bodily conditions, rate of pulse, temperature, urine, urea excretion, etc., etc., as influenced by coca. Two detailed tables (p. 666) (196a), give the results, which, to the utter disparagement of coca, are summed up by Dowdeswell as follows:
It has not affected the pupil nor the state of the skin: it has caused neither drowsiness nor sleeplessness; assuredly it has occasioned none of those subjective effects so fervidly described and ascribed to it by others—not the slightest excitement, nor even the feeling of buoyancy and exhilaration which is experienced from mountain air, or a draught of spring water. This examination was commenced in the expectation that the drug would prove important and interesting physiologically, and perhaps valuable as a therapeutical agent. This expectation has been disappointed. Without asserting that it is positively inert, it is concluded from these experiments that its action is so slight as to preclude the idea of its having any value either therapeutically or popularly; and it is the belief of the writer, from observation upon the effect on the pulse, etc., of tea, milk-and-water, and even plain water, hot, tepid, and cold, that such things may, at slightly different temperatures, produce a more decided effect than even large doses of Coca, if taken at about the temperature of the body.
The result of the investigations of these eminent authorities, in connection with the physiological experimentations with cocaine, demonstrated to the satisfaction of the world of science and the professions that this drug was, at the very best, merely a something in the line of the caffeine-bearing stimulants, such as tea and coffee, and, next, that instead of being of any value whatever, or of possessing any inherent quality whatever, it was positively inert, having (196a) an action so slight as to preclude the idea of its having any value, either therapeutically or popular; that it has no greater effect on the pulse than tea, milk-and-water, or even plain water, hot, tepid, and cold; that it occasioned none of those subjective effects so fervidly described and ascribed to it by others—not the slightest excitement, nor even the feeling of buoyancy and exhilaration which is experienced from mountain air, or a draught of spring water.
To this may be added the similar results obtained by Professor Roberts Bartholow, M. D., to the effect that "it acts like theine and caffeine as an indirect nutrient," etc. (Therapeutic Gazette, July, 1880, p.280) (564).
Just at that time the American "New Remedy Craze" of the 70's was at its height. Among the substances eulogized was coca, which had received thereby a position in the Prices Current of all the American manufacturing pharmaceutical establishments, as well as the eulogistic commendations of physicians in American medical prints.
Paralyzing to such as these were the adverse "authoritative" reports concerning the worthlessness and inertness of the drug (196a). All this, together with the variations in the quality of the commercial article (such variations in quality being confirmed later by Professor H. H. Rusby, M.D.), very much disturbed the talented, careful, and exceptionally conscientious chemist, the leading American manufacturing pharmacist of that date, Dr. Edward R. Squibb, of Brooklyn, N. Y. In the height of the commercial demand for coca he determined to sacrifice his commercial opportunities to his professional ideals, and to accept the provings of "scientific authority," by excluding all coca preparations from his pharmaceutical list, commending tea and coffee in their stead. He writes as follows in his Ephemeris (610a), July, 1884:
Almost every purchase (of the crude drug.—L.) has been made on mental protest, and he (Squibb) has been ashamed of every pound of the fluid extract sent out, from the knowledge that it was of poor quality; and there seems to be no more prospect of a supply of a better quality than there was this time last year, because so long as an inferior quality sells in such enormous quantities at good prices, the demands of trade are satisfied.
Under this condition of the markets, the writer has finally decided to give up making a fluid extract of Coca, and has left it off his list, adopting a fluid extract of tea instead, as a superior substitute, for those who may choose to use it, and regrets that this course was not taken a year ago.
Dr. Squibb, however, with even more than his usual carefulness and desire to extend professional courtesy to one and all, perhaps guided also by a latent questioning of the possibility of paralleling the action of a drug in abnormal conditions of the human being by a study of the action of that drug on the lower animals or even on a man in health, refers to the fact that "authorities are often in error or opposed in opinion," fortifying this statement in the following words:
Conflicting and contradictory testimony from competent authority is not uncommon in therapeutics, and the reasons for it are well recognized in the impossibility of an equality in the conditions and circumstances of the investigations, and hence the general decision commonly reached, is upon the principles of averages.
And yet, the investigations of Dowdeswell seeming incontrovertible, Dr. Squibb adds as follows:
But there has been no observer on either side whose researches have been anything like so thorough, so extended or so accurate as those of Mr. Dowdeswell. Indeed, no other account has been met with, wherein the modern methods of precision have been applied to the question at all; the other testimony being all rather loose and indefinite, often at second or third hands, or from the narratives of more or less enthusiastic travelers. But if Mr. Dowdeswell's results be accepted as being conclusive, the annual consumption of 40,000,000 pounds of Coca, at a cost of $10,000,000, promotes this substance to take rank among the large economic blunders of the age.
Now came the "irony of fate!" Scarcely had the ink dried in the publication (Ephemeris) aforenamed, recording Dr. Squibb's faith fore it was announced in a letter to Dr. Squibb, dated September 19, 1884, from Dr. Henry D. Noyes, a physician of New York then in the results of the investigations of Bennett and of Dowdeswell, be-Kreuznach, Germany (Ephemeris, Nov., 1884, p. 685), that a medical student named Koller, of Vienna, had discovered that a solution of hydrochlorate of cocaine was possessed of marvelous qualities as a local anesthetic.
This letter of Dr. Noyes was immediately given a setting, or reference was made thereto, in every pharmaceutical and medical journal of America. Such an authority as Dr. D. Agnew, of Philadelphia, wrote as follows in the Medical Record, October 18, 1884:
We have to-day (Oct. 18, 1884), used the agent in our clinic at the College of Physicians and Surgeons, with most astonishing and satisfactory results. If further use should prove to be equally satisfactory, we will be in possession of an agent for the prevention of suffering in opthalmic operations of inestimable value.
Came also leading editorials in the various publications on medicine and pharmacy, of which that from the pen of the then editor of the Druggists' Circular, Mr. Henry B. Parsons, brother of the present editor of the Practical Druggist, is typical. From it we quote as follows:
For the past month American medical journals have fairly bristled with reports from various hospital surgeons, and it is pleasing to note that, on the whole, the claims first made for this remedy have been sustained. It seems to be proved that, in the majority of cases, the application to the eye of a few drops of a 2 or 4 per cent solution of this salt will produce a more or less complete, but transient, insensibility to pain, with enlargement of the pupil. Operations upon the conjunctiva and cornea ordinarily requiring the use of chloroform or ether have been performed upon patients conscious of everything being done, but saved from pain by the application of a weak aqueous solution of this salt. In several operations for removal of hard cataract, the patients complained of no pain whatever, the entire conjunctival surface being insensible to repeated pinchings with the surgeon's forceps. The only sensation described was that of "numbness and hardness." After a time the eye returns to its normal sensitiveness, and there seems to be no troublesome local after-effects.
Let it be observed that in the beginning cocaine was commended in operations on the cornea of the eye, its latest application in minor operations in surgery, dentistry, and elsewhere being at that time not even a theoretical possibility.
Turning his face to the future, and accepting the facts of the present, Dr. Squibb now threw all his efforts into a new investigation of coca and its alkaloid, his process of manufacture being yet a standard, and his writings on cocaine being yet authority. These need but be referred to as occupying many pages in the Ephemeris, 1884-5. They stand as a lasting memorial to the man who took pleasure in publicly correcting an error, and whose record in American pharmacy is monumental.
The discovery of the anesthetic qualities of coca marked the beginning of an epoch in medication whose story, in connection with the past, pleads irresistibly for tolerance of thought and action toward men who know that which they know by reason of personal experience and the art of empirical experimentation. Perhaps in no other instance has the almost hopeless cry for recognition of the facts developed by empiricism been more prominently illustrated than by the struggle of this drug. One of the greatest blessings to humanity, it was for nearly three centuries neglected by men of science and subjugated by professional prejudices. At last the eminent botanist and pharmacologist Henry H. Rusby, M. D., was led to undertake a journey to South America in behalf of science, coca being a dominant factor, in which enterprise the great pharmaceutical house of Parke, Davis & Co., of Detroit, who financed the expedition, deserves great credit. The result of Dr. Rusby's study is presented in The Therapeutic Gazette (564), 1886, pp. 14-18, and 1888, pp. 158-303, and it may be added that this exceptionally valuable treatise is at this date not less important than when written.
Needless is it to do more than refer to the marvelous reaction that followed Roller's discovery of the power of cocaine as a local anesthetic. A library would be required to shelve the works devoted, eulogistically, to the new discovery. A volume would scarcely print the names of the enthusiastic converts to cocaine, formerly so discredited, and the titles of their contributions.
Let us now do tardy justice to the prophetic words of the seer-like poet, who so often foresees that which others either neglect or do not appreciate. The poet Cowley, 1618-1667 (170a), in his Book of Plants, published in 1662, not only mentions coca, but sets forth that marvelous drug in terms that, neglected and discredited for nearly three centuries, need to-day no apology, as evidenced by the following translation:
Eulogy of Coca
From Cowley's Book of Plants,* V: 783-838.
(* In this portion of the poem, Cowley describes a feast of the gods, including the deities of both the New and the Old Worlds. Venus presides, and Bacchus offers wine to Omelochilus, a South American deity. Pachamama (the "skin mother") is a leading deity of the Incas. The "Quitoita," "Vicugni," and "Paci" are tribes of Indians, now obscurely known. The translation is in most cases strictly literal, but in a few lines the sense requires a somewhat free rendering. Several editions of Cowley's "Sex Libri Plantarum" are on the shelves of the Lloyd Library. The one from which the translation is made was printed in London, 1678.—S.)
Translated from the Latin by Margaret Stewart, M. A.
The vine departs; and all the deities of the old world applaud, and with purpled hands seize the clusters. Bacchus, in jesting mood, brings a generous cup of wine, pressed from many grapes, to thee, Omelochilus. "Come, drink, comrade," he said. "If thou dost taste this wine, no other of the gods will be more fit than thou to tempt the crude appetites of the cannibals."
And Omelochilus, not accustomed to the acid Grecian wine, drinking it, rages in frantic wrath, and would doubtless repay the jest with blows, but fears the well known strength and courage of the European deity. Therefore (to be quits with his tormentor.—S.) he bids the fruits advance to strife less cruel. They all stand forth in beautiful array, displaying their various products, and like Amazons they advance, with pictured armor.
First in line, dishonored from lack of fruit, (The shrub coca bears a creamy white flower, and a berry somewhat like a small cranberry, red when immature, but darkening to nearly black. Of this Cowley was evidently unaware.—S.) stands Coca, a little tree, gleaming with slender stem. And Venus scoffs. "Truly, the race of American husbandmen have chosen with little judgment, coming into a contest as regards fertility with a dwarf eunuch as their leader." The gods shout with laughter. But Mother Pachamama rebukes the bold goddess, and defends her loved Coca. "How greatly dost thou err, Cytherea! Truly, the lustful fertility of lovers is alone known to thee. Here, thou art a bad judge. My realms, lacking sex, are an unknown country to thee. Beyond all others, everywhere, the land is fertile. This tree at which you scoff, is perennially fertile, and ever swells with unnumbered fruits. Do you still laugh? See how full of leaves it is! In every leaf it bears a fruit. Nor will these leaves yield in usefulness to any fruits from any tree. These, by the wonderful gift of Pacchamacus Virococha (who was moved to pity by the coming hardships of the land, reduced to poverty because of its too great wealth), remaining for a time in the mouth, the juice trickling thence continuously to the stomach, restore the weak, made languid by long continued hunger and lengthened toil, and give back vigor to the limbs and strength to the weak body, tottering under its burden, in a manner such as you, Bacchus and Ceres, deities both, could never do. The Quitoita, carrying three of these as supplies for their journey, will sometimes endure for twice three days, and feasting abundantly upon these, will traverse the dreadful Andes, a frightful land, situated among the highest clouds, the home of winds and rain and winter storm, and likewise thine, brave Coca, whom the warlike goddess Venus derides as an insignificant leader. Nor shalt thou be less esteemed for thy admirable qualities, illustrious Coca, than for thy services to mankind. The merchant fears not to seek thee here, to bear thee hence. Yearly he loads the groaning Vicugni and Paci in countless numbers with thy leaves, bringing a pleasing commerce to the wretched world."
Thus speaks the mother Pachamama, her skin painted with numberless figures, and with a nod she bids Hovia to advance, Hovia, bearing fruits stony and despised, but ranking next in value (to those of Coca.—S.) though of different kind.