Friday, September 23, 2011

The Absurdity of Simply Defining 'Cocaine' as a drug of addiction

Even more intriguing to Freud were a series of clinical papers published in George Parke’s house organ, the Therapeutic Gazette. In 1878, an American physician named W.H. Bentley described successfully treating a patient addicted to the “opium habit” with coca. Two years later, in 1880, Bentley reported his success in treating both opium and alcohol abusers with cocaine. With the twenty-twenty vision of historical hindsight, it is easy to shake one’s head at such a harebrained theory. Substituting one addictive drug for another was a common medical means of treating substance abuse in the late nineteenth century and I fact, remains so to this day. It is impossible to give an accurate number of how many morphine addicts were unwittingly turned into cocaine addicts by well-intentioned physicians during this area; similarly, alcoholics were often prescribed morphine to the point of addiction, and later, cocaine and even nicotine to help them kick their drinking habits. At the dawn of doctors’ recognition of addiction as a disease, what all these games of medical musical chairs most reliably did was to create “new and improved addicts” – p76 An Anatomy of Addiction- Howard Markel

This quote is my nomination for most arrogant, deliberate mis-direct, representing the absurdity of viewing or defining a particular drug as primarily a drug of addiction, as done by the title of this book.

The term here is a negative spin confusing a phenomenon of physical withdrawal with another of toxic-mania, and mistakenly applied to the drug in general. We are to forget the real benefits of coca, by confusing Coca with cocaine either dilute or at any level of infinitely higher concentration. Cocaine is more correctly a drug of either great benefit as a superior alternative to caffeine and nicotine, or one of great detriment of toxic-mania- all depending upon the context, particularly of form.

Isolated cocaine was not even commercially available in 1880.

Yet – makes this deliberate misstatement of fact – Bentley used Coca leaf extract, diluted , not isolated cocaine concentrated.

An infinitely better account appears within the book by Joseph Kennedy, Coca Exotica:

In July of 1878, Bentley was called to a house somewhere in the hills of Kentucky; when he arrived there, he was astonished to find a tenth of an acre in opium poppies (Papaver somniferium). The lady of the house, a forty year old widow, confessed to the doctor that she had been an opium eater for quite some time, consuming about a half pound of the drug a year. Bentley says: “I persuaded here to give up the habit. She declared that she could not. She agreed, however, to try, so I sent her one pound of the fluid extract of coca to begin with. When used up, she sent for half the quantity, stating that she thought it would complete the cure. I sent her one half pound. She sent me her opium crop that winter, with the message that the medicine had cured her.

The medicine Bentley prescribed for her was the fluid extract of coca manufacture red by Parke Davis and Company in Detroit, Michigan. The preparation they offered was standardized in the United States Pharmacopoeia, 6th to 8th editions (1880—90), and contained 0.5 grams of coca alkaloids per one hundred cubic centimeters of solution. Of course, cocaine was one of those alkaloids contained in the fluid extract, but according to Bentley’s recommended dose (1 drachm of fluid extract when the desire for whiskey or opium is quite urgent), a patient would only consume .0185 grams (slightly more then 1/200 of a gram) of cocaine per dose, and even then it would automatically be taken in conjunction with coca’s natural complement of other alkaloids; because it was prescribed to be drunk, this solution would necessarily have to pass through the liver and kidneys. In these two important respects the use of the fluid extract closely resembled the Indian method of taking the drug, a procedure proven harmless by centuries of use. It is also interesting to note that one would have to take 13.5 one drachm doses of Parke Davis fluid extract just to get the amount of cocaine alkaloid consumed daily by an average Peruvian Indian. This is based upon Hanna’s study that estimates the average Indian digests approximately 0.25 grams of cocaine a day by normal coca use.


Bentley’s idea of curing these addicts with coca caught on immediately and was put into practice throughout the country. Reports of its effectiveness began to appear as a regular feature in the Therapeutic Gazette as well as the Philadelphia Medical Times, New Remedies, Medical and Surgical Report, and the New York Medical Review.

As a valuable antidote to the opium habit, it is spoken highly of by Dr. W. H. Bentley, of Kentucky; Dr. G. Leforge, of Illinois; Dr. H. F. Stimmell, of Tennessee, and many others. Dr. R. P. Henderson states in the Louisville Medical Neii's that one patient who took as much as a pint of tincture of opium in a week, was cured by taking the coca in drachm doses as often as he felt that he could no longer do without the laudanum. He used it frequently for two or three days, gradually lessening the dose until cured. Dr. C. H. Poizat, of Eaton, Philadelphia, mentions in the Medical and Surgical Reporter two cases of asthma, in which coca afforded decided relief.

Erythoxylon Coca on the Opium and Alcohol Habits

Dr. Bentley, in Therapeutic Gazette, reports the following cases:

Miss M., a sprightly, intelligent blonde, aet. 30. I had been acquainted with her for 15 years, and for several years of our early acquaintance, when the family lived near me, was her father's family physician. In June, 1878, I accidentally met her on a train. Eight years previous she had a protracted attack of pneumonia, during which she contracted the habit of using morphine, which she still retained. These facts were well known to me, so I took occasion to ask her if she had left it off. She replied in the negative, and told me that she then required 10 grs. twice a day. She had tried nostrums and had visited some advertising quack in another State, to no purpose. I then suggested the erythoxylon, fully explaining its action. The result was I prescribed a pound for her. I received a note from her when she had used this. She was much encouraged, and had ordered two pounds more. This quantity completed the cure. I saw her recently, when she assured me that she had no desire for morphine.

Case 2. July, 1878, was called to a case some 15 miles distant, and nearly all the way "in the hills." I was quite astonished to find about •one-tenth of an acre in poppies. On inquiry, the lady of the house, a widow, about 40, told me that she was an "opium eater," to use her expression, and that she used her own opium. From what I could learn, she used about half a pound of the drug a year. 1 persuaded her to give up the habit. She declared that she could not. She agreed, however, to try, so I sent her ? lb. fluid. extract coca to begin with. When used, she sent for half the quantity, stating that she thought it would complete the cure. I sent her a half pound. She sent me her opium crop that winter, with the message that the medicine had cured her.

Case 3. An aged lady, set. 72. She had been addicted to the habit for 35 years. I persuaded her to try the coca. She was then taking 2 drachm doses of opium three times a day. She said she felt sure she would be unable to leave off the opium, but as she was wealthy and extravagant, she readily consented to try the coca. She procured two pounds on my prescription, and began its use. The progress of the case is rather amusing. She uses one for a time, and then resorts to the other. Sometimes she does not taste opium for a fortnight, using the coca during the time, then she returns to her opium, and thus she alternates. Her doses of opium have been reduced, to as little, I think, as 10 grs., and her general health has greatly improved. Before using the coca, she was a great sufferer from duodenal dyspepsia. She has so far improved, in this respect, that she rarely suffers in this particular, and it is a wonder, too, for she is a ravenous feeder, and as fond of "cake and pastry" as a child, and, withal, uses a great deal -of wine.

Case 4. An unmarried man, aet. 27. Contracted the "opium habit" five years previous to using the coca. Had become a great slave to morphine. June, 1879, I put him upon coca. He ordered three pounds at the beginning. In October following, I met him, and he assured me that he was entirely relieved of the habit, and had one pound of his medicine left.

Medical summary, Volume 2

A FEW years since I procured six or eight pounds of the saturated tincture of erythoxylon coca from a druggist of Philadelphia, with a view of testing the virtues of the plant, therapeutically. I used all with the exception of a single bottle, within the course of about fifteen months. All the cases, but one, in which I prescribed it, were those of a chronic character affecting the lungs, and simulating phthisis.^ The excepted case was one of "nervous dyspepsia" complicated with uterine troubles and hysteria. The patient was married, the mother of two children, the youngest six months old, while the mother was herself 23 years of age. She was greatly emaciated, was very despondent, and was, withal, addicted to the opium habit. It was as a substitute for her accustomed morphine, the use of which I absolutely forbade, that I directed the coca, in drachm doses, three times a day. It answered the purpose admirably.

In short, the coca gave me entire satisfaction in all the cases in which I used it, acting promptly as a nervous stimulant, allaying irritation, reviving the despondent without depressing reaction, and all without producing febrile or other unpleasant symptoms. My only objection was the high price, which was such as to prevent the druggists from ordering it, unless I would guarantee its sale. I still had one pint on hand; which I used myself recently, and the good results were so remarkable, and I noted its action so carefully, that I think a detail of the case may be both of interest and utility to your readers.

My age is 43, height 5 feet 7 inches, weight 125 pounds, complexion rather dark, hair thin, fine, and dark; eyes dark, but neither hair or eyes black; the nervous temperament largely prevails; easily and unpleasantly affected by most stimulants and narcotics, and cannot bear opiates, even in medicinal doses, March 5th, 1878, had a most severe and prostrating attack of continued fever, which came very near a fatal termination. The fever, entirely subsided on the tenth day, leaving me greatly emaciated in body, and completely prostrated in strength. Convalescence was extremely tardy. My appetite returned slowly and digestion was quite good, yet there was not a corresponding return of strength. Alcoholic stimulants were used in moderation, and tonics, including both the mineral and vegetable, very freely. All seemed to be of little service, for, at the end of three weeks, I had made but little progress in the accumulation of either flesh or strength. At this juncture, I resolved to try the erythoxylon tincture. I accordingly began with teaspoonful doses three times a day, taken with an ounce of water before meals. The salutary effects were perceptible with the second dose. My appetite rapidly increased, and, although in a few days I grew to partaking too heartiest meals of flesh, vegetables, and at dinner, desert in variety, I would suffer from violent hunger, long before the hour for the next regular meal. My digestion, which as a rule, is feeble, became, under the use of the drug, perfect, while assimilation was likewise complete, and return of strength rapid.

To determine whether all was due to the medicine, I occasionally left it off a few days, when I soon could perceive that both appetite and digestion began to fail. Both always returned as above stated, with the resumption of the medicine.

On a few occasions, I experimented with large doses, or the ordinary doses repeated at short intervals, neither of which plans agreed with me. In either instance, if I pushed the drug, I became weak and tremulous, and several hours were required to wear off the unpleasant feelings.

A drachm dose, taken at any time, was followed immediately by feeling of agreeable warmth in the stomach, which was soon succeeded by moderate stimulation, exhilarating mental activity, and filling me with the most pleasant emotions. These effects would last from three to four hours, and were never succeeded by depression or other ill consequences. If I took a dose an hour after meals, I was never hungry until three hours after. Taken when quite hungry, the appetite was appeased for about the same period. Taken without the water, its effects were not so rapid, nor at any time so well pronounced.

After using all, I experienced considerable desire for the medicine for three or four days, which occurred two or three times subsequently at intervals of some days.
At no time did I ever detect any change in the numbers either of my pulse or respirations. I shall hereafter give Erythoxylon Coca a thorough trial in "wasting diseases," tardy convalescence from acute maladies, and certain forms of dyspepsia, and carefully test it in the "opium habit."

The Therapeutic gazette, Volume 1

[Written for the Therapeutic Gazette.]
Erythroxylon Coca.
By W. H. Bentley, M. D. I_L. D., Valley Oal', Ky.

THE first time I heard of Erythroxylon Coca, was in 1869, when I received a pamphlet with the request to take, on agency, certain proprietary medicines therein described, and which were prepared by an advertising physician, now deceased, but then living in one of the eastern states. Among them was a very highly recommended cough mixture, certified to be very efficacious in all chronic diseases of the lungs and of the air passages. The medicines were not nostrums as all the formulae were given, or, at least, purported to be given. Among the ingredients one with the title "Ninga," was mentioned. A very long and minute description of this plant ensued. Highly stimulant, tonic and nutritive properties were claimed for this plant, which the writer claimed to have discovered from information received from the natives, and especially the Indians, during his South American travels, extending over a period of several years. Among other things, it was claimed that the Indians would perform long journeys with no other food than a few "Ninga" leaves.

I found that the writer possessed much learning, a good deal of genius and superior shrewdness. I wrote to him declining the sale of his medicines, but asking a confidential, yet candid, statement in regard to the wonderful plant, and asking for a sample at even an unreasonable price. I received a reply in due course of mail informing me that the statements in the pamphlet were true, entirely declining to furnish me any of the plant, but stating that " Ninga" was one of the local Indian names, and that the botanical name was Erythroxylon Coca.

At that time I had a lay friend residing in South America with headquarters in Lima, though his business required much travel, and, in this way, he visited Paraguay, Bolivia, Equador, etc. I knew, too, that he was perfectly reliable, for we had been room-mates during two years in college, graduating in the same class. After this he went to the law, I to medicine. He soon abandoned his profession for trade, and went to reside in South America as above stated. To this friend I wrote, requesting all the information he could conveniently obtain from South American physicians respecting the Erythroxylon, (provided it was not a myth,) together with a small supply of the plant.

In about nine months I received his reply, with some seventy-three pages of manuscript, containing statements from thirty-three different physicians together with about one pound of the Erythroxylon leaves made up in different parcels, as my friend could purchase.

The samples were mostly different in appearance, and as I found, different also in active properties. I went to work making tinctures, being guided in their use by the manuscript statements of the South American doctors, cautiously feeling my way, so to speak, for there was great diversity in the statements both as to the diseases in which it was indicated, and as to its physiological effects.

I prescribed it in chronic diseases of the lungs and bronchi, leucorrhoea, spermatorrhoea, etc., and, when the article was good, always, or nearly so, with gratifying results; but, as my supply was small and much of it nearly or quite worthless, I did not reach any very definite conclusions. My first practice with the Coca was in the year 187o-71. In 1872 I saw the saturated tincture, also the Cocoain advertised by an eastern house. I immediately ordered a dozen pints of tincture and one-fourth dozen bottles of the Coca---. I used all of this except a single pint of the tincture within about one year—this pint I took myself in a case of convalescence from an attack of fever, in the spring of 1878. Some of this was used successfully in combating the opium-habit as indicated in an. article which I furnished New Preparations, and which was published in that journal July, 1878. I then promised a more extended research into the properties of the Erythroxylon Coca, which I have made under more favorable circumstances, for I have used the fluid extract as prepared by Messrs. Parke, Davis & Co., and since the date of my communication to New Preparations, I have purchased on an average one pound of their fluid extract Erythroxylon Coca a month, testing it in every variety of cases (except paralysis) that I considered dependent upon defective innervation.

My theory of tubercular consumption, for instance, is, that it is nervous disease, so, I think are dyspepsia and numerous other chronic diseases. Take consumption for an illustration: I think the brain and nerves become enervated from various causes, and from whatever cause, digestion and assimilation become impaired; next the blood, by losing some of its healthy constituents, becomes too thin and watery, and the circulation thereby languid and sluggish. Then, as it passes through the lungs, a spongy tissue, it parts with a portion of its fibrine, which, being semi-vitalized, organizes in the form of tubercle.

The opium and alcoholic habits, I conceive are formed thus: Both opium and alcohol are stimulants, and, if pushed, become narcotics. When taken into the stomach both alike produce, at first, an agreeable feeling of stimulation. Both soon pass away and leave the system more or less depressed. This condition calls for more stimulation, oft repeated the nervous system is more or less broken down, and a real disease is found, weakening the will-power—so much as to bring about a complete surrender of humanhood to the new master.

Now to cure any of these, we want, not only a stimulant, but a new tonic, something that will produce the stimulus of opium or alcohol, as the case may be, and leave the nervous system braced, so as not to be followed by any depression. My long experience with Erythroxylon Coca, and my close observation of its action in both disease and health, I believe that in this valuable agent we possess the very desirable drug—the desideratum.

In the country producing it, the natives eat it, and become as much its slave as De Quincy ever was to opium, or Beau Brummel ever was to wine, yet it produces no bad results. It promotes not only longevity but vital energy, enterprise and a desire for labor. Those addicted to the Coca habit are, at least in some places, called coqueros, and according to Dr. Quisina, one of the physicians reporting in my manuscript, live to an indefinite age. He reports an old man, a half-breed, 17o years old, and numbers of others over 1oo years of age, but states that the coqueros loose all their virile powers. Dr. Q, is a Bolivian physican, then (Jan. 187o) 58 years old. He and several others stated that it would, if used to excess, entirely destroy the sexual desire. My experience, however, is the reverse of this as far as it goes, but, I have made no "coqueros" in my practice. In two cases of impotency, treated with Coca alone, the desired effect has been produced, after the strychnia, savin, Ignatius bean and phosphorus treatment had utterly failed.

Mr. G. A., bachelor, about 47, residing on a farm with his servants only, came to me October 1879. He was greatly distressed in mind and utterly depressed in spirit. He had been a "great rake," and had, consequently, indulged to extreme excess his sexual passions, or, as Mrs. Elmira Slenker would put it, had been guilty, of great "sexual intemperance." He had lost all sexual power; had a serious gleet; was much reduced in flesh; was sullen and morose, sitting for hours silently gazing at vacuity, and then talking with great volubility of his affections as long as he could retain an auditor.

At first I gave him iron, quinine and strychnia in combination. He took this for six months. His appetite and digestion returned. He also regained his color and flesh, but his craziness remained because there was no amelioration of his impotency I then put him upon phosphorus with no better result after thirty days' use. At this juncture I prescribed for him two pounds fluid extract Coca| to be taken in teaspoonful doses four times a day, namely, before meals and at bed time. "It acted like a charm," and he was perfectly well of all his diseases before he had used all his medicine, and remains so at this writing, November, 188o.


Such is the intrinsic problem of any academic work that insists upon defining a particular drug was an object of “abuse”. Though it may certainly be, it may hardly necessarily be. --- would have done better to target not “cocaine” but instead “isolated cocaine in concentrated doses” or simply “concentrated cocaine”.

The purpose is to confuse. To confuse the acute and chronic effects of high doses of concentrated cocaine with the effects of low dose dilute cocaine. It is the sort of nonsense we can expect from an 'academia' utterly rotted out by 'good old boys' fraternal-ism, as is our government.

The dangers of alcoholism would be avoided if no other stimulant was taken...than...Vin Mariani

Coca as Tobacco Habit Cure

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