Editor’s note: In this section Dr. Searle reviews the then-current thinking on the range of “New World” substances that had been changing the face of European/American society for several hundred years at the time he wrote in 1881. It may seem quaint to us in 2014 to read about the pros and cons of coffee and tea as narcotics/stimulants, but IMO that is more of a comment on knowledge we have lost than on how far we have advanced in our thinking.
Coffee, Tea, Tobacco, Wine, Narcotics, And Coca
In regard to all experiments of this kind, such as have been undertaken by scientific men in respect to the influence of tea, wine, coffee, etc., upon the human body, it must be remarked that their difficulty and liability to error may be estimated from the very various and even opposite conclusions at which equally honest investigators have arrived. For example, Smith’s experiments with tea (Philos. Trans., 1859), showed a great increase in the excretion of carbonic acid under its use, and he therefore concluded that it increased waste in the system. Coffee he found to have a similar though slighter effect. But other experimenters just as distinguished have come to precisely opposite conclusions, because they found that the use of tea and coffee diminished the excretion of urea. Smith claims to have proven that the true and only measure of waste from muscular tissue, at least, is to be found in the rate of elimination of carbonic acid gas from the lungs, and to have shown that the violent exercise of the tread-wheel caused a scarcely appreciable increase in the emission of urea (Philos. Trans., 1862).
In this he is supported by Bishoff and Voit. But if his conclusions are correct, the general and indubitable experience of mankind in regard to the sustaining powers of tea and coffee must be abandoned. It has often happened to me, and I doubt not, to every physician as well as to every housekeeper, to find women of the laboring classes who work hard every day, and who live almost altogether upon tea, taking an incredibly small amount of ordinary food, and yet they maintain flesh and strength year after year at the same standard. How can Dr. Smith and his fellow philosophers reconcile such a state of facts with their experimental theories?
In respect to Coca, which must be regarded as a substance of the same class, we have the testimony of an entire nation, employing it constantly during centuries of time, as well as that of many who have used it by way of experiment, that it does in some way obviate the necessity for food and sleep to a remarkable degree – a degree unknown by those who do not use it or by the same men when not under its influence, and that it does enable one to undergo unusual exertion of both body and mind, without experiencing the fatigue which otherwise would surely accompany or follow it. If we eliminate the trials of those who (as seems probable), have employed worthless specimens of the plant, we have so much concurrent testimony upon this point as to render doubt ridiculous. And it appears to me that to insist that it has not these effects because we have, as yet, not been able to show, from our partial experiments with imperfect specimens of the substance, that excretion of urea or of carbonic acid or of phosphoric acid is materially lessened, or because we cannot yet give the how or why, is quite as un-philosophical as it would have been, in a former age, to deny the growth of a blade of grass because we were ignorant of the processes of its development.
That tea, coffee, tobacco, coca, wine, and the various narcotics and stimulants used by mankind have an influence of some sort is sufficiently proved by the fact that mankind persists in employing them. Abundant facts prove that most, if not all, of them enable men to accomplish more work with less food than they otherwise could, and such facts cannot be controverted by any amount of experiments, however they may show an increase or non-diminution of waste under the use of these substances. Some time or other experiment will and must confirm these facts. When theory conflicts with fact, it is the theory which must succumb.
Whether or not the employment of paratriptics injures health or shortens life, is and long will be an open question. Meantime, it may help to calm the fears of some and confirm the faith of others (even though it proves nothing), to recall the fact that it is only three hundred years since tea, coffee, and tobacco have come into general use by the human race, having spread within that time from their local and limited habitats all over the world, until at the present time it is calculated that, in regard to tobacco, for every man, woman, and child on the face of the earth about five pounds are annually used: and yet the average duration of life has increased and is increasing. In regard to the influence of tobacco we may refer to the investigations of Sir John Sinclair, the results of which are given in his “Code of Health” recently published. He found in the Pension Hospitals of the United Kingdom one hundred and fifty men over eighty years of age. Eighteen of these were over ninety, and several over one hundred, and yet, almost without exception, they were and had long been consumers of tobacco.
Probably the increase in the use of coffee and tea quite parallels that of tobacco, and the aggregate influence upon mankind must be something enormous.
It certainly ought to be evident to philosophers by this time that there must be some sound physiological reason why mankind has so universally adopted the use of these substances, and particularly why they have so adopted tobacco, which to the novice is a nauseous and disgusting thing. If it be held that this fact is to be explained by the enjoyment derived from its use, why has not its spread been equaled or exceeded by opium or haschish, substances whose effects are far more exhilarating, more powerfully intoxicating?
We cannot enter here upon a resumè of all the experiments which have been made upon these substances. Nor is it necessary. They are familiar to all who have studied the subject. And no theory is so consistent and accordant with all the facts and all experiments as this, viz., that in some way not yet wholly determined, they all supplement food or lessen the necessity for food. Some of them have a similar effect also in regard to sleep.
Now, since all physicians recognize that each of these substances has some effects prejudicial to the health of a part of those, at least, who employ them, it surely behooves us to attempt to determine which of them are most innocuous and endeavor to supplant the rest by these.
Is Coca, then, better than tea for the community in general? I believe that it is, and for the following reasons:
1st. Tea contains much the greater proportion of tannin, and is therefore, by so much, more productive of constipation. Coca does not have this effect. In fact I have cured chronic constipation by its use.
2d. If we are to credit Dr. Smith (loc. cit.) tea increases the amount of carbonic acid exhaled from the lungs, thus rendering more and purer air necessary. Now it is true that no similar experiments have been made with Coca, but it seems to be an undisputed fact that at levels high above the sea, where the atmosphere is so rarefied that rapid respiration, even while at rest, is necessary to the sufficient aeration of the blood, the Coca enables the hunter to engage in as active exercise as at sea-level. Surely this could not be, unless, far from increasing the elimination of carbonic acid from the lungs, it rather diminished it, and that to a great extent. (I may remark here, in parenthesis, that perhaps the effects of Coca should be looked for rather in the excretions from the lungs than from the kidneys; a priori, we should expect that the lessening of the excretion of carbonic acid from the lungs and of that of urea, etc., from the kidneys, would be co-ordinate and correlative. They may be so, but, in the absence of proof that this is the case, we must acknowledge that it is at least doubtful. And, if it should turn out not to be so, it certainly looks as though it might be shown that Coca diminishes the excretion of carbonic acid to a remarkable degree. Certainly no known substance at all parallels its power in preventing breathlessness in elevated regions.)
3d. The use of tea in excess tends to produce a highly irritable state of the nervous system. Tea-drinkers shake and quiver under excitement, and start at the slightest noise. The Coca calms and renders placid.
4th. Tea has not one quarter of the power to sustain the body under excessive labor when it is deprived of food.
Coffee and Coca are, perhaps, more closely related, though, as was said of tea, coffee has far less power. It is to be noted that, if one unaccustomed to the use of coffee drinks a cup of it, he quickly becomes conscious of an exhilaration. This persists for two or three hours. His mental powers are stimulated, and his ideas and words flow with increased facility, but ask him to hold his hand steadily in one position, or let him attempt some delicate surgical operation and his fingers will quiver even to the point of danger for the patient. But if, instead of coffee, he takes a cup of Coca infusion, no such excitement follows. Indeed, he would not know he had taken anything unless called upon for some unwonted effort, when he would find himself unusually competent to the task, and unfatigued by it.
The effects of tobacco are much more varied and complicated than those of tea and coffee, and comparison is therefore more difficult. We will attempt only a superficial view.
1st. The use of tobacco, both by smoking and chewing, is offensive – the former to many, the latter to every decent man. Since, however, Coca is not smoked, and the juice extracted by chewing the leaves is swallowed, these objections do not apply. The breath of the tobacco-user is offensive to everybody; that of the Coca-chewer to but very few, and they sensitive persons who would be troubled by so faint an odor as that of tea.
2d. As to the comparative usefulness of these two substances in sustaining under exertion, the balance inclines heavily in favor of Coca.
3d. Smoking is said to promote digestion. The same, is said, by Mantegazza, to be true of drinking an infusion of Coca.
4th. Tobacco to the novice in its use is exceedingly nauseous and disagreeable. Coca is unpleasant to no one.
Wine and alcoholic liquors of all sorts prevent waste, as is evidenced by the fact that those who use them eat less food. But the evils of alcohol are numberless and need not be recounted here. He who could persuade men to substitute the use of Coca for that of intoxicating liquors would be one of the greatest benefactors the world has ever seen.
It is not a little remarkable that while no other known substance can rival Coca in its sustaining power, no other has so little apparent effect. To one pursuing the even tenor of his usual routine, the chewing of Coca gives no especial sensation. In fact the only result seems to be a negative one, viz.: an absence of the customary desire for food and sleep. It is only when some unusual demand is made upon mind or body that its influence is felt. And to this fact is to be attributed much of the incredulity of those who have carelessly experimented with it, and who, expecting some internal commotion or sensation, are disappointed.
For more than three years past the writer has used the Coca himself and prescribed it extensively for others. I need not repeat to those who hear me my experience with it in treating nervous affections, since I have lately addressed you upon that subject.
In addition to this, however, I have found for myself that, when compelled by the exigencies of my profession to forego sleep, if I chew the leaves the loss is not felt, or, if a brief nap is caught in the morning, the waking is free from the stale, exhausted feeling which used to mark those hours, and I am as elastic and buoyant as if I had slept all night. But if I chew it freely during a day of ordinary labor, the sole result is a diminution of customary appetite. It is not a little curious that, while its use disperses the desire and need for sleep, it does not prevent sleep as do coffee and tea.
I have advised its use to a large number and variety of persons during the past three years, for various conditions, and the great majority have found benefit from its employment.