Tag Archives: ME/CFS
Coca Leaf Therapy For Compromised Human Gut Microbiome?
Introduction
Readers of this blog have probably seen a number of my posts detailing 18th-19th Century medical research showing how effective Coca Leaf therapy was in dealing with inflammatory processes in the body. In addition, the medical research from previous centuries on which these posts were based makes it clear that one of the most common (and most effective) modalities for the use of medicinal Coca Leaf was in the treatment of dyspepsia – what we now call reflux, which is a sure sign of Gut Microbiome issues.
In an undeterminable, but undoubtedly very large proportion of cases of dyspepsia in those days the culprit was an exogenous bacteria called Helicobacter pylori, which is now known to be the cause of well over 90% of all stomach and intestinal ulcers. H. pylori is acquired in two ways – it can be acquired directly through ingestion of feces-contaminated water (not as uncommon as one might think, even in the US today), and it can be passed from person to person – often parent to child – through oral contact (Come on sweetie, eat your applesauce – look, Mommy is tasting it! Yum! Now you try some.). That is why H. pylori tends to run in families, and why it was so common in 18th – 19th Century Europe and America, when almost everyone was exposed pretty constantly to feces-contaminated water.
Now for the interesting bit.
While H. pylori infection is epidemic in most of the under-developed world, as shown by epidemiological studies, and is also pretty common in the US (virtually everyone who has diagnosed or undiagnosed ulcers is infected) it is almost unknown among the indigenous, Coca-chewing people of the Andes. HOWEVER, in the non-indigenous, non Coca-chewing cities of Peru and Bolivia H. pylori infection, and the consequent diseases, are as common as anywhere else in the developing world.
Wouldn’t it be interesting to compare the Gut Microbiomes of Coca-chewing indigenous Andean people with non-Coca Chewing city dwelling Peruvians and Bolivians, and also perhaps with the profiles of Americans who have participated in the American Gut Project?
So, to summarize.
1. Coca Leaf was well-known in the 18th – 19th Centuries as a treatment and positive cure for Dyspepsia, which means that it was able to control/eliminate gut infection by H. Pylori, and quite likely by other gut-dwelling pathogens.
2. H.pylori infection is virtually unknown among Coca-chewing Andean peoples, while it is common in the cities of Andean countries.
In science when a theory sounds plausible but the data to test it are absent, the rule is “Think about what the world would look like if the theory were true, and then look at the world.”
If we recall the well-established observations by doctors in the 18th-19th centuries that coca leaf-chewing indigenous Peruvian and Bolivian people showed (and still show) virtually no signs of oral cavity disease, have clearly healthy-functioning digestive systems, are highly resistant to diseases causes by external pathogens, and have highly efficient metabolic systems, it seems fair to speculate that Coca Leaf therapy might be able to arrest and reverse the damage to both the gut wall and the Gut Microbiome caused by antibiotics, industrial food chemicals, and other sources of the suffering and death that seems to be the fate of so many of us living in the “Advanced Economies” of the world.
There is little question in my mind that when Coca Leaf is finally given its day in scientific court it will be shown to be highly effective at treating inflammatory conditions in the gut, as well as conditions involving colonies of pathogens and degraded epithelial cells and the mucosal wall itself. It will be shown to be effective because it not only directly addresses inflammatory processes in the gut tissues, but also addresses the degenerative processes initiated by chemical damage, as with emulsifiers (see below), or by “bad bacteria” that have colonized the upper gut, or by oral cavity bacteria hiding in the plaque below the gums, or by exogenous bacteria like H. pylori that have colonized and set about destroying the integrity of the gut wall while they implant themselves in protective burrows in the mucosal layers.
After all, if the use of a simple, natural medicine like Coca Leaf could treat even one or two diseases like Crohn’s, Ulcerative Colitis, Hashimoto’s, IBS, SIBO, Celiac disease, Primary Biliary Cirrhosis, COPD, Asthma, Congestive Heart Failure, Atherosclerosis, Metabolic Disorder, Insulin Resistance, Obesity, Hyperglycemia, and possibly Alzheimer’s more effectively than the “medicines” currently offered by Pig Pharma – wouldn’t that be a marvelous gift from Mama Coca, the Mother Nature of the Andean people?
In the following discussion I hope to offer plausible if not convincing arguments that this possibility should be considered and seriously investigated.
Discussion
Those of us who for personal or professional reasons wonder about the origins of the diseases that seem to strike people in economically developed countries far more frequently than they do people who live in economically undeveloped parts of the world are increasingly seeing evidence that factors that affect gut bacteria play a major, poorly understood role in generating these advanced economy diseases, and offer a plausible explanation for why people in less advanced economies seem not to suffer from these diseases – at least until economic conditions improve for them.
Collectively these gut bacteria are known as the “Gut Microbiome”, and there are hundreds of thousands of species of these little communal creatures living in every part of the gut. While most of us think of the “Gut” as our stomach and intestines, in fact the gut runs from our mouth to our anus, colonized all the way by bacteria that specialize in living and performing specific functions in a specific part of our gut.
The Lane Lab at the University of Rhode Island is a treasure trove of research in this area. In a recent paper they write: “The human intestine is an ecosystem that supports up to 100 trillion microbes—a cell number that is roughly ten times greater than the human cells that comprise our bodies. In addition to the vast number of cells comprising the microbial community of the gut, there may be over 100 times the number of bacterial genes present compared with the number of genes in our own DNA (Bäckhed et al., 2005). These beneficial microbes are instrumental in our ability to extract nutrients from food, and also play an important role in the development of our immune systems.”
For example, our mouth contains @ 15% of the total number of species of bacteria in our gut, and although only dental hygienists ever mention it to us, having a healthy mouth is a critical part of whole body wellness. Leaving out, for the moment, the rest of the gut, a sick mouth biome can, by itself, trigger all kinds of disease conditions in organs as distant from the mouth as the brain and the heart.
(As an aside, if you have access to a dentist who uses the new laser technology for deep gum cleaning rather than the old “pick and scrape” technique – give it a try. I can tell you anecdotally that my wife, who suffers from a severely compromised Gut Microbiome, and who has been doing all of the “Leaky Gut” therapies, found that after a single teeth cleaning with this laser technology her “Brain Fog” symptoms disappeared. She was not miraculously cured of all symptoms, but this one very annoying one simply went away.)
When all of these hundreds of thousands of little communities of bacteria are healthy and functioning as they should, our whole body tends to be healthy and vigorous. Not that there aren’t diseases that have nothing to do with a healthy gut that can ravage and destroy us – some of them caused by exogenous bacteria, some by exogenous viruses, some by environmental chemicals, some by radiation, etc. It’s a long list.
However, in this post I would like to ask you to indulge me as I speculate on the potential for simple, inexpensive Coca Leaf therapy as a possible preventative of some, or even many of the “Advanced Economy Diseases”, and also as a treatment and possible cure for others.
Because there are so many factors to consider when discussing the health of the Human Gut, let’s focus just on the role of bacteria in maintaining, or degrading, the mucosal lining of the gut – the “Wall” as it’s called. In the normal, healthy gut there are large numbers of bacterial species whose primary, or sometimes secondary role is to maintain the “Wall” as a thick, protective lining of the gut, allowing ingested substances – primarily food and drink, often called the “Luminal Mass” – to pass smoothly through the upper and mid-gut while nutrients are extracted from the passing mass. These nutrients are processed by the bacteria into forms that can then pass through the mucosal layer, where they are taken up by the blood vessels that lie beneath this protective layer. Many gut researchers call these upper-gut bacteria “good bacteria”.
The mucous surface contains epithelial cells, which are a critical part of the barrier between the contents of the gut and the blood, lymph, and organ systems of the body. After all, when you think about it, the inside of your entire intestinal tube is OUTSIDE the body, although it passes through the body. So the walls of your gut serve to prevent materials that are outside the body from getting in – much the same as your skin. However, the mucous wall serves to allow nutrient absorption and to promote waste secretion, which means that the mucosal wall must be selectively permeable. It must allow some things through, and prevent other things from getting through.
And a healthy gut wall does just that, and it is maintained in good condition by the “good bacteria” that live on its surfaces.
Normally these “good bacteria” don’t live within the mucosal wall – they colonize its surface and work their nutrient-absorbing magic on the contents of the gut as it passes by and is ultimately expelled from the body as nutrient-exhausted waste – feces and urine. (Way too simple, I know, but this isn’t intended to be an academic paper, just a small speculative essay.)
Researchers are now, almost daily, publishing studies that show that when the mucosal wall of the Upper/Mid Gut is compromised, some of our most devastating diseases begin to appear. Crohn’s, Ulcerative Colitis, Hashimoto’s, IBS, SIBO, celiac disease, primary biliary cirrhosis, atherosclerosis, and – some believe – Alzheimer’s. That’s the short list.
There are an increasing number of studies into how the mucosal wall is breached – a condition that some call “Leaky Gut”, but almost all of these breaches begin with a disturbance in the Gut Microbiome.
A common breaching event occurs when a person is administered a heavy dose of antibiotics to deal with an attack on the body by dangerous outside bacteria like Staph, for example. Unfortunately because of the increasing heavy doses of ever more powerful antibiotics needed to deal with increasingly resistant invaders, many of the “good bacteria” in the upper and mid-gut are also wiped out, along with the epithelial cells in the mucosal lining.
So far I haven’t mentioned the lower gut and its denizens, called “Bad Bacteria” by many scientists. Bugs like C. Dificil and Klebsiella, to name just two of hundreds of these lower intestine bugs, normally stay in place and perform all kinds of functions that are essential to successful elimination of waste from the body. In that sense they are not “bad”, because as long as they stay put and do what they are supposed to do, they are behaving themselves and causing no harm.
However, these “Bad Bugs” are also much stronger than the “Good Bugs” that dwell upstairs, so in the event of a whole body antibiotic assault far more of them survive. But that’s not the end of the story. They not only survive, they sense newly vacated territory in the upper gut and they begin migrating and establishing colonies. These bacteria – now earning their designation as “bad” – are not content to live peacefully on the surface of the mucosal lining of the upper gut. Because the lower gut has a completely different kind of lining, the “Bad Bacteria” begin burrowing into the mucosal wall of the upper gut – for reasons that are not yet understood. Some researchers say it is because the mucosal wall offers them a way to strengthen their foothold in the new territory; others say it is because the mucous is yummy. Whatever the reason, these “Bad Bacteria” soon eat through the epithelial cells and mucous lining of the upper gut and – voila – the selectively permeable barrier is no longer selective. All kinds of substances from the “Luminal Mass” can transit directly through the gut wall and into the bloodstream, setting into motion a furious reaction by both the body’s immune system and its endocrine systems which recognize these substances as things that should not ever be inside the body, and the body’s defenses immediately attack. And because the person inside whom this is happening continues to eat and drink, the substances keep leaking through the gut wall and the body’s defenses keep ramping up their responses to the highest possible levels.
Just one brief example – in Hashimoto’s Thyroiditis, what appears to happen is that when the Gut Wall is compromised and certain proteins begin “leaking” through into the blood, the body’s immune system begins attacking these foreign proteins – primarily the gluten protein molecule from grains. Unfortunately, the gluten molecule is almost identical to a thyroid gland tissue molecule, and so the body’s immune system, alerted to the foreign invader gluten protein molecule, also begins attacking and destroying the Thyroid gland tissue. Voila – Hashimoto’s Thyroiditis. If not checked, the immune system will ultimately destroy the Thyroid gland in its misguided mission to protect the body from foreign, and therefore dangerous proteins circulating in the blood and lymphatic systems.
This never would have happened if the gut wall had not been breached, and in almost every case this breach is the consequence of colonization of the upper gut by “bad” bacteria.
Zap – You’re Emulsified
Antibiotic overdose and upward migration of “Bad Bacteria” are not the only identified causes of “Leaky Gut” and its disastrous consequences. For example, an extremely interesting new research paper shows that several of the common emulsifiers used in food manufacturing to keep ingredients from separating such as polysorbate 80, lecithin, carrageenan, polyglycerols, and xanthan and other “gums,” wreck havoc with the gut. In lab animals. This research found that polysorbate 80 (common in ice cream) and carboxymethylcellulose altered microbiota in a way that caused chronic inflammation.
They also found that mice with abnormal immune systems fed emulsifiers developed chronic colitis, while those with normal immune systems developed mild intestinal inflammation and a metabolic disorder that caused them to eat more, and become obese, hyperglycemic, and insulin resistant.
The conclusion of this research seems to be that “emulsifiers” in food somehow “emulsify” the mucosal wall of the gut. Well all I can say is “Duh”.
In Conclusion
The Human Gut has evolved over millions of years into a remarkable organ that, in a natural world, is fully capable of protecting the body that serves as its host from virtually any biological or chemical threat found in that natural world. When the Microbiome of the gut is in balance within itself, the entire organism of the body tends to be in balance with the environment.
However, as ‘civilization’ has evolved, and especially since the industrial and scientific revolutions have changed the natural world irrevocably, the Human Gut has simply not had time to adapt and therefore, like the rest of the Human body, it has increasingly fallen victim to both the deliberate creations of these revolutions like antibiotics and processed foods as well as to the waste products of the revolutions like chemical and biological pollution of the air, water and earth.
As the saying goes, we are what we eat, and if what we eat is instead eating us from the inside, there is little hope for a solution coming from our scientific and industrial revolutions. If there is a solution perhaps it will come from reaching back into time and understanding the relevance of at least some of the old ways to our contemporary dilemmas. Surely Mama Coca, just like Mother Nature, is waiting there to help us, if we have the will and wisdom to seek her help.
More Proof: Coca Leaf Is A Safe & Effective Natural Medicine
Although I’ve tried to illustrate this point many times in this blog, it is so critical to overcoming decades of government propaganda that it bears repeated emphasis. In this case I’m offering the abstracts of two key articles published decades ago, but still well within the scope of contemporary science. (Those who follow Natural Medicine research will no doubt recognize the author of these two articles as the incomparable Dr. Andy Weil.) Just in case anyone might miss the key information here, I’ve bolded it.
The medicinal, healing properties of Coca Leaf do not lie in the Cocaine alkaloid – it is the whole, natural leaf that was the great gift of Mama Coca to her people and through them to the world. This leaf is the loving gift of the Spirit of Coca to those in the world who have the openness of mind to pull aside the deliberately woven veils of illusion that have been put in place to keep her hidden from the tens of millions of people who suffer and die unnecessarily from diseases that this profoundly powerful natural medicine could help to cure.
American Journal of Drug and Alcohol Abuse 1978;5(1):75-86.
Coca Leaf As A Therapeutic Agent
Weil AT
Abstract
South American Indians have used coca leaf as a remedy for thousands of years. Coca might be useful as a treatment for gastrointestinal ailments and motion sickness, as a fast-acting antidepressant medication, as a substitute stimulant for coffee in certain cases, and as an adjunct in programs of weight reduction and physical fitness. In leaf form, coca does not produce toxicity or dependence. Its effects are distinct from those of cocaine, which is but one of a number of active compounds in the leaf. Coca can be administered as a chewing gum containing a whole extract of the leaf, including alkaloids, natural flavors, and several nutrients. Legal mechanisms exist for importing, distributing, and dispensing coca, and experimentation with it by interested physicians would be valuable.
Journal of Ethnopharmacology 1981 Mar-May;3(2-3):367-76.
The Therapeutic Value Of Coca In Contemporary Medicine
Weil AT
Abstract
Coca appears to be a useful treatment for various gastrointestinal ailments, motion sickness, and laryngeal fatigue. It can be an adjunct in programs of weight reduction and physical fitness and may be a fast-acting antidepressant. It is of value in treating dependence on stronger stimulants. Coca regulates carbohydrate metabolism in a unique way and may provide a new therapeutic approach to hypoglycemia and diabetes mellitus. With low-dose, chronic administration it appears to normalize body functions. In leaf form coca does not produce toxicity or dependence. Coca can be administered as a chewing gum or lozenge containing a whole extract of the leaf, including alkaloids, natural flavors, and nutrients.
Coca Leaf & Muscular Energy
Because I have received such interesting feedback on a recent blog post on the possibilities of Coca Leaf as a treatment ME/CFS, I thought that I would post Chapter 12 of “The History of Coca” by W. Golden Mortimer, MD (1901). Anyone interested in the role of fatigue, nutrition, metabolic waste in the blood, and the therapeutic role of Coca Leaf that was fully known in the 1800s and yet which has been completely ignored in the search for treatments and even cures for a range of muscular & neurological conditions will probably find this information – at a minimum – interesting.
It will also be interesting to critics of one of today’s medical fads – the imposition of progressively strenuous exercise on people with CFS, ME/CFS, MS and other conditions – that Dr. Mortimer writing in 1901 is saying exactly the same thing – PET (Progressive Exercise Therapy) is potentially dangerous. I had a football coach in high school whose only response to an injury was to tell the player to “Jog it off.” I remember getting seriously crunched in practice and then, on Ole’ Coach’s orders, doing a couple of laps with what turned out to be a broken collarbone. Finally I fainted at which point ole’ coach finally decided to have an assistant toss me in a car and drive me to a hospital.
Somehow I think the spirit of “Ole Coach” lives on in a lot of doctors.
The section of this Chapter that deals with the balancing, restorative impact of Coca on body proteins is equally fascinating. It is highly suggestive of potentially safe and effective pathways to addressing some severe diseases involving protein metabolism gone awry. Alzheimer’s perhaps?
Finally, I hope you will find it as fascinating as I did to read Dr. Mortimer’s discussion of metabolic waste in the blood and Coca Leaf’s role in cleansing the blood of this toxicity
This entire book, and several others that are equally well-written and revealing, are available along with a large hyperlinked bibliography that will take you to original 18th-19th Century source material, in my ebook “The Coca Leaf Papers”. (And don’t forget that you can request a free copy of this book on the “Request A Free Copy” page of this blog.
CHAPTER XII INFLUENCE OF COCA UPON MUSCULAR ENERGY
“Leaves of wond’rous nourishment.
Whose Juice Succ’d in, and to the Stomach tak’n
Long Hunger and long Labour can sustain;
From which our faint and weary Bodies find
More Succor, more they cheer the drooping Mind,
Than can your Bacchus and your Ceres joined.” – Cowley.
There has been no period since the command was given Adam in the garden of Eden, when physical exertion was not essential to existence. The ancient philosophers instilled the doctrine that a sound mind is only possible in a sound body, and so Homer pictured Achilles as eating his own heart in distress because he might not fight. Idleness has been so recognized as a common precursor of discontent and melancholia, that when the children of Israel murmured against Pharaoh their tasks were wisely doubled to prevent retrospection. Occupation is not only essential to prosperity, but is morally and physically conducive to health and longevity and a rest is best attained not by total cessation, but by a change of employment. I believe it was Hammond who advised a wealthy neurasthenic to collect used corks, with the result that the patient became so interested in this unique occupation that his brooding was soon forgotten, while he became an expert in old stoppers.
With a popular regard for the benefits of appropriate exercise, the matter of athletics has been greatly overdone, and has often resulted in injury instead of the anticipated good. The early Greeks, who elaborated every form of gymnastics, only undertook the severe strain incidental to their games after a suitable preparatory period. They were encouraged to these performances – which were instituted in honor of the gods or deified heroes – through the idea that they were sacred, and in fulfillment of this the exercises always began with a sacrifice, and concluded in the same religious manner. In the period of Caesar, a victory in the Olympic games was considered such a triumph that honors were not only extended to the victor, but to his relatives and even to his place of birth. There was, however, no impromptu emulation permitted in these contests, but those who desired to compete were obliged to submit themselves for preparatory practice at least ten months before the exercises began.
Wherever there is an incentive for supremacy, there is a possibility of overstrain, and Hippocrates cautioned the athlete against the possible error of immoderate exercise. Galen foreshadowed the modem wear and tear theorists when he asserted: “much exercise and weariness consumes the spirits and substances.” Sustained and straining effort in any direction, whether it be mental or physical, cannot be continued without a following train of troubles. When any function of the body is put in action there is a chemical change within the tissues which gives rise to the energy set free, and before new power may be had the substance which affords this energy must be rebuilt. While this is true of all the tissues of the body, owing to the greater bulk of the muscular system the changes are apparently more active in this organism. Incessant activity often prevents an adequate opportunity for repair.
We have seen that the Incas, during the period when their young men were preparing for knighthood, devoted the greatest attention to athletic training. It was only when the young nobles had proved themselves worthy, by appropriate exhibition of their powers of endurance, that they were presented with the chuspa in which to carry the Coca leaves, and the poporo to contain the lime to be employed in preparing the Coca for mastication. These decorations were thereafter worn through life as emblems of ennoblement, and buried with the mummied body, the Coca affording support on the journey to the unknown. The ancient philosophers were quite as ignorant of the exact changes which induced the transformation of energy displayed in muscular activity as were the Incas, or as are the modem Andeans regarding the true workings of Coca in its yield of force.
Mind, Muscle, Energy & Nutrition
The muscular system comprises two varieties of muscles. One of these acts under mental influence, while the other acts independent of the will, while the heart – which is essentially a muscle – partakes of qualities in both of these varieties. The voluntary muscles are chiefly attached to the bony framework, and are concerned in bodily movements, while the involuntary muscles enter into the formation of the blood vessels, the lymphatics and the walls of various structures, as the air passages, the alimentary canal and other important organs, as well as forming parts of the skin and mucous membranes.
The framework muscles are supported by thin sheaths of tissue, which in their interior divide by numerous ramifications and separate the contained muscular substance into bundles. These are still further divided into little fibres, each ultimate fibre being enveloped with a close network of minute blood vessels. These vessels afford an ample means for bringing nutriment to the muscle substance, as well as for carrying away the waste products which are constantly being formed, even in the state commonly regarded as absolute rest. The importance of this hurrying stream of nutriment, and waste elimination to the muscular organism, may be inferred from the estimate that one-fourth of the entire blood of the body is contained in the muscles.
When the little muscle fibres are examined under the microscope, they are seen to be made up of alternating lines which appear as light and dark striations. The darker of these lines, when viewed in transverse section, is found composed of little polygonal compartments. Within these divisions is contained a semi-fluid material which has been demonstrated to be the contractile element of the muscle substance.
The ancients presumed the muscles acted by some pulling influence exerted through the nerves. Harmonious nerve action is essential to every movement, yet muscle substance has been shown to have an inherent property of contractility quite independent of nerve influence. The chief nerves controlling the movements of the muscular system have their origin in the brain and spinal cord. These each consist of fibres conveying sensation and fibres which control motion. These latter end in expansions on the surface of the muscle in intimate contact with the contractile element, the function of which it regulates through the reflex influence of the sensory nerves. In other words a stimulation of the sensory nerves excites the motor nerves to cause muscular activity.
Each fibre is not continuous through the entire length of muscle structure, but the tapering end of one fibre is united to the body of its neighbor by a cement-like substance to form a bundle which constitutes the muscle proper. These bundles taper, or are expanded, as the case may be, to a dense fibrous tissue for attachment to different portions of the movable framework of the body. When a muscle acts, each of its individual fibres shortens through some chemical influence of the contractile element. The combined action of the fibres exerts a pull toward either end of the muscle, which occasions movement of the less fixed portion of the framework to which the muscle is attached.
The involuntary muscles have not definite tendons like the voluntary muscles, and their microscopical structure is also different, their fibres being smaller and instead of being cross-striped they are marked longitudinally. In their arrangement the fibres are so interlaced that by their contraction they lessen the capacity of the vessels or organs in the walls of which they are located.
The property of contraction is inherent in the muscle itself, and continues even after its nerve supply has been cut off. For this experiment in the laboratory, curare is employed; this paralyzes the nerve filaments deep down in the muscle substance yet leaves the muscle intact. Under these conditions though contraction will not be produced when the nerve is stimulated, movement will follow when stimulus is directly applied to the muscle substance. It is presumed that this inherent property is generated by some substance brought in the blood, which induces a chemical change in the contractile element and liberates the energy displayed as muscular movement. This change is influenced by temperature, and by the presence or absence of waste material in the muscle structure or in the circulation. Whatever this explosive substance may be, it is presumed to be built up in the muscle structure from some carbohydrate material – possibly glycogen – under the influence of a nitrogenous substance. For, as Foster has said: “The whole secret of life may almost be said to be wrapped up in the occult properties of certain nitrogen compounds.” Hermann named this hypothetical substance inogen. During a muscle contraction it is inferred this carbohydrate splits into carbonic acid, sarcolactic acid and some nitrogenous material which may be myosin or a substance akin to it, the acids being carried off in the blood stream, while the proteid substance remains in the muscle to be again elaborated into the inogen energy yielding material. Helmholtz calculated that in the human body one-fifth the energy of the material consumed goes out as work, thus contrasting favorably with the steam engine, in which it hardly ever amounts to more than one-tenth.
The Key Role Of Nitrogen
According to the theory of Liebig the nitrogenous food is utilized in the building up of proteid tissues, and the non-nitrogenous food is exclusively devoted to heat producing purposes, being directly oxidized in the blood, while its excess is stored as fat. In accordance with this theory, muscular exercise increases the waste of muscle substance, while the wear and tear is estimated by the amount of urea excreted. Originally this idea was generally accepted, but was attacked from many sources when it was found that facts of subsequent research did not coincide. Troube suggested in opposition that muscle and nerve tissue is not destroyed by exercise, but that force is contributed to these tissues through the oxidation of non-nitrogenous substances of which the muscle and nerve were simply mediums of expression.
Following the idea of Liebig, that work results in wear and tear of the tissues, there should be an increased output of nitrogen during exertion, but many observers in trying to harmonize results with this view have found little increase of urea – which practically represents all the nitrogen passed out of the body – while a decided increase of urea is found from the consumption of nitrogenous foods. Among the more noted experiments which controverted the theory that the nitrogenous waste represented the relative expenditure of energy is that of Dr. Fick, Professor of Physiology, and Dr. Wislicenus, Professor of Chemistry, both of the University of Zurich. They ascended the Faulhom, two thousand metres high (6,561 feet) for the purpose of determining the resultant wear and tear upon the nitrogenous tissues from a known amount of exercise. To accurately determine this, they limited their diet to non-nitrogenous materials, taking starch, fat and a little sugar, with beer, wine and tea as beverages. For seventeen hours before the ascent they limited themselves to non-nitrogenous food, and their first examinations were made eleven hours before their start. The ascent was completed in eight hours, and after a rest of six hours they ate an ordinary meal, which included meat. The urine secreted was examined to estimate the nitrogen excreted for each hour’s work, which showed the following results : Nitrogen excreted per hour. [Estimated in grammes.] Before work: Fick – 0.63, Wislicenus – 0.61; During Work: Fick – 0.41, Wislicenus – 0.39; After work: Fick – 0.40, Wislicenus – 0.40; During The Night: Fick – 0.45, Wislicenus – 0.51.
This indicates that the amount of nitrogen excreted was in relation to the food eaten and not to the work done, less relative nitrogen being passed in the “work” and “after work” periods when on a non-nitrogenous diet than during the period when nitrogenous food was eaten. The calculations were based on the amount of work which the oxidation of muscular substance containing fifteen percent, of nitrogen would produce as determined from the excreted urea. The result showed this inadequate to have enabled the experimenters to perform the task which they did, Fick’s work exceeding the theoretical amount by one-half, while that done by Wislicenus was in excess by more than three-fourths the theoretical amount, without in either case considering the necessary work of the various vital processes. These facts led many experimenters to further investigation, and resulted in a decided reaction from Liebig’s rigid theory, which had been accepted more literally than that physiologist intended. Instead of regarding the decomposition of proteids as the sole source of muscular energy, the carbohydrates were now looked upon as a formative element for generating force, because during muscular activity the glycogen stored in muscle disappears, to accumulate again during rest.
Pflüger, one of the most eminent of modem physiologists, in attempting to harmonize the theory of Liebig, experimented with a dog, which he kept upon an exclusive meat diet free from fat, and made him perform hard labor several times a day for weeks, during which the animal showed: “Very extraordinary strength and elasticity in all his movements.” In this experiment he wished to show that all the energy produced during hard work was from the transformation of proteid. To further show whether proteid simply was compensatory, he gave a mixed diet, and this led him to the conclusion that in a diet composed of proteid, carbohydrates and fats the quantity of the two latter substances destroyed in metabolism depends wholly upon the fact whether much or little proteid be fed. His conclusions are that: “In general the quantity of carbohydrates and fat that undergoes destruction is smaller the greater the income of proteid.” This may be regarded as the accepted view of modem physiologists with this qualification, that proteids must be built up from carbohydrates under a nitrogenous stimulus, just as we have seen is the process in plant structure.
The Impact Of Coca On Body Proteins
It has already been pointed out that the nitrogenous Coca has a direct bearing upon the structure of tissue through a possible quality of elaborating the carbohydrates of the protoplasm into proteids. Since the muscles form the largest bulk of tissues in the body in which chemical changes are constantly going on, it may be inferred how important is this upbuilding of the complex substance by which muscle activity is produced. The action of Coca on yeast as well as penicillium and other low organisms indicates its peculiar activity upon protoplasm. The experiments of Huxley and Martin long since showed that penicillium can build itself up out of ammonium tartrate and inorganic salts, and can by a decomposition of itself give rise to fats and other bodies, and we have every reason, says Foster, to suppose this constructive power belongs naturally to all native protoplasm wherever found. At the same time we see, even in the case of penicillium, it is of advantage to offer to the protoplasm as food, substances which are on their way to become protoplasm, which thus saves the organism much constructive labor. “It is not unreasonable, even if opposed to established ideas, to suppose that the animal protoplasm is as constructive as the vegetable protoplasm, the difference between the two being that the former, unlike the latter, is as destructive as it is constructive, and therefore requires to be continually fed with ready constructed material.”
In further support of the influence of Coca upon the formation of proteid it may be again emphasized that the nitrogen found in the urea is not a measure of the proteid transformation of the body. This conclusion would be justified if it were known that all nitrogenous cleavage products of the proteid molecule without exception leave the body. But there is no ground for such belief. On the contrary, there is no fact known to contradict the idea that nitrogenous cleavage products of the proteid molecule can rebuild themselves synthetically again into proteid with the aid of new non-nitrogenous groups of atoms. This latter possibility has been overlooked, and in consequence views have arisen, especially in relation to muscle metabolism, which though bearing the stamp of improbability have been accepted and handed down, but which recently have been criticized by Pflüger.
Urea – The Toxic Waste Of Nitrogenous Protein Metabolism
Just where urea is manufactured in the organism is not definitely known. It is presumed that kreatin, xanthin and other nitrogenous extractives which are found in the circulation resulting from tissue activity may be converted either by the blood or by the epithelium of the kidneys, and discharged as urea. In certain kidney diseases it is known that these waste products are retained in the circulation, “with consequent symptoms of poisoning. In addition to this it has been found that an increase of nitrogenous food rapidly augments this excretion, the products of intestinal digestion, the leucin and lyrosin, being carried to the liver and converted by the liver cells to urea, and this organ is considered at least the chief organ of urea formation.
It has been found that in functional derangements of the liver, when the normal urea formation is interfered with, there is imperfect oxidation of the products which should be eliminated as urea, and a deposit of lithates occurs in the urine as a signal of imperfect oxidation. This also may follow excessive exercise. In serious organic diseases the urea excretion may cease entirely, being replaced by the less oxidized leucin and tyrosin, M. Genevdix, from observations of his own and those of Charcot, Bouchardat and others, concludes that disorders of the liver which do not seriously implicate the secreting structure of that tissue increase the amount of urea excreted, while graver disorders diminish it very considerably.” A Belgian physician, Doctor Rommelaere, maintains that diagnosis of cancer of the stomach may be made when the urea excretion falls and continues below ten grammes a day for several consecutive days.
The average excretion of urea is sixteen grains an hour, the excretion fluctuating between thirteen and twenty-five grains, being greater soon after eating, and much less during the early morning hours. Uric acid, which is probably a less advanced form of oxidation, being present in the relation to urea as one to thirty-five, its relation to body weight being three and a half grains per pound; thus when urea excretion equals thirty-five grains for each ten pounds of body weight, there is commonly present one grain of uric acid. The effect of these waste products in the tissues is to so impede the functions of the cells as to occasion symptoms of depression and fatigue, whether this be manifested by irritability, drowsiness or profound muscular tiredness. There is a loading up – not necessarily within the cells of the tissues, but in the blood stream which supplies these – of excreta which vitiates the proper pabulum of the protoplasm, and a period of rest is absolutely necessary to enable the tissues to get rid of this matter before a healthful condition may be resumed.
Origins & Mechanisms Of Physical Fatigue
All the symptoms of fatigue are due to the effort of the tissues at repair. There is an increase of respiration to bring the necessary increase of oxygen demanded, and accompanying this respiratory effort there is a frequency of the heart beat, while the body becomes cool because its heat is lessened through the evaporation of perspiration. In protracted fatigue there may be a rise of temperature due to irritation by the increased force of the blood stream, occasioning sleeplessness, while the digestive functions are interfered with because of the excessive demands of other organs on the blood stimulus.
In over-exertion, where there is actual loss of proteid tissue, the effects of prostration and tiredness may not be experienced immediately, but only after several days. Similar symptoms to these accompany the infectious diseases when the blood is loaded with the products formed by invading bacteria. Again they are manifest when the organism is poisoned through toxic products of indigestion. These may be simply the products of proteid decomposition – leucomaines as they are termed, or they may be ptomaines produced by the activity of certain micro-organisms which affect the body through the toxic principles which they elaborate. Some of these are excessively poisonous in minute doses, and are chiefly developed in such articles of food as milk, ice cream, cheese, sausage and canned fish. It has been inferred that the muscles may also produce toxins which by their presence give rise to poisonous symptoms.
From whatever source they may have been derived, waste products in the blood impede the action of all the tissues of the body. This influence is well shown in the laboratory upon a prepared muscle, the contractions being recorded by a series of curves upon a suitable machine. Following stimulation there is a short interval known as the latent period, and then contraction is indicated by a rising curve commencing rapidly and proceeding more slowly to a maximum height, and as the muscle returns to its normal condition there is a descending curve, at first sudden and then more gradual. After repeated shocks of stimulation these curves become less marked, until the contractions record almost a continuous line – a condition which is termed muscular tetanus.
Such tired muscle has a longer latent period than a fresh one, and a stronger stimulation is necessary to produce contractions equal to those at the beginning of experimentation. Bernard experimented with blue bottle flies – rausca vomitoria, and found that the muscle of fatigued flies compared with that of flies at rest showed microscopical distinction, the contractile disks of the tired muscle being almost obliterated, while the capacity of such a muscle for taking a stain for microscopic examination evidenced an important difference over that of normal muscle, the whole contents of the segments staining uniformly, indicating that extraordinary exertion had used up the muscular substance more rapidly than it was repaired.
Ranke found that by washing out a fatigued muscle with common salt solution, though it added no new factor of energy, it freed the tissue from poisonous excreta and enabled it to again perform work. To confirm this a watery extract of fatigued muscle, when injected into fresh muscle, occasioned it to lose its working capacity. Mosso has also shown by experiments on the dog the presence of these fatigue substances. When the blood of a tired dog was injected into a dog which had been at rest all the phenomena of fatigue were manifest, but when the blood injected was from a normally resting dog no such symptoms were induced. This physiologist has shown that in man small doses of cocaine remove the fatigue sense and raise muscular ability above normal.
Dr. Alexander Haig, of London, attributes all the symptoms of depression and fatigue as due to the presence of uric acid in the blood, which he regards as the particular poison of the excreta. Uric acid, he claims, obstructs the capillaries throughout the entire body, the consequent deficient circulation preventing a proper metabolism by retarding the removal of waste products.
The relative excretion of waste is influenced not only by the routine of living, but by changes in the weather, tiredness being more easily produced in warm than in cold weather because of the increased elimination of acids by perspiration raising the alkalinity of the blood and permitting the passage of an excess of uric acid from the tissues into the blood. With this excess there is a diminished excretion of urea accompanied by the symptoms of fatigue. Exercise when excessive increases the formation of urea, which may at first be carried off in a free blood stream, but when the flow in the capillaries is diminished through the presence of uric acid in excess, the urea excretion is retarded and fatigue is manifest.
Cocaine, it is found, will free the blood of uric acid and abolish all the symptoms of fatigue both of mind and body, doing this by raising the acidity of the blood and so directly counteracting the effect of exercise by preventing the blood becoming a solvent for uric acid. The effect of he pure blood is to produce a free circulation with increased metabolism in the muscles and nerve centres. When the blood is loaded with excreta the circulation is retarded and there is high blood pressure, which may ultimately result in dilatation of the heart.
The long train of troubles which may follow retention of waste have been found to be worse during the morning hours when the acid tide of the urine is lowest. These conditions are all relieved under the influence of Coca, a knowledge of which has been gleaned from its empirical use. As an instance of this, a lady suffering from a severe influenza accompanied with rheumatism, was induced to try a grog of Vin Mariani – as advocated by Dr. Cyrus Edson in the treatment of La Grippe, and much to her surprise found that she was not only cured of her cold, but entirely relieved from the symptoms of her rheumatism as well, despite a preformed prejudice against Coca in any form. Acting upon this suggestive hint, I have found that alternate doses of Coca and the salicylates constitute an admirable treatment for rheumatism.
Coca Leaf & The Elimination Of Physical Fatigue
The influence of Coca in banishing the effects of extreme fatigue is well illustrated in an account of its use communicated to me by Dr. Frank L. James, Editor of the National Druggist, St. Louis. While a student at Munich he experimented with the use of Coca upon himself at the request of Professor Liebig, whose pupil he was. On one occasion, when exceedingly tired both physically and mentally, he was induced to try chewing Coca after the proper Peruvian fashion with a little llipta. Before commencing this experiment he was hungry, but too tired to eat and too hungry to sleep. In a few moments after beginning to chew hunger gave place to a sense of warmth in the stomach, while all physical weariness disappeared, though mentally he was still somewhat tired and disinclined to read or study, though this condition soon passed away, giving rise to an absolute eagerness to be at some sort of exercise. These sensations lasted altogether for probably three hours, gradually passing off after the first hour, leaving the subject none the worse for his experience and able to eat a hearty dinner the same evening.
Some years afterward, while practicing in the South, this gentleman returned from a thirty-six hours’ ride so tired as to necessitate being helped off the horse and up-stairs to his room. While preparing for bed his eyes fell upon a package of Coca leaves which he had recently received by way of San Francisco, and the idea immediately occurred to him to repeat the experiment of his student days. In the course of a quarter of an hour – following the chewing of probably a drachm of Coca leaves – he felt so refreshed and recuperated that he was able to go out and visit patients about the town to whom he had previously sent word that he was too tired to call on them that night. In describing the result, Dr. James said: “I was not very hungry at the time before taking the Coca, but all sense of the necessity or of a desire for food vanished with the weariness.”
Professor Novy, of the University of Michigan, is referred to by one of his former classmates as having formed one of a group of experimenters upon the use of Coca leaves. The influence being tested during a walk of twenty-four miles, taken one afternoon without any other nourishment but water and Coca. Over four miles an hour was averaged, and although unaccustomed to such long walks or vigorous exercise, no special muscular fatigue was experienced by four of the party who chewed the leaves almost constantly during the journey. No change was noted in the urine and no depression was experienced the next day. One who did not chew Coca, but was addicted to alcohol and chewed tobacco constantly, was somewhat more fatigued than the others, and suffered considerably from soreness of the muscles on the following day.
The experience of Sir Robert Christison, of Edinburgh, with the use of Coca upon himself and several of his students, is full of interest because of his extended experiments and the high rank of the investigator. Two of his students, unaccustomed to exercise during five months, walked some sixteen miles without having eaten any food since breakfast. On their return they each took two drachms of Coca made into an infusion, to which was added five grains of carbonate of soda, in imitation of the Peruvian method of adding an alkali. All sense of hunger and fatigue soon left, and after an hours walk they returned to enjoy an excellent dinner, after which they felt alert during the evening, and their night’s sleep was sound and refreshing. One of these students felt a slight sensation of giddiness after drinking the infusion, but the other experienced no unpleasant symptoms. Ten students, under similar conditions, walked varying distances, from twenty to thirty miles, over a hilly road. Two of these were unable to remark any effects from the use of Coca, several felt decided relief from fatigue, while four experienced complete relief, and one of these had walked thirty miles without any food. Professor Christison, though seventy-eight years of age and unaccustomed to vigorous exercise, subsequently experimented on himself by chewing Coca leaves with and without llipta, some of which had been forwarded to him from Peru. He first determined the effect of profound fatigue by walking fifteen miles on two occasions without taking food or drink. On his return his pulse, which was normally sixty-two at rest, was one hundred and ten on his arrival home, and two hours later was ninety. He was unfit for mental work in the evening, though he slept soundly all night, but the next morning was not inclined for active exercise. Then, under similar conditions, he walked sixteen miles, in three stages of four, six, and six miles, with one interval of half an hour, and two intervals of an hour and a half. During the last forty-five minutes of his second rest he chewed eighty grains of Coca, reserving forty grains for use during the last stage, even swallowing some of the fibre. He felt sufficiently tired to look forward to the end of his journey with reluctance, and did not observe any particular effect from the Coca until he got out of doors and put on his usual pace, of which he said: “At once I was surprised to find that all sense of weariness had entirely fled and that I could proceed not only with ease, but even with elasticity. I got over the six miles in an hour and a half without difficulty, and found it easy when done to get up a four and a half mile pace and to ascend quickly two steps at a time to my dressing room, two floors up-stairs; in short, I had no sense of fatigue or any other uneasiness whatsoever.”
During this walk he perspired profusely. On reaching home his pulse was ninety, and in two hours it had fallen to seventy-two, showing that the heart and circulation had been strengthened under the influence of Coca. The urine solids were the same as during the walk without Coca. In describing this walk, he said: “On arrival home before dinner, I felt neither hunger nor thirst, after complete abstinence from food and drink of every kind for nine hours, but upon dinner appearing in half an hour, ample justice was done to it.” After a sound sleep through the night he woke refreshed and free from all sense of fatigue. An influence of Coca not anticipated was the relief of a tenderness of his eyes, which during some years had rendered continuous reading a painful effort. In another trial at mountain climbing, he ascended Ben Vorlich, on Loch Earn, 3,224 feet above the sea. The climb was along a rugged foot path, then through a short heather and deep grass, and the final dome of seven hundred feet rise was among blocks and slabs of mica-slate. The ascent was made in two and a half hours, the last three hundred feet requiring considerable determination.
His companions enjoyed a luncheon, but Sir Robert contented himself chewing two-thirds of a drachm of Coca, and after a rest of three-quarters of an hour was ready for the descent. Although this was looked forward to with no little distrust, he found upon rising that all fatigue was gone, and he journeyed with the same ease with which he had enjoyed mountain rambles in his youth. The experimenter was neither weary, hungry nor thirsty, and felt as though he could easily have walked four miles to his home. After a hearty dinner, followed by a busy evening, he slept soundly during the night and woke refreshed in the morning, ready for another days exercise. During the trip he took neither food nor drink of any kind except chewing sixty grains of Coca leaves. Eight days after this experiment was repeated, using ninety grains of Coca. The weather had changed and the temperature was forty-four degrees at the top of the mountain and a chilly breeze provoked the desire to descend. While resting sixty grains of Coca was chewed. The descent was made without halt in an hour and a quarter, and followed by a walk of two miles over a level road to meet his carriage. He then felt slightly tired, because three hours had elapsed since he had chewed Coca.
In summing up his experience Professor Christison says: “I feel that without details the general results which may now be summarized would scarcely carry conviction with them. They are the following: The chewing of Coca not only removes extreme fatigue, but prevents it. Hunger and thirst are suspended, but eventually appetite and digestion are unaffected. No injury whatever is sustained at the time or subsequently in occasional trials.” From sixty to ninety grains are sufficient for one trial, but some persons either require more or are constitutionally proof against the restorative action of Coca. From his observations there was no effect on the mental faculties except to prevent the dullness and drowsiness which follow great bodily fatigue.
Coca Leaf & Muscle Foods
It is a matter of much interest to determine just what food is appropriate to generate muscle or to stimulate the tissues for work. As the capacity of an organ is in proportion to its bulk – under proper conditions – it seems essential that proteids should be eaten in order to create the muscle substances of which they form so great a part; but as has been repeatedly indicated, no one variety of food makes that same variety of tissue. All conversion in the body is due to a chemical change within the cell of the tissue; the food taken in is broken down by the digestive processes, and after assimilation is doled out according to the particular requirements of the individual parts of a normal organism.
The muscles are not set at work from the immediate intake of food, but are rendered capable for action by a chemical conversion of the material already stored up in the tissues, which is elaborated into energy as it may be required. It would seem as though this fact had not been carefully considered when calculating the effect of any diet upon muscular exertion during a brief period. The capacity of the body for work is due to the integrity of its tissue and the ability to draw suitable supplies from these stored substances. It is the appropriate conversion of this stored-up material which constitutes energy in a capable being rather than a mere automatism. Without this power of conversion the human organism would simply be clogged up by an accumulation of fuel which would impede rather than create activity. The body should not be regarded as a machine constituted with certain working parts which are gradually worn out through the so often expressed “wear and tear.” The facts long since have proved that life is a succession of deaths. The highest type of physical life is that which is capable of the greatest activity, creating useful energy and properly eliminating the waste matters resulting from the chemical changes from this conversion. Indeed, one of the gravest problems in the maintenance of a healthful activity is the one of excretion. To the retention of waste products in the blood or tissues a whole train of ills, both physical and mental, is unquestionably due, whether this poison be uric acid or not.
Preoccupied humanity seems constantly seeking some medicinal measure toward buoyancy and vigor rather than regarding the rational effects of appropriate eating and proper exercise. The success of many patent nostrums is chiefly based upon the fact of the necessity for elimination, and a good diuretic or laxative disguised as a panacea for all ills often produces the required result. As to the proper food essential to promote the greatest energy there have been many conflicting conclusions drawn from the known physiological facts. On the one side it has been asserted that all energy is induced from nitrogenous substances, while on the other side equally competent observers have asserted that the non-nitrogenous substances are alone used; yet all the evidence points to the fact that the constructive metabolism in animals is paralleled by similar processes in plant life, in which it has been shown that carbohydrates are built up into proteids, while these latter are also broken down into carbohydrates, and each of these may be converted again and again under the appropriate stimulus of the other substance. We know that starch, which is the representative of the carbohydrate class, is converted into glucose and carried to the liver to be stored up as the animal starch – glycogen – and as the various tissues of the body are called into activity this stored-up material is hurried to them in a soluble form to be utilized by the cell in the production of energy. When meat is eaten – which is the representative type of the nitrogenous class – its proteid material is changed into a soluble peptone, and this, carried to the liver, is converted into glycogen, which indicates, as has been proven by experiment, that either class of food substance is capable of maintaining the functions of the body so long as the chemical elements comprising the food taken be appropriate. While the meat eater and the vegetarian are each right, they are equally both wrong when advocating an exclusiveness in either dietary. The fact is, as will be shown in the chapter upon dietetics, it is purely an individual matter as to what particular food may be best. It all depends upon the body, or the machine – as you will – as to what substance each particular organism shall have the privilege of converting into energy.
While the body may be supported on either class of foodstuffs for a time, a man would surely starve as quick on a purely nitrogenous dietary as he would upon one purely non-nitrogenous. It will be recalled that the experiment of Fick and Wislicenus was conducted upon a food, the solid portion of which was carbohydrate, but with this tea was drunk as a beverage. Tea loaded with Xanthin would afford sufficient of the nitrogenous element to convert the stored-up carbohydrates to action, but as Haig and Morton have both shown, tea contains so much of an equivalent to uric acid that it could not long be relied upon as an energy exciter, for while the tissue might be stimulated for a time, waste matter would soon be augmented in the blood. Coca, as we have seen, has the quality of freeing the blood from waste material, and yet possesses sufficient nitrogenous quality to convert the stored- up carbohydrates into tissue and energy. The Andeans are a race small of stature and of low muscular development. The average American or European could easily tire a native Indian in a day’s travel, but while the former continuing on an ordinary diet would soon become stiff, the Indian sustained by Coca remains fit and active, and is apparently fresh and ready after a hard day’s jaunt. It seems probable that this condition is occasioned through the converting influence of the nitrogenous Coca acting upon the stored-up carbohydrates of the Andean’s accustomed dietary. Thus while promoting metabolism and increasing energy the blood current is at the same time kept free.
The custom of the Andean to measure distances by the cocada has already been referred to; it is the length of time that the influence of a chew of Coca will carry him – equal to a period of some forty minutes – and during which he will cover nearly two miles on a level ground or a mile and a quarter up hill. Taking the suggestion from this a preparation of Coca made in Paris known as ‘Velo-Coca,” is purposely intended for the use of bicyclists, a given dose of which is calculated to sustain the rider through forty kilometres – twenty-five miles. The advantage of Coca in long distance contests has long been known to certain professionals, who have endeavored to keep their use of this force sustainer a secret.
Some years ago the members of the Toronto La Crosse Club experimented with Coca, and during the season when that club held the championship of the world Coca was used in all its important matches. The Toronto Club was composed of men accustomed to sedentary work, while some of the opposing players were sturdy men accustomed to out of door exercise. The games were all very severely contested, and some were played in the hottest weather of one summer; on one occasion the thermometer registered 110oF. in the sun. The more stalwart appearing men, however, were so far used up before the match was completed that they could hardly be encouraged to finish the concluding game, While the Coca chewers were as elastic and apparently as free from fatigue as at the commencement of the play. At the beginning of the game each player was given from one drachm to a drachm and a half of leaves, and this amount, without lime or any other addition, was chewed in small portions during the game. The first influence experienced was a dryness of the throat, which, when relieved by gargling with water, was not again noticed, while a sense of invigoration and an increase of muscular force was soon experienced, and this continued through the game, so that fatigue was resisted. The pulse was increased in frequency and perspiration was excited, but no mental symptoms were induced excepting an exhilaration of spirits, which was not followed by any after effects.
Coca Leaf & Healthy Blood Circulation
As has been shown, fatigue and its ills is occasioned by a diminution of the elements necessary to activity as well as to an excess of waste materials in the blood. This latter cause alone explains many problems dependent upon this condition which are commonly assigned to other causes. Under this hypothesis it is easy to appreciate not only the cause of muscle fatigue, but the irritability from nerve tiredness as well as the restlessness in wasting disease. When the tissues are not supplied with a blood stream that is pure and uncontaminated they cannot respond healthfully. A blood current already overburdened with waste can neither stimulate to activity nor carry off the burden of excreta.
The power of Coca to relieve the circulation, and so bring about a condition indicating a free blood stream, has been emphasized by a host of observers. Speaking of the action of but one of its alkaloids, Dr. Haig says: “Some have asserted that it is oblivion men seek for when they take opium, cocaine, etc., I believe this to be a great error. Give me an eternity of oblivion and I would exchange it for one hour with my cerebral circulation quite free from uric acid, and opium or cocaine will free it for me. When the blood stream is free the pulse tension is reduced, the rate is quickened, and the increased flow alters the mental condition as if by magic; ideas flash through the brain; everything is remembered.”
Hitherto the usual explanation that has been advanced as to the influence of Coca – when any influence has been accorded – has been its stimulant action upon the nerves. In view of the facts set forth in this research such a theory seems inadequate. I have endeavored to show by a succession of facts and many examples, that the sustaining influence of Coca in fatigue, as well as its curative power in so many diseased conditions, as to render it a seeming panacea, is largely due to a direct action upon the cells of the tissues, as well as through the property which Coca has of freeing the blood from waste. This influence may chiefly be upon the brain or upon the muscular structure, in accordance with the relative proportion of the associate principles present in the Coca leaf employed. Under this hypothesis, based upon physiological research as well as upon the theory of the formation of proteid in plants and in animals. Coca not only stimulates the cells to activity and so sets free energy, but may build up new tissue through exciting the protoplasm to appropriate conversion. Such an hypothesis is certainly plausible when we consider the action of amides and other nitrogenous elements in plant structure. This is again emphasized by its harmony with recent theories of Pflüger regarding the building up of proteid tissue in the animal organism. So much testimony points to this conclusion that in the entire absence of other scientific explanation this is certainly worthy of serious consideration. The facts of which will be more specifically elaborated in the chapter on physiology.
Coca Leaf As A Potential Treatment For Deadly Forms Of Fatigue
Editor’s Note: I’m going to take a quick break from posting Dr. Tibbles’ Coca Leaf remedies and address a closely related subject. I’ll resume posting the recipes with the next post.
One of the friends of this blog has an illness that this person, out of a personal sense of privacy and reserve, doesn’t ever identify in her blog, but which I have reason to believe is Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). After reading the Twitter feed from one of her recent messages I discovered that a lot of her interactions were with bloggers who had this terrible condition, which I was not previously aware of. (Twitter is such a gossip!) I will respect her privacy completely, but after reading about this disease I am moved to make this post.
Reading the commentary on ME/CFS set me thinking how many times in the Coca Leaf source literature from the 18th-19th centuries the beneficial effects of Coca Leaf on fatigue is mentioned. Not just in terms of Incas being able to carry heavy loads over the Andes with little food or water, and not just in terms of re-invigorating people after strenuous exercise.
These source materials talk of the wide-ranging effects of Coca Leaf on blood, nervous system, muscle, digestion, and brain function – and this made me think. Why aren’t the multitudes of caring, dedicated scientists and physicians who are researching ME/CFS investigating the possibility the something as simple as Coca Leaf tea might – just possibly – make a difference for the people who, currently, have so little hope of successful treatment?
Of course the answer is – because Coca Leaf has been effectively excluded from consciousness by a calculated conspiracy extending over decades, and it would never enter the minds of even these dedicated healers to ever consider for a brief moment that Coca Leaf might hold at least a small key to amelioration of this terrible source of suffering and death.
If you, as I was, are unaware of the scope of this problem there is a widely recommended Canadian document that you can read to inform yourself: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners.
This is a disease that affects a huge number of people, according to this document: “Epidemiological studies indicate a wide range of prevalence. However, in a large American sample of more than 28,000 adults, 422 per 100,000 had ME/CFS, suggesting that between 125,000 and 150,000 adult Canadians suffer from ME/CFS. (This also translates to 1,266,000 people in the US.) It is more prevalent than lung cancer and AIDS. This illness affects all age groups, including children, all racial/ethnic groups, and all socioeconomic strata. There is a higher prevalence in females.” I would challenge you to reflect on how many of the diagnostic criteria for ME/CFS, shown below, a disease that was unknown in the 18th and 19th centuries, are nevertheless remarkably similar to the conditions that physicians in those times treated successfully with simple Coca Leaf preparations. This isn’t to say that Coca Leaf is the answer here – but there are enough such ‘coincidences’ to surely merit investigation.
So, with that said, let me present just a small sampling of the findings of the physicians of the 18th-19th centuries regarding Coca Leaf and Fatigue – deadly fatigue in the case of ME/CFS. A search of my collection of these writings in “The Coca Leaf Papers” reveals hundreds of similar observations. (And just in case anyone thinks I am touting my book at the expense of suffering people let me point out that if you want to verify this for yourself without having to buy my book you can do so simply by asking for a free copy here on my blog.)
Oh – and, dear reader, if you don’t already realize it, I am not an adherent of the 21st Century rule-of-thumb that readers can’t handle more than a paragraph or two at a time, and won’t read plain text unless there are lots of pretty pictures. If you’re looking for a quick skim with lots of pictures you are definitely in the wrong place. Otherwise – welcome to the blog!
Coca Leaf & Healthy Blood Circulation
History Of Coca, Dr. Mortimer – Chapter 8
As has been shown, fatigue and its ills are occasioned by a diminution of the elements necessary to activity as well as to an excess of waste materials in the blood. This latter cause alone explains many problems dependent upon this condition which are commonly assigned to other causes. Under this hypothesis it is easy to appreciate not only the cause of muscle fatigue, but the irritability from nerve tiredness as well as the restlessness in wasting disease. When the tissues are not supplied with a blood stream that is pure and uncontaminated they cannot respond healthfully. A blood current already overburdened with waste can neither stimulate to activity nor carry off the burden of excreta.
The power of Coca to relieve the circulation, and so bring about a condition indicating a free blood stream, has been emphasized by a host of observers. Speaking of the action of but one of its alkaloids, Dr. Haig says: “Some have asserted that it is oblivion men seek for when they take opium, cocaine, etc., I believe this to be a great error. Give me an eternity of oblivion and I would exchange it for one hour with my cerebral circulation quite free from uric acid, and opium or cocaine will free it for me. When the blood stream is free the pulse tension is reduced, the rate is quickened, and the increased flow alters the mental condition as if by magic; ideas flash through the brain; everything is remembered.”
Hitherto the usual explanation that has been advanced as to the influence of Coca – when any influence has been accorded – has been its stimulant action upon the nerves. In view of the facts set forth in this research such a theory seems inadequate. I have endeavored to show by a succession of facts and many examples, that the sustaining influence of Coca in fatigue, as well as its curative power in so many diseased conditions, as to render it a seeming panacea, is largely due to a direct action upon the cells of the tissues, as well as through the property which Coca has of freeing the blood from waste. This influence may chiefly be upon the brain or upon the muscular structure, in accordance with the relative proportion of the associate principles present in the Coca leaf employed. Under this hypothesis, based upon physiological research as well as upon the theory of the formation of proteid in plants and in animals. Coca not only stimulates the cells to activity and so sets free energy, but may build up new tissue through exciting the protoplasm to appropriate conversion. Such an hypothesis is certainly plausible when we consider the action of amides and other nitrogenous elements in plant structure. This is again emphasized by its harmony with recent theories of Pflüger regarding the building up of proteid tissue in the animal organism. So much testimony points to this conclusion that in the entire absence of other scientific explanation this is certainly worthy of serious consideration.
Modern Civilization – A Bad Case Of Nerves
History Of Coca, Dr. Mortimer, Chapter Nine
Among the annoyances incidental to a modem civilization are those troubles produced from a possible nervous perversion, engendered through overtaxing the powers mentally or physically in the modem whirl and bustle of a busy life. We all realize the effects of muscular fatigue, but few seem to appreciate the extreme tiredness which is possible to the nervous system of the purely sedentary worker. This may manifest itself in the mildest form as a mere irritability or restlessness, or more profoundly as peevishness and even despondency.
It is not as easy to demonstrate nerve fatigue in the laboratory as it is to show the fatigue of muscle, yet there can be no doubt that similar factors are at work to induce either. It is known that all the activity of the tissues, of whatever kind, is due to a chemical conversion of the substance contained in the minute cells which go to complete the organism. Fatigue results from the retention of products of waste in the blood which normally should be excreted. As a result the tissues are not properly nourished by a purified circulation for their work, and exhaustion is a consequence, whether the structure under this influence be muscle or nerve.
When we learn that Coca relieves muscular fatigue, mental depression or nervous fatigue, that it calms to refreshing sleep or stimulates to wakefulness and activity, that it allays hunger or induces appetite as the case may be, we can only harmonize such seemingly opposite applications through appreciating that this influence is extended to the tissues through the fluid which supplies them with nourishment. We have already seen that the blood is so speedily purified under the action of Coca that the circulation may at once return an appropriate pabulum to all the cells of the body and so may promote in them a normally healthful action.
The brain may be broadly considered as made up of cells and nerve fibres. The outer portion, which is termed the cortex, consists of many convolutions which through this arrangement affords a greater superficial area for the brain cells. These cells are located in layers over the surface, as well as arranged in groups at the base of the brain and in the medulla and spinal cord. The convolutions are merely rudimentary in animals and are poorly developed in the lower orders of the human race and in the uneducated. By intellectual development these are increased in a manner quite analogous to that in which muscle is increased by exercise. Gross bulk of brain substance does not necessarily indicate giant intellect, but merely the structure for such possible development.
The brain practically attains its greatest size in early childhood, at least this is the period of its most active increase, and remembering the law that the part of the body which is subject to the greatest physiological growth is most liable to disease, it will keep before us the fact that children are particularly susceptible to disorders of the brain and nervous system. In childhood the tendency should be to restrain these organs, which are already too alert, from an undue excitement. From birth an education of the individual cells of this intellectual centre should be carefully conducted. A refinement of nerve tissue progressing by easy gradations until strength and power shall be secured. It is through this alone that man may be raised superior to the beast or savage. Not only present enjoyments but future comforts and realizations are so absolutely dependent upon this that even “Spiritual life can only reach the human form by and through the brain cell.”
Quite as important as the brain in maintaining mental stability is the action of the sympathetic nerve in controlling physical well being, while both brain and sympathetic nerve must act together to sustain the organism in true harmony. The sympathetic nerve runs on either side and in front of the spinal column as a double chain of little brains. From these centers not only the great organs are supplied, but also the coats of the blood vessels, through which association a controlling influence is maintained over the entire organism. Along its route these nerves are intimately connected with branch nerve fibres from the brain and spinal cord. Through groups of fibres sent to the heart, to the stomach and to the organs of the pelvis the functions of either one of these may be influenced in sympathy from the derangement of some other organ far distant, the workings of which are not directly associated, but the action of which is affected by a reflection of the troubles elsewhere. This reflex effect between distant parts of the body is analogous to the switching on of a branch telegraph loop to the main line to carry news to points with which it was not directly connected.
So intimate is the relation of this regulating nerve with the various functions of the body that it is possible for these to be seriously interfered with through action of the sympathetic on the blood vessels, by which the tension of their walls is altered and the circulation is accordingly hastened or retarded. Common examples of this effect are seen when the emotions are excited and occasion the capillary vessels to contract as in pallor, or, when these are suddenly dilated, to cause blushing. The idea that the emotions have their seat in the heart because of this influence of the blood vessels in occasioning an irregularity of its action has led to an erroneous and sentimental regard for that organ.
This intricate nervous development suggests the extreme importance of a well trained organization as a factor toward preventing that broad class of cases which are grouped under the generic title of neurasthenia. In this condition – rather than disease – a similar restlessness and over-sensitiveness is present as in profound fatigue. In chronic illness the same symptoms are seen, but when these are complained of without any characteristic signs of disease the indications point to nerve irritability through imperfect elimination of tissue waste. If with this excess of waste materials in the blood there be associated a defective will, then the influence on the sympathetic nerve must be pronounced. Either cause may unbalance the circulation through the arterial system and so disarrange various functions of the body, while a low power of resistance intensifies the mental disability. It is remarkable that these sufferers are at first rarely treated appropriately, but are often impatiently urged to exert will power. While it is undoubtedly true, as so aptly phrased by Shakespeare: “There is no condition, be it good or ill, but thinking makes it so,” will power must emanate from a primary store of bodily health.
The greatest factor, however, must be derived through the guidance of the emotions, particularly during the formative period of development. An early education of the will should form a basis for mental control. In this will be found a prominent factor in the production of future happiness, as well as a means of support in many a physical ailment, and even a source of contentment in hopeless disease. But as has already been indicated, the greatest benefit can only result from a healthful working of the entire organism. That there shall be a sound mind in a sound body is an old adage, and recently the great universities have appreciated this sufficiently to officially recognize physical training as an important part of a collegiate education.
Neurasthesia – The Language Of Diagnosis
History of Coca, Dr. Mortimer, Chapter 8
Whether the title neurasthenia be scientifically correct for the peculiar train of symptoms which go to make up the complainings of the victims of over-nervous irritability, it has served since the classification of some thirty years ago to enable the acute medical examiner to group the particular sufferers from this morbid condition. As defined by Dr. Beard, neurasthenia is: “A chronic functional disease of the nervous system, the basis of which is the impoverishment of nervous force; deficiency of reserve, with liability to quick exhaustion, and the necessity for frequent supplies of force. Hence the lack of inhibitory or controlling powers, both physical and mental, the feebleness and instability of nerve action, and the excessive sensitiveness and irritability, local and general, and the vast variety of symptoms, direct and reflex.”
The condition may be summed up as one of nervelessness, or a weakness of irritability akin to the symptoms which indicate profound fatigue. A host of modem physiologists regard fatigue as due to some poison in the blood. If we accept this theory founded upon chemical facts which may be clearly demonstrated by experiment, there is ample means for explaining the multiplicity of nervous symptoms as resulting from this cause alone. Waste matters in the circulation by clogging the capillaries prevent the venous blood from being appropriately purified. The nerve centers do not receive suitable stimulus for repair, and the increased irritability occasions an excessive waste which still further impedes the circulation. Functional changes must necessarily result in the heart, kidneys, liver and the brain from this continued irritation.
The subjective symptoms of neurasthenia are not so much engendered by a weakness of the nervous system, nor any lack of susceptibility of the nervous protoplasm to respond to irritation, as through excessive irritability, which renders the organism over-sensitive to normal and healthful stimulus. It is a condition which may be allied to the harp, so strung up as to permit the slightest breath to set its strings in a discordant hum. Often the subjects of this form of trouble are found among those who are in the prime of activity, in early adult life, when the various forces for the production of energy are being vigorously employed.
As it is that part of the body which is most active at any one period of life – particularly of growth – that is most liable to disease, so during the different epochs of pubescence, adolescence, and the early marital life in either sex, the symptoms of neurasthenia may be exhibited. These symptoms are particularly manifest when there has been at these periods a condition of overstrain, associated with malnutrition. Among all possible causes my experience has been that the genetic factor, through repeated explosive shocks upon the nervous system, is pre-eminent in the production of neurasthenic symptoms in those already overworked or suffering from imperfect nutrition.
Neurotics are prone to excesses as well as to extremes in any particular line. They are the class to which habits cling and “habit drugs” belong, and the apparent candor of their sufferings might often lead the sympathetic, unwary listener astray. In such subjects these habits and excesses should be regarded rather as symptoms than the underlying cause of the condition. If this fact were more generally thought upon we should hear less of those who have been wrecked by alcohol or opium. Indeed it is a fact that a perfectly healthy man rarely becomes a morphinist, cannabist, etc., but that such individuals are without exception neuropathic.
The numerous symptoms which go to make up the condition of nervous prostration have only been made prominent through the push for supremacy, and even for maintenance, in the various specialisms of life. While the causes always have existed, modem civilization has greatly exaggerated them, and the present dwellers in cities are consequently eminently of the nervous type. The sufferers are not all from one class, but are numbered among the high, the low, the rich and the poor, though the symptoms may be varied in accordance with the cultivation and environment of the patient. What the poor Andean Indian, working laboriously for days on scanty food, might regard as the ban of some “spirit of the mountain” cast upon him for presuming to invade some hallowed precinct and as a charm against which he chews the sacred Coca, the used up subject of protracted social functions considers in a different light. But the symptoms and conditions are similar, whether occasioned from over-indulgence and overwork, because of exalted ambition or from enforced labor associated with hygienic errors.
The title neurasthenia has been made responsible for a multitude of evils, quite as bad as has that of “malaria” or “biliousness.” While the group of subjective symptoms which Beard classed under this head has been expanded to embrace about every condition generated from nervous irritability, it remained for the classic guidance of Charcot to accentuate the importance of a certain few symptoms into what he styled “the stigma of neurasthenia,” in an effort to combine these as an exact disease.
It is very different whether we consider this classic form or the commonly accepted type. On the one hand there may be mere nervous irritability, while on the other this is accentuated until it approaches the border line of psychical aberration. The more grave condition has been traced from a neurotic heredity or degeneracy, while the simpler application is made to embrace all forms of mental worry, from a mere nervous headache to some pronounced phobia, or dread. The two types, however, often intermingle on the threshold of some severe nervous affection, with hypochondriacal, epileptic or paralytic symptoms, or even insanity.
The popular idea of nervous debility held by the laity as well as by the general practitioner in medicine is not the serious disorder of the alienist any more nearly than is a “fit of the blues” – which, since the days of Burtons Anatomy of Melancholy has been attributed to “biliousness” – is true melancholia. The two terms are used by the unknowing or the unthinking ones as interchangeable, the one being a simple temporary mental despondency, which may arise from any one of many causes, while the more serious ailment manifests this condition profoundly and characteristically all the time.
Charcot claimed that neurasthenia was entitled to a definite place in mental pathology, because the disease as witnessed by him maintains its identity under varying circumstances of origin. He believed the condition to be essentially distinct from hysteria, although it might be associated with that disease, and so present a complex hystero-neurasthenia – a combination which was also described by Beard. That is, the patient may exhibit only neurasthenic symptoms, or united with these the symptoms may be of positive hysteria.
Levillain has, with many other authors, described two varieties of neurasthenia – that from heredity and the acquired. The two forms differ not only in their progress, but in their response to treatment. Among the peculiar train of symptoms commonly seen in this disorder are curious feelings of morbid fear or dread experienced by its subjects. This is similar to the hallucinations which the Germans term “zwangsvorstellungen” and “zwangshandlungen,” and which others have given a long list of terrible names. Agoraphobia is a dread of open spaces, anthropophobia is a fear of society, the antithesis of which is monophobia – the fear of being alone. Then there is pantophobia, a fear of everything, and a culmination which must be the last straw – phobophobia, a fear of being afraid. The French term this condition ”peurs maladies.” “Folie de doute” is the name given by Le Grande du Saulle to a condition of chronic uncertainty when there is a morbid doubt about everything.
Hereditary neurasthenia, it is asserted, may develop in those whose parents were distinctly nervous, even though the usual determining cause may not be present. Among predisposing causes, over-excitation including all forms of over-strain, whether sudden or gradual, is predominant, while the condition is not markedly influenced by alcohol or narcotics. The essential symptoms which Charcot described as the stigmata of the disease are: (1) Headache of a special kind; (2) Digestive troubles; (3) Incapacity for work; (4) Loss or diminution of sexual desire; (5) Muscular lassitude, marked by easily induced fatigue, and painful stiffness; (6) Spinal pain; (7) Insomnia; (8) Hypochondriacal views of life. Other symptoms which may appear are vertigo, cardialgia simulating angina pectoris, palpitation of the heart, feelings of faintness, and irritable pulse; but these may not be constant. The muscle weakness, with an indescribable irritability expressive of fatigue, Charcot considered so prominent a symptom that he reserved for it the term “amyosthenia” The headache is of a peculiar character, suggestive of a weight or constriction over the back of the head or vertex, and sometimes over the whole cranium, described as the “neurasthenic helmet.” In some cases this sense of pressure may be hemi-cranial. The insomnia, or troubled sleep, so annoying in pronounced cases, is a very important symptom. The backache may be limited to the sacral region, or to the neck, or may at times be in the coccyx, and is commonly aggravated by pressure. The digestive symptoms are of a general nervous type. With these there is incapacity for mental work, and particularly a lack of concentration of thought.
From the classic grouping it will be seen that it is often difficult to draw the line between actual organic nerve trouble and neurasthenia. Perhaps the usual type, as seen by the general practitioner, presents a nerve depression – an inability of the organism to speedily repair itself after some call for unusual strain, while the two most prominent factors of this condition are sleeplessness and mal-assimilation. Under such influences it is easy to understand that the symptoms presented may be manifest as cerebral, spinal, genital, chlorotic, vascular, cardiac, or gastric, while there may be an especial indication pointing toward the liver. It is quite plausible, as Boix has shown, to have a “nervous dyshepatia” as well as a nervous dyspepsia, due to defective innervation.
It should be understood that the vast array of symptoms which go to make up the condition known as neurasthenia are largely those of reflex irritation, an irritation which may arise from any part of the organism and be transmitted through the sympathetic, and acting chiefly upon the blood vessels through the vaso-motor nerves. It is because of this reflex nature of the symptoms that the condition is often confounded with other diseases, and the sufferer may go the round of the various specialists, and receive “local treatment” for conditions which are erroneously considered to be the chief cause of trouble. What the oculist regards as occasioned from eye strain the rhinologist may look for in the nose. If the patient be a woman, the gynaecologist locates the concentration of troubles in predominant functions. On the other hand, the genito-urinary expert has predetermined that in any nervous man the seat of ills is the prostate gland. It is, therefore, a very common occurrence to find that patients who are nervously irritable have become in themselves multiple specialists. Through constantly going the rounds in search of relief they become familiar with various local conditions, which may give rise to similar symptoms to those they suffer.
These subjects, as a class, are acute and quick; they belong to the clever people, and they are either all elation and prone to overdo or way down “the blues.” It is not surprising then that they soon become familiar with the various remedial efforts toward relieving their symptoms. They not only know in advance what their medical advisers may suggest, but are often prepared to offer a long series of protests against each particular effort toward aiding them to recover from their deplorable condition. If to such a patient, complaining of insomnia, the physician suggests sulphonal – that drug keeps them awake. Then ensues a hasty enumeration of the several hypnotics they have employed, while they recount wherein each had proved in their case an utter failure. If the symptoms complained of are pronouncedly about the head, they know all about refraction, astigmatism, and the cutting of eye muscles, or they have had their turbinated bodies taken out, or hypertrophied tissue removed from nose or throat, their ears inflated, or they have inhaled and been sprayed to an alarming extent. If by chance the stomach but manifests a twinge of protest, then that poor organ has been dieted and washed, both gavage and lavage – ad nauseam. Thus these patients are commonly treated through all the operative procedures until it is no wonder they should finally become nervous wrecks, ultimately going about from one resort to another, unable to find relief, unable even to find what they deem a competent trained nurse to cater to their imaginings, while a kindly disposed helpmate dances attendance upon their peevish whims.
Frequently these cases are subjects of plethoric prosperity, who, if not constitutionally weak, have had no education in self-control. They have spoiled themselves by fretting, and are being more rapidly ruined by petting; the very kindness and consideration that is bestowed upon them at home only adds fuel to their weakness. Often an entire change of environment affords the best condition for the treatment of such cases, such as the rest cure of Weir Mitchell, or one of the German watering establishments, where the regimen is rigid and exact. They must be coerced into recovery or else they will go through the balance of life a nuisance alike to themselves as well as to those who would wish to be their friends. Examples of this condition are legion, and the complainings are as multiple and varied as the ideas of man.
There are instance of self-control when sufferings are held in check while continuing at work. Some of the ablest men in the world’s history have been those of weak nervous organization. “Wise judges are we of each other,” says Bulwer. Often those whom we look upon as of indomitable will may suffer keenly from some seemingly trivial nervous symptom. A few years ago a prominent justice, who though outwardly was the very picture of health, assured me he suffered more keenly than the abject criminals brought before him, and was literally a coward from nervous dread. He came a long distance for consultation. Possibly it was a satisfaction to get out of his immediate environment and relate his sufferings to one who could listen patiently with a wish to guide him understandingly. Being a popular politician, he was often called upon to make speeches at the most inopportune times – for him, and he seriously proposed to give up a life position because he felt he could not stand the nervous strain.
This is but one example of many similar cases occurring among professional men, with mental faculties constantly at full tension. Whenever there is a lull in their work their thoughts revert to themselves, and the symptoms of an over-tired nervous organism are magnified into some serious physical ailment. These are the cases that maintain the advertising quacks. They wish to be treated confidentially because they would not have their friends know for the world that they are ailing in any particular. They, who are seemingly so strong, would feel humiliated to recount a tale of personal weakness even to a medical man. It can readily be appreciated how necessary it is that a physician shall listen attentively to the story these patients tell, and advise with them openly and candidly as to the plan of treatment, which primarily must consist in some better means of living rather than a dependence upon medication alone. An interchange of confidence between patient and physician, while always advisable, is more necessary in these particular cases than in any other in the entire field of practice of medicine. There must be faith, and in this much I am an advocate of the faith cure. Indeed, faith is necessary in every walk of life. A chimney may blow off the roof, one may fall on a slippery pavement, a horse may run away, a bridge might fall, a boat might sink, and a hundred and one possibilities might occur to the nervously imaginative. Fear often becomes so exaggerated in the minds of these weak patients that they finally become too timid to attempt anything serious. Such a subject must be assured why and how he is to get well. I once had a patient who would be excited to an indescribable dread if, when walking in the street, he met a truck having any part of the load projecting, such as a chair leg or plank. To avoid it he felt compelled by some uncontrollable influence to turn off into a side street. In another case – a young man, could never go into the society of women, and actually avoided meeting them as much as possible in the street because of an expressed fear that he “must punch them.” These were cases of simple neurasthenia, which appropriate hygienic measures, combined with the administration of Coca – a remedy which the homoeopaths have long associated as a specific in cases of timidity and bashfulness – completely cured.
The numerous examples which Kraft-Ebing relates of the “Jack the Ripper” order belong to this same class. The complainings of these patients should not be treated flippantly, for the subjects are earnest in their endeavor to find relief from a form of suffering which, while not actually painful, is profoundly humiliating and mentally agonizing. It can be well understood how readily such cases might adopt a drug habit in an unguided effort to find some means of relief.
There is a tendency in the human mind which is overweighted to seek support in unburdening a portion of trouble by recounting mental sufferings, whether of illness or not, to another. The celebrated actor, Mr. Frank Drew, related to me a curious example illustrating this, which occurred to him on a recent visit to England. He was dining alone in a restaurant, when a gentleman approached with the remark : “I trust you will not mind if I take a seat at your table?” “Not at all,” replied the actor; “I shall enjoy company.”
The two fell into a casual chat, which was resolved into the stranger telling a long and intricate story regarding a purely personal matter, of no interest to an outsider, yet which was patiently listened to without interruption to the end. Then, as though having unburdened himself of a weight of woe, he arose, saying:
“You will excuse my having troubled you with this story, but really it has been a great source of comfort to me to have found some one to whom I could tell it. Knowing that we are absolute strangers, and shall never meet again, I have not hesitated to talk freely to you.” On the assurance of a hearty sympathy, and that the secret should remain inviolate, they parted, neither expecting to ever see the other. But it so chanced, in the littleness of this world, that the following night brought them together again at a dinner party, where they were introduced under embarrassing recollections.
Not long since, a physician told me of an incident bearing upon this same tendency, which had occurred to him. One day at the close of his office hours he was preparing to leave for some outside work, when a lady was ushered into the consulting room, and instead of relating any physical ailment, entered into a long story of family history, which was listened to attentively, in expectation that it was to lead up to the real cause of her visit.
After this story was completed, the relator asked what she was indebted for the consultation, to which the physician, conscious of his hurry and delay, said in a perfunctory way: “Five dollars.” “Five dollars? Why, I should think that was altogether too little for having taken up so much of your time.” “Well, then, I will say ten dollars,” said the doctor, treating the whole matter very much as a joke. But the sincerity was shown by the willingness with which the fee was extended with the query: “When shall I come again?” “Say in two weeks,” said the consultant smilingly. “Two weeks! Hadn’t I better see you in one week?” “Very well, make it one week.” And so for several weeks in succession this patient returned and continued to revert to this same story, each time leaving well satisfied after having deposited the customary ten-dollar fee. A case of insanity! Oh, no, merely an over troubled mind which, without apparent physical ailing, had sought relief of mental worries from a physician, who undoubtedly prevented more serious trouble and effected a cure simply through being a good listener. While such instances are not rare in the routine of any practitioner, they seem almost incredible.
I was recently talking with a leading laryngologist, whose practice is in Philadelphia, upon this same line of thought, when he related an anecdote which had occurred in his own practice. He had gone to Paris for a short visit and had left instructions that his assistant would continue his practice. One day he was visited at his hotel in Paris by one of his Philadelphia patients, who, entering in the most casual way, said: “Doctor, I have a little trouble with my throat I would like to have you look at to-day.” The physician, being really surprised to see his patient thus unexpectedly so far from home, asked him how long he had been in Paris and how long he proposed to remain, and was the more astonished at the reply: “Oh, I just ran over to have my throat treated, and shall take the steamer back to-morrow.”
These examples, while in a measure indicating the smallness of the world, illustrate the fact that patients recognize and require the personal factor in the treatment of their troubles. An element of confidence is established, not necessarily in consequence of any superior preliminary qualifications on the part of the medical man, but because perhaps he has applied his knowledge understandingly.
Dr. Tuke has written scientifically and very entertainingly regarding the subtle relations existing between mind and body – a subject which surely has a very important bearing upon the entire range of functional nervous troubles. The mind has an extraordinary influence, even in health, in causing disorders of imagination, sensation and also of organic functions. An outgrowth from this – a going off as it were on a tangent – leads to various beliefs in phenomena of a superstitious nature and forms a fertile field for the growth of unfortunate methods of treatment; unfortunate because disappointment must follow after the loss of valuable time in experimenting. In this connection I recall a remark made at an alumni dinner by the late Dr. John Hall in speaking of the so-called Christian science: “There is no Christianity in it, and it is not at all scientific.”
It is a well-known fact to the physiologist that the mind may excite or depress the various nerve centres, and through these occasion functional changes in muscles or nerves. I hope it has been conclusively shown that this is the underlying factor occasioning many of the numerous subjective symptoms among that immense class known as neurasthenics. When the famous Dr. John Hunter’s attention was drawn to the phenomenon of animal magnetism – which was exciting the scientific world more than a century ago, he recognized the possible influence of expectancy upon the imagination, and in his lectures said: “I am confident that I can fix my attention to any part until I have a sensation in that part.” It is because this possibility of the influence of the will is overlooked that greater success is not more commonly met with in the treatment of functional nerve troubles. Mr. Braid emphasized this fact when he said: “The oftener patients are hypnotized from association of ideas and habit, the more susceptible they become, and in this way they are liable to be affected entirely through the imagination. Thus, if they consider or imagine there is something doing, although they do not see it, from which they are to be affected, they will become affected; but, on the contrary, the most expert hypnotist in the world may exert all his endeavors in vain if the party does not expect it, and mentally and bodily comply, and thus yield to it.” A trite application of this thought is the example of the patient who felt “better” as soon as the clinical thermometer had been placed under his tongue.
Coca Leaf & Disorders Of The Mind and Nervous System
History of Coca, Dr. Mortimer, Chapter Ten
In the answers received to my inquiry in this research regarding therapeutic application, fully one-half of those who went at all into detail advocated the use of Coca for cases of neurasthenia, and for the various symptoms of nerve and muscle depression grouped under that title. The whole train of ills resulting from debility, exhaustion, overwork, or overstrain of nerve or mind, recalls the early designation given to the classification of this long group of symptoms by some of the European physicians as “the American disease,” the derangement of an overworked and overhurrying people. The general advocacy of Coca for this condition indicates that the causes which tend to produce such derangement are not only important problems to the general practitioner throughout our country, but must be predominant factors wherever there is an impulse to supremacy. It makes little difference under just what name the symptoms may be treated so long as the patient shall be relieved of suffering.
There is a general idea in the minds of the laity which, unhappily, is also shared by some physicians, that to name a disease is far more important than its treatment. I well recall, when attending lectures upon medicine, how eager the first year students were to make notes of the various remedies which each lecturer might advocate for different conditions. It is a difficult task to fill such a therapeutic notebook, but far more difficult to find an appropriate application for the prescriptions suggested. Diseases are of necessity broadly taught in types, and treatment is wholly a result of judgment on the part of the individual practitioner. When a physician has advanced far enough in his struggles in medicine to realize how few specifics there are, he surely broadens himself by cutting loose from the narrow channels of thought he had originally traced in his early student days.
Dr. Tibbles, Brain Exhaustion, Chapter 8
Clements R. Markham in his “Travels in Peru and India” bears out fully the statements of Garcilasso de la Vega, Bias Valera, and Von Tschudi. This gentleman had charge of Government expeditions to Peruvian territories in order to procure cinchona plants for transportation to India, and while there, in forest districts around Bolivia, had ample opportunities of obtaining information respecting the influence of Erythroxylon coca upon the native Indians and likewise upon himself. He says the properties of Erythoxylon coca are such as to enable a greater amount of fatigue to be borne with less nourishment (in the form of ordinary food,) and to prevent difficult breathing in the ascent of steep mountainsides; that, although when used to excess it is prejudicial to health, yet “of all the narcotics used by man, it is the least injurious and most soothing and invigorating.” He frequently chewed it, and, besides imparting an agreeable soothing feeling, found he could endure long abstinence from food with less inconvenience than he otherwise would have felt; and further, that he was enabled by it to ascend precipitous mountain-sides with feelings of lightness and elasticity, and without shortness of breath. “It enabled him to ascend the mighty passes of the Andes with ease and comfort. It is a stomachic, soothing, nutritive.”
Beniley says “The Peruvian Indians have always ascribed to the coca the most extraordinary virtues. Thus they believe that it lessens the desire and the necessity for ordinary food; and, in fact, that it may be considered as almost a substitute for food.” Dr. Bennet of Edinburgh, in the British Medical Journal, publishes an elaborate investigation of the properties of the Coca leaf; his conclusions are that coca has a marked effect in diminishing the waste of the tissues, conferring thereby the power of sustaining prolonged exertion, also that it possesses the power of regulating the temperature of the body. Prescot treats Coca as an article possessing so invigorating a quality that with a small quantity of it in his pouch and a handful of roasted maize, the Peruvian Indian of our time performs his wearisome journeys day after day without fatigue. The Indian miners are furnished by their employers with little food but as much coca leaves as they want, some Indians consuming as much as a pound a week of it, and they work twenty to thirty hours at a stretch without sleep. Wittingham gave an account of two men who had been buried in a mine for eleven days before they could be got out, and they lived all that time on a few coca leaves they happened to have with them.
Dr. Tibbles – Physiological Action and Medicinal Uses Of Coca Leaf
Mental labour is frequently productive of such arterial tension – an exhausted Brain, whereby its influence over the heart’s action is diminished, will give rise to it; the diminution of nervous influence over the excretory organs whereby an increased amount of urea is produced and collected in the blood will give rise to it; as will also abnormal nutrition during exertion. These variations are abnormal and give rise to ill effects. In extremely low tension of the arterial and capillary vessels, the increased supply of blood to the muscles causes anemia of (being a deficiency of supply of blood to) the brain, and there is produced a feeling of fatigue, giddiness, or fainting. In this condition there is abnormal rise in the internal temperature. On the other hand, if the arterial tension be increased, then the strain will fall upon the heart, which will become overtaxed, dilated, and in some cases entire failure will be produced, either by over-distention and paralysis, or, by gradually increasing signs of dilatation, producing breathlessness, a sensation of lightness in the head, coldness of the extremities, pallor of face, anxious expression, and the temperature is abnormally decreased. These are the results of discordant action of the circulatory system, produced by exertion or excitement.
It may be asked, what has all this to do with the action of coca-leaf? Well, it is found by experiment that coca-leaf regulates the action of the heart and circulatory system and thereby nearly altogether preventing such results as above recorded as the consequence of muscular exertion or mental excitement. I, myself, have made experimental walks and performed other forms of exertion, physical and mental, and during which I have observed various functional differences, and of these observed experiments many might be quoted, but let my own observations be exemplified by the following:
My pulse, normally are 70 per minute, and at the end of a sharp walk of two hours’ duration, had risen to 92 pulsations per minute, and did not subside until after a period of six hours had elapsed. A walk performed under like conditions of distance, speed, and with like dietary as before, but during which twenty-five drops of a concentrated preparation, representing twenty-five grains of coca-leaf, was twice taken; the first dose before starting and the second at the end of the first hour. At the end of this walk the pulse beat eighty-four per minute, and, in less than two and a half hours, subsided to a normal condition.
Coca Leaf & The Elimination Of Physical Fatigue
History of Coca, Dr. Mortimer, Chapter 8
The influence of Coca in banishing the effects of extreme fatigue is well illustrated in an account of its use communicated to me by Dr. Frank L. James, Editor of the National Druggist, St. Louis. While a student at Munich he experimented with the use of Coca upon himself at the request of Professor Liebig, whose pupil he was. On one occasion, when exceedingly tired both physically and mentally, he was induced to try chewing Coca after the proper Peruvian fashion with a little llipta. Before commencing this experiment he was hungry, but too tired to eat and too hungry to sleep. In a few moments after beginning to chew hunger gave place to a sense of warmth in the stomach, while all physical weariness disappeared, though mentally he was still somewhat tired and disinclined to read or study, though this condition soon passed away, giving rise to an absolute eagerness to be at some sort of exercise. These sensations lasted altogether for probably three hours, gradually passing off after the first hour, leaving the subject none the worse for his experience and able to eat a hearty dinner the same evening.
Some years afterward, while practicing in the South, this gentleman returned from a thirty-six hours’ ride so tired as to necessitate being helped off the horse and up-stairs to his room. While preparing for bed his eyes fell upon a package of Coca leaves which he had recently received by way of San Francisco, and the idea immediately occurred to him to repeat the experiment of his student days. In the course of a quarter of an hour – following the chewing of probably a drachm of Coca leaves – he felt so refreshed and recuperated that he was able to go out and visit patients about the town to whom he had previously sent word that he was too tired to call on them that night. In describing the result, Dr. James said: “I was not very hungry at the time before taking the Coca, but all sense of the necessity or of a desire for food vanished with the weariness.”
Professor Novy, of the University of Michigan, is referred to by one of his former classmates as having formed one of a group of experimenters upon the use of Coca leaves. The influence being tested during a walk of twenty-four miles, taken one afternoon without any other nourishment but water and Coca. Over four miles an hour was averaged, and although unaccustomed to such long walks or vigorous exercise, no special muscular fatigue was experienced by four of the party who chewed the leaves almost constantly during the journey. No change was noted in the urine and no depression was experienced the next day. One who did not chew Coca, but was addicted to alcohol and chewed tobacco constantly, was somewhat more fatigued than the others, and suffered considerably from soreness of the muscles on the following day.
The experience of Sir Robert Christison, of Edinburgh, with the use of Coca upon himself and several of his students, is full of interest because of his extended experiments and the high rank of the investigator. Two of his students, unaccustomed to exercise during five months, walked some sixteen miles without having eaten any food since breakfast. On their return they each took two drachms of Coca made into an infusion, to which was added five grains of carbonate of soda, in imitation of the Peruvian method of adding an alkali. All sense of hunger and fatigue soon left, and after an hours walk they returned to enjoy an excellent dinner, after which they felt alert during the evening, and their night’s sleep was sound and refreshing. One of these students felt a slight sensation of giddiness after drinking the infusion, but the other experienced no unpleasant symptoms. Ten students, under similar conditions, walked varying distances, from twenty to thirty miles, over a hilly road. Two of these were unable to remark any effects from the use of Coca, several felt decided relief from fatigue, while four experienced complete relief, and one of these had walked thirty miles without any food. Professor Christison, though seventy-eight years of age and unaccustomed to vigorous exercise, subsequently experimented on himself by chewing Coca leaves with and without llipta, some of which had been forwarded to him from Peru. He first determined the effect of profound fatigue by walking fifteen miles on two occasions without taking food or drink. On his return his pulse, which was normally sixty-two at rest, was one hundred and ten on his arrival home, and two hours later was ninety. He was unfit for mental work in the evening, though he slept soundly all night, but the next morning was not inclined for active exercise. Then, under similar conditions, he walked sixteen miles, in three stages of four, six, and six miles, with one interval of half an hour, and two intervals of an hour and a half. During the last forty-five minutes of his second rest he chewed eighty grains of Coca, reserving forty grains for use during the last stage, even swallowing some of the fibre. He felt sufficiently tired to look forward to the end of his journey with reluctance, and did not observe any particular effect from the Coca until he got out of doors and put on his usual pace, of which he said: “At once I was surprised to find that all sense of weariness had entirely fled and that I could proceed not only with ease, but even with elasticity. I got over the six miles in an hour and a half without difficulty, and found it easy when done to get up a four and a half mile pace and to ascend quickly two steps at a time to my dressing room, two floors up-stairs; in short, I had no sense of fatigue or any other uneasiness whatsoever.”
During this walk he perspired profusely. On reaching home his pulse was ninety, and in two hours it had fallen to seventy-two, showing that the heart and circulation had been strengthened under the influence of Coca. The urine solids were the same as during the walk without Coca. In describing this walk, he said: “On arrival home before dinner, I felt neither hunger nor thirst, after complete abstinence from food and drink of every kind for nine hours, but upon dinner appearing in half an hour, ample justice was done to it.” After a sound sleep through the night he woke refreshed and free from all sense of fatigue. An influence of Coca not anticipated was the relief of a tenderness of his eyes, which during some years had rendered continuous reading a painful effort. In another trial at mountain climbing, he ascended Ben Vorlich, on Loch Earn, 3,224 feet above the sea. The climb was along a rugged foot path, then through a short heather and deep grass, and the final dome of seven hundred feet rise was among blocks and slabs of mica-slate. The ascent was made in two and a half hours, the last three hundred feet requiring considerable determination.
His companions enjoyed a luncheon, but Sir Robert contented himself chewing two-thirds of a drachm of Coca, and after a rest of three-quarters of an hour was ready for the descent. Although this was looked forward to with no little distrust, he found upon rising that all fatigue was gone, and he journeyed with the same ease with which he had enjoyed mountain rambles in his youth. The experimenter was neither weary, hungry nor thirsty, and felt as though he could easily have walked four miles to his home. After a hearty dinner, followed by a busy evening, he slept soundly during the night and woke refreshed in the morning, ready for another days exercise. During the trip he took neither food nor drink of any kind except chewing sixty grains of Coca leaves. Eight days after this experiment was repeated, using ninety grains of Coca. The weather had changed and the temperature was forty-four degrees at the top of the mountain and a chilly breeze provoked the desire to descend. While resting sixty grains of Coca was chewed. The descent was made without halt in an hour and a quarter, and followed by a walk of two miles over a level road to meet his carriage. He then felt slightly tired, because three hours had elapsed since he had chewed Coca.
In summing up his experience Professor Christison says: “I feel that without details the general results which may now be summarized would scarcely carry conviction with them. They are the following: The chewing of Coca not only removes extreme fatigue, but prevents it. Hunger and thirst are suspended, but eventually appetite and digestion are unaffected. No injury whatever is sustained at the time or subsequently in occasional trials.” From sixty to ninety grains are sufficient for one trial, but some persons either require more or are constitutionally proof against the restorative action of Coca. From his observations there was no effect on the mental faculties except to prevent the dullness and drowsiness which follow great bodily fatigue.
