This excerpt from W. S. Searles’s 1881 book “A New Form Of Nervous Disease” focuses on why this new set of symptoms should have emerged in America when it apparently had not yet been seen in the rest of the world. Readers in today’s world of 2014 may find it fascinating to see how little has changed in the national psyche since Dr. Searles wrote this in 1881.

It Is Not “Just In Your Head”

Severe and debilitating nervousness, in many forms and to a degree before unknown in any country, is being rapidly developed in this land and age, is a melancholy fact to which the eyes of American physicians are being speedily opened. Our climate is stimulating, our habits are stimulating, the struggle for existence is stimulating, and human nature is over-driven on every side. May not Coca be destined to be the grand palliative of these conditions, and the useful sustainer of exertion among our professional and business men? Contributing so marvelously to endurance both of mind and body, and doing this with certainly less injury to the system than any cognate substance known, I look to Coca as the great preserver of life and health in future generations.

From what has been said of the nature and effects of Coca it will be seen that I do not regard this plant in the light of a drug, any more, at least, than coffee, tea, or tobacco can be so termed. Nor, indeed, is it as susceptible of application as a drug as those substances even; since its effects upon the body are marked by much less disturbance than those of any of them. To be of value as a drug, a substance must have pathogenetic power. It is, then, not as a drug that we should regard Coca, though its sphere in medical practice is destined to be a very wide, and an immensely important one. Its place is that of a food, or, if you please, supplemental or adjunct to food. Its economic uses in the community will be of a high grade, and its employment in the army, navy, and merchant marine will be still higher. It will sustain the life of many an exhausted soldier and ship-wrecked sailor. Had our army at Gettysburg been supplied with it, Lee and his troops need never have been allowed to re-cross the Potomac. A bale of it should form part of the supply of every ship, since, in case of shipwreck, it would sustain life much longer than a corresponding amount of food. Physiology teaches us that where there is use in the body, there is waste: where there is waste, there must be repair; for repair there must be food; and for food to become fitted for repair, there must be digestion and assimilation. All this is true, but we must go farther, and recall the fact that food never varies in its constituents. Each mouthful contains a definite, fixed, and practically invariable amount of each element contained in the food. Doubtless the normal proportion of these elements would be the proper one to furnish suitable material for repair in case we were born physiologically perfect, and then lived physiologically. But few of us are born with any approach to perfection of structure, and none of us can live physiologically. And this for two reasons:

First, we do not know all of nature’s laws. And, second, we could not obey them if we did. The demands of life, civilized or savage, prevent it. Probably nature demands that we should go naked. We cannot do it. It demands a proper relation of exercise, food, and sleep. We cannot attain to it; and so on ad infinitum.

Now, consider the case of the sedentary man. Does he not waste his brain out of all proportion to his muscles? And is it not clear that to nourish his brain, he must eat more muscle-food than he requires? Even at the best must not his brain often go hungry? What becomes of this over-plus of muscle-food? Well, two things happen. If the man’s stomach is feeble it refuses to digest so much food, and he gets dyspepsia. If he does digest it, and it is absorbed, his blood is filled up with material which he cannot or does not use: his liver becomes congested; and, in ordinary parlance, he is bilious.

Now, are not dyspepsia and biliousness the diseases, par excellence, of sedentary men? And is it not true that literary men, of inactive bodily habit and abstemious as to stimulants, are great eaters? If you do not know it, you have only to ask any housewife who is accustomed to entertain the clergy – a class who avoid wine and tobacco, a part of whom only are able to take tea and coffee in sufficient amount to diminish excessive waste without rendering them nervous; and who are therefore obliged to eat hugely.

For these and all classes in the community upon whom the demands of life are similar, Coca is, in my opinion, infinitely better than wine or tobacco, even with the addition of coffee and tea. And this for reasons already given.

Only less important to the laboring classes is it, as the bulk of the muscles and other parts of the body exceeds that of the brain. An overplus of brain food is of small account to the laborer compared with the overplus of other food to the sedentary.

Fat can be stored up in the body or burnt up as fuel, and phosphorus, etc., can be easily eliminated by the kidneys. The surplus, being much smaller in this instance, can be more easily disposed of. Still, he would be a bold man who would say that the laborer is liable to no disease through the lack of a proper relation of food to his exact wants.

Now, it can be shown that tea, coffee, wine, tobacco, and, more than all, Coca, prevent waste. And not this alone, but they prevent excess of waste in parts excessively used, or called upon for an undue proportion of work. In this way they help to balance up between the needs of the system, under the strain of life, and the constant and uniform proportion of the elements of food. Who shall measure the benefit of this effect? It is beyond all human computation.

If, then, my philosophy and physiology be correct, and if Coca is and does what is claimed, and what I believe it will be proven to be and do, the introduction of this substance into general use is a matter of exceeding importance, and its employment should be fostered by every true physician.