Introduction
An alkaloid obtained from coca,.
Provings.
1. External Application.-a. Conjunctiva. – When 1 dr. of a 4 per cent. solution (and the same is true of much weaker solutions) is introduced into the eye, a slight burning sensation is felt. A.M. or two later, the cornea and conjunctiva become anaesthetic, and lose all reflex excitability; the finger can be placed over them, and the conjunctiva taken up with the forceps, without causing any unpleasant sensations. At the same time there is a feeling of tension in the lids, and the eye seems protruded, as in a case of Graves’ disease. The conjunctiva becomes exceedingly pale. These phenomena last for about 10 m. and gradually disappear. In from 10 to 15 m. the pupil begins to dilate, and there is slight paresis of accommodation. Mydriasis is never present to any great extent, but it lasts for some hours after the anaesthesia has disappeared.
1 b. Nasal Mucous Membrane. – When applied to the mucous membrane of the nose, a 4 per cent solution produces, in a few seconds, a sense of numbness which grows more marked as the applications are repeated. If they are renewed at intervals of 5 m. for 15 or 20 m. at the expiration of that time the mucous tissue may be cut or cauterized without any well – defined sensations, unless the instruments enter very deeply into the submucous tissue. Very soon after cocaine has been applied, the membrane looks pale and turns almost white, so anaemic does it become. It retracts in a marked manner even if it were swelled before the application. But although its primary action produces anaesthesia and anaemia of the membrane, there occur secondary effects of great swelling and hyperaesthesia of the parts treated, and these symptoms are even more prominent than they were before the drug was applied. (Journ. of AM. Medorrhinum Assoc, Feb., 1886.) 2. Inasmuch as the writer-whose nervous system is of an almost unfortunate degree of sensitiveness-has taken doses of the hydrochlorate, equivalent in the aggregate to no less than 32 gr. of cocaine itself, within the space of 3 hours without (as the present lines sufficiently prove) a fatal result following, this remarkable body cannot fairly be classed among the poisonous alkaloids. Among the chief symptoms induced were increased cerebral activity, mounting at intervals into the region of delirium, the latter tendency always subservient to a powerful effort of the will. This continued for 5 hours, the heart action and breathing being meanwhile slightly increased, but not to any painful extent. At first the muscular powers seemed to be enhanced, heavier weights being lifted without undue stress than is ordinarily the case, while the reflective faculties-as instanced by ability to read and form conclusions upon novel scientific matter-seemed stimulated. An hour after the entire quantity named has been taken, the sensibility of the limbs to external influences-which had gradually diminished from the
first-became materially lowered, and neither pinches, pricks, nor slight burns with a heated wire could be felt upon the fleshy portions of the arms of legs. The trunk, however, never lost its sensibility to pain in any marked degree. Slight convulsive movements and a sensation of bodily torpor succeeded, giving way about the 8th hour to increased somnolency. No special desire or distaste for food was noticeable, but sleep overcame all other symptoms between 10 and 11 hours from the commencement, and continued for 13 hours afterwards; a slight feeling of dizziness was experienced on waking, but this gradually went off, and had entirely disappeared 24 hours later. (Brit. and Colonial Druggist, 1885, p. 36.)
3. M. D. HAGE, jun., M. D., of Richmond, Va., reports the following proving upon himself. At 4:45 p. m. pulse 88, before beginning experiment. At 5, gr. 1/4 in 6 minims of water injected in left forearm on radial side, just about where external cutaneous nerve from brachial pierces through ante-brachial fascia. At 5.14, some slight tingling in little finger, which may have been caused by resting arm heavily upon knee. At 5:15, gr. 1/4 was injected about 1/8 in. apart from the first. At 5:30, gr. 1/4 more. NO pain on insertion of hypodermic needle. At 5:40, pulse 110, slight perspiration on forehead, and a little nervousness. At 5:45, gr. 1/4 No special symptoms except slight restlessness. At 6.5, gr. 1/2 was injected without once feeling needle. Whole left arm feels numb and heavy; hands moist and cool; pupils dilated immediately after injection. At 6:10, pulse 114, slight ringing in ears, and vacant feeling in stomach. At 6:30 gr. 1/2 was injected; needle not felt. Pulse 120. Very dry feeling in mouth and throat. At 6:40, pulse 114. I have a drowsy, sleepy feeling, and head feels heavy. Respiration 25; temperature 100o Pupils well dilated, right more so than left. Face is slightly flushed, and skin moist and clammy. At 6:50, a large sewing-needle was slowly introduced 3/4 in straight through skin, fascia, and supinator long us muscle without least pain and only slight feeling or pressure, but when it reached periosteum it caused intense pain, as if something was gnawing at it. At 7, gr. 1/2 more was administered. Pulse 120. Hands cold. At 7.35, took hypodermically another 1/2 gr. Pulse 120. Hands cold. At 7:35, took hypodermically another 1/2 gr. Pulse 120. Great ease in breathing. Marked perspiration on forehead. At 7:45, pulse 120; temperature 100o; respiration 28. Hand still cold, and slight headache. Area of complete insensibility is well defined, and measures 2 by 4 inches, having elliptical form. all of above injections were put in a space about size of ten – cent piece, needle directed towards elbow, and skin held between fingers in usual way. Sensibility is perfect for 1/4 inch above the point of inspection, but here the line is very sharply drawn, which might point to the fact that the cocaine was carried to the extremities by the arterioles. Moderate degrees of heat and cold were not noticed in the slightest. A lump of ice placed on arm was not felt until some of it had melted and trickled down on ulnar side. A piece of mental heated almost to redness- in fact, so hot as to scorch the hairs and raise blisters – could only be felt after contact of 2 to 3 seconds, when pain, although not intense, was dull and perceptible. At 8.5, gr. 1/2 was injected, with needle pointing towards fingers. at 8.12, pulse 120; temperature 100o; and resp. 28. Area of insensibility has a pear shape, and measures 4 by 6 in. At 8:30, another 1/2 gr. injection. Pulse 116. Continued dryness about throat, and extreme ease in breathing, with inclination to sigh frequently. At 9, still another 1/2 gr. injection. Pulse 116; temperature 99.3/4o. A needle introduced down to bone in several places caused not a particle of pain. Pupils equally dilated and responsive to light. Slight twitching of muscles in various parts of body. Headache is quite severe. At 9:25, pulse 120. Head full and heavy. Respiration principally thoracic, very superficial, and delightfully easy. Anaesthetic area undiminished. No feeling of nausea o dizziness at any time. Hands still cold and clammy. Sensibility of mucous membrane of eye, mouth, and nose not perceptibly diminished. There is continued dryness of throat. There is feeling of great wakefulness, accompanied by weakness in the legs when walking. At 11, general symptoms are much less marked. Area of insensibility greatly decreased. Headache much less marked. Area of insensibility greatly decreased. Headache much better; only superficial breathing continues.
Resume. – In 4 hour, gr. 4.1/2 inj 3ij of water were injected into left forearm, resulting in a complete anaesthetic area measuring 4 to 6 in., and extending 1/2 to 2/3 inch in depth; headache depth; headache, clammy perspiration on forehead and hands the latter cold; dilatation of pupils, weakness of legs, accelerated pulse, rise of temperature, very superficial breathing, and dryness in mouth and throat. (Virginia Medorrhinum Monthly, August, 1886.)
4. Dr. EDWARD MCCARTHY proved drug under Dr. Hage’s supervision. Before beginning experiment, pulse was 68, and temperature 99.1/2 o F. At 2:40 p. m., gr. 1/2 dissolved in 2 teaspoonfuls of water was taken by mouth. It has a very bitter taste, similar to quinine but without the rough feeling. At 2:45, slight nervous feeling, with some little warmth in stomach. At 2:50, gr. 1/2 more was taken. Pulse 64. At 2:55, warmth in stomach more marked. At 3, another gr. 1/2 was taken. Pulse 64; temperature 99o; tongue feels a little numb on end; pupils slightly dilated; some warmth in pharynx. At 3:10, yet another gr. 1/2 was taken. Pulse 60, and weaker; respiration 24. at 3:15, feels in very good spirits, and rested. At 3:20, another gr. 1/2 was taken. Pulse 56; temperature 99o; resp. 24. Warmth in stomach decidedly more marked. Describes his feelings as ” very good; similar to that after a big drink of whisky. ” On walking about room, feels light; face flushed. Up to now 2.1/2 gr. in all have been taken. At 3:25, after walking, feeling of exhilaration passes off. At 3:30, gr. 1/2 more is taken. Pulse 60. Describes his feelings as “glorious all over the body, with stimulating waves rushing through the limbs. ” Says he is intoxicated. A drowsy feeling 5 m. before has given way to one of great energy. The flushed face and dilatation of pupils come and go. At 3:40, took still another 1/2 gr. Pulse 64; temperature 98.3/4o. At 3:45, every breath feels stimulating. At 3:50, another 1/2 gr. is taken. Pulse 65. Taste of drug not so bitter as at first. Mouth and tongue are very dry. At 4, some slight tremor in all fingers when outstretched. Pulse 76; temperature 98.3/4o. No headache or dizziness, but continued happy exhilarated feeling; and as no grave symptoms were present, it was decided to give 3 gr. more, in 1 gr. doses every 15 m. At 4:10, 1 gr. in 2 teaspoonfuls of water was swallowed. Pulse 76; temperature 98.3/4 o. All superfluous movements with arms and legs, such as gesticulations and strides around room, are very pleasant, in fact irresistible. Has a constant desire to undertake vast feats of strength, and feels like haranguing. At 4:15, pulse 88; tongue anaemic and dry. Same delightful sensations have full sway; feels as if nothing he could see or hear would depress him. At 4:20 1 gr. more is taken. Pulse 66; resp. 28. Pleasant tremors shooting trough whole body. At 4:25, with closed eyes, and toes together, body has a pendulum – like motion laterally Marked tremor of outstretched fingers, and disposition to sigh; and he is unable to draw keep breath. At 4.34;final dose is taken. Pulse 88; temperature 99o. He is very talkative; talk is not disconnected, but repetition of same idea over and over, because words fail to express delightful sensations. At 5:20, feeling of exhilaration fast wearing off; is sober but feels foolish. At 7:30, has had no hunger although last meal was at 8:30 a. m. Seven grains were taken in the course of 5 hours. After 2 1/2 gr. first effects were felt, and after gr. intoxication was produced. (Ibid.).
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.