: Strangers at Lisconnel by Barlow Jane - Ireland Social life and customs Fiction

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COCAINE.

A new discovery in medicine, which has established its claim to general utility, is as much a matter for congratulation on the part of the general public as on the part of the members of that profession whose duty it is to use it. The stir in the world which Simpson's grand discovery of chloroform excited is still well remembered, and upon reflection, persons even now could not fail to be impressed with the incalculable amount of relief from suffering of which the drug is the source, if they were to pay a visit to one of our large hospitals and judge for themselves. It is true that chloroform has some drawbacks; it is even true that indirectly, if not directly fatal results have followed its use; but what good thing is free from all blemish, and how, 'in this best of all possible worlds,' can we expect everything to be as we should wish?

The discovery of ether, it should be remembered, afforded surgeons the opportunity in after-years of making a choice between the two drugs. Fortunately, in this connection the effects of each are different in certain particulars, so that, in a given number of cases, the use of ether is advisable, and chloroform is to be avoided. The explanation of this can be readily understood. The effect of chloroform is to depress the action of the heart. In cases of an overdose of this drug, the heart is paralysed; and when death occurs during its administration, there need not necessarily have been more than a very small dose given; but owing to some undiscovered weakness of the heart, which the drug unfortunately becomes the means of rendering manifest, sudden stoppage of the organ takes place, with, of course, death as a consequence. On the other hand, ether has exactly the opposite effect. The heart's action is stimulated during its administration, and the contractions of the organ are rendered more vigorous. Thus, whenever there is any suspected weakness of the heart in patients to whom an anaesthetic is about to be administered, there is no hesitation on the part of the surgeon in using ether, which under these circumstances is certainly the safest drug to employ.

A few details with reference to this remarkable plant may not here be out of place. It is described as a 'shrub from four to six feet high, branches straight and alternate, leaves in form and size like tea-leaves, flowers, with a small yellowish white corolla, ten stamens, and three pistils. In raising the plant from the seed, the sowing is commenced in December and January, when the rain begins, and continues until April. The seeds are spread on the surface of the soil in a small nursery or raising-ground, over which there is generally a thatch-roof. At the end of about fourteen days, they come up, the young plants being continually watered and protected from the sun. At the end of eighteen months, the plants yield their first harvest, and continue to yield for upwards of forty years. The first harvest, the leaves are picked very carefully one by one, to avoid disturbing the roots of the young tender plants. Gathering takes place three times, and even four times in the year. The most abundant harvest takes place in March, immediately after the rains. With plenty of watering, forty days suffice to cover the plants with leaves afresh. It is necessary to weed the ground very carefully, especially while the plants are young. The harvest is gathered by women and children. The greatest care is required in the drying of the leaves; for too much sun causes them to dry up and lose their flavour; while, if packed up moist, they become fetid. They are generally exposed to the sun in thin layers.' Such is, in brief, the account of the plant whose alkaloid, cocaine, has attained so marked a popularity within the short space of a few months.

Although the plant has only recently become known to us, its virtues have long been recognised by the natives of that part of the world in which it grows. It is stated that in 1583 the Indians consumed one hundred thousand 'cestos' of coca, worth 2 1/2 dollars each in Guzco, and four dollars in Potosi. In 1591 an excise of five per cent. was imposed on coca; and in 1746 and 1750, this duty yielded eight hundred and fifteen hundred dollars respectively, from Caravaya alone. Between 1785 and 1795, the coca traffic was calculated at 1,207,436 dollars in the Peruvian vice-royalty, and including that of Buenos Ayres, 2,641,478 dollars. The coca trade is a government monopoly in Bolivia, the state reserving the right of purchasing from the growers and reselling to the consumer. This right is generally farmed out to the highest bidder. The proximate annual produce of coca in Peru is about fifteen million pounds, the average yield being about eight hundred pounds an acre. More than ten million pounds are produced annually in Bolivia; so that the annual yield of coca throughout South America, including Peru, Bolivia, Ecuador, and Pasto, may be estimated at thirty million pounds.

It is scarcely pleasant news for us to learn that the natives who cultivate the coca-plant themselves absorb so much of the products of their own cultivation. We have here, doubtless, the explanation of the costliness of cocaine and the scarcity of the drug in England. This can hardly be otherwise, it is to be feared, for some time to come, when we remember that the reliance upon the extraordinary virtues of the coca-leaf amongst the Peruvian Indians is so strong, that in the Huanuco province they believe that if a dying man can taste a leaf placed upon his tongue, it is a sure sign of his future happiness! When Weston the pedestrian was performing his feats of endurance in England, it was noticed that from time to time he placed something in his mouth, which he afterwards chewed. For long he refused to divulge what the nature of this substance was, but at last he acknowledged that he always provided himself with some coca-leaves; and he added, that the chewing of these gave him strength, and enabled him more easily to accomplish his allotted task.

In the states above referred to, the natives are accustomed to use the leaves largely for the purpose of allaying hunger. Now, the sense of hunger takes origin in the nerves of the stomach, and it is evident that if these nerves are rendered incapable of exercising their functions, the sensations to which they give rise must decline and remain temporarily in abeyance. This is precisely what takes place when coca-leaves are eaten. Their effect is to paralyse for the time being the sensitive ends of the nerves of the stomach, and to establish practically a condition of local anaesthesia within the interior of that organ. The sensation of hunger, of course, under such circumstances becomes impossible; and the native, after eating a few leaves, goes on his way rejoicing, with the same sensations as if he had partaken of a hearty repast.

Although cocaine has been known for a good many years, and has from time to time formed the subject of inquiry amongst distinguished British and continental savants, including the veteran Sir R. Christison, it was reserved for Dr Carl Koller of Vienna to demonstrate the practical use to which its marvellous property could be put. It occurred to this gentleman that the drug might be of use in the department of diseases of the eye. With this object in view, he experimented upon the eyes of animals, applying the drug in solution of a certain strength, and carefully noting the results. He found that in the course of a few moments, after the drug had been instilled several times into the conjunctival sac of an animal, the organ became insensible; that he was able to touch the cornea--the front part of the eye, which is endowed with extreme sensibility--with a pin without the least flinching on the part of the animal. Experimenting further, he ascertained that the insensibility was not confined to the superficial parts of the eye, but that it extended throughout the corneal substance, even to the structures within the ocular globe, and thus the fact so far of the utility of the drug for operative purposes came to be established. Then he turned his attention to cases in which the eye was the seat of disease, and the cornea acutely inflamed and painful, and he found that much relief from the symptoms was obtained by the use of the drug. Soon after this, he commenced to employ cocaine in operations performed upon the eyes of patients. The results were highly satisfactory; and since then, cataracts have been operated on, squinting eyes put straight, foreign bodies upon the cornea removed painlessly and with ease, under the influence of the drug. In cataract especially, cocaine is of great value; this operation can be performed by its means without the slightest sensation of pain, and yet the patient is fully conscious, and is of course able to follow during its performance the precise instructions of the surgeon.

Such is cocaine, and such is its effect upon every mucous membrane. We have referred to its utility in the practice of ophthalmic surgeons; but it is not only in this department of the healing art that cocaine has been found useful; it can be employed whenever an operation upon any mucous membrane has to be performed. The drug has been used in the extraction and stopping of teeth; and results, nothing less than startling in their completeness, have been obtained with cocaine in all branches of medicine and surgery, bringing relief to thousands of sufferers, and--it is true to remark--more than that, unqualified gratification to the physician or surgeon in charge. Even that immemorial bugbear, sea-sickness, has often fled before the influence of cocaine.

One word more. In the present prosaic condition of the world, when the surfeit of new discoveries seems to have bred in this connection the familiarity which produces the conventional contempt, it is refreshing to draw attention to a discovery which has surpassed the ordinary standard of greatness sufficiently to enable it to figure as a wonder of the age. Cocaine flashed like a meteor before the eyes of the medical world, but, unlike a meteor, its impressions have proved to be enduring; while it is destined in the future to occupy a high position in the estimation of those whom duty requires to combat the ravages of disease.

IN ALL SHADES.

BY GRANT ALLEN,

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