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JAMA 100 Years Ago |

The Cocain Habit.

JAMA. 2002;287(18):2330. doi:10.1001/jama.287.18.2330.
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Bose gives an interesting account of the cocain habit as observed in Calcutta. He finds its exhilirating effect very temporary and quickly followed by depression. The habit is quickly acquired and very difficult to abandon. He thinks the depression of spirits is more imaginary than real, as he has not noticed any fall of temperature or slowing of pulse, but the respiration becomes slightly hurried. The teeth and tongue of confirmed cocain eaters become jet black, probably due to the chemical change produced by the action of lime and saliva on the drug. The habit increases on one very rapidly. It was noticed in one case that the dose was raised from 1 to 12 gr. in a month. Unlike opium, it produces insomnia and anorexia, soon followed by dyspepsia and diarrhea. The dyspepsia of a cocain inebriate is very obstinate and prolonged use of the drug brings on deafness. The quantity of urine is diminished, delusions and hallucinations often occur and sometimes acute mania which is not amenable to treatment. He reports a number of cases and from analysis finds that the action of cocain on the nerve centers is slightly stimulative, but this is very temporary, followed by a feeling of depression, which gradually passes into complete lethargic inertia. The power of control is gradually lessened. The virile power is lost, with depression of the heart and vascular symptoms. The cardiac action is irregular and the circulation becomes languid. The loss of appetite and the failure of the digestive power is marked and emaciation follows. The craving for the drug increases. The elimination is impaired, depressing the function of the brain and causing insomnia and loss of memory. The toxic symptoms are not observed as long as moderate doses are used, but the person soon becomes a useless member of society and life becomes a burden to him. The only remedy is to lock him up and forcibly withdraw the drug.


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