[Cocaine: half a century of therapeutic use (1880-1930)]

After observations concerning the cultivation, the trade and the use of coca by the Peruvian population, several Spanish physicians--among whom MONARDES--had already in the XVIth century, proposed to use this plant as a medicine. Therapeutical experiments however were not effected until the second half of the XIXth century. In 1559 the Italian neurologist MANTEGAZZA was the first to try out the remedy on himself and to advocate the use of coca as an internal medicine. Experiments with cocaine were still made during about twenty years, until more and more therapeutical applications clearly appeared. In psychiatry cocaine was used--also on Freud's recommendation--as an euphoriant excitant in cases of melancholia, both physical and psychic exhaustion and of cachexia. It was further used as a substitution therapy for morphine-addicts. 1884 also meant a break-through for the use of cocaine as a local anesthetic. It was first used in eye-surgery and was applied later on in dentistry and in cases of minor surgery. Local pain-killing injections seems to have been used at the beginning of our century in all sorts of indications. Cocaine was also applied to cure asthma, mountain-sickness, sea-sickness, pregnancy vomiting and all possible sorts of cramping pains. Although in the last years of the XIXth century the medical literature already clearly warned against the danger of therapeutically induced cocaine mania, it is only several years after World War I that the use of cocaine pills for painful diseases of the mouth and of the upper digestion organs still appeared. Between 1880 and 1930, we may assert that cocaine had taken the place of the universal panacea of the Middle Ages, the Theriaca.