(First of three columns about cocaine)

THE FIRST archaeologically verified use of coca leaves is found in the dessicated contents of pottery associated with 6th Century C.E. royal burials in the eastern Andean region. It is likely, however, that its use predates this by centuries. Coca leaves have since followed a long and circuitous pathway from their presumed use in prehistory as an oral stimulant and tranquillizer for the governing classes, then to its role as a work-enhancing agent in the higher Andean altitudes, and now to its current status as an illicit drug employed primarily for recreational purposes.

The coca shrub (Erythroxylon coca), in contrast to many of the other mood-altering botanical species (such as opium, tobacco, marijuana, and even tea and coffee), has been confined to certain valleys of South America, despite efforts to transplant it to other regions.

Andean mythology declares that the coca plant was created by the sun god, Inti, son of Viracoca, god of all life. Inti then assigned it to Mama Quilla, goddess of the floating moon and Inti’s sister. She was instructed to plant and sustain it in the humid valleys at the base of the mountains. It was further stipulated by Inti that only the local nobility may be permitted to enjoy its benefits. By the 12th Century, during the reign of Inca Roca, coca plantations became a royal monopoly, and under selective cultivation a broader leafed plant was achieved. The chewing of coca leaves was deemed to be solely a divine entitlement and its selective use became a major element in certain religious rituals. During intervals of warfare, however, the privileges of coca chewing were temporarily extended to military personnel and sometimes to gangs of laborers constructing the royal highways.

Coca leaves were occasionally consumed as a hot watery extract, much as was coffee or tea, but more commonly they were chewed as wads of dampened leaves. By custom, these leaves were first mixed with some powdered lime, presumably to increase the rate of absorption of the active alkaloid within the leaves.

What purposes did coca leaves allegedly fulfill? Chewing the leaves was believed to lessen headaches, stomach disorders, toothaches and perhaps, too, serve as a local anesthetic agent. Chewing the leaves was said to yield a sense of inner harmony and an ability to work more productively, particularly under stressful circumstances and in the higher altitudes of the Andes, where the concentration of ambient oxygen was diminished.

Furthermore, chewing coca leaves suppressed the appetite. Workers might then labor for many hours without the need for a meal break. A Capt. Don Antonio d’Ulloa wrote: “This herb is so nutritious and invigorating that the Indians labor whole days without anything else, and on the want of it they find a decay in their strength.”

The successful subjugation of the Incan empire in 1536, led by Francisco Pizarro (1471-1541), opened the territories of Peru to Spanish exploitation. Coca leaves were initially viewed by the Spanish authorities with profound suspicion as a pagan remnant, and, accordingly, as an obstacle to religious conversion. Attempts to abolish the chewing of coca leaves were unsuccessful and, by 1569, Philip II of Spain decreed that coca leaves had a legitimate place in a peaceful and regulated Andean society, and even as a means of increasing the productivity of slave labor in the mines of Peru. Nicholas Monardes, describing Peruvian life in 1569, declared that when Incans sought to make themselves drunk, they chewed a mixture of tobacco and coca leaves.

The Spanish attitude toward the coca plant gradually underwent a dramatic shift: From their original fear and loathing of the leaves as a barbaric convention, to their reluctant acceptance of the plant as a necessary social evil, and then finally to their conscious exploitation of the substance for economic purposes. The mild degree of euphoria experienced by coca-leaf chewers suggested to some military and religious leaders of Spain that a monopoly in its cultivation and commercialization, akin perhaps to the quinine monopoly, might be undertaken. Yet attempts to transplant it to the Eastern Hemisphere uniformly failed and the dreams of exploiting it as a substitute for tea or even as a social anodyne for the European working class collapsed.

There was little doubt, though, that the leaves of the coca plant harbored a pharmacologic agent of considerable power. It required the technical skills and ingenuity of the north European chemists finally to isolate, and then concentrate this unknown substance hidden in the coca leaves.

A German medical student named Albert Neimann (1834-1921), in seeking a suitable subject for his doctoral thesis at the University of Gottingen, stumbled upon the continuing enigma of the coca leaves. He then applied the newer techniques of qualitative chemistry and, in 1859, finally isolated a bitter white powder from the leaves, which he named “cocaine.” His findings were published in 1860 and he then went on to become one of Europe’s most productive research pediatricians. The hereditary ailment called Neimann-Pick disease bears his name.

The following two decades witnessed the meteoric rise and uncritical acceptance of cocaine for a variety of miraculous purposes.

Stanley M. Aronson, M.D., a weekly contributor, is dean of medicine emeritus, Brown University ( smamd@cox.net ).