1890 Coca and its Therapeutic Application by Angelo Mariani

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throat, which were irritated constantly by cigarette smok ing. "The patient at first only used morphine,but his phy sicians committed the imprudence of treating him by hypodermic injection. A notable change for the better was produced during the first month,but, unfortunately, abuse succeeded promptly the use of the medicament— so much so that when I commenced to treat the patient, he was taking daily from 1 gramme 50 centigrammes to 1 gramme 80 centigrammes of morphine hypodermically. When he was four hours without his dose there appeared insomnia, hallucinations and delirium; constipation last ing sometimes for fifteen days, which brought on in the spring a very alarming perityphlitis, jerking of the mus cles, sudden frights, dyspepsia, and at last frightful con gestion of the face whenever he drank a drop of wine or brandy. "After a month's treatment I had succeeded in reducing the daily doses without causing alarming symptoms; the physiological functions seemed to awaken again. How ever,the congestion and especially the dyspepsia was very grave,and the cough which had been suppressed by mor phine returned. It was then that I treated my patient with phosphate of lime, the pdte and the Vin Mariani. Lacking his habitual stimulant, he was plunged in a semi- coma from which he could not always be relieved with weaker daily doses of morphine. "The danger I feared most was a relapse of bronchitis, and that the cough and expectoration might end fatally. But in about a week,during which he took ten doses of Pdte de Coca daily,the cough became less fatiguing and dis appeared entirely in about twenty days. The patient then commenced to take smalldoses of Vin Mariani(two Madeira- glasses a day). At first congestion appeared, but little by little, as digestion became more easy, my patient, who on account of his profound anaemia could not tolerate any