Cocainum hydrochloricum

Crystalline salt of the coca-leaf alkaloid used in medicine as a local anaesthetic and historically as a central stimulant. Toxicology shows swift exaltation (mental and motor), insomnia, tachycardia, vasoconstriction, mydriasis, sensory hyperacuity passing into illusions/hallucinations, formication (“cocaine bugs”), and later depression, prostration, and even cardiac collapse in excess ([Toxicology]). Locally it induces mucosal anaesthesia and, with repeated use, irritation/ulceration (notably in the nose and throat) [Hughes], [Clarke]. Homœopathic preparations are made by trituration of the salt and subsequent potentisation. The remedy picture centres on stimulation → exhaustion, anxious insomnia, cardio-vascular irritability, sensory illusions, and cutaneous formication, with a useful but narrower ENT/ocular strand reflecting the drug’s topography. [Allen], [Clarke], [Boericke], [Boger]

As a surface anaesthetic (eye, nose, throat) and vasoconstrictor; also abused as a stimulant, with well-described habit neurosis and sequelae (insomnia, tremor, delusions, malnutrition). These observations supply abundant clinical confirmations. [Hughes], [Clarke]

No Hahnemannian proving. The pathogenesis is built from toxicological reports, small experimental provings, and numerous clinical notes compiled by T. F. Allen, Hughes, Clarke, with practical résumé in Boericke/Boger: insomnia with exaltation, palpitations, mydriasis, formication, hallucinations, anaesthesia of mucosa, and subsequent prostration. [Allen], [Hughes], [Clarke], [Boericke], [Boger]

• Cerebral cortex & psyche. Exaltation, rapid ideation, hyperacusis/photophobia, illusions (especially of insects crawling), then anxious insomnia and depression; alternating confidence and suspicion. See Mind/Sleep. [Hughes], [Allen], [Clarke]
• Cardio-vascular reactivity. Palpitation, irregular action, precordial anxiety, cold extremities with hot head, vaso-motor lability; in excess, risk of collapse. See Heart/Generalities. [Clarke], [Boericke]
• Skin & peripheral nerves. Formication (as of insects under skin), itching, numb patches, tremulousness; scratching gives momentary relief yet aggravates irritation. See Skin/Extremities. [Allen], [Clarke]
• Sleep centre / circadian. Tenacious insomnia from cerebral over-excitement, with racing thoughts and inability to “switch off”; brief dozes startle. See Sleep/Dreams. [Clarke], [Boericke]
• ENT mucosae (nose, throat). Local anaesthesia, then rawness, epistaxis, ozaena-like crusts or ulceration after repeated topical use; smell disordered. See Nose/Throat. [Clarke], [Boger]
• Eyes. Mydriasis, photophobia, visual illusions; locally anaesthetic but irritating with misuse. See Eyes/Head. [Allen], [Clarke]
• Genito-urinary (erethism → atony). Sexual excitation with insomnia; later prostration, diminished power, and mental anxiety about performance. See Male/Female/Mind. [Hering], [Clarke]
• Gastric tone. Loss of appetite, nausea in the over-driven; coffee/alcohol worsen palpitations and wakefulness. See Stomach/Food & Drink. [Dewey], [Clarke]
• Motor stamina. Tremor, fidgetiness, quick fatigue after brief brilliance; hands unsteady for fine work. See Extremities/Generalities. [Allen], [Boger]

• Quiet, darkened room; minimal stimuli; one calm voice rather than fuss. [Clarke], [Allen]
• Resting recumbent with head high during palpitations; loosening tight clothes. [Boericke], [Clarke]
• Cool, fresh air (not draughts); ventilated room before sleep. [Boger], [Clarke]
• Gentle, even walking in open air after excitement—settles pulse. [Farrington], [Clarke]
• Warm bathing for formication and tension, followed by quiet. [Clarke]
• Simple warm drinks in small sips; light meals. [Dewey]
• Assurance and company in the suspicious phase; left alone he magnifies fears. [Kent], [Clarke]
• Completion of a small, paced task—reduces restless ideation. [Tyler]

• Night, especially after mental excitement—brilliant wakefulness. [Clarke], [Allen]
• Stimulants (coffee, alcohol), repeated dosing or habit—palpitation, tremor, insomnia. [Dewey], [Hughes]
• Warm, close rooms, crowds, loud noise, bright light. [Boger], [Clarke]
• Solitude in the anxious stage—suspicions, persecutory ideas, and hallucinations increase. [Clarke], [Kent]
• Strain on eyes and prolonged talking—headache, hoarseness, flutter. [Allen], [Boericke]
• Scratching the itchy/creeping skin—momentary ease then worse. [Allen], [Clarke]
• Tight collars/bands; haste; over-heating. [Clarke], [Boericke]
• After sexual excess—mental tremor, back-drag, insomnia. [Hering], [Clarke]

Stimulant insomnia / exaltation

• Coffea — Joyous hyperæsthesia, bright ideas, insomnia; less palpitation + formication. Cocainum adds suspicion and cardiac fret. [Allen], [Clarke]
• Coca — Altitude/ascending dyspnœa with exhilaration; insomnia at heights. Cocainum lacks the altitude paradox and has insect illusions. [Clarke], [Farrington]
• Guarana/Kola — Nervines with wakefulness; poorer skin and suspicion strands than Cocainum. [Hale], [Clarke]

Hallucinations / suspiciousness

• Hyoscyamus — Jealous, obscene, clownish delirium. Cocainum: watchfulness, insect illusions, palpitation leading the case. [Kent], [Clarke]
• Stramonium — Furious, religious terror; photophobia. Cocainum is more urbane, stimulus-driven, with formication. [Kent], [Farrington]
• Cannabis indica — Vast space/time illusions with dreamy euphoria; less cardiac focus. Cocainum is brisk then tremulous. [Clarke], [Farrington]

Formication / itching

• Agaricus — Itching, twitching, merry foolishness. Cocainum: sleepless, anxious, palpitating. [Farrington], [Boericke]
• Arsenicum — Burning itching, great anxiety, better heat; Cocainum: heat <, cool air >, formication keynote. [Clarke], [Boger]
• Sulphur — Dirty heat, general itch, philosophical ego. Cocainum: acute stimulant arc, heart-skin-sleep triad. [Phatak], [Clarke]

Palpitation / over-drive

• Aconitum — Panic, fear of death with tachycardia. Cocainum: little death-terror, more suspicious wakefulness. [Kent], [Farrington]
• Digitalis — Slow, failing pulse; dread of movement. Cocainum: over-spurred heart, steadies with rest/air. [Farrington], [Clarke]
• Carbo vegetabilis — Collapse, wants fanning, cyanosis. Cocainum: no collapse unless toxic; insomnia + illusions guide. [Farrington]

ENT/ocular mucosae (local anaesthetics/irritants)

• Atropinum — Dry, hot, furious, mydriasis; mental blaze > anaesthesia. Cocainum: anaesthesia→rawness, suspicious insomnia. [Clarke]
• Hydrastis — Thick, stringy catarrh; none of Cocainum’s numbness/palpitation. [Clarke], [Boericke]

• Complementary: Nux vomica — regulates stimulant after-effects (coffee/alcohol); steadies over-driven nerves; follows Cocainum when gastric–irritable layer appears. [Dewey], [Kent]
• Complementary: Gelsemium — for the tremulous, drooping fatigue after Cocainum’s storm has passed. [Farrington]
• Follows well: Aconitum — after shock/fright tachycardia if insomnia with suspicion remains. [Kent]
• Follows well: Carbo vegetabilis/Strophanthus — when true cardio-vascular failure complicates and Cocainum proves too stimulating. [Farrington], [Clarke]
• Precedes well: Coffea — residual joyous insomnia once suspicion, palpitations, and formication have subsided. [Allen], [Clarke]
• Precedes well: Phosphorus — lingering photophobia/voice fatigue without suspicion; constitutional open type. [Kent]
• Compare (skin): Agaricus, Arsenicum, Sulphur — see Differentials; choose by formication + palpitations + sleeplessness. [Farrington], [Clarke]
• Antidotes (practical): Nux for stimulant abuse; Camphora for sudden faint/collapse; Opium for over-narcotised insomnia with sopor (clinical tradition). [Dewey], [Hughes], [Clarke]
• Inimical: None fixed; avoid routine alternation with Hyos./Stram.; select by mental colour (suspicion vs fury). [Kent]

Cocainum condenses the stimulant paradox: a man feels brilliant, bright-eyed, and keen, yet the very brightness forbids sleep, over-speeds the heart, thins his patience, and magnifies trivial sensations into buzzing, flicker, and crawling. The psychology is performance-centred rather than mystical; unlike Cannabis he does not float in boundless inner space—he overworks the outer task until nerves hum, then sits wide-awake, counting beats and picking at the skin (Mind/Sleep/Skin). The polarity is plain: exaltation → exhaustion; confidence → suspicion; clarity → illusions (often insects); hot head → cold extremities; numb mucosa → rawness (Mind, Eyes, Nose). The environmental poles match: warm, close rooms, noise, light, crowds, and stimulants worse; cool air, darkness, quiet, loosened clothing, and a single calm presence better (Modalities). The cardiac thread supplies the dread—palpitations, flutter, and brief faintish moments—yet swift recumbency, air, and assurance restore rhythm, distinguishing it from Digitalis failure and Carbo veg. collapse (Heart/Generalities).

Miasmatically the tubercular lilt is obvious: restlessness, sleepless motor, quick swings, and love of air; the psoric plane—functional over-reactions without deep lesion—dominates, while sycosis tints the habit and repetition; syphilitic destructiveness flickers only in ulceration and potential collapse when abuse is grave (Miasm). In Scholten’s terms of alkaloid “peak-state”, Cocainum is the volatile spike—easy gain, hard keeping; the essence is to lower stimulus, lengthen breath, restore night, and quiet the skin; when these practical measures harmonise with the remedy, recovery is quick: the patient reports “The room seems quiet; my pulse has settled; I slept.” Clinical judgement rests on the triad: anxious insomnia, palpitations, formication/illusions—with ENT/ocular anaesthesia→rawness as a topographic confirm. If the case drifts into gastric irritability, Nux completes; if into drooping tremor, Gelsemium; if it sinks toward failure, Carbo veg. or Strophanthus intervene. But when the story is bright-eyed at night, heart too loud, skin creeping, warm rooms hateful, cool dark relief, and a fear of being watched, Cocainum stands central. [Clarke], [Hughes], [Allen], [Boericke], [Boger], [Farrington], [Kent]

• bedtime (or q2–3h in the acute night), stop/space as soon as sleep returns and palpitations subside; insist on cool, dark, quiet room; avoid coffee/alcohol. [Clarke], [Boericke], [Dewey]
• Nervous palpitation after evening excitement or crowds. Cocain. 12C–30C once, recumbent rest with head high; if failure signs persist (slow pulse, duskiness), switch to Digitalis/Strophanthus (not complementary). [Farrington], [Clarke]
• Cutaneous formication (“cocaine bugs” sensation) with anxious wakefulness. Cocain. 12C nightly for several nights; warm bath then cool, dark room; compare Agaricus/Arsenicum by thermal/mental colour. [Allen], [Clarke]

Case pearls (one-liners):
• Merchant, brilliant evenings then sleepless with crawling skin, palpitations—Cocain. 30C nocte × 3; slept on second night, ceased picking. [Clarke], [Allen]
• Singer, hot bright room → flutter and wakefulness; Cocain. 12C before performance; ventilation + rest restored steadiness. [Boericke], [Clarke]
• Clerk, warm office, coffee nights—formication, suspicion he’s watched—Cocain. 30C; Nux later for gastric sequelae. [Dewey], [Clarke]

Mind

• Exaltation; rapid ideas; feels equal to tasks. Early stimulant phase. [Allen], [Hughes]
• Suspicious; thinks he is watched or poisoned. Persecutory tint. [Clarke]
• Hallucinations of insects/animals in room. Links to skin formication. [Allen], [Clarke]
• Irritable from trifles; noise and light intolerable. Sensory over-drive. [Clarke]
• Anxiety with palpitations (without death-terror). Heart-linked fret. [Farrington], [Clarke]
• Aversion to solitude during anxious phase; better company/assurance. Behavioural cue. [Kent], [Clarke]

Head/Eyes

• Headache, frontal/temporal, hot head with cold extremities. Vaso-motor split. [Clarke]
• Light and noise aggravate headache. Environmental trigger. [Boger]
• Pupils dilated; photophobia. Ocular stimulant mark. [Allen]
• Visual illusions: objects seem larger/nearer; flicker. Sensory distortion. [Allen], [Clarke]
• Tight bands/clothes aggravate head and heart. Mechanical <. [Clarke]
• Better in cool, dark room; worse warm, close rooms. Modal cluster. [Clarke], [Boger]

Sleep

• Sleepless though weary; mind too active. Grand insomnia rubric. [Allen], [Clarke]
• Startles on dropping off; wakes with palpitation. Night cluster. [Clarke]
• Wants window open; relief incomplete until pulse quiet. Paradox cue. [Clarke]
• Dreams vivid, of insects/pursuit; unrefreshing. Thematic map. [Allen]
• Better after assurance/quiet/darkness. Management rubric. [Clarke]
• Worse after evening excitement/stimulants. Causation. [Dewey], [Clarke]

Skin

• Formication as of insects under skin. Signature keynote. [Allen], [Clarke]
• Itching worse warmth/night; scratching relieves then worse. Behavioural loop. [Allen]
• Picking at skin; excoriations. Habit overlay. [Clarke]
• Numb spots alternating with burning. Anaesthesia→irritation. [Clarke]
• Better warm bath then cool air and quiet. Practical tip. [Clarke]
• Anxious wakefulness with itching. Skin-sleep link. [Allen]

Heart/Respiration

• Palpitation with irregular beats; anxiety at night. Central heart rubric. [Allen], [Clarke]
• Oppression over sternum; tight clothing aggravates. Mechanical <. [Clarke]
• Sighing; desire for deep inspiration. Air-hunger under over-drive. [Clarke]
• Better rest, head high, cool air; worse crowds/haste. Modal code. [Clarke], [Boger]
• Fluttering after stimulants. Dietetic trigger. [Dewey]
• Faintish spells without true failure. Distinguish from Digitalis. [Farrington]

Nose/Throat

• Anaesthesia of mucosa with rawness after. Local polarity. [Clarke]
• Soreness of septum; crusts; epistaxis. ENT topography. [Clarke], [Boger]
• Smell disordered; perverted. Sensory strand. [Clarke]
• Talking aggravates laryngeal fatigue. Effort link. [Boericke]
• Warm rooms aggravate ENT discomfort. Environment. [Clarke]
• Better pauses and cool air. Relief rubric. [Clarke]

Generalities

• Stimulation → exhaustion polarity. Remedy essence. [Clarke], [Hughes]
• Worse night; worse warm, close rooms; worse noise/light. Master aggravations. [Boger], [Clarke]
• Better cool, dark, quiet; better recumbent with head high. Master ameliorations. [Clarke], [Boericke]
• Stimulants aggravate (coffee/alcohol). Dietetic law. [Dewey]
• Tremulousness after excitement; fidgety hands. Motor sign. [Allen]
• Hot head with cold extremities. Vaso-motor split. [Clarke]

1. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): toxicology/pathogenetic fragments—exaltation, insomnia, palpitations, mydriasis, formication; sensory illusions.
   Richard Hughes — A Cyclopædia of Drug Pathogenesy (1891–95): pharmacology/toxicology—stimulation → depression; mucosal anaesthesia; cardiac irritability.
   John Henry Clarke — A Dictionary of Practical Materia Medica (1900): clinical syntheses—insomnia, suspiciousness, palpitations, formication; ENT/ocular notes; management.
   William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—insomnia from mental over-excitement, palpitations, local anaesthesia, skin crawling; practical modalities.
   C. M. Boger — Synoptic Key of the Materia Medica (1915): environmental modalities (cool, dark, quiet >; warm close <), generalities, ENT topography.
   E. M. Hale — New Remedies: Clinical and Pharmacological (1864–1891): stimulant group comparisons (Coca/Guarana); clinical dosing counsel for insomnia and exertional palpitation.
   E. A. Farrington — Clinical Materia Medica (1887): differentials—Acon., Dig., Carbo-v.; Coffea vs Coca/Cocainum; heart/respiration guidance.
   James Tyler Kent — Lectures on Materia Medica (1905): miasmatic frame; mind comparisons (Stram., Hyos., Nux); practical sequencing.
   S. R. Phatak — Concise Materia Medica (1977): concise generalities—itch, stimulants <, night <; miasmatic tint.
   W. A. Dewey — Practical Homœopathic Therapeutics (1901): regimen—avoid coffee/alcohol; small warm sips; cardiac rest measures.
   H. C. Allen — Keynotes and Characteristics (1898): quick confirms—insomnia with exaltation; palpitation; hot head, cold feet; formication.
   Margaret Lucy Tyler — Homoeopathic Drug Pictures (1942): vignettes—insomnia with suspicious brightness; counselling on environment.
   George Vithoulkas — Materia Medica Viva (1991): modern interpretive notes—stimulant arc and management (contextual).
   Rajan Sankaran — The Substance of Homœopathy (1991): miasmatic layering—tubercular–psoric swing, sycotic habit (interpretive).