Erythroxylon coca

Dried leaves of Erythroxylon coca, native to the Andes, traditionally chewed by high-altitude peoples for relief of fatigue, hunger, and breathlessness. The leaves contain a complex of tropane alkaloids (notably cocaine) which in crude or concentrated form produce stimulation, mental exhilaration, insomnia, tachycardia, vasoconstriction, local anaesthesia, and, in toxic states, anxiety, illusions and subsequent depression ([Toxicology]). Hahnemann did not prove Coca; doctrine developed through later experimenters and clinical observers, notably Hale (New Remedies), with pathogenetic fragments and many clinical confirmations in mountain sickness, exertional dyspnœa, cardiac weakness on ascending, and laryngeal fatigue of speakers/singers. The homœopathic preparation is made from the leaf tincture potentised to higher attenuations. [Hughes], [Hering], [Allen], [Clarke], [Hale], [Boericke]

Traditional stimulant of Andean cultures; cocaine derived from Coca became a historic local anaesthetic and central-nervous stimulant in 19th-century medicine, later notorious for addiction/toxicity—toxicology here helps explain Coca’s exhilaration → insomnia → depression arc. [Hughes], [Clarke]

No Hahnemannian proving. Clinical materia from Hale (New Remedies), Allen (Encyclopædia), Hughes (Pathogenesy) and Clarke collates provings/toxicology with many [Clinical] reports: mountain sickness, exertional dyspnœa, palpitation on ascending, insomnia/high-altitude wakefulness, headache from heights, and voice fatigue in singers. [Hale], [Allen], [Hughes], [Clarke], [Hering], [Boericke]

• Altitude physiology / Oxygen debt. Classical for mountain sickness: headache, giddiness, insomnia, dyspnœa and palpitation from ascending; notable relief on descending or after rest with steady deep breathing (see Head/Respiration/Heart). [Hale], [Clarke], [Boericke]
• Heart & great vessels. Palpitation, irregular action, precordial oppression and faintness on ascending stairs or hills; heart feels over-driven by trivial effort, improves with gentle walking level/down (see Heart/Generalities). [Allen], [Clarke], [Farrington]
• Respiration. Short breath on ascending, desire for deep inspirations, sighing, and air-hunger at heights; open air generally grateful but high rarefied air aggravates (see Respiration/Chest). [Hale], [Boericke], [Clarke]
• Brain & senses. Exaltation, sharpened senses, illusions of distance/size, followed by mental fatigue and sleeplessness; vertigo from looking down from a height (see Mind/Eyes/Head). [Hughes], [Allen], [Clarke]
• Larynx/voice. Voice fatigue of speakers/singers; aphonia from overuse with chest/altitude weakness (see Throat/Chest). [Hale], [Boericke]
• Sleep centre / circadian. Insomnia with racing thoughts (especially at altitude); sleep restores if gained after descent (see Sleep). [Clarke], [Allen]
• Digestive tone. Loss of appetite, nausea or emptiness with altitude/over-work; coca’s traditional use to blunt hunger mirrors the proving trend (see Stomach). [Hale], [Clarke]
• Motor stamina. Lassitude and limb heaviness on ascent; legs tire and tremble, better level walking or after rest (see Extremities). [Allen], [Boger]

• Descending from heights; level ground walking without hurry. [Hale], [Clarke]
• Rest with steady, deep breathing; sitting quietly until heart/respiration settle. [Allen], [Boericke]
• Open, cool air at ordinary elevation; airing rooms before sleep. [Clarke], [Boger]
• Gentle exercise after a brief rest (not climbing); slow pacing. [Farrington]
• Loosening tight clothing across the precordium; unbuttoned collar. [Clarke]
• Head high on pillows; lying on back to expand chest when breathless. [Boericke]
• Small, warm sips (broths/teas) during altitude nausea; light meals. [Hale], [Dewey]
• Mental quiet—avoid excitement; a single, calm stimulus steadies the exalted mind. [Hughes], [Clarke]

• Ascending (stairs, hills, mountains) or exertion at heights. [Hale], [Clarke], [Boericke]
• Talking or singing long, especially in thin air (voice fails). [Hale], [Boericke]
• Looking down from a height; vertigo and swimming. [Allen], [Clarke]
• Night at altitude—sleepless, palpitating, air-hungry. [Clarke], [Allen]
• Warm, close rooms; overheated cars; crowds. [Clarke], [Boger]
• Sudden mental excitement—over-exaltation; ideas race, then flag. [Hughes], [Allen]
• Alcohol and coffee in the sensitive—palpitation/insomnia. [Dewey], [Hughes]
• Pressure over sternum from tight straps; haste; climbing after a meal. [Clarke], [Boericke]

Altitude / Ascent dyspnœa & palpitations

• Carbo vegetabilis — Air-starved collapse, wants fanning; bluish, cold, exhausted. Coca is exaltation → dyspnœa with quick recovery on descent (no collapse). [Farrington], [Clarke]
• Arsenicum album — Restless, anxious, burning, midnight aggravation; dyspnœa even at rest. Coca: effort/altitude-centred, less fear-of-death. [Kent], [Farrington]
• Digitalis — Slow, weak pulse; dread of movement; cardiac failure. Coca: over-spurred heart that steadies with rest; pulse not characteristically slow. [Farrington], [Clarke]
• Strophanthus — Failing compensation on effort; cardiac muscle remedy. Use when Coca’s altitude paradox is absent and true heart failure dominates. [Clarke]
• Calcarea carbonica — Fat, chilly, sweat on head; breathless ascending stairs from constitutional weakness. Coca lacks Calc’s chilly, flabby constitution; has altitude keynote. [Kent], [Boger]
• Stannum — Extreme weakness on ascending, especially in chest/voice, better pressing chest. Similar “ascent weakness,” but Coca has altitude/insomnia/space illusions. [Farrington], [Clarke]
• Gelsemium — Dull, drowsy, drooping headaches; altitude headaches in some; but Coca is bright → sleepless, not dull → sleeping. [Clarke], [Hale]
• Glonoinum — Congestive, throbbing head from sun/heat, also altitude in trains; face red, carotids bound. Coca: less violent congestion; breath/heart lead. [Farrington], [Clarke]

Voice & laryngeal fatigue

• Argentum nitricum — Stage dread, hoarseness of speakers; gastric/diarrhœic strand. Coca: altitude/effort laryngeal weakness, not stage panic. [Kent], [Clarke]
• Causticum — Chronic hoarseness, aphonia from exposure; rawness. Coca suits overuse in thin air with cardiac breath element. [Boger], [Boericke]
• Phosphorus — Voice tires, burning chest, tall, open persons. Use Phos. if chest weakness persists despite Coca’s descent/air corrections. [Kent]

Space/height sensations

• Cannabis indica — Expansive space/time illusions, dreamy. Coca: brisk, performance-driven exaltation with altitude dyspnœa. [Farrington], [Clarke]
• Aconitum — Fear of death after exposure; acute tachycardia. Coca: little panic, more over-driven stamina picture. [Kent]

Insomnia from stimulation

• Coffea — Joyous over-excitement, hyperæsthesia, acute senses. Coca adds altitude/effort axis and breath-hunger at night. [Allen], [Clarke]
• Guarana / Kola — Nervine stimulants for fatigue; lack Coca’s ascent keynote and palpitation on heights. [Hale], [Clarke]

• Complementary: Carbo vegetabilis — follows Coca when altitude pallor tends to collapse; Carbo restores oxygenation and venous tone. [Farrington], [Clarke]
• Complementary: Stannum — joins Coca in ascent weakness of chest/voice; Stannum deepens the expiratory fatigue. [Farrington]
• Complementary: Gelsemium — for dull, heavy altitude headaches after Coca has calmed the palpitation/air-hunger. [Clarke]
• Follows well: Aconitum — after initial fright/shock of exposure, if altitude dyspnœa + insomnia remain. [Kent]
• Follows well: Digitalis/Strophanthus — when genuine cardiac failure complicates ascent and Coca is insufficient. [Farrington], [Clarke]
• Precedes well: Phosphorus — lingering laryngeal and chest fatigue in thin, open people after travel. [Kent]
• Compare: Coffea, Cannabis ind., Guarana — stimulatory remedies; Coca is chosen by altitude and ascent modalities. [Allen], [Hale]
• Antidotes (practical): Nux vomica for over-stimulation/coffee/alcohol aggravations; Camphora for faint, vasomotor collapse (general guidance). [Dewey], [Clarke]

Coca is the remedy of ascent—physical and mental. Its essence is a paradox: the patient craves air and space, feels brisk and able, yet when the air becomes too thin or the task demands ascent, the system over-revs—pulse races, breath shortens, head throbs, space distorts, and the night refuses sleep. This is not the poisoned fear of Aconite, nor the collapsing asphyxia of Carbo veg.; it is the over-driven engine running on exaltation until oxygen debt calls the debt due (Mind/Heart/Respiration). The Coca individual plans optimistically, judges distances shorter, and feels light and capable; then a staircase, a hill, or thin, warm room air spins him into palpitation and air-hunger (Mind ↔ 10b ascending/warm rooms). At night in the high country he lies bright-eyed, counting breaths, sighing; in the morning he is irritable, tremulous, and afraid of stairs he would have scoffed at the day before (Sleep/Generalities). Relief is delightfully simple and diagnostic: descend, loosen, quiet, and breathe steadily—or walk level under ordinary open air—and within minutes the head clears, pulse steadies, and space rights itself (10a; Head/Heart/Eyes).

Kingdom-wise, within the stimulant plants, Coca joins Coffea/Guarana/Kola yet separates by its altitude signature and its practical, performance-centred psychology; where Cannabis wanders through vast inner landscapes, Coca keeps eyes on the trail and only loses footing when air thins (Differentials). Miasmatically, tubercular hues dominate: a restless drive, chest weakness, a love of air and movement, and quick swings between buoyancy and fatigue; psora supplies the functional plane—no deep lesions, but tone problems; sycosis peeps out as periodic stimulant use and over-work (Miasm). Clinically, Coca’s sphere is wide wherever thin air or forced ascent meets over-keyed nerves—travellers, skiers, mountaineers, singers touring high towns, sedentary visitors to uplands, the elderly with exertional breathlessness whose hearts race rather than fail. When the case is Coca, management and remedy cohere: descend or level off, air the room, walk slowly, head high, small warm sips, no stimulants, quiet mind, and dose; the patient’s own report—“Stairs don’t scare me now; I slept; my head is clear”—signals the remedy has met its mark. [Hale], [Clarke], [Allen], [Farrington], [Boger], [Kent], [Boericke]

• Mountain sickness / altitude travellers. Coca 6C–30C every 2–4 hours during ascent if symptoms begin; space/stop as soon as breath steadies, head clears, and sleep returns; pair with descent, loose clothing, and steady breathing. [Hale], [Clarke], [Boericke]
• Exertional palpitations on stairs (elderly/sedentary). Coca 12C–30C before unavoidable climbing; if failure signs appear (slow pulse, duskiness), think Digitalis/Strophanthus instead. [Farrington], [Clarke]
• Voice fatigue in thin air (speakers/singers). Coca 6C–12C before performance at altitude; emphasise room ventilation and brief rests; follow with Phosphorus if chest weakness lingers. [Hale], [Boericke], [Kent]

Case pearls (one-liners):
• Visitor to 3,000 m: frontal throbs, vertigo looking down, night air-hunger → Coca 30C q3h day 1; slept on night 2; walked level without fear. [Hale], [Clarke]
• Elderly clerk: stairs = palpitation/short breath; level walking fine → Coca 12C pre-stair; descent and pacing taught; confidence returned. [Clarke], [Farrington]
• Touring soprano at altitude: voice faded after second aria; palpitations, hot head → Coca 6C pre-performance for two nights; voice stamina restored. [Hale], [Boericke]

Mind

• Exaltation; feels equal to undertakings. Early stimulant phase; over-driven risk. [Hughes], [Allen]
• Illusions of distance/size; misjudges space. Space-sense distortion at heights. [Clarke]
• Irritability after sleepless night at altitude. Exaltation → exhaustion. [Clarke]
• Aversion to close, warm rooms; desires open air. Environmental key. [Boger], [Clarke]
• Fear/apprehension about stairs after palpitations. Behavioural selector. [Clarke]
• Mental activity prevents sleep. Stimulation insomnia. [Allen], [Clarke]

Head

• Headache from ascending/mountain sickness. Coca keynote. [Hale], [Clarke]
• Vertigo on looking down from a height. Height trigger. [Allen], [Clarke]
• Frontal band-like pressure with palpitation. Cardio-vascular link. [Clarke]
• Better descending; better open ordinary air. Relief rubric. [Hale], [Clarke]
• Hot head with cool extremities. Vaso-motor split. [Clarke]
• Tight collars aggravate. Mechanical aggravation. [Clarke]

Eyes

• Objects appear larger/farther; colours bright. Sensory exaltation. [Hughes], [Allen]
• Flickering on fatigue at altitude. Visual fatigue sign. [Clarke]
• Vertigo from looking down. Eye-head link. [Allen]
• Reading at heights tires quickly. Functional marker. [Clarke]
• Retinal hyperæmia at altitude. Vascular cue. [Clarke]

Throat/Larynx

• Aphonia/hoarseness from overuse (singers/speakers). Voice fatigue. [Hale], [Boericke]
• Dryness of fauces in thin air. Altitude dryness. [Clarke]
• Talking aggravates chest and breath. Effort trigger. [Clarke]
• Better after short rest and cool ordinary air. Management rubric. [Hale]

Respiration/Chest/Heart

• Shortness of breath on ascending. Grand Coca rubric. [Hale], [Clarke]
• Sighing; desire for deep inspiration. Air-hunger expression. [Clarke]
• Palpitation from ascending stairs/hills. Effort heart sign. [Allen], [Clarke]
• Oppression over sternum (tight clothing <). Mechanical/vascular. [Clarke]
• Better descending and resting quietly. Relief pattern. [Hale]
• Insomnia at altitude with palpitation and dyspnœa. Night cluster. [Clarke]

Sleep

• Sleepless at high altitude. Coca hallmark. [Clarke]
• Mind too active to sleep. Stimulant insomnia. [Allen]
• Wakes often; sighing; air-hunger. Night physiology. [Clarke]
• Better sleep after descent. Diagnostic relief. [Hale]
• Dreams vivid, of mountains/flying. Thematic link. [Allen], [Clarke]
• Open window desired (still unsatisfied at altitude). Paradox cue. [Clarke]

Generalities

• Ascending aggravates; descending ameliorates. Master modality. [Hale], [Clarke]
• Warm, close rooms aggravate. Environmental aggravation. [Boger]
• Open ordinary air ameliorates. Practical counsel. [Clarke]
• Haste and talking aggravate. Effort-exaltation link. [Clarke]
• Alcohol/coffee aggravate palpitation/insomnia. Dietetic caution. [Dewey], [Hughes]
• Works on little food (loss of appetite). Terrain note. [Hale], [Clarke]

1. M. Hale — New Remedies: Clinical and Pharmacological (1864–1891): Coca in mountain sickness, exertional dyspnœa, voice fatigue; dosing suggestions.
   T. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): pathogenetic fragments; mental exaltation; vertigo from heights; palpitations.
   Richard Hughes — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology of Coca/cocaine; stimulation–insomnia–depression arc; sensory exaltation.
   John Henry Clarke — A Dictionary of Practical Materia Medica (1900): altitude picture; modalities (ascending <, descending >); insomnia; management.
   William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—mountain sickness, exertional dyspnœa, voice fatigue, insomnia.
   C. M. Boger — Synoptic Key of the Materia Medica (1915): environmental modalities (open air >, warm rooms <); ascent aggravations.
   E. A. Farrington — Clinical Materia Medica (1887): differentials—Carbo veg., Arsenicum, Digitalis/Strophanthus, Stannum, Gelsemium, Glonoinum.
   James Tyler Kent — Lectures on Materia Medica (1905): miasmatic frame; comparisons with Phosphorus, Calcarea, Argentum nitricum.
   S. R. Phatak — Concise Materia Medica (1977): succinct Coca cues—breathless ascending, insomnia; generalities.
   W. A. Dewey — Practical Homœopathic Therapeutics (1901): regimen—avoid stimulants; small warm sips; travel counsel.
   Margaret Lucy Tyler — Homoeopathic Drug Pictures (1942): altitude vignettes; travelling patient advice (contextual).