COCAINOMANIA, OR COCAINE HABIT.
Definition.—Cocainomania is an irre sistible craze, crave, or impulse to intox ication by cocaine, or any of its salts or combinations, at all risks. -Unless a cure of the "habit," or, more accurately, the disease of cocainonmnia be effected, the cocaine habitue cannot refrain from resorting to the employment of the drug, if a supply can possibly be procured, whenever the craze, crave, or impulse seizes upon him.
Varieties.—The two leading types of the cocaine habit are (1) periodical; (2) continuous. In the former the habitue will, after an outbreak of cocaine intoxication, go on without cocaine in any form for a longer or shorter interval, till a condition of mental unrest, aris ing sometimes apparently from within, ushers in a period of more or less com plete temporary abandonment to the drug. Sometimes the outburst is in augurated by a recurrence of the acute pain, or the asthma, or other physical trouble, for the assuagement of which the poison was originally taken. In some highly-strung women the menses act as the exciting provocative, partic ularly when accompanied by acute dys menorrhcea. In the latter variety, the continuous, the unfortunate victim keeps on steadily taking the drug daily in rapidly-increasing quantities till he or she is rendered incapable of exertion, sometimes of connected thoug,ht, by ad vancing paralysis or by insanity. In some instances the indulgence is social, in others solitary, the latter being the rule and the former the exception. Some variation is observable when co caine addiction is associated with alco holic or other narcotic indulgence. In this way the addiction may be double, triple, or fourfold: twofold, as alcohol I or morphine with cocaine; threefold, as with alcohol and chloral; fourfold, as , with alcohol, morphine, and chloral.
Symptoms.—On taking a fresh dose, in chronic cocainomania, there are, gen erally within ten minutes, exuberance of spirits, quickened pulse, general accelera tion of the circulation, talkativeness, , restlessness, hallucinations, with rapid and somewhat spasmodic breathing, in tense joyous activity, and a remarkable overconfidence in one's capacities and strength. Even when actually weaker, during the cocaine-delirious intoxica tion, the taker feels infinitely stronger ' and more agile. Occasionally there is ; vertigo, with some confusion of the in tellectual faculties. There is usually great cerebral excitement, with dilated pupils, throat dryness, and headache, the last named frequently not severe enough to be painful. There is a rise of tem perature, with a loss of the sense of time, ' though memory is usually intact. De
pression and prostration follow very often. When the dose has been rela- , tively moderate,—i.e., not larger than the cocaine-taker has been gradually accus tomed to take,—the period of nervous hyperexcitation has passed away by from half an hour to two hours. When the close taken has been relatively immod erate, the depression and nervous debil ity may remain for days or till the next dose.
In chronic cocaine poisoning, though some habitual cocainists do not appear to show any symptoms of injured health or vigor, others appear wasted, with pale yellowish skin, the extremities clammy, with cold perspiration. The eyes are glistening, and sunken with dark, sub ocular rings, the pupils being dilated. Anorexia and impaired digestion are present, with palpitation, dyspncea, tin nitus aurium, tremors, neurasthenia, and uncertainty of step. Hallucinations, especially of sight and. hearing; mis trust; delusions of persecution; and general paralysis sometimes end the scene. Yet, in some cases, one sees occa sional spells of brightness, brilliance, and mental activity.
[The effects of chronic cocaine intox ication are as follows: Physically there is the rapidly-developing marasmus so characteristic of chronic cocaine intox ication. Psychically we find feelings of apprehension; delusions, chiefly of per secution; and hallucinations, visual or sensory. Frightful forms appear every where, or small living things creep upon the skin. Insomnia, loss of appetite, and impotence complete the picture of cocainism. OBERSTEINER, COTT. Ed., An nual.] Three cases of chronic cocainism in which the predominant symptoms were those relating to general sensibility, con sisting chiefly of hallncinations produc ing a sensation as if foreign bodies were under the skin. The first, a merchant aged 48, was continually scraping his tongue, imagining that it was filled with small, black worms, and picking the skin to find choleraic microbes. The second, a pharmacist, attempted to ex tract microbes from his skin with his nails and with a needle. The third, a. physician, sought for crystals of cocaine under the skin. Hallucinations of cu taneous sensibility are first to develop; hallucinations of vision, hearing, taste, and smell occur later. Disturbances of ideation, as delirium, are consecutive to the hallucinations. The latter are less active than those produced by alcohol or absinthe. Epileptiform attacks oc curred with two of the patients and cramps in the third. Toxic epilepsies, when there is no predisposition, disap pear with the cause. Magnan and Saury (La Tribune Medicale, Feb. 3, Mar. 2S, '89).