historyWellcome Collection1880s · Vienna, Austria
Victorian doctors hailed cocaine as the first safe local anaesthetic for surgery
In 1884 the Viennese ophthalmologist Karl Koller showed that a cocaine solution applied to the eye numbed it, the first effective local anaesthetic. Before that, surgery relied on general anaesthetics like chloroform and ether, which carried a real risk of death and were feared by patients. Cocaine could be rubbed onto skin or injected, numbing one area while the patient stayed awake. Within six months the British Medical Journal had run over 60 articles on it, and doctors praised it as the answer to surgery's pain problem. Its popularity soon spread to cold remedies, seasickness treatments and even cosmetic surgery.
Cocaine blocks sodium channels in nerve cells, so the electrical signals that carry pain cannot fire. That local numbness is why it could be used on the eye or skin without putting the patient to sleep, unlike general anaesthetics that act on the whole brain.
It shows how a medical breakthrough can be celebrated before its harms are understood, and how cocaine's reputation swung from medical marvel to symbol of addiction. The local anaesthesia it pioneered led to safer surgery, and later drugs such as lidocaine replaced cocaine for most uses.
Coca-Cola's original 1886 recipe included extracts of the coca leaf.
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Cocaine is a central nervous system (CNS) stimulant and tropane alkaloid, derived primarily from the leaves of two coca species native to South America: Erythroxylum coca and E. novogranatense. The leaves are processed into cocaine paste, a crude mixture of coca alkaloids, from which cocaine base is isolated and then converted to cocaine hydrochloride. Although total synthesis is possible, it is complex and not used for production. Historically, cocaine was a standard topical medication used as a local anesthetic with intrinsic vasoconstrictor properties. However, its high abuse potential, adverse effects, and cost have limited its medical use and led to its replacement by alternative medicines.
Street cocaine is commonly snorted, injected, or smoked as crack cocaine; its effects last up to 90 minutes depending on the route of administration. Pharmacologically, cocaine acts as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI), producing reinforcing effects such as euphoria, increased alertness, concentration, libido, and reduced fatigue and appetite.
From Wikipedia: Cocaine (CC BY-SA 4.0) ↗
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Wellcome Collection · CC BY 4.0
Illustrative photo · The Drug Users Bible, CC BY 2.0, via Wikimedia Commons
