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Coca Chewing and High-Altitude Stress: A Spurious Correlation [and Comments and Reply]
Author(s): Warwick Bray, Colin Dollery, Gene Barnett, Ralph Bolton, Florian Deltgen, Darna
Dufour, Joel M. Hanna, Anthony Henman, Ted C. Lewellen, Michael A. Little, E. Picón-
Reátegui, Andrew Fuchs Sillen, Linda Patia Spear, Teresa Valiente, T. G. Vitti
Source: Current Anthropology, Vol. 24, No. 3 (Jun., 1983), pp. 269-282
Published by: The University of Chicago Press on behalf of Wenner-Gren Foundation for Anthropological
Research
Stable URL: http://www.jstor.org/stable/2742662 .
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CURRENT ANTHROPOLOGY Vol. 24, No. 3, June 1983
? 1983 by The Wenner-Gren Foundation for Anthropological Research, all rights reserved 0011-3204/83/2403-0002$1.75
Coca Chewing and High-Altitude Stress:
A Spurious Correlation'
by Warwick Bray and Colin Dollery
THE RECENT DISCUSSION in these pages of the possibility of a
relationship between coca chewing and high-altitude stress
(Fuchs 1978, Bolton 1979, Burchard 1980) has concentrated
exclusively on the medical and pharmacological aspects of the
question. The central assumption-that the coca habit is
I This paper gives an outsider's (i.e., non-Andean) view of coca
chewing. Its genesis goes back to 1977, when one of us (WB) had his
first experience of lowland coca use as a member of the Colombian
Amazonas Expedition and was at the same time reading the ethno-
WARWICK BRAY is Reader in Latin American Archaeology at the
University of London Institute of Archaeology (31-34, Gordon
Square, London WC1H OPY, England). Born in 1936, he received
his Ph.D. from Cambridge University in 1962 and was
Lecturer in European Prehistory at Sheffield University before
assuming his present position in 1967. He has directed various
campaigns of excavation in the Andes of Colombia and Ecuador
and in Colombian Amazonas. His research interests are the
archaeology and ethnohistory of Mesoamerica and the Intermediate
Area and aboriginal American technology (especially
metallurgy), agriculture, and land use. Among his publications
are Everyday Life of the Aztecs (London: Batsford, 1968); "Ancient
American Metalsmiths" (Proceedings of the Royal Anthropological
Institute for 1971, 1972); "From Predation to Production: The
Nature of Agricultural Evolution in Mexico and Peru," in Problems
in Economic and Social Archaeology, edited by G. de G.
Sieveking, I. H. Longworth, and K. E. Wilson (London: Duckworth,
1975); "From Foraging to Farming in Ancient Mexico,"
in Hunters, Gatherers, and First Farmers outside Europe, edited by
J. V. S. Megaw (Leicester: Leicester University Press, 1977); and
The Gold of El Dorado (London: Times Books, 1978).
COLIN DOLLERY iS Professor of Clinical Pharmacology at the
Royal Postgraduate Medical School (University of London) and
Consultant Physician at Hammersmith and Ealing Hospitals. He
was born in 1931 and educated at the University of Birmingham
(B.Sc., 1953; M.B., Ch.B., 1956). His research interest is drug
action in man, especially that of drugs with effects upon the heart
and circulation. His publications include, with M. J. Brown, D. A.
Jenner, and D. J. Allison, "Variations in Individual Organ Release
of Noradrenaline Measured by an Improved Radio-enzymatic
Technique: Limitations of Peripheral Venous Measurements in
the Assessment of Sympathetic Nervous Activity" (Clinical
Science 61:585-90); with I. A. Blair, S. E. Barrow, K. A. Waddell,
and P. J. Lewis, "Prostacyclin Is Not a Circulating Hormone
in Man" (Prostaglandins 23:579-89); with P. W. Ind, M. J.
Brown, F. J. M. Lhoste, and I. Macquin, "Concentration-Effect
Relationships of Infused Histamine in Normal Volunteers"
(Agents and Actions 12:12-16); and, with J. L. Reid, "Doubleblind
Comparison of Hypotensive, Sedative, and Salivary Flow
Effects of Lofexidine and Clonidine in Normal Subjects" (Arzneimittel
Forschung/Drug Research 32 [11] 8a: 984-87).
The present paper was submitted in final form 27 viii 82.
Vol. 24 * No. 3 * June 1983
intimately connected with the stresses of life in the high Andes
-has never been challenged. We shall argue here that this
assumption is unjustified. Ethnohistorical and archaeological
evidence indicates that, far from being purely a high-altitude
phenomenon, coca use was widespread at all altitudes before
the European conquest. This being so, the physiological benefits
from coca chewing should be of a general nature, rather than
altitude-specific. In corroboration, we cite pharmacological
data which demonstrate that coca serves as a general stimulant
rather than as a special-purpose drug.
THE BOTANY OF CULTIVATED COCA
The genus Erythroxylum includes some 250 species, whose
American distribution extends from the Rio Mayo in Mexico
eastward to the Bahamas and south into northern Argentina.
Of these, only the cultivated species contain enough alkaloid
to be worth chewing as a stimulant. Even so, the taxonomy
and history of coca are poorly understood. The archaeological
and ethnographical literature often lacks botanical precision,
and many of the early identifications at the species level are
unreliable or confusing. Since neither of us has any standing
as a botanist, we have relied very heavily on recent survey
articles by Plowman (1979a, b, 1981) for the following discussion.
Erythroxylum coca Lamarck, colloquially known as Huanuco
or Bolivian coca, is the classical coca of the Montafia, the
eastern slopes of the Andes. In the 1608 dictionary of Diego
Gonzalez Holguin and in Fray Martin de Murua's Los origenes
de los Inkas of 1600 and 1611, its Quechua name is given as
mumus or mamas coca, and it is described as a large-leafed
plant, highly prized, and cultivated in the Andes (Rostworowski
de Diez Canseco 1973). E. coca is found from Ecuador to
Bolivia along the eastern foothills of the cordillera and in the
intermontane valleys throughout the moist tropical zone at
altitudes between 500 m and 1,500-2,000 m. Only one occur-
historical literature on Colombia and the Caribbean. The second
author is a clinical pharmacologist interested in the relationship
between the action of drugs and their concentration in biological
fluids. What brought us together, and stimulated CD's interest in
the absorption of cocaine from coca leaves, was the "Gold of El
Dorado" exhibition at the Royal Academy in London (Bray 1978).
For advice, information, and help with literature we thank Bo
Holmstedt, Tony Morrison, Barbara Pickersgill, John Rowe, Richard
Evans Schultes, and Henry Wassen. Our greatest debt is to Timothy
Plowman, who read an early draft, corrected the botany, and allowed
us to read his then unpublished manuscripts.
269

ence is reported from the western slopes of the Andes, at
Sanagiiin, in the moist hills of the Ecuadorian Department of
Cafiar (Plowman 1979b:114). Within its geographical range,
several local forms are recorded, and there is considerable
variation in its alkaloid content.
A distinct form of E. coca (E. coca var. ipadfi Plowman) is
cultivated by certain tribes of the Amazon Basin down to ca.
250 m. The Amazonian variety is botanically distinct from the
Montafia form, has a much lower cocaine content, and is prepared
in powder form rather than as a quid of leaves (Plowman
1979a, 1981).
Erythroxylum novogranatense (Morris) Hieronymus is closely
related to E. coca and may well be derived from it by a process
of selection under cultivation. Wild forms are unknown. E.
novogranatense differs from E. coca in morphology, chemistry,
and ecological preferences. Whereas E. coca is adapted to the
moist and relatively cool conditions of the Montafia, E. novogranatense
will tolerate a wide range of conditions in both lowland
and montane areas and is well adapted to the hot and
seasonally dry habitats of interior Colombia, the Caribbean
littoral, and Central America. As with E. coca, the alkaloid
content is variable, but E. novogranatense differs markedly from
E. coca in having large amounts of methyl salicylate in its leaves
(Plowman 1979a, b). Under the name hayo and its local variants,
this "Colombian coca" was chewed at the time of Spanish
contact in the isthmian countries, coastal Venezuela, and
throughout Colombia. Over much of this area the custom has
now disappeared, but it persists in the Sierra Nevada de Santa
Marta (where ceramic toasting pans and pre-Hispanic clay
figurines of coca chewers show continuity with the past) and
among the Paez and the Guambiano of the Cauca and Magdalena
headwaters (Antonil 1978; Uscategui Mendoza 1954;
Bray 1978:133-37).
A second variety of E. novogranatense is the so-called Trujillo
coca, E. novogranatense var. truxillense (Rusby) Plowman, cultivated
today in the northwestern Peruvian department of La
Libertad (Plowman 1979a). The early Spanish sources quoted
by Rostworowski de Diez Canseco (1973) describe it as "a
small-leafed coca that they call tupa coca, which grows in the
Llanos [i.e., the Pacific lowlands]; this is appreciated and
esteemed by all, and accepted by the Inca" (Muriua), for
which reason it was called "royal coca" (Gonzalez Holguin).
The leaves are smaller and more delicate than those of E. coca
and have a distinctive flavor due to the high content of wintergreen
oil and other compounds. Trujillo coca exists only as a
cultigen, since, although drought-resistant and adapted to
desert conditions, it depends on irrigation for its survival. It
is grown today in the dry Andean valley of the Rio Marafion,
but its principal habitat is the chaupiyunga zone of Pacific
Peru, the subtropical desert or xeric belt at altitudes between
200 and 1,200 m, where temperatures remain fairly constant
within the 18-25? C range. This chaupiyunga zone, from Trujillo
in northern Peru to Arica in Chile, was a major coca
producer in Inca times, and documentary evidence indicates
that some of these plantations go back into the pre-Inca period
(Rostworowski de Diez Canseco 1973, Netherly 1975).
Leaves of Trujillo coca are tentatively identified from archaeological
deposits much older than the Inca expansion
(Towle 1961:60). Plowman notes that all the archaeological
coca specimens he examined from coastal sites are Trujillo coca,
and he suggests that occasional reports of E. coca in the older
literature (summarized by Towle) are misidentifications.
Attempts at reconstructing the evolutionary history of coca
point to the Peruvian Montafia as the botanical center of origin
(Plowman 1981, Rury 1981). The Montafia zone is the natural
habitat of E. coca, and the shrub has probably been cultivated
in this region for thousands of years. Today E. coca is rarely
found in a truly wild state, though semiwild or feral bushes are
not uncommon on the eastern slopes of the Andes. This variety
of coca appears to be the form from which all the others ulti-
mately derive. Bohm, Ganders, and Plowman (1982) indicate
that E. coca var. coca is the ancestral taxon, Trujillo coca
(E. novogranatense var. truxillense) derives from this, and Colombian
coca (E. novogranatense var. novogranatense) derives in turn
from Trujillo coca. These three taxa therefore represent a linear
evolutionary series with considerable time depth. Amazonian
coca (E. coca var. ipadfu) represents a separate line of development,
with an independent derivation from E. coca var. coca.
The present distributions of the cultivated varieties of coca
are allopatric; each has its own distinct range, and there is virtually
no overlap. Botanically, as well as culturally, Colombia
and the Caribbean stand out as a coca-chewing province quite
separate from that of the Central Andes-topographically and
climatically unlike the altiplano, lacking in E. coca, politically
outside the area of Inca control, and never significantly influenced
by Peru.
In Peru/Bolivia we must distinguish between a western
region with E. novogranatense and an eastern, Montafna, province
with E. coca. The ethnohistorical record makes it abundantly
clear that the inhabitants of the altiplano, above and
midway between these producing regions, were importing coca
on a large scale from both eastern and western plantations. In
a single region, several varieties of leaf are likely to have been
in circulation during Inca times and probably long before that.
The same dual pattern of eastern and western coca sources
extends into Ecuador, though botanical information is scant
(Plowman 1979b). Documents show that both the.eastern and
western yunga zones of Ecuador were contributing coca leaves
to the highlands at the time of the Inca conquest. In the Quito
region, for example, the pre-Inca rulers maintained formal trade
links with the coca-growing zones of the Chota Valley on the
Pacific side and with the Quijos/Pastaza region east of the
cordillera (Salomon 1978). Plowman has recently found E. novogranatense
growing near the Ecuadorian frontier, in the wet
montane habitat of the Pacific slopes of the Andes from 1,450
to 2,000 m, and also at sea level near the Colombian port of
Tumaco (Plowman 1979a: 58). Just across the border from
Tumaco, in Ecuadorian Esmeraldas, Fray Gaspar de Torres
reported that the Cayapa were using coca in 1596 (Alcina
Franch and de la Pefia 1976:26, 32, 35). The Cayapa still cultivate
coca and provide a rare instance of the survival of coca
chewing in the Pacific lowlands.
This survey shows that none of the varieties of coca can be
considered a high-altitude plant and that many varieties are at
home in lowland conditions. Given such botanical and cultural
complexity, it seems unwise to generalize about the effects of
coca chewing from studies of a few altiplano Peruvian and
Bolivian populations who today use only E. coca. When the
anthropological and archaeological evidence is examined in
more detail, the assumption that coca chewing is, or was,
primarily a response to high-altitude stress begins to seem very
weak indeed.
THE DISTRIBUTION OF COCA CHEWING AT THE
TIME OF EUROPEAN CONTACT
Early Spanish sources provide a mass of data on coca chewing
at the time of European discovery. Much of this information
goes back to the moment of initial contact and pre-dates any
change in plant distributions or trade patterns under Spanish
rule. Most of this evidence is summarized in the Handbook of
South American Indians (Steward 1946-59) and by Patifio
(1967:201-23). Only a resume is given here. Thus, for example,
Columbus recorded the custom of chewing leaves, sometimes
with a "powder," in coastal Veraguas (Panama), while Amerigo
Vespucci left a very detailed description of coca chewing as he
saw it in 1499 in Caribbean Venezuela (perhaps in Paria, in the
far east of the country, or-more probably-the Guajira
270 CURRENT ANTHROPOLOGY

peninsula on the western frontier [Patifno 1967:202; Plowman
1981:199]):
Bray and Dollery: COCA AND ALTITUDE STRESS
They all keep their mouths filled with a certain green herb which they
ruminate, in almost the same manner as animals, so that they are
hardly able to utter a word. Also, around their necks they all of them
carry two dried calabashes, one filled with the herb which they have
in their mouths, and the other with a certain white flour like powdered
plaster, and with a little stick which they moisten and chew in
the mouth, and frequently dip into the flour calabash, they take out
enough to sprinkle on both sides of the herb which they carry, an
operation which they repeat frequently and very slowly.
to Chile and from sea level to the high Andes. Since the region
from Colombia northward is outside the area of Inca influence,
this wide dispersion is not simply a consequence of Inca expansion.
Coca chewing can therefore be expected to show a long
history of indigenous development all over this vast region.
Archaeological evidence corroborates this view.
THE ARCHAEOLOGICAL EVIDENCE FOR COCA
Observations spanning the next few decades attest to the
habit among the Nicarao of Pacific Nicaragua and all along the
CHEWING
Caribbean coasts of Venezuela and Colombia. Of the Indians Archaeology demonstrates that the 16th-century pattern outin
the Caracas area, Juan de Pimentel wrote in 1578: "they say lined above has considerable antiquity. Most of the finds of
that it takes away hunger and thirst, and gives them strength actual coca leaves are from the arid coasts of Peru and Chile,
to work, and so they use this hayo [the local name for coca] where organic materials are well preserved; elsewhere the eviwhen
they work or have to walk" (Patifno 1967:203).
dence is indirect, taking the form of stone or pottery represen-
For inland Colombia the 16th-century documents make it tations of coca chewers and examples of the paraphernalia (lime
clear that coca chewing was widespread all over the country containers, dippers, spoons) associated with coca taking.
and at all altitudes, from the Sinfu lowlands (Castellanos 1955 In coastal Peru, coca chewing first appears in the late Pre-
[1598]) through Antioquia and the middle Cauca Valley at ceramic period. At Culebras, on the central coast, Engel (1957:
around 1,000-2,000 m (Cieza de Leon 1971 [1554]) to the 67-68) excavated two burials (one of them a female) accom-
Muisca kingdoms of the altiplano at over 2,500 m (summarized panied by a gourd vessel and three Mytilus-shell containers
in Patifio 1967 and Perez de Barradas 1950-51:42-64) and filled with powdered lime. The Culebras site should be dated
southward to Popayan and to Pasto on the Ecuadorian frontier. somewhere around 2000 b.c. Coca leaves are found at Anc6n,
Of the warrior tribes of the Magdalena Valley, Vargas Machuca in the Chill6n Valley, between 1800 and 1400 b.c. (Cohen 1978:
commented in 1599 that they could keep going for three days 125), and coca-like leaves (variety unspecified) and powdered
on coca alone and also chewed it to keep awake when they were lime came from the site of Asia, in the Omas Valley of the
on sentry duty.
south-central coast, with a radiocarbon date of 1314 + 100 b.c.
The abundant information on coca chewing in Inca territory (Engel 1963).
need not be repeated here, but the data from another lowland For the ceramic period, evidence is abundant from all parts
area-the Amazon Basin-do require some consideration of the coast. At Huancayo Alto, in the chaupiyunga zone (i.e.,
(Plowman 1981). Here coca may be chewed as a quid (e.g., the coca-producing zone, between 600 and 2,000 m above sea
among the Mashco [Califano and Fernandez Distel 1977]) or level) of the Chillon Valley, Dillehay (1979) tested a group of
taken as a snuff (Schultes and Holmstedt 1968:119; Schultes storage structures dating somewhere between 800 and 200 B.C.
1981), but it is more often ingested in the form of a powder The main products stockpiled for distribution were maize, coca,
made from toasted leaves. To this powder is added an alkaline and marine shell. From the midvalley plantations, the leaf was
substance, usually an ash made from the wood, bark, or leaves presumably traded to both highlands and coast, for coca was
of certain trees or lianas (Holmstedt et al. 1979; Schultes 1981; found at the contemporary coastal site of Garagay with pottery
Plowman 1980, 1981). Coca may also be taken with tobacco resembling that of Huancayo Alto (Dillehay 1979:31 n. 17).
snuff (Califano and Fernfandez Distel 1977) or tobacco concen- From Tembladera, in the Jequetepeque Valley of northern
trate (Uscategui Mendoza 1954:283). The combination of coca Peru, comes a Chavinoid effigy pot representing a figure with
and tobacco is not confined to Amazonia. The Indians of the a quid in its cheek and dated ca. 500 B.C. (Jones 1974:4, 7).
Sierra Nevada de Santa Marta take tobacco concentrate with Another effigy jar, this one clearly showing the lime dipper, is
their coca (Uscategui Mendoza 1954:273; Reichel-Dolmatoff attributed to the Lambayeque Valley and is dated around the
1949-50:79), and some archaeological coca bags from south- time of Christ (Jones 1974:4).
coastal Peru, dating from Nazca to Inca times, contain a mix- For the last 1,500 years before the Conquest, the evidence
ture of coca leaves and what appears to be tobacco, though this from coastal Peru is too abundant to discuss in detail. There are
latter identification has yet to be confirmed by analysis (Rost- numerous representations of coca chewers on Moche and Nazca
worowski de Diez Canseco 1973:205).
pottery; Rostworowski de Diez Canseco (1973) notes a series
It is still uncertain whether coca chewing has a long history of coca bags in the Ica museum ranging from Nazca to Inca
in Amazonia or is an introduction from the Andes in late pre- periods in date; Towle (1961) and Jones (1974) list a selection
Hispanic or colonial times as Uscategui Mendoza tends to of finds, of all periods, from the south and central coasts. If we
believe. All one can say is that the custom was recorded over a had to rely on archaeological evidence alone, we could conclude
wide area at the time of first European contact. Patinlo (1967: -not necessarily correctly-that coca chewing was more
214-17) notes that the Cofanes were cultivating coca by 1560- ancient and widespread on the coast than in the Andes.
70 and that it was used by the tribes of the Rio Coca in 1662, Farther north, in coastal Ecuador, there is a late Valdivia
in the Ambiyacu region near the Amazon confluence in 1740,
and at the confluence of the Purfus and Amazon Rivers in 1774.
figurine of ca. 1600 B.C. depicted with a quid in its cheek and
also a series of Valdivia lime pots which push the history of coca
In the 1774 account, the Indians reported that the coca kept chewing back beyond 2000 B.C. (Lathrap, Collier, and Chandra
them awake through nocturnal ceremonies. On botanical 1975:48, 79). Inland, in the Jubones Valley at about 1,000 m,
grounds, Plowman (1981:210) believes that the development
of Amazonian coca as a distinct cultigen must have preceded
the first European reports by several centuries, and the myunpublished
excavations by Bray and Elizabeth Carmichael
have produced miniature lime-encrusted pots in Machalillarelated
deposits, one of which has a radiocarbon date of 1231 ?
thology of various tribes of the northwestern Amazon attributes 53 b.c. (BM-912). From the early centuries A.D. to the Conto
the plant an ancient and supernatural origin (Schultes 1981, quest, a group of poorly dated pottery figurines and lime pots
Plowman 1981).
from the coastal provinces of Manabi and Esmeraldas extends
In summary, the ethnohistorical evidence indicates that, at the documentation to the whole of the Ecuadorian coast
the time of European contact, coca was used from Nicaragua (Saville 1910: pl. 92.5; Jones 1974: 12; Lowe Art Museum 1981:
Vol. 24 * No. 3 * June 1983 271

nos. 98, 28, 54; Naranjo 1974). The well-known "Capu'i"
figurines, from the highlands on either side of the Colombia-
Ecuador frontier, show male personages with coca bulges in
their cheeks and may fall anywhere between the 9th century
A.D. and the Conquest (Francisco 1969; Uribe 1977-78, 1980).
In Colombia, some of the statues from San Agustin, near the
headwaters of the Rio Magdalena, apparently depict coca
chewers and in general seem to belong within the 1st millennium
A.D. (Reichel-Dolmatoff 1972). One such statue (from
Monticulo 5 at Alto de los Idolos, with a clear rendering of a
lime container and dipping stick) was associated with a tomb
which produced a radiocarbon date in the 7th century A.D.
(Cubillos and Duque Gomez 1979:120). At medium altitudes
in the Colombian highlands, the gold and tumbaga lime flasks
and dippers in the so-called Quimbaya and Calima styles seem
to fall somewhere between A.D. 1 and 1000 (Bray 1978).
From the Caribbean lowlands, the archaeological evidence is
rather scanty. Lothrop (1937:199) has published a small bone
head with a distinct coca bulge in its cheek. This item is from
Grave 32 at Sitio Conte, in the Cocle region of Panama, and
can be dated between A.D. 500 and 700. In Caribbean Colombia,
certain urns of the Moskito style from the lower Rio Magdalena
depict individuals holding gourds and dippers (Cano collection,
Bogota). The precise chronology of this Moskito style is unknown
(Reichel-Dolmatoff and Dussan de Reichel 1943).
Summarizing the archaeological information, we can say that,
predictably, the taking of coca has a long history, in some areas
going back to 2000 b.c. in radiocarbon vears or ca. 2500 B.C. in
calibrated figures. It is clear, too, that the habit was widespread
in highlands and lowlands alike. It would, indeed, be surprising
if the leaf had not been chewed in the producing areas, where
we might expect its properties to have been first discovered.
COCA CHEWING AND HIGH-ALTITUDE LIFE:
A SPURIOUS CORRELATION
In the light of the historical and archaeological data, the correlation
between coca chewing and high altitude begins to look
distinctly shaky. It appears still more dubious when one considers
the present-day distribution of the habit, from which it
is apparent that coca taking is still practised-or was, until very
recently-by residual Indian populations at all altitudes.
We suggest that the correlation between coca chewing and
high altitudes is spurious and that the link is rather between
coca use and the persistence of relatively unacculturated Indian
communities that have kept many of their traditional customs.
This proposition can be tested in a rather gross way by comparing
the reported incidence of coca chewing with the relative
"Indianness" of the corresponding populations (cf. also Lobb
1974; Burchard 1976:46).
Monge (1952) noted that coca use was nearly universal above
15,000 ft. (4,500 m), rare at 8,000 ft. (2,400 m), and virtually
nonexistent at sea level. Similar results came from observations
by Buck, Sasaki, and Anderson (1968:99) on the chewing
habits of the adult populations of four Peruvian villages at
different altitudes: 72% of the population chewed at 11,500 ft.,
28% at 5,600 ft., 29% at 3,500 ft., and only 3% at sea level.
Both sets of observations show a progressive reduction in the
coca habit with decreasing altitude. At first sight, these data
suggest a causal relationship between high-altitude life, with
its attendant stresses, and the custom of chewing coca. The
matter is not, however, quite so straightforward, for an equally
strong correlation emerges between the incidence of coca taking
and the degree of Indianness of the chewers, irrespective of
altitude.
As a criterion of Indianness we can take the use of Quechua
or Aymara speech, since this is a purely cultural phenomenon
that is not physiologically altitude-dependent in any way.
Linguistic information is not normally categorized by altitude
zone, but the general trend can be reconstructed from the
figures for individual departments. Table 1 gives this information
for Peru, as recorded in the 1940 census, reproduced by
Mishkin (1946:412), and discussed in detail by Rowe (1947).
These 1940 figures avoid the distortions resulting from modern
development and just pre-date the start of the great "coca
debate" of the late '40s and early '50s.
Although no department falls entirely within a single altitude
zone, the general trend of the statistics is clear. The central and
southern Andean departments from Ancash to the Bolivian
frontier (i.e., the classical coca-chewing areas), show a very
high incidence of indigenous speech. Junin, although less than
half its territory lies above 3,000 m, has most of its population
in the Andean zone and is markedly bilingual. The coastal
departments cluster at the bottom of the list, with La Libertad
(a major coca producer in Inca times) one of the lowest. The
middle ranges of the table, from Moquegua to Tacna, are rather
more difficult to evaluate. The Amazonian departments (San
Martin, Loreto, and Amazonas) are almost certainly more
Indian than the figures suggest, for speakers of "forest languages"
are grossly underrepresented in the census returns
(Rowe 1947:211-13). Arequipa and Moquegua are unusual in
that they stretch from the high Andes to the Pacific coast;
their figures represent an averaging out of a high incidence of
native speech in the highland provinces with a low percentage
on the coast (Rowe 1947: table 1). Further distortions are
introduced by the presence of large cities.
With these limitations in mind, the linguistic figures show a
pattern resembling the ones for coca chewing. Although his
ordering of the departments is slightly different from ours, Lobb
(1974:928) presents a broadly similar ranking. Cuzco is the
most Indian department in his scheme, followed by Ayacucho,
Puno, Ancash, Apurimac, Huancavelica, Junin, Huanuco, and
Pasco. All lines of evidence suggest that the use of coca is as
TABLE 1
NUMBER OF SPEAKERS OVER FIVE YEARS OF AGE OF
INDIGENOUS LANGUAGES, BY DEPARTMENT, AND
PROPORTION OF TOTAL POPULATION, 1940
NUMBER OF SPEAKERS INDIGE-
NOUS-
Quechua TOTAL LAN-
Quechua and POPU- GUAGE-
DEPARTMENT only Spanish Aymar6a LATION SPEAKERS
Apurilmac ...... 186,448 28,819 ... 216,243 99.5
Ayacucho ...... 246,947 49,942 ... 299,769
Huancavelica. . 160,153 40,434 ... 203,128
Cuzco.... 326,238 77,378 61 411,298
Puno .......... 210,236 40,736 176,129 463,080
Huanuco ....... 97,557 68,125 ... 193,235
Ancash ......... 194,888 105,135 ... 354,892
Junin .......... 112,397 169,921 ... 361,878
Moquegua ...... 4,414 3,856 2,651 29,034
Arequipa ....... 37,817 38,347 817 225,244
San Martin..... 9,580 15,662 ... 77,197
Loreto ......... 8,881 34,527 ... 137,932
Amazonas ...... 1,715 9,970 ... 53,982
Tacna..... 13 391 5,085 31,684
Ica ............ 2,157 14,982 ... 118,371
Lima ...... .. 17,072 81,814 ... 721,818
Madre de Dios.. 92 465 ... 4,098
Lambayeque ..... 4,562 6,856 ... 162,967
Cajamarca ...... 3,368 21,808 ... 405,795
Callao. ...... ... 3,903 ... 72,295
I
La Libertad
I.A534 3,493 ... 319,514
Tumbes ...... . . 96 . ... 21,212
Piura ...... 87 306 ... 343,357
99.0
98.7
98.1
92.2
85.7
84.5
78.0
37.6
34.4
32.7
31.5
21.6
17.3
14.4
13.7
13.6
7.0
6.2
5.4
1.3
0.45
0.1
SOURCE: Adapted from Mishkin (1946 :412).
272 CURRENT ANTHROPOLOGY

much a cultural phenomenon as a biological one, related more
to Indianness than to high-altitude life.
Similar conclusions can be drawn from the Bolivian contributions
to the 1980 Interamerican Seminar on Coca and Cocaine
(Jeri 1980), based on a large-scale survey of the highland
departments of La Paz, Potosi, Oruro, Cochabamba, Chuquisaca,
and Tarija, some of which also include coca-producing
lands in the tropical yunga zone east of the Andes. The main
conclusions of this survey (Sandagorda 1980, Carter, Parkerson,
and Mamani 1980) are as follows: (a) Coca enters into all aspects
of life-as a stimulant, medicine, and digestive, as a component
of oracle taking and various rituals, and as a "social
lubricant" in general. In other words, coca is not merelv a
drug, but also a symbol of ethnic identification. (b) Coca chewing
is significant also in the tropical cantons, attaining altiplano
levels of importance in the producing areas of Yungas and
Apolo. (c) On the altiplano and in the montane valleys, the
highest proportions of coca chewers are found in the more traditional
villages, especially in those areas that are physically
isolated from modernizing influences. Conversely, the people
least likely to chew are those whose traditional culture has been
eroded by membership of an evangelical sect or by exposure to
education. It is difficult to fault these authors' statements that
coca chewing "has separated those who are proud of their traditions
from those who only want to be identified with the
European or Occidental world" (Sandagorda 1980:152) and
that the traditional use of coca "is apparently more a question
of cultural heritage than of adaptation to the rigors of high-altitude
life" (Carter, Parkerson, and Mamani 1980:159).
One virtue of this interpretation is that it accounts for the
coca users of Amazonia, so often ignored or dismissed in the
physiological arguments. In terms of our reasoning, the taking
of coca in Amazonia is not at all aberrant. It is, in fact, predictable
and is an essential element in the discussion. In Peru,
Ecuador, and Bolivia today, the least acculturated groups live
predominantly in the high Andes and, to a lesser extent, in the
eastern tropical forests-the two regions in which coca use is
most prevalent. For reasons which are beyond the scope of this
paper but are touched on briefly by Rostworowski de Diez
Canseco (1973), the lands along the Pacific coast rapidly lost
their Indian character soon after the European conquest.
Under colonial administration the same fate overtook most of
the lowland tribes of Central America and the Caribbean as a
result of physical extinction, mestizaje, and cultural absorption.
One casualty of this process was the custom of chewing coca.
The modern situation is not, therefore, an accurate reflection
of pre-European conditions. In aboriginal times, coca chewing
was not exclusively a high-altitude habit. Without denying that
coca may confer certain benefits at high altitudes (or that these
benefits might include those discussed by Fuchs in his 1978
article), logic requires that we look for some benefit-real or
merely perceived-to be derived from coca chewing at all altitudes.
At this point, as Burchard (1976) emphasizes, the term
"benefit" must be broadened to include the economic, social,
and psychological aspects of coca chewing in the setting of
Indian culture.
Returning to physiological matters, and taking the (possibly
naive) view that Indian informants mean more or less what
they say, we find an impressive uniformity in their response to
European enquiries from the 16th century to the present day.
As Vazquez de Espinosa (1942 [1629]:475) wrote of the province
of Jauja, in the Peruvian Andes, "the Indians value it
[coca] highly; with it in their mouths, they do not feel hunger,
thirst or fatigue; in short, this plant is for them what tobacco
is for its devotees." (His reference to tobacco seems no more
than a lucky shot, since there is no other indication that he
knew of tihe links between coca and tobacco use-though he
liked the comparison well enough to use it once more when
talking about the coca plantations at Timana, in Colombia
[p. 345].) Again and again, the reports come back to the same
Bray and Dollery: COCA AND ALTITUDE STRESS
things; coca helps people to stay awake and confers resistance
against hunger, thirst, and muscular fatigue, as well as producing
a degree of euphoria and mental excitement. In addition,
coca had, and frequently has today, a reputation as an aphrodisiac
(at least, in the early years of use) and as a remedy for
diseases of the teeth and gums, respiratory troubles, soroche
(mountain sickness), rheumatism, headaches, indigestion,
stomach pains, and a long list of other ailments (Martin 1970,
Patifio 1967, Jeri 1980). In several of these treatments, its
main value seems to have been as a local anaesthetic. With the
exception of soroche and perhaps the respiratory difficulties, the
diseases on the list have no connection with the particular
stresses of life at high altitudes. Identical reports on the principal
uses of coca come from all periods, all regions, and all
altitudes-from the Caribbean lowlands, from middle altitudes
in Colombia (Cieza de Leon 1971 [1554]: chap. 96), and from
the Amazon Basin, as well as from the Andean altiplano well
above the coca-growing belt. At least at the level of anecdote
and personal conviction, if not of pharmacological analysis, coca
chewers everywhere believe that they gain the same benefits
from the drug.
The impression, derived from European experimenters as
well as Indian informants, that coca serves as a general stimulant
(akin in some ways to caffeine and the amphetamines) is
supported by pharmacological evidence.
THE PHARMACOLOGICAL ACTION OF COCAINE
Chemically, cocaine is an ester formed from benzoic acid and a
nitrogen-containing base, ecgonine (Mansta and Holmes 1950,
Steward et al. 1979). It has two distinct pharmacological actions.
First, it is a local anaesthetic; it inhibits the propagation
of nerve impulses in pain fibres. Although once extensively used
in medicine for this property, it has been superseded by synthetic
substances such as lignocaine. Local-anaesthetic activity
probably accounts for the severe toxic effects, such as convulsions,
that occur on large overdoses; lignocaine also causes convulsions
in overdosage. The second property of cocaine, apparently
unconnected with the first, is that it potentiates the
action of drugs that stimulate the sympathetic nervous system.
The mechanism of this potentiation is well established. Sympathetic
nerve fibres release a chemical transmitter substance,
noradrenaline, at their endings. Noradrenaline acts upon a
specialized receptor molecule on the cell that is to receive the
stimulus from the nerve. As the response required from the cell
receiving the message (e.g., a smooth-muscle cell or a nerve
cell of a different circuit) may be very brief, an efficient method
of terminating the action is required; otherwise it would last
too long to permit rapid changes in activity. The action of
noradrenaline is terminated by pumping it back into the nerve
cell from which it was released. The pump is sometimes called
uptake-i, or the amine pump, and its action is blocked by
cocaine. In consequence, the effects of noradrenaline are potentiated
in that there is more of it present at the site of action for
a longer time. There is no reason to believe that this action
would have any greater effect at the oxygen pressures prevailing
at 3,000 m than at sea level. Nor would it necessarily have
a deleterious effect upon physical health (van Dyke and Byck
1982); the reported associations of coca consumption with poor
general health may be more a reflection upon the social circumstances
of the Indian villagers who use it (Buck et al. 1968).
Hanna (1974) suggested that cocaine might be used at high
altitude because of its ability to constrict skin blood vessels
and thereby reduce heat loss. Local applications of high concentrations
of cocaine do cause vasoconstriction, but this would
not occur at the much lower concentrations present in blood.
Vol. 24 * No. 3 * June 1983 273

A more important effect might be to increase heat production
in the body (Van Dyke and Byck 1982), but this only occurs
at high doses and is unlikely to contribute to the action of cocaine
absorbed from a quid of coca leaves in the buccal cavity.
It is interesting to place this effect in context. The most
widely used drugs for the treatment of mental depression are
the so-called tricyclic antidepressants, amitriptyline and imipramine.
Their favourable effect on depression depends upon
the same mechanism as that of cocaine-inhibition of the
amine pump. (They have other pharmacological properties that
differ from those of cocaine, but the inhibition of noradrenaline
uptake is the critical one.) Amphetamine is another drug which
acts upon this system, exerting its effect by releasing increased
amounts of noradrenaline from stores in the nerve endings.
Other, more familiar substances also act upon the system,
although at a different point. When noradrenaline acts upon a
receptor on the surface of a cell, it switches on the production
of a second messenger called cyclic adenosine monophosphate.
Cyclic AMP is the messenger within the cell for many types of
hormone and neurotransmitter whose first message is delivered
to a specialized receptor on the cell's surface. It is the specialized
nature of this receptor that gives specificity to the action
upon a particular cell. Again, a way of terminating the action
of the messenger is required, and cyclic AMP is destroyed by
an enzyme called phosphodiesterase. A powerful inhibitor of
this enzyme is caffeine, the active substance in coffee. In a
nerve circuit using noradrenaline as its messenger, both cocaine
and caffeine can amplify the message. Cocaine does it by blocking
removal of the first messenger released from the nerve.
Caffeine does it by inhibiting the breakdown of the second
messenger within the cell that receives the first message on its
surface. It would be an exaggeration to say that the action of
the two substances is the same, but in moderate doses their
actions have similar consequences.
Why do Andean Indians take their coca by storing a quid of.
chewed leaves adulterated with lime (see Salomon 1949, Cruz
Sanchez and Guillen 1948) in the cheek pouch? It seems probable
that they have made two fundamental discoveries about
drug delivery systems. Cocaine has a relatively brief duration
of action or half-life (the time it takes for its concentration in
the blood to be reduced by half)-from about one up to two
hours (Fish and Wilson 1969, Holmstedt et al. 1979, van Dyke
et al. 1982). This is of no consequence to an addict who sniffs
cocaine, since he is seeking a rapid peak of the concentration
in the blood so as to cause a short-lived but powerful stimulant
effect to his brain. For a worker in the fields or a runner seeking
a prolonged effect, however, it is too brief. Leaving a quid in
the cheek pouch must be an effective way of securing a slow
release into the body. In modern times many ingenious methods
have been used to prolong the action of drugs with an inconveniently
short half-life. These include special formulations
that slowly release drugs in the gut, from a wax matrix or a
plastic core. Another method that has been tried is to place a
device which slowly releases the drug on the skin, inside the
eyelid, in the vagina, or in the mouth. There seems no reason
to doubt that the quid of leaves is a slow-release formulation of
cocaine. But what was the purpose of the lime?
One purpose that has often been suggested is to help release
the cocaine from the leaves. In commercial production, both
lime and sulphuric acid have been used for this purpose.
Another suggestion has been that lime hydrolyzes cocaine to
ecgonine and that this is the active principle. There is no doubt
that the active principle is cocaine and that hydrolysis by
enzymes in blood is the main route of inactivation (Holmstedt
et al. 1979, Van Dyke and Byck 1982). Transformation of
cocaine to ecgonine would reduce the effect, not enhance it,
so some other explanation must be sought.
There may be a more sophisticated reason for the use of lime.
Cocaine is a weakly basic substance because it possesses a nitro-
gen atom in the configuration of a tertiary amine. Acids and
bases in their ionized form cannot cross the membranes of cells
such as those lining the mouth or the intestine. Cell membranes
contain a thin layer of fat, like a layer of olive oil, and substances
that will dissolve in fat cross these boundaries readily; molecules
soluble in water do not. Since ionized cocaine cannot cross the
cell membrane, then, the trick is to keep as much of the cocaine
as possible in the un-ionized form. This is accomplished by
making the environment alkaline, which raises the pH and
prevents the ionization of the basic molecule. The significance
of this for coca chewing was first discussed by Henman (Antonil
1978:123-25). The general process is known as "non-ionic" or
"pH-dependent" diffusion and is now a well-known method of
facilitating or hindering the passage of drugs across biological
membranes. For example, Dollery has for the past ten years
conducted a clinical pharmacology class experiment which involves
measuring the absorption of the basic amine amphetamine
from a weak solution held in the mouth for five minutes.
If the mouth contents are made slightly acid with an appropriate
acid buffer (Coca Cola!), little is absorbed; if they are made
slightly alkaline, absorption proceeds rapidly.
Thus, the swollen cheek of the Andean Indian conceals a
sophisticated drug delivery system. How was it discovered?
While it would not have been particularly difficult to learn that
storing the quid in the buccal pouch prolonged its action, to
discover the action of lime would have been much more difficult.
Did the ashes of some ancient fire find their way onto the
coca leaves by chance? And who was the astute Indian pharmacologist
alert enough to note that the effect was enhanced by
it? These, unfortunately, are questions hardly susceptible of
archaeological investigation.
CONCLUSIONS
All the lines of approach employed in this survey converge on a
single set of conclusions:
1. In pre-European America, coca was widely used, in highlands
and lowlands alike, for thousands of years before the
Conquest.
2. The botanical centre of origin of the plant is the Montafia
zone of the eastern Andes, below 2,000 m.
3. The concentration of coca chewing today in Peru and
Bolivia, and at high altitudes, is more a function of history than
of physiological need.
4. The present distribution of coca taking correlates very
closely with the residual distribution of traditional Indian
culture, of which it is an integral part. Wherever indigenous
culture is still strong, coca use remains significant. This is true
of both highland and lowland regions.
5. Coca acts as a general stimulant rather than simply as a
specific against the rigors of life at high altitudes.
6. This is precisely the way that coca is perceived by the
Indians themselves.
The last word in this controversy should be allowed to the
native Americans. In the conclusions to a manifesto drawn up
in 1980 at the Primer Encuentro Indlgena Nacional and signed
by representatives of most of Colombia's indigenous groups
(see Micronoticias Antropol6gicas M-68:12), the section on
coca chewing begins with the following words: "Some of us
cultivate jayo, ipatu, massW, or coca, the leaves of which we
chew to help our bodies and our minds to support the fatigue
of work and to remain alert and clear-headed in meetings and
ceremonies."2 In the struggle to live their own lives and to
retain their Indian identity, the signatories of this document
2 "Algunos de nosotros cultivamos el jayo, ipatu, masse o coca,
cuyas hojas masticamos para ayudar a nuestro cuerpo y a nuestro
entendimiento a soportar la fatiga del trabajo y a estar atentos y
ligeros de pensamiento en las reuniones."
274 CURRENT ANTHROPOLOGY

insist on the right to continue chewing coca in the traditional
way, and they deplore the misuse of the drug by non-Indians
over whom they have no control. The relationship between
Indianness and coca use can hardly be made more explicit.
Comments
Bray and Dollery: COCA AN ALTITUDE STRESS
of historical and cultural factors and coca's properties as a
general stimulant.
In denying altitude-specific variables a unique role in the
etiology of coca use, they are undoubtedly on the right track,
and they are correct to insist on seeking the benefits provided
by coca to users at all altitudes. Unfortunately, Bray and
Dollery fail to discuss the one physiological explanation that
can account for the contemporary geographical pattern of coca
use. Moreover, while dismissing altitude-specific stressors, they
overlook the possibility that the general stress level to which
a population is exposed may be highly significant as a cause
of coca use. The important point is that total stress load contributes
to the physiological condition that enhances coca use.
I have proposed (Bolton 1976a, 1979) the hypothesis that coca
is chewed because it serves to regulate blood glucose levels in
individuals who have problems in glucose homeostasis. It is
stress from whatever source, not just the stressors associated
with high altitude, that is at least partially responsible for glu-
by GENE BARNETT
Research Technology Branch, Division of Preclinical Research,
Room 10A19, NIDA, 5600 Fishers Lane, Rockville,
Md. 20857, U.S.A. 3 xii 82
In order to relate cocaine pharmacologic effects to plasma concentrations,
one needs to distinguish between pharmacokinetics
and pharmacodynamics. Pharmacokinetics describes the time
course of cocaine absorption into the circulatory system, distribution
throughout the body, and transformation into metabolites,
which are in fact the major elimination route from the
body for cocaine. The rate of absorption depends upon the
route of ingestion and can usually be characterized by an ab- cose homeostasis difficulties. Environmental stressors at exsorption
half-life which ranges from 5 minutes to 20 minutes tremely high and low (such as in Amazonas) altitudes differ,
for oral and nasal ingestion. While cocaine is thought to be to be sure, but both very high and very low altitudes in the
rapidly eliminated from the body, recent observations suggest tropics are likely to be zones of greater stress than are areas
that the value for the elimination half-life, which is the time at intermediate altitudes, where, indeed, coca chewing is less
required for elimination of 50% of the cocaine remaining in widespread or engaged in minimally. In lowland areas, one
the body, depends on the size of the administered dose (Bar- tends to find a higher disease load and heat stress, while the
nett, Hawks, and Resnick 1981). It is in the range of a half to stress of cold and hypoxia are found at high elevations. In
one hour for small doses and may be much longer for very both areas dietary deficiencies may be prevalent (high-carbolarge
doses.
hydrate diets and low levels of protein consumption). Conse-
It has been established that the work of Holmstedt et al. quently, I would expect populations at both altitude extremes
(1979) on absorption of cocaine from a quid of leaves chewed to have the higher incidence of hypoglycemia that has been
with alkali is indeed a drug delivery system. The input de- found correlated with coca consumption. Precisely this equivlivery
system had a half-life of one to two hours, while the alence of high and low elevations was found in research on
elimination half-life for the small doses was approximately another of the effects of hypoglycemia, namely, aggressivea
half-hour (Barnett et al. 1981). Thus a quid would deliver ness, in the East African context (Bolton and Vadheim 1973).
50% of its cocaine content in one to two hours, an additional So why the association between coca chewing and "Indian-
25% in the next one to two hours, an additional 12J% in the ness"? European colonists in Latin America tended to occupy
next one to two hours, etc. Since drug elimination is much the best lands in the most advantageous locations, i.e., where
more rapid than drug input, the chewers will want to recharge economic potential was highest and environmental stress lowthe
quid periodically depending on their own pharmacokinetics. est. Indian groups managed to survive in remote Andean and
Pharmacodynamics describes the time course of pharmaco- Amazonian regions of western South America, "regiones de
logic response to the ingested drug. It is not required that the refugio" (Aguirre Beltran 1967), but in most cases they were
response relate directly to the plasma concentration of the confined to harsh, poor environments, places subject to what
drug, and it is usually not known what role metabolites play. Monge (1968) has called "climatic aggression." Thus, I sug-
In the case of a person who sniffs cocaine (Resnick, Kesten- gest that Indians at both high and low altitudes use coca for
baum, and Schwartz 1977), it is possible that the desired its effects in countering the negative consequences of stress
recreational "high" effect is proportional to the rate of increase on glucose metabolism. By raising glucose levels, coca reduces
in plasma concentration, as nasal absorption is relatively slow, sensations of hunger and fatigue and helps to stabilize cycles
whereas the systolic blood pressure rises more slowly than the of sleep and wakefulness, which tend to be disrupted by hypoplasma
concentration, thus invoking a lag or intermediate- glycemic states. Native explanations for coca use, which the
mediated mechanism. The search for correlations between the authors note are highly consistent, permit clear recognition of
pharmacokinetics and pharmacodynamics, which may well re- the major effects of coca.
sult in time-dependent and non-single-valued relationships, is Although archaeological and documentary records on prea
current area of active research.
Columbian coca use are interesting, and useful to demonstrate
that coca was known and to some degree used outside areas
of contemporary use, it seems to me that the inherent limitaby
RALPH BOLTON
tions of such data make it unlikely that they can help us much
Department of Anthropology, Pomona College, Claremont, to answer the question of why people use coca, mainly because
Calif. 91711, U.S.A., and Sosialantropologisk institutt, Uni- it is impossible to infer from such data how extensive and inversitetet
i Trondheim, 7055 Dragvoll, Norway. 29 x 82 tensive coca use was in an area. Differential survival rates for
Bray and Dollery summarize archaeological and ethnohistor- artifacts and materials in different ecological conditions and
ical data on coca use by indigenous groups at all altitudes from differential coverage by archaeological investigations in diverse
Nicaragua to Chile in pre-Conquest times, and they remind us regions reduce the possibility of making valid quantitative
that coca is still used today by Indians in some tropical forest comparisons across zones. In all populations at all elevations,
areas. From this they conclude that coca use cannot be ex- it is likely that some individuals suffer from glucose homeoplained
by physiological benefits conferred on high-altitude stasis problems, and therefore knowledge and utilization of
users. Rather, its use, they maintain, is the combined product coca to some degree everywhere in western South America
Vol. 24 * No. 3 * June 1983
275

would be reasonable. Contemporary evidence suggests that gued that coca chewing and aggressive behavior may be partial
there are differences in usage rates within Indian groups today, functional equivalents as far as glucose homeostasis is conand
these rates appear to vary with altitude. For instance, in cerned. The effects of antidepressants are similar to those of
Indian groups at higher elevations in the Andes adults of both cocaine. Recently it has been noted that aggressive behavior,
sexes tend to use coca, whereas at lower altitudes often one too, has an antidepressant effect, and that this effect is due
finds that only men chew. This is hard to explain from an to the action of various neurotransmitters (Cocchi 1982). De-
Indian-ethnicity perspective, especially inasmuch as females pression is one of the prirnary symptoms of hypoglycemia, as
generally are more conservative of cultural values in the Andes well as of susto (Bolton 1980, 1981). Chewing coca and enand
tend to have less contact with outside culture; presum- gaging in aggressive behavior are two means of coping with
ably, then, if "Indianness" were the main factor, elevation
should have no effect on whether or not women chew coca and,
if anything, they should be more involved than men in prehypoglycemia.
serving this practice. But such is not the case.
Coca is intimately connected with traditional religious practices
and beliefs and with hospitality. Thus there is no doubt
that the continuation of this custom is made more likely by
its linkages to important aspects of cultural systems (Bolton
1976a, 1979; Allen 1981). In this instance, however, as with
so many human practices, culture and biology are both responsible,
and tightly intertwined. To say that Indians chew
coca because they are Indians tells us little. While the association
between coca chewing and "Indianness," therefore, is
not entirely spurious, it is not a sufficient explanation. Indeed,
the authors do not mention the fact that in some high-stress
situations mestizos as well as Indians may chew coca, and certainly
the medicinal use of coca is common among highland
mestizo populations in spite of coca's identification with Indianness.
The primary adhesions of coca are poverty, ill health,
poor diet, and stress, not simply Indianness. A question that
needs to be raised, especially if one thinks the main biological
factor in connection with coca use is its general stimulant
properties, is why Europeans never adopted this substance as
a mild stimulant (leaving aside the special case of its derivative,
cocaine). Europeans did adopt other non-European substances
with stimulant properties, e.g., tobacco, coffee, tea.
Ethnohistorical research might provide clues to answer this
question. Meanwhile, I would suggest that the stresses on the
conquering Spaniards were lower than those being experienced
by native populations and that they had no biological need for
coca, which then became associated exclusively with the re.
quirements of hard physical labor (disdained by the Spanish)
and with the Indians who performed such labor on behalf of
the European invaders. Indeed, coca use may have expanded
after the Conquest because of increased pressures on the native
population and new stressors, e.g., new diseases, labor
demands, disruption of indigenous social systems, interference
by FLORIAN DELTGEN
Wessum, Griinstrasse 1, D-4422 Ahaus, Federal Republic of
Germany. 22 x 82
It was the author.' intention to refute the idea that coca taking
might have something to do with altitude. They have done it,
but they have killed a mouse with 12-gauge buckshot. They
have by far overproven their point. Most of what they say
is not new, and to prove their point it would have been sufficient
to draw attention to the likewise well-known fact that
coca consumption occurs throughout the tropical rain-forest
region of South America. In addition, it might have been useful
to enlarge somewhat more on the argument made by
Schultes that coca has its place in the mythic traditions of
most of the tropical rain-forest tribes. During- my own field
research among the Yebamasa of the middle Piraparan'a in
Colombia I have found coca so well integrated into the Yebamasa's
myth of creation and so intricately connected with
other elements of their culture that I must conclude that coca
must have been part of their life for a very long time.
It was interesting to me that the coca species predominantly
cultivated in the tropical rain-forest regions is not E. coca
Lamarck, but rather E. coca var. ipadu Plowman. It was also
new to me that the admixture of alkaline ashes enhances the
effect of the coca. The Yebamasa toast the coca leaves in a
clay pot, pound them, and pass them through a bark sack.
This produces a very fine green powder which they mix with
the ashes of the dried leaves of the caimaron (Pourouma apaporiensis
Cuatr., according to Garcia-Barriga's Flora medicinal
de Colombia). I never understood why they add the caimardn
ashes, but if they do it to get a stronger effect from the coca,
what pharmacological, chemical, and physiological explanation
do we have for this?
with traditional dietary patterns through the destruction of
normal trade and exchange channels across ecological zones,
and so forth.
Giving the "last word" to Native Americans, the authors
quote a manifesto in which it is claimed that coca is chewed
"to help our bodies and our minds to support the fatigue of
work and to remain alert and clear-headed in meetings and
ceremonies." This comment is extremely interesting inasmuch
as recent work (Bolton and Leon n.d.) shows that hypoglycemia
produces cognitive deficits and mental confusion (i.e.,
non-clear-headedness), and it would be expected that by raising
glucose levels coca would induce alertness and clear-headedness
as this manifesto claims. Also, given the irritability and
aggressiveness promoted by hypoglycemia, the use of coca
would indeed facilitate meetings and ceremonies by reducing
the likelihood that such activities would be disrupted by antisocial
behavior (Bolton 1972, 1973, 1976b, 1982). The quoted
by DARNA DUFOUR
Department of Anthropology, Campus Box 233, University
of Colorado, Boulder, Colo. 80309, U.S.A. 6 xii 82
Bray and Dollery's article makes several useful points. First,
they note that although attention has been focused on presentday
use of coca in the Andean highlands, there is a long history
of use in both the lowlands and the highlands. Second,
they observe that the present-day distribution of coca users
coincides with that of relatively traditional indigenous groups.
While this is probably correct, the data they use to support it
are inadequate. Third, they argue that coca is used by indigenous
peoples as a general stimulant. This argument is supported
by ethnographic explanations and pharmacological data.
It also accords with my own experience in the Northwest
Amazon. Bray and Dollery consider the stimulating properties
of coca sufficient to explain its use at all altitudes. While I
words of the manifesto emphasize the importance of chewing
coca "to help our bodies and our minds"; no mention is made
can accept the use of coca as a general stimulant, I feel it is
premature to dismiss the possible adaptive role of coca chewof
chewing coca because of Indian identity or cultural vralues. ing at high altitude. This question is complex and will not be
The authors' mention of depression is valuable. I have ar- resolved without further laboratory and field studies.
276 CURRENT ANTHROPOLOGY

y JOEL M. HANNA
Department of Physiology, University of Hawaii, 1960 East-
Bray and Dollery: COCA AND ALTITUDE STRESS
West Rd., Biomed T-608, Honolulu, Hawaii 96822, U.S.A. ypadu powder and can remember the time when their fathers
8 xii 82
and grandfathers used it regularly. On the other hand, certain
Bray and Dollery have presented some rather interesting evidence
that the use of coca leaves is not limited to high-altitude
populations. It is difficult to take issue with this point, since
the evidence is overwhelming. However, their remark "There
is no reason to believe that this action (coca potentiation of
amine reabsorption) would have any greater effect at oxygen
pressures prevailing at 3,000 m than at sea level" does require
districts in the vicinity of Tefe-including some virtually on
the outskirts of the town itself-are characterized by widespread
coca use, notwithstanding the fact that the population
of these districts neither considers itself Indian nor even evidences
a great deal of "Indianness" in its genetic or cultural
traits.
some clarification. One of the major consequences of life at
high altitude is a continual physical stress resulting in an elevated
sympathetic tone. Use of cocaine-containing coca leaves
would thus potentiate this stress response, perhaps promoting
greater neurotransmitter economy or enhancing the response
itself. In any case, the continual hypoxic stress is limited to
high elevations, and coca use would prove of special benefit
there. Such a mechanism could be responsible for the persistence
of coca use among high-altitude populations in the face
of official pressures toward its elimination.
by TED C. LEWELLEN
Department of Sociology, University of Richmond, Richmond,
Va. 23173, U.S.A. 25 x 82
People (including anthropologists) can function perfectly well
at 12,500 ft. or above without resorting to artificial stimuli.
This is clearly evident in the declining use of coca in the Lake
Titicaca area, where I did my fieldwork. Though I did not
specifically study this issue, I am under the impression that
among the Peruvian Aymara three separate factors militate
against coca chewing. First, those who are relatively acculturated,
through circular migration to wage-labor jobs on the
by ANTHONY HENMAN
coast, tend to view coca chewing as old-fashioned. Second, the
Department of Anthropology, IFCH-UNICAMP, 13100
Campinas SP, Brazil. 9 xi 82
Seventh-Day Adventists (about 11% of the population in the
communities I studied) reject coca as they would any stimu-
As an ex-student of Warwick Bray's who left London with his lant and associate it with Catholicism and the traditional reencouragement
in 1973 to study the use of coca in Colombia, ligion. Finally, public education, usually taught by young mes-
I can only welcome the thorough and incisive treatment of tizos, demeans those Indian values the state perceives as negathe
theme in this paper. The kind of biological determinism tive. Thus, though coca remains an essential ingredient in
inherent in the correlation of coca chewing and human sur- Aymara ritual, its casual, daily use is largely confined to those
vival at high altitudes has all too often been misappropriated who are old and/or relatively unacculturated.
by the narcotics agencies, and the resulting cant has led to
at least one ludicrous piece of legislation that has direct bearing
on the issues discussed by the authors: the prohibition of
On the other hand, the value of coca-chewing for preventing
soroche is widely known, and the leaves are sometimes used
for this purpose even by urban cholos or mestizos. The father
the use of coca in Peru at altitudes below 1,500 m, promul- of a family I lived with in Cochabamba, Bolivia, would use
gated with the encouragement of the U.S. Drug Enforcement
Administration in 1978.
coca only when he drove up to 15,000 or 16,000 ft. to hunt
bizcacha.
My only major reservation concerns the replacement of the
correlation between coca chewing and high-altitude living with
Altitudes under 15,000 ft. would not be a problem for someone
who is altitude-adapted and in good health. However, there
the less spurious but nonetheless imprecise "link . . . between
coca use and the persistence of relatively unacculturated Incan
be little doubt that high altitude is significant when it is
combined with poor nutrition or disease. In such cases the
dian communities." Anthropologists have always experienced
some difficulty in defining "Indianness," and in recent years
many have moved away from genetic, cultural, and/or histormild
stimulant of coca may be, if not essential, at least useful
in carrying on normal activities. Since the poorer communities
are also usually the more traditional, the correlation between
ical criteria towards the more explicit but no less problematic
self-identification. In line with this thinking and the authors'
argument, one would not expect to find the use of coca among
coca chewing and tradition may have some basis in biology.
The adaptive value of coca should not, therefore, be entirely
ruled out, though the stresses it alleviates are general ones
those who, despite their ancestry, no longer consider them- that are merely amplified at high altitudes.
selves Indians and are not seen as such by the surrounding In any case, the authors present a good case that coca chewpopulation.
ing did not evolve primarily as a response to the stresses of
In at least two areas that I have researched personally, altitude, and thus they provide a welcome corrective to some
however, the data plainly do not support this view. One is the perhaps overzealous attempts at a direct correlation between
region of southern Cauca, Colombia, where the use of coca by
the Spanish-speaking peasantry-including, incidentally, the
biology and culture.
descendants of African slaves-contrasts notably with the
more typical Andean pattern of the Paez of Tierradentro. This
is a theme developed in some detail in my book Mama Coca
(Antonil 1978), where I also point out the converse case of
by MICHAEL A. LITTLE
Department of Anthropology, State University of New York,
Binghamton, N.Y. 13901, U.S.A. 1 xi 82
the Guambiano Indians of Silvia, who have abandoned the use
of coca almost completely in recent years, and this despite the
survival of a life-style which in most other respects is con-
Bray and Dollery have done a very scholarly job in demonstrating
that coca use was quite widespread in pre-Hispanic
times in the Andean nations and that it was not exclusively
siderably less "acculturated" than that of the Paez.
a high-altitude practice. This information weakens, of course,
The other area, surrounding the town of Tefe in the Brazil- the hypothesis that coca use confers some advantage on
ian state of Amazonas, I visited only more recently (1981). coqueros at high altitude, but it does not falsify it. Testing
The only self-defined "Indians" in this region, the Miranha this hypothesis is a difficult task requiring numerous studies.
cultivate the coca bush today exclusively for medicinal pur- It is a task that no rational investigator should attempt withposes,
though some of the older men still know how to prepare out enormous resources and time.
Vol. 24 No. N 3 * June 1983
277

Two points in the paper do require clarification. First, the
authors suggest that in the discussion following Fuchs's (1978)
paper the assumption that the coca habit is intimately connected
with the stresses of life in the high Andes was never
challenged. Both Little (1978) and Mazess (1978) were skeptical
of Fuchs's (1978) polycythemia hypothesis and of the
meaning of the altitude-hypoxic-stress correlation. Second, the
observation by Bray and Dollery that coca use is strongly related
to degree of Indian culture was suggested in one of the
comments on Fuchs's paper (Little) and probably by many
other observers before that.
by E. PICON-REAiTEGUI
Instituto de Biologza Andina, Universidad Nacional Mayor
de San Marcos, Apartado 5073, Lima, Peru. 25 xi 82
The scrupulous perusal of the literature on the ecology of coca
and coca chewing in ancient and modern America carried out
by Bray and Dollery must be welcomed by all those concerned
with coca-chewing and high-altitude problems. The subject
is introduced with seriousness, and the conclusions are
based on reputable sources. I agree with the authors when they
state that any relationship between coca chewing and hypoxia
may be a spurious one, linked to the culture of certain autochthonous
groups.
by ANDREW FUCHS SILLEN
Department of Anthropology, National Museum of Natural
History, Smithsonian Institution, Washington, D.C. 20560,
U.S.A. 18 xii 82
Bray and Dollery have presented a fine literature review on
the archaeology and ethnohistory of coca. I was particularly
interested in the documentation of widespread precontact and
early-contact use of the leaf, since it so well demonstrates the
unique and special nature of Andean coca chewing: in this
region, in contrast to others, the practice has tenaciously survived.
As I understand it, they have no argument with the idea
that coca may provide pharmacological relief from polycythemia,
but they do object to one line of evidence on which that
idea was based: the correspondence of coca chewing with altitude
stress. However, apart from their inosculation of historic
and modern usage, there are two other differences between the
argument I put forth in 1978 and Bray and Dollery's casual
paraphrase of it. These are their confusions of (a) coca use
with coca chewing and (b) altitude (a geographical phenomenon)
with polycythemia (a physiological one).
With regard to the first item, the authors stress the importance
of Amazonian usage. They correctly emphasize that the
method of coca preparation differs in the lowlands, as does the
species of coca employed (Plowman 1981). For these reasons,
together with the recognition that there are even some other
cultural differences between Andean and Amazonian Indians,
in 1978 I distinguished explicitly between Andean coca chewing
and other contemporary forms of use. In contrast, Bray
and Dollery insist that any explanation for Andean chewing
needs to lump Amazonian and Andean usage. I think it is appropriate
to question this novel conjunction, even at the risk
of seeming undemocratic.
As for the second, I argued that Andean coca chewing was
not a function of altitude, but was instead related to ethnic,
occupational, age, and sex criteria that also happened to identify
those individuals most susceptible to polycythemia. For
example, I noted that, at all but the highest altitudes, adult
men chew where women and children do not. As a substitute,
Bray and Dollery suggest that an "equally strong correlation
emerges when the incidence of coca taking and the degree of
'Indianness' of the chewers" is considered. But since so many
Andean Indian women and children don't chew, the authors'
suggestion that coca chewing covaries only with ethnicity negates
the cultural heritage of this part of the population.
In short, the correspondence between modern coca chewing
and polycythemic stress is neither spurious nor shaky, neither
assumptive nor disproven. Of course coca has been used in
a manner and place other than the high Andes, but that does
not address the central issue of whether the Andean Indians
who chew it derive pharmacological relief from it. That issue
will only be resolved by the design and execution of the appropriate
field research.
by LINDA PATIA SPEAR
Department of Psychology and Center for Neurobehavioral
Sciences, State University of New York, Binghamton, N.Y.
13901, U.S.A. 22 xi 82
Two major conclusions reached by Bray and Dollery in their
article are (a) that the use of coca in Peru and Bolivia is predominantly
a function of cultural values and historical antecedents
and (b) that coca acts as a general stimulant at all
altitudes and does not have differential physiological effects
on the noradrenergic system of particular benefit to individuals
living at high altitudes. As a psychopharm,acologist, I wish
to address my comments to this latter conclusion.
As the authors point out, cocaine blocks noradrenergic reuptake
into the nerve terminals from which it was released,
with the effect that the amount of norepinephrine available
at the site of action is increased. Bray and Dollery go on to
state that "there is no reason to believe that this action would
have any greater effect at the oxygen pressures prevailing at
3,000 m than at sea level." While I agree with this statement,
it is important to consider that the effectiveness of cocaine
on a particular individual's noradrenergic system may be influenced
more broadly by the functional level of activity of the
entire noradrenergic system. For example, if an individual's
noradrenergic system is already working at peak levels of efficacy,
further increases in noradrenergic activity induced by
cocaine seemingly would have little beneficial effect; on the
other hand, in an individual with a submaximally functional
noradrenergic system, use of cocaine may well increase noradrenergic
activity to peak levels of efficacy. Thus, when considering
possible differential effects of cocaine at different altitudes,
one must look at the effects of altitude on the entire
noradrenergic system, not merely on the uptake system that is
inhibited by cocaine.
Indeed, it appears that the lowered oxygen availability characteristic
of high altitudes may well influence functional activity
of the noradrenergic system. Both the rate-limiting hydroxylating
enzymes (tyrosine hydroxylase, tryptophan hydroxylase)
in the synthesis of monoamines such as norepinephrine
and one of the enzymes in imonoamine degradation
(monoamine oxidase) require molecular oxygen for activity,
and thus their activities are affected by oxygen availability.
Moreover, the stresses presumably associated with adaptation
to high altitudes may also influence central and peripheral
noradrenergic activity. Thus, high altitude may alter noradrenergic
activity through interactions among alterations in
the activity of oxygen-dependent metabolic enzymes, stressinduced
effects on noradrenergic activity, and possible compensatory
modulations occurring within the nervous system in
response to these disruptions in homeostasis. While the effects
of high altitude on noradrenergic activity have not been carefully
investigated in humans, experimentation in other animals
suggests that chronic exposure to a hypoxic environment beginning
early in life does produce alterations in the activity
of oxygen-dependent metabolic enzyme systems controlling the
synthesis and degradation of norepinephrine and other neurotransmitter
systems (e.g., Vaccari et al. 1978a, b).
278 CURRENT ANTHROPOLOGY

From these kinds of experiments, it appears to be a viable
Bray and Dollery: COCA AND ALTITUDE STRESS
hypothesis that, in individuals adapted to living at different
altitudes, baseline levels of noradrenergic activity may vary,
perhaps influencing the functional efficacy of cocaine and possibly
other alkaloids present in coca. At least, on the basis of
not lime, is used to extract cocaine and other alkaloids from
the coca leaf; the lime is used to convert all of the extracted
ecgonine-related alkaloids, including cocaine, to free ecgonine,
the available data, this hypothesis appears to be as tenable as
the conclusion to the contrary reached by Bray and Dollery,
which after purification is resynthesized to cocaine. Thus the
lime is used because of its direct hydrolytic action on cocaine,
who argue that the physiological effects of coca on noradrener- not as a releasing agent. In our own laboratory, in vitro exgic
activity are similar at all altitudes. Clearly, more research periments have clearly demonstrated that cocaine is most labile
is needed to assess the effects of altitude on noradrenergic toward limelike materials. When cocaine was exposed to a
functioning and sensitivity to psychoactive drugs such as saturated aqueous extract of an ishku (burned limestone)
cocaine. However, it should be pointed out that even if the
magnitude of the physiological effects of coca were found to
sample, 50% disappeared in 5 minutes, 90% within 20 minutes.
These findings are inconsistent with the suggestion that "Leavvary
across altitudes, this information, in and of itself, would ing a quid [of leaves] in the cheek pouch must be an effective
not necessarily weaken the conclusion of Bray and Dollery way of securing a slow release [of cocaine] into the body....
that the use of coca is based more strongly on cultural values There seems to be no reason to doubt that the quid of leaves
and historical antecedents than on considerations involving is a slow-release formulation of cocaine." On the contrary, the
the altitude of the user. When considering the patterning of quid provides an excellent opportunity and enough time to
drug use of any individual or group, social and cultural factors "detoxify" most of the cocaine content. One would have to deas
well as pharmacological and physiological variables must scribe the amount of cocaine escaping the digestive action of
always be considered.
the lime as minimal.
Finally, the discussion of the basic pharmacology of cocaine
is simplistic, presenting cocaine as purely a central nervous
by TERESA VALIENTE
Lateinamerika Institut, Riidesheimerstr. 54-56, 1000 Berlin
33, Germany. 30 xi 82
system stimulant. That it acts by blocking the re-uptake of
endogenous amines within the sympathetic system is certainly
correct, but no mention is made that this enhancing effect on
In modern Andean research the study of coca occupies a central
position in which several different points of view have
cropped up. One of the most generalized arguments is that
which considers the habit of chewing coca a reaction to excessive
fatigue and inherent to higher-altitude regions.
This study examines this widespread idea. By means of a
detailed review of the results of pharmacological as well as
catecholamines leads to significant peripheral metabolic effects
such as increased oxygen utilization, increased basal metabolic
rate, hyperglycemia, free fatty acid mobilization (lipolysis),
etc. One could easily argue that these effects, rather than being
detrimental, are beneficial as part of a facilitative or adaptive
mechanism in preserving the internal milieu of an organism
subjected to less than a favorable environment regardless of
archaeological, botanical, and ethnohistorical research, the authors
demonstrate that the use of coca has no connection with
problems of high altitude and that it is used at present as a
altitude.
means of resisting hunger, thirst, drowsiness, and exhaustion.
The question arises whether coca has had this social function
throughout the various phases of Andean history. To date,
Reply
ethnohistorical evidence has proved otherwise. According to by WARWICK BRAY and COLIN DOLLERY
archaeological data, it has been demonstrated that coca has London, England. 10 I 83
been used since at least 2000 B.C., and in regions of different As various commentators remark, the facts presented in our
altitude, from the lowest to the highest.
paper are not new. Most of them have been available in the
After making a statistical and geographical evaluation with literature for a considerable time; hence our surprise that the
reference to the present situation, the authors conclude that (to us) self-evident conclusions have not been drawn from
the use of coca is probably more a cultural phenomenon than them. Deltgen's high-altitude mouse, alas, remains alive and
a biological one. Here there is a parallel between their con- well in many parts of the Andes. This was particularly evident
clusions and those reached about coca and cocaine at the in the 1978 CA article and the comment that followed it
Interamerican Seminar in Lima in 1980.
(Fuchs 1978), even among such sceptics as Little and Mazess.
We agree with Little's remarks on that occasion but feel that
he did not put the point strongly enough. The most relevant
by T. G. VITTI
section of his comment reads as follows: "Coca chewing does
Faculty of Pharmacy, University of Manitoba, Winnipeg, appear to be altitude-related; unfortunately, so are oxygen
Manitoba, Canada R3T 2N2. 2 xi 82
pressure, temperature, diet, disease patterns, subsistence, and
This paper seems to be based on the premise that researchers general cultural patterns of the Quechua Indian. As an imporsupporting
the practice of coca chewing among Peruvians and tant sociocultural element in highland native life, coca use
Bolivians are anxious to make an obligatory connection between would be expected to persist in those areas where its integracoca
use and high altitude. The connection between the two tion is greatest." While agreeing with this, our paper broadens
factors could well be a spurious one, but this alone does not the geographical range of the evidence and introduces a time
constitute an exclusive argument against the possibility that perspective. Anthropologists who persist in regarding the prescoca
use is related in a more specific way to the widespread ent-day pattern of coca use as the "natural," "normal," or
constitutional deprivation resulting from a variety of factors, even "inevitable" one do so at their peril, since their data base
not the least of which is under- or malnutrition, regardless of is already distorted by the effects of European conquest. This
altitude.
approach has produced some useful regional studies of physio-
Several statements relating to the basic biochemical/phar- logical and cultural adaptation but has not yet provided an
macological aspects of cocaine!/coca reveal an incomplete if adequate general explanation of why people chew coca.
not erroneous understanding. For one, cocaine can be visual- From much of the published literature (Antonil 1978/Henized
as an ester of benzoic acid and ecgonine methylester, not man 1980 is an exception) one would never realize that the
ecgonine. Also, in the commercial production of cocaine, acid, people who chew coca regard the act as a pleasure and not as
Vol. 24 * No. 3 * June 1983
279

a medicinal duty. If the pleasure motive is denied, the inves- evidence. Oxygen lack is associated with wide dilation of blood
tigator is forced to look around for some sort of stress that vessels to increase the blood flow and oxygen supply. One conwould
impel people to chew; after all, most of us don't take sequence is to apply a higher pressure to the smallest vessels
cough mixture unless we have a cough. At times, as in much (capillaries) because the normal upstream resistance to flow
of Bolton's comment, the attempt to define the appropriate is reduced. The high pressure leads to increased passage of
stress takes on the quality of special pleading.
fluid from the capillaries into the tissues. Increased amounts
Without repeating our evidence, we reiterate that, before of fluid (oedema) in the brain and lungs cause the clinical
the European conquest, coca chewing was not confined to the manifestations of soroche (headache, coma, severe breathing
"difficult" environments of the high Andes and the tropical difficulty). The muscular coats of arteries have receptors for
rain forest, but was practised also in the most favourable en- noradrenaline (alpha receptors) which cause blood vessels to
vironments. Nor is social stress a sufficient explanation for the constrict when they are stimulated. There is also evidence
coca habit. Bolton is correct in his assertion that today the to suggest that membrane beta receptors (which respond to
primary adhesions of coca are poverty, ill health, poor diet, adrenaline and noradrenaline) on the lining cells of some
stress, and hard physical labour-but that is precisely the con- glands and blood vessels can partly inhibit the outward pasdition
of much of the Indian population within the present- sage of ions and water (Cherksey and Zadunaisky 1981).
day national cultures of Latin America. We maintain that the Whether coca has sufficient effect upon circulating noradrencorrelation
is with "Indianness," rather than with misery per aline during exercise at high altitude to constrict upstream
se. Why, if Bolton is correct, do the poor, unhealthy, under- blood vessels and diminish fluid transport is an open question,
fed, and distinctly stressed inhabitants of the urban slums not but it seems a rather long shot.
make greater resort to coca? And why, in pre-Hispanic times, We are not persuaded by Bolton's hypothesis concerning
was coca chewed by all segments of society, including the least the role of cocaine in glucose regulation. Hypoglycaemia is a
stressed (the caciques and the ruling classes), who were neither potent stimulus to the release of adrenaline (epinephrine)
poor, malnourished, nor overworked? As a sole explanation for from the adrenal gland, but adrenaline acts as a circulating
coca chewing, the biological imperative is simply inadequate. hormone and not as a neurotransmitter. Circulating adrenaline
We are not, of course, denying that coca taking has physio- is mainly removed by the action of an enzyme, catechol
logical effects, and we are grateful to those colleagues who o-methyl transferase, and the concentrations reaching the tishave
contributed to the medical debate. The question of co- sues are much less affected by the action of cocaine upon recaine,
catecholamines, and thermogenesis raised by Vitti is uptake into nerves than is the case with noradrenaline. Furvery
interesting and is difficult to answer. In a newborn ani- thermore, circulating adrenaline has its main action upon the
mal or a human baby a special type of fat, "brown fat," which beta2 subclass of adrenergic receptors, which do not appear
has a rich sympathetic innervation and blood supply, plays an to be supplied by sympathetic nerve fibres. Thus there is no
important role in nonshivering thermogenesis. There is great amine pump in the near vicinity of these receptors whose
controversy about the amount and role of brown fat in the action could be modified by cocaine.
adult (Hervey and Tobin 1983, Rothwell and Stock 1983), We did not address the question of polycythaemia, but we
particularly in relation to obesity. Intravenous infusion of think it is very unlikely that cocaine could have a beneficial
fairly high doses of the sympathetic neurotransmitter nor- effect by this means. It is necessary to distinguish an increased
adrenaline (norepinephrine) does stimulate heat production haemoglobin concentration (caused by concentration of the
in adults (Jung et al. 1979). However, the amounts required blood) from a true increase in the functioning mass of red
produce circulating concentrations of noradrenaline such as cells in the body. Patients with a rare tumour of the adrenal
are seen only during heavy muscular exercise. In studies with gland, a phaeochromocytoma, often have very high circulating
the antidepressant drug desmethylimipramine, which has a levels of adrenaline and noradrenaline and sometimes have a
similar action to cocaine upon the amine pump in sympathetic moderate increase in the haemoglobin concentration in the
nerves, the resting concentrations of adrenaline and noradren- blood. This is usually the result of an increase in haemoglobin
aline in plasma did not rise (Brown and Macquin 1982). The concentration rather than in red cell mass, and this would not
reason may be that there is local negative feedback control of be beneficial at altitude. It is doubtful whether the much
noradrenaline release by a (presynaptic alpha2) receptor on smaller changes in catecholamines brought about by chewing
the nerve ending at low rates of nerve traffic. It is therefore coca would have any independent effect upon haemoglobin
unlikely that coca chewing would increase heat production at concentration.
rest, and this would seem the most relevant factor for tolera- Turning to the question of the delivery system, there is no
tion of a cold environment. Potentiation of noradrenaline ther- doubt that the quid of leaves is a form of sustained release
mogenesis during heavy exercise would represent a small in- formulation, and we agree with Barnett that its role must be
crement in the normal large increase in heat output during related to the speed of absorption from the mouth. If all the
exercise.
cocaine were to be absorbed quickly it would not be necessary
Spear's comments about the effect of oxygen deprivation on to hold the leaves in the buccal pouch, and the half-life in
the biosynthesis of catecholamines are most interesting. How- blood would be long enough to provide an effect of moderate
ever, molecular oxygen is required by a great many other duration.
enzymes, and the limit of adaptation to altitude is reached In an article intended to make a general point, we deliberwhen
the oxygen pressure in the mitochondria falls to a level ately refrained from detailed discussions of regional idiosynwhich
cannot sustain the energy supply to cells. Resting heart crasies in the coca chewing habit. Henman's comment, with
rates and exercise responses do not suggest greatly increased its Colombian and Brazilian examples, shows that there is still
sympathetic activity at altitude, though a modest increase un- a need for regional studies of coca chewing (especially where
doubtedly occurs. We cannot rule out some modification of legislation is contemplated), though his particular cases do not
the effect of coca by high altitude but are glad to note her invalidate our overall argument. We describe a general trend,
agreement that this does not weaken our conclusion that this and, as with any statistical correlation, there will be deviations
is not the main factor determining its use.
from the "normal" pattern. Some non-Indians will chew coca;
We are aware of the belief, mentioned by Lewellen, that some Indians will not. Nor is the pattern a static one. Hencoca
may prevent soroche. There are possible mechanisms man (1980) has provided an excellent study of the way in
whereby it might have a physiological effect, as opposed to which economic factors have influenced the distribution of
alleviation of psychological stress, although there is no direct coca taking among Indian communities in the Colombian
280 CURRENT ANTHROPOLOGY

Andes, and in doing so he provides some support for our
Bray and Dollery: COCA AND ALTITUDE STRESS
argument that coca chewing tends to correlate with the more
traditional cultures. At the time when the Guambiano and
. 1981. Susto, hostility, and hypoglycemia. Ethnology 20:
Coconuco started to give up chewing, the habit "began to be 261-76. [RB]
. 1982. The hypoglycemia-aggression hypothesis: An overconsidered
an uncouth [barbara] form of behaviour by many view of research. Paper presented at the NATO Conference on
of the more progressive Indians" (Henman 1980: 76, our the Biological Bases of Antisocial Behavior, Skiathos, Greece,
translation and italics). Meanwhile, their P'aez neighbours, one September 20-24. [RB]
of the most cohesive and tenacious ethnic minorities in Co-
. n.d. The hypoglycemia-aggression hypothesis: Debate versus
research. CURRENT ANTHROPOLOGY. In press. [RB]
lombia, continue to campaign for the right to chew coca in the BOLTON, RALPH, and SUSANA A. LEON. n.d. The effects of glycemic
traditional way (Henman 1980: 79, 290). Lewellen, too, com- condition on cognitive and linguistic complexity. MS, Departments
that it is the more acculturated Aymara who tend to ment of Anthropology, Pomona College. [RB]
reject coca.
BOLTON, RALPH, and CONSTANCE VADHEIM. 1973. The ecology of
East African homicide. Behavior Science Research 8:319-41.
All lines of evidence suggest that coca chewing is a volun- [RB]
taristic act, not primarily a response to a powerful physio- BRAY, WARWICK. 1978. The gold of El Dorado. London: Times
logical need. The question then becomes: Who chooses to Books.
chew? The answer, by and large, seems to be those most dis- BROWN, M. J., and I. MACQUIN. 1982. Catecholamine amine neurotransmitters
and the heart. Acta Medica Scandinavica (Suppletanced
from the values of the dominant white-mestizo culture. ment) 660:34-39.
This is a broad category (which includes not a few alienated BUCK, A., T. SASAKI, and R. ANDERSON. 1968. Health and disease
intellectuals), but numerically by far the largest element is in four Peruvian villages. Baltimore: Johns Hopkins.
made up of traditional Indian groups, those least influenced BUCK, A., T. T. SASAKI, J. J. HEWITT, and A. A. MACRAE. 1968. An
epidemiologic study among residents of a Peruvian village. Amerby,
or most resistant to, the dominant "national" culture. ican Journal of Epidemiology 88:159-77.
In this connection we cannot understand why Bolton insists BURCHARD, RODERICK E. 1976. Myths of the sacred leaf: Ecological
that in documents prepared by native Americans "no mention perspectives on coca and peasant biocultural adaptations in Peru.
is made of chewing coca because of Indian identity or cultural Unpublished Ph.D. dissertation, Indiana University, Bloomington,
Ind.
values." The P'aez manifesto quoted by Henman (1980) ap-
. 1980. On coca chewing and the polycythemia hypothesis.
pears in the general conclusions of the Fourth Congress of the CURRENT ANTHROPOLOGY 21:108-9.
Consejo Regional Indigena del Cauca, and the example we CALIFANO, MARIO, and ALICIA FERNbNDEz DISTEL. 1977. El empleo
cited comes from a meeting attended by 300 delegates from de la coca entre los Mashco de la Amazonia del Per(u. Annals,
most of Colombia's Indian communities, plus representatives
Goteborgs Etnografiska Museum, pp. 16-32.
CARTER, W. E., P. PARKERSON, and M. MAMANI. 1980. "Traditional
from Ecuador, Venezuela, and Panama. The whole purpose of and changing patterns of coca use in Bolivia," in Cocaine 1980:
these meetings was to assert ethnic identity and culture in the Proceedings of the Interamerican Seminar on Medical and Socioface
of an encroaching, hostile, majority culture. The fact that logical Aspects of Coca and Cocaine. Edited by F. R. Jeri, pp.
coca chewing was specifically mentioned in such a context
159-64. Lima.
CASTELLANOS, JUAN DE. 1955 (1598). Elegias de varones ilustres de
surely proves our point.
Indias. Bogota: Editorial A.B.C.
We admit that, all too often, our case relies on circumstan- CHERKSEY, B. D., and J. A. ZADUNAISKY. 1981. Membrane betatial
evidence and agree that we need much more analytical receptors: Interaction with cytoskeleton in chloride secretory
information, not only on coca, but on the additives as well systems. Annals of the New York Academy of Science 372:309-
31.
(see Plowman 1980:253). The diversity of views among those CIEZA DE LEON, PEDRO DE. 1971 (1554). La cronica del Peru'.
who commented on our paper shows how far we are from Bogota: Revista Ximenez de Quesada.
a consensus, but we believe that the general trend of the evi- COCCHI, RENATO. 1982. Aggressive behavior as a neurophysiologidence
strongly supports our argument.
cal compensation against depression. Paper presented at the
NATO Conference on the Biological Bases of Antisocial Behavior,
Skiathos, Greece, September 20-24. [RB]
COHEN, MARK N. 1978. "Population pressure and the origins of
agriculture: An archaeological example from the coast of Peru,"
in Advances in Andean archaeology. Edited by D. L. Browman,
References Cited
pp. 91-132. The Hague: Mouton.
CRUZ SANCHEZ, G., and A. GUILLE'N. 1948. Estudio quimico de las
AGUIRRE BELTRAN, GONZALO. 1967. Regiones de refugio. Instituto substancias alcalinas auxiliares del cocaismo. Revista de Farma-
Indigenista Interamericano, Ediciones Especiales 46. [RB] cologia y Medicina Experimental 1:209-15.
ALCINA FRANCH, JOSE, and REMEDIOS DE LA PERA. 1976. Textos CUBILLOS, JULIO CE'SAR, and Luis DUQUE GOMEZ. 1979. Arqueopara
la etnohistoria de Esmeraldas. Madrid: Universidad Com- logia de San Agustin: Alto de los Idolos, monticulos y tumbas.
plutense, Departamento de Antropologia y Etnologia de America. Bogota: Banco de la Rep6iblica, Fundacion de Investigaciones
ALLEN, CATHERINE J. 1981. To be Quechua: The symbolism of Arqueologicas Nacionales.
coca chewing in highland Peru. American Ethnologist 8:157-71. DILLEXAY, TOM D. 1979. Pre-Hispanic resource sharing in the Cen-
[RB]
tral Andes. Science 204:24-31.
ANTONIL. 1978. Mama Coca. Leiston: Practical Paradise.
ENGEL, FREDERIC. 1957. Early sites on the Peruvian coast. South-
BARNETT, GENE, RICHARD HAWKS, and RICHARD RESNICK. 1981. Co- western Journal of Anthropology 13:54-68.
caine pharmacokinetics in humans. Journal of Ethopharmacology . 1963. A Preceramic settlement on the central coast of Peru:
3:353-66. [GB]
Asia, Unit 1. Transactions of the American Philosophical Society
BOHM, BRUCE A., FRED R. GANDERS, and TIMOTHY PLOWMAN. 1982. 103(3).
Biosystematics and the evolution of cultivated coca. Systematic FISH, F., and W. D. C. WILSON. 1969. Excretion of cocaine and
Botany 7:121-33.
its metabolites in man. Journal of Pharmacy and Pharmacology
BOLTON, RALPHI. 1972. Aggression in Qolla society. Unpublished 21 (suppl.): 135S-138S.
Ph.D. dissertation, Cornell University, Ithaca, N.Y. [RB] FRANcIScO, ALICE E. 1969. An archaeological sequence from Carchi,
. 1973. Aggression and hypoglycemia among the Qolla. Eth- Ecuador. Unpublished Ph.D. dissertation, University of Californology
12:227-57. [RB]
nia, Berkeley, Calif.
. 1976a. Andean coca chewing: A metabolic perspective. FUCHS, ANDREW. 1978. Coca chewing and high-altitude stress: Pos-
American Anthropologist 78:630-34. [RB]
sible effects of coca alkaloids on erythropoiesis. CURRENT ANTHRO-
. 1976b. Hostility in fantasy: A further test of the hypo- POLOGY 19:277-91.
glycemia-aggression hypothesis. Aggressive Behavior 2:257-74. HANNA, JOEL M. 1974. Coca leaf use in southern Peru: Some bio-
[RB]
social aspects. American Anthro pologist 76: 281-396.
. 1979. On coca chewing and high-altitude stress. CURRENT HENMAN, ANTHONY. 1980. Mama Coca. Bogota: El Ancora/La
ANTHROPOLOGY 20:418-20.
Oveja Negra.
. 1980. Susto: The myth of a folk illness. Paper presented HERVEY, G. R., and G. TOBIN. 1983. Luxuskonsumption, diet-inat
the 79th annual meeting of the American Anthropological As- duced thermogenesis, and brown fat: A critical review. Clinical
sociation, Washington, D.C. rRBI
Science 64:7-18.
Vol. 24 No. 3 June 1983 281

HOLMSTEDT, Bo, JAN-ERIK LINDGREN, LAURENT RIVIER, and Tm-
OTHY PLOWMAN. 1979. Cocaine in blood of coca chewers. Journal
of Ethnopharmacology 1:68-78.
JERI, F. R. Editor. 1980. Cocaine 1980: Proceedings of the Interamerican
Seminar on Medical and Sociological Aspects of Coca
and Cocaine. Lima.
JONES, JULIE. 1974. Rituals of euphoria: Coca tn South America.
New York: Museum of Primitive Art.
JUNG, R. T., R. S. SHETTY, W. P. T. JAMES, M. A. BARRAND, and
B. A. CALLINGHAM. 1979. Reduced thermogenesis in obesity.
Nature 279:322-23.
LATHRAP, DONALD W., DONALD COLLIER, and HELEN CHANDRA. 1975.
Ancient Ecuador: Culture, clay, and creativity. Chicago: Field
Museum.
LITTLE, M. A. 1978. Comment on: Coca chewing and high-altitude
RESNICK, RICHARD, RICHARD KESTENBAUM, and LEE SCHWARTZ.
1977. Acute systemic effects of cocaine in man: A controlled
study by intranasal and intravenous routes. Science 195:696-98.
[GB]
ROSTWOROWSKI DE DIEz CANSECO, MARIA. 1973. Plantaciones prehispanicas
de coca en las vertientes del Pacifico. Revista del
Museo Nacional (Lima) 39:193-224.
ROTHWELL, N. J., and M. J. STOCK. 1983. Luxuskonsumption, dietinduced
thermogenesis, and brown fat: The case in favour. Clinical
Science 64:19-23.
ROWE, JOHN HOWLAND. 1947. The distribution of Indians and Indian
languages in Peru. Geographical Review 37:202-15.
RURY, PHILLIP M. 1981. Systematic anatomy of Erythroxylum
P. Browne: Practical and evolutionary implications for the cultivated
cocas. Journal of Ethnopharmacology 3:229-63.
stress: Possible effects of coca alkaloids on erythropoiesis, by
Andrew Fuchs. CURRENT ANTHROPOLOGY 19:286. [MAL]
LOBB, C. GARY. 1974. El uso de la coca como manifestacion de cultura
indigena en las montafias occidentales de Sudamerica. America
Indigena 34:919-38.
LOTHROP, SAMUEL KIRKLAND. 1937. Cocle: An archaeological study
of Central Panama. Pt. 1. Memoirs of the Peabody Museum of
Archaeology and Ethnology 7.
LOWE ART MUSEUM. 1981. Pre-Columbian ceramics from Ecuador.
Coral Gables: University of Miami.
MANSTA, R. H. F., and H. L. HOLMES. Editors. 1950. The alkaloids:
Chemistry and physiology. New York: Academic Press.
MARTIN, RICiARDJ T. 1970. The role of coca in the history, religion,
and medicine of South American Indians. Economic Botany 24:
422-38.
MAZESS, R. B. 1978. Comment on: Coca chewing and high-altitude
stress: Possible effects of coca alkaloids on erythropoiesis, by
Andrew Fuchs. CURRENT ANTHROPOLOGY 19:286. [MALI
MISHKIN, BERNARD. 1946. "The contemporary Quechua," in Handbook
of South American Indians, vol. 2. Edited by J. Steward,
pp. 411-70. Washington, D.C.: Smithsonian Institution, Bureau
of American Ethnology.
MONGE M., C. 1952. The need for studying the problem of coca
leaf chewing. Brulletin on Narcotics 4:13-15.
. 1968. "Man, climate, and changes of altitude," in Man in
adaptation: The biosocial background. Edited by Y. Cohen. Chicago:
Aldine. [RB]
NARANJO, PLUTARCO. 1974. El cocaismo entre los aborigenes de Sud
America. Ame'rica Indigena 34:605-28.
NETHERLY, PATRICIA J. 1976. Inca coca lands on the north coast of
Peru. Paper delivered at the annual meetings of the American
Anthropological Association, Washington, D.C.
PATIRO, ViCTOR MANUEL. 1967. Plantas cultivadas y animales dome'sticos
en Ame'rica equinoccial. Vol. 3. Cali: Imprenta Departamental.
PEREZ DE BARRADAS, Josi. 1950-51. Los Muiscas antes de la conquista.
Madrid: Instituto Bernardino de Sahagiun, Consejo Superior
de Investigaciones Cientificas.
PLOWMAN, TIMOTHY. 1979a. The identity of Amazonian and Trujillo
coca. Botanical Museum Leaflets 27:45-68.
. 1979b. Botanical perspectives on coca. Journal of Psychedelic
Drugs 11:103-17.
. 1980. Chamairo: Mussatia hyacinthina, an admixture to
coca from Amazonian Peru and Bolivia. Botanical Museum Leaflets
28:253-61.
. 1981. Amazonian coca. Journal of Ethnopharmacology 3:
195-225.
REICHEL-DOLMATOFF, GERARDO. 1949-50. Los Kogi: Una tribu de
la Sierra Nevada de Santa Marta, Colombia. Revista del Instituto
Etnolo'gico Nacional (Bogota) 4(1-2).
. 1972. San Agustin: A culture of Colombia. New York:
Praeger.
REICHEL-DOLMATOFF, GERARD, and ALICIA DUSSAN DE REICHEL.
1943. Las urnas funerarias de la cuenca del Rio Magdalena. Revista
del Instituto Etnolo'gico Nacional 1:209-81.
SALOMON, FRANK LOEWEN. 1978. Ethnic lords of Quito in the age
of the Incas: The political economy of North-Andean chiefdoms.
Cornell University Latin American Studies Program, Dissertation
Series 77.
SALOMON, P. 1949. Potentiality of the neuro-stimulant effect of
cocaine by alkaline substances. Revista de Farmacologia y Medicina
Experimental 2:114.
SANDAGORDA, ARMANDO E. 1980. "Coca production in Bolivia," in
Cocaine 1980: Proceedings of the Interamerican Seminar on
Medical and Sociological Aspects of Coca and Cocaine. Edited
by F. R. Jeri, pp. 165-69. Lima.
SAVILLE, MARSHALL H. 1910. The antiquities of Manabi, Ecuador:
Final report. New York.
SCHULTES, RICHARD EVANS. 1981. Coca in the Northwest Amazon.
Journal of Ethnopharmacology 3:173-94.
SCHULTES, RICHARD EVANS, and Bo HOLMSTEDT. 1968. The vegetal
ingredients of the myristaceous snuffs of the Northwest Amazon.
Rhodora 70:113-60.
STEWARD, D. J., T. INABA, M. LUCASSEN, and W. KALOW. 1979.
Cocaine metabolism: Cocaine and norcocaine hydrolysis by liver
and serum esterases. Clinical Pharmacology and Therapeutics 25:
464-68.
STEWARD, JULIAN H. 1946-59. Handbook of South American Indians.
7 vols. Washington, D.C.: Smithsonian Institution, Bureau
of American Ethnology.
TOWLE, MARGARET A. 1961. The ethnobotany of pre-Columbian
Peru. Viking Fund Publications in Anthropology 30.
URIBE, MARiA VICTORIA. 1977-78. Asentamientos prehisp6anicos en
el altiplano de Ipiales, Colombia. Revista Colombiana de Antropologia
21:57-195.
. 1980. Las etnias prehisp'anicas del altiplano de Ipiales:
Consideraciones finales. Paper presented to the II Congreso de
Antropologia, Medellin, Colombia.
USCATEG-UI MENDOZA, NESTOR. 1954. Contribucion al estudio de la
masticacion de las hojas de coca. Revista Colombiana de Antropologia
3:207-89.
VACCARI, A., S. BROTMAN, J. CIMINO, and P. S. TIMIRAS. 1978a.
Adaptive changes induced by high altitude in the development of
brain monoamine enzymes. Neurochemical Research 3:295-311.
[LPS]
VACCARI, A., J. CIMINO, S. BROTMAN, and P. S. TIMIRAS. 1978b.
"High-altitude hypoxia and adrenal development in the rat: Enzymes
for biogenic amines," in Environmental endocrinology.
Edited by I. Assenmacher and D. S. Farner, pp. 283-89. New
York: Springer. [LPS]
VAN DYKE, C., and R. BycK. 1982. Cocaine. Scientific American
246(3):10f8-19.
VAN DYKE, C., P. JATLOW, J. UNGERER, P. G. BARASH, and
R. BYCK. 1978. Oral cocaine: Plasma concentrations and central
effects. Science 200:211-13.
VAZQUEZ DE ESPINOSA. ANTONIO. 1942 (1629). Compendium and
description of the West Indies. Edited by C. U. Clark. Smithsonian
Miscellaneous Collections 102.
282 CURRENT ANTHROPOLOGY