In the old book ‘Erythroxylon coca: a treatise on brain exhaustion, as the cause of disease” by W. TIBBLES, MD. A disorder is described we do not recognize anymore: brain exhaustion.

Dr. Tribbles believed coca leaves is the remedy of choice….

Brain exhaustion was a special case of nervous exhaustion, states of the nervous system we now know that those are probably related to slow inflammation. For symptoms of tiredness, irritability, lack of energy, chronic pain in the past doctors could only diagnose these as ‘exhaustion’.

Why palmitoylethanolamide is used.

Nowadays we know much more. For such states, the natural anti-inflammatory compound and supplement palmitoylethanolamide (PEA) seems quite a good fit.

Many patients suffering from chronic fatigue syndrome have benefited from PEA (eg. 2-3 times daily 400 mg). Patients often prefer the PeaPlex capsules, because the biological and physiological normalizing action of PEA has been supported by a special selection of low dose vitamins of the B group, suited to support the immune system and the nervous system.

For pain relief and for inhibiting inflammation, most patients choose:

  • PEA capsules produced in the Netherlands by Russell
  • PEA tablets produced in Italy by Epitech

Here we disclose an old text on brain exhaustion, part 6, chapter 2,

in this chapter is enclosed the part on ‘THE EXCITING CAUSES OF DISEASE.’



“Disease! thou ever most propitious power, Whose kind indulgence we discern each hour Thou well canst boast thy numerous pedigree, Begot by Sloth, maintained by Luxury. In gilded palaces, thy prowess reigns, But flies the humble sheds of cottage swains. To you, such might and energy belong, You nip the blooming and unnerve the strong. The purple conqueror in chains you bind, And are to us your vassals only kind.”

Sir Samuel Garth, M.D.

A disease is the disorganized action of any part of the machinery of the body. Its primary effects, or more properly its primary obvious effects, are impeded or disordered functions; and of these, the results are alterations of nerve structure, and various symptoms indicative of functional and structural changes.

Life is a condition of unending change, and this change is two-fold — first, a construction of the body from foreign organic materials; and second, a destruction of it into inorganic matter.

State of health.

Where these changes sustain their equilibrium, the different functional actions of the various organs of the body are performed with perfect ease and comfort, and a sense of well being. This is a state of health, which nature is ever striving to maintain in its natural condition. Whenever any bodily or mental function is not performed with just adaptation and proportion of parts, there is an interruption of this state, however slight the condition of health may be departed from. The first appearance of this slight disease, for such it is, is mere uneasiness. As the disorder proceeds, if it does proceed, from this slight beginning, the uneasiness or discomfort is succeeded by pain and various other attendant inconveniences, which are all symptoms of the disease. Thus the slightest disordered action may produce the only inconvenience; as nausea, trembling, &c, and increased disordered action will produce increased inconvenience; as vomiting, fainting, loss of sensation, inflammation of the skin, with symptoms of pain. On this aggravated state changes of structure supervene, proportionate to the power of vital resistance.

Wm. Hitchman, M.D., D.C.L., F.R.S., says, ” The bodily organization of man and other animals possesses a peculiar property, called excitability — every agent acting upon it during life does so as a stimulant, physiologically, when they are duly exercised, produce the healthy performance of mental and physical functions, but when excessive — they produce nervous exhaustion — cerebral and spinal; in other words, there is direct debility of body and soul; when very deficient the morbid effect is really an accumulation of this same excitability, known as indirect debility. Now, from one or other of these abnormal conditions, or debilitated states arise loss of vital force, and consequently all those diseases which concern doctor and patient.”

Importance of digesting

Consistent with the state of health, also are considerable varieties in the performance of certain functions. They do not interrupt health, so far as to produce even discomfort. The pulse of some individuals is never beyond fifty, and of others never below one hundred. In some the function of digestion is more rapidly performed than in others; and the intellectual force and promptitude of different persons is well known to be widely different, yet without the disease. But when the food is not digested without discomfort and pain, or the circulation retarded or increased, or the mental movements not made, without similar results; when the appetite is lost, when there is fainting, when there is privation or other affection of any of the sensations or mental faculties; then there is disease.

Observation shows us that man is exposed to various circumstances capable of disordering his bodily and mental functions, and all these circumstances are so many causes of disease. They are found in the elements by which he is surrounded; in the food on which he subsists; in excess or defect of voluntary exercise; and in the nature of his mind, sensations, and affections. Man is also liable to connate, inherited, and acquired defects, and also to diseases due to the natural decay of his bodily frame.

Production of disease.

Two things are necessary for the production of disease; a disposition in an organ to be acted upon, and a cause, capable of acting upon some organ. Two kinds or classes of causes are therefore required for the production of disease; first, a predisposing cause, and second, an exciting cause. This may be illustrated by the following: — One man is affected with typhus fever, and his neighbors escape. The exciting cause of the fever is supposed to be some peculiar poisonous matter in the air, generated by decomposing organic matter. But his neighbors have been exposed to the same peculiarity, and are not affected with fever. His power of vital resistance was not previously sufficient to overcome.

This presumed disorder of his health, was, in this instance, the cause which predisposed him to the influence of the exciting cause. In the same way, half-a-dozen persons may be simultaneously exposed to cold and moisture, one becomes affected with a sore throat, one with pleurisy, and one with rheumatism; and the remaining three may continue in health. The exciting cause was present to all, but a predisposing cause existed only in some of them and was different in each of those in whom it did exist. There is in the system a tendency to throw off or get rid of any injurious materials that may be lurking in the body, and the violence of the malady will be in the inverse ratio to this power. The power, by which nature preserves the organism against the attacks of injurious materials, is called the vis medicatrix naturae. Where this is powerful it considerably holds in check the exciting causes of disease, and sets up an opposing force against their action, — hence, some persons, although, to a certain extent predisposed to a particular disease, are not attacked or only slightly so, from the simple reason that their vital force is sufficient to overcome the exciting cause.


One of the most potent of predisposing causes and one that is very deeply rooted is termed hereditation. This is a tendency to a particular disease, engendered in the constitution of a child by its parents. Everyone knows how susceptible an individual is to consumption of the lungs, whose parents have died of that malady. A tendency to scrofula, gout, numerous forms of skin diseases, epilepsy, insanity, asthma, and even disorders of the senses, such as partial or total blindness or deafness, will pass down from generation to generation more certainly than titles or estates.

Young women who have been more than ordinarily subject to hysteria, frequently give birth to children, who, at an early age, become the subject of convulsions. As these children grow up, if females, they too, become attacked with hysteria. Children born to them have to pass, in their turn, through the same phases that their parents had gone through before them. These tendencies are engendered in the constitution of the child before birth, and it enters upon life, with the sword of Damocles hanging over its head, to fall at any moment when a favorable opportunity occurs. All children, born of the same parents do not suffer in like manner. Frequently, a whole generation may escape, and the tendency appears with redoubled force in the next.

Hereditation can scarcely be said to be the communication of a disease from parent to child, but simply the tendency to a disease. Nor will this tendency become developed until a series of favorable circumstances constituting an exciting cause, aids its manifestation. Thus a child inheriting from its parents the predisposition to gout, the malady does not appear until the individual has reached that age at which the constitution is most commonly attacked by that disease.

The exiting causes of disease.

The element to which man is chiefly and at all times exposed is air. Pure atmospheric air, is composed of two elementary gases, viz., oxygen and nitrogen, in the proportion of one volume of the former, and four volumes of the latter; thus there are in 100 parts, by volume, of air, oxygen 21, nitrogen 79; but, in our cities and towns, it is usually contaminated with other gases — such as, carbonic anhydride, water vapour, ammonia, nitric acid, and sometimes sulphureted hydrogen, together with various miasma generated in damp places Its variable temperature, dryness, and moisture; its alteration of calmness and commotion, and also its various electrical states; immediately affect the surface of the respiratory organs and through the nervous system the energy of the whole body. Some of the variations seem to have a direct influence on the whole nervous system; thus in a thick, foggy, atmosphere, the electric fluid, which is identical with, and supports nervous power, is deficient; and we feel dull, drowsy, and languid. There are properties — morbid poisonous gases — in the air, which are largely concerned in the production of our common continued, yellow, and intermittent fevers, cholera, smallpox, influenza, etc., no doubt can be entertained of the potent agency of such atmospheric influences in the production of the common eruptive disorders, and of the disorders characterized by a particular portion of the nervous system, the respiratory, and by spasm, — circumstances exemplified by the hooping cough. To the direct influence of the contaminating substances contained in the atmosphere, must be ascribed the variations and feelings of so many individuals in changeable states of the weather, and the suicidal despondency which is found to be induced by the oppression. The condition of certain structures of the body, and of their nerves, is seen in the course of the seasons to be materially affected by certain states of the atmosphere; the effects, being sometimes, apparently, only the result of temperature, as in colds, and obstructions of the respiratory and circulatory organs in the cold weather of severe winters; but at other times more obscure, as in irritability of the mucus membrane of the stomach and intestines in the summer and autumn of the year. The consequences are periodical dyspepsia, gastric fevers, diarrhea, dysentery, and cholera. Of the diseases thus obscurely arising, some, peculiar to particular localities are called endemic; others appearing and disappearing with some regularity are called epidemic, and many of the latter become, under certain circumstances, capable of being communicated from one individual to another.

Unhealthy trades are a great source of diseases.

The occupations of great numbers are frequently carried on in confined and ill-ventilated buildings, where the mere assemblage of so many persons deteriorates the quality of the air: the effect of breathing this poisoned air is a common cause of disease. The influence of a high temperature, combined with excessive moisture, has been abundantly experienced in the diseases incidental to tropical climates. There are occupations in which light particles of foreign matter are mingled with the air and inspired; and also somewhere poisonous chemicals — are manufactured, or used, in various trades — which continually coming in contact with the skin produce disabling and acutely painful diseases: — such as, ulceration, inflammation, etc. The diseases produced by the inhalation of irritant poisonous particles are first, Chest diseases — consumption of the lungs, bronchitis, asthma, etc.; second, diseases affecting the heart and blood — palpitation and irregular action of the heart, nervous derangement, extreme fluidity of the blood and anemia or deficiency of red corpuscles in the blood; third, glandular diseases — irritation of the salivary glands produced by mercury, and inflammatory degeneration of the membraneous structure of the kidneys, produced by lead; fourth, the stomach and digestive organs — colic, gastro-enteric irritation and choleraic diarrhoea; fifth, Brain and nervous system, — vertigo, neuralgia, paralysis produced by lead, cerebral exhaustion induced by Bisulphide of carbon, cramps, spasms, etc.; sixth, Irritation of the eyes, and sometimes deafness. Some coloring matters are very poisonous — especially that which is used so very commonly for imparting a green color to paper hangings, ornamental papers — as writing paper and cards, for various ornaments connected with ladies dresses, -artificial flowers, candles, &c. ; I refer to Scheele’s green or arsenite of copper. It acts both by absorption through the lungs and also through the skin. It produces disagreeable sores on various parts of the body, of those who use it in their daily avocations, there is also constant soreness of the eyes; the chest and throat are sore, there is a cough, irritation, and pain of the stomach, diarrhea, &c. Dr. Hassal has pointed out that ball dresses coloured with this pigment are a source of danger to the wearer of the dresses as well as to the manufacturers of them. Likewise, the atmosphere of a room whose walls are covered with paper containing this pigment is injurious to health.

Food and water.

In the Quality and Quantity of our food and drink are also found the causes of disease. Some kinds of food produce disorder by their stimulating properties, and some by otherwise producing departures from healthy processes. The most simple and evident causes are eating or drinking hot fluids and eating or drinking impure or badly cooked food, as also eating or drinking too little or too much. Hot fluids act by debilitating the nerve fibers of the stomach, thus the muscular power of that organ becomes impaired, and is rendered incapable of digesting nourishing food. Such things as tea and coffee, before drinking, should be rendered lukewarm by the addition of milk and sugar.

Bad food. Certain kinds of food are difficult of digestion, and frequently ” upset the stomach.” Fat meat, oily fish, smoked and salted meat or fish, are difficult of digestion.

So are unripe fruits, rich cake, and pastry, these latter are full of butter or some kind of grease, which protects the fine flour from the action of the gastric juice. Generally what will keep meat or fish from putrifaction, will also make it hard for digestion. Some persons cannot digest cheese — lobsters, crabs, and mussels disagree with others. The white portion of hard-boiled eggs is acted upon but slowly in the stomach, and fried eggs are worse. Frying makes albumen hard, tough, and greasy. New bread is also very difficult for digestion. Bad Water. The human body is four-fifths water; and of our most important parts — our blood, brains, and nerves — water form a much larger proportion.

Water is thus a very important element. It dissolves our food; it conveys everywhere the elements of nutrition; it carries off the waste matter which would poison our life if it remained in the system; it pours out of the lungs with every breath; it constantly exudes from the millions of pores all over the body. Under certain conditions men can live for days and weeks without food; they quickly perish when deprived of water.

This water, so necessary to every form of life, should be of the purest and the best. Hard water — that which holds minerals in solution — is not so good to drink, or even to bathe in, as that which is soft and pure. It will not so readily dissolve substances and is, therefore, less fitted to aid digestion, circulation, and purification. Foul water, containing either living or decaying vegetable or animal substances, is not nice to drink, and may contain the germs of fatal diseases.

Unfortunately the rivers of England have been turned into common sewers, carrying into the sea or spreading in the air matter which should enrich the land and make it fertile. They are made foul with the wash and waste of butcheries, stables, tanneries, glueworks, and various chemicals from thousands of factories, paper mills, dyeworks, metal works, &c, &c. In too many cases this filthy water is pumped into reservoirs and, with very little purification, is distributed for the drink of great populations.

A large part of the water of the metropolis is pumped from the Thames, which is the common sewer of some millions of people living in towns on its banks above London.

Some is pretty well filtered by the companies that supply it; some so little purified that a drop placed under a microscope is seen to be crowded with vegetable and animal organisms. It is generally admitted that the water distributed to, and drunk in many towns, and even that drawn from wells may be the cause of diarrheas, dysenteries, typhoid fever, and cholera.

Too much food.

Over Eating. Eating too much food is a more frequent cause of disease than eating bad food. The stomach is overloaded, and its powers overtasked. It might be equal to a pound of food, whereas we give it two or three pounds. It is a physiological fact that just as much, and no more, gastric juice is secreted in the stomach as is sufficient to digest enough food to supply the necessities of the system, therefore, if more be taken than the stomach can digest, the remaining portion lies and turns sour, ferments and putrifies in that organ, thus becoming a great cause of exhaustion; Borne people, however, live as though eating and drinking were the sole employment of their very existence, and the stomach entirely breaks down under the heavy tasks laid upon her. More food than is necessary, if digested, is a drag upon the system and causes waste of life. Too much food produces as much mischief as too little.

Irregular eating is, doubtless, as frequently the cause of disease as intemperance in eating. The regular process of digestion becomes interrupted. Before the stomach is halfway through with one lot, we give it another job. It must needs set to work again — secrete more gastric juice, churn and grind a new load, and so on, a-dozen times a day, with biscuits, cakes, buns, sweetmeats, &c, until it is completely disordered, paralyzed, and disgusted, and its owners have sacrificed their health for the baby pleasure of tickling their tongues. This gluttony and intemperance in eating are equally injurious, physically and morally, as intemperance in drinking; and we need not be surprised at the prevalence of Brain exhaustion and indigestion, in these highly civilized nations. The stomach needs rest as much as the brain and limbs. Eat your regular meals; the grown man, especially as his bodily activity declines, and digestion grows feebler, may take his food at comparatively long intervals, but during the growing period, when every portion of the frame is in the full tide of vigorous life, the utmost limit between the meals during the active portion of the day should be four hours.


Alcoholic drinks. Under this designation reference is made to spirits, wines, beer, &c, the use of which is a frequent cause of disease. When taken in what is called a moderate quantity, its action is to reduce the nervous control over the minute blood vessels, and thus vascular excitement is produced, the capillary or minute, hair-like, blood vessels are paralyzed, and expanded with the flowing blood, hence the flushing of the countenance. With the disturbance of power in the extreme vessels, more disturbance is set up in other organs. In the ordinary natural condition, with each movement of the heart, there is a certain degree of the opposition offered by the vessels, when their nervous power is in perfect order, and the beat of the heart is moderated in degree and time. But when the capillary vessels are relaxed, the blood runs through them with greater freedom, the heart works quicker, losing nothing in force, but with an enfeebled recoil stroke. The daily work of the heart, when in its natural condition, is equal to about one hundred and twenty-two tons weight lifted one foot high, but, when under the influence of alcohol, its daily work is sometimes equal to ten, fifteen, or even twenty tons weight lifted one foot, in excess of its natural work. The flushing observed in the cheek after imbibing alcoholic drinks is not merely extended to the visible parts, but the condition is universal. If the lungs, brain, spinal cord, liver, stomach, kidneys, or, in fact, any other organ could be exposed, the vascular engorgement would be found to exist in the same manner.

If the use of these drinks is continued, the functions of the spinal cord are affected, there is a deficiency of the power of co-ordinate action of the muscles, nervous control over certain muscles is lost, and the nervous power is more or less enfeebled generally. The muscles themselves begin to fail in their power, they respond more feebly than a natural to the nervous force, their structure becomes temporarily changed, their power of contraction reduced; sickness also occurs. If still the drinking is carried on to a further stage, the brain itself becomes affected, the controlling influences of the judgement and will are lost, the rational part of the man gives way before the emotional, and the mere sensuous animal instincts and sentiments are laid bare, the senses become in a state of carnival and chaos. The man still drinks, he soon becomes entirely overpowered, the senses are benumbed, voluntary muscular prostration is perfected, and sensibility lost. The heart still remains at its duty, and while it just lives, it feeds the breathing power. In this stage, the man is dead drunk, reduced to a state infinitely worse than that of the lower animals. The circulation and respiration keep the mass of animal matter just within the domain of life until the poison begins to die away, and the nervous centers to revive again.

Such is the outline of the action of these pleasant drinks. For a long time the organism will bear these perversions of its functions without apparent injury, but if repeated in any degree, too often and too long, a series of organic structural changes are the effects produced.

It has been asserted and held for a considerable length of time, that alcoholic drinks by decomposition in the body raised the animal temperature, and that it is necessary to “take just a little drop to keep out the cold,” but recent experimental research has demonstrated that alcohol acts merely as an excitant, that when taken into the body it is partly decomposed at the expense of the oxygen which ought to be applied for the natural heating of the body; that it reduces the animal temperature, and prevents the yield of so much product of decomposition as is natural, and necessary for the continuance of the organic life. Muscles are undoubtedly more rapidly excited into motion by the nervous tumult induced by the alcohol, but the muscular power is actually diminished.

Beer and Wines

But very few persons who habitually drink beer, wines, or spirits, are exempt from injury, varying in degree according to the amount drank. As a cause of disease it gives origin to a very large number of afflicted persons, a great number of whom suffer from its effects even unto death, without suspecting from what they suffer. Some are carried off in their early manhood, others live to middle age, and some live just short of the first stage of old age. The diseases which are eventually produced by the habitual use of alcoholic beverages, when taken in what is considered a moderate quantity, are first a chronic decrease of nervous influence over the circulating system, and thus producing arterial relaxation, increased action of the heart, and sometimes paralysis of the small blood vessels, palpitation is induced, the heart becomes enlarged, the power of the brain is very changeable. The constant excess of work thus entailed upon the heart, &c., renders the necessity for a frequent repetition of the stimulus to excite the various organs to hold up. As these changes in the circulatory system are advancing, deteriorations of the structure of the organic tissues are in active development. Of all the systems that suffer from the continued excitement and paralysis, the nervous and the digestive are injured most positively. When beer, wine, or spirit is taken into the stomach, the action of its alcohol is directly exerted upon the nervous system ; and we have produced exhaustion, indigestion, and partial paralysis, enlargement and congestion of the liver and kidneys, sleeplessness, and very frequently consumption of the lungs.

The effects of intemperance in women (which I am sorry to say has greatly increased of late) are evidenced by its producing dyspepsia, tremulous tongue, with a white or brown coating, bowels irregular in their action, sleep disturbed, hysteria and neuralgia, quick pulse, palpitation and uterine diseases. Victims of intemperance in married life are subject to frequent abortions. All sense of moral rectitude is deadened, and frequently no sacrifice is considered too great for the gratification of the morbid sensuous appetite. The effects upon her family are, if possible, more strongly marked; children born at the fall period are generally puny and weak, predisposed to various diseases, which with a very small amount of certain exciting conditions produce actual disease.

If the effects of the so-called stimulants taken to excess by women be such that the uterine functions are affected, which cannot be denied, then we are not far wrong in saying that the moderate use has an effect which differs only in degree, and not in manner. Therefore, it is very probable that a large portion of our excessive mortality among young children is due to the malnutrition of the child in the womb, caused by the use of alcoholic drinks. Therefore, let me suggest to mothers that they should abstain from taking any food or drink that is likely to interfere with the nutrition of their unborn children. It is a lamentable fact that sufficient attention is not bestowed upon the bodily training of our female population, and the proper regimen of women during the pregnant state.

According to ancient historical writings, we find the health of the mother and her demeanor during pregnancy, were considered to have no small influence on her offpring. Thus, in the Old Testament we read that “the angel of the Lord appeared to Manoah’s wife and said, ‘ Behold, thou art barren and bearest not, but thou shalt conceive and bear a son. Now, therefore, beware, I pray thee, and drink not wine nor strong drink, and eat not any unclean thing; for, lo! thou shalt conceive and bear a son.’ And the woman bare a son, and called his name Samson, and the child grew, and the Lord blessed him.” Judges chap. xiii. An angel is here directing a woman how to conduct herself in the prospect of her becoming a mother; and is it not right that all women should follow the advice under similar circumstances? Mothers of unborn children, allow yourselves to be guided by the advice given to the wife of Manoah, let your diet be of a simple and nourishing kind, take proper exercise, and your general health will be the better for it, you will be better enabled to undergo the pains of childbearing, and your offspring, when born, will be sound and grow and wax strong.


  1. Tibbles (1859-1928) Erythroxylon coca: a treatise on brain exhaustion, as the cause of disease, 1877, Helmsley: W. Allenby; Leeds: Joseph Dodgson; Leicester