AN OVERVIEW OF COFFEE AND HOMOEOPATHY

INTRODUCTION 

Dr. Samuel Hahnemann says, in order to enjoy a healthy long life, man requires foods which contain nutritious, but not irritating, medicinal parts and drink which are either merely diluent and nutrition at the same time, but which contain no medicinal and irritating component parts, such as pure spring water and milk.¹ 

For example, the ingredients which we call spices, as well as beverages reduced to spirits or similar to alcohol, partake more or less of medicaments they become equivocal and injurious to our health and opposed to longevity. 

Medicinal products are substances which do not nourish our bodies, but alter its state of health; but every such alteration is a condition opposed to nature, that is, a species of disease. 

So, whatever we eat or drink has a definite effect, such effect can be curative or positive, might hinder the process of cure or even aggravate the disease.² 

Modern times have introduced the use of many other medicinal beverages and luxuries, such as smoking, tobacco and snuff, brandy, several kind of irritant beers, tea and coffee.³ 

Coffee has effects on healthy human body, Coffee has an active ingredient called “caffeine” which is a natural stimulant. Caffeine is very strong and has the potential of deterring the efficacy of homeopathic medicines by destroying their properties, but coffee is not an antidote of all homoeopathic remedies. The patient will experience a sensitive reaction to the conception of coffee, and it is this particular group of patients for whom coffee may inhibit therapeutic measures. Some sensitive patients cannot tolerate coffee and not that coffee blocks the action of a prescribed homeopathic remedy in the sense of an antidote.² 

Coffee consists of several biological active compounds, such as caffeine, diterpenes, chlorogenic acids, and melanoidins, which may affect human health. The intake of each compound depends on the variety of coffee species, roasting degree, type of brewing method and serving size. The bioavailability and the distribution of each compound and its metabolites also contribute to coffee mechanisms of action. The health benefits of coffee consumption regarding cardiovascular system and metabolism mostly depend on its antioxidant compounds. In contrast, diterpenes and caffeine may produce harmful effects by raising lipid fraction and affecting endothelial function, respectively.⁴ 

It is a frequently debated topic whether coffee is, in fact, capable of impairing the desired effect of homeopathic medication as an antidote, some homeopaths strictly forbid any consumption of coffee during homeopathic therapy. Other take the positions that coffee has no effect whatsoever on the success or failure of therapy, and therefore see no need for such restrictions. 

This study is to experiment the effect of coffee in both the consumers and non- consumers of South Indian Filter Coffee as per the statistics south India have more number of consumers and also have industrial importance in coffee plantations, exports and imports etc. 

Among the South Indian States, Tamil Nadu accounts for 60 percent of consumption, while Karnataka, Andhra Pradesh, and Kerala account for 25%, 10%, and 5% respectively. In the North, East and West zones, consumption of instant coffee is more predominant than filter coffee.⁵

REVIEW OF LITERATURE 

Coffee is a drink prepared from roasted coffee beans. Darkly coloured, bitter, and slightly acidic, coffee has a stimulating effect on humans, primarily due to its caffeine content. It is the most popular hot drink in the world. 

The two most commonly grown coffee bean types are C. arabica and C. robusta. Coffee plants are cultivated in over 70 countries, primarily in the equatorial regions of the Americas, Southeast Asia, the Indian subcontinent, and Africa. As of 2018, Brazil was the leading grower of coffee beans, producing 35% of the world’s total. Green, unroasted coffee is the most traded agricultural commodity and one of the most traded commodities overall, second only to petroleum. Despite sales of coffee reaching billions of dollars worldwide, farmers producing coffee beans disproportionately live in poverty. 

ETYMOLOGY: 

The word coffee entered the English language in 1582 via the Dutch koffie, borrowed from the Ottoman Turkish kahve , borrowed in turn from the Arabic qahwah. Medieval Arab lexicographers traditionally held that the etymology of qahwah meant ‘wine’, given its distinctly dark color, and derived from the verb qahiya , ‘to have no appetite’. The word qahwah most likely meant ‘the dark one’, referring to the brew or the bean; qahwah is not the name of the bean, which are known in Arabic as bunn and in Cushitic languages as būn. Semitic languages had the root qhh, “dark color”, which became a natural designation for the beverage. There is no evidence that the word qahwah was named after the Ethiopian province of Kaffa (a part of where coffee originates from: Abyssinia), or any significant authority stating the opposite, or that it is traced to the Arabic quwwa (“power”). 

The terms coffee pot and coffee break originated in 1705 and 1952 respectively. 

BIOLOGY OF COFFEE PLANT: 

Several species of shrub of the genus Coffea produce the berries from which coffee is extracted. The two main species commercially cultivated are Coffea canephora (predominantly a form known as ‘robusta’) and C. arabica. 

All coffee plants are classified in the large family Rubiaceae. They are evergreen shrubs or trees that may grow 5 m (15 ft) tall when unpruned. The leaves are dark green and glossy, usually 10–15 cm (4–6 in) long and 6 cm (2.4 in) wide, simple, entire, and opposite. ⁶ 

FIGURE 1 – COFFEA ARABICA FLOWERS²⁰ 

FIGURE 2 – COFFEA ARABICA FRUIT²⁰ 

FIGURE 4 – COFFEA CANEPHORA FLOWERS²¹ 

COFFEE PRODUCTION WORLD WIDE: 

Since the beginning of the 20th century, annual world production has grown to over 100 million bags, which corresponds to six to seven million tonnes, whereas in 1825 only 100,000 tonnes were produced. More than 80% of the bags are exported each year. 

Nearly 90 countries export coffee cherries, 60 of them developing countries, with coffee constituting the main export revenue for countries such as Burundi, Ethiopia, Rwanda, and formerly Haiti. The largest producer by far is Brazil (almost 30% of world production in 2015), followed by Vietnam, Colombia, Indonesia, and Ethiopia.  

Statistical data on world agricultural coffee production differs slightly depending on whether it comes from the FAO or the ICO. However, these data are monitored monthly by the ICO and cross-checked, which makes the Organisation a more established reference for international market. Beyond the occasional overproduction crises and inventory differences, the volumes produced, traded, and consumed are following an upward trend. 

Coffee production provides a living for about twenty-five million people, mainly small-scale producers, while imports, processing, and distribution provide a living for about one hundred to one hundred and ten million people.⁶ 

TABLE 1 – TOP TEN GREEN COFFEE PRODUCERS IN 2020 (MILLIONS OF METRIC TONS)⁶ 

Brazil	3.70
Vietnam	1.76
Colombia	0.83
Indonesia	0.77
Ethiopia	0.58
Peru	0.38
Honduras	0.36
India	0.30
Uganda	0.29
Guatemala	0.23
World total	10.80

India has largely been a tea-drinking nation since time immemorial. However, coffee has become an increasingly popular drink since the turn of the twentieth century. It is now no longer a typical drink, but a refreshing and voguish beverage. 

While the urban consumption dominates with about 73 percent of total volumes, the remaining 27 percent it is speculated to account for rural consumption, especially in South India. Among the South Indian States, Tamil Nadu accounts for 60 percent of consumption, while Karnataka, Andhra Pradesh, and Kerala account for 25%, 10%, and 5% respectively. In the North, East and West zones, consumption of instant coffee is more predominant than filter coffee. Occasional drinkers in these regions contribute to 52% of total consumption. However, in the south zone, the consumption of filter coffee is higher than that of instant coffee.⁵ 

HISTORY OF COFFEE IN INDIA: 

India’s tryst with coffee is said to have its origins in early 17th century Karnataka. Baba Budan, a Muslim saint from Chikmagalur, is said to have smuggled seven coffee beans from present day Yemen while returning from Hajj, or a pilgrimage to Mecca. At the time, it was illegal to transport green coffee beans out of the Arabian Peninsula as local coffee producers and traders wanted to preserve their monopoly. However, Baba Budan not only managed to sneak them into India by hiding the beans in his beard but he was also able to plant them in the Chandragiri Hills of the Chikmagalur district, where they soon flourished. 

While coffee production continued in the Chandragiri Hills for well over a century afterward, it is estimated to have been mostly restricted to the area. It was only in the 19th century that coffee plantations aimed at exporting the yield. Regardless, by the 20th century, coffee had become immensely popular throughout the southern states of Karnataka, Tamil Nadu, Andhra Pradesh and Kerala. 

As the British established their rule in India, they also came across South India’s coffee culture and took it upon themselves to commercialize its production. Under these efforts, coffee plantations became ubiquitous throughout the hills of Coorg in southern Karnataka, Wayanad in northern Kerala and other regions. While the yield was mostly exported, a local market was also developing at the time. 

At some point in the 19th century, South Indians widely began brewing their coffee with milk and then sweetening it with honey or jaggery. While it became a daily necessity in many southern households by the late 19th century, coffee was still a rarity in the northern half of the country. It was the establishment and spread of the famous Indian Coffee House during the mid-20th century that bridged this divide. 

With the advent of coffee houses, earthen pots used to brew and serve coffee were replaced by stainless steel tumblers – which are synonymous with Indian filter coffee to this day. The tumbler consists of two halves that resemble cylindrical cups, onto one of which fresh grounds are loaded and then compressed (much like how it is done with a French press) while the other half collects the brewed coffee.⁷ 

The South Indian phonetic rendering of “coffee” is “kaapi,” which is what the drink is also known as. For the kaapi drink, medium-roast Arabica or Robusta beans are commonly used.⁸ 

FIGURE 5 – COFFEE CONSUMPTION PATTERN IN INDIA⁵ 

SOUTH INDIAN FILTER COFFEE: 

Indian filter coffee is a coffee drink made by mixing frothed and boiled milk with the infusion obtained by percolation brewing of finely ground coffee powder in a traditional Indian filter. Internationally, the drink is referred to as MADRAS FILTER COFFEE or SOUTH INDIAN FILTER COFFEE to distinguish it from drip brew coffee, which is normally known as filter coffee. 

FIGURE 6 – SOUTH INDIAN FILTER COFFEE²² 

PREPARATION: 

South Indian filter coffee is brewed with a metal device that resembles two cylindrical cups, one of which has a pierced bottom that nests into the top of the ‘tumbler’ cup, leaving ample room beneath to receive the brewed coffee. The upper cup has two removable parts: a pierced pressing disc with a central stem handle and a covering lid.  

The upper cup is loaded with freshly ground coffee. The grounds are then compressed (tamped) with the stemmed disc into a uniform layer across the cup’s pierced bottom. The coarser the coffee grinds, the more one must tamp the coffee to obtain the same extraction. With the press disc remaining in place, the upper cup is nested into the top of the tumbler; boiling water is poured in. The lid is placed on top, and the appliance is left to slowly drip the brewed coffee into the bottom. The chicory retains the hot water longer, letting the water dissolve and extract more of the ground coffee. 

The resulting brew is generally much stronger than Western drip/filter coffee, and often stronger than espresso. 

Traditionally, the coffee is consumed by adding 1–2 tablespoons of the brew to a cup of boiling milk with the preferred amount of sugar. The coffee is drunk from the tumbler (although a word of English origin, it seems to be the most commonly used name for this vessel), but is often cooled first with a dabarah (also pronounced in some regions as ‘davarah’), a wide metal saucer with lipped walls. 

Coffee is typically served after pouring back and forth between the dabara and the tumbler in huge arc-like motions of the hand. This serves several purposes: mixing the ingredients (including sugar) thoroughly; cooling the hot coffee to a sipping temperature; and most importantly, aerating the mix without introducing extra water (such as with a steam wand used for frothing cappuccinos). An anecdote related to the distance between the pouring and receiving cup leads to another name for the drink, “Meter Coffee”.¹⁰ 

USES OF COFFEE AS A BEVERAGE: 

Coffee is a drink made from coffee beans, which are the roasted fruit of the Coffea arabica bush. People most commonly drink coffee to relieve mental and physical fatigue and to increase mental alertness. Coffee contains caffeine. Caffeine works by stimulating the central nervous system (CNS), heart, and muscles.¹¹ 

The use of coffee as a beverage is continued, and sensitiveness alternates ever more with insensibility, over-hasty resolves with irresolution, noisy, quarrelsomeness with cowardly compliance, affectation of friendship with malicious envy, transient rapture with joylessness, grinning, smiling with inclination to shed tears -symptoms of constant hovering betwixt excitement and depression of the mind and the body.¹ 

Coffee is the major source of caffeine for many populations, but it also contains hundreds of other compounds, many of which might impact pathways related to disease development or prevention. 

ACUTE EFFECTS OF COFFEE ON COGNITION AND MOOD: 

Cognitive and mood benefits of coffee are often attributed to caffeine. However, emerging evidence indicates behavioural effects of non-caffeine components within coffee, suggesting the potential for direct or synergistic effects of these compounds when consumed with caffeine in regular brewed coffee. 

Regular coffee produced the expected effects of decreased reaction time and increased alertness when compared to placebo. When compared to decaffeinated coffee, increased digit vigilance accuracy and decreased tiredness and headache ratings were observed. Decaffeinated coffee also increased alertness when compared to placebo. 

However, coffee contains more than 1000 different compounds including phenolics, diterpenes, and melanoidins, all of which have the potential to affect behaviour either directly or indirectly through interaction with caffeine.  

Similarly, lengthened startled blink onset latency has been shown following decaffeinated coffee as compared to caffeinated coffee, caffeinated juice, and noncaffeinated juice.  

The evidence for behavioural effects of decaffeinated coffee and highlights the need to consider the synergistic contribution of non-caffeine compounds in coffee. 

Coffee is one of the most widely consumed beverages in the world, yet intervention trials examining the specific impact of consuming regular, brewed coffee on cognition and mood are lacking. Given the potential for non-caffeine components within coffee to exert psychoactive effects or to interact synergistically with caffeine, it is important that the effects of regular coffee and decaffeinated coffee are compared to placebo.  

In addition, despite physiological differences between men and women, including in their nutrient needs and in cognitive performance, sex differences are rarely considered in nutritional intervention trials.  

Furthermore, given the impact of the menstrual cycle on resting metabolic rate and systemic clearance of caffeine , it is also possible that sex differences in response will be moderated by age.  

In order to explore this further, the current study compared the behavioural effects of regular coffee, decaffeinated coffee and placebo in elderly participants (61– 80 years) to those in a younger (20–34 years) adult group and examined differential responses in men and women. As debate continues as to whether caffeine’s effects are modulated by habitual consumption  only those who regularly consumed coffee and tea were included.  

Of particular relevance here, low-doses of caffeine have therefore been shown to increase the bioavailability of phenolic compounds and have a synergistic effect in terms of the cardiovascular benefits of polyphenols. 

Coffee also has the potential to impact glucose metabolism as evidenced by an increase in insulin sensitivity observed following decaffeinated coffee when compared to placebo . Interestingly, this effect was not apparent following regular coffee, which may be due to counteractive effects of caffeine and non-caffeine components within regular coffee. Support for this comes from data showing decreased insulin sensitivity  

Whilst learning and memory are not typically susceptible to caffeine, it has been proposed that these tasks may show sensitivity in low arousal situations as is expected in the elderly as energetic resources diminish .  

However, in the current study there was no evidence of higher arousal in the young sample when compared to the older participants on subjective measures of ‘arousal’ or psychomotor tasks. This may suggest that the older cohort studied here were relatively high functioning, as is supported by their status being higher than national averages both in relation to fruit and vegetable consumption and education level . 

It has also been suggested that cognitive benefits of caffeine consumption may be more pronounced in those aged over 80 years . 

Significantly observed derangements are: 

• Rapid Visual Information Processing  
• Learning Delayed  
• Impaired Alertness 
• Marked Tiredness 
• Headache  
• Mental Fatigue 
• Alterations in Overall Mood  
• Jittery¹² 

EFFECTS OF COFFEE ON PREGNANT WOMEN: 

Even before some women realize they are pregnant, they decrease their coffee consumption. Coffee consumption by women tends to decline as early as the 4th and 5th weeks of normal pregnancy. Perhaps the first signal of a viable pregnancy is the sensitivity to odours, which can be accompanied by a diminished desire for coffee and the aromas associated with it.  

As the pregnancy signal intensifies, nausea and overt aversion to odours become increasingly evident . Because women who have early nausea are at a lower risk of early foetal loss (miscarriage) than women who do not experience nausea , a strong pregnancy signal is seen as an indicator of a viable pregnancy, and the absence of a pregnancy signal is seen as an indicator that the situation might be suboptimal.  

The decline in coffee consumption early in pregnancy among women who apparently did not intend to reduce their coffee consumption has been attributed to epiphenomena, including “aversion to tastes and smells ordinarily well tolerated.” A similar phenomenon occurs in premenopausal women also. 

If a weak pregnancy signal is an indicator of a placenta not able to produce the high concentrations of hormones and growth factors needed for foetal wellbeing and optimal growth, the foetus is at increased risk of death and limited growth. If a weak pregnancy signal also allows the gravida to continue her normal coffee consumption, then coffee will be blamed (inappropriately) for increasing the risk of miscarriage and lower birth weight.  

Both of these have been associated with continued normal (pre-pregnancy) level of coffee consumption. To some extent, each of these (i.e., foetal wastage, low birth weight, and continued coffee consumption during pregnancy at pre-pregnancy levels) is a correlate of impaired implantation of the placenta, and a weaker pregnancy signal than occurs following a healthy implantation.¹³ 

EFFECTS OF COFFEE ON LIPID CHANGES: 

High-throughput osmic profiling techniques enable thorough studies of an individual’s response to coffee intake and provide potentially new mechanistic insight to the role coffee plays in health. 

Through Lipid profiling to observe the lipid molecules that they are a subset of the metabolome and serve as ubiquitous and essential multifunctional metabolites. Lipids are directly exposed to intracellular and extracellular biochemical changes and as a result undergone various modifications themselves in accordance with coffee intake. 

Changes in lipid species generally correlated with metabolites that also decreased in response to coffee and thus unlikely originated from the coffee beverage itself. These metabolites were also lipid derivatives; particularly those of the acyl choline and endocannabinoid pathways. Besides kynurenine and xanthine’s, few other aqueous metabolites were consistently represented among correlations with either clinical makers or lipid species.¹⁵ 

CAFFEINE: 

Caffeine is a stimulant, which means it increases activity in your brain and nervous system. It also increases the circulation of chemicals such as cortisol and adrenaline in the body. In small doses, caffeine can make you feel refreshed and focused. In large doses, caffeine can make you feel anxious and have difficulty sleeping.¹⁶ 

CAFFEINE CONSUMPTION: 

Caffeine is one of the most widely consumed stimulants worldwide and is present in a wide range of substances such as coffee, soft drinks, energy drinks, tea, and chocolate . The European Food Safety Authority (EFSA) recently published a scientific opinion paper regarding the safety of caffeine. The papers conducted extensive surveys in 22 European countries. They report a wide variability of mean daily caffeine intake per country. The daily intake ranged from 21.8–416.8 mg per day in individuals ≥18 years old, with coffee being the predominant caffeine containing beverage consumed. 

An average cup of coffee contains approximately 85 mg of caffeine. When taking the average amount of caffeine per cup, the reported coffee intake in the ESFA database roughly translates to a mean coffee intake of 0.25–5 cups. However, it should be recognized that the caffeine dose varies extensively depending on several factors, for example the type of coffee bean and brewing method.¹⁴ 

GLOBAL CAFFEINE CONSUMPTION THROUGH COFFEE: 

Currently, approximately 80% of the world’s population consumes a caffeinated product every day, mainly for its stimulating effects, which makes it the most widely consumed psychoactive substance in the world. Over the last 50 years, world coffee consumption increased at a mean annual growth rate of 1.9%, to almost 9.7 million tons in 2018. The highest coffee consumption occurs especially in the Americas, Europe and Japan.  

The European Union is responsible for the largest consumption volume (about 28% of the total world consumption), but breaking up into individual countries, the USA are the first consumer country (about 16% of the total world consumption), followed by Brazil (the largest producer, with 13% of world consumption), European Union countries, and Japan. Philippines, Russia, Ethiopia, Canada and Mexico contribute about 2.8%, 2.5%, 2.4%, 2.3% and 1.5% of total world consumption, respectively. 

In Canada (6.5 kg/year coffee per capita consumption), as well as in many European countries, such as Denmark (8.7 kg/year), Norway (9.9 kg/year) and Finland (12 kg/year), coffee consumption is very prevalent and accounts for most of the daily caffeine consumption among adults. Considering these data, it is not difficult to accept that coffee is the major contributor to caffeine intake in most countries worldwide.  

Exceptions occur in specific areas, such as regions of South America, Ireland and the United Kingdom, China, India and other Asian countries  

The daily caffeine intake and the type of caffeinated product consumed vary considerably around the world, with sex, age segments, cultural habits and household income.  

The age interval considered for each category also varies among studies and reviews. The cultural habits influence not only the total intake but also the percent contribution of foods to such intake. Differences also occur among geographic regions and between metropolis and countryside, where certain types of products are not available.  

Other than cultural habits, one reason for the differences in consumption levels is the variable concentrations of caffeine found among homemade beverages.  In addition, the estimates did not include soft drinks, although they may be a major source of caffeine for children and adolescents, especially in Western society. As a result, the intake was underestimated.  

CAFFEINE IN ROASTED AND GROUND COFFEE: 

The content of caffeine is not significantly altered during coffee roasting due to its thermal stability, but small losses may occur owing to sublimation. In terms of percent composition, an increase in caffeine content may be observed due to the loss of thermolabile compounds. The range of caffeine contents reported for roasted C. arabica seeds vary in the literature between 0.7 and 1.6 g/100 g (dm), while those for C. canephora vary in the range between 1.8 and 2.6 g/100 g (dm). South Indian filter coffee obtains through roasted and grounded form only and one cup of brewed coffee (8 oz) contains about 70–140 mg of caffeine, or about 95 mg on  an average. 

CAFFEINE IN SOLUBLE COFFEE: 

Soluble coffee production typically involves treating ground roasted coffee with hot water and high pressure to extract the water-soluble compounds, followed by drying. While in Western countries commercial ground roasted coffee generally consists of C. arabica seeds alone or of a blend with a small percentage of C. canephora seeds, in some Western countries, a high percentage of C. canephora or plain C. canephora may be designated for instant coffee production owing to the yield of higher amount of soluble solids in the brew. This explains the higher caffeine contents often observed in reconstituted soluble coffees purchased in some countries, such as Brazil.  

CAFFEINE IN COFFEE BREW: 

Caffeine content in coffee brew is closely related to its stimulating properties as well as to about 10% or less of its bitterness. The final content of caffeine ingested by coffee drinkers depends on all factors that affect the seeds contents, including blend composition, which depends mainly on genetics, the degree of maturation, and the method used to brew the coffee, which may vary considerably according to social and cultural habits of each country. Caffeine is well extracted by the most common hot brewing methods.  

Percolation and decoction methods tend to extract more than infusion methods which have low extraction power, but not only the extraction method is important. The proportion of water to powder, water temperature, size of particle and duration of the brewing process are determinant factors.  

CAFFEINE IN DECAFFEINATED COFFEE: 

Coffee decaffeination is performed in the green seeds but given that recommendations for residual content are made for roasted coffee.  

Current information on decaffeinated coffee sales in the US is not available in common coffee market reports. The consumption of decaffeinated coffee has been fairly static over the last two decades and currently accounts for approximately 12% of total worldwide coffee consumption, although in many countries new low-caffeine coffee products have been introduced.  

The decaffeination process can be performed using different methods and extraction vehicles (water, supercritical carbon dioxide, ethyl acetate, methanol chloride) and often leaves residual amounts of caffeine in the seeds. For a heavy coffee drinker, the ingestion of multiple servings of decaffeinated beverages could result in caffeine doses equivalent to a caffeinated beverage.  

CAFFEINE METABOLISM: 

Caffeine is involved in several biological effects in the human body, most of them related to improvements in brain and Central Nervous System (CNS) functions. However, the biological effects associated with caffeine consumption largely depend on its biotransformation in the body.  

The most complete pharmacokinetic studies on caffeine in human subjects as well as various experimental animals started to be performed late in the 1950s. 

Subsequently, theobromine and theophylline were also reported to be urinary metabolites of caffeine in men and dogs. The extensive metabolization of caffeine, identifying secondary metabolites such monomethylxanthines (1-methylxanthine and 7-methylxanthine), and methyluric acids (1-methyluric acid and 1,7-dimethyluric acid) in both plasma and urine. However, the most important results obtained in earlier studies have been ratified by recent studies. 

Absorption: 

The pharmacokinetics of caffeine is relatively well elucidated and has been reported in several studies, including recent ones. Most existing reports on the matter come from studies using pure caffeine in the form of solutions, capsules, and tablets. Among the food matrices evaluated, the most common are coffee, cola, and cocoa products.  

About 20% absorption occurs in the stomach, and the remaining 80%, in the small intestine. Caffeine can also be quickly absorbed through the oral mucosa, as it does not need to pass the stomach and intestine to get into the blood, and when administered via enema.  

In studies using different food matrices, the absorption of caffeine from soda and chocolate was slightly delayed, relative to coffee, caffeine in a chewing gum format was absorbed faster than in coffee or in capsules and in capsules, the absorption of the same caffeine dose was faster than in coffee. After oral consumption of 70–500 mg of caffeine, peak plasma concentration varies in reports between 1.1 to 17.3 µg/mL. 

Metabolism And Distribution: 

After absorption, caffeine is quickly distributed to most tissues (mean volume distribution of 0.6–1.0 L/kg) and body fluids (i.e., bile, milk, saliva, semen, sweat, and urine), although it is received in the body as a xenobiotic substance. Studies have reported that concentrations of caffeine in saliva are approximately 20–40% lower than in plasma.  

The distribution pattern usually does not change during a person’s entire life, and it can be significantly higher in women when compared to men.  

However, severely obese subjects have exhibited an increased volume of distribution, although this volume was decreased with weight reduction. The effect was more important in females, and it was suggested that caffeine distribution into the adipose tissue was incomplete, representing 70–80% excess of body weight in obese subjects. Caffeine and its major metabolite paraxanthine can be found in the amniotic fluid throughout gestation, and they are distributed to fluids and tissues of the foetus.  

Caffeine has also been identified in women’s milk. Caffeine is rapidly and extensively metabolized in the liver cells to form dimethyl and monomethylxanthines, dimethyl and monomethyluric acids, and uracil derivatives.  

Paraxanthine is the major caffeine metabolite in plasma, while methylated xanthines and methyluric acids are the main metabolites excreted in urine.  

In a lesser extent, caffeine may be converted to 1,3,7-methyluric acid. Paraxanthine. And the secondary metabolites, such as 7-methylxanthine (~20%) may also be oxidized to 7-methyluric acid. 

The pharmacological and biochemical properties of caffeine make it a model substrate capable of revealing activity of other drug metabolizing enzymes in animals and humans.  

Caffeine’s half-life is altered in the neonatal period. It increases shortly after birth due to lower activity of cytochrome P-450 enzymes and the relative immaturity of some demethylation and acetylation pathways. Caffeine’s half-life is about 80 h for the full-term new born infant and can be over 100 h in premature infants. Infants up to the age of eight to nine months still present a reduced ability to metabolize caffeine, excreting in urine about 85% of the administered caffeine in its unchanged form. 

In fact, health status, in general, is another factor that influences caffeine metabolism. The biotransformation is related to the proper function of the liver and kidneys, and the decrease of caffeine plasma clearance is a typical complication of these organ’s diseases.  

Cirrhosis and non-cirrhotic cases of viral hepatitis are the most common liver diseases that may disturb such process. Obesity significantly increases plasma half-life, and decreases elimination rate, without significant effect on the clearance.  

The consumption of high amounts could lead to saturation in caffeine metabolism. Thus, while linear pharmacokinetics have been observed with caffeine intake between 70 and 100 mg, doses ranging between 250 and 500 mg have resulted in increased plasma concentration, a non-linear kinetic and prolonged half-life.  

During pregnancy, the excretion of 1-methylxanthine and 1-methyluric acid was decreased in women of between 34–36 gestational weeks that consumed caffeine doses from 123 to 369 mg, owing to a decrease in CYP1A2, xanthine oxidase, and acetyltransferase activities. During pregnancy,  some studies report that there is a risk of low birth weight and not any changes in the gestation. 

Excretion: 

In humans, the total urinary excretion of monomethylxanthines (1methylxanthine, 3-methylxanthine, and 7-methylxanthine), dimethylurate derivates (1,3-methyluric acid and 1,7-methyluric acid) and monomethylurates (1-methyluric acid), has been estimated to be equivalent to about 90–95% of the amount of caffeine orally administrated (5–7.5 mg of caffeine/kg body weight–bw), and that less than 5% is recovered as caffeine itself.  

Caffeine clearance is strongly dependent on renal blood flow and urine passage because this alkaloid and its primary metabolites are extensively reabsorbed (98%) in renal tubule, but the final urine concentration significantly correlates with the plasma caffeine level, as well as fluid intake. The fecal excretion is not so relevant because it covers only a small percentage (1–5%) of the caffeine ingested.  

CAFFEINE AND ITS EFFECTS ON HUMAN BODY METABOLISM: 

Caffeine (1,3,7-trimethylxanthine) is the most consumed psychoactive substance in the world, acting by means of antagonism to adenosine receptors, mainly A1 and A2A. Coffee is the main natural source of the alkaloid which is quite soluble and well extracted during the brew’s preparation.  

After consumption, caffeine is almost completely absorbed and extensively metabolized in the liver by phase I (cytochrome P450) enzymes, mainly CYP1A2, which appears to be polymorphically distributed in human populations. Paraxanthine is the major caffeine metabolite in plasma, while methylated xanthines and methyluric acids are the main metabolites excreted in urine. In addition to stimulating the central nervous system, caffeine exerts positive effects in the body, often in association with other substances, contributing to prevention of several chronic diseases. The potential adverse effects of caffeine have also been extensively studied in animal species and in humans. 

HEALTH BENEFITS OF CAFFEINE CONSUMPTION:  

The most well-known acute effects of caffeine consumption are stimulation of brain function and improvement in mood, and physical performance. However, along the past few years, several epidemiological studies have associated moderate coffee consumption with the reduction in the relative risk of development of chronic degenerative diseases and death, and caffeine is one of the compounds responsible for many of these benefits. They include reduction in the risk of Parkinson’s and Alzheimer’s diseases as well as hepatoprotective effects. The mechanisms involve antioxidant and anti-inflammatory activities, among others.  

Caffeine, Mood, And Behaviour: 

Once caffeine is absorbed, it exerts a variety of pharmacological actions at diverse central and peripheral sites. These effects are predominantly related to its antagonistic activity at adenosine receptors, which are widely distributed throughout the body, allowing the substance’s wide range of effects. positive changes occur in mood and human behaviour, such as enhanced energy, well-being, sociability, willingness and motivation to work, improved self-confidence and cognitive function, including enhanced alertness and mental focus, vigilance, learning and memory. This is generally true for both caffeine-deprived and caffeine-tolerant individuals.  

Caffeine And Exercise Performance: 

Caffeine exerts a positive effect on endurance and exercise capacity owing to the aforementioned neural mechanisms that trigger a chain of physiological reactions, which makes it an ergogenic resource. Exercise performance is shown to be significantly improved by oral caffeine administration or by the consumption of dietary sources, either by avoiding fatigue, improving substrates supply or by enhancing oxygen uptake. Because of the difficulty to differentiate the low levels of habitual caffeine ingestion from the intentional use of caffeine to improve athletic performance. 

Caffeine And Antioxidant And Anti-Inflammatory Activities  

Some of the beneficial health effects reported for caffeine have been associated with antioxidant properties although not all studies have found such activity at concentrations. Since inflammation is correlated with and influenced by various cytokines and chemokines, reduction of these markers should decrease the degree of overall inflammation. The anti-inflammatory action of caffeine is thought to be related to phosphodiesterase inhibition and/or with adenosine receptor antagonism mechanisms. Caffeine anti-inflammatory potential has also been linked to modifications in cell signalling molecules production.  

Caffeine And Antimicrobial Activity: 

Regarding caffeine’s antimicrobial activity, there are a few in vitro studies showing that caffeine contributes to the antibacterial effect of coffee against Streptococcus mutans, the main cariogenic bacteria, as well as intestinal pathogenic bacteria’s. The effectiveness of caffeine in inactivating and inhibiting significantly the growth of Escherichia coli O157:H7 in brain heart infusion broth, indicating that caffeine has potential as an antimicrobial agent for the treatment of E. coli O157:H7 infection and could be investigated further as an eventual food additive to increase biosafety of consumable food products. 

Caffeine And Neurodegenerative Diseases: 

The effect of caffeine on neurodegenerative diseases has gathered considerable attention in the last years. Several studies have reported that regular coffee/caffeine intake is related to lower risk of neurodegenerative diseases development, especially Parkinson’s and Alzheimer´s, and prevention of memory decline during aging. 

Parkinson’s disease is characterized by selective degeneration of dopaminergic neurons in the midbrain with a clinical presentation of motor and non-motor symptoms and by the prominent alpha-synuclein-containing proteinaceous inclusions, called Lewy bodies.  

FIGURE 7 – NEURODEGERATIVE DISEASES¹⁷ 

Coffee consumption appears to reduce the risk of Parkinson’s disease or to delay its onset, by attenuating dopaminergic neurodegeneration. The overall risk has been reported to fall at least by 24–32% per 300 mg (three cups of 100 mg) increase in caffeine intake. 

Higher risk reduction (up to 80%) have been suggested for the intake of more than four cups of caffeinated coffee daily.. 

Alzheimer’s disease is the most frequent cause of dementia, leading to a progressive cognitive decline. Definitive diagnosis of Alzheimer’s disease is based on the presence of senile plaques and neurofibrillary tangles that are identified in postmortem brain specimens.  

The formation of Alzheimer’ disease-specific lesions is attributed to the pathological accumulation of either toxic extracellular amyloid beta peptide in the brain , or intraneuronal hyperphosphorylated Tau protein. Constituents of the lesions are prone to promote synaptic deficits leading to memory impairments.  

Currently, there is no medication against Alzheimer’s disease once it is installed , but there are a few ways of preventing it, among them the consumption of foods rich in polyphenols and caffeine.  

The mechanism for caffeine protection is believed to be related to an antiinflammatory effect on the A1 and A2 receptors as well as to the reduction in the deposits of toxic beta-amyloid peptide in the brain. Alzheimer’s disease mouse model study confirmed these findings, reporting that heavy coffee intake (the human equivalent of 500 mg caffeine or five coffee cups/day) was able to protect against and could treat Alzheimer’s disease. 

Caffeine And Liver Diseases: 

In the past three decades, caffeine has been related to a lower incidence of chronic liver diseases, such as cirrhosis and hepatocellular carcinoma. Additionally, in several studies, regular coffee consumption has been significantly associated with reduced hepatic fibrosis related or not with non-alcoholic fatty liver disease and with chronic hepatitis C.  

In prospective studies, coffee consumption was associated with a lower risk of liver cirrhosis. 

Caffeine, together with other bioactive compounds, such as chlorogenic acids and trigonelline, has been reported to be responsible for coffees hepatoprotective effect.  

The mechanisms underlying the potential benefits of caffeine have not yet been fully determined. However, some plausible explanations have been suggested. In patients with chronic hepatitis C, a suggested possible mechanism would be the alteration in liver signalling and inflammatory pathways.  

 Smad comprises a family of structurally similar proteins that are the main signal transducers for receptors of TGF-β, which are critically important for regulating cell development and growth. Caffeine also has a direct inhibitory effect on hepatic stellate cells by downregulating focal adhesion kinase and actin synthesis and also induces hepatic stellate cells apoptosis. 

Caffeine And Central Nervous System: 

Caffeine is the most widely consumed central nervous system stimulant. Three main mechanisms of action of caffeine on the central nervous system have been described. Mobilization of intracellular calcium and inhibition at high nonphysiological concentrations of caffeine. Caffeine increases energy metabolism throughout the brain but decreases at the same time cerebral blood flow, inducing a relative brain hypoperfusion. Caffeine activates noradrenaline neurons and seems to affect the local release of dopamine. Many of the alerting effects of caffeine may be related to the action of the methylxanthine on serotonin neurons.  

The effects of caffeine on learning, memory, performance and coordination are rather related to the methylxanthine action on arousal, vigilance and fatigue. Caffeine exerts obvious effects on anxiety and sleep which vary according to individual sensitivity to the methylxanthine. However, children in general do not appear more sensitive to methylxanthine effects than adults. The central nervous system does not seem to develop a great tolerance to the effects of caffeine although dependence and withdrawal symptoms are reported.  

Caffeine is a psychostimulant with the same central effects as the classical nervous system psychostimulants cocaine and amphetamine. That is, it increases motor activity and has both arousal and reinforcing effects, although its reinforcing effects are not as strong as those of the classical psychostimulants. 

Caffeine Acute And Chronic Toxicity: 

Based on the moderate caffeine consumption considered by EFSA, FDA, intoxication results in ‘caffeinism’, which refers to a syndrome characterized by a range of adverse reactions, for instance, restlessness, nervousness, anxiety, irritability, agitation, muscle tremor, insomnia, headache, diuresis, tachycardia, arrhythmia, pulse irregularity and increased frequency, elevated respiration and gastrointestinal disturbances (e.g., nausea, vomiting, diarrhoea). Besides tachycardia and diuresis, caffeine toxicity in children has also been implicated in severe emesis, photophobia, palpitations, muscle twitching, convulsions, and unconsciousness.  

POTENTIAL ADVERSE EFFECTS OF CAFFEINE 

CONSUMPTION: 

Caffeine On Mood, Behaviour, And Sleep: 

Ingestion at low to moderate doses tends to licit the pleasant sensations previously described in this review, higher doses consumed either on a single occasion or within short periods of time can produce or exacerbate jitteriness, insomnia (especially in those who are caffeine-abstinent, nervousness and anxiety, especially in those with pre-existing psychiatric anxiety disorders, but also in healthy adults, particularly when they are non-habitual caffeine consumers. 

Caffeine On Cardiovascular System:  

Caffeine intake has also been associated with the occurrence of arrhythmias in humans. It produces a direct stimulation of myocardial tissue, leading to increased heart rate and force of contraction. Cardiovascular disease has been assessed by a range of outcome variables, including death from myocardial infarction or CHD. 

Caffeine On Glucose Metabolism And Insulin Resistance:  

Coffee consumption has been associated with reduced risk of type 2 diabetes. However, a key issue that remains to be resolved is whether the consumption of caffeinated and decaffeinated coffees. 

Caffeine On Calcium Balance:  

This is one of the most discussed potential adverse effects of caffeine intake. Caffeine potential to adversely influence calcium excretion and bone metabolism was investigated by epidemiological studies which evaluated the relationship between caffeine intake and the risk of fracture and fall, BMD and osteoporosis, and the effect on calcium homeostasis. On the potential risk factor for bone fracture and fall, most studies reported a lack of association between caffeine intake and increased risk of fracture considering consumption below 400 mg/day. 

Caffeine On Fertility And Reproductive And Developmental Effects: 

The effects of caffeine consumption have been reviewed in terms of reproduction or fertility and in terms of pregnancy outcomes, including spontaneous abortion, birth weight, gestational length, and congenital malformations. pregnant, women who regularly consume caffeine may be at risk of miscarriage, but current evidence of spontaneous abortion remains insufficient to allow conclusions regarding the potential role of caffeine. The potential adverse impact of caffeine consumption during pregnancy on foetal growth has also been a concern for many years. 

Potential Carcinogenicity Of Caffeine: 

Comparatively high doses of caffeine had shown weak teratogenic effects in experimental animals and mutagenic effects in vitro, but not in vivo, and it was concluded that there was no evidence for concern over carcinogenic, teratogenic, or mutagenic effects of caffeine in man at the actual levels of intake (between 2.0 and 4.5 mg/kg of body weight/day) and that human epidemiological studies provided no evidence for any association between coffee consumption and congenital defects. 

Caffeine Withdrawal Syndrome:  

It has been widely experienced that the sudden cessation of regular caffeine ingestion produces specific interrelated symptoms, which are named caffeine withdrawal syndrome as stated by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (APA) Withdrawal symptoms generally begin about 12 to 24 h after cessation of caffeine consumption and reach a peak after 20 to 48 h. However, in some individuals, these symptoms can appear within only 3 to 6 h and can last for a week. 

Caffeine withdrawal syndrome can be avoided if caffeine ingestion decreases slowly.¹⁷  

RESEARCH IN THE EARLY 1990’S: 

Cocaine and amphetamine are able to produce psychostimulant effects by binding to what is known as a dopamine transporter and either blocking (e.g., cocaine) or reversing (e.g., amphetamine) its effects. In both cases, the end result is a significant increase of dopamine in the extracellular space, which in turn activates the postsynaptic dopamine D1 and D2 receptors. 

Also in the 1990s, scientists were aware that caffeine does not produce a clear or strong presynaptic dopamine-releasing effect. That is, it does not really increase dopamine in the extracellular space in the brain. The only way to counteract the cataleptic effect is to administer a dopamine receptor agonist, that is, something that stimulates the postsynaptic dopaminergic receptors.) They used bromocriptine (a D2 agonist) to produce locomotor activity in reserpinized mice.  

Subsequent study pointed to the efferent striatal (GABA)-ergic medium spiny neuron, also known as MSN. MSNs are efferent neurons that constitute more than 95 percent of the striatal neuronal population. 

They found that perfusion of a D2 receptor agonist, pergolide, through the striatal probe resulted in a significant reduction of extracellular levels of GABA in the ipsilateral globus pallidus. The effect was significantly counteracted by the striatal cope fusion of an A2A receptor agonist, CGS21680, and significantly potentiated by the xanthine theophylline. 

TWO NEW CONCEPTS: 

The concept, local module, relates to the MSN and the convergence of MSN’s two main inputs (i.e., the cortical-limbic-thalamic glutamatergic terminal making synaptic contact with the head of the dendritic spine and the mesencephalic dopaminergic terminal making synaptic contact with the neck of the dendritic spine). Together, these various elements—the dendritic spine, the glutamatergic terminal, dopaminergic terminal, and glial processes that wrap around the glutamatergic synapse—constitute a functional unit known as the striatal spine module, a type of local module. A local module is defined as the minimal portion of one or more neurons and/or one or more glial cells that operates as an independent integrative unit  

Dopamine is released not only intra synoptically, but also extra synoptically, which allows activation of extra synaptic receptors localized at dopamine and glutamate synapses and modulation of glutamatergic neurotransmission. The same is true of glutamate. It is not only released intra synoptically but also spills over and stimulates extra synaptic glutamate receptors localized at glutamate and dopaminergic synapses and modulates dopaminergic neurotransmission. Extra synaptic transmission and extra synaptic localization of receptors, in turn, provide a framework for understanding the existence and possible functional role of receptor heteromers. 

PSYCHOSTIMULANT EFFECTS: 

The mechanism explains not only the motor-depressant effects of A2A receptor agonists but also the motor activating effects of caffeine and other A2A receptor antagonists. On the basis of this knowledge, researchers have been testing the efficacy of A2A receptor antagonists in the treatment of Parkinson’s disease. 

In addition to postsynaptic mechanisms, presynaptic mechanism could also be involved in caffeine’s locomotor-activating effects. Although no evidence indicates that caffeine releases dopamine like cocaine and amphetamine showed that it does release dopamine in the very ventral part of the striatum, in an area called the shell of the nucleus accumbent, by acting on adenosine A1 receptors localized in glutamatergic and dopaminergic terminals. 

A final mechanism for the motor and probably reinforcing effects of caffeine was recently described in the literature. It involves paraxanthine, the main metabolite of caffeine in humans, which has a very strong psychostimulant effect in rats and is correlated with a significant dopamine release in striatal areas of the brain where caffeine is ineffective. 

PSYCHOMOTOR CHANGES: 

Caffeine has been consumed since ancient times due to its beneficial effects on attention, psychomotor function, and memory. Caffeine exerts its action mainly through an antagonism of cerebral adenosine receptors, although there are important secondary effects on other neurotransmitter systems. Recently, functional MRI (fMRI) entered the field of neuropharmacology to explore the intracerebral sites and mechanisms of action of pharmacological agents. 

However, as caffeine possesses vasoconstrictive properties it may interfere with the mechanisms underlying the functional contrast in fMRI. Yet, only a limited number of studies dealt with the effect of caffeine on measures in fMRI. Even fewer neuroimaging studies examined the effects that caffeine exerts on cognition.¹⁸ 

COFFEE AND HOMOEOPATHY: 

The primitive effect of coffee consists, in general, of an increase more or less agreeable of vital activity; the animal functions, natural and vital (as they are called), are found during the first hours in a state of artificial perfection. But the secondary effects, which manifest themselves only insensibly after the lapse of several hours, produce exactly the contrary of all this, that is, a disagreeable sentiment of our existence, an oppressed activity, a species of paralysis of the animal, natural and vital functions.  

It is a fact that in homeopathic literature it is frequently mentioned that conception of coffee can impair the effect of homoeopathic medication. 

Coffee is a purely medicinal substances and medicinal things are substances that do not nourish, but alter the healthy condition of the body; any alteration, however, in the healthy state of the body constitutes a kind of abnormal, morbid condition.  

Homeopathic medicines are absorbed by the oral mucosa and thus work from the mouth. For this reason, it is often advised to take the medicines when the mouth is clean from any food particles or fragrances. This is to ensure better absorption. Coffee has a very strong odour and has the possibility of disrupting the efficiency and absorption of homeopathic medicines. 

COFFEE IN ORGANON OF MEDICINE: 

In the 6th edition of his organon in the note to §260, Hahnemann lists a great number of substances and provides following demand; 

All these things must if at all possible be avoided or strictly removed, in order to prevent impairing or even rendering impossible a cure it is long list here include coffee, spiced chocolate, excessive use of herbs in foods and sauces, European celery root, parsley, all varieties of onion, as well as alcoholic beverages which have not been strongly diluted with water .in his listing, however Hahnemann states in §260.  

Drinking of warm coffee and Chinese tea has spread so generally in those centuries of Hahnemann period and it has so largely increased the irritability of muscular fibres as well as the excessive irritability of the nerves. However, in actual practice it is noticed that many patients do not follow instructions strictly and yet respond to treatment.¹⁹ 

EFFECTS OF COFFEE IN CHRONIC DISEASES: 

In the case of patients affected by chronic diseases, the careful investigation in to such obstacles to cure is so much more necessary as their diseases as usually aggravated by such noxious influences and other disease-causing problems with the dietary regimen, which often unnoticed Kent’s says ,….to advise persons to avoid coffee ,vinegar and the consumption of other harmful substances. 

J. T. KENT ON COFFEE: 

In this context, Kent call attention to Hahnemann’s §4 organon, the physician is at the same time sustained of his patients health if he recognizes those factors which impairs health and which cause and further illness , and if he is capable of eliminating these influences from the lives of healthy people. 

Kent summarizes as follows: The chief mission of the physician is differentiation, removal of the exogenous causes of illness, and restoration of order in internal causes. In his note to organon, §93 Hahnemann speaks of ….indulgence in wine, hard liquors, punsch (an alcoholic fruit drink)other hot drinks, tea or coffee….”in other words, of excessive consumption, by no means, however does he explicitly prohibit coffee consumption as many homeopaths have incorrectly interpreted. 

Kent says that there are patients who are not in the least susceptible to the higher potencies of coffea, such patients, however, are often made sick by large quantities of coffee. However, it is not the case with every homeopathic medicine. There is no clear evidence of the fact that coffee is an antidote to Homoeopathic medicines. However, coffee can have several negative effects on the body including digestive problems, insomnia, increased heart rate, and high blood pressure. These conditions can indirectly affect the homeopathic treatments and slow down the recovery rate. 

Hahnemann had warned of overindulgence to a stage where they would act as stimulants. This is very easily understood by the fact that every homoeopath would warn of indulgence in alcohol as a stimulant during treatment even though every homoeopathic medicine is dispensed in alcohol. 

It is quite possible that the consumption of certain foods can trigger an allergic response and would aggravate the disease condition, but this does not imply the “antidoting” of homoeopathic drugs. Also certain food substances that are not permitted during disease conditions (e.g. coffee and tea in acidity) should not be misunderstood as antidotes to homoeopathic medicine.  

TREATISE ON THE EFFECTS OF COFFEE BY SAMUEL HAHNEMANN: 

All medicaments given in large doses, make a disagreeable impression on the sensibilities of a healthy person. No one ever smoked tobacco for the first time without experiencing some disgust; no healthy person, with equal certainty, ever took with pleasure pure and unsweetened coffee for the first time. It is nature herself that admonishes by this of the first violation of laws of health; it is herself that exhorts us not to despise trivially the preserving instinct of life. 

All medicaments produce two quite opposite states in the human body; the primitive effect which manifests itself when the remedy begins to operate and the secondary effect which appears only after the lapse of several hours, when the primitive effect has ceased. 

Most medicaments cause disagreeable and painful sensations to a healthy person, as well as well as in their primitive as in their secondary effects, both cause trouble in the organism, though in a different manner. 

Coffee : A Purely Medicinal Substance: 

All medicaments given in a larger dose makes a disagreeable impression on the sensibilities of a healthy person. 

No one ever smoked tobacco for the first time without experiencing some disgust, likewise no healthy person ever took unsweetened coffee for the first time with pure pleasure. By continuing the use of these medicinal products, the disagreeable sensations which first produced in us will dispel by degrees and becomes a habit. The disgust which they at first caused us finally becomes less striking by their continued use and on the contrary, the agreeable effects which they apparently produce upon our organs insensibly become necessities. The vulgar man seems to find happiness in artificial necessaries and by degrees attaches to their satisfaction of a sensual pleasure. 

All medicaments produce two quite opposite states in the human body. 

The primitive effect which manifests itself when the remedy begins to operate. 

The secondary effect which appears only after the lapse of several hours, when the primitive effects ceased.  

Most medicaments cause disagreeable and painful sensation to a healthy person, as well in their primitive as in their secondary effects; both cause trouble in the organism, though in a different manner and even a continued use of these objects will never produce agreeable effects in a healthy man. 

But there are few medicinal substances, chosen by a refined and pleasure seeking world as dietetic objects, (It may be wine, brandy, tobacco, tea, coffee, &c.) that, so far as their primitive effects are concerned. They have, then, the remarkable virtue of producing a species of artificial augmentation of the ordinary state of health, and of exciting almost none but agreeable sensations, while the disagreeable results of the secondary effects remain insignificant for some time, supposing, at all events, that the person in question makes a moderate use of above named substances, that he enjoys pretty good health, and that in other respects, he leads a life conformable to nature. 

Among that small class of medicinal products forcibly received among the number of our dietetic luxuries, coffee is also found, the effects of which, agreeable as well as disagreeable, are still considerably unknown. 

The inordinate use of this beverage at almost all hours of the day, the difference in its quality and quantity, finally its general use in all classes of society, of all ages and of the most varied constitutions, make it very difficult for the observer to abstract the true effects of coffee from this chaos of the phenomena, and to deduce there from pure and certain results. It is like a writing attached to a swiftly revolving target; however distinct the characters and words may be in themselves, everything becomes confounded and illegible even to the best eyes. 

It is only by continued exact, and sincere observations, removed as far as possible from all illusions; it is only by carefully referring the phenomena to their causes, that one can succeed in discovering the nature of the most important of beverages, that of coffee. 

The primitive effect of coffee consists, in general, of an increase more or less agreeable of vital activity; the animal functions, natural and vital (as they are called), are found during the first hours in a state of artificial perfection. But the secondary effects, which manifest themselves only insensibly after the lapse of several hours, produce exactly the contrary of all this, that is, a disagreeable sentiment of our existence, an oppressed activity, a species of paralysis of the animal, natural, and vital functions. 

If anyone not accustomed to coffee should take a moderate portion of it, or if someone who is accustomed to this beverage should take an immoderate portion of it, Each one must here apply the measure which is particularly suited to his body, for one can bear more than another.  

Action Of Coffee Upon Human Body: 

Further remark that all the symptoms of the primitive effects of coffee do not appear simultaneously, and that their totality does not manifest itself in each individual. The one will experience a certain portion of these symptoms, another some will experience the other portions of it. The one will present a great number, while the other will offer but few. He will experience during the first hours a more active sentiment of his existence; the pulse is higher and more frequent, but also softer. His cheeks assume a circumscribed redness which does not insensibly vanish in the adjacent parts, but presents itself apart like a red spot.  

When the forehead and the palms become humid; he feels more heat than before, and this sensation causes him an agreeable uneasiness. The heart is agitated in a voluptuous palpitation, as it is on occasions of great joy; the veins of the hands swell. By touching him externally, one also observes a supernatural heat. However, this heat never becomes ardent, even after taking a large portion of coffee, but it rather passes into a general sweat. 

Action Of Coffee Upon Human Mind: 

The presence of mind, the attention, the sympathies are more active than in the regular and natural condition of the body. It seems to the person in question that all the objects which surrounds him have received a seducing appearance; everything seems to be covered with a gay varnish and shines with an infinitely agreeable lustre, especially if the portion of coffee has been greater than usual. However, if the portion were excessively large, and the body should be singularly irritable and wholly unaccustomed to coffee, a unilateral headache would follow, which descends from the superior part of the parietal bone down to the cavity of the brain.  

The humour of the person in question passes into a form of hyperaesthesia; he is angered and vexed; no one can please him. He is timid and trembles continually; he is uneasy; weeps without scarcely any cause, or smiles almost involuntarily. After a few hours he falls into a light sleep, and at intervals awakes by starts. Hahnemann have twice observed this rare and singular condition. 

During the first hours one sees on the lips of the coffee drinker self-complacency and a satisfaction with everything that surrounds him; and this is just what elevated coffee to the rank of a social beverage. Every agreeable sentiment, which is communicated to one’s self, rises rapidly to the degree of enthusiasm though but for a short time. All vexatious recollections are effaced from the memory; all disagreeable sensations are silenced during this species of enchanting fever. 

 Man, in a regular and healthy condition, should experience agreeable and disagreeable sensations alternately; the wise organization of our nature demands this. But during the primitive effects of this medicinal beverage all is but pleasure, and even the corporal functions, which, in a natural state of health, are accompanied by rude and almost painful sensations, now operate with an astonishing facility and even with a species of pleasure. 

Whoever no longer lives in the primeval simplicity of nature will well experience, during the first moments after awakening (especially when it has taken place earlier than usual), a certain physical and mental dullness; the sentiment of existence will be less active, the head heavy, the limbs somewhat dull and less agile than usual; rapid movements require efforts, and thoughts are sluggish. 

But coffee almost instantaneously dispels this disagreeable and natural sensation, this uneasiness of body and mind; and we suddenly revive. 

Having finished our daily task, nature also desires us to be fatigued; a disagreeable sensation of languor in our physical and natural forces now renders us morose and obliges us to give ourselves up to necessary sleep and repose. But let us take coffee, and this state of moroseness and inactivity, this disagreeable lassitude of body and mind, will suddenly disappear; an artificial vivacity will succeed the desire of sleeping, and we wake in spite of nature. 

In order to live we need food, and nature obliges us to seek it through hunger, a gnawing sensation in the stomach, joined to a tormenting desire for food, to a quarrelsome humour, to debilitation, etc.  

In like manner thirst, an equally wise institution of nature, is a very inconvenient sensation; for, besides a languishing desire for liquids, which our bodies need to repair their losses, we experience also a parching dryness in the throat and mouth, a dry heat of the body which somewhat hinders respiration, a certain uneasiness, etc. 

Sensations Induced by Coffee: 

We take coffee and we feel nothing more of the painful sensations of hunger and thirst. Real coffee drinkers are almost ignorant of natural hunger and thirst; this is especially the case with women who take no exercise in the open air, which deprives them of an advantage which annihilates, at least from time to time, the vexatious consequences of this beverage. 

 The body is thus cheated out of its food and drink by a sort of illusion, and the cutaneous vessels are, at the same time, forced, in a manner contrary to nature, to absorb from the air as much moisture as the organism absolutely needs for its existence.  

This is the reason that professional coffee drinkers discharge much more liquid through the urinary duct than they have actually swallowed. It is thus that we refuse the body the enjoyment of its prime necessities; it is thus, thanks to the divine beverage, that we insensibly approach the state of the blessed.  

The supreme preserver of our days also ordained that, after satiating ourselves with food, a short interruption should intervene in our affairs, and that we should give a little rest to our bodies and minds, that the important function of digestion might quickly begin.  

The disagreeable sensations which arise from pursuing an opposite course should induce us not to violate said law. Wishing to make physical efforts immediately after meals, a certain stupor of body and mind, an oppressive weight in the region of the stomach, a sort of disagreeable compression of plenitude and tension in the abdomen, etc., remind us that the time to taste repose is at hand.  

In like manner, if we wish to make mental efforts, a dullness of the intellectual forces follows immediately, the head becomes dull, the limbs are cold, while the face is warm, and a disagreeable compression of the stomach, joined to an inconvenient tension of the abdomen, still increases. For it is but too certain that the efforts of the mind, made when digestion begins, are still more opposed to nature and more pernicious than physical labour. 

But coffee rapidly vanishes this lassitude of body and mind, as well as the inconvenient sensations in the abdomen. This is the reason that refined sybarites take this beverage immediately after meals, and they fully enjoy the above-mentioned effects. They recover their good humour and feel as light as if their stomachs contained but little or nothing at all. 

Evacuation Of Coffee: 

Nature also desires that the evacuation of the excrement should be made with a certain effort, and she forces us to it by pains and very inconvenient necessities which suppress all agreeable sentiments of life until the necessary function is in operation.  

But the refining spirit of this century has also provided for this inconvenience and has also sought to elude this natural law. It is coffee that accelerates and aids the work of digestion in an artificial manner, which, in the ordinary order of things, would only take place in the course of several hours. 

Effect Of Coffee In Intestines: 

 For the intestines, being excited by the primitive effect of this beverage, have a more rapid peristaltic movement. They convey their contents more promptly toward the anus. But as the aliments cannot be sufficiently digested in so short a time, and as the chyle cannot be sufficiently modified in the stomach, nor sufficiently absorbed by the absorbents of the intestinal canal, the mollified mass passes through the intestines so that the body does not receive one half of its nourishing particles, and reaches the orifice still in a semi-fluid state. 

Primitive Effects Of Coffee: 

The primitive effect of coffee also incites the anus to open and close more rapidly during the evacuation, so that the same takes place almost without effort and more frequently than among those who do not take this beverage. 

It is thus that coffee diminishes and almost annihilates the disagreeable sensations analogous to the wise organization of our bodies, so that we do not perceive, nor even suspect, the sad consequences which result therefrom. 

The primitive effect of this beverage, more than all other artificial means, also excites the sexual instinct, which the refinement of our age has placed in the rank of principal pleasures. On the least occasions voluptuous images present themselves to the mind, the genitals are excited in a few moments even to erection, and the effusion of semen is almost irresistible. Coffee awakens the sexual instinct ten or fifteen years too soon, before the age of puberty, and in the most tender youth of both sexes, a refinement. 

 Thus, the men of our days exclaim. They desire to enjoy life promptly and without interruption, even at the expense of all other interests! Now, they accomplish their purpose pretty well by means of this marvellous beverage, which, at once, reanimates and destroys the vital forces which hastens the time of impotence, and exercises the most evident influence on morals and morality. 

The effects of coffee exhibit themselves in a light still more striking among persons of an extremely irritable temperament, or who have already become enervated by the frequent use of coffee and by a sedentary life.  

The simple and honest man, in considering the moral and physical condition of those persons, recognizes therein everywhere the opposite of nature, and the stamp of an irregular excitement. 

 He observes an exaggerated gaiety or sentimentality which far exceeds the nature of its object, a tenderness almost convulsive or an extreme sadness, or sallies which surpass the limits of reason, or contortions of the muscles of the face, which degenerate into true caricatures, instead of a mild smile, a little irony, a moderate affliction or compassion.  

Effect Of Coffee In The Musculoskeletal System: 

Even the muscles of the remainder of the body now exhibit an extraordinary mobility contrary to nature; all is life and activity during the first hours of the effect of strong coffee, or, to make use of the customary expression, of good coffee.  

The most varied ideas and images present themselves in great number, and succeed one another rapidly before the throne of thought and sensibility. It is a life artificially doubled, artificially exalted! 

Man in his natural state must make some effort to recollect things long since passed; but immediately after taking coffee the memory’s magazine spreads itself, so to speak, upon the tongue and imprudent chit-chat and the revelation of important secrets are but too often the result. 

Moderation and just bounds are everywhere exceeded. The serious reflections of our ancestors, the solidity of judgment, firmness of will and resolution, the perseverance of the body in executing its slow but energetic movements, all these qualities which formerly distinguished the national character of the Germans vanish before this medicinal beverage.  

Imprudent effusions of the heart, precipitate and ill-founded resolutions and judgments, levity, loquacity, and vacillation, finally a fugitive and non-energetic mobility of the muscles, and a theatrical countenance. Who knows what dietetic enervation was the cause that the prodigies of the heroic virtues of patriotism, of filial love, of inviolable fidelity, of integrity and zeal for duty, acknowledged attributes of our antiquity, have dwindled away to a petty egotism!  

It is true that we do not see any more of those heroic crimes, evidences of physical and mental vigour, such as were committed in the Middle Ages and in more remote antiquity; but, in change, we are surrounded by myriads of individuals, making profession of cunning intrigues, of well-guarded frauds and deceptions of all kinds which threaten an honest man at every step. Which then of the two is best, a single bomb, or a million invisible caltrops. 

Hahnemann well know that to abound in luxuriant imaginations, to compose lascivious romances, and to make flippant, jocular, and pointed poems, the German must drink coffee. The ballet dancer, the improvisator, the juggler, the boatman, the banker of a Pharoah bank, the modern virtuoso-physician with his extraordinary rapidity, and the fashionably omnipresent physician who. wishes to make ninety visits in a single morning all these people necessarily need coffee. Let us abandon to these people their excitants opposed to nature, with all the vexatious consequences which result therefrom for their own health and for the good of others. 

But it is certain that the most refined sybarite and the most consummate spend thrift of life, could not have found in the world any medicinal dietetic more suitable than coffee (and in certain cases tea) for changing all his ordinary sensations into agreeable sensations for a few hours.  

What could, like it, spread over our humour a serene and even impetuous joy, cause our spirit to gush forth in sallies, and inflame our imaginations with a fire exceeding our temperament? What could thus accelerate the movement of our muscles to a trembling point, double the slow march of our digestive and secretory organs, and maintain the sexual instinct in a state of excitement almost involuntary!  

Finally, what could, like it, vanish the torments of hunger and thirst, remove sleep from fatigued members, and produce an artificial wakefulness, while the entire creation of our hemisphere are tasting the sweets of repose in the quiet shades of night! 

It is thus that we conquer the wise institutions of nature, but to our great detriment. 

After a few hours, the primitive effect of the coffee being passed, an opposite state, the secondary effect, insensibly follows. The more the former has been marked and agreeable, the more will the latter be sensitive and disagreeable. 

Hahnemann shall, however, state beforehand that the noxious consequences of this medicinal beverage are not similar for each individual. 

Our bodies have such an excellent organization that a few faults against diet become almost imperceptible, if in other respects we lead a life conformable to nature. In this way, for example, the peasant and the journeyman in Germany take brandy, a very injurious beverage in itself, almost every morning; but if they take it in small quantities they, nevertheless, reach a very advanced age. Their health suffers but little from it, for their good constitutions and the healthy mode of life which they lead in other respects, overcome the injurious effects of this beverage to such an extent that they suffer very little from it. 

If the father of a poor family of journeymen or peasants takes a few cups of weak coffee instead of brandy, the result will be the same. The vigour of his body, the violent exercise which he gives his limbs, the pure air which he inhales every day in abundance, all this removes the sad consequences of the beverage in question, and his health suffers but little or not at all. 

Noxious Effects Of Coffee: 

But the noxious effects of coffee become much more evident among those persons who do not enjoy the advantages of the above mentioned favourable circumstances. 

It is true that some persons spending their time in sedentary occupations, and even some men of a feeble complexion, fixed for the most part to their rooms by sedentary pursuits, enjoy a sort of health, provided they observe in other things a regimen suitable to their situation.  

This regimen requires that we take none but simple aliments, easily digested, purely nutritive, mild, and little seasoned, as well as beverages equally innocent; that much sobriety be exercised in the use of said enjoyments; that the air of apartments be frequently renewed; finally, that all passions be moderated with wisdom. 

Upon these conditions women who take but little exercise, and even prisoners, may also enjoy a species of health which, though easily disturbed by exterior accidents, however furnishes a degree of relative well-being. It is upon such persons that the effects of all morbific substances, that is to say, of all medicaments, will be more pointed and greater than upon robust men accustomed to labour in the open air, who can bear pretty noxious things without suffering any considerable injury. 

Secondary Effect Of Coffee: 

Those feeble recluses whose health is at such a low degree enjoy, so to speak, but one ‘half of life. Their sensations, their vital functions, their activity, all these have no true energy. It is not astonishing; then, that they should take with avidity such a beverage as coffee, which for several hours exalts the sentiment of their existence so powerfully; they care but little for the evil consequences and the secondary effects. 

This secondary effect is similar to the uneasy state in which they find themselves before taking coffee, but it is a little more severe. 

Primary Effects Of Coffee: 

The primary effect of this medicinal beverage, that is, the totality of this vital, exalted, and artificial activity having disappeared after a few hours, a desire to sleep, joined to yawning’s and a greater inactivity than that of the ordinary condition, insensibly follow; the motions of the body become more difficult, and the extreme serenity which reigned in the mind during the few preceding hours now passes into a gloomy, downcast humour.  

While the digestion and secretion of the aliments had been artificially accelerated during the first hours after taking coffee, painful flatulency and as lower and more difficult secretion now follow than in the preceding condition. If the persons in question had been penetrated with an agreeable heat by the primary effect of the coffee, this artificial fire now becomes insensibly quenched; they become chilled and have cold hands and feet. All external objects appear to them less agreeable than before.  

The sexual desires, excited during the first hours, now become the more feeble and lax. Their bad humour increases, and they are more easily vexed. The natural appetite is replaced by a kind of canine appetite, easily satisfied, and yet food and beverages load their heads and stomachs more. They have more difficulty to recover sleep, which is more feeble, and on awaking they are more sleepy, more sad and melancholic, than they usually were before they become acquainted with coffee. But they repeat the use of this injurious palliative, and, behold! all the pains of which I have spoken are dissipated!  

A new artificial life begins, with the only difference that the happy period this time is a little shorter than the first. The use of coffee must then be more frequently repeated, or it must be made stronger and stronger, if it is to excite anew the vital functions for a few hours. 

It is thus that the bodies of the inhabitants of chambers continually degenerate more. The injuries caused by the secondary effects of coffee enlarge and take such deep roots that even more frequent and stronger repetitions of this palliative can no longer dissipate them, not even for a few hours. 

The skin now becomes more sensitive to cold, and, in general, to the influence of much air, even when it is not cold; digestion becomes more difficult, the evacuations are often delayed several days; flatulence causes agonies and a number of painful sensations. The constipation of the abdomen alternates only with diarrhoeas, and not with natural stools. Sleep comes only with difficulty, and rather resembles a slight sluggishness which does not refresh. On awaking, the persons in question have the head much engaged, a drowsy imagination, and a sluggish memory; the movement of the limbs is much constrained, and their hearts are filled with an oppressive sadness, which darkens the aspect of the beautiful nature which surrounds them. The beautiful emotions, such as the love of humanity, gratitude, pity, heroism, force and nobleness of soul; as well as serenity and gaiety of spirit, are metamorphosed into timidity, indifference, apathetic hardness, fickleness, and moroseness. 

The use of coffee is continued. Sentimental affectations always alternate with insensibility, precipitate resolutions with irresolution, fits of anger with a loose condescension, grimaces of friendship with jealousies and hidden malice, transient exaltations with sadness, scoffing’s with weeping miens in a word, caprices follow caprices, and attest the continual vacillations of the body and mind between a state of irritation and a state of relaxation. 

It would be difficult for me to describe all the evils which lurk among the generation of coffee bibbers, under the name of debility, or that of nervous or chronic diseases, evils which enervate humanity and cause it to degenerate in body and spirit. 

We must not, however, think that all lovers of coffee are affected in the same degree by each of the injurious effects of which I have just spoken. No, doubtless one will suffer more from a certain symptom of the secondary effect of this beverage, another will suffer more from some other. My painting embraces the whole race of coffee bibbers;  

Hahnemann here collected a single frame all the evils, derived from this source, which have successively fallen under my observation. 

Coffee As A Palliative: 

The agreeable, but palliative, sensation which coffee diffuses, even among the minutest fibres for a few hours, afterwards causes, as a secondary effect, an extreme inclination to painful sensations, an inclination which increases in proportion as the coffee has been taken longer, more frequently, of a stronger quality, or in larger quantities. Even trivial causes (which scarcely make any impression at all on healthy men unaccustomed to the use of coffee) cause a headache to the female coffee drinker; often also toothache almost unendurable, and generally nocturnal, accompanied by redness of the face, and finally producing swelling of the cheeks; sometimes also tearing and cutting sensations in different parts of the body, now in a single side of the face, then in this or that member. (This tearing sensation in the members, excited by the continual use of coffee, is not felt in the articulations themselves, but from one articulation to the other. The pain seems rather to be in the muscles or in the cellular membrane than in the bones. The members in question are not swollen or otherwise altered exteriorly, and scarcely experience any pain when touched. The nosology’s do not know this singular affection.) 

The body becomes very much inclined to erysipelas, either manifesting itself in the thigh (which often causes chronic ulcers in the legs), or taking place in the breasts (which sometimes occurs while nursing children), or, finally, it may make its appearance in one side of the face. Anguish and flying sensations of heat are their daily ailments, and unilateral and nervous headache are the by preference. (We should not here confound the headache which I have before mentioned. This comes only on certain occasions, perhaps after having had trouble, or after having overloaded the stomach, a cold, and makes its appearance, in general, suddenly and at any time. But the unilateral and nervous headache, of which I speak at present, comes in the morning, soon after waking, or even at waking, and increases insensibly. The pain is almost unendurable and often burning; the cuticle is very sensitive, and the least touch causes pain. Generally, the mind and body of those persons are found to be in a state of excessive irritability. Having a feeble and downcast appearance, they shun society and even the light of day, and seek a solitary and obscure place, where they give themselves up to a kind of waking sleep, having their eyes closed and remaining immovable, elevated obliquely upon a couch, or in an arm-chair. Every movement, each noise increases their sufferings; they avoid speaking themselves and hearing others speak. The body, without shivering, is still colder than usual; especially the hands and feet are very cold. 

 Everything is odious to them, and chiefly aliments and beverages, for continual nauseas prevent their taking anything. If the paroxysm is very severe these nauseas cause vomiting of mucus, but the headache is rarely up pleased thereby. Neither does the patient have evacuations. This headache never censes before night, and in very stubborn cases I have seen it last thirty-six hours, so that it only left on the evening of the following day. If the attack is less violent, the prime cause of this evil, that is, strong coffee, abridges its duration in a palliative manner; but the body becomes so much more inclined to reproduce it after the lapse of a shorter interval. The period varied of the return of this evil is indefinite; it may be within fifteen days, or three weeks, or four weeks, etc. It appears suddenly without any proximate cause; even during the preceding night the patient rarely feels the slight indications of the nervous headache which awaits him on the morrow morning. I have never observed this singular condition except among real coffee bibbers.). 

Little infractions of regimen, as well as vexatious passions, cause them painful sufferings of the chest, stomach, and abdomen, known under the false denomination of cramps.  

The menses never take place without pain, and do not occur at their regular periods, or else they are less copious than usual, and finally they become quite trifling in quantity; the blood itself appears aqueous and slimy; the leucorrhoea (generally of an acrid and pungent nature) continues to flow almost from moon to moon, or entirely replace the flux of blood. The act of coition sometimes causes pains.  

An earthy, yellowish, or very pale colour, languishing eyes surrounded by a bluish circle, pale lips, a soft flesh, flabby and pendant breasts, are the exterior signs of the miserable condition of the internal organism. The scanty menses sometimes alternate with strong haemorrhages of the womb. Men suffer from painful hemorrhoidal difficulties and nocturnal pollutions.  

The genital faculty insensibly dies away in both sexes. The natural energy which a healthy couple exercise in the act of coition is reduced to a futile result. Men become impotent, women sterile or incapable of suckling their children. It is behind the coffeetable that the hollow-eyed phantom, masturbation, that execration of nature, chiefly hides itself! (However, the reading of passionate and lascivious novels, bad company, excessive efforts of memory, and the inactivity of a sedentary life in the corrupt air of rooms, also contribute their share in the producing this hideous evil.) 

The secondary effect of the frequent use of coffee producing in the body an eminent disposition for all sorts of disagreeable sensations and the most piercing pains, it will be easy to conceive how it is more proper than any other injurious substance to excite a strong inclination for caries. No irregularity of diet occasions more easily and more certainly the decay of the teeth than the coffee debauch.  

Coffee, grief, and the abuse of mercury, are the most active destroyers of this ornament of the mouth, this necessary organ of distinct language and of an intimate amalgamation of the saliva and the food. The confined air of chambers and the nocturnal repletion of the stomach also contribute thereto. But coffee alone is capable of destroying the teeth in a very short time, or, at least, to make them black and yellow. The incisors are especially attacked by it. 

With the exception of the real spina-Ventosa, scarcely any other caries among children are produced by any other cause than coffee, (Such caries, produced by coffee, causes ulcers of the bones, hidden under elevated cutaneous tumours which are hard and of a bluish red colour. From these ulcers a slimy matter, mingled with caseous particles and having but a faint odour, oozes. The pains of the affected parts are piercing. 

 The remainder of the body presents a real image of phthisis produced by coffee.) unless they have been maltreated with mercurial cures. It also sometimes engenders among them deep seated ulcers, which pierce very slowly and have very narrow openings. 

In general, coffee exercises the most pernicious influence over children, which is greater as they are more delicate. Although it does not, of its own propensity, excite the real rachitis (English disease, a knotting of the limbs), it however accelerates this disease conjointly with its peculiar producing causes, that is, non-fermented vegetable food and the confined, damp air of rooms.  

But it also alone engenders among little children, who, on the other hand, enjoy healthy food and pure air, a certain phthisis, almost as sad as rachitis itself. Children subject to said phthisis have a pallid complexion and very flabby flesh. They are a long time learning to walk; their walk is tottering, they easily fall, and always want to be carried. They have a stammering voice. They ask much and many things, and yet eat and drink but little. The native simplicity, the gaiety, and playfulness which form the amiable character of infancy, are replaced by a mean prostration. Nothing gives pleasure to these little unfortunates, nothing satisfies them; all they do denotes but half a life; they are very timid and are easily frightened. Diarrhoeas alternate with constipations. Their respiration is rattling, especially in sleep, for their chest is always filled with a tenacious mucus, which no cough will detach; they always have the chest engaged, as it is generally expressed. 

 Dentition takes place with difficulty and causes suffering, even convulsions; nevertheless, the teeth are imperfect and decay before the time for their change has arrived. In the evening, some time before the hour of retiring, or even at bedtime, one or both of their cheeks generally redden and become heated.  

Effects Of Coffee On Sleep: 

During the night their sleep is disturbed, they are much agitated, and often ask for drink; they transpire, not only on the forehead, but also on the head, and, above all, in the back part of the head. They also cry sometimes during sleep. It is only with difficulty that they overcome all illness, and their convalescence is always imperfect. They are often subject to a chronic inflammation of the eyes, joined jugular relaxation of the upper eyelids, which does not permit them to open their eyes, even when the redness and swelling of the lids are only moderate.  

This species of ophthalmic sometimes lasts several years; children who suffer from it are continually sad and inclined to weep; they often sleep on their faces, or they hide themselves in the dark and remain there, lying down or sitting in a stooping position. Said inflammation chiefly attacks the cornea, covering it at first with red veins, and finally with dark spots, or causing little pimples or ulcers to appear, which sometimes enter deep into the cornea, even threatening the loss the sight. 

This ophthalmy and this rattling of the chest, as well as some other of the abovementioned sufferings, even affect suckling that take nothing but their mother’s milk when she takes much coffee and keeps herself shut up in the air of rooms. What must be the strength of this medicinal beverage if the suckling is already compelled to suffer from it? 

After children, coffee, as I have said, has the most injurious influence over women and literary persons, for the occupations of both oblige them to follow a sedentary life in the air of chambers. Those artisans whose trade is sedentary are joined to these two classes of persons. 

It is certain, as has been stated above, that much exercise and an energetic activity in the open air are the best means to attenuate the injurious effects of coffee; however, they do not suffice in the end. 

Some persons also, as if driven by instinct, find a sort of antidote against coffee in spirituous drinks. Neither can it be denied that these last produce some reactive effects. However, they are in themselves new irritants, containing no nourishing juices at all, or, in other terms, they are also medicinal substances, which, being taken each day, cause inconveniences of another character, without being able to annul the injurious qualities of coffee. We, therefore, gain nothing by this but new artificial pleasures which likewise abridge life and have equal sufferings as consequences, though of a different nature and still more complicated. 

The principal means for curing sufferings caused by coffee is to discontinue its use; (It is not so very easy to abolish a strong habit of using coffee, especially among delicate persons). This is the process which I observe in regard to it. 

In the first place I endeavour to persuade my patients of the urgent necessity of getting rid of the habit question. Now, truths which are founded upon evident experience rarely fail to attend the end of conviction, especially when coming from the lips of an affectionate physician, certain of his good cause and filled with the reality of his assertions.  

Nothing will prevent penetrating into the spirit of the auditor; a private interest on the part of the converter is not to be imagined; the entire gain is on the side of the converted. 

This end being truly attained (a thing which a judge of human nature can see in every mien of the patient), every three or four days the accustomed portion of said person should be reduced by one cup until he takes only a single one for his breakfast, which he should be permitted to take still for a week. Then he should be made to give up this last cup suddenly, or he might be permitted to take it yet a week alternately from one day to another, as circumstances may require. 

If one has to do with persons in whom one can confide, the whole work will be done in four weeks. But in case the feebleness and vacillation incident to the slaves of coffee should be opposed to the project question, or if the debilitated health of the patient should be too sensitive to such a privation, it would be well to substitute a cup of tea for each cup of coffee retrenched, so that at the end of a week nothing will be left him but the tea, a beverage still injurious, but still less injurious. Now, tea not being taken as a beverage of a long-contracted habit; the patient will more easily quit its use, and, finally, instead of all coffee and tea, he will take some cups of warm milk for his breakfast. 

 Chocolate, free from heterogeneous mixtures, or, in other words, pure cacao, is equally admissible)  

Annihilation Of The Injurious Effect Of Coffee: 

To annihilate the injurious effects of coffee effectually and to maintain the constancy of him who deprives himself of it, it is further indispensable to fortify his body by daily walks in the open air, to enliven his spirits by innocent amusements, and restore his strength with nourishing and suitable aliments.  

Finally, if this has all been executed in the best manner possible, the physician or some other friend of the patient would, nevertheless, do well to inform himself from time to time of the reality of his conversion, and lift up his courage, if the force of the example which society gives shakes his resolution.) the exercise taken in the open air will accomplish the rest. 

But if the body and mind are in a state of too great decrepitude recourse must be had to certain sanitary medicaments which exist for such cases, but which I shall not mention here, this book not being destined for physicians, but for laymen. 

Convinced by the results of a long experience and by the observations of very many years, I have just depicted the daily use of coffee as very injurious, and as the surest means of relaxing and attenuating our physical and moral energies. But I have ascribed to it the qualities of a medicinal beverage; this might give rise to objections.  

“Medicaments are salutary things!” I may be told. Yes, they are; but only in an indispensable condition; that is, that it be suitable to the case in question. But no medicament whatever can be suitable to a regular and natural state of health; it is contrary to reason and injurious, that a man being in this state should select for his usual beverage a medicinal substance. 

Medicinal Virtues Of Coffee: 

Hahnemann appreciate the medicinal virtues of coffee as much as those of any other medicament, in case it be applied in proper cases. Nothing which has been created by divine power can be useless; all its productions are to contribute to the welfare of men, especially very efficacious products, such as coffee. But strict attention should be given to the following observations. 

Every medicament produces in the body of a healthy man some specific changes, which properly belong to it. If we are acquainted with these changes, and if we employ the medicament in cases of sickness which have almost a perfect resemblance to the symptoms which the medicament can alone produce in a healthy body, a radical cure will follow. This application of remedies is the curative application, and it is the only one admissible in chronic diseases or diseases of long standing. 

This power of a medicament to modify in a particular manner the state of the human body, I call the primitive effect of the remedy. This primitive effect, after a few or several hours, is replaced by an entirely opposite effect, which dominates the body after the primary effect of the remedy has ceased to operate. This second state, I call the secondary effect of the remedy. 

Now, if the medicament which is used for a disease excites in its primary effects symptoms opposed to those of the disease in question, the cure is only palliative. An improvement follows almost immediately, but after a few or several hours have elapsed, the sickness returns and rises to a higher degree than it had attained before the use of the remedy, for it is re-enforced by the secondary effect of the medicament which resembles it. This method of curing is, therefore, very absurd, if we wish to apply it to diseases of long standing. 

For example, the juice of poppy in making its primary effect upon a healthy body excites a relaxing sleep, accompanied by rattling in the throat; but its secondary effect is sleeplessness. Now, if the physician is irrational enough to seek to combat an habitual sleeplessness with the juice of poppy, he proceeds in a palliative manner. A stupefying, rattling, and non-strengthening sleep will soon follow the remedy, but the secondary effect will be sleeplessness and consequently an aggravation of the existing evil. After twenty-four hours the patient will sleep still less than before the use of the opium, unless the dose be reiterated and increased; the secondary effect of the latter will still more aggravate the evil in question and a cure will never follow. 

In the same way coffee produces only palliative and apparent alleviations, when applied as a remedy according to the principle of antithesis; for example, against chronic constipations, arising from inactivity of the intestinal canal, which is the ordinary case with persons of sedentary habits.  

The primary effect of coffee is the opposite of this state; now, being employed for the first time or seldom in such cases, it will not fail to operate an evacuation very quickly. But on the following days the secondary effect of this beverage will increase the obstructions so much the more. If we should desire to vanish them anew in a palliative manner with coffee, it would then already be necessary to cause a greater or stronger portion to be taken.  

However, the chronic constipation would not be cured by it, for the secondary effect of the coffee would cause it to reappear anew, and thus each reiteration of a more copious or a stronger dose would only aggravate the evil in question and render it more obstinate. 

It will be found that the so-called beneficial effects which coffee drinkers attribute to this beverage, to justify their habit, are nearly reducible to palliative reliefs against certain sufferings. Now, the continual use of a palliative medicament being a very injurious thing, the daily and dietetic use of such a thing is, without contradiction, the most pernicious of all. 

If Hahnemann esteem the virtues of coffee, he do so only in relation to its medicinal employment. This enjoyment consists: 

1. In the properly curative application of this substance against chronic diseases, the symptoms of which have a great resemblance to the primary effects of coffee 
2. In its palliative application against evils recently engendered, which are eminently dangerous, and which resemble very much the secondary effects of this remedy.  

Such is the rational and wise use of this medicinal substance, of which very few persons know the true value, but of which millions of men make a false abuse.³ 

REFERENCE FROM THE ORGANON OF MEDICINE OF SAMUEL HAHNEMANN: 

In Organon Of Medicine, Hahnemann clearly states that where the emetic drugs are avoided, a small quantity of coffee expedites the remains of stomach downwards. Even in state of paralyzed state of stomach, an emetic medicine would only have the effect of producing a dangerous or fatal inflammation of intestines; where a small quantity of strong infusion of coffee, frequently administered would dynamically exalt the sunken irritability of stomach. 

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th 

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