COFFEA TOSTA.

Preparation , Infusion of the well-roasted berries. A decoction of raw

Coffea furnishes a preparation very rich in Coffeïnum; an infusion of the roasted Coffea contains some Coffeïnum (the amount varying with the roasting), but much of the alkaloid is changed into "Coffeone" (to which the aroma is due). This Coffeone is obtained free from the alkaloid by distilling an infusion of roasted Coffea; some effects of this distillate are here included.

Authorities.

1 , Zimmerman (from Wibmer), effects of two cups more than usual; 2 , Willis, from ibid., general effects; 3 , Hoffmann, ibid., effects of several cups of strong coffee; 4 , Kapper, Zeit. f. H. K., 4, 194, a woman took (for suppression of menstruation) an infusion of about 3 ounces three evenings in succession; 5 , Höring, Wurt. Corr. Bl., 1831, Frank's Mag., 2, 68, gradually increasing doses to 30 cups of strong coffee a day; 6 , Träschel, Frank's Mag., 1, 41, a man drank 32 cups within an hour, containing 8 ounces of berries; 7 , Observations and experiments from Boecker's Beiträge; 8 , Lamare-Picquot, proving on self, with cold infusion taken in the morning, in bed, fasting, Études Expérimentales, etc., sur l'action dynamique du Café, Paris, 1864; 9 , Curschmann, an anæmic woman took an infusion of 250 grms., Deutsch. Klin., 1873; 10 , Wood, chronic effects of a single cup, in the morning, N. A. J. of Hom., 12, 248; 11 , Dr. Lindsley (New York City), MSS., took for a proving 3 cups of strong coffee, three mornings in succession; 12 , Dr. J. Lehman instituted a series of experiments as follows: placing two men on strict diet, he examined the urine daily, with especial attention to amount of urea, phosphates, and sodium chloride, for two weeks or more, after which, the men were allowed 4 glasses of strong coffee instead of water; subsequently experiments were instituted with distilled coffee ("

Coffeone "), and also with the alkaloid; 13 , Dr. H. V. Miller, effects of two cups, N. A. J. of Hom., N. S., 4, 87; 14 , Marvaud, Aliments d'Épargne, effects of infusion (taken cold for sphygmographic tracings), and also of distilled coffee ("Coffeone"); 15 , Dr. E. M. Hale, effects of a cup of intensely strong coffee, H. Month., 9, 465; 16 , Dr. Œhme, daily use of coffee for breakfast, in a man of forty-five, of late unused to C., N. A. J. of Hom., N. S., 3, 418.

MIND

• Emotional.
• An agreeable mental excitement, causing wakefulness, 14.
• Completely developed delirium tremens, 5 . [Following a rheumatic attack, with great prostration and weakness.]
• Great loquacity, 13.
• Love for family, 13.
• Desire to perform good deeds intensified (Benevolence excited), 13.
• Veneration for Supreme Being, 13.
• Anxiety, 12.
• A kind of fearfulness, which seems unendurable, 1.
• Timidity, and fear of sudden death; this fear sometimes occasions trembling from head too foot (secondary effect), 13.
• Intellectual. [10.]
• Brain feels clear, and is very active, 13.
• The intellectual faculties chiefly stimulated are the imagination and the memory, 14.
• The power of judgment is increased, 14.
• Attention is more alive, 14.
• Feels impelled to push things; wants to keep going ahead and doing something, 13.
• It gives rise to a need of creative activity, a vivacity of thought, a versatility and ardor of desire, more favorable to the exaggerated expression of ideas previously formed, than to the quiet examination of new conceptions (Moleschott), 14.
• Symptoms would come suddenly; and took away all mental energy, 10.
• Somewhat unconscious (after two hours), 9.

HEAD

• Vertigo.
• Vertigo, 1 ; (after half an hour), 7, 12.
• Vertigo so that she was unable to stand, 6. [20.]
• Vertigo, with whirling sensation in head, occasioning a general faint feeling, with aggravation, when thinking; has to banish reflection; with vertigo, burning in stomach; vertigo partially relieved by a change of position (secondary effect), 13.
• Swimming or vertiginous feeling, 10.
• Sensation as if everything in the head were going in slow circles, now in one direction, now in another; with incessant noises in the ears, 4.
• General Head.
• Rush of blood to the head, 6.
• Violent headache, 6.
• Forehead.
• Sensation of heaviness in forehead over eyes (secondary effect), 13.
• Parietals.
• Sensation as though a piece of lead were nailed to the parietal bones, which every motion of the head aggravates, 4.
• Occiput.
• Stinging pain into locality of amativeness on left side, 13.

EYE

• Blue rings around the eyes, 4.
• Lids.
• Conjunctiva of the lids slightly red, especially towards the margin; conjunctiva of the bulb slightly injected in the canthi and corners, 4.
• Pupil. [30.]
• Iris contracted but sensitive, 4.
• Vision.
• Intolerance of the candlelight; it seems surrounded by a dim broad halo, causing painful pressure in the eyebrows, 4.
• Sensation as though a fog were before the eyes, 4.
• Muscæ volitantes, 10.
• Aggravation of the myopia, 16.

EAR

• Every step and every loud word is painfully felt in the ears, 4.
• Incessant noises in the ears, 4.
• Ringing in the ears, 4.
• Roaring, buzzing, and singing in the ears, 10.
• Sounds as of pounding of bell-ringing in the distance, 10.

FACE. [40.]

• Paleness of face, 8.
• Countenance very pale, and had an anxious expression (after two hours), 9.
• Pale as a corpse, 7.
• Face waxy pale, 4.
• Face very puffy, as if dropsical, waxy, pale-yellow, 4.

MOUTH

• He was seized with such an intense pain in the teeth of the right lower jaw (not decayed) that it drove him nearly crazy . He came to my office after midnight to get relief. He had already observed that no application relieved the pain but cold water. So soon as the water became warm in the mouth, the pain returned, 15.*
• Lips and tongue pale and dry.

THROAT

• Spasmodic contraction of the throat, 6.

STOMACH

• Appetite.
• Aversion to all food; she is able to take only small quantities of water, 4.
• Nausea and Vomiting.
• Nausea, with faintness, 4. [50.]
• Nausea in the stomach, and ineffectual efforts to vomit, 4.
• Vomiting with difficulty (soon), 6.
• Stomach.
• Distension in the epigastric region, tympanitic, extremely sensitive to touch, less so to pressure, 4.
• Tension in the stomach, so that she is obliged to loosen the clothes, 4.
• Sensation of heaviness in cardiac region (secondary effect), 13.
• Great fulness in epigastrium, and partial loss of appetite (secondary effect), 13.
• Cold water and cold food aggravate the distress in epigastrium and left chest (secondary effect), 13.

ABDOMEN

• Hypochondria.
• Painfulness of the hypochondria, 4.
• Extreme sensitiveness of the hepatic region, 4.
• General Abdomen.
• Abdomen swollen and hard, especially in the region of the bladder, which was very sensitive to touch (fifth day), 6. [60.]
• Painful tympanitic distension of the abdomen, 4.
• Rumbling in the bowels causing warmth, painful, obliging her to bend up and press with the hands, 4.
• Pain in the left upper portion of the abdomen, just below the spleen, not affected by pressure, 6.
• Sticking pains in the abdomen (second day), 6.

RECTUM AND ANUS

• Hæmorrhoids, 1.
• Discharge of exceedingly bright blood, every morning with the regular stool, 16.

STOOL

• Diarrhœa.
• Frequent stools, with tenesmus (after two hours), 9.
• Copious evacuations of the bowels, after the first dose, followed by constipation, 4.
• Constipation.
• Constipation (secondary effect), 13.
• It sometimes accelerates the peristaltic motion, but in many cases (especially in weak persons) constipation follows, 7. [70.]
• No stool during the first two days, 7.

URINARY ORGANS

• Urethra.
• At close of micturition, a slight milky discharge (probably prostatic), attended with a smarting or burning sensation at orifice of urethra; afterwards, cutting pains below the bladder (in sphincter vesicæ, or region of prostate gland), (secondary effect), 13.
• Constant tickling in the urethra, which was very annoying, 4.
• Frequent desire to urinate, with passage of scanty pale urine, 4.
• Excessive urging, with inability to urinate, 6.
• Micturition.
• Frequent micturition (secondary effect), 13.
• Increased secretion and discharge of urine, with diminished specific gravity (after two hours), 9.
• Profuse and colorless urine (secondary effect), 13.
• Amount of urine increased 68 c. c. per day; urea diminished 6.5 grammes; phosphates diminished 1 gramme; sodium chloride diminished 2.4 grammes, 12.
• Amount of urine increased 355 c.c., urea diminished 7.1 grammes, c.c.; phosphoric acid diminished 1.6 grammes; sodium chloride increased 1 gramme. (Coffeone), 12.
• Amount of urine increased 370 c.c. per day; urea diminished 9.4 grammes; phosphoric acid diminished 1.3 grammes; sodium chloride diminished 1 gramme, 12. [80.]

Normal Urine Urine after a Coffee diet.

Amount in 24 hours 1364.500 Grs.

1739.750 Urea, 22.275 Grs.

12.585 Uric acid, 0.578 Grs.

0.402 Phosphoric acid, 1.291 Grs.

0.854 (Boecker and Lehman, average from numerous experiments.)

• Ischuria for many days; she was almost unable to urinate, and could only evacuate the bladder after frequent attempts, and with passage of a few drops at a time, with much burning and pressure in the region of the bladder, 6.
• It diminishes all the solid constituents of the urine except the earthy phosphates, 7 . [Conclusions from a large number of detailed observations and analyses.]

SEXUAL ORGANS

• Male.
• Weakness of the sexual power in men, 2.
• Female.
• Spasmodic sensation deep in the uterine region; it seems as if something tried to press outward and could not, because it constantly gave rise to spasms, 4.
• Menstruation increased and prolonged, 1.

RESPIRATORY APPARATUS

• Objective.
• Rattling respiration, 6.
• Diminution of the expired water, 7.
• Diminution of the amount of expired carbonic acid takes place soon after drinking Coffee, and is especially noticed after long-continued use of it, 7 . [Wibmer calls attention to the fact, that this is the reverse of the condition after taking

Senega , in which the amount of carbonic acid is increased.]

• The amount of expired carbonic acid is 195, 593.6 cubic centimetres less than normal during twenty-four hours; this amount seemed really astounding, but is not so remarkable, seeing that a real dyspnœa follows the use of strong coffee, 7.
• Subjective.
• Much subjective dyspnœa, with quick, labored respiration (after two hours), 9. [90.]
• A real asthma, with oppression of the chest (after half an hour), 7.

HEART AND PULSE

• Præcordium.
• Præcordial symptoms, 8.
• Heart's Action.
• Greatly increased vigor of the action of the heart, 12.
• Palpitation, 3, 4, 12.
• Diminished action of heart, 8.
• Pulse.
• Rapid pulse, 12.
• Pulse full and frequent, 13.
• Very frequent and tense pulse (after two hours), 13.
• Pulse increased from 75 to 82 (half a litre), (Trousseau, Montegazza, et al.), 14.
• Before the proving, pulse 69; after the fifth cup, it fell to 61, 8. [100.]
• Pulse variable; often weak and almost imperceptible; sometimes intermitting (secondary effect), 13.

EXTREMITIES IN GENERAL

• Trembling of the limbs, 1.
• Trembling of all the limbs (after half an hour), 7.
• Trembling of the arms and legs, 4.
• Considerable tremor in limbs (after two hours), 9.
• Jerking of limbs (secondary effect), 13.

GENERALITIES

• Objective.
• General excitement, 12.
• General agreeable excitement, with slight sweat. (Coffeone), 12.
• The preceding tracings plainly indicate quite a marked decrease of the pulse, with diminished extent of oscillation, and a consequent increase of arterial tension. They are similar to the tracings taken by Meplain ten or fifteen minutes after drinking the cold infusion; but are still more strongly marked under the action of a simple decoction of the unroasted berry. When, however, the tracings are taken a few moments after drinking an infusion of black coffee, especially when well roasted and of a strong aromatic odor, the peculiarities of the pulse are directly opposed to those presented above. In this case, they indicate more or less excitement of the circulation, as shown in the tracings by the more extended oscillations, by the greater abruptness and height of the ascending line, by its sharp angle at the top, and by the jerking contour of the descending line. This important fact, first noticed by Meplain, is accounted for by him as follows. He distilled a litre of a strong infusion of roasted coffee, and obtained therefrom about 200 grammes of a liquid which, in addition to the aromatic smell and taste of coffee, possessed a slightly acrid taste and decided empty rheumatic odor. After taking this, he observed the pulse to rise from 64 to 72. Hence he inferred that the symptoms of vascular excitement (quickened circulation, diminished vascular tension, flushed face, etc.), which appear immediately after drinking an infusion of black coffee, are effects of the Coffeone. Our own investigations have led us to accept implicitly the ideas of Meplain, as to the part played by Coffeone in inducing the primary effects on the circulation experienced after drinking a strong infusion of roasted coffee. As we ascertained from the experiments we instituted, in order to test the soundness of our colleague's opinion, the changes in the circulation which are among the effects of coffee depend not only on the length of time which may have elapsed since the taking of the beverage before the observations are made, but also on the more or less thorough roasting of the berry. Thus we may account for the astonishing diversities in the opinions expressed by different authorities as to the effects of coffee on the circulation, and especially on the pulse, which latter, according to some (Trousseau, Deltel, Penilleau, Prompt), is increased, while according to others (Rognetta, Caron, Jomaud) it is lessened, in frequency. We remark, in the first place, that those writers who have observed an acceleration of pulse after drinking an infusion of coffee, have taken it either warm, or with the addition of chicory (which Jomaud has shown to be a violent vascular irritant), or else they have made their observations immediately after partaking of the beverage. Those, on the other hand, who have observed the pulse to become slower, have chiefly used in their experiments coffee raw, or but slightly roasted, or else have waited at least ten or fifteen minutes after drinking it, before examining the pulse, .

SLEEP AND DREAMS

• Sleeplessness.
• Sleeplessness, 3.
• Great sleeplessness from mental and nervous excitability (secondary effect), 13. [130.]
• Loss of sleep. (Coffeone), 12.
• Complete inability to sleep on account of rush of all kinds of thoughts through the mind, 4.
• Wakefulness, with ecstatic mental excitement, intermitting with dreams, 11.
• When going to sleep, starts up suddenly in affright, with groans and fear of falling, or of some impending danger (secondary effect), 13.
• Dreams.
• Sleep restless on account of many unpleasant and confused dreams, 12.
• Dreams all night for three nights; vivid and brilliant visions of magnificence, 11.
• On the third night, dream that the dome of the sky is spanned by rainbows from horizon to zenith. Visions of enchantment. Beautiful landscapes. View of Paradise. These delightful dreams followed by dreams of death of dear friends, which do not abate the cheerfulness or mental exhilaration, but he looks at all with supernatural indifference, 11.

FEVER

• Chilliness.
• Skin cool and moist, 4.
• Coldness of the surface and limbs, 8.
• On account of easy perspiration, chilliness and shivering from the least exposure to cold air (secondary effect), 12. [140.]
• Chilliness, with general shaking and chattering of the teeth; cannot get warm; the chills ascend from the fingers and toes to nape of neck, and thence to vertex; when chilly, Cayenne pepper taken internally produces general warmth, and makes him feel fearless and courageous (secondary effect), 13.
• Feet and hands cold (secondary effect), 13.
• Heat.
• Heat, 3.
• Excessive heat, so that she threw off the outer clothing and sat for a while in a draft, 6.
• At one time, flushes of heat, at another currents of cold air down the back, 4.
• Excessive orgasm of blood (after half an hour), 7.
• Violent fever, 6.
• Hot flushes to the face, and heat (with which, however, there is a scarcely noticeable redness) of the cheeks, 4.
• Sensation as though alternate warmth and coldness were moving about in the bowels, 4.
• Sweat.
• Sweat, 12. [150.]
• General sweat, 6.
• Profuse sweat. (Coffeone), 12.
• Cold clammy perspiration all over body, but chiefly in the palms of the hands (secondary effect), 13.

CONDITIONS

• Aggravation.
• ( Cold food ), Distress in epigastrium.
• ( Cold water ), Distress in epigastrium.
• ( Motion of head ), Sensation in parietal bones.
• ( Thinking ), Vertigo, etc.
• Amelioration.
• ( Cold air ), Momentary relief.
• ( Cold water ), Toothache.
• ( Outdoor exercise ), The symptoms.
• ( Change of position ), Vertigo.
• ( On rising ), Feels better.

SUPPLEMENT: COFFEA TOSTA. Authorities.

9 , Dr. Curschmann (Deutsche Klinik, No. 41), Med. Times and Gaz., 1873 (2), p. 584, additional symptoms; 17 , Dr. Eustradiadis, Étude Expér. sur les Prop. Phys. de la Caféine et du Café, Paris, 1870.

MIND

• She recognized those about her, and was aware of the cause of her sufferings, but still her sensorium was evidently not quite clear; and next day she retained only a very obscure recollection of what had occurred. Plain or connected answers were not obtainable from her, and only after much effort and persuasion would her attention be engaged at all, she continuing to incessantly repeat the same phrases in the most dolorous tone, 9.

EYE

• The pupils somewhat enlarged, acted normally, 9.

STOOL

• In one hour severe diarrhœa, which continued to recur about every half hour for long afterwards, 9.

URINARY ORGANS

• Frequent desire to pass urine, which came on every quarter of an hour. The urine having a specific gravity of 1014, was considerably increased in quantity, 9.
• The general conclusions were that there was great diminution of urea, over 15 per cent. Coffea did not prove a diuretic, though there was increased frequency of micturition, 17.

RESPIRATORY ORGANS

• Respiration painful, short, and rapid, counting from 24 to 30, 9.
• Complained of want of air, and a sensation as if her chest were compressed, and clung convulsively to articles of furniture or the persons near, her, but sinking down again quite powerless, 9.

HEART AND PULSE. [160.]

• Distressing palpitation, and the impulse seemed almost to raise the chest, 9.
• Pulse 112, 9.

EXTREMITIES

• The limbs, and especially the hands were affected by chorealike movements, so that the patient was unable to hold either a glass or spoon, 9.

GENERALITIES

• Restlessness, 9.

FEVER

• The forehead was cold, and the temperature of the other parts of the body did not seemed raised, 9.