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Medical ArticlesConclusive Remarks Obstacles
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Source: Disturbances Of The Heart
Caffein can irritate the heart and cause irregularity and
tachycardia, especially in certain persons. In fact, some can never
take a single cup of coffee without having an attack of palpitation,
and many times when coffee and tea have been unsuspected by the
patient as the cause of cardiac irritability, their removal from the
diet has stopped the symptoms, and the heart has at once acted
Caffein is a stimulant and tonic to the heart, increasing its
rapidity and the strength of the contractions. It is also a cerebral
stimulant, one of the most active that we possess among the drugs.
It increases the blood pressure, principally by stimulating the
vasomotor center and by increasing the heart strength. It acts as a
diuretic, not only by increasing the circulatory force and blood
pressure, but also by acting directly on the kidney. This action on
the kidney contraindicates the use of caffein in any form, except in
rare instances, when there is acute or chronic nephritis. The
increased blood pressure caused by caffein also contraindicates its
use when there is hypertension. Caffein first accelerates the heart
and later may slow it and strengthen it; but if the dose is large or
too frequently repeated, the apex of the heart ceases to relax
properly and there is an interference with the contraction of the
ventricles, the heart muscle becomes irritable, and a tachycardia
Therefore when a heart has serious lesions, whether of the
myocardium or of the valves, with compensation only sufficient, the
action of caffein in any form is contraindicated. The fact that it
raises the blood pressure, thus increasing the force against which
the heart must act, and that it irritates the heart muscle to more
sturdy or irregular contraction, indicates that a patient with a
heart lesion or with a nervously irritable heart should never drink
tea and coffee or take caffein in any beverage.
Many patients cannot sleep for many hours after they have taken
coffee or tea, as the cerebral stimulation of caffein is projected
for hours after its ingestion. Caffein does not absorb so quickly
and therefore does not act so quickly when taken in the form of tea
and coffee as it does when taken as the drug or as a beverage which
contains the alkaloid. Persons who are nervously irritable, excited
and overstimulated cerebrally, with or without high blood pressure,
should not take this cerebral and nervous excitant. This is true in
early childhood and in youth, and continues true as age advances, in
most persons. It is a crime to present caffein as a soda fountain
beverage to children and young persons when the excitement of the
age is such as already to overstimulate all nervous systems and all
A considerable majority of persons over 40 learn that they cannot
drink tea or coffee with their evening meal without finding it
difficult to sleep. Such patients, of course, should omit this
stimulant. Some patients have already recognized this fact and its
cause; others must be told. The majority of adults are probably no
worse and may be distinctly benefited by the morning cup of coffee
and the noon coffee or tea, provided the amount taken is not large.
It seems to be a fact that the drinking of coffee is on the
increase, especially as to frequency. Certainly the five o'clock
tea, with women, is on the increase, and we must deal with one more
cerebral and nervous excitant in our consideration of what we shall
do to slow this rapid age.