Part II

Caffeine

Caffeine, one of a class of chemicals known as the xanthines, is still prescribed occasionally by physicians. Xanthines (caffeine, theobromine, theophylline) can in varying degrees cause central nervous system stimulation and cardiac stimulation; they also act as mild diuretics. Combined with other drugs, caffeine is sometimes used for headache, particularly migraine, and in some "pain remedies" (for example, A-P-C capsules). Nonmedically, caffeine is the most widely used central nervous system stimulant, popular in the form of coffee, tea, cocoa (which also contains theobromine), and "cola" drinks. Heavy users of these beverages report tolerance (including cross-tolerance among the xanthine beverages), physical dependence with withdrawal symptoms, and craving.

Chapter  21. Early history

In Part I, we dealt with the most hated and feared of all drugs––– heroin and other narcotics. In subsequent sections, we shall consider other widely publicized drugs that are today considered responsible for the "drug problem." People tend to categorize these and other drugs in various ways-as "licit" or "illicit," as "good" or "bad"––– and some drugs are treated as if they were not drugs at all. As we shall show, however, the boundaries of those categories have little objective justification; they vary from generation to generation and from country to country.

In this Consumers Union Report, accordingly, we have sought to provide an overview of psychoactive drugs in general-especially those that, licitly or illicitly, are subject to recreational, nonmedicinal use. Caffeine, nicotine, and alcohol are considered as fully and as objectively as their importance in our culture warrants––– without regard for their current legal status as "licit" or their popular status as "nondrugs."

A sound history of drugs in our culture must begin with the era of the great fifteenth- and sixteenth-century European explorers. American schoolchildren learn that Christopher Columbus and countless others set sail across unknown seas in search of the treasures of the Indies-gold and spices. And, the school books might have added, drugs. For the civilized residents of western Europe in Columbus's time were very poor in mind-affecting substances: no coffee, no tea, no tobacco, little opium, no LSD-like drugs, little or no marijuana, no cocaine-like stimulants, and no sedatives or intoxicants except alcohol. As a result, Europeans had to make use of alcohol in a variety of ways-as a social beverage, a before meals aperitif, a thirst-quenching beverage during meals, an after-dinner drink, an evening drink, a nightcap, a tranquilizer, a sedative, a religious offering, an anesthetic, a deliriant, and a means of getting drunk. Alcohol thus permeated every aspect of European culture, and still does.

Wherever they went, however, the European explorers from Columbus on found other mind-affecting drugs, and brought them home with them. * Tobacco was discovered on Columbus's first voyage. Cocaine was found in large areas of South America. Caffeine and LSD-like drugs were found scattered all over the world. During the next two centuries, the Europeans not only adopted nicotine and caffeine but spread them everywhere. They also imported opium. In a remarkably short space of time, western Europe was converted from an alcohol-only culture to a multidrug culture.

* The Arctic was an exception. Dr. Andrew T. Weil said (1970): "Every culture throughout history has made use of chemicals to alter consciousness except the Eskimos, who had to wait for the white man to bring them alcohol, since they could not grow anything."

European explorers, travelers, and traders found caffeine in many forms:

• Coffee was found and brought back to Europe from Arabia and Turkey; it had spread to these and other Near Eastern and North African regions from Ethiopia.
• Tea was brought back from China.
• The  kola nut was found in common use in West Africa, and was later introduced into cola drinks as a source of caffeine.
• The  cocoa tree was found in Mexico, the West Indies, and much of Central and South America. Chocolate from this tree was the favorite beverage of the Emperor Montezuma; it was said that 50 pitchersful a day were prepared for his use. This drink was soon popular throughout the world.
• The  ilex plant, source of the caffeine drink known as mate or Paraguayan tea, was found in Brazil and elsewhere in the American tropics; this tea is still drunk in the United States as yerba mats, and in parts of South America it rivals coffee and tea in popularity.
• Cassina––– also known as yaupon, as the Christmas berry tree, and as the North American tea plant-was found in common use as the source of a caffeine beverage among Indians from Virginia to Florida and west along the Gulf coast to the Rio Grande. It was reported at the time that "none [of] the Indians but their great Men and Captains, who have been famous for their great Exploits of War and Noble Actions, are admitted to the use of this noble Bevaridge." White settlers in these regions prepared a tea known as the "Black Drink," "Black Drought," or dahoon, from the same plant; they also let the leaves ferment to produce a drink containing both alcohol and caffeine.

During the Civil War, when the South was under blockade so that supplies of coffee and tea were cut off, cassina again became a popular beverage in the Confederacy. During and after World War I, when coffee prices soared, Congress and the United States Department of Agriculture launched projects to popularize cassina as a substitute source of caffeine; cassina-flavored ice cream and cassina soft drinks as well as cassina teas were marketed.

The introduction of caffeine drinks into countries that had not previously known them––– like the introduction of other exotic drugs such as nicotine and marijuana––– aroused a sense of deep moral outrage and evoked efforts to repress the new drug. The Mohammedans of Arabia, for example, first used the newly introduced coffee to help them stay awake during prolonged religious vigils. This "use as a devotional antisoporific stirred up fierce opposition on the part of the strictly orthodox and conservative section of the priests. Coffee by them was held to be an intoxicating beverage, and therefore prohibited by the Koran, and severe penalties were threatened to those addicted to its use." An early Arabian writer summed up: "The sale of coffee has been forbidden. The vessels used for this beverage . . . have been broken to pieces. The dealers in coffee have received the bastinado, and have undergone other ill-treatment without even a plausible excuse; they were punished by loss of their money. The husks of the plant ... have been more than once devoted to the flames, and in several instances persons making use of it . . . have been severely handled." "Notwithstanding threats of divine retribution and other devices," however, "the coffee-drinking habit spread among the Arabian Mohammedans, and the growth of coffee and its use as a national beverage became as inseparably connected with Arabia as tea is with China."

Dr. Robert S. de Ropp notes that when coffee was introduced into Egypt in the sixteenth century, "the 'coffee bugaboo' . . . caused almost as much fuss as the 'marijuana bugaboo' in [the] contemporary United States. Sale of coffee was prohibited; wherever stocks of coffee were found they were burned.... All this fuss only bad the result of interesting more people in the brew and its use spread rapidly."

In Europe, too, coffee became a popular drink despite (or perhaps because of) efforts at repression and medical warnings.

Medical opposition to coffee continued into the twentieth century. A typical medical attack can be found in  Morphinism and Narcomanias from Other Drugs (1902) by T. D. Crothers, M.D., superintendent of the Walnut Lodge Hospital in Connecticut, editor of the  Journal of Inebriety, and professor of nervous and mental diseases at the New York School of Clinical Medicine. Dr. Crothers classed coffee addiction with morphinism and alcoholism. "In some extreme cases delusional states of a grandiose character appear; rarely violent or destructive, but usually of a reckless, unthinking variety. Associated with these are suspicions of wrong and injustice from others; also extravagant credulity and skepticism." One case of coffee psychosis he cited concerned "a prominent general in a noted battle in the Civil War; after drinking several cups of coffee he appeared on the front of the line, exposing himself with great recklessness, shouting and waving his hat as if in a delirium, giving orders and swearing in the most extraordinary manner. He was supposed to be intoxicated. Afterward it was found that he had used nothing but coffee." Another of Dr. Crothers's charges against coffee resembles an accusation currently levied against marijuana: "Often coffee drinkers, finding the drug to be unpleasant, turn to other narcotics, of which opium and alcohol are most common."

A similar view of the evils of caffeine drinks can be found in  A System of Medicine (1909), edited by Sir T. Clifford Allbutt, K.C.B., M.A., M.D., LL.D., D. Se., F.R.C.P., F.R.S., F.L.S., F.S.A., Regius Professor of Physic (Internal Medicine) in the University of Cambridge, England, and by Humphrey Davy Rolleston, M.A., M.D., F.R.C.P. The chapter on "Opium Poisoning and Other Intoxications" in this textbook, used in American as well as British medical schools, was by Sir Clifford and Dr. Walter Ernest Dixon, professor of materia medica and pharmacology, King's College, London––– one of the foremost pharmacologists of his generation.

We have seen several well-marked cases of coffee excess ... [Sir Clifford and Dr. Dixon reported]. The sufferer is tremulous, and loses his self-command; he is subject to fits of agitation and depression; he loses color and has a haggard appearance. The appetite falls off, and symptoms of gastric catarrh may be manifested. The heart also suffers; it palpitates, or it intermits. As with other such agents, a renewed dose of the poison gives temporary relief, but at the cost of future misery.

Tea, Sir Clifford and Dr. Dixon found, is in some respects even worse; it produces 11 a strange and extreme degree of physical depression.... A grievous sinking may seize upon a sufferer.... The speech may become vague and weak. By miseries such as these, the best years of life may be spoilt." *

* Sir Clifford's and Dr. Dixon's views on coffee and tea may be contrasted with their statement that "opium is used, rightly or wrongly, in many oriental countries, not as an idle or vicious indulgence, but as a reasonable aid in the work of life. A patient of one of us took a grain [60 milligrams] of opium in a pill every morning and every evening for the last fifteen years of a long, laborious, and distinguished career. A man of real force of character, concerned in affairs of weight and of national importance, and of stainless character, he persisted in this habit, as being one which gave him no conscious gratification or diversion, but which toned and strengthened him for his deliberations and engagements."

Footnotes
Chapter 21

1. Andrew T. Weil, "Altered States of Consciousness, Drugs, and Society," September 18, 1970; unpublished.

2. Quoted by Ralph Holt Cheney, Coffee (New York: New York University Press, 1925), p. 207.

3. Ibid., p. 209.

4.  Encyclopaedia Britannica, 11th ed., s.v. "Coffee," VI, 646.

5. Quoted by Edward Forbes Robinson,  The Early History of Coffee Houses in England (London: Regan Paul, Trench, Trubner & Co., Ltd., 1893), pp. 19, 20.

6. Ibid., p. 26.

7. Robert S. de Ropp,  Drugs and the Mind (New York: St. Martin's Press, Macmillan, 1957), 248.

8. T. D. Crothers,  Morphinism and Narcomanias from Other Drugs (Philadelphia: W. B. Saunders & Co., 1902), p. 303.

9. Ibid., pp. 303-304.

10. Ibid., p. 304.

11. Sir T. Clifford Allbutt-and Humphrey Davy Rolleston, eds.,  A System of Medicine, Vol. II, Part I (London: Macmillan, 1909), pp. 986-987.

12. Ibid., pp. 987-988.

13. Ibid.