Dr.G.Suresh: I think, at the outset it has been made clear it is not a debate but only a discussion. Coffee or no coffee has been a question right from Hahnemann’s time. We all know, we have learnt about it from various homoeopathic literatures, those written by Hahnemann and his followers till the current generation of stalwarts that there seems to be no clear-cut answer to this question. Although the discussion is supposed to be on coffee I suppose my fellow members and all the participants on dais and all of us in the audience will agree we can to a certain extent extend the “yes” or “no” question to a variety of things including tea, other spices we are taking and sometimes even with other systems of medicine has been taking parallel along with our homoeopathic treatment for certain fears, necessities or for other reasons. Since my duty is to moderate I shall keep quiet for a moment and just pass on the mic to the participants. From the left extreme I request Dr.R.D.Pavalan to say his views first.

Dr. D. Manju

Dr.R.D.Pavalan:My views are actually Hahnemann during his initial place of practice, before finding out the psora theory in 1803.He published a paper on “Effects of coffee” at Leipzig where he mentioned coffee is the reason for almost all the chronic disease so it was the theory before psora theory and he told that coffee is one of the reason for all the diseases like constipation, hypertension etc which are more similar to psora theory after that he found out psora theory in his denied version he overcome about coffee and had been mentioned in Dudgeon’s translation of Chronic disease. Here the present position is sticking on to the repeated question, whether coffee is allowed during Homoeopathic medicine, first of all most of the authors told that not all the Homoeopathic remedies are antidoted by coffee and again it depends on the sensitiveness of the patient. How to find out the sensitiveness, if a patient is having a symptoms like palpitation or raising BP after taking coffee, probably he will be more sensitive to coffee and he is taking homoeopathic remedy, coffee may antidote these kinds of patient. Secondly, those addicted to coffee are also having some antidotal effects over Homoeopathic remedies, not all those people casually using coffee.
When Hahnemann was practicing in Germany, where coffee was introduced into the general population, especially women using more coffee. Coffee is considered as a foreign material which is migrated to Germany, so Hahnemann was deadly against coffee he was totally talking all the points against coffee but when he moved to Paris where he found all the people were using coffee. So here he changed his view and that made him to find some other device which cannot be antidoted by coffee so one of the thought in his mind, which gives the way to the birth of LM potency. During LM potency we prescribed to take the medicine almost every day so that the least chance of antidotal effect of coffee towards the medicine.

According to our own experience it was very hard to advice the patient to stop coffee and some patient are very fond of coffee they don’t come for follow-ups. So in my experience I found that LM potency if we are prescribing, coffee is not antidoting since we are giving daily dose even though coffee antidotes that particular dose next dose will act. This was the one thing apart from that individual stoppage of coffee in all the patients who are under Homoeopathic treatment, I feel it is not necessary.

Dr. R.D.Pavalan	Dr. N.S.Senthil Mohan

Dr.G.Suresh: This reminds me of a patient. A couple came to me, for both of them I given certain restrictions and he will take
20-30 cups of coffee a day, I asked him to reduce the coffee and not to stop. After some days his wife came alone and told me “Doctor my husband stopped it!”Then I asked “oh! he stopped the coffee…”.For that she said that “No Doctor, he stopped your treatment! .This is what happened. They leave what is convenient for them to leave and not what we ask them to do. At the same time there are over enthusiastic patients also.

Dr.N.S.Senthil Mohan : that there is no need of restricting coffee when giving Homoeopathic medicines, you have to substantiate on your point …. during the time of Hahnemann,they have used berries, nuts of that coffee plant and they just boiled in water they extract the juice and they drank that as coffee it was the coffee available that time but later on now a days even in India we are getting what is, not 100% pure coffee it is the crude extract of the pulp or seeds or leaves almost our common coffee items we are drinking today…. For Example Bru instant which contains 70% coffee and 30 % chicory, Green label 53% coffee and 47% of chicory so there is no 100% pure coffee whatever coffee type used in India is roasted type variety that also contains less caffeine more better taste and less flavour so in India every coffee items we are adding the chicory, so the problem is the main ingredient caffeine in coffee that is creating problem when we are adding chicory in that, no caffeine and the bad effects of coffee and all, only thing available is ,am talking practical point, Nescafe classic is the 100% pure coffee prepared from coffee seeds, so you have a doubt of coffee then Nescafe classic is a problem. Today there are more coffee day shops their they giving 100% pure original coffee taking that thing then it may create a problem not our regular coffee, then we go to different authors one side Boenninghausen says coffee even with chicory also restricted is given in the lesser writings. Some other authors like Burnett, Farrington,Clarke says Black coffee is a problem so avoid coffee, in another side practitioners like Murphy says you can boldly give coffee if there is a need of restriction but not in all cases, then our favourite Materia medica Allen’s key notes there also said that psorinum patient won’t improve while taking coffee so like this contradictory points are there, but what is the solution then ..certain authors said that as Homoeopathic medicines are highly potentized, when you are giving a high potency drug there is no need to restrict coffee and that will act, so that is the one point.

Then another thing certain individuals who are sensitive either to coffee or to drug they are only have problem with coffee what I felt is in sensitive patients I will give low potency so only highly dynamized high potency drug don’t have any effect with coffee before you going for lower potency in sensitive individuals we can advice the person to reduce the coffee intake and tell the patient to avoid coffee either one hour after or before taking the medicine. Immediately taking the medicine with coffee that also in some authors I heard in India some doctors are giving medicines in coffee they also give good results I don’t know how far it is, but my suggestion is it is better to avoid 1 hour before and after taking the medicines then most of all authors told avoid strong black hot coffee this is what repeated, they told from their own experiences. Already I told that what coffee we drinking is not 100% so we can advice them to have a mild coffee with or without sugar, we can add means definitely. No problem!

When suddenly restricting the coffee it will create some problems, there is no need to restrict it immediately gradual withdrawal of the coffee is advisable. One more author said that when we are using vegetable remedies we can avoid coffee and we are going for a minerals or nosodes then you leave coffee….. I advice coffee restricted, only with certain conditions not in all cases.’

Dr.G.Suresh … now regarding this various ways of preparing coffee I would like to add few points coffee preparation is more or less similar throughout the world at least the last few decades that the seeds are roasted, then percolated after that only drying and instant coffee comes.

I just give you small statistics the crude coffee in 250 ml contains 75-135 mg of caffeine, Tea on the other hand contains 30 mg of caffeine, cocoa contains 30 mg of caffeine, cola also contains reasonable amounts of caffeine now we are thinking that caffeine as a antidotal agent or so many other unnamed ingredients in coffee which may also contribute in both therapeutic action and antidotal action, even in coffee they may have got three preparations, the “Coffea cruda” from the fresh berry then the roasted coffee “Coffea tosta”, then the “Caffeinum” also has a alkaloid is there in the Materia Medica you find there is a minor variation in the symptoms but the caffeine symptoms are seem to be prominent and the way in which we prepare coffee incidentally has around 95 mg of caffeine in later of the decoction and the basic thing is how light !or how strong! we take the basic cultural difference between the west and east, especially in south India we add lot of milk to coffee and reduce the quantity of actual decoction in coffee that make our caffeine intake probably not as much!

Dr. K.S.Anandhi	Dr.s.Bhuvaneswari

Dr.Ananthi: What Hahnemann mentioned in effects of coffee was, he talks fully about the primary effects and secondary effects of coffee fully on his Lesser writings,Hahnemann studied secondary effects of coffee that is why he wanted to avoid coffee during the homoeopathic treatment! Because, as we all know the substance which going to stimulate the nervous system is going to depress in secondary effect! so he doesn’t want the patient to get more sake by taking coffee because he has already be suffering from some disease condition and his vital force is week that condition if they take coffee that also a very strong fake as Dr.Pavalan had said, from Hahnemannian day the coffee was black coffee without sugar and without milk but nowadays! What we use is all full of adulteration the coffee excise the vital force and the patient is stimulated too much, already the vital force is weak! This stimulates and the patient may not in a condition to recover fast with our Homoeopathic medicines. So he told the secondary action it depresses the nervous system it weakened and finally it exhausts the nervous system. So Hahnemann has advised to stop coffee.

When coming to George Vithalkous who has been in our time says Coffee disrupts a case, because it affects the sense of wellbeing. Some patients say “I feel better when I take coffee” then in such patient coffee is going to do some harm in him when you are going to give the Homoeopathic medicines because it is also having an effect on that person.

Many authors are of opinion that because all of us of afraid that we may lose the patient or patient may not come to us because they do not take Homoeopathic medicines if we say don’t take coffee. So many authors from their experience says when certain drugs are given it is better to avoid coffee. Now Farokh J.Master had told in his book he talks about decaffeinated coffee that can be allowed to the patient because the caffeine content in the coffee will made more harm but he also advises regular coffee drink must be avoided! As we all know various researchers is going on in various part of the world year to year results are being changed! One year they say coffee prevents heart diseases, another year says coffee causes heart diseases! So, we can’t go by the results of it moreover nowadays in our own practice what we see is mainly more of the female patient who are mostly coffee drinkers or tea drinkers, whatever it may be! All present with iron deficiency anaemia.This iron deficiency anaemia is difficult to correct even with our homoeopathic medicines and I should attribute where this coffee drinking continued for a long time it causes deficiency, anaemia so that has been thought whether stopping the coffee, in our previous day/olden day culture no one take coffee or tea all those take only “Ragi” they didn’t have any anaemia problem. Nowadays civilization grown we all say instant coffee! But still health has not been improved! coffee or beverages whatever we take now so that has been given importance in our treatment, Then one more point I want to say is the secondary effects of coffee we have to give importance because as it impairs the nervous system and moreover in our Organon. Our medicine when it taken on the tongue it dissolves and spreads to the sentient nerves and is going to affect and when you are taking coffee it going to weakened the nervous system and the continuous use of it either once in a week is ok but better to avoid, I don’t say, should not take because it depends on our own opinion and so that was a weakened nervous system how would our medicine will act in a better way and our patient will not get fast improvement, while taking coffee need more repetition of doses –its from my experience and the improvement we found also very slow in that persons. Because we already see in children marvelous improvement than in old patients sometimes because children are not addicted to coffee or tea that could be we can just make a note of it. Then I would like to conclude my speech Hahnemann has says that in his organon of medicine in 4th aphorism. Physician must be a preserver of health so that saying whether coffee antidotes or not as a physician we have to be clear which is good for the patients health has been advised which the patient may or may not follow is not the thing, but which is good is we have to advise it is our duty. So as for my opinion so as a preserver of health we have to take the part of it and we have to educate the patient which is good for and which is not good!

Dr. Thamaraiselvan

Dr.G.Suresh: So coffee as a habit itself, she says, is not necessary for life! It causes more harm than the apparent pleasure we derive from coffee drinking! This is a totally philosophical approach whichr we respect. So it has to be kept in mind. But coming to the closer point of clinical effects of coffee on patient taking Homoeopathic medicine incidentally! Even decaffeinated coffee has slightly is only 10% caffeine than decaffeinated, decaf is not totally decaff!. Cocoa has as much effect of caffeine in it is almost like tea. Children take more of cocoa than adults, in spite of that our Homoeopathic medicines work.!
In diet restrictions given by Hahnemann in acute disease he says give whatever he likes only. For chronic diseases he advised this yes & no and gradual restrictions whether it tea or coffee any other if you see anybody writing from Hahnemann to Boenninghausen you will find that whatever is accepted socially in their culture is generally allowed and what is alien to their culture is restricted. If you go to northern part of India most of the homoeopathic doctors advised not to take tamarind in their food. Here when you say that nobody will come to you. I think we are underestimating the power of Homoeopathic medicines if works far better than we think, It cannot be just subdued by the effects of just anything medicinal we take day to day in our life. This is one thought I am putting open for all of us.

Dr.Bhuvaneshwari: As this question raised when Hahnemann has been treated he has written the treaties on the effects of coffee ,in 1808,but actually stating this effects of coffee it depends whether is negative or positive is depends upon the amount of caffeine. This caffeine is in alkaline this has been discovered by German chemist Fredrick in 1819 before these only Hahnemann has written the effects of coffee and that is why still we are discussing about that before going through whether the coffee antidotes are not, what I feel is what does caffeine actually does and what is the effects of coffee in the normal healthy subject and what are the positive effects and negative effects on human beings.

Previous days, as it is said by the moderator it depend upon the type of preparation method of Coffee and that is depending upon the method of preparation used and those days has been taken in a raw form but it has been found that this large roast coffee which we are using now is less caffeine than what has been previously used. So it generally depends upon the methods of preparation. By discussing about the coffee it is practically very difficult most of them especially (Brahmins) they are hardly need of coffee in such cases it is very difficult to manage them, when we say that don’t take coffee, as the previous speakers said they will withdraw the treatment first so it is very difficult practically to ask them to withdraw coffee, these coffee depends upon how much quantity you take the long continued, overuse or abuse of coffee is going to create a problem so when we use a mild dose less decoction you can ask your patient to continue coffee. What I feel in my practice is I allow my patient if they say that not able to survive without coffee, most of the patient says I want to take coffee, if I not taking coffee I feel that all the symptoms are aggravate so it depend up on the quantity we are using so we can avoid i.e., if you are able to avoid or discontinue. If is not possible take in small doses not in a chronic user. In America they recommended that this US food and drug administration, caffeine as a multiple purpose generally recognized as safe food substance and most of the 90% of Americans dependant on coffee it also has been said that global conception of caffeine has been estimated as 12 lakhs times per year so it is very difficult to asking our patient to completely stop coffee, it is very difficult in practically speaking and before that I want to say here is to know the metabolics of the caffeine some of the speakers said they can allow the patient to take medicine one hour before and after so for that this metabolism of caffeine take place in the liver and it has been said that this offline elimination of the caffeine in a normal health is approximately 4 hrs ,so elimination is 4.9 hrs ,so around 4 hrs and it has been said that it takes more time in ladies under oral contraceptives and in the pregnant women and in the children and it is said in liver disease it increasing the off life up to 96 hrs so what they say the result is,esp in liver disease advice the patient to restrict the coffee, In liver diseases and those patient using contraceptives ,in pregnancy, in children. This off life elimination of the caffeine from this is it takes very long duration especially in the liver disease advice your patient to restrict coffee it definitely going to inhibit the action of medicine. As sir said me as a repertorian,I am in hardly saying the rubrics in Murphy’s repertory it is given for Coffee aggravation in Murphy in the chapter that is cant, caus, cham, Ign, nux vom, these drugs are given. The universal antidote Nux vom can be used in these type of the cases apart from this, It is very interesting to know that this coffee also had some positive effects i.e., it reduces the risk of Alzhemirs disease also drinking coffee reduces the risk of Parkinson’s disease and reducing the risk of constituent diseases because it is a laxative and diuretic so that regular not in over dose consumption of coffee in some extend that found in the research it reduces the risk of gall stones, It should not be mistaken that I am recommending the patient to drink coffee but it also had some positive effects we should also aware of that it also said that it improves the short term memory because it’s an antioxidant, increases the oxygen carrying capacity so it can used as a short term these are the positive effects also present so practically speaking as the previous speaker said I also use in some of the cases is found that aggravation is only due to medicines I recommended coffee but not in all cases. By speaking this coffee antidotes homoeopathic medicines when practically speaking when it is large doses i.e., in chronic users it has been found that it antidotes but others in small doses taking a cup of tea or coffee per day it is allowed to some extend because we cannot say all the patient to completely stop this habits practically in all the cases it is very difficult esp. in case of liver disease as per the reason we think of the coffee to reduce some extend.

Dr. S.Jawahar

Dr.G.Suresh: Incidentally coffea is complementary to aconite according to our drug relationships, Now that all the panelists have given their opinion I would like members from the audience to give their own views, experiences, or any points adding or opposing any of the views. You are most welcome to open up and say few points before we come to a conclusion about the whole discussion. But I must say the path has been opened for every one of us to think more before we blindly say I do not believe in stopping coffee or I am a staunch homoeopath and I will not allow any of the patient to take coffee. Life is not in Black and white there are lots of shades of grey in-between. These grey areas have to be brightened, come on, brighten these grey areas please.

Dr.Jawahar: If our drug is correct similimum definitely coffee will not antidote anything.

Dr. Sengamalam

Dr.Jothimani: Medicines are in the higher dilutions, potency and in almost correcting the LM potency almost we are taking double the care or triple the care to select the similimum we are going to give in a daily manner or once or twice a day so it will not antidote by any other substance not only coffee. In Hahnemanian time coffee was considered as a universal beverage but nowadays almost all the spicy food, fast food, pastry items we have to restrict means have restrict our day today daily food substances. It is highly impossible to restrict the coffee but we can advice them to reduce and most of the coffee addicts usually …have to ask them because they are used to the deaddiction only so we have to give or we can take that symptom as, to make the similimum because they are unable to reduce the coffee that we can do.In my practice I not advice the patient to stop the coffee. Thank you.

Dr.Senkamalam: ... given decaffeinated coffee the triglyceride level rises so it is up to the physician and type of the patient either coffee can be administered or decaffeinated or totally can be avoided, but this is under research.

Dr. Jothimani

Dr.Jothimani: If antidoted by coffee or not during that when Hahnemann documented or postrated that coffee miasm, the coffee theory he believed that coffee was the one of the miasm he prostrated like that only before discovering the psora theory that time what he thought means coffee suppresses all the things then after that then around 1817 he postated the psora theory after just before the chronic diseases,so that time psora is considered as the itch miasm which brings what are all the suppressed things so what he believed means psora opposite to coffee,so he himself confirst in his lesser writings coffee overemparises it suppress all the thing or it produces all the thing now am confessing psora is the almost 7/8th of all the chronic disease, now what he believed means psora is doing the favourable effect Psoric diathesis which will bring out all the suppressed itch miasm or whatever discharges or excretions he believed that coffee suppress all the effect so what he mentioned means psorinum is antidoted by,Psoric miasm,psoric patient who needed psorinum is antidoted by coffee that is the thing in some instances some people in their experience also said Psorinum is not antidoted by coffee.In this situation only he told,it is opposite he believed like that before discovering the Psoric miasm and afterthat he himself doubleminded and he himself confirst that “I can over emphasizes in Psoric miasm and we can justice because what we are thinging like cure directions of cure all the suppressed thing would come out this coffee is doing the suppressing effect so that in Psoric miasm or in Psoric patients or in psorinum patient we can avoid the coffee otherwise not.

Dr.G. Suresh

Dr.G.Suresh: Coffee and Homoeopathy! We have to see from many perspectives,
1. The effect of coffee on the person 2.Effect of coffee on the disease 3.Effect of coffee on the prescription. These are the various angles which we have see, this title indicates we primarily talk about the action of coffee on the prescribed drug on that patient but we cannot stick to that alone so when you give coffee or ask a patient to stop coffee and he or she stops coffee and takes your medicine first the set of symptoms especially. the patient who is habituated and abruptly obeys you and stop the coffee instantly..some of the symptoms he may showing the withdrawal symptoms of the coffee which may be attributed as medicine symptoms. Coffee which is not native of India, tea is not native of India, Cocoa is not native to India,but good for the heart that cannot used as a licence to ask every body to drink it, Cocoa is supposed to be a great antidepressant and it is one of the best antidepressant the taste of cocoa makes relax therefore it acts as antidepressant…….dark chocolates without sugar is suppose to be again good for heart it will helps to improves the HDL level and all that. Likewise there are so many aspects to coffee. We have to look at all the aspect and take a holistic view of the coffee drinking habit in a particular patient and see whether he needs to avoid coffee for the sake of his general condition he may be obese, drinking 3or 4 cups of coffee and that he will add sugar, milk, etc. Each glass of coffee contains nearly 100 calories so his daily cups of coffee are equal to two breakfasts. Practical confusions are abundant. So we can’t come to a concrete conclusion whether coffee has to be avoided or used. One thing we can safely say is since it is not a essential item for life there is no harm in restricting it, If the patients health condition clearly can be attributed to over use of coffee or any other stimulants for that matter it must be restricted. Just for the sake of prescribing Homoeopathy if you are sure that your drug is going to act esp. you are following the latest method of potentization you need not really restrict coffee. Just for that ensuring our medicines act….but prolonged usage of coffee causes osteoporosis, prolonged usage inhibits the absorption of iron from food nutritional deficiency anaemia. So, in a disease from which no manifest exciting or maintaining cause has to be removed then alone the totality of symptoms comes into play. As a maintaining factor coffee is there in your patient get rid of it. This generalized viewpoint holds good for coffee and any of the umpteen stimulants he or she may be using. I think this has been a fair enough conclusion If there are still any more points to be added, you are most welcome!