Tea, Coffee, And Tobacco
( Originally Published 1921 )
WHEN one approaches the subject of tobacco without prejudice and considers it in the light of experience, it appears that there is a marked difference in the way different people react to this drug. Were the use of tobacco a matter of indifference, instead of a source of great pleasure and its withdrawal often a source of great suffering, it would be easy to advise all heart patients to stop tobacco ; but the question must be decided according to each individual's reaction. If tobacco causes irregularity of the heart, and increases symptoms, then, of course, it must be given up.
It is better to smoke mild cigars than cigarets, and no person with heart trouble should smoke more than three a day. Many heart patients give up tobacco voluntarily because they find that it increases their discomfort; this is particularly true of patients with weak hearts.
When a person without heart disease uses tobacco to the point of poisoning, the heart becomes rapid, irregular, and irritable, so that anything that calls for exertion, or causes excitement, makes the heart beat quickly. It is fair to suppose that the -symptoms attributed in a particular case to tobacco are due to its use if the symptoms cease when the tobacco is no longer used.
In a number of heart patients the moderate use of tobacco is harmless. Among those who are injured, a considerable number discover it themselves, and stop using tobacco. Only occasionally do patients suffer for a long time from a "tobacco-heart" without knowing it. In these days, when women are beginning to smoke so much, heart symptoms from tobacco are no longer confined to men.
The nurse should use her influence with patients to persuade them to give up tobacco entirely, or if not, to be moderate in its use.
If a patient shows restlessness when confined in bed by a heart attack for the first time, the nurse should always think of the deprivation of tobacco as a possible cause. A person, even tho ill, can not always' give up a life-long habit without a strong reaction. I have seen patients suffer severe torture from nervousness who were promptly relieved when they were allowed to have a small amount of tobacco ; under such circumstances it is only common sense to give it, to them.
Much that has been said about tobacco is also true of tea and Coffee, Too much human happiness and comfort depend upon their use to put them aside thoughtlessly because of their acknowledged harm to certain people. Like tobacco, they are to be classed as drugs, with an effect which differs to a great extent according to individual temperaments and tendencies. Tea and coffee are direct heart stimulants, and should never be taken habitually in excess by heart patients. Tea and coffee in moderation, however, are often not only allowable but distinctly advantageous.
There is this to be said about all such things while the patient is under a course of treatment designed to start the heart and circulation right, tea, coffee, and tobacco should, if possible, be given up so as to leave the field clear for treatment. The nurse should keep a close supervision over the use of tea and coffee in patients with heart disease, and it should be re-membered that it is always possible that there may be individual peculiarities that make even a small quantity of tea or coffee harmful to some. It is within the nurse's province to experiment in a harmless way by observing the effeet on her patient of going without tea and coffee for a few days, and then allowing its use again. Patients will often submit to what they are told is a temporary experiment who would be horrified with the idea of foregoing tea and coffee entirely. Sometimes, under this experiment, the patient will feel so much better that he will not desire to resume its use again.
The effect of tea and coffee upon sleep is often noticeable, even in those who in no sense at all have the tea or coffee habit. I have, on several occasions, been at a health resort where, as a matter of routine and without the knowledge of the people concerned, coffee was served to every one from which the strength had been removed. Many people going to this place complain of intense sleepiness, and for a few days can hardly get enough sleep. Very few of the visitors realize how much this condition is due to the withdrawal of habitual stimulation.
A few well known methods of preparing tea and coffee for invalids follow.
Tea Scald out the teapot and put in the tea, using one teaspoonful for each cup. Pour on boiling water and let the tea remain for four or five minutes. If allowed to stand too long, the tannin in the tea is developed, and this not only darkens the tea but also renders it harmful.
Coffee Stir together two tablespoonfuls of freshly ground coffee, four of cold water and half an egg. Pour upon them one pint of boiling water and let them boil for five minutes. Stir down the grounds and let the coffee stand where it will keep hot, but not boil, for five minutes longer. In serving, sugar and cream should be put in the cup first and coffee poured upon them.
Coffee (French) Some people prefer filtered to boiled Coffee, Filtered coffee is best made in a French biggin, consisting of two tin vessels, one fitting into the other, the upper one being supplied with strainers. The coffee, finely ground, is placed in this utensil, and the boiling water allowed to percolate slowly through it. The pot should be set where it will keep hot, but not boil, till the' water has gone through. Pouring the coffee through a second time will make it stronger, but it loses in delicacy of flavor. Café noir is always made in this way.
Nutritious Coffee Dissolve a little gelatine (Knox) in water; pour one-half ounce of freshly ground coffee into a saucepan with one pint of new milk, which should be nearly boiling before the coffee is added; boil together for three minutes; clear by pouring some of it into a cup and dashing it back again; add the gelatine and leave the coffee on the back of the range for a few minutes to settle. Beat up one egg in a breakfast cup and upon it pour the coffee; if preferred drink without the egg.
Crust Coffee Take one pint of crusts those of Indian meal are the best brown well in a quick oven but do not let them burn; pour over them three pints of boiling water and let them steep for ten minutes. Serve with cream.
Rice Coffee Parch and grind like coffee a half cupful of rice. Pour over it one quart of boiling water, and let it stand where it will keep hot for a quarter of an hour; then strain and add milk and sugar. This is excellent for children.