As a cardiac stimulant, caffein may be used in any form of heart failure; the indications for its use are those which call for the employment of digitalis. It is superior to digitalis in never disagreeing with the stomach, in having no distinctive cumulative tendency, and in the promptness of its action. It is pronouncedly inferior to digitalis in the power and certainty of its action, and in the permanence of its influence once asserted. As a diuretic it is superior; it is very valuable in the treatment of _cardiac dropsies_, and is often useful in _chronic Bright's disease_ when there is no irritation of the kidneys. On account of its tendency to produce wakefulness, it is usually better to mass the doses early in the day, at least six hours being left between the last dose and the ordinary time for sleep. From eight to fifteen grams (of caffein) may be given in the course of a day in severe cases. If tried, it would probably prove a useful drug in cases of _sudden collapse_ from various causes. Good effects of coffee are recounted by Thompson.[237] It removes the sensation of fatigue in the muscles, and increases their functional activity; it allays hunger to a limited extent; it strengthens the heart action; it acts as a diuretic, and increases the excretion of urea; it has a mildly sudorific influence; it counteracts nervous exhaustion and stimulates nerve centers. It is used sometimes as a nervine in cases of migraine, and there are many persons who can sustain prolonged mental fatigue and strain from anxiety and worry much better by the use of strong black coffee. In low delirium, or when the nervous system is overcome by the use of narcotics or by excessive hemorrhage, strong black coffee is serviceable to keep the patient from falling into the drowsiness which soon merges into coma. In such cases as much as half a pint of strong black coffee may be injected into the rectum. Strong coffee with a little lemon juice or brandy is often useful in overcoming a malarial chill or a paroxysm of asthma. It is a useful temporary cardiac stimulant for children suffering collapse. Dr. Restrepo,[238] of Medellin, Colombia, claims to have cured many cases of chronic malaria and related diseases with infusion of green coffee, after quinine had failed. Wallace[239] states that tincture of green coffee is a natural and efficacious specific for cholera, and that she knows of more than a thousand eases of cholera and diarrhea which have been treated with it without an isolated case of failure. Landanabileo has been quoted as using raw coffee infusion in hepatic and nephritic diseases, venal and hepatic colics, and in diabetes.