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Drink Up! Alcohol as Medicine Through History
The use of alcohol through history is entrenched in the messy complications of human life—social norms, culture, rituals, religion, economics, medical beliefs, fun times, and probably much more. The therapeutic use of alcohol appears to be as old as alcohol itself and is, unsurprisingly, common to many cultures throughout time and across the world. In the following slides, we peek into a few societies to see what they were drinking and for what medical reasons, as we build toward our 21st-century understanding of the pros and cons of alcohol as they relate to health and well-being.
Rice Wines and Herbal Remedies in Ancient China
Clay vessels found in northern China, which date from 7000-6000 BCE, appear to be the oldest surviving proof of the existence of alcohol. They contained a mixture of rice wine, flavored with honey and grapes.[2,3]
Yao jiu, or purely medicinal alcohol (as opposed to fermented alcohol [huang jiu] and distilled alcohol [bai jiu]), had specific uses to the ancient Chinese on the basis of a patient's sex and age, as well as the situation and affliction.[2,3]
Alcohol-based herbal remedies are a part of all major Chinese works on herbal prescriptions and medicine and were, on a general level, thought to promote blood "warming" and "vitalizing."[4] Chinese medical literature also refers to circumstances necessitating that quantities of alcohol be imbibed and discusses side effects of its use and abuse.[4]
Beer and Wine in Pharaonic Egypt
Dating to approximately 3400 BCE, the oldest known brewery is thought to have been in Nekhen (also known as Hierakonpolis) in Egypt. Brewing was a sophisticated art in Pharaonic Egypt and beer, a "necessity of life," was popular. Osiris, the god of life and of the dead, was also the god of wine, which was considered a potion of renewal that was mostly imported for the wealthier classes. Both beer and wine were integral to ritualistic life, tied to health and religion. The consumption of alcohol was widespread and generally moderate for "pleasure, nutrition, medicine, religious ritual, remuneration, and funereal purposes."[2,3]
Wine and Sophistication in Classical Greece
Considered a therapeutic agent for the body and the mind, for men and women,[7] wine was widely prescribed by physicians in classical Greece[6] for such ailments as "wind," bad breath, cancer, and wounds, and to "loosen bowels."[2] Hippocrates considered wine an appropriate medicine for many conditions except those involving "an overpowering heaviness of brain."[2] Wine played an active role in pathology and treatment (for internal and external use),[7] with Greek physicians exercising their judgment regarding its appropriate uses.[6]
Hippocrates and Galen both catalogued their knowledge of wine in medicine, writing about the positive and negative effects of alcoholic consumption. Their therapies were sensitive to the wine's color, provenance, taste or consistency, smell, and age, and were targeted to the patient's age, sex, and lifestyle as well as the illness.[6] Galen believed that alcoholic therapies weren't appropriate for children, but were effective in the elderly.[6]
Wine Remedies and Binging in the Roman Empire
The use of wine as medicine in the Roman Empire was influenced by Greek and Etruscan traditions.[8] The Romans adopted a mixture of wine and frankincense or myrrh to numb the senses before surgery, a practice thought to derive from Talmudic medicine.[9] The consumption of wine for a number of purposes—notably for sustenance and pleasure—increased in the second century BCE and, with the expansion of the empire, was spread far and wide.[10] For perhaps the first time in history, binge drinking became a popular pastime.
Water of Immortality in the Middle Ages
Throughout Europe in the Middle Ages, brewing was an important occupation for monasteries and religious orders.[3] Beer was an essential source of sustenance[11]: Between 1000 and 1500 AD, the average adult in England is thought to have consumed roughly 1 gallon of it per day.[3] Physicians and monks continued to believe in the medicinal properties of alcohol, including—with enthusiasm—those of new distilled concoctions, such as aqua vitae, a "divine medicament."[2]
In eighth-century Poland and ninth-century Russia, vodka, made from fruit, herbs, spices, wormwood, acorn, birch, chicory, sorrel, dill, horseradish, mint, lemon, was attributed medicinal properties.[11]
The physician Arnaldus de Villanova considered aqua vitae a "cure for all ailments,"[3] which provided warmth against fevers and "cold diseases" and prophylaxis against the ever-present plague. He conceived as distillation as "the essence of life."[12] In Liber de vinis, he described the medicinal properties of alcohol that were "suited to every age, every time, and every region." Alcohol helped comfort the heart; heal "sores on the head"; promote digestion and appetite; and protect against yellow jaundice, dropsy, pain in the breast, and gout. He used it to treat diseases of the bladder and the "bites of mad dogs," to promote courage, and to increase memory.[2,3]
Pulque, Mead, and Maize-Based Alcohols in Mesoamerica
The consumption of alcohol for social, ritual, medicinal, and religious purposes appears to be widely spread through history and societies. In Mesoamerica, evidence suggests that Mayans brewed mead and maize-based alcohol as long ago as 1000 BCE.[1] Alcohol was also derived from cacti, fruits, and bark,[2] as reflected in surviving artifacts and described in a number of the codices written by Spanish conquistadors. Medicinal use of alcohol is thought to have been widespread in the pre-Columbian Americas, varying with position in society and individual cultures.[2]
Imprisoned in the Tower of London in 1603, Sir Walter Raleigh sought to concoct a "great cordial"—an alcoholic mix with over 40 plants and herbs that he had brought back from the Americas, an "elixir of life" that apparently met with the approval of the Queen of Denmark.[12]
A Question of Dosage
Well into the Renaissance and Enlightenment periods, there was a continued belief in the restorative and medicinal properties of beer and wine despite improved anatomical understanding. Alcohol was prescribed in London hospitals until the 18th century, but ultimately, with an increase in medical knowledge, there was a growing disbelief in the role of alcohol to promote health and an awareness of the burden of alcoholism.[2]
Although more sophisticated physicians began to question the role of alcohol-based "folk" remedies, David Hume was apparently treated with drink therapies for his nervous breakdown (a "disease of the learned"), and alcoholic tonics were still prescribed to children for a range of illnesses.[2]
Tea, imported from Asia, gained traction as a new panacea, perhaps superseding alcohol as the new "miracle" cure-all.[2]
The Gin Craze
Among the seeds of change introduced to England from Holland by King William of Orange was a popular new alcoholic drink: distilled juniper water ("geneva" or "gin"), thought to be an ideal tonic for the treatment of stomach complaints, gout, and gallstones, and for the kidneys, liver, and heart.[12] According to the Irish physician Dr Robert Bentley Todd, medical professor at King's College, London, it assisted natural healing processes.[11]
Cheap and widely available, gin caused widespread addiction, provoking a public health crisis comparable to today's heroin epidemic.[12] A series of political initiatives—the 1726 petition by the Royal College of Physicians, the 1736 Gin Act, stringent taxation, and policing policies—eventually helped to calm the "Gin Craze."[11,12]
Absinthe, the Green Fairy
An apothecary favorite for millennia, with therapeutic properties known since ancient Egypt, wormwood was thought to be the main medicinal ingredient in absinthe—a bright green, anise-flavored alcoholic concoction rumored to have been created in France in 1792 by Swiss physician Dr Pierre Ordinaire.
Absinthe, or the "green fairy," is a 120-proof alcohol that became all the rage in 19th-century Parisian artistic society, and was celebrated by Charles Baudelaire, Paul Verlaine, and Arthur Rimbaud. Purported medicinal effects of the irradiant quaff included alleviating indigestion, intestinal worms, rheumatism, "scabs on virgins," and the pains of childbirth. Yet absinthe was banned across Europe in the early 1900s for inducing "absinthism," a nasty syndrome of tremors, convulsions, and hallucinations.[2]
Science now tells us the artistic class was mostly likely simply suffering from alcoholism and alcohol withdrawal. Absinthe, including turn-of-the-century samples, does not appear to contain any hallucinogens or psychoactive substances aside from ethanol.[17]
Mint Julep, Cocktails, and Tonics in the United States
The mint julep, a combination of mint and whiskey (and perhaps the ancestor of the modern cocktail), was created in the southern United States in the 18th century. It was prescribed by some as treatment for "all sorts of conditions and ailments of the (southern) climate."[12] As a tonic or cure-all, mint julep was part of a wave of pseudomedicinal drinks known as "cordials," "patent medicines," and "stomach elixirs," frequently used to "treat women's constitutions." Other popular tonics of the time—less cocktail than medicine and frequently marketed as alcohol-free—included Parker's Tonic (42% alcohol), Dr Hoofland's German Bitters (26% alcohol), Dr Kaufmann's Sulphur Bitters (26% alcohol), Whiskol (28% alcohol), Colden's Liquid Beef Tonic (27% alcohol), and Lydia E. Pinkham's Vegetable Compound for "female complaints."[12]
Temperance Movements
During the Civil War, in the absence of medications, brandy, punch, and eggnog were often used to treat shock, disease, fainting, and snake bites.[12] This may have helped to spread the use and misuse of alcohol, and perhaps played a part in the development of the temperance movement.[12] Officially founded in 1808 in the United States, 1817 in England, 1818 in Sweden, the 1820s in Ireland, and 1836 in New Zealand,[3] most temperance movements were at first hostile to the consumption of strong spirits—in favor of weaker alcohols, such as beer and wine—before turning against alcohols of all sorts. With an increase in medical knowledge at the end of the 19th century, alcohol became less popular for medical uses; its use as "treatment" was increasingly associated with ineffective (unscientific) "folk medicines."
Prohibition and the Winds of Change
The use of alcohol for therapeutic purposes divided the medical profession in the early years of the 20th century. In the absence of other options, it was in some cases used as therapy during Spanish influenza epidemic and as a treatment for pneumonia.[12] Nevertheless, increasing awareness of the side effects of its abuse fueled the call for a total ban, leading to prohibition in several countries, including Russia (1916-1917), Norway (1919-1927), Finland (1919-1932), and the United States (1920-1933).[3]
In the United States, therapeutic alcohol reached new heights during the tumultuous prohibition years. US doctors were permitted 100 prescriptions for "medicinal whisky" per 3-month period, which amounted to 1.8 million gallons in 1927.[11]
Modern Attitudes
With a wealth of medical research in the 20th century reporting the negative effects of alcohol, it's hardly surprising that its therapeutic use slowed to a virtual halt. But what to make of the growing evidence of the possible heart-protective properties from moderate wine drinking? And what about the social well-being from sharing a glass or two? The (medical) debate continues.
References
1. Unschuld PU, Tessenow H. Huang Di nei jing su wen. An Annotated Translation of Huang Di's Inner Classic—Basic Questions. Berkeley and Los Angeles: University of California Press; 2011. http://www.rgm.hu/download/Huang_Di_Nei_Jing.pdf Accessed February 3, 2017.
2. Gately I. Drink: A Cultural History of Alcohol. New York: Gotham Books; 2008.
3. Hanson DJ. Historical evolution of alcohol consumption in society. In: Boyle E, Boffetta P, Lowenfels A, et al, eds. Alcohol: Science Policy, and Public Health. Oxford: Oxford University Press; 2013.
4. Fruehauf H. Alcohol use in traditional Chinese formulas. ClassicalChineseMedicine.org. https://classicalchinesemedicine.org/gp ... -formulas/ Accessed February 4, 2017.
5. Nunn JF. Ancient Egyptian Medicine. Norman: University of Oklahoma Press; 1996.
6. Jouanna J. Greek Medicine from Hippocrates to Galen. Allies N, trans. Leiden and Boston: Brill; 2012.
7. Villard L. [Wine and women: an overlooked passage in the Hippocratic Corpus]. Rev Etud Grec. 1997;110:362-380. https://www.ncbi.nlm.nih.gov/pubmed/17228502 Accessed February 5, 2017.
8. Etruscan and Roman medicine. University of Virginia Historical Collections at the Claude Moore Health Sciences Library. 2007. http://exhibits.hsl.virginia.edu/antiqua/etruscan/ Accessed February 4, 2017.
9. Faria MA. Another medical journey to ancient Rome and Roman medicine with medical historian Plinio Prioreschi, MD, PhD. Surg Neurol Int. 2015;6:104. http://surgicalneurologyint.com/surgica ... hi-md-phd/ Accessed February 7, 2017.
10. Institute of Alcohol Studies. Chapter 2: a brief history of alcohol in Europe. In: Report: Alcohol in Europe. 2006. http://btg.ias.org.uk/pdfs/alcohol-in-e ... ap2_en.pdf Accessed February 10, 2017.
11. Brownlee N. This Is Alcohol. London: Sanctuary; 2002.
12. Barr A. Drink: A Social History of America. New York: Carroll and Graf; 1999.
13. Berdan FF, Anawalt PR. The Essential Codex Mendoza, Vols 2, 4. Berkeley: University of California Press; 1997. http://www.ucpress.edu/op.php?isbn=9780520204546 Accessed February 9, 2017.
14. Sandler M, Pinder R, eds. Wine: A Scientific Exploration. New York: Taylor and Francis; 2003.
15. Saturday 10 October 1663. The Diary of Samuel Pepys. http://www.pepysdiary.com/diary/1663/10/10/ Accessed February 11, 2017.
16. L'Antiquaire Distillateur. Story of the absinthe by l'Absintherie Bourbonnaise. musedefrance.com. http://www.musedefrance.com/histoireuk.html Accessed February 11, 2017.
17. Lachenmeier DW, Nathan-Maister D, Breaux TA, Sohnius EM, Schoeberl K, Kuballa T. Chemical composition of vintage preban absinthe with special reference to thujone, fenchone, pinocamphone, methanol, copper and antimony concentrations. J Agric Food Chem. 2008;56:3073-3081.
18. Rush B. An Inquiry Into the Effects of Ardent Spirits Upon the Human Body and Mind. 1819. archive.org. https://archive.org/stream/2569031R.nlm ... ch/medical Accessed February 11, 2017.
Source: Medscape