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IN CONTEXT
ALCOHOL: FRIEND OR FOE?
A HISTORICAL PERSPECTIVE
Alcohol is the oldest and still probably the drinker. Remnants of this belief persist to modern times. We still refer to alcohol and alcoholic many consider it as an ally. Moderate amounts “The mouth of a perfectly happy man is filled stimulate the mind and relax the muscles, but with beer”, is an ancient Egyptian proverb. Indeed, larger amounts impair coordination and judgment, numerous ancient Egyptian inscriptions and finally producing coma and death. It is an addictive documents show that beer, together with bread, drug leading to alcoholism. Alcohol is known since was a daily food. Beer was an important offering antiquity to have some therapeutic value. Opium to the gods, and was placed in tombs for the and alcohol had long been used as analgesics.
afterlife. An inscription in the tomb of Ramses II Greek medicine had employed wine and vinegar (c. 1200 B.C.) reads: “And thou shall give me to in wound care (1). Now we know that alcohol is a eat until I am satisfied, and thou shalt give to me good antiseptic. Alcohol has other values in modern medicine such as pain relief, delay labor, The ancient Greeks called beer “zythos”, which raising HDL level, etc. Dr. Sigwart describes a new was derived from the Egyptian word “zythum”. The therapeutic benefit of alcohol in this issue of Heart Romans brewed and drank “cerevisia”, named Views. He injected alcohol in a septal artery of the after Ceres, the goddess of agriculture. The heart to induce a small basal septal infarction as Romans had a god Dionysus, or Bacchus, the god of wine, who they worshipped in bouts of alcoholic hypertrophic obstructive cardiomyopathy. Pure frenzy. The hangover plagued mankind. It was a alcohol is needed for such injection in vivo. Pure top medical priority in the days of ancient Egypt.
ethanol is a colorless, flammable liquid (boiling Cabbage juice was the Pharaoh’s remedy. For point 78.5º C). Ethanol, produced by fermentation many hundreds of years we have looked upon this as in wine or beer or by synthesis, is a dilute “old wives” tale with amusement. However, recent solution and must be concentrated by distillation scientific studies have shown that cabbage juice for making other alcoholic beverages or pure can chelate some of alcohol’s byproducts after the This article will review the origins of alcohol and Ancient cultures brewed beer for religious ceremonies as well as for their own enjoyment.
Drinking beer was the principal means by which Alcohol in antiquity (2)
worshippers achieved religious ecstasy. Beeroccupied a major role in ancient literary repertoire.
Since antiquity, alcohol-containing beverages For example, the Finnish poetic saga, Kalewala, played a vital part in the daily lives of ancient has 400 verses devoted to beer but only 200 were people. Beer, from fermented barley, is the earliest needed for the creation of the earth. According to known alcoholic drink to man. Beer was an integral the Edda, the great Nordic epic, wine was reserved part of their religious ceremonies and mythology.
for the gods, beer belonged to mortals, and mead Early civilizations found the mood-altering [an alcoholic drink of fermented honey and water] properties of beer supernatural, and the newfound to inhabitants of the realm of the dead.
state of intoxication was considered divine. Beer, Although beer and brewing was known in many it was thought, must contain a spirit or god, since ancient cultures, the oldest proven records of drinking the liquid so possessed the spirit of the brewing are about 5,500 years old and can betraced to Mesopotamia [ancient Iraq]. A vastrepository of cuneiform writings from the area *Director, Non-invasive Cardiac Laboratory, Cardiology and Cardiovascular Surgery Department, Hamad MedicalCorporation, P.O. Box 3050, Doha, Qatar. Mesopotamians are credited with the first beer.
The earliest account of barley is found on an HEART VIEWS VOL. 1 NO. 9 SEPTEMBER - NOVEMBER 2000: 341-344 ancient Sumerian engraving describing beer have been the driving force for our hunter-gatherer making. Beer made people feel “exhilarated, ancestors to settle and cultivate grains (2).
The Royal Cemetery of Ur, one of the most Alcohol and the Arabs
spectacular discoveries in ancient Mesopotamia,contains mid-3rd millennium BC tombs of kings and “The oldest alcoholic drinks were fermented queens of the city of Ur. One of the tombs belonged beverages of relatively low alcohol content, that to Queen Pu-abi who was buried with her servants.
Among the hundreds of gold and silver items found introduced the then recent science of distilling into to accompany her to the afterlife was a five-liter Europe in the Middle Ages, the alchemists believed silver jar, her daily allotment of barley beer.
that alcohol was the long-sought elixir of life.
Alcohol was therefore held to be a remedy for collection of laws, established a daily beer ration.
practically all diseases, as indicated by the term This ration was dependent on the social standing whisky (Gaelic: ‘water of life’)”(3).
of the individual. For example, a normal worker The concept of an elixir or life-giving potion received 2 liters, civil servants 3 liters, and originated from the writings of Jabir ibn Hayyan administrators and high priests 5 liters per day. In (8th century AD) and al-Rahzi (9th century AD) and those ancient times beer was not sold, but exchanged for barley. As beer brewing was a respectively (4). They were the most important h o u s e h o l d a r t , i t w a s a l s o w o m e n ’ s w o r k .
scientists in the history of chemistry and chemical Hammurabi once ordered a female saloon-keeper technology in Islam. Their works exerted a drowned for serving low quality beer.
dominating influence on later generations of highlighted in Gilgamesh, the great Mesopotamian Epic and written in the 3 rd millenium B.C. It is the discoveries in the Middle Ages were alcohol and oldest literary epic in the world. Enkidu, the bestial mineral acids, and the key to finding them was primitive man, “drank seven cups of beer and his through the process of distillation, which the Arabs spirit loosened and his heart soared. In this developed and mastered. Distillation was one of condition he washed himself and became a human the most important processes in Islamic chemical being.” Thus, Enkidu, the wild-man, evolved from technology and was employed for both medicinal primitive man to “cultured man” after tasting beer.
preparations and a variety of other technologicaland industrial uses, including the preparation of The archaeology of beer
acids and the distillation of perfumes, rosewaterand essential oils (4).
Archaelogists have identified the first chemical evidence of beer. An organic residue from inside described the distillation of wine using specialized a pottery vessel dated circa to 3500 to 3100 B.C.
distillation equipment. Al-Rahzi, in his book Kitab found in western Iran, tested positive for oxalate al-Asrar (The Book of Secrets) described the ion. Calcium oxalate is a major component of process of distillation and the apparatus used. He “beerstone” and settles out on the surfaces of used distillation to concentrate alcohol, which was fermentation and storage tanks of barley beer (2).
then taken as an anesthetic. Al-Kindi (9th century In an attempt to trace the spread of agriculture AD), describes distillation and the apparatus in his and hence civilization, archaeologists and book, Kitab Kimya’ al-‘itr wa al-Tas-idat (Book of anthropologists have unearthed and dated pottery.
Perfume Chemistry and Distillation). Al-Kindi says: The earliest dates they find forms a spreading “In the same way, one can distill wine using a pattern from the Middle East outward suggesting water-bath, and it comes out the same color as an expansion from that point from 10,000 BC to rosewater.” In Spain, the Arab surgeon Aub al- 5,000 BC. Some theorized that the pottery was a Qasim al-Zahrawi, (d.1013 AD), known to the West means of transmitting grains for transport. But what as Albucasis, described the distillation of vinegar has intrigued them is that many of the pottery in an apparatus similar to that used for rosewater, shards appear to have beer residue and were thus adding that wine could be distilled in the same used for containing beer, not food. This implies, way. He described using alcohol as a solvent for they say provocatively, that the desire for beer may drugs. The flammable property of alcohol was HEART VIEWS VOL. 1 NO. 9 SEPTEMBER - NOVEMBER 2000: 341-344 Is the word alcohol derived from Arabic al-kohl? Most Arab laymen would think so. In Arabic al means “the”, and Kohl or kohol means “black powder or paint for eyelids”. For thousands ofyears the most widely used eyelid paint by Arab women for cosmetic purpose is called ethmid which is a fine black powder pulverized from black mountain stones. Some men, due to ancient beliefthat kohl protects vision, also use it.
Some medical history books state that the word alcohol is derived from Arabic kohl. Likewise, Webster’s English dictionary tracing the derivation of the word alcohol states: “from ML (middleLatin) is finely pulverized antimony used by women to darken the eyelids, derived from OS (oldSpanish), which was derived from Arabic al-kuhul or al-kuhl.” But the famous Webster dictionary iswrong. How could such highly irritant and corrosive substance have anything to do with materialthat is applied to the eye? Alcohol will burn the eye.
There is no doubt that the word alcohol was derived from Arabic but from another word: al-kol (al-ghol.). The old Arabic dictionaries state that: Al- Kol (Al-ghol): 1. A genie or spirit that takesvaried forms and shapes (a supernatural creature in Arab mythology). 2. Any drug or substance thattakes away the mind or covers it. Obviously, the last statement fits well with alcohol – it does takeaway the mind.
noted by Jabir (Geber): “And fire which burns on brandy, shortened from the German term for “burnt the mouths of bottles [due to] . . . boiled wine and wine.” Brandy was used as medicine by itself for salt, and similar things with nice characteristics various diseases and later became popular as a which are thought to be of little use, these are of recreational drink as well. In the 16th century, the great significance in these sciences.” The Swiss physician Paracelsus popularized the use flammable property of alcohol was utilized for of distilled alcohol as a solvent to prepare tinctures various applications in Arabic military and chemical treatises of the 12th and 13th centuries. Many Arabicmanuscripts describing the chemical recipe for History of alcohol abuse
alcohol eventually found their way into 12th and13th century European works and attributed to The harmful effects of alcohol have been known since ancient times. The first known description Clearly, the Arabs were the first to distill alcohol of death from alcoholism appears on an ancient Egyptian tomb inscription circa 2800 BC: “His From the Arab world, knowledge of distillation earthly abode (body) was torn and broken by beer. spread to Europe and European alchemists began His spirit escaped before it was called by God” experimenting with the distillation of many items, (2). Intoxication was known and understood in but medicines were still mostly given as infusions or decoctions of single herbs. Arabic writings in discouraged. In the papyrus Sallier, a father tells Spain began to influence Christian schools of his son: “Whoever smells beer is repulsive to all; medicine in Italy and France. The 13th century the smell of beer holds people at a distance, it Spanish alchemists, Arnold Villanueva and hardens your soul . . . you think it proper to run Raymond Lully, introduced wine spirits, which they down a wall and to break through the board gate; called aqua vitae (water of life) as a solvent into the people run away from you . . . If you then talk, European medicine. This later became known as so from your mouth comes nonsense” (2).
HEART VIEWS VOL. 1 NO. 9 SEPTEMBER - NOVEMBER 2000: 341-344 Greek literature is full of warnings against mortality. Binges may result in arrhythmias.
intemperance – they were well acquainted with Alcoholics have elevated levels of plasma the health and social implications of excessive homocysteine, which has been linked to premature drinking. Overindulgence was frowned upon in the Jewish religion and although beer was part ofJewish rituals, it was under strict social control Beneficial effects of alcohol
because of its ceremonial importance (2). Islamforbids drinking alcohol.
There is no doubt that when used appropriately, From the eighth through the tenth centuries alcohol has many medicinal uses, as mentioned A.D., Vikings spread terror throughout the civilized earlier. Beer was used as anesthetic since ancient world. In a state of ale-induced “berserk” they times and was a common component in ancient raped, burned and pillaged their way through North prescriptions in Mesopotamian, Egyptian, and Africa, Holland, England, Ireland, Wales, France, Greek medicine (6). Since many recorded ancient Germany, and Italy (2). Historians say that the prescriptions contain many ingredients, it is often excessive thirst for strong liquors often urged the difficult to determine which is the active barbarians to invade wine-producing lands.
component. Many powerful drugs must have been Interestingly, it has been suggested that the slave administered unintentionally, for the wisdom revolt against the Romans led by the gladiator Spartacus, a beer-drinking barbarian, might have accumulated weight of empiric experience through been due to bad beer (2). Clearly, it seems that the millennia. One of the fascinating finds of drunkenness, in a less civilized state of mankind, medical archaeology is the detection of the was sometimes capable of inciting man to battle, antibiotic tetracycline on a thin section of bone from Roman Egypt (6). It is thought that tetracycline From antiquity to the present, alcohol abuse has was formed in the brewing process as a result of remained a major problem. Alcohol is the most contamination with an airborne streptomycete, and frequently abused drug throughout the world.
then ingested with the beer (6). Beer, therefore, Alcohol related injuries are a major cause of might have been an unintentional vehicle for the morbidity and mortality. Acute alcohol intoxication, delivery of powerful antibiotics in those early times.
which is common in both social drinkers and Since beer was a fundamental food staple, a alcoholics, profoundly impairs cognitive function constant intake of this antibiotic might have and motor skills, often while paradoxically influenced the pattern of bacterial infection. It is enhancing the drinker’s sense of mastery. Other possible that the well-known great bacterial types of fatal accidents including fires, falls, and resistance to tetracycline today maybe due to drowning are caused by drunkenness. In addition, bacterial exposure to it since antiquity.
alcohol is implicated in most homicides, many suicides, and domestic violence (5).
Harmful effects of alcohol
The long-term harmful effects of alcohol abuse Porter R. The greatest benefit to mankind: A medicalhistory of humanity from antiquity to the present. on the body are also great. Fifty percent of chronic London: HarperCollins Publishers, 1997. liver disease is caused by alcohol abuse. Alcohol Nummer BA. The art, science, and history of beer. Food is also associated with many other diseases, Science and Technology 2020, University of Georgia, including pancreatitis, cardiomyopathy, peripheral USA. http//www.arches.uga.edu/~athbrew Goodman and Gilman: The pharmacological Basis of neuropathy, dementia and other central nervous Therapeutics, 4th edition. London: MacMillan Co., 1970. system disorders, and the fetal alcohol syndrome.
Al-Hassan AY, Hill DR. Islamic technology. An illustrated Alcohol abuse is associated with cancers of the history. Paris UNESCO: Cambridge University Press, alimentary and respiratory tracts and possibly with breast cancer. High amounts of alcohol or long- Lieber CS. Medical disorders of alcoholism. N Engl JMed. 1995; 333(16): 1058-1065. term ingestion increase insulin resistance, Nunn JF. Ancient Egyptian medicine. London:British triglyceride levels, blood pressure and all-cause HEART VIEWS VOL. 1 NO. 9 SEPTEMBER - NOVEMBER 2000: 341-344

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