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Alcoholism in Antiquity: from Repression to Therapy*

The Mediterranean people started to leave


Barbary when they learned how to cultivate
olive-tree and vine.
Thucydides

Today, alcoholism is an international sanitary


priority, considered both by the WHO and
DSM IV as a complete and complex disease1.
But what about the history of such an exces-
sive consummation?

Alcohol production.
First, one may ask if alcohol was more harmful than water during Greco-Roman An-
tiquity? Indeed, the answer depends of the sanitary control of drinking water, life
expectancy at birth, social activities, etc. Maybe was it better, in such period, to die
of an alcoholic cirrhosis at an advanced age rather than of an acute infectious illness
at a young age2? The high frequency of viral, bacterial, fungal, and parasitic diseases
related to stagnant water made its consummation at high-risk of developing acute
and/or chronic infection, potentially mortal and especially for fragile individuals
(neonates, infants, children, pregnant women, elders). Large cisterns conserving
great quantities of cold water, were diffusely constructed in the ground of houses
and important buildings (theatres, basilicas, etc.); frequently contaminated by plants,
animal dejections, worms, they were very uneasy to clean3. The same with water
from wells, also infected by all kinds of rubbishes (cadavers of animals, babies and,
sometimes, when not recuperated by their families, adults), alimentary wastes, ce-
ramics, tissues, wood fragments, as shown by archaeological excavations of such
structures (Athens, Rome, Pompeii, etc.). In order to purify water, vinegar was fre-
quently added to it, associated to a kind of filtration threw pieces of textiles; others
simply avoided water consummation, preferring drinking wine ( mixed with wa-
ter!).
Currently, wine was not taken pure, but mixed with water, on the opposite way of
Barbarians (i.e. non-Greek citizens such as Scythes and Thracian people, who where
considered as drunkard individuals). The fact of drinking pure wine may have
caused acute or progressive madness, as for the Spartan king Cleomene, according
to Herodotus (6, 84), of for the Macedonian king and conqueror Alexander the
Great4. Wine in Antiquity was probably much more alcoholized than today, with an
approximation of 25 to 30, associated with much more tannin. In order to avoid its

*
The authors would like to thank warmly Danielle Gourevitch (EPHE, IVth Section, Paris, France)
and Marie-Hlne Marganne (CEDOPAL, Lige, Belgium), for their precious comments on this
paper.
1
Hasin Hatzenbuehler Keyes Ogburn 2006.
2
Grmek 1991.
3
Corvisier 1985.
4
Liappas Lascaratos Fafouti Christodoulou 2003.
Philippe Charlier Clarisse Prtre

acid transformation, wine was sometimes mixed with honey (hydromel), resin of
pine (leading to modern retsina), spices (leading to medieval hippocras), and even
seawater (turriculae of Roman amateurs)! Most appreciated origins were, in Italy,
the regions of Calabria (Falerna) and Latium (especially Albanum, Fondi, Formies,
and Velletri) and, in Greece, the island of Chios and Thasos. As of today, three
kinds of wine existed: red, white and ros.
Did liquor and distilled alcohol were produced in Greco-Roman Antiquity? Yes,
but not very frequently, distillation being mostly used by perfume makers, or physi-
cists such as Alexander of Aphrodisias (3rd century B.C.) when preparing distilled
drinking water from seawater, following Aristotles Meteorologica (II.3, 358b16).
But distillated wines for gastronomic purposes did not really existed in Antiquity,
only concentration of some of them by evaporation or by double ebullition5.

Physical consequences of alcoholism.


In the absence of any precise and objective pathological sign of acute and/or chronic
alcoholism visible on skeletons discovered in archaeological context, some descrip-
tions and inscriptions may help in the reconstruction of alcohol use and misuse dur-
ing Antiquity. This funeral one is indeed very interesting, because describing a sud-
den death related to acute alcohol consummation: Asclepiades, son of Anaxippos,
from Ephesus. At the age of 22, I drunk cul-sec a great quantity of pure wine, and I
died spitting blood. If the shortness of the medical description does not authorize a
precise diagnosis, various possibilities arise: rupture of oesophagus varicose veins in
a context of cirrhosis (uncertain, due to the young age of the patient)? Acute gastritis
with huge, and fatal haemorrhage (this diagnosis being the most probable)? Haemor-
rhage from another site of origin (lung, trachea, etc.), as the site of origin of the
bleeding is not precisely given?
Side effects of long-term alcohol consummation were well known by physicians
and philosophers from Antiquity. For Plutarch, is it with vine the same as with
drunkard who become bald because the heat of the wine provokes an evaporation of
their brains humidity? Is it because the winy liquor is an effect of the alteration of
wine, as stated by Empedokles?6 Concerning acute alcoholic psychosis, descrip-
tions may be found in Hippocratic treatises, Galens works, and Cassius Felixs
book De medicina. As stated by Leibowitz, while the term frenesis was chiefly ap-
plied to mental disorientation accompanying febrile diseases, it was also used with
regard to acute alcoholism7. On the opposite side, alcoholic withdrawal syndrome
(i.e. delirium tremens), first described in 1813 by modern physicians, was already
identified by the Roman African (and early Christian) medical writer Cassius Felix
on the 5th century A.D., drawing heavily on ancient Greek sources.
The frequently used medical term dropsy (that may be seen non solely in scien-
tific treaties, but also in religious books such as the miracles of the Christ), recovers
many causes of anasarca, including cardiac insufficiency, cirrhosis, nephrotic syn-

5
Forbes 1970, 15 s.; Bguin Villard Jouanna 2002.
6
Plu. Quest. Nat. 919d.
7
Leibowitz 1967, 102.

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Alcoholism in Antiquity

drome, and severe vitamin deficiency that can all be related to (but not only) chronic
alcohol consummation.
Physicians sometimes prescribed complete stop of any alcohol consummation for
their patients, for example P. Aelius Then, according to his votive therapeutic in-
scription (iama) discovered in Pergamon (actual Turkey) dating from the 2nd c. A.D.
Some other chronic alcoholic patients became famous in Antiquity: one of them is
Anacreon, the canonical Greek lyric poet from the 6th to 5th c. B.C., known for his
important consummation of wine, who died at 85. Another one could be the tragedi-
an Aeschylus (6th-5th c. B.C.), who was able to compose only when drunk, the only
way for him to get inspiration (according to Plutarch8) something relatively logi-
cal, according to the traditional consecration of theater to the god of wine, Dionysus.
Prescription against excessive drinking were given both by physicians and phi-
losophers, but also forwarded by poets, such as the elegiac Theognis of Megara
(during the 6th c. B.C.): It is bad to abuse of wine. To be used with measure, wine
makes good, not bad.
If isolated limitation is recommended, collective ones also existed. This fragment
of an archaic inscription (Figure 1) written in boustrophedon script records a decree
against excessive drinking dated between 600 and 450 B.C. from the old city of
Eleftherna (Crete, Greece / conserved in the Archaeological Museum of Rethymnon,
N Inv. E 125):

One has not to get drunk.


may drink the young man who
will participate to collective drinking at
Dion Cape.
But not the priest.
But if he makes a sacrifice toward the god child []
The old habit is the one that

This prescription is individual and collective, avoiding public drinking session


(probably both for sanitary reasons and conservation of civil order). Beyond the
meaning of drinking at will, it should well be understood that there is an idea of
excess contained in this compound; one raises it in particular in the De ebrietate of
Philo of Alexandria (1st c. A.D.) where excessive drinking is regarded as a good sto-
ical mean of entertainment, out of any religious ritual. This decree states in one
hand, prohibition to be drunk alone, and, in the other hand, authorization to get col-
lectively drunk within perhaps a rite of passage or special events, as the term
seems to indicate it by designating an ephebos or young man in Cretan texts
(Law of Gortyne, 6th c. B.C.). Indeed, such symposia were extremely important for
their social role of men integration, as attested by the discovery of innumerable kylix
and vases with related inscriptions: the 6th c. B.C. Berlin oenochoe
(Antikensammlung, N Inv. 31131), and 8th c. B.C. Nestor cup from Pithecussa, for
example9. Lastly, this Dion cape could correspond to a sanctuary of Dionysus, ex-
plaining the alcoholic context of the ceremony. In fact, a direct line relies this in-

8
Plu. Symp. 612c.
9
Lissarague 2001, 242 s.

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Philippe Charlier Clarisse Prtre

scription to modern legal protection for alcoholic subjects and the rest of the com-
munity.
A parallel could be given with the 5th c. B.C. inscription from the Delphi stadium
(N Inv. 3709) avoiding the introduction of wine within the limits of the sanctuary10;
indeed, alcohol is dietetically considered prejudicial for athletes, but sacrifices and
receptions were also , i.e. alcohol free11.

Department of Forensic and Medical Anthropology, Philippe Charlier


(AP-HP, UVSQ) France MD, PhD

Charg de recherche CNRS Clarisse Prtre


ArScAn UMR 7041, Universit Paris Ouest, France

10
Rougemont 1977, 11-5.
11
Sokolowski 1969, 151 s.

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Alcoholism in Antiquity

Figure 1. The inscription E125 from Eleftherna (Crete).

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Philippe Charlier Clarisse Prtre

BIBLIOGRAPHICAL REFERENCES

Bguin Villard Jouanna 2002 = D. Bguin L. Villard J. Jouanna, Vin et sant en Grce an-
cienne, Paris 2002.
Corvisier 1985 = J.N. Corvisier, Sant et socit en Grce ancienne, Paris 1985.
Forbes 1970 = R.J. Forbes, A Short History of the Distillation from the Beginnings up to the Death of
Cellier Blumenthal, Leiden 1970.
Grmek 1991 = M.D. Grmek, Diseases in the Ancient Greek World, Baltimore-London 1991.
Hasin Hatzenbuehler Keyes Ogburn 2006 = D. Hasin M.L. Hatzenbuehler K. Keyes E.
Ogburn, Substance Use Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition (DSM-IV) and International Classification of Diseases, Tenth Edition (ICD-10), Addiction
101, 2006, Suppl. 1, 59-75.
Liappas Lascaratos Fafouti Christodoulou 2003 = J.A. Liappas J. Lascaratos S. Fafouti
G.N. Christodoulou, Alexander the Greats Relationship with Alcohol, Addiction 98, 2003, 561-7.
Leibowitz 1967 = J.O. Leibowitz, Acute Alcoholism in Ancient Greek and Roman Medicine, Brit J
Addiction 62, 1967, 83-6.
Lissarague 2001 = F. Lissarague, Lcriture des vases grecs, in A.M Christin (ed.), Histoire de
lcriture. De lidogramme au multimedia, Paris 2001, 241-3.
Meillier 1980 = C. Meillier, Un cas mdical dans une inscription funraire, ZPE 38, 1980, 98.
Prtre Charlier, 2009 = C. Prtre P. Charlier, Maladies humaines, thrapies divines, Villeneuve
dAscq 2009.
Rougemont 1977 = G. Rougemont, Corpus des inscriptions de Delphes. Tome I (lois sacres et
rglements religieux), Paris 1977.
Sokolowski 1969 = F. Sokolowski, Lois sacres des cites grecques, Paris 1969.

Abstract: This study sought to describe objectively all paradoxes of alcohol consummation during classical An-
tiquity. Based on texts from Greco-Roman physicians and an unpublished inscription from the archaic period
recently discovered in Eleftherna, Crete (Greece), it is possible to know all kinds of alcohol consummation (from
wine to liquors), and its precise administrative and law limitation. Diverse patients from Antiquity are described,
some of them consuming pure undiluted wine periodically, with strong health consequences. Others used wine
mixed with other substances as a pharmaceutical beverage, with positive results. Existing data is available de-
scribing acute and chronic complications of alcohol consummation (or arrest), such as acute gastritis and deliri-
um tremens. Lastly, a juridical interdiction of public collective drinking session seems to have existed almost
from the archaic period (600 to 450 B.C.).

Keywords: Drug consumption, public health, retrospective diagnosis, forensic medicine, history of alcoholism.

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