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Absinthism: fictitious 19th century syndrome

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Absinthe – a bitter spirit containing wormwood (Artemisia absinthium L.) (Figure 1) and other herbs – was one of the most popular alcoholic beverages of late 19th century Europe. The emerald green drink was consumed by people from all walks of life, including the bohemian upper class, artists, poets and intellectuals. While the lower classes celebrated l'heure verte (the green hour) in numerous bars and cafés, painters and poets created famous paintings and poems dedicated to the "green fairy." Absinthe was popular in fin-de-siècle Paris and la vie bohème of Prague. The most remarkable celebrity known as an absinthe drinker is the Dutch post-impressionist painter Vincent van Gogh (1853–1890, Figure 2), whose illness is still a matter of debate among neurologists and psychiatrists [ 1 -7]. Other famous painters of the time, such as Henri de Toulouse-Lautrec and Paul Gaugin, and illustrious poets like Oscar Wilde, Charles Baudelaire, and Edgar Allan Poe were all fond of absinthe.


 Image    Image
Wormwood, Artemisia absinthium L., drawing of plant, flowers, seeds and fruits (drawing by W. Müller, 1885 reproduced from Thomé [106])   Vincent van Gogh: Still Life with absinthe (Paris 1887). The picture shows one of the countless cafés in Paris, in which absinthe was served. Next to the glass filled with absinthe, a
water bottle is illustrated, which was necessary for drinking

 Because absinthe consumption reached excessive and alarming proportions at the turn of the 19th century, many European governments, as well as the U.S. administration, successively banned the icon of la vie bohème by several prohibition acts. Absinthe was used as an easy target of the temperance movement with the aim of later prohibiting alcohol in general. But absinthe remained a singularity as the only kind of alcoholic beverage with a long-term ban. In some European countries (e.g. UK, Spain, Czech Republic), however, the "green fairy" survived, but consumption was comparatively low. The European Council enacted in 1988 the directive "on the approximation of the laws of the Member States relating to flavorings for use in foodstuffs and to source materials for their production," that re-allowed wormwood as ingredient of alcoholic beverages. However, maximum limits of the wormwood ingredient thujone (Figure 3), which was speculated to be the most probable cause for absinthism, were issued [8].

Because of this change of policy, absinthe has seen a recent resurgence. In contrast to the social, legal and medical problems of the late 19th century, today the image of the "green fairy" has markedly changed, but still remains titillating. Today's so called "new absinthe" is offered as a newly fashionable, exclusive drink for yuppie parties with claimed properties ranging from spiritual elucidation to aphrodisiac stimulation – with corresponding pricing. In parallel, a fan club within the internet community has emerged. Absinthe can be purchased via the internet from various countries worldwide, making it possible to receive it in countries where it is not legally available. Moreover, numerous recipes for the self-production of absinthe are available on the internet. To date, it is unclear if the re-licensing of absinthe will cause similar or even new and different forensic, medical and social problems as it did in the late 1800's.

Figure 3
Structure of ±- and ²-thujone, the principal components
of wormwood oil (Artemisia absinthium L.). 
α-thujone                       β-thujone


This article provides information on the history of absinthe and a prime constituent, thujone. Medical and toxicological aspects experienced and discovered before the prohibition of absinthe are discussed in detail, along with their impact on the current situation. It is the intention of the authors to provide a comprehensive overview of this topic of multifaceted interest and to discuss this issue objectively.

The rise and fall of wormwood spirits

Documented medical use of wormwood can be dated back to the Ebers Papyrus, an Egyptian medical document dating from about 1552 B.C. and the oldest preserved medical document [9]. This papyrus is believed to be a copy of the even more ancient books of Thoth (3500 B.C.). The name "wormwood" is derived from its anthelmintic properties, which were recognized by the ancient Egyptians.

Wormwood, in the context of its bitter taste, is mentioned several times in the Old Testament (Jeremiah 9:15, 13:15). In the biblical context, the plant represented a curse, calamity (Lamentations 3:15) or injustice (Amos  5:7). In Revelations 8:11, the Greek equivalent ho apsinthos is used as a name for a star that fell into the waters and turned them bitter. The Greek word apsinthion – undrinkable – is most probably the ancestor of the word absinthe. The Greek mathematician and philosopher, Pythagoras of Samos (569-475 B.C.), recommended wine-soaked wormwood leaves to alleviate labor pains; Hippocrates (~460-377 B.C.) used wormwood extracts for the treatment of menstrual pain and rheumatism [10].

Pliny the Elder (23–79), the Roman scholar and scientist, also mentioned extracts of wormwood in his opus Historia Naturalis [11 ]. In the Middle Ages, wormwood was used as a purge and vermifuge, and it developed towards a "general remedy for all diseases" and was "a herb of Mars" for its medical powers [10]. Wormwood's bitter taste inspired women in those days to apply it to their nipples to encourage the weaning of their babies. In fact, Shakespeare has Juliet's nurse expound upon this in Romeo and Juliet.

The image of just a bitter medicine changed to a popular drink among the masses in the 16th century. The so-called Purl of Tudor England was a drink composed of hot ale and wormwood. Dried leaves of wormwood were infused in proof-spirits, distilled, and sweetened with sugar as prescribed in Smith's Complete Body of Distilling in 1731 [12 ]. The French physician Pierre Ordinaire is supposedly the originator of the classic absinthe recipe. Being acquainted with the ancient use of wormwood, he began to develop a recipe for an alcoholic drink, which probably contained wormwood, anise, hyssop, dittany, sweet flag, melissa and varying amounts of coriander, veronica, chamomile, parsley and (allegedly) spinach. Dr. Ordinaire, who had fled the French revolution, settled down in Val-de-Travers in western Switzerland, which has remained an important centre of absinthe production. In the small town of Couvet, the elixir (68%vol) soon attained the nickname fée verte.

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