Absinthium: a nineteenth-century drug of abuse
Some twenty-five years earlier, the use of absinthe was largely confined to persons of the lowest class. By the time the liqueur was outlawed, in 1915, literary figures, professors, artists, actors, musicians, financiers, speculators, and shopkeepers were included among those who yielded to the liqueur's seductive influence. Absinthe was popularly believed to impart renewed activity to the brain, develop new worlds of ideas, expand consciousness, and thereby inspire noble works of imagination in literature and art. At the same time, grave questions were raised concerning the physiological effects observed in absinthe users.
On the surface, the liqueur was an innocuous combination of an alcoholic solution of oil of wormwood (Artemisia absinthium) and alcoholic extracts of angelica, anise, and marjoram (Wood, 1889). Absinthe was prepared by steeping the absinthium and other aromatic herbs in alcohol, distilling the spirit, and adding flavoring (Dick, 1880). An inferior substitute could be made by combining the oil of wormwood, alcoholic extracts of various herbs, and coloring in alcohol without distillation. The preferred distillate was approximately 136° proof and was seldom consumed neat. Instead, it was usually diluted with five parts of water. The latter was often dripped over a lump of sugar held in a perforated spoon above the serving glass into the liqueur.
Particular care was taken in the manufacture of the liqueur to obtain the proper shade of green in the color of the product and to ensure that the liqueur whitened well when mixed with water. Investigations published in the American Journal of Pharmacy (1868) and The Lancet (1873) revealed that if manufacturers of the liqueur found their product to be aesthetically lacking, they did not hesitate to add indigo, tumeric, hyssop, nettles, or copper sulfate to achieve the precise tint of green. Antimony chloride was sometimes added to assure the necessary white precipitate demanded by consumers, the toxic potential notwithstanding.
The liqueur is said to have been "invented" in Couvet, Switzerland, by one Dr. Ordinaire, a Frenchman, who sold the formula for its preparation to M. Pemod in 1797 (Lichine, 1967). French soldiers returning from the military campaign of 1844-1847 in Algeria brought back with them a taste for wine infused with wormwood, a combination used medicinally for diarrhea. Wine of absinthium was described in the second century (Dioscorides, 1959). "Purl," a twig of wormwood (or mugwort) infused in ale, was widely consumed on both sides of the Atlantic (Paris, 1831). Absinthe schnapps was distilled over anise and wormwood.
Wormwood had been employed in medicine from early antiquity. Many of the traditional uses of the drug were summarized by an American eclectic physician, Wooster Beach, in 1847. "Wormwood is possessed of very valuable stimulant and tonic properties. When given in moderate doses, it promotes the appetite and digestion, quickens the circulation, and imparts to the whole system a strengthening influence. It is given in all cases requiring the administration of tonics, in dyspepsia, and other atonic states of the intestinal canal, in certain cases of amenorrhea, chronic leucorrhea and obstinate diarrhea.... It is often administered in intermittent fevers with complete success...." (Beach, 1847).
The pernicious blue-green oil
It was alleged that ale in which wormwood was infused was more intoxicating than other ales. One authority insisted that "there is in every bitter, when largely employed, a power of destroying the sensibility and irritability of the nervous power" (Barton, 1812). By 1839, some clinicians were ascribing a "narcotic" property to wormwood by virtue of the drug's action in occasioning headache and producing disorders of the nervous system. These properties were thought to depend upon the volatile oil and were therefore less obvious in the decoction than in the powder or infusion (Wood and Bache, 1858).
Attention became increasingly focused upon oil of wormwood and the physiological effects resulting from its ingestion. Experimental work reported in the Proceedings, American Pharmaceutical Association (1864) suggested that poisonous, but not fatal, effects arose from doses of three to eight grams of the oil. The symptoms produced within this dosage range were trembling, stupor, epileptic convulsions, and stertorous breathing. These indications closely approximated absinthism.
In Paris, Magnan observed that absinthe given to animals in small doses induces brisk muscular contractions, while large amounts provoke attacks in which the animal falls in tonic and clonic convulsions, with stertorous respiration, and involuntary faecal and urinary excretion. The convulsions are not prevented by depriving the animal of its cerebral lobes. "Absinthe gives rise to a kind of intoxication to which is added the phenomenon of epilepsy" (Biddle,1895).
An investigation by Magnan is described in The Lancet (1869). A guinea pig was placed under a glass case with a saucer of oil of wormwood by its side. Another guinea pig was similarly imprisoned in a glass case with a saucer containing pure alcohol. A cat and a rabbit were respectively encased along with saucers full of oil of wormwood. The three animals that inhaled the vapors of the wormwood experienced, first, excitement and then epileptiform convulsions. The guinea pig that merely breathed the fumes of the alcohol became lively, then simply drunk. Upon this observation it was sought to establish the conclusion that the effects of absinthe are seriously different from those of alcohol.
Others were not convinced that absinthe exerted any special effect beyond that of alcohol. After all, the oil of wormwood represented only a small proportion of the liqueur. On the other hand, it was noted that some of the absinthe in commerce contained a large proportion of antimony as an adulterant, a poison which could significantly add to the irritant effects produced by the liqueur. With the presence of the antimony, absinthe represented a dangerous hazard.
Absinthism: a point of no return?
The physiological effects of the ingestion of absinthe appeared to differ markedly from the effects of alcohol. The effects of absinthe were graphically described in the American Journal of Pharmacy (1868). After drinking absinthe, "...you seem to lose your feet, and you mount a boundless realm without horizon. You probably imagine that you are going in the direction of the infinite, whereas you are simply drifting into the incoherent. Absinthe affects the brain unlike any other stimulant; it produces neither the heavy drunkenness of beer, the furious inebriation of brandy, nor the exhilarant intoxication of wine. It is an ignoble poison, destroying life not until it has more or less brutalized its votaries, and made driveling idiots of them." Continued, even moderate, use of the liqueur very often resulted in a condition described as absinthism.
Heavy users were usually noisy and aggressive during the periods of intoxication. These periods lasted much longer than drunkenness produced by spirits or wine. Intoxication was followed by persistent and deep depression with a sensation of fatigue. Gradually, the digestion became deranged, and anorexia developed along with an intense thirst. The user began to experience a constant feeling of uneasiness, painful anxiety, sensations of giddiness, and tinglings in the ears. Hallucinations of sight and hearing were experienced, and aberrant behavior was often exhibited by the user.
Frequently, the user exhibited a peculiar affection of the muscles, beginning with fitful contractions of the muscles of the face and extremities. These contractions were often accompanied by tinglings, numbness, and a distinct loss of physical energy. Alopecia sometimes developed. With continued use, the body gradually became emaciated, and the body assumed a yellowish tinge. Eventually, the brain was affected. Sleep became increasingly difficult, disturbed by dreams, nightmares, and sudden wakings. Giddiness and headaches gave way to painful hallucinations and delirium. The victim exhibited a marked impediment in speech. Finally, there followed a complete loss of intellect, general paralysis, and death.
Thujone: behind the blue-green mask
Distillation of oil of wormwood (oleum absinthii) was apparently known, but information is lacking in most of the distillation literature of the 16th century. It was described by Hieronymus Brunschwig in 1500 and by Portae about 1570 (Gildemeister and Hoffman, 1961). In the 18th century, investigation of the oil was undertaken by Geoffroy, (1721), Kunzemuller, (1784), Buchholz, (1785), and Margueron, (1798).
Identification of the constituents of the plant drug was begun by Braconnot, (1815), Cavantou, (1828), and others early in the 19th century (Wehmer, 1911). The first chemical investigation of the oil was undertaken by Leblancinl845. The principal fraction of the rectified oil was determined to be an isomer of camphor, C10 H16 O. This work was confirmed by the later investigations of Cahours, (1847), Schwanert, (1863), and Gladstone, (1864). Beilstein and Kupffer, (1873), called this isomer "absynthol" (Gildemeister and Hoffmann, 1900).
In 1892, Semmler showed that absynthol was, in fact, thujone. The latter was shown to be identical with the tanacetone of tansy and the salvanol of sage (Gildemeister and Hoffman, 1963). Thujone was identified by one authority as "the cause of epilepsy in chronic absinthe drinkers" (Cushny, 1906). Today, the thujones are generally classified as convulsant poisons.
More recently, it has been observed that there are certain similarities between the psychological effects attributed to absinthe use and experiences reported by users of marijuana (Castillo et al, 1975). It has been observed that acute intoxication by the ingestion or inhalation of the smoke of marijuana is sometimes accompanied by hallucinations (both visual and auditory), ataxia, tremor, and hyperreflexia, increasing confusion, restlessness, disorientation, and delirium. The patient may exhibit elaborate paranoid delusions and severe emotional depression which may persist days after the acute phase of intoxication. Possible central nervous system depression may also be present (Gosselin et aL% 1976).
Investigators have compared the properties of thujone and tetrahydrocannabinol (THC), believed to be the active principles of absinthium and marijuana (Cannabis sativa), respectively. Both substances are terpenoids (Castillo et al, 1975). Thujone and THC have similar molecular geometry and similar functional groups available for metabolism. It has been proposed that they both exert their effects by interacting with a common receptor in the central nervous system (Castillo et al,, 1975).
The early pharmacotherapeutic uses of the oil of wormwood were comparatively limited. Hoffman had recommended it as a mild anodyne in spasmodic contractions, and Boerhaave commended it in tertian fevers (Nourse, 1765). In the 19th century, the oil, in medicinal dosage, continued to find limited use as a stimulant tonic, but its wide use was viewed with increasing apprehension (Stille and Maisch, 1887; Potter, 1899; Sollman, 1901). As early as 1872, it was reported in The Lancet that the principal effect elicited by the administration of concentrated fractions of absinthium was, in fact, epileptiform attacks.
Prohibition of the liqueur
As early as 1862, the use of the liqueur had reached such alarming proportions in France, especially in the army, that the Council General of the Department of War represented to the government the necessity of curtailing the consumption of absinthe by means of a large increase in the excise duty on this commodity. It was reported in the American Journal of Pharmacy (1868) that Swiss exports of absinthe to France after mid-century were in the magnitude of two million gallons annually. To this amount must be added indigenous production.
The consumption was very real and alarming.
In 1872, a decade later, the French National Assembly, acting upon a wave of popular concern, passed legislation designed to control the manufacture and sale of the essential oil. Under the new law, French pharmacists, alone, had the right to sell the oil and concentrated wormwood preparations only upon prescription (American Journal of Pharmacy, 1872). In 1907, the Swiss banned the manufacture and sale of absinthe. In the United States, the National Pure Food Board ruled that on and after October 1,1912, the importation of absinthe into this country was illegal, since such imports would come from countries where its manufacture and sale was restricted or forbidden and because the product was injurious to health. The liqueur was officially banned in France in 1915.
In the 19th century, oil of wormwood, combined in a highly alcoholic liqueur, was widely consumed in France and elsewhere. The ingestion of this liqueur elicited a peculiar form of intoxication. Chronic use resulted in a recognizable syndrome â absinthism â with often tragic sequelae. The widespread use of this popularly accepted liqueur presented an unusual problem of world-wide significance.
An explanation of the unusual toxicity of this liqueur and additional insight into the social phenomena may possibly follow more recent investigations which compare the effects of thujone with those of THC.