In our discussion of archaeological and cross-cultural findings, we have already discussed the evidence for the religious, medical, nutri-tional, and social use of alcoholic beverages in early Mesopotamia and Egypt. The possibility of a Paleolithic discovery and use of alcohol is advanced by many writers (Hoffman, 1956; Roueché, 1963; Smith and Helwig, 1940; Westermarck, 1912), but we have noted that the evidence does not confirm the speculation. Neolithic evidence for beer and berry wine about 6400 B.c. tells us that these beverages were known to the early settled agriculturists; we can expect earlier dates as excavations continue. Grape wine did not appear before the fourth or third millennium. An important commerce in alcohol and its ap-paratus apparently followed shortly after evidence for its presence in each region, and social distinctions in alcohol use also appeared very early. By 2500 B.c., evidence also indicates trouble associated with drinking. Crothers (1903), in an early report without adequate cita-tions, describes how the distribution of beer and wine on feast days at temples was terminated because of thieves' exploitation of the drinking masses. He also reports that the regimes of the pharaohs some-times suppressed drinking, especially when it took place in temple "houses of beer and wine" (as at Memphis) where altar offerings were drunk by worshippers who talked politics of a sort leading to plots and intrigues against the regime.'1

By 2000 B.c., one has reason to suspect, according to Crothers, that military disasters occurred because the soldiers were drunk before battle. Regulations prohibiting Egyptian soldiers from drinking were promulgated. Egyptian efforts to suppress drinldng—to which deaths were attributed in early "public-health" concern—included restrictions on public wine sales, fines, and property confiscation. Later, by 1500 according to McKinlay (1959d), heavy drinking was accepted and drunkenness among Egyptian women as well as men was common-place. By the time of Rameses III (1198 B.c.), soldiers received a strong, daily wine ration, and priests, too, were apparently given wine by the state.

During the same centuries wine, of course, received the atten-tion of the Hebrews, who memorialized its early role in shame and sin and in stirring up family troubles when Noah (as described in Gen-esis 9:20-29, written probably about 1700 p.c.) fell drunk and was seen naked by Ham, father of Canaan, for which Canaan was cursed for generations. Nearby in Babylon, Hammurabi (circa 1800-1760 n.c.) in his code detailed restrictions on wine sales, on the company in wine houses (if outlaws were found, they and the wine seller were to be executed), priestesses were forbidden entry to wine shops, and wine prices were controlled (Harper, 1904).

To the west in the Indus Basin, the evidence for alcohol's use is later. By inference the stemmed cups, termed "champagne" or "brandy" pots by excavators, may have been used for drinking. These date about 1700 B.C. (Wheeler, 1966). Only by the sixth century in the Indus Basin is there proof of at least knowledge of drinking—this from Greek objects and later, in the first century, from Greek wine jars. Lucia (1963) cites a mention of wine in the fifth century B.C. in India in which discriminations were made by sex and class as to who might drink; wives could not, mistresses could, and higher castes were forbidden wine, although it was associated with the worship of the gods and with healing—an inconsistency suggesting an inadequacy in the sources available to us.

Northwest of the Indus, in the plains of Central Asia, the first descriptions of alcohol use come from Herodotus describing the Scyth-ians. There, wine was used in manly martial ritual. Once a year, the king gave a banquet and only those who had slain a man in battle could drink the wine; slayers of many men were given two cups of wine to drink. The Scythians also used wine in swearing oaths, for they mixed it with blood and drank the brew. Sacrificial use is also described; human victims had their throats cut, after which a libation of wine was poured over their heads; the mixed blood and wine after flowiug to a bowl below were then put on faggots and a scimitar. He-rodotus also describes the Persians' use of wine. When drinking, they were not allowed to get sick or urinate in the presence of others, but they did discuss the most important matters. Decisions made when drunk were re-examined when they were sober. If the same, action was taken. Likewise, decisions made when sober were re-examined when they were drunk before there was a commitment to action. One of the earliest reports of the use of alcohol in warfare comes from the time of Cyaxares (624-584 B.c.), who, Herodotus tells us, regained Persia from the occupying Scythians by inviting them to a fea,st, making them drunk, and then slaughtering them. These same Persians had, by a later date, apparently come to imbibe too much themselves, for the Roman historian Ammaianus Marcellinus describes a fourth-cen-tury A.D. penal code requiring that heavy drinkers be led by a cord strung through their nose; persistent offenders were tied with a nose cord to a stake in the public square (MacKinlay, 1959b).

As for China, the early tales are legendary and cautionary. Prior to written records, two royal astronomers were said to have been put to death for being drunk and missing an eclipse (Smith and Helwig, 1940Y, and another tale daims that the man who invented rice wine was banished (Moore, in McCarthy, 1959Y. By the time of the Shang (Yin) Dynasty (1766-1123 B.c:Y, drunkenness was not only known but railed against (Waley, 1958Y and wine was used as an everyday beverage. During the later Chou Dynasty (1122-256 B.c.Y, the religious use of wine was emphasized in documents—as, for ex-ample, mixing red wine with blood and bone marrow for sacrifice and ceremonial drinking (Waley; Moore in McCarthy, 1959Y. Waley (1954Y, in his translation of The Book of Songs, presents several eighth- and ninth-century B.C. poems, all mentioning the ceremonial importance of wine, which was offered to ancestors, at harvest time, and at social ceremonies. It is also clear that ceremonial controls were by no means always effective, as these lines show:

When guests are drunk, they howl and bawl . . . cut capers, lilt and lurch. . . . It is always the same when wine is drunk, some are tipsy, some are not . . . (p. 266).

Further Chinese realism during the same period is cited by Rouech6 (1963), quoting, "Men will not do without beer, to prohibit it and secure total abstinence from it is beyond the power even of sages" (p. 170Y. Confucius (551-479) counseled against boisterous drinking, consistent with his general counsel for ethics, order, and ceremony in an age of social and political upheavals. In Japan both the orderly ethic of Confucius and the Buddhist creed, which was introduced later (about 550 Ai:1.Y, led to stringent regulations on drinking. One tenet of the latter is never to take strong drink. Prohibition was declared by a number of emperors from 646 through 777 (Yamamuro in Mc-Carthy, 1959Y. On the other hand, an eighth-century A.D. poet, Ohtomo, praised sake and a merry drunkenness in this world as opposed to reincarnated uncertainty in the next. In China, in the seventh century A.D., one emperer, Tai Tsung, undertook what appears to be the first formal educational effort 'in how to drink by circulating a pamphlet to teach wine-drinking propriety (Moore, 1959Y. In Japan the temperance decrees continued for centuries, apparently in compe-tition with drinking extravaganzas. Sake sales were prohibited again in 1252 after the Mongol invasion, and tea drinking was promulgated as a substitute activity by Eisai, the Zen Buddhist. Later, however, popular Buddhism was more relaxed and total abstinence was no longer required (Yamamuro, 1959Y. In China, by the early fourteenth century, decrees were passed against the manufacture, sale, and consumption of wine, with penalties including confiscation of property, slavery, and death. The purpose of these is said to have been to con-serve grains rather than to counter inebriety; in any event, Chinese prohibition vs. Chinese drinking had a see-saw history, since the prohibition laws were repealed and then passed again on dozens of occa-sions over the years. During the seventeenth and eighteenth centuries, "heroic" drinking was praised in novels but no adverse social effects were implied (Weakland, 1968). Contemporary data on Chinese drinking are absent. Moore (1959) states that moderation is the rule and that any problems with drunkenness are quite rare. In 1967, po-lice statistics from Hongkong supported that contention, since, in a city of over three million, practically no cases of problem drunkenness (drunk and disorderly and so forth) were reported. Such drunkenness as does occur is among family or friends and neither involves public exposure on the street nor constitutes an issue for concern.

Let us return now to the history of drinking in the Near East. The many therapeutic uses of wine are set forth by Lucia (1963b), begin-ning with Mesopotamian culture. During early Greek medicine, wine was much employed, as it was later in Rome. For details about the use,s of wine in modern medicine, the reader is referred to Leake and Silverman (1966).

Herodotus introduces a familiar hedonism plus a warning in his description of the Egyptian custom whereby at rich men's banquets a wooden corpse in a coffin "painted exactly to look like a real corpse" was carried about and shown to each of the company. The bearer said, "Look upon this and drink and be merry: for thou shalt die and such shalt thou be." A little later, writing in Luke (12:19) and in Eccle,siastes (8:15), the Hebrews reaffirmed the Egyptian advice. Co-existent were Hebrew injunctions against drunkenness and, in later writings, recommendations for the medicinal use of wine. Consider Timothy (5 :23) : "Drink no longer water, but use a little wine for thy stomach's sake. . . ." Binkley (in McCarthy, 1959) correctly notes the ambiguity and inconsistency in Hebrew-Christian writings concerning drinking. For example, the New Testament (Gal. 5 :21)' warned, "They which do such things [drunkenness, revelings] shall not inherit the kingdom of God," as well as, ". . . make not provision for the flesh, to fulfill the lusts thereof (Rom. 13:14)." And finally in Romans 14

It is good neither to eat flesh, nor to drink wine, nor any thing whereby thy brother stumbleth, or is offended, or is made weak. . . . Happy is he that condemneth not himself in that thing which he alloweth. And he that doubteth is damned if he eat, because he eateth not of faith; for whatsoever is not of faith is sin.

Here, of course, is expressed that Gospel foundation for abstinence which Comber (1964) points out continues to divide the Western community in its beliefs on the propriety of using any euphoria-producing drugs.

History after Herodotus is full of tales demonstrating how al-cohol was used to manipulate and destroy enemies. Judith charmed the Assyrian Holofernes, who, drinking too much, lost his head to her. During a fourth-century war, Illyrians left poisoned wine for the enemy to drink (Gremek, 1950). During the Gallic Wars, the Romans would wait for the Gauls to drink themselves into a stupor and would then attack—a device the Romans themselves fell victim to during Rome's own civil wars (McKinlay, 1959e). During the First Punic War, a Roman general blamed a defeat upon his soldiers' being drunk; another general, to prevent a similar outcome, banned liquor sales in camp. Conversely, when, during a Byzantine siege, defending soldiers were deserting their posts, one commander is said to have set up wine sellers' booths on the defending ramparts. At a later date, Babur, the Mogul emperor, described the widespread alcoholism in his army and court (and in himself) and how he, fearing defeat in battle because of that drunkenness, prohibited wine in Mogul India (Lamb, 1961). In Mohammed's day the penalty for drinking was forty lashes

Much attention has been paid to drinking in early Greece and Rome because of the wealth of documentation and because our own cultural roots are there. Greek wine use, as recorded by the time of Homer and Hesiod (eighth century B.c.)', involved several distinct functions, including magical-religious invocations and appeasements of the dead, offerings to the gods, hospitality rituals, manly displays, formal banquets and informal feasts, healing and pain relief, and as a food. We have taken a special intere,st in the cultural context of drinking in both ancient and modern Greece (see Chapter Nine). We suggest a long-standing ideal of temperance contrasted with tendencies toward outbursts of passion and for ecstatic (Dionysian) experience— a conception which implies polarity. McKinlay (1953) might agree, at least in denying consistent temperance as a quality of the Homeric Greek warrior. Certainly wine's capabilities for debauching a man and unstringing an enemy were known, for, as McKinlay observes, Odys-seus overcame Cyclops by getting him drunk and then boring out his eye. Several centuries after Homeric times, a recognized antisocial hazard in drinking was reflected in a Mytilene law that doubled the penalties for offenses committed while drunk ( McKinlay, 1949). In Lesbos at the same time, McKinlay describes drinking rampant enough to deserve suppression by Cleomis.

In early Rome, Pliny contended that wine was scarce and costly. Beer never became popular. Wine remained scarce through the fourth century when it was still used in worship, but by the time of the Republic wine was easily available and debauchery was often described ( McKinlay, 1959e). Temperate men were singled out for praise. By the second century, women were allowed to drink; earlier Roman law, albeit legendary, provided the death penalty for drinking or adultery ( McKinlay, 1959f). In early Rome children, men under thirty, and servants were also forbidden wine, although soldiers re-ceived a limited ration. In Sparta and Carthage soldiers were re-stricted in the amount they could consume, although in Sparta Mc-Kinlay (1959a) says drunkenness itself was unknown; generally, Greece was more moderate than Rome (Rolleston, 1927). Indeed, as feasting became fashionable in Rome, it was the practice to eat as well as to drink too much—and to vomit voluntarily so that consump-tion could be continued. Feasting was necessarily limited to either the wealthy or to those—like the soldiery—who were in a position to seize supplies or to be issued them. By the first century B.C., alcoholism as such was recognized in Rome and reached its zenith by 100 A.D. ( Mc-Kinlay, 1959e) when it was apparently common among wealthier folk. The Greek philosophers of the fifth and fourth centuries consid-ered intoxication as debasing (McKinlay, 1959a)—a view still preva-lent in Greece; Plato recommended wine be prohibited to children, slaves, judges, and councilors. It was his view that drinking parties should be regulated, demonstrating that in Athens intemperate drink-ing was common. Critias' description of the disabling effects of such a party is recounted by McKinlay, who notes that, given the Greek practice of watering wine, it took a great amount to produce intoxi-cation.

As earlier indicated, Roman viticulture expanded immensely from the fourth to second centuries and the international wine trade became of great importance. Rome imported from Greece and Spain and in turn exported throughout the Mediterranean. To protect her trade she restricted vine planting in Gaul—a restriction not lifted until 280 A.D. ( McKinlay, 1959d). The prestige of Rome is held to have led its subject peoples to emulate its practices—one reason to expect a considerable expansion in wine drinking throughout the Roman world. A modern parallel is in the adoption of the use of spirits throughout Asian and African urban society in the nineteenth and twentieth cen-turies with the spread of colonialism and of admired industrialism. In 90 A.D., Domitian was worried about the devotion of land to grapes rather than to food products and decreed a decrease in viticulture both in Italy and abroad. The edict was most unpopular and was enforced only in parts of Gaul and Spain. It was repealed by about 280 A.D. on the grounds of its being unenforceable. A modem parallel here is found in the unsuccessful Moroccan endeavor to prevent can-nabis production without providing an adequate economic substitute for farmers. Modern failures in Asia to control opium planting are also analogous. Before the end of the Western Empire, vine culture had spread through Gaul and was the beginning of the fine vineyards, of France and the Rhineland.

The introduction of spirits--that is, the discovery of distilla-tion—is of uncertain date and subject to considerable dispute but was independent in many areas of the world. China, India, and Central Asia sometimes are credited with the discovery of fermentation before the time of Christ, whereas mead from honey appeared in Britain about 500 A.D., brandy from grapes appeared in Italy about 1000 A.D., and whiskey in Scotland appeared not before 1500 A.D. (Encyclopae-dia Britannica, 1965). Poznanski (in McCarthy, 1959) proposes that it was the Arabian physician Rhazes whose distillation led to Euro-pean spirit production in the tenth century. Leake and Silverman (1966) and Roueché (1960), on the other hand, credit the Arabian Jabir Ign Hayyan about 800 A.D. They note that the invisible essence of the wine when distilled was called the "finely divided spirit" or "alcohol" in Arabic. As with many other potent newly discovered psychoactive agents, initial dramatic daims for spirits were broadcast —at least in Europe—hailing the value of various preparations in medicine and in magic. Spirits were held to be an antidote to senility—thus, "aqua vitae" and the same meaning in the Gaelic "usequebaugh" front which "whiskey" derives (Poznanski, 1959). Almost all human ailments were claimed curable with one or another distilled prepara-tion. During medieval times, various prescriptions against hang-overs and alcoholic disability were offered, as were means for producing abstinence, such as drowning an eel in one's wine (Eis, 1961). Me-dieval and pre-Reformation drinking and drunkenness were wide-spread in Europe; monks, the clergy, and the nobility were well chron-icled in their cups.

In eleventh-century Russia, the church accepted moderate drinking, and in Russia under Ivan IV the central government dosed private taverns and opened drinking places as a state monopoly. Op-erators of these had to render increasing profits to the government, which led government and sellers to encourage drinldng. That policy was also said to encourage robbery of patrons by tavern operators. According to Efron (1955), this was the beginning of the long-stand-ing Russian pattern: state monopoly on sales and widespread public drunkenness.

By the sixteenth century, European alcoholism was widespread across social classes (Blanke, 1953Y. Luther, Zwingli, and Calvin pleaded for moderation without success, so it was from the extreme disseqtist movements such as the Baptists that the demand for total abstinence emerged. In England, James I (1603-1625) decreed drastic punishment for drunkenness—also without effect—and Charles I tried quite as ineffectually to suppress it, so that during the Cromwell reign (1649-1660Y England was known as the land of the drunkards (Smith and Helwig, 1940Y.

A Dutch physician in the mid-1600's distilled alcohol in the presence of the juniper berry to produce a diuretic, thus inventing gin. British soldiers, returning from continental wars, brought back the taste for gin, which was soon heavily imported (Encyclopaedia Britannica, 1965Y. Queen Anne gave home distillation a boost by raising import duties and lowering home excise in the early 1700's, so that by 1715 spirits were retailed cheaply and indiscriminately. "Drunk for a penny, dead drunk for two pence, clean straw for noth-ing" read the inn advertisements (George, 1965Y.

It was during this same period, 1700-1800, that England be-gan undergoing massive socioeconomic changes. Overseas discovery, colonization, and expanding international trade thrived, while the process of industrialization was effecting changes at home. The first invention revolutionizing the textile industry was the flying shuttle in 1733, a process which gave England the world's industrial leadership. A decline in the death rate increased the population by 50 per cent in one century. As a consequence of land enclosure and reduced farming, urbanization increased, bringing mercantile-industrial development and, of course, population expansion. Each of these developments con-tributed to the growth of the urban poor, a mass whose misery was not much reduced by employment in jobs with a thirteen-hour work-ing day, low wages, residence in slum tenements, and slavery to the machine. Many others were without work, so that in this century the city saw for the first time chronic mass unemployment.

By the Mutiny Act of 1720, retailers who were distillers were exempted from having to quarter soldiers—a fact that led to massive installation of stills. In 1729, an act was passed to control retail sales by requiring an excise license and paid duty on spirits. In this period the crude death rate was one in twenty, much of it attributed to alco-hol-related disease ( MacGregor, 1948). The act was repealed in 1733 after protests, but in 1736 a new law prohibited retailing of spirits. This in turn led first to bootleg sales, then to rioting—the famous "gin riots" in which the liquor-loving mob's pressure defeated the govern-ment bills (George, 1965). Again, in 1743, an act to control gin shops was passed which also increased the price of gin; licenses were granted only to alehouse license holders, and distillers were forbidden to retail. This act is said to have reduced consumption but in 1747 distillers petitioned Parliament for the right to sell, and this, being allowed, reportedly led again to increased consumption and public drunken-ness. A general protest against debauchery took place in 1751 (see Hogarth's "Gin Lane" drawings and read Fielding's "Reasons for the Late Increase of Robbers" )., and a new act strengthened retail con-trols. This act, enforced, is said to have been a turning point in the social history of London in that it led to considerably reduced public drunkenness. Nevertheless, Britain imported ten million gallons of Dutch gin in 1792. Gin had been the drink of the poor, of workhouse inmates, and beggars, so that as its price went up, consumption by poor people necessarily was reduced. Artisans apparently never became gin tipplers; they limited themselves to beer and reportedly suffered neither from disability nor from abstinence.

AN ETHER INTERLUDE

Later in the history of the British Isles, an experiment in prohibition occurred which led to a remarkable chapter in the epidemiology of psychoactive substances—the history of which is well chroni-cled by Connell (1965). In the early 1800's, ether had been mar-keted as an industrial solvent and as a pharmaceutical. Social use of ether soon followed and expanded, first as its anesthetic use brought its properties to public attention and later as both increased publicity and decreased production costs made it more easily available. English physidans at conventions, American young people at dances, and de-pressed ladies on the continent explored its pleasures but abandoned it because of certain difficulties in its administration and retention and because it had a telltale odor. According to Connell, the daring moved on to newer drugs (morphine at the end of the 1800's), whereas their ether pioneering was adopted by persons lower in the social scale—a common-enough sequence in the history of psychoactive substances. European peasants, faced with high alcohol costs due to taxes, took to ether, although never in large numbers except in Ulster, the scene of Connell's remarkable account where an eighth of the population in one area became "etheromaniacs" in the 1890's.

Connell accounts for the phenomenon in terms of a number of factors. The Irish, already accustomed to hard liquor in large quan-tities:were faced with an initial poverty which became nearly intoler-able as alcohol prices went up under taxation, as temperance cam-paigns fought the use of spirits, and as the constabulary's enforcement of tax laws reduced the widespread home-brew distilling of poteen—an enforcement made easier as malt and grain used in home-brew be-came harder to get due to changes in farming and merchandising. Looking for a substitute, the Irishmen were first taught of ether by re-turnees from Glasgow, who had learned its use there as a preventive and remedy against cholera and who touted it as a folk remedy. This lesson was expanded by fierce temperance campaigners, for their lead-ers undertook to bundle off any reformed drinker to cooperative phy-sicians who in turn sold him ether. That manly fellow soon enjoyed the "hot-all-the-way-down" sensation, the triumphant, trumpeting flatus which followed, and in ten minutes an intoxication achievable re-peatedly during the day without hang-over. Soon, druggists, grocers, hawkers, bakers, and others were selling ether, although tavern-keep-ers were reluctant to do so because its low cost brought little profit.

In response to the "epidemic," a reaction built up against its use. Church and government cried "abuse" and gave instances of ter-rible things that happened to users, although physicians on the scene reported few untoward consequences (except the one which tragically came to those who unwarily lit a pipe while taking ether). Alarmists won out, and restrictive legislation controlled importation of the stuff, which, coming from England, was easily monitored. Clerical denunci-ations aided the reform, but paramount to the Irish change of heart were, as Connell (1965) reports, rising incomes, which lessened the need for ether intoxication since more attractive drugs could be pur-chased. In retrospect, Connell holds that ether was maligned; neither crime nor illness was attributable to it although there were risks from an overdose, fire, and possible suffocation when the vapor escaped from a broken bottle.

We deem Connell's history to be the classical epidemiological case. It shows how a potent psychoactive substance spreads from small to large groups and from informed and wealthy innovators to poorer and less informed folk. One sees how there are initial daims for dra-matic medical virtue--some of which may be substantiated over time —how folk medical application leads to widespread self-dispensing, and how use depends upon publicity and, economically, upon low cost and high availability. Spread of use depends upon a self-diagnosed need—in this case the dear desire among a heavy-drinking popula-tion for an immediate substitute after being deprived of their tradi-tional intoxicant. Further, the substitute must bear a resemblance to the original; with ether, its fiery sensation was akin to the home-brew itself and appealed to the same image of the drinker as a "he-man." Necessary, of course, is the effect, and ether provided a most satisfac-tory intoxication. Its limitations, on the other hand, aided in its aban-donment—nausea, flatus, the strong smell, and the awkward nose-holding administration. Fundamental to its control were these factors : government ability to enforce controls over distribution; an alliance of moral and state authority in its denunciation; the failure of ether to enlist an overt lobby or covert activists in its behalf ; and, in the turn of the wheel, a change in economic conditions, which resulted once again in the production of a better-tasting, more-prestigeful, and tra-ditional brew, whiskey. Thus, the population did not need to suffer abstinence and deprivation and could return to prized old ways.

ALCOHOL IN AMERICA

In Colonial America there was, according to Bay (1968), widespread acceptance of beer, wine, and cider as well as rum. The Puritans, contrary to some notions, were not anti-alcohol (Beard and Beard, 1947Y but did punish drunkenness. However, the first stirrings of condemnation were in the early colonial days when Increase and Cotton Mather both inveighed against "demon rum." While the colo-nies were importing rum but making cider, Franciscan priests in Cali-fornia in the mid-1700's were planting vineyards to establish a pattern of wine production and drinking which continues in that state to the present. By 1774, physicians were writing about the harmful effects of spirits (Keller, 1966Y, and the first political-sodal problem over liquor in the United States was the Whiskey Insurrection in Western Penn-sylvania in 1794, which took place when the federal government tried to enforce the excise law of 1791. Revenue officers were tarred and feathered, and a militia was sent to subdue the folk in this first test of the power of the Congress and the central government to enforce law within the states. Earlier, a different "social problem" had been evident, but one which did not evoke great sympathy from the colonial Americans; it was the plight of the Northeastern Indian tribes who, upon exposure to the white man's ways, suffered social and physical disintegration, some part of which was attributable to alcohol (Horton in McCarthy, 1959Y. By the early 1800's, the debate over the effect of alcohol—on Americans—was great enough to agitate Congress as it copsidered the whiskey ration of the military—a ration abolished for the Army in 1830 and for the Navy in 1862 (Keller, 1944Y. It was during this period that the Reverend Beecher described alcohol use as a disease, the American Temperance Society was formed in 1827 (Binkley in McCarthy, 1959; McPeek, 1945Y, and the first pro-hibition law came into effect in Maine in 1851. By 1855, thirteen states had such laws, but by 1863 eight had repealed them and four others had modified them (McCarthy and Douglass in McCarthy, 1959). In the 1880's, a second wave of prohibitory laws was passed and again, by 1904, most states had repealed the enactments. In the 1890's, Carrie Nation, after an unhappy marriage to an alcoholic, took to the "hatchetation" of saloons (and to lecturing at carnivals and burlesque shows Y. A third prohibition wave hit the United States and, under the pressure of Protestant churches, by 1919 the Eighteenth Amendment and the Volstead Act were passed. In that same year lobbies against prohibition were formed and by 1933, after an epoch of speak-easies and organized crime, the Twenty-first Amendment repealing the Eighteenth was passed (the only Constitutional Amendment ever to be repealed). In an appropriate historical juxtaposition, Alco-holics Anonymous was founded in 1934.

Over the years American drinking patterns have changed. As Leake and Silverman (1966) and Bay (in Sanford, 1968) observe, drinking in Colonial America was nearly universal and not a problem. It was not until the Westward movement that a concern over excessive drinking grew and drinking as a "social problem" came to be defined. These were the result of a combination of events, including at least (1 the social disorganization and lawlessness of the frontier, (2) industrialization, urbanization, and heavy immigration from abroad to the new cities, (3 ) possibly growing individual behavioral excesses in the East with the increasing availability of rum, and (4) the produc-tion of corn "likker" for rural drinkers and Western frontiersmen who required a strong, cheap, and portable liquor. The campaign against drinking was based on moral grounds and began with temperance but came to call for total prohibition. As far as the drinker was concerned, it vilified him and called for criminal penalties, although the notion of reform implied individual regeneration. The prohibition banner was buttressed by concern for public health, by the growing industrial ethic of individual efficiency, and by the exercise of political muscle on the part of middle-class mid-America—the small-town, Anglo. Saxon mentality directed against the foreign immigrant, the Eastern elites, and the Western frontier rowdy.

Observers claim that after the 1850's American drinking be-came extremist People were either abstinent or were heavy consumers of spirits.2 By the end of World War II, moderate drinking had in-creased and the consumption of milder beer and wine surpassed that of spirits. Cisin and Cahalan's 1966 national survey shows that 68 per cent of all adults consumed some alcoholic beverages. Heavy drinkers are not necessarily alcoholic, but those who become heavy drinkers from among deprived minority groups, the big-city poor, religious older males, and especially persons who drink to escape and are unhappy and badly adjusted do suffer a high risk of having alcohol-related prob-lems. Heavy drinkers who, on the other hand, are among the elite—better-off, well-adjusted young males—are better able to drink without disability (Knupfer, Rink, Clark, and Goffman, 1963).

A number of writers, including Leake and Silverman (1966) , Plaut (1967), and Blum and Blum (1967), reviewing the literature agree that the differences among groups generating high numbers of problem drinkers as opposed to those generating proportionately low numbers are strong indications for cultural, social, psychological, and physiological determinants of risk. Groups with a low risk of generating alcoholism are those in which drinking is learned at an early age in a context of complex social and ceremonial activity supervised by re-spected authorities who themselves drink safely. In such groups drink-ing is of milder beverages accompanied by food and is not an emotional release linked to escapist, rebellious, self-proving, personal tension-re-ducing, or solely hedonistic functions. As well, safe and acceptable be-havior' with alcohol is explicitly communicated by a cohesive group norm. Risk is not linked to per-capita alcohol consumption, to the occurrence of approved intoxication (as in ceremonials) , or to the ex-istence of blanket prohibitions in the law. It does seem likely to be re-duced by educational endeavors, by socioeconomic reforms which re-duce misery, deprivation, and anxiety, by child-rearing procedures which foster mental health, by nutritional and hygienic regimens foster-ing good physical health, and by social controls which limit drinking settings and the variety of behavior allowed under the influence of alcohol.

SUMMARY

The available evidence suggests that alcoholic beverages were the first psychoactive substances to be discovered by man and, upon discovery, rapidly diffused so that they remain, with tobacco, a para-mount drug. Dates of discovery and initial routes for diffusion are unknown, but alcoholic beverages appeared shortly after agricultural settlement in Mesopotamia and Asia Minor and shortly thereafter in Egypt. Different beverages were used in different ways in early civili-zations, depending upon cost and availability and, apparently, on taste and nutritive value. Early archaeological findings and documents suggest that within the same culture alcohol would be used in reli-gious-magical ceremonials, in healing, in social ceremonials, and in feasting. Evidence exists for differences in styles of use depending upon the social status of persons; age, sex, social class, and religious roles appear early as determinants of who employed what beverage in what settings. Evidence also exists from contemporary nonliterate societies which, if extrapolated backwards in time, would imply a diversity of uses for alcohol in prehistorical societies prior to agriculture, settlement, and civilization. These uses are also social and occasionally personal (private, secular) as well as—secondarily—religious and magical.

In early civilizations there was recognition of the disabling ef-fects of alcohol, induding ill-health and death, predatory exploitation of the intoxicated through crime, war, or politics, personal foolishness or disgrace, and the impairment of group solidarity or competence. Early methods to control alcoholic excess included regulations govern-ing production and distribution, taxation, punishment, and, of course, group norms and individual ideals and controls dictating safe and ac-ceptable behavior. We see no reason to posit a "golden age" in urban dvilizations whereby alcohol problems would have been unknown; neverthele,ss, among urbanized societies in pre-Christian times, as well as among preurban peoples, marked differences existed in the extent to which disapproved or damaging behavior occurred as related to alcohol use. This is a function, of course, of the standards of judgment as well as of drinking styles and variability of behavior within a popu-lation. Among primitive groups the inferred frequency of disapproved behavior in association with alcohol is taken to be very low.

Documents reveal considerable differences within a society—over time from one era to another and within an era among classes and individuals—in the extent of alcohol problems. There is also a record of considerable differences in the effectiveness of efforts to con-trol alcohol production, distribution, or alcohol-associated behavior. Retrospectively, it is an uncertain exercise to attempt to identify fac-tors within societies which increase or decrease the risk of alcohol abuse's being defined and the extent of its occurring once defined. Various authorities have linked extensive alcoholism to rapid social change, to nonaccommodating culture contact, to urbanization, to strain, social disorganization, and the like. These may well be valuable notions; certainly Horton (in McCarthy, 1959) and Child, Bacon, and Barry (1965) have shown that economic-agricultural and socio-psychological factors can be linked to the prevalence of alcohol prob-lems in nonliterate societies. Nevertheless, in an examination of com-plex societies, which are necessarily heterogeneous and often changing, such global yardsticks are difficult to apply reliably. We have, at the moment, no better conceptions or variables to propose as determinants of extensive alcohol problems in complex societies. We would agree, after this cursory historical review, that rapid social change leading to inferred group disorganization and personal hopelessness, uncertainty, misery, and anxiety when occurring in situations where alcohol is cheaply available appear linked to some rampant alcohol problems. However, the data are insufficient for identifying such factors in, let us say, ancient Egyptian "abuse." It is equally important to note that Asian societies with apparently similar troubles—if not much greater ones—have avoided serious alcohol problems for several thousand years. If some of them are now coming to alcohol troubles--as is said to be occurring in some Asian urban centers--it is reportedly among Westernized, wealthier persons rather than among the traditional poor. This suggests that an additional necessary component for actual abuse is compatibility of a drug's image as well as its effects with acceptable, if not pre,stige, values within a group (Carstairs, 1954; Lolli, Serianni, Golder, and Luzzato-Fegiz, 1958; Sadoun, Lolli, and Silverman, 1965

On the other hand, quite different features also appear linked to alcoholic excesses—for example, prizing manly drinking and the warrior code appears repeatedly as a component of heavy drinkin' g in the armies of Rome and ancient Gaul, in the Viking raiders, and among the contemporary Irish. Valuing the free and passionate spirit, the mystical embrace, and the plumbing of the depths reflects itself also in a pattern discernible from time to time whether in Dostoevsky or William James. One sees alcohol-inspired intensity in assoc,iation with the Dionysian ethic (Benedict, 1950)., religious frenzy, as in the Bacchae, or in communion with the dead, a modern practice in Guate-mala (Bunzel in McCarthy, 1959; also Blum and Blum, personal ob-servation, 1966)'. In any event, these are not matters of strain or anx-iety; they are matters of life style and a way of seeking experience. Whether or not the accompanying drunkenness constitutes abuse depends upon whether or not there are observers who do not adhere to the warrior, mystical, or ecstatic creed. In any case, a moral may be drawn from Ulster, which is that the authoritative cry of "abuse" may have the same irrational, if not self-serving, roots. Whether or not a pattern of heavy, continuing alcohol intake as a life style leads, as in Jellinek's delta syndrome, to dependency is another matter—one prob-ably involving nutrition, manner of intake, and individual personality and life stress.

As a final comment, we would note that from its beginnings alcohol appears to have been a favored drug and, in its competition with other psychoactive substances, is maintaining its preferential po-sition. It continues to be employed in religion, in healing, and in cere-monies, but nowadays these functions are secondary to secular ones. Although alcohol is the drug most widely abused, it is, nevertheless, used safely and acceptably by the majority of those employing it (Blum, 1967). This suggests that with it, as with most other drugs in widespread use, human beings generally can handle mind-altering experiences rather well. There are, of course, those who cannot—up-wards of 7 per cent in our own society. For them, the ancient regula-tory methods of control over distribution and intake, along with the modern methods of rehabilitation (Blum and Blum, 1967), are dearly necessary.

1 We shall see during the course of history that "Establishment" suppres-sion of one or another drug was often political—for example, when the inno-vators gathering together to try a new drug also engaged in antistate activities as another aspect of their change orientation, the holders of power responded violently to that new drug use, which was symbolic, for all concerned, of re-bellion, separatism, or other dissatisfaction with the status quo. Government opposition to traditional drugs may also occur on political grounds, as, for ex-ample, when occupying or colonial powers sensed a traditional or ceremonial drug use as a unifying symbol of the old ways, which might help subject peo-ples resist imposed changes. Contrariwise, when changes in styles of use of a traditional drug--or subsequent behavior—were identified with new groups which threatened established power, the elite sought to curb such changes by regulat-ing either the drug or the behavior of power-aspiring or otherwise convention-challenging groups.

2 This is not to say that all Americans were teetotalers or drunkards but, rather, that extreme drinking behavior and rigid moral positions were prom-inent. On the other hand, in that same period, among cultivated men very dif-ferent perspectives on alcohol were possible. Among these the position of Wil-liam James is outstanding. In The Varieties of Religious Experience (1902), he wrote of the potential of alcohol for producing mystical experiences. "The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties. . . . To the poor and the unlettered it stands in the place of symphony concerts and of literature. . . . The drunken consciousness is one bit of the mystic consciousness, and our total opinion of it must find its place in our opinion of that larger whole" (pp. 377-378). James' emphasis on the pharmacological production of religious experience bears profoundly on to-day's debates about mystical experience as producible by LSD, peyote, and mescaline, among others.