absinthism and hallucinations

   The term absinthism is indebted to the French noun absinthe, which in turn derives from the Greek noun apsinthion (wormwood). It has various connotations, referring either to the habitual ingestion of absinth or to a group of symptoms associated with absinth intoxication and/or withdrawal. This group of symptoms includes hallucinations and other * psychotic phenomena, * amaurosis fugax, insomnia, vertigo, tremors, transient paralysis of the limbs, * delirium, and epileptic seizures. Absinth is an emerald-green liqueur flavoured with extracts of green anise, florence fennel, and grande wormwood (sometimes referred to as the 'holy trinity'), as well as a mix of other herbs. It was created around 1792 as an all-purpose patent remedy by the French physician Pierre Ordinaire (1741-1821). The drink, which was marketed by the Swiss distiller Henri-Louis Pernod (1776-1851), became extremely popular in 19th-century Europe and, to a lesser extent, in the United States. Among those who contributed to the almost mythical proportions of absinth's reputation were Charles

   Fig. 1 The Absinthe Drinker. Oil painting (around 1903) by Viktor Oliva. Source: Café Slavia, Prague

   Baudelaire (1821-1867), Edouard Manet (18321883), Edgar Degas (1834-1917), Vincent van Gogh (1853-1890), Oscar Wilde (1854-1900), and Henri de Toulouse-Lautrec (1864-1901). The mechanism of action of absinth in the mediation of hallucinations is unknown. The person credited with conducting the first experimental biomedical research on the drink's hallucinatory effects is the French alienist Jacques JosephValentin Magnan (1835-1916). Magnan exposed various mammals to the vapours of either wormwood oil (the essence of absinth) or alcohol (the base of absinth). As he reported in 1874, the animals that inhaled the alcohol vapours got drunk, while those that inhaled the vapours of wormwood had a heightened risk of epileptic seizures. On the basis of observations such as Magnan's, it has been suggested that thujone (one of the active components of wormwood oil) acts as a convulsant and is thus responsible for mediating the notorious hallucinatory activity of absinth intoxication. However, it has also been suggested that the absolute amounts of thujone in absinth are so small that its effects are overshadowed by those of ethanol, and that the latter ingredient should therefore be held responsible for the majority of symptoms associated with absinthism. In the latter reading, the hallucinations are attributed either to ordinary *alcoholic hallucinosis or to the effects of alcohol withdrawal delirium. A third hypothesis suggests that the hallucinatory effects reported in the 19th century did differ from alcoholic hallucinosis and withdrawal delirium, but only because they were due to cheap imitations of absinth that contained copper sulphate and other toxins - instead of chlorophyll from plant extracts - to mimic the drink's characteristic emerald-green colour. Some of the other candidate substances for the purported hallucinogenic effects of those imitations are methanol, * nutmeg, calamus, turmeric, and aniline green. The 19th-century European and Acenesthesia

   American authorities considered absinth such a severe threat to public health that around 1900 it was legally prohibited in many Western countries. For over a century, that ban remained largely in place. During the early 21st century many of those countries legalized the consumption of absinth, thus far without any notable effects upon public health.

   References

   Magnan, V. (1874). On the comparative action of alcohol and absinthe. Lancet, 104, 410-112.

   Holstege, C.P., Baylor, M.R., Rusyniak, D.E. (2002). Absinthe: Return of the green fairy. Seminars in Neurology, 22, 89-94.