[Absinthe rehabilitated]. / L'absinthe réhabilitée.

Absinthe (Artemisia absinthium) has been known for its medicinal properties since Antiquity. The Egyptians in 1600 BC, then Hippocrates, Galien, The Salerne School in 1649, and 18th-century physicians all recommended it for a variety of maladies. In 1780-1790 in Switzerland (Val de Travers), a traditional healer and, probably, a itinerant physician by the name of Docteur Ordinaire, transformed this purgative elixir into an aperitif liqueur, a move followed by two centuries of unexpected success. Absinthe was manufactured in France, at Pontarlier, for tax reasons. In 1900, the town counted 25 distilleries. Its production then extended to other French provinces. La fée verte ("green fairy") was particularly popular with the military, literary and artistic circles, and, finally the general public. In 1902, following a parliamentary vote, the Minister of the Interior asked the National Academy of Medicine to issue an opinion on "The indication of aperitif liqueurs, including absinthe". The Commission on Alcoholism, chaired by J.V. Laborde, examined the composition of absinthe liqueurs, the physiological and toxic action of their essences, the risks associated with "bitter" aperitifs, and the composition of essence-based liqueurs that were not used as aperitifs. The Commission compiled a list of the most dangerous aperitifs and liqueurs placing absinthe at the top, and recommended that the authorities prohibit the manufacture, circulation, advertisement and sale of all such drinks, including absinthe. However, because these drinks, and especially absinthe, represented an important source of tax revenue, this recommendation was only acted upon 13 years later, with a law adopted in March 1915. Despite subsequent prohibition of the production of absinthe liqueur, manufacturers in the Val de Travers region and a distillery in Pontarlier continued to work in secret until the prohibition was finally lifted in the year 2000. This decision was based on scientific analyses showing that thuyone was only toxic when ingested in very large amounts incompatible with normal consumption. In addition, it was found that the high alcohol content, often including adulterated alcohol, was particularly detrimental. A handful of manufacturers are now authorized, with strict limits placed on the alcohol content and thuyone concentration. Does this mean that the Academy of Medicine was wrong? While the report can be criticized, the fight against alcoholism was a worthy and necessary cause at the time, and remains so today.

Wormwood (Artemisia absinthium L.)--a curious plant with both neurotoxic and neuroprotective properties?

The medical use of the wormwood plant Artemisia absinthium L. dates back to at least Roman times, while during the last century this tradition was seemingly on the decline due to fears of absinthism, a syndrome allegedly caused by the wormwood-flavoured spirit absinthe and more specifically as a result of thujone, a monoterpene ketone often present in the essential oil of wormwood. If threshold concentrations are exceeded, thujone does in fact exhibit neurotoxic properties leading to dose-dependent tonic-clonic seizures in animals, likely caused by GABA type A receptor modulation. Research has shown that the concentrations of thujone present in absinthe were not sufficient to exceed these thresholds, and the marketing of wormwood-flavoured alcoholic beverages has ultimately been reinstated. The declining fears of absinthism may have led to a revival of the medical uses of wormwood, evidenced by several experimental reports, e.g. on the treatment of Crohn's disease. Most recently in this journal, neuroprotective properties of wormwood were detected in rats, and the plant was suggested to be possibly beneficial in the treatment of strokes. While these results sound promising and worthwhile for further investigation, the well-defined profile of adverse properties of wormwood demands a more cautious interpretation of these results. It remained unclear in the studies, for example, if the threshold dose for thujone (e.g. as set by the European Medicines Agency) would be exceeded during therapeutic usage. Due to the colourful history of wormwood, its application in humans should be preceded by a thorough and careful risk-benefit analysis.

Absinthe, epileptic seizures and Valentin Magnan.

Absinthe is an alcoholic liquor containing extracts from the wormwood plant. It was widely consumed in France in the late nineteenth century. Its production was banned in 1915, partly because it was thought to cause neurological disturbances, including mental changes and epileptic seizures. Modern knowledge of an acceptable content of the convulsant alpha-thujone in absinthe has allowed the lifting of the production bans, and called into question the experimental work of Valentin Magnan in the 1870s, which formed the scientific background to the campaign against absinthe. An examination of Magnan's published investigations suggests that his science was very adequate by the standards of his time, and that he had shown that an alcohol-soluble component of wormwood did produce lapses of consciousness, myoclonic jerks and tonic-clonic convulsions in animals. Whether that component, presumably thujone, was present at convulsant concentrations in some of the available absinthes of Magnan's time cannot now be known.

[Thujone-attributable effects of absinthe are only an urban legend--toxicology uncovers alcohol as real cause of absinthism]. / Thujon-Wirkungen von Absinth sind nur eine Legende. Toxikologie entlarvt Alkohol als eigentliche Absinthismus-Ursache.

In the discussion about thujone as possible toxic constituent of the wormwood-containing alcoholic beverage absinthe, the dose-response-relationship is frequently ignored. The effects of absinthe are very often attributed only to thujone, an association that is not scientifically proven. Especially the alleged psychotropic effects of thujone are scientifically unproven. However, the question about thujone effects in absinthe is irrelevant, because thujone is contained in both modern commercial absinthes and historic pre-ban products in such low amounts that a pharmacological effect can be excluded per se. The effects of the spirit that are summarized under the term absinthism observed in late 19th century's France, can be explained by chronic alcohol misuse and dependence alone according to today's standards of knowledge. Especially from the perspective of youth and public health protection, an ambiguous and biased reporting about absinthe should be avoided. For example, the alleged antagonistic effects of thujone on the action of ethanol might lead to a trivialization of alcohol-related harms. Scientifically unproven speculations about the influence of certain drinking rituals of absinthe on its toxicity must be rebutted. A return to more evidence and less conjecture in the reporting about absinthe would be desirable.

Absinthe--is its history relevant for current public health?

This paper briefly addresses the history of the social experience with absinthe in France during the 19th century and the beginning of the 20th. We draw on some important parallels of this history with that of smoking to demonstrate that public health threats in the form of (ill-)health related behaviour recur in different disguises, while the social causes if these threats are left to endure. Probably the most important of the parallels between absinthe and smoking is their association with social disadvantage. Nevertheless, it appears that it is not yet fully realized that tackling these threats requires an equity approach.

Absinthe--a review.

The alcoholic beverage absinthe is recently experiencing a revival after a yearlong prohibition. This review article provides information on all aspects of this bitter spirit and its major components, especially wormwood (Artemisia absinthium L.), which contains the toxic monoterpene thujone. Over 100 references on historic and current literature are provided. The topics comprise the history of the alcoholic drink starting from its invention in the eighteenth century. Historical and modern recipes are discussed in the context of different quality categories and possibilities to reduce the content of thujone are given. The analytical techniques used to verify compliance with the maximum limit of thujone as well as further possibilities for quality control of absinthe are discussed. The toxicology of absinthe is reviewed with regard to the cause of a syndrome called "absinthism," which was described after chronic abuse of the spirit in the nineteenth century. Finally, a food regulatory and food chemical evaluation is provided and minimum requirements for absinthe are suggested. Absinthe should have a recognizable wormwood flavor and after dilution with water the characteristic clouding should arise (louche-effect). Products, which are advertized as being of premium grade should be made by distillation, should have an alcoholic strength of at least 45%vol, and should not contain artificial dye.

Absinthe: return of the Green Fairy.

Among the most popular and intriguing intoxicants of the Victorian Age, absinthe had all but disappeared after it was banned in nearly all developed countries in the early 1900s. A number of great artists and writers from the late 1800s used absinthe as a social drink, including Vincent van Gogh and Toulouse-Lautrec. A recent resurgence of absinthe use has occurred in Europe and is rapidly spreading to the United States. Despite its increasing popularity limited information exists on the mechanism of action and neurotoxicity of absinthe. This paper reviews some of the historical aspects of absinthe and aims to shed light on the mechanism of action and neurotoxicology of this the Green Fairy.