The Ethnobotany of Wine as Medicine in the Ancient Mediterranean World
“Wine [is] one of the oldest, perhaps the oldest, of all medicines.” S.P. Lucia, MD, 1963
Wine is not only one of humankind’s most ancient drinks, it also may be the first recorded medicine.1 It is not merely a beverage but has served as an analgesic, antiseptic, menstruum (solvent), soporific (sedative), valuable economic commodity, water purifier, social lubricant, and even an inspiration. Wine is, for some, the ultimate creative juice. In fact, this author proposes that wine, and the wine grape (Vitis spp., Vitaceae) from which it is prepared, has played a greater role in the evolution of human society than any plant other than cereal grains.
Many people associate the beginnings of wine culture with the Greeks and Romans of the ancient Mediterranean world. However, this is incorrect, both biologically and historically. “Catching a buzz” from alcohol from fermented fruits did not originate with the Greco-Roman world of 2,000 years ago and did not even begin with our own species. Alcohol consumption presumably predates the emergence of Homo sapiens by millions of years, since fermented fruits are known to be consumed by insects like bees, butterflies, and fruit flies, birds like cedar waxwings and robins, and mammals as diverse as bats, chimpanzees, elephants, howler monkeys, and tree shrews.2,3 Undoubtedly, a complete list of animals that experience altered states induced by alcohol from fermented fruit would be much longer.
Viniculture in Transcaucasia
While the fermentation of sugars from many sources can yield an alcoholic drink, this article focuses on wine derived from the common wine grape, Vitis vinifera, whose original range covered much of Eurasia. Ancient humans may have been consuming naturally fermented grape juice throughout this range for many thousands of years. But archaeological evidence clearly points to Transcaucasia — a region roughly comprising the present-day countries of Armenia, Azerbaijan, and Georgia and parts of both Iran and Turkey — as the place where humans began to purposefully and systemically plant grapes and process them into wine.4 The oldest known extant proof of wine production is pottery shards of vats that once held wine and were excavated in the Republic of Georgia by Patrick McGovern, PhD, of the Penn Museum and a leading authority on the production of wine in the ancient world. McGovern and his colleagues date the production of this wine to around 8000 BCE. Other jars used for wine storage were found at the Hajji Firuz Tepe archaeological site in northwestern Iran and dated to approximately 5000 BCE.2
In Uncorking the Past (University of California Press, 2009), McGovern writes:
It is also becoming increasingly clear … that the world’s first wine culture — one in which viniculture, comprising both viticulture and winemaking, came to dominate the economy, religion, and society as a whole — emerged in this upland area by at least 7000 BCE.2
Interestingly, the wine residues found at this Iranian site contained a plant resin from the terebinth tree (Pistacia terebinthus, Anacardiaceae). Plants from the genus Pistacia appear repeatedly in the Bible. Terebinth resin was valued for its preservative properties and was used by the Egyptians in the mummification process.5 A major challenge for winemakers has always been to keep bacteria from converting the alcohol to vinegar. Though they could not have understood the underlying processes, the winemakers in this region likely were using this natural product to kill unwanted microorganisms, a practice that anticipates the research of Louis Pasteur and Alexander Fleming that revolutionized medicine almost 7,000 years later.6
Evidence of the most ancient winery known, believed to be in use as early as 4000 BCE, was found in the Areni-1 cave complex in central Armenia. This site yielded not just pottery shards but also cups, fermentation vats, storage jars, and a wine press. In the words of McGovern: “The fact that winemaking was so well developed in 4000 BCE suggests that the technology probably goes back much earlier.”7
Why wine cultivation evidently began in the Transcaucasus region remains unknown. Transcaucasia is bracketed by two seas, the Black Sea to the west and the Caspian Sea to the east, and was a crossroads of trade and culture. The legend of Jason and the Golden Fleece, which recounts the Argonauts’ sailing east from Greece to the land of Colchis (modern-day Georgia), most likely represents a retelling of the Greeks’ initial meeting with the people living on the east coast of the Black Sea and coming away possibly with the Golden Fleece, but in all probability with new grape cultivars and additional knowledge as to how to best cultivate grapes and process them into wine.8
A Symbol of Wealth in Mesopotamia
The history of wine and viniculture does not move directly from Georgia to Greece. Ironically, wine next appears in the historical record where the wine grape did not thrive — in the hot and dry deserts of Mesopotamia. In fact, the first known depiction of wine drinking is featured on a Sumerian box dated to 2600-2400 BCE. The artwork, known as the “Standard of Ur” and now on display at the British Museum, portrays a king seated on a carved stool while being toasted by six attendees holding wine cups.9 Wine, which had to be transported from far away, was the preferred drink of royalty because it was safer and tastier to drink than much of the available water, it induced altered states, and it could be used for curative purposes.
King Ashurnasirpal II of Assyria (reign: 883–859 BCE) is said to have invited almost 70,000 guests to a feast to celebrate the completion of his new palace at Nimrud in 870 BCE. According to Tom Standage in his classic A History of the World in 6 Glasses (Bloomsbury Publishing, 2005):
[He] served ten thousand skins of wine — [an] impressive display of wealth. Previously, wine had only been available in Mesopotamia in very small quantities, since it had to be imported from the mountainous, wine-growing lands to the northeast. The cost of transporting wine down from the mountains to the plains made it at least ten times more expensive than beer, so it was regarded as an exotic foreign drink in Mesopotamian culture. Accordingly, only the elite could afford to drink it, and its main use was religious; its scarcity and high price made it worthy for the gods, when it was available. Most people never tasted it at all.10
McGovern echoes Standage’s analysis that wine became the drink of royalty in Mesopotamia because, unlike in the Caucasus, it required massive labor and expense to be produced in a challenging environment: “Wine belonged to a different social order in lowland Mesopotamia … where grapes could be grown only by irrigation and had to be protected [from] the intense sun. Only royalty could afford to indulge in this luxury.”2
Early Evidence of Wine as Medicine
Meanwhile, the earliest known record of wine used as medicine also comes from ancient Sumer. A cuneiform tablet from the ancient city of Nippur in the Iraqi desert, dated to about 2200 BCE, features what is widely regarded as the world’s oldest medical prescription, suggesting that the use of wine for medical purposes is likely as ancient as wine itself. Not only is wine our oldest documented medicine, it is also our oldest man-made medicine.
The tablet contains detailed accounts of various prescriptions, many consisting of salves created from crushed medicaments, some of which are then infused with wine.11
One translated prescription appears in Lucia’s 1963 book, A History of Wine as Therapy (J.B. Lippincott & Co.): “Pound together: dried wine dregs, juniper and prunes, pour beer on the mixture. Then rub [the diseased part] with oil, and bind on [as a plaster].”1
Though the disease being treated is not specified, the external application of the mixture as a plaster probably indicates that it is a wound or infection. The alcohol in the beera that was poured onto the mixture may have had a mild antibacterial effect; the Sumerians were passionate about beer and brewed many different varieties. More important from a therapeutic standpoint, however, was the wine: grape wine has been proven to contain several antibiotic compounds.
Famous in the annals of medical history is English physician John Snow’s (1813–1858) study of the 1854 Broad Street cholera outbreak in London, which led to the understanding that cholera can be transmitted through contaminated water. Less widely celebrated was an 1892 paper by the Austrian military physician Alois Pick (1859–1945) that constituted the first known scientific demonstration of wine’s antiseptic properties.
Like Snow four decades before him, Pick noticed who did — and more importantly, who did not — get sick during a cholera epidemic, this time in Paris. Noting that wine drinkers did not contract the deadly disease, Pick carried out a simple experiment. He mixed both cholera and typhoid bacteria with wine and observed that the microbes expired, leading to many subsequent experiments that yielded similar results and conclusions.11 Guido Majno, MD, in his book The Healing Hand (Harvard University Press, 1975), notes:
The antiseptic power of wine is no myth…. Since it cannot depend on alcohol alone … [recent research has pinned] down the mechanism to the anthocyanes, a subgroup in the large group of polyphenols present in wine. The most important member of this group of compounds, as regards antibacterial effects, is also the principal pigment of red wines, malvoside or oenoside; there is a colorless equivalent for white wines. This pigment is already present in grapes, but combined with a carbohydrate and not antiseptic; during alcoholic fermentation it splits free and becomes activated.11
Thus, observations in Paris at the end of the 19th century confirmed the effectiveness of wine as an antibacterial, a property ancient people took advantage of more than 4,000 years ago, and likely far earlier than that.
Wine in Canaan and Mediterranean Trade
From Mesopotamia, wine culture moved west to the land of Canaan. The Canaanites were Semitic peoples who inhabited much of the ancient Near East. Canaan itself usually refers to Lebanon, and portions of present-day Israel, Palestine, and Syria.
Lebanon in particular, with its greater precipitation, higher elevation, and better soils, proved ideal for viticulture compared to the flat, parched, and sandy landscapes of much of Mesopotamia. A group of enterprising Canaanites from coastal cities like Byblos, Sidon, and Tyre, as well as the fertile Beqaa Valley to the east, developed an extraordinary maritime culture focused on trade rather than conquest. These coastal Canaanites later became known as the Phoenicians and appear in ancient sources as varied as Egyptian tomb paintings, Homer, Herodotus (ca. 485–424 BCE), and the Bible. (The Phoenicians flourished from approximately 1200 BCE to 539 BCE.)4
Three ethnobiological products — two botanical, the other zoological — played fundamental roles in the Phoenicians’ mastery of Mediterranean trade. The cedars of Lebanon (Cedrus libani, Pinaceae) were once the largest and most majestic trees in the region now known as the Middle East. They also produce a magnificent wood: beautiful, easy to work, fragrant, and decay resistant. The cedar enabled the Phoenicians to build the biggest and strongest ships of the day, so for the first time in Mediterranean history people were able to sail across the open sea instead of just hugging the shore. The wood was in such demand that it was believed to have been used as far afield as Egypt to build Khufu’s colossal funerary ships and Israel to build Solomon’s Temple.
Another product that helped make Phoenicians the masters of the Mediterranean commercial trade was their near-monopoly on Tyrian purple, a spectacular red-purple dye from the secretions of predatory murex sea snails.b
The Phoenicians introduced viticulture and winemaking to areas in present-day Algeria, Egypt, France, Greece, Italy, Portugal, and Spain. In so doing, they also reportedly disseminated grape varieties that are still prized in Europe.4 So valued was the Phoenician knowledge of wine that when the Romans sacked Carthage (originally a Phoenician colony located on the Mediterranean coast of modern-day Tunisia), the army reportedly was instructed to save the 28 books by Mago (unknown epoch), who had written classic works on agriculture, including some of the earliest texts on viticulture (the cultivation and harvesting of grapes) and viniculture (the cultivation and harvesting of wine grapes specifically).
Although the Phoenicians invented the precursor of the modern alphabet, little of their writing survives today. While the Mesopotamians inscribed records in cuneiform script on clay tablets, the Phoenicians, like the Egyptians, wrote on papyrus (derived from the Greek word papuros, meaning “paper”). In the dry, desert climate, inside Egyptian tombs, these papyri survived, but in the more humid coastal climes of the Levant (area including present-day Israel, Jordan, Lebanon, Syria, and southern Turkey) they did not. Even the works of Mago — which were rescued and brought to Rome, where they were translated into both Greek and Latin — have disappeared and are known only through citations by Roman writers.c Notably, no known documentation exists with respect to the Phoenicians’ possible use of wine for medicinal purposes.
In the absence of written accounts, significant advances in underwater archaeology — particularly side-scanning sonar and deep-sea submersibles — are yielding abundant information about the wine culture of the Phoenicians and other citizens of the ancient Mediterranean. Previous finds were made by sponge divers and scuba divers who were working in depths of less than 100 feet. Over the past three decades, however, astonishing finds of Phoenician shipwrecks off the coasts of southeastern Spain, Israel, and Malta reveal details about international trade, shipbuilding techniques, and even wine composition.14 These wrecks, some of which have been dated to ca. 750 BCE, typically contain numerous amphorae (the preferred shipping containers of the ancient Mediterranean; amphorae are also known as “Canaanite jars” because they were the Phoenicians’ container of choice), and laboratory investigations have found that the wines therein were both resinated and filled with herbs, an indication that they were probably used for therapeutic purposes as well as enjoyment.15
Advances in human and plant genetics also are providing a better understanding of the Phoenicians and their wine. Scientists now believe that the Phoenicians were growing grapes that originated in the Caucasus, and that some of Europe’s major grape varieties originated in Canaan.4 Further progress in both underwater archaeology and genetics will continue to illuminate current understanding of ancient peoples and their wines.
Fit for a Pharaoh: Wine in Ancient Egypt
In Egypt, a taste for wine was inculcated thousands of years ago. Wine and wine making are depicted on obelisks, papyri, and sculptures and in vividly colored and highly evocative tomb paintings. One early oenophile (wine connoisseur) was King Scorpion I, whose tomb (ca. 3150 BCE) in Abydos contained 700 hundred jars of wine that are believed to have been imported from the eastern Mediterranean, including present-day Israel, Jordan, Lebanon, and Palestine.
Laboratory analysis by McGovern and his team showed that Scorpion’s wine contained not only terebinth resin but also coriander (Coriandrum sativum, Apiaceae), lemon balm (Melissa officinalis, Lamiaceae), mint (Mentha spp., Lamiaceae), sage (Salvia officinalis, Lamiaceae), savory (Satureja spp., Lamiaceae), senna (Senna spp., Fabaceae), and thyme (Thymus spp., Lamiaceae).16These herbs may have been added to improve flavor, slow spoilage, and enhance healing properties, since all are still used for both culinary and therapeutic purposes.
The Egyptians found that much of their territory was unsuitable for growing grapes, as was the case in Mesopotamia, but they determined that grape vines would flourish in the fertile soils of the Nile Delta, where viticulture was established around 3000 BCE. Again, similar to the situation in Mesopotamia, because production was limited, wine in Egypt remained primarily the drink of the pharaohs and other members of the ruling classes, while the masses drank beer.2,10
As wine was the preferred beverage of the king, priests, and leading officials, winemaking became a celebrated activity in ancient Egypt, appearing in numerous tomb pictographs and paintings. Winemaking is illustrated vividly in pictographs within the tomb of Ptahhotep (late 25th century to early 24th century BCE), a vizier and philosopher, in Saqqara. Famous paintings of viticulture are found in Thebes in the tomb of Nakht (ca. 1400 BCE), an astronomer and priest who was laid to rest surrounded by strikingly colorful depictions of grape cultivation and harvesting.
Numerous medical papyri have survived — the Kahun (ca. 1900 BCE), the Edwin Smith (ca. 1650 BCE), the Ebers (ca. 1550 BCE), the Hearst (ca. 1500 BCE), the London (ca. 1350 BCE), and the Berlin, also known as the Brugsch (ca. 1350 BCE) — that provide detailed information on medicines used in pharaonic Egypt.17 Wine features as an important component in many of these, such as this recipe from several medical records like the Ebers Papyrus: “To eradicate asthma: honey 1 [mouthful], beer 8 [mouthfuls], wine 5 [mouthfuls], are strained and taken in 1 day.”1
Wine also appears in the Ebers Papyrus as a component in treatments for digestive problems and jaundice. It is prescribed in the Hearst Papyrus, the London Papyrus, and others to treat ailments as diverse as what appear to be epilepsy, fevers, and wounds. Wine was valued as a component in which medical plants and their compounds could be dissolved and consumed. Wine-based medicaments also were used in salves and enemas and applied to bandages.
In the London Papyrus, wine serves as a component in a treatment for aural discharge: “Medicament for an ear that is watery: Salt, heat with good wine; you apply it after cleaning [the ear] first. You scrape salt, heat with wine, and apply it for four days.”1
Lucia (1963) also makes an important observation about these Egyptian prescriptions that feature wine and other plants and plant products like anise (Pimpinella anisum, Apiaceae), caraway (Carum carvi, Apiaceae), castor bean (Ricinus communis, Euphorbiaceae), coriander, cumin (Cuminum cyminum, Apiaceae), dill (Anethum graveolens, Apiaceae), frankincense (Boswellia spp., Burseraceae), myrrh (Commiphora myrrha, Burseraceae), and opium:
The fact that Egyptian papyri written at dates several centuries apart are often found to contain identical prescriptions suggests that some of the remedies must have accomplished their purpose with regularity. This continuous recording of the therapeutic effects constitutes the beginning of [therapeutic] lore.1
Perhaps the most famous pharaoh of ancient Egypt also looms large in wine history. Tutankhamun (ruled ca. 1336-1327 BCE) was entombed with 36 amphorae of wine to accompany him to the afterlife. His funereal wine cellar included both red and white wine, and 26 of the jars are labeled with the name of the winemaker, the location of the vineyard, and the year of production — not unlike the wines of today, and proof that a royal winemaking industry was flourishing.18
Recent investigations of ancient Egyptian wine residues reveal that these ancient peoples added numerous spices and healing herbs. Healing plants apparently incorporated into some of these wines include coriander, lemon balm, mint, rosemary (Salvia rosmarinus, Lamiaceae), sage, savory, senna, and thyme.16 Whether these species were added to slow spoilage, imbue a certain taste, or actually heal is impossible to discern at this point, although it seems highly likely that they were selected for at least one and possibly all of these purposes.
Not only was wine used because of its efficiency in extracting many of the pharmacologically active compounds of plants, it also often served to mask the bitterness of some of these herbs. Additionally, not all the unpleasant, purportedly therapeutic compounds added to wine were derived from plants (e.g., Egyptians treated epilepsy by adding ground donkey testicles to wine).
Wine in Religious Texts
The medical lore described in the Five Books of Moses, the Pentateuch (the first five books of the Hebrew Bible), draws heavily on Egyptian therapeutic traditions. As Moses was said to have been raised in the palace of the Pharaoh, he would have presumably learned much about Egyptian medicine.d
The Old Testament, believed to have been written before 400 BCE, repeatedly mentions medicinal uses of wine, including its mixture with olive (Olea europaea, Oleaceae) oil and balsam as a wound dressing. One of the sayings of Lemuel, a king mentioned in Proverbs 31, is to “give … wine unto those that be of heavy heart,” implying that it serves as a mood enhancer, while another verse states, “Let him drink and forget his poverty, and remember his misery no more,” suggesting its value as both a mood enhancer and a sedative. Psalm 104 states that “wine … maketh glad the heart of man” (Psalm 104:15).
In fact, grapes and wine are mentioned more often than any other plant in the Bible; so much that Hanneke Wilson states in The Oxford Companion to Wine (Oxford University Press, 1994) that “The Bible is not suitable reading for teetotalers.”19 In the Book of Genesis, Noah plants a vineyard as soon as the Great Flood subsides, and becomes the first person to produce wine, later becoming inebriated. Nonetheless, the implication was that viticulture represents progress in the development of civilization.
The Talmud states that wine is beneficial for treating problems of the heart, eyes, and bowels and possibly as a treatment for impotence.1 In the text, a piece of bread soaked in wine is applied to infected eyes. The Talmud also claims that “wine taken in moderation induces appetite and is beneficial to health” and “wine is the foremost of all medicines; wherever wine is lacking, medicines become necessary.”20
Wine has always served multiple purposes in Jewish religion and culture. Every major event, from birth to death, from weddings to holidays, involves the drinking of wine. In The Story of Wine (Mitchell Beazley Publishers, 1989), Hugh Johnson writes, “Jewish devotion to wine runs through their law and literature. It is the very essence of their civilization.”18 Wine, for example, is served at circumcision ceremonies and applied to the incision to prevent infection, and the newborn is sometimes orally dosed with a few drops as an analgesic.
Wine Culture in Ancient Greece
Wine also has been described as the touchstone of ancient Greek civilization, central to their cultural identity. Ancient Greeks believed that truly civilized people spoke Greek and drank wine. Ignorance of the Greek language and viticulture, especially by cultures that favored beer, was regarded as the hallmark of barbarians and savages.e As both a drink and a libation, wine served as a key component in Greek rituals and rites of passage including burials, marriages, sacrifice, and worship of the wine god Dionysus.22
Wine was enjoyed for its own sake but also served as a dietary, religious, and economic staple, and was a driving force in the colonization of much of the Mediterranean.f In a mountainous country with little arable land and no major rivers, the seafaring Greeks looked elsewhere to develop trade while expanding their wine culture further afield. In that sense, some might say that wine fueled a significant portion of the spread of Western civilization.
Wine featured as the centerpiece of the famous symposium (derived from a Greek word meaning “drinking together”), one of the most vital social events in ancient Greece. A symposium was a lively wine-centered feast, at which a range of topics were debated and discussed (Standage described the process as rational inquiry through adversarial discussion), which helped lay the foundation for aspects of Western law, medicine, philosophy, and science. Both Plato (428/7–348/7 BCE) and Xenophon (ca. 430–354 BCE) recounted discussions at symposia they attended, and depictions of these drinking parties are common illustrations on Greek vases from the fifth century BCE.
An enduring aspect of ancient Greek culture is their system of medicine, which codified and systematized knowledge of health and healing. As was the case with the previous cultures discussed, wine played a prominent role.
Though Hippocrates (ca. 460–370 BCE) is widely regarded as the “father of medicine,” the first detailed accounts of ancient Greek medicine were sung by a blind poet: Homer. Almost 150 wounds are mentioned in the Iliad and the Odyssey, and considerable knowledge of medical practice is featured in both. Homer displays such detailed understanding and insight about wounds and treatments that some have suggested that he may also have been a physician. And wine is the medicine most frequently mentioned in both these epics. The Greek warriors returning home in the Odyssey carry wine, water, and grain with them. And the Trojans also drink wine, as does the Cyclops!
Born several hundred years after Homer during the epoch of Classical Greece, Hippocrates remains respected and revered more than 2,000 years later for launching the scientific study and treatment of disease. He is essentially the first major figure in the history of medicine to adopt an empiric approach, rather than attribute disease or healing solely to the spirit world.
One of the famous dictums attributed to Hippocrates was that “natural forces within us are the true healers of disease”; in other words, the human body is, to a large extent, self-regulating and self-healing, usually requiring only a bit of assistance in terms of exercise, fresh air, judicious use of medicine, and an optimal diet, of which Hippocrates considered wine an important component. He also recommended wine as preventative medicine and regarded regular consumption as a key to good health.
Hippocrates used wine as a diuretic and febrifuge (to reduce fever) and to treat many different ailments, including anxiety, eye pain, obstinate ulcers, and head wounds. In one famous passage attributed to him, he wrote, “No wounds should be moistened with anything except wine.” Hippocrates was one of the first to write that different wines had different therapeutic properties (e.g., sweet white wines are diuretic, while tannin-rich red wines are antidiarrheic). According to Lucia, “[Hippocrates] made no extravagant claims for wine, but incorporated it into the regimen for almost all acute and chronic diseases, and especially during the period of convalescence.”1
Hippocrates’ fellow Greeks Aristotle (384-322 BCE), Plato, and Socrates (ca. 469-399 BCE) all commented on the value and uses of wine. Aristotle may have learned something about the medicinal value of wine from his father Nicomachus (unknown to ca. 374 BCE), who served as court physician to the King of Macedon, Amyntas III (unknown–370 BCE). In turn, Aristotle’s most esteemed pupil was Alexander the Great (356–323 BCE), perhaps the greatest warrior of the ancient world. Generals are concerned for the welfare of their troops, if for no other reason than to be able to heal their wounds and send them back into battle. Undoubtedly, Aristotle, as the greatest polymath of his day, likely would have learned from his father of the medicinal value of wine and would have passed this wisdom on to his pupil Alexander.
Theophrastus (371/0–287/6 BCE) was a pupil, colleague, and eventual successor of Aristotle. He often was deemed the “father of botany” because he wrote the first extensive treatise on plants covering plant structure, growth, and reproduction. Known in English as Enquiry into Plants (Historia Plantarum), it features detailed descriptions of many species, both native and foreign, with accounts of their uses. The book has had an effect on botany and medicine for more than 20 centuries. He further recorded the use of perfumed wines and their effect on the sense of taste. Theophrastus also made enduring contributions to viticulture: he wrote about the effects of terroir (environmental conditions that affect wine’s flavor and aroma) and conditions for planting, as well as methods of grafting and pruning.
Wine in the Greco-Roman World
Greek civilization and wine culture massively impacted the Romans. Educated Romans spoke Greek as a second language and knew the Iliad and the Odyssey as some now know the Bible or the Quran. The Roman world drew heavily on Greek architecture, art, coinage, drama, literature, philosophy, religion, warfare, and, in particular, medicine and viticulture. The cultivation and consumption of grapes and wine tightly linked the cultures of Greece and Rome.
The questions of who the Romans were and whether they knew of cultivated wine grapes before the arrival of the Greeks on the Italian Peninsula are intricately intertwined. The Greeks had colonized southern Italy as early as the eighth century BCE. Recent genetic analyses have demonstrated that the inhabitants of the Roman world were a mixture of local Italian tribes — groups like the Etruscans, Oscans, and Samnites — as well as relative outsiders like the Anatolians, Greeks, and Persians. Per Brian Muraresku, a scholar on the ancient Mediterranean: “The original inhabitants of the Italian Peninsula were probably cultivating grapes and making wine in a relatively desultory fashion prior to the eighth century BCE, but it was in all likelihood the Greeks who introduced a culture of viticulture” (B. Muraresku, personal communication, August 7, 2020).
Stuart Fleming, the author of Vinum: The Story of Roman Wine (Art Flair, 2001), described the importance of wine to the ancient Romans:
[It] was truly a central element of Roman everyday life. [Wine] was not just something which enhanced a meal or gave zest to a party. Rather, it was central to Roman overseas trade policies and political interactions with the peoples of their provinces; and it was an integral part of health care practices, of religious practices (initially pagan and cultic, but later on, Christian as well) both in life and in death. In Roman times wine was something with huge social overtones, in the sense that the quality of wine consumed was such an immediate reflection of status, senator to slave.… [T]hough some Roman vintners and traders did make a great deal of money out of wine production, profit was by no means their only motivation. Truth is, the Roman psyche was locked into Rome’s origins among Italy’s sturdy agricultural stock, so any kind of investment in farming, including viticulture, had a special meaning and a special virtue far beyond any we can instinctively imagine today.23
The Greek loss at the Battle of Corinth in 146 BCE marked the end of the Achaean Confederation and resulted in Roman rule of Greece. Despite Roman superiority on the battlefield, their healers were comparatively unsophisticated and unsuccessful, and thus some Greek physicians were brought to Rome where they began to practice their medicine. One of the first of these arrivals who helped establish Greek medicine as a respected discipline was Asclepiades (ca. 129/124–40 BCE; named after the Greek god of healing, Asclepius), who rose to such prominence that he served as physician to Cicero (106–43 BCE). His approach featured a healthy diet, exercise, music therapy, and cleanliness (he is said to have invented the shower). So frequently did Asclepiades prescribe wine to his patients that he earned the nickname oinodotes — “giver of wine.”24
Another towering figure in the history of medical wine and medicinal botany was Pedanius Dioscorides (first century CE), a Greco-Roman physician who traveled widely throughout the Empire. His book De Materia Medica created the template for the great majority of herbals that followed and served as the prototype for the modern pharmacopeia. Together with the works of Theophrastus and Pliny the Elder, De Materia Medica served as a principal authority on botany and, to some degree, medicine for more than 1,500 years. Written in Greek, it was translated into Latin, Arabic, and, in 1665, English. De Materia Medica was a major influence on botany and medicine in both the Christian and Islamic world and is considered history’s most widely read botanical work. Dioscorides’ enduring genius was turning medical botany into an applied science.
He recommended the use of wine for a wide range of illnesses, including cardiac ailments, disorders of the digestive system, and respiratory problems. Like Hippocrates, he specified which wine was to be taken for each malady, distinguishing carefully between the effects of old, new, dry, and sweet wines. Dioscorides also recommended therapeutic uses for other parts of the grape vine, including the flowers, leaves, stalks, and tendrils.
Pliny the Elder
A contemporary of Dioscorides, Pliny the Elder (ca. 23/24–79 CE) was both a scholar and an army and navy commander. Pliny attempted to combine all known knowledge into a 37-book encyclopedia — the Naturalis Historia — including everything from astronomy to zoology. Though he was for the most part more a compiler than a researcher, he claimed to have drawn information from more than 2,000 treatises written by nearly 500 Greek and Roman authors. Most of those original references have been lost, meaning that Pliny’s encyclopedia contains a library of information that would otherwise have disappeared.
Pliny was a strong proponent of the use of wine for therapeutic purposes. The 14th book of his encyclopedia focuses almost exclusively on wine, and in contrast to most of his writings is believed to be based primarily on personal observations. Book 17 conveys considerable information on viticulture, while number 23 is devoted to the medical uses of wine. Pliny knew wine well: He mentioned 200 grape varieties, 50 types of Roman wines, 38 kinds of foreign wines, 18 varieties of sweet wines, and seven types of salted wines.
He ascribed special therapeutic capabilities to honeyed wines, salted wines, and wines into which medicinal herbs had been dissolved. For example, he recommended wine flavored with anise and bitter almonds (Prunus spp., Rosaceae) as a mouthwash; wine with rue (Ruta graveolens, Rutaceae) for stings of bees, hornets, and scorpions, and the bites of spiders and rabid dogs; wine with saffron (Crocus sativus, Iridaceae) as a diuretic and to relieve itching; and wine with “nep” (probably catnip, Nepeta cataria, Lamiaceae) to promote menstrual discharge and frighten away snakes. He wrote that “wines possess the remarkable property of drawing into themselves the flavor of other plants” and “there are two liquids especially agreeable to the human body: wine on the inside and olive oil on the outside.”9 Ever the investigator, he died in 79 CE when he sailed from Misenum (Miseno) to nearby Pompeii to more closely observe the eruption of Mount Vesuvius and rescue a family friend.g,18
Wine in Pompeii
Much of what is known about Roman wine culture has been learned through excavations of Pompeii and nearby sites such as Herculaneum, Oplontis, and Stabiae. The eruption of Mount Vesuvius simultaneously destroyed and preserved these towns. Roman devotion to wine is depicted in numerous paintings and mosaics of grapes, wine, vineyards, and the wine god, Bacchus. The ruins brim with the remains of vineyards, wine presses, wine vats (dolia), and wine jugs (amphorae).h
Pompeii served as an epicenter of trade in wine, shipped both to and from many corners of the Empire.i The town and its environs served as Rome’s principal source of wine, due in no small part to the rich and productive volcanic soil. So passionately devoted were the Pompeiians to their favorite beverage that many of the houses were decorated with figures of Bacchus. One particularly poignant painting in the House of the Centenary features Bacchus dressed in grapes, standing next to Vesuvius, whose slopes are covered in grapevines.
Much of what is known about how and where grapes were planted in ancient Pompeii is due to the ethnobotanical detective work of Wilhelmina Feemster Jashemski (1910–2007). She removed the volcanic debris that filled cavities created when roots decayed and filled them with plaster. She was then able to determine precisely which crops had been planted and where. Her research proved that grapes were cultivated throughout Pompeii, including at least one sizeable vineyard with more than 2,000 grapevine root cavities within the confines of the city itself, on a plot of land previously believed to have been a cattle market.26
At the conclusion of Gardens of Pompeii (Oxford University Press, 2000), Annamaria Ciarallo writes:
[In Pompeii,] the great importance of viticulture and wine production was not due solely to the popularity of wine that was consumed for pleasure. It was an extremely important basic constituent of the so-called medicated wines, which had been steeped with plant essences containing active ingredients. Medicated wines were kept in the home pharmacy as medicines to treat short-lived ailments, such as stomach ache, cough or insomnia. This practice demonstrates how one could arrive in an intuitive manner at knowledge of the extractive capacity of alcohol, even though its nature obviously remained unknown.27
Though investigations at Pompeii have not yet yielded information on the use of wine for medical purposes, one ancient library, with papyri still relatively intact, is still being investigated, and a quarter of the ancient city remains unexcavated.
Approximately a century after Pliny died at Pompeii in 79, Galen (129–ca. 216) became the last dominant figure in the Greco-Roman medical tradition known for employing wine as one of his most essential therapeutics. In History of Pharmacy (J.B. Lippincott & Co., 1949), Kremers and Urdang wrote:
Galen was the first physician if not the first scientist to explain that observation and experiment are the principal sources of knowledge and to act accordingly…. With Galen, the Greco-Roman epoch of medicine and pharmacy reached its climax. For a long time, it was essentially his treatises and the materia medica of Dioscorides which in innumerable copies, commentaries and extracts … disseminated medical and pharmaceutical wisdom throughout the western world.28
So widely renowned was Galen that he served as personal physician to several Roman emperors, including Marcus Aurelius (121–180). But the most formative experience of his career was when he served three years as surgeon to the gladiators in his native Pergamon (on the western coast of present-day Turkey). His observations and treatments of injured fighters provided unparalleled insight into the human body and the form and functions of organs. He referred to the terrible gladiatorial wounds he treated as “windows into the body.”29
Galen was a major proponent of wine as medicine, particularly as an anti-infective wound dressing. He used wine to clean out fistulous abscesses. In cases in which gladiators had been eviscerated, he soaked the exposed organs in wine before stuffing them back into the abdominal cavity and then sewing up the wound.1,11
Galen’s legacy was profound: a system of diagnosis and treatment that dominated Western medicine for well over a thousand years. Some of his therapeutic formulations of natural products, many of which contained wine, were known as Galenicals. Today, the term more commonly refers to preparations consisting of one or several natural ingredients but still pays homage to this medical pioneer.
Importance of Wine in Christianity and Islam
As the Christian world began to develop, wine maintained an important role, especially as a symbol. Jesus called himself “the true vine,” (John 15:1) and his first miracle was turning water into wine. No other plant besides the wine grape is more intimately associated with his life and ministry.5 At the Last Supper, Jesus declines the wine on offer, preferring to wait until he can consume it in the Kingdom of his Father (Luke 22:18).j
The early accounts of Christianity such as the New Testament feature many mentions of wine but markedly fewer references to therapeutic uses than the Hebrew texts that precede them. One famous exception is the Parable of the Good Samaritan in the Gospel of St. Luke, in which the Samaritan rescues a traveler beaten by robbers and applies olive oil and wine to his wounds. According to physician and wine historian Philip Norrie, St. Luke was originally a Greek physician and would therefore have known of the efficacy of wine as an antiseptic from the teachings of Hippocrates, and possibly Pliny and Dioscorides.31
Writers as diverse as Herodotus and Omar Khayyam (1048–1131) documented the Persians’ devotion to wine. Hafez (1315–1390) — one of the most beloved of the mystic Persian poets, who was born and died in the city of Shiraz, formerly known as Persia’s city of wine — composed poetry on the joys of love and wine. The Greek soldier-philosopher Xenophon, who fought both for and against the Persians, noted that they were well-aware of the antiseptic value of wine. Northwest Iran extends into the Caucasus region where winemaking originated. Zoroastrianism, the original major religion of Persia, starting around 500 BCE or earlier, was not opposed to wine.4
With the rise of Islam and its spread into Persia, the prohibition of alcohol led to many changes in this part of the cradle of viticulture and brought challenges for Persian and Arabic physicians. The Quran seemingly prohibits alcohol and therefore presented Arab physicians with a dilemma.
Much of Islamic medicine was influenced by Greek and Roman texts written by healers like Galen who championed the therapeutic value of wine. Muslim healers like Rhazes (Abū Bakr Muhammad ibn Zakariyyā al-Rāzī; 854–925) and Avicenna (Ibn Sina; 980–1037) used wine primarily for external purposes such as wound dressings. The first distillation of wine is believed to have been conducted by the Muslims (possibly by Rhazes); the process markedly increases the alcohol content and made possible the invention of hard liquor — an unintended irony.
More than any other plant or plant product, wine was regarded almost as a panacea in the ancient Mediterranean world. It was used as an analgesic, antibiotic, antidiarrheal, aphrodisiac, diuretic, menstruum, and soporific. Wine also was used to treat anxiety, asthma, cardiac problems, digestive problems, epilepsy, insect stings and spider bites, jaundice, respiratory problems, and wounds and to purify water. Several of these uses appear repeatedly in the historical record, undoubtedly due to the fact that wine is highly effective in some instances as an antimicrobial, painkiller, water sanitizer, and wound disinfectant.
Today, we know that wine, when included as a moderate addition to the diet, can reduce the risk of cardiovascular disease and may help ward off certain cancers as well. Research on wine’s health benefits continues, including analyses of single components like resveratrol and its holistic benefits as part of the Mediterranean diet.32
It likely has been more than 10,000 years since the world’s first wine culture emerged, but the appeal of this ancient beverage has endured. Socrates, quoted by Xenophon, observed: “Wine does in fact moisten the soul and lulls our pains to sleep … it revives our joys, just as oil does a flame.”33
I would like to dedicate this paper to four great teachers: the late Aritana Yawalapiti of the Xingu Indigenous Reserve (Brazil); Patrick McGovern, PhD, of the University of Pennsylvania; John Riddle, PhD, of North Carolina State University; and the late José de los Santos Sauna Limaco of the Sierra Nevada (Colombia).
The author and the American Botanical Council (ABC) would like to thank expert historian Alain Touwaide, PhD, Scientific Director of the Institute for the Preservation of Medical Traditions, for his contributions to this article.
Mark Plotkin, PhD, LHD, is an ethnobotanist who serves as the president of the Amazon Conservation Team (www.amazonteam.org). His most recent book is The Amazon: What Everyone Needs to Know, published by Oxford University Press (2020). He is a longtime member of the ABC Advisory Board.
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- Gore R. Who were the Phoenicians? New clues from ancient bones and modern blood. October 2004. Center for Democracy in Lebanon website. Available at: www.democracyinlebanon.org/Documents/CDL-Documentaries/Phoenicians(NatGeo).htm. Accessed September 27, 2020.
- Ballard RD, Stager LE, Master D, et al. Iron Age shipwrecks in deep water off Ashkelon, Israel. American Journal of Archaeology. 2002;106(2):151. doi:10.2307/4126241.
- Ferentinos G, Fakiris E, Christodoulou D, et al. Optimal sidescan sonar and subbottom profiler surveying of ancient wrecks: The ‘Fiskardo’ wreck, Kefallinia Island, Ionian Sea. Journal of Archaeological Science. 2020;113:105032. doi:10.1016/j.jas.2019.105032.
- McGovern PE, Mirzoian A, Hall GR. Ancient Egyptian herbal wines. Proceedings of the National Academy of Sciences. 2009;106(18):7361-7366. doi:10.1073/pnas.0811578106.
- Nunn JF. Ancient Egyptian Medicine. London: British Museum Press; 1996.
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- McGovern PE, Fleming SJ, Katz SH. The Origins and Ancient History of Wine. Amsterdam: Routledge; 1996.
- Mark JJ. Beer in the ancient world. September 15, 2020. Ancient History Encyclopedia website. Available at: www.ancient.eu/article/223/beer-in-the-ancient-world/. Accessed September 27, 2020.
- Hyams E. Dionysus: A Social History of the Wine Vine. New York: Macmillan; 1987.
- Fleming SJ. Vinum: The Story of Roman Wine. Glen Mills, PA: Art Flair; 2001.
- Varriano J. Wine: A Cultural History. London: Reaktion Books; 2011. David A. Remains found by Pompeii really are Pliny the Elder, new tests indicate. January 23, 2020. Haaretz. Available at: www.haaretz.com/archaeology/.premium-remains-found-by-pompeii-really-are-pliny-the-elder-new-tests-indicate-1.8439072. Accessed September 27, 2020.
- Jashemski WF. The Gardens of Pompeii: Herculaneum and the Villas Destroyed by Vesuvius. New Rochelle, NY: Caratzas Brothers; 1979.
- Ciarallo A. Gardens of Pompeii. Malibu, CA: J. Paul Getty Museum; 2000.
- Kremers E, Urdang G. History of Pharmacy: A Guide and Survey. New York: J.B. Lippincott & Co.; 1951.
- Jackson R. Doctors and Diseases in the Roman Empire. London: British Museum Press; 2000.
- Muraresku BC. The Immortality Key: The Secret History of the Religion with No Name. New York: St. Martin’s Press; 2020.
- Norrie P. History of Wine as a Medicine: From Its Beginnings in China to the Present Day. Newcastle, UK: Cambridge Scholars Publishing; 2020.
- Sandler M and Pinder R. Wine: A Scientific Exploration. London: Taylor & Francis; 2003. Xenophon. The Symposium. 224.
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