BMJ  2007;335:1302-1304 (22 December), doi:10.1136/bmj.39420.333565.BE

Altered states

Classically intoxicated: correlations between quantity of alcohol consumed and alcohol related problems in a classical Greek text

¹ Department of Theology and Religion, Durham University, Durham DH1 3RS, ² Department of Classics and Ancient History, Durham University, ³ Institute of Psychiatry, King’s College London

From fragments of a play, Christopher Cook, Helen Tarbet, and David Ball discover that you couldn’t teach the ancient Greeks much about drunkenness

Contemporary discourse about the misuse of alcohol asserts that wise people use alcohol respectfully, appropriately, and moderately whereas unwise people cause harm by inappropriate and immoderate consumption. This is implicit in the foreword to the UK government’s Alcohol Harm Reduction Strategy for England written by the then prime minister Tony Blair.¹ We consider a classical text in which an early form of this message about drinking may be identified.

Drinking in classical Greek society

Drinking in classical Greek society (about the 5th and 4th centuries BC) took place in various contexts.² The symposium provided men in the higher echelons of society with a formal social context for drinking. After dinner, groups of between about 14 and 22 men, but sometimes as many as 30, reclined on couches around a room to engage in drinking, conversation, and song. A cup of wine was initially passed around as a libation to the divinity, but subsequently the wine was diluted with 50% to 75% water,^{3 4} mixed in a large bowl or krater.

A slave ladled the diluted wine into a jug and then poured the wine into the guests’ cups; alternatively, a cup of the diluted wine was passed around. Guests were expected to consume equal amounts of wine during the evening, the amount being determined both by discussion beforehand and by the pace set by the symposiarch as the evening progressed. Three kraters seem to have been deemed a reasonable quantity for the evening. Moderate drinking was understood as facilitating conversation, which was supposed to predominate over drinking, but that is not to say that drinking did not take pre-eminence sometimes.

For the lower echelons of society wine was sold in the tavern in larger quantities for consumption at home, or else in smaller and diluted quantities for consumption on the premises. Drinking in the tavern was not in the ordered manner of the symposium.

Fragments of a comic play

The relation between alcohol consumption and alcohol related problems is described in a play attributed to Eubulus, a Greek comic poet of the 4th century BC. The play is not necessarily to be taken seriously but it does betray the assumptions and world views of the society in which it was written.

The title of this play is traditionally given as Semele or Dionysus. According to Greek mythology, Semele was the human mother of Dionysus, the Greek god of wine (his father was Zeus). Dionysus (in Roman mythology known as Bacchus) was a more complex and subtle character than the commonly held view suggests. Dionysian ecstasy was not merely drunkenness but a state of divine possession, in which humans might behave in an emotional and uncharacteristic way; in the worst imaginable scenario committing violent acts (as in the tragic play The Bacchae, by Euripides). However, little is known about what happened at Dionysiac rites.

Three fragments of the play survive (box).⁵

Three fragments of the play The fragment known as Fragment 93 describes the successive consumption of between one and 10 kraters of diluted wine. Dionysus speaks, apparently in the role of symposiarch: "I mix three kraters only for those who are wise. One is for good health, which they drink first. The second is for love and pleasure. The third is for sleep, and when they have drunk it those who are wise wander homewards. The fourth is no longer ours, but belongs to arrogance. The fifth leads to shouting. The sixth to a drunken revel. The seventh to black eyes. The eighth to a summons. The ninth to bile. The tenth to madness, in that it makes people throw things."

Evidence is lacking for a krater being a standard measure equivalent to the contemporary notion of a "unit" of alcohol. Inspection of the kraters on display in the British Museum in London suggests that they were variably sized but potentially quite large—more like a fruit bowl than a wine glass—and that they were shared among a variable number of guests. None the less, the description of the effects of between one and 10 kraters of wine suggests a recognition of the progressive effects of alcohol on humans, proportionate to the amount consumed.

Classical understanding of the progressive effects of alcohol

The effects of each successive krater of wine are portrayed in the text by nouns used in the genitive form. The first four nouns, associated with the first three kraters, are unambiguously positive (figure).

View larger version (22K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   Effects of successive kraters of wine

 
Traditionally three toasts were drunk before a symposium, with the third toast usually being drunk to Hygeia, the goddess of health. It is not clear why Hygeia comes first in the text, but the Greek is ambiguous and can equally be taken to imply that the first krater belongs simply to "health" rather than to Hygeia. In any case this text refers to the appropriate number of kraters to be consumed during a symposium and not to the preceding toasts.

After the first three kraters, Dionysus suggests that the one who is wise will go home. The implied threshold is therefore three kraters of diluted wine, below which drinking is enjoyable and healthy and above which it is unwise to proceed. The effects of subsequent kraters of wine are all negative (figure).

It might be possible to infer a progression, from relatively minor adverse consequences of hubris and shouting through to being both the victim and the perpetrator of violence who is taken to court, through to eventual madness or possession. In this text, however, Dionysus has disclaimed responsibility for this "possession." It was his advice that the drinker should go home after only three kraters of wine. Furthermore, in fourth century Greek law, hubriswas a civic offence that covered physical assault and perhaps also rape and adultery, as well as a host of more minor offences. According to Aristotle, men were thought to have committed hubris not because of an innocent excess of high spirits or a desire to redress some balance but because they wanted to take pleasure from degrading another person. The more serious offences were liable to severe penalties imposed by courts. It is therefore possible that the successive effects of the fifth through to the 10th kraters of wine are all to be understood as the results of hubris.

Although the description of the effects of these additional kraters of wine is unambiguously negative, there is still room to see a possible division of opinion within classical Greek society that mirrors the division of opinion in contemporary Western society. The "drunken revels", associated with the sixth krater, relate to the end of the evening, when the party leaves the symposium and spills out on to the streets. This part of the evening was often the occasion for acts of vandalism and violence (hence the reference to black eyes and the inference of a possible court appearance) but the evening could also pass off relatively peacefully—apart from waking the neighbours! It carried a sense of enjoyable revelry as well as of being an antisocial vice, just as contemporary youth culture might see getting drunk as a good way to spend a Saturday evening out, despite the disapproval of wider society.

The black eyes (or literally "under the eyes") associated with the seventh krater might be understood as descriptive of the baggy eyes of someone who has a hangover, or else of the black eyes of a victim of assault. The effects of the eighth krater are described in terms of being a witness—a legal term that implies involvement in a law suit. The association of the next krater with anger employs a word that usually refers to excessive anger, or anger experienced in a physical sense (as "bile"). This sequence thus carries an implication of involvement in court proceedings as a result of violence and of the risk of being both the victim and the perpetrator of violence.

The "mania" attributable to the final (10th) krater is said to cause the drinker to throw, but no object is specified. In some translations (www.physics.uq.edu.au/people/nieminen/alcliterature.html#dionysos and www.winterscapes.com/sannion/wine.htm) the throwing of furniture is specified, although the basis for such an inference is not clear. One study⁶ refers to the traditional understanding that madness was associated with the throwing of stones. Possibly an association or similarity was implied between drunkenness and madness. The author notes that the "black bile" or anger, attributed to the immediately preceding (ninth) krater of wine, was thought to cause madness.

In the final lines of the fragment of the text we are told that, much wine having been poured into one "small vessel," the drinkers will find their legs "pulled from under them." The reference to a small vessel is ambiguous. It might refer to the one krater filled 10 times over but it might also refer to the drinker as a metaphorical vessel. Similarly, the reference to the legs of the drinkers being pulled from under them (the word being that used in wrestling) has a possible double sense of both a literal and metaphorical inability to stand any longer.

Alcohol misuse—ancient and modern

The idea that alcohol may be used or misused is an ancient one, as are the observations that the effects of alcohol vary according to the amount consumed and that more harmful and undesirable effects are more likely to appear the greater the amount consumed. This understanding would seem to correlate well with everyday observation and asserts the primacy of reason and will over personal behaviour. It suggests that our decisions about our drinking behaviour are what determines observable alcohol related harm.

Contemporary research might well be said, to an extent, to support this distinction between alcohol use and misuse. It is interesting to note, however, that educational measures designed to reinforce moderate or "sensible" drinking actually have little, if any, observable effect in terms of reduced alcohol related harm.⁷ Perhaps the wisdom of classical civilisation, appealing to our desire to understand ourselves as being in control of our own destiny, seems more attractive to us as a basis for alcohol policy than the findings of empirical research?

Summary points The nature, severity, and risk of alcohol related problems are correlated with the amount of alcohol consumed by an individual The classical world was aware of this relation, as is contemporary society This relation is the basis of the "sensible drinking" message It therefore appeared in antiquity, as it does today, that the wise person will use alcohol moderately and appropriately Despite this, educational measures designed to promote sensible drinking are not based on evidence

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We thank Diana Barclay and Ian McEwen for their helpful comments and Ian McEwen for his translation of the Greek text.

Competing interests: None declared.

Contributors and sources: CCHC has worked for over 20 years in the addictions field, mainly with a clinical and research interest in alcohol misuse. He is particularly interested in spirituality and addiction and has traced the ethical and theological understandings of alcohol misuse in the Christian tradition from their origins in early Jewish and Greco-Roman society. He undertook the major role in drafting and redrafting the paper. HT was, until recently, a postgraduate student in classics at Durham University. She provided classical scholarly input to the writing of the paper and alerted us to the existence of Davidson’s useful book. DB is a senior lecturer and honorary consultant psychiatrist with an interest in alcohol misuse, and has undertaken research into the genetic basis of alcohol related problems. The original idea of writing this paper was his. CCHC and DB are guarantors of this paper.

Provenance and peer review: Not commissioned; externally peer reviewed.

References

1. Prime Minister’s Strategy Unit. Alcohol harm reduction strategy for England. London: Strategy Unit, 2004.
2. Davidson J. Courtesans and fishcakes: the consuming passions of classical Athens. London: Harper Collins, 1997.
3. Hunter RL. Eubulus: the fragments. Cambridge: Cambridge University Press, 1983:186.
4. Rolleston JD. Alcoholism in classical antiquity. Br J Inebriety 1927;24:101-20.
5. Kassel R, Austin C, eds. Poetae comici graeci. v 5. Berlin: Walter de Gruyter, 1986.
6. Hunter RL. Eubulus: the fragments. Cambridge: Cambridge University Press, 1983:189.
7. Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, et al. Alcohol: no ordinary commodity. Oxford: Oxford University Press, 2003:189-207.

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