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Bitter medicine: gout and the birth of the cocktail

2012; Elsevier BV; Volume: 379; Issue: 9824 Linguagem: Inglês

10.1016/s0140-6736(12)60586-8

1474-547X

Richard Barnett,

American Sports and Literature

Most of us know that the gin and tonic, with its quinine-laced tonic water, is one outcome of three centuries of military and medical efforts to overcome malaria. But another disease—gout, the classic complaint of Enlightenment consumer culture—inspired the creation of a key ingredient in modern cocktails. Gout was to the 18th century what melancholy was to the high Renaissance, or stomach ulcers were to the 1950s. When they were not examining a Hogarth print or conversing in a coffee-house, men from the Hanoverian middle classes might well have been consulting a physician about a nasty episode of the gout. Typically gout struck a joint in the big toe or thumb, but 18th-century physicians understood it as a mutable condition, one that might move around the body and cause headaches or heart palpitations. Like so many diseases, gout had a double face: although it caused agonising pain, it was also seen to indicate a certain degree of civilisation, luxury, ease, even literariness. Just as John Keats rejoiced when he saw spots of tuberculotic blood in his handkerchief, so an 18th-century merchant might feel a certain pride when he suffered his first bout of gout; it was a sign that he had made it. Many 18th-century doctors took their cues on gout from the physician George Cheyne. Cheyne saw gout as the result of blood stagnating in the extremities, and in this sense it was a kind of bodily safety valve: the substances that precipitated from the blood in the fingers and toes might have caused more serious mischief if they had been released within the major organs. Cheyne in turn adapted many of his ideas about gout from Thomas Sydenham, the 17th-century “English Hippocrates”. Sydenham's Treatise on the Gout, published in 1683, argued that gout was the result of “ease, voluptuousness, high living, and too free an use of wine and other spirituous liquors”. Bleeding and purging could, he thought, be counterproductive, driving “peccant humours” further into the extremities. Instead he recommended a light diet, plenty of fluid, and regular doses of a digestive remedy he called bitters—distilled alcohol infused with watercress, horseradish, wormwood, and angelica root. Sydenham's bitters became a popular remedy for gout—not least because they gave sufferers an excuse to take nips of strong spirit during attacks—and other practitioners sought to emulate their success. In 1712 a recipe for Stoughton's Elixir, devised by the Reverend Richard Stoughton, became one of the first medicines to receive a British royal patent. Stoughton's bitters became a successful British export to the American colonies, and after the War of Independence distillers in Boston were quick to produce a native version. And in 1783 Nicholas Husson, an officer in the French army, began to sell bitters that included an extract of meadow saffron, Colchicum autumnale—one component of which, colchicine, is now known to block the metabolic pathways that cause gout. Following Stoughton's example, another group of practitioners—quacks—took patent medicines in a more nakedly commercial direction. Travelling from town to town, quacks offered flashy, inexpensive remedies that promised instant results. They were showmen and bricoleurs, patching together their credibility from whatever came to hand, and they could work the crowd like a hellfire preacher. Their nostrums were usually based on spirit, coloured and flavoured with vegetable dyes, spices, and substances ranging from malt extract to strychnine. Dr Radcliffe's Famous Purging Elixir, Bateman's Pectoral Drops, Daffy's Elixir, Godfrey's Cordial, Radcliffe's Royal Tincture—all drew on the fiery potency of alcohol, and all had more in common with Sydenham's bitters than most physicians would have cared to admit. By the middle of the 18th century, these spirit-based tonics were in wide use as a way to improve the flavour of cheap, fiery gin. A recipe for bitters from Adam's Luxury and Eve's Cookery, published in 1744, contained gentian root, dried orange peel, Virginia snake root, plus: “half a dram of cochineal and half a dram of loaf sugar. This last will heighten the Bitter to admiration. A few drops of this bitter in a glass of wine or other liquor is good to create an appetite.” Henry Sabine's Publican's Sure Guide (1807), offered a recipe for bitters specifically intended to be mixed with gin. Similarly, Peter Jonas and John Sheridan's Complete Treatise on the Art of Distillation (1830), gave instructions for making bitters from “common gin” mixed with essential oils of lemon, wormwood, and orange: “This will be a most pleasant cheap bitter, equally wholesome, and as good as many that are much dearer. This is only fit to be taken with gin. The same ingredients, and rectified malt spirits, or molasses spirits, will either of them make a bitter of more general use.” But bitters also took on a new role in the 19th century, as western soldiers, sailors, and colonial migrants sought a tonic that would help their bodies adjust to the extremes of tropical climates. The range of botanicals was widened to include not only cinchona bark, the source of quinine, but also such novelties as angostura bark, cascarilla, artichoke leaf, blessed thistle leaves, goldenseal rhizome, wormwood leaves, and yarrow flowers. The Scientific American Cyclopedia of Receipts, Notes and Queries, published in 1898, advised readers contemplating a long voyage to make up a simple bitters a month or so before they planned to leave, comprising of quassia chips, powdered catechu, cardamom, dried orange peel, strong whiskey, and water. John Rack's French Wine and Liquor Manufacturer, published in 1868, listed eight recipes for medicinal bitters. His “Stomach Bitters” were intended to relieve sea-sickness, and were sweetened with syrup and flavoured with cardamom seed, nutmegs, grains of Paradise, cinnamon, cloves, ginger, galangal, orange peel, and lemon. And what tropical traveller would dare to embark without a bottle of Rack's “Amazon Bitters (A SPLENDID Recipe)”, which included red Peruvian bark, calisaya bark, calamus root, orange peel, cinnamon, cloves, nutmeg, cassia buds, and “red saunders” (sandalwood)? By the late 19th century, however, the most popular bitters were not home-brewed, but made by two companies: Peychaud and Angostura. Antoine Amedee Peychaud was born in 1803, into a wealthy family of coffee planters. Originally from Bordeaux, the Peychauds owned large and lucrative plantations in what is now Haiti. Their estate was destroyed during the Haitian Revolution of 1804, but they and the infant Antoine fled to New Orleans, and made a new life for themselves in the French Quarter of the city. After training as an apothecary, Peychaud opened a pharmacy at 123 Royal Street, where he began to make and sell his own proprietary brand of bitters, flavoured with gentian. (One story has Peychaud inventing the cocktail, by dispensing his bitters to customers in a glass known as a coquetier, but in fact the cocktail was several decades old by the time Peychaud went into business). By the 1840s, Peychaud was marketing his bitters both as a digestive and as a general tonic, and by the time of his death in 1883 they had supplanted Stoughton's as the American bitters of choice. Peychaud's bitters were sold around the world, but British drinkers tended to prefer the bitters developed by a German doctor, Johann Gottlieb Benjamin Siegert. In the early 1820s, Siegert went to South America to serve in Simón Bolívar's revolutionary army, and settled in the Venezuelan river port of Angostura (now Ciudad Bolívar). Spotting a business opportunity, he devised a new recipe for bitters, and marketed it as a treatment for sea-sickness among the crowds of foreign sailors in the city. By 1830 he had made enough money to set up a factory, and the officers of Royal Navy ships visiting Angostura took up Siegert's tonic with great enthusiasm. At some point in the 1840s—the precise date and circumstances are unknown—they started to drink their favoured Plymouth gin with a dash of Angostura bitters. The Pink Gin was originally served at room temperature, although most bars now serve it shaken over ice, and for abstainers a long version, the Campbell, was made with lemonade standing in for the gin. Officials in the Indian Civil Service spiced it up by adding onions pickled with chilli—a Gin Piaj—and in colonial Malaya, where stomachs seem to have required more soothing, the Gin Pahit (“bitter gin” in Malay) upped the quantity of bitters from a dash to one part in three. The Pahit makes several passing appearances in the early short stories of William Somerset Maugham, where it becomes one of the fixtures of colonial life, and Maugham revealed his personal fondness for gin and bitters in his travelogue The Gentleman In the Parlour, published in 1930. And from time to time Royal Navy ships still fly the green-and-white “gin pennant”—an invitation to come aboard and take a glass of “Pinkers”. Although the “drug cocktail” remains a potent medical metaphor, a 21st-century physician is unlikely to prescribe a soothing glass of gin and bitters. But the strange story of the birth of the cocktail takes us back to a time when the boundaries between medicine and culture were more flexible and more porous. Emerging as they did from the first flowering of consumer culture, bitters bridged the boundary between the home-prepared remedies of early modern times and the mass-produced pharmaceuticals of the 19th century. They were brewed and prescribed by the most elite physicians and the most venal quacks. And they fortified the minds (if not the livers) of generations of European colonists. Their story reveals the many faces of medicine in the age of the Enlightenment.