Was Hippocrates the first to describe an epidemic caused by methanol poisoning?
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Abstract
During the COVID-19 pandemic, the world witnessed an increase in deaths and hospitalisations due to methanol poisoning associated with accidental exposure to this toxic form of alcohol. Fake news spread through the social media that drinking alcohol or hand sanitizers can be protective against COVID-19 infection. As a consequence, in Iran 6,000 people were hospitalised and as many as 800 people lost their lives due to methanol poisoning. Some of the victims were children and teenagers. Drinking methanol contaminated alcoholic beverages kills thousands of people each year. Methanol is deliberately added to beverages as it is cheaper than ethanol. However, methanol can also be produced naturally in foods such as wines and fruit juices and its concentration in wine and spirits is strictly regulated in many countries around the world. To the authors best knowledge, there are no description of ancient epidemics caused by methanol poisoning. Here it is suggested that Hippocrates is the first person to describe a methanol poisoning epidemic. In his first book of Epidemics, Hippocrates describes the following symptoms that fits perfectly well with what is currently known about methanol poisoning. The following is taken from the translation by Francis Adams (Book I, Section II): “Pains about the head and neck, and heaviness of the same along with pain, occur either without fevers or in fevers. Convulsions occurring in persons attacked with frenzy, and having vomitings of verdigris-green bile, in some cases quickly prove fatal. In ardent fevers, and in those other fevers in which there is pain of the neck, heaviness of the temples, mistiness about the eyes, and distention about the hypochondriac region, not unattended with pain, hemorrhage from the nose takes place, but those who have heaviness of the whole head, cardialgia and nausea, vomit bilious and pituitous matters; children, in such affections, are generally attacked with convulsions, and women have these and also pains of the uterus; whereas, in elder persons, and those in whom the heat is already more subdued, these cases end in paralysis, mania, and loss of sight”. Nearly all of the symptoms described are those seen with methanol poisoning that are currently well known. The source of methanol could be wine which was not only drunk for pleasure but was also an important medicine used by Hippocrates and others in ancient Greece. It is well known that methanol can be produced from grapes during fermentation and its concentration can increase when it is produced from grapes contaminated with fungus. It is possible, that the epidemic described by Hippocrates in his first and third book relates to poisoning from unusually higher levels of methanol in wine and other beverages produced from contaminated grapes. Over 25 centuries after his death, detailed observations made by Hippocrates continues to influence modern medicine and medical history in diverse ways.