The product of natural fermentation was discovered by man in prehistoric time and was soon followed by deliberate pro duction of wines and beers from sugary and starchy plants. Primitive alcoholic beverages served as foods, medicines, and euphoriants, in religious symbolism and social facilitation. They alsocaused such recognized troubles as diseases (including alcoholism itself), accidents, and quarrels, and they came under early social regulation, but the benefits sufficiently out weighed the

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... costs that occasional attempts to banish them usually failed. Records of peoples from all over the world reveal essentially the same repetitious history up to modern times. Distillation provided a more potent intoxicant, a more efficient anesthetic-euphoriant, and more dangerous pathogen; this in tensified but did not essentially change the problems surround ing alcohol. A further intensification of problems occurred with industrialization and with frontier conditions in America. This led to the growth of an organized political antialcohol movement and to prohibition. As in several other countries, prohibition failed in America when large segments of the population per sisted in resorting to illegal supplies of alcohol. The repeal of prohibition was followed by new recognition of the scope of alcoholism and its associated diseases, including alcoholic encephalopathies, liver cirrhosis, a fetal alcohol syndrome, and cancer of the aerodigestive tract. To enlist science in newer attempts to cope with the problems of alcohol misuse, a multi disciplinary Center of Alcohol Studies with a systematization of the knowledge about alcohol was founded; a National Institute on Alcohol Abuse and Alcoholism as well as additional centers specializing in research on alcohol have been established; and public health educational efforts aiming at prevention have been launched. This overview of the history of the use, misuse, and effects of alcohol requires an exposition of some 50,000 years of history in less than 50 minutes. It is appropriate to begin, then, with the paraphrase of a famous brief statement: In the beginning there was alcohol. It is hard to understand why the human liver should be endowed with enough alcohol dehydrogenase, the enzyme that catalyzes the first step in the oxidation of alcohol and does not seem to have very much else to do, to metabolize a quart of whisky a day unless alcohol was amply present in the dietary of man, or of his ancestors, in remote evolutionary time. From this suggestion, we must leap over eons to a period when homo is sapient, living in what the paleohistorians call the gathering stage, but does not yet have alcohol. By chance, some fruits or berries, quite possibly grapes, have been left unattended in a @