Alcohol

Ketuvot 65a ~ Too Drunk To Say No

In today's daf, the Talmud is discussing the provisions that an absent husband must legally provide for his wife, at least until his return home. Wine is not to be provided - unless the woman is used to drinking it (רגילה שאני). In this case, she may be given a single cup of wine, even though her husband is not at home. And then comes this teaching:

תנא: כוס אחד יפה לאשה, שנים ניוול הוא, שלשה תובעת בפה, ארבעה אפילו חמור תובעת בשוק ואינה מקפדת

One cup of wine is good for a woman; two is a disgrace; if she drinks three cups of wine she will verbally demand marital relations. And after four cups of wine a woman will solicit even a donkey in the marketplace, and she could not care...

The Effects of Alcohol on Sexual Desire

The pharmacological effects of alcohol have been extremely well studied.  Although in popular culture alcohol is thought to be a sexual stimulant, its physiological effects actually reduce sexual arousal. Alcohol also causes disinhibition, making those who have been drinking more likely to engage both in sex, and in sexual risk-taking. Alcohol has depressant effects and caused its disinhibition in all the animals models in which it has been tested, including, most recently, the nematode, c. elegans. It is these effects that the Talmud is referencing here, in so far as they effect only women. (Men's sexual desire and sexual performance is also affected by alcohol, but since this is not the subject of the discussion in the daf, we won't go there.) 

...alcohol specifically disinhibited these behaviors [locomotion, feeding and escape] in worms...
— Topper SM, et al. (2014) Alcohol Disinhibition of Behaviors in C. elegans. PLoS ONE 9(3): e92965. doi:10. 1371

Too Drunk To Say No

The Talmud describes an effect of too much alcohol: it causes such a degree of sexual disinhibition that an intoxicated women looses all sense of propriety. In fact, she gets so drunk that she is prepared to commit bestiality.  In the United Kingdom three high profile court cases (the Dougal case-November 2005, the Hagan case-November 2006, and the Bree case-December 2006) illustrated the talmudic supposition in today's daf. In all cases the women who were raped were heavily intoxicated and the defendants, who admitted having had sexual intercourse but denied rape, were acquitted. If a woman is drunk, her no doesn't mean NO

Writing in the Stanford Law Review, Karen Kramer outlined ways which cultural myths surrounding alcohol and the place of men and women in society converge to produce a double standard. If the rapist was drunk, it reduces his culpability; if the victim was drunk, it increases her culpability.

Expectancy beliefs about alcohol - which include the beliefs that alcohol increases sexual arousal, loosens women's sexual inhibitions and increases men's feelings of power and dominance - interact with traditional notions of male aggressiveness and female submission  to set the stage for acquaintance rape. When a woman is visibly intoxicated a man may interpret friendly or flirtatious behavior an invitation to have sex. Believing that alcohol reduces a women's inhibitions, the man may read her behavior as a demonstration of her true but disguised desire for sexual activity.  Even if she fails to become physically affectionate, since alcohol is a depressant, the woman may be less able to resist unwanted sexual advances. Her lack of resistance may sound like a resounding "yes" to a man who subscribes to the tradition model of male aggression and female submission.  Moreover if the man is drinking as well, he may feel safe disregarding her will,because he knows that he can blame his aggressionon the alcohol. This is not to say that any sexual interaction between intoxicated individuals constitutes rape, but drinking does enable a man to overpower an unwilling woman while feeling confident that he can blame his own actions on the alcohol.

Over  twenty years ago, the journalist Helen Benedict in her book Virgin or Vamp described the myth of our culture in which women who drink too much are "asking for it." I had no idea that the myth could also be found embedded in our Talmud. 

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Ketuvot 10b ~ More than You Ever Wanted to Know about the Barrel Test

On tomorrow’s page of Talmud, we will read the following:

כתובות י, ב

הַהוּא דַּאֲתָא לְקַמֵּיהּ דְּרַבָּן גַּמְלִיאֵל בַּר רַבִּי אֲמַר לֵיהּ רַבִּי בָּעַלְתִּי וְלֹא מָצָאתִי דָּם אֲמַרָה לֵיהּ רַבִּי עֲדַיִין בְּתוּלָה אֲנִי

אָמַר לָהֶן הָבִיאוּ לִי שְׁתֵּי שְׁפָחוֹת אַחַת בְּתוּלָה וְאַחַת בְּעוּלָה הֵבִיאוּ לוֹ וְהוֹשִׁיבָן עַל פִּי חָבִית שֶׁל יַיִן בְּעוּלָה רֵיחָהּ נוֹדֵף בְּתוּלָה אֵין רֵיחָהּ נוֹדֵף אַף זוֹ הוֹשִׁיבָה וְלֹא הָיָה רֵיחָהּ נוֹדֵף אָמַר לוֹ לֵךְ זְכֵה בְּמִקָּחֶךָ

The Gemara relates: A certain man who came before Rabban Gamliel bar Rabbi Yehuda HaNasi said to him: My teacher, I engaged in intercourse and did not find blood. The bride said to him: My teacher, I am still a virgin.

Rabban Gamliel said to them: Bring me two maidservants, one a virgin and one a non-virgin, to conduct a trial. They brought him the two maidservants, and he seated them on the opening of a barrel of wine. From the non-virgin, he discovered that the scent of the wine in the barrel diffuses from her mouth; from the virgin he discovered that the scent does not diffuse from her mouth. Then, he also seated that bride on the barrel, and the scent of the wine did not diffuse from her mouth. Rabban Gamliel said to the groom: Go take possession of your acquisition, as she is a virgin.

And so there was a happy ending to the story, and thus began the couple on a journey of happiness and mutual trust.

Another case of the Barrel TesT

In the last, bloody chapter of the Book of Judges, the civil war against the tribe of Benjamin reaches its climax. For reasons that we don’t have time to get into, four hundred virgins were captured from the town of Yavesh Gilad, and offered as a peace offering to the men of Benjamin.

21:12 שופטים

וַֽיִּמְצְא֞וּ מִיּוֹשְׁבֵ֣י ׀ יָבֵ֣ישׁ גִּלְעָ֗ד אַרְבַּ֤ע מֵאוֹת֙ נַעֲרָ֣ה בְתוּלָ֔ה אֲשֶׁ֧ר לֹא־יָדְעָ֛ה אִ֖ישׁ לְמִשְׁכַּ֣ב זָכָ֑ר וַיָּבִ֨אוּ אוֹתָ֤ם אֶל־הַֽמַּחֲנֶה֙ שִׁלֹ֔ה אֲשֶׁ֖ר בְּאֶ֥רֶץ כְּנָֽעַן׃

They found among the inhabitants of Jabesh-gilead 400 maidens who had not known a man carnally; and they brought them to the camp at Shiloh, which is in the land of Canaan

How, wondered the rabbis on that page of Talmud, did the soldiers know who was, and who was not, a virgin? Easy, said Rav Kahana, who lived in Babylon around the year 250 CE. All you need is a barrel of wine and a good sense of smell.

יבמות ס, ב

מְנָא יָדְעִי? אָמַר רַב כָּהֲנָא: הוֹשִׁיבוּם עַל פִּי חָבִית שֶׁל יַיִן, בְּעוּלָה — רֵיחָהּ נוֹדֵף, בְּתוּלָה — אֵין רֵיחָהּ נוֹדֵף

How did they know that they were virgins? Rav Kahana said: They sat them on the opening of a barrel of wine. If she was a non-virgin, her breath would smell like wine; if she was a virgin, her breath did not smell like wine.

(Rav Kahana, by the way, demonstrated an unusual enthusiasm when it came to the study of sexuality. It was he who hid under the bed of his teacher Rav, while the latter was having intercourse with his (Rav’s) wife. When Rav discovered this intrusion and asked for an explanation, Rav Kahana famously replied “תּוֹרָה הִיא, וְלִלְמוֹד אֲנִי צָרִיךְ” - “this too is Torah, so I need to learn all about it.” Rav’s outrage is not recorded.)

Maybe it’s all a metaphor

Perhaps this passage of Talmud should be understood as a metaphor. Here, for example is the commentary of Rabbi Shmuel Eidels, better known as the Maharsha (1555 – 1631):

מהרש"א חידושי אגדות מסכת יבמות דף ס עמוד ב

הכתוב שהוא מורה על הזנות ועבירה דבתולות כמ"ש זנות ויין וגו' ותירוש ינובב בתולות וק"ל

The verse teaches a relationship between immorality and virginity, as it is written “harlotry and wine [and new wine take away from the heart]" (Hos. 4:11) and "new wine will cause maids to speak" (Zec. 9:16), which is easy to understand.

Except that the passage in Ketuvot is clearly describing something that Rabban Gamliel actually did, and Rav Kahana in Yevamot was not suggesting a metaphor. So today on Talmudology, we ask what you were all thinking. “Is there anything to the suggestion that this test really works?”

©ufabizphoto - Can Stock Photo Inc.

Bertrand RusselL’s Teapot

The great British philosopher Bertrand Russell (d.1970,) was also a great British atheist, who tired of some of the claims made in support of a belief in God. In 1952 he wrote the following:

Many orthodox people speak as though it were the business of sceptics to disprove received dogmas rather than of dogmatists to prove them. This is, of course, a mistake. If I were to suggest that between the Earth and Mars there is a china teapot revolving about the sun in an elliptical orbit, nobody would be able to disprove my assertion provided I were careful to add that the teapot is too small to be revealed even by our most powerful telescopes. But if I were to go on to say that, since my assertion cannot be disproved, it is intolerable presumption on the part of human reason to doubt it, I should rightly be thought to be talking nonsense. If, however, the existence of such a teapot were affirmed in ancient books, taught as the sacred truth every Sunday, and instilled into the minds of children at school, hesitation to believe in its existence would become a mark of eccentricity and entitle the doubter to the attentions of the psychiatrist in an enlightened age or of the Inquisitor in an earlier time.

Whether or not one believes that Russel’s teapot is a reasonable analog to theistic belief, it is a reminder that when making an empirically unfalsifiable claim, the burden of proof does not lie on others to disprove it. We have no reason to believe the claim unless it has been proven by those who asserted its truth. It is worth remembering Russel’s teapot when considering some claims made in the Talmud; those which are not plausible must be considered to be just that, regardless of whether the claim has been empirically disproven.

Rather unexpectedly, one noted scholar seems to have taken up Russel’s Teapot challenge, and set out to explain that the Barrel Test as described by Rabban Gamliel, was a reliable test of a woman’s virginity.

Rabbi Mordechai Halperin AND The Barrel TesT

Rabbi Mordechai Halperin is an accomplished and highly respected physician in Jerusalem. Some of his books adorn the Talmudology library. He was the Chief Ethics officer at the Israeli Ministry of Health, and the editor of Assiah, the Journal of Jewish Ethics and Halacha. And Rabbi Halperin believes that the test has a basis in fact. Here are the steps in his argument, (and you can read the original here):

1) Some foods, like garlic, are broken down into substances that are absorbed into the bloodstream. These may later be expelled from the blood in the lungs, and may be smelled on the breath.

2) Many medicines and food substances can be directly absorbed from the mucosa. So, for example, some drugs are placed under the tongue, where they may directly enter the blood stream by crossing into the tiny blood vessels that line the mucosal surface. Alcohol can not only be absorbed into the blood by ingestion into the stomach. It may also cross directly, via a mucosal surface. The vagina is a mucosal surface,

3) The difference between a virgin and non-virgin is in the tone of the vaginal passage.

As a result, Rabbi Halperin claims that a non-virgin has a lower vaginal tone and that the vaginal mucosa will absorb more alcohol when placed over a wine barrel when compared with a woman who is a virgin. And so the blood alcohol concentration will be higher in the former than in the latter. This will be detectable by the smelling the breath of the woman. QED.

Before we go on, an apology

OK, before we go on any further, I want to apologize to the many woman (and men) who might feel outraged at this discussion. I know it reminds us of a time when, in Judaism (and in Christianity too) virginity was the most important of qualities that a bride could have. (For more on that, see yesterday’s post.) In many cultures it still is, and women who are suspected of not being virgins on the night of their wedding sometimes face violence and even murder. Here is Michael Rosenberg’s take, from his terrific (and expensive) book Signs of Virginity: Testing Virgins and Making Men in Late Antiquity (p.139):

We need not - and should not - ignore the grotesque and degrading image of setting a woman up on a barrel to test her virginity to see that Rabban Gamliel b. Rabbi’s action is meant to bear the trappings of an objective process….

Critical to understanding the story is reading it in the light of its parallel in Tractate Yevamot of the Bavli. There, the Babylonian sage Rav Kahana suggests the barrel method for determining virginity. The striking difference between the appearance of the barrel test in bYev60b and its appearance here is that the version in Yevamot lacks the use of two maidservants to test out the method. There, Rav Kahana simply explains what one should do. In our passage [in Ketuvot] , this plot device highlights the “objectivity” of what Rabban Gamliel b. Rabbi is doing; the editor(s) of the story depict Rabban Gamliel b. Rabbi’s experiment as rigorous and /or objective. In the language of the modern scientific method: he tests out a hypothesis using controlled variables, and when that hypothesis is confirmed, he then makes use of it to determine the answer to an unknown question.

So, we must continue, in the name of science. The problem with Rabbi Halperin’s suggestion is that while the individual steps might be correct, they do not in any way lead to his conclusion.

How Scientific was Rabban Gamliel’s Methodology?

Rosenberg points out some of the features that Rabban Gamliel’s test has in common with “the language of the modern scientific method.” But to be clear, there was nothing scientific about it, at least in so far as we use the word today. For this, Rabban Gamliel cannot be blamed. He lived about 1,300 years before the birth of modern science, and it is silly of us to think he should have been conducting his test along the same lines that we conduct scientific tests today. Still, it is worth thinking about his methods through the lens of modern science. We will quickly see that the test, at least as described in Ketuvot, was far from scientific.

  1. Rabban Gamliel selected two women to take part in the calibration phase. They were “maidservants” a position that might mean anything from an employee to a slave. Were they coerced, or did they volunteer? If the former, the study was unethical.

  2. What were their ages, had they borne the same number of children, and where in their menstrual cycles were they? The latter is especially important since it affects the lining of the vagina and uterus (more on this below).

  3. Was the test blinded? Were the barrels identical? Was the same wine used in each? When calibrating his nose, how often did he smell? How long did each woman sit over the wine?

  4. In the actual test, did the bride seat herself for the same length of time as the women in the calibration phase? Was the same barrel used? Was it the same wine? Was the woman in the same part of her menstrual cycle as the women in the calibration phase?

Unless we know the answers to these questions (and many more), Rabban Gamliel’s test, interesting as it is, remains a far cry from anything that would pass as modern science. While it was published in the Talmud, it would not make it into any peer reviewed journal today. (Well, OK, maybe this one.)

With the possible exception of Rabbi Shimon ben Chalafta, the rabbis of the Talmud weren’t scientists. They were rabbis.

How good is the nose at detecting blood alcohol Levels?

Most of us are able to smell alcohol on the breath of a person who has consumed it. (Yes, I know that actually, pure alcohol has very little or no odor [think of vodka] and that the smell is really from the tannins, hops and other substances that make up the wine or beer or whatever. But let’s keep going.) How sensitive are our noses? Not very, it turns out. In one study, twenty “experienced” police officers were asked to smell the breath of fourteen volunteers who had been drinking, and whose precise blood alcohol concentrations (BACs) were known. How did the officers do?

Well, it depends on the BAC. Consider a BAC of 0.08%, the legal limit for driving in many places. To get that, most people would need to have four or five drinks. At that high level, the odor was correctly identified 80% of the time. At levels less that that, the alcohol could not usually be detected.

Decisions for positive BACs by beverage type and BAC. From H. Moskowitz et al. Police officers’ detection of breath odors from alcohol ingestion. Accident Analysis and Prevention 1999. 31; 175–180.

It should be noted that wine was the hardest odor to detect, and that when BACs were lower than 0.04% fewer than one third of noses could smell alcohol.

It might be countered that Talmudic wines were far stronger than wine made today; in fact, Rabbi Yosef Chaim of Baghdad, better known as the Ben Ish Chai, makes just this claim in his commentary on Yevamot.

ומה שהיה מסתפק רבן גמליאל בתחלה בניסיון זה היינו משום דחשש אולי יין של דורות ראשונים בזמן שעשו לבנות יבש גלעד היה יותר חזק מן יינות שבימיו ולכך אותו יין בדק וזה אינו בודק על כן עשה ניסיון תחלה בשפחות

Rabban Gamliel was initially uncertain about the test because of the concern that the wine that was used earlier in history , when it was used to test the women of Yavesh Gilad, was stronger that the wines of his time. Perhaps, therefore, that earlier wine worked in this test, but the current wines were untested. That is why Rabban Gamliel started with the experiment with the maidservants…

These wines contained a greater alcohol content, and so would cause a greater spike in the blood alcohol level. This may have been so, but there is good evidence (like this) that water was added to wine because that was the way the Greeks drank it, not because it was otherwise too strong to imbibe.

The Vaginal Mucosa and drug absorption

I am not aware of any research describing how a woman’s blood alcohol content varies with time she spent over a barrel of wine. But there is a lot of work on the vagina and its role in drug absorption. One review of the topic from two pharmacologists at Texas Tech noted that the“successful delivery of drugs through the vagina remains a challenge, primarily due to the poor absorption across the vaginal epithelium.” If that is true for drugs directly introduced into the vagina, the vaginal absorption of alcohol over a barrel must be considerably worse, if it exits at all.

To counter this factor, there is the urban legend of women inserting vodka filled tampons into their vaginas to get drunk. Snopes, which concluded the rumor was false did add this, though:

If one were to ingest vodka vaginally (or anally, as the rumor is also expressed that way), the practice wouldn’t result in booze-free breath because alcohol is partially expelled from the body via the lungs. Once liquor is in the blood, at least some of it gets breathed out, which is how breathalyzers measure blood alcohol content.

They provided no reference for this claim, though I suppose they could have cited Yevamot 60b. Be that as it may, the amount of alcohol absorbed by the vaginal mucosa would be so negligible as to be unmeasurable, and certainly not detectable on the breath.

Ancient Greeks and the Barrel Test

In his Hebrew defense of the barrel test, Rabbi Dr. Halperin did not place the belief into a context. And context is always important when examining the Talmud, because it was, after all, a product of its time and place (even if that time spanned several hundred years, the the place spanned many hundreds of miles). It turns out that the belief in smells and fragrances easily passing in and out of a woman’s body was also one that was held by the Ancient Greeks. Writing at least six hundred years before Rabban Gamliel bar Rabbi (who was a first generation Amora, and lived around the third century C.E) or Rav Kahana, the Greek physician Hippocrates had this to say:

If a woman does not conceive, and wish to ascertain whether she can conceive, having wrapped her up in blankets, fumigate below, and if it appears that the scent passes through the body to the nostrils and mouth, know that of herself she is not unfruitful.

The uterus, it was once believed, had a sort of mind of its own, and was especially partial to strong smells. Here, for example, is Aretaeus of Cappadocia, who lived around the time of Galen in the second century CE, perhaps only two or three generations before Rabban Gamliel Bar Rabbi:

In the middle of the flanks of women lies the womb, a female viscus, closely resembling an animal; for it is moved of itself hither and thither in the flanks, also upwards in a direct line to below the cartilage of the thorax, and also obliquely to the right or to the left, either to the liver or the spleen, and it likewise is subject to prolapsus downwards, and in a word, it is altogether erratic. It delights also in fragrant smells, and advances towards them; and it has an aversion to fetid smells, and flees from them; and, on the whole, the womb is like an animal within an animal.

Still, even among the Greeks, the assumption that the uterus could absorb smells was not accepted by all. The second century physician Soranus thought the idea was mistaken, but his objections demonstrate that the idea was popular.

The fumigation of women to determine their fecundity was not only a Talmudic belief. It was apparently one that was part of the ancient world. So why would the rabbis not believe it? Has Rabbi Dr. Halperin succeeded in persuading you that Rabban Gamliel’s test could reliably work? Or have the objections we have raised left you skeptical? I will leave that for you to discuss around your shabbat table this evening.

Shabbat Shalom from Talmudology

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Ta’anit 17b ~ Alcohol Metabolism

In today’s page of Talmud there is an interesting discussion of how to dissipate the intoxicating properties of alcohol:

תענית יז ,ב

דְּאָמַר רָמֵי בַּר אַבָּא: דֶּרֶךְ, מִיל, וְשֵׁינָהכל שֶׁהוּא — מְפִיגִין אֶת הַיַּיִן! לָאו מִי אִיתְּמַר עֲלַהּ, אָמַר רַב נַחְמָן אָמַר רַבָּה בַּר אֲבוּהּ: לֹא שָׁנוּ אֶלָּא בְּשֶׁשָּׁתָה שִׁיעוּר רְבִיעִית, אֲבָל שָׁתָה יוֹתֵר מֵרְבִיעִית — כל שֶׁכֵּן שֶׁדֶּרֶךְ מַטְרִידָתוֹ וְשֵׁינָה מְשַׁכַּרְתּוֹ

Rami bar Abba said: Walking a distance of a mil, and similarly, sleeping even a minimal amount, will dispel the effect of wine that one has drunk. But wasn’t it stated about this halakha that Rav Nahman said that Rabba bar Avuh said: They taught this only with regard to one who has drunk the measure of a quarter-log of wine, but with regard to one who has drunk more than a quarter-log, walking this distance will preoccupy and exhaust him all the more, and a small amount of sleep will further intoxicate him.

How alcohol is metabolized

Alcohol, or really ethanol ,which is the specific kind of alcohol found in our alcoholic drinks, is metabolized in the liver. This is why, if you drink too much of it for too long, you will irreversibly damage that organ. The liver first breaks down ethanol into acetaldehyde; that is then broken down into acetic acid and a molecule called acetyl coenzyme, or acetyl-CoA. Once acetyl-CoA is formed, it is further used in the citric acid cycle, ultimately producing cellular energy and releasing water and carbon dioxide.

The amount of ethanol that the liver can break down per hour varies greatly between individuals. Here are some of the factors at play:

Gender

Men and women generally have similar alcohol elimination rates when results are expressed as grams per hour, but per unit of lean body mass, women are faster at breaking down ethanol.

Age

As we age we get slightly slower at eliminating ethanol.

Race

Native American men and women appear to eliminate alcohol faster than whites. There is also evidence that people of Asian descent have a slightly faster rate of metabolism, owing to a polymorphism in the Class I hepatic ADH enzyme. But overall, racial and ethnic differences in rates of ethanol elimination are small compared with many other factors.

Alcoholism

Heavy drinking increases alcohol metabolic rate. But advanced liver disease will decrease the rate of ethanol metabolism.

Nutritional state

Alcohol metabolism is slower in people with a poor nutritional state. Kinda like drinking on an empty stomach.

Here is the bottom line. Although rates vary widely, the “average” metabolic capacity to remove alcohol is about 7 gm/hr which translates to about one drink per hour. In the graph below, you can see the blood alcohol concentration in an average man at hourly intervals after drinking one, two, four, or six ounces of spirits containing 50 percent alcohol. A person who drink alcohol frequently might metabolize his drinks more quickly, because (among other things) alcohol induces the production of more alcohol dehydrogenase, which is needed to break alcohol down. Conversely, a person who rarely drinks might metabolize it more slowly. This is the reason that when I worked in the emergency department, it was the young drunks, especially those of college age, who worried me more than the older, chronic drunks. The chronic drinkers will metabolize their alcohol much faster.

Image from here.

Another measure to remember is that in general, the elimination rate is around 10-15mg/dL/hr in alcohol naive people and around 20mg/dL/hr or higher in those with chronic alcohol use. Try as you might, there is really nothing you can do to speed up this rate of elimination. Which brings us to…

Exercise and alcohol metabolism

According to Rami bar Abba on today’s page of Talmud, exercise can increase the elimination of alcohol.

אמר רמי בר אבא דרך מיל ושינה כל שהוא מפיגין את היין

Rami bar Abba said: Walking a path of a mil, and similarly, sleeping even a minimal amount, will dispel the effect of wine that one has drunk. 

Does exercise help, as Rami bar Abba suggested? Well, there is one study that looked at this very question. It studied rats, which were fed alcohol mixed into their liquid diet “with use of a kitchen wire whisk and bowl.” They were then made to run on a little rodent treadmill, and blood was removed from their tails at various time intervals. The researchers, from the University of Texas at Austin, concluded that “…running exercise for periods of at least 60 min will increase rates of ethanol clearance compared with rates measured at rest.” So if you are a rat with a hangover, a vigorous run for an hour might help you feel better. But what about us?

Well, it depends how much you exert yourself. A study published in 1982 tested the rates of alcohol elimination in a very small group of volunteers, who got drunk and hopped on an exercise bike. It found that

prolonged physical exercise produces an enhanced ethanol elimination if the intensity and duration of exercise are sufficient. But this finding has hardly any pathological meaning.The reasons for the enhanced elimination of blood alcohol are probably to be found in the elevated body temperature caused by physical exercise and in a supplementary loss of alcohol by perspiration and exhalation. The muscles are not able to utilize ethanol either directly or indirectly.

TIME-DEPENDENT ELIMINATION OF ALCOHOL

Sleep does nothing to speed up the metabolism of alcohol either. But what if Rami bar Abba was not suggesting an activity, but rather a length of time? Perhaps he is in effect saying that the alcohol wears off in about the time it takes to walk a mil, or have a short nap. That certainly makes physiological sense. To which Rav Nachmun pointed out that this time period only applied after a small amount of wine (“a quarter log”). Any more than that could not be eliminated in such a short period. Also physiologically correct.

But as Rami bar Avuha (not the same Rami as before) noted, if you are really intoxicated, you would need more time to sober up.

אָמַר רַב נַחְמָן אָמַר רַבָּה בַּר אֲבוּהּ: לֹא שָׁנוּ אֶלָּא שֶׁשָּׁתָה כְּדֵי רְבִיעִית, אֲבָל שָׁתָה יוֹתֵר מֵרְבִיעִית — כל שֶׁכֵּן שֶׁדֶּרֶךְ טוֹרַדְתּוֹ וְשֵׁינָה מְשַׁכַּרְתּוֹ

Rav Nachman said that Rabba bar Avuh said: They only taught this with regard to one who has drunk a quarter-log of wine, but with regard to one who has drunk more than a quarter-log, this advice is not useful. In that case, walking a path of such a distance will preoccupy and exhaust him all the more, and a small amount of sleep will further intoxicate him.

Of course so long as you stop drinking, there is no way that a nap will further raise your alcohol level, but again, if you have consumed a lot of alcohol and take a nap, you may wake with an awful hangover, which may make you feel as if you were intoxicated.

How to drink the Four Cups of Wine at the Seder

In tractate Shekalim there is a lengthy excursus into the laws of the Four Cups of wine that must be drunk on the night of the Seder. May one drink the four cups little by little, sip by sip, or must they be drunk in large gulps?

שקלים ח, ב

מָהוּ לִשְׁתוֹתָן בְּפִיסָקִין. כְּלוּם אָֽמְרוּ שֶׁיִּשְׁתּוּ לוֹ כְּדֵי שֶׁיִּשְׁתַּנֶּה וְלֹא יִשְׁתַּכֵּר. אִם שָׁתָה בְפִסָקִין אַף הוּא אֵינוֹ מִשְׁתַּכֵּר

What is the halakha with regard to drinking the four cups of wine little by little, with interruptions? The Gemara answers: When the Sages said that one must drink four cups of wine, didn’t they institute that he must drink them, and not that he should become intoxicated from drinking them? Therefore, if he drank them little by little, with intervals, he too is acting in accordance with the will of the Sages, as he is not becoming intoxicated, and therefore he need not drink the entire quarter-log at once.

In other words, because the rabbis specifically wanted to avoid the Seder celebrants becoming intoxicated, they did not allow additional wine to be drunk between the Third and Fourth cups of wine. Hence, the Talmud concludes that sipping wine a little at a time is certainly permitted. And now that we have reviewed the way in which alcohol is metabolized, this ruling makes physiological sense. You are less likely to become intoxicated if you sip your cup slowly over some time, rather than finish it in one or two gulps. It’s all about the alcohol dehydrogenase.

On the other effects of alcohol

The Talmud has a few conflicting statements about wine and its intoxicating effects. In another tractate (Eruvin 65a) Rav Chaninah claimed that the relaxed feeling a person gets after drinking wine puts him in the same mindset as the Creator of the universe:

עירובין סה, א

אמר רבי חנינא כל המתפתה ביינו יש בו מדעת קונו שנאמר וירח ה׳ את ריח הניחוח וגו׳ 

Rabbi Chanina said: Whoever is appeased by his wine, i.e., whoever becomes more relaxed after drinking, has in him an element of the mind-set of his Creator, who acted in a similar fashion, as it is stated: “And the Lord smelled the sweet savor, and the Lord said in His heart, I will not again curse the ground any more for man’s sake” (Genesis 8:21).

And according to Rav Chanan bar Papa, it is a sign of prosperity if “wine flows like water” in the house (Eruvin 65a).

But rabbis also pointed out the dangers of drinking to excess. One explanation for the deaths of the sons of Aaron the High Priest (described in Lev.10) is that they were drunk when they performed in the Mishkan. Elsewhere we have discussed how the Talmud described alcoholic liver disease, and how it precluded a Cohen from service in the Temple. Like many things, wine should be taken in moderation. That lesson, taught in Avot D’Rabbi Natan, was true in talmudic times, and remains so in ours too.

אבות דרבי נתן 37:5

ח׳ דברים רובן קשה ומיעוטן יפה. יין מלאכה שינה ועושר ודרך ארץ ומים חמין והקזת דם 

There are eight things which are dangerous in excess but good in moderation: wine, work, sleep, [having] wealth, sexual relations, [bathing in] hot water, and bloodletting.


Want more? Here are some other Talmudology posts that also discuss alcohol and its effects:

Cohanim and alcoholic liver disease

The healing effects of alcohol

Too drunk to say no

Alcohol and cognitive function


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Eruvin 64 ~ Wine and Cognitive Function

In this page of Talmud we begin a long digression about the effects of wine, both good and bad. There is a dispute whether wine precludes a rabbi from rendering a legal decision. Rabbi Yehuda thought it did, but Rav Nachman thought the idea ridiculous. He claimed that he could only render a legal ruling after he had drunk some wine.

עירובין סד, א

אמר רב יהודה אמר שמואל שתה רביעית יין אל יורה אמר רב נחמן לא מעליא הא שמעתא דהא אנא כל כמה דלא שתינא רביעתא דחמרא לא צילא דעתאי 

Rav Yehuda said in the name of Shmuel: If one drank a quarter-log of wine, he may not issue a halakhic ruling, as the wine is liable to confuse his thinking. With regard to this second statement, Rav Nachman said: This halakha is not excellent, as concerning myself, as long as I have not drunk a quarter-log of wine, my mind is not clear. [It is only after drinking wine that I can issue appropriate rulings.]

What are we to make of Rav Nachman’s statement that he could only render a legal decision after he had some wine. Does alcohol indeed sharpen the mind?

Nope.

In study after study, alcohol actually impairs you cognitive function. (You can see more evidence of this if you joined me in the Emergency Department on a Saturday night.) For example, one study, published in 2000, demonstrated that alcohol impaired both the speed of information processing and as well as higher order cognitive abilities. While the study only used twenty subjects, I think we can all agree that these findings would be replicated in a larger population (see above regarding the ED). The authors concluded that

Alcohol administration resulted in impaired performance on perceptual organization, synthesis of thought, abstract thought, decision making and attention to detail, but not on short-term memory, visual memory, freedom from distractibility and anxiety and visuo-motor coordination.

It is of course, precisely the powers of abstract thought, decision making and attention to detail that are needed in order to render a fair legal decision of any sort. Another review of the action of alcohol on vigilance concluded that “nonverbal, spatial information processing are very sensitive to low doses of alcohol.” Alcohol is involved in over half of all fatal car crashes in the US and so on and so on. Alcohol does nothing to sharpen the mind.

...results show that alcohol impaired visual information processing, attention, abstract reasoning and visuo-motor coordination...
...the results indicate that all stages of information processing are impaired independently...
— Tzambazis, K. Stough, C. Alcohol impairs speed of information processing and simple and choice reaction time and differentially impairs higher order cognitive abilities. Alcohol & Alcoholism 2000. 35( 2 ) 197-201.

Rav Nachman and the CAGE Questionnaire

Why then did Rav Nachman believe that he could only render a legal decision after he’d had some wine? Here is one possibility: for people who have a drinking problem, the addiction to alcohol can lead to nasty withdrawal symptoms, that can only be alleviated with …more alcohol. Today, one of the four screening questions that are asked using the CAGE questionnaire to detect a possible drinking problem is “have you ever felt the need to drink first thing in the morning to steady your nerves?” It is precisely the need for alcohol in order to “think straight” (or to have the illusion of thinking straight) that is a warning sign of potential alcoholism.

Rav Nachman (d.~320C.E.) was a wealthy man, who had high self-esteem. He claimed that if anyone was worthy of being the Messiah in his generation “he must be like me” (אמר רב נחמן אי מן חייא הוא כגון אנא, see Sanhedrin 98b). He also owned an enormous wine cellar (see Berachot 51b). Of course none of this proves that Rav Nachman had what today we would call alcoholism, but it is an interesting idea to ponder.

Does Exercise help eliminate alcohol?

Elsewhere on today’s page of Talmud we read that exercise can increase the elimination of alcohol.

עירובין סו,ב

אמר רמי בר אבא דרך מיל ושינה כל שהוא מפיגין את היין

Rami bar Abba said: Walking a path of a mil, and similarly, sleeping even a minimal amount, will dispel the effect of wine that one has drunk. 

These observations are perfectly reasonable. Alcohol is eliminated in the body by the liver, although the rate at which it does so varies. It is faster in those who drink regularly, and slower in those who are alcohol naive. In general, the elimination rate is around 10-15mg/dL/hr in alcohol naive people and around 20mg/dL/hr or higher in those with chronic alcohol use. Try as you might, there is really nothing you can do to speed up this rate of elimination.

Does exercise help, as Rami bar Abba suggested? Well, there is one study that looked at this very question. In rats, which were fed alcohol mixed into their liquid diet “with use of a kitchen wire whisk and bowl.” They were then made to run on a little rodent treadmill and blood was removed from their tails at various time intervals. The researchers, from the University of Texas at Austin, concluded that “…running exercise for periods of at least 60 min will increase rates of ethanol clearance compared with rates measured at rest.” So if you are a rat with a hangover, a vigorous run for an hour might help you feel better. But what about us?

Well, it depends how much you exert yourself. A study published in 1982 tested the rates of alcohol elimination in a very small group of volunteers, who got drunk and hopped on an exercise bike. It found that

prolonged physical exercise produces an enhanced ethanol elimination if the intensity and duration of exercise are sufficient. But this finding has hardly any pathological meaning.The reasons for the enhanced elimination of blood alcohol are probably to be found in the elevated body temperature caused by physical exercise and in a supplementary loss of alcohol by perspiration and exhalation. The muscles are not able to utilize ethanol either directly or indirectly.

Time-dependent elimination of alcohol

Sleep does nothing to speed up the metabolism of alcohol either. But what if Rami bar Abba was not suggesting an activity, but rather a length of time? Perhaps he is in effect saying that the alcohol wears off in about the time it takes to walk a mil, or have a short nap. That certainly makes physiological sense. To which Rav Nachmun pointed out that this time period only applied after a small amount of wine (“a quarter log”). Any more than that could not be eliminated in such a short period. Also physiologically correct.

But Rami bar Avuha (not the same Rami as before) noted that if you are really intoxicated, you would need more time to sober up.

אָמַר רַב נַחְמָן אָמַר רַבָּה בַּר אֲבוּהּ: לֹא שָׁנוּ אֶלָּא שֶׁשָּׁתָה כְּדֵי רְבִיעִית, אֲבָל שָׁתָה יוֹתֵר מֵרְבִיעִית — כׇּל שֶׁכֵּן שֶׁדֶּרֶךְ טוֹרַדְתּוֹ וְשֵׁינָה מְשַׁכַּרְתּוֹ. 

Rav Nachman said that Rabba bar Avuh said: They only taught this with regard to one who has drunk a quarter-log of wine, but with regard to one who has drunk more than a quarter-log, this advice is not useful. In that case, walking a path of such a distance will preoccupy and exhaust him all the more, and a small amount of sleep will further intoxicate him.

Of course so long as you stop drinking, there is no way that a nap will further raise your alcohol level, but again, if you have drunk enough and take a nap you may wake with an awful hangover, which may make you feel as if you were intoxicated.

Time dependent elimination of alcohol at various doses. For “one drink” you might substitute a quarter log of wine.” For “four drinks” you might substitute the more potent “Italian wine.”

Time dependent elimination of alcohol at various doses. For “one drink” you might substitute a quarter log of wine.” For “four drinks” you might substitute the more potent “Italian wine.”

The Talmud is full of conflicting statements about wine and its intoxicating effects. In tomorrow’s page of Talmud Rav Chaninah claimed that the relaxed feeling a person gets after drinking wine put him in the same mindset as the Creator of the universe:

עירובין סה, א

אמר רבי חנינא כל המתפתה ביינו יש בו מדעת קונו שנאמר וירח ה׳ את ריח הניחוח וגו׳ 

Rabbi Chanina said: Whoever is appeased by his wine, i.e., whoever becomes more relaxed after drinking, has in him an element of the mind-set of his Creator, who acted in a similar fashion, as it is stated: “And the Lord smelled the sweet savor, and the Lord said in His heart, I will not again curse the ground any more for man’s sake” (Genesis 8:21).

And according to Rav Chanan bar Papa it is a sign of prosperity if “wine flows like water” in the house (Eruvin 65a). But rabbis also pointed out the dangers of drinking to excess. One explanation for the deaths of the sons of Aaron the High Priest (described in Lev.10) is that they were drunk when they performed in the Mishkan. Elsewhere we have discussed how the Talmud described alcoholic liver disease, and how it precluded a Cohen from service in the Temple. Like many things, wine would be taken in moderation. That lesson, taught in Avot D’Rabbi Natan, was true in talmudic times, and remains so in ours too.

אבות דרבי נתן 37:5

ח׳ דברים רובן קשה ומיעוטן יפה. יין מלאכה שינה ועושר ודרך ארץ ומים חמין והקזת דם 

There are eight things which are dangerous in excess but good in moderation: wine, work, sleep, [having] wealth, sexual relations, [bathing in] hot water, and bloodletting.


Want more? Here are some other Talmudology posts that also discuss alcohol and its effects:

Cohanim and alcoholic liver disease

The healing effects of alcohol

Too drunk to say no










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