facts and opinion “To your health” is a common expcrience. Hippocrates was another toast heard on many occasions of of the early advocates, prescribing it convivial gatherings. I would like to as a iiourishirig, dietary bevcmge; as explore the ramifications of this salu- a cooling agent for fevers; as a diutation, specifically in the area of wine retic or purgative; or as a dressing for and its clinical uses, rmphasizing its \vounds. Cyrus The Great, in 539 Oenefits to those of us involved in B.C:., had his soldiers carry wine on thrir march to Babylonia to avoid obstetrics arid gynecology. W i n r is as old as civilization. It has uxter-l)orne diseases. Galen, during been the companion of man; cheer- his stint as tcam physician to the ing, nourishing, and stimulating gladiators, found that dressings satuhim. N o drink, except watcr and ratrd in red wine minimizcd wound m i l k , has won s u c h a c c o l a d e s infections. In World War II, Italian through the ages. It is used to per- and Frcneh soldiers, who drank wine form rites in churches, to observe as part of their life style, tended to memorable occasions, to launch have fewer infections than our Amerships, t o welcome guests, a n d to ad- ican doughboys. In 1820, the United States Pharminister to the sick. In The Biblc there are over 200 references to macopoeia listed nine wine medicines. Now there are none. Medical text books too have dropped wine from thvir pages. Temperance movements; the Prohibition era; and the advent of new drugs, such as antibiotics, vitamins, and tranquilizers, caused that change. With the spectacular advances in modcrn mediEVEI-YN J . ROGERS, LT. COL., IJSAF-NC, RN,B S N , M S cine., physicians demand objective proof for each therapeutic substance thcy use. Today, with the increased M’iiie is one of the oldest medicines known to n u n . Prohihition and the advrnt of n e w cniphasis on nutrition and pretlriigs cu~isedthe disappearance of wine froni the United Stutes pliurmacopeia and ventative medicine, research workers nirtlical texts; consequently, younger lieuith care professionals may be unauare of the are finding renewed interest in the tlierupeutic uses of wine. Recent findings indicate thut i t is eflectioe (1s a mild medicinal va1uc.s of wine. They are 1runquilizcr, un aid to digestion, an uppetite stimulant, and a sedative. I n the area of broadening our understanding of it O h / G y n , wine can he used us an additional source of vitamins and iron wid to help and distilling empirical data reruse first trimester nausea, the discomforts of the lust month of pregnuncy, corded by thoughtful physicians over privncwlruul tension and cramping, and pre- und postoperative concerns. the past centuries.

Wine: Its Uses in Clinical Practice

wine The Book of Proverbs says, “Give ytrong drink unto him that is ready to periqh and wine unto those of heavy heart” (Proverbs 31 6). St Paul advised Timothy to “Drink no longer water, but use a little wine tor thy stomach’s sake and thine infirmities” (Timothy 1-5 23) And, the Pwlms proclaim, “Wine that makcth glad the heart of men” (Psalms 104 15) It is probably the medicine with which humanity has had its longest

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Chemical Properties of Wine

l’he production of wine is deceptively simple. You squeeze some grapes, let the juice ferment in a barrel, filter, pour into a bottle, cork and store. The chemical composition, however, has such intricacies and complexities that it defies the most sophisticatcd analysis. Broadly, it is made up of 85% water, 12%’ ethyl alcohol, and miscellaneous compounds which give it its color, aroNovember/December 1976 J O C N Nursing

ma, and taste. It has been called a chcmical symphony composed of sugars and other carbohydrates, polyphenols, aldehydes, ketones, enzymes, 15-20 minerals, more than 22 organic acids, and other constituents yet to be identified. It has enough vitamin B complex to be considered a supplementary source. Approximately 80% of iron present is in the physiologically available ferrous form. The pigment of the grape skin, which gives wine its characteristic color, contains anthocyanin, which has potent antibiotic effects, especially against bacterial disorders. Wine differs from other medicinal agents, however, in that it may be regarded as a food. It meets the two basic dietary requirements of providing energy and contributing to the maintenance of the body. A 4-oz serving contains approximately 95 calories, which are readily burned rather than stored like other carbohydrates. With a pH of 3.2, it more nearly resembles gastric juice than does any other natural beverage. In small amounts it increases salivation, gently stimulates stomach activity, and aids in colon evacuation. Its rate of absorption into t h e blood stream is slow and sustained, especially when used with meals. T h e a l c o h o l i c c o n t e n t is low (12-2OYO ).

General Clinical Uses The most obvious site of action is in the central nervous system. Relaxation is a necessary element in o u r lives. Hans Selye’s important work on the effect of stress on every bodily system points u p the need for balance between tension and relaxation. However, the frenetic pace of our modc,rn life fills the days with ever incrcming tensions and frustrations. Many people are on Valium, Librium, or one of the other anxiety reducers. But these act broadly on the November/December 1976 JOGN Nursing

nruromuscular system, causing unpleasant side effects of dizzyness, drowsiness, tremors, a n d depression. Wine, on the other hand, can give a cerebral sense of richness-a more sercme state, a pleasant calming effect-derived primarily from its content of alcohol and aldehydes. In a tiarrel, bottle, o r glass of wine is comingled a n infinite variety of chemical products which account for its hypnotic-sedative-tranquilizing properties. Any depressant effect is greatly modified by its many polymeric constituents . An important psychological component enters the picture when wine, poured into a glass, tends to stimulate and please our senses of sight, smell, and taste. T h e sense of hearing is satisfied when we clink our glasses together and toast one another. We are rnore apt to sit down and savor the drink, allowing its relaxing qualities to enfuse us. This is far better than hastily “popping” a pill while continuing our hurried existence. I n general, significant relief of anxiety can be produced by 4-8 oz of table wine or 2-4 oz of a dessert wine. The duration of tranquilization is usually prolonged and blood alcohol levels are kept at safer levels if the tieverage is taken with food or no more than 20 minutes before the meal is served. Taken just before bedtime, dessert wines have been effectively used as mild, safe sedatives for many years. As with any other tranquilizing agent, the prescription of wine should be avoided for patients who display any signs of developing a dependence on alcohol or who already have demonstrated inability to use alcoholic beverages wisely. It should also be noted that alcohol in any form may have synergistic or potentiating effects when used in combination with other tranquilizers, sedatives, barbiturates, or narcotics.

Anorexia and obesity are two diverse clinical prot)lems but with a common base of cvnotional dif€icultics. In one, the patient will not vat; in the othcr, the patient eats too much. I n the first condition, the administration of 4 o z of dry red wine daily with one regular meal has proven useful. ‘I’he acetic, tartaric, and tannic acids secm to havc a stimulating cffect on the appetite. A reducing dict for second condition is simple to prescribe but often d i E cult for the heavyweight to follow. Four to six ounces of wine taken approximately 30 minutes before mealtime may make it easier for the patient t o adhere to a diet. Also, use bcfore bedtime may reduce insomnia, lessen the craving for a nocturnal mcal, a n d discourage, “ refrigerator raiding.” Hospitals throughout the country havc begun to incorporate wine in their meal planning as an aid to digestion, nutrition, and relaxation. Noticeable improvement in patient morale, a decrease in complaints about the food, less sedation needed, and a morc rapid recovery have been the results of this change. Under a new policy, wine is now available in the maternity units of three leading hospitals in San Diego, California; and in Sari Antoiiio, Texas, a gourmet dinncr, complete with champagne, is served t o every new mother a n d father prior to discharge. t h c b

Obstetrical/Gynecological Uses

I have already alluded to the fact that wine can bc considered an additional source of iron, vitamins, and minerals. Chilled champagne can be effectivc as a remedy for the nausea of w r l y pregnancy or to chasc away the postpartum depression that often hits new mothers. T h e quick rclease of glucose from the liver is the physiological explanation for this phenomc’non T h e content of carbon

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dioxidc helps propel the tranquilizing substances mentioned earlier into t h e blood stream. Two to three ounces evrry 3 to 4 hours prn, sipped slowly, is usually effective. -rhr last month of pregnancy, with its vexing discomforts of restlessness, Hraxton-Hicks contractions, and fatigue, can be made a bit easier to tolrratt, with t h e judicious use of \vine. This is not a new suggestion. IIr. B. L. Hill in his book Illustruted ,\/lidrcifL.ry, published in 1860, states t h a t a \vine remedy called ‘Mother’s Corclial’ “is a very good article for otiviating false labor pains. This preparation combines excellent diurvtic, anodynct, and some tonic quali ties. .’ I ofttm suggest a glass of wine at 1)rdtinie to our prenatal patients who are having difficulty sleeping, with gratifying results. They sleep better, thr. fctus isn’t bouncing around, and t l i c Iiusl~antlhas a more restful night, too. I f t h e y wrinkle their noses at this atlvicc I)ecause they are still iy,!he cola set, I snggcst Boo2,e’s Farm or Annie Green Springs which have more fruity flavors. Hreastfreding mothers having trouhle bvith the Irt-down reflex may I)encfit from a glass prior to the feeding. The calniing effrct helps release milk into the ducts. Dr. Fnchs of Cornell, who used t,thyl alcohol in preventing premature labor, concluded from his experiments that the inhibition of uterin

Wine: its uses in clinical practice.

facts and opinion “To your health” is a common expcrience. Hippocrates was another toast heard on many occasions of of the early advocates, prescribin...
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