In recognition of how most of you felt yesterday morning, I thought a few words on veisalgia might be in order.

Veisalgia – known in the non-medical vernacular as the hangover – is the cumulative physiologic and psychological effect of over-consumption of alcohol. It is characterized by severe discomfort involving a pounding headache, dry mouth, dizziness, fatigue yet insomnia, nausea and vomiting, occasionally diarrhea, hyper-sensitivity to environmental stimuli.

Lautrec's 'The Drinker'

Lautrec’s ‘The Drinker’

Given how much veisalgia is discussed, little formal medical research has been done on the subject. This is likely a reflection that it’s not considered a pressing public health concern – no one usually dies from a hangover alone, despite the fact that many sufferers probably wish they would. Most observers see it as “just deserts.”

There are many contributors to the feelings of death-warmed-over – a lack of restorative sleep, altered glucose metabolism, vasodilatation, dehydration and electrolyte disarray, cortisol imbalances, hyperuricemia, and metabolic acidosis all play a role.

After consumption, alcohol (ethanol) is first converted to acetaldehyde, a substance that is far more toxic on the cellular level than is the alcohol itself. Acetaldehyde is then converted to acetate by oxidation. Genetically, some individuals accumulate these two metabolic toxins more quickly than others, which bodes poorly since high acetate levels then cause adenosine concentrations to rise in the central nervous system, and that markedly contributes to the classic bad headache.

Women are more prone to hangovers than men, and the older one gets, the more one is susceptible to hangovers. Not much you can change about that.

So what is one to do? Aside from abstain?

Well, choice of beverage does play a role. Congeners are chemical byproducts of the production of alcohol or the flavoring process, and many people are very sensitive to their presence. Dark liquors have up to thirty times higher concentrations of congeners than do clear liquors. So drink vodka over whisky.

But dark and clear alcohols alike contain small quantities of methanol, a very potent congener that arises during the distillation process; methanol is metabolized in part into the toxin formaldehyde. Needless to say, this will make you feel as if you’ve been embalmed, which in a sense is what formaldehyde is doing inside your body while you’re lying in bed moaning and lamenting that last round of drinks.

If you can avoid smoking, that will help. Studies have shown that the additive effects of acetaldehyde and nicotine can be most unpleasant in many who imbibe.

aspirin bottle 1899

aspirin bottle 1899

And while hydrating thoroughly and taking aspirin might help with some symptoms such as dry mouth and headache, there is little that can be done to shorten the duration of the hangover itself. That said, the myriad folk remedies of which one hears all share one common root – a placebo effect. Many of the more inventive ones border on sheer quackery.

Take heart, though: those before you have tried, and have failed, to find the magic bullet.

In ancient Rome, Pliny the Elder favored raw owl’s eggs or fried canary for those who had over-consumed. The “Prairie Oyster” restorative, introduced at the 1878 Paris World Exposition, called for raw egg yolk mixed with Worcestershire sauce, Tabasco sauce, and salt and pepper. By 1938, the Ritz-Carlton Hotel provided a hangover remedy in the form of Coca-Cola and milk. Ernest Hemingway relied on tomato juice and beer. And a 1957 survey by a folklorist at Wayne State University found widespread belief in the efficacy of heavy fried foods and post-binge sexual activity to stave off a hangover.

But there is one thing NOT to do: saunas and steam baths can be very dangerous by combining the effects of hyperthermia and dehydration and yielding possibly fatal cardiac arrhythmias in susceptible individuals.


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