Delving into the History of FASD

 

Significance of Study of the History of FASD

For many years, it has been assumed that Fetal Alcohol Syndrome is a “new” malady. 

Although the etiology of the disorder was first mentioned in 1968 paper by Dr. Paul Lemoine, it does not mean that the symptoms were not recognized years if not centuries before.  Although not each citation is a study in the earlier centuries, it is evident that these observations detected a connection between drinking alcohol and the unsuccessful outcomes for the resultant offspring by several observers.  As scientific procedures were applied in the 20th Century, notes and case studies seem to more clearly reflect an obvious pattern of behavior that might indicate that these modern researchers were observing children with prenatal alcohol exposure.  And if they wrote about these children/adults and included chapters on them, then there must have been enough cases appearing on a regular basis that they felt the behaviors and their observations were more than an errant anomaly.

There has often been a question as to the frequency of occurrence of FASD.

Many researchers ask,
“If maternal alcohol consumption is such a problem, why did we not hear about it before 1968?”

Modern estimates have ranged from 9.7 per 10,000 births to almost 1 per 100. The lower estimates do not reflect the occurrence of the non-physical forms of FAS [also called Fetal Alcohol Effects (FAE), partial FAS (pFAS), Prenatal Effects of Alcohol (PEA), Alcohol Related Birth Defects (ARBD) and Alcohol Related Neurodevelopmental Disorders (ARND)…all of which are now grouped under the term Fetal Alcohol Spectrum Disorders (FASD)], where only the brain is affected.  FASD without the physical signs (historically referred to as FAE, pFAS, PEA, ARBD, ARND) is thought to occur 3-5 times or more often than the full FAS which has both physical and behavioral manifestations.  Studies are seldom done on conditions that rarely occur.  Therefore, the existent studies and records of conditions that closely resemble FASD but not properly named could mean that unnamed FASD cases existed in enough numbers to be observed and scientifically recorded as far back as the 16th Century.

There are some important caveats to this study.  The researchers of this period were limited by the number of patients they could see and the limitation of correspondence and publications available during their lifetimes.  Note that the Gutenburg Press was first developed in 1450.  Prior to that time, books were copied by hand and there was not any widespread use because of the prohibitive cost and educational exclusivity.  Also, books printed for a few centuries after the invention of the movable press are considered to be rare and difficult to obtain until the general population gained the ability to read and write and generated a greater interest in printed books and articles.    

The words and phrases used in these studies are in the language of the period.  The labels and descriptive phrases do not necessarily have the same connotations then as they do now.  And the different combinations of the words often carry a much different meaning.   For example, having a neurosis is very different from having a neurotic character…the latter considered to be less definitive, more of a lifelong problem and less likely to have a program of treatment than an episodic condition that might be remedied.

It is also important to note that each of the researchers appears to have recognized a particular facet of FASD without recognizing there are other behaviors that may be attributed to the same cause.  This is due to the nature of FASD which follows a wide spectrum of physical and behavioral characteristics.

Finally, contrary to popular opinion, there are, in all probability, several hundred articles and books that have dealt with unrecognized FASD over the centuries. I am constantly finding new ones.  If I have left some out, it was because I have not yet found them.  This present set of information probably represents only 20% of my current file.

Items offset by a *** boundary are those articles that are considered to be pivotal in refuting the research that indicated that maternal drinking caused physical and mental problems in the offspring. I included them because they give an idea of when the researchers started to deny the connection between maternal drinking and fetal damage.   

Editions of the Merck Manual for physicians and medical personnel (1950-2005) have been added in order to demonstrate what is being taught in psychiatry and psychology classes.  This includes description of the conditions and the treatments and/or recommended therapies.

Notations on the printings of the Special Reports to Congress on Alcohol and Health (1978-2000) were added because of the extensive amount of current research that was presented in each report and because the bibliographies indicate the large number of researchers presently in the field.  It also marks the entrance of the federal government into the recognition of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders.

Other notations on various landmark decisions, laws or studies on FAS were included to compare the action of the government and of the medical community.

Peggy Seo Oba has been a driving force to help parents and professionals connect the puzzle pieces of FASD by helping us connect the research studies. 

Peggy Oba’s work in The Fetal Alcohol Syndrome Information Network (FASIN) offers information regarding FASD in many cultures and languages. Hidden in documents – what we know today.

FAS in Antiquity

• Biblical References.  Exodus, 20:5:  “…visiting the iniquity of the fathers upon the children unto the third and fourth generation…”  (Fathers, in this case, may be thought of as parents in general.) 
• Judges, 13:3-5:  “…you shall conceive and bear a son…take no wine or strong drink and to eat nothing unclean…for this boy is to be consecrated to God from the womb.”  (Said to Samson’s mother and not to the Jewish community in general.)
• 814-146 B.C.  Carthage (city-state) in Northeast Africa.   From “The Effects of Drinking on Offspring” by Rebecca Warner and Henry L. Rosett in Journal of Studies on Alcohol, (1975.  Warner and Rosett mention that the ancient civilization of Carthage (814-146 B.C.) forbid the use of alcohol for newlyweds.  Cited from Robert Burton’s Anatomy of Melancholia (1621).  This information has also been variously cited  J.P. Frank in System einer vollstandingen medincinischen Polizei (1784) and by Haggard and Jellinek in Alcohol Explored (1944). 
• 725-371 B.C.  Sparta (city-state) in Greece.    From “The Effects of Drinking on Offspring” by Rebecca Warner and Henry L. Rosett in Journal of Studies on Alcohol, (1975.  Warner and Rosett mention that the ancient civilization of Sparta (725-371 B.C.) forbid the use of alcohol for newlyweds.  This is cited from Robert Burton’s work, Anatomy of Melancholia (1621). 
• Plutarche’s Life of Lycurgus, on Sparta, “In order to the good education of their youth, he went so far back as to take into consideration their very conception and birth by regulating the marriages.”  From an article in the British Medical Journal by Dr. John Haddon (1876).  [Plutarche also suggested that pregnant women exercise.]
• 500 B.C.  Buddhism’s Five Precepts warn against strong drink.  From East Asia:  The Great Tradition by Edwin Reischauer.  (1958) Harvard:  Harvard University Press. 
• 427-347 B.C.  Plato’s  Laws.  From “The Effects of Drinking on Offspring” by Rebecca Warner and Henry L. Rosett in Journal of Studies on Alcohol, (1975). 1397,  Robert Burton’s Anatomy of Melancholia (1621) noted that Plato (427-347 B.C.) recommended that newly married couples forgo alcohol…”…that the child that is begotten may be sprung from the loins of sober parents.”  The last quote is from Ernest Abel in Fetal Alcohol Syndrome and Fetal Alcohol Effects (1984).
• 322 B.C. Aristole’s Problemata.   From a journal study by A. Lynn Martin.  (2003) “Fetal Alcohol Syndrome in Europe, 1300-1700:  A Review of Data on Alcohol Consumption and a Hypothesis”. Food and Foodways.  Martin mentions the work of Robert Burton’s Anatomy of Melancholia (1621), in which he talks of ancient Greek authorities (Aristole in Problemata in 322, B.C.) who stated, ” Foolish, drunken or hair-brained women, for the most part bring forth children like unto themselves, morose and languid.”  
• 120 A.D.  Plutarche in Symposiacs. From “The Effects of Drinking on Offspring” by Rebecca Warner and Henry L. Rosett in Journal of Studies on Alcohol, (1975),  Burton in Anatomy of Melancholia (1621) is also said to have quoted Plutarch (120 A.D.), “..one drunkard begets another…” 
• 130-180 A.D.  Aulus Gellius (Roman).    From “The Effects of Drinking on Offspring” by Rebecca Warner and Henry L. Rosett in Journal of Studies on Alcohol, (1975),  Robert Burton reported Gellius (130-180 A.D.), a Roman diarist,  is cited as saying, “…if a drunken man get a child, it will never likely have a good brain.”  
• 200-500 A.D. Babylonian Talmud, Kehuboth, 32b, warns, “One who drinks intoxicating liquor will have ungainly children.”  From Michael Dorris’ The Broken Cord (1989).

Of interest in history from China legend

The earliest alcohol makers in Chinese legend were Yi Di and Du Kang of the Xia Dynasty (about 2000 BC－1600 BC). Research shows that ordinary beer, with an alcoholic content of 4% to 5%, was widely consumed in ancient China and was even mentioned on oracle bone inscriptions as offerings to spirits during sacrifices in the Shang Dynasty (1600 BC–1046 BC). After that, Chinese discovered that adding more cooked grain in water during fermentation could increase the alcohol content, so stronger drinks began to appear. Around 1000 BC, the Chinese created an alcoholic beverage which was stronger than 11%. The potent libation was mentioned in poetry throughout the Zhou Dynasty (1050 BC–256 BC). Meanwhile, no beer in the West reached 11% until the 12th century, when distilled alcohol was first made in Italy. In Tang Dynasty, Alcohol was famous by Li Bai who is titled poem god. For Li Bai always has inspiration of poem when he drink wine . That’s why he is called poem god. (Source Top 10 Greatest Inventions of China)

We ask that if you have further information you may believe is a historic clue to FASD that you let us know so we may add it to this list. 

Thank you — Peggy Oba