The product of natural fermentation was discovered by man in prehistoric time and was soon followed by deliberate production 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 also caused such recognized troubles as diseases (including alcoholism itself), accidents, and quarrels, and they came under early social regulation, but the benefits sufficiently outweighed the 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 intensified but did not essentially change the problems surrounding 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 persisted 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 multidisciplinary 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.

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Presented at the Alcohol and Cancer Workshop, October 23 and 24, 1978, Bethesda, Md. A portion of this article is revised from Chapter 1 in W. Filstead, J. Rossi, and M. Keller (eds.), Alcohol and Alcohol Problems: New Thinking and New Directions. Boston: Ballinger, 1976.

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