The Pharmaceutical Journal
Vol 280 No 7496 p408
5 April 2008

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Knowing one’s onions

Devil in the detail

Why austere Benedictine monks were offered five pints of ale a day

Knowing one’s onions

The onion (Allium cepa) is a close relative of garlic (A sativum) so it is hardly surprising that they share many characteristics, not least their purported health benefits, of which there are several.

Both are held to be good at preventing platelet agglutination, an important consideration in recovering stroke victims. Both are recommended as a natural antiviral in traditional cold remedies. Both are claimed to be mild antihypertensives. Both are said to be useful in various respiratory diseases.

Both are even supposed to reduce varicose veins. So if your partner is OK with onion breath rather than garlic breath, you can still eat healthily.

However, one characteristic is peculiar to the onion. Cutting either plant causes an enzyme to be brought into contact with a substrate, with the formation of a characteristic odour. The compound released by garlic, allein, is only mildly pungent, but the onion produces propanthiol-S-oxide, which delivers a major shock to the system. It hydrolyses instantly on contact with water — including that in our eyes — to produce propanol, hydrogen sulphide and sulphuric acid.

The instant this happens, the body’s defence mechanisms kick in and the lacrimal glands go into overdrive, flooding the eyes with tears to dilute the acid — which is why peeling onions can temporarily blind you.

Fortunately, several remedies are to hand, most of them variants on the theme of putting something between your teeth. Suggestions I have seen include a piece of bread, a sugar cube, a metal spoon and a slice of lemon, and I have no doubt there are more.

What you use matters less than the fact that your mouth is being held open, causing you to breath through your mouth. This means that the propanthiol-S-oxide bypasses your nose — its principal route to your eyes.

If none of the above is to your taste, substitute whatever you prefer; otherwise, a respirator or gas mask may be purchased quite cheaply from most army surplus stores!

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Devil in the detail

The recent enlargement of the EU has affected many aspects of our daily life — the arrival in Britain of Polish plumbers and suchlike — but its principal effect on community pharmacy has been to make clients’ names harder to pronounce.

I can hack that. What worries me is, with pharmacogenetics playing an increasing role, how much longer it can be before we have to start obtaining more detailed personal information for medicines use reviews.

Where will that lead us? I suspect to the same place as the hapless recruiting sergeant tasked with getting the details of the future playwright, Arnold Wesker, as set out in the latter’s autobiography, ‘As much as I dare’:

Sergeant: “Father’s place of birth?”
Wesker: “Dnepopetrovsk.”
Sergeant (looking up): “You what?”
Wesker: “Dnepopetrovsk. It’s in the Ukraine.”
Sergeant: “Spell it.”
Wesker: “D-N-E-P”
Sergeant (interrupting): “No. Spell ‘Ukraine’.”
Wesker: “U-K-R-A-I-N-E.”
Sergeant: “That’ll do. Mother’s place of birth?”
Wesker: “Transylvania.”
Sergeant: “Now, look!”
Wesker: “No, really.”
Sergeant (suspiciously):” All right. Where in Transylvania?”
Wesker:”Gyergyószentmiklós”
Sergeant (handing over form): “Just take it away and fill it in yourself, OK? Next!”

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Why austere Benedictine monks were offered five pints of ale a day

More than 150 years have passed since John Snow famously managed to have the handle removed from the water pump in London’s Broad Street to stop the spread of cholera.

When residents in the area were struck down with the disease on Thursday 31 August 1854, Snow had already spent five years gathering evidence to support his theory that cholera was a waterborne disease and not, as conventional medical opinion believed, transmitted in the air from putrefying matter.

Broad Street was merely the latest in a long list of cholera hotspots in London that Snow investigated. He arrived on the Saturday, 2 September, and spent the weekend investigating the 83 fatalities known to have occurred in the preceding two days. (In fact, there had been 197, but not all had been notified by that time; still more were people who had been passing through the area.)

By the following Tuesday, he was able to determine that no fewer than 77 of the 83 victims had almost certainly drunk from the pump. He immediately took his data to the parish vestry, which owned the pump, and asked for the handle to be removed.

It is debatable how many lives were saved directly by this action, since the disease had probably run its course by this time. What really mattered was that Snow’s message had got through. From that moment on, water quality became an issue, so that today we may consume water from our taps with relative confidence.

For further details, I recommend David Wootton’s new book, ‘Bad medicine: doctors doing harm since Hippocrates’.

The above serves to remind us how great a scourge waterborne diseases were in the past and, to our shame, still are throughout the developing world. This has been the case for five millennia, since the first great cities came into being and the need for copious amounts of drinking water ran slap bang into the need for mass sanitation.

In all civilisations the preferred remedy was the same — alcohol. Early in human history, it was noted that, whereas stored water tended to become unpleasant, the same did not apply to beer. We now know this to be due to alcohol’s bactericidal properties; our ancestors merely gave thanks to their gods and raised their cups.

From then on, beer became a staple (a few preferring wine). Even the austere Benedictine monks were allotted a daily ration of five pints, which makes one wonder how much the laity got through. Not until the late 18th century did a rival appeared on the scene, and that was tea. Boiling the water removed the bacteria as effectively as alcohol.

A testament to alcohol’s life-saving effects, together with the pitfalls of backsliding, can be found in the grounds of Winchester Cathedral, on a headstone erected in 1764 to the memory of one Thomas Tetcher, a grenadier in the North Hampshire militia, who died of “a violent fever contracted by drinking small [ie, low alcohol] beer when hot” which concludes with the following warning:

“Here sleeps in peace a Hampshire Grenadier; / Who caught his death by drinking cold small beer; / Soldiers be wise from his untimely fall / And when you’re hot, drink Strong or not at all.”

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