Illustration by Floc’h

Of the miseries regularly inflicted on humankind, some are so minor and yet, while they last, so painful that one wonders how, after all this time, a remedy cannot have been found. If scientists do not have a cure for cancer, that makes sense. But the common cold, the menstrual cramp? The hangover is another condition of this kind. It is a preventable malady: don’t drink. Nevertheless, people throughout time have found what seemed to them good reason for recourse to alcohol. One attraction is alcohol’s power to disinhibit—to allow us, at last, to tell off our neighbor or make an improper suggestion to his wife. Alcohol may also persuade us that we have found the truth about life, a comforting experience rarely available in the sober hour. Through the lens of alcohol, the world seems nicer. (“I drink to make other people interesting,” the theatre critic George Jean Nathan used to say.) For all these reasons, drinking cheers people up. See Proverbs 31:6-7: “Give . . . wine unto those that be of heavy hearts. Let him drink, and forget his poverty, and remember his misery no more.” It works, but then, in the morning, a new misery presents itself.

A hangover peaks when alcohol that has been poured into the body is finally eliminated from it—that is, when the blood-alcohol level returns to zero. The toxin is now gone, but the damage it has done is not. By fairly common consent, a hangover will involve some combination of headache, upset stomach, thirst, food aversion, nausea, diarrhea, tremulousness, fatigue, and a general feeling of wretchedness. Scientists haven’t yet found all the reasons for this network of woes, but they have proposed various causes. One is withdrawal, which would bring on the tremors and also sweating. A second factor may be dehydration. Alcohol interferes with the secretion of the hormone that inhibits urination. Hence the heavy traffic to the rest rooms at bars and parties. The resulting dehydration seems to trigger the thirst and lethargy. While that is going on, the alcohol may also be inducing hypoglycemia (low blood sugar), which converts into light-headedness and muscle weakness, the feeling that one’s bones have turned to jello. Meanwhile, the body, to break down the alcohol, is releasing chemicals that may be more toxic than alcohol itself; these would result in nausea and other symptoms. Finally, the alcohol has produced inflammation, which in turn causes the white blood cells to flood the bloodstream with molecules called cytokines. Apparently, cytokines are the source of the aches and pains and lethargy that, when our bodies are attacked by a flu virus—and likewise, perhaps, by alcohol—encourage us to stay in bed rather than go to work, thereby freeing up the body’s energy for use by the white cells in combatting the invader. In a series of experiments, mice that were given a cytokine inducer underwent dramatic changes. Adult males wouldn’t socialize with young males new to their cage. Mothers displayed “impaired nest-building.” Many people will know how these mice felt.

But hangover symptoms are not just physical; they are cognitive as well. People with hangovers show delayed reaction times and difficulties with attention, concentration, and visual-spatial perception. A group of airplane pilots given simulated flight tests after a night’s drinking put in substandard performances. Similarly, automobile drivers, the morning after, get low marks on simulated road tests. Needless to say, this is a hazard, and not just for those at the wheel. There are laws against drunk driving, but not against driving with a hangover.

Hangovers also have an emotional component. Kingsley Amis, who was, in his own words, one of the foremost drunks of his time, and who wrote three books on drinking, described this phenomenon as “the metaphysical hangover”: “When that ineffable compound of depression, sadness (these two are not the same), anxiety, self-hatred, sense of failure and fear for the future begins to steal over you, start telling yourself that what you have is a hangover. . . . You have not suffered a minor brain lesion, you are not all that bad at your job, your family and friends are not leagued in a conspiracy of barely maintained silence about what a shit you are, you have not come at last to see life as it really is.” Some people are unable to convince themselves of this. Amis described the opening of Kafka’s “Metamorphosis,” with the hero discovering that he has been changed into a bug, as the best literary representation of a hangover.

The severity of a hangover depends, of course, on how much you drank the night before, but that is not the only determinant. What, besides alcohol, did you consume at that party? If you took other drugs as well, your hangover may be worse. And what kind of alcohol did you drink? In general, darker drinks, such as red wine and whiskey, have higher levels of congeners—impurities produced by the fermentation process, or added to enhance flavor—than do light-colored drinks such as white wine, gin, and vodka. The greater the congener content, the uglier the morning. Then there are your own characteristics—for example, your drinking pattern. Unjustly, habitually heavy drinkers seem to have milder hangovers. Your sex is also important. A woman who matches drinks with a man is going to get drunk faster than he, partly because she has less body water than he does, and less of the enzyme alcohol dehydrogenase, which breaks down alcohol. Apparently, your genes also have a vote, as does your gene pool. Almost forty per cent of East Asians have a variant, less efficient form of aldehyde dehydrogenase, another enzyme necessary for alcohol processing. Therefore, they start showing signs of trouble after just a few sips—they flush dramatically—and they get drunk fast. This is an inconvenience for some Japanese and Korean businessmen. They feel that they should drink with their Western colleagues. Then they crash to the floor and have to make awkward phone calls in the morning.

Hangovers are probably as old as alcohol use, which dates back to the Stone Age. Some anthropologists have proposed that alcohol production may have predated agriculture; in any case, it no doubt stimulated that development, because in many parts of the world the cereal harvest was largely given over to beer-making. Other prehistorians have speculated that alcohol intoxication may have been one of the baffling phenomena, like storms, dreams, and death, that propelled early societies toward organized religion. The ancient Egyptians, who, we are told, made seventeen varieties of beer, believed that their god Osiris invented this agreeable beverage. They buried their dead with supplies of beer for use in the afterlife.

Alcohol was also one of our ancestors’ foremost medicines. Berton Roueché, in a 1960 article on alcohol for The New Yorker, quoted a prominent fifteenth-century German physician, Hieronymus Brunschwig, on the range of physical ills curable by brandy: head sores, pallor, baldness, deafness, lethargy, toothache, mouth cankers, bad breath, swollen breasts, short-windedness, indigestion, flatulence, jaundice, dropsy, gout, bladder infections, kidney stones, fever, dog bites, and infestation with lice or fleas. Additionally, in many times and places, alcohol was one of the few safe things to drink. Water contamination is a very old problem.

Some words for hangover, like ours, refer prosaically to the cause: the Egyptians say they are “still drunk,” the Japanese “two days drunk,” the Chinese “drunk overnight.” The Swedes get “smacked from behind.” But it is in languages that describe the effects rather than the cause that we begin to see real poetic power. Salvadorans wake up “made of rubber,” the French with a “wooden mouth” or a “hair ache.” The Germans and the Dutch say they have a “tomcat,” presumably wailing. The Poles, reportedly, experience a “howling of kittens.” My favorites are the Danes, who get “carpenters in the forehead.” In keeping with the saying about the Eskimos’ nine words for snow, the Ukrainians have several words for hangover. And, in keeping with the Jews-don’t-drink rule, Hebrew didn’t even have one word until recently. Then the experts at the Academy of the Hebrew Language, in Tel Aviv, decided that such a term was needed, so they made one up: hamarmoret, derived from the word for fermentation. (Hamarmoret echoes a usage of Jeremiah’s, in Lamentations 1:20, which the King James Bible translates as “My bowels are troubled.”) There is a biochemical basis for Jewish abstinence. Many Jews—fifty per cent, in one estimate—carry a variant gene for alcohol dehydrogenase. Therefore, they, like the East Asians, have a low tolerance for alcohol.