Spirits and liqueurs in European traditional medicine: Their history and ethnobotany in Tuscany and Bologna (Italy)

Fermented drinks, often alcoholic, are relevant in many nutritional, medicinal, social, ritual and religious aspects of numerous traditional societies. The use of alcoholic drinks of herbal extracts is documented in classical pharmacy since the 1st century CE and it is often recorded in ethnobotanical studies in Europe, particularly in Italy, where are used for a wide range of medicinal purposes. Formulations and uses represent a singular tradition which responds to a wide range of environmental and cultural factors.This research has two overarching aims To determine how long ancient uses, recipes and formulas for medicinal liqueurs from the pharmacopoeias and herbals of the 18th century persisted in later periods and their role in present ethnobotanical knowledge in areas of Tuscany and Emilia-Romagna (Italy). To trace other possible relationships among ancient and recent recipes of alcoholic beverages, from both popular and 'classic' (learned) sources in N-C Italy and neighboring areas.The review of herbals and classical pharmacopoeias, and ethnobotanical field work in Alta Valle del Reno (Tuscany and Emilia Romagna, Italy) were followed of a systematic study of ingredients and medicinal uses with multivariate analysis techniques.The multivariate analysis clearly shows six different styles of preparing medicinal alcoholic beverages: 1. The medicinal wine formulae by Dioscorides (1st century CE). 2. The pharmacopoeias of Florence and Bologna in the 18th century CE. 3. The formularies of Santa Maria Novella and Castiglione (19th and early 20th centuries CE). 4. The ethnobotanical data from Appennino Tosco-Emiliano; home-made formulations based almost exclusively on the use of local resources. 5. Traditional recipes from NE Italy and Austria. 6. Traditional recipes from NW Italy, Emilia, and Provence (France). A total of 54 ingredients (29 fruits) from 48 species are used in different combinations and proportions in Alta Valle del Reno (Italy) to produce fermented beverages, liqueurs, distilled spirits and aromatized wines. Among these, 37 ingredients (33 species) are used as medicinal remedies. 15 ingredients (14 species) are also used to prepare specific medicinal liqueurs. Most are addressed to the treatment of diseases of the digestive system, dyspepsia in particular, followed by diseases of the respiratory system symptoms, not elsewhere classified and diseases of the skin and subcutaneous tissue, fundamentally of allergic origin.Although medicinal wines, liqueurs and spirits are recorded in numerous classical herbals and pharmacopoeias in Italy and other countries of Europe these show in terms of formulations and ingredients little influence in the ethnobotanical formulations recorded in Alta Valle del Reno (Italy), they apparently play no role in present ethnobotanical knowledge in Appennino Tosco-Emiliano and similarly in other areas of Italy, France and Austria. No (or very poor) persistence was found of ancient uses, recipes and formulas for medicinal liqueurs from pharmacopoeias and herbals of the 16th century CE in later periods in the formulas in use in the pharmacies of Tuscany. Popular recipes are strongly dependent on the availability of local wild and cultivated plants. Overall, Alta Valle del Reno ethnobotanical formulations of medicinal wines and spirits are extremely simple involving from one single ingredient to a few, which are locally produced or collected and selected among relevant medicinal resources used for a wide range of diseases in form of non-alcoholic aqueous extracts. Fruits gathered in the forests are the main ingredients which in this aspect show similarities with those from Tyrol (Austria). Medicinal liqueurs and wines are in analyzed ethnobotanical data mainly employed as digestives.