The end of The Garrison Commander left us with Claire drinking large amounts of whisky and coming to terms with the fact she would tomorrow be marrying a Scot.
One James Alexander Malcolm MacKenzie Fraser, to be exact.
One of my few criticisms of the TV adaptation of the Outlander story was Claire telling Jamie on their wedding day that she couldn’t marry him because she didn’t even know his name. As we just saw above, at the end of The Garrison Commander, Claire is reading the marriage contract which we can see lists Jamie’s full name. However, let us assume perhaps she forgot because of all the whisky.
And how about all that whisky?
The next morning, Murtagh wakes a very hungover Claire. It is time to dress for the wedding in the absolutely breathtaking gown which Ned Gowan has obtained (and hopefully he hasn’t obtained any other lasting gifts from his new friends that night – more on that in a future post!)
The symptoms of hangover are universally known but scientists are still working to determine what exactly causes it. Some theories include:
1. The effect of the byproducts of ethanol as the body digests it.
After ingestion, ethanol is converted to acetaldehyde by the enzyme alcohol dehydrogenase. It is then converted to acetic acid. Acetaldehyde is more toxic than alcohol itself and remains at elevated levels for many hours after ethanol is ingested.
2. The effect of other substances in the beverage, known as congeners
Many alcohol drinks also contain other substances, either as flavoring or as a byproduct of the fermentation or aging process. These can include amines, amides, acetones, polyphenols, methanol, histamines, esters and tannins, many of which are toxic.
Different types of alcoholic beverages have differing amounts of congeners and in general, the darker the liquor, the higher the concentration. The amount found in bourbon is 37 times higher than that found in vodka. This doesn’t bode well for our whisky drinking Scots!
Ethanol increases urine production (diuresis) and dehydration may be responsible for some of the symptoms of a hangover – thirst, dizziness and lightheadedness. Initially thought to be contributory, studies show that electrolyte changes are minimal after drinking, though.
4. Stomach acid
Nausea and vomiting may be due to the effect alcohol has on the stomach by stimulating the production of hydrochloric acid and delaying stomach emptying.
5. Low blood sugar
Alcohol can cause blood sugar to fall, causing fatigue, weakness and shakiness
6. Effect on blood vessels
Alcohol causes blood vessels to expand, leading to headaches
7. Immune response
Alcohol can cause an inflammatory response, causing the concentration of several cytokines (immune system communication signals) to be significantly increased. In fact, researchers have found if healthy subjects are injected with cytokines, the persons will have the symptoms of hangover such as nausea, headache, chills and fatigue!
Some ethnic groups have a mutation in the alcohol dehydrogenase gene making the conversion from ethanol to acetaldehyde very fast. Others convert acetaldehyde to acetic acid more slowly and see a larger buildup of the more toxic acetaldehyde than other groups. Accumulation of acetaldehyde causes an alcohol flush reaction – redness to the face, neck and shoulders, or even the entire body, nausea and tachycardia (rapid heart rate).
Remember Henri de Toulouse-Lautrec from our discussion of Colum’s deformed legs? He was an artist in France at the end of the 19th century who suffered from the condition and for whom it was named. Below is one of his works depicting a hangover.
What to do?
2. Anti-inflammatories! If the mechanism of hangover is an inflammatory response, then anti-inflammatory medications may be the key. In fact, we already saw Claire thinking ahead and stockpiling willow bark for hangovers in preparation for The Gathering!
3. Eat! Get that blood sugar up and eat some carbs. Hopefully Murtagh has brought something for Claire when he came to wake her.
4. Caffeine! If the headache in a hangover is due to dilated blood vessels, then caffeine may counteract this with its action to constrict the blood vessels in the brain.
And if you are in modern day Scotland, packing fluids, caffeine and carbs in the form of Irn-Bru is the thing to try!
An older Scottish cure was the “Highland Fling” – mix a tablespoon of cornflower into a pint of buttermilk. Add salt and pepper and drink!
Cornflower has anti-inflammatory properties, so between that, the hydration and fats/carbs it provides, this remedy may be helpful!
Throughout the course of the wedding night, Claire drank no less than eight glasses of whisky by my count.
Perhaps someone will be nice enough to prepare a Highland Fling for her!