A bottle of wine contains more philosophy than all the books in the world.

Louis Pasteur, French biologist, microbiologist and artist (1822–1895).

Clearly there is disagreement universally about the price of wine to the consumer. I have certainly noticed that the price of wine in Italy has increased markedly over the last few years. There is no evidence that the moderate consumption of wine one glass per day [1] is detrimental to one’s health although the consumption of a large amount of alcohol during pregnancy may be extremely harmful and lead to the Foetal Alcohol Syndrome (FAS) [2]. In non-pregnant people excessive alcohol consumption especially binge drinking, can lead to anti-social behaviour and personal disintegration and, of course, liver disease. There appears to be variation in alcohol consumption in different jurisdictions for reasons that are not exactly clearcut and efforts to curtail alcohol consumption are not always successful [3].

It is probable that increasing the price of alcohol will limit consumer consumption. However, there are other factors which may influence consumption.

A number of alcohol producers are marketing alcohol-free gin and other spirits. Although I have not tasted these they appear to be gaining in popularity. Alcohol-free beer and wine have been available for some time. I don’t know if their popularity is increasing. I am not a beer drinker but, by all accounts, alcohol-free beer tastes OK. I cannot say the same about the alcohol-free wine I have tasted! Alice Lascelles writing in the Financial Times in April 2024 [4] says that champagne is decreasing in popularity at wedding receptions however, champagne is being replaced with English sparkling wine! It seems there are numerous alcohol-free champagne alternatives. One suggestion for a wedding reception: serve something fairly low-alcohol like a Bamboo, a vermouth and sherry-based Martini, or wine-based punch.

The most draconian way to prohibit alcohol consumption was the introduction of ‘prohibition’ in the United States (1920–1933). ‘Prohibition’ was a nationwide ban on the production, importation, transportation and sale of alcoholic beverages. The Volstead Act enforced the 18th amendment which exempted alcohol that was used for medicinal, cosmetic or religious purposes, specifically sacramental (altar) wine. This intervention (prohibition) was not successful but the sales of altar (sacramental) wine increased dramatically. I don’t think anybody anticipated the extent of religiosity among the wine-drinking population in the USA! [3]. Somehow, I don’t think all the altar wine was used for religious purposes.

Another way of reducing alcohol sales is to increase the price to the consumer. Peter Forster writing in the Financial Times on the 30/31st March [5] complains. He maintains that the new tax code, which will be imposed on wine importers shortly in the UK, will increase the price of wine to the consumer. He says that: ‘I’ll have to hire another full-time member of staff to keep up with the paperwork.’. Apparently, the alcohol content (on which the tax will be calculated) of wine can vary from year to year.

What has this to do with haematology? Altruism, behaviour that benefits another at one’s expense, is a phenomenon that is intrinsic to blood transfusion in many jurisdictions. One could ask the question: is altruism the ultimate form of selfishness? It is rare that altruistic individuals are questioned about the origin of their fortunes. If the fortune was the result of ill-gotten gains, then the question may seem more relevant.

Of course, the existence of altruism is not new. Gazing at the beautiful frescos by Giotto, in the Arena chapel in Padua, Italy it is easy to see a fresco of the sponsor, the banker Enrico Scrovegni, so presumably his gift of the beautiful chapel enhanced his chances of gaining access to Heaven! This was common practise, however, during the Renaissance.

Frome the point of view of the haematologist, the gift of blood transfusion stands out. Although there were efforts made at blood transfusion during the sixteenth and seventeenth centuries (Fig. 1). Interestingly, blood transfusion was recommended as a treatment for ‘insanity’. The first ‘Blood Bank’ in the USA was opened in Chicago in 1937 and credited to B Fantus [9] although it is not clear if the donations were truly altruistic. Thankfully a recent report from the National Collection and Utilization Survey (NBCUS) claims that most blood donations are from voluntary unpaid donors. It transpired that during the HIV crisis a number of blood donors were paid for their donation. This did not endear blood transfusion to the general population. Overall, blood donations are increasing in frequency in the USA and this increase is in the over 65 age group. The majority of donations take place in community-based collection centres and the good news is that donations from groups which are ‘minorities’ are increasing in frequency. The donation rate remains stubbornly low at around 6–7% and 5% in many jurisdictions, however, sadly, war (Fig. 2) acted as a stimulus for modern blood transfusion and now it has become a routine procedure. When blood is collected it is separated into its different constituents (Fig. 3).

Public domain. Source Wikipedia.

Some altruistic acts are truly altruistic although there are a number of research publications which suggest that altruistic donations provide solace and perhaps longevity to the donor. The late ‘Chuck’ Feeney comes to mind. Although he made his considerable fortune selling duty-free booze he donated the majority of his fortune, during his lifetime. Indeed Trinity College, Dublin was the recipient of some of his largess.

It seems that alcohol consumption has been and still is a feature in most societies but excess consumption should be avoided. In the meantime, enjoy an occasional glass of wine and if you have a fortune, consider an altruistic donation.