Chapter 1

Chocolate in Science, Nutrition and Therapy: An Historical Perspective

Philip K. Wilson*a
a Department of History, East Tennessee State University, Johnson City, Tennessee, 37614-1709, USA. E-mail: wilsonpk@etsu.edu


To better place the following chapters within an historical context, this brief introduction aims to help readers fully appreciate the relatively long-standing quest to identify, validate and promote chocolate's potential in fulfilling nutritional needs, improving health and preventing disease. This historical introduction provides a broader framework for the themes addressed in the following chapters. The brief synopsis that follows describes centuries of nutritional and medicinal associations with cacao and chocolate in a manner that corresponds with the three sections of this volume, namely science, nutrition and health. Readers who wish to delve further into this historical quest are referred to Philip K. Wilson and W. Jeffrey Hurst's Chocolate as Medicine: A Quest over the Centuries, Royal Society of Chemistry, Cambridge, UK, 2012.


The Chocolate Tree supplied the “raw product for a most delicious, healthy and nourishing drink”.Carl Linnaeus, the 18th-CenturyPhysician who classified this tree with the name Theoboroma cacao1

1.1 Introduction

As culinary and healing arts schools are increasingly combining efforts to promote an enhanced understanding of and practices around the theme of “food as medicine”, chocolate remains at the core of this discourse. This volume, Chocolate and Health: Chemistry, Nutrition and Therapy, provides a snapshot in time identifying major areas whereby key bioactive ingredients of chocolate are being increasingly scrutinized to ascertain possibilities and potentials. Of course, snapshots never completely reveal the total scene,2 though together they can provide something of a synthesis of the total landscape. Over time, current investigations will provide the historical rendering of the nutritional and biomedical pursuits of the early 21st century. As in all science-based research, some leads from previous times meet roadblocks, thereby diverging efforts onto entirely different paths. Just where chocolate will be featured in nutrition, health and therapy by the middle of the century is unknowable. Still, the pursuit to that eventual placement needs a starting point. This volume serves, among other uses, as that point. Although this chapter's focus is intentionally historical, the references cited throughout this volume provide the respective chapter authors with springboards of earlier work from which to frame their own interpretations and research protocols. As such, they too provide selective historical cornerstones from which the authors’ modern accounts are construed.3

To better place the following chapters within an historical context, this brief introduction aims to help readers fully appreciate the relatively long-standing quest to identify, validate and promote chocolate's potential in fulfilling nutritional needs, improving health and preventing disease. This historical introduction produces a broader framework for the themes addressed in following chapters. The brief synopsis that follows describes centuries of nutritional and medicinal associations with cacao and chocolate in a manner that corresponds with the three sections of this volume, namely science, nutrition and health. Though considerable history has been noted to be foundational for this volume, much of chocolate's luscious heritage has, alas, been neglected. Readers who wish to delve further into this historical quest are referred to Philip K. Wilson and W. Jeffrey Hurst's Chocolate as Medicine: A Quest over the Centuries, as well as a number of other recent writings by authors or editors including Sophie D. and Michael D. Coe; Teresa L. Dillinger et al.; Meredith L. Dreiss and Sharon Edgar Greenhill; Martha Makra Graziano; Louis Evan Grivetti and Howard Yana Shapiro; Donatella Lippi; Murdo J. MacLeod; Cameron L. McNeil; Marcia and Frederic Morton; Sarah Moss and Alexander Badenoch; Deanna Pucciarelli and James Barrett; and David Wolfe and Shazzie.4

Of all the products to emerge from the diversity of the tropical rain forest, none approaches the universal appeal and popularity of chocolate.Allen M. Young, Tropical RainforestZoologist and Museum Coordinator

1.2 Chocolate in Science

The chocolate tree's official name, Theobroma cacao (food of the gods), acknowledges both scientific and sacred associations with this plant. The chocolate we consume derives from one of three cacao bean varieties: forastero (foreign born) being the most common variety, which supplies up to 90% of the global use;6 criollo (native born), which, being more rare, is used in preparing what many deem the finest of chocolates; and trinitario (sent from heaven), being a hybrid of the other two varieties.

Though “chocolate” is commonly referred to in a general sense, several distinctions should be noted. Chocolate itself is the main processed by-product of the cacao bean (or nib or cotyledon). Cacao, the species of the Theobroma cacao plant, is typically used in reference to the tree, pod or bean, whereas cocoa refers to the powder made from the processed bean.

Pods of the chocolate tree—historically referred to as oro negro (black gold) or pepe de oro (seeds of gold)—have long been highly valued and laboriously harvested with machetes or purposefully made cutlasses on long poles. Processing the nibs within the pods has also required intensive skilled labor. The Maya would pound the nibs with stones called manos against a hard-surfaced metate, facilitating the process by adding a heat source underneath (Figure 1.1).

Fig. 1.1 An indigenous American surrounded by a chocolate drinking cup, a molinet, and a chocolate pot, all atop an image of the cacao pod. Frontispiece from Phillippe Sylvestre Dufour's Traitez Nouveaux et Curieux du Cafe, du The et du Chocolate (1688). (Courtesy of Hershey Community Archives, Hershey, Pennsylvania, USA.)

This treasured plant of the New World found its way to the Old World via Hernán Cortés in 1528, with more regular transport after 1585. In these new surrounds, modifications in its use ensued over the centuries. Among the most crucial modifications that revolutionized the industrial processing of chocolate employed James Watts’ steam engine in the place of Mayan muscle. An even greater contribution, so David G. Mitchell argued, was the later introduction of commercial refrigeration: “No longer was the [chocolate] industry limited as to geographical location for the longest spell of cool weather; neither was it limited to operation only during the cool season of the year”.7

In time, further industrialization efforts focused on improving the physical processes of roasting (adding flavor and color), winnowing (separating nibs from their outer husks), milling and conching (kneading in the traditionally shell-shaped machines, together with aerating machines, to increase smoothness, viscosity and flavor), as well as chemically treating components along the production line (e.g., alkalinizing or “Dutching”) to enhance the proper solubility, flavor and color.8

In areas surrounding the chocolate tree's natural habitat, select members of Olmec, Maya, Zapotec, Mixtec, Toltec and Aztec cultures claimed nutritional and medicinal benefits of their specially prepared ka-ka-wa (Olmec)- or cacao (Maya)-based drink preparations. Over the centuries, our refined understanding of the chocolate tree has shown that its delectable product requires delicate care throughout the agricultural enterprise.9 In order to prosper, cacao needs biologically rich and diverse growing areas. The equatorial rainforests provide optimal agronomic conditions, though enhancing its cultivation requires constant attention to planting, pollination, pruning and protection. The significant amount of shade that the chocolate tree requires has been appreciated for centuries.

Accompanying the first known engraved illustration (Figure 1.2) of this tree in Giralamo Benzoni's La Historia del Mondo (1565) is an inscription that, in translation, informs us that the chocolate tree

grows only in hot places, but under shade, for if the sun were to shine on it, it would die. Therefore, they plant it in forests where it is humid, and, afraid that this is not enough, they plant it next to a tree which is higher and which they bend over it, spreading its top so that it covers the cocoa tree, which thus gets shade all over it, so that the sun no longer does any harm.

Fig. 1.2 First engraving of the chocolate tree, Giralamo Benzoni's La Historia del Mondo (1565), from C.J.J. Van Hall's Cacao (1914).

Only later was this thick rainforest canopy found to widely support the growth of the Ceratopogonid (biting) and Cecidomyiid (gall) midges (family Diptera) that consume nectar from and simultaneously pollinate the tiny pink blossoms of the chocolate tree. Each pollinated blossom subsequently produces small cherelles that, upon maturation, form the characteristic rugby ball-shaped pods. Given that not all cherelles from the same cluster of blossoms mature simultaneously, extra care is needed during harvesting.

Adding to these agronomic needs are efforts to overcome the diseases to which the chocolate tree is most susceptible. Among this tree's predominant predatory pests are the brown and black capsids (Sahlbergella singularis and Distantiella theobroma, respectively), both of which damage inner tissue by feeding on the sap. The fungi Phytophthora megakarya and Moniliophthora roreri induce black pod rot and frosty pod rot, respectively, whereas the broom-like fungal growths of Moniliophthora (Crinipellis) perniciosa (commonly known as witches’ broom)—first reported in Surinam in 1895—destroy chocolate tree leaf buds, flowers and pods. Pod-boring moths (Conopomorpha cramerella) are also known to damage bean development, and mealybugs (Planococcoides njalensis) serve as the vector for introducing the cacao swollen shoot virus (family Caulimoviridae, genus Badnavirus), which primarily produce stem and root swelling types of destruction. Problems created by cacao or cocoa thrips (Selenothrips rubrocinctus), the “enxerto” ant (Azteca paraensis var. bondari) and various stem-attacking beetles are considerable, as are losses attributed to rats, squirrels, birds and parasitic plants.11

Though many of these plant–pathogen connections were identified in the late 1800s or early 1900s, their wrath became particularly apparent with the “neglect of the [cacao] plantations” during World War II. Following the war, “when demand again rose, it was found that there was a definite shortage of cocoa beans”.12 Consequently, the prices of all chocolate products “rose markedly” for a few years. Once chocolate tree diseases were more stringently addressed, chocolate supply rose to approximate the demand and, in 1949, the rationing allocation that had been instituted by the Internal Emergency Food Committee during the war was finally revoked.

More recently, agroforestry efforts have aimed at establishing more sustainable cacao farming, often in regions beyond cacao's natural habitat. In particular, alterations at the genetic level are being explored in the hopes of increasing plant resistance to disease and producing higher-yield varieties of cacao. These efforts are, in turn, “increasingly threatened” by deforestation measures including farming, grazing, logging and mining—all of which are being touted as responsible measures of “agricultural expansion”.13 Chocolate, which has long held seemingly mystical and magical properties,14 may have yet another seemingly “magical” role to play in regards to agronomy. It may very well be the increased demand for this precious product that consequently leads to major efforts in saving the natural diversity of rainforest regions.15

So, just where are these cacao-growing regions? The first cacao plantations were established in Brazil in 1745, and this region continues to be recognized for its cacao crop. By the early 1800s, cacao was predominantly grown in Central and South America and the West Indies. A century later, African smallholdings and farms had become the predominant growing areas, especially within the rainforest lands of the then-named Gold Coast (now Ghana) and the Ivory Coast.16 Since then, Malaysia has also become an increasingly important growing region.

As no other product truly mimics the multifaceted cacao, it has become a widely traded commodity since its introduction on the New York Cocoa Exchange in 1925. Only recently, however, have large chocolate companies began devoting significant attention towards acknowledging the rights, welfare and health of laborers whose livelihoods ultimately provide the world with such pleasures of the palate.17

The cacao bean is a phenomenon, for nowhere else has nature concentrated such wealth of valuable nourishment in so small a space.Alexander von Humboldt,19th-Century Natural Philosopher andExplorer Extraordinaire

1.3 Chocolate as Nutrition

“In its many forms chocolate may be consumed as a beverage, a syrup, a flavoring, a coating or a confection itself”, so Norman Potter noted in Food Science (1973).19 But does chocolate have an even greater nutritional value than this comment suggests? Chocolate remains, as tropical rainforest zoologist Allen M. Young claimed, a “gustatory bond between past and present peoples”. Indigenous among New World peoples, chocolate was transported to the Old World then back to North America, thereby forming a “bridge between two very distinct spheres of humankind”.20 In terms of nutrition, Old World peoples viewed chocolate as providing “the greatest delicacy for extraordinary entertainments”.21 Speculation about its nutritional value can be based upon an early recipe for drinking chocolate that Antonio Colmenero de Ledesma reported in the first book devoted entirely to chocolate, Curioso Tratado de la Naturaleza y Calidad del Chocolate (1631).

Of cacaos 700 (beans)Of white sugar, one pound and a halfeCinnamon 2 ouncesOf long red peppers 14Of cloves, halfe an ounce (the best writers use them not)Three Cods of the Logwood or Campeche tree. These Cods are very good, and smell like Fennell.[O]r instead of that the Weight of 2 Reals or a shilling of Anniseeds [sic]. As much of Achiote as will give it colour which is about the quantity of a hasell-nut [sic].

Indeed, reputable sources over the centuries have identified the “goodness” of chocolate in terms of food and nutrition. Centuries ago, writers frequently offered opinions on cacao's nutritive value, though their opinions often “differed greatly”. Beginning in the mid-19th century, as one early bibliographer of chocolate and nutrition noted, “a greater uniformity of opinion” was found, and writers grew “more and more in accord” regarding its specific nutritional aspects.23 Consider, for example, the following appellations to chocolate as a food drawn from professional literature worldwide published within the last 150 years.

Table
1860 Chocolate was “among the many articles which have come to be regarded as auxiliarious, if not necessary in our diet”.24
1864 Chocolate provides a compact and concentrated form of both stimulant and food.25
1875 “The value of cocoa as a food is thus apparent, and fully justifies the high eulogiums which have been passed on it”.26
1879 Cocoa is a “most nourishing article of diet” that contains enough nutrients “to be classified as a food”.27
1882 Cocoa provides “an indispensable, all-round nursery food”.28
1897 Chocolate is “a food, which is nourishing for all kinds of people and good for aged persons”.29
1906 “Ten adjectives sum up the story with regard to good cocoa—it is pure, nutritious, wholesome, strengthening, readily digested, sustaining, invigorating, delicious, refreshing and convenient”.30
1907 “What has mainly led to the widespread use of cocoa is the understanding that it is not only a food but also a nutritive food”.31
1908 Chocolate's “food value is highly regarded by all civilized governments”.32
1910 The theobromine in chocolate “contains 90% nutritive matter, mak[ing] it a very valuable foodstuff …”.33
1926 “Breakfast Cocoa … is nourishing and easily digested. Owing to its concentrated nutriment it becomes, when milk is added, an almost perfect food”.34
1951 The chocolate industry possesses a product “noted not only as one of the most popular flavors, but also as a valuable food item”.35

In recent years, chocolate's value in terms of food and nutrition has been regularly highlighted.36

Table
1974 Chocolate's “high food value” is widely noted.37
1977 Chocolate is characterized as a “thoroughly efficient food, giving you both energy and a representative amount of most of the necessary nutrient” that is servable as a “food for the most philosophical gourmet”.38
1987 Chocolate is an “emotional food associated with warmth, sweetness and contentment”.39
1999 Chocolate is defined as a “solid or semiplastic food”.40
2000 After defining food as that substance which is “required to give us energy”, chocolate was identified as being “able to do this relatively rapidly”.41
2002 No “respectable synthetic [i.e., artificial] substance” exists to mimic cacao's taste and nutritional value.42
2005 When “consumed as part of a balanced and varied diet, chocolate can be both a source of nutrients as well as pleasure, and can be considered as being part of a healthful, wholesome diet”.43

Such passages attest to the long-standing acknowledgement of chocolate's nutritive value. In order to meaningfully appreciate this significance, a working definition of nutrition is helpful. Among the various definitions available, that provided in The Concise Encyclopedia of Foods & Nutrition (1995) contains many points common to other characterizations. There, nutrition is defined as “the science of food and its nutrients and their relation to health”.44 Using this broad definition, all of the chapters in this volume address some important aspect of chocolate as nutrition. Questions remain, however, in determining more precisely what type(s) of food chocolate represents and what specifically are chocolate's key nutritive values.

In 1953, Eileen M. Chatt of the British Food Manufacturing Industries Research Association explained that chocolate lacked “accessory factors” whereby it “f[e]ll short of being a perfect food”. Still, it was deemed to be a “satisfactory base for the incorporation of supplementary vitamins”.45 Similar language is evident in earlier 20th-Century initiatives into the developing language of food nutrition as a science. As the following select areas of cacao and chocolate research demonstrate, the quest for specialized nutritive knowledge regarding chocolate was underway nearly a century ago. These research areas are drawn from Stroud Jordan's contemporary review of the literature of that period, a work designed “in order that some of the lesser known and understood results will be [made] available” to the greater chocolate manufacturing community.46

Table
1922 Chemical analysis of the composition of cocoa butter; determination of the theobromine content of cacao beans.
1928 Quantitative determination of the tannins in cacao.
1929 Identification of the theosterols in cacao and the glycerides in cocoa butter.
1931 Quantification of the fat and phosphate content of cacao; nutritive valuation of commercial cacao; digestibility of cacao's nitrogenous substances.
1932 Caloric determination of cacao; estimation of cacao's solubility; determination of the vitamin A and B content of milk chocolate.
1937 Epicatechins identified in cacao.

An early giant in nutrition science, E.V. McCollum, offered an overview of the increasing emphasis during the early 20th century on approaching nutritional research strictly from a scientific basis in A History of Nutrition (1957).47 Other interwar writers, notably the Kansas City physician–author Logan Clendening, influenced a generation of general readers through his popular representations of the body's biochemical makeup in his The Care and Feeding of Adults, With Doubts about Children (1931) and The Balanced Diet (1936).48

Similar depictions of chocolate's biochemical composition also began to appear at this time. Some of this work transpired at the pioneering Dunn Nutritional Laboratory formed in Cambridge, England, in 1927. There and elsewhere, nutritional authorities investigated claims that chocolate's natural nutritive value was enhanced by adding milk, which was consumable as chocolate milk or cocoa drink or as a milk chocolate bar to eat. Indeed, adding milk elevated chocolate to what many deemed to be a “complete food”.49

Among the leading chocolate companies of that era, Hershey's made great strides in documenting why chocolate and cacao were “foods which have gained a rightful place in the diet”. Such claims were among the concluding remarks of A Bibliography of the Nutritive Value of Chocolate and Cocoa, a 1925 Hershey Company publication prepared by the American Food Journal Institute in which noted nutritional expert Edith C. Williams reviewed 166 contemporary scientific reports investigating the nutritive value of chocolate (Figure 1.3).50

Fig. 1.3 Cover of Edith C. Williams's A Bibliography of the Nutritive Value of Chocolate and Cocoa (1925). (Courtesy of Hershey Community Archives, Hershey, Pennsylvania, USA.)

Twenty-five years later, Samuel Hinkle, then Chief Chemist of the Hershey Company, was still touting chocolate's nutritional benefits. All “activities of the human body” were known to “require a constant expenditure of energy” and an “interchange of material”. Chocolate products—particularly Hershey's chocolate products—were offered to the public “with the knowledge that they contain the highest grade ingredients prepared under rigid sanitary conditions and … [prepared with] the finest [chocolate] that can be made”. Noting these products to be “sources of highly concentrated food energy”, chocolate was deemed to have earned a “rightful place” alongside “all well-known and well-prepared foods”.51

To further broadcast these nutritive findings, illustrative figures and tables appeared in various popular media rhetorically substantiating the “wise choice” people would make by adding substantial amounts of chocolate to their daily consumption (Figure 1.4). Such charting continued through the century. By 1975, the US Department of Agriculture published tabular comparisons of chocolate (including milk chocolate with and without almonds or peanuts, chocolate-coated peanuts and chocolate-coated raisins) with other regular consumables including apples, bananas, cheese crackers, cookies, ice cream, oranges, peanuts, raisins, sunflowers and yogurt. Chocolate came in second (after sunflowers) in terms of total food energy, close to ice cream and yogurt in terms of protein and midrange in terms of carbohydrates. Based upon these findings, the US Chocolate Manufacturers Association (CMA) noted that since “no one food supplies exactly the right balance” of nutrients (specifying water, protein, carbohydrates, fats, vitamins and minerals), “nutritionists recommend [consuming] a variety of foods” as the “best method of assuring good nutrition”. Given that chocolate's nutritional value had been scientifically validated by independent investigations across the globe, it is not surprising to find the CMA strongly endorsing the regular consumption of chocolate products as a smart way of “maintaining that daily balance”, especially when “combined with other foods such as milk, almonds, peanuts and peanut butter”.52

The persons who habitually take chocolate are those who enjoy the most equable and constant health and are least liable to a multitude of illnesses which spoil the enjoyment of life.Jean Anthelme Brillat-Savarin,Physiologie du Goût, ou Méditations de Gastronomie Transcendante (1825)53

Fig. 1.4 Chocolate's nutritional value, from Bernarr Macfadden's “Hershey, The Chocolate Town” (c. 1923). (Courtesy of Hershey Community Archives, Hershey, Pennsylvania, USA.)

1.4 Chocolate as Therapy

Chocolate, a therapeutic medicine? Yes, and a preventative medicine as well! What an “appealing idea that a food commonly consumed for pure pleasure could also bring tangible benefits for health”.54 Indeed, it is the “epitome of nutritional indulgence” that chocolate “has of late attracted increasing attention because of health effects”.55 Few natural products have been purported to effectively treat such a wide variety of medical disorders as has chocolate, ranging from a “specific” to an aphrodisiac to a panacea. Since the 1990s, investigators have increasingly scrutinized chocolate's potential therapeutic benefits for humans. These claims have been reviewed in a few key multi-authored volumes including edited works by Ian Knight (1999); Rodolfo Paoletti, Andrea Poli, Ario Conti and Francesco Visioli (2012); and Ronald Ross Watson, Victor R. Preedy and Sherma Zibadi (2012).56Chocolate and Health: Chemistry, Nutrition and Therapy distinguishes itself from these other helpful tomes in covering the vast range of chocolate's science, nutrition and therapeutic potential in a concise yet complete manner.

Promulgating chocolate for its therapeutic claims, however, has a centuries-long heritage, with many claims extending back to Aztec medical practices. There, remedies concocted from cacao beans were used to soothe stomach and intestinal complaints, control childhood diarrhea, reduce fevers, steady the fainthearted, expel phlegm by provoking cough, reduce the passage of blood in stool and promote strength before military conquests as well as before “acts of venery”. In later eras, chocolate remedies were used to combat emaciation, decrease “Female Complaints”, delay hair growth, promote the expulsion of kidney stones, increase breast milk production, prolong longevity, both encourage and prohibit sleep, clean teeth and diminish one's timidity.57

As seen in Appendix 1, a number of early printed monographs appeared in the New World which described the seemingly magical health benefits derived from chocolate. The first book devoted entirely to chocolate, Antonio Colmenero de Ledesma's Curioso Tratado de la Naturaleza y Calidad del Chocolate (1631), was widely translated into European languages. Chocolate's perceived medicinal benefits appear on the very title page which states: by the “wise and moderate use whereof health is preserved, sickness diverted, and cured, especially the plague of the guts; vulgarly called the new disease; fluxes, consumptions, and coughs of the lungs, with sundry other desperate diseases. By it also, conception is caused, the birth hastened and facilitated, beauty gain’d and continued”.

The physician Henry Stubbe's The Indian Nectar; or, A Discourse Concerning Chocolata (1662) included medical cases from cacao growing regions of the New World. For instance, he noted that “English soldiers stationed in … Jamaica lived [for many months on only] cacao nut paste mixed with sugar … which they [drank having] dissolved [it] in water”. There, women were reported to have eaten chocolate “so much … that they scarcely consumed any solid meat yet did not exhibit a decline in strength”.58

In a summary statement, Stubbe noted chocolate to be “one of the most wholesome and pretious [sic] drinks, that [has] been discovered to this day: because in the whole drink there is not one ingredient put in, which is either hurtful in it self, or by commixtion; but all are cordial, and very beneficial to our bodies, whether we are old, or young, great with child, or … accustomed to a sedentary life.”59 Stubbe referenced Dr Juanes de Barrio's claim that chocolate was “all that was necessary for breakfast, because after eating chocolate, one needed no further meat, bread or drink”.60

Further information regarding chocolate's use as medicine in Nicaragua, New Spain, Mexico, Cuba and Jamaica is found in William Hughes’ The American Physician, or a Treatise of the Roots, Plants, Trees, Shrubs, Fruit, Herbs &c. Growing in the English Plantations in America; with a Discourse on the Cacao-Nut-Tree … and All the Ways of Making of Chocolate (1672). While sailing amongst the West Indies, Hughes “liv’d, at Sea for some Months” on “nothing but Chocolate, yet neither his strength, nor flesh were diminished”.61 Hughes found chocolate to be helpful in balancing “Lean, Weak, and Consumptive Complexions”, and he claimed that it “may be proper for some breeding Women, and those persons that are Hypochondriacal, and Melancholly [sic]”.62 Chocolate, when “internally administered”, was found to be “good against all coughs, shortness of breath, opening and making the roughness of the Artery smooth”, thereby “palliating all sharp Rheums, and contributing very much to the Radical Moisture, being very nourishing, and excellent against Consumptions”. The “fat Butter or Oyl” of the cacao bean was reputed to be “very effectual, being externally applied, against all inflammations, i.e., Phlegmons, Erysipelas, St Anthony's Fire, Smallpox, Tumours, Scaldings and Burnings”. When applied on the skin, it cooled the “pains proceeding from heat”, minimized the “crustiness or scars on Sores, Pimples, chapped Lips and Hands” and “wonderfully refresheth[ed] wearied limbs” and “mitigate[d] the pain of the Gout, and also Aches by reason of old Age”.63 Hughes concluded noting that medicines “whereof the cacao is the principal ingredient” had become “approved of by Learned Physicians, and sufficiently recommended to the world”.64

Chocolate's usefulness as a medicine prompted its spread throughout Europe. Such claims are noted in the following works: Spanish Court Physician Augustin Farfan's Bref Traité de Médecine (1579) cited chocolate's usefulness in eliminating kidney stones and purging the gut. Un Discurso del Chocolate (1624) promoted a wider array of New World views of chocolate's medicinal benefit for Old World audiences. Francisco Maria Brancaccio, later Cardinal Brancaccio, described chocolate's usefulness as a medicine that “restores natural heat, generates pure blood, enlivens the heart, [and] conserves the natural faculties”.65 René Moreau, in 1643, published his medical dissertation of the healthfulness of chocolate. By 1659, the Paris Faculty of Medicine had bestowed their imprimatur on its use. Cornelis Bontekoe, Dutch physician to the Elector Wilhelm of Brandenburg, in 1678 published Tractaat van het Excellenste Kruyd Thee in which praise for chocolate's medical qualities increased its consumption throughout Germany. Daniel Duncan's Wholesome Advice Against the Abuse of Hot Liquors, Particularly of Coffee, Tea, Chocolate (1706) claimed the best benefits were derived from chocolate when drunk in moderation. Leonhard Ferdinand Meisner's Caffe, Chocolatae, Herbae Thee ac Nicotianae: Natura, Usu, et Abusu Anacrisis: Medico-Historico-Diatetica (1721) described the uses and abuses of chocolate, as did Girolamo Giuntini's Alto Parere Intorno alla Natura ed all'uso della Cioccolata Disteso (1728). Further remedies containing chocolate which were claimed as useful for fighting disease appeared in François Foucault's An Chocolatae Usus Salubris? (1684), in D. Quelus's Histoire Naturelle du Cacao et du Sucre (1719), in Pierre Joseph Buc'hoz's Dissertations sur l'Utilite, et les Bon et Mauvais Effects du Tabac, du Café, du Caco, et du The (1788), and in Munster College of Medicine Director, Christopher Ludwig Hoffmann's late 18th-Century treatise, Potus Chocolate.80

The entrepreneurial English physician William Salmon (who some contemporaries dubbed a quack)66 prepared a special “liquid medicine” he named “chocolate wine”, which he prescribed and sold to his patients to be drunk by the glassful. His contemporary, the physician from St Dizier, Champagne, Pierre-Toussaint Navier, also advocated chocolate as medicine in Observationes sur le Cocao et sur le Chocolate (1772). Among the benefits Navier noted were chocolate's usefulness against scurvy, consumption, worms, digestive acids and general disorders of the lungs, heart and vessels. In details far beyond the typical descriptions of the day, Navier articulated his view that chocolate's particular usefulness to gut and bowel disorders was due to its being “incorruptible” throughout the digestive tract. Unlike milk and meat, which experimenters of the day had found to easily go rancid, chocolate's cocoa butter content offered it a “high degree of resistance to rancidity”.67 For those who were unable to “stomach” cacao's high fat concentrations, Navier recommended cacao shell infusions that he claimed in medical terms to be “stomachic, balsamic, pectoral and especially aperient” in its properties. In addition to noting the benefits of cacao itself, Navier further described chocolate's medicinal benefit of being used as a vehicle for other types of medicines such as purgatives, attenuants, expectorants, diuretics and incidentia.68

A century later, chocolate's potential health benefits were still being touted. For example, Alfred Franklin promoted chocolate's ability to preserve and control health in his 1893 Le Café, le The et le Chocolate, as did Edwin Franke in his 1914 Kakao, Tee und Gewurze. At times, chocolate prescriptions and recipes appeared in the same work, such as in Thomas Cooper's 1824 Treatise of Domestic Medicine, to which is added, A Practical System of Domestic Cookery. Beginning in the 19th century, European and US advertisements revealed an important conceptual change regarding chocolate and health. It was during this time that advertising helped solidify what was to become chocolate's enduring reputation as both a medicine and a food. Soon, chocolate became the medicine handed out by confectioners and the food prescribed by physicians.

By the early 1700s, chocolate had become figuratively and literally linked with milk. London physician and Royal Society President Sir Hans Sloane specifically touted milk chocolate as the new restorative—an additive to his medical armamentarium gleaned from his 1687 voyage to Jamaica. Its benefits were primarily advertised for its “lightness on the stomach” and for its “great use in all Consumptive cases”. John Cadbury and his sons George and Richard later purchased Sloane's milk chocolate. The Cadbury's were Quakers who viewed chocolate as a nourishing, healthy alternative to alcohol and promoted it as a healthy “flesh forming substance”. In order to enhance its popularity, the Cadbury Brothers promoted their Sloane recipe as a “health food”, rhetorically adding that to call it a “medication would not be too strong a term”.69

Nineteenth-century improvements in cacao drink palatability owed much to Coenraad Johannes Van Houten who, in the 1870s, refined cacao into a more digestible form by extracting the natural fat (cocoa butter) from the bean, leaving only the powder. The powder could then be mixed with potash to darken its color, lighten its flavor and improve its solubility in water or milk. The powder produced by this “Dutching” process is what officially became known as cocoa. Van Houten's mixture soon became advertised as “The Food Prescribed by Doctors”. Contemporary French manufacturers promoted their own milk chocolate remedies as being specifically beneficial for individuals with fragile stomachs, as well as more generally for convalescents and children.

Although it was at this time when the ingredients within chocolate became increasingly scrutinized in terms of purity, such claims were found as far back as the 1600s when a “number of quibblers” began to “question the safety of some of the additives commonly found in cocoa and chocolate”.70 Still, the increased use of filler material (i.e., adulterants) in the mid 1800s were depicted as diminishing chocolate's otherwise healthy benefits. The popular Peterson's Magazine directed readers in 1891 to two categories of chocolate adulteration: Those that were “simply fraudulent, but not necessarily injurious to health” by using “some cheap but wholesome ingredient [mixed] with the pure article for the purpose of underselling and increasing profits”, and Those that were injurious to health, by using “drugs or chemicals for the purpose of changing the appearance or character of the pure article, as for instance, the admixture of potash, ammonia, and acids with cocoa to give the apparent smoothness and strength to imperfect and inferior preparations”.71

The “monstrous fraud perpetuated upon the poor by the adulteration of cocoa cannot be over-estimated”.72 In 1906 the US Pure Food and Drug Act (based on the Heyburn Pure Food Bill) was passed. In it, a food and drug—like chocolate—was considered to be adulterated if “mixed or packed with another substance to lower its quality; if any substance was substituted by another; if any valuable constituent was wholly or in part omitted; or if it was mixed, colored, coated, or covered in any way to conceal inferiority or damage”.73 Following this Act, and the subsequent Pure Food, Drug and Cosmetic Act in 1938, “marketing the healthiness of chocolate products in terms of “purity” rapidly became the norm”.74

Drawing attention to chocolate's potential therapeutic benefits, the CMA distributed a pamphlet in 1923 devoted to “Chocolate and Health”. During the second half of the 20th century, quests for experimental evidence were increasingly undertaken to support claims gathered regarding these potential benefits. Biomedical science began to experimentally assess chocolate's potential for alleviating medical disorders, just as it did with all pharmaceutical products. Randomized control trials of increasingly complex design based at multiple clinical sites were used to identify standards of normalcy and degrees of difference. By the close of the century, claims for chocolate's medical benefits were supported by a growing “science” of chocolate.75

By 2000, claims of chocolate's benefits typically focused upon its richness in carbohydrates and fat. Chocolate's natural flavonoid phenolics had been found to prevent the rancification of fat, thereby diminishing the need to add preservatives that might bring their own health risks. The plant-derived, saturated, stearic acid fats were not those guilty of increasing cholesterol levels. Cocoa butter within chocolate products was found to coat the teeth, thereby preventing tooth decay from chocolate's high sugar content. Tannins in cacao were noted to promote healthy teeth as they inhibited dental plaque formation. More recently, investigations have centered on a particular flavonoid, epicatechin. Following chocolate consumption, epicatechin has been found to promote anti-oxidant activity, which decreases low-density lipoprotein cholesterol activity, thereby delaying the onset or progression of atherosclerosis and arteriosclerosis. It may also increase high-density lipoprotein cholesterol levels. Chocolate has also been found to initiate antiplatelet activity, thereby reducing plaque formation and platelet clotting properties. Flavonoids have been demonstrated to stimulate blood flow in the brain, hands and legs due to the regulation of nitric oxide synthesis. Dark (high cacao-concentrated) chocolate also works to reduce blood pressure by promoting blood vessel dilation.

For some time, high-quality dark chocolate's psychoactive attributes have been linked to its high concentration of the stimulant theobromine. Late 20th-century investigators have also explored chocolate's supposed aphrodisiac effects. When people become infatuated or fall in love, the levels of phenylethylamine released from their brain increase. Chocolate was also found to promote this release, though in relatively small quantities. Chocolate appears to promote the neurotransmitter serotonin release as well, thereby producing calming, pleasurable feelings. Finally, an anandamide is also released following chocolate consumption, likely contributing to the euphoria that many claim chocolate induces. All of these psychopharmacological alterations may contribute to chocolate's perceived aphrodisiac effects.

Questions also continue to arise over chocolate's reputed addictive nature. Despite anecdotal evidence that may say “Yes, Yes, Yes”, little modern biomedical evidence supports such claims. Since depriving one of chocolate fails to produce scientifically significant signs of withdrawal, it is not technically classed as a physically addictive agent. Further, scientists have not shown a state of dependence regarding chocolate's use. Admittedly, chocolate may pharmacologically stimulate compulsive eating, but this may just as well be the result of a more generalized aesthetic craving for the sweetness and oily richness and complete orosensory experience that chocolate provides. Chocolate's rich natural complexity—a complexity that rivals any other food—makes the actual source of perceived cravings or “chocoholism” exceedingly difficult to ascertain.

Chocolate manufactures continue to expend considerable resources and marketing towards the potential therapeutic benefits of their products. Such efforts were seen in the International Cocoa Organization and the International Cocoa Research and Education Foundation's support of a research symposium and a subsequent publication devoted to “Chocolate and Cocoa: A Review of Health and Nutrition”.76 In recent years, chocolate has also become more apparent in the products of distillers and brewers. This presence is somewhat ironic since, in previous centuries, “chocolate houses” were established as alternatives to the popular Old World public houses (i.e., pubs) that served only alcoholic beverages. The power of chocolate house culture exacerbated chocolate's own stimulant ability. By the 1800s, as Ruth Lopez noted, serving chocolate where working men gathered became “a boon” to the temperance campaigners who relied upon chocolate as central to “keeping workers from alcohol”.77 Such views of chocolate, however, did not entirely dominate the market. By the early 20th-Century, J. Scholz was promoting his own patented “chocolate-health-beer”.78 Chocolate has, in recent years, become widely touted in marketing such products as Young's Double Chocolate Stout, Rogue Ale's Chocolate Stout, Samuel Adams’ Chocolate Bock, Sonoran's White Chocolate Ale, Harpoon's Chocolate Stout, Souther Tier's Chokolat and Dogfish Head's Theobroma Ale, among others.

One offshoot of early 20th-century medical reform was the extensive research expended on drug design and development. Indeed, drugs came to dominate the Western medical marketplace. Growing disenchantment with such a reign over medical practice provoked considerable consumer health demands for more holistic, integrative health care.79 Patients’ skepticism over the benefits obtainable from traditionally prescribed remedies alone is evidenced by the increasing demand for more natural medicine.

And what could be more natural than chocolate? As the nomenclature Theobroma cacao suggests, we have long viewed chocolate as a “Food of the Gods”. Steadily, authorities have been reinforcing chocolate's potential medicinal benefits. According to Harvard Medical School's Norman K. Hollenberg, the “pharmaceutical industry has spent tens, probably hundreds of millions of dollars in search of a chemical that would reverse … [or ward off vascular diseases]. And God gave us flavanol-rich cocoa which does that”.80

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