Although the Olmecs, Maya and Aztecs all had different variations on the theme, most cacao drinks of the pre-contact period included corn, chilis, cacao and water. The drink was frothed by pouring from one vessel to another until a head formed on top.

Also, cacao (as a drink) was used as a medicine and was most often mixed with other ingredients, such as rhubarb water, vanilla, various nuts and seeds, roots, and many other things. The Mesoamerican medicine system operated through concepts of hot/cold and wet/dry in which all diseases were perceived as either hot or cold, wet or dry. All available foods were likewise perceived as such, with hot diseases treated using cold foods/medicines and dry diseases treated with wet foods/medicines. Cacao itself was regarded as a cold ingredient and when heated was referred to as hot, and when mixed with various ingredients, it was also hot. So in this respect, this could be where the concept of "hot chocolate" stemmed. Cool, huh?