Preparations: Extracta et Extracta Fluida.—Extracts and Fluid Extracts. - Tinctures
Related entry: Alcohol Amylicum.—Amylic Alcohol - Alcohol Methylicum.—Methyl Alcohol - Spiritus Vini Gallici (U. S. P.)—Brandy - Spiritus Frumenti (U. S. P.)—Whiskey - Vinum.—Wine
FORMULA (Absolute, or ethyl alcohol): C2H5OH. MOLECULAR WEIGHT: 45.9.
SYNONYMS: Ethyl alcohol, Ethylic alcohol, Ethyl hydroxide, Alcohol, Alcohol vini, Rectified spirit, Spiritus rectificatus, Vinic alcohol; Spirit of wine.
- ALCOHOL ABSOLUTUM (U.S.P.), Absolute alcohol. "Ethyl alcohol, containing not more than 1 per cent, by weight, of water"—(U. S. P.).
- ALCOHOL (U. S. P.)—Alcohol. "A liquid composed of about 91 per cent, by weight, or 94 per cent, by volume, of ethyl alcohol (C2H5OH=45.9), and about 9 per cent, by weight, of water"—(U. S. P.).
- ALCOHOL DILUTUM (U. S. P.)—Diluted alcohol. "A liquid composed of about 41 per cent, by weight, or about 48.6 per cent, by volume, of absolute ethyl alcohol (C2H5OH=45.9), and about 59 per cent, by weight, of water"—(U. S. P.).
- ALCOHOL DEODORATUM (U. S. P.)—Deodorized alcohol. "A liquid composed of about 92.5 per cent, by weight, or 95.1 per cent, by volume, of ethyl alcohol (C2H5OH=45.9), and about 7.5 per cent, by weight, of water "—(U. S. P.).
The foregoing "should be kept in well-closed vessels, in a cool place, remote from lights or fire"—(U. S. P.).
History and Source.—The Bible frequently mentions fermented juices from various fruits, as the grape or pomegranate. However, the art of abstracting the alcohol from alcoholic beverages by distillation, was, in all probability, discovered by the Arabs in the ninth, or later centuries. The raw materials used in the making of alcohol by distillation, may be taken from three sources:
- Alcoholic liquids which have already undergone fermentation, e. g., wine, beer, cider.
- Saccharine material which exists, for example, in sugar cane, or grape juice; from this, alcohol is generated by fermentation.
- Starch-bearing material, of which an innumerable variety is available for this purpose, e.g., root tubers, such as potatoes, and such cereals as rye, corn, barley, wheat, rice, etc. With this class of material, the conversion of starch into fermentable sugars (maltose, or dextrose), is effected in the so-called mashing process, whereby the starchy material, after preparatory treatment, is acted upon by an infusion of malt, the active principle of which, diastase, converts starches into maltose and dextrin, at temperatures not to exceed 70° C. (158° F.). In rare cases, perhaps, the starch is converted into dextrose (glucose) by treatment with dilute sulphuric acid, at a temperature near the boiling point of water.
Vinous, or Alcoholic Fermentation.—Fermentation, generally speaking, is a process of decomposition of more or less complex organic substances into simpler compounds, induced by the vegetative action of exceedingly small, living organisms, called ferments (to which belong, e.g., the yeast plants and bacilli). The action of purely chemical ferments, called enzymes, as, e.g., diastase in malt, or myrosin in black mustard seeds, etc., is analogous to, though not identical with, fermentation. Accordingly, we speak familiarly of acetic, lactic, butyric, putrid fermentation, etc. In the vinous fermentation, a solution of sugar, e.g., dextrose, is decomposed into alcohol and carbonic acid gas, under the influence of the yeast plant, of which there are several species, the most prominent of which is Saccharomyces (Torula) cerevisiae. Dextrose, for example, is decomposed as follows: C6H12O6=2C2H6O +2CO2. This formula, however, illustrates the process only in a general way, as various circumstances tend to alter the above reaction. Pasteur has found among the products of vinous fermentation, about 0.6 per cent of succinic acid and 3 per cent of glycerin, as regular constituents. The most favorable temperature at which fermentation takes place, is from 15.5° to 32.2° C. (60° to 90° F.); at temperatures somewhat higher than 30° C. (86° F.), butyric and other kinds of fermentation are liable to set in. Not all sugars are directly fermentable. Cane sugar, for example, under the influence of yeast, first becomes converted into fermentable invert sugar (an equi-molecular mixture of laevulose and dextrose).
The part played by the yeast cells has not yet been completely elucidated, notwithstanding the advances made in this direction through the famous researches of Pasteur, Liebig, Naegeli, and others. Some contend that fermentation is purely physiological, others, that it is a physical, and others again, that it is an essentially chemical process. Quite recently, E. Buchner demonstrated that a fluid obtained by expressing, under high temperature, moistened yeast, previously dried by strong pressure, is capable of producing fermentation.
Preparation.—The bulk of commercial alcohol is, at the present day, derived from cereals and potatoes; in Germany, principally from the latter source. If potatoes are the raw material used, they are first steamed in suitable, ingeniously devised vessels, in order to gelatinize the starch grains. After cooling the mass to a temperature of about 65.5° C. (150° F.), it is subjected to the process of mashing, in large vats with steam fittings, by mixing the mushy material with finely comminuted malt, whereby, under the influence of the malt diastase, starch is converted into maltose and dextrin, the latter being subsequently converted into maltose by prolonged action. Then the temperature is reduced to 21.1° C. (70° F.), and yeast is added, which starts the fermentation. Cereals are treated either in the same manner, or are merely crushed without being steamed, and are then subjected to the same treatment.
The fermented mass contains, of non-volatile matters, fibers and husks, inorganic salts, protein bodies, peptones, fat, yeast, lactic and succinic acids; of volatile matters, alcohol, fusel oils, and traces of fatty acids, e.g., acetic acid, but not the higher acids, such as butyric, if the fermentative process was properly conducted. The alcohol may then be separated from the mash by fractional distillation in a simple copper still with worm condenser, the distillate being repeatedly distilled or rectified, in order to get a stronger product. This process is still in use in the making of Irish whiskies. In recent times this rather primitive procedure has been replaced by the introduction of ingeniously contrived stills, especially the so-called column-stills, the construction of which has reached such a state of perfection that it is possible to obtain, with some of these, a strong alcohol of 94 per cent, by direct distilling from the fermented mash in a single operation; the higher alcohols, as fusel oil, remaining behind for the most part. (For details see Sadtler, Indust. Org. Chem., 1895.) The alcohol resulting from the first distillation, unless obtained at once pure and of the desired strength by the use of the perfected stills aforementioned, must be subjected to redistillation, called rectification. As it is extremely difficult, however, to completely remove by fractional distillation certain impurities, especially the higher alcohols, propyl, isobutyl, and the amyl alcohols, collectively called fusel oils or grain oils, it has been found advisable to purify the raw spirit prior to rectification. This has been tried more or less successfully by chemical means, employing oxidizing agents, as ozone, or silver nitrate; but a rather expedient and efficient method seems to be to dilute the spirit to a strength of about 50 per cent, whereby the fusel oil is thrown out as an insoluble layer; the spirit is then filtered through charcoal, and rectified (see Sadtler). Another efficient method is said to consist in distilling the spirit over fused acetate of sodium, employed in the quantity of 2 per cent. Another method, which seems promising, is to shake out the fusel oils from the dilute spirit with mineral oils (Bang and Rufin).
Commercial Forms.—Absolute alcohol. Mere rectification will not produce a liquid stronger than about 94 per cent, by volume. The remaining 6 per cent of water must be removed by chemical means; which is best accomplished by allowing the alcohol to stand over freshly prepared, unslacked lime, for several hours, then distilling from a water-bath, a process which should be repeatedly carried out. It is often preferred to boil the alcohol with unslacked lime for one hour, using a reflux condenser, and then distilling off the alcohol. This process, however, is attended with some danger if the alcohol has more than 5 per cent of water. Dehydrated chloride of calcium has also been used in preparing absolute alcohol.
Alcohol of the U. S. P. contains 91 per cent, by weight, or 94 per cent, by volume, of pure ethyl alcohol, and has a specific gravity of 0.820 at 15.6° C. (60° F.). This strength is obtained in the process of redistillation or rectification.
ARDENT SPIRITOUS BEVERAGES.—Holland gin, is obtained by distilling grain spirit with juniper berries.
Rum, is made in the West Indies by fermentation and subsequent distillation of molasses derived from the sugar cane.
Brandy, is the product of distillation of wines, or the fermented juices from such fruits as the apple or pear, called cider and perry.
Genuine cognac, is a fine grade of brandy, the product of distillation of French wines. Its characteristic aroma is due to the presence of oenanthic ether (oil of wine).
American whiskey, is prepared from malted corn and rye; either mixed grains are used (Kentucky bourbon), or malted rye alone (Pennsylvania whiskies).
Irish whiskies, have a smoky flavor, due to the peat fuel used in the making of the malt.
Description and Tests.— Ɣ I. ALCOHOL ABSOLUTUM (U. S. P.), Absolute alcohol, Anhydrous alcohol, Ethyl alcohol. Pure absolute alcohol is "a transparent, colorless, mobile, and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Very hygroscopic. Specific gravity not higher than 0.797 at 15° C. (59° F.); or 0.789 at 25° C. (77° F.). In other respects, absolute alcohol has the properties, and should respond to the reactions and tests, of deodorized alcohol (see Alcohol Deodoratum)"—(U. S. P.).
It boils at 78.3° C. (174° F.), and assumes an oleaginous consistence at -90° C. (-130° F.). It is very combustible, burning with a pale-blue flame, without smoke or residue, giving out a very intense heat, and producing carbonic acid gas and water. Chloride of sodium added to it will render its flame yellow; chloride of potassium, whitish violet; boric acid, or a salt of copper, green; chloride of lithium, carmine red; chloride of strontium, crimson; and chloride of barium, greenish-yellow. A solution of barium hydrate in absolute alcohol, detects traces of water in absolute alcohol by yielding a precipitate when mixed with it. Dehydrated copper sulphate, which is white, turns blue with absolute alcohol when water is present. It mixes in all proportions with water, wood-spirit, and ether; heat is evolved when it is added to water, and contraction of volume takes place, which amounts to nearly 4 per cent when 53.9 parts of alcohol, and 49.8 parts of water, are mixed, resulting in a volume of 100 parts, instead of 103.7 parts. One part of ether added to 2 parts of alcohol, forms with 1/10 part of oil of wine, Hoffmann's Anodyne Liquor. Partly on account of its affinity for water, it preserves animal and vegetable tissues. It dissolves hydroxide of potassium and of sodium, certain metallic chlorides and bromides, the organic acids, camphor, volatile oils, iodine, urea, resins, balsams, etc. With nearly all acids it produces the compound ethers. Most oxygen salts with inorganic acids, excepting calcium and magnesium nitrates, starch, caoutchouc, the protein compounds, etc., are insoluble in it. Of the fixed oils, castor oil is the most freely dissolved by it. It combines with many neutral metallic chlorides, as of magnesium, calcium, manganese, etc.; taking, in these compounds, the place of water of crystallization. Sulphur and phosphorus are dissolved by it to a limited extent. Dry chromic acid introduced into a mixture of air and alcoholic vapor, causes an explosion. If a spiral piece of platinum wire be placed upon the wick of an alcohol lamp, and the flame be suddenly blown out, the platinum wire will continue to glow with a white heat, caused by the imperfect combustion of the alcoholic vapors.
II. ALCOHOL (U. S. P.)—Alcohol. The alcohol of commerce possesses the above qualities (see Absolute Alcohol) in proportion to its freedom from water, as known by its specific gravity. The strength of alcoholic fluids, the sole ingredients of which are alcohol and water, is determined in the spirit trade, under the supervision of the U. S. Government, by taking the specific gravity by means of hydrometers, also observing the temperature at which the specific gravity is taken. By the aid of tables, the actual percentage of the spirit, by volume, is then ascertained. Proof spirit, as defined by the U. S. Revenue Office, is a liquid containing 50 volumes of absolute ethyl alcohol in 100 volumes of spirits, this solution being called 100 per cent proof spirit. Its specific gravity is 0.9343 at 15.6° C.(60° F.). If higher, the spirit is below proof; if lower, the spirit is over proof. It is used in pharmacy to form tinctures, extracts, etc. The Pharmacopoeia gives the following description and tests: "A transparent, colorless, mobile, and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Specific gravity about 0.820 at 15° C. (59° F.); or 0.812 at 25° C. (77° F.). Miscible with water in all proportions, and without any trace of cloudiness; also miscible with ether or chloroform. It is readily volatilized, even at low temperatures, and boils at 78° C. (172.4° F.). It is inflammable and burns with a blue flame. It should not affect the color of blue or red litmus paper previously moistened with water. If 50 Cc. of alcohol be evaporated in a clean glass vessel, no color or weighable residue should remain. On allowing alcohol, mixed with one-third of its volume of water, to evaporate spontaneously from clean, odorless blotting-paper saturated with it, no odor of fusel oil, nor other foreign odor, should become perceptible. If 10 Cc. of alcohol be mixed in a test-tube with 5 Cc. of potassium hydrate T.S., the liquid should not at once become dark-colored (absence of aldehyde, methyl alcohol, or oak tannin). If 20 Cc. of alcohol be shaken in a clean, glass-stoppered vial with 1 Cc. of silver nitrate T.S., the mixture should not become more than faintly opalescent, or acquire more than a faint brownish tint, when standing during six hours in diffused daylight (limit of organic impurities, amylic alcohol, etc.)"—(U. S. P.).
III. ALCOHOL DILUTUM (U. S. P.)—Diluted Alcohol. "Alcohol, five hundred cubic centimeters (500 Cc.) [16 fl℥, 435 ♏]; distilled water, five hundred cubic centimeters (500 Cc.) [16 fl℥, 435 ♏]. Mix them. If the two liquids be measured at the temperature of 15.6° C. (60° F.), the mixture, when cooled to the same temperature, will measure about 971 Cc. Diluted alcohol may also be prepared in the following manner: Alcohol, four hundred and ten grammes (410 Gm.) [14 ozs. av., 202 grs.]; distilled water, five hundred grammes (500 Gm.) [1 lb. av., 1 oz., 279 grs.]. Mix them. Diluted alcohol has a specific gravity of about 0.936 at 15° C. (59° F.), about 0.937 at 15.6° C. (60° F.), and about 0.930 at 25° C. (77° F.). It should respond to the reactions and tests given under Alcohol"—(U. S. P.).
Ɣ IV. ALCOHOL DEODORATUM (U. S. P.)—Deodorized alcohol. "Specific gravity about 0.816 at 15° C. (59° F.), or 0.808 at 25° C. (77° F.). If 25 Cc. of deodorized alcohol be mixed with an equal volume of water and 5 Cc. of glycerin, and the mixture allowed to evaporate spontaneously from a piece of clean, odorless blotting-paper, no foreign odor should become perceptible when the last traces of the alcohol leave the paper (absence of fusel oil constituents). If 25 Cc. be allowed to evaporate spontaneously in a porcelain capsule carefully protected from dust, until only a moisture is left, no red or brown color should be produced upon the addition of a few drops of colorless, concentrated sulphuric acid (absence of amylic alcohol, non-volatile, carbonizable, organic impurities, etc.). In other respects, deodorized alcohol has the properties, and should respond to the reactions and tests, of Alcohol"—(U. S. P.).
Rules for making an alcohol of any required lower percentage, from an alcohol of any given higher percentage:
I. BY VOLUME.—Designate the volume-percentage of the stronger alcohol by V, and that of the weaker alcohol by v.
Rule.—Mix v volumes of the stronger alcohol with pure water to make V volumes of product. Allow the mixture to stand until full contraction has taken place, and until it has cooled, then make up any deficiency in the V volumes by adding more water.
Example.—An alcohol, of 30 per cent by volume, is to be made from an alcohol of 94 per cent by volume.—Take 30 volumes of the 94 per cent alcohol, and add enough pure water to produce 94 volumes.
II. BY WEIGHT.—Designate the weight-percentage of the stronger alcohol by W, and that of the weaker by w.
Rule.—Mix w parts, by weight, of the stronger alcohol with pure water to make W parts, by weight, of product.
Example.—An alcohol of 50 per cent, by weight, is to be made from an alcohol of 91 per cent, by weight.—Take 50 parts, by weight, of the 91 per cent alcohol, and add enough pure water to produce 91 parts by weight"—(U. S. P.).
Uses in Pharmacy and the Arts.—In the numerous official pharmaceutical preparations, alcohol, of various strengths, is a prominent constituent. Pharmacists also employ it as a fuel producing a high temperature during combustion without depositing soot upon bodies introduced into its flame. It is largely used in the arts as a solvent and preservative.
Action and Toxicology.—Applied locally to the skin, alcohol first causes a cooling sensation, but if evaporation be prevented, heat and irritation follow, and inflammation may result if too long applied. The skin and the mucous membranes are hardened by it, and the latter corrugated, owing to its coagulating power over albumen, and the abstraction of water from the tissues. Some fat is also removed from the integuments. As it at first constringes the arterioles, it may act slightly as an anaesthetic. Taken into the stomach in small amounts, (usually of the various liquors) it augments the appetite and increases digestive power. Owing to dilatation of the arterioles, slight congestion of the mucous tissues takes place, and the buccal and gastric secretions are increased, but if continuously imbibed, this excessive secretion results in catarrhal conditions, and, continuing, may produce atrophy of the gastric glands and hyperplasia of the gastric connective tissue. Furthermore, pepsin is precipitated by it, allowing digestive impairment through the loss of that ferment. The inordinate outpouring of gastric mucus (gastric catarrh) causes fermentation of the fatty, starchy, and saccharine foods, resulting in sour stomach, heart-burn, pyrosis, and that peculiar retching and morning vomiting of the drunkard.
Alcohol is believed to enter the blood before reaching the duodenum, and in that fluid it diffuses itself with great rapidity. The portal circulation is impressed, and greater hepatic activity follows, but finally, this over-stimulation leads to destruction of the liver cells, fatty and atrophic alterations taking place, while the connective tissue is increased. This hyperplasia, with consequent shrinkage of the cells, allowing contraction of the connective tissues, results in that shrunken, hardened, and nodular state of the organ, known as cirrhosis. These liver changes take place more rapidly than those of the stomach. Alcohol in small doses increases the heart's action and surface circulation; all the body functions are stimulated and better performed, and temperature is slightly elevated. Larger doses produce exhilaration and vascular excitement, and a mild intoxication. Still larger doses affect muscular power, causing incoordination of movement (staggering), and the victim speaks incoherently and in a rambling manner—all the well-known phenomena of drunkenness.
Upon the nervous system, the first effects are increased cerebral activity, rendering the senses more acute, and all the mental actions more energetic. These effects are shared in common with the increased functional activity of the economy in general. In an exposed brain, turgescent and throbbing vessels have been observed as the effects of its first action, with dilatation of the vessels, and passive congestion as the secondary phase (Jacobi). In toxic amounts, cerebration is suspended, and profound insensibility takes place; there is a feeble performance of the body functions, and the movement centers are poisonously impressed, resulting in complete muscular inactivity, stertorous respiration, and arrest of breathing and the heart's action.
In large quantities, and continued daily, alcoholic liquors occasion intoxication, nervous derangement, loss of appetite, mental imbecility, dyspepsia, indurated liver, granular disease of the kidneys, paralysis, mania, atheroma of the vessels, apoplexy, and death. The alcohol is absorbed, and may be detected in the blood, urine, breath, brain, liver, and other organs, producing permanent injury to them. The treatment of acute alcoholic poisoning consists in emptying the stomach by means of the stomach-pump, and cautiously applying ammonia gas to the nostrils; external warmth should be used, cold water applied to the head, and faradism employed to stimulate respiratory action. It is extremely difficult to differentiate acute alcoholic poisoning from apoplexy, opium poisoning, cerebral concussions, and hemorrhage into the brain tissues. The pupil may be contracted or dilated; unequal dilatation, however, is somewhat of a guide to intracranial hemorrhages. The odor of the breath will assist somewhat, but can not be relied upon, as alcoholic drinking is so common that any of these conditions may take place after one has imbibed an insufficient amount of alcohol to produce toxic symptoms. A person "dead drunk" should be treated as if poisoned, and not allowed to "sleep off" the effects.
After death from acute alcoholism, the gastric membranes are found intensely hyperemic, as are the meninges of the brain. The subarachnoidean spaces, and the cerebral ventricles, are filled with an effusion of serous fluid; and the right ventricle of the heart, and the great veins, are distended with blood. From chronic poisoning, hyperplasia of the connective tissue, as thickening of the stomach walls, cirrhotic liver, and fatty heart, and hardened and contracted, or fatty, kidneys as well as atheromatous vessels and sclerosed nervous structures, are found. Taken into the system in moderate amounts (1 to 1 1/2 ounces of absolute alcohol) alcohol is scarcely eliminated, but is destroyed by oxidation in the system, and imparts circulatory, nervous, glandular, and muscular force. It refreshes the exhausted system by yielding to it a force to be applied in the body functions, and in this way acts as food, though it is not known to contribute to the building of a single cell or fibre of the animal structures. It also acts as food, in that it retards or checks tissue waste by partially preventing the excretion of carbon dioxide and nitrogenous material; and it even favors the formation of fatty tissues, as is shown by its pathological tendency to cause depositions of fat in certain organs. That the temperature is increased by moderate amounts is well known, as is the fact that large doses depress the temperature; and this depression is more pronounced if fever be present. It may be concluded that alcohol serves as food, when it is used short of gastric impairment, does not over-stimulate, and is not in excess of what can be burned in the oxidation processes of the organism. In quantities in excess of those above mentioned, it is excreted by the lungs, skin, kidneys, etc.
Contrary to popular notions, alcohol does not protect one from the influence of cold, as has been shown by the experience of Arctic explorers, and by the ease with which drunkards are frozen to death. Nor does it protect one from the effects of the heat. The facility with which topers are attacked with, and succumb to, epidemic disorders, proves conclusively the deleterious effects of its continued use, injuries do not heal so readily in the inebriate as in the temperate, and it is well known that chloroform is not well borne by them, nor can they as well withstand the shock of surgical operations. On the other hand, enormous amounts of alcohol may be ingested by those unaccustomed to it, when meeting with accidents, or suffering from the effects of hemorrhage, bites of insects and serpents, when suddenly depressed, and in convalescence from acute diseases. Infants and old people bear alcoholics well.
Medical Uses and Dosage.—Alcohol is seldom or never used internally, except in dilution. Undiluted, it is a powerful irritant and poison, rapidly causing intoxication, and, if in large quantities, death. It is usually employed in the form of wine, brandy, gin, beer, whiskey, etc., which, in moderate doses, act as diffusible stimulants, and are highly beneficial in prostrating diseases, and in cases where these kinds of stimuli are indicated. Brandy is said to be cordial and stomachic; rum, heating and sudorific; gin and whiskey, diuretic. There are very few cases in which alcoholic stimulants are necessary to be given, and those are seldom of a chronic character, or in which these fluids have to be used longer than a few days. The use of our small doses of concentrated alcoholic preparations, and improved modes of treating diseases, have done much to set aside the dangerous and unscientific practice of indiscriminately prescribing alcoholics. Exceptions to its non-use in chronic disorders, are cases of great debility with feeble digestion, such as the gastric debility of old age, and wasting of tissue, in phthisis. Here, as long as it favors digestion, acts kindly and prevents tissue waste, it is of marked value. If, however, it should occasion unpleasant symptoms, it will aggravate phthisis, a form of which is also known to result from alcoholic excesses. An ounce of brandy or whiskey may be given with milk, egg-nog, broth, or other liquid food; when cod-liver oil agrees with the stomach, alcoholics may be given with it. While in small doses it is a stomach tonic, it should not be employed in ordinary atony of the stomach, which other agents will overcome, on account of the danger of fixing upon the patient the alcoholic habit. Nor should those subject to neuralgic pains make general use of it; and for general, chronic adynamic states it is of less value than other agents.
Alcohol is mostly employed in acute disorders. Its utility in delirium tremens is well established. It will aggravate cases dependent upon the direct and sudden action of excess of alcoholics upon the gray brain-matter, but when it depends upon failure of the stomach to take and appropriate food, no remedy is more efficient; and opium and other stimulants assist its action. As long as the patient is able to take and retain and digest food, delirium will not occur. As soon, however, as gastric rebellion ensues, the stimulant must be given to allay the irritability and sustain the nervous powers. An ounce of whiskey, alone, or in milk, may be given every hour or two until the stomach will act without its aid. Give no more than enough to sustain the nervous system (Locke). In high fevers and inflammations, in those accustomed to the use of alcoholics, it is dangerous to wholly withdraw the stimulant, and it may be given at intervals in small doses. In acute diseases it is never admissible where there is determination of blood to the brain, or where there is severe, darting headache of a throbbing character, suffusion of the skin and eyes, and noisy or violent delirium. Nor should it be continued in any case where it increases the rapidity of the pulse, elevates temperature, or causes or increases dryness of the tongue. The condition in which it is admissible, is that of prostration, as in low fevers, the pulse being soft and feeble. Small quantities should be frequently repeated. Thus, in typhoid, and other low fevers, where there is a tendency to fainting, with low, muttering delirium, and dry tongue, the patient will die unless stimulation is resorted to, and nothing is better for this purpose than alcohol. Add 1 ounce of brandy to 3 of milk and give frequently, as necessary. If it slows the pulse, rendering it fuller, calms the delirium, tends to moisten the tongue and promote sleep, it is doing good as well as acting as food; if it increases the symptoms, it is doing harm, and should be discontinued.
In certain forms of vomiting, as of sea-sickness and pregnancy, alcoholics are of service. Give a glass of wine before rising from bed in the morning in the latter complaint. Insomnia and somnambulism, both when due to cerebral anemia, are benefited by alcohol. Refreshing sleep will follow its administration. Hyperemia of the brain contraindicates it. Threatened inflammation of the internal organs from exposure or cold, causing suppression of the functions of the skin, is often averted by a hot toddy and putting the patient to bed. In this manner, threatened pleurisy and pneumonia may be prevented. In the exanthemata, when exhaustion threatens, alcohol may be resorted to. In the collapse of Asiatic cholera, it is called for, and is of value in some cases of traumatic tetanus. Large doses sustain the nervous system while undergoing the effects of serpent and insect bites and stings. It should also be locally applied. Alcohol may be made to act as an external stimulant or refrigerant, by merely applying it to a part, and preventing its evaporation by placing a compress of linen or muslin over it, to produce the first effect; or, by allowing it to evaporate, to produce the latter. With an equal quantity of water, it forms a good dressing for bruises, orchitis, arthritis, and other superficial inflammations. Cracked nipples, should be bathed with brandy and dusted with bismuth subnitrate (Locke). Applied to threatened bed-sores, it hardens the tissues and prevents excoriations. Dr. Christison recommends "a mixture of equal parts of rectified spirit and white of egg as an application to excoriations, from pressure, in fever and other exhausting diseases. It is to be applied frequently with a fine brush or feather, and renewed as it dries, till an albuminous coating is formed over the part."
As a dressing to fresh wounds, alcohol, diluted, is of much value; and even in suppurative injuries, it corrects fetor and acts as an antiseptic, as well as to stimulate granulation. Owing to its coagulating power over albuminous material, alcohol is a hemostatic in conditions in which the blood slowly oozes, as from abrasions. Aural polypi and unhealthy granulations of the tympanum, the result of long suppurative processes, are well treated with absolute alcohol. This it does by coagulating albumen and abstracting water, and may cause permanent dryness of the tympanic membrane. Foltz regards it a specific in tympanic cholesteatoma (Dynam. Ther.). The dose of alcoholics (brandy, whiskey, etc.) should not be such as to exceed 1 1/2 fluid ounces of absolute alcohol, except in serpent poisoning, when more may be given.
Specific Indications and Uses.—Prostration, with soft, feeble pulse, hurried respiration, and irregular heart action; prostration, with dry tongue, low, muttering, or wandering delirium, tremor, subsultus, and insomnia; delirium tremens, when the gastric powers fail. Locally, to cholesteatoma of the tympanic cavity (absolute alcohol).