Alcohols chemically considered, are a class of substances of organic origin, known as hydrocarbons, isomeric in character, belonging to a simple homologous series. They are the hydrates of the methyl group of organic radicals. Those best known and in common use are constructed as follows:
- CH3HO. Methylic Alcohol. Synonym: Wood Alcohol.
- C2H5HO. Ethylic Alcohol. Synonym: Rectified Spirit of Wine.
- C3H7HO. Propylic Alcohol.
- C4H9HO. Butylic Alcohol.
- C5H11HO. Amylic Alcohol. Synonym: Fusel Oil.
Alcohol proper, as commonly understood, is the second in the series— Ethylic Alcohol.
Synonyms—Spiritus Vini Rectificatus, Rectified Spirit of Wine. Alcohol Ethylicum, Ethylic Alcohol. Ethyl Hydrate. Vinic Alcohol, Spirit of Wine.
Under this head all substances containing alcohol are treated in a general sense. Specific substances will receive specific mention. The common forms of alcohol and of spirituous and malt liquors come under the following general or specific heads:
- Absolute Alcohol, Dilute Alcohol, Deodorized Alcohol, Whisky.
- Synonym: Spiritus Frumenti.
- Synonym : Spiritus Vini Gallici.
- White Wine.
- Synonym: Vinum Album.
- Sherry Wine. Red Wine.
- Synonym: Vinum Rubrum. Port Wine. Rum, Gin, Porter, Cider, Kumyss.
Description—Alcohol is a light, colorless, transparent, volatile liquid, with a sharp irritating taste and a spirituous odor. It is lighter than water, its specific gravity being only 0.80. It boils at 173 deg. Fah., and will freeze at 203 deg. Fah. It has a great affinity for water, mixing with it in all proportions.
Alcohol is an active solvent, dissolving solids of many kinds— alkaloids, resins, gums, oils, liquids, gases,etc. It destroys vegetable and animal tissues. It preserves animal tissue from decomposition by hardening, condensing and contracting its structure. It coagulates its albuminoids.
Alcohol Absolutum—Absolute alcohol is the pure alcohol, without water or other foreign substance. It is rarely obtained. That which is purchased for absolute alcohol contains at least two per cent of water. Alcohol U. S. P. contains ninety-four per cent of the absolute.
It has a specific gravity of 0.82. The rectified spirit of wine—spiritus rectificatus, Br. P., contains eighty-four per cent of the absolute alcohol.
Alcohol Dilutum—Dilute alcohol, U. S. P., contains fifty-four per cent of the absolute. This is about the same as the proof spirit of commerce. In its official form it is made by combining equal volumes of water and absolute alcohol.
It is an excellent solvent, dissolving many substances insoluble in water. Medicinal substances dissolved in alcohol are called tinctures. Gaseous and volatile substances so dissolved are called spirits.
Alcohol Deodoratum—Deodorized alcohol contains about 92.5 per cent of alcohol and 7.5 per cent of water. It is free from methyl or amyl alcohol, other foreign odors or organic impurities.
Physiological Action—Because of its immediate and profound influence upon animal tissues, alcohol undiluted is not used internally. A small quantity taken in this form has produced immediate death. It is a powerful irritant and produces a shock from overstimulation to which the nervous system speedily succumbs. There are profound muscular relaxation, a sudden fall in the temperature, and diminished respiration. There is central vaso-motor paralysis, which influences these functions, with direct depression of the action of the heart.
In small doses it acts as a prompt and general stimulant to every function of the body. There is an exalted sensation a feeling of exhilaration, and a rise in the. temperature and pulse rate that is not merely subjective, but actual and appreciable.
Its direct influence is upon the nervous system. It increases at first the normal functional operations of the brain, inducing a free flow of thought and expression, and a clearness and freedom of mental action without depth. This condition is rapidly increased until the harmony of action is lost and an extreme or exaggerated condition follows, which soon becomes a pronounced disorder of mental action, with incoherent and incoordinate irregular action of the mind and body.
These effects are more pronounced in one not habituated to its use. Its continued use produces a toleration which often becomes extreme, but it induces a permanently debilitated and diseased condition of the nervous system, with a long train of symptoms known as alcoholism or dipsomania.
Acute Intoxication—In the first stage there is a want of mental balance, perversion of intellect, hallucinations, emotional excitement and incoordination.
In the second stage there are dilated pupils, stertorous breathing, more or less complete insensibility, a condition of coma, slow full pulse, complete muscular relaxation and great depression of the mental and physical faculties, with headache, nausea and vomiting. Recovery of the normal functions is in reverse order of their perversion.
Chronic Alcoholism—In this condition the power to resist fatigue or the results of injury, or to recuperate from prostrating diseases, is greatly lessened. There is established a gastro-intestinal catarrh of a chronic character, with dilatation of the stomach often, which results in nausea, vomiting, anorexia and a confirmed dyspepsia. The integrity of the liver, kidneys and heart become greatly impaired, and fatty degeneration of these organs is common. The nervous system suffers greatly. There are serious lesions of the structure of the spinal cord, brain, and also of the neural structure in its distribution, resulting in faults of vision, neuralgias, paralysis agitans and milder forms of muscular tremor and muscular incoordination. The heart and circulatory apparatus are seriously involved. There are palpitation, dilatation with valvular incompetency, and atheroma, of the blood vessels. The arterial tension is so influenced that the functional action of all organs, especially that of the kidneys, is greatly impaired.
Its continued use fixes a habit or demand upon the individual which is imperative, and the satisfaction of which induces a mental and moral degradation exceeded by the use of no other agent with the one exception, perhaps, of cocaine alone.
There is anorexia in many cases, complete dyspepsia and mal-assimilation of food. Ultimately there is atony and permanent dilatation of the stomach. There is disordered liver which in time becomes organic, resulting in atrophy or hypertrophy, induration, fatty or amyloid degeneration, or at least extreme torpor with jaundice.
Cancerous conditions and other blood dyscrasias readily find a nidus in these depraved tissues. Permanent structural intractable kidney change occurs more often with this class of patients than in any other. There is diabetes mellitus, parenchymatous or interstitial nephritis, or amyloid degeneration. It quickly produces alteration of function of the nervous system—a form of neurasthenia, structural change, and in some cases paralysis and locomotor ataxia and general incoordination.
The most lamentable condition, however, is the paralysis of the will, and the inevitable moral degradation and intellectual failure, which results finally in imbecility.
Alcohol interferes with the elimination of carbonic acid, and lessens the amount of nitrogenous tissue waste in the system. It is impossible to accept the theory of Wood, that because of the stimulating influence of this agent upon the digestion of the nitrogenous products, there is better assimilation and less nitrogenous waste. The nitrogen, if received, must at some time be eliminated, if not as a food, then certainly as tissue waste. Alcohol, doubtless, interferes with the secretory function of the epithelium of the renal tubules and also materially alters blood pressure in the kidneys, and thus prevents the elimination of urea which remains in the blood.
Dr. Winfield Scott Hall says: "Alcohol is an excretion toxic to the organism that produces it. An excretion of this type is also toxic to higher organisms, and this is the case with alcohol.
"Admitting that it is oxidized in the liver and produces heat, and that it may lead to decrease in the catabolism of carbonaceous foods, the heat produced is not a normal catabolism, but is simply the result of an insufficient protective oxidation, the toxic action showing in its narcotic effects.
"The decreased metabolism of carbonaceous and nitrogenous foods following the ingestion of a narcotic is a universal fact depending on the drug effect and giving to the oxidized narcotic no significance as a food. Ethyl alcohol is not a food in the scientific significance of the word."
Alcohol is appropriated to a certain extent within the system, the atoms within its molecule are rearranged or appropriated by different chemical substances in different combinations. This appropriation, however, is not great, especially in health, but in extreme prostration it is much greater, and there has seemed to be a gain in weight from its use. It is absorbed to a certain extent by all absorbents, and is eliminated by the skin, kidneys and lungs. In confirmed alcoholics the ingestion exceeds the elimination to such an extent, that it is found in the fluids of the brain and of the cord, and its odor is perceptible in other fluids and tissues of the body.
When applied to the skin there is a sensation of coolness because of the rapidity of its evaporation and absorption of heat. If it be retained in contact with the skin and the air excluded it produces heat, irritation, redness and consequent inflammation.
Its hardening influence on the integument is induced by its ability to coagulate albuminoids, abstract water and dissolve fats.
Therapy—Alcohol is introduced into the system through the medium of wines, brandy, whisky, beers, etc., as the diluted alcohol is not used to any extent as a beverage. In its therapeutic range the field is an important one, although many of the very best known physicians—Dr. N. S. Davis and others—believe that it is not needed as a medical agent, but can be substituted to even a better advantage by agents which do not induce the alcohol habit. We believe that it is entirely unnecessary to prescribe as tonics or restoratives, wines, beer or any alcoholic beverages, or the alcoholic beverages under fashionable names, as malt tonics manufactured by brewers, or the fashionable tipple—beef, iron and wine. It will act as follows, but can be readily substituted.
As an emergency remedy, alcohol, as an immediate stimulant, exercises an important function. In heart failure from sudden shock, in acute prostration of any character evidenced by weak heart, slow pulse and failing respiration, it is used. In asphyxia, either from the inhalation of noxious gases, or from the use of anesthetics or from drowning, hypodermics of brandy or whisky will enforce the heart's action, restore respiration and improve the general condition. It is of common use in shock after surgical operations, but is best used in conjunction with heart supporters and strychnine. It is given preceding the administration of anesthetics to prevent shock. It promotes the action of the anesthetic. In poisoning with depressing agents of a non-caustic or non-irritating character, and in the bites of venomous snakes and insects, it is of value and has been in common use.
With the aged and feeble, in the convalescence of prostrating diseases of all characters, and especially after inflammation of the lungs, the agent was in the past in common use as a restorative. It is a stimulant to the digestion and to the secretion of the digestive ferments. Its influence upon absorption and nutrition is not, we think, as desirable as that of other tonics non-alcoholic in character.
As a restorative to adynamic conditions it is given to best advantage in conjunction with concentrated nutritious foods, as in egg-nog, with eggs and milk, with albuminoids, and with beef juices and meat extracts.
In some cases of prostration with distress and even pain, great restlessness and wakefulness, small, frequent doses, by building up the forces temporarily more nearly to the normal point, produce quiet restfulness and promote sleep. In cerebral anaemia its influence in temporarily re-enforcing the cerebral circulation will promote sleep, but the results of the sleep usually are not rest and are unsatisfactory.
Alcohol, externally, is an antiseptic. It is especially useful in suppurating wounds, and especially in preventing and curing bed sores. It is cleansing and stimulating, and promotes granulating and healing. In preparing for surgical operations it is used in full strength as an application to the skin to render it aseptic in the field of the operation.
In bruised and swollen parts, in inflamed joints and glands, it serves a good purpose. It hardens the skin and contracts the tissue, promoting healing by resolution and preventing abrasion, ulceration or suppuration.
It is prescribed in vomiting from atony, in the vomiting of pregnancy, in seasickness and in the vomiting of extreme prostration. It is even thought necessary to administer it to allay the uncontrollable vomiting of delirium tremens. It is advised in disorders of the stomach and bowels, in atonic, gastric and intestinal indigestion.
An excellent use for alcohol is in the sudden hoarseness or croupal cough of children, as an external application, mixed with an equal part of water and kept moist and warm. It is surprising how quickly the child will breathe more easily, and the hoarseness will have disappeared. It is of immediate benefit in sudden attacks of the croup.
During the past few years much use has been made of hypodermic injections of alcohol into the structure surrounding cancer and malignant growths, and into the immediate substance of the growth itself, with the result that in many cases the abnormal growth has at least been retarded and in some cases removed. The method is considered one worthy of trial in a certain class of cases.
Wines and Malt Products.
Therapy—While wines are consumed in all civilized countries, they are seriously detrimental to health. They induce plethora, gout, lithemia and apoplexy, dropsy, unsteady nerves and enfeebled and disordered mental action. In the consideration of wines as medicinal agents, their action is fully covered under the subject of alcohol, as their medicinal effect in the main is due to the amount of alcohol they contain. It is true, however, that there is considerable difference in the action of different wines. They have more of a sedative influence upon the stomach, and probably possess greater nutritive properties. They are less stimulating than the liquors, but containing a larger quantity of sugar, their free ingestion induces greater disorders of the stomach, and is apt in some cases to produce constipation and fever.
In their application, however, to specific disease conditions, they must be adapted with regard to the percentage of alcoholic strength, and with consideration to the percentage of nutritive properties.
Beer, ale and porter are malt products, and as stomachic tonics, as restorative agents, especially in pulmonary diseases, as stimulating nutritive agents for administration during recovery from protracted illness, they are considered as of much value.
The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.