Nerves of Motion.
Alcohol rarely causes convulsions; but it exerts some influence over the nerves of motion, probably through the cerebellum, whose office it is to coordinate muscular movements; for intoxicated persons do not possess full control over the voluntary muscles, as is seen in their stammering speech, the staggering to and fro, and tendency to fall. In delirium tremens, also, there are peculiar tremors, particularly of the tongue and hands.
There is also trembling of the hands and arms; a constant trembling motion of the muscles under the skin (tremblement vermiculaire). Shaking and shivering are merely higher degrees of trembling, and only occur when the muscular system is much weakened. Diminished strength and a state of weakness and relaxation of the locomotive muscular system. Partial paralysis. Subsultus, jerking, and spasmodic drawing and starting of the muscles. Convulsions and epileptic attacks.
Nerves of Sensation.
Formication in or under the skin is one of the most common chronic effects of Alcohol on the nerves of sensation; it is frequently attended with restlessness, which obliges the patient to move the affected limbs constantly. Fleeting sensations of drawing or piercing, generally in the feet and legs. Hyperaesthesia, pain, and neuralgic rendings; these are generally preceded for some time by formication, flying pains, and piercings. These may be followed by dullness of sensation, or even loss of sensation, or anaesthesia; it is noticed first in the tips of the toes, then in those of the fingers, finally it extends over the back of the foot to the legs, or tibia, or to the back of the hands.
Great Sympathetic Nerves.
The chronic action of alcohol upon this nerve and its ramifications are evinced more by alterations in the structure and functions of the various organs of the chest, abdomen, and pelvis than by any particular sensations. In small quantities, Alcohol expends its action almost exclusively upon the abdominal organs. One can distinctly feel how its action expands from the solar plexus upon those organs in which the splanchnic nerves ramify. There is a feeling of comfort in the abdomen, more rapid and powerful digestion, more active peristaltic movements, increased desire for food and drinks, more profuse secretions, especially from the kidneys.
ON THE BLOOD.
Through whatever channel Alcohol operates, there is no doubt that it enters the blood; for in man the breath has a strong smell of spirits for a considerable time after it is swallowed, and it has been found in the tissues and secretions after death from large doses. One of the most important appearances in poisoning with Alcohol is the fluid and venous condition of the blood. According to Steinheimer and Roesch, Alcohol acts directly on the blood, and intoxication is owing to an alcoholic venous plethora, in which the proportion of hydrogen and carbon in the blood is much increased. A similar alteration of the blood occurs in poisoning with narcotic drugs, and the delirium and excitement of the nervous system produced by them and Alcohol is consequent upon this change in the quality of the blood. If Alcohol be added to blood which has been drawn from a vein, it becomes dark, and loses its normal opacity; or becomes more or less transparent, and changes to a cherry juicelike fluid. With the aid of a microscope we see the blood-globules gradually losing their red coloring matter, which becomes uniformly dissolved and diffused through the serum, which then assumes a peculiar cherry-red color. This serum coagulates to the consistence of thick milk, but cannot form solid coagulae, and no watery particles separate from it. These appearances coincide with those of the blood of topers, which is thick but fluid; it coagulates very loosely, contains little fibrin, but much albumen and fat. – J.C.P.
According to C.H. Schultz, when Alcohol is absorbed into the blood, it renders the coloring matter of blood-globules soluble in the blood-plasma, and produces a contraction of the walls of the blood-globules. The quantity of fat in the blood of topers in considerably increased, it may increase to eleven per cent according to Lecanu. The blood often seems milky or curdy. According to Moleschott, Alcohol burns off in the blood, or forms a combination with the oxygen of the blood, and is converted into carbonic acid and water; this prevents the oxygen of the blood from combining with the organic mass, thus stopping its oxygenation and combustion, and retarding the normal and constant metamorphosis of the tissues hence it occasions a lesser demand for food and solid nourishment. Dr. Ogston has furnished the most positive proofs of the absorption of Alcohol into the blood. He says, “that Alcohol will escape by the kidneys unchanged, is proved by the fact that it can be tested chemically in the urine.” This he has verified in several cases of death by drowning. That this fluid, however, could be found in the urine in any but the minutest quantities, and in a highly diluted state, he did not consider at all likely till the following occurrence showed its possibility:
Case.
A man, aged forty-seven, while intoxicated, threw himself into the water; the body was recovered in less than an hour, and inspected fourteen hours after death. At the inspection, from three to four drachms of urine from the bladder was being heated in an iron spoon over the flame of a candle, to ascertain if it contained albumen, when the flame set fire to the vapor rising from the fluid. This unexpected event was witnessed by Dr. James Jameson, and several medical students. – J.C.P.
Alcohol passes directly from the stomach and intestines into the blood; a part of the spirit is, perhaps, then decomposed, but another portion is carried directly by the portal system through the liver, and from thence to the lungs, where much is exhaled with the air that is breathed, but the remainder passes into the arterial system, and from thence over the whole body.
All authors are agreed that the blood of dram-drinkers contains a much larger proportion of carbon than that of healthy individuals. Scharlau has estimated the excess of carbon in the blood of drunkards to be not less than thirty per cent. Huss comes to the conclusion that both the arterial and venous blood of dram-drinkers is loaded with fat; that it is impregnated likewise with Alcohol; that the solid constituents in defibrinated blood are diminished, as is likewise the proportion of blood-globules. – J.C.P.
Boecker thinks that Alcohol causes a decidedly venous condition of the blood, with a proclivity towards melanosis. Also that it produces a partial solution of the coloring matter of the blood in the plasma, rendering the serum reddish and turbid. – The blood in five drunkards contained: In 1000 parts Health.
Solid constituents of defibrinated blood 202.180 221.000
Blood-globules 122.484 141.100
Albumen 76.804 69.400
Extractive matters and soluble salts of serum 12.594 6.800
Fibrin 2.200 2.200
Hence Alcohol diminishes the solid constituents and the blood globules; increases the quantity of albumen, fat, and other extractive matters; and exerts little or no influence upon the fibrin.
CLINICAL REMARKS.
Alcohol is evidently suitable in some dyscrasias and blood diseases. It is homoeopathic to adiposis and venosis; more or less antagonistic to tuberculosis. In tuberculosis there is a deficiency of fat in the system, which Alcohol may supply, especially if aided by fatty food, cream, Cod-liver oil, there is an excess of albumen which Alcohol may increase; there is a deficiency of iron and the chlorides of soda and potassa which Alcohol cannot supply. Hence Alcohol alone may prevent tuberculosis, but cannot entirely cure it when fully developed; it may require the aid of Codliver oil, Iron and Chlorides of Soda and Potassa. In this connection we may be permitted to add, that the morbid condition of the blood produced by the malaria or poison of intermittent fever, is totally distinct from the morbid condition of the blood which attends tuberculosis. As far as chemical analysis goes, the facts show that the state of the blood which attends tuberculosis. As far as chemical analysis goes, the facts show that the state of the blood in confirmed and aggravated intermittent fever is the very antithesis of the state of the blood in tuberculosis in several important particulars; and, more especially, that the proportion of albumen is greatly diminished, while that of the red corpuscles is uniformly and to a very considerable extent increased – two circumstances which are in direct opposition to the state of the blood in tuberculosis. – J.C.P.
The blood of four persons, residing in malarious districts, and suffering from intermittent fever, was analyzed by Cozzi; the following are the results:
1 2 3 4 Average
Water and Salts 737.67 705.49 732.45 809.17 746.19
Fibrin 2.20 2.06 2.29 1.96 2.12
Fat 15 21 13 16 16
Albumen 48.71 56.61 47.59 53.10 15.50
Blood-corpuscles, 221.27 235.63 217.54 135.61 200.01
