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Alcohol "94 "

Spiritus Rectificatus [B. P.]. " 90 "

Spiritus Tenuior (Proof Spirit) . " 57-9 "

Rum, Gin, Strong Liqueurs . . " 51 to 59 "

[Spiritus Frumenti " 50 to 58] "

Alcohol Dilutum "48.6 "

Spiritus Vini Gallic! .... " 46 to 55 "
Vinum Album Fortius (U. S. P.,

1880) " 23 to 29 "

[Vinum Porteuse] " 2O to 30 "

[Vinum Xericum or] Madeira . " 16 to 22 "

Vinum Album " 12.41017.3 "

[Vinum Rubrum " 12.41017.3] "

Champagne ....... " IO to 13 "

Vinum Aurantii [B! P.] ... " 10 to 12 "

Burgundy " 9 to 12 "

Hock " 9 to 12 "

Claret " 8 to 12 "

Cider " 5 to 9 "

Strong Ale or Stout .... " 5 to 9 "

Beer [or] Porter " 2 to 5 "

[Kumyss] " * I to 3 "

ACTION OF ALCOHOL.

External. It is a powerful antiseptic, preventing the for-
mation of and killing putrefactive bacteria. If applied to the
skin, alcohol quickly evaporates. It therefore cools the skin,
which consequently becomes pale from the contraction of the



282 INORGANIC MATERIA MEDICA.

small vessels ; owing to this less sweat is secreted. Alcohol is
thus refrigerant, astringent and anhidrotic. But if evaporation
is prevented in any way, such as by a watch-glass or a piece of
gutta-percha, or the alcohol is rubbed in, it quickly absorbs water
from the skin, and thus hardens it. Having thus passed through
the epidermis, it dilates the vessels, causes a feeling of warmth,
and produces a rubefacient effect. It has the power of coagu-
lating albumin, but the coagulum quickly re-dissolves. It extracts
water from all tissues.

Internal. Mouth. When concentrated, alcohol produces a
feeling of warmth, or often even a burning sensation, in the
mouth. If held there for some time, the albumin of the super-
ficial tissues is coagulated, and the mucous membrane becomes
whitish, congested, and opaque ; but this appearance soon disap-
pears, as the coagulum is re- dissolved by the fluids of the tissues.
Directly [after] the alcohol is put in the mouth there is an increased
flow of saliva, and the pulse may be quickened ; these results are
reflex, for they occur before there is time for the alcohol to be
absorbed. Alcohol has a slight local anaesthetic effect.

Stomach. Here also, if the alcohol is sufficiently concen-
trated, there is a sensation of warmth or even of burning. If
only small quantities are given, the gastric vessels dilate, the
mucous membrane becomes red, and there is an increased secre-
tion of gastric juice. All this [has been] seen to happen in cases
of gastric fistula. The result of these effects is that the appetite
is sharpened, and this explains the custom, common with many
people, of taking a little alcohol immediately before meals, and
also the common experience that alcohol taken during meals aids
digestion. It also increases the activity of the gastric move-
ments and promotes absorption. Thus there are several ways in
which moderate dosea of alcohol may help the digestive
process, and Binz has actually demonstrated, by removing the
gastric contents at stated times after a meal, that alcohol aids
digestion, and by giving potassium iodide he showed that it in-
creased the rapidity of absorption. In some cases it produces a
local anaesthesia in the stomach, and so it may relieve gastric
pain. It is to a slight extent decomposed into aldehyde and



CARBON AND ITS COMPOUNDS. 283

acetic acid, and consequently some of the pepsin, peptones, and
proteids are precipitated. This hinders digestion, but usually
not sufficiently to outdo the aid due to the vascular dilatation,
the increased secretion, and the greater movement. The effect
of large doses is very harmful.. The activity of the gastric
juice is destroyed, the gastric walls are inflamed, large quantities
of mucus are poured out, and if the over-indulgence is continued
chronic gastritis ensues, the gastric glands atrophy, and conse-
quently we get the permanent dyspepsia of drunkards.

A single dose of alcohol introduced into the stomach in a
concentrated form, e.g., [clear] brandy, immediately produces
important reflex effects. The heart beats more rapidly and
more forcibly, the vessels of the whole body dilate, especially
those of the skin ; hence there is a feeling of warmth. The
blood- pressure rises. These reflex effects are well seen in the
immediate restoration of a fainting person by the ingestion of a
single dose of brandy. Diluted alcohol, e.g., beer, does not
produce them. They are quickly followed by the effects of
alcohol upon the circulation due to its presence in the blood
after absorption.

Intestines. Here alcohol has a slight astringent effect, and
consequently it may check diarrhoea.

Blood. Alcohol is absorbed more largely by the blood-vessels
than the lacteals. It first increases and then diminishes the
amoeboid movements of the white blood- corpuscles. It so acts
on the red corpuscles as to prevent oxyhsemoglobin from readily
yielding up its oxygen, consequently it diminishes the oxida-
tion of the tissues. This, in habitual drinkers of large quan-
tities of alcohol, may lead to an imperfect combustion of fat,
consequently it accumulates in the tissues, and obesity, which
is often increased by the amount of saccharine matters alcoholic
liquids contain, results. The skin acquires a velvety feeling.

Alcohol is slightly antipyretic, lowering the temperature in
fever. This is chiefly due to cutaneous vascular dilatation and
rapidity of circulation, but also slightly, perhaps, to general dimin-
ished oxidation. A litre, [about a quart] of Rhine wine of average
strength produces by its oxidation about as much heat as five or six



284 INORGANIC MATERIA MEDICA.

tablespoonfuls [100. to 120. c.c.] of olive oil. Neither the intake
of oxygen nor the output of carbon [dioxide] is altered by alcohol,
therefore as it has been oxidized in the body it saves the tissues
and is a food. Repeated observations have shown the proof of
this, for moderate doses of alcohol diminish the output of urea
and uric acid, 6 or 7 per cent. ; and that it is a food is also proved
by the fact that the weight of the body may be maintained if a
large amount of alcohol is taken, even if the rest of the food is
very small in amount. [Alcohol ceases to be a food when it is
ingested in such large amounts that it cannot be completely oxid-
ized. In this instance the excess is likely to be harmful.]

If only moderate doses are drunk, very little alcohol leaves
the body in the urine ; with large doses the case is different.

Circulation. The effects upon the circulation reflexly pro-
duced by stimulation of the mouth and stomach have already
been mentioned. After alcohol is absorbed it influences the
heart markedly. It beats more powerfully and more
rapidly, the pulse becomes fuller ; these results are due to the
peripheral arterial dilatation and to a stimulating effect on the
accelerator nerves. The vaso -motor system is acted upon, all the
vessels of the body dilate, especially those of the skin;
therefore, if he previously felt cold, the person who has taken the
alcohol feels warm. The blood-pressure rises, the increased
action of the heart more than compensating for the vascular dila-
tation. [This is not true for dogs, as has been demonstrated in
the laboratory (Long).] The direct effects of alcohol on the
circulation after absorption appear more slowly and last longer ;
but they are clearly similar to those due to the reflex stimulus
from the stomach, and therefore they continue them. The re-
sult of the increased circulation through the various organs is
that they work to greater advantage, hence the mental faculties
are brightened for a time, the muscular strength seems increased,
more urine is passed, and the skin perspires. The person who
has taken the alcohol, in fact, usually feels generally better for
it. This is by no means always so ; some persons have a head-
ache or feel very sleepy immediately after alcohol. This is
probably because the vessels of the abdomen or skin have dilated



CARBON AND ITS COMPOUNDS. 285

so excessively that almost all the blood in the body is in them,
and consequently there is very little in the brain. There are
many individual peculiarities in the effects of alcohol.

It has been repeatedly proved that these good results are but
transitory. The heart, although at first stimulated, is more
exhausted after the stimulation has passed off than it was
before. This is also true of all the organs of the body stimulated
by the increased circulation induced by alcohol. In many cam-
paigns and arctic expeditions it has been found that although at
first the men, after taking alcohol, could do more work, yet soon
they felt so tired and exhausted, that on the whole they could do
much more without than with the alcohol. Large doses of
alcohol do not stimulate the heart at all ; they paralyze it, both
reflexly from the stomach and after absorption. Enormous doses
poured into the stomach kill almost immediately by reflex action.
A drunkard who is "dead drunk" is, accurately speaking, one
who is killed by the paralyzing effect of alcohol on the heart ;
but the phrase is often applied to any one who is very drunk.

Skin. Alcohol is a mild diaphoretic, partly because of its
vaso-dilator action, and perhaps also because of some direct in-
fluence on the sweat-glands. As just mentioned, the cutaneous
vascular dilatation leads to a feeling of warmth if the patient's
cutaneous vessels were previously contracted from cold. It may
be that part of the antipyretic power of alcohol is due to in-
creased radiation from the dilated vessels, and also to evaporation
of the increased amount of sweat. If a person is in a cold atmos-
phere, alcohol, by increasing the radiation from the skin, leads
to the loss of so much heat that he may die from cold, although
at first the increased cutaneous circulation, making him feel
warmer, gives him a delusive feeling of warmth.

Kidneys. About 5 per cent, of the alcohol ingested unless
very large quantities are taken is excreted unchanged, mostly
in the urine, to a less extent in the expired air, only the merest
trace in the sweat and none in the milk or faeces. Most of it is
oxidized in the body. It acts as a diuretic ; probably this is a
secondary result of its vascular effects, but it probably also acts
directly on the glomeruli.



286 INORGANIC MATERIA MEDICA.

Nen>ous system. Unless the dose be very large the whole
nervous system is stimulated, perhaps to a slight extent directly,
but chiefly as a secondary result of the vascular dilatation and
cardiac stimulation. The highest functions are most affected.
The person who has taken the alcohol talks more fluently and
brilliantly, his wits are sharpened, he has a feeling of strength.
If the dose has been large, the stage of exaltation of these or any
other functions quickly passes into one of depression, the highest
functions being affected first, and the stimulation and depression
of function proceed regularly from the highest to the lowest. The
action of alcohol thus illustrates both the fact that stimulation is
usually succeeded by depression, and also the "law of dissolu-
tion," which (see p. 104) states that functions which have ap-
peared latest in the animal series or the individual are the most
easy to influence, those which have appeared earlier are less easy
to influence ; and so by regular sequence till we arrive at those
functions which are first developed, which are the last to be in-
fluenced. The stimulation and subsequent depression of func-
tion, therefore, proceeds in a descending scale from the highest
or least firmly fixed function to the lowest or most firmly fixed.
Thus the power of judgment is abolished very early by alcohol ;
this is so while the imagination, the emotions, and the power of
speech still remain stimulated ; but soon the power of imagination
goes, the patient loses all command over his emotions, he cries
and laughs irregularly, but this soon stops. He next begins to
lose control over his speech, talking incoherently and thickly ;
shortly afterwards he cannot talk at all, but can only make a noise.
Muscular movements, which are not so highly developed as those
of speech, are next affected ; delicate, lately developed move-
ments, as writing, feeding himself, etc., are for a time performed
inco-ordinately, but soon they are paralyzed. Next the muscular
movements, developed before these, are implicated, and the patient
cannot undress himself or walk straight, and inco-ordination of
these movements passes into the inability to do them at all. Next
the activity of the reflex centres of the cord is abolished, the
patient passes his urine and faeces [involuntarily]. Then the
respiratory centre, which was previously stimulated, becomes



CARBON AND ITS COMPOUNDS.

paralyzed, breathing is difficult, and the face is livid. Lastly, the
heart, which was also at first stimulated, is paralyzed, and the
patient dies. The depression of the reflex centres of the cord
accounts for the fact that injuries which would kill a sober man
do not kill a drunken one, for the .heart and respiration, owing
to the general central depression, are not affected reflexly by
them.

THERAPEUTICS OF ALCOHOL.

External. Four parts of alcohol to one of water form the
Lotio Spiritus of many pharmacopoeias. [Cotton] or lint dipped
in it are applied to sprained joints, bruises, etc. The alcohol
evaporates, cools the part, consequently the vessels contract, and
inflammation may thus be checked. At the same time the local
anaesthetic effect of the cold relieves the pain. In a similar way
many varieties of headache may be soothed by bathing the fore-
head with eau de Cologne or Bay Rum. Brandy or some other
form of alcohol is often used to bathe the skin in order to harden
it, by abstraction of water, and thus prevents the formation of
bed-sores or cracked nipples. Spirit lotions dabbed on the skin
may, by means of the vascular contraction produced, stop sweat-
ing. Alcohol rubbed in, as in the use of Linimentum [Saponis] ,
is commonly employed for its rubefacient effect, to aid the ab-
sorption of inflammatory products and relieve pain, as in chronic
rheumatism, myalgia, etc.

Internal. Mouth. A little brandy held in the mouth will
be a local anaesthetic and relieve toothache. Alcohol is used as
a gargle of port wine for its power of precipitating albumin and
acting as an astringent in cases of chronic sore throat, excessive
salivation, or inflammation of the gums.

Stomach. Because it increases the secretion of gastric juice,
the vascularity and the movements of the stomach, alcohol aids
digestion. It must only be taken in small quantities, for large
amounts paralyze the secretion and cause gastritis, and ultimately
lead to atrophy of the gastric glands. It should be given just
before or during a meal. It is harmful in acute dyspepsia, but
for the indigestion of the aged and feeble, or for those who are
thoroughly exhausted by overwork, it is very valuable, as the



288 INORGANIC MATERIA MEDICA.

stomach shares in the general exhaustion. It is also useful be-
cause it increases the appetite. Owing to its anaesthetic property
it may relieve painful dyspepsia, and may check vomiting, espe-
cially if taken with carbon [dioxide], as, for example, in the
form of champagne or brandy and soda-water, and because it
increases the activity of the gastric movements it may relieve
flatulence. A single dose of strong spirits poured into the stomach
is often employed with great benefit for its reflex stimulant effects
on the circulation for those who have fainted, or who are col-
lapsed from cold or any other cause.

Intestines. Brandy and water will often check diarrhoea.
Perhaps this is owing to the astringent power of the brandy,

Fever. Alcohol has been largely used in all sorts of febrile
conditions. We have seen that it impairs oxidation by its action
on the red corpuscles, that it is oxidized and is therefore a food,
and that it is mildly antipyretic and diaphoretic. These results
would be beneficial in fever. On the other hand, the accelera-
tion of the pulse would be distinctly harmful, although it must
be remembered that very often, for some unexplained reason,
alcohol lowers the pulse in fever ; the indigestion caused by the
taking of large quantities, and the liability to depression of the
respiratory and cardiac centres, would be very undesirable. The
best rules are that while alcohol may be given, often with im-
mense advantage in fever, either to aid digestion, to slow the
pulse, as a cardiac stimulant if the patient be much collapsed, or
to produce sleep, yet it may, in any of the ways alluded to, do
harm. Therefore, when it is being used, the effect must be care-
fully watched, and if the pulse becomes quick and feeble, or, as
indicating gastric irritation, the tongue becomes dry and brown,
or the skin becomes hot and dry, or the breathing hurried, or the
patient suffers from insomnia, the alcohol should be stopped. On
the other hand, if the pulse becomes stronger and slower, the
tongue and skin moist, the breathing tranquil, and the patient
sleeps well, the drug is doing good, and may be continued. We
have so many more powerful diaphoretics and antipyretics that
alcohol is not often given for these purposes. Of all fevers it is
most used for acute lobar pneumonia, and, speaking generally,



CARBON AND ITS COMPOUNDS. 289

it is most likely to be valuable when our object is to keep up the
patient's strength for a few days only, till the termination of a
specific fever of short duration ; but it is often given when it is
quite unnecessary.

Nervous system. Alcohol may, as ^just mentioned, be used as
a soporific in fever. Many persons who suffer from insomnia
find that they can sleep better for a glass of whiskey and water
just before going to bed, no doubt because of its depressant
action upon the highest centres.

Kidneys and skin. Alcohol is occasionally given as a diuretic.
Gin is the best form, because it usually contains some juniper,
which is also diuretic. Although but little alcohol is excreted by
the kidneys, it seems to be particularly irritant to the urethra in
cases of gonorrhoea and gleet, and some authorities consider that
chronic Bright' s disease may be induced by alcohol. Almost the
only use made of its diaphoretic effect is as a help to cure a cold
in the head, for which purpose a glass of strong spirits and water
may be taken immediately before going to bed.

TOXICOLOGY.

Large doses of Alcohol will produce death, either instantly by reflex stop-
page of the heart, or later by cardiac and respiratory depression after absorp-
tion.

Chronic poisoning causes so many diseases that it is really the part of a
text-book upon medicine [to enumerate them.] Very often confirmed drunk-
ards, particularly if they take much spirits, are very thin ; this is probably due
to the fact that strong spirits cause such marked indigestion that sufficient
nourishing food is not absorbed. Other drunkards are fat, especially if they
drink beer. Chronic gastritis, cirrhosis of the liver, gout, peripheral neuritis,
delirium tremens, mania, and perhaps chronic Blight's disease, may all be
directly due to excessive indulgence in alcohol. It renders patients particu-
larly liable to phthisis, and makes them bad subjects for withstanding- any
severe illness, especially pneumonia, or to undergo severe surgical operations.
Alcoholic beverages contain other bodies than alcohol, which are probably
partly responsible for these evil effects.

II. [ALCOHOL AMYLICUM.]

AMYLIC ALCOHOL. (Not official. ) C 5 H n OH=87.8i. Synonym.
Fusel Oil.

SOURCE. Separated during the rectification of crude spirit and re-distilled
at from 250 to 260 F.; 121.1 to 126.6 C.

19



2QO INORGANIC MATERIA MEDICA.

CHARACTERS. A colorless, very inflammable, oily liquid, with a peculiar
odor. Sp. gr. , 0.818.

Amylic Alcohol is used to make Amyl Nitrite.

USES OF AMYLIC ALCOHOL.

Fusel oil is a poison, and is not used in medicine. The manu-
facturers of cinchona alkaloids employ it as a solvent ; formerly
it was required for the preparation of valerianic acid.

III. CHLOROFORMUM.

CHLOROFORM. CHCl 3 =i 19.08. A liquid consisting of 99 to 99.4
per cent., by weight, of absolute Chloroform, and I to 0.6 per cent, of Alcohol.
Synonyms. Chloroformum Purificatum.] Trichloromethane.

SOURCE. Heat water and Alcohol in a still to 100 F. [37.7 C.J, then
add Chlorinated Lime ; [Chloroform distils over. It is believed that reaction
takes place as follows : On bringing together Alcohol and Chlorinated Lime,
the Chlorine converts the former into Chloral, which is at once decomposed
by the Calcium Hydroxide, yielding Chloroform and Calcium Formate
(Ca(CHO 2 )j). The Calcium Formate is decomposed by another portion of
Chlorinated Lime into Calcium Carbonate and Chloride, and water. 2C,H 5 OH
+loCaOCl 1 =2CHClj+7CaCI 2 +2CaCO 3 +Ca(OH)j-|-4H. ( O. In late years a
Chloroform quite free from Chlorinated bye products has been obtained from
the distillation of Acetone (from destructive distillation of Calcium Acetate)
and Chlorinated Lime, from which Chloroform is produced, together with
Calcium Acetate, Hydroxide and Chloride. 2(C 3 H 6 O)-f-6(CaOCl,)=
2(C HCl s )-fCa(C 2 H 3 O 2 ) 2 +2Ca(OH ) 2 -f 3CaCl 2 ] .

CHARACTERS. A heavy, clear, colorless, [mobile and very diffusible
liquid of a characteristic, ethereal odor, and a burning sweet taste. Sp. gr. ,
not below 1.490. It imparts a green color to flame. Solubility. In 200 parts
of water, in which it sinks in heavy drops.]

IMPURITIES. Hydrocarbons, shown by darkening with sulphuric acid,
non-volatile compounds, shown by not completely evaporating, and by un-
pleasant odor, acids, and free chlorine.

['Purification. Chloroform which fails to respond to tests of the Phar-
macopoeia should be purified by the following process: Chloroform, 400;
Sulphuric Acid, 80 ; Dried Sodium Carbonate, 2O.gm. ; Deodorized Alcohol,
4 c.c. Add the Sulphuric Acid to the Chloroform, contained in a glass-stop-
pered bottle, and shake them together occasionally during twenty-four hours,
avoiding exposure to bright daylight. Separate the lighter Chloroform layer ;
add to it the Dried Sodium Carbonate, previously rendered anhydrous by
heating it in a porcelain capsule on a sand bath until it ceases to give off
aqueous vapor, and shake them together frequently and thoroughly during half
an hour. Then transfer the Chloroform to a dry retort, add to it the Alcohol ;



CARBON AND ITS COMPOUNDS. 2pl

and distil, by means of a water-bath, at a temperature not exceeding 153 F.,
67.2 C., into a well-cooled, tarred receiver, until the distillate measures
255 c.c.]

Dose, 2 to 20 m. ; [.12 to 1.20 c.c.]

Prepa rations.

1. Aqua Chloroform!. [Chloroform Water. Chloroform and
distilled water, by agitation, there being always an excess of Chloroform
present.

Dose, i to 4 fl. dr. ; 4. to 15. c.c.]

2. Linimentum Chloroform!. [Chloroform Liniment. Chloro-
form, 300 ; Soap Liniment, 700.

3. Emulsum Chloroform!. Emulsion of Chloroform. Chloro-
form, 40; Expressed Oil of Almond, 60; Tragacanth, 15; water to

1000.

Dose, i to 4 fl. dr. ; 4. to 15. c.c.]

4. Spiritus Chloroformi. [Spirit of Chloroform. Synonym.
Chloric Ether. Chloroform, 60 ; Alcohol, 94.0. Strength. 6 per
cent.

Dose, Yz to i fl. dr. ; 2. to 4. c.c.]

5. Tinctura Chloroformi et Morphinae Composita, [B. P., not
official. Compound Tincture of Chloroform and Morphine.] Intended
to be an imitation of the proprietary medicine called Chlorodyne. [Mix
Chloroform, 75 ; Tincture of Capsicum, 25 ; Tincture of Indian Hemp,
100 ; Oil of Peppermint, 1.5 ; and Glycerin, 250 ; with Alcohol, 450 j
and dissolve in this Morphine Hydrochlorate, IO ; add Diluted Hydro-
cyanic Acid, 5 ; then mix with sufficient Alcohol to form looo parts.]

Strength. 10 m. [.60 c.c.] contains chloroform ^ m. [.045 c.c.],
morphine [hydrochlorate,] -fa gr., [.0054 gm.], diluted hydrocyanic
acid ^ m. [.03 c.c.]

Dose, 5 to 15 m. ; [.30 to i.oo c.c.]

ACTION OF CHLOROFORM.

External. Chloroform in many respects acts like alcohol ;
but it is more powerful. Thus if allowed to evaporate on the
skin it produces cold ; therefore the vessels at the point of appli-
cation contract, and at the same time local anaesthesia is
induced. If the vapor be confined, or if chloroform be rubbed
into the skin, it acts as an irritant. The vessels dilate, the part
becomes red, and there is a sense of heat. This rubefacient effect
may pass on to vesication. It is a powerful antiseptic. [Chloro-



292 INORGANIC MATERIA MEDICA.

form is an excellent antiseptic to preserve urine during trans-



Online LibraryWilliam Hale-WhiteMateria medica, pharmacy, pharmacology and therapeutics → online text (page 25 of 67)