In animals killed by alcohol, Orfila says he found the villous coat of the stomach constantly of a cherry-red odour. I have several times remarked the same appearance. When the stomach was empty before the alcohol was introduced, I have always found the prominent part of its rugæ of a deep cherry-red tint, the margin of the patches being more florid, and evidently consisting of a minute network of vessels.
In man these signs of irritation have not been always observed. In the patient who died in the Infirmary here, the stomach was quite natural to appearance. Dr. Ogston notices injection of the small intestines and thickening of the mucous membrane of the stomach and intestines as common appearances in the cases he has examined; but he seems to consider these the effects not of the last fatal dose, but of the habit of frequent excessive drinking.[1]
The blood in the heart and great vessels is commonly fluid and very dark, and the lungs are sometimes more or less gorged with the same fluid.
The state of the brain differs much according to the mode of death. Sometimes great congestion and even actual extravasation of blood are found in the heads of persons who have died of excessive continuous drinking,—the excitement of such a debauch being apt, as already mentioned, to induce apoplexy in a predisposed habit. Accordingly extravasation was found by Professor Bernt of Vienna in no less than four cases of the kind, two of which happened in the persons of young men not above twenty-two years of age;[2] and Dr. Cooke quotes another in his work on nervous diseases.[3] I have myself met with another remarkable instance. A female out-pensioner of Trinity Hospital here, who was much addicted to drinking, and for fourteen days after the New-year of 1830 had been very little in her sober senses, soon after arriving at home one evening much intoxicated, fell down comatose, and died in ten or twelve hours. An enormous extravasation of clotted blood was found in the ventricles, producing extensive laceration of the right middle and anterior lobes of the brain.—In such cases it is natural to suppose that a predisposition to apoplexy must concur with the intoxication; otherwise it is not easy to see why death from extravasation is not more frequently produced by excessive drinking.
Extravasation is not apt to occur in the cases of rapid death brought on by a very large quantity swallowed at once. The circulation, indeed, is during life in a state quite the reverse of excitement; and accordingly the brain and its membranes are found quite healthy. They were particularly so in the man who died in the hospital here. It is right to mention, however, that one of Bernt's cases, although the symptoms and other particulars are not mentioned, possibly belongs to the present variety, as the man swallowed for a wager a quart of brandy at a draught.[4] According to Dr. Ogston, who has given the best account of the appearances within the head
