From Big Medical Encyclopedia

ALCOHOL (synonym: ethanol, hydroxyethane, alcohol, spirit of wine) — the most famous representative of a class of alcohols possessing specific physiological action on a human body and animals. AA. villages apply in medicine as an antiseptic agent, use for grindings and compresses as solvent

at preparation of liquid dosage forms and as a preservative at production of anatomic drugs (see Drugs anatomic). In biochemical, clinicodiagnostic, dignity. - gi

giyenichesky laboratories and in chemical pharmaceutical industry E. the page is one of the most usable solvents and reagents. As raw materials or supporting material E. the page is used more than in 150 various productions, including in the food and paint-and-varnish industry, perfumery, in production of gunpowder, films and films, and also as raw materials for receiving a number of chemical products (e.g., ethyl acetate, chloroform, ethyl ether). In the nek-ry countries E. the page is applied as motor fuel.

Thanks to the spirit fermentation (see) which is carried out by means of microorganisms, education E. page from carbohydrates (see) it is widespread both in the nature, and in life and from antiquity it is mastered by the person. In trace amounts E. the page contains in natural waters, the soil, an atmospheric precipitation, it is found in fresh leaves of plants, milk, tissues of animals. Traces E. pages are found in tissue of a brain, muscles, a liver of the person; normal contains in blood of the person 0,03 — 0,04 ° the/00th alcohol.

C2H5OH alcohol — colorless hydroscopic liquid of burning taste, with a characteristic (spirit) smell; g°kip 78,39 °, t°UJl — 114,15 °, ud. weight (at 20 °) 0,789, coefficient of a refraction at 20 °

1,3614. Alcohol easily lights up and temperature of flash 14 °, concentration limits of explosibility of vapors E burns with a slabookrashenny flame. page in air

from 3 to 19 about %. Maximum allowable concentration E. the page in air of a working zone makes 1000 mg/m3. Like other alcohols (see), alcohol in liquid state is strongly associated owing to formation of intermolecular hydrogen bindings. Usual E. the page represents the constant boiling mixture (see. Constant boiling mixtures) with water (£ °kip 78,15 °) containing 95,57% of ethanol from a cut if necessary receive anhydrous, so-called absolute, alcohol. AA. the page gives also constant boiling mixtures with many organic liquids (benzene, chloroform, ethyl acetate, etc.). With water, alcohols, ethyl ether (see), glycerin (see), acetone (see) and many other solvents E. the page mixes up in all ratios (with water — with calorification and reduction of volume). AA. the page dissolves many organic and nek-ry inorganic compounds, in a lab. practice it serves one of the most often used solvents (see). With nek-ry inorganic salts (see) E. the page forms kristal-losolvata, e.g. Sas12 • 4C2H5OH, kristallosolvata are formed also E. page and separate organic compounds (see).

For E. pages are characteristic chemical properties of primary alcohols. At oxidation or catalytic dehydrogenation E. the page turns into acetic aldehyde (see Aldehydes), and at more vigorous oxidation — into acetic acid (see). Eliminating of water from E. the page during the heating in the presence of catalysts (a chamois to - you, aluminas) depending on conditions leads ethylene or diethyl ether to its turning into (see. Ethyl ether). With carboxylic and inorganic to-tami or their derivatives E. the page forms esters (see). This reaction is widely used for the synthetic and analytical purposes. Exchange of hydroxylic group in a molecule E. the page on halogen atom (C2H5OH + NVG — S2n5vg + H20) leads to formation of etilga-logenid — the substances applied in organic synthesis. At interaction E. the page in alkaline condition happens to halogens so-called galoformny splitting: C2H5OH + 4Х2 + 6NaOH-^ SNH3 +

HCOONa + 5NaX + 5H20, where X — chlorine, bromine or iodine. Galoformny splitting is used for receiving chloroform (see) also by detection E. page (yodoformny test). With alkali metals (see) alcohol forms alko-go lyat (ethoxides): C2H5OH + Na —> — * C2H5ONa + V2H2. Chlorination E. villages receive trichloroacetaldehyde (trichloracetaldehyde): CH3CH2OH + 4C12 —>

-> CC13CHO + 5HC1.

By a traditional method of receiving E. the page is fermentation of ug-levodsoderzhashchy raw materials (grain, potatoes, molasses). Overall reaction of spirit fermentation (S6N1206->—> 2C2H5OH + 2C02) goes with high yield E. the page (over 90%) also consists of a number of stages with gradual splitting of glucose (see) or fructose (see) to acetic aldehyde, to-ry is recovered to E. page. This reaction is catalyzed by barmy alcohol dehydrogenase (KF Received diluted-rastvo-ry E. pages concentrate distillation before formation of rectified alcohol (96 — 96,5 about. % of C2H5OH). The starchy materials used for receiving E. pages, subject previously an osakhariva-niya to glucose amylase of malt (see Amylases) and then ferment yeast. As uglevodsoderzhashchy raw materials apply also

hydrolysates of cellulose (see) and waste of its production (sulphitic leach). AA. the page, received by fermentation of raw materials with the high content of pectic substances or a lignin, as impurity contains noticeable amount of methyl alcohol (see).

Great practical value has also production E. page from ethylene: CH2 — CH2 + H20 ^

^ C2H5OH (reaction takes place at an elevated temperature and pressure and is catalyzed by a chamois to - that), and also direct hydration of ethylene in the presence of acid catalysts; by this method in a crust, time in the majority of the countries receive the main quantity E. page.

In a human body E. the page is oxidized to acetic aldehyde (see Acetaldehyde): CH3CH2OH +

OVER + ^ SNDSNO + OVER • N + H+. This reaction is catalyzed by alcohol dehydrogenase (KF of a liver; this catalyst — primary enzyme of metabolism E. page. The formed acetic aldehyde is oxidized (hl. obr. in a liver) to acetic acid, edge, turning in atsetil-KOA, joins in a metabolism (see. Tricarboxylic acids cycle).

On a human body E. the page has narcotic and toxic effect, causing excitement, and then sharp oppression of the central nervous system in the beginning (see. Alcoholic intoxication). The systematic use of alcoholic drinks even in small doses leads to disturbance of the major functions of an organism and the heaviest defeat of all bodies and fabrics, causes organic diseases of nervous and cardiovascular systems, a liver, a digestive tract, leads to moral and mental degradation of the personality (see Alcoholism, an alcoholism).

The damage rate, various frequency and rate of progressing of defeat of different bodies depend on a dose and the frequency of alcohol intake by the alcoholic. The most characteristic signs of a drunkenness, especially in a stage of its aggravation, existence is at morfol. a research of biopsy material of a so-called alcoholic hyalin in hepatocytes and accumulation of intermediate filaments in cytoplasm of epithelial and mesenchymal cells (the last is morfol. expression of disorder of protein metabolism). Disturbance of lipidic exchange at a drunkenness is shown in accumulation of inclusions of fat in cytoplasm of cells of different bodies. The most characteristic morfol. displays of a so-called alcoholic disease is the combination of signs of disturbance of proteinaceous and lipidic exchanges, the expressed microcirculator frustration in the form of a plethora of vessels, existence of plasmorrhagias and hemorrhages; in exudate polymorphonuclear leukocytes and macrophages with morfol prevail. signs of functional insufficiency that confirms a condition of immune deficit at the alcoholic (see. And to a mm but logical insufficiency).

Methods of definition. Contents E. pages in mixes with water determine by density of solutions by means of special tables (spir-tometriya). For chemical detection E. villages use yodoformny test, to-ruyu, however, it is possible to apply only for lack of the substances which are also forming an iodoform (acetic aldehyde, acetone, milk and pyroracemic to - t); formation of ethyl ether of the benzoic to - you are C6H5COOC2H5, distinguished on a characteristic smell (it must be kept in mind that methyl alcohol gives similar test), or formation of ethyl ether of the tg-nitro-benzoic to - you are n-02NC6H4C00C2H5, the melting determined by temperature (57 °); and also specific staining reaction of the acetic aldehyde which is formed oxidation E. page, with secondary amino and Sodium nitroprussidum (Simon's test). For definition E. pages apply its easily received ethers with characteristic temperatures of melting (the gs-nitrobenzoic to - you, 3,5-dinite-robenzoynoy to - you, etc.). For quantitative determination of content E. villages in water solutions use also refractometry (see) and a range about photometry (see) on the basis of Simon's test. The majority of modern chemical methods of definition, alcohol in biol. liquids it is based on its oxidation and spektrofotometrichesky measurement of concentration of oxidates or titration of not reacted oxidizer, most often bichromate (see. Titrimetric analysis); from the analyzed samples E. pages isolate previously an otgonka or diffusion (Vidmark's method, etc.). Enzymatic methods of definition E are more specific. the pages based on its oxidation by alcohol dehydrogenase and spektrofotometrirovaniya formed OVER • N, and also definition E. page by means of a gas liquid chromatography (see). These methods are applicable also for definition E. page in expired air. Quantitative definition E. the page in blood and urine is a reliable indicator of intoxication E. page. For carrying out the most precision, specific and sensitive measurement of concentration E. the page by means of a gas liquid chromatography is enough 2 — 5 ml of blood or urine. For establishment of intoxication E. pages apply also other quantitative methods of definition of ethanol, napr, Vidmark's method, a titrimetric method (titration of not reacted oxidizer), etc.

For quantitative definition E. pages from a vein take 5 — 10 ml of blood in a small test tube (to the brim) so that there was no air left. Sample of urine in the same volume is taken from total quantity of the urine produced in pure capacity. Processing of skin, ware and tools is made a nonvolatile antiseptic agent, free of E. the page the Taken material can be stored no more than 1 days, it is obligatory in the refrigerator.

Qualitative tests on E. pages at suspicion of alcoholic poisoning are preliminary and not specific therefore their results shall be confirmed by quantitative definition E. page. Couple E. pages in expired air are found in 10 — 20 min. after its reception and during

1V2 — 20 of hour, depending on the fortress of alcoholic drink and the accepted dose. Among qualitative tests on E. by page test is most widespread on Mokhov and Shinkarenko with use of indicator tubes. The lyanny tubes soldered since both ends stekt contain reagent of orange color — the silica gel processed by solution of chromic anhydride in concentrated sulphuric acid. For conducting test the ends of a tube break off, and the examinee during 20 — 30 sec. blows air in a tube. Under the influence of vapors E. the page occurs recovery of ions of chrome, and orange coloring of reagent changes on green or blue. However the positive take can be received also at action on reagent of vapors of methyl alcohol, acetone (at patients with a diabetes mellitus), ether and aldehydes. Vapors of gasoline, acetic to - you, a dichloroethane, phenol paint reagent in dark brown color. Rapoport's test based on dissolution in distilled water E is less often applied. page, contained in expired air, and the subsequent its permanganate oxidation of potassium in the presence of sulphuric acid. At the same time there is decolourization of solution. This test is also not specific since the positive take at its use can be received at dissolution in water of vapors of ether, acetone, gasoline, hydrogen sulfide, methyl alcohol. For definition of presence E. villages in urine or cerebrospinal liquid use Niklu's test based on decolourization of the studied liquid with orange on green after consecutive addition of crystal potassium permanganate and concentrated sulphuric acid.


Mechanism of toxic action E. the page connected with its selective defeat c. N of page, first of all nervous cells of bark of big hemispheres (see. Alcoholic intoxication). A number of the substances which came to an organism along with E. the page (hypnotic drugs of a barbituric row, tranquilizers, carbon oxide, etc.), strengthens its action. The substances raising standard metabolism usually increase oxidation rate E. page in an organism. Treat such substances adrenaline (see), insulin (see), thyroxine (see), etc. Nek-ry substances are direct antagonists E. pages (Phenaminum, Pervitinum, etc.) and at receipt in an organism considerably weaken external displays of intoxication E. page.

At the first stage of intoxication E. the page collects in blood, reaching a maximum on average through

1 — 1V2 (a phase of a resorption). After the small period of diffusion balance of concentration E. the page in blood and other liquids, in bodies and fabrics the content of alcohol in blood gradually decreases, at the same time its concentration increases in urine (a phase of elimination).

Survey is made for establishment of alcoholic intoxication in the direction of law enforcement agencies, vessels and administrations of institutions. In the act of survey anamnestic data shall be specified (the previous diseases and injuries, frequency of reception E. page, its portability, time of the last alcohol intake, etc.), data of an objective research — the constitution and weight (weight) of a body, results a wedge, inspections and psychotechnical tests, results of qualitative tests on alcohol and quantitative definition E. page in blood and urine. Conducting examination consists of two stages: medical survey, a cut it is carried out, as a rule, by neuropathologists or psychiatrists, and chemical researches for the purpose of detection E. page in an organism.

«Methodical instructions on medicolegal diagnosis of fatal poisonings with ethyl alcohol and the mistakes made at the same time» M3 of the USSR (1974) recommend the following approximate toxicological assessment of various concentration of alcohol in blood: less than 0,3%0 — lack of influence of alcohol; from 0,3 to 0,5%0 — insignificant influence of alcohol; from 0,5 to 1,5 °/oo — easy intoxication;

from 1,5 to 2,5 °/oo — intoxication of average degree; from 2,5 to 3 °/00 — strong intoxication; from 3 to 5%0 — a serious poisoning, there can come death; from 5 °/00i above — fatal poisoning. The given assessment is applicable only for a phase of a resorption. In a phase of elimination the condition of the person who accepted alcohol can be easier or heavier stated above therefore it is necessary to carry out comparative assessment of contents E. page in blood and urine.

Absence E. pages in blood and existence it in urine testify to the fact of reception E. villages, however do not allow to establish degree of a drunkenness. By comparison of concentration E. the page in blood and urine can be defined approximately time of alcohol intake.

Detection E. page at court. - a medical research of a corpse matters for diagnosis of fatal poisoning E. page and for establishment of the fact of a drunkenness before approach of death. It is necessary to define concentration E. page in a corpse to collect anamnestic data, to establish age of the dead, to collect data on circumstances of death etc. A lethal dose 200 — 300 ml pure E are considered. the page, however this dose fluctuates depending on age, accustoming to E. page, states of health, etc. For the people accustomed to alcohol, and hron. the lethal dose can be higher than alcoholics several times. Death from poisoning E. page it is possible at any stage of a drunkenness. Average deadly concentration E. the page in blood is considered 3,5 — 5%0, and concentration is higher 5%o is certainly deadly.

Poisoning E. the village aggravates the course of many diseases and can promote approach of death. It is necessary to carry out differential diagnosis of death from acute poisoning E. page with death from a disease (is more often than cardiovascular) which came in a condition of an acute drunkenness. To establishment of acute poisoning E. page as a cause of death it is necessary to approach carefully and in all cases carefully to reason this conclusion.

P. I. Novikov (1967) recommends for assessment of quantitative contents E. to take page in a corpse for a chemical research blood, urine, contents of a stomach and cerebrospinal liquid. Ratio of concentration E. the page in these liquids allows to define approximately a stage of a drunkenness, time of reception E. page and the accepted dose. If court. - not all corpse, and only its separate parts is exposed to a medical research, it is possible to define concentration E. page in internals or in muscles with the subsequent recalculation on contents E. page in blood. It is necessary to remember that at putrefactive decomposition in a corpse there is an education E. the page, concentration to-rogo can reach 0,5 — 1 °/oo *

the Bibliography: Balyakin V. A. Toksi

kologiya and examination of alcoholic intoxication, M., 1962; Karrer P. A course of organic chemistry, the lane with it., page 118, L., 1960; Kolkovski P. Colorimetric express method of polukolichest-venny definition of alcohol, Laborat. business, No. 3, page 17, 1982; Novikov P. I. Examination of a drunkenness on a corpse, M., 1967; Spiders V. S. and Ugryumov A. I. Pathoanatomical diagnosis of alcoholism, Arkh. patol., t. 47, century 8, page 74, 1985; Polyudek-Fabini R. and B e y r and x T. Organic analysis, the lane with it., page 54, L., 1981; The Guide to forensic medical examination of poisonings, under the editorship of R. V. Berezhny, etc., page 210, M., 1980; Sirs V. V. and Lebedev S. P. Clinical morphology of alcoholism, Arkh. patol., t. 47, century 8, page 3, 1985; Soldatenkov A. T. and Sytinsky I. A. Methods of definition of alcohol in biological liquids, Laborat. business, No. 11, page 663, 1974; Stabnikov V. H., P about y t e r I. M., and Protsyuk T. B. Alcohol, M., 1976; Whyte A., etc. Fundamentals of biochemistry, the lane with English, t. 2, page 780, M.,


A. I. Tochilkin; R. V. Berezhnaya (court.).