Liver Injury in Acute Alcoholic Poisoning.

Abstract

Although in most text books of Pharmacology and Medicine the statement is made that alcohol has a directly injurious effect on the liver, recently much doubt has been expressed as to an etiological relationship between alcohol and liver disease. An opportunity of studying altered liver function in acute alcoholic poisoning has been taken advantage of in an attempt to throw light on this question, and a short statement of the positive results obtained is given. The subjects of the observations were 17 of the patients admitted to Bellevue Hospital with the diagnosis of acute alcoholic poisoning. Two tests of liver function were employed, namely the indirect Van den Bergh quantitative test for bilirubin and the quantitative determination of urobiligen in the urine. The blood and urine specimens were obtained at arbitrary intervals over a period of several days. In all 17 cases there was found an increase in the amount of bilirubin in the blood serum. Accepting as normal .6 to .8 unit, the increase found ranged from .85 to 2.1 units and all except one were 1 unit or above. The increase persisted for four or five days with a gradual decline to the normal. In 5 cases urobiligen estimations were made. An increase was found ranging in dilutions from 1:90 to 1:350. The urobiligen curve closely corresponded to the bilirubin curve. This increase of both bilirubin and urobiligen was directly proportionate to the severity of the poisoning. It may be concluded from these observations that in acute alcoholic poisoning there is definite evidence of liver injury and this is proportionate to the severity of the poisoning.