This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Appearances on Dissection. When death has occurred suddenly from enormous quantities of the poison, no pathological appearance need be expected after death; the stomach and brain being at once overwhelmed by the violence of the shock. In the more protracted cases of acute poisoning, the signs of inflammatory congestion of the stomach are sometimes, though not always presented; but there is usually congestion of the brain, with occasional effusion into the ventricles, which has the odour of alcohol, and in one instance is said to have been inflammable. Congestion of the lungs is also an occasional result of acute alcoholic poisoning; and, in the case of a child recorded by Dr. John Ashhurst, appeared to be, the cause of death, through the copious effusion into the air-passages. (Am. Journ. of Med. Sci., July, 1863, p. 128).
In cases of habitual drunkards, dying either directly from the effects of the poison, from suicide, or other forms of violent death, and from accidental diseases, there is almost always some lesion discoverable, which may be fairly ascribed to the poison; sometimes the direct consequence of constant irritation, as hypertrophy; sometimes of pure deficiency of action, as atrophy; very frequently of inflammation, and still more frequently of various degeneration.
Out of 117 cases examined by Dr. Ogston, only one was without some discoverable lesion.* The lesions were most numerous in the brain and its appendages, and after this, successively, in the respiratory organs, the liver, the circulatory organs, the kidneys, and the alimentary canal. That the smallest number should have been found in the stomach and bowels is not what might have been anticipated; but the probability is that more of the lesions in this structure were to be ascribed to the alcohol exclusively than in the others, unless the brain be excepted. It will of course be understood that many of the morbid appearances would have been found in temperate persons; but assuredly in greatly less proportion. In the brain the most frequent changes were thickening of the arachnoid, effused serum, injection of the pia mater, and induration or softening of the cerebral substance; in the respiratory organs, pleural adhesion and partial emphysema; in the heart and its appendages, hypertrophy and dilatation, obesity, valvular disease, pericardial adhesion or thickening, and atheromatous or osseous deposition or degeneration in the large vessels; in the stomach, extraordinary diminution of size or atrophy, congestion, softening of the mucous membrane, and hypertrophy or thickening of the walls, which, however, was seen in three only out of the whole number of cases; in the liver, fatty degeneration, hypertrophy, cirrhosis, and the nutmeg appearance; in the kidneys, hypertrophy, congestion, and fatty degeneration. (Brit, and For. Med.-chir. Rev., April and October, 1854).
* Of the different organs, the brain and its appendages were affected in 108 of the cases, or 92.3 per cent.; the respiratory organs in 74, or 63.24 per cent.; the liver in 66, or 56.4 per cent.; the heart and its appendages, including the aorta and pulmonary artery, in 56, or 47.86 per cent.; the kidneys in 51, or 43.58 per cent.; and the intestinal tube in 48, or 41 per cent. (Brit, and For. Med.-chirurg. Rev., July, 1855, Am. ed., p. 145).