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January 28, 1974

Blood Alcohol

Author Affiliations

Baltimore City Hospitals Baltimore, Md

JAMA. 1974;227(4):441. doi:10.1001/jama.1974.03230170057028

To the Editor.—  The report of unusually high ethanol levels in a living patient by Hammond et al (226:63, 1973) is indeed remarkable because of the degree of tolerance that the patient exhibited to such high concentrations. However, the explanation of the exponential disappearance of the ethanol in this patient on the basis of induction of the hepatic ethanolmetabolizing enzymes is difficult to accept. There was an extremely rapid initial disappearance of ethanol from the blood in the first six hours, from a level of 780 mg/100 ml to about 200 mg/100 ml, approximately 97 mg/100 ml/hr. This rapid disappearance is well beyond known capabilities of the hepatic ethanol-metabolizing enzymes to oxidize ethanol1-4More likely, the initial rapid disappearance of ethanol from the blood was due to loss from the gastrointestinal tract5 and urine because of therapeutic measures used, namely gastric lavage followed by instillation of charcoal, and diuresis