Reliability of Spinal Fluid Analysis in the Diagnosis of Drunkenness

Abstract

The medico-legal importance of establishing the state of inebriety of an individual has given rise to a great mass of research on the reliability of analysis of the various body fluids as an index of drunkenness. Those most commonly used are the blood, the urine, and the breath, but most authors mention that except for its impracticability the spinal fluid should yield the most reliable information.

Nicloux 1 found that in dogs about an hour after ingestion of a single dose of alcohol the values in the blood and spinal fluid were approximately equal. Schumm and Fleishmann 2 administered a constant dose of alcohol to a series of patients, puncturing each at a different period after ingestion, and so obtaining a composite curve of blood and spinal fluid alcohol. They found that during the first hour the blood alcohol rose more rapidly than did the spinal fluid alcohol, but that during the decline of the blood alcohol the spinal fluid alcohol surpassed it and remained at a higher level. Because of their use of single punctures on various patients some of their figures fall far out of line. Recently Abramson and Linde 3 repeated this work, using a dose of alcohol proportional to body weight, and leaving the lumbar needle in place during the 3 hours over which they collected their specimens.

In support of the contention that the spinal fluid alcohol is the best index of intoxication, Gettler and Freireich 4 showed in a series of cases coming to autopsy that there was a more constant relation between the alcohol content of the brain and spinal fluid than between the brain and blood. Some of their values appear rather bizarre, probably being accounted for by the fact that the material was obtained post mortem.