[Pathologic anatomy of hard drinking and alcoholism]

The analysis of 826 autopsies is presented. 654 persons in their life abused alcohol but refused treatment; they were considered as hard drinkers. 172 persons were repeatedly treated for alcoholism and were included into the group of alcoholics. The control group consisted of persons who had not abused alcohol. Morphological and morphometric methods were used. It is shown that chronic alcoholic intoxication involves all internal organs with the same trend in pathological processes in hard drinkers and alcoholics. There was progressing alteration of microcirculatory bed, fat degeneration of parenchymatous organs, atrophic and sclerotic processes, primarily in the liver, lungs, heart and brain. While in hard drinking pathological processes can be considered reversible and well compensated, in alcoholism the degree of organ damage makes these lesions irreversible. It is suggested that less severe organ damage in hard drinking is due to the effect of ethanol while grave atrophic and sclerotic processes as well as psychic dependence on alcohol are due to acetaldehyde. The key point in alcohol abuse is hard drinking (or preclinical stage of alcoholism) as there is neither psychic no physical dependence on alcohol and organ alterations are reversible under adequate treatment. The treatment should be performed first of all of the liver to enhance its basal metabolism.