The short answer is that alcohol is poison and the body responds accordingly.
Longer answer is: there’s next to nothing therapeutic that it can accomplish. So, when you ingest it, the body treats it as a threat (if very slowly, probably thanks to the poison). More importantly is that acetyl stuff that was mentioner. Normally it’s a normal part of body functioning that you don’t notice. However, when the liver is preoccupied filtering alcohol and not the acetyl stuff, the acetyl stuff kinda overloads you (with itself), and a new version of expelling it (since liver is busy) is making you vomit.
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