Forensic toxicology deals with investigating poisoning cases from a legal perspective. Some key points:
- There is no legal definition of poison, but anything that disturbs body functions or causes disease/death when introduced to the body can be considered a poison.
- Common sources of poisons include domestic/household chemicals, agricultural/horticultural sources, industrial sources, foods/drinks, drugs/medicines, and things like snake bites.
- Poisonings can be intentional (homicidal, suicidal) or accidental (food contamination, medication mistakes).
- Factors like quantity ingested, physical form, route of administration, and individual physiology influence how a poison affects the body.
Forensic toxicology deals with investigating poisoning cases from a legal perspective. Some key points:
- There is no legal definition of poison, but anything that disturbs body functions or causes disease/death when introduced to the body can be considered a poison.
- Common sources of poisons include domestic/household chemicals, agricultural/horticultural sources, industrial sources, foods/drinks, drugs/medicines, and things like snake bites.
- Poisonings can be intentional (homicidal, suicidal) or accidental (food contamination, medication mistakes).
- Factors like quantity ingested, physical form, route of administration, and individual physiology influence how a poison affects the body.
Forensic toxicology deals with investigating poisoning cases from a legal perspective. Some key points:
- There is no legal definition of poison, but anything that disturbs body functions or causes disease/death when introduced to the body can be considered a poison.
- Common sources of poisons include domestic/household chemicals, agricultural/horticultural sources, industrial sources, foods/drinks, drugs/medicines, and things like snake bites.
- Poisonings can be intentional (homicidal, suicidal) or accidental (food contamination, medication mistakes).
- Factors like quantity ingested, physical form, route of administration, and individual physiology influence how a poison affects the body.
Forensic toxicology deals with investigating poisoning cases from a legal perspective. Some key points:
- There is no legal definition of poison, but anything that disturbs body functions or causes disease/death when introduced to the body can be considered a poison.
- Common sources of poisons include domestic/household chemicals, agricultural/horticultural sources, industrial sources, foods/drinks, drugs/medicines, and things like snake bites.
- Poisonings can be intentional (homicidal, suicidal) or accidental (food contamination, medication mistakes).
- Factors like quantity ingested, physical form, route of administration, and individual physiology influence how a poison affects the body.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT or read online from Scribd
Download as ppt
You are on page 1of 73
Forensic toxicology
• Forensic toxicology deals with the source,
physical and chemical properties, absorption, fate, pharmacological and toxic actions, signs and symptoms in human being, fatal dose, fatal period of different poisons, treatment and circumstances and other medico-legal aspects of different poisoning cases. Definition of poison. • There is no legal definition of poison. Anything which when used internally or on the body surface, in a dose or repeated doses, if acts chemically and physiologically, causing disturbance of body functions and leads to disease or death, is a poison. SOURCES OF POISON
• 1. Domestic or household source- In
domestic environments poisoning may more commonly occur from detergents, disinfectants, cleaning agents antiseptics, cooking gas, insecticides, rodenticides and some common drugs available at home. • 2. Agricultural and horticultural sources – Different insecticides, pesticide, fungicides and weed killers. • 3. Industrial sources – In factories, where poisons are manufactured or poisons are produced as by-products. • 4.commercial sources – From store-houses, distribution centers and selling shops. • 5. Food and drink – contamination in way of use of preservatives of food grains or other food materials additives like coloring and odouring agents or other ways of accidental contamination of food and drink. • 6. From use as drugs and medicines – Due to wrong medication, overmedication and abuse of drugs. • 7. Miscellaneous sources – Snake bite poisoning, city smoke, sewer gas poisoning etc. Nature of poisoning (a) Examples of use of poisons with criminal intent- 1. Homicidal 2. Suicidal 3. To cause injury or annoyance to a person 4. Stupefaction with intent to commit some crime 5. To cause abortion 6. To kill cattle to procure hide 7. Adulteration of food and drink (b). Examples of accidental circumstances of poisoning- 1. Food/drink poisoning due to contamination 2. Consuming a poison for a medicine by mistake 3. Wrong medication 4. Overdose of medicine or drug • 5. Snake bite, scorpion stinging etc. • 6. Cooking gas poisoning • 7. Poisoning at industrial and commercial places • 8. Agricultural fields • 9. Use of cosmetics Factors influencing the actions of a poison in the body 1. Quantity. A high dose of a poison acts quickly and more severely, often resulting in fatal fulminating type of poisoning. A moderate dose causes acute poisoning which also may be fatal. A low dose may have sub-clinical effects, but if introduced repeatedly at intervals, it may have subacute or chronic effects, particularly if the poison is cumulative in nature. Regular intake of some drugs in low dose may cause dependence on the drug. • 2. Physical form. Gaseous or volatile poisons are very quickly absorbed and are thus most rapidly effective. The rate of absorption and the effect is quicker when a poison is taken in liquid form than when taken in solid form. • In case of solid poisons when the same is taken in powder form the absorption and action is quicker than when taken in lump. Some poisonous vegetable seeds may pass through the intestinal canal ineffective when taken intact due to their impermeable pericarp. But when taken crushed, they may be rapidly fatal. • 3. Chemical form. Chemically pure metallic arsenic and mercury are not poisonous because these are insoluble and are not absorbed. But white arsenic (arsenious oxide) and mercuric chloride are deadly poisonous. Barium sulphide is deadly toxic but barium sulphate is non-toxic. • 4. Concentration (or dilution). Generally speaking, in concentrated form poisons are absorbed more rapidly and are also fatal more rapidly. But this is not true with some poisons. A dilute solution of oxalic acid is less corrosive but of more rapidly absorbed and hence may be more rapidly fatal. • 5. Condition of the stomach (a). Food content. Presence of food-stuff in the stomach acts as diluent of the poison and hence protects the stomach wall from the corrosive and irritating action of the poison. Dilution of poison also delays its absorption of the poison. Fatty food usually delays the process of absorption. But, for phosphorus, presence of fatty food accelerates the process of its absorption. • (b). Abnormal condition of the stomach. In case of pyloric stenosis and where gastro-jejunostomy operation was performed on the person, poisons which are absorbed from the intestine are absorbed late due to delayed emptying of the stomach in case of pyloric stenosis and due to repeated backward flow of the stomach content from the jejunum to the stomach through the anastomosis. • (c). Empty stomach absorbs poison most rapidly. • 6. Route of administration – Through some routes poisons are absorbed very rapidly and exerts their actions equally rapidly. • 7. Age – Some poisons are tolerated better in some ages and badly in some other ages. Opium and its alkaloids are tolerated better by elderly subjects but badly by children and infants. Belladona group of drugs on the other hand, are better tolerated by children than by adults. • 8. State of body and health – A well built person with good physique and health will tolerate the action of a poison better than a weak subject. • 9. Presence of any disease – In certain diseased conditions some drugs are tolerated exceptionally well, e.g., sedatives and tranquilizers are tolerated in very high doses by maniac and deliriant patients. • 10. Intoxication and poisoning states – In certain poisoning cases some drugs are well tolerated, like, in case of strychnine poisoning, barbiturates and sedatives are better tolerated. Whereas in case of barbiturate poisoning any sedative or tranquilizer will accentuate the process of death. • 11. Sleep – Due to slow metabolic process and depression of other body functions during sleep, usually the absorption and action of the poison is also slow. But depressant drugs may cause more harm during the state of sleep. • 12. Exercise – Action of alcohol on C.N.S. is slowed during exercise because more blood is drawn to the muscles during exercise. • 13. Cumulative action of a poison – Preparations of cumulative poisons(poisons which are not readily excreted from the body and are retained in different organs of the body for a long time) like, lead may not cause any toxic effect when enters the body for once in a low dose. But when such poisons enter the body over a long period even in low dose, may ultimately cause harm when their concentration in different tissues reaches high level due to their cumulative property. • 14. Idiosyncracy – Some persons are idiosyncratic to some drugs and react most adversely though the general population tolerates the drug well. Examples – Some serum preparations, aspirin. • 15. Tolerance – Due to prolonged use, persons may develop tolerance to certain drugs and may not show any alarming sign even when they consume a high dose of drugs. A person addicted to opium may tolerate such a dose of the drug which can cause death to even two or more persons. • 16. Mental alertness and make up – Some drugs when consumed inadvertently may lead to alarming signs and symptoms though, if taken knowingly, they may not do so. Example – L.S.D. POSTMORTEM FINDINGS IN A CASE OF DEATH DUE TO SUSPECTED POISONING External postmortem findings- 1. Postmortem staining: Deep blue – In case of asphyxiant poisons and aniline. Bright red or cherry red – In case of CO and HCN poisoning. • 2. Deep cyanosis – With opium and cardiac poisons. • 3. Early rigor mortis – With strychnine. • 4. Early appearance of the sign of decomposition – With H2S gas. • 5. Detectable smell – In case of volatile poisons, opium and HCN,KCN,or NaCN. • 6. Haemorrhagic spots under the skin and mucus membrane – Phosphorus. • 7. Ulceration on lips and near the angles of mouth – Corrosive poisons. • 8. Stain near mouth and on hands – Nitric acid and copper sulphate. • 9. White froth from mouth and nose – Opium and its alkaloids. • 10. Blood tinged froth from mouth and nose – Organophosphorus compounds. • 11. Alopecia, hyperpigmentation and hyperkeratosis – Arsenic poisoning over a long period. • 12. Staining, erosion and ulceration near the female external genitalia – Use of abortifacient agents or torturing agents. • 13. Injection marks – Injection of poisons (snake bite or otherwise), sign of treatment. Internal postmortem findings-
• 1. Corrosion, ulceration and desquamation
of inner aspects of lips, mucus membrane of mouth and tongue – Corrosive agents. • 2. Soft, swollen, sodden, translucent, bleached tongue and mucus membrane of mouth – Corrosive alkali. • 3. Hardening of mucus membrane – Phenol. • 4. Yellowish discolouration –Nitric acid. • 5. Bluish discolouration – Copper sulphate. • 6. Carbonisation and charring – Conc. Sulphuric acid. • 7. Chalky appearance and consistency of teeth – Sulphuric acid • 8. Blue lining in the gum – Chronic lead poisoning. • 9. Swollen gum, loose teeth, foetid smell – Acute mercuric chloride poisoning, chronic phosphorus poisoning • 10. Corrosion, irritation, desquamation and haemorrhage in the inner wall of the oesophagus – Corrosive and irritant poisons • 11. Hardening and whitish discolouration – In case of Carbolic acid poisoning • 12. Discolouration and staining of inner aspects of mouth – With coloured poisons • 13. Oesophageal stricture – A complication of sulphuric acid ingestion • 14. Stomach – (a)Thickening and softening of the wall – Corrosive and irritant poisons (b) Hard wall – Carbolic acid (c) Hard and leathery wall – Formaldehyde (d) Hyperaemia, haemorrhage and desquamation of mucus membrane – Irritant poison (e) Ulceration and sloughing – Corrosive poison. • (f) Perforation – H2SO4 and HNO3 • (g)Yellowish discolouration of mucus membrane – HNO3; Bluish Cu2SO4; Slaty grey – HgCl • (h) Stomach content: Blood – Corrosive and irritant; Yellowish – HNO3; Bluish – Cu2SO4; Detectable tablet – soneryl; Powder – oxalic acid, white arsenic; Detectable smell – kerosene, alcohol, chloroform, organophosphorus compounds, chlorinated hydrocarbons, opium, cyanogen, formaldehyde, phosphorus; Detectable liquid – kerosene. • 15. Small intestine – May show irritation, sometimes may show presence of poisonous remains. • 16. Large intestine – May show ulcerations, as in case of HgCl3 , similar in appearance of uclers of bacillary dysentery. It particularly involves the ascending and transverse colons. • 17. Liver – Different degenerative changes occur in cases of poisoning with poisons like phosphorus, carbon tetra-chloride, chloroform, tetrachlorethylene and many other poisons. The type and extent of the degenerative changes occur depending on the type of the poison, dose, duration of the exposure and the physical condition of the patient. • 18. Kidneys – Swollen, reddish, soft, sometimes greasy in touch with haemorrhage in the calyces and other degenerative changes in cases of poisoning with mercury, oxalic acid, carbolic acid, phosphorus, cantherides, viper snake bite and many others. In case of oxalate crystals are present in the tubules and the calyces. Preservation of viscera and other materials in poisoning death cases • Materials preserved for chemical analysis B. Usual viscera to be preserved in all cases of death due to poisoning or suspected poisoning- 3. Stomach with its full content. 4. Half of liver or 500gms of liver, whichever is more. When the weight of the liver is less than 500gms then, the whole of the liver has to be preserved. • 3. A loop (about 500gms) of the small intestine, from the upper part. • 4. Half of each kidney. Identical longitudinal half of each kidney should be preserved instead of preserving one kidney or transverse section of the kidneys, because if one kidney or a part of one kidney was nonfunct before death, preservation of that part alone may be useless for the purpose of detection of poison. If identical longitudinal halves of each kidney is preserved then that risk is to a great extent avoided. • 5. Some recommend preservation of spleen as a routine measure. But from practical point of view, when other organs mentioned above are preserved, preservation of the spleen does not add much to the advantage. • B. In some particular types of poisoning, apart from the usual viscera noted above, some specific organ, tissue or material may be required to be preserved, e.g. • 1. Blood should be preserved in all cases where poisons act after being absorbed in the system. Quantity of blood required to be preserved – 100ml. It should be preserved from the chamber of the heart or the inferior vena cava. • 2. Urine should be preserved in all cases where blood is required to be preserved, if urine is available in the bladder. While collecting urine it should be seen that, it is not contaminated with blood. For collection, the urine can either be syringed out or can be spooned out after dissecting the anterior wall of the bladder. Quantity of the urine to be collected – 100ml or the whole amount of the urine present in the bladder. • 3. Parts of both the lungs should be preserved in all cases of poisoning with volatile poisons or poisons which are partly excreted with the expired air. • 4. The whole of the heart should be preserved in case of suspected poisoning with cardiac poisons. • 5. The whole of the brain should be preserved in case of suspected poisoning with cerebral poisons. • 6. Spinal cord should be preserved in case of use of spinal poison like, strychnine. • 7. In suspected heavy metal poisoning cases, particularly in case of arsenic or lead poisoning, bone should be preserved. • 8. Hair should be preserved in case of poisoning with arsenic or copper. • 9. Nails should be preserved in case of poisoning with arsenic. • 10. Uterus and vagina should be preserved in case of use of abortifacient drugs either locally or systemically, when the drug had direct action on the uterus. • 11. Skin-scrap – From an area stained with a suspected poison. • 12. Skin, subcutaneous tissue and muscle – from the site of injection of a suspected poison. • 13. Suspected stained area of the dress, suspected packet of poison, strips of tablet recovered from the pocket of the dress of the deceased. Preservatives used • For preservation of viscera, organs or tissues, the best preservative is absolute alcohol or rectified spirit. But alcohol cannot be used if the suspected poison is alcohol, chloroform, chloral hydrate, formaldehyde, ether etc. because, if alcohol is used in these cases then, after chemical test of the material the nature of poisoning in these cases cannot be inferred, due to similarity of the observation. • Alcohol also cannot be used in case of phosphorus poisoning, because alcohol prevents the luminosity of phosphorus in dark, which is an important test for its detection. Saturated solution of common salt is a more commonly used preservative because, it has no contraindication. • Tissue preserved for histological examination, should be cut into small pieces, washed with tap-water and preserved in 10% formol saline solution. • Blood should be preserved in fluoride, oxalate, EDTA., gold chloride, mercuric chloride or citrate tube. The choice of the preservative depends on the type of test necessary and the type of poison suspected. • Urine may be preserved in a sterile glass container without use of any preservative. • Stained clothes should be dried and preserved as such. Mode of preservation of viscera • For preservation, the viscera should be submerged in the preservative inside a clean glass container with a glass lid. One third of the container which may evolve due to partial decomposition of the viscera. The container should be made airtight with the help of paraffin wax, used to close the mouth with the lid. It should then be properly labelled and properly sealed with sealing wax. • The label should contain the name, age, sex and address of the deceased; the name of the police station, the case reference; name of the station(mortuary), sl. number of the postmortem examination, date of P.M. examination; preservative used and the signature and designation of the autopsy surgeon. In all cases the sample of the preservative used should be preserved in a separate clean container. This is necessary to avoid the argument that, the poison detected in the viscera, was due to contamination by the poison present in the preservative used. • It is recommended that, stomach and the small intestine should be preserved in one container and liver and kidney in another container, other viscera should be preserved in a separate container. This will help to infer that the poison was not only ingested but was also absorbed in the system and exerted its action, if the poison is detected from the contents of both the containers. • Blood, urine and skin tissue etc. should be preserved in glass container and bone, hair or nails and clothes (after drying) in polythene packets. All should be properly labeled and sealed. • The preserved materials should be sent to the concerned forensic science laboratory through the concerned police station as quickly as possible, otherwise, the poison may not be detected during analysis of the viscera, even though they may contain some poison. • Reasons for non-detection of poison in the viscera though death was due to some poisoning 2. Delay in the examination of the viscera. 3. Improper preservation of the viscera. • 3. Use of wrong analytical technique. • 4. Early disintegration of the poison. • 5. Complete metabolisation of the poison in the body. • 6. The amount of poison in the preserved viscera being negligible. • 7. Lack of suitable chemical tests for certain poison. • 8. Tampering of the preserved viscera.