TOXICOLOGY – Is that branch of science that treats of poison, their origin, physical and

chemical properties, physiological action, treatment of their noxious effect and methods of
detection. The etymology came from “toxico” that means poison ang “ology” that means study
or science
POISON – From the medical point of view, is a substance that when introduced into the body
and is absorbed through the blood stream and acting, chemically is capable of producing noxious
effect.
CLASSIFICATION OF POISON
1. According to Kingdom
a. Animal – ex. Cantharides
b. Vegetable – ex. Strychnine
c. Mineral – ex. Hydrochloric Acid

2. According to Chemical Properties

A. Inorganic Poison – Poison without Carbon
a. Volatile – ex. Bromine, Chlorine and Iodine
b. Non-Volatile – ex. Sulfuric Acid
c. Mineral Acid – ex. Hydrochloric Acid
d. Mineral Alkalis – ex. Sodium Hydroxide
B. Organic Poison – Poison that contains Carbon.
a. Volatile – ex. Alcohol, Chloroform
b. Alkaloid – ex. Strychnine
Alkaloids – are nitrogenous organic based compound with bitter taste containing usually
oxygen that occurs especially in seed plants.
c. Animal Poison – ex. Snake Venom
d. Bacterial – ex. Ptomaine
e. Organic Poison – ex. Salicylic Acid
f. Glucosides – ex. Digitalis

3. According to Physiological Action

A. Corrosives – Highly irritant poisons that cause local destruction of tissues and
characterized by nausea, vomiting, great local distress. E.g. Strong Acids and Alkalis
B. Irritants – One that produces irritation or inflammation of the mucus membrane and
characterized by vomiting, pain in the abdomen and purging. E.g. Arsenic
C. Narcotics – One that produce stupor, complete insensibility, or loss of feeling. E.g.
Opium, Demerol and Cocaine.
 D. Neurotics – One that act chiefly on the nervous system producing delirium,
convulsion and respiration as the outstanding symptoms. E.g. CO, Alcohol, Opium, and
Strychnine
E. Tetanics – Substances that act chiefly upon the spinal column producing such
spasmodic and continuous contraction of muscles as a result of stiffness or immobility of
the parts to which they are attached.
F. Depressants or Sedatives – Agents that retard or depress the physiological action of
an organ. E.g Nicotine and Cocaine
G. Asthenics or Exhaustive – Agents that produce exhaustion, marked loss of vital or
muscular power. E.g. Hydrocyanic Acid

4. According to Pharmacological Action

A. Substance characterized by local action – ex. Volatile oils and skin irritants.
B. Substances characterized by their action after absorption – ex. Alkaloid.
C. Heavy metals and metalloids – ex. Phosphorus, Arsenic and Mercury.

5. According to Methods of Isolation

A. Volatile poisons are those isolated by distillation with or without current or stream.
E.g. Alcohol, Phenol and Chloroform
B. Non-Volatile poisons are those isolated by extraction with organic solvents. E.g.
Alkaloids and Organic Acid
C. Metallic poisons that are isolated by refluxion. E.g. Arsenic and Mercury
D. Substances for which special method of isolation are required. E.g. Acids and Alkali
metals are extracted with water.

Two Types of Poisoning:

1. From medical point of view
2. From legal point of view

I. From Medical Point of View

1. Acute Poisoning – One that there is prompt and marked disturbance of function or
death within a short period of time. Due to either taking a strong poison in excessive
single dose or several doses at short interval.
2. Sub-acute Poisoning – Cases of short duration and extreme violence that may include
symptoms of chronic poisoning.

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 3. Chronic Poisoning – Kind of poisoning in which there is gradual deterioration of
function of tissues and may or may not result to death. Either taking several doses at long
intervals or taking only toxic doses of the drug produces it.
II. From Legal Point of View
1. Accidental Poisoning – Those in which the poison was taken without intention to
cause death. It may be taken by mistake or without knowing that it is poison.
2. Suicidal Poisoning – Those in which the victim voluntarily for the purpose of taking
his own life took the poison.
3. Homicidal Poisoning – Those in which the poison was given willfully wantonly and
with intent to cause death to the victim.
4. Undetermined – Those in which the history is hazy as to how the poison was obtained
and why it was administered.

ACTION OF POISON
1. Local – The changes or disturbance produced on the part with which the poison come in
contact. Ex. The corrosion produced by corrosive poisons.
2. Remote – The changes or disturbance produced in distant parts away from the site of
application. Ex. Dilation of the pupils when belladonna is taken orally.
3. Combined – The effect of the poison is not only localized at the site but also affects remote
organs: Ex. Phenol causes corrosion of the gastro-intestinal tract (local) and causes convulsion
(remote).

CONDITIONS MODIFYING THE ACTION OF POISONS

1. Those attributed to the individual
a. Age and Sex
b. Health
c. Habit – The repeated taking of small dose of drug.
d. Idiosyncrasy – A term applied to individuals who exhibit unusual reactions to certain
substances.
e. Diseases
f. Food
g. Sleep
h. Exhaustion

2. Those attributed to the poison itself

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 a. Physical state or form of the poison
b. Dilution
c. Solubility of the poison
d. Mode of Administration
e. Chemical Combination
f. Mechanical Combination
g. Dose – Is the quantity of a poison to be administered at one time.

POSOLOGY – A branch of science that treats of the form and quantity of medicine to be
administered within a certain period.

KIND OF DOSE
1. Safe Dose – One that does not cause harmful effect.
2. Toxic or poisonous Dose – One that is harmful to both healthy and sick.
3. Lethal Dose – One that kills.
4. Minimum Dose – Is the smallest amount that will produce the therapeutic effect without
causing harm.
5. Maximum Dose – IS the largest that will cause no harm but at the same time produce desired
therapeutic effect.

ENTRACE OF POISON

Poison May Enter the Body Through:

1. Mouth and are absorbed into the circulation after passing the stomach and intestinal wall.
2. Nose and enter the blood from the upper respiratory passages or lungs.
3. Eyes
4. Rectum, vagina, urethra, bladder and ureter by injection
5. Hypodermic injection
6. Intravenous injection

ELIMINATION OF POISON

Poison May be Eliminated by:

1. Emesis 5. Milk

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 2. Respiration 6. Saliva
3. Feces 7. Sweat
4. Urine 8. Tears
DIAGNOSIS OF POISONING FROM DISEASE

Diagnosis of poisoning before death is very difficult because of:

1. The large number of poisons and the factors modifying them
2. Some of the symptoms observed in cases of poisoning are also seen in certain diseases.

DISTINGUISHING POISONING FROM DISEASE

1. Symptoms of poisoning come suddenly upon a person who previously has been in good
health, while disease is usually preceded by a number of hours, days or even weeks of local or
general disposition.
2. In case of poisoning, the symptoms commonly make their appearances after taking food or
medicine.
3. If several poisons take the same food and drinks, they should all show similar symptoms.
4.Diseases are generally much slower their progress and are preceded by circumstances as
exposure, recognized symptoms and general or local indisposition of longer duration.

SYMPTOMS CAUSED BY POISONING AND DISEASE

1. Vomiting (Frequently associated with purging and abdominal pain)

Poisons: arsenic, antimony, corrosive acid and alkali, barium, cantharides, digitalis,
copper, iodine, mercury, phosphorus, phenols and wood alcohol.
Diseases: gastritis, gastro-enteritis, cholera, acidosis, early stage of pregnancy, brain
tumor

2. Convulsion
Poisons: cyanide and strychnine
Diseases: tetanus, epilepsy and uremia

3. Coma
Poisons: opium and most of its derivatives, chloral hydrate, paraldehyde, CO2,
chloroform, atropine, various alcohols and phenols
Diseases: uremia, acidosis, cerebral thrombosis, brain injury, epilepsy and other brain
diseases

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4. Dilation of pupils
Poisons: belladonna, cocaine and nicotine
Diseases: certain nervous diseases causing optic atrophy
5. Contraction of pupils
Poisons: opium and its derivatives, physostigmine and its derivatives
Diseases: certain nervous diseases

6. General and partial paralysis

Poisons: cyanides, CO, CO2, and botulism
Diseases: brain tumor and meningitis

7. Slow respiration
Poisons: opium and its derivatives
Diseases: uremia, compression of the brain as from hemorrhage
8. Rapid respiration
Poisons: atropine group, cocaine and CO2
Diseases: acute respiratory disease

9. Delirium
Poisons: atropine group, cannabis and cocaine
Diseases: epilepsy, insanity and meningitis

10. Cyanosis
Poisons: nitrobenzene, aniline, acetanilide and opium
Diseases: disease of cardiac and respiratory system

EFFECTS OF BLOOD ALCOHOL (ETHANOL) CONCENTRATION

STAGE OF PERCENT OF ALCOHOL CLINICAL

INTOXICATION (ETHANOL) IN BLOOD MANIFESTATION

Normal by ordinary
Stimulation 0.01 – 0.10 observation.
Decreased inhibition
Apparent 0.05 – 0.20 Emotional instability
stimulation Incoordination
Slowing reaction to stimuli
……….. Disturbance of sensation
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 Confusion 0.10 – 0.30 Decrease pain sense.
Staggering gait
Slurred speech
Marked decreased to stimuli
Stupor 0.25 – 0.40 Approaching paralysis

Complete unconsciousness
Coma to Death 0.35 – 0.50 Subnormal temperature
Anesthesia
Impairment of circulation
Stertorous breathing

GENERAL TREATMENT OF POISONING

1. Removal of poison from the stomach

2. Administration of antidotes
3. Elimination of poisons by excretion
4. Stimulation and other symptomatic treatment
5. Special treatment

I. Removal of poison from the stomach – If the poison is taken orally the removal of the poison
is brought about by:
a. Inducing vomiting using emetics.
Emetics – Are substances or agents that produce vomiting.

b. Use of stomach pump or stomach tube

 If the poison is applied or installed – wash.
 If the poison is injected – ligatures and bleeding.

II. Administration of antidotes

a. Mechanical antidote – An agent that removes the poison without changing it or coats
the surface of the organ so that absorption is prevented.
Examples:
Stomach tubes or pumps: emetics, cathartics, demulcents and precipitants

Classes of emetics:
1. Local emetics – Produce their effects by their irritation of the terminal nerve filaments of the
pharynx, esophagus or stomach.
2. System or general emetics – Produce their effects through the medium of circulation.

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Cathartics – Agents that produce intestinal evacuation.
Demulcents – Substances that soothe and protect the part which they are applied.
Precipitants -These are substances that prevent absorptions of poisons by precipitating them and
rendering them insoluble.

b. Chemical antidote – Substance that make the poison harmless by chemically altering
it.
c. Physiological antidote – Sometimes called “antagonist”, An agent that acts upon the
system so as to counteract the effect of the poison. It merely masks the symptoms
produced.

III. Elimination of poisons by excretion – Poisons are eliminated through excretory organs.
Made by intravenous infusion of saline solution, dilute alkali solution or dilute solution of
glucose. The poison is generally excreted through the urine, feces, vomitus or saliva.

IV. Stimulation and other symptomatic treatment

a. For excessive pain – morphine or another analgesic
b. For convulsion – chloroform
c. For shock – oxygen inhalation

V. Special treatment

 If the poison is gas – immediate need is fresh air and artificial respiration.
 If poison is external like burn on the hand by concentrated acid – wash with
plenty of water or with alcohol, sodium bicarbonate, lime water, or milk of
magnesia.
 If alkali burn – wash with lemon or other citrus fruits.
 If the poison has come from a bite or injection – The poison can be checked from
spreading through the body by applying tourniquet or a restricting band tightly
above the wound. These retards the absorption of poison by the blood. The poison
may then be removed by sucking.

INVESTIGATION OF FATAL CASES

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 In the investigation of fatal cases, it is not necessary that an investigation should be an
expert on the poisons, since a medico-legal officer and a toxicologist will assist him in his
investigation, but it is important and will be of great help to him if he knows the following:
1. Symptoms of various kinds of poisoning
2. The lethal dose of the poisons
3. The length of time that may elapse after the poison has been taken before death occurs
4. Where the poison was obtained
5. The chemical formula of the poison
6. Other names it is known in the market
7. Uses of poisons
8. And the antidote for the poison

EVIDENCE OF POISONING IN THE LIVING BODY

The evidence of poisoning will depend upon whether the poisoning is acute or chronic. In
acute poisoning the symptoms appear suddenly while the individual is in good health. The
person is usually affected with a group of symptoms of definite characteristics out of consonance
with his previous state of health. In chronic poisoning, the onset of symptoms is more gradual
and insidious due to the small quantity of poison that has been administered on such occasion
since the intention of the poisoner is to kill his victim slowly in order to avert suspicion.

EVIDENCE OF POISONING IN THE DEAD

In all cases of poisoning whether homicidal or suicidal, fatal or not, the presence of poison must
be proven and proofs of poisoning in the dead may be obtained from:
1. Presence of Dye in Hair – An examination of a dead body specially to determine the
cause of death.
2. Evidence from the chemical analysis of the organs taken from the body – The most
important proof of poisoning is the detection of the poison within the body. In some
cases, however, on account of the decomposition of the tissue, the lapse of time between
death and examination, and the instability of some poisons, negative results maybe
obtained even if at the time of death certain poisons are present.

POST-MORTEM APPEARANCE POISON INDICATED

1. Lesion of the mouth
a.) Blackening and sever corrosion Sulfuric Acid

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b.) Brownish yellow skin Strong mineral acids, oxalic acids, Lysol and
carbonic acid

c.) Corrosion and softening of tissue of mouth Alkalis

and throat

d.) Severe corrosion without blackening Hydrochloric acid

e.) Severe corrosion and yellow stain Nitric acid
f.) Lips swollen, tongue raw, esophagus with
red cracks, bronchopneumonia if death is Ammonia
delayed
2. Lesion of the gastric-intestinal tract
a.) Corrosion Strong acids
b.) Soapiness Caustic alkalis
c.) Dark brown gelatinous mass in stomach Oxalic acid
d.) Stomach grayish white Acetic acid
e.) Stomach yellow or reddish yellow Picric acid
f.) Stomach green or bluish green Copper salts
3.Other lesion. Hydrocyanic acid,
a.) Bright red spots on skin cyanides, CO
b.) Tissue abnormally red Potassium or sodium nitrate, CO
c.) Odors marked opening the body Opium and some of its derivatives in some
cases
d.) Pupils contracted Belladonna
e. Dry gangrene or extremities Ergot

SPECIMEN/ORGANS TO BE SUBMITTED FOR CHEMICO-TOXICOLOGICAL

ANALYSIS

SPECIMEN/ORGANS MINIMUM AMOUNT POISON FOR WHICH

BEST SUITED
In case of poisoning in which
1. Stomach content All available it is suspected that the poison
was taken
2. Stomach The whole stomach For all types of poisoning
taken by mouth
For cases in which the poison
3. Intestinal contents All available was taken by mouth within
one or two days
Metals, barbiturates,
4. Liver 300 grams fluorides, oxalate, sulfonals
and many other poison
5. Kidney One kidney Metals, especially Hg,

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 sulfonamides
All gas poisons,
6. Blood At least 10 ml sulfonamides, bromides
alcoholism, drowning for
chloride contents
7. Brain 500 grams Volatile poisons, barbiturates,
alkaloids alcoholism
8. Urine All available I nearly all types of poisoning
9. Bone 200 grams Lead, arsenic, radium
In most acute poisoning and
10. Muscle 200 grams internal organs are badly
putrefied
11. Hairs 5 grams Chronic arsenic poisoning

INTERPRETATION OF TOXICOLOGICAL ANALYSIS

Reasons for Negative Results of the Toxicological Examination:

1. Some poisons may be rapidly altered in the body to a form that is not detectable by the
methods of the analysis employed.
2. Some poisons with or without previous chemical change maybe rapidly excreted although its
toxic effect remains and may only be detectable in the urine but not in the body tissue or organ.
3. Sometimes symptoms of poisoning may appear, which may be fatal following the
administration of even small and ordinarily harmless quantity of a substance class as poison.

FORENSIC QUESTIONS FOR THE TOXICOLOGIST TO ANSWER/EXPLAIN:

1. Was the death or illness of the subject caused by the poison?

2. What poison produced the illness or death?
3. When and how was the poison administered?
4. Could the substance administered cause illness or death?
5. Was the poison found by the toxicologist in the body the poison that caused death?
6. Is the substance given in minute quantity a poison?
7. Was the poison taken in sufficient quantity to produce death?
8. May the poisoning have occurred and the poison either be or become undetectable?
9. May the poison extracted from the body have an origin other than that of poisoning?

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10. May the poisoning be stimulated?

PRESERVATION OF SPECIMEN FOR TOXICOLOGICAL EXAMINATION

1. Blood – place in a test tube with sodium oxalate or anticoagulant
2. Refrigerated with solid carbon dioxide (dry ice) good for 72 hours.
3. Chemical preservatives – 100 ml of ethyl alcohol (95%) for each 100 grams of sample and
extra 250 ml for analysis.
4. Do not use denatured alcohol, rubbing alcohol or similar preservative since denatures will give
false and misleading results in the analysis.
5. Formalin – extremely undesirable as preservative of specimen for toxicological examination
since it will seriously interfere with the test for the most organic poisons.

LABORATORY METHODS USED IN THE TOXICOLOGICAL ANALYSIS

1. Physical test
2. Crystalline test
3. Chemical test
4. Spectrographic test
5. Chromatic test

LAWS REGARDING SALE AND STORAGE OF POISON – The laws controlling the sale
and storage are found under Sec 755 to 757 of the Administrative Code.
SEC 755 – Provision relative to dispensing of violent poisons like arsenic, cyanide,
atropine, morphine and strychnine.
SEC 756 – Provisions relative to dispensing of less violent poisons like aconite,
belladonna, cantharides, digitalis, ergot, carbonic acid and chloroform.
SEC 757 – Receptacle for poisonous drugs.

THREE STAGES IN CHLOROFORM POISONING BY INHALATION

1. Stage of excitement
2. Stage of surgical anesthesia
3. Stage of paralysis

COMMON VOLATILE, NON-VOLATILE AND METALLIC POISONS

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1. Benzene – also called Benzol. A solvent for rubber. gums, resins and fats.
2. Carbon Disulfide - a solvent for sulfur. Burns with bluish flame giving carbon dioxide and
sulfur dioxide.
3. Nitrobenzene — a pale yellow, only liquid with sweet odor. Resembles oil of bitter almond.
4. Acetone – use as solvent for cellulose acetate and nitrocellulose. Colorless liquid of
characteristic fruity color.
5. Ether – highly volatile inflammable liquid. Transparent, colorless, mobile liquid. Used as
general anesthesia. Safer than chloroform.
6. Caffeine – found in coffee.
7. Formalin – an embalming liquid.
8. Salicylic acid – found in “ap-ap” solution.
9. Cocaine – found in coca leaf.
10. Picrotoxin – derived from fish berries (the of picrotoxin). Locally known as lagtang.
11. Ethyl alcohol or ethanol – alcohol found in wine. Also called grain alcohol.
12. Ergot – develops on rye plants. A fungus that grows on kernels of rye and other cereal grains.
13. Barbiturates – sleeping pills. A derivative of malonyl urea or barbituric acid.
Examples are secobarbital, Phenobarbital and amobarbital.
14. Strychnine – an alkaloid found in dried ripe seeds of nux vomica.
15. Nicotine – found in leaves of tobacco plants.
16. Morphine – found in poppy plants (papaver somniferum). An alkaloid present in opium by
about 9%. A white crystal.
17. Physostigmine – also called serine. Found in the Calabar beans.
18. Choral hydrate – used as “knock-out drops”.
19. Carbonic Acid or Phenol – obtained from coal tar.
20. Arsenic – a rat poison. Brittle, steel gray.
21. Lysol – a disinfectant. A brown liquid from cresol and soap emulsion.
22. Methyl alcohol or methanol – causes blindness. A solvent for vanish. An anti-freeze in
automobiles. Also called wood alcohol.
23. Chloroform – colorless liquid with a sweet taste and suffocating odor. An anesthesia.
24. Carbon tetrachloride – a dry cleaning agent. Found “pyrine” fire extinguisher.
25. Formic Acid – acid found in ants and spiders.
26. Hydrogen cyanide – found in kamoteng kahoy. Also called hydrocyanic acid or prussic acid.
27. Acetic acid – acid found in vinegar. In pure form is called glacial acetic acid.
28. Aspirin – an analgesic. Its chemical name is aceto-salicylic acid.
29. Atropine – obtained from the plant group “SOLANACEAE”.
30. Amygdalin – white crystalline substance found in bitter almond.
31. Phosphorus – glows in the dark.
32. Peyote – same as mescaline. Found in cactus.
33. Ptomaine – found in the dead or decaying matter like spiled meat.

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34. Isopropyl alcohol – present in rubbing alcohol.
35. Cannabinoids – found in marijuana and hashish.
36. Methamphetamine Hydrochloride – a stimulant. Commonly called “shabu”. A dangerous
drug.
37. Heroin – also called diacetylmorphine. A derivative of morphine. A light brown power.
38. Potassium Cyanide – also called jeweler’s solution.
39. Opium – the milky exudates from the unripe capsule of the poppy plant (papaver
somniferum) that has been dried. Dark, chocolate brown has characteristic coffee odor. It is
found in poppy plant. Contains the alkaloids morphine, codeine, thebaine, and papaverine.
40. Mescaline – crystalline alkaloidal drug that produces hallucinogenic effect.
41. Cyanides – from kernels of various fruits in the form of amygdalin.
42. Codeine – methyl morphine.
43. Conine – most active poisonous alkaloid of common or spotted hemlock.
44. Quinine – an alkaloid of cinchona bark.
45. Cantharides – an aphrodisiac. Prepared from dried body of a beetle.
46. Carbon monoxide – produced by the incomplete combustion of carbon found in exhaust of
automobile.
47. Bufotoxin, bufotalin or bufotonin – poisonous substance isolated from the skin of poisonous
frog.
48. Scopolamine – poisonous alkaloid found in some plants of the nightshade family and used as
“truth serum”.
49. Toluene – colorless, mobile, inflammable liquid that burns smoky flame. Found in “rugby”.
50. Hydrogen sulfide – a poisonous substance with odor like that of a rotten egg.
.
THE END OF PART 2

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