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FORENSIC

TOXICOLOGY
Dr Mohd Kaleem Khan

Assistant Professor
Department Of Forensic
Medicine
JNMCH AMU Aligarh
TOXICOLOGY :
 Toxicology is the science dealing with properties,
action, toxicity, fatal dose, detection, estimation of,
interpretation of the result of toxicological analysis and
management of Poisons

Forensic Toxicology:
 Branch of Forensic Medicine dealing with Medical and
Legal aspects of the harmful effects of chemicals on
human beings.

POISON:
 Any substance which when administered in living body
through any route (Inhalation, Ingestion, surface
absorption etc) will produce ill-health or death by its
action which is due to its physical, chemical or
physiological properties. Eg: alphos, sulphuric acid,
arsenic etc.
Drug (WHO 1996):
“Drug is any substance or product that is used or intended to be
used to modify or explore physiological systems or pathological
states for the benefit of the recipient.” Eg: paracetamol,
ciprofloxacin, salbutamol, oestrogen, insulin etc.

Clinical Toxicology:
 Deals with human diseases caused by, or associated
with abnormal exposure to chemical substances.

• Toxinology :
 Refers to toxins produced by living organism which
are dangerous to man, eg: snake venom, fungal and
bacterial toxins etc.
• Acute poisoning
 Caused by an excessive single dose, or several dose
of a poison taken over a short interval of time.

• Chronic Poisoning
 Caused by smaller doses over a period of time,
resulting in gradual worsening. eg: arsenic,
phosphorus, antimony and opium.

• Sub-acute poisoning
 Shows features of both acute and chronic poisoning.

• Fulminant poisoning:
 Produced by a massive dose. In this death occur
rapidly, sometimes without preceding symptoms.
LAWS IN RELATION TO MEDICINE

(1) The drug and cosmetic act, 1940:


 Regulates import, manufacture, distribution and sale
of all kinds of drugs. Its main feature is to control
purity, quality and strength of drug.

(1) The drug and cosmetic rule, 1945 :


 regulate storage, display, dispensing, sale, labeling,
prescribing etc.
 Schedule
▫ C- biological and special products,
▫ E- poison,
▫ F- vaccine and sera,
▫ G- Hormones,
▫ J- list of diseases for which
▫ no drug should be advertised,
▫ H- drugs to be sold on prescription of RMP,
▫ L- antibiotics, antihistaminics and other chemotherapeutic agents
3. The pharmacy act, 1948 :
 allows only registered pharmacists to compound, prepare and
dispense medicine
4. The drug control act, 1950 :
 (sale, supply and distribution, fixing of prices )

5. The drug and magic remedies act, 1954

6. The narcotic drugs and psychotropic substance


act, 1985.
 Psychotropic subs alters mental function e.g. LSD,
amphetamine, barbiturates etc

 Narcotics causes dullness of senses and induces sleep e.g.


cannabis, opium and cocaine.

 The law prohibits cultivation, manufacture, possession, sale


purchase import export etc of these drugs except for medical
and scientific purpose.
Sources of Poison:
• Domestic or household sources –
 detergents, disinfectants, cleaning agents, antiseptics, insecticides,
rodenticides etc.
• Agricultural and horticultural sources-
 insecticides, pesticides, fungicides and weed killers.
• Industrial sources –
 poisons are manufactured or poisons are produced as by products.
• Commercial sources-
 store-houses, distribution centers and selling shops.
• From uses as drugs and medicines
 wrong medication, overmedication and abuse of drugs.
• Food and drink –
 preservatives of food grains or other food material, additives like
colouring and odouring agents or other ways of accidental
contamination of food and drink.
• Miscellaneous sources-
 snakes bite poisoning, city smoke, sewer gas poisoning etc.
INCIDENCE OF POISONING
▫ Homicidal poisoning
▫ Suicidal poisoning
▫ Accidental poisoning:
▫ Household poisons

▫ Stupefying agents:
 Alcohol, dhatura, cannabis indica, chloral hydrate, rophynol
▫ Aphrodisiacs:

 Canthrides, opium, cannabis, cocain .


▫ Abortificients:

 Calotropis, croton, semecardium, lead, kmno4 ,ergot etc.

▫ Animal poisoning:
 Cattle, stray dogs, rodents
Classification of Poisons
(I) Corrosives (it erodes the surface with which it
comes in contact)

(1) Strong Acids:

 Inorganic or Mineral Acids-


▫ sulphuric, nitric, hydrochloric
 Organic Acids-
▫ Carbolic, oxalic, acetic, salicylic

(2) Strong Alkali:


 Hydrates of – sodium, potassium
 Carbonates of- sodium, potassium, ammonia
(II) Irritants: (they causes inflammation on the site of
contact esp GIT, respiratory tract and skin)
(1) Agricultural

(2) Inorganic :
• Non-metallic – P, I, Cl, Br etc
• Metallic – Ar, Cu, Zn, Pb, Hg
• Mechanical – powdered glass,brick, hair, nails, pins

(3) Organic :
• Vegetable – Abrus precatorius, aloes, croton, castor,
calotropis
• Animal – snake, bees, wasps
(III) Systemic: which involves toxic effect on a particular
system

(1) Cerebral
• CNS depressants- Alcohol, opioids
• CNS stimulants- antidepressants, amphetamine, caffeine
• Deliriants- dhatura, balladona,cocaine

(2) Spinal: nux vomica


(3) Peripheral: curare, conium
(4) Cardiac: aconite, quinine, tobacco, cyanide
(5) Asphyxiants: CO, H2S, CO2
• Nephrotoxic:
 Oxalic Acid, Mercury, Cantherides Hepatotoxic: Phosphorus, Carbon
tetrachloride, Chloroform

• Miscelanious
 Agrochemicals
 Pesticides:organophosphorous
 Fumigants:alphos
 Rhodenticides: thalium, Zn phosphide

• Drug dependence
• Petroleum products
• Food poisoning
• Other:
 Analgesic,
 Antipyretic
Classification of Poison according to motive or nature of use:

• Homicidal:
 Arsenic, Aconite, Digitalis, Abrus Precatorius, Strychnos nux vomica.
• Suicidal:
 Opium, Barbiturate, Organophosphorus, carbolic acid, copper sulphate.
• Accidental:
 Aspirin, organophosphorus, copper sulphate, snakes bite, Ergot, CO, CO2, H2S.
• Abortifacient:
 Ergot, Quinine, Calotropis, Plumbago.
• Stupefying agent:
 Dhatura, cannabis, chloral hybrate.
• Agents used to cause bodily injury:
 Corrosive acids and alkalies.
• Cattle Poison:
 Abrus precatorius, Calotropis, plumbago.
• Used for malingering:
 semicarpus anacardium
Characteristics Of Ideal
Homicidal And Suicidal Poison
Characteristics Suicidal Homicidal

Accessibility Cheap & Easy Cheap & Easy

Antidote Difficult Difficult


Lethal Dose Small Small
Lethal Period Small Long

Taste Pleasant Pleasant

Signs / Symptom Few Or None Resemble Ds

E.G. Cyanide, Opium Arsenic, Aconite


Insulin,opium Barbiturates,
Thallium, Orgph,
Madar,strychnine
Route of Administration/absorbtion:

 Oral (commonest) e.g. alphos, acids, Inhalation: gas


poison

 Parenteral (IM, IV, Sub-Cutaneous, Intra-Dermal)

 Natural Orifices other than mouth (Nasal, Rectal,


Vaginal, Urethral),

 Ulcers, wounds and intact skin.


Fate of poison in body
▫ A part of the poison taken orally gets eliminated unabsorbed by means of
defecation and vomiting.
▫ Liver is the main organ to detoxify or metabolize most of the poisons.
▫ Certain poisons like Chloroform, Phosphorus, Nitrates and Acetic acid
disappear by evaporation or oxidized or destroyed in the body.

• Excretion of poisons:
 Unabsorbed poisons are excreted through faeces and vomits.
 Absorbed poisons are excreted mostly by urine.
 A part of volatile poison is exhaled out .
 Some portion of poison is excreted through bile, saliva, milk, sweat,
tear, hair and nails.
Factors influencing the actions of a
poison in the body.
• 1. Quantity:
 A high dose of poison acts quickly and often resulting in fatal
consequences.
 A moderate dose causes acute poisoning.
 A low dose may have sub -clinical effects and causes chronic
poisoning on repeated exposure.
• 2. Form:
▫ Physical state:
 Gaseous or volatile poisons are very quickly absorbed.
 Liquid poisons are more rapid than solid poisons.
 Powder act more quickly than coarse substance.
• 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.
▫ Chemical combination:
 Chemically pure arsenic and mercury are not poisonous because these are
insoluble and are not absorbed.
 But white arsenic(arsenic oxide) and mercuric chloride are deadly poisonous.
 Barium sulphide is deadly toxic but barium sulphate is non-toxic.
▫ Mechanical combination:
 Action of poison is altered when it combines with mechanically inert
substances.

• 3.Mode of Administration:
 Absorption rate is different for different routes

 GAS>IV>IM>SC/ID>WOUND>SEROUSSURFACE>INGESTION>NATURAL
ORIFICES>UNBROKEN SKIN

• 4. Condition of patient
 Age:
 poisons have greater effect on two extremes of age.
• State of body health:
• A well built person with good health can tolerate the action of poison
better than a weak person.

▫ Presence of disease :
 In certain diseased conditions some drugs are tolerated exceptionally well
e.g.: sedatives and tranquilizers are tolerated in very high dose by manic
and deliriant patients.

• Intoxication arid 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.

▫ 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.

▫ Exercise –
 Action of alcohol on C.N.S. is slowed during exercise because more blood is
drawn to the muscles during exercise.

▫ Cumulative action of poisons:


 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 in low dose.
 But when such poisons enter over a long period of time, may cause harm when
their concentration in different tissue reaches high level due to their cumulative
property.

• Tolerance may develop by individuals on long term exposue to a particular poison.


• Idiosyncracy: some persons may react adversely to a particular drug though the
general population tolerates the drug well.
Duties of a Doctor
▫ Dr. must record preliminary particulars, viz, name in
full, age, sex, occupation, address, date and time,
brought by whom, history, dying declaration necessary
or not.

▫ A Dr. is not bound to supply information of his own


accord to police or magistrate. However, if summoned
by the investigating police officer or magistrate for such
information, he should do so.

▫ A medical practitioner is legally bound to notify cases of


homicidal poisoning to the nearest police station as per
S. 39 Cr PC failing which he is liable for prosecution
proceedings under section 176 IPC.
▫ In Government Institutions, all types of poisoning cases
irrespective of whether accidental, suicidal or homicidal
should be intimated to the police station as a routine.

▫ Bodies of person dead due to poisoning must be kept in


the mortuary for further investigation. If the body is
released to the relatives before inquest by any chance,
the doctor can be made liable for suppression of crime.

▫ A doctor should never grant a death certificate stating


the cause of death before an autopsy is conducted.

▫ False information, if any, furnished to the police can


lead to prosecution proceedings under section 193 IPC.
▫ Recording of a dying declaration is another important
legal formality, which the doctor has to bear in mind.

▫ Material objects like stomach wash, vomitus, excreta,


blood, urine etc. are to be preserved for chemical
analysis and kept under safe custody to avoid
tampering. They should be sent to the Forensic
Science Laboratory/ Chemical Examiner’s Laboratory
through constables at the earliest opportunity.

▫ All relevant records connected with poisoning cases


must be kept under safe custody and shown to the
Investigating Officers upon demand. No information
should be withheld from them by the doctor.
Laws in relation to poison and drugs:
• Different sections of Indian penal code related to poisons are as
follows

▫ Sec. 272 I.P.C. - Punishment for adulterating food or drink intended for
sale, so as to make the. same noxious, may extend upto 6 months
imprisonment of either term and/or fine upto one thousand rupees.

▫ Sec. 273 I.P.C. - Punishment for selling noxious food or drink may be
imprisonment of either description for a period of 6. months and or fine
upto one thousand rupees.

▫ Sec. 274 I.P.C. - Punishment for adulteration of drugs in any form with
any change in its effect knowing that it Will be sold and used as un-
adulterated drug, may be imprisonment of either description for a period-
of 6 months and or fine.

▫ Sec. 275 l.P.C. - Punishment for knowingly selling adulterated
drugs with less efficacy or altered action serving it for use as
unadulterated may be imprisonment of either description for 6
months and or fine.

▫ Sec. 276 I.P.C. - Punishment for selling a drug as a different


drug or Preparation, may be imprisonment of either description
which may extend up to 6 months and or fine. .

▫ Note - In the State of West Bengal, the punishment for these


offences described under sections 272 to 276 may be up to
imprisonment for life with or without fine.

▫ Sec. 277 I.P.C. – Punishment for fouling water of public spring


or reservoir may be imprisonment of either description which
may extend up to a period of 3 months and or fine.
▫ Sec. 278 I.P.C. - Punishment for voluntarily making
atmosphere noxious to health is fine which . may extend upto five
hundred rupees.

▫ Sec. 284 I.P.C. Punishment for negligent conduct with respect


to poisonous substance may be imprisonment of either
description which may extend up to 6 months and or fine which
may extend up to one thousand rupees.

▫ Sec. 328 I.P.C. :Punishment' for causing hurt by means of
poison or any stupefying, intoxicating or unwholesome drug or
any other thing with the intent to commit an offence shall be
imprisonment of either description for a term which may extend
to ten years with or without fine.