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.