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POISONS
Arsenic
Lead
Mercury
Dr.Abhishek Karn
Asst.Professor, Dept. of Forensic
Medicine & Toxicology, CMC
Poisonous compounds of arsenic are as follows:
1. Arsenious oxide / Arsenic Trioxide (sankhya of
somalkhar) /white arsenic
2. Copper compounds of As- coloring agents for wall paper,
toys etc
3. Sulfides of As
GIT symptoms
Loss of weight & appetite
Salivation, colicky pain
Vomiting
Tongue is coated with thin, white silvery fur
Peripheral neuropathy
Tolerance
Some people take arsenic daily as tonic or as
an aphrodisiac and they acquire tolerance up
to 0.3gm or more in one does.
Such people are known as Arsenophagists .
FD:- 0.1-0.2 gm
FP:- 1-2 days
S.N TRAITS ARSENIC POISONING CHOLERA
.
1 Pain in throat Before vomiting After
2 Purging After vomiting Before
3 Stools Dark-colored & Rice-watery, not
bloody, later rice- bloody
watery
4 Tenesmus & + -
anal irritation
5 Vomitted Mucus, bile & blood Watery
matter
6 Voice Not affected Rough & whistling
7 Conjuctivae inflamed Not
8 Analysis of As + Cholera vibrio +
excreta
9 Circumscribed Of As poisoning + Other cases in locality
evidence
Diagnosis
Tests
1. Marsh test
2. Reinschs test
Treatment
1. Gastric lavage repeatedly
2. Butter or fatty substance prevent absorption
3. Freshly precipitated hydrated ferric oxide
(arsenic antidote)
The antidote is prepared by mixing 45 ml of
tincture ferric perchlorate with 5gm magnesium
oxide or potassium carbonate in a glass of
water
4. BAL (british antilewisite)
400800 mg on first day, 200400 mg 2nd and 3rd
day in divided doses 4 hourly then 100200mg BD
for 1 week
5. Penicillamine 100mg/kg q.i.d for 5 days
6. DMSA (dimercapto Succinic acid)10gm/kg
orally t.d.s for 5 days then same dose BD for 2
weeks.
Post mortem Appearances:
Externally:
Pigmentation of the skin and Mees lines in finger nails
Rigor mortis lasts longer
Shrunken appearance- body, eye ball
Cyanosed
Internally:
Garlicky odor
Inflamed & congested- GI mucosa
Petechial hemorrhages under the endocardium of the left
ventricle
Patchy fatty degenerative changes- liver, spleen & kidney
POST MORTEM IMBIBITION OF ARSENIC
possible
Poisonous compounds of Lead:
leading to anemia.
Acute lead poisoning
Rare
with teeth
4. Retinal stippling
Acute poisoning
Corrosive action
Metallic taste, increased salivation
Abdominal pain, vomiting and diarrhoea
Renal tubular necrosis with oliguria,
proteinuria, hematuria and progressive renal
failure
Leucocytosis in peripheral smear
Chronic poisoning (hydrargyrism)
Metallic taste, gingivitis, halitosis, loosening of teeth
Anorexia, insomnia, abnormal sweating, headache
Mercuria lentis- discoloration of the anterior capsule
of the lens of the eye
Neurological toxicity
Danbury Tremors occurs in hand, then progresses
to lips, tongue and finally involves arms and legs.
Moderately coarse and is interspersed by jerky
movent
Hatters Shake or glass blowers shakes- common
in persons working in glass blowing industries. The
patient cannot dress himself and cannot walk
properly
Mecurial erethism
is seen in person working with mercury in
mirror manufacturing firms.
psychological effects - anxiety, depression,
shyness, timidity, irritability, loss of confidence,
delusion, hallucination or suicidal melancholia or
maniac depressive psychosis
Acrodynia or pink disease generalized body rash,
irritation in hands and feet usually followed by
desquamation, loss of hair, hyperkeratosis
Gastric wash with milk or water.
100 ml of 5% sodium sulphate I.V. to help
anuria
Sodium bicarbonate- for acidosis
Chelating agents
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