THE FOLLOWING ARTICLE APPEARED IN THE

APRIL 2000 ISSUE

THE POISON SLEUTHS

DEATH BY HYDROGEN PEROXIDE

-Dr. Anil Aggrawal

"Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young boy today. What happened to him? Please tell me.”

“Good morning Tarun. The name of this young boy is Ramu and he is five years old. Yesterday he was playing alone in front of his house at around 5 pm. At about 6 pm, he suddenly started vomiting. His mother noted some blood in his vomit. She got scared and immediately phoned her doctor. His abdomen was bloated, and he complained of severe pain in his abdomen. By the time the family doctor arrived, he was having great difficulty in respiration. His face turned blue and he started having seizures. His doctor immediately advised to take him to the hospital, but by the time he could be taken to the hospital, he was dead.”

“Oh, that is most unfortunate. But how did he die? Was he having some disease?”

“Nobody knows how he died. In fact, that is why Ramu’s body has been brought to me. The doctor, who examined him at the house is not in a position to say anything. The police has however done some preliminary enquiries. Ramu was the son of Mangelal, who was having some tiff with his tenant Bansi for the last five years. Mangelal wanted to have his house vacated, but Bansi wouldn’t do so. On this issue there was lot of enmity between the two. In fact, they were fighting a court case also.”

“So is it possible that Bansi had some hand in killing Ramu?”

“That is what the police is alleging. But we need some proof. We have enquired into the antecedents of Bansi, and have come up with some interesting findings. One of the most interesting findings is that Bansi works in a textile factory.”

“That doesn’t sound like a very exciting finding to me.”

“Yeah, but to me it is. You see, the symptoms which Ramu showed pointed only towards one poison, and that poison is very commonly available in a textile factory. So it does appear that Bansi had access to that poison with which Ramu died.”

“With which poison did Ramu die? Please tell me.”

“Tarun, I took an X-ray of the chest and abdomen of this dead boy Ramu, and I found lot of gas in his heart and in the veins of his abdomen. I took an X-ray before doing a post-mortem, because this was the only way in which I could demonstrate gas in his body. Once I had opened the body, the gas would escape, and I would have no proof to show to the court that there was any gas in his body.”

“But how did you suspect gas in his body? And from where did the gas come in the first place?”

“Tarun, I suspected gas in his body from his symptoms. Remember his abdomen was bloated and he complained of severe pain in his abdomen. These were sufficient to tell me that there was gas in his abdomen, and probably in some of his veins. I say that because he turned blue very soon, which means that his veins were probably blocked by something, say air. Now there is only one poison which I can think of, and that is Hydrogen Peroxide. When we came to know that Bansi worked in a Textile factory, my suspicion grew stronger, because hydrogen peroxide is very commonly used in textile industry, and it was quite easily accessible to him.”

“Does this mean that Bansi gave Hydrogen Peroxide to Ramu? But how can Hydrogen Peroxide be used as a poison? I use it daily for my mouth gargles.”

“Yes, most of use hydrogen Peroxide for mouth gargles. It is in fact also used to remove wax from the ear. But in all these preparations, the hydrogen peroxide that is available is in very dilute concentration, say, around 1.5%. In industry, hydrogen peroxide is available in much stronger concentrations, which could be fatal to life.”

“Doctor, the story is getting somewhat intriguing. Please tell me in detail about hydrogen peroxide, so that I can understand about it clearly.’

“Tarun, hydrogen peroxide (H2O2), was first recognized as a chemical compound in 1818. It is the simplest member of the class of peroxides. It is a colourless liquid usually produced as aqueous solutions of various strengths. It is used commercially for several purposes, but principally for bleaching cotton and other textiles and wood pulp, in the manufacture of other chemicals, as a rocket propellant, and for cosmetic and medicinal purposes. Hydrogen peroxide is an oxidising agent with antiseptic properties and has also been used for many years as an antiseptic and a disinfectant. However it has not proved much beneficial because of several reasons. First it loses its potency rapidly when kept on the shelf for some time. Secondly a tissue enzyme called catalase destroys it before it can act on microorganisms. This agent is generally available in two strengths: dilute hydrogen peroxide, with a concentration of 3-9% (usually 3%), sold for home use, and concentrated hydrogen peroxide, with a concentration greater than 10%, used primarily for industrial purposes. Commercial-strength hydrogen peroxide is most commonly found as a 27.5-70% solution. Home uses for dilute hydrogen peroxide include ear cerumen removal, mouth gargle, vaginal douche, enema and hair bleaching. It is used as a mouth rinse in the concentration of 1.5%, but the fact is that the contact time is too short for the preparation to be effective. At a concentration of 3-6%, it has been used as a disinfectant and sterilant. For ear wax removal, it is used in a concentration of 1.5% in a solution of salt. In some countries, 35% hydrogen peroxide has become available now to the general public in health food stores, where it is sold as “hyper-oxygenation therapy”. Solutions containing more than about 8 percent hydrogen peroxide are corrosive to the skin. Hydrogen peroxide decomposes into water and oxygen upon heating or in the presence of numerous substances, particularly salts of such metals as iron, copper, manganese, nickel, or chromium. Pure hydrogen peroxide freezes at -0.430 C (+31.30 F) and boils at 150.20 C (3020 F); it is denser than water and is soluble in it in all proportions. Nowadays stabilized hydrogen peroxide has also become available, which doesn’t lose its oxygen very soon. Stabilized Hydrogen Peroxide is made by adding certain negative catalysts to the solution, most commonly, certain tin salts and phosphates.”

“How much hydrogen peroxide is needed to kill a human being doctor?”

“About 120-180 mL of 35% Hydrogen Peroxide can cause death in a child, and I would say about 250-300 mL of the same concentration could kill an adult human being. This is roughly the same amount as is present in a soft drink bottle, and if a person is thirsty, he can drink this amount in a few quick gulps. So if a killer presents it to an unsuspecting thirsty man, he can kill him easily.”

“How does hydrogen peroxide kill doctor?”

“Hydrogen peroxide has no taste. The color is also something like that of water, so it can easily be given to an unsuspecting individual. Hydrogen peroxide has two main mechanisms of toxicity: local tissue injury and gas formation. The extent of local tissue injury is determined by the strength of the Hydrogen Peroxide. Dilute hydrogen peroxide is an irritant and concentrated hydrogen peroxide is a caustic. Local toxicity is mediated by hydroxyl radical (OH-), and not by superoxide (O2-), or peroxide (O2-2) radical, as you might imagine. Hydrogen peroxide is also an oxidising agent. Gas formation occurs when hydrogen peroxide interacts with tissue catalase, liberating molecular oxygen and water. One milliliter of 3% hydrogen peroxide can liberate 10 mL of oxygen at standard temperature and pressure. Gas formation can result in life-threatening embolization. This means that gas can form within the veins. This gas travels with the blood up to the heart, and there it can cause blockage of the heart, which is technically known as embolization. The use of hydrogen peroxide in closed spaces such as operative wounds or its use under pressure during wound irrigation increases the likelihood of embolization. When dilute hydrogen peroxide is ingested one gets vomiting and abdominal bloating. The mouth cavity may be discolored white. There may be irritation of the stomach wall, and gas may form in the veins leaving the intestines - mostly portal vein. Ramu ingested concentrated form, and that is why his symptoms were so pronounced.”

“How do you know so surely doctor?”

“I had the house of Bansi searched, and sure enough we found a large bottle in his house containing 70% Hydrogen Peroxide, which he has stolen from his factory. When we asked him, what that bottle was doing in his house, he could not give any satisfactory reason. The police enquired him, more sternly and he came out with these facts. He and Mangelal were not on friendly terms because of the issue of vacating the house. Bansi did not want to vacate the house, while Mangelal was pressing him to do that. Finally Bansi decided to teach Mangelal a lesson. He wanted to kill his son, and for this purpose, he chose a most unusual poison - Hydrogen Peroxide. This poison was easily available to him in his factory. Furthermore, he was quite sure, that if he used such an unusual poison, nobody would be able to catch him. At about 5.30 pm on that fateful day, Bansi saw Ramu playing. He somehow was successful in coaxing him to drink a glass of water, which actually was nothing but concentrated hydrogen peroxide which he had flicked from his factory. Rest all is known to you. He was sure, he wouldn’t be caught, as the poison disintegrates in the body to just water and oxygen, both of which are ordinary constituents of the body. But he did not realize that I would take the X-ray of the body, and demonstrate that gas - the oxygen- in the veins by X-ray. I have also seen some damage to the stomach wall of Ramu, which is another proof that Hydrogen peroxide was given to him. Coupled with all these findings, the fact that a bottle of concentrated hydrogen peroxide was found in his home would go far in proving his guilt in court.”

“Can you demonstrate hydrogen peroxide in Ramu’s body chemically also?”

“No Tarun. Unfortunately that is not possible, as Hydrogen Peroxide disintegrates in the body so quickly. This is one of those rare poisons, which can kill, but is impossible to be demonstrated chemically. But I have the X-ray report of Ramu to show to the court, and all the rest as I told you, and I am sure, the court would easily find him guilty.”

“That is very clever of you doctor. Without your clever deduction, no one would have thought Ramu was poisoned. Everybody would have thought that he died just of some natural disease. What are you going to tell me next time?”

“Tarun, next time, I would tell you about a very interesting poison - Hydrofluoric Acid."