Sitemap Sections Forensic Medicine & Toxicology Book Review Journal Forensic Quotes & Aphorisms (A-Z) Forensic Toxicology Forensic Science Fiction Forensic Career Forensic Programming Poison Stories in World Science in Crime Detection Forensic Jokes, Puns & Tidbits Hindi page on crime & crime detection Best Toxicology Books Quick Links Home Books Blogs Guestbook Contact info. Authors' Submission Page Reviewers' Submission Page Find me on Amazon Anil Aggrawal's Internet Journal Of Forensic Medicine & Toxicology Main Page (current Issues & Archives) Paper/Thesis Submission Guidelines Call for Reviewers Aims & Objectives Frequently Asked Questions (FAQs) Undergraduate Section Postgraduate Section History of the Journal Contributing Partners Be our Sponsor Editorial Board Journal CD Awards Credits Cumulative Index (Sorted by Publishers) of Reviews of Forensic gadgets/toys/other tidbits Models related to Forensics/Toxicology Electronic books related to Forensics/Toxicology Calenders related to Forensics/Toxicology Software/Multimedia/Videotape Reviews Books on CD/Audio books, CDs and tapes Cumulative Index of Editorials Theses/Dissertations Online Courses Reviews with Quizzes Animated Book Reviews Featured Reviews Interviews with Prominent Writers/Authors/Forensic Professionals/ Toxicologists Cumulative index of Book Reviews Sorted by Publishers Subjects (General) Subjects (Technical) Book Review Journal Main Page (Archives) Aims & Objectives Frequently Asked Questions (FAQs) Reviewers' Panel Interviews Editorial/Reviewer Board Featured Reviews Journal CD Be our Sponsor Anil Aggrawal's Books Cumulative index of Book Reviews Sorted by Publishers Subjects Cumulative Index of Multimedia Reviews (Sorted by Publishers) Books Reviews on Audio Cassettes (Sorted By Publishers) Combined Index of All Issues Editorial's Cumulative Index Cumulative index of Reviews with Quizzes Submit books/journals/software/multimedia for review (Book Review Policy ) Policies Privacy Policy Cookie Policy Terms & Conditions

Explore a leading peer-reviewed journal in forensic medicine and toxicology. Access original research, case reports, dissertations, and expert insights—freely available to forensic professionals worldwide. ISSN: 0972-8066 (CD version) ISSN: 0972-8074 (Online version) NLM Unique ID: 100960452 Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology ( Peer-reviewed electronic journal for Forensic professionals ) (Published biannually on the 1st January and 1st July every year) [Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology is Indexed / Listed with EMBASE / the Exerpta Medica database, NCJRS (National Criminal Justice Reference Service), Chemical Abstracts Service (A division of the American Chemical Society), Ulrich's Periodicals Directory, MedWebPlus (A service of Flexis, Inc., California), Genamics JournalSeek, getCITED, National Library of Medicine's LocatorPlus, Scopus™ (A service of Elsevier B.V., Amsterdam), Leids Universitair Medisch Centrum, Electronic Journal Miner, EBSCO, Budapest Open Access Initiative (BOAI), Electronic Journals Library (maintained by the University Library of Regensburg), Index Copernicus, Galter Health Sciences Library, Chicago, Directory of Open Access Journals (DOAJ), HINARI and Clarivate Analytics' Emerging Sources Citation Index.] Mentioned in the British Medical Journal [BMJ Volume 324 9 February 2002, page 372 Column - Netlines by Harry Brown, general practitioner, Leeds DrHarry@dial.pipex.com 1st entry in the column mentions this journal A t that time, the journal was hosted at a different URL, which is mentioned in the column. That URL still accesses the journal.] Read this Article (on BMJ) In Association With NCJRS (National Criminal Justice Reference Service), USA Major sources indexing this journal are given below. [For a complete listing, please refer to above paragraph]: Combined index of all Issues Current Issue Volume 26, Number 2, July - December 2025 View Archives Issue Volume-1 Volume-2 Volume-3 Volume-4 Volume-5 Volume-6 Volume-7 Volume-8 Volume-9 Volume-10 Volume-11 Volume-12 Volume-13 Volume-14 Volume-15 Volume-16 Volume-17 Volume-18 Volume-19 Volume-20 Volume-21 Volume-22 Volume-23 Volume-24 Volume-25 Volume-26 Number 1 January - June 2000 January - June 2001 January - June 2002 January - June 2003 January - June 2004 January - June 2005 January - June 2006 January - June 2007 January - June 2008 January - June 2009 January - June 2010 January - June 2011 January - June 2012 January - June 2013 January - June 2014 January - June 2015 January - June 2016 January - June 2017 January - June 2018 January - June 2019 January - June 2020 January - June 2021 January - June 2022 January - June 2023 January - June 2024 January - June 2025 Number 2 July - December 2000 July - December 2001 July - December 2002 July - December 2003 July - December 2004 July - December 2005 July - December 2006 July - December 2007 July - December 2008 July - December 2009 July - December 2010 July - December 2011 July - December 2012 July - December 2013 July - December 2014 July - December 2015 July - December 2016 July - December 2017 July - December 2018 July - December 2019 July - December 2020 July - December 2021 July - December 2022 July - December 2023 July - December 2024 (Archived issues can be accessed by clicking on them) IMPORTANT NOTE: THE READERS OF THIS JOURNAL HAVE THE RIGHT TO READ, DOWNLOAD, COPY, DISTRIBUTE, PRINT, SEARCH, OR LINK TO THE FULL TEXTS OF ALL ARTICLES AND OTHER MATERIALS APPEARING IN THIS JOURNAL. HOWEVER THE ARTICLES AND OTHER MATERIALS MAY NOT BE REPOSTED ON THE NET OR REPRINTED FOR COMMERCIAL GAIN WITHOUT THE PERMISSION OF THE EDITORIAL BOARD. Scope of the Journal Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology is published online twice a year. It is the world's first online journal of forensic medicine and toxicology. Started by Professor Anil Aggrawal of Maulana Azad Medical College, New Delhi, on 25 February 2000, it publishes original on forensic medicine, toxicology, medical law, science and the law and allied subjects such as criminology, police science, deviant behavior, forensic psychiatry and psychology. Any subject that has a forensic interest e.g., forensic astronomy, forensic economics, forensic geoscience, forensic gemology, forensic herpetology, forensic hypnosis, forensic limnology, forensic linguistics, forensic mathematics and statistics, forensic metallurgy, forensic microbiology, forensic microscopy, forensic nursing, forensic palynology, forensic pharmacy, forensic phonetics, forensic social work, jurimetrics, nanoforensics, teleforensics, veterinary forensics, wildlife forensics etc., as well as papers related to medicolegal aspects of various medical disciplines, such as pediatrics, surgery, ENT, ophthalmology etc. are also published. The journal has regular undergraduate and postgraduate sections, book reviews, interviews with famous forensic professionals, poster sessions, announcements of conferences etc. All back issues are archived for easy access and are available to all. The journal has an impressive editorial board comprising of at least one specialist from every single continent of the world. About 10,000 visitors visit and read the journal daily from all parts of the world. The journal is indexed/listed with several major abstracting services such as Chemical Abstracts Service, EMBASE, Index Copernicus, SCOPUS, and Web of Science [Clarivate (formerly Thomson Reuters)]. For more information, please visit following link (Wikipedia). Submit Here Call for Reviewers Interested in becoming a reviewer for this journal? Check Details Anil Aggrawal's Internet Journal Of Forensic Medicine & Toxicology (Access the pages by clicking on them.) Main Page (current Issues & Archives) Paper/Thesis Submission Guidelines Call for Reviewers Aims & Objectives Frequently Asked Questions (FAQs) Undergraduate Section Postgraduate Section History of the Journal Contributing Partners Be our Sponsor Editorial Board Journal CD Awards Credits Cumulative Index (Sorted by Publishers) of Reviews of Forensic gadgets/toys/other tidbits Models related to Forensics/Toxicology Electronic books related to Forensics/Toxicology Calenders related to Forensics/Toxicology Software/Multimedia/Videotape Reviews Books on CD/Audio books, CDs and tapes Cumulative Index of Editorials Theses/Dissertations Online Courses Reviews with Quizzes Animated Book Reviews Featured Reviews Interviews with Prominent Writers/Authors/Forensic Professionals/ Toxicologists Cumulative index of Book Reviews Sorted by Publishers Subjects (General) Subjects (Technical)

Explore Dr. Anil Aggrawal’s comprehensive forensic medicine ecosystem—featuring peer-reviewed journals, forensic books, career guidance, programming tutorials, expert quotes, book reviews, and more. A one-stop resource for students, professionals, and researchers in forensic science and toxicology. Anil Aggrawal's Forensic Ecosystem The World's First Online-only Journal dedicated to Forensic Medicine & Toxicology Dedicated to the advancement and dissemination of forensic science and medicine, the platform integrates rigorous scholarship, practical insights, and comprehensive educational resources. It strives to support and connect the global forensic community by fostering academic excellence, profesional development. and , multidisciplinary collaboration, serving as an essential resource for students, educators, and practiconers alike. Fully Open Access Journal International Authorship Publishing Since 2000 Access the journal Anil Aggrawal's Forensic Ecosystem Forensic Medicine & Toxicology Internet Journal Forensic Science Fiction Forensic Quotes & Aphorisms Forensic Career Forensic Programming Forensic Jokes, puns and Tidbits Forensic Toxicology Explore Books. 2nd Edition Textbook Of Forensic Medicine And Toxicology Price ₹2,510.00 Clinical and Forensic Toxicology Regular Price ₹6,000.00 Sale Price ₹5,789.00 Necrophilia: Forensic and Medico-legal Aspects Regular Price ₹14,727.00 Sale Price ₹12,274.00 Forensic Medicine and Toxicology for MBBS Price ₹1,090.00 Essentials of Forensic Medicine and Toxicology Price ₹1,155.00 Forensic Medicine and Toxicology for Ayurveda Price ₹984.00 Forensic Medicine and Toxicology for Homeopathy Out of stock Basic Sciences As Applied to Forensic Medicine And Toxicology Regular Price ₹1,350.00 Sale Price ₹1,310.00 FORENSIC AND MEDICO LEGAL ASPECTS OF SEXUAL CRIMES AND UNUSUAL SEXUAL PRACTICES Price ₹8,164.00 Injuries Forensic and Medicolegal Aspects Regular Price ₹4,500.00 Sale Price ₹3,999.00 Self Assessment and Review of Forensic Medicine: Volume 1 Regular Price ₹650.00 Sale Price ₹595.00 Narcotic Drugs Price ₹240.00 Modern Diagnostics Out of stock SOME COMMON AILMENTS Price ₹125.00 Textbook of Forensic Medicine and Toxicology (1st Edition) Out of stock

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Discover critical reviews of key books in forensic science, toxicology, criminology, and related disciplines. Curated by experts, this journal guides readers through the most impactful academic and professional titles. ISSN: 0972-9666 (CD version) ISSN: 0972-9674 (Online version Anil Aggrawal's Internet Journal of Book Reviews (Published biannually on the 1st January and 1st July every year) [Anil Aggrawal's Internet Journal of Book Reviews is Indexed / Listed with Academic Search Complete, EBSCO, Gale Cengage, Humanities International Complete, Library Information Science & Technology Abstracts (LISTA) and MasterFILE Premier.] Combined index of all Issues Archives Issue Volume-1 Volume-2 Volume-3 Volume-4 Volume-5 Volume-6 Volume-7 Volume-8 Volume-9 Volume-10 Volume-11 Volume-12 Volume-13 Volume-14 Number 1 January - June 2002 January - June 2003 January - June 2004 January - June 2005 January - June 2006 January - June 2007 January - June 2008 January - June 2009 January - June 2010 January - June 2011 January - June 2012 January - June 2013 January - June 2014 January - June 2015 Number 2 July - December 2002 July - December 2003 July - December 2004 July - December 2005 July - December 2006 July - December 2007 July - December 2008 July - December 2009 July - December 2010 July - December 2011 July - December 2012 July - December 2013 July - December 2014 July - December 2015 (Archived issues can be accessed by clicking on them) IMPORTANT NOTE: ALL REVIEWS APPEARING IN THIS ONLINE JOURNAL ARE COPYRIGHTED BY "ANIL AGGRAWAL'S INTERNET JOURNAL OF BOOK REVIEWS" AND MAY NOT BE REPOSTED, REPRINTED OR OTHERWISE USED IN ANY MANNER WITHOUT THE WRITTEN PERMISSION OF THE WEBMASTER. Book Review Journal (Access the pages by clicking on them.) Aims & Objectives Frequently Asked Questions (FAQs) Reviewers' Panel Interviews Editorial/Reviewer Board Featured Reviews Journal CD Be our Sponsor Anil Aggrawal's Books Cumulative index of Book Reviews Sorted by Publishers Subjects Cumulative Index of Multimedia Reviews (Sorted by Publishers) Books Reviews on Audio Cassettes (Sorted By Publishers) Combined Index of All Issues Editorial's Cumulative Index Cumulative index of Reviews with Quizzes Submit books/journals/software/multimedia for review (Book Review Policy )

Have questions, feedback, or collaboration ideas? Contact Dr. Anil Aggrawal directly through this page. We welcome inquiries from students, researchers, and professionals in forensic science and related fields. Contact +91-11-41731893 dr_anil@hotmail.com Address Books for review must be submitted to the following address. Professor Anil Aggrawal (Editor-in-Chief) Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology S-299 Greater Kailash-1 New Delhi-110048 India Submit Your Papers Here (AAIJFMT) For All Journal-Related Matters~ Full name* Email* Phone (optional) Reason for Contact* Your Message / Concern* I confirm that the information provided above is accurate to the best of my knowledge and I agree to be contacted by the editorial team. Submit

Book Review Journal Aims & Objectives This journal has been started by Dr Anil Aggrawal, Professor of Forensic Medicine at the Maulana Azad Medical College, New Delhi - 110002. Dr. Aggrawal is quite keen to interact with people who are interested in books. Dr. Aggrawal adores books and literally thrives on them. Though being a medical doctor specializing in forensic medicine, he loves books on all subjects encompassing such diverse ranges from astronomy and zoology to paleontology, history, occult science, philosophy, mathematics, and classical literature, et al. His penchant for books was conceived quite early in life. Even as a three year old he always pined for books instead of toys-as his siblings did. There is a legend about the Greek mathematician and engineer Archimedes (ca. 287 B.C. - ca. 212 B.C.). When Roman armies sacked Syracuse in 212 B.C. he was busy studying a geometrical figure made in sand. When a Roman soldier commanded him to come along, he motioned to him imperiously, "Don't disturb my circles". The soldier felt so insulted that he killed Archimedes on the spot! In a similar situation Dr. Aggrawal would probably say, "Don't disturb my books!" Writers and thinkers have always been his idols. Some of the people who have inspired him are (i)Lord Buddha (he remains first on his list) (ii)Albert Einstein (iii)Robert James Fischer (The only American who has been an official World Chess Champion) and (iv)Isaac Asimov (he wrote close to 500 books, and is reputed to be the only author to have published books in all ten categories of the Dewey Decimal System! Oh, well, we all know it's not true, but he has really written so widely, it seems cruel to challenge this statement.) Aggrawal is no Asimov, but like him, he loves writing books. He has written nine books so far (till 2006 end). Four of them are quiz books, which reflect his morbid passion for quizzes. The books, in order they were published are (i) 1000 Crime Quiz (published 30 March 1992) (ii)1000 Love & Sex Quiz (published 13 August 1992) (iii) Some Common Ailments (Published 27 January 1993)(iv)The Book of Medicine (Published 5 February 1994) (v)Narcotic Drugs (Published on 2 May 1995) (vi) 1000 Biology Quiz (Published on 29 August 1995) (vii)Modern Diagnostics (Published on 8 March 2001) (viii) Health Quiz Book (Published on 5 August 2002) (ix) Self Assessment and review of Forensic Medicine and Toxicology (the first book related to his profession). And since we all love statistics, here is a detailed statistics of these books. Here they are: S. no. Book Started on Completed on Published Publisher Publisher Cost 1. 1000 Crime Quiz 1.2.91 31.5.91 31.5.91 March 1992 Rupa 30 2. 1000 Love & Sex Quiz 1.6.91 7.1.92 7.1.92 August 1992 Rupa 30 3. Some Common Ailments 1.6.91 28.11.91 28.11.91 January 1993 NBT 25 4. The Book of Medicine Nov 92 15.1.93 15.1.93 February 1994 Rupa 30 5. Narcotic Drugs 1.1.93 9.5.94 9.5.94 May 1995 NBT 46 6. 1000 Biology Quiz 6.1.92 17.3.93 19.3.93 August 1995 Rupa 80 7. Modern Diagnostics 1995 1996 1996 March 2001 NBT 80 8. Health Quiz book Feb 2002 July 2002 July 2002 August 2002 Ocean Books 200 9. Self Assessment and review of Forensic Medicine and Toxicology 2005 April 2006 April 2006 May 2006 PeePee 295 (Books published till 2007 end) N.B. 1. NBT stands for National Book Trust, India. 2. Dates mentioned are in this format: day/month/year. 3. The cost is in Indian Rupees. 4. Some Common Ailments has been translated in Assamiya, Bangla, Hindi, Kannada, Konkani, Marathi, Nepalese, Oriya, Punjabi, Telugu and Urdu (Total 12 languages). 5. Narcotic Drugs has been translated in Assamiya, Bangla, Hindi, Punjabi and Urdu (Total 6 languages). 6. Health Quiz Book has been translated in Hindi (Total 2 languages). Why is Dr. Aggrawal interested in writing book reviews? Whenever he reads a book he tries to discover its strong points. There is a subconscious effort on his part perhaps, to incorporate those points in his own writings. He then wants to share his findings with everyone. In the year 2000, he started an Internet Journal of Forensic Medicine and Toxicology , and out of his sheer interest in books, he included a book review section to it. The unprecedented popularity of the review section took him by complete surprise. He received books from authors and publishers in thousands. And they belonged to all subjects-not only forensic medicine and toxicology, which he had intended at the inception of the above journal. With time he and his group realized that they must conjure another journal devoted solely to Book Reviews for books of all genre. In this all-new journal they would accommodate all kinds of books, and hence the present Anil Aggrawal's Internet Journal of Book Reviews . Dr. Aggrawal fondly cites the examples of many regular journals (not devoted to book reviews), which have come out with issues especially devoted to book reviews. One pertinent example is Archives of Sexual Behavior , which came out with an issue (Volume 28, Number 5 / October, 1999, pages 377-467) especially devoted to book reviews in 1999. Readers can access this issue by clicking here .

| Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Paper/Thesis/Dissertation Submission GUIDELINES A ll papers can be submitted electronically (by E-mail, floppy, magneto-optical disk, zip drive, tape drive or CD). If you are comfortable with sending just a typed manuscript, this is also acceptable (please include your E-mail ID in the covering letter). The submitted material must come along with the submission letter. This is a signed statement on official letterhead, which must state the following: SUBMISSION LETTER 1. "I/We hereby submit that the paper/dissertation entitled [please give name of the paper/dissertation here] has been written by me/us along with [please include number of photographs here (write 0 if no photograph accompanies the paper)] photographs, [please include number of audio files here (write 0 if if no audio file accompanies the paper)] audio files and [please include number of video files here (write 0 if no video file accompanies the paper)] video files. This paper/dissertation/audio and visual files are my/our original work and has neither been published anywhere else, electronically or in print, nor has been submitted elsewhere simultaneously for publication. The paper has not been rejected previously by any journal*. The views expressed in this paper/dissertation/ audio and video files are entirely my/our own. I have agreed for this paper/dissertation/audio and video files to be published in Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology". *[Declaration whether the manuscript has been rejected by another journal - If the paper has been rejected by another journal/s previously, please omit the sentence "The paper has not been rejected previously by any journal". Instead, please state here "The paper has been rejected previously by journal/s entitled 'XYZ'". Please also submit the reviews or editorial statements forwarded to you by the journal/s along with a copy of the rejection letter / copy of the email rejecting the paper.] 2. I/we vouchsafe that the authorship of this article will not be contested by anyone whose name(s) is/are not listed by me/us here. 3. I/we vouchsafe that I/we have gone through all papers cited by me/us in the references section. I/we also understand that if requested by the reviewers for cross-checking facts stated in the paper, I/we would be able to send a pdf/scan/photocopy of the paper. 4. The article contains no libellous or other unlawful statements and does not contain any materials that violate any personal or proprietary rights of any other person or entity. In case, any legal action is instituted because of any statement(s) made by me in the paper, I will be completely responsible for it, and the journal would carry absolutely no liability in that matter. 5. I/we hereby acknowledge Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology's conflict of interest policy requirement to scrupulously avoid direct and indirect conflicts of interest. Therefore I/we hereby agree to promptly inform the editor-in-chief of any business, commercial or other proprietary support, relationships, grants or research support or any other interests that I/we may have which relate directly or indirectly to the subject of the work. 6. I/we also agree to the authorship of the paper in the following sequence: Authors' Names in sequence Signatures of authors 1. 2. 3. 4. 7. Detailed contribution statements (i.e., if a manuscript has more than one author: who contributed what part?) - If the manuscript has more than one author, please be kind enough to specify here the specific part played by each author towards the preparation of the final paper. 8. I/we understand that my/our paper may be published in a future issue as “publication ahead of print” or “epubahead.” [As mentioned in the guidelines page, the paper will be available online and citable by other workers, right from the day/year of publication as “epubahead”]. 9. I/we transfer the copyright of the paper/all associated photographs, line diagrams and other associated material to "Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology." Signed (First/Main author) Current Position with complete mailing address Telephone number Email Submission letters through Email Submission letters can be submitted via Email, as a scanned copy. They must (1) Clearly show signatures of authors (2) Must be on institution or personal letterhead (3) Should have contact details of all authors [emails, phones etc]. In addition, authors must keep in mind the following rules. (A) All documents related to the paper must be submitted in one lot and not in parts. (B) Only one paper [plus all related documents] can be submitted per email. More papers may be submitted, but each paper [plus all related documents] must be sent in a separate email. Some sample letters are given below. Please click to enlarge. S ubmission letters can be on multiple pages as below. Please click to enlarge. Submitting Images/Pictures/Photographs Authors whose papers are accompanied with Images/Pictures/Photographs must submit pictures in accordance with the guidelines set by PubMedCentral. Please click here to view these guidelines and requirements. Please also refer to the "Image Quality Specifications" by clicking here . Any paper accompanied by pictures not adhering to these guidelines cannot be accepted. Pictures must be *.jpg format. Pictures embedded in word, powerpoint, or any other file format will not be accepted. Audio and Video files The journal accepts audio and video files for publication. Papers accompanied by audio and video files are given preference . For an example please click here . These are merely illustrative audiovisual files unaccompanied by any paper. Only audio files [eg paper read aloud, sounds perceptible on clinical examination, eg heart and respiratory sounds etc] and only video files [eg displaying Chvostek’s and Trousseau’s signs] can also be sent. For more sample audio and video files, please request by sending an Email to the editor. Authors' Photographs Authors must submit their pics along with papers, because all papers in this journal are published with authors' pics. The guidelines for authors' photographs are same as above [See under the heading "Submitting Images/Pictures/Photographs" above]. Papers not accompanied by authors' pics cannot be accepted . Ethical policy on patient confidentiality Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology expects that a statement of consent must accompany any paper/article/other contribution containing identifiable patient information. If there is any doubt about whether or not information is identifiable, the Editor-in-chief is happy to discuss this before the piece is submitted. Reviewers will also be asked to take careful account of issues relating to patient confidentiality when reviewing articles/papers. Please discuss in case of any doubt by clicking here . Quality control We at the Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology believe in publishing only high quality papers. Please read Clarivate's Journal citation reports 2023 . Please also read the 24 rigorous quality criteria applied by them on the evaluation of journals. We follow each of these strictly. Online submission Online submission of papers is possible. If you want to submit papers online, please click here . Submission letter can similarly be sent online (Please see above). The paper would be considered only after all required documents, including the submission letter have been received. Note - This journal DOES NOT ACCEPT PAPERS THROUGH ANY OTHER WEBSITE / LINKS, than the one mentioned here. Why should you publish with us? Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology is indexed with most leading indexing databases, thus ensuring maximum visibility among your peers. The content of the journal being freely accessible to all is another factor of great advantage. This greatly increases the chances of your paper getting cited in other journals /books of repute. For some examples, please click links below: National Library of Medicine, Bethesda, USA Please see visit this journal at National Library of Medicine, USA. References in Journals Aggression and Violent Behavior. 2003 Sep;10(3):153-7. [Please see reference on page 145, highlighted in yellow]. International Orthopaedics (SICOT) (2004) 28: 187–190 [Please see reference 7, highlighted in yellow]. Journal of Clinical and Forensic Medicine. 2003 Sep;10(3):153-7. [Please see reference 15, highlighted in yellow]. Journal of Trauma. 2004;57:125–129. [Please see reference 18, highlighted in yellow]. J Forensic Sci, Jan. 2005, Vol. 50, No. 1. [This is a book review. Please see mention of the journal highlighted in yellow]. Pediatr Nephrol (2005) 20:1610–1614. [Please see reference 20, highlighted in yellow]. Journal of Clinical and Forensic Medicine. 2005 Jun;12(3):149-52. [Please see reference 14, highlighted in yellow]. The American Journal of Forensic Medicine and Pathology : March 2006 - Volume 27 - Issue 1 - pp 75-78 [Please see reference 12, highlighted in yellow]. Traffic Injury Prevention, Volume 7, Issue 1 March 2006 , pages 70 - 75 [Please see reference to this journal highlighted in yellow]. The American Journal of Forensic Medicine and Pathology : March 2007 - Volume 28 - Issue 1 - pp 86-90 [Please see reference 28, highlighted in yellow]. The Spine Journal 8 (2008) 703–704 [Please see reference 4, highlighted in yellow]. Leg Med (Tokyo). 2009 May;11(3):107-10. [Please see reference 4, highlighted in yellow]. References in Books / Book chapters Essential Forensic Biology , by Alan Gunn, 2nd ed ( Wiley , 2009) [Please see the reference on page 397, highlighted in yellow]. Forensic Entomology - An Introduction , by Dorothy E. Gennard, 1st ed ( Wiley , 2007) [Please see the reference on page 17, highlighted in yellow]. Forensic Evidence Science And The Criminal Law , by Terrence F. Kiely, 2nd ed ( CRC Press , 2006) [Please see the 11th reference on page 328, highlighted in yellow]. Manejo de la evidencia física de posible fuente biológica [Spanish], by Mercedes Salcedo Cifuentes ( Universidad del Valle , 2007) [Please see reference 29 on page 52, circled in yellow]. You can also visit this book on google books by clicking here . Please go to page 52. Other Papers of Interest Growing Visibility of Indian Biomedicine and Life Sciences Journals in Global Alerting Services , by N.C. Jain. 30 May 2008. Sawant, S. The current scenario of open access journal initiatives in India. Collection Building . 2009; 28(4) :159–163 Vancouver Style All manuscripts should conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (Ann Intern Med 1997;126:36-47). References must be in accordance with Vancouver style. Please visit the following sites for guidance on Vancouver style. AMA Style Guide Bibliographic Services Division of the United States National Library of Medicine, National Institutes of Health BMA - Reference styles Citing your sources - Vancouver style Download reference styles Sample PubMed Central Citations Vancouver Style Vancouver Style Quick guide - How to use it The Columbia Guide to Online Style , second edition by Janice R. Walker and Todd Taylor We can provide help and support if needed: Guideline Support It is important that authors double-check the grammar and style used in the paper. Publication of papers with defective English may be inordinately delayed. Authors wanting to refine the use of English in their manuscripts might consider utilizing the services of SPi. Please click here to visit. Keywords Please choose your keywords in accordance with Medical Subject Headings prescribed by the United States Library of Medicine, National Institutes of Health. Please click here to visit their site. Please click here to visit their MeSh (Medical Subject Headings) browser. Download a complete list of recommended keywords by clicking here . Citing References Pubmed journals Authors should strictly check the accuracy of each reference cited in their papers. Please do provide either the PMID of the paper cited in your own paper. For example if you want to cite the paper below: Szulman AE. The histological distribution of blood group substances A and B in man. J Exp Med. 1960;111: 785-800 . then please cite its PMID which is as below: PMID: 13774694 [Note: PMID of all papers is available from pubmed site . For more help, please download this sample paper by clicking here .] The complete citation in your paper should be as follows: Szulman AE. The histological distribution of blood group substances A and B in man. J Exp Med . 1960;111: 785-800. PMID: 13774694 or Aggrawal A, Setia P. Vertebral artery dissection revisited. J Clin Pathol . 2006;59(9):1000-2. PMID: 16935980 Note: If you visit the pubmed site, then inserting the PMID in the "search box" should get you the relevant paper. Please note that the PMID provided by you will not appear as such in the published paper. It will ONLY be used to provide pubmed links to your citations. For one example of how pubmed links will be provided to your citations, please click the following link: https://anil.aggrawal.org/ij/vol_006_no_002/papers/paper006.html Go down to the References section, and check the Pubmed Links. [Note: For further help, please download this sample paper by clicking here . Please go to the references section, where we have highlighted the PMID in yellow. You must provide the PMID in similar fashion.] medIND journals Indian Medlars Center (medIND) provides free fulltext of several journals participating in its program. If your reference quotes a paper from these journals, please provide a medIND link. For example if you want to cite a paper below: Jha N, Srinivasa DK, Roy G, Jagdish S. Injury pattern among road traffic accident cases: A study from South India. Indian Journal of Community Medicine 2003; 28(2):85-90. then please cite its medIND URL also as below. This URL will be used by us to give a link to medIND medIND URL: http://medind.nic.in/iaj/t03/i2/iajt03i2p85o.pdf The complete citation in your paper should be as follows: Jha N, Srinivasa DK, Roy G, Jagdish S. Injury pattern among road traffic accident cases: A study from South India. Indian Journal of Community Medicine 2003; 28(2):85-90.medIND URL: http://medind.nic.in/iaj/t03/i2/iajt03i2p85o.pdf Please note that as with pubmed links, the medIND URL provided by you will not appear as such in the published paper. This URL will ONLY be used to provide medIND links to your citations. For one example of how medIND links will be provided to your citations, please click the following link: https://anil.aggrawal.org/ij/vol_006_no_002/papers/paper006.html Electronic journals For electronic papers, please provide citations like below: Friedlander, ER. Cryptogenic Organizing Pneumonia Masquerading as Coal-Worker's Pneumoconiosis. Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology [serial online] , 2007; Vol. 8, No. 2 (July - December 2007): [about 8 p]. Available from : https://anil.aggrawal.org/ij/vol_008_no_002/papers/paper002.html Published : July 1, 2007, (Accessed: June 23, 2025) What's new in your paper All papers must be accompanied by a separate sheet detailing these four columns: 1. What is already known on this topic? 2. What question did this study address? 3. What does this study add to our knowledge? 4. Suggestions for further development These columns will make it clear in the mind of readers, what exactly is the new message given in your paper. Furthermore, it would give them new ideas for further research in the area, which should be the aim of all good academic journals. For further guidance on the above matter, you may want to visit the paper by Edward R. 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Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE MARCH 1997 ISSUE THE POISON SLEUTHS THE MYTH OF THE SPANISH FLY -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing with the dead body of this young woman? " "Good morning Tarun. This is the body of an unmarried 20 year old girl Rita. She was in love with one Suresh, who is a student of Ayurvedic medicine. It is suspected that they had secret relations and Rita was pregnant. In order to get rid of this unwanted pregnancy, Suresh secretly administered some drug to her. Immediately thereafter Rita complained of severe cramps in her abdomen. She vomited blood, passed blood in her urine, and died in about 4 hours." "So her body has been brought to you, so you can tell the police how she died?" "Exactly. The police apprehended Suresh, but he has alleged that he did not give anything to her. He has also alleged that she had an ulcer in her stomach which might have perforated and given rise to these symptoms. So it has become extremely important for me to find out the truth. Stomach ulcer does give rise to some of the symptoms exhibited by her, but at her age one does not generally get stomach ulcer. Moreover a patient of perforated stomach ulcer does not pass blood in the urine. To me it seems more like a case of Spanish Fly poisoning..." "What! Spanish Fly!! What kind of a poison is that? To me it appears the name of some insect rather than poison." "Yes Spanish Fly indeed is an insect. But the name is rather a misnomer. It is neither strictly Spanish nor a fly. It is a beetle belonging to the order Coleoptera, and Family Meloidea. Besides Spain, it is also found in several other Mediterranean countries such as southern France, and Italy and also in Russia. In Europe, it is usually found clustered on privet (an evergreen shrub, bearing small white flowers, much used for garden hedges) or such trees as ash or elder. Also known as blister beetle, it is about 2 cm long and 0.75 cm broad and is usually found on olive trees. Its body and wings have a shiny metallic green color. Its biological name is Cantharis vesicatoria. It is the most celebrated of all aphrodisiacs. When an average person thinks of an aphrodisiac, Spanish Fly comes immediately to his mind. "Just a minute doctor. You have introduced certain terms which I don't quite understand. You say that Spanish Fly is also known as the blister beetle. Why is that? And what is an aphrodisiac?" Spanish Fly. These are the crushed bodies of the insect, which can be used as a poison "Tarun, Spanish fly has a chemical in its body known as Cantharidin. It is an irritant. When it is rubbed over the body, it produces blisters. That is why it is known as blister beetle. The term aphrodisiac comes from Aphrodite, the Greek Goddess of love and beauty. When the dried and crushed body of Spanish fly is ingested, it causes severe inflammation in kidneys, ureters and all other organs of genital tract. Because of this property there is a swelling in genital organs. This gave rise to a false belief that Spanish fly could be used for the treatment of impotent people. There is however no truth in this. The swelling of the genital organs, instead of being pleasurable, is extremely painful. Moreover, the dose required to produce such swelling is close to the fatal dose. In women, it may cause violent and painful contractions of the uterus. Because of this, the beetle is sometimes administered by quacks for inducing clandestine abortions." "Are there several types of Spanish flies doctor?" "Tarun, Several different genus and species of beetles are known to contain Cantharidin. All of them have been called the Spanish fly. In the USA, Epicauta and Nemognatha genuses are commonly encountered, of which Epicauta vittata is very well known. In India, three different varieties are found. One variety known as Telni Makkhi (Mylabris cichorii), occurs abundantly in the rainy season in certain parts of North India, especially Kashmir. Another variety (Mylabris pustulata), is found in the fields of cereals and vegetables in the neighborhood of Bangalore. The third species known as Mylabris macilenta is found in southern regions of our country. In Morocco it is available freely in pure form or as an ingredient in the melange of hot spices called ras el hanout, which is usually taken to increase the libido. In 19th century France, it was commonly available as philtre amoureux or love philtre. "Doctor, how is the so-called aphrodisiac made from these flies?" "Tarun, by tradition the beetles were gathered before sunrise while still torpid and unable to fly, the collectors veiling their faces and hands before shaking them down on to cloths laid on the ground. This method may still be in use today. The insects were then dried and heated until they disintegrate into a fine powder. The powder can be easily recognized from its bright green metallic lustre. Several proprietary medicines are made from this powder. In USA, cantharides collodion is in recognized topical use for wart treatment. Cantharidin is used in several hair oils in India. The belief is that the cantharidin stimulates the hair roots and induces them to grow, but this belief has little scientific sanction. Sometimes a tincture is produced by dissolving the powder in alcohol. A vinegar type preparation may also be produced by percolation with acetic acid and water. Aphrodisiac sweets were made by impregnating sugared sweets, and were widely used under the name pilles galantes. They were also sometimes called pastilles de Richelieu, because Duc de Richelieu (1585-1642) administered them to his mistresses. As you must surely be knowing, he was chief minister to the French king Louis XIII from 1624 till his death in 1642. It was said that Madame du Barry, a famous French courtesan, referred to them as pastilles de sérail (pastilles of the seraglio), using them on herself, or perhaps administering them to young women to prepare them for their amorous duties with the ageing Louis XV. " Doctor, earlier you said that Spanish Fly contains a chemical known as cantharidin. Could you please let me know a little bit more about it?" "Yes, certainly. Cantharidin was isolated in 1810 by a French chemist, Roviquet. It is present in the ovaries, soft tissues and blood of the beetle. Cantharidin is a comparatively simple organic compound which occurs as colorless, odorless crystals..." "But doctor, you have just said that Spanish Fly powder is bright metallic green...?" "Tarun, although the Spanish Fly powder has a bright green metallic lustre, cantharidin- its active chemical constituent- is colorless. These crystals glisten in light yet give no color reactions and can not be detected by any simple chemical test. The old powdered preparations of Spanish Fly can however be identified by using a microscope to show the characteristic fragments of insect in the powder. "What is its fatal dose doctor?" "Tarun, about 1.5 grams of powdered Spanish Fly or 50 mg of pure crystalline cantharidin is enough to cause death. I must tell you that although Spanish fly is not an aphrodisiac at all, it has been used effectively in veterinary medicine in breeding farm animals." "What symptoms does one experience on swallowing the poison?" "When swallowed, there is a burning sensation in the throat and stomach, difficulty in swallowing, nausea, abdominal pain, vomiting of blood stained material, intense thirst, and diarrhoea with blood and mucus. As time passes, kidneys get damaged. There is a dull heavy pain in the loins, and a constant desire to pass urine, but only small amount of blood stained urine is passed This last symptom is known as strangury. After some time, convulsions occur and death occurs in 24 hours. Occasionally, blister formation may take place in the mouth and other parts of the gut with which the poison has come in contact. You will remember that Rita had several of these symptoms." "Yes, I do. Suresh probably gave it to her for abortion. But you told me earlier that it has a great - although false - reputation as an aphrodisiac. Has anyone administered it to someone to increase the desire" "Tarun, there is a very interesting case in which a married man Arthur Ford deceptively administered Spanish fly powder in coconut candies to two female colleagues, both of whom had earlier spurned his advances. He approached a pharmacist he knew personally to provide him with some cantharidin. It was used in those days in some lotions, so it was usually available with pharmacists. He gave the reason as administration to a neighbor's rabbits which were not breeding fast enough! Although the pharmacist was known to him, he refused to oblige. Ford returned during the lunch hour when the pharmacist was absent and stole some cantharidin. With a pair of scissors he inserted the powder in coconut candies and gave it to his female colleagues. His idea was to increase their desire, so that they may come running to him in his arms, but quite predictably both of them died and Ford got six years in jail! This celebrated case of Spanish fly poisonings occurred in UK in 1954. But about two centuries earlier another famous case occurred..." "What was that case doctor? Please tell me about it." "Tarun this case is most interesting. It is a very long and interesting one, but I shall tell you only the gist. On Saturday, 27 June 1772, the notorious French sex pervert Marquis de Sade (1740-1814) with the help of his valet Latour, arranged for four French prostitutes to gather at a place where he wanted to have fun with them...." "Sorry to interrupt you doctor, but isn't he the same man after whom the word Sadism has been coined?" "Yes, you are right Tarun. Although de Sade was a sex pervert, he was a great writer too, and has written such classical books as 120 Days of Sodom, Justine and Juliette. His writings revolved around a single dominant theme: cruelty of every kind performed for the purpose of achieving sexual excitement. This practice was later named "sadism". "Yes, so we were talking about Marquis de Sade...." "Oh yes Tarun. After he had called the prostitutes, he gave them sweet aniseed (saunf) balls laced with Spanish Fly, in the belief that it would "set them on fire". Later on the same day evening he met another - the fifth- prostitute and repeated the same practice with her. She as well as one of the earlier 4 prostitutes started having incessant and uncontrollable vomiting. You might wonder why the other girls did not get poisoned. Well, they had secretly dropped the sweets on the floor after suspecting something black at the bottom. A written complaint of poisoning was formally lodged on Tuesday, 30 June 1772. The investigating officer was Jean-Pierre Chomel, Lieutenant Général criminel at the Seneschal's Court in Marseille. He collected the sample of vomit and sent it for chemical analysis to two toxicologists, André Rimbaud and Jean-Baptiste Joseph Aubert. The first suspicion was that the poison was arsenic. We have already discussed about this poison in our last meeting. It may be interesting to note that in 1772, the methods of chemical analysis of poisons were extremely primitive, the first reliable chemical test of note for any poison being developed in 1836 for arsenic." "Yes, we talked about that last time. That was the Marsh test. Were these toxicologists able to detect cantharidin from the vomitus?" "No, they used very primitive methods, which could not determine the nature of the poison. The maximum they could say was that it was neither arsenic nor corrosive sublimate, the two poisons known in those times to cause severe vomiting." "This means that de Sade and Latour must have gone scot free." "Tarun, as we discussed in our very first meeting, in those times poisoning was considered a very grave offense, and the tendency of the authorities was to punish the suspects irrespective of the presence of evidence. The failure to detect poison did not, therefore, deter the legal authorities. Police teams were dispatched to arrest both de Sade and Latour, but they had fled. On 3 September the same year, despite the absence of both Marquis de Sade and his valet, the case was brought to trial. Both de Sade and his valet were found guilty of poisoning and sodomy. They were sentenced in absentia. The Marquis de Sade was to have his head struck off while Latour was to be hanged or strangled by the public executioner. Afterwards their bodies were to be burnt and the ashes scattered. However as both of them could not be caught, their straw effigies were hanged on 12 September 1772. For an utterly wrong belief, two innocent girls were in agony for almost a week, and almost lost their lives. This case occurred almost two and a quarter centuries back. But it is indeed unfortunate that Spanish fly still enjoys a reputation as an aphrodisiac and figures largely in lavatorial jokes and bawdy ballads. Its use is to be actively discouraged. "Yes, surely it must. But doctor, in the second case, which occurred in 1954, doctors must have been able to detect the poison quite successfully?" "Tarun, it is interesting to note that although almost two centuries had elapsed between the two cases, the advances in knowledge and technique brought about during this period still seemed scarcely sufficient for the task of solving it. The chemical analysis of the poison in Arthur Ford's case was done by Dr. Lewis C. Nickolls, director of the Metropolitan Police Laboratory at New Scotland Yard. He also could not find an infallible chemical test for it. He concluded that there were only three ways in which one could arrive at a positive identification for cantharidin: by its melting point; by the X-ray diffraction pattern obtained from its crystals; and by the standard observation that, when cantharidin is applied to human skin, pain and blistering are produced. But these tests can not be called ideal. For instance, applying cantharidin to skin can be dangerous....." "Really? How? Tell me doctor." "Tarun, in 1953- just one year before the notorious Arthur Ford case- an important case of accidental death with Spanish Fly had occurred, in which the poison seeped through the skin. A keen 43-year old fisherman had managed to obtain some cantharidin, believing it would attract fish...." "It is indeed remarkable how such bizarre beliefs have centered around Spanish Fly. Isn't it doctor?" "Yes, sure, and all of them are wrong. Well, we were talking about that fisherman. After shaking up the powder with water, he stopped the mouth of the bottle with his thumb, and then, within minutes, unfortunately pricked his thumb with one of his fish hooks. Within half an hour he was ill, within three days dead. This shows that the drug can penetrate broken skin, and possibly unbroken skin too, with toxic if not fatal results." "Oh, that certainly is most interesting. Doctor what have you found in the post-mortem of Rita?" "Tarun, Rita's mouth showed blisters, which at once made me suspicious about Spanish Fly. The whole alimentary tract from the mouth downwards is inflamed. You can see it is completely injected with blood. But the finding that has nabbed Suresh is the presence of bright green particles in Rita's stomach and intestines..." "Oh, yes sure. I can see bright metallic green particles sticking on the walls of stomach. Are there more clues doctor?" "Oh yes there are, but none as specific as the finding of green particles in the stomach. You can see that the kidneys and ureters are congested. The uterus is congested and it shows a fetus about 2 months of age. It is almost sure that Suresh administered Spanish Fly to abort this fetus to save her from the ignominy of childbirth before marriage." "Great, let us go and tell about this to the police." "Oh, I have already done that Tarun, and have instructed the police specifically to look for some bright metallic green powder in his possession. I knew that if this powder is found in his possession, Suresh's lawyers would find it very difficult to save him. And do you know what? Police specifically looked for this powder and has actually been able to locate it in one of the shelves of his house. Had I not informed them about it, they would probably have left it untouched. So Forensic medicine has indeed been able to nab Suresh." " Oh, Great, and thank you doctor for telling me about such an interesting poison. What are you going to tell me the next time?" "Tarun, next time I shall tell you about Boron, which as you shall see is a very important poison. "

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE AUGUST 1997 ISSUE THE POISON SLEUTHS POISONING BY METHYL BROMIDE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? Oh well, today you are examining the dead body of a young infant. What happened to him? Please tell me." "Good morning Tarun. The name of this 3 month old girl is Varsha. She is the daughter of RadheyShyam and Sita who were living in the ground floor of Mahajan's house as tenants. RadheyShyam and Sita are a young couple in their late twenties. Mahajan was living with his family on the first floor. He had been asking RadheyShyam and Sita to vacate his house for quite sometime but they refused to vacate the house. Many times Mahajan had threatened them with dire consequences, but nobody took it seriously..." "So obviously he killed Varsha to teach them a lesson?" "Don't jump to conclusions Tarun, I haven't finished yet. Yesterday, i.e. on 20 August, RadheyShyam, Sita and their daughter Varsha had gone to attend a marriage party from where they returned late in the night. On entering their house, both RadheyShyam and Sita experienced a foul smell. However, as they had experienced smell from the sewage during previous days, they took little notice of the smell. These sewage problems had resulted in maintenance work on the sewage pipes in their street just after noon on the very same day. They nourished the infant and went to bed in their room at about 10.30 pm., keeping the door open to the infant's next door room. Two hours later at 1.30 am and about 3 hours before expected, Varsha started to cry vigorously. The mother took care of the child, who vomited and had severe diarrhoea. At the same time the parents were alarmed by a "burning" sense in their eyes, throat and mouth, and they also started to vomit. They contacted a local doctor on phone but he didn't turn up. Without knowing what was happening in the house, they realized that something very wrong was going on, especially as Mahajan was threatening them with dire consequences for quite some time. They came out of their house immediately along with their child, called a Taxi and went to Sita's parents' house to spend the rest of the night. Subsequently Varsha became drowsy and unable to drink water or milk. At noon on 21st August, Sita's parents and all the other adults went to the city's hospital arriving there at about 1 pm. But unfortunately she was declared dead on arrival." "Oh, that's indeed very sad and depressing. So what do you think was going on in the house?" "Tarun, the whole scenario and symptoms of the three persons involved point very strongly in favor of one poison- methyl bromide." "What? Methyl Bromide? Doesn't sound like a common poison to me. Please tell me more about it." "Sure Tarun. Methyl Bromide surely is not commonly known, but it is indeed a very interesting poison. Methyl Bromide (CH3Br) is also known as bromomethane, monobromomethane, Embafume or iscobrome. Pure methyl bromide is a colorless gas that is heavier than air. Thus it is one of those rare poisons which occur as gases. Odorless and tasteless in low concentrations, it has a musty, acrid smell in high concentrations. That's why RadheyShyam and Sita noticed that strange smell on coming back from the marriage party." "Doctor, who in the world uses methyl bromide, and why?" "Tarun, Methyl Bromide is in relatively widespread industrial use as a fumigant and insecticide because of its effective penetrating power and absence of fire or explosion hazard. Occupational exposure to it also occurs frequently. Nobody knows about Indian figures, but it is estimated that about 75,000 American workers are occupationally exposed to this gas annually. Its toxicity is severe and despite safeguards, cases of acute and chronic intoxication occur, chiefly in fruit and tobacco industries, because of its use in these industries as a fumigant and an insecticide. It has also been used as a refrigerant, solvent, methylating agent, and in dyes and fire extinguishers." "Quite interesting. How can poisoning occur due to this gas?" "Tarun, toxic exposure to this gas can occur by inhalation as in the case of Varsha or by skin absorption. Body tries to excrete this poison out of the system. Excretion takes place mainly through the lungs. The remainder is metabolized in the body, and inorganic bromine is excreted in the urine. In European countries cases of accidental poisoning due to fumigation of houses are quite well-known." "But at the time of fumigation, the houses are vacated. How can one possibly get poisoned?" "Yes, you are right Tarun, yet poisoning has occurred in sinister ways. In many European countries, the houses are made up of wood, and the European house-bores (Hylotrunes bajulus) occasionally invade old wooden houses. To kill these house-bores methyl bromide is often used for fumigation, and as you rightly say, the houses are indeed vacated for fumigation. But cases are known in which the gas has entered the sewage pipes of the fumigated house (which of course had been vacated) and from there it travelled to the main sewage pipe. From there it gained access to the adjacent houses or even to houses at quite some distance. Of course, it can occur only if the houses in question don't have the water-locks that are now obligatory in all sewage pipes. Now you must be able to understand why you have water-locks in the sewer pipes of the places where you relieve yourself. If these water-locks were not made obligatory, gases from the adjacent houses, or even from the main sewer could easily enter one's house." "Quite interesting. Have people died in such a way?" "Yes, I am personally aware of persons dying in such exotic manner. These cases are frequently reported in learned journals too." "Doctor, how does methyl bromide kill a person? Since bromine itself is a poison, I would tend to believe that the bromide ion in the methyl bromide molecule does the damage." "Tarun, it would indeed appear so, but it is not true. I will give you certain figures which will make things very clear in your mind. Normal bromide levels in adults are about 0.3-0.4 mg/dL and come primarily from bromide residues in fumigated foodstuffs. If one ingests an inorganic bromide, such as sodium or potassium bromide then he does die of bromine toxicity. Technically we know it as bromism. In the case of a fatality due to inorganic bromide ingestion, the blood levels of bromine are quite high- almost 300 mg/dl, which as you can see are almost 1000 times the normal level. Levels lower than this produce serious toxicity but not death. For instance levels of 100 mg/dl produce toxic symptoms and level of 200 mg/dL produce serious toxicity. But in the case of methyl bromide intoxication, which is an organic bromide, death may occur when the bromine levels of the blood are as low as 8-9 mg/dL. This clearly means that bromide ion is not responsible for the death in the case of methyl bromide intoxication." "Then what is the cause of death in these cases?" "Tarun many important enzymes in our body contain important entities called Sulfhydryl groups. These groups can chemically be represented as "-SH". Methyl bromide releases methyl ions in the body, which combine with these sulfhydryl groups and make the enzymes ineffective. This is technically known as methylation of the sulfhydryl groups. Enzymes in the central nervous system seem particularly prone to this destruction. That is why a patient suffering from methyl bromide poisoning displays neurological symptoms quite prominently. Major manifestations are vomiting, headache, vertigo, gait disturbances, double vision, delirium and seizures. All the three persons in question have displayed several of these symptoms. Since methyl bromide affects the brain in a major way, in cases of death, the main changes are observed in the brain. The brain is water-logged and swollen, which we term as edema of the brain. The coverings of the brain, or the meninges are red and there may be hemorrhages under them. Loss of neurons have also been seen at times." "Did you see these changes in the body of Varsha?" "Yes, Indeed I did. But the most interesting finding was the bromine levels in her blood which are almost 17 mg/dL. As you know this is much above the normal limit and does indicate that she was exposed to methyl bromide." "Then surely Mahajan has done the trick. But how did he introduce the gas in RadheyShyam's house?" "Mahajan was asking RadheyShyam and his family to vacate his house for quite some time, but they were not doing so, so he decided to finish them off in a very clever and sinister manner. I must admit that I have never heard of such an exotic method to kill an entire family. In fact, he would have easily got away with the murders, had the police not decided to contact me..." "Doctor, I am getting curious. How did he do it?" "He contacted an insecticide company and bought a cylinder of Methyl Bromide gas on the pretext that he wanted to fumigate his crops. From the cylinder he connected a pipe and inserted the other end of the pipe into the chimney which leads to the kitchen on the ground floor. Since the top of the chimney is on the barsati above the first floor, where Mahajan was living, it was accessible to him. After making this elaborate arrangement, he opened the valve of the cylinder releasing the gas in the chimney. The gas being heavier than air, quickly "dropped down" into the kitchen and from there it seeped into the entire ground floor. When RadheyShyam and his family entered their house after attending their party, Mahajan had literally converted their place into a gas chamber! RadheyShyam showed presence of mind and left the house quickly with his family, otherwise even he and his wife would have died. I have asked the police personnel to look specifically for a gas cylinder in Mahajan's house. Oh here comes the police inspector... What! you did find the methyl bromide cylinder in his house. Look Tarun, I was right. My investigation has indeed worked. The police can now successfully prosecute Mahajan." "Fantastic! And many thanks for letting me know about such an interesting poison. You indeed are a great poison sleuth. What are you going to tell me next time?" "Tarun, next time I shall tell you about ratti seeds, which as you shall see is another important poison. This is a vegetable poison, as you shall see. "

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE AUGUST 2000 ISSUE THE POISON SLEUTHS DEATH BY ETHYLENE GLYCOL -Dr. Anil Aggrawal “Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young man today. What happened to him? Please tell me.” “Good morning Tarun. The name of this young man is Ramlal and he died this morning. Yesterday night his friend Shyam visited his house with a bottle of liquor as he was reportedly getting married next month, and wanted to enjoy with his friend. Many neighbors saw them enjoying together. He left at around 10 pm. Around 2 am in the night, Ramlal began vomiting severely. Quite alarmingly there was blood in his vomit. At that time only his sister was there at the house. She took him to the hospital, where he died this morning. The doctors were unable to find out what disease he was suffering from. So the police has handed over his body to me, so I can tell them, how he died” “Doctor, are you suspecting some foul play?” “The police certainly is. Ramlal and Shyam are childhood friends. About a year back Ramlal had a severe tiff with Shyam as he had caught him in a compromising position with his sister. Shyam was having an affair with Ramlal’s sister and he (Ramlal) did not like that. At one time in the past, Ramlal had severe fight with Shyam too in this regard. Later Shyam compromised with Ramlal, and swore that he would never meet his sister. Following this Ramlal relented and the two met sometimes, although not as often as they used to be in the past.” “Do you think Shyam give him some poison mixed with alcohol?” “The police thinks so. I have met the doctors and asked them in great detail the symptoms he exhibited at the time of admission. The doctors told me that he was quite inebriated, which was quite natural as till ten p.m. the previous day, he was taking alcohol. But what interested me were the symptoms like coma, seizures, nystagmus, paralysis of muscles of eye and gait, depressed reflexes and tetany. Coma is a technical term for unconsciousness. Nystagmus is also a technical term which describes oscillatory movements of the black circular portion of the eyes (cornea). Tetany refers to spasms of the muscles. Depressed reflexes refers to depression of reflexes like the knee jerk. You may recall that if a person is sitting in a relaxed state, and if his knee is hit gently, at a particular point with a rubber hammer, the lower leg suddenly gives a jerk. This is known in medical parlance as the “knee jerk”. In many diseases, it can not be elicited, i.e. it disappears while in many others it is accentuated. Accentuation of the knee-jerk means that the lower leg would give a more energetic jerk than normal. Knee jerk is a very useful sign for doctors for diagnosing diseases. Neurologists -doctors who diagnose and treat disease of the nervous system - make good use of this jerk for diagnosing diseases. Toxicologists also make use of this knee jerk for diagnosis poisonings, as many poisonings can cause depression of the knee jerk. One of the poisons that cause this is ethylene glycol.” “So you think Ramlal died because of ethylene glycol. Never heard of this being used as a poison. Anyway how can you be so sure that he died of ethylene glycol poison, as you yourself say that many poisons can cause depression of knee jerk?” “That’s right. But look at the cluster of symptoms that he had. They are very typical of ethylene glycol poisoning. Anyway, I would confirm my suspicions by various typical findings after the autopsy is completed..” “Doctor, although I have heard about ethylene glycol in my chemistry class, yet I do not know enough about it to follow your conversation. Kindly tell me something about this poison.’ “Tarun, Ethylene glycol is also called 1,2-ethanediol. Its molecular formula is (CH2)2(OH)2. It is a colourless, odorless, water soluble, viscous, oily liquid possessing a sweet taste and mild odour. It is produced commercially from ethylene oxide, which is obtained from ethylene. Ethylene glycol is widely used as antifreeze in automobile cooling systems..” “Excuse me doctor, what is an antifreeze? Kindly tell me.” “Tarun, antifreeze is a compound which is used in cars to prevent the water in its radiators from freezing. In cold weather, freezing water can cause a burst in the radiator of a car which has been left standing. This freezing can be avoided by adding ethylene glycol to lower its freezing point. Good-quality solutions sold as antifreeze have a sodium-based inhibitor added, to prevent corrosion. Generally a 25% content of antifreeze in the radiator water will give protection against freezing, but some manufacturers prefer 33.33% solution. Antifreeze gives protection against corrosion too, so it is left in the radiator all the year round. An interesting fact is that manufacturers add a fluorescent dye called fluorescein to ethylene glycol. This dye fluoresces in ultraviolet light. This “trick” allows mechanics to detect radiator leaks by using an ultraviolet light. But this very fact can be made use of by doctors in detecting poisoning of patients by this compound. They direct Wood’s lamp on the patient’s urine. If the urine fluoresces, it is a sure sign of ethylene glycol poisoning.” “Doctor, you have used another term with which I am not familiar - the Wood’s lamp. What is it? Is it some kind of lamp made of wood?” “No, no. Wood is actually the name of a physicist who devised this lamp. He was a Baltimore physicist and his name was Robert William Wood (b. 1868). In this lamp, there is a special glass called Wood’s glass, which transmits only the ultraviolet radiation (with some red in the visible region). The radiation thus passed is known as “Wood’s rays”, and have a wave length of about 360 nm. This glass contains nickel oxide. One use of this lamp is for the detection of small spore ringworm of the scalp. I have taken some urine from the urinary bladder of Ramlal and have shone Wood’s light over it. Come on, you can also see it.” “Oh, doctor, I can clearly see the urine fluorescing. This is remarkable. This is enough proof that Ramlal died of ethylene glycol.” “I will do better than that, and come up with some more proofs. So I was telling you that ethylene glycol is used as an antifreeze. It was even used as a coolant in the Lunar Module! It is also used in the manufacture of man-made fibres, low-freezing explosives, and brake fluid. I may tell you that it was discovered as a substitute for glycerine (used in enemas). It has also been used in commercial products such as detergents, paints, lacquers, pharmaceuticals, polishes and cosmetics. It’s other uses are as a preservative in juices and as a deicer. Since the compound is easily available, has a warm sweet taste and produces a state of inebriation much like that of ethyl alcohol, it has been used by poor people in place of alcohol. For the same reasons, it has also been used by people for committing suicide. One can easily mix it in alcohol and give it to his adversary for killing him. Only about 100 ml are sufficient to kill an adult human being. I must tell you that Ethylene Glycol poisoning is one of the most serious and dramatic intoxications encountered in clinical toxicology. Just like methanol and isopropanol, it is used as a second-rate substitute for ethyl alcohol by poor people, because it is cheaper. However, while methanol poisoning occurs in epidemics, ethylene glycol poisoning is sporadic. There was a time when it was used in pharmaceutical preparations (as a solvent), but now it is banned. Yet many cases of poisoning still occur. In May 1998, over 20 children died in Gurgaon after consuming medicines, which were thought to be adulterated with ethylene glycol” “Oh, that’s terrible. How does ethylene glycol kill doctor?” “Toxicity due to ethylene glycol is not as much because of the compound itself, as because of its breakdown produces. Ethylene glycol itself causes some CNS depression, and a state of inebriation quite like that produced by ethyl alcohol. After ingestion, peak blood levels occur at 1 to 4 hours. Half-life of ethylene glycol is 3 hours, which means that half of the quantity ingested would get metabolized in 3 hours. Principally four breakdown products cause damage, namely aldehydes, glycolate, lactate and oxalate. The first three are responsible for severe acidosis. This means that the pH of the blood becomes less alkaline. The damage because of oxalate is because it gets deposited in tissues and causes widespread tissue destruction. Kidney damage is particularly likely. The compound itself is mildly toxic. Acute inflammation of the eye has been reported following accidental eye contact. Contact with skin can cause mild skin irritation. Inhalation can cause toxicity too. Factory workers who are exposed to vapors of ethylene glycol can suffer from chronic poisoning. The symptoms are nystagmus and recurrent attacks of unconsciousness. Toxicity occurs due to two main reasons. Tissue destruction due to deposition of calcium oxalate crystals (mainly in kidneys, but also in brain, blood vessels, liver and pericardium. Because of chelation of calcium, hypocalcemia occurs, and production of severe acidosis due to aldehyde, glycolate and lactate production.” “What symptoms does the victim of poisoning experience doctor?” “Tarun, the symptoms appear in three fairly well-defined phases. The first phase occurs within 30 minutes to 12 hours after ingestion. The patient appears drunk, but there is no characteristic alcoholic odour from his breath. Nausea, vomiting and hematemesis may be seen. CNS effects include coma, seizures, nystagmus, paralysis of muscles of eye and gait, depressed reflexes and tetany is seen as was seen in the case of Ramlal. The tetany is due to fall in calcium levels in the blood. This occurs because ethylene glycol produces oxalic acid in the body and it combines with calcium in the blood to form calcium oxalate crystals. The second phase begins 12-14 hours after the onset of first phase. By this time there is widespread deposition of oxalate crystals in the tissues. This results in tachycardia (increase in heart beat), mild hypertension (raised blood pressure), pulmonary edema (water logging of lungs) and congestive cardiac failure (heart becoming unable to pump blood out to the body). The third phase occurs 24-72 hours after ingestion. There is flank pain, with tenderness in the chest and evidence of kidney disease usually manifested by stoppage of urine. This is technically known as oliguria. Proteinuria (protein appearing in the urine) and microscopic hematuria (blood appearing in the urine) may occur. Urine with a low specific gravity may be observed.” “Doctor what is its fatal dose and fatal period?” “The Fatal dose is about 2 ml/kg weight, or about 120 g for a 60 kg man. About 90% patients die within 24 hours due to CNS damage. Rest die in about 8-12 days from renal failure.” “Doctor, I was reading somewhere that in 1937, more than 100 people died in USA because of ethylene glycol. Is this information correct?” “ Oh, you are talking about the famous Elixir of Sulfanilamide-Massengill disaster of 1937, which occurred during the months of September and October 1937. No, the incriminating compound was NOT ethylene glycol, but DIETHYLENE GLYCOL - sometimes also known as ETHYLENE DIGLYCOL. There is a difference between ethylene glycol and diethylene glycol. While the formula of ethylene glycol is (CH2)2(OH)2 or C2H6O2, as I told you earlier; that of diethylene glycol is HO[CH2CH2O]2H, or C4H10O3. In fact, the formula of Polyethylene Glycols (PEGs) is HO[~CH2CH2O~]nH. You can go on substituting n for 1,2,3 etc to get higher ethylene glycols. Substitute n for 1, and you get the so-called (mono)ethylene glycol - or simply ethylene glycol - about which we have been taking. Substitute n=2, and you get diethylene glycol, the one responsible for the tragedy you are talking about. Substitue n=3 and you get triethylene glycol. I do not know of any interesting disaster connected with this or any of the higher ethylene glycols. But Polyethylene glycols are toxic no doubt. Polyethylene glycols with molecular weights between 200 and 600 Daltons are clear viscouse liquids, while those with molecular weights between 1000-6000 are rather wax like or waxiform. These are known as Carbowaxes. Their solubility in water is - very roughly - inversely proportional to their molecular mass.” “Good. So what was the "Elixir of Sulfanilamide-Massengill" disaster all about?” “Tarun, Let me first give you some background, so you could appreciate the full significance of this disaster. Scientists had long been hunting for some kind of a magic bullet which could kill disease causing bacteria. The first antibiotic - as we all know - was penicillin. Although it had been described by Alexander Fleming as early as 1928, a usable form was not developed till 1941. So before this time, the world was practically devoid of antibiotics." “Sorry to interrupt you doctor, but what exactly do we mean by the term "antibiotic"?” “Tarun, the term antibiotic - as we all understand and use it - refers to a chemical substance produced by a LIVING ORGANISM, generally a microorganism, that is detrimental to other microorganisms. If the chemical is NOT produced a LIVING ORGANISM, we would NOT call it an antibiotic, even if it killed or were detrimental to microorganisms. Therapy by such a chemical would be known as "chemotherapy", as against "antibiotic therapy", if it were to be done by antibiotics." “Oh, I see.” Prontosil soluble Sulphanilamide Note the -SO ₂ NH ₂ moiety in both. “Coming back to our story. Before 1941, some of these other chemicals (i.e. those not produced by living organisms) were known. The first one to be described was a red dye PRONTOSIL RUBRUM - or "prontosil red" as some would call it - which cured certain bacterial infections in mice. It was described by a German chemotherapist Gerhard Domagk (1895-1964), in 1932. Domagk was awarded the 1939 Nobel Prize for Medicine for this remarkable discovery. Drugs against bacteria were very much sought after during this period, and virtually anyone who could discover an effective medication could get the Nobel Prize. Alexander Fleming, who discovered Penicillin, the first antibiotic got the Nobel Prize for Medicine 6 years later - in 1945. Thankfully his discovery penicillin had come in handy for wounded soldiers during World War II, which had started in 1939." “It must have been a proud moment for Domagk to receive the award.” “No, he never received it, because he was not allowed to." “Why so? That is preposterous.” “Tarun, Domagk lived in the era of Hitler's Germany. Right from the days of Ossietzky, Hitler had adopted a policy never to allow any German to receive the Nobel Prize." “Doctor, I know I am deviating, but who was Ossietzky.” “Tarun, Carl von Ossietzky (1889-1938) - sometimes spelled as Ossietsky- was a German journalist and pacifist who was against the war, and wrote a lot against the Nazis. He was declared the winner of the Nobel Prize for Peace for 1935. Hitler was enraged because the award had been received for writing against him. At least he perceived the situation like that. So he didn't allow Ossietzky to receive the award. In fact a policy was developed never to let any German accept the award. Domagk became a victim to this policy. It was only two years after the war ended - in 1947 - that he could travel to Stockholm to receive the award, but unfortunately by that time the award money had been reverted to the Nobel Foundation, so he did not receive any money. He did however receive the gold medal and the citation (the diploma)." “Doctor, you know so many stories. I am amazed. This must have been a great setback for Domagk.” “Sure it was. However I think that for Domagk, the greatest reward would have been when his own daughter Hildegarde was saved by his drug "Prontosil Rubrum". In February 1935, she pricked her finger with a needle and developed a severe bacterial infection - called septicaemia. Domagk's new drug "Prontosil Rubrum" was given to her and her life was saved. While on the subject of "Prontosil Rubrum", I may tell you that a related compound "Prontosil soluble" also became available during this period. It soon became clear that these compounds themselves were not responsible for the killing action. Instead, a chemical moiety - known as sulphonamide group - broke off from these compounds within the body. It was this chemical moiety which was responsible for the antibacterial activity of Prontosil. The chemical formula of this moiety is -SO2NH2. Scientists derived a number of drugs from this chemical moiety. All these drugs became famous as Sulpha drugs, and they heralded the era of modern chemotherapy against bacterial infections. By 1935, many of these sulpha drugs had become very popular and were marketed as tablets and capsules. One such drug was Sulphanilamide, which was successfully marketed by The Massengill Company of the US. In September and October of 1937, the executives of this company decided to market the same product for children too. But since small children can not take tablets or capsules, it was decided to sell the formulation in the form of an elixir. Technically speaking an elixir meant the solution of a drug in ethyl alcohol and NOT in any other solvent. But the company decided to make a solution of Sulfanilamide in diethylene glycol. Their Elixir was essentially a solution of 10% Sulphanilamide in 72% percent diethylene glycol, with some flavouring and coloring agents. In those times, it was not legally required for a company to test a new drug on animals before marketing it. So The Massengill Company floated the new elixir without any tests. Since diethylene glycol is a dangerous poison, about 76 people died as a result of taking this elixir. The cause was severe liver and kidney damage caused by diethylene glycol. These 76 were the confirmed deaths, but there are unconfirmed reports asserting that more than 100 people died as a result of this disaster.” “That is amazing. The Massengill Company must definitely have been sued by the relatives of all these people?” “No. How could anyone? The Massengill Company was well within its legal rights to sell anything to the consumers. You may laugh at it, but the company could only be prosecuted for mislabelling its product as an elixir, which applies only to an alcoholic solution and not to a solution in diethylene glycol. That is a very small offence though. The fact is that at that time all drug manufacturing and distribution companies were being guided by a very old and archaic law - The Pure Food and Drugs Act of 1906. Althouth it had been amended by the Sherley Amendment of 1912, it still allowed lot of freedom to drug manufacturers. It was only this tragedy, that the much more modern law - The Food, Drug and Cosmetic Act of 1938 was passed. In our country too, a similar Act was passed two years later. It was initially known as The Drugs Act of 1940. In 1962, by an amendment, cosmetics were also included within the purview of this Act and it became known as The Drugs and Cosmetics Act. It is unfortunately true, that it usually takes a great disaster for the government to change an archaic Act.” “Oh, come on. You can't say that just because of one incident, can you?” “Perhaps you are right. But interestingly yet another disaster occurred in late 50s and early 60s which caused further changes in similar Acts around the world. It was the much feared Thalidomide disaster, but if I were to tell you about this, we would be deviating from our initial topic - ethylene glycol.” “Doctor, either you should have not brought about this new topic at all, or you should explain it fully. Since you have mentioned it, my curiosity is aroused. Please let me know about this disaster. I don't mind being late at home.” Thalidomide Glutethimide Glutethimide is still sometimes used as a sedative. Note the structural similarity of both. “Alright, as you wish. But let me tell you an additional fact about Diethylene Glycol. Its story did not end with the Massengill company. This compound keeps raising its head again and again. As recently as in July 1985, Diethylene Glycol was again in the news - this time because it was discovered that Austrian wines were contaminated with this substance. Stocks of all Austrian wines were promptly withdrawn throughout the UK. About Thalidomide? Well it is chemically written as C13H10O4N2. This drug was marketed in more than 40 countries - mainly in West Germany and the UK in the late 50s and early 60s. In Germany, it was manufactured by Chemie Grünenthal and marketed by it as Contergan since 1956, and enjoyed good sales. In Britain it was licensed by Chemie Grünenthal to the Distillers Company. It became available in Great Britain from the beginning of 1958 as Distaval. In Sweden the license was given to a local company Astra. It was being used by pregnant women to counter nausea, which is usually seen in early pregnancy. It also acted as a sedative. Developed in West Germany in the mid-1950s, Thalidomide was touted as one of the safest sedative-hypnotics, just as Titanic was hailed as the unsinkable! Ironically both suffered the same fate. Titanic sank on its maiden voyage, and Thalidomide sank too - in a figurative sense. It caused birth defects in children known as peromelia. An estimated 5,000-10,000 children suffered from this terrible deformity. This ultimately caused its downfall.” “What is peromelia doctor? I have never heard this term.” “Tarun, peromelia is the collective name given to a number of deformities, where there is a congenital absence or malformation of the extremities. It is caused by errors in the formation and development of the limb bud, which normally occurs from about the fourth to the eighth week of intrauterine life. As I told you peromelia has several forms. One of the worst and most horrible is amelia in which there is a complete absence of all limbs. There is just head and the trunk of the baby - absolutely nothing else. Since all the essential organs of the body - brain, heart, lungs, kidneys, liver etc reside in head and trunk, such an infant, if cared for properly would not die. But imagine the quality of life of such an infant. He is just like a plant - with an essential difference. He can see, feel and sense his absolute helplessness. Fortunately this condition was very rarely seen in thalidomide disaster. The second form is Ectromelia, in which there is the absence of one or more extremities. There was also an interesting condition known as phocomelia or “seal extremities", because the extremities resembled like those of a seal. In this condition, the upper part of the limb was extremely underdeveloped or missing, and the lower part was attached directly to the trunk, resembling the flipper of a seal. It was as if the palms and feet were directly stuck to the trunk. Its counterpart was Hemimelia in which the upper part of the limb was well formed but the lower part was rudimentary or absent. Finally there was a condition known as Sirenomelia, in which the newborn resembled a mermaid or siren. The term literally means “mermaid extremity”. This was also a very severe abnormality in which the legs were fused to a greater or lesser degree and contained malformed bones; the anal and urinary orifices were absent, and the genitals and parts of the intestinal and urinary tracts were malformed. As limb buds form during fourth to the eighth week of intrauterine life, this condition was very common in women who took thalidomide during this period. Exposure during the later periods of pregnancy did not cause any abnormalities. Interestingly in the US, the rights had been given by Chemie Grünenthal to a local company W.S.Merrell Co., but they could not market it, because of the earlier Act passed by the Govt, about which I have already told you. The Food and Drug Administration (FDA) was simply not convinced of its safety. In Canada, a license to market it was granted by the Canadian Food and Drug Directorate. In our country too the drug failed to gain entry because of usual bureaucratic hurdles. Thus US and India were the two big countries which were saved of this disaster!” “Chemie Grünenthal must have been prosecuted for their wanton act?” “Tarun, it has traditionally been very difficult to prosecute big giants. Nine senior members of Chemie Grünenthal were tried in a criminal court in Aachen, but they disputed the very fact that the limb deformities had been caused by thalidomide, although there was very strong statistical evidence in favour of the fact that thalidomide did cause this disaster." “What was this evidence doctor?” “Phocomelia is such a rare disease that no case was reported in Germany in ten years between 1949 and 1959. But in just a single year in 1961, there had been 477 cases! Moreover after this drug was taken off in 1961, the cases stopped once again. Yet the defendants challenged the causation. Finally trials had to be conducted on rabbits to convince the court that it was indeed the thalidomide which had caused these deformities. Yet the case dragged on for about two years and was finally abandoned. The representatives of the deformed children however settled the issue with Chemie Grünenthal for just about 114 million Deutschmarks! In Britain, a good thing that happened was that The Medicines Act was passed in 1968, which forbade any company to market drugs like this. As I told you earlier, it is an unfortunate truism that it often takes a great disaster for governments to "wake up" from their slumber. This was yet another case of a disaster paving the way for the passing of a law. In our country too, this disaster had its echoes. The Drugs and Cosmetics Act of 1940, which had become archaic, was amended in 1964, mainly because of this disaster. Many other indigenous drugs were brought into its purview, which includes Ayurvedic and Unani drugs. As an aside I may tell you that Thalidomide comes in two enantiomers. While the right-handed molecules had the desirable property of sedation, it were the left-handed molecules which caused the deformities. So if somehow, only the right handed molecules had been used for sedation, there would have been no adverse effects at all!” “Now you are introducing new things. Please tell me what are enantiomers?” “Tarun, certain chemical compounds are mirror images of each other. So although their chemical and even structural formula is same, they are not exactly the same molecules. They are in fact mirror-images of each other. These compounds are called enantiomers. Your right and left palms are good examples of enantiomers. Although they are similar looking, you can't superimpose your one palm over the other. If you look at your right palm in the mirror, it will look like a left palm and vice-versa. If a chemical compound exists in its two enantiomeric forms, they would roughly be equal in number. When the scientists of Chemie Grünenthal manufactured thalidomide in their factories, roughly equal number of both enantiomers were produced. Only the right handed molecules - the so called D forms - were beneficial. The left handed molecules - the so called L forms - caused the defects.” “How very sad! Had they known about this, they would only have manufactured the D forms.” “It appears doubtful to me, because technology to do so did not exist at this time. Although once formed, they could have perhaps separated the two. I may tell you that there are several other drugs, which show the same dilemma. One of the best known is Dihyroxyphenylalanine (DOPA) which is used for a Central Nervous System disorder Parkinsonism. In this disorder, the person trembles and has a staggering gait. This disorder can be treated by DOPA. This too comes in two enantiomers - a D form and an L form. I may tell you here that these forms can be differentiated by a very shrewd test. It you pass a beam of polarized light through them, the D form would shift it to the right and the L to the left. In fact the D form and L form get their names from this property. D stands for Dextrorotatory (or turning to the right) and L stands for Laevorotatory (turning to the left). In the case of DOPA, the L form of the molecules are effective. D forms are not effective, but fortunately they do not cause any deformity too. It still makes far better sense to give just L-Dopa or Levodopa (as some call it) than just plain DOPA, which would contain both forms of the drug, of which the D form would be totally useless. You may be interested to know that in 2001, three scientists received Nobel Prize in chemistry for developing the first ever chiral catalysts [N.B. by the author: The original article appeared in AUGUST 2000 - at a time when these Nobel Prizes had not been awarded, so one would not find this information in the original article. It has been added subsequently]. These are the Japanese Noyori Ryoji (1938 - ) and the American scientists K. Barry Sharpless (1941 - ) and William S. Knowles (1917 - ). It was as late as in 1968, that Knowles produced the first ever chiral catalyst. This was seven years after thalidomide had been banned from everywhere. So as I said earlier, even if scientists would have known about the L forms of thalidomide causing problems, they probably would not have been able to synthesize it preferentially." “Doctor you have talked about chiral catalysts. What exactly are these?” “Tarun, chiral means "handedness". Remember that the art of palmistry - studying hands - is also known as Chiromancy, or Chirosophy! Chiral catalysts can favour a chemical reaction in the direction of a particular enantiomer - literally a left handed or a right handed molecule. Thus if one were to manufacture L-dopa without the help of these chiral catalysts, one would get both D and L forms in roughly equal quantities. But if these chiral catalysts were used, one could manufacture only the useful L-form. These catalysts are thus very helpful in the drug industry.” “Doctor you are amazing. Coming back to our initial topic. How do doctors diagnose ethylene glycol poisoning?” “One of the best points in favour of ethylene glycol poisoning is that the person appears inebriated without accompanying smell of alcohol. Calcium oxalate crystals in the urine are present. I have examined the urine of Ramlal and have found calcium oxalate crystals. The White Blood Count (WBC Count) may rise to 10,000-40,000 per cubic mm, while normally the maximum limit is just about 11,000 per cubic mm. On autopsy, there is extensive destruction of the renal substance. On microscopic examination of kidneys, birefringent crystals of oxalate are seen. I have found all these changes in Ramlal’s body after autopsy. I can now guess what happened yesterday at Ramlal’s house. Shyam was stung at Ramlal’s behavior and wanted to get even with him. He arrived at his house with a bottle of liquor and a can of coolant. This was probably hidden somewhere in his clothes. Shyam was preparing the pegs. After two or three pegs, when Ramlal was sufficiently inebriated, Shyam furtively mixed some quantity of coolant in his alcohol. Ethylene glycol is tasteless, so Ramlal did not know that something had been mixed in his drink. Moreover he was already drunk and was not paying very much attention to him. After giving him two or three more pegs like this, he left for his house. He was quite pleased with himself, as he had thought he had planned a perfect murder. Lo! Here comes the policeman from Shyam’s house and he has recovered the left over bottle of coolant from his house. Shyam does not have a car and would have tough time explaining to the court what this bottle was doing in this house.” “That is very clever of you doctor. Without your clever deduction it would have been impossible to say how Ramlal died and Shyam may have gone scot-free. What are you going to tell me next time?” “Tarun, next time, I would tell you about a very interesting poison - Botulinum Toxin.”