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Forensic Jokes, Puns & Tidbits FORENSIC LIMERICKS 1. The science of Medicine Forensic has applications prolific It's the use of medicine For detection of sin, There's little to do with treatment of the sick 2. There was a woman from a nation, Who had twins and to one's consternation, One was black, the other white, A truly awkward sight, Sure enough, it was superfecundation. (Both of the above composed by Professor Anil Aggrawal) The limericks may not be very elegant, but I composed these to show what can be done with this new genre. Could you contribute more limericks of better quality please? 3. Henceforth the trouble begins For the careless lady who sins her spouse may request the HLA test in case of biovular twins N.B. This limerick appeared in the New England Journal of Medicine Vol. 300, No. 1, Jan 4, 1979 at page 50 in response to an earlier paper Twins with two different fathers identified by HLA by Paul I. Terasaki Ph.D. et al, appearing in the New England Journal of Medicine Vol. 299, No. 11, Sept 14, 1978 at pages 590-592. This is one of the rare examples of a medical limerick appearing in a respectable medical journal. If you are aware of more examples, kindly let me know. Thanks. OTHER LIMERICKS IN SCIENCE During my younger days, it was my hobby to devise science limericks. But since I don't know anything about "metres", they were almost invariably unmetred. Once I sent a whole lot of them to Khushwant Singh, the famous Indian writer, and quite surprisingly he reproduced two of them in the weekly magazine Sunday of 30 August - 5 September 1987, at page 9 (with acknowledgement to me of course). That assured me that at least those two were alright. I am reproducing those two here for the benefit (?) of readers. 1. There was a computer scientist from London Who had with binary digits lots of fun When asked his age Replied the sage "I'm 100001" 2. There was a young prodigy from Sevagram Who was muttering PQR... in his pram Said a guest, "He's precocious" Replied his father, "Yes! These days he is learning electrocardiogram."

Forensic Science Fiction The mystery of the dead infant I had just got up from the bed. It was a nice Sunday morning, and lazily I asked my wife to prepare a cup of coffee for me. Tarun, my son brought me the newspaper, and just when I sank further deep in my bed anticipating a nice sunny Sunday morning, with a cup of coffee in one hand, and the newspaper in the other, the telephone bell rang. “Who is it?”, I asked somewhat impatiently. “Sir, I am the Sub divisional Magistrate of this hill district located about 200 km from your place. We have a very tricky case on our hands. Could you come immediately please?” and then without waiting for my answer, added. “I am sending the vehicle. It is a Fiat car DL 4C A 6600. It will be there in about half an hour. Please be ready with your post-mortem kit.” “Hell”, I thought, “Why in the world did I chose forensic medicine as a career?” To be honest with you, I chose this career because I love the dead. But probably a minor reason was that by choosing it, I would not be getting any emergency calls. The dead hardly call you on Sunday mornings. And yet, here I was getting calls almost all Sundays. Well, that’s life. I was already quite worked up by the time my wife brought me coffee. I quickly gulped it down, and became ready with my post-mortem kit. The car soon arrived at my house, and in about 6 hours took me away to a nice sleepy little hamlet tucked away in the lap of some very huge mountains. The air was so fresh and invigorating, I was glad I came there. The SDM was waiting for me at the office. “Thank you doctor for coming. It’s already 3 pm. Let us first have some lunch and then we would talk”, and quickly he took me inside. He made some motions with his hands to his subordinates and they all swung in action. Soon trays, plates, cups with nice little eatables started pouring in. What he told me over the lunch was this. Sushila was a 27 year old woman married to Dinesh, and both of them had a happy life. They lived about 5 km from where we were sitting. They had a neighbor called Sitaram, with whom they were having a land dispute for almost one generation now. Their (Dinesh and Sitaram’s) fathers had died while the litigation was on, and now Dinesh and Sitaram were getting on with the litigation. Sitaram had a bad reputation in the area, and he had threatened Dinesh many times with dire consequences if he did not relinquish his claim on that controversial piece of land. However since about one year, the two had buried the hatchet, and were meeting each other regularly at least on social occasions such as Diwali, Holi, marriages etc. The case of course was going on in the court as usual. This is not a very unusual occurrence in our country. Land disputes do go on, while people mix together in social occasions. About a week back Sushila gave birth to her first son in a local hospital. When she started having labor pains - at about 4 pm - she was taken to the local hospital, and admitted there. Soon the word spread among the locality and many people gathered at the hospital. Many of them came with sweets. Dinesh’s mother and Sushila’s parents were there to receive them. Sitaram also came to congratulate the young couple. After exchanging some pleasantries most of them melted away. By the time the baby was born - at about 3 am the next day- only Dinesh, Sushila’s father and Sitaram were outside the labor room. All of them distinctly heard the baby’s cries. Dinesh and Sushila’s father became ecstatic and ran outside to phone their friends. Only Sitaram remained there. When they came back after fifteen minutes after telephoning all the relatives they found Sitaram talking with the doctor in somber tones. They were told that the child had been born dead! They could not believe their ears. They had heard the child’s cries with their own ears. This definitely meant that the child had been born alive. How could the doctor play this fast one on them by saying that he had been born dead. Definitely there was something black at the bottom. When the police made enquiries, both Dinesh and Sushila’s father asserted that they had heard the child’s cries standing outside the labor room. Sitaram was also standing along with them, but when he was asked about it, he said he hadn’t heard any such cries, and may be Dinesh and his father-in-law were mistaken. Sometimes you do listen what you want to listen. This now became a two versus one story, and naturally a lot of doubt started whether the baby had actually cried or not. This was important, because if the baby had cried he had been born alive, and somebody - most probably Sitaram - had killed him. And if the baby had not cried, then it was possible that he was a case of a still born child. Many fingers started raising at Sitaram. He did have an old rivalry with Dinesh, and he had a strong motive to harm him. He was alone for as much as 15 minutes outside the delivery room, and the nurse told to the police that for five minutes after the baby was born, there was no one in the delivery room, as they had to rush to the next room for an emergency case. In these five minutes, it was quite easy for Sitaram to enter the room and -say- strangle the child. Sushila was of course too exhausted to note anything. She had probably passed out for some time after delivery. The doctor and nurse were questioned. The doctor was a young man, who had passed his MBBS only a year back, and had taken up this job to pass his time while he studied for his post-graduate entrance examination. The nurse was also very young and inexperienced. They had probably already sensed some medico legal problems and had become very defensive. Both of them asserted that the baby was born dead. As you can very well understand, things had become very complicated by now with some saying the baby was born alive and others saying he was born dead. The only way to solve this puzzle was to order an autopsy. Since in that little hamlet no expert forensic expert was available, the autopsy was entrusted to a young pediatrician named Dr. Harish. I looked at the autopsy report. It was a fairly nice job, considering it was done by a pediatrician. I certainly could not do a pediatric job as nicely as he had done this forensic job being a pediatrician. He had conducted the hydrostatic test and had found it to be positive and in addition had found several semilunar marks around the baby’s neck. As we all know these semilunar marks indicate nail marks and often form on the neck in cases of throttling or manual strangulation. As regards hydrostatic test, I am sure all of us know about it, but just for recapitulation, it is an interesting test which tells us - the forensic pathologists- whether a baby was born alive or not. The premise is that if the baby was born alive, he would have respired - at least once - and this would fill his lungs with air, making their specific gravity less than that of water. If on the other hand, the baby was born dead, he would not have respired and his lungs’ specific gravity would remain more than that of water. So what one does in such cases is just to dissect out the lungs and put them in water. If the lungs float, the test is positive - meaning thereby that the infant was born alive - and if the lungs sink, the test is negative implicating the opposite conclusion. To be sure, the actual test is much more complicated than this, but this is the gist. There are some problems with the test, with many pathologists claiming that it is not an infallible test, but we will leave aside those controversies for the time being. As I told you, the doctor had made a fairly thorough post-mortem. His conclusions were summed up like this: “The baby had been born alive, and survived probably five minutes. The cause of death was asphyxia due to manual strangulation.” This raised a very strong finger of suspicion at SitaRam, and the police arrested him. The basis of arrest was of course the implicating post-mortem report. But SitaRam was a well-connected man. He contacted someone high up in the political hierarchy, and got an order for a repeat post-mortem. And this post-mortem had to be done by a forensic expert of some standing. That is how I came into this picture. My job was of course to conduct the autopsy again, and find out if the earlier findings by Dr. Harish were alright. I must say, this was not an enviable task. First autopsy destroys many organs, and disturbs their natural relationships with one another. A repeat autopsy is at least ten times as difficult as the first one, yet the SDM had reposed his faith in me, and I had to live up to my reputation. The first thing I did was to talk to SitaRam at length. Now after remaining in this specialty for almost 25 years now, I have developed a knack of sensing when a person is speaking the truth. I don’t know how I do it, but I can give you some pointers. When you question a suspect, look straight in his eyes. If his eyes flinch, he might be speaking a lie - otherwise he would look straight at you too. Look at his fingers, and observe any fine tremors there. Look at his Adam’s apple, while he is speaking and look for the very faint quivering there. Touch his hands and see if he has just those tiny traces of sweat on his hands. These little things tell me if the person is speaking the truth. An accomplished liar can consciously control his voluntary nervous system, but can’t control his sympathetics and parasympathetics, and they usually give him away. Above all there is this sixth sense which has developed in me, which tells me if the person is speaking the truth. After talking to Sitaram for about an hour, I was convinced he was not the murderer. He was definitely at loggerheads with Dinesh and Sushila, but he would not go to the extent of killing their new born son. Either the infant had been born dead in the first place, or he had been killed by someone other than Sitaram. There were some difficulties though. First of all, courts don’t act on hunches. They need real proof. I could tell them, I had a knack of knowing a liar, but they would still want scientific proof, and I had to get one. When Dinesh and his father-in-law left the hospital to phone their relatives, their was no one beside the labor room except Sita Ram, so there was no question of someone else killing the new born infant. So I was left with just one option; that the infant was born dead. But what was I to make of the positive hydrostatic test? And furthermore how was going to explain the tell-tale semilunar nail marks on the neck of the infant. That was the main question. Without waiting further, I demanded to see the infant’s body. It was lying in the cold room of the mortuary, and was brought out for me. I looked at him. He was a nice sweet little boy. It was heart-rending to see his chest and abdomen all sewed up (after the first autopsy). I closely examined the so-called nail marks on his neck, and I must say, they were looking quite similar to the usual nail marks that we see day in and day out in cases of manual strangulation. There were no other injuries on the infant’s body. I opened the stitches and examined the internal organs closely. I looked at his lungs, which definitely seemed inflated. I conducted the hydrostatic test again, and it was undoubtedly positive. In addition I conducted some additional tests which the previous doctor had not done. For instance, I also conducted the so-called Wreden’s test (sometimes wrongly called as "Wredin's test"). First suggested by R. Wreden in 1868 (in Otitis media neonatorum), this is a rather dubious test, yet in a case of second post-mortem, it was strongly indicated. If not for anything else, then just for confirmation. For the purposes of recapitulation again, this test relies on the fact that a fetus’s middle ear contains jelly like material till he resides in the womb. When he is born and takes a deep breath, his Eustachian tubes open and air enters through them to the middle ear. So if you find a small bubble in the middle ear, you can be quite sure, the baby was born alive. On the contrary if you find just jelly like material in the middle ear, the baby was most probably born dead. Again this is a highly controversial test, and no pathologist worth his salt performs this test these days. But as I told you earlier, this was a case, where we were leaving no stones unturned. [More information on Wreden's test for the more scientific minded amongst you. In 1873 - five years after the initial report by Wreden - another scientist Wendt reported in Arch. f. Heilkunde that if the infant respired when he was immersed within the amniotic fluid, one could detect even amniotic fluid in the middle ear of such babies. Based on the researches of these two scientists, the test is often known as Wreden-Wendt test, or Wreden-Wendt tympanic cavity test. One may also want to go through the following paper for the details of the test:Jobba G, Sandor T. (1971) Medicolegal evaluation of the Wreden-Wendt tympanic cavity test [Article in German]. Z Rechtsmed 69(3):173-6 Or you may want to click on the following link http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=5170412&dopt=Abstract ]. Wreden’s test also came positive and I was quite depressed. The baby had indeed been born alive. So depressed was I that I came back to my hotel, and tried to sleep. Tried hard as I would, I couldn’t sleep. After sometime, I went out for a walk in the mountain roads. The fresh air invigorated me. After about one hour of aimless stroll, I came back and slept. Probably I kept dreaming of the case. I know this because at 4 am, I suddenly got up. I had probably dreamt something strange. I kept sitting for some time, and then I remembered there was a phenomenon called vagitus vaginalis, which is such a rare phenomenon, that most people take it as a myth. Here we might be dealing with a case of vagitus vaginalis. You might be wondering what this strange term means. Let me explain. In the nineteenth century, there were a number of reports by reputed obstetricians, which stated that a fetus can in fact respire while he is still in the vaginal canal. He can emit a cry in the vaginal canal, while he is being born! This would be heard as a muffled cry by people standing close by, and anyone would swear he had heard the infant cry. There is a still stranger phenomenon known as vagitus uterinus, in which the baby cries while he is still higher up - in the uterus. Well here we probably had a case either of vagitus vaginalis or vagitus uterinus. These babies who utter such a cry either inside the vagina or uterus may be born alive or dead. If born alive, naturally no problem would occur, but if such babies were born dead, they could land the doctor in severe trouble. Relatives standing outside the labor room would invariably have heard the cry and they would hold the doctor responsible for the death of the baby. They would keep asserting the baby was born alive, and died subsequently due to doctor’s negligence. I personally know of many such cases, in which doctors had to face the patients’ ire. The more I thought about it, the more I got convinced that I could convince any court of law about its possibility. I had xerox copies of all those reports of vagitus vaginalis and vagitus uterinus. And if so many reputed obstetricians had seen this phenomenon, certainly this phenomenon was possible in our case too. But what indeed remained to be explained were the strange looking semilunar marks on the baby’s neck. They did look like nail marks, indicating someone had tried to kill him. If he was born dead, why anyone in the world would try to kill him. I could not solve this problem despite thinking deeply about it. Finally I got tired and slept again. Next day I took out the body of the infant again from the cold room and looked closely at his neck. There were these unmistakable nail marks. There was no doubt about that. I was quite nonplussed. Without having the faintest idea of what I was doing, I began examining his abdominal contents. Suddenly I was gripped with excitement. When I looked near the area of his liver, I found that the baby had not just one, but two ligamentum teres. The previous doctor had probably missed this strange finding. And I wouldn’t blame him for that, for he was so inexperienced. Now before you throw up your arms in despair, let me tell you a little bit about this strange structure. In a fetus, originally there are two umbilical veins which take oxygenated blood from the placenta to the fetus. After sometime, the right umbilical vein disintegrates; only the left persists. After birth the baby starts respiring and this umbilical vein becomes quite redundant. Nature has a way of dealing with this new situation. This umbilical vein obliterates and becomes a ligament like structure in about 3-5 days after birth. This ligament like structure is called ligamentum teres. This is a very useful marker for forensic pathologists. By seeing this structure, they can tell how long the child survived after being born. For instance if we see only the umbilical vein, we can say, that the child died within 3-5 days of being born, but if we see a ligament in its place we would be quite sure that the child survived at least 3 days after being born - probably more. Does that meant, the little child survived 3 days after birth? Not in the least. The child’s death immediately after death was so well documented that there was not an iota of doubt about it. It was probably a case of very early disintegration. Such cases do occur once in a while. But what surprised me no end was that he was showing not just one, but two ligamentum teres. To my feeble mind, the only implication was that his right umbilical vein had not obliterated early in his uterine life. It had persisted till birth and only after that it obliterated. Well, I am no anatomist, and did not want to make any further conjectures on it. So I phoned, one of the best anatomists I know of - Professor J.M. Kaul of our own anatomy department. What she told me over the phone was quite surprising to me. She said that in some lower animals, the right umbilical vein does persist till birth. She was not aware of any case where it was seen in humans, but if I had seen one this must be a case of atavism. You might accuse me of throwing one technical term after other, but I can’t help it. I was taking things as they were coming to me. Thankfully I did know something about atavism, so I did not have to bother her more for that. I thanked her profusely and rushed back to mortuary. Atavism is a technical term which comes from the Latin at, meaning above or beyond and avus, meaning a grandfather. Thus Atavism literally means “above a grandfather”. It refers to a reversion or throw-back of an inherited characteristic which has skipped a number of successive generations. To the best of my knowledge, the presence of a cervical rib in a human being is a good example of atavism. Evolutionarily there has been a reduction in the number of ribs, especially in the region of our pectoral and pelvic girdle (to allow for greater freedom of movement), but every once a while we see persons with cervical ribs. These people are very good living examples of atavism. Well, what about this boy. I dissected his neck, and was amazed to see not just one, but two cervical ribs - both on sixth and seventh cervical vertebra. Are you getting the picture now? This boy was showing several primitive characteristics. In other words, he showed many atavistic characteristics. Probably my salvation lay in him showing atavism. What about neck scales? Lower animals like snakes and crocodiles show scales on their necks, while humans do not. Was it possible that his little boy showed another atavistic character in his neck? Was it possible that those little semilunar marks on his neck were not nail marks, but very primitive scales? I could not rule the possibility out, as this boy was showing so many of the atavistic characters. I am no biologist, and I contacted a very prominent biologist - Dr. Lalji Singh of Hyderabad. He told me to send over some of the skin samples from those semilunar marks, so that he could put them to tests. I did exactly that. He examined them in great detail and his reports really astounded me - well! Not so much after what I had been seeing all throughout. Those semilunar marks were not nail marks at all. They were very tiny scales which were probably again a relic from the past. He had histological reports with him to confirm his findings. Those semilunar marks did not show the structure of skin, but that of scales! So this little child indeed showed a number of atavistic characters. I will now tell you what exactly happened. This child cried probably in the vagina, because of which his hydrostatic test - and other tests depending on respiration - came positive. In fact he died somewhere within the birth canal probably because of fetal distress. In addition, he showed a number of atavistic characters, one of which was tiny scales over his neck, which looked exactly like nail marks. These marks stumped not only the young inexperienced Dr. Harish, but even me. I was very happy when the court accepted my findings, and released SitaRam. He came to me and thanked me no end. I was happy I could do justice to that person. Meanwhile, I am told, Dr. Kaul has written a very good paper on atavism, and is going to Berlin to deliver it there. As for Dr. LaljiSingh, he is trying to find the incidence of atavism in Indian children, taking that child as an example. As for me, I am burdened with more dead bodies and more post-mortems. Well, who cares. The dead are after all ones whom I love most!

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JANUARY 2000 ISSUE THE POISON SLEUTHS DEATH BY SUCCINYLCHOLINE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young boy today. What happened to him? Please tell me.” “Good morning Tarun. The name of this 26 year old young boy is Subodh, and he was a post-graduate medical student in a leading medical college of this city. For the last few months, he was in love with a fellow medical student Rita. Recently she had ditched him and had got married to someone else. This had hurt him very much. Actually a few days before her marriage, he had got a hint that she was going to ditch him. So he had gone to her to plead his case. At that time she was reportedly sitting with his fiancée Suresh, who literally pushed him out. There was a minor scuffle too, and Suresh had threatened to kill him, if he ever troubled Rita again. Today morning Subodh did not report at the O.P.D. his fellow doctors got suspicious, and went to his hostel room. There they found his dead body.” “Oh, that is indeed very unfortunate. So do you think that Suresh has carried out his threat?” “Let us get all the facts straight, before we can say anything. The body of Subodh was lying on his charpoy (a charpoy is a popular hand woven bed used in India mostly by villagers). A syringe was inserted in his leg vein. And there were two empty vials of Anectine lying on the floor beside him.” “What is Anectine doctor?” “Tarun, Anectine is the trade name of a very useful drug in medical practice. Its chemical name is succinylcholine, and it is a very useful drug for surgical operations.” “Oh, so obviously Subodh has not died of Succinylcholine. How has he actually died doctor? And do you think he has committed suicide?” “Why can’t he die of succinylcholine Tarun?” “How can a useful drug kill a person doctor? He must have died of something else.” “This is a mistake Tarun. All drugs are poisons in large doses, and many poisons may act as useful drugs in extremely small doses. Some time back I told you the story of a death by Digitalis (See Science Reporter Death By Digitalis (August 1999, Pages 22-24). Now Digitalis as you know is a very useful drug in several heart ailments, and yet it killed when given in more than the required dose. So it is incorrect for you to think that a useful drug can not kill. Now to your other questions. No one knows how he has actually died, and that is indeed why the police has handed over his dead body to me. As far as your conjecture concerning suicide is concerned, he might indeed have committed suicide. The scene certainly appears as if he has committed suicide. Had the room been locked from inside, and a suicide note found, we would have very strongly thought that he has committed a suicide. But neither was the room locked from inside, nor was any suicide note found. The police knows that Suresh had threatened to kill him some days back. Suresh - like Subodh - is a medical student and knows about drugs like succinylcholine. So it is quite clear that Suresh is the prime suspect with police. In fact, Subodh’s parents have lodged an FIR with the police, naming Suresh as the possible killer.” “Doctor, is succinylcholine very commonly used as a homicidal poison?” “No, not at all. In fact, I am aware of only one instance, when a person has been convicted of murder by succinylcholine. In 1983, a Texas-licensed vocational nurse Genene Jones was tried on a single charge of murder, even though those who had worked with her believed she had been responsible for the deaths of more than a dozen children under her care. In her first 31 days of work for a child specialist, nine incidents of respiratory failure involving eight patients occurred before Jones was finally arrested. She was finally sentenced to 99 years for the murder of one patient and 60 years for the attempted murder of a second. So succinylcholine can definitely be used for homicide, although its use is very rare. But before we come to any conclusions, we have to first prove that Subodh indeed died of succinylcholine poisoning.” “How are you going to prove that doctor?” “Tarun, to do that you must know a little bit about succinylcholine and how it actually kills. Succinylcholine actually mimics a natural chemical within the body, acetylcholine. The function of acetylcholine is to make a muscle contract. Whenever we make any muscular movement- be it walking, running, climbing, even laughing and crying - some muscle has to contract, and in most of the cases, it is the acetylcholine, which makes the muscle contract. First of all, a nerve impulse goes from the brain to the required muscle. Then a tiny amount of acetylcholine is liberated at neuro-muscular junction..” “Doctor, what is neuro-muscular junction?” “Tarun, it is technical name of the junction of that nerve with the muscle. It is also known as the myoneural junction. So I was telling you about acetylcholine, being released at the neuro-muscular junction. This small amount of acetylcholine starts a train of physical and chemical events at that junction, which ultimately leads to contraction of that muscle. Whole of this procedure takes a fraction of a second only. Of course, once acetylcholine has succeeded in making the muscle contract, it must be removed from the junction. For if it is not removed, the muscle would remain in a contracted position. And this can be very disastrous indeed. For instance, when the heart contracts, it is due to acetylcholine making the heart muscle contract. But if this acetylcholine could not be removed, the heart muscle would remain in a contracted state, and no useful purpose would be served. In fact, the person would die within minutes.” “Oh, I see. How does the body remove this acetylcholine then doctor?” “There is another chemical at the junction- acetyl cholinesterase. It destroys the acetylcholine, after it has done its work. Succinylcholine may be regarded as a sister chemical to acetylcholine. Earlier I was telling you that succinylcholine is widely used in surgery. Now you can understand why. In most abdominal operations, the doctors want that the abdominal muscles remain in a relaxed state. If the muscle is relaxed, doctors can make incisions easily, and make several manipulations in the abdomen easily. Succinylcholine is used to relax the abdominal muscles….” “Just a minute doctor. You said that acetylcholine makes the muscles contract, and also that succinylcholine is a sister chemical to acetylcholine. Doesn’t it mean that succinylcholine should also contract the abdominal muscles?” “That is an interesting question, Tarun. Actually succinylcholine belongs to a class of muscle relaxants, known as depolarizers. Let me first tell you the meaning of this new term. Earlier I told you that acetylcholine starts a train of physical and chemical events at the neuro-muscular junction, which ultimately leads to contraction of muscle. One of these events is the reversal of the electric charge normally found on the muscle fibres. In other words, the muscle is depolarized. Since succinylcholine depolarizes the muscle, it is known as a depolarizer or a depolarizing agent. There are several other depolarizing agents. One of these is decamethonium. It also acts very much like succinylcholine. All depolarizing agents, including succinylcholine, initially do act much like acetylcholine, i.e. they cause the muscle to contract. But since doctors give succinylcholine continuously in an intravenous drip, it keeps contracting the muscles. Finally a stage comes, when the muscle is exhausted, i.e. it can no more work. In other words it gets paralyzed. That is why despite acting very much like acetylcholine, succinylcholine paralyses the muscles, while acetylcholine makes the muscles contract. When an animal is injected with succinylcholine, the animal indeed shows repeated contractual movements of the muscles. These repetitive muscular movements have been given the name fasciculations. After a few minutes of fasciculations, the muscles get tired, and paralysis sets in.” “Doctor, is succinylcholine easily available in the market?” “Oh, yes. Succinylcholine is available as injections of Anectine. It is marketed also as a sterile powder. Injections are available in three different concentrations- 20 mg/ml, 50 mg/ml and 100 mg/ml. Now that you have understood some basic facts about succinylcholine, I can tell you, how this drug kills. It repeatedly stimulates and finally paralyses, respiratory muscles. This causes respiratory failure and death. The usual dose in surgical operations is 20 mg, but more can be given too. It is interesting to note that this succinylcholine not only relaxes abdominal muscles, but also respiratory muscles, so the anesthetists maintain the respiration of the patient artificially throughout the operation. If however the same dose is injected by a person for suicidal purposes, or by someone with homicidal intentions, it would easily kill, because there is no one to support the respiration artificially. In other words, the same dose helps a surgeon in operation, and the very same dose would kill a person, if it were given with homicidal intentions.” “Doctor how are we going to prove that Subodh indeed died of succinylcholine poisoning?” “Tarun, in the body, succinylcholine is broken down by enzymes in human plasma, especially by one known as pseudocholinesterase, into succinic acid and nitrogen containing choline. Both of these are normal components of human tissues. That is why it is indeed difficult to say by chemical examination of Subodh’s viscera alone that he died of succinylcholine poisoning. However, I have found the lungs to be swollen and loaded with water. In technical terms we say that the lungs are oedematous. This is a sign that Subodh’s respiration was compromised just before his death. If we couple this finding with other findings at the scene of his death, it becomes very plain and simple that Subodh has died of succinylcholine poisoning. Regarding the manner of death, I do not think, Suresh has injected this drug into Subodh’s body. Subodh would simply not allowed him to do that. It appears that Subodh has committed suicide because of failure in love.” “Doctor, had someone caught him during the act, or just after it, could he have been saved? In other words, what is the antidote of succinylcholine?” “Tarun, unfortunately there is no antidote to succinylcholine. The only thing one could have done is to give artificial respiration as the respiration is compromised in succinylcholine poisoning.” "This was a most interesting discussion doctor. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison - Gold."

SCIENCE IN CRIME DETECTION-15 SPEECH SPECTOGRAMS CATCH CRIMINALS This time I tell you about an exciting new technique, by which we can recognize a person from his speech. This technique is useful in cases like abduction, when kidnapper asks for ransom over the telephone. Can a person be positively recognized from his voice? You must have noticed that you can readily recognize a person from his voice. Even when you are sitting engrossed in your work and someone calls you from the back, you can readily recognize his voice. This is because, the voice‑generating system in each individual is different. In fig(1) you can see the various structures of the mouth which are involved in speech production such as palate, tongue, teeth, lips, cheeks, nasal aperture etc. These structures are different in different individuals and this is the basis of speech recognition. For a long time scientists were thinking of having a kind of "photographs" of human speech. It is always easier and simpler to compare two photographs, than to compare two sounds. Moreover, if a person has not heard the voice of a culprit for a long time, and he was asked to recognize that culprit again by his voice after a period of, say ten years, he might be at a loss to recognize him. If there was no way of converting the sound to a photograph, a police officer would face this problem very often. To overcome this handicap, in 1963, as scientist Lawrence G.Kersta, developed a unique machine in his laboratory in Somerville, New Jersey. This machine is known as the speech spectrograph and is shown Fig(2). The speech spectrograph converts a human speech into various graphs which can be easily compared. Fig 3 , shows the spectrograms (the voice graphs) of male and female voice. Once can easily spot the difference between the two. Fig 4 , shows the spectrograms or voice prints of 5 people saying a single word"you". there are 6 spectrograms which show clearly that one person has said" you" two times. Try to visualize the photograph carefully and try to find out which two voice prints look similar. These are the words uttered by the same person. With this background in mind, it is now easier to explain, how the machine helps in police investigation. Suppose a kidnapper has kidnapped a child, and then asks for ransom over the phone. The police scientist can record his voce and make speech spectrograms from that recorded voice, by the help of the spectrograph. The voice prints are then stored in the police prints are then stored in the police records for future reference. In future whenever a suspect is arrested, his voice prints can be made again and matched with that of the telephone caller. If the voice prints match perfectly, then the suspect is indeed the real kidnapper, otherwise not. The same technique can he used in several other situations. Sometimes people phone young females just for fun sake and speak obscene languages over the phone. These are basically harmless people, but their repeated malicious calls may be a nuisance. Till now the only way to tackle with such malicious callers was to keep the phone off the hook or to keep the receiver off the cradle. But now the affected party can call the police and ask them to make voice prints of such callers. These voice prints are permanent records in the files of the police and can be used anytime later when a suspect is arrested. Several countries are using this new technique now regularly to investigate crime.. Michigan State Police for example have been using this method with success since 1968. Some very famous crimes have been solved by this technique. This account should give you an idea of how deeply modern science has affected crime investigation. This is a new field of crime investigation. This is a new field of crime investigation and more research is needed before we can say the final word on it.

SCIENCE IN CRIME DETECTION-9 TESTING FOR HOMOSEXUALITY Two years back, I was involved in a most bizarre case. A young boy of eight, Kalu was once coming home from school. The time was around 2.00 p.m. Two sturdy looking persons came to him and lured him away with a chocolate. They took him to his house and tried to have intercourse with him tried to have intercourse with him through anus. When the boy protested, they offered him a ten‑rupee not for this "little job". He was told that he would not be hurt. Kalu was a poor boy and a sum of Rs.10/‑ was big amount for him. He could purchase many toys with that amount, which he had always wanted to. Although he did not like the idea of someone introducing his 'organ' in to his anus, yet the lure of the money let him allow that. During the act, however, he suffered from great pain and even bled slightly. His gait became painful and wobbling after that. When his parents asked him why he was walking in a peculiar way, he replied cautiously that he had fallen down and hurt himself. The parents paid no further attention to him. However things did not stop there. The next week, the two youths met Kalu and suggested the same bargain. The boy hesitated a little, but then decided that he could do with another ten rupee note! From then on, this became quite regular. Those two youths would regularly have anal intercourse with Kalu‑almost twice every week‑and would each time give him ten rupees. The affair went on for quite a number of weeks. Then trouble started when the boy developed some ulcers around his anus. These ulcers were discharging pus. His parents thought that the boy had caught some infection and so brought him to me. When I examined him I found that he was suffering from syphilis‑a venereal disease. Such a young boy could catch syphilis in only one way‑through anal intercourse. I explained the situation to his parents and at the same time informed the police also, because it had become a medico‑legal case. Kalu's parents lost their temper and started beating Kalu. Kalu then revealed that Jagga and Kaka, two youths of his area had been using him in this way. Before we go on with our story further, a few words about homosexuality or 'coitus through anus' would be in order. Intercourse through anus is known as sodomy or buggery. An adult male can perform anal intercourse on an adult male, adult female or on a young child(of either sex), as in Kalu's case. When homosexuality is done on an adult male, the practice is known as homosexual sodomy. When a male commits anal intercourse on a female, it is known as heterosexual sodomy. When a child is used, the practice is known as paederasty. This child is usually known as a catamite. The person who performs the act is known as the active agent and the one on whom the act is performed is known as the passive agent. Sometimes two adult males act as active and passive agents alternately. More commonly however, a passive agent always remains a passive agent. n our country, many people regularly earn their livelihood by acting as passive agents and charging a fat fee from their customers. These are known as male prostitutes. Several hijrahs whom are all familiar with, mostly act a passive agents,. Several boys like Kalu agree to become passive agents for the sake of money only. In our country, anal intercourse is a crime. According to section 377 of I.P.C., if it can be proved in anal intercourse, he can be sent to jail for 10 years. So Jagga and Kaka had every reason to deny their involvement in anal intercourse with Kalu. It was not merely a matter of shame, but a criminal act. As we shall see later, they did deny their involvement and it remained for me to prove conclusively that they had indeed used Kalu as a passive agent. An interesting thing is that if a passive agent consents for anal intercourse, even then the he can be incriminated under Section 377 of I.P.C. In our case, Kalu had consented for the act, but since he was only eight years old, his consent was not valid and he could not be incriminated. According to our law, any child under 16 years of age can not understand the nature of such acts and thus his consent for such act is not legal. Another interesting thing is that if a person performs anal intercourse on his own wife, even then he is a culprit under section 377 I.P.C. If his wife consents for such an act, then even she is a culprit and both can be sent to jail for 10 years. A wife can refuse her husband who demands anal intercourse from her. Interestingly she can not legally refuse normal vaginal intercourse to her husband even if she is not in "mood", but she can and must refuse anal intercourse, because if she does not refuse anal intercourse, she also becomes a culprit. If a wife refuses normal vaginal intercourse with her husband and her husband forcibly commits such an intercourse with her, she can not bring him before thee law, but the same is not true of anal intercourse. Not only can she send him to jail for 10 years (if she wants to), but is also entitled to divorce him In fact if a male commits anal intercourse on any man, child or woman, the wife is entitled to divorce him. So much regarding some of the legal points regarding homosexuality. When Jagga and Kaka were interrogated by the police regarding their criminals act, they denied any such involvement. So the burden of proving their involvement fell on me. Whenever a passive agent is brought to us, we examine mainly his anus which tells us several tell tale signs. The person is examined in a knee‑elbow position (Fig.1) . In this position the person rests on his knees and elbows. This position is chosen because it exposes the anus in a most prominent way. I first 'inserted a cotton swab (just like Johnson's buds; but with longer handle) into Kalu's anus. The idea was that if any seminal fluid was present in the anal canal, it would be absorbed by the cotton. It could then be tested for the presence of seminal fluid. the presence of seminal fluid in the anal canal confirms that buggery has been done on the passive agent. One of the most common preliminary tests to confirm semen is the Florence test. In this test, we prepare an extract of the suspected, seminal fluid from the anus and mix it with the Florence reagent. If the suspected fluid is semen, then dark brown needle‑shaped crystals are formed (see figure 3) Formation of these crystals confirms the presence of semen. We also try to look at the extract under the microscope. The presence of small tadpole‑like sperm cells confirms the presence of semen. We also see the underwear of the active and passive agents under a special light, the ultraviolet light. If seminal stains are present on the underwear, they begin to glow brightly. The examination of anus also tells several things. Figure 2 shows three main findings in and around the anus. For the purpose of clarify, anal opening is shown slightly enlarged. An important is tearing of the skin around the anus. this is known as fissure. these fissures appear because of the introduction of large‑sized male organ in relatively narrow anal canal. Second important thing is the laxity of the anal sphincter. Anal sphincter is a circular muscle which acts much like a highly elastic rubber band (Figure 3) . It actually checks the faecal matter from coming out involuntarily. But when male organ is repeatedly introduced in the anal canal, as during buggery, this sphincter becomes lax and the anus starts gaping. The third important sign is the smoothness of the covering of the anal canal. If we dilate the anus of a normal person and look inside, we find that the covering inside is much like an orange peel, i.e., rugged and rough. But repeated acts of penis insertion smoothers out the ruggedness of the covering. These three signs were quite suggestive that the boy was being used as a catamite. Interestingly, when I subjected the swab taken from Kaka's rectum to Florence test, it came positive for seminal fluid. His anus also showed all the three classical signs. The lawyers of Jagga and Kaka could not refute this hardcore medical evidence in the court. The court admitted my evidence and sentenced both of them to ten years of rigorous imprisonment.

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE NOVEMBER 1999 ISSUE THE POISON SLEUTHS DEATH BY CICUTOXIN -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a middle aged man today. What happened to him? Please tell me.” “Good morning Tarun. The name of this man is Radhey and he is about 54 years old. He was a carpenter by profession and had been in good health till yesterday. Yesterday morning he went to catch some fish in a nearby lake, along with his friend Shyam. Both of them were very friendly. While they were fishing, a person by the name of Lal came there and offered some sweet potatoes to them. Sweet potatoes as you perhaps know are known as ShakkarKandi in Hindustani. Both of them ate some of it. Shyam however spat out after one bite, because he thought it was not tasting how it should be. Radhey took some lusty bites from it, because he was hungry, and he liked its taste too. Half an hour after eating the plant, Radhey felt nauseated and dizzy and had stomach pains. Following this, he suddenly stiffened, fell on the ground unconscious, and made gross, irregular movements of his arms and legs. Shyam was alright by this time.” “Oh, from the story it appears to me, that Lal had given Radhey some poison mixed in sweet potatoes.” “Yeah, it sure does. The police has investigated into the background of Lal, and they have found that Lal held some grudge against Radhey. He wanted to settle an old score with him. So it does appear that Lal had a motive to give him some poison. The question is whether we can prove he gave him some poison or not. According to the only eye witness available - Shyam - the only thing Lal gave to Radhey was sweet potatoes. And sweet potatoes are not poisonous. So the police is going to have a tough time in the court proving anything against Lal. Sure enough they are banking heavily on my investigation.” “So what have you found doctor?” “Let me complete my story first. About one and a half hour after eating the sweet potatoes, Radhey was admitted to a hospital emergency room. On the way to the hospital, he was reported to have had four convulsions. I have asked the doctors who treated Radhey, about his condition when they first saw him. They tell me that when he was brought to them - at about 10 am yesterday - he was comatosed, and was bluish all over. This bluishness is known as cyanosis in medical terminology.” “Oh, that is terrible!” “Yes. He was not responding to any painful stimuli, which means he was really in a deep coma. His blood pressure was normal, but his pulse was more than twice the normal- about 150 per minute. The normal rate as you know is about 72 per minute. His breathing was stertorous. He was perspiring extensively, drooling saliva from his mouth, and his parotid glands were markedly swollen. He alternately clenched and ground his teeth and made chewing movements. His tongue was bleeding from a left sided laceration. His arms and legs showed intermittent, coarse, uncoordinated, and restless movements. He had extreme but intermittent muscle spasms, in particular of the muscles of shoulder and neck, causing throwing back of the neck. The pupils of his eyes were markedly constricted. In fact so constricted were they, that the doctors told me they were like pin points. You know that normally the pupils have a diameter of about 4mm. In this case, they were smaller than half a mm. His eyes were red. The eyeballs protruded somewhat.” “Oh, Radhey must surely have died dreadfully. What did the doctors diagnose?” “They couldn’t know what had befallen Radhey. They gave some conservative treatment, but Radhey’s condition worsened and he expired yesterday night at about 10 pm, about 14 hours after having ingested those mysterious ‘sweet potatoes’.” “Doctor, how do you think Radhey must have died? I think Lal injected some poison in those sweet potatoes.” “He probably could have done that. But by listening to the history of this case, and after talking to the doctors, I can only think of one poison.” “What is that poison doctor. Please tell me. I am getting curious.” “Tarun, the symptoms are so peculiar that there could only have been one poison- Water hemlock.” “What? Water hemlock? Never heard of it as a poison. Could you tell me more about it please?” “Tarun, Water Hemlock is a member of the genus Cicuta, of the Umbelliferae family of plants. There are nine subspecies of Cicuta, and all are very poisonous. Cicuta virosa is the common European water hemlock, and Cicuta maculata and Cicuta douglasii are the varieties found in North America. These varieties are found in India also. Common eponyms for Cicuta are cowbane, five-finger root, snake weed, wild carrot, dead man’s fingers, poison parsnip, wild parsnip, beaver poison, muskrat weed, spotted hemlock, spotted cowbane, musquash root, false parsley, fever root, mockeel root, wild dill, spotted parsley and carotte à moreau. They are found in marshy sloughs and meadows and on the banks of streams. Cicuta plants are difficult plants to identify, which may explain why Radhey mistook them for sweet potatoes. In fact, they have been mistaken for many diverse edible plants such as artichokes, celery, sweet potatoes, sweet anise, and wild parsnip. Cicuta plants are difficult to identify in the early spring, when only the fleshy swollen roots, particularly toxic at this time, are present. Later in the year, the roots are less poisonous, but the leaves and stem then contain sufficient poison to prove fatal if ingested.” “Oh, I see. What is the poisonous substance present in these plants doctor?” “Cicutoxin. Chemically, it is a highly unsaturated higher alcohol. Its formula -if you care- is: HOCH₂ (CH₂)₂ (C≡C)₂ (CH=CH)₃ CH(OH)CH₂CH₂CH₃ There is another poison in these plants, and that is Oenanthotoxin. This is found in Cicuta virosa, and is actually an isomer of cicutoxin. It was first isolated by a scientist Boehm in 1876 and was crystallized by Clarke in 1949.” “Doctor, how do these poisons actually kill the person?” “Tarun, Cicutoxin belongs to a category of poisons known as cholinergic poisons. This name comes from a natural substance found in the nerve endings, acetylcholine. You may be surprised to know that although acetylcholine is normally found in nerve endings - in fact it is essential for muscle contraction - an excess of this substance can prove dangerous to human body. Many insecticides such as organophosphorus compounds also show cholinergic effects and prove poisonous because of that.” “Oh, I see. Please tell me more about these poisons doctor.” “Cholinergic poisons exhibit two main groups of symptoms. One are called muscarinic effects, because they resemble the symptoms caused by eating a poisonous mushroom Amanita muscaria. These symptoms include salivation, perspiration and constriction of pupils. In fact, the moment I heard these symptoms from the doctor, coupled with the information that Radhey had been given “sweet potatoes” by a potential foe, I came to the conclusion that he had been given the root of some plant of the Cicuta species. The second group of symptoms is called the nicotinic effects, because they include symptoms caused by nicotine, a very poisonous alkaloid found in tobacco. Main among these symptoms are muscle twitchings and convulsions.” “Doctor, we have all the circumstantial evidence that Lal gave some poisonous roots to Radhey, but how are you conclusively going to prove in the court that Lal indeed gave him this substance?” “Tarun, I have taken the stomach contents of Radhey and have done a chemical test on that. They have proved positive for Cicutoxin and Oenanthotoxin. This surely means he has been given Cicuta roots by Lal. I did not stop at that. I specifically asked the police to raid Lal’s house. They raided and found many more such roots. Here they are, and any botanist can tell to the court that they are roots of Cicuta plants. Do we need any more proof than that?” "Surely not doctor. That was very clever of you doctor. Without your clever deduction - especially your noticing the peculiar symptoms of Radhey at the time of his death, and your sound knowledge of botany- everybody would have thought he died of some mysterious natural disease. This was a most interesting discussion doctor. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- Brodifacoum."

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE MARCH 1998 ISSUE THE POISON SLEUTHS DEATH BY COMMON SALT -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a very young female infant today. What happened to her? Please tell me." "Good morning Tarun. The name of this 6 month old tiny girl is Babli. When she was born, her mother died due to some obstetric complication. Her father Ramdev soon remarried a nubile young girl Rekha. Before marriage she had promised that she would look after Babli well, but after marriage she often showed frank animosity towards this girl. She would not look after her well and would often not even feed her properly.." "Oh, so she probably starved her to death?" "Don't jump to conclusions Tarun. Look at her body. She doesn't look starved. An infant who dies of starvation looks just like a bag of bones. There is no fat in his or her body. But this girl is looking fairly well fed. What I was going to tell you is that Babli's grandmother Shanti Devi, i.e. Ramdev's mother, is still alive. She was not in favor of Ramdev getting married to Rekha in the first place. She probably knew that Rekha was not of good nature. Rekha was undoubtedly not feeding her well, but Shanti would always make up for her, giving her feeds in time. In fact that is why starvation was never a problem for Babli." "Then how did Babli die?" "Babli died of some respiratory disorder. At least that is what her physician told me just now. I will tell you what happened yesterday. Till yesterday morning, Babli was fine. Ramdev left for work in the morning at 8. As usual Rekha started seeing TV just after that, completely ignoring Babli. Seeing that it was her feeding time, Shanti prepared her feed, and filled her milk bottle with that. Just then a neighbor came to meet her, and she went to the drawing room to attend her, leaving the bottle in the kitchen. For half an hour they discussed about some religious programme they were going to attend that evening. After the guest left, Shanti went back to the kitchen, picked up the bottle and gave the feed to Babli. About half an hour later, Babli, who had consumed only about half the bottle by that time, started showing some strange symptoms. She started crying. It appeared as if she was irritable. She vomited twice. Shanti tells me that she had convulsions and muscular twitchings, fluttering of eyelids and of facial muscles. She displayed avid thirst. Shanti knows this because when she gave her water, she would feel a little relaxed, but after some time she would start crying again. But what was most prominent was that she was not breathing well. She had extreme difficulty in respiration. Shanti called Rekha for help, but she kept on seeing TV. Then Shanti phoned her son Ramdev, who immediately got in touch with their family doctor on phone. Dr. Saxena, the family doctor, arrived within 15 minutes, and found that the child was in real bad shape. Ramdev also reached home soon after. Dr. Saxena injected some medicines for respiratory distress, but although the injections seemed to help initially, they weren't of any lasting help. The doctor couldn't really understand what had happened to her. He thought that probably it was an attack of asthma. But what was most confusing was that Babli never displayed this symptom before. They were preparing to shift her to some big hospital for diagnosis and treatment, but before arrangements could be made, Babli died." "Oh, I see. So Babli's body has been brought to you to let them know how she really died?" "Yes, that's right. Actually Dr. Saxena was quite prepared to give the cause of death as asthma, but Shanti Devi immediately raised doubts. She has alleged that while her guest came to meet her, Rekha went to kitchen and mixed some poison in her feed. That is why Babli started having those strange symptoms immediately after having that feed. Rekha, of course, vehemently denied this, and Ramdev too refused to believe her mother, but she wouldn't listen to anyone. She phoned police immediately and called them to their house. The police ransacked the whole house and even searched all Rekha's belongings, but they couldn't find any poison anywhere in the house. That is what is lending weight to Dr. Saxena's theory that Babli indeed died of asthma. Every one including the police is thinking that Shanti Devi is making all this fuss, because she didn't like Rekha in the first place." "Yeah, that looks likely to me as well. So what are you going to do now?" "Tarun, since the matter has reached the police, Dr. Saxena preferred not to give cause of death and leave that to me. The body has been brought to me for post-mortem so that I could comment upon the cause of death." "How do you think Babli died?" "Tarun, the symptoms that Babli displayed surely point towards some respiratory trouble. But the symptoms also point towards a very unusual poison, a poison no one can ever think of. And that is why I have to be extra careful. You have got to remember, that I have a reputation as a poison sleuth, and so I can not afford to leave out even a remote possibility as far as administration of poison is concerned. "Come on doctor. No poison was ever found in the possession of Rekha. Not even that, there was no poison in the whole house. How could anyone administer any poison to Babli?" "Yeah, that sounds very convincing to the police, and that's why they think Shanti Devi is a nut. But I don't think so. I know of a poison which produces exactly the same symptoms as displayed by Babli..." "Please don't talk in riddles doctor. Explain everything to me in clear terms." "Yeah sure. To test my theory, I took some of the stomach contents of Babli and subjected them to chemical analysis. Not to my great surprise, they have shown very high concentrations of salt. Then I took Babli's blood and examined it chemically too. And again it showed very high levels of sodium. I am inclined to think that Babli has been killed with ...." "With what?" "With common salt!" "Common salt? You must be joking doctor. How can anyone be killed with common salt. This is what all of us take daily in our food. Well my father is so fond of common salt he always puts an extra teaspoonful of common salt in his dal." "Yeah, this is what is not known to most people. Common salt is a deadly poison. The only difference between this and other commonly known poisons is that one has to administer rather large quantities to kill with it. One or two teaspoonfuls of salt would not kill an adult but can easily kill a 6 month old baby. Come to think of it, even an adult can be killed with common salt. Only he would have to be fed larger quantities. About 40 teaspoons of common salt would kill an adult human being too." "Well the information is getting interesting. Why don't we begin from the beginning doctor?" "Tarun, before you start visualizing it as a villain, I must hasten to add that there is no doubt that common salt or sodium chloride (NaCl) is indeed essential to all life. It is the basic milieu of mammals. It occurs as colorless cubic crystals or as white crystalline powder. When salt is administered in larger quantities than required, it can cause death too. One teaspoonful of salt weighs about 5 gms. Normal uptake by adults is about 5 to 15 g daily or about 1-3 teaspoonfuls. Children consume less. Salt is even necessary for normal growth in children. The sodium needed for growth is 0.5 mEq/kg from birth to 3 months of age, which decreases to 0.1 mEq/kg at 6 months. The average content of sodium in human milk is 7 mEq/L and that in cow milk is 21 mEq/L ..." "Doctor, you started your answer telling me weights in grams, but suddely you have switched to milliEquivalents. I don't really understand the concept of milliEquivalent so well. And why should we talk in milliEquivalents, when we can talk equally well in grams?" "Tarun, in ordinary day-to-day life, it is useful and convenient to talk in grams and kilograms, but chemists and biochemists often find it easier to talk in terms of equivalent weights because of several reasons. You would surely agree that chemists are mainly interested in chemical combinations, and Equivalent weights are actually measures of the characteristic proportions in which given elements combine. For this reason, this term is also often known as Combining weight. Equivalent weights can be used for elements as well as for compounds. In plain and simple words, they are the measure of the combining capacity of a substance with other chemical substances. Well, even if after this, you are feeling inconvenient with equivalent weights, let me add that 1 mEq of sodium equals 23 mg and that of salt equals 58.5 mg. I would also like to tell you that 1 milliequivalent would be equal to 1/1000 Equivalent weight. Now when I say that the sodium needed for growth is 0.5 mEq/kg from birth to 3 months of age, I simply mean that for every kg of baby's weight, 0.5 mEq of sodium is needed. Thus if the infant weighed, say, 4 kg, he would need 4x0.5 or about 2 mEq of sodium. Since 1 mEq of sodium is 23 mg, it would mean that the infant would need about 46 mg of sodium daily. This much sodium would be available from about 117 mg of salt. Thus in effect, a baby from birth to 3 months needs about 117 mg of salt. Similarly you can convert other values which I told you earlier in grams. I told you the sodium contents of human milk, because this is the only food available to young babies." "Oh, I see. Doctor, you were saying that 40 teaspoons of salt would kill even an adult?" "Yes Tarun. The toxic oral dose of salt is 0.5 to 1.0 gm/kg. For a 70 kg man this amounts to about 35-70 gm. That means that if an adult consumes about 70 g of salt (or about 14 teaspoons), he would be severely poisoned. The estimated fatal amount, i.e. one that would kill is about 1 to 3 gm/kg. This amounts to about 70-210 gm (or about 40 teaspoonfuls) of salt for a 70 kg man." "Oh, that is interesting. Has salt been used to kill people before?" "Tarun, interestingly the Chinese used saturated salt solution for suicide. Salt intoxication and death have occurred when it is used to induce vomiting." "Why would one want to vomit anyway?" "When somebody has consumed some poison, it is imperative to remove as much poison from his stomach as possible. One of the best ways to do this is to make the person vomit. It has been known from ancient times, that a strong solution of common salt induces vomiting, and that is why for centuries, it was a favorite method of doctors to induce vomiting in poisoned patients. But it is known now that saturated solution of salt itself can cause salt poisoning, so it is rarely used these days." "Oh, I see. So you are suggesting that Rekha mixed salt in Babli's feed when Shanti was talking to her neighbor in the drawing room." "Babli's stomach contents, and her blood analysis definitely tells me that salt has been administered to her. I have examined her brain tissue under the microscope too, and I have found that the capillaries of her brain are damaged. They are full of blood, and there are innumerable bleeding points - technically known as hemorrhages- in her brain. There is bleeding underneath one of the coverings of the brain. We call it subarachnoid bleeding, because it occurs underneath the covering known as arachnoid mater. Many venous channels of her brain - technically known as dural sinuses- are blocked. All these findings are strongly in favor of salt poisoning. I have no doubt that someone had indeed mixed salt in her feed. To tell you the truth now, I surreptitiously picked up the milk bottle from Ramdev's house and have analyzed it for salt. It showed as much as 11 g of salt and it was only half full. It means that the full bottle must have contained about 22 g of salt. In other words, Rekha must have put about 4 teaspoonfuls of salt in Babli's bottle when Shanti was talking to her neighbor. There was no other person in the house at that time, and no one except Rekha could have done that." "Rekha indeed is a wicked woman. It is surprising she knew that salt can kill." "I have enquired about Rekha's background. She studied biochemistry in college, although she dropped out of college later. Surely when she was studying biochemistry she must have learnt that salt is a poison and can be used to kill infants. It is indeed a rather safe poison, because you don't need to buy anything. It is available right at everyone's home. And the police won't suspect you either, because they won't find any poison....any traditional poison, I mean. Come let us tell the police that Babli didn't die of asthma. It is Rekha who has added salt to Babli's feed to kill her." "Oh, how very clever of you doctor. This was a most interesting discussion. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- iodine"

SCIENCE IN CRIME DETECTION-4 WAS SHE ACTUALLY RAPED ? Sexual crimes are on the increase these days. Many times we are asked to examine girls and young women- both alive and dead- who have been sexually molested. The questions which the police wants to ask us are many. One of the questions which is invariably asked is whether the woman has been raped or not. It might seem surprising to many here, why the police wants to ask this question. After all, if a woman is asserting that she has been raped then she must have been. Unfortunately this is not true in all cases. Many times women falsely accuse innocent men of having raped them. In such cases it becomes very important for medical personnel to thoroughly examine the victims and tell the police whether she has been raped or not. To determine the answer to this question, the doctor relies very heavily on examination of female genitalia and it would be pertinent to have a quick review of the structures present there. Fig 1 shows the genitalia of a female who has recently had a sexual intercourse. On the top one can see the pubic hair and at the bottom is anus. In between are structures which are collectively known as vulva. Two main openings can be seen. The upper one is urethra through which urine come out. The lower one is the vaginal opening. Intercourse takes place through this opening. Menstrual blood comes out of this opening too. Both these openings are covered by two very thick fleshy lips called labium majus . Clitoris, a very sensitive, pea sized organ lies at the top, between the folds of the labium majus. The vaginal opening is covered in the virgins by a thin delicate membrane- the hymen. It is very thin and delicate and ruptures on sexual intercourse. The first thing that we do is to look whether the hymen is intact or not. If the hymen is intact, the presumption is that the female is telling a lie and trying to implicate the person falsely. In the diagram 1, the hymen is showing a tear at 5 O' clock position. By referring to figure 2, you can know why this tear is called to be at 5 O' clock position. Forcible intercourse also causes injuries to vestibule, an area lying between urethra and vagina (see fig 1) . Injuries may also occur to fourchette and perineum. These are very strong indications that the woman has been raped. Even married women, who are used to sexual intercourse by their husbands don't show rupture of fourchette, perineum or vestibule. Sometimes the walls of the vagina may be so severely torn that they may reach the anus. This is a very severe injury and may even cause death. This is a certain sign of forcible rape (fig 3) . Most people who commit rape are of low socio-economic status and suffer from multifarious venereal diseases. During intercourse they transmit these diseases to their victims. A careful examination of the victim for the signs of disease is also very helpful in estimating whether rape has been done or not. This is a very valuable pointer to us. Interestingly, this can happen the other way round too. An infected woman may give the disease to her attacker, and can thus punish him in more ways than one! She not only gives him a nasty disease, but if the same disease is found in the accused, as that in the woman, it may be a strong indication that he really assaulted the female. We also introduce a cotton swab deep in the vagina (fig 4) and take out the semen from the vagina. In an unmarried female the presence of semen in the vagina is a very strong indication that rape has taken place. We can identify the semen by making a smear of the semen on a glass slide and looking under the microscope. If the material picked up by the swab is indeed the semen, then we see thousands of little snake like sperms (fig 5). Thus the presence of sperms almost confirms that we are dealing with a case of rape. But what about rape on married women? Married women may have sperms in their vagina as a result of intercourse with their husbands. For this we have a slightly more complicated technique. These days there is a special technique called DNA fingerprinting which can differentiate between sperms of any two or more given individuals. We apply this technique and know whether the sperms belonged to the victim's husband or not. Other injuries that we look for are injuries on the thighs, buttocks and abdomen. During a forcible rape, the person tries to force the thighs apart while the women wants to keep them together, to avoid rape. In this scuffle, injuries appear almost invariably on the inner side of abdomen (fig 6). During passionate love storm, the assailant may attack victim's breasts, producing multifarious injuries to the breasts. He may tug at the breasts, squeeze and scratch them, suck them or even bite the nipple off. This might produce several injuries to the breasts including teeth bite marks (fig 7) . These injuries strongly suggest that forcible intercourse may have taken place. Most of the times, the victim scratches at the assailant and thus small tags of skin can be found underneath her nails. These tags of skin obviously belong to the assailant. We can take these tags of skin out and can estimate the blood group of the individual. This can help us greatly in nabbing the criminal. We can even do DNA fingerprinting with these skin tags. This can pick out the culprit from among millions. When the accused is apprehended, he might deny that he had sexual intercourse with the victim. Forensic experts again come to the rescue of police here. If his body shows multiple scratches, abrasions and bruises, it is a clear indication that he has had a scuffle with someone. But he case is clinched by another very ingenious technique. If the accused has had a sexual intercourse with the victim, there could be vaginal cells over his penis. These vaginal cells can not be seen with the naked eye, but can be detected by a test. These cells turn brown when exposed to the vapors of a chemical (Lugol's iodine). We wipe the skin of the penis with a filter paper moistened with salt solution and then expose it to vapors of Lugol's iodine. It the filter paper turns brown, we can tell the police that he has indeed had sexual intercourse with the victim. Thus we can see that by a clever battery of tests, not only can we say that the woman is raped or not, we can also say who raped her. This medical evidence goes a long way in sending the accused to jail.

Explore a unique collection of forensic science fiction curated by Dr. Anil Aggrawal. Blending medical accuracy with thrilling narratives, these stories captivate students, professionals, and lovers of scientific mysteries alike. Anil Aggrawal's Forensic Science Fiction Page Hi, I am Professor Anil Aggrawal from India. I teach forensic medicine and toxicology at the Maulana Azad Medical College, New Delhi. I love reading and writing science fiction, especially that related to forensic medicine. My favorite SF author is....yes, you guessed it right- Isaac Asimov! Unfortunately he was not a forensic man, and so not many stories related to forensic medicine exist in current SF literature. Although I am no Asimov, I have made a humble attempt and tried to fill up this gap by writing SF stories related to forensic medicine. Some of these stories have been hosted on the net by science fiction enthusiasts. Anyone wishing to exchange ideas with me on forensic medicine, science, and science fiction is welcome. Many of my Science Fiction stories have been published in Spandan, the inhouse magazine published by the students association of Maulana Azad Medical College. You may want to go to this site for some other very interesting articles. Anil Aggrawal's Forensic science fiction stories ~ ( click on title below to access ) The mysterious old man The Freak A tale of detection The New Antibiotic The mystery of the drowned man The mystery of the burnt bride The mystery of the electrocuted man The mystery of the slain General The mystery of the dead infant The mystery of the assassinated prince Anil Aggrawal's other science fiction stories Why dinosaurs became extinct ? The Weird House. (click on title above to access) My favorite science fiction pages Isaac Asimov Check Website DO YOU HAVE AN INTERESTING TALE TO TELL? E-MAIL ME, AND I WILL PUT YOUR STORY ON THE WEB WITH CREDIT TO YOU. YOU WILL FIND NEW STORIES ON THIS PAGE VERY OFTEN. BOOKMARK THESE PAGES. YOU MAY WANT TO COME TO THESE PAGES AGAIN! Contact

SCIENCE IN CRIME DETECTION-7 WHEN THE BODY TURNS BLUE ! The police found the hanging body of Basesar at 7.15 am. on February 26, 1983. The body was naked except for a dhoti ( dhoti is a piece of cloth wrapped over the loins. It is a popular piece of garment in warm countries like India) over his loins. The head was tilted to one side. The body was hanging from the branch of a thick fat banyan tree at the outskirts of his village. From a preliminary look one could say that he had been hanging for several hours. His wife had been looking for him since the previous day. He usually came back from work at 5.00 p.m., but on the evening of February 25, he did not turn up. His anxious wife waited for him till 8.00 p.m., then made inquires from relatives. When everybody answered in the negative, she made a complaint at the police station at about 9.00 p.m. To be sure, Basesar was facing several difficulties. Last year he had taken a loan of over one lakh rupees ( Lakh is an Indian measure, meaning one hundred thousand. Rupees is Indian currency) from the local moneylender against the security of his house and fields. He had married off his two daughters with that amount and had done some long-pending repair work in his house. He was sure that he would he able to repay his loan, but this year’s crop was destroyed in the rain and he did not have enough money to run even his own house. The moneylender had been demanding his money from Basesar for the last several days. Last week he had even sent two goons to him to terrify him into paying back the money. The moneylender had set his eyes on Basesar’s property, which he could acquire at very cheap rates. It was not hard to imagine that under such desperate circumstances, the aging Basesar had taken the extreme step of committing suicide. When Basesar’s wife saw his dead body, she started crying and wailing. The police took off the body from the tree and then called for me to make a preliminary examination of the dead body and of the place, where the dead body was hanging. They thought that they could get some lead from my examination. When I reached the spot, the body had been lying on the ground for some half hour. I looked at the feet and then turned over the body. The back was bluish purple. I pressed the back with my thumb for about half a minute, then removed my thumb and looked at the back again. Then I turned to the Investigating officer, Gajendra Singh, and said, “It’s a case of murder and not suicide”. Gajendra Singh was obviously taken by surprise. I had hardly examined the body in any detail. I had not even conducted a postmortem examination. Then how on earth could I say it was a case of murder? Let us start the story from the beginning. When a person dies, his heart stops beating and the blood comes to a standstill. Gradually this blood starts gravitating to the lower portion of the body. If you moisten a sponge thoroughly and keep it on a table for 3-4 hours, you will find that its top portion has dried while the bottom portion has become even more moist. What actually happens is that the water within the fibers of the sponge starts gravitating to the bottom portion of the sponge. After 3-4 hours practically all water has seeped to the bottom of the sponge. This makes the top portion dry and bottom portion moist after some time. Practically the same thing happens in a dead body. All the blood starts seeping to the bottom portion of the body. After death, generally a body lies on its back, so all the blood collects on the back. This collection of blood gives a characteristic bluish purple color to the portion of the body where it collects. This coloration is known as postmortem staining or hypostasis (Figure 1). Those portion of the body which are in firm contact with the ground remain pressed and no blood collects there. So these areas remain pale. In Figure 1, one can see that the hips and shoulder blades which remain in firm contact with the ground are pale, but rest of the body has turned bluish purple. Post-mortem staining or hypostasis can tell us many important points regarding a crime. Post-mortem staining (or p.m. staining, for short) starts to appear by about 2-1 hour after death and in 4 hours, it is quite well established. If at this time, one presses the area of p.m. staining for about 2 minute, the blood collected blood starts to clot. So after 6 hours of death, if one presses the area for 2 minute or even more, the area will not blanch. The p.m. staining is now said to be fixed. The fixation of p.m. staining appears after 6 hours. So, by seeing the p.m. staining and if it is fixed or not, we can say how long a person has been dead. P.M. staining tells us another vital aspect about death - the position of the body after death. The blood will gravitate to the lowest portion of the body and stain it. Thus if the body was lying on its back, the back portion will get stained as shown in Figure 1. But if the body were lying prone, i.e. on its stomach, then chest and stomach will get stained. If the body were hanging as in the case of Basesar, then feet will get stained (Figure 3 ). On the other hand, if somebody tied the body by legs and hanged it upside down, the face and hands will get stained (Figure 4 ). It all depends on which portion of the body was lowest. If the body was lying on its back for say 3 hours, then the p.m. staining would develop on the back , but it swill not be fixed (as we have already seen). If at this time somebody turned the body, so that it came to lie on its stomach, the blood collected at the back would start moving to the chest and stomach, because in the new position these are the portions which are lying lowest. This causes the staining to disappear from the back and reappear on chest and stomach. This is called shifting of the p.m. staining. Continuing will our old analogy of sponge, if after keeping the wet sponge for 3-4 hours, you invert it, the previously dry portion will become wet and the wet portion dry, because the water will start moving to the new low position. However when the p.m. staining has become fixed, then the turning of the body does not cause shifting of the post-mortem staining. It is because fixation involves clotting of blood and the clotted blood does not move. Thus if a body has been lying on its back for say 8 hours the p.m. staining would become fixed on the back. Turning the body over on its stomach now would not cause shifting of p.m. staining to a new area. Now I must tell you what I found in Basesar’s body. When I examined Basesar’s legs, I did not find any p.m. staining there, which puzzled me somewhat, as Basesar had been found hanging. Then I turned over the body and looked at the back. The back showed p.m. staining. This meant that the body had been lying on its back for a minimum period of 6 hours, after which someone hanged the body to give the appearance of suicide. Since the p.m. staining has already become fixed on the back, it did not shift to the legs later on when the body was hanged. From this examination, I could deduce the whole crime scenario in great detail. Basesar was murdered at least 6-8 hours before, perhaps 10 hours before. Then for some reason his body was kept lying on its back for 6-8 hours. Then someone hanged his body to give the appearance of suicide. The police swung into action now. The local moneylender Dhanprasad denied any hand in the murder. Under sustained interrogation however, he did admit having sent his two goons, Kallu and Lalla to Basesar. But he reiterated that they had been instructed merely to terrify him into paying. Murder was never his aim. Kallu and Lalla, when interrogated, denied all knowledge of murder. They said that on Dhanprasad’s instructions they did go to Basesar at about 5 p.m. on February 25, but had merely enquired from him about the repayment of loan. They said that they had departed after half an hour when Basesar had assured them to do something regarding the loan soon. However the police knew the blueprint of the story now, so they pressed them further. Under sustained interrogation, they broke down and told the whole story which was an eye opener. On the evening of February 25, when Kallu and Lalla met Basesar at 5.00 p.m. he expressed his inability to repay the loan. Kallu and Lalla then took him to the outskirts of the village. The idea was to beat the hell out of him. However before they could start a beating, an altercation started and Kallu grabbed Basesar by the neck. In the heat of passion, he did not realize that Basesar by the neck. In the heat of passion, he did not realize that Basesar was an old and ailing man and the slightest pressure on his neck could prove dangerous. It was only after he felt Basesar going limp in his arms, did he realize that he had unwittingly murdered Basesar. Both of them now panicked. They did not know what to do. Lalla suggested that they should hang Basesar’s body from the branch of a banyan tree. Everybody would then think that Basesar had committed suicide. The idea appealed to Kallu. They did not have a rope however. It was decided that they would cover Basesar’s body with leaves, twigs and grass, go back to village and bring some rope. When they were leaving for the village, it was about 8.00 p.m. They saw a big marriage procession coming towards them and gathering towards some tents which had been pitched to receive those guests. Doing all the gymnastics of hoisting Basesar’s body up the banyan tree was no easy task, especially with so many people only a few hundred yards away. Anyone could wander towards the jungle and catch them in the act. It was decided that they would wait for the marriage procession to dispense away and then they would start their work. It was nearly 4.00 a.m. on February 26, when finally the marriage rites were completed and everybody went away. Now Kallu and Lalla returned to the jungle and hoisted Basesar’s body up. So Basesar’s body was lying on its back for almost 8-10 hours. This caused p.m. staining to appear on the back and become fixed there too. So when finally Basesar’s body was hanged, the p.m. staining did not shift to the legs. This little knowledge of p.m. staining could help me to unravel this seemingly impossible case in no time. There is hardly any doubt that without medical evidence, the case would have passed off as a suicide. The court admitted the medical evidence and awarded a sentence of 7 years’ rigorous imprisonment to both Kallu and Lalla.

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JULY 1998 ISSUE THE POISON SLEUTHS DEATH BY DNOC -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young girl today. What happened to her? Please tell me." "Good morning Tarun. The name of this young girl is Seema, and she died this morning in the hospital. Yesterday night she had some severe problem for which her neighbors had taken her to a hospital, but there she died soon after. Well, let me tell you everything from the beginning. She is 24 years old and used to live alone. She is originally from UP, where her parents and family is still residing. She was doing a job in Delhi as a typist, and so was living here for about 2 years. She apparently had a love-affair with one of her colleagues Ramesh. They had a good relation for quite some time, and there were rumours that they were even going to marry." "Oh, I see. But how did she die?" "About a month back, Ramesh's parents fixed his marriage somewhere else, to which Ramesh also did not object much, which in effect meant, that he had tacitly consented for the marriage. When Seema came to know about it, she became mad, and there was a verbal duel between the two. Quite coincidentally, this happened in their office, and everyone saw them fighting them in this manner. That's how we know about this incident." "What was she saying during the verbal duel?" "The colleagues who were present there told the police, that the verbal duel suddenly started and went on for about 15 minutes, till their colleagues intervened. She was saying that Ramesh had shown utter meanness and had deserted her because of her looks. As you can see, she is quite fat. I have measured her height and weight. She is 157 cm in height and her weight is 76 Kg, which as you can see is quite much for her height. Apparently there were sexual relations between the two also, and she was heard saying that Ramesh used their friendship for his advantage, and is now deserting her. He never intended to marry her in the first place." "Is this accusation correct?" "Well, nobody knows for sure. But from what I hear from the office colleagues, Seema was not a very attractive girl, and no male was much interested in her, except for official relations. If Ramesh started nurturing relations with her, it's quite possible, that he was looking for some free fun. Once he had his fun, he decided to marry elsewhere." "Are you hinting that he killed Seema?" "No. Not me. I do not say anything before I have scientifically confirmed my facts. The sequence of events was this. Ramesh had visited her flat last night. Apparently the meeting was aimed at reconciliation. Ramesh wanted to explain Seema the circumstances under which he was marrying elsewhere. The fact of his visit last night is confirmed by Seema's neighbors. Even Ramesh himself has agreed to this fact. Apparently, he stayed there for about 15 minutes and then left. Sometime after he left, Seema knocked at a neighbor's door and told her she was not feeling well. She was sweating profusely, had very high fever, complained of intense thirst, and was in great distress. The neighbors immediately realized that something was terribly wrong with her. They took her to the nearby hospital. Before the doctors could ask her anything, she fell into a coma, from which she never recovered. She died after 6 hours." "Oh, I see. So how did she die? "I will tell you about that a little later, when I tell you about my scientific deductions. But before that, it would be very necessary for you to know, why this case has been brought to me. Her parents were immediately informed by the neighbors and they have arrived this morning. After hearing everything, they have put a very damning allegation on Ramesh. They say that last night during his visit, Ramesh must have given her something to eat because of which these symptoms started. The fact that the symptoms started just after Ramesh left has given credence to this allegation. The police also believes this theory. They think that Ramesh wanted to get rid of Seema, otherwise she could have made life hard for him. She could even have kept troubling him after marriage, and could even infuse all kinds of doubts in the mind of his future wife, so the best course for Ramesh was to put an end to her life." "What does Ramesh have to say in this regard?" "The police has enquired Ramesh, and he says that he did visit Seema to explain her his position. The marriage was being held at the instance of his parents, and he could not interfere in that. But Seema was not ready to listen to him. She was very depressed. After about 15 minutes of unsuccessful attempts at reconciliation, he left." "What do the doctors at the hospital say about the cause of her death?" "The doctors did not have much time to examine her. I have talked to the doctors there. They feel it could be a case of salicylate poisoning or perhaps even thyrotoxicosis." "I don't really understand these two terms. Please explain them to me." "Tarun, acetylsalicylic acid is used in modern medicine for the relief of pain. Ordinary dispirin, which is available in the market for pain relief contains 350 mg of acetylsalicylic acid. If too many tablets are ingested, one can get salicylate poisoning. The toxic dose of acetylsalicylic acid is about 200-300 mg/kg. Thus you can plainly see that for Seema who was 76 kg, the toxic dose is about 65 tablets. People may ingest pain killers for committing suicide. This practice although very common in foreign countries, is not so common in our country, mainly because people are not aware of this fact. But Seema was an educated girl, and she might be well aware of this fact. She was depressed because of recent developments and she might have ingested these tablets after Ramesh left. Ramesh obviously could not give her so many tablets to eat, and even if he had given her, she would not have eaten them. So if this case does turn out to be that of salicylate poisoning, it is quite probable that Ramesh is indeed speaking the truth, and had nothing to do with her death." "Why did the doctors at the hospital think in the first place that she was having salicylate poisoning?" "Because of her symptoms. The symptoms of high fever, thirst and profuse sweating are seen in salicylate poisoning. It might surprise you to know, that although acetylsalicylic acid is normally used for the control of high temperature, during overdose, it produces high fever itself. The doctors also noted difficulty in respiration and very rapid heart rate. Before she went into coma, she also had convulsions. These features are quite typical of salicylate poisoning. The same features are also seen in thyrotoxicosis, a disorder of the thyroid gland, in which the thyroid starts secreting excessive amounts of thyroxine. That is why the doctors gave this as the second diagnosis." "Oh, so now we have all the views. Now tell me what your investigation reveals." "Tarun, we can straightaway rule out thyrotoxicosis. In this disorder, the person is excessively lean and as you can see, Seema is very much overweight. Acetylsalicylic acid poisoning seems a more likely choice. But when I examined her hands, I found some yellow stains on them. This, and certain other findings, which I shall explain shortly, immediately alerted me in the direction of another poison- a very rare one, but one which causes exactly the symptoms exhibited by Seema" "What is that poison doctor? Please tell me. I am getting curious." "Tarun it is known as DiNitroOrthoCresol or DNOC for short." "DNOC? Never heard of this poison. Please tell me something more about this poison." "Tarun, DNOC belongs to a family of compounds known as dinitrophenols (DNP). These compounds are highly toxic and can rapidly produce death. Toxic effects often appear at blood concentrations greater than 30 mg/l while concentrations greater than 60 mg/l are associated with severe toxicity. Dinitrophenols are mainly used as pesticides. Dinitro-ortho-cresol (DNOC) and Dinitrophenol are the two main phenolic pesticides. These substances are used in agriculture chiefly as selective weed killers for cereal crops and for the destruction of potato haulm. In dilute solution they may be used as an insecticidal winter wash for fruit trees. The principal risk of poisoning is in the agricultural use of concentrated solutions for spraying crops. Absorption occurs by inhalation and ingestion and also through the skin; excretion is extremely slow so the poison tends to accumulate in the body. The risk of absorption is much greater during hot weather. Those exposed to these chemicals (such as farmers when spraying these chemicals) are generally recommended to wear respirators to avoid inhaling them. They are also subjected to periodical examination to determine the concentration of these compounds in the blood, which should not exceed 20 micrograms per gram. Dinitrophenolic compounds, especially DNOC stimulate the human metabolism very strongly. In fact DNOC can increase the tissue metabolism by 1200%! The effects of dinitrophenol in stimulating metabolism have been known since 1885, and at one time DNOC was even used in the treatment of obesity and misused for "slimming". "I couldn't understand that last point very well doctor." "Tarun, any compound which stimulates metabolism that greatly basically burns up your energy stores in the body. The main energy store in the body is the fat. If it is burnt, the person will get slim. All exercises are aimed at this only- to burn as much fat as possible. But exercise is time consuming, boring and exerting, so people are on the lookout for easy way out such as chemicals and drugs which can either reduce appetite or enhance metabolism, i.e. help burn up excessive fat. For the former effect, drugs known as amphetamines were once very popular, but they have lost favour as their side effects are too many and too serious. DNOC stimulates metabolism by as much as 1200%, i.e. it burns fats 12 times faster than in a normal man. Obviously this will form a good candidate for weight reduction." "Then why don't doctors prescribe it for weight reduction?" "Because it is a very toxic drug. But early in the century several people did take it for the reduction of weight. When fatalities started occurring, the doctors came to know about its serious toxic nature, and they advised the people against taking this drug. But it was commonly available, as it was a herbicide, so people purchased it with impunity and many overweight girls are known to have consumed it in an attempt to become slim overnight. But in fact nothing of that sort happened. They died instead. Following the deaths of several girls in this way, the availability of this drug was restricted to certain people only. But still many people can get hold of this drug and may consume it. You may be surprised to know that today DNP and DNOC can be illegally bought over the internet too! Many gullible youngsters who fall prey to these internet advisers are paying with their lives. These internet advisers are quacks who encash upon the gullibility of such youngsters. They claim that their concoction would cause a quick weight reduction, but it doesn't. It kills them instead. DNOC is about 5 times as potent as dinitrophenol. The characteristic effect of these two drugs is the uncoupling of the oxidative phosphorylation, causing a great increase in tissue metabolism......" "Sorry to interrupt you doctor. You just talked about uncoupling of oxidative phosphorylation. I don't understand this term quite well. Can you explain me please?" "Tarun, this is a technical term the details of which I may not be able to explain in such a short discussion. But I will tell you certain basics. When glucose is burnt in the body to carbon dioxide and water, it passes through 3 stages. The last stage is technically known as oxidative phosphorylation. During each stage some energy is liberated, which is stored in the form of ATP (Adenosine TriPhosphate) molecules. DNOC and other dinitrophenolic compounds inhibit the formation of ATP molecules, without inhibiting the process of oxidative phosphorylation. This means that although body is burning glucose continually, it is not getting any energy in the form of ATP molecules. This situation when energy is being produced, but is not available for the formation of ATP molecules is technically known as uncoupling of oxidative phosphorylation. This excess energy has to be dissipated in the form of heat. That is why patients poisoned by this poison show high body temperature and sweating. Since body is not getting adequate amounts of energy, it tries to burn more and more glucose in a futile attempt to get energy. Even fat stores are mobilized, but all the energy produced is dissipated as heat. This is the basis of increase of metabolic rate by these compounds." "Oh, I see. But the symptoms are also seen in salicylate poisoning. How did you know she had taken DNOC?" "By the yellow stains on her hands. This yellow staining is very typical of dinitrophenolic compounds. When these compounds come in contact with skin, they form trinitrophenol or picric acid, which is yellow in color. By the yellow stains on her hands, I immediately realized that she must have handled dinitrophenol compounds. I believe she was quite concerned about her weight, and was taking this compound reqularly in small doses. I do not know where she procured this compound from, but probably she must have contacted one of those quick weight reducing quacks, who must have given her this compound. When she was taking small doses, nothing dangerous happened. But due to recent developments, she was quite convinced that she had lost Ramesh because of her weight problem. In a bid to overcome her weight problem overnight, she must have tried to get at it in one go, and may have consumed a great amount of drug immediately after Ramesh left. That is how the symptoms appeared." "But how are you sure, Ramesh did not administer her this drug?" "Because of this drug's peculiar color, odor and taste. No one can administer this drug to another by deceit, without the other immediately coming to know about it. I have exmained her blood and have found high amount of DNOC in her blood. The levels are about 100 mg/l, which is surley a fatal level. Subsequent to this, I asked the police to search her house and look for all medication bottles there. Normally the police would never have even peeped there. But following this discovery, they looked at her almirah and did indeed find a medicine chest. They brought her entired medicine chest. I noticed 3 suspect looking bottles and put their contents to examination, and in one of these, not very surprisingly, I did find high amounts of DNOC. The police have noted the name and address of the doctor from the label of that bottle, and a party has been despatched to UP to arrest that doctor. It appears that the quack who prescribed this medicine to her is based in UP, and during one of her visits to her parents, Seema must have picked this medicine." "Oh, how very clever of you doctor. Without your clever deduction, poor Ramesh would have unnecessarily been arrested and implicated. This was a most interesting discussion. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- Cadmium."