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

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Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE OCTOBER 1999 ISSUE THE POISON SLEUTHS DEATH BY VITAMIN A -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young man today. What happened to him? Please tell me.” “Good morning Tarun. The name of this 24 year old man is Ramlal, and he died in the hospital today morning. He was admitted to the hospital about two days back, with complaints of throbbing headache, pain in the stomach, diarrhoea, vomiting, irritability, dizziness, muscular weakness and cramps. Some peculiar symptoms, which confused most doctors at the hospital was that his skin was peeling off from many parts of the body, his hair were falling and that he had an irresistible desire to sleep. Doctors were trying to figure out what his illness was, but in the meantime he expired.” “Seems like a most strange illness to me doctor. But since you have said that his hair were falling, I can surmise that he might be suffering from Thallium poisoning.” “Tarun, I do remember having told you that hair start falling in thallium poisoning, but look at his other symptoms too. All the symptoms taken together are pointing towards only one direction - I can think of nothing but one poison, with which Ramlal must have been poisoned. It remains to be seen who gave him this poison.” “Doctor please tell me which is that poison. I am getting curious.” “Tarun, somebody has given Ramlal a dangerously high dose of Vitamin A, and probably that is why he has died.” “Vitamin A! Come on doctor. You are being preposterous. We all know that Vitamin A is an essential vitamin, which must be regularly taken to stay healthy. How can such a nutrient prove toxic?” “This is the paradox. Vitamin A acts as a double edged sword. Before saying anything, let me clarify a few basic concepts about Vitamin A. The term “Vitamin A” covers two chemicals - a true pre-formed vitamin known as retinol, and a pro-vitamin beta-carotene. A pro-vitamin is a substance which gets converted into the proper vitamin in the body. In human beings, some beta-carotene gets converted into Vitamin A in the intestinal mucosa, while the most gets converted in the liver. Vitamin A is usually measured in International Units or I.U. One I.U. of Vitamin A is equal to about 0.3 micrograms of retinol, which as you now know is the true Vitamin A. I must also tell you that one microgram of beta-carotene (which is the pro-vitamin) gets converted to about 0.167 micrograms of true vitamin A or retinol. Another way of saying this is that the “retinol equivalent” of one microgram of beta-carotene is 0.167.” “Oh, yes, I am understanding it. What is the daily requirement of Vitamin A, and what is its toxic dose?” “Normal daily requirement of Vitamin A for an adult is about 3000 I.U. per day. In pregnancy and lactation, it increases to about 4000 I.U. per day. Vitamin A capsules available in the market provide a little more than this amount. For instance Adexolin, a commonly available capsule of Vitamin A contains about 5000 I.U. of vitamin A. You must remember that Vitamin A and D are not soluble in water so if someone takes more quantities of these vitamins than required, there is no way they can be excreted. They generally are stored in the liver. On the other hand Vitamins B and C are water soluble vitamins. If someone takes enormous quantities of Vitamin B and C, they would be excreted in urine.” “Oh, I see. So this means Vitamin A can act as a poison too?” “Oh yes. Certainly. This is a fact which most people do not know. The medical condition which results from an intake of excessive amounts of Vitamin A is known as Hypervitaminosis A. About one million I.U. of vitamin A are very toxic to human beings, and about 3 million I.U. may prove fatal, as they have in the case of Ramlal. To put it another way, about a year’s requirement of Vitamin A if taken as a single dose may prove toxic, and about three years’ requirement taken as a single dose may kill a human being. Well, we do say often that ‘too much of a good thing can be bad’. Nowhere does this maxim prove truer than in the case of Vitamin A.” “Doctor, you are repeatedly saying that Ramlal died of Vitamin A poisoning, but how could he have got poisoned. You tell me that an average capsule of Vitamin A available in the market provides about 5000 I.U. of vitamin A, and also that about 3 million I.U. are fatal. This means that someone with an intent to kill his enemy has to administer as many as 600 capsules of Vitamin A to his enemy. How is that possible?” “Tarun, I did not tell you a very interesting fact. Most polar animals such as polar bears have dangerously high levels of Vitamin A in their liver. In fact there have been cases, where polar explorers have died of Vitamin A poisoning, because they ate the livers of animals residing in those regions.” “Really? That’s an interesting fact. How does such dangerous amounts of Vitamin A reach their liver?” “Vitamin A originates in marine algae, and then passes up the food chain to reach the large carnivorous animals. Toxic levels of Vitamin A may accumulate in the livers of a wide range of creatures such as Polar bears, seals, porpoises, dolphins, sharks, whales, Arctic foxes and huskies. Even a small meal of southern Australian seal liver, say 80 g, may produce illness in man. I may tell you that several foods are recommended as good sources of Vitamin A. Most of them contain well below the toxic levels of vitamin A, but one - Halibut liver oil - contains dangerously high amounts of Vitamin A, as you can see from the accompanying table. Source of Vitamin A Vitamin A content in International Units (I.U.) per gram of food Ox liver 550 Cod liver oil 600 Halibut liver oil 30,000 Table 1: Vitamin A content of some commonly recommended foods rich in Vitamin A In contrast look at the vitamin A contents of the livers of some common animals living in the polar regions in the following table. For comparison, I have also given the vitamin A content of the human liver. As you can see, most animals, especially the polar bear have very high amounts of Vitamin A in their livers. Common Name Zoological Name Vitamin A content of the liver in International Units (I.U.) per gm of specimen Weddel Seal Leptonychotes weddelli 444 Man Homo sapiens 575 Southern Elephant Seal Mirounga leonina 1,160 Antarctic huskies Canis familaris 10,570 Arctic bearded seal Erignathus barbatus 12,000-14,000 Polar bear Thalaractos maritimus 24,000-35,000 Table 2: Vitamin A content of the livers of some common animals living in polar regions - compared with that in humans “Oh, these two tables are real eye openers. Doctor, you were telling me that some polar explorers have actually died of Vitamin A poisoning. Could you tell me that story in detail please? I am getting curious.” “Oh sure. The story starts in January 1912, when a three man party of explorers from the Australasian Antarctic Expedition started their expedition to explore Antarctica. The team was led by Douglas Mawson, and the other two members were Lt. B.E.S. Ninnis and Xavier Mertz, a Swiss scientist. Disaster struck on December 14, 1912, when Ninnis fell into a very deep pit and died. With him also went precious food supplies. With most of their food gone, Mawson and Mertz decided to return to their base at Commonwealth Bay, which is at the shores of Antarctica. From here they could take the ship back to their country. But Commonwealth Bay was about 315 miles from where they were stationed. Covering that distance in the inhospitable surroundings of Antarctica would have taken them weeks, and they had only 10 days’ food left with them. They had six huskies with them. Huskies, as you know are Eskimo dogs, used as ponies in Antarctic region. They knew that sooner or later they would have to eat those dogs to remain alive.” “Oh, it was really terrible. But the story is getting interesting. What happened then?” “They did kill the huskies and ate their flesh, but the flesh was stringy and they could not eat it. In contrast to flesh, they found the liver softer and easier to eat so they took generous quantities of liver. Mertz was a near vegetarian; he could not eat the stringy flesh, so he took more liver than Mawson. Little did he realize that he was taking fatal amounts of Vitamin A in this form. On New Year’s Eve, Mertz began to feel ill. Next day he complained of stomach pains. Few days later both men began displaying typical symptoms of Vitamin A poisoning, although Mawson was affected less. Their skin was falling off their bodies in strips and their hair was dropping out in handfuls. A week later, Mertz fell into a delirious sleep - a sleep from which he never woke. As far as we know, he was the first case of death due to overdose of Vitamin A. Mawson survived, and ultimately did return to Commonwealth Bay." Note by the Editor There are counterclaims insisting that the death of Xavier Mertz and the suffering of Douglas Mawson was not due to overdose of Vitamin A. For more on this, please click here “This is certainly a most interesting incident doctor.” “So I was telling you about the vitamin A content of polar animals. With the amounts I told you, you can see that really very little quantities of livers of these animals are required to kill a human being. For instance, it would require about 30 to 90 g of the liver of a polar bear, 80 to 240 g of the liver of bearded seal and 100 to 300 g of the liver of Antarctic Husky to kill a human being. You may think that the livers of these animals are not commonly available. That is true, but Halibut liver oil also contains almost the same amounts of Vitamin A as that of the liver of Polar Bear. About 30 to 90 g of Halibut liver oil could thus prove fatal to a human being, and this is commonly available with the chemists. It is not very difficult for someone to coax another to drink this amount, especially when Halibut Liver Oil is commonly considered to be a health food.” “So you think someone coaxed Ramlal into drinking this amount of Halibut liver oil?” “This is exactly what has happened. I have made inquiries, and found that Suresh a person working in the same factory as Ramlal held a grudge against him. Suresh was an educated person - he held a first division in chemistry in college- and yet Ramlal, probably due to his hard work, rose to a higher position than him in the factory. He held another grudge against him, that Rekha, a co-worker whom he loved and wanted to marry was attracted more towards Ramlal.” “Oh, I see. But how did he coax Ramlal to drink a fatal amount of Halibut liver oil?” “Ramlal thought that he was not strong enough, and before marriage he could do with some more nutritious foods. Suresh knew about health foods well, and one day he took his advice. Suresh saw his chance and advised him to contact him the next day. Next day he handed him a bottle of Halibut liver oil and asked him to drink copious amounts from there. He told him that it acted as a good aphrodisiac and would serve him well before marriage. Poor Ramlal believed him, and drank almost the whole bottle, which contained 100 g of oil in one go. This is how he died.” “This is all very well doctor, but how are you going to prove in a court of law that Ramlal died of Vitamin A poisoning?” “Tarun, I have examined the vitamin A content of Ramlal’s liver and it is more than 40,000 I.U. per g. As you know, a human being should have at the most about 600 I.U. of Vitamin A per g of liver. This proves beyond doubt that Ramlal had Vitamin A poisoning. Added to this is the hospital record which gives us the typical symptoms of vitamin A poisoning. I don’t think the court would have any hesitation awarding sentence to Suresh. Come, let us tell the police to arrest Suresh.” "That was very clever of you doctor. Without your clever deduction - especially your noticing the peculiar symptoms of Ramlal at the time of his death- 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- Cicutoxin."

ANIL AGGRAWAL'S PAGE OF FORENSIC QUOTES AND APHORISMS About Myself Hi, I am Professor Anil Aggrawal from India. I am working as a Professor of Forensic Medicine at the Maulana Azad Medical College, New Delhi-110002, India. I love to exchange ideas on Forensic Medicine, Forensic Pathology and Forensic Toxicology. I love quotes. There are all kinds of quotation books available in the market, but unfortunately none caters exclusively to Forensic Quotes. This page is a modest effort to fill this gap. It includes quotes which I have collected during the last 25 years of my experience in Forensic Medicine. It also includes quotes submitted by several of the discerning readers. All contributions by the web surfers have been added with due acknowledgements. I hope to put the collective wisdom of all of us on the net for the benefit of all. After all that is why the God invented the internet, isn't it! So if you remember any of the witty forensic quotes that you heard somewhere, E-mail it to me, and I will put it on the internet with due credits. My E-mail is dr_anil@hotmail.com. All quotes submitted by readers will be put on the web with due credit. Please don't forget to mention the source of the quotes. That will make my work that much easier. If you have enjoyed these pages (or even if you haven't), please be good enough to leave your comments in the guestbook. These are my only rewards. It keeps me on track (your criticisms), and keeps my morale high (your appreciations). Thanks! Guestbook Statistics Our Valued Contributors A B C D E F G H I J K L M N O P Q R S T U V W X Y Z ABORTION I will not aid a woman to produce abortion. - Hippocratic Oath All your better deeds shall be in water writ. - Philaster II, IV (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 88, in Chapter 5 entitled "Abortion and its complications") ACCIDENTS Now and then there is a person born who is so unlucky that he runs into accidents which started out to happen to somebody else. - Don Marquis, archys life of mehitabel AGE ESTIMATION (MEDICOLEGAL ESTIMATION OF AGE) Attempting to estimate the age of a person from the closure of his skull sutures is no less hazardous than doing so from graying of his hair; the only difference is that the former appears more technical! - Anil Aggrawal, Professor of Forensic Medicine, Maulana Azad Medical College, New Delhi, India If the first permanent molar hath not protruded, you can have no hesitation in affirming that the culprit has not passed his seventh year. - A.T. Thomson in his classical paper written as far back as 1836. The full quotation of the paper is "Thomson AT. (1836). Lectures on medical jurisprudence now in course of delivery at London University. Lancet 1:281-286 (This quote is reproduced in "Developmental Juvenile Osteology" by Louise Scheuer and Sue Black, Academic Press 2000 on page 12) ALCOHOL Candy is dandy, but liquor is quicker. - Don Marquis, archys life of mehitabel The trouble with liquor is that one drink makes a new man out of you, and then the new man has to have another drink! - Alvy Moore Not drunk is he who from the floor Can rise alone and still drink more, But drunk is he who prostrate lies Without the power to drink or rise. - Thomas Love Peacock (1785-1866): English novelist and poet A drunkard is like a whiskey bottle; all neck and belly and no head! - Austin O'Malley In vino veritas (in wine there is truth) - Old Roman saying ANAESTHETIC DEATHS There are many minor operations, but no minor anesthesias. - Kenneth Heard (1897-1948) (Quoted in "Historical Medical Classics involving new drugs, by John C. Krantz, Jr. Ph.D. on page 112) Care charming sleep, thou loser of all woes. - Valentinion V (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 79, in Chapter 4 entitled "Respiration". This quote appears at the top of a sub-chapter entitled "Anaesthesia for dental treatment") ANALYSIS AND DEDUCTION I have no data yet. It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories instead of theories to suit facts. - Sherlock Holmes in "A Scandal in Bohemia", when Dr. Watson asks him what he makes of a mysterious note which had just arrived. Whenever you have excluded the impossible, whatever remains, however improbable, must be the truth. - Sir Arthur Conan Doyle (The Adventures of Sherlock Holmes - "The Adventures of the Beryl Coronet" -Quoted on the front page of "An Introduction to Forensic DNA Analysis" by Keith Inman and Norah Rudin) Like all other arts, the Science of Deduction and Analysis is one which can only be acquired through long and patient study. - Sherlock Holmes in Sir Arthur Conan Doyle's "The Book of Life" (Quoted in "Hard Evidence" By David Fisher at page 1) ARSON AND FIRE INVESTIGATION The person who reports finding an arson is usually the person who set the fire. - Contributed by Harold J. Porter, Crown Counsel, Newfoundland, Canada (Address: Harold J. Porter, Department of Justice , Civil Division, 4th Floor , East Block,Confederation Building, St. John's Newfoundland A1B 4J6, TEL 709-729-1179, FAX 709-729-2129. Mr. Porter goes on to add "this is not a well-known maxim, but an accurate one, in my limited experience". The quote was sent on 20 December 1999. To me this quote sounds much like "The murderer always returns to the scene of crime". Visitors to this page are welcome to send relevant comments) Time is an enemy to the fire investigator. - Paul E. Pritzker, P.E. (quoted on page 37 in Chapter 3 written by him on "fire investigation" in the book "Forensic Engineering" by Kenneth L. Carper (CRC Press 1998)) (Pritzker follows up the quote with this explanation: When one is called late to investigate a fire, physical evidence may have been altered or may have deteriorated) Wellington once said that the Battle of Waterloo was won on the playing fields of Eaton. It is important to prepare before arrival at the fire scene! - Paul E. Pritzker, P.E. (quoted on page 35 in Chapter 3 written by him on "fire investigation" in the book "Forensic Engineering" by Kenneth L. Carper (CRC Press 1998)) ASPHYXIA The term "Asphyxia" is a partial misnomer, as many of the conditions described under this heading are not truly asphyxial in nature; the term is both inappropriate and inaccurate. - Bernard Knight (Forensic Pathology, 2nd Edition, page 345) Anoxia begets anoxia. - G.K. Dinker Petechial hemorrhages, congestion and edema, cyanosis, engorgement of the right heart and fluidity of the blood are the obsolete diagnostic quintet of asphyxial deaths. - Lester Adelson ( Quoted by Bernard Knight in his Forensic Pathology, 2nd Edition at page 347) Traumatic asphyxia provides the most extreme demonstration of the classic signs of asphyxia. - Bernard Knight (Forensic Pathology, 2nd Edition, page 358) His face is black and full of blood, His eye balls farther out than when he lived, Staring full ghastly, a strangled man, His hair upreared, his nostrils stretched with struggling, His hands abroad displayed, as one that grasped, And tugged for life, and was by strength subdued. - William Shakespeare I thought I could not breathe in that fine air, That pure severity of perfect light. - Tennyson (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 204) (N.B. Please also look up quotes under "Hanging") ASPHYXIA, AUTOEROTIC Those kids are stupid. They don't know what they're doing. - A 16 year old boy to his mother, who showed him an article about autoerotic deaths in a newspaper (Reproduced from "Practical Homicide Investigation-Tactics, Procedures, and Forensic Techniques", Second Edition, by Vernon J. Geberth, page 278) (N.B. Interestingly, the boy himself was engaged in such activities, and was found dead two weeks later) Vladimir: “What do we do now?” Estragon: “Wait.” Vladimir: “Yes, but while waiting.” Estragon: “What about hanging ourselves?” Vladimir: “Hmm. It’d give us an erection.” Estragon: (highly excited) “An erection! ... Let’s hang ourselves immediately!” - Samuel Beckett, Waiting for Godot (reproduced also at page 10 of "Autoerotic Asphyxiation: Forensic, Medical, and Social Aspects" by Sergey Sheleg and Edwin Ehrlich. Wheatmark, Inc. 2006) ASSAULTS A certain man went down from Jerusalem to Jericho, and fell among thieves, which stripped him of his raiment, and wounded him, and departed, leaving him half dead. - Luke 10:30 (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 109) AUTOPSY The next time I see a doctor, it had better be for an autopsy. - A.J. Duhe, linebacker for the Miami Dolphins, after his fifth knee operation, 1985 (Quoted in "The Autopsy-Medical Practice and Public Policy" by Rolla B. Hill and Robert E. Anderson; Butterworths 1988, page 157) In some autopsy laboratories, the most significant breakthrough during the last 100 years has been the introduction of disposable gloves! - Jan Vincents Johannessen et al. 1979 (Quoted in "The Autopsy-Medical Practice and Public Policy" by Rolla B. Hill and Robert E. Anderson; Butterworths 1988, page 175) There's nothing like an autopsy for prognosis. - Anonymous (Contributed by Dean H. Garrison, Jr., Crime Scene Technician.) Often the autopsy reveals the diseases and lesions that the person lived with, rather than those that killed him! - Anonymous If an autopsy is worth doing at all, it is worth doing right the first time. - LeMoyne Snyder in his book "Homicide Investigation", (Third Edition, May 1977) Published by Charles C. Thomas, Springfield, Illinois, USA, on page 158, in chapter 7 entitled "Homicide due to Gunshot Wounds" A good pathologist holds a knife just like a violinist holds a bow. - Contributed by Dr. Gyan Fernando, Home Office accredited Consultant Forensic Pathologist for Devon & Cornwall Constabulary We have plenty of post-mortem examinations but often these are useless because the history of the case is not known. - J. Kerr Love (1897). Some Modern Aspects of Deaf-Mutism, J. Laryngology, 12, 593 (Quoted in Pathology of the Ear by I. Friedmann, 1974, Blackwell Scientific Publications) (N.B. This short and pithy quote, although more than 100 years old, remains valid even today.) AUTOPSY RISKS There is still not a single documented case of a pathologist or a technician getting AIDS from their professional activities. - Contributed by Dr. Gyan Fernando, Home Office accredited Consultant Forensic Pathologist for Devon & Cornwall Constabulary The fact that I have never caught anything from an autopsy in 25 years of carving in two different parts of the world should put everyone's mind at ease. - Contributed by Dr. Gyan Fernando, Home Office accredited Consultant Forensic Pathologist for Devon & Cornwall Constabulary You are more likely to injure yourself with blunt knives than with sharp ones! - Contributed by Dr. Gyan Fernando, Home Office accredited Consultant Forensic Pathologist for Devon & Cornwall Constabulary BATTERED BABY SYNDROME Spare the rod! - Title of a paper by James E. George of the Emergency Department, Underwood Memorial Hospital, Woodbury, N.J. (U.S.A.) on Battered Baby Syndrome published in Forensic Science, 2 (1973) 129-167 Hark ye, good parents, to my words true and plain, When you are shaking your baby, you could be bruising his brain. So, save the limbs, the brain, even the life of your tot; By shaking him never; never and not. - a quatrain from the paper “On the Theory and Practice of Shaking Infants” published in Amer. J. Dis. Chil,. on page 169. Full reference of the article is this: Caffey, John. On the Theory and Practice of Shaking infants. Amer. J. Dis. Child. August 1972, Vol. 124, no. 2, Pp 161-169 Whiplash-shaking is practiced commonly in a wide variety of ways, under a wide variety of circumstances, by a wide variety of persons, for a wide variety of reasons. - John Caffey of “Caffey’s syndrome” fame in his paper: On the Theory and Practice of Shaking infants. Amer. J. Dis. Child. August 1972, Vol. 124, no. 2, Pp 161-169, on page 161 BLOOD STAINS Out damned spot! Out, I say Here's the smell of the blood still, All the perfumes of Arabia will not Sweeten this little hand. Oh, Oh, Oh! - William Shakespeare Blood though it sleeps a time, yet never dies, The Gods on murtherers fix revengeful eyes. - Dryden (The Cock and the Fox) Any butcher is just as good an expert on that as this witness. - Commonwealth v. Sturtivant (1875) (Quoted in “Scientific and Legal Applications of Bloodstain Pattern Interpretation” Ed. Stuart H. James, page 122) (N.B. A little background above the above quote may be appreciated. In this case, the Massachusetts Supreme Judicial Court addressed the admissibility of blood spatter interpretation and the qualifications of an “expert”. The witness, a chemist accustomed to chemical and microscopic examination of blood and bloodstains, testified for the prosecution as to directionality; i.e., “if the force of a stream of liquid, whatever it may be, and especially blood, be from below upward, the heaviest portion of the drop will stop at the further end of the stain; if from above downward, it will stop below.”. Defence counsel objected to this testimony at trial, stating, “That is pure opinion as to a matter of mechanics, not chemistry. Any butcher is just as good an expert on that as this witness.”) When blood is their argument. - King Henry V, iv, i (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 161, in Chapter 9 entitled “Immunoserology”) (N.B. See also under “Disputed paternity”) BRUISES It is impossible to comment on the age of a bruise less than 24 hours since infliction. - Bernard Knight (Forensic Pathology, 2nd Edition, page 143) It is not practicable to construct an accurate calendar of the color changes of bruises, as was done in older textbooks. - Bernard Knight (Forensic Pathology, 2nd Edition, page 143) If anyone thinks that he can accurately tell you the age of a bruise based on its appearance, he needs to have some serious re-education. - Jo Duflou, in an E-mail to a Forensic Discussion Group on Fri, 27 Oct 2000 NSW Institute of Forensic Medicine BURNS AND SCALDS Traditionally most authors claim that differentiation can be made between an ante-mortem and a post-mortem blister by an analysis for protein and chloride in the fluid; but I have yet to meet a pathologist who does this as a routine! One suspects that the test is another of the apocryphal procedures that have been handed down from textbook to textbook without verification. - Bernard Knight (Forensic Pathology, 2nd Edition, page 310-1) The exposed skin surface may be reddened in both ante-mortem and post-mortem burns; the classical distinction of a "red flare" or "vital reaction" is unsafe as an index of infliction before death. - Bernard Knight (Forensic Pathology, 2nd Edition, page 310) Can a man take fire in his bosom, and his clothes not be burnt? - Proverbs 6:27 (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 178) CAPITAL PUNISHMENT Don’t hang me too high.... for the sake of decency. - Mary Blandy, who murdered her father with arsenic to her executioner in 1775 (quoted in “Murder - Whatdunit” by J.H.H. Gaute and Robin Odell, page 40) CARDIAC AND VASCULAR LESIONS I would not have such a heart in my bosom for the dignity of the whole body. - Anonymous (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 17, in Chapter 3 entitled "Cardiology and Vascular Lesions") CAUSE OF DEATH The causes of death appear, unto our shame, perpetual. - Winter’s Tale (Quoted in “The Pathology of Trauma” 2nd Edition, Edited by J.K.Mason, page 1) Coronary atherosclerois is the Captain of the Men of Death. - Partially modified from a statement in Bernard Knight’s “Forensic Pathology”, 2nd Edition, page 488 Never diagnose two diseases when one will account for all the findings. -A common teaching (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 221, in Chapter 13 entitled “Medico-Legal aspects of Exotic Diseases”) (N.B. This quote comes with an interesting rider. The author goes on to say,”When dealing with patients who have travelled in the less developed parts of the world this rule should be reversed; never be satisfied that you have made a complete diagnosis when you have only found one abnormality.”) CHILD ABUSE Child abuse is the difference between a hand on the bottom and a fist in the face. - Henry Kempe COMPUTERS AND FORENSICS I’ll never write to my mistress using the wife’s PC again! - A Security Manager in a large company who witnessed computer forensic techniques in action (Quoted in “Computer Evidence: A Forensic Investigations Handbook” by Edward Wilding, page 183, on the last page of chapter 6 entitled “The Forensic Examination of PCs”) CRIMINAL INTERROGATION And He said,“Who told thee that thou wast naked? Hast thou eaten of the tree, whereof I commanded thee that thou shouldest not eat?” - Genesis 3:11 (Quoted by LeMoyne Snyder in his book “Homicide Investigation”, (Third Edition, May 1977) Published by Charles C. Thomas, Springfield, Illinois, USA, on page 87, in chapter 6 entitled “Scientific Criminal Interrogation”. This, according to the author, is the earliest example of Criminal Interrogation.) You are going to have to talk to people.. .. talk to people and make them feel like people.. .. you get a lot of results that way.. .. very smooth, very quiet. - E.W.Count, Cop Talk, Pocket Books, 1994 (Quoted in “Criminal Investigation - Basic Perspectives” by Paul B. Weston, Charles Lushbaugh and Kenneth M. Wells, eighth edition, 2000, Prentice Hall, page 134) CUTIS ANSERINA (See Drowning) DACTYLOGRAPHY Fingerprints can not lie, but liars can make fingerprints. - Paraphrase of a Old Proverb “Figures do not lie, but liars can do figures” (Reproduced in the “Journal of Forensic Sciences” Vol 44, No. 5, September 1999, on page 963, at the top of the Paper “A chronological Review of Fingerprint Forgery” by B. Geller et al.) Jekyll’s finger patterns remain the same when he transforms himself into Hyde! - Henry Faulds (1843-1930), one of the founders of the science of dactylography, commenting on the famous story “The Strange case of Dr. Jekyll and Mr. Hyde” by Robert Louis Stevenson, stressing that despite a complete change in appearance, the person could still be caught by the science of dactylography. (Quoted in “Suspect Identities - A History of Fingerprinting and Criminal Identification” by Simon A. Cole, Harvard University press, 2001, Page 3) Every human being carries with him from his cradle to his grave certain physical marks which do not change their character, and by which he can always be identified - and that without shade of doubt or question. These marks are his signature, his physiological autograph, so to speak, and this autograph can not be counterfeited, nor can he disguise it or hide it away, nor can it become illegible by the wear and mutations of time. This signature is not his face - age can change that beyond recognition; it is not his hair, for that can fall out; it is not his height, for duplicates of that exist; it is not his form, for duplicates of that exist also, whereas this signature is this man's very own - there is no duplicate of it among the swarming populations of the globe. This autograph consists of the delicate lines or corrugations with which Nature marks the insides of the hands and the soles of the feet. - Samuel Clemens, writing as Mark Twain, in The Tragedy of Pudd’nhead Wilson, 1894 (Quoted by Colin Beavan, at the beginning of his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001 A fingerprint expert can tell apart the marks of two digits more easily than he can differentiate two people’s faces. - Colin Beavan, on page 11 of his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001 A person’s fingerprint set is like a biological seal which, one impressed, can never be denied. - Colin Beavan, on page 11 of his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001 Fingerprints are like pages from the Recording Angel’s book of deeds. - Colin Beavan, on page 14 of his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001 The glands make each finger like a self-inking rubber stamp, leaving calling cards on every surface it touches. - Colin Beavan, on page 14 of his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001 But by far the most beautiful and characteristic of all superficial marks are the small furrows, with the intervening ridges and their pores that are disposed in a singularly complex yet regular order on the under surfaces of the hands and feet. - Francis Galton in his lecture “Personal Description and Identification” at the weekly evening meeting of the Royal Institution on May 25, 1888. Quoted by Colin Beavan, in his book “Fingerprints - The origins of crime detection and the murder case that launched forensic science”, Hyperion, New York, 2001, page 105 No scientific basis exists for requiring that a pre-determined minimum number of friction ridge features must be present in two impressions in order to establish a positive identification. - The “Ne’urim Declaration” 1995 (Quoted in “Suspect Identities - A History of Fingerprinting and Criminal Identification” by Simon A. Cole, Harvard University press, 2001, Page 259) I at first had little faith in this expert evidence, but after the experiment conducted by Lieutenant Faurot in the court-room, in the presence of the Court and jury….. when he was able to designate the person who made the imprint on the glass, I became satisfied that there is something to this science. - Judge Otto A. Rosalsky, sentencing hearing, “People of the State of New York v. Carlo Crispi, 1911 (Quoted in “Suspect Identities - A History of Fingerprinting and Criminal Identification” by Simon A. Cole, Harvard University press, 2001, Page 168) DIATOMS There is hardly a medicolegal journal that has not taken part in the “war of diatoms” in one way or another. - Spitz and Fisher in their book “Medicolegal Investigation of Death” 2nd Edition, page 360 The forensic pathology community has been, historically, polarized in its general acceptance of the diatom test as a definitive diagnostic test for drowning. - Michael S. Pollanen in his excellent book “Forensic Diatomology and drowning”, Elsevier, 1998 at page 6 DISPUTED PATERNITY A trial of bastardy is a trial of the blood. - Y.B., 12 Edw. 2, 388 (ed. 1679 from Sergeant Maynard’s MS) (From “Legal Medicine Annual, 1976, page 239, appearing at the top of the article “Paternity Actions - A matter of opinion or a trial of blood?” by Michael J. Beautyman) DISSECTION AND OBSERVATION Those who have dissected or inspected many bodies have at least learnt to doubt; while others who are ignorant of anatomy and do not take the trouble to attend it are in no doubt at all. - Giovanni Battista Morgagni (1682-1771); Italian Anatomist and Pathologist The corpse is a silent witness who never lies. - Anonymous Pay attention to the little things, and the big things will take care of themselves. - S. Venston Oh! Look, the dead teach the living! - Winternitz Taceant colloquia. Effugiat risus. Hic locus est ubi mors gaudet succurrere vitae. (Let conversation cease. Let laughter flee. This is the place where death delights to help the living) - Latin Proverb (Quoted in Bernard Knight’s “Forensic Pathology” at the Title Page. This quote is also supposed to have been inscribed on the lobby wall of Milton Helpern’s new office building {Milton Helpern was the third Chief Medical Examiner of the City of New York}) Mortui vivos docent - The dead teach the living. - Anonymous (Quoted in "The Autopsy-Medical Practice and Public Policy" by Rolla B. Hill and Robert E. Anderson; Butterworths 1988, page 191) Only the living have problems with the dead. Death is a mystery only to the living, and the living look to death for help - (From the frontpage of a forensic medicine practical notebook prescribed for undergraduate students at the Department of Forensic Medicine, Al-Ameen Medical College, Bijapur, India) Death comes to the aid of life. - An inscription in a Paris dissecting room I see no more than you, but I have trained myself to notice what I see. - Sherlock Holmes, "The Adventure of the Blanched Soldier" (Quoted in "Forensic Investigation of Explosives" Ed. Alexander Beveridge. Page 101 What the mind knows, the eyes will detect - (From the frontpage of a forensic medicine practical notebook prescribed for undergraduate students at the Department of Froensic Medicine, Al-Ameen Medical College, Bijapur, India) Dead body is extremely eloquent and honestly informative, if one exercises patience in listening to it. - Anonymous No autopsy should be taken as trivial; even those appearing most routine may throw up unexpected surprises. - Anil Aggrawal DNA TECHNOLOGY We wish to suggest a structure for the salt of deoxyribonucleic acid (DNA)…. - James D. Watson and Francis H.C. Crick in a scientific article published in “Nature” on April 23, 1953 (N.B. This quote is given in the book “DNA Technology - The Awesome skill” by I. Edward Alcamo, at the top of the Preface section. The author goes on to say that this article - with this opening sentence - stimulated a revolution in science and medicine. 31 years later - in 1984 - (Sir) Alec Jeffreys would develop the first DNA profiling test.) DNA technology could be the greatest single advance in the search for truth, conviction of the guilty, and aquittal of the innocent since the advent of cross-examination. - Judge Joseph Harris (1988) in People vs Wesley, 140 Misc. 2d 306, 533 N.Y.S. 2d 643 (Co. Ct. 1988) (Quoted in “DNA Fingerprinting- An introduction” by Lorne T. Kirby page xv: Stockton Press, 1990) DNA technology is the most awesome skill acquired since the splitting of the atom. - Editorial in a major news magazine (Reproduced on the back jacket of the book “DNA Technology - The Awesome skill” by I. Edward Alcamo) We have the potential within our grasp of a technology that in routine investigations will identify suspects as reliably as fingerprints. - Jeremy Travis, Director, National Institute of Justice (quoted in “Blood Trail - True crime mysteries solved by DNA Detectives” by Judge Gerald Sheindlin and Catherine Whitney on page 117) If we had called this “idiosyncratic Southern blot profiling,” nobody would have taken a blind bit of notice. Call it “DNA fingerprinting,” and the penny dropped. - Alect Jeffreys, 1996 (Quoted in “Suspect Identities - A History of Fingerprinting and Criminal Identification” by Simon A. Cole, Harvard University press, 2001, Page 287) Our genetic differences are at the heart of one of the most fascinating paradoxes of the human condition: that we are all different, yet we are all the same. - Geneticist Mary-Claire King, 1993 (Quoted in “Suspect Identities - A History of Fingerprinting and Criminal Identification” by Simon A. Cole, Harvard University press, 2001, Page 303) DROWNING Odysseus bent his knees and sturdy arms, exhausted by his struggle with the sea. All his flesh was swollen and streams of brine gushed from his mouth and nostrils. Winded and speechless he lay there too weak to stir, overwhelmed by his terrible fatigue. - The Odyessey, Calypso (Book V), Homer (Quoted in the Preface in “Forensic Diatomology and drowning” by Michael S. Pollanen) Lord, Lord! methought what pain it was to drown, What dreadful noise of water in mine ears! What sights of ugly death within mine eyes. - Shakespeare, Richard III (1 iv), (Quoted in “Medicine, Science and the Law” (1980), Vol 20, No. 4, page 254; and also in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 214) If the man go to the water and drown himself, it is, will he, nill he, he goes. - Hamlet, Act V, Scene I (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 70, in Chapter 4 entitled “Respiration”. This quote appears at the top of a sub-chapter entitled “Immersion in fluids”) The ability to swim is not an important correlate of drowning since most victims of drowning are able to swim. - Michael S. Pollanen in his book “Forensic Diatomology and drowning”, Elsevier, 1998 at page 8 Cutis anserina or gooseflesh (is) due to postmortem rigidity of short muscle fibers in the skin. - Caption to figure II-2, on page 15 in “Medicolegal Investigation of Death”, by W.U. Spitz and Russell S. Fisher, 2nd Edition, 1980, Charles C. Thomas, Springfiled, Illinois, USA Cutis anserina - or ‘goose flesh’ - is a common finding in immersed bodies.. ..It is often stated that rigor mortis can produce this goose-flesh appearance, but this is doubtful, as rigor does not shorten muscles appreciably. - Bernard Knight in his “Forensic Pathology” 2nd Edition 1996, page 391 (N.B. Last two quotes are antethetical in nature - and both are from contemporary books - meaning thereby that this controversy is far from over) DYADIC DEATHS “I kissed thee ere I killed thee. No way but this, Killing myself to die upon a kiss.” (He falls over her and dies) - Othello exclaiming after killing Desdemona and stabbing himself. Othello, Act 5, Scene 2, William Shakespeare (Quoted in “Combined Homicide-Suicide in Galveston County” by Alan R. Felthouse et.al. J. Forens. Sci. 2001, 46(3) 586-592”. This quote appears on page 586) EMBOLISM BULLET Missiles often attain more curious places by accident than they could by design. - Sir John Bland-Sutton in his classic paper “A lecture on missiles as emboli”. Lancet, i:773, 1919 (This interesting quote is reproduced in the paper“Rich N.M. et. al. Missile Emboli. The Journal of Trauma, 1978, Vol 18. No. 4, on page 237) The occurrence of free projectiles in the bloodstream, although doubtless very rare, has already become something more than a surgical curiosity, and its possibility may well be borne in mind by those who observe anomalous symptoms after gunshot wounds, especially when the projectile is not found. - Editorial: Migration of projectiles in the blood stream. Lancet, ii: 395, 1917 (This interesting quote is reproduced in the paper “Rich N.M. et. al. Missile Emboli. The Journal of Trauma, 1978, Vol 18. No. 4, on page 237) Understandably, the literature on bullet embolism consists of a number of single case reports. - Lam, C.R. and McIntyre, R. Air pistol injury of pulmonary artery and aorta: Report of a case with peripheral embolization and pellet and residual aorticopulmonary fistula. J. Thorac. Cardiovascular Surg., 59: 729, 1970 (This interesting quote is reproduced in the paper “Rich N.M. et. al. Missile Emboli. The Journal of Trauma, 1978, Vol 18. No. 4, on page 236) An aura of mystery and intrigue often surrounds these unusual lesions. - Norman M. Rich, in his paper “Rich N.M. et. al. Missile Emboli. The Journal of Trauma, 1978, Vol 18. No. 4, on page 236” PULMONARY Pulmonary embolism is the most underdiagnosed cause of death, where no autopsy is performed. - Bernard Knight (Forensic Pathology, 2nd Edition, page 334) EXHUMATION Those who arrange exhumations, and doubtless sleep through them, have always assumed that if timed at the crack of dawn an exhumation will be quiet, private affair. - Professor Keith Simpson, in his autobiography “Forty Years of Murder”, Grafton Books 1978, at page 234) EXPERT TESTIMONY The role of the expert witness is not to provide the evidence which supports the case for the Crown nor for the defence, unless that opinion is objectively reached and has scientific vailidity. - Practice Guidelines of the Police Advisory Board in Forensic Pathology of the British Home Office (Quoted in Bernard Knight's Forensic Pathology, 2nd Edition, Preface) A good medical expert must serve but one client, and that client should be truth. - Erle Stanley Gardner If the law has made you a witness, remain a man of science; you have no victim to avenge or guilty or innocent person to ruin or save. You must bear testimony within the limits of science. - Dr. P.C.H. Brouardel( Late 19th century French Medico-Legist)(Reproduced in “Forensic Radiology” by B.G. Brogdon, at page 364. Also quoted in “The American Journal of Forensic Medicine and Pathology”, Vol 20, Number 1, March 1999 at page 17, where it is attributed to Paul H. Broussard, Chair of Forensic Medicine, Sorbonne, 1897) The conscience is a thousand witnesses. - Richard Taverner Let no man swear on oath falsely, even in a trifling matter, for he who swears on oath falsely, is lost in this world and after death. - Manu (Ancient Hindu Law giver) You can lead a jury to the truth, but you can’t make them believe it. - Herbert Leon Macdonell (Quoted at the opening page in his book “The Evidence never lies”) An expert, as the word imports, is one having had experience. No clearly defined rule is to be found in the books what constitutes an expert. Much depends upon the nature of the question in regard to which an opinion is asked. - Oil Co. v. Gilson, 63 Pa. St. 146, 150 (1869) (Quoted in “Scientific and Legal Applications of Bloodstain Pattern Interpretation” Ed. Stuart H. James, page 131) "..the thing from which the deduction is made must be sufficiently established to have gained general acceptance in the particular field in which it belongs" - (Frye v. United States (1923), often known as "The Frye Standard". In this case, the scientific evidence being presented was the theory underlying lie-detector testing. It ultimately was not admitted and remains inadmissible to this day in law courts) "For gauging the scientific validity of evidence, it should be seen whether the technique in question can be or has been tested; whether the technique has been subjected to peer review and publication; its known or potential error rate; the existence of standards controlling its operation and whether the methodology in question has attracted widespread acceptance within the relevant scientific community." - US Supreme Court in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S.C.T. 2786 (1993); popularly referred to as the “Daubert Standard” There is nothing worse than a pompous expert. - Judge Haskell M. Pitluck (Reproduced in “Forensic Radiology” by B.G. Brogdon, at page 372) Expert witnesses should refrain from conducting themselves as though their service is a contest between themselves and some other party. - Reproduced from the document entitled “Recommended Practices for Design Professionals Engaged as Experts in the Resolution of Construction Industry Disputes” prepared by The Association of Soil and Foundation Engineers (ASFE) (quoted on page 353 in the book “Forensic Engineering” by Kenneth L. Carper (CRC Press 1998)) The witness must never be considered an advocate, and should always “call the shots as they are”. - Joseph S. Ward, P.E. (quoted on page 336 in Chapter 12 written by him on “The Engineer as Expert Witness” in the book “Forensic Engineering” by Kenneth L. Carper (CRC Press 1998)) For every expert there is an equal and opposite expert. - Contributed by Mike Duxbury Direct questioning in the initial stages of a trial is like a walk in the park when compared with the antagonistic manner evident in cross examination. - Tom Bevel and Ross M. Gardner in “Bloodstain pattern analysis” CRC Press, 1997, page 271 What the doctor puts into his report at the time of examination must be of sufficient resilience to survive intense cross-examination in the court room many months later. - Bernard Knight in “The Estimation of the Time Since Death in the Early Postmortem Period”, Edward Arnold, 1995, page 2 FALL FROM HEIGHTS Falls from heights represent the third most common cause of accidental death in the United States. - National Safety Council. Accidental Facts, 1985 Chicago. National Safety Council, 1985 (Quoted in the paper "The Investigation of Fatal Falls and Jumps from Heights in Maryland (1987-1992)" by Ling Li and John E. Smialek. American Journal of Forensic Medicine and Pathology 15(4):295-299, 1994) FOETUS, AGE OF Morphological measurements are by no means infallible indicators of chronological age. - Bernard Knight (Forensic Pathology, 2nd Edition, page 444) The time of appearance of ossification centers (in a foetus) is no longer as uniform as once thought. - Bernard Knight (Forensic Pathology, 2nd Edition, page 444) FORENSIC ANTHROPOLOGY That's how I feel about the skeletons in my laboratory. These have tales to tell us, even though they are dead. It is up to me, the forensic anthropologist, to catch their mute cries and whispers, and to interpret them for the living, as long as I am able. - William R. Maples (1937-1997), the famous Forensic Anthropologist, in his book "Dead Men do tell tales" at page 280 (published by Doubleday, New York, 1994) For me, every day is Halloween. - William R. Maples in his book "Dead Men do tell tales" at page 2 FORENSIC ART AND ILLUSTRATION It has been said that pen is mightier than the sword.. .. if used correctly, so is the pencil.. . - Karen T. Taylor in her book "Forensic Art and Illustration", CRC Press 2001, at page 561 FORENSIC BALLISTICS A cartridge case at the scene of offence could prove as incriminating as if the murderer had left his visiting card! - Sir Sydney Smith Second only to motor vehicles as instruments of death, firearms will kill more than 32,000 Americans this year. - (National Research Council 1985: Reproduced in "Gunshot Wounds - Pathophysiology and Management" by Kenneth G. Swan & Roy C. Swan. 2nd Edition, 1989, Yearbook Medical Publishers Inc. Chicago, at page ix) Gunshot wounds are now becoming almost a distinct branch of surgery - (J.A. Hunter in "Treatise on the Blood, inflammation and Gunshot wounds: London, G. Nicol, 1794: Reproduced in "Gunshot Wounds - Pathophysiology and Management" by Kenneth G. Swan & Roy C. Swan. 2nd Edition, 1989, Yearbook Medical Publishers Inc. Chicago, at page 1) We are aware of no report of a penetrating wound of the abdomen, during pregnancy, not involving the uterus - (Dyer I, Barclay D: Accidental Trauma complicating pregnancy and delivery. Am. J. Obstet. Gynec. 1962; 83: 907) Only a man who has a pistol needs it. - An old saying My wife yes; My dog maybe; My gun never! - Bumper Sticker (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 1) There is nothing more exhilarating than to be shot at without result. - Winston Churchill (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 65) God created men equal. Sam Colt made 'em equal. - Anonymous (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 123) The U.S. Exports Coca Cola; Japan exports Sony; Russia exports Kalashnikovs. - Anonymous (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 167) Is there life after death? Trespass and find out. - Bumper Sticker (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 253) This property is protected by Smith & Wesson. - Bumper Sticker (Quoted in "Gunshot Wounds", 2nd Edition, by Vincent J. M. Di Maio, on page 253) It is always hazardous to conclude that a person could not have done some rational act after receiving gunshot wounds in vital organs. - LeMoyne Snyder in his book "Homicide Investigation", (Third Edition, May 1977) Published by Charles C. Thomas, Springfield, Illinois, USA, on page 139, in chapter 7 entitled "Homicide due to Gunshot Wounds" You will acquire a deep understanding of that ancient Christian moral principle, as applied to aimed fire,"It is better to give than to receive" - George Prosser, Black Politics, 1968 (quoted at the beginning of the book "Armed and Dangerous - A writer's guide to weapons" by Michael Newton, Writer's Digest Books, Ohio, 1990) There is nothing wrong with shooting, as long as the right people get shot. - "Dirty Harry" Callahan (quoted at the beginning of the book "Armed and Dangerous - A writer's guide to weapons" by Michael Newton, Writer's Digest Books, Ohio, 1990) Whatever happens, we have got, The Maxim gun and they have not. - A popular jingle quite popular with the imperialists in the late 19th and early 20th Century. (Quoted by Isaac Asimov in "Asimov's New Guide to Science", Penguin Books 1987, page 495) (N.B. In the 1860s the American Inventor Richard Gatling produced the first machine gun. This was improved upon in the 1880s by another American inventor Hiram Stevens Maxim in 1880s. These guns were respectively called the Gatling gun and the Maxim gun. The Gatling gun also gave rise to the slang gat for gun. These guns gave tremendous advantage to the Imperialists over Africans and Asians. The word "they" in the jingle refers to these Africans and Asians.) FORENSIC ENTOMOLOGY 'Who saw him die?' 'I', said the fly 'With my little eye, I saw him die.' - Anon., 'Who killed Cock Robin' (quoted by Zakaria Erzinçlioglu in his book "Maggots, Murder and Men - Memories and Reflections of a Forensic Entomologist" Harley Books, England 2000, on page 13) In the midst of all this decay, death calls in reinforcements. - Heather Pringle in her book "The Mummy Congress - Science, Obsession, and the Everlasting Dead", Theia, New York, 2001, page 39 FORENSIC MYTHOLOGY Descriptions of an abnormal fluidity of blood seen at autopsy in asphyxial deaths are part of forensic mythology and can be dismissed with little discussion. - Bernard Knight (Forensic Pathology, 2nd Edition, 1996, page 350) Persistent fluidity of the blood likely relates to inhibition of the coagulation process due to some unknown mechanism. - Michael S. Pollanen in his book "Forensic Diatomology and drowning", Elsevier, 1998 at page 26 (N.B. Quotes 1 and 2 are antethetical in nature - and both are from contemporary books - meaning thereby that this controversy is far from over. For other similar forensic controversies, see quotes on "Petechial haemorrhages" and "Hydrostatic Test") Descriptions and photographs of air segments in the cerebral veins are part of the mythology of forensic pathology, handed on uncritically from one book and one author to another. - Bernard Knight (Forensic Pathology, 2nd Edition, page 342 and 433) (N.B. Knight tells us through this pithy quote that air-embolism can not be, and should not, be diagnosed by seeing air bubbles in cortical veins, because there is simply no way, air bubbles could travel upstream!) FORENSIC ODONTOSTOMATOLOGY The jaws that bite, the claws that catch! - Through the Looking Glass (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 137, in Chapter 7 entitled "Odontology: its Forensic Applications") Dormouse to the expanding Alice : "I wish you wouldn't squeeze so" said the Dormouse who was sitting next to her. "I can hardly breathe." "I can't help it" said Alice very meekly, "I'm growing." "You've no right to grow here" said the Dormouse. "Don't talk nonsense," said Alice more boldly: "you know you're growing too."Yes, but I grow at a reasonable pace," said the Dormouse. "Not in that ridiculous fashion." - Cited in Lovat LS. The prosecution view of dental evidence. J Forensic Sci Soc. 1974 Jul;14(3):253-8. This quote – my favorite – is very cleverly cited by Lovat to show how sometimes science can grow at a much faster rate that associated law. In this very pertinent allegory, while Alice refers to the fast growing science of forensic odontostomatology, the Dormouse refers to “not so fast growing” law, which may have difficulties accepting dental evidence. FORENSIC OSTEOLOGY The skin and bones tell a story which the child is either too young or too frightened to tell. - Johnson, Cameron and Camps (Quoted in Bernard Knight's Forensic Pathology, 2nd Edition, page 458) It is difficult for me to evaluate how a single skull is classified as white, or Negro, or Mongoloid. - W.M.Krogman, in his "The Human Skeleton in Forensic Medicine" (1962), at page 195 As those who study them have come to learn, bones make good witnesses - although they speak softly, they never lie and they never forget. - Dr. Clyde Collins Snow, forensic anthropologist (Quoted in "The Bone Detectives" by Donna M. Jackson at the front page) FORENSIC PATHOLOGY AND FORENSIC PATHOLOGISTS Professor John Glaister II (1892-1971) He is the man who furnishes Perry Mason with so many authentic facts. - Erle Stanley Gardner on Professor John Glaister II (1892-1971), Professor of Forensic Medicine at Glasgow University, Scotland (Quoted in "The Bedside Book of Murder" by Richard & Molly Whittington-Egan, at page 171) Edward O. Heinrich (1881-1953) Just the mention of his name was enough to send shudders through opposing counsel. -Colin Evans on Edward O. Heinrich (1881-1953) in his book "The Casebook of Forensic Detection" John Wiley & Sons 1996, page 301 (N.B. Edward Oscar Heinrich was one of the most remarkable figures in the history of US Jurisprudence. Epithets commonly ascribed to him are "The American Sherlock Holmes" and "The Edison of Crime Detection") Henry C. Lee (1938-) How the hell did he know? - A defendant heard to whisper, after Lee had methodically walked the court through each step the killer took during the murders. (N.B. Lee used blood spatter and other other evidence to do this. This anecdote appears in "Cracking Cases" by Henry C. Lee with Thomas W. O'Neil, Prometheus books, 2002, page 9) Thomas T. Noguchi (1927- ) I love to enter the crime scene from the kitchen. - This is what Noguchi said, when interviewed in November 1986 by Douglas Stein. For full story please visit http://www.omnimag.com/index.html (Readers may want to know why. He follows up the above statement with this: People's minute-to-minute movements are registered here. I routinely open the refrigerator to get people's life-styles: the type of food they like, where they buy, how much they pay, how they wrap. In one homicide I investigated, the homeowner returned early, surprising the burglar, so the burglary ended in murder. But the burglar was hungry, so he had a bite to eat before leaving. We found distinct teeth marks in the cheese!") Sir Bernard Henry Spilsbury (1877-1947) ~ His Adulation He stood for forensic pathology as Hobbs stood for cricket or Dempsey for boxing or Capablanca for chess. - Edgar Lustgarten on Sir Bernard Henry Spilsbury (1877-1947), probably the greatest Forensic Pathologist, the English world has seen (Quoted in "The Bedside Book of Murder" by Richard & Molly Whittington-Egan, at page 164) He could achieve single-handed all the legal consequences of homicide - arrest, prosecution, conviction and final post-mortem - requiring only the brief assistance of the hangman. - Dr. Richard Gordon on Sir Bernard Henry Spilsbury (1877-1947) (Quoted in "The Bedside Book of Murder" by Richard & Molly Whittington-Egan, at page 164) A simple newspaper report of Sir Bernard's attendance at a mortuary or churchyard is enough to condemn an accused man to death, even before committal proceedings have begun. - Dr. Patrick Brontë, Spilsbury's bitter professional rival (this quote appears on page 25 in the article "Is Sir Bernard Spilsbury Dead?" in "Crime Investigation: Art or Science?", edited by Alistair R. Brownlie. Scottish Academic Press, Edinburgh 1984) ~ His Criticism When did you last examine a live patient Sir Bernard? - A young chirrupy young barrister to Sir Bernard Henry Spilsbury in the court room (Quoted in "The Bedside Book of Murder" by Richard & Molly Whittington-Egan, at page 164) Spilsbury's statements in the witness box were often based upon insufficient material, and a lack of clinical experience. - Professor Michael A. Green on page 24 in the article "Is Sir Bernard Spilsbury Dead?" in "Crime Investigation: Art or Science?", edited by Alistair R. Brownlie. Scottish Academic Press, Edinburgh 1984 When Sir Bernard speaks as a pathologist, I respect his opinion. When he gives a view on an obstetric matter, I hold him in contempt. - Alec Boune, the distinguished gynaecologist called by the defence in a case in which Spilsbury appeared from the other side (this quote appears on page 24 in the article "Is Sir Bernard Spilsbury Dead?" in "Crime Investigation: Art or Science?", edited by Alistair R. Brownlie. Scottish Academic Press, Edinburgh 1984) ~ His Conceit I have never claimed to be God - but merely his locum on his weekends off. - Bernard Spilsbury (this quote appears on page 25 in the article "Is Sir Bernard Spilsbury Dead?" in "Crime Investigation: Art or Science?", edited by Alistair R. Brownlie. Scottish Academic Press, Edinburgh 1984) Rudolph Virchow (1821-1902) Rudolph Ludwig Karl Virchow, where are you now that we need you? - Leon Eisenberg, 1984 (Quoted in "The Autopsy-Medical Practice and Public Policy" by Rolla B. Hill and Robert E. Anderson; Butterworths 1988, page 251) General The commonest causes of death amongst forensic pathologists are alcohol related! - Contributed by Dr. Gyan Fernando So why the dead body, the often smelly morgue, exhumation, lust and violence, the inconvenience of calls to derelict premises, dells in Epping Forest, ponds, prostitutes' bedrooms at odd hours; of sudden challenge, hard duels with lawyers, pompous old judges and obtuse juries? Why? - Professor Keith Simpson, asking himself the question "Why he chose Forensic Pathology despite being the best student in his medical career" (This interesting quote appears in his autobiography "Forty Years of Murder", Grafton Books 1978, at page 9) (N.B. Professor Keith Simpson follows it up with this answer: Well, few doctors can enjoy a more exciting life, such a challenge to be constantly on the qui vive, or should it be the qui meure?) As Stethoscope and BP Instruments are status symbols of a physician and Surgeon, so are Lens and Measuring tape to an Autopsy Surgeon. - Professor Heeresh Chandra (Quoted in his site) An operation during life is attended by pain and is for the benefit of the individuals. An operation after death is free from pain and is for the benefit of humanity. - Braouardel & Jasolin (Quoted by Professor Heeresh Chandra in his site) FORENSIC PHOTOGRAPHY A picture tells a thousand words. - An old adage (quoted in Chapter 9 of the book "Craniofacial Identification in Forensic Medicine". The chapter is on "Crime Scene Photography") A picture is worth a thousand words. However, few investigators may realize that 'a picture may also contain a thousand measurements'. - John H. Garstang, in chapter 6 entitled "Aircraft Explosive Sabotage Investigation" page 153, in the book "Forensic Investigation of Explosions" edited by Alexander Beveridge, Taylaor & Francis, 1998 (N.B. There is a veiled reference here to photogrammetry, a technique which is increasingly being used in forensic investigations now. Photogrammetry is the art, science and technology of obtaining reliable information about physical objects and the environment through processes of recording, measuring and interpreting photographic images and patterns of electromagnetic radiant energy and other phenomena.) A good photograph is tantamount to stopping the clock. - unknown (quoted on page 35 in Chapter 3 (fire investigation) of the book "Forensic Engineering" by Kenneth L. Carper (CRC Press 1998)) FORENSIC PSYCHIATRY ".. . the Tories have compelled me to do this. They follow and persecute me wherever I go and have entirely destroyed my peace of mind.. .," - Daniel M'Naughten 1843 (quoted in "Forensic pharmacology - Medicines, Mayhem, and Malpractice" by R.E. Ferner, Oxford University Press, 1996, page 66) (N.B. Daniel M'Naughten was a mentally disturbed person - a Scotsman from Glasgow. He had a delusion of persecution, that Tories were trying to kill him. In his time Sir Robert Peel was the Prime Minister of Britain - from December 1834 till March 1835, and then again from September 1841 till July 1846. On 20th January 1843, Daniel was seen loitering in Whitehall Gardens, and followed Mr. Edward Drummond, the private secretary of Sir Robert Peel, from Sir Robert Peel's house till a street in Charing Cross, where he shot him. He believed that Mr. Edward Drummond was the Prime Minister himself. Mr. Drummond lingered, in great pain, until January 25th, when he died. M'Naughten was brought to trial on 3rd March, 1843 at the Old Bailey before Chief Justice Tindal, and two other Queen's bench judges, Williams and Coleridge. It was at this historic trial that the famous "insanity defense" emerged, known to this day as the "M'Naughten rule".) -- We do not believe that anyone could be insane who wanted to murder a Conservative Prime Minister. - A young Queen Victoria (1840-1901) referring to Daniel M'Naughten (see above for details). The quote appears in "If A Man Be Mad - A scientist testifies against the insanity defense" by David T. Lykken. Lykken, who is a professor of psychiatry and psychology at the University of Minnesota, says that this was an immortal quip by Queen Victoria, not otherwise known for her wit. When you speak to God it's called praying; but when God speaks to you it's called schizophrenia. - A West German observer comment on the psychiatric evidence given during the Yorkshire Ripper's Trial (quoted in "Science Against Crime", Published by Marshall Cavendish, 1982, on page 175) (N. B. A brief note may be appropriate here. The Yorkshire Ripper or Peter Sutcliffe killed 13 women in Leeds and adjoining areas between October 1975 and November 1980. At his trial, which began May 1981, he said he had heard the voice of God instructing him to kill.) -- Such terms as 'mental disease and mental defect' give expert pyshiatric witnesses a blank check. - Justice Kaufman criticizing the Durham test (N. B. A brief note might well be in order here. In Durham vs. United States, 1954, Justice David L. Bazelon abandoned the M'Naghten criteria, and used a new criterion known as the Durham test, which was perpetually in criticism. It was finally overturned by Justice Bazelon himself in 1972 in United States vs. Brawner. The Durham rule stated that "an accused is not criminally responsible if his unlawful act was the product of mental disease or defect".) -- The psychiatrists spun sticky webs of pseudoscientific jargon, and in those webs the concept of justice, like a moth, fluttered feebly and was trapped. - A prominent columinst, after the 1982 verdict of a District of Columbia jury, which found John W. Hinckley, Jr., the would-be assassin of President Ronald Reagan, not guilty by reason of insanity (quoted in Kaplan and Sadock's Synopsis of Psychiatry - Behavioral Sciences/Clinical Psychiatry, eighth edition 1998, by Harold I. Kaplan, M.D. and Benjamin J. Sadock, M.D. Page 1316) Had M'Naghten been tried under M'Naghten's rules in any American court, there would have been a battle of the "experts" and M'Naghten would surely have been found legally sane and would have been found guilty as charged. - Matthew Brody, M.D., Acting Chief, Psychiatry, Brooklyn Jewish Hospital and Medical Center, testifying in 1965, before a joint legislative commission of the penal law and criminal code. This commission recommended some alteration of the M'Naghten Rule. This quote is reproduced by Matthew Brody himself in his paper entitled "Trial of Daniel M'Naghten" published in March 1982 issue of "New York State Journal of Medicine". This quote appears on page 381 A man might say that he picked a pocket from some uncontrollable impulse, and in that case the law would have an uncontrollable impulse to punish him for it. - Baron Alderson, the presiding judge deciding on the fate of Robert Pate, who went on trial in 1850 for the high misdemeanor of striking Queen Victoria with his walking stick. Pate's counsel had claimed irresistible impulse as a defence. The quote appears in "If A Man Be Mad - A scientist testifies against the insanity defense" by David T. Lykken. FORENSIC RADIOLOGY Now we see through a glass darkly. -I Corinthians 13 (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 149, in Chapter 8 entitled "Radiology and its forensic application") FORENSIC SCIENCE AND FORENSIC MEDICINE Forensic Science is the link between the criminal and the crime. - Ken Goddard, Wildlife Forensics, (quoted in Natur (German) Nov. 1990) Forensic Science can be defined as the application of the laws of nature to the laws of man. - Michael J. Camp, (quoted by P. ChandraSekharan in "Indian Journal of Forensic Sciences" Vol 5, April 1991, No. 2, p. 37) Forensic Science is used to predict not the future but the past. - Henry C. Lee (Reproduced in "Forensic Radiology" by B.G. Brogdon, at page 279) (N.B. The book goes on to say,"Nowhere in Forensic Radiology is Dr. Lee's provocative aphorism less applicable than in the field of abuse. Here lies the opportunity to go beyond the limits of the necropsy 'where death delights to help the living'.") Legal medicine has been described as the key to the past, the explanation to the present, and, in some measure, as a signpost to the future. - Professor J. Malcolm Cameron, in his Presidential address to the British Academy of Forensic Sciences, also published in "Medicine, Science and the Law" (1980), Vol 20, No. 1, in the paper entitled "The Medico-legal Expert - Past, Present and Future" page 3 There is only one path to the mastery of Forensic Medicine, and that is an extensive practical experience. - Harvey LittleJohn She's cold Her blood is settled and her joints are stiff, Life and these lips have long been separated, Death lies on her like an untimely frost, Upon the sweetest flower of all the field - William Shakespeare Most sudden deaths are of cardiac origin. - Fortunatus Fidelis (1598) It will never be possible to eliminate all chance of error or misjudgement, but the Forensic Science Service strives to do the greatest good for the greatest number, for the greatest part of time. - Professor Michael Green, University of Sheffield (quoted in "The Modern Sherlock Holmes- An Introduction to Forensic Science Today" by Judy Williams, at page 12) The science of Forensic Medicine turns the clock back. It relivens the dead. - R.D. Rikhari (Editor "Invention Intelligence". Sent on July 14, 2000. His original quote was "Your profession turns the clock back. It relivens the dead") Forensic medicine is like an illegitimate child of health and home departments. We belong to both, but none belong to us. We offer our services to both, we are answerable to both, but we receive nothing from either. I feel that it is high time that our paternity be ascertained and we be adopted by our rightful parentage. - Professor L. Fimate, President of the Indian Academy of Forensic Medicine (IAFM), in his inaugural speech on the occasion of XXII Annual Conference of The Indian Academy Of Forensic Medicine, Jaipur, India, 5 - 7 January 2001 Many people ask me why I chose Forensic Medicine as a career, and I tell them that it is because a forensic man gets the honor of being called when the top doctors have failed! - Anil Aggrawal, Professor of Forensic Medicine, Maulana Azad Medical College, New Delhi-110002, India There is no such thing as 'forensic science'; instead it is a collection of scientific techniques and principles that are begged and borrowed from 'real' sciences such as chemistry, biology, physics, medicine and mathematics. - A general saying by some experts (cited in the Introduction to "Encyclopedia of Forensic Sciences" edited by Jay A. Siegel, Pekka J. Saukko and Geoffrey C. Knupfer. 2000 Academic Press.) The 'sciences' of fingerprints, firearms and toolmarks and questioned documents are the only real forensic sciences; all the rest of it is on loan from the classical hard sciences. - Another general saying (cited in the Introduction of "Encyclopedia of Forensic Sciences" edited by Jay A. Siegel, Pekka J. Saukko and Geoffrey C. Knupfer. 2000 Academic Press.) It has always been a source of amazement to me, how a subject as inherently fascinating as Forensic Medicine, can be presented in a dull and uninteresting manner as is the case with some of the existing books on the subject. - Dr. V.V.Pillay, in the preface of the book "MKR Krishnan's Handbook of Forensic Medicine and Toxicology", Paras Publishing, 12th Edition, 2001 FORENSIC SCIENTISTS Francis Galton (Feb 16, 1822 - Jan 17, 1911) ~ General Francis Galton's arrival on Henry Fauld's stage was like the antihero's entrance in a tragically ending play. - Colin Beavan, in "Fingerprints - The origins of crime detection and the murder case that launched forensic science", Hyperion, New York, 2001, page 94 ~ His Criticism He was notorious for using his status against those with fewer advantages. - Colin Beavan, in "Fingerprints - The origins of crime detection and the murder case that launched forensic science", Hyperion, New York, 2001, page 94 Those who dared to oppose him learned that he was, by all accounts, that dangerous breed of dog who bites before even bothering to growl. - Colin Beavan, in "Fingerprints - The origins of crime detection and the murder case that launched forensic science", Hyperion, New York, 2001, page 94 GENERAL Satyameva Jayate (Truth alone triumphs) - An Old Sanskrit saying, very popular in India, often written on plaques in Judges’ rooms If you can't prove it, don't claim it. - Bernard Knight, (Quoted in Bernard Knight's “Forensic Pathology”, 2nd Edition, Preface) I keep six honest serving men (They taught me all I knew); Their names are What and Why and When And How and Where and Who - Rudyard Kipling (1865-1936) Indian born British writer, in “Just so stories” (Cited in “Recent Advances in Forensic Pathology” edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 216, in Chapter 13 entitled "Medico-Legal aspects of Exotic Diseases") (N.B. The author at the end of this chapter stresses on Population explosion and advises the doctors to think in terms of global medicine. On page 221, he modifies Kipling’s quote like this: ..She keeps ten million serving men, Who get no rest at all! She sends ‘em abroad on her own affairs, From the second she opens her eyes- One million Hows, two million Wheres, And seven million Whys!) Truth is incontrovertible Panic may resent it Ignorance may deride it Malice may distort it But here it is. - Winston Churchill In a sense, the victim shapes and moulds the criminal. - Hans von Hentig "Excellent," I cried. "Elementary", said he. - Arthur Conan Doyle (1859-1930): ("The Memoirs of Sherlock Holmes" (1894) 'The Crooked Man'. The oft quoted "Elementary, my dear Watson" is not found in any book by Conan Doyle) Seldom say never- seldom say always! - Forensic Proverb (Quoted in Bernard Knight's “Forensic Pathology”, 2nd Edition, at the Title page) In God we trust......All others are suspects - (Contributed by Signal45@aol.com who picked this quote from a homicide investigators school in Southern Louisiana) In Forensic Medicine, eye the most, hand the next and tongue the least. - (From the frontpage of a forensic medicine practical notebook prescribed for undergraduate students at the Department of Froensic Medicine, Al-Ameen Medical College, Bijapur, India) Well now; there’s a remedy for everything except death. - Sancho Panza in Don Quixote by Miguel de Cervantes (1547-1615) (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 30) He that digeth a pit shall fall into it. - Ecclesiastes 8 (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 269) The problem isn’t with what we don’t know. The problem is with what we do know that isn’t so. - Will Rogers. (Quoted at the beginning of the article “Shaken Baby Syndrome and Death of Matthew Eappen” by John Plunkett, M.D., in The American Journal of Forensic Medicine and Pathology”, Vol 20, Number 1, March 1999 at page 17) You do the work in the daytime and cry at night! - Clyde Snow (1928- ), forensic anthropologist, on his philosophy of life I guess you can say law enforcement officials have come a long way since the days of Sherlock Holmes and his magnifying glass. - Northumberland County District Attorney Robert Sacavage, at the conclusion of the Robert Auker murder trial (Quoted in “Hard Evidence” By David Fisher at page 381) Dead Men tell tales! - The title of Juergen Thorwald’s book (Published by Thames and Hudson, London, 1965) Dead Men tell no tales! - LeMoyne Snyder in his book “Homicide Investigation”, (Third Edition, May 1977) Published by Charles C. Thomas, Springfield, Illinois, USA, on page 376, in chapter 20 entitled “Popular Fallacies in Homicide Investigation” (N.B. This interesting quote, although outwardly appearing as an antithesis to the quote preceding it, must be read in the proper context. Snyder follows up this interesting quote with the following qualifying remark: “How much they tell may be in direct proportion to the care, diligence and conscientious effort that the investigators and the laboratory technicians apply to the investigation. Sometimes the dead man actually becomes eloquent. As the science of homicide investigation advances, dead men will tell more and more.”) Dead Men do tell tales! - The title of William R. Maple’s (1937-1997), book (published by Doubleday, New York, 1994) (N.B. Quite appropriately, this quote sets the matter right once again, by reiterating the earlier quote! Thus the wheel seems to have turned one full circle.) Take nothing for granted because things are not always what they seem. - LeMoyne Snyder in his book “Homicide Investigation”, (Third Edition, May 1977) Published by Charles C. Thomas, Springfield, Illinois, USA, on page 141, in chapter 7 entitled “Homicide due to Gunshot Wounds” A medicolegist must avoid talking too much, talking too soon and talking to the wrong persons. - Anonymous Fools and Wise men are equally harmless. Dangerous are those who are half foolish and half wise, and only see half of everything.. - General saying (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 8, in Chapter 2 entitled “Thanatology”) A Corpus Delicti is not a corpse. - Title of chapter 6 (at page 177) in Herbert Leon Macdonell's book “The Evidence never lies", published by Dell Publishing, 1984 Life is like an autopsy -- one piece at a time. - Anonymous (I found the above interesting quote as an attachment from an E-mail I received from clemency@innocent.com ) One can not expect a quality investigation if the technical consultant is given inadequate time for preparation and analysis. - Genck 1987 (Quoted in “Tire Imprint Evidence” by Peter McDonald, 1989 Elsevier, page 185) The truth - the whole truth - and nothing but the truth. - General saying (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 1, in Chapter 1 entitled “General advances in Forensic Medicine”) HAIR The drug test is moving from the bathroom to the barber shop. - U.S. News and World Report (Quoted by Heather Pringle in her book “The Mummy Congress - Science, Obsession, and the Everlasting Dead”, Theia, New York, 2001, page 86) (N.B. A two-inch-long strand can tell almost five months of personal drug history, as almost all drugs of abuse find their way into hair. Urine test on the other hand can tell only a few days’ drug history. Hence it is much more useful to take samples from the barber’s shop (hair) than from bathroom (urine), especially for employers to screen applicants.) HANGING, JUDICIAL They hanged ‘em; I execute ‘em. - William Marwood (N.B. Marwood was the famous Lincolnshire executioner from 1875 till 1883. Before Marwood’s time, executioners simply allowed the victims to suspend from a rope till they asphyxiated slowly over a period of several minutes. For the first time in history Marwood introduced a long drop, breaking victim’s neck, killing him instantaneously, thus lessening his agony. (This quote appears in “The Book of Victorian Heroes” by Adam Hart-Davis and Paul Bader, Sutton Publishing 2001, at page 96) Question: “If pa killed ma, who’d kill pa?” Answer:”Marwood”. - a famous jingle about Marwood in his time. (From “The Book of Victorian Heroes” by Adam Hart-Davis and Paul Bader, Sutton Publishing2001, page 95) HYDROSTATIC TEST Hydrostatic test smatters of black magic and is a complete waste of time. - Bernard Knight (Forensic Pathology, 2nd Edition 1996, page 442-3) Whatever its fallacies it was a welcome substitute for the torture which had preceded it in questions of alleged infanticide. - Professor J. Malcolm Cameron, in his Presidential address to the British Academy of Forensic Sciences, also published in "Medicine, Science and the Law" (1980), Vol 20, No. 1, in the paper entitled "The Medico-legal Expert - Past, Present and Future" page 5 IDENTIFICATION To write the history of identification is to write the history of criminology - Edmond Locard (1877-1966), French Criminologist INFANTICIDE Breathing is living; the onset of respiration is the beginning of life. - J. Barcroft The best way of seeking proof of respiration is to look at, to feel and to listen to the lungs. - Bernard Knight (Forensic Pathology, 2nd Edition, page 442-3) (For related quotes, see also "Hydrostatic Test") INJURIES Antistius, the physian examined the dead body of Julius Caesar after he was murdered, and opined that only one of the twenty three wounds present on his body was mortal, namely that which had penetrated his chest between the first and second ribs. - (The first ever autopsy recorded in history, 44 B.C.) Meanwhile, I will keep on treating the injuries, not the weapon. - D. Lindsey (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 86) Come, thick night,… that my keen knife see not the wound it makes. - Macbeth, Shakespeare (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 97) INQUEST At an inquest, regard nothing as unimportant. A difference of a hair will be the difference of a thousand li. - Hsi Yuan Lu ("Instructions to Coroners" published in China in A.D. 1248) (N.B. Li is a Chinese Linear measure equivalent to about one third of a mile.) As a hunter traces the lair of a wounded deer by the drops of blood, even so the king shall discover on which side the right lies by inferences from the facts. - Manu Dharma Shastra (Ancient Hindu Law book written by Manu) Having searched the dead body, we find not any blows, or wounds, or any other bodily hurt. We find that bodily weakness caused by long fasting and weariness, by going to and fro, with the extreme cold of the season were the causes of his death. - First record of an inquest from the Colony of New Plymouth, New England, 1635 We must have the courage to know the causes of death. - Ramsey Clark, 1972 (Quoted in "The Autopsy-Medical Practice and Public Policy" by Rolla B. Hill and Robert E. Anderson; Butterworths 1988, page 107) There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance - that principle is contempt prior to investigation. - Herbert Spencer (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 192) There is no such thing as a “born investigator”. - (Quoted in “Computer Evidence: A Forensic Investigations Handbook” by Edward Wilding, page 33, on the first page of chapter 3 entitled “A guide to Investigative methods”) INVESTIGATION OF CRIME Just as life depends on the equal functioning of the tripod of life i.e., heart, lung and brain, so also a successful investigation of crime depends on equal functioning of forensic medicine, forensic science and police investigation. - Professor L. Fimate, President of the Indian Academy of Forensic Medicine (IAFM), in his inaugural speech on the occasion of XXII Annual Conference of The Indian Academy Of Forensic Medicine, Jaipur, India, 5 - 7 January 2001 "I think we have a murderer on board". - Wireless message sent by Captain Henry Kendal of SS Montrose, to London, informing Walter Dew, Chief Inspector of the CID, Scotland Yard, London, that Dr. Crippen, who was suspected of having murdered his wife Cora Crippen, could be on board.) (N.B. A short note on this interesting quote would be in order. Dr. Crippen was an American who lived in London, where he murdered his wife at their house at 39 Hilldrop Crescent, Camden Town with an excessive dose of Hyoscine. He bought about 17 grains of hyoscine on 17 January 1910, and killed his wife in the early hours of 1 February. Shortly afterwards, along with his lover Ethel le Neve, he took the ship SS Montrose from Antwerp and tried to flee to Canada. However Captain Henry Kendal recognized him on board and sent the above message back to London. Dew boarded a faster ship and confronted the pair on the morning of 31 July 1910 (as the ship lay off the mouth of the St Lawrence river) with the words,” Good morning, Dr. Crippen” (which is yet another good quote!). Dr. Crippen was tried at the Old Bailey on 18 October, found guilty and hanged at Pentonville on 23 November 1910. This quote is important because Crippen was the first murderer to be caught using the newly discovered wireless technology. Marconi had received the Nobel Prize for wireless telegraphy only the previous year. The first UK demonstration of wireless telegraphy was in 1896, and when in 1996, wireless telegraphy completed 100 years, British Telecom celebrated the occasion by issuing six special BT phone cards. Number 3 of these cards celebrated Crippen’s arrest by showing Crippen’s photograph on the front, and the wireless message on the back. Surprisingly British Telecom got the date of this message wrong. According to the card, the message was sent in 1911, while actually it was 1910. In fact Crippen never lived to see the year 1911. Click below to see the front and back of this phone card.) Currently there are no entries under this heading. Readers' contributions are welcome. Currently there are no entries under this heading. Readers' contributions are welcome. LAW AND FORENSICS No man is above the law and no man is below it. - Theodore Roosevelt MASS DISASTERS With the exception of the more dramatic murders, the activity which focuses most public attention on the work of forensic pathologists is the mass disaster. - Bernard Knight (Forensic Pathology, 2nd Edition, page 43) The (Mass Disaster) plans are clinically oriented, but often completely ignore provision for the dead. - Bernard Knight (Forensic Pathology, 2nd Edition, page 43) MICROSCOPY Microscopes of hextra power. - Pickwick Papers (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 178, in Chapter 10 entitled “Microbiology and Parasitology”) MURDER Thou shalt not kill. - Old Testament, Exodus 20:13 Clarissa: Oh dear, I never realized what a terrible lot of explaining one has to do in a murder! - Agatha Christie (Spider's Web, 1956) ) Murder is a serious business. - Francis Iles 1893-1970, in “Malice Aforethought (1931) Other sins only speak; murder shrieks out. - Anne Hocking, British mystery writer (Death Loves a Shining Mark, 1943) For murder though it has no tongue, Will speak with the most miraculous organ. - William Shakespeare (Hamlet) Up the close and down the stair, But and ben with Burke and Hare, Burke's the butcher, Hare's the thief, Knox the boy that buys the beef. - A song commemorating murders by William Burke and William Hare in 1820's, who allegedly killed as many as 32 persons, to supply their bodies for dissection to the anatomist Dr. Robert Knox of Edinburgh. This song is still sung on macabre occasions in England today (quoted in "Almanac of World Crime" by Jay Robert Nash at page 271) Lizzie Borden took an axe, And gave her mother forty whacks, When she saw what she had done, She gave her father forty-one. - A song sung about Lizzie Borden, who allegedly killed her parents (father and step mother) at Fall River, Massachusetts on 4 August 1892, but was acquitted by the jury in June 1893 (quoted in "Almanac of World Crime" by Jay Robert Nash at page 194) You have borne up under all, Lizzie Borden, With a mighty show of gall, Lizze Borden, But because your nerve is stout, Does not prove beyond a doubt, That you knocked the old folks out, Lizzie Borden. - Another song sung about Lizzie Borden, this one giving her benefit of doubt: composed by A.L. Bixby (quoted in "Almanac of World Crime" by Jay Robert Nash at page 194) You can’t chop your poppa up in Massachusetts, Not even if it’s planned as a surprise No you can’t chop your poppa up in Massachusetts You know how neighbours love to criticize. - Yet another song sung about Lizzie Borden:. Composed by Michael Brown in “Lizzie Borden” (1952) Sometimes Playmates get killed. - Paul Snider (1980) to his friend shortly before killing his wife Dorothy Stratten, who had been Playboy’s Playmate of August 1979 (quoted in “Murder - Whereabouts” by J.H.H. Gaute and Robin Odell, page 82) NARCOTICS If you are smoking ganja, you first watch the curls of smoke. In other moment, you feel yourself crouched together in the bowl of your pipe smoked by yourself at the other end. - M. Baudelaire Cocaine isn't habit forming. I should know- I have been taking it for years. - Tallulah Bankhead (1903-1968), US stage and screen actress Thou hast the keys of Paradise, Oh, just, subtle and mighty Opium! - Thomas De Quincey (1785-1859): English essayist and critic "H" is for heaven: "H" is for hell: "H" is for heroin. In the life of the addict, these three meanings of "H" seem inextricably intertwined. - Isador Chein, 1964 (Reproduced in "Historical Medical Classics involving new drugs, by John C. Krantz, Jr. Ph.D. on page 121) That is the nectar, you call it a gum. Ah! The lean tree whence such gold oozings come. - R. Browning (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 204, in Chapter 12 entitled "Drugs of Dependence") NEGATIVE AUTOPSY A higher rate of negative conclusions will originate from older and more experienced pathologists than from juniors. - Bernard Knight (Forensic Pathology, 2nd Edition, page 47) (N.B. Knight follows up this “ paradoxical quote” with this interesting statement: The younger pathologist is often uneasy about failing to provide a cause of death, feeling that it reflects upon his ability, whereas the more grizzled doctor, enjoying the security of tenure and equality with - or even seniority over - his clinical and legal colleagues, is less inhibited in his admissions of ignorance when the cause of death remains obscure. I have a different opinion - and experience - though ( I am bald, not grizzled however). Frequently when I fail to find a cause of death, with my students standing over my head, I feel very embarrassed, and tend to offer a cause of death, knowing it to be wrong. On the contrary a younger pathologist - certainly in my hospital - is very comfortable - even happy - in facing an obscure death. Because he has the facility of rushing to his senior colleagues and asking for their opinion. An added pleasure for him might be the possible confusion causing to the senior in the process! Readers' opinions on this subject are welcome. Currently there are no entries under this heading. Readers' contributions are welcome. PETECHIAL HEMORRHAGES La seule présence… de extravasations sanguines disséminées… suffit pour démontrer… que la suffication est bien, en réalité la cause de la morte. - Ambroise Tardieu, 1855 (The full citation of the paper in which he made this assertion is: Tardieu A. Ann Hyg Pub et de med Legale (series II) 1855;(6):371-82. This paper is quoted in the paper “Petechial Hemorrhages - A review of Pathogenesis” by Frederick A. Jaffe. American Journal of Forensic Medicine and Pathology 15(3):203-207, 1994) Petechiae arise at the capillary level. - Frederick A. Jaffe, Forensic Pathology Branch, Toronto, Ontario, Canada (in his paper entitled “Petechial Hemorrhages - A review of Pathogenesis”. American Journal of Forensic Medicine and Pathology 15(3):203-207, 1994. This quote appears on page 204, column 2, top line) A common error is to attribute the petechiae to the rupture of capillaries, whereas they actually emanate from small venules - capillary bleeding would be invisible to the naked eye. - Bernard Knight (Forensic Pathology, 2nd Edition, 1996, page 348) (N.B. Note the contradiction between quotes 2 and 3 - both from contemporary books and journals. This is another important forensic controversy that is far from over. For other similar forensic controversies, see quotes on "Forensic Mythology" and "Hydrostatic Test". Interestingly, Bernard Knight, writing under the pseudonym of Bernard Picton in his book "Murder, Suicide or Accident - The Forensic Pathologist at Work", (Robert Hale & Company, London, 1971), has this to say on page 102: "The lining of the smallest blood vessels - the capillaries - is very sensitive to both increased pressure and oxygen lack. When these become deranged, the capillaries become fragile and burst at many points, causing small haemorrhages into the tissues, called 'petechiae'." One would tend to believe that while Knight changed his view between 1971 and 1996, others stuck to the traditional view.) PHILOSOPHICAL Sometimes life is like an autopsy - gutted & emptied. An autopsy reveals the cause of death; whereas, being gutted & emptied can reveal a new beginning in life. - Found as an attachment to the E-mail received from e. catherine on Fri, 22 Sep 2000 PHYSICAL EVIDENCE Physical evidence can not be intimidated. It does not forget. It sits there and waits to be detected, preserved, evaluated, and explained. - Herbert Leon Macdonell (Quoted at the opening page in his book “The Evidence never lies”) Physical evidence does not get excited, like people do. - Herbert Leon Macdonell (Quoted at the opening page in his book “The Evidence never lies”) Wherever he steps, whatever he touches, whatever he leaves even unconsciously, will serve as silent witness against him. Not only his fingerprints or his footprints, but his hair, the fibers from his clothes, the glass he breaks, the tool marks he leaves, the paint he scratches, the blood or semen he deposits or collects - all of these and more bear mute witness against him. This is evidence that does not forget. It is not confused by the excitement of the moment. It is not absent because human witnesses are. It cannot perjure itself. It cannot be wholly absent. Only its interpretation can err. Only human failure to find it, study and understand it, can diminish its value. - Crime Investigation, second edition, Paul L. Kirk (deceased), edited by John I. Thornton (1974), p. 2. (Quoted also in “Footwear Impression Evidence” by William J. Bodziak, at page 1) In the course of a trial, defense and prosecuting attorneys may lie, witnesses may lie, the defendant may certainly lie. Even the judge may lie. Only the evidence never lies! - Herbert Leon Macdonell (Quoted at the opening page in his book “The Evidence never lies”) Absence of Evidence is not the same as Evidence of Absence. - Howard Frumkin, M.D. Emory University School of Public Health, Chairmain, Dept: of Environmental & Occupational Health (Quoted in Jornal of Forensic Sciences, March 2000 at page 510) POISON, DEFINITION OF Poison is any substance, which introduced into the system, either directly or by absorption, produces violent, morbid or fatal changes, or which destroys living tissue with which it comes in contact. - Watkins v. National Elec. Products Corp., C.C.A. Pa., 165, F. 2d 980, 982 Poison: Any substance which, when relatively small amounts are ingested, inhaled, or absorbed, or applied to, injected to, or developed within the body, has chemical action that may cause damage to structure or disturbance of function producing symptomology, illness or death. - Stedman’s Medical Dictionary, 26th Edition, Williams & Wilkins, Baltimore MD, 1995 Poison: Any substance which, when ingested, inhaled or absorbed, or when applied to, injected into, or developed within the body, in relatively small amounts, by its chemical action may cause damage to structure or disturbance of function. - The Sloane-Dorland Annotated Medical-Legal Dictionary, West Publishing Company, New York, NY, 1987 Poison is any substance in relatively small quantities that can cause death or illness in living organisms by chemical action. The qualification “by chemical action”, is necessary because it rules out such effects as those produced by a small quantity of lead entering the body at high velocity. - Scientific American (N. B. It may be interesting to note that the usual fatal dose of a lead salt such as lead acetate is considered to be about 20 g. A lead bullet weighing 20 g can also kill a person, but in that case, the death would not be by chemical action, and thus lead in the second case, would not be supposed to kill as a poison!) POISONS AND TOXINS All substances are poisons. There is none, which is not. The right dose differentiates a poison and a remedy. - Paracelsus (1495-1541), Swiss physician and Chemist (N. B. There are several versions of this quote, which differ. This is understandable as this quote has been translated in English from a different language. The real quote in the original language is given in “Handbook of Pesticide Toxicology, Vol. 1 (Principles), page xxvii, 2nd Edition, Edited by Robert I. Krieger, (Academic Press, 2001)”. The quote -in German- goes like this, “Alle Ding sind Gift und nichts ohn Gift; alein die Dosis macht das ein Ding kein Gift ist”. Krieger in his Foreword goes on to say, “With the exception of E=mc2, perhaps no other single statement has wielded such force in establishing the popular notoriety and the professional stature of an individual in the history of science as the words just quoted”. This in itself appears a very fine quote to me!). Other similar quotes attributed to him are- What is there that is not poison. All things are poison and nothing (is) without poison. Solely the dose determines that a thing is not a poison.) --- Even nectar is poison if taken in excess. - Hindu Proverb (Quoted in “Encyclopedia of Clinical Toxicology” by Irving S. Rossoff, 2002, “The Parthenon Publishing Group”, a CRC Press Company, page vi) Give me a decent bottle of poison and I’ll construct the perfect Crime. - Agatha Christie (Quoted in “Dame Agatha’s poisonous pharmacopoeia”. The Pharmaceutical Journal. Dec 23 & 30, 1978, Page 573) Alcohol, Hashish, Prussic acid, strychnine are all weak dilutions; the surest poison is time. - Ralph Waldo Emerson (1803-1882): American poet, essayist, philosopher The gnat that sings his summer song Poison gets from slander's tongue, The poison of the snake and newt Is the seat of envy's foot. The poison of the honey bee Is the artist's jealousy. - Blake, (Auguries of Innocence) There is no such thing as a safe drug - only safe doses. - C. Pippenger There are no safe drugs, only safe ways of using them. - Voltaire (quoted in “Introduction to Toxicology” 2nd Edition by J. A. Timbrell, 1995, Taylor & Francis Ltd, at page 61) The dose is the difference between the victim and the patient. - M. Gerald Plants are the most overrated poisons of childhood. - N.C. Fraser in “ Accidental poisoning deaths in British children 1958-77”. Br Med J 1980; 280: 1595-1598 (In a survey of deaths due to accidental poisoning in British children, out of 598 registered deaths over 20 years, Fraser found that only three were attributable to the ingestion of plant poisons!) Having sniffed the dead man’s lips, I detected a slightly sour smell, and I came to the conclusion that he had poison forced upon him. - Sherlock Holmes, in Sir Arthur Conan Doyle’s “A Study in Scarlet” (Quoted in “Hard Evidence” By David Fisher at page 23) Poisons and medicines are oftentimes the same substance given with different intents. - Peter Mere Latham Passion (poison) often makes fools of clever men; sometimes even makes clever men of fools. - La Rochefoucauld I maintain that though you would often in the fifteenth century have heard the snobbish Roman say, in a would-be-off-hand tone, “I am dining with the Borgias tonight”, no Roman was ever able to say, “I dined last night with the Borgias.” - “And Even Now”, Max Beerbohm When you consider what a chance women have to poison their husbands, it’s a wonder there isn’t more of it done. - Kim Hubbard Most signs and symptoms associated with natural disease can be produced by some poison, and practically every sign and symptom observed in poisoning can be mimicked by those associated with natural diseases. - L. Adelson Poison is a chemical bomb. - John Harris Trestrail III, on page 30 of his book “Criminal Poisoning”, Humana Press, 2000 If you poison us, do we not die? - The Merchant of Venice. III.i.69 (quoted on the front page in “Curare -Its history and usage” by K. Bryn Thomas, Pitman Medical Publishing Co. Ltd. London, 1964. I found this book while leisurely scanning the S.M.S. Medical College library at Jaipur on 14 June 2001, when I had gone there as a post-graduate examiner) Poison is a silent weapon. - John Harris Trestrail III, on page 31 of his book “Criminal Poisoning”, Humana Press, 2000 Revolted by the odious crime of homicide, the chemist’s aim is to perfect the means of establishing proof of poisoning so that the heinous crime will be brought to light and proved to the magistrate who must punish the criminal. - “Traite de Poison”, M.J.B. Orfila (1814) MARTHA: “Well, dear, for a gallon of elderberry wine, I take one teaspoonful of arsenic, and add a half a teaspoonful of strychnine, and then just a pinch of cyanide. - “Arsenic and Old Lace” by Joseph Kasserling, New York Pocket Books, New York, NY, 1944 (quoted by John Harris Trestrail III in his book “Criminal Poisoning” on page 93. Also by Serita Deborah Stevens and Anne Klarner in their book “Deadly Doses - A writer’s guide to poisons”, Writer’s Digest Books, Ohio, 1990 on page 10) If all those buried in our cemeteries who were poisoned could raise their hand, we would probably be shocked by the numbers! - John Harris Trestrail III, in this book “Criminal Poisoning” on page 99 And yonder soft phial, the exquisite blue Sure to taste sweetly - is that poison too? - R. Browning (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 191, in Chapter 11 entitled "Forensic Chemistry") It would be nice if someday, like Star Trek’s Dr. McCoy, we could pass a “Tricorder” over the body in question and thereby scan for over a million different chemical entities. - John Harris Trestrail III, in this book “Criminal Poisoning” on page 71, stressing the fact that when an analytical result for toxicology comes negative, it does not necessarily mean that the specimen was free of all chemical substances. It only means that none of the substances tested for were present in detectable quantities. Every death with no visible signs of trauma must be considered a poisoning until the facts prove otherwise. - John Harris Trestrail III, in this book “Criminal Poisoning” on page 99 Doctors put drugs of which they know little, into our bodies of which they know less, to cure diseases of which they know nothing at all. - Voltaire (quoted in “Introduction to Toxicology” 2nd Edition by J. A. Timbrell, 1995, Taylor & Francis Ltd, at page 61) POISONS (INDIVIDUAL) ACETAMINOPHEN APAP - induced heart injury? May be yes, may be no. Next question? - Title of a paper by Martin J. Smilkstein in Clinical Toxicology, 34(2), 155-156 (1996) I have just taken Tylenol, will I die? - A frantic call made by several Americans in September - October 1982 to poison centres, following unfortunate deaths of 7 people, who took Tylenol Capsules, which all turned out to be laced with cyanide. Such a panic spread among the Americans that many reported that their toothpaste smelt oddly or their antacids tasted strangely. Many pharmacists described this reaction as “Tylenol Syndrome”. (Taken from “Dunea G. Death over the Counter. British Medical Journal, Vol, 286, 15 January 1983, pages 211-212”. This incident is also reported in “Forensic Pharmacology - Medicines, Mayhem, and Malpractice” by R.E. Ferner, Oxford University Press, 1996, at page 15) ARSENIC Arsenic was a popular homicidal poison; women purchased it with the ostensible excuse of destroying rats. The rat in this context was usually the husband! - Anonymous The history of arsenic poisoning is, at the same time, the history of murder by means of poisoning. - Leschke (quoted in “The Power of Poison” by John Glaister, Chritopher Johnson, London, 1954, page 78) ACONITE Aconite is useful to hunters for destroying tigers and elephants, useful to the rich for putting troublesome relatives out of the way, and useful to jealous husbands for destroying faithless wives. - saying common among Lepchas of Sikkim, India CHLOROFORM Now she's acquitted, she should tell us in the interests of science how she did it! - Sir James Piaget, a distinguished Victorian surgeon, exhorting Adelaide Bartlett, when she was acquitted, to tell how she killed her husband by giving him chloroform (quoted in "Murder - What dunit" by J.H.H. Gaute & Robin Odell, at page 93) DATURA Datura makes you hot as a hare, blind as a bat, dry as a bone, red as a beet and mad as a hen. - H.G. Morton And some of them ate plentifully of it, the effect of which was a very pleasant Comedy; for they turned natural Fools upon it for several Days. One would blow a Feather in the Air; another would dart straws at it with much fury; and another stark naked was sitting up in a Corner, like a Monkey grinning and making Mows at them; a Fourth would fondly kiss and paw his Companions, and sneer in their Faces with a Countenance more antik than any in a Dutch Droll. - Robert Beverly, describing the condition of some soldiers who accidentally ate Datura stramonium (Jimson weed) leaves in their salad. This description appears in the book “History and Present State of Virginia”, Book 2 (1705 A.D.), p 24 (N.B. This is one of the most widely quoted quotes on Datura stramonium by medical and lay authorities alike. It has appeared in (i) JAMA 1939; 112:2500-2 in a paper by JD Hughes and JA Clark Jr. (ii) Editorial, Lancet 1948;i:649-50 (iii) Clinical Toxicology by CJ Polson, MA Green, MR Lee, 3rd Edition, page 393 (iv)The Medical Detectives by Berton Roueché, Washington Square Press 1980, page 184) DDT I hate Bosco, It's full of DDT. Mommy put it in my milk to try to poison me. But I fooled Mommy, I put some in her tea. Now there's no more Mommy to try to poison me. - Children's rhyme (Quoted in "The New England Journal of Medicine" Volume 330:1095, April 14, 1994, Number 15, (in the Review of the book "The Poisonous Pen of Agatha Christie" By Michael C. Gerald. 275 pp. Austin, Tex., University of Texas Press, 1993. $32.50. ISBN 0-292-76535-5). Review by Orah S. Platt, M.D. and Richard Platt, M.D.,Children's Hospital Medical Center, Boston, MA 02215. Available on the net at http://content.nejm.org/cgi/content/full/330/15/1095) HELLEBORE Besides, hellebore is rank poison to us, but given to goats and quails makes them fat. - Lucretius: “De Rerum Natura” Book 4, lines 640-641, Translated by W.H.D. Rouse (This quote appears in “Handbook of Pesticide Toxicology, Vol. 1 (Principles), page 109, 2nd Edition, Edited by Robert I. Krieger, (Academic Press, 2001)” HYOSCINE ‘.. .Upon my secure hour thy uncle stole, With juice of cursed hebenon in a vial, And in the porches of mine ears did pour The leprous distilment.. .’ - Hamlet, Act 1, Scene 5 (Quoted in “The Encyclopedia of Forensic Science” by Brian Lane, Headline 1992, at page 375 MERCURY Mercury is ‘the hottest, the coldest, a true healer, a wicked murderer, a precious medicine, and a deadly poison, a friend that can flatter and lie’. - Woodall J. (1639), The Surgeon’s Mate or Military & Domestic Surgery, London, p256 (quoted from Cassarett and Doull’s Toxicology. Also quoted in “Introduction to Toxicology” 2nd Edition by J. A. Timbrell, 1995, Taylor & Francis Ltd, at page 118) MUSHROOMS There are old Mushroom Hunters and Bold Mushroom Hunters, but no Old Bold Mushroom Hunters. - Anonymous Had nature any outcast face? Could she a son condemn? Had nature an Iscariot That mushroom - it is him - Emily Dickinson (Quoted in “Wilderness Medicine”, 4th edition, by Paul S. Auerbach, Mosby, 2001; chapter 49 entitled “Mushroom Toxicity” by Sandra Schneider and Mark Donnelly, page 1141) PHOSPHORUS Keep any cakes and sandwiches over, for the funeral. - Mrs. Mary Elizabeth Wilson of Durham, who poisoned her two husbands with phophorus, jokingly at her wedding feast in 1958 (Quoted in “The Bedside Book of Murder” by Richard & Molly Whittington-Egan, at page 81) STRYCHNINE We’ll murder them all amid laughter and merriment, Except for a few we’ll take home to experiment. My pulse will be quickenin’ with each drop of strychnine we feed to a pigeon. (It just takes a smidgin!) To poison a pigeon in the park. - Tom Lehrer (1928- ): in “Poisoning Pigeons in the Park” (1953) TOADS (POISONOUS) Toad, that under cold stone, Days and nights went thirty-one, Swelter’d venom sleeping got, - Shakespeare alluding to the evil reputation of the toad in Macbeth (Reproduced from “Poisons and Poisoners” by C.J.S. Thompson, page 103) POLICE AND POLICING The more technical knowledge a police officer possesses, the greater the probability of securing not only a criminal arrest but also a guilty verdict from the jury. - Howell 1988 (Quoted in “Tire Imprint Evidence” by Peter McDonald, 1989 Elsevier, page 189) The police are the public and the public are the police. - Sir Robert Peel (Quoted in “Criminal Investigation - Basic Perspectives” by Paul B. Weston, Charles Lushbaugh and Kenneth M. Wells, eighth edition, 2000, Prentice Hall, page 396) You become a cop so you can watch the parade from the front. Detective is even better because you don’t have to be in uniform to watch the parade. - Detective Captain Frank Bolz (quoted in “Cop Talk” by E.W.Count, Pocket Books, 1994. The quote appears at the beginning of the book) POST MORTEM CHANGES PUTREFACTION The process of putrefaction is simple in its complexity and complex in its simplicity, resting upon the variables operating in a particular case. - Dr. Krishan Vij, Professor and Head, Department of Forensic Medicine, Government Medical College, Chandigarh, India, in his book “Textbook of Forensic Medicine - Principles and Practice”, B.I. Churchill Livingstone, 2001, page 186 QUESTIONED DOCUMENTS It is a compliment to monetary stability when currency is forged. - Jay Levinson in his book “Questioned Documents - A Lawyer’s Handbook”, Academic Press 2001, page 165 It is competent for a judge and jury to compare the handwriting of a disputed document. - A Canadian Court in 1918, in the case Rohoel v. Darwish, 1 WWR 627; 13 Altn LR 180 (Quoted by Jay Levinson in his book “Questioned Documents - A Lawyer’s Handbook”, Academic Press 2001, page 1) No matter how extensive his background may be, no document examiner can know all the answers to all the questions. - Jay Levinson in his book “Questioned Documents - A Lawyer’s Handbook”, Academic Press 2001, page 24 “Handwriting” is not hand writing. - Ron N. Morris in his book “Forensic Handwriting Identification: Fundamental concepts and principles”, Academic Press 2000, page 1 (N.B. To those who find this interesting little quote confounding, the following lines from the same page may be quoted. Morris follows up this quote with this: There are a substantial number of people who are not able to use their hand so they write with their foot, mouth etc. Writing is actually a brain function and the hand, foot, mouth etc are merely the devices which carry out brain orders.) ROAD SIDE VEHICULAR ACCIDENTS There are only two classes of pedestrians these days - the quick and the dead. - Lord Dewar (1864-1930) (Quoted in “The Pathology of Trauma” 2nd Edition, Edited by J.K.Mason, page 17) Drive slowly, reach safely, And not race with the devil, To reach the tomb prematurely. - S.C. Mestri (Professor and Head, Dept. of Forensic Medicine, KIMS, Hubli-580022, India), in “Preventive and safety measures to be adopted in road traffic accidents”, Journal of Karnataka Medicolegal Society; 9(2): December 2000, pages 28-30 (this quote appears on page 30) I wasn’t the driver. - Statement often made by occupants of an automobile which has been involved in a fatal collision. (cited on page 24 of “Encyclopedia of Forensic Sciences” edited by Jay A. Siegel, Pekka J. Saukko and Geoffrey C. Knupfer. 2000 Academic Press.) SCENE OF CRIME “Lestrade showed us the exact spot at which the body had been found, and indeed, so moist was the ground, that I could plainly see the traces which had been left by the fall of the stricken man. To Holmes, as I could see by his eager face and peering eyes, very many other things were to be read upon the trampled grass.” - Dr. Watson, the companion of the Legendary Sherlock Holmes in “The Boscombe Valley Mystery” by Arthur Conan Doyle Scenes as well as suspects often conceal the truth. - Jon J. Nordby, forensic science investigative consultant, in his book “Dead Reckoning - The Art of Forensic Detection”, CRC Press 2000, on page 23 SERIAL KILLERS They are the waste product of our frustrated, bored, over-stressed Western industrialized society. - Sean Mactire in his book “Malicious Intent-A writer’s guide to how murderers, robbers, rapists and other criminals think”. Writer’s Digest Books, Cincinnati, Ohio, 1995. This quote appears in on page 67, in 5th chapter entitled “Serial Murder”) SEXUAL OFFENCES No man shall have sexual intercourse with any woman against her will. - Charaka Samhita (Book of Medicine written in the 4rth Century B.C. by the Ancient Hindu writer Charaka) In no state can a man be accused of raping his wife. How can any man steal what already belongs to him? - Susan Griffin, American Poet (Ramparts, September 1971) … marriage [is] in modern times regarded as a partnership of equals and no longer one in which the wife [is] the subservient chattel of the husband. - Lord Keith in Regina v R. 23 October 1991 (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 138) Rape is the only crime in which the victim becomes the accused and, in reality, it is she who must prove her good reputation, her mental soundness, and her impeccable propriety. - Freda Adler, American Educator (Sisters in Crime, 1975) Insertion or thrust of male organ between the thighs kept tight amounts to penetration sufficient to constitute rape. - In the Indian case of State v Gobindan, 1969 Cr LJ 818 Rape is an accusation easily to be made and hard to be proved and yet harder to be defended by the party concerned though never so innocent. - Khelleher v Queen, 1974 (131) Commonwealth Law Reporter 534 The act of actus reus is complete with penetration and emission is not essential or relevant. - Queen v Marsden, 1821 QBD 149 If his bones in general, and his shoulders are strongly made, if his gait and voice are vigorous, by these tokens may a potent man be known; and one impotent by the opposite characteristics. - Narada Smriti (Ancient Hindu text) There is no difference between being raped and being bit on the ankle by a rattlesnake except that people ask if your skirt was short and why you were out alone anyhow. - (Mary Piercy, excerpt from 'Rape Poem': Reproduced in "Clinical Approaches to sex offenders and their victims" edited by Clive R. Hollin and Kevin Howells, at page 261 The worst myth that has to be busted is that rape and sex crimes are about sex. They are only about power and anger. - Sean Mactire in his book “Malicious Intent-A writer’s guide to how murderers, robbers, rapists and other criminals think”. Writer’s Digest Books, Cincinnati, Ohio, 1995. This quote appears in on page 94, in 7th chapter entitled “Sexual predators”) Not enough people understand what rape is, and, until they do.. .., not enough will be done to stop it. - rape victim (quoted in “Men Who Rape” by N. Groth 1979, Plenum p.87, also quoted in “A Natural History of Rape” by Randy Thornhill and Craig T. Palmer, 2000, MIT Press, on page 1) SUDDEN DEATH The fact that an AV or SA node, or the bundle of His or its branches shows fibrosis or some other lesion, does not necessarily mean that this played any part in the death. - Bernard Knight (Forensic Pathology, 2nd Edition, page 498) SUDDEN INFANT DEATH SYNDROME (SIDS) ..there has developed a “maxim in Forensic pathology: one unexplained infant death in a family is SIDS. Two is very suspicious. Three is homicide.” This is dangerous and scientifically shaky dogma. - (Cyril H. Wecht, MD, JD , Coroner of Allegheny County , Pittsburgh, in JAMA Jan 7, 1996, Vol. 279, No. 1, page 85) (N.B. A little background above the above quote may be appreciated. This above maxim developed following Van Der Sluys case in 1986, Tinning case in 1987 and Wanda Hoyt case in 1995, each of which involved three dead infants. Wanda Hoyt was convicted of murder in 1995) Elevated T3 levels in SIDS can be considered as a post-mortem artifact. - J.I.Coe (in “Postmortem chemistry update. Emphasis on Forensic Application". Am. J. Forensic Med Pathol, 1993, 14, 91-117; cited in “de Letter EA, Piette MHA, Lambert WE, De Leenheer AP. Medico-Legal Implications of Hidden Thyroid Dysfunction: A study of two cases. Med. Sci. Law (2000)Vol. 40, No. 3, Pp 251-257, on page 255) SIDS is perhaps the greatest single medical mystery confronting scientists. - (Cyril H. Wecht, MD, JD , Coroner of Allegheny County , Pittsburgh, in JAMA Jan 7, 1996, Vol. 279, No. 1, page 86) SUICIDE If one wants to get away with murder, one has to jolly well keep one’s wits about one. It’s the same way with suicide. - Starr Faithful (1931) (quoted in “Murder - Whereabouts” by J.H.H. Gaute and Robin Odell, page 78) Every homicide is also unconsciously a suicide and every suicide in a sense a psychological homicide. - Stephen Nordlicht, MD, Clinical Associate Professor in Psychiatry, Cornell University Medical College, in his paper entitled “Medical Deterrents” published in Bull. N.Y.Acad. Med. Vol. 62, No. 5, June 1986. This quote appears on page 584 TERRORISM “Terrorism” means the use of violence for political ends, and includes any use of violence for the purpose of putting the public or any section of the public in fear. - Prevention of Terrorism (Temporary Provisions) Act 1989, s.20(1) (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 71) THROMBOSIS, DEEP VEIN Deep vein thrombosis is a hazard of long air flights. - Bernard Knight (Forensic Pathology, 2nd Edition, page 507) TIME SINCE DEATH Estimating the time of death is one of the most difficult and inaccurate techniques in forensic pathology. - Milton Helpern in his book “Autopsy - The Memoirs of Milton Helpern, the World’s greatest medical detective”, published by St. Martin’s Press, New York, 1977, on page 116 The time of death is sometimes extremely important. It is a question almost invariably asked by police officers, sometimes with a touching faith in the accuracy of the estimate. Determining the time of death is extremely difficult, and accuracy is impossible. - Bernard Knight, Legal Aspects of Medical Practice, 4th edition, 1987, Churchill Livingstone, Edinburgh page 115 I will be the first to admit that if any physical or even mental disturbance occurs soon after the food is swallowed, the whole digestive process can be drastically altered. - Milton Helpern in his book “Autopsy - The Memoirs of Milton Helpern, the World’s greatest medical detective”, published by St. Martin’s Press, New York, 1977, on page 118 Considering the variables which influence the rate of body heat loss, the best one can say about the reliability of algor mortis as a post mortem clock is that it permits a rough approximation of the time of death. Errors in over-estimating and under-estimating the post mortem interval based on body cooling are common, even in the face of considerable experience by those making the estimate. Body temperature as an indicator of the post mortem interval should be correlated with all other phenomenon and observations utilised in establishing the time of death. - Adelson, The Pathology of Homicide, 1974, Thomas, Springfield, Illinois, page 164 To offer an unreasonably accurate time of death is worse than providing such a wide range on times that the police derive no help from it. - Bernard Knight in “The Estimation of the Time Since Death in the Early Postmortem Period”, Edward Arnold, 1995, page 2 A medical witness who attempts to determine the time of death from temperature estimation in minutes or fractions of hours is exposing himself to a severe challenge to his expertise which may well amount to near ridicule, thus denegrating the rest of his evidence. - Polson, Gee and Knight, The Essentials of Forensic Medicine, 4th edition, 1985, Pergamon Press, Oxford, page 12 It is often the least experienced medical witness who tends to offer the most accurate estimate of time since death. - Bernard Knight in “The Estimation of the Time Since Death in the Early Postmortem Period”, Edward Arnold, 1995, page 2 Livor mortis, rigor mortis and algor mortis … provide, at best, “postmortem windows”. - Stephen J. Cina, Charleston County Medical Examiner’s Office, Charleston, SC 29425, USA (Quoted by him in his paper “Flow Cytometric Evaluation of DNA Degradation: A predictor of Postmortem Interval?”. American Journal of Forensic Medicine and Pathology 15(4):300-302, 1994) The opinion of any doctor who offers a single time of death, instead of a range, must be viewed with suspicion. - Bernard Knight in “The Estimation of the Time Since Death in the Early Postmortem Period”, Edward Arnold, 1995, page 2 No problem in forensic medicine has been investigated as thoroughly as that of determining the time of death on the basis of post mortem findings. Apart from its obvious legal importance, its solution has been so elusive as to provide a constant intellectual challenge to workers in many sciences. In spite of the great effort and ingenuity expended, the results have been meagre - Jaffe, A Guide to Pathological Evidence : For Lawyers and Police Officers, 2nd edition, 1983, Carswell Criminal Law Series, Carswell Ltd., Toronto, page 33 Repeated experience teaches the investigator to be wary of relying on any single observation for estimating the time of death (or "duration of the post mortem interval"), and he wisely avoids making dogmatic statements based on an isolated observation. - Adelson, The Pathology of Homicide, 1974, Thomas, Springfield, Illinois, page 151 Formerly, it was a hallowed "rule of thumb" that the rectal temperature dropped at an average of 1.5oF per hour, rather faster during the first few hours. This method was a guarantee of inaccuracy, but little has been found to replace it. - Bernard Knight, Legal Aspects of Medical Practice, 4th edition, 1987, Churchill Livingstone, Edinburgh, page 119-120 Some difference of opinion exists over the use of a thermometer at the scene of a suspicious death. Considerable caution must be employed when considering the taking of a rectal temperature with the body in situ. If there is any possibility at all of some sexual interference, whether homosexual or heterosexual, no intereference with the clothing or perineum must be made until all forensic examinations have been completed. Certainly, no instrument should be inserted into the rectum before trace evidence has been sought. - Polson, Gee and Knight, The Essentials of Forensic Medicine, 4th edition, 1985, Pergamon Press, Oxford, page 9-10 The timing of the sequence of events concerned in the dissolution of the body cannot be done with accuracy and one must be cautious never to pronounce too readily that the decomposed state of the body is inconsistent with the time interval alleged. - Camps, Lucas, Robinson, Gradwohl's Legal Medicine, 3rd edition, 1976, John Wright & Sons, Bristol, page 91 TIRE IMPRINT EVIDENCE I am familiar with forty-two different impressions left by tyres. - Sherlock Holmes to Dr. Watson in “The Adventure of the Priory School” 1901 A motor vehicle is used in 75 percent of all the major crimes reported today. - Given, Nehrich and Shields 1977 (Quoted in “Tire Imprint Evidence” by Peter McDonald, 1989 Elsevier, page 37) The ultimate goal of the tire track investigation is the identification of the vehicle producing the track. - Given, Nehrich and Shields 1977 (Quoted in “Tire Imprint Evidence” by Peter McDonald, 1989 Elsevier, page 67) Tire “Footprints” help solve Homicide cases (Title of article in Law and Order 1981) - Quoted in “Tire Imprint Evidence” by Peter McDonald, 1989 Elsevier, page 111 TONGUES OF SLIP “They told me you could help me, Dr. Zak… the people at the Funny Society.. .er.. . I mean the Forensic Society". - A patient (Henry Nash) over phone to forensic entomologist Zakaria Erzinçlioglu (quoted by Zakaria Erzinçlioglu in his biographical book “Maggots, Murder and Men - Memories and Reflections of a Forensic Entomologist” Harley Books, England 2000, on page 138) TRACE EVIDENCE Every contact leaves a trace. - Edmond Locard (1877-1966), Pioneering French Criminologist (This is often touted as the “Locard’s Exchange Principle”. Although nothing is wrong in this statement, the true principle goes like this: “The dust and debris that cover our clothing and bodies are the mute witnesses, sure and faithful, of all our movements and all our encounters.” It is quoted on page 299 of “Encyclopedia of Forensic Sciences” edited by Jay A. Siegel, Pekka J. Saukko and Geoffrey C. Knupfer. 2000 Academic Press.) For a long time he remained there, turning over the leaves and dried sticks, gathering what seemed to me to be dust into an envelop and examining with his lens not only the ground, but even the bark of the tree as far as he could reach. - Dr. Watson recalling the actions of Sherlock Holmes in “The Boscombe Valley Mystery” If evidence has been properly gathered and preserved, a mistake in interpretation may always be corrected. If the facts required for a correct interpretation are not preserved, the mistake is irreversible. - Alan R. Moritz, MD (Quoted in "The Pathology of Trauma" 2nd Edition, Edited by J.K.Mason, page 227) What is not looked for will not be found! - William J. Bodziak in his book “Footwear Impression Evidence” at page 2 The best evidence in the world will not stand up in court if the jurors have doubts about its integrity. - Los Angeles Times (Quoted in “Criminal Investigation - Basic Perspectives” by Paul B. Weston, Charles Lushbaugh and Kenneth M. Wells, eighth edition, 2000, Prentice Hall, page 6) Trace evidence is one of the most valuable, misunderstood, misused and underutilised forms of physical evidence. - Peter R. De Forest in his chapter "What is trace evidence" in the book "Forensic Examination of Glass and Paint" edited by Brian Caddy, Taylor & Francis, 2001, page 23 Currently there are no entries under this heading. Readers' contributions are welcome. Currently there are no entries under this heading. Readers' contributions are welcome. WITTICISMS Well folks, you’ll soon see a baked Appel. - George Appel, as he was being strapped into the electric chair in 1952 (Quoted in “Witticisms of 7 condemned criminals” on page 87 in “The Book of Lists #3” by Amy Wallace, David Wallechinsky and Irving Wallace) Nothing will happen until I get there. - Guy Clark (1832) on the way to gallows to the sheriff, when he asked him to speed up the pace (Quoted in “Witticisms of 7 condemned criminals” on page 87 in “The Book of Lists #3” by Amy Wallace, David Wallechinsky and Irving Wallace) You work in forensics and you don't know what FUBAR means???? - Contributed by James (Jamie) Crippin , Colorado Bureau of Inv., 3416 N Elizabeth St., Pueblo, CO 81008. Phone: 719-542-1133 (N.B. Anyone, who wants to know more about this interesting quote, or wants to know what FUBAR means, may want to get with touch with Mr. Crippin himself. He can be contacted by clicking on his name) When in doubt, think dirty. You’ll be right ninety percent of the time. - An old pathologist to Dr. William R. Maples (N.B. Dr. William R. Maples gives this quote in his book “Dead Men do tell tales” at page 11. Dr. Maples goes on to say, that it was good advice and that he put it to good use on many occasions.) Better save that. We'll need it for the autopsy. - A surgeons’ conversation overheard during a life saving surgery - sent by Dr. Vivek Jain, MD (Skin & VD) Forensic medicine in most of the countries is some kind of an unwanted Cinderella. - Dr. Peter Kovac, Institute of Forensic Medicine, Comenius University, Bratislava, Sasinkova 4, 81103 Slovakia (In an informal E-mail sent to this webmaster on 23 November 2000) To treat is human, to dissect divine. - This is the answer I frequently give to people who ask me why I left a lucrative career in medicine (way back in 1979) to take up forensic pathology Those who can, dissect; those who can’t, dissent. - Another perfectly valid answer to the same question, although I don’t remember having said this to anyone WOUNDS INCISED Incise the abdomen and conceal the jewel. - An old Chinese Proverb (Quoted in “Forensic Science”, 2(1973) 191-199 at page 191) PENETRATING Makes such a wound the knife is lost in it. - Shelley (Cited in "Recent Advances in Forensic Pathology" edited by Francis E. Camps, J.& A. Churchill Ltd., 1969, on page 101, in Chapter 6 entitled "The interpretation of wounds (Penetrating)") Currently there are no entries under this heading. Readers' contributions are welcome. Currently there are no entries under this heading. Readers' contributions are welcome. Currently there are no entries under this heading. Readers' contributions are welcome. Know a forensic quote which does not appear here? Well why not share it with us, and add to this growing pool of forensic quotes. Your contribution would appear with due credit to you. For submitting your quote, mail me. Contact

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Main page > Vol-15 No-1 > Book001 LinkedIn WhatsApp X (Twitter) Facebook Copy link Anil Aggrawal's Book Review Journal Volume-1, Number-1 ( July - December ) Book Review (Technical Section) Basic Sciences as applied to Forensic Medicine and Toxicology By Anil Aggrawal A forensic masterclass in basic sciences for postgraduates. The current book by the Author is an attempt- novel and unique, in the sense that the effort is inspired by the Indian post-graduate curriculum designed by the erstwhile Medical Council of India (known as National Medical Commission now) for M.D. course in the discipline of Forensic Medicine, more specifically the Paper-I of the Theory examination. The import of the title “Basic Sciences as Applied to Forensic Medicine and Toxicology” is very wide in scope and pertains to all the relevant anatomy, biochemical and physiologic principles, etc which is the basis of understanding the morbid anatomy and application of those to better understand the core Forensic Pathology. The book is an attempt to provide a one stop solution to the postgraduates in the discipline who earlier had to scroll through voluminous texts of Anatomy, Physiology, Biochemistry, etc to derive examination oriented content for better presentation in the examinations. Although the relevant basic sciences applicable to particular topics of interest in Forensic Medicine have already been provided by the Author in his earlier books viz. Textbook of Forensic Medicine & Toxicology, Injuries- Forensic and Medico Legal Aspects and Clinical and Forensic Toxicology, the present book goes several leaps ahead to explain most commonly asked topics from the entire ream of basic sciences which are some of the emerging domains e.g. stem cells, immunohistochemistry and molecular pathology- to name a few. Yet, the book remains connected to the very soul of Forensic Medicine, Traumatology and Toxicology by referring back to prior cited texts and thus avoiding repetition and maintaining chronology stimulating the reader and allowing for both horizontal and vertical integration, which is also the essence of Competency Based Medical Education Curriculum. The text is amply studded with memory aids and some of the handmade diagrams by the Author- one of particular note is memory aid designed for remembering cranial nerves on Page No 18, which makes the anatomical orientation of the various cranial nerves with respect to each other as well as vastly simplifies the topographic anatomy. Not to suffice, the text contains numerous demonstration videos which are a rarity in the existing literature and help the reader in grasping the basic concept e.g. experimental demonstration of the law of Laplace given on page no 51, which helps in conceptual understanding of the abstract terminologies. General Pathology given in Chapter 4 is a welcome inclusion as it helps in understanding the basic pathologic principles which are the basis for understanding and interpreting Forensic Pathology. A clear differentiation between Septicemia, sepsis and septic shock, based on updated scientific criteria is heartening to see on Page no’s 96 and 97. Another exciting feature of the book is the innumerable case studies which make the topics both entertaining to read and further act as reminders how one particular development has a legal bearing or implication. Chapter 6 discusses general pharmacological principles which have importance in the field of clinical and forensic toxicology. Questionnaire towards the end of each topic are though provoking e.g. anti-neoplastic drug for homicide brings one to an old case of murder by means of Lomustine, which is a drug employed for brain tumor treatment but the aplastic anemia and multi-organ failure which are the consequence of it’s overdose resemble natural death. This is significant for even clinicians/ emergency physicians who treat a significant number of accidental drug over-dosages to be mindful of the drug history- both prescriptions as well as Over-the-counter (OTC). The chapter on “Radiology as Applied to Forensic Medicine and Toxicology” is very thoughtfully designed considering the advent of Virtual Autopsy at AIIMS in 2021 by the Government of India after the Virtopsy project under Prof Richard Dirnhofer of the Institute of Forensic Medicine, University of Bern, Switzerland. The radiographs important from the point of view of a forensic practitioner have been given along with comparative diagrammatic representation for simplification purposes. Readers shall be in a better position to interpret the basic postmortem radiographic findings if and when needed. National Board of Examinations (NBE) has been asking one question every year in Paper I of Forensic Medicine DNB Theory Examination based upon biostatistics accounting for 10 marks. The inclusion of statistics as applied to Forensic Medicine and Toxicology in Chapter 8 of the book is a welcome step to strengthen the students with the most essential and desired topics e.g. Null Hypothesis, P-value, Z score, etc. which could be asked. The next chapter on Research Methodology is educative for the thesis going and any researcher to understand the various study designs and how to calculate the sample size for a proposed research study. Types of citations and referencing systems have also been elaborated upon and the various indexing systems have been deliberated upon. This is very much needed for a novice researcher as imprecise understanding of these may create impediments in the growth and advancement of the latter. The last few chapters focus on infrastructural requirements related to setting up of a Museum and Analytical Toxicological Laboratory in the Department of Forensic Medicine and Toxicology. Basic chemistry has been given at the end to simplify the understanding of subtlety and nuances of Forensic Toxicology. Few sample questions have been provided in the appendix which could further be enhanced through the addition of previous year questions from various universities. Tentative thesis/ research topics given in the appendix give important food for thought to the examinees and the research oriented ones. Overall the book is a novel and fresh initiative in an unexplored genre/ theme which will bode well to the lot to whom it is intended to cover- postgraduates in Forensic Medicine & Toxicology and the faculty. - Dr. Varun Modgil He is currently working as Assistant Professor at Dayanand Medical College & Hospital, Ludhiana, Punjab. He was Senior Resident at Postgraduate Medical Education & Research (PGIMER), Chandigarh. He deposed as an expert witness at various courts in Punjab, Haryana and Chandigarh. He has completed his D.N.B. in Forensic Medicine and also published articles in various National & International journals and also delivered guest lectures in National Conferences on Forensic Medicine. He can be contacted at dr_varun_modgil@dmch.edu ,

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE NOVEMBER 1998 ISSUE THE POISON SLEUTHS DEATH BY ARGEMONE MEXICANA -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young man today. His whole body is swollen, especially his legs. What happened to him? Please tell me." "Good morning Tarun. The name of this young man is Ghanshyam, and he was found dead in his hospital bed today morning. He is about 32 years old, and belongs to a low socio-economic status family. He was a champion of the cause of downtrodden, and was their leader for quite sometime now. For some days he had been complaining of marked swelling of the whole body especially of his legs. He had some gastrointestinal symptoms also such as vomiting and diarrhea, but the doctors were not very much worried about these symptoms. The main cause of worry was his swelling which could be an indication of some heart or kidney trouble. He had been admitted to the hospital and investigations were being carried out, but today morning he was found dead. Doctors were initially quite at ease giving his cause of death as kidney failure, but there was some organization of Jhuggi-Jhompri settlements, which raised the doubt that the death could have been as a result of deliberate poisoning by someone. Obviously they seem to have some political clout too. Just after a delegation met the local MLA with this doubt, an inquiry was ordered, and hence the police has brought his dead body to me. My job is to find out how he actually died." "But why would a person want to kill Ghanshyam? He does not seem to have a fight with anyone, does he?" "We do not know yet. I may remind you, that Ghanshyam was a leader of the downtrodden, and he may have had some enemies. It is not uncommon for leaders to have enemies who can go to any extent to have the leader removed from their way. It is possible that Ghanshyam had some enemies, who might have done away with him with some poison. Once his body is cremated, and then if someone raises a doubt that he had been poisoned, we would not be in a position to do anything about it. But right now, we have his body in our possession. So it is indeed very prudent to find out the right cause of death right now. Especially since this has now become such a hot political issue." "So what are you going to do now?" "I went through the hospital records, and found out what symptoms he was suffering from. I also had a detailed discussion with the doctors who were treating him. I already told you that he was having diarrhea, vomiting and marked swelling of his body, especially his legs. On inquiring from the doctors, I found out some other symptoms too. He had loss of appetite, and his liver was enlarged and tender. He complained of tingling sensations in the skin, and tenderness of the calf muscles. But what really interested me was that he was also having increased intraocular pressure.." "Sorry to interrupt you doctor, but what is meant by intraocular pressure?" "Tarun, the word intraocular is a Latin word meaning inside the eye. It is the pressure exerted by the fluid inside the eye. Normal intraocular pressure or tension is about 15 mm of Mercury, which simply means that normally the pressure inside the eye is so much as to support a column of about 15 mm of mercury. If you compare this figure with certain other commonly known figures, you would be better able to appreciate this pressure. The normal systolic blood pressure is about 120 mm of mercury, which means that the pressure generated by heart during contraction is roughly 8 times the pressure inside the eye. The normal atmospheric pressure at sea level is 760 mm of mercury, which means that it is about 50 times higher than that found inside the eye. In raised intraocular tension, the pressure rises more than 25 mm of mercury. Increase in intraocular tension is technically known as glaucoma. Rise in intraocular tension occurs in very few poisonings. Coupled with other symptoms, I at once made a certain guess about the possible poison that he might have ingested.." "What is that poison? Please tell me doctor. I am getting curious." "Tarun, it comes from a plant called Satyanashi in vernacular. Botanically it is known as Argemone mexicana." "Oh, I have heard about Satyanashi. It is a common weed found in our country, isn’t it?" "Yes, you are right Tarun. Its seeds are very much similar to that of dark variety of mustard seeds. I must tell you mustard (which is edible) has two varieties of seeds, a dark variety (Brassica nigra) and a light variety (Brassica compestris). The light variety is yellowish and quite distinctive. The seeds of Argemone mexicana give out a very poisonous oil, known as Argemone oil or katkar oil. This oil also looks very much similar to mustard oil. So katkar oil is very much used to adulterate mustard oil. It appears Ghanshyam got adulterated mustard oil from somewhere and consumed it. That is why he got these symptoms." "Just one thing doctor before we go ahead. Could you tell me, why this plant is called Argemone mexicana?" "Yeah sure Tarun. The name Argemone comes from the Greek argema, meaning "a cataract in the eye". Interestingly, the juice of this plant was once very popular in the treatment of cataract and hence the name. Of course, now it is known that it is not only useless for treating cataract, but can in fact be dangerous to the eye. The name mexicana, simply refers to its native place Mexico. I may tell you that this is originally an American herbaceous annual belonging to the family Papaveraceae, but has now become a pantropical weed throughout tropical and subtropical parts of the world. It has come to India through activities of man and occurs as a local weed in cold season, exclusively in low rainfall regions at elevation from sea level to 2,500 m. It grows wild all over the country in wastelands and along roadsides. It is called Sialkanta in Bengal and North India, Satyanashi in Gujrat and Bharamdandi or Pila-Dhatura in Maharashtra. It is known by several other names such as Ujarkanta and Phirangi Dhatura. It is a robust prickly herbaceous annual, 1-4 ft high, with spreading branches. The flowers are 1-3 inch across and are colored yellow. Seeds are blackish brown, round and netted, and as I told you earlier, resemble those of mustard (Brassica nigra). The extract of the whole plant (latex) contains two alkaloids Berberine and Protopine. Seeds yield 22-36% of a pale yellow, nauseous, bitter, non-edible oil, which as I told you earlier is known as katkar oil or simply Argemone oil. This oil is rich in two other alkaloids Sanguinarine and Dihydrosanguinarine, the former being more toxic than the latter. These latter two alkaloids are mainly responsible for the poisonous symptoms produced by ingestion of Argemone oil. It is said that if katkar oil is heated to 2400 C for 15 minutes, it loses its toxic properties. Other alkaloids of lesser importance are cheletrythrine and coptisine." "Doctor, you told me that the seeds of the dark variety of mustard look very similar to those of Argemone mexicana. Is there some test, by which the two can be differentiated?" "Oh yes. Certainly. The light variety of mustard seeds (Brassica compestris) can easily be differentiated from Argemone by simple visual inspection. The tricky part is to differentiate the dark variety of mustard seeds (Brassica nigra) with those of Argemone. This is done by placing the seeds in normal saline. Mustard seeds will sink, while Argemone seeds will float. If you have trouble remembering this fact, remember the mnemonic 'False will Float'. Remember Argemone seeds are 'false' seeds." "Oh, that is truly marvelous. Is there a scientific way to detect adulterated mustard oil too?" "Oh, yes, there certainly is. There are at least three interesting color tests to detect adulterated mustard oil. The first is the Nitric acid test. We take 5 ml of adulterated oil and mix it with an equal volume of Nitric acid. The test tube is shaken and then allowed to stand. After some time the acid layer turns yellow, orange or crimson, depending on the amount of argemone oil in the adulterated sample. This is a simple test but has the great drawback of lack of specificity. This means that there are a number of false positives. The second is Ferric Chloride test. In this test, we use three reagents, namely Hydrochloric acid, ethanol and of course ferric chloride. The test is carried out in three steps. In step 1, two ml of adulterated oil is mixed with an equal amount of Hydrochloric acid and heated in a water bath at 35 degrees Celsius for two minutes. After this 8 ml of ethanol is added and heating continued for one more minute (Step 2). Finally in the third step we add 2 ml of ferric chloride, and the mixture is heated for a further ten minutes. If an orange-red precipitate forms, it indicates adulteration with Argemone oil. Finally there is the Cupric acid test, where 5 ml. of adulterated oil in taken in a test tube. One ml. glacial acetic acid and 2 mg. of cupric acetate solution are added to it. Development of green colour confirms the presence of argemone oil in the sample. Besides these color tests, the adulterated oil can also be detected by Paper chromatography and Thin Layer Chromatography (TLC). These are slightly complicated techniques, but I will tell you the basics of these tests. In paper chromatography, the mixture (of mustard and argemone oils) is allowed to run on a paper which is much like a blotting paper. The speeds with which each oil travels on this paper is different, with the result that after some time the two oils separate. These oils can be made visible by adding suitable reagents. This is the basis of paper chromatography. TLC is also quite similar. Paper chromatography is a very sensitive technique and can detect down to 0.0001% adulteration with argemone oil." "Doctor, you earlier told me that Katkar oil is used to adulterate mustard oil. So does this mean it is cheaper than mustard oil?" "Yeah sure. But an additional factor often held responsible for adulteration is the maturation periods of the two plants, which is almost similar. Those defending intentional adulteration (mainly merchants and retailers of mustard oil) often point to the fact that the two plants often grow together and ripe at the same time, so during harvesting, there is an inadvertent mixing of the two seeds. But this argument appears fallacious for several reasons. Argemone grows mostly on fallow land and mustard has a canopy that does not let anything grow under it. Mustard ripens in March and Argemone in May. By May mustard has already been harvested, so adulteration can only be intentional." "Oh, I see. Does this mean Katkar oil has no use at all? It is only misused for adulteration." "No Tarun. Katkar oil has several legitimate uses. It is used medicinally in several countries in the treatment of dropsy (swelling of the body), jaundice and skin diseases. It is often given as an aperient (laxative). It is also used for lighting lamps, as it is very cheap. I might tell you that although the seeds of Argemone look very much like those of mustard seeds, there are some important differences between the two. If the seeds are placed between two fingers and rubbed, the Argemone seeds are found to have spiny edges. Mustard seeds do not have such spiny edges. Furthermore the seeds of mustard are heavier having a specific gravity of 1.3 as compared to 1.08 of Argemone. This helps in easy differentiation. The seeds of mustard will drown in saline water of appropriate specific gravity (say 1.2), while those of Argemone will keep on floating. Always remember the mnemonic I told you earlier - 'False will Float" "Oh, that is certainly interesting. Could you tell me the name of the disease one suffers from, when he consumes Katkar oil?" "Tarun, the name of the disease is epidemic dropsy. Dropsy means swelling of the body, and the name epidemic is self-explanatory. This disease usually occurs in epidemic form. The reason is that when adulterated oil comes in the market, several people consume it and fall ill at the same time. That is why the name epidemic dropsy is quite apt, although modern textbooks of medicine rarely use this term now. I told you that the chief symptom of Argemone oil poisoning is marked swelling over the legs. The cause of this swelling (technically known as edema or dropsy) is the increased porosity of the blood vessels, which is caused by Sanguinarine. Because of the increased porosity, water leaves the blood vessels and comes to lie in the tissues. This is mainly responsible for the swelling. Sometime so much water oozes out of the blood that it accumulates in the cavities around the heart and lungs. Look here at Ghanshyam’s body. I have dissected the body for you. Can you see the fluid accumulated around his lungs and heart?" "Oh, sure doctor. There is lot of fluid around his lungs and heart. And of course his legs are very much swollen. It is becoming clear to me now that he died of Argemone oil poisoning. I was just curious to know how old this disease is." "Tarun, the first case of poisoning in the country was reported in Bombay in 1877. In 1926, a doctor in Bengal discovered its link with consumption of cooking oil adulterated with Argemone oil. In 1935, the scourge killed 1,500 people in Bengal, and in 1966 an outbreak incapacitated hundreds of people in Bombay. In 1983, dropsy created havoc in Delhi, and again in 1998 during the months of August and September. During 1998 epidemic in Delhi, a total of 2552 cases were reported officially of which as many as 65 died. I may tell you, that although katkar oil is poisonous to animals, they do not show classical symptoms of epidemic dropsy. Experiments have shown that monkeys and cats develop sleepiness and diarrhea culminating in death. Guinea pigs and mice lost weight and died without showing any symptoms. Since epidemic dropsy can not be produced in animals, most studies on the Argemone oil have been done on human volunteers." "Doctor, have the outbreaks of Argemone poisoning occurred in other countries too, or is it just a peculiarity of our country?" "Tarun, Argemone poisoning has occurred in several other countries too, namely Fiji islands, South Africa and the 3 Ms - Madagascar, Myanmar and Mauritius. In our own country, it seems to occur more commonly in Northern India. South India has rarely suffered from this condition perhaps because mustard oil is not very popular there. Another interesting fact is that while almost all outbreaks of poisoning have occurred due to contamination with argemone oil, in South Africa an epidemic occurred due to adulteration of wheat flour with argemone seeds." "Oh, I see. So how do we arrive at the final diagnosis that Ghanshyam indeed has died due to Argemone oil poisoning?" "Tarun, I looked at his eyes, and dissected the retina. His intraocular tension is high. In addition, I also saw retinal hemorrhages, which is another thing that occurs in Argemone oil poisoning. Look here at the retina, which I have dissected out. Can you see retinal hemorrhages here?" "Oh sure doctor, they are very obvious. What else?" "Tarun, I told you that Sanguinarine causes dilation of blood vessels. Owing to dilation of peripheral blood vessels, a bluish mottling appears on the skin. Here you can see those bluish mottlings all over his skin. You can also see some small, fleshy, dark red, warty growths or nodules in the mucous membranes of cheek, gums, tongue and nose. This is quite characteristic of Argemone oil poisoning. Another characteristic thing is enlargement of liver. In this case too, it is enlarged. So we are almost sure that Ghanshyam died of Argemone oil poisoning. I have enquired the place from where Ghanshyam used to buy his mustard oil. It is from a local retailer Kauwa Ram. Come let us tell the police to seize all oil from his possession. It is quite obvious that he has adulterated the mustard oil with Argemone oil, and is selling it to gullible public for his own profit." "Oh yeah, this was a most interesting discussion doctor. Because of your sterling sleuthing, this dishonest trader will be caught and the public will be saved of this unnecessary agony. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- Sodium chlorate." "

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JUNE 1999 ISSUE THE POISON SLEUTHS DEATH BY NITRIC ACID -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. He has these strange yellowish stains over his face and chest. What has happened to him? Please tell me." "Good morning Tarun. The name of this middle aged man is Radhey Shyam, and he was living alone in this house for the last five years. His dead body has been found today morning from his house. His wife and son died long ago, and since then he is living in a very depressed state of mind. He had become alcoholic and had taken to gambling too. He had taken lot of loans from various sources. It is said that from one person Munna, he took as much as one lakh of rupees. Munna was actually a professional money lender and he used to give money at a very exorbitant rate of interest..." "Oh, I see. But what has all this to do with his death?" "I am coming to that Tarun. Munna was pressing Radhey Shyam for his money for quite some time. Last week Munna had visited Radhey Shyam's house, along with some of his goons for his money, and when Radhey expressed his inability to return the money for about six more months, Munna had threatened him with grave consequences." "So Munna has killed Radhey for retaliation?" "This is what the police thinks. Actually Munna had visited Radhey's house yesterday night too, and had threatened him with grave consequences once again. Today morning they have found the dead body of Radhey. So it is very natural to assume that Munna and his goons have killed Radhey." "What does Munna say?" "The police has arrested him. He looks terrified. He is swearing that he has nothing to do with this killing. He does admit that he had visited Radhey yesterday night, and that he indeed was with two of his goons. He also admits that he had threatened Radhey with grave consequences, but he swears he gave those threats merely to terrify Radhey into returning his money as soon as possible. He never intended to kill Radhey. He has also come out with an interesting argument. He says that he would not have got his money anyway by killing Radhey. So killing Radhey was not in his interest anyway." "Sounds like a valid argument. What do you think doctor?" "Tarun, as you know, I deal every case from a scientific angle. Are you looking at the yellowish stains over his face and chest and over his clothes?" "Yeah, they are very prominent. In fact that is the first thing I noticed, when I came here." "I have looked at his teeth and tongue too. Even they are stained yellow. Come, you also have a look" "Yes, indeed. But what are you trying to arrive at?" "Tarun, it seems to me, that Radhey has died because of Nitric Acid" "Nitric Acid? Never heard of this poison being used to kill anyone." "Nitric acid is not a homicidal poison. It can not be given homicidally to anyone, because it has such a pungent taste. It is in fact a suicidal poison." "Looks like we are on to another of your rare and exotic poisons. Doctor please tell me about nitric acid from the beginning." "Tarun, Nitric acid is a colorless or yellow fuming liquid with an acrid odour. It is a powerful oxidizing agent and reacts with organic matter such as with proteins to produce trinitrophenol or picric acid with the liberation of nitrogen monoxide. This is known as xanthoproteic reaction. Organic matter is thus turned yellow. Stains of this acid on clothing are also yellow, which is a distinctive feature of poisoning by nitric acid. In fact this is how I first suspected that this could be nitric acid poisoning." "Oh, I see. Can you tell me, what are the symptoms a person experiences when he consumes nitric acid?" "Sure. The person gets eructations and abdominal distension. Actually this symptom is also seen with other acids such as sulphuric acid, but eructations and abdominal distension are more severe in nitric acid than with sulphuric acid, because with nitric acid more gas is formed. Then, as you know by now, there is yellowish staining of the teeth as well as of the skin around the mouth, cheeks, and neck, which is very characteristic. Yellow stains may also be found on hands, forearms, and the chest because of splashing. In severe cases, the stomach may perforate, but this is unusual." "Doctor, what is the usual fatal dose of nitric acid?" "It is around 10-15 ml. Actually one tablespoonful contains about 5 ml of liquid. So about two to three table spoonfuls of nitric acid are enough to kill a person." "And what is the usual fatal period?" "It is around 18-24 hours" "How can a person obtain nitric acid to kill himself?" "Tarun, nitric acid is widely used in the art and manufacturing industry. It is used for cleansing nickel ornaments and separating gold from other metals. It is also used in the preparation of gun cotton, nitroglycerin, picric acid, and colouring matters. Because of its wide use in industry, and even in domestic affairs, it is commonly available in the market. And because of its easy availability, suicidal and accidental poisoning is quite likely." "Can a person commit murder with nitric acid?" "Majority of cases of poisoning by nitric acid are either suicidal or accidental. Homicide with nitric acid is extremely difficult, and perhaps even impossible. Because of the corrosive nature of the acid, it can not be given to an unsuspecting individual, who would immediately discard it on tasting. However forcible administration of this acid in drunk patients has been reported. A forensic expert by the name of Christison describes a case where nitric acid was forcibly poured down the throat of a woman when she was drunk. Nitric acid has also been used in vitriolage, although the use of sulphuric acid is more common for this purpose." "Excuse me doctor, you have used a new word. I am not quite familiar with this. What is vitriolage?" "Tarun, vitriolage is intentional throwing of a corrosive substance over the face of an enemy. Often the corrosive substance such as sulphuric or nitric acid is filled up in an old used bulb, and this bulb is then thrown over the face of the victim. A person who commits vitriolage generally does not intend to kill his victim. He merely wants to disfigure him or her. When this bulb smashes on the victim's face, the corrosive substance is released and corrodes the face of the individual. This method is usually employed by disgruntled youths to disfigure the face of beautiful girls who have spurned their love offers." "Oh, that is really sad. Now in the current case of Radhey, how did you reach the conclusion that he had died of nitric acid poisoning?" "By his peculiar post-mortem findings. I have already talked to you about his yellowish stains. These yellowish stains have to be differentiated from those of the iodine stains, because they can cause similar stains. However if ammonia or some other alkali is applied to the stains, the ones due to nitric acid deepen in colour to become orange, whereas those by iodine are decolorized. I did this test in this case, and found that these stains were indeed caused by nitric acid only. In addition, I found that his stomach was perforated. This can only happen if the acid has corroded the stomach wall. But I did not stop at that. I took some material from his stomach and chemically tested it in my lab. I have confirmed chemically that the substance which Radhey ingested was indeed nitric acid. Subsequent to this, I asked the police to search his house and look for some suspicious looking half filled bottle. And sure enough they found a bottle of nitric acid in his almirah which was half filled. Now I will tell you what must have happened. Munna indeed visited Radhey's house yesterday along with his goons, and he also threatened Radhey. But he did not kill him. After Munna had left, Radhey got depressed. He anyway was living alone and no meaning to life was left to him. He wanted to commit suicide and the only thing available to him was nitric acid. He consumed this acid and died. Come let us tell the police that Munna has not killed Radhey. He has actually committed suicide." "Very clever indeed. This was a most interesting discussion doctor. Without your masterly deduction, police could have unnecessarily went on harassing Munna. Everyone might have thought, it was a case of killing by Radhey. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison. It is oxalic acid. "

Main Page > Vol-26 No- 1 > Editorial by Puneet Setia (you are here) LinkedIn X (Twitter) Facebook Copy link Share Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Volume 26 Number 1 (January - June 2025) Ref: Setia P. Apology Laws – Are they the right answer for Medical Practitioners? (Editorial). Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology, 2025 ; Vol. 26, No. 1 (January - June 2025): https://www.anilaggrawal.com/ij/vol-026-no-001/others/editorial ; Published January 1, 2025, : [about 5 p]. DOI: 10.5281/zenodo.14599219 . Available from : (Accessed: July 01, 2025) Apology Laws – Are they the right answer for Medical Practitioners? Puneet Setia Mahatma Gandhi, famously said this a number of times, “Confession of errors is like a broom which sweeps away the dirt and leaves the surface brighter and clearer. I feel stronger for confession. ” This year, I want to begin surmising, whether this broom can be applied to medical practitioners too? Can medical practitioners make their – and the entire world’s inhabitants’ – life easier by confessing to their errors, the moment they discover it? Can this be done? Has it ever been done in the form of any legislation? Of course it has been, in several US and Canadian states and several countries in Europe. In Japan there are no explicit “apology laws”, but she does have a strong cultural practice of medical professionals apologizing and explaining errors to patients and families when they occur. After a medical error, usually there are informal meetings between medical staff and affected parties, written explanations of what went wrong, expression of regret and even an offer of compensation. But what happens in other countries? But why in the first place should be worry about some countries, when in general it is clear that these laws do exist at some places and thus the possibility of implementing them everywhere is very much there? These “apology laws” are also called "I'm Sorry" Laws. ¹ They refer to legal provisions in a country/state, where, after a medical error has occurred, the doctor is treated less harshly, if -and only if- he discloses the error and apologizes to a patient or his survivors. On the contrary, if he decides to keep quiet, and the error is discovered later, he would be treated more harshly. ² . . .These kinds of laws have been implemented in some form or the other, virtually in every continent – although not necessarily in relation to medical errors. . These kinds of laws have been implemented in some form or the other, virtually in every continent – although not necessarily in relation to medical errors. Take India for example. India does not have “apology laws” for medical practitioners as such. But apology laws make their appearance in hidden form in several laws. Take for example the recently enacted Bharatiya Nyaya Sanhita, 2023 or BNS, 2023 [roughly translates as the Indian Justice Code, 2023; it replaced the older Indian Penal Code (IPC)]. Several provisions in this new Code include apology laws – albeit hidden. But let me take the example which a forensic pathologist encounters almost on a daily basis – Death by rash and negligent driving. The former law addressed this crime through s304A IPC. Briefly it stated that if someone caused the death of a person by doing a rash or negligent act [such a rash driving] shall be punished with imprisonment of 2 years or fine or both. . . .What was the punishment if someone caused the death of more than one person by rash and negligent act? What about killing 100 people or more, say by driving a vehicle through a crowd. . . Glaring deficiencies in this law were: *What was the punishment if someone caused the death of more than one person by rash and negligent act? What about killing 100 people or more, say by driving a vehicle through a crowd – of course unintentionally; merely because the driver was drunk? Will he still get away with 2 years? No clear cut answer was available. Of course the judge could pronounce 2 years for each of those 100 deaths, and pronounce that the punishments would run consequently – not concurrently [as is the norm]. However I never saw that kind of judgment. Glaring examples are Bhopal gas tragedy of 1984 , and Uphaar Cinema fire of 1997 . None of the perpetrators was given any sentence commensurate with the gravity of crime. *Secondly, was this law applicable to medical practitioners? Nothing was mentioned in the law, although it was usually invoked for this purpose. . . .My prediction is there would be apology laws for medical practitioners everywhere in the world sooner than later.. . . The newly enacted Bharatiya Nyaya Sanhita, 2023 or BNS deals with it through s106. There is a radical change in wordings now. The actual text is far longer and extensive, but I will not get into its details. There are several improvements in it, most importantly inclusion of an apology law, although it is not so apparent at first. Essentially it says that if a rash and negligent driver hits – say a pedestrian – and runs away, and the victim dies, the driver would get 10 years. But if he reports it to a police officer or a magistrate soon after the incident, he will get only 2 years. This is actually an “apology law” loud and clear. Apology laws are here to stay. My prediction is there would be apology laws for medical practitioners everywhere in the world sooner than later. I know currently these laws have not succeeded in US and elsewhere, ³ but there are good reasons for this. And let this be a topic for another day. References Bender FF. "I'm Sorry" Laws and Medical Liability. Virtual Mentor. 2007 Apr 1;9(4):300-4. [ PubMed ] Fields AC, Mello MM, Kachalia A. Apology laws and malpractice liability: what have we learned? BMJ Qual Saf. 2021 Jan;30(1):64-7. [ PubMed ] McMichael BJ, Van Horn RL, Viscusi WK. "Sorry” Is Never Enough: How State Apology Laws Fail to Reduce Medical Malpractice Liability Risk. Stanford Law Rev. 2019 Feb; 71(2): 341-409. [ PubMed ] - Puneet Setia Professor of Forensic Medicine and Toxicology Department of Forensic Medicine, AIIMS, Jodhpur, India Email: forensicaiimsjdh.ps@gmail.com

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE APRIL-MAY 1997 ISSUE THE POISON SLEUTHS POISONING BY BORON -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the body of a young woman here." "You are right Tarun. This woman lying here on my table is Lata. She is a 23 year old young unmarried girl. Her parents tell me that she was not feeling well for the last few days. She got frequent bouts of vomiting and in general was down and out. They insisted to take her to a doctor, but she said the symptoms were not troublesome and she would soon get well. She did not inform her parents but the police has found out during the investigations that about a week back she contacted a quack Dr. Harish for treatment, and allegedly he administered her some medication. Soon after she began to feel nauseated. She had severe diarrhea and vomiting. Her parents tell me that the color of both her feces and vomitus was somewhat bluish green. She was also reported to have severe pain in her stomach, severe convulsions and tremors. They did not know why the symptoms had become so severe and they again insisted to take her to a doctor, but again she declined. Since two days she was feeling extremely lethargic and was having headaches off and on. She again contacted Dr. Harish yesterday and he was reported to have administered something to her again. Within about 2 hours of this she died. Now the police has brought her body to me to tell them how she died." "Should be quite simple. Obviously Dr. Harish has administered some poison to her." "Yes, it appears so. But the question is why he would administer her the poison. The police has talked to Dr. Harish and he seems quite confident that he gave her the correct medicine. He asserts that Lata died of her original illness which she was complaining of." "So what are you going to do now?" "Well, I will have to conduct an autopsy on her dead body. Do you see her fingers and fingernails? Do they not seem abnormal to you?" "Why! they certainly do. They appear as if they have been painted red! Doctor I am getting curious. Please let me know what this is?" "And if you look at her buttocks you would find the same change. In medicine, we call it erythema. It is a kind of inflammation of the skin. The skin as you can see, is sloughing off at several places. Of course the most prominent finding as you have noticed is the marked redness of the skin. You may be surprised to know that in toxicology there is a special term for this change. This is known as "boiled lobster" syndrome. The skin appears like a boiled lobster, doesn't it?" "Now that you tell me, it certainly does. But tell me doctor, does it indicate any particular poison?" "Yes Tarun. It indicates one and only one poison- boron. It appears to me that Dr. Harish gave her one of boron compounds." "What? Boron? Doesn't sound like a poison to me. Poison to me means things like cyanide. Please tell me more about boron." "Tarun, admittedly boron is not a common poison, but it is certainly poisonous and can cause death. Boron in elemental form is not poisonous, but its salts are. Its most common salts are sodium borate, sodium biborate, sodium pyroborate and sodium tetraborate. Boric acid (H3BO3) is a colorless, odorless compound commercially available as granules, and white powder. A teaspoon of 100% boric acid crystals contains approximately 4 g of boric acid..." "Sorry to interrupt you doctor, but does it have any medical use?" "Tarun, it was introduced in 1702 by Homberg as a sedative, pain-killer, and antispasmodic. An antispasmodic relieves spasms, especially those of the stomach and is thus useful in stomach pains. At that time it was widely known as "Homberg's sedative salt". But by next century it had fallen in disfavor till Joseph Lister (1827-1912) revived its use once again employing it as an antiseptic in 1875. A little later- in about 1885- it was used as a food preservative, being frequently added to milk to keep it from rotting. But it was soon discovered that its use as a food preservative can cause serious poisoning. Since then its use as a food preservative has been abandoned, but it has been used in several other forms- as solutions, medicated powders, skin lotions, ointments, toothpastes, mouthwashes, water softeners, topical astringents and antiseptics. In the early part of this century, it was recommended for the treatment of ammoniacal dermatitis in children...." "What is ammoniacal dermatitis, doctor?" "Tarun, dermatitis means inflammation or redness of the skin. Ammoniacal dermatitis is an inflammation of the skin caused by ammonia. You might be surprised how children can get exposed to such an unusual gas as ammonia. Well, the gas is produced as a result of the chemical breakdown of urine by bacteria in the feces. Nappies of very young children can get soiled with both urine and feces. The bacteria in the feces produce ammonia from the urine. Ammonia has a burning effect on soft baby skin. It produces a rash in the surrounding area. Since the rash is in the area of the diaper it is commonly known as diaper or nappy rash. In fact, so commonly was boric acid prescribed for diaper rash, that at one time it was suggested that a history of diaper rash in any infant under the age of one year, who has died unexpectedly, should raise the suspicion of boric acid poisoning! This aphorism was true for two reasons. Not only was it often applied as a remedy for diaper rash but its poisoning in children often took the appearance of a diaper rash, even if did not have it in the first place! You have seen marked redness of the skin in Lata's case; in children the same happens in the diaper area, giving an appearance mimicking diaper rash. Boric acid was once famous for the treatment of burns too. In fact it was successfully used in the treatment of burns sustained in the Cocoanut Grove disaster..." "Sorry to interrupt you once again doctor, but what was the Cocoanut Grove disaster?" "Tarun, Cocoanut Grove was a Boston night club in USA, which caught fire on Nov 28, 1942. A corner of the Lounge had fallen into complete darkness as someone -probably a customer- had taken out a bulb. A 16 year old employee of the club was asked to replace the bulb. He lighted a match in order to illuminate the area and tried to screw the bulb in position, but the match started an artificial palm tree burning, and the fire spread quickly. As a result 491 men and women lost their lives. During the two hours following the onset of fire, 114 casualties were brought to the Massachusetts General Hospital. Many were dead on arrival and many died soon afterwards. Only 39 lived and were treated. In this disaster, the doctors successfully used boric acid to treat many cases of burns. Following this success, it began to be used widely in the treatment of burns as a sterile boracic ointment in place of tannic acid, which was being used earlier. But it was once again shown that poisonous amounts of boric acid can get absorbed from burn wounds and can cause serious symptoms..." "So it appears boric acid is no good as a medicine after all" "You can say that again. British Medical Association in 1966 published a statement in which practitioners were advised to refrain from prescribing boric acid and related salts in any form of treatment. The Pharmaceutical Society of Great Britain in the same year advised pharmacists not to sell boric acid as a dusting powder, nor to supply borax in any form. Boric acid solutions have been used as antiseptic irrigating solutions for cleaning wounds and abscesses and even internally for irrigating bladder, pleural cavity and lower bowel, but as I have already told you, it may produce toxicity. Other poisonous compounds of boron are the boron hydrides.." "Doctor please tell me something about boron hydrides." "Tarun, Boron Hydrides are a class of chemical compounds having the general formula BnHn+4. They have been investigated as possible propellant fuels as they have nearly double the energy content of standard hydrocarbon fuels. Examples include diborane (B2H6), a gas; pentaborane (B5H9) a liquid, and decaborane (B10H14), a solid under standard conditions. They oxidize vigorously to produce boric acid, water and much heat. Some of the hydrides are spontaneously pyrophoric, i.e. they have the capability of catching fire spontaneously in air, just like phosphorus. Boron hydrides are extremely poisonous compounds. It is believed that they are even more poisonous that cyanide! Levels in air as low as 0.005 parts per million may be toxic!" "Have poisonings occurred from boron hydrides as well?" "Yes surely. Boron hydrides are used in the industry for several purposes. You must be knowing that for making semiconductors, the wafer of silicon has to be "doped" with boron. This doping is done with boron hydrides. There are several other complicated uses of boron hydrides in the industry. Cases have occurred when pentaborane has accidentally released in industrial area and poisoned the workers. This can cause quick death. Another curious boron preparation is the Dobell's solution...." "What is Dobell's solution doctor?" "Tarun, Dobell's solution was first prepared by the London physician Horace Benge Dobell (b. 1828) in the last century. It consists of a solution of borax, sodium bicarbonate, phenol and glycerine in water and it was used as an antiseptic in the last century and in the early part of this century. Borax (Na2B4O7.10H2O), another poisonous boron compound has been known as a cleaning agent since the days of the Greek and Roman empires and has long been used as a food preservative in Europe and America. Today the principal compound of boron easily available to a common man is sodium perborate. It is an oxidizer which is normally present in tooth powders and toothpastes. It is available to the general public in powder or tablet form for the cleansing of dentures. The white tablets of sodium perborate look quite like sweets and may be taken by curious children! Contact lens solutions also contain salts of boron." "Doctor, how can one get poisoned from boric acid or other boron salts? Can it be administered homicidally? "Tarun, Boric acid- one of the most important toxic salts of boron- can certainly be administered homicidally especially as it is a colorless and odorless compound, and is quite commonly available. But no homicidal poisoning with boric acid has yet been reported perhaps because its lethal dose is rather high- about 20 g. As I told you in one of my earlier meetings, an ideal homicidal poison is one which is not only colorless, odorless and tasteless, but whose lethal dose is very small too. But this is not to say that homicidal cases may not have occurred. It is quite possible that cases of homicidal poisoning occurred, but because of poor investigation techniques, the poisoners remained scot free." "Has it been taken for suicidal purposes?" "Not to my knowledge, but certainly people have got poisoned when they mistook it for certain other salts. There are cases on record when boric acid crystals have been mistaken for other innocuous salts and ingested. It has frequently been mistaken for Epsom salt.... "Sorry to interrupt you doctor, but is Epsom salt the same as magnesium sulphate?" "You are right Tarun. Epsom is actually a place in England, very near London which is now famous for Derby- the world's best known horse race. Before the first Derby race here - in 1780- this place was better known as a spa. A spa as you know is a place where one goes to take bath in natural spring waters. Mineral springs were discovered here in 1618, which were quite rich in magnesium sulphate. This is how magnesium sulphate came to be known as Epsom salt. It has great medicinal value and is taken orally to treat constipation and heartburn. It is also prescribed as injection to prevent seizures, especially in preeclampsia, a dangerous condition seen in pregnant mothers." "Well, I think now I know a lot about boron. Coming to our own case, why do you think Dr. Harish administered Boron to Lata? Did he want to kill her with an exotic little known poison, so that no one could suspect him?" "It is a possibility but I do not think it must have happened, especially as Dr. Harish had no motive to kill Lata. Actually Borax has a reputation among quacks as an emmenagogue; it is supplied to induce criminal abortion...." "Well, you have introduced two new terms doctor. What are emmenagogues, and what is criminal abortion?" "Tarun, emmenagogue is a drug which increases the flow of menstrual blood. The term comes from the Greek roots emmena, menses, and agogein, to draw forth. Thus literally the term refers to any drug which "draws forth the menses". Interestingly the root agogein is seen in many other medical terms such as cholagogue, which refers to any drug which increases the secretion of bile (from Greek chole, bile). Many drugs have a reputation as emmenagogues, some of them being aloes, potassium permanganate, pennyroyal, caulophyllin and apiol. You would surely remember that last time we talked about cantharides in another context. Well, it is also an emmenagogue. Borax is also a strong emmenagogue. Criminal abortion is any abortion done against the law. The law requires that the doctor doing the abortion should have certain requisite qualifications and experience. Girls who become pregnant before marriage can not go to regular doctors for abortion for obvious fears of facing embarrassment and insult in society. So they chose an easy way out; they go to quacks who often do it in a hush-hush manner so that no one else may come to know about it. But they do not have the requisite qualifications, so abortions performed by them are obviously criminal in nature. If found out, they could be prosecuted by law. Since these doctors are not properly qualified, they do not know of standard and safe methods of abortion. They resort to centuries' old dangerous methods of abortion; methods which properly qualified doctors do not resort to. One of the methods employed by the quacks is to administer emmenagogues. The idea is that by promoting the flow of menstrual blood, they would somehow be able to "wash down" the young embryo lodged in the uterine wall. This method does work at times but is an extremely dangerous method. It is like trying to cut your nails by banging your fingers against a sharp knife." "I am getting the picture now. Lata was pregnant and she contacted Dr. Harish for a criminal abortion. Dr. Harish administered her borax as an emmenagogue. But it did not work; it caused her death instead." "You are very right Tarun. This is indeed what happened. The symptoms which Lata had were symptoms of pregnancy. Since she was unmarried, she did not want to make it known to her parents. She herself contacted Dr. Harish who was quite sure that he could do the job, but he killed her instead. Post-mortem findings in boron poisonings are not very specific. The mucosa or the lining of the stomach may be bright red and the blood may be cherry red in appearance. Characteristic rash as described earlier may be seen. I have seen all these findings in Lata's body. But I have not relied on autopsy findings alone. I have conducted blood tests on Lata's blood which are confirmatory. The levels of boron in her blood were important. Normally boron levels in the blood are minimal. A level of 50 mg/100 ml indicates poisoning, but I found boron levels exceeding 500 mg/100 mg, which surely is enough to cause death. The actual lethal dose of a boron salt is between 15-20 g for adults and from 3-5 g in infants. So I believe the second time Dr. Harish must have administered her a dose greater than about 20 g. He must have given her a lesser dose the first time, but when it did not do the trick, he administered a larger dose the next time, which killed her. Let us call the police and tell them how she died." "Oh sure we should. And thank you doctor for telling me about such an interesting poison. What are you going to tell me the next time?" "Tarun, next time I shall tell you about silver which as you shall see is a very important poison. "

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