SCIENCE IN CRIME DETECTION-6 THE VITAL EVIDENCE ? During my long professional career, I have been involved in a number of interesting cases, where a sound medical knowledge helped me to unravel crime. I will discuss one such case here. Ram Avtar was a God fearing man living on the outskirts of Delhi. He had a small family; a religious wife, a fifteen year old son Raju and a twenty-one year old daughter Neetu. Ram Avtar was worried about Neetu as she was growing older rapidly, and he wanted to get her married. She was beautiful and moderately educated, but as Ram Avtar did not have enough money to pay as dowry, he was having difficulty in finding a suitable groom. A beautiful, poor, young girl is often the target of bad elements in the neighborhood. Shamsher and Kishore, two bad characters of the locality, often teased her. Whenever Neetu would pass through the streets, they would pass filthy remarks on her. In several such remarks, they proposed marriage with her even. But Neetu knew them well and quite rightly ignored and avoided them. But one day they transcended all limits of decency. It was about 10.00 pm on August 22, 1983. Neetu was returning home after visiting her aunt. Normally she wouldn't have been so late but the DTC bus in which she was traveling, went out of order. She could not get an alternative transport for quite some time. Finally she decided to walk home as she could not afford an auto rickshaw. Shamsher and Kishore were drinking at the local pub, round the corner. By the time they saw Neetu arrive, they were quite tipsy. They staggered towards her as she advanced towards her house. One of them caught hold of her dupatta (Dupatta is a small band of cloth used in India by the girls to cover breasts) and pulled it while the other tried to touch her breasts. He managed to lay his hand on her left breast and even succeeded in stealing a kiss on her cheeks. Naturally this enraged her and she started calling for help. Ramavtar came out of the house and as soon as he saw the two youths and his disheveled daughter, he understood the whole story and instinctively started beating them. He also raised an alarm, on hearing which many residents came out of their houses. They also gave them a sound thrashing and later dragged both of them to the police station. The police swung into action and registered a case under Section 354 on the Indian penal Code (which deals with “indecent assault on women”). The case did not drag on for long. Eight residents of the colony, besides Ramavtar and Neetu, gave evidence against Shamsher and Kishore. Against such an overwhelming evidence, the court found no difficulty in prosecuting both of them. They were sentenced to six months of rigorous imprisonment. When the two criminals were being dragged to jail, they openly swore to get even with Ramavtar and Neetu. Many people heard their threats, but none took them seriously as they were petty criminals and could not do much harm to them. On January 14, 1986, the unexpected happened. Ramavtar's wife and son were away on a marriage. Only Ramavtar and Neetu were at home. At 6.00 am when the milkman knocked at Ramavtar's door, there was no response. Normally the milkman would have gone away but he had to collect the payment, which was already delayed by a week. When there was no response even after 5 minutes, the milkman got suspicious and informed the neighbors. Soon many people collected outside. Someone informed the police. When the police broke open the door, they found a horrible scene. Ramavtar was found dead on his bed, his head badly mangled. Neetu was lying stark naked, spread-eagled on the floor. There was a gag in her mouth and foam at her nostrils. Her genitals were bleeding. Anyone with a rudimentary knowledge of crime could see that she had been sexually assaulted a number of times. The window of the room was ajar. It appeared that the criminals had escaped from the window. A detailed enquiry could not reveal much. A faint lead came from one neighbor, Satbir. He said that on the night of January 13-14, he had got up to urinate twice, sometime in the night. For urination, he had to go to his backyard, from where he could clearly see Ramavtar's house. He usually got up in the night to urinate and he couldn't help but see Ramavtar's house, as it lay exactly at the back of his house. Normally the lights in Ramavtar's house used to be off, but last night, when he went to urinate for the second time, he found that the lights were on. He was quite drowsy initially, but he noticed that the lights were flickering. It appeared that someone was moving about with a torch. It was a strange sight, but he did not give it much importance, as no sound was coming from there. He thought that their electricity may have failed and they were looking for something, probably a candle. The police asked him for more information, but he could not reveal more. Finally they came to me for help. I saw the scene of the crime and listened to Satbir's versions. The police inspector was standing besides me when I was interrogating him. The police inspector again asked him if he could remember the time when he saw those flickering lights. Clearly if he could remember the time, the police would know the exact time of murder, down to the last minute. But Satbir had not looked at the clock and try hard as he would, he could not remember the time. It could have been 1 am, 2 am or even 5.15 am. He just did not know the time. The already faint clue was becoming fainter. I looked at my watch. It was 8.15 am now. Tired of interrogation, Satbir asked to be permitted to go to the urinals. I asked him if he had gone to the urinals again after seeing those lights. He answered in the negative. I produced a flask from my bag and asked him to urinate in that. The police officer was surprised at this strange request, but I told him that everything could become clear soon. When Shamsher and Kishore were rounded up for investigation, they came up with an iron-strong alibi. They were in Chandigarh the previous night and had landed in Delhi only at 3.00 am, on January 14. They had bus tickets to prove this. When the driver and conductor of the bus were contacted, they affirmed that Shamsher and Kishore had indeed traveled on that bus that night. With the time of murder not yet fully solved, it seemed difficult to implicate them for murder, although the police had a strong hunch that Shamsher and Kishore were the ones who had murdered them out of revenge. The police inspector came to me and asked if I could say anything about the time of murder. On hearing the latest developments, I realized that in the light of fresh revelations, the calculation of the time of murder had become vital now. I brought out the flask of urine, measured the volume of urine and told him that Ramavtar and Neetu had been murdered at 4.35 am on January 14. This took the police officer by surprise. Indeed if my calculation was correct, he could implicate Shamsher and Kishore in the murder, because by that time they were already in Delhi. In fact, if the time of murder was found to be earlier than 3.00 am (the time when Shamsher and Kishore landed in Delhi), his task would have become a lot more difficult. He asked me how I had calculated the time of death of Ramavtar and Neetu, from Satbir's urine. In fact, initially he thought that I was joking. But like a good old medical detective, I wanted to keep my secrets. I told him that I would reveal my calculations in the court only. The court duly acknowledged my scientific evidence and both Shamsher and Kishore were sent to jail for life. Now, let me share this secret with the readers. All medical people know that our kidneys produce 1 ml of urine in 1 minute. Thus, in a day we produce about 1440 ml of urine. When the bladder accumulates about 300-400 ml of urine, we feel an urge to go to the urinals. When Satbir got up in the night to urinate, he emptied his bladder completely. We can be sure of that. Now what is important is that his kidneys started pouring exactly 1 ml of urine per minute into his urinary bladder. When at 8.15 am, I took his urine in my flask, its volume was 220 ml. It meant that Satbir had emptied his bladder 220 minutes earlier, i.e. 3 hours and 40 minutes earlier. When this time was subtracted from the time the urine sample was taken (which was 8.15 am), I got the required time, which was 4.35 am. This meant that Satbir must have got up at 4.35 am (for the second time) to urinate and it was at that time when he saw strange lights in Ramavtar's house. Here Satbir's kidneys worked as effective clocks for me. The human body works in a rhythmic fashion and if we know how to make use of this rhythm, we can unravel seemingly unsolvable mysteries.

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

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Reviewers' Board: Best Toxicology Books A journal affiliated to Anil Aggrawal's Forensic Toxicology Page V.V.Pillay, MD, DCL Professor, Dept. of Forensic Medicine & Toxicology Chief, Poison Control & DNA Typing Units, Amrita Institute of Medical Sciences & Research, Cochin 682026 South India E-mail: toxicology@medical.amrita.edu Professor V.V.Pillay has been in the vanguard of the movement among medical professionals in India to develop the neglected field of Toxicology. He has published extensively in both the scientific and lay press on matters relating to Toxicology, as well as his chosen discipline - Forensic Medicine. Dr.Pillay has authored 5 books on Forensic Medicine and Toxicology, and has received an award for one of them (Modern Medical Toxicology), generally considered to be a trend setter among books on the subject in India. He has reviewed several books on Toxicology for the Internet Journal of Forensic Medicine and Toxicology. Dr.Pillay received a scroll of honour in appreciation of work done in the field of Toxicology from the Medicolegal Society, All India Institute of Medical Sciences, New Delhi. He is instrumental in establishing a state-of-the-art Poison Control Center at the institute where he is currently employed, which is among the few such Centers in India recognized by the World Health Organization. Among his most sought-after publications is a 700 page reference work on Toxicology. Dr. Pillay has recently started a professional organization exclusively dedicated to toxicology - The Indian Society of Toxicology, which has drawn membership of professionals and researchers from all over the country and abroad. The Society brings out a peer reviewed journal biannually (Journal of Indian Society of Toxicology). Professor Pillay is also an Executive Editor in Anil Aggrawal's Internet Journal of Book Reviews.

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

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE SEPTEMBER 2000 ISSUE THE POISON SLEUTHS DEATH BY BOTULINUM TOXIN -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 Badal and he died in the hospital today morning, i.e. on 16th September at about 9 am. The doctors could not find out the cause of his death. He is only 25 years old, and everybody is concerned why he died. That is why the police has brought his body to me. My job of course is to find out how he died.” “Please explain the circumstances of his death doctor.” “Badal and Shatru were friends and they both loved a 21 year old girl Sudha. Both wanted to marry her, but Shatru could go to any length to get her. It so happened that Sudha showed more interest in Badal. Many times Shatru had asked Badal to get out of his way, otherwise the consequences would not be good for him. But Badal ignored his threats taking them to be just friendly pranks. On the outside both of them remained as friends, although it appeared to many that Shatru held a grudge against Badal. Badal was working as a clerk in a local private company and was living alone on a rented flat. On 12th September Shatru came to his flat in the evening with a bottle of whiskey apparently to celebrate his birthday. They both had whiskey together, and had dinner together. On 13th Badal was fine. On 14th morning, Badal started having some strange symptoms. First he had nausea, vomiting, diarrhea, abdominal distension and abdominal pain. He thought he was having an ordinary bout of diarrhea and contacted a local doctor for this. He too thought that he was having an attack of gastroenteritis, and prescribed some standard medicines. But they could not prove beneficial. On 15th morning, Badal developed double vision, technically known as diplopia, difficulty in speaking (dysarthria and dysphonia) and difficulty in swallowing (dysphagia). He became alarmed, informed one of his neighbors who immediately took him to a nearby hospital, where the doctors started investigating his illness. At the hospital, he reported some additional symptoms. He had dizziness, very dry and sore throat, blurred vision and drooping of eyelids. But the most alarming symptom of all was a paralysis of the muscles of his face and neck, which gradually moved downwards. That means that after the development of paralysis of muscles of his face and neck, first his arm muscles became paralysed, and then his leg muscles. Quite remarkably there was no fever. I have talked to the doctors who were treating him, and I have been told that his pupils were dilated. The doctors tried their level best to save him, but he died today morning, i.e. after about 48 hours of having those strange symptoms. On hearing his death, Badal’s family members have arrived here from the capital. They are blaming Shatru for his death. They think that when Shatru came to Badal’s house on 12th, he probably gave him some poison mixed in whiskey. They say that Shatru could do anything to get him out of his way. They are obviously very well connected. There was tremendous pressure on police to catch Shatru, and they have caught him today. But Shatru says he is innocent, and that he has done nothing.” “Doesn’t look like Shatru killed him. After all, Badal started having those symptoms almost 36 hours after he had that meal with Shatru. I have been discussing poisons with you for quite some time now. I don’t know of any poison which starts its action so late after being administered. To me it looks like he had a terrible disease. What disease did he die of doctor? Tell me.” “Tarun, I can say anything definitely only after a thorough post-mortem examination, but from the symptoms which have been told to me by the police and by the treating doctors at the hospital, I am of the opinion that Badal died of Botulism.” “Botulism? As far as I know this is a disease connected with food poisoning. Then why have the police apprehended Shatru? They must immediately release him.” “Tarun, I have asked them to continue keeping him in custody. I learnt that Shatru had studied microbiology at M.Sc. level. So I don’t want to take chances. I want to exclude everything, before I can say anything with confidence. In one of my earlier discussions with you (See Science Reporter May 1998 issue), I told you that the symptoms of botulism may resemble that of barium poisoning . In fact, so similar may be the symptoms that according to most doctors, barium poisoning should always be considered as a possible diagnosis in all cases of food poisoning accompanied by neurological complications. So the first thing I did was to exclude barium poisoning in this case, by checking for barium levels in various organs of Badal. And I could safely exclude barium poisoning, as I did not find any barium there.” “But if it is not barium, how can it be botulism? I mean how could Shatru give him Botulism even if he wanted to?” “Tarun, do you know that Botulin toxin is now used as a medicine too? And that medicine is available in vials. A certain number of vials, if mixed in one’s food, can definitely kill a person.” “A toxin being used as a medicine? Never heard of that. Looks like we are on to one more of your fantastic poison stories. Well, why don’t we begin from the beginning?” “Tarun, Botulism is a disease caused by the gram positive bacterium Clostridium botulinum. Before proceeding further I may tell you that the term gram positive refers to certain bacteria which take up a violet stain when stained with a special staining technique called gram staining. Gram staining was developed in 1884 by a Danish physician Hans Christian Joachim Gram (1853-1938). Bacteria which take up a pink color by this staining method are referred to as gram negative bacteria. So much so about gram staining and its nomenclature. So I was telling you about the Clostridium botulinum bacterium. I may tell you that its name comes from Latin botulus, meaning sausage. Indeed consumption of contaminated sausage was one of the major causes of this condition, when it was first recognized. It can however be caused by contamination of any type of foodstuff - vegetarian and non vegetarian. This bacterium is present in soil and infected water. Improper canning of foods at home may cause some contamination of food with soil or infected water during the process of canning. When canning is complete, the contents inside are devoid of air, a condition which is very much loved by these bacteria. In fact in technical terms Clostridium botulinum is known as a strict anaerobe, which means that a lack of oxygen is necessary for its growth; it gets killed in the presence of oxygen. This might appear paradoxical to you, since we are so used to talking about organisms which need oxygen for growth, but this is a fact. In an environment, which lacks oxygen, i.e. the closed can, these organism keep on multiplying. They produce a toxin known as botulin, which is supposed to be the most toxic substance found in nature. When someone consumes this food, he unwittingly consumes the toxin, and immediately becomes sick. He is said to be suffering from botulism. And he depicts almost the same symptoms, which were shown by Badal before his death. To summarize, we can say that Botulism is caused when food contaminated with Clostridium botulinum is canned or otherwise stored for long periods in anaerobic conditions.” “Doctor, many bacteria have different strains. Are there different strains of these bacteria too?” “Yes, there are eight different types of botulinum toxins have been described, and all of them are released by different strains of bacteria. They are all Clostridium botulinum, but differ in very subtle ways, so they are known as different strains of Clostridium botulinum. These different toxins are designated as A, B, C1, C2, D, E, F, and G. All are neurotoxins (poisons affecting the nerves), except for C2, which is a cytotoxin (poison having a direct effect on cells). Its significance is not clear. All these toxins are proteinaceous in nature, and thus antibodies against them may be prepared. However antibodies against any one of these toxins is effective only against that particular toxin and not against any other. Human poisoning mostly occurs due to A, B, and E. Type E poisoning is frequently associated with fish products. Rarely F and G can also cause human poisoning. C1, C2, and D cause poisoning in some mammals and birds. The toxin is not destroyed by acid or proteolytic (protein splitting) enzymes, but is heat labile and is destroyed when heated to 800C for 30 minutes, or 1000C for 10 minutes as during routine home cooking. It is thus a good practice to heat the canned food properly before cooking. Botulinum Toxin A (also known as BTX-A) has been isolated as a pure crystalline protein and is the most potent toxin known to man. You may be surprised at the fatal dose of this toxin. It is just 1 pg (10-12 g)/kg of body weight. This means that just about 10-10 g of toxin is required to kill a 100 Kg man! Even lesser doses would be required for ordinary human beings weighing 60-70 kg. Another figure may give you some idea of its lethality. One g of BTX-A toxin would kill 30,000 million mice! About 3 million molecules injected in the abdomen of a mouse would kill it. That would sound like lot of molecules, but the very fact that its lethal dose can be described in terms of molecules rather than in milligrams or grams speaks volumes about its lethality! So less is the fatal dose of BTX-A that it is often measured in a special unit called a mouse unit. It is a very small quantity. One Mouse Unit of BTX-A is equal to just 3 x 107 molecules. Again because of its such high lethality, many nations have seriously thought about using it as a biological weapon. As a biowarfare or terrorist agent, exposure is likely to occur following inhalation of aerosolized toxin or ingestion of food contaminated with the preformed toxin or microbial spores. Recently, Iraq admitted to active research on the offensive use of botulinum toxins and that they weaponized and deployed over 100 munitions with botulinum toxin in 1995.” “Oh, that is really interesting. Doctor, does this bacterium forms spores too?” “Oh, yes. The bacteria does form spores, when it finds that the conditions have become difficult for it to live. These spores (in contrast to toxin) are highly heat resistant, requiring exposure to moist heat at 1200C for 30 minutes for inactivation, as in steam sterilizers or pressure cookers. The spores are ubiquitous. They are present in soil, sea water and even air. Earlier I was telling about the fatal dose of BTX-A. I must tell you that its fatal period is just about 24 hours. I may also tell you that the toxins formed by Clostridium botulinum are known as exotoxins. Very broadly speaking exotoxins are those toxins which are produced by bacteria while they are still alive. On the contrary, there are certain other bacteria which release toxins when they get killed. Their cell walls rupture and the toxins are released. Those toxins are known as endotoxins. Thus the correct term for Botulinum toxin type A is BTX-A exotoxin.” “That is a lot of information doctor. You told that these bacteria make toxins while remaining in the can. Then the food inside must get spoiled too. Then why at all does someone consume such food?” “Unfortunately that is not the case. The food may or may not appear spoiled, depending on what strain of bacteria attacked it. If it released proteolytic enzymes, (the enzymes which break down proteins) along with the toxin, the food would spoil, otherwise not. Food contaminated by type A and B bacteria often appear putrefied, because they release proteolytic enzymes too. In contrast food infected with type E bacteria may look and taste normal, as they do not produce proteolytic enzymes. There are however ways to prevent botulism. First of all, if you are buying cans of food from a supermarket, never buy cans which are leaking, spouting, dented or otherwise show any other sign of abnormality. This is because the bacteria may release gases during their activity. And this build up of gas pressure inside the can may cause all these effects. Secondly all canned items should be cooked thoroughly by boiling and stirring for 15 minutes. This destroys any toxin if it is present. Commercial canners usually heat food to at least 1200C to guarantee the destruction of both toxins and spores. If you don’t want to use the food cans immediately, the cans should be frozen or refrigerated at very low temperatures. This is because some strains, especially type E, can produce toxin at temperatures as low as 50C. So a temperature lower than this must be achieved. There are some precautions suggested for those who do canning of food at home. One is the use of phosphoric and citric acids during canning. This is because the optimum pH for the growth of these bacteria is between 4.6 to 7.0. pH above and below this range are not conducive to their growth. Acid environment obviously is not conducive to their growth, and the use of phosphoric and citric acids provide a sound acidic environment. This is also the reason why acidic fruits may generally be safely canned. Many other facts seem to prove that an acidic environment prevents the growth of C. botulinum. Infants below the age of one year seem to become victims of infant botulism for the reason that their gastro-intestinal tract (GIT) is deficient in bile acids and gastric acid, which normally prevent the growth of C. botulinum. For preventing botulism, it has also been suggested that if you are canning meat at home, it should be cured with sodium nitrite (3.5% to 6%). This is said to prevent botulism, as sodium nitrite has an antimicrobial, especially antibotulinal activity. There is however a controversy that when such cured meats are fried, the nitrites may get converted to nitrosamines, a known carcinogen. But this is a different controversy and we would not concentrate it here now.” “Doctor, how does Botulinum A Exotoxin work? “BTX-A is an enzyme. It produces its effects by preventing release of acetylcholine (ACh) from the nerve endings. This chemical is very necessary for the transmission of impulses across nerves. Thus in a way the connections between nerves become ‘dead’, and the activities of the whole organism come to a stand still. Do you remember how Badal had a paralysis of his arms and legs? This is typical of botulism. Actually it was this symptom, which partly alerted me and made me think in this direction. I may tell you that the symptoms of food borne botulism start within about 18-36 hours of ingestion of contaminated food. After having food with Shatru, Badal also developed his symptoms roughly in the same time period. This period has often been referred to as the incubation period, but it is a actually a misnomer. The illness may be very mild for which no medical advice may be sought, or it may be so fulminant as to cause death within 24 hours. Badal died within three and a half days.” “Doctor, you have just mentioned a term “food borne botulism”. Does this mean there are other forms of botulism too?” “Oh yes. In fact the Center for Disease Control in Atlanta, USA (often referred to as CDC) currently classifies four different types of botulism. The first is the food borne botulism, which occurs from ingestion of preformed toxins. This is the best known form, and I have been talking about this form till now. The second form is infant botulism, which occurs mostly in infants below 6 months of age (90% cases). Rest of the cases occur between the ages of 6 months to 1 year. It occurs not from the ingestion of preformed toxins, but from ingestion of spores, which germinate in the mildly alkaline environment of the intestines, and produce toxin in-vivo, which gets absorbed. In adults the bile acids and the gastric acid tend to restrict the growth of C. botulinum. But the gastrointestinal tract of infants lacks these acids, and this factor may be responsible for their growth. Since the toxin is formed within the intestine and is absorbed gradually, the symptoms and signs are less dramatic, compared to adult type food-borne botulism, where preformed toxin is ingested all at once. The first signs to toxicity in infant botulism are constipation, feeding difficulty, feeble crying, and a “floppy” baby with diffuse decreased muscle tone, particularly apparent in the limbs and neck. Infant botulism is the most common form of botulism. Certain infants are more susceptible to infant botulism, while others seem resistant. The reason for this strange phenomenon is not clear. It is believed that giving of honey to infants may be a source of infection, as it contains spores of C. botulinum. Giving of honey to young infants is thus not advised now. The third form is Wound botulism, which occurs due to contamination of wounds with spores of C. botulinum. This usually occurs when they get soiled with dirt and nothing is done about it. The condition is also seen in chronic drug abusers and after caesarian delivery. This entity was first noted in California in 1976. This has now become the most common form of botulism. The symptoms and signs are quite similar to those seen in food borne botulism, except for the fact that gastric symptoms like nausea and vomiting are absent in wound botulism. Finally there is the Indeterminate type, which occurs in patients over 1 year of age with no recognized source for disease. Some authorities suggest that a mechanism similar to infant botulism may be at work here. Their studies suggest that the adults may ingest spores of C. botulinum, which may germinate in the gut, much like they do in infants. Several factors such as achlorhydria in these people, i.e. lack of acid in the stomach may be responsible for their germination. You may recall that I told you strongly acidic environments restrict the growth of this bacteria.” “Yes, I do. Doctor, in the beginning you told that this toxin is also used as a medicine. How can this toxin - which you say is the most dangerous toxin in the world - be used as a medicine? To me this sounds like a paradox.” “Tarun, now it is known that wrinkles in old people are caused by sustained contraction of facial muscles. If somehow these muscles could be paralysed, these wrinkles would go away too. BTX-A does this remarkably well. This toxin in nanogram doses is used for removal of wrinkles. Injection of BTX-A directly in these muscles causes their paralysis, which are then allowed to weaken by atrophy over a 3-week period. Similarly the toxin has been used in the treatment of certain eye disorders such as blepharospasm (abnormal contraction of eye lids) and in squint surgery. Commercially BTX-A is available under two different trade names - BOTOX and Dysport (produced by Speywood, Maidenhead, United Kingdom). BOTOX is prepared by a multiple precipitation technique, whereas Dysport is produced by column-based methods. These are technical terms and you need not bother about them. Suffice it to say, that this difference in production methods produces a differential between the effects on humans and mice. In particular, the dose (in mouse units) of Dysport required to produce a given effect is 3 to 4 times greater than the dose of BOTOX. Now I will come to the most important point. Work in primates, in conjunction with estimates derived from accidental botulism, suggests a human fatal dose of approximately 40 U/Kg if the toxin is delivered systemically. The BOTOX vial contains 100 units; the Dysport vial, 500 units. Thus a few vials if mixed in someone’s whiskey would be enough to kill him. This is actually what Shatru had done. I suspected him the moment I came to know that he was a brilliant student of microbiology and also when I heard the typical symptoms of Badal. I have chemically examined the blood of Badal and it shows BTX-A. I did not stop at that. I also did bioassays which proved that the blood of Badal contained something which paralyses muscles.” “What is a bioassay doctor? “Bioassay is a term which refers to determining a chemical by biological means. I prepared an extract from Badal’s serum, and injected it in mice. By doing this, I could produce paralysis in mice, which was a positive indication that some abnormal substance was there in Badal’s blood. I have lab reports to show to the court that this abnormal substance was in fact BTX-A. Now I will tell you one more secret. I sent policemen to Shatru’s house and they have recovered some empty BOTOX vials from his house. These vials had no business being present in his house, which tells us that he is the one who mixed those vials surreptitiously in Badal’s whiskey. Come let us tell the police to put him under more sustained questioning, and he would surely spill the beans.” “That is very clever of you doctor. Without your clever deduction it would have been impossible to say how Badal died and Shatru 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 - Lithium.”

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE APRIL 1998 ISSUE THE POISON SLEUTHS DEATH BY IODINE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of an old man. He has some brownish-yellow stains too around his mouth. What happened to him? Please tell me." "Good morning Tarun. The name of this 57 year old man is Ramlal. He was living alone in this house. He had no children, and his wife expired some time back. From all the accounts of neighbors, it appears he was having some depression. There were other reasons for depression too. He was a gambler and had taken a lot of money as loan from his friends. Some of them were pressing him to return his amount, and some were even threatening him with dire consequences, if he did not return the amount soon. The main among these was a person known as Mahto. He was seen entering Ramlal's house yesterday evening. Nobody knows what happened after that. Today morning when the maid came to Ramlal's house and knocked at his door, nobody opened the door. She got suspicious and called the neighbors. The neighbors broke the door open and found Ramlal dead." "Oh, I see. So definitely Mahto must have killed Ramlal." "Don't jump to conclusions Tarun. How do you know he didn't die a natural death?" "Well.....I thought that was the most natural conclusion to make. But come to think of it, Ramlal could well have died a natural death too." "But surely he didn't die a natural death. The reason is that a bottle was found in the room containing some dark liquid. The bottle was marked "poison" and it was half empty. As you can see Ramlal's face, the angles of his mouth are stained. It does appear he had taken this liquid." "Oh, yes, now I see. The area around his mouth is stained brownish yellow. So do you think Mahto gave him this poison?" "Well, this is what police is thinking. They have come to a startling conclusion. According to them, Mahto went to Ramlal's house to ask for money, but when Ramlal couldn't give him the money, Mahto wanted to get even with him, and gave him this poison. They have called Mahto, but he is denying this allegation completely. He says, that he did go to Ramlal's house and demanded his money, but when Ramlal expressed his inability to pay up, he left after giving him another warning." "It is quite possible that the police would torture Mahto to arrive at the truth." "Well, the possibility can not be ruled out. But I have examined Ramlal's dead body, and it appears to me Mahto is indeed innocent." "Oh, my God. How can you say about Mahto's innocence by just looking at Ramlal's dead body?" "Tarun. I have examined the contents of the empty bottle. It containes a strong tincture of iodine. It is the medicine which one applies to abrasions and wounds. It is used as an antiseptic. Iodine has a strong odor and a very bad taste. This poison can not be given to anyone as a poison...." "Do you think Ramlal never ingested the contents of the bottle, and died by some other means?" "No, Tarun, Ramlal did ingest the contents of the bottle. In fact, I have found signs on his dead body, which point to death by iodine. Not only this I have recovered some iodine from his stomach too. But the iodine was not given to him with homicidal intention. He ingested it himself with suicidal intentions. He probably did it so, because he was very depressed. He was not able to pay up his debts. Yesterday night Mahto visited him and demanded his money again. It dawned upon Ramlal, that he would not be able to stall his creditors for long, so after Mahto left, he consumed iodine to kill himself." "So iodine is such a strong poison, that it can kill? Well, can you tell me a little bit about iodine, so that I understand better how you detected iodine in his body?" "Tarun, Iodine was discovered by the French Chemist Bernard Courtois (1777-1838) in 1811. It might interest you to know that he was not interested in discovering a new element at all. He was actually in the buisiness of manufacturing potassium nitrate which was needed for making gunpowder. He used to get potassium nitrate from potassium carbonate (potash), which in turn he got from seaweed. As one of the steps to get the potassium carbonate, he had to heat the seaweed in acid. One day in 1811, he added too much acid and, on heating, obtained a beautiful violet vapor. On condensing the vapor, he produced dark lustrous crystals. This was in fact iodine. Courtois had in fact unwittingly discovered a new element! The element was given its name 3 years later by Sir Humphry Davy from the Greek iodes (like the violet). The name clearly refers to its unique color. It was originally prepared from the ashes of kelp and other seaweeds, just as Courtois had done. However at the present time, the major sources of iodine are natural and oil field brines, from which they are separated by a special process known as ion exchange chromatography. Kelps are very rich in iodine. I may tell you that although iodine in large amounts is poisonous to our body, it does need iodine in very small quantities. It is needed by the thyroid gland to make the hormone thyroxine. If someone's diet is deficient in iodine, his thyroid gland may enlarge. This disease is known as goitre. Kelps are so rich in iodine, that people who consume kelps don't suffer from goitre at all." "Oh, I see. How much iodine is required by our body daily?" "Tarun, the daily requirement of iodine is about 150 micrograms/day in adults, of which the thyroid gland takes up about 70 micrograms. Rest of the iodine is used for some other essential purposes. Some commercial preparations containing iodine are povidone-iodine and tincture of iodine. These are basically used as antiseptics and disinfectants. Ramlal probably kept the tincture of iodine in his general medical chest, as most of us do. Povidone-iodine is primarily used as a vaginal disinfectant. Tincture of iodine is usually applied on cuts and abrasions, to prevent them from getting infected. Tincture of iodine consists of 2% iodine, 2.4% sodium iodide, 47% ethyl alcohol and rest is water. Then there is the strong iodine tincture, which was found in Ramlal's house. It consists of 7% iodine, 5% potassium iodide, 83% ethyl alcohol, and water. It might interest you to know that the word tincture comes from the Latin tinctura (dyeing), which in turn comes from tingere (to dye). This Latin word also gives us the common English word tint. It is interesting that the word tincture is applied only to alcoholic solutions. Medicine and dyeing may appear to have no connection at all, but in fact there is an interesting link. In pharmacy alcoholic solutions are commonly called tinctures because many dyes will dissolve in alcohol but not in water. Tincture of iodine is reddish brown in color. In addition to tincture iodine, another preparation, Lugol's iodine is also available which consists of 5% iodine and 10% potassium iodide and the rest is water." "Oh, the information is interesting indeed. Can you tell me what symptoms does one experience if he is given iodine?" "I would like to tell you, it is not easy for someone to give iodine to others for homicidal purposes, because it has a characteristic color, odor and taste. Iodine vapors too have a characteristic odor and taste and are intensely irritating to the eyes, mucous membranes, and skin. In several countries, such as the US, the maximum allowable concentration is 0.1 ppm (1 mg/m3). Ppm, as you know stands for Parts Per Million. Even at this concentration, i.e. 0.1 ppm, some people may experience eye irritation. Higher concentrations may lead to excessive tearing, tightness in the chest, sore throat, headaches, irritation of the respiratory tract, and water-logging in the lungs, similar to that seen with chlorine gas exposure. Iodine is a powerful irritant and vesicant, which means it can cause skin eruptions. Symptoms may occur through inhalation, skin or eye contact, or ingestion. Iodine vapor may cause brown staining of the cornea. A 7% solution of iodine, which as you know now is the strong iodine tincture, is corrosive to the eye and the skin. Owing to its strong oxidizing action, iodine acts as an acid corrosive, precipitating cell proteins. Symptoms of iodine ingestion include unpleasant metallic taste, brownish-colored vomit, diarrhea, weak pulse, and retention of urine. There may be corrosion of skin and and mucus membrane with brownish yellow stains. Finally there may be delirium, stupor, and collapse. Changes in the body involve staining of the walls of food pipe and of stomach walls and rapid development of pneumonia-like symptoms." "Doctor, how much iodine is sufficient to kill a person?" "Tarun, about 3-4 g of elemental iodine or 30-250 mL of strong ticture can kill a person. Death usually occurs in the first 48 hours. However death can occur as early as about ½ hour after ingestion to as late as 52 days." "Oh, I see. Well, in the current case how can you prove to the court that Ramlal did die of iodine poisoning?" "As I told you, I found Iodine in his stomach. Iodine can be detected in stomach by some deceptively simple tests. If the stomach contents contains iodine, it may be made to sublime, by taking the stomach contents in a beaker and warming it gently. The purplish iodine vapours may be made to condense on a watch glass placed on the top of the beaker. Another test involves adding 1 ml of starch solution to 10 ml of stomach contents. A blue-black colour will develop immediately due to the formation of starch iodide. If death has occurred after 2-3 hours, some iodine may have reached urine too. To detect iodine in the urine, we add 5 ml of chloroform and a few drops of nitric acid to 10 ml of urine and allow to stand for 3 minutes. A pinkish violet chloroform layer forms, which confirms the presence of iodine in the urine. I have done all these three tests on Ramlal's body and have found iodine in stomach contents as well as in the urine." "You said you found some signs on Ramlal's body also which pointed towards iodine poisoning. What are those signs?" "Tarun, the main sign is the brownish or yellowish stains of skin, which you can see on Ramlal's body. Furthermore all internal organs such as liver and spleen are found engorged with blood. Sometimes there is a characteristic odor too from the body, but this is very rarely perceptible. Now since we have proved that this is a case of death due to iodine, we can easily prove that Mahto couldn't have given this solution to Ramlal. Come, let us tell the police about it, so they can release Mahto." "Oh, how very clever of you doctor. This was a most interesting discussion. It is doubtful if Mahto could have been proved innocent without your excellent detective work. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- Barium "

SCIENCE IN CRIME DETECTION-14 CONTUSIONS - THE VITAL EVIDENCE A remarkable case came to me in the summer of 1992. Bali Ram, a nine‑year‑old stepchild of Hari Ram and Bhairon Devi had fallen down the stairs and had fallen down the stairs and had died. Actually, when he fell down the stairs, there was a big hue and cry in the neighborhood. Some neighbors came to the spot immediately and brought the child to LNJP casualty. The child was declared dead on arrival and sent to me for post mortem examination. A few facts about the family may be said her, before we go on further. HariRam had lost his first wife Kasturi about 5 years back. She had died of tuberculosis. Bali Ram was Kasturi's son. After Kasturi's death, Hari Ram became a recluse for almost two years, but gradually the shock of his wife's death faded and Hari Ram married for the second time. From the beginning, it was apparent that Bhairon Devi, the new bride hated Bali Ram intensely. In the beginning, she would merely ignore him but gradually she started handing him more severe punishment. She would often beat him and deny him food. I got this history from the neighbor. The moment I got this history, I became very cautious and decided to look for clues that might give me the correct story. The boy had died from head injury which he had sustained during the fall from stairs. There were several fractures on his skull, and the brain inside showed blood clots. This was ample proof that he had indeed fallen down the stairs. However, the clues that could give me some 'behind‑the scene' story still eluded me. Finally I turned over the body and looked for injuries more closely. There were several contusions on the back. these are also known as bruises. In common parlance, in Hindi, we know these as " Neel ". These are commonly caused by blunt force application. I had looked at these contusions before starting the post‑mortem, but at that time I thought that they were produced by fall from stairs. Contusions can indeed be produced by a fall from the stairs. However, when I looked at them closely, I found them to have some pattern. These contusions are known as patterned contusions and are quite helpful in the forensic work. They tell us the shape of the object which was used to hit the deceased. If the hitting object was a lathi or an iron rod, the contusions would be linear in shape. If a hockey stick was used to beat the deceased, the contusions would take the shape of hockey stick and so on. Look at the figure A and you would realize that the contusions indeed have a pattern. I tried to decipher what the object could be, but the exact object eluded me. Then suddenly, like a flash of lightning, the object came to my mind. It had to be a coat‑hanger. The contusions looked exactly like that. I told this fact to the police officer Tejpal. I thought that Bali Ram was first mercilessly beaten by Bhairon Devi and then pushed down from the stairs. If this point of view could be proved, it would change the whole scenario from an accident to murder! The case was beginning to take a serious turn. Bhairon Devi was summoned by Tejpal, the investigating officer, and questioned. She reaffirmed that Bali Ram had indeed fallen down the stairs and she hadn't beaten him. She asserted that she loved Bali Ram like her own child. How ever her neighbors refused to confirm her assertion that she loved Bali Ram like her own child. They asserted that she often beat Bali Ram. Finally Tejpal decided to search her house. The specific thing he was looking for, was the hanger with which Baliram was supposed to have been beaten. Finally he indeed found the hanger and brought it to me. When I matched the shape of the hanger with that of the contusions, the shapes corresponded completely. (See figure B). This testified that the boy was indeed beaten. This evidence broke Bhairon Devi and she confessed the whole crime. She was duly prosecuted by the court on my evidence and sentenced to life imprisonment. This case amply illustrates, how a seemingly trivial clue can turn a case entirely.