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

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

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

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

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

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Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE FEBRUARY 1997 ISSUE THE POISON SLEUTHS ARSENIC - THE KING OF POISONS -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing with this dead body? He seems to have a terrible rash all over his body. Would you explain me what he died of?" "Good morning Tarun. This man is Radheyshyam who is a 56 year old man. His first wife died about 5 years back, and soon after he married again. He was complaining of loose motions and vomiting off an on for the last two years. The doctors suspected he was suffering from gastroenteritis, which as you know is an inflammation of the stomach and intestines. But what they could not find out was the cause of this inflammation. Consequently he was being given only the symptomatic treatment. Finally he succumbed yesterday to his illness." "Then why is he here? Why haven't his relatives taken him for cremation. You are a forensic pathologist, and if I understand it correctly, you only look after cases with legal implications. What possible legal implication could be involved in this case." "Y ou are right Tarun. I deal only with legal cases. But yesterday, the brother of this person, Harishyam has alleged that his brother's relations with his new wife Shanti were not good. He suspects some foul play in his death. Many times he saw her mixing some whitish powder in his food. When he enquired, she would say it was some medicine she had brought from the local doctor for his illness. Immediately after his brother's death he reported the matter to the police. In response to his complaint, the police has registered a case against Shanti, and has submitted the body to me for post-mortem. Now my job is to find out if he really died of gastroenteritis." "Doctor, it seems very confusing. Just now you said that he did die of gastroenteritis. His symptoms were that of gastroenteritis, and he was getting treatment for it. Then what else could he die of?" "On the face of it, it does appear that he died of gastroenteritis, but there could be foul play as well. You yourself remarked over the rash he has all over the body. Well, in gastroenteritis one does not get rash over the body." "Then he might be having some concomitant skin disease, isn't it?" "Could be. But a more likely explanation could be arsenic poisoning, especially as Harishyam repeatedly saw Shanti mixing some white powder in his brother's food." "You mean Shanti was giving him arsenic, because of which he developed gastro-enteritis like symptoms and also the rash?" "Yes, that's what I mean Tarun. But I must tell you that pure metallic arsenic is seldom poisonous. It is its white colored salt Arsenious oxide, known in the vernacular as Sankhya or Somalkhar which is poisonous. It is this salt which is often loosely referred to as arsenic. When a chemist talks of arsenic, it is the pure arsenic, but when a toxicologist or a pathologist like me talks of arsenic, he is probably referring to arsenious oxide. We sometimes refer to it as white arsenic also, because of its white color" "Arsenic certainly seems an interesting poison. Please tell me more about it doctor." "Tarun, arsenic is a metallic poison known since ancient times. An eighth century Arab alchemist Geber produced arsenious oxide, from realgar, a naturally occurring red colored ore of arsenic found in lead and iron mining, and thus made available to the humanity one of the most cruel, deadly and widely administered poisons. In Imperial Rome a form of arsenic was used as a poison to such an extent, that kings, queens, and other important court officials regularly employed official food-tasters! It has been a favorite with the poisoners because it fulfills many of the criteria of an ideal homicidal poison..." "I beg your pardon? Do you mean to say that there are things like ideal homicidal poisons? What in the world does this term mean? How can anything as sinister as poison be ideal?" "Tarun, there not only are ideal homicidal poisons, but ideal suicidal poisons too. You see, there are several poisons in this world, but not all can be used homicidally or for suicide. Only certain poisons are ideally suited for these purposes. Poisons which suit well for these purposes are known as ideal poisons." "It is still not very clear to me. Would you please explain with some examples?" "Sure. Let us talk about homicidal poisons first. A bitter poison, like strychnine, can obviously not be given with homicidal intent. The victim would immediately spit it out. Thus a homicidal poison must be tasteless. Similarly a poison which is colored can not be given. Copper sulphate is poisonous, but it is blue colored. If a killer mixes it in water or milk, it will render these liquids blue, and the victim would not drink it. Thus a homicidal poison should be colorless too. There are several other criteria which have to be fulfilled as well before a poison qualifies as an ideal homicidal poison. It should be easily available, fatal in only a small quantity and symptoms of both acute and chronic poisoning must mimic natural diseases..." "Why should this be so?" "Because then the public at large would think that the person died of that natural disease whose symptoms the poisoning mimics, and the killer would go scot free. Arsenic qualifies well in all the above criteria. Symptoms due to its poisoning mimic natural diseases. While acute arsenic poisoning resembles gastro-enteritis, chronic arsenic poisoning presents a combined picture of stomach upsets, peripheral neuritis and dermatitis..." "Sorry to interrupt you doctor. You have introduced some new terms which I don't understand. What in the world is meant by acute and chronic arsenic poisoning?" "Tarun when a large dose of a poison is given in one go, killing the victim within minutes, it is called acute poisoning. On the other hand when small doses of a poison are given over a long period of time, typically over years, it is called chronic poisoning. If a wife wants to kill her husband, it would be very easy for her to mix sublethal doses of a poison in his food over a long period of time. By sublethal dose, I mean a quantity of poison which is not enough to kill the victim in one dose. The hapless husband would die in the end after a few years. In this case he would be said to have died of chronic poisoning." "oh, I see. So you were telling me about the criteria of an ideal homicidal poison." "Yes, I was telling you that the effects of arsenic poisoning resemble natural diseases. Its effects are cumulative, so the poisoner does not have to rely on one large, fatal dose; he can give it little and often, thereby weakening his victim by stages before delivering the fatal dose. An ideal homicidal poison should be undetectable in the dead body. About one and a half century back, arsenic fulfilled this criteria as well, but no more now. Before 1836, it was impossible to detect it in the body organs. All these facts made it the poisoner's ideal choice. So commonly and successfully was it used for homicidal poisoning that once it was variously referred to as king of poisons or poison of poisons. Since many people used it to do away with rich old uncles and aunts, it became known in France as poudre de succession, or "inheritance powder". The history of crime is replete with cases of homicidal poisonings by arsenic. Arsenic was ostensibly bought for killing rats, but it was often used for homicidal purposes. Women purchased it to kill rats; the rat in most cases used to be the husband!" "Funny joke! What about ideal suicidal poisons?" "A person who is going to commit suicide with poison, probably wouldn't worry about its color or even taste. He wouldn't be bothered with taking large doses too. He would be more concerned about the pain the poison is likely to produce. He needs a poison which produces minimum discomfort, and produces death or at least sleep within minutes, so his agony is lessened. Sulfuric acid is a deadly poison, but it would kill rather slowly; in about 12-24 hours. Moreover it is a strong corrosive producing severe burning pain in the mouth and throat. A potential suicide may be interested in death, but he probably wants a quieter death. So Sulfuric acid is not an ideal suicidal poison. Barbiturates or sleeping pills on the other hand are ideal suicidal poisons, because they would put a person rapidly to sleep, and then to death. There are no unpleasant symptoms." "Oh I see. While talking about arsenic you mentioned the year 1836. What happened in that year?" "In that year a successful test for arsenic was developed for the first time. It was called the Marsh test and it ultimately brought about its downfall as an extremely successful homicidal poison. One quality of arsenic makes it a very poor candidate as a homicidal poison; it can be detected in the dead body, virtually years after the body has been buried. Thus the poisoner leaves a permanent record of his deed in the dead body... "But how can anyone detect the poison in the body, once it has been buried?" "There are laws in all countries which allow the law enforcement agencies to unearth or exhume the body, if strong suspicion develops against some person later on. There have been cases where the bodies have been exhumed as late as 3-4 years after death, and arsenic has been detected in their bones. An ideal homicidal poison should immediately disintegrate after doing its job. Before 1836, this peculiar property of arsenic did not cause any problems to the poisoners because there was no test for arsenic in the first place. With the development of Marsh test, this property assumed paramount importance and it rapidly fell into disfavor." "So before the development of Marsh test, all the cases of poisoning must be going undetected?" "Yes! Many celebrated cases are on record when the suspected poisoner went Scot Free merely because of the inability of the chemists of those times to detect it in a dead body. In fact tests weren't available for any poison. The only reliable test was to feed the remains of the poison to an animal and see if it died. So desperate was public that Henry Fielding (1707-1754), a celebrated English novelist clamored in despair for some way to make poison visible so that one could hang the poisoner. That was in the year 1740. This was in connection with a case in which a widow was accused by neighbors of having poisoned her husband. But no poison was found in the widow's house, nor could it be proved that she had ever purchased poison. The only thing left, therefore, was to show that the corpse had poison in it. When Fielding appealed to the doctors, they answered that there was no way to do this. The widow had to be acquitted" "And then came the Marsh test"? "Marsh test came much later. Many interesting things happened before that. One of the most celebrated cases of arsenic poisoning occurred in 1752, when a 31-year old spinster Mary Blandy murdered her father with arsenic. Her court appearance was the first trial for murder by poison at which medical evidence was called in regard to the cause of death. Dr. Anthony Addington did not possess the knowledge to analyze the victim's organs for poison, nor was he able to use chemical tests to prove that the powder Mary used was arsenic. Nevertheless, on the basis of simple comparison he convinced the court that the powder was arsenic, and Mary Blandy was convicted and sentenced to death." "How were those comparisons made?" "Mary Blandy mixed white arsenic in gruel and gave it to her father. She wanted to kill him, because he was not agreeing for her marriage with someone she loved. Two days after eating the gruel, Mr. Blandy fell seriously ill. Some of the gruel left over was eaten by the charwoman and she was violently sick too. A maid also ate some of it, and she also fell sick. Because of this peculiar chain of events, they became suspicious and examined the pan used to prepare the gruel and saw a white sediment at the bottom. They locked up the pan and next day handed it over to the doctor." "And he compared that sediment with a known sample of arsenious oxide, and found them to be similar?" "Exactly. In today's parlance they would be called physical tests. He believed the sediment on the pan to be white arsenic because it had a milky whiteness, it was gritty and almost insipid. When put in cold water, part of it swam on the surface, but the greater part sank to the bottom and remained there undissolved. Arsenious oxide behaves in exactly the same way. When thrown on red-hot iron it did not burn, but sublimated, i.e. it rose in thick white fumes. These fumes had the stench of garlic. To be sure he did perform some simple chemical tests but they were also comparative in nature. This means that he conducted some chemical tests both on the sediment and on a known sample of arsenious oxide, and both gave similar looking reactions. The court accepted these tests- the first time any court accepted a scientific evidence in a case of arsenic poisoning- and sentenced Mary Blandy to death." "That certainly is interesting! I mean science ultimately catching up with the poisoners." "Twenty-three years after Mary was hanged, in 1775, a Swedish chemist made an important discovery. Karl Wilhelm Scheele found that he could change arsenious oxide to arsenious acid by treating it with nitric acid. Arsenious acid in turn when treated with zinc produced arsine, a highly poisonous gas. This epoch making work had the germs from which a reasonably good test for arsenic could be developed. This work was actively pursued by scientists in Germany, but the break-through was provided by an English chemist James Marsh. In 1836, he published a method for converting arsenic in body tissues and fluids into arsine gas, which was quite similar to that of Scheele. But the interesting thing was that Marsh was able to convert arsine back to metallic arsenic which could be shown to the court. It is much easier for a non-technical person like a judge to convict a criminal when he can actually be shown the poison which killed the victim." "How did Marsh convert arsine to metallic arsenic?" "As the gas escaped, the gas was ignited, and Marsh held a cold porcelain bowl against the flame. The metallic arsenic precipitated on the porcelain in the form of a black deposit. The process was unbelievably sensitive, making it possible to detect as little as a fiftieth of a milligram of arsenic! The Marsh test revolutionized the investigation of poisoning, and it was quickly taken up by crime scientists." "After the development of the Marsh test it must have become a lot easier for crime scientists to prove the presence of arsenic in a dead body?" "Yes surely. In 1840, the Marsh test was used in the celebrated Lafarge poisoning case. In January of that year Charles Lafarge, a minor French industrialist, died of suspected poisoning at his home in Le Glandier. Arsenious acid was found in his stomach, and it became known that his wife, Marie, had bought arsenic as rat-poison. She was arrested and sent for trial. The application of new scientific methods proved futile at first. When the Marsh Test was applied to corroborate earlier findings of arsenic by traditional methods, the results proved negative. The defence was elated, but the elation was short-lived, as the experts declared that the test worked better on organs other than the stomach. Exhumation of Lafarge's body was carried out for the purpose of retrieving these other organs for testing. Famous French toxicologist Dr. Mathieu Orfila was summoned by the court. He applied the Marsh test correctly and found arsenic in Lafarge's body. This case stirred up so much controversy in France, that the entire country was divided into Pro-Marie and anti-Marie factions. The case ended up in Marie being delivered the sentence of life imprisonment. Marie served 10 years of sentence. She was released by Napoleon III in 1850, and she died the following year still declaring her innocence! "Every killer does assert he is innocent. So arsenic has really been responsible for many killings. Good that the scientists ultimately came up with a good test for arsenic. Tell me doctor, what are your conclusions regarding this man Radheshyam?" "When his body was brought to me, I immediately suspected chronic arsenic poisoning..." "Really? What made you think so?" "The fact that his relations were not good with his wife, and that he was complaining of loose motions and vomiting for the last two years. The doctors were not able to find out a cause for his gastroenteritis. This is a classic picture of chronic arsenic poisoning, when the wife is stealthily mixing it in her husband's food. To top it all, she was often seen mixing some white powder in his food. But what clinched the diagnosis was the examination of his dead body. I am now positive he died of chronic arsenic poisoning." "How did you arrive at this conclusion?" "One of the landmark symptoms of chronic arsenic poisoning are the skin changes. The most important skin changes are, first, pigmentation and second hyperkeratosis, which is nothing but a technical term for thickening of the skin. If arsenic is given continuously for some years, even skin cancer may develop. You yourself remarked on the rash this person has all over his body. This rash is nothing but pigmentation. As you can see, this is finely mottled, brown rash, presenting a picture as if colored rain drops splashed his body. In fact this rash is often called "raindrop rash". This rash resembles measles rash in many ways. You can also see that his palms and soles are thickened. This is the hyperkeratotic change, another classical sign of chronic arsenic poisoning. In fact, even if I hadn't been told anything, just this change would have brought arsenic poisoning to my mind. You can also see that he has an irregular thickening of nails which is another good sign of chronic arsenic poisoning. The final clinching fact was the chemical test. when I applied Marsh test to his internal organs like liver, spleen and kidneys, arsenic was found to be present in abnormally high amounts. It is certain that he died of chronic arsenic poisoning. Let us phone the police and tell them about it." "Yes, certainly we should. Thank you doctor for giving me such interesting information on arsenic. What are you going to tell me the next time?" "Tarun, next time I shall tell you about Spanish Fly, which as you shall see has acquired a very notorious reputation. "

SCIENCE IN CRIME DETECTION-34 DEATH BY COCAINE On 23 December 1992, a very interesting case was brought to me. A 23 year old youth was found dead in a park. The youth was identified as one Geeta who studied in a local college. The police found several wounds on her body (Please reproduce figures XX-16,17,18 on page 543 here). It was suspected that Geeta had been killed by someone. Their main reason for thinking this was the multiplicity of the so-called wounds on her body. When the police made enquiries they found that Geeta belonged to a rich trader family. Her father had a flourishing export business. Geeta used to get a good amount of pocket money. Lately she was demanding her parents to increase her pocket money to Rs 10,000 per month. Previously she was getting only about Rs 5,000. It was found that lately she was going steady with a boy Harish, who also studied in the same college. Geeta was previously in love with another boy Ganesh, who was somewhat of a dada of his college. When Geeta switched favors, Ganesh held Harish responsible for this and told him to keep off his girl friend. He also told Geeta not to meet Harish. But neither Geeta nor Harish paid any attention to him. Once while sitting in canteen Ganesh bragged among his goons that if Geeta did not mend her ways he would finish her off. The police immediately summoned Ganesh and held him responsible for the murder. Ganesh seemed horrified to know that Geeta had actually been killed. He admitted that he did brag about killing her, but actually he had done nothing to her. But the police wouldn't listen to him, and took him to their "torture chamber" to get the truth out of him. It was at this stage that the case was brought to me. When I had a careful look at the body, I found that she had a strange key like thing dangling from her neck, which the police had completely ignored thinking it was an ordinary medallion usually worn by girls (reproduce fig XX-24 on page 551 here). This was not the ordinary medallion. It gave me some inkling as to the cause of her death. Then I looked closely at the hair of her nose, and as I had suspected, I found some white particles sticking there. I plucked some of those hairs with tweezers, and sent them for chemical analysis. I wanted to find out the chemical composition of those particles. Her nasal septum, the cartilage that divides the nose into two nostrils, showed a perforation. I immediately realized how she must have died. I called the investigating officer, and told him that Ganesh hadn't killed Geeta. I told him that I knew how she had died, and asked him not to torture Ganesh any more and release him at once. The police officer looked back at me in surprise and said,"But sir, you have hardly had a look at the body, let alone do an autopsy. How could you say that Ganesh has nothing to do with this death? How can you tell the cause of death in this case?" "Well, experience my boy, experience!", I said in smug confidence, and then wrote out a cause of death, on a rough sheet of paper, and asked him to keep it in his pocket. Of course the subsequent autopsy conducted by me proved that I was right. The cause of death given by me after conducting an autopsy was the same as I had given the police officer on the rough sheet of paper immediately after seeing the body. The readers may be surprised as to what magic I had done to find out the cause of death so quickly. Well, before going any further, let me tell you a little bit about a dangerous narcotic drug cocaine . The youth of today is in the grips of narcotic drugs. Many narcotic drugs are in use, main among them being heroin, LSD, amphetamines, barbiturates, cocaine and several others. Heroin is the narcotic drug of choice today, but now many users are shifting to cocaine, especially in America. Its use in India is also increasing. The use of cocaine has permeated into the powerful and socially prominent circles. It is used by the youth of rich families. Of all the drugs cocaine is considered the largest producer of illicit income in the United States today. Cocaine is a white, crystalline powder derived from the leaves of coca plant (known botanically as Erythroxylon coca ). The coca plant is native to South America, particularly the countries of Peru, Bolivia, Brazil, Chile and Colombia, and must not be confused with the similar‑sounding coca plant from which chocolate is made. The scientific name of the plant is derived from the Greek word erythros meaning `red', and xylon meaning `wood'. The name is based on the flesh‑red colour of the inner layers of the bark. The wood itself is tinged with red or yellow. Although the coca plant is natural to South America, it has been successfully cultivated in Java, West Indies, Australia and India . It's not that cocaine use has become popular in modern times only. It has been in use for a long time. Recent archaeological findings in Ecuador indicate that the use of cocaine dates back to at least 5,000 years. Small bags of coca leaves have been found in the graves of the Incas, mysterious South American people, who lived in the Cuzco Valley of the Andes mountains on the west coast of South America. This area roughly constitutes the modern‑day Peru. Cocaine which is used these days is usually available in adulterated form only. During its "journey" from the clandestine lab where it is prepared to the addict, it is adulterated a number of times, a practice often known as cutting . Every dealer who gets hold of the cocaine powder mixes some adulterant powder in it. The cutting or diluting agents can be any soluble powder that is not disruptive to the body such as baking soda, powdered sugar, powdered milk, starch, etc. Since pure cocaine is also a white crystalline powder, these agents can not easily be detected and serve as good dilutants. Other agents which are usually employed to cut cocaine are lactose, dextrose, Epsom salts (magnesium sulphate), quinine or powdered vitamins. A dangerous narcotic, methamphetamine, known as speed , is also sometimes used. Cocaine use is a very expensive habit and because of the expense, cocaine habit is often referred to as the king's habit . Cocaine has traditionally been popular with pimps, prostitutes, musicians, jet‑setters and the wealthy. It can be taken by the addict in a number of ways, but the most commonly employed method is by inhalation (known as snorting or horning ). In snorting cocaine, the immediate euphoric effect (known as the rush ) takes place within about thirty minutes. The usual time period for euphoric effects are generally in the same range when cocaine is injected directly into a vein. When cocaine is taken by mouth, the effects begin after five minutes and the rush is not as great as when cocaine is injected or snorted . That is why oral intake of cocaine, or cocaine eating , as it is often known, is not a preferred method among the addicts. There is a little compensation however. The euphoric effect after an oral intake lasts about fifteen to thirty minutes longer. The rush is most intense when cocaine is injected. Snorting produces a slightly lesser effect, yet the effect is not so minor as to make injection a preferred method. In snorting cocaine, the user brings the powdered cocaine up to one nostril, holding the other nostril closed and sniff the cocaine into the nose. The user may use any nostril but usually holds the other nostril closed for better suction. The immediate effect of snorting cocaine is a burning or freezing of the nostril area, depending on the purity of the cocaine and the substance the cocaine has been adulterated with . If it has been "cut" with procaine, there will be more of a freezing. The user may snort anywhere from one‑tenth of a gramme to half of a gramme at one time. Sometimes little particles of cocaine can get lodged in hair of the nose, and if they remain there for any length of time, they tend to irritate the membrane and cause sores and bleeding. Because of this irritation, chronic cocaine addicts usually have a perforated nasal septum. This is what I found in Geeta's dead body, and that is why I took no time in concluding that she had died of cocaine poisoning. Geeta was actually a cocaine addict . She had to buy cocaine regularly from the underworld of drug dealers. This was the reason she was pestering her parents for increasing her allowance. Usually for snorting, the users simply put the cocaine powder on a paper or a knife blade, hold it up to the nose, close one nostril and snort. Some users, however, adopt a very elaborate ritual. For instance they use a coke spoon, purchased from head shops (illegal shops selling drugs and drug paraphernalia), which is a highly ornamental tiny spoon, to hold about 50 mg of cocaine powder. The spoon, containing the cocaine, is brought up to the nostril and then the cocaine snorted. One can often identify a cocaine addict by seeing this spoon, which is often attached to a chain and worn round the neck. Some coke spoons have two small bowls so that the cocaine can be snorted into both nostrils at the same time. This was the key like thing which I found around Geeta's body, and which had been ignored by the police as an ordinary medallion. It was actually the spoon used by her for snorting. In fact, this spoon is so characteristic of cocaine users, that just its presence was enough for me to say that Geeta was a cocaine addict. Some addicts inject the cocaine directly into the veins or just beneath the skin. Injecting cocaine beneath the skin is commonly known as skin popping . It can cause ulcers, which often look like maps of various countries. Because of their fancied resemblance to maps, these ulcers are also known as geographical ulcers . I found these ulcers also on Geeta's dead body. Obviously Geeta was not only snorting cocaine, but injecting it too. Because of this practice, there were ulcers all over her body. These were the so-called wounds which the police was suspecting as indicative of homicide. She was probably going to the park to have her regular dose of cocaine. On the day of her death, she went to the park, and chose a lonely corner for her regular dose. First of all she snorted cocaine for some time. This was responsible for the white cocaine particles sticking to her nasal hair. Then she perhaps decided that she should inject cocaine for more intense feeling. During the procedure, she accidentally injected an overdose of cocaine. That is how she had died. It was an accidental death due to overdose of cocaine. No one had murdered her. Chemical analysis of her body organs revealed lethal doses of cocaine. Analysis of the white powder particles sticking to her nasal hair also turned out to be cocaine! When the police told Geeta's already depressed parents that she was a cocaine addict, they couldn't believe their ears. They realized that they should not have been giving such a heavy pocket money to her. Well, this is a warning to all parents to see what their children have been doing with their pocket money. It is not surprising if the large pocket money they are demanding is for the purposes of narcotism only. When the police released Ganesh, he came and fell on my legs. He said that his life had been saved because of me only. The poor boy did not know that it was not me, but forensic science which had saved him. I only used the science! ( To protect the identity of the individuals, their names, as well as the various dates of occurrence have been changed )

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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Tarun and Anil Aggrawal's Forensic Programming Page MASTER INDEX OF LESSONS Hi. It is at this page, where I ultimately intend to put some preliminary lessons in computers, internet and computer languages. The instructions would mainly be meant for forensic professionals, but professionals from other specialties can use the information with almost equal ease. Hopefully, after these basics in computers and programming, forensic professionals would be able to put together their own web pages. They would also be able to produce their own programs to manipulate their data. They would, for instance, be able to write programs, which could tell them in a matter of seconds, how many homicides they dealt with in the previous year, how many of them were, say, gun shots, how many stab wounds and so on. These programs could be very useful in writing statistical papers. To be sure, a number of such "ready made" can be bought from the software market. But if you think like I do, you would prefer to make your own programs. Besides the satisfaction of having been able to write your own programs, it has a more practical value. You could devise a program to "suit" YOUR needs, and not be dependent on some other "ready-made" program written by someone else, who was never aware of your own special needs in the first place. Here are some languages which I intend to put on these pages. But I am afraid, you will have to bear with me for some time. I have about ten other websites to maintain, besides of course, perform post-mortems, take undergraduate and postgraduate lectures, conduct research work and so on. I will gradually - but surely - be there. Languages C++ (To appear soon) HTML (To appear soon) DHTML (To appear soon) Visual Basic (To appear soon) JavaScript (To appear soon)

Explore a leading peer-reviewed journal in forensic medicine and toxicology. Access original research, case reports, dissertations, and expert insights—freely available to forensic professionals worldwide. ISSN: 0972-8066 (CD version) ISSN: 0972-8074 (Online version) NLM Unique ID: 100960452 Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology ( Peer-reviewed electronic journal for Forensic professionals ) (Published biannually on the 1st January and 1st July every year) [Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology is Indexed / Listed with EMBASE / the Exerpta Medica database, NCJRS (National Criminal Justice Reference Service), Chemical Abstracts Service (A division of the American Chemical Society), Ulrich's Periodicals Directory, MedWebPlus (A service of Flexis, Inc., California), Genamics JournalSeek, getCITED, National Library of Medicine's LocatorPlus, Scopus™ (A service of Elsevier B.V., Amsterdam), Leids Universitair Medisch Centrum, Electronic Journal Miner, EBSCO, Budapest Open Access Initiative (BOAI), Electronic Journals Library (maintained by the University Library of Regensburg), Index Copernicus, Galter Health Sciences Library, Chicago, Directory of Open Access Journals (DOAJ), HINARI and Clarivate Analytics' Emerging Sources Citation Index.] Mentioned in the British Medical Journal [BMJ Volume 324 9 February 2002, page 372 Column - Netlines by Harry Brown, general practitioner, Leeds DrHarry@dial.pipex.com 1st entry in the column mentions this journal A t that time, the journal was hosted at a different URL, which is mentioned in the column. That URL still accesses the journal.] Read this Article (on BMJ) In Association With NCJRS (National Criminal Justice Reference Service), USA Major sources indexing this journal are given below. 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HOWEVER THE ARTICLES AND OTHER MATERIALS MAY NOT BE REPOSTED ON THE NET OR REPRINTED FOR COMMERCIAL GAIN WITHOUT THE PERMISSION OF THE EDITORIAL BOARD. Scope of the Journal Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology is published online twice a year. It is the world's first online journal of forensic medicine and toxicology. Started by Professor Anil Aggrawal of Maulana Azad Medical College, New Delhi, on 25 February 2000, it publishes original on forensic medicine, toxicology, medical law, science and the law and allied subjects such as criminology, police science, deviant behavior, forensic psychiatry and psychology. Any subject that has a forensic interest e.g., forensic astronomy, forensic economics, forensic geoscience, forensic gemology, forensic herpetology, forensic hypnosis, forensic limnology, forensic linguistics, forensic mathematics and statistics, forensic metallurgy, forensic microbiology, forensic microscopy, forensic nursing, forensic palynology, forensic pharmacy, forensic phonetics, forensic social work, jurimetrics, nanoforensics, teleforensics, veterinary forensics, wildlife forensics etc., as well as papers related to medicolegal aspects of various medical disciplines, such as pediatrics, surgery, ENT, ophthalmology etc. are also published. The journal has regular undergraduate and postgraduate sections, book reviews, interviews with famous forensic professionals, poster sessions, announcements of conferences etc. All back issues are archived for easy access and are available to all. The journal has an impressive editorial board comprising of at least one specialist from every single continent of the world. About 10,000 visitors visit and read the journal daily from all parts of the world. The journal is indexed/listed with several major abstracting services such as Chemical Abstracts Service, EMBASE, Index Copernicus, SCOPUS, and Web of Science [Clarivate (formerly Thomson Reuters)]. For more information, please visit following link (Wikipedia). Submit Here Call for Reviewers Interested in becoming a reviewer for this journal? Check Details Anil Aggrawal's Internet Journal Of Forensic Medicine & Toxicology (Access the pages by clicking on them.) Main Page (current Issues & Archives) Paper/Thesis Submission Guidelines Call for Reviewers Aims & Objectives Frequently Asked Questions (FAQs) Undergraduate Section Postgraduate Section History of the Journal Contributing Partners Be our Sponsor Editorial Board Journal CD Awards Credits Cumulative Index (Sorted by Publishers) of Reviews of Forensic gadgets/toys/other tidbits Models related to Forensics/Toxicology Electronic books related to Forensics/Toxicology Calenders related to Forensics/Toxicology Software/Multimedia/Videotape Reviews Books on CD/Audio books, CDs and tapes Cumulative Index of Editorials Theses/Dissertations Online Courses Reviews with Quizzes Animated Book Reviews Featured Reviews Interviews with Prominent Writers/Authors/Forensic Professionals/ Toxicologists Cumulative index of Book Reviews Sorted by Publishers Subjects (General) Subjects (Technical) The Punjab Corneal Grafting Act, 1963 Leading papers Aggrawal A., Busuttil A. Age Estimation in the living. The Police Surgeon (Journal of The Association of Police Surgeons). No. 38, Jan 1991, Pp 33-36. Aggrawal A. References to the paraphilias and sexual crimes in the Bible. J Forensic Leg Med. 2009 Apr;16(3):109-14. [Pubmed ] Aggrawal A. Estimation of age in the living: in matters civil and criminal. J Anat. 2009 May 11. [Pubmed ] Aggrawal A. A new classification of necrophilia. J Forensic Leg Med. 2009 Aug;16(6):316-20. [Pubmed ] Aggrawal A. A new classification of zoophilia. J Forensic Leg Med. 2011 Feb;18(2):73-8. [Pubmed] Some selected chapters in books and encyclopedias Aggrawal A. (2003) Age Estimation in the Living. In: Payne-James JJ, Busuttil A, Smock W (Eds.) Forensic Medicine: Clinical and Pathological Aspects, Pp. 391-408. Greenwich Medical Media, San Francisco & London Aggrawal A. (2005) Allergies. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 1, Pp. 58-68. Elsevier Academic Press, London Aggrawal A. (2005) Drug Induced Injury, Accidental and Iatrogenic. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 2, Pp. 230-238. Elsevier Academic Press, London Aggrawal A. (2005) Drug Prescribed: Product Liability. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 2, Pp. 243-252. Elsevier Academic Press, London Aggrawal A. (2005) History of Toxicology. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 2, Pp. 525-538. Elsevier Academic Press, London Aggrawal A. (2005) Internet: Toxicology. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 3, Pp. 171-181. Elsevier Academic Press, London Aggrawal A. (2005) Mass Murder. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 3, Pp. 216-223. Elsevier Academic Press, London Aggrawal A. (2005) Mass Poisonings. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 3, Pp. 223-229. Elsevier Academic Press, London Aggrawal A. (2005) Refugee Medicine. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 3, Pp. 514-525. Elsevier Academic Press, London Aggrawal A. (2005) Terrorism: Medicolegal Aspects. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 4, Pp. 269-276. Elsevier Academic Press, London Aggrawal A. (2005) Terrorism: Nuclear and Biological. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 4, Pp. 277-289. Elsevier Academic Press, London Aggrawal A. Tsokos M (2005) Terrorism: Suicide Bombing, Investigation. In: Payne-James JJ, Byard RW, Corey TS, Henderson C (Eds.) Encyclopedia of Forensic and Legal Medicine, Vol. 4, Pp. 289-296. Elsevier Academic Press, London Aggrawal A. (2006) Agrochemical poisoning. In: Tsokos M (Ed.) Forensic pathology reviews vol 4. Humana Press, New Jersey, chapter 10, Pp 261-327. Aggrawal A. (2007) Bride Capture. In: David S. Clark (Ed.) Encyclopedia Of Law And Society: American And Global Perspectives. SAGE Publications, Thousand Oaks, London. Pp. 134-35 (vol. 1). Aggrawal A. (2007) Discrimination, Sociology of. In: David S. Clark (Ed.) Encyclopedia Of Law And Society: American And Global Perspectives. SAGE Publications, Thousand Oaks, London. Pp. 418-20 (vol. 1). Aggrawal A. (2007) Dowry Customs. In: David S. Clark (Ed.) Encyclopedia Of Law And Society: American And Global Perspectives. SAGE Publications, Thousand Oaks, London. Pp. 435-7 (vol. 1). Aggrawal A. (2007) Homicide. In: David S. Clark (Ed.) Encyclopedia Of Law And Society: American And Global Perspectives. SAGE Publications, Thousand Oaks, London. Pp. 709-11 (vol. 2). Aggrawal A. (2007) Incest. In: David S. Clark (Ed.) Encyclopedia Of Law And Society: American And Global Perspectives. SAGE Publications, Thousand Oaks, London. Pp. 730-2 (vol. 2). Aggrawal A. (2011) Sexual Deviant Behavior and Crimes. In: Lynch, VA, Duval, JB (Eds.) Forensic Nursing Science, 2nd ed, ch 41,Pp. 512-20. Elsevier Mosby, Missouri. Aggrawal A., Sardana K (2014) Medicolegal aspects of Lasers in Dermatological practice. In: Sardana K, Garg VK (Eds.) LASERS in Dermatological practice, ch 16,Pp. 441-54. Jaypee, New Delhi. "I play 90 hours a week. Many people call it work."