Book Review Policy Reviews of Forensic Books/Journals/Software/Multimedia SPREADING AWARENESS The journal strives to spread awareness about the latest forensic literature among the forensic professionals of the world. Every month tens of new books related to forensic sciences and allied subjects are published, but it takes a while before forensic professionals become aware of them. In several cases, they just remain unaware of these publications throughout. I have been personally handicapped by several such instances. I will tell you just one. In 1998, I went to Bijapur (a historical city in Karnataka State in India), to take a guest lecture, and as is my wont, was thumbing through their library books in my spare time. I was amazed to see a nice biography of Thomas Noguchi published sometime in the late seventies. It gave some of his best cases (among them the murder of Dorothy Stratten, Playboy Playmate of August 1979, who was killed by her lover Paul Snider, when she was six months short of her twenty-first birthday. I had been searching for the details of this murder investigation for quite sometime without any success!). I was completely unaware of this book for all these years , and would have given a fortune to possess this book, but alas, the book was already out of print. What pained (and annoyed) me most was that I have been frantically buying books since late sixties, and had I been aware of the existence of this book at the time it was published, I would have done anything to acquire it - even if it would have entailed writing to the publishers overseas. As I pined for this book (and several others - "Pathology of Homicide" by Adelson is another, "Guinness Book of Crime", which I saw at the British Council Library in New Delhi another, "Poisons, Antidotes and Anecdotes" by William Tichy (Sterling Pub. Comp., New York, N.Y., 1977) still another - the list is endless), I became acutely aware that there should be some surefire and foolproof system by which forensic professionals could become aware of important publications soon after they came in existence. We have been running this very successful Internet Journal for quite sometime now. This has become a sine qua non for most professionals around the world (its beauty is that unlike most other online journals, it is available free online to all), and they turn back often to this journal to see what is the latest happening here. And we at the Journal office decided that it would be best to use this journal as a forum to spread awareness. We wrote to several authors and publishers and the response was amazing. We received books from them regularly and as they came in we got down to scanning them, sorting them, describing them. As can be seen, our reviews are radically different from those appearing in most "Paper journals". We give the front and back cover in high color resolution, and also some of the key diagrams, contents, tables etc in full color, which can be enlarged further at the command of the viewer. The idea is to make the reader feel as if he is himself thumbing through the book, and can take an intelligent decision regarding it. We also began reviewing other items related to forensic medicine (Software, Multimedia, Journals). With time, this section also became really valuable for our readers. Encouraged by the response to reviews of Professional Publications, software and multimedia, we took to reviews of popular books on crime too. Again we wrote to several authors and publishers and again the response was encouraging. I think if somebody had been running such a journal twenty years back, all of us would have had much more books in our collection than we have now (I Certainly would have had Thomas Noguchi's book!). But better late than never! (The journal accepts important books, journals, software and multimedia (VHS, CDs, DVDs) related to Forensic Science, Forensic Medicine, Toxicology, Criminology and Allied subjects for extensive reviews. Both technical and general books are reviewed in separate sections. The journal is visited not only by Forensic Professionals from all over the world, but also by general public exploring subjects related to mystery, crime, suspense, intrigue, supernatural and horror. The reviews are usually hosted within two weeks an item is received at the journal office. For more details please visit our FAQ section.) Books and other items for review must be submitted at the following address Professor Anil Aggrawal (Editor-in-Chief) Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology S-299 Greater Kailash-1 New Delhi-110048 India Phone:+91-11-29235460

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE OCTOBER 1997 ISSUE THE POISON SLEUTHS POISONING BY THALLIUM -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today. You seem to be doing the post-mortem on a rather old man. And he seems to have a most peculiar rash over his face. His hair have also come off his head. Please tell me what happened to him." "Good morning Tarun. This man is a 56-year old man Ramlal, who worked in a store in New Delhi. He suddenly fell ill on 27 August. He developed acute griping pain in the stomach for about 1 hour, and he also had vomiting and diarrhoea. He was well until four days later when he developed severe burning pain in the toes of both feet and tingling sensation in the tips of all the fingers. These symptoms increased over the next five days with some reduction in the power of hand grip. His company admitted him to a leading private nursing home in Delhi. Some leading medical experts examined him, but couldn't diagnose his illness. Ramlal's condition remained unchanged until 9 September when he suddenly developed more symptoms. He had difficulty opening the eyes in strong light, a symptom known in medical parlance as photophobia. There was some disturbance in his vision also. His condition worsened further over the next few days and by 11 September there was drooping of eyelids (known in medical parlance as ptosis) and weakness of face muscles. Swallowing became increasingly difficult. He had difficulty in breathing too, which became so severe that on 15 September, a surgical opening had to made in his neck to help him breathe. However his condition continued to worsen and he died on 19 September, 23 days after his first symptoms started." "Oh, he had a most terrible illness. What do you think he died of?" "Everybody thought he had died from some undiagnosed natural illness. But when the dead body was brought to me, I noticed this curious rash over his face. I also noticed- as you also did- that his hair were also falling off his scalp. This made me suspect that Ramlal was being poisoned- perhaps with thallium." "What! Thallium!! I never thought that it could be used as a homicidal poison" "Tarun, on the contrary, it is a very good homicidal poison. I will tell you in a short while, why this is so. But before proceeding any further, let me tell you a little bit about thallium, so that you can know something about this interesting poison. "Sure doctor, go ahead. I like listening to good scientific stories." " Tarun, Thallium was discovered in 1861 by the British physicist Sir William Crookes (1832-1919). He was working with selenium ores, and in 1861 he came upon a sample of such ore that when heated showed in its spectrum a bright green line characteristic of no known element. It indicated a new hitherto undiscovered element. When he ultimately found it, he named it thallium, from the Greek word thallos meaning "green twig" after the color of its line. The botanical word thallophyta comes from the same root." "That's very interesting. And when did murderers start using it as a homicidal poison?" "It is significant that it was not used as a poison in the first instance. Its earliest use - albeit unaccountably- was to check the "night sweats" in tuberculosis, and when it was noticed that loss of hair occurred with its use, a scientist named Sabouraud instituted its therapeutic use for tinea capitis or ringworm in 1898. The salt used was thallium acetate. It was supplied as a cream (Koremlou cream), containing 7.18% thallium acetate. This practice was finally abandoned half a century later, when it was realized that it was a potential poison. Quite interestingly Thallium has also been used a rodenticide (e.g. to kill rats and moles) and as cockroach poison, particularly in Germany. For this purpose it was available either as tablets or pellets of thallium sulphate or as pastes. Some time in the 1920s the firm of Bayer-Leverkusen in Germany marketed 30 g tubes of a paste known as Zelio paste, each of which contained 2.3%, or about 600-700 mg of thallium sulphate. It had a wide sale on the continent and in the United States, apparently without any restriction of sale or purchase. A French preparation, Virus Rouge contained thallium nitrate. In 1965, the US banned the use of thallium as a commercial rodenticide. However thallium salts as cockroach poison may still be available today in many countries. It is still used in homeopathic remedies!" "Doctor, why did anyone use thallium as a rodenticide at all, when it was so dangerous to human beings?" "Tarun, the earlier rodenticides contained phosphorus, but the value of thallium as a rodenticide lay in the fact that the usual phosphorus containing rat-killer was harmful to the pigs that ate the poisoned rats, whereas the pigs seemed unaffected by rats killed with thallium salts! The use of thallium rodenticides in Europe spread when the Germans conquered and occupied most of Europe during the 2nd World War." "Is thallium useful for other purposes too?" "Yes, Thallium is widely used in industry. Its addition confers a high refractive index on optical glass. For this reason it is used in imitation jewellery which sparkles rather like diamonds. It is also used as an alloy, a catalyst, and for making low-temperature thermometers. But unfortunately like arsenic (see Science Reporter February 1997) , thallium also accumulates slowly in tissues, and over a short period of time, has cumulative toxicity. This method of administration has been used in many criminal cases. I must tell you that the fatal dose of thallium is about 1 g." "Excuse me doctor, what do we mean by the fatal dose?" "When dealing with poisons, we often speak of their fatal dose and fatal period. You will perhaps remember that we first talked about the concept of fatal dose, while talking about arsenic and Spanish Fly (see Science Reporter February 1997 & March 1997). Fatal dose of a poison is the average dose which is enough to kill an adult human being, while fatal period is the average period taken by the poison to kill. A tube of Zelio paste would contain about 0.6 to 0.7 g of thallium which is considered somewhat less than the average dose to kill a human being. Death usually occurs in 11 to 16 days, which is called the fatal period of thallium. If the patient survives 4 to 5 weeks, he would probably live, but the damage to organ systems may be permanent." "Tell me doctor, can thallium be taken for suicidal purposes too?" "Tarun, cases of both accidental and suicidal poisoning occur with thallium, but probably most sinister is its use as a homicidal poison, as it possesses many of the qualities of an ideal homicidal poison. Its salts are colorless, odorless and tasteless, besides being freely soluble in water. Furthermore, in the body the salts are converted into a relatively insoluble salt thallium chloride. This is favorable to the criminal, as the insoluble salts take longer to act; the effects are rarely noticeable before 12 hours and may be delayed as long as 48 hours. This gives the criminal enough time to cover its tracks. Because of the wide gap between ingestion and the onset of symptoms, it is also that much more difficult to associate the symptoms with what the criminal gave to the victim. The initial symptoms of an ideal homicidal poison must mimic some natural disease, and that's exactly what happens with thallium salts too; its initial symptoms are those of a digestive upset of a non-specific character. More specific neurological symptoms occur only after about 2 to 5 days, but still they are very difficult to differentiate from some neurological diseases such as Guillain-Barré syndrome. That is probably why the doctors were at a loss to diagnose thallium poisoning in the case of Ramlal. One of the most characteristic signs of thallium poisoning- gross loss of hair- does not appear until almost a fortnight has passed." "Excuse me doctor, you introduced quite a frightening term Guillain-Barré syndrome. I know I may be deviating from the main topic, but please let me know something about it." "Tarun, the actual name of this condition is Landry-Guillain-Barré Syndrome or LGBS. It is the name given to the conditions previously known by two different names- Landry's ascending paralysis and Guillain-Barré Syndrome. Now the two conditions are known to be identical. It is an acute disease of the nerves, in which they lose their outer protective covering or myelin. This myelin coat is also important for the smooth functioning of the nerves. The result of this loss of myelin coat is that the nerves can not conduct messages properly. This disease occurs at a rate of one case per million population per month. At this rate about 950 new cases of LGBS must be occurring in India every month. The weight of evidence favors that the cause of the disease may be immune related. However in over two-thirds of the cases, a viral infection is associated. After the infection, demyelination- or loss of myelin coat- in spinal and peripheral nerves occur. The symptoms of thallium poisoning may mimic this disease very much. The good news about LGBS is that its prognosis is good, with about 85% of the patients making a complete recovery. The mortality rate is just 3-4%. You would probably want to know, how the name of the disease came about. Well, it comes from the names of three doctors who described this disease at different intervals. The earliest to describe it was the Paris physician Jean Baptiste Landry (b. 1826). Subsequently Paris neurologist Georges Guillain (b. 1876) and Strasbourg neurologist Jean Alexander Barré (b. 1880) also described it correctly." "Excellent. Coming back to thallium. You said thallium fulfills many of the properties of an ideal homicidal poison. It means killers have got an ideal weapon, isn't it?" "Not exactly. Fortunately nature has put some negative qualities in it too. Had it not been for these counterbalancing features, thallium would indeed have been a poisoner's delight." "Really? And what are these counterbalancing features?" "An ideal homicidal poison must not be readily detectable by analysis, but thallium salts can be readily detected. Furthermore, an ideal homicidal poison must disappear from the body after doing its job. Of course a substance can not magically disappear from the body, but what it effectively means is that the poison must at least be destroyed by putrefaction, so that with the onset of time, it becomes impossible to detect that poison. I must tell you that this does happen with most vegetable poisons. Thallium however remains in the body even after putrefaction. It is also not a product of putrefaction." "Wait a minute doctor. You just said that thallium is not a product of putrefaction. You imply that if a poison is a product of putrefaction, it would be an ideal homicidal poison. Please explain this point to me in some detail." "Tarun, first of all you must know what exactly is meant by putrefaction. It is the destruction of the body with the onset of time. You must have noticed that dead animals start to rot after some time. The same happens with human bodies, if they are not disposed of properly. This rotting is known as putrefaction in medical parlance. Now imagine a killer has killed his victim with some poison, and has hidden the body somewhere, say in some bushes or a nallah. With the onset of time, putrefaction would start and the body would start to smell. This would soon lead to its discovery. Now if the poison is such that it is destroyed by putrefaction, the doctor doing the autopsy at this time would not be able to find this poison, and thus the killer would remain untraced. Wouldn't it make an ideal homicidal poison?" "Yes, I do appreciate that. But how can a poison be an ideal homicidal poison, if it is a product of putrefaction? That is what I really want to know." "Tarun, putrefaction is a chemical process, in which many chemicals are destroyed and many new chemicals appear. For instance, the chemicals skatol and indole are produced during putrefaction which indeed are responsible for the offensive smell of the body. If a poison is a known product of putrefaction, it could reasonably be argued by the defence in a court of law, that the detected poison (in a putrefied body) was not administered during life but was produced as a result of putrefaction. Cyanide, alcohol and ptomaines are well-known poisons which are products of putrefaction. Arsenic and thallium, which otherwise fulfil several of the criteria of an ideal homicidal poison do not fulfil this criteria. Similarly another criteria of an ideal homicidal poison is that it should normally be present in the soil." "Well, what is the explanation for that?" "In some communities, instead of cremation, the dead bodies are buried. Poisoners - and in fact all murderers- don't feel easy with this method of disposal of the body, because the potential evidence of murder -the body- remains beneath the soil. Any time after the burial of the body, if suspicion gathers momentum against the murderer, the body can be exhumed, i.e. unearthed and sent for a post-mortem examination. Now if a poison is normally present in the soil, it can be -and has successfully been- argued by the defence that the detected amount of poison had leached in the body from the surrounding soil. Arsenic - a deadly poison- is normally present in the soil in fairly good concentration, and this argument has successfully been used by many murders. But thallium is not present in the soil in any great quantity, and thus the same argument would not hold, if the poisoner had used thallium to dispose of his victim." "Oh, I see. Doctor, can you tell me what symptoms does the victim experience when thallium is given to him?" "Yes sure. Thallium salts irritate the stomach and intestines. It is a gastro-intestinal irritant so to say and that's why symptoms like abdominal colic, nausea, vomiting, diarrhoea occur first. Vomiting and diarrhoea may contain blood. There may be sores in the mouth, a symptom known in the medical parlance as stomatitis. The interesting difference from those of other irritant poisons is that the symptoms start very late- after about 24 to 48 hours of ingestion. In fact it is one of the idiosyncrasies of this poison which makes it a good homicidal poison. Thallium appears to act on nerves too. The symptoms relating to nerves ensue one to five or more days after ingestion. An intense pain develops in the body which is worse at night and is readily provoked by mild stimuli. For instance, even the weight of the bedclothing is enough to induce bouts of pain. The soles of the feet are first involved. The pain gradually travels upwards; to the legs and to the trunk. Sometimes there is intense pain in the big toe, and this can simulate gout. In some cases this may be the first sign. Joint pains which move from joint to joint also occur. There is numbness, especially of the fingers and toes, with detectable loss of sensation to pin-prick and to touch. There is a feeling of tiredness in the legs. This is followed by weakness and finally paralysis. The arms are always less affected. An interesting symptom is the appearance of a "butterfly" rash on the face. In fact this is the first thing I noticed on Ramlal's face, and that had alerted me at once. Another interesting symptom is alopecia or loss of hair. In fact it is highly characteristic of thallium poisoning. Hair loss occurs about a fortnight after the ingestion. The hair is lost in large tufts and within three weeks, the whole of head is bare. The root of the hair -the part of hair that remains buried underneath the skin- shows dense black coloration. This may be seen on the actual hair too, if there has been repeated intake. In fact, if there has been a repeated but interrupted intake, several dark bands coinciding with the period of intake may be seen. Interestingly the same thing happens in arsenic poisoning. It is widely thought that the great Napoleon was killed by the British in this manner. His hair too showed arsenic in bands. The bands are seen only on growing hairs. Thallium finally arrests hair growth and the hair falls. Even you noticed both the rash and the loss of hair, as soon as you entered the post-mortem room. During the autopsy I pulled some of his remaining hair and saw them under the microscope. I was struck with the finding that the hair root was completely black, while normally it is not so. The excessive blackness is considered to be due to an excess of melanin laid down through catalytic action by thallium." "Oh, I see. Coming to think of hair, I find that Ramlal's eyebrows look a little bit curious. Am I right?" "Yes, you sure are right Tarun. Just like hair on the scalp, eyebrows are also involved in thallium poisoning, but for some curious reason, their inner third is spared- only the outer two-third falls off. It is such a characteristic sign of thallium poisoning that it has even been accorded a name; the sign is called signe de sourcil. This is a French term, which literally means "The eyebrow sign"! It has been suggested that the inner third is spared because it is phylogenetically much older than the rest of the eyebrow hair. The fingernails may bear horizontal white bands or white cross lines. This change appears quite late- several weeks after the exposure. That's why you can't see this change in Ramlal's body." "Oh, this is most interesting indeed. Especially the information on eyebrows." "Tarun, there are more interesting nuggets I can give you. You would perhaps be quite interested to know that the noted English crime writer Agatha Christie has given a graphic description of the effects of thallium poisoning in her novel The Pale Horse (Christie, 1952), and this has led a nurse to correctly diagnose a case of thallium poisoning, which had earlier been diagnosed as a case of encephalitis by "experts"." "Really? Please tell me the details of this case" "Tarun, this case occurred in the late 70s. A 19-month-old girl in Qatar was having undiagnosed and unexplained ataxia, which in plain and simple terms means that she was unable to walk. Her physician in Qatar telephonically contacted experts in Hammersmith Hospital, London for help. She had a most extraordinary illness. It apparently began some 10 days earlier with a major convulsion lasting about 5 minutes and associated with a high fever. Over the next 3 days she became increasingly clumsy and lethargic and developed slurring of her speech. By the seventh day of her illness she was unable to sit, stand or walk, and had difficulty with swallowing. The following day she had a further generalized convulsion lasting about 5 minutes. At this stage she was transferred to Hammersmith Hospital. Detailed investigations led experts to believe she was suffering from encephalitis -an infection of the brain- but a staff nurse, who was reading Christie's novel The Pale Horse, realized that her symptoms were remarkably similar to those of thallium poisoning mentioned in the novel! The girl had also started losing hair which normally occurs in about 10-15 days of ingestion- a fact which was also mentioned in the book. She expressed her doubt to the doctors and on subsequent examination, she was indeed found to be suffering from thallium poisoning. On detailed discussion with the child's parents it seemed that the most likely source of thallium was domestic poison used to eliminate cockroaches and rodents in the drains and septic tank of their home. This is a common practice in Middle East!" "Oh, how very interesting. Has Thallium been used for murder in modern times? "Oh yes, it has. One of the most famous cases of murder with Thallium in modern times is that committed by George Trepal - a 42-year-old computer programmer - in 1988. He was a man with a very high I.Q. In fact he was a member of the high I.Q. club Mensa and this case later became famous as the Mensa Murder case. Trepal lived in the small central Florida town of Alturas. He was quite fed up with his neighbor Peggy Carr, 41, and her family, because they always listened to loud music which disturbed him. Carrs' dogs also used to trouble Trepal's cats, which he did not like. In June 1988, he sent the Carr family a chilling typewritten note in the mail. It said, 'You and all your so-called family have two weeks to move out of Florida forever or else you will die. This is no joke.' Carr's family did not pay much attention to this note. Four months later - in October 1988 - Peggy Carr was hospitalized with mysterious symptoms her doctors couldn't explain. At the same time, her son and stepson developed similar symptoms. While they recovered, Peggy did not, and she died with her doctors still mystified as to what killed her. One of her sons was permanently disabled. Officials were completely baffled. Trepal had actually surreptitiously spiked eight-pack of Coca-Cola bottles with thallium nitrate, and secreted them into Carrs' kitchen. Peggy Carr and her family members unsuspectingly consumed the drink. Peggy lapsed into a three-month coma and died thereafter. Four other members of her family were poisoned, though not fatally, but one son, as we have already seen was permanently disabled due to effects of Thallium on his Central Nervous System. Interestingly, Trepal was so confident of his "perfect murder" that when the investigating officials came to him for enquiries, instead of keeping quiet, or expressing his ignorance in this matter, he speculated that someone might poison people to get them to move out of the neighborhood! This immediately allerted the officials, who at once started thinking in terms of poisoning. When Trepal's home was searched, a small vial of thallium nitrate - generally unavailable to the public - was found there. Other incriminating things found in his house were a detailed homemade notebook titled, "General Poisoning Guides," with several entries on thallium, and an extensive store of dangerous chemicals. He was found guilty by the court, and sentenced to die." "Amazing! It appears we have another Trepal on our hands now. It is now sure that poor Ramlal died due to Thallium poisoning?" "Yes, and I confirmed this by several other means too. First of all I analyzed for thallium in his urine, and it was present in high quantities. Furthermore there was a widespread destruction of nerve cells in the brain. Liver and kidneys were damaged as is usually seen in thallium poisoning." "So from an apparent natural death, you have suddenly discovered murder in it. Who could possibly have poisoned him?" "Tarun, before you came, I had already given my findings to police and the police has done a detailed investigation subsequent to my report. You are right that someone was indeed trying to poison him. on detailed investigations, it was found that a colleague Karim was mixing Thallous acetate in his tea daily for some days. He had an old axe to grind with Ramlal. Faced with the scientific evidence, the police questioned Karim and he admitted his guilt. Thus a poisoner who could have gone scot free was caught with the help of forensic science." "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 deadly poison - Capsaicin. "

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

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

Forensic Jokes, Puns & Tidbits Forensic Poems The Toxic Avenger From the grave, if lips could speak the person who was, pleads – you must seek the individual who had my trust, and thru deceit and cunning into the grave did thrust this body once alive and well, now silenced by death, who can not tell my death was NOT what all thought then, for a poison brought my life to end! Avenge me now, for you alone can find the truth beneath the stone. Look close and the clues you will see that tell the tale of what killed me. For you must tell all others now, That this was MURDER – and tell them how! For if no one looks to find what’s here, An injustice was done to a life so dear. If now only you could hear, My muted pleadings to make wants clear. I’d speak as plain as it could be. Since I can’t – You must AVENGE ME! -Anonymous. From a promotional leaflet on the book “Criminal Poisoning” by John Harris Trestrail, III (Acknowledgement: This leaflet was sent to me by John Harris Trestrail, III of the Regional Poison Center, Grand Rapids, MI) Milton Helpern (1902-1977) What kind of man is he we honor here, A doctor who has served his science well? Why, yes, of course, but most of us could tell Of science or profession served. A peer Without a peer in his own field and sphere? Why, yes, that too, but more than this, his spell Is cast by greatness of the mind. We dwell On inner strengths of character so dear To all who know him, radiance that springs From hidden depths of manliness and truth. These are the constant hallmarks of the soul That draw us to the man, these are the things Of which we offer now as humble proof The heartfelt testimony of this scroll -Anonymous. From the book “Autopsy – The Memoirs of Milton Helpern, the World’s Greatest Medical Detective” by Milton Helpern, M.D. with Bernard Knight, M.D. (Acknowledgement: This book was kindly lent to me by Dr. R.K. Sharma of the DDU Hospital)

Forensic Jokes, Puns & Tidbits Forensic Puns 1. A tourist in Vienna is going through a graveyard and all of a sudden he hears some music. No one is around, so he starts searching for the source. He finally locates the origin and finds it is coming from a grave with a headstone that reads: Ludwig van Beethoven, 1770-1827. Then he realizes that the music is the Ninth Symphony and it is being played backward! Puzzled, he leaves the graveyard and persuades a friend to return with him. By the time they arrive back at the grave, the music has changed. This time it is the Seventh Symphony, but like the previous piece, it is being played backward. Curious, the men agree to consult a music scholar. When they return with the expert, the Fifth Symphony is playing, again backward. The expert notices that the symphonies are being played in the reverse order in which they were composed, the 9th, then the 7th, then the 5th. By the next day the word has spread and a throng has gathered around the grave. They are all listening to the Second Symphony being played backward. Just then, the graveyard's caretaker ambles up to the group. Someone in the group asks him if he has an explanation for the music. "Don't you get it?" the caretaker asks incredulously. [Guess now, before scrolling down] No cheating, make a guess before scrolling. Not even a wild guess before scrolling? He's decomposing.* 2. I was standing in line at an airport to check in for a flight. For 15 minutes, the queue hardly moved, and patience was wearing thin. Suddenly an irate voice from the back demanded to know what the holdup was. A voice from the front replied,"I'm afraid Riga mortis has set in." (Contributed by Chris Bane. Published in Readers' Digest December 1999 page 32) 3. Is it correct to say that all Forensic Personnel are in a grave situation?

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JUNE 1998 ISSUE THE POISON SLEUTHS DEATH BY SELENIUM -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young boy today. And his mouth is smelling as if he had eaten garlic before his death. What happened to him? Please tell me." "Good morning Tarun. The name of this young boy is Shyam and he is about 3 years old. His father is an old military hand, and a lover of guns. He was the only child of the family. His mother is a housewife. Yesterday his parents left home to visit one of their relatives, leaving the child with the maid, a young woman named Anita. The maid knew the child well, and Shyam was quite comfortable with her. It appears that for some time, the maid went to the bathroom. At least that is what the maid's version is. When she came back, she saw the child rolling on the ground, retching and vomiting. She immediately telephoned the parents. They rushed to the house and took Shyam to the hospital. When seen in hospital, he was moaning and making purposeless movements with his limbs. Salivation was profuse and he had a strong smell of garlic in his breath- as you have rightly observed now also. Doctors were trying to diagnose what his illness was, but within 45 minutes of his arrival at the hospital, he died." "Oh, that is most terrible. So the police must have now handed over his dead body to you to find out how he actually died?" "Yeah, that's true. Anita is actually a decent woman, and wouldn't do any mischief. But the child's parents are obviously in a very terrible grief, and wouldn't like to spare anyone. The police wouldn't want to spare anyone either in this heinous death. So Anita is not totally out of suspicion. And I have to tell the police how he actually died." "So what have you found out doctor?" "Tarun, when I found the strong smell of garlic from the boy's breath, immediately a bell rang in my mind. I asked the parents if they used garlic at home, and they replied in the negative. This set me thinking......" "Really? So the boy had not eaten any garlic. But I can swear he has eaten garlic. He is smelling so bad of garlic." "Yeah, that's right Tarun. But I must tell you that there are a few poisons which when ingested give rise to almost the same smell. These are selenium, phosphorus, arsenic, tellurium and dimethyl sulfoxide." "Oh, so the boy must have been given either of these poisons?" "Well, let us not jump to conclusions Tarun. These are the possibilities, but certainly the boy might have died of some other cause too. For instance he might have died of some natural illness. But I have enquired the parents if he ever suffered from some major illness, and they have answered in the negative. Then I looked at the body for some obvious injury marks. They are also not present. So it does appear to me that he died of some poison, and the poison is most likely to be one of those I already mentioned." "So how are you going to find out how Shyam actually died?" "Tarun, when I was making enquiries from the parents, I came to know that Shyam's father was a lover of guns. This immediately alerted my mind in one particular direction. Most gun lovers keep a special compound with them; it is called gun-bluing compound. It is actually selenious acid or hydrogen selenide. When rubbed on the guns, it gives them a beautiful metallic sheen. It seemed very probable to me that Shyam had accidentally ingested the gun bluing compound, especially when we take into account that his breath was smelling of garlic. I asked his father if he owned gun-bluing compound, and he was quite surprised how I actually came to know about it. I told him that it was just a hunch. He told me that he did own a bottle of this compound. I asked him to check the bottle. He used to keep the bottle in an open Almirah. When he checked the bottle, he found it open and it was partly empty. He thought that may be he had accidentally spilled the contents over........." "Oh, great. So just by making one or two nice observations you could diagnose the cause of death. But of course the court will require more rigorous proof. Before we go on to that, would you please tell me something about selenium doctor? It is beginning to appear to be such an interesting substance to me." "Oh sure Tarun. Selenium is a nonmetallic element closely related to sulphur. It is found commercially in steel and copper alloys and metal bluing solution as we have seen just now. It is also used for making stained glass, ink and even cosmetics. A suspension of selenium disulphide has been used as a shampoo in the treatment of seborrhoea, which is a kind of skin disease. It is still used, in a 2.5% aqueous solution of selenium sulphide, as a shampoo for the treatment of dandruff!" "Really. I do use a shampoo for dandruff. So does it contain selenium?" "I don't know. It may. You must check its contents which must be written on its wrapper. In any case selenium is not absorbed through unbroken skin, so if you use an anti-dandruff shampoo you are quite well off, if your scalp is not abraded. But if it is, the selenium may get absorbed. If absorbed, it may cause motor neurone disease, which is a kind of neurological disorder. Furthermore if someone accidentally ingests such a shampoo, he may be in trouble." "Alright. The first thing I will do today, is to check the contents of my shampoo. How else does selenium occur?" "Naturally it occurs in the surface soil in certain areas, and is readily absorbed by plants, including grain and vegetables growing in these areas. Herbivorous animals feeding on these plants may accidentally get poisoned by selenium. Endemic poisoning of herbivorous animals and in hens was first described under the name "alkali disease". It could have been the cause of "blind staggers" in cattle in South Dakota where the selenium content of the soil is high." "What is "blind staggers" doctor? Please tell me." "Tarun, it is a disease of cattle in which they show impaird gait and vision- hence the term "blind staggers". In addition, the animals show wasting, stomach upsets, liver damage, bizarre growth, loss of hair and hooves and sometimes sterility. South Dakota is a state in the US, where the soil is excessively rich in selenium. So naturally this selenium is taken by plants and grass too. Animals who fed on this vegetation showed signs of selenium poisoning. And this disease was given the name "blind staggers. Extensive studies have shown that similar symptoms may occur in man, and as grain and vegetables may be conveyed considerable distances these symptoms may occur well outside the recognized endemic areas." "What are the endemic areas" "By this term, I mean those areas where the soil is known to contain high amounts of selenium. There are some very interesting facts connected with selenium. For instance in 1901, it was suggested by some scientists, that some of the toxic manifestations attributed to arsenic in beer were in fact due to the presence of selenium in addition to arsenic." "Well, this point is not very clear to me." "Tarun, beer generally contains some arsenic. And heavy beer drinkers may show some signs of arsenic poisoning too. These scientists suggested that beer may contain selenium in addition to arsenic, and the toxic symptoms may be due to that too. In fact when the Government made a Royal Commission on Arsenical Poisoning, one of these scientists actually gave evidence that such a thing was possible" "Doctor, are all selenium compounds poisonous?" "Yeah, almost all. Many selenium compounds are very irritating or even corrosive to the skin, mucus membranes and respiratory tract. Many selenium compounds were formerly used as plant insecticides, but they have been abandoned now because of their toxicity to man. Selenium oxychloride destroys skin on contact. Selenious acid or hydrogen selenide about which we have just talked, is very caustic when ingested. Fatalities from accidental ingestion of gun bluing agents are however possible. One of the reasons for this is that hydrogen selenide is colorless and odorless, so children may accidentally take it." "But just now you said that hydrogen selenide has garlicky odor. In fact, the child is smelling so bad of garlic, and that actually put you on trail of arsenic" "Tarun, I never said hydrogen selenide is garlicky in odor. I only said that in selenium poisoning one has garlicky odor. Let me tell you how these two statements are compatible. Garlicky odor is actually due to the excretion of dimethyl selenide in the breath. In the body, various selenium compounds can actually get converted to this compound to give rise to garlicky odor. So although selenious acid is odorless in itself, it can give rise to garlicky breath. I may tell you that the garlicky breath of selenium poisoning is so characteristic, that even its discovery itself is attributed to it." "Really? How? Tell me. I like listening to interesting true science stories." "It is said that the housekeeper of the house where Berzelius (the Swedish chemist who discovered Selenium) lived, complained that he had eaten too much garlic. But it was due to his having examined a selenium deposit in a sulphuric acid chamber. He had inhaled fumes which were probably those of dimethyl selenide. This set Berzelium thinking and he went on to discover selenium" "Oh, that is indeed very interesting doctor. Now tell me in how many different ways selenium toxicity can be produced?" "Tarun, toxicity can be produced in a number of ways. One of the ways of course is the direct ingestion of selenium either suicidally, homicidally or accidentally. However, no case of homicidal selenium toxicity has however been reported till now in literature, but it is certainly possible, especially as some of its compounds such as arsenious acid are colorless and odorless. But of course arsenious acid is very corrosive and when one is given this poison mixed in some liquid, he would at once come to know about it, from the corrosive action in his mouth. It is like having drunk dilute hydrochloric acid which also is colorless but very corrosive. Selenium poisoning is also recognized as an industrial hazard in the metal refining, glass making, electrical and chemical industries. And as we have seen, sportsmen and military people who keep shotguns in their homes may also keep gun-bluing compound, which is selenious acid, which can also cause accidental poisoning. Since it is a colorless and odorless fluid, it must be kept out of reach of children. Recently there has been some evidence that selenium is a naturally occurring antioxidant in the body and may be anticarcinogenic. Because of these suggestive findings selenium in various forms is being consumed in megadoses as a dietary supplement. The Centres for Disease Control (CDC), in USA reported 12 persons with nausea, vomiting, nail changes, fatigue and irritability from excessive selenium intake. About half of the patients experienced hair loss, and about one-third lost nails. Other symptoms included watery diarrhoea, abdominal cramps, dryness of hair, paresthesias (abnormal sensations) and garlic breath odor." "Doctor, can you tell me how selenium actually causes the death of a person?" "Tarun, there are certain enzymes within our body which contain sulfhydryl groups, i.e. -SH groups. These enzymes are very necessary for cellular respiration. Selenium bonds sulfhydryl enzymes and causes poisoning. I may tell you that arsenic also does the same, and is thus an equally deadly poison. Other compounds of selenium besides selenious acid are dangerous too. For instance, as sodium selenate, selenium is highly toxic. Acute selenium poisoning produces primarily central nervous system effects, including convulsions. The initial symptoms are nausea, vomiting and a metallic taste in the mouth, dizziness and extreme lassitude. Garlicky odor of the breath and sweat is very characteristic. In industrial situations, a worker may slowly absorb selenium in his system. He will then be said to have been suffering from Chronic selenium poisoning or chronic selenosis. It is manifested by garlic breath odor, stomach and intestine distress, upper airway irritation, metallic taste in mouth and inability to smell. The odor of garlic is perhaps the most characteristic feature. I may tell you that more than half the absorbed selenium is excreted in urine, the remainder in the faeces and in the breath as I have already told you. In endemic areas, urinary excretion of selenium may be as high as 200 micrograms/100 ml without obvious symptoms, while in industry symptoms have been noted with as little as 5-13 micrograms/100 ml." "Doctor, how much selenium can actually kill a person?" "Nobody knows for sure Tarun. But from the various poisoning cases that have come to light, doctors are of the opinion that the fatal dose is about 4 mg/kg body weight. That is, if a person weighs 60 kg, about 240 mg of a selenium compound would be enough to kill him. This, as you can see is quite a low dose, and this makes selenium a very dangerous poison. Its fatal period is about half to one hour. This means that after ingestion, a person would usually die within this period." "Oh, now I know so much about selenium. Now I am ready to listen to you, how you are actually going to prove in the court that the child did die of selenium poisoning, and who killed him?" "Tarun, we have already noted the garlicky odor which is a strong indicator towards selenium poisoning. Furthermore there is congestion (redness) and edema (swelling) of the gastric mucosa, the membrane which lines the stomach. The most important thing is that I have analysed Shyam's organs chemically, and have found high amounts of selenium in them. I have also chemically analysed the gun bluing fluid found at his house and it was found to contain 1.81% of selenious acid. I do not think Anita gave this poison to Shyam. She is an illiterate woman and does not know about the toxicity of gun-bluing compound. Moreover she had no motive to do so. Gun-bluing compound, as I told you earlier, can very easily be ingested accidentally as it is colorless and odorless, and doesn't alarm the person at all. It does appear to me, that when the maid was away, Shyam wandered towards his father's almirah, which was open. He looked at the bottle and was quite curious. Children like to put everything in their mouth, and in his naturally curiosity, he drank some of the liquid, which was responsible for all his symptoms. Well these are my observations only, and it is for the court to decide what actually happened. I can only tell the court with certainly that the child did die of selenium poisoning, and most probably Anita is not guilty." "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- DNOC."

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE MAY 2000 ISSUE THE POISON SLEUTHS DEATH BY HYDROGEN FLUORIDE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young man today. He is showing some burns on his body, especially on his fingers. What happened to him? Please tell me.” “Good morning Tarun. The name of this person is Shamlal, and he worked in a sweetshop in a Delhi based shop as a sweetmaker. He had migrated from Bihar sometime back, and was living alone in his house. For some days he was having some conflict with a person named Sunder, who worked as a lab attendant in a chemistry lab in a local school. On this Holi (Holi is a traditional festival enjoyed by the Hindus about the month of March every year. Typically this festival is celebrated by throwing water and colors over the friends), Sunder reportedly came to Shamlal, and asked him to forget all past differences. You would surely agree with me that for Hindus, Holi is a festival when everyone tends to forget past enmities. Shamlal also wanted to bury the hatchet, and invited him inside and offered him sweets. After applying some color on the face of Shamlal, Sunder threw some watery liquid over Shamlal, as a gesture to play Holi. Shamlal immediately felt pain all over his body, but instead of helping him, Sunder immediately left the house. On hearing Shamlal’s hue and cries, the neighbors took him to a nearby hospital and admitted him there. He died in the hospital a day later.” “Oh, I see. But why is his body brought to you?” “Tarun, when Shamlal was admitted in the hospital, he told the police all the incidents. He also said that he started feeling pain after Sunder threw some watery liquid over him, under the pretext of playing Holi. The police strongly suspect that Sunder threw some corrosive substance over him, and they want me to tell them what substance it was.” “Oh, I see. So what was it doctor?” “Tarun, I have conducted a thorough autopsy on the dead body, and have examined his burns in detail. You can see this typical burn on his finger. I feel that Shamlal has been killed deliberately by a very deadly poison - Hydrofluoric acid.” “Hydrofluoric acid! Never heard of this acid being used as a poison. And come to think of it, how can you be so sure?” “Tarun, I made some discreet enquiries from the doctors who treated him at the hospital. I specifically asked them, how Shamlal described his burns. The doctors told me that he described his burns in a very strange fashion, especially those on his fingers. He said that he felt as if his fingers had been struck with a hammer! This is a very typical description of a Hydrofluoric acid burn by a patient.” “That is very strange indeed. I think, I should know more about hydrofluoric acid, before I could be able to understand your talks more fully. Please tell me in some detail about Hydrofluoric acid.” “Tarun, Hydrofluoric acid is also known as hydrogen fluoride and its formula is often written as HF or H2F2. It is a colorless, fuming liquid, with molecular weight 20.01. It boils at 19.40 C. It is its great solubility in water that causes it to fume strongly in moist air. HF is found extensively in industry and at home. It was first synthesized by the French chemist Edmond Frémy (1814-1894). It is one of the most important fluorine compounds, and is prepared by heating calcium fluoride in sulfuric acid. The aqueous solution of this acid, generally used commercially, is obtained by passing the anhydrous hydrogen fluoride vapors into a leaden receiver containing distilled water, thus yielding the acid in dilute form. Hydrofluoric acid is extremely corrosive and must be preserved in platic, lead or steel containers. It can not be preserved in glass bottles, as it has the property of dissolving glass (reacts with silica to form gaseous silicon tetrafluoride). In fact this property is used in a common test for the presence of a fluoride. For the same reason, hydrofluoric acid is also used extensively in various forms of glass etching, such as the marking of divisions on thermometer tubes and the etching of designs on glassware, and in other forms of ceramic etching, such as pottery decoration. It is also used for frosting and polishing glass, and for removing sand from metal castings. It is also used as a catalyst for the production of certain hydrocarbons for high-octane gasoline. Some of its other common uses are rust removal, in manufacture of dyes, plastics, germicides, tanning, solvents, fire-proofing, pottery glazing and photography. It is also used as a laboratory reagent.” “Oh, that is interesting. What are its harmful effects on humans” “Tarun, scientists have studied its harmful effects in animals systematically by exposing them to varying concentrations of Hydrofluoric acid vapors. This helps to study the effects in man too. When inhaled by rabbits and guinea pigs in a concentration of 15 mg/cu. meter, they could tolerate it for prolonged periods. A concentration of 24 mg/cu. meter was tolerated for a total of 41 hours without fatality, although the animals subsequently lost weight. In a concentration of 50 mg/cu. meter HF induced signs of mild irritation, such as coughing and sneezing, which appeared to lessen after 5 to 15 minutes. Inhaled in greater concentrations, it acted as a severe irritant: the eyes were kept closed, paroxysms of coughing and sneezing were frequent, the respirations were slowed, and there was a copious discharge from the nose and eyes. Concentrations below 100 mg/cu. meter could be tolerated by animals for 5 hours without causing death. When exposed to the concentration of 500 mg/cu. meter for 15 minutes or more, all animals showed signs of weakness and ill-health. Inhalation at a concentration of 1000 mg/cu. meter for 30 minutes didn’t kill any animal, but caused damage to tissues. When inhaled at a concentration of 1500 mg/cu. meter for 5 minutes, all animals died, indicating this to be the fatal dose. When necropsies were done on animals, who had survived repeated exposures of HF, increased fluoride was seen in bones. Lungs, livers and kidneys were found damaged.” “Doctor, you said that HF is used in several industries. Does this mean, that industrial workers are also exposed to HF?” “Yes, surely. And they can get harmful effects too. The highest concentration of HF that can be tolerated by man for 1 minute is 100 mg/cu. meter. This causes a definite smarting of skin, a definite sour taste, and some degree of eye and respiratory irritation. If the air contains 50 mg/cu. meter, the sour taste is apparent and there is irritation of the eyes and nose, but no smarting of the skin. The concentration of 26 mg/cu. meter can be tolerated for several minutes, but the sour taste becomes evident after a short time, and there is mild smarting of the nose and eyes. You may want to know that the American Conference of Governmental Industrial Hygienists has adopted 2 mg/cu. meter as the threshold limit for hydrogen fluoride. This comes to about 3 ppm (parts per million).” “Doctor, I have seen some burns on the body of Shamlal too. Obviously they were caused by Hydrofluoric acid. Could you tell me in some more details about these burns?” “Tarun, contact of the skin with the anhydrous liquid produces severe burns. This is the most frequently reported route of HF toxicity. If the solution is not promptly removed, the skin may be penetrated by the fluoride ion, leading to the later development of painful ulcers, which heal slowly. Solutions of less than 20% HF can produce pain and redness up to 24 hours after exposure; 20 to 50% HF produces pain and redness within 8 hours, and solutions of more than 50% produce immediate burning, redness and blister formation. Fatalities have been reported from dermal exposure to as little as 2.5% of body surface area (about the size of the sole of the foot). HF burns range from first-degree to third-degree. The characteristic features are severe pain. Patients often describe feeling as if they had struck their fingers with a hammer! The hallmark of HF exposure is pain that is out of proportion to the burns produced. Only a few days back, I treated a case of Hydrofluoric acid burns in a young boy, on whom too, someone had thrown HF with an idea to kill him. He got severe burns on his legs. But fortunately I could save him. See this picture of his legs after one month. As you can see, he has almost recovered. His burn wounds are looking much more healthy. He became all right after a few months.” “Doctor, how much HF can kill a person?” “Tarun, inhalational exposure to concentrated HF for as little as 5 minutes is usually fatal, producing death within 2-10 hours. When HF is thrown on the body, the person may die in variable periods of time, usually within a day or so.” “How does hydrofluoric acid kill doctor.” “Tarun, you must be knowing that all acids yield free hydrogen ions or protons in solution. The more hydrogen ions an acid produces, the stronger it is considered to be. These hydrogen ions or protons exert a deleterious effects on the body in several complicated ways. That is why all mineral acids such as HCl, H2SO4 and HNO3 are so dangerous. HF is far less strong than its mineral acid cousins. It produces approximately 1000 times less free hydrogen ions or protons than an equimolar solution of hydrochloric acid, and about 450 times less free hydrogen ions than an equimolar solution of sulfuric acid. Yet it is this poor dissociation that proves so lethal to man. A poorly dissociated acid can penetrate far deeper in the tissues as it is uncharged. In fact all uncharged molecules have the ability to penetrate cells much better than charged ions. Combined with this ability is the specific ability of the fluoride ion to complex with body calcium and magnesium, even when present in exceedingly small concentrations. The combination of these two factors gives HF its unique toxicity. Free proton produced by HF does contribute to the injury (as in the case of mineral acids), but what is more important are the two factors I mentioned earlier, i.e. its unique ability to penetrate tissues, and its ability to combine with calcium and magnesium. This causes body calcium and magnesium levels to fall down. The body if affected in several other ways. I may also tell you about a unique property of the fluoride ion, which makes it very deadly. It can hold an electron more tightly than any other ion. This strong electronegativity of the fluoride ion allows it to bind tightly to any cation. These effects have the potential of disrupting all metabolic pathways, and may result in several body disorders.” “Doctor, now I know about HF enough to follow your talks. Tell me what has happened in Shamlal’s case?” “Tarun, I have no doubt in my mind that Shamlal has been killed by Sunder by this unique poison. Sunder worked in a chemistry lab, so HF was available to him. He offloaded some HF in a container and smuggled it home, with a view to throw it over his long adversary Shamlal. He knew that Holi was approaching soon, and he could throw it over him and leave the house quickly. As this is such a rare corrosive, he thought that he police would never be able to determine which corrosive was Shamlal killed with. But his typical findings and especially his typical description of his pain before death have given away everything. I have conducted some chemical tests on the washings which I took from Shamlal’s burnt areas, and they have tested positive for Hydrofluoric acid. Following this, I asked police to raid Sunder’s house. They did so, and found a half empty bottle containing HF. We then contacted the chemistry teacher of the school, where he was working, and asked him to check his HF supplies. He was surprised, as HF was hardly used in a routine way, and they always kept it under lock and key. But on our insistence he opened the lock and key and checked the HF bottle. To his utter surprise, it was empty. All these facts have confirmed, that Sunder stole HF from his school lab to throw it over Shamlal. Come, let us tell the police that Sunder is guilty and that the police must apprehend him.” “That is very clever of you doctor. Without your clever deduction it would have been impossible to say how Shamlal died and Sunder 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 - Fluorine."

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. "

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE OCTOBER 1998 ISSUE THE POISON SLEUTHS DEATH BY ALUMINIUM PHOSPHIDE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young lady today. What happened to her? Please tell me." "Good morning Tarun. The name of this young lady is Sushila, and she was found dead in her bed today morning. It is suspected that her husband gave her something in her food, which took her life. I will tell you some details, which will put the whole crime in perspective for you. She was married to a young boy Suresh only 2 months back. Suresh is a petty clerk in a bank, and it appears that there was a dowry demand in the house, which was not properly catered to, by the bride's side. Because of this there was a lot of tension in the house, and Sushila had complained several times to her parents about it. Now suddenly she is found dead in her bed. It is suspected by Sushila's parents, as well as by the police that Sushila has been given some poison by Suresh and his parents to do away with her." "What makes them think that? Do they have any proof against them?" "Well, the main thing is that there is a very strong motive for Suresh's parents to kill Sushila- dowry. They could get their son married again for better dowry. It seems a reasonable motive. Moreover brides don’t usually die so mysteriously just after 2 months of their marriage, until and unless there is some serious trouble with the marriage." "But it is quite possible that she committed suicide. What makes the police think that it is a case of murder?" "Well it could be. But Suresh and his parents are going one step further. They are alleging that she may have died of some natural disease. In fact Suresh has alleged that she had some gynecological problem about which she once discussed with him." "Really? Did you find any evidence of a fatal disease in her body? And by the way, have you found something in her stomach?" "Tarun, I didn’t find any fatal disease in her body. If she had any of it, like leukemia, or other cancers, or some gynecological trouble, I would surely have found out. I have indeed analyzed the contents of Sushila's stomach and I have found out lot of Aluminum hydroxide in her stomach." "Aluminum hydroxide? Doesn't seem like a poison to me. It is a very weak alkali though. Can it kill someone?" "You are right. Aluminum hydroxide generally doesn't kill a person. But just by it's presence, I have come to know of the poison, which might have been administered to her." "And what that poison is doctor? Please tell me. I am getting curious." "Tarun, it is Aluminium Phosphide, a very dangerous poison. It is available in the market at tablets of Celphos, Quickphos or Fumigant. The last trade name is perhaps quite apt. These tablets are used for killing insects in the grains such as wheat and rice. Generally people buy these tablets and mix them with stored wheat. Insects which would otherwise appear in these grains after some time, generally don’t appear if you preserve the grains along with these tablets." "Oh, I see. I have heard about such tablets. But how do they prevent insects from breeding inside the grains." "Tarun, when Aluminium Phosphide comes in contact with water, or moisture in the air, it liberates a very dangerous gas phosphine. This gas is actually dangerous for the insects, and they can't breed inside the grains. Since you are so good in chemistry, I will give you the exact chemical equation of this chemical reaction. The chemical equation for the liberation of phosphine is: 2 AlP + 6 H2O = 2 Al(OH)3 + 2 PH3 I hope it is quite clear to you. The gas phosphine is liberated and aluminum hydroxide is left behind." "Yeah it indeed is clear to me. Tell me why such a dangerous poison is freely available in the market. I agree that it is such a good fumigant, but keeping in mind its poisonous nature, can't the scientists find some better alternative?" "That's a good point of discussion Tarun. In fact there has been much debate and discussion on this already. But I don’t want to go into that. For the time being I will tell you why they are finding it so hard to abandon it. Aluminum phosphide is commonly used as insecticide, rodenticide and fumigant all over India and even in developed countries. To be sure, there are several other fumigants available, such as ethylene dichloride, ethylene dibromide, carbon tetrachloride mixture and methyl bromide. But only aluminum phosphide is considered as an ideal fumigant over all other fumigants. It has almost all the properties of an ideal fumigant…." "Really? What are those? Please let me know." "Tarun, Aluminum Phosphide is highly toxic to almost all stages of insects with remarkable penetration power. It dissolves well in water, oils and fats. It is considered an ideal seed fumigant since the seeds' viability is not affected and is practically free from residual toxic hazards- provided the seeds contain less than 20% water. It is minimally absorbed and easily desorbed from the treated commodity such as wheat grains. It is non flammable at the prescribed dosage and devoid of tainting on fumigated stock. It has a distinct odor, which has been described as a fishy odor. Because of this and also because of delays in evolving phosphine provide considerable safety in handling this fumigant. Since the tablet generates the predetermined weight of gas, it is very convenient to administer the exact dose. Cost of fumigation is low and its effects on the fumigated stock last longer. It is easy to transport and handle. Treatment is more or less known, so in case accidental poisoning occurs in humans, they can be taken care of. But unfortunately no specific antidote is known. These are all very desirable properties in any fumigant, and all of these are available in aluminum phosphide." "Doctor how can you detect phosphine in the environment?" "Tarun, Phosphine is a colorless and odorless gas, but when it is generated from aluminum phosphide tablets available in the market, generally there are some impurities along with it. Because of this, the gas has a typical garlic odor. Besides the smell, the presence of phosphine can be detected by a simple test. When a filter paper soaked with silver nitrate solution comes in contact with the gas, it turns from brown to black. The usual fatal concentration of phosphine is 200 ppm. After the reaction with moisture, less than 25% of the original tablet weight is left behind from which the amount of aluminum phosphide consumed can be detected." "Doctor, tell me something more about these tablets. I need to know more about them, so next time I see them, I recognize them at once." "Tarun, the tablets are dark brown or grayish in color, 3 g in weight and measure 20 mm in diameter and 5 mm in thickness. They come in an aluminum container containing ten tablets. Aluminum phosphide is also available as 0.6 g pellets. The tablets are composed of pure aluminum phosphide (the active ingredient) and ammonium carbamate/carbonate (the inert ingredient). The ratio of the active and inert ingredient is generally about 56:44. On contact with moisture each 3 g tablet evolves about 1 g of phosphine along with carbon dioxide and ammonia, which prevents self ignition of phosphine gas. This is why it is also called "Protective gas". Carbon dioxide and ammonia are liberated by combination of water with other inert ingredients in the tablets. In fact the main function of the inert ingredients is to produce these gases, so phosphine may not ignite easily. The phosphine gas thus liberated spreads quickly and kills insects and rodents almost in all stages of development. After complete decomposition of the tablet, aluminum hydroxide is left behind as a harmless and non toxic grayish white residue." "And this is what you have found out in Sushila's stomach. So it is almost clear that she died of Aluminum Phosphide poisoning. But how can you prove whether it is a homicidal or suicidal poisoning?" "Tarun, Celphos poisoning is generally suicidal in nature. As I told you earlier, the tablet emits a strange fishy smell. So it is rather difficult to administer it homicidally. It is almost certain, that Sushila took it with suicidal intention. I will give my report to the police accordingly. Of course the police can still register the case as murder under Section 304B of Indian Penal Code. This section defines Dowry death. And this stipulates that the husband and his relatives are responsible for her death if the bride dies from any cause within seven years of marriage, and it is shown that she was harassed for dowry before her death. Of course, to bring Sushila's death under this section, the police would have to work hard, and prove positively beyond doubt that she was harassed for dowry, so I guess, it makes their task that much difficult." "Oh yeah, I am sure, they will be able to do that. This was a most interesting discussion doctor. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison- Argemone mexicana. " Additional notes by readers On April 5, 2001, Sergio Salazar from Nicaragua wrote: In Nicaragua the aluminum phosphide is named "pastilla del amor" -tablets of love- because the suicides ingest these products. I'm a chemist and my job is analytical toxicology in the Instituto de Medicina Legal in Nicaragua. But when there are suicide by phosphine I don't know of any analytical procedure for the detection of phosphine residues. Would you suggest me any methodology? kind regards Sergio Salazar sergio1953@yahoo.com

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JANUARY 1997 ISSUE THE POISON SLEUTHS POISONS, ANTIDOTES AND ANECDOTES -Dr. Anil Aggrawal "Good morning doctor. I have heard a lot about poisons, and unscrupulous criminals killing innocent people with poisons. Could you tell me a little bit about it?" "Good morning Tarun. Sure I would tell you about them. Poisons of various descriptions were commonly used in ancient times by unscrupulous people to kill their enemies. Even today, mere mention of the word poisoning is enough to conjure up in the minds of most people ideas of diabolical infamy. No doubt this is due to what they have read about the subject in history. Numerous killers in the past set out to achieve their evil designs by using poison to dispose of those who stood in their way. The records over the ages are replete with accounts of this kind. By its very nature, poison is premeditated and secret- the real horror lies not so much in those poisonings that are discovered but in those which remain undetected." "Should be exciting to know about such an interesting thing. But first, would you tell me what you call this science?" "Tarun, the study of poisons in all its aspects is known as toxicology. You would be surprised to know that this word has an unusual origin. It comes from the Greek word toxon which means a bow for shooting arrows. The word toxeuma meant an arrow. Since in ancient times, poisons were often used on the tips of arrows to render them more lethal, the word toxicos came to refer to such a poison. From this we get the word toxicology. Of course you would be knowing that the Greek word logos means "the study of" or "the science of". If you combine the two words, you would understand the proper meaning of the word toxicology." "That is certainly interesting doctor. I do recall now that another term for archery is toxophily. So that explains the origin of this other entirely non-related term too." "Sure Tarun. Greek philos means "love of". So the term toxophily literally means "love of arrows". A person who loves archery is often known as a toxophilite. I may tell you that in the year 1545 A.D. a man called Roger Asham published a book called Toxophilus. The intended meaning of the title was “lover of the bow”. Since then the word toxophilite has come to be associated with archers. Another term for poison is toxin, which also has the same origin. Of course, in modern times, we use this word more often in connection with bacterial poisons." “And what is the origin of the word “poison” doctor?” “The origin of this term is also quite unusual. The word comes from Old French puison, which means ‘drink’. The French word itself comes from Latin potio, which has the same meaning. The word drink came to be associated with poison in a very interesting way. Many times in the past, the poison was mixed with drinks. In English, the French word puison entered as poison. This term was initially applied to a drink prepared with a poison. Later, the poisonous substance itself came to be known as poison.” "Good. Doctor, could you please tell me why poisons are so much important in the annals of crime and crime detection?" "Tarun, poison has been called "the coward's weapon". It is administered unemotionally and by stealth, often little by little over a long period, and in full recognition of the victim's often prolonged suffering. Special hatred attaches to the poisoner, who is regarded as more sinister than the gunman or knife-user. The poisoner is thus reviled for his lack of pity. He often kills his victim in cold blood, unlike a gunman who often kills in the heat of the moment. A poisoner carefully plans for the murder, and he knows exactly what he is going to do, and what the result of his deeds would be. It is commonly supposed that female murderers resort more readily to poison and get away with it more readily than their male counterparts. This prejudice probably arises because of the activities of such celebrated historic poisoners as the Marquise de Brinvilliers (1630 - 1676) and Mary Ann Cotton (1833 - 1873), whose murderous ways probably accounted for a collective total of well over a hundred lives. Mary Ann Cotton, thrice married former nurse is regarded as Britain's greatest mass murderer...." "You mean to say that these women killed as many as 100 people among them? That certainly is outrageous." "I haven't finished yet Tarun. An Italian woman of the 17th Century, Madame Giulia Toffana (ca. 1635-1719), invented a strong poisonous mixture in about 1690, and is reputed to have been responsible for as many as 600 killings! She is perhaps the greatest poisoner of all time. Her invention was called Agua Toffana, also sometimes referred to as Aqua Toffana, Aquetta di Napoli, Manna of St. Nicholas di Bari, or Elixir of St. Nicholas of Bari, Bari being a town whose water had healing qualities. Aqua Toffana literally means "the water of Toffana". It was a poisonous liquid containing the deadly arsenic. She sold it to the would-be-murderers who paid well for it and were instructed about its poisonous properties and its potential as a lethal weapon. She was executed at Naples in 1719. After her death Heironyma Spara of Rome imitated and perfected her art. She was a sorceress and fortune-teller by profession, but trained young housewives in the art of poisoning too. Sixty years before Toffana's execution - in 1659, she is said to have formed a society in which she taught women how to murder their husbands by means of poisons. Her influence increased as a number of bored wealthy housewives gathered around her. She was eventually arrested by the Papal police, and as was the custom in those times with poisoners, tortured on the rack. She refused to confess. Nevertheless she was hanged along with a dozen other women, suspected to have been her aides. "Even kings and queens did not refrain from giving poisons. Poisons were given not only to their rivals but also to the poor deliberately just to study their effects on human beings! You may be surprised to know that Catherine de Médici (1519-1589) of Florence and later queen of France tested and carefully studied the effects of various toxic concoctions on the poor and the sick. At this time, France was literally infested with poisoners. The pinnacle of the "poisoners' glorious period" reached in France, in the late 17th century when a woman Catherine Deshayes (1638-1680), also popularly known as La Voisin developed a flourishing trade in selling poisons to wives who wished to rid themselves of their husbands! She is said to have been responsible for the death of many thousands, and could well have been a greater poisoner than even Toffana. La Voisin was burnt at stake in 1680." "This is certainly most outrageous. It is also surprising that even kings and queens revelled in poisoning others!" "You would be surprised that even Popes and their children have been involved in notorious poisonings. The most famous case is of the 15th and 16th century family of Borgias which flourished in Italy. The most notorious poisoners of this family were Cesare Borgia (1476-1507) and Lucrezia Borgia (1480-1519) who dispatched several of their rivals with a secret poison, then known as "La Cantarella". Their name is so inseparable with 15th and 16th century Italy, that whenever there is a mention of this time and location, the name of Borgias immediately springs to one's mind. Most people associate them with murder-by-poison plots. They were the illegitimate son and daughter of one Rodrigo Lenzuoli Borgia (1431-1503), who went on to become Pope Alexander VI from 1492 onwards till his death. He is said to have had five children by his mistress Vanozza de Cattanei, out of which two - Cesare and Lucrezia - proved to be most notorious. La Cantarella, often known as "the poison of the Borgias", was a secret poison and no one seems to know its composition today, but it most probably was a mixture of subacetate of copper, arsenic and crude phosphorus. Borgias were such feared poisoners that a historian, Max Beerbohm has made a very interesting comment about them. At one place he says, that in fifteenth century Italy, though one might have heard a snobbish Roman say, in a would-be-off-hand tone, ‘I am dining with the Borgias tonight’, no Roman was ever able to say, ‘I dined last night with the Borgias.’! Borgias were not only dreaded poisoners, but they had other vices too. For instance, incest is supposed to have been rampant among them, with Lucrezia rumoured to have had sexual relations with her father and brother. Certainly her first husband Giovanni alleged incest between Lucrezia and her father. He was so apprehensive of the whole family that he fled Rome in great terror. In 1501, she brought out a son, then aged three. He was recognized by papal bulls first as the son of Cesare (her brother), and later of Alexander (her father). " "Lucrezia sounds like an interesting character. Can you tell me more about her?" "Sure. In her short life span of 39 years, she married as many as three times. Some historians think that Lucrezia probably never poisoned anyone, but certainly her brother Cesare dispatched several people with poison. She was most probably used by her father and brother to further their own political ends. She married for the first time in 1493 into the powerful Sforza family of Milan. This was just one year after her father was made a pope. However as we have already seen, her husband ran away from Rome in terror. In 1497, her father Alexander annulled the marriage, and in 1498, she married one Alfonso, an illegitimate son of the King of Naples. In 1500, he was murdered at the behest of Cesare. The following year (1501), she brought out a son, and as we have seen earlier, he was three years of age at that time. She married for the third time in the same year (1501); this time to the son of the Duke of Ferrara. This marriage was arranged by her brother. After her father's death in 1503, she retired to Ferrara, where she spent the last days of her life." "How was La Cantarella, the famous poison of the Borgias prepared?" "The recipe sounds quite interesting. It is believed that first of all a hog was killed with arsenic. Its abdomen was opened and sprinkled with more powder, which contained more poisons. Some historians think that the powder contained just arsenic, but it might have contained other poisons as well. The animal was then allowed to putrefy. The juices which trickled from the decaying corpse were collected and evaporated till only dry powder remained. This dry powder was called La Cantarella" "That's remarkable! You said that the Borgias lived in Italy. Were the Italians as skilled poisoners as the French?" "Sure. In fact it were the Italians who developed poisoning to a fine art! You may be surprised to know that in Venice there was a "Council of Ten" who met regularly to arrange poisoning for the State and their written records are preserved. Victims were named, prices agreed and contracts with poisoners recorded. When the deed was accomplished the marginal note "Factum" was written in the record and payments were made, sometimes in the form of a regular pension. The "Council of Ten" appears to have had a number of poisons in their repertoire. Three of them are preserved as the "secreta secretissima" in archives dating from 1540-1544 A.D. Their chief ingredients were corrosive sublimate (mercuric chloride), white arsenic (arsenic trioxide, also known as Sankhya or Somalkhar in Hindi), arsenic trisulfide and arsenic trichloride. So rampant was poisoning in 15th to 17th century Italy, that expert poisoners ran schools for would-be-poisoners, just as there are schools today for medical and Engineering entrance examinations! Even the great Italian Renaissance man Leonardo the Vinci (1452-1519) experimented with poisons." "Really! It seems he didn't leave any area of knowledge untouched. Anyway can you tell me, what those experiments were?" "Leonardo invented the so-called technique of "passages", in which an animal was killed by an injection of poison and the essential organs that had been impregnated with the poison, such as the liver, spleen and lungs were then removed. An extract was prepared from these organs and administered to another animal and the process was repeated. With each "passage" the strength of the poison was supposed to increase. He also studied the procedure in plants. In an effort to produce most innocuous looking poisons such as fruits, he injected the bark of certain fruit trees with potassium cyanide. The idea was that it would rise up along the conducting system and be incorporated in the fruits. The resulting fruit were of course poisonous, but contained only small amounts of cyanide. They had to be eaten for weeks before they could cause death." "Fantastic! Did his recipe manage to kill someone after all?" "Tarun, legend has it that at a banquet in the house of Lodovico Il Moro, fruit from Leonardo's garden was presented to Giangaleazzo Sforza, who was fighting for Italian unity. More fruit was sent to him during the following days, until he finally died of poisoning." "Unbelievable! What about the tradition of poisoning in our own country?" "Tarun, ancient Hindu physicians were very well-versed in the art of poisons. The famous Indian surgeon Sushruta who lived in the 7th century BC defined agadatantra, which is very much akin to the modern term of "toxicology". It dealt with the diagnosis and treatment of any person bitten by poisonous insects or venomous reptiles or affected by any natural, artificial or compound poison. Tradition also tells us that many Indian kings used to have poison damsels or Vish Kanyas in their courts. Legend has it that they were fed on poisons right from their birth, and were thus made so venomous that a mere kiss would prove fatal to her lover. It is said that when Alexander the Great invaded India, King Chandragupta sent such poison damsels to him, in consultation with his minister Chanakya." "It seems to me now that poisons held a kind of morbid attraction for the ancient people and that most ancient cultures revelled in studying them." "You can say that again. Take for example the Egyptians. you may be surprised to know that the earliest documentary accounts of poisons are to be found in ancient Egypt. Three millennia before Christ, Menes, the first of the Pharaohs, is reported to have cultivated and studied poisonous and medicinal plants and to have accumulated animal, mineral, and vegetable poisons. Ebers Papyrus also mentions several of them...." "Doctor, sorry to interrupt you, but what is Ebers papyrus?" "Tarun, it is one of the oldest medical documents available. It was found in the 19th century, between the legs of a mummy in a tomb near Luxor which is a town on east bank of river Nile in upper Egypt. It was advertised for sale, and acquired by Professor Ebers in 1872; hence the name Ebers papyrus. The papyrus is dated about 1550 BC, and it reveals many customs, traditions and practices of the ancient Egyptian doctors. It describes over 800 recipes, many containing recognizable and identified poisons-for example, hemlock, aconite, opium and some of the toxic heavy metals such as lead and antimony. Some of the pharaohs are known to have experimented with poisons, perhaps for practical matters of government and State. Similarly the mythology and literature of classic Greek history also shows a considerable knowledge of poisons. In the Odyssey of Homer, Helen is described as discreetly introducing into the wine of Telemachus and Menelaus a drug that acted as a powerful anodyne. An anodyne as you know is a drug which relieves pain. In Greek legend, Hecate was knowledgeable about aconite, Medea was familiar with the properties of colchicum and Hercules is said to have met his end from wearing a shirt after his wife had impregnated it with poison. The first professional treatment of toxicology begins to appear in various Greek writings in around 3rd to 4th century BC. Thus Theophrastus, who lived from 370 to 286 BC, a pupil of Aristotle, included numerous references to poisonous plants in his work De Historia Plantarum. Nicander of Colophon (204-138 BC) wrote two treatises, which are the most ancient works devoted entirely to poisons. One was on snake poisons, the other on plant poisons, including opium, henbane, poisonous fungi, colchicum, aconite and conium. Nicander divided poisons into those that killed quickly and those that killed slowly and he recommended emetics in the treatment of poisoning, a recommendation which is valid even today." "Doctor, can you tell me how many poisons exist in this world?" "Nobody really knows Tarun. It has been said that anything and everything in the world can act as a poison. It is merely a matter of dose. A drug which acts as a medicine in small doses may act as a poison in a large dose. A striking example is that of common salt. We all take it daily in small doses, but half a kilogram of it can kill a man. That way it also is a poison. Of course, nobody could give common salt to his enemy in such a large dose. In a more accepted sense, the term poison is restricted to those chemical substances which kill in very small doses. The idea of classifying all known poisons has vexed scientists since ancient times. The Greek physician, Dioscorides (AD 40-90) classified poisons under three headings. They were the animal poisons, such as cantharides, toads, snakes, etc; poisons from plants, including opium, hyoscyamus, mandrake, hemlock, aconite, cherry laurel and yew, and mineral poisons, including arsenic, copper, mercury and lead. This simple classification remained in use for many centuries and is still vaguely recognizable in modern classifications of poisons. "I have heard that poisons were used as a mode of capital punishment too." "Yes, you are right. Poisons were used by the ancient Greeks as a means of capital punishment, the best remembered case being that of Socrates who was given hemlock. It was also used as a means of political assassination, though this use was developed on a much greater scale by the Romans subsequently. Thus started the search for antidotes for poisons. In fact it became a practical necessity if the king wished to survive in office." "Doctor, you introduced a new term antidote. What is it?" "Tarun, antidotes are the remedies administered against poisons. The term literally means "give against". It is derived from the Greek words anti or against and didonai, to give. The most famous example of an antidote was that devised by King Mithridates VI. He was king of Pontus in Asia Minor, living from 114-63 BC. The Roman scholar Pliny (AD 23-79) wrote a good deal about him. Mithridates experimented with poisons, trying them out on condemned criminals, and he also tried out various antidotes to the various poisons on these prisoners, either before they were poisoned or immediately after they were poisoned to see whether in fact the antidotes were effective. In this way he discovered various antidotes or what he considered to be antidotes against different poisons and he then compounded them all together in order to produce a universal antidote which could neutralize any poison. Adopting an overcautious approach, he then began taking this supposed universal antidote daily, so that nobody could secretly kill him with poison. It is often stated that the original recipe had more than 36 ingredients; Greek physician Galen (AD 130-200) said there were 54!" "Great! Did this recipe help him finally?" "This has an interesting ending. Eventually Mithridates was defeated by the Roman general and statesman Pompey (106-48 BC) and holed up in his fortress; he massacred his wives, concubines and daughters and he then took poison to commit suicide, but, alas, protected as he was by his daily dose of his magnificent antidote, the poison failed to act! The antidote by this time was known as Mithridatium. Perhaps he failed to die from poison because of this antidote. He had to get his Celtic soldier servant to stab him to death with his sword! After his defeat and death, Pompey discovered Mithridates' notebooks on antidotes for poisons, and so Mithridatium became known in Rome." "And the science of poisons and antidotes moved on to Rome?" "Well, the Roman emperor Nero (AD 37-68) showed a great interest in poisons. Andromachus, one of Nero's personal physicians, improved the formula of Mithridatium and it then became known as Theriac of Andromachus, containing 64 ingredients-and this included the flesh of vipers! For some strange reason, people have always thought that the flesh of vipers is a good antidote to poison. Perhaps this thought arose because the snakes are poisonous yet they do not die of their own poison, so it is rather reasonable to think that the snakes' flesh acted as an antidote. Viper's flesh was a very common ingredient of any antidote that was developed in ancient times. In the course of time Theriac became not only an antidote against poison but also a panacea against all diseases and it was in medical use until the 18th century. To prevent fraud, in many cities, including Venice, Montpellier, Toulouse and Strasburg, Theriac was carefully compounded and prepared in public under official supervision! Even today Theriac jars can be seen in museums. It was only in the 18th century, that a serious challenge was mounted against this antidote. In 1745, William Heberden (1710-1801), one of the most outstanding physicians of London of the mid 18th century published a critical analysis of this antidote. It was entitled Antitheriaka: An Essay on Mithridatium and Theriaka." "Are there some other so-called Universal antidotes too?" "Sure there are. Other universal antidotes which survived for centuries in popular use were bezoars-stomach stones-found in certain animals, particularly ruminants and some varieties of goats. They were probably gallstones. These were first used in the Middle East and they were introduced into Europe by the Arabs, who still have some faith in them in some parts of the Middle East to this present day. These stones were pulverized and put into drinks of wine to treat cases of poisoning, but small stones were also mounted and worn as amulets as a protection against poison. Bezoars were also thought to be very effective against snake bite." "How popular were the bezoar stones?" "Oh, they were very popular - even among the kings and queens! Charles IX of France (1550-1574) was once presented with a bezoar of which he was very proud. Ambroise Paré (1510-1590), French physician and one of the most notable surgeons of the European Renaissance told him that there was no universal antidote, much less the bezoar that he possessed, but so strong was everyone's belief in bezoars, that Charles refused to believe him. Somehow Paré coaxed Charles into conducting an experiment - if somewhat disgusting and gory - to convince him that bezoar was indeed useless. Paré suggested that Charles test his bezoar on a condemned criminal. Charles IX agreed to this happily. He sent for his provost and asked if he had on hand any prisoner who merited hanging, and was told that there indeed was such a prisoner. He was a poor cook who had stolen two silver plates from his master, and he was to be hanged the next day. You may be surprised at such a severe punishment being handed down for such a trifling crime, but it was the order of the day. The cook's consent was taken, who was only too happy to give the consent. He is supposed to have said that he would like much better to die of poison in the prison, than to be strangled in view of the people. And of course there was an outside chance of him being saved by the bezoar, in which case, he would probably have been let off, as a kind gesture. The apothecary was asked to give him a poison, and he duly administered him a strong dose of bichloride of mercury, immediately after which he was given the bezoar stone. The poor cook immediately started vomiting and purging, and so burning was he from the inside that he asked for water immediately. It was given to him. An hour later the cook was on all-fours, going like an animal, his tongue hanging out from his mouth, his eyes and face red, retching and in cold sweat, bleeding from his ears, nose, and mouth. Paré made him drink oil, which was probably a much better remedy, considering the state of knowledge in those times. Oil acts as a demulcent and might have served to prolong his life somewhat. The cook died an agonizing death after seven hours, cursing that he would probably have been better off at the gibbet. The king was so disgusted that he burnt the bezoar - or whatever was left of it." "That might have brought about an end to an era of superstition." "Not at all! So strong was the belief in bezoars that even after this convincing experiment, Charles never lost faith in bezoars; he only thought he had been cheated. To be sure, it was very common in those days to pass of ordinary pebbles as costly bezoars. In fact during the reign of King James I of England (1566-1625), considerable attention was attracted by legal action brought against a goldsmith for having sold a hundred pounds' worth of counterfeit bezoar stones. In any case, the use of these stones did not cease at all; they even spread across the Atlantic! It is known that Governor John Winthrop (1588-1649), first governor of the Massachusetts Bay Colony and the chief figure among the Puritan founders of New England desired a bezoar to use in his practice. He was supplied one by John Endicott (1588-1665), who in turn had procured it from one Mr. Humphry." "Oh, that is certainly most interesting!" "Tarun, then there was another very interesting substance being touted as the Universal antidote. It was the Unicorn's horn. It was supposedly derived from the mythical unicorn. The unicorn, as you surely must be knowing is a mythological animal resembling a horse or a kid with a single horn on its forehead. Unicorn's horn was first described as far back as 400 B.C. by the historian Ctesias. Although the Unicorn as is described in most legends never exists, there IS an actual animal which resembles the mythical unicorn, and that is the Narwhal. Also spelled as Narwal, or Narwhale (Monodon monoceros), it is a small whale belonging to the family Monodontidae. It is found along coasts and, sometimes, in rivers throughout the Arctic. It is mottled gray in colour and grows to about 16 feet long. It has only two teeth, both at the tip of the upper jaw. In the male, the left tooth develops into a straight tusk protruding forward from the upper lip. This tusk grows to about 8 or 9 feet in size - about one and a half times your height - and it was this tusk, which was prized in medieval times as the fabled horn of the unicorn. Interestingly, it is grooved on the surface in a left-handed spiral. Rare males may develop two tusks; females usually develop none. The tusk has no known function; it is believed to have developed as a result of sexual selection. Quite possibly the tusk of a rhinoceros was also being passed off as the Unicorn's horn." "Was the Unicorn's horn as popular as the bezoar stones?" "Oh, certainly! They were being sold for thousands of dollars. A specimen in Dresden was estimated in the sixteenth century to be worth $75,000. So costly was it, that its use was confined to the nobility. Ordinary lay people simply could not afford to buy it. So afraid were kings at this time (of poisoning), that the Unicorn's horn became part of official regal dowry! When Henry II (1519-1559) the king of France , married Catherine de Médicis (1519-1589) in 1533, Pope Clement VII, bride's uncle presented Francis I - the bridegroom's father - with a piece of unicorn's horn. A legend was rife at this time that the unicorn purified poisoned waters with its horn so that other animals may drink. Interestingly it was valued as a remedy despite the fact that the identical substance is in every tooth and is therefore in the mouth of everyone who has any teeth. During medieval France, there was the curious custom among the nobles and kings of dipping the unicorn's horn in any drink before it was taken. Court intrigues were rife at the time, and one was always worried about getting poisoned from some unsuspected enemy. Many would go a step ahead and would drink from a cup made from such a horn! The famous French physician Ambroise Paré tried to abolish this custom, but was unsuccessful. In England, the belief in unicorn's horn as an antidote for poison lasted until the reign of Charles II, when the Royal Society was requested to investigate the properties of a cup made from such a horn. The society reported that the cup was useless as an antidote. Like the bezoars, Unicorn's horn also enjoyed popularity across the Atlantic and it is known that Governor Endicott loaned Governor John Winthrop a horn for use in his medical practice." "Fantastic! Bezoars...Unicorn's horns...Were there other Universal Antidotes too?" "Yes, sure, there were several others. Another interesting universal antidote was Terra Sigillata, a special clay earth from a particular hill on the island of Lemnos. It might have had some value, as clay is quite adsorbent, and it must have adsorbed some poisons. This clay was often formulated with goat's blood to make it into a paste. Like the bezoars and the Unicorn's horn, there was fraud in its sale too. And it was quite easy. Because virtually any kind of clay - which is so easily available - could have been passed off as the real one from the Island of Lemnos. To prevent fraud, this special clay was often prepared in tablets and stamped with a seal, thus giving the substance its name. Later, other sources of similar earth were found in different parts of Europe and in the 16th and 17th Centuries mugs were made of it, from which anyone could drink without fear of poisoning. In much modern times, another formulation has been touted as the Universal antidote, and it was supposed to consist of 2 parts of activated charcoal, 1 part of magnesium oxide and 1 part of tannic acid. It definitely sounds more scientific than the bezoars, Unicorn's horns and Terra Sigillatas, but it is equally worse - probably much more. The reason is that it could be quite easy to convince a scientifically minded person of the uselessness of the bezoars etc. but it takes quite an effort to convince him of the uselessness of such scientifically sounding formulation as the so-called "modern universal antidote". You may be surprised that even in several of today's text books, this antidote finds mention as a useful antidote. Till recently it could be purchased legally from respectable chemists' shops under the trade name Unidote® or Res-Q®. The latter as you can very well see is an interesting take-off from the word "rescue", implying that it would rescue one from every kind of poisoning." "Alright, but what was the idea behind this antidote?" "Tarun, it was thought that charcoal would adsorb many alkaloids, magnesium oxide would neutralize acids without gas formation and the tannic acid would precipitate many of the glucosides and several metallic poisons. But it was all humbug, simply because the ingredients which were included were not the real thing. Burnt toast was included as activated charcoal - which it is not; strong tea was included as tannic acid, and milk of magnesia was included to account for magnesium oxide. Even if actual ingredients were included, it is doubtful if it would have been of any use. This Universal antidote has probably killed more persons that it has saved, simply because it instilled false sense of security among people, who were poisoned. They did nothing except taking this antidote and died. Had they not fallen prey to this false sense of security, they would probably have taken advise from some wise doctor, and would have been able to save their lives." "Oh, certainly. What has been the status of toxicology in modern times?" "Tarun, modern toxicology has emerged from the dark, murky world of secret poisoners, fantastic antidotes and so on. The last 150 years have seen great progress in the analysis of poisons. Today, with modern techniques and instrumentation, the most minute traces of alien compounds can be detected, not only from tissues and organs at post-mortem, but also in biological samples such as blood and urine collected during life. The science of antidotes has also become more scientific. We have moved from the age of Mithridatium, bezoars and Terra Sigillata to the age of physiological antidotes and chelating agents. Several medical journals are devoted solely to the study of toxicology. Toxicology is taken up by several promising young students as their career. It is no longer the murky, shady, crime-infested vocation of the poisoners; instead it has become a true science pursued by brilliant investigators. Toxicology is a promising career for any young scientist." "Thank you doctor for introducing the science of poisons to me. What are you going to tell me the next time?" "Tarun, next time I shall tell you about Arsenic, which has often been called the 'King of poisons'. "

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE AUGUST-SEPTEMBER 1998 ISSUE THE POISON SLEUTHS POISONING BY CADMIUM -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 Kanta, and she died this morning in the hospital. She was a chemistry student and about 19 year old. Yesterday night she took part in a party thrown by Sohan who was her classmate. Three other students also participated in that party, two of whom were girls. So in all there were 2 boys and 3 girls, including Kanta and Sohan. All are chemistry students studying in a local college. At the party, Kanta took some food and some soft drinks. Soon after that she complained of a choking sensation around her throat and excessive salivation. She also had a feeling of nausea and vomited several times, and had diarrhoea too. She was rushed to a local hospital, where the doctors diagnosed that she was suffering from gastroenteritis, a kind of infection of the stomach and intestines which gives rise to these symptoms. It was thought that she had some form of food poisoning. But what was surprising was that the other four students did not have any problem whatsoever. Had they suffered the same symptoms, the death could have been passed off as a natural death due to gastroenteritis, but since all the others are well off, the police has suspected some foul play and has brought her dead body before me. Of course they have requested me to conduct a post-mortem on the dead body and tell them about the cause of death." "Oh, so how are you going to find out the cause? Do you think that there has been some foul play somewhere?" "Well, anything is possible in this world. I contacted the doctors in the local hospital where she was taken, and also went through her hospital case sheet. What caught my attention was that Kanta was suffering from severe aches and pains too. And these aches and pains started only after she drank the soft drinks, and ate the foodstuff at Sohan’s house. I do not know of any form of gastroenteritis where you also get generalized aches and pains...." "So what are you trying to arrive at?" "Tarun, I have made a detailed study of the symptoms which Kanta displayed, and a very unusual poison is coming to my mind as the possible cause of her death" "Doctor, what is that poison? Please tell me. I am getting curious." "Tarun it is a very unusual poison- cadmium chloride." "Cadmium Chloride? Never heard of its being used as a poison. Is it a poison really? "Yeah it is indeed a very deadly poison. If fact its very discovery is related to its toxicity..." "Really? How? Seems like we are in for another of your interesting historical stories." "Yeah, it does make an interesting story. The story starts in the early part of 19th century. Zinc oxide was then widely used for a number of ailments, and was freely available at chemists shops. To ensure that the medicines were not adulterated, the Government of Germany in those days employed district physicians. Their job was to go to chemists’ shops and find out if the medicines they sold were spurious or not. One such physician named Rolow – who was incharge of the province of Hannover - got the reports of toxicity from zinc oxide being sold at local chemists’ shops. From the reports of symptoms, he suspected arsenic poisoning (for details of arsenic poisoning, see Science Reporter February 1997 issue). So he went around from shop to shop, collected zinc oxide samples from the shops and put them to test. One of the standard methods in those times to test for various oxides was to treat them with hydrogen sulphide. This caused various metallic sulphides to form which could be detected from their color. When Rolow treated zinc oxide with hydrogen sulphide, he got a yellow precipitate strongly resembling the sulphide of arsenic. From this he concluded that the samples of zinc oxide were indeed impure- they contained arsenic oxide as well." "So did they really contain arsenic?" "Wait. The local supply of zinc oxide was made by one influential businessman- a man called Hermann. He was also a chemist by profession. He got his own samples tested for arsenic in his own way. He employed all chemical tests known for arsenic at that time and came to the conclusion that his samples did not contain arsenic at all. On the strength of his analysis, he applied to the local authorities, requesting them to restart his supply of zinc oxide to the local chemists’s shops." "So how was this controversy resolved?" "To resolve the controversy, the authorities of Hannover employed the services of a very reputed chemist of those times- Professor Friedrich Stromeyer (1776-1835), head of the department of chemistry at the Göttingen University. The added advantage was that he also held the post of Inspector General of all Hanover chemists’ shops. Hermann’s factory was situated in a place called Schönebek. Samples of zinc oxide were sent from Schönebek to Göttingen where Professor Stromeyer got to work. Quite intelligently first he investigated how zinc oxide was being produced. He found that chemists in Schönebek calcined zinc carbonate to obtain zinc oxide. So he started from zinc carbonate instead, and heated it strongly. To his surprise he got a yellow colored compound. He was expecting zinc oxide, which as we all know is a white colored compound. He asked both Hermann and Rolow to explain that." "Oh, so even the Great Stromeyer was confused, is it?" "Not in the least. On the contrary he gave enough opportunities to both sides to explain their stand before he got to work. Interestingly both sides gave wrong explanations. Hermann explained away the color by saying that the samples contained iron, although it is not known how that explained the yellow color. For him it was better to explain by resorting to something like iron which is a natural constituent of the body, and can do no harm to anyone. Well, to be sure, even iron can be poisonous, but for that it should be administered in very large quantities. Rolow, who was intent on getting Hermann’s factory closed, explained away the color by contending that the samples contained arsenic. After listening to both sides, Stromeyer got to work and discovered a hitherto unknown metal in the samples. It looked very much like zinc, but could easily be separated from it by means of hydrogen sulphide. So much did it look like zinc that Professor Stromeyer preferred to call it Cadmium- after cadmea, a word which in Greek means zinc ore." "Oh, very interesting indeed!" "In fact how the zinc ore came to be called cadmea is in itself an interesting story. Legend has it that a Phoenician Cadmus was the first to have found a zinc rock and to notice that it gave a golden tinge to copper during smelting. It is from his name that zinc ore finally came to be called Cadmea. You may be surprised to know that naming chemical elements was a big fashion in 19th century Europe, becuase new and new elements were discovered almost every year, and it became fashionable to name elements after various Gods, legends, scientists, countries, even rivers. Element Rhenium for instance is named after the German river Rhine! In 1818, when Professor Stromeyer published his paper on Cadmium, many people came forward with the suggestion that they had already discovered that element first and even suggested names for this new element. German chemist Kersten, for instance, suggested that the new element be called melinium (yellow) after the color of its sulphide. Two other scientists Gilbert and John proposed two more names. One of them suggested that it be called junonium (after the newly discovered asteriod Juno in 1804) and the other suggested that it be called klaprothium, after the German chemist Martin Heinrich Klaproth (1743-1817), but ultimately the name given by Stromeyer stuck." "Oh, this is most interesting. Tell me some other important facts about Cadmium." "Tarun, Cadmium is used in a wide range of industrial processes, which include electroplating to impart corrosive resistance to ironware. Cadmium compounds are used as pigments, as components of batteries and photographic materials and cadmium is also used as a plastic stabilizer. Cadmium sulphate in a 1% solution, is a constituent of a shampoo used in the treatment of seborrheic dermatitis and dandruff." "So we were talking about the Cadmium poisoning. How can it occur?" "Cadmium poisoning can occur accidentally in a variety of circumstances. In the 1940s, it was usual for people to have their kitchenware electroplated with cadmium, as this makes them corrosion resistant. In the very beginning, Cadmium coating was deposited by immersing the metallic ware in molten cadmium...." "Sorry to interrupt you doctor, but melting cadmium must be quite a task. That too for just coating metals. Wasn’t it a very costly process?" "No, not at all. Cadmium melts very easily. It’s melting point is only 3210 C. In fact, its such a low melting point makes it a very suitable candidate for making low melting alloys. Among them Wood’s alloy containing 12.5 percent of cadmium was developed as far back as 1860 by a British Engineer Wood. These low melting alloys are used as solders and as the material for delicate and intricate castings, as well as in automatic fire-warning systems. Okay so I was telling you about the cadmium coating on kitchen ware. Later on, the coating was done with the help of electroplating. Unfortunately organic acids, many of which are used in day-to-day cooking such as vinegar (acetic acid), imli (tartaric acid) and lemon (citric acid) can dissolve cadmium from the thin electroplated layer, and this caused several cases of poisoning. In one accident which involved three adults and five children, the source of poison was "lemonade" ices prepared with citric acid in metal trays of a reconditioned refrigerator. All were sick and four also had diarrhoea, but recovery was complete within 24 hours. The citric acid solution contained 279 ppm (parts per million) of cadmium and it was estimated that each ice contained about 3 mg of cadmium. The ill effects resemble those of zinc poisoning. It is thought that the salts formed by organic acids are converted into cadmium chloride by HCl in the stomach. When the cause of these poisonings was discovered, the practice of cadmium electroplating was abandoned. But by no means are the incidences of accidental poisoning by cadmium ceased altogether. As late as in 1981, a case of accidental cadmium was reported. In this case, the victims inhaled fumes from a plated shelf of a refrigerator, used as an improvised barbeque grill!" "Oh, that is certainly most extraordinary!" "Yeah, that is right Tarun. Accidental cases of cadmium poisoning can also occur from cadmium fumes and dust. Cases have been reported where the poisoning occurred in some women who were using a cadmium powder to clean silver. These cases occur especially if the cleaning was being done in small, ill-ventilated rooms. It is interesting to keep in mind that inhaled cadmium is about six times more dangerous than ingested cadmium. Thus poisoning from inhaled cadmium fumes is much more dangerous. We have seen that in earlier times, metals were frequently electroplated with cadmium. Interestingly this practice has given rise to some cases of "delayed" poisoning now. Scrap metal from those times – if cut, dismantled, or recycled today, especially if with the help of oxyacetylene torches – can give rise to dangerous levels of cadmium fumes. Cases of fatal poisoning in such circumstances have been reported. It is important to realize that since cadmium was once used to electroplate metals, and there may be several such metallic objects in an average house, a housefire can give rise to cadmium fumes, and firemen must wear protective masks. There was a time when carbon tetrachloride was used as a fire extinguisher. But when carbon tetrachloride came in contact with hot metal surfaces, it gave rise to the poisonous phosgene (see Science Reporter Jan 1998 "Death by Phosgene"). Cadmium fumes, if produced during these fires were often confused with phosgene gas, and this caused serious blunders in treatment of such poisoned victims. But now since the use of carbon tetrachloride in fire extinguishers has been banned, chances of such graves mistakes are very remote." "This is very interesting. Have cases of poisoning occurred in such circumstances?" "Oh yes. In one interesting incident which occurred in 1956 in a chemistry laboratory in Leeds (Great Britain), some cadmium propionate was being dried in an oven for experimental purposes. This is a safe procedure as long as the temperature does not rise above 1000 C; above this temperature fumes of cadmium oxide and propionic acid are produced. Because of an inadvertent mistake, although the temperature of the oven reached 1600 C, it was read only as 600 C. Because of this, an explosion occurred, followed by a fire, and thick red fumes were seen to be coming out of that room. Four of the firemen, who entered the room to put out the fire inhaled those fumes, and one died after 6 days. On postmortem examination, significant amounts of cadmium were found in his internal body organs." "Oh, I see. Is cadmium found in some of our day to day products too?" "Tarun, Cadmium is found in significant amounts in unfiltered cigarettes, and this can be a cause of poisoning. Twenty unfiltered cigarettes a day can yield 6 mg of cadmium, of which the smoker may retain upto 65%." "Doctor you said that Kanta was suffering from muscle aches and pains and from this you deduced that she might be suffering from Cadmium poisoning. Can you elaborate on that?" "Oh, sure. This symptom is so prominent in Cadmium poisoning that it has even given a name to a disease caused by Cadmium. Let me elaborate. An outbreak of food poisoning due to Cadmium occurred in Japan in 1945. The syndrome has been called itai-itai disease, which when translated in English means ouch-ouch disease. The syndrome has been so called because it caused severe pain in the back and legs (which forced the victims to cry "ouch-ouch" so to say!). In more serious cases, there was decalcification and fracture of bone. Dislocations were also found to occur. For some strange reason, the complete syndrome was restricted to post-menopausal women, who had had several pregnancies. On investigation it was found that a local mine – the Kamioke zinc-cadmium-lead mine – released its effluents (containing cadmium) in the local Jintzu river. The water from this river was used both for drinking as well as for irrigating the local paddy fields. Thus cadmium found its way in the rice grown there as well. Cadmium ingested through intake of water as well as rice caused chronic cadmium poisoning, which was responsible for this syndrome. For the osteomalacia, undernutrition (common in post-war Japan) was also thought to be a factor." "So now it is becoming clear that somebody mixed Cadmium salts in Kanta’s drinks. Tell me has Cadmium been used for murder before?" "Not many times, but I do remember a case which was even reported in The Yorkshire Post of July 23, 1981. In this case two youths aged 14 and 15 administered cadmium chloride mixed in an orange drink to eleven children. They suffered from sickness and blurred vision, but fortunately no one died. The younger boy had strong political views and intended to poison his opponents. They had stolen the chemical from the Humberside Education Authority." "Doctor, you have already told me the symptoms one experiences when one ingests the poison. What happens when one inhales Cadmium fumes?" "Tarun, the initial symptoms and signs are sensation of constriction around the throat, a nasty taste in the mouth, irritation of the upper respiratory tract manifested by troublesome cough and redenning of the eyes. After a latent period of about one to two hours grave respiratory symptoms develop rapidly. Signs of pulmonary oedema (a technical name of a condition in which lungs are water logged) are also seen. The prominent respiratory symptoms are difficulty in respiration, pain in the chest, malaise, shivering and profuse sweating." "Has Cadmium been administered in some other way also?" "Tarun, I know of an interesting case of poisoning by intravenous injection which occurred in Japan. The patient had to be given an injection of calcium bromide, but by a rare accident, an injection of cadmium chloride was given. I may tell you that when Cadmium is given as a poison, the person usually dies in 24 hours, although death may be delayed for 7 to 14 days. If death occurs within 24 hours, the cause of death is shock due to loss of fluids. If the death is delayed, the cause is likely to be acute kidney failure or cardiopulmonary depression (depression of heart and lungs)." "Doctor, you have certainly made most interesting conclusions. Now how are you going to conclusively prove that Kanta was given Cadmium?" "Tarun, I have taken out Kanta’s internal organs, and have tested them for Cadmium. They have all given positive tests for Cadmium. Since it is not a normal body constitutent, it is clear that Cadmium has been given to her by someone. Following this I told police the whole story, and they investigated the death further. But this time they had murder in their minds, so they investigated more deeply. They found out that Sohan had been spurned in love by Kanta, and he wanted to take revenge. He stole some Cadmium Chloride from the chemistry lab, and then invited Kanta to his house. Although Kanta had spurned his love offer, she did not say no to his party as she wanted to continue a clean friendship with him. Moreover he told her that some other friends were coming over too. So there was nothing to be afraid of. When she and other friends arrived at Sohan’s house, he offered them cold drinks, and in the cold drink of Kanta, he mixed Cadmium Chloride. He probably chose this poison as this is such an unusual poison, and he thought that he could get away with that. But he didn’t know that forensic science can catch even the most intelligent of criminals. So even all his knowledge of chemistry could not come to his rescue." "Oh, how very clever of you doctor. If you had not made such an intelligent and logical deduction, Sohan could be roaming in free world today. Criminals like him are very dangerous and should be put behind bars. 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- Aluminium Phosphide. "