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 Science Fiction

OUR VALUED CONTRIBUTORS The following contributors have been kind enough to submit forensic quotes to this ever growing page of Forensic Quotes and Aphorisms. Contributor Clemency, E. Crippin, James (Jamie) Duxbury, Mike Signal45@aol.com Garrison Jr., Dean H. Jain, Vivek Kovac, Peter Porter, Harold J. Rikhari, R.D. Fernando, Gyan Category in which contributed General, Philosophical Witticisms Expert testimony General Autopsy Witticisms Witticisms Arson and fire investigation Forensic science and forensic medicine Autopsy, Autopsy risks, forensic pathologists E-Mail clemency@innocent.com jcrippin@rmi.net MDuxbury@aol.com Signal45@aol.com Gunhand@aol.com vivek@wilnetonline.net kovac@crick.fmed.uniba.sk haroldp@mail.gov.nf.ca rdrikhari@hotmail.com ssu.management-dcc@btinternet.com gyan_f@hotmail.com You may have enjoyed the quotes by these contributors, as well as other quotes appearing on these pages. May be you know more forensic quotes which are funny, hilarious, educative, instructive, stunning, pithy,.....you know what. You know what kinds will impress your colleagues. Click the button to contribute your own forensic quotes. All quotes which are found suitable would be put on the web with suitable credits. If you want, a link can be inserted so the readers can directly contact you via E-mail too. If you are not sure, whether a particular quote appears on these pages or not, send the quote just the same to me, and I will check it for you. I want to contribute my own forensic quotes too!

Discover critical reviews of key books in forensic science, toxicology, criminology, and related disciplines. Curated by experts, this journal guides readers through the most impactful academic and professional titles. ISSN: 0972-9666 (CD version) ISSN: 0972-9674 (Online version Anil Aggrawal's Internet Journal of Book Reviews (Published biannually on the 1st January and 1st July every year) [Anil Aggrawal's Internet Journal of Book Reviews is Indexed / Listed with Academic Search Complete, EBSCO, Gale Cengage, Humanities International Complete, Library Information Science & Technology Abstracts (LISTA) and MasterFILE Premier.] Combined index of all Issues Archives Issue Volume-1 Volume-2 Volume-3 Volume-4 Volume-5 Volume-6 Volume-7 Volume-8 Volume-9 Volume-10 Volume-11 Volume-12 Volume-13 Volume-14 Number 1 January - June 2002 January - June 2003 January - June 2004 January - June 2005 January - June 2006 January - June 2007 January - June 2008 January - June 2009 January - June 2010 January - June 2011 January - June 2012 January - June 2013 January - June 2014 January - June 2015 Number 2 July - December 2002 July - December 2003 July - December 2004 July - December 2005 July - December 2006 July - December 2007 July - December 2008 July - December 2009 July - December 2010 July - December 2011 July - December 2012 July - December 2013 July - December 2014 July - December 2015 (Archived issues can be accessed by clicking on them) IMPORTANT NOTE: ALL REVIEWS APPEARING IN THIS ONLINE JOURNAL ARE COPYRIGHTED BY "ANIL AGGRAWAL'S INTERNET JOURNAL OF BOOK REVIEWS" AND MAY NOT BE REPOSTED, REPRINTED OR OTHERWISE USED IN ANY MANNER WITHOUT THE WRITTEN PERMISSION OF THE WEBMASTER. Book Review Journal (Access the pages by clicking on them.) Aims & Objectives Frequently Asked Questions (FAQs) Reviewers' Panel Interviews Editorial/Reviewer Board Featured Reviews Journal CD Be our Sponsor Anil Aggrawal's Books Cumulative index of Book Reviews Sorted by Publishers Subjects Cumulative Index of Multimedia Reviews (Sorted by Publishers) Books Reviews on Audio Cassettes (Sorted By Publishers) Combined Index of All Issues Editorial's Cumulative Index Cumulative index of Reviews with Quizzes Submit books/journals/software/multimedia for review (Book Review Policy )

Science Fiction The Weird House -Marygold Gupta (Author's Note: This story was written under the pseudonym Marygold Gupta, a female character (she is my wife actually). The story deals with the weird consequences of being present in a four-dimensional universe. According to Einsteinian physics, we live in a 4-dimensional universe; we perceive 3 dimensions as belonging to space, and the remaining dimension as time. Theoretically the space-time dimensions are interchangeable, although in ordinary day-to-day experiences these dimensions remain "fixed" and do not appear to interchange. This story deals with the hypothetical situation when these dimensions interchange frequently. There is no technical flaw in the story, except for the fact that the story assumes that these dimensions interchange very frequently. The consequences are interesting and serve to strengthen the concepts of space-time in people's minds.) **** I should have known I was asking for trouble when I asked Gujral to build a four-dimensional house for me. Well, it all happened like this. I was reading the classic science fiction by Heinlein called "And He Built a Crooked House" in which one Quintus Teal makes a four dimensional house for his rich oilman friend Homer Bailey. Many bizarre incidents occur in this house because of its weird topological properties, which really baffle the mind, till finally one severe earthquake makes it disappear. The incident seemed so interestingly bizarre to me that I myself wanted such a house so I reached Gujral and asked him to built me one such house. "Sure, I can do that but do you know what it means in the first place?" he asked me. "A lot more money than the three dimensional house", I replied naively. "No, no that. I mean the concept of a four-dimensional house." "Sure. Perhaps I can explain you the concept with the help of a diagram. Look, there can be six cardboard squares joined along edges to make a cube. You can cut along seven edges and unfold the cube to make a flat Latin cross". Saying this, I reached out for a paper and a pen and made out a diagram explaining him that I did know what I was talking about. The diagram was like this:- There can be six cardboard squares joined along edges to make a cube. You can cut along seven edges and unfold the cube to make a flat Latin cross He gaped at me in admiration. I continued, "In a similar way, one could join eight cubes at their faces to make a four-dimensional tesseract. Of course lots of engineering skill would go into it to keep some of the cubes getting distorted. If you cut certain of these faces, the tesseract will unfold to make a solid three-dimensional cross of eight attached cubes. In such a house when you pass from one cube - or room to be more precise - to another, lots of weird things happen, because of the peculiar connections of these rooms." While I was saying this, I quickly doodled out the diagram of a three dimensional projection of a four dimensional house. Such a projection is essentially a solid three-dimensional cross of eight attached cubes, much in the same way a two dimensional unfolding of a three dimensional cube shows up as a Latin cross. This diagram appeared like the one appearing to the right. One could join eight cubes at their faces to make a four-dimensional tesseract He studied the diagram and then looked at me in admiration. Finally, to my relief, he said that he would do the job. He warned me though that it was his first job. He had indeed learnt the art of four-dimensional architecture from his visit abroad to Betelguese last year, but lot more could be learnt from actual experience. In a year the house was ready. When I moved in it, I found it really funny. Just the type of house Teal had built. I thanked Gujral and paid him the money. But within a day I found a strange things happening in the house. No clock would move in the house. Watches, clocks, metronomes, all time measuring devices would work alright outside the house but once brought inside the house they would go kaput. When brought out they would start moving again. I immediately rang Gujral. He came over immediately and after examining the house (and all clocks and watches in it) for some time scratched his head and began mumbling something. "What is it?" I snapped. "Rather logical, I would say. Look, we made a four dimensional house and in the process converted the temporal dimension to spatial dimension. Now here we have four spatial dimensions instead of three spatial and one temporal, so you see clocks can't move in this house. You can't eat your cake and have it too." "Keep that to yourself," I broke in angrily,"nothing of that sort happened to Teal's house. You have erred somewhere." "That was fiction madam. This house is for real. Anything can go in fiction. We are talking about the real thing now." he replied. I swallowed that and decided to try the house anyway. But it was hellish without the clocks. I would have to rely on guesswork. Sometimes I would reach office two hours late or sometimes had to wait endlessly for the peon to come and open the office. I got tired finally and asked Gujral to make repairs. "Do something Gujral, but make the clocks move again. I don't mind losing one dimension but do something." "Okay, I will try.", he scratched his head,"Meanwhile what about moving to your original house?" I did that and kept hearing sounds of hammers, chisels and drills working inside the house for a whole month. I didn't have even the faintest idea as to how he was demolishing one dimension. But demolishing he was. That was for sure. Finally I received a call from him informing me that the house was ready and I cold move in. To my great relief the clocks were moving. But another problem seemed to have arisen! When I moved in, I found I was in a circus. Everything seemed flattened like a cardboard. Tables, chairs, almirahs, my books, everything. I looked in a mirror. A cardboard-like figure stared back at me. Even I had been compressed like a cardboard! I was horrified. I rushed to the 'phone and rang Gujral. No need to tell you the phone was compressed like a cardboard. "I will come over", he sounded anxious. I prayed to God he hadn't demolished one spatial dimension in error and made us two dimensional creatures. However, when he came he confirmed my fears. "But what the hell did you do with the temporal dimension?", I asked, after I had heard him. He shuffled his feet nervously. "I don't know what really happened. Let us see what we started with. We had four dimensions, which all appeared as spatial dimensions to us. This is what you wanted, right! One of these was the temporal dimension, which I converted into the Spatial dimension. Now since you wanted your clocks to run, I had to recreate the temporal dimension, which had earlier been converted to the spatial dimension. Since all dimensions looked the same, I couldn't really locate the temporal dimension. It seems I demolished a spatial dimension by mistake and converted it into the temporal one." But that still left us with one unaccounted dimension. One dimension can not just evaporate in thin air. I was wondering what had happened to it. I asked Gujral about it, but he appeared as confused as ever. After he had left I looked at my watch. It was 6.00 pm and it was moving. That was some solace. I went to the kitchen as it was my tea time. When I looked at the kitchen clock I had the shock of my life. It was showing 12.00 noon. It was an automatic clock hung at a considerable height. Nobody could have tampered with it. How could two different watches in my house show two different times? Utterly confused, I rang Gujral again. After a moment's confusion, he blurted out. "Oh, now I get it madam. I probably smashed two dimensions and converted them to two temporal dimensions. That brings back your lost dimension as well. You are now living in a space comprising of two spatial and two temporal dimensions. That's why everything is appearing to you like a cardboard, and the clocks are showing two different times." Oh, go to hell." I said and hung up. (MaryGold Gupta, S-299 Greater Kailash-1, New Delhi-110048, INDIA, Ph: 91-11-6465460; FAX:91-11-5759476)

Forensic Science Fiction

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JULY 1999 ISSUE THE POISON SLEUTHS DEATH BY OXALIC ACID -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a middle age man today. He shows some strange marks around his mouth. How did he die? Please let me know." "Good morning Tarun. The name of this unfortunate man is RadheyShyam. He is about 45 years old. He is living in a slum cluster of Delhi for the last several years. Some years back he was a fairly well-to-do man, but then suddenly his fortunes took a turn and he became quite poor. His wife and children deserted him, and he came to live in a shady slum cluster. He used to pick up odd jobs for his livelihood. He was very much in debt too, for the last so many months." "Oh, so you think one of his creditors killed him?" "I didn't say that. Although the police is investigating along those lines. He had taken about Rs. 25,000 from one Kale over a period of last few months, and Kale was pressing him to give his money back. Radhey Shyam had no means to pay him back his money. Yesterday night Kale had visited him. Everybody in the slum cluster saw him coming to his house and then leave surreptitiously. Nobody thought that he would go to such an extent as to kill him. Radhey's dead body was found in his house today morning. For all intents and purposes, it appears that it is Kale who has killed him." "So he killed Radhey Shyam, when he realized he is not going to get his money back. Perhaps it was his way of telling his other debtors that they must pay up or face dire consequences?" "Again this is the line police is investigating on. The police has arrested Kale and are questioning him. But Kale is swearing he did not do anything to Radhey Shyam. He does admit that he went to Radhey's house, but he simply gave a threat and came back. But police does not agree with his version. As for me, I generally don't give my opinion till I have examined all the facts, and especially till I have done the post-mortem. I have seen some strange things in this case, which tells me that it is probably not a case of homicide, but of suicide." "What makes you think that?" "Tarun, look at the strange whitish streaks running downwards from his mouth. You yourself remarked about them, when you first came here. Do you know what they are? They are in fact corrosion lines generally found when a person drinks acid. And let me tell you, acid is so corrosive, it is almost impossible to give it homicidally. Acid can only be taken by a person who wants to commit suicide. For instance if Kale had wanted to give Radhey this acid, he couldn't have done so, even if he had brought it mixed in some foodstuff, say, milk. The reason is that Radhey would have immediately discarded the milk after just the first sip." "So you think Radhey drank this acid to kill himself. But why would he do that?" "Radhey was upto his neck in debts. So it doesn't seem entirely confounding that he committed suicide. The question is which acid did he drink. And if we can find the half empty bottle of that acid from his house, our work is done. Finding a bottle of corrosive in the house is another proof that Radhey did commit suicide. Had Kale by any chance given him the acid, he would not have committed the blunder of leaving the bottle behind." "Yeah that seems fairly plausible. Which acid did he drink doctor? I am sure that this is an important question for you to answer, because the police as well as the court would be very interested in knowing the answer to this question." "Tarun, I have examined the stomach and kidneys of Radhey. And I have come to the conclusion that Radhey has drunk Oxalic Acid." "What? Oxalic Acid? Doesn't sound like a very common suicidal poison to me. How in the world did he get hold of Oxalic acid in the first place?" "Tarun, Oxalic acid is a constituent of many household products. It is found in many disinfectants, household bleach, metal cleaning liquids, antirust products and furniture polish. Its chemical formula is (COOH)2. Oxalic acid is a crystalline, colourless substance which is efflorescent. This means that it tends to become powdery on account of loss of water of crystallization. Its solubility is 1 in 12 in water. It is called Oxalic acid, after Greek "oxalis", which means sorrel. It occurs in the sorrel plant, and because of this the French chemist Lavoisier, in 1787, named it Oxalic acid." "Oh, that is really very interesting. Does it occur in other plants too?" "Oh yes. It occurs in the leaves and young stalk of rhubarb (Rheum rhaponticum), spinach and even cabbage. I must tell you that sorrel is a succulent acid herb used in salads. Accidental poisoning has been known to occur after a hearty meal of rhubarb or sorrel. Food rich in oxalate can also lead to kidney stones, because kidney stones are generally made up of oxalates." "Oh, that is really very interesting information." "Tarun, crystals of oxalic acid are similar in appearance to those of magnesium sulphate - also known as Epsom salt- and zinc sulphate. Because of this similarity, cases of accidental poisoning have occurred. Magnesium sulphate in doses of 15 g is used as a laxative, and is non-toxic. Since oxalic acid - a dangerous poison - is so similar looking to Epsom salt - a commonly used drug - it is necessary to be able to differentiate between the two. If the doctor or the nurse fails to differentiate between the two, accidental poisonings may occur. You may be interested to know that two patients at a mental hospital in Scotland died in 1956 after receiving doses of oxalic acid administered in mistake for Epsom salts. Zinc sulphate is also a commonly used drug. It has been used in such skin diseases and infections as acne, ivy poisoning, lupus erythematosus, and impetigo. Don't worry about the confusing disease names. What I want to impress upon you is that even zinc sulphate is a commonly used drug, and whenever a commonly used drug looks very similar to a dangerous poison, it becomes very necessary to be able to differentiate between the two." "So how do doctors differentiate between the two?" "Well, if you taste a small amount of crystal of each, oxalic acid is sour in taste, magnesium sulphate is nauseatingly bitter and zinc sulphate is metallic bitter. But surely, this is not the best of the methods to find out a poison. The reaction of oxalic acid is strongly acidic, that of zinc sulphate is slightly acidic, and that of magnesium sulphate is neutral. On application of heat oxalic acid sublimes while the rest of the two salts remain fixed. When you react each salt with sodium carbonate, oxalic acid shows effervescence, but no precipitation, while the other two salts show no effervescence, but a white precipitate. But perhaps the easiest test is to see if stains of ink or iron moulds disappear by a solution of one of these salts. While a solution of oxalic acid makes the stains disappear, the other two salts can not do that. In fact, that is why oxalic acid is used in products like ink removers and furniture polishes. Oxalic acid, as I have already told you, is used in households as a bleach to remove stains or to clean metals, notably brass or leather, and also in calico-printing. It was widely used when the straw hat industry flourished, during 1880-1910. Potassium oxalate is also used to remove ink stains and to cleanse metals. Solutions of oxalic acid and oxalates should never be left unguarded, since the colourless, and odourless fluid may readily be mistaken for water. However the taste is sour as I have already told you, so an unsuspecting person may take it, but would be quick in discarding it." "Can oxalic acid be used for homicide?" "No Tarun, that is not possible. That is why I think Kale is innocent. Because of its sour taste, it has not been used for homicide very much. Oxalates have however been used to procure abortion by vaginal injection. This is done by quacks who are approached by unmarried girls who have conceived due to premarital relations. But I may tell you that now no girl needs to contact such quacks. Now the law allows even unmarried girls to approach a properly qualified doctor in a government hospital to have an abortion done." "Doctor, how does oxalic acid affect the human body?" "Tarun, oxalic acid has both a local, and a systemic action on the body. By local action, I mean the action of stomach and intestinal walls with which it comes in contact. By systemic effect, I mean remote effect on organs with which it does not really come in contact. Oxalic acid readily corrodes the mucous membrane of the digestive tract. Unlike corrosive mineral acids and alkalies - like hydrochloric acid, sulphuric acid and nitric acid, oxalates do not lose their poisonous properties when diluted. On the contrary, dilute solutions of oxalates, can cause grave systemic effects. Oxalic acid however rarely damages the skin." "So these are the local effects of oxalic acid. What are its systemic effects?" "Large doses of oxalic acid can cause death due to shock. Oxalates can readily combine with the calcium ion in the body tissues, causing a precipitous fall in the level of ionized calcium. This can cause muscle irritability, tetany and convulsions, and irregular action and slowing of the heart. I may remind you that all muscle cells in the body are very much dependent on calcium for their proper functioning, and it includes heart muscle too." "Yeah I do know about that. Doctor, what are the signs and symptoms of oxalic acid poisoning?" "The symptoms of oxalic acid poisoning are modified by the size and concentration of the dose. A large concentrated dose would kill within a couple of hours by shock or hypocalcaemia, i.e. lowering of calcium levels in the blood. A large dilute dose would cause kidney failure. Depending on the size and concentration of dose, the clinical picture may vary. Fulminant poisoning occurs when a large concentrated dose of about 15 gms or more is taken. This is actually the lethal dose of oxalic acid. The clinical picture is dominated by gastrointestinal symptoms. There is immediate sour or bitter taste, associated with a burning sensation in the mouth, throat and food pipe because of the corrosive action of oxalic acid. Agonizing pain in the epigastrium, which soon spreads all over the abdomen associated with tenderness is seen. There is eructation, distension of abdomen, thirst, nausea and vomiting. The vomitus has a "coffee ground" appearance, because oxalic acid badly corrodes the stomach walls. There may be bloody vomiting for the same reason. Finally shock supervenes and death occurs. Acute poisoning occurs when a moderately large dose is taken and in such cases, the survival is upto 48 hours. The clinical picture is dominated by symptoms due to hypocalcaemia rather than due to gastrointestinal upset. These are muscle irritability, tenderness, tetany, convulsions, numbness and tingling of the finger tips and legs, cardiac irregularity, slowing of the heart, ventricular fibrillation (irregular and fast beating of the ventricles of the heart). In some patients, oxalates may have a narcotic effect. Delayed poisoning may occur when a smaller dose is taken. The clinical picture is characterized by symptoms of renal failure and uraemia. Death occurs in 5-14 days. I may tell you that the fatal dose of oxalic acid is about 15-20 gms, and the fatal period is 1-2 hours." "Doctor, in the case of Radhey, how exactly did you make out that it was a case of oxalic acid poisoning?" "Tarun, my first lead was given by these strange streaks running downwards from the angles of the mouth. Burns of the skin are actually quite rare in oxalic acid poisoning. Corrosion of the mucous membrane of the GIT, starting from lips is common. There is whitening or yellow-white discoloration of the lips, lining of the mouth, and upper surface of the tongue. The mucous membrane of the mouth gives an appearance similar to scalding. This is exactly the picture that I saw in Radhey Shyam. Then I got curious and did the post-mortem. I was very much interested in seeing his stomach. The lining of the stomach in oxalic acid poisoning is blackened by the production of acid haematin. There may be superficial corrosion. The stomach may contain fresh or altered blood. Furthermore, crystals of calcium oxalate can be demonstrated in scrapings of the stomach mucosa. Radhey Shyam's stomach showed all these findings, and I even could chemically demonstrate oxalic acid crystals sticking to his stomach mucosa. The kidneys of a person dying of oxalic acid poisoning are congested and swollen with oedema. The tubules contain oxalate crystals. The renal tubules are necrosed, which in plain and simple terms means that they are dead. I could demonstrate oxalic acid crystals even in the renal tubules of Radhey. I am sure it is a case of Oxalic acid poisoning. Lo and behold, here comes the policeman with the half empty bottle of Oxalic acid from Radhey Shyam's house. I had earlier sent him to Radhey Shyam's house to look for oxalic acid bottle. Now it is clear that it is a case of suicidal poisoning by oxalic acid. The police will now not harass Kale and would release him from custody." "Oh yeah, I am sure, the police will 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- Digitalis. "

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

< Back To Main Page. LinkedIn WhatsApp X (Twitter) Facebook Copy link Anil Aggrawal's Book Review Journal Volume-15 Number-1 (July -December) Book Review (Technical Section) Basic Sciences as applied to Forensic Medicine and Toxicology by Anil Aggrawal Publisher: Arya Publishing Company, India (1st edtion) Pages: XVIII + 301 Publication Date: 2025 ISBN: 9789360590864 Language: English Read >

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

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

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