Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE SEPTEMBER 1999 ISSUE THE POISON SLEUTHS DEATH BY YELLOW KANER -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a very young girl today. What happened to her? Please tell me.” “Good morning Tarun. The name of this six year old girl is Radha. Her father is a Secretary to the Government of India, and fairly well-to-do person. He had only one child. Yesterday she was playing along with her friends under a tree in a park near her house. The time was around 4 pm. There were about 5-6 other boys and girls with her. They were apparently fine when they were playing. Suddenly Radha started vomiting. She had diarrhoea too. She was rushed to the hospital, where the doctors thought she was having gastro-enteritis, and she was being treated along those lines. The doctors also noted some additional symptoms. I have talked to the doctors who treated her. And they say that they noted clamminess of skin, coldness in extremities, dilation of pupils, sunken eyes and delirium. The pulse was slow and feeble in the beginning, but later it became fast and irregular. After a few hours she had convulsions, then paralysis, and finally death. She died at about 8 am in the morning today." "Oh, that is most terrible doctor? Why do you think she died? Did she die of any natural disease? Or did she die of infections such as gastro-enteritis?" "Tarun, it doesn't look like natural death to me. The symptoms are pointing towards a poison which affected her heart. So probably we are talking about some heart poison here. I have gone to the place where she was playing, and I was surprised to see that there were lot of Yellow Kaner plants in the garden where she was playing. These plants are known to botanists as Cerbera thevetia or Thevetia peruviana. In normal everyday parlance, they are known as Pila kaner or be-still tree. I am inclined to believe that either she took the seeds of that plant by mistake, or somebody gave it to her on purpose.” “That’s most preposterous. I have seen Kaner plants growing along the roads, but I never believed it was such a dangerous poison” “Oh, sure they are poisonous. The yellow oleander or be-still tree is a native of tropical America and is now widely cultivated as an ornamental shrub in tropical and subtropical regions of the world, including India. It is a small shrub with milky sap. Leaves are evergreen, alternate, ribbon like, about 6 inches long, 3/16 to 3/8 inch wide, dark and glossy above and pale beneath. Flowers are more or less fragrant, funnel form, yellow or peach-colored, rarely white, 2 to 3 inches long and to 2 inches wide, the five lobes spirally twisted and not spreading. Fruit is somewhat diamond-shaped -distinctly so in cross section. It is about one and half inches wide and 5/8 inch thick. It turns from green to yellow; then the thin layer of flesh becomes completely dehydrated, the skin becomes black and wrinkled and disintegrates, exposing the bony, light brown, attractive stone, which contains two to four flat gray seeds. The sap of the plant may cause skin inflammation in sensitive individuals. Chewing the bark or seed kernel causes a slight numbing sensation and a feeling of heat in the mouth, and purging. Ingestion of a toxic dose causes burning in the mouth, tingling of the tongue, dryness of the throat, headache, vomiting, purging, excitement followed by drowsiness.” “Sounds like a very dangerous plant to me. Are all parts of the plant poisonous? Also please tell me, which poisons are found in this plant?” “Except for the thin layer of flesh covering the stone, all parts of the plant are poisonous, especially the seeds, which contain 3.6 to 4 per cent of the cardiac glycoside thevetin. This toxin is one eighth as potent as ouabain and very similar to digitalis in activity, about which we have talked last time. Also present are thevetoxin (C30H46O10), similar to but less toxic than thevetin; neriifolin (C33H61O30) more potent than thevetin in action on cat heart; peruvoside (C30H44010); and also ruvoside (C30H46010). There has also been reported a bitter principle that acts on the central nervous system and produces tetanoid convulsions.” “Doctor, how much portion of the plant can cause death in a human being?” “Nothing is positively known about the fatal dose in human beings, although experiments have been done on animals. Fifteen to twenty grams of dry leaves are fatal to the horse; lesser amounts are fatal to cattle. Since such fatal experiments can not be conducted on human beings, our knowledge of the fatal dose of Cerbera thevetia depends upon actual cases of death which have occurred following its ingestion. A single seed has caused death in a child; 8 to 10 seeds in an adult. About 5-10 leaves of the plant are also said to be fatal. The root is very poisonous.” “Oh, I see.” “Tarun, this plant is a very popular ornamental in warm regions of both hemispheres, especially in dry coastal areas because of its resistance to drought and salinity and because it is not eaten by goats and cattle. It is often planted in numbers as a hedge. Grazing animals instinctively avoid this plant, and that is why this is a very popular plant as a hedge in India. Besides India, it is also found in other parts of the world. It is occasionally seen in the southern half of Florida and California, is very common in the West Indies, Latin America, Africa, and the Orient. In the Hawaiian Islands it has been declining in popularity with the realization that it is the most frequent local cause of human poisoning. The fruit flesh is eagerly consumed by chickens and is casually eaten by humans in Ghana and Queensland. The handsome stones, after polishing, are worn as pendants, tied together as rattles, or strung with other seeds in necklaces. Many myths and legends are associated with this plant. In the West Indies, the stone is carried in the pocket in the belief that it will ward off hemorrhoids. In East Africa, it is put in the hand of an infant at birth as a good luck token. Quantities of the seeds have been exported from Hawaii to the mainland of the United States for extraction of thevetin as a substitute for digitalis, but 40 per cent of the patients receiving this drug have suffered gastrointestinal disturbances. Indian scientists believe the more recently discovered peruvoside holds greater promise in cardiac therapy. In Africa, the seed kernels are occasionally chewed to cause purging. In the Philippines, half of one leaf is given as an emetic and purgative. The sap and bark have been utilized in small amounts to treat malarial fever as well as to induce vomiting and purging, but overdoses have caused paralysis and death. The sap has been applied to sores and ulcers, also to tooth cavities and decayed teeth to relieve toothache. It is said to cause the teeth to disintegrate. In Brazil, the seed is taken as an abortifacient. In Indonesia, immigrants from India have been seen to dry and smoke the leaves. The toxicity of the plant has been generally known since the sixteenth century. Its Sanskrit name "Ashwamarak" is translated as "horse killer. Early European explorers in tropical America reported that the Indians used the seed for homicidal purposes. In India, the seeds are commonly employed for suicide and homicide, and in Bombay they are used for killing cattle. They have poisoned pigs in Queensland.” “Looks like a very interesting plant to me. Have there been cases of poisoning with this plant before?” “Several cases of Yellow Kaner poisoning have been recorded in India. In 1900, a woman in India took two seeds in a suicide attempt. The following day, she experienced vomiting, purging, pain in the throat, headache, and fainting spells alternating with drowsiness. Her pupils were normal; heart action was weak and pulse slow. She recovered after three days of treatment. In November 1962, a four-year-old boy in Poona, India, swallowed a seed at 6 P.M., vomited 15 to 20 times, was hospitalized, was found very restless, with sunken eyes but normal pupils, dry tongue, and cold extremities. An electrocardiogram showed severe abnormalities. The following morning diarrhea occurred; on the second day the pulse became irregular, and it remained so for 36 hours. Treatment was continued for eight days; then the child was discharged with normal pulse and heart action. Some interesting cases have come from Queensland, Australia. In one case, a 3-year-old girl played "tea parties" under a yellow oleander tree in her backyard. She later developed persistent vomiting, sweating and bradycardia. Cardiac arrest occurred during her transfer to hospital and she could not be resuscitated. Another young girl was "dared" by her brother to eat the fruit of the yellow oleander. She did, and later developed severe vomiting and a variety of cardiac arrhythmias which persisted for three days before she recovered. In southwest Africa, two European children were poisoned by eating the seeds, and one died in six hours. In Southern Rhodesia, a death occurred two hours after ingestion of one seed." "Looks like this plant has really caused deaths! In this case doctor, how are you going to prove to the court of law that this child died of Cerbera thevetia poisoning?" "Tarun, I have examined her stomach, and have found remains of some leaves which look very much like Cerbera thevetia leaves. This is a very strong indication that she was given the leaves of Yellow Oleander to eat. I did not stop at that. I examined the extracts of her heart muscle and it demonstrated the presence of poisons found in Thevetia leaves or fruit. This is ample proof for any court of law to assume that Radha died of Yellow oleander poisoning. Actually when I saw Kaner plants growing in the garden nearby, I got suspicious. I thought that there might be some foul play involved in this. I found out that the father of this girl, one Mr. Sharma, had sacked one of his juniors Katkar about a year before, and since then Katkar held a grudge against Mr. Sharma. I may tell you that Katkar was a fairly intelligent man, and in his college, he had studied botany and chemistry with keen interest. Apparently he was aware of the poisonous nature of the Cerbera thevetia plant. He wanted to get even with Mr. Sharma very keenly. He had observed that there were Cerbera thevetia plants in the nearby garden, and that Mr. Sharma's only child Radha used to play there. On that fateful day, he came to the child and somehow coaxed her to chew those leaves. I really don't know what he told to the child, but her friends who were playing at a short distance away are saying that they did see Katkar talking to Radha, and Radha subsequently chewing the leaves of Kaner plant. You might think that it is very silly for a child to listen to such strangers, but you must keep in mind that a six year child does not have much judgement of her own. She apparently chewed some leaves on Katkar's insistence and that was the cause of her death. Come, let us tell the police to catch Katkar, because it is he who is responsible for her death. "That was very clever of you doctor. Without your clever deduction everybody would have thought Radha died of some mysterious natural disease. This was a most interesting discussion doctor. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison. You would normally think it to be a vitamin, essential for growth, but it is a very dangerous poison too. I will talk about Vitamin A next time."

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE MARCH 1999 ISSUE THE POISON SLEUTHS DEATH BY DIESEL FUMES -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a old man today. What has happened to him? Please tell me." "Good morning Tarun. The name of this old man is Shyam. He was a big industrialist and was about 83 years old. His dead body was found today morning at about 9 am in his Ford saloon car. This car was parked in his garage. I may tell you that this car was fitted with a diesel engine." "So how do you think he has died?" "That is what I have to find out. But police has a suspect with them, and they think that he has killed Shyam. Well, let me begin from the beginning. Shyam had a business associate Sohan Lal. Both Sohan and Shyam had been working together for quite some time. However lately they had fallen out over some monetary matter. Sohan is a relatively young man - only about 48 years old. The police has interrogated many persons who knew both of them, and all of them have told the police that Sohan did not have good relations with Shyam. The things had deteriorated to such an extent that on one occasion, Sohan had even threatened Shyam with dire consequences." "Oh, I see. It does appear that Sohan has a hand in Shyam's killing." "Shyam Lal lives alone in his big mansion. His wife died about two years back and his only son is settled in Netherlands. He comes to India only occasionally. Rarely a guest comes to his house to spend a night with him. So for all practical purposes Shyam Lal lives alone in his house. Shyam Lal used to remain quite depressed after his wife's death, and it appears he had lost all will to live, especially as his only son had also left him. Two days before, i.e. on Saturday evening Sohan invited Shyam Lal for dinner. He came to Shyam Lal's house in his own car, parked it at his house and from there both of them drove to a 5-star hotel in Shyam Lal's car. It was somewhat surprising to Shyam, but he thought that probably Sohan wanted to settle matters with him, and so accepted his invitation. They had their dinner and returned quite late - at about 12 midnight. We know these details because the police has made thorough inquiries from the hotel staff. Shyam Lal was not seen on whole of Sunday, and on Monday morning, i.e. today his dead body has been found in the garage in his car. So the presumption is that Shyam Lal died just after his return from the hotel. I have made some preliminary examination of the dead body, and from the various changes seen in the body, I am also of the view that Shyam Lal died somewhere around 1 am on Sunday morning, i.e. just about one hour after return from the hotel." "So what do you conclude from all this?" "Well, the police has come up with an interesting story. According to them, Sohan mixed some poison in his food surreptitiously when they were having dinner together. He came with Shyam Lal back to his house. There he left him, collected his own car from his residence, and drove away. Shyam Lal was already feeling weak from the effect of the poison Sohan had given him. He wanted to get some rest. But just as we was parking his car in his garage, he fainted and dropped dead within his car. His body was only discovered today." "So what are they waiting for? They must immediately arrest Sohan." "They have already done that. But Sohan is swearing he didn't mix any poison in Shyam's food. He says that he did want to patch up things with Shyam, and for this purpose he had invited him for dinner. But from the talks it appeared to him that Shyam was reluctant to his proposal. They had talks for about 2 hours after which Sohan came back to Shyam's house, bade him good bye and went to his own house. He does not know what happened to Shyam Lal after that. However the police are reluctant to believe his version. They are holding him, and interrogating him more severely, so he could come out with the truth." "What do you think doctor?" "Tarun, a forensic pathologist goes only by the evidence that he has with him. I am a forensic pathologist and I won't form any theories merely from the details of circumstances. From the circumstances, it does appear that Sohan has a hand in the death, but I would make my deductions only from the hard scientific facts that I have seen for myself. I went to Shyam's house and made some preliminary observations. The first thing that struck me when I was examining the car was that, a hose pipe was connected to the interior of the car from the exhaust..." "Sorry to interrupt you doctor, but how is this observation important?" "Tarun. It is a common method of committing suicide. Carbon monoxide is known to emit from all car exhausts. Many persons - especially in the western countries- close themselves in a garage along with their car, run the engine of the car and simply wait there till the level of carbon monoxide rises enough to kill them. The attraction of this method among suicides is that it is a very painless death, and all persons wanting to commit suicide want a painless death. A hosepipe going to the interior of the car from the exhaust means an arrangement had been made to let the carbon monoxide come inside the car." "But doctor, these days most cars are fitted with catalytic converters. I believe such an advanced car as the Ford saloon, in which Shyam Lal's body was found must definitely be fitted with a catalytic converter." "You are right Tarun. Catalytic converters convert carbon monoxide to relatively non-toxic carbon dioxide. This has not only enabled the carbon monoxide levels in the atmosphere to go down, but also reduced the risk of suicides substantially. Now anyone who makes this arrangement for the purpose of committing suicide is likely to fail. The reason is that carbon dioxide is not as deadly as carbon monoxide. In fact, if you read medical literature, you will find many instances of failed suicides because of these catalytic converters." "Oh, I see." "Tarun, with the coming of new vehicles on the Indian roads, there is now an apparent progressive increase in diesel-driven motor vehicles in all forms of road transportation. Diesel is a commonly used vehicle now and it is believed to be safer than petrol as diesel fumes contain substantially less carbon monoxide. However their emissions are still potentially toxic. Diesel engines emit more than twice the amount of sulphur dioxide than that contained in petrol emissions. They also emit 14 times the amount of black smoke, i.e. particulate materials, than of petrol engines. Diesel emissions also contain marginally more nitrogen dioxide than petrol. Petrol, as I told you earlier, however creates more carbon monoxide - 28 times to be exact- than diesel." "Oh, I see. So if someone wants to commit suicide in the manner you just described, probably he is better off with a petrol engine than with diesel engine?" "You are right Tarun. The reason is obvious. Petrol engines create substantially more carbon monoxide. Of course only those petrol engines would do so, which are not fitted with catalytic converters. I must however tell you that both fuels cause acute toxicity if substantial quantities of their emissions are inhaled. However the mode of toxicity would be different. Whereas petrol engines cause death by carbon-monoxide poisoning, diesel fumes cause death by blocking the air passages with soot and other material in the emissions. The absorption of toxic materials in the latter case is increased owing to the blockage of tiny lung alveoli by the soot particles. These soot particles effectively plug the alveoli, thus "holding back" the toxic fumes within the alveoli. This greatly enhances the absorption of toxic substances. Thus although diesel fumes do not contain much carbon monoxide, they can still be very harmful." "Doctor, have you found any evidence that Shyam Lal died of diesel fumes?" "Tarun when I examined Shyam's heart, I found that the coronary arteries - the arteries that supply the muscles of the heart - were blocked to a great extent. However the amount of blocking was not sufficient to cause death, so I looked at other organs for more clues. The interesting finding was that the windpipe (trachea) and the bronchi were thickly covered with soot. The lungs were very much congested, which meant that they had been exposed to some irritating substance like diesel fumes. But what clinched the diagnosis in favour of death by diesel fumes was the fact that there were thick beads of black oily sticky material in the smaller bronchi. When I cut the lungs and pressed the cut ends, these thick beads of oily materials could be expressed. These beads were nothing but toxic material -including some diesel fuel- in the lungs. To see if the blood had any carbon monoxide in it, I did a toxicological analysis of the blood too, and found that there was less than 5% saturation with carbon monoxide. This indicates that there wasn't a substantial amount of carbon monoxide in the fumes that Shyam Lal inhaled. It is almost sure that Shyam Lal died of diesel fumes." "Oh, that is interesting. So would you reconstruct the events for me doctor?" "Sure. On Saturday evening, the talks between Shyam Lal and Sohan failed and this sent Shyam Lal again into a bout of depression, which he was already suffering from. He came back to his house and probably decided to take his own life. He had already lived a full life, his wife was no more there and his son was living far away from him. On that day, probably he lost all will to live. He was an educated man. He had read about deaths by carbon monoxide. I personally feel that he intended death by carbon monoxide. But it was a diesel engine, which does not emit carbon monoxide. He ultimately died of diesel fumes. Come let us tell the police that Sohan is innocent and they should release him." "Very clever indeed. This was a most interesting discussion doctor. Without your masterly deduction, police could have unnecessarily went on harassing Sohan. People might have thought, it was a case of killing by Sohan. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about death by arsine gas. "

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Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE JANUARY 1999 ISSUE THE POISON SLEUTHS DEATH BY SODIUM NITRITE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a young woman today. Her whole body seems to have a chocolate brown color. I remember last time too, I had seen a dead body with chocolate brown color. Did this woman also die of the same poison? Please tell me." "Good morning Tarun. The name of this young woman is Radhika, and she is about 25 years old. She died in her flat at about 9 am today morning. She was a junior executive in a private firm here in Delhi, and was living alone in this flat. Her family members are living in Jaipur. She was living here solely for the purpose of this job. Her parents were looking out for a match for her marriage." "Oh, I see." "Yesterday night she was fine. In fact, she met one of her neighbors Shyamala -also a 25 year old girl- at about 9pm, and she tells us that she was perfectly in good spirits. That rules out suicide...." "Wait a minute doctor. If a person is in good spirits and cheerful a day before his or her death, does it rule out suicide? Is it not possible that she was trying to mislead the neighbors by being cheerful so that nobody gets to know her intentions?" "There are other indications too. There is no suicide note. Generally a person who commits a suicide, leaves a suicide note." "Oh, I see" "Well, the police interrogated Shyamala more about her as she was the only one, who knew Radhika very well. She told the police that she (Radhika) was in love with Chaman, a 26 year old colleague in her office. Recently she had become pregnant by him, and she was pressing him for marriage. However Chaman had lost interest in her, and was trying to avoid her. Only 2 days back she had threatened him to go to his parents if he did not agree for the marriage. Chaman's parents are very religious and God-fearing, and he knew if she approached them, they would force him to marry her. To settle matters he came yesterday to Radhika's flat at about 7 pm. Shyamala knows because when he came, Radhika called her as a mediator. Shyamala tells the police that Chaman was looking very tense and jittery. She thought it was because he had such a difficult matter to resolve. Anyway she just sat there for about an hour. When she saw that the matter is going to take more time, she left the house making an excuse. When she left, Radhika was just preparing to go inside the kitchen to make tea for everyone. She offered Shyamala to go after having tea, but she just left. She however saw Chaman leaving Radhika's house only about 15-20 minutes later. She was sitting idly at her window when she saw him. He looked to be in great hurry." "Oh, I see. So did you find anything in the post-mortem that corroborates what Shyamala is saying?" "Yes, I found a 4 month old male baby inside Radhika's uterus, which definitely tells us that she was pregnant. I have kept the tissues of this fetus for his DNA profiling, which will tell us definitely if Chaman was his father or not. More about that later. What interested me was the color of her body. I told you last time (See SR December 1998 issue) that there are certain poisons which can cause methemoglobin to form inside the body. It is this compound which imparts such color to the body. Well one of such poisons is sodium nitrite. I got a hint that she might have died of sodium nitrite poisoning when I went to her flat and saw that she had unfinished breakfast on her table. She was in the habit of having a full meal in the morning itself. She had prepared Dal and Roti and must be eating it. And it was lying there unfinished. Nearby I could see some dried vomitus on the floor. Obviously when she was eating the food, she must have got sick and must have vomited. I saw a salt cellar on her table which was open. I got quite curious, when I glanced underneath the dining table and found lot of white salt like powder spilled over there. As a poison sleuth, I don't want to take chances and intuition told me there was something either in the salt cellar or in the powder spilled over the floor that we were looking for. So I quietly kept the salt cellar in my pocket and also some of the powder spilled over the floor underneath the dining table. I examined both these substances in my lab. And do you know what I found?" "What? Please tell me doctor. I am getting curious." "Tarun, I had the most extraordinary finding in the salt cellar. It had a substance looking like salt but it was not sodium chloride. It was sodium nitrite. And the salt like powder which was spilled underneath the table was nothing but sodium chloride. Do you get the picture now?" "Well, not really. I don't understand how such a curious thing happened." "To me it is clear like glass. Obviously someone replaced the salt in the cellar with sodium nitrite. And before doing this he spilled the salt underneath the table to empty the cellar so he could fill it with the poison he had brought with him. The only commonly available poison which looks and tastes like salt is sodium nitrite" "Really? Doctor I am getting curious. Please tell me more about sodium nitrite." "Tarun, as I told you earlier, sodium nitrite causes methaemoglobinaemia; even small doses of sodium nitrite can kill within a few minutes. Even the nitrates can be dangerous. Organic nitrates in fact are reduced to nitrites in the intestine. Inorganic nitrates, bismuth subnitrate excepted, are not normally reduced to nitrites in the body, but this may occur when the upper digestive tract (stomach and upper part of small intestines) is infected with nitrate-reducing bacteria, e.g. Escherichia coli. Inorganic nitrates are irritants of the stomach and, in large doses, potassium nitrate is a diuretic. A diuretic is a chemical which increases the production of urine. Poisoning by nitrites is actually not very common. It can result from mistaking this salt for common salt or Epsom salts." "Doctor, under what circumstances can sodium nitrite poisoning occur?" "Tarun, poisoning can be homicidal, accidental or suicidal. With sodium nitrite, accidental poisoning is probably most common, although homicidal poisoning is also possible as we have seen in the case of Radhika. One of the earliest reports of sodium nitrite poisoning came from Middlesborough, UK in 1936. Two adults and their daughter aged five were suddenly taken ill after the midday meal. The adults died before a doctor could reach them and their daughter died shortly after her admission to hospital. It appears they had complained to neighbors of acute abdominal pain and vomiting. Their faces went blue. Investigation showed very similar results to what I found in Radhika's case. A basin of cooking salt and a salt cellar contained sodium nitrite; the upper layer in the latter was of 98% sodium nitrite and the lower layer 98.2% common salt. Unconsumed food contained sodium nitrite, e.g. cabbage 6.5% and Yorkshire pudding 4.5%. The gastric contents of the man contained 4.275 g and those of the woman contained 1.284g of sodium nitrite. Over a gram of the poison was present in the child's vomit. The vomit of the adults was not available for analysis, but presumably they had ingested considerably more than remained in their stomachs. The source of the poison was not determined, but the man had had access to sodium nitrite in the course of his employment. Nobody knows how the mix up happened. Probably someone filled up a half empty salt cellar either intentionally or mistakenly with sodium nitrite." "Oh, that is most extraordinary and bears an eerie resemblance to the case we have on our hands." "Yeah sure. Accidental deaths due to the ingestion of sodium nitrite used in error for common salt in the preparation of soup have also occurred. Several such accidental deaths have been reported. Death in these cases occurred within a few minutes following symptoms which included nausea, headache, vertigo, urgent vomiting, profuse diarrhoea and cyanosis (bluing of the skin). Stomach contents in most of these cases contained sodium nitrite ranging from 1.74 to 84.0 mg/kg of the gastric contents. There was a more consistent concentration in the organs, e.g. in the liver, where the concentration was between 3.0 and 4.35 mg/kg. A quarter of a litre of the soup in most of these cases contained l.5 g of sodium nitrite. I must tell you that the fatal dose of sodium nitrite is from 1 to 2 g. I have already explained you the concept of fatal dose (see "Poisoning by Thallium" SR, October 1997)." "Yes doctor, I do remember you having mentioned it." "In another case, eleven men were poisoned after eating oatmeal seasoned with sodium nitrite in mistake for common salt. The men added more salt from salt shakers later shown to contain sodium nitrite. Immediately after the meal they felt sick and vomited. There was dizziness and abdominal cramps. They went blue and five lost consciousness. Methaemoglobin was later demonstrated in their blood. One of these men, aged 82, died the next morning; his organs had a diffuse brown colour. The source of the poison was nitrite used to cure meat. Only eleven of 125 persons who ate of the oatmeal were affected and these eleven had used contaminated salt shakers of which one contained 0.137% of nitrite. It was estimated they had taken at least 163 mg. In yet another case, a boy aged two months suddenly went blue, 'almost black', after his 7.0 am feed. Sodium citrate had been prescribed for the relief of indigestion and two tablets had been added to the feed. When seen in hospital, about five hours later, the appearance of the child simulated those of congenital heart disease; he was neither distressed nor febrile. A diagnosis of toxic methaemoglobinaemia was made and the remaining tablets, fortunately available, were subjected to analysis. They proved to contain 65 mg of sodium nitrite each. The infant, therefore, had ingested 130mg, the maximum dose for an adult. There are a host of other such cases of which I am aware." "Doctor please tell me a few interesting ones out of these." "In one case, two children aged two and three months respectively took feeds to which from 35 to 40g of sodium nitrite had been added in error for sodium citrate. The elder infant died. Cyanosis and blackening of the mouth were outstanding features. In another case, a boy aged two years vomited while playing with his elder brother aged nine. After a second vomit he was given a glass of water to drink. Vomiting continued and he was taken to hospital. He was deeply cyanosed, collapsed and crying with spasms of pain. Poison was taken out from the stomach with the help of a tube and oxygen was administered, but the child died at about three hours after being poisoned. Sodium nitrite was detected by analysis of his stomach contents. There was methaemoglobin in the blood. It is probable that the boy had ingested and absorbed appreciably more of the poison. The source of the poison in this case was a bottle of sodium nitrite, now nearly empty, which the elder boy had brought for the purposes of a chemical experiment. The dead child had licked the bottle. I must tell you that sodium nitrite is highly soluble in water and its taste resembles that of common salt and that is what makes it such an attractive homicidal poison. Interestingly sodium nitrite is used in machine oil also as a corrosion inhibitor, and deaths have occurred when someone accidentally drank machine oil. There is a case of a girl on record who died in this way. She was eleven years old, and drank a mouthful of machine oil accidentally, some of which she immediately spat out...." "Just a minute doctor. I think sodium nitrite is an oxidizing agent, and if I remember my chemistry alright, corrosion is an oxidative process. Then how can nitrite be used as a corrosion inhibitor?" "Tarun, sometimes oxidizers are also reducing agents. Such is the case of nitrite, which can be further oxidized to nitrate. I must tell you that the tendency of nitrite to act as an oxidizer is increased in an acid environment such as that found in the stomach. At higher pH levels its oxidizing potential is greatly decreased. Corrosion can be inhibited by using a sacrificial reducing agent such as nitrite. Sodium nitrite is also commonly put into packaged foods like meat to keep oxidation from happening. So I was telling you about that little girl. Within an hour she was unconscious and deeply cyanosed. Fortunately she recovered after proper treatment. Analysis showed that the oil contained 36.5% sodium nitrite, 7.5% of an emulsifying agent and 56.0% water. Her stomach washings contained 7-8mg/ 100 ml of sodium nitrite." "Oh, that is certainly most extraordinary!" "Tarun, sodium nitrite poisoning has happened in other ways too. Poisoning by well water drawn from badly constructed wells near farmyards may contain an appreciable amount of nitrate which makes it unfit for drinking and a source of poisoning newborn infants. This illness is however rarely fatal. About 30 cases are on record and only one, it appears, was fatal. It is apparent that the risk is only to infants of under 90 days old, who live in rural communities..." "Doctor, can boiling the water make such water safe? I have heard that boiling the water makes it cleaner." "Yes boiling the water does make it free of infective micro-organisms, because they get killed by boiling, but when the water is contaminated with a chemical substance, it gives no protection whatsoever. On the contrary, it concentrates the nitrates, which can get concentrated upto 3 times on boiling the water! Older children are unaffected, probably because they can tolerate the amount of nitrate likely to be present in their normal fluid intake. It does appear that poisoning in these circumstances is not dependent only upon the amount of nitrate ingested· It has been suggested that poisoning by nitrate will only occur in those whose gastric juice exceeds pH 4.0 and when nitrate-reducing bacteria are present in the upper digestive tract." "Doctor, this is a most extraordinary fact that you have told me. Can you tell me what is the concentration of nitrites in such contaminated water coming from wells?" "The contaminated water, usually drawn from shallow wells, of not over 75 feet deep, usually contains over 20 ppm (parts per million) of NaN03. Methaemoglobinaemia (the existence of too much methemoglobin in the blood) does not normally occur unless the water contains 30 ppm. The upper limit of nitrate should not exceed 10 ppm because as I told you earlier, if boiled the water could be concentrated threefold and thus to a dangerous concentration. Even cows which feed on beet tops rich in nitrates develop methaemoglobinaemia. This is known as the condition of 'purple' cows and is well recognized. Purple is the color the cows get when there is lot of methemoglobin in their blood." "Oh, this is most extraordinary." "There are more interesting facts Tarun. Nitrite poisoning from spinach has also occurred. During 1959-65 in Germany there were 15 cases of nitrite poisoning in infants, aged two to ten months, who had eaten spinach. Nitrite and the remains of spinach were found in the stomach contents of one of the infants. Two factors were responsible. First, the excessive use of nitrate fertilizer, which should not, but often did, exceed 80 kg/hectare. Second, bacterial activity converted the nitrate in spinach into nitrite. Samples of spinach, fresh, frozen and tinned, showed a nitrate contamination of from 40 to 2100 mg/kg. The risk arose when the feed was prepared in advance and stored overlong at room temperature. Even after cooking, a sufficient number of bacteria remained to produce nitrite. The maximum nitrate content of spinach should not exceed 200mg/kg. It has even been recommended that during the first three months infants should not be given spinach." "Doctor, such an interesting poison must have caught the fancy of suicides also. Have there been cases of suicidal poisoning too with sodium nitrite?" "Yes, sure. Suicidal poisoning with sodium nitrite has also occurred. A medical practitioner, aged 51, committed suicide in 1942 by ingesting sodium nitrite. He had been mentally ill for some time. On the night of his death he awoke his son, a medical student, and told him that his mother had suddenly been taken ill during the night. A doctor was summoned and while he was attending to the woman a bump was heard in the passage. The deceased was then found lying on the floor; he died within five minutes of his fall. Poisoning was suspected, but a search revealed only a glass of brandy and another which appeared to contain water. Toxicological analysis demonstrated 2g of sodium nitrite in the gastric contents. The blood was 'dark'. Unfortunately no analysis was made of the brandy or water, otherwise I am sure they would have found nitrite in the brandy. The deceased had given his wife some of the brandy during the night and this may have been the vehicle of poison responsible both for her illness and his death. I feel he first gave brandy laced with nitrite to his wife and then consumed the poison himself, but of course it is only a guess. But sure enough, it is possible to kill someone by lacing his or her drink with as little as 2 grams of sodium nitrite. It was believed that the poison was taken within an hour prior to his death. It was suggested by the relatives that he had died of a heart attack, but the doctor said that he had died of nitrite poisoning." "Oh, doctor. We could go on and on with such interesting stories. Tell me how you can prove Radhika died of nitrite poisoning?" "Tarun, I told you I examined both the contents of the salt cellar as well as the powder spilled over the floor. Now I will tell you what happened. Chaman came to Radhika's house not for reconciliation, but for killing her. He was sure, killing her was his only way out. He got sodium nitrite from a chemistry lab. We have still to find out, how he got hold of it, and who gave it to him. He came fully armed with this poison in a packet. When Shyamala left and Radhika went inside the kitchen to make a cup of tea, he quickly picked up the salt cellar, spilled the salt in it on the floor underneath the table and refilled it with the powder that he had brought. He knew that sometime she would consume the contents of the salt cellar thinking it was salt and she would die. It was no doubt a very clever plan, but thankfully we could catch it. The color of Radhika's body at once told me we were looking for a poison which produces methemoglobinemia, and that was Chaman's undoing. I have found an appreciable quantity of Sodium nitrite from Radhika's stomach contents, and to top it all, the police has found some left over sodium nitrite from Chaman's house too. Initially he denied having any hand in Radhika's death, but when he was told of all the medical and circumstantial evidence against him, he broke down and admitted his guilt." "Very clever doctor. This was a most interesting discussion doctor. Without your masterly deduction, Chaman could never have been caught. People might have thought, it was an accidental death. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about a very interesting poison. You may not have even thought that it was a poison. I will tell you about death by Potassium Permanganate."

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

Forensic Toxicology THE FOLLOWING ARTICLE APPEARED IN THE FEBRUARY 1999 ISSUE THE POISON SLEUTHS DEATH BY POTASSIUM PERMANGANATE -Dr. Anil Aggrawal "Good morning doctor. Oh, my God, what are you doing today? You have the dead body of a middle aged man today. The corner of his lips seem to be stained with some dark black substance. What has happened to him? Please tell me." "Good morning Tarun. The name of this middle aged man is Sagar, and he is about 45 years old. He died in the hospital today morning. Yesterday night, he was having his dinner when suddenly he developed a burning pain in his abdomen. He had nausea and vomiting too, and the vomited material contained some brown material. He complained of intense thirst too. Because of this, the was brought by some of his neighbors to the hospital. But while the doctors were still investigating, he died today morning. Now since the doctors had not arrived at any diagnosis, the police has handed over his body to me. They want me to tell them, how Sagar has actually died." "So what are you going to do now?" "I have taken a detailed history from the police. The police tells me that Sagar was a builder, and he was running a very successful business. He however had business rivalry with a person called Nath. Apparently his business endeavors had caused great losses to Nath. Nath however kept visiting him often and posed as if he was his friend. Deep in his heart however, he wanted to get rid of him. Yesterday Nath visited him in his house for the New Year celebrations and gave him a bottle of red wine too for celebrations. Sagar was a sucker for red wine, so immediately after Nath left, he started consuming the red wine. However I am told that before Nath left, Sagar treated him to some very nice champagne from his own stock. But after Nath left, Sagar opened the wine bottle and emptied it in no time. After that he started having his dinner, but soon he started having all those symptoms." "Oh, I see. Looks like there was something in the red wine, which caused these symptoms. Is it?" "Probably you are correct Tarun. I became suspicious when I saw these dark stains on Sagar's face. You also noticed these stains, didn't you? Furthermore, the inside of his mouth and foodpipe were also stained. From these and certain other post-mortem findings which I am going to tell you later, I could zero down only on one poison....." "What is that poison doctor? Please tell me." "Tarun, it is a very rare poison. You probably never even imagined it is a poison. It is potassium permanganate or KMnO4." "Really? Yes, I never believed Potassium permanganate could be a poison too. In fact as far as I know, it is used to treat certain poisonings." "You are right Tarun. In certain poisonings, such as poisoning by Opium, potassium permanganate solution indeed is recommended. Doctors actually wash the stomach with this solution, because potassium permanganate oxidizes the opium. Similarly in many other poisonings, doctors wash the stomach with potassium permanganate solution. But unfortunately permanganate acts as a poison too. In fact about 10-20 g of potassium permanganate is enough to kill a person." "Is it? Oh, I think, we are on the trail of yet another interesting poison. Doctor please tell me more about Potassium permanganate (KMnO₄)?" "Tarun, potassium permanganate is a common substance, and it may be acquired without restriction by members of the public. Yet poisoning by it is uncommon and although in the case of Sagar we are probably facing a death due to this substance, in fact fatal poisoning by KMnO4 is rare. This must not cause its danger to be overlooked or underrated. Children in particular must be protected against the ingestion of colored crystals which may be eaten in mistake for sweets. In fact, I am personally aware of a child aged about 22 months who died after eating some permanganate crystals which his father used for gardening. Tablets of KMnO4 are still on sale in the USA and as Condy's tablets in Australia. In India too, this substance is not difficult to acquire. You may be surprised to know that KMnO4 has been used for illegal abortions." "Really? How??" "Potassium permanganate is an irritant substance. It irritates the uterus too, and may cause it to expel its contents. This has made the use of KMnO4 very popular in illegal abortions. Some women simply ingest it, while some make its solution and introduce it in their uterus through the vaginal route. Some women simply introduce crystals of KMnO4 in their vagina in order to procure abortion. The insertion of tablets of potassium permanganate into the vagina to procure abortion first came to notice in Spain and Italy during the 1930s. The practice spread to the USA in about 1936. This practice was noticed in England during World War II. It was thought that this 'new way to miscarry' was introduced to England by American servicemen, and indeed the tablets of KMnO4 were being hawked outside the local antenatal clinic of several doctors! You may be surprised to know that the mothers of newly married brides often regarded a box of these tablets as an appropriate gift to their daughters on the eve of their wedding!" "Oh, that is indeed most interesting. Probably it was because proper methods for abortion had not been developed by then?" "No, proper methods for abortions were there, but unfortunately abortion was not legal in most countries at that time. For instance in India, abortion became legal only as late as 1971. Before this time, if any married or unmarried woman became pregnant, the only way for her to have an abortion was to resort to such dangerous "household" methods. Although abortion has become legal in most countries, yet this practice has not yet have been abandoned in most of the countries. The reason is that most unmarried girls - for fear of society's censure - still don't want to disclose they have fallen pregnant. They prefer to do it themselves by these dangerous methods. They learn of these methods from their friends, acquire KMnO4 from somewhere and then try it out on their own. This has caused several deaths too. Douching with potassium permanganate is also very common..." "What is douching doctor?" "Women make a solution of KMnO4 and then with the help of an appropriate instrument, push this solution into their uterus. The douching may be done with intent to procure an abortion or only for hygienic reasons as KMnO4 is supposed to be an antiseptic. If however, the solution is too concentrated, it can have dangerous and probably fatal consequences." "Oh, I see. Has it been used for some other illegal activities too?" "Yes, potassium permanganate has been used to produce fictitious injuries. A trick is often employed by soldiers to simulate the lesions of tertiary syphilis by applying a tablet of permanganate to the skin for 10 to 20 minutes..." "Doctor what is tertiary syphilis? And what do you mean by lesions?" "Tarun, syphilis is a venereal disease which spreads by sexual contact. It affects the victim in several stages. Tertiary syphilis is the last stage of this disease, which commences several years after the sexual contact with an affected partner. By lesions, I simply mean the various abnormal and harmful changes which occur because of disease. A peculiar lesion in tertiary syphilis is a perforating ulcer of the feet. Such a lesion can be produced by applying potassium permanganate on the feet for several minutes..." "But why would a person want to produce such a lesion?" "Many persons want to simulate disease in order to get medical leaves. This trend is very common in the Army, where getting leaves is very difficult. Such people who pose that they are ill, yet are not, are called malingerers. A case of a soldier has been described who swallowed a solution of permanganate to simulate 'coffee ground' vomit. Such kind of vomit is usually seen in gastric ulcers. So probably this soldier wanted leave on this ground." "Oh, that is most interesting. Has it been used for other illegal activities too?" "Well, not for illegal activities, but certainly for some dangerous activities. For instance potassium permanganate solution was used at one time, notably during and after World War I, as an irrigant of the urethra and bladder in the treatment of gonorrhoea. The reasoning behind it was the same - it acts as an antiseptic." "Doctor, you told earlier that KMnO₄ is used for stomach wash in certain poisonings. Does it not kill the patient then?" "Tarun, when KMnO₄ is used for stomach wash, it is used in a solution of the strength 1:5000. It acts as an irritant in higher concentrations - about 1:1000. I may tell you that from the color of the KMnO4 solution, a rough idea can be made about the concentration. When the solution has a faint pink colour, the concentration is about one part per million. When the concentration rises to 1 part in 76,000 (65 mg/4.5 l) the fluid becomes purple. Because of its color, the solution has been used for staining also. Those who use the chemical as a stain for flooring and woodwork, working with a concentrated solution, must exercise care. Deep staining of the skin of the hands is immediate and prolonged contact can cause damage to the skin. There was a time when permanganate was used to dye white hair a chestnut brown." "Oh really?" "Yes, and I can tell you certain other interesting facts about permanganates too. Permanganates are normally stable in crystalline form but zinc permanganate can become explosive. In fact, storing it in tightly stoppered bottles can be highly dangerous. When handling these containers one should exercise utmost caution." "Doctor, do you think Nath mixed Potassium permanganate in something which he gave to Sagar?" "Yeah, looks like. Remember he gave a bottle of Red wine which Sagar immediately consumed after he left. Potassium permanganate can be easily dissolved in red wine because the colors of both are similar. Moreover the taste of red wine would mask the taste to potassium permanganate. Furthermore, Nath ensured that Sagar was not completely in his senses by having some drinks with him in his house. He knew that after he left his house Sagar would consume the red wine, and he would get severely poisoned." "Doctor, has Potassium permanganate been used for homicide often?" "Not really. It has more often been used for suicidal purposes, but accidental poisoning also occurs, notably in children under the age of four years, who usually mistake the red colored crystals for sweets. Adults, however, have taken the poison by mistake. A solution of permanganate may easily be mistaken for wine. And as I already told you, in the past it occasionally caused poisoning when taken orally as an abortifacient." "What is an abortifacient doctor?" "Tarun, abortifacient is a drug which causes abortion. Another popular - although wrong - belief is that it is a remedy for amenorrhoea. Amenorrhoea means absence of menstruation. Normally a girl should start menstruation at about the age of 13 years, but if the menstrual cycle does not start, the condition is known as amenorrhoea. Ideally when faced with such a symptom, a woman should contact a doctor, but many women prefer to treat themselves by folk remedies, and potassium permanganate is one of the folk remedies for amenorrhoea. Pills containing 65-130 mg of potassium permanganate, taken shortly before the expected period are supposed to cure the condition." "Doctor, what symptoms does the person get when he ingests potassium permanganate?" "Tarun, the symptoms are exactly as seen in Sagar's case. Staining of the tissues is very obvious. Some patients may have brown stains on the face, in linear form running down from an angle of the mouth on to the chin as you have seen in Sagar's case. The eyes and face may be stained if crystals fall on to the face. It is more usual to find discoloration of the interior of the mouth. If seen soon after poisoning the colour is purple-brown, but within minutes this changes to brown or dark brown and, later, following the formation of manganese dioxide, it may be coal black. A slight metallic lustre may also be apparent. I have seen Sagar's food pipe and it is coal black from the inside. This is a very clear indication that he had ingested potassium permanganate. I may tell you that potassium hydroxide is a product of the action of permanganate on the tissues, so corrosion of the foodpipe and stomach may be present. It is however superficial. The lips, gums, teeth, tongue, tonsils, pharynx, and the upper end of the larynx are all likely to be discoloured, inflamed and superficially corroded. This is especially severe at points where any crystals may lodge inside the mouth or throat. Occasionally, crystals may be seen on the lips, inside the cheeks or at the back of the throat and in the piriform fossae, especially when unusually deep." "What are the piriform fossae doctor?" "Tarun, the word piriform comes from the Latin pirum which means a pear. These are deep pear shaped pockets on either side of the pharynx. They are present at just the point where the pharynx ends and oesophagus starts. These pockets are at the sides. In fact any swallowed object - like pins for instance - is likely to get entangled in these pockets. If crystals of KMnO4 get lodged in piriform fossae, they can corrode these areas. Burning pain from the mouth to the pit of the stomach occurs soon after the ingestion of permanganate. Nausea and vomiting are not long delayed and the latter may become intractable. The vomit contains purple-brown or brown material which may be mistaken for altered blood from a bleeding peptic ulcer, i.e. 'coffee ground' vomit. Fluid loss by vomiting may cause intense thirst. A number of the patients experience difficulty in speaking or swallowing; this may persist for several days. About half of the patients complain of epigastric pain and tenderness. This may be accompanied and exaggerated by distension of the abdomen. The stools are black due to manganous sulphide. Potassium permanganate can come in contact with the air passages and when it does that, it provokes severe swelling of the air passages. Irritation of the trachea and bronchi leads to difficulty in respiration, and a persistent, spasmodic cough. Any sputum produced may contain dark flecks. A lethal dose, e.g. about 20g, usually kills in from 20 to 90 hours. When potassium permanganate is introduced into the uterus death may occur in only 12 hours." "Doctor, I have known enough about potassium permanganate to interact intelligently with you. Now tell me how you are going to convince the court positively that Nath killed him by giving KMnO4 in red wine?" "Tarun, I have got the wine bottle seized, and I have analyzed its washings. It has shown traces of KMnO4. How could KMnO4 come in a wine bottle? Obviously someone had put it there. And who else except the one who gave the bottle to him, and that too his business rival. Moreover I have found all the changes in Sagar's body, which are found in deaths due to KMnO4. As I told you, the changes produced by potassium permanganate are essentially those produced by an irritant and mildly caustic poison, but distinguished by brown-black staining of the tissues. I have found the staining of tissues in Sagar's case all over - over his face, inside his mouth, foodpipe and stomach. All these organs show congestion too, which is seen in ingestion of irritant poisons like KMnO4. I have also analyzed the contents of his stomach and I have found KMnO4 there as well. This is enough evidence to nail Nath. Come, let us tell the police to arrest Nath at once. He should not escape the legal net." "Very clever doctor. This was a most interesting discussion doctor. Without your masterly deduction, Nath could never have been caught. People might have thought, it was an accidental or perhaps a natural death. Tell me what are you going to tell me the next time?" "Tarun, next time, I would tell you about death by diesel fumes." "

Forensic Science Fiction The mysterious old man (one) I met him at a party. He was surrounded by a few friends and they were all laughing their heads off. No doubt the booze was showing its effect. The party was entering into its second phase- phase of loosening inhibitions. People would take off their masks during this phase and would show them as their real self. The man whom I am going to talk about, had a sort of magnetism around him. He was about 5'10", lean and thin, with a thick white hair, a goatee and a glowing face with wrinkles just appearing. From his looks he appeared to be no more than 50, but being a medical man I knew he had crossed sixty. I found myself drifting towards him. The party looked up at me. Everyone except him knew me. "Come on Dr. Aggrawal", said one of them,"Meet Mr Quatra her. A company executive." "Dr. Aggrawal. Professor of forensic medicine", I said and thrust my hand forward. He took my hand in both of his and pumped them till I thought he wanted them pulped. His hands seemed unusually warm. "Quatra here. Working with Jaykay exporters." There was an aura of mystery around him. From his looks, I could guess he was an unusual man. I am not sure what made me think that. Probably an intuition only. I looked again at him. No, I couldn't be wrong. This man had an ace up his sleeve. What? "Gentlemen! Now I am going to demonstrate something special to you", Mr. Quatra said. There were some groans around. Then some one said,"No card tricks for God's sake. We have had enough of that. Everyone seems to be demonstrating that in the recreational session of the party" "Bring me a glass of water", he said, completely ignoring the comment. This engendered some curious looks around. A waiter was passing around with a tray of drinks. Someone picked up a glass of whisky and thrust it towards him. "No, not alcohol. It could be dangerous. I want just plain water". Plain water was brought. The old man put the glass of water on the table. Then he looked around with an aura of mystery and then declared, "Gentlemen, I am going to boil this water without any heat whatsoever" Again there were may groans around. Then someone said, "Okay, Okay, we have seen enough of that vacuum business. You simply create some kind of partial vacuum somehow, and since water boils at a lower temperature in a partial vacuum, it begins to boil at the room temperature" "No, not that at all. That is high school physics. The thing I am going to show you is unexplainable. This is real magic; or perhaps mystery you can say. Definitely it does not involve any science trick." "Okay show it to us," Goldie said, pouting her beautiful breasts in a low cut blouse forwards for everyone to see. She was perhaps disconcerted that people had started taking more interest in that wrinkled old man than her frontal eminence. "Gentlemen, I am going to dip my hands in this water", said Mr Quatra, completely ignoring what the young lady had to offer,"and you will all see, it would become warmer." "Okay go ahead you stuntman", I said to myself,"You can't make it warmer than 370 C, the temperature of the human body. I would be damned if you do that." He dipped his right hand in water and then closed his eyes as if in meditation. After about a minute, he asked me to dip my index finger in the glass of water. I found the water somewhat warmer. But skin temperature is only around 300 C. If the water was even at, say 340 C, it would appear warmer to everyone. No magic whatsoever. He continued for some more time and then asked someone else to dip his finger. He immediately retracted the finger in amazement. "It's warm, very warm!" he exclaimed. "Fools!" I thought, "He is keeping his hand long enough till the water comes to 370 C. Water at this temperature would seem warm to any human being, for the simple reason that skin is at a lower temperature. Water is getting the heat from his blood. Not so easy to do for every human being however. May be he has done some practice and can apparently do it with much ease." After 2 minutes he invited me to dip my fingers in it again. I advanced my fingers to the bowl quite nonchalantly and dipped them deep inside the bowl. Immediately I had to jerk them out. The water was unbearably hot. I found myself sucking at my fingers. Soon fumes started appearing at the surface of water. Everyone of us had had enough of that. We asked him to stop. With a victorious grin, that almost reached his ears, he took off his hand, and mopped it with a handkerchief. "Can you give me your card?" I asked him, still dazed. "Sure" he dished out his visiting card from his wallet. After that he left quietly. (Two) A battery of tests conducted on him showed some unusual results. Thankfully, next day when I had 'phoned him and had asked him if he could make himself available for some lab tests, he readily agreed. Radiographs of the blood vessels of his right hand (after injecting a radio opaque dye in his brachial artery) showed an unusual rich network of arteries there. That was one reason why he could bring so much warmth in his right hand. Still, causing water to boil? That couldn't be explained. For a whole week I couldn't sleep. My friends at the party asked me to forget the incident. "People can do a lot of things with yoga" they said. But I shook them off. Finally I called him one day. "Mr Quatra", I said," I want to take a few cells from your hypothalamus. Would you allow me to do that? It is a small area of the brain sitting at the base of the skull. I would use the nasal route. Don't worry. Nothing would happen to you. With advanced techniques available now, I would just pick up about fifty odd cells which is about one millionth of the total cells you have in your hypothalamus." "Do whatever you like doctor", he said gleefully. "I am all for the advancement of science". I studied the cells for 2 weeks. I did everything possible on them; histology, histochemistry, physiology, radio-nitrogen tagging, everything; but didn't get any clues. Nothing had perturbed me more in life than this problem. Then one night when I was sleeping and dreaming, suddenly the solution came to my mind like the flash of a lightning. I immediately woke up with a start, and thought of the solution from every angle. The more I thought about it, the more I got convinced that I had indeed found the correct solution. So confident was I that I decided to present the results of my findings to the next international science conference I was attending in Geneva. Mr. Quatra was a mutant! Which means he had an altered thermostat. Well, I won't go in details. You all know about hypothalamus and built-in thermostats. The hypothalamus of all human beings has a built-in thermostat which is "pre-programmed" to keep the body temperature at 370 C. If there is cold outside, one would start shivering to generate more heat in order to maintain this temperature. On the other hand if it is too hot outside, one would start sweating. Like the thermostat of an electric appliance, it is the hypothalamic thermostat which decides the human body temperature. In all human beings this thermostat is set at a temperature of 370 C. But this man could apparently set his thermostat at a higher level- at will. The biochemistry of his hypothalamic cells led me to that. To be sure, setting of the body's thermostat at higher level is not abnormal. It happens in ordinary day-to-day life. Bacterial toxins set it at a higher level. That is why one gets fever in bacterial infections. In almost all infections- malaria, pneumonia, typhoid- it would be set at a higher level and then the body's temperature would rise. No man could however do it at will. What was most astounding was that this man could apparently do it at will. Some kind of chemical - a hormone probably- would be released from his brain and set it at a higher level. The mystery was that his whole body temperature would not rise appreciably. Only his right hand's temperature would rise. Admittedly this stumped me. May be a good concentration of capillaries there had something to do with it. I presented the findings of my investigation in the international conference the next month. But contrary to my expectations, the paper was booed over. It was taken to be a paper in pseudo-science. I swallowed the insult with a dismal heart. (Three) Next week I got the startling news that Mr Quatra was dead. He was found burnt in his study. The police was suspecting homicide. That is why they called for me immediately. I visited the place at once. The scene was familiar to me- in fact to all forensic experts. The torso had burnt beyond recognition. In fact there was merely ash where the torso should have been. The legs below the level of knees were almost unharmed. My brain started ticking... Spontaneous human combustion! Undoubtedly. This was the classic picture of Spontaneous human combustion. I assured the police officers, it was neither a case of homicide, nor suicide. It was a rare phenomenon, seen once in a century probably. And then I left his house and pressed down the accelerator viciously. I had to reach my lab soon. Lot of work was pending. Besides, I wanted to forget this witch of a man. But somehow my brain was going back to Mr Quatra again and again. Was there something I was missing completely? A missing link perhaps? One which could link all the bizarre facts nicely and logically? My brain felt as if it was full of jig-saw puzzles, needing to be adjusted in their proper order. Suddenly the solution came to my mind. It gave me such a shudder, I lurched forward. I couldn't help it. The car swerved here and there violently till I slammed over the brakes. That jig-saw puzzle! It had been solved! Suddenly all the pieces seemed to fall together in their right places. That gave me this unexpected shivering. Spontaneous human combustion is an unexplained phenomenon for many centuries. Charles Dickens even mentioned the phenomenon in one of his novels. Various theories have been advanced but none seemed satisfactory. There have been for instance, theories regarding building up of high concentrations of combustible substances in the body; high phosphorus levels in bodies, high alcohol levels in alcoholics and the like. Well, these theories do look attractive, but they don't explain everything properly. If you dip a piece of meat in alcohol and burn it, it would burn only till the alcohol is present in the piece of meat. After that the fire would extinguish. Then there are theories regarding high voltages being built inside the body by walking on things like carpets and so on. But now I knew what really goes on. These people are really mutants. And very rare ones at that. For one thing that explains the rarity of the phenomenon of Spontaneous Human Combustion. The mutation enables the affected persons to set their hypothalamic thermostats at a higher level- at will. Even at levels of 3000 C as in the case of Mr Quatra. You may find it unbelievable but I have the biochemistry reports to show you just that. Some of these people can do it at will while others can't, but in all cases this thermostat gets set at a higher level automatically on a very cold chilly night (perhaps to keep them warm). That's why you get spontaneous combustions on cold chilly nights only. Usually however, their thermostats would be set normally. Raising the thermostat to 3000 C would mean that the body would catch fire, as fat catches fire at 2930 C. That is the gist of my whole theory. I know questions are lurking in your minds. What is the exact biochemistry? How is the thermostat set at a higher level? Why would only the hand get warmer and not the rest of the body? Well, I can't explain all that in this short report which I am writing merely because Mr. Suneel Galgotia, the publisher of this book requested me to do so. In any case they are merely trifling details. The main gist should satisfy most people. Even then, I would not disappoint the scientifically minded people. They can fruitfully scan through the following papers, which I wrote subsequently. Aggrawal A. A Biochemical explanation of Spontaneous Human Combustion. New England Journal of Medicine. 311: 1072-1074, 1999 Aggrawal A. Spontaneous Human Combustion. Do the thermostats go awry? British Medical Journal. 321: 72-87,1999 I hope these should satisfy the more scientifically minded of you. Thanks. This story was published in Published in Spandan (Maulana Azad Medical College's Magazine) 1989-90 on Pages 43-46

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

< Back To Main Page. LinkedIn X (Twitter) Facebook Copy link Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Volume 27 Number 1 ( January - June 2026) Contents Papers Posttraumatic Ischemic Brain Stroke After Sharp Neck Injury: A Case Report Based on Autopsy Ivan Tsranchev Pavel Timonov Stela Yancheva Kristina Hadzhieva Teodora Gudelova Mirena Sotirova Antoaneta Fasova Elizabet Dzhambazova Petar Uchikov 1. Medical University of Plovdiv, Republic of Bulgaria, Europe DOI: 10.5281/zenodo.15743623 Read Can Lip Prints Change Overnight?: A Study of Lip Print Stability Across Day and Night as a Forensic Identification Tool Noor Hazfalinda Hamzah Khairul Osman Naakshectra Nadarajan Tham Jia Ci Nurhanis Khairuddin Muhammad Izhan Sabri Atikah Mohd Nasir Nur Mahiza Md Isa ¹⁻⁷ Forensic Science Program, Centre Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia Bangi, Selangor D.E. , Malaysia ⁸ Department of Veterinary Pathology & Microbiology, Faculty of Medical Veterinary, Universiti Putra Malaysia, Serdang, Selangor D.E. , Malaysia DOI: 10.5281/zenodo.15743496 Read

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

SCIENCE IN CRIME DETECTION-20 DEFENCE WOUNDS I have received a very good response for the article " Death due to accidents" published in the September 1994 issue of C&D. Letters were received from all over the country and some even from foreign lands. Mr. Sanjiv Gupta, an NRI from Perth, Australia writes," I received the cuttings of your article through a friend in Bombay, and was quite impressed by reading it. I was particularly impressed by the way you deduced whether Sohan was walking or lying on the ground when he was hit by the car. Keep the good work up. Please give us something on aircraft accidents too." Thanks, Sanjiv. I am pleased you liked my article. As for the aircraft accidents I promise to give an article very soon. Mr. Ravindra Saxena from Hari Nagar, New Delhi wants to know if we can know the speed of the vehicle too, by doing the post mortem of the person killed by it. Sorry, Ravindra. The only thing about speed that I can tell by doing post mortem is whether the vehicle was going fast or slow. Nothing more than that! If the vehicle was going at a very fast pace, there would be drag marks over the body. We call them graze abrasions in technical language. If the body did not reveal any significant drag marks, I would be tempted to say that the vehicle was moving at a slow pace, perhaps less than 40 km/hour. But I can not be much more accurate than this. For instance, I can not say ( by merely doing the post mortem) that the vehicle was going at a speed of, say, 56 km/hour. Yes! there is a way of saying this; but not by post mortem. It is by looking at the brake marks over the road. This is a long topic and certainly you have given me a good topic to work one of my next articles on. I promise to tackle this issue in one of my next articles. Meanwhile if any reader can suggest me the ways to deduce the speed of the vehicle by doing only the post mortem, please feel free to write to me, and I promise to include it in my next feedback column. This time I am going to tell you about the so called Defence wounds. These are the wounds sustained by a person, when he is defending himself from the attackers. For instance, if an attacker is coming towards his victim with a knife, and the victim is aware of this, he will attempt to stop him in several ways. One of the ways is to catch the knife with his bare hands. The attacker then tries to free the knife from the grip of the victim. This produces deep gashes on the palms of the victim. During the post mortem examination when I see these types of injuries on the victim, I can make some conclusions immediately. It tells me that the victim was conscious of the attack on him and he was not taken unawares. This question is of vital medico legal importance in several cases. Another important thing that these wounds tell me is that the death was not suicidal. In suicidal deaths, there is no question of sustaining defence wounds. Defence wounds are mostly seen on the upper limbs, because these are the body parts with which a defendant tries to defend himself. The wounds are mainly cuts and gashes, when the attacking weapon is a sharp edged weapon such as a dagger or knife ( reproduce fig. 4.40 and 4.41 on page 150 here). If the attacking weapon was a blunt edged weapon such as an iron rod or some such similar weapon, then the injuries can take the shape of bruises too ( reproduce fig. 4.39 on page 149 here) . These injuries need not necessarily be on upper limbs only. If the victim tries to defend himself when he is lying on the ground, he may try to use his legs to ward off blows etc. In such cases, the injuries may be on thighs, knees and shins. One of the best examples of such injuries is that seen in attempted rape, when the victim tries to save her genitals from attack by her thighs. Many defence injuries are seen on the inside of thighs in such cases. On 29 November last year, an interesting case was brought to me, in which the presence of defence injuries proved vital in solving the case. One Ramlal was found dead in his room with his neck slashed. He was a 50 year old rich man who lived with his wife and a 27 year old son, Mohan. Mohan was a bad characterized guy and had an eye on his father's money right from the beginning. There had been too many fights in the household over the money. When Mohan got married, Ramlal's troubles increased because his wife was in no way better than Mohan. In fact, she used to instigate Mohan to get his father's money by any means whatsoever. One night, Mohan driven by greed, decided to do the ultimate. He took a knife and went to his father's room. As soon as he entered the room, Ramlal woke up and tried to save himself from Mohan's knife. In the process his right palm received two deep gashes which did not come to the notice of Mohan. Even if Mohan had noticed those cuts, there is hardly anything he could have done about them. The chances were that he would not even have understood their significance, let alone do something about hiding them. When the body was found the next day, Mohan could convince everyone even the police that it was a case of suicide. He had planted the knife in the hands of the dead body and it appeared to everyone that Ramlal had put an end to his life. It was understandable because Ramlal had become very tired of his life. There were too many fights going on in the house¬hold. When I received the dead body from the police, the story that was given to me was that it was a case of suicide, and if I could add further light to the case. So much was the conviction of the police that it was a case of suicide! When I made a preliminary examination of the dead body, I found those gashes in the palms of Ramlal's dead body. This immediately told me that I was dealing with a case of murder and not of suicide. I called the police and told them the whole story. The police could not believe my version. But when Mohan was questioned under the weight of forensic evidence, he cracked and admitted his guilt. This was a victory of forensic science. Mohan got the life imprisonment for his ghastly deed. Were it not for those two tell tale defence wounds on the palms of Ramlal's dead body, Mohan would have been a free man today.

Forensic Science Fiction