deliriant poisons
TRANSCRIPT
DELIRIANT POISONS
Dhatura Atropa belladonna Hyoscyamus niger Cannabis indica Cocaine
DHATURA(THORN APPLE) Two Types
Dhatura Alba (Safed Dhatura) White
Flowered
Dhatura Niger (Kala Dhatura) Black or Purple
Flowers
Characteristics
Flowers: Bell shaped
Fruits: Spherical, having sharp
spines
Seeds: Brown kidney shaped resembling
chilli seeds
450 to 500 seeds in a fruit
100 seeds weight about 1 gram
Seeds & fruit most noxious
Active Principle
Contains Alkaloids:
Laevo-hyoscyamine
Hyoscine or scopolamine
Traces of atropine
Absorption
Distribution
Metabolism
Crushed seeds Absorption of alkaloids from small intestine blood body tissues partial oxidation
Analyst may not detect them due to their oxidation
Same for all alkaloids
Mode of Action
Stimulate the higher centers of brain
Followed by the motor areas
Depression and paralysis – vital center of
medulla
Respiration – stimulated then depressed
Signs & Symptoms
Symptoms described as:
“ Dry as a bone, red as a beet, blind as a bat,
hot as a hare and mad as a wet hen”
Alkaloids : Immediately
Seeds: Within half an hour
Decoction: Within few minutes
(concentrated water extract)
Powered seeds given in food
Earliest symptom: Bitter taste in mouth
Inhibition of salivation: Dryness of mouth
and throat (dry as a bone)
Difficulty in talking
Dysphagia
Unquenchable thirst
Dilatation of cutaneous blood vessels
Face is flushed (red as a beet)
Pupils:
Dilated
Insensitive to light
Power of accommodation near vision
paralyzed
(Blind as a bat)
Inhibition of sweat secretion & stimulation of
heat regulating center:
Body temp. raised
Skin dry and hot (hot as a hare)
Vomiting
Giddiness, unsteady gait (drunken individual)
Initially restless and confused
Later delirious, mutters indistinct words (mad
as a wet hen)
Visual and auditory hallucinations:
Grasps at imaginary objects
Picks at his clothings
Tries to pull imaginary threads from tips of
fingers
Scarlatiniform rash
Delirium passes off in an hour
Drowsiness Stupor or coma
Death…..Respiratory paralysis
Secondary delirium: After recovery
9 Ds1. Dryness of the mouth and throat
2. Difficulty in talking
3. Dysphagia
4. Dilatation of cutaneous blood vessels
5. Dilatation of pupils
6. Dry hot skin
7. Drunken gait
8. Delirium
9. Drowsiness
FATAL DOSE & FATAL PERIOD
Seeds: 100 to 125
Alkaloids: 60 mg (Adult)
4 mg (Children)
Death occurs within 24 hours
TREATMENT
Stomach wash:
Weak solution of potassuim permangmate
OR
4 to 5% tannic acid
Physiological anti dote Physostigmine: 1 to 4 mg every 1 to 2
hours
OR
Neostigmine: 2.5mg i.v. every three hours
Purgatives
Symptomatic
Recovery: 1 to 2 days (in non fatal cases)
Effect on pupils last to disappear
POSTMORTM APPEARANCES
Asphyxia
Seeds found in stomach
Congestion of GIT
Seeds resist putrefaction
Poisons resisting putrefaction
1. Phosphorus
2. Arsenic
3. Antimony
4. Hyoscine
5. Strychinne
6. Nicotine
MEDICOLEGAL ASPECTS
Stupefying Poison: Robbery Kidnapping
Rape
Road Poison: Powered seeds mixed with food, tea or drinks or pan & given to travelers
Small dose due to smoking or ingestion causes
loss of reasoning ability
By mixing Dhatura with tobacco in cigarettes
Children kidnapped by giving candy mixed
with Dhatura. They comply with the
instructions of the poisoner to follow him
Accidental Cases: Children & Adults
Eat raw fruits or seeds mistaking them for
edible fruits or capsicum seeds
Quacks for treatment of various ailments
Aphrodisiac
Added to country liquor
Chilli SeedChilli Seed Dhatura SeedsDhatura Seeds
Small & thinSmall & thin Large and thickLarge and thick
Pale yellowPale yellow Brown or blackBrown or black
Smooth & roundSmooth & round Kidney shaped, finely Kidney shaped, finely
pittedpitted
Pungent smellPungent smell OdourlessOdourless
Pungent tastePungent taste Bitter tasteBitter taste
On section embryo On section embryo
curved inward like curved inward like
figure of 6figure of 6
On section embryo On section embryo
curved outwardcurved outward
Cannabis
CANNABIS INDICA (hemp)
It is a CNS stimulant
Cultivation is restricted by Law
All parts of the plant are poisonous
Cannabis Origins & History of use Psychoactive properties were first recorded
about 2800 BC in China and 2000 BC in India
Early uses included rheumatic pains, constipation, malaria, ‘absentmindedness’, menstral cramps, and for its anxiolytic and euphoric properties
ACTIVE PRINCIPLE
Fat soluble oleoresin- cannabinol
Stored in fat cells of body and acts like
time release capsule
The effect of a single dose lasts for 7 days
Common Names
Indian hemp or cannabis sativa in India
Dagga in South & Central Africa
Hashish in Egypt
Marihuana: Mexican term meaning
pleasurable feeling
Routes of Absorption
GIT
Respiratory tract
Forms of hemp
Common forms of hemp
BHANG
MAJOON
GANJA
CHARAS
MARIJUANA
BHANG
Least potent form
Also called siddhi, patti, sabji
Prepared from dried leaves & fruit shoots
Used as an infusion in the form of a
beverage
Suspension (Sardai) also mixed in ice cream,
sweets, pakauras
Mildest and contains 15% of active
principle
Produces a feeling of happiness
Person sings and dances
Effect lasts for about 3 hours & followed
by sleep
MAJOON
Sweet prepared with bhang
Produces grandiose delusion in addition
to all effects of drug
GANJA
Consists of flowering tops of the female plant
It is mixed with tobacco and smoked in pipe
Contains active principle in conc. of 25% Smoker feels lazy & indulges in day
dreaming Used by sadhus and fakirs
MARIHUANA OR MARIJUANA
Common names are pot, grass tea, Mary Jane Similar to Ganja Eaten alone or as part of confection or drunk
in beer Smoked in pipe or rolled in cigarette called
reefers or weed Their use leads to consumption of more
dangerous drugs & in particular to heroin addiction
Cannabis Origins & History of use Marijuana (the name for the dried and
crushed flowers) comes from the spanish maraguanaquo (meaning an inebriant plant)
Cannabis became an illegal substance in North America in the 1920’s
Revival in marijuana interest occurred in the 60’s
Cannabis Origins & History of use Claims for medicinal and psychiatric uses
expanded in the 1800’s and 1900’s as for all drugs
Hash (the name for the resin) comes from the arabic word hashsha shim (meaning hash eaters- it also spawned the word assasin)
CHARAS OR HASHISH
Resin exuding from leaves and stems
Dark green or brown color
Smoked with tobacco in a pipe ‘hookah’
Active principle is in con of 25- 40%
It is the most powerful of all cannabis
preparations
Main effects are:-
Aphrodisiac, hypnotic and analgesic
Psychological dependence
Fatal Dose Charas 2gm/ kg body wt
Ganga 8.0gms/ kg body wt
Bhang 10 gm/ kilo body wt
Fatal Period Death is rare, but may occur in
12hrs in case of acute
poisoning.
Sign & Symptoms
With Small Doses Euphoria Feeling of well being, talkative appetite
With Moderate Doses Impaired immediate memory function Disturbed thought patterns Lapses of attention
With High Doses
Loss of perception of time and space
Visual hallucinations
Changes in body image
Depersonalization
Marked sensory distortion
HASHISH INSANITY (Chronic Poisoning)
(Often attributed to chronic use) Patient suffers from hallucinations and
delusions of a persecuting nature Irresistible desire to destroy willfully life and
property of which he has no recollection after wards
Likely to commit sexual jealousy crimes Chronic use reduces serum testosterone
and sperm count
Loss of appetite Weakness Wasting Tremors Sleepy facial expression Vacant look Red eyes Impotence Moral & mental deterioration May suffer from hallucinations & delusions of
persecution
RUN AMOK
It is a psychotic disturbance caused by the continued use or even first time use of cannabis
It is characterized by a frenzied desire of the person to commit murders
He first kills a person against whom he may have real or imaginary enmity and then kills anyone who comes in his way until the homicidal tendency lasts.
Then he may commit suicide or surrender himself.
TOLERANCE & PSYCHOLOGICAL DEPENDENCE
Develops when the drug is consumed
over a prolonged period of time
TREATMENT
Stomach wash with warm water
100ml of 50% glucose
2mg naloxone
5-10mg diazepam if aggressive
Hypodermic injection of strychnine
Strong tea or coffee by mouth
If necessary saline purgatives
POST- MORTEM APPEARANCES
Not characteristic
Usual appearance of asphyxia
Medicolegal Aspects
Accidental ingestion or inhalation
Overindulgence
Majun and charas used by road poisoners
To strengthen the nerves before committing a crime or a bold act
Aphrodisiac
Used by fakirs and poojaris to get into a religious mood