Professional Documents
Culture Documents
The gastroenteric
type (Subacute
type or common
form of acute
type): - 1hr after
ingestion; delayed
when taken with
food (2hr);
sweetish metallic
taste
Small doses of As
given at repeated
intervals;
resembles case of
Narcotic form
Chronic type
Persons
engaged in
smeltering or
refining ore or
inhibition of SH
enzyme necessary
for cellular
metabolism
cholera or bacterial
food poisoning;
first dyspepsia,
cough & tingling in
throat (constriction
in throat, difficulty
swallowing,
burning colicky
pain, intense thirst,
severe projectile
vomiting)
Followed by
vomiting, purging
(within 1-3 hrs)
with pain abdomen
& tenesmus,
irritation about
anus
Stool: expelled
frequently &
involuntarily, darkcoloured, stinking
& bloody first; then
later colorless,
odourless, watery
(rice-water stools
of cholera), garlicky
odour of breath &
faeces
long-term
exposure to As
compounds
(accidental
ingestion of
repeated small
doses by those
working with
metal, or by
food /drink with
traces of drug;
recovery from
large dose;
homicidal due
to repeated
small dose)
GIT: N/v, abd
cramps,
diarrhea,
salivation,
gradual wt
loss,
malnutrition,
fatigue, loss of
appetite, liver
cirrhosis
Skin:
pigmentation
consists of a
finely mottled
brown change
mostly on the
skin flexures,
temples,
eyelids & neck
which persists
for many
months
(raindrop type
of
pigmentation),
rash resemble
fading measles
rash ,
Direct action on
heart muscle
(myocardial
failure)
Hepatic: fatty
infiltration; renal:
oliguria, uraemia,
urine contains
albumin, red cells
& casts, pain
during micturition
GI symptoms are
absent
CVS: acute
circulatory collapse
with vasodilation,
increased vascular
permeability,
ventricular
tachycardia,
ventricular
fibrillation; skin:
delayed loss of
hair, skin
eruptions, death
due to circulatory
failure
Replaces P4 in
CNS: headache,
prolonged
contact:
hyperkeratosis
of palm, sole,
with irregular
thickening of
nails (BCC)&
dev of
transverse
white lines in
fingernails
(Aldrich-Mees
lines); alopecia
Arsenical
neuritis (CNS):
polyneuritis,
optic neuritis,
anesthesia,
paresthesia,
encephalopath
y, atrophy of
extensors
leading to wrist
& foot drop
Catarrhal
changes:
running nose,
headache,
conjunctivitis,
bronchial
catarrhal, eyes:
congestion,
watery,
photophobia;
hepatomegaly,
cirrhosis,
jaundice;
anaemia, wt
loss, hair loss,
brittle nails;
cough,
hemoptysis,
dyspnea
Chronic
bone ; gets
deposited in bone,
hair
vertigo,
hyperthermia,
tremors,
convulsions, coma,
general paralysis, a
peripheral
neuropathy
(sensory > motor)
asymmetric, distal
stocking-glove
distribution after 12 weeks of acute or
chronic exposure
nephritis,
cardiac failure,
dependent
oedema
Mees's lines: the victim's nails manifest whitish lines 1-2 mm breadth across
the nails of the fingers & toes, representing deposition of poison (As) as a
result of high sulphhydryl content of keratin (also seen in Thallium); linear
Trait
Pain in throat
Purging
Stools
Arsenic poisoning
(subacute/acute
gastroenteric type)
Before vomiting
After vomiting
Dark-colred & bloddy,
later rice-watery
Present
Contains mucus, bile &
blood
Not affected
Inflamed
Arsenic present
Cholera
After vomiting
Before vomiting
Rice-watery, not bloody &
passed in continuous
involuntary jet
Absent
Watery without mucus,
bile, blood
Rough & whistling
Not inflamed (normal)
Cholera vibrio present
Circumstantial evidence
Pain in throat
Of As poisoning may be
present
Present before vomiting
transudation occurs into the organs of the left side before those of right & the
signs of inflammation & ulceration are absent
Tolerance: some people take arsenic daily as a tonic or as an aphrodisiac; &
they acquire tolerance upto 0.3 g or more in one dose; such people are
known as arsenophagists
CHEMICAL TEST/diagnosis (reinsch's & marsh's test are absolete)
1) Reinsch's test: 1-2 strips of bright copper foil + suspected acidified soln /
previously acidulated (HCl)---boil for 5-10 mins-------cooling of copper foil
with steel gray or black deposit arsenic-------wash it with DW, alcohol,
ether-----put in test tube & heat---white deposit on cooler portion of test
tube ------------take deposit on a slide------------under microscope-----------octahedral crystal of arsenic (white deposits of arsenious oxide:
octahedral crystal on microscopy) (RCC-REINSCH'S: HCl +Cu)
2) Marsh's test: sensitive test ; can detect small quantity arsenic 1/1000 mg;
based on the principle that arseniuretted hydrogen is liberated when
nascent hydrogen reacts with arsenic; thus a suspected material is
exposed to nascent hydrogen formation of hydrogen arsenide is
detected by chemical means (HIS MAJESTY: H=HYDROGEN; M=MARSH):
Arseniuretted hydrogen: when inhaled acts as a direct poison to the
haemoglobin, producing haemolysis, haemoglobinuria, renal failure &
death is almost instantaneous
3) Urinary excretion > 100ug in 24hrs (Diagnosis; blood & hair levels
are not reliable)
4) Detection by atomic absorption spectroscopy
5) by neutron activation analysis quantities in nanograms can be detected
6) Gutzeit's test
-
ML Importance
Arsenic is an ideal or popular homicidal poison (Napoleon Bonaparte)
because: it is cheap, easy to obtain, easily mixed with food/drink, no smell,
no taste, colourless, potent-small quantity required, symptoms resemble
cholera or gastroenteritis, gradual onset of symptoms (lag period=15-30
mins), disadv: legal restriction on sale; easily detected in dead bodies in
1/1000 mg dilution : Marsh's test----as it doesnt deteriorate by itself so
revealed on chemical analysis; retard putrefaction so body preserved for
longer duration; can be found in bone, hair, nails for several years, even in
charred bones or ashes, even in burnt bodies as heat doesnt destroy it;
duration can be said if chemical analysis done from root to tip hair grows 1
cm/month, nail grows 0.3 cm/month, etc ------orally mixed with food like
sweets, bread, milk, tea, cold drinks, etc; mass homicidal poisoning occurs
when mixed with food or in a well; sometimes mixed with tobacco or cigars
(Passing Show cigarettes) for homicide or to rob (railway passengers)
Accidental: when used for aphrodisiac (quick remedy for impotence), eating
arsenic arsenophagy, for better respiratory stamina among mountaineers,