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