GENERAL PRINCIPLES SYMPTOMS AND SIGNS

I. POISONING - Effects stated or observed, produced by the

action of a particular poison on the physiologic
TYPES OF POISONING
functions of the body
A. MEDICAL POINT OF VIEW
COMMON SIGNS AND SYMPTOMS:
1. Acute Poisoning
– Headache
- Is produced by taking an excessive single dose of a
– Nausea
poison or several small doses with such frequency as to
result in prompt and marked disturbance of function or – Vomiting
death within a definite period.
– Upset GI
Examples:
– Muscle Weakness
 Nitrobenzene – 8 – 15gtt (fatal)
POISONING EFFECT
 ASA – 62mg – 80mg
• Local Poisoning
2. Chronic Poisoning
- Impressions made directly by the poison upon
- Is produced by taking or absorbing for protracted the contact ( corrosives, irritation or
period small doses of a poison, thereby producing inflammation)
gradual but progressive deterioration of function of
Examples: corrosives – alkaline and acids
tissue.
• Remotes poisoning
Examples:
- Influencing other than the contact
 Lead
EVIDENCES OF POISONING
 morphine
CIRCUMSTANTIAL/MORAL EVIDENCE
3. Cumulative Poisoning
• Attributed by the circumstances or deduced from
- Sudden intensity of effects
various occurrences and facts, motives for
Examples: poisoning, possession or purchase of poison.
 Heavy metals (Hg, Pb, As) SYMPTOMATIC EVIDENCE
B. LEGAL POINT OF VIEW • Contributed by the symptoms.
1. Accidental- taken without intention to cause death. It • It may be subjective or objectives.
may be taken by mistake or without knowing that is
• Not conclusive
poisonous.
• Example: Arsenic poisoning and cholera give
2. Suicidal- taken by the victim voluntarily for the
similar symptoms
purpose of taking his own life
CHEMICAL EVIDENCE
3. Homicidal- Given willfully, wantonly, and with intent
to cause death to the victim • Obtained by means of chemical analyses if the
substance supposed to have caused the
4. Undetermined- History is hazy as to how the poison
poisoning, or what has been vomited, or of
was obtained and why it was administered
material found in the secretion.
• Not reliable. Why? Because the poison may be
decomposed, or the chemical investigation is
interfered with the presence of certain ptomaine
SYMPTOMS OF POISONING
POST MORTEM EVIDENCE
 • Obtained by an examination of the organs and 3. Blood (10-50ml)
tissues of the body after death
4. Vomitus and first 2 gastric washings
EXPERIMENTAL EVIDENCE
5. Feces
• Obtained by administering the suspected
6. Body fat
substances to some living animal and observing
the effects 7. Hair clippings
• Testing animal: 8. Clippings of fingernails and toenails
Dogs 9. Food
Cats B. EVIDENCES TO BE SAVED IN FATAL
POISONING
Rabbits and Frogs
1. Stomach and contents
DIAGNOSIS AND EVALUATION
2. Liver (at least ½)
3 CATEGORIES
3. Kidneys (at least 1)
• Exposure to a known poison
4. Blood ( 50-100ml)
• Exposure to an unknown substance that may be
a poison 5. Bone
• Disease of undetermined cause in which 6. Lung(at least 1)
poisoning must be considered as part of the
differential diagnosis 7. Brain (1/2)

DIAGNOSTIC WORKUP C. LEGAL CHAIN OF CUSTODY

• CONSIST: • In cases of poisoning in which specimens are

medicolegal importance, the physician must use
- A complete history care to establish a legal chain of custody so that
each person having responsibility for the
- Complete physical examination
material can state oath that it has not been
- Appropriate laboratory tests contaminated or tampered with.
PREVENTION
• Education
• Proper instruction
• “keep things out of the reach of small children

PRESERVATION OF EVIDENCE
A. EVIDENCES TO BE SAVED IN NON FATAL
POISONING
1. Prescription containers or other containers from
which the poison was obtained
2. Urine (24hr specimen)