Arsenic

Introduction - It is a colorless, odorless, tasteless & greyish substance.

● Nomenclature

सं कृ त नाम - गौरीपाषाण, फे ना म
हद नाम - सं खया
English Name - White Arsenic

पयाय - शंख वष - दा मूष दा मोच म ल - फे ना म आखुपाषाण - हतचूणक आ द

इ तहास -सु ुत सं हता क प ान (अ. 1) म सव थम इसका उ लेख इस कार मलता है।
"फे ना मह रतालं च े धातु वषे।"

● Type of Poison

आयुवद - ावर धातु वष

Modern - Irritant Metalic Poison
● Toxic Compound :-

(a) Oxide-As2O3, As2O5, AsO

(b) Sulphide-As2S2, As2S3

(c) Copper Arsenite

(d) Organic Arsenicals- Carbarsone

(e)Arsine Gas- Arsine trighydride

In general inorganic arsenic is more toxic than organic arsenic and

Trivalent Arsenic is more toxic than pentavalent or monovalent arsenic.

● Mode of Action

आयुवद-उ ण गुण के आ ध य से प क वकृ त होती से होता है, जससे अ वह ोतस म

शोफ एवं पाक क उ प होता है। अ तसार ती वरेचक भाव के वजह होता है।

Modern - It causes iritation & Inflammation to Mucus membrane of GIT. it

increases Permeability of Small Vessel, Inflammation & Necrosis of
intestinal Mucosa Arsenate causes uncoupling of Mitrochondrial oxidative
phosphorylation.
● Theraplutic Dose-

Fatal dose - Arsenic trioxide (As2O3) 120 - 300 mg

Fatal Peroid - 2-4 hours

● सोमल वषा ता के ल ण
सोमल, उसके रासाय नक सं म ण या योग अ धक मा ा म सेवन करने से न न ल ण मलते
ह।

● Symptoms-Acute Poisoning (Ingestion)

1. Metallic Taste in mouth & Garlic odour in Breath

2. Burning sensation in mouth, throat, chest & epigastric region (Upper GII)

3. Excessive Salivation, Nausea & Vomiting

4. Pain & cramps in Abdomen (Entire)

5. Severe Rice Water Purgation, sometime with Blood Stains & mucous

6. Excessive Thirst, Oligourea, anurea

7. . Acute Hepato-Renal failure after some hours

● Sign:- Signs of Dehydration as per Severity will found

1. Tongue-Dries, skin Turgor-loss, Eyes-Shrunken

2. Pulse- Feeble & Tachycardia, BP.-Hypotension, Respiration-Sigh

3. Death due to Hypovolumic Shock & Circulatory Failure

● Clinical Manifestations of Chronic Poisoning (Ingestion)

1.GIT-Loss of Appetite & Weight, Malaise, Salivation, Colicky Pain,

Constipation or Diarrhea

2.Skin-Erythematus Hyperkerotic skin, Patchy Pigmentation

3.Anemia & Leucopenia & Thrombocytopenia

4.Peripheral Neuropathy

Patchy skin hyperpigmentationIn chronic arsenic poisoning

● Difference between Arsenic Poisoning and Cholera Symptoms:

Symptoms Arsenic Cholera

Pain in throat Before Vomiting After Vomiting

Vomiting & Purging follows Vomiting Vomiting

Purging follows Purgang

Vomitus contain mucous, watery without

Bile and blood mucous, bile or

Blood .

Stools Rice-watery stool Rice-watery stool,

may contain blood contain no blood

and passed in a

continuous

involuntary jet.

Tenesmus Present Absent

& Pain around

anus
Laboratory X-ray abdomen seen Vibrio Cholera

Investigations in Arsenic trioxide. present

Arsenic in Chemical

Analysis.

Motive Homicidal, rarely No Such things

accidental
● Difference between Arsenic Poisoning and Cholera Symptoms:

Symptoms Arsenic Cholera

Pain in throat Before Vomiting After Vomiting

Vomiting & Purging Purging follows Vomiting follows

Vomiting Purgang

Vomitus contain mucous, Bile watery without

and blood mucous, bile or blood .

Stools Rice-watery stool may Rice-watery stool,

contain blood contain no blood and
passed in a continuous
involuntary jet.

Tenesmus & Pain Present Absent

around anus

Laboratory X-ray abdomen seen in Vibrio Cholera present

Investigations Arsenic trioxide.
Arsenic in Chemical
Analysis.

Motive Homicidal, rarely No Such things

accidental
● Management of Ingested Acute Arsenic Poisoning

Sr. Principle Condition of Treatment

Patient

1. Resuscitation Hypovolumic Inj. Dopamine5µg/

(संजीवन च क सा) Shock kg/min. in DNS

(Dextrose normal saline)

2. Removal of If patient is स वमन य ीमधू फा या

Unabsorbed counscious, लवण जल आकं ठ दे कर
Poison oriented & वमन करवाये।।
having stable vital

If patient is KMnO4 solution

Unconscious 1:1000 से आमाशय

disoriented & having धावन करना चा हए।
Unstable vital not fit

For emesis
3. Removal of If no renal failure Forced Diuresis or

Absorbed पुननवा क वाथ

Poison (मू ल )

If renal failure Hemodialysis

4. Use of Antidote Mechanical गोघृत यो गो ध (Milk)

Chemical गै रक भ म (Hydrated
Ferric Acid)

Specific (Modern) Inj. BAL 3-5mg/deep

IM+4 hrly for 2 days

& 6 hrly on 3rd day &

12 hrly for further 10

days

Specific (आयुवद) 1. मेघनादरस सतासह यु

2. न बु वरस पान
3. गो ध शकरायु
4. ख दरसार शकरायु
5. Symtomatic दाह (Burning) धा यक हम
Management उदरशूल (Colic Pain) कोलीकॉप न सरप
Dehydration षडंगपानीय,
शीत ृत जल,
न बुपानी
Oral Rehydration

Solution, IV fluid (RL)

● जीण सोमल वषा ता क आयुव दक च क या -

1. वरेचन - नुही वट ( नुही ीर- 125 ml सै व)

2. सावदै हक र मो ण- वरेचन एवं र मो ण से धातुगत जीण सोमल वष का नहरण होता
है।
3. ला णक च क सा
● Postmortum Appearance:-

▪ External- Rigor Mortis longer than usual & Shrunken

appearance due to Dehydration

▪ Internal-

(a) Stomach- Red Velvet Tinged with Blood, Swollen & Red
appearance of Mucosa Arsenic or it's compound
will be found in Stomach Ulceration or erosion will be found
in Pyloric End.

(b) Endocardium of Left Ventrical- petechial Hemorrhage

(c) Liver, Spleen, kidney - Patchy Fatty degenerative changes.

● Chemical Analysis:-

▪ Common viscera:-

V1 - Stomach whole+Stomach content 100ml+

Small Intenstine 30cm

V2 - Liver ½ kg+Spleen + kidney ½ each

▪Specific Viscera:-

V3 - Shaft of Long Bone-10cm+ plucked Scalp Hair-5gm +finger

Nail
● Preservatives:- Salt (NaCl) water

● Medicolegal Case:

▪ Accidental- It has been mistaken for Baking Powder, Soda, Salt or flour &
causes poisoning.

▪ Sucidal - May be

▪ Homicidal - The Arsenic coumpound have been administered in Food with

Homicidal Intention.

▪ Theurapeutic Overdose - Found in case of Ingestion of Ayurvedic yoga in

over doses

▪ Occupational Hazard-Will be found among Worker working in Factories

belonging Arsenic

▪ शोधन-
कारवे लक काटकर बीज के जगह सोमल 3 घंटे तक रखना चा हए और उसके बाद
नकालकर गुनगुने पानी से धोना चा हए।

▪ आयुव दक योग - समीरप ग रस, वडवानल रस, मल स र रस, म लवट , स ीपातभैरव रस।