Introduction to Agada Tantra,

Visha & it’s Classification,

Properties & Action of Visha,
Diagnosis of Poisoning, Treatment of
Poisoning

Dr. Prashant Kumar Singh

MD (Ayu)
 Derivation of AgadaTantra
• Agada- अच् + गद प्रत्यय Where Gada means
Disease, Discomfort, Pain, Poison or Morbid/ Fatal Conditions
produced by any type of Poison Inhaled, Absorbed, Applied,
Injected or Developed within the body. So, Agada means the
Medicaments which are used as an Antidotes to combat these
Morbid Conditions.

• According to AmarKosha (2/6/50) भे षजम्, औषधम,

भै षज्यम, अगदः & जायु ः etc are considered as Synonyms.

• Tantra- The Science through which the Positive Health

of an Individual is Preserved. (“त्रायते शरीरम् अने न इति तन्त्रम्”)
• Definition-
“ अगदतन्त्रं नाम सर्पकीटलु तामूषिकादिदस्टविषव्यञ्जनार्थं
विविधविषसंयोगोपशमनार्थञ्च”
(सु .सू. १/१४)

- Agada Tantra deals with the Signs & Symptoms & also with
the management of Poisoning, resulting from the bites of Snakes,
Insects & Worms, Spiders, Rodents etc. & various other Poisons
produced by improper combinations of substances or Drugs.

• Different Acharya termed Agada Tantra as-

- विष गरवैरोधिक्प्रशमनं by Charak- e.g. Equal dose of Madhu

& Ghrita.
- दरं् स्टाचिकित्सा by Vagbhatta- means Bite & it’s Treatment.
- जाङ्गली by Koutilya- means Sapera, VishaVaidya.
 Aim, Scope & Utility of AgadaTantra
• Aim- as same as of Ayurveda.
1. Prevention of Healthy people from effect of Poison.
2. To Cure people which are effected by the Poison.

• Scope- The area of Agada Tantra is very Wide. To

know about Visha, it’s Source, Types, Sign & Symptoms,
Effect on Animals & Human Being, Treatment, Clinical
Dose, it’s Buying & Selling rules, used in Cosmetics, Home
Cleaning, Agriculture etc
 Historical reference of AgadaTantra
• In AtharvaVeda (7-88-1) we get the references
regarding the Morbid Conditions arising due to different
types of Poisons & it’s Antidote. e.g. The Jaangam Visha
is used as Antidote for the Sthavar Visha & vice versa.
• There is also description in-
Charak Samhita – ChikitsaSthana Chapter- 23, Susruta
Samhita- Kalpa Sthana Chapter- 1 to 8, Astanga
Samgraha & Astanga Hridya- Uttar Sthana, Kashyap
Samhita, Haarita Samhita, Rasa RatnaSamucchya &
Rasa Tarangini, Bhava Prakasha, Sharangdhar Samhita,
Bhaishajya Ratnavali & Yoga Ratnakar etc.
• Definition of Visha- (A/c to Ayurveda)

ू त्वा रसादिकात
“दे हं प्रविय यद ् दर् व्यं दश्यि
स्वास्थ्यप्रान्हरम् च स्यात् तद ् दर् वं विषमु च्यते ”
- The Substance immediately after entering into the Body causes the
Vitiation of the healthy Dhatus or killing of the Healthy Person is
defined as Visha.

् ष्ष्नम् तं दृष्ट वा ते नासौ विष सं ज्ञितं ”

“ज्ञगदवि
- A/c to Acharya Charak- The Substance which causes
Sadness to the World is called as Visha.

“विशादज् ननत्वाच् विश्मित्यभिदियते ”

- A/c to Acharya Sushruta- The term Visha is derived for
Causing Vishada (Depression of Spirits) even for Devtas.
• Definition of Visha- (A/c to Modern)
- A Substance which, on Ingestion, Inhalation, Absorption,
Application, Injection, or development within the Body, in
relatively small amounts, Produces injury to the body by its
Chemical Action is Called as Poison. (Dorland: Pocket Medical
Dictionary)

- A Poison is commonly defined as a Substance which

when administered, inhaled or swallowed is Capable of
acting deleteriously on the Body. (Parikh, C.K.: Textbook of Medical
Jurisprudence & Toxicoloy)
 Mythological Origin of Poison
• In Susruta Samhita – Kaitabh Demon created obstructions
during the Creation of the Cosmos by the Originator Brahma.
Brahma got very angry & resulted in the production of a very
dreadful person (i.e. Anger) who killed the demon Kaitabh.
Then the Anger created Sadness or Depression (Vishada)
among the Gods.

• In Charak Samhita - When Ocean was being churned for

Ambrosia, a Ferocious-Looking Person (VishaPurusha)
appeared. The world become despaired (Vishanna) at his sight
because of which he was called Visha or Poison. Lord Brahma
deposited this Poison in Jangama & Sthavar Things.
• Synonyms of Visha-
A/c to AmarKosha- क्षवे ड, गरल, विष
A/c to RasaTarangini- क्षवे ड, गरल, विष & कालकू ट

• Site of Poison (विष अधिष्ठान)-10 Sites for स्थावर विष & 13 for जान्गम विष.

• स्थावर विष अधिष्ठान-

“मूलं पत्रं फलं पु ष्पं त्वक्क्षीरं सार एव च
निर्याशो धात्वश्चै व कन्दस्च दशमः स्मृ तः”
- Root, Leaf, Fruit, Flower, Bark, Milk, Pith, Gum, Metals & Minerals &
Bulb.

• जान्गम विष अधिष्ठान-

“तत्रदृष्ट्निःश्वासदर् ं ष्टानख्मु तर् पु रिषशु क्रलार्तवमु खसं दंशविर्धिततु न्डाष्टिपित्त
शु कशवानीति”
- Sight, Breath, Teeth, Nail, Urine, Stools, Semen, Saliva, Menstrual Blood, Stings (मु ख),
Belching (दं श), Anus, Bile & Dead body of an Animal.
 Movement of Poison
• “ जङ्गम स्याद्धोभागम ऊर्धवभागं तु मूलजं”
- The Movement of Jaangam Visha – Upward.
Movement of Sthavar Visha - Downward.
 Classification of Visha (A/c to Ayurveda)

1. अकृत्रिं or स्वभाविक (Original or Natural)- Sthavar & Jaangam.

Sthavar Visha is divided into two- 1. वानस्पतिक 2. खनिज or धातु ज्
Jaangam is Animals Poisons.

2. कृत्रिं or संयोगज (Chemically Prepared)-

A. गर विष (Prepared by Non-Poisonous substance / Chemically Prepared
Swallowing Poison)- e.g. equal Qt. of Madhu & Ghrita, Fish & Milk
Combination etc. also called सं योगज विष .

B. दूषि विष (Deficient, Mild or Slow-Acting Poison)- A Part of Sthavar,

Jangam or Kritim Visha which lies in the Body for long time & give
bad effect to all dhatus especially “Rakta Dhatu”.
Apart from this, in RasaShastra there are 9 Vishas 11 UpaVishas.

• 9 Vishas- A/c to Rasa Tarangini- Halahala, Kaalkut, Sringka,

Pradipana, Saurastrika, Brahmputra, Haridra, Saktuka & Vatsanabh .
Out of these only Vatsanabh is identified properly and is being used in
Medicines.

• 11 UpaVishas- A/c to Rasa Tarangini- Seeds of VishaTinduka

(Strychnos nux vomica), Ahiphena (Opium), Rechakam (Seeds of
Corton tiglium), Seeds of Dhattura (Dhatura metel), Vijaya (Cannabis
indica), Seeds of Gunja (Abrus precatorius), Bhallataka (Semicarpus
anacardium), Arka Kshira (Latex of Calatropis gigantia),
SnuhiKshira (Latex of Euphorbia nerifolia), Langali (Gloriosa
superba) & KarVirak (Nerium indicum) etc are UpaVishas.
 Classification of Poisons (A/c to Modern)

A/c to Symptoms/ Effect/ Mode of Action-

(I) Corrosives Poison-The substance which cause destruction

of the parts with which they come to contact. (Symptoms are Burning
Sensation, Swelling & Wounds etc.)
(1) Strong Acids:
• Inorganic or Mineral Acids- Sulphuric Acid, Nitric Acid, Hydrochloric
Acid etc.
• Organic Acids- Carbolic Acid, Oxalic Acid, Acetic Acid, Salicylic Acid
etc.

(2) Strong Alkalies:

• Hydrates of – Sodium, Potassium.
• Carbonates of- Sodium, Potassium, Ammonia etc.
(II) Irritants: The Substance that cause inflammation on the site of
contact esp. GIT, respiratory tract and skin)
(1) Inorganic :
• Non-metallic – P, I, Cl, Br etc
• Metallic – Ar, Cu, Zn, Pb, Hg etc.
(2) Organic :
• Vegetable – Castor, Croton, Calotropis, etc.
• Animal – Snake, Bees, Spider etc.
(3) Mechanical :
Diamond Dust, Powdered Glass, Brick, Hair etc. (Known as Gara Visha)
(III) Systemic: which involves toxic effect on a particular system.

(1) Cerebral (Affects the Brain)

• CNS Depressants- Alcohol, Analgesics, Hypnotics and Sedatives.
• CNS Stimulants- Antidepressants, Caffeine etc.
• Deliriants- Dhatura, Cocaine, Cannabis.

(2) Spinal (Affects the Spinal Cord): Nux vomica (VishaTinduka),

Gelsimium etc.

(3) Peripheral (Affects the Peripheral Nervous System ): Curare,

Conium.

(4) Cardiac: Aconite, Quinine, Tobacco etc.

(5) Asphyxiants (Affects the Respiratory System): Poisonous Gases CO2

(6) Others: Analgesics & Anti-Pyretics etc.
 A/c to Purpose or Intension

• Suicidal: (For One’s Killing) -Opium, Arsenic, Potassium Cyanide etc.

• Homicidal: (For Others Killing)-Arsenic, Aconite, Digitalis, Mercury,
Cupper etc.
• Accidental: Aspirin, Copper sulphate in Children, Snakes Bite.
• Abortion: Calotropis, Oleanders, Aconite, Lead etc.
• Stupefying agent: Dhatura, Cannabis, Chloral hydrate.
• Cattle Poison: Arsenic, Calotropis, Aconite, Nitrate, Zinc Phosphide etc.
 Characteristic/ Properties of Visha
“लघु रुक्षमाशु विशदं व्यवायि तिक्षणं विकासि सूक्ष्म च
उष्णंनिर्देश्यरसं दशगुणमुक्तं विषं तज्ज्ञैः” - (Ch.Chi.23/24)
- Laghu (Light), Ruksha (Rough), Aashu (Quick- acting), Vishad
(Non-slimy), Vyavayi (Quickly absorbed), Tikshan(Sharp), Vikashi
(Depressant), Suksham (Minute) , Ushna (Hot) & Anirdeshya Rasa
(Undefined Taste).
- A/c to Shusruta, instead of Anirdeshya Rasa- Apaki.
- A/c to Sharangdhar,
“ व्यवायि च विकासि स्यात्सूक्षमं छे दी
आग्ने य जिवितहरं योगवाहि स्मृतम विषं ” (Sh.Pra.Kha. 4/22)
Action of Visha in the Body- (A/c to Ayurveda)

 Laghu- which is easily digestible & causes the lightness in the

body. It also helps to do the Lekhana Karma.
 Ruksha- it causes Sthambhan (Withholding), Kharatav, Kathinatwa
& Shoshanatwa (Emaciation) of the Body & aggravates Vata.
 Aashu- due to its Quickness Spreads all over the Body & Proves
Speedily Fatal.
 Vishada- It doesn’t adhere or Stick to any Part of the Body.
 Vyavayi- it first Spreads all over the body & then get digested.
 Tikshna- gives rise to Burning Sensation & do Sraavan &
Lekhana karma. It overwhelms the Mind (Produces Unconsciousness)
& tends to disintegrate the limbs & Muscles.
 Vikashi- while spreading all over the body, Produce looseness of
the Ligaments & Destroy Root-Principles (Dhatu) as well as
Doshas & finally Oja.
 Sukshma- due to Sukshamatwa, it enters into minutes channels
& deranges the Physiology.
 Ushna- it produces heat in body due to which Trishna, Daaha &
Sweda is produce. It vitiated Rakta along with Pitta.
 Anirdeshya Rasa- doesn’t have any Specific Rasa or Taste.

 Apaki/ Avipaki- which is indigestible. It doesn’t digest thus

proves troublesome for a long time.
Action of Poison in the Body- (A/c to Modern)

 Direct Action (Local)-

1. Corrosive Action- as by Strong Acids & Alkalies.
2. Inflammation & Irritation- as by Hg or Dilute Mineral Acids.
3. Neural Effects- Tingling & Numbness by Aconite or Change in the
Shape of the Pupils by Atropine & Escerine.

 Indirect Action (Remote)-

1. Shock- by large Corrosive Poison.
2. Tetanic Spasm- as in Nux Vomica Poisoning.

 Combined Action- Certain Poison like Arsenic, Carbolic Acid,

Phosphorus & Oxalic Acid acts Locally by their Irritants Effects on the
Alimentary Canal & also Produce Toxic Effects after being Absorbed
into the System.
Factors Modifying Action of Poison- (A/c to Ayurveda)
1. According to Patient-
- The Effect of Poison increases from these- Hunger, Thirst,
Increased Heat, Weakness, Anger, Grief, Fear, Exertion, Indigestion,
Diarrhoea, Increase of Pitta & Vata, Smelling the Flowers & Fruits
of Tila, by Fumes of the Earth, Thunder, Sound of Roaring of the
Elephant, Sound of Musical Instruments, during Fatal Period (विष
सं कट ) , Direct Breeze, Fragrance of Utpala & Madan (Sexual
Desire).

2. According to Season-
- Poison being Born from Water becomes very Moist like Jaggery
(Treacle) & Spreads to all places during Varsa (Rainy Season). It is
made to become Weak by Star Agastya & during Sarat (Autmn
Season) Poison is Mild in Potency.
Factors Modifying Action of Poison- (A/c to Modern)
1. Dose / Quantity of Poison-
- Generally, Large Dose causes Death more rapidly but in certain
Cases e.g. Copper Sulphate in large dose includes Vomiting & the Poison is
thrown out. Similarly, Arsenic in Large Dose causes Shock & Death, Moderate
Dose causes Irritant Symptoms & Small Dose produces Therapeutic Action.

2. Form of the Poison-

A. Physical- The Order of Action is – 1. Gases & Vapours act Most Rapidly. 2.
Liquids 3. Fine Powders 4. Coarse Solids.
B. Chemical- Certain Chemical Combination are Non-Poisonous e.g. 1. Agno3
+ HCL are Non-Poisonous but individually they acts as Poison. 2. Acids+
Alkalies. 3. Strychhine + Tannic Acid become Inert on Combination.
C. Mechanical- Action is altered on combination with certain substances. e.g.
1. Heavy Metals + Water may not be Harmful as it settels below down. 2.
Dilution of Acid & then if taken on Full Stomach is Less Effective. 3.
Alkaloids + Animal Characoal are rendered Inert.
3. Mode of Administration-
A. IntraVenous Route is more Rapid & Deleterious.
B. Absorption from Stomach is better then from Rectum.
C. Absorption is more from Abraided Skin than from Intact Skin.

4. Physical Condition of the Body-

A. Age- Poison is more Harmful in Extremes of Age e.g. Opium is
not Tolerated by Children.
B. Idiosyncracy & Hyper-Sensitivity may be shown by Certain Individuals to Particular
Substances, e.g. Pencillin, Sulpha Drugs, Food Articles, Quinine etc.
C. Habit- An Addict can Tolerate Higher Dose than a Normal Person. E.g.
Morphine,Alcohol, Barbiturates etc.
D. Cumulative Action- Poison which are Eliminated slowly may Accumulate in the Body
when given in Repeated Dose for a long time and may ultimately produce symptoms of
Poisoning.
E. Health Status of an Individual.
F. Mental Conditions.
G. Desha- Kala etc.
Effect of Poison on the Body-
- After getting entered into the body, the Poison immediately Vitiates the Blood
then simultaneously it vitiates all the TriDoshas & its respective Sites & last
proves to be Fatal after getting entered into Hridya (Heart).
- The blood after getting vitiated by Poison leads to Tingling or Pricking
Sensation all over the Body, leads to Red Color of Patches on the Skin, Sweating,
Feeling of the Ants moving over the Body, Severe Aches & Pain all over the body,
Yawning, desire for Food Stuffs having Cold Potency. The dominant or the
Potency of TriDoshas also gets debilited & Looses their Potency by Mixing up
with the Blood which gets Vitiated by the Poison, thus leading to the Death or
Hampering the Health.
- If the Poison is present in the Seat of Vata (Vatasaya) produces diseases of
Vata as well as disease of Sleshma (Kapha). If the Poison is present in the Seat of
Pitta (Pittasaya) produces diseases of Pitta & Kapha. Similarly if it is present in
the Seat of Kapha (Kaphasaya) produces disease of Kapha as well as Pitta.
- When the Poison is present in the Head, there is Swelling of the Head associated
with appearance of Rashes, esp. seen around the Eye, Lips, Nose & Mouth,
Tingling of the Teeth, Dryness of Palate, Pain in the Head, Tingling inside the
Mouth; Improper function of the Sensory Organs & Stiffness of the Lower Jaw.
Visha Vegantara-
- The Interval which takes place while Poison driven by Vayu
cross One Kala to the other is known as Vegantara (The
Intervening Stage).
ImPulse of the Poison-
- The Poison is found to attack the Seven Kalas or Facia
described in Sarira Sthana. The Interval of Time during which a
deadly poison leaves one Kala to preceding Kala is called as
VisaVega (Impulse of the Poison), gives rise respectively to the
Seven Stages (Seven Impulse of the Poison) & finally it invades
the Oja. Because of this Susruta & Vagbhatta described Seven
Impulses , but Charak Considered the Death (Mritu) as the Eight
impulse of the Poison & described Eight Impulse of the Poison.
- In Animals, the Impulse of the Poison are Four & in Birds
Three.
Poisonous Impulse General Features-
- A/c to Charak, the VishaVegas are Eight & explained the same
features for both Sthavara & Jaangama Vishas.
- A/c to Susruta & VagBhatta, the VishaVegas are Seven. Acharya Susruta
explained Different features for Sthavar & Jaangam.
A. A/c to Charak- (Charak Chikitsa Sthana 23)
1. First Impulse- The Poison exhibits Symptoms such as Thirst, Mental Confusion,
Sensitiveness of Teeth, Excessive Salvation, Vomiting & Exhaustion due to Vitiation
of Rasa.
2. Second Impulse- The Symptoms are Abnormal Complexion, Giddiness,
Trembling, Fainting, Yawning, Irritation, Sensation & Feeling of Darkness due to
Vitiation of Rakta.
3. Third Impulse- Mamsa is affected which give rise to Circular Patches, Itching &
Swelling.
4. Fourth Impulse- The Symptoms like Burning Sensation, Vomiting, Body Pain,
Fainting etc. are due to Vitiation of Vata etc.
5. Fifth Impulse- One Sees the Object as Blue & Vision becomes Dark.
6. Sixth, Seventh & Eight Impulses- In the Sixth Impulse there is Hiccup, in
Seventh Shoulder Falls down & in Eight Impulse the Patient Dies.
B. A/c to Susruta- (Susruta KalpaSthana 4)
1. First Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Rasa & Rakta Dhatu.
2. Second Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Rakta & Mamsa Dhatu.
3. Third Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Mamsa & Meda Dhatu.
4. Fourth Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Meda Dhatu & Kapha.
5. Fifth Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Kapha & Purisha.
6. Sixth Impulse- If the Poison Over- Crossing the Kala which is
Present in between the Purisha & Pitta.
7. Seventh Impulses- If the Poison Over- Crossing the Kala which is
Present in between Pitta & Shukra.
• Impulses in Animals & Birds- There are Four Impulse in
Animals & Three in Birds.
A. In Animals-
1. First Impulse- The animals get Depression & Giddiness.
2. Second Impulse- Giddiness then it Trembles.
3. Third Impulse- The Animals Feels Emptiness (Sunya) & Stop
Eating.
4. Fourth Impulse- And lastly it dies because of Obstruction to
Respiration.
B. In Birds-
1. First Impulse- Look Anxious.
2. Second Impulse- Feels Giddiness.
3. Third Impulse- The Bird develops Loathness of the Limbs
resulting in Death.
 Diagnosis- According to Ayurveda
1. PanchaBhautika Pariksha / Nidana-
The Evolution of the Whole World has taken place from the
PanchaMahaBhutas. Like other Dravyas of World, Visha is also
PanchaBhautika.
• After Entering into Body, Visha Enters into Minute Cells /
Organs indicates “आकाशीय वृति” of Visha.
• After Entering into Body, its Fast Spreading indicates
“वायव्यता”.
• It is Fast as Agni in Virya which indicates its “ आग्ने यता”.
• It’s Originated from Water (जल) which Indicates its
“आप्यता”.
• Afetr Entering into Body, Visha Produce Daziness /
Heaviness (जडत्व) in Body which indicates its “पार्थिवता”.
• PanchaBhautika Pariksha / Nidana-
Thus the Visha Dravyas also are Composed of PanchaBhutas &
are Present with Specific Characters i.e शब्द, स्पर्श, रूप, रस र गन्ध
which is being expalined by Dalhan in his Susruta Commentary in
the Context of विषान्न परिक्षा (Examination of Poisonous Food)
explained in the following Way:
• शब्द परिक्षा - When Poisoned Food Burns Making Loud Cracks.
• स्पर्श परिक्षा - When Poisoned Food Comes in Contact with
Hand, it Causes Burning Sensation in Hand & Falling of Nails.
• रूप परिक्षा - When Cast into the Fire it acquires the Colour of a
Peacock’s Neck.
• रस परिक्षा - Flies die after flying over the Poisoned Food.
• गन्ध परिक्षा - When it Burns it Emits Irritating Fumes & it
cannot be Speedily Extinguished.
 • PanchaBhautika Pariksha / Nidana-
PanchaBhautik Nidan of Visha is based on its Guna & Nidan of
Guna is based on its Specific Characteristics Features. So, it is
necessary first to know the Main Guna of Visha, it’s PanchaBhautika
Sangathan, Dosha Prabhav & Karma etc.
गुण भौतिक संगठन दोष प्रभाव कर्म
रूक्षता अग्नि + वायु + पृथ्वी वातकर, कफ्घ्न Shoshan, Rukshta, BalaVarna Haani,
Avrishyata, Sthambhana & Kharata.
उष्णता अग्नि पित्तकर, Swedan, Murchha, Trisha, Daha.
वातश्लेष्महर
तिक्षणता अग्नि पित्तकर, कफ्घ्न Daha-Paka, Sravakar & Lekhana.
सूक्ष्मता अग्नि + वायु + आकाश वातकर LaghuPaka, MalaShoshana,Entry into
Sukshma Srotas.
विशदता अग्नि + वायु + आकाश + वातकर Kshalan, KledaShoshan & VranaRopana.
पृथ्वी
लघुता अग्नि + वायु + आकाश कफहर , वातहर Langhana, Utsah, Sphurti, MalaKshaya,
Atripti, Daurbalya & Krista etc.
2. Examination of Poison on the Features (लक्षणानुसार) /
General Symptoms of Poisoning-
According to Ayurveda, The Vishas are divided into Sthavar & Jaangam on the
basis of its Origin &the type of the Visha can be known by its Poisonous Features.

A. जाङ्गम विष (Animal Poison Features)-

“निदर् ां तन्दर् ां क्लमं दाहं सपाकं लोमहर्षणम्
शोफ़् चै वातिसारं च जनये ज्जङ्गं विषम” (च.चि.23/15)
- The Animal Poison produces Sleep, Drowsiness, Exhaustion (अकारण थकावट),
Burning Sensation, Inflammation, Horripulation (रौं खडा हुनु ), Oedema &
Diarrhoea.

B. स्थावर विष (Vegetable Poison Features) -

“स्थावरं तु ल्वरं हिक्कां दन्तहर्षं गलग्रहम
् शम्” (च.चि.23/16)
फ़ेनव्म्यरुचिश्वाश्मूर्च्हस्च्ह जनये दवि
- The Vegetable Poison produces Fever, Hiccup, Sensitiveness of the Teeth, Spasm
in the Throat (जकडाहट), Frothy Saliva (मु ख बाट फ़ेन्), Vomiting, Anorexia
(अरुचि ), Dyspnoea (श्वाश्) & Fainting.
• According to Modern, there is no such Specific Characters of
Poisoning is found by which it can be Diagnosed.
• Main Characters found is वमन, अतिसार, आक्षे प & मूर्छ हा
or सन्यास (Coma). Other general characters like तीव्र उदरशु ल
(Colic), आध्मान (Tymphanitis), लालास्राव (Salivation),
कर्णक्षवे ड (Buzzing in the Ears), Increasment in Temperature,
शीतान्गता (Collapsing Condition), प्रलाप (Delirium), Nervous
System Disturbance, Changes in Respiration Rate etc.
• Differential Diagnosis- Gastritis, Gastric & Duodenal
Ulcer, Appendicitis, Epilepsy, Tetanus, Heart Disease, Nervous
System Disorders etc.
• So, one have to more Careful in Diagnosis of Poison.
• The Food & Drink taken by Patient, Medicine, Vomiting,
Urine & Faeces must be Examined carefully because one can
find the Sign & Symptoms of Poisoning in it.
Specific Symptoms of Poisoning :
Sudden Death- Potassium Cyanide, Hydrocyanic Acid,
Carbon Monoxide, Carbon Dioxide, Ammonia & Oxalic
Acid.
Loss of Consciousness- Morphine, Alcohol, Camphor,
Chloroform & Chloral Hydrate.
Heart Failure- Acids, Alkalis, Arsenic, TamalPatra
(Garcinia morilla), Vatsanabh, Nilanjana (Antimony) &
Antipyretics.
Paleness of the Face- Antifebrin.
Delirium- Bhanga, Dhattura, Alcohol, Camphor &
Belladonna.
Tetanus like Convulsions- Kuchala, Arsenic, Antimony.
Paralysis- Vatsanabh, Arsenic, Lead & Conium.
Dilation of the Pupils- Dhattura, Belladonna, Vatsanabh,
Alcohol, Opium & Chloroform.
Constriction of the Pupils- Morphine, Carbolic Acid &
Chloral Hydrate.
Dryness of the Skin- Dhattura & Belladonna.
Humidity of the Skin- Opium, Vatsanabh, Alcohol,
Tobacco & Antimony.
Bleached Face (श्वे त मुख )- Corrosive Acids & Alkalis.
Vomitting- Arsenic, Antimony, Vatsanabha, Ammonia &
Phosphorus etc.
- Apart from these Direct Observation, one have to also
Observed Pulse Rate & Heart Rate, Respiration,
Consciousness & Loss, Mental Conditions.
 Diagnosis- According to Modern
• Poisoning may be Suicidal, Homicidal or Accidental, and a
definite history of Ingestion, or Contact with a known
Poisonous Substances may or may not be available.
• Therefore, the Possibility of Poisoning should always be
considered in a Puzzling Situation when differential diagnosis
presents a difficult Problem.
• Accordingly, it is Essential that one should be familiar with
the outstanding Symptoms & Signs of Poisoning in the Living
Persons together with its effects as found in the Examination
of the Dead.
• So, Diagnosis of Poisoning can be done in Two Ways-
1. Diagnosis of Poisoning in the Living & 2. in Dead.
1. Diagnosis of Poisoning in the Living –
A. Acute Poisoning – The following considerations may be taken out-
I. The Symptoms appear suddenly in a Healthy Person.
II. Proper History Taking may be difficult in Homicidal or
Suicidal Cases.
III. Sudden onset of Symptoms after Meals in the Previously Healthy
Individual.
IV. Other Family Members if Affected Uniformly.
V. Detection of Poison can be attempted in Stool accordingly to
Poisons used. e.g. - Corrosive Poisons leave External Marks.
- Spinal Poisons stimulate Convulsions etc.
VI. Strong Evidence in favour of Poisoning is the detection of the
Poisons in the Food, Medicine, Vomit, Urine or Faeces. Therefore in all
the Suspected Cases of Poisoning these Samples must be sent for
Chemical Analysis to the Laboratory.
B. Chronic Poisoning –
Chronic Poisoning (चिरकारि विषाक्तता) :
I. The Symptoms appeared after the Administration of
- InSuspected Food,Visha
Ayurveda, Dushi Fluid(Slow
or Medicine.
Poisoning) is known as Chronic
II. Poisoning.
Depression & Gradual Deterioration of General
- A/c to VagBhatta (A.Hrd.Utt.Chap.35),
Conditions
- Due of the
to Alpa Virya, Patient
it does is seen.
not Kill Instantaly.
III. Repeated
- Due Attacks
to KaphaVritta of Diarrhoea,
(UnDigestion), Vomiting
it lies etc.,forare
in the Body seen.
Years.
- The
IV. Patient
When theaffected
Patientfrom this DushiVisha
is removed from his willusual
continously
surroundings
suffering from Atisara, Pyaas, Aruchi, Murchha, Vamana, Bhaari
the Symptoms disappear.
Aawaz, Moha & Abdominal Diseases & Dushita Raktawala (Vitiated
V. Traces of Poison may be found in the Urine, Stools or
Blood).
Vomit.
2. Diagnosis of Poisoning in the Dead–

A detailed history of –
- the quality & quantity of the Poison administered,
- the character of the Symptoms with reference to their onset,
- the time that passed between the intake of the Poison &
development of Symptoms,
- the duration of illness,
- the Treatment given and
- the Time of Death etc. should be obtained from the
Relatives.
The following Consideration should be made into account-
A. Post Mortem Examination
B. Chemical Examination
C. Experiments in Animals
D. Collection of Moral & Circumstantial Evidence
1. Postmortem Examination –
-All deaths due to Poisoning are Medico- Legal Cases & in
all Probability will have to be subjected to a detailed Autopsy.
The general procedure of examination as in any other
Unnatural Death is carried out with particular reference to
those aspects which can give a clue to the Detection and
identification of Poison.
I. External Examination & II. Internal Examination
External Examination –

A. Stains or Marks of Vomit, Faeces etc.

B. Certain Poison impart characteristics colouration for example :

Phosphorous - Yellowish or Brownish Colouration.
Cyanide – Brick Red.
Carbon Monoxide – Cherry Red.

C. Injection Marks (Some Poisons are Injected).

D. Extent of Putrefaction- Some Poisons are reputed to retard Putrefaction

of the Dead Body, e.g. Arsenic, Organophosphate etc.

E. Orifices of the Body for Marks of Corrosion or Foreign Body.

F. Odour, especially around the Mouth & Nose, which can be explained
in the following table :

Poison Nature of Odour

Cyanide Bitter Almonds
Ethyl Alcohol Fruity
Hydrogen Sulphide Rotten Eggs
Cannabis (Marijuana) Burnt Rope
NitroBenzene Shoe Polish
Paraldehyde & Chloral Hydrate Pear-like (Acrid)
Phospphorus, Arsenic, Malathion, Thallium Garlicky
Zinc Phosphide Musty (Fishy)
Phenol & Camphor Difficult to describe
II. Internal Examination –
a. Odour always helps before Opening the Skull, since many Poisons
impart a faint odour to Brain Tissues, e.g. Alcohol, Phenol, Cyanide etc.
b. Examination of the GastroIntestinal Tract-
1. Hyperemia (रक्ताधिक्य) or Redness of the Mucous Membrane. If there
is Discolouration, it may be present due to various substances e.g. Fruit
Juice etc.
2. Softening (मृदुता) occurs due to Corrosive Poisons, mostly with Alkalis
seen in the Stomach, Mouth , Throat & Oesophagus.
3. Ulceration (व्रणीभवन) is seen mostly in the Stomach & has to be
differentiated from a Peptic Ulcer.
4. Perforation (छिदर् ता) occurs rarely except with Sulphuric Acid
Poisoning. Perforation could also occur as a result of Chronic Ulcer, but
the Perforation in this Case is commonly Oval or Rounded.
c. Contents of GI Tract- Sometimes the Poisonous Substances in the
Form of Tablets, Powders or Fluid may be Present
d. State of the Liver and Kidneys- Congested, Necrosis or Degenerative
Changes are Produced by some Poisons.
e. Heart- Haemorrhage is Characteristically seen in Arsenic Poisoning.

B. Chemical Examination- In every Case of Poisoning, an attempt

must be made to demonstrate the presence of Poison by accepted
analytical methods. For this Purpose, Certain Body Fluid & Viscera
must be sent to nearest Forensic Science Laboratory, through the Police.
For the Chemical Analysis, Two Points are important-
a. Collection of the Viscera &
b. Preservatives for the Viscera & Body Fluids
a. Collection of the Viscera : Detection of Poison in Blood, Faeces,
Urine or in the Organs of the Body is the Surest Proof of Poisoning.
Poison may be detected in the Stomach, Intestine & Sometimes in the
Liver, Spleen & Kidney. The Viscera Collection is done in 2 Ways-
1. Routine Viscera - Routinely for every case of Poisoning.
2.Materials Quantity
Special Viscera – in certain specified case of Poisoning.
1. Stomach
Routine Viscera - Entire
2. Stomach Contents Upto 300 ml
3. Small Intestine 100 to 200 cm (entire in Infants)
4. Small Intestine Contents Upto 100 ml
5. Liver (Portion containg Gall 500 gms
Bladder )
6. Kidneys One Half of each Kidneys
7. Urine Upto 200 ml
8. Blood 5 to 10 ml
Special Viscera -

Materials Quantity Poison

1. CSF As much as we can Alcohol
2. Brain Half (One Barbiturate, Carbon
Hemisphere) Monoxide,
Anaesthetics, Cyanide,
Strychnine, Opiates,
Alcohol etc.
3. Spinal Cord Entire Length Strychnine, Gelemium
4. Lung One Lung Inhaled Poison
5. Skin Affected Portion Corrosive
6. Long Bone 10 cm length Heavy Metals
7. Scalp Hair 5 gm Heavy Metals
II. Preservatives for the Viscera & Body Fluids –
1. Rectified Spirit – it should not be used in certain Poisons e.g. in
Alcohol, Carbolic Acid, Phosphorous Paraldehyde.
2. Sodium Chloride (Saturated Solution) – should not be used as it
hardens the Tissues. Hence Extraction of Poison become very
difficult.

Material Preservatives
1. Viscera Saturated Solution of Common Salt
2. Blood For every 10 ml of Blood, use of 30 mg
Potassium Oxalates & 10 ml of Sodium
Fluoride
3. Urine Saturated Solution of Common Salt or 5 ml
Conc. HCL for every 250 – 500 ml
 C. Experiments in Animals
• In Ayurveda using of the Animals in the detection of the Poison is described by
Susruta in the KalpaSthanam i.e.
- On the Sight of Poisonous Food, Chakora bird loses its Redness of Eyes
instantaneously .Jivajivaka (Flies) dies under a similar condition.
- The Voice of Cuckoo (Kokila Bird) becomes Abnormal,
- Krauncha (Heron) becomes excited.
- A Mayur (Peacock) becomes Unstable and a Suka & Sarika Scream (Fear).
- A Hamsa (Swan) roams excessively, and a Bhringaraja (a type of
Bird) rises its inarticulate voice. Hence keeping these Birds & Animals in the
Royal Palace for Show and Entertainment as well as for the Protection of the
Sovereign Master.
• In Modern Medicine this is not the ideal test, for Signs & Symptoms may be due
to other causes. Absence of Sign and Symptoms may be due to insusceptibility of
the Animal to the Particular Poison, e..g.
- Rabbits are insusceptible to Belladonna, Hyocyamus & Stramonium.
- Pigeons are not affected by Opium.
- Cats & Dogs are not affected by Poisons almost in the same way as Man.
 D. Collection of Moral & Circumstantial Evidence

--- (नै तिक र पारिस्थितिक साक्ष्य)

Such Evidence may consists of Motive, the evidence of Witness about

the recent Purchase of the Poison, his Behaviour before & after the
Committing of the Offence, and the Recovery of the Poison from the
Possession of the Accused.
 Duties of Medical Practitioner
• The Duties are Two –
Medical - Care & Treatment of the Patient.
Legal – Assist the Police to determine the manner of Death.
1. Note Preliminary Particulars of the Patient e.g. Age, Sex, Address, Date &
Time, Identification Marks i.e “Case History” & if the Patient is in Serious
Condition than one should registered the Patient “Dying Declaration”.
2. In Case of Suspected Homicidal Poisoning, the Doctor must confirm his
suspicion before expressing his Opinion. For this the Doctor must-
I. Collection of Vomitus & Urine, and also should Submit for analysis , some
part of the contents should also be Preserved in his Custody.
II. Carefully observe and Record the Symptoms in relation of Food, in case if it
is Food Poisoning origination from a Public Eatery (Canteen, Café, Hotel etc.)
, the Public authorities must be Notified.
III. The Opinion of another Doctor is worthwhile & Wherever possible the case
should be shifted to the Hospital.
IV. The Doctor should keep Detailed Records of the number of his Visits, the
Symptoms & Signs observed and Treatment given time to time.
3. Once the Suspicions are Confirmed, he should request the shifting
of the Patient to Hospital. If the Victim is an Adult , it might be
Desirable to Speak to him about the steps to be taken.

4. After the Dying of the Patient, Doctor should not give Death
Certificate. For inquiry, one should Inform the Police.

5. If the Practitioner is summoned by the investigating Police Officer,

he is bound to give all information regarding the Case that has come
to his Notice. If he Conceals or gives False Information he is liable to
be charged with the Offence of giving False Information.
RajaVaidya Lakshnas – (Su.Kalpa 1)

Powerful Enemies, even the Servants & Relatives of the King in

subdued Anger to Avenge themselves on the Sovereign sometimes
administration of Strong Poisonous Compound to kill.

Sometimes the Ladies of Royal House hold are found to administer to

the King various Preparations of Food & Drink, which often prove to
be Poisonous .

Sometimes it is found that by the Embrace of Poisoned Girl

(VishaKanya) , the King died almost instantaneously.
Hence it is the main duty of the Royal Physician to protect the King
against such Poisoning.
RajaVaidya Lakshnas -
A King should appoint a Physician. He should be Well- Paid &
Possess the following Qualifications.
--- He should come from a Respectable Family, should be Virtuous in
Conduct, and always be Watchful of the Health of the King.
--- He should be Greedless, Straight- Forward, God – Fearing,
Grateful, Good Looking, and Devoid of Anger, Roughness, Vanity,
Arrogance and Laziness.
--- He should be Forbearing, Self – Controlled, Merciful, Clean, with
Good Conduct & Compassion, Intelligent, Sincere, Well- Wisher,
Soft- Spoken, Bold, Skilful and Ever-Ready Physician with these
qualities, respected by the Experts in the Field and Possessing Anti-
Poisonous Remedies should be Appointed by the King.
• Treatment of Poisoning
 Assessment of the Patient’s Condition
• A/c to Ayurveda –
“दे शप्रकृतसात्म्यतु र्विषवे गबलाबलं
प्रधार्य निपु णं बु द्धया ततः कर्म समाचरे त् ” (सु . क. ५/ ३५)
- A Wise Physician should Treat a Case of Poisoning with a full
regard to the Nature of the Country, Body Constitute, Compatibility,
Season, Poisonous Impulse & Intensity of Poison.

In similar way VagBhatta has also explained-

“इति प्रकृतिसात्म्यतु स्थानवे गबलाबलम
आलोच्य निपु णं बु द्धया कर्मान्तरमाचरे त् ” (अ. ह्रद.उ. ३५/ ६५)
- The Wise Physician should determine the Appropriate Treatment
only after Considering the Nature, Accustomisation, Season,
Location, Stage, Strength of the Poison & Weakness of the Patient.
 Assessment of the Patient’s Condition
• A/c to Modern –

• First of all find out whether the Patient is in more

dangerous Stage (i.e. Emergency). In such a Case, the
initial Priority should correct immediate Life Threating
Problems of :

- A = Airway,
- B = Breathing,
- C = Circulation &
- D = CNS Depression.
 Assessment of the Patient’s Condition
• In the absence of a Crisis, a thorough examination of the
Patient must be conducted with reference to :

A. Level of Consciousness
B. Poison Severity Score
C. Respiratory Status
D. Cardiac Status
E. Body Temperature
F. Pupillary Status &
G. Presence or Absence of Convulsions.
 Assessment of the Patient’s Condition
A. Level of Consciousness – This is to be Assessed as per
Reed’s Classification described as follows –
Group Symptoms
Group “O” Arousable.
Group “1” Respond to Painful Stimuli & have intact
Reflexes.
Group “2” Do not respond to Painful Stimuli – most
Reflex are Normal.
Group “3” Do not respond to Painful Stimuli – most
Reflex are Absent.
Group “4” Deeply Comatose, with Respiratory and / or
Circulatory Failure.
 Assessment of the Patient’s Condition

C. Respiratory Status - This must be assessed after a clear

Airway has been Established, by means of Arterial
Puncture & Measurement of Blood pH, PCo2 & Plasma
Bi- Carbonate. A simple method to measure the Respiratory
Minute Volume is by Wright’s Spirometer. If it is less than
4 Litres / Minute, Respiratory insufficient is Present.

D. Cardiac Status – It is assessed by Recording &

Monitoring the Pulse, Blood Pressure & Urinary Output.
Various Poisons cause Abnormalities in these
Measurements. The Poisons which affect on these systems
are as follows :
Blood pH = 7.35.
A pH of 7 is Neutral. The lower the pH, the more Acidic the Blood. A Variety of
Factors affect Blood pH including what is Ingested, Vomiting, Kidney Function &
Urinary Tract Infection. The Normal Blood pH is tightly regulated between 7.35
and 7.45
Plasma Bi- Carbonate = The BiCarbonate of the Blood Plasma, an important
Parameter of Acid Base Balance measured in Blood Gas Analysis.
The Respiratory Minute Volume – or Minute Ventilation or Expired Minute
Volume is the Volume of Gas inhaled or Exhaled from a Person’s Lungs per
Minute.
PCo2 / Partial Pressure of Carbon Dioxide – reflects the Amount of Carbon
Dioxide Gas dissolve in the Blood. Indirectly, the PCo2 reflects the Exchanges of
this Gas through the Lungs to the Outside Air.
TachyCardia = is a Heart Rate that Exceeds the Normal Resting Heart Rate. In
General a Resting Heart Rate over 100 Beats per Minute is accepted as
TachyCardia.
BradyCardia = is a Heart Rate of less than 60 Beats per Minute.
Oliguria / HypoUresis = is the Low Output of Urine. In Humans, it is Clinically
classified as an Output more than 80 ml/ Day but less than 400 ml/ Day.
 Assessment of the Patient’s Condition
D. Cardiac Status :
I. Drugs producing changes in Blood Pressure -
A. Hypertension – Cocaine, Nicotine & Amphetamines.
B. Hypotension – Antihypertensive Drugs, AntiPsychotics,
Diuretics, Ethyl Alcohol, Sedatives & Hypnotics.
II. Drugs producing changes in Heart Beat / Pulse Rate -
A. TachyCardia - Alcohol, Dhattura, Salicylates & Nicotine.
B. BradyCardia – Aconite, Digitalis, Opiates, Organophosphates.
III. Drugs causing Oliguria – Barbiturates, Carbolic Acid,
Cantharidin, Ethylene Glycol, Oxalic Acid, Petroleum
Derivatives, Salicylates, Sulphonamides.
 Assessment of the Patient’s Condition
E. Body Temperature – Hypothermia is a Common
Complication in many Poisoned Comatose Patients. It is
said to be Present when the Rectal Temperature falls below
35 Degree C (95 Degree Fahrenheit).
Some Drugs in Overdose produce Hyperthermia, i.e.
Temperature above 38 Degree C (100.4 Degree Fahrenhit),
(if it exceeds 42 Degree C (107.6 Degree Fahrenheit) there
can be Serious Threat to Life). The Effect of different
Drugs are described as follows –
A. HypoThermia – Anaesthetic Drugs, Barbiturates,
Carbon Monoxide, CNS Depressants, Opiates etc.
B. HyperThermia – Amphetamines, AntiCholinergic,
AntiHistamine, Cocaine & Salicylates etc.
 Assessment of the Patient’s Condition
F. Pupillary Status - Several Poisons produce Pupillary changes, and
this can helpful in identifying the Nature of Poison in a particular Case
as described below-
A. Dilated Pupils – Alcohol (Constriced in Coma), AntiHistamines,
Carbon Monoxide, Cocaine, Cyanide, Dhattura, Ephedrine,
Pethidine etc.
B. Constricted Pupils – Barbiturates, Caffeine, Ergot, Nicotine, Opiates
& OrganoPhosphates etc.
- Aconite is reputed to Produce a Spasmodic Pupil (Hippus), i.e.
Alternate Constriction & Dilation.
G. Presence Or Absence of Convulsions – Several Drugs
Provoke Convulsions in Toxic Doses or during Withdrawal. e.g. Nux
Vomica (Kuchala), Arsenic & Antimony (Nilanjana) etc. produce
Tetanus like Convulsions.
 Treatment of Poisoning
A/c to Ayurveda, The Treatment of Poison can be Proceeded in Two
ways –
1. General Treatment (सामान्य चिकित्सा ) &
2. Specific Treatment (विशिष्ट चिकित्सा )

- In General Treatment, Rules & Regulation can be followed but

in all types of Poisonings as well as in the condition where
Physician is in doubtful about the Poisoning, the Physician
should carry out the General Treatment Principles.

- The Specific Treatment Principles is carried out in Specific

Type of Poisoning which will be described elaborately in the
concerned chapters.
Principles of General Treatment :
A. In all kinds of Poisons & in all Stages of Poisoning,
Four Therapies viz
1. Sramsana / (स्रंसन) (Mild Purgation),
2. Pralepa (प्रले प) (Application of Paste on the Skin),
3. Food (भोज्य) &
4. Drug Recipe (औषध) , should not be done without the
addition of Ghrita.

- There is no other Medicine equal to Ghrita (in the

Treatment of Poisons) especially so when Vata is
Predominant. ---Astanga Samgraha Uttar 40 / 168
B. “श्लै ष्मिक वमनै रुष्णरुक्षतीक्ष्णै ः प्रले पनै ः
कषायकटुतिकतै श्र्च भोजनै ः शमये दवि ् षम् ” (अ. सं .उ. ४० / १६५)
- Poison which possess qualities of Sleshma (Kapha)
should be mitigated by Emesis, Application of Paste of Drugs
having the Hot, Dry & Penetrating Qualities (Ushna, Ruksha,
Tikshna) and the use of Foods having Astringent, Pungent &
Bitter Tastes (Kashaya, Katu & Tikta Rasas).

C. “पै तिकं स्रंसनै ःसे कदे हभृशशीतलै ः

कषायतिक्तमधु रैघृतयु क्तै श्च भोजनै ः” (अ. सं .उ. ४० / १६६)

- Poison which possess qualities of Pitta should be Mitigated by

Mild Purgation, Bathing, Application of Pastes which has the
qualities of Cold with Foods of Astringent, Bitter & Sweet
Tastes (Kashaya, Tikta & Madhura Rasas) added with Ghrita.
D. “वातात्मकंजये त् स्वादुस्निग्धाम्ललवणान्वितै ः
सघृतैभोजनाले पैस्तथै व पिशिताशनै ः” (अ. सं .उ. ४० / १६७)
- Poison which possesses qualities of Vata should be
Pacified by use of Foods having Madhura, Snigdha, Amla &
Lavana (Sweet, Unctous, Sour, Salt Taste) added with Ghrita &
Application of Paste of Similar Qualities on Skin & Eating Meat (as
Food).
E. Poisoned localised in the Asaya of the Doshas that should be
Treated first without Contradicting the Concept of Asraya & Asrayi.
F. Charak described 24 types of General Treatment Principles of the
Poisoning and can be Applied according to the Condition of the
Poisoning. These are मन्त्र, अरिष्टा बन्धन, उत्कर्तन, निष्पिडन, चूषण,
दहन / अग्निकर्म, परिषे चन , अवगाहन, रक्तमोक्षण ,वमन, विरे चन, उपधान,
हृद्यावरण , अञ्जन, नस्य, धूमन, ले ह, औषध, प्रधमन, प्रतिसारण, प्रतिविष,
सं ज्ञास्थापन, ले प & मृत सं जीवन.
A/c to Dr. K.M.ShyamSundar in Visha Vijyana :
The 24 Remedial Measures for the Poisoning can be
understood in the following way :

1. To Check Entry & Circulation of Blood –

I. अरिष्टा - बन्धन (Binding or Ligature)

II. उत्कर्तन (Incision)
III. निष्पिडन (Compression)
IV. चूषण (Suction)
V. दहन / अग्निकर्म (Cauterisation / Heating)
VI. परिसे क (Sprinkling)
VII. अवगाह (Bath / Cold Treatment)
2. Eliminative Therapy –
VIII. रक्तमोक्षण (Blood – Letting / Bleeding)
IX. वमन (Emesis)
X. विरे चन (Purgation)
XI. नस्य (Inhalation / Snuffing)
3. Symptomatic Therapy -
XII. हृद्यावरण (Protecting & Stimulating of the Heart)
XIII. सं ज्ञास्थापन (Revival of Consciousness / Resuscitation)
XIV. मृत सं जीवन (Revivation)
4. CounterActing Measures -
XV. मन्त्र (Mantra)
XVI. औषध (Medicaments)
XVII. प्रतिविष (Antidotes)
5. Pacificatory Measures –

XVIII. ले प (Paste)
XIX. प्रतिसारण (Local Application / Rubbing of
AntiPoisonous
Powders)
XX. अञ्जन (Applying the Medicine into the Eyes / Collyrium)
XXI. उपधान ( Placing the Medicine on Incised Scalp)
XXII. प्रधमन (Blowing up through Nose)
XXIII. धूमन (Medicinal Smokes) &
XIV. ले ह (Licking Semi Liquids / Linctus).
1. Mantra (मन्त्र):

Definition - Mantra is termed as a Word or the Combinations

of the Words, if Recited in a Prescribed Manner the Person is
able to Reach the God or Could Possess the Immortal Power
which is Considered to be the Best & most Effective among
all types of the Treatments.

Importance – The Mantra full of Energy with the Nature of

Truth and Divine Communion delivered by Devarishi and
Bramharishis. These never Fail to Eliminate the Poison from
the System. Even these will Act immediately in Terrible
Poisoning. Poison will get Eliminated Very quickly by
Mantras than the Medicine.
Method of Recitation of Mantras :
- While Learning the Mantras one should be abstaining from
Women, Meat, Wine, Honey. One should take little Food,
Maintaining the Hygiene of the Body and should Sleep on
the Mattress which is made with Kusa Grass.

- For Accomplishment of the Mantras one should also

Worship the Gods devotedly with Offerings of Perfumes,
Garlands, Oblations, Repeated Chanting of the Mantras
(Japa) and Sacrificial Oblations. The Mantras do not Fulfil
their Objects if Pronounced in Wrong Way or Deficient in
Accent & Letters, in Such Conditions Anti – Poisonous
Drugs has to be Used. The Mantra Specified for all types of
Poisonings are Described in the Ayurveda Prakasha.
- In Today Era of Technology and Science, as advancement
is taking in Every Field, the Perception of the Peoples are
getting Changed day by day even though the effect of the
Mantra cannot be Perceived Practically, but if the Mind is
Tuned in the Spiritual Aspect thoroughly, definitely the
effect of the Mantra can be Proved which is obviously
beyond the Materialistic View of the Common Person.
2. अरिष्टा - बन्धन (Binding or Ligature) :
- अरिष्ट means Unfavourable or which gives the Indication of
Death. Obviously when the Intensity of the Poison increases, it
signifies the Arista. As Poison starts combining with the Blood
and gets Spreaded all over the Body, successively it invading
the other Organs in the Body. Thus to Prevent or Stops the
Disasters which could be created by the Poison, the Physician
has to adopt the Bandhana. To Stop the Arista can be called as
Arista – Bandhana.
Materials :
- Cloth,
- Skin,
- Soft Fibre or any other Soft Articles can be used for
Ligature.
Procedure :

- In Susruta Samhita - Kalpa Sthana – Chap.5 , it is said that

The Ligature should First of all be Bound to Four Fingers
apart above the Seat of the Bite in the Event of its
Occurring in the Extremities, in as much as such a
Proceeding would arrest the further (Upward) Course of
the Poisoning in the Body.

- If it is Tied with the Mantra by a Physician who is Well –

Versed in the Mantras of Anti – Venomous Potency will
act very Effectively.
PreCautions :

- Vrudha VagBhatta (Astanga Samgraha .Uttarsthana - 42)

Specified that the Depending on the Nature of the Place, it
is beneficial to Tie it neither very Tight nor very Loose;
Very Tight Binding Produces Bad Smell, Swelling etc. at
the Site; where as Loose Binding will be Unable to
Prevent the Spreading of Poison to other Places.

- Again Vrudha VagBhatta Specified that Just as Water is

Obstructed from moving (Out) by Dam, so also Poison
should be Obstructed by the Arista Bandhana and it does
not Flow through the Vessels.
3. उतकर्तन (Incision) :
- Acharya Charak (C.Ch.23/44) had Mentioned that Poison
does not Advance after Incision of the Bite like a Tree after
Cutting its Root, which means the Spreading of the Poison
can be Stopped.
4. निष्पीडन (Compression) :
- Vrudha VagBhatta (Astanga Samgraha .Uttarsthana - 42)
Mentioned that Expelling of the Poison by Squeezing the
Area of Bite where the Incision is not Advisable. This
method helps in Removing the Poison from the Body just
like Destroying of the Seed before Sprouting. This Procedure
should not be done if the Bite is Present on Vital Parts &
Joints, if it is Performed on Vital Parts may Lead to Death,
Similarly on the Joints leads to Distortions of the Body.
5. चूषण (Sucking) :
- Vrudha VagBhatta (Astanga Samgraha .Uttarsthana - 42) has
Mentioned that The Physician should Suck the Poison along with
Blood filling his Mouth earlier with either Mud, Ash, Medicinal
Recipe or Cow Dung, through an Incision made below the Arista
Bandhana on the Site of the Bite. This method should be specially
adopted on Fleshy Parts.

6. अग्निकर्म (Cauterisation) :
- Acharya VagBhatta has described that Except the Site of Bite
of Mandali Snake with Patches which is Pitta Predominant (Causing
Aggravation of Pitta) all other Bites, should be Burnt by Heated Rods of
Gold, Iron etc or even by a Burning Faggot. The Fire Converts
everything into Ash immediately, even earlier than a Second.
- Acharya Charak told that AgniKarma is Mainly indicated in
the Twak & Mamsa Gata Visha.
7. परिषे क (Sprinkling) :
- Acharya Susruta has Described Parisheka after the
RaktaMokshan in Poisonous Conditions. It is Prepared by
the Decoction of the Chandana & Ushira. Then the
Decoction should be Sprinkled on the Affected Part to
Pacify the Aggravated Doshas.
- Acharya Charak also described that the Application of
Cold Paste or Sprinkling of Cold Decoction helps in the
Condensation of the Blood is the only Media for the
Spreading of the Poison in the Body.
8. अवगाह (Bath) :
- Avagaha means Immersion or Dipping the Affected Part in
a Medicated Decoction or Oil.
9. रक्तमोक्षण (Blood- Letting) :
a. Importance - Acharya Charak has mentioned that Blood –
Letting eliminates the Poison from the Blood as the Blood is the
major media which blow up the Poison just like how Air blows
up the Fire. That’s how the Blood – Letting Procedure Plays an
important Role in Controlling the intensity of the Poison.
b. Indications :
- Blood – Letting should be Speedily restored in the Case where
the Poisoned Area has become Discoloured, Rigid, Swollen &
Painful. (Su.Kal.5/36)
- And also if the Poison has Spreaded to Distant Areas,
Venesection should be done which is the Best Treatment. If
(Poisoned) Blood is not Removed out, the Poison removes
(Destrous) everything, Vitiated Blood Spreading through out the
Body which surely cause Death. (A.S.U.42)
c. Contra-indications :
- In the Case of an Infant, an Old Man, or a Pregnant Woman in
these Patients it is Contra-indicated. (Su. K.5)
d. Selection of the Vein : The Expert Clinician should Puncture
Veins around the Site of the Bite. In Case the Poison has
Spreaded, Veins at the End of the Extremities or in Fore head
should be Punctured. (Su. K.5)
e. Procedure : Blood Letting should be Performed by
Scraping, Application of Horn, Leech or Venesection. The Blood
afflicted by Poison causes Vitiation of other Tissue Elements in the
Body leading to Death. From Site of Bite if the Blood does not
comes out, then Rubbing Therapy (प्रघर्शन) should be employed
for Proper Flow of the Blood. For the Purpose of Rubbing should
be done with the help of Powders of the Trikatu, GrhaDhuma,
Rajani, PanchaLavana, Rechana & Vartaka. (Ch.Ch. 23)
- Acharya VagBhatta has explained that while doing the
Venous Puncture if Vein is not available due to Oedema, in
such Conditions for Blood Letting either Srunga or Leach
should be Used. (As. Sam. Utt.42)
- And the Veins of the Fore-Head and Extremities should
be Opened in the Case where the Poison would be found
to have Spreaded through out the whole Body. (Su.K.5)

f. Features of Poisonous Blood :

- The Poisonous Blood will have Bad Odour and if it is Put
into the Fire, makes the Crackling Sound. (A.S.U.42)
g. PreCautions :
- As the Features are Showing the Flow of Pure Blood
should be Arrested. After the Blood Letting Therapy the
remaining amount of Blood which is Existing in the Body
if gets Liquefied by the influence of Heat of Poison,
should be Stopped immediately by the intensive Cold
Procedures repeatedly and helps in Restricting the Blood
Flow. If the Blood does not Clot due to the Power
influence of the Poison leads to Fainting, Toxicity, Cardiac
Complications etc. develops. These should be Treated by
Cold Therapies and Fanning the Patient till he gets
Horripilation. (A.S.U. 42)
10. वमन (Emesis) :
- During the First Phase the ingested Poison should be Eliminated
by Emesis, which means if the Poison is in the Stomach.
(Ch.Chi.23)
- This Procedure is also indicated in other Conditions such as the
Patient who is affected with a Poison marked by a
Predominance of Aggravated Kapha and Bitten in the Winter
would have Cold Salivation, Fainting and in toxication should
be Treated with Strong Emetics. (Su.K.5)
- In Astanga Samgraha UttaraSthana 42, Acharya tells other than
the above, that this Vamana could be done if the Snake Bite is
above Umbilicus and by the different Procedures of the
PreCautions
Hridyavaran:Kapha
Avoidgets
Useincreased
of Liquids
andsuch as SourinGruel,
accumulates the Heart
Soup of Horsegram,
Producing Oil, Wine
Feeling Heaviness, etc. so that
Salivation Kapha hence
and Nausea, does
notPatient
Spread to the
should be Entire
made toBody.
Vomit using Emetic Drugs which are
AntiPoisonous.
11. विरे चन (Purgation) :
- In the Second Stage of the Poisoning the Purgation is
Indicated which means if the Poison is in the Pakvasaya
the Purgation can be done. (Ch.Chi. 23)
- Virechana can be followed in the Conditions such as a
Patient affected by the Poison with Marked Symptoms like
Pain and Burning Sensation in the Abdomen, Adhmana
(Distension of Abdomen), Retention of Urine, Stool and
Flatus, Painful Urination and other troubles of the
Deranged Pitta. (Su.K.5)
- VagBhatta described that the Person of Pitta Constitution
bitten by a :Snake
PreCautions of Pitta Suffering
The Patient Predominant features,
from the Bite
Poisoning
below
should bethe Umbilicus
made to PurgeandLying
if it ison
Localized in the has a
the Cot which
Pakvasaya
Hole requires
(For Passing thethe Virechana.
Faeces) becauseAfter Vomiting
Frequent &
getting
up Purgation
will causethe Patient should
Aggravation Drink(A.S.U.
of Vata. AntiPosinous
42) Yavagu.
(A.S.Utt.42 )
12. उपधान (Medication on Incised Scalp) :
- When the Channels of Kapha gets Vitiated by Poison, then
this Cause Obstruction in the Channels because of which
the Movement of Vayu gets Obstructed. As a result of this,
the Patient Breathes as if he going to Die Very Soon. If he
is free from Signs and Symptoms of Incurability, then the
Incisions should be made on his Scalp resembling the Paw
of the Crow (काकपाद) and One Bilva Quantity of the Paste
of Carmakasa , or Meat of Goat, Cow, Buffalo or Cock
should be applied which will absorbs the Poisons from the
Body. (Ch.Chi.23)
- Acharya VagBhatta has Stressed regarding the Procedure
with respect to Site of Bite. If the Snake Bite is in the
Lower Parts of the Body Incision should made on the
Scalp, similarly if it is on the Upper Part of the Body the
Incision should be made on the Feet. (A.S.U.)
13. प्रधमन (Blowing up through Nose) :
- After the Upadhana in the Patient’s Nostrils blow up the
Powder of Katabhi, Katuka & Katphala . (Ch.Chi.23)
14. हृदयावरण (Protection of Heart) :
- Poison by its Penetrating Property Weakens the Heart, so
in order to Protect it, the Patient should be made to drink
Pure Ghrita, Ghrita mixed with Honey or Anti-Poisonous
Drugs added with More Ghrita. (A.S.U.)
15. अन्जन (Collyrium) :
- Pippali, Maricha, YavakaKshara, Vacha, Saindhava &
Sigru, Macerated with the Bile of Rohita Fish and applied
as Collyrium,
Anjana destroys
should the Poison
be Applied alongpresent in the in
the Eyelids Eye.
theAfter
the
CaseUseofofa Strong
SwellingNasal Drops
of the & Collyrium,
EyeBalls, Ghrita
Somnolence,
should be Drunk of
Discolouration in the
larger Dose,
Eye, because
Blurred Poison
Vision andby
itsPenetrating
DisColoured Property
Appearance destroys
of allthe Eye which
Objects. is Dry
(Su.K. 5)
and
Irritating. (A.S.U.)
16. नस्य (Nasal Medication) :
- When Poison is Presented in the Head, Nasal Medication should be done
with the Juice of Root of Bandhujiva, Bharangi and Atisa Surasa, or the
Powder of Pippali, Hingu, Vrisrchikali, Manasila, SirisBija, Apamarga,
Lavaenam, blown into the Nose, restores Consciousness.
(A.S.U)

17. धूमन (Smoking) :

- Dhumana means Medicated Smoke which helps to Clear off Blocked
Channels due to which the Respiration Process gets Stabilised. This Anti
Toxic Medicated Smoke enters in the Body and Nullifies the Adverse
Effect of the Poison. Due to this Medicated Smoke the Toxic Ants , Flies
also leave their Place, we get many such Combinations of this Medicated
Smoke in the Classics, e.g. DhoomaAgada : Tagara & Kustha mixed with
Ghrita, Head of the King Serpent and Sirisa Flowers make DhoomaAgada
(AntiPoison Fumigation) which alleviates all types of Poison and Swelling.
(C. Ch.23) Also it Prevents the Entry of the Snakes to those Places.

- In another Context Acharya Susruta has told that where ever the Swedan is
Contra-indicated, there the Dhoopan Karma can be done. e.g. Vrishchika
Visha (Su.K.8)
18. ले ह (Linctus) :
- Lehya means the Preparation of the Medicine in the Palatable
Form. Generally in the Poisoned Conditions the Dryness of
Throat and Mouth is most Common and in this Condition as to
avoid the Adverse Effects of the Poison, the immediate
Medication should be administered which also should be easily
digestible.
- Thus in this Condition Lehya are generally used as a Anupana.
The most Preferred one is the Combination of Honey & Ghee.

19. औषध (Oushadha) :

- Using of different Medicines in different Complications which are
raised through Poisoning.
20. प्रतिसारन (Rubbing of AntiPoisonous Powders) :
- While doing the Blood letting at the Site of Snake Bite, if the
Blood is not Coming out, it should be impelled by application of
rubbing of Powders such as Sunthi, Marciha, Pippali, GrihaDhuma,
Haridra, PanchaLavana, Brihati etc.
21. प्रतिविष (Antidotes) :
- When the Effects of Poison does not Subside by Curative
Hymns & Drug Administration, after the Lapse of the
Fifth Stage and before the Lapse of Seventh Stage,
Counter-Poison has to be Administered, after duly
• informed
Antidotethe
acts like Nectar when applied / administered
King (Master / Authority) but never without
to Wounds or person who have Poison in them.
intimating Some One (other than the Patient). (A.S.U.48)
Whereas it acts like Poison only if the Wound or
- Selection
Person isofnot
thehaving
Counter-Poison (Antidote)
Poison. Powerful : Jangama
Counter-Poisons
Visha is usedtoinWeak
administered Sthavara Visha
Persons Poisoning
give & Vice
rise to many
Versa. Hence Patient
Complications who is bitten by Jangama Prani
/ Diseases.
• should be of
In Case administered Sthavara
doubt whether Visha
a Person & the Patient
is having Poisonwho
or
has Consumed
not, Sthavara an
in such condition Visha
Agadashould
whichbe is
gotharmless
bitten by
Snake
shouldbybe
Clever Physician ; Nothing is equal to Poison to
administered.
• Neutralise
Hence thethe Poison. (A.S.U.)
Physician should be understand the Presence
of Poison by all Efforts.
22. संज्ञास्थापन (Revival of Consciousness / Resuscitation):
- To do Treatment in Poisoning Case, first it is very
important to make Conscious State of an Unconscious
Patient. So why this is a very important Procedure which
Plays a Vital Role. This Procedure is described by Acharya
Susruta which is as follow :
- Nasya should be blown into the Nostrils of the Patients
suffering from the Effects of Poisoning, in the case where
Symptoms such as Loss of Consciousness, upturned eyes
and drooping of the Neck would be set in. The Venous
Section should be done immediately to the Veins of the
Patient’s Forehead & Extremities. If the desire bleeding
does not appear by Venous Section the Expert Surgeon
should immediately do the Superficial Incisions on the
Scalp in the Shape of KakPada by the instrument.
- By doing such Wound, the bleeding will start. After that on
that incision Flesh with Blood or the Decoction or Paste of
CharmaVriksha (Chamer) should be applied over the Scalp.
Big Drums (दुन्दुभि / ठुलो ढोल वा नगाडा) smeared with
antiVenomous Plasters should be Sounded around the
Patient. The Patient thus restored the Consciousness should
be Treated with both Purgatives & Emetics.

- Complete elimination of the Poison from the System is a

very difficult Task but it is very necessary since least
remnant of the Poison may again be aggravated in course of
Time and Cause Lassitude (शिथिलता), Loss of Complexion
(विवर्णता ), Fever, Cough, Headache, Swelling, Blindness,
Cold, Aversion of the Food to Patient (अरुचि) etc. These also
should be Treated according to Dosha.
 ले प (Paste):
23.
- Due to Poison causes Narcosis, Fainting, Affliction and Palpation
of Heart, theses should be averted with Cold Application, which
Pacify the Poison like Ceasing of the Fire by Sprinkling of Water.

24.मृतसंजीवन (Revivation):
- MritSanjeevan is one of the Ancient Classical Therapy through
which the Life of an individual can be regained. But nowadays
this Therapy has got Vanished. This Therapy could be considered
as Broad Spectrum or Universal Antidote which can be used to
nullify the toxic effects of almost all the types of Toxins.
- In Charak Samhita Chikitsa Sthana 23, there is one Agada named
as मृतसंजीवन अगद which is indicated in – सबै प्रकारको विष-विकारमा , सबै
प्रकारको ज्वरमा, नस्यमा, ले पनको लागि, धारणको लागी, धूमपान र घरमा राख्ने
योग्य हो. यसको प्रभावले भूत-प्रेतबाधा, दरिदर् ता, कार्मन (जादु – टोना),
अनिष्टकारक (मारण, मोहन, उच्चाटन), अग्निभय, वज्रभय, शत्रुभय र अकाल
मृ त्यु – यि सबै को विनाश हुन्छ.
 “According to Modern”
The basic Principles of Treatment of Poisoning
are of Five Stages:
A. Prevention of further exposure to the Poison

B. Removal of Unabsorbed Poison

C. Use of an Antidote

D. Removal of Absorbed Poison &

E. Symptomatic Treatment.
A. Prevention of further exposure to the Poison :
- This is mainly useful in Inhaled and Injected
Poisons. If the Poison has been given by
Inhalation, then remove the Patient from that
- In some cases
Atmosphere, where
begin the Poison
Artificial has been (Avoid
Respiration
introduced
Mouth to Mouthby aResuscitation,
SubCutaneousas Injection or by a
far as Possible),
Bite an immediate
administer Oxygen. Ligature, ice Cold Pack or
Sucking could Prevent the Absorption of the
- If there is Severe BronchoSpasm, administer
Poison.
Broncho-Dilators,
- Washing with Water if there is Pulmonary
is Useful where the Oedema,
Poison
give Diuretics
has like Furosemide
been introduced (40Rectum
into Vagina, mg) oror
Urinary Bladder.
Corticosteroids likeHowever if the Nature
Hydrocortisone (100ofmgtheIV 6
Poison
hourly) is known
e.g. as Specific Solvent could
as in Carbon-Monoxide Prove to
Poisoning.
more Useful.
 Emesis
B. Removal Methods
Contraindications of are :
UnAbsorbed to Emesis
Poison :
(DeContamination) :
a. Put the Finger in the Mouth & Tickle the Posterior Wall of Pharynx.
• Since
-b. Corrosive
As most
a First ofPoisoning
the
Aid useful Poisons
Household – because
are
Emetics – ingested,of the
- Drink Copious amount of Warm Water.
APossibility
- decontamination
Table Spoonful ofofMustard
Perforation
is usually aStomach.
Powder inachieved
Tumbler (200 byml)Evacuation
of Warm
•
- Two
Kerosene
Water.
of the Stomach.
Spoonful
Poisoning – The main danger is the
of NaCl in Warm Water Produce Emesis.
- This Aspiration
c. Zinc Sulphate 20-30Pneumonia
is done either by inducingwhich
grains in 4 ozs of Water. has
If necessary
Emesis Proved
repeat the
(Vomiting)
Process.
Fatal
d. or20-30
by grains inofMany
Performing aCases.
ipecacuanha Stomach
(root of SmallWash (Gastric
Shrub Cephalis ipecacuanha, it
• Lavage).
Strychnine
contains CephaelinePoisoning
& Emetine Active – Principles)
If Vomiting dissolvedisin Water.
e. Cupper Sulphate 5-10 grains in One Oz. of Water. This is never used in
induced
Arsenic there
Poisoning is Cupric
because the Possibility
Arsenic is Formed ofwhich
inducing
is more
1. Emesis – This must be attempted only in the
Convulsions.
harmful than Arsenic (Strychnine
itself. = a Pesticide)
Conscious
f. ApoMorphine & Alert Patient.
injected 1/20 Due
to 1/10 grains to the danger
SunCutaneously acts of
as a
• Centrally
Unconscious Patient
Acting Emetic. The Effect –comes
Because of theAndanger
in 3- 4 Minutes. Important
inhaling Gastric
Side Effect Contents,
which could
of Aspiration be dangerous
leading Vomiting
to the Patient
tobyAspiration should
is Cardiac only be
induced when
Irregularity.
Pneumonia.
injection
Thisa
Atropine.
Conscious
should
The
be
use of
Patient
Countered
ApoMorphine
is
injection.
is
Lying
Nalorphine
avoided in
on &
Patients
his
in
sideComa.
with Head dependent.
The above methods D & F are avoided in these days because of its
Adverse Effects.
II. Gastric Lavage (Stomach Wash) :
Indication : This is Useful in ingestion type of Poisoning & must be
undertaken only in the Conscious, Alert Patient. If the Patient is
Unconscious, inert a Cuffed Endotracheal Tube in the Airway before
attempting to wash out the Stomach.
- Gastric Lavage must preferably be done within 4- 6 Hours of
Ingestion of the Poison. But in the Case of Certain Drugs (Salicylates,
Phenothiazine, Tricyclic AntiDepressants etc.), it can be done of
benefit even upto 12- 18 Hours Post-Ingestion.
Type of Tube :
For Adult – 30 to 40 French Ewald Tube or 30 Gauge Jacques Tube.
For Child – 16 to 28 French Organic Type Tube or Ryle’s Tube.
Length of Tube to be Inserted :
For Adult – 50 cm.
For Child – 25 cm.
II. Gastric Lavage (Stomach Wash) :
Procedure : The preferred route of insertion of Lubricated
Tube is Oral. Passing the Tube Nasally can damage Mucosa
considerably.
- The Patient must be Placed in the Left Lateral Decubitus
Position, with the Head at a Lower Level than the Feet.
- Use a Mouth Gag so that the Patient will not bite an Tube.
A Funnel must be Present at the End of the Lavage Tube
through which 300 ml Aliquots (Portions) of Warm Water or
Saline is then Poured at a Time, (100 ml in a Child).
- After the Funnel empties, lower it below the Patient and let
the Fluid drain by gravity into a collecting basin. Always
retain the First Washing (done with Plain Water) for
Chemical Analysis. This is continued until the returning
Fluid becomes Clear.
Lavage Fluid :
Contraindications :
-- Warm Water (even
Corrosive Tap Water
(except is Sufficient),
Carbolic Acid)
Convulsants
-- Saline (0.9 % or 0.45 %)
ForeignSolutions
-- Oxidising Body indigestion
: Potassium PerManganate (1:5000),
Oesophageal
- Tannic Acid (4 %),Varices
Iodinated Water.
- Petroleum
These Distillates
are Preferred in Alkaloidal Poisons, Salicylates etc. –
- Sodium ThioSulphate Solution 25 % for Cyanide &
-At the Oil
Castor end&ofWarm
Stomach Wash,
Water (1:2) for the Stomach
Carbolic Acid. can
either be left Empty, or a Specific Antidote
Complications :
Solution (if available) for the Particular
-Poison
Vomiting
may be Left behind.
- Aspiration Pneumonia
- Damage to Oesophageal & Gastric Mucosa (rarely
Perforation)
C. Use of the Antidote in Poisoning :
- An Antidote is a Substance which Counteracts the
Effects of the Poison.
- In Popular Fiction, Miraculous Properties are
attributed to Antidotes. They are usually Projected
as “Magic Bullets” which fly to Heart of the
Problem, effecting a Dramatic Recovery in the
Patient. Strangely, this Myth is Perpetuated even in
some Textbooks of Toxicology.
- It is True that there are a few Poisons for which
Genuine Antidote exist, but the Vast Majority
unfortunately are without such Magic Remedies.
Types of the Antidotes in Poisoning :
a) Mechanical or Physical
b) Chemical
c) Physiological

a. Mechanical Antidotes : These are Substances which render a

Poison inert by their Mechanical Action e.g.
- Bulky Foods in Case of Poisoning by Glass Powder, Diamond
Dusts and other Mechanical Poison as it Prevents their Action
by entangling their Particles within its Meshes.
- Egg Albumin, Ghrita & Taila etc. as it forms a Coating along
with the Layers of the Mucosa & does not allow the Poison to
get absorbed from the Gut.
- Charcoal Dust acts by absorbing the Organic Poison & Partly
Mineral Poison by absorbing and Retaining in its Pores.
b. Chemical Antidotes : These are Substances which after
Chemical Combination with Poison renders the Poison inert.
- Weak Acids for Strong Alkali Poisons.
- Weak Alkalis for Strong Acids Poisons.
- Lime (चु ना) for Oxalic Acid Poisoning.
- The Potassium PerManganate is a very important Chemical
Antidotes because of its Strong Oxidising Property. It can
be Used for – Phosphate Poisoning, Quinine Poisoning,
Phosphorous Poisoning & HydroCyanic Acid Poisoning.
- The Chief Disadvantage of Potassium PerMangante is the
Detection of Poison. An Alternative Potassium
PerMangante is a Dilute Solution of Tincture of Iodine (15
Drops in 100 ml of Water). It is Useful as it Precipitates
most of the Alkaloids.
c. Physiological Antidotes : These are Substances
which act on Tissues of the Body and Produce certain
Symptoms exactly Opposite to those Produced by the
Poison.
-Atropine
A Perfect Physiological Antidote exactly
Physostigmine
Counteracts all Harmful Effects produced by a
Paralyses the Vagus Nerve, Stimulates the Vagus Nerve,
Poison.
hence the Heart Rate is hence the Heart Rate is
-Accelerated.
Atropine and Physostigmine are the Real
Decreased.
Physiological Antidotes.
The Third Cranial Nerve The Physiological
The Actions of
Third Cranial Nerve
these Two
Endings arecould be Compared
Paralysed, as : are Stimulated, hence
hence Endings
the Pupils are Dilated. the Pupils are Constricted.
The Secretion of the Glands The Secretion of the Glands
are Decreased. are Increased.
BAL Dose : in Severe
The Examples are :Poisoning condition a Dose of 3 to 4
mg/kg. is given. 3ml
• Physostigmine of 10% of BAL
or Neostigmine & 20% or
for Dhattura of Atropine
Benzyl
Benzoate
Poisoning.in Arachis Oil is injected deep IntraMuscularly
4th Hourly for the First 2 Days, and then Twice Daily for
•10Bemegride for Barbiturate Poisoning.
Days or till Recovery.
•BAL
Nalorphine for Opium or Morphine
Toxic Manifestations : Poisoning.
•Restlessness,
Barbiturate for Nux vomica
Salivation, Poisoning.
Vomiting, Convulsions, Coma. If
these
• BAL appears
(BritishitAnti
is useful to administer
Lewisite) – ChemicallyEphedrine
it is 2:3
Sulphate 2 ml.Propanol. It acts on Cellular Level and
Dimercapto
BAL Contraindications
Dislodges the Metals from: its combination with Sulfhydryl
HepatoCellular
- Radical Damage,
in the Tissues Kidney
Enzymes and Damage,
Carries it to the Tissue
If injected
- Fluids, to thefor long it
Plasma andinduces
finallyTetany because
to the Urine. It isofuseful in
elimination
Poisoning of –ofArsenic,
large Quantities of Calcium
Mercury, Bismuth, from
Gold, the
Organic
Body. Hence
Antimony, Calcium
Other Heavy Gluconate
Metals. I/V should be given
along with.
• EDTA (Ethylene Diamine Tetra Acetic Acid) - it acts like
BAL, as Chelating Agent. It is Useful in Lead Poisoning. The
Formed Product is Water Soluble and NonToxic. It is
Excreted intact in the Urine.
- Dose : Given in a Drip Form in 50-500 cc of Normal Saline.
The Dilution being One 5 cc Ampoule of 20% Solution in
250-500 cc of Normal Saline. It is to be given in Morning and
in the Evening for 5 Days.
Chelating Agents = Chemical Compounds (Usually
- Toxic
OrganicEffects are – Nephrotoxicity,
Compounds) Mayalgia (Pain
that form Complexes in
with
Muscle or Group
Metal ions of Muscles),
or other Fever,
Substrates (anRigors (a sudden
underlying
feeling of Cold
Substance with Shivering
or Layer). with raiseAgent
The Chelating in Temperature)
has a Ringetc.
- Contraindications
like Center, whichare : a Complex with the Metal
forms
- Renalby
ion / Substrate Dysfunction,
Two or more Bindings and the
Metal is Bound and Excreted.
- HepatoCellular Damage &
- Calcium Deficiencies.
• Penicillamine - it is Aminoacid derivative of Penicillin. It
Universal
is Useful inAntidote
Poisoning= from
Mixture of Gold,
Lead, Two Parts Activated
Copper Mercury.
Charcoal, One Part Tannic Acid, and one Part
- Dose : 200-300 mg per day Orally for 10 Days. The Dose
Magnesium
may Oxide.
be increased to 4 gm a Day.
List of Antidotes & Indication :
- Toxic Effects are – Thrombocytopenia, Agranulocytosis
1. Activated Characoal with Sorbitol in – Many Oral &
Renal Damage
Toxins . etc.
2. Theophylline in – Adenosine Poisoning
• DesferriOxamine : Acts as Chelating&Agent,
3. Atropine in – OrganoPhosphte Useful in
Carbamate
Poisoning from Iron.
insecticides, Nerve Agents, Some Mushrooms.
4. Beta
- Dose : 10Blocker in –mlTheophylline.
gm in 100 Water Orally or 1-3 Per Day I.M.
5. 100 % Oxygen or HyperbBaric Oxygen Therapy
(HBOT) in – Carbon Monoxide Poisoning &
• स्वर्णभस्म, प्रवालपिष्टि, ताप्यादी लौह etc. are Physiological
Cyanide Poisoning.
Antidotes.
d. Removal
Peritoneal of Absorbed
Dialysis Poison
– Before Dialysis :
was available, Total
Kidney Failure means Death. Today, People with Kidney Failure
can live because of Such Treatment like Peritoneal Dialysis.
1. Renal PDExcretion
is a Treatment: Whatever
for KidneyPoison
Failureis that
absorbed could
uses the lining
of Abdomen,
be got ridoroutBelly, to filter
of the Bodyblood inside the
by giving I/VBody. This
Fluids andLining
is known as Peritoneum.
simultaneously using safe Diuretics as Frusemide,
This is a Way to remove Waste Products from Blood
when Kidneysor
Mannitol canChlorthiazide.
no longer do the Job adequately.
Haemodialysis – A Medical Procedure to remove Fluid &
Waste
2. Products
Purging from
: 30 gmtheof Blood
Sodium andSulphate
to Correct Electrolyte
with large
imbalance.
amountsThis is accomplished
of Water, hastens theusing a Machine and
elimination a Dialyzer,
of Poison in
also referred as “Artifical Kidney”.
the Haemodialysis
Stools. is used to Treat both Acute (Temporary) &
Chronic (Permanent) Kidney Failure.
Haemodialysis
3. Peritoneal Dialysisis one
&ofHaemodialysis
Three Renal Replacement
: In most Cases,
Therapies (the other
it is doubtful Two being
whether this Kidney
SpeedsTransplant & Peritoneal
up the Excretion of
Dialysis).
Toxic Agents. But it can be used in Renal Failure.
e. Symptomatic Treatment :
I. Raising of the Foot and of the Bed.
II. VasoPressor (Anti Hypotensive Agent) used in
Cases where B.P. is Falling e.g. Mephentine I/V,
Dose depending upon the Severity of the Case.
III. Replacement of Electrolytes is done in Cases where
Dehydration is Extreme e.g. in Arsenic Poisoning.
IV. In Case of Severe Pain & Shock – Morphine 1/8 to
1/4 grain S/C or Pethidine 50 mg to 100 mg I/M is
the Best Choice. The Depressive Effect of these
Drugs on the CNS has to be Carefully watched
henceforth it is best to avoided in Poisoning which
depress the CNS.
V. In Case where Anaphylactic Shock is Evident, Adrenaline is
given S/C followed if necessary by I/V Drip of Nor
Adrenaline. Steroids are must in addition to this Treatment.
VI. In the Respiratory Failure, Passage of the Air is kept Clear,
Oxygen is given and Drugs which Stimulates Respiration are
to be given e.g. Coramine.
VII.If the Patient has Fever, AntiPyretics are Used.
VIII.The Nutrition of the Patient is Maintained.
IX. In Treating the Poisoning, it is very important to remove the
Residual Poison from the Body by Use of Drugs, by Sight and
Sound. Even slight remnant of Poison causes either Diseases
or Death. (अ.स.उ.४७/४८) (Look by the Peacock, Seeing
Precious Stones and Divine Herbs are examples for
Antipoisonous Drugs of Sight, Application of AntiPoisonous
Herbs on Kettle Drums, Musical Instruments etc and Beating
them to fill the Air with AntiPoisonous Dust is the example of
Drugs of Sound)
 Features & Treatment A/C to Mode of
Poisoning
1. Poisonous Food :
I. Features of Poisoned Drinks & Vegetables – In Case of
Poisoning, all Liquids-Milk, Wine etc.- Develop Streaks,
Froth & Bubbles, Shadows in them are not Visible and if
Visible they are Twins, Holed, Smaller or Abnormal.
- Vegetables, Pulses, Rice etc. and Meat become Moistened
& State-like immediately losing their Normal Taste &
Aroma; other Edibles also lose their Aroma, Colour & Taste;
Fruits if Ripe, get rotten and if Unripe get ripened.
- The Poisoned Food features were described in the Chapter
of Visha Pariksha. (Su.KalpaSthana 1)
II. Features of Poisonous Food Vapour –
- If the Poisoned Food served the Vapours get Spreaded
upwards Causes Pain in the Heart, Abnormal Movements of
Eyes & Headache.
- The Treatment in such Cases is Snuff & Collyrium of
Kustha, Lamajjaka, Nalada & Honey should be applied.
Sisira, Haridra & Chandana should be used as Paste,
particularly of Chandana in the Cardiac Region which gives
Relief.
III. Features of Poisonous Food Touch – If the Poisoned
Food comes in the Contact with Hand, it causes Burning
Sensation in Hand & Falling of the Nails.
- In this Case, Paste of Shyama, Indra, Gopa, Soma &
Utpala is Used.
IV. Features of Poison on Ingestion –
- If by Careless or Ignorance, one takes the Food the Tongue
becomes Stony Hard, Loses the Taste Sensation, has
Pricking Pain, Burning Sensation & Salvation.
A. Amashayagata Visha Lakshanas : If the Poisoned Food
goes to Stomach, it may cause Fainting, Vomiting,
Diarrhoea, Flatulence, Burning Sensation, Trembling and
Abnormality of Sense Organs.
- For the Amashayagata Visha – Emesis should be
B. Pakvashayagata
given immediately Visha
withLakshanas : If the Poisoned
Fruits of Madana , Bitter
reached
Gourd,to the Intestines
Bimbi – Produces
& Kosataki mixedBurning Sensation,
with Curd &
Fainting,
ButterDiarrhoea, Thirst,
Milk or Rice Abnormalities of Sense Organs,
– Water.
-Gurling Sound,
For the Pallor & Emaciation.
Pakvashayagata Visha – Nilini Fruits should
be Treatment
- The administered with
should beGhrita
followedforduring
Purgation,
initial or Dushi
Stages for
VishaHari
ingested Formulation
Poisons as like to thebeVapour
Drunk–with
PoisonCurd mixed
& Poisoned
with
Tooth Honey.
Brush.
2. Poisonous Tooth Twig (Visha DantaKastha):
- If the Twig for Cleaning Teeth is Poisoned, the Brushy ends
drops drown and Swelling arises in Tongue, Gums and Lips.
- The Treatment for this , the Site of Swelling should be
Scarified and then rubbed with Dhataki Pushpa, Hareetaki
and Seeds of Jambu Fruit mixed with Honey; or Root of
Ankota or Bark of SaptaParna or Seeds of Sirish mixed with
Honey should be used as Rubbing Recipe.

3. Poisonous Tongue Scraper & Gargling

(Vishayukta JihvaNirlekhana, Kavala Lakshana):
- Features & Treatments as like described for Poisonous Tooth
Twig.
4. Poisonous features of Massage Oil (Visha Yukta
Abhayanga Lakshana):
- If the Material for Massage is Poisoned, it becomes Slimy, Thick
or DisColoured. When applied, it causes Eruption of Boils, Pain,
Discharge, Suppuration of Skin, Sweating, Fever & Tearing of
Muscles.
- The Patient should be Bathed with Cold Water and then Paste of
Chandan, Tagara, Kushtha, Ushira, VenuPatraka, Somavalli,
Amruta, Sveta, Kamal, Kaliyaka & Tvaka should be applied.
The same should be used as drink along with the Juice of
Kapittha & Cow’s Urine.

5. Poisonous Features of Utasadan & Parisheka :

- Poisoning of an Ointment, Bath Decoction (or Powder), after-
Paste, Bed, Clothes and Armour should be known by the Signs &
Symptoms in the Case of Massage.
6. Poisonous features of Comb :
- In Case the use of Poisoned Comb, there are falling of
Hairs, Headache, Bleeding from Passages & appearance
of Cysts on Head.
- In such Case Paste of Black Earth impregnated with Bile
of Deer, Ghrita, Shyama, Palindi and Tanduliyaka should
be applied repeatedly or Paste of CowDung Juice or Juice
of Jaati or MushikaParni or Soot is Useful.
- Massaging Oil to Head (Sirobhyanga), Protective
Wearings to Head, Shampoo, Garland, if these are
Poisoned the Features manifested will be same as that of
features of Poisoned combining and Treatment adopted in
this should be same as that of Poisoned Combing.
7. Poisonous features of Cosmetics :
- If the Poisoned Cosmetics is applied on the Face, the Face
become Blackish and Exhibits the features of Poisoned
Massage.
- For this – Drink of Honey and Ghrita mixed together should
be used and also the Paste of Chandana, Ghrita, Madhuka,
Phanji, BandhuJiva and Punarnava.

8. Poisonous features of Nasya & Dhumapana :

- Haemorrhage from Passages, Headache, Excessive
discharge of Mucous and abnormalities in Sense Organs –
these are the Signs of Poisoned Snuff and Smoking.
- Here Ghrita Cooked with Milk of Cow along with AtiVisha
and added with Shweta & Madyantika is useful as Drink
and Snuff.
9. Poisonous features of Flowers :
- In Case of Poisoning Flowers, Lose Smell and Colour, by
Smelling them one Suffers from Headache and Tearful
Eyes.
- This should be managed with Recipes as Prescribed for
Poisoned Vapour or Facial Cosmetics.

10. Poisonous features of Karna Taila :

- If Ear Oil is Poisoned it Produces Disorders of Hearing,
Swelling, Pain and Discharge from Ear.
- This should be Treated with Ear-Filling with the Juice of
Shatavari mixed with Ghrita and Honey. The Juice of
SomaVallaka (KatPhal) is also for Ear Filling.
11. Poisonous features of Anjana :
- In Case of Poisoned Collyrium there are Slimness due to
Lachrymation, Burning Sensation, Pain, Defects of Vision
and even Blindness.
- In this Case, Ghrita should be used immediately as
Saturating filling in Eyes and Same mixed with Pippali
should be taken internally.
- The following should be used as Collyrium – Juice of
MeshaSringi, Varuna, Mushkaka and AjaKarna or
SamudraPhena mixed with Gorochan. The Flower of each
Kapithha, MeshaSringi, Bhallataka, Bandhuka and
Ankota should also be used as Collyrium.
12. Poisonous features of Foot Wear :
- Poisoned Wooden Foot Wear causes inflammation,
Discharge, Numbness and Eruptions of Boils in Feet.
- The Case of Poisoned Foot - Wear & Ornaments should
be Treated with the Recipes as Prescribed for Massage.

13. Poisonous features of Ornaments :

- Poisoned Ornaments Lose their Brilliance and Shining as
before. Moreover, they cause in their respective Sites,
Burning Sensation, Suppuration and Tearing.
- The Treatment is as like to the Massage.
 Features of Recovery from the
Poisoning (विषमु क्त लक्षण)
“प्रशान्तदोषः प्रकृ तिस्थ धातु आहारकामं सममूतर् विटकम
प्रसन्नवर्णेन्द्रियचित्तचे ष्टं वै धोवगत्छे दविषम मनस्यम”
(अ.स. उ. ४७/८२)
- After the Treatment, the Physician should examine the
Patient free from the Poison, when the Doshas have been
SubSided, the Tissue have become Normal, who is Desirous
of Food, is Normal in respect of Urine and Faeces, has
Pleasing Colour / Complexion, Good Working of the Sense
Organs and the Mind.