DIAGNOSIS OF

POISONING
Atchaya D
2019
GDMCH
IN THE LIVING:
 Sudden symptoms
 Shortly after food
 Common source of poison
 Sudden collapse
 Coma
 Convulsions
 Delirium
 Paralysis
 Cyanosis
 DIAGNOSIS IN THE DEAD
(I) POSTMORTEM APPEARANCES:
(1) EXTERNAL

 (1) The surface of the body and the clothes may show vomit, faeces or the
poison itself.
 The colour changes
 Black: oxalic acid, H2SO4, HCl
 Brown: Nitric acid
 Bluish white : Mercuric chloride
 Orange: Potassium chromate
COFFEE GROUND VOMITUS
2. PM STAINING
 (3) Smell about the mouth and nose:

 Garlic-like: phosphorus, arsine gas, arsenic (breath and

perspiration), thallium, selenium, dimethylsufoxide, tellurium,
parathion, malathion.
 Sweet or fruity: ethanol, chloroform, nitrites
 Acrid: paraldehyde, chloral hydrate.
 Rotten eggs:hydrogen sulphide, mercaptans, disulfiram.
 Fishy or musty: zinc phosphide.
 (4) The natural orifices
 (5) Injection marks
 (6) Skin : hyperkeratosis and pigmentation :chronic arsenical
poisoning.
Jaundice : senecio, phosphorus
INTERNAL
 (1) Peculiar smell : cyanide, alcohol, phenol
 (2) Mouth and throat
 (3) Oesophagus: cantharidin ulceration.
 Perforation paraquat and fluorides.
 (4) Upper respiratory tract: volatile irritants or inhaled
poisonous matter
CANTHARIDE
 (5) Stomach:
 (a)Hyperaemia: The ridges are more involved.
Covered with a sticky secretion and shows
small haemorrhagic foci.
 (b) Softening: Corrosive poisons, chiefly alkaline corrosives.
mouth, throat and oesophagus.
 (c) Ulcers: erosion with thin, friable margins.
 (d) Perforation: strong mineral acids Ammonia.
 (6) The Duodenum and Intestines: mercury poisoning.
 (7) Liver: Chloroform, carbon tetrachloride necrosis.
Phosphorus, potassium Jaundice
 (8) Kidneys: Parenchymatous degenerativechanges irritant metal &
cantharidin poisoning.
Necrosis of PCT ( Phenol, Carbon Tetrachloride ) Mercuric
chloride, Lysol

(9) Heart: Subendocardial haemorrhages acute arsenic poisoning.

(II) Chemical Analysis:

 Poison found in liver,kidney and blood is proof of absorption.

 Advanced decomposition: thigh muscles are preserved & reflects blood levels
 Poison found in urine, unless added with evil intention, is a proof of absorption
 Single direct spot tests.
 In delayed deaths, the toxic agent may be found in the urine, when none is found
in the viscera.
 Blood : specimen of choice
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