It could play a role in the development of diabetes, cancer, vascular disease and lung disease. The Food and Drug Administration says that long-term exposure to high levels of arsenic is associated with higher rates of skin cancer, bladder cancer and lung cancer, as well as heart disease

2. POISONS
IRRITANTS
INORGANIC
NON-
METALLIC
METALLIC
ORGANIC
ANIMAL VEGETABLE
MECHANICAL

3. INORGANIC
 METALLIC
 ARSENIC
 ANTIMONY
 MERCURY
 LEAD
 COPPER
 THALLIUM
 ZINC
 MANGANESE
 BARIUM
 RADIOACTIVE SUBSTANCES

4. IRRITANTS
INORGANIC
NON-METALLIC
PHOSPHORUS
CHLORINE
BROMINE
IODINE

5. ORGANIC
ANIMAL
CANTHARIDES
SNAKES
SCORPIONS
SPIDERS
POISONOUS INSECTS

6. ORGANIC
VEGETABLE POISONS
CASTOR OIL SEEDS
CROTON SEEDS
ABRUS PRECATONIUS
COLOCYNTH
ERGOT
CAPSICUM
SEMECARPUS ANACARDIUM
CALOTROPIS
PLUMBAGO ROSEA
PLUMBAGO ZEYLANCIA

7. MECHANICAL
COARSELY POWDERED GLASS
CHOPPED HAIR
DRIED SPONGE
DIAMOND DUST

8. MODE OF ACTION OF
IRRITANT POISONS.
THEY PRODUCE SYMPTOMS OF
ABDOMINAL PAIN
VOMITING
PURGING.

11. ARSENIC
(Metallic Poison Main
Homicidal Poison)
 Grey -- Non poisonous
 White -- Arsenious Oxide – Tasteless,
Colorless odorless
Sankhia : white powder
Somalkhar: opaque white brittle masses

12. Where do we find Arsenic?
 paints
 In industries, water contaminated with industrial
waste.
 strengthening alloys of copper and
especiallylead (for example, in car batteries)
 pesticides, treated wood products, herbicides,
and insecticides

13. Arsenic trioxide

14. SULPHIDES OF ARSENIC: Yellow or Red
Insoluble & non poisonous but if contaminated
then poisonous
Copper Compounds:
Scheel’s green
Paris green
Emerald green
Hirwa

15. OTHERS
Arsenate of lead
Arsenites of sodium & potassium
MECHANISM OF ACTION
Combines with SH-group of enzymes
Interferes with cell metabolism
(floats on the surface & stick to vessel wall)

16. ARSENIC POISONING
 Acute
 Sub acute
 Narcotic
ACUTE: (Appears with in 15 to 30 minutes).
Sign & Symptoms:
 Nausea
 Vomiting --- first stomach contents than blackish
or greenish due to bile finally mucous mixed with
blood.
 Burning pain in epigastriam ed by pressure

17.  Diarrhea with tenesmus & tinged with
blood
 Rice watery stools
 Intense thirst
 Painful cramps in legs
 Unconsciousness death

18. SUBACUTE POISONING: 7 to 10 days
Symptoms persists in lesser degree.
NARCOTIC POISONING:
Large doses quickly absorbed gastric
symptoms mild ---- cerebrospinal symptoms
present.
 Vertigo
 Headache
 Stupor
 Depression of circulation
 Patient dies of heart failure

19. FATAL DOSE
 120 – 200mg. However 15gms have been
ingested without fatal effects
 Fatal Period :
Narcotic - 2 – 3 hrs
GIT form - 12 – 48 hrs
Sub-acute - days

20. TREATMENT
 Stomach wash
 Antidote -- freshly precipitated hydrated
ferric oxide
 Butter & greasy substances
 Saline purgatives & sodium sulphate
 Inj dimercaprol 3 mg/kg – 4hourly for 2 days
then 6 hourly for 3rd day
then 12 hourly for 6 days

21.  Parentral fluids
 Sodium thiosulphate 1 gm in 10 ml saline 4-6
hourly for 1st 24 hrs.
 Morphine for pain
 Glucose to combat liver damage
 Transfusion
 Dialysis

22. POSTMORTEM APPEARANCE
EXTERNALLY (acute cases)
Dehydration
Rigor mortis lasts longer
INTERNALLY
Stomach --- red velvety appearance
patchy distribution
Acute ulceration at pyloric end
Patecheal haemorrhages

23. SMALL INTESTINE:
Mucous membrane is inflamed especially in
upper Part
HEART:
Haemorrhages under endocardium of left
ventricle even when stomach findings are less
prominent.
ABDOMINAL ORGANS
LARYNX
TRACHEA
LUNGS
Haemorrhages

24. Liver
Kidney Fatty degeneration

25. CHRONIC POISONING
Results from:
i. After effects of acute poisoning.
ii. Accidental ingestion of repeated doses.
iii. Taking food or drink in which traces are
present.
iv. When excretory function is interfered.

26. STAGES
 STAGE OF NUTRITIONAL DEFICIENCY
 STAGE OF CATARRHAL CHANGES
 Stage of skin rash • Rain drop pigmentation
• Hyperkeratosis of palms
& sole
• Falling of hair and nail
• MEES LINES (White band
on nails)

27. Rain drop pigmentation

28. Rain drop pigmentation

29. Hyperkeratosis

30.  STAGE OF NERVOUS DISTURBANCES
 Peripheral neuritis (extensor of foot)
 Tingling and numbness of hands and feet
 Parises
 Liver, kidney and heart damage
 Bone narrow depression

31. TREATMENT
 Removal from the source
 IV sodium thiosulphate 1gm/10 ml H2O 2 – 3
times weekly.
 BAL
 Symptomatic treatment
(6months to 1yrs for complete recovery)

32. POSTMORTEM APPEARANCE
i. Retardation of decomposition
ii. Great loss of flesh
iii. Fatty degeneration of heart, liver, kidney
iv. Congestion of GIT
v. Skin changes
vi. Hair, nail, urine and faces for lab test

33. MEDICOLEGAL IMPORTANCE
 Mostly homicidal
 Accidental
 Rarely suicidal
 Cattle poison

34. USES
 Therapeutic IM or IV
 Used by quacks for common cold cancer and
venereal diseases
 Oxides are used in weed killer
 Sulphides are used for colouring purposes
 Cosmetic preparations
 Aphrodisiac
Also present in very small amounts in
Soft drinks
Ice cream
As a preservative

35.  If less than 1mg is found in dead body
symptomatology prior to death should be
considered.
ARSENIC IMBIBITION
Samples of suspected body should
contain more arsenic than found in the
earth in which it is buried.

36. DIAGNOSIS ARSENIC
POISONING
CHOLERA
Pain in throat Before vomiting After vomiting
Vomiting Before diarrhea After diarrhea
Vomitus Contains mucus
bile and streaks of
blood
Watery or like
whey
Stool Rice water in early
stage later bloody
Rice water
throughout
Tenesmus Marked Not so marked
XRay abdomen
Laboratory tests
Circumstantial
evidence
-- --
DIFFERENCES BETWEEN CHOLERA
& ARSENIC POISONING