This document discusses phosphorus poisoning from red and white phosphorus. It notes that red phosphorus is used in matchboxes and is odorless, tasteless, and non-toxic, while white phosphorus is highly toxic, flammable, and has a garlicky odor. Symptoms of white phosphorus poisoning include nausea, vomiting, liver and kidney damage, and potentially death from cardiac or electrolyte issues. Treatment involves gastric lavage, activated charcoal, supportive care, and potentially hemodialysis. Autopsy findings may include jaundice, liver damage, and a garlicky odor. Causes of poisoning include accidental, homicidal, criminal abortion, and arson.

1. Dr Mohd Kaleem Khan
Assistant Professor
Department Of Forensic Medicine
JNMCH AMU Aligarh

2.  It exists in two varieties:
◦ White/ yellow phosphorus
 Fertilizers, insecticide, rodenticide, incendiary bombs, smoke
screens, firework
◦ Red phosphorus
 matchbox

3. Red phosphorus White phosphorus
 Violet red/ reddish
brown
 Amorphous, solid
mass
 odourless, tasteless
 Non luminescent
 Soluble in carbon
disulphide
 Non toxic
 Does not ignite in air
 White or yellow
 Waxy, translucent, soft
stick
 Garlicky taste and
odour
 Luminescent in dark
 Insoluble
 Highly toxic
 May ignite in air

4. ◦ Protoplasmic poison
◦ Affect cellular oxidation
◦ Causes necrobiosis especially of liver ( yellow atrophy of
liver) and kidneys
◦ Causes bone formation in epiphysial cartilage and haversian
canal

5.  First stage(0.5-6 hr)
◦ Skin: painful penetration, second and third degree burn.
◦ Ingestion :
 Nausea, vomiting , diarrhoea, thirst,
 Burning pain in throat and abdomen,
 Garlicky odour in breath, vomitus and faeces,
 Luminescent smoking urine and faeces

6.  Symptoms second stage( after 2-3 days)
 Severe abdominal pain
 Nausea, vomiting, haematemesis, diarrhoea
 Tender hepatomegaly, jaundice, pruritis
 Oliguria, haematuria, albuminuria
 Headache, insomnia, convulsions, coma
 Carpopedal spasm, tetany, stridor, opisthotonus
 Purpura, epistaxis
 Death d/t cardiac dysrythmias, hypocalcemia and hyperkalemia.

7.  F.D.: 60- 120 mg
 F.P. : 24 hrs

8. ◦ Airway support and fluid maintenance
◦ External burns
◦ Gastric lavage: KMNO4 ( antidote), charcoal
◦ Demulscents are contraindicated
◦ Purgatives
◦ Vit K or blood transfusion
◦ Haemodialysis
◦ N acetylcystein, ubiquinon and sulphate to prevent liver
damage

9. ◦ Emacition, purpura, jaundice and garlicky odour
◦ Hypostasis dark brown in colour
◦ Liver is soft , swollen, fatty and easily ruptured
◦ Kidney; enlarged greasy and yellow

10. ◦ Accidental
◦ Homicidal
◦ Criminal abortion
◦ Arson

11. ◦ Necrosis of jaw in region of decayed tooth
◦ Phossy jaw: toothache, swelling of jaw, loosening of teeth,
necrosis of gums and sequestration of bone with multiple
sinuses discharging foul smelling pus
◦ nausea, vomitig , diarrhoea, thirst, burning pain in throat and
abdomen, joint pain, jaundice, ascitis, anaemia