This document discusses poisons and their classification. It focuses on phosphorus poisoning, describing phosphorus' properties, symptoms of poisoning, treatment approaches, and outcomes. Phosphorus poisoning causes initial gastrointestinal distress followed by multi-organ damage, especially to the liver and kidneys, which can lead to death within days if not treated promptly with chemical antidotes and supportive care.

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

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

4. NON-METALLIC
PHOSPHORUS
CHLORINE
BROMINE
IODINE

5. ANIMAL
CANTHARIDES
SNAKES
SCORPIONS
SPIDERS
POISONOUS INSECTS

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

7. COARSELY POWDERED GLASS
CHOPPED HAIR
DRIED SPONGE
DIAMOND DUST

8. THEY PRODUCE SYMPTOMS OF
ABDOMINAL PAIN
VOMITING
PURGING.

9. ONSET OF SYMPTOMS AND
SIGNS IS VARIABLE
WITHIN ½ AN HOUR TO 1
HOUR.
INITIALLY
BURNING SENSATION
OCCURS IN
 MOUTH
 THROAT
 ESOPHAGUS
 STOMACH
 ABDOMEN
 THIS IS FOLLOWED BY
 INTENSE THIRST.
 DIFFICULTY IN
SWALLOWING.
 CONTINUOUS RETCHING.
 PAINFULL VOMITING
 DIARRHEOA.

10. INITIALLY LATER
 NORMAL
STOMACH
CONTENTS.
 STOMACH CONTENTS ARE
BILIOUS INCHARACTER.
 MAY BE DARKBROWN IN
APPEARANCE DUETO ALTERED
BLOOD.

11. SEVERE
ACCOMPANIED BY TENESMUS
INITIALLY STOOLS ARE LOOSE IN
CHARACTER
EVENTUALLY THE STOOLS ARE MIXED
WITH BLOOD AND MUCUS

12. SKIN IS COLD AND CLAMMY.
FACE IS PALE AND ANXIOUS.
RESPIRATION IS SIGHING IN
CHARACTER.
CRAMPS SET IN THE MUSCLES OF THE
LIMBS.
TILL NOW THE CONCIOUS LEVELS ARE
RETAINED.

13. IMMEDIATE OUTCOME SEQUELAE INCLUDES
 CONVULSIONS SET IN.
 FOLLOWED BY COMA.
 EVENTUALLY DEATH
OCCURS WITHIN 24
HOURS FROM SHOCK.
 DEATH OCCURS IN A FEW
DAYS FROM
EXHAUSTION.
 PATIENT MAY RECOVER
AND DEATH MAY ENSUE
LATER FROM STRICTURE
OF ESOPHAGUS.

14. CHANGES ARE CHIEFLY SEEN IN
STOMACH
REDNESS
ULCERATION
FREQUENTLY PORTIONS OF INTESTINAL
TRACT ARE ALSO INVOLVED INCLUDING
DUODENUM.
RECTUM.

15. PHOSPHORUS

16. IS A PROTOPLASMIC POISON.
IT AFFECTS CELLULAR OXIDATION.
ITS EFFECT ON CELLULAR METABOLISM IS
COMPARABLE TO ISCHEMIA.
THESE ANOXIC CONDITIONS LEADS TO
DIMINISHED CELLULAR METABOLISM
CONSIDERABLY KNOWN AS NECROBIOSIS.
THIS NECROBIOSIS IS CLASSICALLY
MANIFESTED IN LIVER AS INCREASE IN FAT
DEPOSITION AND INHIBITION OF GLYCOGEN
DEPOSITION.

17. WHITE AS
CRYSTALLINE
 RED AS
AMORPHOUS

18. WHITE PHOSPHORUS
BECOMES YELLOW ON EXPOSURE TO AIR
ALSO KNOWN AS YELLOW PHOSPHORUS.
EXISTS IN FORM OF TRASLUCENT, WAXY ,LUMINOUS
CYLINDERS.
SLIGHTLY SOLUBLE IN ALCOHOL.
FREELY SOLUBLE IN CARBON DISULPHIDE.
INSOLUBLE IN WATER.

19. IS EASILY OXIDIZABLE SO IT IS KEPT SUBMERGED
UNDER WATER TO PREVENT IGNITION.
WHEN EXPOSED TO ATMOSPHERE IT GIVES OFF
WHITE DENSE FUMES OF
PHOSPHORIC ACID
PHOSPHORUS ACID.
IT IS LUMINOUS IN DARK.
THE FUMES GLOW WITH PALE YELLOW COLOR AND
THIS PHENOMENON IS KNOWN AS
PHOSPHORESCENCE.
IT BURNS WITH A STRONG ODOUR OF GARLIC.

20. THIS IS INERT FORM UNLESS MIXED WITH YELLOW
PHOSPHORUS.
IT IS NON-LUMINOUS.
AMORPHOUS IN CHARACTER.
ODOURLESS.
INSOLUBLE IN CARBON DISULPHIDE.
DOES NOT GIVE OFF FUMES WHEN EXPOED TO AIR.
IT IS MIXED WITH POWDERED GLASS TO BE USED ON SIDE OF
MATCHBOX.
TIP OF MATCH STICK CONTAINS POTASSIUM CHLORATE AND
ANTIMONY SULPHIDE.

21. Difference between White and Red phosphorus
Trait White Phosphorus Red Phosphorus
1 Colour White or yellow Reddish-brown.
2. Appearance Translucent, waxy
cylinders
Amorphous, solid
mass
3 Smell Garlic like Odourless.
4 Taste Garlic like Tasteless.
5. Luminosity Luminous in dark Non-luminous.
6. Exposure to
air
Oxidises & emits
white fumes; ignites at
34°C and as such is
kept under water
Non-oxidised, Non-
fuming, Non-
inflammable.
7.
8.
Toxicity
Solubility
Highly toxic
Freely soluble in
carbon disulphide
Non-toxic
Insoluble in carbon
disulphide

22. SYMPTOMS AND SIGNS CONSIST OF TWO
PHASES.
PRIMARY DUE TO LOCAL IRRITANT ACTION
ON G.I.T.
SECONDARY DUE TO ACTION OF
ABSORBED POISON.
BOTH PHASES HAVE CONSIDERABLE
INTERVAL BETWEEN THEM.

23. THESE OCCUR WITHIN TWO – SIX HOURS.
BURNING PAIN IN
THROAT.
ESOPHAGUS.
STOMACH.
THERE IN INTENSE THIRST.
FREQUENT GASEOUS ERUCTATIONS.

24. NAUSEA.
VOMITING.
DIARRHOEA.
COMPLAINT OF GARLIC TASTE IN
MOUTH.
GARLIC SMELL PRESENT IN BREATH.

26. LASTS FOR 1 – 2 DAYS.
MAY BE SO SEVERE THAT VICTIM DIES FROM
COLLAPSE .
CARDIAC FAILURE.
HOWEVER THIS IS NOT THE USUAL COURSE OF THE
DISEASE.
REMISSIONS ARE COMMON AFTER BOUTS OF VOMITING AND
DIAHRROEA.
IN USUAL CLINICAL COURSE
THIS REMISSION LASTS FOR ABOUT 2 – 3 DAYS.
CONTACT OF PHOSPHORUS WITH SKIN PRODUCES SLOW
HEALING ULCERS.

27. THESE OCCUR DUE TO THE ABSORBED POISON
DAMAGE MAINLY OCCURS IN
LIVER
KIDNEY
THE ORIGINAL SYMPTOMS ALSO RETURN
LIVER DAMAGE CAUSES JAUNDICE
ABDOMINAL DISTENTION OCCURS DUE TO
LIVER ENLARGEMENT
NECROSIS OF THE LIVER

28. IN EARLY STAGES IN LATER STAGES
 LIVER IS ENLARGED DUE
TO FATTY
DEGENERATION
 [ NECROBIOSIS]
 LIVER IS SHRUNKEN DUE
TO NECROSIS
 [ ACUTE YELLOW
ATROPHY]

29. HYPOPROTHOMBINEMIA CAUSES
PURPURA
EPISTAXIS
FECES BECOME PALE

30. SCANTY.
CONCENTRATED.
STRONGLY ACIDIC IN REACTION.
DUE TO DISTURBED METABOLISM URINE
MAY CONTAIN
BLOOD.
ALBUMIN.
SUGAR.
CRYSTALS OF
TYROSINE
LEUCINE
CYSTINE

31. THIS IS MANIFESTED BY
FRONTAL HEADACHE.
INSOMNIA.
RINGING IN THE EAR.
IMPAIRED VISION.
FORMICATION.
CRAMPS.
PARALYSIS.

32. PREGNANT WOMAN MAY ABORT WITH
ALARMING FLOODING.
PRIAPISM IS A FREQUENT SYMPTOM.

33. RESULTS FROM
HEPATIC INSUFFICENCY
RENAL INSUFFICENCY
CLINICAL PICTURE IS SUGGESTIVE
OF
ACUTE YELLOW ATRPHY OF LIVER

34. FATAL DOSE FATAL PERIOD
 60 – 120 MG
 ALTHOUGH AS WITH ALL
GASTRIC IRRITANTS
VOMITING MAY PERMIT
RECOVERY FROM MUCH
LARGER DOSE.
 DEATH MAY OCCUR
FROM
 COLLAPSE
 WITHIN 24 HOURS.
 IN DELAYED CASE
 DEATH OCCURS IN 6-7
DAYS.

35. DEMULCENTS
[ OILY AND FATTY SUBSTANCES E.G. MILK ]
THESE ARE CONTRAINDICATED.
AS THEY DISSOLVE AND PROMOTE
ABSORPTION OF PHOSPHORUS.

36. THIS IS DONE WITH
0.5 % POTASSIUM PERMEGANATE
SOLUTION REPEATEDLY
TILL NO MORE SMELL OF GARLIC IS
PERCEPTIBLE.

37. THESE ARE EVACUATED BY A BRISK
PURGATIVE
IN ORDER TO ENSURE REMOVAL OF
THE POISON AS QUICKLY AND AS
COMPLETELY POSSIBLE

38. THIS ACTS AS A CHEMICAL ANTIDOTE.
IT ACTS AS AN OXIDIZING AGENT.
IT OXIDIZES PHOSPHORUS TO HARMLESS
COMPOUNDS
PHOSPHORIC ACID
PHOSPHATES

39. A DILUTE SOLUTION OF COPPER
SULPHATE 0.1 % SOLUTION.
200 MG OF COPPER SULPHATE.
GIVEN EVERY 5 MINUTES
UNTIL VOMITING OCCURS

40. COPPER SULPHATE IS REDUCED BY
PHOSPHORUS
PRECIPITATES AS METALLIC COPPER
ON PHOSPHORUS PARTICLES
THUS RENDERING THEM INERT.

41.  LIQUID PARAFFIN
 MAY RETARD
ABSORPTION
 INTAVENOUS SALINE
 GIVEN TO COMBAT
SHOCK
 CALCIUM
GLUCONATE
 GIVEN IF BLOOD
CALCIUM LEVEL IS
DIMINISHED
 SODIUM
BICARBONATE
 TO MAINTAIN ALKALI
RESERVES
 INTRAVENOUS
DEXTROSE WATER
 TO PROTECT LIVER
 PERITONEAL
DIALYSIS
 HEMODIALYSIS
 TO COMBAT RENAL
FAILURE
 1% COPPER SULPHATE
SOLUTION TO
 THOROUGHLY WASH THE
SKIN BURNS