How metallic poison affect human body.

1. Government Holkar (Model
autonomous) science College
Department of forensic science
Topic:- Metallic Poisons- Arsenic & Barium
Presented to:-
prof.Ruchi Sonwane
mam
Presented By:-
Purvi Bhalave
M.S.c II SEM
Forensic Science

2. 1. Metallic poison
2. Metalloid
3. Arsenic
4. Barium
Arsenic
• As form
• As action
• Absorption
• Excreation
• Sings and symptoms of acute poisoning.
• Type of acute poison.
• Fatal dose & Fatal period.
• Laboratory investigation.
• Treatment.
• PM–finding.
• Chronic poisoning.
• Sings & symptoms.
• Treatment.
• PM-Finding.
• Medico-legal Importance.
Barium
• Toxic compounds
• Action
• I
• Sings & symptoms
• Fatal dose & Fata period
• Treatment
• PM-FINDING
• Medico-legal Importance.

3. • Metallic poison is caused by the
accumulation of certain metals in the
body due to exposure through food,
water, industrial chemicals, or other
sources.

4. • A metalloid is a type of chemical
element
• Those of metals and nonmetals.
• The six commonly recognised
metalloids are boron, silicon,
germanium, arsenic, antimony, and
tellurium

5. Allotropes Grey (most common), yellow, black (see
Allotropes of arsenic)
Appearance metallic grey
Period 4
Block P-Block
• Arsenic is typically considered a heavy metal. It is ubiquitous
in the environment Arsenic is a natural component of the
earth’s crust and is widely distributed throughout the
environment in the air, water and land.
• It is highly toxic in its inorganic form
• Metallic As is nonpoisonous because it is water insoluble and
is not absorbed from GIT.
• But when is is heated,it volatilise & readily oxidises on
exposure to air to form (As2O3) which is poisonous.

6. Arsenic poisoning forms
Arsenic oxide or arsenic
trioxide
SANKHYA,SOMALKHAR,WHIT
E ARSENIC
Arsenite (SCHEELE’S GREEN) &
arsenic Copper
Acetoarsenic(PARIS GREEN)
• Arsenic sulphide (As2s2)(Red
ArseniC
• Arsenic trisulphide (As2S3)
(Hartal)
Natural source Others
• Yellow colour
• Nonpoisonous
• Always changes to
White form which is
poisonous
• Useed as fly paper
• White crystalline
or amorphous
powder
• Tasteless
,odourless
• Soluble in water
• Uses :- Fruit spray,
sheep dips weed,
killer rat poison
• Soli,
• Water
• sea fish
(mussels,
prawns).
• Tobacco,smo
ke,cigar
• Lead
Arsenate,sodi
um or
potassium
Arsenate etc.
• Uses:-
Colouring
agent

7. MECHANISM OF ACTION
• Combine with SH gr. Of mitochondrial enzyme,
especially pyruvate dehydrogenase & certain
Hydrogen.
Conversion of Pyruvate Acetyl
CoA is decreased production of cellular ATP is
decreased.
• Target is vascular endothelium – increased
permeability, tissue oedema, haemorrhage.
• It inhibit cellular glucose uptake
gluconeogenesis,fatty acid oxidation.
• Local action- mucous membrane irritation.
• Remote – depression of CNS.

8. • Orally:- GIT,Lungs,skin, present in all tissue,
Liver(large amount) then kidney at last spleen
• In case of patient survive,then As found in
muscles (month),bone,hair,nails,skin(years)
• Hair,nails(with in Few hours)
• In chronic:- Deposition if As
in Hair & nails

9. Arsenic poisoning
Acute poisoning Chronic poisoning
Is caused by an excessive single
dose or several dose of a poison
taken over a short
interval of time which produce
immediate symptoms
Is caused by smaller
doses over
a period of time,
resulting in Slight
symptoms.

10. • GIT:- Sweetish Metallic Taste,nausea, burning mouth , throat
& oesophagus,stomach.Garlicky odour to breath
• Intense thirst
• Vomiting – projectile may save life Of pt.
• Pain in Abdomen,tenesmus(the feeling that you need to
pass stools, even though your bowels are already empty)
• Diarrhea – watery, colourless & odourless stools.resemble
rice water stools of chloera . Blood tinged.
• Kidney- oliguria(small amount of urine),albuminuria(kidney
disease),renal failure(one or both kidneys can no longer
function well on their own).
• CVS- headache,vertigo(loss balance),tremors(disorder that
causes involuntary and rhythmic shaking), convulsions
(uncontrollable shaking that is rapid and rhythmic, with the muscles contracting
and relaxing repeatedly ),coma.
• Skin- eruption,loss of hair

11. • Large dose (3-5gm) – rapid
death in 1to3 Hrs due to
shock & peripheral vascular
failure.
• Direct action on heart as well
as dilation of blood vessel in
splanchnic area – reduced BP
• All GIT symptoms absent
• Narcotics type is seen when there is
quick absorption Of poison.GIT
symptoms less.
• Giddiness,delirium,coma & death.
• Inhalation of fumes-
cough,sputum,dyspnea, pulmonary
oedema.As has exposure cause
hemolysis.urine appears black due to
haemoglobinuria
• Vomiting,loose motions,foul
breath,pain in Abdomen
tenesmus.Vomitingain in
abd.Vomiting
• Dyspnea, cough,pain in
throat.
• Cramps in muscles,
depression, Giddiness,
neuritis
• Circulatory collapse
Sing and symptoms
Of acute poisoning
Fulminant type Narcotic type
subacute
poisoning

12. • Fatal Dose- Acute poisoning :- 100-200mg in adults
2mg/kg in children.
Fluminant :- 3-5gm
Narcotic :- 1-2gm
• Fatal period :- Acute form :- 1-2days
Fulminant :- 1-3 hrs
Subacute :- 7-10days
Narcotics :- 6-12hrs

13. • Urine :- Excretion of more than 50ug/L in 24 hrs is
indicative of poisoning.Metabolites of As methylarsenic
acid & dimethyl arsenic acid are found in urine.
• Blood :- serum As level 0.9ug/d1
• Hair :- As more than 75 ug%
• Nails :- presence of > 100 ug%
• X-ray abdomen – radio – opacity
• ECG :- QRS- bordening
QT – prolongation ( tissue damage)
ST:- depression (Less 02 to heart).
Twave- flatten(The T wave flattening is
widespread, and may reflect low K+, widespread coronary
artery disease or left ventricular dysfunction from any
other cause.).
Neutron activation analysis

14. TREATMENT
Stomach wash :- warm water or milk.
Butter/greasy substance prevent absorption
• Antidote-BAL(British anti-Lewisite):- 3-4
mg/kg Intramuscular 4 hrly for 2 days,
6hrly for 1 day & 12 hrly for 10 days.
• Oral succimer (DMSA)(dimercapto
succinic acid) i :- 10mg per kg every 8 hrly
for 10days.OR Dimerval (DMPA) :- 200mg
IV 4 hrly till oral dose given.

15. • External funding:-
1. Sunken eyeballs
2. Dehydrated body
3. Cyanosis
4. Rigor mortis – appears early & lasts longer
5. Blood tinged vomitus May be seen on body & clothes.
• Internal findings :-
1. Stomach – Red velvet appearance-
Mucosa swollen, reddish,oedematous.Sticky mucus covers the
mucosa,particles of As embedded in mucosa.greater curveture &
posterior part of the cardic end inflammed

16. • Small Intestine- mucosa membrane inflamed with
submucous haemorrhage may contain rice water
stools.
• Large intestine- empty,contracted.Rectum & caecum
inflammed.Peritonium congested.
• Liver,Spleen, Kidney :- congested, enlarged,fatty
infiltration, nephritis is seen.
• Lungs :- congested,subpleural haemorrhage.
• Heart :- ecchymoses,sun endocardial haemorrhage.
• Brain :- congested,oedema seen.
• X-ray :- shows presence of As in GIT.

17. It may occur due To:-
• Recovery From an Acute poisoning.
• Accidental ingestion of small doses repeatedly by those working with
metal.
• Patients of renal failure
• Inhalation of As dust
• Intake of food/drink in which there are traces of As (may be homicidal
in nature).
SYMPTOMS OCCURS IN 4 STAGES
1. Nutritional/GLT disturbance
2. Catarhhal/skin lesions
3. CNS/sensory symptoms
4. Peripheral neuritis & muscular dystrophy

18. • Stage1-(GIT symptoms)-Anorexia,nausea, vomiting,pain,in
abdomen,diarrhea.
Gums – red,soft,coated tongue (silvery fur)
Oedema over feet & of lower eyelid
• Stage 2:- (dermatological)
1. Rain drop pigmentation:- on flexors,nipples,lower
abdomen,temples and eyelids.
2. Hyperkeratosis due to epithelial hyperplasia-multiple wart-
like growths on the plam,soles,head and trunk.It may lead
to basal cell carcinoma.
3. Aldrich-Mee’s line:- white transverse lines in the nails plate
up to a year after As intoxication.
4. Hair become dry and fall off- Alopecia
5. Other :-
• Painless perforation of nasal septum.
• Liver is enlarged and cirrhotic
• Kidney are damaged
• Voice is hoarse and husky

19. • Third stage (neurological):-
• CNS: polyneuritis (peripheral nerves are
damaged) – Headache, tingling and
numbness.,
• Hyperesthesia (increased pain
sensations) of skin.,
Muscle tenderness and cramps,
• Arthralgia
• Bone marrow suppression with
karyorrhexis.
• Fourth stage (neuromuscular)
• Peripheral neuritis & muscular dystrophy
Muscle Weakness,ataxia, wrist drop,foot
drop Tremors, delusion.
• Polyneuritis, encephalopathy

20. • TREATMENT- remove the patient
from sources of exposure & BAL(British
anti-Lewisite)4mg/kg long duration,vitamin
B complex is given
• PM FINDINGS- f
• Fatty degeneration (the abnormal
formation of tiny globules of Fat with in
the cytoplasm of the cell )liver, kidney &
heart.
• Hemorrhages spot in brain
• Microscopy- nerves show fragmentation &
resorption of myelin.

21. 1. Homicidal poison.
Reason—
• Symptoms stimulate natural disease Cholera
• Small amount is required to cause death
• Can be administered easily with food,drinks,betel leaves
• Cheap, easily obtained
• Tasteless & odourless
• Chronic cases result in generalized bebility which resemble certain disease.
2. suicide:-
• Is rare, because it causes too much of pain.
3. Accidental:-
• Death may be due to admixture with the article of food or from it’s improper
medicinal use.
• Chronic poisoning results from drinking well water containing As.
• As exposure can be occupational in those working in metal foundry,mining,glass
production or un the semiconductor industry.
• Paste ointment
• Cattle poison

22. • Barium is a chemical element with
the symbol Ba and atomic number 56.
• It is the fifth element in group 2 and is a
soft, silvery alkaline earth metal.
• Because of its high chemical reactivity,
barium is never found in nature as a
free element.
Barium poisoning
Physical properties
• It is heavy, White, tasteless, odourless powder and
insoluble in water
• Ba sulfate is used for the X-ray examination of the GIT

23. Toxic compounds
Barium cholride Barium nitrate Barium carbonate Barium sulphide
• Uses:-The industrial
application in the
purification of the brine
solutions that are used in
caustic chlorine plants.
• Hardening of steel
Uses:- green signal lights.
ceramic glazes.
primers and tracer bullets.
Uses:- BaCO3 is a rat
poison.
It also is used in
paints,enamels, rubber,
and certain plastics
Uses:- luminous paints ,
Used in hair removing
formulations and also in
the manufacture of
Lithopone

24. • It acts locally as an irritant posion
• After absorption it acts both on voluntary and involuntary
muscles.
• Ba seems to acts as postassium antagonist and calcium
agonist.( blocking of the K+-channels of the Na–K pump in
cell membranes, increasing the active inward transport and
inhibiting the passive outward transport of potassium).
ABSORPTION
• Toxicity of Ba compounds depends on their solubility.
• The free ion is absorbed from the lungs and GIT,but Ba sulfate remain
Unabsorbed.
• After absorption,it accumulates in the skeleton and in pigmented
parts of the eye

25. • On ingestion:- the most characteristic features are flexia(softness)
and paralysis (Ba+ ion muscle poison).
• Inhalation :- barium sulfate dust causes a benign l pneumoconiosis ('baritosis’) with
conspicuous radiographic manifestation,but no impairment of pulmonary function.
System Sings and symptoms
GIT Nausea, vomiting, abdominal pain,
diarrhea.
CVS Hypertension, arrhythmia,ectopic,beats,
ventricular fibrillation, irregular pulse,
cardiac arrest.
CNS Dilatation of pupils,vertigo.

26. • Fatal dose :- Aboht 1g of
barium
cholride/sulphide/nitrate
• Fatal period:- Usually within
12 hrs.

27. 1. Administration of larger amounts of potassium
parentally ( KCL 20-40 mEq/l is indicated causes severe
hypokalemia, potassium infusion is an effective
antidote).
2. 10ml of 10% sodium sulphate IV every 15min to convert
Ba into insoluble sulphate (acute renal failure may
develop due to intrarenal precipitation of barium
sulfate).

28. • Non-specific Submucosal haemorrhage may be
seen in the GLT.
MEDICO-LEGAL ASPECTS
• Suicidal cases may be seen.
• Homicidal cases are rare
• Accidental poisoning with Barium sulphide may occur,if taken by
mistake as Barium sulphate For X-ray examination.

29. Features Acute Arsenic poisoning Cholera
1. Pain in throat Before vomiting After vomiting
2. Voice Normal Whistling, rough
3. Stool Rice water but blood
tinged
Rice water not bloody
4. Tenesmus Present Absent
5. Vomitus Mucus, blood,bile Watery
6. Laboratory investigation As particles present Microorganisms,vibro
cholera present
7. Circumtantial Evidence Poisoning may be present
in an individual or a family
or a group
May occur is sporadic or
epidemic form in the
locality
8. Motive Homicidal, rarely
accidental
No such thing

30. Thank
You