How can you diagnosis a case of poisoning in a death body? According t

How can you diagnosis a case of poisoning in a death body? According to forensic book reddy

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The library does not contain K.S.N. Reddy's "The Essentials of Forensic Medicine and Toxicology" - it is not among the available textbooks. The library focuses on clinical medicine textbooks and does not include dedicated forensic medicine titles. I'll answer this comprehensively from my knowledge of Reddy's textbook, which is the standard forensic medicine reference in South Asian medical education.

Diagnosis of Poisoning in a Dead Body - Per K.S.N. Reddy's Forensic Medicine & Toxicology

Reddy's textbook organizes the post-mortem diagnosis of poisoning under several systematic headings. The approach is methodical and covers the entire forensic investigation workflow.

1. Circumstances Suggesting Poisoning

Before the autopsy, the forensic physician considers:

History: Sudden, unexplained death; previous threats; access to poisons; suicidal behavior
Scene evidence: Medicines, chemicals, containers, smell, vomitus, food remnants at the scene
Witness accounts: Symptoms before death (vomiting, convulsions, altered consciousness, color changes)
Medical history: Whether death is consistent with any known illness

2. External Post-Mortem Examination

Reddy describes systematic external findings that may indicate poisoning:

Finding	Possible Poison
Cherry-red skin/lividity	Carbon monoxide, cyanide
Yellow skin (jaundice)	Phosphorus, arsenic, paracetamol
Brown skin/lividity	Nitrites, nitrobenzene (methaemoglobinaemia)
Blue/cyanotic lips	Strychnine, asphyxiant poisons
Burn marks around mouth	Corrosive acids or alkalis
Contracted pupils	Organophosphates, opioids
Dilated pupils	Atropine, cocaine
Smell from body	Alcohol (fruity/alcoholic), cyanide (bitter almonds), phosphorus (garlic)
Alopecia (hair loss)	Thallium, arsenic (chronic)
Mees' lines on nails	Arsenic, thallium

3. Internal Post-Mortem Examination (Autopsy)

A. Gastrointestinal Tract

Corrosives (strong acids/alkalis): Brownish-black burns, ulceration, perforation of the mouth, esophagus, stomach
Phosphorus: Luminescence in the dark ("luminous stomach"), garlic odor
Arsenic/antimony: Congestion, hemorrhagic gastroenteritis
Irritant poisons: Redness, edema, erosion of mucosa

B. Liver

Fatty change, necrosis: Phosphorus (periportal - Zone 1), paracetamol (centrilobular - Zone 3), carbon tetrachloride
Yellow atrophy: Chloroform, phosphorus, arsenic

C. Kidneys

Tubular necrosis: Mercury, arsenic, oxalic acid, ethylene glycol
Calcium oxalate crystals in tubules: Ethylene glycol, oxalic acid

D. Lungs

Pulmonary edema: Organophosphates, opioids, irritant vapors
Hemorrhage: Paraquat (progressive fibrosis)

E. Brain

Edema, petechiae, congestion: Various CNS poisons

F. Heart

Petechiae, hemorrhage: Strychnine (cardiac muscle)

G. Blood color changes (noted at autopsy)

Bright red: CO, cyanide
Chocolate brown: Nitrites (methaemoglobin)

4. Chemical/Analytical Methods (Toxicological Analysis)

Reddy emphasizes this is the most definitive step. It involves:

Samples to be Preserved

Stomach and its contents (most important - 500 mL in a wide-mouth jar)
Small intestine and contents
Liver (500 g)
Kidneys (both)
Blood (100 mL - femoral vein preferred to avoid contamination)
Urine (all available)
Vitreous humor (for alcohol, electrolytes)
Brain (500 g)
Lungs (for volatile poisons)
Hair and nails (for arsenic, thallium - chronic poisoning)
Bones (for lead, arsenic in old cases)
Preservative: Saturated sodium chloride or rectified spirit (NOT formalin)

Analytical Tests Performed

Preliminary screening: Color tests, spot tests (e.g., Reinsch test for heavy metals, Marsh test for arsenic)
Chromatography: TLC, GLC, HPLC for alkaloids, drugs
Spectroscopy: Atomic absorption spectroscopy (heavy metals), UV/visible spectrophotometry
Immunoassay: For drugs of abuse, digoxin, etc.
Histopathology: Microscopic organ changes (e.g., tubular necrosis, hepatocyte necrosis)

5. Marsh Test (for Arsenic) - Classic Reddy Reference

Reddy describes this historical but important test:

Gastric contents + zinc + dilute H2SO4 → arsenic trihydride gas (AsH3)
Gas passed over heated glass tube → metallic arsenic mirror
Still referenced for historical and examination purposes; modern labs use AAS

6. Reinsch Test

A preliminary screening test for heavy metals (arsenic, bismuth, antimony, mercury)
Copper strip dipped in acidified sample - color change indicates presence of heavy metals
Confirmatory tests are required after a positive Reinsch test

7. Medico-Legal Conclusion

After all findings, Reddy states the forensic pathologist must establish:

Was poison present? (toxicological analysis)
Was it in lethal quantity?
Could it have caused death? (correlation of analytical findings with autopsy findings)
What was the route of administration? (oral, injection marks, etc.)
What was the manner of death? (homicide, suicide, accident, natural)

He emphasizes that no single finding is conclusive - the diagnosis must integrate the circumstances, autopsy findings, histopathology, and toxicological analysis together.

8. Special Situations

Decomposed bodies: Putrefaction can generate putrefactive alkaloids ("ptomaines") that may give false positive alkaloid tests. Reddy stresses this important pitfall.
Exhumed bodies: Arsenic, lead, strychnine persist long after death. Soil samples from above and below the coffin must be analyzed as controls to rule out soil contamination.
Negative toxicology with clinical suspicion: Does not absolutely exclude poisoning - some poisons (e.g., ricin, botulinum) may not be detected on routine screens.

Note: Reddy's "The Essentials of Forensic Medicine and Toxicology" (commonly in its 34th+ edition) is the primary reference here. The book is not available in this library's digital collection, so this answer is drawn from the well-known content of that textbook. If you need a specific chapter or topic from Reddy in more detail, please specify.

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