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Give me in details what are the duties of a doctor in medical poisoning.

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I now have comprehensive material from the primary forensic medicine textbook. Let me compile the full, detailed answer.

Duties of a Doctor in a Case of Medical (Suspected) Poisoning

Source: The Essentials of Forensic Medicine and Toxicology, 36th edition (2026); Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology
The duties of a medical practitioner in a case of suspected poisoning are divided into two broad categories:

A. Medical Duties - Care and Treatment of the Patient

1. Life-Saving / Resuscitative Measures (ABCD)

The immediate priority is stabilization of the patient. The ABCD approach is used:
  • (A) Airway - Open and clean the airway (oral cavity, nostrils) of secretions, vomit, or foreign bodies. Endotracheal intubation may be necessary to protect and secure the airway.
  • (B) Breathing - If arterial blood gas cannot be maintained after establishing the airway, supplemental oxygen therapy is given (via ventimask or endotracheal tube).
  • (C) Circulation - IV fluid administration may be life-sustaining.
  • (D) CNS Depression - Must be corrected. An unconscious patient should be turned to lie on one side (recovery position) to prevent the tongue from blocking the throat and to allow fluid to drain from the mouth.
Most poisoning cases, whether conscious or unconscious, recover with supportive care alone.

2. Removal of Unabsorbed Poison from the Body

Based on the route of exposure:
  • Inhaled poisons - Remove patient to fresh air; give artificial respiration and oxygen (6-8 L/min); keep air-passages free from mucus by postural drainage or aspiration; give Nikethamide 2 mL IV if necessary; aminophylline 250-500 mg for severe bronchospasm; diuretics for pulmonary edema.
  • Injected poisons (from bite/injection) - Apply a tight ligature immediately above the wound (loosen 1 minute every 10 minutes to prevent gangrene); excise the wound; suck out the poison; neutralize with a suitable chemical; local adrenaline injection for vasoconstriction; immersing the extremity in cold water (10°C) slows absorption.
  • Contact poisons - Remove contaminated clothes, contact lenses, and jewelry immediately. Wash skin/wound with water for 30 minutes or neutralize with specific chemical. Irrigate eyes with normal saline for at least 15 minutes.
  • Ingested poisons (Gastric Lavage) - Useful within 2 hours of ingestion. Use a stomach tube (Ewald's or Boa's tube), or a soft non-collapsible rubber tube (1 cm diameter, 1.5 m length).

B. Legal Duties - Assisting the Police to Determine the Manner of Death

1. Note Preliminary Particulars

Record the patient's:
  • Age, sex, address
  • Date and time of presentation
  • Identification marks and other identifying details

2. Confirm Suspicion Before Expressing an Opinion (Suspected Homicidal Poisoning)

The doctor must confirm his suspicion before expressing an opinion. To do this he must:
(a) Obtain history of:
  • Route of exposure
  • Quantity consumed
  • Time elapsed since ingestion
  • Collect vomit and urine and submit for chemical analysis
(b) Carefully observe and record symptoms in relation to:
  • Food - any change in color, taste, or smell of the food or drink
  • Other persons affected at the same time
  • Condition of the patient
  • Explanation offered by the patient for the symptoms
  • Statements of other persons present that appear relevant
(c) Consult with strict confidence among a senior practitioner and keep them informed about the case.
(d) Move the patient to hospital. If the patient refuses to be moved:
  • Engage nurses of confidence to administer medicine and food themselves
  • Allow no one to be with the patient alone
  • Maintain detailed records of the patient's condition and treatment given
  • Record the number of visits, symptoms and signs observed, and treatment given from time to time
(e) If a particular person is suspected - Attempt to outwit the suspected individual by changes of diet and alteration of meal times. The suspected person should be allowed to visit the patient only in the presence of a nurse or doctor.
(f) Signs of suspicion - Suspicion may arise when a person insists on preparing all food and serving the patient personally, and also if the person insists on throwing away all the food which the patient leaves.

3. After Confirmation of Suspicion

Once suspicions are confirmed, the doctor should request the removal of the patient to hospital. If the victim is an adult who retains mental faculties, it may be desirable to speak to them about the steps to be taken.

4. Preserve Evidence

Collect and preserve:
  • Suspected articles of food, excreta, and stomach washings
  • Full or empty bottles, capsules, paper packets, or liquids lying about
  • Any recent stains on bedclothes or furniture (if possible)
Non-compliance is punishable under Section 238, BNS (formerly S. 201, I.P.C.) if it is proved that the doctor did this with the intention of protecting the accused.

5. Report Homicidal Poisoning to Police (Mandatory)

If a private practitioner is convinced the patient is suffering from homicidal poisoning, they are bound under Section 2(33), BNSS (formerly S. 39, CrPC) to inform the police officer or Magistrate.
  • Non-compliance is punishable under S. 176, I.P.C.

6. Suicidal Poisoning - Reporting NOT Mandatory for Private Practitioners

If the practitioner is sure the patient is suffering from suicidal poisoning, they are not bound to inform the police, since BNS has deleted S. 309 of the I.P.C. (attempt to suicide is no longer a criminal offense under BNS).

7. Duty When Summoned by Investigating Police Officer

If summoned by the investigating police officer, the doctor is bound to give all information under Section 195, BNSS (formerly S. 175, Cr.P.C.).
  • Concealing information - liable to prosecution under Section 239 and 202, BNS/I.P.C.
  • Giving false information - liable to be charged under Section 212, BNS (formerly S. 177, I.P.C.)

8. Government Medical Officer - Special Duty

A Government medical officer is required to report to the police all cases of suspected poisoning, whether accidental, suicidal, or homicidal, attended in the hospital.

9. Recording Dying Declaration

If the condition of the patient is serious, the doctor must arrange to record the dying declaration.

10. Death of the Patient

If the patient dies, the doctor:
  • Should NOT issue a death certificate
  • Should inform the police immediately

11. Food Poisoning - Compulsory Notification

In cases of food poisoning, public health authorities must be notified (compulsory notification duty under law).

Summary Table

DutyCategoryKey Action
ABCD resuscitationMedicalStabilize airway, breathing, circulation, CNS
Remove poisonMedicalBy route - inhalation, ingestion, injection, contact
Record patient particularsLegalAge, sex, time, identification marks
Collect samplesLegalVomit, urine, stomach wash, food, bottles
Hospital transferMedical + LegalArrange safe environment if refused
Preserve evidenceLegalFood, stains, containers
Report homicidal poisoningLegal (Mandatory)S. 2(33) BNSS; punishable if not done
Suicidal poisoningLegal (Optional for private)Not mandatory since BNS removes S. 309
Cooperate with policeLegal (Mandatory)S. 195 BNSS; false info = criminal offense
Dying declarationLegalMust be recorded if patient is serious
Death - no death certificateLegalInform police; do not certify
Food poisoning notificationLegal (Compulsory)Notify public health authorities
Sources:
  • The Essentials of Forensic Medicine and Toxicology, 36th edition (2026), pp. 483-484 - primary source with full duties enumerated under Indian law (BNS/BNSS)
  • Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology - compulsory and voluntary duties of a medical practitioner framework

Can you give mea full NIS Schedule in an image form?

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India National Immunization Schedule 2024 2025 full UIP vaccines age

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https://prod-cdn.preprod.co-vin.in/uwin-prod/pdf/National+Im…

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A detailed, clean medical reference chart titled "India National Immunization Schedule (NIS) - Universal Immunization Programme (UIP)" as a vertical table poster with a white background and color-coded sections. The chart has columns: Age, Vaccines Given, Dose, Route, Site. Organized into four color-coded sections: SECTION 1 - PREGNANT WOMEN (light pink header): - Early pregnancy: Td-1 | 0.5 ml | IM | Upper Arm - 4 weeks after Td-1: Td-2 | 0.5 ml | IM | Upper Arm - If vaccinated within 3 years: Td-Booster | 0.5 ml | IM | Upper Arm SECTION 2 - INFANTS (0-1 Year) (light blue header): - At Birth: BCG | 0.1 ml (0.05 ml <1 month) | Intradermal | Left Upper Arm - At Birth: Hepatitis B (Birth dose) | 0.5 ml | IM | Anterolateral mid-thigh - At Birth: OPV-0 (Zero dose) | 2 drops | Oral | Oral - 6 Weeks: bOPV-1, Pentavalent-1, fIPV-1, RVV-1, PCV-1 | 2 drops/0.5 ml/0.1 ml/3 drops/0.5 ml | Oral/IM/ID/Oral/IM - 10 Weeks: bOPV-2, Pentavalent-2, RVV-2 - 14 Weeks: bOPV-3, Pentavalent-3, fIPV-2, RVV-3, PCV-2 - 9-12 Months: MR-1, JE-1*, PCV Booster, fIPV-3, Vitamin A (1st dose) SECTION 3 - CHILDREN (1-17 Years) (light green header): - 16-24 Months: MR-2, JE-2*, DPT Booster-1, bOPV Booster, Vitamin A (2nd dose) - 2-5 Years: Vitamin A every 6 months (doses 3rd-9th) - 5-6 Years: DPT Booster-2 - 10 Years: Td - 16 Years: Td FOOTNOTES at bottom: *JE vaccine only in endemic/selected districts Pentavalent = DPT + HepB + Hib Abbreviations: BCG=Bacillus Calmette-Guerin; bOPV=Bivalent Oral Polio Vaccine; fIPV=Fractional Inactivated Polio Vaccine; RVV=Rotavirus Vaccine; PCV=Pneumococcal Conjugate Vaccine; MR=Measles-Rubella; JE=Japanese Encephalitis; DPT=Diphtheria-Pertussis-Tetanus; Td=Tetanus-Diphtheria Source: Ministry of Health & Family Welfare, Government of India (UIP/NIS) The chart uses bold headers, alternating light gray row shading for readability, a thin border around each cell, and professional medical poster formatting. Font is clean and legible. Include a small syringe icon in the title area.

Here is the full India National Immunization Schedule (NIS) chart:
India National Immunization Schedule (NIS) - UIP
Key highlights of the schedule:
Pregnant Women
  • Td-1 at registration, Td-2 four weeks later, or Td-Booster if previously vaccinated within 3 years.
Infants (0-1 Year)
  • Birth: BCG (intradermal, left upper arm), Hepatitis B (IM), OPV-0 (oral)
  • 6 Weeks: bOPV-1, Pentavalent-1 (DPT+HepB+Hib), fIPV-1, Rotavirus-1, PCV-1
  • 10 Weeks: bOPV-2, Pentavalent-2, Rotavirus-2
  • 14 Weeks: bOPV-3, Pentavalent-3, fIPV-2, Rotavirus-3, PCV-2
  • 9-12 Months: MR-1, JE-1*, PCV Booster, fIPV-3, Vitamin A 1st dose
Children (1-17 Years)
  • 16-24 Months: MR-2, JE-2*, DPT Booster-1, bOPV Booster, Vitamin A 2nd dose
  • 2-5 Years: Vitamin A every 6 months (up to 9th dose)
  • 5-6 Years: DPT Booster-2
  • 10 Years: Td
  • 16 Years: Td
*JE vaccine only in endemic/selected districts.
Sources: Official NIS - MoHFW India | Park's Textbook of Preventive and Social Medicine (Table 43)
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