Deliriant poison

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Deliriant Poisons

Deliriant poisons are a subgroup of cerebral (neurotoxic) poisons that act on the cerebrum to produce a characteristic and well-marked deliriant stage - defined by delirium, hallucinations, and delusions, before coma supervenes. They are classified under cerebral poisons alongside somniferous (opium) and inebriant (alcohol, ether) types.

The classical deliriant poisons are:

Dhatura (Datura fastuosa / stramonium) - most important
Atropa belladonna (Deadly nightshade)
Hyoscyamus niger (Henbane)
Cannabis indica (Indian hemp)
Cocaine is also described as a deliriant/convulsant when ingested

(P C Dikshit Textbook of Forensic Medicine and Toxicology; Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology)

1. Dhatura (Datura fastuosa)

Dhatura plant illustration showing bell-shaped flower and spiny fruit (thorn apple)

Fig: Dhatura plant with its characteristic bell-shaped flower and spiny fruit

Dhatura spiny fruit (thorn apple) - close up

Fig: Dhatura fruit - the "thorn apple" with sharp spines

The most medico-legally important deliriant poison in India.

Botanical Details

Two varieties: Datura alba (safed dhatura, white flowers) and Datura niger (kala dhatura, black/purple flowers)
Grows in waste places all over India
Fruit is spherical with sharp spines = "thorn apple"
Contains 450-500 yellowish-brown seeds per fruit; seeds resemble chilli/capsicum seeds
All parts poisonous, but seeds and fruit are most so

Active Principles

Laevohyoscyamine (primary)
Hyoscine (scopolamine)
Traces of atropine (actually a racemic form of hyoscyamine formed during extraction)

All are anticholinergic (parasympatholytic) alkaloids - they block muscarinic receptors.

Signs and Symptoms

The classic mnemonic: "10 D's"

D	Feature
Dysphagia	Difficulty in swallowing
Delusions	Fixed false beliefs
Dermatitis	Contact with leaves/flowers
Delirium	Noisy, restless, purposeless
Drowsiness	Progresses to coma
Dry skin/mucous membrane	Anhidrosis, intense thirst
Dilated pupils (Mydriasis)	Photophobia, loss of accommodation
Dreadful hallucinations	Visual and auditory
Dysuria	Urinary retention
Dysarthria	Difficulty speaking

Also remembered as the "5 Hots":

Hot as a hare - raised temperature (107-108°F)
Blind as a bat - disturbed vision, photophobia
Dry as a bone - intense thirst, dry skin
Mad as a hen - delirium, hallucinations, delusions
Red as a beet - flushing of face

Characteristic delirium: The patient mutters indistinct words, tries to run away, picks at bedclothes, and exhibits "pin-rolling movements" (tries to pull imaginary threads from fingertips / threads imaginary needles).

Course: Excitement phase passes in 1-2 hours → deep coma or sleep → may end in death from respiratory paralysis. Improvement begins in 24 hours; patients remember nothing about the episode.

Fatal Dose & Period

Fatal dose: 4 fruits, 100 seeds, or 0.5-1 g of the active principle
Fatal period: 24 hours

Treatment

Gastric lavage (stomach wash) - emetics can also be used
Specific antidote: Physostigmine (eserine) - a cholinesterase inhibitor; given 1-3 mg subcutaneously, repeated as needed
Pilocarpine subcutaneously (stimulates parasympathetic system)
Catheterize for urinary retention
Supportive: IV fluids, cool the patient (cold sponging for hyperthermia)
Diazepam for convulsions
Avoid morphine (both depress respiration)

Medico-legal Significance

Homicidal: Most common use in India - given in food or drink to incapacitate victims for robbery, dacoity, or abduction. Victims comply with instructions of the poisoner ("Thagi poisons"). Women have been abducted, robbed, and raped under dhatura influence.
Accidental: Children eating raw fruits; adults mistaking seeds for capsicum seeds; added to country liquor for a stronger kick.
Suicidal: Rare
Dhatura is used as an aphrodisiac in folk medicine

2. Atropa Belladonna (Deadly Nightshade)

Atropa belladonna plant with leaves, fruit and flowers

Fig: Atropa belladonna plant

A plant of the Solanaceae family; grows in Europe and temperate regions
Active principles: Atropine, hyoscyamine, hyoscine - same family as dhatura
All parts are poisonous, especially the berries (look like cherries)

Signs & Symptoms

Similar to dhatura - the hallmark is the same anticholinergic toxidrome:

Dry mouth, thirst, dysphagia
Flushed, hot, dry skin
Dilated pupils (mydriasis), photophobia
Tachycardia (pulse full and bounding initially)
Restlessness, delirium, hallucinations
Urinary retention
Eventually coma and respiratory failure

Fatal Dose

Berries: 3-4 berries may be fatal in a child; ~10-20 berries in an adult
Atropine: 100 mg in adults; 10 mg in children

Treatment

Same as dhatura: physostigmine is the specific antidote; gastric lavage; supportive care.

Medico-legal Points

Accidental (most common) - children eating attractive berries
Used medicinally for its mydriatic effect (eye drops), antispasmodic, and premedication in anaesthesia
Historically used in cosmetics by women to dilate pupils (hence "belladonna" = beautiful woman)

3. Hyoscyamus Niger (Henbane)

Also known locally as Khorasani ajwayan; also called scopolamine or henbane.

Grows in the Himalayan ranges at high altitudes
All parts of the plant are poisonous
Active principles: Atropine, hyoscine (scopolamine), hyoscyamine - identical to dhatura/belladonna family

Signs & Symptoms

Closely resemble dhatura poisoning. The symptoms are anticholinergic in nature.

Fatal Dose

Hyoscyamine: 125 mg
Hyoscine hydrobromide: 15-30 mg
Fatal period: 24 hours

Treatment & Postmortem

Same as dhatura; physostigmine is the antidote
Hyoscyamine seeds may be found in the stomach at autopsy
Hyoscine resists putrefaction - important for forensic analysis in advanced decomposition

Therapeutic uses (small doses)

Controls tremors in Parkinson's disease
Used in delirium and psychotic states
Controls spasms of asthma and whooping cough
Combined with morphine for twilight sleep (painless childbirth) historically
Used in shell-shock during war
Used as a truth serum / lie detector: under its influence, a criminal is in a half-awake, half-asleep state and is unable to fabricate lies or withhold truth (forensically significant)

Medico-legal Significance

Generally accidental (overdose) or rare homicidal
Famous case: Crippen case - hyoscine used as the murder weapon
Can be used as a forensic truth serum

4. Cannabis Indica (Indian Hemp / Marijuana)

Fig: Cannabis sativa / Indian hemp plant

Also called:

Cannabis sativa (India), Marijuana (USA), Dagga (South/Central Africa), Hashish (Egypt)
Grows all over India; cultivation is restricted by law

Active Principle

Tetrahydrocannabinol (THC) - an oleoresin (fat-soluble), NOT an alkaloid
Cannabinol, cannabidiol, cannabinolic acid also present
THC is absorbed from digestive tract (when ingested) and from lungs (when smoked)
THC compounds are labile and may change on exposure to UV light or acid

Preparations (in order of potency)

Preparation	Source	Active Principle (%)	Notes
Bhang (siddhi, patti, sabji)	Dried leaves + fruit shoots	~15%	Mildest; drunk as beverage; intoxication lasts 3 days
Majun	Bhang + sugar + milk + butter (sweetmeat)	~15-20%	Produces grandiose delusions; sometimes dhatura is mixed in
Ganja	Flowering tops of female plant	15-25%	Rusty green, characteristic odour; smoked in pipe (chillum) with tobacco
Charas (hashish)	Resinous exudate from leaves and stems	25-40%	Dark green/brown; most potent; smoked in pipe or hookah

Signs and Symptoms of Acute Cannabis Poisoning

Initial stage: Euphoria, uncontrollable laughter, excitement, garrulousness
CNS effects: Delirium, grandiose delusions, visual hallucinations, paranoia
Eyes: Conjunctival injection (suffusion), lacrimation
CVS: Tachycardia (very characteristic), palpitations
Appetite: Increased (the "munchies")
Sexuality: Perceived increase in sexual desire
Later: Drowsiness, deep sleep
Pupils: Normal or slightly dilated (unlike dhatura - markedly dilated)

Fatal Dose

No definite fatal dose established for cannabis
Deaths are rare from cannabis alone; usually from accidents or cardiac events

Medico-legal Significance

Most important narcotic in India from a forensic standpoint
Covered under the NDPS Act (Narcotic Drugs and Psychotropic Substances Act, 1985) in India
Long-term use leads to cannabis psychosis ("ganja psychosis") - a chronic mental disorder
Amotivational syndrome: Chronic users show apathy, lack of initiative, social withdrawal
May be used to stupefy victims (sometimes mixed with majun for criminal purposes)
Detected in urine for up to 30 days after chronic use (lipophilic)

Summary Comparison Table

Feature	Dhatura	Belladonna	Hyoscyamus	Cannabis
Active principle	Hyoscyamine, hyoscine, atropine	Atropine, hyoscyamine, hyoscine	Atropine, hyoscine, hyoscyamine	THC (oleoresin)
Pupil	Dilated (mydriasis)	Dilated	Dilated	Normal/slightly dilated
Skin	Hot, dry, red	Hot, dry, red	Hot, dry, red	Normal
Delirium type	Purposeless, noisy, hallucinations	Similar to dhatura	Similar to dhatura	Euphoric, grandiose
Pulse	Full, bounding then weak	Tachycardia	Tachycardia	Tachycardia
Fatal dose	4 fruits / 100 seeds	~10-20 berries (adult)	125 mg hyoscyamine	No definite fatal dose
Antidote	Physostigmine	Physostigmine	Physostigmine	None specific
Main use in crime	Robbery, dacoity, abduction	Rarely homicidal	Rarely homicidal (Crippen)	Stupefaction

Classification of Cerebral Poisons (Context)

Cerebral poisons act on the brain and are sub-classified as:

Somniferous (narcotic): Opium, barbiturates - produce deep sleep/coma
Inebriants: Alcohol, ether, chloroform - produce excitement then depression
Deliriants: Dhatura, belladonna, hyoscyamus, cannabis, cocaine - produce delirium + hallucinations

(PC Dikshit Textbook of Forensic Medicine and Toxicology; Parikh's Textbook; The Essentials of Forensic Medicine and Toxicology, 36th edition 2026)

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