---

Forensic Toxicology: Comprehensive Poison Reference

---

1. LEAD (Plumbum)

• All lead compounds are toxic. Most dangerous: lead arsenate, lead oxide (litharge), lead carbonate (white lead). Least toxic: lead sulphide.
• Lead acetate (sugar of lead) is a white, crystalline, water-soluble salt with a sweetish taste.
• Burton's line: a blue-black line on the gum margin (where lead sulphide deposits at the gingival margin).
• Basophilic stippling of RBCs on blood film is a hallmark finding.
• Blood lead level: normal ~25 µg/100 ml; symptomatic above 70 µg/100 ml.

• Lead acetate: 20 g (some sources cite 1.8-2.0 g as the minimum toxic dose)
• Lead carbonate: 30 g
• Generally uncertain; depends on compound, form, and individual tolerance.

1. Lead acetate was historically used in medicine as an astringent and for treating skin conditions (Goulard's lotion).
2. Lead is extensively used in industry: manufacture of storage batteries, radiation shielding in X-ray departments, cable covering, glass manufacture, and as a component of alloys (>200 industries use lead).

1. Lead-containing paints applied to toys, window sills - children chew these causing accidental poisoning; also adulterated food/drink in pottery glazes.
2. Homicidal poisoning by adding lead acetate (tasteless/sweetish) to food or drink; also occupational malingering and industrial poisoning via deliberate exposure.

• Metallic taste, burning sensation, dryness of throat, intense thirst
• Vomiting within 30 minutes (vomitus blood-streaked)
• Colicky abdominal pain (relieved by pressure)
• Constipation (constant feature), scanty urine
• Coated tongue, foul breath
• Nervous symptoms: drowsiness, insomnia, headache, vertigo, muscle cramps, convulsions, paralysis of lower limbs
• Wasting; death from exhaustion

• Burton's line on gums (blue-black)
• Anaemia, basophilic stippling of RBCs
• Wrist drop and foot drop (peripheral motor neuropathy - extensor muscles of forearm and peroneal muscles)
• Abdominal colic, obstinate constipation, anorexia, loss of weight
• Renal involvement (lead nephropathy)
• CNS: insomnia, headache, mental confusion, delirium
• In children: reduced IQ, hyperactivity, learning disability, acute encephalopathy (apathy, ataxia, vomiting, stupor, convulsions)

• Lead combines with sulfhydryl (-SH) groups of essential enzymes, inhibiting them - particularly enzymes in porphyrin synthesis (ALA dehydratase, ferrochelatase) causing anaemia and elevated urinary ALA.
• Inhibits carbohydrate metabolism enzymes.
• Affects membrane permeability, causing potassium leakage from erythrocytes.
• 95% of absorbed lead enters erythrocytes; deposited in bone (as inert lead phosphate) but released during bone resorption.
• Organic lead (tetraethyl lead) acts primarily on CNS, causing encephalopathy.

---

2. ARSENIC

• White arsenic: white, odourless, slightly soluble powder with a faint sweetish taste.
• Arsenic trioxide is the most commonly used compound in poisoning.
• Mees' lines: transverse white bands (1-2 mm) on fingernails appear after 5 weeks of exposure.
• Reinsch test (copper strip turns grey), Marsh test, Gutzeit test.
• Garlic odour in decomposed bodies (arsenic trihydride - arsine).
• Arsenic is preserved in hair, nails, and bone even after exhumation.

• Arsenic trioxide: 180 mg (range 30-300 mg; as low as 30 mg can be fatal in sensitive individuals)
• Fatal dose depends on compound, physical form, and individual tolerance.

• 12-48 hours (acute); can be fatal within 2-3 hours in large doses.

1. Arsenic trioxide (Trisenox) is approved for treating acute promyelocytic leukaemia (APL). Fowler's solution (potassium arsenite) was historically used for leukaemia and skin diseases.
2. Arsenic compounds used as pesticides and insecticides (Paris green - copper arsenite); wood preservative (chromated copper arsenate); and in veterinary medicine as antiparasitics.

1. Homicidal poisoning: historically the most common homicidal poison ("inheritance powder" in Europe) due to tastelessness, white colour resembling sugar/flour, and mimicry of gastroenteritis symptoms.
2. Chronic suicidal/self-harm use; malingering by self-dosing; contamination of food/water in mass poisoning events; added to food to "cause disease" for insurance/financial gain.

• Metallic taste and faint garlic odour in breath; xerostomia; dysphagia
• Severe nausea, projectile vomiting, colicky abdominal pain
• Profuse diarrhoea - initially yellow-green, then rice-water stools (resembling cholera)
• Generalised vasodilation, capillary damage - transudation, severe hypovolemia
• In large doses: cyanosis, cold clammy extremities, hypoxic encephalopathy, convulsions, acute tubular necrosis, shock
• Hyperpyrexia and acute haemolysis may occur
• Death from circulatory failure, renal failure, or haemorrhagic shock

• Earliest: persistent erythematous flushing (capillary dilation)
• Aldrich-Mees' lines on nails (5 weeks after exposure)
• Hyperkeratosis, desquamation of palms and soles
• "Raindrop pigmentation": hyperpigmentation (bronze) with scattered pale spots - pathognomonic
• Patchy alopecia; periorbital oedema
• Peripheral neuropathy: symmetrical sensorimotor polyneuropathy resembling Guillain-Barre; glove and stocking distribution, wrist drop, atrophy
• Haematological: normocytic normochromic anaemia, leukopenia, thrombocytopenia
• Bowen's disease (intraepithelial squamous cell carcinoma); increased risk of skin, lung, bladder cancers
• Hepatic: fatty degeneration, cirrhosis

1. Reversible combination with sulfhydryl (-SH) groups of enzymes → disrupts cellular metabolism (especially pyruvate dehydrogenase complex - "arsenic inhibits Krebs cycle").
2. Arsenite reacts with SH groups in tissue proteins, inhibiting multiple enzyme systems essential for cellular metabolism.
3. Capillary poison: dilates capillaries → transudation, fluid loss, hypovolemia.
4. Fatty degeneration of liver.
5. Hyperemia and haemorrhages in intestinal wall.
6. Renal tubular necrosis.
7. Peripheral nerve axonal neuropathy with fragmentation and resorption of myelin.

---

3. SEEDS OF ABRUS PRECATORIUS (Rosary Pea / Jequirity / Gunja / Ratti)

• Seeds are hard, bright scarlet-red with a black spot at the hilum, 6-8 mm long.
• They have a hard testa; unbroken seeds swallowed whole are relatively non-toxic (pass through GI tract).
• Active principle: abrin - a heterodimeric toxalbumin with A chain (ribosome inactivating) and B chain (cell-binding lectin).
• Secondary active principles: abricin, precol, abralin, and abrasine (an alkaloid).
• The "sui" (needle/spike) is a classic forensic presentation: seeds mixed with datura, opium, onion paste, made into pointed needles (~15 mm, 90-120 mg), used to stab animals or humans.

• 1-2 seeds by mouth (oral route)
• 90-120 mg of abrin by injection
• Note: subcutaneously, abrin is 100 times as toxic as by the oral route (20-70 mg subcutaneous)

1. Seeds used in Ayurvedic medicine (Charaka, Sushruta): root used as a tonic, aphrodisiac; leaves used in skin diseases; seeds (highly diluted preparations) used for treatment of endogenous depression, certain neurological conditions.
2. Seeds used as weights (1 ratti = 121.5 mg) in traditional Indian goldsmithing; abrin is being investigated in cancer research as an immunotoxin (targeted cancer therapy - abrin-conjugated antibodies).

1. Sui poisoning of cattle: leather workers decorticate seeds, mix with datura/opium, form sharp needles (suis), insert into wooden handles, and strike cattle to obtain cheap hides or for revenge. Deaths resemble viper snakebite, so poisoning is not suspected.
2. Homicidal use in humans: the needle is kept between two fingers and a slap drives it into the victim's body; also powdered seeds applied to wounds; malingerers use powdered seeds to produce artificial conjunctivitis; used as an arrow poison.

• Local: painful swelling, ecchymosis, necrosis at site of injection
• Systemic: faintness, vertigo, vomiting, dyspnea, general prostration
• Cardiac arrhythmia, convulsions, death from cardiac failure
• Symptoms resemble viperine snakebite

• Nausea, vomiting, colicky abdominal pain
• Diarrhoea (haemorrhagic gastritis)
• Dehydration, collapse
• In severe cases: haemolysis, renal failure, multiorgan dysfunction

• Abrin B chain binds to galactose residues on cell surface → endocytosis into cell.
• Abrin A chain (ribosome-inactivating protein - RIP) depurinates 28S ribosomal RNA, permanently inactivating ribosomes → complete inhibition of protein synthesis → cell death.
• Causes agglutination and lysis of red cells (haemagglutinin activity).
• Blocks renal tubules with haemoglobin → renal failure.
• Has antigenic properties (immune-mediated reactions possible).

---

4. FRUITS OF SEMECARPUS ANACARDIUM (Marking Nut / Bhilawan / Bhilwa)

• Fruit (marking nut): black, roughly heart-shaped or cone-shaped, with rough projection at base.
• Thick cellular pericarp containing brownish, oily, acrid juice that turns black on exposure to air.
• Commonly used by dhobis (washermen) as a marking ink on clothes.
• The lesion produced externally closely resembles a bruise (artificial bruise).

1. Used in Ayurvedic medicine: juice internally (highly diluted) by Vaidyas for treatment of pain, paralysis, rheumatism, leucoderma, and neurological conditions.
2. Bhilawanol in the juice is used as a dye and ink; the nut is used industrially for marking cloth (dhobis' ink) and in traditional varnishes.

1. Criminal abortion: juice applied to the os uteri using an abortion stick (introduces the juice into the uterus/cervix), causing intense local irritation and abortion.
2. False charge of bruise / malingering: juice applied to skin produces a blister that mimics a genuine bruise - used to falsely allege assault; criminally introduced into the vagina as a punishment for alleged infidelity; applied to eyes by malingerers to produce artificial ophthalmia (conjunctivitis).

• Irritation, painful blisters containing acrid serum
• Eczematous eruption on surrounding skin (contact dermatitis)
• Lesion resembles a bruise; later ulcerates and sloughs
• Blister fluid is acrid and causes secondary eruption wherever it contacts skin

• Blisters in mouth and throat
• Severe gastrointestinal irritation
• Dyspnea, tachycardia, hypotension, cyanosis
• Absence of reflexes, delirium, coma, death

• Bhilawanol and semecarpol act as direct chemical irritants and vesicants.
• Cause intense local inflammation of mucosa and skin.
• On systemic absorption: produce cardiovascular depression and CNS depression.
• Mechanism is direct protoplasmic toxicity through phenolic irritant action.

---

5. CROTON SEEDS (Croton tiglium / Jamalgota / Nepal)

• Seeds: blackish-brown, oval, similar in size and shape to small castor seeds, but with longitudinal lines and a white oily kernel. Approximately 1.25 cm long.
• Croton oil: brownish, viscid, with unpleasant smell and extremely bitter, acrid taste.
• Plant grows throughout India. The active principles are crotin (toxalbumin - irritant and vesicant) and crotonoside (glycoside).

1. Croton oil was historically used in small doses as a drastically powerful purgative/cathartic when other purgatives failed; also as a counter-irritant in topical preparations for neuralgia and paralysis.
2. Croton oil is used in chemical peels (cosmetic dermatology) in highly diluted forms (Baker-Gordon phenol peel uses small amounts of croton oil); phorbol esters from croton oil are used extensively in cancer research as PKC activators.

1. Homicidal use: seeds powdered and added to food; croton oil added to alcoholic drinks (undetectable due to small quantity needed) to cause severe gastroenteritis and death.
2. Criminal abortion: croton oil applied to the cervix or taken orally; administered to cattle to kill them (applied externally or given with fodder); used to produce artificial vesication of the skin.

• Vesication, burning, redness of skin (croton oil is a powerful vesicant)

• Burning pain in abdomen and throat
• Nausea, vomiting (may be severe)
• Powerful purging (violent watery/bloody diarrhoea - drastic cathartic effect)
• Burning pain at anus
• Dehydration, cramps
• Feeble pulse, collapse, cardiovascular depression
• Coma, convulsions may precede death

• Crotin (toxalbumin): similar mechanism to ricin and abrin - inhibits ribosomal protein synthesis → cell death.
• Croton oil / phorbol esters: are potent activators of Protein Kinase C (PKC) → hyperactivation of cellular signalling → inflammation, excessive secretion in GI mucosa, vesication.
• Acts as a drastic irritant on GI mucosa and skin, causing intense inflammation, oedema, and loss of fluid.
• Externally: vesicant action on skin keratinocytes.

---

6. SEEDS OF RICINUS COMMUNIS (Castor Oil Plant / Arandi) - containing RICIN

• Seeds: oval, glossy brown, mottled (speckled pattern), 5-15 mm long, with a caruncle at the hilum. Come in two sizes (big and small).
• The entire plant is poisonous. The seeds are most dangerous.
• Active principle: ricin - a heterodimeric toxalbumin (glycoprotein) = RIP Type II (ribosome-inactivating protein).
• Important distinctions: unbroken seeds swallowed whole are relatively non-toxic (hard testa prevents absorption). Cooking inactivates ricin. The extracted castor oil does NOT contain ricin - it contains ricinoleic acid (purgative) and is non-toxic. The press cake (residue after oil extraction) does contain ricin and is poisonous.

• Ricin: 5-10 seeds; ricin itself: 6 mg (oral) or 60 µg/kg body weight (injected)
• Some sources state 60 mg ricin is fatal

1. Castor oil (which does NOT contain ricin) is used as a laxative/purgative, as a lubricant in the motor industry, and in manufacturing.
2. Ricin is under active research as an immunotoxin in targeted cancer therapy - ricin A chain conjugated to tumour-specific monoclonal antibodies (immunotoxins) to kill cancer cells selectively; also investigated as a vaccine adjuvant.

1. Political assassination: the George Markov assassination (London, 1978) - a tiny pellet drilled to carry ricin was injected into his calf from an umbrella air-weapon. Accidental poisoning in children from eating seeds.
2. Homicidal poisoning: powdered seeds added to food (common in East Africa); deliberate contamination of water/food supplies as a bioterrorism agent; "press cake" powder used to kill livestock; administered to children in East Africa as food adulterant.

• Burning in mouth, throat, and stomach
• Burns of oral mucosa (resembling alkali burn)
• Salivation, nausea, copious and painful vomiting
• Colicky abdominal pain, bloody diarrhoea (dysentery-like)
• Severe dehydration, cramps in calves and abdomen
• Haemolysis, drowsiness, delirium, convulsions
• Shallow breathing, uremia, jaundice
• Weak rapid pulse, collapse, death

• Watering of eyes, conjunctivitis, sneezing
• Acute nasal inflammation, headache, pharyngitis
• Asthmatic bronchitis, dermatitis

• Ricin B chain (lectin) binds to galactose residues on cell surfaces → receptor-mediated endocytosis into cells (virtually all cell types).
• Ricin A chain is a ribosome-inactivating protein (RIP): depurinates a specific adenine from 28S rRNA → permanently inactivates ribosomes → complete inhibition of protein synthesis → cell death.
• Additionally, ricin has a special binding protein that allows access to the endoplasmic reticulum in GI mucosal cells → severe haemorrhagic gastroenteritis.
• Can be absorbed via inhalation, ingestion, injection, and skin contact.
• Causes agglutination and haemolysis of RBCs; blocks renal tubules with haemoglobin.

---

7. CAPSICUM (Chilli Seeds / Red Pepper / Lalmirch)

• Capsicum fruits are universally used as a condiment (red pepper, lalmirch).
• Seeds: small, flat, kidney-shaped, yellowish-white, smooth. Embryo is curved inwards (key distinguishing feature from datura seeds, where embryo is curved outwards).
• Has a pungent smell and taste which lasts for a long time.
• Active principle: capsaicin (8-methyl-N-vanillyl-6-nonenamide) - a vanillyl amide.

1. Universally used as a food condiment (spice); capsaicin cream/patch (e.g., Qutenza) is used medically as a topical analgesic for postherpetic neuralgia, diabetic neuropathy, and other chronic pain conditions via TRPV1 receptor desensitisation.
2. Capsaicin used in self-defence sprays (pepper spray / OC spray) - a legitimate personal protection tool; used therapeutically as a topical counter-irritant in rheumatic conditions, arthritis.

1. Torture: powder introduced into nostrils, eyes, urethra, vagina, or rectum to extort money or confessions - a classic method of torture.
2. Robbery and assault: used in pepper spray attacks; administered in food/drink during robbery to incapacitate victims; seeds resemble datura seeds and have been mistakenly or fraudulently substituted (forensic importance in misidentification).

• Irritation, burning, vesication

• Burning pain, intense lacrimation, redness, conjunctival injection

• Burning sensation in mouth, throat, oesophagus, stomach
• Salivation, local inflammation of GI mucosa
• Irritant gastroenteritis (dose-dependent)

• Intense airway irritation, bronchospasm, lacrimation, rhinorrhoea

• Capsaicin selectively binds to TRPV1 (Transient Receptor Potential Vanilloid 1) receptors on nociceptive C-fibres and Aδ-fibres.
• Initial binding causes intense burning sensation (calcium influx) and release of substance P.
• Repeated or excessive exposure causes desensitisation and depletion of substance P → analgesia (basis of therapeutic use).
• Acts as a direct mucosal and skin irritant at high concentrations.

---

8. DATURA SEEDS (Dhatura / Jimsonweed / Thorn Apple - Datura fastuosa, Datura stramonium, Datura metel)

• Plant: Datura fastuosa (black datura), Datura stramonium (white/common datura), Datura metel.
• Seeds: small, black, kidney-shaped, flat, with rough surface. Embryo is curved outwards (key distinction from capsicum seeds, where embryo is curved inwards).
• All parts of the plant are poisonous: seeds, leaves, roots, flowers.
• Contains: atropine (hyoscyamine), hyoscine (scopolamine), and hyoscyamine in all parts.
• Forensic test: seeds detected in suspected food or drink using microscopy.

• Seed powder: approximately 60-100 seeds or 4-8 g (seed powder)
• Pure atropine: approximately 100 mg in adults; 10 mg in children
• Fatal period: 24 hours (commonly within 24 hours)

1. Atropine (derived from datura alkaloids) has extensive medical use: pre-anaesthetic medication (reduces secretions), treatment of bradycardia and heart block, antidote to organophosphate poisoning, mydriatic for ophthalmic examination, antispasmodic for GI/biliary colic, treatment of motion sickness (scopolamine patch).
2. Hyoscine (scopolamine) used as an antiemetic, sedative, treatment of Parkinsonism, motion sickness; historically used in obstetrics ("twilight sleep"); datura leaves smoked in Ayurveda for asthma (bronchodilator effect).

1. "Dhatura poisoning": classic road/travel poisoning in India - seeds or powder added to food or drinks (bhang, sweet meats, sweets offered by strangers) to stupefy and rob travellers; used for kidnapping. "Thuggees" and "Poisoners by profession" (road poisoners) classically used dhatura.
2. Homicide and criminal abortion: used to murder; administered for criminal abortion; used in "date rape" scenarios; given to commit burglary while victim is incapacitated; chronic or repeat exposure used for slow homicide.

• Hot as a hare: hyperthermia (inhibition of sweating)
• Dry as a bone: dry mouth (xerostomia), anhidrosis, dry skin
• Red as a beet: flushing of face and skin
• Mad as a hatter: confusion, delirium, hallucinations (visual hallucinations are classic), agitation, restlessness, incoherent speech
• Blind as a bat: dilated pupils (mydriasis), blurred vision, photophobia, cycloplegia
• Full as a flask: urinary retention, abdominal distension (ileus)

• Tachycardia (marked)
• Headache, dizziness
• Difficulty in swallowing
• Increased intraocular pressure
• In severe poisoning: convulsions, coma, cardiovascular collapse, respiratory depression, death

• Atropine and hyoscine are competitive antagonists of acetylcholine at muscarinic receptors (M1, M2, M3) throughout the body.
• Block parasympathetic effects at all smooth muscle, cardiac muscle, glands, and CNS muscarinic receptors.
• Scopolamine also has potent CNS effects: sedation, amnesia, confusion at low doses; excitement and hallucinations at toxic doses.
• Results in: decreased secretions, tachycardia, mydriasis, ileus, urinary retention, hyperthermia.

---

9. GANJA (Cannabis indica / Cannabis sativa / Indian Hemp / Marijuana)

• Ganja (1-2% THC): resinous mass made from leaves, bracts, and inflorescence of female Cannabis plants. Prepared by crushing leaves and flowers of female plants. Smoked in a "chillum" (pipe) or as beedi/reefer.
• Bhang (~0.5% THC): dried leaves and buds, ground into paste.
• Charas / Hashish (~10% THC): dried resin from flower tops.
• Marijuana (all preparations).
• Cystolith test (forensic identification): place suspected material on slide with 10% chloral hydrate, examine under low-power microscope - crystals appear like "elephant husk" or "bear claws" with calcium carbonate cluster at the base; add 20% HCl → CO₂ bubbles are released.
• Urine THC metabolites detectable 7-8 weeks after use (fat-soluble; stored in body fat).
• THC urine level: positive threshold 50-100 ng%.

• Charas (hashish): ~2.0 g/kg body weight
• Ganja: ~8.0 g/kg body weight
• Bhang: ~10.0 g/kg body weight
• IV cannabis: 1-2 g
• Note: Authentic fatal dose data is difficult to establish; practical fatal poisoning is rare.

1. Medical cannabis: Δ-9-THC (dronabinol) and cannabidiol (CBD) are licensed medicines - used for chemotherapy-induced nausea and vomiting, HIV-associated anorexia (nabilone/dronabinol), chronic neuropathic pain, spasticity in multiple sclerosis (Sativex/nabiximols), and epilepsy (Epidyolex/cannabidiol for Dravet syndrome).
2. Hemp plant (Cannabis sativa, low-THC variety) is legally cultivated for its fibre (rope, textiles, paper), seeds (nutritional hemp oil), and industrial uses; cannabis preparations in Ayurveda (bhanga) used as analgesic, sedative, and for dysentery.

1. Road poisoning / stupefying for crime: majun and charas mixed into food, sweets, or drinks to stupefy victims for roadside robbery, kidnapping, and rape. "Bhola Manucca" chocolates (Mumbai case) containing THC sold near schools to create addiction in children.
2. Addiction and running amok: chronic abuse leads to "hashish insanity" - in rare cases, after first or continued use, the person may "run amok" - a frenzied homicidal state. Ganja taken to "steady the nerves" before committing bold criminal acts (homicide). Used to dope cigarettes; impaired judgement leads to accidents, sexual crimes, violence.

1. Phase 1 (Euphoria/Stimulation): relaxation, euphoria, increased talkativeness, hilarity; colours more vivid, sounds clearer, increased clarity of perception; philosophical thinking, introspection.
2. Phase 2 (Hallucinations/Delusions): visual hallucinations, conjunctival congestion (red eyes, "bloodshot"), increased appetite (munchies), sedation; paranoia in some.
3. Phase 3 (Depression/Stupor): deep sedation, drowsiness, tachycardia, palpitation, hypotension; in large doses: convulsions followed by cardiac arrest.

• Dry mouth, increased heart rate
• Pulmonary irritation (when smoked): cough, sore throat, rhinitis, bronchitis
• Weakness, drowsiness, deep sleep; in overdose: coma

• "Amotivational syndrome": apathy, poor concentration, social withdrawal, lack of motivation
• Psychological: manic episodes, schizophreniform psychosis, confusional psychosis
• Cyclical hyperemesis (cannabinoid hyperemesis syndrome)
• Medical complications: chronic pulmonary infections, lung malignancies, cancer of mouth and larynx, aspergillosis, clubbing of digits
• Sexual: loss of sexual power (due to reduced testosterone)
• Mental deterioration, moral decline

1. THC acts on endocannabinoid receptors (CB1 and CB2).
2. CB1 receptors are concentrated in the cerebral cortex, hippocampus, basal ganglia, cerebellum - explains psychotropic effects, memory impairment, motor effects.
3. THC mimics/modulates neurotransmitters including GABA, dopamine, acetylcholine, histamine, serotonin, noradrenaline, and prostaglandins.
4. In small doses: CNS excitation (euphoriant, stimulant).
5. In large doses: CNS depression (narcotic, hypnotic, hallucinogenic).
6. Smoking gives immediate effects; oral consumption gives slow and unpredictable effects (first-pass metabolism and variable GI absorption).

---

Quick Comparison Table

---

---

10. POPPY CAPSULE (Papaver somniferum / Opium / Post ka Doda)

• Phenanthrene group (narcotic): Morphine (9-14%), Codeine (2-4%), Thebaine (0.5%)
• Isoquinoline group (non-narcotic, antispasmodic): Papaverine (1%), Narcotine (6%)

• Papaver somniferum (opium poppy): cultivation is banned in India except under Central Government licence (Government Opium Factory at Ghazipur).
• Opium: the dried milky latex (juice) obtained by incising the unripe green poppy capsule (seed pod). When fresh it is plastic and internally moist; it dries to a reddish-brown to dark brown, hard, brittle mass.
• Post ka doda (dry poppy capsule): the dried capsule itself, used as a sedative fomentation and poultice. Contains 0.1-0.3% morphine.
• Standard opium = 10% morphine content.
• Poppy seeds (Khus khus): white, harmless, used as food; Poppy seed oil: used for cooking and lighting.
• Other preparations: laudanum (tincture of opium), paregoric (camphorated tincture), Dover's powder.
• Characteristic raw flesh-like smell (opium) - detectable in breath of poisoned person.
• Heroin (diacetyl morphine) = "brown sugar" - the most dangerous addiction-forming derivative.

1. Medical use of alkaloids: Morphine is the gold-standard analgesic for severe acute pain and cancer pain (palliative care); codeine is used as a mild analgesic and antitussive; papaverine as an antispasmodic and vasodilator; apomorphine (derived from morphine) as an emetic and in treatment of Parkinsonism; pethidine/meperidine in obstetric analgesia; methadone in opioid substitution therapy.
2. Dry poppy capsule (Post ka doda): used in traditional/Ayurvedic medicine as a sedative fomentation, poultice, and analgesic; opium has been used historically as a painkiller, antidiarrhoeal (tincture of opium / laudanum for dysentery), and cough suppressant; poppy seeds (khus khus) are used as a nutritious food and in culinary preparations.

1. Suicide: Opium is described as "the poison of choice for suicidal purposes in India" due to its easy availability, painless death, characteristic odour/taste (rarely detected in food), and the relative ease of obtaining a fatal dose.
2. Infanticide / criminal use against children: Opium smeared on nipples by mothers to kill infants through breastfeeding (recorded cases). Drugging of infants and children to keep them quiet (accidental/intentional). Used to "steady the nerves" before committing homicide. Used for road-poisoning (administering to stupefy victims), doping of racehorses, and as a cattle poison. Heroin addiction is a major societal problem; brown sugar (crude heroin) trafficking is widespread.

• Sense of well-being, restlessness, euphoria
• Laughter, hallucinations, flushing of face
• Raised pulse
• In children: convulsions
• In adults: wide excitement

• Weariness, headache, giddiness
• Sense of weight in the limbs
• Diminished sensibility; strong urge to sleep (patient rousable by painful stimuli at this stage)
• Pupils contracted (miosis); conjunctiva congested
• Cyanosis, itching sensation all over skin
• Pulse and respiration nearly normal at this stage

• Deep coma - patient cannot be aroused by any stimuli
• Muscles completely relaxed; reflexes abolished
• Pin-point pupils (bilateral miosis) - do not react to light (classic triad with coma + respiratory depression)
• Blood pressure falls; pulse rapid and feeble
• Slow, sighing respirations, gradually decreasing to 2-4 breaths/min → Cheyne-Stokes breathing
• Skin cold with profuse perspiration (opium suspends all secretions except sweat)
• Hypothermia (body temperature below 35°C)
• Marked cyanosis; froth from mouth and nose
• Pupils dilate terminally when asphyxia supervenes (but still do not react to light)
• Death from respiratory paralysis/asphyxia
• Breath smells of opium (raw flesh-like) throughout illness

• Vomiting, purging, convulsions
• Raised temperature, dilated pupils, syncope after subcutaneous injection

• Pontine haemorrhage (pupils pin-point but with hyperpyrexia)
• Uraemic coma (ammoniacal breath, renal history)
• Diabetic coma (Kussmaul breathing, acetone breath, raised blood sugar)
• Alcohol poisoning (alcoholic breath, pupils dilate on stimulation - MacEwan's sign)
• Carbolic acid poisoning (white patches on lips, carboluria - green urine)
• Organophosphorus poisoning (garlic breath, excessive secretions, fasciculations)
• Barbiturate poisoning, epileptic coma, hysterical coma

1. Morphine and other opioid alkaloids bind to specific opioid receptors (G-protein coupled receptors) in the CNS and peripheral tissues:
   • µ (mu) receptors: supraspinal analgesia, euphoria, respiratory depression, GI dysmotility (constipation), miosis, physical dependence - primarily responsible for toxicity and death.
   • κ (kappa) receptors: supraspinal analgesia, miosis, dysphoria, sedation.
   • α (alpha/sigma) receptors: CNS stimulation.
2. Analgesia: Depression of cerebral cortex → modifies emotional response to pain; morphine acts at substantia gelatinosa in brainstem and spinal cord.
3. Respiratory depression (cause of death): Acts on the chemoreceptor trigger zone (CTZ) and respiratory centre in the medullary brainstem → depresses the respiratory response to CO₂ → progressively decreasing rate and depth of breathing → asphyxia.
4. Miosis (pin-point pupils): Acts on Edinger-Westphal nucleus → parasympathomimetic-like effect on pupil → constriction. (Note: Terminally, pupils dilate due to hypoxia/asphyxia.)
5. Euphoria and addiction: Opioid receptors in amygdaloid nuclei and medial thalamic nuclei are the sites where addiction is mediated; dopamine release in nucleus accumbens.
6. GI effects: Reduces peristalsis (via enteric opioid receptors) → constipation. Stimulates CTZ initially → nausea and vomiting.
7. Naloxone (a pure competitive opioid antagonist) reverses all effects - the specific antidote; given 0.4-0.8 mg IV/IM, repeated every 10-15 minutes up to 10 mg.

• Comatoasphyxial changes
• Deep cyanosis of face (almost black), blue nails, engorged neck veins
• Postmortem lividity nearly black
• Froth at nose and mouth (not as fine or copious as in drowning)
• Stomach: small, soft brownish lumps of opium may be found
• Lungs: oedematous, congested; trachea and bronchi covered with froth
• Blood: dark and fluid
• Forensic preservation: blood, bile, brain, and routine viscera

---