Arsenic is found in significant concentrations in the groundwater of a number of countries. In its inorganic form, arsenic is extremely hazardous. The greatest concern to human health from arsenic is contaminated water used for drinking, food preparation, and irrigation of food crops. Arsenic poisoning from drinking water and eating can lead to cancer and skin sores over time. It has also been linked to diabetes and cardiovascular disease. In prenatal and early childhood exposure has been related to poor cognitive development and an increase in the number of young adults who die. The most critical measure in impacted communities is to provide a safe water source to prevent further arsenic exposure.
As it is not absorbed from the GIT hence Metallic arsenic (black in colour) is non-poisonous in nature. It is a normal component of all animal tissues, in small amounts.
Arsenic was used as a healing agent after Greek physicians such as Hippocrates and Galen popularized its use. Fowler's solution was 1% arsenic trioxide preparation which was mostly used during the 19th century.
Use of fowler solution
The long term use of Fowler’s solution causes chronic arsenic intoxication. In World War II, it was used for the treatment of syphilis. Arsphenamine (neoarsphenamine), a light yellow compound containing 30% arsenic was used intravenously to treat syphilis, yaws, and some protozoan infections.
Arsenic continues to be an important component of many non-western traditional medicine products. In Some Chinese traditional medications, realgar (arsenic sulphide) are present and are present in the form of pills, tablets, and other preparations. For the treatment of psoriasis, syphilis, asthma, rheumatism, haemorrhoids, cough and pruritus, arsenic is generally used. It is also recommended as a health tonic, an analgesic and also anti-inflammatory agent. It is also used for the treatment of malignant tumours. In India, herbal medicines containing arsenic are used for the preparation of some homoeopathic medicine and haematological malignancies. In Korea arsenic is present in herbal medicine which is used for the treatment of haemorrhoids.
Absorption and Excretion
When a large dose of arsenic is taken for a short duration of time.
Table 1 - Signs and Symptoms
|Sr. No.||Sign and symptoms|
|1||Eye- Dilated pupil, sunken eye.|
|2||Skin- Cold, calmly, skin eruption.|
|3||Breath rate- Difficulty in breathing.|
|4||Heartbeat- Slows down.|
|5||Stool- Contain blood, mucous and watery like rice water.|
|6||Vomiting- Contains bile content, stomach content, blood and mucus. continuous vomiting occurs.|
|8||Legs- Cramps, shaking legs.|
|10||Urine-Pain during urination.|
|11||CNS- Headache, dizziness, increases in temperature, tremors, seizure, coma, general paralysis.|
|12||Oesophagus -Burning sensation, garlic-like odour in the mouth.|
Fatal Dose- 120-200 mg of arsenic trioxide (adults), 2 mg/kg (children) is fatal dose.
Fatal Period-1-2 days.
It depends upon the amount of dose and the period which has elapsed before death.
Externally the body becomes dehydrated and appears blue in colour. The eyeball got sunken. The skin appeared wrinkled. Rigour Mortis last for a long time. Putrefaction is retarded.
Internally- Given in the below table
Table 2 - Post mortem Appearance in Internal Body Organ
|1||Stomach- Appear as red velvet.|
|2||Mucosa- appears red, Swollen in patches. |
|3||Pyloric entry- Small Ulceration are present.|
|4||Liver- Fatty degenerative changes and jaundice are also present frequently.|
|5||Heart and kidney- Fatty degeneration, Subendocardial petechial haemorrhages are present in the heart.|
|6||Decomposition- Is not slowed down.|
|7||Small intestine- In faeces, a large amount of mucus is present, little sign of inflammation, and submucous haemorrhages are present; mucus is of pale violet in colour. |
|8||Caecum and rectum-Slightly inflammated.|
|9||Brain- Edema with patchy necrosis or hemorrhagic encephalitis. The meninges are congested.|
It may occur due to:
Sign and Symptoms
It generally occurs in 4 stages-
Table 3 - Second Stage of Chronic Poisoning - sign and Symptoms
|1||Mucous membrane- inflamed.|
|2||Eyes and nose- runny.|
|3||Voice- Hoarseness, coughing.|
Table 4 - Third Stage of Chronic Poisoning - Signs and Symptoms
|1||Skin- Irritation, vesicular eruption, Raindrop type pigmentation-due to long exposure the patchy brown pigmentation develops in the skin.|
|2||Palm and sole- Hyperkeratosis develops.|
Mee’s line- generally occurs around the nails of fingers and toes, they indicate the period of arrested growth due to interference with normal metabolism.
Table 5 - Fourth Stage of Chronic Poisoning - Sign and Symptoms
|1||Hand and feet- Tingling, numbness.|
|3||Arsenical neuritis- Headache, damage in vision and in mental activity .thee symptoms are related to chronic alcoholism.|
Table 6 - Postmortem Appearance in Chronic Poisoning
| Sr. No.||OrganAppearance|
|1||External appearance- Emaciation, pigmentation, keratosis, alopecia, white streaks on nails, jaundice, wasting of muscles, and ulceration of nasal septum.|
|2||Small intestine- Red in appearance with thick mucosa.|
|3||Liver- Fatty degeneration.|
|5||Heart- Myocardial necrosis.|
It can be used for the following purpose-
Homicidal purpose-in the past it was a popular homicidal agent because it is less expensive and easily accessible. The fatal dose is small. The fatal period was also small. It has no taste; no odour hence can be mixed easily into food without anyone’s notice. The symptoms also develop gradually and resemble cholera. Very less quantity is needed.
While performing postmortems and exhumations, the imbibition from natural sources should be taken into consideration. Hence necessary measures should be taken so that arsenic could not be able to percolate in the body through any of the natural sources like soil, groundwater etc. If there is arsenic contamination outside then it can be easily absorbed by keratin tissue. Then in such case, the concentration will be higher in hair and nails and in the case of poisoning, the concentration of arsenic will be more than in soil/water.
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