⚕️ Diagnosis of Poisoning
- For diagnosis, it is essential for expert doctors to be aware of the signs and symptoms of various poisons.
- This knowledge allows them to establish a definite diagnosis of poisoning in both living and deceased individuals.
(A) Diagnosis of Poisoning in Living Victims
- The symptoms of poisoning in living individuals depend on whether it is Acute or Chronic poisoning.
1. Acute Poisoning
- The symptoms of acute poisoning appear suddenly after consuming a suspected food, liquid, or medicine.
Nature of Symptom Detail Onset Symptoms appear suddenly after consuming the suspicious substance (except for microbial food poisoning, where symptoms may appear later). Patient’s State The victim is generally completely healthy before the acute poisoning. Symptom Difference The current symptoms are completely different from those of a common illness. Co-Victims If someone else consumed the same suspicious substance, they will show similar symptoms. Severity Symptoms rapidly become severe, which can lead to the death or recovery of the victim. Poison Identification The poison can be identified in the victim’s vomitus, gastric lavage fluid, blood, urine, and feces, as well as in the food, liquid, or medicine that was consumed.
2. Chronic Poisoning
The symptoms of chronic poisoning develop internally and gradually.
Basis for Diagnosis:
- If the patient suffers from any kind of Malaise (general discomfort),
- experiences gradual weakening of health,
- or has Irritation of the alimentary canal that remains undiagnosed,
- they should be considered a victim of chronic poisoning.
Poison Identification:
- The poison can be identified in the patient’s feces and urine, blood,
- and in the food, liquid, or medicine they have been consuming over time.
(B) Diagnosis of Poisoning in the Dead
The diagnosis of poisoning in a dead body depends on the following four fundamental pieces of evidence:
1. Post-mortem Appearance
This diagnosis is based on the external and internal examination of the body.
(a) External Appearance
- Delayed Decomposition: Due to the poison, the putrefaction (decomposition) of the body is largely delayed, and the corpse remains intact for a significant period.
- Signs: Poisoning can be inferred by observing the smell emanating from the body and clothes, the presence of foam on the mouth and nose, stains of poison around the lips and chin, skin coloration, post-mortem lividity, signs of an injection on the body, and the condition of natural and medical orifices.
(b)Internal Appearance
- Signs of corrosive and irritant poisons are found in the alimentary canal.
- These signs may appear as Hyperaemia (congestion), Tender (inflammation), Ulceration (sore), or Perforation (hole).
2. Chemical Analysis
This is the most crucial and concrete evidence.
- Presence of Poison: The finding of poison in the tissues of the viscera is the most significant proof of poisoning.
- Analysis of Other Materials: Chemical analysis is also important for the food, fluid, or medicine consumed by the deceased.
3. Experiments on Animals
This method is used to confirm the toxic effects of the poison.
- Method: The poison extracted from the deceased’s body, or the food/fluid/medicine consumed by the deceased, should be administered to domestic animals (like dogs or cats) and observed.
- Result: If poison is present, toxic effects will manifest in these animals.
4. Circumstantial Evidence
This helps in understanding the intent and cause of the poisoning.
Investigation Points:
- Where the victim purchased the poison.
- Information about the deceased’s behavior and conduct from family and friends.
- The victim’s mental or financial distress.
- A letter written by the victim (e.g., a suicide note).
⚕️ Duties of a Doctor in Cases of Poisoning
The duties of a doctor when dealing with suspected cases of poisoning are categorized as follows:
1. Saving the Patient's Life (Primary Duty)
- Immediate Priority: The doctor’s first and foremost duty is to save the patient’s life and administer immediate treatment.
- Notification (Private Practice): If a doctor, in private practice, suspects a case of self-inflicted (attempted suicide) or accidental poisoning, it is not mandatory for them to immediately report it to the police or magistrate.
2. Cooperation with Legal Authorities
- Duty to Assist: If the investigating Police Officer or Magistrate wishes to summon the doctor and obtain information regarding the patient, it is the doctor’s duty to provide full assistance and cooperation.
3. Reporting under Criminal Procedure Code (CrPC)
- Confirmed Cases: If the doctor knows or confirms that a person has consumed poison, they must inform the nearest police station under Section 44 of the Criminal Procedure Code (CrPC).
4. Public Health Protection
- Public Danger: In a case of poisoning where the doctor suspects that a large number of people may be affected (e.g., poisoning caused by contaminated food at a hotel or polluted public water), it is the doctor’s duty to notify the Health Authorities about the matter.