Datura Poisoning

Introduction

Datura is a Deliriant poison or celebral poison. These type of poisons acting on the brain and inducing altered consciousness with confusion, delusions, hallucination. It exists in many varieties such as D. fastuosa and D. stramonium. It grows in the wild. All Parts of dathura are poisonous but seeds and fruits are more poisonous.

Common Names

  • Jamestown weed
  • Jimson weed
  • Thorn apple
  • Stinkweed
  • Devil’s weed or Devil’s apple
  • Angel’s trumpet

Family– Solanaceae

Nature

● Datura is a wild small coarse shrub up to 3 to 5 feet and grows at waste places and has handsome foliage of dark green ovate, pointed leaves, and large tubular (trumpet-shaped) flowers. There are 2 varieties of Datura fastuosa are found in India as follow-

  1. Datura alba — They are white color flowers.
  2. Datura niger — They are deep purple color flowers.

● These plant bears fruits which are spherical in shape, green in colour and have multiple spikes or thorn is called as “thorn apple. The fruit contains brownish or yellowish-brown kidney shaped seeds. The fruits contains more than 100 seeds resembling chilly seeds.

● These plants have unpleasant smell.

● These plants grow all over India and are offered to Lord Shiva in Puja.

Active Principle

The active principles are Hyoscine (scopolamine), hyoscyamine, and traces of atropine, together referred to commonly as belladonna alkaloids.

Uses

  • Dhatura is used in Ayurvedic system of medicine.
  • It is used for Abortifacient.
  • It is mixed in liquors to enhance the intoxication effect.
  • The criminals often use it to stupefy their victims to rob them and kidnap them.

Fatal Dose

  • Usually, non-fatal but excessive dose that is 50-100 seeds (60mg of dhaturine) can prove fatal.
  • Correspondong, dose of dhathurine for children it is about 4 mg.
  • 60 mg of hyocine, the active alkaloid.

Fatal Period

  • About 24 Hours through dhatura poisoning is rarely fatal.

Administration

Dhatura is administered in the following ways-

  • Seeds and leaves are mixed with tobacco and given as smoke.
  • The powdered seeds are mixed in sweetmeats (given as Prasad) and in food and given to the victims.
  • Aqueous extracts of plants especially of the seeds are mixed with liquor and given to the victim as a drink.

Mode of Action

►The alkaloids competitively inhibit the muscarinic effects of acetylcholine.

►Site of action are at automatic effectors innervated by postganglionic cholinergic nerves or on sweat glands, smooth muscles which do not contain cholinergic innervations.

►Majority of the CNS actions are due to blockage of muscarinic receptors in the brain viz. vagal stimulation, decrease in heart rate. High doses cause cortical excitation, restlessness, disorientation, hallucinations and delirium followed by respiratory depression and coma.

Absorption, Metabolism and Excretion

  • The alkaloids are quickly absorbed from all mucus membrane and skin.
  • The alkaloids are excreted by the kidneys.

Sign and Symptoms

  • Dryness of mouth (dry as bone)
  • Bitter taste
  • Excessive thirst
  • Difficulty in talking
  • Dysphagia
  • Dilated pupils
  • Flushed face
  • Diplopia
  • Difficulty in speech
  • Difficulty in vision (blurring of vision, blind as bat)
  • Dry hot skin with flushing (red as beet)
  • Hyperpyrexia (hot as hare)
  • Drunken gait (ataxia)
  • Increases cardiac and respiratory activity
  • Elevate blood pressure
  • Temperature elevation
  • Inability to swallow Urine retention
  • Hyperreflexia
  • Convulsions
  • Delirium
  • Hallucinations
  • Agitation
  • Amnesia
  • Inability to swallow
  • Urine retention
  • Incoherence
  • Clouded sensorium
  • Disorientation
  • Depression
  • Dehydration
  • Anxiety
  • Visual or auditory hallucinations.
  • Deficit of recent memory.
  • Remote memory undisturbed
  • Dysuria
  • Distention of bladder (retention of urine)
  • coma
  • Death.

Management

● Treat the patient in quiet and dark environment.

● Gastric lavage with activated charcoal.

●Treat respiratory failure with endotracheal intubation and assisted ventilation. Catheterize bladder.

●Cathartic is given when patient is treated 24 hours after ingestion because intestinal motility is decreased.

● Monitor ECG, pulse and regulate patient’s temperature.

● Hyperpyrexia can be managed by hydration, cold sponging or cooling measures.

● Administer IV fluids, keeping a close watch on intake and output and renal function.

● Agitation can be controlled with judicious use of diazepam/lorazepam.

●Antidote is physostigmine should be administered. Intravenous physostigmine is given slowly over 5–10 minutes if hyperthermia, delirium, convulsions, hypertension and arrhythmias occurred.

● Drugs to be avoided during the treatment of datura poisoning such as antihistamines, phenothiazines, tricyclics, quinidine, disopyramide, procainamide, and morphine.

Contraindicated Drugs

  • Phenothiazines
  • Antihistamines
  • Morphine
  • Tricyclics
  • Quinidine
  • Disopyramide
  • Procainamide

Isolation

  • The minced tissues and other biological materials are treated with 5% of acetic acid.
  • Ammonium sulphate are is used for deproteinisation.
  • The material is heated over boiling water bath for 6 hours.
  • The filterate is extracted with organic solvent in alkaline medium.

Forensic Examination and Test For Detection

Microscopic Test– Microscopic examination of seeds or fragments of seeds picked from stomach contents or vomitus shows characteristics features.

Physiological Test– 1 drop of the purified extracted residue in 0.5% acetic acid is installed in cat’s eye which become dilated after a few hours.

Mydriatic Test-If the pupils do not constrict within 15 to 30 minutes after instillation of 2–3 drops of 1% pilocarpine, then it indicates atropine or anticholinergic poisoning.

Chemical Test (Vitalis test)– A few drops of conc. Acid are added to dry residue in a porclain basin and evaporated to dryness on a hot water bath. After cooling a drop of freshly prepared alcoholic caustic potash solution is added which gives violet colour.

Thin Layer Chromatography (TLC)– TLC give different Rf values for different constituents of dhatura such as atropine, hyoscine etc.

Gas Chromatography-Mass Spectrometry– Minute traces of atropine in blood (as low as 10 ng/ ml) can be detected by GC-MS (gas chromatography-mass spectrometry).

High Performance Liquid Chromatography.

Estimation

  • The extracted purified residue containing datura alkaloids is dissolved in neutral ethyl alcohol.
  • A known volume of 0.02N sulphuric acid is added to it and kept in water bath after 30 minutes the unreacted sulphuric acid is titrated against 0.02N sodium hydroxide solution using methyl red indicator. Each ml. of 0.02 N sulphuric acid = 5.786% mg of atropine alkaloid.

Toxicological Materials

  • Vomitus
  • Purges and faeces
  • Stomach contents and wash
  • Blood and urine
  • Intestine

Postmortem Findings

  • There is nothing characteristics.
  • Seeds may be found in viscera and gastrointestinal track.
  • Gastrointestinal tract shoe inflammation and may be congested.
  • Signs of asphyxia are often present.
  • Pulmonary edema

Medicolegal Importance

Accidental: Accidental poisoning may result from any one of the following ways:

● Sometimes people taken dhatura seeds by mistaken because its seeds resembles like capsicum seeds. They fails to identify.

● Foraging children in the countryside chewing on the seeds (or other parts of the plant) out of curiosity.

● Therapeutic misadventures.

● Overenthusiastic use of atropine as an antidote for organophosphate or carbamate poisoning.

Suicidal: It is easily assessable and available. Datura is not infrequently reported in suicidal ingestions, especially in rural parts of India.

Homicidal: There have been rare instances of murder being accomplished with one or the other belladonna alkaloids.

Stupefaction: The term “stupefaction” is loosely applied to the process of rendering a victim suddenly incapacitated by exposing him to a deliriant poison such as datura, in order to facilitate robbery or rape. An extract of the seeds is usually employed, which is mixed with food or drink and administered to the unsuspecting victim. Sometimes, stupefaction is induced by exposing the person to fumes of incense, by mixing datura with other constituents of an incense or joss stick (agarbathi). Even cigarettes may be adulterated in a similar fashion. Gullible railway or bus passengers are the usual victims who fall into the trap of accepting food, drink, or tobacco from “friendly” strangers.

● Dhatura seeds are abused. The seeds are mixed with cigarette and belladonna and smoked as hallucinogen.

● Datura seed resist putrefaction of body.

● Criminal responsibility: Dhatura produces temporary insanity. Usually, the poison is administered without the victim’s knowledge. Hence the individual is not held responsible for his acts under the influence of Dhatura.

● Scopolamine is used as truth serum in Narcoanalysis test.

● It is also used as love philter or potions. In Anthony and Cleopatra, it was mentioned that Cleopatra employed the datura extract in her famous wooing of Caesar.

Difference between the seeds of Datura and Capsicum

TraitsDatura SeedsCapsicum Seeds
Size Large and thick Small and thin
Shape Kidney-shaped Rounded
Colour Dark or yellowish-brown. Pale-yellow
Margins Laterally compressed and double-edged at the convex border. The convex border is simple and sharp.
Surface Numerous small depressions Smooth
Smell Odorless Pungent
Taste Bitter Pungent
Embryo On longitudinal section, embryo is curved outward at the hilum. Embryo is curved inward

References

  1. Dr. K.S. Narayan Reddy. The essential of forensic medicine and toxicology.34th edition.
  2. VV Pillay.Modern medical toxicology.4th edition.
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