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Criminal Mischief: Episode #16: Arsenic: An Historical and Modern Poison

Arsenic

Criminal Mischief: Episode #16: Arsenic: An Historical and Modern Poison

LISTEN: https://soundcloud.com/authorsontheair/criminal-mischief-episode-15-arsenic-an-historical-and-modern-poison

SHOW NOTES: http://www.dplylemd.com/criminal-mischief-notes/16-arsenic-an-historical.html

PAST SHOWS: http://www.dplylemd.com/criminal-mischief.html

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From HOWDUNNIT:FORENSICS

Toxicology is a relatively new science that stands on the shoulders of its predecessors: anatomy, physiology, chemistry, and medicine. Our knowledge in these sciences had to reach a certain level of sophistication before toxicology could become a reality. It slowly evolved over more than two hundred years of testing, starting with tests for arsenic. 

Arsenic had been a common poison for centuries, but there was no way to prove that arsenic was the culprit in a suspicious death. Scientist had to isolate and then identify arsenic trioxide—the most common toxic form of arsenic— in the human body before arsenic poisoning became a provable cause of death. The steps that led to a reliable test for arsenic are indicative of how many toxicological procedures developed. 

1775: Swedish chemist Carl Wilhelm Scheele (1742–1786) showed that chlorine water would convert arsenic into arsenic acid. He then added metallic zinc and heated the mixture to release arsine gas. When this gas contacted a cold vessel, arsenic would collect on the vessel’s surface. 

1787: Johann Metzger (1739–1805) showed that if arsenic were heated with charcoal, a shiny, black “arsenic mirror” would form on the charcoal’s surface. 

1806: Valentine Rose discovered that arsenic could be uncovered in the human body. If the stomach contents of victims of arsenic poisoning are treated with potassium carbonate, calcium oxide, and nitric acid, arsenic trioxide results. This could then be tested and confirmed by Metzger’s test. 

1813: French chemist Mathieu Joseph Bonaventure Orfila (1787–1853) developed a method for isolating arsenic from dog tissues. He also published the first toxicological text, Traité des poisons (Treatise on Poison), which helped establish toxicology as a true science. 

1821: Sevillas used similar techniques to find arsenic in the stomach and urine of individuals who had been poisoned. This is marked as the beginning of the field of forensic toxicology. 

1836: Dr. Alfred Swaine Taylor (1806–1880) developed the first test for arsenic in human tissue. He taught chemistry at Grey’s Medical School in England and is credited with establishing the field of forensic toxicology as a medical specialty. 

1836: James Marsh (1794–1846) developed an easier and more sensitive version of Metzger’s original test, in which the “arsenic mirror” was collected on a plate of glass or porcelain. The Marsh test became the standard, and its principles were the basis of the more modern method known as the Reinsch test, which we will look at later in this chapter. 

As you can see, each step in developing a useful testing procedure for arsenic stands on what discoveries came before. That’s the way science works. Step by step, investigators use what others have discovered to discover even more. 

Acute vs. Chronic Poisoning 

At times the toxicologist is asked to determine whether a poisoning is acute or chronic. A good example is arsenic, which can kill if given in a single large dose or if given in repeated smaller doses over weeks or months. In either case, the blood level could be high. But the determination of whether the poisoning was acute or chronic may be extremely important. If acute, the suspect list may be long. If chronic, the suspect list would include only those who had long-term contact with the victim, such as a family member, a caretaker, or a family cook. 

So, how does the toxicologist make this determination? 

In acute arsenic poisoning, the ME would expect to find high levels of arsenic in the stomach and the blood, as well as evidence of corrosion and bleeding in the stomach and intestines, as these are commonly seen in acute arsenic ingestion. If he found little or no arsenic in the stomach and no evidence of acute injury in the gastrointestinal (GI) tract, but high arsenic levels in the blood and tissues, he might suspect that the poisoning was chronic in nature. Here, an analysis of the victim’s hair can be invaluable. 

Hair analysis for arsenic (and several other toxins) can reveal exposure to arsenic and also give a timeline of the exposure. The reason this is possible is that arsenic is deposited in the cells of the hair follicles in proportion to the blood level of the arsenic at the time the cell was produced. 

In hair growth, the cells of the hair’s follicle undergo change, lose their nuclei, and are incorporated into the growing hair shaft. New follicular cells are produced to replace them and this cycle continues throughout life. Follicular cells produced while the blood levels of arsenic are high contain the poison, and as they are incorporated into the hair shaft the arsenic is, too. On the other hand, any follicular cells that appeared while the arsenic levels were low contain little or no arsenic. 

In general, hair grows about a half inch per month. This means that the toxicologist can cut the hair into short segments, measure the arsenic level in each, and reveal a timeline for arsenic exposure in the victim. 

Let’s suppose that a wife, who prepares all the family meals, slowly poisoned her husband with arsenic. She began by adding small amounts of the poison to his food in February and continued until his death in July. In May he was hospitalized with gastrointestinal complaints such as nausea, vomiting, and weight loss (all symptoms of arsenic poisoning). No diagnosis was made, but since he was doing better after ten days in the hospital, he was sent home. Such a circumstance is not unusual since these types of gastrointestinal symptoms are common and arsenic poisoning is rare. Physicians rarely think of it and test for it. After returning home, the unfortunate husband once again fell ill and finally died. 

As part of the autopsy procedure, the toxicologist might test the victim’s hair for toxins, and if he did, he would find the arsenic. He could then section and test the hair to determine the arsenic level essentially month by month. If the victim’s hair was three inches long, the half inch closest to the scalp would represent July, the next half inch June, the next May, and so on until the last half inch would reflect his exposure to arsenic in February, the month his poisoning began. Arsenic levels are expressed in parts per million (ppm).

An analysis might reveal a pattern like that seen in Figure 11-1. 

IMAGE in HOWDUNNIT: FORENSICS

 The toxicologist would look at this timeline of exposure and likely determine that the exposure occurred in the victim’s home. The police would then have a few questions for the wife and would likely obtain a search warrant to look for arsenic within the home. 

LINKS: 

Arsenic Poisoning (2007): CA Poison Control: https://calpoison.org/news/arsenic-poisoning-2007

Arsenic Poisoning Cases Wikipedia: https://en.wikipedia.org/wiki/Arsenic_poisoning_cases

Arsenic” a Murderous History: https://www.dartmouth.edu/~toxmetal/arsenic/history.html

Facts About Arsenic: LiveScience: https://www.livescience.com/29522-arsenic.html

Poison: Who Killed Napolean?: https://www.amnh.org/explore/news-blogs/on-exhibit-posts/poison-what-killed-napoleon

Victorian Poisoners: https://www.historic-uk.com/HistoryUK/HistoryofEngland/Victorian-Poisoners/

12 Female Poisoners Who Killed With Arsenic: http://mentalfloss.com/article/72351/12-female-poisoners-who-killed-arsenic

 

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Criminal Mischief: The Art and Science of Crime Fiction: Episode #12: Fentanyl—A Most Dangerous Game

Criminal Mischief: The Art and Science of Crime Fiction Podcast: https://soundcloud.com/authorsontheair/fentanyl-a-most-dangerous-game

PAST SHOWS: http://www.dplylemd.com/criminal-mischief.html

SHOW NOTES: 

Fentanyl is a synthetic opioid that is as much as 300 times more powerful than morphine sulfate. It can be injected, ingested, inhaled, and will even penetrate the skin.

It is used in medical situations frequently for pain management, sedation, and for twilight-anesthesia for things such as colonoscopies. 

Fentanyl is the number one cause of drug ODs.

Americans have a slightly higher than 1% chance of ultimately dying of an opioid overdose. That’s better than one in 100 people. In fact, 60 people die every day from opioid ODs. That translates to over 22,000 per year. In fact, US life expectancy dropped slightly between 2016 and 2017 due to opioid overdoses.

Thirteen people suffered a mass OD at a party in Chico, Ca in January 2019.

It is often added to other drugs such as heroin to “boost” the heroine effect. Unfortunately, Fentanyl is much more powerful than heroin and when the two are mixed it becomes a deadly combination. It’s also often added to meth and cocaine.


How powerful is fentanyl? A single tablespoon of it could kill as many as 500 people; 120 pounds as many as 25 million people. A recent bust, the largest in US history, recovered over 250 pounds of Fentanyl secreted in a truck crossing the US-Mexico border-—enough to kill 50 million people. 

When cops arrest people who possess or are transporting fentanyl they must take precautions not to touch or inhale the product as it could prove fatal. The opioid crises is the reason many cops carry Narcan (Naloxone) with them as either an injection or a nasal spray. It reverses the effects of narcotics very quickly. 

The “Dark Web” is a source for many things that can’t be purchased or the open market. Weapons, hitmen, and drugs. But even many of these dealers won’t deal Fentanyl.

Could fentanyl be used as a weapon of terror? Absolutely. A fentanyl aerosol sprayed into a room of people could easily kill everyone present in a matter of minutes. It is a powerful narcotic that acts very quickly and depresses respiration so that people die from asphyxia.

In 2002 a group of around 50 Chechen terrorists who took 850 people hostage in a Moscow theater. Many of the attackers were strapped with explosive vests. The standoff lasted 4 days until the Russians pumped Fentanyl-maybe carfentanil or remifentanil—through the vents and took everyone down. All the terrorists were killed but unfortunately, over 200 of the hostages died before medical help could reach them. 

Carfentanil—-Been around since 1974 but just now entering the world of drug abuse. Used in darts as a large animal tranquilizer. AN analog of fentanyl but is 100X stronger.

The famous Kristin Rossum “American Beauty” case involved fentanyl.

Kristen Rossum

 

Fentanyl Deaths Top Car Accidents: https://www.breitbart.com/politics/2019/01/15/accidental-opioid-deaths-top-car-accident-deaths-for-the-first-time/

Mass OD in Chico, CA: https://www.ems1.com/overdose/articles/393267048-Calif-mass-overdose-highlights-severe-new-phase-of-opioid-epidemic/

Narcan: https://en.wikipedia.org/wiki/Naloxone

Even many “Dark Web” Dealers won’t sell Fentanyl: http://www.newser.com/story/268019/even-dark-web-dealers-refuse-to-sell-this-drug.html

Fentanyl As Terror Weapon: https://www.breitbart.com/asia/2019/01/03/report-experts-insist-opioid-fentanyl-could-be-used-as-tool-of-terror/

Fentanyl as WMD: https://www.bloombergquint.com/business/killer-opioid-fentanyl-could-be-a-weapon-of-mass-destruction#gs.UwnsSzO8

Carfentanil Wikipedia: https://en.wikipedia.org/wiki/Carfentanil

Kristin Rossum Wikipedia: https://en.wikipedia.org/wiki/Kristin_Rossum

 

 

Criminal Mischief: Episode 05: Making Characters Compliant

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Criminal Mischief: The Art and Science of Crime Fiction: Episode 05: Making Characters Compliant

LISTEN: https://soundcloud.com/authorsontheair/character-compliance

PREVIOUS EPISODES: http://www.dplylemd.com/criminal-mischief.html

Making Characters Compliant Show Notes:

Coercion and Threat

Leverage

Trauma:

Trauma is time limited

Unconscious vs Pain/Fear of death

Drugs:

Drugs have variable timelines

Drugs don’t have timers

Alcohol and Mickey Finn

Narcotics and sedatives

Date Rape Drugs

Rohypnol

GHB—Gamma Hydroxybutyrate

E, Ecstasy, MDMA—3.4-Methylenedioxy Methamphetamine

Ketamine

Links:

Date Rape Drugs: http://www.dplylemd.com/articles/date-rape-drugs.html

ROHYPNOL: https://www.drugs.com/illicit/rohypnol.html

GHB: https://www.drugs.com/illicit/ghb.html

ECSTASY: https://www.drugabuse.gov/publications/drugfacts/mdma-ecstasymolly

KETAMINE: https://www.medicalnewstoday.com/articles/302663.php

Andrew Luster: https://en.wikipedia.org/wiki/Andrew_Luster

Dr. Grant Robicheaux: http://www.newser.com/story/264806/calif-surgeon-girlfriend-may-have-raped-hundreds.html

 

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Your Eye Drops Can Kill You

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Anything can be a poison, it all depends on the dose. This includes the drops you use to clear your eyes. 

The active, and dangerous, ingredient in many of these preparations is tetrahydrozoline hydrochloride. If ingested in sufficient amounts, it can elevate the blood pressure, drop the heart rate to dangerously low levels, reduce body temperature, and cause nausea, vomiting, shortness of breath, blurred vision, an unsteady gait, seizures, coma, and death. And you thought those little dropper bottles were harmless.

In a new case, it appears that Lana Clayton killed her husband by adding a few drops to his water over several days. He apparently fell down the stairs. Since this chemical causes walking difficulties, blurred vision, and even seizures, he could easily have staggered and fallen down the steps. Or even been pushed. Regardless, a significant amount of the chemical was found in his blood at autopsy.

I’ve blogged about this before in discussing a case of possible munch Munchausen By Proxy. Samantha Elizabeth Unger apparently poisoned her children by adding a few drops of the medication to their juice on multiple occasions. Here is the link to that post:

https://writersforensicsblog.wordpress.com/2014/07/03/visine-and-munchausen-syndrome-by-proxy/

 

Improved GHB Testing

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NMR Spectrograph

GHB is one of the so-called Date Rape Drugs—along with Ecstasy, Rohypnol, and Ketamine. I have an article on these on my website (See Below).

GHB has been difficult to detect, primarily because it’s rapidly metabolized (destroyed) by the body. But new techniques employing Nuclear Magnetic Resonance (NMR) Spectroscopy allow the detection of GHB metabolites (breakdown products) as much as 24 hours later. This gives investigators a longer time period to uncover GHB in a victim.

GHB can also often be found in the victim’s hair up to a month or more after exposure, but this testing is not as yet perfected.

https://www.forensicmag.com/news/2017/08/chemists-discover-marker-date-rape-drug-testing

http://www.dplylemd.com/articles/date-rape-drugs.html

https://www.ncbi.nlm.nih.gov/pubmed/25433016

More on the fascinating world of Forensic Toxicology can be found in FORENSICS FOR DUMMIES:

http://www.dplylemd.com/book-details/forensics-for-dummies.html

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Beware: Health Food Can Kill You

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Aconite, also known as monkshood or wolfsbane, is beautiful and looks harmless. Not true. It’s a deadly poison. When ingested, it has potentially deadly cardiotoxic and neurotoxic effects. Its most often kills through the generation of deadly changes in the cardiac rhythm. Victims suffer shortness of breath, palpitations, chest pain, numbness and tingling of the face and other body parts, nausea, and ultimately paralysis, cardiac arrest, and sudden death. Pleasant, huh?

Aconite is easily available, not only at your local nursery but also at various health food stores where it comes in many varieties, including herbal teas. Several recent poisonings related to an aconite-containing herbal tea sold by a San Francisco company show how dangerous this chemical can be. Of course, other health food stores sell aconite and you can easily buy it on the Internet.

I always tell my patients that the second most dangerous place on earth, after a aircraft carrier deck during flight operations, is a health food store. Though most of the products they sell are mostly harmless, and mostly not helpful, some are downright deadly. Many years ago there was a Ma Huang crisis in that several people died from taking supplements laced with this material. Ma Huang is basically an amphetamine and, like aconite can cause deadly cardiac arrhythmias as well as a marked elevation of blood pressure and strokes.

The point is, none of these are regulated. The FDA, for all its warts, does indeed protect consumers. It’s very difficult to create, test, and bring a new drug to market. It cost billions and takes many years, sometimes more than a decade. The FDA requires strict proof that the medicine actually does what it’s designed to do and that its side effects and toxic potential are acceptable and well understood. This is not the case in products you buy at your local health food store. Many are mixed up by a guy named Joe in his garage in a cat box. Trust me, Joe is not a chemist, or a pharmacist, and he possesses no medical training. He might not even have a GED. But he can mix up some cool stuff and put it in fancy packaging and make it look real. And safe. And it might be. But of course, it might not.

The take-home message here is that do not accept the packaging, the product description, or its prime location at eye level on the display rack. Do your research. Find out what’s really inside and what its toxic potential is. And do not buy anything from a guy named Joe.

 

The Queen of Poisons and The Marsh Test

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Arsenic has, over the centuries, garnered many colorful names. It was called the “queen of poisons” because it was so readily available, easy to use, highly effective, and untraceable. Thus, it was used by many famous historical poisoners. Some called it the “king of poisons” but since over the years,  female killers have favored poisons, “queen” seems more apt. It was also called “inheritance powder,” for obvious reasons—-once the estate holder is dead and gone, the heirs can party down.

Arsenic is the nearly perfect poison. This was definitely true centuries ago when there was no way to trace it. But what about today, with modern toxicological techniques? Unfortunately, arsenic is still a pretty good choice for the poisoner. It’s not often looked for in unexplained deaths and its effects mimic many medical conditions, particularly neurological and gastrointestinal.

Back a couple of centuries ago, because of its common use, a method for finding arsenic in the dead or ill became an imperative. There were many steps along this path. This search for arsenic was essentially the beginning of forensic toxicology.

From HOWDUNNIT: FORENSICS

Arsenic had been a common poison for centuries, but there was no way to prove that arsenic was the culprit in a suspicious death. Scientists had to isolate and then identify arsenic trioxide—the most common toxic form of arsenic— in the human body before arsenic poisoning became a provable cause of death. The steps that led to a reliable test for arsenic are indicative of how many toxicological procedures developed.

1775: Swedish chemist Carl Wilhelm Scheele (1742–1786) showed that chlorine water would convert arsenic into arsenic acid. He then added metallic zinc and heated the mixture to release arsine gas. When this gas contacted a cold vessel, arsenic would collect on the vessel’s surface.

1787: Johann Metzger (1739–1805) showed that if arsenic were heated with char- coal, a shiny, black “arsenic mirror” would form on the charcoal’s surface.

1806: Valentine Rose discovered that arsenic could be uncovered in the human body. If the stomach contents of victims of arsenic poisoning are treated with potassium carbonate, calcium oxide, and nitric acid, arsenic trioxide results. This could then be tested and confirmed by Metzger’s test.

1813: French chemist Mathieu Joseph Bonaventure Orfila (1787–1853) devel- oped a method for isolating arsenic from dog tissues. He also published the first toxicological text, Traité des poisons (Treatise on Poison), which helped establish toxicology as a true science.

1821: Sevillas used similar techniques to find arsenic in the stomach and urine of individuals who had been poisoned. This is marked as the beginning of the field of forensic toxicology.

1836: Dr. Alfred Swaine Taylor (1806–1880) developed the first test for arsenic in human tissue. He taught chemistry at Grey’s Medical School in England and is credited with establishing the field of forensic toxicology as a medical specialty.

1836: James Marsh (1794–1846) developed an easier and more sensitive version of Metzger’s original test, in which the “arsenic mirror” was collected on a plate of glass or porcelain. The Marsh test became the standard, and its principles were the basis of the more modern method known as the Reinsch test, which we will look at later in this chapter.

As you can see, each step in developing a useful testing procedure for arsenic stands on what discoveries came before. That’s the way science works. Step by step, investigators use what others have discovered to discover even more.

I ran across an excellent article on the Marsh Test and it’s definitely worth a read. I can imagine when this was performed in the courtroom it did elicit a few gasps.

A few useful links:

http://www.dplylemd.com/book-details/howdunnit-forensics.html

http://www.atlasobscura.com/articles/marsh-test-arsenic-poisoning

http://www.huffingtonpost.com/sandra-hempel-/arsenic-the-nearperfect-m_b_4398140.html

http://www.dartmouth.edu/~toxmetal/arsenic/history.html

 

Howdunnit Forensics Cover

 
 
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