Compilation of Forensic science and Toxicology (Agadtantra Vyavaharayrved Evm Vidhivaidyak)

Under guidance of

1) Dr. Abhay. Patkar HOD (Dept. of Agadtantra)

2) Dr. Bhushan.Mogal Lecturer (Dept. of Agadtantra)

Opium (Ahiphena) Papaver Somniferum Linn. Family: Papaveraceae

Index
Sr.No. Topic 1) Historic Review I. II. III. Vedic Kala Samhita Kala Laghutrayi Sharangadhara Page.No. 8 8 8 8 8 9 9 9 9 10 10 10 11 12 13 14 14

- Bahvaprakasha IV. Madhyam kala - Bharat Bhaishajya Ratnakar - Nighantu - Rasatarangini - Yogratnakara - Bhaishajyaratnavali V. 2) 3) 4) Modern Literatre

Vernacular Names Synonyms Classification I. General Classification

3

II.

Botanical Information - Taxonomy - Geographical Distribution - Features of Papaveraceae family - Sangraha Kala(Preservation Period)

15 15 16 16 17 18 18 19 20

5)

Uses & Action I. II. According to Ayurved According to Modern

6)

Types I. According to Ayurveda - Mode of Action - Color of Flower II. According to Modern - Location of its growth

20 20 20 20 20 21 23 23 23 24

7) 8)

Chemical Composition Useful parts of plants I. II. According to Ayurved According to Modern Toxicology

9)

Properties

I. II. III.

Organoleptic Character According to Yogratnakar Rasapanchak

24 25 26 28

10) Pharmacological action I.

Pharmacological action of Medicinal 28 Formulations - Morphine - Heroine - Codeine - Dicodid 28 28 29 30 30 30 31 33 33 33 34 35 37

II. III. IV.

Mode of administration Mechanism of action Elimination

11) Medicinal Formulations I. II. III. Rasatarangini Bhaishajyaratnavali Bharat Bhishajya ratnakar-1

12) Medicinal and Fatal dose 13) Fatal Period

14) Poisonous Sign and symptoms I. General symptoms - S/S of patient in various stages - Diagnosis of Opium poisoning - Triat of Opium poisoning II. III. IV. V. Unusual symptoms Drug and drug dependence Opium habit

38 38 38 40 40 41 42 43

S/S of chronic poisoning in addicts of 44 Opium 45 47 47 47

VI.

Differential Diagnosis

15) Treatment I. II. III. According to Ayurved According to Allopathy Methods

Treatment of addicts and chronic 51 poisoning for withdrawal symptoms drug 51 53 53

IV.

Treatment dependence

to

reduce

16) Post Mortem Appearance I. External

II.

Internal - Physical Examination - Chemical Analysis

54 54 55 57

17)

Medico legal Importance

I.

Procedure to investigate the death 58 due to narcotism Act and rules to prevent drug 58 addiction 60 62 65

II.

17) Shodhana Process of Ahiphena 18) Sandharba Shlokavali 19) Bibliography

Photographs: 1)
2) Flowers and poppy capsule Useful part of plant (1) (2) (3) (4) Freshly incised Dried extracted Removing the extract from the capsule Crude and refine form of Opium
7

3)

Medicinal formulations Analgesic tablets Antipyretc and cough supressent Cough syrup Inj.Morphine

4)

Drug and dependence Method of using heroine as drug Graph Drug addiction in America Heroine

Abbreviations :

S.S. Bh.S. B.B.R. Bh.N. M.N. D.N. R.N. R.T.

Sharangadhara Samhita Bhavaprakasha Samhita Bharat Bhaishajya Ratnakara Bhavaprakasha Nighantu Madanpala Nighantu Dhanvantari Nighantu Raj Nighantu Rasatarangini

Y.R. B.R.

Yogratnakara Bhaishajyaratnavali

[1] Historic Review

Vedic kala:

Samhita Kala:

No reference of opium in Veda, charka, sushrut samhita, as well as in sangraha i.e. Ashtang sangraha & Hridaya

(1) Laghutrayi
Reference to opium appear in veterinary and medical works belonging to the 12th to 13th Centuries AD onwards. Jayaditya, in his work Ashwavaidyaka-A treatise on the treatment of horsesmakes a reference to opium This work is considered to have been written sometime during the 12th to 13th Centuries AD. Sharangdhar Samhita:
1

Sharanadhara Samhita, a compendim of therapeutics (13th

Centuries AD) , has included properties and shodhana process of opium in rasashodhana maran kalpana prakarna.

Bhavprakash Samhita:
2

In Bhavprakash samhita Madhyma Khanda Ahifen is

mentioned as an example of vyavahi guna.

(2) Madhyama kala

10

In Nighantu, detailed information like, synonyms, classification, pharmacological action etc. are described of all available herbs. They are classified according to groups and they are termed as varga. The list of various Nighantu along with vargas in which ahifen is included is listed below: Bhavprakash Nighantu:
3

There is description of synonyms, vernacular names,

Shodhana, action, properties & fatal does of opium .

Ref:1) S.S /rasashodhana maran kalpana prakarna/296 2) Bh.S/P.K-6/230 3) Bh.N/Haritakyadi varga/ 238

2) Madanpala Nighantu: There is description of synonyms and properties of opium.

3) Dhanvantari Nighantu: Classification, synonyms and properties of opium.

11

4) Raj nighantu: In Raj nighantu, opium comes under Pippalyadi varga

5) Rasatarangini:
1

There are Ayurvedic medicinal formulations uses, fatal

dose, synonyms of opium.

6) Yogratnakara:
2

There are classifications, property and shodhana

process of opium in Yogratnakara.

7) Bhaishajyaratnavali:
1

There is description of different ayurvedic

formulations of opium.

Ref 1) - Rasatarangini 24/235, 163-164, 258,259,260,261, 271-278, 281-284, 287289, 298-300) 2) Yogratnakar Athopvish Athahifenants/2) 3) Bhaishajyaratnavali Atisara chikitsa 129-131,164-166)

12

Summary:

Bhavprakash Nighantu Madanpal Nighantu Dhanvantari Nighantu Raj Nighantu Yogaratnakara

Haritakyadi varga Abhayadi varga Mishrakadi saptam varga Pippalyadi varga Upavisha

13

(3)Modern literature
1) Poppies have been grown as ornamental plants since 500 BC in Mesopotamia There were found in Egyptian tomb in Greek mythology the poppy was associated goddess of fertility & agricultural the ancient Greeks portrayed Hypnos Nix & Thana tons the god of sleep, night & death with symbol of poppy.

2)

Hippocrates (960-377BC) was one of first to emphasize the

medicinal uses of poppy & its methods of preparation the described poppy juice as narcotic, hypnotic cathartic. He also recognized the plants uses as food particularly seeds.

3) 1st century AD Disokoreds wrote down first poppy taxonomy.

4) Opium wars between China & Great Britain that occurred in 1839-1842 & 1856-1860 were result of Chinese Emperors attempt to suppress the increasing opium imports to British East India Company into China.

14

5) 800-100 tons of Indian opium are processed legally each year the represents only 5% of total opium production worldwide 1st opium processing was establish in Indian as 1829. -Wikipedia.org/wiki/papaver somniferous

15

[2]Vernacular Names
According to Bhavaprakasha

Region

Name

India Bengal Maharashtra Gujrat Karnataka Tamilnadu Telagu(kerala) Arab Labnyl

Aafim Aafim Aafu Afin Afini Abini Abhini Afyun khashkhash

According to Rajnighantu

Region

Name

India Bengal

Afim Aafi, Ahifenaka

16

Maharashtra Gujrat Karnataka Pharasi Arab

Aafu Afirag Afen Afyuntiryaka Lavasanokhasa

[3]Synonyms
1) According to Bhavaprakasha, Kharphal Aafuka Ahifenakam 2) According to Madanpala, Ahifena Ahifenak 3) According to Rajnighantu, Afen Kharkhasarasc Nifen Ahifenakam Afen 4)According to Rasatarangini,
17

 Ahifen Afen Nifen Ahifenaka Aafuka Phanifena Nagfena

18

[4]Classification:
(1)General Classification

According to ayurveda:

1) 1

According to Bhaishjyaratnavali, opium is classified under

upavisha 2) 2 According to Rasataangiri, opium acts as purgative 3) 3According to Yogratnakar, opium is classified under Upavisha.

Modern aspects: 1) Opium (afim) is Neurotoxic cerebral somniferous Poison 2) Homicidal poison -S.K.Singal 3) Somniferous poison (opioids) - C.K.Parihk

19

[Ref-1) BR-Shodhanamarana prakarana 2) RT 3) YR

(2)Botanical information: (1)Taxonomy:

Domain Kingdom Phylum Super division Division Class Order Family Subfamily

Eukaryote Planate Tracheophyla Spermatophyla Magnoliophyta Magnoliospsida Papaverales Papveraceae Papaveroideae

20

Genus Species

Papaver Papaver sominiferum

There are 70-100 species. The species that are commonly used and cultivated all over the world are : 1) P.acrochactum 2) P.aculeatum (South African poppy) 3) P.alboroseun (pale poppy) 4) P.alpinum (dwarf poppy) 5) P.argemone (long prickly head poppy) 6) P.californicum (fire poppy/ Western poppy) 7) P.croceum (ice poppy) 8) P.dahlianum (Svalbard poppy) 9) P.dubuim (long headed poppy, blind eyes) 10) P.glaucum (tulip poppy, Turkish red poppy)

(2) Geographical Distribution White poppies belong to N.C.Papaveraceae & are grown in India, Persia, Asia Minor, Turkey, China & Egypt also cultivated in England & other cold countries like Russia & Yugoslavia.
(3) Features of Papaveraceae family

21

Annual to perennial herbs with colored juice, crarelcshurbs or small trees. Leaves - Alternate or the floral ones opposite or whorl, often much divided stipules-o, indumentums of simple or barbell ate hairs. Flowers-Mostly solitary, showy, actinomorphic,

hermaphrodite, visited by insects for pollen. Sepals 2-3, caduous or calyptrate. Petals -4-6 or 8-12, free, biseriate, imbricate often crumpled. Nectaries 0 Stamen numerous, free Anthers 2 celled, opening lengthwise Ovary superior, composed of 2 or more united carpel-1 celled with parietal placenta or several celled by the intrusive placement as reaching the middle, rarely 2-celled by a superior wall Carpel rarely loosely united and becoming free in fruit Stigmas opposite or alternate with placentas Ovules numerous, anatropous Fruit capsular, opening by valves or pores Seed small with a crested or smooth raphe or arillate Embryo minute in copious fleshy or oily endosperm
22

Genera 28. Species 600 chiefly N. Temperate

[5]Uses and Actions:

1) According to Ayurved
1

Opium is especially used for external purpose. It is used in

diseases of lungs & in oedema (shofa). It is also used to subside pain caused by nerve out irritation (dantshulaghna) due to dental carries. It is best for rhumatic arthirits (aamavata) & anorectal diseases (arshas) where it act as an analgesic (vednashamak). Opium is antihelmenthic (krumihna) & CNS depressant (madkari) overall.

232

Vrushya & Gurupaki . It is regarded as Kapha Prakopak & Vata Shamankar.

2

Indian opium -

Vishamjwarghna

23

Turkey opium

Vednastapan

Ref- 1) Rasatarangini 24/258,259,260,261. 2) Rajnighantu

2) According to modern 1) Poppy seeds (khas khas) They are innocuous & white in colour & are used as food they are sprinkled over some Indian sweets. They are regarded as demulcents & nutritive They yield bland oil, known as poppy seed it, which is largely used for cullinary & lighting purpose. 2) Poppy capsules (post ka Doda) - When they ripe & dry contain trace of opium about 0.1-0.3% morphine & are used for their negative & narcotic action. Their warm decoctions is used locally a sedative fomentation & poultice. Property medicines containing opium or Morphine

24

1) Chlordane Strength about 4 grains of morphine hydrochloride to an ounce, also certain chloral, chloroform hydrocyanic acid & tincture of Cannabanis indica 2) Sydenhams Laudanum This is tincture of opium flavored with saffron & called Tincture opium. It certain 1% of morphine -Modi 3) Codeine is methyl morphine. It is used as cough suppressant. 4) Morphine & pethidine are used as analgesics. 5) Apo morphine prepared from morphine is used as an emetic.

-S.K.Singhal

[6]Types
1

Rajnighantu: In Rajnighantu types of opium are described according to : Mode of action 1) Jarana 2) Marana
25

3) Dharna 4) Sarana Color of flower 1) Shwet(white) 2) Peet(yellow) 3) Krishna(black) 4) Chitra(brown) Location of its growth 1) Turkey 2) European 3) Iran 4) Indian 1

26

1) Ref- pg182 Rajnighanta Pandit Narahari Chaukhamba Sanskrit series

[6]Chemical composition -

1) Primary alkaloids Morphine 5-21% Codeine 0.3-4% Thebaine 0.3% Narcoune 2-7% Narane Papaverine1% Psadomorphine Cryptopine Protopine Hydracatarine Laudanine Laudanosine Meconidine Phoeadine Xanthaline codamine Nascopine 2) Secondary alkaloids
27

 Aponorphine Oxydimorphene Apocodein Desoxycodeo Thebamine Porphyroun Gatatine Rhoeadnine

3) Traces of Opionin Meconin Meconoidine

4) Carbonic acid Latic acid Meconic acid 5) Water 16% 6) Glucose, volatile oil, sulphides, ammonia etc.

Its activity is due to1) Phenanthrene group

28

2) Isoquinoline group 1)Phenanthrene group-It comprises of morphine(10%)

codeine(0.5%), thebeune(0.3%) & their synthetic derivatives such as dionin, heroin etc and narcotic property is due to them. 2) Isoquinoline group -It consist of papaverene (1%) & nareotine (6%) which have mild analgesic but no narcotic properties.

[12]Prayoyja anga
1

Phala Niryasa(afim)

29

[13]Poisonous part

1) Opium is coagulated air dried latex juice obtained by incision of unripe capsule of white poppy, papaver somniferum. -Modi 2) Poisoning may occur from any of preparations containing opium its alkaloids and their derivations. - C.K.Parikh 3) Stem contains a milky later that may cause skin irritation. - Wilkepedia

30

[14]Properties
1

According to sharangadhara & Yogratnakara

UM M SlaoG-M la T\ M \n|| o- / 2 : M

31

Ref -1)pg 169 yogratnakara Laxmipatishastri Chaukhamba Sanskrit Series

Rasapanchaka :
1

According to Bhavaprakasha

Guna Rasa Vipaka Virya Prabhava

Sukshma, Ruksha Tikta, Kashaya Katu Ushna Madak

32

Sr.No.

Reference Properties

Bhavprak Sharang ash + + + + + dhar + + + + +

Yogratna Madanap kar + + + + + ala + + + + -

1 2 3 4 5

Shoshan Grahi Shleshmagna Vatpittalam Madatruta Dahakrut (thurst,burning)

33

Kruchha Shukrastambhan

Dipan (appetizer)

Pachan -

8 9 10 11

Bharama(Giddiness) Balya Vrushya Suguriru + + +

+ -

+ -

34

[17]Pharmacological actions
17.1Pharmacological action of Medicinal forms 17.1.1 Morphine (C17 H 19 O3 H):

This is named after Morpheus the Greek God of dreams and is poisonous to which the poisonous properties of opium chiefly due to. It occurs as white powder, shining crystals having a bitter taste & alkaline reaction. It is very sparingly souble in cold water but soluble in 400 to 500 parts of boiling water it forms crystalline salts of which morphine hydrochloride, morphine sulphate are pharmacological preparation & morphine acetate is nonofficial preparation the dose of each being 8-20 mg. These salts are bitter in taste & neutral reaction & freely soluble in water. On exposure to light they darken it is five to eight times mote powerful than opium. Morphine has depressant action on the cortex the respiratory & cough centre in the medulla are depressed but the vagus & vomiting centers are stimulated. The spinal cord is also stimulated its most outstanding effect is relief of pain due to partly depression of the cerebral area of pain perception & partly due to its euphoric effect.
17.1.2Heroin (Diacetyl Morphine or Diamorphine):

Dion in (Ethyl- Morphine) & Peronin (Benzyl- Morphine) are synthetic alkaloids derived from Morphine & are used in medicine to suppress to cough.
35

Hydrochloride of heroin is now official under the name, Dimorphine hydrochloridum of heroin is now official under the name Diamorphine hydrochloridum, and the doses begin 5 to 10mg. Since 1954 following a World Health Organization Enquiry, nearly 54 countries have decided against using heroin as a medicine, as amongst all drugs of addiction the most dangerous. It can be smoked, injected even used orally or as a snuff. It is more analgesic & puphorognic than opium. Dicaudid (Dihydro Morphine Hydrochloride) an oxidation product of Morphine. It is colorless, crystalline substance, freely soluble in alcohol & water, but insoluble in ether. Its dose is 1 to 4 mg by mouth or 2 mg subcutaneously, it is more toxic than Morphine.

17.1.3 Codeine (C18 H21 O3 N) :

This is chemically methyl Morphine, & occurs nearly colorless trimetric crystals It is soluble in 120 parts of water, in 2 part of alcohol & in chloroform Soluble in aqueous ammonia, but insoluble in excess of potash or soda solution. It dissolves easily in dilute acids & forms neutral salts. Codeine & its salts, codeine phosphate, are pharmacopoeia preparations, the dose of each being 10-60 mg.
36

Narcotine, papaverine & thebaine are not important from a toxicological point of view Nicotine & its salt, narcotine hydrochloride, are non-official preparations, the dose of each being 60-180mg. Narcotine is much less poisonous than either Morphine or codeine and produces toxic effects only in very large doses. Papaverine is an isoquinoline alkaloid, it has no narcotic effect but it relaxes smooth muscle. One gram me might cause dangerous symptoms. It appears to undergo complete destruction in appears to under grow complete destruction in the tissues. The baine has convulsing action, & produces titanic spasms resembling those caused by strychnine but is much less powerful. The fatal dose is not known. poisonous symptoms. About 0.5 G would produce

17.1.4 Dicodid (Dihydrocodeinone acid titrate) & Eukodal (Dihydroxycodeinone hydrochloride):

These are salts which occur as white crystals, soluble in water. The dose of dicodid is 4-5 mg & that Eukodal is 5-10mg, orally & 10-20mg subcutaneously. Powered opium synonym, pulvis opii (10% of an hydro Morphine) Dose: 30 to 180mg.

37

38

17.2 Mode of Administration:Cases of poisonings, sometimes attended with fatal results have occurred when opiate or Morphine preparations have gained across to the system by channels other than the mouth e.g. Application on abraded surface, a wound or even the unabraded skin hypodermic injections or introduction into rectum or vagina. 17.3 Elimination: Opium is eliminated chiefly as Morphine in the urine & faeces. Necessary to preserve urine in for chemical analysis esp. in non-fatal cases of poisoning where the stomach wash does not give the test for opium owing to stomach having been washed out with a solution of KMnO4. A small amount of morphine excreted by stomach & intestine even when administered hypodermically It is sometimes detected in saliva & bite. That it is eliminated by milk is proved by the occurrence of fatal poisoning by infant sucking their mothers, who have been poisoned by opium. Cases :1

A woman, aged 30 yrs was admitted into KEM Hospital,

Bombay, with a history of having taken opium. Opium was

39

detected in stomach washing of her child 1yr old, who sucked the womans mill & showed signs of opium poisoning. It can also pass through the placenta to the fetus.
1) (Ref. Bom. Chem. Analyzers Annual Rep 1939,5)

Elimination being very slow, a portion of opium accumulates in the system & a certain, amount may be oxidized into oxydimorphine which is found in the urine.
1

Opium is said to withstand putrefaction in the presence of

decomposing material. Highly decomposed viscera, after being preserved in the usual manner, have shown evidence on analysis of the presence of Morphine after 3 -4 months. Exception: It is, however, conceivable that under certain adverse circumstances, morphine may undergo a charge beyond recognition. - Modi The poisonous sign and symptoms usually appear within 1/2-1 hr after ingestion and 3-5 min after injection. The poison acts on CNS 1st cause stimulation and later a depression followed by narcoses. - C.K.Parik

40

[24]Antitoxic medical formulations

Name of disease Nidranash Name of kalp Nidrodaya vati Reference Rasataranini pg Shloka 271,272,273,274 Rasataranini pg Shloka 275,276,277,278 -698

Astisara

Sindurbhushan rasa

-699

Viryastambhan

Harshodaya vati

Rasataranini pg -698 Shloka 279,280,281,282,283,28 4 Rasataranini pg -700 Shloka- 287,288,289

UgraAtisara, Dantanshula, Asthibhanga vedanashamkach; Darun visuchika(Chloera), Pravahika(dysentry) Sannipataka Jwara

Ahifenasava

Manglodaya Vati

Rasataranini pg 702,703 Shloka 298,299,300

Gudankurprashoma Vedantakamaluha Rasataranini pg 702,703 Shloka n r 301,302, 303, 304, 305

41

Name of disease Atisara

Name of Kalp Ahifen vatica

Reference Bhaishajyaratnavali pgno-162 shloka 129 Bhaishajyaratnavali pgno-162 shloka 130,131 Bhaishajyaratnavali Pg.no.164 Shloka Bhaishajyaratnavali Pg.no 164 Shloka 164, 165 Bhaishajyaratnavali Pg.no 165 Shloka -166

Aatistara

Jatiphaladi vati

Aatisara grahani

Abhayanrusinha Rasa Karpura rasa

Raktatisara

Aatisara

Aatisarvarano Rasa

Sangraha Kala / Preservation period Best period for preservation of opium is February March (magha-falgun) Vasant rutu. According to Bhavaprakasha

42

1) (Ref. Annual Report, 1954)

[18]Poisonous signs & Symptoms:18.1 General Symptoms

These commence usually in from half-an hour to an hour after the poison has been taken. The symptoms commonly take more time to appear when opium is taken in a solid form than when it is taken in solution, cases have, however, occurred, where the symptoms have appeared almost immediately or within few minutes, especially in children and after hypodermic injection of morphine or have been delayed for several houses. The symptoms manifest themselves in 3 stages 1) Stage of excitement 2) Stage of sopor 3) Stage of narcosis

18.2 Unusual Symptom

1] Vomiting & purging may be present in a few eases. 2] Convulsions of a tetanoid character are occasionally present; more frequent in children that in adult. 3] In few cases the pupils may be found dilate in the earlier stage, especially when chorodyne has been taken. The dilation of pupil is probably due to hydrocyanic contained in it. 4] Syncope may occur in some individuals as the subcutaneous administration of morphine. A case is recorded when 10 mg

43

of moths hydrochloride injected subcutaneously almost proved total to an old man. 5] After an apparent remission of symptoms sometimes it so

happens that they return with more severity to end in death thus us explained by the that absorption is practically is the poison is reabsorbed from the alimentary improved. 6] Codeine is slightly less depressant to the cortex & canal when circulation has

medullary centre then morphine but stimulates the spinal cord more. 7] The symptoms provided by codeine poisoning are

sometimes nausea vomiting abdominal pain delium and convulsions and this differ from these caused by morphine powering. 8] There is also less constipation than with morphine

18.3Drug & Drug Dependence

Introduction A drug addiction is defined as a state of periodic or chronic intoxication, harmful to the individual & to society. It is produced by repeated consumption of drug, either natural or synthetic.

44

Drug habit is defined as a condition which results from the continued use of drug which does not causes much harm to individual or society. WHO has coined the term drug dependence to replace the term drug addiction & drug habit.

1) Drug dependence has been defined by WHO expert committee (1952) as a state arising from repeated administration of a drug on a periodic or continuous basis .Its character are more or less specific through varying with type of drug involved & the addict suffers from unpleasant with drawl symptoms when prevented from taking such a drug or drugs. The chief features of drug addiction are that the person feels a compulsive over powering desire for taking the drug &

becomes psychology & physiology dependent on the drug, he will use any means to obtain it.

In some the dose is gradually increasing but not in all. Hereditary factors abnormal mental conditions, frustrations in life, anxiety, chronic tension, physical inability to do a job, curiosity etc. are some of the causes of drug addiction such addicts are also liable to passion their habit to susceptible individuals & thus promote drug traffic all analgesic & narcotics drugs age liable to cause adduction. The drug commonly issued for this purpose is opium & related compound.
45

Pethidyne Cannabis Sativa Mandrax Amphetamine Ritalin LSD Barbiturate Cocaine Surfing glue & excessive use of alcohol Even tranquilizers like diazepam (valiums) &

chlordiazepoxide (Librium) & can case addition. The morphine habit in western countries is usually acquired by those who are advised to take the drug either by mouth or subcutaneously as a remedy for some excruciating pain, as of sciatica. Heroin is one of the worst habit forming drugs & is used by addicts either hypodermically or a snuff likes cocaine.
18.4 Opium habit:

The habit of taking opium is prevalent throughout India ordinary. Opium is used but on special festive occasions, kasoonba a decoction is offered to the guests. Opium is also smoked in the form of Modak, chandu or opium dress.
46

In India the habit is acquired usually by young people of certain classes in consequence of the belief that morphine produces the sense of euphoria & that it has remarkable power as an aphrodisiac. Once the habit is from it is difficult to give it up in fact the eviction has to take the drug in a larger does to combat the feeling of lathery & mental depression as the symptoms the first dose weak off.
1

An infusion of poppy capsules is habitually drunk by some people

in certain districts in Punjab & in parts of Rajasthan esp. Jaipur. Bhujri a preparation made by frying very green ripe capsule in butter of ghee is eaten by addicts 9 cases of poppy capsule addicts from Indian foundry inbernigham has been reported

Opium is believed to increase the duration of sexual act hence is often taken by young man who get accustomed to drug by constant use. It is also used to steady the nerves for doing some bold deeds requiring special courage. For instance in ancient times the Rajput used to take the drug before they took part in battles.

18.5Sign & Symptoms of chronic poisoning in addicts of opium

47

Unlike alcohol opium does not seem to produce injurious effects

on the system or to shorten life if used in moderation but its abuse for prolonged period leads to emaciation lowering of general nutrition, dry skin & hair, a dry characteristic pigmentation around mouth eyelids & cheeks dry furred tongue, anorexia, nausea, loaded, bowels & marked constipation disturbance of sleep, impotence, neurasthenia, premature old age & melancholic dementia. The addict is so depraved in morals that he will stoop to any mean or criminal act to obtain the drug which has becomes a necessity to him.

Ref : 1)S.M. Smith et al Brit Med Jr 19 feb 1972] 480)

18.6Differential Diagnosis
Death due to Opium has to be diagnosed from the following
18.6.1 APOPLEXY

In apoplexy the patient affected is usually elderly and the onset is sudden and abrupt in cerebral hemorrhages not so in
48

thrombosis. The chief symptoms are a slow full pulse and paralysis usually hemiplegic. The pupils are dilated except when the lesion is an the pone varolli when they are untreated but not symmetrical is the temp is rained to 1030 F to1040F A case is reported where encephalitis this lethargic was diagnosed as opium poisoning as the patient was semi comatose with the pupils fixed and contracted to pin points & his temperature was subnormal.
18.6.2 URAEMTIC COMA :

In uremic coma there always the previous history of a kindly disease with the presence of albumin and caste in the urine & enasarea epileptiform convulsions generally precede coma.

18.6.3 DIABETIC COMA:

The onset is gradual they skin is flushed & the intraocular tension is low. The respirations are slow & deep and the always has a sweet odor of acetone the urine contain sugar & acetic acid.

18.6.4 EPILEPITC COMA

This follows an epileptic sit which may affect persons of all ages. The face and lips are generally is livid. The pupils are dilated. The patients are easily roused as the coma is less profound, though prolonged coma follows status epileptic us.
18.6.5 HYSTERICAL COMA

49

This is commonly met with female & rarely in males. There is a history of hysterical fits with convulsive movements. Saliva may be seen issuing from the mouth, the tongue is as rule not bitten and the reflexes are not altered. Recovery is generally rapid.

18.6.6 ACUTE ALCOHOL POISONING

In acute alcoholic poisoning the chief symptoms are the congested face, injected eyes, and dilated pupils, odor of alcohol in the breadth & sonring respiration. The patient may be roused by loud shout or vigorous shaking and there is no paralysis.

18.6.7 CARBOLIC ACID POISONING

The most characteristic signs are white patches on the lips & mouth, characteristic odor of breath & green colored urine.

18.6.8 BARIBITURATES POISONING

Pupils are dilated and greater respiratory rate.

18.6.9 COMPRESSION OF BRAIN (Brain Trauma):

History of an accident injury to scalp and skull bone may be found. Bleeding from the ear and nose facture of the base of skull

50

the

pupils

are

unequal

or

dilated

with

subconjuctival

hemorrhages.

18.6.10 ENCEPHALITHES

Acute onset, signs of meningeal irritation, fever, CSF changes

18.6.11 HEAT HYPERPYREXIA

Prolonged exposure to high temperature or sun congested conjunctiva with contracted pupils hyperpyrexia, absence of sweating, dry skin, circulating collapse & convulsions. -Modi

51

[15]Medicinal and Fatal Dose

15.1 In adults The smallest dose that has proved total to an adult is 0.24gm of crude opium The lethal dose for a healthy adult, not addicted to opium usually varies from 0.9-0.18gm smallest fatal dose of tincture of opium is 20 minims

52

Medical does of heroin have produced toxic symptom & 6.9grain have proved fatal. 240 gm of codeine have caused dangerous symptoms. Minimal fatal dose of pethidine is 1gm. 15.2 In Children 60 mg of Doves power = 6 mg of opium 1-2 minims of tinchture of opium 5 mg of morphine hydrochloride -Modi In a person not addicted to opium 200 mg of Morphine (2 mg) In adult 10 ml of tinctures of opium In children 2-3 drops if tincture of opium

-C. K. Parikh
Opium Morphine Codeine Pethidine 2gm 200mg 0.5 mg 1.0 gm -S.K.Singal

53

Medicinal dose: Rajnighntu: afim mg -2 gm Bhavpraksha: -2 ratti(afim)

[16]Fatal Period
Shortest fatal period on record is 45 min Usual fatal period 8-12 hrs If a patient survives 24 death has been delayed for 2 hrs -3 hrs. -Modi Usual Fatal Period is adult 9-12 hrs -C. K. Pariek
54

6-12 hrs -S. K. Singal

[20]Sign and symptom of patient in various stages

The symptoms manifest themselves in 3 stages 1) Stage of excitement 2) Stage of sopor 3) Stage of narcosis
55

20.1 Stage of excitement (Euphoria):1) During this stage symptoms are increased sense of well being, mental activity, freedom from anxiety, loquacity, restlessness, hallucinations, flushing of the face & increased action of heart. 2) These stage is of a short duration & may be absent if large does in taken. 3) In children:-Convulsions marked in first stage. In adults:-Widely excited, maniacal condition may be seen.

20.2 Stage of sopor:1) The nerve centers are depressed during this stage, which sometimes comes on quite suddenly. 2) The symptoms are headache, nausea, vomit giddiness, lethargic condition, drowsiness and an uncontrollable desire to sleep, from which the patient may be roused by external stimuli. 3) The pupils are contracted, the face and lips as enclosed and itching sensation is felt all one the skin. 4) The pulse & respirations are still normal.

56

20.3 Stage of narcosis:1) The patient now passes into deep coma from which he cannot be roused. There in mark insensibility to pain. 2) During this stage the muscles are relaxed & the reflexes are lost. All the secretions all almost completely suspended, except that of which feels cold and clammy. 3) 4) Face is pale, the lips are livid and the lower I am drops. The pupils are contracted to pin points probable due to depression of super nuclear inhibition papillary constrictor tone and are insensible to terminally they may dilate when asphyxia intervenes. Conjunctiva is injected. 5) 6) BP begins to fall and pulse slow, small & compressible. The respirations are slow, labored and Sertorius rate may be 2 to 4 per minute. 7) At this stage recovery may take place by prompt & proper treatment otherwise in the case of total termination rigidity of the surface increases. 8) The pulse becomes slower, more irregular & imperceptible. and the

9) As the respiratory system becomes insensitive cheyne-stokes breathing follows before respiratory failure and dearth occurring from asphyxia. 10) Heart may continue to beat for short time after respiration has stopped.
57

11)

Convulsive twitching in groups of the muscles is observed &

the pupils become widely dilated towards the end. 12) Death (sometimes) occurs from failure of heart.

13) Odour of opium may be present in the breath throughout the illness. 14) This is sometimes masked by the injudicious administration of alcohol by relatives.

[21] TREATMENT
21.1 According to Ayurved
1

In opium poisoning 10 gm Bruhati (Solaunm indicum),

Kantakari (Solunum surattense) is mixed with milk in same quantity. This is given 3 or 4 time in a day.

21.2 According to Allopath

As poisons have very fast action and fatality the treatment of poisoning cases differ significantly from the treatment of diseases.

58

Principles of Treatment of poisoning

21.2.1 Stabilization of vital function 21.2.2 Prevention of further spread of poison 21.2.3 Elimination of unabsorbed poison 21.2.4Use of antidotes (Pharmacological and Physiological antidotes i.e. the substances with opposite pharmacological action) 21.2.5 Elimination of absorbed poison 21.2.6 Symptomatic treatment 21.2.7 Rehabilitation & secondary prevention

1)(Ref- Ayurvediya Rasashatra by siddhinindan Mishra pg No 309)

59

Treatment:21.2.1 Stabilization of vital function

Shock is treated by giving 1000 ml of 5 percent glucose saline intravenously by drip method and vasopressors like ephedrine 25 mg or metherine.

If a patient is seen in the earlier stages before coma has supervened on attempt should be made to keep him awake be flicking a wet towel on the face or slapping, pinching etc. He should not be made to walk Administration of oxygen at high tension is necessary if cyanosis is present. If respiration is markedly depressed artificial respiration must be give. Patient may be put in an iron lung if available Maintain the respiration by careful use of and analeptic drugs like amphetamine, caffeine or ephedrine.

The body heat should be maintained by hot water bottles and warm blankets A 25 percent solution may be administrated intravenously or intramuscularly as a stimulant to the respiratory and circularly systems and repeated as necessary.

60

Hot Coffee or tea may be administered either by mouth or by rectum.

21.2.2 Prevention of further spread of poison

Emetics usually fail due to depression of vomiting centre Wash out the stomach first with warm water preserving the washing for chemical analysis
21.2.3 Elimination of unabsorbed poison

Then with solution of potassium permanganate (KMnO4) of the strength of 0.2 percent in water this washing should not be preserved for transmission to the chemical examiner as potassium permanganate oxidizes opium and its alkaloids and renders them unidentifiable It also converts morphine into oxydimorphine which does not satisfy any of the tests for morphine to continue this action it is advisable to allow a about half- a pint of the solution to remain in the stomach the partial test to stop the ravage of the stomach is to find the return water of pink color If potassium permanganate in not available the stomach may be washed out with infusions of tea or tonic acid or a mixture of finely powered anima charcoal and water. Mustered or zinc sulphate may be given as an emetic. The bowels should be cleared by the administration of 15 G of magnesium sulphate in water and the bladder should be emptied by catheterization if necessary
61

21.2.4 Use of antidotes (Pharmacological and Physiological antidotes i.e. the substances with opposite pharmacological action)

If there is no doubt that coma is due to opiate poisoning then 5 mg of nalorphine hydro bromide (Lethidrone B.W. & Co) should be given intravenously (in a couple of minutes the respiratory rate usually increase and pupils dilate). If not then 10 mg more may be given intra veinously. As its antagonistic action subsides 5 to 10 may be given I.V. or I.M at 15 to 30 mi. interval as required until the patient is around but nor more than about for new born infants This drug should be used with care in opiate addicts as its use precipitates the maniacal dysphoria of the abstinence syndrome. Noloxone hydrochloride 0.01 to 0.02 mg / kg I.V. to be repeated as required is also effective and preferred (now a days popular) J.Mckeogh and F.H. Shaw advice amiphenazole daptazole 20 to 40 mg given intravenously.
21.2.5 Elimination of absorbed poison

In poisoning by the hypodermic injection of morphine the stomach should always be washed out as after absorption in blood morphine is excreted into the stomach from which it is again liable to be reabsorbed but repeated stomach wash should not be done to avoid depletion of chloride.
21.2.6 Symptomatic treatment

Antibiotics are necessary in cases of prolonged coma

62

The rest of treatment is symptomatic The treatment must be continual till the patient is conscious and even then care must be taken that a relapse does not occur.
21.2.7 Rehabilitation & secondary prevention

Pethideine Hydrochloride and methadone are morphine like synthetic narcotic analgesics and give rise to almost similar symptoms of poisoning need the same treatment. One comes across a good few cases of pethidine addiction amongst doctors. At the site of injection there is often tissue induration. Pethidine addicts are best treated in an institution withdraw the drug give plenty of fluids either 6hourly ml of paraldehyde to produce a twilight sleep or give 20-40 units of insulin I.M to improve appetite.

21.3Treatment of addicts & chronic poisoning for with drawl syndromes:

The Best treatment for such a condition is the total deprivation of the drug form the patient but this con not be achieved without great moral control over once mind which is not possible in such persons. They are best treated in an institution as in those depent there drug sudden withdrawal produce a typical abstinence syndrome, characterized by yawning, running nose & eyes perspiration, tremors, goose fleas, loss of appetite,
63

restlessness, nausea, vomiting, loose

stool, muscular cramps,

dehydrations, loss of weight & burning sensation in the due to formation of oxydimorphine an acrid irritating substance in the tissues these can be treat by pill containing 10 grains of lecithin three times a day given usually for first five days & 25 ms of 25 % glucose solutions are given intravenous. Glucose may then administer by mouth for cramps give 10 ml of 10% solution of calcium gluconate to glucose solution. Diet should can fluid only for 1st 2 or 3 days & then light solid rich in protein & lecithin should be added gradually Librium 20 mg three times a day chloral hydrate 2 g once at night for about weeks is also recommended they also use serpasil for restlessness & chlorpromazine (Lagactil) for excitement & insomnia symptoms shown withdrawal psychological treatment is importance amiphinazol & tetrahydroaminacrine hydrochloride is also recommended.

21.4Treatment to reduce drug dependence:

1) Methadone 100 mg, a long acting narcotics which can be taken orally can be used for treating heroin addicts, as a single daily maintenance dose, the patients becomes refractory to euphoria action of some or more of heroin. 2) Treatment according to J. Crosland (Ref. the practitioner, may 1971, 702) 1 mg of methadone can be substituted for 2
64

mg of heroin, 4 mg of morphine & 20 mg of Pethidine. The total daily dose can be gradually reduced by about 20% daily. 3) Treatment according to leading article Brit. Med Jour. June 3, 1967, 588 Cyclazocin, an opiate antagonist and analgesic has a considerable antagonism to the subjective effect of morphine may also be used as four mg. of cyclazocin in daily counteracts the euphoric and systemic effects of 15 mg of heroin. As an alternative to methadone Lomotil 2 tables four times a day and gradually reducing it in about 8 days or heminervin (chlormethiazole) 1 Tablet 4 times a day for 4 or 5 days may be tried no other sedatives should be given with it .

65

[22]Post-Mortem Appearance
The post-mortem appearance is not very characteristic, but the sings of asphyxia are prominent. [Comato asphyxia seen] 22.1 External- The face and the finger nails are livid forth is seen at the mouth and nostrils. The blood is usually dark and fluid. -Modi Following symptoms are externally observed:1. Smell of opium 2. Face is deeply cyanosed and almost black. 3. Finger nails blue. 4. Neck veins engorged and distorted 5. Postmortem lividest is almost black and is better seen in a fair skinned body. 6. There is forth at the nose and mouth but neither so fine nor so fine nor as copious as in drowning.

66

In cases of suspected opium poisoning, blood, bile and brain should be preserved in addition to routine viscera. In main liners, hyper pigmented linear needle track scars (tracers) Overlying scleroses thromboses subcutaneous veins of antecubital fossa, for arms & dorsal aspects of hands are common. In addicts using inhalation method irritation, congestion & atrophy of nasal mucosa is common perforation of nasal septum may be seen The most conspicuous feature of a fatal narcotic injection is severe congestion & edemas of lungs which manifest as showing cream froth at the nose & mouth falling the trachea & bronchi. This gives rise of suspicion of drowning if victim is found in bathroom a common place for drug administration hepatic lymph adenopathy is common sub acute bacterial endocarditis may be seen. The urinary bladder is frequently distended an often this in only due to death from drugs. -C.K.Parikh

22.2 Internal22.2.1 physical examination(naked eye examination):-

67

I)

When the stomach is opened, small soft, brownish lumps of opium may be found in its contents, which may also look brown and viscid, and may give the smell of opium.

II)

The smell of opium is often noticed, as soon as the chest is opened, but it disappears with the setting in of putrefaction.

III)

Trachea is rosy colored, congested and covered with forth.

IV)

The lungs are often engorged and edematous and exude frothy fluid blood on section.

V)

The bronchial tubes are also congested and contain froth.

VI)

The right side of the heart is full of blood, and the left is empty. Sometimes both the chambers are full with venous engorgement.

VII) The brain and its membranes are congested. VIII) Similarly, the abdominal organs are largely congested, and exude dark fluid blood on section. IX) The bladder is generally full of urine. -Modi
22.2.2Chemical Analysis:-

To ascertain whether the suspected article contains opium or not, it is necessary to detect the presence of meconic acid and morphine if possible.

22.2.2.1 Test for Meconic Acid:68

A neutral solution of ferric chloride gives a blood-red color, which is not destroyed by boiling or by adding hydrochloride acid (distinction form acetates and formats) or mercuric chloride solution (distinction from thiocynates).The red color disappears on the addition of stannous chloride, but it reappears on the addition of nitrous acid. 22.2.2.2 Test for Morphine:1) Marquiss Test:- A drop of a mixture consisting of 3 ml of concentrated sulphuric acid three drops of formalin (40% formaldehyde solution) added to a fragment of the suspected

1) It produces a purple-red color, which changes Gradually to violent and finally to blue if morphine is present. 2) Codeine and apomorphine produce a violet color changing to blue but not the initial purple-red. 3) Narcotine produces a violet color, but it becomes olive green and finally yellow. 4) Oxydimorphine gives a green color. 5) Dionin gives a dark blue violet color. 6) Heroin produces the same colors as morphine. 2) One or 2 drops of neutral ferric chloride Solution added to a neutral Solution produces the same colors as morphine. One or two drops of neutral ferric chloride Solution added to a neutral Solution of a morphine salt produces a blue color. 3) Husomanns test: - Of two or three drop of concentrated sulphuric acid & added to the morphine residue & the mixture is heated on a water bath for about half an hour. A
69

reddish or reddish brown or black color appears on cooling & on adding a drop or 2 of concentrated nitric acid or crystal of potassium nitrate. Reddish violet color appears which changes immediately to blood red & then to reddish yellow & finally fades away. 4) Frohdes Molybdic Test:- one or 2 drops of freshly prepared frohdes reagent (0.1 g of ammonium or sodium moybalate dissolve in 10 ml of concentrated sulphuric acid) added to a fragment of dry morphine residue on a white porcelain dish produces a violet color which changes to blue, green & finally to pink rose red. 5) Porphyroxine Test: - The alkaline other extract obtained by the stas-otto process is allowed to evaporated spontaneously in small proclaim dirs. 20 the drug residue a few drops of hydrochloride acid are added of the disc heated over a flame when a Pink or rose-red colors. Shows the presence of porphyroxine a natural constituent of opium. This test was thought to be popular to Indian opium only but bam ford has show that at heart some specimen of both Turkish & Smyrna opium resided.

70

[22] Medico Legal importance

1) Suicides usually mix opium with mustard oil or asafetida in the belief that these substances increase its absorptive power but there is no foundation about this belief However it is true that muster oil
71

makes it difficult to be eliminated even by washing out the stomach. 2) Suicide by morphine is comparatively rare in India in this annual report for the year 1927 the Chennai analyzer of Bombay reported 2 cases of suicide of morphine as against 79 cases by opium. While in the years 1954, 1955, and 1956 46 cases per year and in Punjab there were 73 cases of opium poisoning in 1964 and only 14 cases in 1974 and in Uttar Pradesh there were 71 cases in 1973 and 78 in 1974. 3) Owing to its bitter taste its characteristic smell and its dark brown color opium in rarely used as a homicidal poison for adults although is sometimes used to destroy illegitimate infants 4) Opium is some times used as a cattle poison. In this annual report for the year 1925 the chemical examiner of UP reports a case in which opium was found in appeal intended for poisoning cattle. He also mentioned case of Ballia, where an attempt was made to poison an elephant with some jowar leaves mixed with gur, the substance on examination was found to contain opium. 5) Cases of poisoning occur in infants and children by their accidently swallowing crude opium or opium pills ment for their parents or grandparents, who are in the habit of using the drug, they are also sometimes poisoned by an accidental overdose, as they are usually dragged with opium by their parents especially of the laboring class with a view to putting them to unnatural sleep. 6) Children are extra ordinarily susceptible to influence of opium. Hence great precautions should be use in a prescribing the drug for them. Procedure to investigate the death due to narcotism Diagnosis of death due to narcotism is based on
72

1) Examination of a scene where body is found. 2) Investigation of circumstances 3) History obtain from a friends and relatives 4) Autopsy examination 5) Toxicological evidence -C.K.Parik General PM Appearance of death due to narcotism: Skin incision of injection site reveals 1) Black debris in dermis from carbonaceous material of sterilized needle. 2) Acute or chronic abscesses or diffuse subcutaneous scarring. 3) Foreign body granulomatus. -C.K.Parikh

Acts & rules to prevent drug addiction: 1) In order to prevent the smoking or opium which is very much in vogue, esp. in Calcutta .The Government of Bengal passed in June 1993, and The Bengal opium smoking Act which provides for registration of existing smokers who should obtain a permit from excise Department. Anyone found smoking without a permit after March1934 will be prosecuted & on conviction will have to undergo six months imprisonment combine with a fine. As a result of

73

recommendation of opium enquiry committee in Bengal since Jan 1, 1933 the limit of poison of opium by person has been reduced from 1 to 72gm. Anyone purchasing it in excess of quantity up to 60 i.e. half tola must obtain a permit from excise department. The officer authorized of the committee appointed for purpose (vide the Bombay prohibition act 1949) .Since 1968 the consumption of beer is not restricted. Similarly, opium smoking acts have also been passed in Bihar and the Uttar Pradesh. These acts forbid the registration of habitual opium smokers under the age of twenty-five yrs. 1) The Bombay opium smoking Act of 1936 as amended by the Bombay Act XLIII of 1949 Provides that a person who opens, keep or uses any place for the purpose of an opium smoking assembly or in any way assist in contributing the business of any place used or kept for the purpose afore said, or being the owner, occupier or having the use or care or management of control of any place knowingly permits, it to be opened, kept or used for the purpose of an opium smoking assembly, shall on conviction, be punished with imprisonment of either description for a term which may extend to six months or with fine which may extend to Rs. 1,000 or with both. 2) Recently, the majority of the state government in India have declared certain dry areas where. The use of intoxicating drugs, especially alcohol, opium and bhang (including ganja and charas)

74

has been prohibited without special permits issued to the addicts on the recommendation of a registered medical practitioner. 3) The Government of Maharashtra have prohibited the use of consumption of intoxication or narcotic drugs, such as any alcoholic liquor of today, opium and Cannabis indica including bhang, charas and ganja throughout the whole state, but may allow certain individuals to use or consume foreign liquor under special permits granted by the commissioner or

75

Shodhana process
Rasa shasthra explains processing of drugs under the name Samskara, which is capable of modifying the qualities of the drug. Shodhana is one such process used for Samskarana of drugs. The term shodhana in Sanskrit means purification. However the word Shodhana is being used with a broader perspective in Rasashastra. Therefore in Rasa-shastra the shodhana means a process of not only purification but also involves the detoxification and enhancing the efficacy of the drugs. The poison or toxins of the plant/ part of the plant will be converted to safe, effective and life saving medicine by subjecting them to the process of shodhana. Shodhana processes are used to remove visha (toxic compounds) or decrease concentration of toxic constituents or convert them to chemically modified compounds which are less toxic and/may be more potent. There are claims that herbal drugs when given after shodhana process possess lesser toxicity and enhanced efficacy. The data on scientific validation of shodhana processes is scanty. It is clear from the ancient literature that a single shodhana process is not described for all the drugs or more than one process is described for a single drug. However, the shodhana process described for various drugs differs depending on the Guna (nature) and Dharma (properties) of the drug. In addition to these, there are several other processes and/or, combination of any two or more above mentioned processes are described in the texts. Objectives of Shodhana * To reduce toxicity * To enhance safety * To enhance potency * To produce synergistic effect with other plant preparations as herbal formulation

76

1) According to Sharangadhara,

h rr : -

- /296
2)According to Yogratnakar,

rr h 296 : - 296

77

1) pg 449, sharangadhara samhita pd.parsuramshastri vidyasagar 2) pg 169,Yogaratnakara,shri Laxmipati shastri,

: = a : 165
BaOYajya ]pivaYa /65 r%naavalaI

:163 rsatrMigaNaI 24/163,164 :1 yaaogar%naakr AqaaopivaYama\ / 1 h- :

78

G-M 258

259 Y-- G-M 260 s 261 rsatrMigaNaI /258,259,260,261 laa: d` 234 -

79

24

Baavap`kaSa inaGaMTu hirt@yaaid vaga- /234,235

235 rajainaGaMTu ipPplyaaid vaga- / 234,235 G-M

|| yaaogar%naakr Aqaaihfonama\ /2 -: h

r.ja.ina. 3/8
80

h- rr : - h- 27 : 272 W: s : 273 d\o- s -: s -

:274 rsatrMigaNaI 271,272,273,274

81

[25]Bibliography
1)Ayurvedic textbooks and samhitas

Name of Book Bhavprakash

Name of Auther Gangasahaya Pandeya, Krishnachandra Chunekar.

Publication Chaukhamba Prakashana Varanasi 1998 Banarasi, 1994

Rasatrangini

Shri. Sadanant Sharman Motilal Reprint Varanasi

Yogaratnakar

Shri. Lakshmipati Shastri Chaukhamba Sanskrit Bhavan Varanasi 7th edition 1999

Sharangadhara

Pt.Parashuram Vidyasagar

Shastri Chaukhamba Sanskrit Bhavan Reprint 1999 Varanasi

Rajnighatu

Pt. Narahari

Chaukhamba Sanskrit Bhavan Varanasi 1st edition 1982

Ayurveda Rasashastra

Pd.Siddhinandan Mishra Chaukhamba Sanskrit Bhavan Varanasi 8th Reprint 2011

82

Bhaishajya Ratnavali Kaviraj Ambikadatta Shastri

Shri Chauhamba Sanskrit bhavan 2ndedition 1987 Varanasi Reprint

83

2)Modern textbook

Modis Textbook of Modi Forensic Medicicne and Toxicology Parikhs Textbook of Dr.C.K.Parikh Medical Jurisprudence forensic Medicine & Toxicology Toxicology at glance S.K.Singhal

1959

CBS

Publishers

&

distribution pvt. Ltd. New Delhi Reprint 2011 6th edition

National Publication New Delhi 8th edition

Indian Plants vol-I

Medicinal K.R.Kritikar & Basu

National Publication New Delhi 8th edition M/S Periodical

experts New Delhi 2nd edition

84