Datura metel.doc

Dhatura

Dhatura Metal Linn.

Compilation of Agadtantra

Evum Vidivaidyak

(Forensic Medicine &

Toxicology)

Under the guidance of

Vd.Abhay Patkar

H.O.D.

(Dept.of Agadtantra)

Vd.Bhushan Mogal

Lecturer

(Dept. of Agadtantra)

Students

Nirgude Anjali P.

Waghmare Shital

S.

Rathod Priyanka D. Sabale Shraddha

S.

INDEX

Sr.No. Topic

Page

_No.

1

Historic Review

1

I) Samhita Kala • Charak Samhita • Sushruta Samhita • Ashtang Hridaya II) Laghutrayi • Sharangdhar Samhita • Bhavaprakash • Yogratnakar III) Madhyam Kala

• Nighantu • Bhaishajya Ratnavali

2

Varnacular Name

4

3

Synonyms

5

4

Classification

7 I) According to Ayurveda • Kula • Varga • Constituent • Morphology

5

Properties

8

• Rasapanchak

• Action on Dosha

6

Action & Uses according to

_{Ayurveda & Siddha}

10

7

Useful parts

11

8

Botanical description

12

• Taxonomy

• Species

• External morphology

• Species & cultivate

9

Toxicological information

15 I) constituents

10

Poisonous parts

18

11

Matra / Dose

19 • Fatal dose • Fatal period

12

Clinical toxicology

20

13

Signs & Symptoms of poisoning

21

I) External II) Internal

15

Treatment of poisoning

25

I) According to Ayurveda II) According to Modern

16

Post mortem apperance

29

I) External II) Internal

17

Medicolegal importance

30

18

Clinical Toxicology

32

19

Medicinal formulations

33

20

Sandarbh Shlokawali

35

21

Bibliography

36

ABBREVIATIONS

Su.U. Sushruta Uttar Tantra

A.H.Su Ashtang Hriday Sustrasthan

B. P. Bharprakash

Y. R. Yogratnaka

Su. N. Sushruta Nidansthan

B. R. Bhaishiya Ratnavalli

A. N. Adarsh Nighantu

PHOTOGRAPHS

Sr.No. Name of photograph Pg No.

1 Botany of plant i

2 Useful Parts- Fruit,Leaf,Flower ii

3 Poisonous Part- Seeds(Beeja) iii

4 Signs & Symptoms - Dermatitis of Skin -Dilatation of Pupils and Redness of Eyes

iv

5 Formulation - Asthamatic Cigarettes v

•

Samhita Kala

A) Charak Samhita

Aacharya Charaka explained the use of Dhatura in Madhvasava and Manashiladilepa (Ref C.Ch.7- Kushthachikitsa)

B) Sushrut Samhita

Dhatura root is the content of Mushikakalpa which is used for Alarkavisha (dog bite) (Ref.Su.K.7/53-59)

•

Sangraha Kala :

A) Ashtang Hridayam

Use of Dhatura Fala (fruit) in Kakkurdanshachikitsa (Ref. - A.H. -38/35-37)

B) Ashtang Sangraha

Signs and symptoms of Dhatura poisoning are mentioned. (Ref. 40/181-184)

Use of Dhatura Fala (fruit) in Mushikalarkavisha. (Ref. 46/69-71)

•

Laghutrayi :

A) Sharangdhar Samhita :

Dhatura is one of the content in Dhaturatailam (Ref-9/ 199) and Sannipatabhairava Rasa (Ref - 12/233-247)

B) Bhavprakash

Dhatura included under Guduchyadi Varga (1st part) Use of Dhatura in Samanyajwara (Ref -2nd part/177-179)

C) Yogratnakar (Uttararadha)

Dhatura Part Reference

1) Shwanchikitsa Dhatura Fala (fruit) Vishadhikar/1 2) Garudanjanam Dhatura Swaras Vishadhikar/1 3) Kameshwar Rasa Dhatura Vajikaranyog 4) Kameshwar Modak Dhatura Vajikaranyog 5) Sannipatikjwar Dhatura Swaras

Bhavna

Shlok No. 7,8 6) Sannipatikjwar Dhatura Fala (fruit)

Bhasma

Shlok No. 2 7) Bhairavarasa One of the content Rasa Adhyaya

Madhyam Kala :

Nighantu Varga 1) Pariyanighantu Shatpushashpadi 2) Bhavprakash Guduchyadivarga 3) Aadarsh Kantakaryadi D) Bhaishajyaratnawali

There is reference of Dhatura as a Upavisha (ref. 2/165) Reference of Dhatura Shodhan (Ref. 2/166, 176)

1) Sannipatikjwara Dhatura Fala (fruit) Jwarachikitsa Prakaran 5/311 2) Tridoshaj Jwara Mahajwarankushrasa

(Dhatura Bij)

5/561 3) Nasya Unmattrasah 5/600 4) Sannipatikjwar Pashchavaktrarasah 5/658 5) Sannipatik Jwar Vadvanalorasah 5/800 6) Different types of

Jwara

Jwarankushrasah 5/636 7) Kafaj-Jwara Shleshmashailendrarasah 5/1224 8) Jwara Kanaksundarorasah 6/64

9) Pittatisar Kanaksundarorasah 6/68 10) Atisar Jatifalarasah 7/151 11) Visharog Bhimarudorasoanyah 72/56, 60

E) Rastarangini

There is description of Dhatura as a content in Chaturvinshastarang, Bradhnashodhahar, Pralapantakrasah (Ref. Shlok No. 342, 360, 369)

Description of Matra of Dhatura (Ref. 367-368)

Use of Dhatura in Alarkavisha

Diseases Shlok No.

1) Dantapidahar (Krimidanta) 372 2) Netrabhishyand 370 3) Stanshothahar 372 4) Manspeshigat Vataprakopa 374 5) Vatpida Sandhivat 375 6) Yukalikhadikam Hanti 375 7) Shothhar 378

2) VERNACULAR NAME

Region Vernacular Name

1) Bengali Dhattura, Dhutura, Dhatura 2) Gujarati Dhattura, Dhaturo

3) Tamil Ummattu, Unmatta 4) Telagu Ummattu, Unmatta 5) Kannad Ummattu, Unmata

6) Mallyalum Ummattu, Unmatta, Unmattam 7) Arab Datur, Baujmasam

8) France Tatur

9) Panjabi Dhattur, Dhatura 10) Maharashtra Dhotra

11) Sanskrit Dhatura

12) Hindi Safed Dhattura, Dhatur, Dhatura, Dhaatura

13) English Thorn apple 14) Marathi Dhattura

3) SYNONYMS

उन्मत - उन्मतं करोतित सेविवितारं मदकृत्विात् इतित उन्मतः । कनकाहय - कनकं आहयोत यस्य सः। िकतब - िकतविः धुर्तरलोतकाः सि अन्त अस्य ग्राहकाः इतित। मातुर्ल - मा- नाडसिसत तुर्लाडसस्य इतित । मदन - मदयित ग्लपयित अङ्गमदकरत्विात्। मातुर्लपुर्त्रक - मातुर्लस्य धन्तुर्रस्य पुर्त्रः इतवि इतित। धतुर्र - धयित धातुर्न् व्रणश्लेवष्मादीश्च इतित । धस्तुर्र - धुर्सयित काि अन्तयुर्क्तं करोतित शरीरम् । धुर्सकाि अन्तकरणेव । - (विण्यर,कांतीयुर्क्त) तुर्यरतेव िहनि अस्त जन्तुर्न् व्रणादीश्च । इतित तुर्री धुर्धासौ तुर्रश्चेवित धुर्स्तूरः ।।(Ref-Adarsha Nighantu)

Synonyms of Dhatura

Nighantu Synonyms

1) Priya Nighantu Dhattur, Dhurta, Matul, Unmatta 2) Raj Nighantu Dhattur, Kitav, Dhurta, Unmatta,

Kankahya, Shath, Matulak, Shyam, Madan, Shivashekhar, Kahla, Mohan, Kantakphal, Shiva

3) Nighantu Aadarsha Dhattura, Unmatta, Madkar, Dhustur, Dhurta, Gantapushpa

4) Bhavprakash Dhattur, Dhurta, Dhuttur, Kitav, Turi, Unmatta, Kankahya, Matul Devata, Madan, Mahamohi, Shivapriya

4) CLASSIFICATION

• According to Ayurveda :

Kula : kantakari kula

Varga-According to Nighantus

Nighantu Varga

1) Priyanighantu Shatpushapadi 2) Bhavprakash Guduchyadi 3) Aadarsh Kantakaryadi

Constituent : Chetan Dravya Morphology : Karya Dravya Use : Aaushadhi

5) PROPERTIES

Properties Of Dhatura according to Ayurveda : Rasapanchaka:

Rasapanchak Ref.

Rasa Tikta- kashaya- katu (B.P.)

Katu (N.A.),(D.N.)

Guna Guru,Laghu,Ruksha,Vyavayi,Vikasi (B.P.)

Virya Ushna (B.P.)(D.N.)

Vipak Katu (N.A.)

Action on Doshas :

• Vatashamak

• Kaphashamak

• Pittavardhak

Action :

1) The alkaloids atropine, hyoscyamine & hyoscine first stimulate the higher centers of brain, than the motor centers & finally causes depression & paralysis especially of the vital centers in the medulla.

2) The respiration is first stimulated then depressed, & the heart centre is stimulated. - (Reddy)

3) By acting on CNS, it inhibit secretions of saliva and sweat gland.

4) It dilate the pupil and stimulate heart regulation centre. -(Parikh)

5) Dhatura leaves closely resemble stramonium leaves in appearance and have a similar characteristic odour & a bitter taste.

The plant as a whole has narcotic, anodyne and antispasmodic properties, analogous to those of belladonna it causes dilation of the pupil when locally applied in wattery solution equal in effect to atropine solution of the strength of 1 in 120.

6) Dried seeds are thought to be more powerful soporific than the leaves.

7) Vaidyas regarded the drug as intoxicant, emetic, digestive, antispasmodic & healing.

8) The black variety is considered to be more powerful. Indian materia medica. (Volume I)

6) ACTION & USES IN AYURVEDA & SIDDHA

1) Tikta rasam, ushna veeryam, katu vipaka

2) Leaves : Swasa, kasa, externally fomentations, ulcers, poisonous bites, earache.

3) Fruit : vata diseases karappan, granthi.

4) Seeds : Diarrhoea, antipoison, intoxicant, fevers. Externally for piles, vata diseases.

5) Black variety is more potent & aphrodisiac. Indian materia medica

( Volume-I)

Uses : - Plant contains many useful phytochemicals which renders

it of benefit for using treatment of many kind of diseases. Notably the leaves are frequently use as remedy for asthma & proctatile caugh.

7)

USEFUL PART

(Prayojyaanga)

• Patra(leaves), Puspha (flower) & Beeja (seeds) are useful parts of plats.

8) BOTANICAL DESCRIPTION

A) Taxonomy :

• Kingdom - Plantae

• Order - Solanales

• Family - Solanaceae

• Sub Family - Solanoideae

• Genus - Dhatura • Species - D. Metal • (Unranked) - Angiosperms • (Unranked) - Eudicots • (Unranked) - Asterids • Order - Solanales • Tribe - Datureae B) Species -

Dhatura is a group of nine species of vespertine flowering plants belonging to the family solanaceae. They are known as Angel's Trumpets sometimes sharing that name with closely related genus Brugmansia. They are also sometimes called moonflowers, one of several plant species to be so.

Dhatura's precise and natural distribution is uncertain. Owing to its extensive cultivation & naturalisation throughout temperate & tropical regions. Its distribution within Americas, however, most likely restricted to united states & Mexico, where the highest diversity of species occurs.

Some south American plants formally thought of as Dhaturas are now treated as belonging to distinct genus.[Brugmansia differs from Dhatura i.e. woody making shrubs or small tress, in that it has

pendulus flowers rather than erect ones. Other related genera include Hyoscyamus and Atropa.

Today experts classify only nine species of

Dhatura-• Dhatura ceratocaula- Torna Loco

• Dature discolour- Desert Thorn- apple

• Dhatura ferox- Long spined Thorn apple

• Dhatura inoxia- Thorn apple, Moon flower

• Dhatura metel- Devil's trumpet

• Dhatura leichhardtii- Leichhardt's Dhatura

• Dhatura quercifolia - Oak-leaf thorn apple

• Dhatura stramonium-Thorn-apple

• Dhatura wrightii- Sacred Dhatura,Sacred Thorn-apple

C) External morphology

An erect spreading annual or biennial plant grows upto 1.5m in height.

• Leaves : Simple, alternate, triangular and unequal at base.

• Flowers : Large, solitary, purpulish white coloured.

• Fruits : Globose capsules covered with numerous yellowish brown seeds.

1) This plant belongs to N.O. solanaceae, as its flowers and fruits are supposed to have been blessed by Lord shiva, they are known as shivashekhara.

2) There exists 2 different varieties , viz. Dhatura alba a cohite flowered plant (Safed Dhatura) & Dhatura Niger, a black or rather deep purple flowered plant or (kula Dhatura).

3) Both these varieties grow commonly on waste places all over India, have bell- shape of flowers & have more or less sphericao fruits which are covered with sharp spinous projections & contain yellowish - brown seeds.

4) Dhatura stromonium (thorn apple) grows in India at high attitudes through out the temperate Himalayas.

5) All parts of these plants are poisonous but the seeds and fruits are considered to be the most noxious. They yield active principles hyoscine which is converted into atropine during the process of extraction.

• Identity, Purity, strength - Foreign matter=Not more than 2% Total ash=Not more than 16%

D) Species &

Cultivates-It is difficult to classify Dhatura as to species, and it often happens that descriptions of new species are accepted prematurely. Later it is found that these "new species" are simply varieties that have evolved due to conditions at a specific location. They usually disappear in a few years. Contributing to the confusion are the facts that various species such as D.wrightii and D.inoxia are very similar in appearance, and that the variation within a species can be extreme. For example, Dhatura have the property of being able to change size of Plants, size of leaf & size of flowers all depending on location. The same species, when growing in a half-shady damp location can develop into a flowering bush half as tall as a person, but when growing in a very dry location-will only grow into a thin little plant just higher than ankles, with tiny flowers & a few miniature leaves.

9) TOXICOLOGICAL INFORMATION OF DHATURA

Chemical constituents and its action

• The active principles contains the alkaloids Laevohyoscyamine. Hyoscine or scopolamine and traces of atropine.

• It has been suggested that atropine does not exist as such in Dhatura plant, but is a recemic form of hyoscyamine, which is converted into atropine during the process of extraction.

• In Dhatura plant, its leaves & flowers contain salts especially-Meteolodine.

• Also oil contain in seeds-12%

• Chlorogenic acid

• Leaves contains 0.045% volatile oil.

• The active constituents in Dhatura plant include scopolamine. atropine hyosaymine and other Tropanes.

• Scopolamine present in higher concentration Hyoscyamine in all varieties.

1) Atropine -

• Atropine is an antimuscarinic agent.

• It competitively binds muscarinic reports, thus interrupting parasympathetic innervations.

• It doesn't block Nicotinic receptor, consequently, there is little or no action of skeletal muscular junction or autonomic ganglion.

• The postganglionic receptor sites are located in autonomic receptor cells found in smooth, muscles, cardiac muscle, C.A., atrial and endocrine gland.

• It is both a central and peripheral muscarinic blocker and its actions last approximately 4 hrs.

• There especial used to reduce activity in gastrointestinal tract to reduce hypermotility of bladder to decrease salivation and to dilate pupils.

• Atropine can produce varying effects on the cardiovascular system, depending on dosage.

• At low doses (<0.5 mg) it causes bradycardia, this effect is likely due to blockage of M receptur, an inhibitory prejunctional neurons, which allows for increased acetylcholine release, higher doses atropine (71 mg) induce tachycardia due to blockage of S.A. node cardiac receptor.

• Atropine is also employed as an antidote to cholinesterase inhibitors, such as organo phosphate pesticide and muscarine.

It is also an antiarhythmic with symptomatic brady arrhythmia.

t1/2 = 2.5 hrs. 2) Scopolamine -

• Scopolamine, likely atropine, another Belladona alkaloid and antimascarinic agent that produces similar peripheral effects.

• In contrast to atropine it is a CNS depressant at therapeutic doses.

• Commonly used to prevent motion sickness, can be absorbed transdermally.

• It also has the unusual effects of blocking short term memory can be used during anaesthetic procedures.

• Other therapeutic indications include use as a gastrointestinal, antispasmodic and as an antidismenorrheal, urinary antispasmodic, antiemetic, antiarhythmic agent.

• Adverse effects include blurred vision, dry mouth, Flushed appearance, anxiety, irritability, insomnia.

t1/2 = 8 hrs. 3) Hyoschyamine -

• It is an antimuscarine agent also similar to atropine. (but more potent in peripheral and central effects.)

• Used as an adjunct in the management of peptic ulcer diseases and Zollinger - Ellison syndrome, in patients of whom have failed standard therapies.

• It is too used as an Antidote to cholinesterase inhibitor, such as cholinergic adjunct.

10) POISONOUS PART

11) DOSE / MATRA

Fatal Dose

• Commonly 100 - 125 seeds

• Alkaloid = 60mg-adult and 4mg-children

Fatal Period

• Death usually occur in 24 hrs.

1) A dog, died m 3-4 Hrs after drinking a large quantity of Dhatura mixed in sharbat.

2) A man, 22 yrs old, died in 4-5 hrs after Dhatura seeds had been administrated to him in sweets.

12) CLINICAL TOXICOLOGY

• Ingestion of Dhatura will induce dellirium.

• Combination of Hyoscyamine, atropine, scopolamine causes CNS stimulation at low doses and depression at higher doses.

• Intoxication with Dhatura often manifest as psychic exhilaration along with panic attacks and vivid hallucination.

• Scopolamine specially van produce a state of excitement followed by a state of depression, and during this transition hallucination can occur.

• Leaves of Dhatura plant, when smoked are hallucinogenic and hypnotic.

• Ingestion of seed may cause a change in mental status that leads to generalized confusion, delirium, powerful hallucinations which leave patient in panic and severe anxiety.

13) SIGNS AND SYMPTOMS OF POISONING

External Signs & Symptoms -

• Contact with leaves or flowers causes dermatitis in sensitive person.

Internal Signs & Symptoms

-• If the seeds are eaten, symptoms appear within half an hour, if a decoction of the seeds is given within few minutes and if alkaloids are used almost immediately. In most cases, powdered seeds are administered in food.

• The symptoms are described as "dry as a bone, red as a beet, blind as a bat, hot as a hare and mad as a wet hen."

• The earliest symptom is a bitter taste in the mouth. Due to inhibition of salivation, there is dryness of mouth and throat [dry as a bone] resulting in difficulty in talking, dysphagia and unquenchable thirst.

• The face is flused due to dilatation of cutaneous blood vesseles [red as a beet]

• The pupils are dilated, insensitive to light [photophobia], dilated pupils with loss of accommodation for near vision, red and injected conjuneivae Diplopia. Light reflex at first is sluggish and later absent. The pollen can cause unilateral mydriasis[cornipickers pupil]( blind as a bat)-C.K.Parikh.

• The body temp is raised. The skin is dry and hot (hot as a hare) due to inhibition of sweat secretion and stimulation of heat regulating centre. Urinary retention and inability to pass urine occurs. The skin is dry & hot the pulse rapid 120 to 140 per minute, full and bounding, but later becomes weak & irregular and respiration are increased. The temp may be raised

by 2-3०_{C. Hyperpyrexid is caused by atropine, amphetamine.}

Muscle tone and deep reflexes are increased, and there may be muscular spasm.

• There is vomiting. These symptoms are soon followed by giddiness and unsteady gait,the person staggering like a drunken individual. The mind is affected early, the patient being at first restless and confused, and later becoming delirious,and mutters indistinct words [mad as a wet hen]

• Carphologia - Patient is subject to visual & auditory

hallucinations. He appears to grasp at imaginary threads from the tips of his finger.

• The delirium passes off in an hour or so and the patient becomes drowsy. There may be scrlatinform rash.

• The drowsiness may progress to stupor or coma and rarely death from respiratory paralysis.

Secondary delirium may appear when the patient recovers.

The important symptoms and signs can be summarized under 9 Ds,

Viz : 1) Dryness of mouth and throat 2) Difficulty in talking

3) Dysphagia

4) Dilatation of cutaneous blood vessels. 5) Dilatation of pupils

6) Dry hot skin 7) Drunken gait

8) Drowsiness And, these may be mistaken for undrunkenness or heat stroke.

In severe poisoning victim feel cold, agitated & combative, urinary retention. They may develop convulsion, paralysis, coma, respiratory failure with circulatory collapse & death.

14) CASE

1) In February 1965 five serious delirious cases of typical Dhatura poisoning due to eating Undhiu (a mixed vegetable preparation) accidentally contaminated with Dhatura leaves, were observed by the editor in this wards. All of them belonged to the same family and respoded within 24 hrs. to gastric lavage, 0.5 mg. prostigmin, intravenous fluids and paradelhyde injections. Next day not one of them had any recollection of being brought to Harikrishondas Hospital.

2) A man drank two mouth full of liquid poisoned with Dhatura, complained of a bitter taste and fell down insensible within fourty yards of the spot where he had drunk, and did not recover his senses until the third day. Another man was struck down so suddenly that his feet saclded by some hot water which he was carrying.

3) Homicidal poisoning by Dhatura

-In 1921, one Musammat Khazanu (16 yrs. old) was convicted for the murder of her husband, Ne Ram,18 yrs.old, by administrating Dhatura seeds in his food.

On his Post mortem examination a few suspicious seeds were sticking to his inner surfaces of the oesophagus which was rather congested.

A substance having the properties of Dhatura was detected in the viscera of the deceased by the chemical examiner of uttar pradesh K. E. V. Mt.kharanu, Allah High court Appl. No. - 645, 1921.

4) Dhatura administered as a love philtre.

A 16 yrs. old boy convicted of poisoning with Dhatura five or six women & sentenced to one year’s rigorous imprisonment. The poison was administrated in peras (sweets) as a love philtre which would turn a girl, 16 years old, with whom he became infatuated and other woman of the house in his favour. (Leader, June, 13 1923).

5) Dhatura administrated as an abortifacient at chhindwara, man gave some Dhatura powder to a woman.

The women felt thirsty, giddy and died three hrs. later. ( U. P. chemical Examiner Annual Report – 1949).

6) Dhatura administered for

Robbery-Two peoples gave Dhatura in sweets, to a old man & his grandson. After some time grandson became excited, talked incoherently and a little later ran towards the river. Particles of dhatura seeds were detected from the stomach of the grandson on post mortem. (Madras chem. Examiner Annual Report-1951).

15) TREATMENT OF DHATURA POISONING

Ayurvedic literature :

1) Godugdha (cow milk) 750 ml mixed with 93 gm of Sharkara (sugar) is given to the patient to diminish the effect of Dhatura poisioning. Dose - 2 to 3 times a day.

2) Decoction of Karpasmoola and Karpaspushpa is mixed with Lavana; dose of this formulation is given to patient 2 to 3 times a day.

(Ref. R.J.N.3/8)

Modern Literature :

Following are principles of all types of poisons -1. Stabilization of vital functions :

2. Prevention of further spread of poison : 3. Elimination of unabsorbed poison : 4. Use of antidotes:

5. Elimination of absorbed poison : 6. Symptomatic treatment :

7. Rehabilitation and secondary prevention : Poisons have two important properties

They act very fast and many times they are fatal. Therefore treatment begins with ascertaining that patient is alive.

1. Stabilization of vital functions :

The following things have to be checked : A - Airway

B - Breathing

C - Circulation or coma D - Depression of CNS.

A - clean the air way with suction machine & mouth gag is placed between teeth.

Plastic or metal air way put in mouth If oedema of vocal cords appear -Intratrachial incubation -

B - Breathing

It respiratory rate is low then, best is to given mouth to mouth respiration.

In hospital setting Ambu bag & mask is used for O2 inhalation.

C - Circulation :

Check heart beats

If asystole is there, eclectroversion has to be given [300-360J]

C- Coma

The coma cocktail is advised-50% glucose - For hypoglycemia. Inj. Nalaxon - For coma.

2. Prevention of spread of poison :

In injected poison use of tourniquate and in indigested poison mechanical antidotes - Demulsents, charcoal, bulky food

3. Elimination of unabsorbed poison :-For ingested poison :

Stomach wash with 2 to 4% solution of tannic acid.

Also give sodium sulphate by mouth as purgative [Light diet & purgation should be carried for 3-4 days to remove seeds & to increase intestinal motility.]

4. Use of Antidotes :

i] Inj. Pylocarpine nitrate [6 - 15 mg] Hypodermically

ii] Inj. Neostigmine [2-5 mg] - slow I.V. route Neostigmine may make the patient more comfortable, but it does not antagonize the central action of datrua on the brain.

iii] Inj. Physostigmine [2-5 mg] - slow I.V. route at 1or2hrs intervals relieve both peripheral and cerebral manifestations. In many cases 1 dose is sufficient to counteract almost all the effects of Dhatura.

5. Elimination of absorbed poison :

Renel excretion- Inj. Frusemide - 40 -50 ml by IV route.

Purgation is useful in both absorbed and unabsorbed poisoning.

6. Symptomatic Treatment :

Artificial respiration and oxygen supply as need of patient. Use Inj. Dextrose, Ringer's lactate, Normal saline in required condition & quantity.

Tepid sponging is good for the raised temp & dry skin. Darken the room for marked photophobia.

7. Secondary Prevention :

Adequate follow up is necessary to treat complication if any. All patients known to have or suspected to having attemted suicide should not be leave the hospital without being interviewed by a psychiatrist who can institute further necessary supportive psychotherapy.

16) POST MORTEM APPEARANCE

• External appearance:

The post mortem appearance are those of asphyxia.

• Internal appearance:

Dhatura seeds or their fragments may be found in the stomach & intestines.

It is therefore necessary to make a careful search for them in the vomited matter, stomach contents & faeces.

The oesophagus, stomach, deodenum and other internal organs are mostly congested.

In cases the mucous membrane of the stomach may be found slightly inflammed.

Dhatura seeds resist putrifaction and are found even when the body is decomposed.

17) MEDICO-LEGAL IMPORTANCE

1) In India Dhatura used as criminal purposes.

2) The chemical analyser to Gov. of Bombay in his annual report for 1957 reports that in 543 cases of poisoning Dhatura was detected during a five year period of 1953-1957.

3) The seeds are generally used by road prisoners to stupefy travelers (the stupefying dose is 30-50 seeds) to facilitate robbery and theft and rarely to destroy life, although deaths have occasionally occurred from excessive quantities.

The poison used for stupefying purpose as it is a content of Cigaratte. The seeds as well as leaves are also mixed with tobacco or ganja and smoked in a chilum(pipe) for the same purpose.

4) The seeds are sometimes given to children with a view to kidnapping them when they become unconscious or delirius. 5) The seeds are given whole or more often crushed, mixed with

rice, dal, sweets, chapatis or vegetables and sometimes with tea, coffee or liquor. .

6) A decoction of the seeds is at times added to liquor with a view to enhansing its intoxicating property.

7) Cases of suicidal poisoning by Dhatura are rare.

8) Accidental cases of poisoning occur among children and even adults from eating raw Dhatura fruits mistaking them as edible fruits or from eating dry Dhatura seeds in mistake for capsicum seeds.

9) Accidental cases also occur from injudicious use of the seeds in medicines by Vaidas & Hakims.

11) The juice of Dhatura leaves is used to subdue pain & inflammation in Rheumatism.

12) If applied to an abroded surface. It may produce poisonous symptoms.

13) The active principle of Dhatura is excreted unchanged in the urine almost immediately on its administration and the excretion is completed in 10 to 20 hrs.

It is therefore advisable to preserve urine in cases of Dhatura poisoning since the urine will show the active principle on chemical analysis, while the stomach wash may not occasionally respond to the test.

14) The seeds of Dhatura resist putrefaction for a long time, but the mydriatic principle contained in them appears to be destroyed by pupefactive changes in the body. although it can be obtained after some lapse of time in the Vomit or from the Earth upon which the patient has vomited.

15) Some times used as abortifaicient. 16) It is sometimes used as love philter.

18) CLINICAL TOXICOLOGICAL REVIEW (JOURNAL)

• Clinical toxicological review is published monthly by Rhode Island

Poison Control System. (March 2001, Vol . 23, No.6).

• Dhatura is an alkaloid containing plan from the Nightshade family, solanceae (Latin quieting) which has recently been gaining increasing popularity amongs garderns.

• The large shrub can grow 10-15 ft. high with large ovate oblong leaves, pendulus trumpet shaped flowers.

• The exotic showy flowers can grow to 10" in length and are known for their powerful musky fragrance that become stronger at night.

• The seeds from plant are similar to Tomato seeds.

• They are brown , flat disc about 1/8" in diameter.

• All parts of plant are toxic.

• It is native to Mexico, India, S. America.

• Datura metel was used in past by Thuggee cult in India for the purpose of drug in sacrificial victims.

• Today Dhatura seeds are important for crushed and consumed for intoxication.

• In 1994, there was ten fold increase in reported ingestion throughout florida alone.

• Causes of intoxication include herbal medication overdose, misuses as edible vegetable and accidental food contamination.

• There have also been cases of accidental contamination of Dhatura seeds in soybean seed and some cereals.

19) MEDICINAL FORMULATIONS

Sr

No Namedisease of Kalpa Referance(chapter/shlok) Charak Samhita

1 Shwitrakushtha manahshiladilep Charak Uttarardha 7(Kushtha chikitsa)/167, Sharangdhar Samhita Dhaturatailam 9(Shehparibhasha)199 Bhavprakash 1 Samanyajwara 177-179 Yogratnakar 1 Vajikaranyog Kameshwar-rasa 2 Vajikaran yog Kameshwar

-modak Bhaishajyaratnawali 1 Tridoshaj Jwara Mahajwarankush-rasa 5(jwar-chikitsaprakaran)561 2 Jwara (Sannipatic) Unmmatrasa 5/600 3 Jwara Chakrika rasa 5/613 4 Jwara Aanandbhairavi

Vatika

5/620 5 Tridosh jwara

Trailokyasundar-rasa 5/623 6 Sannipatik Jwara Sannipatik-bhairavo rasa 5/636 7 Kamala Paniyvatika 5/651 8 Paittik Jwara

Sannipatsuryo-rasa 5/708,67 9 Pandurog

shriprataplankesh-rasa 5/845

11 Gulma Jwararth bhram 5/1135 12 Grahani Kanakprabhavati 6/73 13 Aamvat Lakshmivilasrasa 5/1224.

Antitoxic Formulation

Toxins Kalpa Referances Sushrut

Alarkvisha(dogbite) mushik kalpa 7/53-59

Ashtang Sangraha

Mushikalaska-vish Dhatura fala (fruit) 46/69-71

Ashtang Hridayam

Kakkurdansh Dhatura fala (fruit) 38/35-37

Yogratnakar

Shwanchikitsa Dhatura Fala (fruit) Vishadikar Shlok-1

Rasatarangini

Alark Visha Dhatura 24/376, 377

Bhaishajyaratnavali Reference of Dhatura as a Upavish 2/165

20) SANDARBH SHLOKAWALI

श्लोतकाविली धुर्स्तूरोत देवविता धूतर उन्मतः कनकाह्वयः । धतूरः िकतविस्तूरी महामोतही िशवििप्रियः ।। मातुर्लोत मदनश्चास्य फलं मातुर्लपुर्त्रकः ।। (R.J.N. 3/8) धतूरः कटुर्कश्चोतष्णस्तथा शोतथिनषूदन । कृिमघ्नः कुर्ष्ठशमनोत िविशेवषाज्जविरनाशनः ।। (R.T. 24)

धतूरकोतपयोतगेवन सविर पश्यित पीतकम् । कम्पलालामदच्छर्दिदरस्मृितभ्रंशभ्रमाि अन्वितः ।। (A.S.U. 40/181) िपबेवत्सधतुर्रफलां श्विेवतां विाs िप पुर्ननरविाम् । ऐकध्यं पललं तैलं रुपिपकायाः पयोत गुर्डसः ।। (A.H.U.38/37) िनहि अन्त िविषमालकर मेवघविृन्दिमविािनलः ।। मूलस्य शरपुर्ङ्खायाः कषर धतूरकािधरकम् ।। (S.S.K.7/53) काकोतदुर्म्बिरकामूलं धतूरफलसंयुर्तम् । पीतं तण्डसुर्लतोतयेवन सारमेवयिविषापहम् ।। (Y.R.U.Vishadhikar-1)

21) BIBLIOGRAPHY

I) Ayurvedic textbooks & Samhitas

Name of book Name of author Publication

Bhavaprakash Gangasahaya Pandeya Krishnachandra Chenekar Chaukhamba Prakashana Varanasi, 1998

Rasatarangini Shri Sadanant Sharman

Motilal Banarasi, Reprint 1994 Varanasi Yogaratnakar Shri Lakshmipati

Shastri Chaukhamba Sanskrit Bhavan Varanasi 7th edition 1999. Sharangadhara Pt.Parashuram Shastri Vidyasagar Chaukhamba Sanskrit Bhavan Varanasi Reprint 1999 Rajnighantu Pt.Narahari Chaukhamba Sanskrit Bhavan Varanasi 1st edition 1982

Bhaishajya Ratnavali Kaviraj Shri

Ambikadatta Shastri Chaukhamba Sanskrit Bhavan Varanasi 2nd edition reprint 1987. Dhanvantari Nighantu Dr.Guruprasad Sharma Chaukhamba Orientalia, Reprint 1982, Varanasi

II) Modern Textbook

Name of book Name of author Publication

Modi's textbook of forensic medicine and toxicology N.J.Modi M.M.Tripathi Private Ltd. New Delhi 20th edition, Second Impression 1979. Parikh's Textbook of Medical Jurisprudence, Forensic medicine and toxicology Dr.C.K.Parikh CBS Publishers and distribution pvt ltd, New Delhi Reprint 2011, 6th edition Toxicology at glance S.K.Singhal National Publication

New Delhi 8th edition Indian Medicinal

Plants K.R.Kirtikar and Basu

National Publication New Delhi 8th edition M/S periodical

experts New Delhi 2nd edition

Web sites

-1. www.wikipedia.com

2. www.medicinalplant.flower.com

3. Global Information Hub On Integreted Medicine(Globinmed) 4. www.ayuvista.com