Viscera should be preserved if death is suspected to be due to poisoning either by the police or the doctor, Deceased was intoxicated or used to drugs, Cause of death not found after autopsy, Death due to burns, Advanced decomposition and Accidental death involving driver of a vehicle or machine operator.
The following must be preserved in all fatal cases of suspected poisoning.
(1) Stomach and its contents. If the stomach is empty, the wall should be preserved.
(2) The upper part of small intestine (about 30 cm. length) and its contents.
(3) Liver 200 to 300 gm.
(4) Kidney half of each. as one kidney may be dysfunctional.
(5) Blood 30 ml. Minimum 10 ml.
(6) Urine 30 ml.
As most poisons are taken orally, it is most likely to be present in the stomach and intestinal contents and in their wall. After absorption it passes through the liver, which is the major detoxicating organ and has the power of concentrating many poisons making them identifiable when the blood and urine concentrations may have declined to very low levels.
The kidney being the organ of excretion contains large amounts of it, which is excreted into the urine. Levels of drugs in the muscle more accurately reflect blood levels than the liver or kidney.
It is essential to prevent contamination of the solid viscera with the contents of the gastrointestinal tract, because an idea of the length of time since ingestion may be had from the relative amounts of it in the stomach, intestines and the solid organs.
If it is only found in the contents of the stomach, and none in the solid viscera and is not an irritant, doubts may occur about the actual proof of absorption.
Therefore, it is important to keep the contents of the alimentary canal in separate bottles. Poison found in urine, unless added with evil intention is a proof of absorption and excretion. If it is also found in the food or medicine preserved, this would be very strong additional evidence.
The stomach contents are of primary value for estimating the quantity ingested in acute overdoses, and qualitatively in identifying substances which have been recently ingested.
For preservation of viscera, the glass bottles used should be of one litre capacity, clean, wide-mouthed, white and fitted with glass stoppers. Rubber inserts should not be used under caps, because it can extract from the contents certain poisons, such as chloroform and phenols. Glass containers should be cleaned with sulphuric acid chromate solution, rinsed with distilled water and dried. Polythylene bags or containers can be used, but volatile poison may diffuse through plastic.
When lungs or other tissues are to be preserved for analysis for volatile substances, nylon bags should be used, as they are not permeable to such substances. Blood should be collected in screw-capped bottle of about 30 ml.
(1) Saturated sodium chloride solution, except in poisoning from corrosive acids except phenol, alkalis, corrosive sublimate, and aconite.
(2) Rectified spirit, except in cases of suspected poisoning by
- alcohol and kerosene
- chloroform, ether
- chloral hydrate
- formic acid
- formaldehyde, acetic acid
- paraldehyde, because the organic acids and paraldehyde are soluble in alcohol and the phosphorescence of phosphorus is diminished by alcohol.
(3) Ten. mg./ml of sodium or potassium fluoride (enzyme inhibitor) and 3 mg. potassium oxalate should be used for preserving blood. Fluoride should also be added to urine, CSF, and vitreous humour if alcohol estimation is required, and also to samples for analysis for cocaine, cyanide and CO. One ml of concentrated hydrochloric acid or 10 mg. of thymol or 100 mg. of sodium fluoride can be used for 10 ml urine as a preservative. Toluene is better. Preservative is not necessary if
- viscera can be analysed within 24 hours
- if sample can be kept in a refrigerator or ice box
- bone, hair, nails
- lung for detecting inhaled poisons
N.B. The viscera should not be preserved in formaldehyde because extraction of it, especially non-volatile organic compounds becomes difficult.
Instructions for Preservation and Despatch of Viscera
(1) The stomach and its contents, and the small intestine and its contents are preserved in one bottle, and the liver and kidney in another bottle. The blood and urine are preserved separately.
(2) The stomach and intestines are opened before they are preserved. The liver and kidney are cut into small pieces of 0.5 to 1 cm. thickness or they can be minced in a grinder or mixer. so that they are well-preserved.
(3) The quantity of preservative should be equal to the viscera in bulk.
(4) Only two-thirds of the capacity of the bottle should be filled with viscera and preservative to avoid bursting of bottle if gases of decomposition are formed.
(5) The stoppers of bottles should be well fitted, covered with a piece of cloth, and tied by tape or string and the ends sealed. The bottles should be sealed as soon as possible to prevent loss of volatile substances and possible contamination by external material.
(6) The bottles should be labelled which should contain the name of the victim, age, sex, autopsy number, police station, crime number, the organs it contains, the date and place of autopsy, preservative used and signature. If the contents are infectious, a clearly visible warning should be put on the label.
(7) A sample of the preservative used, i.e. 25 ml. of rectified spirit or 25 g. of sodium chloride is separately kept in a bottle and sent for analysis, to exclude the possibility of any poison being present as a contaminant.
(8) The sealed bottles containing viscera and preservative are put into a box which is locked and the lock is sealed using personal or departmental seal.
(9) A copy of the inquest report, postmortem report and the authorisation from the Magistrate are sent to the Forensic Science Laboratory along with viscera. The viscera are not analysed unless there is an authorisation letter from the Magistrate or a police officer not below the rank of Deputy Superintendent, which is issued on an application by the investigating police officer.
(10) The key of the box and a sample seal on a piece of paper, corresponding to the seal used on bottles and lock are kept in an envelope, which is sealed and sent with viscera box.
(11) The viscera box is handed over to the police constable after taking a receipt, who delivers it personally in the office of the FSL, after obtaining a receipt for the same.
In certain cases of poisoning, the following articles are preserved.
(1) Heart: strychnine, digitalis.
(2) Brain: 100 gm. of cerebrum or cerebellum: alkaloids, organophosphorus compounds, opiates, CO, cyanide, strychnine, barbiturates anaesthetics and volatile organic poisons.
(3) Spinal cord entire length: strychnine and gelsemium.
(4) C.S.F: alcohol.
(5) Bile: It is best removed by puncturing the gall bladder in situ. Narcotic drugs, cocaine, methadone, glutathione, barbiturates and some tranquilisers.
(6) Vitreous humour : alcohol, chloroform, etc.
(7) Lung : one lung in gaseous poisons, hydrocyanic acid, alcohol, chloroform, etc. Use a nylon bag which should be heat-sealed.
(8) Skin: in deaths where hypodermic injection marks, or areas where absorption of it through the skin may have occurred and in corrosive poisons an area of 10 cm. radius about the site, with as much underlying fat and muscle as possible, and the whole needle track is removed. Control specimens should be taken from the opposite side of the body. The usual substances injected are insulin, morphine, heroin, cocaine and other illicit drugs.
(9) Bone 10 cm. of the shaft of the femur is taken in cases of subacute or chronic poisoning by arsenic, antimony, thallium or radium.
(10) Hair: An adequate sample (20 to 30) of head hair should be removed with a tweezer to remove the roots, and tied in locks.
(11) Nails: All the nails should be removed entire by inserting the blade of a Spencer- Wells forceps under the nail-plate, grasping it and twisting.
(12) Uterus: Uterus and appendages and upper part of vagina are preserved in cases of criminal abortion. Sticks and foreign bodies found in the genital tract are preserved separately.
(13) Muscle: If the internal organs are badly putrefied, muscle tissue (3x3cm) especially of thigh is well preserved and can be analysed.
(14) Fat: 10 g. from abdominal wall or perinephric region in cases of poisoning by pesticides and insecticides.
N.B.: If the contents are infectious, e.g., hepatitis B virus, HIV, tuberculosis, tetanus, anthrax, gas gangrene, etc. or contain radioactives , this must be communicated to the chemical examiner.
The viscera should be refrigerated at about 4°C. if not forwarded to the laboratory. They can be destroyed either after getting the permission from the Magistrate, or when the investigating police officer informs that the case has been closed.
Preservative is not necessary
(1) If visceracan be analysed within 24 hours.
(2) If samples can be kept in a refrigerator or ice box.
(3) Bone, hair, nails.
(4) Lung for detecting inhaled poisons.