It is heavy metal and bright silvery in appearance.It is liquid and is non poisonous if swallowed. However, it volatilizes at room temp and inhalation of vapors is toxic. It gets widely distributed throughout the body and causes toxic damage to brain, kidney, peripheral nervous system, mucous membranes etc

1. Dr Kaleem Khan
Assistant Professor
Forensic Medicine
JNMCH,AMU

3. ◦ It is heavy metal and bright silvery in appearance
◦ It is liquid and is non poisonous if swallowed.
◦ However, it volatilizes at room temp and inhalation of vapors is
toxic
◦ It gets widely distributed throughout the body and causes toxic
damage to brain, kidney, peripheral nervous system, mucous
membranes etc

4.  It exist in elemental, inorganic and organic form in environment.
 Elemental Hg
 Organic Hg:
 Methyl Hg,
 Ethyl Hg,
 Methoxy methyl mercurial
 Inorganic Hg: it form two series of compounds
 Mercuric: soluble and more toxic e.g.
a) Mercuric oxide,
b)Mercuric sulphide
c) Mercuric nitrite etc.
 Mercurous: less soluble, thus, less active e.g.
 Mercurous chloride (calomel)

6. 1. Mercuric chloride: (corrosive sublimate). Occurs as odorless, white
crystalline powder, styptic, nauseous, metallic taste and soluble in water,
alcohol, ether, glycerin.
Used in medicines and taxidermy

7. Mercurous chloride: (ras kapoor, calomel). Heavy amorphous white tasteless
powder, insoluble in water, alcohol and ether.
On exposure to light turns to Mercuric chloride.
Used in laxatives.

8. Mercuric sulphide: (ras sindoor, cinnabar). Artificially prepared as red powder-
vermillion.
Non poisonous but vapours poisonous.
Used in dentures, vermillion

10.  Elemental mercury:
 It is heavy and bright silvery in appearance.
 It is liquid metal and metallic Hg is non poisonous if swallowed.
 However, it volatilises at room temp and inhalation of vapours is
toxic.
 Elemental Hg is lipid soluble and can cross blood-brain barrier.
After absorption most of the elemental Hg get oxidized to mercuric
form which is not lipid soluble.
 Elemental Hg is not absorbed through intact gastrointestinal tract.
 Sources: Batteries, Dental amalgams, Gold and Silver production,
Jewelry industry, Paints, thermometers etc.

11.  Most toxic form of Hg.
 It primarily targets enzymes.
 It readily crosses placenta and is secreted in breast milk
 These are extremely toxic to fetus.
 Methyl Hg can build up to certain level in aquatic animals.
 It is lipid soluble and gets widely distributed throughout the
body.
 SOURCES:SOURCES: Fungicides, seed preservatives, mercury
containing vaccines, fish consumption etc.

15. Combines with sulphydryl group resulting in enzyme inhibition and
pathological alteration of cellular membranes.
Absorbed through all routes
Salts of mercury are lipid soluble and can cross blood brain barrier, get
secreted in milk and crosses placental barrier.
It gets widely distributed throughout the body and causes toxic damage to
brain, kidney, peripheral nervous system, mucous membranes etc

16. Inhalation of mercury vapors causes
Chemical pneumonia,
Pulmonary oedema,
Gingivostomatitis,
Increased salivation
CNS symptoms like
Ataxia,
Restriction of field of vision,
Paresis,
Delerium
Polyneuropathy.

17.  The signs and symptoms start immediately after swallowing the
poison:
 Acrid metallic taste in mouth.
 Feeling of constriction or choking of throat.
 Hoarseness of voice, there is difficulty in breathing and
mouth and tongue are corroded and swollen with grey
white coating.
 Hot burning pain in mouth, stomach and abdomen.
 Stools are blood stained , urine is suppressed and scanty,
contain blood and albumin is accompanied by necrosis of
renal tubules and damage to the glomeruli.

18. Pulse is quick small and irregular, there is circulatory
failure.
Thrombocytopenia and bone marrow depression.
When injected intravenously, it produces dyspnoea,
cyanosis, hypotension and convulsions, death may be due
to an anaphylactic shock or ventricular fibrillation.
After 1-3 days- renal tubular necrosis l/t polyuria,
albuminuria, uremia and acidosis and in GIT membranous
colitis l/t dysentry may develop.

19. F.D.
1-4 gm of mercuric chloride,
10-60 mg/kg of methyl mercury
10 mg/ m3
of Hg vapor.
F.P. : 3-5 days
Blood Hg level
> 3.6 µg/dl
24 hr urine excretion >15 µg/dl.
Assessed by atomic absorption spectrophotometer.

20. Reduce exposure
 Albumin such as eggs, skimmed milk, vegetable glutens, to ppt
Hg.
 Gastric lavage with 250 ml of sodium formaldehyde
sulphoxylate. Sodium formaldehyde sulphoxylate is the
chemical antidote that reduces the perchloride to metallic
mercury.
 5-10% sulphoxylate and 5% sodium bi carbonate is used for
stomach wash of which 200ml should be left in stomach. This is
beneficial if given in the first half an hour.

21.  If colitis has developed, high colonic lavage as1:1000 solution is to
be given with 1: 1000 solution of sulphoxylate BD
 B.A.L is to be given in the dose of :
 3-5mg/kg 4 hourly for 2 days.
 2.5 mg/kg 6 hourly for1 day.
 2.5 mg/kg twice daily according to the severity.
 For diuresis5-10% glucose is used in normal saline.

22. Workers may get poisoned due to vapors or dust.
When small doses are taken for prolonged time or used as
ointment for long period.
The signs and symptoms of chronic mercury start at a blood level
100 mg/ml.
Patient is symptomatic at daily urinary excretion more than 300
mg/ml

23. Excessive salivation with swollen and painful salivary glands.
Foul smelling breathing, inflamed and ulcerated gums with
brownish blue line and loosening of teeth.
Necrosis of jaw that should be differentiated from phosphorous
poisoning.
Mercura lentis: A brownish reflex from the anterior lens capsule of
both the eyes is seen when observed in slit lamp in person exposed to
mercury vapors for some years. It is bilateral and has no effect on the
visual acuity.

24. ACRODYNIA (PINK
DISEASE):-
There is generalized rashes
over the body.
This results from chronic
exposure to mercury in any
forms.
Erythematous, eczematous
(watery and weeping) popular
type of skin lesion
Mostly in the hands and feet
accompanied with thickening
of skin are produced.

25.  Mercurial tremors (Hatter’s shake or glass blower’s
shake): these are moderately coarse tremors starting from hands
than to the lips and tongue and finally arms and legs occur
(DANBURY TREMORS).
 These are detected early in the writing.
 These are excited by voluntary movements and are absent during sleep.
 These are interspersed with jerky movements, in coordination of
movements, increased deep reflexes, paresis of limbs and peripheral
neuritis.
 The tremors should be differentiated from thyrotoxicosis in which there is
presence of fine tremors, exophthalomos, raised pulse and goiter.

26.  Especially in the 19th century, inorganic mercury in the form of mercuric
nitrate was commonly used in the production of felt for hats.
 During a process called carroting, in which furs from small animals such
as rabbits, hares or beavers were separated from their skins and matted
together, an orange-colored solution containing mercuric nitrate was used
as a smoothing agent.
 The resulting felt was then repeatedly shaped into large cones, shrunk in
boiling water and dried.
 In treated felts, a slow reaction released volatile free mercury.
 Hatters (or milliners) who came into contact with vapours from the
impregnated felt often worked in confined areas.

28. Mental symptoms: (ERETHISM): seen in the person
working in mirror manufacturing factory.
Feature of insanity such as shyness, timidity, irritability, loss of
confidence, mental depression, loss of memory, insomnia,
hallucinations and delusion develop in the workers.
Sometimes suicidal melancholia or manic depressive psychosis
(Mad hatter) develops.

29.  Chronic mercury intoxication d/t consumption of contaminated
fish.
 Symptoms: disturbance in hand co-ordination, gait and speech,
chewing and swallowing difficulty, tremors, rigidity, seizures and
clouding of consciousness.

30. Removal of the individual from the source of exposure
 Plenty of milk should be given
 Mouth wash by borax
 Saline purgative to be given
 Periodic medical checkup for workers

31.  Mercuric chloride causes accidental poisoning when it is widely
used as, disinfectant and antiseptic, contraceptive vaginal tablets,
for antisyphilitic treatment,

 phenyl mercuric acetate jelly leads to poisoning when used as a
contraceptive
 Mercury is not a constituent of human body, hence it presence
indicates that it must have been introduced into the system.
 5-150 mg/ 100gm is normally presenting the tissues like kidney
and liver.

32. thanks