Tobacco

Introduction

The plant Nicotinum tabacum is a native plant of America but now grows almost all over the world. All parts of this plant are poisonous except ripe seeds. The dried leaves of tobacco are used in India for chewing and smoking etc.

Active principles

  1. Nicotine
  2. Nicotianine

Action

Stimulation and depression followed by paralysis of autonomic ganglia, mid brain and spinal cord etc.

Signs and symptoms

(i) Mild poisoning

Mild tobacco poisoning occurs when it is chewed or smoked for the very first time producing following signs and symptoms :

  • Dizziness
  • Nausea
  • Vomiting
  • Headache
  • Perspiration
  • General weakness etc.

(ii) Acute poisoning

Acute tobacco poisoning occurs when nicotine is absorbed in poisonous amount producing following symptoms in addition to the above said ones

  • Burning sensation in mouth, throat and stomach
  • Prostration (extreme exhaustion or lack of energy)
  • Confusion
  • Incordination
  • Convulsions
  • Cardiac irregularities
  • Coma

(iii) Chronic Poisoning

Chronic poisoning results from the continued use of tobacco among the tobacco chewers, cigarette smokers and nicotine insecticide sprayers etc producing following signs and symptoms

  • Chronic cough
  • Laryngitis
  • Pharyngitis
  • Bronchitis
  • Dermatitis
  • Tremors
  • Amblyopia (dimness of vision)
  • chest pain (Angina pectoris)
  • Increase in the incidence of cancer of the mouth, tongue, larynx and lungs etc.

Fatal dose

40 to 60 mg if nicotine

Fatal period

Few minutes to few hours

Treatment

  1. Gastric lavage with warm water containing charcoal, potassium permanganate.
  2. Purgatives such as sodium sulphate 15 gms in 100 ml of water
  3. Inj. Hexamethonium chloride 25-30 mg Subcutaneously
  4. Inj. atropine 0.6 - 2 mg I.V - hypotension
  5. Inj. Diazepam 0.3 mg / kg I.V slowly to control convulsions
  6. Oxygen inhalation
  7. Artificial respiration
  8. Symptomatic treatment

Post-mortem Appearance

  1. The characteristic Smell of tobacco and fragments of the leaves may be found on opening the stomach.
  2. Signs of asphyxia may be seen
  3. The mucous membranes of the stomach and intestines is congested and inflamed.
  4. The brain, lungs and liver are congested.
  5. Nicotine resists putrefaction

Medico-legal Importance

  1. Nicotine is a common drug of addiction
  2. Accidental poisoning may occur from
    1. chewing a large dose
    2. Ingestion
    3. Excessive smoking
    4. Application of leaves or juice to wound or skin
    5. Exposure to fertilizers, insecticides and fumigants containing nicotine.
  3. Suicidal and homicidal cases are rare.

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