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An Introduction to Poisoning

In honour of our new show, The Death of Anton Orlov, starting this September, we take a further look at poison, poisoners, and the foundation of toxicology.

Let’s look at the history of poison. Poison is one of the oldest weapons there is. We have references to it throughout our literature from ancient Greece to Serket the Egyptian goddess of poisons to Romeo and Juliet.

But what is poison?

Paracelsus the 15th-century father of toxicology famously said, “the dose makes the poison”. Never were truer words said, in fact, today forensic toxicologists measure poisons in a few different ways. The median lethal dose is one of these measures. This is the dose needed to kill 50% of trial subjects.

This is measured as the LD50, the lethal dose at 50% if it is a solid dose. The LC50 is used for the lethal concentration in fluids at 50% and the LCt50 is used for vapours and gas concentration at 50%.

Typically, we express this per kilogram. The more toxic, the smaller the unit per kilogram. If we look at Botulinum toxin its LD50 for humans is just 1 nanogram per kilogram. The average weight of a man in the UK is 84 kilograms, so 84 nanograms are enough to kill a man 50% of the time. The Botulinum toxin produced by bacteria is one of the deadliest poisons known to man as it takes so little a dose to kill you and can be found in contaminated food. It was discovered in 1870’s Germany and given the name sausage poison. Botulinum toxin binds to the synapses of your nervous system and prevents the release of the neurotransmitter acetylcholine. This prevents nerve signals from getting to their final destination.

In turn, this causes symptoms such as blurred vision, dry mouth, trouble swallowing, trouble speaking, weakness of facial muscles, drooping eyelids, paralysis, and trouble breathing. We also see vomiting and diarrhoea as it is often taken into the body through contaminated food.

Eventually, the paralysis extends to the diaphragm, stopping breathing altogether. Yet we use a form of Botulinum toxin in medicine as Botox. Botox injections can be used to stop excessive sweating, stop chronic migraines, treat lazy eyes, and treat an overactive bladder. Cosmetically it is also used to paralyze muscles of the face to smooth out wrinkles. As Paracelsus said, the dose does make the poison.

Most Common Poisonings in the UK

Today we have many health and safety laws written in the blood of the past to keep us safe from poison. But poisonings still happen in the UK today. From food poisoning to the overdose of drugs, to consumption of cleaning products, to lead poisoning.

There is still one silent killer on the loose. Each year in the UK around 25 people die of carbon monoxide poisoning. Carbon monoxide gas is produced when fuel isn’t being burned efficiently. The gas can build up in confined spaces. Carbon monoxide is heavier than air so as it builds up it can displace the air pushing it upwards in confined spaces.

Carbon monoxide can be generated from faulty gas boilers, gas stoves, faulty gas heating, or fires. As you inhale carbon monoxide you are inhaling less and less oxygen. Carbon monoxide binds to the haemoglobin in your blood making it harder and harder for oxygen to be distributed around your body. You start to feel dizzy and have a headache from the lack of oxygen. This continues into confusion, shortness of breath, feeling weak, feeling sick, and chest and muscle pain.

Eventually, the lack of oxygen causes hypoxia in the brain leading to death. The body will take on a pink hue from the carboxyhaemoglobin build-up. This is the calling card for pathologists that carbon monoxide poisoning has taken place.


Many poisons have no antidote. The first port of call if we don’t know what the poison is or if it has no antidote is limiting the exposure. If it is a gas or vapour get the casualty out of the environment if it is safe to do so and administer oxygen, then the casualty is put on a ventilator. If someone has ingested a poison, administering activated charcoal will get the poison to bind to the charcoal. preventing it from being absorbed into the bloodstream through the gastrointestinal tract.

Next, treat the symptoms if the casualty is agitated, they might be given a sedative. If the casualty is experiencing seizures anti-epileptic drugs can be given to manage this.

Finally, some poisons may have antidotes, in most cases, this can be another poison. In instances of poisoning with a nerve agent, atropine can be administered as an antidote. Atropine is an alkaloid found in deadly nightshade and can cause paralysis and death in its own right. The dose may make the poison but that is true of the antidote as well.

Want to learn more about the effects of poison on the human body? Tickets selling for our upcoming shows starting this September - get yours here!

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