Investigation of hemlock (Conium maculatum L.) poisonings

Conium maculatum L. (hemlock), which is from the Apiaceae (Umbelliferae) family, is in the class of poisonous plants due to its toxic substances. The most common poisonous compounds in this plant are coniine and γ-coniceine alkaloids. The amount and percentages of these alkaloids in hemlock may vary according to season and weather conditions. The toxic and teratogenic effects of γ-coniceine alkaloids are significantly higher than coniin due to the double bond of the alpha carbon in its structure with nitrogen. It is known that by blocking the response of muscles to acetylcholine due to binding of neuromuscular cells to their nicotinic receptor, it first stimulates the respiratory system, then suppresses it, and then causes cyanosis and respiratory failure. It is seen that hemlock poisoning usually occurs as a result of consuming the plant by analogy with another species. In the cases of poisoning that occur, it is seen that primarily the gastrointestinal tract, nervous system, cardiovascular system and especially the respiratory system are affected. In this thesis study, 11 case reports in the literature with the registration of hemlock poisoning and 10 cases who died with the suspicion of hemlock poisoning in Turkey and were referred to the Forensic Medicine Institute for autopsy by the prosecutor's order were evaluated from clinical, biochemical, toxicological and pathological perspectives, and multidisciplinary interpretations were made in accordance with the criminalistic literature. According to the information obtained from the poisoning cases in the thesis study, the symptoms and signs seen in hemlock poisoning are generally not specific; It is seen that patients apply to health institutions with nonspecific complaints that can be seen in many diseases such as nausea, vomiting, dizziness, headache, feeling of fainting and loss of consciousness. In cases of poisoning due to hemlock, it is generally seen that blood gases and electrolyte values are monitored, and the definitive diagnosis is made by detecting hemlock alkaloids in the toxicological analysis of biological samples taken from the patient and identifying the plant specimen causing the poisoning as C. maculatum L. The lack of a database that contains information that can help physicians in the diagnosis of plant poisoning and allows the registration of poisoning cases is considered as a deficiency in our country. The preparation of a database or guides, including the data to be obtained from this thesis and similar studies, will help to reduce the loss of life caused by plant poisoning.