How painful is cyanide poisoning when dying

Poisons with and without "time fuse"

Part 1: The at Emergencies Foreign substances (drugs, pesticides, metal poisons, etc.) that are frequently detected by forensic toxicologists can be identified with regard to the Onset of action basically in 2 main groups subdivide.

On the one hand there is fast acting Poisons, on the other hand, can only be poisons after a certain amount of time delay (Latency) develop their often fatal effect (toxicity). These particularly dangerous substances with "Missing initial symptoms" should be in the foreground of this article. First of all, the following first part will deal with poisons rapid onset of effect To be received.

1. Fast acting poisons:

This type is characterized by the fact that the effects appear immediately after ingestion or only a short time later (Fig. 1).


cyanide: The one described in many crime novels, for example "Second death" usually only occurs in acidic (acidic) conditions in the stomach and the resulting rapid release of hydrocyanic acid.

The time course of hydrocyanic acid poisoning is for suicide of Heinrich Himmler documented: Himmler died on May 23, 1945 in Lüneburg in the presence of British interrogators twelve minutes after biting into a cyanide capsule hidden in a gap in the lower jaw, which his wife said he had always carried with him since the first year of the war. The effect came quickly, from one "Second death" but it can certainly not necessarily be spoken.

When the stomach is full, there is often only hydrolysis (conversion) to potassium hydroxide (from potassium cyanide). This is often associated with a painful death from chemical burns to the esophagus, stomach and other parts of the body.

Occasionally, however, fatal poisoning can also be “unusual”, as the following case study 1 shows.

Case study 1 with "unusual" test material

A young woman is found dead in the apartment by her husband after his return from a long business trip with a complete alibi.

The autopsy result clearly proves cyanide poisoning. The case is still unclear at first because it is in the stomach no Cyanide can be detected, but only lethal concentrations can be detected in the blood.

The result of the meticulous criminal investigation: the cyanide was put into a tampon by the husband before the trip and from there later absorbed in the wife's body through the vaginal mucous membrane. The perpetrator cold-bloodedly calculated that his wife's menstruation and the associated poisoning was not to be expected until a week after his departure.

This spectacular case was also the subject of a TV documentary with the participation of the Institute for Forensic Medicine at the University of Giessen.

Parathion (E 605): This pesticide used to be very common in the past (most famous murder case Christa Lehmann in the 1950s) usually acts quickly, but can also only lead to death after prolonged violent convulsions.

Carbon monoxide: Few survivors agree that the onset of action was quick and subjectively perceived as not painful. This is why carbon monoxide (not least because of its easy availability as exhaust gas or for barbecues) is at the top of the "ranking list" of suicide drugs in many countries.

A detailed presentation on the subject of "Death from carbon monoxide." Was already published in Health Compass (3/2017) published.

Other fast-acting toxins:

Carbon dioxide (e.g. in mines, fermentation cellars, feed silos).

chloroform and Ether (e.g. for stunning victims of criminal offenses).

Case study: Introducing anesthetic through a thin hose into the driver's cab of a truck in order to then steal the freight.

alcohol (e.g. with nonsensical drinking bets).

Of course, all sedatives and hypnotics (tranquilizers and sleeping pills) can also act quickly, especially if they intravenous (i.v) administered. To oral On the other hand, the onset of action depends on the rate of absorption, which is often closely linked to the degree of filling of the stomach and numerous other factors.

The prognosis for the consequences of poisoning is often favorable, even if the substances are highly toxic. For example, a lay artisTreated intoxication with cyanide, carbon monoxide or alcohol are largely without consequences and the patient can be discharged from the clinic after just a few days.