In a "Press Box" item posted earlier this week, "The d-Con Bomb," I questioned the veracity of reports in the New York Times, Los Angeles Times, the Washington Post, Newsweek, Time, the AP, and other publications that Palestinian terrorists had been making their suicide bombs more lethal by adding rat poison—an anticoagulant in both rat and man.
The Israeli press, specifically Yediot Ahronot and the Jerusalem Post, addressed the rat poison bomb story with more skepticism than did their American colleagues. Soon after the early December bombings in Jerusalem, Yediot Ahronot reported that nearly all the poison in one of the alleged rat poison bombs was consumed by the energy of the explosion. In February, the Jerusalem Post disclosed that one of the bomb sites produced a false positive for rat poison because municipal authorities had spread rodenticide to control vermin and it contaminated the samples.
Still, it remains debatable whether or not Palestinian terrorists have added rat poison to their bombs, as Israeli authorities continue to insist. No forensic evidence has been presented, but the story refuses to die.
Let's assume for the purposes of argument that the juiced bombs exist. And let's assume that some of the rat poison survives the heat and pulverizing energy of the blast and makes contact with the shredded flesh of one of the victims. How lethal would the poison be? Listen to Hadassah Hospital trauma surgeon Dr. Avi Rivkind describe the device's effect on one patient to Newsweek's Joshua Hammer in the July 1 issue:
One suicide bomber sprinkled rat poison among his nuts and bolts, which acts as an often-fatal anticoagulant. "This 14-year-old girl was bleeding uncontrollably from every one of her puncture wounds," Rivkind says. The doctor managed to stop the bleeding by using a coagulant, still unapproved by the American Food and Drug Administration, which he has since used to treat several other bomb-blast victims.
Although none of the rat bomb stories names the specific rat poison being used, the most common anticoagulant rodenticides around the world are warfarin, chlorophacinone, diphacinone, and bromadiolone. Warfarin is the most ubiquitous rat killer, marketed in the United States (but not Israel) by Reckitt Benckiser PLC as d-Con. (A Reckitt Benckiser spokesperson phoned Slate in a howling huff earlier this week over the headline "The d-Con Bomb" because she thought it unfairly maligned her company's product. The fact that the piece argued against the existence of such a bomb was lost on her. In this piece we hope to mollify her by noting that the poison allegedly added to the bombs in Israel could be any one of the generic anticoagulant rodenticides named above.)
Anticoagulant rodenticides all kill by inhibiting the process in which the liver produces clotting agents in the blood. Over time, Mr. Rat eats too much rodenticide, loses the ability to clot efficiently, and finally dies from uncontrolled bleeding.
These anticoagulants are poison for wildlife, but one of them—warfarin—is a spectacularly great medicine for human beings when meted out in the proper dose. Marketed under the Coumadin trade name by Bristol-Myers Squibb and available in generic form, warfarin is routinely prescribed to "thin the blood" of old folks with circulatory maladies. If your grandpop has had a stroke, undergone heart valve therapy, or suffers from deep vein thrombosis (blood clots in the legs), chances are good he's taken lots of warfarin.
Humans take warfarin orally, just like rats, but its action on mammals is the same if taken intravenously—or if introduced into the body by sizzling shrapnel, a Washington pharmacist who declines to be named tells me. But, he disputes whether the latter method would have the effect hypothesized by Dr. Rivkin. A "sprinkle" of warfarin won't block clotting immediately. When taken in its daily therapeutic doses, which range from 5 to 10 milligrams, warfarin requires between two and five days to inhibit clotting. Warfarin sensitivity varies widely from person to person, and only in an exceptional case can signs of reduced clotting come in one day.
So, logic argues against adding warfarin or one of its chemical cousins to a bomb: The stuff is not quick-acting, and oral doses of vitamin K1 halt its worst effects. In fact, the reason that the anticoagulant rodenticides are so widely used is that they are so safe. (Scroll to the middle of this page for additional treatments.) So the only additional punch warfarin might lend to a suicide bomb would psychological.