Legal Med Compiled Notes

1
LEGAL MEDICINE HAND OUT

College of Law
USA
TABLE OF CONTENTS
Page
SEX Crimes
Medico Legal Aspects of Death
Medico Legal Aspects of Physical
Injuries
Identification
Crime Scene Investigation
Abortion
Paternity and Filiation
Impotency and Sterility
Disturbance of Mentality
Drug Dependence
Alcoholism
Asphyxia
Death of Physical Injuries due
to Automotive Crash or Accident
Autopsy
Casuses of Death
Burns
2
6
10
13
17
19
20
21
21
22
22
22
25
26
27
29
SEX CRIMES
Virginity
Defloration
These are the official 2014 Gulp Club 7 Hand Outs for Legal Med prepared and released by members of the Gulp Club 7 and are distributed
only in soft copy primarily and exclusively to the GULP CLUB 7 members.
Death related to sexual act

Sex crimes
Rape
Seduction
Acts of lasciviousness
Abduction
Adultery and concubinage
Prostitution
1.
2.
3.
General condition of the hymen.

Original shape of the orifice.
If lacerated:
Sexual abnormalities
Virginity
It is a condition of a female who has not experienced sexual
intercourse and whose genital organs have not been altered by
carnal knowledge.
Kinds of virginity:
1.
2.
3.
4.
5.
6.
Moral virginity
Physical virginity
True physical virginity
False physical virginity
Demi-virginity
Virgo intacta
Determination of virginity:
Parts of the female body:
1.
2.
3.
4.
5.
Breasts
Vaginal canal
Labia majora and labia minora
Fourchette
Hymen
Degree of laceration
Location of laceration
Duration of laceration
Complications of lacerations
Degree of laceration of hymen:
1.
2.
3.
Incomplete laceration
-Superficial
-Deep
Complete laceration
Compound or complicated laceration
Duration of laceration of hymen:
Defloration:
It is the laceration or rupture of the hymen as a result of sexual
intercourse.
Determination of defloration:
Hymen:
Condition of the vulva-gaping or not

Fourchette- v shaped
Vaginal canal- decrease rugae
Hymen
Fresh bleeding laceration- recent

Fresh healing with fibrin formation with edema of the
surrounding tissues after 24 hours
Healed laceration with congested edges and with
sharp coaptible borders 4-10 days
Healed laceration with sharp coaptible borders without
congestion 2-3 weeks
Healed laceration with rounded non-coaptible borders
and retraction of edges 1 month
Complication of laceration of hymen:
Secondary infection
Hemorrhage
Fistula formation
Stricture
Sterility
Death related to sexual act:

1.
2.
-Use of force or intimidation:
Death of a male partner:

-Death from natural cause: increase demand in the
cardiovascular system.
-Death maybe due to the defensive act of a womanvictim.
Death of the female partner:

In case of oral sex: asphyxia
Accidental suffocation or strangulation during the act
In cunnilingus, air embolism
Infliction of injuries by saddist partner
Deliberately done to conceal the crime of rape
Shock as a result of extreme physical and mental
trauma in rape
Hemorrhage and infection
3.
Death of both partners

CO poisoning
Homicide-suicide pact
-The woman is deprived of her reason or otherwise

made unconscious
.
-The woman victim is less than 12 years old.
-Rape committed by depriving the victim of
her reason or otherwise made unconscious:
-Deprival of reason:
-Rape committed on insane or mentally
deficient woman.
-Rape committed while the woman is under
the influence of alcohol or other depressant
drugs
-Sexual act on a woman under the
influence of sex stimulating drugs.
-The woman victim is unconscious.
-Sexual act committed while the woman is
on her natural sleep.
-Sexual act on a woman suffering from
sleeping sickness.
-Sexual act on a woman who is
unconscious because she was knockedout.
-Sexual act after administration of narcotics
or other knock-out drugs.
Sex crimes:
Characteristics:
Ancient and universal

Close physical contact between the offender and the
victim
Crime by one sex against the other
Sex is an inborn instinct.
It is a crime committed in strict privacy.
Many sex crimes are not reported; undue publicity is
prejudicial to the reputation of the victim.
More frequent among lower socio-economic class.
Pardon and forgiveness will extinguish criminal liability
of offender.
The severity of punishment does not deter its
commission.
If the offender is past middle age, the victims are
usually children.
The psychic trauma suffered by the victim of sex
crimes varies with the moral standard of the victim.
Common in month of May.
-When the woman is under 12 years of age.

Instances when rape is punishable by death.
Carnal knowledge:
It is the act of man in having sexual bodily connection with a
woman.
Slightest penetration in the sexual organ of the female

by the sexual organ of a male.
Rape:
Elements of the crime:
The offender has carnal knowledge of the woman. The

victim of the crime must always be a woman while the
offender must inferentially be a man.
The carnal relation must be made under any of the

following circumstances:
When by reason or on the occasion of the rape, the

victim becomes insane.
When the rape is attempted or frustrated and a
homicide is committed by reason or on the occasion
thereof
When by reason or on the occasion of the rape, a
homicide is committed.
Medical evidences in rape:
MEDICAL EVIDENCES IN RAPE:

Evidences from the victim:
Date, time and place of alleged commission of rape.

Date, time and place of examination.
Condition of clothings.
The physician must observe the gait, the facial
expression and the bodily and mental attitude of the
subject.
Physical and mental development of the victim.
Physical exam, mental state
Examination of the body for signs of violence.
Tenderness and swelling, age of lesion, x-ray
Examination of the genitalia including the breast.

Breast, vulva, hymen, pubic hair, vaginal canal
Throat of the victim/ anal canal of the victim
Examination of seminal fluid:
Medical
1.
2.
Gross examination
Chemical examination
1. Florence test: presence of animal
substance; not specific for seminal fluid.
2. Berberio`s test: specific for spermatic
fluid.
3. Puramen test: reliable and characteristic
of seminal fluid
4. Acid phosphatase test: conclusive for the
presence of semen
3.
4.
-
evidences in rape:
1.
2.
Examination of the alleged offender.

Physical development, mental condition and
strength
Evidence of physical injury
Abrasions in the neck, chest, penis
Condition of sex organ.
Evidence from the pubic hair.
Potency of the offender.
Evidence of genital infection.
Evidences from te companion of the victim.
Investigation of the crime scene:

-
Disturbance in the place of the commission.

Strands of hair, blood, seminal fluid and other
stains to prove consummation.
Pieces of personal belongings of the
offender/victim maybe recovered.
Investigation of the witness.
Examination of seminal fluid:

-
Semen is a viscid, albuminous fluid with faint

grayish-yellow color, having the characteristic
fishy odor and containing spermatozoa, epithelial
cells, etc
Spermatozoa living organism present in
seminal fluid consisting of a head, neck and tail.
60 million per cc, 80% motile
Specimens to be examined for seminal fluid:

-
Wearing apparel of the victim and the allege

offender.
Vaginal smear from the victim.
Stains on the body of the victim and of the
accused.
Stains found at the site of the commission of the
offense.
Microscopic examination
Biological examination
Precipitin test: human or not
Seminal grouping
How long after sexual intercourse can spermatozoa be found

in the vaginal canal?
Vagina: 48 hours
Uterus and cervix: 2-4 days
Can a woman be raped while she is on her natural sleep?
For virgins: highly improbable
For multiparous: possible
Can a woman commit a crime of rape on a man?
She commits acts of lasciviousness.
Can rape cause death?
Death secondary to bleeding, shock and infection
Can the husband commits the crime of rape on his wife?
Other crimes against chastity:
Seduction: it is the act of man enticing women to have unlawful
intercourse with him by means of persuasion, solicitation,
promises, bribes or other means without employment of force.
Types:
-
Qualified seduction
Simple seduction
Seduction:
-
Qualified seduction:
-Ordinary qualified seduction
-Incestuous qualified seduction
Simple seduction:
-deceit
5
-
Medical evidences:
-Same as in rape but there is no application

of force
-Issue of age of the victim
Acts of lasciviousness:
1. These are acts which tend to excite lust;conduct which is
wanton, lewd, voluptuous or lewd emotion.
-Embracing, kissing and holding the woman`s breast
-Placing of the man`s private organ over the girls
genital organ.
2.
3.
4.
Prostitution is one of the venues in spreading

venereal disease and other diseases
Evidences may be gathered to prove sexual or
lascivious acts
Types:
-
Bar or tavern pick-up

Street walker
Door knocker
Factory girl
Effects of prostitution:
-
Acts of lasciviousness
Use of force or intimidation, depriving of reasons
or unconscious
Acts of lasciviousness with the consent of
offended party.
Medical evidence:presence of physical injuries
Arrest and imprisonment.

Venereal infection
Social ostracism
Poor personal hygiene
Excessive use of alcohol
Irregular habit or eating and sleeping
Demoralization and physical deterioration.
Sexual abnormalities:
Abduction:
-
1.
It is the carrying away of a woman by an
abductor with lewd design.
Lewd design: is the intent of the abductor to
have sexual intercourse with the woman
abducted
Two types:
-
Forcible abduction
Consented abduction
Adultery and concubinage:

Adultery: committed by any married woman who shall have
sexual intercourse with a man not her husband and by the man
who has carnal knowledge of her, knowing her to be married.
Concubinage: any husband who shall keep a mistress in the
conjugal dwelling, or, shall have sexual intercourse, with a woman
who is not his wife, or shall cohabit with her in any other place.
Prostitution:
They are women who, for money and profit, habitually indulge in
sexual intercourse or lascivious conduct.
Reasons:
-
Physiologic and psychological traits

Economic factors
Home and neighborhood
Influence of contraceptive
Poor social background with personality
handicaps
Previous sexual experience
Contact with a person in the fringe of prostitution.
Desire for money or forced by loneliness,
desertion or broken promises.
Prostitution:
Medico-legal aspects:
As to the choice of sexual partner:

Heterosexual
Homosexual
Overt
Latent
Infantosexual
Pedophilia (homosexual and heterosexual)
Bestosexual : bestiality or zoophilia
Autosexual: masturbation
Gerontophilia
Necrophilia
Incest
Reasons why physician fail to detect child sexual abuse.

-
The lack of hard physical evidence of abuse.

A belief that sexual abuse does not exist.
A fear of antagonizing parents.
Ignorance of how to obtain a detailed sexual
history from the child.
Theories why adults become interested in children:

1.
2.
3.
4.
Emotional congruence
Nondominant
Low self-esteem, immaturity, narcissism
Conditioning modeling early childhood
experience
Blockage-alternative sexual gratification is
unknown because of unresolved conflicts,
anxiety about sex
Disinhibition
Sexual abnormalities:
1.As to instinctual strength of sexual urge:
1. Over sex: compulsive neurosis

Satyriasis
6
2.
-
Nymphomania
Under-sex:
Sexual anesthesia
Dyspareunia
Vaginismus
Old age
Death
-
2.As to the mode of sexual expression:

-
Oralism
Fellatio, cunnilingus, anilism
Sado-masochism (algolagnia) pain as a factor
in gratification
Flaggelation, sadism(active), masochism
(passive), cannibalism, necrosadism, love
bites
Fetishism (an
gratification)
object
is
necessary
for
Anatomic, necrophilic, clothing, odor

(urolagnia, coprolagnia), pygmalionism,
narcissism, incendiarism, vampirism
3.As to visual stimulus:
-
Voyeurism
mixoscopia
4.As to the part of the body:

-
Sodomy
Uranism
Frottage
partialism
5.As to number:
-
Troilism (menage a trois`)

Pluralism
Is the termination of life

It is the complete cessation of all vital functions without
possibility of resuscitation.
It is an irreversible loss of the properties of living
matter.
Classification:
Brain death
Deep irreversible coma, absence of

electrical brain activity and complete
cessation of all vital functions without
possibility of resuscitation
Cardio-respiratory death
Occurs when there is a continuous and

persistent cessation of heart action and
respiration.
Brain Death
Unreceptivity and unresponsibility
No movement or breathing
No reflexes
Flat electroencephalogram
Importance of death determination
-
The civil personality of a natural person is extinguished

by death.
The property of a person is transmitted to his heirs at
the time of death.
The death of a partner is one of the causes of
dissolution of partnership agreement.
The death of either the principal or agent is a mode of
extinguishment of agency.
The criminal liability of a person is extinguished by
death.
The civil case for claims which does not survive is
dismissed upon death of defendant.
Kinds of Death
A. Kinds of Death
Somatic or clinical death
Others:
The state of the body in which there is

complete, continuous and persistent
Coprolalia (obscene language)
cessation of the vital functions of the brain,
Don Juanism
heart and lungs which maintain life and
Exhibitionism
health.
Molecular
or
cellular death
Sexual reversal:
Death of individual cells
Occurs about 3 6 hours after somatic

Tranvestism: psychic
identification wit the
death
opposite sex. Sexual maladjustment
Kinds of Death
Transexualism: surgical change of anatomic sex.
Apparent death or state of suspended animation
Intersexuality:
A transient loss of consciousness or

i.
Gonadal agenesis
temporary cessation of vital functions of the
ii.
Gonadal dysgenesis
body
iii.
True hemaphrodite
Important to determine to avoid premature

iv.
pseudohermaphrodite
burial
B. Signs of Deaths
Cessation of heart action and circulation
Cessation of respiration
Medico-legal Aspect of
Cooling of the body (algor mortis)
DEATH
Insensibility of the body and loss of power to move
7
-
Changes in the skin

Changes in and about the eye
Action of heat on the skin
1.Cessation of heart action and circulation

Methods of detecting heart action:
Palpation of the pulse
Wrist or neck
Auscultation of the heart sounds
at the precordial area
Difficult to hear in
stout person, with
pericardial effusion
Flouroscopic examination
Use of electrocardiograph best
method
Methods of detecting peripheral pulse
Magnus test
Bloodless zone when a ligature
is applied to the finger
Opening of small artery
Blood escapes in jerk.
Icard`s test
Injection
of
flourescein
subcutaneously
Pressure on fingernails
Zone of paleness at the site of
application
Diaphanous test
The finger webs are viewed in the strong
light; it appears red in living and yellow in
dead
Application of heat on the skin
There will be no blister formation in a dead
man
Palpation of radial pulse
Dropping of melted wax
There will be no inflammatory edema
around the melted wax.
2. Cessation of Respiration
Methods of detecting cessation of respiration:
Observe for chest movement
Listen to the chest with aid of stethoscope
Placing a mirror in front of the mouth and
nostrils ( no dimming in dead)
Placing a feather and cotton in front of lips
and nostrils (no movement in dead)
Winslow`s test (no movement of the image
formed by reflecting artificial or sun light
contained in the saucer placed on the chest
or abdomen of dead person)
3. Cooling of the body (algor mortis)
One of the most prominent signs of death
Fall of temp of 15-20 degrees Fahrenheit is certain
sign of death
Temp may fall before death in cases of cancer, sepsis,
cardiovascular collapse
Post-mortem caloricity rise of temperature of the

body after death due to rapid and early putrefactive
changes. Usually in the first 2 hours after death
Ex: peritonitis, liver abscess, yellow fever,
etc
Factors influencing the rate of cooling of the body
Factors that delay cooling
Obesity, pyrexial disease, death from
asphyxia
Clothing, small room, warm surroundings
Factors that accelerate cooling
Extreme age, leanness of the body, long
standing illness
Unclothed body, large room permitting the
dissipation of air, body in water
Estimation of time of death based on the cooling of the body

When the temp is normal at time of death the
average rate of fall during the first 2 hours is one half
the difference of the body temp and that of air; during
the next 2 hours, the fall is of the previous rate..and
so forth. As a rule the body attains a temp equal to
environment 12-15 hours after death
Formula: (N temp) 98.4F (rectal temp)
1.5
= approx nos of hrs after death
*Schourup`s formula
4. Insensibility of the body and loss of power to move
Should be observed in conjunction with other signs
Can occur in the living in the ff. conditions:
Apoplexy
Epilepsy
Trance
Catalepsy
Cerebral concussion
Hysteria
5. Changes in the skin
Pale and waxy looking; dependent area develop livid
discoloration due to pooling of blood
Loss of elasticity of the skin; post-mortem contact
flattening
Opacity of the skin
Loss of inflammatory reaction upon application of
melted wax.
6. Changes in and about the eye
Loss of corneal reflex
Clouding of the cornea
Flaccidity of the eyeball
Pupil is in the position of rest
Ophthalmoscopic findings
tache noir de la sclerotique
7. Action of heat on the skin
In a dead person, application of heat produces dry
blister without redness of surrounding skin.
CHANGES IN THE BODY AFTER DEATH
8
C. Changes in the body following death
Changes in the muscle
Changes in the blood
Autolytic or autodigestive changes
Putrefaction of the body
1.Changes in the muscles
A. Stage of primary flaccidity or period of muscular
irritability
Complete relaxation and softening of all
muscles and sphincters.
Muscles are still contractile and react to
external stimuli
About 3-6 hours after death ( 1 hour and 50
min in warm countries
Changes in the muscles
B. Stage of post-mortem rigidity, or cadaveric rigidity, or death
stiffening, or death struggle of muscles, or rigor mortis.
Starts 3-6 hours after death and complete by 12 hours
Muscles stiffen due to coagulation of muscle proteins
In temperate countries it may last for 2-3 days; in warm
countries 24 to 48 hours in cold weather and 18-36
hours in summer
Factors influencing onset of rigor mortis
State of the muscles
Rigor mortis appears late and prolonged in

healthy muscles
Age
Early onset in extreme of ages

Integrity
Delay onset in paralyzed muscles

Temperature
Accelerated by high temperature

Moisture
Rigor mortis starts early but shorter in

duration
Conditions simulating rigor mortis
Heat stiffening if the body is exposed to temp above
75 C
Body assumes pugilistic attitude with the

lower and upper extremities flexed
Cold stiffening
frozen; due to solidification of fat

Cadaveric spasm or instantaneous rigor
Cadaveric spasm
This is the instantaneous rigidity of the muscles which
occurs at the moment of death due to extreme nervous
tension, exhaustion and injury to the nervous system
or injury to the chest.
The voluntary muscle contraction does not stop after
death but is continuous with the cadaveric rigidity
Rigor mortis vs. cadaveric spasm
Rigor mortis
3-6 hrs after death
All muscles of body
Natural occurrence after death
Utilized to approximate time of death

Cadaveric spasm
Appears immediately after death

Muscle groups/asymmetrical
May or may not appear after death
Useful to determine the nature of crime
Changes in muscles
C. Stage of secondary flaccidity or secondary relaxation
- disappearance of rigor mortis
- due to dissolution of the muscle proteins which have
previously been coagulated
Changes in the blood
A. Coagulation of blood
- blood may remain fluid inside blood vessels for 6-8
hours after death
- ante-mortem clot: firm in consistency, surface of
blood vessels raw after clots are removed, homogenous and
uniform in color
-post-mortem clot: soft in consistency, surface of blood
vessels smooth and healthy after clots are removed, clots with
distinct layer and can be stripped off
2.Changes in blood
Post-mortem lividity or cadaveric lividity, or postmortem suggilation or post-mortem hypostasis or livor
mortis
Blood began to accumulate in the most

dependent portion of the body
Starts to appear 3-6 hours after death and

fully developed at 12 hours after .
If the body was moved during the early

stage of its formation, it may develop in the
dependent portion of the new position
Physical characteristics
It occurs in the most extensive areas of the most
dependent portions of the body
It only involves the superficial layers of the skin.
It does not appear elevated from the rest of the skin
The color is uniform but the color may become
greenish at the start of decomposition.
There is no injury to the skin
Importance of cadaviric lividity
It is one sign of the signs of death.
It may determine whether the position of the body has
been changed after its appearance in the body.
It may determine how long the person has been dead
It gives us an idea as to the time of death.
The color of the lividity may indicate the cause of
death:
Asphyxia lividity is dark
CO poisoning lividity is bright pink
Anemia less marked
Phosphorus dark brown
If the body is in ice or snow it is bright red

Kinds of post-mortem lividity
Hypostatic lividity
9
Blood gravitates to the most dependent
portion of the body still inside the blood
vessels and still fluid in form
Occurs in early stage of its formation
Any change in the position may lead to

formation of lividity to another place.
Diffusion lividity
Appears during the later stage of formation
Blood has coagulated or diffused into the

tissues.
Any change in the position will not change

the location of the lividity
3. Autolytic or autodigestive changes

Proteolytic, glycolytic, and lipolytic ferments of the
glandular tissue.
Facilitated by weak acid and higher temperature.
Can be observe in parenchymatous and glandular
tissues.
4. Putrefaction of the body
It is the breaking down of complex proteins into simpler
components associated with evolution of foul smelling
gases and accompanied by change in the color of the
body.
Tissue changes in putrefaction:
Changes in the color of the tissues
Change in color from greenish yellow to

greenish black; earliest seen in the iliac
fossa
marbolization
Evolution of gases in the tissues
CO2, ammonia, hydrogen, sulphurated

hydrogen,methane gases
Causes bloating of the body, frothy

secretions, expulsion of fetus
Causes floating of the body in water

Liquefaction of soft tissues
Factors modifying the rate of putrefaction
Age, condition of the body and cause of death
Free air
Moderate moisture, condition of

temperature of air, light
Earth
Water (running water vs still water)
Clothings
air,
Sequence of putrefactive changes in tropical regions

12 hours
Rigor mortis all over, hypostasis well developed and
fixed
24 hours
Ova of flies, trunk bloated,face swollen, blisters

present, moving maggots seen
72 hours
Whole body grossly swollen and disfigured,hair and
nails loose, tissues soft and discolored
1 week
Soft viscera putrified
2 weeks
Soft tissues
distinguishable
gone,
more
resistant
viscera
1 month
Body skeletonized
Putrefactive changes in water

4-5 days
Rigor mortis may be present. If cold, little changes is
seen
5-7days
Hands and feet sodden and bleached,face whitens
1-2 weeks
Face swollen and red,greenish discoloration,skin in
hands and feet are wrinkled
4 weeks
Skin wrinkled, scrotum and penis distended with
gas,lungs emphysematous
6 to 8 weeks
Abdomen distended, skin of hands and feet come off
with nails like a glove
Factors influencing the floating of the body in water
Infants and fetuses floats rapidly
Women floats sooner than men
Stout person floats quicker than lean and thin bodies.
Hot air of summer hasten putrefaction and floating
Body float sooner in shallow, stagnant water of ponds
and creeks than in running stream.
Body will float sooner in sea than fresh water.
Presence of weights will delay floating.
Agents of decomposition
Bacteria
Aerobic and anaerobic bacteria
Clostridium welchii
Flies
Maggots
Adult flies
Others
Reptiles,rodents,dogs,fishes and crabs
molds
Duration of Death
Presence of rigor mortis
Presence of post-mortem lividity
Onset of decomposition
48 hours
Stage of decomposition
Entomolgy of cadaver
Rigor mortis absent, greenish discoloration all over the

abdomen, distension of abdomen with gases
10
Stage of digestion of food in the stomach

Amount of urine in the bladder
State of clothing
Chemical changes in the Cerebrospinal fluid
Post-mortem clotting and decoagulation of blood
Presence or absence of soft tissues in skeletal
remains
Condition of bones
Temperature of the body
Presumption of Death
Rule 131, Sec.5, Rules of Court:
Disputable presumption:
That a person not heard from for
seven years, is dead.
Presumption of death:
Art. 390, Civil Code and Sec. 5,
Rule 131, Rules of Court:
After an absence of 7
years,
it
being
unknown whether or
not the absentee still
lives, he shall be
presumed dead for all
purposes, except for
those of succession.
The absentee shall
not be presumed
dead for the purpose
of
opening
his
succession till after
an absence of 10
years.
If
he
disappeared after the
age of 75 years, an
absence of 5 years
shall be sufficient in
order
that
his
succession maybe
opened.
Art. 391, Civil code and Sec.5,
Rule 131, Rules of Court:
The following shall be presumed dead for

all purposes, including the division of the
estate among the heirs:
A person on board a vessel lost
during a sea voyage, or an
aeroplane which is missing, who
has not been heard of for 4
years since the loss of the
vessel or aeroplane.
A person in the armed forces
who has taken part in the war,
and has been missing for 4
years.
A person who has been in
danger of death under other
circumstances and his existence
has not been known for 4 years.
Art. 392, Civil Code;
If the absentee appears, or without

appearing his existence is proved, he shall
recover his property in the condition in
which it may be found, and the price of any
property that may have been alienated or
the property acquired therewith; but he
cannot claim either fruits or rents.
Presumption of Survivorship
Sec. 5 (jj), Rules 131, Rules of Court:
When 2 persons perish in the same

calamity, such as wreck, battle, or
conflagration, it is not known who died first,
there are no particular circumstances from
which it can be inferred, the survivorship is
presumed from the probabilities resulting
from the strength and age of the sexes,
according to the following:
If both were under the age of 15
years, the older is presumed to
have survived.
If both were above the age of 60,
the younger is presumed to have
survived.
If one is under 15 and the other
above 60, the former is
presumed to have survived.
If both over 15 and under 60 and
the sexes be different, the male
is presumed to have survived; if
the sexes be the same, then the
older.
If one be under 15 or over 60,the
other between those ages, the
latter is presumed to have
survived.
Art. 43, Civil Code
If there is a doubt, as between two or more persons
who are called to succeed each other, as to which of them died
first, whoever alleges the death of one prior to another, shall
prove the same; in the absence of proof, it is presumed that they
died at the same time and there shall be no transmission of rights
from one to another.
MEDICO-LEGAL ASPECT OF PHYSICAL INJURIES
Causes of physical injuries:
Physical violence
Heat and cold
Electrical injury
Chemical injury
Radiation injury
Barotrauma
Infection
Wounds:
It is the solution of the natural continuity of any tissue

of the living body.
11
The effect of physical violence may not always result

to the production off wound but the wound is always
the effect of physical violence.
Physics of Wounds:
Wound=kinetic energy X time X area X other factors
Kinetic energy = (mass) (velocity)2
The greater the velocity, the greater is the magnitude

of injury.
The shorter the period of time needed for the transfer
of energy, the greater the likelihood of producing
damage.
The larger the area of contact between the force
applied on the body, the lesser is the damage.
The less elastic and plastic the tissue, the greater the
likelihood of laceration to occur.
Movements of body parts will cause stretching of
tissues causing internal injuries.
Tissue reaction to injuries:
rubor redness or congestion of the area due to

increase blood supply.
calor increase in temperature.
dolor pain
Loss of function
THE PRESENCE OF VITAL REACTIONS DIFFERENTIATES AN

ANTE-MORTEM FROM A POST-MORTEM INJURY.
Special types of wounds:
Blunt instrument
Sharp instrument
Tearing force
Barotrauma
Temperature
Explosion
Infection
Explosion
Electrical injury
As to manner of infliction
Hit
Thrust or stab
Gunpowder explosion
Sliding, rubbing or abrasion
As to the depth of the wounds
Defense wounds result of a person`s instinctive

reaction of self protection.
-Nightstick fracture
Patterned wounds wound in the nature and shape of
an instrument causing it.
Self-inflicted wound- wound produced on oneself. The
person has no intention to end life. (head banging, nail
biting)
Legal classification of physical injuries:

Mutilation it is the act of looping or cutting off any part or parts
of the human body
Kinds of mutilation:
Fatal injuries to the heart, big blood vessels, brain,

spinal cord, lungs
Non-fatal
As to kind of instrument
Coup-injury
Contre-coup
Coup contre-coup
Locus minoris resistencia
Extensive injuries
As to the regions or organs of the body involved.
Classification of Wounds:
As to severity
Superficial- only the layers of the skin

Deep
Penetrating
Perforating
As to the location of impact and injury.

2
Intentionally depriving a person, totally or

partially of some of the essential organs
of reproduction,
Intentionally depriving a person of any part
or parts of the human body other than
organs of reproduction
Is vasectomy and tubal ligation within the purview of

mutilation?
Classification of Physical Injuries as to time of medical
attendance:
Slight physical injury
Requiring medical attendance from 1 to 9 days

Requires medical certification
Less serious physical injury
Requiring medical attendance or incapacitated for 1030 days

Requires medical certification
Serious physical injury
Requiring medical attendance for more than 30 days
Types of Wounds:
12
Closed wounds
Superficial-wounds in the layers or beneath the skin
i.
Petechiae (not always a product of trauma)
ii.
Contusions may develop after several
minutes
iii.
Hematomas
iv.
Deep
Musculo-skeletal injuries sprain, dislocation, fracture,
strain and subluxations
Internal hemorrhage
Cerebral concussion
Age of contusions;
After injury:
red to purple
4-5 days: greenish
7th-14th day:
yellowish
14th day: gradually disappears.
Change of color from periphery inwards
.
Types of Wounds
Open wound
Abrasions
Incised wound
Stab wound
Punctured wound
Lacerated wound
Avulsed wound
Abrasions
Types:
Scratch (fingernails)
Graze
Impact or imprint abrasions
Pressure or friction abrasions
Distinction between ante-mortem and post-mortem

Incised Wounds
Cause by a sharp-edged instruments

Maybe an impact cut, slice cut, chopped or hacked
Characteristics: clean cut edges, gaping wound
May suicidal, homicidal or accidental
Distinction between suicidal and homicidal cut-throat:

Suicidal
Oblique wound
Usually superficial
Presence of superficial cuts
Sitting/facing a mirror
Weapon is grasped or lying beside the victim
Blood is in front of the body, bloody hand
History of mental illness
Homicidal
Horizontal wound
Usually deep
Maybe absent superficial cuts
Usually lying
Weapon is absent
Blood at the back of neck, hands clean
Absence of mental illness
Stab Wound
Descriptions
Edges serrated or clean cut

Length of the edges
Extremities single blade or double blade,three
cornered file
Direction of the surface wound
Depth of penetration
Location of the wound
Suicidal vs Homicidal Stab Wound:

Suicidal
Located in vital parts

Usually solitary
Accessible to the hand
Hands are bloody
Presence of cadaveric spasm
Wound tailing abrasion is towards the hand inflicting
No disturbance in scene
Wounding instrument with the victim
History of self destruction
Homicidal
Located in any parts of the body

Associated with other injuries
Multiple stab wounds
Disturbance in the crime scene
Punctured Wound:
Opening in the skin is very small

Cause by a thrust of a sharp-pointed instrument
Minimal bleeding externally
Lacerated Wound:
Characteristics:
Edges are irregular and rugged.

The borders of the wound are contused and swollen.
The size and shape of the wound does not conform to
the wounding instrument.
13
Usually located near the bony areas.

Bleeding not extensive.
Tendency to form scar.
Classification of lacerated wound:
Crushing of skin between two hard objects.

Overstretching of the skin.
Grinding compression.
Tearing
Factors responsible for the severity of wounds:
Bleeding
Size of injury
Organs involved
Shock
Foreign body or substance introduced into the body
Absence of medical or surgical intervention.
Fatal effects of the wounds:

Wound maybe directly fatal by reason of:
Hemorrhage
Mechanical injuries to vital organs
Shock
Wound maybe indirectly fatal by reason of:
Specific infections
Secondary hemorrhage following sepsis
Scarring effect
Secondary shock
Nature of death due to secondary causes:
Changes whose natural consequence are direct and

obvious.
Changes producing separate pathological lesions
which in turn proves to be fatal.
Changes where a definite pathological condition was
present before the injury.
Changes where a definite pathological condition of
totally different nature arises after the wounding.
Medico-legal investigation of wounds:
Character of the wound

Location of the wound
Depth of the wound
Condition of the surroundings
Extent of the wound
Direction of the wound
Number of wounds
Condition of the locality
Examination of the wounded body:

Living and dead body
Age of the wound, weapon

suicidal,homicidal or accidental
used,
whether
Living body
Fatal or non-fatal, presence of deformity, complications
Dead body
Ante mortem or post-mortem wound

Fatal or nonfatal
Suicidal or homicidal
Ante-mortem vs post-mortem wounds:

Ante-mortem
Copious bleeding
Spouting of blood
Clotted blood
Deep staining of edges
Gaping of edges
Presence of inflammatory process
Post-mortem
Minimal bleeding
No spouting of blood
Non-clotted blood
Edges are not deeply stained
Edges do not gape
No inflammatory process
IDENTIFICATION
Importance:
In criminal cases, the identity of the offender and the

victim must be established, otherwise it will be a
ground for dismissal.
The identity of the person missing or presumed dead

will facilitate settlement of estate, retirement,
insurance, etc
Identification resolves the anxiety of the next-of-kin as

to the whereabouts of the missing person.
Identification is needed in some transactions like

cashing a check, sale of property, etc.
Rules
The greater the number of points of similarities and

dissimilarities of two persons compared, the greater is
the probability for the conclusion to be correct. (Law of
Multiplicity of evidence in identification)
The value of different points of identification varies in

the formulation of conclusion.
The longer the interval between death and the

examination of the remains, the greater is the need for
the experts in establishing identity.
Methods
By comparison
By exclusion
By ordinary method
By scientific method
Methods of Identification
Ordinary methods of identification
14
Characteristics which may be changed
easily
Color of hair, mustache, clothing
Characteristics that may not be changed

easily
Speech, Gait, mannerisms,

facies, L or R handed
Scientific methods of identification
Fingerprinting,
dental
identification,
handwriting, skeletal identification
Light as a factor in identification
The best known person cannot be recognized by the

clearest moonlight at a distance greater than 16 to 17
yards.
In broad daylight, an unknown person can be

recognized at a distance of 25 yards.
With flash of firearm, it is possible to see the person

but assailant are usually hidden or the assault is
unexpected that attention of the person or witness is at
its minimum.
IDENTIFICATION
General appearance
Personal effects
Presence of scars, tattoos, moles, birthmarks and

other permanent marks
Presence of physical deformities or congenital defects
Fingerprints
Dental identification
X-ray and other health records
Skeletal remains
General appearance
Estimated weight and height
Determination of Age
Determination of Sex
Determination of Race
General nutritional status
Color of hair, skin and eyes

Methods of approximating the height
Distance between the tips of the middle fingers with

arms extended laterally
Two times the length from the vertex of the skull to the
symphysis pubis
Eight times the length of the head

Determination of age: Importance
As an aid to identification
Determination to criminal liability
Determination of the right of suffrage
Determination whether a person can exercise civil

rights
Determination of the capacity to contract marriage
As a requisite to certain crimes such as rape,

infanticide, seduction
Determination of age
Can be determined by:
Physical appearance
Appearance of ossification centers
Union of bones and epiphyses
Dental identification
Obliteration of cranial sutures
Adult has 32 permanent teeth
Presidential decree 1575
All dental practitioner should keep and

maintain accurate and complete record of
the dentition of all their patients.
Upon lapse of 10 years from the last entry,

the records shall be turned over to the NBI
Age based on eruption of teeth
Temporary
Central incisors: 6th month
Lateral incisors: 9th month
First molars: 12th month
Canines: 18th month
2nd molar: 2 years
Permanent
First molar: 6th year
Central incisors: 7th year
First bicuspid: 9th year
Canines: 11th year
3rd molar: 17th-18th year or later

Epiphysis
1-1 years anterior fontanelles closed
13 years ileum and pubic bone should be united
18-20 yrs head of the femur should have joined diaphysis
25 years and > all the epiphysis have united
Age determination in fetus
Haase`s rule:
For fetus of less than 25 cm long (crown

feet length), the age is the square root of
the length. Ex: In 16 cms fetus, the age is 4
months.
For fetus more than 25 cm, divide the

length by 5 and the result is the age.
Ex: if fetus is 40 cms, the age is 8 months.
Age determination in infancy
Age based on height and weight
Newborn: 50 cms
6 mos: 60 cms
1 yr:
68 cms
4 yrs: double the birth height

- newborn: 2.5-3 kg
. Increases weight by .5 kg /month
. At 1 yr weighs 3X the birth weight
Age determination in infancy
Physical characteristics of infant
Newborn : skin covered by vernix caseosa
After 24 hours: skin firm and less red
2nd 3rd day: skin yellowish tinge, umbilical

cord brown and dry
3rd 4th day: skin becomes more yellow,

umbilical cord brownish red and flattened
4th 6th day : umbilical cord separates from

abdomen
6th -12th day : cicatrization of umbilical cord

Other points to consider in determination of age:
Growth of pubic hair, beard and muscle
Changes of the breast in female
Development of voice
Changes in the color of hair
Grade or year in school or college
Menstruation in women
Manner of dressing, self beautification and social life
Atheromatous changes of blood vessels, opacity of

lens and cornea
Wrinkles of the skin
15
Degree of mental development

Determination of Sex
Legal Importance
As an aid in identification
To determine whether an individual can exercise

certain obligations vested by law to one sex only
Marriage or the union of a man and a woman
Rights granted by law are different to different sexes
There are certain crimes wherein a specific sex can

only be the offender or victim
Social test
Genital test
Gonadal test
Chromosomal test
Exception: gonadal agenesis and true hermaphrodism

Evidences of sex
Presumptive evidences
Highly probable evidences of sex
Conclusive evidences
Presumptive evidences:
General features and contour of face.
Presence or absence of hair in certain parts of the

body.
Length of scalp hair.
Clothes or wearing apparel.
Figures
Voice or manner of speech
Adam`s apple
Striaes in breast and abdomen.

Highly probable evidences of sex:
Possession of vagina, uterus and accessories in

female, and penis in male.
Presence of developed and large breast in female.
Muscular development and distribution of fat in the

body.
Conclusive evidence:
Presence of ovary in female and testis in males.

Determination of race
Color of the skin
Feature of the face
Shape of the skull
Wearing apparel
Tattoos
Information name, age , date of birth, religion, name

of spouse, social status, memberships
Can be remove by surgical excision, electrolysis, laser

or application by caustic substance
Scar
Remaining mark after healing of the wound
Characteristic scar may show cause
Age of scar
Personal effects
Type of clothing worn
Jewelry
Shoes
Atypical object in a victim or immediate vicinity

Handwriting
Writing maybe proven by the following:
Acknowledgement by the alleged writer.
Statement of a witness who saw the writing made.
By opinion of persons who are familiar with the

handwriting of the alleged writer.
By opinion of an expert who compares the questioned

writing with that of other writings which are admitted or
treated to be genuine by the party against whom the
evidence is offered.
Practical uses of handwriting examination.
Financial crimes
Death investigation
Robberies
Kidnapping with ransom
Anonymous threatening letters
Falsification of documents
Bibliotics the science of handwriting analysis
Graphology the study of handwriting for the purpose

of determining the writer`s personality, character and
aptitude.
Primary factors for analysis:
Form shape of the letter, proportion, slant, angles,

lines, retracing, connections and curves
Line quality results from the type of instrument used,

pressure exerted, flow and continuity of the script
Arrangement spacing, alignment, formatting and

distinctive punctuation
Content spelling, phrasing, punctuation and grammar

Standard (exemplar) writings:
Collected (procured) writings a known specimen

written by an identified person. It maybe from a public
or private records. This is the most appropriate
standard.
Requested standard the identified person is asked to

provide handwriting samples. Contemporaneous.
Characteristics of disguised writing:
Inconsistent slant
Inconsistent letter formation
Change of capital letters
Lack of free flowing movement
Lack of rhythm
Unnatural starts and stops
Irregular spacing
Writing with unaccustomed hand

Forgery
Traced forgery
Simulated forgery
Spurious forgery
Fingerprints
Most valuable method of identification
No two identical fingerprints
Dactylography art and study of recording fingerprints

as a means of identification.
Dactyloscopy art of identification by comparison of

fingerprints.
Poroscopy study of pores found on the pappilary or

friction ridges of the skin.
Kinds of impressions:
Real impression
Chance impression
Visible print made by chance and visible

without previous treatment
Plastic print made by chance by pressing

the fingertips on melted paraffin,
cellophane, plastic tape
Latent print prints not visible after

impression but made visible by addition of
substances. Ex: application of fine powder.
16
Methods
Plain method
Rolled method
In dead bodies
Automated fingerprint identification system (AFIS)
Arch
Loops
whorls
DNA
Forensic DNA
DNA
First use in 1985
First accepted as court evidence in 1986 (serial rapist
Tommie Lee Andrews)
It cannot distinguish between identical twins.
It should pass tests of acceptability in the scientific

community.
Faces few challenges from the court.
Loopholes: handling of samples,interpretation of

samples
DNA FINGERPRINTING
DNA profile of an individual
Unique DNA sequence
Can be determined from any tissues of the body
DNA data bank: CODIS (Combined DNA Index System

Can be useD in the following:
Identify potential suspects whose DNA may match

evidence left in the crime scenes
Exonerate persons wrongly accused of the crimes.
Identify crime and catastrophic victims
Establish paternity and other family relationships

DNA technologies:
Restriction Fragment Length Polymorphism (RFLP)
Polymerase Chain Reaction Analysis (PCR analysis)
Short Tandem Repeat (STR) Analysis
Mitochondrial DNA Analysis
Y Chromosome analysis
Concerns about DNA Databanking
Intrusion into privacy
Expensive
Vidocq Society
The advances in technology (DNA) and profiling of

criminals causes an increase in re-investigation of
unsolved cases.
The Vidocq Society is founded by forensic

professionals to brainstorm on past unsolved cases.
From French police surgeon Eugene Vidocq, the father

of modern criminal investigation.
Forensic Medicine
Goal:
Scientific method:
Observation and collection of data

Conjecture of collected data (analysis)
Formulation of hypothesis
Testing the hypothesis or reconstruction
Theory
Forensic Medicine
The application of medical science to elucidate legal

problems
Dr. William J. Currran
Legal Medicine
The application of medicine to legal science.
Dr. Pedro Solis
Deals with investigation, preparation, preservation and

presentation of evidence and medical opinion in courts
Dr. Pedro Solis
Areas of medicine concerned with relations with

substantive law and with legal institutions
Dr. William Curran
Medicolegal practitioners
Doctors handling medicolegal cases

o Health officers
o Medical officers of law enforcement agency
o Members of medical staff of accredited
hospital
Private practitioners
PNP criminal laboratory
NBI criminal laboratory
Forensic Science in the Philippines

The goal of this course is to provide law students with
fundamentals of forensic science and equip them with
knowledge needed for the law profession.
Definition:
Forensic science science that is applied to legal

matters.
Spanish regime
o Medico Titulares in charged of public
sanitation and medico-legal aid
American regime
o Medico-Titulares under the Board of Health
Philippine Republic
Latin: forensis public; of a forum
17
o
o
Medico-legal Division was established at

the PGH and was later transfer under the
authority of Department of Justice.
In 1947, the Medico-legal Division was
transferred to the National Bureau of
Investigation
Forensic sciences
Forensic anthropology
Forensic medicine
Forensic pathology
Forensic pschiatry/psychology
Forensic meteorology
Forensic DNA analysis
Forensic odontology
Forensic archeologist
Forensic entomology
Forensic chemistry and toxicology
Fingerprint experts
Handwriting experts
Forensic linguistics
Forensic nursing, etc
Victims of physical injuries cause by any of the following.
GSW, SW, mauling, etc.

VA
Asphyxia
Electrocution, burns
Accident, homicide or suicide
Poisoning
Cases of child abuse, domestic violence, rape,
alcoholism and drug addiction.
Cases involving mental competency of the patient.

Iatrogenic causes brought about by negligent acts or
omissions of the hospital staff resulting in violation of
rights of patients or leading to patient`s physical and
mental incapacitation, physical injury and death.
Under Philippine Laws, medico-legal deaths must
undergo mandatory autopsy.
CRIME SCENE INVESTIGATION:
Scope of Forensic Medicine
Crime Scene Investigation

Medico-legal aspects of Identification
Medico-legal aspect of Death
Causes of Death and Conduct of Autopsy
Medico-legal aspect of Physical Injuries
Ballistics
Sex Crimes
Pregnancy/Abortion/Paternity and Filiation
Disturbance of Mentality
Alcoholism and Poisoning
Medico-legal cases
Injuries or death involving persons who have no

means of being identified.
Persons pronounced as dead on arrival.
Deaths under the following circumstances:
Death occurring within 24 hours of
o admission when cause of death is unknown
Unexpected death when the decease is in
o apparent good health
Death due to natural cause but with
o physical evidence of foul play.
Death as a result of violence, accident,
o suicide or poisoning.
Death due to improper or negligent act
o of another person.
Crime scene: It is the place where the essential

ingredients of the criminal act took place.
Crime scene investigation: collection of the physical
evidences that may lead to the identity of the
perpetrator, the manner the criminal act was executed
and other things that may be useful in the prosecution
of the case.
Members of the team:
Police investigators
Medico-legal experts (medical examiners)
Fingerprint experts
Photographer
Chemist
Sketch artist
Evidence recorder
Methods of conducting the search:
Strip method
Double strip or grid method
Spiral method
Wheel method
Zone method
Salient points:
Determine if the victim is alive or not.

Preserve the scene of the crime until proper
markings/photographs are taken.
The scene of the crime must be cordoned off.
The immediate environment inspected for clue and
evidences.
18
Evidence collected must be properly identified, sealed

and signed by the investigator and endorsed to the
custodian.
Evidence
All evidences collected must be protected, identified

and preserved.
Evidence custodian is responsible to preserve the
shape, minimize contamination and chemical changes
and transfer of evidences.
Types of evidences:
Autoptic or real evidence
Limitations
Indecency
and
impropriety
Repulsive
objects
and those offensive
to the sensibilities
o Testimonial evidence
Ordinary witness
Expert witness
o Experimental evidence
o Documentary evidence
Medical certification/report
Medical expert opinion
deposition
Physical evidence
o Corpus delicti evidence
o Associative evidence
o Tracing evidence
o
Physical evidence examination should prove:
That a crime has indeed taken place.

Determine the perpetrators MO.
Establish contact between a victim and a suspect.
Establish contact between a person and a scene.
Support or disprove a witness`testimony
Provide investigative lead.
Preservation of evidence
Photographs, audio/video tape, micro film

Sketching
o Rough sketch
o Finished sketch
Description
Manikin method
Preservation in the mind of the witness
Special methods
Death or Physical Injuries caused by Explosion

Classification of explosion as to the source of energy:
Mechanical (Hydraulic ) explosion

Spray canister, water tank, kerosene burner
Electrical explosion
Arcing of electricity, lightning
Nuclear explosion
Atomic explosion
Chemical explosion
Brought about by chemical explosion
Chemical explosion:
Diffused reactant explosion

Condensed reactant explosion
Low order explosives
High order explosives
Stable high order explosives
Unstable high order explosives
Injuries are due to:
Close
contact:
complete
disintegration
or
fragmentation of the body parts
Near the explosion: body in one piece but some parts
maybe dismembered. Triad of punctate bruises,
abrasions and lacerations are found
At a distant: peppering
Blast wave:airway injury, rupture of tympanic
membrane
Burns: flame or heated gas
Asphyxia: lack of oxygen
Gas poisoning
Falling debris
Investigation:
Presence of crater
Traces of detonation mechanism; residues
Collection of gas
Scrapings
Color spot tests
Atomic bomb explosion:
Fission of uranium producing millions of pounds of gas

pressure.
Creates fireball with a diameter of 7,200 feet in ten
seconds and height of 4 miles
Emits radiation: alpha, beta, gamma and neutron rays
Effects of atomic explosion in the body:
Local effects: chromosomal aberrations, radiation

dermatitis,endothelial necrosis and thrombosis,
cataract and sterility
19
General effects: generalized erythema, coma and

death, vomiting and leukemia, leukopenia
Long term effects: cancer
Other sources of radiation:
Natural source
Cosmic
Terrestial origin
Man-made source
Diagnostic x-ray equipment
Clinical nuclear pharmaceutical agent
Therapeutic radiation apparatus
Nuclear power plants
Thermal Injuries and Death

Death or injury from cold
Systemic: death due to cerebral anoxia and cold stiffening
Local effects: frostbite, immersion foot, trench foot
Death or injury from heat

Systemic effects:heat cramps, heat exhaustion, heat stroke
Local effects: Burns / scald
Burns:
Moist heat
Scalding
geographical lesions
Clothings and hair are not burned
Blisters are formed with redness around
Usually not fatal; death is due to sepsis
Dry heat
Thermal
Chemical
Electrical
Radiation
Friction
Burns:
Characteristics:
From redness to carbonization of the body

Singeing of hair and carbon deposits
Areas involved are without demarcation line.
Classifications:
1st degree: sunburn

2nd degree: vesicle formation; superficial skin
3rd degree:whole layer of the skin
4th degree:whole layer of skin and the subcutaneous
tissues
5th degree: muscles
Purpose of intentional fire:
To conceal identity and true cause and manner of

death.
To kill or with homicidal intent (torch murder).
The victims might have committed suicide by other
means and try to hide the cause and manner of death
by setting fire on the surroundings.
To perpetuate insurance fraud both property and life.
Victim might have been trapped in the building set afire
accidentally or intentionally
A person in pursuance of a cause may soak himself
with an inflammable substance and burn himself to
death.
Cause of death in burns:
Immediate: shock, associated physical injuries,

suffocation
Delayed: shock, exhaustion, complications- sepsis,
multi-organ failure
Time required to completely burn the body:
Depends on: intensity of heat applied, duration,
physical condition, and presence of clothing
In incinerator: 4 hours to transform the body to ashes.
Proof that the victim was alive before burned to death:
Presence of smoke in the air passages.

Increase carboxy-hemoglobin blood level.
Dermal erythema, edema and vesicle formation.
Subendocardial left ventricular hemorrhage.
Distinction between ante-mortem and post-mortem burns

Investigation:
Determine the following:
Establish the identity: clothing, size of footwear,

properties in the pockets, physical characteristics,
scars
Whether the person was alive in the fire.
Cause of death.
Information indicating a possible cause of fire
Medico-legal aspect of burns and scald
Branding
Torture
Accidental
Spontaneous combustibility
Preternatural combustibility
Others:
Chemical burns:
Sulphuric acid
Nitric acid
Hydrochloric acid
Caustic soda
Electrical burns:
Contact burn
20
Age of viability: fetus id potentially able to live outside the

mother`s womb although with respiratory aid.
Elements of the crime:
That the expulsion of the product of
conception is induced.
Physical Injuries or Death by Lightning and Electricity
That the fetus dies either as an effect of the
Lightning and electricity:
violence used, drug administered or the
Electricity:
fetus was expelled before the term of its
viability.
Domestic lines: 100-250 volts

Abortion:
Clinical type:
Lightning:
Missed abortion
Threatened abortion (cervix close)
It is an electrical charge in the atmosphere.

Inevitable abortion (cervix dilated)
1,000 million volts and about 2,000 amperes.

Incomplete abortion
Complete abortion
Lightning:
A. Elements of lightning that produce injury:
Kinds of abortion:
1. Direct effect from the electrical charge
Spontaneous or natural abortion
2. Surface flash burns
Induced abortion
3. Mechanical effect
Therapeutic abortion
4. Compression effect
Criminal abortion
B. Points to consider:
Post-mortem abortion
1. History of thunderstorm
How abortion is induced or procured:
2. Evidences in the surrounding
By general violence (inflicted or violent exercise)
3. Absence of other wounds and other injuries
By local violence
Lightning:
By the use of drugs (abortifacient)
Classes of burns:
By surgical intervention (D & C)
Others: amniocentesis, vacuum suction
Surface burns
Medical evidences of abortion:
Linear burns
In the living:
Arborescent or filigree burns

Presence of external signs of violence
Examination of generative tract.
Medico-legal aspect:
Examination of instrument for the presence
of blood, fetal parts
Eliminate the possibility of a felonious act of another

History
person
Signs of previous pregnancy
Electrical shock:
Examination of the expelled product of
conception
Mechanism of death:
In the dead:
Evidence of instrumentation
Ventricular fibrillation
Examination of stomach and its contents
Respiratory failure
Examination of the kidney and other organs
Mechanical asphyxia
for irritants
Examination of the uterine contents.
Factors that influence the effect of electrical shock:
Biological test.
Personal idiosyncracy
Examination of some untoward effects of
Disease (cardiac)
abortion.
Infection, toxemia
Sleep
In the fetus:
Electrical voltage, amperage, density of current, nature

Blood examination for paternity and
of the current
maternity.
Resistance of the body, duration of contact

Marks of instrumentation
Point of entry
Signs of physical violence
Earthing
Proof of viability or non-viability
Presence of abortive drugs
Abortion
Presence or absence of malformation
Abortion:
Completeness of the placenta.
Expulsion (forcible) of the contents of gravid uterus
Grounds for therapeutic abortion:
anytime before full term or age of viability.
Cardiovascular condition such as CHF, severe cardiac
arrthymias, repeated hemoptysis.
Spark burn
Flash burn
Radiation burns
21
Renal condition such as Renal failure.

Advanced TB
Blood dyscrasias
Organic nervous condition such as psychosis
Diabetes, toxic goiter
Hereditary insanity
Reasons why it is difficult to prosecute physicians

committing the crime of abortion:
The crime is performed clandestinely.
The physician has several reasons to justify the act.
The product of conception is removed or disposed.
The pregnant woman is in connivance with the
physician.
Medical society has a lukewarm attitude on abortionist.
Infanticide:
The killing of a child less than 3 days old.
Motives:
To conceal dishonor
Financial reason
Desired number of children has already
been attained.
Congenital abnormality of the child.
Belief that the child will bring bad luck to the
family.
Criminological characteristics:
It is most often committed by the mother.
The criminal act is almost always committed at home.
The crime scene has no disturbance.
The trauma applied si so minimal.
A newly born child found dead was born dead.
Complete examination shows marks of physical

violence.
Examination of the mouth and gastro-intestinal tract
shows signs of poisoning.
Injuries to the air passages and lungs.
Fractures of the bone, lacerations of internal organs.
Toxicology reports of internal organs.
Paternity and filiation:

Paternity: civil status of the father with respect to the child
begotten by him.
Filiation: civil status of the child in relation to its mother or father.
Legal importance:
For succession
For enforcement of the naturalization and
immigration laws.
Paternity and Filiation.
A. Medical evidence
1. Parental likeness
2. Blood group test
3. Evidences from the mother
a. proofs of previous delivery
b. proofs of physical potency and fertility
c. proof of capacity to have access with the
husband
4. Evidences from the father
a. proof of physical potency and fertility
b. proof of access
B. Non-medical evidence
Parental likeness:
General feature
Manner of gesture
Personal pecularities
Personal deformities
How the crime is committed:
Gait, speech, movement
By omission or neglect
Color and texture of hair
By failure to protect the child from heat or
Color of the eyes
cold
General built and size
Failure to take the necessary help of a
Non-conventional method of procreation:
midwife or a skilled physician
Artificial insemination: the semen is introduced into the
Failure to supply the child with proper food.
vagina by means other than copulation
Failure to remove the child from the
In-vitro fertilization
mother`s discharge which resulted to
Artificial inovulation
suffocation.
Type of evidences in infanticide:
Embryo transplantation
Prosecution must show the following proofs:
Parthenogenesis
That the child was born alive.
Cloning
That the child was deliberately killed.
Artificial insemination:
That the child killed was less than 3 days
Types: AIH, AID, AIHD
Indications: failure of coitus, poor motility or paucity
old.
Selections: screening
By commission:
Precautions
Inflicting physical injuries.
Consent
Suffocation
Status of a child
Strangulation
In vitro fertilization
Drowning
Procedure
Poisoning
Possible situations
Burning
Wife (fallopian tube is blocked)
Deliberate exposure to heat or cold
Husband
Shaken baby syndrome
Surrogate mother
Shaken baby syndrome
Sperm donor
Post-mortem findings in infanticide:
Problems:
22
Defective baby
Problem of surrogate mother
Status of the child
Basis of legality of in-vitro fertilization:
Right of procreation
Right of marital privacy
Right to decide whether to bear or beget
Right of self-determination.
Marital union:
Causes of sexual dissatisfaction after marital union:
Fear of consequence of repeated abortion
Fear of unwanted pregnancy
Faulty contraceptive methods (inadequate
opportunity for orgasm)
Dyspareunia
(vaginismus,
improper
technique)
Fear of coitus
Emotional frustration due to fertility.
Ignorance of the reproductive process and
genital anatomy.
Aversion to coitus. (frigidity)
No sex desire
Anatomic cause of unsatisfaction in coitus
(tight hymen, size and location of clitoris,
extreme obesity, infantile genital dev.
Disparity in age
Venereal disease
Masturbation preferred to coitus.
Infidelity
Marital union and dissolution:
Causes of non-consummation of sexual act:
Septate hymen, thick hymen, fear of pain or
inability to stand pain, ignorance of genital
anatomy,ignorance of sex technique, fear of
pregnancy, sense of shame regarding sex
and coitus
Contraceptive methods
Condom,
coitus
interruptus,
douche,suppository, safe period, no sex,
vaginal
diaphragm,contraceptive
jelly,external
coitus,lactation,abstinence,
vasectomy
Impotency and Sterility
Impotency- is the physical incapacity of either sex to allow or
grant to the other legitimate sexual gratification.
Causes: age, illness, emotion, hormonal
dysfunction, congenital defects, disease or
accident
Sterility is the loss of power of procreation
Absolute (azoospermia) and oligospermia
Legal importance of impotency:
Impotency, if proven, will overthrow the presumption of
legitimacy.
Impotency may be a ground for the annulment of
marriage.
Impotency maybe a defense in rape.
Impotency maybe a cause to the development of
abnormal sexual behavior.
Impotency maybe a cause for the development of
suicide tendency.
Methods of sterilization:
Male: removal of testis, ligation of tubular
passage of sperm (vasectomy)
Female: removal of ovary, ligation of
fallopian tube
Removal of uterus
Causes of sterility: Male and female
General: pre-pubertal age
Local: congenital conditions, acquired
(disease or trauma)
Disturbance of Mentality:
Insanity: prolonged departure of the individual from his natural
mental state. Inability to adapt oneself to the ordinary
environment.
Factors having positive correlation with the development of
mental disorder.
Heredity
Incestuous marriage
Impaired vitality
Poor moral training and breeding
Psychic factors
Physical factors
Non-toxic
toxic
Factors having positive correlation with the development of
mental disorder.
Heredity
Incestuous marriage
Impaired vitality- grief, mental worry
Poor moral training and breeding
Psychic factors
Physical factors
Toxic
Non-toxic
Manifestations of mental disorders:
1. Disorder of cognition (knowing)
1. Perception: illusion, hallucination
2. Memory: dementia, amnesia
3. Content of thought: delusion, obsession
4. Trend of thought: mania, melancholia
2. Disorder of emotion (feeling)
Exaltation, depression, apathy, phobia, fear of illness
or death
1. Disorder of volition or conation (doing)
Impulsion or impulse (kleptomania, pyromania)
Steps in diagnosis of mental affection:
1. Family history, personal history, information from
relatives, friends and neighbors.
2. Physical examination
3. Instrumentations: EEG, CT scan
4. Mental examinations:
Pyschological testing
Psychiatric evaluation
Mental deficiency:
Classification:
Profound: IQ under 20
Severe: IQ of 20-35
Moderate: IQ of 36-51
Mild: IQ of 52-67
Idiot :IQ of 0-20
imbecile :IQ of 20-40
23
Feeble-minded: IQ of 40-70 (moron)
Moral defective
Methods of estimating mental capacity:
Intelligence tests
Intelligence quotient
Other conditions manifesting disturbance of mentality:
Somnabulism
Semisomnolence
Hypnotism or mesmerism
Delirium
Drug Dependence
Dangerous drug
Prohibited drug
Opium, heroin and morphine
Coca leaf, cocaine
LSD
Regulated drug
Sedatives
Amphetamines
Hypnotic drugs
Drug addiction:
Is a state of periodic or chronic intoxication produced by the
repeated consumption of a drug, whether synthetic or natural and
found to be detrimental to the individual.
Characteristics:
An overpowering desire or need
(compulsive) to continue taking the drug or
to obtain it by any means.
A tendency to increase the dose.
A psychological and physical dependence
on the effects of the drug.
A detrimental effect to the society and to
individual.
Pharmacologic Classification of Dangerous Drugs:
Hypnotics
Opiates and their derivatives
Sedatives and tranquilizers
Barbiturates, methaqualone,
Hallucinations and psychomimetics
Marijuana, LSD
Stimulants
Amphetamines,cocaine
Deliriants and intoxicants
Skin popping: subcutaneous cocaine injection
Subcutaneous hemorrhage: cocaine injection
Diagnosis of drug dependence:
Blood
Alcoholism:
Made from ethyl alcohol formed out of the fermentation
of various grains, fruits etc
Provisions of law regarding alcoholism.
Classification of alcoholic beverages:
Wine
Distilled liquor: whiskey, gin,rum, vodka
Malt liquors: ale, beer, stout
Effects of alcohol:
10 mg% Pleasant clearing of the head.
20 mg% Physical feeling of well-being.
50 mg% self-confidence,
inhibitions, diminution of
attention, judgment and control.
100 mg% Intoxicated; under the influence;mental
confusion, incompetency
150-300 mg% Loss of muscular coordination, slurred
speech
>300mg % Stuporous, loss of sphincter control
400 mg% Anesthetic level; death
Degree of intoxication:
Slight inebriation: flushing
Moderate inebriation: talkative, argumentative and
overconfident
Drunk: confused, movement uncontrolled, behavior
uncontrollable
Very drunk: disoriented, motor incoordination, difficulty
in speech
Coma: stuporous or comatose
Diagnostic point of drunkeness:
Alcoholic smell of the breath or vomitus.
Dry furred tongue or with excessive salivation.
Irregular behavior
Congestion of the conjunctiva.
Hesitancy or thickness of speech with impaired
articulation.
Tremor or error of coordination and orientation.
Examination of the blood and urine.
History of having taken alcoholic beverages.
Physical test to determine drunkeness:
Romberg`s test
Let subject stand straight with one foot ahead of the
others. Compare.
Let subject sit comfortably and get samples of
handwriting. Compare.
Let subject bend down and pick up a small object from
the floor.
Let subject walk straight forward to a corner of a room
and back without stopping.
Blood alcohol level:
0.5 % or < - presumed not influenced by alcohol
0.5% to 0.10% - possibly under the influenced of
alcohol.
0.10% to 0.15% - presumption that the person is
drunk.
Why are chronic alcoholics able to tolerate better?
Consumption tolerance
Constitutional tolerance
AIDS/HIV
HIV infection
Acquired Immune Deficiency Syndrome (AIDS)
Misconceptions
Mode of transfer
Best protection
Rights and duties of HIV carrier and AIDS victims:
Discrimination in the workplace
Discrimination in school
Discrimination in hospitals and health institutions
Responsibilities of infected individual
Death by asphyxia
Types of asphyxial death:
24
Anoxic death
Anemic anoxic death
Stagnant anoxic death
Histotoxic anoxic death
Phases of asphyxial death:
Dyspneic phase
Convulsive phase
Apneic phase
Classification of asphyxia:
Hanging
Strangulation
Suffocation
Asphyxia by submersion or drowning
Asphyxia by pressure on the chest
Asphyxia by irrespirable gases
Asphyxia by hanging:
The constricting force is the weight of the body.
Mechanism of death
Constriction of the larynx
Compression of veins and arteries
Compression of nerves
The thinner and tougher the ligature, the more
pronounced the mark in the skin
The presence of a noose
Application of ligature
Position of the knot
As to the location of ligature:
Typical
Atypical
As to the amount of constricting force:
Complete
Partial
As to symmetry:
Asymmetrical
Symmetrical
Ligature in hanging:
Materials used in ligature
Noose
Mode of application of the ligature
Position of the knot
Course of ligature around the neck.
Hanging: Investigation
The rule is that hanging is suicidal unless there are
evidences to show that it is not.
Determine whether hanging is ante-mortem or postmortem
Presence of vital reaction
Determine whether hanging is accidental, homicidal or
suicidal
Presence of signs of struggle
Presence of other injuries or defense
wounds
Asphyxia by strangulation:
Compression of the neck by means of a ligature which is
tightened by force
Causes of death:
Asphyxia due to occlusion of windpipe
Coma due to arrest of cerebral circulation
Shock or syncope
Inhibition of the respiratory center due to

pressure ion the vagus and sympathetic
nerves
Asphyxia by hanging:
Time required in the process of death depends on:
Severity of constricting force
Jugular veins 2 kilos
Carotid artery 5 kilos
Trachea 15 kilos
Vertebral artery 30 kilos

Point of application of the ligature of the
knot
Physical condition of the subject
Postmortem findings in hanging versus strangulation:
Hanging
Hyoid bone is frequently injured
Direction of the ligature is inverted V shape
with apex as the site of the knot
Ligature is at the level of hyoid bone
Ligature groove is deepest at the opposite
side of the knot
Vertebral injury is frequently observed
Strangulation by ligature
Hyoid bone is frequently spared
Ligature mark is usually horizontal
Ligature is usually below the larynx.
Ligature groove is uniform in depth in its
whole course
Vertebral injury is not observed
Asphyxia by strangulation:
Strangulation by ligature
Ligature tightened by force
Common in infanticide
Manual strangulation or throttling
Manual strangulation or throttling:
Methods of throttling
Manner of death:
Blockage of air passage
Compression of blood vessels
Compression of the nerves
Suicidal throttling is not possible
Accidental throttling
Common method in infanticide
Special forms of strangulation:
Palmar strangulation
Garroting
Form of judicial execution
Mugging (strangle hold)
As seen in wrestling
Compression of the neck with a stick
Asphyxia by suffocation:
Occlusion of air from the lungs by closure of air
openings or obstruction of the air passageway
Smothering maybe in the form of:
Overlaying
Accidental smothering of epileptic
Gagging
Plastic bag suffocation
Choking:impaction of foreign body in the airway: food,
vomitus, dentures, blood
25
Caf`coronary
Asphyxia by submersion or drowning:
Phases:
Respiration de surprise
Phase of resistance
Dyspneic phase
apneic phase
Terminal respiration
Causes:
Typical drowning- asphyxia
Atypical
drowning-cardiac
inhibition,
laryngeal spasm, unconscious
Other condition the body strikes a hard
object in the water, intoxicated, presence of
cramps, cold exposure
Drowning:
Average time for death to occur: 2-5 minutes; the
amount of froth in the respiratory tract is proportional to
the length of survival.
Questions:
Did death occurs prior to entry in the water?
Did drowning cause death?
Were there any ante-mortem injuries?
Were there any post-mortem injuries?
Was there a natural disease or any
evidence of poisoning?
What was the manner of death?
Post-mortem findings:
External findings
Clothes are wet, face is pale
Skin is puckered, pale, contracted (cutis
anserina or gooseflesh)
Penis and scrotum are contracted and
retracted.
Washerwoman`s hand and feet
Mouth half-opened with tongue protruding
Post-mortem lividity is most marked in the
head, neck and chest.
Presence of cadaveric spasm
In suicidal drowning, pieces of stone in the
pockets
Postmortem findings:
Internal findings:
Emphysema aquosum
edema aquosum
champignon d`ocume
Heart: the blood chloride content is greater
in the left side of the heart if drowning took
place in salty water (Gettler`s test)
Stomach: absence of water in the stomach
shows death is rapid or submersion is
made after death.
Brain: congested
Blood: difference in the chloride content, it
becomes dark, decrease hemoglobin
Findings conclusive that the person died of drowning:
Presence of materials in the hands of the victim.
(clenching)
Increase in volume and edema of the lungs.
Presence of water and fluid in the stomach contents.

Presence of froth, foam or foreign bodies in the air
passages.
Presence of water in the middle ear.
Floating of body in drowning:
Body floats within 24 hours of death due to
decomposition (gas formation).
Floating is with flexed extremities, head submerged
tete de nigre dark bloated face as seen in
decomposing body in water.
Compression asphyxia(Traumatic or crush asphyxia)
Exchange of air is prevented by the immobility of the
chest and abdomen due to external pressure or crush
injury:
Assailant may kneel on the chest of the
victim or between arms and legs as in
wrestling.
Sudden fall of earth or masonry
Pinned under the rubble of a collapsed
building.
Crushed in a highway accident.
Crushed in crowd.
Traumatic asphyxia:
Burking:
Burke and Hare
Traumatic asphyxial death
Sitting or kneeling on the chest of the victim
with hands closed on the nostrils and
mouth.
No external marks
Crucifixion
Asphyxia by breathing irrespirable gases:
Carbon monoxide
Carbon dioxide
Hydrogen sulfide
Hydrogen cyanide
Sulfur dioxide
War gases
Carbon monoxide:
Incomplete combustion of carbon fuel.
Also called the silent killer
Its main action is oxygen deprivation since
carboxyhemoglobin is 250X more stable than
oxyhemoglobin.
Symptoms include: mild headache, lethargy, fatigue,
convulsions and coma.
Painless deaths
Use in judicial death by gas chamber.
Carbon dioxide:
Product of complete combustion of carbon containing
compounds.
Found in drainage pipes, deep wells, sewage tanks
Symptoms include hypotension, anesthesia, muscular
weakness,coma, convulsions and death.
Post-mortem findings: cyanotic face, swollen, frothy
mouth, pupils are dilated
Hydrogen sulfide: (H2S)
Decomposition of substances containing sulphur.
Found in septic tank, sewers, deep wells or byproducts
in some industries
26
Colorless transparent gas with odor similar to a rotten
egg.
Produce irritation to the eyes, air passages followed by
headache, vomiting, cyanosis and labored breathing.
Post-mortem findings: putrefaction is early, offensive
odor on opening the body
Hydrogen cyanide:
One of the most toxic and rapid acting gases.
Naturally found in bitter almond, kernels of berry,
plums, peaches, bamboo shoots, oil seeds and beans.
As tablet: 60-90 mg is fatal
As vapors: symptoms within seconds and death within
minutes
Post-mortem findings:Body is livid or violet in color.
Lividity is bright red or pink
Sulfur dioxide:
Colorless gas with pungent odor
Found in eruption of volcanoes
Use as disinfectant, bleaching agent
Causes irritation of respiratory system and eyes.
War gases:
Characteristics:
The substance must be heavier than air.
It must be capable of spreading rapidly on
the area where the chemical effects is
desired.
It must be capable of producing effect even
in low concentration.
It may be a true gas, smoke, volatilized
liquid or finely divided solid.
It can be manufactured in big quantity.
It must be stable substance or not easily
made non-toxic by rapid chemical reaction.
It is capable of storage for an ample length
of time.
Classification:
Lacrimator or tear gas
Causes irritation and copious flow of tears.
Chloracetophenone (CAP)
Bromobenzyl cyanide (BBC)
Ethyl iodoacetate (KSK)

Vesicant or blistering gas
Contact with skin causes bleb or blister
formation.
Mustard gas sulfide (yellow

cross,
yperite):dichlordiethyl
sulfide; mustard like odor
Lewisite
(chlorovinyldichlorarsine):odor of geranium
Classification:
Lung irritants (asphyxiant or choking gas)
When inhaled causes dyspnea, coughing,
vomiting, coma and death
Chlorine: yellowish green gas;

pungent iritating odor; death is
due to laryngeal spasm.
Phosgene (COCl2): 10X more

toxic than chlorine but has poor
solubility
Chloropicrin: 4X more toxic than

chlorine
Diphosgene: intense lacrimator

Classification:
Sternutator (nasal irritants or vomiting gases)
Causes coryza, nausea, headache,
vomiting, salivation and chest pain
Paralysants (nerve gas)
Blood poisons
Death of Physical Injuries due to Automotive Crash or
Accident
Factors responsible for automotive crash:
Human factor
Environmental factor
Mechanical factor
Social factor
Pedestrian
Human Factor:
Mental attitude
Reckless driving, inattention, fatigue,
inexperience
Perceptive defect
Defective vision and hearing
Delayed or sluggish reaction time
Disease
Driver suffer from epileptic fit or heart attack
while driving
Chemical factor
Alcohol, drugs, marijuana, CO
Environmental factor:
Poorly maintained road, poor visibility, rain, blind
intersection, parked vehicle, trees, absence of road
signs
Stiff and slippery road prolonged sked time
Mechanical factor:
Defect in the steering wheel, poor brake, transmission
failure,worn out tires
Social factor:
Speed is an added dimension of our life.
Car insurances develop devil may care attitude
Collisions:
First collision
Impact of a moving vehicle with another
vehicle or a fixed object.
Second collision
The impact of the unrestrained occupant
with the interior of the vehicle.
Front impact crash:
Driver
Driver may strike the steering wheel,
windshield, side window and the
dashboard; accordioned car injuries
Front seat passenger
Like the driver; injuries include- abrasions
and lacerations in face and scalp, fracture
of the skull, crashing of the neck, laceration
or rupture of the heart, lacerations and
contusions of the heart, fracture of ribs and
sternum, laceration of liver and spleen.
Rear seat occupants
27
Strike the back of the front seat
Side impact crash
Common in street intersections
Injuries more severe because sides of the
car less rigid; ribs fractures, contusions and
lacerations of the lungs
Rear impact crash
Causes whiplash injury
Roll over crash
Injuries from striking the interior of the
vehicle
Because of process of rolling, severe
injuries are rarely seen.
Homicide by motor vehicle:
Simulation of a crash to conceal a prior homicide.
Driver maybe shot while driving
Pedestrian-vehicle collision:
Primary impact:
First contact between the pedestrian and
the vehicle
If the impact is below the center of gravity,
pedestrian moves toward the vehicle;
above the center of gravity, the body is
moving away from the vehicle.
Average height of bumper: 40-60 cms
Bumper fracture: fracture of leg bones
If brake is applied, injuries to the legs are
lower.
Secondary impact:
Impact of the pedestrian to the ground after the first
impact.
This accounts for the multiple contusions and
abrasions on the body.
Run over injuries:

Usually occurs in children
May occur after the initial impact or thereafter
Crash fracture, skid or tire marks, rupture of internal
organs maybe seen
Hit and run injuries:
Injuries sustained from vehicular accident with the
vehicle getting away from the scene without regard to
the unfortunate victim.
Thread marks, abrasion prints of parts of the vehicle
and paints detached from the vehicle found in the body
or crime scene may be compared with the suspect car.
The suspect car maybe examined for blood stain, hair
and clothings.
Evidences in vehicular crash:
From the scene of the crime
Photographs of the scene; skid and tire
marks on the road; condition and position of
the victim;condition of the vehicle involved;
blood, paint stain; narration of the
witnesses
From the driver
Fitness
to
drive;alcoholic
drunkeness;injuries due to second collision
Alcohol blood level: 0.15% and more
considered drunk
From the victim

Crush injury
Tire thread marks
Abrasion marks
Paint marks
Blood, hair or clothings of the victim
Physical defects of the victim
Inebriation of the victim
Purposes of the autopsy:
The examiner can give his opinion as to the deceased
position in the vehicle or the pattern of the injuries
correlated to the point of contact with the vehicle.
Examination will determine the true nature of the
cause of death.
The examiner can form an opinion as to who from
among them survived the longest. (survivorship)
The size of the monetary reward in a civil suit may
depend on the nature and extent of the injuries.
AUTOPSY
Autopsy
It is a comprehensive study of a dead body,
performed by a trained physician employing
recognized dissection procedure and
techniques. Tissues maybe removed for
further examination and preservation.
Autopsy vs Post-mortem Examination
Post-mortem examination- external examination of a

dead body without incision being made. Blood and
body fluids maybe collected for examination.
Autopsy- in addition to external examination, the body

is opened and an internal examination is conducted.
Kinds of Autopsies
Hospital or non-official autopsy
Medico-legal or official autopsy
Hospital Autopsy
Purpose:
o Determine the cause of death
o Provide correlation of clinical diagnosis and
clinical symptoms
o Determine the effectiveness of therapy
o Study the natural course of disease process
o Educating students and physicians
Consent of the rightful person needed.

Medico-legal Autopsy
Purpose:
o Determine the cause, mode and time of
death.
o Recover, identify and preserve evidentiary
material.
o Provide interpretation and correlation of
facts and circumstances related to death
o Provide a factual, objective medical report
for law enforcement, prosecution and
defense agencies
o Separating death due to disease from death
due to external cause for protection of the
innocent.
o
28
When shall an autopsy be performed?
Whenever required by special laws.
Upon order of a competent court, a mayor and a

provincial or city fiscal.
Upon written request of police authorities.
Whenever the Solicitor General, Provincial or City

fiscal as authorized by existing laws, shall deem it
necessary to disinter and take possession of the
remains for examination to determine the cause of
death
Whenever the nearest kin shall request in writing the

authorities concerned in order to ascertain the cause
of death.
Persons authorized to conduct autopsies:
Medical health officers
Medical officers of law enforcement agencies
Members of the medical staff of accredited hospital

Guidelines in the performance of autopsies:
It should follow the protocols in conducting autopsies.
It must be comprehensive.
Bodies which are mutilated, decomposing or burned

are still suitable for autopsy.
Autopsies must be performed in a manner which show

respect of the dead body.
Proper identity of the deceased autopsied must be

established in non-official autopsy.
A dead body must not be embalmed before autopsy.
The body must be autopsied in the same condition

when found in the crime scene.
Stages in the conduct of Autopsy:
Preliminary examination
o Examination of the surrounding
o Examination of the clothing
o Identity of the body
External examination
o Examination of the body surfaces
o Determination of the position and
approximation time of death
Internal examination
Mistakes in autopsies:
Error or omission in the collection of evidence for

identification.
o Failure to take photographs, fingerprints
Error or omission in the collection of evidence required

for establishing the time of death
o Failure to report rectal temperature.
Error or omission in the collection of evidence required

for other medico-legal examination.
o Failure to collect nail scrapings, sample of
hair,, seminal fluid
Error or omission result in the production of

undesirable artifacts or in the destruction of valid
evidence.
o Using hammer and chisel to open skull
Negligent autopsy:
Failure to have an adequate history or facts and

circumstances surrounding the death.
Failure to make a thorough external examination.
Inadequate or improper internal examination.
Improper histological examination.

Lack of toxicological or other laboratory aids.
Pathologist incompetence
CAUSES OF DEATH
Cause of Death
It is the injury, disease or the combination of both

responsible for initiating the trend or physiologic
disturbance, brief or prolonged, which produces the
fatal termination.
Cause of Death
Immediate (primary) cause of death: it is when trauma

or diseases kill quickly that there is no opportunity for
sequelae or complications to develop.
Proximate (secondary) cause of death:it is when the

injury or disease was survived for a sufficiently
prolonged interval which permitted to the development
of serious sequelae which actually caused the death.
Mechanism of death
It is the physiologic derangement or biochemical

disturbance incompatible with life which is initiated by
the cause of death. Ex: hemorrhagic shock, sepsis,
respiratory depression.
Cardio-respiratory arrest should never stand as the
cause of death.
Manner of Death
It is the explanation as to how the cause of death

came into being or how the cause of death arose.
Natural: death is caused solely by a disease.
Violent or unnatural death: death due to injury of any
sort.
Medico-legal Masquerade
Violent deaths maybe accompanied by minimal or no

external evidence of injury or natural death maybe
accompanied by signs of violence.
Degree of certainty to the cause of death:
When the structural abnormalities established beyond

doubt the identity of the cause of death.
When there is that degree of probability amounting to

almost certainty the cause of death.
When the cause of death is established primarily by

historical facts.
When neither history, laboratory and anatomic findings

is sufficient to determine the cause of death but merely
speculate as to the cause of death. (probably)
Instantaneous physiologic death:
Sudden death within seconds or minutes after a minor

trauma or peripheral stimulation. Circulatory failure is
caused by vagocardiac stoppage of heart and
dilatation of blood vessels. (urination, kick in the
scrotum)
Death by inhibition: diagnosis by exclusion
Diseases with no pathognomic findings:

o Sudden infant death syndrome
o Sudden unexplained nocturnal death
29
For cases where there is no working diagnosis upon

death, the cause of death should be undetermined.
Medico-legal Classification:
Natural death
Violent death
o Accidental death
o Negligent death
o Infanticidal death
o Parricidal death
o Murder
o Homicidal death
Natural death
Affection of the CNS
Affection of the circulatory system
Affection of the respiratory system
Affection of the gastrointestinal tract
Affection of the genito-urinary tract
Affection of the glands
Sudden death in young children
If violence was applied on a dead person, the person

inflicting the physical injuries cannot be guilty of
murder, homicide or parricide.
If the violence inflicted on a person suffering from a

natural disease only accelerated the death of the
victim, the offender inflicting such violence is
responsible for the death of the victim.
If the victim died of a natural cause and the physical

injuries inflicted is independent of the cause of death,
the accused will not be responsible for the death but
merely for the physical injuries he had inflicted.
To make the offender liable for the death of the victim,

it must be proven that the death is the natural
consequence of the physical injuries inflicted.
The physician must determine for the interest of justice

with absolute care at autopsy and laboratory
examination the real cause of death.
Violent death
The following should be established:
o The the victim at the time the physical
injuries were inflicted was in normal health.
o That the death maybe expected from the
physical injuries infected.
o That the death ensued within a reasonable
time.
Classification of trauma or injuries:
Physical injury
Thermal injury
Electrical injury
Atmospheric injury
Chemical injury
Radiation injury
Infection
Refusal of the victim to submit to a surgical operation

do not relieve the accused from the natural and
ordinary result of the felonious act and does not relieve
him of his criminal liability.
The presence of infection on the wounds inflicted if not

deliberately induced by the victim makes the offender
also responsible for it.
Penal Classification of Violent Death:

A.Accidental death
Death due to misadventure or accident

Elements of provision:
A person is performing a lawful act.
He performed it with due care.
He caused injury to another by mere
accident.
He is without fault and with no intention
of causing it.
B. Negligent death
o
Death due to reckless imprudence,

negligence, lack of skill or lack of foresight
C. Suicidal death
o
o
o
o
Acts punishable in giving assistance to

suicide
The offender assisted in the commission of
suicide which was consummated.
The offender gave assistance in the
commission of suicide to the extent of doing
the killing himself which is consummated.
The offender assisted another in the
commission of suicide which is not
consummated.
D. Parricidal Death
Requisite for the crime:
o A person was killed by the offender.
o The person killed was the father, mother, or
child whether legitimate or illegitimate in
relation with the offender, or other legitimate
ascendants, or descendants or spouse of
the offender.
E. Infanticidal Death
Requisite to a crime:
o A person was killed.
o The person killed was a child less than 3
days old.
F. Murder
Requisite for the crime of murder.
o The offender killed the victim.
o The killing was attended by any of the
qualifying circumstances mentioned;
o There was the intent of the offender to kill
the victim.
o The killing is not parricide or infanticide.
G. Homicidal Death
Requisite of the crime of Homicide:
o The victim of a criminal assault was killed;
o The offender killed the victim without any
justification.
o There is the intention on the part of the
victim and such presumption can be
inferred from the death of the victim.
30
That the killing does not fall under the
definition of the crime of murder, parricide
and infanticide.
Death under special circumstances:
Death caused in a tumultuous array
Death or physical injuries inflicted under exceptional

circumstances.
Pathological classification of the causes of death.
Death from syncope

o Death from sudden cessation of heart
action
Death from asphyxia

o Death from low or absent oxygen in the
blood and tissues.
Death from coma

o Death resulting from arrest in the function of
the brain.
Special Deaths
Judicial death
Euthanasia
Suicide
Death from starvation

o
Judicial Death
Death by electrocution
Death by lethal injection
Death by hanging
Death by musketry
Death by gas chamber
Others
o Beheading
o Crucifixion
o Stoning
o Smothering
Euthanasia
Types of euthanasia
o Active euthanasia
Active euthanasia in demand

o Passive euthanasia
Orthothanasia when an
incurably ill person is allowed to
die a natural death without the
application of any operation or
treatment.
Dysthanasia when there is an

attempt to extend the life span of
a person by the use of
extraordinary treatment without
which the patient would have
died earlier.
Who may perform euthanasia
The patient himself.
The physician, with or without the knowledge and

consent of the patient.
Suicide:
It is an unfortunate consequence of mental illness and

social disorganization.
Rare in children, common in adults and elederly.
Male > female
Usually occurs at home.

Psychological classification of suicide:
o First degree deliberate, planned
o Second degree impulsive, unplanned
o Third degree accidental
o Suicide which suggest lack of capacity for
intention.(ex. psychotics)
o Self destruction due to self negligence.
(reckless driving)
o Justifiable suicide (incurable diseases)
Evidences that will infer death is suicidal.
History of depression, mental disease or unresolved

personal problem.
Previous attempt of self destruction.
In committed by inflection of physical injuries, the

wounds are located in areas accessible to the hand,
vital parts of the body and usually solitary.
Others: presence of cadaveric spasm in in hand

holding the gun; bottle of poison;absence of signs of
struggle.
Presence of suicide note.
Suicide scene in a place not susceptible to public view.

Death from starvation:
Types:
o Acute starvation
o Chronic starvation
Causes:
o Suicidal
o Homicidal
o Accident
o
BURNS
Burns: 1st degree
Burns: 2nd degree
Burns: 3rd degree
Burns: 3rd degree
1. Scalding burns
2. Charred bodies:
3. Chemical burn
4. Chemical burn
5. Electrical burn
6. Electrical burns
Indication for admission:
- 2nd and 3rd degree burns greater than 10% of total body
surface area in patients under 10 or over 50 years of
age
2nd and 3rd degree burns greater than 20% of total

body surface area in other age groups.
2nd and 3rd degree burns involving the face, hands,

feet, genitalia, perineum and major joints
3rd degree burns greater than 5 % in any age group.
Electrical burns, lightning injury]
Chemical burns
31
Inhalational burns
Burns in patients with pre-existing medical problems
Burns patients with other traumatic injuries such as

fracture, cerebral traum
-Burn injury in patients requiring special social,
emotional and/or long term rebilitative support such as
drug depedents.
32

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1

LEGAL MEDICINE HAND OUT

Death related to sexual act

General condition of the hymen.

Duration of laceration of hymen:

Condition of the vulva-gaping or not

Fresh bleeding laceration- recent

Complication of laceration of hymen:

Death related to sexual act:

-Use of force or intimidation:

Death of a male partner:

Death of the female partner:

Death of both partners

-The woman is deprived of her reason or otherwise

Ancient and universal

-When the woman is under 12 years of age.

Slightest penetration in the sexual organ of the female

The offender has carnal knowledge of the woman. The

The carnal relation must be made under any of the

When by reason or on the occasion of the rape, the

MEDICAL EVIDENCES IN RAPE:

Date, time and place of alleged commission of rape.

Examination of the genitalia including the breast.

Throat of the victim/ anal canal of the victim

Examination of seminal fluid:

Examination of the alleged offender.

Investigation of the crime scene:

Disturbance in the place of the commission.

Examination of seminal fluid:

Semen is a viscid, albuminous fluid with faint

Specimens to be examined for seminal fluid:

Wearing apparel of the victim and the allege

How long after sexual intercourse can spermatozoa be found

-Same as in rape but there is no application

Prostitution is one of the venues in spreading

Bar or tavern pick-up

Arrest and imprisonment.

Adultery and concubinage:

Physiologic and psychological traits

As to the choice of sexual partner:

Reasons why physician fail to detect child sexual abuse.

The lack of hard physical evidence of abuse.

Theories why adults become interested in children:

1. Over sex: compulsive neurosis

2.As to the mode of sexual expression:

Anatomic, necrophilic, clothing, odor

4.As to the part of the body:

Troilism (menage a trois`)

Is the termination of life

Deep irreversible coma, absence of

Occurs when there is a continuous and

The civil personality of a natural person is extinguished

The state of the body in which there is

Death of individual cells

Occurs about 3 6 hours after somatic

A transient loss of consciousness or

Important to determine to avoid premature

Changes in the skin

1.Cessation of heart action and circulation

Post-mortem caloricity rise of temperature of the

Estimation of time of death based on the cooling of the body

Rigor mortis appears late and prolonged in

Early onset in extreme of ages

Delay onset in paralyzed muscles