Legal Medicine Solis Notes

FROGLETS NOTESCHAPTER I GENERAL CONSIDERATION Legal Medicine- branch of which deals with application of medical knowledge to the purposes of law and in the administration of justice. It is the application of basic and clinical, medical and paramedical sciences to elucidate legal matters.  Concept and practice of Legal Medicine in the Philippines is of Spanish origin. Legal Medicine Application of medicine to legal cases Forensic Medicine Application of medical science to elucidate legal problems Medical Jurisprudence- knowledge of law in relation to the practice of medicine. It concerns with the study of the rights, duties and obligations of medical practitioner with particular reference to those arising from doctor-patient relationship. Summary of Legal Medicine Book by Solis treatment Purpose in examining a patient is to arrive at a definite diagnosis so that appropriate treatment can be instituted Minor or trivial injuries are usually ignored inasmuch as they do not require usual treatment. Example: Presence of PHYSICAL INJURIES of a victim of sexual abuse = presumes that force was applied; hence, crime committed must be RAPE. Presence of PHYSICAL INJURIES on the offender of the crime of physical injuries= proof that the victim acted in SELF-DEFENSE. OTHER DEFINITIONS NATURE OF THE STUDY OF LEGAL MEDICINE     Knowledge of legal medicine means the ability to acquire facts, the power to arrange those facts in their logical order, and to draw a conclusion from the facts which may be useful in the administration of justice. Medical Jurist (medical examiner, medico-legal officer, medico-legal expert) – a physician who specializes or is involved primarily with medicolegal duties. They are mostly in the service of the government. It is the duty of every physician, when called upon by the judicial authorities, to assist in the administration of justice on matters which are medico-legal in character.‖ To be involved in medico-legal duties, a physician must possess sufficient knowledge of: o Pathology o Surgery o Gynecology o Toxicology o Other branches of Medicine germane to the issues involved. Ordinary Physician Sees an injury or disease on the point of view of 1 Medical Jurist Sees injury or disease on the point of view of cause By 4D2014-2015 Purpose in examining a patient is to include those bodily lesions in his report and testify before the court or before an investigative body Records all bodily injuries even if they are small or minor because these injuries may be proofs to qualify the crime or to justify the act. 1. LAW- rule of conduct, just, obligatory, laid by legitimate power for common observance and benefit. Characteristics of Law: - It is a rule of conduct; It is dictated by legitimate power; and Compulsory and obligatory to all. Forms of Law: A. B. 2. Written or Statutory Law (Lex Scripta) – composed of laws which are produced by the country’s legislations and which are defined, codified and incorporated by the law-making body. Ex. Philippine Laws. Unwritten or Common Law (Lex non Scripta) – composed of unwritten laws based on immemorial customs and usages. Sometimes referred to as case law, common law, jurisprudence or customary law. Ex. Laws of England. FORENSIC- denotes anything belonging to the court of law or used in court or legal proceedings FROGLETS NOTES or something fitted argumentations. 3. 4. 5. for legal or public MEDICINE- a science and art dealing with preventation, cure and alleviation of disease. It is that part of science and art of restoring and preserving health. It is the science and art of diagnosing, treating, curing and preventing disease, relieving pain, and improving the health of a person. LEGAL- that pertains to law, arising out of, by virtue of or included in law. Refers to anything conformable to the letters or rules of law as it is administered by the court. JURISPRUDENCE- science of giving a wise interpretation of the law and making just application of them to all cases as they arise. PRINCIPLE OF STARE DECISES A principle that, when the court has once laid down a principle of law or interpretation as applied to a certain state of facts, it will adhere to and apply to all future cases where the facts are substantially the same. BRANCHES OF LAW WHERE LEGAL MEDICINE MAY BE APPLIED In CIVIL LAW, knowledge of legal medicine may be useful on the following: 1. 2. 3. 4. 5. Determination and termination of civil personality (Art.40-41); Limitation or restriction of a natural person’s capacity to act (Art. 23 and 29); Marriage and legal separation Paternity and filiation Testamentary capacity of a person making a will. 2. 3. Summary of Legal Medicine Book by Solis Proceedings for hospitalization of an insane person (Rule 101); and Rules on evidences (Part IV). In SPECIAL LAWS: 1. 2. 3. 4. 5. 6. Dangerous Drug Act (RA 6425, as amended) Youth and Child Welfare Code (PD 603) Insurance Law (Act No. 2427 as amended) Code of Sanitation (PD 856) Labor Code (PD 442) Employee’s Compensation Law MEDICAL EVIDENCE Evidence- the means, sanctioned by the Rules of Court, of ascertaining in a judicial proceeding the truth respecting a matter of fact. If the means employed to prove a fact is medical in nature then it becomes a medical evidence. TYPES OF MEDICAL EVIDENCE 1. Autoptic or Real Evidence – evidence made known or addressed to the senses of the court. It is not limited to that which is known through the sense of vision but is extended to what the sense of hearing, taste, smell and touch is perceived. (Sec.1, Rule 130) Limitations to the Presentation of Autoptic Evidence: a) Ex: Court may not allow exposure of the genitalia of an alleged victim of sexual offense to show the presence and degree of the genitalia and extra-genitalia injuries suffered. In CRIMINAL LAW, legal medicine is applicable in the following provisions of the Penal Code: 1. 2. 3. Circumstances affecting criminal liability; Crimes against person; Crimes against chastity. In REMEDIAL LAW, legal medicine is applied in the following provisions of the Rules of Court: 1. Physical and mental examination of a person (Rule 28); 2 By 4D2014-2015 Indecency and Impropriety – presentation of evidence may be necessary to serve the best interest of justice but the notion of decency and delicacy may cause inhibition of its presentation. b) Repulsive Objects and those Offensive to Sensibilities – foul smelling objects, persons suffering from highly infectious and communicable disease, or objects which when touch may mean potential danger to the life and health of the judge may not be presented. FROGLETS NOTES However, if such evidence is necessary in the adjudication of the case, the question of indecency and impropriety or the fact that such evidence is repulsive or offensive to sensibilities, it may be presented. This will depend on the sound discretion of the court. 2. 4. Documentary Evidence- Medical Documentary Evidence may be: a. Medical Certification or Report on: i. Medical examination ii. Physical examination iii. Necropsy/ autopsy iv. Laboratory v. Exhumation vi. Birth vii. Death b. Medical Expert Opinion c. Deposition 5. Physical Evidence – these are articles and materials which are found in connection with the investigation and which aid in establishing the identity of the perpetrator or the circumstances under which the crime was committed, or in general assist in the prosecution of a criminal. Testimonial Evidence – a physician may be commanded to appear before a court to give his testimony. His testimony must be given orally and under oath or affirmation. A physician may be presented in court as an ordinary witness and/or as an expert witness: ORDINARY WITNESS A physician who testifies in court on matters perceived from his patient in the course of physician-patient relationship. (Sec. 20, Rule 130, Rules of Court) Exception: Privilege of Communication between physician and patient. (Sec. 24 c, Rule 130) EXPERT WITNESS A physician on account of his training and experience can give his opinion on a set of medical facts. He can deduce or infer something, determine the cause of death, or render opinion pertinent to the issue and medical nature. Criminalistics - is the identification, collection, preservation and mode of presentation of physical evidence. It is the application of sciences such as physics, chemistry, medicine and other biological sciences in crime detection and investigation. Type of Physical Evidences: Rule a. The probative value of the expert medical testimony depends upon the degree of learning and experience on the line of what the medical expert is testifying, the basis and logic of his conclusion, and other evidences tending to show the veracity or falsity of his testimony. b. (Sec. 130) 48-49, c. Experimental Evidence – A medical witness may be allowed by the court to confirm his allegation or as a corroborated proof to an opinion he previously stated. 3 By 4D2014-2015 Corpus Delicti Evidence – objects or substances which may be a part of the body of the crime. Associative Evidence- these are physical evidence which link a suspect to the crime. Tracing Evidence- these are physical evidence which may assist the investigator in locating the suspect. PRESERVATION OF EVIDENCE The physical evidence recovered during medico-legal investigation must be preserved to maintain their value when presented as exhibits in court. Methods of Preserving Evidence 1. 3. Summary of Legal Medicine Book by Solis 2. Photographs, audio and/or video tape, microfilm, Photostat, Xerox, voice tracing, etc. Sketching- rough drawing of the scene or object to be preserve is done. It must be simple, identifying significant items and with exact measurement. occupation. Soft tissues (skin. Description. Skin Lesion Penetrating wound Hymenal Laceration Person Manikin Method. b. Control questions – unrelated to the matter under investigation but are of similar nature although less serious as compared to those relevant questions (ex: Have you ever used a gun?). b. Compass direction must always be indicated to facilitate proper orientation in the case of crime scene. semen) – drying. d. Special Ways of Preservation: a. Poison. Actual interrogation and recording through the instrument Standard test questions: 1. It must cause a vivid impression on the mind of the reader. e. 3. Blood. trauma or disease.embalming. Minimum Standard Requirements which must be satisfied in the description of the person or thing to make it complete: a. sealed bottle container. . Relevant questions – pertaining to the issue under investigation (ex: Did you shoot to death Mr. muscles. Finished Sketch.made at the crime scene or during examination of living or dead body. d. 4. Pre-test interview ii. age of the witness. Rough Sketch. visceral organs) – 10% formalin solution.sealed container. Whole human body. Devices which record the psycho-physiological response a. placing in sealed container. addition of chemical preservatives. 4 By 4D2014-2015 Summary of Legal Medicine Book by Solis 6. Polygraph or lie detector machine – records physiological changes that occur in association with lying in a polygraph. Scale and proportion must be stated by mere estimation. Essential Elements to be Included in a Sketch: a. Phases of Examination i. Irrelevant questions – no bearing to the case under investigation (ex: age. There must be a title and legend to tell what it is and the meaning of certain marks indicated therein.FROGLETS NOTES Kinds of Sketch:  The preservation is co-terminus with the life of the witness. Preservation may be essential from the time it is recovered to make the condition unchanged up to the period it reaches the criminal laboratory for appropriate examination. 5. Special Methods. Preservation in the Mind of the Witness Drawbacks of preserving evidence in the mind of the witness:  The capacity of a person to remember time. place and event may be destroyed or modified by the length of time. d. confusion with other evidence. c. c. Measurement must be accurate. thereby making the recollection not reliable. c. etc).putting into words the person or thing to be preserved.refrigeration. e. b.Special way of treating certain type of evidence may be necessary. a true picture of the thing described. 3. X?). 2. Stains (blood. citizenship. CHAPTER II DECEPTION DETECTION Methods of deception detection used by law enforcement agencies: 1.miniature model of a scene or of a human body indicating marks of a various aspects of the things to be preserved.  Human mind can easily be subjected to too many extraneous factors that may cause distortion of the truth.sketch prepared from the rough sketch for court presentation. Essential item which has a bearing in the investigation must be included. 4. subject will swallow saliva which causes frequent upward and downward movement of the Adam’s apple. By observation Physiological and psychological signs and symptoms of guilt: a. ―Spotless past record‖ – subject may assert that it is not possible for him to do ―anything like that‖ inasmuch as he is a religious man and that he has a spotless record. Dryness of the mouth – nervous tension causes dryness of the mouth which causes continuous swallowing and licking of the lips. picking and tweaking the nose. f. b. Physiological abnormalities 3. i. Psychiatric sodium amytal or sodium penthotal is administered to the subject. Intoxication – the apparent stimulation effect of alcohol is really the result of the control mechanism of the brain. Unresponsiveness in a living or guilty subject 5. Such oscillations of the muscles or microtremor occur at the rate of 8 to 14 cycles per second and controlled by the central nervous system. ii. Use of drugs that try to ―inhibit the inhibitor‖ 5 By 4D2014-2015 Summary of Legal Medicine Book by Solis a. be it a ―yes‖ or ―no‖. Narcoanalysis or narcosynthesis – practically the same as that of administration of truth serum. iii. The test is not concerned with the answer. b. Result of troubled conscience. without making any verbal response. The important factor is the time of response in relation to the stimulus or non-stimulus words. Inability to look at the investigator “straight in the eye” – because of fear that his guilt may be seen in his eyes. to himself. may indicate shock or fear. Sweating hands indicate tension. Truth serum – In the test. rubbing his face. When the proper point is reached. irrelevant and control questions are asked. c. e. there are audible voice frequencies. Post-test interrogation Supplementary tests: i. (In vino veritas – in wine there is truth) 3. Color change – flushed face may indicate anger. When a person speaks. The only difference is the drug used. ―Peculiar feeling inside‖ – there is a sensation of lightness of the head and the subject is confused. and narcoanalytic drugs ―inhibit the inhibitor‖. etc. d. like truth serum. Silent answer test – conducted in the same manner as when relevant. Unobserved application of muscular pressure which produces ambiguities and misleading indications in the blood pressure tracing b. Swearing to the truthfulness of his assertion – ―I swear to God I am telling the truth‖ h. c. The time interval between the words uttered by the examiner and the answer of the subject is recorded. Factors responsible for the 25% errors of the lie detector: 1. c.FROGLETS NOTES iii. the questioning begins and the subject feels a compulsion to answer the questions truthfully. embarrassment or shame. Peak-of-tension test – may be given if subject is not yet informed of the details of the offense for which he is being interrogated by the investigator. measures. Pale face is sign of guilt. pulling his ears. Hypnotism – the alteration of consciousness and concentration in which the subject manifests a heightened of suggestibility while awareness is maintained. so alcohol. Guilt complex test – applied when the response to relevant and control questions are similar in degree and consistency in a way that the examiner cannot determine whether the subject is telling the truth or not. Nervousness or extreme emotional tension experienced by a subject who is telling the truth regarding the offense in question 2. Fidgeting – constantly moving about in the chair. Attempt to ―beat the machine‖ by controlled breathing or by muscular flexing 6. Mental abnormalities 4. but the subject is instructed to answer the questions silently. Psychological stress evaluator (PSE) – detects. g. 2. Excessive activity of the Adam’s apple – on account of dryness of the throat. Word association test – A list of stimulus and nonstimulus words are read to the subject who is instructed to answer as quickly as possible. Sweating – if accompanied with a flushed face indicate anger. and graphically displays the voice modulations that we cannot hear. Indicative of nervous tension. embarrassment or extreme nervousness. . hyoscine hydrobromide is given hypodermically in repeated doses until a state of delirium is induced. and superimposed on these are the inaudible frequency modulations which are products of minute oscillation of the muscles of the voice mechanism. If with a pallid face. Scientific interrogation – the questioning of a person suspected of having committed an offense or of persons who are reluctant to make a full disclosure of information in his possession which is pertinent to the investigation. one (Mutt) who is arrogant and relentless. Mutt and Jeff Technique. The statements are inconsistent with the material facts. Based on behavioral attitude: i. Basis of Interrogator’s Inference that the Subject is not Telling the Truth    The statements have many improbabilities and gaps on its substantial parts. Non-emotional offenders – commit crimes for financial gain and are usually recidivist or repeaters. The statements are incoherent.One interrogator (Mutt) is arrogant and relentless. Bluff on split-pair technique – applicable where there are two or more persons who allegedly participated in the commission of a crime. time-consuming narration. sympathetic and kind. The subject is given the opportunity to make a lengthy. While one of them is interrogated. Confession – an expressed acknowledgment by the accused in a criminal case of the truth of his guilt as to the crime charged. and kind. or revenge. Jeff will advise the subject to make a quick decision and plea for cooperation. All of them are interrogated separately and the interrogator may claim that the subject was implicated by the author and that there is no use for him to deny participation. or of some essentials thereof. Professional offenders – commit crimes which require special skills rather than violence. 6. Active aggressive offenders – commit crimes in an impulsive manner ii. Suspect – person whose guilt is considered on reasonable ground Witness – person other than the suspect who is requested to give information Different types of criminal offenders a. Irrational offenders – commit crime without knowing the nature and quality of his act. The subject is given the opportunity to make a lengthy. Emotional appeal – interrogator must create a mood that is conducive to confession b. the interrogator may claim that the subject was implicated by the author and that there is no use for him to deny participation. promise or reward. Psychological classification i. b. Stern Approach. ii. and the interrogator utilizes harsh language. he knows the subject to be guilty. Techniques of Interrogation a. The other (Jeff) is friendly.safeguards were established for the interrogation of suspected persons. d. d. “Not that I remember” expression – resort to this expression to avoid committing something prejudicial to him. Ordinary offenders – engaged in crimes which require limited skill ii. Based on the state of mind i. Based on proficiency i.Immediate and clear response from the subject is demanded and the interrogator uses harsh language. Emotional offenders – commit crimes in the heat of passion. Passive inadequate offenders – commit crimes because of inducement. Stern approach – questions must be answered clearly.FROGLETS NOTES j.The interrogator creates a mood that is conducive to confession. Bluff on Split-Pair Technique. He may be sympathetic or friendly to the subject. c.Applicable where there are two or more persons who allegedly participated on the commission of a crime. sympathetic. and the other (Jeff) who is friendly. c. Mutt and Jeff technique – there must be at least 2 investigators with opposite character. Requirement for the Admissibility of Evidence Obtained Through Interrogation   Custodial Investigation and Self-Incrimination (1987 Constitution) Miranda v. Arizona (Miranda Rights). When Mutt is not present. 6 By 4D2014-2015 Summary of Legal Medicine Book by Solis e. Rational offenders – commit crime with motive or intention ii. Some Techniques of Interrogation      Emotional Appeal. 5. time-consuming narration. Confession . anger. o Extra-judicial confession may be:  Voluntary.  Involuntary. or (2) by inflicting such punishment in a cruel and humiliating manner. 235. Tokyo Declaration.is a confession made outside of the court prior to the trial of the case.the accused speaks on his free will and accord.is the confession of an accused in court.provides guidelines to be observed by physicians concerning torture and other inhuman treatment o The doctor shall not countenance. Maltreatment of Prisoners  Elements (Art.FROGLETS NOTES   Is an expressed acknowledgement by the accused of the truth of his guilt as to the crime charged. or in the course of the trial or other proceedings do not require proof and cannot be contradicted unless previously shown to have been made through palpable mistake. CHAPTER III MEDICO-LEGAL ASPECTS OF IDENTIFICATION Identification is the determination of the individuality of a person or thing. o Under the Rules of Court.obtained through force. and fellow doctors. o Under the Rules of Court. duress. or participate in the practice of torture or other forms of inhuman procedures o The doctor shall not provide premises. Such are inadmissible in evidence. without inducement of any kind. threat. Judicial Confession. he or she shall not be fed artificially. RPC) o The offender is a public officer or employee o The offender has under his charge a convicted or detention prisoner o The offender maltreats the prisoner by overdoing in the correction and handling of the prisoner by the (1) imposition of punishment not 7 By 4D2014-2015  Summary of Legal Medicine Book by Solis authorized by the regulation. Importance of Identification . substances. the national medical associations. or by maltreating to extort a confession or obtain information. intimidation. and with full and complete knowledge of the nature and consequence of the confession. Kinds of Confession   Extra-judicial Confession. instruments. or knowledge to facilitate such in practices o The doctor shall not be present during any procedure during which inhuman treatment is used or threatened o A doctor must have complete clinical independence in deciding upon the care of a person for whom he is medically responsible o Where the prisoner refuses nourishment and is considered by the doctor as capable of forming an unimpaired and rational judgment concerning the consequences of such voluntary refusal of nourishment (as confirmed by at least one other independent doctor). admissions made by the parties in the pleadings. or of some essentials thereof. or anything influencing the voluntary act of the confessor. It is conclusive upon the court and may be considered to be a mitigating circumstance. to support the doctor as his/her family in the face of threats or reprisals resulting from refusal to condone the use of torture and inhuman treatment. condone. Such consequences of the refusal of nourishment shall be explained by the doctor to the prisoner o The World Medical Association will support and encourage the international community. extra-judicial confession is not a sufficient ground for conviction unless corroborated by evidence of corpus delicti. Confession is a statement of guilt while admission is usually a statement of fact by the accused which does not directly involve an acknowledgment of guilt. movement of hand. or a nurse by her cap  Body ornamentationsearrings.e. movement of body. beard or mustache  Clothing. a mechanic may be recognized by his tools.stereotype movement or habit peculiar to an individual. There is no rigid rule to be observed in the procedure of identification of persons. necklaces. movement of facial muscles. Identification resolves the anxiety of the next-ofkin. and other social benefits.  Foot or hand impressiondevelops when a .  Speech. stutter.a person may stammer. It is necessary for the team to act in the shortest possible time specially in cases of mass disaster. release of dead bodies to relatives. and abnormalities. By exclusion. or lisp. The value of the different points of identification varies in the formulation of conclusion (e. Methods of Identification   By comparison-Identification criteria recovered during investigation are compared with records available in the file. Identification may be needed in some transactions like cashing of check. sale of property.g.no special training or skill required 8 By 4D2014-2015  Summary of Legal Medicine Book by Solis Those which are based on scientific knowledgemade by trained men. Identification of Persons Classification of the Bases of Human Identification  Those which laymen use to prove identity. on account of disease or some inborn traits. retirement. etc. etc. the greater is the need for experts in establishing identity. rings. manner of leaning. the greater is the probability for the conclusion to be correct.  Mannerism. visual recognition by relative or friends may be of lesser value as compared with fingerprints or dental comparison).If two or more persons have to be identified and all but one is not yet identified. entering a premise. (E.  Gait. The longer the interval between the death and the examination of the remains. texture or style  Frequent place of visit. may show a characteristic manner of walking. shape.FROGLETS NOTES     To establish the identity of the offender and that of the victim in the prosecution of the criminal offense. etc.)  Hands and feet.a recollection of time.Size. To identify a person missing or presumed dead in order to facilitate the settlement of the estate. Usually worn by persons o Characteristics that may not be easily changed  Mental memory. a clergy man by his robe. then the one whose identity has not been established may be known by the process of elimination. pins.A person’s special desire or habit to be in a place if he has the opportunity to do so  Grade of profession.a person may have a special preference for certain form. and events. other relatives and friends as to the whereabouts of a missing person or victim of calamity or criminal act.g. Rules in Personal Identification      Law of Multiplicity of Evidence in Identificationthe greater the number of points of similarities and dissimilarities of two persons compared. well-seasoned by experience and observation Ordinary Methods of Identification  Points of Identification Applicable to Living Persons Only o Characteristics which may easily be changed  Growth of hair. manner of talking and quality of the voice.a person. parties to a contract. place. way of sitting..g. insurance. state of being color blind.scar has inflammatory redness. and it is soft and sensitive  Two to six monthsbrownish or coppery red.nearsightedness.a footmark or handmark on a hard base contaminated or smeared with foreign matters like dust. far-sightedness. etc. clay. Weight.  Age of scar  Recently formedslightly elevated.  Footprint or handprint. rate of growth Tattoo marks. and soft .Flat head  Wearing Apparel. blood.introduction of coloring pigments in the layers of the skin by multiple puncture.Almond eyes and prominent cheek bone 9 By 4D2014-2015 Summary of Legal Medicine Book by Solis  o o o o o o o o Negro. reddish or bluish in color.Thick lips and prominent eyes  Shape of the skull  CaucasianElongated skull  Malayan. region.not a good point of identification for it is easily changed from time to time. Complexion Changes in the eyes. Left.or right-handedness Degree of nutrition. and custom. Facies. free from contraction and corrugation.Flat nose with round face  Mongolian. cement mixture.Round head  Red Indians and Eskimos.may be congenital or acquired Birth marks Injuries leaving permanent results.Casual and customary wearing may indicate race as well as religion.different kinds of facial expressions brought about by disease or racial influence.a remaining mark after healing of the wound. and tender to touch  Few weeks to two months. Stature. nationality.Round head apparel  Mongolian.Black  Feature of the face  CaucasianProminent sharp nose  Malayan. improper union of fractured bones Moles Scar.e.FROGLETS NOTES       foot or hand is pressed on mouldable materials like mud. etc. Deformities. floor.change in height.g.certain occupations may result in some characteristic marks or identifying guide o Race  Color of the skin  Caucasian-Fair  Malayan-Brown  Mongolian-Fair  Negro. or other semi-solid mass. amputation. Points of Identification Applicable to Both Living and Dead before Onset of Decomposition o Occupational marks.in relation to height and age. scars 3.FROGLETS NOTES  Six months or more. Dental identication C. Measurement of head C. Arms 17. Body marks .bulbs of the last phalanges of the fingers and thumb are pressed on the surface of the paper after pressing them on ink 2. Age. Dactylography is the art and study of recording fingerprints as a means of identification Dactyloscopy is the art of identification by comparison of fingerprints Poroscopy is the study of the pores found on the pappillary or friction ridges of the skin Merhods of Producing Impression 1. SCIENTIFIC METHODS OF IDENTIFICATION A. and tough Anthropometry (Bertillon System) . Determination of sex F. but the whole pattern with all its details will reappear when the wound heals 1.scar is white. 5. glistening. Built 7. Rolled method . Body measurement B. eyes 2. Plain method . Posture 8. Handwriting D. 3. Height 5. Head 9. Fingerprints are not changeable Practical uses 1. Hair 10. There is no two identical fingerprints 2. Weight 6. Among illiterates. 2. Such information may be given bybthe witness. 4. contracted. Prints on file are useful for comparative purposes 4. 6. Race or color 4. accurate and picturesque description of the person identified. 7.scheme utilizing anthropometrical measurement of the human body as the basis of identification Basis 1. It is impossible to find two human beings having bones exactly alike.bulbs of the thumb and other fingers are rolled on the surface of the paper after being rolled on an ink pad Kinds of Impression . right thumbprint is recognized as substitute for signature. The necessary measurement can easily be taken. Wrist 14. Prints recoveres from crime scene associate person 3. Personal belongings 10 By 4D2014-2015 3. Neck 12. Face 11. Fingerprinting considered to be the most valuable method of Identification the finger may be wounded or burned. Ornamentation 2. Summary of Legal Medicine Book by Solis Waering apparel Foreign bodies Identification by close friends and relatives Identification record Photographs II.moles. Fingerprinting B. or persons who ate acquainted with the physical features of the person to be identified 1. Identification of skeleton E. General impression 2. Anthropometrical measurements A. Measurement of the limbs Portrait Parle (spoken picture) . Identification of Blood H. Help establish identity in cases of dead bodies 2. Information included 1. The human skeleton is unchangeable after twentieth year.color of hair. sex 3. Identification of Hair and Fibers A. Shoulder 13. Determination of Age G.verbal. Fingers 16. relatives. Descriptive Data . Hands 15. Feet Extrinsic Factors in Identification 1. This area of the skin is placed in a small labelled test tube containing formaldehyde solution. and has thus acquired knowledge of the handwriting of such person. The dentist may only concern himself with the affected teeth and may not care to have a detailed examination of the other teeth. Robberies 4.In case of fresh bodies.If the "floater" has been in the body if water for a longer time and the friction ridges have disappeared. the greater the degree of tissue deatruction. . Real impression . DENTAL IDENTIFICATION 1. It may outlast all other tissues. as long as the dermis of the bulbs of the finger is not completely destroyed. . 4. B. Acknowledgement of the alleged writer 2. Arches . No uniformity in nomenclature in the charting of teeth 3. Death inveatigation 3. Although there may be a law obligating dentists to have a record of their patient. Radial loop 3. never turning back to make a loop A. Summary of Legal Medicine Book by Solis The enamel of the teeth is the hardest substance in the body.the ridgea go from one side of the pattern to another. Whorls . and has seen the person write. recurves and terminate on the same side from which it entered A. Simple whorl B. The possibility of two persons to have the same dentition is quite remote. 11 By 4D2014-2015 2. Accidentals Q: Can fingerprints be effaced? A: No. After death. Central pocket loop C. the fingerprints will always remain unchanged and indestructible. 2. Opinion of an expert Practical Uses of Handwriting Examination 1. Tented arches 2. Chance impression . Ulnar loop B. Opinion of persons who are familiar with the handwriting of the alleged writer 4.study of handwriting for the purpose of determining the writer's personality. Types of Fingerprint Patterns 1. 3. Falsification of documents Bibliotics . the skin of the fingertips is cut away. Causes of Unreliability of the Dental Records 1. Loops . Statement of the witness who saw the writing 3.patterns with two deltas and patterns too irregular in form to classify A.impresses by mere chance without any intention to produce it How to Get Fingerprint Impressions on Dead Bodies . Plain arches B.impression of the finger bulbs with the use of printing ink on the surface of the paper 2. Q: Can fingerprints be forged? A: There is considerable controversy as various experiments could almost make an accurate reproduction. the greater is importance of the dental characteristic. Twin loop E. Lateral pocket loop D. The genuineness of any disputed writing may be proven by any of the following ways 1. Anonymous threatening letters 6.science of handwriting analysis Graphology . character and aptitude. The more recent the ante-mortem records of the person to be identified. the more reliable is the comparative or exclusionary mode of identification that can be done. HANDWRITING . the fingers are uncleanched and each one is inked individually with the aid of small rubber roller.FROGLETS NOTES 1. Changes in the teeth which are not seen by the dentist C. or has seen writing purporting to be his upon which the witness has acted or been charged. the law does not mention the agency which will enforce it 4. Financial crime 2. still there is no case in record known or have been written. Kidnapping with ransom 5.The handwriting of a person may be proved by a witness who believes it to be the handwiting of such person.one or more ridges enter on either side. FROGLETS NOTES Handwriting - complex interaction of nerves c. d. e. Writing - conscious act, but on the account of repeated act it becomes habitual and unconscious Movements in Writing 1. Finger movement- letters are made entirely by the action of the thumb, the pointing and middle fingers 2. Hand movement – letters are produced by the action of the hand as a whole with the wrist as the center of action 3. Arm movement – movement in writing is made by the hand and arm supported with the elbow at the center of later swing 4. Whole arm movement – action is produced by the entire arm without any rest The Form, Style and Characteristics of the Handwriting of a Person are Basically Determined By: Primary Factors 1. Survival of the letters are formed when a person begins to write 2. Inclusion of some characteristics due to admiration of a peculiar design in writing 3. Identifying characteristics may be the result of the great volume of writing done 4. The presence or absence of physical abnormalities or defects originating from illness, injury, psychological variations and other similar conditions Secondary Factors 1. Position of writer 2. Temporary physical or psychological disturbance 3. Other external temporary variables 4. Physical and chemical factors A. Writing instrument a. Ballpen b. Fountain pen c. Steel pen d. Pencil B. Paper a. Color b. Surface appearance c. Watermarks d. Weight and thickness C. Ink a. Iron gallotannate ink b. Washable ink 12 By 4D2014-2015 Summary of Legal Medicine Book by Solis Logwood ink Carbon ink Ballpoint ink CHAPTER III MEDICO-LEGAL ASPECTS OF IDENTIFICATION Instruments Necessary in Questioned Document Examination: 1. 2. 3. 4. 5. Photographic instruments- to view the writing in sufficient magnification for detail examination and preparation of evidence for presentation Magnifying lend and stereoscopic binocular microscope- to determine unusual appearances of writing. Obliterations, erasures and alterations may be more visible UV lamp and infra red radiation- to mae visible the chemical erasures Measuring caliper Good lighting facilities Purpose of Handwriting Examination 1. 2. 3. 4. Whether the document was written by the suspect Whether the document was written by the person whose signature it bears Whether the writing contains additions or deletions Whether the document such as bills, receipts, suicide notes or checks are genuine or a forgery Points to Consider in Questioned Document Examination    Slant, spacing, size, proportion of the letters, speed and rhythm in writing, shading, pen strokes The greater the variation in the way of writing, the greater the amount of standard of writing needed to form a reliable impression To determine whether a certain instrument or document has been written by a certain person, compare the writings with some standard of writings of the same person o Two Types of Standard Writings:  Collected Standards: handwriting by the person who is suspected to have written the questioned document; may be found in the private or public records of the persons  Requested Standard: standards made by the alleged writer upon request of the examiner; usually FROGLETS NOTES applicable only to recently written documents 7. The deliberate attempt on the part of the writer to alter his writing habit to invent a new writing style of by imitating the writing of another person.  Done by changing the direction of the slant, changing the speed in writing, deliberate carelessness 8. 9. Disguised writing Signature forgery Signature forgery examination is the most common activity of a questioned document examiner Classifications of Signature Forgery 1. Traced forgery: the outlining of a genuine signature from one document onto another 2. Simulated forgery: an attempt to copy in freehand manner the characteristics of a genuine signature either from the memory of the signature or from as model. 3. Spurious forgery: one prepared primarily in the forger’s own handwriting wherein little or no attempt has been made to copy the characteristics of the genuine writing Typewriter Identification The identification of the typing machine used in a questioned document IDENTIFICATION OF THE SKELETON In the examination of bones, the following points can be determined: 1. Whether the remains are of human origin or not: Study the shape, size, and general nature of the remains, especially that of the skull 2. Whether the remains belong to a single person or not: Any plurality or excess of the bones after a complete lay out denotes that the remains belong to more than one person 3. Height 4. Sex: Study the pelvis, skull, sternum, femur and humerus 5. Race 6. Age: Determined by the appearance of ossification centers and union of bones and epiphyses, dental identification, and obliteration of cranial structures 13 By 4D2014-2015 Summary of Legal Medicine Book by Solis Length of interment or length from the time of death May be determined by the nature and presence of soft tissues and the degree of erosion of the bones. Ordinarily, all the soft tissues in a grave disappear within a year. Presence or absence of ante or post mortem injuries Congenital deformities and acquired injuries on the hard tissues causing permanent deformities (pp. 86-102) Procedure of the Test Two Methods may be utilized and both should be employed in the examination: 1. Detection of Agglutinins 2. Detection of Agglutinogens Value of the Test  It may solve disputed parentage (maternity or paternity).  Positive result - not conclusive that the one in question is the offspring  Negative result - conclusive that he is not the child of the alleged parents. Grouping is true not only with blood but also with other body fluids like saliva, vaginal secretion, seminal fluid, milk, urine and others INHERITANCE PATTERNS OF ABO BLOOD GROUPS Group Parents OxO OxA OxB AxA AxB BxB O x AB A x AB B x AB AB x AB of Group of Children O O, A O, B O, A O, A, B, AB O, B A, B A, B, AB A, B, AB A, B, AB Exclusion Cases A, B, AB B, AB A, AB B, AB A, AB O, AB O O O Different Characteristics of Blood from Different Sources: 1. Arterial Blood – bright scarlet in color, leaves the blood vessel with pressure, high oxygen contents 2. Venous Blood – dark red in color, does not spill far from the wound, low oxygen content 3. Menstrual Blood – does not clot, acidic in reaction owing to mixture with vaginal mucous, on FROGLETS NOTES microscopic examination, there are vaginal epithelial cells, contains large number of Deoderlein’s bacillus. 4. Man’s or Woman’s Blood- no method of differentiating man and woman’s blood 5. Child’s Blood- at birth, it is thin and soft compared with that of adult, red blood cells are nucleated and exhibit greater fragility, red blood cells count more than in adult. Identification of Hairs and Fibers 1. Addition of a substance that will coat the outer surface of the hair so as to impart a different color. Ex.: Salts of bismuth, lead, silver and pyrogallic acid 2. Addition of substances which bleach change the natural color of the hair. Ex.: Hydrogen peroxide, chlorine diluted nitric acid or fiber or and Distinctions between Human and Animal Hair: Medulla Human Air network in fine grains Cells invisible without treatment in water Value of I lower than 0.3 Fuzz without medulla Cortex Looks like a thick muff Pigments in the form of fine grains Cuticle Thin scales not protruding, covering one another to about 4/5 14 By 4D2014-2015 Animal Air network in forms of large and small sacks. Cells visible easily Value of I higher than 0.5 Fuzz with medulla Looks like a fairly thin hollow cylinder Pigments in the form of irregular grains larger than that of human’s Thick scales protruding, do not cover one another the Summary of Legal Medicine Book by Solis same degree as human’s Note: Medullary index (I) is the relation between the diameter of the medulla and the diameter of the whole hair. The hair and fiber may be examined microscopically in its cross-section and longitudinal aspect.Comparative study must be made to show similarity of the hair and fiber. Other Points in the Identification of Hair: 1. Characteristics of the hair: Hair on body surfaces is fine while those from the beard, mustache and scalp are very thick. Hair from the eyebrows and lashes is tapering gradually to finepoints. 2. Length of the Hair: Hair from the scalp grows 2.5 cms. a month. Beard hair grows at the rate of 0.4 millimeter a day. 3. Color of the hair:  May be black, blonde or brunette.  Hair from older persons may be white or gray.  The hair may be artificially colored by bismuth, lead or silver salts.  It may be bleached by addition of hydrogen peroxide, chlorine or diluted hydrochloric or nitric acid. Male or a Female Hair In many instances it is quite impossible to state the sex from the hair, but certain points may be worthy of mention:  Hair on the scalp of male is shorter, thicker and more wiry than that of female's.  Eyebrow hair of a male is generally long and more wiry than that of a female's. Estimation of Age Based on the Hair:  Hair of children is fine, short, and deficient of pigments and, as a rule, devoid of medulla.  At the adolescent age, hair may appear at the pubis. Hair on the scalp becomes long, wiry, and thick.  In the case of older persons, the color is usually white or gray, with marked absorption of pigments and degenerative changes CHAPTER IV MEDICO-LEGAL ASPECTS OF DEATH Importance of Death Determination 1. The civil personality of a natural person is extinguished by death; 2. The property of a person is transmitted to his heirs at the time of death;  the ascertainment of death is a clinical and not a legal problem. Chapter 378 of Kansas Statute) Brain Death 1. that the apparatus is functioning normally.  It is a condition in which the physician and the members of the family pronounced a person to be dead based on the common sense or intuition 3.  it is an irreversible loss of the properties of living matter. 5.  Swallowing. Cardio-Respiratory Death  Death occurs when there is a continuous and persistent cessation of heart action and respiration.FROGLETS NOTES 3. In 1969. 2. tapping the tendons of the biceps. triceps and pronator muscles. absence of electrical brain activity and complete cessation of all the vital functions without possibility of resuscitation.  As a rule. 4. and that the personnel in charge are competent. Note: All of these tests shall be repeated at least 24 hours later with no change. and the following were considered: .  an event that takes place at a precise time. d. if he is then on respirator.  There is no evidence of postural activity (decerebrate or other).  it is the complete cessation of all the vital functions without possibility of resuscitation. The criminal liability of a person is extinguished by death. Duquesne University School of Law adopted the proposed criteriafor the determinationof death otherwise known as Philadelphia Protocol. death may be: 1. Death  is the termination of life. It is emphasized that the patient be declared dead before any effort is made to take him off the respirator. Brain and Cardio-Respiratory Death A person will be considered medically and legally dead if in the opinion of a physician based on ordinary standards of medical practice. (Section 1. these functions to cease.e.G.  Ocular movement (to head turning and to irrigation of the ears with ice water) and blinking are absent. i. it appears that further attempts at resuscitation or supportive maintenance will not succeed.E. Unreceptivity and Unresponsibility  There is a total unawareness to externally applied stimuli and inner need and complete unresponsiveness b. 2. there is:  absence of spontaneous respiratory and cardiac function. No movements or breathing  Observation covering a period of at least l hour by physicians is adequate to satisfy the criteria c.  Plantar or noxious stimulation gives no response.  Corneal and pharyngeal reflexes are absent. quadriceps and gastrocnemius muscles with the reflex hammer elicits no contraction of the respective muscles. 6. assuming that the electrodes have been properly applied. Based on the Criterion Used in its Determination. No reflexes Irreversible coma with abolition of central-nervous system activity is evidenced in part by the absence of elicitable reflexes. 15 By 4D2014-2015 Summary of Legal Medicine Book by Solis Death will have occurred when these conditions first coincide. the following are the characteristics of ―irreversible coma‖: a. directly or indirectly. attempts at resuscitation are considered hopeless. Flat electro-encephalogram  Of great confirmatory value is the flat or iso-electric E. Brain Death  Death occurs when there is deep irreversible coma. The civil case for claims which does not survive is dismissed upon the death of the defendant.  The pupil will be fixed and dilated and will not respond to a direct source of bright light. the stretch or tendon reflexes cannot be elicited. and because of the disease or condition which caused.  absence of spontaneous brain function and if based on ordinary standards of medical practice during reasonable attempts to either maintain or restore spontaneous circulatory or respiratory function in the absence of aforesaid brain function. The death of either the principal or the agent is a mode of extinguishment of agency. yawning. the Ad Hoc Committee of Human Transplantation convened under the auspices of the Institute of Forensic Sciences. vocalization are in abeyance. According to Harvard Report of 1968. The death of the partner is one of the causes of dissolution of partnership agreement. or because of the passage of time since these functions ceased. the lower jaw tends to drop . d. No reflex response to lower airway stimulation.8. Reflexes and response: d. d. Iso-electric electro-encephalogram (in the absence of hypothermia.may be made at the region of the wrist or at the neck a. d. CESSATION OF HEART ACTION AND CIRCULATION  There must be continuous cessation of the heart action and the flow of blood in the whole vascular system Methods of Detecting the Cessation of Heart Action and Circulation a. d.2. Corneal reflexes absent. there is still animal life among individual cells. Mohandas and Chou (1971) – standards of Brain Death accepted at the University of Minnesota Science Center. 2. in the absence of hypocarbia and while breathing room air. Supra-orbital or other pressure response absent (both pain response and decerebrate posturing). No superficial reflexes. No reflex response to upper airway stimulation. persistent and continuous cessation of the vital functions of the brain. Absence of snucking or snouting response. No ocular response to ice water stimulation of the inner ear. The Ottawa General Hospital (1970) guidelines for the criteria of cerebral death.the sphincters are relax .the Council of Ministers published a decree which adopted the official definition of death on recommendation of the French Academy of Medicine. Absence of spontaneous breathing movements for 3 minutes.the face and lips become pale .skin loses its elasticity .5. Auscultation for the heart sound at the precordial Area .FROGLETS NOTES a. . uremia.body heat gradually assumes the temperature of the surroundings 2. c. MOLECULAR OR CELLULAR DEATH  After cessation of the vital functions. No plantar responses. Lack of responsiveness to internal and external environment. heart and lungs which maintain life and death. non-reactive stimuli. SOMATIC DEATH OR CLINICAL DEATH  state of the body in which there is complete. external stimulus or other forms of influence. d.7. to strong e. No deep tendon reflexes. d. Falling arterial pressure without support by drugs or other means. In France (1968) . It is further laid down that these criteria shall have been present for at least 2 hours and that death should be certified by two physicians other than the physician of a potential organ recipient. Pupils fixed and dilated. d. SIGNS OF DEATH 1. f.  immediately after death. Heart sound can be audible during life even without the aid of a stethoscope by placing the ear at the precordial area . d. No muscular movements with generalized flaccidity and no evidence of postural activity or shivering. KINDS OF DEATH 1. 16 By 4D2014-2015 Summary of Legal Medicine Book by Solis A. Other Set of criteria to Establish Brain Death: 1.  hardly impossible to determine the exact time of death.body fluids tend to gravitate to the most dependent portions of the body . d. catalepsy and electric shock B. Palpation of the Pulse.1.the muscles become flaccid . d.pupils dilate .6. APPARENT DEATH OR STATE OF SUSPENDED ANIMATION  This condition is not really death but merely a transient loss of the vital functions of the body on account of disease.9.10. there is death of individual cells known as molecular or cellular death  Exact occurrence cannot be definitely determined due to several factors 3.  About 3-6 hours later. 3. Examination of the Heart a. b.the rhythmic contraction and relaxation of the heart is audible through the stethoscope. Note: The use of the criteria of brain death may only be applied to those persons who are potential organ donors.3.4.  It may arise especially hysteria. anesthetic agents and drugs intoxication) recorded spontaneously and during auditory and tactile stimulation.the eyelids remain open .1.2. In cases of apparent drowning.6. b. Dead: No such pulsation will be observed b. and reactions of the injured area will be observed. Magnus’ Test:  A ligature is applied around the base of a finger with moderate tightness. Dead: there will be no inflammatory edema at the neighborhood of the dropped melted wax. Flouroscopic Examination. In the following conditions there may be suspension of respiration without death ensuing: a.3. b. . b. INTERNAL HYPOSTASIS IN VISCERAL ORGANS Post-mortem lividity occurs in internal organs.  Dead: the blood vessel is white and there is no jerking escape of blood but may only ooze towards the nearby skin. no sign of congestion. Examination of the Peripheral Circulation: b. the dye will spread all over the body and the whole skin will have a gleenish-yellow discoloration due to flourescein. there will be a zone of paleness at the site of the application of pressure which become livid on release. Pressure on the Fingernails:  lf pressure is applied on the fingernails intermittently. but the apneic interval cannot be longer than fifteen to twenty seconds. Dropping of Melted Wax Melted sealing wax is dropped on the breast of a person.2.3. CESSATION OF RESPIRATION  must be continuous and persistent. Icard's Test  This consists of the injection of a solution of fluorescein subcutaneously. By the Use of Electrocardiograph This is the best method of determining action but quite impractical heart b. Newly-born infants may not breathe for a time after birth and may commence only after stimulation or spontaneously later. 2. c.  In a living person there appears a bloodless zone at the site of the application of the ligature and a livid area distal to the ligature. swimmers. Simple Congestion Generally uniform and found all over the body. Dull and lustreless mucous membrane Imflammatory exudates is not seen. a. In some peculiar condition of respiration. there is no such change in color. Not seen in simple congestion.  There will be no such change of color if the test is applied to a dead man. but it cannot be longer than two minutes.  Living: the finger webs appear red Dead: yellow a.1. like CheyneStokes respiration.  If the ligature is applied to the finger of a dead man. areas of redness alternating with pale areas found in a hollow viscus.5.7.8. b.4. Post Mortem Lividity Staining in organs is irregular and occurs in most dependent parts. congestion.  When bigger arteries are cut. etc.4. or other vital reactions. The shadow may be enlarged and the excursion made less visible due to pericardial effusion.FROGLETS NOTES Summary of Legal Medicine Book by Solis Difficulties in Auscultation may be encountered in: (a) Stout person (b) Fatty degeneration of the heart.  If circulation is still present.  This test should be applied only with the use of the daylight as the color is difficult to be appreciated with the use of artificial light. Dead: will not produce true blister. In a purely voluntary act. Opening of Small Artery:  Living: the blood escapes in jerk and at a distance. Palpation of the Radial Pulse With Fingers  Living: will feel the rhythmic pulsation of the vessel due to the flow of blood. b. as in divers. blood may flow without pressure continuously. b. (c) Pericardial effusion.  The fingers are spread wide and the finger webs are viewed through a strong light.will reveal the shadow of the heart in its rhythmic contraction and relaxation. Not so. d. Application of Heat on the Shin  If heated material is applied on the skin Living: blister formation. Diaphanous Test 17 By 4D2014-2015 other vital b. Magnesium as a result of diffusion. Fluid Coming out of both nostrils and mouth. floating of the body. 18 By 4D2014-2015 Time elapsed between death and burial and environment of the body. Liquefaction of the Soft Tissues Post Mortem Lividity Haemorrhage of scurvy Presence can be revealed in history. Skin lesion present before death May be found all over the skin and organs. Changes in the color of the tissue 2. Factors Modifying the Rate of Putrefaction Internal Factors Age Condition of the Body Cause of Death External Factors Free Air Earth Water Clothings CHANGES IN THE BLOOD: FACTORS INFLUENCING THE CHANGES IN THE BODY AFTER BURIAL Hydrogen Ion Concentration Rise of non-protein nitrogen and free amino-acid Chemical: Chloride in the plasma. Present in the most dependent portions of the body. proteolytic. Skinny persons have more tendency to decompose.FROGLETS NOTES Summary of Legal Medicine Book by Solis 3. glycolytic and lipolytic ferments of glandular tissues continue to act which lead to the autodigestion of organs. Inclusion of something in the Grave which will hasten Decomposition Access of Air to the Body after Burial: Air may hasten evaporation of the body fluid and promotes mummification. Condition and type of soil: Dry. Clothing and Any other Coverings on the Body when buried: Clothings retard decomposition because it affords protection from insects and aids adipocere formation. Effect of Coffin: the use of a coffin will delay decomposition if it is airtight and hard. Mass Grave: There is relatively rapid decomposition of the bodies Trauma on the Body: CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES OCCURING IN TEMPERATE REGIONS . Extrusion of the Fetus in a gravid uters. State of the Body before Death: An emaciated person at the time of death will decompose slower than a wellnourished individual. Phosphorus poisoning Presence can be revealed in history. Depth at which Body is buried: the greater the depth the body is buried the better the preservation. Their early appearance is observed in the parenchyatous and glandular tissues. Skin lesion present before death May be found all over the skin and organs. Skin lesion appears after death. arid and sandy soil promotes mummification. Potassium increases owing to diffusion. This action is facilitated by weak acid and higher temperature and delayed by the alkaline reaction of the tissues of the body and low temperature. PUTREFACTION OF THE BODY Putrefaction is the breaking down of the complex proteins into simpler components associated with the evolution of foul smelling gasses and accompanied by the change of color of the body. Tissue changes in Putrefaction: 1. Evolution of Gasses in the tissues Effects of the Pressure of Gasses of Putrefaction Displacement of Blood. AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER DEATH After Death. Bloating of the Body. Sphincters relaxed. Srotum and penis distended with gas. Trunk bloated. Frothy blood from the moth and nostrils. Hair and nails loose. Purplish red streaks of veins prominent on the extremities. The microorganism that plays an important role in decomposition is Clostridium Welchii. later on activities of the anaerobes are the most prominent with the production of gasses. Abdomen distended with gas. External Influence: the presence of heavy-wearing apparel or addition weight in the pockets or attached to the body delays floating. Special Modification of Putrefaction . Rigor mortis may persist. fishes and crabs. arms. and molds. The face appears softened and has a faded white color. Other destructive agents during decomposition include flies and maggots. Water: Dead body floats in a shallow and stagnant water of creeks or pond sooner than in deep water in running streams. Lungs emphysematous and covered the heart. CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES OCCURING IN TROPICAL REGIONS Rigor mortis present all over. Skin of the hands and feet wrinkled. Upper surface of brain greenish in color. lips. external genitals and other parts of the body. Face discoloured. semi-fluid black mass 1-3 days 3-5 days 8-10 days 14 – 20 days 2-5 mos after death 12 hrs 24 hrs 48 hrs. CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES WHEN THE BODY HAS BEEN SUBMERGED IN WATER Very little change if water is cold. destruction of nuclei and generation of gasses in the cells. Softening of tissues is the result of bacterial action. abdomen. Whole body grossly swollen and disfigured. Maggots found on the body. Season of the Year: The moist hot air of summer is very favourable for putrefaction. The skin on the hands and feet became sodden and bleached. Abdomen distended with gasses. rodents. Moving maggots seen. Order of putrefaction when body is in water: Face. Greenish discoloration spreading over the while abdomen. Soft tissues largely gone. Skin peels off. Soft parts changes into a thick. Rigor mortis absent all over. It grows in the parenchyatous organs and is responsible for the disintegration of cytoplasm.FROGLETS NOTES Greenish Discoloration over the iliac fosae. Body swollen up owing to distention. Only more resistant viscera distinguishable. Tissues soft and discoloured. skin of hands and feet come off with nails like a glove. proteolytic and autolytic ferments. Green discoloration over whole abdomen and spreading to chest. legs. Aerobic activities are present in the early stages of decomposition. Eyeballs are soft and yielding. Skin wrinkled. Body greenish-brown. 19 By 4D2014-2015 4 wks 6 – 8 wks Factors Influencing the Floating of the Body in Water Sex: Women float sooner than men. Greenish discoloration showing over the castum. Summary of Legal Medicine Book by Solis 4-5 days 5-7 days Decomposition is due to action of bacteria in various tissues of the body. reptiles. Nails and hair still intact. Hypostasis well developed and fixed. neck and sternum. 1 – 2 wks Age: Bodies of fully-developed and well-nourished newlyborn infants float rapidly. Body skeletonised. Blisters forming all over the body. Features unrecognizable. Nails firm. Soft viscera putrefied. Scrotum distended. Nails and hair loose and easily detached. neck and sternum. Greenish discoloration on the eyelids. Face swollen and red. other mammals. Ova of flies seen. Conditions of the body: Stout persons float quicker. Abdomen distended. Cornea fallen in and concave. shoulders. INFLUENCE OF BACTERIA IN DECOMPOSITION 72 hrs 1 wk 2 wks 1 mo. Blisters present. pulverization of flat bones and diminution of weight due to the loss of animal matter may be the basis of the approximation. Entomology of the Cadaver: to approximate the time of death. Article 391 Civil Code  Presumed DEAD FOR ALL PURPOSES: . effect of a coffin.FROGLETS NOTES I. the soft tissues of the body may disappear 1-2yrs after burial. mass grave. Stage of digestion in the stomach: it normally takes 3-4 hrs for the stomach to evacuate its contents after a meal. Onset of Decomposition: In tropical areas. Presence or absence of soft tissues in skeletal remains: under ordinary conditions. Duration of Death Presence of Rigor Mortis: in warm countries. rigor mortis sets in from 2-3 hrs after death. Time interval between death and burial. Artificial: (1) acceleration of the evaporation of the tissue fluids of the body before actual onset of decomposition. usually from the clothing of the victim. o If he disappeared after 75 years old: Absence of 5 years SUFFICIENT to open succession. Fleas recovered. The 20 By 4D2014-2015 Disputable Presumption: not heard from for 7 years = DEAD o Dead for all purposes. Appears as small petechia-like red spots which later coalesce with each other to involve bigger areas in the most dependent portions of the body. the presence of flies in the cadaver is sometimes used. he was last seen voiding his urine. type of soil. Saponification or Adipocere Formation: a condition wherein the fatty tissues of the body are transformed to soft brownish-white substance known as adipocere. PRESUMPTION OF DEATH Rule 131 Section 5 Rules of Court Article 390 Civil Code   Stage of Decomposition: the approximate time of death may be inferred from the degree of decomposition. is observed if it still living to approximate the time when said was submerged in water. Kinds of mummification: Natural: the body will become dehydrated and mummified due to the forces of nature. access of air to the body after burial. Summary of Legal Medicine Book by Solis approximate time of death may be deduced from the amount of food in the stomach in relation to his last meal. Condition of the Bones: if all the soft tissues have already disappeared from the skeletal remains. Maceration: the softening of the tissues when in a fluid medium in the ansence of putrefactive microorganism which is frequently observed in the death of the fetus en utero. State of Health before Death. Mummification usually happens in warm countries where evaporation of body fluids takes place earlier and faster than decomposition. EXCEPT: SUCCESSION Absentee shall not be presumed dead for the purpose of opening his succession till after absence of 10 years. Mummification: the dehydration of the whole body which results in the shivering and preservation of the body. It si fully developed in the body after 12 hrs. Amount of urine in the bladder: the amount of urine in the urinary bladder may indicate the time of death when taken into consideration. Presence of Post-mortem lividity: usually develops 3-6 hrs after death. decomposition is early and the average time is 24-48hrs after death. Presence of live fleas in the clothing (drowning cases): a flea can survive for approximately 24hrs submerged in water. It may last from 18 – 36 hrs and its disappearance is concomitant with the onset of putrefaction. II. (2) addition of preservatives to inhibit decomposition. State of the clothings: a circumstantial proof of the time of death is the apparel of the deceased Chemical changes in the Cerebro-Spinal Fluid Factors Influencing Adipocere Formation Post-mortem clotting and decoagulation of blood: blood clots inside the blood vessels in 6-8hrs after death. III. presence of clothing. the degree of erosion of the epiphyseal ends of long bones. 7. 3. CHAPTER VII SPECIAL DEATHS I. Same Sex: Older One UNDER 15. such as: Wreck Battle Conflagration 1. 3. Person in armed forces who has taken part in war. he shall recover his property in the condition in which it may be found. hypnotics.FROGLETS NOTES o o o Lost on board a vessel lost during sea voyage. If absentee appears or without appearing his existence is proved. a. the survivorship is presumed from the probabilities resulting from the strength and age of the sexes. 1. 4. or ABOVE 60. Other UNDER 60. Civil Code: If there is a doubt. as to which of them died first. whoever alleges the death of one prior to the 21 By 4D2014-2015 Death by Electrocution Death by Hanging Death by Musketry Death by Gas Chamber OTHER METHODS OF CAPITAL PUNISHMENT PRESUMPTION OF SURVIVORSHIP Not shown who died first. Active Euthanasia Passive Euthanasia a. Administration of a lethal dose of poison Overdosage of sedatives. 3. Different Sex: Male presumed survived b. and the price of any property that may have been alienated or the property acquired therewith. 2. Rule 131 Section 5(jj) Rules of Court When 2 persons die in same calamity. 2. 5. 8. 2. there are no particular circumstances from which it can be inferred. shall prove the same. other pain relieving drugs Injection of air into bloodstream Application of strong electric currents . Dysthanasia Ways of Performing Euthanasia 1. 5. as between 2 or more persons who are called to succeed each other. 4. 2. missing airplane. according to the following: JUDICIAL DEATH METHODS Article 392 Civil Code    Summary of Legal Medicine Book by Solis II. missing for 4 years Person In danger of death other circumstances and his existence not known 4 years. 6. 1. Beheading Crucifixion Beating Cutting Asunder Precipitation from a height Destruction by a wild beast Flaying Impaling Stoning Strangling Smothering Drowning EUTHANASIA ―Mercy Killing‖ – deliberate and painless acceleration of death of a person usually suffering from an incurable and distressing disease. it is presumed that they died at the same time and there shall be no transmission of rights from one to the other. 2. 4. 12. 10. the other BETWEEN those ages: latter presumed survived Article 43. Both UNDER 15: Older presumed survived Both ABOVE 60: Younger presumed survived One UNDER 15. in the absence of proof. Other ABOVE 60: UNDER 15 presumed survived One OVER 15. not been heard of for 4 years since loss of vessel or airplane. but he cannot claim either fruits or rents. 3. TYPES: 1. other. 11. 4. 9. Orthothanasia b. FROGLETS NOTES 5. such provision will prevail over the provisions of the Administrative Code. if able to do so. Evidence which will rule out homicide. Third degree – sometimes called accidental suicide. the wounds are located in areas accessible to the hand. Surviving spouse has the preferential right and duty to make the arrangements but if deceased spouse left a will stating among other things the manner his body will be disposed. Unmarried or child: nearest kin if they be adults and within the Philippines and in possession of means to pay the necessary expenses. custody of which will remain to local board of health or municipal council until buried. Methods of Disposal of the Dead Body 1. 5. III. 2. Treachery is inherent to the act of poisoning and treachery qualifies it to murder. premeditated. murder. Failure to institute the necessary management procedure which is essential to preserve the life of the patient. 2. 3. First degree – deliberate. Self-destruction due to negligence 6. 6. Burial or Inhumation . mental disease Previous attempt of selfdestruction If committed by infliction of physical injuries. This occurs when a person puts his or her life into jeopardy by voluntary self – injury 4. 3. If married: surviving spouse if possesses means to pay the necessary expenses. under great provocation or mitigating circumstances 3. SUICIDE Psychological Classification of Suicide 1. Unmarried or no kin left with means: municipal authorities *Shall perform such duty within 48 hours after death. Right of custody means possession. The right of possession of a corpse is equivalent to ownership and unlawful interference is an actionable wrong. Suicide under circumstances which suggest a lack of capacity for intention as when the person was psychotic or under influence and effects of drugs and alcohol. and other manner of violent death. with or without the knowledge and and consent of the patient Poison was administered by the physician to the patient without the knowledge and consent of the patient.Body must be buried within 48 hours after death except when required for legal investigation or authorized . Effects of act of self-destruction found in the body of the victim Presence of suicide note Suicide scene in place not susceptible to public view By 4D2014-2015 7. planned. 2. parricide. 22 Summary of Legal Medicine Book by Solis History of depression. Justifiable suicide – self.destruction action of a person with terminal illness. Right of Custody to body: To the person charged with the duty of burying the body except when inquest is required by law to determine cause of death or cause of death is accompanied by communicable disease. vital parts of the body and usually solitary. then it is murder. unplanned. Ways of Performing Euthanasia 1. the holding of a thing or the enjoyment of a right. Enjoyment of a thing could either be in the concept of ownership or holder of a thing while ownership belongs to another. Patient himself The physician. CHAPTER VIII DISPOSAL OF THE DEAD BODY Persons Charged with Duty of Burial: 1. Second degree – impulsive. 5. 3.Artificial way of preserving body be injecting formalin and perchloride of mercury or arsenic in the common arteries and the femoral arteries. self-murder 2. Evidence that will infer death is suicidal: 1. Embalming . 4. unresolved personal problem. 2. (b) The burial of remains in city or municipal burial grounds shall not be prohibited on account of race. It is the duty of the local health authorities to cause such body to be thoroughly disinfected before being prepared for burial. body needs to be buried within 24 hours because of the climatic condition. Only adult members of the family may be permitted to attend the burial. Cremation Pulverization of the body into ashes by the application of heat. 307. nationality. If not. After 48 hours. A special permit needs to be secured from officers authorized to issue permits. (c) No burial ground shall be located within 50 meters from either side of a river or within 50 meters from any source of water supply. Copy of death certificate shall accompany transfer permit if body will be transferred from one municipality to another. within 12 hours after death unless directed otherwise by local board of health. Revised Administrative Code) Burial Grounds Requirements (PD 856. They shall not be taken to any place of public assembly. Only the adult members of the family of the deceased may be permitted to attend the funeral. Burial of the person sentenced to death must not be held with pomp (Art. Will of the deceased b. no unembalmed remains shall remain unburied longer than 48 hours after death. the secretary or of a councilor. 309 and 2219 of the NCC as well as Articles 132 and 133 of the RPC. in the capacity of secretaries of municipal boards of health or as clerks to municipal councils as the case may be. the remains shall be buried within 12 hours after death. 23 By 4D2014-2015 Study Articles 305. When not granted: . 3. Summary of Legal Medicine Book by Solis (b) A burial ground shall at least be 25 meters distant from any dwelling house and no house shall be constructed within the same distance from any burial ground.It must be forwarded within 48 hours after death. If with communicable disease. Body must first be identified and there must be a permit for cremation. 85. Those bodies with dangerous communicable disease shall not be carried from place to place except for burial or cremation. (c) Except when required by legal investigation or when permitted by the local health authority. religion or political persuasion.  Death Certificate necessary before burial except in cases of emergency. Burial and transfer Permits Municipal secretaries. shall issue burial or transfer permits upon the presentation of the death certificate. Burial permit (death certificate) must be presented before burial. 2695. Code of Sanitation) Burial Grounds Requirements the following requirements shall be applied and enforced: (a) It shall be unlawful for any person to bury remains in places other than those legally authorized in conformity with the provisions of this Chapter. Permission from the provincial fiscal or mayor is necessary if death due to violence or crime. RPC) c. The burial remain is subject to the following requirements: (a) Shipment of remains abroad shall be governed by the rules and regulations of the Bureau of Quarantine.FROGLETS NOTES by local health authorities or when embalmed (impliedly allowed). The Law Penalizes Desecration of Burial Premises (Sec. Limitations to the Funeral Rites a. local health officer. 4. In Philippines. new permit is needed. Primary duty of physician to furnish if available. 306. Order is successive and exclusive. . mayor. Restrictions as to funeral in cases of deaths due to communicable disease When the cause of death is a dangerous communicable disease. Disposal of Dead Body to the Sea Allowed when death is not due to dangerous communicable disease. * The person who issued the death certificate shall notify the justice of the peace or the auxiliary justice or the mayor if neither of the two is available if he observed any indication of violence or crime. Identity has not yet been definitely ascertained a. Signed by the grantor and 2 disinterested 5. (b) A married person may make such donation without the consent of his spouse. License physician or surgeon 2. It must be . and members of the family of the deceased. a hospital or a scientific institution upon his death for transplant. Further inquiry needed to cause of death 5. A copy of the written authorization shall be forwarded to the Secretary. guardian with the approval of the court or by the legitimate father or mother. Head of hospital or institution having custody in the absence of relatives Persons permitted to detach body parts: 1. Use of Body for Scientific Purposes Unclaimed remains may be used by medical schools and scientific institutions for studies and research subject to the rules and regulations prescribed by the department. Nearest relative 2. If minor. a scientist. 3. 24 By 4D2014-2015 1. (f) Any authorization granted in accordance with the requirements of this Section is binding to the executors. the organ or part of his body to be donated and the specific purpose for which it will be utilized. Must be in writing 2. or research purposes subject to the following requirements: (a) The donation shall be authorized in writing by the donor specifying the recipient. administrators. (c) After the death of a person the next of kin may authorize the donation of an organ or any part of the body of the deceased for similar purposes in accordance with the prescribed procedure. Married woman can give consent without husbands consent. Deceased during his lifetime 2. a physician. medical. Known scientist banks. (e) A simple written authorization signed by the donor in the presence of two witnesses shall be deemed sufficient for the donation of organs or parts of the human body required in this Section. Exhumation The deceased buried may be raised or disinterred upon lawful order from fiscals. Copy furnished to the Secretary of Health Limitation to the Authorization Not allowed when died with dangerous communicable disease Penal Provision Imprisonment of not less than six months nor more than one year. Specify the person/institution granted the authorization 3. Surgical and Scientific purposes Any person may donate an organ or any part of his body to a person. court and any entity vested with authority to investigate. Before death: 3. If deceased left a written direction that he will not be cremated Persons who can grants permission to used body parts of deceased: 2. notwithstanding the provisions of the Civil Code of the Philippines on matters of donation.FROGLETS NOTES Summary of Legal Medicine Book by Solis 1. b. Medical or scientific institutions including eye Requirements: 1. Study RA 349 as amended by RA 1056 (Donations of Human Body Parts) Donation of Human Organs for Medical. the Director of the hospital may donate an organ or any part of the body of the deceased in accordance with the requirement prescribed in this Section. (d) If the deceased has no next of kin and his remains are in the custody of an accredited hospital. After death: 1. Specify the organ/part to be detached persons 4. of the deceased person. If the dead body is a subject matter of criminal investigation. Reasons could be: a.Metalic fragment or whole slug for ballistic examinations . Recover foreign bodies . shorter time when in the opinion of Director of Health. subject to the approval of Regional Director (Director of Health) concerned or his duly authorized representative. It will be immediately disinfected and inclosed in a coffin. brothers and sisters  Sec 1098 Revised Administrative Code Shipment of remains at sea . nationality. Determine cause of death b. no human remains shall be retained. permission may be granted after a burial period of 5 years Shorter period may be granted in special cases.  If dead body is a subject matter of criminal investigation.FROGLETS NOTES identified by relatives.toxicology analysis .dangerous communicable disease may be granted after burial period of 3 years If death is due to a communicable dangerous disease. ascendants of the nearest degree. (c) Disinterment of remains covered in paragraphs "a" and "b" of this Section may be permitted within a shorter time than that prescribed in special cases.Operative sponge. the public health will not be endangered. disposed of or exhumed without the consent of: spouse. Disinterment of remains is subject to the following requirements: (a) Permission to disinter remains of persons who died of non-dangerous communicable diseases may be granted after a burial period of three years. it may be exhumed anytime. Determine identity c. Even members of NBI are required to get permit from the Director of Health for exhumation. the cause of death. age. 2.histopathological examination 25 By 4D2014-2015 Permission to disinter remains of persons who died of non . Person died with for a cause other than dangerous communicable disease may be disinterred after 3 years of being buried or in special cases. friends or by marks on the body. a petition in court must be done. Disinterment Requirements: 1. clothing and degree of decomposition before stating the actual disease or violence in his report. Physician must describe the coffin. (d) In all cases of disinterment. If the next of kin refuses to give consent for exhumation autopsy. it may be exhumed anytime 1. case or box. the destination and remains.  Read article 308 of the NCC  Summary of Legal Medicine Book by Solis . 4. subject to the approval of the Regional Director concerned or his duly authorized representative. According to Art 305 of the Civil Code. descendants of the nearest degree. medical instrument to prove medical negligence 2. 3.smears from vaginal canal and blood for alcohol determination d. In all cases of disinterment. the remains shall be disinfected and placed in a sealed container prior to disposal. interred. Recover organs or tissues for further examination for: . The outside box containing the remains shall be plainly marked so as to show the name. How long can exhumation be done after interment: Sec 92 Code of Sanitation. . There must be a formal request from any of the law enforcement agencies authorized to make investigation addressed to any establishment authorized to perform medico-legal investigation. the remains shall be disinfected and places in a durable and sealed container prior to their final disposal. (b) Permission to disinter remains of person who died of dangerous communicable diseases may be granted after a burial period of five years.no body or remains shall be shipped to the US except under such conditions as may be prescribed by the United States Public Health Service. FROGLETS NOTES Requirements to be satisfied in exhumation: a.legal investigation. h. k. shall also infor the local health officer to assist the physician in the exhumation to ensure that public health will not be prejudiced. the body must be viewed by any or more persons who can identify the deceased 26 By 4D2014-2015 g. identity of the deceased . e.often in disaster victims refusal of the next-of-kin to give consent or to cooperate in the exhumation-autopsy . b. d. Summary of Legal Medicine Book by Solis Actual autopsy and adoption of procedure is needed to accomplish the purpose of exhumation Disinfection of the body and all areas involved must be carried out with the assistance of the local health officer and return of the body to the burial place Included in the Exhumation Report: a. time place of exhumation Description of the burial place Name and address of the persons who identified the burial place Condition of the body and coffin if there is interment Name and address of the persons who identified the body of the deceased The post-mortem examination and accomplishment of the purpose of exhumation Conclusions based on the findings and result of examination Remarks if any Signature and designation of physician’ Problems in Exhumation: a. The request must mention the name of the deceased. i. such that the body or remains. During exhumation.often when the next-of-kin is involved in the investigation Remedy: petition in court for an order to exhume body CHAPTER IX MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES     Physical injury is the effect of some stimulus on the body Effect is apparent: stimulus applied is insufficient to cause injury and body resistance is great Effect is real: effect is visible Effect of application of stimulus: Immediate (sharp object causing stab wound). contamination or such other effects After opening the coffin. after exhumation shall immediately be disinfected and enclosed in a coffin or box and this box shall be placed in an outside box which shall also be securely fastened. h. d. Delayed (blunt object causing contusion) . l. g. deformity. place and date of interment suspicion as to the cause of death etc. Procedure in medico .legal exhumations a. b.      There must be formal request from any law enforcement agency to make an investigation addressed to any person authorized to perform medico . The name of the deceased person and circumstances Purpose of exhumation Name address and designation of the requesting party Date. care and diligence must be observed to avoid destruction. c. Duration of interment as required Exhumation permit to be provided by the Director of Health Compliance of sanitary requirements. e. b. Reasons for the request are:  To determine the cause of death  Determine the identity of the deceased  Recover organs for further examination  Recover foreign bodies If the physician found that there is justification to the exhumation and a strong probability for the purpose to be realized. he may set the date and time for exhumation A written request for exhumation must be sent to the regional director or ministry of health stating: Name of deceased Place of exhumation Date and time of exhumation Duration of interment Purpose of exhumation The Ministry of Health. the grave must be properly identified by the person who was present when the body was interred During disinterment. j. b. aside from issuing the necessary permit. c. c. f. f. body cells during that period may not have the potential capacity to react to trauma If death is so sudden as not to give the tissues in the body the chance to react properly e.FROGLETS NOTES Summary of Legal Medicine Book by Solis c. tissue may not be able to function normally Vital reaction differentiates an ante-mortem from postmortem injury In the ff instances. heat or cold (frostbite.pain on account of involvement of sensory nerve d. b. Physics of wound production: If PI were inflicted during agonal state of a living person . rubor . Effect of physical violence may not always result to production of wound but wound is always an effect of physical violence. Time: shorter period used for transfer of energy. Effect is the production of wound. Causes of Physical injuries: a. Wound is the solution of the natural continuity of any tissue of the living body. As to severity: a.mortal wound . blunt instrument (contusion. e. As to manner of infliction: Vital Reaction: sum total of all reactions of tissue or organ to trauma. Area of transfer: The larger the area of contract between the force applied on the body the lesser is the damage to the body. PI by Physical Violence dolor . Velocity component is the important factor. chemical explosion (gunshot or shrapnel wound) 3.   b. f. Other factors: the less elastic and plastic the tissue.not capable of causing death immediately . Physical violence Heat or cold Electrical energy Chemical energy Radiation by radio-active substances Change of atmospheric pressure (barotrauma) Infection A. liver. lacerated wound) b.sensation of heat or increase in temperature 27 By 4D2014-2015 Heart and big blood vessel Brain and upper portion of spinal cord  Lungs  Stomach. b. deaths due to sudden coronary occlusion Classification of wounds: 1. loss of function .on account of trauma. greater likelihood of producing damage. sharp instrument: sharp-edged instrument (incised wound) sharp-pointed (puncture wound) sharp . burns or scald) f. Elasticity and plasticity refer to the ability of a tissue to return to its normal size and shape after being deformed by pressure. tearing force (lacerated wound) d.edged and sharp . Ff are common reactions of a living tissue to trauma: a.capable of causing death immediately after infliction or shortly thereafter Parts of body where wound is inflicted considered mortal: Wound is kinetic energy times time times area times ―other factors‖     Kinetic energy: mass X velocity (squared) divided by 2. b. It is the disruption of the anatomic integrity of tissue in the body. change of atmospheric pressure (barotrauma) e. d. hematoma. Mortal wound . c.redness or congestion of the area due to an increase of blood supply as a part of reparative machine calor . 2. g.pointed (stab wound) c. vital reactions or changes may not be observes even if injury was inflicted during life: a. the greater the likelihood that a laceration will result. spleen and intestine Non .g. Kind of instrument used: a. FROGLETS NOTES a. b. c. d. hit - means of bolo, blunt, instrument, axe thrust or stab - bayonet, dagger gunpowder explosion - projectile or shrapnel wound sliding or rubbing or abrasion 4. Depth of wound: a. superficial - only layers of skin b. deep - inner structure beyond layers of skin  penetrating - wounding agent enters the body but did not come out or mere piercing of solid organ or tissue or body Penetrating wound - wound where dimension of depth and direction is an important factor in its description. It involves the skin or mucous surface and the deeper underlying tissues or organs caused directly by the wounding instrument. Example: punctured, stab, gunshot wounds.  Perforating - wounding agent produces communication between the inner and outer portion of the hollow organs. Traversing pr piercing completely a particular part of body Summary of Legal Medicine Book by Solis 6. Special types of wounds: a. Defense wound - result of person’s instinctive reaction of self - protection; injuries suffered by a person to avoid or repel potential injury from aggressor (injury on flexed forearms when about to be hit by blunt object; incised or stab wound on palm when about to be stabbed by another) b. Patterned wound - Wound in the nature and shape of an object or instrument and which infers the object or instrument causing it. Ex. Impact of the face on the radiator grill of a car may cause imprint of the radiator grill on the face. c. Self-Inflicted Wound - Self inflicted wound is a wound produced on oneself. As distinguished from suicide, the person has no intention to end his life. Motive of Producing Self-Inflicted Wounds: (1) (2) 5. Relation of site of application of force and location of injury: a. coup injury - physical injury which is located at the site of application of force b. contre - coup injury - physical injury found opposite the site of application of force c. coup contre - coup injury - physical injury located at site and also opposite the site of application of force (fixed head is hit with moving object then falls on another hard object) d. locus minoris Resistencia - PI located not at the side or opposite the site of application of force but in some areas offering the least resistance to the force applied. Blow on forehead may cause contusion at region of eyeball because of fracture on the papyraceous bone forming roof of orbit. e. Extensive injury - PI involving greater area of body beyond site of application of force not only wide are of injury but various types of injury. (fall from height or run-over of victim in vehicular accident) *stationary head is hit by moving object, contusion is with the site of impact.; when moving head hits a firm fixed and hard object, Brain contusion may develop at opposite side of impact. 28 By 4D2014-2015 (3) (4) (5) To create or deliberately magnify an existing injury of disease for pension or workman’s compensation; To escape certain obligations or punishment. During war time soldiers may cut their fingers to avoid frontline assignments and prisoners may inflict physical injuries on their body to avoid hard labor and just be confined in a hospital to receive food and rest. To create a new identity or destroy the existing one. Fingerprints may be destroyed by acid, by cutting or burning. To gain attention or sympathy. Psychotic behavior Some Ways of Self-Mutilation: (1) Head banging or bumping - this is commonly observed in overactive children and causes hematoma. (2) Exposure of parts of the body to heat radiation from open fires, radiators, or protective grills over radiator thermophilia. (3) Penetrating nail or spike to the chest wall or insertion into the urinary bladder in a female. (4) Castration by amputation of the penis. (5) Trauma inflicted on the female genitalia to induce abortion or promotes hemorrhage and creates an anemia. FROGLETS NOTES (6) Subcutaneous injection of fecal matters to promote abscess formation. (7) Pricking of acne eruption to lead to a severe facial disfigurement. (8) Subcutaneous injection of air to create a condition of emphysema. (9) Nail-biting (onychophagia) which may lead to maceration of the skin and an infection. (10) Grinding of the teeth (bruxism) is frequently seen in the mentally retarded and can lead to abnormal tooth wear, a bilateral hypertrophy of the masseter and a pain on chewing. (11) Pressure on the subcutaneous tissue by a tightly applied cord or belt around the body: (a) Tribal customs of metal band around the neck or a leg by some African tribes may cause a permanent disfigurement. (b) Use of shoes made of metal by chinese women. (12) Pulling of the body hair (Trichotillomania) (Forensic Medicine a Study in Trauma & Environment Hazards by Tedeschi, Eckert &Tedeschi, Vol, 1, p.496) Legal Classification of Physical Injuries:  Mutilation: Art. 262, Revised Penal Code Kinds of Mutilation Punishable Under the Code: 1. Intentionally depriving a person, totally or partially of some of the essential organs for reproduction, and 2. Intentionally depriving a person of any part or parts of the human body other than the organs for reproduction. Mutilation is the act of looping or cutting off any part or parts of the living body. In order to be punishable under the Code, it must be intentional, otherwise it will be considered as a physical injury.  29 ―Mayhem‖ is the unlawful and violent and deprival of another of the use of a part of the body so as to render him less able in fighting, either to defend himself or to annoy his adversary. Mutilation of other parts of the body other than the organ of reproduction may be classified as mayhem. By 4D2014-2015 Summary of Legal Medicine Book by Solis However, if it is not deliberate then it may fall on paragraph 2, Art. 263, Revised Penal Code (Serious Physical Injuries).  Is vasectomy and tubal ligation within the purview of mutilation as defined and penalized by Art. 262 of the Revised Penal Code? The Secretary of Justice rendered an opinion that vasectomy and tubal litigation are not mutilation and a legitimate method of contraception despite the fact that it is done intentionally and deprives a person of his power of reproduction. Because: …these two methods of surgical sterilization are affected by the closing of a pair of tubes in either man or the woman so that the sperm and ovum cannot meet; it does not involve the removal of reproductive glands or organs as in the case of castration, with which it is sometimes confused. Serious Physical Injuries: Art. 263, Revised Penal Code: to: The Crime of serious physical injuries my be due 1. 2. 3. 4. Wounding; Beating; Assaulting (Art. 263); or Administering injurious substances (Art. 264) without the intent to kill. It may be committed through a simple negligence or imprudence The main purpose of dividing the provision into four paragraphs is to graduate the penalties depending upon the nature and character of the wound inflicted and their consequences on the person of the victim. In paragraph one, the injured person became insane, imbecile, impotent, or blind. Article. Insanity has not been defined or qualified by the Imbecility infers that the injured person must be of the preadolescent age and that on account of the physical injuries inflicted there is an arrest of mental development. Impotency is the inability to grant to the partner sexual gratification. FROGLETS NOTES Summary of Legal Medicine Book by Solis Blindness must be total or involvement of both eyes. If only one eye became blind, then the physical injury will fall in paragraph 2 of Article 263. In paragraph four, the injured person becomes ill or incapacitated for labor for more than thirty days and impliedly less than 90 days. In paragraph two, the following nature and character of the wound or consequences of the injuries inflicted must be present: It is noteworthy to mention that in paragraph 3 and 4 of article 263 there is no mention of periods of medical attendance but merely incapacity. a. Loss of the use of speech or the power to hear or to smell, or loss of an eye, a hand, a foot, an arm, or a leg; b. Loss of the use of any such member; or c. Becomes incapacitated for the work in which he was therefore habitually engaged. There must be total loss of hearing capacity. If the loss of power to hear is only in one ear, it is a serious physical injury under paragraph 3, article 263 (People v. Hernandez, 94 Phil. 49) Insofar as loss of a hand is concerned, the prosecution must prove by clear and conclusive evidence that the offended party cannot actually make use of his hand and that such impairment is permanent (People V. Reli. C.A. 53 O.G. 5695). In paragraph 3, the following injuries of their consequences are included: a. b. c. d. Deformity; Loss of any other member of his body; Loss the use thereof; or Becomes ill or incapacitated for the performance of the work in which he was habitually engaged for more than 90 days, as a consequence of the physical injuries inflicted. Deformity is a condition of physical ugliness. It must be a permanent and conspicuous. The loss of the front teeth, the development of a pigmented scar on the face, or the loss of the pinna of the ear is considered deformities. However, the development of a scar in covered parts of the body may not be considered deformity because it is not a conspicuous and visible. ―The loss of any other part of his body‖ means loss of the parts of the body not mentioned in paragraph 2, Art. 263. Incapacity means the inability of the injured person to perform, or engage on a work or vocation before he sustained injury. 30 By 4D2014-2015 Administering Injurious Substances or Beverages: Art. 264, Revised Penal Code: Elements of the Crime: a. The offender inflicted upon another person or any serious physical injury. b. The infliction of physical injury was done knowing that the substance or the beverage administered is injurious or took advantage of the victim’s weakness or credulity; and c. There was no intent to kill on the part of the offender. If the offender does not know that the substance administered is injurious, he cannot be held liable under the above provision. The throwing of acid on the face of someone does not fall within the provision because what the provision contemplates is administering or taking in the injurious substance or beverages (U.S. Chiong Songco, 18 Phil 459). The provision does not contemplate of sight or less serious physical injuries are the consequence of injurious substances of beverages, but results only in serious physical injuries. If the administration of injuries substances or beverages is intentional, the crime committed is frustrated murder. Treachery is inherent when injurious substances or beverages are introduced into the body. Less Serious Physical Injuries: Art. 265, Revised Penal Code: The basis to determine whether the physical injury is less serious or not is by either the period of medical attendance or period of incapacity; both of which is ten days or more but not more than thirty days. The fact that the injury only requires medical attendance for two days but incapacitated the victim from attending to his ordinary work for a period of 29 days 252-268) In the Description of a Stab Wound. d. 152). 3. g. the crime committed is only slight physical injuries (People v. the following must be included: a. 31 By 4D2014-2015 The stab wound is accessible to the hand of the victim The hand of the victim is smeared with blood The wounding weapon is firmly grasped by the hand of the victim (cadaveric spasm) If stabbing is accompanied with slashing movement. wounding instrument is found near the victim More than one stab wounds Located on different parts of the body or on parts where vital organs are located Deep Stab wound with serrated or zigzag borders Irregular or stellate shape skin defects . c. located on one part of the body  If located on covered parts of the body. The victim is the offender’s parents.If without motive offender is insane or under the influence of drugs There is a disturbance in the crime scene Medical evidences showing intent of the offender to kill the victim: a. b.  There is a manifest intent to insult or offend the injured person.    (pp. In the absence of such proof of medical attendance or incapacity. provided that the crime is not direct assault. curators or teachers. b. ascendants. Length of the skin defect Condition of the extremities Condition of the edges Linear direction of the surface wound Location of the stab wound Direction of penetration Depth of the penetration Tissue and organs involved Stab Wound(s) may be Suicidal. 4 Phil. b. e. 81 Phil. d. Suicidal – Evidences showing that the stab wound is suicidal:  Located over vital parts of the body  It is usually solitary. There are circumstances adding ignominy to the offense. although the wound actually healed in more than 30 days. Injuries other than stab wound may be present Stab wound located in any part of the body Usually more than one stab wound There is a motive . f.  There must be proof as to the period of medical attendance. 2. If multiple. 398)   The Crime of less serious physical injuries may be qualified and a fine or a higher penalty imposed when: a. or The victim is a person of rank or person in authority.FROGLETS NOTES Summary of Legal Medicine Book by Solis makes the crime less serious physical injuries (U. the wound tailing abrasion is seen towards the hand inflicting the injury A suicide note may be present There is the presence of a motive for selfdestruction No disturbance in the death scene. e. h. v. 4. the clothing is not involved b. c.S. c. guardian. Homicidal – stabbing with homicidal intent is the most common Characteristics: 1. d. Trinidad. Penesa. Homicidal or Accidental: a. 5. others without sharp objects Force applied to tissue is greater than its cohesive force and elasticity The tissue tears and laceration is produced Characteristics: a. Poison dart. iron bar. b.  The opening on the skin is very small and may become unnoticeable because of clotted blood and elasticity of the skin. needle.sign of struggle Proof to show it is suicidal: 32 By 4D2014-2015 Located where vital organs are located Usually singular but may be multiple but located in one area Parts of the body involved is accessible to the hand of the victim Clothing is usually not involved Wounding is made while the victim is sitting or standing. Shape and size of the injury do not correspond to the wounding instrument Tear on the skin is rugged with extremities irregular and ill-defined Injury developed is at the site where the blunt force is applied Borders of the wound are contused and swollen Usually on areas where the bone is superficially located. pointed stick. d. Stretch. front part of the leg.cyanide or nicotine b. fist blow. Injection of air and poison as a way of euthanasia 5. f. e. 3. stone. butt of firearm. h. a. Punctured Wound  A result of a thrust of a sharp pointed instrument  External injury small but depth is to a certain degree  Produced by: icepick. c. c. Lacerated Wound (Tear. spear. b.FROGLETS NOTES      Different measurement of the stab wounds may be produced by one weapon if it is tapering towards the sharp point Withdrawal of the instrument not on the same direction as when it was introduced may increases length of the skin defect Three-cornered file when used as a stabbing weapon. Rupture. It is multiple and usually located on different parts of the body Deep Defense wounds on the victim Disturbance of the crime scene. f. fang of animal. like scalp. dorsum of the foot Examination shows bridging tissue joining the edges and hair bulbs intact Bleeding is not extensive because blood vessels are not severed evenly Healing process is delayed . Dog bites with hydrophobia virus d. d. 1. Fish spines c. c.three-cornered skin defect The most common immediate cause of deathhemorrhage Accidental stab wounds are rare 4. e. g. nail. The wound is much deeper than it is wide. d. thorn. ―Putok‖)  2. h. There is bleeding towards the lower part of the body No disturbance of the crime scene Presence of suicide note Wounding instrument found near the body Punctured would with puncturing instrument loaded with poison:  Characteristics: Summary of Legal Medicine Book by Solis  A tear of the skin and the underlying tissues due to forcible contact with a blunt instrument Produced by: wood. hook  External hemorrhage is limited but internal injuries may be severe  Direct involvement of blood vessels and bloody organs may cause fatal consequences  Site of external wound can be easily sealed  Punctured would is usually accidental but in rare instances it may be homicidal or suicidal a. g. External hemorrhage is limited although internally severe Sealing of the external opening will be favorable for the growth of anaerobic microorganism Medical Evidences that tend to show it is homicidal: a. b. malar region on the face. If an incised wound or stab wound was inflicted wherein the long axis of the wound is parallel or on the same direction as the cleavage line of the part of the body involved.Healing is delayed -Scar is linear or spindleshaped . the wound will appear narrow or slit-like because the Lacerated wounds may involve deeper tissues like laceration of the muscles and fracture bones It may be homicidal or accidental but rarely suicidal Distinction between and incised wound and a lacerated wound: Incised Wound Lacerated Wound -Edges are clean cut.Produced by semi-sharp-edged instrument which causes irregular edges on the would . the skin over the area will be stretched up to a breaking point to cause laceration and exposure of the fractured bone . the edges of the remaining tissue is that of laceration c. Overstretching of the skin .Examination with a magnifying lens shows that the hair bulbs are preserved 33 Summary of Legal Medicine Book by Solis By 4D2014-2015 .Presence of a mechanical device on the edges to prevent coaptation will cause separation 2.Best seen in laceration of the scalp.Hatchet and choppers   -Healing is faster .Scar is irregular -Caused by a sharp-edged instrument . The loss of tissue may be due to: i. Mechanical stretching or dilatation .Separation of edges of a wound may be on account of loss of tissue bridging them. irregular.caused by a blunt instrument Gaping of Wound: The separation of the edges especially in deep wound may be due to the following: 1. Avulsion or physical or mechanical stretching resulting to separation of a portion of the tissue iii. This is called cleavage direction or lines of cleavage of the skin. cut eyebrow of boxer.FROGLETS NOTES Classification of lacerated wounds: a. ill-defined -No swelling or contusions around the incised wound . burning or chemical reaction ii.In avulsion.There is swelling and contusion around the lacerated wound -Extremities of the wound are sharp or may be round or contused . cell lysis. Splitting caused by crushing of the skin between two hard objects .When pressure is applied on one side of the bone. Retraction of the Edges . .Underneath the skin are dense networks of fibrous and elastic connective tissue fibers running on the same direction and forming a pattern more or less present in all persons. Grinding Compression . well-defined . Destruction by pressure. Trimming of the edges 3.Extremities of the wound are ill-defined and irregular -Examination by means of a magnifying lens shows that the hair bulbs are cut . infection.Weight and grinding movement may cause separation of the skin d. Tearing . laceration of the chin of motorcyclist b. regular.Edges are roughly cut. Loss of Tissue . contusion.2. storage of water. Hemorrhage may influence the severity of wound by: a. blood: Hemorrhage a.  Hemorrhage into the chest cavity may cause diminution of the respiratory output with subsequent anoxia a. dermal manifestation of certain diseases Burns in children and old age persons. Hemorrhage may result in an increase in pressure in or on the vital organs to affect the normal function:  Intracranial hemorrhage may cause compression of the vital centers of the brain.fatal Estimation as to how much of the body surface involved.FROGLETS NOTES - edges of the wound will not be subjected to the lateral pull of the severed connective tissue fibers If the long axis of the wound is perpendicular to or with an angle with the lines of cleavage.3. excretor of sweat and organ for absorption Determination of how much skin is involved is important to determine the mode of treatment and prognosis Significant in cases of: burns. the rule of the nine is used Body surface expressed as percentage using the rule of nine: Whole of head and neck 9% 9% Whole of one upper extremity 9% 18% Whole of front chest and abdomen 18% 18% Whole of posterior chest and abdomen 18% 18% Whole of one lower extremity (front) 9% 18% Whole of one lower extremity (back) 9% 18% 34 By 4D2014-2015 Summary of Legal Medicine Book by Solis Pudental areas 1% Total 1% 100% Factors responsible for the severity of wounds: 1. the tendency of the borders of the wound is to separate on account of the retraction of the severed fibers Practical ways of determining how much of the skin surface is involved in an injury or disease:        Skin serves as the mechanical protection of the body It is punctuated with sensory nerve endings for pain. an average size adult has 5 to 6 quarts of blood  A loss of 1/3 to 2/5 of the circulating blood may result to irreversible hypovolemic shock and may be fatal  The volume of blood lost may be related to the rate or space of time a certain volume of blood has been shed  Males can stand more lost of blood than females a. Hemorrhage may cause mechanical barriers to the function of organs:  Hemorrhage into the tracheobronchial lumina can cause asphyxia .  Hemopericardium may cause embarrassment of the contraction of the heart.1. Loss of blood incompatible with  Blood constitutes about 1/20 of the body weight of an adult  By volume. temperature and touch It acts as thermo-regulator. involvement of more than 70% of the body surface. Gauze or rubber drain d.1. Trauma:  Destruction of the blood vessel wall or increase permeability of its wall due to external force b. Organs Involved   Trauma on the vital organs of the body are always serious Crushing wounds of the heart. or slight violence on the head or neck may cause severe shock But violent traumas to healthy. brain or longs are almost fatal 4. Size of Injury:   Burns affecting 1/3 of the body surface of the third degree type is usually fatal Bigger wounds are more exposed to infection and other physical conditions of the surroundings 35 By 4D2014-2015 Summary of Legal Medicine Book by Solis 3.Hydrophobia .Bullet .Pathogenic microorganism b. Foreign body or substance introduced into the body:   Incision with an unsterilized scalpel may not be serious as the bite of a venomous snake A foreign substance or body may be toxic by itself or may act as a physical irritant The foreign body or substance may be: a.Glass fragments . strong persons may not produce shock 5. Bacterial: . Cause of Hemorrhage: b.Hepatitis c. Foreign body: . Shock    May occur with or without violence Slight blow on genitalia. Chemical: .Shrapnel .Cyanide .FROGLETS NOTES b.Tetanus . Viral: . slight burns in children or old persons. Natural Causes:  Common causes of hemorrhage due to natural causes: o Intra-cerebral hemorrhage (apoplexy) o Spontaneous subarachnoid hemorrhage o Rupture of the arteriosclerotic aneurysm of the aorta o Rupture of the esophageal varices in cases of cirrhosis of the liver and bleeding of peptic ulcer of the stomach and duodenum o Pulmonary hemorrhage o Ruptured ectopic pregnancy o Spontaneous rupture of cavernous hemangioma or hepatoma o Rupture of the enlarged spleen 2.2. Emergency treatment may be: a. vomiting. ascending paralysis. Placing ice on the bite site d. May cause nausea. vomiting. convulsion. The immediate treatment instituted Snake venoms are of two principal classes: a. Toxin  Summary of Legal Medicine Book by Solis c. hemolytic and hemorrhagic effect o Produces only one punctured wound on the center of a reddened area o Main symptoms are pain edema and reddening  Coelenterate Sting (jellyfish) o The tentacles penetrate into the skin and cause explosion of the nematocyst and liberation of the venom o Symptoms are extreme pain. Incision of the wound to promote more external hemorrhage to drain the venom 36 By 4D2014-2015 6.FROGLETS NOTES . abdominal pain. nausea. Size of Patient d. petechial hemorrhage on the gum. paleness and labored breathing Snake venom toxicity will depend on: a. The amount of venom depends on the season of the year and the length of time the snake has eaten. Mechanical injuries on the vital organs  Blow on the head may not necessarily produce external lesions but may produce severe meningeal hemorrhage producing compression of the brain . abdominal pain.primarily paralyzes the respiratory and cardiac center of the brain. but because of neglect in its management it may become serious or fatal Fatal Effect of Wounds: 1. Hematoxic . Potency of venom injected b. The manifestations are pain and swelling of the affected area. Sucking the wound to drain venom Snake Venom o Characterized as two punctured wounds at the center of the reddened affected area e. Hemorrhage  Incised wound on carotid artery without surgical intervention is fatal b. Administration of anti-snake venom serum  Scorpion Venom o Has neurotoxic. pulmonary and cardiac edema. Tourniquette above the site of the wound e. intravascular hemolysis. urticarial rash. the toxic content is smaller c. Wound may be directly fatal by reason of: a. Absence of medical or surgical intervention:  A wound may not be fatal. coma. b. Neurotoxic . and cardiac and respiratory arrest. If a snake has just killed his prey. dilated pupils.affects particularly the blood.Nicotine b. Shock  Summary of Legal Medicine Book by Solis 2. Changes where a definite pathological condition was present before the injury Ex: A person suffering from tumor or cyst and was stabbed by someone. tetanus or complications arising from wounds . 37 By 4D2014-2015 Changes whose natural sequence are direct and obvious Ex: Septicimia. but may later die of its secondary effects or changes These changes may be classified as follows: 1. Changes producing separate pathological lesions which in turn proves to be fatal Ex: Operation performed on a patient to ligate bleeding vessel inside the abdominal cavity with reasonable skill and due diligence but as a result of which peritonitis developed and caused death of patient 3. deeper tissues are involved b. bacteremia. Secondary hemorrhage following sepsis  On account of infection that sets in. Scarring Effect  Chronic gonorrheal infection may cause stricture or urethra d. Changes where a definite pathological condition of totally different nature arises after the wounding and the Disturbance of the balance of fluid in the body capable of producing delayed or immediate death 2. Specific Infection  Pathogenic microorganisms may develop and multiply in the wound causing septicemia. Wound may be indirectly fatal by reason of: a. Secondary Shock Nature or death due to secondary shock - A person may have recovered from the immediate effects of the trauma or violence.FROGLETS NOTES c. or toxemia c. The person may die of the pathological condition and the accused is liable for his death 4. The stab is not capable of producing death ordinarily. Primary Hemorrhage  It is the bleeding which occurs immediately after the traumatic injury of the blood vessel b. 2. Kinds of Hemorrhage: Complication of trauma or injury: 1. a. Shock    The disturbance of fluid balance resulting to peripheral deficiency which is manifested by the decreased volume of blood. reduced volume of flow. kind and location of the blood vessel cut. 4. Injury to the receptive nervous system b. Anoxemia – reduction of effective volume of oxygen carrying capacity of the blood c. b. especially among the aged and the young children and makes the patient succumb to terminal disease Deliberate introduction of microorganisms at the site of the injury Embolism:  A condition in which foreign matters are introduced in the blood stream causing .  The degree and nature of hemorrhage depends upon the size. b. hemoconcentration and rental deficiency Clinically characterized by severe depression of the nervous system Three major factors operate in the production of shock and all are likely to be associated together as the condition develops a. e. Primary Shock  Caused by immediate nerve impulse set up at the injured area which are conveyed to the central nervous system By 4D2014-2015 d. From the instrument or substance which produces the injury From the organs involved in the trauma applied As an indirect effect of the injury which creates a local area of diminished resistance causing the invasion and multiplication of microorganisms Injury may depress the general vitality. Kinds of Shock: a. growth and development of microorganisms at the site of the injury How injury or trauma acquires infections: a.FROGLETS NOTES consequential sequence is doubtful Ex: Tuberculosis meningitis that develops following a blow on the head Summary of Legal Medicine Book by Solis  The extravasation or loss of blood from the circulation brought about by wounds in the cardio-vascular system. Endothelial damage. Delayed or Secondary Shock  Patient shows sign of general collapse which develop some time after the infliction of injury Hemorrhage 38 c. thus increasing capillary permeability 3. Secondary Hemorrhage  This occurs not immediately after the infliction of the injury but sometime thereafter on or near the injured area Infection:  Infection is the appearance. there is an acute neutrophilic response and scab will be formed due to dehydration of the surface clot. age of person. After three days. b. Connective tissues Blood forming tissues Surface epithelium of the skin Those having no power or limited capacity to regenerate: a. Kinds of Healing Wounds Healing of Wounds 1. Highly specialized glandular epithelium Smooth muscle Neurons of the central nervous system  Small clean-cut wound is covered with lymph in 36 hours The edges adhere in two days and wound heals on the 7th day leaving a linear scar Larger incised wound shows swelling of the edges 8 to 12 hours Blood-stained serum is present in 2 days which afterwards become seropurulent on the 3rd day. Healing by Primary (First) Intention It takes place when there is minimal tissue loss. lasting in state from 4 to 5 days Small red granulation forms in 12 to 15 days and the epithelium grows from the edges Scar develops later      Healing of Wounds The time of healing wounds is dependent on the following: vascularity. more approximation of the edges and without significant bacterial contamination. c. Collagen fibers will bridge the raw area and differentiated surface cells begin to proliferate to cover the exposed area. 2.FROGLETS NOTES sudden block to the blood flow in the finer arterioles and capillaries Summary of Legal Medicine Book by Solis   The most common emboli in the blood stream are: a. b. microphages and fribroblasts will appear. degree of rest or immobilization and nature of the injury. Fat Embolus  Causes of Fat Embolus: o By injection of oily substance into the circulation o By injury of the adipose tissue which forces fat into the circulation Air Embolism  Causes of Air Embolism: o Gaping incised wound of the jugular vein o Injection of soapsuds or air into pregnant uterus for the purpose of tubal insuflation or criminal abortion o Injection of air into the urinary bladder for radiological study o Insuflation of the other non-potent tubes or hollow organs o Injection of air under pressure into the nasal sinus after a therapeutic lavage Capacity for regeneration decreases as age increases State of nutrition of the individual affects capacity or regeneration The following regenerates rapidly: a. Power of the human tissue to regenerate  Regeneration is the replacement of destroyed tissue by newly formed similar tissue  The more highly specialized the tissue. b. the less capacity for regeneration 39 By 4D2014-2015 a. The normal state of the area may . Within 24 hours after the injury. c. (3) Stricture . General Investigation of the Surroundings: (a) place of the commission of the crime.It is material in determining the relative position of the victim and offender. presence of contusion collar. hesitation cuts in suicidal incised wound or contusion in lacerated wound  Extent . (b) clothing. healing process may deviate from the normal way on a normal individual and may result to: (1) Formation of Excessive Granulation Tissue or "Proud Flesh" . Examination of the Wound  Character . .It is the contraction of the fibrous tissue of the scar formed. surgical intervention. sketching or accurate description of the scene of the crime for preservation b. It must not be attempted in a living subject if it will prejudice the health or life or in a stabbed wound in the abdomen due to movability of the abdominal wall  Condition of Area Surrounding the Wound . Location is important in determining trajectory or course of the wounding weapon  Depth . scab formation. Inflammatory reaction is more intense and granulation tissue growth bears all the responsibility for its closure. (2) Keloid Formation .State the type of wound. (e) photography. Examination of the Wounded Body Living Victim Dead Victim Age of the wound from degree of healing Weapon used Reasons for multiplicity of wounds Whether injury is accidental. (4) Fistula or Sinus Formation .  Location . 40 By 4D2014-2015 Summary of Legal Medicine Book by Solis 2. sweat and sebaceous glands) and slower reparative process may occur. (c) witnesses to the incident. hair and other foreign bodies in the scene.  Number . distance of the wound from some fixed point in the body prominence.It is the a large bulging tumorous scar produced by an abnormal amount of collagen in the connective tissue. It may remain for a lone time unless the causal factor (infection or foreign body) is removed. Description must be comprehensive with sketches or photographs if possible.Multiple wounds in different parts of the body are generally indicative homicide or murder. Aberrated Healing Process In some instances. etc. suicidal or homicidal Ante-mortem or postDangerous to life of injury mortem wound Permanent deformity Mortal or non-mortal wound caused by injury Presence of disease or abnormal development at Shock produced by wounds time of wounding which may accelerate death Complications produced by Cause of wound (accident.FROGLETS NOTES return after a lapse of one month with or without the formation of a scar. homicide) 3. Outline of Medico-Legal Investigation of Physical Injuries 1.Fistula is a communication between an inner cavity and the outside while sinus is a tract of infection traversing the inner part of the body. Production of a large scar and greater loss of skin appendages (hair. (d) wounding instrument. injury suicide.Region of the body where it is situated. cuts. c. characteristic marks.Extensive injury may show marked degree of force applied  Direction . Healing by Secondary Intention It take place when the injury causes more extensive loss of cells and tissues.Presence of burning or tattooing in gunshot wounds by near or contact fire.It may prevent the closing of wound and can be remedied by excision or cautery. infection. stains.It is measurable if the outer wound and inner end is fixed. Examination must not be influenced by other information obtained from others in making a report or conclusion. CHAPTER X MEDICO-LEGAL INVESTIGATION OF WOUNDS Rules to observe by the physician in examining wounds:    ALL injuries must be described. (d) presence of suicide note. Summary of Legal Medicine Book by Solis 3.extensive in accidental death. Violence upon a living body may not show bruise until after death. Accidental cuts are frequent everyday occurrences but rarely cause of death.  Contusion .  Nature and extent of wound . Distinction between Ante-Mortem and Post-Mortem Wounds AnteMortem Wound Hemorrhage more or less copious and generally arterial Marks of spouting of blood from arteries Deep staining of the edges 41 PostMortem Wound Hemorrhage slight or none at all and always venous No spouting of blood Blood is not clotted or a soft By 4D2014-2015 clot Edges and cellular tissues are not deeply stained and can be removed by washing. the amount of bleeding is comparatively less due to loss of tone of blood vessels. Factors in Determining Whether Wounds were Inflicted During Life or After Death 1. 3. (c) position of the body.common in suicide and homicide. Nature of the wound inflicted  Abrasions . Retraction of the Edges of the Wound inflicted during life cause gaping of the wound while in case of wound inflicted after. growth of epithelium. Hemorrhage is more profuse when the wound was inflicted during lifetime. (b) evidence of struggle.rare in suicide unless done by jumping from a height. Signs of Repair such as fibrin formation. But absence of such does not show wound was inflicted after death since the tissue may not have been given ample time to repair before death took place.(a) degree of hemorrhage. generally transverse in homicide while oblique in suicide. (e) condition of weapon. edges do not gape and are closely approximated to each other. 4. rare in suicidal. scab or scar formation conclusively show that wound was inflicted during lifetime.Its absence is more in suicide. and cellular tissues not removed by washing Edges gape owing to the reaction of the skin and muscle fibers Inflammation and reparative processes 1. . No inflammation or reparative processes Factors in Determining Whether Wound is Homicidal. not common in murder unless the body is dragged on the ground. 5. If wounds are inflicted after death. Suicidal or Accidental 2. absence of heart action and post-mortem clotting of blood. Single wound in a position the deceased could have been conveniently inflicted is suicidal. In cut-throat. Presence of hair or portion of skin on nails of assailant or deceased  Number and direction of wound . accident or murder. Signs of Inflammation such as pus. 4. may be found in accidental death often due to a fall or forcible contact with some hard object. External signs and position and attitude of the body when found Location of the weapon or manner it is held Motive Personal character of the deceased Other information such as:  Signs of struggle . Postmortem wounds do not show any manifesting signs of vital reaction. Edges do not gape but are closely approximated to each other unless wound is caused within one or two hours after death.Multiple wounds in concealed parts of the body are indicative of homicide.  Incised wound . adhesion of the edges and other vital reactions may be present whenever the wound was inflicted during lifetime although they may be less pronounced when resistance of the victim is markedly weakened. 2.FROGLETS NOTES  Conditions of the Locality . 6.Homicidal wounds may be caused by any wounding instrument while suicidal wounds are due to sharp instruments. common in homicide especially when victim offered some degree of resistance. testimony of witnesses and presence of defense wounds. Effect of Medical and Surgical Intervention on the Death 1. 4. even aorta) . anemia.blunt instrument  Punctured wound . offender can only be held liable for physical injuries. Age of the Blood Stain It may be determined from the physical color changes of the skin although it is not reliable. 3. determining which injury caused the death depends on the testimony of the physician by examining which of the wounds caused injury to some vital organs or large vessels or led to secondary results causing death. it is not necessary to determine who inflicted the fatal blow. Changes in the Body Systemic changes such as degree of wasting.blunt instrument  Incised wound . medical evidence as to duration of survival is merely corroborative. 2. Testimony of the Witnesses In cases where witnesses testify as to the exact time. 2.   A physician can only state that it is possible that a certain injury is possibly caused by a certain instrument presented. In case of multiple offenders and there is conspiracy. If death occurred after medical intervention. organs involved and degree of injury.sharp-edged instrument inflicted by hitting  Lacerated wound . 42 By 4D2014-2015 1. the age of the wound may be estimated.  Wounds of big blood vessels (carotid.victim may still move and speak Extrinsic Evidences in Wounds 1. offender is still liable provided (1) death is shown to be inevitable and even without intervention. Where victim received multiple injuries. trajectory of the wound inside the body. He must be cautious in making categorical statements.body surface rubbed on rough hard surface  Gunshot wound . Negligence of the victim in the proper care and treatment of the injury will not exonerate the offender since he is not bound to submit himself to medical treatment. Factors in Determining Length of Time of Survival of the Victim After Infliction of the Wound  Summary of Legal Medicine Book by Solis Determining which of the wounds were inflicted first depends on relative position of the parties. But if negligence is deliberate and is really the cause of death. Possible Instruments Used by Assailant Inferred from Nature of Wound Power of Volitional Acts of the Victim After Receiving a Fatal Blow  Contusion . condition of the face and bed sore formation may provide for a basis. offender is liable only for the physical injuries inflicted.sharp-pointed instrument  Abrasion .not prevent performance of voluntary acts  Penetrating wound of heart .diameter of the wound of entrance may approximate caliber of firearm The determination of the victim's capacity to perform volitional acts rests upon the medical witness.FROGLETS NOTES  State of clothings .instantaneously fatal but experience shows victim may still be capable of locomotion  Rupture of organs . jugular.Near the body of the victim in suicidal and accidental death or firmly grasped by the victim in case of suicide . By the degree of the granulation of tissue formation and other reparative changes. death is a normal and direct consequence. (2) physician must be competent and exercised care and diligence.Usually no change in its condition in suicide while it may be in disorderly position due to struggle in homicide. Effect of Negligence of the Injured on the Death  Severe injury of the brain and cranial box usually produces unconsciousness but power to perform volitional acts depends upon areas of the brain involved. Degree of Healing Signs of repair appear in less than a day after infliction of injury. Minor wounds were received by victim but death resulted on account of gross incompetence or negligence of physician. From Wounding Weapon (a) Position . shot. (c) Presence of hair and other substance 2. Classification of Small Firearms Small firearms are those which will propel projectile of less than one inch in diameter. Firearm Wound as being of small caliber and limited range are used a toys.e.200 . Revised Penal Code) Any person who shall shoot at another with any firearm shall suffer the penalty of prision correccional in its minimum and medium periods. 254. From Examination of the Assailant Determination of the degree of intoxication. 3.2. 155. Definition An instrument used for the propulsion of a projectile by the expansive force of gases coming from the burning of gunpowder Includes rifles.With muzzle velocity of not more than 1. shotgun) b.The bore of the barrel has spiral lands and grooves which run parallel with one another but twisted spirally from breech to muzzle (i. shotguns.e.FROGLETS NOTES (b) Presence of blood . military riffle) 2. shotgun) . Any person who within any town or public place shall discharge any firearm.In some cases. In the Clothings of the Victim In gunshot wounds. physical power. and all other deadly weapons from which a bullet. revolvers. it also includes air rifles except such Summary of Legal Medicine Book by Solis As to Nature of the Bore a.e. High Power Firearm . Rifled Bore Firearm . homicide or any other crime for which higher penalty is prescribed by any of the articles of the Code. 4. 43 By 4D2014-2015 As to Wounding Power a. unless the facts of the case are such that the act can be held to constitute frustrated or attempted parricide. absence of blood stains is due to the rapidity of the blow and compression of the blood vessels or blood may be wiped out by the clothings in the process of withdrawal. Revised Administrative Code) Penal Provisions of Law Relative to Firearm Alarms and Scandals (Art. Revised Penal Code) The penalty of arresto menor or fine not exceeding 200 pesos shall be imposed upon: 1. Rifle . holes in the clothing may determine the wound of entrance whole presence of gunpowder at the hole indicates distance. rocket. xxxxxxxxxx Discharge of Firearms (Art. muskets.The injury is caused by the missile propelled by the explosion of the gunpowder in the cartridge shell and at the rear of the missile.  Detonation of high explosives as in grenades. 1. or other missile may be discharges by means of gunpowder or other explosives. bombs and mine explosion.e. ball. The barrel of any firearm shall be considered as complete firearm for all purposes thereof (Section 877.e. Clean-cut tears indicates use of sharp-edged instrument. Low Velocity Firearm . etc of the offender may be necessary. The degree of soaking of the clothing with blood may depict hemorrhage. pistols. From the Scene of the Crime CHAPTER XIII GUNSHOT WOUNDS Death or physical injuries brought about by the powder propelled substances may be due to the following:  Firearm shot . Pistol .Inside portion of the barrel is perfectly smooth (i.Fired only by a single hand (i. As to the Manner of Firing a.e. revolver) b. murder.2500 feet/second (i.400 feet/second (i. shell.Fired from shoulder (i. Severe tearing may show struggle. mental condition. firecracker. Smooth Bore Weapon . or other explosive calculated to cause alarm or danger. The missile may be single as in the case of a pistol or revolver or multiple shots or pellets in case of a shotgun. military rifle) 3. revolver) b. 7. infection. Range: In close range fire. 5. A miniature riffle is a single self-loading weapon. Muzzle Blast in Contact Fire: When gun muzzle is pressed on the skin when fired. except in near shot or in gazing or slap wound. Types of Small Firearms of Medico-Legal Interest  Revolver . The wound of exit is usually larger than the wound of entrance. Conical shape free end bullets have more piercing power without marked tissue destruction while missiles with hemispherical free ends are more destructive. Empty shell is ejected when the cartridge is fired and a new one is slipped into the breech automatically. is oval or circular with inverted edges.500 feet/second and a range of 3.FROGLETS NOTES 4.000 feet. Vertical or Horizontal Magazine . 3.It has a long barrel and butt and is fired from a shoulder. Inshoot): The appearance of the gunshot wound of entrance depends upon the following: 1. 8.e. shock. the injury is not only due to the missile but also due to the pressure of the expanded gases. It has muzzle velocity of 1. Direction of the Fire: A right angle approach of the bullet will make the wound of entrance circular in shape.Cartridge is held one after another vertically or horizontally by a spring side to side or end to end (i. which may cause disability or death on the victim. As to the Nature of Magazine a.336-352) 6. It has muzzle velocity of 600 feet/second. pressure to other organs and tissues. (pp. the higher the caliber of the wounding bullet the greater will be the size of the wound of entrance. The following factors must be taken into consideration: . except when the missile is deformed or the fire is in contact or near. pistol) Gunshot Wound of Entrance (Entrance Defect. flame and other solid products of combustion. the wound of entrance is oval in shape with the contusion or abrasion collar widest on the side of the acute angle of approach.More appropriately called "selfloading firearm". In cases of an acute angle of approach of the bullet. It has a muzzle velocity of 2. 6. Characteristics Inherent to the Wound of Entrance: The wound of entrance. Cylindrical Revolving Magazine . 4. 2. A military riffle has a magazine and volt action.  Automatic Pistol . Kind of Weapon: High power weapon has more destructive effect as compared with low power one. Other Consequential Effects on the Body of the Victim: Aside from direct involvement of vital structures of the body. the gunshot wound may be the source of hemorrhage. The shape of the bullet also plays an important role.  Rifle . all of the products of combustion primarily the muzzle blast will penetrate the tissues causing severe mechanical destruction on account of pressure. The explosive effect will cause extensive laceration of soft tissues and fracture of bones. Caliber of the Wounding Weapon: Excluding other factors which may influence the size of the wound of entrance. Distant fire usually produces the characteristic effect of the bullet alone. loss of functioning etc.Cartridge is in a cylindrical magazine which rotates at the rear portion of the barrel (i. 44 By 4D2014-2015 Summary of Legal Medicine Book by Solis Contact Fire: The nature and extent of the injury is caused not only by the force of the bullet but also by the gas of the muzzle blast and part of the body involved. Fragmentation of Hard Brittle Object in the Trajectory: Bone involvement along the trajectory may cause comminuted fracture and each bone fragment may cause additional damage on the surrounding tissues and even in the wound of exit. revolver) b.e. paralysis.It has a cylindrical magazine at the rear of the barrel capable of revolving motion and can accommodate of five or six cartridges housed in separate chamber. Shape and Composition of the Missile: Deformity of the bullet modifies the shape of the wound of entrance.200 feet/second. as a general rule. Entrance wound may be large circular or oval depending upon the angle of approach of the bullet.Carboxyhemoglobinispresentinthewoundandsurrounding areas. it is rotated by the lands and grooves. The wound of entrance is large. and (2) when the bone is deeply located in loose or soft parts of the body. 4.When the bullet travels the whole length of the tight fitting barrel. e. frequently star-shaped b. Loose Contact or Near Fire: 1. Edges are everted due to outward slapping of the skin. b. Pressed and Firm Contact Fire: 1. On Parts of the Body Where Bone is Superficial: This is commonly observed on the head where the skull is just underneath the scalp. distance) Medium Range Fire (more than 15 cm. the rule is that the diameter of the gunshot wound of entrance is almost the same as the caliber of the wounding firearm. 4. Singeing of the hair. 2. Wound of entrance is usually large. Distance Instances When the Size of the Wound of Entrance Do Not Approximate the Caliber of the Firearm: In distant fire. Bullet might have entered the skin sidewise d. character and extent of injury in contact fire is different (1) when the bone is superficially located under the skin. Factors which make the wound of entrance bigger than the caliber: a. In contact or near fire b. Barrel impression (Profile of the muzzle) on the skin e. c. tattooing and smudging. Metal Fouling . 2. Factors which make the wound of entrance smaller than the caliber: a. Nature of Bullet: Bigger caliber bullet is obviously more destructive than smaller ones. Blood and tissue become pink due to carbon monoxide. c. Parts of the Body Where the Bone is Deeply Located: 45 By 4D2014-2015 Summary of Legal Medicine Book by Solis a. b. but in the following instances. burning and tattooing are prominent with singeing of the hair. g. The Effectiveness of the Sealing Between the Gun Muzzle and the Shin: If all the gaseous product of combustion is prevented from being spilled out. and tattooing. Muzzle imprint may be seen depending upon the degree of slapping of the skin of the gun muzzle. Short Range Fire (1 to 15 cm. It may lodge on the clothings or may cause small abrasions or superficial lacerations on the skin around the main wound. Fragments of lead and bullet jacket may be found. Abrasion collar or ring is distinct. 3. Areas in the entrance wound is blackened by burns. Fragmentation of the bullet before penetrating the skin Contraction of the elastic tissues of the . There is blackening of the bullet tract to a certain depth' 6. Acute angular approach of the bullet 2. d. The bullet may cause radiating fracture f. the greater will be the tissue destruction. 3. Muzzle imprint. d.FROGLETS NOTES 1. circular and without radiating laceration. Edges of the wound may be everted. the rule is not followed: 1. Its surface is scraped by the lands and the scraping is ejected from the barrel and strikes the target. h. Deformity of the bullet which entered c. The following are the characteristics of the injuries: a. but less than 60 cm) Fired More Than 60 cm. Muzzle imprint due to outward slapping of the skin and heat. there will be more destructive effects on the tissues. 5. Part of the Body Involved: The nature. Smudging. 2. blackening of the wound due to fouling. Singeing of hair. burn. Pinkish color of the deeper structures due to carbon monoxide. The Amount of Gas Liberated by the Combustion of the Propellant: The greater is the amount of gas in a confined area. Distinction Between Gunshot Wound of Entrance and Wound ot Exit: Entrance Wound Exit Wound Appears to be smaller than Always bigger than the the missile owing to the missile elasticity of the tissue Edges are inverted. the size of the wound of entrance is dependent upon the distance of the fire. Examination of the clothing. Shape of the Wound of Entrance b. brassiere may also support the skin to enhance formation of a circular wound of exit. Examination of the internal injuries caused by the bullet 3. Internal Examination : a. Paraffin test may be positive Always absent. Underlying tissues may be seen protruding from the wound. External Examination : a. waist band. Variation on the shape of the wound of exit may be attributable to the deformity of the bullet in its passage in the body and to the wabbling and stumbling movement of the bullet during its course and fragmentation of the missiles. "Contusion collar" or ―Contusion‖ is absent "Contact ring is present due to the invagination of the skin and spinning of missile Tattooing or smudging may be present when firing is near Underlying tissues are not protruding.. but if the number of the gunshot wounds of entrance and exit is odd. It may be possible that all of those wounds or a majority of them are entrance wounds with some bullets lodged.FROGLETS NOTES In shotgun fire. the presumption is that one or more bullets might have been lodged in the body. Edges are everted Usually oval or round It does not manifest any depending upon the angle definite shape of approach finite shape of the bullet. The rule is merely presumptive and actual inspection and autopsy will verify the truth of the presumption. if involved in the course of the bullet 2. belt collar. Only in this instance may the wound of entrance of the same size as the gauge of the shotgun pellets. yet the number may still be even.If the place where the gunshot wound of exit is pressed on a hard object as 46 By 4D2014-2015 Summary of Legal Medicine Book by Solis when the victim is lying on his back on a hard object or in small caliber shots the wound of exit tends to be circular or nearly circular with abrasion at its border. Fracture of Bones and Course in Visceral Organs c. irregular or even similar to the wound of entrance. This is due to the absence of external support beyond the skin so the bullet tends to tear or shatter the skin while sufficient amount of kinetic energy is still in the bullet during the process of piercing the skin. Shored Gunshot wound of Exit . Actual Dissection and Tracing the Course of the Wound at Autopsy b. By Probing the Wound of Entrance 2. It may be slit-like. Testimony of witnesses: Determination of the Traiectory of the Bullet Inside the Body of the Victim: 1. Paraffin test always negative. X-ray examination Exit (Outshoot) Wound: An exit wound does not show characteristic shape unlike the wound of entrance. Other Pieces of Evidence or Findings Used to Determine Entrance of Gunshot: 1. and as distance increases the pellets disperse with individual pellets causing individual wounds of entry. stellate. Near fire causes concentration of entry of the pellets. Difference in Level Between the Entrance and Exit Wounds d. Location of Bone Fragments and Lead Particles d. It is also observed that tight-fitting clothings. Shape and Distribution of the Contusion or Abrasion Collar c. The "Odd and Even Rule" in Gunshot Wounds: If the number of gunshot wounds of entrance and exit found in the body of the victim is even the presumption is that no bullet is lodged in the body. How to Determine the Number of Fires Made by the Offender: . 2. Alteration of the Lesion Due to Natural process 2. 2. This might . A bullet which strikes the neck may enter the air passage. each of which made a separate exit. then the gunshot wound is ante-mortem. It may cause sudden loss of function of the area supplied or death if vital organs are involved. There is a strong possibility for them to enter the target in a common hole. 2. Its long presence causes the development of a dense fibrous tissue capsule around the bullet causing no untoward effect. In near shot with a shotgun. 2. 3. Determination of Entrance Wounds in the Body of the Victim 3. the bullet may be lodged in ihe barrel and a succeeding shot may cause the initial and the succeeding bullet to travel in tandem. Bullets Embolism . The bullet may enter the wound of entrance and upon 47 By 4D2014-2015 Summary of Legal Medicine Book by Solis hitting the bone the course is deflected to have the wound of entrance as the wound of exit Determining whether the wound is Ante mortem or postmortem: If the wounds inflicted after death show no evidence of profuse hemorrhage. Deep seated location may not cause any problem to warrant its immediate removal. A bullet might have entered the body but split into several fragments. and there are no vital reactions. Instances when the Number of Gunshot wounds of Entrance is More than the Number of Gunshot Wounds of Exit in the Body of the Victim: 1. When the bullet is lodged in the gastro-intestinal tract and expelled through the bowel. Medical and Surgical Intervention 3. When alt of the bullets produce through and through wounds but one or more made an exit in the natural orifices of the body 3. Souvenir Bullet: Bullet has been lodged and has remained in the body. mouth. and it may be coughed out or swallowed and recovered in the stomach or intestine. Wounds inflicted after death show no evidence of profuse hemorrhage. e. When one or more bullets are not through and through and the bullet is lodged in the bodY. Problem Inherent to the Injury itself 6. When different shots produced different wounds of entrance but two or more shots produced a common exit wound Instances when there is No Gunshot wound of Exit but the Bullet is Not Found in the Body of the Victim: 1. It may be located just underneath the skin to be easily palpated and may cause 'inconvenience and irritation. or lodged in the pharynx and expelled through the mouth by coughing. One of the bullets might have entered a natural orifice of the body. 3.FROGLETS NOTES l.a special form of bullet migration when the bullet loses its momentum u'hile inside the charnber of the heart or inside the big blood vessels and carried by the circulating blood to some parts of the body where it may be lodged. X-ray Examination The use of an X-ray is almost indispensable in the examination of gunshot injuries. There might be two or more bullets which entered the body through a common entrance and later making individual exit wounds. Bullet Migration: Bullet that is not lodged in a place where it was previously located. In cases of misfire or a defect in the cartridge. no retraction of the edges. 3. The use of the apparatus will facilitate recovery of the lodged bullet together with the location of its fragments Special Consideration on Bullets: L. Problems confronting Forensic physician in the identification of Gunshot Wounds: 1. the pellets might have entered in a common wound and later dispersed while inside the body and making separate wounds of exit. nostrils. or there are signs of vital reactions in the tissue. Near fire with a blank cartridge produced a wound of entrance but no slug may be recovered. Determination of the Number of Spent Shells: 2.g. 4. Embalming 4. thereby making it not visible and then producing a wound of exit. Number of Shots Heard by Witnesses Instances when the Number of Gunshot wounds of Entrance is Less than the Number of Gunshot Wounds of Exit in the Body of the Victim: 1. Tandem Bullet: Two or more bullets leaving the barrel one after another. each member will cock and pull trigger with muzzle directed to the temple or other vital parts. burning. Direction of the fire 4. GUNSHOT WOUNDS MAY BE SUICIDAL.FROGLETS NOTES create doubt to the statement made by the firer that he made only a single shot. If the shot is made on the head involving the brain. The strot was fired with the muzzle of the gun in contact with the part of the body involved or at close range. witness testimony Evidences to show that the wound is accidental: 1. However. disturbance of the surroundings 5. Entrance wound do not usually involve clothings. 2. Could the wound be inflicted by the weapon? 2. victim’s fingerprints on butt Questions that a physician is expected to answer in court: 1. no special area of body involved 3. severe frustration or previous attempt of self-destruction. complete description of wound of entrance and exit 2. place where the shot took place may reveal suicide note Can the Caliber of the Wounding Firearm be determined from the size of the gunshot wound of 7. roof of the mouth. precordial or epigastric region. location of missile. business or marital problem which the victim cannot solve. A person committing suicide wilI do the act in his most convenient way. He may have history of mental disease. 4. but ballistic examination can show as to whether the bullet travelled in tandem. Relative position of assailant and victim 12. shots in some parts of the body which may not produce immediate death cir sudden loss of consciousness. 8. The direction of the fire is compatible with the usual trajectory of the bullet considering the hand used and the part of the body involved. The wound of entrance may show signs of muzzle impression. the shocking effect of the injury will not make him capable of firing another shot. determination of relative position of victim and assailant 4. witness testimony Points to be considered and included in the report of the physician: 1. the possibility of additional shots is not remote 6. Did the victim die instantaneously? 8. 9. Examination of the hand of the victim may show presence of gunpowder. defense wounds (signs of struggle) 4. no disturbance in the place of death Russian Roulette: -agreement among persons to load a revolver with live cartridge. The location of the gunshot wound of entrance is in an accessible part of the body to the wounding hand. depression. unless he has the intention of deceiving the investigator. The shot was fired in a closed or locked room' usually in the office or bedroom. 48 By 4D2014-2015 . Possibility that gunshot wounds are self-inflicted 5. It may be at the temple. the person who will pull trigger with live cartridge in the firing chamber will suffer the fatal consequence -may be considered suicidal Evidences to show the gunshot wound is homicidal: 1. organs or tissues involved 5. 3. economic. location of the wound 3. The death weapon is almost always found near the place where the victim was found. Signs of struggle 6. Possibility of the victim to fire or resist the attack after being injured 7. Summary of Legal Medicine Book by Solis 13. if lodges in the body 6. diagram and other illustration showing location of wounds 11. The shot is usually solitary. Personal history may reveal social. smudging and tattooing. wounding firearm cannot be found at crime scene 6. no point of election in he wound entrance 2. fire is made when victim is at some distance 3. 5. direction and length of bullet tract 4. At what range was it fired? 3. usually one shot 2. HOMICIDAL OR ACCIDENTAL Pieces of evidence that tend to show that the Gunshot(s) wound is Suicidal: 1. bore in millimeters *Not standard length of barrel. clothings are interposed between the victim and the firearm 3. show bone involvement 4. nature of wound 2. the odor will disappear as gases usually evaporate or chemical transform to doorless compounds 2. facilitate location of bullet 2. *It is impossible to distinguish and memorise the report from two firearm of the came caliber.410 bore shotgun is the only shotgun at present designated 3. Nature of base of cartridge or spent shell revolver VS automatic pistol wider diameter than no such difference that of cylindrical body 49 By 4D2014-2015 Summary of Legal Medicine Book by Solis *It is not possible to determine the direction of the shot from the direction of the sound UNLESS that flash or the person firing the shot is seen at that time. Metric system .shoulder-fired firearm having a barrel that is smooth-bored Classes of shot in a shotgun shell: 1. Location of empty shells revolver VS automatic pistol in clylindrical magazine chamber after fire driven out of weapon after shot 2. show effects of bullet wound and other injuries SHOTGUN WOUNDS Shotgun.33 inch in diameter. Chemical changes inside the barrel 3. product of a near shot wound has been washed out of the wound X-ray examinations may: 1. *It may be possible for a person who is accustomed to sound of firearms of different calibers to identify firearm by the sound produced. age of wound 2. area of body involved 2.only a single or slug in a shell Systems employed in the determination of the diameter of barrel of a shotgun: 1. Determination as to length of time a firearm had been fired: 1. Single Projectile (rifled slug). physical condition of victim Capacity of the Victim to Perform Volitional Acts: Depends upon the following: 1. vital organs involved 3. Expression of the bore diameter in inches-0. fewer in number of shots (9shots) 3. Determination of the Length of Survival of the Victim: 1. resistance of victim *Injuries in the brain and spinal cord which cause incapacity to do voluntary acts negates the capacity. failure of examining physician to distinguish between a near or far shot wound 4.5 inch to 0. each fitting of the bore totals to one pound in weight 2.determination of number of lead balls. when a device is set up to hold the firearm 2.shot ranges form 0. degree of healing 3. Nature of spent bullet revolver VS automatic pistol no coating bullet is copper jacketed 3. degree of infection Determination Whether the Wounding Weapon is an Automatic Pistol or Revolver: 1. Buckshot. use for hunting fowls and small animals 2.FROGLETS NOTES entrance? Yes. . Later. reveal fragmentation and location 3. Evidence that may be deduced from the wound 1. The caliber may be inferred from the diameter of the gunshot wound. amount of blood loss 5.shot are small (0. presence or absence of infection 4.24 to 0. Birdshot. Gunshot wound may not be a near fire: 1.15 diameter). Gauge System . organs involved 3. Odor of the gas inside the barrel *mixture of gases has peculiar characteristic order which is noticeable several hours afar discharge. reveal trajectory of bullet 5. smudging visible *The same test may be applied to dorsum of hand of persons suspected to have fired the gun . As to manner of firing and reloading: a. disrupted deeper tissues h. Choke.not more than 6 inches Indicators: a. gunpowder tattooing up to 24 inches g. Microscopic examination 3. Unchoke.FROGLETS NOTES Grade of choke: 1. contusion of tissue f. Double Barrel Shotgun 2. Chemical tests a. the powder particles which escape may cling on the dorsum of the hand *Detection of metallic residue on the primer palm hand may indicate that the individual was making a defensive movement trying to ward off the weapon *In suicide. Determining whether a person has fired a firearm *When a person fires a gun. 6 feet-> shots begins to separate from conglomerate shot 10 feet-> produces independent wounds of entry ―Billiard ball ricochetted effect‖. Long range shot . tattooing. Types of shotgun: 1. Bolt action b. usually an abrasion d. Determination of the distance of the gun muzzle from the victim’s body when fired *The presence of gunpowder at or near the wound of entrance shows that the gun muzzle when fired is not more than 24 inches but its absence will not preclude near fire because other factors might have intervened 2. gunpowder tattooing is densely located e. the number obtained will give the muzzle-target distance in yards *A close shot produces more serious injuries because of concentration on specific target and greater kinetic energy of pellets. Contact or near contact shot . 5-6 feet-> wad tends to produce independent injury. Gross examination or examination with the use of hand lens *This examination is not conclusive because other foreign particles may be mistaken for gun powder or other primer components. Autoloading *A shotgun cartridge is usually 2-3/4 or 3 inches long and diameter depends on the gauge of the firearm Shotgun wound of entrance: 1. Lever Action c. Single Barrel Shotgun b. in an unchoked shotgun. recovery of wad together with shot (pellets) 2. smudging due to smoke up to 15 inches f. entrance wound is burned c.tendency for one shot to stoke another causing changes of the shot course 50 By 4D2014-2015 Summary of Legal Medicine Book by Solis e. shape of wound b. 2-3 feet muzzle distance-> single wound of entry b.more than 6 inches skin-muzzle distance Indicators a. presence of carbon monoxide along the bullet tract i. 2. 3-4 feet distance-> serrated wound of entry referred to as ―rat hole‖ c. blackening due to smoke d. Pump action d.diameter of barrel from rear to muzzle is the same 2. singeing of hair (less than 6 inches) g. Laboratory test to determine firearm residues *There is inference of contact or near distance of the gun muzzle to the skin when there is burning. to estimate the distance: measure the distance between the farthest shot in inches and subtract one. residue may be deposited on the palm of the hand used to steady the barrel at the time of discharge Procedures in determining the presence of gunpowder: 1.diameter of barrel at muzzle end is smaller than rest of the barrel *The lethal range is in an area of 30 inches in diameter at 30 to 40 yards according to degree of choking. As to number of barrel a. DETERMINATION OF THE PRESENCE GUNPOWDER AND PRIMER COMPONENTS OF The importance of determining the gunpowder on the skin of the victim: 1. Flameless Atomic Absorption Spectroscopy (FAAS) *Sample of hand washing is subjected to a high temperature to vaporise the metallic elements of the primer residue. Harrison and Gilroy Test *A cotton swab moistened with 0. development of instability of color 2. FIREARM IDENTIFICATION Factors: 1. Ballistic examination *Ballistics . Fingerprints *may determine if homicidal or suicidal nature of death 3. Cleaning *All oil. *The test requires access to a nuclear reactor (very expensive test) *Unable to detect lead *Principle: Barium and antimony are converted into isotopes by means of neutron 51 By 4D2014-2015 Summary of Legal Medicine Book by Solis bombardment. 3.50 cc Copper chloride . urine and other nitrogenous compounds with nitrites and nitrates will give a positive reaction *Subjection of suspect is not selfincriminatory. Lung’s test or Gonzales’ test) *The presence of small particles containing either nitrate or nitrite will be indicated by a blue reaction of the particles upon contact with Lung’s reagent. Neutron Activation Analysis (NAA) *A sample is obtained from the hands by the use of paraffin or washing the hand with dilute acid. Fouling of the barrel *recently fired firearm may have a characteristic door smoke inside the barrel 4. Test for the presence of Primer Components: 1. cosmetics. deals with examination of fired bullets .FROGLETS NOTES *The test may involve determination of presence of gunpowder residues of primer components the Test for the presence of gunpowder residues: 1. On clothing's (Especially coloured ones) Walker’s tes (C-acid test.1 molar hydrochloric acid is used to gather antimony.60 cc Ethyl alcohol . Dermal nitrate test (Paraffin test. Use of Scanning Electron Microscope with a Linked Xray Analyzer *Adhesive material is used to remove any residue particles from the hand. H-acid test) *A glossy photographic paper is fixed thoroughly in hypo solution for 20 minutes to remove all silver salts and then washed for 45 minutes and dried. It is then exposed to radiation from a nuclear react emitting neurons. *If unburned powder grains are present. antimony and lead 4. act purely mechanical 2. Caliber of the weapon 2.10 grams *The solution is swabbed until the numbers appear. The material then examined under the scanning electron microscope with a linked X-ray analyzer. grease and paint should be removed with gasoline. cigarettes. the following etching may be used Hydrochloric acid . 4. On the skin (Dorsum of the hand or site of the wound of entrance): 1. lacks specificity of color reaction 2. afterwards their quantity is measured. Serial number Procedure of restoring serial number if tampered: 1. sensitive and employs equipment within economic means *Can determine presence of barium. dirt.study of physical forces reaction on projectiles *Foreign ballistics . *Test is not conclusive as to the presence of gunpowder because fertilizers. barium and lead. interference of color reaction among three elements themselves 4.also known as firearm identification. *This method is quick. xylol and acetone 2. Etching *For all iron or steel materials. it will result to production of dark red or orange-brown spots on the prepared paper. Polishing (Most important) *Whole surface should be smoothly polished using a fine file followed by a medium to fine grade carborondum cloth *The area should always have the mirror-like surface 3.80 cc Distilled water . *The test does not enjoy substantial utilisation in forensic laboratory because: 1. Diphenylamin test. inadequately sensitive 3. the following marks are found in the shell and from the bullet: Marks found in the Shell: a. dragging. In the process of contact between the part of the gun involved and the cartridge.g. Firearms have certain physical characteristics of certain type of caliber which differentiate it from others. severity and appearance of the wound due to bullet or missile Basic Principles Involved in Firearm Identification: 1.instrument consists of two compound microscopes which allows comparison of two objects by looking through single eyepiece. Medical Ballistics. Marks found in the bullet: . 2. bullet surface may show the rifling marks on its surface of the barrel. b. 2. No two firearms can be manufactured with identical surface characteristics. Shot fired on a block of ice 52 By 4D2014-2015 Summary of Legal Medicine Book by Solis 3. siding or slipping cross the softer one leaving a series of abrasions. Vertical or horizontal shot on water tank 3. Comparison Microscopes.concerns with the effect of the bullet on the target or until it comes to rest 4. Exterior Ballistics . referred to as ―individual characteristics‖ Instruments Use in Firearm Identification: 1.concerned with the penetration. Caliper 6. Terminal Ballistics. striking of the firing pin on the percussion cup. Striation or serration mark – produced by a harder surface scraping. Shot may be fired on a box with oil and sawdust 2. When the cartridge is fired from the firearm. Hand lens 4. Marks on the cylindrical surface of the shell. 3.deals with what happened to the bullet or projectile from the moment it leaves the gun barrel to the moment of impact on the target or object 3. It is a long cylindrical container filled with cotton and an open shooting end. 2. marks 5.deals with what happened to the cartridge and its bullet from the time trigger is pulled until the bullet exits from the barrel 2.instrument for the purpose of recovering the test bullet and shell.marks found in the head of the shell Marks from breechblock: the impact of the shell in the bleechblock in the recoil impresses the ridges of the bleechblock and often gives identification mark characteristic of a firearm. Bullet Recovery Box.g. There is an attachment for photographic camera to facilitate the taking of pictures of the findings. E. e. Impression type Mark (Stamp Mark) – the forcible application of hard surface against the softer one leaving an impression on the softer surface. serrations and scrapes. d.mark brought about by the magazine. *The test shell and bullet may be used for comparison with the evidence bullet or shell. Interior Ballistics . Quality of metal in the manufacture of firearm is much harder and resistant to deformity than the quality of metal used n the manufacture of cartridge. Marks of firing pin – impressions in the percussion cap Marks from the extractor – marks found in front of the rim of the shell Marks from the ejector. E. Sharp pointed instrument for scraping I. c. the surface condition of the part of the gun can easily be impressed on the shell or bullet. Analytical Balance See illustration on page 386 Types of marking on the examination through Comparison Microscope: 1.FROGLETS NOTES and cartridge cases in a particular gun to the exclusion of all others Three separate and distinct area of Ballistics: 1. Other ways of recovering test bullet as used in other countries: 1. The individual or accidental characteristics of two objects may be compared.D. a. b. Examination with the use of comparison microscope: this is the comparison between evidence shell or bullet with the test shell or bullet a. The wound exit will be clean-cut oval round . Firing pin mark: when the base of the cartridge is hit by the firing pi. Number of lands and groovesnumber of grooves. E. Style of the cannelure Determination of individual accidental characteristics: By 4D2014-2015 or GUNSHOT WOUNDS IN DIFFERENT PARTS OF THE BODY Head and Neck 1.g. Cranium: Close or near contact fire in the head may produce marked laceration of the skin. The refling barrel is reflected in the bullet as it passes through it. depth. identity marks placed by previous possessor. flesh d. presence or absence of deformity or loss part c. 2. v. caliber of the bullet b. blood. Direction and rates of rifiling marks iii. Direction of the twist of the Rifling Marks. ii. iv. The skull is fractured without any definite shape with the linear extensions to almost all of the bones comprising the cranial box. Each manufacturers of firearms make certain marks which will distinguish firearms manufacturered by them and makes specific number of spiral grooves and direction of the twist in the brrel of the firearm. Dimension of the lands and grooves iv. Breechblock mark: as the bullet is propelled forward by the force of the expanded gas. burning and tattooing of the surrounding skin. iii.the direction of the spiral lands and grooves may twist to the right or to the lest. the fracture is oval at the outer table. the casing is forcibly moved backward against the breech force or recoil plate. and width depend upon the manufacturer of the firearm.FROGLETS NOTES Summary of Legal Medicine Book by Solis i. There will be radiating linear fractures from point of entrance. Number of rifling ii. 53 Determination of the clss characteristics: physical characteristics of certain caliber of firearm used by the manufacturer: i. Ejector mark: mark produced by the ejector in the process of throwing away the spent shell. gross examination or examination with magnifying lense: a. presence of foreign elements. The backward force transfers the marking on the breechblock to the base of the cartridge. Depth of the grooves v. Extractor mark: mark made by the extractor on the cartridge rim when pulled away from the firing chamber. In fire Arm Identification the Examiner must take into consideration the following: 1. The bullet recovered from the ody may show those marks in the examination and the examiner may have the presumption where the firearm came. b. the pin produces distinct markings which can be reproduced by succeeding shots. Fire from distance with the bullet having a right angle of approach to the skull. Summary of Legal Medicine Book by Solis 4. Face May noy cause serious trouble except that it becomes potential avenue for infection that may cause deformity. Injury in the cerebral hemispheres is as a rule not immdediately fatal and the victim may survive the injury. When the pulmonary vessel is involved. Lungs: it produces a cylindrical tunnel much larger than the diameter of the projectile with the bloody contents and ecchymotic borders. Some victims may live for a while but developed epileptiform convalsions as a sequel. the profuse hemorrhage may cause collapse of the lungs. and other vital centers causes the immediate death. 54 By 4D2014-2015 Neck 5. In jury of the brain causes sudden loss of consciousness and incapable of voluntary movement. Fragments of bones may be felt in the tunneled bullet tract. 2. with mark ecchymosis of the surrounding area and filled with fresh and clotted blood. causing instantaneous death if the upper portion is involved. If involve the carotid or jugular vessel and death may be due to profused hemorrhage. The bullet may strike the rib. The tangential impact of the bullet may cause it to split and it is not uncommon to see a fragment lodging in the brain substance while the other ricochet outside hitting other objects nearby. The bullet may pierce the front portion of the neck and may involve the cervical portion of the spinal cord. Chest: 1. however if the bullet courses the medulla.FROGLETS NOTES opening at the inner table with beveled fracture at the outer table. 3. 2. If only the lungs is involve. Grazing approach of the bullet may produce an elongated gutterlike depressed fracture of the cranium. Emphysema is present when there is marked injury to the air sacs. Injury to trachea and upper bronchi may cause asphyxia or aspiration pneumonia. pons. The victim may not die immediately but later may develop aspiration pneumonia or cerebral embolism. . When the intercostal or mammary vessel are injured there will be perfused hemorrhage. Brain Substance: Usually a rugged tunnel with a diameter larger than that of the caliber of the bullet. the profuse hemorrhage is observe that produces death before medical intervention can be done. sternum or the body of the vertebra and may cause deformity or deflection of its course. Chest wall: usually has an upward course and may involve both sides. displacement of the heart. Bullet wounds in the stomach and other hollow areas are usually small on the account of he contractility of the walls. Injury in the body of other parts of the vertebra and contusion. walking or to do other forms of volitional acts for death is not usually instantaneous. Spine or Spinal Cord: injury of the spine may not involve the spinal cord but injury of By 4D2014-2015 Summary of Legal Medicine Book by Solis 6. etc may lead to fatal resuls. fresh and clotted blood. pancreas. death due to peritonitis is not rare on the account of the spilling of its contents into abdominal cavity. Usually the wound is not so serious except when it involves the principal blood vessels and nerves. Bullet wound of the liver and other parenchymatous abdominal organs may cause stellate perforations which are usually larger than the caliber of the bullets that causes them. Timely surgical intervention may prevent untoward complications. wound of the auricle is more rapidly fatal as compared with the would of the ventricle on the account of thickness of the musculature of the latter which produces temporary closure of the wound. CHAPTER XVII DEATH BY ASPHYXIA Asphyxia – general term applied to all forms of violent death which results primarily from interference with the process of respiration or the condition in which the . The tunnel may contain fragmented tissue. 4. Lower spinal cord injury may cause motor or sensory paralysis and may later succumb to hypostatic pneumonia. However. Injury of the upper cervical spinal cord may cause immediate death because the vital nerve tracts may be involved. Extremities: it may show the characteristic lesion of gunshot wounds.FROGLETS NOTES 3. of the kidney. Abdomen: wounds are quite frequent but not as serious as those of the chest and head because of its ability to surgical operation. 5. Bullet affects the canal and the spinal cord causing either partial or complete severance b. Loss of function. It is limited to one or several organs. 55 Heart: wound may be circular or stellate with subepicardial hemorrhage in the surrounding tissue. suppuration or other complications. The bony tissue may involves the principal blood vessels and nerves. As a general rule does not prevent the victim from running. The wound entrance is smaller than the exit wound. the spinal cord may be due to: a. concussion or compression on the account of impact. kneeling. Traumatic crush asphyxia c. typical: ligature runs from the midline above the thyroid cartilage symmetrically encircling the neck on both sides to occipital region. . Stagnant Anoxic Death: this is brought about by the failure of circulation which may be due to heart failure. or arterial and venous obstruction. 2. reclining. Cyanide and alcohol is common agents responsible. Histotoxic Anoxic Death: this is due o the failure of the circulation of the cellular oxidatives process. b. 3. 3. Mugging or yoking iv. Compression of the neck with stick Suffocation: a. Phases of Asphyxial Death: 1. shock. Special forms of strangulations: i. Atypical: the ligature is tied or noosed and present on one side of the neck. By ligature b. prone or in any other positions. pulse rate increase and rise of blood pressure. although the oxygen is delivered to the tissues. etc. 2. 4. The breathing shallow and gasping and the rate becomes slower till death. Palmar strangulation ii. Garroting iii. Breathing becomes rapid and deep. Manual strangulation or throattling c. 2. partial: body is partially suspended as when the victim is sitting. Choking or closing of the air passage by the obstruction of its lumen asphyxia by submersion or drowning. injury or anesthesia. High altitude b. The victim may be sitting or lying with the face down provided that the pressure is present in front or in the side of the neck. Visceral organs shows petechial hemorrhages known as Tardieu Spots (caused by the hemorrhage produced by the rapture of the capillaries on account of the increase if intra-capillaries pressure). 6. Mechanical interference with the passage of air into or down the respiratory tract due to: i. shutting blood from the right side of the heart to the left without passage through the lungs Anemic Anoxic Death: this is due to a decreased capacity of the blood to carry oxygen. This condition may be due severe hemorrhage. The cyanosis becomes more pronounced and yes becomes staring and pupils are dilated. 4. Closing the mouth and nostrils by solid object b. or low hemoglobin level in the blood. Classification of Asphyxia: 1. Closure of external respiratory ortifice ii. Respiratory abnormalities e. as to location of the ligature and knot: a. complete: body is completely suspended and he constricting force is the whole weight b. Classification of asphyxia by hanging: 1. poisoning. 56 By 4D2014-2015 Summary of Legal Medicine Book by Solis Apneic Phase: is due to the paralysis of the respiratory center of the brain. it cannot be utilized properly. 2.FROGLETS NOTES supply of oxygen to the blood or to the tissues or both has been reduced below normal level. Types of death by Asphyxia: 1. in front or behind the ear or on the chin. Convulsive phase: this is due to simulation of the cntral nervous system by carbon dioxide. Asphyxia by pressure on the chest Asphyxia by irrespirable gases Asphyxia By Hanging: is a form of violent death brought about by the suspension of the body by a ligature which encircles the neck and the constricting force is the weight of the body. 3. 5. Dyspenic Phase: symptoms due to lack of oxygen and retention of carbon dioxide in the body tissue. Anoxic Death: associated with failure of the arterial blood to become normally saturated with oxygen may be due to : a. The heart later fails. The victim may become unconscious in the convulsive stage. Paralysis of the respiratory centerdue to poisoning. Obstruction of air passage iii. as to amount of constricting force: a. d. Hanging Strangulation: a. the larynx is pushed backwards and its opening is closed by the contact of the anterior to the posterior laryngeal wall producing asphyxia. 4. Upon suspension of the body. if the not is just underneath the chin. Other materials includes beddings. This can be distinguished on the nature of the ligature marks. 5. It is not easy to retain the knot beneath the chin. the number of loops around the neck and the point of suspension. electric wire etc. the loop is found below the thyroid cartilage. The pressure of the band will cause the air passage to constrict. The thinner the ligature and the tougher the material. symmetrical: the knot or noose is at the midline of the body either at the occiput or just below the chin.FROGLETS NOTES 3.. Protrusion of the tongue depends upon how pressure is applied around the neck. 6. window casing. the groove at the back of the neck is not deep on account of the firmer skin and muscular tissue. Mode of Application of the Ligature The ligature may be placed around the neck with a single loop or with two or more hoops. blood vessels and nerves of the neck is established when the body is suspended. producing pressure at the region of the neck. the more pronounced will the the mark on the skin of the neck. 2. Position of the Knot The knot or joint is usually located on either side of the neck. Pressure of the ligature may also cause compression of the superior laryngeal nerve. the ligature is usually pull of the constricting force. In hanging. It may be tightened after it has been encircled around the neck and the pressure on the air passage. 3. ceratoid arteries and jugular veins producing cerebral anoxia. tree. There is more pressure in a single loop ligature on account of concentration of force at the weight compare to several loops. 7. he will suffer the following symptoms: 1. The level of the ligature around the neck may differentiate hanging from strangulation by ligature. there will be several ligature marks with an intervening redness between the furrow. If the material is soft and broad the ligature impression on the neck is less marked. the tongue is kept inside the buccal cavity. 4. Gradual loss of sensibilities Sensation of constriction of the neck Loss of consciousness and muscular power Numbness of the legs and clonic convulsion Sensation of ringing inside the ear Sensation of flash of light before the eyes Face becomes red with eyes prominent and feeling of heat in the head. In single loop. while in case of strangulation by ligature. b. 2. door knob. Materials used in Ligature. the weight causes the noose or band to tighten. The head is flexed opposite the location of the knot. If the victim is timely rescued and revived after artificial respiration. The rope is commonly used as ligature because it is easily available and strong. Noose 57 By 4D2014-2015 Summary of Legal Medicine Book by Solis Symptoms 1. belts. 2. Whistling sensation insede the ear Watering of the eyes . However. Mechanism of Death: There is a ligature around the neck with a knot or with a sliding noose and the other end is fastened to an elevated object like peg. as symmetry: a. Ligature in Hanging 1. If above the larynx and in an upward direction. 5. but if there are several. 3. the tongue will be pushed outward and will protrude from the mouth but if the pressure is below. Course of the ligature around the neck The usual appearance is that the groove or ligature mark is deepest opposite the location of the knot. with the head tilted to the side opposite the location of the noose or knot. nail. There may be no sliding noose at the end of the ligature. Asymmetrical: knot or noose is not is not in the midline but on the one side. Forms of furrow that develops in the neck depends upon the type of ligature. etc. there is but one ligature furrow. Saliva dribbled from the mouth with froth g. The rate of consumption of oxygen in the blood and tissues. Urination or defecation due to the loss of power of sphincter muscles. State of erection or semi erection of the penis with seminal flued in the urethral meatus h. Maintain the natural body temperature a. Neck elongated and stretched with the head inclined on the side opposite the knot or noose b. 5. Cause of Death in Hanging 1. 3. e. a. Eyes closed or partially opened with pupils usually dialted on one side and small on the other side (facies sympathetic) c. Severity of the constricting force If the constricting force is only sufficient to occlude the windpipe. Engorgement of the lungs b. Sensation of number ness of both legs. 6. Tongue must be pulled forward and the body must be laid on back rest. Hands are clenched firmly and purple colored fingernails e. Internal Findings: a. 2. Kidneys are congested. Venous system contains dark-colored fluid blood. Induce the natural act of respiration a. All the above symptoms may last for 12 days after rescue. or other stimulants c. Apply heat at the region of the precordium b. Ligature must be loosened and mouth msut be wiped to remove all obstacle to free air. Administration of respiratory stimulant. c. Electrical stimulation of the phrenic nerve e. Point of application of the ligature When the ligature is made below the larynx. . then unconsciousness develops immediately and death is accelerated. Cover the body with blanket b. maximum pressure is at the back of the neck cause merely partial occlusion of the windpipe and blood vessels of the neck. Stimulate the heart to renew action if it ceases to beat. 2. b. Place the patient where there is free current of fresh air d. Right side of the heart and the big blood vessels connected with it are distended with blood. Any combination of the above Time Required in the Process of Death Time is influenced by the following: 1. strychnine. like ammonia. 3. Other factors a. Physical condition of the subject b. Hanging with the knot situated on one side of the neck may delay death because of closure of cerebral vessels cannot be maintained.FROGLETS NOTES 3. Lips livid or blue f. but if the pressure is sufficient to occlude the carotid arteries. 2. d. Blood vessels of the brain is generally congested. 4. Administration of brandy. jugular veins and vagus nerve. death is almost instantaneous. Treatment 1. Difficulty of breathing and swallowing 4. death may not occur for three to five minutes. but when applied above the larynx. Place the patient in a warm room Post mortem findings in death by hanging 1. Post mortem lividity with ecchymosis are mostly marked at the legs i. If knot is below the jaw. death may be delayed. Hypodermic injection of coramine. c. 58 By 4D2014-2015 Summary of Legal Medicine Book by Solis 2. 3. Simple asphyxia by blocking the air passage Congestion of the venous blood vessel in the brain Lack of arterial blood in the brain due to pressure on the carotid arteries Syncope due to pressure on the vagus and carotid sinus which leads to reflex irritation and paralysis of the medullary autonomic centers Injury on the spinal column and spinal cord. General External Appearance a. Lividity or pallor of the face with swelling and protrusion of the tongue d. thereby delaying death. Homicidal or Suicidal Strangulation by Ligature 59 By 4D2014-2015 . while hanging of a living subject whose bodily resistance has been markedly weakened may show slight vital reaction The following finding show that hanging is ante mortem 1. they are hanged by means of a rope on a tree or some similar objects. Ecchymosis of the neck depends upon the width and softness of the ligature. 2.whether entrance was forcibly opened or have been used as an escape by the offender in homicide case b. e. Presence of signs of struggle. Determinations whether hanging is accidental. muscles and other soft tissue g. It may be observed in infanticide using the umbilical cord as the constricting material. subepicardial punctiform hemorrhages Summary of Legal Medicine Book by Solis It is advisable to look for other injuries which are capable of producing death to eliminate the possibility of hanging as the cause of death. Presence of stains. But. Accidental. but the presence of findings in the genitalia and other physical injuries are distinctive findings. Coma due to arrest of cerebral circulation. 2. Ligature mark which forms groove is about or rather leass than the knot. the umbilical cord is abnormally long and there is no disturbance in the wharton's jelly. There may be rapture of the underlying blood vessels. Fold markings on the neck of an obese individual – the marks are not continuous and removed on stretching the skin of the neck Marks of tight neckwear – the location and history will differentiate this from ligature marks. Evidence in support of homicidal hanging a. Asphyxia by Strangulation Strangulation by Ligature: It is produced by compression of the neck by means of a ligature which is tightened by a force other than the weight of the body. 4. d. B. redness or ecchymosis at the site of ligature ecchymosis of the pharynx and epiglottis line of redness or rupture if the intima of the carotid artery subpleural. Inhibition of the respiratory center due to the pressure on the vagus and sympathetic nerves. c. Causes of Death in Strangulation by Ligature 1. homicidal or suicidal 1. b. The course of the ligature is inverted vshape with the apex of the v at the site of the knot. Whenever colored offenders are apprehended. 3. Sub-pleural. This must be differentiated from accidental strangulation during child birth. Fracture of the hyoid bone or tracheal rings. Different diagnosis: 1. f. The lining membrane of the blood vessels may be lacerated. Shock or syncope. Nature of windows and doors . 2. sub-pericardial punction hemorrhages Findings on the neck: a. 3. Usually practiced by Americans against the Negros who commit crime against the white American. bodily injuries in the body of the victim d. h. Asphyxia due to the occlusion of the windpipe. Strangulation by ligature is commonly observed in rape cases. 3. Presence of defense wounds in the body of the victim ―Lynching‖ a form of homicidal hanging usually found in southern states of US. Determinations Whether Hanging is Ante Mortem or Post Mortem The principal criterion is the vital reaction.furniture and beddings may be disturbed whenever there is a previous struggle. The Negroes are executed without due process of the law. The skin at the site of the ligature is hard with red line of congestion and hemorrhage in some points. c. hanging made immediately after death may also show to a certain extent vital reaction. Neck is flexed opposite the side where the knot is located.FROGLETS NOTES f. 4. Using both hands with assailant in front 3. The average time required for death in drowning is 2 to 5 minutes. either by the use of the hand or by some other means. The nostrils and mouth may be blocked by the introduction of foreign substances. using any of the following methods: Schaefer's Method or Sylvester's Method. although it may be utilized in suicide or in homicide. etc. It may be done by placing a ligature around the neck and tightened by means of twisting a piece of stick. the hands are relaxed and the victim recovers. viscid or pultaceous fluid for a time to prevent the free entrance of air into the air passage and lungs. C. It is common among children. Palmar Strangulation The palm of the hand of the offender is pressed in front of the neck without employing fingers. Place the face down and perform artificial respiration. The nerves of the neck may be traumatized especially the superior laryngeal branch of the glossipharyngal. Suicidal smothering by means of his own hand is not possible Homicidal and accidental smothering is frequent. if ordinary efforts for respiration is made. It is a method of choice in infanticide.FROGLETS NOTES Homicidal strangulation is the most common of the three forms of strangulation by ligature. 3. There are a few instances of strangulation which are accidental and most of the victims are children or epileptics who are helpless and incapable of extricating themselves. Garroting A ligature. Suicidal throttling is impossible because of the pressure of the person's own hand must be maintained for sometime but when unconsciousness begins. however. 2. accidental smothering of epileptic. epilepsy or in any other helpless state. cloth. Manual Strangulation or Throttling This is a form of asphyxial death whereby the constricting force applied in the neck is the hand. like mud. Asphyxia by Suffocation Asphyxia by suffocation is exclusion of air from the lungs by closure of air openings or obstruction of the air passageway from the external openings to the air sacs. Smothering This is a form of asphyxial death caused by the closing of the external respiratory orifices. . a metal collar or a bowstring is placed around the neck and tightened at the back. The pressure on the neck may cause compression of the blood vessels and disturb the blood supply of the brain 3. Using both hands with assailant at the back Manners of Death in Manual Strangling 1. Most of suffocation by choking is accidental. Using one hand 2. Suicidal strangulation by ligature is quite rare. Homicidal manual strangulation is the most common. Examples: overlaying. a person may survive even after 4 minutes of submersion. It may occur when a person is under the influence of alcohol. 2. Methods of Throttling 1. there are evidence of struggle or marks of violence in other parts of the body. Special Forms of Strangulation 1. D. gagging. Emergency Treatment in Drowning Remove the bodily clothings especially the tight ones and wrap the body with blanket. 4. Time Required for Death in Drowning Submersion for 1-1/2 minutes is considered fatal. hypoglossal nerves and the plexus surrounding Bifurcation of the common carotid artery or of the vagus producing shock. The air passage may be blocked and death is due to asphyxia 2. Accidental throttling may occur but the victim never died of asphyxia but of other causes. paper. Asphyxia by Submersion or Drowning This is a form of asphyxia wherein the nostrils and mouth has been submerged in any watery. Aside from the ligature mark in the neck. Homicidal or Suicidal Manual Strangulation 1. plastic bag suffocation Choking This is a form of suffocation brought about by the impaction of foreign body in the respiratory passage. Compression of the Neck with a Stick The victim may be forced to place his back behind a post. 3. Accidental. Mugging (strangle-hold) 60 By 4D2014-2015 Summary of Legal Medicine Book by Solis This is a form of strangulation with the assailant standing at the back and the forearm is applied in front of the neck. Classified as traumatic asphyxia. In accidental cases. dark brown in color is due to conversion of hemoglobin to sulmethemoglobin. H2S) NATURE and CHARACTERISTICS    Death by Crucifixion When person is nailed on a cross the weight is supported by the nailed feet. Transparent gas. etc. sweetish taste and emitting an odor similar to a rotten egg. dilated pupils. The specific gravity of human body is slightly more than of the water. HYDROGEN SULFIDE (SULPHURETTED HYDROGEN. aromatic vinegar. product of complete combustion of carbon containing compounds. the body may be pinned between two big objects or collapsing building on the ground. Victims may be accidentally imprisoned or deliberately enclose themselves in a room or garage with motor engine running or slow burning is present. etc. drainage pipes. and deep wells. Gas Chromatograph 5. kerosene 61 By 4D2014-2015 COLORLESS. Very rarely is traumatic asphyxia attempted in suicide. cold extremities. headache. nausea. Potassium Ferrocyanide Test 3. cyanosis. Infrared Analysis Carbon Dioxide (Carbonic Gas Acid) Carbon Dioxide is the gas blown out of the lungs during respiration. Floating of the Body in Drowning The body may not immediately be recovered after drowning because it is under water. E. on account of the decomposition which causes the accumulation of gas in the body. POST-MORTEM FINDINGS     Putrefaction sets rapidly. Lungs are congested and edematous. The floating of the body is markedly influenced by the weather. caffeine. delirium. Examination Through a Spectroscope 4. the body floats. Summary of Legal Medicine Book by Solis  A dilute solution produces irritation of the eyes. Formed during a decomposition process of organic substances containing sulphur. The fatal carbon monoxide poisoning usually involves burning wood. F. Injection of strchnine. septic tanks. and labored breathing Prolonged exposure on a diluted atmosphere may cause tetanic convulsion. abdominal pain. and the end result of fermentation and decomposition of organic matters.the bronze color of the head and neck of a person who died in water during the process of decomposition. Found in large quantities in a sewer. age. vomiting. The body when recovered. Accidental and suicidal death by carbon monoxide poisoning is common. or gasoline engine in cars. Blood in fluid state. and charcoal used in heating or cooking. Kunkel's Test 2. "tete de negri" . coramine. followed by dizziness. Within 24 hours. Qualitative Test for Carbon Monoxide in the Blood 1. condition of the fluid medium where drowning took place. the assailant may kneel on the chest of the victim or squeeze the victim between the arms and legs as in wrestling. EFFECTS  Burking This is a form of traumatic asphyxial death invented by Burke and Hare for the purpose of murdering people to be sold to medical schools for dissection. stupor. throat and air passages. floats usually with flexed extremities. . oil. nose. sex and body built. coma and death. Offensive odor is noticed on opening the body. The head is submerged because it has a higher specific gravity than the rest of the body.FROGLETS NOTES Administration of stimulants as ammonia. Inhalation of oxygen combined with 5% to 8% carbon dioxide to stimulate respiration. Compression Asphyxia (Traumatic or Crush Asphyxia) This is a form of asphyxia whereby the free exchange of air in the lungs is prevented by the immobility of the chest and abdomen due to external pressure or crush injury. In homicidal cases. Asphyxia by Breathing Irrespirable Gases Carbon Monoxide (Carbonic Oxide Gas. Co "Silent Killer") Carbon Monoxide is formed from the incomplete combustion of carbon fuel. presence of wearing apparel.coal. ) EFFECTS:     Irritation of the eyes with copious flow of tears Severe lacrimation.A. peaches. in kernels of common cherry. bleaching agent Found in eruption of volcanoes EFFECTS   Irritation of the respiratory passage. SULFUR DIOXIDE NATURE and CHARACTERISTICS    COLORLESS gas Employed as a disinfectant.C. burning sensation in the throat and discomfort on the chest Vomiting. spasm of the glottis and suffocation Irritates the eyes and caused congestion and lacrimation 62 By 4D2014-2015 Summary of Legal Medicine Book by Solis POST-MORTEM FINDINGS  Not characteristics but there may be cyanosis with signs of asphyxia WAR GASES ESSENTIAL CHARACTERISTICS        Heavier than air Capable of spreading rapidly on the area where the chemical effects is desired Capable of producing effect even in low concentration on a specified area May be a true gas.) Bromobenzyl Cyanide (B. bronchitis and blistering of the skin PREVENTIVE MEASURES    Wearing of Gas mask Washing of the affected eyes with boric acid solution Sodium bicarbonate solution may be applied in other affected areas . EFFECTS  Loss of muscular power.) Ethyl Iodoacetate (K.P. in ordinary bamboo shoots. congestion of the conjunctivae and temporary blindness Irritation of the respiratory passages and lungs. nausea.FROGLETS NOTES  Other organs are congested and dark colored. thus causes sneezing. fingernails are blue and jaws firmly closed Eyes are bright and glistening and pupils are dilated Odor of the acid may be noticed on opening the body Heart is engorged with bright red blood Mucous membrane of the esophagus and the stomach may be congested and covered with froth. HYDROGEN CYANIDE NATURE and CHARACTERISTICS    One of the most toxic and rapid acting gases. plum. spasm of the eyelids. and in certain oil seeds and beans.B. slow and stertorous breathing with loss of consciousness which may or not be preceded by convulsion before death POST-MORTEM FINDINGS        Body is livid or violet in color Post-mortem lividity is bright red or pink due to the formation of cyanmenthhemoglobin Fingers are clenched. giddiness.S. volatilized liquid or finely divided solid Manufactured in big quantity in a relatively cheap price Stable substance or not easily made non-toxic by rapid chemical reaction Capable of storage for an ample length of time CLASSIFFICATION BASED ON THE PHYSIOLOGICAL ACTION LACRIMATOR or TEAR GAS KINDS:    Chloracetophenone (C. in bitter almond. smoke. coughing. Formed by addition of acid to potassium or sodium salt of cyanide. Found in leaves of cherry-laurel.K. marijuana. Yellow Cross. Reckless driving. stricken with coryza. defective hearing c. poor brake. EFFECTS  Nausea.C. coma and death STERNUTATOR (Nasal Irritants or Vomiting Gases) KINDS    Diphenyl chlorarsine (D. INJURIES AND DEATH ON THE DRIVER AND PASSENGERS 63 By 4D2014-2015 . they cause dyspnea. showing of. leak in the exhaust system of the vehicle 5. MECHANICAL FACTOR – ex. Driving under influence of alcohol or drugs (depressant drugs. inattention. psychotrophic drugs) .) 2. vomiting. d. Mental Attitude – ex. absence of road signs. Delayed or Sluggish Reaction Time – Reaction Time – the space of time the driver perceives an impending danger and the actual application of the brake. inexperience b. tightness of chest and coughing. Disease – the driver may develop an epileptic fit or suffer from a heart attack while on the steering wheel e. Chemical Factor – ex.FROGLETS NOTES VESICANT or BLISTERING GAS  KINDS    Mustard Gas (Dichlordiethyl Sulfide. unstable body 4. fatigue. blind intersections. Perceptive Defect – ex. worn out tires.A. Insurance – develop ―devil may care‖ attitude on the driver inasmuch as he will not be financially held liable for damages as a consequence of a crash PEDESTRIAN EFFECT  HUMAN FACTOR a. malaise. Speed. SOCIAL FACTOR – ex. Roads.  When inhaled. and prostration PARALYSANTS (Nerve Gas)  Paralysis at the myoneural junction BLOOD POISONS KINDS ENVIRONMENTAL FACTOR – ex. transmission failure. varying degree of conjunctival irritation. vomiting. ―Ypertite‖) Lewisite (Chlorovinyl-dichlorarsine)  Contact with the skin may cause bleb or blister formation Hydrocyanic Acid (Hydrogen Cyanide or Prussic Acid) Hydrogen Sulfide (Sulphurated Hydrogen) Carbon Monoxide (Carbonated Oxide. salivation and pain in the chest.M. Defect in the steering wheel. headache.) Diphenylamine chlorarsine (D. Defective vision. stiff and slippery road may prolong the sked time Sked time – the space of time between the actual application of the brake and the stopping of the car 3. weather. C0) CHAPTER XVIII DEATH OR PHYSICAL INJURIES DUE TO AUTOMOTIVE CRASH OR ACCIDENT EFFECTS  Summary of Legal Medicine Book by Solis AUTOMATIVE CRASH: LUNG IRRITANTS (Asphyxiant or Choking Gas) FACTORS RESPONSIBLE TO AN AUTOMOTIVE CRASH KINDS     Chlorine (CL2) Phosgene (COCL2) Chloropierin Diphosgene EFFECTS  1.) Diphenyl cyanarsine (D. The backward and forward movement of the head is known as ―acceleration-deceleration injury‖ or ―whiplash‖. The fender. bumper and other parts of the car commonly involved in the impact are made of metal which can absorb energy. c. 4. fibula. 3.FROGLETS NOTES KINDS OF COLLISIONS IN AUTOMOTIVE CRASH 1. femur. The impact of the face to the circular rim of the steering wheel may cause fractures of the teeth. Displacement of the occupants within the vehicle with impact against structures Ejection Distribution of the passengers in the compartment resulting in direct impact injuries FRONT IMPACT CRASH 1. MEANS EMPLOYED TO MINIMIZE INJURY TO DRIVER AND PASSENGER 1. face or neck. Fracture of the skull. Abrasion of the face and scalp. 2. the passenger does not sustain severe injuries. Impact of the lower extremities against the dashboard may cause fracture of the tibia. Severe impact of the driver’s head on the windshield may cause laceration of the scalp. On account of the ling period of the process of rolling. or may be propelled over the front seat striking the front seat passenger and driver. SIDE IMPACT CRASH    Common impact in street intersections The lateral impact to the chest may cause fracture of the ribs. Special restraints to the occupants are being applied to reduce the severity of the second collision in the forms of lap and shoulder belt and air bag. including the steering wheel. crushed or may be thrown away and fall on the ground. jaw and facial bones. side doors are prevented from intruding into the passenger compartment and strike the occupants. First Collision – the impact of the moving vehicle with another vehicle or a fixed object Second Collision – the impact of the unrestricted occupants with the interior of the vehicle   FACTORS RESPONSIBLE FOR PASSENGERS AND DRIVER INJURY 1. Laceration of the spleen and kidneys and pelvic may also be observed. dissipate such force and prevent its transmission to the driver and passengers. 2. 3. b. contusion with laceration of the lungs. g. ROLL OVER CRASH (Turn-turtle Impact)   In the process of rolling. Laceration or rupture of the heart. The rolling process causes the different sides of the vehicle to absorb the force of the impact. Driver a. But the use of seat belt is not absolutely considered as a safety device. Crashing injury of the neck. or pelvis as well as lacerations and abrasion of the skin of the area. 2. c. the occupants may be pinned. It may result to muscle spasm or injury to the ligament of the neck resulting to pain. e. dashboard with perforation to allow metal to deform easily. windshield safety glass. Laceration of the liver and/or spleen. 3. Front Seat Passenger a. Ejection may increase further the injury sustained by the occupant. Laceration of the face and scalp. Use of soft padded dashboard. dashboard. the pillar between the front and rear side doors. Rear Seat Occupants – they may strike the back of the front seat. f. d. the head moves backward or hyperextended. EJECTION OF THE OCCUPANTS   The primary impact of the vehicle may forcibly open the unlocked door. dashboard or windshield. REAR IMPACT CRASH 64 By 4D2014-2015 Summary of Legal Medicine Book by Solis With the impact at the rear. It may cause . b. then the head will move forward until the chin strikes the front portion of the chest and with the neck hyperflexed. 2. enlarged and padded central steering wheel hub and collapsible steering column The interior of the passenger compartment. Fracture of the ribs and sternum. in an isolated road and with no eyewitnesses or someone who could take note of the identity of the vehicle SUICIDAL CRASH    Usually a single vehicle and single occupant crash Head on collision with roadside object. reflex time. paint strains. contusion and hematoma of the lower portion of the abdomen. visual and hearing perception. ground or on the vehicle Narrations of witnesses as to how the incident took place including the identity of the vehicle and the victims PEDESTRIAN – VEHICLE COLLISION DEATH OR PHYSICAL INJURIES TO PEDESTRIAN Summary of Legal Medicine Book by Solis  1. PRIMARY IMPACT  First violent contact between the pedestrian and the motor vehicle The severity of the injury depends on the position of the victim when the impact occurred. EVIDENCE IN VEHICULAR CRASH 1.FROGLETS NOTES injuries to the abdominal wall. HIT-AND-RUN INJURIES  A fast moving vehicle may run over. No evidence of any effort to apply the brake or to avoid striking the object (foot still on the accelerator pedal)  HOMICIDE BY MOTOR VEHICLE   The simulation of a crash may occur to conceal a prior homicide Victim of other means of violent death may be placed on the road to simulate that he is a victim of ―hit and run‖. FROM THE DRIVER  The subsequent impact of the pedestrian to the ground after the first impact The injury sustained by the pedestrian depends mostly on the force of the ground impact. nature of the road and part of the body involved  Fitness to drive – capacity to manipulate the steering wheel. rupture of organs and internal hemorrhage may be seen at autopsy 4. etc. and the amount of bodily support (clothing and other apparel) The movement of the body after the primary impact depends on the location of the impact Bumper Fracture – Fracture of the leg bones as a consequence of the primary impact  2. hit or sideswipe a pedestrian or collide with another vehicle or fixed object and get away from the scene without regard to the unfortunate victim This usually happens when the driver is drunk or ―high‖ at night time. FROM THE SCENE OF THE CRIME  The area of the road – a photograph sketch must be taken to determine who violated the traffic rules and regulation The skid and tire marks on the road – for identification of vehicle and whether the driver stepped on the brake immediately before the crash Condition and position of the victim – whether pedestrian or occupants Condition of the vehicle and of other structures in the vicinity Blood. SECONDARY IMPACT 2. step on the brake and accelerator. history of epileptic seizure. heart condition. pieces of clothing that may be found in the body of the victim. visceral organs and vertebral column. RUN OVER INJURIES    The pedestrian may be run over by the moving vehicle during the initial impact or thereafter Usually. Seat belt Syndrome – the acute flexion of the trunk (jackknifing) with the belt as the central fulcrum may cause fracture of the trunk with the visceral organs in forward motion. speed of the moving vehicle. pole or bridge support at a high speed. may stretch the mesentery and causes injury to the intestine and mesentery itself.     65 By 4D2014-2015    . skid or tire marks. the victim dies of shock Crash fracture. There may be abrasion.  Accounts for the multiple abrasions and contusions on the body of the pedestrian-victim 3. Inasmuch as the cyclist is exposed to crashes. thick pants. True Physical Virginity.15% alcohol in the blood is considered drunk Injuries due to second collision – like steering hub imprint. ejection from the motorcycle is common. Summary of Legal Medicine Book by Solis There are so little crushable materials to absorb the impact that the motorist himself is subjected to the severe force. KINDS OF VIRGINITY 1. It has a small profile that the driver of other vehicles may fall to see it. VIRGINITY AND DEFLORATION Virginity. 4. though her mind and heart is impure. the tire may skid.the hymen is intact.condition of a woman who permits any form of sexual liberties as long as they abstain from rupturing the hymen by sexual act.the state of not knowing the nature of sexual life and not having experienced sexual relation. and gloves to protect the skin from injuries that result from ejection Leather boots to protect from injuries of the bones of the feet and legs. 3. .FROGLETS NOTES   Alcoholic drunkenness – a person with at least 0. No restraint system is available to keep the operator and the passenger on the bike and as a result. False Physical Virginity. FROM THE VICTIM IN VEHICLE-PEDESTRIAN COLLISION        Crush injury Tire Thread Marks Abrasion Marks Paint Marks Blood. or the cyclist may be drunk. Whenever the motorcycle strikes another vehicle or a fixed object the injuries is quite severe because: 66 By 4D2014-2015 1. 2. Demi-Virginity. 3. a. A motorcycle can attain a high speed compared with other ordinary road vehicle. 3. 3. 2.is a condition of a female who has not experienced sexual intercourse and whose genital organs have not been altered by carnal connection. fractured skull. the cyclist may lose control of the brake. There is a presumption that a woman is virgin whenever it is shown that she is single and continuous until overthrown by proof to be contrary. 1. CHAPTER XXI MEDICO-LEGAL ASPECTS OF SEX CRIMES A. it may hit a fixed object. Determine deceased’s position on the vehicle or the pattern of injuries Determine whether death occurred as a result of the crash and not due to natural disease. 2.hymen is unruptured but the orifice is wide and elastic. the only alternative approach is the protective wearing apparel. multiple abrasions and laceration of the face and scalp. ribs and sternum 3. b. fracture of the leg bones. gunshot wound or other causes prior to the crash Question of survivorship when more than one member of the family died in a crash Size of monetary reward in a civil suit may depend on the nature and extent of the injuries suffered MOTORCYCLE CRASH REASONS WHY THERE IS A HIGH PERCENTAGE OF MOTORCYCLE CRASH 1. 2. At high speed and frequently in curves. hair or Clothing of the Victim Physical Defects of the Victim Inebriation of the Victim – the victim might have been under the influence of alcohol and other depressant drugs PURPOSES OF THE AUTOPSY OF VICTIMS OF VEHICULAR ACCIDENTS 1.a condition where a woman is conscious of the nature of the sexual life but has not experienced sexual intercourse. Leather jacket. A woman is a VIRTOUS FEMALE if her body is pure and if she has never had any sexual intercourse with another. Motorcyclist helmet which must be buckled to protect the head. Moral Virginity. poisoning. Physical Virginity. 2. ) Hymen a. Stellate. Multiple. yet she may be unchaste. vii. a. Self-scratching due to irritation viii. Infantile. lacerate without pain or appreciable bleeding. Semilunar or crescentric. Thick yielding hymen with scarce blood vessels. Linear.a truly virgin woman. 1. b. 2.the border of the opening shows small irregular protrusiontowards the opening. 5. THE FOLLOWING FACTS MUST BE INCLUDED. Medical instrumentation vi. Summary of Legal Medicine Book by Solis Breast Viginal Canal Labia Majora and Labia Minora Fourchette (present a V-shape appearance as the two labia minora unite posteriorly.the opening is slit-like and usually running vertically. Falling on hard and sharp object v. Membranous hymen.there are two openings separated by a bridge of hymenal tissue. c. vi.no opening in the hymen. Insertion of foreign bodies x.no opening Virginity is NOT synonymous with Chastity. Condition of the Vulva Fourchette Viginal canal Hymen. As to the shape and size of the opening: i. b. General condition of the hymen Original shape of the orifice (opening) If lacerated. 3.the opening is small. ii. may be transparent and may be 67 By 4D2014-2015 c. 4. ix. DEFLORATION Defloration is the laceration or rupture of the hymen as a result of sexual intercourse. Ulceration due to disease iii.hymen is parchment like.several openings iv.two openings iii. As to number of opening: i. B. PARTS OF THE FEMALE BODY TO BE CONSIDERED IN THE DETERMINATION OF THE CONDITION OF VIRGINITY. There are no structural changes in her organ to infer previous sexual intercourse and that she is a virtuous woman. Septate.the fact that hymen is intact does not prove absence of previous sexual intercourse and the presence of laceration does not mean defloration. iii. 2. Virgo Intacta. Cribiform. Previous operation IN THE MEDICAL EXAMINATION OF THE HYMEN. Imperforate. Single orifice ii.the concavity may be facing either side or upwards or downwards. Septate.the hymen presents several openings instead of a single one. the following must be noted: . a. Annular or Circular. Firm and with strong connective tissue and plenty of blood vessels. Parts of the female genitalia that must be examined to determine defloration: 1. viii.the opening is oval or circular located at the center of the hymen. Other causes of hymenal laeration: i. A woman may resort to many forms of homosexual as well as heterosexual practices without losing her virginity. 4. Imperforate. iv. Local medication vii. As to structure and consistency: i. Masturbation ix. v. 3. Fimbriated. Jumping or running iv.FROGLETS NOTES 4. ii.hymenal opening is like a star. Passage of clotted blood during menstruation ii. iii. In case of cunnillingus (a prevented sexual act wherein the male licks the female genital organ) the male partner may blow air in the vulva and may cause embolism especially when the woman is pregnant. Must be a manifested and tenacious resistance. Sadist who may not be sexually satisfied by sexual intercourse but by inflicting physical injuries to the partner . healed with sharp coaptible borders without congestion or healed laceration with rounded non-coaptible borders and retraction of the edges. tachycardia and hyperventilation due to emotional response and muscular exertion. Increase of pulse rate ii. incomplete or complicated laceration) ii. b. In the female. f. e. Death of BOTH partners a. Brrr brr brr 68 By 4D2014-2015 Summary of Legal Medicine Book by Solis DEATH RELATED TO SEXUAL ACT A. Evidences of Force or Intimidation: or -Mere initial reluctance of the offended party or verbal refusal alone will not prove force. Death from natural cause. Death may be due to the defensive act of the woman-victim. Degree of laceration (complete. there is contraction of the smooth muscles of the uterus and rhythmic contraction of the viginal sphincter. B.) iv. c. The Size and the length of the penis may cause total or partial block of the air passage. Brrr brrr brrr b. h. d. During sexual excitement a. Complications of laceration PSYCHOLOGICAL CONSIDERATION A. . b. orgasm is the sensation resulting from the contraction of the smooth muscles of the genital and the striated muscles of the pelvic floor coinciding with ejaculation. The female may die of shock as a result of the extreme trauma in case of rape. Location of laceration iii. Local Changes – the parasymphatetic innervations of the sex organ is from the 2nd . b. Marked increase in blood pressure making its peak during orgasm iii.because of increased blood pressure. A decrease of sensory perception During Orgasm In the male.FROGLETS NOTES i. May be due to the performance of the sexual act in an enclosed place with carbon monoxide or asphyxiant gas. Brrrr brr brr Character of the Offended Party: -The person is guilty of rape if force and violence were used regardless of the good or bad morals of the offended party. the ischiocavernousus and the pelvic floor musculature. An increase of peripheral flow of blood experienced as an increase of body warmth iv. during orgasm. g. Homicide-suicide pact. 3rd and 4th spinal sacral segments. Death by male partner a. The sexual intercourse might be done in a relatively confined space like the back of the seat of a car. causing asphyxia. Hemorrhage. In case of oral sex (fellatio) wherein the male penis is placed in the mouth of the female partner. B. In concealing the crime. A decrease in bleeding during arousal vii. Sysmetic effects: i. Tumescence. Death by female partner a. Duration of laceration(fresh bleeding. Increased respiration vi. Infection C.consequence of this peripheral flow concentrating on erectile tissue v. fresh healing. and the sympathetic innervations is from the 11th thoracic down to the 1st lumbar. Sexual act on a woman who is unconscious because she was knocked-out d. Rape committed on insane or mentally deficient woman -victim: woman. Rape Committed by Depriving the Victim of Her Reason or Otherwise Made Unconscious 1. b. Sexual act after administration of narcotics or other "knock out" drugs 3. sexual intercourse with a deafmute woman is not rape in the absence of proof that she is an imbecile -proof of mental condition of the victim by medical findings of the physician who needed b.Application of threat will cause fear in the victim of the untoward consequence. Information not signed by the offended party is insufficient to . When the woman is under 12 years of age -called statutory rape -regardless of whether or not force or intimidation is applied or the child is not deprived of her reasons or otherwise unconscious -even if child consented or even if child a prostitute -reason: one must not take advantage of the meager intelligence and incomplete physical development of a child below the age of 12 -multiple rapes committed by each accused was independent to others -victim and accused must immediately be examined by the physician to have a strong medical evidence of rape. it is not necessary that there are signs that she put up a determined resistance. Rape committed while the woman is under the influence of alcohol or other depressant drugs -in the absence of decided cases. Sexual act on a woman under the influence of sex stimulating drugs -If the offender is the father of the girl who is of a tender age. also rape 69 By 4D2014-2015 c. The victim may suffer all types of physical injuries depending upon the resistance offered by her and the degree of force applied by the offender. BUT local courts would consider this as rape because actually deprived her of reason -Employment of force is established not only by testimony of the injured girl but also by the signs of finger grips on the front part of her neck. The woman-victim is unconscious a. c. -if did not deprive her of reason. need not be irresistible as long as it brings the desired result. 2. as an element in rape. the crime may constitute intimidation. WON it will prosper depend upon the evidences offered. on the arms and the fact that the garments worn at the time were torn and heavily stained with blood.because woman is unconscious Rape Committed by Employment of Intimidation -if offender inflicted physical injuries on a woman sufficient to make her unconscious before the sexual act was done . cannot be proven by medical evidence. If she will not accede to the will of the offender. BUT lack of medical examination of victim NOT an indispensable element in the prosecution of rape.FROGLETS NOTES Summary of Legal Medicine Book by Solis -Force. Lung). not rape (US v. Deprival of Reason a. feeble-minded and can only speak mono-syllables -sexual intercourse with insane woman -BUT. -complaint for rape NOT valid unless it is a complaint by the offended party. -Intimidation purely subjective. Sexual act on a woman suffering from sleeping sickness . 14 years of age.Strong evidence of force is the presence of physical injures found on the person of the victim in the course of medical examination. Sexual act committed while the woman is on her natural sleep . blood stains c. date. hymen fresh lacerations etc. the victim becomes insane 2.does it correspond to the alleged date of commission? g. Filing of complaint by father of a girl who is only 14 years old. time and place of the examination 1. body louse 2. time and place of the alleged commission of rape -to determine how long has elapsed after alleged commission of crime before filed complaint or subjected herself to medical examination Summary of Legal Medicine Book by Solis e. Instances When Rape is Punishable by Death 1. Examination of the alleged offender and . When by reason or on the occasion of the rape. When by reason or on the occasion of the rape. pubic hair of offender -material to the determination of the possible findings of the physician on the victim 2. physical and mental development of the victim -height. -place: determine which court can acquire jurisdiction -in the pubic hair the ff may be gathered: b.FROGLETS NOTES confer jurisdiction on the court. if confined on correctional institution by the head of the institution -short history of the rape in writing -the following must be recorded by the physician: a. examination of including the breast genitalia. semen spermatozoa 3. physician must observe the gait. condition of the clothings d. When the rape is attempted or frustrated and a homicide is committed by reason or on the occasion thereof 3. examination of the body for signs of violence -signs of physical violence on the body if actual force was applied -whole body subjected for inspection -may use xray for bone lesions -determine of probable age of the physical injuries-. nipples bitten. sufficient compliance with RPC. strength and degree of muscular development of woman must be noted to determine whether she has capacity to resist unlawful resistance -describe mental state of victim f. -breast roughly handled or presence of finger marks. Evidences from the victim -written consent from victim or guardian if not of age. vulva swelling. a homicide is committed Medical Evidences in Rape 1. the facial expression and the bodily and mental attitude of the subject 70 the By 4D2014-2015 4. date. seminal and other stains may be recovered to prove consummation and struggle b. Investigation of witnesses who may possibly be material to the prosecution of the case may be conducted EXAMINATION FOR SEMINAL FLUID AND SPERMATOZOA c. mental condition and strength 1. Strands of hair. wearing apparel of the victim and alleged 3. urethral meatus moist d. albuminous fluid with faint grayishyellow color. evidence from pubi hair -matted together due to blood stains or seminal fluid discharge -presence of body louse e. and containing spermatozoa.Semen: the viscid. mental condition. examination of clothings d. normally present in the seminal fluid consisting of a head. vaginal epithelium and doderleins bacillus. to determine whether the companion might have participated as an accomplice e. stains found at the site of the commission of the offense PROCEDURE: 1. The head is ovoid and flattened when viewed in front and pearshape when viewed on the profile. won they are consistent with narration of facts of victim b. physical development. blood. lecithin bodies and other substances -Spermatozoon: living organism. vaginal smear from victim 3. if companion helped victim when force was applied by offender. history of the incident. Inspection by means of Ultraviolet light patches -to make visible small seminal stains or -shows bluish fluorescence . evidence of genital infection accused 2. From 5055 microns in length. presence of alcohol or other depressants Investigation of the Crime Scene: 71 By 4D2014-2015 1. epithelial cells. Disturbances in the place of commission may infer or affirm the statement of victim that she did offer resistance -won offender can overpower the resistance offered by the victim 2. companion must be subjected to physical and medical examination for physical injuries c. evidence of physical injuries -whole body must be examined -victim in the course of struggle may have inflicted injurie upon him 3. neck and tail. Gross Examinations a. -The ff specimens may be examimed for seminal fluid and spermatozoa: . age and emotional state to determine capacity to resist unlawful aggression from offender f. potency of the offender . Inspection by means of the naked eye or with the use of the hand lens color -stain is grayish-white to faint yellow in b. having the characteristic fishy odor. Pieces of personal belongings of offender and/or victim may be recovered to prove consummation and struggle 4. physical power. Evidences form the companion of the victim a.defense that he is impotent f. stains on the body of the victim and accused 4. seminal stain. condition of the sex organ -blood.FROGLETS NOTES Summary of Legal Medicine Book by Solis a. WOMAN CAN COMMIT CRIME OF RAPE ON A MAN. Gaguli's Method: best way to stain spermatozoa in India 4. subsequent infection such as gangrene or peritonitis. Death may be due to hemorrhage brought about by laceration of vaginal canal. . Microscopic Examinations -presence of complete spermatozoon will undoubtedly infer presence of seminal fluid. husband may be guilty of rape on wife. Can husband commit the crime of rape on his wife? NO. differing views (2 or 3 days at most. 43 hours. Florence Test: produced by the action of iodine on choline. Perform any of the following: a. 48 hrs after intercourse) Can a woman be raped while she is on her natural sleep? Occasionally it may happen. suitable substrate 3. reaction probably depends on the presence of spermatic secretion c. Berberio's Test: some allege this test is specific for spermatic fluid. Legal separation does not dissolve the matrimonial tie between husband and wife. if there is a decree of legal separation by the court. no. Seminal Grouping -test is of value for elimination -positive result does not definitely imply that the person is owner of sperm in question. However. negative result: totally exclude alleged accused as possible owner of semen How long after sexual intercourse can spermatozoa be found in the vaginal canal? Short period of time in vagina but in uterus. shock. introduction of matured male sex organ into vagina of young girl may produce injury sufficient to produce death. negative result: in all probability it is not that of the seminal fluid b. Allow the liquid portion to dry on the side. Dr. Micro-chemical Examinations -moisten portion of stained fabric with diluted hydrochloric acid solution and let soaking stay for 1/2 to 5 hrs depending on age of stain. such as in cases of aspermia (semen without spermatozoa) or oligospermia (semen with few spermatozoa) a. citrate buffer solution 2. diazonium salt 3.FROGLETS NOTES 2. Biological Examinations a. positive result: merely presumptive evidence of small fluid. under present laws. Puramen Reaction: based on the presence of spermine in the prostatic fluid. 17 days. Precipitin Test (Biological test of Farnum) -to determine whether semen is of human origin or not 72 By 4D2014-2015 Summary of Legal Medicine Book by Solis -test of unknown semen in the same way as blood precipitin is done b. Normal virgin: hard to conceive such could be committed. more than 2 weeks. although semen may be present without spermatozoa. Marriage is a license of the husband to have sexual intercourse with his wife. Purpose of marriage is procreation and there can be no procreation if there is no sexual intercourse. (See crim :p) Can rape cause death? Although not usual. BUT. The husband may also be guilty of rape on his wife if he is a principal by cooperation or by inducement for the act committed by another man. not a proof of seminal fluid but only of the presence of some vegetable or animal substance. Laceration of vagina with accompanying hemorrhage can also occur even in adult women if man's sex organ is exceptionally big and sexual act was done roughly. BUT possible to woman who had several sexual intercourse and to those who have given birth Can a woman commit the crime of rape on a man? "commited by having carnal knowledge of a woman" thus. Puramen reaction is found to be very reliable and rather characteristic of seminal fluid d. Hankin's Method b. Acid Phosphate Test: semen produces a very high phosphate activity as compared with other body fluids the ff are needed: 1. but highly improbable. but merely separation in bed. teacher or any person who. (People v. The sexual act must be committed by means of deceit. — The seduction of a woman who is single or a widow of good reputation. shall be entrusted with the education or custody of the woman seduced. woman seduced need not be a virgin or may be more than eighteen years of age and the penalty is higher basis: father and brother obliged to lead the descendant or sister to the path of rectitude and morality. 337. shall be punished by prision correcional in its minimum and medium periods. but to punish the seducer who by means of his promise of marriage. Art. whether or not she be a virgin or over eighteen years of age. committed by any person in public authority. and d. guardian. shall be punished by arresto mayor. there must be sexual intercourse between the offender and the offended party. the sexual act was done through abuse of authority or confidence (1) those who acted with abuse of authority (a) Person in public authority (b) Guardian (c) Teahcher . and 4.  The statute making simple seduction a crime is not to punish illicit intercourse.The seduction of a virgin over twelve years and under eighteen years of age. priests. QUALIFIED SEDUCTION -seduction where there is blood relationship between the seducer and the seduced. The offended party is over 12 but less than 18 years of age.FROGLETS NOTES OTHER CRIMES AGAINST CHASTITY Summary of Legal Medicine Book by Solis 2. Under the provisions of this Chapter. Brother who seduces his sister b. domestic. Ascendant who seduces his descendant A. house servant. Revised Penal Code . Elements: 1. in any capacity. The offended party must be single or a widow of good reputation. Types of Qualified Seduction 1. over twelve but under eighteen years of age. 3. Father seducing daughter or other descendants. offendede party must be over twelve years and under eighteen years of age c. Iman) . offended party must be a virgin b. Incestuous Qualified Seduction - A. 338. but same school (d) Person who.need not be teacher. Simple seduction. SIMPLE SEDUCTION: Art. There must be sexual intercourse done by the offender with her. is entrusted with the education or custody of the woman seduced 73 By 4D2014-2015 B. Ordinary Qualified Seduction a. and then fails or refuses to fulfill his promise. SEDUCTION a. or brother seducing sister. seduction is committed when the offender has carnal knowledge of any of the persons and under the circumstances described therein. in any capacity. committed by means of deceit. but instead virtually persuader her to become immoral or be a party to the condemnable act The penalty next higher in degree shall be imposed upon any person who shall seduce his sister or descendant. and who draws her aside from the path of virtue and rectitude. -In this type of seduction. destroyed the chastity of an unmarried female of previous chaste character. 2. Acts of lasciviousness with the consent of the offended party. Elements: . lewd. relationship or deceit. Forcible abduction. virgin. The lascivious act is done under any of the following circumstances: a. 3. The offender commits the act by abuse of authority. 2. Elements: C. — The abduction of any woman against her will and with lewd designs shall be punished by reclusion temporal. The offender commits any acts of lasciviousness. ACTS OF LASCIVIOUSNESS: Art. Acts of lasciviousness. The offended woman must be over 12 but under 18 years of age. single. except when the victim is the sister or descendant of the offender. A. ABDUCTION 1. 4. or widow of good reputation. if the female abducted be under twelve years of age. voluptuous or lewd emotion.   When the issue of age of the victim becomes a problem and its determination may be proved through medical proofs When the alleged criminal act developed into pregnancy and birth of the child.  Medical proofs on account of the application of force. ACTS OF LASCIVIOUSNESS  Like in the crimes of rape and seduction. 342. conduct which is wanton. A. B. confidence. Medical Evidences in the Crime of Acts of Lasciviousness B. except when she is the sister or descendant of the offender where virginity is not required. The same penalty shall be imposed in every case. the question of paternity may be necessary. The offender commits acts of lasciviousness. b. medico-legal investigation is involved in proving the lascivious act itself and the other elements to constitute the crime. Acts of Lasciviousness are acts which tend to excite lust. — The penalty of arresto mayor shall be imposed to punish any other acts of lasciviousness committed by the same persons and the same circumstances as those provided in Articles 337 and 338. 3. ACTS OF LASCIVIOUSNESS WITH THE CONSENT OF THE OFFENED PARTY: 74 By 4D2014-2015 Lewd design is the intent of the abductor to have sexual intercourse with the woman abducted. under any of the circumstances mentioned in the preceding article. The offended party must be a person of either sex. c. FORCIBLE ABDUCTION: Art. 2. Abduction is the carrying away of a woman by an abductor with lewd design.  Physical injuries may be suffered by the victim on the part of the body where the lascivious act was committed. — Any person who shall commit any act of lasciviousness upon other persons of either sex. Elements: 1. When the woman is under 12 years of age. and conditions that will cause the victim to be deprived of her reason or otherwise unconscious are no longer relevant. Summary of Legal Medicine Book by Solis Art. 339. 336. By using force or intimidation.FROGLETS NOTES Medical Evidences in the Crime of Seduction  Medico-legal investigation of a victim of seduction is practically the same as in the case of rape. The victim must be a woman. By depriving her of her reasons or otherwise unconscious. shall be punished by prision correccional. 2. She has had sexual intercourse with a man not her husband. The man with whom she had sexual intercourse knows her to be married even if the marriage has subsequently been declared void. the penalty next lower in degree than that provided in the next preceding paragraph shall be imposed. — The abduction of a virgin over twelve years and under eighteen years of age. shall be punished by prision correccional in its minimum and medium periods. habitually indulge in sexual intercourse or lascivious conduct. 2. shall be punished by the penalty of prision correccional in its minimum and medium periods. Adultery shall be punished by prision correccional in its medium and maximum periods. Reasons why some women become prostitutes:     Physiological and psychological traits. D. CONCUBINAGE: 2. The victim abducted is a woman.FROGLETS NOTES Summary of Legal Medicine Book by Solis 1. CONSENTED ABDUCTION: Art. The offended party must be over 12 but under 18 years old. 343. and 4. Art. 75 By 4D2014-2015 scandalous 3. or shall cohabit with her in any other place. Having sexual intercourse. Keeping a mistress in the conjugal dwelling. — Adultery is 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. or 1. ADULTERY: Art. The abduction is against her will. and 3. under scandalous circumstances. The offended party must be a virgin. Door knocker. for money or profit. Concubinage. Influence of contraceptives Medico-legal Aspects of Prostitution   Prostitution is one of the venues in spreading venereal and other diseases Evidences may be gathered to prove sexual or lascivious acts Types of Prostitutes: 1. The woman is married. 334. PROSTITUTION 3. under circumstances. Consented abduction. carried out with her consent and with lewd designs. Prostitutes are women who. If the person guilty of adultery committed this offense while being abandoned without justification by the offended spouse. B. Ways of Committing the Crime: 1. Home and neighborhood. with a woman who is not his wife. Call girl. or shall have sexual intercourse. Factory Girl Effects of Prostitution . Who are guilty of adultery. Cohabiting with her in any other place. b) Street walker 2. 3. 4. 3. B. Hustler: Elements: a) Bar or tavern ―pick-up: 1. 333. The abduction is with lewd design. with a woman not his wife. Economic factors. ADULTERY AND CONCUBINAGE A. even if the marriage be subsequently declared void. The carrying away of the offended party is with her consent. — Any husband who shall keep a mistress in the conjugal dwelling. Elements: 2. The taking away must be with lewd design. Excessive use of alcohol. Penalties. Strict prohibition 1. obscene publications and . Most of those persons suffering from the conditions do not exhibit criminal intent but manifesting aberrations which may be a subject-matter for the psychiatrist to treat. Venereal infection. UNNATURAL SEXUAL OFFENSES AND SEXUAL ABNORMALITIES Unnatural Sexual Offenses are not only a deviation to the normal course of nature but also commonly observed manifestations of sexual perversion. Poor personal hygiene. By soliciting or making immoral or indecent advances to the wife.FROGLETS NOTES        Arrest and imprisonment. — The penalties of arresto mayor and public censure shall be imposed upon any person who shall offend against decency or good customs by any highly scandalous conduct not expressly falling within any other article of this Code. Demoralization and physical deterioration Summary of Legal Medicine Book by Solis a superior officer. Methods of Control: If the person solicited be the wife. Any warden or other public officer directly charged with the care and custody of prisoners or persons under arrest who shall solicit or make immoral or indecent advances to a woman under his custody. By soliciting or making immoral or indecent advances to a woman interested in matters pending before the offending officer for decision or with respect to which he is required to submit a report to. he shall also suffer the penalty of temporary absolute disqualification. Social ostracism. Upon any public officer who shall solicit or make immoral or indecent advances to a woman interested in matters pending before such officer for decision. Legalized but regulated. (As amended by Batas Pambansa Blg. 340. Immoral doctrines. By soliciting or making immoral or indecent advances to a woman under the offender’s custody. obscene publications and exhibitions: Art. 201. White slave trade. Grave scandal. in any manner. Corruption of Minors: Art. Grave Scandal: Art. Irregular habit of eating and sleeping.) C. Provisions of the Penal Code which may be Applicable to Unnatural Sexual Offenses: 1. daughter or relatives with the same degree by affinity of any person in custody of the offending warden or officer. the penalties shall be prision correccional in its minimum and medium periods and temporary special disqualification. 3. daughter. Immoral doctrines. 1. Corruption of minors. shall be punished by prision mayor. or with respect to which he is required to submit a report to or consult with 76 By 4D2014-2015 2. 2. 2. 341. — The penalty of prision mayor in its medium and maximum period shall be imposed upon any person who. or under any pretext. 245. Abuses against chastity. 186. shall engage in the business or shall profit by prostitution or shall enlist the services of any other for the purpose of prostitution (As amended by Batas Pambansa Blg. including those in government-owned or controlled corporations. and if the culprit is a pubic officer or employee. or consult with a superior officer.Genital examination required is the same as in any other sexual offense OTHER PERSONS INVOLVED IN THE BUSINESS OF PROSTITUTION ARE PUNISHED BY THE FOLLOWING PROVISIONS OF THE RPC: A. — The penalties of prision correccional in its medium and maximum periods and temporary special disqualification shall be imposed: 1. or Ways of Committing Abuse of Chastity: 2. B. Medical Evidence in Prostitution. 92). 200. White Slave Trade: Art. sister of relative within the same degree by affinity of any person in the custody of such warden or officer. Abuse Against Chastity: Art. — Any person who shall promote or facilitate the prostitution or corruption of persons underage to satisfy the lust of another. morals. or both such imprisonment and fine. Heterosexual. (2) serve no other purpose but to satisfy the market for violence. give away or exhibit films. and good customs. Homosexual. (3) offend any race or religion. acts or shows. 
 (b) Those who. 202. anal. (As amended by PD Nos. vaginal. 
 77 By 4D2014-2015 compulsive desire to have sexual intercourse with a child of either sex. 3. 3. shall be found loitering in any inhabited or uninhabited place belonging to another without any lawful or justifiable purpose. 287. Heterosexual pedophile. fairs. whether live or in film. prints. Infantosexual.sexual desire towards opposite sex. which are prescribed by virtue hereof. (4) tend to abet traffic in and use of prohibited drugs. or both. a. Light coercions. 2. Any person having no apparent means of subsistence.sexual desire towards an immature person. Any idle or dissolute person who ledges in houses of ill fame. not being included in the provisions of other articles of this Code. the editors publishing such literature. ruffians or pimps and those who habitually associate with prostitutes. 
 5. public order.may attempt intercourse with his b. lust or pornography. 
 Summary of Legal Medicine Book by Solis 4. (3) Those who shall sell. penalty. shall include those which (1) glorify criminals or condone crimes. sculpture or literature which are offensive to morals. 4. (2) (a) the authors of obscene literature. Vagrants and Prostitutes: b) Latent. engravings. 1.may attempt either oral. exhibit. SEXUAL ABNORMALITIES As to the Choice of Sexual Partner: 1. Vagrants and prostitutes.sexual desire towards same sex. shall be imposed upon: (1) Those who shall publicly expound or proclaim doctrines openly contrary to public morals. — The following are vagrants: 3. Art. a) Overt. Any person found loitering about public or semi-public buildings or places or trampling or wandering about the country or the streets without visible means of support. — The penalty of prision mayor or a fine ranging from six thousand to twelve thousand pesos. and (5) are contrary to law.a form of sexual perversion wherein a person has the 2. Any person who. published with their knowledge in any form. scenes. and the owners/operators of the establishment selling the same. indecent or immoral plays. Homosexual pedophile. . — xxx xxx xxx xxx xxx xxx xxx xxx Any other coercions or unjust vexations shall be punished by arresto menor or a fine ranging from 5 pesos to 200 pesos.FROGLETS NOTES exhibitions and indecent shows. Prostitutes. lawful orders.persons who may or may not be aware of the tendency in that direction but are inclined to repress the urge to give way to their homosexual yearning. established policies. decrees and edicts. Unjust vexation or any other coercion: Art. a) Pedophilia.persons who re conscious o their homosexual cravings. and who make no attempts to disguise their intention. who has the physical ability to work and who neglects to apply himself or herself to some lawful calling. cinematographs or any other place. 960 and 969). A Pedophile may be: either oral or anal victim. in theaters. Necrophilia. dementia.sexual controls may become disinhibited due to senility. which may also be considered as ―masturbation equivalent‖. c. child pornography and the misattribution of arousal as being only from children.absence of sexual desire or arousal during sexual act in women. as well as repressive social sexual norms. a. 5. c.painful sexual act in women. Fellatio (Irrumation). Theories Why Adults become Interested in Children: a. c.painful spasm of the vagina during sexual act.sexual desire with elder person. Cunnilingus. compulsively to repeat child-adult sex contact to master.FROGLETS NOTES intracrural intercourse as well as cunnilingus. 7. situational stress. unavailability of or conflict with a committed partner. elderly. Dyspareunia.weakening of sexual feeling in the As to Mode of Sexual Expression or Way of Sexual Satisfaction: 1. and his or her own early experience of child-adult sexual abuse.a form of sexual perversion wherein a person derives excitement by licking the anus of another person of either sex. b. d. 8.the person deliberately resorts to some mechanical means of producing sexual excitement with or without orgasm. Old age. As to Instinctual Strength of Sexual Urge: 1.The female agent receives the penis of a man into her mouth and by friction with the lips and tongue coupled with the act of sucking initiates orgasm. Sado-masochism (Algolagnia). and is conditioned by hormonal abnormalities. b. unresolved oedipal conflicts.sexual desire towards animals. Emotional congruence. Disinhibition. d. impulse disorders. psychosis. but attempts at vaginal penetration are most common.behavioral modeling begins with the early childhood experience.the release of sexual tension may come about via the mechanism of nocturnal stimulation with or without emission. 78 By 4D2014-2015 Sexual Abnormalities .excessive desire of men to intercourse. anxiety about sex. socialization to male dominance or narcissism. Adults have low self-esteem. Bestosexual.the use of the mouth as a way of sexual gratification. Under Sex (Sexual frigidity): b. drug or alcohol. Vaginisimus. Nymphomania. mental retardation. Anilism (anilingus). Over Sex: a. Autosexual (Self-gratification or maturbation).a sexual perversion characterized by erotic desire or actual sexual intercourse with a corpse. by reason of blood relationship cannot legally marry. Blockage.sexual relations between persons who. Sexual anesthesia.pain or cruel act as a factor for gratification. failure of incest avoidance. Summary of Legal Medicine Book by Solis 6. Oralism. b.Children are sexually attractive to adult:    Children are non-dominant.sexual gratification is attained by licking or sucking the external female genitalia a. Gerontophilia. Conscious Type. immaturity. Incest. Unconscious Type. b. 4. 2. positive or negative. Satyriasis. Types of Masturbation: a.strong sexual desire of women 2.alternative sexual gratification may become blocked due to poor social skills with adults of the opposite sex.it is a form of ―self-abuse‖ or ―solitary vice‖ carried without the cooperation of another person. Conditioning Modeling. a general cultural acceptance. and Unconscious impulse. Dyspaureunia – painful sexual act in women c. Vaginismus – painful spasm of the vagina during intercourse d. Flaegellation – act of whipping or being whipped b. Necrophilic – near a dead body. 4. coupled with the act of sucking. etc. a schizo. suffering from organic brain disease. buttocks) b. Clothing – shoes. Sado-masochism (Algolagnia) – pain or cruel act a. epileptic or a psychopath Masochism (Passive algolagnia) – pain or humiliation from opposite sex is the primary factor for sexual gratification Fetishism – real or fantasied presence of an object or bodily part is necessary for sexual stimulation and/or gratification a. Fellation (Irrumation) – female receives the penis into her mouth. Urolagnia – sight of women urinating. Saboteur fetish – deviate does damage while he gets satisfaction (ex. Frottage – compulsive desire of a person to rub his sex organ against some body parts of another (ex. Satyriasis – excessive sexual desire of men to intercourse b. Sexual anesthesia – absence of sexual arousal during intercourse in women b. intercourse is merely secondary to satisfy the sexual desire. etc. breasts. but accomplishment is difficult. incest. 2. Anatomic – particular portions of the body (ex. deviate has a strong homicidal urge. cutting clothes or hair) j. there is desire. sometimes. accompanied by odd behaviour like exhibitionism. form of sexual perversion 2. but with presumed unconscious wish to consume ii. differs . initiates orgasm b. usually. homosexuality As to Mode of Sexual Expression or Way of Sexual Satisfaction: 1.FROGLETS NOTES Summary of Legal Medicine Book by Solis As to Instinctual Strength of Sexual Urge: 1. Sadism (Active algolagnia) – infliction of pain on another is necessary or sometimes the sole factor in sexual enjoyment i. 3. c. Cunnilungus – licking and sucking the external female genitalia c. Anilism (Anilingus) – licking the anus of another. 2. handkerchiefs. Oralism – use of mouth a. c. Mysophilia – filth or excretion e.  Over Sex: a. Nymphomania – strong sexual feeling of women. Pygmalionism – statues f. undergarments. 3. Cannibalism – biting without flesheating. Odor (Ospresiophilia) – pleasant or foul odor i. looking at the mirror and appreciating oneself h. rubbing or pressing organs against women’s buttocks in crowded places and pretends it is ―accidental‖) Partialism – special affinity to certain part of the female body. other body parts caused by forcible sucking of the mouth (teeth guarded by the lips) applied to the loose tissue 79 By 4D2014-2015 Necrosadism (Lust murder) – victim dies. Negative fetish – marked dislike for things i. Under-sex or Sexual Frigidity: a. Love bites – superficial punctuate contusions seen usually at the side of the neck. licking parts of the body. Sodomy – sexual act through anus Uranism – fingering. Vampirism – sight of blood As to the Part of the Body: 1. may or may not violate dead person d. breast. by friction with the lips and tongue. fondling with breast. Coprolognia – sight of women defecating iii. Old age – weakening of sexual feeling in the elderly. ―hot‖ or ―fighter‖  Both are general expressions of compulsive neurosis. Narcissism – extreme admiration and love of one’s self. Incendiarism – from setting fire k. even a desire to drink the urine ii. Manikinism – manikins g. sometimes. sexual behaviour a. coitus. sex character may be neutral or whichever is dominant d. 13375): Dancer in a burlesque show in a night club was apprehended and charged for immoral exhibition because her act of dancing only wearing nylon panties and patches on her breasts corrupted those minds which were susceptible to immoral influence. ―eternal triangle‖ Pluralism – group of persons participate in sexual orgies. 2. Coprolalia – need to use obscene language to obtain gratification. Female pseudohermaphrodite – gonads are ovaries but the character is masculine CHAPTER XXII PREGNANCY Introduction Definition: state of a woman who has. As to Visual Stimulus: 1. determined very early in fetal life b. 3. Turner’s syndrome – structurally and phenotypically female but the ovaries are small. masturbates in excess afterwards. Gonadal dysgenesis – external sexual structures are present but at puberty fail to develop i. Pseudohermaphrodite – anatomically of one sex but the sex character is that of the opposite sex i.FROGLETS NOTES from frottage in that there may not only be rubbing but actual intercourse 1. Gonadal agenesis – testes or ovaries have never developed. True hermaphroditism – bisexuality. 2. 3. reproductive organs. cannot find anyone to be a permanent companion Indecent exposure (Exhibitionism) – wilful exposure in a public place of one’s genital organ in the presence of others. within her body. Psychical hermaphroditism. ―Peeping Tom‖ Mixoscopia (Scoptophilia) – watching a couple undress or during their sex intimacies 2.R. with or without masturbatory act. Klenefetter’s syndrome – male type where the anatomical structure is male. XXY chromosomes ii. women may expose themselves as in ―bubble and fan‖ dances and the ―strip tease‖ acts in night clubs  People v. kissing the buttock. but the nuclear sexing is female (Chromatin positive). two or more couples perform intercourse in one room and may agree to exchange for ―variety’s sake‖ during the ―sexual festival‖ Other Sexual Deviates: 1. nuclear sex is usually female. Male pseudohermaphrodite – gonads are testicles but the character is effeminate ii. go beyond uttering by making some writings and sketches on the walls of toilets Don Juanism – applied by psychiatrists to describe characteristics of promiscuity and making seduction of many women as part of his career. sterility with the absence of the second X chromosomes c. having both ovaries and testicles. take sex hormones or subject themselves to surgery Intersexuality – genetic defect wherein an individual shows intermingling of the characteristics of both sexes including physical form. 2. ―suixante-neuf‖ or 69. hate their genitalia that sometimes they attempt to castrate or mutilate themselves. usually of the opposite sex. generally harmless insofar as they have no desire to assault anyone. Aparici (G. Metamorphosis sexualis paranoia) – male derives pleasure from wearing female apparel and vice versa. Sexual Reversal: 80 By 4D2014-2015 Summary of Legal Medicine Book by Solis Transvestism (Sexo-esthetic inversion. but merely to attract attention Transexualism – identify themselves with the opposite sex as completely as possible and to discard forever their anatomical sex. Troilism (Menage a trois) – three persons are participating in sexual orgies where the usual activity may be fellatio. Voyeurism – compulsion to peep to see persons undress or perform other personal activities and usually. As to Number: (sexual deviation because more than two persons are participating) 1. the growing product of conception or a fecundated germ . 4. fundus of the uterus is anteflex d. Jacquemin-Chadwick’s Sign – pale violet discoloration of the anterior wall of the vagina b. (Arts. Pregnancy is a ground for the suspension of the execution of the death sentence in a woman. 83. MacDonald’s Sign – softening of the isthmus. 85-87. 742. NCC) Concealment of the woman that she is pregnant at the time of the marriage is a ground for annulment of the marriage. No ground to become pregnant – unmarried. no synchrony between coitus and fertilization  Abnormally Prolonged Gestation – extends to 300 days Minimum Period of Gestation Compatible with Viability of Child – a child born at 180 days of gestation may live. 2. nursing mother may not menstruate 2. Presumptive or Probable Signs and Symptoms 1. Changes in the breast 4. (Arts. Changes in color of the vagina and softening of the cervix  Different Signs to Show Changing of Color: a. Count forty weeks or ten lunar months from the date of the first day of the last menstruation. Ground for suspension of death sentence in a woman Lawful plea in mitigation when charged with theft – kleptomania may be brought about by her temporary insanity due to conception Ground for widow’s larger claim Claim for the posthumous child For black-mailing purposes or inducing a man to marry her Instances Why Some Women Deny the Existence of Pregnancy: 1. 2. living separately from husbands. Hegar’s Sign – bi-manual examination of the gravid uterus shows extreme softening of the cervix c. Goodell’s Sign – cervix of the uterus feels as hard as the tip of the nose. 40-41. 3. inasmuch as some authorities consider more than two weeks as the life span of the spermatozoa in the vaginal canal. add seven days and count three months backward. 5. NCC) 81 By 4D2014-2015 Summary of Legal Medicine Book by Solis Instances Why Some Women Claim Pregnancy Even if None Exists: 1. 2. but when as soft as the lips. RPC) A conceived child is capable of receiving donation. MacDonald Method – distance from the symphysis pubis up to the fundus of the uterus in centimters divided by 3. child born before this period may be born alive but is not viable or capable of living Methods of Estimating the Date of Expected Delivery: 1. Date of the quickening – count ahead in 24 weeks multigravidas and 22 weeks in primagravidas from date of quickening. (Art. no pregnancy. the fundus of the uterus is at the level of the brim of the pubic bone 5. 2.5 gives the age in month gestation 6.FROGLETS NOTES Commencement: from time egg cell is fertilized and terminates at the time such product is expelled or delivered Duration: 270-280 days from first day or onset of last menstruation. From the date of the first day of the last menstruation. 4. Progressive enlargement of the abdomen – at the end of the third month. NCC) A conceived child may exercise civil rights. Cessation of menstruation – it must be noted that a woman is capable of menstruating even during pregnancy during the first three months. 3. uterus is gravid . to defend moral and social reputation Defense when accused of infanticide or abortion Marriage inducement Medical Evidences of Pregnancy: A. (Art. Count forward nine calendar months from the date of the first day of the last menstruation and add one week. Determination of the level of the fundus of the uterus 5. divorced. 3. Morning sickness 3. it is hard to ascertain the exact date of the fertilization. 4. found not to be reliable   Legal Importance: 1. 3. hand placed on abdomen 8. Perineum is lax with a scar if there was previous laceration. Fourchette is markedly restracted. if result is doubtful. Place 1 drop of urine then 1 drop of PST antiserum 1 in one of the circles on the test slide and mix thoroughly. 5. c. Gravindex is merely a trade name Signs of Pregnancy in the Dead: (additional findings to the objective signs already mentioned) 1. Vaginal examination showed previous laceration of cervix. Regeants: a. Superfoetation is the fertilization of two ova which have escaped at different acts of ovulation. 82 By 4D2014-2015 d. The patient may imagine fetal movement which is in reality a muscle contraction. b. Bladder irritability or Frequent urination – usually at second month 10. 3. - - Superfecundation is the fertilization made by separate intercourses of two ova which have escaped at the same act of ovulation. Movement of the fetus (Quickening) – at the fifth month 4. X-ray Examination Laboratory Test for Pregnancy: A. 4. Pregnancy Slide Test antigen – HCG latex suspension. 5. perceptible to the hand on the abdomen 9. 3. Presence of ovum or fetus Findings on the uterus itself Corpus Luteum – usually well-developed at the time of delivery Proofs of Pregnancy: 1. Capricious appetite 11. Breast is lax with enlarged nipples. Presence of Striae of pregnancy on the abdominal wall. Read the results after two minutes. Braxton-Hick’s Sign – rhythmical contraction and relaxation of the uterus. Principle – an agglutination-inhibition reaction is used to demonstrate the hormone human chorionic gonadotropin (HCG) which is excreted into the urine during pregnancy 2. Ballottement – feeling perceptible to the fingers on giving sudden impulse to the child through the neck of the uterus. Vestige only of the hymen is present. Pregnancy Slide Test (PST) 1. Diagnosis of Fetal Death (Proof of Fetal Death): . Gravindex HCG Slide Test – same principle and procedure involved as PST. B. 4. Pregnancy Slide Test antiserum – human HCG antiserum from rabbit b. 6. rate is 120-140 beats per minute 2. Carefully agitate the slide with a circular motion to ensure that the fluid revolves slowly within the circle. Positive Signs and Symptoms of Pregnancy: 1. chemically-bound 3. Laxity of abdominal wall. 2. Agglutination (granular) – not pregnant Sensitivity – often possible within 5 days after missed menstrual period. 2. Easy Fatigability – due to weight of the gravid uterus and insufficiency of nutrient and oxygen supply to the tissues due to a deviation of a portion to the growing fetus Summary of Legal Medicine Book by Solis 6. Outlining of the fetal parts – through palpation 3. Procedure: a. No agglutination (homogeneous) – pregnant b. Abnormality in pigmentation – especially in abdomen and perineum 12. Shake well and mix well. Add 1 drop of PST antigen 2. Hearing of the fetal heart sounds (Mayor’s Sign) – compared to ticking of a watch under a pillow. Spurious Pregnancy is an imaginary pregnancy usually observed among women nearing menopause or younger women who are very desirous of having children.FROGLETS NOTES Funic soufflé or Umbilical soufflé – whistling sound synchronous with the fetal heart 7. 6. Interpretation of results: a. pregnancy will be diagnosed 12 days after the missed menstrual period Remarks – fresh morning urine is preferable and suitable. repeat test after a few days B. Positive pregnancy slide test. concealment of birth. 3. Flaccidity of the abdominal wall. Causes of Abortion: 1. patulous and may be torn. That the woman is pregnant. Linea Albicantes (Striae of Pregnancy) present in the abdominal wall. 11. Principal Elements of Abortion: 1. 5. Presence of Linea Negra. she has the potential of becoming pregnant. Absence of fetal heart sounds after repeated and prolonged examination. - The size remains stationary even after the lapse of a number of weeks or months. As long as the woman starts menstruating. Aborifacent drugs 5. Abnormality of the uterus 3. Vaginal canal is lax and with possible lacerations. 3. infanticide. CHAPTER XXIV ABORTION - Abortion is the expulsion of the contents of a gravid uterus anytime before full term while others consider it as the forcible expulsion of the product of conception anytime before the age of viability. drug administered or the fetus was expelled before the term of its viability. Breasts cease to be enlarged and become soft and flabby. The study of delivery is important because proof of delivery is necessary in judicial action on: legitimacy. 8. umbilical cord and newborn child. with pulse and temperature slightly increased. That the fetus dies either as an effect of the violence used. Trauma whether direct or indirect 6. Natural Route – expulsion of the products of conception through the normal passage. 4. Missed Abortion – an ovum destroyed by hemorrhage into the choriospace usually before the 4th month of the pregnancy. 12. Surgical Route – expulsion of the products of conception is not through normal openings of the female generative tract but through some artificial openings brought about by surgery. Endocrine test for pregnancy is negative on more than one occasion. 9. that is through the vaginal canal. 5. Incomplete Abortion – not all products of conception had been expelled from the uterus. Hormonal deficiency 7. That the expulsion of the product of conception is induced. Palpation of softened macerated fetal head with bones freely movable on each other and the scalp hanging over a loose sac. 13. 4. 83 By 4D2014-2015 Summary of Legal Medicine Book by Solis 10. Presence of lachial disahcrage. CHAPTER XXIII DELIVERY - Delivery is the process by which a woman gives birth to her offspring. 2.FROGLETS NOTES 1. Viability is at the point at which the fetus is potentially able to live outside of the mother’s womb. 5. In the Philippines. Uterus is enlarged and palpable. albeit with respiratory aid. 2. Inevitable Abortion – hemorrhage with dilatation if the internal os and the presence of rhythmical pain. 6. Laxity of the perineum with possible tear. 6. Threatened Abortion – hemorrhage without dilatation of the internal os. . Complete Abortion – the whole product of conception is expelled. Intentional Abortion (Elements) a. Signs of Recent Delivery: 1. 4. Death of the fetus 2. Peculiar odor which is present up to the 10th day of confinement. Clinical Types of Abortion: 1. Acute specific fever and high temperature Provisions of the RPC on Abortion: 1. 7. abortion. 2. 3. fragments or portions of which is retained. 2. and in slander or libel. Changes in the breast (sensation of tightness in breasts and milk may be expressed). Languid look. 2. Cervix is the uterus is flabby. Emotional condition 4. Methods of Delivery: 1. menstruation begins at the age of 12-14 years old and ceases at the age of 45. Cessation of fetal movement after they have been felt. Evidence of placenta. Abortion is intended to be committed. c. Reasons why some people procure Abortion: 1. b. 3. b. presence of foreign bodies and atony of the uterus may cause hemorrhage for failure of the uterine muscles to contract. Kinds of Abortion: 1. or acts of the offender.FROGLETS NOTES b. or either of them for the purpose of concealing her dishonor and with the consent of the woman herself. rectum. The woman is pregnant. The woman must be pregnant. 4. By Local Violence – violence is applied in any portion of the generative organ. Hemorrhage and Anemia – Adherent placental tissue. Spontaneous Abortion – occurs without any form of inducement or intervention. 2. Induced abortion may be: a. By General Violence – includes intentional violence. By the Use of Drugs 4. c. or a person acts upon such pregnant woman. b. Induced Abortion – this will not take place had it not been for some form of inducement or intervention. signs of toxemia may be observed at autopsy. The woman is pregnant. (2) Other persons with the consent of the pregnant woman herself. d. . Preserve the life and health of the pregnant woman. To preserve body form. exerting strong physical efforts and other forms of strenuous and exhaustive exercises. Abortion practiced by a physician or midwife and dispensing abortive (Elements) a. Therapeutic Abortion – abortion purposely done to preserve the life of the mother. Unintentional Abortion (Elements) a. Abortion is induced by: (1) The pregnant woman herself. 2. By Surgical Intervention 5. intestine or blood vessels. 2. Modern Methods like Amniocentesis and Vacuum Suction Complications of Abortion 1. (3) The parents of the woman. The woman aborted as a result of the violence. the fetus dies or is expelled. 3. c. midwife or the parents. Shock – may be due to the laceration of the uterus or the adjacent organ like the bladder. Local violence may be applied by the pregnant woman herself. b. by the physician. drug. Criminal Abortion – done without therapeutic indication but with criminal intent is punishable by law. - Post-mortem Abortion is the expulsion of the product of conception after death of the pregnant 84 By 4D2014-2015 Summary of Legal Medicine Book by Solis woman brought about by the post-mortem contraction of the uterine muscles. This is usually resorted to when general violence and the use of drugs fails to give the desired result. 4. Terminate prematurely illegitimate pregnancy in order to conceal the dishonor of the woman. That the effect of such violence. The acts done by the physician or midwife was intended to cause abortion. Violence was applied on such pregnant woman without the intention of aborting her. 2. 3. The injury may be due to the introduction of instruments or the application of hot fluid or corrosive substances. Immediate Untoward Effects: a. How Abortion is Induced or Procured: 1. Abortion practiced by the woman herself or by her parents (Elements) a. Infection – Pathogenic organism may be introduced into the uterus and produce systemic symptoms. That violence was applied. infection. That the offender has the intention to abort the pregnant woman. c. b. Financial difficulty. c. The physician induced or assisted in causing the abortion with the use of scientific knowledge. If death occurs. Embolism: (1) Air Embolism (2) Fat Embolism (3)Thrombo-Embolism (4) Bacterial Embolism d. or drug was administered. Presence of external signs of violence in the form of contusions. d. iodine solution are frequently used for vaginal douche and may cause systemic poisoning. Signs of previous pregnancy: f. History – Note the state of health beforehand after abortion. g. . Poisoning – Lysol. infection of the ovaries may cause sterility.FROGLETS NOTES e. Perforation of the bladder or any of the neighboring organs b. its consistency and location. contusion. d. Summary of Legal Medicine Book by Solis By 4D2014-2015 Appearance of the external genitalia and vagina may show laceration. Infection – The infection may originate from the vaginal canal or from the blood stream coming from a focus of infection in the body. Sterility – Plugging of the fallopian tubes. abrasions and other marks of instrumentation. 1. abrasions. If violence is applied locally in the generative tract. Vaginal Inhibition – Sudden dilatation of the cervix due to the introduction of some objects may cause sudden collapse due to reflex inhibition of the vagus nerve. b. Medical Evidences of Abortion Medical Evidences of Abortion in the Living a. Inquire as to the motive of the abortion and history of having ingested with abortives. Examination of the instrument used for the presence of blood. Pelvic Adhesion – Infection and trauma may cause the uterus or vagina to become adherent to the surrounding organs or tissues. injuries of whatever form or description may be seen therein 3) Note the size of the uterus. hematoma. e. tear and discharge. 1) Condition of the breasts 2) Laxity of the abdominal wall 3) Paleness of integument 4) General body weakness 5) Presence of characteristic lochial discharge and odor 6) Palpability of the uterus and laceration of the cervix and perineum Examination of the expelled product of conception 1) Blood examination for maternity and paternity 2) Marks of instrumentation 3) Signs of physical violence 4) Proof of viability or nonviability of the fetus 5) Presence of abortives and other toxic materials in the fetal blood 6) Presence or absence of malformation 7) Completeness of the placenta 8) Other identifying marks Examination of the generative tract: 1) 85 Examine the external os for softness. open wounds of whatever form on the body surface if induced by general violence. 2) c. corrosive sublimate. f. Delayed Untoward Effects a. 2. c. placental tissue or fetal parts. Fistula Formation – Communication between the vagina or the uterus with the rectum or bladder may be an after effect of perforation due to instrumentation. the life of the mother and the life of the fetus. Evidence of instrumentation  b. 4. Examination of uterine contents . 11. No. does an act which causes damage to another. Testimony of the physician who completed the abortion or of other persons who witnessed the criminal act Summary of Legal Medicine Book by Solis following: (1) infection (2) stage of pregnancy (3) other complication of abortion. toxemia or bacteremia (2) embolism (3) fistulae formation (4) pelvic adhesions. presence of remnants of the placenta inside the uterine cavity. in order to avoid an evil or injury. other organs like the kidneys. namely. f. Examination of the kidneys and other organs for irritants  d. Biological test Any person who. e. This will include the presence of punctured wounds in the placenta. spleen must be subjected to a qualitative and quantitative examination for the presence of irritant poisons. two lives are involved.  In the performance of an abortion. the following may be observed at autopsy: a. Examination of stomach and its contents:  c. liver. Therapeutic Abortion  An abortion which the law allows under some justifications Legal Justification to Therapeutic Abortion  Art. provided that the following requisites are present: (1) that the evil sought to be avoided actually exists. Such evil may be infection. organic condition or abnormality existing on the person of the woman and which under ordinary course of event will cause death. g. .  The evil sought to be avoided is the danger on the life of the mother if such pregnancy will be allowed to continue.FROGLETS NOTES 2. (2) that the injury feared be greater than that done to avoid it. presence of perforation of the uterus. Revised Penal Code o Abortifacent drugs and other irritants may be found inside the stomach upon chemical examination.Remnant of the product of conception for the By 4D2014-2015 1) Paternity test 2) Test for pregnanc Examination of some untoward effects of abortion: (1) infection. One life must be sacrificed to save the life of another in case of therapeutic abortion. (3) that there be no other practical and less harmful means of preventing it. Medical evidence of abortion in the dead:  Aside from the evidences of abortion in the living which may be found in the dead. Laboratory test for pregnancy h. 86 Like the stomach and its contents. Miscellaneous conditions as diabetes. 380 Wis. 32. Blood condition as severe anemia. threatened to commit suicide. 4. 2. 2. Gynecological conditions as refractory chorea gravidarum. He may claim that there is medical justification to such abortion because the woman is suffering from a disease which might imperil her life if pregnancy will be allowed to progress to full term. 7. The lawful abortion must be performed by a licensed physician or surgeon. 2. The opinion of one might be influenced by prejudice and misjudgment. But modern advancement of medical science has reduced the number of diseases which will endanger the life and health if pregnancy is allowed to progress to full term. The physician has several medical reasons to justify his act. 4. inasmuch as abortion will affect marital relationship. exophthalmic goiter. Hereditary conditions as insanity. The pregnant woman herself is in connivance with the physician and it is quite difficult to let her testify truthfully as to the actual happening. She. 6. the patient died of gangrene of the uterus. The physician whom she repeatedly made her threat during her unexpected visits referred her to a psychiatrist who recommended abortion. There is no hard and fast rule in medicine. 5. Abortion must be performed openly in a hospital to avoid suspicion that it was done for some cause other than to save the life of the mother. Cardio-vascular conditions as congestive heart failure. The operation was carried on by a reputed gynecologist but unfortunately. State (48 N. auricular fibrillations. the products of conception removed which may be utilized as corpus delcti in the crime is lost. 87 By 4D2014-2015 Summary of Legal Medicine Book by Solis Reasons Why It Is Difficult to Prosecute Physicians Committing the Crime of Abortion 1. 5. 3. a married woman with unstable character finding herself pregnant. Organic nervous conditions as psychosis. In most cases. The crime is performed clandestinely by an intelligent being who is fully aware of his criminal act. paroxysmal tachycardia.) a woman who threatened to commit suicide unless she could be relieved of the child with which she was pregnant does not present such a necessity for the performance of the operation to save the life of the woman. A physician must exercise due diligence in considering a disease or a combination of diseases or conditions as grounds for the therapeutic abortion. Safeguards to be Observed by Physician in Performing Therapeutic Abortion: 1. previous eclampsia. Is the eminent danger of committing suicide on account of her existing pregnancy be a ground to induce therapeutic abortion to save the life of the woman?   Hatchard v. 4. pyelitis. In a case cited by Camp and Purchase (Practical Forensic Medicine.W. 1957). Grounds for Therapeutic Abortion: 1. Renal conditions as chronic nephritis. p. The coroner did not recommend prosecution because the operation was done to save the life of the mother. Abortion in order to be justifiable must be performed to save the life or to preserve the health of the mother. 3. . tuberculosis Pulmonary conditions as advanced tuberculosis. 8. It is advisable to have the opinion of other competent physicians as to the justifiability of such therapeutic abortion. it is a common concept that the life of the mother must be preferred than that of the unborn child. herself. 3.FROGLETS NOTES  In the evaluation as to whose life must be spared. A conceived child is not definitely sure of its independent existence while the mother has already manifested real life. It is advisable to have also the consent of the husband. repeated hemoptysis. Enlightened and expressed consent must be obtained from the woman herself if she has no impediment to give consent. Abortion performed in a private clinic wherein there are no sufficient facilities to cope with emergency which may arise in the course of the operation may be a ground for malpractice. is in pari delicto to the crime of criminal abortion. The intention of the law applies only to cases where death of the mother might reasonably be anticipated from natural causes unless the product of conception is destroyed. Birth may be: 88 By 4D2014-2015 b. may be revoked or reduced as provided in the next article. the foetus is considered born if it is alive at the time it is completely delivered from the mother’s womb. RPC – Infanticide: The penalty provided for parricide (reclusion perpetua to death) in article 246 and for murder (reclusion temporal in its maximum period to death) in article 248 shall be imposed upon any person who shall kill any child less than three days of age. 41. To have a child acquire a personality distinct as that of the mother. Congenital diseases or malformation 3. Proof of live-birth must first be shown before death of the child by the prosecution in the case of infanticide:  Art. by the happening of any of these events. 40. Live-Birth – the child after birth exhibited clear signs of vitality and viability is not necessary. but the conceived child shall be considered born for all purposes that are favorable to it. intraplacental hemorrhage. after the donation has legitimate or legitimated or illegitimate children. provided it be born later with the conditions specified in the following article. (1) if the donor. Medical society seems to have a lukewarm attitude in helping the state prosecute the abortionist. septicemia) 4. or illegitimate. 255. the presumption is every newborn child found dead was born dead. toxemia. Immaturity 2. 2. placenta previa 5. made by a person having no children or descendants. a.  Proofs of Live Birth 1) Presence of Heart Action and Circulation 2) Movement of the Child and Crying 3) Presence of Respiration 4) Examination of the Stomach and Intestine 5) Changes in the Middle Ear (Wredin’s Test: The middle ear of the a child before birth is filled with gelatinous. General debilitating diseases (acute specific infection.FROGLETS NOTES 5. ablation placenta. either deliberate or accidental at birth. Appearance of a child is a ground for the revocation of donation:  Art. if the foetus had an intrauterine life of less than seven months. 760.  Art. acute liver disease.Civil Code: Birth determines personality. The burden of proof lies on those who declare otherwise.  CHAPTER XXV BIRTH Legal Importance of the Study of Birth 1. kidney disease. legitimate or legitimated by subsequent marriage. Civil Code: Every donation inter vivos. Violence. Causes of Still Birth 1. Local disease of the generative organ (syphilis. it is not deemed born if it dies within twenty-four hours after its complete delivery from the maternal womb. even though they be posthumous. embryonic connective . or extensive infarction.  In law. Summary of Legal Medicine Book by Solis Still Birth – when the child has not breathed or has not shown any sign of life after being completely born. Accidents in the delivery 6. there must be proof of life after complete separation from the mother’s womb. Civil Code: For civil purposes. kind of the cord. However. 3. Birth determines personality:  Art. but an approximate idea may be formed after consideration of the following points: 1) Changes in the skin 2) Presence of caput succedaneum 3) Changes in the umbilical cord 4) Changes in the circulation Signs of Maturity of the Child at Birth 1.)) 6) Condition of the Skin 7) Marks of Violence 8) Changes in the Umbilical Cord 9) Condition of the Heart and Blood Vessels Proof of Live-Birth can be deduced in the following: 1) Well-developed signs of breathing 2) Presence of air or food in the stomach 3) Changes having taken place in the region of the umbilicus If Born Alive. There are color changes in the course of its absorption c. An approximate may be formed after consideration of the following points: 1. At birth – body of the child is bright-red in color. The Caput lasts up to the 7th day . Changes in the skin a. Face lost its wrinkles 6. 3. Weight – 3. At a week’s time – normal color of the skin c. Presence of Caput Succedaneum a. If present – the child was born with head presentation b. Limbs and body plump 5. covered with vernix caseosa which may be present up to 2 days b. Well-developed sings of breathing Presence of air or food in the stomach Changes having taken place in the region of the umbilicus 89 By 4D2014-2015 If born alive.FROGLETS NOTES Summary of Legal Medicine Book by Solis tissue. This disappears after the birth of the child. 2. Lanugo hair almost disappeared 4. Length of the fetus – 50 centimeters 2. Skin covered with vernix caseosa 7. how long did the child survive?   It is not possible to determine the exact length of time that the child has lived after birth. Head covered with hair about 2 inches long Proof of Live-Birth can be deduced in the following: 1. First 3 days after birth – exfoliation of the skin in the abdomen 2. How Long Did the Child Survive?  It is not possible to determine the exact length of time the child has lived after birth.0 kilos 3. 3. RPC. 2. Penalties    If killing done by parents. Changes in the Umbilical Cord a. 4. a. 90 By 4D2014-2015 Summary of Legal Medicine Book by Solis If the crime penalized in this article be committed by the mother of the child for the purpose of concealing her dishonor. 5. Foramen ovale closes on the 2nd or 3rd month Signs of maturity of the child at birth 1. Infanticide. 6. Why is the crime of infanticide applied only to kiiling of less than 3-day old infant rather than within the 1st year of the life of the child? When the head and neck of the child are already out of the birth canal and the child has breathed through the lungs but the child is not yet capable of independent existence and it was deliberately put to death. or labia have close the vulva 10. the child had all the chances to live. Is the killing a case of infanticide? Can the crime of infanticide be committed on someone who is not yet a person as contemplated by law? Motives for committing infanticide 1. To conceal dishonor (single. Head covered with haird about 2 inches long 8. 255. — The penalty provided for parricide in Article 246 and for murder in Article 248 shall be imposed upon any person who shall kill any child less than three days of age. 2. 4. Umbilical artery begins to contract – about 10 hours after birth b. Mummification of the cord does not occur if the child is submerged in water after birth b. 3.FROGLETS NOTES 3. is it considered infanticide? When a child was born less than 7 months of uterogestaton. or other direct ascendants  penalty: parricide If killing done by any other person  penalty: murder If killing done by mother or maternal grandparents for the purpose of concealing her dishonor  lenient penalty Problems: 1. living separately from husband) Financial reason Desired number of children has already been attained (substitute for ineffective family planning) Congenital abnormality of the child Mental abnormality of the parent . 5. and if said crime be committed for the same purpose by the maternal grandparents or either of them. With modern neonatal management.The killing of a child less than 3 days old. 2. Umbilical vein and ductus venosus obliterate – 4th and 5th day c. Length of the fetus – 50 cm Weight – 3 kg Lanugo hair almost disappeared Limbs and body plump Face lost its wrinkles Skin covered with vernix caseosa (waxy or cheese-like white substance found coating the skin of newborn human babies) 7. the chold was deliberately killed. the penalty shall be prision mayor. grandparents. 4. Nails project from the fingers. she shall suffer the penalty of prision correccional in its medium and maximum periods. A mummified cord may again be soft after continuous soaking in water Changes in the Circulation a. Art.6 cm in diameter CHAPTER XXVI INFANTICIDE (NEONATICIDE) Infanticide . One or both testes are in the scrotum. Ductus arteriosus – on the 3rd day d. widowed. 3. toe-nails reach only to the end 9. estranged from husband. Infancy is the period in the life of a child from birth up to one year. Lower end of femur may show center of ossification about 0. After a few hours after birth. FROGLETS NOTES 6. Contusion d. 2. Naturalized citizens give ipso facto Philippine citizenship to their minor children. 2. Burden of proof that a living child has been killed is placed on the prosecution What must be proven by evidence 1. Criminological Characteristics of infanticide 1. Suffocation c. Drowning (child disposed in a sewerage disposal in a creek) e. 5. Poisoning f. 3. the minors must prove that they are legitimate children of the naturalized citizen. Burning g. basin of cold water) Post-mortem findings in cases of infanticide 1. through which food is passed and digested) a. Right of legitimate children is different from that of illegitimate childrem For enforcement of naturalization and immigration laws a. Can show signs of poisoning In case of poisoning. no noise. 3. Strangulatioin d. Presence of marks of physical violence (fingernail marks at the neck) b. 2. Most often committed by the mother Almost always committed at home Crime scene: no manifest disturbance. hard or sharp objects) b. no witnesses. the organs must be preserved and sent to a competent toxicologist for proper analysis Laceration or other injury of the upper portion of air passage Lungs may show signs of drowning Fracture of the bones. Inflicting physical injuries (use of kitchen utensils. Delibreate exposure to heat cold (direct sunshine. Failure to take the necessary help of a midwife or a skilled physician d. b. 5. Failure to ligate the umbilical cord (if not cut or not tightly ligated. For succession a. Failure to remove the child from the mother’s discharge which resulted to suffocation By commission a. 3. Hematoma e. Belief that child will bring bad luck to the family a. child may bleed to death) b. Failure to supply the child with proper food (child starved to death) e. By omission or neglect a. Lacerated wounds f. Abrasion c. . Ligature or pressure marks on the neck Examination of mouth and upper portion of the alimentary tract (the tubular passage extending from the mouth to the anus. That the child was born alive That the child was deliberately killed That the child killed was less than 3 days old Summary of Legal Medicine Book by Solis 2. Thus. 4. Complete examination of skin surfaces 91 By 4D2014-2015 CHAPTER XXVII 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 of determining paternity and filiation 1. Failure to protect the child from heat and cold (depriving the child of necessary clothing) c. no outcry Trauma applied is so minimal A newly born child found dead was born dead. 2. 4. laceration of the internal organs How Infanticide is committed 1. 6. A minor child of a naturalized or permanent resident alien may be given the right to land in the Philippines upon proof that he is a legitimate child of the latter. Children conceived or born during the marriage of the parents ii. serious illness of the husband. b. which absolutely prevented sexual intercourse. any of his heirs. these rules shall govern in the absence of proof to the contrary: i. Summary of Legal Medicine Book by Solis legitimacy or may have been sentenced as an adulteress. provided. except in the instance provided in the second paragraph of Article 164. That in case of children conceived through artificial insemination. That it is proved that for biological or other scientific reasons. whichever is earlier. If the birth of the child has been concealed from or was unknown to the husband or his heirs. Thanks. A child born before one hundred eighty days after the solemnization of the subsequent marriage is considered to have been conceived during the former marriage. 2. g. The instrument shall be recorded in the civil registry together with the birth certificate of the child. intimidation. or undue influence. the physical incapacity of the husband to have sexual intercourse with his wife. Children conceived as a result of artificial insemination of the wife with the sperm of the husband or that of a donor or both are likewise legitimate children of the husband and his wife. or 3. If the husband should died before the expiration of the period fixed for bringing his action. the child could not have been that of the husband.FROGLETS NOTES (Hello blockmates. fraud. iii. If the husband or. f. ii. The legitimacy or illegitimacy of a child born after three hundred days following the termination of the marriage shall be proved by whoever alleges such legitimacy or illegitimacy. all of his heirs do not reside at the place of birth as defined in the first paragraph or where it was recorded. c. violence. that both of them authorized or ratified such insemination in a written instrument executed and signed by them before the birth of the child. even though it be born within the three hundred days after the termination of the former marriage. . The child shall be considered legitimate although the mother may have declared against its 92 By 4D2014-2015 e. The action to impugn the legitimacy of the child shall be brought i. if the husband or. in his default. A child born after one hundred eighty days following the celebration of the subsequent marriage is considered to have been conceived during such marriage. Kinds of Children 1. ii. If the marriage is terminated and the mother contracted another marriage within three hundred days after such termination of the former marriage. the written authorization or ratification of either parent was obtained through mistake. provided it be born within three hundred days after the termination of the former marriage. the period shall be two years if they should reside in the Philippines. the period shall be counted from the discovery or knowledge of the birth of the child or of the fact of registration of said birth. That it was physically impossible for the husband to have sexual intercourse with his wife within the first 120 days of the 300 days which immediately preceded the birth of the child because of: 1. Who are considered legitimate children i. Within 1 year from the knowledge of the birth or its recording in the civil register. Grounds to impugn legitimacy of a child: i. ii.) d. should reside in the city or municipality where the birth took place or was recorded. or iii. The heirs of the husband may impugn the filiation of the child within the period prescribed in the preceding article only in the following cases: i. in a proper case. and three years if abroad. Legitimate Children a. the fact that the husband and wife were living separately in such a way that sexual intercourse was not possible. the book used provisions from the Civil Code re: Paternity and Filiation but I think we now use the Family Code for this so I will put here the relevant FC provisions instead. Who may be adopted . emotionally and psychologically capable of caring for children. one who seeks to adopt the legitimate son/daughter of his/her Filipino spouse. at the time of the conception of the former. or iii. If the child was born after the death of the husband. Husband and wife shall jointly adopt. a former Filipino citizen who seeks to adopt a relative within the fourth (4th) degree of consanguinity or affinity. In case husband and wife jointly adopt. ii. at least sixteen (16) years older than the adoptee. one who is married to a Filipino citizen and seeks to adopt jointly with his/her spouse a relative within the fourth (4th) degree of consanguinity or affinity of the Filipino spouse. The annulment of a voidable marriage shall not affect the legitimation. Children conceived and born outside of wedlock of parents who. Who may adopt i. were not disqualified by any impediment to marry each other may be legitimated. However. Adopted Children a. Any Filipino citizen of legal age.  The legitimation of children who died before the celebration of the marriage shall benefit their descendants. of good moral character. If he should die after the filing of the complaint without having desisted therefrom. in possession of full civil capacity and legal rights. iv.  Legitimated children shall enjoy the same rights as legitimate children.FROGLETS NOTES ii. Legitimated Children a. if one spouse seeks to adopt the legitimate son/daughter of the other. or 3. joint parental authority shall be exercised by the spouses. or iii. except in the following cases: 1.  The effects of legitimation shall retroact to the time of the child's birth. The guardian with respect to the ward after the termination of the guardianship and clearance of his/her financial accountabilities. or is the spouse of the adoptee's parent. That the requirements on residency and certification of the alien's qualification to adopt in his/her country may be waived for the following: 1. or one spouse adopts the illegitimate son/daughter of the other. v. within five years from the time their cause of action accrues. Summary of Legal Medicine Book by Solis (3) continuous years prior to the filing of the application for adoption and maintains such residence until the adoption decree is entered. if one spouse seeks to adopt his/her own illegitimate son/daughter: Provided. or 2. and that his/her government allows the adoptee to enter his/her country as his/her adopted son/daughter: Provided. Any alien possessing the same qualifications as above stated for Filipino nationals: Provided. that he/she has been living in the Philippines for at least three 93 By 4D2014-2015 b. Further. has not been convicted of any crime involving moral turpitude. that the other spouse has signified his/her consent thereto. if the spouses are legally separated from each other.  Legitimation may be impugned only by those who are prejudiced in their rights. The requirement of sixteen (16) year difference between the age of the adopter and adoptee may be waived when the adopter is the biological parent of the adoptee. or 3. that he/she has been certified by his/her diplomatic or consular office or any appropriate government agency that he/she has the legal capacity to adopt in his/her country. or 2. and who is in a position to support and care for his/her children in keeping with the means of the family. That his/her country has diplomatic relations with the Republic of the Philippines.  Legitimation shall take place by a subsequent valid marriage between parents. 3. 2. Civil Liability of Persons Guilty of Crimes Against Chastity:  Art. 94 By 4D2014-2015 Summary of Legal Medicine Book by Solis a. c. . Children conceived and born outside a valid marriage are illegitimate. A child whose adoption has been previously rescinded. B. Parental Likeness: -Heredity transmits traits and characteristics from parents to the offsprings. iii. 3.children conceived in an act of adultery or concubinage. or vi. If the woman abused is married.    The adulterer and the concubine may also be sentenced. Civil Code). That no proceedings shall be initiated within six (6) months from the time of death of said parent(s). d. Natural Children by Legal Fiction: -those children born out of void marriages or those born of voidable marriages after the decree of annulment. Natural Children: a. To indemnify the offended woman. The legitimate son/daughter of one spouse by the other spouse. 2. Incestuous Children: -children born by parents who are legally incapable of contracting valid marriage because of their blood relationship. Illegitimate Children a. A person of legal age if. Spurious Children:  Illegitimate children who are not natural. -There must be some gross manifestation of the children which may be in common with the father. To acknowledge the offspring. prior to the adoption. Evidence of Paternity and Filiation A. Medical Evidences 1. Manceres: -children conceived by prostitutes. In cases of multiple rape. seduction or abduction shall also be sentenced: 1. 2. at the time of the conception of the former. v. b. In every case to support the offspring. 4. to indemnify for damages caused to the offended spouse. Illegitimate Children  Those who were born out of lawful wedlock or after a competent time after its dissolution. Natural Children by Presumption: -those natural children acknowledged by the father or the mother separately if the acknowledging parent was legally competent to contract marriage at the time of conception. Any person below eighteen (18) years of age who has been administratively or judicially declared available for adoption. unless the law should prevent him from so doing. b. A child whose biological or adoptive parent(s) has died: Provided. Revised Penal Code: Persons guilty of rape. Natural Children (Proper): -those born outside wedlock of parents who. said person has been consistently considered and treated by the adopter(s) as his/her own child since minority. Adulterous Children: . Sacrilegious Children: -children born of parents who have been ordained in sacris (priest and nun). 1. iv. ii. 269. the child born subsequently cannot be recognized and support cannot be demanded from the offender. An illegitimate son/daughter by a qualified adopter to improve his/her status to that of legitimacy. 345. c. unless otherwise provided in this Code. were not disqualified by any impediment to marry each other (Art. in the same proceeding or in a separate civil proceeding.FROGLETS NOTES i. the offenders may not be required to recognize the offspring. Non-medical Evidences 1. Civil Code). Any other evidences allowed by the Rules of Court and special laws (Art. 95 By 4D2014-2015 Summary of Legal Medicine Book by Solis 4. -blood type of the child is not the possible product of the parents  conclusively show that the child is not that of the husband. CHAPTER XXVIII PATERNITY AND FILIATION ON NON-CONVENTIONAL METHODS OF PROCREATION  The standard method of reproduction is the introduction of the male sperm into the generative organ of a female through sexual intercourse followed by fertilization. Blood Grouping Test: -blood type of the child is a possible product of the parents  not conclusively show that the child is born by such parents. -examination of spermatozoa in the seminal fluid is necessary to determine fertility. 265. Proof of Physical Potency and Fertility: -medical examination must be done whether husband is capable of erection. 2. congenital or acquired abnormalities. or by an authentic document or a final judgment (Art. Continuous possession of the status of a legitimate child (Art. the presence of disease.FROGLETS NOTES 2. Civil Code). 3. Proofs of Previous Delivery: -supposed mother may be subjected to an examination to determine the presence of signs of previous childbirth and which are compatible with the age of the child. Proof of Access: -physician must determine the health and vigor of the father. b. -fertility may be inferred from the presence of other pregnancies and the absence of organic abnormalities of the generative system. -presence of disease. Civil Code). Proof of Capacity to have Access with the Husband: -general physical examination of the woman is necessary to determine whether she is physically capable of having sexual intercourse with her husband. 267. Evidences from the Mother: a. may be factors that may bring about impotency or sterility. B. Evidences from the Father: a. etc. Record of birth in the Civil Registrar. Proofs of Physical Potency and Fertility: -the woman may be manifesting some acquired or congenital defect wherein impotency may be inferred. 266. c. 3. growth and . which may bring about his incapacity to perform sexual intercourse. b. D. A. b.B. of semen with infertility of long duration. 3. under no circumstances except by court order. 4. 4.D. Hereditary disease in the husband making propagation inadvisable for eugenic reason. A.  ―therapeutic insemination‖ – more suitable term for the procedure. Precautions to be Observed by the Physician in Performing Artificial Insemination: 1. Artificial Insemination Heterologous) – Sperm comes from a donor other than the husband. reveal the fact of artificial insemination or the identity of the donor or of the couple to each other or to other persons.I. modern advancement of medicine modified the conventional method as a solution to some specific problems of reproduction. A.D.I.I. Polled Donor Semen) – Donor semen comes from the husband and a third party donor.H. Artificial Insemination Classified According to the Source of Semen: 1.O. Physician should make certain by reasonable testing that the procedure is medically indicated for the couple. A. Proper screening must be made of the donor. Absolute male sterility (Azoospermia). However. (Artificial Insemination Husband Donor. Physician must.. or d.  If the child born becomes defective which can be traced from a physician’s negligence or carelessness in choosing the donor. Physician must ensure that the identity of the donor is not known to the parents and vice versa. Physician must use freshly donated sperm or frozen semen.I.H. Physician must use all reasonable precautions in selecting the donor. paucity or otherwise defective sperm cells or too small a volume of the ejaculant. For A. When the deposition of the husband’s semen within the vagina is by coitus. 3. 5. An Rh blood incompatability is expected to cause an abnormal baby on situations where other techniques to overcome such incompatability are not applicable.H. Artificial Insemination  A medical procedure by which the semen is introduced into the vagina by means other than copulation for the purpose of procreation. 2. Artificial Insemination Husband) – Sperm comes from the husband.: a. and Rh genotype of the wife. (Artificial Insemination Homologous. the physician may be held liable.I. the selection of the appropriate donor of semen resides in the physician. b. Complete physical examination with standard test for syphilis and gonorrhea is obtained not more than 1 week before the seminal fluid is collected.FROGLETS NOTES  development of the conceptus and its subsequent delivery. 6. When the infertility is due to poor motility. 3. The insemination procedure must be performed by the physician in accordance with the currently accepted techniques. Oligospermia – Less than 10-15 million sperm per cc. Donor must have the racial characteristic and physical proportion as those of the husband and wife and the blood type must be compatible with A. 96 By 4D2014-2015 Summary of Legal Medicine Book by Solis Selection of Donor of Semen:  In A.D.I. Physician should establish by proper evaluation that the couple is emotionally stable and psychologically suited for this type of parenthood. (Artificial Insemination Donor. 2.D. For A. 2.  Obligations imposed on a physician in the selection of donors: 1. or A. .: a. 2.I. c. Husband is infertile and such condition is permanent.H. Medical Indications for Artificial Insemination: 1. o Ectogenesis (extra corporeal gestation) – whenever the embryo is allowed to develop in an artificial womb Procedure of In Vitro Fertilization: 97 By 4D2014-2015     Summary of Legal Medicine Book by Solis Process begins with injections into the oocyte (ovum) donor of a hormone known as gonadotropin. it is the fertilization of the egg cell by the sperm cell extracted from the respective donors placed in an artificial medium and after reaching a certain stage of cellular division and development: 1. After successful transplantation. The resulting conceptus. The removed oocytes are placed in a Petri dish or a test tube containing growth medium simulating the environment of the woman’s body.I. the woman carried the blastocyst to term.  Consent of husband is necessary to avoid the wife being charged with adultery  Consent and release of the donor should be obtained for the unrestricted use of the semen supplied  Donor should also certify in writing that he will make no effort to ascertain the identity of the couple involved.I.D. The ovum removed from the wife is fertilized by the husband’s sperm and the blastocyst is implanted to a ―host‖ or surrogate.D. 2.FROGLETS NOTES 7. Gestation (development of the embryo to a child) in an artificial womb. – child is a legitimate child of the 2. The ovum removed from a single woman is fertilized by the sperm taken from a male donor.   1.  If the donor is married. or 2.‖ Status of the Child Born by Artificial Insemination: husband. The ovum removed from the wife is fertilized by the husband’s sperm and the resulting zygote is implanted into the wife’s uterus. with consent of the husband – child is legitimate although the fertilization semen is not from the husband. is then inserted through the vagina and cervix into the uterus where it is implanted at a proper time in menstrual cycle.H. . In Vitro Fertilization  Also known as test tube baby. the blastocyst is implanted into the single woman’s uterus.D.I. 3. In A.. 4.:  The consent and release for any future claim must be obtained by the physician from all parties in writing. consent of the wife must also be obtained B. 3. Approximately 30 hours later. without consent or against the will of the husband – child is illegitimate Consent on A. Implanted into the woman’s uterus. 5.I. The oocytes are then fertilized by a sperm which has been held in vitro.  Consent of wife is necessary to avoid being held liable for an assault. Possible Situations in In Vitro Fertilization: 1. Full and valid consents and releases should be obtained in writing from all parties involved. after it divides and grows for a few days until it reaches the blastocyst stage (stage at which the embryo normally enters the uterus). a surgical procedure accomplished by inserting two thin glass tubes into the ovary through a small incisiom in the abdomen. The ovum taken from the ovum donor is fertilized by the sperm coming from the sperm donor and the blastocyst is implanted into the wife’s uterus. The ovum removed from the wife is fertilized by the sperm coming from a third party (sperm donor) and is implanted into the wife’s uterus. the oocytes are removed from the ovary by laparoscopy. and each consent must be an ―informed consent. In A.. In A. 6. The ovum coming from a third party (ovum donor) is fertilized by the husband’s sperm and the blastocyst is implanted into wife’s uterus. which induces super-ovulation. The probability that the child to be born will be defective. Prospective parents are normally briefed of the potential risks of the procedure before their consent is obtained. 1. 8. unless by clear and unquestionable authority of law. o Right of marital privacy – Prohibition of in vitro fertilization as a way to have children will mean government intrusion into the marital bedroom in search of evidence for violating the law. In vitro fertilization has yet to evolve a clearly defined standard of care by which to determine whether the action of the physician is negligent. 2. Problem of surrogate mother: -Reasons why the services of a surrogate mother may be necessary: a. o Right of self-determination – ―Every human being of adult age and of sound mind has the right to determine what shall be done on his own body. Necessity . Other implication of the right of privacy which may be the basis of legality of in vitro fertilization: o Right of procreation – A ban on the use of in vitro fertilization would prevent an individual from using means to fulfill his or her procreative mission. nor shall any person be denied the equal protection of the laws. The ovum coming from the ovum donor is fertilized by the sperm coming from the husband and the blastocyst is placed into the surrogate’s uterus. It is the right of an individual to the possession and control of his own person. b. It is the right of parents or guardians to establish their family life as they see fit. (Art. Defective donors (sperm or ovum) -A physician need not fear too much of the possible liability on account of a defective child because: a. The plaintiff will find difficulty in proving negligence because birth defects are well known to occur in normal or natural pregnancies.FROGLETS NOTES 7.‖ 98 By 4D2014-2015 Summary of Legal Medicine Book by Solis Problems in In Vitro Fertilization: 1. Basis of Legality of In Vitro Fertilization:     No person shall be deprived of life. o Right to decide whether to bear or beget – The right of a person to determine whether to carry or not to carry a product of conception. -Social Problem in In Vitro Fertilization:  The progress of science must be geared towards improvement in the quality of men and not towards retrogression or deterioration. Administration of hormone to the prospective source of ovum b. d. c. III. Mechanical manipulation of the oocyte and embryo c. 1987 Constitution) From the term ―liberty‖ emanates the right of privacy The right of privacy means the right to be left alone. to be or not to be a mother or to raise or not to raise a family. liberty. Sec. The ovum coming from the ovum donor is fertilized by the sperm coming from the sperm donor and the blastocyst is implanted into the surrogate’s uterus. -Some of the probable causes of the birth of a defective child: a. Mistake in the ―screening process‖ or selection of the best ovum for fertilization d. or property without due process of law. The plaintiff is required to meet the difficult task of proving negligence. 9. free from all restraints or interference of others. The ovum coming from the wife is fertilized artificially by the sperm coming from the sperm donor and the blastocyst is implanted into the surrogate’s uterus. or that the child may be born with abnormalities. The surrogate mother may decide to keep the child after birth rather than surrender him to the genetic parents. -Problems that may arise in the agreement in the use of surrogate mother for gestational purpose: a. e.  Couple is unable to adopt a child. Can the couple enforce the contract in the event that the surrogate mother committed other breaches? f. Situation 1 – Child is legitimate b. Problem of the status of the child born by in vitro fertilization (please refer to possible situations in in vitro fertilization portion above) a. If the surrogate mother decided to abort the child contrary to the wish of the genetic parents. c. -Motivation of a woman to become a surrogate mother: a. d. If the child was born with abnormality and the parents 99 By 4D2014-2015 Summary of Legal Medicine Book by Solis refused to take the child from the surrogate mother. Is there a need to go through the procedure of adoption in order to legitimatize the child at birth? -Potential solution to the problems of surrogate mother: a. otherwise a special legislation may be necessary.  Genetic mother may possess deleterious genetic traits which may be passed on to the child. Situation 5 – Child is illegitimate c. it is tantamount to ―rental‖ for the use of the uterus.FROGLETS NOTES  Genetic mother is unable to carry the child to term because of disease or injury. Convenience  A woman may not want to interrupt her career during the gestational period. 7. Adoption may be a legal remedy provided there is no impediment to the application of the procedure. By contract – There must be a contract specifically mentioning the rights and duties of each party. Material consideration  If the surrogate mother merely receives all expenses incurred in carrying the fetus to term and then delivered: altruistic motive If payment is beyond the reasonable cost of pregnancy. b. Other Non-Conventional Methods of Procreation 1. adoption may be done The status that the child may be a problem may change if the in vitro fertilization was done with the knowledge and consent or against the will of the sterile spouse. b. 8 and 9 – Genetic parents are different from the gestational mother.  Genetic mother may believe either that she is too old to safely carry a child to term. 6. b. C. If child is not considered legitimate. d. Altruistic motive b. Artificial Inovulation – The removal of an unfertilized egg from a woman and placing it on the reproductive tract of another woman. By legislation – The court is bound to enforce the legislation unless found to be unconstitutional. (better solution) 3. Situation 2 and 3 – Child may still be legitimate if there is consent of the sterile party to the in vitro fertilization. The parents may decide to abort the child because of the fear that abnormality may be present but the surrogate mother refuses to do so. Situation 4. . 100 By 4D2014-2015 Summary of Legal Medicine Book by Solis .FROGLETS NOTES 2. Resulting offspring is genetically identical to the parent. Embryo Transplantation – The removal of a fertilized egg from a woman’s uterus to transfer to that of another woman’s uterus. 4. Parthenogenesis (―Virgin Birth‖) – A type of sexual reproduction whereby the unfertilized egg with 23 chromosome compliment doubled its content to become a diploid cell that starts dividing as if it is a fertilized egg without the intervention of a male sperm cell. The renucleated egg is then placed in a uterus for gestation and normal development. the resulting offspring is a female. 3. Cloning – A type of sexual reproduction whereby the nucleus of a female egg is removed (enucleation) which contains the genetic material and replaced with the nucleus of a body (somatic) cell of the same or another woman (renucleation).