Você está na página 1de 100

FROGLETS NOTES

CHAPTER 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

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 countrys 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 persons
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)
Employees 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);

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.

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.

FROGLETS NOTES
Kinds of Sketch:

The preservation is co-terminus with


the life of the witness.
Human mind can easily be subjected to
too many extraneous factors that may
cause distortion of the truth.

Rough Sketch- made at the crime scene or


during examination of living or dead body.
Finished Sketch- sketch prepared from the rough
sketch for court presentation.
Essential Elements to be Included in a
Sketch:
a.
b.
c.
d.
e.

3.

Measurement must be accurate;


Compass direction must always be
indicated to facilitate proper orientation
in the case of crime scene;
Essential item which has a bearing in
the investigation must be included;
Scale and proportion must be stated by
mere estimation;
There must be a title and legend to tell
what it is and the meaning of certain
marks indicated therein.

Description- putting into words the person or


thing to be preserved. It must cause a vivid
impression on the mind of the reader, a true
picture of the thing described.
Minimum Standard Requirements which must be
satisfied in the description of the person or thing
to make it complete:
a.
b.
c.
d.

4.
5.

Skin Lesion
Penetrating wound
Hymenal Laceration
Person

Manikin Method- miniature model of a scene or


of a human body indicating marks of a various
aspects of the things to be preserved.
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, age of the witness, confusion with
other evidence, trauma or disease,
thereby making the recollection not
reliable;

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

6.

Special Methods- Special way of treating certain


type of evidence may be necessary. 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.
Special Ways of Preservation:
a.
b.
c.
d.
e.

Whole human body- embalming.


Soft tissues (skin, muscles, visceral
organs) 10% formalin solution.
Blood- refrigeration, sealed bottle
container, addition of chemical
preservatives.
Stains (blood, semen) drying, placing
in sealed container.
Poison- sealed container.

CHAPTER II
DECEPTION DETECTION
Methods of deception detection used by law
enforcement agencies:
1. Devices which record the psycho-physiological response
a. Polygraph or lie detector machine records
physiological changes that occur in association with
lying in a polygraph.
Phases of Examination
i. Pre-test interview
ii. Actual interrogation and recording through the
instrument
Standard test questions:
1. Irrelevant questions no bearing to the case
under investigation (ex: age, citizenship,
occupation, etc).
2. Relevant questions pertaining to the issue
under investigation (ex: Did you shoot to death
Mr. X?).
3. 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?).

FROGLETS NOTES
iii. Post-test interrogation
Supplementary tests:
i. 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.
ii. 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.
iii. Silent answer test conducted in the same
manner as when relevant, irrelevant and control
questions are asked, but the subject is instructed
to answer the questions silently, to himself, without
making any verbal response.
Factors responsible for the 25% errors of the lie
detector:
1. Nervousness or extreme emotional tension
experienced by a subject who is telling the truth
regarding the offense in question
2. Physiological abnormalities
3. Mental abnormalities
4. Unresponsiveness in a living or guilty subject
5. Attempt to beat the machine by controlled
breathing or by muscular flexing
6. Unobserved application of muscular pressure which
produces ambiguities and misleading indications in
the blood pressure tracing
b. Word association test A list of stimulus and nonstimulus words are read to the subject who is
instructed to answer as quickly as possible. The time
interval between the words uttered by the examiner
and the answer of the subject is recorded. The test is
not concerned with the answer, be it a yes or no.
The important factor is the time of response in relation
to the stimulus or non-stimulus words.
c. Psychological stress evaluator (PSE) detects,
measures, and graphically displays the voice
modulations that we cannot hear. When a person
speaks, there are audible voice frequencies, and
superimposed on these are the inaudible frequency
modulations which are products of minute oscillation
of the muscles of the voice mechanism. 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.
2. Use of drugs that try to inhibit the inhibitor

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

a. Truth serum In the test, hyoscine hydrobromide is


given hypodermically in repeated doses until a state of
delirium is induced. When the proper point is reached,
the questioning begins and the subject feels a
compulsion to answer the questions truthfully.
b. Narcoanalysis or narcosynthesis practically the
same as that of administration of truth serum. The
only difference is the drug used. Psychiatric sodium
amytal or sodium penthotal is administered to the
subject.
c. Intoxication the apparent stimulation effect of
alcohol is really the result of the control mechanism of
the brain, so alcohol, like truth serum, and
narcoanalytic drugs inhibit the inhibitor. (In vino
veritas in wine there is truth)
3. Hypnotism the alteration of consciousness and
concentration in which the subject manifests a
heightened of suggestibility while awareness is
maintained.
4. By observation
Physiological and psychological signs and symptoms of
guilt:
a. Sweating if accompanied with a flushed face
indicate anger, embarrassment or extreme
nervousness. If with a pallid face, may indicate shock
or fear. Sweating hands indicate tension.
b. Color change flushed face may indicate anger,
embarrassment or shame. Pale face is sign of guilt.
c. Dryness of the mouth nervous tension causes
dryness of the mouth which causes continuous
swallowing and licking of the lips.
d. Excessive activity of the Adams apple on
account of dryness of the throat, subject will swallow
saliva which causes frequent upward and downward
movement of the Adams apple.
e. Fidgeting constantly moving about in the chair,
pulling his ears, rubbing his face, picking and tweaking
the nose, etc. Indicative of nervous tension.
f. Peculiar feeling inside there is a sensation of
lightness of the head and the subject is confused.
Result of troubled conscience.
g. Swearing to the truthfulness of his assertion I
swear to God I am telling the truth
h. 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.
i. Inability to look at the investigator straight in the
eye because of fear that his guilt may be seen in
his eyes.

FROGLETS NOTES
j. Not that I remember expression resort to this
expression to avoid committing something prejudicial
to him.
5. 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.
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. Based on behavioral attitude:
i. Active aggressive offenders commit crimes in
an impulsive manner
ii. Passive inadequate offenders commit crimes
because of inducement, promise or reward.
b. Based on the state of mind
i. Rational offenders commit crime with motive or
intention
ii. Irrational offenders commit crime without
knowing the nature and quality of his act.
c. Based on proficiency
i. Ordinary offenders engaged in crimes which
require limited skill
ii. Professional offenders commit crimes which
require special skills rather than violence.
d. Psychological classification
i. Emotional offenders commit crimes in the heat
of passion, anger, or revenge.
ii. Non-emotional offenders commit crimes for
financial gain and are usually recidivist or
repeaters.
Techniques of Interrogation
a. Emotional appeal interrogator must create a mood
that is conducive to confession
b. Mutt and Jeff technique there must be at least 2
investigators with opposite character; one (Mutt) who
is arrogant and relentless, and the other (Jeff) who is
friendly, sympathetic and kind.
c. Bluff on split-pair technique applicable where
there are two or more persons who allegedly
participated in the commission of a crime. While one
of them is interrogated, the interrogator may claim that
the subject was implicated by the author and that
there is no use for him to deny participation.
d. Stern approach questions must be answered
clearly, and the interrogator utilizes harsh language.

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

e. The subject is given the opportunity to make a


lengthy, time-consuming narration.
6. Confession an expressed acknowledgment by the
accused in a criminal case of the truth of his guilt as to
the crime charged, or of some essentials thereof.
Requirement for the Admissibility of Evidence Obtained
Through Interrogation

Custodial Investigation and Self-Incrimination


(1987 Constitution)
Miranda v. Arizona (Miranda Rights)- safeguards
were established for the interrogation of
suspected persons.

Some Techniques of Interrogation

Emotional Appeal- The interrogator creates a


mood that is conducive to confession. He may be
sympathetic or friendly to the subject.
Mutt and Jeff Technique- One interrogator (Mutt)
is arrogant and relentless; he knows the subject
to be guilty. The other (Jeff) is friendly,
sympathetic, and kind. When Mutt is not present,
Jeff will advise the subject to make a quick
decision and plea for cooperation.
Bluff on Split-Pair Technique- Applicable where
there are two or more persons who allegedly
participated on the commission of a crime. 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.
Stern Approach- Immediate and clear response
from the subject is demanded and the
interrogator uses harsh language.
The subject is given the opportunity to make a
lengthy, time-consuming narration.

Basis of Interrogators Inference that the Subject is not


Telling the Truth

The statements have many improbabilities and


gaps on its substantial parts.
The statements are inconsistent with the material
facts.
The statements are incoherent.

Confession

FROGLETS NOTES

Is an expressed acknowledgement by the


accused of the truth of his guilt as to the crime
charged, or of some essentials thereof.
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.

Kinds of Confession

Extra-judicial Confession- is a confession made


outside of the court prior to the trial of the case.
o Under the Rules of Court, extra-judicial
confession is not a sufficient ground for
conviction unless corroborated by
evidence of corpus delicti.
o Extra-judicial confession may be:
Voluntary- the accused
speaks on his free will and
accord, without inducement
of any kind, and with full and
complete knowledge of the
nature and consequence of
the confession.
Involuntary- obtained through
force, threat, intimidation,
duress, or anything
influencing the voluntary act
of the confessor. Such are
inadmissible in evidence.
Judicial Confession- is the confession of an
accused in court. It is conclusive upon the court
and may be considered to be a mitigating
circumstance.
o Under the Rules of Court, admissions
made by the parties in the pleadings, 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.

Maltreatment of Prisoners

Elements (Art. 235, 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

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

authorized by the regulation, or (2) by


inflicting such punishment in a cruel
and humiliating manner; or by
maltreating to extort a confession or
obtain information.
Tokyo Declaration- provides guidelines to be
observed by physicians concerning torture and
other inhuman treatment
o The doctor shall not countenance,
condone, or participate in the practice
of torture or other forms of inhuman
procedures
o The doctor shall not provide premises,
instruments, substances, 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), he or she shall
not be fed artificially. 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, the national
medical associations, and fellow
doctors, 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.

CHAPTER III
MEDICO-LEGAL ASPECTS OF IDENTIFICATION
Identification is the determination of the individuality of a
person or thing.
Importance of Identification

FROGLETS NOTES

To establish the identity of the offender and that


of the victim in the prosecution of the criminal
offense.
To identify a person missing or presumed dead in
order to facilitate the settlement of the estate,
retirement, insurance, and other social benefits.
Identification resolves the anxiety of the next-ofkin, other relatives and friends as to the
whereabouts of a missing person or victim of
calamity or criminal act.
Identification may be needed in some
transactions like cashing of check, entering a
premise, sale of property, release of dead bodies
to relatives, parties to a contract, etc..

Rules in Personal Identification

Law of Multiplicity of Evidence in Identificationthe greater the number of points of similarities


and dissimilarities of two persons compared, the
greater is the probability for the conclusion to be
correct.
The value of the different points of identification
varies in the formulation of conclusion (e.g. visual
recognition by relative or friends may be of lesser
value as compared with fingerprints or dental
comparison).
The longer the interval between the death and
the examination of the remains, the greater is the
need for experts in establishing identity.
It is necessary for the team to act in the shortest
possible time specially in cases of mass disaster.
There is no rigid rule to be observed in the
procedure of identification of persons.

Methods of Identification

By comparison-Identification criteria recovered


during investigation are compared with records
available in the file.
By exclusion- If two or more persons have to be
identified and all but one is not yet identified, then
the one whose identity has not been established
may be known by the process of elimination.

Identification of Persons
Classification of the Bases of Human Identification

Those which laymen use to prove identity- no


special training or skill required

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Those which are based on scientific knowledgemade by trained men, 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, beard or
mustache
Clothing- a person may have
a special preference for
certain form, texture or style
Frequent place of visit- A
persons special desire or
habit to be in a place if he
has the opportunity to do so
Grade of profession- e.g. a
mechanic may be recognized
by his tools, a clergy man by
his robe, or a nurse by her
cap
Body ornamentationsearrings, necklaces, rings,
pins, etc. Usually worn by
persons
o Characteristics that may not be easily
changed
Mental memory- a
recollection of time, place,
and events.
Speech- a person may
stammer, stutter, or lisp;
manner of talking and quality
of the voice.
Gait- a person, on account of
disease or some inborn traits,
may show a characteristic
manner of walking.
Mannerism- stereotype
movement or habit peculiar
to an individual. (E.g. way of
sitting, movement of hand,
movement of body,
movement of facial muscles,
manner of leaning, etc.)
Hands and feet- Size, shape,
and abnormalities.
Foot or hand
impressiondevelops when a

FROGLETS NOTES

foot or hand is
pressed on
mouldable
materials like mud,
clay, cement
mixture, or other
semi-solid mass.
Footprint or
handprint- a
footmark or
handmark on a
hard base
contaminated or
smeared with
foreign matters like
dust, floor, blood,
etc.
Complexion
Changes in the eyes- nearsightedness, far-sightedness,
state of being color blind, etc.
Facies- different kinds of
facial expressions brought
about by disease or racial
influence.
Left- or right-handedness
Degree of nutrition- in
relation to height and age.

Points of Identification Applicable to Both Living


and Dead before Onset of Decomposition
o Occupational marks- certain
occupations may result in some
characteristic marks or identifying
guide
o Race
Color of the skin
Caucasian-Fair
Malayan-Brown
Mongolian-Fair
Negro- Black
Feature of the face
CaucasianProminent sharp
nose
Malayan- Flat nose
with round face
Mongolian- Almond
eyes and
prominent cheek
bone

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

o
o
o
o
o
o
o
o

Negro- Thick lips


and prominent
eyes
Shape of the skull
CaucasianElongated skull
Malayan- Round
head apparel
Mongolian- Round
head
Red Indians and
Eskimos- Flat head
Wearing Apparel- Casual and
customary wearing may
indicate race as well as
religion, nationality, region,
and custom.
Stature- change in height; rate of
growth
Tattoo marks- introduction of coloring
pigments in the layers of the skin by
multiple puncture.
Weight- not a good point of
identification for it is easily changed
from time to time.
Deformities- may be congenital or
acquired
Birth marks
Injuries leaving permanent results- e.g.
amputation, improper union of fractured
bones
Moles
Scar- a remaining mark after healing of
the wound.
Age of scar
Recently formedslightly elevated,
reddish or bluish in
color, and tender to
touch
Few weeks to two
months- scar has
inflammatory
redness, and it is
soft and sensitive
Two to six monthsbrownish or
coppery red, free
from contraction
and corrugation,
and soft

FROGLETS NOTES

Six months or
more- scar is white,
glistening,
contracted, and
tough

Anthropometry (Bertillon System)


- scheme utilizing anthropometrical measurement of the
human body as the basis of identification
Basis
1.
2.
3.

The human skeleton is unchangeable after


twentieth year.
It is impossible to find two human beings having
bones exactly alike.
The necessary measurement can easily be
taken.

Information included
1. Descriptive Data - color of hair, eyes
2. Body marks - moles, scars
3. Anthropometrical measurements
A. Body measurement
B. Measurement of head
C. Measurement of the limbs
Portrait Parle (spoken picture)
- verbal, accurate and picturesque description of
the person identified. Such information may be
given bybthe witness, relatives, or persons who
ate acquainted with the physical features of the
person to be identified
1. General impression
2. Age, sex
3. Race or color
4. Height
5. Weight
6. Built
7. Posture
8. Head
9. Hair
10. Face
11. Neck
12. Shoulder
13. Wrist
14. Hands
15. Fingers
16. Arms
17. Feet
Extrinsic Factors in Identification
1. Ornamentation
2. Personal belongings

10

By 4D2014-2015

3.
4.
5.
6.
7.

Summary of Legal Medicine


Book by Solis

Waering apparel
Foreign bodies
Identification by close friends and relatives
Identification record
Photographs

II. SCIENTIFIC METHODS OF IDENTIFICATION


A. Fingerprinting
B. Dental identication
C. Handwriting
D. Identification of skeleton
E. Determination of sex
F. Determination of Age
G. Identification of Blood
H. Identification of Hair and Fibers
A. Fingerprinting
considered to be the most valuable method of
Identification
the finger may be wounded or burned, but the whole
pattern with all its details will reappear when the
wound heals
1. There is no two identical fingerprints
2. Fingerprints are not changeable
Practical uses
1. Help establish identity in cases of dead bodies
2. Prints recoveres from crime scene associate person
3. Prints on file are useful for comparative purposes
4. Among illiterates, right thumbprint is recognized as
substitute for signature.
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. Plain method - bulbs of the last phalanges of the
fingers and thumb are pressed on
the surface of the
paper after
pressing them on ink
2. Rolled method - 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

FROGLETS NOTES
1. Real impression - impression of the finger bulbs with
the use of printing ink on the
surface of the paper
2. Chance impression - impresses by mere chance
without any intention to produce it
How to Get Fingerprint Impressions on Dead Bodies
- In case of fresh bodies, the fingers are
uncleanched and each one is inked individually
with the aid of small rubber roller.
- If the "floater" has been in the body if water for a
longer time and the friction ridges have
disappeared, the skin of the fingertips is cut
away. This area of the skin is placed in a small
labelled test tube containing formaldehyde
solution.
Types of Fingerprint Patterns
1. Arches - the ridgea go from one side of the
pattern to another, never turning back to make a
loop
A. Plain arches
B. Tented arches
2.

Loops - one or more ridges enter on either side,


recurves and terminate on the same side from
which it entered
A. Ulnar loop
B. Radial loop

3.

Whorls - patterns with two deltas and patterns


too irregular in form to classify
A. Simple whorl
B. Central pocket loop
C. Lateral pocket loop
D. Twin loop
E. Accidentals

Q: Can fingerprints be effaced?


A: No, as long as the dermis of the bulbs of the finger is not
completely destroyed, the fingerprints will always
remain unchanged and indestructible.
Q: Can fingerprints be forged?
A: There is considerable controversy as various
experiments could almost make an accurate
reproduction, still there is no case in record known or
have been written.
B. DENTAL IDENTIFICATION
1. The possibility of two persons to have the same
dentition is quite remote.

11

By 4D2014-2015

2.
3.
4.

Summary of Legal Medicine


Book by Solis

The enamel of the teeth is the hardest substance


in the body. It may outlast all other tissues.
After death, the greater the degree of tissue
deatruction, the greater is importance of the
dental characteristic.
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.

Causes of Unreliability of the Dental Records


1. The dentist may only concern himself with the
affected teeth and may not care to have a
detailed examination of the other teeth.
2. No uniformity in nomenclature in the charting of
teeth
3. Although there may be a law obligating dentists
to have a record of their patient, the law does not
mention the agency which will enforce it
4. Changes in the teeth which are not seen by the
dentist
C. HANDWRITING
- The handwriting of a person may be proved by a
witness who believes it to be the handwiting of
such person, and has seen the person write, or
has seen writing purporting to be his upon which
the witness has acted or been charged, and has
thus acquired knowledge of the handwriting of
such person.
The genuineness of any disputed writing may be
proven by any of the following ways
1. Acknowledgement of the alleged writer
2. Statement of the witness who saw the writing
3. Opinion of persons who are familiar with the
handwriting of the alleged writer
4. Opinion of an expert
Practical Uses of Handwriting Examination
1. Financial crime
2. Death inveatigation
3. Robberies
4. Kidnapping with ransom
5. Anonymous threatening letters
6. Falsification of documents
Bibliotics - science of handwriting analysis
Graphology - study of handwriting for the purpose of
determining the writer's personality,
character and aptitude.

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
forgers 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 Deoderleins bacillus.
4. Mans or Womans Blood- no method of
differentiating man and womans blood
5. Childs 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
humans
Thick
scales
protruding, do
not cover one
another
the

Summary of Legal Medicine


Book by Solis

same degree as
humans
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;

FROGLETS NOTES
3. The death of the partner is one of the causes of
dissolution of partnership agreement;
4. The death of either the principal or the agent is a mode
of extinguishment of agency;
5. The criminal liability of a person is extinguished by
death;
6. The civil case for claims which does not survive is
dismissed upon the death of the defendant.
Death
is the termination of life.
it is the complete cessation of all the vital functions
without possibility of resuscitation.
it is an irreversible loss of the properties of living matter.
an event that takes place at a precise time.
the ascertainment of death is a clinical and not a legal
problem.
Based on the Criterion Used in its Determination, death
may be:
1. Brain Death
Death occurs when there is deep irreversible coma,
absence of electrical brain activity and complete
cessation of all the vital functions without possibility of
resuscitation.
2. Cardio-Respiratory Death
Death occurs when there is a continuous and persistent
cessation of heart action and respiration.
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. 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, there is:
absence of spontaneous respiratory and cardiac
function, and because of the disease or condition which
caused, directly or indirectly, these functions to cease,
or because of the passage of time since these functions
ceased, attempts at resuscitation are considered
hopeless;
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, it appears that
further attempts at resuscitation or supportive
maintenance will not succeed.

15

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Death will have occurred when these conditions first


coincide. (Section 1, Chapter 378 of Kansas Statute)
Brain Death
1. According to Harvard Report of 1968, the following are
the characteristics of irreversible coma:
a. Unreceptivity and Unresponsibility
There is a total unawareness to externally applied
stimuli and inner need and complete unresponsiveness
b. No movements or breathing
Observation covering a period of at least l hour by
physicians is adequate to satisfy the criteria
c. No reflexes
Irreversible coma with abolition of central-nervous
system activity is evidenced in part by the absence of
elicitable reflexes.
The pupil will be fixed and dilated and will not respond to
a direct source of bright light.
Ocular movement (to head turning and to irrigation of the
ears with ice water) and blinking are absent.
There is no evidence of postural activity (decerebrate or
other).
Swallowing, yawning, vocalization are in abeyance.
Corneal and pharyngeal reflexes are absent.
As a rule, the stretch or tendon reflexes cannot be
elicited, i.e. tapping the tendons of the biceps, triceps
and pronator muscles, quadriceps and gastrocnemius
muscles with the reflex hammer elicits no contraction of
the respective muscles.
Plantar or noxious stimulation gives no response.
d. Flat electro-encephalogram
Of great confirmatory value is the flat or iso-electric
E.E.G. assuming that the electrodes have been properly
applied, that the apparatus is functioning normally, and
that the personnel in charge are competent.
Note: All of these tests shall be repeated at least 24
hours later with no change. It is emphasized that the
patient be declared dead before any effort is made to
take him off the respirator, if he is then on respirator.
2. In 1969, the Ad Hoc Committee of Human Transplantation
convened under the auspices of the Institute of Forensic
Sciences, Duquesne University School of Law adopted the
proposed criteriafor the determinationof death otherwise
known as
Philadelphia Protocol, and the following were considered:

FROGLETS NOTES
a. Lack of responsiveness to internal and external
environment;
b. Absence of spontaneous breathing movements for 3
minutes, in the absence of hypocarbia and while breathing
room air.
c. No muscular movements with generalized
flaccidity and no evidence of postural activity or shivering;
d. Reflexes and response:
d.1. Pupils fixed and dilated, non-reactive
stimuli;
d.2. Corneal reflexes absent;
d.3. Supra-orbital or other pressure
response absent (both pain response
and decerebrate posturing);
d.4. Absence of snucking or snouting
response;
d.5. No reflex response to upper airway
stimulation;
d.6. No reflex response to lower airway
stimulation;
d.7. No ocular response to ice water
stimulation of the inner ear;
d.8. No deep tendon reflexes;
d.9. No superficial reflexes;
d.10. No plantar responses.

to strong

e. Falling arterial pressure without support by drugs or


other means.
f. Iso-electric electro-encephalogram (in the absence of
hypothermia, anesthetic agents and drugs intoxication)
recorded spontaneously and during auditory and tactile
stimulation.
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.
Other Set of criteria to Establish Brain Death:
1. Mohandas and Chou (1971) standards of Brain Death
accepted at the University of Minnesota Science
Center.
2. The Ottawa General Hospital (1970) guidelines for the criteria of cerebral death.
3. In France (1968) - the Council of Ministers published a
decree which adopted the official definition of death on
recommendation of the French Academy of Medicine.
Note: The use of the criteria of brain death may only be
applied to those persons who are potential organ donors.

16

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

A. KINDS OF DEATH
1. SOMATIC DEATH OR CLINICAL DEATH
state of the body in which there is complete, persistent and
continuous cessation of the vital functions of the brain,
heart and lungs which maintain life and death;
hardly impossible to determine the exact time of death;
immediately after death,
- the face and lips become pale
- the muscles become flaccid
- the sphincters are relax
- the lower jaw tends to drop
- the eyelids remain open
- pupils dilate
- skin loses its elasticity
- body fluids tend to gravitate to the most
dependent portions of the body
- body heat gradually assumes the
temperature of the surroundings
2. MOLECULAR OR CELLULAR DEATH
After cessation of the vital functions, there is still animal life
among individual cells.
About 3-6 hours later, there is death of individual cells
known as molecular or cellular death
Exact occurrence cannot be definitely determined due to
several factors
3. 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,
external stimulus or other forms of influence.
It may arise especially hysteria, uremia, catalepsy and
electric shock
B. SIGNS OF DEATH
1. 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. Examination of the Heart
a.1. Palpation of the Pulse- may be made
at
the
region of the wrist or at the
neck
a.2. Auscultation for the heart sound at
the
precordial Area - the rhythmic
contraction
and
relaxation of the heart is audible through the
stethoscope. Heart sound can be
audible
during life even without the aid of a stethoscope by
placing the
ear at the precordial area

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.
(c) Pericardial effusion.

The fingers are spread wide and the finger webs are
viewed through a strong light.
Living: the finger webs appear red
Dead: yellow

a.3. Flouroscopic Examination- will


reveal
the shadow of the heart in its rhythmic contraction and
relaxation.
The shadow may be enlarged and the
excursion made less visible due to
pericardial effusion.

b.6. Application of Heat on the Shin


If heated material is applied on the skin
Living: blister formation, congestion, and
reactions of the injured area will be observed.
Dead: will not produce true blister, no
sign of congestion, or other vital reactions.

a.4. By the Use of Electrocardiograph


This is the best method of determining
action but quite
impractical

heart

b. Examination of the Peripheral Circulation:


b.1. Magnus Test:
A ligature is applied around the base of a finger with
moderate tightness.
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.
If the ligature is applied to the finger of a dead man,
there is no such change in color.
b.2. Opening of Small Artery:
Living: the blood escapes in jerk and at a distance.
Dead: the blood vessel is white and there is no
jerking escape of blood but may only ooze towards
the nearby skin.
When bigger arteries are cut, blood may flow
without pressure continuously.
b.3. Icard's Test
This consists of the injection of a
solution of fluorescein subcutaneously.
If circulation is still present, the dye will spread all
over the body and the whole skin will have a
gleenish-yellow discoloration due to flourescein.
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.
b.4. Pressure on the Fingernails:
lf pressure is applied on the fingernails
intermittently, there will be a zone of
paleness
at the site of the application of pressure which become
livid on release.
There will be no such change of color if the test is
applied to a dead man.
b.5. Diaphanous Test

17

By 4D2014-2015

other vital

b.7. Palpation of the Radial Pulse With Fingers


Living: will feel the rhythmic pulsation of the vessel due
to the flow of blood.
Dead: No such pulsation will be observed
b.8. Dropping of Melted Wax
Melted sealing wax is dropped on the breast of a person.
Dead: there will be no inflammatory edema
at the neighborhood of the dropped melted
wax.
2. CESSATION OF RESPIRATION
must be continuous and persistent.
In the following conditions there may be suspension of
respiration without death ensuing:
a. In a purely voluntary act, as in divers, swimmers, etc. but
it cannot be longer than two minutes;
b. In some peculiar condition of respiration, like CheyneStokes respiration, but the apneic interval cannot be longer
than fifteen to twenty seconds;
c. In cases of apparent drowning;
d. Newly-born infants may not breathe for a time after birth
and may commence only after stimulation or
spontaneously later.
INTERNAL HYPOSTASIS IN VISCERAL ORGANS
Post-mortem lividity occurs in internal organs.
Post Mortem Lividity
Staining in organs is
irregular and occurs in most
dependent parts.
Dull and lustreless mucous
membrane
Imflammatory exudates is
not seen, areas of redness
alternating with pale areas
found in a hollow viscus.

Simple Congestion
Generally uniform and
found all over the body.
Not so.
Not seen in simple
congestion.

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

3. Liquefaction of the Soft Tissues


Post Mortem
Lividity

Haemorrhage of
scurvy
Presence can be
revealed in history.

Skin lesion
appears after
death.
Present in the
most dependent
portions of the
body.

Skin lesion present


before death
May be found all
over the skin and
organs.

Phosphorus
poisoning
Presence can be
revealed in
history.
Skin lesion
present before
death
May be found all
over the skin and
organs.

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, Magnesium as
a result of diffusion, Potassium increases owing to
diffusion.

State of the Body before Death: An emaciated person at


the time of death will decompose slower than a wellnourished individual. Skinny persons have more tendency
to decompose.

AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER


DEATH
After Death, proteolytic, glycolytic and lipolytic ferments of
glandular tissues continue to act which lead to the
autodigestion of organs. 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.
Their early appearance is observed in the parenchyatous
and glandular tissues.

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. Changes in the color of the tissue
2. Evolution of Gasses in the tissues
Effects of the Pressure of Gasses of Putrefaction
Displacement of Blood, Bloating of the Body, Fluid Coming
out of both nostrils and mouth, Extrusion of the Fetus in a
gravid uters, floating of the body.

18

By 4D2014-2015

Time elapsed between death and burial and


environment of the body.
Effect of Coffin: the use of a coffin will delay
decomposition if it is airtight and hard.
Clothing and Any other Coverings on the Body when
buried: Clothings retard decomposition because it affords
protection from insects and aids adipocere formation.
Depth at which Body is buried: the greater the depth the
body is buried the better the preservation.
Condition and type of soil: Dry, arid and sandy soil
promotes mummification.
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.
Mass Grave: There is relatively rapid decomposition of the
bodies
Trauma on the Body:
CHRONOLOGICAL SEQUENCE OF THE
PUTREFACTIVE CHANGES OCCURING IN
TEMPERATE REGIONS

FROGLETS NOTES
Greenish Discoloration over the iliac fosae.
Eyeballs are soft and yielding.
Greenish discoloration spreading over the
while abdomen, external genitals and other
parts of the body. Frothy blood from the moth
and nostrils.
Abdomen distended with gas. Cornea fallen
in and concave. Purplish red streaks of veins
prominent on the extremities. Sphincters
relaxed. Nails firm.
Body greenish-brown. Blisters forming all
over the body. Skin peels off. Features
unrecognizable. Scrotum distended. Body
swollen up owing to distention. Maggots
found on the body. Nails and hair loose and
easily detached.
Soft parts changes into a thick, 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.

19

By 4D2014-2015

4 wks
6 8 wks

Factors Influencing the Floating of the Body in Water

Sex: Women float sooner than men.


Conditions of the body: Stout persons float quicker.
Season of the Year: The moist hot air of summer is very
favourable for putrefaction.
Water: Dead body floats in a shallow and stagnant water of
creeks or pond sooner than in deep water in running
streams.
External Influence: the presence of heavy-wearing
apparel or addition weight in the pockets or attached to the
body delays floating.
Order of putrefaction when body is in water: Face, neck
and sternum; shoulders; arms; abdomen; legs.
INFLUENCE OF BACTERIA IN DECOMPOSITION

72 hrs
1 wk
2 wks
1 mo.

CHRONOLOGICAL SEQUENCE OF THE


PUTREFACTIVE CHANGES WHEN THE BODY HAS
BEEN SUBMERGED IN WATER
Very little change if water is cold. Rigor mortis
may persist.
The skin on the hands and feet became
sodden and bleached. The face appears
softened and has a faded white color.

1 2 wks

Age: Bodies of fully-developed and well-nourished newlyborn infants float rapidly.

CHRONOLOGICAL SEQUENCE OF THE


PUTREFACTIVE CHANGES OCCURING IN TROPICAL
REGIONS
Rigor mortis present all over. Hypostasis well
developed and fixed. Greenish discoloration
showing over the castum.
Rigor mortis absent all over. Green
discoloration over whole abdomen and
spreading to chest. Abdomen distended with
gasses.
Ova of flies seen. Trunk bloated. Face
discoloured. Blisters present. Moving maggots
seen.
Whole body grossly swollen and disfigured.
Hair and nails loose. Tissues soft and
discoloured.
Soft viscera putrefied.
Only more resistant viscera distinguishable.
Soft tissues largely gone.
Body skeletonised.

Face swollen and red. Greenish discoloration


on the eyelids, lips, neck and sternum. Skin
of the hands and feet wrinkled. Upper surface
of brain greenish in color.
Skin wrinkled. Srotum and penis distended
with gas. Nails and hair still intact. Lungs
emphysematous and covered the heart.
Abdomen distended, skin of hands and feet
come off with nails like a glove.

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. Aerobic activities are present in the
early stages of decomposition, later on activities of the
anaerobes are the most prominent with the production of
gasses. Softening of tissues is the result of bacterial action,
proteolytic and autolytic ferments.
The microorganism that plays an important role in
decomposition is Clostridium Welchii. It grows in the
parenchyatous organs and is responsible for the
disintegration of cytoplasm, destruction of nuclei and
generation of gasses in the cells.
Other destructive agents during decomposition include flies
and maggots, reptiles, rodents, other mammals, fishes and
crabs, and molds.
Special Modification of Putrefaction

FROGLETS NOTES
I.

Mummification: the dehydration of the whole body


which results in the shivering and preservation of the
body. Mummification usually happens in warm
countries where evaporation of body fluids takes place
earlier and faster than decomposition.

Kinds of mummification:
Natural: the body will become dehydrated and mummified
due to the forces of nature.
Artificial: (1) acceleration of the evaporation of the tissue
fluids of the body before actual onset of decomposition; (2)
addition of preservatives to inhibit decomposition.
II.

Saponification or Adipocere Formation: a condition


wherein the fatty tissues of the body are transformed
to soft brownish-white substance known as adipocere.

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.
Presence of live fleas in the clothing (drowning cases): a
flea can survive for approximately 24hrs submerged in
water. Fleas recovered, usually from the clothing of the
victim, is observed if it still living to approximate the time
when said was submerged in water.
Amount of urine in the bladder: the amount of urine in the
urinary bladder may indicate the time of death when taken
into consideration, he was last seen voiding his urine.
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.

State of Health before Death, Time interval between death


and burial, effect of a coffin, presence of clothing, type of
soil, access of air to the body after burial, mass grave.

Presence or absence of soft tissues in skeletal remains:


under ordinary conditions, the soft tissues of the body may
disappear 1-2yrs after burial.

III. 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.

Condition of the Bones: if all the soft tissues have already


disappeared from the skeletal remains, the degree of
erosion of the epiphyseal ends of long bones, pulverization
of flat bones and diminution of weight due to the loss of
animal matter may be the basis of the approximation.

Duration of Death
Presence of Rigor Mortis: in warm countries, rigor mortis
sets in from 2-3 hrs after death. It si fully developed in the
body after 12 hrs. It may last from 18 36 hrs and its
disappearance is concomitant with the onset of
putrefaction.
Presence of Post-mortem lividity: usually develops 3-6 hrs
after death. 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.
Onset of Decomposition: In tropical areas, decomposition
is early and the average time is 24-48hrs after death.

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.
Entomology of the Cadaver: to approximate the time of
death, the presence of flies in the cadaver is sometimes
used.
Stage of digestion in the stomach: it normally takes 3-4 hrs
for the stomach to evacuate its contents after a meal. The

20

By 4D2014-2015

Disputable Presumption: not heard from for 7


years = DEAD
o Dead for all purposes. EXCEPT:
SUCCESSION
Absentee shall not be presumed dead for the
purpose of opening his succession till after
absence of 10 years.
o If he disappeared after 75 years old:
Absence of 5 years SUFFICIENT to
open succession.

Article 391 Civil Code

Presumed DEAD FOR ALL PURPOSES:

FROGLETS NOTES
o

o
o

Lost on board a vessel lost during sea


voyage, missing airplane, not been
heard of for 4 years since loss of
vessel or airplane.
Person in armed forces who has taken
part in war, missing for 4 years
Person In danger of death other
circumstances and his existence not
known 4 years.

other, shall prove the same; in the absence of proof, it is


presumed that they died at the same time and there shall
be no transmission of rights from one to the other.
CHAPTER VII
SPECIAL DEATHS
I.

1.
2.
3.
4.

If absentee appears or without appearing his


existence is proved, he shall recover his property in the
condition in which it may be found, and the price of any
property that may have been alienated or the property
acquired therewith; but he cannot claim either fruits or
rents.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Rule 131 Section 5(jj) Rules of Court


When 2 persons die in same calamity, such as:
Wreck
Battle
Conflagration

1.
2.
3.
4.

5.

Both UNDER 15: Older presumed survived


Both ABOVE 60: Younger presumed
survived
One UNDER 15, Other ABOVE 60: UNDER
15 presumed survived
One OVER 15, Other UNDER 60,
a. Different Sex: Male presumed
survived
b. Same Sex: Older
One UNDER 15, or ABOVE 60, the other
BETWEEN those ages: latter presumed
survived

Article 43, Civil Code:


If there is a doubt, as between 2 or more persons
who are called to succeed each other, as to which of them
died first, whoever alleges the death of one prior to 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; there are no particular


circumstances from which it can be inferred, the
survivorship is presumed from the probabilities resulting
from the strength and age of the sexes, according to the
following:

JUDICIAL DEATH
METHODS

Article 392 Civil Code

Summary of Legal Medicine


Book by Solis

II.

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.
TYPES:
1.
2.

Active Euthanasia
Passive Euthanasia
a. Orthothanasia
b. Dysthanasia

Ways of Performing Euthanasia


1.
2.
3.
4.

Administration of a lethal dose of poison


Overdosage of sedatives, hypnotics, other
pain relieving drugs
Injection of air into bloodstream
Application of strong electric currents

FROGLETS NOTES
5.

Failure to institute the necessary


management procedure which is essential
to preserve the life of the patient.

Ways of Performing Euthanasia


1.
2.
3.

Patient himself
The physician, 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, then it is murder.
Treachery is inherent to the act of poisoning
and treachery qualifies it to murder.

III. SUICIDE
Psychological Classification of Suicide
1. First degree deliberate, planned,
premeditated, self-murder
2. Second degree impulsive,
unplanned, under great provocation or
mitigating circumstances
3. Third degree sometimes called
accidental suicide. This occurs when a
person puts his or her life into jeopardy
by voluntary self injury
4. 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.
5. Self-destruction due to negligence
6. Justifiable suicide self- destruction
action of a person with terminal illness.
Evidence that will infer death is suicidal:
1.
2.
3.

4.
5.
6.

22

Summary of Legal Medicine


Book by Solis

History of depression, unresolved


personal problem, mental disease
Previous attempt of selfdestruction
If committed by infliction of
physical injuries, the wounds are
located in areas accessible to the
hand, vital parts of the body and
usually solitary.
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.

Evidence which will rule out


homicide, murder, parricide, and
other manner of violent death.

CHAPTER VIII
DISPOSAL OF THE DEAD BODY
Persons Charged with Duty of Burial:
1. If married: surviving spouse if possesses means to pay
the necessary expenses.
2. Unmarried or child: nearest kin if they be adults and
within the Philippines and in possession of means to pay
the necessary expenses.
3. Unmarried or no kin left with means: municipal
authorities
*Shall perform such duty within 48 hours after death, if able
to do so.
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, custody of which will remain to
local board of health or municipal council until buried.
Right of custody means possession, 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. The right of
possession of a corpse is equivalent to ownership and
unlawful interference is an actionable wrong.
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, such provision will prevail over the provisions of
the Administrative Code.
Methods of Disposal of the Dead Body
1. Embalming
- Artificial way of preserving body be injecting
formalin and perchloride of mercury or arsenic in the
common arteries and the femoral arteries.
2. Burial or Inhumation
- Body must be buried within 48 hours after death
except when required for legal investigation or authorized

FROGLETS NOTES
by local health authorities or when embalmed (impliedly
allowed). After 48 hours, new permit is needed. If with
communicable disease, within 12 hours after death unless
directed otherwise by local board of health.
In Philippines, body needs to be buried within 24
hours because of the climatic condition.

Death Certificate necessary before burial except


in cases of emergency. Primary duty of physician
to furnish if available. If not, local health officer,
mayor, the secretary or of a councilor. Order is
successive and exclusive.

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.
(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.
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.

- It must be forwarded within 48 hours after death.

(b) The burial of remains in city or municipal burial grounds


shall not be prohibited on account of race, nationality,
religion or political persuasion.

* 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. Permission from the
provincial fiscal or mayor is necessary if death due to
violence or crime.

(c) Except when required by legal investigation or when


permitted by the local health authority, no unembalmed
remains shall remain unburied longer than 48 hours after
death.

Burial and transfer Permits


Municipal secretaries, in the capacity of
secretaries of municipal boards of health or as clerks to
municipal councils as the case may be, shall issue burial or
transfer permits upon the presentation of the death
certificate. Copy of death certificate shall accompany
transfer permit if body will be transferred from one
municipality to another. Those bodies with dangerous
communicable disease shall not be carried from place to
place except for burial or cremation. It is the duty of the
local health authorities to cause such body to be thoroughly
disinfected before being prepared for burial. Only adult
members of the family may be permitted to attend the
burial.
Burial permit (death certificate) must be
presented before burial.
The Law Penalizes Desecration of Burial Premises
(Sec. 2695, Revised Administrative Code)
Burial Grounds Requirements (PD 856, 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.

23

By 4D2014-2015

Study Articles 305, 306, 307, 309 and 2219 of the NCC
as well as Articles 132 and 133 of the RPC.
Limitations to the Funeral Rites
a. Will of the deceased
b. Burial of the person sentenced to death must not be held
with pomp (Art. 85, RPC)
c. Restrictions as to funeral in cases of deaths due to
communicable disease
When the cause of death is a dangerous
communicable disease, the remains shall be buried within
12 hours after death. 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.
3. Disposal of Dead Body to the Sea
Allowed when death is not due to dangerous
communicable disease. A special permit needs to be
secured from officers authorized to issue permits.
4. Cremation
Pulverization of the body into ashes by the
application of heat. Body must first be identified and there
must be a permit for cremation.
When not granted:

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

1. If deceased left a written direction that he will not be


cremated

Persons who can grants permission to used body parts of


deceased:

2. Identity has not yet been definitely ascertained

a. Before death:

3. Further inquiry needed to cause of death


5. 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.
Study RA 349 as amended by RA 1056 (Donations of
Human Body Parts)
Donation of Human Organs for Medical, Surgical and
Scientific purposes Any person may donate an organ or
any part of his body to a person, a physician, a scientist, a
hospital or a scientific institution upon his death for
transplant, medical, or research purposes subject to the
following requirements:
(a) The donation shall be authorized in writing by the donor
specifying the recipient, the organ or part of his body to be
donated and the specific purpose for which it will be
utilized.
(b) A married person may make such donation without the
consent of his spouse.
(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.
(d) If the deceased has no next of kin and his remains are
in the custody of an accredited hospital, 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.
(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, notwithstanding the provisions of
the Civil Code of the Philippines on matters of donation. A
copy of the written authorization shall be forwarded to the
Secretary.
(f) Any authorization granted in accordance with the
requirements of this Section is binding to the executors,
administrators, and members of the family of the deceased.

24

By 4D2014-2015

1. Deceased during his lifetime


2. If minor, guardian with the approval of the
court or by the legitimate father or mother. Married woman
can give consent without husbands consent.
b. After death:
1. Nearest relative
2. Head of hospital or institution having custody
in the absence of relatives
Persons permitted to detach body parts:
1. License physician or surgeon
2. Known scientist
banks.

3. Medical or scientific institutions including eye

Requirements:
1. Must be in writing
2. Specify the person/institution granted the
authorization
3. Specify the organ/part to be detached
persons

4. Signed by the grantor and 2 disinterested


5. 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.
Exhumation
The deceased buried may be raised or
disinterred upon lawful order from fiscals, court and any
entity vested with authority to investigate. It must be

FROGLETS NOTES
identified by relatives, friends or by marks on the body.
Physician must describe the coffin, clothing and degree of
decomposition before stating the actual disease or violence
in his report. Even members of NBI are required to get
permit from the Director of Health for exhumation.
Person died with for a cause other than
dangerous communicable disease may be disinterred after
3 years of being buried or in special cases, shorter time
when in the opinion of Director of Health, the public health
will not be endangered. It will be immediately disinfected
and inclosed in a coffin, case or box.
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.
(b) Permission to disinter remains of person who died of
dangerous communicable diseases may be granted after a
burial period of five years.
(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, subject to the
approval of the Regional Director concerned or his duly
authorized representative.
(d) In all cases of disinterment, the remains shall be
disinfected and places in a durable and sealed container
prior to their final disposal.

- smears from vaginal canal and blood for alcohol


determination
d. Recover foreign bodies
- Metalic fragment or whole slug for ballistic
examinations
- Operative sponge, medical instrument to prove
medical negligence
2. If the next of kin refuses to give consent for exhumation
autopsy, a petition in court must be done.
How long can exhumation be done after interment:
Sec 92 Code of Sanitation, Disinterment Requirements:
1.
2.
3.

4.

According to Art 305 of the Civil Code, no human


remains shall be retained, interred, disposed of
or exhumed without the consent of: spouse,
descendants of the nearest degree, ascendants
of the nearest degree, brothers and sisters

Sec 1098 Revised Administrative Code Shipment


of remains at sea - 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. The outside box containing the
remains shall be plainly marked so as to show
the name, age, nationality, of the deceased
person, the cause of death, the destination and
remains.

If dead body is a subject matter of criminal


investigation, it may be exhumed anytime.

If the dead body is a subject matter of criminal


investigation, it may be exhumed anytime

1. 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. Reasons could be:
a. Determine cause of death
b. Determine identity
c. Recover organs or tissues for further
examination for:
- toxicology analysis
- histopathological examination

25

By 4D2014-2015

Permission to disinter remains of persons who


died of non - dangerous communicable disease
may be granted after burial period of 3 years
If death is due to a communicable dangerous
disease, permission may be granted after a burial
period of 5 years
Shorter period may be granted in special cases,
subject to the approval of Regional Director
(Director of Health) concerned or his duly
authorized representative.
In all cases of disinterment, the remains shall be
disinfected and placed in a sealed container prior
to disposal.

Read article 308 of the NCC

Summary of Legal Medicine


Book by Solis

FROGLETS NOTES
Requirements to be satisfied in exhumation:
a.
b.

Duration of interment as required


Exhumation permit to be provided by the Director
of Health
Compliance of sanitary requirements, such that
the body or remains, 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.

c.

Procedure in medico - legal exhumations


a.

b.

c.

There must be formal request from any law


enforcement agency to make an investigation
addressed to any person authorized to perform
medico - legal investigation. The request must
mention the name of the deceased, place and
date of interment suspicion as to the cause of
death etc. 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, aside from issuing the


necessary permit, shall also infor the local health
officer to assist the physician in the exhumation to
ensure that public health will not be prejudiced.
d.
e.
f.

During exhumation, the grave must be properly


identified by the person who was present when
the body was interred
During disinterment, care and diligence must be
observed to avoid destruction, deformity,
contamination or such other effects
After opening the coffin, the body must be viewed
by any or more persons who can identify the
deceased

26

By 4D2014-2015

g.
h.

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.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

The name of the deceased person and


circumstances
Purpose of exhumation
Name address and designation of the requesting
party
Date, 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.
b.

identity of the deceased - often in disaster victims


refusal of the next-of-kin to give consent or to
cooperate in the exhumation-autopsy - 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); Delayed
(blunt object causing contusion)

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

c.

Causes of Physical injuries:


a.
b.
c.
d.
e.
f.
g.

Physical violence
Heat or cold
Electrical energy
Chemical energy
Radiation by radio-active substances
Change of atmospheric pressure (barotrauma)
Infection

A. PI by Physical Violence

dolor - pain on account of involvement of sensory


nerve
d. loss of function - on account of trauma, tissue
may not be able to function normally
Vital reaction differentiates an ante-mortem from postmortem injury
In the ff instances, vital reactions or changes may not be
observes even if injury was inflicted during life:
a.
b.

Effect is the production of wound.


Wound is the solution of the natural continuity of any tissue
of the living body. It is the disruption of the anatomic
integrity of tissue in the body.
Effect of physical violence may not always result to
production of wound but wound is always an effect of
physical violence.
Physics of wound production:

If PI were inflicted during agonal state of a living


person - 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.g. deaths
due to sudden coronary occlusion

Classification of wounds:
1.

As to severity:
a. Mortal wound - 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. Velocity component is the important factor.
Time: shorter period used for transfer of energy,
greater likelihood of producing damage.
Area of transfer: The larger the area of contract
between the force applied on the body the lesser
is the damage to the body.
Other factors: the less elastic and plastic the
tissue, the greater the likelihood that a laceration
will result. Elasticity and plasticity refer to the
ability of a tissue to return to its normal size and
shape after being deformed by pressure.

b.

2.

Kind of instrument used:


a. blunt instrument (contusion, hematoma,
lacerated wound)
b. sharp instrument: sharp-edged instrument
(incised wound) sharp-pointed (puncture
wound) sharp - edged and sharp - pointed
(stab wound)
c. tearing force (lacerated wound)
d. change
of
atmospheric
pressure
(barotrauma)
e. heat or cold (frostbite, burns or scald)
f. chemical explosion (gunshot or shrapnel
wound)

3.

As to manner of infliction:

Vital Reaction: sum total of all reactions of tissue or organ


to trauma.
Ff are common reactions of a living tissue to trauma:
a.
b.

rubor - redness or congestion of the area due to


an increase of blood supply as a part of
reparative machine
calor - 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, liver, spleen and
intestine
Non - mortal wound - not capable of causing
death immediately

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 persons 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
workmans 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 victims 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

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

makes the crime less serious physical injuries (U.S. v.


Trinidad, 4 Phil. 152).

There must be proof as to the period of medical


attendance. In the absence of such proof of medical
attendance or incapacity, although the wound actually
healed in more than 30 days, the crime committed is only
slight physical injuries (People v. Penesa, 81 Phil. 398)

The Crime of less serious physical injuries may


be qualified and a fine or a higher penalty imposed when:
a.
b.
c.
d.

There is a manifest intent to insult or offend


the injured person;
There are circumstances adding ignominy to
the offense;
The victim is the offenders parents,
ascendants, guardian, curators or teachers;
or
The victim is a person of rank or person in
authority, provided that the crime is not
direct assault.

(pp.252-268)
In the Description of a Stab Wound, the following must be
included:
a.
b.
c.
d.
e.
f.
g.
h.

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, Homicidal or Accidental:


a.

Suicidal Evidences showing that the stab


wound is suicidal:
Located over vital parts
of the body
It is usually solitary. If
multiple, located on one
part of the body
If located on covered
parts of the body, the
clothing is not involved

b. Homicidal stabbing with homicidal intent is the most


common
Characteristics:
1.
2.
3.
4.

5.

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
- 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.
c.
d.
e.

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, 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, 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

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- three-cornered skin defect
The most common immediate cause of deathhemorrhage
Accidental stab wounds are rare

4. 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, needle, nail, spear, pointed
stick, thorn, fang of animal, 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.
b.
c.
d.
e.
f.
g.
h.

1.

a. Poison dart- cyanide or nicotine


b. Fish spines
c. Dog bites with hydrophobia virus
d. Injection of air and poison as a way of
euthanasia
5. Lacerated Wound (Tear, Rupture, Stretch, Putok)

2.
3.

The opening on the skin is very small and may


become unnoticeable because of clotted blood
and elasticity of the skin. The wound is much
deeper than it is wide.
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.
c.
d.

It is multiple and usually located on


different parts of the body
Deep
Defense wounds on the victim
Disturbance of the crime scene- 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. 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, iron bar, fist blow, stone, butt
of firearm, 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.
b.
c.
d.
e.
f.
g.
h.

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, like scalp, malar region on the face, front
part of the leg, 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

FROGLETS NOTES
Classification of lacerated wounds:
a. Splitting caused by crushing of the skin between
two hard objects
- Best seen in laceration of the
scalp, cut eyebrow of boxer,
laceration of the chin of
motorcyclist
b. Overstretching of the skin
- When pressure is applied on one
side of the bone, the skin over the
area will be stretched up to a
breaking point to cause laceration
and exposure of the fractured
bone
- In avulsion, the edges of the
remaining tissue is that of
laceration
c. Grinding Compression
- Weight and grinding movement
may cause separation of the skin
d. Tearing
- Produced by semi-sharp-edged
instrument which causes irregular
edges on the would
- Hatchet and choppers

-Healing is faster

- Healing is delayed

-Scar is linear or spindleshaped

- Scar is irregular

-Caused by a sharp-edged
instrument

- caused by a blunt
instrument

Gaping of Wound:

The separation of the edges especially in deep wound may


be due to the following:
1.

Mechanical stretching or dilatation


- Presence of a mechanical device
on the edges to prevent
coaptation will cause separation

2.

Loss of Tissue
- Separation of edges of a wound
may be on account of loss of
tissue bridging them. The loss of
tissue may be due to:
i. Destruction by pressure,
infection, cell lysis, burning or
chemical reaction
ii. Avulsion or physical or
mechanical
stretching
resulting to separation of a
portion of the tissue
iii. Trimming of the edges

3.

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. This is called
cleavage direction or lines of
cleavage of the skin.
- 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, 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;


regular; well-defined

- Edges are roughly cut;


irregular; ill-defined

-No swelling or contusions


around the incised wound

- There is swelling and


contusion around the
lacerated wound

-Extremities of the wound


are sharp or may be round
or contused

- Extremities of the wound


are ill-defined and irregular

-Examination by means of a
magnifying lens shows that
the hair bulbs are cut

- Examination with a
magnifying lens shows that
the hair bulbs are preserved

33

Summary of Legal Medicine


Book by Solis

By 4D2014-2015

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, 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, temperature and touch
It acts as thermo-regulator, storage of water,
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, contusion, dermal
manifestation of certain diseases
Burns in children and old age persons,
involvement of more than 70% of the body
surface- fatal
Estimation as to how much of the body surface
involved, 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.

blood:

Hemorrhage
a. Hemorrhage may influence the severity of
wound by:
a.1. Loss of blood incompatible with

Blood constitutes about 1/20


of the body weight of an adult
By volume, 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.2. 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.
Hemopericardium may cause
embarrassment of the
contraction of the heart.
Hemorrhage into the chest
cavity may cause diminution
of the respiratory output with
subsequent anoxia
a.3. Hemorrhage may cause
mechanical barriers to the function of
organs:

Hemorrhage into the tracheobronchial lumina can cause


asphyxia

FROGLETS NOTES
b.

Cause of Hemorrhage:
b.1. Trauma:

Destruction of the blood


vessel wall or increase
permeability of its wall due to
external force
b.2. 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. 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. Organs Involved

Trauma on the vital organs of the body are


always serious
Crushing wounds of the heart, brain or longs are
almost fatal

4. Shock

May occur with or without violence


Slight blow on genitalia, slight burns in children or
old persons, or slight violence on the head or
neck may cause severe shock
But violent traumas to healthy, strong persons
may not produce shock

5. 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. Bacterial:
- Tetanus
- Pathogenic microorganism
b. Viral:
- Hydrophobia
- Hepatitis
c. Foreign body:
- Bullet
- Glass fragments
- Shrapnel
- Gauze or rubber drain
d. Chemical:
- Cyanide

FROGLETS NOTES
- Nicotine

b. Tourniquette above the site of the wound

e. Toxin

Summary of Legal Medicine


Book by Solis

c. Placing ice on the bite site


d. Sucking the wound to drain venom

Snake Venom
o Characterized
as
two
punctured wounds at the
center of the reddened
affected area

e. Administration of anti-snake venom serum

Scorpion Venom
o Has neurotoxic, 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,
urticarial rash, abdominal
pain, dilated pupils, paleness
and labored breathing

Snake venom toxicity will depend on:


a. Potency of venom injected
b. The amount of venom depends on the season
of the year and the length of time the
snake has eaten. If a snake has just killed his
prey, the toxic content is smaller
c. Size of Patient
d. The immediate treatment instituted

Snake venoms are of two principal classes:


a. Neurotoxic - primarily paralyzes the respiratory
and cardiac center of the
brain. May cause nausea,
vomiting, ascending
paralysis, coma,
convulsion, and cardiac
and respiratory arrest.
b. Hematoxic - affects particularly the blood. The
manifestations are pain and
swelling of the affected
area, intravascular
hemolysis, abdominal pain,
nausea, vomiting, petechial
hemorrhage on the gum,
pulmonary and cardiac
edema.

Emergency treatment may be:


a. Incision of the wound to promote more
external hemorrhage to
drain the venom

36

By 4D2014-2015

6. Absence of medical or surgical intervention:

A wound may not be fatal, but because of


neglect in its management it may become
serious or fatal

Fatal Effect of Wounds:


1. Wound may be directly fatal by reason of:
a. Hemorrhage

Incised wound on carotid artery without


surgical intervention is fatal

b. 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

FROGLETS NOTES
c. Shock

Summary of Legal Medicine


Book by Solis

2.

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.

Changes where a
definite
pathological
condition
was
present before the
injury
Ex: A person
suffering from
tumor or cyst and
was stabbed by
someone. The stab
is not capable of
producing death
ordinarily. The
person may die of
the pathological
condition and the
accused is liable
for his death

4.

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. Wound may be indirectly fatal by reason of:


a. Secondary hemorrhage following sepsis

On account of infection that sets in,


deeper tissues are involved

b. Specific Infection

Pathogenic microorganisms may


develop and multiply in the wound
causing septicemia, bacteremia, or
toxemia

c. Scarring Effect

Chronic gonorrheal infection may


cause stricture or urethra

d. Secondary Shock
Nature or death due to secondary shock
-

A person may have recovered


from the immediate effects of the
trauma or violence, but may later
die of its secondary effects or
changes
These changes may be classified
as follows:
1.

37

By 4D2014-2015

Changes
whose
natural sequence
are direct and
obvious
Ex: Septicimia,
tetanus or
complications
arising from
wounds

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.
The degree and nature of hemorrhage
depends upon the size, kind and location
of the blood vessel cut.
Kinds of Hemorrhage:

Complication of trauma or injury:


1.

Shock

The disturbance of fluid balance


resulting to peripheral deficiency which
is manifested by the decreased volume
of blood, reduced volume of flow,
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. Injury to the receptive
nervous system
b. Anoxemia reduction of
effective volume of
oxygen
carrying
capacity of the blood
c. Endothelial
damage,
thus increasing capillary
permeability

3.

a.

Primary Hemorrhage
It is the bleeding which
occurs immediately after
the traumatic injury of
the blood vessel

b.

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, growth and
development of microorganisms at the site
of the injury
How injury or trauma acquires infections:
a.
b.

Kinds of Shock:
a.

b.

2.

Delayed or Secondary Shock


Patient shows sign of general
collapse which develop some
time after the infliction of
injury

Hemorrhage

38

c.

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.

e.

4.

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,
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

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.

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.
b.
c.

Connective tissues
Blood forming tissues
Surface epithelium of the skin

Those having no power or limited capacity to


regenerate:
a.
b.
c.

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, 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, age of person, degree of rest or
immobilization and nature of the injury.
2. Kinds of Healing Wounds

Healing of Wounds

1.

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, the
less capacity for regeneration

39

By 4D2014-2015

a. Healing by Primary (First) Intention


It takes place when there is minimal tissue loss, more
approximation of the edges and without significant
bacterial contamination. Within 24 hours after the injury,
there is an acute neutrophilic response and scab will be
formed due to dehydration of the surface clot. After
three days, microphages and fribroblasts will appear.
Collagen fibers will bridge the raw area and
differentiated surface cells begin to proliferate to cover
the exposed area. The normal state of the area may

FROGLETS NOTES
return after a lapse of one month with or without the
formation of a scar.

cuts, hair and other foreign bodies in the scene; (c)


witnesses to the incident; (d) wounding instrument;
(e) photography, sketching or accurate description of
the scene of the crime for preservation

b. Healing by Secondary Intention


It take place when the injury causes more extensive
loss of cells and tissues. Inflammatory reaction is more
intense and granulation tissue growth bears all the
responsibility for its closure. Production of a large scar
and greater loss of skin appendages (hair, sweat and
sebaceous glands) and slower reparative process may
occur.
c. Aberrated Healing Process
In some instances, 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" - It may prevent the closing of wound and
can be remedied by excision or cautery.
(2) Keloid Formation - It is the a large bulging tumorous
scar produced by an abnormal amount of collagen in the
connective tissue.
(3) Stricture - It is the contraction of the fibrous tissue of
the scar formed.
(4) Fistula or Sinus Formation - 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. It may remain for a lone time unless the
causal factor (infection or foreign body) is removed.
CHAPTER X
MEDICO-LEGAL INVESTIGATION OF WOUNDS
Rules to observe by the physician in examining wounds:

ALL injuries must be described.


Description must be comprehensive with sketches or
photographs if possible.
Examination must not be influenced by other
information obtained from others in making a report
or conclusion.

Outline of Medico-Legal Investigation of Physical Injuries


1.

General Investigation of the Surroundings: (a) place


of the commission of the crime; (b) clothing, stains,

40

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

2.

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, 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,
injury
suicide, homicide)
3.

Examination of the Wound


Character - State the type of wound, characteristic
marks, presence of contusion collar, scab
formation, infection, surgical intervention, etc.
Location - Region of the body where it is situated,
distance of the wound from some fixed point in the
body prominence. Location is important in
determining trajectory or course of the wounding
weapon
Depth - It is measurable if the outer wound and inner
end is fixed. 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 - Presence
of burning or tattooing in gunshot wounds by near
or contact fire, hesitation cuts in suicidal incised
wound or contusion in lacerated wound
Extent - Extensive injury may show marked degree of
force applied
Direction - It is material in determining the relative
position of the victim and offender.
Number - Multiple wounds in different parts of the
body are generally indicative homicide or murder.

FROGLETS NOTES
Conditions of the Locality - (a) degree of hemorrhage;
(b) evidence of struggle; (c) position of the body;
(d) presence of suicide note; (e) condition of
weapon.
Factors in Determining Whether Wounds were Inflicted
During Life or After Death
1.

2.

3.

Hemorrhage is more profuse when the wound was


inflicted during lifetime. If wounds are inflicted after
death, the amount of bleeding is comparatively less
due to loss of tone of blood vessels, absence of heart
action and post-mortem clotting of blood. Violence
upon a living body may not show bruise until after
death.
Signs of Inflammation such as pus, 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. Postmortem wounds do not show any manifesting signs
of vital reaction.

and cellular tissues not


removed by washing
Edges gape owing to the
reaction of the skin and
muscle fibers

Inflammation and reparative


processes

1.

Signs of Repair such as fibrin formation, growth of


epithelium, scab or scar formation conclusively show
that wound was inflicted during lifetime. 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.
Retraction of the Edges of the Wound inflicted during
life cause gaping of the wound while in case of
wound inflicted after, edges do not gape and are
closely approximated to each other.

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.
Edges do not gape but are
closely approximated to
each other unless wound is
caused within one or two
hours after death.
No
inflammation
or
reparative processes

Factors in Determining Whether Wound is Homicidal,


Suicidal or Accidental

2.
4.

Summary of Legal Medicine


Book by Solis

3.
4.
5.
6.

Nature of the wound inflicted


Abrasions - extensive in accidental death, rare in
suicidal, not common in murder unless the
body is dragged on the ground, common in
homicide especially when victim offered some
degree of resistance.
Contusion - rare in suicide unless done by
jumping from a height, may be found in
accidental death often due to a fall or forcible
contact with some hard object.
Incised wound - common in suicide and
homicide. Accidental cuts are frequent
everyday occurrences but rarely cause of
death.
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 - Its absence is more in suicide,
accident or murder. Presence of hair or portion
of skin on nails of assailant or deceased
Number and direction of wound - Multiple
wounds in concealed parts of the body are
indicative of homicide. Single wound in a
position the deceased could have been
conveniently inflicted is suicidal. In cut-throat,
generally transverse in homicide while oblique
in suicide.
Nature and extent of wound - Homicidal wounds
may be caused by any wounding instrument
while suicidal wounds are due to sharp
instruments.

FROGLETS NOTES
State of clothings - Usually no change in its
condition in suicide while it may be in disorderly
position due to struggle in homicide.
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, trajectory
of the wound inside the body, organs involved and
degree of injury, testimony of witnesses and
presence of defense wounds.

Effect of Medical and Surgical Intervention on the Death

1.

Degree of Healing
Signs of repair appear in less than a day after
infliction of injury. By the degree of the granulation of
tissue formation and other reparative changes, the
age of the wound may be estimated.

2.

Changes in the Body


Systemic changes such as degree of wasting,
anemia, condition of the face and bed sore formation
may provide for a basis.

3.

Age of the Blood Stain


It may be determined from the physical color
changes of the skin although it is not reliable.

4.

Testimony of the Witnesses


In cases where witnesses testify as to the exact
time, medical evidence as to duration of survival is
merely corroborative.

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. But
if negligence is deliberate and is really the cause of death,
offender can only be held liable for physical injuries.

Possible Instruments Used by Assailant Inferred from


Nature of Wound

Power of Volitional Acts of the Victim After Receiving a


Fatal Blow

Contusion - blunt instrument


Incised wound - sharp-edged instrument inflicted by
hitting
Lacerated wound - blunt instrument
Punctured wound - sharp-pointed instrument
Abrasion - body surface rubbed on rough hard
surface
Gunshot wound - 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.

A physician can only state that it is possible that a


certain injury is possibly caused by a certain
instrument presented. He must be cautious in making
categorical statements.
In case of multiple offenders and there is conspiracy,
it is not necessary to determine who inflicted the fatal
blow. Where victim received multiple injuries,
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.

42

By 4D2014-2015

1. If death occurred after medical intervention, offender is


still liable provided (1) death is shown to be inevitable and
even without intervention, death is a normal and direct
consequence; (2) physician must be competent and
exercised care and diligence.
2. Minor wounds were received by victim but death resulted
on account of gross incompetence or negligence of
physician, offender is liable only for the physical injuries
inflicted.
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.
Wounds of big blood vessels (carotid, jugular,
even aorta) - not prevent performance of
voluntary acts
Penetrating wound of heart - instantaneously
fatal but experience shows victim may still be
capable of locomotion
Rupture of organs - victim may still move and
speak
Extrinsic Evidences in Wounds
1.

From Wounding Weapon


(a) Position - Near the body of the victim in suicidal
and accidental death or firmly grasped by the victim
in case of suicide

FROGLETS NOTES
(b) Presence of blood - In some cases, 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.
(c) Presence of hair and other substance
2.

3.

4.

In the Clothings of the Victim


In gunshot wounds, holes in the clothing may
determine the wound of entrance whole presence of
gunpowder at the hole indicates distance. Clean-cut
tears indicates use of sharp-edged instrument.
Severe tearing may show struggle. The degree of
soaking of the clothing with blood may depict
hemorrhage.
From Examination of the Assailant
Determination of the degree of intoxication, mental
condition, physical power, etc of the offender may be
necessary.
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 - 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. The
missile may be single as in the case of a pistol or
revolver or multiple shots or pellets in case of a
shotgun.
Detonation of high explosives as in grenades, bombs
and mine explosion.
Firearm Wound

as being of small caliber and limited range are


used a toys. The barrel of any firearm shall be
considered as complete firearm for all purposes
thereof (Section 877, Revised Administrative
Code)
Penal Provisions of Law Relative to Firearm
Alarms and Scandals (Art. 155, Revised Penal Code)
The penalty of arresto menor or fine not exceeding
200 pesos shall be imposed upon:
1. Any person who within any town or public place shall
discharge any firearm, rocket, firecracker, or other
explosive calculated to cause alarm or danger;
xxxxxxxxxx
Discharge of Firearms (Art. 254, 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, unless the facts of the case
are such that the act can be held to constitute frustrated or
attempted parricide, murder, homicide or any other crime
for which higher penalty is prescribed by any of the articles
of the Code.
Classification of Small Firearms
Small firearms are those which will propel projectile of
less than one inch in diameter.
1.

43

By 4D2014-2015

As to Wounding Power
a. Low Velocity Firearm - With muzzle velocity of not
more than 1,400 feet/second (i.e. revolver)
b. High Power Firearm - 2,200 - 2500 feet/second
(i.e. military riffle)

2.

Definition
An instrument used for the propulsion of a projectile
by the expansive force of gases coming from the
burning of gunpowder
Includes rifles, muskets, shotguns, revolvers, pistols,
and all other deadly weapons from which a bullet,
ball, shot, shell, or other missile may be
discharges by means of gunpowder or other
explosives. it also includes air rifles except such

Summary of Legal Medicine


Book by Solis

As to Nature of the Bore


a. Smooth Bore Weapon - Inside portion of the barrel
is perfectly smooth (i.e. shotgun)
b. Rifled Bore Firearm - The bore of the barrel has
spiral lands and grooves which run parallel with one
another but twisted spirally from breech to muzzle
(i.e. military rifle)

3.

As to the Manner of Firing


a. Pistol - Fired only by a single hand (i.e. revolver)
b. Rifle - Fired from shoulder (i.e. shotgun)

FROGLETS NOTES
4.

As to the Nature of Magazine


a. Cylindrical Revolving Magazine - Cartridge is in a
cylindrical magazine which rotates at the rear portion
of the barrel (i.e. revolver)
b. Vertical or Horizontal Magazine - Cartridge is held
one after another vertically or horizontally by a spring
side to side or end to end (i.e. pistol)

Gunshot Wound of Entrance (Entrance Defect,


Inshoot):
The appearance of the gunshot wound of entrance
depends upon the following:
1.

Caliber of the Wounding Weapon:


Excluding other factors which may influence the size
of the wound of entrance, the higher the caliber of the
wounding bullet the greater will be the size of the
wound of entrance.

2.

Characteristics Inherent to the Wound of Entrance:


The wound of entrance, as a general rule, is oval or
circular with inverted edges, except in near shot or in
gazing or slap wound. The wound of exit is usually
larger than the wound of entrance.

3.

Direction of the Fire:


A right angle approach of the bullet will make the
wound of entrance circular in shape, except when the
missile is deformed or the fire is in contact or near. In
cases of an acute angle of approach of the bullet, the
wound of entrance is oval in shape with the contusion
or abrasion collar widest on the side of the acute
angle of approach.

4.

Shape and Composition of the Missile:


Deformity of the bullet modifies the shape of the
wound of entrance.

5.

Range:
In close range fire, the injury is not only due to the
missile but also due to the pressure of the expanded
gases, flame and other solid products of combustion.
Distant fire usually produces the characteristic effect
of the bullet alone.

6.

Kind of Weapon:
High power weapon has more destructive effect as
compared with low power one. The shape of the bullet
also plays an important role. Conical shape free end
bullets have more piercing power without marked
tissue destruction while missiles with hemispherical
free ends are more destructive.

Types of Small Firearms of Medico-Legal Interest


Revolver - 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. It has muzzle velocity of 600
feet/second.
Automatic Pistol - More appropriately called "selfloading firearm". Empty shell is ejected when the
cartridge is fired and a new one is slipped into the
breech automatically. It has muzzle velocity of
1,200 feet/second.
Rifle - It has a long barrel and butt and is fired from a
shoulder. A military riffle has a magazine and volt
action. It has a muzzle velocity of 2,500
feet/second and a range of 3,000 feet. A miniature
riffle is a single self-loading weapon.
(pp.336-352)
6. 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.
7. Muzzle Blast in Contact Fire:
When gun muzzle is pressed on the skin when fired, 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.
8. Other Consequential Effects on the Body of the Victim:
Aside from direct involvement of vital structures of the
body, pressure to other organs and tissues, the gunshot
wound may be the source of hemorrhage, infection,
paralysis, shock, loss of functioning etc. which may cause
disability or death on the victim.

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. The
following factors must be taken into consideration:

FROGLETS NOTES
1. 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, there will be more destructive
effects on the tissues.
2. The Amount of Gas Liberated by the Combustion of
the Propellant:
The greater is the amount of gas in a confined area,
the greater will be the tissue destruction.
3. Nature of Bullet: Bigger caliber bullet is obviously
more destructive than smaller ones.
4. Part of the Body Involved: The nature, character
and extent of injury in contact fire is different
(1) when the bone is superficially located under the
skin, and (2) when the bone is deeply located in loose
or soft parts of the body.
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. The
following are the characteristics of the injuries:
a. The wound of entrance is large, frequently
star-shaped
b. Edges of the wound may be everted.
c. Areas in the entrance wound is blackened by
burns, tattooing and smudging.
d. Muzzle imprint, Barrel impression (Profile of
the muzzle) on the skin
e. The bullet may cause radiating fracture
f. Blood and tissue become pink due to carbon
monoxide.
g. Fragments of lead and bullet jacket may be
found.
Metal Fouling - When the bullet travels the
whole length of the tight fitting barrel, it is rotated
by the lands and grooves. Its surface is scraped
by the lands and the scraping is ejected from the
barrel and strikes the target. It may lodge on the
clothings or may cause small abrasions or
superficial lacerations on the skin around the
main wound.
h. Singeing of hair.

2. Parts of the Body Where the Bone is Deeply Located:

45

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

a. Wound of entrance is usually large, circular and without


radiating laceration.
b. Edges are everted due to outward slapping of the skin.
c. Singeing of the hair, blackening of the wound due to
fouling, burn, and tattooing.
d. Muzzle imprint due to outward slapping of the skin and
heat.
e. Pinkish color of the deeper structures due to carbon
monoxide.
Loose Contact or Near Fire:
1. Entrance wound may be large circular or oval depending
upon the angle of approach of the bullet.
2. Abrasion collar or ring is distinct.
3. Smudging, burning and tattooing are prominent with
singeing of the hair.
4. Muzzle imprint may be seen depending upon the degree
of slapping of the skin of the gun muzzle.
5. There is blackening of the bullet tract to a certain depth'
6.Carboxyhemoglobinispresentinthewoundandsurrounding
areas.
Short Range Fire (1 to 15 cm. distance)
Medium Range Fire (more than 15 cm. but less than 60
cm)
Fired More Than 60 cm. Distance
Instances When the Size of the Wound of Entrance Do
Not Approximate the Caliber of the Firearm:
In distant fire, the rule is that the diameter of the gunshot
wound of entrance is almost the same as the caliber of the
wounding firearm, but in the following instances, the rule is
not followed:
1. Factors which make the wound of entrance bigger than
the caliber:
a. In contact or near fire
b. Deformity of the bullet which entered
c. Bullet might have entered the skin sidewise
d. Acute angular approach of the bullet 2. Factors which make the wound of entrance smaller than
the caliber:
a.
b.

Fragmentation of the bullet before penetrating


the skin
Contraction of the elastic tissues of the

FROGLETS NOTES
In shotgun fire, the size of the wound of entrance is
dependent upon the distance of the fire. Near fire causes
concentration of entry of the pellets, and as distance
increases the pellets disperse with individual pellets
causing individual wounds of entry. Only in this instance
may the wound of entrance of the same size as the gauge
of the shotgun pellets.
Other Pieces of Evidence or Findings Used to
Determine Entrance of Gunshot:
1. Examination of the clothing, if involved in the
course of the bullet
2. Examination of the internal injuries caused by the
bullet
3. Testimony of witnesses:
Determination of the Traiectory of the Bullet Inside the
Body of the Victim:
1.

External Examination :

a. Shape of the Wound of Entrance


b. Shape and Distribution of the Contusion or
Abrasion Collar
c. Difference in Level Between the Entrance and
Exit Wounds
d. By Probing the Wound of Entrance
2.

Internal Examination :

a. Actual Dissection and Tracing the Course of the


Wound at Autopsy
b. Fracture of Bones and Course in Visceral Organs
c. Location of Bone Fragments and Lead Particles
d. X-ray examination
Exit (Outshoot) Wound: An exit wound does not
show characteristic shape unlike the wound of
entrance. It may be slit-like, stellate, 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.
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.
Shored Gunshot wound of Exit - 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. It
is also observed that tight-fitting clothings, waist band,
belt collar, brassiere may also support the skin to
enhance formation of a circular wound of exit.
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.
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.
"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.
Paraffin test may be positive

Always absent..
Underlying tissues may be
seen protruding from the
wound.
Paraffin test always
negative.

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, but if the number of the
gunshot wounds of entrance and exit is odd, the
presumption is that one or more bullets might have been
lodged in the body. The rule is merely presumptive and
actual inspection and autopsy will verify the truth of the
presumption. It may be possible that all of those wounds or
a majority of them are entrance wounds with some bullets
lodged, yet the number may still be even.
How to Determine the Number of Fires Made by the
Offender:

FROGLETS NOTES
l. Determination of the Number of Spent Shells:
2. Determination of Entrance Wounds in the Body of the
Victim
3. 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. A bullet might have entered the body but split
into several fragments, each of which made a
separate exit.
2. One of the bullets might have entered a natural
orifice of the body, e.g. mouth, nostrils, thereby making it
not visible and then producing a wound of exit.
3. There might be two or more bullets which
entered the body through a common entrance and later
making individual exit wounds.
4.

In near shot with a shotgun, the pellets might


have entered in a common wound and later
dispersed while inside the body and making
separate wounds of exit.

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 one or more bullets are not through and through
and the bullet is lodged in the bodY.
2. 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. 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. When the bullet is lodged in the gastro-intestinal tract
and expelled through the bowel, or lodged in the pharynx
and expelled through the mouth by coughing.
2. Near fire with a blank cartridge produced a wound of
entrance but no slug may be recovered.
3. 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, or there are signs of vital reactions in
the tissue, then the gunshot wound is ante-mortem.
Wounds inflicted after death show no evidence of profuse
hemorrhage, no retraction of the edges, and there are no
vital reactions.
Problems confronting Forensic physician in the
identification of Gunshot Wounds:
1. Alteration of the Lesion Due to Natural process
2. Medical and Surgical Intervention
3. Embalming
4. Problem Inherent to the Injury itself
6. X-ray Examination The use of an X-ray is almost
indispensable in the examination of gunshot injuries. The
use of the apparatus will facilitate recovery of the lodged
bullet together with the location of its fragments
Special Consideration on Bullets:
L. Souvenir Bullet: Bullet has been lodged and has
remained in the body. Its long presence causes the
development of a dense fibrous tissue capsule around the
bullet causing no untoward effect. It may be located just
underneath the skin to be easily palpated and may cause
'inconvenience and irritation. Deep seated location may not
cause any problem to warrant its immediate removal.
2. Bullet Migration: Bullet that is not lodged in a place
where it was previously located. A bullet which strikes the
neck may enter the air passage, and it may be coughed out
or swallowed and recovered in the stomach or intestine.
Bullets Embolism - 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. It may cause sudden loss of function of the area
supplied or death if vital organs are involved.
3. Tandem Bullet: Two or more bullets leaving the barrel
one after another. In cases of misfire or a defect in the
cartridge, the bullet may be lodged in ihe barrel and a
succeeding shot may cause the initial and the succeeding
bullet to travel in tandem. There is a strong possibility for
them to enter the target in a common hole. This might

FROGLETS NOTES
create doubt to the statement made by the firer that he
made only a single shot, but ballistic examination can show
as to whether the bullet travelled in tandem.
GUNSHOT WOUNDS MAY BE SUICIDAL, HOMICIDAL
OR ACCIDENTAL
Pieces of evidence that tend to show that the Gunshot(s)
wound is Suicidal:
1. The shot was fired in a closed or locked room' usually in
the office or bedroom.
2. The death weapon is almost always found near the
place where the victim was found.
3. The strot was fired with the muzzle of the gun in contact
with the part of the body involved or at close range. The
wound of entrance may show signs of muzzle impression,
burning, smudging and tattooing.
4. The location of the gunshot wound of entrance is in an
accessible part of the body to the wounding hand. It may
be at the temple, roof of the mouth, precordial or epigastric
region. A person committing suicide wilI do the act in his
most convenient way, unless he has the intention of
deceiving the investigator.
5. The shot is usually solitary. If the shot is made on the
head involving the brain, the shocking effect of the injury
will not make him capable of firing another shot. However,
shots in some parts of the body which may not produce
immediate death cir sudden loss of consciousness, the
possibility of additional shots is not remote
6. 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.

Summary of Legal Medicine


Book by Solis

13. no disturbance in the place of death


Russian Roulette:
-agreement among persons to load a revolver with live
cartridge; each member will cock and pull trigger with
muzzle directed to the temple or other vital parts; 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. no point of election in he wound entrance
2. fire is made when victim is at some distance
3. defense wounds (signs of struggle)
4. disturbance of the surroundings
5. wounding firearm cannot be found at crime scene
6. witness testimony
Evidences to show that the wound is accidental:
1. usually one shot
2. no special area of body involved
3. determination of relative position of victim and
assailant
4. witness testimony
Points to be considered and included in the report of
the physician:
1. complete description of wound of entrance and exit
2. location of the wound
3. direction and length of bullet tract
4. organs or tissues involved
5. location of missile, if lodges in the body
6. diagram and other illustration showing location of
wounds

11. victims fingerprints on butt

Questions that a physician is expected to answer in


court:
1. Could the wound be inflicted by the weapon?
2. At what range was it fired?
3. Direction of the fire
4. Possibility that gunshot wounds are self-inflicted
5. Signs of struggle
6. Possibility of the victim to fire or resist the attack after
being injured
7. Did the victim die instantaneously?
8. Relative position of assailant and victim

12. 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. Personal history may reveal social, economic, business


or marital problem which the victim cannot solve. He may
have history of mental disease, depression, severe
frustration or previous attempt of self-destruction.
8. Examination of the hand of the victim may show
presence of gunpowder.
9. Entrance wound do not usually involve clothings.

48

By 4D2014-2015

FROGLETS NOTES
entrance? Yes. The caliber may be inferred from the
diameter of the gunshot wound.
Determination of the Length of Survival of the Victim:
1. nature of wound
2. organs involved
3. presence or absence of infection
4. amount of blood loss
5. physical condition of victim
Capacity of the Victim to Perform Volitional Acts:
Depends upon the following:
1. area of body involved
2. vital organs involved
3. resistance of victim
*Injuries in the brain and spinal cord which cause
incapacity to do voluntary acts negates the capacity.
Determination as to length of time a firearm had been
fired:
1. Odor of the gas inside the barrel
*mixture of gases has peculiar characteristic
order which is noticeable several hours afar
discharge. Later, the odor will disappear as
gases usually evaporate or chemical transform to doorless
compounds
2. Chemical changes inside the barrel
3. Evidence that may be deduced from the wound
1. age of wound
2. degree of healing
3. degree of infection
Determination Whether the Wounding Weapon is an
Automatic Pistol or Revolver:
1. Location of empty shells
revolver
VS
automatic pistol
in clylindrical magazine chamber after fire
driven out of weapon after shot
2. Nature of spent bullet
revolver
VS
automatic pistol
no coating
bullet is copper jacketed
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.
*It is impossible to distinguish and memorise the report
from two firearm of the came caliber.
*It may be possible for a person who is accustomed to
sound of firearms of different calibers to identify firearm by
the sound produced.
Gunshot wound may not be a near fire:
1. when a device is set up to hold the firearm
2. clothings are interposed between the victim and the
firearm
3. failure of examining physician to distinguish between a
near or far shot wound
4. product of a near shot wound has been washed out of
the wound
X-ray examinations may:
1. facilitate location of bullet
2. reveal fragmentation and location
3. show bone involvement
4. reveal trajectory of bullet
5. show effects of bullet wound and other injuries
SHOTGUN WOUNDS
Shotgun- shoulder-fired firearm having a barrel that is
smooth-bored
Classes of shot in a shotgun shell:
1. Birdshot- shot are small (0.5 inch to 0.15 diameter);
use for hunting fowls and small animals
2. Buckshot- shot ranges form 0.24 to 0.33 inch in
diameter; fewer in number of shots (9shots)
3. Single Projectile (rifled slug)- only a single or slug in a
shell
Systems employed in the determination of the
diameter of barrel of a shotgun:
1. Gauge System - determination of number of lead
balls, each fitting of the bore totals to one pound in
weight
2. Expression of the bore diameter in inches-0.410 bore
shotgun is the only shotgun at present designated
3. Metric system - bore in millimeters
*Not standard length of barrel.

FROGLETS NOTES
Grade of choke:
1. Unchoke- diameter of barrel from rear to muzzle is the
same
2. Choke- 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.
Types of shotgun:
1. As to number of barrel
a. Single Barrel Shotgun
b. Double Barrel Shotgun
2. As to manner of firing and reloading:
a. Bolt action
b. Lever Action
c. Pump action
d. 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. Contact or near contact shot - not more than 6 inches
Indicators:
a. shape of wound
b. entrance wound is burned
c. blackening due to smoke
d. gunpowder tattooing is densely located
e. contusion of tissue
f. singeing of hair (less than 6 inches)
g. disrupted deeper tissues
h. presence of carbon monoxide along the bullet
tract
i. recovery of wad together with shot (pellets)
2. Long range shot - more than 6 inches skin-muzzle
distance
Indicators
a. 2-3 feet muzzle distance-> single wound of
entry
b. 3-4 feet distance-> serrated wound of entry
referred to as rat hole
c. 5-6 feet-> wad tends to produce independent
injury, usually an abrasion
d. 6 feet-> shots begins to separate from
conglomerate shot
10 feet-> produces independent wounds of entry
Billiard ball ricochetted effect- 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. smudging due to smoke up to 15 inches


f. gunpowder tattooing up to 24 inches
g. in an unchoked shotgun, to estimate the
distance: measure the distance between the
farthest shot in inches and subtract one, 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.
DETERMINATION
OF
THE
PRESENCE
GUNPOWDER AND PRIMER COMPONENTS

OF

The importance of determining the gunpowder on the


skin of the victim:
1. Determination of the distance of the gun muzzle from
the victims 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. Determining whether a person has fired a firearm
*When a person fires a gun, 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, 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. 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.
2. Microscopic examination
3. Chemical tests
a. 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, tattooing, smudging visible
*The same test may be applied to
dorsum of hand of persons suspected to have
fired the gun

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 the skin (Dorsum of the hand or site of the wound
of entrance):
1. Dermal nitrate test (Paraffin test, Diphenylamin
test, Lungs 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 Lungs reagent.
*Test is not conclusive as to the
presence of gunpowder because fertilizers,
cosmetics, cigarettes, urine and other
nitrogenous compounds with nitrites and
nitrates will give a positive reaction
*Subjection of suspect is not selfincriminatory; act purely mechanical
2. On clothing's (Especially coloured ones)
Walkers tes (C-acid test, 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.
*If unburned powder grains are
present, it will result to production of dark red or
orange-brown spots on the prepared paper.
Test for the presence of Primer Components:
1. Harrison and Gilroy Test
*A cotton swab moistened with 0.1 molar
hydrochloric acid is used to gather antimony,
barium and lead.
*The test does not enjoy substantial utilisation in
forensic laboratory because:
1. lacks specificity of color reaction
2. inadequately sensitive
3. interference of color reaction among three
elements themselves
4. development of instability of color
2. Neutron Activation Analysis (NAA)
*A sample is obtained from the hands by the use
of paraffin or washing the hand with dilute
acid. It is
then exposed to radiation from a nuclear react emitting
neurons.
*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, afterwards their quantity is


measured.
3. Flameless Atomic Absorption Spectroscopy (FAAS)
*Sample of hand washing is subjected to a high
temperature to vaporise the metallic
elements
of the primer residue.
*This method is quick, sensitive and employs
equipment within economic means
*Can determine presence of barium, antimony
and lead
4. Use of Scanning Electron Microscope with a Linked Xray Analyzer
*Adhesive material is used to remove any
residue particles from the hand. The material
then examined under the scanning electron
microscope with a linked X-ray analyzer.
FIREARM IDENTIFICATION
Factors:
1. Caliber of the weapon
2. Fingerprints
*may determine if homicidal or suicidal nature of
death
3. Fouling of the barrel
*recently fired firearm may have a characteristic
door smoke inside the barrel
4. Serial number
Procedure of restoring serial number if tampered:
1. Cleaning
*All oil, dirt, grease and paint should be removed
with gasoline, xylol and acetone
2. 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. Etching
*For all iron or steel materials, the following
etching may be used
Hydrochloric acid - 80 cc
Distilled water
- 60 cc
Ethyl alcohol - 50 cc
Copper chloride - 10 grams
*The solution is swabbed until the numbers
appear.
4. Ballistic examination
*Ballistics - study of physical forces reaction on
projectiles
*Foreign ballistics - also known as firearm
identification; deals with examination of fired
bullets

FROGLETS NOTES
and cartridge cases in a particular gun to the exclusion of
all others
Three separate and distinct area of Ballistics:
1. Interior Ballistics - deals with what happened to the
cartridge and its bullet from the time trigger is pulled
until the bullet exits from the barrel
2. Exterior Ballistics - 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. Terminal Ballistics- concerns with the effect of the
bullet on the target or until it comes to rest
4. Medical Ballistics- concerned with the penetration,
severity and appearance of the wound due to bullet or
missile
Basic Principles Involved in Firearm Identification:
1. 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. In the
process of contact between the part of the gun
involved and the cartridge, the surface condition of the
part of the gun can easily be impressed on the shell or
bullet.
2. Firearms have certain physical characteristics of
certain type of caliber which differentiate it from
others.
3. No two firearms can be manufactured with identical
surface characteristics; referred to as individual
characteristics
Instruments Use in Firearm Identification:
1. Comparison Microscopes- instrument consists of two
compound microscopes which allows comparison of
two objects by looking through single eyepiece. The
individual or accidental characteristics of two objects
may be compared. There is an attachment for
photographic camera to facilitate the taking of pictures
of the findings.
2. Bullet Recovery Box- instrument for the purpose of
recovering the test bullet and shell. It is a long
cylindrical container filled with cotton and an open
shooting end.
*The test shell
and bullet may be used for comparison with the
evidence bullet or shell.
Other ways of recovering test bullet as used in
other countries:
1. Shot may be fired on a box with oil and
sawdust
2. Vertical or horizontal shot on water tank
3. Shot fired on a block of ice

52

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

3. Hand lens
4. Sharp pointed instrument for scraping I.D. marks
5. Caliper
6. Analytical Balance
See illustration on page 386
Types of marking on the examination through
Comparison Microscope:

1.

2.

Impression type Mark (Stamp Mark) the


forcible application of hard surface against the
softer one leaving an impression on the softer
surface. E.g. striking of the firing pin on the
percussion cup.
Striation or serration mark produced by a
harder surface scraping, dragging, siding or
slipping cross the softer one leaving a series of
abrasions, serrations and scrapes. E.g. bullet
surface may show the rifling marks on its surface
of the barrel.
When the cartridge is fired from the firearm, the
following marks are found in the shell and from
the bullet:
Marks found in the Shell:
a.
b.
c.
d.

e.

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- 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.
Marks on the cylindrical surface of
the shell- mark brought about by
the magazine.

Marks found in the bullet:

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

i. The refling barrel is reflected


in the bullet as it passes
through it.
ii. Firing pin mark: when the
base of the cartridge is hit by
the firing pi, the pin produces
distinct markings which can
be reproduced by succeeding
shots.
iii. Breechblock mark: as the
bullet is propelled forward by
the force of the expanded
gas, the casing is forcibly
moved backward against the
breech force or recoil plate.
The backward force transfers
the marking
on the
breechblock to the base of
the cartridge.
iv. Extractor mark: mark made
by the extractor on the
cartridge rim when pulled
away from the firing
chamber.
v. Ejector mark: mark produced
by the ejector in the process
of throwing away the spent
shell.

a. Number of lands and groovesnumber of grooves, depth, and


width
depend
upon
the
manufacturer of the firearm.
b. Direction of the twist of the Rifling
Marks- the direction of the spiral
lands and grooves may twist to the
right or to the lest.
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. The bullet recovered
from the ody may show those marks in the examination
and the examiner may have the presumption where the
firearm came.
In fire Arm Identification the Examiner must take into
consideration the following:
1.

2.

gross examination or examination with


magnifying lense:
a. caliber of the bullet
b. presence or absence of deformity or
loss part
c. presence of foreign elements. E.g.
blood, flesh
d. identity marks placed by previous
possessor.
Examination with the use of comparison
microscope: this is the comparison between
evidence shell or bullet with the test shell or
bullet
a.

b.

53

Determination
of
the
clss
characteristics: physical characteristics
of certain caliber of firearm used by the
manufacturer:
i. Number of rifling
ii. Direction and rates of rifiling
marks
iii. Dimension of the lands and
grooves
iv. Depth of the grooves
v. 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.

Cranium:
Close or near contact fire in the
head may produce marked
laceration of the skin, burning and
tattooing of the surrounding skin.
The skull is fractured without any
definite shape with the linear
extensions to almost all of the
bones comprising the cranial box.
Fire from distance with the
bullet having a right angle of
approach to the skull, the fracture
is oval at the outer table. There
will be radiating linear fractures
from point of entrance. The wound
exit will be clean-cut oval round

FROGLETS NOTES
opening at the inner table with
beveled fracture at the outer table.

Summary of Legal Medicine


Book by Solis

4.

The bullet may pierce the front


portion of the neck and may
involve the cervical portion of the
spinal cord; causing instantaneous
death if the upper portion is
involved. If involve the carotid or
jugular vessel and death may be
due to profused hemorrhage.
Injury to trachea and upper
bronchi may cause asphyxia or
aspiration pneumonia.

Grazing approach of the bullet


may produce an elongated gutterlike depressed fracture of the
cranium. 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.

2.

Brain Substance:
Usually a rugged tunnel with a
diameter larger than that of the
caliber of the bullet, with mark
ecchymosis of the surrounding
area and filled with fresh and
clotted blood. Fragments of bones
may be felt in the tunneled bullet
tract. In jury of the brain causes
sudden loss of consciousness and
incapable of voluntary movement.

Injury in the cerebral hemispheres


is as a rule not immdediately fatal
and the victim may survive the
injury, however if the bullet
courses the medulla, pons, and
other vital centers causes the
immediate death. Some victims
may live for a while but developed
epileptiform convalsions as a
sequel.

3.

Face
May noy cause serious trouble
except that it becomes potential
avenue for infection that may
cause deformity.

54

By 4D2014-2015

Neck

5.

Chest:
1. Chest wall: usually has an
upward course and may
involve both sides. The bullet
may strike the rib, sternum or
the body of the vertebra and
may cause deformity or
deflection of its course. When
the intercostal or mammary
vessel are injured there will
be perfused hemorrhage.
2.

Lungs: it produces a
cylindrical tunnel much larger
than the diameter of the
projectile with the bloody
contents and ecchymotic
borders.
When
the
pulmonary vessel is involved,
the profuse hemorrhage is
observe that produces death
before medical intervention
can be done. If only the lungs
is involve, the profuse
hemorrhage may cause
collapse of the lungs,
displacement of the heart.
Emphysema is present when
there is marked injury to the
air sacs. The victim may not
die immediately but later may
develop
aspiration
pneumonia
or
cerebral
embolism.

FROGLETS NOTES
3.

4.

5.

55

Heart: wound may be


circular or stellate with
subepicardial hemorrhage in
the surrounding tissue. As a
general rule does not prevent
the victim from running,
walking or to do other forms
of volitional acts for death is
not usually instantaneous.
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.
Abdomen: wounds are quite
frequent but not as serious
as those of the chest and
head because of its ability to
surgical operation. It is
limited to one or several
organs. 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. The tunnel may
contain fragmented tissue,
fresh and clotted blood. Loss
of function, of the kidney,
pancreas, etc may lead to
fatal resuls. Bullet wounds in
the stomach and other hollow
areas are usually small on
the account of he contractility
of the walls. The wound
entrance is smaller than the
exit wound. Timely surgical
intervention may prevent
untoward
complications.
However, death due to
peritonitis is not rare on the
account of the spilling of its
contents into abdominal
cavity.
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.

the spinal cord may be due


to:
a. Bullet affects the
canal and the
spinal cord causing
either partial or
complete
severance
b. Injury in the body of
other parts of the
vertebra
and
contusion,
concussion
or
compression on the
account of impact.
Injury of the upper
cervical spinal cord
may
cause
immediate death
because the vital
nerve tracts may
be involved. Lower
spinal cord injury
may cause motor
or
sensory
paralysis and may
later succumb to
hypostatic
pneumonia,
suppuration
or
other
complications.
Extremities: it may show the
characteristic
lesion
of
gunshot wounds. Usually the
wound is not so serious
except when it involves the
principal blood vessels and
nerves. The bony tissue may
involves the principal blood
vessels and nerves.

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

FROGLETS NOTES
supply of oxygen to the blood or to the tissues or both has
been reduced below normal level.

3.

Types of death by Asphyxia:


1.

2.

3.

4.

Anoxic Death: associated with failure of the


arterial blood to become normally saturated with
oxygen may be due to :
a. High altitude
b. Traumatic crush asphyxia
c. Paralysis of the respiratory centerdue
to poisoning, injury or anesthesia, etc.
d. Mechanical interference with the
passage of air into or down the
respiratory tract due to:
i. Closure
of
external
respiratory ortifice
ii. Obstruction of air passage
iii. Respiratory abnormalities
e. 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,
poisoning, or low hemoglobin level in the blood.
Stagnant Anoxic Death: this is brought about by
the failure of circulation which may be due to
heart failure, shock, or arterial and venous
obstruction.
Histotoxic Anoxic Death: this is due o the
failure of the circulation of the cellular oxidatives
process, although the oxygen is delivered to the
tissues, it cannot be utilized properly. Cyanide
and alcohol is common agents responsible.

Phases of Asphyxial Death:


1.

2.

Dyspenic Phase: symptoms due to lack of


oxygen and retention of carbon dioxide in the
body tissue. Breathing becomes rapid and deep,
pulse rate increase and rise of blood pressure.
Convulsive phase: this is due to simulation of
the cntral nervous system by carbon dioxide. The
cyanosis becomes more pronounced and yes
becomes staring and pupils are dilated. 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). The victim may become unconscious
in the convulsive stage.

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. The breathing
shallow and gasping and the rate becomes
slower till death. The heart later fails.

Classification of Asphyxia:
1.
2.

3.

4.
5.
6.

Hanging
Strangulation:
a. By ligature
b. Manual strangulation or throattling
c. Special forms of strangulations:
i. Palmar strangulation
ii. Garroting
iii. Mugging or yoking
iv. Compression of the neck with
stick
Suffocation:
a. Closing the mouth and nostrils by solid
object
b. Choking or closing of the air passage
by the obstruction of its lumen
asphyxia by submersion or drowning.
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. 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.
Classification of asphyxia by hanging:
1.

2.

as to location of the ligature and knot:


a. typical: ligature runs from the midline
above
the
thyroid
cartilage
symmetrically encircling the neck on
both sides to occipital region.
b. Atypical: the ligature is tied or noosed
and present on one side of the neck, in
front or behind the ear or on the chin.
as to amount of constricting force:
a. complete:
body is completely
suspended and he constricting force is
the whole weight
b. partial: body is partially suspended as
when the victim is sitting, kneeling,
reclining, prone or in any other
positions.

FROGLETS NOTES
3.

as symmetry:
a. symmetrical: the knot or noose is at the
midline of the body either at the occiput
or just below the chin.
b. Asymmetrical: knot or noose is not is
not in the midline but on the one side,
with the head tilted to the side opposite
the location of the noose or knot.

There may be no sliding noose at the end of the


ligature. It may be tightened after it has been
encircled around the neck and the pressure on
the air passage, blood vessels and nerves of the
neck is established when the body is suspended.
3.

Mode of Application of the Ligature


The ligature may be placed around the neck with
a single loop or with two or more hoops. This can
be distinguished on the nature of the ligature
marks. In single loop, there is but one ligature
furrow, but if there are several, there will be
several ligature marks with an intervening
redness between the furrow. There is more
pressure in a single loop ligature on account of
concentration of force at the weight compare to
several loops.

4.

Position of the Knot


The knot or joint is usually located on either side
of the neck. The head is flexed opposite the
location of the knot. The level of the ligature
around the neck may differentiate hanging from
strangulation by ligature. In hanging, the ligature
is usually pull of the constricting force, while in
case of strangulation by ligature, the loop is
found below the thyroid cartilage. It is not easy to
retain the knot beneath the chin.

5.

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. However, if the not is just underneath
the chin, the groove at the back of the neck is not
deep on account of the firmer skin and muscular
tissue.

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, nail, window casing, door knob,
tree, etc..
Upon suspension of the body, the weight causes
the noose or band to tighten, producing pressure at the
region of the neck.
The pressure of the band will cause the air
passage to constrict, the larynx is pushed backwards and
its opening is closed by the contact of the anterior to the
posterior laryngeal wall producing asphyxia.
Pressure of the ligature may also cause
compression of the superior laryngeal nerve, ceratoid
arteries and jugular veins producing cerebral anoxia.
Forms of furrow that develops in the neck
depends upon the type of ligature, the number of loops
around the neck and the point of suspension.
Protrusion of the tongue depends upon how
pressure is applied around the neck. If above the larynx
and in an upward direction, the tongue will be pushed
outward and will protrude from the mouth but if the
pressure is below, the tongue is kept inside the buccal
cavity.
Ligature in Hanging
1.

2.

Materials used in Ligature.


The thinner the ligature and the tougher the
material, the more pronounced will the the mark
on the skin of the neck. If the material is soft and
broad the ligature impression on the neck is less
marked. The rope is commonly used as ligature
because it is easily available and strong. Other
materials includes beddings, belts, electric wire
etc.
Noose

57

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Symptoms
1.
2.
3.
4.
5.
6.
7.

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.

If the victim is timely rescued and revived after artificial


respiration, he will suffer the following symptoms:
1.
2.

Whistling sensation insede the ear


Watering of the eyes

FROGLETS NOTES
3. Difficulty of breathing and swallowing
4. Sensation of number ness of both legs.
All the above symptoms may last for 12 days after rescue.

c.

Cause of Death in Hanging


1.
2.
3.
4.
5.
6.

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.
Any combination of the above

Time Required in the Process of Death


Time is influenced by the following:
1.

Severity of the constricting force


If the constricting force is only sufficient to
occlude the windpipe, death may be delayed; but
if the pressure is sufficient to occlude the carotid
arteries, jugular veins and vagus nerve, then
unconsciousness develops immediately and
death is accelerated.

2.

Point of application of the ligature


When the ligature is made below the larynx,
death is almost instantaneous, but when applied
above the larynx, death may not occur for three
to five minutes. Hanging with the knot situated on
one side of the neck may delay death because of
closure of cerebral vessels cannot be
maintained. If knot is below the jaw, maximum
pressure is at the back of the neck cause merely
partial occlusion of the windpipe and blood
vessels of the neck, thereby delaying death.

3.

Other factors
a. Physical condition of the subject
b. The rate of consumption of oxygen in
the blood and tissues.
Treatment
1.

Induce the natural act of respiration


a. Ligature must be loosened and mouth
msut be wiped to remove all obstacle
to free air.
b. Tongue must be pulled forward and the
body must be laid on back rest.

58

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

2.

3.

Place the patient where there is free


current of fresh air
d. Electrical stimulation of the phrenic
nerve
e. Administration of respiratory stimulant,
like ammonia.
Stimulate the heart to renew action if it ceases to
beat.
a. Apply heat at the region of the
precordium
b. Hypodermic injection of coramine,
strychnine, or other stimulants
c. Administration of brandy.
Maintain the natural body temperature
a. Cover the body with blanket
b. Place the patient in a warm room

Post mortem findings in death by hanging


1.

2.

General External Appearance


a. Neck elongated and stretched with the
head inclined on the side opposite the
knot or noose
b. Eyes closed or partially opened with
pupils usually dialted on one side and
small on the other side (facies
sympathetic)
c. Lividity or pallor of the face with
swelling and protrusion of the tongue
d. Hands are clenched firmly and purple
colored fingernails
e. Lips livid or blue
f. Saliva dribbled from the mouth with
froth
g. State of erection or semi erection of the
penis with seminal flued in the urethral
meatus
h. Post mortem lividity with ecchymosis
are mostly marked at the legs
i. Urination or defecation due to the loss
of power of sphincter muscles.
Internal Findings:
a. Engorgement of the lungs
b. Venous system contains dark-colored
fluid blood.
c. Right side of the heart and the big
blood vessels connected with it are
distended with blood.
d. Blood vessels of the brain is generally
congested.
e. Kidneys are congested.

FROGLETS NOTES
f.

3.

Sub-pleural, sub-pericardial punction


hemorrhages
Findings on the neck:
a. Neck is flexed opposite the side where
the knot is located.
b. Ligature mark which forms groove is
about or rather leass than the knot.
c. The course of the ligature is inverted vshape with the apex of the v at the site
of the knot.
d. The skin at the site of the ligature is
hard with red line of congestion and
hemorrhage in some points.
e. Ecchymosis of the neck depends upon
the width and softness of the ligature.
f. There may be rapture of the underlying
blood vessels, muscles and other soft
tissue
g. The lining membrane of the blood
vessels may be lacerated.
h. Fracture of the hyoid bone or tracheal
rings.

Different diagnosis:
1.
2.

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.

Determinations Whether Hanging is Ante Mortem or Post


Mortem
The principal criterion is the vital reaction. But,
hanging made immediately after death may also show to a
certain extent vital reaction, 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.
2.
3.
4.

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,
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.
Determinations whether hanging is accidental, homicidal or
suicidal
1.

Evidence in support of homicidal hanging


a. Nature of windows and doors - whether
entrance was forcibly opened or have
been used as an escape by the
offender in homicide case
b. Presence of signs of struggle- furniture
and beddings may be disturbed
whenever there is a previous struggle.
c. Presence of stains, bodily injuries in
the body of the victim
d. Presence of defense wounds in the
body of the victim
Lynching a form of homicidal hanging usually
found in southern states of US. Usually practiced
by Americans against the Negros who commit
crime against the white American. Whenever
colored offenders are apprehended, they are
hanged by means of a rope on a tree or some
similar objects. The Negroes are executed
without due process of the law.

B. 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.
It may be observed in infanticide using the
umbilical cord as the constricting material. This must be
differentiated from accidental strangulation during child
birth, the umbilical cord is abnormally long and there is no
disturbance in the wharton's jelly.
Strangulation by ligature is commonly observed
in rape cases, but the presence of findings in the genitalia
and other physical injuries are distinctive findings.
Causes of Death in Strangulation by Ligature
1. Asphyxia due to the occlusion of the windpipe.
2. Coma due to arrest of cerebral circulation.
3. Shock or syncope.
4. Inhibition of the respiratory center due to the pressure
on the vagus and sympathetic nerves.
Accidental, Homicidal or Suicidal Strangulation by Ligature

59

By 4D2014-2015

FROGLETS NOTES
Homicidal strangulation is the most common of
the three forms of strangulation by ligature. Aside from the
ligature mark in the neck, there are evidence of struggle or
marks of violence in other parts of the body.
Suicidal strangulation by ligature is quite rare. It
may be done by placing a ligature around the neck and
tightened by means of twisting a piece of stick.
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.
Manual Strangulation or Throttling
This is a form of asphyxial death whereby the
constricting force applied in the neck is the hand.
Methods of Throttling
1. Using one hand
2. Using both hands with assailant in front
3. Using both hands with assailant at the back
Manners of Death in Manual Strangling
1. The air passage may be blocked and death is due to
asphyxia
2. The pressure on the neck may cause compression of
the blood vessels and disturb the blood supply of the
brain
3. The nerves of the neck may be traumatized especially
the superior laryngeal branch of the glossipharyngal,
hypoglossal nerves and the plexus surrounding
Bifurcation of the common carotid artery or of the
vagus producing shock.
Accidental, Homicidal or Suicidal Manual Strangulation
1. Suicidal throttling is impossible because of the
pressure of the person's own hand must be
maintained for sometime but when unconsciousness
begins, the hands are relaxed and the victim recovers.
2. Accidental throttling may occur but the victim never
died of asphyxia but of other causes.
3. Homicidal manual strangulation is the most common.
It is a method of choice in infanticide.
Special Forms of Strangulation
1. Palmar Strangulation
The palm of the hand of the offender is pressed
in front of the neck without employing fingers.
2. Garroting
A ligature, a metal collar or a bowstring is placed
around the neck and tightened at the back.
3. 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.
4. Compression of the Neck with a Stick
The victim may be forced to place his back
behind a post.
C. 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, 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, like mud, paper, cloth, etc.
Suicidal smothering by means of his own hand is
not possible
Homicidal and accidental smothering is frequent.
It may occur when a person is under the influence of
alcohol, epilepsy or in any other helpless state. It is
common among children.
Examples: overlaying, accidental smothering of epileptic,
gagging, plastic bag suffocation
Choking

This is a form of suffocation brought about by the


impaction of foreign body in the respiratory passage. Most
of suffocation by choking is accidental, although it may be
utilized in suicide or in homicide.
D. Asphyxia by Submersion or Drowning
This is a form of asphyxia wherein the nostrils
and mouth has been submerged in any watery, viscid or
pultaceous fluid for a time to prevent the free entrance of
air into the air passage and lungs.
Time Required for Death in Drowning
Submersion for 1-1/2 minutes is considered fatal,
if ordinary efforts for respiration is made, however, a
person may survive even after 4 minutes of submersion.
The average time required for death in drowning is 2 to 5
minutes.
Emergency Treatment in Drowning
Remove the bodily clothings especially the tight
ones and wrap the body with blanket. Place the face down
and perform artificial respiration, using any of the following
methods: Schaefer's Method or Sylvester's Method.

FROGLETS NOTES
Administration of stimulants as ammonia,
aromatic vinegar, etc.
Injection of strchnine, coramine, caffeine, etc.
Inhalation of oxygen combined with 5% to 8%
carbon dioxide to stimulate respiration.
Floating of the Body in Drowning
The body may not immediately be recovered
after drowning because it is under water. The specific
gravity of human body is slightly more than of the water.
Within 24 hours, on account of the decomposition which
causes the accumulation of gas in the body, the body
floats. The floating of the body is markedly influenced by
the weather, condition of the fluid medium where drowning
took place, presence of wearing apparel, age, sex and
body built. The body when recovered, floats usually with
flexed extremities. The head is submerged because it has
a higher specific gravity than the rest of the body.
"tete de negri" - the bronze color of the head and neck of a
person who died in water during the process of
decomposition.
E. 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, the assailant may kneel on
the chest of the victim or squeeze the victim between the
arms and legs as in wrestling.
In accidental cases, the body may be pinned
between two big objects or collapsing building on the
ground.
Very rarely is traumatic asphyxia attempted in
suicide.

and charcoal used in heating or cooking, or gasoline


engine in cars.
Accidental and suicidal death by carbon
monoxide poisoning is common. Victims may be
accidentally imprisoned or deliberately enclose themselves
in a room or garage with motor engine running or slow
burning is present.
Qualitative Test for Carbon Monoxide in the Blood
1. Kunkel's Test
2. Potassium Ferrocyanide Test
3. Examination Through a Spectroscope
4. Gas Chromatograph
5. Infrared Analysis
Carbon Dioxide (Carbonic Gas Acid)
Carbon Dioxide is the gas blown out of the lungs
during respiration, product of complete combustion of
carbon containing compounds, and the end result of
fermentation and decomposition of organic matters.
HYDROGEN SULFIDE (SULPHURETTED HYDROGEN,
H2S)
NATURE and CHARACTERISTICS

Death by Crucifixion
When person is nailed on a cross the weight is
supported by the nailed feet. Classified as traumatic
asphyxia.
F. Asphyxia by Breathing Irrespirable Gases
Carbon Monoxide (Carbonic Oxide Gas, Co "Silent Killer")
Carbon Monoxide is formed from the incomplete
combustion of carbon fuel. The fatal carbon monoxide
poisoning usually involves burning wood, oil,coal, kerosene

61

By 4D2014-2015

COLORLESS, Transparent gas, sweetish taste


and emitting an odor similar to a rotten egg.
Formed during a decomposition process of
organic substances containing sulphur.
Found in large quantities in a sewer, septic tanks,
drainage pipes, and deep wells.

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.

Summary of Legal Medicine


Book by Solis

A dilute solution produces irritation of the eyes,


nose, throat and air passages, followed by
dizziness, headache, nausea, vomiting,
abdominal pain, cyanosis, dilated pupils, cold
extremities, and labored breathing
Prolonged exposure on a diluted atmosphere
may cause tetanic convulsion, delirium, stupor,
coma and death.

POST-MORTEM FINDINGS

Putrefaction sets rapidly.


Offensive odor is noticed on opening the body.
Blood in fluid state, dark brown in color is due to
conversion of hemoglobin to sulmethemoglobin.
Lungs are congested and edematous.

FROGLETS NOTES

Other organs are congested and dark colored.

HYDROGEN CYANIDE
NATURE and CHARACTERISTICS

One of the most toxic and rapid acting gases.


Formed by addition of acid to potassium or
sodium salt of cyanide.
Found in leaves of cherry-laurel, in bitter almond,
in kernels of common cherry, plum, peaches, in
ordinary bamboo shoots, and in certain oil seeds
and beans.

EFFECTS

Loss of muscular power, giddiness, 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, 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.

SULFUR DIOXIDE
NATURE and CHARACTERISTICS

COLORLESS gas
Employed as a disinfectant, bleaching agent
Found in eruption of volcanoes

EFFECTS

Irritation of the respiratory passage, thus causes


sneezing, coughing, 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, smoke, 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.A.P.)
Bromobenzyl Cyanide (B.B.C.)
Ethyl Iodoacetate (K.S.K.)

EFFECTS:

Irritation of the eyes with copious flow of tears


Severe lacrimation, spasm of the eyelids,
congestion of the conjunctivae and temporary
blindness
Irritation of the respiratory passages and lungs,
burning sensation in the throat and discomfort on
the chest
Vomiting, nausea, 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

FROGLETS NOTES
VESICANT or BLISTERING GAS

KINDS

Mustard Gas (Dichlordiethyl Sulfide, Yellow


Cross, 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, 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.

When inhaled, they cause dyspnea, tightness of


chest and coughing, varying degree of
conjunctival irritation, vomiting, coma and death

STERNUTATOR (Nasal Irritants or Vomiting Gases)


KINDS

Diphenyl chlorarsine (D.A.)


Diphenylamine chlorarsine (D.M.)
Diphenyl cyanarsine (D.C.)

2.

EFFECTS

Nausea, stricken with coryza, malaise,


headache, vomiting, salivation and pain in the
chest, and prostration

PARALYSANTS (Nerve Gas)

Paralysis at the myoneural junction

BLOOD POISONS
KINDS

ENVIRONMENTAL FACTOR ex. Roads,


weather, absence of road signs, blind
intersections, 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.

MECHANICAL FACTOR ex. Defect in the


steering wheel, poor brake, transmission failure,
worn out tires, unstable body

4.

SOCIAL FACTOR ex. Speed, 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. Mental Attitude ex. Reckless driving,
showing of, inattention, fatigue, inexperience
b. Perceptive Defect ex. Defective vision,
defective hearing
c. Delayed or Sluggish Reaction Time
Reaction Time the space of time the driver
perceives an impending danger and the actual
application of the brake.
d. Disease the driver may develop an
epileptic fit or suffer from a heart attack
while on the steering wheel
e. Chemical Factor ex. Driving under
influence of alcohol or drugs (depressant
drugs, marijuana, psychotrophic drugs) ,
leak in the exhaust system of the vehicle

5.

INJURIES AND DEATH ON THE DRIVER AND


PASSENGERS

63

By 4D2014-2015

FROGLETS NOTES
KINDS OF COLLISIONS IN AUTOMOTIVE CRASH
1.
2.

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.
2.
3.

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.

2.

3.

Driver
a. Severe impact of the drivers head on the
windshield may cause laceration of the
scalp, face or neck.
b. Impact of the lower extremities against the
dashboard may cause fracture of the tibia,
fibula, femur, or pelvis as well as lacerations
and abrasion of the skin of the area.
c. The impact of the face to the circular rim of
the steering wheel may cause fractures of
the teeth, jaw and facial bones.
Front Seat Passenger
a. Abrasion of the face and scalp.
b. Laceration of the face and scalp.
c. Fracture of the skull.
d. Laceration or rupture of the heart.
e. Crashing injury of the neck.
f. Fracture of the ribs and sternum.
g. Laceration of the liver and/or spleen.
Rear Seat Occupants they may strike the back
of the front seat, the pillar between the front and
rear side doors, or may be propelled over the
front seat striking the front seat passenger and
driver, dashboard or windshield.

SIDE IMPACT CRASH

Common impact in street intersections


The lateral impact to the chest may cause
fracture of the ribs, contusion with laceration of
the lungs.
Laceration of the spleen and kidneys and pelvic
may also be observed.

REAR IMPACT CRASH

64

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

With the impact at the rear, the head moves


backward or hyperextended, then the head will
move forward until the chin strikes the front
portion of the chest and with the neck
hyperflexed.
The backward and forward movement of the
head is known as acceleration-deceleration
injury or whiplash. It may result to muscle
spasm or injury to the ligament of the neck
resulting to pain.

ROLL OVER CRASH (Turn-turtle Impact)

In the process of rolling, the occupants may be


pinned, crushed or may be thrown away and fall
on the ground.
On account of the ling period of the process of
rolling, the passenger does not sustain severe
injuries. The rolling process causes the different
sides of the vehicle to absorb the force of the
impact.

EJECTION OF THE OCCUPANTS

The primary impact of the vehicle may forcibly


open the unlocked door.
Ejection may increase further the injury sustained
by the occupant.

MEANS EMPLOYED TO MINIMIZE INJURY TO DRIVER


AND PASSENGER
1.

2.

3.

4.

Use of soft padded dashboard, windshield safety


glass, dashboard with perforation to allow metal
to deform easily, enlarged and padded central
steering wheel hub and collapsible steering
column
The interior of the passenger compartment,
including the steering wheel, dashboard, side
doors are prevented from intruding into the
passenger compartment and strike the
occupants.
The fender, bumper and other parts of the car
commonly involved in the impact are made of
metal which can absorb energy, dissipate such
force and prevent its transmission to the driver
and passengers.
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. But the use of seat belt is not absolutely
considered as a safety device. It may cause

FROGLETS NOTES
injuries to the abdominal wall, visceral organs
and vertebral column.
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, may stretch
the mesentery and causes injury to the intestine
and mesentery itself. There may be abrasion,
contusion and hematoma of the lower portion of
the abdomen.

Accounts for the multiple abrasions and


contusions on the body of the pedestrian-victim

3.

RUN OVER INJURIES

The pedestrian may be run over by the moving


vehicle during the initial impact or thereafter
Usually, the victim dies of shock
Crash fracture, skid or tire marks, rupture of
organs and internal hemorrhage may be seen at
autopsy

4.

HIT-AND-RUN INJURIES

A fast moving vehicle may run over, 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, 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, pole or
bridge support at a high speed.
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.

EVIDENCE IN VEHICULAR CRASH


1.

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, paint strains, pieces of clothing that may
be found in the body of the victim, 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, speed of
the moving vehicle, 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.

SECONDARY IMPACT

2.

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, step on the brake and
accelerator, visual and hearing perception, reflex
time, heart condition, history of epileptic seizure,
etc.

65

By 4D2014-2015

FROGLETS NOTES

Alcoholic drunkenness a person with at least


0.15% alcohol in the blood is considered drunk
Injuries due to second collision like steering
hub imprint, fractured skull, multiple abrasions
and laceration of the face and scalp, fracture of
the leg bones, ribs and sternum

3.

FROM THE VICTIM IN VEHICLE-PEDESTRIAN


COLLISION

Crush injury
Tire Thread Marks
Abrasion Marks
Paint Marks
Blood, 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.
2.

3.
4.

Determine deceaseds 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,
poisoning, 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.
3.

A motorcycle can attain a high speed compared


with other ordinary road vehicle.
It has a small profile that the driver of other
vehicles may fall to see it.
At high speed and frequently in curves, the
cyclist may lose control of the brake. it may hit a
fixed object, the tire may skid, 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.

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.
No restraint system is available to keep the
operator and the passenger on the bike and as a
result, ejection from the motorcycle is common.

Inasmuch as the cyclist is exposed to crashes, the only


alternative approach is the protective wearing apparel.
1.
2.
3.

Leather jacket, thick pants, 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.
Motorcyclist helmet which must be buckled to
protect the head.

CHAPTER XXI
MEDICO-LEGAL ASPECTS OF SEX CRIMES
A.

VIRGINITY AND DEFLORATION


Virginity- is a condition of a female who has not
experienced sexual intercourse and whose
genital organs have not been altered by carnal
connection.
A woman is a VIRTOUS FEMALE if her
body is pure and if she has never had
any sexual intercourse with another,
though her mind and heart is impure.

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.
KINDS OF VIRGINITY
1.
2.

3.

Moral Virginity- the state of not knowing the


nature of sexual life and not having experienced
sexual relation.
Physical Virginity- a condition where a woman is
conscious of the nature of the sexual life but has
not experienced sexual intercourse.
a. True Physical Virginity- the hymen is
intact.
b. False Physical Virginity- hymen is
unruptured but the orifice is wide and
elastic.
Demi-Virginity- condition of a woman who
permits any form of sexual liberties as long as
they abstain from rupturing the hymen by sexual
act.

FROGLETS NOTES
4.

Virgo Intacta- a truly virgin woman. There are no


structural changes in her organ to infer previous
sexual intercourse and that she is a virtuous
woman.

PARTS OF THE FEMALE BODY TO BE CONSIDERED


IN THE DETERMINATION OF THE CONDITION OF
VIRGINITY.
1.
2.
3.
4.
5.

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.)
Hymen
a. As to the shape and size of the
opening:
i. Annular or Circular- the
opening is oval or circular
located at the center of the
hymen.
ii. Infantile- the opening is
small.
iii. Semilunar or crescentric- the
concavity may be facing
either side or upwards or
downwards.
iv. Linear- the opening is slit-like
and usually running vertically.
v. Cribiform- the hymen
presents several openings
instead of a single one.
vi. Stellate- hymenal opening is
like a star.
vii. Septate- there are two
openings separated by a
bridge of hymenal tissue.
viii. Fimbriated- the border of the
opening shows small
irregular protrusiontowards
the opening.
ix. Imperforate- no opening in
the hymen.
b. As to structure and consistency:
i. Firm and with strong
connective tissue and plenty
of blood vessels.
ii. Thick yielding hymen with
scarce blood vessels.
iii. Membranous hymen- hymen
is parchment like, may be
transparent and may be

67

By 4D2014-2015

c.

lacerate without pain or


appreciable bleeding.
As to number of opening:
i. Single orifice
ii. Septate- two openings
iii. Multiple- several openings
iv. Imperforate- no opening

Virginity is NOT synonymous with Chastity.


A woman may resort to many forms of
homosexual as well as heterosexual practices without
losing her virginity, yet she may be unchaste.
B. DEFLORATION
Defloration is the laceration or rupture of the hymen as a
result of sexual intercourse.
Parts of the female genitalia that must be examined to
determine defloration:
1.
2.
3.
4.

Condition of the Vulva


Fourchette
Viginal canal
Hymen- the fact that hymen is intact does
not prove absence of previous sexual
intercourse and the presence of laceration
does not mean defloration.
a. Other causes of hymenal
laeration:
i. Passage of clotted blood
during menstruation
ii. Ulceration due to
disease
iii. Jumping or running
iv. Falling on hard and
sharp object
v. Medical instrumentation
vi. Local medication
vii. Self-scratching due to
irritation
viii. Masturbation
ix. Insertion of foreign
bodies
x. Previous operation

IN THE MEDICAL EXAMINATION OF THE HYMEN, THE


FOLLOWING FACTS MUST BE INCLUDED;
a.
b.
c.

General condition of the hymen


Original shape of the orifice (opening)
If lacerated, the following must be
noted:

FROGLETS NOTES
i. Degree of laceration
(complete, incomplete or
complicated laceration)
ii. Location of laceration
iii. Duration of laceration(fresh
bleeding, fresh healing,
healed with sharp coaptible
borders without congestion or
healed laceration with
rounded non-coaptible
borders and retraction of the
edges.)
iv. Complications of laceration
PSYCHOLOGICAL CONSIDERATION
A.

B.

During sexual excitement


a. Local Changes the parasymphatetic
innervations of the sex organ is from
the 2nd , 3rd and 4th spinal sacral
segments, and the sympathetic
innervations is from the 11th thoracic
down to the 1st lumbar. Brrr brrr brrr
b. Sysmetic effects:
i. Increase of pulse rate
ii. Marked increase in blood
pressure making its peak
during orgasm
iii. An increase of peripheral
flow of blood experienced as
an increase of body warmth
iv. Tumescence- consequence
of this peripheral flow
concentrating on erectile
tissue
v. Increased respiration
vi. A decrease in bleeding
during arousal
vii. A decrease of sensory
perception
During Orgasm
In the male, 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.
In the female, during orgasm, there is
contraction of the smooth muscles of
the uterus and rhythmic contraction of
the viginal sphincter, the
ischiocavernousus and the pelvic floor
musculature. Brrr brr brr

68

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

DEATH RELATED TO SEXUAL ACT


A.

Death by male partner


a. Death from natural cause- because of
increased blood pressure, tachycardia
and hyperventilation due to emotional
response and muscular exertion.
b. Death may be due to the defensive act
of the woman-victim.
B. Death by female partner
a. The sexual intercourse might be done
in a relatively confined space like the
back of the seat of a car.
b. In case of oral sex (fellatio) wherein the
male penis is placed in the mouth of
the female partner. The Size and the
length of the penis may cause total or
partial block of the air passage,
causing asphyxia.
c. 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.
d. Sadist who may not be sexually
satisfied by sexual intercourse but by
inflicting physical injuries to the partner
.
e. In concealing the crime.
f. The female may die of shock as a
result of the extreme trauma in case of
rape.
g. Hemorrhage.
h. Infection
C. Death of BOTH partners
a. May be due to the performance of the
sexual act in an enclosed place with
carbon monoxide or asphyxiant gas.
b. Homicide-suicide pact. 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.
Evidences of Force or Intimidation: or
-Mere initial reluctance of the offended party or verbal
refusal alone will not prove force. Must be a manifested
and tenacious resistance.

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

-Force, as an element in rape, need not be irresistible as


long as it brings the desired result.

c. 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, it is not necessary that there are signs that she put up
a determined resistance.

-if did not deprive her of reason, not


rape (US v. Lung), 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, on the arms and the fact that the
garments worn at the time were torn and heavily stained
with blood.

2. The woman-victim is unconscious


a. Sexual act committed while the woman is on
her natural sleep

- Strong evidence of force is the presence of physical


injures found on the person of the victim in the course of
medical examination. 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.

b. Sexual act on a woman suffering from sleeping


sickness - 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

- Application of threat will cause fear in the victim of the


untoward consequence. If she will not accede to the will of
the offender, the crime may constitute intimidation.
-Intimidation purely subjective, cannot be proven by
medical evidence.
Rape Committed by Depriving the Victim of Her
Reason or Otherwise Made Unconscious
1. Deprival of Reason
a. Rape committed on insane or mentally
deficient woman
-victim: woman, 14 years of age,
feeble-minded and can only
speak
mono-syllables
-sexual intercourse with insane woman
-BUT, 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. Rape committed while the woman is under the
influence of alcohol or
other depressant drugs
-in the absence of decided cases, also

rape

69

By 4D2014-2015

c. Sexual act on a woman who is unconscious


because she was knocked-out

d. Sexual act after administration of narcotics or


other "knock out" drugs
3. 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, BUT lack of medical
examination
of
victim
NOT
an
indispensable element in the prosecution of rape.
WON
it will prosper depend upon the
evidences offered.
-complaint for rape NOT valid unless it is a
complaint by the offended party. Information not
signed by the offended party is insufficient to

FROGLETS NOTES
confer jurisdiction on the court. Filing of complaint
by father of a girl who is only 14 years old,
sufficient compliance with RPC.
Instances When Rape is Punishable by Death
1. When by reason or on the occasion of the rape, the
victim becomes insane
2. When the rape is attempted or frustrated and a homicide
is committed by reason or on the occasion thereof
3. When by reason or on the occasion of the rape, a
homicide is committed
Medical Evidences in Rape
1. Evidences from the victim
-written consent from victim or guardian if not of
age, 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. date, 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. physical and mental development of


the victim
-height, 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. 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-- does it
correspond to the alleged
date of commission?
g. examination of
including the breast

genitalia,

-breast roughly handled or


presence of finger marks,
nipples bitten,
vulva
swelling,
hymen
fresh
lacerations etc.

-place: determine which court


can acquire jurisdiction

-in the pubic hair the ff may


be gathered:

b. date, time and place of the


examination

1. pubic hair of
offender

-material to the determination


of the possible findings of the
physician on the victim

2. semen
spermatozoa
3. blood stains

c. condition of the clothings


d. physician must observe the gait, the
facial expression and the bodily and
mental attitude of the subject

70

the

By 4D2014-2015

4. body louse
2. Examination of the alleged offender

and

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

a. physical development, mental condition and


strength

1. 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. Strands of hair, blood, seminal and other stains may be


recovered to prove consummation and struggle

b. evidence of physical injuries


-whole body must be examined
-victim in the course of struggle may
have inflicted injurie upon him

3. Pieces of personal belongings of offender and/or victim


may be recovered to prove consummation and struggle
4. Investigation of witnesses who may possibly be material
to the prosecution of the case may be conducted
EXAMINATION FOR SEMINAL FLUID AND
SPERMATOZOA

c. condition of the sex organ


-blood,
seminal stain,
vaginal
epithelium and doderleins bacillus,
urethral meatus moist
d. evidence from pubi hair
-matted together due to blood stains or
seminal fluid discharge
-presence of body louse
e. potency of the offender

- Semen: the viscid, albuminous fluid with faint grayishyellow color, having the characteristic fishy odor, and
containing spermatozoa, epithelial cells, lecithin bodies and
other substances
-Spermatozoon: living organism, normally present in the
seminal fluid consisting of a head, neck and tail. From 5055 microns in length. The head is ovoid and flattened when
viewed in front and pearshape when viewed on the profile.
-The ff specimens may be examimed for seminal fluid and
spermatozoa:

- defense that he is impotent


f. evidence of genital infection

accused

2. vaginal smear from victim

3. Evidences form the companion of the victim


a. history of the incident, won they are consistent
with narration of facts of victim
b. if companion helped victim when force was
applied by offender,
companion must be
subjected to physical and medical examination
for
physical injuries
c. examination of clothings
d. to determine whether the companion might
have participated as an accomplice
e. mental condition, physical power, age and
emotional state to determine capacity to resist
unlawful aggression from offender
f. presence of alcohol or other depressants
Investigation of the Crime Scene:

71

By 4D2014-2015

1. wearing apparel of the victim and alleged

3. stains on the body of the victim and accused


4. stains found at the site of the commission of
the offense
PROCEDURE:
1. Gross Examinations
a. 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. Inspection by means of Ultraviolet light

patches

-to make visible small seminal stains or


-shows bluish fluorescence

FROGLETS NOTES
2. 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. Allow the liquid portion to dry on
the side. Perform any of the following:
a. Florence Test: produced by the action of
iodine on choline, not a proof of seminal fluid but only of
the presence of some vegetable or animal substance,
positive result: merely presumptive evidence of small fluid,
negative result: in all probability it is not that of the seminal
fluid
b. Berberio's Test: some allege this test is
specific for spermatic fluid, reaction probably depends on
the presence of spermatic secretion
c. Puramen Reaction: based on the presence of
spermine in the prostatic fluid, Puramen reaction is found
to be very reliable and rather characteristic of seminal fluid
d. Acid Phosphate Test: semen produces a very
high phosphate activity as compared with other body fluids
the ff are needed:
1. citrate buffer solution
2. suitable substrate
3. diazonium salt
3. Microscopic Examinations
-presence of complete spermatozoon will
undoubtedly infer presence of seminal fluid, although
semen may be present without spermatozoa, such
as in cases of aspermia (semen without
spermatozoa) or oligospermia
(semen with few
spermatozoa)
a. Dr. Hankin's Method
b. Gaguli's Method: best way to stain
spermatozoa in India
4. Biological Examinations
a. 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. Seminal Grouping
-test is of value for elimination
-positive result does not definitely imply
that the person is owner of sperm in
question, 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, differing views (2 or 3 days at most, 43 hours,
17 days, more than 2 weeks, 48 hrs after intercourse)
Can a woman be raped while she is on her natural
sleep? Occasionally it may happen, but highly improbable.
Normal virgin: hard to conceive such could be committed,
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,
no. BUT, under present laws, WOMAN CAN COMMIT
CRIME OF RAPE ON A MAN. (See crim :p)
Can rape cause death? Although not usual, introduction
of matured male sex organ into vagina of young girl may
produce injury sufficient to produce death. Death may be
due to hemorrhage brought about by laceration of vaginal
canal, shock, subsequent infection such as gangrene or
peritonitis.
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.
Can husband commit the crime of rape on his wife?
NO. 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.
However, if there is a decree of legal separation by the
court, husband may be guilty of rape on wife. Legal
separation does not dissolve the matrimonial tie between
husband and wife, but merely separation in bed.
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.

FROGLETS NOTES
OTHER CRIMES AGAINST CHASTITY

Summary of Legal Medicine


Book by Solis

2. Incestuous Qualified Seduction -

A. SEDUCTION

a. Brother who seduces his sister


b. Ascendant who seduces his descendant

A. QUALIFIED SEDUCTION

-seduction where there is blood relationship


between the seducer and the seduced. Father
seducing daughter or other descendants, or
brother seducing sister.

Art. 337, Revised Penal Code - The seduction of a virgin


over twelve years and under eighteen years of age,
committed by any person in public authority, priests, house
servant, domestic, guardian, teacher or any person who, in
any capacity, shall be entrusted with the education or
custody of the woman seduced, shall be punished by
prision correcional in its minimum and medium periods.

-In this type of seduction, 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, 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,
whether or not she be a virgin or over eighteen years of
age.
Under the provisions of this Chapter, seduction is
committed when the offender has carnal knowledge of any
of the persons and under the circumstances described
therein.
Types of Qualified Seduction
1. Ordinary Qualified Seduction
a. offended party must be a virgin
b. offendede party must be over twelve years and
under eighteen years of age
c. there must be sexual intercourse between the
offender and the offended party; and
d. 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 - need not be
teacher, but same school
(d) Person who, in any
capacity, is entrusted with the
education or custody of the
woman seduced

73

By 4D2014-2015

B. SIMPLE SEDUCTION:
Art. 338. Simple seduction. The seduction of a woman
who is single or a widow of good reputation, over twelve
but under eighteen years of age, committed by means of
deceit, shall be punished by arresto mayor.
Elements:
1. The offended party is over 12 but less than 18 years of
age;
2. The offended party must be single or a widow of good
reputation;
3. There must be sexual intercourse done by the offender
with her; and
4. The sexual act must be committed by means of deceit.

The statute making simple seduction a crime is


not to punish illicit intercourse, but to punish the
seducer who by means of his promise of
marriage, destroyed the chastity of an unmarried
female of previous chaste character, and who
draws her aside from the path of virtue and
rectitude, and then fails or refuses to fulfill his
promise. (People v. Iman)

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.

Medical proofs on account of the application of


force, and conditions that will cause the victim to
be deprived of her reason or otherwise
unconscious are no longer relevant.

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, the question of
paternity may be necessary.

Summary of Legal Medicine


Book by Solis

Art. 339. Acts of lasciviousness with the consent of the


offended party. 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.
Elements:
1. The offender commits acts of lasciviousness;
2. The offended woman must be over 12 but under 18
years of age, except when the victim is the sister or
descendant of the offender;
3. The offender commits the act by abuse of authority,
confidence, relationship or deceit;
4. The victim must be a woman, virgin, single, or widow of
good reputation, except when she is the sister or
descendant of the offender where virginity is not required.
Medical Evidences in the Crime of Acts of Lasciviousness

B. ACTS OF LASCIVIOUSNESS

Like in the crimes of rape and


seduction, medico-legal investigation is
involved in proving the lascivious act
itself and the other elements to
constitute the crime.

Physical injuries may be suffered by


the victim on the part of the body where
the lascivious act was committed.

Acts of Lasciviousness are acts which tend to excite lust;


conduct which is wanton, lewd, voluptuous or lewd
emotion.
A. ACTS OF LASCIVIOUSNESS:
Art. 336. Acts of lasciviousness. Any person who shall
commit any act of lasciviousness upon other persons of
either sex, under any of the circumstances mentioned in
the preceding article, shall be punished by prision
correccional.
Elements:

C. ABDUCTION

1. The offender commits any acts of lasciviousness;

Abduction is the carrying away of a woman by an abductor


with lewd design.

2. The lascivious act is done under any of the following


circumstances:
a. By using force or intimidation.
b. By depriving her of her reasons or otherwise
unconscious;
c. When the woman is under 12 years of age;
3. The offended party must be a person of either sex.
B. 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.
A. FORCIBLE ABDUCTION:
Art. 342. Forcible abduction. The abduction of any
woman against her will and with lewd designs shall be
punished by reclusion temporal. The same penalty shall be
imposed in every case, if the female abducted be under
twelve years of age.
Elements:

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

1. The victim abducted is a woman;

B. CONCUBINAGE:

2. The abduction is against her will;

Art. 334. Concubinage. Any husband who shall keep a


mistress in the conjugal dwelling, or shall have sexual
intercourse, under scandalous circumstances, with a
woman who is not his wife, or shall cohabit with her in any
other place, shall be punished by prision correccional in its
minimum and medium periods.

3. The abduction is with lewd design.


B. CONSENTED ABDUCTION:
Art. 343. Consented abduction. The abduction of a virgin
over twelve years and under eighteen years of age, carried
out with her consent and with lewd designs, shall be
punished by the penalty of prision correccional in its
minimum and medium periods.

Ways of Committing the Crime:


1. Keeping a mistress in the conjugal dwelling;

Elements:

2. Having sexual intercourse, under


circumstances, with a woman not his wife; or

1. The offended party must be a virgin;

3. Cohabiting with her in any other place.

2. The offended party must be over 12 but under 18 years


old;

PROSTITUTION

3. The carrying away of the offended party is with her


consent; and
4. The taking away must be with lewd design.
D. ADULTERY AND CONCUBINAGE
A. ADULTERY:
Art. 333. Who are guilty of adultery. 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, even if the marriage be subsequently declared
void. Adultery shall be punished by prision correccional in
its medium and maximum periods.

If the person guilty of adultery committed this offense while


being abandoned without justification by the offended
spouse, the penalty next lower in degree than that provided
in the next preceding paragraph shall be imposed.

Prostitutes are women who, for money or profit, habitually


indulge in sexual intercourse or lascivious conduct.
Reasons why some women become prostitutes:

Physiological and psychological traits;


Economic factors;
Home and neighborhood;
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. Call girl;
2. Hustler:

Elements:

a) Bar or tavern pick-up:

1. The woman is married;

b) Street walker

2. She has had sexual intercourse with a man not her


husband; and
3. The man with whom she had sexual intercourse knows
her to be married even if the marriage has subsequently
been declared void.

75

By 4D2014-2015

scandalous

3. Door knocker;
4. Factory Girl
Effects of Prostitution

FROGLETS NOTES

Arrest and imprisonment;


Venereal infection;
Social ostracism;
Poor personal hygiene;
Excessive use of alcohol;
Irregular habit of eating and sleeping;
Demoralization and physical deterioration

Summary of Legal Medicine


Book by Solis

a superior officer;
2. 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.

Methods of Control:

If the person solicited be the wife, daughter, sister of


relative within the same degree by affinity of any person in
the custody of such warden or officer, the penalties shall be
prision correccional in its minimum and medium periods
and temporary special disqualification.

1. Legalized but regulated; or

Ways of Committing Abuse of Chastity:

2. Strict prohibition

1. 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, or consult with a superior
officer;

Medical Evidence in Prostitution- 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. Corruption of Minors:
Art. 340. Corruption of minors. Any person who shall
promote or facilitate the prostitution or corruption of
persons underage to satisfy the lust of another, shall be
punished by prision mayor, and if the culprit is a pubic
officer or employee, including those in government-owned
or controlled corporations, he shall also suffer the penalty
of temporary absolute disqualification. (As amended by
Batas Pambansa Blg. 92).
B. White Slave Trade:
Art. 341. White slave trade. The penalty of prision mayor
in its medium and maximum period shall be imposed upon
any person who, in any manner, or under any pretext, 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. 186.)
C. Abuse Against Chastity:
Art. 245. Abuses against chastity; Penalties. The
penalties of prision correccional in its medium and
maximum periods and temporary special disqualification
shall be imposed:
1. 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, or with respect to which
he is required to submit a report to or consult with

76

By 4D2014-2015

2. By soliciting or making immoral or indecent advances to


a woman under the offenders custody;
3. By soliciting or making immoral or indecent advances to
the wife, daughter or relatives with the same degree by
affinity of any person in custody of the offending warden or
officer.
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. 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.
Provisions of the Penal Code which may be Applicable to
Unnatural Sexual Offenses:
1. Grave Scandal:
Art. 200. Grave scandal. 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.
2. Immoral doctrines, obscene publications and exhibitions:
Art. 201. Immoral doctrines, obscene publications and

FROGLETS NOTES
exhibitions and indecent shows. The penalty of prision
mayor or a fine ranging from six thousand to twelve
thousand pesos, or both such imprisonment and fine, shall
be imposed upon:
(1) Those who shall publicly expound
or proclaim doctrines openly contrary to public
morals;
(2) (a) the authors of obscene
literature, published with their knowledge in any
form; the editors publishing such literature; and
the owners/operators of the establishment selling
the same;
(b) Those who, in theaters, fairs,
cinematographs or any other place, exhibit,
indecent or immoral plays, scenes, acts or
shows, whether live or in film, which are
prescribed by virtue hereof, shall include those
which (1) glorify criminals or condone crimes; (2)
serve no other purpose but to satisfy the market
for violence, lust or pornography; (3) offend any
race or religion; (4) tend to abet traffic in and use
of prohibited drugs; and (5) are contrary to law,
public order, morals, and good customs,
established policies, lawful orders, decrees and
edicts;

Summary of Legal Medicine


Book by Solis

4. Any person who, not being included


in the provisions of other articles of this Code,
shall be found loitering in any inhabited or
uninhabited place belonging to another without
any lawful or justifiable purpose;
5. Prostitutes.
4. Unjust vexation or any other coercion:
Art. 287. Light coercions. 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, or both.
SEXUAL ABNORMALITIES
As to the Choice of Sexual Partner:
1. Heterosexual- sexual desire towards opposite sex.
2. Homosexual- sexual desire towards same sex.
a) Overt- persons who re conscious o their
homosexual cravings, and who
make no attempts
to disguise their intention.

(3) Those who shall sell, give away or


exhibit films, prints, engravings, sculpture or
literature which are offensive to morals. (As
amended by PD Nos. 960 and 969).
3. Vagrants and Prostitutes:

b) Latent- 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.

Art. 202. Vagrants and prostitutes; penalty. The


following are vagrants:

3. Infantosexual- sexual desire towards an immature


person.

1. Any person having no apparent


means of subsistence, who has the physical
ability to work and who neglects to apply himself
or herself to some lawful calling;

a) Pedophilia- a form of sexual perversion


wherein a person has the

2. 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;
3. Any idle or dissolute person who
ledges in houses of ill fame; ruffians or pimps
and those who habitually associate with
prostitutes;

77

By 4D2014-2015

compulsive desire to have sexual intercourse


with a child of either sex.
A Pedophile may be:
either oral or anal
victim.

a. Homosexual pedophile- may attempt


intercourse with his

b. Heterosexual pedophile- may


attempt either oral, vaginal, anal,

FROGLETS NOTES
intracrural intercourse as well as cunnilingus, but
attempts at
vaginal penetration
are most common.
Theories Why Adults become Interested in Children:
a. Emotional congruence- Children are sexually attractive
to adult:

Children are non-dominant;


Adults have low self-esteem, immaturity,
socialization to male dominance or narcissism;
and
Unconscious impulse, compulsively to repeat
child-adult sex contact to master, and his or her
own early experience of child-adult sexual abuse.

Summary of Legal Medicine


Book by Solis

6. Gerontophilia- sexual desire with elder person.


7. Necrophilia- a sexual perversion characterized by erotic
desire or actual sexual intercourse with a corpse.
8. Incest- sexual relations between persons who, by reason
of blood relationship cannot legally marry.
As to Instinctual Strength of Sexual Urge:
1. Over Sex:
a. Satyriasis- excessive desire of men to
intercourse;
b. Nymphomania- strong sexual desire of women
2. Under Sex (Sexual frigidity):

b. Conditioning Modeling- behavioral modeling begins with


the early childhood experience, positive or negative, and is
conditioned by hormonal abnormalities, child pornography
and the misattribution of arousal as being only from
children.
c. Blockage- alternative sexual gratification may become
blocked due to poor social skills with adults of the opposite
sex, anxiety about sex, unresolved oedipal conflicts,
unavailability of or conflict with a committed partner, as well
as repressive social sexual norms.
d. Disinhibition- sexual controls may become disinhibited
due to senility, dementia, mental retardation, psychosis,
drug or alcohol, impulse disorders, situational stress, failure
of incest avoidance, a general cultural acceptance.

a. Sexual anesthesia- absence of sexual desire


or arousal during sexual act in
women.
b. Dyspareunia- painful sexual act in women.
c. Vaginisimus- painful spasm of the vagina
during sexual act.
elderly.

d. Old age- weakening of sexual feeling in the

As to Mode of Sexual Expression or Way of Sexual


Satisfaction:
1. Oralism- the use of the mouth as a way of sexual
gratification.

4. Bestosexual- sexual desire towards animals.

5. Autosexual (Self-gratification or maturbation)- it is a form


of self-abuse or solitary vice carried without the
cooperation of another person.
Types of Masturbation:

a. Fellatio (Irrumation)- 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.
b. Cunnilingus- sexual gratification is attained by
licking or sucking the
external female genitalia

a. Conscious Type- the person deliberately


resorts to some mechanical means of producing sexual
excitement with or without orgasm;

c. Anilism (anilingus)- a form of sexual perversion


wherein a person derives
excitement by licking the
anus of another person of either sex.

b. Unconscious Type- the release of sexual


tension may come about via the
mechanism
of
nocturnal stimulation with or without emission, which
may also be considered as masturbation
equivalent.

2. Sado-masochism (Algolagnia)- pain or cruel act as a


factor for gratification.

78

By 4D2014-2015

Sexual Abnormalities

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

As to Instinctual Strength of Sexual Urge:


1.

Over Sex:
a. Satyriasis excessive sexual desire of men
to intercourse
b. Nymphomania strong sexual feeling of
women; hot or fighter
Both are general expressions of compulsive
neurosis.

c.

3.
2.

Under-sex or Sexual Frigidity:


a. Sexual anesthesia absence of sexual
arousal during intercourse in women
b. Dyspaureunia painful sexual act in women
c. Vaginismus painful spasm of the vagina
during intercourse
d. Old age weakening of sexual feeling in the
elderly; there is desire, but accomplishment
is difficult; accompanied by odd behaviour
like exhibitionism, incest, homosexuality

As to Mode of Sexual Expression or Way of Sexual


Satisfaction:
1.

Oralism use of mouth


a. Fellation (Irrumation) female receives the
penis into her mouth, by friction with the lips
and tongue, coupled with the act of sucking,
initiates orgasm
b. Cunnilungus licking and sucking the
external female genitalia
c. Anilism (Anilingus) licking the anus of
another; form of sexual perversion

2.

Sado-masochism (Algolagnia) pain or cruel act


a. Flaegellation act of whipping or being
whipped
b. Sadism (Active algolagnia) infliction of
pain on another is necessary or sometimes
the sole factor in sexual enjoyment
i. Cannibalism biting without flesheating, but with presumed unconscious
wish to consume
ii. Love bites superficial punctuate
contusions seen usually at the side of
the neck, breast, 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; deviate has a strong homicidal
urge, suffering from organic brain
disease, a schizo, 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. Anatomic particular portions of the body
(ex. breasts, buttocks)
b. Clothing shoes, handkerchiefs,
undergarments, etc.
c. Necrophilic near a dead body; may or may
not violate dead person
d. Odor (Ospresiophilia) pleasant or foul
odor
i. Urolagnia sight of women urinating;
sometimes, even a desire to drink the
urine
ii. Coprolognia sight of women
defecating
iii. Mysophilia filth or excretion
e. Pygmalionism statues
f. Manikinism manikins
g. Narcissism extreme admiration and love of
ones self; looking at the mirror and
appreciating oneself
h. Negative fetish marked dislike for things
i. Saboteur fetish deviate does damage
while he gets satisfaction (ex. cutting clothes
or hair)
j. Incendiarism from setting fire
k. Vampirism sight of blood

As to the Part of the Body:


1.
2.
3.

4.

Sodomy sexual act through anus


Uranism fingering, fondling with breast, licking
parts of the body, etc.
Frottage compulsive desire of a person to rub
his sex organ against some body parts of another
(ex. rubbing or pressing organs against womens
buttocks in crowded places and pretends it is
accidental)
Partialism special affinity to certain part of the
female body; usually, intercourse is merely
secondary to satisfy the sexual desire; differs

FROGLETS NOTES
from frottage in that there may not only be
rubbing but actual intercourse

1.

As to Visual Stimulus:
1.

2.

Voyeurism compulsion to peep to see persons


undress or perform other personal activities and
usually, masturbates in excess afterwards;
Peeping Tom
Mixoscopia (Scoptophilia) watching a couple
undress or during their sex intimacies

2.

3.
As to Number: (sexual deviation because more than two
persons are participating)
1.

2.

Troilism (Menage a trois) three persons are


participating in sexual orgies where the usual
activity may be fellatio, kissing the buttock,
suixante-neuf or 69, coitus; eternal triangle
Pluralism group of persons participate in sexual
orgies; two or more couples perform intercourse
in one room and may agree to exchange for
varietys sake during the sexual festival

Other Sexual Deviates:


1.

2.

3.

Coprolalia need to use obscene language to


obtain gratification; sometimes, 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; cannot find anyone to be a permanent
companion
Indecent exposure (Exhibitionism) wilful
exposure in a public place of ones genital organ
in the presence of others, usually of the opposite
sex; with or without masturbatory act; women
may expose themselves as in bubble and fan
dances and the strip tease acts in night clubs
People v. Aparici (G.R. 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.

Sexual Reversal:

80

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Transvestism (Sexo-esthetic inversion; Psychical


hermaphroditism; Metamorphosis sexualis
paranoia) male derives pleasure from wearing
female apparel and vice versa; generally
harmless insofar as they have no desire to
assault anyone, but merely to attract attention
Transexualism identify themselves with the
opposite sex as completely as possible and to
discard forever their anatomical sex; hate their
genitalia that sometimes they attempt to castrate
or mutilate themselves, 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, reproductive organs, sexual behaviour
a. Gonadal agenesis testes or ovaries have
never developed; determined very early in
fetal life
b. Gonadal dysgenesis external sexual
structures are present but at puberty fail to
develop
i. Klenefetters syndrome male type
where the anatomical structure is male,
but the nuclear sexing is female
(Chromatin positive); XXY
chromosomes
ii. Turners syndrome structurally and
phenotypically female but the ovaries
are small; sterility with the absence of
the second X chromosomes
c. True hermaphroditism bisexuality, having
both ovaries and testicles; nuclear sex is
usually female; sex character may be
neutral or whichever is dominant
d. Pseudohermaphrodite anatomically of one
sex but the sex character is that of the
opposite sex
i.
Male pseudohermaphrodite
gonads are testicles but the character
is effeminate
ii.
Female pseudohermaphrodite
gonads are ovaries but the character is
masculine
CHAPTER XXII
PREGNANCY

Introduction
Definition: state of a woman who has, within her body, the
growing product of conception or a fecundated germ

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; inasmuch as some authorities consider more
than two weeks as the life span of the spermatozoa in the
vaginal canal, it is hard to ascertain the exact date of the
fertilization; 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; 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. From the date of the first day of the last
menstruation, add seven days and count three
months backward.
2. Count forward nine calendar months from the
date of the first day of the last menstruation
and add one week.
3. Count forty weeks or ten lunar months from the
date of the first day of the last menstruation.
4. Determination of the level of the fundus of the
uterus
5. MacDonald Method distance from the
symphysis pubis up to the fundus of the uterus
in centimters divided by 3.5 gives the age in
month gestation
6. Date of the quickening count ahead in 24
weeks multigravidas and 22 weeks in
primagravidas from date of quickening; found
not to be reliable

Legal Importance:
1.
2.
3.
4.

Pregnancy is a ground for the suspension of the


execution of the death sentence in a woman.
(Art. 83, RPC)
A conceived child is capable of receiving
donation. (Art. 742, NCC)
A conceived child may exercise civil rights. (Arts.
40-41, NCC)
Concealment of the woman that she is pregnant
at the time of the marriage is a ground for
annulment of the marriage. (Arts. 85-87, NCC)

81

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Instances Why Some Women Claim Pregnancy Even if


None Exists:
1.
2.
3.
4.
5.

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 widows 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.
3.

No ground to become pregnant unmarried,


divorced, living separately from husbands; to
defend moral and social reputation
Defense when accused of infanticide or abortion
Marriage inducement

Medical Evidences of Pregnancy:


A. Presumptive or Probable Signs and
Symptoms
1. Cessation of menstruation it must be noted that
a woman is capable of menstruating even during
pregnancy during the first three months; nursing
mother may not menstruate
2. Morning sickness
3. Changes in the breast
4. Progressive enlargement of the abdomen at
the end of the third month, the fundus of the
uterus is at the level of the brim of the pubic bone
5. Changes in color of the vagina and softening of
the cervix
Different Signs to Show Changing of Color:
a. Jacquemin-Chadwicks Sign pale violet
discoloration of the anterior wall of the
vagina
b. Hegars Sign bi-manual examination of
the gravid uterus shows extreme
softening of the cervix
c. MacDonalds Sign softening of the
isthmus, fundus of the uterus is anteflex
d. Goodells Sign cervix of the uterus feels
as hard as the tip of the nose, no
pregnancy; but when as soft as the lips,
uterus is gravid

FROGLETS NOTES
Funic souffl or Umbilical souffl whistling
sound synchronous with the fetal heart
7. Ballottement feeling perceptible to the fingers
on giving sudden impulse to the child through the
neck of the uterus; hand placed on abdomen
8. Braxton-Hicks Sign rhythmical contraction and
relaxation of the uterus, perceptible to the hand
on the abdomen
9. Bladder irritability or Frequent urination usually
at second month
10. Capricious appetite
11. Abnormality in pigmentation especially in
abdomen and perineum
12. 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.

B. Positive Signs and Symptoms of Pregnancy:


1. Hearing of the fetal heart sounds (Mayors Sign)
compared to ticking of a watch under a pillow;
rate is 120-140 beats per minute
2. Outlining of the fetal parts through palpation
3. Movement of the fetus (Quickening) at the fifth
month
4. X-ray Examination
Laboratory Test for Pregnancy:
A. Pregnancy Slide Test (PST)
1. Principle an agglutination-inhibition
reaction is used to demonstrate the
hormone human chorionic gonadotropin
(HCG) which is excreted into the urine
during pregnancy
2. Regeants:
a. Pregnancy Slide Test antiserum
human HCG antiserum from rabbit
b. Pregnancy Slide Test antigen HCG
latex suspension, chemically-bound
3. Procedure:
a. Place 1 drop of urine then 1 drop of
PST antiserum 1 in one of the circles
on the test slide and mix thoroughly.
b. Add 1 drop of PST antigen 2.
Shake well and mix well.
c. Carefully agitate the slide with a
circular motion to ensure that the
fluid revolves slowly within the
circle.

82

By 4D2014-2015

d.

4.

5.

6.

Read the results after two


minutes.
Interpretation of results:
a. No agglutination (homogeneous)
pregnant
b. Agglutination (granular) not pregnant
Sensitivity often possible within 5 days
after missed menstrual period; pregnancy
will be diagnosed 12 days after the missed
menstrual period
Remarks fresh morning urine is preferable
and suitable; if result is doubtful, repeat test
after a few days

B. Gravindex HCG Slide Test same principle and


procedure involved as PST; Gravindex is merely
a trade name
Signs of Pregnancy in the Dead: (additional findings to
the objective signs already mentioned)
1.
2.
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. Laxity of abdominal wall.
2. Presence of Striae of pregnancy on the
abdominal wall.
3. Perineum is lax with a scar if there was previous
laceration. Fourchette is markedly restracted.
4. Vestige only of the hymen is present.
5. Breast is lax with enlarged nipples.
6. Vaginal examination showed previous laceration
of cervix.
-

Superfecundation is the fertilization made by


separate intercourses of two ova which have
escaped at the same act of ovulation.
Superfoetation is the fertilization of two ova
which have escaped at different acts of ovulation.
Spurious Pregnancy is an imaginary pregnancy
usually observed among women nearing
menopause or younger women who are very
desirous of having children. The patient may
imagine fetal movement which is in reality a
muscle contraction.

Diagnosis of Fetal Death (Proof of Fetal Death):

FROGLETS NOTES
1.
2.
3.
4.
5.
6.

The size remains stationary even after the lapse


of a number of weeks or months.
Endocrine test for pregnancy is negative on more
than one occasion.
Cessation of fetal movement after they have
been felt.
Absence of fetal heart sounds after repeated and
prolonged examination.
Palpation of softened macerated fetal head with
bones freely movable on each other and the
scalp hanging over a loose sac.
Breasts cease to be enlarged and become soft
and flabby.
In the Philippines, menstruation begins at the age
of 12-14 years old and ceases at the age of 45.
As long as the woman starts menstruating, she
has the potential of becoming pregnant.
CHAPTER XXIII
DELIVERY

Delivery is the process by which a woman gives


birth to her offspring.
The study of delivery is important because proof
of delivery is necessary in judicial action on:
legitimacy, abortion, infanticide, concealment of
birth, and in slander or libel.

Methods of Delivery:
1. Natural Route expulsion of the products of
conception through the normal passage, that is
through the vaginal canal.
2. 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.
Signs of Recent Delivery:
1. Languid look, with pulse and temperature slightly
increased.
2. Peculiar odor which is present up to the 10th day
of confinement.
3. Changes in the breast (sensation of tightness in
breasts and milk may be expressed).
4. Flaccidity of the abdominal wall.
5. Linea Albicantes (Striae of Pregnancy) present in
the abdominal wall.
6. Presence of Linea Negra.
7. Uterus is enlarged and palpable.
8. Laxity of the perineum with possible tear.
9. Vaginal canal is lax and with possible lacerations.

83

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

10. Cervix is the uterus is flabby, patulous and may


be torn.
11. Presence of lachial disahcrage.
12. Evidence of placenta, umbilical cord and newborn child.
13. Positive pregnancy slide test.
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. Viability is at the point at which the
fetus is potentially able to live outside of the
mothers womb, albeit with respiratory aid.

Principal Elements of Abortion:


1. That the expulsion of the product of conception is
induced.
2. That the fetus dies either as an effect of the
violence used, drug administered or the fetus
was expelled before the term of its viability.
Clinical Types of Abortion:
1. Missed Abortion an ovum destroyed by
hemorrhage into the choriospace usually before
the 4th month of the pregnancy.
2. Threatened Abortion hemorrhage without
dilatation of the internal os.
3. Inevitable Abortion hemorrhage with dilatation
if the internal os and the presence of rhythmical
pain.
4. Incomplete Abortion not all products of
conception had been expelled from the uterus;
fragments or portions of which is retained.
5. Complete Abortion the whole product of
conception is expelled.
Causes of Abortion:
1. Death of the fetus
2. Abnormality of the uterus
3. Emotional condition
4. Aborifacent drugs
5. Trauma whether direct or indirect
6. Hormonal deficiency
7. Acute specific fever and high temperature
Provisions of the RPC on Abortion:
1. Intentional Abortion (Elements)
a. That the woman is pregnant.

FROGLETS NOTES
b.
c.
d.
2.

3.

4.

That violence was applied, or drug was


administered, or a person acts upon such
pregnant woman.
That the effect of such violence, drug, or
acts of the offender, the fetus dies or is
expelled.
That the offender has the intention to abort
the pregnant woman.

Unintentional Abortion (Elements)


a. The woman must be pregnant.
b. Violence was applied on such pregnant
woman without the intention of aborting her.
c. The woman aborted as a result of the
violence.
Abortion practiced by the woman herself or by
her parents (Elements)
a. The woman is pregnant.
b. Abortion is intended to be committed.
c. Abortion is induced by:
(1) The pregnant woman herself.
(2) Other persons with the consent of the
pregnant woman herself.
(3) The parents of the woman, or either of
them for the purpose of concealing her
dishonor and with the consent of the
woman herself.
Abortion practiced by a physician or midwife and
dispensing abortive (Elements)
a. The woman is pregnant.
b. The physician induced or assisted in
causing the abortion with the use of
scientific knowledge.
c. The acts done by the physician or midwife
was intended to cause abortion.

Kinds of Abortion:
1. Spontaneous Abortion occurs without any
form of inducement or intervention.
2. Induced Abortion this will not take place had it
not been for some form of inducement or
intervention. Induced abortion may be:
a. Therapeutic Abortion abortion purposely
done to preserve the life of the mother.
b. 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.
Reasons why some people procure Abortion:
1. Preserve the life and health of the pregnant
woman.
2. Terminate prematurely illegitimate pregnancy in
order to conceal the dishonor of the woman.
3. Financial difficulty.
4. To preserve body form.
How Abortion is Induced or Procured:
1. By General Violence includes intentional
violence, exerting strong physical efforts and
other forms of strenuous and exhaustive
exercises.
2. By Local Violence violence is applied in any
portion of the generative organ. This is usually
resorted to when general violence and the use of
drugs fails to give the desired result. Local
violence may be applied by the pregnant woman
herself, by the physician, midwife or the parents.
3. By the Use of Drugs
4. By Surgical Intervention
5. Modern Methods like Amniocentesis and
Vacuum Suction
Complications of Abortion
1.

Immediate Untoward Effects:


a.

Shock may be due to the laceration


of the uterus or the adjacent organ like
the bladder, rectum, intestine or blood
vessels. The injury may be due to the
introduction of instruments or the
application of hot fluid or corrosive
substances.

b.

Hemorrhage and Anemia Adherent


placental tissue, infection, presence of
foreign bodies and atony of the uterus
may cause hemorrhage for failure of
the uterine muscles to contract.

c.

Embolism: (1) Air Embolism (2) Fat


Embolism (3)Thrombo-Embolism (4)
Bacterial Embolism

d.

Infection Pathogenic organism may


be introduced into the uterus and
produce systemic symptoms. If death
occurs, signs of toxemia may be
observed at autopsy.

FROGLETS NOTES
e.

Poisoning Lysol, corrosive


sublimate, iodine solution are
frequently used for vaginal douche and
may cause systemic poisoning.

f.

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.

g.
2.

Perforation of the bladder or any of


the neighboring organs

b.

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, infection of the ovaries may
cause sterility.

d.

Pelvic Adhesion Infection and


trauma may cause the uterus or vagina
to become adherent to the surrounding
organs or tissues.

Medical Evidences of Abortion


Medical Evidences of Abortion in the Living
a.

b.

Presence of external signs of violence


in the form of contusions, abrasions,
hematoma, open wounds of whatever
form on the body surface if induced by
general violence. If violence is applied
locally in the generative tract, injuries of
whatever form or description may be
seen therein

3)

Note the size of the


uterus, its consistency
and location.

d.

History Note the state of health


beforehand after abortion. Inquire as to
the motive of the abortion and history
of having ingested with abortives.

e.

Signs of previous pregnancy:

f.

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, tear and
discharge.

Examination of the instrument used for


the presence of blood, 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.

c.

2)

c.

Delayed Untoward Effects


a.

1.

Summary of Legal Medicine


Book by Solis

By 4D2014-2015

Appearance of the
external genitalia and
vagina may show
laceration, contusion,
abrasions and other
marks of
instrumentation.

FROGLETS NOTES

2.

g.

Laboratory test for pregnancy

h.

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.
e.

Medical evidence of abortion in the dead:

Aside from the evidences of abortion in


the living which may be found in the
dead, the following may be observed at
autopsy:
a.

Evidence of
instrumentation

b.

86

Like the stomach


and its contents,
other organs like
the kidneys, liver,
spleen must be
subjected to a
qualitative and
quantitative
examination for the
presence of irritant
poisons.

Examination of uterine
contents - 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,
toxemia or bacteremia (2)
embolism (3) fistulae
formation (4) pelvic
adhesions.

Therapeutic Abortion

An abortion which the law allows under


some justifications

Legal Justification to Therapeutic Abortion

Art. 11, No. 4, Revised Penal Code


o

Abortifacent drugs
and other irritants
may be found
inside the stomach
upon chemical
examination.

Examination of the kidneys


and other organs for
irritants

d.

This will include the


presence of
punctured wounds
in the placenta,
presence of
remnants of the
placenta inside the
uterine cavity,
presence of
perforation of the
uterus.

Examination of stomach
and its contents:

c.

f.

Biological test

Any person who, in order to


avoid an evil or injury, does
an act which causes damage
to another, provided that the
following requisites are
present: (1) that the evil
sought to be avoided actually
exists; (2) that the injury
feared be greater than that
done to avoid it; (3) that there
be no other practical and less
harmful means of preventing
it.

In the performance of an abortion, two


lives are involved, namely, the life of
the mother and the life of the fetus.
One life must be sacrificed to save the
life of another in case of therapeutic
abortion.

The evil sought to be avoided is the


danger on the life of the mother if such
pregnancy will be allowed to continue.
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.

FROGLETS NOTES

In the evaluation as to whose life must


be spared, it is a common concept that
the life of the mother must be preferred
than that of the unborn child. A
conceived child is not definitely sure of
its independent existence while the
mother has already manifested real life.

2.

Abortion in order to be justifiable must be


performed to save the life or to preserve the
health of the mother. 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. A
physician must exercise due diligence in
considering a disease or a combination of
diseases or conditions as grounds for the
therapeutic abortion.

3.

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.
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.

4.

It is advisable to have the opinion of other


competent physicians as to the justifiability of
such therapeutic abortion. The opinion of one
might be influenced by prejudice and
misjudgment.

5.

Enlightened and expressed consent must be


obtained from the woman herself if she has no
impediment to give consent. It is advisable to
have also the consent of the husband, inasmuch
as abortion will affect marital relationship.

Grounds for Therapeutic Abortion:


1.
2.
3.
4.
5.
6.
7.
8.

Cardio-vascular conditions as congestive heart


failure, auricular fibrillations, repeated
hemoptysis, paroxysmal tachycardia.
Renal conditions as chronic nephritis, previous
eclampsia, pyelitis, tuberculosis
Pulmonary conditions as advanced tuberculosis.
Blood condition as severe anemia.
Gynecological conditions as refractory chorea
gravidarum.
Organic nervous conditions as psychosis.
Miscellaneous conditions as diabetes,
exophthalmic goiter.
Hereditary conditions as insanity.

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. State (48 N.W. 380 Wis.) 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. 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.
In a case cited by Camp and Purchase (Practical
Forensic Medicine, p. 32, 1957), a married
woman with unstable character finding herself
pregnant, threatened to commit suicide. The
physician whom she repeatedly made her threat
during her unexpected visits referred her to a
psychiatrist who recommended abortion. The
operation was carried on by a reputed
gynecologist but unfortunately, the patient died of
gangrene of the uterus. The coroner did not
recommend prosecution because the operation
was done to save the life of the mother.

Safeguards to be Observed by Physician in Performing


Therapeutic Abortion:
1.

The lawful abortion must be performed by a


licensed physician or surgeon.

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.

The crime is performed clandestinely by an


intelligent being who is fully aware of his criminal
act.

2.

The physician has several medical reasons to


justify his act. There is no hard and fast rule in
medicine. 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.

3.

In most cases, the products of conception


removed which may be utilized as corpus delcti
in the crime is lost.

4.

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,
herself, is in pari delicto to the crime of criminal
abortion.

FROGLETS NOTES
5.

Medical society seems to have a lukewarm


attitude in helping the state prosecute the
abortionist.

a.

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.

CHAPTER XXV
BIRTH
Legal Importance of the Study of Birth
1.

2.

3.

Birth determines personality:


Art. 40,Civil Code: Birth determines
personality; but the conceived child
shall be considered born for all
purposes that are favorable to it,
provided it be born later with the
conditions specified in the following
article.
Art. 41, Civil Code: For civil purposes,
the foetus is considered born if it is
alive at the time it is completely
delivered from the mothers womb.
However, if the foetus had an intrauterine life of less than seven months,
it is not deemed born if it dies within
twenty-four hours after its complete
delivery from the maternal womb.
Appearance of a child is a ground for the
revocation of donation:
Art. 760, Civil Code: Every donation
inter vivos, made by a person having
no children or descendants, legitimate
or legitimated by subsequent marriage,
or illegitimate, may be revoked or
reduced as provided in the next article,
by the happening of any of these
events. (1) if the donor, after the
donation has legitimate or legitimated
or illegitimate children, even though
they be posthumous.
Proof of live-birth must first be shown before
death of the child by the prosecution in the case
of infanticide:
Art. 255, 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.

Birth may be:

88

By 4D2014-2015

b.

Causes of Still Birth


1. Immaturity
2. Congenital diseases
or malformation
3. General debilitating
diseases (acute
specific infection,
toxemia, kidney
disease, acute liver
disease, septicemia)
4. Local disease of the
generative organ
(syphilis; ablation
placenta, intraplacental
hemorrhage, or
extensive infarction;
kind of the cord;
placenta previa
5. Accidents in the
delivery
6. Violence, either
deliberate or
accidental at birth.

Live-Birth the child after birth exhibited clear


signs of vitality and viability is not necessary.

In law, the presumption is every newborn


child found dead was born dead. The
burden of proof lies on those who declare
otherwise. To have a child acquire a
personality distinct as that of the mother,
there must be proof of life after complete
separation from the mothers womb.

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


(Wredins Test: The middle ear of
the a child before birth is filled with
gelatinous, embryonic connective

FROGLETS NOTES

Summary of Legal Medicine


Book by Solis

tissue. This disappears after the


birth of the child.))
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, How Long Did the Child Survive?

It is not possible to determine the exact


length of time the child has lived after birth,
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.

Length of the fetus 50 centimeters

2.

Weight 3.0 kilos

3.

Lanugo hair almost disappeared

4.

Limbs and body plump

5.

Face lost its wrinkles

6.

Skin covered with vernix caseosa

7.

Head covered with hair about 2 inches long

Proof of Live-Birth can be deduced in the following:


1.
2.
3.

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, how long did the child survive?

It is not possible to determine the exact length of


time that the child has lived after birth.
An approximate may be formed after
consideration of the following points:
1. Changes in the skin
a. At birth body of the child is
bright-red in color; covered
with vernix caseosa which
may be present up to 2 days
b. At a weeks time normal
color of the skin
c. First 3 days after birth
exfoliation of the skin in the
abdomen
2. Presence of Caput Succedaneum
a. If present the child was
born with head presentation
b. There are color changes in
the course of its absorption
c. The Caput lasts up to the 7th
day

FROGLETS NOTES
3.

4.

Changes in the Umbilical Cord


a. Mummification of the cord
does not occur if the child is
submerged in water after
birth
b. A mummified cord may again
be soft after continuous
soaking in water
Changes in the Circulation
a. Umbilical artery begins to
contract about 10 hours
after birth
b. Umbilical vein and ductus
venosus obliterate 4th and
5th day
c. Ductus arteriosus on the 3rd
day
d. Foramen ovale closes on the
2nd or 3rd month

Signs of maturity of the child at birth


1.
2.
3.
4.
5.
6.

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. Head covered with haird about 2 inches long
8. Nails project from the fingers; toe-nails reach
only to the end
9. One or both testes are in the scrotum, or labia
have close the vulva
10. Lower end of femur may show center of
ossification about 0.6 cm in diameter
CHAPTER XXVI
INFANTICIDE (NEONATICIDE)
Infanticide - The killing of a child less than 3 days old.
RPC. Art. 255. Infanticide. 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.

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, she shall suffer the
penalty of prision correccional in its medium and
maximum periods, and if said crime be
committed for the same purpose by the maternal
grandparents or either of them, the penalty shall
be prision mayor.
Penalties

If killing done by parents, grandparents, 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.

2.

3.

Infancy is the period in the life of a child from


birth up to one year.
a. 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, is it considered infanticide?
When a child was born less than 7 months of
uterogestaton.
With
modern
neonatal
management, the child had all the chances to
live. After a few hours after birth, the chold was
deliberately killed. 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.
2.
3.
4.
5.

To conceal dishonor (single, widowed, estranged


from husband, 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

FROGLETS NOTES
6.

Belief that child will bring bad luck to the family

a.

Criminological Characteristics of infanticide


1.
2.
3.
4.
5.

Most often committed by the mother


Almost always committed at home
Crime scene: no manifest disturbance, no
witnesses, no noise, no outcry
Trauma applied is so minimal
A newly born child found dead was born dead.
Burden of proof that a living child has been killed
is placed on the prosecution

What must be proven by evidence


1.
2.
3.

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.

3.
4.
5.
6.

Presence of marks of physical violence


(fingernail marks at the neck)
b. Abrasion
c. Contusion
d. Hematoma
e. Lacerated wounds
f. 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, through which food
is passed and digested)
a. Can show signs of poisoning
In case of poisoning, 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, laceration of the internal
organs

How Infanticide is committed


1.

2.

By omission or neglect
a. Failure to ligate the umbilical cord (if
not cut or not tightly ligated, child may
bleed to death)
b. Failure to protect the child from heat
and cold (depriving the child of
necessary clothing)
c. Failure to take the necessary help of a
midwife or a skilled physician
d. Failure to supply the child with proper
food (child starved to death)
e. Failure to remove the child from the
mothers discharge which resulted to
suffocation
By commission
a. Inflicting physical injuries (use of
kitchen utensils, hard or sharp objects)
b. Suffocation
c. Strangulatioin
d. Drowning (child disposed in a
sewerage disposal in a creek)
e. Poisoning
f. Burning
g. Delibreate exposure to heat cold (direct
sunshine, basin of cold water)

Post-mortem findings in cases of infanticide


1.

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.
2.

For succession
a. Right of legitimate children is different
from that of illegitimate childrem
For enforcement of naturalization and
immigration laws
a. Naturalized citizens give ipso facto
Philippine citizenship to their minor
children. Thus, the minors must prove
that they are legitimate children of the
naturalized citizen.
b. 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.

FROGLETS NOTES
(Hello blockmates, 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. Thanks.)

d.

Kinds of Children
1.

Legitimate Children
a.

b.

c.

Who are considered legitimate children


i. Children conceived or born during the
marriage of the parents
ii. 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, provided, that both
of them authorized or ratified such
insemination in a written instrument
executed and signed by them before the
birth of the child. The instrument shall be
recorded in the civil registry together with
the birth certificate of the child.
Grounds to impugn legitimacy of a child:
i. 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. the physical incapacity of the
husband to have sexual
intercourse with his wife;
2. the fact that the husband and
wife were living separately in
such a way that sexual
intercourse was not possible; or
3. serious illness of the husband,
which absolutely prevented
sexual intercourse;
ii. That it is proved that for biological or
other scientific reasons, the child could
not have been that of the husband,
except in the instance provided in the
second paragraph of Article 164; or
iii. That in case of children conceived
through artificial insemination, the written
authorization or ratification of either
parent was obtained through mistake,
fraud, violence, intimidation, or undue
influence.
The child shall be considered legitimate although
the mother may have declared against its

92

By 4D2014-2015

e.

f.

g.

Summary of Legal Medicine


Book by Solis

legitimacy or may have been sentenced as an


adulteress.
If the marriage is terminated and the mother
contracted another marriage within three hundred
days after such termination of the former
marriage, these rules shall govern in the absence
of proof to the contrary:
i. 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, provided it be born within three
hundred days after the termination of the
former marriage;
ii. A child born after one hundred eighty
days following the celebration of the
subsequent marriage is considered to
have been conceived during such
marriage, even though it be born within
the three hundred days after the
termination of the former marriage.
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.
The action to impugn the legitimacy of the child
shall be brought
i. Within 1 year from the knowledge of the
birth or its recording in the civil register, if
the husband or, in a proper case, any of
his heirs, should reside in the city or
municipality where the birth took place or
was recorded.
ii. If the husband or, in his default, all of his
heirs do not reside at the place of birth as
defined in the first paragraph or where it
was recorded, the period shall be two
years if they should reside in the
Philippines; and three years if abroad.
iii. If the birth of the child has been
concealed from or was unknown to the
husband or his heirs, 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, whichever is
earlier.
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. If the husband should died before the
expiration of the period fixed for bringing
his action;

FROGLETS NOTES
ii. If he should die after the filing of the
complaint without having desisted
therefrom; or
iii. If the child was born after the death of the
husband.
2.

Legitimated Children
a. Children conceived and born outside of wedlock
of parents who, at the time of the conception of
the former, were not disqualified by any
impediment to marry each other may be
legitimated.
Legitimation shall take place by a
subsequent valid marriage between
parents. The annulment of a voidable
marriage shall not affect the legitimation.
Legitimated children shall enjoy the same
rights as legitimate children.
The effects of legitimation shall retroact to
the time of the child's birth.
The legitimation of children who died
before the celebration of the marriage
shall benefit their descendants.
Legitimation may be impugned only by
those who are prejudiced in their rights,
within five years from the time their cause
of action accrues.

3.

Adopted Children
a. Who may adopt
i. Any Filipino citizen of legal age, in
possession of full civil capacity and legal
rights, of good moral character, has not
been convicted of any crime involving
moral turpitude, emotionally and
psychologically capable of caring for
children, at least sixteen (16) years older
than the adoptee, and who is in a position
to support and care for his/her children in
keeping with the means of the family. 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 is the spouse of the adoptee's
parent;
ii. Any alien possessing the same
qualifications as above stated for Filipino
nationals: Provided, That his/her country
has diplomatic relations with the Republic
of the Philippines, that he/she has been
living in the Philippines for at least three

93

By 4D2014-2015

b.

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, 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, and that his/her
government allows the adoptee to enter
his/her country as his/her adopted
son/daughter: Provided, Further, 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. a former Filipino citizen who
seeks to adopt a relative within
the fourth (4th) degree of
consanguinity or affinity; or
2. one who seeks to adopt the
legitimate son/daughter of
his/her Filipino spouse; or
3. 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; or
iii. The guardian with respect to the ward
after the termination of the guardianship
and clearance of his/her financial
accountabilities.
iv. Husband and wife shall jointly adopt,
except in the following cases:
1. if one spouse seeks to adopt
the legitimate son/daughter of
the other; or
2. if one spouse seeks to adopt
his/her
own
illegitimate
son/daughter:
Provided,
However, that the other spouse
has signified his/her consent
thereto; or
3. if the spouses are legally
separated from each other.
v. In case husband and wife jointly adopt, or
one spouse adopts the illegitimate
son/daughter of the other, joint parental
authority shall be exercised by the
spouses.
Who may be adopted

FROGLETS NOTES
i. Any person below eighteen (18) years of
age who has been administratively or
judicially declared available for adoption;
ii. The legitimate son/daughter of one
spouse by the other spouse;
iii. An illegitimate son/daughter by a qualified
adopter to improve his/her status to that
of legitimacy;
iv. A person of legal age if, prior to the
adoption, said person has been
consistently considered and treated by
the adopter(s) as his/her own child since
minority;
v. A child whose adoption has been
previously rescinded; or
vi. A child whose biological or adoptive
parent(s) has died: Provided, That no
proceedings shall be initiated within six
(6) months from the time of death of said
parent(s).
4.

Illegitimate Children
a. Children conceived and born outside a valid
marriage are illegitimate, unless otherwise
provided in this Code.

B. Illegitimate Children
Those who were born out of lawful wedlock or
after a competent time after its dissolution.
1. Natural Children:
a. Natural Children (Proper):
-those born outside wedlock of parents
who, at the time of the conception of the former,
were not disqualified by any impediment to marry
each other (Art. 269, Civil Code).
b. Natural Children by Legal Fiction:
-those children born out of void
marriages or those born of voidable marriages
after the decree of annulment.
c. 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.
2. Spurious Children:
Illegitimate children who are not natural.

94

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

a. Adulterous Children:
- children conceived in an act of
adultery or concubinage.
b. Sacrilegious Children:
-children born of parents who have
been ordained in sacris (priest and nun).
c. Incestuous Children:
-children born by parents who are
legally incapable of contracting valid marriage
because of their blood relationship.
d. Manceres:
-children conceived by prostitutes.
Civil Liability of Persons Guilty of Crimes Against Chastity:
Art. 345, Revised Penal Code:
Persons guilty of rape, seduction or abduction
shall also be sentenced:
1. To indemnify the offended woman.
2. To acknowledge the offspring,
unless the law should prevent him from
so doing.
3. In every case to support the
offspring.

The adulterer and the concubine may also be


sentenced, in the same proceeding or in a
separate civil proceeding, to indemnify for
damages caused to the offended spouse.
In cases of multiple rape, the offenders may not
be required to recognize the offspring.
If the woman abused is married, the child born
subsequently cannot be recognized and support
cannot be demanded from the offender.

Evidence of Paternity and Filiation


A. Medical Evidences
1. Parental Likeness:
-Heredity transmits traits and
characteristics from parents
to the offsprings.
-There must be some gross
manifestation of the children
which may be in common
with the father.

FROGLETS NOTES
2. 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.
-blood type of the child is not
the possible product of the
parents conclusively show
that the child is not that of the
husband.
3. Evidences from the Mother:
a. 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.
b. Proofs of Physical Potency
and Fertility:
-the woman may
be manifesting
some acquired or
congenital defect
wherein impotency
may be inferred.
-fertility may be
inferred from the
presence of other
pregnancies and
the absence of
organic
abnormalities of the
generative system.
c. 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.

95

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

4. Evidences from the Father:


a. Proof of Physical Potency
and Fertility:
-medical
examination must
be done whether
husband is capable
of erection.
-examination of
spermatozoa in the
seminal fluid is
necessary to
determine fertility.
-presence of
disease, congenital
or acquired
abnormalities, etc.
may be factors that
may bring about
impotency or
sterility.
b. Proof of Access:
-physician must
determine the
health and vigor of
the father, the
presence of
disease, which may
bring about his
incapacity to
perform sexual
intercourse.
B. Non-medical Evidences
1. Record of birth in the Civil Registrar,
or by an authentic document or a final
judgment (Art. 265, Civil Code).
2. Continuous possession of the status
of a legitimate child (Art. 266, Civil
Code).
3. Any other evidences allowed by the
Rules of Court and special laws (Art.
267, Civil Code).
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, growth and

FROGLETS NOTES

development of the conceptus and its


subsequent delivery.
However, modern advancement of medicine
modified the conventional method as a solution
to some specific problems of reproduction.

A. Artificial Insemination
A medical procedure by which the semen is
introduced into the vagina by means other than
copulation for the purpose of procreation.
therapeutic insemination more suitable term
for the procedure.
Artificial Insemination Classified According to the
Source of Semen:
1. A.I.H. (Artificial Insemination Homologous,
Artificial Insemination Husband) Sperm comes
from the husband.
2. A.I.D. (Artificial Insemination Donor, Artificial
Insemination Heterologous) Sperm comes from
a donor other than the husband.
3. A.I.H.D. (Artificial Insemination Husband
Donor, Polled Donor Semen) Donor semen
comes from the husband and a third party donor.
Medical Indications for Artificial Insemination:
1. For A.I.H.:
a. When the deposition of the
husbands semen within the vagina is by coitus;
b. When the infertility is due to poor
motility, paucity or otherwise defective
sperm cells or too small a volume of
the ejaculant.
2. For A.I.D. or A.I.H.D.:
a. Absolute male sterility
(Azoospermia);
b. Oligospermia Less than 10-15
million sperm per cc. of semen with
infertility of long duration;
c. Hereditary disease in the husband
making propagation inadvisable for
eugenic reason; or
d. An Rh blood incompatability is
expected to cause an abnormal baby
on situations where other techniques to
overcome such incompatability are not
applicable.

96

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Selection of Donor of Semen:


In A.I.D., the selection of the appropriate donor of
semen resides in the physician.
If the child born becomes defective which can be
traced from a physicians negligence or
carelessness in choosing the donor, the
physician may be held liable.
Obligations imposed on a physician in the
selection of donors:
1. Proper screening must be made of
the donor.
2. 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.B.O. and Rh genotype of the wife.
3. Physician must ensure that the
identity of the donor is not known to the
parents and vice versa.
4. Complete physical examination with
standard test for syphilis and
gonorrhea is obtained not more than 1
week before the seminal fluid is
collected.
Precautions to be Observed by the Physician in Performing
Artificial Insemination:
1. Physician should make certain by reasonable
testing that the procedure is medically indicated
for the couple. Husband is infertile and such
condition is permanent.
2. Physician should establish by proper
evaluation that the couple is emotionally stable
and psychologically suited for this type of
parenthood.
3. Physician must use all reasonable precautions
in selecting the donor.
4. Physician must, under no circumstances
except by court order, reveal the fact of artificial
insemination or the identity of the donor or of the
couple to each other or to other persons.
5. Physician must use freshly donated sperm or
frozen semen.
6. The insemination procedure must be
performed by the physician in accordance with
the currently accepted techniques.

FROGLETS NOTES
7. Full and valid consents and releases should be
obtained in writing from all parties involved, and
each consent must be an informed consent.
Status of the Child Born by Artificial Insemination:
husband.

1. In A.I.H. child is a legitimate child of the


2. In A.I.D., with consent of the husband child is
legitimate although the fertilization semen is not
from the husband.
3. In A.I.D., without consent or against the will of
the husband child is illegitimate

Consent on A.I.D.:
The consent and release for any future claim
must be obtained by the physician from all
parties in writing.
Consent of wife is necessary to avoid being held
liable for an assault.
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.
If the donor is married, consent of the wife must
also be obtained
B. In Vitro Fertilization
Also known as test tube baby, 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. Implanted into the womans uterus,
or
2. Gestation (development of the
embryo to a child) in an artificial womb.
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, which induces super-ovulation.
Approximately 30 hours later, the oocytes are
removed from the ovary by laparoscopy, a
surgical procedure accomplished by inserting two
thin glass tubes into the ovary through a small
incisiom in the abdomen.
The removed oocytes are placed in a Petri dish
or a test tube containing growth medium
simulating the environment of the womans body.
The oocytes are then fertilized by a sperm which
has been held in vitro.
The resulting conceptus, after it divides and
grows for a few days until it reaches the
blastocyst stage (stage at which the embryo
normally enters the uterus), is then inserted
through the vagina and cervix into the uterus
where it is implanted at a proper time in
menstrual cycle.
After successful transplantation, the woman
carried the blastocyst to term.

Possible Situations in In Vitro Fertilization:


1. The ovum removed from the wife is fertilized
by the husbands sperm and the resulting zygote
is implanted into the wifes uterus.
2. The ovum removed from the wife is fertilized
by the sperm coming from a third party (sperm
donor) and is implanted into the wifes uterus.
3. The ovum coming from a third party (ovum
donor) is fertilized by the husbands sperm and
the blastocyst is implanted into wifes uterus.
4. The ovum taken from the ovum donor is
fertilized by the sperm coming from the sperm
donor and the blastocyst is implanted into the
wifes uterus.
5. The ovum removed from a single woman is
fertilized by the sperm taken from a male donor,
the blastocyst is implanted into the single
womans uterus.
6. The ovum removed from the wife is fertilized
by the husbands sperm and the blastocyst is
implanted to a host or surrogate.

FROGLETS NOTES
7. The ovum coming from the wife is fertilized
artificially by the sperm coming from the sperm
donor and the blastocyst is implanted into the
surrogates uterus.
8. The ovum coming from the ovum donor is
fertilized by the sperm coming from the husband
and the blastocyst is placed into the surrogates
uterus.
9. The ovum coming from the ovum donor is
fertilized by the sperm coming from the sperm
donor and the blastocyst is implanted into the
surrogates uterus.
Basis of Legality of In Vitro Fertilization:

No person shall be deprived of life, liberty, or


property without due process of law, nor shall
any person be denied the equal protection of the
laws. (Art. III, Sec. 1, 1987 Constitution)
From the term liberty emanates the right of
privacy
The right of privacy means the right to be left
alone. It is the right of an individual to the
possession and control of his own person, free
from all restraints or interference of others,
unless by clear and unquestionable authority of
law. It is the right of parents or guardians to
establish their family life as they see fit.
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.
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.
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, to be or
not to be a mother or to raise or not to
raise a family.
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.

98

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Problems in In Vitro Fertilization:


1. The probability that the child to be born will be
defective.
-Some of the probable causes of the
birth of a defective child:
a. Administration of hormone
to the prospective source of
ovum
b. Mechanical manipulation
of the oocyte and embryo
c. Mistake in the screening
process or selection of the
best ovum for fertilization
d. 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.
b. Prospective parents are
normally briefed of the
potential risks of the
procedure before their
consent is obtained.
c. 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.
d. The plaintiff is required to
meet the difficult task of
proving negligence.
-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.
2. Problem of surrogate mother:
-Reasons why the services of a
surrogate mother may be necessary:
a. Necessity

FROGLETS NOTES
Genetic mother is unable
to carry the child to term
because of disease or injury.
Genetic mother may
believe either that she is too
old to safely carry a child to
term, or that the child may be
born with abnormalities.
Genetic mother may
possess deleterious genetic
traits which may be passed
on to the child.
Couple is unable to adopt
a child.
b. Convenience
A woman may not want to
interrupt her career during
the gestational period.
-Motivation of a woman to become a
surrogate mother:
a. Altruistic motive
b. 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, it is tantamount to
rental for the use of the
uterus.
-Problems that may arise in the
agreement in the use of surrogate
mother for gestational purpose:
a. If the surrogate mother
decided to abort the child
contrary to the wish of the
genetic parents.
b. The surrogate mother may
decide to keep the child after
birth rather than surrender
him to the genetic parents.
c. 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.
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.
e. Can the couple enforce the
contract in the event that the
surrogate mother committed
other breaches?
f. 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. By contract There must
be a contract specifically
mentioning the rights and
duties of each party.
b. By legislation The court
is bound to enforce the
legislation unless found to be
unconstitutional. (better
solution)
3. Problem of the status of the child born by in
vitro fertilization (please refer to possible
situations in in vitro fertilization portion above)
a. Situation 1 Child is legitimate
b. Situation 5 Child is illegitimate
c. Situation 2 and 3 Child may still be
legitimate if there is consent of the
sterile party to the in vitro fertilization. If
child is not considered legitimate,
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.
d. Situation 4, 6, 7, 8 and 9 Genetic
parents are different from the
gestational mother. Adoption may be a
legal remedy provided there is no
impediment to the application of the
procedure, otherwise a special
legislation may be necessary.
C. Other Non-Conventional Methods of Procreation
1. Artificial Inovulation The removal of an
unfertilized egg from a woman and placing it on
the reproductive tract of another woman.

FROGLETS NOTES
2. Embryo Transplantation The removal of a
fertilized egg from a womans uterus to transfer
to that of another womans uterus.
3. 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 resulting
offspring is a female.
4. 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). The renucleated egg is then
placed in a uterus for gestation and normal
development. Resulting offspring is genetically
identical to the parent.

100

By 4D2014-2015

Summary of Legal Medicine


Book by Solis

Você também pode gostar