LEGAL MEDICINE :

CONSIDERATION

GENERAL

Legal Medicine is a branch of medicine

which deals with the application
of medical knowledge to the
purposes of law and in the
administration of justice.
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.
SCOPE: Application of medical and paramedical
sciences as demanded by law and
administration of justice.
NATURE OF THE STUDY OF LEGAL MED:
- The ability to acquire facts, arrange them and
draw a conclusion from facts in the
administration of justice.
Medical jurist, Medical examiner,
Medicolegal officer, Medicolegal expert
- A physician who specializes primarily with
medico-legal duties.
- Imhotep 2980 B.C. earliest medico-legal
expert.
DIFFERENCE :
ORDINARY
PHYSICIAN
MEDICO-LEGAL OFFICER
a) Injury/Disease point of view Treatment
Cause
b) Examine a patient
Diagnose
Testify / justice
c) Minor injuries
Ignored
Records all / qualify crime
PRINCIPLE OF STARE DECISIS:
- When the court has once laid an interpretation
of law as applied to certain facts, it will adhere
to and apply to all future cases where the facts
are substantially the same.
BASIC PRINCIPLES GOVERNING
APPLICATION AND EFFECTS OF LAWS:
1. Ignorantia legis nominem excusat
prevent use as defense in violation
2. Law shall have no retro-active effect.
3. Rights may be waived, unless the waiver is
contrary to law, public order, public policy,
morals or good customs, or prejudiced to a
third person with a right recognized by law.
4. Customs which are contrary to law, public
order or public policy shall not be
countenanced.

5. Laws are repealed by subsequent ones, and

their violation or non-observance shall not be
excused by dis-use, custom or practice to the
contrary.
Persons authorized to perform autopsies:
1. Health Officers
2. Medical officer of law enforcement
agencies.
3. Members of the medical staff of
accredited hospitals.
Autopsies shall be performed in the
following cases.
1. Required by special laws
2. Order of competent court, mayor, fiscal
3. Written request of police officers
4. SolGen, fiscal disinter to determine
cause of death.
5. Written request of nearest kin to
ascertain cause of death.
MEDICAL EVIDENCE
- is the means sanctioned by the rules of court
of ascertaining in a judicial proceeding the truth
respecting a matter of fact.
Types of evidence:
1. Autoptic or Real evidence made known to
the senses
2. Testimonial evidence
oral under oath
3. Experimental evidence
4. Documentary evidence
Methods of preserving evidence:
1. Photo, videotape,photocopy
4.Manikin
method
2. Sketching
5.In the
mind of the witness
3.Description
6. Special
methods: embalming
DECEPTION AND DETECTION
Knowledge of truth is important in the
administration of justice, lies solely in the ability
to evaluate the statement given by the suspect
or witness.
Methods of deception detection:
1. Devices which record the psychophysiological response:
a) Use of a polygraph or lie detector
machine
b) Word association test
c) Psychological stress evaluator
2. Use of drugs that try to inhibit the inhibitor
a) Administration of the truth serum
b) Narcoanalysis or Narcosynthesis
c) Intoxication
3. Hypnotism
4. By observation
5. Scientific interrogation
6. Confession
I.
RECORDING OF PSYCHOPHYSIOLOGICAL RESPONSE

Nervous control CNS/ANS

Sym/ParaS
Sympathetic influenced by physical and
emotional stimuli, effects
Parasympathetic works to restore things
A. Use of a Lie Detector or Polygraph
= The fear of the subject when not telling
the truth activates the symp.
= To a series of automatic and involuntary
physiological changes which are recorded by the
instrument.
= Use of control questions > Most reliable &
effective questioning technique.
= Supplemetary tests:
a. Peak of tension test - peak of
tension on relevant questions
b. Guilt complex test - does not
response to added relevant quest.
c. Silent answer test - subject
verbal response creates distortion
in the tracing or clearing of the
throat.
Reason for admissibility to the court of the
result of Polygraph exam :
1. Have not received the degree of
standardization of acceptance.
2. Trier of fact is apt to give almost conclusive
weight to the experts opinion
3. No way to assure the a qualified examiner
administered the test.
4. May waive right against self-incrimination.
5. It has many errors.
Factors responsible to 25% errors:
1. Nervousness experienced by a subject who is
telling the truth
- apprehension by the fact that he is a
suspect.
- over-anxiety to cooperate
2. Physiological abnormalities > BP inc. or dec.,
Cardiac prob.
3. Mental abnormalities
4. Unreponsiveness in a guilty subject no fear
of detection
5. Attempt to beat the machine
Can a person be compelled? No, use of
intelligence and other faculties.
B. Word association test:
-Time interval between the words uttered by
the examiner and the answer of the subject is
recorded.
C. Psychological Stress Evaluator
- when a person is under stress/lying, the
microtremor in the voice utterance is
moderately or completely suppressed.
- degree of suppression varies inversely to
degree of psychological stress

II.
USE OF DRUGS THAT INHIBIT THE
INHIBITOR
- Not admissible in court
A. Administration of truth serum
- Hyocine hydrobromide given
hypodermically until state of delirium which the
subject feels a compulsion to answer the
question truthfully.
B. Narcoanalysis or Narcosynthesis
- Sodium amytal or sodium penthotal
C. Intoxication with alcohol - In wine there is
truth
III.
HYPNOSIS
- alteration of consciousness, not all
subjects can be hypnotized
IV.
OBSERVATION
Physiological and psychological signs and
symptoms of guilt:
a) Sweating, color change
b) Dryness of the mouth
c) Excessive activity of adams apple
d) Fidgetting
e) Peculiar feeling inside
f) Swearing, spotless past record
g) Inability to look at the investigator
V.
INTERROGATION
- emotional appeal, mutt and jeff technique
VI.
CONFESSION
- expressed acknowledgement of his guilt.
TOKYO DECLARATION
- contains guidelines to be observed by
physician concerning torture, inhuman and
degrading punishment.
MEDICO-LEGAL ASPECTS OF
IDENTIFICATION
- determination of the individuality of a person
Importance of identifying a person:
1. In the prosecution of a crime, the identity of
the offender and victim.
2. Settlement of estates, retirement, insurance
3. Resolves anxiety of nest of kin.
4. In some transactions sales, release of dead
body
Rules in personal identification:
1. Law of multiplicity of evidence in
identification greater number of similarities
2. Value of different points of identification
fingerprints , moles
Visual recognition of relatives lesser value
than fingerprints/dental
3.The longer interval between death the more
experts are needed in establishing the identity.
4.The team to act in shortest time because it is
perishable.
5. No rigid rule in the procedure of identification
of the person.

Methods of identification:
1. By comparison Id found in the crime
scene compared with the file.
2. By exclusion
IDENTIFICATION OF PERSONS
A. Ordinary methods of identification
1. Characteristics which may easily be
changed:
a) growth of hair, beard
d)
grade of profession
b) clothing
e)
body ornamentations
c) frequent place of visit
2. Characteristics that may not be easily be
changed:
a) mental memory
f)
hands and feet
b) speech
g)
complexion
c) gait
h)
changes in the eyes
d) mannerism
i)
facies
e) handedness-left /right
j)
degree of nutrition
Points of identification applicable to both
living and dead before onset of
Decomposition:
1. Occupational marks painters have
stains
2. Race: Malay:brown, flat nose round
face, Round head, Wearing apparel
3. Stature: Tips of middle fingers of both
hands extended laterally
4. Tatoo marks
5. Weight not good point changes
from time to time
6. Deformities,
injuries leaving
permanent deformities
7. Birth marks
moles,
scar
Age of Scar:
Recently formed: Slightly elevated,
reddish/bluish, tender to touch
Few week-2 months: Inflammatory
redness, soft, sensitive
2 6 months: brownish, free from
contraction, soft
> 6 months: white, glistening,
contracted, tough
Scar formation is delayed by: sepsis,
age, depth of wound, mobility
May not develop mall, superficial,
healed by first intention.
8. Tribal marks, Sexual organs, blood exam
ANTHROPOMETRY ( BERTILLON SYSTEM)
Alphonse Bertillon

- utilizes anthropometrical measurement of the

human body for identification.
Basis:
1. Human skeleton is unchangeable after
20 years.
2. No two human beings have exactly the
same bones.
3. Use of simple instrument
Information:
1. Descriptive data color of hair, eyes,
shape of nose
2. Body marks
3. Anthropometric measurement height
4. Measurement of the head, limbs
Portait Parle ( spoken picture) picturesque
description of a person
Extrinsic factors in identification:
1. ornamentation
2. personal belongings
3. wearing apparel
4. foreign bodies
5. identification by close friends, police
records, photographs
Light as a factor in identification:
1. Clearest moonlight = Less than 16-17 yards
Starlight = Less than10-13 yards
2. Broad daylight = Not farther than 100 yards
not seen before
Almost strangers
=recognized at 25 yards
3. Flash of firearm = 2 inches letters can be
read with the aid of the flash of 22 caliber at a
distance of 2 feet.
4. Flash of lightning sufficient light to identify
5. Artificial light relative to the intensity of
light
B. Scientific methods of identification
1. Fingerprinting
2. Dental identification
3. handwriting
4. Identification of skeleton
5. Determination of Sex, Age
6. Identification of blood, blood stains
7. Identification of hair, fibers
1. FINGERPRINTING
= most valuable method of identification.
a) No two identical fingerprints 1 : 64,000,
000, 000
b) Not changeable - 4th month formed in
the fetus
= Practical uses
a) Identity of dead bodies
b) Prints recovered at crime scene
c) Prints on file for comparison
d) Right thumb print is substitute for
signature
= DACTYLOGRAPHY : art and study of
recording fingerprints as means of id.

= DACTYLOSCOPY: art of id by comparison of

fingerprints
= POROSCOPY : study of pores found on the
pappillary friction ridges of skin
Fingerprints cant be effaced:
=as long as the dermis of the bulbs of the
finger is not completely destroyed.
2. DENTAL IDENTIFICATION
= possibility of 2 persons to have the same is
remote
= enamel is the hardest substance of the
body, outlast other tissues in putrifaction
3. HANDWRITING
= BIBLIOTIC
: Science of handwriting
analysis
= GRAPHOLOGY : study of handwriting for the
purpose of determining the writers personality,
character and aptitude.
4. IDENTIFICATION OF THE SKELETON
human shape, size, general nature
single individual plurality or excess of
bones
Height add 1 to 1 in. for the soft
tissues
Pearsons formula for the reconstruction
of the living stature of long bones
Topinard and Rollet
= two French anatomist devised a formula
for the determination of the height fro males
and females.
Humphreys table
= Table of different height of bones for
different ages and their corresponding statures.
Manouvrier made the following coefficient for the determination of height.
Determination of sex of the skeleton:
a) Pelvis
d) Femur
b) Skull
e) Humerus
c) Sternum
Difference between
Male
PELVIS
Female
1) Construction
Heavier
Lighter
Wall
More
pronounced
Less pronounced
2) Height
Greater
Lesser
3) Pubic arch
Narrow &
less round
Wider/rounder
4) Diameter of the true pelvis Less
Greater
5) Curve of iliac crest
Reaches
higher level
Lower level

6) Greater Sciatic notch

Wide

7) Body of pubis
Wider
8) Iliopectineal line
Rounded
9) Obturator foramen
triangular
10) Sacrum
narrow
Long and wide
CRANIUM
MALE
1) Shaft

Narrow
Narrow
Sharp
Egg-shaped
Short and

FEMALE
less curve
more curve
2) Mastoid process
larger
smaller
3) cranium placed horizontally rest on
mastoid process
occipital&
maxillary bones
4) Styloid process
shorter
longer/slender
5) Forehead
higher, more
oblique
less high,
more vertical
6) Superciliary ridges
less sharp,
more rounded
sharper
7) Zygomatic arches
more
prominent
less prominent
8) Lower jaw
larger &
wider
narrower
and lighter
9) Face
larger in
proportion to cranium
smaller
Determination of the duration of interment:
- All soft tissues in a grave disappear within one
year.
Basis of the estimate fro duration of interment:
1) Presence or absence of soft tissue
adherent to the bones.
2) Firmness and weight, brittleness, dryness
of the bones.
3) Degree of erosion of the surface of the
bones.
4) Changes in the clothings, coffin, and
painting.
5. IDENTIFICATION OF SEX
Test to determine the sex:
1. Social test
2. Genital test
3. Gonadal test
4. Chromosomal test barr cells in females
Evidences of sex:
1. Presumptive evidence
= General features, hair in some parts

= Transvestism sexual deviation by

desire to assume the attire and be accepted as
a member of the opposite sex.
2. Highly probabale
= vagina, large breast
3. Conclusive evidence
= ovary in females
6. DETERMINATION OF AGE
Legal importance
a) Aid to identification
b) Determination of criminal liability
c) Determination of right of suffrage
d) Determination whether a person can
exercise civil rights
e) Determination of the capacity to marriage
f) Requisite to certain crimes
Determination of age of fetus:
Hesss rule or Haases rule
a) Fetus of less than 25 cm long- get square root
of length in cm, result in months
b) > 25 cm- divide the length of the fetus by 5
and the result is the age in month.
7. IDENTIFICATION OF BLOOD AND BLOOD
STAINS
Legal importance:
a) Disputed parentage
b) Circumstantial evidence against
perpetrator of a crime
c) Determination of the cause of death
d) Determination of the direction of the
escape
e) Determination of the appropriate time
crime was committed
f) Determination of the place of the crime
g) Determination of the presence of certain
diseases.
Physical examination
a) Solubility test
b) Heat test
c) Luminescence test: 3 amino-phtalic-acidhydrazide-HCL, Sodium peroxide,
distilled water
Bluish-white in a
dark room
Chemical examination:
a) Saline extract of the blood plus ammonia
brownish > alkaline hematin
b) Benzidine test blue color in white filter
paper
c) Guaiacum test ( Van Deens Dyas or
Schombeins test) - blue
d) Phenolpthalein test ( Kastle-Meyer test) pink
e) Leucomalachite Green test
Microscopic examination
- saline extract of stain
Micro-chemical tests:
1. Hemochromogen crystal or Takayama test:

2. Teichmanns blood crystals or Hemin crystal

test= Sodium chloride dark brown rhombic
prisms of chloride, hematin formed
= best of the micro-chemical test.
3. Acetone-haemin or Wagenhaar test
Spectrospcopic examination
- blood pigments have the power to absorb light
of certain length and produce the characteristic
absorption bands on the spectrum.
= Fresh blood oxyhgb, Hgb, reduced
hematin
= olders stains methemoglobin, alkaline
hematin
Biologic examinations
1. Precipitin test blood is human or
not
2. Blood grouping
Age of blood stains:
Hgb converted to Methgb of hematin red to redbrown
= warm weather- within 24 hours
8. IDENTIFICATION OF HAIR AND FIBERS
Differences between hair forcibly extracted and
naturally shed hair:
- bulb is irregular , undulating surface,
excrescence of diff, size and shape
HAIR
HUMAN
ANIMAL
Medulla
1. Air network
In fine grains
large or small sacks
2. Cells
Invisible w/out tx in
H2O
Easily visible
3.
Fuzz w/out medulla
Fuzz w/ medulla
Cortex
1.
Looks like a thick muff
Fairy thin hollow cylinder
2.
Pigments in the form of fine grains
irregular grains
Cuticle
1.
thick scale

thin scales

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.
3. The death of a partner is one of the causes of
dissolution of partnership agreement.
4. The death of either the principal or agent is a
mode of extinguishment of agency.
5. The criminal liability is extinguish by death.

6. The civil case fro claims which does not

survive is dismissed upon death of the
defendant.
Death is the termination of life.
Kinds of death:
1. Somatic or clinical death persistence of
vital functions
2. Molecular or cellular death 3 to six
hours after cessation of life
3. Apparent death or State of suspended
animation transient loss of
consciousness in hysteria, uremia,
electric shock
Signs of death:
1. Cessation of heart action and
circulation., Usually the auricle contract after
somatic death fro a longer period than the
ventricle, last to stop so called ULTIMEN
MARIENS.
Methods of detecting the cessation of heart
action and circulation:
a) Examination of the heart- pulse,
aucultation, flouro, ECG
b) Examination of peripheral circulation
= Magnus test application of ligature
around the base of the finger
- bloodless area at
site of application
- dead man no
change
= Opening of small artery- spurting
= Icards test injection of flourescein
SQ
- greenish yellow
discoloration in the whole skin
- dead man only in the
area of injection
= Pressure on fingernails
= Diaphanous test fingers are spread
wide through a strong light- Red
= Application of heat on the skin blister
= Palpation of Radial pulse
= Dropping of melted wax
2. Cessation of respiration more than 3
minutes
Methods of detecting cessation of respiration:
a) Observance of movement of chest and
abdomen
b) With the aid of stet.
c) Examination with a mirror
d) Examination with a feather or cotton
fibers
e) Examination with a glass of water
f) Winslows test no movement in the
image formed by reflecting artificial light
on the water in a saucer and placed in
the chest if respiration is taking place.

3. Cooling of the body ( ALGOR MORTIS)

- After death the metabolic process inside
the body ceases.
- The progressive fall of the body temp. is
one of the most prominent signs.
- First two hours after death the cooling is
rapid.
- Fall of temp. of 15 to 20 degrees Fahrenheit
is considered as a certain sign of death.
POST-MORTEM CALORICITY is the rise of
temp. of the body after death due to rapid
and early putrefactive changes. Usually in
the first 2 hours.
= seen in cholera, liver abscess, tetanus,
RF,Strynine poisoning, Peritonitis
A. Conditions connected with the body:
Factors delaying the rate of cooling of the body:
1. Acute pyrexial disease
2. Sudden death in good health
3. Obesity of person
4. Death from asphyxia
5. Death of the middle age
Factors accelerating cooling:
1. Leaness of the body
2. Extreme age
3. Long-standing illness
4. Chronic pyrexial disease with wasting
B. Conditions that are connected with the
surroundings
Factors delaying cooling:
1. Clothings
2. Want of access of air to the body
3. Small room
4. Warm surroundings
Factors accelerating cooling:
1. Unclothed body
2. Conditions allowing the access of air
3. Large room permitting the dissipation of
heat
4. Cooling more rapid in water than in air
Methods of estimating how long a person
has been dead from the cooling of the
body:
1. If body temp. is normal at the time of death:
= the average rate of fall of the temp. during
the first 2 hours is of the difference of the
body temperature and that of the air.
= the body attains the temp. of the
surrounding air from 12 to 15 hours after death
in tropical countries.
2. Chemical Method ( Schourups formula for the
determination of the time of death of any
cadaver whose CSF is examined for the
concentrations of L.A., NPN, A.A.
= L.A> 15 mg to 200 mg/100cc rapid in
1st 5 hours.

= NPN inc. from 15 to 40 mg/100 cc in 1st

15 hours
= A.A. inc. from 1 mg to 12 mg% 1st 15
hours.
4. INSENSIBILITY OF THE BODY AND LOSS
OF POWER TO MOVE
= may be seen in the living with- apoplexy,
epilepsy , trance, catalepsy, hysteria
5. CHANGES IN THE SKIN opacity,
flattening, loss of elasticity
6. CHANGES IN AND ABOUT THE EYE
a) Loss of corneal reflex seen I n live pts:
G.A., uremia, narcotic poisoning
b) Clouding of cornea
c) Flaccidity of the eyeball
d) Pupil in the position of rest.
e) TACHE NOIR DE LA SCLEROTIQUE
spot found in the sclera after death.
7. ACTION OF HEAT ON THE SKIN
= Heat applied while alive produced blister
with serum and redness around the area.
= Following combinations of signs show
death has occurred:
a) Loss of animal heat to a point not
compatible with life
b) Absence of response of muscle
stimulus
c) Onset of rigor mortis.
CHANGES IN THE BODY FOLLOWING DEATH
1. CHANGES IN THE MUSCLE complete
relaxation of the whole muscular system.
Three Stages After Death:
a) Stage of primary flaccidity ( POSTMORTEM IRRITABILITY)
= muscle relax, may contract, dilated
pupil, sphincters are relaxed
= presence of molecular life
= warm place: 1 hour and 51 minutes
= chemical reaction of muscle is
alkaline
b) Stage of post-mortem rigidity
( CADAVERIC RIGIDITY , DEATH STRUGGLE
OF MUSCLES OR RIGOR MORTIS)
= whole body is rigid due to contraction
of the muscles
= starts at muscle of neck, lower jaw
= Reaction is acidic due to inc. of lactic
acid
= develops 3 to 6 hours after death in
temperate, earlier in warm
= last from 2 to 3 days in temperate,
warm: 24-48H cold weather
18-36H summer
c) Stage of Secondary flaccidity or
Commencement of putrefaction ( DECAY
OF MUSCLES)

= muscle are flaccid, not respond to

stimuli, reaction is alkaline
= due to dissolution of muscle proteins
FACTORS INFLUENCING THE TIME OF
ONSET OF RIGOR MORTIS
(1) Internal Factors
a) State of the muscles
= healthy appears late
= Onset is hastened in:
a.1 hunted animal
a.2 prolonged
convulsion/lingering illness
a.3 death from- TY, Cholera,
Phthisis, typhus
b) Age
= early onset aged and newborn
= delayed good health, good
muscular development
c) Integrity of nerves
= section of the nerve will delay onset,
paralyzed muscle
(2) External factors
a) Temperature
= Hastened by high temperature
= > 75 degrees will produce heat
stiffening
b) Moisture
= rapidly but with short duration in
moist air
Conditions simulating RIGOR MORTIS:
1. Heat stiffening - > 75 degrees coagulates
muscle proteins resulting to rigidity.
= Pugilistic attitude flexed upper and
lower limb
= hands clenched, flexor stronger than
extensors, burned to death
2. Cold stiffening
= due to solidification of fats when
exposed to cold temp.
3. Cadaveric spasm or Instantaneous Rigor
= instantaneous rigidity due to extreme
nervous tension, exhaustion, injury to the
nervous system.
= weapon in hand, weeds

RIGOR MORTIS
CADAVERIC SPASM
1. Time of appearance
death
2. Muscles involved
3. Occurrence

3-6H after death

Immediately after
All muscles
Certain group
Natural phenomena
May or may not appear

4. Medico-legal signif.
death
death

Approximates time of
Determine nature of

RIGOR MORTIS
MUSCLE CONTRACTION
1. Contracted muscle
Losses transparency
More or less transparent
2. Elasticity
Loss elasticity
Very elastic
3. Litmus reaction
Acidic
Neutral or sl. alkaline
4. Contraction
Absolute flaccidity
Possess inherent
contraction
2. CHANGES IN THE BLOOD
a) Coagulation of blood
= blood may remains fluid inside the blood
vessels 6-8H after death.
ANTE-MORTEM CLOT
POST-MORTEM CLOT
1. Consistency

Firm
Soft
2. Surface of blood vessels
Raw after clots are
removed
Smooth, health after
3. Clots
Homogenous;
cant be stripped
Can be stripped off in
layers
b) Post-mortem Lividity or Cadaveric Lividity ,
or Post-mortem Suggilation or Post-mortem
Hypostasis or Livor Mortis
= Stoppage of heart action and loss of tone
of b.v. accumulates in dependent areas except
in bony areas.
= capillaries coalesce > purplish in color
called Post-mortem lividity.
= Hasten by death due to cholera, uremia,
Typhus fever
= appears 3 6 H after death and fully
developed 12 H after death.
Physical characteristics of Post-mortem
Cadaveric Lividity
1. Occurs in the most dependent areas.
2. Involves the superficial layer of the skin
3. Does not appear elevated from the rest
of the skin.
4. Color is uniform.
5. No injury of the skin
Kinds of Post-mortem Cadaveric Lividity
1. Hypostatic lividity
2. Diffusion lividity
Importance of Cadaveric lividity:
1. One of the signs of death.

2. Determines the position of the body has

been changed after its appearance in
the body.
3. Color of lividity may indicate the cause of
death.
a) asphyxia lividity is dark
b) CO poisoning pink
c) Hemorrhage less marked
d) Hydrocyanic acid bright red
e) Phosphorus dark brown
f) Potassium chlorate coffee brown
4. Determines how long the person has been
dead
5. Gives us an idea as to the time of death.
Points to be considered which may infer
the position of the body at the time of
death:
1. Posture of the body when found.
2. Post-mortem hypostasis or lividity
3. Cadaveric spasm
CONTUSION (BRUISE)
POST-MORTEM
HYPOSTASIS
1. Small bruises
Below epidermis in true skin
In the epidermis or cutis
larger ones below this
2. Cuticle
Abraded by the same violence
Unabraded
that produce the bruise.
3. Bruise
Appears at the seat or
surrounding
Always dependent
may or may not be dependent
4.
Elevated, inflammatory
condition
Not elevated, blood in b.v.
5.
the b.v.

Incision shows blood outside

Blood inside the vessels
= most certain test of

difference
6.

Color variegated
Uniform color
Internal hypostasis in Visceral organs:
1. Lungs
2. Loops of intestine
3. Brain
POST-MORTEM
LIVIDITY OF ORGANS
SIMPLE
CONGESTION
1. Post-mortem staining in organs Irregular,
most dependent parts
Uniform, all organs
2. Mucous membrane
Dull,lusterless
Not in congestion
3. Inflammatory exudate

Not seen

Not seen
Other changes in the blood
1. Hydrogen ion concentration acid pH CO2,
L.A., After 24H alkaline ammonia.
2. Breakdown of liver glycogen leads to
accumulation of dextrose in the IVC and the
right side of the heart.
3. Rise in NPN and Free A.A.
4. Chemical:
= chloride in the plasma/RBC decrease
due to extravascular diffusion, in 72 H only of
its content.
= Mg increases due to diffusion from
without.
= K increases due to diffusion from the
vascular endothelium.
3. AUTOLYTIC OR AUTODIGESTIVE
CHANGES AFTER DEATH
- After death, proteolytic, glycolytic&lipolytic
ferments of the glandular tissues continue to act
w/c lead to the autodigestn of organs.
4. PUTREFACTION OF THEBODY
- Is the breaking down of 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
Hemolysis of blood within blood vessels >
Hgb diffuses through the walls
Reddish-brown in color
In the tissues > Hgb
undergo chemical change
Greenish-yellow 1st seen at R Iliac fossa
MARBOLIZATION prominence of the
superficial veins with reddish discoloration
which develops on both flanks of the
abdomen, neck, and
shoulder
= look like marbled
reticule of branching veins.
2. Evolution of gasses in the tissues
CO2, ammonia, H2, Suphurated hydrogen,
methane= offensive odor
Effects of pressure of gasses of putrefaction:
a) displacement of the blood
bleeding in open wounds
b) bloating of the body
c) fluid coming out from nostrils,
mouth
d) extrusion of the fetus in a gravid
uterus
e) floating of the body

3. Liquefaction of the soft tissues

Putrefy rapidly :
Eyeball, lining of
trachea, larynx , brain, stomach, intestine, liver,
spleen
Putrefy late
:
Highly muscular organs
and tissues, Esophagus, diaphragm, heart,
lungs, kidneys, U.B., uterus, P.G.
Factors modifying the RATE of
putrefaction:
1. INTERNAL FACTORS
a) age
: healthy
adults, NB not yet fed, later than
infants
b) condition of body : full
grown/obese rapid , Stillbornlate
c) cause of death
: infection rapid
2. EXTERNAL FACTORS
a) Free air
a.1 air : free air hastens decomposition
a.2 moderate moisture - accelerates
a.3 loaded with septic bacteria early
aerobes, later anaerobic
Clostridium welchii= decomposition
b) Earth
b.1 dry absorbent soil - retards
b.2 moist fertile soil - accelerates
c) Running water- more rapid than still water
d) Clothings early it hastens but delays in
the later stage.
- tight clothings - delay
Factors influencing the changes in the
body after burial:
1. state of the body before death thin
slower, mummify
2. time elapsed between death and burial
and environment of the body
3. effect of coffin later
4. clothings and other coverings on the
body when buried pressure, insects
5. depth at which the body was buried greater the later
6. condition and type of soil
7. inclusion of something in the grave
which will hasten decomposition-food
8. access of air to the body after burial
9. mass grave rapid
10. trauma to the body violent death - slow
CHRONOLOGICAL SEQUENCE OF
PUTREFACTIVE CHANGES OCCURING IN
TEMPERATE REGIONS
1-3 DAYS AFTER DEATH - greenish discoloration
over iliac fossa, soft eyeballs
3-5 DAYS
- frothy blood from
mouth, nostrils
8-10 DAYS
- abdominal
distention, nails firm

14-20 DAYS
body, maggots
2-5 MONTHS
orbits empty

- blisters all over the

- skull exposed,

IN TROPICAL REGION
12 HOURS
Rigor mortis all over, hypostasis,
greenish-discoloration caecum
24 HOURS
Rigor mortis absent all over,
abdominal distention
48 H
Ova of flies, trunk bloated, face
discolored
72 H
Whole body grossly swollen,
hairs and nails loose
ONE WEEK
Soft viscera putrefied
TWO WEEKS Soft tissues largely gone
ONE MONTH Body skeletonized
BEEN SUBMERGED IN WATER
FIRST 4 OR 5 DAYS Cold water little change, in
rigor mortis
FROM 5 7 DAYS
Skin on hands, feet is
bleached, face faded white
1 2 WEEKS
Face swollen and red, skin
of hands and feet wrinkled
4 WEEKS
Skin wrinkled, nail intact
6 8 WEEKS
Abdomen distended, skin of
hands/ feet come off with nails
Factors influencing the floating of the body
in water:
1. age fully developed, well nourished rapid
2. sex females floats sooner
3. conditions of the body obese float
quicker
4. season of the year moist hot air
putrefaction floats due to gas
5. water- shallow and stagnant water of
creeks, higher specific gravity
- sea water floats sooner than fresh
water, higher specific gravity
6. external influence heavy-wearing
apparel - slower
**Only teeth, bones and hair remain for an
indefinite time.
**Flat bones disintegrates faster than round
bones.
SPECIAL MODIFICATION OF PUTREFACTION
1. Mummification
= is the dehydration of the whole body which
results in the shivering and preservation of the
body.
= usually occurs when buries in a hot, dry
with free access of hot air
2. Saponification or Adipocere fromation
= a condition where the fatty tissues of the
body are transformed to soft brownish-white
substance known as ADIPOCERE at SQ level.

3. Maceration
= softening of the tissues when in fluid
medium in the absence of putrefactive mircroorg, seen in death in utero
reddish or greenish color, skin peeling off
and arms flaccid and frail.
HOW LONG A PERSON HAS BEEN DEAD?
DURATION OF DEATH
1. Presence of rigor mortis : 2-3 hours after
death
12 H fully
developed
18-36 H disappears
concomitant with putrefaction
2. Presnce of Post-mortem lividity
3-6 H after death
appears as small
petechia-like red spots
3. Onset of decomposition
24-48 H after
death
manifested watery.
foul smelling froth, mouth, nostrils
4. Stage of decomposition
5. Entomology of the cadaver 24 H before
eggs are hatched, maggots
6. Stage of digestion
empty

- 3-4 H gastric

6-8 distal ileum,

cecum
7. Presence of live flies in the clothing in the
drowning victim less than 24H
8. State of clothings
- pajama , night
9. Changes in CSF
10. Blood clots inside the b.v. in 6 8 H after
death.
11. Soft tissues of the body may disappear 1 to
2 years after burial.
Post-mortem conditions simulating
disease, poisoning or injury:
1. post mortem hypostasis contusion,
inflammation , poisoning
2. blisters of the cuticle scald and burns
3. swelling, detachment or splitting - injury
PRESUMPTION OF DEATH
Disputable presumption - not heard in 7 years
Presumption of death
Absence of 7 years except succession 10
years
Vessel for 4 years
Armed forces 4 years
In danger of death 4 years
PRESUMPTION OF SURVIVORSHIP
1. under 15 y.o. older survives
2. above 60 y.o.- younger

10

3. under 15, above 60 - former

4. over 15 and under 60 y.o. male, older
5. under 15, or over 60 y.o. and the other in
between - latter
MEDICO-LEGAL INVESTIGATION OF DEATH
Inquest Officer is an official of the state
charged with the duty of inquiring into certain
matters.
- in medico-legal examination:
manner and cause of death
The following officials of the government
are authorized to make death
investigations:
1. Provincial and City Prosecutors
2. Judges of the RTC, MTC
3. Director of NBI
4. SolGen
Stages of MEDICO-LEGAL INVESTIGATION:
1.Crime Scene Investigation investigation of
place of commission of the crime
2.Autopsy
- investigation of
the body of the victim
1. Crime Scene Investigation
- place where the essential ingredients of the
crime took place.
- Person composed the Search Team:
a) Physician MLI trained
b) Photographer
c) Assistant, evidence collector, note
taker
2. Autopsy
- comprehensive study of a dead body, in
addition to the external examination . Postmortem examination- external exam without
incision being made.
Purpose of autopsy:
1. Determine cause of death
2. Correlate clinical diagnosis and
symptoms
3. Determine effectiveness of treatment
4. Study the natural course of the disease
5. Educate students and physicians
MEDICO-LEGAL OR OFFICIAL AUTOPSY:
1. Determine cause, manner, time of death
2. Recovering, identifying, preserving
evidentiary material
3. Provide interpretation and correlation of
facts related to death
4. Provide factual, objective medical report
5. Separating death due to disease from
external causes.
Dead body belongs to the state for cases that
requires medico-legal autopsy.

PATHOLOGICAL AUTOPSY
MEDICO-LEGAL AUTOPSY
1. Requirement
2. Confirmation

Consent of next of kin

Law that gives the consent
Clinical findings of research
Correlate tissue changes to

criminal act
3. Emphasis
findings
4. Conclusion
findings
5. Minor

Notation at all abnormal

Effect of wrongful act
Summation of all abnormal
Specific to the purpose
Need not be mentioned
Included if useful

The following manner of death should be

autopsied:
1. Death by violence
2. Accidental deaths
3. Suicides
4. Sudden death of persons who are in
good health
5. Death unattended by physician
6. D.O.A. with no clinical diagnosis
7. Death occurring in an unnatural manner
Mistakes in autopsy:
1. Error or omission in the collection of
evidence for identification
2. Errors or omission in the collection of
evidence required fro establishing the
time of death
3. Errors or omission in the collection of
evidence required fro the medico-legal
examination.
4. Errors or omission result in the
production of undesirable artifacts or in
the destruction of valid evidence.
Negative autopsies
- if after all efforts including gross and
microscopic studies and toxicological analysis
fail to reveal a cause of death.
Negligent autopsy
No cause of death is found due to imprudence,
negligence, lack of skill, lack of foresight.
CAUSES OF DEATH
Primary purpose of a medico-legal
autopsy: Determination of the cause of death.
Death is the direct and the proximate
consequence of the criminal or negligent act.
Defense wounds on the victim:
Qualify the crime to homicide.
Series of cuts in the borders of the wound:
Multiple trust- intent to kill.

11

Cause of death: is the injury or disease or both

which initiates the physiological disturbance
resulting to a fatal termination.
1. Immediate or Primary cause of death
when injury or disease kills quickly the
victim and no opportunity for
complications to develop.
Ex: extensive brain injury
2. Proximate cause or Secondary cause the injury or disease was survived for a
longer period
Mechanism of death: is the physiologic
derangement or biochemical disturbance
incompatible with life which is initiated by the
cause of death.
Ex: Hemorrhagic shock, pulmonary
depression, cardiac arrest, tamponade
metabolic problem.
Manner of death: is the explanation as to how
the cause of death arose.
1. Natural death fatality is cause solely by
disease. Ex: pneumonia, cancer
2.Violent or unnatural death due to injury
Medico-legal masquerade- violent deaths
may be accompanied by minimal or no external
evidence of injury or natural death where signs
of violence may be present.
Degree of Certainty to the cause of death:
1. Structural abnormalities established beyond
doubt the cause of death. Ex. SW with H.
2. Degree of probability amounting to the cause
of death. Ex: Electrical shock
3. History establishes cause of death and
confirmed by anatomic or chemical findings.
4. When neither history, laboratory and
anatomic findings, taken individually or in
combination is sufficient to determine the cause
of death but merely speculate as to the cause of
death.
Ex. Crib death among infants.
Steps in the Intellectual Process in the
determination of the cause of death:
1. Recognition of the structural organic changes
or chemical abnormalities responsible for the
cessation of vital functions.
2. Understanding and exposition of the
mechanism by which the anatomic and other
deviations from normal caused the death.
Instantaneous physiologic death or Death from
inhibition, death from primary shock, Syncope
with instantaneous exitus.
- This is sudden death which is cause
within seconds or minute or two after a
minor trauma or peripheral stimulation of
relatively simple nature.

The peripheral stimulation initiates the

cardio-vascular inhibitory reflex.
Ex: Vagocardiac slowing or stoppage of
the heart.
Blow to the larynx, solar plexus,
scrotum, pressure to the carotid sinus.
-

Diseases with no specific findings of a

disease:
1. Sudden infant death syndrome (SIDS) or
crib death
2. Sudden unexplained nocturnal death
(SUND)
DOA means actually dead or dying, provided
the physician had not been given ample
opportunity to arrive at a working diagnosis as
to the cause of death.
Undetermined - if the physician cannot
determine the cause of death.
MEDICO-LEGAL CLASSIFICATION OF THE
CAUSES OF DEATH
a. Natural death cause by natural disease
condition in the body.
b. Violent death
1. Accidental death
2. Negligent death
3. Infanticidal death
4. Parricidal death
5. Murder
6. Homicidal death
If signs of violence are associated with the
natural cause of death:
* Did the person die of a natural cause
and were the physical injuries inflicted
immediately after death?
- violence applied in a dead person :
Impossible crime.
* Was the victim suffering from a natural
disease and the violence only accelerate
the death?
= Offender responsible of the death of the
victim.
= Criminal liability shall be incurred by any
person committing a felony although the
wrongful act done be different from which he
intended. (Art.4 no.1 RPC)
* Did the victim die of a natural cause
independent of the violence inflicted?
- accused will not be responsible for the
death but merely for the physical injuries he
had inflicted. Ex. Slapping a person with
heart problem, only slight physical injury.
- to make the offender liable for the death of
the victim, it must be proven that the death
is the natural consequence of the physical
injuries inflicted.
The following are deaths due to natural
causes:

12

1. Affection of the CNS

a. Cerebral apoplexy sudden loss of
consciousness followed by paralysis or
death due to Hemorrhage from
thrombosis or
embolism in the
cerebral vessels.
b. Abscess of the brain
c. Meningitis of the fulminant type
2. Affection of the circulatory system
a. Occlusion of the coronary vessels =most
common cause of Sudden death due to
natural causes.
b. Fatty or myocardial degeneration of the
heart.
c. Rupture of the aneurysm of the aorta
d. Valvular heart disease
e. Rupture of the heart
3. Affections of the Respiratory system
a. Acute edema of the larynx
b. Tumor of the larynx
c. Diptheria
d. Edema of the lungs
e. Pulmonary embolism
f. Lobar pneumonia
g. Pulmonary hemorrhage
4. Affections of the GIT
a. Ruptured PUD
b. Acute intestinal obstruction
5. Affections of the GUT
a. Acute strangulated hernia
b. Ruptured tubal pregnancy
c. Ovarian cyst with twisted pedicle
6. Affection of the glands
a. Status thymico-lymphaticus
b. Acute hemorrhagic pancreatitis
7. Sudden death in young children
a. Bronchitis
b. Congestions of the lungs
c. Acute broncho-pneumonia
d. Acute gastroenteritis
e. Convulsion
f. Spasm of the larynx
B. Violent death
- are d/t injuries inflicted in the body by
some forms of outside force. The physical injury
must be the proximate cause of death.
= That the victim at the time the physical
injuries were inflicted was in normal health.
= That the death may be expected from the
physical injuries inflicted.
= That the death ensued within a
reasonable time.
CLASSIFICATION OF TRAUMA OR INJURIES
1. Physical injury trauma sustained
through the use of physical force.
2. Thermal injury injury by heat or
cold

3. Electrical injury electrical energy.

4. Atmospheric injury due to
change of atmospheric pressure.
5. Chemical injury chemicals
6. Radiation injury radiation
7. Infection microbic invasion
PENAL CLASSIFICATION OF VIOLENT
DEATHS
1. Accidental deaths due to misadventure or
accident.
Art. 12 no. 4 RPC
Any person who while performing a lawful
act with due care, causes an injury by mere
accident without fault or intention of causing it.
Ex. Patient died of ATS injection after proper
skin test.
2. Negligent death felonies may be committed
when the wrongful act is due to reckless
imprudence, negligence, lack of skill or
foresight.
Ex. Surgeon left a pack Homicide
through reckless imprudence
3. Suicidal death , destruction of ones self
- not punished, unfortunate being.
- Art 253 RPC Giving assistance to suicide.
Punishable because he has no right to destroy
or assist in the destruction of life of another.
4. Parricidal deaths
Art. 246 father, mother, child, (leg/illeg)
ascendant, descendant, spouse (leg.)
5. Infanticidal deaths Art. 255 killing of a child
less than 3 days
6. Murder Art. 248
- treachery, consideration, means of
inundation, occasion of calamities,
- evident pre-meditation, cruelty
7. Homicidal deaths Art 249
DEATHS UNDER SPECIAL CIRCUMSTANCES
1. Death caused in a tumultuous
affray Art 251.
2. Deaths or physical injuries
inflicted under exceptional
circumstances. Art 247
2. PATHOLOGICAL CLASSIFICATION OF THE
CAUSES OF DEATH
a. Death due to syncope fatal and sudden
cessation of the action of the heart.
b. Death from asphyxia a condition in
which the supply of oxygen to the blood
or to the tissues or to both has been
reduced below normal working level.
Stage of increasing dyspnea 1 min
Stage of Expiratory convulsion
Stage of exhaustion 3 min
c. Death from coma

13

SPECIAL DEATHS
1.
Judicial deaths Art. III Sec.1 Par. 19
Phil. Const. cruel and unusual
punishment shall not be
inflicted. ; electrocution, hanging,
musketry, gas chamber.
2.
Euthanasia or mercy killing
3.
Suicide
Automatism - due to drug may be
considered as accidental rather than
suicidal.
Evidences that will infer death is suicidal:
1. History of depression, mental disease.
2. Previous attempt
3. Injuries are located in areas accessible to
hand.
4. Effects of the act of self-destruction may
be found in the victim;, empty bottle
5. Presence of suicidal note.
6. Secluded, not in public view.
7. Evidences which rule out H,M, P
4.

Death from starvation :

Cause may be due to suicidal, homicidal or

accidental.
**The human body without food losses 1/24th of
its weight daily.
And 40% loss>death
Factors that influence the length of survival:
age, condition of the body, sex, environment.
DISPOSAL OF THE DEAD BODY
Sec.1103 Revised Administrative Code :
Persons charged with the duty of burial.
1. Deceased was married: the surviving
spouse
2. If unmarried : the nearest of kin of the
deceased; adults, within the Phil. And in
possession of sufficient means to defray
the necessary expenses.
3. If none of the above municipal
authorities.
Sec 1104 RAC Right of custody
Any person charged by law with the study of
burying the body of a deceased person is
entitled to the custody of such body for the
purpose of burying it, except when an inquest is
required by law for the purpose of determining
the cause of death.
If communicable, the local board of health or
local health officer or municipal council.
Concept of possession the right of custody
over a dead body.. The right of custody does not
mean ownership of the dead body.

Executors right of custody superior to the right

of spouse dead body. An executor is the person
mentioned in a will who will carry on the
provision of the will. In the absence of a
testamentary disposition, the right of the
surviving spouse is paramount.
METHODS OF DISPOSAL OF THE DEAD
BODY
1. Embalming 6 to 8 quarts of antiseptic
solutions of formalin, perchloride of
mercury or arsenic which is carried into
the internal carotids and the femoral
arteries.
2. Burial or inhumation
a. Sec 1092 RAC buried within 48
hours if unembalmed.
Within 12 hours, if
communicable.
Except: 1. Subject of legal
investigation.
2. Authorized by the local health
authorities that may be buried more than
48H.
3. Impliedly when embalmed.
b. Death certificate necessary before
burial:
Sec. 1087 RAC Requirement of Death
Cert. and the duty of the physician to issue
or the local health officer, or if none by the
mayor, secretary, councilor of the
municipality to issue the certificate..
Sec 91 P.D. 856 Code of Sanitation ;
Burial requirement:
- death cert., issued by
physician.
c. Permission from the Provincial
fiscal or from the municipal mayor.
Is necessary if death is due to
violence or crime.
= Sec. 91(f) P.D. 856 Code of
Sanitation
Sec. 1094 Revised Administrative Code
Disposition of body and belonging of
person dying of dangerous communicable
disease.
Ex. Meningococcemia in Bagiuo City
1.
The body of a person who died of
any dangerous communicable disease
shall not be carried form place to place
except for burial or cremation.
2.
Duty of the local health official to
disinfect the body before being prepared
for burial; the furniture, house, either
disinfect or burned if capable of conveying
infection.

14

Sec. 91(h) P.D. 856 Code of Sanitation

1. Remains shall be buried within 12 hours
after death. Cause of death is due to a
dangerous communicable disease;
2. Not to be taken any place of public
assembly.
3. Only adult members of the deceased are
allowed to attend the funeral.
Sec. 1091 RAC Death Certificate must be
presented before burial.
Sec. 1099 the placing of the body of any
deceased person in an unsealed overground
tomb is prohibited unless if permanently sealed.
Except: 1. Tombs and vaults which are strictly
receiving vaults for bodies or remains awaiting
final disposition.
2. Embalmed bodies awaiting final
disposition.
Sec. 1100 of RAC, Sec. 91 of P.D. 856
Code of Sanitation
The depth of the grave must be at least 1
meters deep, filled well and firmly.
Sec. 2695 RAC Penalizes the desecration of
burial premises; tombstone, plant, tree, fence,
post or wall. P200/ not greater than 6 months.
Sec. 90 code of Sanitation Burial Grounds
requirements
1. It shall be unlawful for any person to
bury the remains in places other than
those legally authorized .
2. At least 25 meters from any dwelling
house and no house shall be constructed
within the same distance from any burial
ground.
3. Not within 50 meters from any water
source.
Other burial requirements:
1. Shipment of remains abroad shall be
governed by the rules and regulations of
the Bureau of Quarantine.
2. The burial or remains in city or municipal
grounds shall not be prohibited due to
race, nationality, religious or political
reasons.
3. Except when required by legal
investigation or when permitted by the
local health authority, no embalmed
remains shall remain unburied longer
than 48 hours.
FUNERALS
Art. 305 CC The duty and the right to make
arrangements for the funeral of a relative shall

be in accordance with the order of support

under Art. 294.
Descendants : Eldest
Ascendants : Paternal
For support as mentioned in Art. 294
1. Spouse
2. The descendants of the nearest degree
3. Ascendant of the nearest degree
4. Brothers and sisters
Art. 306 CC ; In keeping with the social
position of the deceased.
Art. 307 CC ; In accordance to the expressed
wishes of the deceased.
Art. 309 CC ; Showing of disrespect to the dead
shall be liable to the family of the deceased for
damages, materials or moral.
Art. 132 RPC: Interruption for religious
worship.
Art 133 RPC: Offending the religious feeling
Art. 2219 CC: Provides for the moral damages
may be recovered for acts mentioned in Art.
309 CC.
LIMITATIONS TO THE FUNERAL RITES
1. Will of the deceased.
2. Burial of a person sentenced to death
must not be held with pomp.
3. Restrictions as to funeral ceremonies in
cases of deaths due to communicable
disease.
3. Disposing of the dead body in the sea
- Provided the deceased is not suffering
from dangerous communicable
deceased.
- Sec. 1093 RAC Permit for conveyance of
body to sea for burial.
4. Cremation is the pulverization of the body
into ashes by the application of heat.
- First must be identified,
- Permit and in a crematory made for the
purpose.
NOT GRANTED:
a. If the deceased left a note.
b. Identity of the person is not
definite.
c. Exact cause of death cannot be
ascertained and the need for
further inquiry or examination.
5. Use of body for scientific purposes
- Corpse of prisoners
- Any person to be buried for public expense
and which is unclaimed for 24 hours.

15

Sec. 98 P.D. 856 Code of Sanitation

Special precautions for safe handling of
cadavers containing radioactive isotopes.
RA 349 as amended by RA 1056
Permission to use Human organs or any
portions of the human body for medical,
surgical or scientific purposes under certain
conditions.
- in writing, specific use, signed by the
grantor and two disinterested witness.
Sec. 96 Code of Sanitation; Donation of
human organs for medical , surgical and
scientific purposes according to the Sanitation
Code.
Persons permitted to detach human
organs:
1. Licensed physicians
2. Known scientist
3. Medical or scientific institutions
Requirements for a valid authorization
1. It must be in writing
2. It must specify the person or
institution grated the authorization.
3. Must specify the organ or part to be
removed.
4. Signed by the grantor and two
disinterested person.
5. Copy of the authorization must be
submitted to the Secretary of Health.
EXHUMATION
The deceased buried may be raised or
disinterred upon the lawful order of the proper
authorities.
Sec 1082 RAC
Cemetery permits even to
NBI agents
Sec. 1097 RAC
Exhumation in case of
death from dangerous communicable disease
after 5 years from burial.
Sec 92 Code of Sanitation
3 years if non-dangerous
communicable disease.
Remains shall disinfected
before burial.
Requirements to be satisfied in
exhumation:
1. Duration of interment as required.
2. Exhumation permit
3. Compliance of sanitary requirements
Procedures followed in MedicoLegal
Exhumations:

1. A formal request from any of the law

enforcement agency or any person
authorized by law.
a. Name of the person, place of
interment, date of interment,
suspicion as to cause of death.
b. To determine the cause of death.
c. To determine as to identity of the
person.
d. To recover organs or tissues for
further examination for :
= Toxicological analysis
= Histopath exams
= Smears from vaginal canal
and blood for alcohol determination
2. Set the date and time of exhumation, if
physician has a strong reason to believe
that for the justification and strong
probability.
3. Written request to the Regional director
or Secretary of Health.
4. Grave must be properly identified by the
person who was present when the body
was interred.
5. After opening the coffin, the body must
be viewed by any person who can
identify the deceased.
6. Actual autopsy and adoption of the
procedure is needed to accomplish the
purpose of the exhumation.
7. Disinfection of the body and all areas
involved must be carried out with the
assistance of the local health officer and
the return of the body to the burial place.
MEDICO-LEGAL ASPECTS OF PHYSICAL
INJURIES
Physical injury : is the effect of some of
stimulus on the body.
Stab wound the effect is
immediate but a blunt object is delayed
production on the contusion.
Causes of Physical Injuries
1. Physical violence
2. Heat or cold
3. Electrical energy
4. Chemical energy
5. Radiation by radioactive substances
6. Change of atmospheric pressure
7. Infection
1. PHYSICAL INJURIES BROUGHT ABOUT BY
PHYSICAL VIOLENCE
= The effect of the application of physical
injury on person is the production of wound.
= A disruption of the anatomic integrity
of the tissues of the body.

16

= However, not all physical violence will

result in the production of wound.
Physics of wound production:
a.

MV2
Kinetic energy = __________
2

`Velocity component is the

important factor:
M16 rifle with a velocity of 3200
ft/ sec causes damage more than a heavier .38
caliber.
b.
Time
= The shorter the period of time
needed for the transfer of energy, the greater
the likelihood of producing damage.
= If a person is hit on the body and
the body moves towards the
direction of the force applied, the
injury is less as when the body is
stationary.
= The longer the time of contact
between the object or instrument
causing the injury, the greater will be
the dissipation of energy.
c.
Area of transfer
= The larger the area of contact
between the force applied on the body, the
lesser the damage to the body.
= By applying an equal force, the
damage caused by stabbing is greater
compared to a blunt instrument.
d. Other factors
= The less elastic and plastic the
tissue > the greater that a laceration will result.
= Elasticity :
Ability of the tissue to return to
its normal sizes and shape after being deformed
by a pressure.
= A force transmitted through a
tissue containing fluid will force the
fluid away from the area of contact
in all directions equally, frequently
causing the tissue to lacerate.
VITAL REACTION
= It is the sum total of all reactions of tissue
or organ to trauma, either observed micro or
macroscopically.
a. RUBOR redness or congestion of the
area due to an increase of blood supply as a
part of the reparative mechanism.
b. CALOR Sensation of heat or increase in
temperature.
c. DOLOR - pain due to involvement of the
sensory nerve.
d. LOSS OF FUNCTION- due to trauma, the
tissue may not function.

The presence of vital reaction differentiates an

ante-mortem from a post-mortem injury.
EXCEPT: vital reactions not seen even if injury
inflicted during life:
1. During agonal state of a living person
were cells dont react to the trauma.
2. Sudden death as in sudden coronary
occlusion.
CLASSIFICATION OF WOUNDS:
1. AS TO SEVERITY
a.
Mortal wound caused immediately after
infliction that is capable of death.
Parts of body that are mortal heart,
vessels, CNS, lungs, other organs.
b. Non-mortal wound - Not capable of
producing death after infliction.
2. AS TO KIND OF INSTRUMENT USED
a. Blunt instrument contusion,
hematoma, lacerated wound.
b. Sharp instrument
= Sharp-edge instrument>
incised wound
= Sharp pointed
>
punctured wound
= Sharp edge& sharppointed > stab
c. Wounds brought about by tearing
force lacerated wound
d. By change in atmospheric pressure
barotraumas.
e. Wounds brought about by heat or
cold frostbite, scald, burns.
f. Wounds brought about by
chemical explosion GSW, shrapnel wound
g. Wounds brought about by infection.
3. AS TO THE MANNER OF INFLICTION
a) HIT means of bolo, blunt
instrument, axe.
b) TRUST or STAB bayonet dagger
c) GUN POWDER EXPLOSION
Projectile or shrapnel wound.
d) SLIDING or RUBBING or ABRASION
4. AS REGARDS TO THE DEPTH OF THE
WOUND
a) Superficial wound involves only the
layers of the skin.
b) Deep inner structures beyond the
layers of the skin.
PENETRATING WOUND - Wounding agent
did not come out or Piercing a solid organ.
PERFORATING WOUND Wounding agent
produces communication between the
inner and outer portion of the hollow
organs. OR piercing or traversing
completely a particular part of the body
causing communication between the

17

points of entry and exit of the instrument

or substance producing it.
5. AS REGARDS TO THE RELATION OF THE
SITE OF APPLICATION OF FORCE AND THE
LOCATION OF INJURY
a. Coup Injury Physical injury which is
located at the site of the application of force.
b. Contre-coup injury opposite the site of the
application of force.
c. Coup contre-coup injury site and also
opposite of application of force.
d. Locus minoris resistencia Physical injury
not located at the site nor opposite the site
of the application of force but in some areas
offering the least resistance to the force
applied. Example: Blow in fore head >
contusion on the region of the eyeball.
e.Extensive injury Physical injury involving a
greater area of the body beyond the site of the
application of force
Example : Fall or MVA
6. AS TO REGIONS OR ORGANS OF THE
BODY INVOLVED
Injuries in various parts of the body
7. SPECIAL TYPES OF WOUNDS
a) DEFENSE WOUNDS
Instinctive
reaction of self-preservation. >hands/fractures
b) ATTERNED WOUND
Wound in the
nature and shape of the instrument. >
Wheels,abrasions from rope.
c)SELF-INFLICTED WOUNDS - Wound
produced on oneself but no intention to end his
life.
Motive of producing self-inflicted
wounds:
1. To create or deliberately magnify an
existing injury or disease for
pension or workmans
compensation.
2. To escape certain obligations or
punishment
3. To create a new identity
4. Gain attention or sympathy
5. Psychotic behaviour
Some ways of self-mutilation:
1. Head banging or bumping
2. Exposure of body to heat radiation
from open fires, radiators
3. Penetrating nail to chest wall
4. Castration by amputation of the
penis
5. Trichotillomania- pulling of body hair
LEGAL CLASSIFICATION OF PHYSICAL
INJURIES
1. MUTILATION

= Art. 262 RPC

Kinds of
mutilation:
a.
Intentionally depriving a
person, totally or partially of some of the
essential organs for reproduction.
b.
Intentionally depriving a
person of any part or parts of the human
body other than the organs for
reproduction.
Mutilation to be punishable it must be
intentional or not physical injury.
MAYHEM is the unlawful and violent
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.
Vasectomy/Tubal ligation 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.
SERIOUS PHYSICAL INJURIES
Art. 263
RPC
Any person who shall wound, beat or assault
another Art. 263 and administering injurious
substance, without intent to kill Art. 264.
The main purpose of dividing the provision into
four paragraphs
a) Is to graduate the penalties depending
upon the nature and character of the wound
inflicted
b) Their consequences on the person of the
victim.
1. Prison mayor because of the physical
injuries inflicted, the injured person becomes
insane, imbecile, impotent or blind.
2. Prision correctional in its medium and
maximum periods
- loss of speech, hear or smell
- loss of eye, hand, foot, arm, leg
= loss of the use or incapacitated
for the habitual work he used to do.
3. Prision correctional in its minimum and
medium periods.
- person injured shall be deformed.
- lost any other part of the body,
incapacitated for more than 90 days.
4. Arresto mayor in its maximum period to
prision correctional
- If the physical injuries shall have
cause the illness or incapacity for labor for more
than 30 days.
Is the offense shall be committed against any of
the persons enumerated in Art. 246 Or with

18

attendance of any of the circumstances

mentioned in Art. 248
= The case covered by subdivision number 1
of this art. will be punished by reclusion
temporal in its medium &maximum periods.
= Subdivision number 2 by Prision correctional
in its maximum period to prision mayor in its
minimum period.
= Subdivision number 3 by prision correctional
in its medium and maximum
= Subdivision number 4 prision correctional in
its minimum and medium periods.
The provisions of the preceding paragraph
shall not be applicable to a parent who shall
inflict physical injuries upon his child by
excessive chastisement. RA 7610. It may be
committed through a simple negligence or
imprudence.
ADMINISTERING INJURIOUS SUBSTANCE OR
BEVERAGES Art 264 RPC
Elements:
1.
The offender inflicted upon another any
serious physical injury,
2.
There is knowledge that the substance/
beverage administered is injurious Or took
advantage of the victims weakness of
credulity.
3. There is no intent to kill in the part of the
offender. If intentional so> frustrated murder.
Treachery is inherent in Art. 264 RPC
LESS SERIOUS PHYSICAL INJURIES Art.
265 RPC
Any person who shall inflict upon another
physical injuries not described in the preceding
articles,
= But which shall incapacitate the offended
party for labor 10 days or more
= Or shall require medical attendance for the
same period Both of w/c is 10 days but not >30
days & there must be proof to it..
The crime of less serious physical injuries may
be qualified and a fine of a higher penalty is
imposed when:
1. There is a manifest intent to insult or
offend the injured person.
2. There are circumstances adding
ignominy to the offense.
3. The victims is the offenders parents,
ascendants, guardian, curators,
teachers.
4. The victim is a person of rank or
person of authority, provided the
crime is not direct assault.
P.D. 169 Obligation imposed on Physicians
treating persons suffering serious and less

serious physical injuries required to report to

law enforcement agencies.
SLIGHT PHYSICAL INJURIES AND
MALTREATMENT Art 266 RPC
1.
Arresto menor- when the offender has
inflicted physical injuries which shall
incapacitate the offended party for labor form
1 to 9 days or shall require medical
attendance of the same period
2.
Aresto menor or fine not exceeding P200
and censure when the offender has cause
physical injuries which do not prevent the
offended party from engaging in his habitual
work nor require medical attendance.
3.
Arresto menor in its minimum period or a
fine not exceeding P50 when the offender
shall ill treat another by deed without causing
any injury.
If there is no evidence to show actual
injury or incapacity for labor or period of
medical attendance, the accused can only be
guilty of slight physical injuries.
So a tender slap on the face, holding the
arm tightly, application of pressure in some
parts of the body or mild blow which show no
sign of physical violence may still be considered
slight physical injuries or maltreatment. ( Parag
3)
PHYSICAL INJURIES INFLICTED IN A
TUMULTOUS AFFRAY Art 252 RPC
Elements:
1. There is a tumultuous affray
2. Participants suffered from serious physical
injuries.
3. The person who inflicted serious physical
injuries cannot be identified.
4. All those who appear to have used violence
upon the person of the offended party shall be
penalized by arrest from 5-15 days.
TYPES OF WOUNDS ( MEDICAL
CLASSIFICATION)
1. CLOSED WOUND no breach of continuity
of the skin or mucous membrane.
a. Superficial When the wound is just
underneath the layers of the skin or mucous
membrane.
a.1 PETECHIAE is a circumscribed
extravasation of blood in
the subcutaneous tissue
or underneath the
mucous membrane.
Example : mosquito bite,
blood disease, hanging
a.2 CONTUSSION is the effusion of
blood into the tissues
underneath the skin on

19

account of the rupture of

the blood
vessels as a result of
the application of blunt
force or violence.
= size of contusion
greater than the size of the object.
= Location of the
contusion is not always the site of application of
the force. Example: Black eye> Forehead
Medico-legal point of view:
A contusion as indicated by its
external pattern may correspond to the >
shape of the object or weapon used.
Extent
applied.

>

the possible degree of violence

Distribution> indicates the character

and manner of injury as in manual strangulation
around the neck.
Age of Contusion: appreciated from its color
change
The size tends to become smaller from the
periphery to the center and passes through
a series of color changes as a result of the
Disintegration of the RBC and liberation of
hemoglobin.
The contusion is red, purple soon after
its complete development.
4 to 5 days > green
7 to 10 days > yellow and gradually
disappears on the 14th or 15th day.
The ultimate disappearance of color varies
from 1 to 4 weeks depending upon the severity
and constitution of the body.
The color changes starts at the periphery.
CONTUSION VS. POST-MORTEM
HYPOSTASIS
Contusion
=Below the epidermis in the true skin in small
bruises or extravasations, below this in larger
ones and often much deeper still.
The epidermis has no blood vessels to be
ruptured.
Post mortem Hypostasis
=In the epidermis or in the cutis as a simple
stain or a showing through the epidermis of the
underlying engorged capillaries.
Contusion
=Cuticle was probably abraded by the same
violence that produced the bruise. In small
punctures such as fleas bites, this is not
observed.
Post-mortem hypostasis
=Cuticle unabraded, because the hypostasis is
a mere sinking of the blood, there is no trauma.

Contusion
=A bruise appears at the seat of and
surrounding the injury. This may or may not be
a dependent part.
Post-mortem hypostasis
=Always in a part which for the time of
information is dependent.
Contusion
=Often elevated because elevated blood and
subsequent inflammation swell the tissues.
Post-mortem hypostasis
=Not elevated, because either the blood is still
in the vessels or at most has simply soaked into
and stained the tissues.
Contusion
=Incision shows blood outside the vessels.This
is the most certain test of difference& can be
observed even in very small bruises.
Post-mortem hypostasis
=Incision shows the blood is still in its vessels&
if any oozing occurs, drops can be seen issuing
from the cut mouths of the vessels.
Contusion
=Color variegated. This is only true of bruises
that are the same days old d/t the changes in
the hemoglobin produced during life.
Post-mortem hypostasis
=Color is uniform. The well known change in
color produced in blood Extravasated Into living
tissues does not occur in dead tissues with the
same regularity.
Contusion
=If the body happens to be constricted at or
supported on a bruised place, the actual surface
of contact may be a little lighter than the rest of
the bruise but will not be white.
Post-mortem hypostasis
=In a place which would otherwise be the seat
of hypostasis pressure of any kind even simple
support is sufficient to obliterate the lumen of
the venules and capillaries and so to prevent
their filling with blood. White lines or patches of
pressure bordered by the dark color of
hypostasis are produced and marks of floggings,
strangulation, etc. are thus sometimes
simulated.
FACTORS INFLUENCING THE DEGREE AND
EXTENT OF CONTUSSION
1.General condition of the patient.
2.Part of the body affected. Fatty tissues,
bloody parts > contused easily
Fibrous areas,
muscle
> less
3. Amount of force applied The greater the
force, the more effusion of blood.
4. Disease Contusion may develop with or
without application of force.

20

Example: Aplastic anemia,

whooping cough
5. Age Children and old age tend to bruise
easily.
6. Sex women, obese easily develops
unlike boxers.
7. Application of heat and cold
The distinction between ante-mortem and
post-mortem contusions in an
undecomposed body is that in ;
1. Ante-mortem bruising: there is swelling,
damage to epithelium,
extravasation,coagulation and infiltration of
the tissues with blood
2. Post-mortem bruising there are no such
findings.
a.3 HEMATOMA
- is the extravasation or effusion of blood
in a newly formed cavity underneath the
skin. When the blunt instrument hit a
hard part of the body like a bony part
which is superficially located.
- Force causes the subcutaneous tissue to
rupture on account of the presence of a
hard structure underneath..
DISTINCTION BETWEEN CONTUSION AND
HEMATOMA
1.
In contusion- the effused blood are
accumulated in the interstices of the tissues
underneath the skin
In hematoma blood accumulates in a newly
formed cavity underneath the skin.
2. in contusion, theskin shows no elevation and
is ever elevated, the elevation is slight and is
on account of inflammatory changes
In hematoma the skin is always eelevated.
3. In contusion, puncture or aspiration with
syringe of the lesion, no blood can be
obtained.
In hematoma shows presence of blood and
subsequent depression of the elevated lesion.
**Abscess, gangrene, hypertrophy, fibroid
thickening and even malignancy are potential
complications of hematoma.
MUSCULO-SKELETAL INJURIES
1. Sprain - partial or complete disruption in the
continuity os a muscular or
ligamentous support of a joint, due to
a blow, kick or torsion force.
2. Dislocation displacement of the articular
surface of bones entering into the
formation of a joint.
3. Fracture solution of continuity of bone
resulting from violence or some
existing pathology.

a. Close or Simple Fx no break in

continuity of the overlying skin.
b. Open or Compound Fx Fx is
complicated by an open wound
caused by the broken bone which
protruded with other tissues of the
broken skin.
c. Comminuted Fx Fractured bone is
fragmented into several pieces.
d. Greenstick Fx Fx wherein only one side
of the bone is broken while the other
is merely bent.
e. Linear Fx when the Fx forms a crack
usually in flat bones.
f. Spiral Fx break in the bones forms a
spiral manner as seen in long bones.
g. Pathologic Fx Fx caused by weakness
of the bone due to disease.
4. Strain the over-stretching instead of an
actual tearing /the rupture of a
muscle / ligament which may not be
assoc w/ the joint.
5. Sublaxation Incomplete or partial
dislocation.
INTERNAL HEMORRHAGE
- rupture of blood vessels which may
cause hemorrhage due to the following:
a. Traumatic intracranial
hemorrhage.
b. Rupture of parenchymatous
organs.
c. Laceration of other part of the
body.
CEREBRAL CONCUSSION ( COMMOTIO
CEREBRI )
- THE JARRING OR STUNNING OF THE BRAIN
CHARACTERIZED BY MORE OR LESS
COMPLETE SUSPENSION OF ITS FXNS AS A
RESULT OF INJURY TO THE HEAD W/C LEADS
TO SOME COMMOTION OF THE CEREBRAL
SUBSTANCE.
- is more severe when the moving or mobile
head struck a fixed hard object as compared
when the head is fixed and struck by a hard
moving object.
Signs and Symptoms
1. unconsciousness which is more or less
complete.
2. muscles are relax and flaccid.
3. eyelids are closed and the conjunctivae
are insensitive.
4. surface of the body is pale, cold and
clammy.
5. respiration is slow and sighing.
6. pulse is rapid, weak, faltering and
scarcely perceptible to the fingers.
7. temperature is subnormal.

21

8. sphincters are relaxed with unconscious

evacuation of the bowel and bladder.
9. reflexes are present but sluggish and in
severe cases may be absent.
**Loss of memory for events just before the
injury is a constant effect of cerebral concussion
and is of medico-legal importance.
2. OPEN WOUNDS
a. Abrasion ( Scratch, graze,
impression mark, friction mark )
- it is an injury characterized by the
removal of the superficial epithelial layer
of the skin caused by a rub or friction
against a hard rough object.
- Contusion with abrasion = forcible
contact before friction occurs.
- the shape varies and the raw surface
exudes blood and lymph which later
dries and forms a protective covering as
SCAB or CRUST.
Characteristics of abrasion:
1.
It develops at the precise point
of the force causing it.
2.
Grossly or with the aid of a hand
lens the injury consists of parallel linear
injuries which are in line with the
direction of rub or friction causing it.
3.
It may exhibit the pattern of the
wounding material.
4.
Usually ignored by attending
physician. Medico-legal viewpoint
=abrasions caused by fingernails may indicate
struggle or assault and are usually located in
the face, neck, forearms and hands. =abrasions
resulting from friction on rough surfaces are
located in bony parts and are usually associated
w/ contusion or laceration. = nature of the
abrasion may infer degree of pressure, nature of
the rubbing object and the direction of
movement.
5. Abrasion heals in a short time and
leaves no scar unless if not
infected or if the whole thickness of
the skin is involved.
Forms of abrasion
1. Linear abrasion appears as a single line,
straight or curve.
= pinching with fingernails =
curve a.
= sliding the point of a needle
= straight linear ab.
2. Multi-linear develops when the skin is
rubbed on a hard rough object producing
several linear marks parallel to one another.
Example: MVA

3. Confluent linear marks in the skin are

almost indistinguishable on account of the
severity of friction & roughness of the object.
4. Multiple several abrasions of varying sizes
and shapes found in different parts of the body.
Types of abrasion
1. Scratch caused by sharp pointed object
which slides across the skin, like pin, thorn or
fingernail.
- Injury usually parallel to the
direction of slide.
= Fingernail scratch > broad at point
of commencement with tailing at the end.
2. Graze usually caused by forcible contact
with rough, hard objects resulting to irregular
removal of the skin surface.
= course indicated by a clean
commencement and tags on the end.
3. Impact or imprint abrasion ( patterned
abrasion, stamping abrasion,abrasion a la
signature)
- those whose pattern and location
provides objective evidence to show
cause, nature of the wounding
instrument and the manner of assault
or death.
= marks of grid of radiator, thread
marks of wheel, teeth marks.
4. Pressure or friction abrasion caused by
pressure accompanied by movement usually
observed in hanging or strangulation.
= spiral strands of the rope as seen in
the skin in hanging.
Differential diagnosis:
1. Dermal erosion-gradual breakdown or very
shallow ulceration of the skin w/c involves only
the epidermis & heals w/out scarring.
2. Marks of insects & fishes bites skin injury
is irregular w/ no vital reaction and usually
found on angles of the mouth, margins of
nose, eyelids and
forehead.
3. Excoriation of the skin by excreta found in
infants and the
skin lesions heals
when the cause is
removed. No
apparent history
of rubbing trauma
on the affected
area.
4. Pressure sore usually found at the back at
the region of bony prominence. History of
longstanding illness, bed ridden.

22

ANTEMORTEM ABRASION
POSTMORTEM ABRASION
COLOR
reddish-bronze due to slight
exudation of blood
yellowish and
transparent
LOCATION
any area
over bony prominence rough handling of the
cadaver
VITAL
with intravital reaction
shows not vital reaction and
REACTION
may show remains of damaged
Epithelium
characterized by a
separation of the epidermis from
Complete loss of the former.
b. Incised wound ( cut, slash, slice)
produced by a sharp-edged ( cutting)
or sharp-linear edge of the instrument like a
knife, razor, bolo, glass etc.
= Impact cut > when there is forcible contact
of the cutting instrument with the body surface.
= Slice cut > when cutting injury is due to the
pressure accompanied with movement of the
instrument
= Chopped or Hacked wound > when the
wounding instrument is a heavy cutting
instrument like saber, injury is severe
Characteristics of incised wound:
1. Edges are clean cut.
2. The wound is straight
3. Usually the wound is shallow near the
extremities and deep at the middle
portion.
4. Profuse hemorrhage because of the
clean cut on the vessels.
5. Gaping is usually present due to the
retraction of the edges.
6. Clothes will also show a clean cut if cut
by the instrument.
7. Faster healing if without complications.
8. Incised wound made by broken glasses
maybe irregular, needs to be removed.
Changes that occur in an incised
wound:
1. After 12 hours edges are swollen,
adherent with blood and with leukocyte
infiltration.
2. After 24 hours proliferation of the
vascular endothelium and connective
tissue cells.
3. After 36 to 48 hours capillary network
complete, fibroblasts running at right
angles to the vessels.
4. After 3 to 5 days vessels show
thickening and obliteration.
Why a person suffers from incised
wound:
1. As a therapeutic procedure.
2. As a consequence of self-defense

3. Masochist may self-inflict incised

wounds for self-gratification.
4. Addicts and mental patients.
Suicidal wounds usually located in peculiar
parts of the body, accessible to the hand.
- the most common site is the wrist, radial
artery and the neck.
Homicidal wounds usually deep, multiple and
involves both accessible and non-accessible
parts.
- clothing are usually involved
- Defense and other forms of wounds are
present.
Accidental wounds multiple incised wounds
observed on the passenger and driver of MVA
due to broken windshields.
- kitchen knives in the preparation of food.
SUICIDAL WOUNDS
HOMICIDAL WOUNDS
DIRECTION
Oblique from below left
ear,downwards across front
Usually
horizontal below the adams apple
neck just above the Adams
apple
SEVERITY
Usually not so deep & may
only involve trachea,
Usually deep
and may cause involvement
carotid & esophagus
of the cartilage & bones
SUPERFL CUT
Usu present before the
commencement of deeper Wound
Practically absent but may rarely be present

when the victim struggled

POSITN OF THE BODY May be sitting or facing
a mirror or standing
Usually
victim lying on bed or in a workplace
WOUNDING
Firmly grasp (cadaveric
spasm)/ found lying beside the
Weapon is absent
WEAPON
victim
BLOOD
Bld found in front part of body
Bld found at the back of neck.
DISTRIBUTION
Hand smeared with blood.
Hands are clean.
MOTIVE
History of mental depression,
Financial, social problem,
Absence of such history
alcoholism
PREVIOUS Hx
May be present
Always absent
Of SELF-DESTRUCTN

23

3. STAB WOUNDS is produced by the

penetration of a sharp and a sharp-edged
instrument like a knife, scissors.
- if the sharp edge is the one that comes
in contact with the skin then it is an
incised wound.
- If the sharp pointed portion first come in
contact, it is a stab wound.
= surface length may reflect the width of
the wounding instrument.
= smaller when the wound is not so deep.
= wider if upon withdrawal is not in the
same direction as seen in slashing
movement. The presence of an abrasion
from the extremity of the skin defect is in
line with direction of the slashing
movement.
The extremities of stab wound may show the
nature of the instrument used.
- a doubled bladed weapon shows both
extremities to be sharp.
- A single bladed weapon one of its
extremities as rounded and contused,
not seen if instrument is quite thin.
The direction of the surface defect may be
useful in the determination of the possible
relative position of the offender and the victim
when the wound was inflicted.
As to whether the wound is slit-like or gaping
depends on the direction of the wound to the
Langers line.
The depth of the wound may be influence
by:
1. size and sharpness of the instrument.
2. area of the body involved
3. the degree of force applied
**Hemorrhage is always the most serious
consequence of stab wound due to the
severance of blood vessels or involvement of
bloody organs.
How to describe stab wound:
1. length of the skin defect edges must be
coaptated first
Tailing the direction of withdrawal of the
wounding weapon.
2. condition of the extremities
= sharp extremity > sharpness of the
instrument used.
= If Both extremity are sharp > double
bladed weapon is used.
3. condition of the edges.
= edges are regular and clean cut>
due to one stabbing act.

= serrated or zigzag in appearance >

several stabbing wounds ( series of thrust
and withdrawal.)
4. linear direction of the wound it may be
running vertically, horizontally, or upward
medially or laterally.
5. location of the stab wound to include
exact measurement from anatomical
landmarks.
6. direction of the penetration must be
tridimentional
7. depth of the penetration
8. tissue and organs involved
Stab wounds may be:
A.Suicidal
1.
Located over vital parts of the
body.
2.
Usually solitary
3. Llocated over covered parts of the
body, the clothing is not involved
4. Stab wound is accessible to the hand of
the victim
5. Hand of victim is smeared with blood
6. wounding weapon is firmly grasp by the
hand of the victim.
7. If stabbing is accompanied w/slashing
movementThe wound tailing abrasion
is seen towards the hand inflicting the
injury.
8. Suicide not may be present
9. Presence of a motive for self
destruction.
10. No disturbance in the death scene with
wounding instrument found near the victim.
B. Homicidal stabbing with homicidal
intent is the most common
Characteristics:1. Injuries other than stab
wound may be present .
2. Stab wound may be
located in any part of the body.
3. Usually more than one
stab wound
4. A motive for stabbing, if
none then the offender either insane/drugs
5. Disturbance in the crime
scene
Medical evidence showing the intent of the
offender to kill the victim:
1. there are more than one stab wounds
2. stab wounds located in different parts of
the body
3. stab wounds are deep
4. serrated stab wounds means thrust and
withdrawal of the wounding weapon to
increase internal damages.
5. irregular or stellate shape skin defects>
due to changing direction of the weapon

24

with the portion of the instrument at the

level of the skin as the lever.
4. PUNCTURED WOUND - is the result of a
thrust of a sharp pointed instrument.
= External injury is quite small but the depth
is to a certain degree.; ice-pick, nail
- Nature of the external injury depends on
the sharpness of the end of the wounding
instrument:
= contusion of the edges> if end is not
sharp
= opening may be> round, elliptical,
diamond shaped or cruciate.
- External hemorrhage is limited although
internal injuries may be severe.> blood
vessels and bloody organs is fatal if no
intervention applied.
- Site of external wound can be easily sealed
by dried bld, serum, or clotted bld.
- Punctured wounds are usually accidental
Characteristics:
1. The opening of the skin is very
small, wound is much deeper than
it is wide.
2. External hemorrhage is limited than
internally may be severe.
3. Sealing of external opening is
favorable for the growth and
multiplication of anaerobic
organism like bacillus tetani.
Homicidal 1. multiple and usually located in
different parts of the body.
2. wound are deep
3. there are defense wounds on the
victim.
4. signs of struggle in the crime
scene.
Suicidal 1.
located in areas of the body where the
vital organs are located.
2.
usually singular, if multiple located in
one area.
3.
parts of body involved is accessible by
the hand of the victim.
4.
clothing usually not involved.
5.
wounding is made while the victim is in
sitting or standing position ,
bleeding is towards the lower part
of the body or clothing.
6.
no disturbance in the crime scene.
7.
wounding instrument found near the
body.
Puncturing wound with puncturing
instrument loaded with poison:
1. poison dart cyanide or nicotine
2. fish spines

3. dog bites with hydrophobia virus

4. injection of air and poison as a way
of euthanasia.
5.LACERATED WOUNDS ( TEAR, RUPTURE,
STRETCH PUTOK)
- is a tear of the skin and the underlying
tissues due to forcible contact with a
blunt instrument.
- May be produced by a hit with a piece of
wood, iron bar, fist, stone, butt.
- If the force is applied to a tissue is greater
than its cohesive force and elasticity>
the tissue tears and a laceration is
produced.
Characteristic:
1. shape and size of the injury does
not correspond to the wounding
instrument
2. tear on the skin is rugged with
extremities irregular, ill-defined.
3. injury developed where the blunt
force is applied.
4. borders of the wound are contused
and swollen.
5. developed in areas where the bone
is superficially located.like scalp.
6. examination with the aid of hand
lens shows bridging tissue joining
the edges and hairs bulbs are
intact.
7. bleeding is not extensive due to
blood vessels are not severed
evenly.
8. healing process is delayed and has
a tendency to develop a scar.
Classification of lacerated wounds:
1.
Splitting caused by crushing of the skin
between two hard objects.
Ex: laceration of scalp hit by a bunt
instrument, cut eyebrow of a boxer.
2. 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.
3. Grinding compression
- the weight and the grinding movement
may cause separation of the skin with
the underlying tissues.
4. Tearing
- this may be produced by a semisharped edged instrument which causes
irregular edges on the wound like
hatchet and choppers.

25

Lacerated wounds are rarely suicidal.

INCISED WOUNDS
Edges are clean cut,
regular, well defined
No contusion or
swelling around the
Incised wounds
Extremities of the
wound are sharp, may
be Round, or contused
Examination by means
of a hand lens shows
that hair bulbs are cut
Healing is faster
Caused by sharp edged
instrument

LACERATED
WOUNDS
edges are roughly cut,
irregular, ill-defined
swelling and
contusion around the
lacerated wounds
extremities are illdefined and irregular
hair bulbs are
preserved
healing is delayed
caused by a blunt
instrument

26

GAPING OF WOUND
- Separation of the edges especially in deep
wound may be due to the following:
1. mechanical stretching or dilatation
- the presence of a mechanical device on
the edges to prevent coaptation will
cause separation. Example: drain in an
abscess, retractor during operation.
2. loss of tissue due to:
a. Destruction due to pressure, inftion, cell
lysis, burning, chemical reaction.
b. Avulsion or physical or mechanical
stretching resulting to separation of a portion of
the tissue.
c. Trimming of the edges debridement of
the skin which come in
contact with the bullet
at the entrance and
exit of GSW and
removal of necrotic
materials.
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 pattern of fiber arrangement is
called cleavage direction or lines of
cleavage of the skin and their linear
representation on the skin is called
Langers line.
Practical ways of determining how much of
the skin surface is involved in an injury or
disease:
- skin functions as a mechanical protection of
the body, storage of water.
- Determination of how much skin is involved is
important in the mode of treatment and
prognosis especially in burns, contusion..
= burns of 70% in children and older age
group are fatal.
= rule of nine is used.
Head and
neck
9%
9%
one upper
extremity
9%
18%
front chest and
abdomen
18%
18%
posterior chest
and abdo
18%
18%
one lower
extremity front
9%
18%
one lower
ext(back)
9%
18%
pudendum
1%
1%

Factors responsible for the severity of the

wound:
1. Hemorrhage may influence the severity of
wound by:
a. loss of blood incompatible with life
- blood constitutes 1/20 of the
body weight of an adult.
- 5 to 6 quarts of blood ( one
quart is 946 cc)
- loss of 1/10th of its volume will
cause no significant change.
- loss of one quart> fainting
- loss of 1/3rd to 2/5th >
irreversible shock
- males can withstand more loss
of blood than females.
- hypertension causes more
excessive and rapid bleeding.
b. Hemorrhage may result in an increase
in pressure in or on the vital organs to affect
the normal function.
- intracranial hemorrhage cause
compression of the vital centers of the brain.
- hemopericardium > pericardial tamp
- hemorrhage to the chest>
diminution of the respiratory output>anoxia.
c.. Hemorrhage may cause mechanical
barriers to the function of organs.
- into tracheo-bronchial lumina>
asphyxia
- into muscles > disturbance in
their contractility.
Causes of hemorrhage:
a. trauma - destruction of its blood
vessel wall
b. natural causes
- intracerebral hemorrhage(apoplexy)>
lenticulostraite br. MCA
- Spontaneous subarachnoid
hemorrhage > saccular berry aneurysm
- rupture of arteriosclerotic aneurysm
- rupture of esophageal varices
- pulmonary hemorrhage due to PTB,
lung abscess, bronchiectasis
- ruptured ectopic pregnancy
2. Size of injury - burns greater than 1/3rd of the
body are fatal
3. Organs involved usually fatal to heart, brain,
lungs.
4. Shock blow to genitalia, slight burns to
young and old.
5. Foreign body or substance introduced into the
body - bacterial, viral, foreign body, chemical,
TOXIN.

27

1. snake bites> 2 punctured wds at the

center of the reddened affected area. The
venom is injected through its fangs which
is connected to the poison gland.
Snake venom toxicity will depend on:
1. potency of venom injected
2. amount of venom injected by the fang
will depend on
- season of the year
- the length of time the snake has
eaten.
- if a snake has just killed its prey>
toxic content is smaller.
3. size of the patient
4. immediate treatment instituted.
Snake venoms are two principal classes:
1. Neurotoxic primarily paralysis the
respiratory and cardiac center of the brain.
- may cause N,V, ascending
paralysis, coma, convulsion, c/p arrest
2. Hematoxic - affects particularly the blood
- manifestations are pain, swelling
on the affected area, IV hemolysis, N,V,
pulmonary and cardiac edema.
Emergency treatment may be:
1. incision of the wound to promote more
external hemorrhage to drain the venom.
2. tourniquette above the site of the wound
3. placing ice on the bite site
4. sucking the wound to drain venom with
the mouth
5. administration of anti-snake venom
serum.
6. Absence of medical or surgical
intervention wound may not be fatal
but due to neglect or ignorance of its
management, may be serious and fatal
2. Scorpion venom
- venom has toxic, hemolytic, hemorrhagic
- one punctured wound on the center of a
reddened area
- pain, edema and reddening
3. Coelenterate sting ( jellyfish )
- tentacles penetrate into the skin and
cause explosion of the nematocyst and
liberation of the venom.
- extreme pain. Urticarial rash, dilated
pupils, paleness, labored breathing
FATAL EFFECT OF WOUNDS:
1. Wounds may be directly fatal by reason of:
a. hemorrhage neck due to
carotid bleed.

b. Mechanical injuries on vital

organs
c. shock
2. Wounds may be indirectly fatal by reason of:
a. secondary hemorrhage
following sepsis
b. specific infection
c. scarring effect
d. secondary shock
NATURE OF DEATH DUE TO SECONDARY
CAUSES
1. Changes whose natural sequence are
direct & obvious sepsis, tetanus
2. Changes producing separate pathological
lesions which in turn proves to be fatal
Ex: operation to ligate vessel but died of
peritonitis despite diligence/skill
3. Changes where a definite pathological
condition was present before the injury.
Ex. Person with tumor and stabbed , stab
is not capable of death but accused is
responsible for his death.
4. Changes where a definite pathological
condition of totally different nature arises
after the wounding and the
consequential sequence is doubtful.
Ex. TB meningitis ffg blow to the
head
COMPLICATIONS OF TRAUMA OR INJURY
1. Shock due to injury to nervous system,
anoxemia, endothelial damage
2. Hemorrhage
3. Infection
a. from the instrument
b. from the organs involved in
trauma ex. Bowels injured
c. injury may depress general
vitality
d. deliberate intro of microorganism
4. Embolism
HEALING OF WOUNDS
1. Power of the human tissue to regenerate
replaced the destroyed tissue by newly
formed similar tissue.
Regenerates rapidly : C.T., blood
forming tissues,surface epith. skin
Slow to regenrate:sm. Muscles, neurons
of CNS, highly specialized
glandular tiss.
Time of healing is dependent on:
a. vascularity
b. age of person

28

c. degree of rest or
immobilization
d. nature of the injury
2. Aberrated healing process:
a. formation of exuberant
granulation or proud flesh
b. keloid formation
c. stricture
d. fistula or sinus formation

MEDICO-LEGAL INVESTIGATION OF
WOUNDS
Rule to follow by a physician:
1. all injuries must be described
2. description of wound must be
comprehensive, sketch/photograph
3. examination must be influenced be any
other information obtained from others in
making a report or a conclusion.

Outline of the medico-legal investigation

of physical injuries:
1. General investigation of the
surroundings:
a. examination of place where
crime is committed.
b. Examination of clothing, stains,
cuts, hair, f.b. in the crime scene
c. Investigations on possible
witnesses to the incident
d. Examination of the wounding
instrument
e. Photography, sketching,
accurate description of the crime
scene.
2. Examination of the wounded body
a. examinations applicable to living or
the dead
- age of the wound from the
degree of healing
- determination of the weapon
used
- reasons for the multiplicity of
wounds
- determination if the wound is
accidental, suicidal or homicidal
living

- determination
- determination
produce permanent deformity
- determination
produces shock
- determination
produces complications

if injury is fatal
if injury will
if wound
if wound

c. examination applicable to a dead victim

only

- determination if wound is pre-mortem

or post-mortem
- determination whether wound is mortal
or not
- determination whether death is
accelerated by a disease present at time of
injury.
- determination whether wound cause by
A,S, H
3. Examinations of wound
- character of wound : abrasion,
hematoma, laceration etc
- location of wound : from some fixed
area
> to determine trajectory/course
- depth of wound : not in the living , only
if the outer and inner are fixed
- conditions of the surroundings of the
wound = near GSW burning, tattooing
= suicidal cuts superficial
tentative cuts or hesitation cuts
= lacerated wounds contusion
on neighboring skin
- extent of the wound
= extensive injury marked
degree of force applied in the production of the
wound.
= homicidal cutthroats are
deeper, extensive, numerous than suicide
- direction of the wound > impt. in the
position of the victim to the offender
- number of wounds several>
homicidal
- conditions of locality
a. degree of hemorrhage
b. evidence of struggle
c. information as to the position of
the body
d. presence of suicide note
e. condition of the weapon

b. examination applicable only to the

29

WOUNDS

ANTE-MORTEM
POST-MORTEM WOUNDS

HEMORRHAGE:
-More profuse, arterial due
to loss of tone of vessels,
Slight or none,
venous
Absence of heart action;
Post-mortem clotting of
blood inside b.v.
-Marks of spouting of blood
from arteries
No spouting of blood
-Clotted blood
Bld not clotted,or soft clot
SIGNS OF INFLAMMN:
Inflammation &
reparative process; Swelling in the area, None
Effusion of lymph, pus;
Adhesion of the edges
Unless if victim is weakened
SIGNS OF REPAIR: Fibrin formation; growth of
epithelium; Scab/ scar formn
No time of
repair
RETRACTION OF THE
Deep staining of
the edges and cellular tissues
Not
deeply stained
EDGES OF THE WOUND
w/c is not removed
by washing
can be removed by washing
Edges gape owing to the
reaction of the skin and Edges do not gape, but
are closely
muscle fibers
approximated to each
other unless if the wound is 1 to 2 hrs after
death
DETERMINATIONS IF WOUND IS:
HOMICIDAL
SUICIDAL
ACCIDENTAL
ABRASIONS

Not common unless

Rarely observed
Extensive

If

dragged Or if victim resisted

abrasions MVA
CONTUSION
Rare except when
Found in any portion
jumping from a height
the body - Fall
INCISED

Commonly observed
Commonly observed
Frequent but rarely

of

WOUNDS
surroundings

* depth, location and

cause of death

Points to consider in the determinatn as

to whether the wounds is A, S, H.
1. external signs and circumstances related
to the position and attitude of the body
when found.
2. location of the weapon or the manner in
which it was held
3. the motive in the commission of the
crime
4. the personal character of the deceased
5. the possibility for the offender to have
purposely changed the truth of the
condition.
6. other information
a. signs of struggle
b. number and direction of wounds
c. direction of wound
d. nature and extent of the wound
e. state of clothing
LENGTH OF TIME OF SURVIVAL OF THE
VICTIM AFTER INFLICTION OF THE WOUND
1. degree of healing> signs of repair of
wound appear in less than a day after
the infliction of injury.
2. changes in the body in relation to the
time of death >systematic changes in
the body = wasting, anemia, bed sore.
3. age of blood stain not reliable
4. testimony of witness when the wound
was inflicted.
POSSIBLE INSTRUMENTS WHEN USED BY
THE ASSAILANT IN INFLICTING THE
INJURIES
1. contusion blunt
2. incised wound sharp-edged instrument
3. lacerated wounds- blunt
4. punctured wounds sharp pointed
5. abrasion body surface is rubbed on a
hard surface
6. GSW the diameter of the wound of
entrance may approximate the caliber of
the wounding instrument.
Could the injury have been inflicted by a
special weapon?
A physician cant determine that a specific
weapon was used in inflicting a wound. It is
possible that it is caused by a certain
instrument presented. He must be cautious in
giving categoric statements
Which of the injuries sustained by the
victim caused death?
If with conspiracy no need coz the act of
one is the act of all.

30

If none- offenders are only responsible for

their individual acts.
If multiple injuries: which of the wound
injured a vital organ.
Or if same organ which caused the
degree of damage.
Which of the wounds was inflicted first?
If multiple for the qualification of the offense
committed.
First treachery , murder
Last - homicide
Consider:
1. relative position of the assailant and the
victim when the first injury was inflicted
on the latter.
2. trajectory/course of the wound inside
the body of the victim
3. organs involved and the degree of injury
4. testimony of witness
5. presence of defense wounds inflicted
first.
Effect of medical and surgical intervention
on the death:
If death followed after operation> offender
is responsible if death was inevitable and that
even with operation death is normal and direct
consequence of the injury, and the physician is
competent and in spite of exercise of degree of
diligence still death is the outcome.
If death ensued even the wounds are minor,
and death due to the negligence or
incompetence of the physician then the offender
cant be responsible.
Effect of negligence of the injured person
on the death
If death occurred from complications arising
from a simple injury owing to the negligence of
the injured person in its proper care and
treatment
= the offender is responsible for the death
= a person is not bound to submit himself to
medical tx for the injuries received during the
assault.
= unless if it is proven that the negligence of
the victim is deliberate so offender is not
responsible but only for physical injuries.
Power of volitional acts of the victim after
receiving a fatal injury:
= dying declaration, attempt to kill the
offender after the first blow of the offender
Relative position of the victim and
assailant when injury was inflicted:
1. location of the wound
2. direction of the wound
3. nature of instrument used in inflicting
the injury
4. testimony of the witness

EXTRINSIC EVIDENCES OF THE WOUNDS

1. evidences from the wounding weapon
= position of the weapon - near or
grasp by victim
= blood on weapon - may be stained
with blood
= hair and other substance on
weapon
2. evidences in the clothing of the victim
= soaked with blood - hemorrhage
= gunpowder - distance
= tears - struggle
3. evidences derived from the examination
of the assailant = paraffin test, tears in
clothing, blood stains, intoxication etc.
4. evidences derived from the crime scene
= amount of hemorrhage, wounding
instrument etc.
PHYSICAL INJURIES IN THE DIFFERENT
PARTS OF THE BODY
1. HEAD AND NECK
= not be underestimated
= bleeding from ears, nose, mouth >
basal fractures
= may have normal x-rays yet with
severe head injury
Factors influencing the degree and extent of
head injuries :
a. nature of the wounding weapon> degree of
violence applied depends on the
thickness of the scalp& the weight of
the weapon.
b. Intensity if the force > intensity and
heavy agent
c. point of impact >extensive in fx of vaults
at side or back
d. mobility of the skull at the application of
force
if head is mobile, free> effect on the
brain is due to the shearing movement imparted
to the brain.
> may produce
contusion, laceration without fx.
If head is fixed and unsupported>
jarring movement of the brain is absent but the
fracture is extensive.
Head injuries are classified as to the site
of the application of force:
1. Direct or Coup injuries
2. Indirect injuries
a. contr-coup injuries
b. remote injuries fall hitting
buttocks> basal fx
c. locus minoris resistencia - injury
in areas with less resistance
3. Coup-contre-coup injuries ( direct and indirect
injuries)

31

Wounds in the Scalp:

1. it is difficult to prevent the spread of
infection
2. there is proximity of the scalp to the
brain
3. there are free vascular connection
between the structures inside and
outside the brain
4. it is frequently difficult to determine the
extent of damage of the skull.
FRACTURES OF THE SKULL p. 302
CHAPTER 13
GUNSHOT WOUNDS
Death or physical injuries brought about
by powdered propelled substances:
1. Firearm shot
= the injury is caused by the missile
propelled by the explosion of the
gunpowder located in the cartridge
shell and the rear of the missile.
2. detonation of high explosives - grenades
= explosion inside the metallic container
will cause fragmentation of the container.
I. FIREARM WOUND
= Firearm : is an instrument used for the
propulsion of a projectile by the
expansive force of gasses coming
from the burning of gunpowder.
(technical definition)
= includes rifles, muskets, shotguns,
revolvers, pistols, other deadly weapons
which a bullet, ball, shell or other missile
may be discharged by means of gunpowder
or other explosives.
= includes air rifle except of small calibers
and limited range.
= the barrel of any firearm shall be
considered as a complete firearm for all
purposes thereof.
Penal provisions of laws relative to
firearm:
a.
Sec. 2692 RAC unlawful
manufacture, dealing in
acquisition, disposition or
possession of firearms or
ammunitions therefore or
instrument used or intended
to be used in the manufacture
of firearms or ammunition.
b.
Sec. 2690 RAC selling of
firearms to unlicensed
purchaser.
c.Sec. 2691 RAC - failure of personal
representative of deceased
licensee to surrender firearm.

d. Art. 155 RPC - Alarms and Scandals

e.Art. 254 RPC Discharge of firearms
CLASSIFICATION OF SMALL FIREARMS:
Small firearms - are those which propel
projectile of less than 1 inch in diameter.
1. as to wounding power:
= low velocity firearm >muzzle velocity of
not more than 1400 ft per sec.
Ex. Revolver
= high power firearm > muzzle velocity
more than 1400 ft. per second
> usual is 2200 to
2500 ft per second or more.
2.as to nature of the bore:
= smooth bore weapon >inside portion of
the barrel that is perfectly smooth from
the firing chamber to the muzzle. Ex.
shotgun
= rifled bore firearm > the bore of the
barrel with a number of spiral lands &
grooves which run parallel with one
another but twisted spirally from breech
to muzzle. Ex. Military rifle
3. as to manner of firing
= pistol fired with a single shot
Ex. Revolver
= rifle may be fired from the shoulder
Ex. Shotgun
4. As to the nature of the magazine
= cylindrical revolving magazine the
cartridge is
located in a
cylindrical
magazine which
rotates at the
rear portion of
the barrel
Ex. Revolver
= vertical or horizontal magazine the
cartridge is held one after another
vertically or horizontally and also held in
place by a spring side to side or end to
end.
Ex. Automatic pistol
Types of small firearms which are of
medico-legal interest:
1. revolver usual muzzle velocity is 600
feet per second
2. automatic pistol self-loading firearm,
muzzle velocity of 1200 feet per second
3. rifle - muzzle velocity of 2500 feet per
second and a range of 3000 feet.
4. shotgun - projectile is a collection of
pellets
A weapon in order to cause injury must
have two principal component parts:

32

1. the cartridge or ammunition - bullet primer,

cartridge case, powder charge
2. firearm instrument for the propulsion of a
projectile force of gases from a burning powder.
ENTRANCE WOUND
Appears to be smaller than
the missile Owing to the
elasticity of the tissue
Edges are inverted
Usually oval or round
depending upon the angle
of approach of the bullet
Contusion collar or contact
ring is present due to
invagination of the skin
and spinning of the missile
Tattooing or smudging may
be present when firing is
near
Underlying tissues are not
protruding
Always present after fire
Paraffin test may be
positive

EXIT WOUND
Always bigger than
the missile
Edges are everted
Does not manifest
any definite shape
Absent

Absent
Underlying tissues
may be seen
Protruding from
the wound
May be absent, if
missile is lodged in
the body
Negative

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 GSW of entrance is almost the same as the
caliber of the wounding firearm except:
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.
fragmentation of the bullet
before penetrating the skin
b.
contraction of the elastic
tissues of the skin
Other evidences or findings used to
determine entrance of GSW
1. examination of the clothing, if involved in the
course of the bullet
a. fabric shows punch in destruction

b. particle of gunpowder
2. examination of the internal injuries caused by
the bullet
a.
bone fragments, cartilage, soft
tissues are driven away from
entrance wound
b.
destruction of the bone is oval, with
sharp edges at the exit it is
irregular, bigger and bevelled
c. testimony of witness
Determination of the trajectory of the
bullet inside the body of the victim
1. external examination
a. shape of wound of entrance
= when bullet is fired at right angle with
the skin> the wound of entrance is circular
except in case of near fire.
= if fired at another angle , it is oval
= when the bullet is deformed no such
characteristics findings will be observed.
b. shape and distribution of the contusion
collar

= contusion collar is widest at the side

of the acute angle of approach of the bullet.
= if the bullet hits the skin
perpendicularly> collar will have a
uniform width around the GSW except
when bullet is deformed or in near fire.
c. difference in level between the entrance
and exit wounds
d. by probing the wound of entrance not
with too much force
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
particle
d. x-ray exam
3. other evidences to show trajectory
a. relative difference in the vertical location
of entrance and exit in the clothing
b. relative position and distance of the
assailant from the victim in the reconstruction of
re-enactment of the crime.
c. testimony of witness
EXIT WOUNDS OR OFFSHOOT WOUND
=Does not show characteristic shape unlike the
entrance wound due to the absence of
external support beyond the skin so the bullet
tends to tear or shatter the skin.
Shored GSW of exit: if pressed on a hard object
like when victim is lying: Wound of exit is
circular or nearly circular with abrasion.

33

1.
ODD AND EVEN RULE IN GSW
= If the number of entrance and exit wound is
even so presumption that no bullet is lodge in
the body.
= verified by x-ray
How to determine the number of fires
made by the offender:
1.
determination of the number of spent
shells
2.
determination of entrance wounds in the
body of the victim number of entrance
wounds may not show the exact number
of fire:
a.
not all fire made may hit the body of the
victim
b.
the bullet may in the course of its flight
hit a hard object thereby splitting it & each
fragment may produce separate wounds of
entrance.
c.Bullet may have perforated a part of the
body and then made another
wound in some other parts of the
body
3. number of shots heard by the witness
Instances when the number of GSW of
entrance is less than the number of GSW
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 separate exit.
2.
one of the bullets might have entered a
natural orifice of the body. Ex. nose
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 GSW of
entrance is more than the number of GSW
of exit in the body of the victim:
1. when one or more of the bullet is not through
and through and the bullet is lodged in the
body.
2.when all 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 GSW of exit but
the bullet is not found in the body of the
victim:

when the bullet is lodged in the GIT and

expelled through the bowel or lodged in
the pharynx and expelled through the
mouth.
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 hitting the bone the course
is deflected to have the wound of entrance as
the wound of exit.
Antemortem GSW hemorrhage, swelling,
vital reaction.
- microscopically:
congestion and leucocytic infiltration.
Problems confronting Forensic Physician in
the identification of GSW:
1. alteration of the lesion due to natural
process:drying of wound, infn, healing
proc..
2. medical and surgical intervention: refer
to clinical record of patient
3. embalming
4. problems inherent to the injury itself.
5. x-ray exam migratory, external
souvenirs
The effects of the clothing on the
movement of the bullet depend on:
1. number of layers of fabric between the
muzzle and subjacent skin
2. nature of the fabric; closely woven
3. muzzle- clothing distance
Examination of the external wearing
apparel of the victim of GSW may be
significant in investigation because:
1. it may establish the possible range of the fire:
a.contact fire
=tear in the clothing covering the skin,
fibers turn outward away from body
= soot deposit, gunpowder tattooing,
burning of fibers around the turned fiber
= muzzle imprint
= dirt and greasy deposit may be wipe
out and visible in the torn clothing
b.not contact but near shot
= same with (a) except for absence of
muzzle imprint and beyond flame range
c. far fire
= there is a hole tear with inward
direction of the thread
2. it may be useful in the determination as to
which is the point of entry and of exit of the
bullet. Entry- the fiber are inverted.

34

3. it may be useful in locating the bullet

Special consideration on bullets
1. souvenir bullet
2. bullet migration
3. tandem bullet
EVIDENCES SHOWING THAT THE GUNSHOT
WOUNDS MAY BE SUICIDAL
1. shot fired in a closed locked room, or
open uninhabited place.
2. death open near the place victim was
found
3. shot fired with the muzzle of the gun in
contact with the part of body involved
4. location of entrance wound accessible
part of body
5. shot usually solitary
6. direction of fire is compatible with the
trajectory of bullet
7. personal history may reveal social,
economic, business or marital problem
which cannot be solve.
8. gunpowder presence in the hand of the
victim
9. entrance wound usually does not contain
clothing
10. fingerprints of victim on the butt
11. suicide note at the vicinity
12. no disturbance in the place of death
Russian roulette = unfortunate victim has no
predetermined desire of self-destruction
EVIDENCES THAT GSW IS HOMICIDAL
1. site of wound of entrance has no point of
election
2. fire is made when the victim is at some
distance
3. signs of struggle or defense wounds
4. disturbance in the surroundings
5. wounding firearm usually not found in
the scene of the crime
6. testimony of witness
EVIDENCES TO SHOW THAT GSW IS
ACCIDENTAL
1. usually one shot
2. no special area of body involved
3. consideration on the testimony of the
assailant and determination as to
whether it is possible by knowing the
relative position of the victim
4. testimony of the witness
POINTS TO BE CONSIDERED AND INCLUDED
IN THE REPORT OF THE PHYSICIAN
1. complete description of the wound of
entrance and exit
2. location of the wound; part of body
involved, distance of wound from
midline, distance of wound from heel or
buttock.
3. direction and length of the bullet track

4. organs or tissues involved in its course

5. location of the missile, if lodged in the
body
6. diagram. Photograph, sketch or drawing
showing the location and number of
wounds.
QUESTIONS THAT A PHYSICIAN IS
EXPECTED TO ANSWER IN COURT;
1. COULD WOUND THE WOUND BE
INFLICTED BY THE WEAPON PRESENTED
TO HIM?
2. AT WHAT RANGE WAS IT FIRED?
3. WHAT WAS THE DIRECTION OF THE FIRE?
4. IS IT SELF-INFLICTED?
5. ARE THERE SIGNS OF STRUGGLE?
6. DID THE VICTIM DIE INSTANTANEOUSLY?
7. IS IT POSSIBLE FOR THE VICTIM TO FIRE
OR RESIST THE ATTACK AFTE THE INJURY
WAS SUSTAINED?
8. WHERE WAS THE POSTION OF THE
ASSAILANT AND THE VICTIM WHEN THE
SHOT WAS FIRED?
The caliber may be inferred from the diameter
of the wound of entrance.
Determination of the length of survival of
the victim:
1. nature of the GSW
2. organs involved
3. presence or absence of infection
4. amount of blood loss
5. physical condition of the patient
Capacity of a victim to perform volitional
acts
depend
s upon
the
area of
the
body
involve
d,
involve
ment
of vital
organs
and
the
resista
nce of
the
victim.
DETERMINATION AS TO THE LENGTH OF
TIME A FIREARM HAD BEEN FIRED
1. odor of the gas inside the barrel
2. chemical changes inside the barrel

35

3. evidences that may be deduced from the

wound
DETERMINING WHETHER THE WOUNDING
WEAPON IS AN AUTOMATIC PISTOL OR A
REVOLVER
1.
location of the empty shells
revolve
r the
empty
shells
are
found
in the
cylindri
cal
magazi
ne
chamb
er after
the fire
2.
nature of the spent shell automatic
firearm
=
bullet
is
copper
jackete
d
3.
nature of the base of the cartridge or
spent
shell =
base of
a
revolve
r has a
wider
diamet
er than
that of
the
cylindri
cal
body
to keep
the
cartrid
ge stay
in the
magazi
ne
chamb
er.
It may be possible for a person who is
accustomed to the sounds of firearms of
different calibers to identify the firearm by the
sound produced.

It is not possible to determine the direction of

the shot by determining the direction of the
sound except when the flash or the person firing
the shot is seen at the time the shot was fired.
GSW may not be a near fire or may not
appear to be near fire:
1.
when a device is set up to hold the
firearm and to enable it to be discharged
at a long range by the victim.
2.
when the GSW of entrance does not show
characteristics of a near shot bec the clothing are
interposed bet. the victim & the firearm
3.
when the examining physician failed to
distinguish between a near or far shot
wound
4.
when the product of a near shot has
been washed out of the wound.
X-ray
1. facilitate the location and extraction of
the wound
2. reveals fragmentation and its location
3. shows bone involvement like fracture
4. reveal trajectory of the bullet
5. shows effect of the bullet wound, like
hemorrhage, escape of air, laceration
SHOTGUN WOUNDS
Is a shoulder fired firearm having a barrel that is
smooth-bored and is intended for the firing of a
changed compound of one or more balls or
pellets.
Measure the distance between the two
farthest shot(pellets) in inches and
subtract one, the number obtained will
give the muzzle-target distance in yards.
Determination of the presence of
gunpowder and primer components:
Importance:
1.
Determination of the distance of the gun
muzzle from the victims body when
fired. Usually not more than 24 inches
when fired.
2.
Determining whether a person has fired
a firearm. dorsum of the hand
= metallic residues, burning and unburned
gunpowder
= in suicide found in the palm
Procedures in determining the presence of
gunpowder:
1. Gross examination use of hand lens Fine
black powder not conclusive
2. Microscopic examination
3. Chemical test:
Tests for the Presence of Powder residues

36

On the skin Dorsum of the hand or

Wound of entrance
Dermal nitrate test ( Paraffin test,
Diphenylamine test, Lungs test, Gonzales
test)
= melted paraffin heated at 150
degrees fahrenheit Lungs reagent
= small particles with nitrate or
nitrite > blue reaction
= not conclusive: fertilizers,
cosmetics, cigarettes, urine
= Negative is not conclusive:
thorough washing
2. On clothings
Walkers test ( C-acid test, Hacid test)
= glossy photographic paper fixed
in hyposolution for 20 min to remove the silver
salts &washed for 45 min. & dries
1.

Tests for the presence of Primer

Components metallic primer residues like
barium, antimony, and lead.
1. Harrison and Gilroy test :Cotton swab
moistened with 0.1 molar HCl to gather the
primer component.
= Reagent sodium rhodisonate yields red
color with the primer components.
= Add 1.5 HCl to the red area> blue-violet
or pink in lead or barium
= lacks specificity, sensitivity
2. Neutron Activation Analysis (NAA)
= Sample obtained by paraffin or by
washing with dilute acid
= Extremely sensitive, even with small
quantity
3. Flameless Atomic Absorption
Spectroscopy (FAAS)
4. Use of Scanning electron
microscope with a Linked X-ray analyzer
THERMAL INJURIES OR DEATHS
- are those caused by deviation from normal
temperature, capable of producing cellular or
tissue changes in the body.
- Exposure to severe cold
= Frost bite
- exposure to high temperature = burning
scalding
1. DEATH OR INJURY FROM COLD
- not common in the Philippines
- Primary cause of death: Decrease
dissociation of O2 from Hgb in the RBC
: Diminished power
of the tissue to utilize O2
- Cold damp air is more fatal than cold dry air.
- Women are more resistant to cold > greater
deposits of SQ fats.

Effects of COLD:
A. Local effect ( Frostbite, Immersion
foot, Trench foot )
1st Blanching , paleness of the skin due
to vascular spasm.
2nd Erthyma, edema, swelling due to
vascular dilatation, paralysis and
increased capillary permeability.
3rd - Blister formation
4th Necrosis, vascular occlusion,
thrombosis and gangrene.
Microscopically: Vacuolization,
degeneration of epidermal cells
: Necrosis of the collage of
the SQ tissue
: Occlusion of the vessels
due to clumping of RBC
B. Systemic effects:
- Reflex in nature due to the stimulation
and paralysis of the nerves
- Pulmonary ,Cardiac action is slowed down
due to cerebral anoxia> resulting to
lethargy, delirium, convulsions, coma/
death.
2. DEATH OR INJURY FROM HEAT effect
may be local or general
Classifications of Heat Injury:
a) General or Systemic effects:
a.1 Heat cramps
a.2 Heat exhaustion
a.3 Heat stroke
b) Local effects:
b.1 Scalding
b.2 Burns
= Thermal
= Chemical
= Electrical, lightning
= Radiation
GENERAL OR SYSTEMIC EFFECT: death
usually accidental
1. Heat cramps( Miners Camp, Firemans
Camp, Strokers camp)
- Involuntary spasmodic painful contraction of
muscles due to dehydration and excessive loss
of chlorides by sweating
- Tx: Fluids with chlorides
2. Heat Exhaustion ( Heat collapse,
Syncopal Fever, Heat syncope, Heat
prostration)
- Due to heart failure, cause:Heat precipitated
by exertion/warm clothes
= Sudden syncope, face turns pale, dim
vision
- Tx: removal from the heated area

37

3. Heat stroke(Sunstroke,Heat
Hyperpyrexia,Comatous form,Thermic
Fever)
- Working in ill-ventilated places with dry
temperature or exposure to the sun
LOCAL EFFECTS OF HEAT
1. Scald: Caused by hot liquid
The injury by scalding is not severe as burns:
a. Scalding liquid runs on the body surface
distributing the heat
b. Easily cools off
c. Temperature not as high except : oils
and molten metals
2. Thermal burns: Caused by heat or chemical
substances like fire, radiant heat, friction, solid
substances, electricity.
: Classification of burns/
DUPUYTRENS CLASSIFCATION
1st Degree erythema
2nd
- vesicle
formation
3rd
- destruction of
the cuticle, part of true skin, painful
4th
- whole skin is
destroyed, ulceration, not painful
5th
deep fascia,
muscles
6th
- charring of the
limbs
1. CAUSE

2. LOCATION
3. SINGEING
4. BOUNDARY
OF NORMAL
5. INJURY
6.
CLOTHINGS

BURNS
Dry heat
flame, heated
solid, radiant
heat
At or above
the site of
contact
of hair is
present
Not clear

SCALDS
Moist heat
liquid, steam

Severe
Involved

Limited
Not burned

Occurs at or
below
Absent
Distinct

Proofs that the victim was ALIVE BEFORE

burned to DEATH:
1. Presence of carbon particles in the air
passage.
2. Increase carboxy-hemoglobin blood level.
3. Dermal erythema, edema and vesicle
formation.
4. Subendocardial left ventricular
hemorrhage.

BURNS
MORTEM BURNS
MORTEM BURNS
1. BLISTERS
albumin/chlorides
Scanty
albumin/chlorides
2. AREA OF INFLAMMATION
antemortem burn
Absent
3. BASE OF THE VESICLE

ANTEPOST
Abundant
Around the
Red
Not much

change in color
4. TRACHEO-BRONCHIAL LUMEN Particles of
soot or carbon
No findings
5. BLOOD
Abundance of
carboxy-Hgb
Absent
Differential diagnosis of blisters:
1. Due to putrefaction fluid content is
blood stained watery fluid; asso. with
putrefactive changes in other parts of body.
2. Due to disease
- heat by the size,
distribution
3. Due to friction
- Hx of application of
heat
3. Chemical burns
Characteristics of lesions:
a. Absence of vesication
b. Staining of the skin or clothing by the
chemical
c. Presence of the chemical substance
d. Ulcerative patches of the skin
e. Inflammatory redness of the skin surface
f. Delayed healing
CHEMICAL BURNS
THERMAL BURNS
1. BLISTERS
Absent
2. SKIN/CLOTHINGS
Stained by
chemicals
No staining
3. ANALYSIS OF SUBSTANCE Shows chemical
cause of corrosion
Absent
4. LESION
Borders are distinct
Diffused
Characteristic lesions by different
chemicals:
a. Sulphuric acid ( Oil of Vitriol)
= most intense action, considerable
destruction
= ulcerations where acid flowed,
clothings destroyed
= blackish-brown sloughs
b. Nitric acid
= Clothing is destroyed, brown
= yellow or yellowish brown slough
c. Hydrocloric acid
= not so destructive
= intense irritation, localized ulceration
red or reddish-gray.

38

d. Caustic soda and Potash

= Corrosive action on the tissues with
bleached appearance
4. Electrical burns Contact burns, spark
burns, Flash burns
5. Radiation burns x-ray, UV light burns
PHYSICAL INJURIES OR DEATH BY
LIGHTNING AND ELECTRICITY
Lightning is an electrical charge from the
atmosphere.
- 1 million volts/ 2000 amperes
Elements of lightning that produces injury:
1. Direct effect from the electrical charge.
2. Surface flash burns from the discharge electrical into heat energy.
3. Mechanical effect expansion of air >
laceration
4. Compression effect sledgehammer
blow
Spasmodic contraction of cerebral vessels >
shock
Electricity - main cause of death is shock
- Above 300 volts are like the effect
of lightning,
Factors which influence the effect of
electrical shock:
1. Personal idiosyncracy personal
condition
2. Disease cardiac dis. Is prone
3. Anticipation of shock Can withstand
4. Sleep increases resistance
5. Amperage or intensity of the electrical
current principal factor
= 70-80 in AC and 250 in DC.
6. Resistance of the body
7. Nature of current AC is more dangerous
8. Earthing- shock is enhanced
9. Duration of contact
10. Point of entry left more dangerous than
the right
Mechanism of death in electrical shock:
1.Ventricular fib leads to rupture of muscle
fibers
2. Respiratory failure due to bulbar paralysis
3. Mechanical asphyxia due to violent and
prolonged convulsion.
Metallization: - specific feature of electrical
injury.
= the metal of the conductor is volatilized
and particles of the metal are driven into the
epidermis causing darkening of the skin
Delayed effects of electrical injuries:
= necrosis of the area develops into
gangrene

= Damaged arteries becomes brittle, friable

and liable to rupture
= Nervous injuries retrograde amnesia,
hemiplegia
= May enter the head > cataract
DEATH OR PHYSICAL INJURIES DUE TO
CHANGE AF ATMOSPHERIC PRESSURE
( BAROTRAUMA)
Increase of atmospheric pressure
( Hyperbarism)
-Normal atmospheric pressure at sea level is
760 millimeters of Hg.
- Henrys Law = At constant
temperature, the amount of gas dissolved
in a liquid is directly proportional to the
pressure
= As he goes deeper there will be an increase in
the amount of gas dissolved in the blood and
other body fluids.
= If ascent is made rapidly, the diver will suffer
from the effects of the sudden release of the
gasses from the body fluids.
= released of air bubbles in the circulation and
act as emboli in different parts of the body
causing interstitial emphysema, pulmonary
embolism, in big joints called bends.
Decrease of atmospheric pressure
(Decompression)
1. Hypobarism at high altitudes the
atmospheric pressure is lower and more
gas will be liberated by the body fluid.
= release of gasses results to:
a) Bends joint and muscular pain
b) Chokes Substernal distress, nonproductive coughing
c) Substernal emphysema
d) Trapped gas
2. Anoxia- Hypoxia felt at 8000-15,000
feet level
- Aircrafts greater than 34,000
feet be provided with O2.
AIRCRAFT INJURIES AND FATALITIES
1. During the flight
a) Altitude: Hypobarism ( Decompression)
b) Speed spatial disorientation ; sudden
change of direction at a speed of
500 miles drains brain from blood
to the lower parts>
unconsciousness
c) Toxins CO, CO2 saturates cabin resulting
to asphyxia
d) Temperature - At 25,000 feet 40 degree
below zero: frost bite , freezing
e) Pre-existing disease Coronary dis./Hpn
fatal due to sudden change env.
2.
During crash fatalities occur us. during
take-off and landing.

39

- Fx, Rupture of the heart due to

= Not necessary the whole body is

suspended: Pressure at side of neck
= Mechanism of death: Air passage is
constricted by pressure of the rope;
Compression of carotids, jugs, Sup.
Laryng nerve> Cereb. anoxia

cmpression.
DEATH BY ASPHYXIA
Asphyxia Applied to all forms of violent death
due to interference with process of respiration
- Conditions in which the supply of O2
to the blood or tissues or both has been reduced
below normal level.
Types of asphyxial death:
1. Anoxic death
Failure of arterial blood to be normally saturated
with O2 due to:
a) Breathing in an atmosphere with
insufficient O2- High altitude
b) External obstruction of the air passage
traumatic crush asphyxia
c) Paralysis of the respiratory center
poisoning, injury, anesthesia
d) Mechanical interference of the passage
of air- drowning, asthma
e) Shunting of blood
2. Anemic anoxic death
=Decrease capacity of the blood to carry O2
due to Hge, CO poisoning, Low Hgb
3. Stagnant anoxic death
=Failure of circulation due to Heart failure,
shock, arterial venous obstruction
4.Histotoxic anoxic death
=Failure of the cellular oxidative process,
cannot be utilized in the tissues. Cyanide

Causes of death in hanging:

1. Simple asphyxia by blocking the air
passage.
2. Congestion of the venous blood
vessels in the brain.
3. Lack of arterial blood in the brain.
4. Syncope due to pressure on the vagus
and carotid sinus.
5. Injury in the spinal column
6. Combination of the above.
Hanging is ante-mortem: Vital
reaction= principal criterion
1. Redness or ecchymosis at the site of
ligature.
2. Ecchymosis of the pharynx and
epiglottis.
3. Line of redness or rupture of the
intima of the carotid artery
4. Subpleural hges.
B. ASPHYXIA BY STRANGULATION
Tightened by force not the weight
HANGING

Phases of asphyxial death:

1.Dyspneic phase Breathing is rapid and
deep, PR inc., Rise of BP
- due to lack of O2 and
retention of CO2
2. Convulsive phase Cyanosis more
pronounced, pupils dilated, unconscious
- Tardieu spots
=petechia /hges in the visceral organs
- due to stimulation of CNS
by CO2
3. Apneic phase Breathing is shallow,
gasping
- Due to paralysis of
respiratory center
Classification of Asphyxia:
1. Hanging
2. Strangulations: by ligature, manual
strangulation, spl forms palmar
3. Suffocation: choking
4. Asphyxia by drowning
5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gasses
A.

STRANGULATION WITH LIGATURE

1.HYOID BONE
Frequently
injured
Frequently
spared
2.DIRECTION OF LIGATURE MARK: Inverted Vshape
Usually
horizontal
3. LIGATURE LOCATION
At level of
Hyoid bone
Below larynx
4.
LIGATURE GROOVE
Deepest
opposite the knot
Uniform
depth
5. VERTEBRAL INJURY
Frequently
observed
Not
observed
Manual strangulation or throttling:
- form of asphyxial death where the
constricting force is the hand.
C.

ASPHYXIA BY SUFFOCATION
- Occlusion of air fr. the lungs by closure of air
openings/ obstruction of the air passageway fr.
the external openings to the air sacs

ASPHYXIA BY HANGING

40

Smothering: A form of asphyxial death

caused by closing the external respiratory
orifices.
Overlaying most common in children :
pressure of pillows
Gagging application of materials to
prevent air to have access to mouth and
nostrils.
Plastic bag suffocation
Choking- Form of suffocation by the
impaction of F.B. in the respiratory passage.
D. ASPHYXIA BY SUBMERSION OR
DROWINING
- Form of asphyxia where the nostrils and
mouth has submerged in watery fluid.
Time required for death in drowning:
- Submersion for 1 minutes considered
fatal.
- Average time required for death in
drowning is 2 to 5 minutes.
Emergency treatment in Drowning
1. Schaefers methodFace down, prone
position:operator exerts pressure in ribs
2. Sylvesters method- Lying on his back,
astride over body, swinging arms
Post-mortem findings:
1. External findings
a) Wet clothes, pale face, F.B. clinging on skin
surface
b) Cutis anserine or goose flesh skin is
pale , contracted
NOT Dxtic
c) Washerwomans hands and feet skin of
hands & feet:bleached NOT Dxtic
d) Postmortem lividity marked in the head,
neck and chest.
e) Presence of firmly-clenched hands with
objects Person was alive at first
f) Physical injuries for struggle
g) Suicidal drowning Pieces of stone
2. Internal findings
A. RESPIRATORY SYSTEM
1. Emphysema aquosum Lungs are
distended overlapping the heart
=D/t irritation made by the inhaled water
on the mucous membrane of the air passage
w/c stimulate the secrn of mucous
2. Edema aquosum Due:Entrance of
water into air sacs, Lungs are doughy
3. Champignon docume whitish foam
accumulates in the mouth/nostrils
= Due: abundance of mucous secretion
= One of the indications that death was
due to drowning.

4. Tracheo-bronchial lumen congested,

filled with froth
5. Blood stained fluid found inside chest
cavity.
6. Section lungs shows fluid with bloody
froth.
B. HEART
1. Both sides of heart may be filled or emptied
with blood.
2. Salt water drowning Blood chloride content
is greater than left side.
Fresh water- Blood chloride is more I the right
side. FRESH- RIGHT
Gettlers Test:
- Quantitative determination of the chloride
content of the blood in the right and left ventricle
of the heart. : Difference of at least 25 mg.
C. STOMACH
- Presence food in the stomach but absence of
water.> Death is rapid or submersion made
after death. Impossible for water to get into
the stomach if body is submerged after
death.
FINDINGS CONCLUSIVE THAT THE PERSON
DIED OF DROWNING
1. The presence of F.B. in the hands of the
victim.
The clenching of the hands is a
manifestation of cadaveric spasm in the
effort of the victim to save himself from
drowning.
2. Increase in volume (emphysema
aquosum)
edema of the lungs ( edema aquosum)
3. Presence of water in the stomach
4. Presence of froth, foam, F.B. in the air
passage found in the medium where the victim
was found.
5. Presence of water in the middle ear due
to violent inspiration when the mouth is full of
water.
Floating of the body in drowning:
-Within 24 H due to the decomposition which
causes the accumulation of gas in the body, the
body floats.
- Body is flexed because of the dominance of
the flexor muscles
-tete de negri bronze color of head and
neck; face as the most dependent portion of
the body.

41

Homicidal D. = struggle, motive, articles found

near the place, phys. injuries
Suicidal D.= note, heavy objects, mentality, Hx
of previous attempt
Accidental = Absence of violence in the body.,
exclusion of suicide, witnesses
E. COMPRESSION ASPHYXIA ( TRAUMATIC
CRUSH ASPHYXIA)
- Form of asphyxia where 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.
- Homicidal =offender kneels on the chest
- Accidental = pinned between two big
objects
Burking invented by Burke and Hare=
murder for the sale to medical schools
- Kneels or sits on the chest and the
hands close the mouth and nostrils
Death by crucifixion- alternative raising
and lowering of the body leads to
exhaustion, unconsciousness and
death from asphyxia = IC mm are
stretched
F. ASPHYXIA BY BREATHING IIRESPIRABLE
GASES
1. Carbon monoxide silent killer,
colorless, insoluble in water and alcohol.
- formed by the incomplete combustion of
carbon fuel.
-Main action is O2 deprivation
Qualitative test for CO in the blood
a) Kunkels test 4 volume of water + 3x
its volume of 1% tannic acid
- crimson red if positive
b) Potassium Ferrocyanide test bright
red
c) Spectroscope exam
d) Gas chromatograph
e) Infra-red analysis
2. Carbon dioxide CO2, Carbonic acid gas
- Blown out of the lungs during respiration
- Product of complete combustion of carbon
containing compounds
- End result of fermentation & decomposition
of organic matters.- septic tank
= The inhalation of pure CO2 may cause
immediate vagal inhibition with spasm of
the glottis and death. = manhole, poorly
ventilated rooms
Tests for the presence of CO2
1. Barium nitrate white precipitate of
Barium carbonate with carbonic acid
2. silver nitrate white ppt. of silver
carbonate when carbonic acid is added.

3. Hydrogen sulfide ( H2S, Sulphuretted

hydrogen ) = rotten egg odor
- Formed during decomposition process of
organic substances containing sulphur
- Causes titanic convulsion, delirium, coma,
death
4. Hydrogen cyanide one of the most toxic,
rapid acting gas
- Formed by the addition of acid to potassium
or sodium salt of cyanide
- Found in plants; leaves of cherry laurel,
bitter almond, kernels of common cherry,
plum, peaches, ordinary bamboo shoots,
certain oil seed and beans
- Contains AMYGDALIN which in the
presence of water and natural enyzme
EMULSIN is readily decomposed to
HYDROCYANIC ACID, glucose and
benzaldehyde.
= 60-90 mg of Hydrogen cyanide is
fatal, death in 2 to 10 min.
5. Sulfur dioxide - Heavier than air, pungent
odor
- employed as disinfectant, bleaching agent,
- found in eruption of volcano
WAR GASES
Classification based on the physiological
action
1. Lacrimator or Tear gas causes irritation
with copious flow of tears
a) Chloracetphene (C.A.P.)
b) Bromobenzyl cyanide (B.B.C.)
c) Ethyl Iodoacetate ( K.S.K.)
High concentration irritation of respiratory
passages, lungs, V,N
2. Vesicant of Blistering Gas contact with
skin cause bleb or blister formation
a) Mustard gas ( Dichlordiethyl sulfide, yellow
cross, Yperite)
b) Lewisite ( Chlorovinyl-dichlorarsine)
3. Lung irritants ( Asphyxiant or choking
gas)
- Dysnea, tightness of the chest, coughing,
coma , death
a) Chlorine ( Cl2) yellowish green gas
b) Phosgene (COCl2)
c) Chloropicrin
d) Diphosgene
4. Sternutator nasal irritants of vomiting
gases

42

5. Paralysants Nerve gas - like

organophosphates
6. Blood poisons CO, H2S, Hydrogen cyanide
DEATH OR PHYSICAL INJURIES DUE TO
AUTOMOTIVE CRASH OR ACCIDENT
Factors responsible to an Automotive
Crash
A. HUMAN FACTOR ( DRIVER)
1. Mental attitude: reckless driving, fatigue,
inexperience
2. Perceptive defect
3. Delayed reaction time
4. Disease
5. Chemical factor
B. ENVIRONMENTAL FACTOR - Poor visibility,
poorly maintained roads, rain, blind intersection
C. MECHANICAL FACTOR: Poor brake, worn
out tires
D. SOCIAL FACTOR: Speed, insurance
E. PEDESTRIAN
Injuries and Death on the Driver and
Passengers:
1. First collision: the impact of the moving
vehicle with another or fixed object
= The MOVING VEHICLE rapidly decelerates
and stops after impact.
= The degree of damage depends: a) speed
b) part of vehicle involved
2. Second collision: Impact of unrestrained
occupants with the vehicle interior
= 1st Col., Occupants move same
direction/velocity towards point of impact
a) Front impact> Occupants move forward.
b) Side impact ( severe) > moves to the
side that was involved in the 1st Col.
>The passenger
nearest to it will suffer the most.
c) Rear impact crash Accelerationdeceleration injury or whiplash
d) Roll over crash ( Turn turtle impact )

CHILD ABUSE OR NEGLECTED

CHILD( Battered child, Battered child
syndrome, Maltreatment syndrome,
Maltreated child, Physically abused
child, Ill-treated child)
= It is the physical and mental injury or
maltreament of a child by a person who is
responsible for the childs welfare.
Duties of parents: Art 46 the child and youth
welfare Code
= To give him affection, extend
benefits, supervise, inculcate values, advise, act
as a good example.
Rights of parents : Right to discipline, punish
moderately require obedience, Respect
Act or omission affecting the childs health
or welfare:
1. Physical abuse The law allows
chastisement for discipline
but it may be physical
abuse when it involves of
instrument or fist blow.
2. Physical neglect Failure to provide the
necessities of life.
Causes of child abuse:
1. Unwanted child: Disputing parentage,
Illegitimacy, born from rape, deformity
2. Abusive parent: Temperamental , Compulsive
disciplinarian
3. Child as center of triangle
4. Child may be hindrance to the socioeconomic activities of the parents.

= If vehicle is not put into a stop after the 1st

Collision, the unrestrained occupants will
continue to strike to some parts of the vehicle
interior.

Medical evidence tending to show injuries

due to Abuse:
1. Skin imprints from forcefully striking
objects
2. Multiple bruises, scars, burns, emersion
burn levels
3. Multiple fresh healing fractures
4. Trauma to the mouth, nose , ears, and
eyes.
5. S.A.-Injuries to genetalia, peri-rectal,
peri-vaginal
6. Neglect: Malnutrition, poor hygiene,
infection, poor growth/development

Pedestrian-Vehicle Collision:
Death or Physical Injuries to pedestrian
1.Primary impact Contact with vehicle
2. Secondary impact Subsequent impact of the
pedestrian to the ground
- Accounts for the multiple
injuries
3. Run over Injuries
4. Hit and run Injuries

Social reaction to the Child abuse and

Neglect:
1. Report of Maltreated or abused child within
48 H
- Freedom from liability of the reporting
person or institution
2. The court may deprive parents of their
authority over the child or adopt other measures
for the welfare of the child.

43

3. Establishment of public and private welfare

institutions for the care of abused,
neglected, abandoned, infirmed, or other
conditions which require aid, support or
treatment.
4. Abuse, neglect or abandonment of children is
made a criminal act or omission.
MEDICO-LEGAL ASPECTS OF SEX CRIMES
Virginity is a condition of a female who has
not experienced sexual intercourse And
whose genetalia have not been altered
by carnal connection
Virtuous female- if her body is pure and if she
ha never had any sexual
intercourse with another, though
her mind and heart is impure.
A woman is presumed to be virgin if she is
unmarried and of good reputation.
Defloration is the laceration of the hymen as
a result of sexual intercourse.
Duration of laceration:
1. Fresh bleeding laceration- recent origin
2. Fresh healing with fibrin formation and
with edema of the surrounding tissue
After 24H
3. Healed laceration with congested edges
and with sharp coaptible borders= 4 to
10 days.
4. Healed laceration with sharp coaptible
borders without congestion= 10 days or
2 to 3 weeks.
5. Healed laceration with rounded noncoaptible borders and retraction of edges
> a month
Rape:
By having carnal knowledge:
1. By using force or intimidation- manifested
and tenacious resistance
2. Deprive of reason, unconscious- insane,
under alcohol, drugs
3. Under 12 y.o.- Statutory rape, even if prosti,
or with consent
= even if the woman is inchaste.
Carnal knowledge is the act of a man in
having sexual bodily connection with a woman.,
even with slightest penetration.
= absence of sperms does not negate the
commission of the crime of rape.
The following specimens may be examine
for seminal fluid and sperms:
1. Wearing apparel of the victim and the
alleged accused
2. Vaginal smear from the victim
3. Stains on the body of the victim and of
the accused

4. Stains found at the site of the

commission of the offense.
Examination for seminal fluid and sperms
1. Gross examinations
2. Micro-chemical examinations
a) Florence test
b) Berberios test specific of spermatic
fluid
c) Puramen reaction
d) Acid phospahatase test
3. Microscopic examinations
a) Dr. Hankins method
b) Gangulis method
4. Biological examinations
a) Precipitin test( Biological test of
Farnum) semen is of human origin
b) Seminal grouping
OTHER CRIMES AGAINST CHASTITY:
1. Seduction Is the act of a man enticing
women to have unlawful intercourse
- With means of persuasion,
solicitation, promises or bribes or other means
without employment of force,
- A virgin over 12 y.o. but below 18
y.o.
- With the use of abuse of authority
or confidence
2. Acts of lasciviousness are acts which
excite lust, wanton conduct , lewd
- embracing, kissing, holdig
womans breast
- under 12 / 12 18 y.o.
3. Abduction Carrying away of a woman by
an abductor with lewd design.
- Under 12 y.o. still forcible
abduction even if with consent.
4. Adultery Married woman committed
intercourse with a man not her husband and
knows she is married.
5. Concubinage Any husband who shall keep
a mistress in the conjugal dwelling,
or shall have sexual intercourse
under scandalous circumstances
with a woman not his wife or
cohabit with her in any other place.
The fetus is considered born:
- If it is alive at the time it is completely
delivered from the mothers womb.
- If the fetus had an intra-uterine life of less
than 7 months, it is not deemed born if it
dies within 24 H after its complete
delivery from the maternal womb.
Paternity Civil status of the father with
respect to the child begotten by him.

44

Filiation Civil status of the child in relation to

its mother or father
Legitimate children are those who were
born on lawful wedlock or within 300 days after
the dissolution of marriage.
Children born after 180 days following the
celebration of the marriage And before 300
days following is dissolution or the separation of
the spouses shall be presumed to be
LEGITIMATE. Provided there is no physical
impossibility of the husband having access to
his wife.
Impotency- is the physical incapacity of either
sex to allow or grant to the other legitimate
sexual gratification.
Sterility is the loss of power of procreation
and is absolutely independent of whether or not
impotence is present.
INSANITY= Sociological concept: is the persistent
inability through mental causes to adapt oneself
to the ordinary environment.
. = Medicine : is the prolonged departure of
the individual from his natural mental state
arising from bodily disease.
= Law- the relation of a person and the
particular act which is the subject of judicial
investigation

1.

FEIGNED INSANITY
TRUE INSANITY
Develops suddenly

Insidiously

2. No peculiar facial expression

Commonly observes
3. Symptoms complete, numerous,
Not refer to a specific disease
4. Violent exertion exhausted
No exhaustion
5. Personal hygiene
None
1. Earlier test for insanity
a) Wild Beast Rule a person is
exempted from criminal liability if he is
totally deprived of his understanding and
memory and knows no more than an
infant, a brute, or a wild beast of what
he is doing.
b) Delusion rule a person is not
responsible for his act if he suffering
from delusion although he knows that he
is wrong.

2. Later tests for Insanity

a) McNaghtenss Rule a defense on the
ground of insanity can be established if
it can be proven that at the time of
committing the act:
a.1 The accused was laboring under
such defect of reason or from a
disease of the mind as not to know
the nature and quality of the act he
was doing. Or
a.2 If he did know, he did not know
what he was doing was wrong.
b) Irresistible Impulse Rule A person is
considered insane when mental disease
has rendered him incapable of
restraining himself, although he
understands what he is doing and knows
it is wrong.
c) Durhams Rule The accused is not
criminally responsible if his act was the
product of mental disease or mental
defect.
d) Currens Rule- In order to make the
accused not responsible for his act it
must be proven that at the time of
committing the prohibited act the
defendant, as a result of mental disease
or defect, lacked substantial capacity to
conform his conduct to the requirements
of the law which he allegedly violated.
e) American Law Institute Rule
e.1 A person is not responsible for his
criminal conduct if at the time of
such conduct as a result of mental
disease or defect he lacks the
essential capacity to appreciates the
criminality of his conduct or to
conform his conduct to the
requirements of the law.
e.2 The term mental disease or defect
does not include as abnormality
manifested only by repeated criminal
or otherwise anti-social conduct.
DRUG DEPENDENCE
Dangerous drug - Is a drug whose use is
attended by risk and therefore unsafe, perilous
and hazardous to people or to society.
Prohibited drugs:
1. Opium and its active components and
derivatives, such as heroin, morphine
2. Coca leaf and its derivatives; cocaine
3. Alpha and beta eucaine, Hallucinogenic
drugs; LSD

45

4. Indian hemp and its derivatives

5.Other drugs whether natural or synthetic with
the physiological effect of narcotic drug.

3. CONTRACTS AGREED TO IN A STATE OF

DRUNKENESS ARE VOIDABLE
Art. 1328, Civil
code.

Regulated drugs:
1. Self-inducing sedatives such as secobarbital,
phenobarbs
2. any salt of an isomer of amphetamine like
benzidrine
3. Hypnotic drugs such as methaqualone

4. THE LAW PENALIZING MANUFACTURE OF

LIQUOR WITHOUT LICENSE IS VALID.
5. THE STATE MAY PREVENT SOME PEOPLE
FROM DRINKING HIGHLY SPIRITED WINE

Identification of some dangerous drugs: Color

test
a. Opium and its derivatives together with
amphetamine Marquis test:
b. Barbiturates Dillie Koppanyi test, Zwikkers
test
c. Marijuana Duquenois-Levine test
d. LSD Van Urk test
e. Cocaine Cobalt Thiocyante test
ALCOHOLISM
Ethyl alcohol Ethanol or grain alcohol=
fermentation of various CHO in grains, fruits or
flowers
- Used as solvents, antiseptic,
beverage
Alcoholic beverages Mixture of water and
ethyl alcohol
Congeners : substances simultaneously
produced during fermentation.
: odor of alcohol
Drunkard A person who habitually uses any
intoxicating alcoholic liquor.
Habitual drunkard One who excessively
uses intoxicating drink.
Provisions of Law regarding alcoholism:
1. INTOXICATION IS AN ALTERNATIVE
CIRCUMSTANCE TO CRIMINAL LIABILITY Art. 15,
RPC
- Mitigating circumstance= Offender
committed a felony in a state of
intoxication, if not habitual or subsequent
to the plan to commit said felony
- Aggravating circumstance = if intoxication
is habitual
= if intoxication is subsequent to the
plan to commit felony.
2. PUBLIC SCANDAL COMMITTED BY A PERSON
WHILE DRUNK IS PUNISHABLE. Art. 155, RPC
- Any person while intoxicated or otherwise
shall cause any disturbance or scandal in
public places.

Absorption and distribution of alcohol:

= Maximum period of absorption occurs 30 to
60 minutes after initial intake.
=The optimum concentration of alcohol in
beverages between 10 20% is the most
rapidly absorbed.
= It is not the quantity of alcohol consumed that
determines intoxication but the amount actually
gets into the blood stream.
Ounces of BW
x.68x Blood alcohol concentration
WIDMARKS FORMULA=
---------------------------------------------------------------0.8
Pharmacologic effects of alcohol:
1. Depresses the CNS.
2. Acuity is progressively diminished to the
point comparable to wearing dark glasses at
night.
3. Hearing decrease, talks louder, cant hear
the sound of horns.
4. Diminished sense of touch, burns fingers
from cigarettes.
5. Decrease sense of taste, smell
6. Increase desire to sex markedly impaired
performance.
7. Blunting of judgment, motor skills
Clinical signs and symptoms in relation
to alcohol level:
BLOOD ALCOHOL
CLINICAL SIGNS
AND SYMPTOMS
10 mg%
Pleasant clearing of the
head
20 mg%
Physical feeling of well
being
50 mg%
Feels on top of the world,
inc. self-confidence
100 mg%
Under the influence
innocent not convicted = some mental
confusion, drowsiness
150 mg%
All individuals are
intoxicated, dec. performance
150-300 mg%
All indiv. Lose muscular
coordination
300 mg%
Stuporous

46

400 mg %
level

anesthetic level, death

Stages following alcohol ingestion:

1. Stage of excitement Few minute after
ingestion, feeling of well being
2. Stage of incoordination or confusion
blunting of perception.
3. Stage of narcosis or coma Slow
breathing, pupils dilated.
Physical tests to determine
drunkenness:
1. Rombergs testStanding straight with eyes
closed ,heels together for 1 min.
2. Stand straight with one foot ahead of the
other
3. Sample of handwriting compared when he
is free from alcohol.
4. Walk to a corner and back
Conditions simulating alcoholic
intoxication:
1. Severe head injuries
2. Metabolic disorders, Diab. Precoma,
uremia
3. Neurologic conditions assoc. with ataxia,
tremor, drowsiness
4. Effect of drug like insulin, barbs,
antihistaminic, morphine
5. Pre-exiting psychological dos-order.
6. High fever
Presumptive limits of alcohol:
0.05% alcohol or less in their blood
uninfluenced by alcohol
0.05 - .10% = considered to be under the
influence of alcohol
0.10% to 0.15% presumption that the
person is drunk.
0.2% - intoxicated, staggering
0.5% coma
**The amount of alcohol in the breath is
proportional to the concentration of alcohol in
the blood.
**Diseases associated with or as a
complication of alcoholism Fatty liver,
cirrhosis.
Delirium tremens Sudden withdrawal from
alcohol may suffer a state of excitement with
hallucination.
Korsakows psychosis a syndrome charac.
by hallucination, disorientation, multiple
neuritis, loss of memory of recent events.
Punch drunkenness Observed in boxers who
develops a physical and mental condition due to
repeated trauma.
***Withdrawal of blood from a dead body
cannot be a ground for civil damage.

***There is no violation of constitutional

privilege against self-incrimination because
the privilege applies only to testimonial
compulsion and does not apply to the taking
of physical evidence from an accused.
= Purely mechanical and it does
not utilize the mental faculties of the
subject.
Laboratory examination for alcoholism:
1. Analysis of blood most widely accepted
2. Analysis of breath
3. Analysis of the urine
4. Analysis of body tissue
5. Analysis of saliva, perspiration, spinal fluid
Objectives of alcohol examination:
1. For screening Apparatus: Alcolyzer,
Alcosensor
2. For evidentiary purpose = determines
quantity of alcohol
Methods used in alcohol detection:
1. Chemical method Oxides -chromate
2. Enzymatic method coenzyme
Nicotinamide adenine nucleutide (NAD)
3. Gas chromatographic method
4. Infrared absorption method
To have an accurate determination as to the
quantity of alcohol in a specimen, immediate
examination must be done.
The longer the time interval between extraction
and examination, the more it increases the
alcohol contents of the sample.
MEDICO LEGAL ASPECT OF POISONING
Poison anything other than agencies which is
capable of destroying life, either in chemical
action on the tissues of the living body
- or by physiological action by
absorption into the living system.
Fatal dose smallest dose known to cause
death.
Signs and symptoms that may lead one
to suspect poisoning:
1. Sudden appearance of the complaints and
symptoms.
2. The symptoms appear when the person is
at the state of health.
3. The symptoms appear after a meal, food,
medicine.
4. When several persons partake the food,
drug at the same time.
5. Course of symptoms either getting worse
or steady improvement.
6. Detection of the poison can be done on
any of the following: = food taken,
container, vomitus, excretions

47