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CHAPTER 1 LEGAL MEDICINE medicine to the proper

administration of justice.
Legal Medicine
- Is that branch of medicine that - In the Phil. , the father of Legal
applies, medical and surgical Medicine can be rightfully bestowed
concepts, scientific knowledge and to Dr. Pedro P. Solis. His book on
skills to medico legal issues, in Legal Medicine copyrighted in 1987,
order to assist the trier of facts in contains the most extensive treatise
the proper dispensation of justice. and teachings in Philippine Legal
Medical Jurisprudence Medicine.
- is the study of the Medical Law and APPLICATION OF LEGAL MEDICINE TO
its applicable Jurisprudence that LAW:
governs, regulates and defines the Legal Medicine is Applied to Law
practice of medicine. 1. Civil law
- the determination and
In the Philippines, Legal Medicine is the termination of civil personality
appropriate name for Forensic - the limitation or restriction of a
Medicine. natural persons capacity to act
Modern Legal medicine has a broad - marriage and legal separation
range of applications, it is used in civil - paternity and filiation
cases such as paternity and filiation, - testamentary capacity of a
annulment of marriage, DNA testing , person making a will
etc. - the right to hereditary
In all cases the medical examiner must succession
conduct an investigation of the crime
scene and also an autopsy. 2. Criminal Law
- Felonies and circumstances which
TECHNIQUES OF LEGAL MEDICINE: affect criminal liability
- Legal Medicine uses sophisticated - Civil liability ex delictu
laboratory techniques to detect the - Crimes relative to opium and
presence of substances in the prohibited drugs
victim, in the suspected criminal, or - Crimes against persons
at the crime scene. - Crimes against chastity
- Forensic examination of substances - Crimes against civil status of
found at a crime scene can often persons
establish the presence of the - Quasi offenses
suspect at the crime scene.
3. Remedial Law
LEGAL MEDICINE AND THE LEGAL SYSTEM - Physical and Mental Examination of
- Courts routinely call upon a person
physicians to give expert testimony - Hospitalization of insane persons
in a trial, especially concerning the - Rules of Evidence
findings of an autopsy and the
results of laboratory tests. 4. Special Laws
- As an expert witness he is allowed - Dangerous Drug Act
to express an opinion about the - Youth and Child Welfare Code
validity of the evidence in a case - Sanitation Code
and may quote the statements of - Insurance law
other experts in support of an - Labor Code
opinion. - Employees Compensation Law
- Ordinary testimony is restricted to
statements concerning what the 5. CORPUS DELICTI
witness actually saw or heard. - Is the body or substance of the
- The evidence to be presented by crime and is defined as the fact that a
the legal medicine expert must crime actually has been committed. In
signify a relation between the facts all criminal prosecutions, the burden is
called the Factum Probandum or on the prosecution to prove the corpus
proposition to be established and delicti.
the factum Probans which is the
material evidencing the proposition. QUANTUM OF PROOF
- The Physician must present
RELEVANT, MATERIAL AND 1. In Civil Cases the quantum of proof
COMPETENT EVIDENCE. necessary to prove a civil complaint is a
PREPONDERANCE OF EVIDENCE. The
HISTORY OF LEGAL MEDICINE: party filing or bringing a civil complaint
has the burden of proof and must
- Paulus Zacchias ( 1584 1659 ) is
establish the truth and righteousness of
the Father of Forensic Medicine.
his allegations by a preponderance of
He was the first to describe the
the evidence admitted by a competent
importance and application of
court.

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Any person who practice any of the
2. In Criminal Cases above acts enumerated, without any
the quantum is proof beyond valid certificate of registration as a
reasonable doubt. physician, is practicing illegal medicine.
- In a criminal case the accused is
entitled to an acquittal, unless his The Nature of the Physician Patient
guilt is shown beyond reasonable Professional Relationship is
doubt 1. Consensual:
- Presumption of INNOCENCE is a - based on mutual consent of both
conclusion drawn by the patient and physician.
constitution and the law in favor of - Contracts that are consensual in
the accused , while REASONABLE nature, are perfected upon mere meetings
DOUBT, is a condition of mind of the minds
produced by proof resulting from
evidence in the case. 2. Fiduciary:
- founded in trust, faith, and
3. To establish matters of defense confidence reposed by one person in the
- The doctrine of reasonable integrity and fidelity of another.
doubt applies only to incriminative
facts. DUTIES AND OBLIGATIONS OF THE
PHYSICIAN TOWARDS HIS PATIENTS:
4. To establish self defense 1. He must possess that knowledge and
- One who sets up SELF skill possessed by an average physician.
DEFENSE must rely on the strength of 2. He must use such knowledge and skill
his own evidence and not on the with ordinary care and due diligence.
weakness of that of the prosecution. 3. He is obliged to exercise his best
judgment
5. To establish Alibi in good faith.
- It must be proved by positive, 4. He has the duty to keep the secrets and
dear and satisfactory evidence. Oral confidentialities of his patients.
Evidence of alibi is so easily
manufactured and usually unreliable The Terms and Conditions not included
that it can rarely be given credence. in the Physician Patient Professional
Relationship Contract ( refer to book )
6. In Administrative Complaints
- In cases filed before The only promise or guaranty that the
administrative or quasi judicial bodies, law requires is that, the physician will
a fact maybe deemed established if it treat the patient in accordance with the
supported by substantial evidence standards of medical care.
which means that amount of relevant
evidence which a reasonable mind PATIENTS RIGHTS RESPECTED BY
might accept as adequate to justify a PHYSICIANS:
conclusion. 1. The right to appropriate medical care
and humane treatment.
CHAPTER 2 MEDICAL AND HOSPITAL 2. The right to his religious belief.
JURISPRUDENCE 3. The right to refuse treatment.
4. The right to Informed Consent.
Medical Jurisprudence: 5. The right to choose his physician.
- Is the study of the Medical Law and 6. The right to medical records.
its applicable Jurisprudence, that 7. The right to privacy and confidentiality.
governs, regulates, and defines the 8. The right to a second or third opinion.
practice of medicine. 9. The right to leave.
- It includes the rights, duties, 10. The right to information.
obligations and liabilities of both 11. The right to self determination.
physician and patient to each other 12. The right to refuse participation in
in a physician patient professional medical research
contract. 13. The right to express grievance
14. The right to be informed of his rights and
The Following Acts Constitute the obligations.
Practice of Medicine:
1. To physically examine and diagnose Obligations of the Patients to their
a patient. Physicians ( Refer to Book )
2. To physically examine and treat a
patient SOCIATAL RIGHTS OF THE PATIENTS
3. To physically examine and perform FROM THE GOVERNEMNT ( Refer to
surgery in a patient Book )
4. To physically examine and prescribe RIGHTS INHERENT IN THE PRACTICE OF
any remedy to a patient. MEDICINE:
1. The right to choose his patients

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2. The right to limit the practice of his Rules of Evidence in Rule 131, section 5
profession paragraph X, paragraph JJ, and
3. The right to determine appropriate paragraph KK.
treatment procedures in the discretion and In common law the presumption of
judgment of the physician. death does not arise until the expiration
4. The right to avail of hospital privileges of seven years of continuous absence.
after being qualified.
5. The right to receive just and fair DEATH IS THE COMPLETE CESSATION OF ALL
compensation from his patients. THE VITAL FUNCTIONS OF THE BODY WITHOUT
POSSIBILITY OF RESUSCITATION. THE
Liabilities of a Physician Which May Arise ASCERTAINMENT OF DEATH IS A MEDICAL AND
from His Negligent or Wrongful Acts or NOT A LEGAL PROBLEM.
Omissions:
1. Administrative Liability Death maybe
- A complaint under oath can be filed A. Brain Death occurs when there is a deeply
before the Professional Regulation irreversible coma, and absence of electrical
Commission Board of Medicine, for brain activity.
reprimand, of the license to practice
medicine. B. Cardio Respiratory Death occurs when
2. Criminal Liability there is continuous and persistent cessation of
- When an act or omission constitutes a heart action and respiration.
crime, the physician can be imprisoned or
fined or both, as any other profession. 4 Kinds of Death:
3. Civil Liability 1. Clinical or Somatic Death
- The aggrieved party can be awarded 2. Brain Death
monetary damages for any wrongful or 3. Biological Death
negligent act or omission, when the 4. Cellular Death
professional is found guilty.
Clinical or Somatic Death
CASES ( Refer to Book ) - This particular kind of death occurs
Ex. Negligent or Wrongful Act when in the judgment of the
physician with the use of his clinical
Medical malpractice is a particular form eye the bodys vital signs of life
of negligence which consists in the cease to exist continuously and
failure of a physician or surgeon to permanently.
apply to his practice of medicine that - The clinical death is verifiable only
degree of care and skill which is by a physician after he observes
ordinarily employed by the profession that the patient no longer has a
generally, under similar conditions, and heart beat no pulse rate, no
in like surrounding circumstances spontaneous breathing and
movement, with the pupils of the
There are Four Elements involved in eye widely dilated and not reactive
medical negligent cases: to light and accommodation.
1. Duty - When a clinically dead person is
2. Breach brought to the morgue the
3. Injury generalized contraction of the
4. Proximate Causation It has been muscles or Rigor Mortis of the body
recognized that expert testimony is within 3 to 6 hours, may simulate a
usually necessary to support the return to life, because of the motion
conclusion as to causation. or movement of the body.

Ex. Whether A Hospital may be Held BRAIN DEATH


Liable for the Negligence of Physicians - This kind of death follows clinical
Consultants allowed to Practice in its death almost immediately unless
Premises. resuscitative procedures are started
promptly, because the human brain
CHAPTER 3 DEATH under normal conditions cannot
survive loss of oxygen for more
Legal Presumption of Death: than 6 to 10 minutes.
- If absent without explanation from - Brain Death may occur in the
his or her usual or last place of Stage 1 Cerebral Cortex- the
residence for a long continuous highest center of the brain that is
period. most sensitive to changes in the
- Circumstantial proof of death supply of oxygen and blood to the
Ex. a passenger on an airplane that brain. When the cerebral cortex
crashed is considered to have died dies, the patient is in cortical death.
even if no remains can be
recovered. Stage 2 - Cerebellum It deals with
the function of equilibrium. It

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follows the death of the cerebral - It is cardiorespiratory and brain
cortex. death altogether with permanent
cessation of all the anatomic and
Stage 3 Brainstem and Vital physiological functions of the body
centers These centers controlling organs.
respiration, heart rate and blood
pressure, ultimately die. When it CELLULAR DEATH:
does, the patient is, Brain Stem - The death of the different parts of
Dead. the body occurs at different times
- If the brain stem is damaged, then and stages.
the vital centers in the medulla - This is the reason why such organs
maybe destroyed, causing the as the corneas and the kidneys can
respiratory center to fail. be removed immediately after
- The occurrence of brain stem death biological death and transplanted
is equivalent to Legal Death, so that successfully.
Doctors can now issue a Death
Certificate, even though the heart is SIGNS OF DEATH:
still beating, and make 1. Cessation of heart action and
arrangements to harvest donor circulation
organs and tissues at this stage. 2. Cessation of respiration
- Further, in the presence of brain 3. Cooling of the body ( Algor Mortis )
stem death, artificial respirators - The temperature of 15 20
only achieve the maintenance of an degrees Fahrenheit is considered as a
oxygenated circulation through a certain sign of death.
corpse or cadaver. 4. Loss of motor power
5. Loss of sensory power
CRITERIA FOR DIAGNOSING BRAIN 6. Changes in the skin
STEM DEATH. ( refer to textbook ) 7. Changes in and about the eye
Persistent Vegetative State ( PVS ) - There is loss of corneal reflex
- This condition exists, when
irreversible destruction of the CHANGES IN THE BODY FOLLOWING
Cortex of the brain occurs without DEATH
damage to the vital centers, and 1. Changes in the Muscle
there are permanent eyes open a. Stage of primary flaccidity
state of unconsciousness, but cardio b. Cadaveric rigidity or rigor
respiratory functions continue, mortis
sometimes without respiratory - muscular contraction
assistance, but most often with which develops 3 6
respiratory support. hours after death and
- They do not however match the may last for 24 36
clinical criteria of Brain Death, in as hours.
much as they have elicitable - may also be utilized to
reflexes, spontaneous respirations approximate the length
and reactions to external stimuli. of time the body has
been dead from 3 to 36
HARVARD CRITERIA OF WHOLE BRAIN hours
DEATH: c. Stage of secondary flaccidity
1. Unreceptivity and Unresponsitivity or commencement of
2. No spontaneous movements or putrefaction
breathing
3. No reflexes Cadaveric Spasm- is the immediate or
4. Flat EEG of Confirmatory value instantaneous spasm or rigidity of the skeletal
muscles occurring at the moment of death due
WHOLE BRAIN DEAD to exhaustion, etc.
- When the brain ceased all functions,
even though the heart continues to Medico legal Importance of Cadaveric Spasm
beat. As a rule doctors can legally ( Refer to Book )
declare whole brain death twelve
hours after they have corrected all 2. Changes in the Blood
treatable medical problems, but the a. Coagulation of the blood
brain still doesnt respond even to b. Postmortem lividity or Livor Mortis
induced pain , they eyes do not 3. Autolytic or Auto Digestive Changes After
react to light and the person Death
doesnt breath without a respirator. 4. Putrefaction of the Body

BIOLOGICAL DEATH PUTREFACTIVE CHANGES OCCURING AFTER


- All the components of the brain are DEATH ( Refer to Book )
dead Kinds of Putrefaction:
- There is also permanent extinction 1. Mummification
of bodily life.

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2. Saponification This is also called Adipocere
Formation. Immediate Cause or Primary Cause
3. Maceration of Death
Ex. Suffocation due to drowning
Factors to Consider in Approximating the Asphyxia
Duration of Death in a Cadaver Cardio Respiratory Arrest
1. Entomology The presence of maggots in
the cadaver indicates duration of death for Antecedent Cause of Death are
more than 24 hours events or conditions that
2. Presence of live Fleas in clothing in death substantially contribute to the
by drowning, a flea can survive for about 24 immediate cause of death
hours submerged in water. After 24 hours Ex. Acute peritonitis, Acute
submersion in water the fleas die. Hypovolemic shock, Acute Septic
3. Blood vessel clots blood clotting occurs in Shock,
6 -8 hours after death.
4. Post Mortem lividity develops in 3 to 6 Underlying Cause of Death is the
hours after death. basic cause or bottom line cause of
5. Rigor Mortis- begins to develop in 3 to 6 death. It is the diagnosis of the
hours after death and may last for 24 to 36 patients or victims illness or
hours after death. sickness that resulted to his death
6. Onset of decomposition Decomposition Ex. Acute Appendicitis,
takes place within 24 48 hours after death. Hepatocarcinoma, Pelvic Fracture,
7. Food in the stomach Stab or Gunshot Wound to the
8. Skeletal soft tissues soft tissues may chest.
disappear from 1.5 years to 2 years after
burial. Non Natural Causes of Death
Ex. Murder, Homecide, Suicide,
Position of the Body at the time of Death Accident
1. Post Mortem lividity
2. Cadaveric spasm Death due to violence or Death Warrant is a warrant from the proper
inflicted physical injuries, usually manifest the executive authority appointing the time and
position of the body at the time of death. place for the execution of the sentence of
Ex. In suicide by gunshot wound, the gun death upon a convict judicially condemned to
maybe tightly grasped in the hand of the suffer death.
deceased
In drowning, the victim maybe holding Manner of Death
objects that come in contact with his hands to - Is the explanation as to how the
cling to life. cause of death arose, and maybe
either Natural Death or Violent
MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS Death
AND CADAVERIC SPASM:
Lazarus Syndrome
Rigor mortis is utilized to approximate the time - Is also called Lazarus Phenomenon
of death. Generalized muscular contractions is the spontaneous return of
occur from 3 to 6 hours until 36 hours. circulation after failed attempts at
resuscitation.
Cadaveric spasm occurs immediately after
death and is useful to ascertain the Implications of Lazarus Syndrome
circumstances of death. - raise ethical and legal issues for
doctors, who must determine when
Medico Legal Investigation of Death medical death has occurred, when
- Deaths which are not obviously due resuscitation efforts should end,
to natural causes, but are criminal, and post mortem procedures such
suspicious, accidental, suicidal, as autopsies and organ harvesting
murderous, homicidal, sudden or may take place.
unexpected, or unexplained, need
medico legal investigation. Lazarus Sign
- Lazarus sign or Lazarus reflex is a
The Death Certificate reflex movement in brain dead
- The death certificate is a legal patients, which causes them to
document necessary for burial of briefly raise their arms and drop
the dead, as it certifies the them crossed on their chests.
occurrence of death. It is a - The phenomenon has been
document from the Office of the observed to occur several minutes
Civil Registrar General, listing the after the removal of medical
particulars of an individuals death. ventilators used to pump air in and
- It contains the Immediate Cause or out of brain dead patients to keep
Primary cause of death, the their bodies alive.
antecedent causes and underlying
cause of death NEAR DEATH EXPERIENCE

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- Refers to a broad range of personal Hemothorax
experiences associated with Flail chest as in multiple rib
impending death, encompassing fractures Cardiac tamponade
multiple possible sensations due to penetrating injuries
including detachment from the b. Potentially Lethal Injuries
body; feelings of levitation etc. b.1. Pulmonary Contussion with
or without flail chest
EUTHANASIA b.2. Thoracic Aortic Tear or
- Meaning good death ( well or good ) Rupture the most common
- Refers to the practice of ending life cause of sudden death after a
in a painless manner. vehicular accident or fall ( major
- Deliberate intervention undertaken decelaration injury )
with the express intention of ending c. Serious Chest Injuries
life, to relieve intractable suffering 4. Abdomen
Types of Injuries:
Classification of Euthanasia: a. Penetrating
1. Voluntary euthanasia is euthanasia - Gunshot wounds of the
conducted with consent abdomen carry 95% probability
of significant visceral injury
2. Involuntary euthanasia - A bullet when it hits the
is euthanasia conducted without consent. abdomen will penetrate the
-is conducted where an individual makes a abdominal wall, enter the
decision for another person incapable of doing abdominal cavity and most
so. likely injure more than one
- also known as physician assisted death, organ.
physician assisted suicide or mercy killing. - The incidence of abdominal
injury is strikingly higher in
3. Passive euthanasia entails withholding of gunshot wounds than in stab
common treatments wounds.
- The major cause of death is
4. Active euthanasia entails the use of lethal hemorrhage and this occurs
substances or forces to end life and is the most within the first 24 hours
controversial means. - In stab wounds of the
abdomen , only 2/3 penetrate
CHAPTER 4 REGIONAL TRAUMA the peritoneal cavity; of these
only cause significant visceral
Trauma injury that requires surgical
is the leading cause of death in the first four repair.
decades of life and the 3rd leading cause of b. Blunt
death in all age groups today. - The spleen and liver are the
-Penetrating trauma particularly handguns is most commonly injured organs
becoming common in nearly all areas of the due to blunt trauma.
country. - Their frequent incidence also
explains why the mortality rate
Trimodal Distribution of Death from Trauma: following blunt trauma is higher
1. Seconds to minutes of injury due to the than that of penetrating injury.
injury to the brain, high spinal cord, heart,
aorta and other large vessels. These patients 5. Fractures and Dislocations
can rarely be salvaged. The word fracture comes from the Latin
2. Minutes to Few hours from injury ( The word fractura which means a break in the
Golden Hour ) continuity of the bone. It is also a combination
- It is in this period that Advanced Trauma Life of a break in the bone and soft tissue injury
Support9 ( ATLS ) techniques are important.
3. Several days to weeks of Injury these are A. Open Fractures - 90% of open
due to sepsis or organ failure. fractures are caused by vehicular accident.
B. Hip fractures are very common in
SPECIFIC INJURIES elderly people and are usually caused by minor
1. Head falls. It is the most common cause of traumatic
a. Types of Head Injuries: death after the age of 75.
a.1 Hematoma
a.2 Contusions 6. Urologic
a.3 Skull fractures - Hematuria following trauma
a.4 Hemorrhage - Blunt kidney injury is usually
2. Spine and Spinal Cord Injuries due to motor vehicular
The most common causes of severe accidents which account for 70
spinal trauma are motor vehicular accidents, 90 % of kidney trauma.
falls, diving accidents, and gunshot wounds. - Penile injury:
3. Chest The erect penis is usually 6 8
a. Life Threatening Injuries inches long and 1 -2 inches in
Pnumothorax diameter.

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- Avulsion of the prepuce this another, shall be guilty of the crime of serious
may follow accidents where the physical injuries
foreskin called prepuce is c. Article 264. Administering Injurious
detached or lacerated by a blunt Substances or Beverages
force. d. Article 265. Less Serious Physical Injuries
- Fracture of the penis this is Any person who shall inflict upon another
the traumatic rupture of the physical injuries which shall incapacitate the
corpora cavernosa penis offended party for labor for 10 days or more, or
resulting from a forceful trauma shall require medical attendance for the same
to the flaccid organ. period
- Amputated penis the penis of e. Article 266. Slight Physical Injuries and
an avid womanizer is sometimes Maltreatment.
intentionally cut or amputated - When the offender has inflicted physical
by a jealous derange wife or injuries which shall incapacitate the offended
lover. party for labor from one to nine days, or shall
require medical attendance during the same
7. Arterial trauma period.
8. Burns
Chapter 3, RAPE When and How rape is
CLASSIFICATION OF WOUNDS committed
1. AS TO LEGAL CLASSIFICATION 1. By a man who shall have carnal knowledge
Chapter 1 of a woman under any of the circumstances
DESTRUCTION OF LIFE a. Through force, threat, or intimidation
a. Article 246. Parricide b. When the offended party is deprived
b. Article 247. Death or Physical Injuries of reason or otherwise unconscious
Inflicted Under Exceptional Circumstances c. By means of fraudulent machinations
c. Article 248. MURDER or grave abuse of authority
- Any person who, not falling within the d. When the offended party is under
provisions of Article 246 shall kill another, twelve ( 12 ) years of age or is demented, even
shall be guilty of murder and shall be punished though none of the circumstances mentioned
by Reclusion Perpetua, to death if committed above is present.
with any of the following attendant
circumstances; 2. By any person who, under any of the
1. With treachery circumstances mentioned in paragraph 1
2. In consideration of a price , reward or hereof, shall commit an act of sexual assault
promise by inserting his penis into another persons
3. By means of inundation etc. mouth or anal orifice or any instrument or
4. On occasion of any of the calamities etc. object into the genital or anal orifice of another
5. With evident premeditation person.
6. With cruelty etc
Classification of Wounds
Article 249 HOMICIDE 2. AS TO THE DEPTH OF THE WOUND
Article 251. Death Caused in a Tumultous a. Superficial When the wound involves only
Affray the layer of the skin
Article 252. Physical Injuries Inflicted In a b. Deep When the wound involves the
Tumultuous Affray structures beyond the layers of the skin.
Article 253. Giving Assistance to Suicide
Article 254. Discharge of Firearms b.1 Penetrating the wound enters the body
Article 255. Infanticide but does not come out. Punctured, stab and
Article 256. Intentional Abortion gunshot wounds usually belong to this type of
Article 257. Unintentional Abortion who shall wound.
caused an abortion by violence but not b.2 Perforating there is a communication
intentional. between the outside, inner and the outer side.
Article 258. Abortion Practiced by the Woman There is both a point of entry and exit.
Herself or By Her Parents
Article 259. Abortion Practiced by a Physician Classification of Wounds
or Midwife and Dispensing of Abortives 3. AS TO MORTALITY
Article 260. Responsibility of Participants in a a. Deadly Wound- Death results immediately,
Duel after the infliction of the wound. Deadly
Article 261. Challenging to a Duel wounds though mortal, maybe prevented with
prompt medical treatment.
CHAPTER
2 PHYSICAL b. Non Deadly Wounds Does not result to
INJURIES death immediately, after the wound is inflicted.
a. Article 262. Mutilation Any person who A non deadly wound may cause death later,
shall intentionally mutilate another by due to complications i.e. tetanus, septicemia
depriving him, either totally or partially , of
some essential organ of reproduction. Classification of Wounds:
b. Article 263. Serious Physical Injuries Any 4. AS TO THE WOUNDING INSTRUMENTS USED:
person who shall wound, beat, or assault

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a. Sharp Instruments Ex. incised wound, B.7. Lacerated wound result of an injury from
punctured wound, stab wound dagger or a blunt instrument. In cerebral laceration, the
kitchen knife brain tissue is torn often with an
b. Blunt Instruments A block of wood or iron accompanying visible head wounds and skull
produces contusion, hematoma, abrasions, fractures.
lacerated wound when used to strike, attack, B.8. Bites they maybe abraded, bruised or
wound, beat or assault another rarely lacerated. They are usually seen in
sexual assaults and in child abuse and also by
Classification of Wounds: animal bites
5. AS TO THE CONSEQUENTIAL INJURY AFTER B.9. Gunshot wounds
THE APPLOCATION OF FORCE
a. Coup Injury - TEST FOR THE PRESENCE OF POWDER
b. Coup Centre Coup Injury RESIDUES:
c. Contre Coup Injury 1. Paraffin test or Dermal Nitrate test present
d. Locus Minoris resistancia on the skin of the hand dorsum or site of the
e. Extensive injury wound of entrance. This test is not conclusive
because fertilizers, cosmetics, cigarettes, urine
Classification of Wounds: and other nitrogenous compounds with
6. AS TO THE INTEGRITY OF THE SKIN nitrates will give a positive reaction. A negative
A. CLOSED WOUNDS Presents no break in the test is also not conclusive . The test usually
integrity or continuity of the skin. There maybe gives a positive result even after a lapse of 3
only outward manifestations of injury days or even if the hands are subjected to
internally. ordinary washing
Ex. of closed wounds:
1. petechiae a circumscribe extravasation of 2. Use of Scanning Electron Microscope with a
blood in the subcutaneous tissue. linked X ray analyzer. This method appears
2. contusion effusion of blood into the tissues to be more specific but seldom used because
underneath the skin as a result of a blunt the instrument is expensive.
force. Ex. black eye
3. Hematoma SPECIAL TYPES OF WOUNDS
4. Blunt injury 1. Assailants wounds these wounds are
5. Musculoskeletal injuries sustained by the assailant from the victim,
Ex. Sprain, Dislocation, Fracture, Strain while the former is in the process of attacking,
wounding, assaulting, beating or killing his
Cerebral Concussion there is a brief loss of victim.
consciousness and sometimes memory after a 2. Defense wounds in the process of
head injury that doesnt cause obvious defending himself from the attacks, assault,
physical damage. wounding, beating or violence of the assailant,
the victim sustains defensive wounds usually
Cerebral Contusion they are bruises to the in the upper extremities.
brain, usually caused by a direct, strong blow 3. Victims wounds these are wounds
to the head. They are more serious than sustained by the victim, from the assailant, the
concussions. former not having the chance or opportunity to
defend himself. The victims wounds maybe
B. OPEN WOUNDS located in any part of the body.
- There is a break in the continuity of 4. Self Inflicted wounds these are wounds
the skin self inflicted by the person on himself. The
Examples: wounds are usually found on the accessible
1. Abrasion parts of the body, usually with no intention to
2. Bruise kill himself. Unless the victim is insane, self
3. Incised wound inflicted wounds are for a fraudulent or self
4. Stab wound serving purpose.
5. Punctured wound 5. Homicidal wounds these are the serious
6. Perforating wound wounds sustained by the victim resulting to his
7. Lacerated wound death, from the criminal assailant. Usually the
8. Bites wounds are situated in the areas of the neck,
9. Gunshot wounds chest, the abdomen and the skull.
6. Accidental wounds these wounds are
B. OPEN WOUNDS there is a break in the sustained by the victim, without any fault or
continuity of the skin intention whatsoever on the part of the
B.1. Abrasion Scratch, friction mark accused to inflict the wounds on the victim.
B.2. Bruise cause by a blunt injury to the The wounds are usually located on any part of
tissues which damage blood vessels beneath the victims body.
the surface, allowing blood to extravasate or 7. Suicidal wounds these are wounds self
leak into the surrounding tissues. inflicted by the victim on himself, and usually
B.3. Incised wound seen on the temple, the roof of the mouth, and
B.4. Stab wound other fatal body areas, accessible to the hand
B.5. Punctured wound of the victim.
B.6. Perforating wound

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CHAPTER 5 COMPREHENSIVE DANGEROUS - a detrimental effect to the
DRUGS ACT OF 2002 society and to the individual

REPUBLIC ACT 9165 B. Drug Habituation is the desire to


have a continuous use of the drug but
A DANGEROUS DRUG is a drug whose use is with the capacity to refrain physically
attended by risk and therefore is unsafe, from using it.
perilous and hazardous to people and society.
Characteristics of Drug Habituation:
A DRUG is any substance , vegetable, mineral - The desire to use the drug is
or animal in origin, used in the composition or not compulsive but merely psychical.
preparation of medicines or any substance
used as medicines. - There is little or no tendency to
increase the dose
The Dangerous Drug Act of 1972, include the
following Dangerous Drugs as follows: - The detrimental effect if any, is
A. PROHIBITED DRUGS primarily on the individual.
1. Opium and its active components
and derivatives such as heroin and 6. Protector
morphine. 7. Pusher
2. Coca leaf and its derivatives, 8. Controlled Delivery
principally cocaine. 9. Den, Dive or Resort
3. Hallucinogenic drugs such as 10. PDEA The Philippine Drug
mescaline, lysergic acid diethylamide Enforcement Agency, which is the
( LSD ) and other substances producing implementing arm of the Dangerous
similar effects. Drugs Board.
4. Other drugs whether natural or
synthetic with the physiological effects UNLAWFUL ACTS AND PENALTIES IN
of a narcotic drug. THE DANGEROUS DRUGS ACT OF 2002
( R.A. 9165:
B. REGULATED DRUGS 1. Importation of Dangerous Drugs and
1. Self inducing sedatives such as or Controlled Precusors and Essential
secobarbital, phenobarbital, Chemicals.
pentobarbital, barbital and any drug 2. Sale, Trading, Administration,
which contains salt or derivative of a Dispensation, Delivery, Distribution and
salt of barbituric acid. Transportation of Dangerous Drugs and
2. Any salt of amphetamine such as or Controlled Precursors and essential
Benzedrine or any drug which produces Chemicals.
a physiological action similar to 3. Maintenance of a Den, Dive or Resort
amphetamine. 4. Employees and Visitors of a Den,
3. Hypnotic drugs, such as Dive or Resort
methaqualone producing similar 5. Manufacture of Dangerous Drugs and
physiologic effects. or Controlled Precursors and Essential
Chemicals
IMPORTANT TERMS in the DANGEROUS 6. Illegal Chemical Diversion of
DRUG ACT OF 2002 Controlled Precursor and Essential
1. Drug Syndicate Chemicals
2. Illegal Trafficking 7.Manufacture or Delivery of Equipment
3. Chemical Diversion , Instrument, Apparatus and Other
4. Planting Evidence paraphernalia for Dangerous Drugs and
5. Drug Dependence or Controlled Precursors and Essential
Chemicals
Two Classes of Drug Dependence: 8. Possession of Dangerous Drugs
a. Drug Addiction is a state of periodic 9. Possession of Equipment,
or chronic intoxication produced by the Instrument , Apparatus and Other
repeated consumption of a drug, Paraphernalia for Dangerous drugs.
whether synthetic or natural and found 10. Possession of Dangerous D During
to be detrimental to the individual and Parties, Social Gatherings or Meetings
to the society. 11. Possession of Equipment,
Instrument, Apparatus and Other
Characteristics of Drug Addiction: Paraphernalia for Dangerous Drugs
A. An overpowering desire or During Parties, Social Gatherings or
need to continue taking the drug or to Meetings
obtained it by any means. 12. Use of Dangerous drugs
13. Cultivation or Culture of Plants
- a tendency to increase the Classified as Dangerous Drugs or are
dose. Sources thereof
-a psychological and physical 14. Failure to Maintain and Keep the
dependence on the effects of the drug. Original Records of transactions on

9
Dangerous drugs and or Controlled Section 73. Liability of a Parent, Spouse
Precursors and Essential chemicals or Guardian Who refuses to Cooperate
15. Unnecessary Prescription of with the Board or any Concerned
Dangerous Drugs Agency
16. Unlawful Prescription of Dangerous Section 77. The Dangerous Drugs Board
drugs Section 82. Creation of the Philippine
Drug Enforcement Agency ( PDEA )
THE CUSTODY AND DISPOSITION OF Section 85. The PDEA Academy
CONFISCATED, SEIZED AND OR Section 90. Jurisdiction
SURRENDERED DANGEROUS DRUGS, Section 91. Responsibility and Liability
PLANT SOURCES OF DANGEROUS of Law Enforcement Agencies and
DRUGS, CONTROLLES PRECURSORS Other Government Officials and
AND ESSENTIAL CHEMICALS, Employees in Testifying as Prosecution
INSTRUMENTS AND PARAPHERNALIA Witnesses in Dangerous Drug Cases
AND OR LABORATORY EQUIPMENT Section 92. Delay and Bungling in the
The PDEA shall take charge and have Prosecution of Drug Cases
custody of all dangerous drugs, plant
sources of dangerous drugs, controlled PHARMACOLOGIC CLASIFICATION OF
precursors and essential chemicals, as DANGEROUS DRUGS
well as Instruments paraphernalia and 1.Hypnotics
laboratory equipment so confiscated, 2. Sedatives and Tranquilizers
seized and or surrendered, for proper 3. Hallucinogens and Psychomimetics
disposition in the following manner 4. Stimulants
( Refer to Book ). 5. Depressants
6. Deliriants and Intoxicants
IMPORTANT PROVISIONS OF R.A. 9165
OR THE COMPREHENSIVE DANGEROUS A.Hypnotics:
DRUGS ACT OF 2002 Opiates and Their Derivatives Opium
is obtained from the milky exudates of
Section 22. Grant of Compensation, the unripe seed capsules of the poppy
Reward and Award plant, Papaver Sornoiferum.
Section 23. Plea Bargaining Provision
Section 36. Applicants for Drivers Derivatives of opium commonly used
License are morphine, heroin, and codeine.
Section 38. Laboratory Examination or
test on Apprehended / Arrested Its synthetic preparation are Demerol
Offenders and Methadone.
Section 39. Accreditation of Drug
Testing Centers and Physicians Narcotics that have a legitimate
Section 40. A physician, dentist, medical used as powerful pain relievers
veterinarian or practitioner authorized are called Opioids, and include codeine,
to prescribe any dangerous drug shall oxycodone, meperidine, morphine and
issue the prescription therefore in one hydromorphone.
original and 2 duplicate copies.
Section 54. Voluntary Submission of a Heroin which is prohibited is a very
Drug Dependent to Confinement, strong pain reliever and narcotic
Treatment and Rehabilitation
Section 55 Exemption from Criminal Signs and Symptoms of Opium
Liability Administration:
Under the Voluntary Submission 1. Stage of Excitement
Program 2. Stage of Stupor
Section 56. Temporary Release from 3. Stage of Narcosis
the Center; After Care and Follow up
Treatment Under the Voluntary B. SEDATIVES:
Submission Program Barbiturates: - are the products of
Section 58. Filing of Charges Against a malonic acid and urea, synthesized on
Drug Dependent who is not St. Barbara day.
rehabilitated Under the Voluntary - Used to treat anxiety and to induce
Submission Program. sleep can cause both psychologic
Section 61. Compulsory Confinement of and physical dependence.
a drug dependent who refuses to apply
under the Voluntary Submission C. HALLUCINOGENS OR
Program PSYCHOMIMETIC DRUGS:
Section 62. Compulsory Submission of a Marijuana ( Cannabis Sativa ) is a
Drug Dependent Charged with an Mexican term for pleasurable feeling.
Offense, to Treatment and Marijuana is not addictive. Physical
Rehabilitation dependence and dose tolerance do not
Section 70. Probation or Community develop with its use. Psychic
Service for a First Time Minor Offender dependence may occur.
In Lieu of Imprisonment

10
Subjective effects of Marijuana:
- There is a feeling of lightness of the SEXUALITY IS A NORMAL BIOLOGICAL URGE
extremities followed by rushes of AND AN IMPORTANT PART OF THE HUMAN
warmth and well being that EXPERIENCE.
eventually lead to a sense of
relaxation, mild euphoria and a 4 Stages of a Sexual Response:
dreamy state where ideas are 1. Desire
disconnected. 2. Arousal
Objective Effects of Marijuana: 3. Orgasm
- Moderate increase in resting pulse 4. Resolution
rate, reddening of the eyes due to
dilatation of the conjunctival blood SEXUAL DYSFUNCTIONS ( Classification )
vessels. Difficulty of speech and of A. As to choice of sexual partners
remembering of the logical trend of 1. Homosexual
what was being said. 2. Infanto sexual
3. Besto sexual
Lysergic Acid Dsethylamide ( LSD ) 4. Auto sexual
- These drugs are false hallucinogens. 5. Gerontophilia
- It produces impaired judgement so 6. Necrophilia
that a user might think that he can 7. Incest
fly, and may even jump out a
window to prove it, resulting in B. As to instinctual strength of the sexual urge:
severe injury or death. 1. Over sex
2. Under sex or sexual frigidity
D.STIMULANTS: a. Sexual anesthesia
Amphetamines methamphetamines b. Dyspareunia
( Shabu, speed ); c. Vaginismus
methylenedioxymethamphetamine d. Old age
( MDMA, ecstasy or Adam ) C. As to the mode of sexual expression
- Acts on the cerebral cortex causing 1. Oralism
alertness, excessive self confidence a. Fellatio
and feeling of well being. Physical b. Cunnilingus
performance may to some degree c. Analism
temporarily improve.
2. Sado masochism
Untoward Effects: a. Sadism
- They increase the blood pressure b. Masochism
and heart rate. Fatal heart attacks 3. Fetishism
have occurred even in healthy, a. Anatomic
young athletes. The blood pressure b. Clothing
maybe so high that a blood vessel .
in the brain ruptures causing a c. Necrophilic
stroke. d. Odor ( ospresiophilia )

Coccaine is an alkaloid from the Kinds of Ospresiophilia


leaves of the coca shrub cultivated in 1. Urolagnia
Bolivia and Peru. 2. Coprolagnia
- It produces effects similar to 3. Mysophilia
amphetamines, but is a much more a. Narcissism
powerful stimulant. b. Saboteur Fetish
- Is used to excite the undersexed. c. Vampirism
- Is a euphoriant and readily relieves
fatigue D. As to the part of the body
1. Sodomy
Untoward Effects: 2. Uranism
- Same as amphetamine 3. Frottage
4. Partialism
E. DEPRESSANTS: E. As to visual stimulus
- Angel dust 1. Voyeurism
- Depresses the brain and abusers 2. Scoptophilia
usually become confused and F. As to number
disoriented shortly after taking the 1. Troilism
drug. 2. Pluralism
- Can be combative and because they G. Other sexual deviates.
dont feel the pain they may 1. Don Juanism
continue fighting even when hit 2. Indecent exposure
hard. 3. Coprolalia
H. Disorders of sexual function:
CHAPTER 6 SEXUAL DYSFUNCTIONS AND 1. Premature ejaculation
SEXUAL CRIMES 2. Retarded ejaculation

11
3. Low sexual desire disorder SEX CRIMES IN THE REVISED PENAL
4. Sexual aversion disorder CODE:
5. Sexual arousal disorder in women A. Rape
6. Inhibited orgasm B. Carnal Knowledge
7. Dyspareunia - is the act of a man in having
8. Vaginismus sexual bodily connection with a
I. Sexual reversal woman. There is carnal knowledge
1. Transvertism if there is the slightest penetration
2. Transexualism in the sexual organ of the female by
3. Intersexuality the sexual organ of the male.

SEXUAL CRIMES: C. Seduction


Chaste An unmarried woman who has had no - is the art of a man enticing
carnal knowledge with men or that she never women to have unlawful intercourse
voluntarily had unlawful sexual intercourse. with him by means of persuasion,
These also denotes purity of mind and solicitation, promises, bribes or
innocence of heart. other means without employment of
force
Virgin A woman who has had no carnal
knowledge of man. Her genital organs have D. Acts of Lasciviosness
not been altered by carnal connection. E. Acts of Lasciviousness with
Consent of the Offended Party
Kinds of virginity F. Abduction
1. Moral virginity the state of not knowing the 1. Forcible Abduction
nature of sexual life and not having experience 2. Consensual Abduction
sexual relation. G. Adultery
2. Physical virginity A condition whereby a H. Concubinage
woman is conscious of the nature of sexual life I. Bigamy
but has not experienced sexual intercourse. J. Marriage Contracted Against the
3. Demi virginity This term refers to a Provisions of Law
condition of a woman who permits any form of K. Premature Marriage
sexual liberties as long as they abstain from L. Performance of Illegal Marriage
rupturing the hymen by sexual act. The woman Ceremony
allows sexual intercourse, but only inter M. Prostitution
femora or even inter labia, but not to the N. Corruption of Minors
extent of rupturing the hymen. O. White Slave Trade
4. Virgo intacta A truly virgin woman. There P. Abuse Against Chastity
is no structural change in her organ,
notwithstanding the fact of a previous sexual PROVISIONS OF THE REVISED PENAL
intercourse. CODE APPLICABLE TO UNNATURAL SEXUAL
OFFENSES
DEFLORATION This is the laceration or
rupture of the hymen, as a result of sexual 1. Grave Scandal ( Art. 200 )
intercourse. All other lacerations which are not 2. Immoral Doctrines, Obscene Publications
due to coitus are not considered defloration. and Exhibitions ( Art. 201 )
3. Vagrants and Prostitutes ( Art. 202 )
SEMEN AND SPERMATOZOA: 4. Grave Threats ( Art. 282 )
5. Light Threats ( Art. 283 )
ERECTILE DYSFUNCTION ( Impotence ) 6. Other Light Threats ( Art. 285 )
- The diagnosis of Erectile 7. Grave Coercions
Dysfunction is important especially 8. Unjust Vexation or Any Other Coercion ( Art.
in complaints of rape. It must be 287 )
proven convincingly that the
accused is permanently impotent, CHAPTER 7 MENTAL HEALTH
so that the crime of rape cannot be DISORDERS
proved beyond reasonable doubt.
Mental Health Disorders include disturbances
- Impotence usually results from in thinking, emotion, and behavior. There is a
vascular impairment, neurologic complex interaction between the physical,
disorders, drugs, abnormalities of psychologic, social, cultural and hereditary
the penis or psychological problems influences.
that interfere with sexual arousal.
- These includes injury, diabetes Factors that Contribute to the Development of
mellitus, stroke and drugs like all Mental Disorders:
antihypertensive and psychotics,
antidepressants and some 1. Heredity the most frequent factor that
sedatives. contributes to insanity and a good history will
- Alcohol can also cause impotence reveal the ascendants afflicted with the same.
and also low levels of testosterone 2. Incestous Marriage The mental illness is
accentuated when they are blood relatives.

12
3. Impaired Vitality Stress, tension, worry, a. Illusion
grief may predispose to insanity b. Hallucination
4. Poor Moral Training and Breeding Corrupt 2. Disorders of Memory
moral upbringing in the family due to a. Dementia
immorality of the parents 3. Disorders in the Content of Thought
5. Psychic Factors Factors like love, hate, A. Delusion
rage, anger, passion disappointments a. Delusion of grandeur
6. Physical Factors b. Delusion of persecution
a. Non toxic factors exhaustion c. Delusion of reference
resulting from severe physical and mental d. Delusion of Self Accusation
strain and traumatic injuries to the head. e. Delusion of infidelity
b. Toxic factors drug addiction, f. Nihilistic delusion
infections of the brain g. Delusion of poverty
h. Delusion of control
KINDS OF MENTAL HEALTH DISORDERS: i. Delusion of depression
1. Psychosomatic disorders physical B. Obsession
disorders caused by psychologic factors. 4. Disorders in the trend of thought
2. Somatiform disorders encompasses Types:
several psychiatric disorders in which people a. Mania
report physical symptoms but deny having b. Melancholia
psychiatric problems.
3. Generalized Anxiety Disorders 5. Disorders of Emotions or Feelings a
4. Panic Attacks and Panic Disorder disorder in the state of mind, fervor, or
sensibility, not in accord with reality.
5. Phobic Disorders 6. Disorders of volition or conation ( doing )
a. Agoraphobia Kinds of Conation:
b. Specific phobias A. Impulsion or Impulse ( Compulsion )
c. Social phobia a sudden and irresistible force
6. Obsessive Compulsive Disorder compelling a person to the conscious
7. Post Traumatic Stress Disorder performance of some action without
8. Depression and Mania motive or forethought.
9. Bipolar Disorder
10. Suicidal Behavior Types of Compulsion:
11. Eating Disorders a. Pyromania
a. Anorexia nervosa b. Kleptomania
b. Bulimia nervosa c. Dipsomania
c. Binge eating disorder d. Homicidal impulse
12. Personality Disorders e. Sex impulse
a. Paranoid f. Suicidal impulse
b. Schizoid
c. Histrionic DISTINCTIONS BETWEEN TRUE AND
d. Narcissistic FALSE INSANITY:
e. Antisocial 1. True insanity develops insidiously
f. Borderline usually with the existence of some
g. Avoidant predisposition to an exciting cause if
h. Dependent careful history is taken, while false
insanity develops suddenly with no
i. Obsessive Compulsive existing predisposition.
j. Passive Aggressive
k. Dissociative 2. In true insanity, there is a peculiar
facial expression, which is absent in
13. Schizophrenia a serious mental disorder false insanity
characterized by loss of contact with reality
( psychosis ) , hallucinations, delusions ( false 3. In true insanity, there is a continuous
beliefs ) , abnormal thinking, disrupted work and persistent manifestation of
and social functioning insanity, which is only present in false
insanity when the pretender is under
Types of Schizophrenia: observation, and absent when not
a. Paranoid under observation.
b. Hebephrenic
c. Catatonic 4. In true insanity, there is a clinical
entity of a specific mental disorder,
14. Delusional Disorder which is absent in false insanity.
15. Psychological Incapacity a waste basket
diagnosis because it is so broad a term, that it 5. In true insanity, the patient can
covers all possible Mental Disorders. endure a violent or stressful activity
without fatigue, which is not present in
SOME MANIFESTATIONS OF MENTAL false insanity
DISORDERS:
1. Disorders of Cognition ( Knowing )

13
6. In true insanity, the patient does not Classification of mental deficiency:
observe personal hygiene, in false 1. Idiot The idiots intelligence never
insanity, the pretender observes exceeds that of a normal child over 2
hygiene years old. The IQ is between 0 20.
This is usually congenital.
Insanity or Mental Illness is an 2. Imbecile the imbeciles intelligence
exempting or mitigating circumstance is compared to a normal child from 2
to Criminal Liability as provided in the 7 years old and the IQ is 20 40.
following: 3. Feeble Minded his mentality is
1. As an exempting Circumstance similar to that of a normal child
Article 12 of the Revised Penal between 7 12 years old and an IQ of
Code provides, When the imbecile or 40 70.
an insane person has committed an act
which the law defines as felony, the The Legal Importance of determining
court shall order his confinement in one the persons state of mind are the
of the hospitals or asylums established following
for persons thus afflicted and he shall
not be permitted to leave without first In Criminal law, insanity exempts a
obtaining the permission of the same person from criminal liability
court.
In Civil law, Insanity is a restriction of
2. As a mitigating Circumstance the capacity of a natural person to act
Article 13, of the Revised Penal as provided in Article 38 of the Civil
Code provides, the following are Code.
mitigationg circumstances:
a. That the offender is deaf and Insanity modifies or limits the capacity
dumb, blind or otherwise suffering from of a natural person to act as providedin
physical defect which thus restricts his Article 39, also of the Civil Code.
means of action, defense or
communication with his fellow beings Insanity at the time of marriage of any
or both parties is a ground for the
The American Law Institute formulated annulment of marriage.
the following Rules on Criminal
Responsibility and states that;
1. A person is not responsible for his
criminal conduct if at the time of such
conduct as a result of mental illness or
defect, he lacks essential capacity to
appreciate the criminality of his
conduct or to conform his conduct to
the requirement of the law.

2. The term mental disease or defect


does not include an abnormality
manifested only by repeated criminal or
otherwise anti social conduct

Fundamental Principles of Insanity and


Criminal Responsibility:
1. A sane man is assumed to be wholly
responsible for the consequence of his
crime.
2. A person who commits a criminal act
is presumed to be sane.
3. Crime is always considered as an
affair of the mind as well as the body
and to make an act or omission a
crime, there must be a criminal act
( actus reus ) and an criminal mind
( mens rea ) . Actur facit reum, nisi
mens sit rea.

Mental Deficiency or mental


retardation, is sub average intellectual
ability present from birth or early
infancy. Intelligence is both determined
by heredity and environment. In most
cases of mental deficiency, the cause is
unknown.

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