250 LEGAL MEDICINE
inherent when injurious substances or beverages are introduced into the
Deformity is a condition of physical ugliness. It must be per manent and
conspicuous. The loss of the front teeth, the development of a pigmented
spar on the face., or loss of the pinna of the ear are considered
deformities. However, the development of a scar in covered parts of the
body may not be considered deformity because it is not conspicuous and
visible.
"The loss of any other part of his body" means loss of the parts of the
body not mentioned in paragraph 2, Art. 263.
Incapacity means the inability of the injured person to perform, or
engage on a work or vocation before he sustained injury.
In paragraph four, the injured person becomes ill or incapacitated for
labor for more than thirty days and impliedly less than 90 days.
It is noteworthy to mention that in paragraphs 3 and 4 of article
263 there is no mention of periods of medical attendance but merely
incapacity.
Administering Injurious Substances or Beverages:
Art. 264, Revised Penal Code:
The penalties established by the next preceding article shall be
applicable in the respective cases to any person who, without intent to
kill, shall inflict upon another any serious physical injury, by knowingly
administering to him any injurious substances or beverages or by taking
advantages of his weakness of mind or credulity.
Elements of the crime:
a. The offender inflicted upon another person any serious physical injury.
b. The infliction of physical injury was done knowing that the
substance or beverage administered is injurious or took advantage of he
victim's weakness or credulity; and
c. T ere was no intent to kill on the part of the offender.
If the offender does not know that the substance administered is
injurious, he cannot be held liable under the above provision.
The throwing of acid on the face of someone does not fall within the
provision because what the provision contemplates is administering or
taking in the injurious substance or beverages (U.S. Chiong Songco, 18
Phil. 459).
The provision does not contemplate of slight or less serious physical
injuries which is the consequence of injurious substances or beverages,
but results only in serious physical injuries.
If the administration of injurious substances or beverages is
intentional, the crime committed is frustrated murder. Treachery is
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 251
body.
Serious Physical Injuries:
Art. 265, Revised Penal Code:
Any person who shall inflict upon another physical injuries not
described in the preceding articles, but which shall incapacitate the
o ffended party for labor ten days or mo re, or shall req uire medical
attendance for the same period, shall be guilty of less serious physical
injuries and shall suffer the penalty of arresto mayor.
Whenever less serious physical injuries shall have been afflicted
with the manifest intent to insult or offend the inju red person, or
under circumstances adding ignominy to the offense, in addition to he
penalty of arresto mayor, a fine not exceeding 500 pesos shall he
imposed.
Any less serious physical injury inflicted upon the offender's
parents, ascendants, guardians, c urators, teachers, or persons of rank or
persons in authority, shall be punished by prision correctional in its
minimu m and medium periods, provided that, in the case o f p erso ns
in autho rity, the deed does not' co nstitute the crime o f assault upon
such person.
The basis to determine whether the physical injury is less serious or
not is by either the period of medical attendance or period of
incapacity; both of which is ten days or more b ut not more than
thirty days.
The fact that the injury only requires medical attendance for two
days but incapacitated the victim fro m attending to his ordinary
work for a period of 29 days makes the crime less serious physical
injuries (U.S. v. Trinidad, 4 Phil. 152).
There must be proof as to the period of medical attend ance. In the
ab sence o f such proo f o f med ical attendance or incap acity, although
the wound actually healed in more than 30 days, the crime committed is
only slight physical injuries (People v. Penesa, 81 Phil. 398).
The crime ' of less serious physical injuries may be qualified and a fine
or a higher penalty is imposed, when:
a. There is a manifest intent to insult or offend the injured person;
b. There are circumstances adding ignominy to the offense;
c. The victim is the offender's parents, ascendants, guardian,
curators or teachers; or
d. The victim is a person of rank or person in authority, provided
that the crime is not direct assault.
252 LEGAL MEDICINE
 Obligation Imposed on Physicians Who have Treated Persons Suffering
From Serious and Less Serious Physical Injuries:
PRESIDENTIAL DECREE NO. 169
WHEREAS, Pursuant to Proclamation No. 1081, dated September 21,
1972 and No. 1104, dated January 17, 1973, martial law has been
declared throughout the Philippines to, among other goals, restore and
maintain peace and order;
WHEREAS, for the attainment of the aforesaid goal, and to enable the
law-enforcement agencies to keep track of all violent crimes, conduct
timely investigation thereon and effect the immediate arrest of the
perpetrators thereof, it is necessary that all persons treating physical
injuries resulting from any form of violence be required to report such fact
to said agencies;
WHEREAS, while some of the victims of violent crimes, or those who
may have sustained physical injuries in the act of committing or as a
result of the commission of a crime submit themselves for medical
treatment in hospitals, medical clinics, sanitariums, or other medical
establishments or to medical practitioners, they do not report their
injuries to the law-enforcement agencies for one reason or another;
NOW, THEREFORE, I, FERDINAND E. MARCOS, pursuant to
Proclamation No. 1081, dated September 21, 1972 and No. 1104, dated
January 17, 1973 and in my capacity as Commander-in-Chief of all the
Armed Forces of the Philippines, do hereby order and decree that:
1. The attending physician of any hospital, medical clinic, sani tarium or
other medical establishments, or any medical practitioner, who has
treated any person for serious or less serious physical injuries as those
injuries are defined in Articles 262, 263, 264 and 265 of the Revised
Penal Code shall report the fact of such treatment personally or by the
fastest means of communication to the nearest Philippine
Constabulary unit without delay: provided, that no fee shall be charged
for the transmission of such report thru government communication
facilities; and
2. The report called for in this Decree shall indicate when prac ticable the
name, age, address and nearest of kin of the patient; the nature and
probable cause of the injury; the approximate time and date when, and
• the place where the injury was sustained; time, date and nature of
treatment; and the physical diagnosis and/or disposition of the patient.
I do further order and decree that any violation of this Decree and/or the rules and
regulations which shall be promulgated by competent authorities in accordance
herewith, with malicious intent or gross negligence, shall suffer the penalty of
impritonment for not less than one year nor more than (3) years and/or a fine of not
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 253
less than 1,000 nor more than 3,000 pesos, as a military tribunal may direct.
In addition, the government license or permit of the attend ing physician to
practice his profession shall be cancelled by the Civil Service Commission after
the sentence imposed by the military tribunal become final and executory.
The Secretary of Health and the Secretary of National Defense shall
promulgate the necessary rules and regulations to carry out the purpose of this
Decree.
Done in the City of Manila, this 4th day of April, in the Year of Our Lord,
nineteen hundred and seventy-three.
(SGD) FERDINAND E. MARCOS
President
Republic of the Philippines
Slight Physical Injuries and Maltreatment:
Art. 266, Revised Penal Code:
The crime of slight physical injuries shall be punished:
1. By arresto menor when the offender has inflicted physical injuries which shall
incapacitate the offended party for labor from one to nine days, or shall
require medical attendance during the same period;
2. By arresto menor or a fine not exceeding 200 pesos and censure when
the offender has caused physical injuries which do not prevent the
offended party from engaging in his habitual work nor require medical
attendance;
3. By arresto menor in its minimum period or a fine not exceeding 50
pesos when the offender shall illtreat another by deed without causing any
injury.
Kinds of Slight Physical Injuries Punishable by the Code:
1. Physical injuries which incapacitate the victim for labor from one to
nine days, or require medical attendance for the same period.
This kind of slight physical injuries will require medical certification
as to the duration of medical attendance, or period of incapacity. In
case of divergency in the duration of medical attendance and
incapacity, the physician must always consider the best interest of the
victim in the determination of the period.
 2. Physical injuries which did not prevent the offended party from engaging a. Superficial — When the wound is just underneath the layers of the skin
in his or mucous membrane.
254 LEGAL MEDICINE habitual (1) Petechiae.
work or which did not require medical attendance. (2) Contusion.
(3) Hemotama.
If the victim merely suffered from small contusion or superficial abrasion
b. Deep.
which does not require medical attendance or incapacity, this falls in the
paragraph of slight physical injury. (1) Musculo-Skeletal Injuries.
2. Ill-treatment of another b y deed without causing any injury. (a) Sprain.
A slight slap on the face or holding tightly the arm of the victim which did ( b ) Dislocation.
not even develop redness of the skin may be a form of ill-treatment. (c) Fracture.
(d) Strain.
If there is no evidence to show actual injury, or incapacity for labor, or (f) Subluxation.
period of medical attendance, the accused can only be guilty of slight (2) Internal Hemorrhage
physical injuries (People v. Penesa, 81 Phil. 398; People v. Amarao et al., C.A.
(3) Cerebral Concussion.
36 O.G. 3462).
A tender slap on the face, holding the arm tightly, application of 2. Open Wound — There is a breach of continuity of the skin or mucous
pressure in some parts of the body, or mild blo w which show no sign of membrane.
physical violence may still be considered slight physical injuries or a. Abrasion.
maltreatment (3rd paragraph). b. In c is ed Wound.
c. S t a b Wo u n d .
Physical Injuries inflicted in a Tumultuous Affray: Art. d. Punctured.
252, Revised Penal Code: e. Lacerated.
When in a tumultuous affray as referred to in the preceding article, only
CLOSED WOUNDS:
serious physical injuries are inflicted upon the p articipants thereof and
the person responsible therefore cannot be identified, all tho se who ap p ear Petechiae:
This is a circumscribed extravasation of blood in the subcutaneous tissue or
to have used vio lence up o n the p er so n o f the offended party shall suffer underneath the mucous Membrane. The cause of passage of blood from the
the penalty next lower in degree than that provided for the physical injuries so capillaries may be due to the increase intra -capillary pressure or incr eas ed
inflicted. permeabilit y of the vess el. The hemorrhage may be small or pinhead sized
When the physical injuries inflicted are of a less serious nature than but several petechiae may coalesce to form a bigger hemorrhagic area.
the person responsible therefor e cannot be identified, all those who appear Mosquito or other insect bites may cause the formation of circumscribed
hemorrhages.
to have used any violence upon% the person of the of fended party shall be
punished by arresto from five to fifteen days. P et e chi a e is not a l wa ys a produ c t o f t r au ma. P et e chi al h e mo r rhage ma y
be a post -mortem finding in asphyxial death, coronary occlusion and blood
Elements of the Crime: diseases, It may also develop post -mortem in d e a t h b y h a n g i n g. T h e r e i s
a. T here is a t u mu l t uo us a f fr a y; g r a v i t a t i o n o f b l o o d i n t o t h e m o s t dependent part of the body which
b. Participant(s) suffered from serious physical injuries; eventually leads to the rupture of o ve r -di st end ed c api lla r ie s sp e ci all y s e en
c. The person(s) who inflicted such serious physical injuries cannot be a t th e l e gion o f the l e g.
identified; and
d. All those who appear to have used violence upon the person of the offended Contusion:
Contusion is the effusion of blood into the tissues underneath the skin on
party shall be penalized by arresto from five to fifteen days. account of the rupture of the blood vessels as a result of the application of blunt
force or violence.
TYPE OF WOUNDS (Medical Classification):
1. Closed Wound — There is no breach of continuity of the skin or mucous
membrane.

MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 255

256 LEGAL When
MEDICINE MEDICO-LEGAL ASPECTS OF
blunt force is applied, it momentarily compresses the blood vessels at the
pointINJURIES
PHYSICAL of contact, thereby
259temporarily forcing the blood out of the area and
setting up a fluid wave under pressure. When the pressure exceeds the
cohesive force of the cells forming the capillary, arteriole, or venule wall, the
vessel ruptures.
Inasmuch as it used to take more time for the blood to get ou t of the blood
vessels, contusion does not immediately develop after the application of force.
It may develop after a lapse of minutes or even hours after the application
of force. The variation depends on the part of the body injured, tenderness
of the tissues affected, condition of the blood vessels involved, and natural
disease. Women are much more easily bruised than men while boxers are less
prone to suffer contusion inspite of heavy punishment.
Contusion of the right eyelid.
The size of the contusion is usually greater than the size of the object causing
it. The location of the contusion may not always indicate the site of the
application of force. For instance, a blow on the forehead may cause black-
eye or contusion around the tissues of the eye-ball, or a kick on the leg may
cause appearance of contusion at the region of the ankle on account of the
gravitation of the effusion., between muscles and fascia.
On the medico-legal viewpoint, a contusion as indicated by its external
pattern may correspond to the shape of the object or weapon used to
produce it; its extent may suggest the possible degree
a MEDICO-LEGAL ASPECTS
259 OF PHYSICAL INJURIES 257
of violence applied; and its distribution may indicate the character and
manner of injury as in manual strangulation around the neck. It may
infer grave complications and consequences on account of serious
injuries of the underlying tissues.
Age of Contusion:
The age of contusion can be appreciated from its color changes. 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 red blood corpuscles and liberation of hemoglobin.
The contusion is red sometimes purple soon after its complete
development.
In 4 to 5 days, the color changes to green.
In 7 to 10 days, it becomes yellow and gradually disappears on
the 14th or 15th day.
The ultimate disappearance of color varies from one to four
weeks depending upon the severity and constitution of the body.
The color changes start from the periphery inwards.
Distinction Between Contusion and Post-mortem Hypostasis
(Supra p. 133).
Factors Influencing the Degree and Extent of Contusion:
(a) General condition of the victim — Some healthy persons are easily
bruised.
(b) Part of the body affected — Bloody parts of the body produce larger
contusion, specially where subcutaneous tissue is loose. In areas of
the body with excessive fat, contusion easily develops, while parts
of the body with abundant fibrous tissue and good muscle tone,
bruising is less.
(c) Amount of force applied — Other factors being equal, the
greater the force applied the more effusion of blood will
develop.
(d) Disease — Contusion may develop with or without the application
of force. Examples: Purpura, Hemophilia, Aplastic anemia,
Whooping cough, even vicarious menstruation.
(e) Age — Children and old age persons tend to bruise more easily.
Children have loose and tender skin. Old people have less flesh
and the blood vessels are more fragile.
(f) Sex — Women, specially if obese, easily develop contusion.
Athletes, like boxers do not develop contusion easily.
(g) Application of heat and cold — If immediately after injury cold
compress is applied the production of contusion will be
258 LEGAL MEDICINE
minimized. After it has already developed, application of warm compress will
hasten its disappearance.
The distinction between ,ante-mortem and post-mortem contusions in an
undecomposed body is that in ante -mortem bruising, there is swelling, damage
to epithelium, extravasation, coagulation and infiltration of the tissues with
blood, while in post-mortem bruising there are no such findings.
Hematoma (Blood Cyst, Blood Tumor, "Bukol"):
Hematoma is the extravasation or effusion of blood in a newly formed
cavity underneath the skin. It usually develops when the blunt instrument
is applied in part of the body where bony tissue is superficially located, like
the head, chest and anterior aspect of the legs. The force applied causes the
subcutaneous tissue to rupture on account of the presence of a hard structure
underneath. The destruction of the subcutaneous tissue will lead to the
accumulation of blood causing it to elevate.
Distinction Between Contusion and Hematoma:
(a) In contusion the effused blood are accumulated in the inter stices of
the tissue underneath the skin, while in hematoma blood accumulates
in a newly formed cavity underneath the skin.
(b) In contusion, the skin shows no elevation and if ever ele vated, the
elevation is slight and is on account of inflammatory changes, while in
hematoma the skin is always elevated.
(c) In co ntusio n, p u nctur e o r asp ir atio n wit h s yr in ge o f the lesio n no
blood can be obtained, while in h emato ma, aspiration will show
presence of blood and subsequent depres sion 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 of a
muscular or ligamentous support of a joint. It is usually caused by 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 vio lence
or some existing pathology.
(a) Close or Simple Fracture Fracture wherein there is no break
— (f) Pulse is rapid, weak, faltering and scarcely perceptible to the fingers.
in continuity of the overlying skin or where the ex ternal air has no
point of access to the site of injury.
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 259
(b) Open or Compound Fracture - The fracture is complicated b y an
open wound caused by the broken bone which pro truded with other
tissues of the broken skin.
(c) Co mminu t ed Fra ctu re - Th e f ractu red bon e i s f ragment ed into
several pieces.
(d) Greenstick Fracture - A fracture wherein only one side of the bone
is broken while the other side is merely bent.
(e) Linear Fracture — When the fracture forms a crack commonly observed in
flat bones.
( f ) S p i r a l F r a c t u r e - Th e b r e a k i n t h e b o n e f o r m s a s p i r a l anner as
observed in long bones.
(g) Pathologic Fracture- Fracture caused by weakness of the bone due
to disease rather than violence.
(4 ) S t ra i n - Th e o ver -s t ret ch i n g, in s t ead o f an act u al t eari n g o r the
rupture of a muscle or ligament which may not be associated with the
joint.
(5) Subluxation- Incomplete or partial dislocation.
Internal Hemorrhage:
Rupture of blood vessel which may cause hemorrhage may be due to the
following:
(a) Traumatic intracranial hemorrhage.
(b) Rupture of parenchymatous organs.
(c) Laceration of other parts of the body.
Cerebral Concussion (Commotio Cerebri):
Cerebral concussion is the jarrin g or stunning of the brain cha ract erized
b y more or less complete suspension of its functions, as a resul t of
i nj ury t o the h ead , wh ich l eads to so me co mmoti on of the cerebral
substance.
Cerebral concussion is much more severe when the moving or mobile
head struck a fixed hard obj ect as compared when the head is fixed and
struck by a hard moving object.
Signs and Symptoms::
(a) Unconsciousness which is more eyeless complete.
(b) Muscles are relaxed and flaccid.
(c) Eyelids are closed and the conjunctivae are insensitive.
(d) Surface of the body is pale, cold and clammy.
(e) Respiration is slow, shallow and sighing.
(g) Temperature is subnormal.
260 LEGAL MEDICINE
(h) Sphincters are relaxed perhaps with unconscious evacuation of the
bowel and bladder.
(i) Reflexes are present but sluggish and in severe cases may be absent.
Loss of memory for events just before the injury (retrograde amnesia)
is a constant effect of cerebral concussion and is of medico-legal importance.
OPEN WOUNDS:
L 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 surface.
Whenever, there is forcible contact before friction occurs, there may be
contusion associated with abrasion. The shape varies and the raw surface
exudes blood and lymph which later dries and forms a protective covering
known as scab or crust.
Abrasions
Characteristics of Abrasion:
a. It develops at the precise point of impact of the force causing it.
b. Grossly or with the aid of a hand lens the injury consists of parallel
linear injuries which are in line with the direction of the rub or friction
causing it.
c. It may exhibit the pattern of the wounding material.
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 261
d. It is usually ignored by the attending physician for it does not require
medical treatment but it has far-reaching importance in the medico -
legal viewpoint.
(1) Abrasions caused by fingernails may indicate struggle or assault
and are usually located in the face, neck, forearms, and hands.
(2) Abrasions resulting from friction on rough surfaces, either
intentional or accidental are located on bony parts of the body
and usually associated with contusion or laceration.
(3) Nature of the abrasion may infer degree of pressure, nature of
the rubbing object and the direction of movement.
e. Unless there is a supervening infection, abrasion heals in a short time
and leaves no scar. If the whole thickness of the skin is involved,
healing may be delayed and occasionally with scar formation.
Forms of Abrasion:
a. Linear:
An abrasion which appears as a single line. It may be a straight
or curved line. Pinching with the fingernails will pro duce a linear
curved abrasion, while sliding the point of a needle on the skin will
produce a straight linear abrasion.
b. Multi-Linear:
An abrasion which develops when the skin is rubbed on a hard
rough object thereby producing several linear marks parallel to
one another. This is frequently seen among victims of vehicular
accidents.
c. Confluent:
An abrasion where the linear marks on the skin are almost
indistinguishable on account of the severity of friction and
roughness o the object.
d. Multiple:
Several abrasions of varying sizes and shapes may be found in
different parts of the body.
Types of Abrasions:
a. Scratch:
This is caused by a sharp-pointed object which slides across
the skin, like . a Pin, thorn or fingernail. The injury is always
parallel to the direction of slide. The commencement and
termination are well defined and the depth depends on the
pressure applied. The fingernail scratch may be broad at the
p o i n t o f c o m m e n c e m e n t a n d m a y t e r m i n a t e wi t h a t a i l i n g .
 Differential Diagnosis:
262 LEGAL MEDICINE MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 263
b. Graze: a. Dermal Erosion — A gradual breakdown or very shallow ulceration
These are usually caused by forcible contact with rough, hard objects of the skin which involves only the epidermis and heals withour
resulting to irregular removal of the skin surface. The nature of the injury scarring. It may appear in spots and with no previous history of
is dependent upon the degree of roughness of the object and the amount friction or sliding.
of pressure in the course of the sliding. The course will be indicated by a b. Marks of Insects and Fishes Bites — The skin injury is irregular with no vital
clean commencement and tags on the end.
reaction and usually found on angles of the mouth, margins of nose, eyelids
c. Impact or Imprint Abrasion (Patterned Abrasion, Stamping and forehead.
Abrasion, "Abrasion A La Signature"): c. Excoriation of the Skin by Excreta — This condition is only found among
Those whose pattern and location provides objective evidence to show infants and the skin lesion heals when the cause is removed. There is no
cause, nature of the wounding material or instrument and the manner of apparent history of rubbing trauma on the affected area.
assault or death. d. Pressure Sore — Usually found at the back at the region of bony prominence.
(1) Marks of the grid of the radiator may be imprinted on the .skin. His to ry of lon g st and in g il ln ess , b ed rid den
(2) Tire thread marks may be seen on the skin in vehicular accidents. condition although pressure sore may start as a previous area of abrasion.
(3) Muzzle imprint in contact fire gunshot wound of entrance.
Distinction Between Ante-mortem from Post-mortem Abrasions: Point of
(4) Teeth impression mark in skin bites.
Ante-mortem Post-mortem
d. Pressure or Friction Abrasion:
Distinction Abrasion Abrasion
Abrasion caused by pressure accompanied by movement usually
Color Reddish -bronze , in appear Yellowish and translu -
observed in hanging or strangulation. The spiral strands:' of the rope may
;

ance due to slight exu - cent in appearance.

be reflected on the skin of the neck. The lesion may dry up and assume
dation of blood.
a papyraceous or parchment-like consistency
Location Any area . Generally occurs over
bony prominence, such as
elbow, and attributed to
rough handling of the cadaver.
Vital With intravital reaction Shows no vital reaction
and ma y s h o w remai n s o f and i s ch aract eri zed b y a
damaged epithelium. separation of the epider
mis from complete loss of
the former.
2: Incised Wound (Cut, Slash, Slice):
This is produced by a sharp-edged (cutting) or sharp-linear edge
of the instrument, like a knife, razor, bolo, edge of oyster shell; metal
sheet, glass, etc, It may be an impact cu)-'when there is forcible contact
of the cutting instrument with the body surface, or slice cut when cutting
injury is due to the pressure accompanied with movement of the instrument.
When the wounding instrument is a heavy cutting instrument, like axe,
big bolo, saber, the wound produced is called Chopped or

Abrasion in the form of tire marks in a victim of vehicular accident

 1 '

264 LEGAL MEDICINE

Hacked wound. The injury is quite severe, edges may or may not be MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 265
contused depending on the nature of the edge of the instrument used.
Characteristics of Incised Wound:
a. Edges are clean-cut and both extremities are sharp, except in areas
where the skin is loose or folded at the time of infliction.
b. The wound is straight and may be shelving if inflicted with the wounding
instrument applied with an acute angle to the surface of the body involved.
c. Usually the wound is shallow near the extremities and deeper at the
middle portion. However, this finding may be modified by the shape of
the wounding instrument and part of the body involved.
d. Because the blood vessels involved are clean-cut, profuse hemorrhage is
invariably a feature.
e. Gaping is usually present due to the retraction of the edges but its presence
and degree of retraction depends on the direction of the incised wound
with the line of cleavage (Langer's line).
f. If the incised wound is located in parts of the body covered with
clothes, the clothing itself will show clean -cut of its texture.
Multiple incised wounds (Homicidal).
g. In the absence of complication and/or when there is deeper involvement
present, healing is relatively fast and the scar may not or may develop Deep incised wound may cause clean-cut fracture of the bone,
conspicuously. severance of blood vessels and nerves or amputation. Paralysis may
develop on account of the severed nerve and profuse he morrhage
h. Incised wound caused by broken edge of glass may be irregular and may may result to death. Embolism or supervening infection may later
appear like a punctured or stab wound. Fragments of the glass may be develop.
removed from the incised wound. 'Examination with the aid of a Why a Person Suffers from Incised Wound:
magnifying lens is necessary to determine the presence and removal of
a. As a therapeutic procedure — Pyogenic abscess and cystic
particles of flakes of glasses in the wound.
conditions may be treated by incision.
Changes that occur in an Incised Wound: b. As a consequence of self-defense — The sharp-edged instrument may
After 12 hours — Edges are swollen; adherent with blood and be held by the victim in his attempt to avoid the offender to inflict
with leucocyte infiltration. more serious injuries on him.
After 24 hours — Proliferation of the vascular endothelium c. Masochist may self-inflict incised wound as a means of sexual
and connective-tissue cells. gratification.
d. Addicts and mental patients may suffer from incised wound
After 36-48 hours — Capillary network complete; fibrolasts running at irrationally.
right angles to the vessels. Incised Wounds may be Suicidal,4micidal or Accidental:
After 3-5 days — Vessels show thickening and obliteration. a. Suicidal 7 Located in peculiar parts of the body, like the neck, flexor
(From: Gradwohl's Legal Medicine by F.E. Camps ed., 3rd ed. p. 272). surfaces of the extremities (elbow, groin, knee), wrist, and
accessibly to the hand in inflicting the injury. The most common
instrument used is the barber's razor blade with an improvised
handle. There is usually superficial tentative cut (hesitation cuts)
and the direction varies with the location and the hand (left or right)
used in inflicting the injuries. The most
266 LEGAL MEDICINE MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 267

Previous May be present. Always absent.

common site of suicidal incised wounds are on the wrist with
histoy
involvement of the radial artery and the neck.
of self-
b. Homicidal — The incised wounds are deep, multiple and involve both destruc-
accessible and non-accessible parts of the body to the hands of the
tion
victim. Defense and other forms of wounds may be present. Clothings
are always involved. 3. Stab Wound:
c. Accidental — Multiple incised wound is commonly observed on the Stab wound is produced by the penetration of a sharp-pointed and
passengers and driver of vehicular accidents on account of the broken sharp edged instrument, like a knife, saber, dagger, scissors. It may involve
windshield and glass parts of windows. Stepping on oyster shell, broken the skin or mucous surface. If the sharp edge portion of the wounding
glasses, sharp edges of metal sheets are co mmon causes of incised instrument is the first to come in contact with the skin, the wound
wo und on the sole of the foot. Those associated in the use of kitchen produced is an incised wound, but if .the sharp-pointed portion first
knives in the preparation of food, carpenters and handicraft workers who come in contact, then the wound is a stab wound. As a general rule,
use sharp edged instruments are frequent victims of accidental incised like an incised wound, the edges are clean-cut, regular and distinct.
wounds. The surface length of a stab wound may reflect the width of the
Distinction Between Suicidal and Homicidal Cut-throat Suicidal wounding instrument. It may be smaller when the wound is not so deep
inasmuch as it is only caused by the penetration of the tapering portion
Homicidal
of the pointed instrument. It may be made wider if the withdrawal is not
Direction Oblique, from below left Usually horizon tal below on the same direction as when it was introduced or the stabbing is
ear, downwards, across the Adam's apple. accompanied by a slashing movement. In the latter case the presence
fr o n t n e c k j u s t a b o v e of an abrasion from the extremity of the skin defect is in line with
Adam's apple. direction of the slashing movement.
Severity Usually deep and may Usually deep and may
may only involve trachea cause involvement of the
carotid and sometimes the cartilage and bones.
eso p ha g u s i s i n vo l ved .
Superficial Usually present before Practically absent but
Cut the commencement of may rarely be present
deeper wound. whe n t he v ict i m s tr u g -
gled when attacked
Position Ma y b e si tt i n g f aci n g a U s u al l y vi ct i m l yi n g o n
of the mirror or standing bed or in other place.
body
Wounding Firmly grasped (Cadaveric Weapon is absent.
weapon spasm) or found lying
beside victim.
Blood Blood found in front part Blood found at the back
distri- of the body. Hand ge n o f t h e n e c k . Hands
bution erally smeared wit h c lea n.
blood.
Motive History of mental depres Absence of such history.
sion, domestic, financial Incised and stab wounds of the face and neck.
social problems, alcoholism
etc. may prove suicide.
268 LEGALMEDICINE
The extremities of stab wound may show the nature of the instrument
used. A double-bladed weapon may cause the production of both extremities
sharp. A single bladed instrument may produce as one of its extremities rounded
and contused. This distinction may not be clearly observed if the 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 a slit-like or gaping depends on the looseness of
the skin and the direction of the wound to the line of cleavage (Langer's line).
The depth may be influenced by the size and sharpness of the instrument,
area of the body involved, and the degree of force applied. Involvement of
the bones may cause clean-cut fracture on it. A portion of the wounding
instrument, usually the tapering part, may remain in the body. X-ray
examinations may be needed to reveal its location.
Hemorrhage is always the most serious consequence of a stab wound. This
is due to the severance of blood vessels or involvement of bloody organs.
Stab Wound(s) may be Suicidal, Homicidal or Accidental:
a. Suicidal — Evidences showing that the stab wound is suicidal:
Multiple stab wounds.
In the Description of a Stab Wound, the following must be
included:
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 269
a. Length of the skin defect The edges must be coaptated before the length
is measured. If the abrasion tailing is present in one of the extremities,
it must not be included in the measurement. The length of the tailing
must be mentioned separately. The tailing infers the direction of
withdrawal of the wounding weapon.
b. Condition of the extremities — A sharp extremity may infer the
sharpness of the edge of the instrument used. If both extre mities
are sharp, it may be inferred that a double-bladed weapon was used.
c. Condition of the edges — If the injury is due to one stabbing act,
the edges are regular and clean-cut. However if the wound is caused
by several stabbing acts (series of thrusts and withdrawal), the edges
may be serrated or zigzag in appearance.
d. Linear direction of the surface wound — It may be running
vertically, horizontally, or upward medially or laterally.
e. Location of the stab wound — Aside from mentioning the region
of body where it is located, its exact measurement to some
anatomical landmarks must be stated.
f. Direction of penetration — This must be tri-dimensional (backwards
or forwards, upwards or downwards, and med ially or laterally).
g. Depth of the penetration.
h. Tissue and organs involved.
(1) It is located over the vital parts of the body.
(2) It is usually solitary. If multiple, they are located on one
part of the body.
(3) If located on covered parts of the body, the clothings are not
involved.
(4) The stab wound is accessible to the band of the victim.
(5) The hand of the victim is smeared with blood.
(6) The wounding weapon is firmly grasped by the hand of the
victim (cadaveric spasm).
(7) If stabbing is accompanied with slashing movement, the wound
tailing abrasion is seen towards the hand inflicting the injury.
(8) A suicide note may be present.
(9) There is the presence of a motive for self-destruction.
270 LEGAL MEDICINE
 (10) No disturbance in the death scene, wounding instrument is found
near the victim.
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 there are more than one stab wound.
(4) There is a motive for the stabbing. If without motive, the offender
must be insane or under the influence of drugs.
(5) There is disturbance in the crime scene.
Stab
wound
with
intestinal herniation.
Medical evidences showing intent of the offender to kill the victim:
a. There are more than one stab wounds.
b. The stab wounds are located in different parts of the body or on parts
of the body where vital organs are located.
c. Stab wou nds a re deep.
d. Stab wound with serrated or zigzag borders infers alternative thrust and
withdrawal of the wounding weapon to increase internal damages.
e. Irregular or stellate shape skin defects may be due to changing direction of
the weapon with the portion of the instrument at the level of the skin as
the lever. In this way a greater area of involvement internally will be
realized.
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 271
Different measurement of the stab wounds may possibly be produced
by one weapon if it is tapering towards the sharp point. Withdrawal of the
instrument not on the same direction as when it was introduced may
increase the length of the skin defect.
A sharpened three-cornered file (tres-cantos) when used as a stabbing
weapon will produce three-cornered (extremities) skin defect.
The most common immediate cause of death is hemorrhage
particularly when located in the chest or abdomen.
Accidental stab wounds are quite rare and are usually caused by falling
against a projecting sharp object like broken pieces of glass or flattened
and pointed iron bars.
4. Punctured Wound:
Punctured wound is the result of a thrust of a sharp pointed
instrument. The external injury is quite small but the depth is to
a certain degree. It is commonly produced by an icepick, needle, nail,
spear, pointed stick, thorn, fang of animal and hook.
The nature of the external injury depends on the sharpness and
shape of the end of the wounding instrument. Contusion of the
edges may be present if the end is not so sharp. The opening may be
round, elliptical, diamond-shape or cruciate. An accurate cross-section
nature of the wounding object may well be appreciated when there is
involvement of flat hard parts of the body especially the skull.
External hemorrhage is quite limited although internal injuries may
be severe. However, direct involvement of blood vessels and bloody
organs may cause fatal consequence unless appropriate medical
intervention is applied.
The site of the external wound can be easily• sealed by the dried
blood, serum or clotted blood so that introduction of pathogenic
microorganism which does not require the presence of air in its
growth and multiplication may find the place favorable, and may
produce fatal consequences.
Punctured wound is usually accidental but in rare instances it may
be homicidal or suicidal.
Characteristics:
a. The opening on the skin is very small and may become un -
noticeable because of clotted blood and elasticity of skin.
The wound is much deeper than it is wide.
b. External hemorrhage is limited although internally it may be
severe.
272 LEGAL MEDICINE
c. Sealing of the external opening will be favorable for the growth and
multiplication of anaerobic microorganism like bacillus tetani.
Medical evidences that tend to show it is Homicidal:
a. It is multiple and usually located in different parts of the body. It
may however be found in certain areas of the body.
b. The wounds are deep.
c. There are defense wounds on the victim.
d: There is disturbance in the crime scene (sign of struggle). Proof
to show it is Suicidal:
a. Located in areas of the body where the vital organs are located.
b. Usually singular but may be multiple but located in one area of the
body.
c. Parts of the body involved is accessible to the hand of the victim.
d. Clothings usually is not involved.
e. Wounding is made by the weapon while the victim is in sitting or
standing position. There is bleeding towards the lower part of body
or clothing.
f. No disturbance of the crime scene.
g. Presence of suicide note.
h. Wounding instrument found near the body of the victim.
Punctured wound with puncturing instrument "loaded" with poison:
a. Poison dart — cyanide or nicotine.
b. Fish spines.
c. Dog bites with hydrophobia virus.
d. Injection of air and poison as a way of euthanasia.
5. Lacerated Wound (Tear, Rupture, Stretch "Putok"):
Lacerated wound is a tear of the skin and the underlying tissues due
to forcible contact with a blunt instrument. It may be pro
firearm, or other objects without sharp objects.
If the force applied to a tissue is greater than its cohesive force and
elasticity, the tissue tears and a laceration is produced.
Since the skin is composed of several types of tissues, namely
epidermis, connective tissue, fat, blood vessels, nerves, glandular cells,
etc. each having its own breaking point, the laceration will be irregular
and having strands of tissues bridging. The rupture of
MEDICOLEGAL ASPECTS OF PHYSICAL INJURIES
- 273.
continuity may only extend deeper to the stronger layer like that of
the galea aponeuritica in case of scalp injury.
Characteristics:
a. The shape and size of the injury do not correspond to the
wounding instrument.
b. The tear on the skin is rugged with extremities irregular and ill-
defined.
c. The injury developed is at the site where the blunt force is
applied.
d. The borders of the wound are contused and swollen.
e. It is usually developed on the areas of the body where the bone is
superficially located, like the scalp, malar region of the face, front part
of the leg, dorsum of the foot, etc.
f. Examination with the aid of the hand lens shows bridging tissue
joining the edges and hair bulbs intact.
g. Bleeding is not extensive because the blood vessels are not severed
evenly.
h. Healing process is delayed and has more tendency to develop scar.
Classification of Lacerated Wound;
a. Splitting caused by crushing of the skin between two hard objects.
This is best seen in laceration of the scalp caused by a hit of a blunt
instrument, cut eyebrow of boxer and laceration of the chin of
motorcyclist.
b. Overstretching of the skin. When pressure is applied on one side of the
bone, the skin over the area will be stretched up to a breaking point
to cause laceration and exposure of the fractured bone. In avulsion, the
edges of the remaining tissue is that of laceration.
c. Grinding compression — The weight and the grinding movement may
cause separation of the skin with the underling tissues.
butt of
d. T earin g This may be produced by a semi-shard-edged in-
strument which causes irregular edges on the wound, like
hatchet and choppers.
Lacerated wounds may involve deeper tissues like laceration of the
muscles and fracture of bones depending upon the degree of force
applied in causing it.
It may be homicidal or accidental but rarely it is suicidal. An
insane person may hit his head on a concrete wall but when loss of
consciousness develops he will not be able to continue further his act of
self-destruction.
274 LEGAL MEDICINE
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 275
Distinctions Between an Incised Wound and a Lacerated Wound:
Incised wound Lacerated Wound I. Mechanical stretching or dilatation -- The presence of a mechanical
Edges are clean-cut, regular Edges are roughly cut, irregular device on the edges to prevent coaptation will cause separation. The
and well-defined. and ill-defined presence of a canula in tracheostomy, drain (rubber or gauze) in an
There is no swelling or con- There is swelling and contusion incised abscess, or a retractor during a surgical operation are examples of
tusion around the incised around the lacerated wound this type of gaping.
wound. 2. Loss of tissue — Separation of the edges of a wound may be on account
Extremities of the wound are Extremities of the wound are of loss of tissue bridging them. The loss of tissue may be due to:
sharp or may be round or ill-defined and irregular a. Destruction by pressure, infection, cell lysis, burning or che mical
contused. reaction.
Examination by means of a Examination with a magnifying
magnifying lens shows that lens shows that the hair bulbs b. Avulsion or physical or mechanical stretching resulting to
the hair bulbs are cut. separation of a portion of the tissue.
Healing is faster. Healing is delayed. c. Trimming of the edges. Debridment of the skin which come in contact
with the bullet at the gunshot wound of entrance and the removal
Scar is linear or spindle-shaped. It is caused by a blunt instrument.
of necrotic material in an infected wound may cause separation of
It is caused by a sharp-edged
the edges.
instrument.
3. Retraction of the edges — Underneath the skin are dense networks of
GAPING OF WOUND: fibrous and elastic connective tissue fibers running on the same direction
The separation of the edges especially in deep wound may be due to the and forming a pattern more or less present in all persons. This pattern of
following: fiber arrangement is called cleavage direction or lines of cleavage of
the skin and their linear representation on' the skin is called Langer's line.
These lines of cleavage are different in different parts of the body.
If an incised wound or stab wound was inflicted wherein the long
axis of the wound is parallel or,on the same direction as the cleavage line
of the part of the body involved, the wound will appear narrow or slit-
like because the edges of the wound will not be subjected to the lateral
pull of the severed connective tissue fibers.
If the long axis of the wound is perpendicular to or with an angle
with the lines of cleavage, the tendency of the tlorders of the wo und
is to separate o n account of the retractio n of the severed fibers.
Practical Ways of Determining How Much of the Skin Surface is Involved
in an Injury or Disease:
The skin serves as a mechanical protection to the body. It is
punctuated with sensory nerve endings for pain, temperature and touch.
It also acts as a thereto-regulator, storage of water, excre tor of sweat
and also an organ. for absorption.
The determination of how much skin involvement is important in the
mode of treatment and prognosis. Such determination may
Avulsion of the skin at the forehead with exposure of the fractured skull and part of the brain.
276 LEGAL MEDICINE

Body surface
Line of cleavage
Langer’s line

278 LECAL MEDICINE

MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 277
 be significant in cases of burns, contusion and dermal manifes tation of
certain diseases.
In cases of burns in children and old age persons, involvement of more
than 70% of the body surface are almost invariably fatal.
In the estimation as to how much (by percentage) of the body surface is
involved, the rule of nine is used.
Body surface expressed as percentage using the rule of nine:
Whole of head and neck ............................... 9% 9%
Whole of one upper extremity .................... 9% 18%
Whole of front chest and abdomen ................ 18% 18%
Whole of posterior chest and abdomen ......... 18% 18%
Whole of one lower extremity (front) ........... 9% 18%
b. Causes of Hemorrhage:
Whole of one lower extremity (back) ........... 9% 18%
Pudental area .................................... 1% 1%
Total .......... 100%
Factors Responsible for the Severity of Wounds:
1. Hemorrhage:
a. Hemorrhage may influence the severity of wound by:
(1) Loss of blood incompatible with life:
Blood constitutes about 1/20 of the body weight of an adult. By
volume, an average size adult has 5 to 6 quarts of blood (one quart
is 946 cc.). A loss of one tenth of its volume may not cause any
significant clinical change. A loss of one quart may cause fainting
even if the subject is lying down. But a loss of 1/3 to 2/5 of the
circulating blood may result to irreversible, hypovolemic shock and
may be fatal.
The volume of blood lost may be related to the rate or space of
time a certain volume of blood has been shed. The blood loss may
be massive but if it occurred for a long period of time, the
hemopoietic organs may be able to replace it thereby preventing
the development of any untoward effects.
Males can stand more lost of blood than females. Hypertension
may cause excessive and rapid bleeding from an arterial wound.
Persons suffering from hemophilia and other clotting disorders
and those being treated by anti-
coagulants can cause prolonged bleeding.
(2) Hemorrhage may result in an increase in pressure in or on the
vital organs to affect the normal function:
Intracranial hemorrhage may cause compression of the vital
centers of the brain. Hemopericardium (pericardial
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 279
tamponade) may cause embarrassment of the contraction of the
heart. Hemorrhage into the chest cavity may cause diminution
of the respiratory output with subsequent anoxia.
(3) Hemorrhage may cause mechanical barriers to the function of
organs:
Hemorrhage into the tracheo-bronchial lumina can cause
asphyxia. Interstitial hemorrhage into the muscles may cause
disturbance in the contractility.
(1) Trauma — Destruction of the blood vessel wall or increase
permeability of its wall due to external force.
(2) Natural Causes:
(a) Common causes of hemorrhage due to natural causes:
i. Intra-cerebral hemorrhage (apoplexy):
The most common blood vessel involved is the
lenticulostraite branch of the middle cerebral artery
with subsequent bleeding into the basal ganglia and
adjacent structure.
ii. Spontaneous subarachnoid hemorrhage:
Usually due to rupture or perforation of a saccular
berry aneurysm, commonly located at the bifurcation
of one of the constituent vessels of the circle of Willis
or one of its major branches. This is usually a congenital
focal defect of the muscular layer with subsequent over
stretching and degeneration of the internal elastic layer of
the blood vessel wall.
iii. Rupture of the arteriosclerotic aneurysm of the aorta:
The weakening and thinning of the aortic wall may lead
to fusiform or saccular aneurysm usually located at the
abdominal portion.
iv. Rupture of esophageal varices in cases of cirrhosis of the
liver and bleeding of peptic ulcer of the stomach and
duodenum.
v. Pulmonary hemorrhage may be due to tuberculosis,
lung abscess, or bronchiectasis. The hemorrhage may be
profused to cause severe anemia or may be small to cause
asphyxia.
vi. Ruptured ectopic pregnancy.
280 LEGAL MEDICINE
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 281
vii. Spontaneous rupture of cavernous hemangioma or hepatoma.
Snake Venom Toxicity will Depend on:
viii. Rupture of the enlarged spleen (malaria, infectious
mononucleoSis, typhoid fever). (a) Potency of venom injected.
(Medico-legal Investigation of Death by Fischer, p. 102). (b) The amount of venom injected by the fang depends on the
2. Size of Injury: season of the year and the length of time the snake has
Burns affecting one-third of the body surface of the third degree type eaten. If a snake has just killed his prey, the toxic content
is usually fatal. Bigger wounds are more exposed to infection and other of its bite is smaller.
physical conditions of the surroundings. (c) Size of the patient.
3. Organs Involved: (d) The immediate treatment instituted.
Trauma on the vital organs of the body are always serious. Crushing Snake Venoms are of Two Principal Classes:
wounds of the heart, brain or lungs are almost fatal. (a) Neurotoxic — It primarily paralyzes the respiratory and
4. Shock: cardiac center of the brain. Absorption of the venom may
Shock may occur with or without violence. A slight blow on the cause nausea, vomiting, ascending paralysis, coma,
genitalia, slight burns in children or old persons, or slight violence on the convulsion, and cardiac and respiratory arrest.
head or neck may cause severe shock. However, violent traumas to healthy, (b) Hematoxic — Which affects particularly the blood. The
strong persons may not produce shock. manifestations are pain and swelling of the affected area,
5. Foreign Body or Substance Introduced into the Body: intravascular hemolysis, abdominal pain, nausea, vomiting,
Incision with an unsterilized scalpel may not be serious as the bite of a petechial hemorrhage on the gum, pulmonary and cardiac
venomous snake. A foreign substance or body may be toxic by itself or may edema.
act as a physical irritant. Emergency Treatment may be:
The Foreign Body or Substance may be: (a) Incision of the wound to promote more external hemorrhage
a. Bacterial: Tetanus Pathogenic to drain the venom.
microorganism (b) Tourniquette above the site of the wound.
b. Viral: (c) Placing ice on the bite site.
Hydrophobia (d) Sucking the wound to drain venom with the mouth.
Hepatitis (e) Administration of anti-snake venom serum.
c. Foreign body:
Bullet (2) Scorpion Venom- The venom of the scorpion has neurotoxic,
Glass fragments hemolytic and hemorrhagic effect. A scorpion sting produces
Shrapnel only one punctured wound on the center of a reddened area.
Gauze or rubber drain The main symptoms are pain, edema and reddening.
d. Chemical: Cyanide
(3) Coelenterate Sting (Jellyfish) — The tentacles penetrate into the
Nicotine
skin and cause explosion of the nematocyst and liberation of
e. Toxin the venom. The symptoms are extreme pain of the affected area,
(1) Snake Venom- Snake bite is characterized as two punctured urticarial rash, abdominal pain, dilated pupils, paleness and
wounds at the center of the reddened affected area. The venom is labored breathing.
injected through its fangs which is connected to the poison gland.
6. Absence of Medical or Surgical Intervention:
A wound may not be fatal but on account of the neglect or ig-
norance in its management, it may become serious and fatal.
282 LEGA L MEDICINE
FATAL EFFECT OF WOUNDS:
1. Wound may be Directly Fatal by Reason of:
a. Hemorrhage:
An incised wound at the lateral aspect of the neck involving the carotid
artery without surgical intervention is fatal due to hemorrhage. While
wounds in some areas of the body where big blood vessels are not present
and the retraction of tissues are strong, death will not be a direct
consequence due to hemorrhage in the absence of complication that may
set in.
b. Mechanical Injuries on the Vital Organs:
A blow on the head may not necessarily produce external lesions but
may produce severe meningeal hemorrhage producing compression of
the brain. A punctured wound of the heart, even though how small,
may produce death on account of the tamponade of the heart.
c. Shock:
This is the disturbance of the balance of fluid in the body capable of
producing delayed or immediate death.
2. Wound may be Indirectly Fatal by Reason of:
a. Secondary Hemorrhage Following Sepsis:
A wound 'because of its nature and location is not capable of producing
severe hemorrhage, but on account of infection that sets in, deeper tissues
are involved including big blood vessels thereby producing severe
hemorrhage.
b. Specific Infection:
Pathogenic microorganisms may develop and multiply in the wound
causing septicemia, bacteremia, or toxemia. Tetanus, gas gangrene infection
are common in open wounds.
c. Scarring Effect:
Chronic gonorrheal infection may cause stricture of the urethra.
Stricture of the esophagus may follow ingestion of irritant poison.
Keloid formation in burns may not only cause deformity but disturbance
of the normal respiration of locomotion.
d. Secondary Shock:
Nature of Death Due to Secondary Causes:
A person may have recovered from the immediate effects of the trauma or
violence, but may later die of its secondary effects or changes. •
These changes may be classified as follows:
1. Changes whose natural sequence are direct and obvious.
MEDICO-LEGAL ASPETS OF PHYSICAL INJURIES 283
Example: Septicemia, tetanus or complications arising from the wounds.
2. Changes producing separate pathological lesions which in turn proves to
be fatal.
Example: Operation performed on a patient to ligate bleeding vessel
inside the abdominal cavity with reasonable skill and with
due diligence but as a result of which peritonitis developed and
caused death of the patient.
3. Changes where a definite pathological condition was present before the
injury.
Example: A person suffering from tumor or cyst and was stabbed by
someone. The stab is not capable of producing death
ordinarily. The person may die of the pathological condition
and the accused is liable for his death.
4. Changes where a definite pathological condition of totally different nature
arises after the wounding and the consequential sequence is doubtful.
Example: Tuberculosis meningitis that develops following a blow on
the head.
IMPLICATIONS OF TRAUMA OR INJURY:
1. Shock:
Shock is the disturbance of fluid balance resulting to peri pheral
deficiency which is manifested by the decreased volume of blood,
reduced volume of flow, hemoconcentration and renal deficiency. It
is clinically characterized by severe depression of the nervous system.
Three major factors operate in the produc tion of shock and all are
likely to be associated together as the condition develops.
a. Injury to the receptive nervous system.
b. Anoxemia — Reduction of effective volume of oxygen carrying
capacity of the blood.
c. Endothelial damage, thus increasing capillary permeability.
Kinds of Shock:
a. Primary Shock:
This is caused by immediate nerve impulse set up at the injured
area which are conveyed to the central nervous system. The impulse
may also whelm the vital centers in the medulla thereby shock
develops within a short time due to vasomotor collapse. If the
reaction is not intense, the patient may live longer or ma y recover
completely from the effect of the shock.
284 LEGAL MEDICINE
 b. Delayed or Secondary Shock:
286 LEGAL MEDICINE
Patient shows signs of general collapse which develop sometime after the
infliction of injury. It is characterized by a low blood pressure, subnormal
temperature, cold clammy perspiration, muscular incoordination, rapid and
shallow respiration. The shock may be severe to produce death or the patient
may recover completely from its effects.
2. Hemorrhage:
Hemorrhage is the extravasation or loss of blood from the circulation
brought about by wounds in the cardio -vascular system. The degree and
nature of hemorrhage depends upon the size, kind and location of the blood
vessel cut.
Kinds of Hemorrhage:
a. Primary Hemorrhage:
It is the bleeding which occurs immediately after the traumatic injury
of the blood vessel.
b. Secondary Hemorrhage:
This occurs not immediately after the infliction o f the injury but
sometime thereafter on or near the injured area.
3. Infection:
Infection is the appearance, growth and development of microorganisms at
the site of injury:
How Injury or Trauma Acquires Infections:
a. From the instrument or substance which produces the injury.
b. From the organs involved in the trauma applied. A bullet wound may
involve the intestine and causes its contents to spill out in the peritoneal
cavity causing peritonitis.
c. As an indirect effect of the injury which creates a loca1 area of diminished
resistance causing the invasion and m u ltiplication of microorganisms.
d. Injury may depress the general vitality, especially among the aged and the
young children and makes the patient succumb to terminal disease.
e. Deliberate introduction of microorganisms at the site of injury.
A. Embolism:
This is a condition in which foreign matters are introduced in the blood stream
causing sudden block to the blood flow in the finer arterioles and capillaries.
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 285
MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 287
The Most Common Emboli in the Blood Stream are:
a. Eat Embolus:
(1) Causes of Fat Embolus:
(a) By injection of oily substance into the circulation. '
(b) By injury of the adipose tissue which forces fat into the
circulation.
b. Air Embolism:
(1) Causes of Air Embolism:
(a) Gaping incised wound of the jugular vein.
(b) Injection of soapsuds or air into pregnant uterus for the
purpose of tubal insuflation or criminal abortion.
(c) Injection of air into the urinary bladder for radiological study.
(d) Insuflation of the other non -potent tubes or hollow organs.
(e) Injection of air under pressure into the nasal sinus after
a therapeutic lavage.
HEALINGOFWOUNDS:
1. Power of the Human Tissue to Regenerate:
Regeneration is the replacement of destroyed tissue by newly formed
similar tissue. The more highly specialized the tissue, the less is the
capacity for regeneration. Capacity for regeneration decreases as age
increases. The state of nutrition of the individual affects the capacity of
regeneration.
The Following Regenerates Rapidly:
a. Connective tissues.
b. Blood forming tissues.
c. Surface epithelium of the skin.
Those Having No Power or Limited Capacity to Regenerate:
a. Highly specialized glandular epithelium.
b. Smooth muscles.
c. Neurons of the central nervous system.
Small clean-cut wound is covered with lymph in 36 hours.
The edges adhere in two days and the wound heals on the 7th day
leaving a linear scar.
Larger incised wound shows swelling of the edges 8 to 12 hours.
Blood-stained serum is present in 2 days which afterwards become
seropurulent on the 3rd day, lasting in state from 4 to 5 days. Small red
granulation forms in 12 to 15 days and the epithelium grows from the
edges. Scar develops later.
 In cases wherein a definite infection is present, the time of healing is
prevent closing of the wound. This can be remedied by
very indefinite, however, at the advent of antibiotic and sulfa drugs, healing is
excision or cautery.
somewhat accelerated.
The Time of Healing of Wounds is Dependent on the following:
a. Vascularity
b. Age of the Person
c. Degree of Rest or Immobilization
d. Nature of the Injury
2. Kinds of Healing of Wounds:
a, Healing by Primary (First) Intention:
T hi s t yp e o f hea li n g t a ke s p lac e wh e n t her e is mi ni mal tis sue lo s s,
mo re ap p ro ximatio n o f the ed ges and wi tho ut 'significant bacterial
contamination.
Histolo gically, within 24 hours follo wing injury, there is an acute
neutrophilic response, the epidermal layer thickened on account of the
mitotic activities of the basal cells. Scab will be formed on the surface on
account of the dehydration of the surface clot.
After three days, the neutrophils will be replaced by the macrophages
and fibroblasts will appear in the epithelial layer. Collagen fibers will bridge
the raw area and epithelial proliferation will then cover the raw area.
Newly formed capil laries sprout on all sides to form the vascular
Keloid formation after a severe acid burns.
network and collagen fibrils become abundant and differentiated
surface cells begin to proliferate to cover the expo sed area. (2) Keloid Formation —There is abnormal amount of collagen
Complete return of the area to its normal state may appear after a lapse formed in the connective tissue thus producing . a large
of one month with or without the formation of a scar. bulging tumorous scar, commonly mo wn as keloid. It has
been claimed to be hereditary.
b. Healing by Secondary Intention: (3) Stricture — This is due to the contraction of the fibrous
This takes place when the injury causes a more extensive loss of cells tissue of the scar formed.
and tissues. Ine vitably, there is more necrotic debris and exudate that
(4) Fistula or Sinus Formation — A fistula is a communication
has to be removed. Inflammatory reaction is more intense as compared
b etween an inner cavity and the o utside. Sinus is a tract
with healing by primary intention. Granulation tissue growth bears all the
of infection traversing the inner part of the body. Unless
responsibility for its cl o sure. Healing pro cess ma y resu lt to the
the causal facto r, usual l y infectio n o r fo reign b o d y is
prod uctio n o f a large scar and greater loss of skin appendages such as hair,
removed, the condition may remain for a long time.
sweat and sebaceous glands, and slower reparative process. *
,
c. Aberrated Healing Process:
In some instances healing process deviates from the normal way on a
normal-individual. Healing may result to:
(1) Formation of Exuberant Granulation or "Proud Flesh" — Excessive
amount of granulation tissue may protrude and

CHAPTER X
MEDICO-LEGAL INVESTIGATION OF WOUNDS:
The following rules must always be observed by the physician in the
examination of wounds:
1. All injuries must be described, however small for it may be important later.
2. The description of the wounds must be comprehensive, and if possible a
sketch or photograph must be taken.
3. The examination must not be influenced by 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 the place where the crime was committed.
b. Examination of the clothings, stains, cuts, hair and other foreign
bodies that can be found in the scene of the crime.
c. Investigation of those persons who may be the witnesses to the incident or
those who could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime
for purposes of preservation.
2. Examinations of the Wounded Body:
a. Examinations that are applicable to the living and dead victim:
(1) Age of the wound from the degree of healing.
(2) Determination of the weapon used in the commission of the offense.
(3) Reasons for the multiplicity of wounds in cases where there are more
than one wound.
(4) Determination whether the injury is accidental, suicidal or homicidal.
b. Examinations that are applicable only to the living:
(1) Determination whether the injury is dangerous to life.
(2) Determination whether the injury will produce permanent deformity.
(3) Determination whether the wound(s) produced shock.
288
MEDICO-LEGAL INVESTIGATION OF WOUNDS 289
Det er mi n at io n wh e t h er t he i nj u r y wi l l p ro d uc e c o mp li cation as a
consequence.
c. Examinations that are applicable to the dead victim:
(1) Determination whether the wound is ante-mortem or postmortem.
(2) Determination whether the wound is mortal or not.
(3) Determination whether death is accelerated by a disease or some
abnormal developments which are present at the time of the
infliction of the wound.
(4) Determination whether the wound was caused by accident, suicide
or homicide.
8. Examinations of the Wound:
The following must be included in the examinations of the wound.
The report made in connection with such examination must also include
in detail the following items:
a. Character of the Wound:
The description must first state the type of wound, e.g. abrasion,
contusion, hematoma, incised, lacerated, stab wound etc. It must
include the size, shape, nature of the edges, ex tremities and other
characteristic marks. The presence of contusion collar in case of gunshot
wound of entrance, scab formation in abrasion and other open wounds,
infection, surgical intervention, etc., must also be stated.
b. Location of the Wound:
The region of the body where the wound is situated must be stated. It
is advisable to measure the distance of the wound from some fixed
point of the body prominence to facilitate reconstruction. This is
important in determining the trajectory or course of the wounding
weapon inside the body.
c. Depth of the Wound:
The determination of the exact depth of the wound must not be
attempted in a living subject if in so doing it will pre judice the health
or life. Depth is measurable if the outer wound and the inner end is
fixed. No attempt must be made in measuring the stabbed wound of the
abdomen because of the movability of the abdominal wall.
Condition of the Surroundings:
The area surrounding the wo und must be examined. In gunshot
wound near or contact fire will produce burning or tattooing of the
surrounding skin. In suicidal incised wound,
290 LEGAL MEDICINE MEDICO-LEGAL INVESTIGATION OF WOUNDS 291
there may be superficial tentative cuts (hesitation cuts). La- the victim is markedly weakened. The vital reaction may als o
cerated wound may show contusion of the neighboring skin. indicate the time of infliction of the wound. Post-mortem wound s do
e. Extent of the Wound: not show any manifesting signs of vital reaction.
Extensive injury may show marked degree of force applied in the
production of the wound. In homicidal cut-throat cases, it is generally 3. Signs of Repair:
deeper than in cases of suicide. Homicidal wounds are extensive and Fibrin formation, growth or epithelium, scab or scar formation
numerous. conclusively show that the wound was inflicted during life. But
f. Direction of the Wound: the absence of signs of repair does not show that injury was
The direction of the wound is material in the determination of the inflicted after death. The tissue may not have been given ampl e time
relative position of the victim and the offender when such wound has to repair itself before death took place.
been inflicted. The direction of the incised wound of the anterior 4. Retraction of the Edges of the Wound:
aspect of the neck may differentiate whether it is homicidal or suicidal.
Owing to the vital reactions of the skin and contractility of the
g. Number of Wounds: muscular fibers, the edges of the wound inflicted during life
Several wounds found in different parts of the body are generally retract and cause of gaping. On the other hand, in the case of the
indicative of murder or homicide. wound inflicted after death, the edges do not gape and are closely
h. Conditions of the Locality: approximated to each other because the skin and the muscles
(1) Degree of hemorrhage. have lost their contractility.
(2) Evidence of struggle.
(3) Information as to the position of the body Distinctions between Ante-mortem and Post-mortem Wounds:
(4) Presence of letter or suicide note. Ante-mortem Wound Post-mortem Wound
(5) Condition of the weapon. 1. Hemorrhage more or less co - 1. Hemorrhage slight or
Determination Whether the Wounds were Inflicted During Life or After pious and generally arterial. none. at all and always
Death: venous.
In the determination whether the wounds were inflicted during life or 2. Marks of spouting of the edges 2. No spouting of blood.
after death, the following factors must be taken into consideration: from arteries.
3. Clotted blood. 3. Blood is not clotte d; if
1. Hemorrhage: at all, it is a soft clot.
As a general rule, hemorrhage is more profuse when the wound was 4. Deep staining of the edges 4. The edges and cellular
inflicted during the lifetime of the victim. In wounds in flicted after death, tissues and cellular tissues, are not de eply sta ined
the amount of bleeding is comparatively less if at all bleeding occurred. Which is not removed by The stain ing can be
This is due to the loss of tone of the blood vessels, the absence of heart re mo ved b y washing.
action and the post-mortem
clotting of blood inside the blood vessels. 5. The edges gape owing to the 5. The edges do not gape,
reactions of the skin and are a n d closely o t h e r ,
Violence inflicted on a living body may not show the formation of a unless the wound
bruise until after death. is caused within one
2. Signs of Inflammation: o r t w o hours after death
There may be swelling of the area surrounding the wound, effusion of
6. Inflammation and reparative 6. No inflammation or
lymph or pus and adhesion of the edges. Other vital reactions are present
reparative processes. processes.
whenever the wound was inflicted during life, although it may be less
pronounced when the resistance of (From: Medical Jurisprudence and Toxicology by N.J. Modi, 12th
ed,p. 237).
292 LEGAL MEDICINE
Determinations whether the wounds are homicidal, suicidal or accidental:
1. As to the Nature of the Wound Inflicted:
a. Abrasions:
Extensive abrasions on the body are always suggestive of accidental
death, especially in death due to traffic accident. IR suicidal death, abrasions
are rarely observed. In case of murder, abrasions are not common except
when the body is dragged on the ground. In homicide, abrasions may
commonly be observed especially when the victim offered some
degree of resistance to the attacker.
b. Contusion:
Contusion is rarely observed in suicidal death, except when the suicidal
act was done by jumping from a height. A person contemplating to
commit suicide will not choose a blunt instrument.
Contusion in accidental death may also be found in any portion of
the body. It is often due to a fall and due to a forcible contact with
some hard objects.
c. Incised Wounds:
Incised wounds are commonly observed in suicide and homicide.
The depth, location and other surrounding cir cumstances will
differentiate one from the other. Accidental cuts are frequent everyday
occurrences, but rarely as a cause of death.
Points to be Considered in the Determination as to whether the Wound is
Homicidal, Suicidal or Accidental:
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 underlying the commission of the crime and the like.
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. Sign.4 of Struggle:
Absence of signs of struggle is more in suicide, accident or murder.
Contusion or abrasion may indicate trauma due to fist, finger or
feet of the assailant.
MEDICO-LEGAL INVESTIGATION OF WOUNDS 293
Presence of hair or portion of the skin (epidermis) on the
nails of the assailant or deceased may be a clue in the determination
whether death is suicidal, homicidal or accidental
b. Number and Direction of Wounds:
Multiple wounds in concealed portions of the body are
generally indicative of homicide.
Single wound located in a position that the deceased could have
been conveniently inflicted is usually suicidal.
c. Direction of the Wound:
This is important in the case of cut-throat. It is generally
transverse in case of homicide while it is oblique in case of suicide.
d. Nature and Extent of the Wound:
Homicidal wounds may be brought about by any wounding
instrument. Suicidal wounds are frequent due to sharp instruments.
Accidental physical injuries may be of any kind.
e. State of the Clothings:
There, is usually no change in the condition of the clothings in
suicide case. In homicidal death, on account of the struggle which
took place before death, the clothings of the victim are in a
disorderly fashion.
Length of Time of Survival of the Victim After Infliction of the
Wound:
In the approximation of the length of survival of the victim after receipt
of the physical injury, the following factors must be taken into
consideration:
1. Degree of Healing:
The injured portion of the body undergoes certain chemical and
physical changes as a normal course \of repair. The capillaries are dilated
and edema develops at once. This is followed by the migration of the
white cells from the capillaries to the damaged area. Fibroblasts begin
to proliferate later with the formation of the granulation tissues.
Signs of repair of the wound appear in less than a day after the infliction
of injury. By the degree of granulation tissue formation and other
reparative changes, the age of the wound may be estimated.
2. Changes in the Body in Relation to the Time o death:
The length of time in the survival of the victim may be approximated
from the systematic changes in the body. \ The degree of
 294 LEGAL MEDICINE
wasting, anemia ; condition of the face, and bed sore formation may be a
basis as to how long a person survived.
3. Age of the Blood Stain:
The age of the blood stain may be determined from the physical color
changes of the skin, although it is not reliable. Al though there are some
basis for such method, it must not be relied upon because the physical
changes of the blood is modified by several external factors.
4. Testimony of the Witness When the Wound was Inflicted:
The actual witness may testify in court as to the exact time the wound was
inflicted by the offender. In this case, medical evidence as to the duration of
survival is merely corroborative.
Possible Instruments Used by the Assailant in Inflicting the Injuries: The
determination of the wounding instrument may be made from the nature of the
wound found in the body of the victim:
1. Contusion — produced by blunt instrument.
2. Incised wound — produced by sharp-edged instrument inflicted by hitting.
3. Lacerated wound -- produced by blunt instrument.
4. Punctured wound — produced by sharp-pointed instrument.
5. Abrasion — body surface is rubbed on a rough hard surface.
6. Gunshot wound — the diameter of the wound of entrance may approximate
the caliber of the wounding firearm.
Could the injury have been inflicted by a special weapon?
A physician cannot determine definitely that a certain specific weapon was
used in inflicting a wound. He can only state that it is possible that a certain
injury is possibly caused by a certain instrument presented. He must be
cautious in making a categoric statement.
Which of the injuries sustained by the victim caused death?
If there are several offenders who conspired with one another in the commission of
the offense, it is not necessary to determine who among them gave the fatal blow.
In the crime of conspiracy, the act of one is the act of all. But if there is n o
conspiracy in the commission of the offense it is necessary to determine who
among the offenders gave the fatal injury to the victim, because they are only
responsible for their individual acts.
In a case wherein the victim is a recipient of multiple injuries, the determination
as to which of the injuries caused death is dependent on the testimo n y o f the
p h ysician . Th is c an b e a sc erta ine d b y
MEDICO-LEGAL INVESTIGATION OF WOUNDS 295
examining individually the wounds and note which of them are involved in
the injury to some vital organs or large vessels, or led to secondary results
causing death. When two or more wounds involved the vital organs, it is
difficult to ascertain which among them caused the death. It is important to
determine the degree of the damage of eAch of the wound caused on the
vital organ.
Which of the wounds was inflicted first?
When there are several wounds present on the body of the victim, it is
important to determine which of them was inflicted first because it may be
necessary for the qualification of the offense committed. If the first wound
was inflicted in a treacherous way that the victim after receipt is incapable
of defense, then murder is committed, but if the fatal wound was inflicted
last, it is possible that the crime committed is only homicide.
In the determination as to which of the wounds present was inflicted
first, the following factors must be taken into consideration:
1. Relative position of the assailant and the victim when the first injury
was inflicted on the latter.
2. Trajectory or course of the wound inside the body of the victim.
3. Organs involved and degree of injury sustained by the victim.
4. Testimony of the witness.
5. Presence of defense wounds on the victim. If the victim tried to make a
defensive act during the initial attack, then the defense wounds must
have been inflicted first.,
Effect of Medical and Surgical Intervention on the Death:
If the death of the victim followed a surgical or medical intervention,
the offender will still be held responsible for the death of the victim if it
can be proven that death was inevitable and that even without the operation,
death is a normal and a direct consequence of the injuries sustained. It
must be shown that the physician treating the victim must be competent
and that in spite his exercise of care and diligence, still death was the final
outcome. A person committing a felony shall be responsible for whatever
will be the outcome of his felonious act. The wound inflicted by him
must be the direct and proximate cause of the death of the victim.
On the other hand, if the victim merely received minor wounds but
death resulted on account of the gross incompetence or negligence of the
physician, then the offender cannot be held responsible for the death. The
offender can only be made responsible for the physical injuries inflicted
on the victim and the physician must be made to answer for the death.
296 LEGAL MEDICINE
Effect of Negligence of the Injured Person on the Death:
If death occurred from complications arising from a simple in , jury owing
to the negligence of the injured person in its proper cat,' and treatment, the
offender is still held responsible for the dea th A person is not bound to
submit himself to medical treatment h the injuries received during the assault.
The fact that the victim would have lived had he received ap p ropriate
med ical attentio n, is immater ial. Hence, the refusal o f the deceased to be
operated does not relieve the offender of tilt, criminal liability for his death
(People v. Sto. Domingo, C.A.
G.R. No. 3783, May 1939).
But, if it could be proven that the negligence of the victim is deliberate
and that this intention is really the cause of death on himself, then the
offender cannot be held responsible for the death but only for the physical
injuries he had inflicted.
Power of Volitional Acts of the Victim after Receiving a Fatal Injury:
Sometimes it is necessary to determine whether a victim of a fatal wound is
still capable of speaking, walking or performing any other volitional acts. A
dying declaration may be presented by the prosecutor mentioning the accused
as the assailant; the offender may allege that the physical injuries inflicted by
him while the victim was inside his house and that he walked for some distance
where he fell, or that the victim after the fatal inj ury made an attempt to inflict
injuries to the accused which justified the latter to give another fatal blow. The
determination of the victim's capacity to perform voli tional acts rests upon the
medical witness.
As a general rule, severe injury of the brain and the cranial box usually
produces unconsciousness, but after a while, the victim may be capable of
performing volitional acts. The power to 'perform volitional acts is dependent
upon the areas of the brain i nvolved. Wounds of the big blood vessels, like
the carotid, jugular or even the aorta, do not prevent a person from exercising
voluntary acts or even from running a certain distance. Penetrating wound of
the heart is often considered to be instantaneously fatal but experience shows
that the victim may still be capable of loco motion. Rupture of the organs
is not always followed by death. The victim has for sometime still retains the
capacity to move and speak.
Extreme caution must be exercised by the physician in expressing his
opinion as to the limitation of powers possessed by the injured person to
perform acts of volition, locomotion, or speech subsequent to receipt of
extensive or fatal injury or wound.
MEDICO-LEGAL INVESTIGATION OF WOUNDS 297
Relative Position of the Victim and Assailant When Injury Was
1nflicted
In the determination of the relative position of the victim and the
assailant when the wound was inflicted, the following points must be
considered by the physician:
I .Location of the wound in the body of the victim.
2. \Direction of the wound.
3. Nature of the instrument used in inflicting the injury.
4. T e s t i mo n y o f wi t n e s s e s .
Extrinsic Evidences in Wounds:
1. Evidences from the Wounding Weapon:
a. Position of the Weapon:
The location and position. of the weapon at the scene of the
crime may afford stro ng evidence in the court. As a rule, in
cases of accidental or suicidal death, the wounding weapon is
found near the bod y o f the victim, b ut it is not unco mmo n to
find the victim at so me distance fro m the weapo n when the
victim is capable of walking. If the wo unding instrument is
firmly grasped by the victim, it is a strong presumption that it
is a suicidal case.
b. Blood on Weapon:
The weapon responsible for the production of wound may be
stained with blood. In some instances, the wounding weapon
does not show blood stains because, of the rapidity of the blow
and compression of the blood vessels. Even if the weapon is
stained with blood, it may be wiped out by the clothings in the
process of withdrawal.
The weapon must be subjected to a complete examination to
determine whether it is the one used in the commission of the
offense.
c. Hair and Other Substance on Weapon:
Hair or fibers of cotton, silk, linen and other fabrics may h
found adhering on the weapon. It must be preserved and sub -
mitted for comparison with the clothings or hair found at the
site of the injury on the victim's body.
2. Evidences in the Clothings of the Victim:
Injuries inflicted on the covered portions of the body may also
sho w injury o n the co vered apparel. In gunshot wound, the hole
in the clothings may be a factor in the determination of the site of
the wound of entrance. Occasionally, two or mo re tears or holes
298 LEGAL MEDICINE
are produced on the dress by a single wound. This can be explained by the
presence of folds on the clothings.
In gunshot wound, determination of the presence of gunpowder at the hole
of entrance may show distance. The presence clean -cut tear in the clothings
shows that the sharp-edged instrument was used. The presence of severe
tearing of the clothing shows struggle. The degree of the soaking of the
clothings with blood may depict the degree of hemorrhage.
3. Evidences Derived from the Examination of the Assailant:
The clothings of the assailant may be stained with blood from the
victim. Tear may be present on account of the struggle which existed at the
time of the commission of the offense. The finger nails may show foreign
substances coming from the body of the victim.
The offender may also show to a certain degree marks of vio lence.
Paraffin test o f the assailant's hands may be useful to determine whether
he fired the gun in case of shooting.
Determination of the degree of intoxication, mental condition, p hysical
po wer, etc. o f the o ffender may b e necessary in the solution of the crime.
4. Evidences Derived from the Scene of the Crime:
T h e c o n d i t i o n o f t h e s u r r o u n d i n g o b j e c t s , t h e a mo u n t o f
hemorrhage, the presence of identifying articles belonging to the victim or
assailant, the wounding instrument, all these must be observed or collected
by the investigator.
Chapter XI
PHYSICAL INJURIES IN THE DIFFERENT
PARTS OF THE BODY:
I . HEAD AND NECK INJURIES:
Inj uries o f the head must no t be underestimated . They must be
treated with extreme care. The absence of an external wound on the
head does not itself permit a conclusion th at there is no internal
damage. Contusion and hematoma of the scalp may only b e
appreciated during the post -mortem examination. The pre se nce o f
ha ir fur t her a u g me n ts t h e d i ffic ul t y o f ap p re cia ti n g head injuries.
The presence of bleeding from the ear, nostrils and mouth may be
associated with basal fracture. Fracture of the vault and other portions
of the cranial box may cause unconsciousness and this may be
mistaken for simple intoxication. It is preferable to have the patient
under careful, intelligent an d continuous observation for at least
twelve to twenty-four hours to avoid risk to the life o f the patient.
X-ray examinatio ns may b e useful in o rder to determine the
presence of fracture. However, it is not uncommon t hat no fracture
is ob served, and yet t he intracranial inj ury is quite severe.
Factors Influencing the Degree and Extent of Head Injuries:
a. Nature of the Wounding Agent:
Weapons with a small striking face usually produce a local ized
depressed fracture with laceration of the scalp. The degree of
injury depends upon the degree of violence applied, the
thickness o f the scalp struck and the weight o f the weapo n.
Violent contact with the wheel of a motor vehicle causes
fissure or comminuted fracture of the cranial box. There is
always an associated injury of the brain substance and lace ration
of the meninges.
Penetrating injuries of the skull like those caused by a dagger, a
nail or a bullet, may leave a clean-cut opening with the shape and
size of the wounding weapon. A glancing hit of a bullet may
cause a gutter-like depressed fracture of the vault of the skull.
299
300 LEGAL MEDICINE
b. Intensity of the Force:
 As a general rule, the intensity of force is proportional to the
degree of damage it will produce. However, in cases where the
striking face is small, the amount of force which produces the same
injury is smaller. This is, however, qualified by the part of the skull
involved. For example, less force is required to produce injury when
applied at the temple than when it is applied elsewhere in the exposed
surface of the skull.
Heavy agents may require less force to produce extensive damage
to the skull although the point of impact is wide.
c. Point of Impact:
There are areas in the cranium wherein if force is applied to them, the
injuries are extensive. Fractures of the vaults, either on the side or at the
back, usually causes a stellate comminution at the point of impact with
linear extensions to some other areas.
Basal fractures are often caused by transmitted force from some points of
impact.
d. Mobility of the Skull at the Time of the Application of Force: If the
head is mobile, unsupported and free, the principal effects on the
brain is due to the shearing movement imparted
to the brain. It may produce contusion, laceration or hemor rhage
without any fracture on the skull.
If the head is fixed and supported, as when the head is caught by the
wheel o f a vehicle, jarring movement o f the brain is absent but the
fracture is extensive. Usually the fracture forms a line from the point
of contact with the wheel up to the point
of support of the head. There may be co mplete separation of the
naso-facial mass from the rest of the skull.
-Head Injuries are Classified as to the Site of the Application of Force:
a. Direct or Coup Injuries:
These are injuries which occur at the site of the application
of force and will develop as a natural consequence of the force applied.
Direct Injuries may Result to:
(1) In compression of the head by the wheel of a vehicle.
(2) When the head strikes an object in motion, as bullets.
(3) When the head is in .motion and strikes an object, as in •
vehicular accidents.
b. Indirect Injuries:
These are injuries in the head which are not found at the site of the
application of force. The injury may be at the opposite, or
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 301
in some areas offering the least resistance, or in areas which have no relation
with the site of the impact.
(1) Contre Coup Injuries:
These are injuries which develop opposite the site of the
application of force. A blow on the occiput may produce
laceration or contusio n of the frontal lobe of the brain.
This is observed when the head is free and mobile.
(2) Remote Injuries:
Remote injuries are produced in cases where the force is applied
in some areas of the body which have no relation to the head. A
fall on the feet or buttocks may cause basal fracture of the skull.
(3) "Locus Minoris Resistencia":
The injury sustained in the head may not be at or op posite
the application of force but may be found in some areas of the
skull offering the least resistance. A blow on the head may
cause a linear fracture of the roof of the orbit on account of the
papyraceous nature of the bone.
c. Coup-contre-coup Injuries (Direct and Indirect Injuries):
The injuries may be at the site of impact and at the same t i me
fo u n d i n s o me o t h e r p a fts o f t h e h e a d wh i c h ma y b e o p p o s i t e
t h e s i t e o f ap p l ic a t io n o f fo rc e , o r e l s e wh e r e . A ha mmer b lo w
in t he fro ntal p o rtio n o f t he head ma y ca use depressed fracture
of the frontal bone and at the same time fracture of the roof of
the orbit and laceration of the posterior lobe of the cerebrum.
Wounds of the Scalp:
A wound of the scalp although small and negligible is always
potentially serious because:
a. It is difficult to prevent the spread of infection.
b. There is proximity of the scalp to the brain.
c. There is a free vascular connection between the structures inside and
outside the cranium.
d. It is frequently difficult to determine the extent of damage of the
skull.
Abrasion of the scalp is commonly unnoticed because of the
protective covering of the hair. Contusion may not be visible because
of the thick resistant scalp and may only be noticed on autopsy.
Hematoma easily develops in the scalp because the cranium is
located superficially and the subaponeurotic tissue is loose.
302 LEGAL MEDICINE
The most common lesion of the scalp is a lacerated wound. There may
or may not be involvement of the skull. Difficulty is some* times
experienced in differentiating a lacerated from an incised wound of
the scalp. With the aid of a hand lens, the laceration shows irregular
borders and hair bulbs are preserved. Laceration of the scalp may be
 due to the impact. of a blunt force or to the sharp edges of the fractured skull.
Incised wounds of the scalp in general involve the cranium.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 305
The force necessary may not be so strong as to produce a clean• cut
fracture of the cranium.
Fractures.of the Skull:
Fractures of the skull may or may not be associated with injury on
the scalp, but usually there is an accompanying injury inside the cranial
box. Meningeal vessels are so situated in the furrows of the cranium that
fracture of the cranium will always lead to laceration of the blood vessels.
a. Fissure Fractures:
Fissure or linear fracture involves the inner and outer table. It is
usually caused by the impact of a blunt object and may appear as a
radiating crack from the site of the aiSplication of force and may involve
the base of the cranial fossae.
b. Localized Depressed Fracture:
Localized depressed fracture is sothetimes called "Fracture a La
Signature". It invariably shows the nature of the instrument that causes
the fracture. The round face of the hammer may show a round
depressed 'fracture in the cranium.
c. Penetrating Injuries of the Skull:
Sharp-edged instrument produces clean-cut fracture of the skull. The
size and shape of the fracture may correspond to the shape of the
wounding instrument. A gunshot produces an oval, or round hole with
bevelling of the inner table at the wound of entrance. The blade of
the wounding weapon may be left inside without causing trouble but
complications like infection
ti
may later develop and may cause a fatal consequence.
d. Comminuted Fractures:
Comminution of the skull may develop as a result of a fissure
or a depressed fracture. The presence of comminuted fracture
is an indication of the severity of force applied or the use of a heavy
weapon.
Majority o f co mminuted fractures are caused b y motor
vehicle accidents. In a near shot with a firearm, there is usually
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 303
a radiating fissure fracture from the point of impact which forms a "spider
web" comminution of the cranium.
e.Pond or Indented Fracture: In the skull of infants wherein there is
undue elasticity, the
production of a pond or indented fracture is common. It may
be a result of a simple compression of the skull, as in a pingpong
ball. Fissure fracture is likely to develop around the periphery
of the dent.
f. Gutter Fractures: A tangential or glancing approach of a bullet
may cause the
production o f a furro w in the cranium. It may involve both
the o uter and inner tables. The furro w may cause injury o n
the blood vessels causing intracranial hemorrhage or laceration
of the brain.
g. Bursting Fractures: It is an extensive fracture running parallel
to the two points
of contact, if mechanical force is applied on one side of the
head, while it is pressed on the other side against a hard sub-
stance, such as a wall, while the individual is standing, or against
the hard ground or floor, when he is in a lying posture. In such
cases the fracture may extend transversely to the base of the
skull. The passage of the wheel of a heavy vehicle over the head
often causes a complete division of the skull into two parts.
T he d irectio n o f the b urst co rresp o nd to that in which t he
wheel passed over the head.
(From: A Handbook of Medical Jurisprudence & Toxicology
with State Medicine & Post-Mortem Techniques by C.C. Mallik, p.
206).
4' Intracranial Hemorrhages:
Intracranial hemorrhages may occur even in the absence of a
fracture. Hemorrhage may be present without trauma. The blood
vessels of the brain may be diseased and may rupture spontaneously.
a. Extradural or Epidural Hemorrhage (almost exclusively due to
trauma):
Extradural hemorrhage is caused by a fracture of the skull.
The fracture will cause laceration of the blood vessels which are
grooved at the inner table of the skull. The branches of the
meningeal vessels are usually involved, the most frequent of
which are the branches of the middle meningeal vessels. The re
laceration is co mmo nly unilateral except when the fractu
extends to the opposite side.
304 LEGAL MEDICINE
 Severe
extra-
dural

hemorrhage with compression of the brain

Extensive subdural hemorrhage
Hemorrhage at the region of the vault produces a discu shaped clot with
compresion of the brain substance and thi may cause neurologic disturbance.
If the patient lives fo sometime, there will be an organization of the clot an d
fibrous thickening of the dura.
Ageing Subdural Hematoma Munro-Merritt Method:
In the determination as to how long subdural hematoma existed,
A person suffering from extradural hemorrhage may corn plain of headache, the study of the structure of its membrane is made as a basis (Munro-
vomiting and drowsiness. The pupils may b dilated on the side of the hemorrhage.
Examination of th cerebro-spinal fluid shows absence of blood, unless it is coin 1st 2 4 hours — Merritt Method).
plicated with hemorrhage in other regions in the cranial cavity Deposit of fibrin at the margin of the clot with red blood cells
and leucocytes well preserved.
b. Subdural Hemorrhage: 24 — 36 hours —
Unlike extradural hemorrhage, subdural bleeding is essential ly venous or
capillary. It is the most common cause of cerebral compression. It may be a
consequence of fracture of the skull, 4 days Fib ro b la st fou nd a t th e jun c tio n o f th e dura mater and the
•
blood clot.
laceration of the brain, spontaneous rupture of the blood vessels on the surface
Definite histological evidence of 2 to 3 layers of cell
of the brain or laceration of the dura and me ningeal vessels. It usually comes
thickness neomembrane. The red blood cells have begun to
from the small blood vessels which cross the subdural space to the
4 to 5 days lose their sharp contour.
subarachnoidal area
Increasingly prominent membrane with ex-
Majority of subdural hemorrhages are traumatic in origin although a few tension of the fibroblasts into the underlying
may be due to a natural disease of the blood vessels of the brain. There are 8th day clot.
difficulties in ascertaining the cause and source of such hemorrhage. The membrane has become 12 — 14 cells in thickness. Pigment-
laden phagocytes are found.
11th day
Clot broken up into islands by the invasion of strands of
fibroblasts.

306 LEGALMEDICINE
— Membrane has formed on the undersurface of the clot and strands of
fibroblasts. Red blood cells have broken up. The outer layer of the
neomembrane is 1 /3 to 1/2 the thickness of the overlaying dura.
Neomembrane is about the thickness of the
o ve rlyin g d u ra . B lo od h as liq u ified. R ed blood
cells not clearly apparent.
1 to 3 months Progressive decrease in the number of nuclei
of the fibroblasts and progressive hyalinization of the
membrane. Large blood spaces ("sinusoidal vessels")
filled with red blood cells have become increasingly
prominent in the new-formed connective tissue.
6 to 12 months — Neomembrane has become thick and fibrous, blood has
disappeared leaving only a few scattered pigment-
laden phagocytes.
1 to 2 years The new-formed membrane is distinguishable
from the overlying dura only by the parallel
arrangements of the connective tissue fibers which have
become more or less completely hyalinized.
(Gradwohl's Legal Medicine by F.E. Camps ed., 3rd ed., p. 316).
c. Subarachnoidal Hemorrhage:
Subarachnoidal hemorrhage may be due to trauma or to spontaneous
rupture of blood vessels. Its causes may be sum marized as follows:
(1) It may be produced by severe lead injury especially in contre
coup kind.
(2) It may be due to ruptured cerebral aneurysm and is commonly seen
at the base of the brain.
(3) It may be an extension of the spontaneous hemorrhage of the brain
which extends to the subarachnoid space.
(4) In asphyxia there may be subarachnoidal hemorrhage in the form of
petechial hemorrhage.
d. Cerebral Hemorrhage:
Cerebral hemorrhage may be traumatic or spontaneous in origin.. If
a person develops rupture of a blood vessel and suddenly collapses and
falls on the ground producing a certain degree of head injury, it is quite
difficult to ascertain the exact origin of the hemorrhage. A careful
dissection of the brain
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 307
tissue involved is necessary to determine the presence of pathology of the
blood vessel.
Traumatic cerebral hemorrhage is usually due to laceration or contusion of
the brain in contre-coup injuries. Severe crushing of the skull in vehicular
accident cases may cause the sharp fractured edges of the bone to
lacerate the brain and produces severe cerebral hemorrhage. It may
involve the gray matter only but in severe cases the hemorrhage extends up
to the white matter.
Distinction between Cerebral Apoplexy and Post-traumatic Intraerebral
Hemorrhage:
In traumatic intracerebral hemorrhage the interval between the injury and
onset of "stroke" (symptoms) is usually a week or less.
In traumatic intracerebral hemorrhage, the injury to the head must be
sustained when the head is in motion and the hemorrhage is the result of
the coup-contre-coup mechanism.
The location of traumatic intracerebral hemorrhage is in the central white
matter of the frontal or temporo-occipital region. Cerebral apoplexy is usually
at the basal ganglia, a very uncommon site of traumatic intracerebral
hemorrhage.
History of hypertension prior to the "stroke" and evidence of degenerative
disease are present in cerebral apoplexy. There is a history of head trauma
in traumatic intracerebral hemorrhage.
(Gradwohl's Legal Medicine, 2nd ed. by F.E. Camps, p, 312).
Brain:
a. Laceration of the Brain:
Lacerations of the brain may be:
(1) Direct or Coup Laceration:
This is produced by the fracture of the skull. The edges of the
fractured bone lacerate the arachnoid and the underlying brain tissue. It
may occur any where in the brain but it usually follows the line of
fracture. The most frequent sites are the parietal and the frontal
lobes.
(2) Contre coup Laceration:
-
Contre-coup laceration occurs usually directly across the point of
impact and fracture. Contre-coup injuries occur only when the
head is free to move at the time of the impact. If the head is held
immovable the mechanism of contre-coup will not operate. A
frontal impact may pro-
 308 LEGAL MEDICINE
duce laceration of the cerebellum while an impact in the occipital
region may cause contre-coup laceration of the frontal. and temporal
lobes of the brain.
Brain laceration may lead to granulatio n tissue for mation and
ultimately to fibrosis in the absence of infection.
Histo-pathological changes following contusion and laceration of the cerebral
cortex:
Within 3 hours — Minimal alteration of the cellular elements at the margin of
the wound. Microglia may show slight swelling of the cytoplasm
of the dendrites. There is fracturing of the myelin sheath. Cortical
nerve cells may show pyknotic changes.
P y k n o t i c c e l l s b e c o m e m o r e a p p a r e n t a n d blood pigment is
6 to 12 hours found between cortical neurons. Glial cells look swollen
especially oligodendroglia in the white matter and perineuronal
satellite cells in the gray matter, as cerebral edema begins to
develop.
1 2 — 24 hours Co r tical ner ve fib er s sho w fairl y n u mero us end-bulbs and
early degeneration of the interrupted fibers. Microglia continue
to show early swelling of their processes. Pyknotic change and
pigmentary infiltration of the nerve cells are still present at the
margin of the contusion. Loss of Nissl substance may be
detected in larger nerve cells.
1 — 2 weeks Increase in the number of granular corpuscles in activity of
phagocytic action. Astrocytes are p l u m p a n d t h e n u c l e i a r e
v e r y p r o m i n e n t . Cerebral edema is well shown by the
spongy ap p ear a nce o f t h e wh i te ma t ter. Ner ve ce ll s in the
border zone may show fatty degeneration or cytoplasmic
vacuolation.
Scarr ing p rocess becomes fairly static. T he gliotic
1 month astrocytic scar shrinks and appears gray or brownish in color.
Blood vessels are thicke n e d , h y a l i n i z e d c o a t s o wi n g t o
i n c r e a s e d density of astrocytic end -process attached to
them.
(Gradwohl's Legal Medicine by F.E. Camps ed., 2nd ed., pp. 317 319).
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 309
II. Edemas of the Brain:
Edema of the brain which is usually the effect of trauma may be
localized or generalized.
(1) Localized Edema:
Localized edema is observed in deep brain lacerations. The
edematous area is soft, swollen, gelatinous and yellowish -red in
appearance. It is observe d in abscess and neoplasm.
(2) Generalized Edema:
This is usually associated with severe trauma of the head. The
brain has a swollen appearance, with flattening and b r o a d e n i n g
o f t h e co n v o l u t i o n s an d d i mi n u t i o n o f t h e sizes of the
ventricle. Microscopically, t here is an intracellular, p ericellular
and p erivascular accu mu latio n o f fluid.
E d e ma o f t h e b r a i n o f t h e g e n e r a l iz ed t yp e m a y a l s o be
observed in a prolonged convulsive seizure, a sudden death due
to tetanus antitoxin, an encephalitis, and in an excesssive
hydration,
c. Concussion of the Brain:
Concussion of the brain is a transitory period of unconscious ness
resulting from a blow on the head, unrelated to any injury to the brain
which is apparent to the unaided eye. The cause of cerebral concussion
is still undetermined. Some authorities consider it to be a rotational
injury as it will occur only when the head is free to move but not when
it is fixed.
The symptoms of concussion vary upon the degree of injury. In a
severe injury the patient may fall down and becomes unconscious.
There is flaccidity of the muscles and sphincters are relaxed. The face
is pale, pupils are dilated and insensible, skin is cold and clammy, the
pulse is rapid, the respiration is slow, irregular and sighin g and the
temperature is subnormal.
In cases of recovery, there is usually a retrograde amnesia of the
accident and even events before and after it. The patient may also
develop automatism and may perform criminal acts which may be
mistaken to be volitional or voluntary.
d. Compression of the Brain:
On account of the severe intracranial hemorrhage, depressed fracture
of the skull, or edema of the brain, compression of some vital areas
of the brain may lead to paralysis or loss of consciousness. Natural
diseases, like newgrowth, abscess and hydrocephalus may also cause
compression of the brain.
310 LEGAL MEDICINE
I n t ra u ma t i c c o mp r e s s i o n , t h e s y mp t o ms d o n o t a p p e a r immediately
after the injury. The symptoms depend upon the area of the brain involved
but signs of increased intracranial pr essure are always p resent. Vo miting,
head ache, irregular b r e a t h i n g , i n c o n t i n e n c e o f u r i n a t i o n a n d
d e fe c a t i o n , a n d paralysis are usually present. Recovery develops when the
cause i s c o mp l e t e l y r e mo v e d b u t u s u a l l y t h e p a t ie n t h a s l o s s o f
memory, epilepsy, paralysis, or insanity as a sequelae.
Medico-Legal Questions in Intracranial Injuries:
a. Is the origin of the intracranial hemorrhage due to trauma or disease?
Ex trad ur al o r ep id ur a l h e mo r r ha ge i s al wa ys ca u sed b y trauma. The
blood vessels causing the hemorrhage which are grooved at the inner table
of the skull are usually lacerated by the fractured skull.
Subdural hemorrhage is, as a rule, traumatic in origin bu t it may also be
caused by some diseased condition of the blood vessels or by a local
inflammatory process.
Subarachnoidal hemorrhages are usually spontaneous and are usually
caused by ruptured aneurysm or sclerotic vessels at the circle of the Willis.
Hemorrhage in the brain substance is usually spontaneous and usually
involves the deep tissues of the brain, pons and cerebellum. Age, blood
pressure, chronic alcoholism, kidney disease must be taken into account to
determine whether it is traumatic or spontaneous in origin.
b. In cases of cerebral concussion, can the victim remember the incidents
before, during or after the accidents?
In mild form of cerebral concussion or after a psychological treat me nt,
the victi m ma y b e ab le to r ecall the incid ent. A p erso n may suffer fro m
severe co ncussio n and still r etain a good memory of the past. In severe
form o f concussio n, the victim may totally lose the recollection•of past
events.
c. Can the victim of head injuries still retain voluntary movement and
speech?
In •severe head injuries with comminuted fracture of the skull there is
immediate loss of consciousness such that voluntary movement and speech
are no longer possible. Depressed frac ture of the skull may cause also
immediate loss of consciousness that may develop sometime after the impact.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 311
T he capacity o f the victim to retain vo luntary mo vements and sp eech
d ep end s up o n the lo ss o f co nscio us nes s and t h e area of the brain
involved.
(1. Post-traumatic Automatism:
A p erso n wh ile und er the state o f p o st -trau mat ic auto ma tism
may commit a crime while in an unconscious state. He is co nsidered
to be exemp ted fro m criminal liability because he d id no t act wi t h
in te ll i ge nc e. T here c a n b e cr i mi n a l i n te nt i f a p e r s o n a c te d wi t h
v o l u n t a r i n e s s o r wi t h i n t e l l i g e n c e . A p erso n un d er the state o f
p o st-trau matic au to matis m acted involuntarily.
e. In gunshot wounds of the head, how can the point of entrance be
determined?
In some instances the gunshot wound on the head may not clearly
show characteristic findings of a wound of entrance. The examiner must
resort to the examination of the fracture of the skull. At the point of
entrance, the injury at the outer table is oval or round while there is
bevelling fracture at the inner table. The opposite is true at the point
of exit.
f. Post-traumatic Irritability:
The victim of a head injury may suffer post -traumatic irrit ab i l i t y
a n d ma y l e a d t o d o ac ts o f i mp u l s i v e v i o l e n c e. I f irritability
develops after a head injury, it is doubtful if it will be a valid
defense following the doctrine of acting under an irresistible
impulse. But, if genuine traumatic psychosis develops later, the
responsibility is evaluated in accordance with the ge neral
p rincip le o f ap praisal o f respo nsib ilit y o f insa nit y (Medical Trial
Technic, Mar. 59, p. 32).
Face:
Generally, wounds on the face heal relatively faster as compared with
wounds of the other parts of the body on account of its great vascularity.
Most often, injuries on the face are serious because they produce ugly
scars or other forms of deformity. Because of their proximity to and
the presence of free co mmunicatio n with the brain, facial injuries are
always a threat to life. As a whole, wo u nd s o n th e face may b e d ue to
a b lo w, vehicular accident, kick, sharp instrument, gunshot, or a blunt
weapon. Fractures of the facial bones, especially of the nasal bone and
mandible, are quite frequent.
a. Eye:
Contusion of the soft tissue about the eyes is sub-conjunctival.
Hemorrhage is frequently observed in a fist blow. Fracture

312 LEGAL MEDICINE
of the base of the anterior cranial fossa may also produce con tusion of the
eyelids, and this may be distinguished from con tusion due to a blow by the
absence of swelling and skin injuries in the former.
The eye may be lacerated by a blunt weapon or by a piece of stone. Acute
inflammatory changes usually occur with injury of the cornea, iris and
lens and may require total enucleation of the eyeball. Penetrating wounds
due to sharp instruments or bullets may cause meningitis or total blindness.
b. Nose:
Fracture of the nasal bone is a common sequelae of fist blows, and may
cause severe epistaxis and facial deformity. The nose may be bitten in a
quarrel, cut with a sharp -edge instrument, and contused, abraded or
lacerated by a blow. In suicide, the muzzle of the death gun might be
placed in the nostril and may cause no visible wound of entrance.
Injuries of the nose are usually dangerous to life on account of the
extension of infection to the brain.
c. Ear:
A blow on the ear may produce a rupture of the tympanic membrane
leading to permanent or temporary deafness. Hemor rhage coming from the
ear may suggest fracture of the base of the middle cranial fossa. In a
quarrel, the pinna of the ear may be cut off or markedly lacerated or
contused by a strong blow.
The trauma in the ear may cause septic infection and may extend to
the brain and causes death.
d. Mouth:
Contusion, laceration and swelling of the lips are usually o b served
in a fi st b lo w, kic k o r b ite. I t ma y o r ma y no t b e a s s o c ia t ed wi t h
fr a c t u r e o f t h e te e t h o r in j u r y o f t h e g u m.
Fracture of the lower jaw is usually due to direct violence and the
most co mmo n site is at the region o f the insertio n of the canine and at
the region of the condyle. Fracture of the jaw is always associated with
laceration of the gums which may extend to the floor of the buccal cavity.
Occasio nall y a g un sho t wo u nd in s uicid al case is fo u nd inside the
mouth and investigators are usually at a loss in the examination and
location of the wound of entrance.
Infections following injury of the mouth may extend to the upper
respiratory system and cause edema or gangrene of the glottis.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 313
Neck:
Ab ra sio n s o f t he n ec k ma y b e p re s e nt i n ca s e s o f ma n u al
strangulation. Ligature marks are present in death by hanging or
strangulation by ligature. Incised wounds may be homicidal or
suicidal. Suicidal cut-throat wounds are usually diagonal while
homicidal wounds are usually horizontal. Incised and stab wounds of
the neck may involve the trachea and the big blood vessels and nerves
and in most cases, end fatally. Asp hyxia, pneumo nia, he mo rrhage
and sho ck are the co mm o n causes o f d eath fro m neck injuries.
Wounds of the esophagus are not common. They are usually
acco mpanied b y wo unds of the trachea and large blood vessels of
the neck. Severance of the recurrent laryngeal nerve causes aphonia.
Contusion or rupture of the muscles, severance of the nerves are
sometimes observed in severe trauma applied to the neck. For cib le
b lo w in the anterior po rtio n o f the neck ma y cause un -
consciousness or even death due to reflexed inhibitory action on the
vagus nerve.
Vertebral Column and Spinal Cord:
a. Fracture of the Vertebrae:
Fracture of the vertebrae is dangerous to life because of the
in v o l ve me n t o f t he sp i na l co rd . I nj ur y o f t he co rd d u e to
fracture of the upper four cervical vertebrae causes paralysis of the
phrenic nerve, while those due to fractures of the fifth cervi cal
vertebra to the first dorsal vertebrae may cause paralysis of all the
extremities. Injury of the cord at other levels may not c a u s e
i m m e d i a t e d ea t h b u t c o mp l i c a t i o n s l i k e h yp o s t a t i c pneumonia,
bed sores and other secondary infections may set in and cause
death.
The causes of the fracture of the spine may be:
(1) Direc t Vio lenc e:
T he fracture o f the sp ine ma y b e d ue to a blo w b y a heavy
instrument coming from the back, fall from a height, collision
with motor vehicles and hit of a projecting instrii ment.
(2) Indirect Violence:
Indirect violence may be due to a fall on the feet or
buttocks, forcible bending of the body as in wrestling, a blow
on the chin or forehead, forcible bending of the head towards the
sternum, and slight twist of the body if the person is suffering
from Pott's disease.
314 LEGAL MEDICINE
 Recovery from spinal fracture may cause deformity or paralysis of
certain areas of the body. Injury of the spine is usually associated with
considerable pain.
b. Concussion of the Spine:
Concussion or jarring of the spinal cord may occur even without any
visible signs of external injuries. A physician usually has much difficulty
making diagnosis of concussion of the spine.
The usual complaints are headache, restlessness, pain and tenderness
over the spine, loss of sexual power, irritability of the bladder, inability
to walk, weakness of the limbs, and derangement of the special senses.
Concussion of the spine may be sustained in a motor vehicle collision and
in a railway accident.
,s 2. INJURIES IN THE CHEST:
Injuries in the chest are important because vital organs are inside the chest
cavity, namely: the heart, lungs and the principal blood vessels.
Injuries to the Chest Wall:
The chest wall is easily contused by the application of moderate force on
account of the superficial location of the ribs. Lacerated wounds are rarely
observed as a direct effect of violence, but are observed when the fractured ends
of the ribs pierce the skin in severe crush injuries due to motor vehicle
accidents.
Stab wounds on the chest are quite common on account of its accessibility
when both the assailant and the victim are in a standing position. The
intercostal vessels may be involved, causing considerable hemorrhage. Stab
wounds df the chest, as a general rule, involve the lungs, heart and the big blood
vessels in the chest cavity.
Bullet wounds of the chest may be superficial or may involve the pleural
viscera. Hemorrhage, collapse of the lungs due to the removal of the negative
intrathoractic pressure and pneumonia may develop if the victim does not die
immediately.
Fracture of the ribs causes severe pain during each phase of respiration and
if complete, it may be associated with laceration of the varietal pleura or of the
skin. The lungs and the heart may also be lacerated when there is an inward
displacement of the fractured ends.
FraCture of .the Ribs may be Caused by: a.
Direct Violence:
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 315
The fracture of the ribs is at the site of the application of force as
in cases of blow, stab, or bullet wounds.
b. Indirect Violence:
The fracture of the ribs is not at the point of the application of force,
as in crush injuries in vehicular accidents, a pressure on the chest by heavy
objects, a fall of earth or pressure with the knee. Fracture of the ribs is
usually along the mid-axillary line or may run obliquely in the chest
depending upon the manner the force was applied.
Fracture of the ribs lacerates the parietal pleura and the sharp ends of the
ribs cause injury to the lungs, heart and big blood vessels. The laceration
of the skin may cause collapse of the lungs and the victim dies of
asphyxia.
The usual site of fracture of the sternum is the junction of the
manubrium and the gladiolus. The fracture is usually transverse and
most often associated with fracture of the ribs. It results from a
sudden impact of heavy, blunt object or compression of the chest due
to a fall or a vehicular accident. Fracture of the sternum may be
associated with laceration of the pericardium and injury to the heart.
Injuries to the Lungs:
Hemorrhage in the pleural cavity coming either from the intercostal vessels
or from the lung tissue itself may cause compression and collapse of the
lungs and the patient may die of respiratory embarrassment or anemia.
Contusion of the lungs may be caused by a blunt instrument with or
without fracture of the ribs, or by compression of the chest. The lungs
may be injured by a sharp-pointed instrument or by a bullet. Injury of the
lungs may cause bloody froth coming out of the mouth.
Severe traction exerted at the region of the hilus may tear the lungs at the
point of attachment. Death is usually due to a severe shock or a rapid
hemorrhage.
Application of a severe crushing or grinding force in the chest wall
causes extensive fracture of the ribs and may results to contusion
and crushing injury to the lungs. The laceration may not be so severe
but later the victim succumbs to lobar pneumonia.
Complications of Lung Injuries:
a. Hemorrhage — Injury to the lung may cause severe hemorrhage and
about 1,500 cc. of blood may be recovered free in the pleural
cavity.
316 LEGAL MEDICINE

b. Compression of the lungs — The hemorrhage or the compression of the chest
wall may cause limitation of the excursion of the lungs during respiration
and ultimately the victim dies of asphyxia.
c. Severe Pneumothorax — Laceration of the bronchi leads to the escape of air
into the pleural cavity and embarrasses the respiration.
d. Cerebral air embolism — Laceration of the lungs may also cause laceration of
the pulmonary veins and causes cerebral air embolism.
e. Hemoptysis The blood from the injured lungs may find its way to the
—
bronchial tubes to the trachea and be spilled out through the mouth. If
hemorrhage is severe, the blood may clot inside the bronchial tubes and
causes acute asphyxia.
f. Subcutaneous emphysema — Laceration of the parietal pleura and the lung
tissue may cause the escape of air which finds its way into the subcutaneous
tissue causing crepitation of the skin.
Injuries to the Heart:
The heart may fail and causes death due to an existing natural disease
independent of trauma. Coronary insufficiency, myocardial fibrosis, valvular
lesion or tamponade due to the rupture of the ventricle are common lesions.
Wounds of the heart are produced by sharp instruments, bullets or the sharp.
ends of the fractured ribs. Contusion of the heart is easily produced on slight
trauma on account of its vascularity. Wounds of the ventricle if small and
oblique are less dangerous than those of the auricle because of the thickness
of its wall. The right ventricle is the most common site of the wounds due
to external violence, because it is the most exposed part of the heart.
Foreign bodies like bullets, shrapnels, fragments of a shell may be embedded in
the myocardium without any cardiac embarrassment. The person may live for a
long time and may die of some other causes.
Tearing of the heart from its attachments may be due to violent compression
of the chest with the pressure forcing the organ downward and away from
the neck. The severe traction may caiise the laceration of the aorta.
Rupture of the heart is usually produced by a blunt instrument or by a
crushing injury due to vehicular accidents. The heart is commonly
ruptured at the right side towards the base. Death is due to severe
hemorrhage, cardiac tamponade or shock.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 317
Crushing injuries of the heart are due to compression of the chest
with the fractured fragments injuring the heart as in vehicular accidents,
violent dynamite blast, or crushing of the chest between hard object.
Wounds of the aorta and pulmonary vessels are rapidly fatal. Rupture
of the aorta may be traumatic or spontaneous. Spon taneous rupture
may be due to aneurysm. The cause of death is either the profuse
hemorrhage or cardiac tamponade.
Injuries of the Diaphragm:
Wounds of the diaphragm due to a sharp instrument and bullets are
caused by injuries either of the chest or abdomen. Their fatal effect is
not on the injury to the diaphragm but on the accompanying injuries
to the other organs. Any penetrating wound in the diaphragm may
cause a potent rent for diaphragmatic herniation.
Rupture of the diaphragm is due to a sudden increase of intraabdominal
pressure crushing injuries caused by vehicular accidents or traumatic
compression of the chest.
Death in diaphragmatic injuries may be due to shock, hemorrhage,
intestinal obstruction caused by herniation, or the accompanying injuries.
3. ABDOMINAL INJURIES:
Abdominal Wall:
The skin may remain unmarked inspite of extensive internal
injuries with bleeding and disruption of the internal organs. The areas
most vulnerable are the point of attachment of internal organs,
especially at the source of its blood supply and at the point where
blood vessels change direction.
The area in the middle superior half of the abdomen, forming a
triangle bounded by the ribs on the two sides and a line drawn
horizontally through the umbilicus forming its base, is vulnerable to
trauma applied from any direction. In this triangle are found several
blood vessels changing direction, particularly the celiac trunk, its
branches (the hepatic, splenic and gastric arteries) as well as the
accompanying veins. The loop of the duodenum, the ligament of Treitz
and the pancreas are in the retroperitoneal space, and the stomach and
transverse colon are in the triangle, located in the peritoneal cavity.
Compression or blow on the area may cause detachment, laceration,
stretch-stress, contusion of the organs (Legal Medicine 1980, Cyril H.
Wecht ed., p. 41).
318 LEGAL MEDICINE
Stomach:
Spontaneous rupture of the stomach may be observed in cases of gastric
ulcer or new growth. A blunt force applied at the upper portion of the abdomen
may cause bruising or even rupture, The pyloric end and the greater curvature
are the most frequent sites of a rupture.
Penetrating stab wounds of the stomach are dangerous to life on account
of a hemorrhage, infection and injury to the adjacent organs like the liver.
Tearing of the stomach is common when the person is run over by a motor
vehicle at the region of the abdomen.
Intestine:
Ulcer at the duodenum may rupture spontaneously. The same is true in
cases of tuberculous, amoebic, cancerous or typhoid ulcerations. Peritonitis
and hemorrhage are the common causes of death.
Traumatic rupture may be due to a blow, kick, fall or vehicular accident.
When force is applied to the front portion of the abdominal wall, the intestine
may be pressed between the vertebral column and the force applied, producing
either partial or complete severance or laceration. Its septic contents will
scatter in the abdominal cavity and cause generalized peritonitis.
Injuries caused by sharp instruments or by gunshots usu ally cause
multiple lesions in the intestine and may also involve other visceral organs.
The intestine may be involved in vehicular acci dents and on account of the
grinding force of the wheel, severe hemorrhage, laceration and herniation in
the abdominal wall are usually observed.
The mesentery may be contused, lacerated or crushed but in most cases
its involvement is secondary to lesion in the intestine.
Liver:
The liver is one of the most vulnerable organs in the abdominal cavity
because of its size, weight, location, friability, and fixed position. Injuries are
frequently met in cases of blow, kick, crush, fall or sometimes in sudden
contraction of the abdominal wall. The right lobe is more frequently
involved than the left owing to its size and exposed location. Rupture is
usually transversely or anteroposteriorly. On account of its extreme
vascularity, the victim usually dies of severe hemorrhage, shock and very rarely
of supervening infection. Sometimes recovery occurs after slight laceration but
occasionally, abscess develops.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 319
Stab and gunshot wounds of the abdomen may involve the liver. Severe
hemorrhage or shock usually causes the death. It may be lacerated by
the fractured ends of the lower ribs in crush injuries.
The gall bladder may be ruptured as a result of a kick, blow or crush
inj ur y. It ma y b e inj ured b y p enetrating weap o n s. Death is due to
hemorrhage and the effusion of bile into the perito neal cavity.
Spleen:
The spleen usually suffers traumatic rupture resulting from the i mp act
o f a fall o r b lo w a nd fro m t he crus hi ng a nd g rind ing effects of
wheels of motor vehicles. Although the organ is pro tected at its upper
portion by the ribs and also by the air -containing visceral organs, yet
on account of its superficiality and fragility, it is usually affected by
trauma. Congestion and diseased condition of the spleen, as in malaria,
typhoid, kala-zar, make it more easily susceptible to slight trauma.
Laceration of the spleen is more common at the region of the hilus
and the lesion may be longitudinal or transverse. Lesion on the convex
surface is also common especially when the force is applied to the left
flank. On account of the vascular natu re of the organ and its
proximity to the plexuses of nerves, the victim usually dies of severe
shock or hemorrhage.
Penetrating stab wounds of the spleen are common but most often
other visceral organs are also involved. Death is due to hemorrhage.
Kidney:
Traumatic injury of the kidney may be due to a blow at the lumbar
region somewhere at the region of the 12th rib. It may be ruptured at the
slightest violence when it is diseased as in cases of hydronephrosis,
pyelonephritis, tuberculosis, abscess or tumo r. The kidney may also
be ruptured when the individual is run over by a vehicle or severely
crushed from a fall.
Injury of the kidney is acco mpanied by perkenal hemato ma wh i c h
co n s is t s o f b lo o d a nd ur in e. D ea t h i s d ue to a se ver e he mo rrhage,
lo ss o f k id ne y functio ns a nd sho ck. Ab d o mi nal hemorrhage is
present only if there is injury to the peritoneum concomitant to the
lesions in the kidney.
The adrenals may be contused , crushed or lacerated by severe
violence. The right is more prone to injury of its vulnerable
location.
"Crush syndrome" -- These are secondary kidney changes in
crush injuries. Edema and anuria follow a crush. If death super-
 320 LEGAL MEDICINE
venes, the kidneys are found to be swollen, pale with mark degeneration of the
cells lining the tubules (Taylor's Principles & Practice of Medical
Jurisprudence by Simpson, 12th ed., Vol.
p. 332).
Pancreas:
The pancreas may be injured by a violent blow at the epigastric region. Death
may be due to hemorrhage, shock, or insulin insufficiency. If death does
not occur immediately, fat necrosis is observed in the abdominal cavity on
account of the leakage the lipolytic enzyme.
Spontaneous hemorrhage of the pancreas is frequently observed in the tropics.
Its exact cause is still a matter of medical research
4. PELVIC INJURIES:
Fracture of the pelvic bones, especially of the pubis, is common in vehicular
accidents and crush injuries. Separation of the symphysis may be observed
without any external sign of injury. The patient may show difficulty of
locomotion, and to a certain degree, damage to the urinary bladder.
Urinary Bladder:
The bladder may be involved in a blow, crush, or kick at the hypogastrium
especially when distended with Urine. Among parturient women, the
bladder may rupture in the course o delivery. It may also be involved in fractures
of the pubic bone Spontaneous rupture is rare when it is over-distended due to
urethal stricture, enlargement of the prostate, or tumor. Symptoms of rupture of
the bladder are pain, tenderness at the lower portion of the abdomen, bloody
urine, difficulty in urination and rigidity of the abdominal muscles. 'Death
may be due to shock or super-imposed infection.
Uterus:
A non-gravid uterus is rarely involved in pelvic injuries, but a gravid uterus is
likely to be ruptured in a blow, kick, or crush injuries. Spontaneous rupture of the
uterus is commonly observed among pregnant women due to the injudicious use
of drugs or abnormal presentation. Partial separation of the Placenta may be
spontaneous or due to trauma. Death is due to shock, hemorrhage, peritonitis or
septicemia.
Vagina
Laceration of the vagina may be due to a sexual act or a faulty instrumentation to
induce a criminal abortion. The vaginal wall
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 321
may be lacerated during parturition.
3 EXTREMITIES:
Physical injuries on both upper and lower extremities are usually
due to direct violence, crushing or some indirect force.
a. Direct violence will result in a contusion and when the force
applied is severe it may cause interstitial muscular hemorrhage and
fractures of the underlying bone. Direct violence may be due
to a fall, a vehicular accident, or a direct application of
force.
b. Indirect violence, such as twisting or pathological fracture of the
bone underneath, causes laceration of the muscles around with
marked hemorrhage. A patient may suffer deformity,
shortening of the extremity and shock.
c. Crushing injuries of the limb can result in severe soft tissue
trauma and are most commonly caused by vehicular accidents
or fall of heavy materials. These are usually accompanied by
marked swelling, comminution of the bone and extravasation
of the blood.
Contusions and abrasions are frequent lesions of the extremities.
Lacerated wounds are commonly observed in portion where the
bones are superficially located as in the anterior aspect of the leg.
Incised and punctured wounds of the hand are quite common on
account of its utility and movability.
Crushing injury of the extremities may cause laceration of the
blood vessels and nerves. Injury of the intima of the blood vessels
causes thrombus formation and in severe cases aneurysm may
develop. Extravasation of the blood into the muscles causes swelling
and pain.
Fracture of the bones may be due to a direct violence, an
indirect violence or a muscular action.
Injury of the extremities may cause shock, hemorrhage and
infection. The shock is principally due to the injury on the nerve,
hemorrhage and fracture of the boles. Infection may be severe
and may require amputation of the extremities.

Chapter XII
DEATH OR PHYSICAL INJURIES
CAUSED BY EXPLOSION
Explosion is the sudden release of potential energy producing a localized
increase in pressure.
Investigation of death or physical injuries that is produced by ex plosion must
be concerned in determining the following:
1. What exploded?
2. W ha t c a us ed i t to e xp lo d e ?
3. Ho w it p ro d u ced t he i nj ur y?
4. H o w w a s i t i n i t i a t e d ?
Classification of Explosion as to the Source of Energy:
1. Mechanical (Hydraulic) Explosion- This occurs when the pressure inside a
container exceeds its structural strength. Explosions of air pressure tanks for
cleaning or paint spray, water pressure tanks to establish water pressure,
and the air pumped kerosene burner are examples of mechanical
explosions. These explode when the pressures applied are in excess of the
strength of the containers. As the container disintegrates, there is a rapid
localized increase in pressure resulting in the characteristic explosive sound.
2. Electrical Explosion- When electricity arcs through the air, a phenomenon
that occurs when two objects of different electrical potential are brought close
to one another, a large amount of heat develops. This heat rapidly expands the
air in and around the arc which produces the popping sound of an arc.
Lightning though it occurs in a much complex form with extremely high
temperature, may be an example of an electrical explosion.
3. Nuclear Explosion- The release of a significant amount of energy by fusion
or fission and consequently with a significant increase of destructiveness.
Atomic Explosion- Atomic nuclei can be regarded as stored condensed
energy. The uncontrolled release of this energy constitutes atomic
explosion.
4. Chemical Explosion- Chemical explosion occurs when a chemical reaction
produces heat and gas at a rate faster than the surroundings can dissipate. At
the start of the reaction the initial heat or gas
DEATH OF PHYSICAL INJURIES CAUSED BY EXPLOSION 323
pressure increases the rate of reaction, which progresses at a faster rate
until the explosion results.
Types of Chemical Explosion:
a. Diffused Reactant Explosion — This is caused b y the mixture of gas
and ai r. If th e gas and air are mi xed in co rrect p ro portion, product
of heat and subsequent pressure is produced. Explos ion of diffu sed
react an ts mus t b e in it i ated b y fl ame, spark or sometimes heat.
Mixture of gases with other materials ma y cau s e p ro du ct i on of
f l ame. Th e mo s t co mmo n examp l e of dispersed gas explosion is in
the internal combustion engine.
b. Con den sed Rea ctant Exp los ion — Thi s ch emi cal exp losi on occurs
when large quantity of heat and gas is produced as a result of rapid
chemical reaction in a solid or liquid material. It has a point of origin
so that the most severe damage is closest to the source and the effects
diminish as the distance from the center increases. There is no need
of atmospheric oxygen and if oxygen is required in the reaction it is
incorporated into the explosive. Condensed reactant explosives may be
classified as:
(1) Low Order Explosive (Deflagrating Explosive) — Those which
rel y on burning and confinement to produce ex plosions. When
the reaction is confined, the built-up of heat and pressure causes the
reaction rate to increase rapidly to an explosion. Gunpowder is the best
known low order explosive. When sufficiently heated the nitrate
content is decomposed to nitrite and oxygen. The oxygen reacts
with sulfur and carbo n p rodu cin g su lfu r o xi de, su lfur d io xi de,
carbon mo no xi d e an d carb on di o xi d e in vari o u s
co mb i n at io n s.
(2) High Order Explosive - This is the kind that detonates.
Detonation is a chemical process which results in the extremel y
rapid decomposition of nitrogenous compounds. Releasing heat
and gas is its reaction by-product. It is the shock wave spreading
out of the explosion that causes the destructive effect of high
explosive. Dynamite is an example of a high order explosive.
(a) S tabl e High Order Exp los ive - Th is co mpoun d wil l not
detonate unless they are subjected to detonation. This
includes dynamite (nitroglycerin made stable by clay
absorption).
(b) Unstable High Order Explosive- Easily detonates from heat,
flame, spark or percussion. This includes trinitrob en zen e
(P i cri c aci d ), fu l mi n at e o f mercu r y, l ead , an t i mo n y o r
b i s mu t h an d n i t ro g l yc e ri n e (C l i n i cs i n
324 LEGAL MEDICINE
(Laboratory Medicine by V. Di Maio, Vol.3, No. 2, June 1983, pp. 309 -314)
Death of Physical Injuries due to detonation of high explosives may be due to the
following causes:
The destructive effects varies with the kind and amount of explosive used and
the location of the victim at the time of the explosion. The explosion i s accompanied
by blast, flame, and fragment primarily. The nature and the extent of the injuries
suffered by the victim may be:
(a) If the victim is in contact with the explosive, as when he is manipulating, carrying
or sitting on it at the time of the explosion, there is complete disruption or
fragmentation of the body. Pieces of the body may be found several meters away
from the site of explosion. Some parts of the body may be found scattered at a
certain distance from the site of the explosion.
Burns and other injuries brought about by dynamite explosion.
The explosion caused sudden increase of atmosphere pressure which is
immediately followed by a sudden fall. This compression -decompression effect
causes displacement, distortion and bursting effects on the body parts, especially
in the brain and abdominal visceral organs. Aside from these injuries, there is
rapid development of scattered foci or small
DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 325
hemorrhages mostly, in organs which easily change in shape and
which are rich in blood supply.
(b) If the victim is not so close to the site of explosion, the body though
badly injured may remain in one piece. Some parts may be
dismembered but may be recovered within a few meters. Certain
areas of the body may show severe injury, but the triad of punctate
bruises, abrasions and lacerations may be found distributed all
over the body. (All of these injuries have still the effect of the blast
wave with a diminishing intensity.)
(c) The peppering kind of injuries may be observed as the distance
from the site of explosion increases. The density ind severity
becomes less until it disappears. However, one o r mo re metallic
frag me nts travelli n g wit h mo d erate velocity may strike the vital
parts of the body and may cause death.
(d) Other effects of the blast wave:
i. The impact of the high pressured wave can knock down the
person.
ii. In the respiratory organ, the bronchus may be lacerated or the
mucosa of the trachea may develop petechial hemorrhages.
This effect is not due to the entry of the high pressured wave
along the trachea and bronchi but by its passing directly on the
body wall.
iii. The ear is the organ most vulnerable to the blast. Most person at
the vicinity of the explosion may suffer from slight reddening of
the tympanic membrane which signifies that the cochlea has
been damaged
(e) Burns from the flame or heated gas — The instantaneous or momentary
flame of high intensity during explosion may cause singeing of the
eyebrow, scalp hair and eyelashes. Clothings may also be burned.
Body surface in contact with the flame or exposed to the heated air
may develop burns, the degree of which depends upon the intensity
and duration of exposure.
(f) Asphyxia due to lack of oxygen — Explosion causes consumption of
oxygen in the surrounding atmosphere, thereby limiting the amo unt
available for human co nsump tion.
(g) Poisoning by inhalation of carbon monoxide, nitrous or nitric gases,
hydrogen sulfide, sulfur dioxide, or hydrocyanic gas — The by-products
of combustion may be protoplasmic poison or may cause death by
interfering with the
326 LEGAL MEDICINE DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 327
Fragments of the explosive materials and debris recovered may be rinsed with
normal transportation and utilization of air by the tissu e of the body. hot water so that water-soluble inorganic substances (nitrates and chlorates)
may be extracted. The materials may be rinsed with acetone inasmuch as most
(h) Direct injury by the flying missiles — The injury due to flying missiles is
explosives. are highly soluble to acetone. The extract is concentrated and
influenced by the proximity of the individual to the site of explosion,
analyzed.
velocity of the missiles, manner or approach of the missiles on the body
Color Spot Tests for Common Chemical Explosives:
surface involved and the subsequent complications arising from such
injuries. Substances Griess Diphenylamine Alcoholic KOH
The shrapnel wound may go much deeper or the foreign body may lodged Chlorate No color Blue No color
inside the body. The edges of the missiles may be irregular or smooth so Nitrate Pink to red Blue No color
that the lesion on the skin may appear like an incised wound. If lacerated,
Nitrocellulose Pink Blue-black No color
the surrounding tissues may be contused.
Nitroglycerin Pink to red Blue No color
The following explosives may cause shrapnel wound: PETN Pink to red Blue No color
Grenade — Rifle or hand.
RDX Pink to red Blue No color
Bomb — Demolition or incendiary.
Mines — Underground or submarine. TNT No color No color Red
Exploding missiles — Anti-aircraft Tetryl Pink to red Blue Red-violet
Griess Reagent:
(i) Injuries from the falling debris — If the explosion took place in a building the Solution 1 — Dissolve 1 mg. sulfanilic acid in 100 ml. of 30% acetic acid.
victim may be injured and buried under the rubbles. The victim may suffer Solution 2 — Dissolve 1 g. alpha-naphthylamine in 230 ml. of boiling distilled
from multiple injuries of whatever description or die of traumatic or crash water, cool.
asphyxia. Decant the colorless supernatant liquid and mix with 110 ml. of glacial
Identification of the Site of Explosion and Collection of Evidences: acetic acid. Add solutions 1 and 2 and a few milligrams of zinc dust to the
The site of explosion may be identified by the presence of a crater. The original suspect extract.
location of other objects located near the blast may be useful clues in the Diphenylamine Reagent:
determination of the site of explosion. Soil and other debris may be collected Solution 1 — Dissolve 1 g. diphenylamine in 100 ml. concentrated sulfuric
acid.
for laboratory examination.
Alcoholic KOH Reagent:
The entire area must be systematically searched for traces of the detonation
Solution 1 — Dissolve 10 g. of potassium hydroxide in 100 ml. of absolute
mechanism. All blown out materials must be tested for explosive residues. alcohol.
If the investigator arrived at the site immediately after the explo sion, he may be (Criminalistics by Richard Saferstein, p. 242).
able to smell the odor of the gas. One of the simplest way pf collecting gas samples
Other Tests on Extract:
for analysis is, to take a bottle full of water in the area where odor is the
1. Infra-red spectrophotometry.
strongest and pour the water out of the container..', The surrounding air will
immediately replace the water removed from the bottle. Then the bottle must 2. X-ray diffraction.
be tightly sealed and sent to the laboratory for examination. 3. Gas chromatographic analysis.
Scrapings from the debris and other materials at or near the site of the ATOMIC BOMB EXPLOSION:
explosion may be subjected to extensive stereoscopic and microscopic Atomic nuclei can be regarded as storage of highly condensed energy and
examination. Particles of unconsumed explosive may be recovered. that the uncontrolled release of this energy constitute an atomic explosion. The
explosion is caused by the fission of about 100 pounds of uranium and
liberates energy equal to that of a
328 LEGAL MEDICINE
million tons of TNT. It produces millions of pounds per square inch of
gas pressure, with heat comparable to the sun and light of more than 30
times as bright as the sun at noontime. After ex plosion, it produces a
luminous ball of fire containing radioactive fission products, which increases
upward in size and creates shock waves moving sidewards in all directions. The
fireball may have the diameter of 7,200 feet in ten seconds and in one minute
time it may reach a height of 4-1/2 miles.
Place of Atomic Explosion:
1. Aerial Explosion — The bomb is made to explode on the air.
2. Ground Explosion — Explosion is made when the bomb reaches the
ground.
3. Submarine Explosion -- Explosion takes place underneath the surface of
a body of water.
Rays Emitted by Radioactive Substances During Explosion:
1. Alpha Rays — Composed of positively charged helium, having a high
linear energy transfer and with a poor penetrating power that can be
stopped by a sheet of paper.
2. Beta Rays — Composed of positively or negatively charged electrons with a
higher penetrating power than the alpha rays but the ionizing power is much
less. The electrons are travelling at a very high velocity and in some cases
approaching the speed of light.
3. Gamma. Rays — Composed of short rays with high energy and greater
penetrating power and like neutrons it extends a significant distance and
causes much damage to the human body.
4. Neutron Rays — Uncharged and composed of highly penetrating particles
and basic element in nuclei of atoms.
Characteristics of Nuclear Bomb Explosion that Distinguishes it from
Conventional High Explosive Bomb Explosion:
1. It is many thousand times as powerful as a highly conventional. bomb
explosion and the effects of the blast are very prominent.
2. A large proportion of its energy is emitted as thermal radiation, causing
skin burns and it is capable of starting a fire at a con siderable distance.
3. The explosion emits a highly penetrating and harmful radiation, '"and the
substance vihich remains after the explosion continues to emit radiation over
a long period of time.
(Forensic Medicine by Tedeschi, Eckert & Tedeschi, Vol. 1, p. 633).
Effects of Atomic Explosion to the Human Body:
The effects of atomic explosion of the human body are inversely
proportional to the distance. One megaton of atomic bomb exploded
DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 329
in air can cause fire of up to a 10 miles radius. The pressure front of the
blast can be felt one mile away in 2 seconds time. The blast wave is of
sufficiently long duration which is accompanied by transient blast
winds causing damages to the people and the sur rounding structures.
Other effects of atomic explosion are the same as that of ordinary
chemical bomb explosion but of a much more severe intensity.
Aside from the immediate traumatic effects, the radiation emitted by the
radio-active substances can also have an effect which may be local or
general.
1. Gen e ra l Ef fec t s:
Massive dose causes generalized erythema, disorientation
followed by coma and death.
Lesser dose may-cause nausea, vomiting followed by prostration and
rapidly developing and persistent leukemia.
Later symptoms may develop in the form of rise of temperature,
ulceration of lymphoid, easy fatigability, oro -pharyngeal ulceration
and severe leukopenia.
2. Local Effects:
a. Individual Cells — It causes retardation of cell division, structural changes
in the chromosomes and cytoplasm, vacuolization, and with evidence
of maturation. There is loss of the supporting mesenchymal cells.
b. Skin — Epilation of the hair with the follicles remaining intact, sweat
glands lose their function, erector pili muscles not much affected. The
skin become edematous and later disquamated and ulcerated.
Radiation dermatitis is persistent, usually painful with patchy
keratitis and foci of ulceration. Hyperpigmentation or
depigmentation may later develop.
c. Bloofl Vessels — There is endothelial necrosis and localized
thrombosis. The blood vessels thicken because of the hyalinization
of the collagen. Some blood vessels are occluded with the loss of
the muscular layer.
•
d. Eye -- Cataract develops.
e. Genital Organ — In female it causes sterility, abortion or stillbirth. In
men, it also causes sterility without loss of sexual potency.
Factors Responsible for the Effects of Radiation:
1. Age — Children and old persons are more susceptible to radiation.
Dosage — Bigger dose of radiation will cause more damaging effects
on the body tissues.
330 LEGAL MEDICINE
 DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 331
3. Kind of Radiation — The biological damage is not always proportional to
the energy absorbed, but it depends on the kind of energy emitted. Gamma
and neutron radiations are most destructive (2) Liquids resulting from leakage, primary coolant water and fro m
4. Fractional Doses — A single dose may be lethal when administered o ther sub stances expo sed to neutro n flux rad io activity.
fractionally over a long interval of time. (3) Solids from inert dust particles that have absorbed radio isotopes
5. Sensitivity — Muscles and connective tissue are radioresistant while actively on the air.
dividing tissues like blood forming organs, intestinal epithelium are quite
radiosensitive.
Other Sources of Radiation:
1. Natural Source:
a. Cosmic Origin — Radiation from the sun or from outer space.
b. Terrestial Origin — Chiefly from radiothorium series of granite rocks.
2. Man-made Source:
a. Diagnostic X-ray Equipment:
The filament inside a vacuum tube is heated by a strong electric
current so that it will emit electrons. The electron is driven on an anode
target (Rhenium and molybdenum) which causes the development of
electromagnetic energy, the wave length and the ability to penetrate
depends on the kilovoltage applied. The higher the voltage the shorter is
the wave length and the more penetrating are the X-rays.
As the X-ray passes the tissues of the body, the degree of absorption
depends on the density. The bones absorb more X-ray than the air
containing tissues. Naturally the film behind receives a differential amount
of X-ray. The denser substance like the bone, will be represented by a
'lighter image while the less denser organs will have a darker image.
In a fluoroscope, the X-ray after passing the body goes to a screen and
the differential absorption of X-ray by the body is reflected in the
fluoroscopic screen (Legal Medicine by Tadeschi
p. 686).
b. Clinical nuclear pharmaceutical agents.
c. Therapeutic radiation apparatus.
d. Radiation sources used in industry, like nuclear power plant:
The problem of the use of nuclear power in generating plants is the
disposal of the radioactive waste which may be in the form of:
(1) Gases chiefly emitted from the vapor.

Chapter XIII
GUNSHOT WOUNDS
DEATH OR PHYSICAL INJURIES BROUGHT ABOUT BY
POWDERED PROPELLED SUBSTANCES
Death or physical injuries brought about by the p owder propelled
substances may be due to the following:
1: Firearm Shot — The injury is caused by the missile propelled by the
explosion of the gunpowder located in the cartridge shell and at the rear
of the missile. The direction of the movement of the missile is influenced
by the desire of the person firing the fire arm. The missile may be single as
in the case of a pistol or revolver or may be of multiple shots or pellets as
in the case of a shotgun. The cartridge shell is physically preserved after the
fire.
2. Detonation of high explosives, as in grenades, bombs and mine explosion.
Explosion of the gunpowder inside the metallic con tainer will cause
fragmentation of the container. Each fragment or shrapnel is moving with
certain velocity without any predeter mined direction.
I. FIREARM WOUND
Definition of Firearm:
1. Technical Definition:
A firearm is an instrument used for the propulsion of a projectile by the
expansive force of gases coming from the burning of gunpowder.
2. Legal Definition:
-
Section 877 Revised Administrative Code — "Firearm" defined:
"Firearm" or "arm", as herein used, includes rifles, muskets, shotguns,
revolvers, pistols, and all other deadly weapons from which a bullet, ball,
shot, shell, or other missile may be discharged b y mea n s o f g u np o wd er o r
o th er e xp lo s i ve s. T he te r m a lso includes air rifles except such as being
of small caliber and limited range are used as toys. The barrel of any
firearm shall be considered as a complete firearm for all purposes thereof.
Penal Provisions of Laws Relative to Firearm:
Section 2692, Revised Administrative Code:
332
GUNSHOT WOUNDS 333
Unlawful manufacture, dealing in acquisition, disposition, or
possession of firearms, or ammunitions there for, or instrument used
or intended to be used in the manufacture of firearms or ammunition:
Any person who manufactures, deals in, acquires, disposes, or
possesses any firearm, parts of firearms, or ammunition therefor, or
instrument or implement used or intended to be used in the manufacture
of ammunition in violation of any provision of sections eight hundred
seventy-seven to nine hundred and six, inclusive, of the code, as
amended, shall, upon conviction, be punished by imprisonm ent for a
period of not less than one year and one day nor more than five
years, or both such imprisonment and a fine of not less than one
thousand pesos nor more than five thousand pesos, in the discretion of
the court. If the article illegally possessed is a rifle, carbine, grease
gun, bazooka, machine gun, submachine gun, hand grenade, bomb,
artillery of any kind or ammunition exclusively intended for such
weapons, such period of imprisonment shall be not less than five years
nor more than ten years. A conviction under this section shall carry with
it the forfeiture of the prohibited article or articles by the Philippine
Government.
Section 2690, Revised Administrative Code:
Selling of firearms to unlicensed purchaser:
It shall be unlawful for any dealer in firearms or ammunition to
sell or deliver any firearms or ammunition or any part of a firearm
to a purchaser or other person until such purchaser or other person
shall have obtained the necessary license therefor. Any person
violating the provisions of this section, upon conviction in a court of
competent jurisdiction, shall be punished by a fine not exceeding two
thousand pesos, or by imprisonment not exceeding two years,
or both.
Section 2691, Revised Administrative Code:
Failure of personal representative of deceased licensee to surrender
firearm:
When a holder of any firearm license shall die or become subject
to legal disability and any of his relatives, or his legal represenative,
or any other person shall knowingly come into possession of any
firearm or ammunition covered by such license, such person, upon
failure to deliver the same to the Chief of Constabulary in Manila
or to the senior officers of Constabulary in the province, shall be
punished by a fine not exceeding five hundred pesos or by imprisonment
not exceeding six months, or both.
 GUNSHOT WOUNDS 335

334 LEGAL MEDICINE b. Rifle — Firearm which may be fired from the shoulder. Example:
Shotgun.
4. As to the Nature of the Magazine:
a. Cylindrical Revolving Magazine Firearm — The cartridge is
Art. 155, Revised Penal Code: located in a cylindrical magazine which rotates at the rear
portion of the barrel.
Alarms and Scandals: Example: Revolver.
The penalty of arresto menor or fine not exceeding 200 pesos shall be b. Vertical or Horizontal Magazine — The cartridge is held one
imposed upon: after another vertically or horizontally and also held in place
1. Any person who within any town or public place, shall discharge any by a spring side to side or end to end.
firearm, rocket, firecracker, or other explosive calculated to cause alarm
Example: Automatic Pistol.
or danger;
2. . . . . . . . . . . . . . . . . . . . Types of Small Firearms which are of Medico-legal Interest:
1. Revolver — A revolver is a firearm which has a. cylindrical ma gazine
Art. 254, Revised Penal Code:
situated at the rear of the barrel, capable or revolving motion and
Discharge of firearms: which can accommodate five or six cartridges; each of which is
Any person who shall shoot at another with any firearm shall suffer the housed in a separate chamber. After a shot, the circular magazine
penalty of prision correctional in its minimum and medium periods, unless the ro tates b y the co ck in g o f the ha mmer in a wa y that t he next
facts of the case are such that the act can be held to constitute frustrated or cartridge is brought in the proper position for firing. The usual
attempted parricide, murder, homicide or any other crime for which a muzzle velocity of a revolver is 600 feet per second.
higher penalty is prescribed by any of the articles of the code: Kinds of Revolver as to Construction or Mechanism:
Classification of Small Firearms: a. Revo lver with the barrel firmly fixed to the frame and the
revolving cylinder may swing out to the side for the purpose
Small firearms are those which propel projectile of less than on e inch
of loading or extraction of the spent shell.
in diameter.
b . Revolver with the barrel hinged to the frame and the revolver
1. As to Wounding Power:
cylinder may be broken to load by releasing the barrel latch.
a. Low Velocity Firearm — These are firearms with muzzle velocity of
not more than 1,400 feet per second. c. Revolver with barrel firmly fixed to the frame and the revolving
cylinder may be remo ved by taking out the cylinder pin o n
Example: Revolver.
which it rotates.
b. High Power Firearm — These are firearms with muzzle velocity of more
2. Automatic Pistol — This is a firing weapon in which the empty
than 1,400 feet per second. The usual muzzle velocity is 2,200 to 2,500
shell is ejected when the cartridge is fired and a new cartridge is
feet per second or more.
slipped into the breech auto matically as a result of the recoil.
Example: Military Rifle. The cartridge is contained in a vertical magazine which holds six
2. As to the Nature of the Bore: to seven cartridges. It is not automatic in action in the sense that
a. Smooth Bore Weapon — This firearm has the inside portion of the barrel a continuous pressure o n the trigger will not make the f irearm
that is perfectly smooth from the firing chamber to the muzzle. fire co ntinuously. It is more correct to call it a "self -loading
firearm." It has a usual muzzle velocity of 1,200 feet or more per
Example: Shotgun, second.
b. Rifled Bore Firearm — This is a firearm with the bore of the barrel
with a number of spiral lands and grooves which run p arallel wi th 3. Rifle — A rifle is a firearm with a long barrel and butt. It may be a
o ne ano ther, b ut t wisted sp ir ally fr o m b reech to muzzle. military rifle or a miniature rifle. A military rifle has a magazine and
volt action of various types. The miniature rifle is a single self-
Example: Military Rifle. loading weapon. A military rifle usually has a muzzle velocity
3. As to the Manner of Firing:
a. Pistol - Firearm which may be fired only by a single hand. Example:
Revolver
336 LEGAL MEDICINE
of 2,500 feet per second and a range of 3,000 feet. Unlike a revolver or
automatic .pistol which can be fired by a single hand, a rifle is fired from a shoulder.
4. Shotgun — A shotgun is a firearm whose projectile is a collection of lead pellets
which varies in sizes with the type of the cartridge applied.
A Weapon, In Order to Cause Injury -must have Two Principal Component Parts,
Namely:
1. The Cartridge or Ammunition — a complete unfired unit consisting of bullet,
primer, cartridge case and powder charge.
2. The Firearm — the instrument for the propulsion of a projectile by the expansive
force of gases from a burning gunpowder.
CARTRIDGESORAMMUNITION
The Principal Parts of a Cartridge or Ammunition are:
1. The cartridge case or shell.
2. Primer.
3. Powder or propellant.
4. Bullet or projectile.
1. Cartridge Case or Shell:
The cartridge case or shell is a cylindrical structure with a base which houses
the powder, the primer at the base and with the bullet attached at the tip. In
ordinary hand guns the cylindrical structure is made of brass while in shotguns it
is usually made of cardboard. The base is always made of metal. Inscription at
the base may show the manufacturer, the caliber and even the date it was
manufactured.
Depending upon the relationship of the diameter of the base with that of the
cylindrical portion, a cartridge may be classified as:
a. Cartridge With a Rim — The base of the cartridge has a diameter more than
the cylindrical portion. The rim is used to prevent cartridge from going
through the barrel. This is common among revolvers.
b. Rimless Cartridge — The base or head of the cartridge has the same diameter
as that of the cylindrical body. There is a groove cut between the base and the
cylindrical body for the extractor to hook into. This is usually found in self-
loading firearms.
c. Semi-rimless Cartridge — This looks like a rimless at first glance but actually
the rim does project very slightly above the line of the cylindrical part.
GUNSHOT WOUNDS 337
d. Belted Cartridge — The cartridges are attached in a series in a canvass
belt for successive fires.
2. Primer:
The primer compound is located and sealed at the cartridge base
covered by a small disc of soft metal, which is usually a lead-tin alloy known
as percussion cap or primer cap. The main function of the primer is the
transformation of mechanical energy by the hit of the firing pin on the
percussion cap to chemical energy by its rapid combustion. As the
firing pin hits the primer cap (percussion cap), the primer compound hits
the anvil which causes the generation of a flash which in turn ignites the
powder. The time of the primer activation is approximately 0.00001
second.
Although, there are variations in the chemical constituents of the
primer in the past, it is composed of a mixture of mercury fulminate,
stibnite (antimony sulfide), potassium chlorate and powdered glass.
Later, mercury fulminate is partially or completely replaced by lead
azide and lead stypnate together with potassium chlorate which are
replaced by barium nitrate to reduce the development of rust. Lead
stypnate is utilized as base, tetracene is sometimes added to control
sensitivity and barium nitrate acts as moderator and oxidizer. The most
common constituents of primer are lead, antimony and barium.
As to the location of the percussion cap at the base, cartridge may be:
a. Cartridge with Center Fire — The percussion cap is located at the
center of the base of the cartridge. This is the most com mon.
b. Cartridge with Rim Fire -- The primer is placed inside the rim of the
shell. This is common in 0.22 caliber firearms.
c. Firearm with Pin — The firing pin strikes a needle which is placed at
the rim of the shell. The needle will then press on the percussion cap
which is inside the cartridge. This type is obsolete and now rarely
found.
3. Gunpowder or Propellant:
The propellant is the primary propulsive force in a cartridge which
when exploded will cause the bullet to be driven forward towards the
gun muzzle.
There are Different Types of Powder Propellant Used:
a,--Black Powder — A, mixture of potassium nitrate (75%), sulfur (15%)
and charcoal (10%).
 GUNSHOTWOUNDS 339
338 LEGAL MEDICINE

Explosion of one grain of black powder (one grain= 0.065 gm.) will
produce 200 to 300 cc. of gas composed of carbon dioxide (50%),
carbon monoxide (10%), nitrogen (35%) , Hydrogen sulphide (3%) and
traces of methane and oxygen. The solid residues following its
combustion are pota-ssium sulphide, potassium carbonate together with
its original components.
b. Smoke Powder – It may be:
(1) Single base – When it contains either cellulose nitrate or
nitroglycerine.
(2) Double base- When the powder is composed of both cellulose nitrate
and nitroglycerine.
Explosion of one grain (one grain = 0.065 gm.) of smokeless powder
will cause the development of 800 to 900 cc. of gas consisting of carbon
dioxide, nitrogen, hydrogen with some unburnt powder in the form of
nitrate and cellulose nitrate which can be detected chemically.
c. Semi-smokeless Powder — This is a mixture of 80% of black and 20% of
the smokeless powder. Bullets lodged and extracted from a victim

Smokeless powder causes development of less flame and less powder
residue as compared with black powder.
There is more complete burning of gunpowder in smokeless as
compared with the black powder.
Inasmuch as the gas produced by combustion of smokeless powder is
three times more than the black powder, the muzzle velocity of bullets with
smokeless powder is also approximately three times greater than the bullets
using black-powder.
Smokeless powder granules are usually coated with graphite and
consequently form different shapes. They may appear as a ball, square,
cylinder, disc or flakes. Consequently when discharged from the
firearm after explosion they will cause individual shapes of tattooing.
The flake or disc shape powder may cause varying shapes of the tattoos
depending upon how the grain struck the skin. Ball powder may cause
small, hemorrhagic punctate marks. The cylindrical shape powder
grains may cause heavy tattooing with deposition of soot at 6 inches
range.
4. Bullet (Slug, Missile, Projectile):
It is the metallic object attached to the free end of the cylindrical tip
of the cartridge case, propelled by the expansive force of the propellant, and
responsible in the production of damages in the target. In some instances
bullets are not metallic but made
of rubber, plastic, or even paraffin, but their uses are primarily
confined to target practice.
Classification:
a. Shape of the free end:
(1) Conical — The free end of the bullet is tapering and pointed.
The purpose is to minimize the resistance offered by the Atmosphere,
to increasing its penetrating power and to minimize deflection
upon hitting the target.
(2) Hemispherical — The free end is dome-like and commonly
observed in short firearms.
(3) Wad-cutter (Square Nose) — The free end is flattened
commonly used in target practices.
(4) Hollow-point — There is a depression at the tip to expand or
"mushroom" at impact on hard object, to slow its speed in the
body so that more kinetic energy will be released thereby
increasing its shocking effect.
b. As to presence or absence of jacket:
(1) Naked Lead Bullet — Bullet without outer coating.
(2) Jacketed Bullet — Bullet with external coating usually
copper, nickel, steel or zinc. The purpose of the coating are to:
(a) To prevent fouling of the barrel;

340 LEGAL MEDICINE

 (b) To withstand deformity in automatic loading process and
(c) To prevent deformity when carried and exposed to rough GUNSHOT WOUNDS 341
handling.
A jacketed bullet may be:
i. Full Jacketed Bullet — the whole bullet up to the base is
enveloped with a metallic jacket.
ii. Semi-jacketed Bullet — The nose or free end is partly or fully
exposed while there is relatively thin but tough coating of
the base and the cylindrical portion. This is made to permit
expansion of the bullet when it hits hard objects. Semi-
jacketed bullets may be hollow-point.
The general rule is that soft-metal, round nose bullets
are fired from a revolver; full-jacketed bullets are fired from
a rifle and self-loading firearm; semi-jacketed bullets are
fired from an automatic (self-loading) firearm or rifle.
Special Bullets:
a. Armour Piercing Bullet — made of steel with copper coating (jacket).
b. Phosphorus Flare or Tracer Bullet — This consists of an aluminum tip
and is packed with incendiary (phosphorus) which burns during flight.
It is used to determine the direction of the fire. The speed of sound in
air is 1,087 feet per second or 331.3 meters per second.
c. Plastic Bullet — used for target practice.
d. Bullet with Plastic Sabot — The bullet together with the sabot travel
up to the bore. The bullet never comes in contact with the barrel and
therefore there will be no rifling marks imparted in the bullet • but on
the sabot. The front half of the sabot has six slits. As the sabot leaves
the barrel it offers resistance and the slit part of the sabot will fold
backward, causing resistance and falls away.
At three feet, the sabot and bullet are still in line. At 6
to 7 feet, they strike the target separately. The sabot
itself travels approximately 50 feet.
e. Bullet with Secondary Explosion — The bullet may leave the barrel
and upon reaching a certain distance it produces secondary explosion
and shrapnel splinters.
of gift Point Bullet — A bullet which is easily flattened upon in the
tat he target to increase the wounding effect.
342 LEGAL MEDICINE
 GUNSHOT WOUNDS 343
b. Number of Shots on Pressure on the Trigger:
344 LEGAL MEDICINE

FIREARM

For purposes of Medico-legal Investigation, the following Parts of a Firearm

(1)Single Shot Firearm — A pull or pressure on the trigger w cause only
are important:
one shot.
1. The trigger with the firing pin. Example: Revolver.
2. The barrel.
(2)Automatic Firearm — A continuous pressure on the trigger
Other a.
0
%)
Id
Parts of a Firearm: will cause a series of shots until the trigger pressure released.
L. O 411), /
Z Handle or Butt — The portion of the firearm used for Example: Machine gun.
handling it. It may house the magazine.
2. I Q \ e v Firing Chamber — The place where the cartridge is held
ui
Trigger pressure is the amount of force (pressure) on the trigg
necessary to fire a gun. Its determination is necessary in th
in lo e,"" position before the fire mechanism starts. assessment of whether the firing can possibly 134 accidental.
U. Im r \

ola&
3. Breechblock — The steel block "Hair trigger" is a vague term used when the firearm trigg
which •
closes the rear of the bore against the pressure is 1.0 lb. (pound) or less. It is intrinsically unsafe an should
force of the . . . 0 " charge. The face of this block which comes in
...." only be used under rigorously controlled situations becau of the
.../.1
contact with the base of the cartridge is known as the possibility of unintended or accidental fire.
breech-face, In general, the single action firearm varies from 3-1/2 to 10
0.
4. Trigger Guard. pounds and in double action, it varies from 6 pounds to as much as
6. Front and Rear Sight. 18 pounds. The following are the approximate trigger pressures of
6. Safety Device like safety lock. certain types of firearms.
7. Sling. In a Self-loading Firearm, the following are the Additional a . S h o tg u n . . . . . . . . . . . . . . . . . . . . 4 lbs.
b . Self-loading pistol ...... 3 to 4 lbs.
Parts: c . Revo lver ................... 3 to 5 lbs.
d . Service rifle ................. 6 to 7 lbs.
1. Extractor — The mechanism by which the spent shell or ammunition is
withdrawn from the firing chamber. Cr 2. Barrel:
2. Ejector — The mechanism by akwhich the
0 U) empty shell or a. Riflings:
ammunition is thrown from the U) firearm. 0
MAGAZINE SPRING

OC The inner surface of a shotgun and that of a home -made gun is

I. Trigger: smooth while single shot standard firearms are with riflings.
This is a part of the firearm which causes firing mechanism. The inner surface of the barrel,has a series of parallel spiral grooves on
Except in a single action firearm, pressure on the trigger is the the whole length called riflings. The space between the two grooves is
commencement of the whole firearm mechanism. To avoid accidental the land. The riflings are made to have a strong barrel grip on the
firing, the trigger is surrounded by a trigger guard. bullet, to stabilize its movement and to impart a rotational movement
on the bullet. Incidentally, the rifling reflected on the bullet becomes
Classification of Firearm Based on Trigger Mechanism:
.J. an important factor
a. CCRelation of Cocking and Trigger Pressure: in the identification of firearms.
4
(1) Single Action Firearm — The firearm is first manually Gun manufacturers vary the way the riflings are imprinted
cocked they z followed by pressure on the trigger to release in the inner surface of the barrel on the following aspects:
the hammer. (1) Number — The number of lands'and grooves varies from 2 to
03
Example: Home- made "Paltik". 12.
(2) Double Action ocFirearm — A pressure applied on the trigger Most high velocity firearms have 4 to 6 grooves. Some
will both cock and A fire the firearm by release of the hammer. firearms have multiple shallow grooves and this is known as
microgrooves rifling.
Example: Standard Revolver.
 GUNSHOT WOUNDS 345 346 LEGAL MEDICINE
minable only after the manufacture. They have characteristics
(2) Twist or Rate — This is the expression for one complete whose e x i s t e n c e i s b e y o n d t h e c o n t r o l o f me n a n d w h i c h
h a v e distribution. Their existence in a firearm are brought about
 turn of the rifling on a certain length of the barrel•. We say the twist through the failure of a tool in its normal operation, through wear,
rate is 1:12 when there is one complete spiral groove in 12 inch abuse, mutilation, corrosion, erosion, or other fortuitous causes.
of the barrel. Spiral groove twist or rate may be: Those M a r k s m a y b e i m p r i n t e d i n t h e b u l l e t o r s h e l l a n d
m a y identification purpose.
(a) Fast Twist — When the number of inches of the barrel
When the bullet or the shell or both has been recovered and the
required for a complete turn is small, like 1:8.
suspected firearm has been found n the possession of a person,
(b) Slow Twist — When a greater number of inches in the barrel is
necessary to have one complete turn, like 1:14. procedure is to fire the suspected firearm at a recovery box and com-
pare the shell and bullet in the comparison microscope with the one
(3) Direction The direction of rifling may either be rig4
—
in question.
(clockwise) or left (counterclockwise). How to determine the Caliber of Firearm:
(4) Width of the Groove and Land — The width of the groove varies The caliber is the diameter of the barrel between two lands.
with the man ufac tu rer and ca liber. So me have the width of the Table showing the relation between American, English and Con-
groove different with that of the land while others are the same or
tinental Caliber:
equidistant.
Example: American Caliber English Caliber Continental Caliber in
Colt 0.32 has 6 lands and grooves, twist to the left, the width of Mm
the land and groove are 0.048 and 0.108 respectively. .22 Inch .220 Inch 5.6
Smith and Wesson 0.32 has 5 lands and grooves, twist to the right .25 “ .250 “ 6.5 (6.35)
and are equidistant at 0.095 inch. .28 “ .280 “ 7.0
.30” (.32 Rev.)
It
.300 “ (.303) 7.65
Table of Number of Grooves and the Direction of Riflings
.32” .320 “ 8.0
No. of Direction of .35” (.351) .350 “ 9.0
Groove Riflings
1. Revolvers: .38” .360” 9.3
s
— Webley, 455, .38, .32 7 right .38” .370” 9.5
— Colt, all calibers 6 left .38-.40-.41 Inch .410” 10.0
— Smith and Wesson, .45, .32 5 right
— J.T. & S. & W. model 4 right .405 Inch 10.5
2. Automatic Pistols: .44 “ .440” 11.0
— Webley, .455, .32, .25 6 right
right .45 “ .450” (.455) 11.25
— Browning 6
— Mauser, .25 6 right To convert millimeter calibratbn to inches, multiply the caliber
— Colt, .45, .38, .25 6 left
left in millimeters by 0.03937 or divide by 25.4.
— Delta 6
— Victoria (Spanish make) 6 left To convert inches calibration to millimeters, multiply by 25.4 or
— Luger P-08, 9 mm. (German) 6 right
right divide by 0.03937.
— Fibrique National, 9 mm. (Belgian) 6
Aside from those marks previously mentioned, the bullet or the shell MECHANISM OF FIREARM ACTION:
shows individual or accidental characteristics which are deter - Generally, the principles involved in all firearm actions are the the
same. When the firearm is cocked and ready to fire, a pull on
trigger will cause the firing pin of the hammer to hit the percussion
cap of the cartridge in the firing chamber which is aligned with rear
 GUNSHOT WOUNDS 347 In ballistics, the wounding power of the bullet due to the
mass (weight) and its velocity, with the velocity playing a very
portion of the barrel. The hit by the firing pin on the percussion cap will important role.
cause generation of a sufficient heat capable of igniting the primer. The primer
will in turn ignite the gunpowder or propellant which will cause evolution of M = Mass (Weight)
gases under pressure and temperature. The marked expansion of the ga ses MV2 V = Velocity
will force the projectile forward with certain velocity. Owing to the Kinetic Energy - _____
presence of the rifling at the 2G G = Gravity
/Inner wall of the bore, the barrel offers some degree of resistance to ,the Tissue damage of a bullet of a very high velocity is very much greater
projectile. Inasmuch as the rifling marks are arranged in a than those with much less velocity.
viral manner, the projectile will produce a spinning movement as it The damage cause by a bullet with impact velocity similar to muzzle
comes out of the muzzle. velocity is greater than when the impact occurred at a reduced speed after
'Together with) the bullet passing out of the barrel are the high - the bullet has travelled a distance.
pressured heated gases, unburnt piowder grains with flame and smoke. Bullet Efficiency:
During explosion, there is a backward kick of the firearm which in an The cartridge powder charge can be burned in approximately 0.00001
automatic firearm causes the cocking and the empty shell thrown second. The conversion rate by combustion of the gunpowder to
out by the ejector. The backward movement is called recoil of the firearm. bullet energy is about 30 to 32 percent. The loss some energies from
the gunpowder explosion may be due to:
Things Coming Out of the Gun Muzzle After the Fire: a. Loss of energy to force the bullet out of the cartridge c rifling
I . Bullet. and friction in the barrel.
2. Flame.
3. Heated, compressed and expanded•gas. b. Heating of the barrel and chamber.
4. Residues coming from: c. Escape of some of the compressed gasses at the breech an barrel.
a. Bullet:. d. Not all gunpowder are ignited.
(1) Fragment (jacket, lead). Obturation:
(2) Lubricant.
This is the sealing or prevention of gunpowder gas after ex plosion
b. Powder particlems: from escaping so as to maintain high pressure in th firing chamber
(1) Powder grains (unburned, burning). thereby increasing the propulsive power on th bullet. This is maintained:
(2) Soot. a. By insuring that the bullet tightly fits the bore throughout its entire
(3) Graphite. length;
c. Primer:
b. By sealing the cartridge case to the chamber wall; and
(1) Lead, barium, antimony, etc..
c. By preventing leakage between the primer cap and its retaining wall in
d. Barrel:
the cartridge.
(1) Lubricant.
(2) Rust, dust, etc.. Ballistics Coefficient;
(3) Scraping from bullet by previous fire. This describes the ability of a bullet to maintain its velocity against
e. Cartridge case: (1) Copper, zinc. air. resistance. It may be expressed in the following formula:

Bullet's Kinetic Energy: C — ballistic coefficient

Kinetic energy is energy associated with motion. In the English system it C= M m— mass
is express in foot pound or the work of a force resulting when a weight of id2 i — form factor
one pound is brought to a height of one foot. d — diameter

348 LEGAL MEDICINE

 The larger the coefficient, the more efficient id the bullet or
projectile . The better the ballistic coefficient of a bullet, the less
velocity loss it will suffer over a given resistance.
Movements of the Bullet as it Moves Out of the Muzzle:
1. Forward Movement — The velocity depends upon the propulsion /-
created by the ignition of the propellant.
2. Spinning Movement — This is due to the passage of the bullet at the spiral
landings and groovings of the barrel. The ratio depends on the twist and length
of the barrel.
3. Tumbling Movement (End-over-end Rotation)— The bullet may be rotating on
the long axis of its flight while the nose and the base are alternating ahead
in its flight. This accounts why in some instances, the bullet hits the skin with
its base.
4. Wabbling Movement (Tailwag) — The rear end of the bullet aside from
spinning may also vibrate vertically or sidewise in its flight. Like tumbling
movement, it may cause hitting the target sidewise.
5. Pull of Gravity — As the bullet is moving forward, it gradually goes
downward on account of the pull of the force of gravity. As the bullet
looses its kinetic energy, the pull of the force of gravity becomes dominant
until it falls on the ground.
Flame:
Ignition of the propellant will cause the production of flame. It is conical
in shape with the vertex located at the gun muzzle. The flame does not usually
go beyond a distance of_6 inches and in pistols or revolvers the flamels often less
than 3 inches.
-The flame causes scorching or burning of the skin and searing of the hair at the
target in a very near shot. In contact fire, the edges of the wound of entry may be
burned.
Heated, Compressed and Expanded Gas:
Ignition of the gunpowder will cause production of heat and gas. Considering
the limited space of the firing chamber and barrel, the compressed gas propels
the bullet to move forward. The volume of the gas generated is dependent on the
nature and quantity of the propellant. Thus a 50 grain gunpowder in a cartridge
with black powder (one grain producing 200 t4:5 300 cc. of gas) will cause the
production of 10 to 15 liters of gas while the same amount of cartridge with
smokeless powder (one grain producing 800 to 900 cc. of gas) will cause
production of 40 to 45 liters of gas confined in a wiry limited space. This is on
the presumption that all of the gunpowder were ignited.
350 LEGAL MEDICINE
GUNSHOT WOUNDS 349
The sudden release of the expanded gas from the muzzle
following the bullet is known as a muzzle blast.
Smoke (Soot, Smudging, Fouling, Smoke Blackening):
T his is o ne o f t he b y p ro d ucts o f co mp lete co mb ustio n o f t he
g u n p o wd e r a n d o t h er e le me n t s wi t h t h e p r o p e l la n t . I t i s l i g h t ,
almost black, and lack sufficient for ce to penetrate the skin. It is
merely deposited on the target and readily wiped off. It may be seen
with a distance of up to 12 inches.
The presence of smudging at the wound of entrance
i n f e r s a near shot. The shape may also be useful in determining
the trajectory. A circular shap e depo sitio n may b e typ ical o f a
p erp endicular approach of the bullet while in case of an acute angle
the deposition may appear to be elliptical.
Powder Grains:
This consists of the unburned, burning and partially burned
p o wd er ,, to gether wit h grap hite which co me o u t o f the muzzle.
Inasmuch as it is relatively heavier than smoke, it leaves the barrel
with ap preciab le velocity and in near shot, is respo nsib le to the
production of tattooing (stippling, peppering) around the gunsho t
wound of entrance.;
In close range, the powder grains penetrate the dermal and epider -
mal layers of the skin and may cause hemorrhage in deeper tissue
which cannot be removed by ordinary wiping. Microcontusion may
be observed around the punctured area an d the shape of the puncture
may denote the shape o f the penetrating grain. As the distance o f
the gun muzzle to the target increases, the area of destruction in -
creases, but the density of tattooing decreases.
In case o f b lack po wd er, the resid ue is co mp o s ed o f nitrates.
thiocyanates, thiosulphates, potassium carbonates, potassium sulphate
and potassium sulphide, while in smokeless powder, the residue is
composed of granules with nitrites and cellulose nitrates with graphite.
The presence of tattooing or stippling may be seen around the
wound of entrance up to a distance of 24 inches, although there may
be considerable variation from gun to gin - T.
Powder Burns:
Powder burns is a term commonly used by physicians whenever
there is blackening of the margin of the gunshot wound of entrance.
The blackening is due to smoke smudging, gunpowder tattooing and
to a certain extent burning of the wound margin 3 It is the combined
effects of these elements that are considered to be powder burns.
Actually, such blackening is primarily due to smoke smudging and
 GUNSHOT WOUNDS 351
gunp o wd er tatto oing so that the ter m so iling of the ta rget rather tha n
powder burns is more appropriate to describe the condition. Factors
Responsible for the Injurious Effects of Missile:
I . Factors Inherent on the Missile:
a. Speed of the Bulle t- T he greater the muzzle velocity, the
g r e a t e r i s t h e d e s tr u c t i o n i n a s mu c h a s mo r e k i n e t i c e n er g y can
be liberated.
h. Size and Shape of the Bullet - The bigger the d iameter or the
more deformed the bullet is, the greater are the injuries in the body
tissues.
c. Character of the Missile's Movement in Fligh t- Spinning movement will
increase the wounding power; "Yawing" and stumbling movement may
cause sidewise penetration and entry and cause
more destruction; and ricochette may alter tissue involvement in its
course.
2. Nature of the Target:
a. Density of Target- The greater the density of the tissue strucl--., the
greater will be the damage. More energy will be sp ent b y the bullet
in its course in penetrating skin, bones and clothes. Heavy thick
clothes may prevent penetration of missile; fragile
bone may fragment when hit and each fragment may act as a
secondary splinter to cause further injuries.
I). Length of Tissue Involvement in its Course - The longer the
distance of travel o f the missile in the bod y, the more kinetic
ener gy it lib erates, and the mo re destructio n it wi ll prod uce.
c. Nature of the Media Traversed- Bullet passing air spaces is less
destructive inasmuch as air is relatively compressible however,
bullet travelling in a liquid or solid media may accelera te trans-
mission of force to the surrounding tissue thus, causing more
destruction.
d. Vitality of the Part Involved - There is more likelihood for a
fatal consequence when vital organs are involved than those in other
parts of the body.
Abrasion Collar (Contuso-abradded Collar, Marginal Abrasion):
The pressure of the bullet on the skin will cause the skin to be
depressed and as the bullet lacerates the skin, the depressed portion will be
rubbed with the rough surface of the bullet / A perpendicular approach will
produce an even width of the collar. An acute angle of approach will
cause an abrasion collar wider at the acute angle o f approach.
352 LEGAL MEDICINE
Destructive Mechanism of Gunshot: ___
The following physical phenomena are responsible for the causation of
injury in the body of the victim:
1. Laceration and Permanent Cavity in the Bullet Trajectory:
The pressure of the speeding bullet produces severe pressure on the
tissues and organs causing laceration and mechanically creates a
permanent cavity. High velocity bullets can cause bigger damage
d wider cavity formation.
2. Temporary Cavity:
This is the instantaneous radial displacement of the soft tissues during
the passage of the bullet due to the liberation of kinetic energy. The
size of the cavity is dependent on the velocity of the bullet and
elasticity of the tissues. The greater the velocity, the larger the
temporary cavity formed. The diameter and volume of the
temporary cavity are many times greater than the diameter and volume
of the projectile that produces it. Although the development is
transient during the passage of the missile, it causes loss of function to
the part involved and further act as a secondary missile to involve other
areas.
3.Hydrostatic Force:
When the bullet traverses organs filled with fluid, like a full
stomach, cerebral ventricle, heart chambers, the liquid contents within
the himen of these organs are displaced radially away from the
bullet path producing extensive laceration. The displaced fluid
carries with it the kinetic energy which in turn acts as a secondary
projectile causing destruction of tissues not on the path -
the bullet.
4. Shock Wave:
This is the dissipation_of kinetic energy in a radial direction
perpendicular to the path of the bullet when the bullet velocity is
more than the speed of sound (tile speed of sound is 1,087 feet
per second). The severe intensity of the wave causes
severe-socking effect on the adjacent tissues and may cause
actual destruction or lessening of function.
5. Fragmentation or Disintegration of the Bullet:
When the bullet hits '‘a hard object (bone), it fragments to
several pieces. When the bullet velocity is more than 2,000
ft/sec. it disintegrates and each fragment has sufficient kinetic
energy to cause injuries similar to the mother bullet. It may cause
laceration, fracture and shocking effect, thus increasing the
destructive effect of gunshot. This causes more "shocking power" or
"knockdown power" of the bullet.
 GUNSHOT WOUNDS 353
6. Fragmentation of Hard Brittle Object in the Trajectory:
Bone involvement along the trajectory may cause comminuted fracture and
each bone fragment may cause additional damage on the surrounding tissues
and even in the wound of exit.
Passage of the bullet causes a clean-cut hole at the point of initial contact and
beveling at the point of exit. The beveling is due to the absence of a hard support
as the bullet leaves the bone.
In the skull a through and through wound will produce a round or oval hole at
the outer table with leveling of the inner table and at the point when a bullet
makes the exit, the clean cut hole will at the inner table and beveling will be at the
outer table.
7. Muzzle Blast in Contact Fire:
When the gun muzzle is pressed on the skin when fired, all of the products
of combustion primarily the muzzle blast will penetrate the tissues causing
severe mechanical destruction on account of pressure. The explosive effect will
cause extensive laceration of soft tissues and fracture of bones.
8. Other Consequential Effects on the Body of the Victim:
Aside from direct involvement of vital structures of the body, pressure to other
organs and tissues, the gunshot wound may be the source of hemorrhage,
infection,. paralysis, shock, loss of functioning etc. which may cause
disability or death on the victim.
Gunshot Wound of Entrance (Entrance Defect, Inshoot):
The appearance of the gunshot wound of entrance depends upon the following:
1. Caliber of the Wound0gWeallon:
Excluding other factors which may_ influence the size of the wound of
entrance, the higher the caliber of the wounding bullet the greater will be the
size of the wound of entrance. It must not be overlooked that the manner of
approach of the bullet to the skin, the distance of the muzzle of the firearm to
the skin (surface, the deformity or splitting of the bullet and the portion of the skin
surface involves modification of the size and shape of the entrance.
2. Characteristics Inherent to the Wound of Entrance:
The wound of entrance, as general rule, is oval or circular with inverted
edges, except in near shot or in grazing or slap wound. As the bullet
approaches the skin, there is an indentation of the skin surface but later, on
account of the extreme pressure; the skin tissues give way. The rough surface
of the bullet comes in contact with the skin thereby producing a contusion or
abrasion
354 LEGAL MEDICINE
collar. In most cases, the size of the wound of entrance is smaller
than the caliber of the wounding bullet on account of the retraction of
the connective tissues.
The wound of exit is usually larger than the wound of entrance. It
may be stellate, slit-like, cruciform, or markedly lacerated. The
deformity of the bullet in its course inside the body, the lack of
support beyond the skin, and the velocity of the missile are
responsible for the increase in size of the exit wound.
3. Direction of the Fire:
A right angle approach of the bullet will make th e wound of
entrance circular in shape, except when the missile is deformed or
the fire is in contact or near. In cases of an acute angle of ap proach of
the bullet, the wound of entrance is oval in shape with the contusion or
abrasion collar widest on the side of the acute angle of approach: •
There is more likelihood for deflection of the bullet course wherever it
hits the bony tissue.
4. Shape and Composition of the Missile:
Deformity of the bullet modifies the shape of the wound o
entrance. Some missiles are purposely made to enhance deformity upon
hitting hard objects like hollow-point, dum-dum and soft point
bullets. Hard or armor-piercing bullets are not usually deformed
on account or their hard metallic constituents.
5. Range:
In close range fire, the injury is not only due to the missile but also
due to the pressure of the expanded gases, flame and oth er solid
products of combustion. Distant fire usually produces th e
characteristic effect of the bullet alone.
6. Kind of Weapon:
High power weapon has more destructive effect as compared with
low power one. The shape of the bullet also plays an important role.
Conical shape free end bullets have more piercing power without
marked tissue destruction while missiles with hemispherical free
ends are more destructive.
Contact Fire:
• The nature and extent of the injury is caused not only by the force
of the bullet but also by the gas of the muzzle blast and part of the body
involved. The following factors must be taken into con sideration:
1. The Effectiveness of the Sealing Between the Gun Muzzle and
the Skin:
If all the gaseous product of combustion is prevented from
 356 LEGAL MEDICINE
GUNSHOT WOUNDS 355
(2) The gun muzzle is pressed on the body, pushed momentarily
being spilled out, there will be more destructive effects on the tissues. away and then hit the body again because of continuous
inward pressure.
2. The Amount of Gas Liberated by the Combustion of the Pro-
(3) When the gun is fired on areas of the body where holly tissue
pellant: is superficial, like the scalp, the muzzle blast has tendency to
The volume of gas liberated after explosion of the propellant is dependent on creep in the loose connective tissue between the skull and
the amount and nature of the powder, and the extent of powder the skin thereby pushing the skin outward to press on the
combustion. The greater is the amount of gas in a confined area, the greater gun muzzle.
will be the tissue destruction.
e. The bullet may cause radiating fracture and the pressure of the
3. Nature of Bullet: gases may cause fragmentation of the skull and a severe laceration
Bigger caliber bullet is obviously more destructive than smaller ones. Soft of the brain and its meninges.
or hollow point bullet has the tendency to flatten and causes more damage f. Blood and tissue become pink due to carbon monoxide.
to tissues.
g. Fragments of lead and bullet jacket may be found.
4. Part of the Body Involved:
The nature, character and extent of injury in contact fire is different Metal Fouling — When the bullet travels the whole length of the tight
(1) when the bone is superficially located under the skin, and (2) when fitting barrel, it is rotated by the lands and grooves. Its surface is
scraped by the lands and the scraping is ejected from the barrel and strikes
the bone is deeply located in loose or soft parts of the body.
the target. It may lodge on the clothings or may cause small abrasions
Pressed and Firm Contact Fire: or superficial lacerations on the skin around the main wound.
1. On Parts of the Body Where Bone is Superficial: h. Singeing of hair.
This is commonly observed on the head where the skull is just underneath
the scalp. The following are the characteristics of the injuries:
a. The wound of entrance is large, frequently star-shaped due to tear
radiating from the entrance wound caused by the blast effect which
follows the sudden release of gases into a confined area between the skin
and the underlying bone.
b. Edges of the wound may be everted. The creeping of the gases between
the skull and the scalp causes the skin to move towards the muzzle.
c. Areas in the entrance wound is blackened by burns, tattooing and
smudging. Singeing of the hair is confined only at the site of wound of
entrance.
d. Muzzle imprint, Barrel impression (Profile of the muzzle) on the skin —
The outward movement of the skin caused by the imprisoned gas will add
more pressure to the gun muzzle coupled with the heat of the explosion
and will cause iron-like effect on the pressed skin.
Causes of Muzzle Imprint:
(1) The gun muzzle is pressed on the body at the time of the fire and the
heated muzzle during the blast produced an ironing effect on the skin.
 GUNSHOT WOUNDS 357

lac eration . Th e g a s from th e mu z ,

deeper structures. ',Ice smaller than the °
b. Edges are everted due to outward slapping of
instances, soft tissues (blood, fibrous and muscular tissues) may be
found inside the gun barrel. This is due to the negative pressure created
in the barrel after the blast.
c. Singeing of the hair, blackening of the wound due to fouling, burn, and
tattooing.
d. Muzzle imprint due to outward slapping of the skin and heat.
e. Pinkish color of the deeper structures due to carbon monoxide.
Loose Contact or Near Fire:
1. Entrance wound may be large circular or oval depending upon ,he angle of
approach of the bullet.
2. Abrasion collar or ring is distinct.
-3. Smudging, burning and tattooing are prominent with singeing . of the hair.
4. Muzzle imprint may be seen depending upon the degree of slap ping of
the skin of the gun muzzle.
5. There is blackening of the bullet tract to a certain. depth.
6. Carboxyhemoglobin is present in the wound and surrounding areas.
Short Range Fire (1 to 15 cm. distance)
1. Edges of the entrance wound is inverted.
2. If within the flame reach (about 6 inches in rifle and high powered
firearms and less than 3 inches from an ordinary handgun), there is an
area of burning.
3. Smudging is present due to smoke.
4. Powder tattooing is present (dense and limited dimension of (2) The gun mi,,s circular or oval depending on the angle of tarilv
spread). 9-- _.orasion collar.
5. Abrasion ring or collar is present (contact ring). 2. Wound of entrance has no burning , smudging or tattooing.
3. Co nt ac t ri n g i s p re se n t.
Medium Range Fire (more than 15 cm. but less than 60 cm,):
Microscopic Examination of Gunshot Wound of Entrance:
1. Gunshot wound with inverted edges and with abrasion collar is present. 1. In Contact or Near Contact Fire:
2. Burning effects (skin a. Epithelial damage and powder residue deposit are present.
Gunshot wound of entrance with contusion collar, powder burns and tattooing, burn and hair singeing) is b. Massive heat may carbonize the epithelial cells.
absent, c. T he hot b ullet may p roduce co agulatio n necro sis.
3. Smudging may be present if less than 30 cm. distance. d. Basilar cells are swollen and vacuolated.
e. The corium may show thermal changes manifest ed by nuclear
4. Gunpowder tattooing is present but of lesser density and has a wider area shrinkage, pyknosis and vacuolization.
2. Parts of the Body Where the Bone is Deeply Located: of distribution.
2. In far Distant Fire:
a. Wound of entrance is usually large, circular and without radiating 5. Contact ring is
present. a. There may be a spotty deposit of powder on skin and subcu -
taneous tissue.
 b. There is cellular destruction along the course of bullet.

Instances When the Size of the Wound of Entrance Do Not Approximate the
Caliber of the Firearm:
In distant fire, the rule is that the diameter of the gunshot wound of
entrance is almost the same as the caliber of the wounding firearm, but in the
following instances, the rule is not followed:
1Factors which make the wound of entrance bigger than the calib,e1
a. In contact or near fire- The size of the entrance wound in contact
and near fire is caused by the force of the expanded gases of explosion
and by the bullet.
GUNSHOT WOUNDS 359
Factors which 'make the wound of entrance smaller than the
caliber:
a. Fragmentation of the bullet before penetrating the skin — If in the
flight of the bullet it hits a hard target which causes its
fragmentation and only the fragments pierce the skin, the
wound produced will be smaller than the caliber of the firearm
which causes the fire.
b. Contraction of the elastic tissues of the skin The form of the —

b. Deformity of the bullet which entered- The bullet might have hit a hard bullet may be preserved but the entrance wound may be smaller
object before it pierces the skin thereby making the wound of entrance than the caliber on account of the contraction of the elastic
bigger than the caliber of the missile. tissues of the skin.
c. Bullet might have entered the skin sidewise- Ordinarily, it is the In shotgun fire, the size of the wound of entrance is dependent
ogival portion which pierces the skin first, but occasionally it may hit u p o n t h e d i s t a n c e o f t h e fi r e . N e a r f i r e c a u s e s c o n c e n t r a t i o n of
the skin sidewise on account of the inequality of resistance of the entry of the pellets, and as distance increases the pellets dis perse
surrounding media in its flight. The spinning movement and the tail wag with individual pellets causing individual wounds of entry. O nl y i n
(wobble) may cause the bullet to enter in as vertical axis. th i s i n st a nce ma y t he wo u nd o f e n tra nc e o f t he sa me size as the
gauge of the shotgun pellets.
d. Acute angular approach of the bullet - Due to the sliding trajectory
of the bullet, the wound becomes oval in shape with prominence of the
contusion collar at the side of the acute angle of approach. Other Evidences or Findings Used to Determine Entrance of Gunshot:
When the course of the bullet is through and through and there is
difficulty in the determinatio n as to which is the entrance because
it does not show characteristic findings, or it has been modified by
healing, infection or surgical intervention, the medical examiner must
resort to the following:

1. Examination of the clothings, if involved in the course of the

bullet:
a. The fabric of the clothings may show punch in destruction at
the site of the wound of entrance.
b. Examination for particles of gunpowder on the clothings at the
site near the wound in question. -If the clothings give a positive
test for gunpo wder, then it must be the wo und of entrance.
This is only true if the fire is near.

2. Examination of the internal injuries caused by the bullet:

a. In case where the missile hits a bone, the bone fragments are
driven away from the wound of entrance.
b. Destruction of the bone at the surface facing the wound of
entrance is oval and with sharp edges, while the surface facing the
wound of exit is bigger, irregular and bevelled.
c. Direction of the cartilage and other soft tissues will be driven
away from the gunshot wound of entrance.

360 LEGAL MEDICINE
3. Testimony of witnesses:
The testimony of the witness as to the position of the victim and the
assailant when the firearm was fired may determine which of the wounds is
the entrance wound.
Determination of the Trajectory of the Bullet Inside the Body of the Victim:
The following must be taken into consideration to determine the course of
the bullet inside the body of the victim:
1. External Examination:
a. Shape of the Wound of Entrance — When the bullet is fired at right
angle with the skin the wound of entrance is circular except in cases of
near fire. If fired at another angle, the wound of entrance is usually oval in
shape. When the bullet is deformed, no such characteristic findings will
be observed.
b. Shape and Distribution of the Contusion or Abrasion Collar —As
a general rule, the contusion (abrasion) collar is widest at the side of
the acute angle of approach of the bullet. If the bullet hits the skin
perpendicularly, then the collar will have a uniform width around the
gunshot wound, except when the bullet is deformed or in near fire.
c. Difference in Level Between the Entrance and Exit Wounds —The
difference in height between the gunshot wound of entrance and exit may
be determined by measuring those wounds from the fixed references in the
body, e.g. sole of the foot, or by drawing a horizontal line across the
body and using it as a reference point.
d. By Probing the Wound of Entrance — The probe must be applied
without too much force so as not to create a new course in the soft
tissues. Care must be observed in cases of deflection of the course due
to some hard objects that might have been involved.
2. Internal Examination:
a. Actual Dissection and Tracing the Course of the Wound at
Autopsy:
The tissues involved are hemorrhagic and bone spicules and lead
particles may be seen or felt.
,b. Fracture of Bones and Course in Visceral Organs:
Occasionally, the nature of the bone fracture may show the direction,
especially when the bullet is not deformed before causing the fracture.
Injuries in solid visceral organs may clearly - manifest the course because
of the absence of contractility.
GUNSHOT WOUNDS 361
c. Location of Bone Fragments and Lead Particles:
The bone spicules and lead fragments go with the flight of -the
bullet and may be utilized in the determination of the
trajectory.
d. X-ray Examination:
Bone spicules and lead fragments may be observed and their
exact location determined in relation with the wound of en trance.
3. Other Evidences to Show Trajectory:
a. Relative difference in the vertical location of the entrance from
the exit in the clothings.
b. Relative position and distance of the assailant from the victim
in the reconstruction or reenactment of the crime.
c. Testimony of witnesses.
Exit (Outshoot) Wound:
An exit wound does not show characteristic shape unlike the
wound of entrance. It may be slit-like, stellate, irregular or even
similar to the wound of entrance. This is due to the absence of
external support beyond the skin so the bullet tends to tear or
shatter the skin while sufficient amount of kinetic energy i s still in
the bullet during the process of piercing the skin.
The edges of the wound are everted and occasionally portions of the
inner tissues are protruding. Aside from the bone, the skin is one of
the most resistant to penetrate in the course of the bu llet so that
most often the bullet is lodged just underneath the skin. It may
only be noticed by the presence of contusion over the area wherein it
is lodged or its presence may be noticed by palpitation. The bullet may
have lost its momentum after piercing the skin and just fall without
perforation of the clothing.
Bones may be involved in the trajectory and its spicules may
create additional injury to the wound of exit.
Variation on the shape of the wound of exit may be attributable to the
deformity of the bullet in its passage in the body and to the wabbling
and stumbling movement of the bullet during its course and
fragmentation of the missiles.
Shored Gunshot Wound of Exit — If the place where the gunshot
wound of exit is pressed on a hard Abject as when the victim is lying on
his back on a hard object or in small caliber shots (like 0.22) the wound
of exit tends to be circular or nearly circular with abrasion at its border.
It is also observed that tight-fitting clothings, waist band, belt collar,
brassiere may also support the skin to enhance formation
 GUNSHOT WOUNDS 363
362 LEGAL MEDICINE
tact ring" is present, due to
of a circular wound of exit. This is known as a shored gunshot wound of invagination of the skin and
exit. spinning of the missile.
Shored gunshot wound of exit is produced when the outstretched skin is 5. Tattooing or smudging may be 5. Always absent.
impaled, sandwiched and crushed between the outgoing bullet and the present when firing is near.
unyielding object is over the exit site, thus making the wound to be circular 6. Underlying tissues are not 6. Underlying tissues may be
with abrasion collar at its margin. Proper coaptation of the wound margin is protruding. seen protruding from
impossible because of the loss of skin just like those observed in entrance the wound.
wound. In contrast with the entrance wound, the supported exit wound shows a 7. Always present after fire. 7. May be absent, if is
scalloped or punched-out abrasion collar and sharply contoured skin in between lodged in the body.
the radiating skin lacerations marginating the abrasion (Journal of Forensic 8. Paraffin test may be positive. 8. Paraffin test always negative.
Medicine and Pathology, Vol. 4, Sept. 1983, p. 99). The "Odd and Even Rule" in Gunshot Wounds:

If the number of gunshot wounds of entrance and exit found in the

body of the victim is even, the presumption is that no bullet is lodged in
the body, but if he number of the gunshot wounds of entrance and exit
is odd, the presumption is that one or more bullets might have been lodged
in the body.
The rule is merely presumptive and actual inspection and autopsy will
verify the truth of the presumption. It may be possible that all of those
wounds or a majority of them are entrance wounds with some bullets
lodged, yet the number may still be even.
Sometimes it is difficult to locate the lodged bullet but with the help of
a portable X-ray, its location and extraction can be facilitated.

How to Determine the Number of Fires Made by the Offender:

1. Determination of the Number of Spent Shells:
Search must be made at the scene of the crime or at the place where
the offender made the fire, for spent shells, if the weapon used is an
Gunshot wound of exit of the skull with punch out edges automatic pistol or rifle. In case of revolver fire, the empty shells may
Distinction between Gunshot wound of entrance and wound of be found still inside the cylindrical magazine. In machine gun fire, the
exit spent shells may still be attached to the cartridge belt.
Entrance Wound Exit Wound 2. Determination of Entrance Wounds in the Body of the Victim:
1. Appears to be similar than 1. Always bigger than the Although most often erroneous, the investigator may be given an
missile idea as to the minimum number of shots made. The number of wounds of
the missile owing to the elasticity entrance may not show the exact number ' of fire because:
of the tissue. a. Not all the fire made may hit the body of the victim.
2. Edges are inverted 2. Edges are everted. b. The bullet may in the course of its flight hit a hard object thereby
3. Usually oval or round depending 3. It does not manifest splitting it and each fragment may produce separate wounds of
upon the angle of approach of the bullet . any definite shape. entrance.
4. “Contusion collar” or “Con 4. “Contusion Collar” c. The bullet may have perforated a part of the body and then
is is absent
364 LEGAL MEDICINE
made another wound of entrance in some other parts of the
body; thus a single shot may produce two wounds of entrance.
3. Number of Shots Heard by Witnesses:
The witnesses might be able to count the number of shots heard
especially if the shots were made at sufficient intervals of succession.
However in cases of machine gun fire, there is difficulty in ascertaining
the number heard and the testimony of witness as to the number
of shots heard must be admitted with caution.
Mutilating gunshot wound of exit
Instances when the Number of Gunshot Wounds of Entrance is Less than
the Number of Gunshot Wounds of Exit in the Body of the Victim:
1. A bullet might have entered the body but split into several frag-
ments, each of which made a separate exit.
2. One of the bullets might have entered a natural orifice of the body,
e.g. mouth, nostrils, thereby making it not visible and then producing a
wound of exit.
3. There might be two or more bullets which entered the body
through a common entrance and later making individual exit
wounds.
4. In near shot with a shotgun, the pellets might have entered in a
common wound and later dispersed while inside the body and
making separate wounds of exit.
GUNSHOT WOUNDS 365
Instances when the Number of Gunshot Wounds of Entrance is
More than the Number of Gunshot Wounds of Exit in the Body
of the Victim:
I. When one or more bullets are 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, e.g.
eyes, mouth, nostrils.
3. When different shots produced different wounds of entrance
but two or more shots produced a common exit wound.
Instances when there is No Gunshot Wound of Exit but the
Bullet is Not Found in the Body of the Victim:
1. When the bullet is lodged in the gastro-intestinal tract and expelled
through the bowel, or lodged in the pharynx and expelled through
the mouth by coughing.
2. Near fire with a blank cartridge produced a wound of entrance
but no slug may be recovered.
3. The bullet may enter the wound of entrance and upon hitting
the bone the course is deflected to have the wound of entrance as
the wound of exit (cited by Modi, A Textbook of Medical Juris -
prudence & Toxicology, 10th ed.).
Trajectory of a gunshot wound in the head
366 LEGAL MEDICINE
Determining Whether the Wound is Ante-mortem or Post-mortem:
If the wound indicates that there has been profuse hemorrhage, or there are
signs of vital reactions in the tissue, then the gunshot wound is ante-mortem.
The presence and degree of vital reactions depends upon the period of survival
of the victim. It may be manifested in the form of swelling, effusion of lymph
or other evidences of repair. Microscopically, there is congestion and
leucocytic infiltration.
Wounds inflicted after death show no evidence of profuse hemorrhage, no
retraction of the edges, and there are no vital reactions.
Problems Confronting Forensic Physician in the Identification of Gunshot
Wounds:
1. Alteration of the Lesion Due to Natural Process:
The drying of the margins of the wound opening may modify
measurements. The size and shape is considerably altered by
decomposition. Healing process and infection may modify its appearance
and it may be mistaken for some other types of injuries.
2. Medical and Surgical Intervention:
The wound may be scrubbed, medication applied, or surgically debridded,
extended, excised or sutured. This problem is properly solved by having access
to the clinical record of the patient.
3. Embalming:
Embalming trocar may be introduced on the gunshot wound itself or the
trocar mark itself may be mistaken for a gunshot wound.
The gunshot wound may be extended to reach the principal artery for the
embalming fluid to enter. The passage of the embalming fluid may wash out
the product of the gunpowder combustion, The trajectory of the bullet may
be modified by the trocar thrust. The suturing of the gunshot wound and the
application of "makeup" may modify the actual appearance of the wound.
4. Problem Inherent to the Injury Itself:
The gunshot wound may be covered with clotted blood or with scab to
make it not visible. Grazing injury caused by glancing of the bullet on the
skin may appear like abrasions or lacerations. Wound brought about by
screw drivers, icepicks or other sharp pointed' instruments might be
considered to be gunshot wounds. Bullet might have entered or made its exit
in the natural openings, like mouth, nostril, ear, etc. making its
identification difficult. The wound may be located in thick haired scalp,
skin fold and make visibility difficult.
GUNSHOTWOUNDS 367
6. X-ray Examination:
The use of an X-ray is almost indispensable in the examination of
gunshot injuries. The use of the apparatus will fa cilitate recovery
of the lodged bullet together with the location of its fragments.
The body might have been X -rayed with unspent and spent
ammunition clinging on the clothings and may be mistaken to be
inside the body; teeth fillings or crown may resemble bullet on X-ray
examination of the skull. "Migratory" bullets may be found in some
parts of the body away from the bullet tract. Victim may have
"bullet souvenir" on account of a previous gunshot injury and may
confuse the examiner as to be an effect of recent shot.
Clothings:
The effects of the garments on the movement of the bullet depend
upon:
1. The number of layers of fabric between the muzzle and subjacent
skin;
2. Nature of the fabric which, may be closely woven or loose mesh,
light or heavy, cotton or synthetic fibers.
3. Muzzle-clothings distance.
Examination of the External Wearing Apparel of the Victim of
Gunshot maybe Significant in Investigation because:
1. It may establish the possible range of the fire:
a. Contact Fire:
(1 ) There is a tear of the clothings covering the skin at the site of
the gunshot wound with fusion of its fibers in case of artificial
fabric. Fibers are turned outward away from the body.
(2) Soot deposit and gunpowder tattooing around the torn
fabric. Burning of the fibers are visible.
(3) Muzzle imprint (profile of the muzzle) especially in arti ficial
fabric may be present.
(4) Dirt and greasy deposit is carried by the bullet and may be,
wiped out and be visible on the torn clothing.
b. Not Contact but Near Shot:
The same findings as in contact shot except when it is be yond
the flame range and absence of muzzle imprint.
c. Far Fire:
There is a hole tear with inward direction of the thread.
368 LEGAL MEDICINE
2. It may be useful in the determination as to which is the point of entry and
of exit of the bullet:
The direction of the fibers will be inward or inverted at the point of
entry, while it is outward or everted at the point of exit. Care must be
exercised in making the inference inasmuch as improper handling may
change the direction of the fibers.
3. It may be useful in locating the bullet:
The clothings, like skin and bone are not easily perforated. It is frequently
observed that the bullet is recovered just underneath the clothings of a dead
victim at the crime scene.
Special Consideration on Bullets:
1. Souvenir Bullet:
Bullet has been lodged and has remained in the body. Its long presence causes
the development of a dense fibrous tissue capsule around the bullet causing no
untoward effect. It may be located just underneath the skin to be easily
palpated and may cause inconvenience and irritation. Deep seated location
may nor cause any problem to warrant its immediate removal.
2. Bullet Migration:
Bullet that is not lodged in a place where it was previously located. A
bullet which strikes the neck may enter the air passage, and it may be coughed
out or swallowed and recovered in the stomach or intestine.
Bullets Embolism — a special form of bullet migration when the bullet
loses its momentum while inside the chamber of the heart or inside the big
blood vessels and carried by the circulating blood to some parts of the body
where it may be lodged. It may cause sudden loss of function of the area
supplied or death if vital organs are involved.
3. Tandem Bullet:
Two or more bullets leaving the barrel one after another. In •
cases of misfire or a defect in the cartridge, the bullet may be
lodged in the barrel and a succeeding shot may cause the initial and the
succeeding bullet to travel in tandem. There is a strong possibility for'
them to enter the target in a common hole. This might create doubt to the
statement made by the firer that he made only a single shot, but ballistic
examination can show as to whether the bullet travelled in tandem.
GUNSHOT WOUNDS 369
GUNSHOT WOUNDS MAY BE SUICIDAL,
HOMICIDAL OR ACCIDENTAL
Evidences that tend to show that the Gunshot(s) Wound is Suicidal.
1. The shot was fired in a closed or locked room,, usually in the
office or bedroom. If in the bedroom, the shot was fired while the
victim was lying in bed and the weapon covered with pillow or
bedding to muffle the sound. It may be committed in an open
isolated or uninhabited place.
2. The death weapon is almost always found near the place where the
victim was found, When a light, low caliber hand firearm was used
and the shot was made in parts of the body where death may
develop almost instantaneously, the victim may be seen with the grip
of the firearm firmly held in the palm of the wounding hand
(cadaveric spasm).
3. The shot was fired with the muzzle of the gun in contact with
the part of the body involved or at close range, The wound of
entrance may show signs of muzzle impression, burning, smudging
and tattooing.
4. The location of the gunshot wound of entrance is in an accessible
part of the body to the wounding hand, . It may be at the temple, roof
.
of the mouth, precordial or epigastric region. A person
committing suicide will do the act in his most convenient way,
unless he has the intention of deceiving the investigator.
5. The shot is usually solitary, If the shot is made on the head
involving the brain, the shocking effect of the injury will not
make him capable of firing another shot. However, shots in some
parts of the body which may not produce immediate death Or
sudden loss of consciousness, the possibility of additional shots is
not remote. The victim may be determined to die and had fired
additional shots to insure realization of his intentioq.
6. The direction of the fire is compatible with the usual trajectory of
the bullet considering the hand used and the part of the body
involved, A shot on the temple is usually directed towards the
opposite temple and upwards, while a shot in the precordium and
epigastrium is usually backwards and downwards.
7. Personal history may reveal social, economic, business or marital
problem which the victim cannot solve ` He may have history
of mental disease, depression, severe frustration or previous
attempt of self-destruction.
8. Examination of the hand of the victim may show presence of
gunpowder,
9. Entrance wound do not usually involve clothing
370 LEGAL MEDICINE
10. Fingerprints of victim on the butt,
11. Search of the place where the shot took place may reveal a suicide
note, which usually mentions among other things the reason why the
victim committed suicide.
12. No disturbance in the place of death.
Russian Roulette:
A group of persons may agree to load a revolver with a single live
cartridge and each member of the group will cock and pull the trigger with the
muzzle pressed or directed to the temple or towards other vital parts of the
body. The person who will pull the trigger with the live cartridge in the
firing chamber will suffer the fatal consequence. Although it may be
considered suicidal because any person who participates to such an
agreement may have the desire to commit it, the unfortunate victim has
no predetermined desire of self-destruction.
Evidences to show that the Gunshot Wound is Homicidal:
1. The site or sites of wound of entrance has no point of election.
2. The fire is made when the victim is usually at some distance from assailant.
3. Signs of struggle (defense wounds) may be present in the victim.
4. There may be a disturbance of the surroundings on account of previous
struggle.
5. Wounding firearm usually is not found at the scene of the crime.
6. Testimony of witnesses.
Evidences to show that the Gunshot Wound is Accidental:
1. Usually there is but one shot.
2. There is no special area of the body involved.
3. Consideration of the testimony of the assailant, and determination as to
whether it is possible to be accidental by knowing the relative position of
the victim and the assailant.
4. Testimony of witnesses.
•
Points to be Considered and Included in the Report by the Physician:
1. Complete description of the wound of entrance and exit.
2. Location of the wound:
a. Part of the body involved.
b. Distance of the wound from the mid-line.
c. Distance of the wound from the heel or buttock.
3. Direction and length of the bullet tract.
4. Organs or tissues involved in its course.
GUNSHOT WOUNDS 371
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 the wound or wounds be inflicted by the weapon presented to
him?
2. At what range was it fired?
3. What was the direction of the fire?
4. May it be possible that those gunshot wounds are self-inflicted?
5. Are there signs of struggle in the victim?
6. May it be possible for the victim to fire or resist the attack after the
injury was sustained by him?
7. Did the victim die instantaneously?
8. Where was the relative position of the assailant and the victim when
the shot was fired?
Can the Caliber of the Wounding Firearm be Determined from the
Size of the Gunshot Wound of Entrance?
Although the size of the gunshot wound of entrance is influenced by
several factors, the caliber may be inferred from the diameter of the
gunshot wound. In most cases, especially when the 'wound is circular,
the caliber is almost the same as the diameter of the wound of entrance.
Determination of the Length of Survival of the Victim,:
The length of survival of the victim may be inferred from the
following:
1. Nature of the gunshot wound.
2. Organs involved.
3. Presence or absence of infection or other complications.
4. Amount of blood loss.
5. Physical condition of the victim.
Capacity of the Victim to Perform Volitional Acts:
The power of the victim to perform voluntary acts depends upon the
area of the body involved, involvement of vital organs, and the resistance
of the victim. Injuries which will cause incapacity to do voluntary acts as
those involving the brain and the spinal cord definitely inhibits
volitional acts.
372 LEGAL MEDICINE
Determination as to the Length of Time a Firearm had been Fired:
Physical and chemical examinations of the residue inside t barrel does
not give a conclusive evidence as to how long t firearm has been
discharged. Most often the examiner does n know whether the barrel
was cleaned immediately after the d charge. Smokeless powder which is
now commonly used does n leave much residue for such determination.
However, inference may be drawn from the following: ,
1. Odor of the Gas Inside the Barrel:
Explosion of the gunpowder produces considerable evolution o gases
consisting of nitrogen, hydrogen sulfide, carbon dioxid carbon
monoxide and methane. This mixture of gases has peculiar
characteristic odor which may be noticed several hour after the discharge.
Later, it will disappear as gases usually evapo rate or chemically
transformed to other odorless compounds.
2. Chemical Changes Inside the Barrel:
Black powder is a mixture of charcoal, sulfur and nitrates of sodium
or potassium. One of the products of combustion is hydrogen sulfide..
Hydrogen sulfide is rapidly converted to thiosulfate, thiocyanate and
finally to sulfates of potassium or sodium. The absence of the peculiar
characteristic odor and the presence of thiosulfate and thiocyanate
which is increasing in amount shows that the discharge occurred in a
matter of few days. Later the thiosulfate and thiocyanate of sodium or
potassium will be chemically transformed to sulfates and its presence
shows that firing occurred for sometime,
The iron salts in the ferrous state are found during the early stage and
may be transformed to ferric salt after a lapse of a certain period.
The residue produced by smokeless powder explosion as nit rates are
not liable to undergo changes even after a lapse of time, hence
approximation of the time of the discharge is much more difficult.
The main difficulty in the determination is that the length of such
physical and chemical transformation of the residue of combustion
from one compound to another, cannot be definitely ascertained. It is
dependent upon several factors.
3. Evidences that may be Deduced from the Wound:
Approximation of the age of the wound also infers the time of
discharge. The degree of healing in the absence of su bsequent infection
must be considered. If an infection is present, then the degree of infection
may be utilized in the approximation.
GUNSHOT WOUNDS 373
Determining Whether the Wounding Weapon is an Automatic Pistol or
a Revolver:
The following must be taken into consideration to determine
whether the wounding weapon is an automatic pistol or a revolver:
1. Location of the Empty Shells:
In a revolver, the empty shells are found in the cylindrical
magazine chamber after the fire, but in cases of automatic pistol the
empty shells are driven out of the weapon after the shot, to give
way to live cartridge to be in the firing chamber. Thus, in cases of
automatic pistol, the empty shells are found a few yards away from the
place of the firing.
2. Nature of the Spent Bullet:
As a general rule, in automatic firearm, the bullet is copper
jacketed or cupro-nickel jacketed, while in cases of revolver, no such
coating is observed. This is not true in all cases.
3. Nature of the Base of the Cartridge or Spent Shell:
The base of a revolver has a wider diameter than that of the
cylindrical body to keep the cartridge stay in the magazine chamber.
There is no such difference in the diameter in case of shells of
automatic pistol.
Can the Direction of the Shot be Determined from the Direction from
which the Sound Came From?
Not possible, unless the flash or the person firing the shot is seen at
the time e shot was fired. T e ear is usually at a loss as to where
the shot was fired.
Can the Firearm be Identified by the Sound of the Discharge?
It is impossible to distinguish and memorize the report from two
firearms of the same caliber. 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.
Example: The sound of a shotgun may be distinguished from the
sound of a caliber 0.22 pistol.
Gunshot Wound may Not be a Near Fire or may Not Appear to be a
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 gunshot wound of entrance does not show characteristics of
a near shot because the clothings are interposed between the victim
and the firearm.

374 LEGAL MEDICINE
3. When the examining physician failed to distinguish between a ne or far shot
wound.
4. When the product of a near shot has been washed out of th wound.
X-ray:
The use of the x-ray must not be overlooked in a gunshot woun investigation.
Several exposures at different' angles must be made t determine the precise
location of the bullet, trajectory, position o the slug, and other injuries.
X-ray Examinations may:
a. Facilitate location and extraction of the bullet lodged.
b. It will reveal fragmentation and their location.
c. It will show bone involvement like fracture.
d. It will reveal trajectory of the bullet.
e. It will show the effects of the bullet wound, like hemorrhag escape of air,
laceration and other injuries.
SHOTGUNWOUNDS
.A shotgun is a shoulder-fired firearm having a barrel that is smooth-bored and is
intended for the firing of a charged compound of one or more round balls or
pellets.
Classes of Shot in a Shotgun Shell:
1. Birdshot — The shot are small ranging in sizes from 0.05 inch to 0.15
diameter and loaded from 200 to 400 shots in the shell. Birdshots are
small and are commonly used for hunting fowls and other small animals.
2. Buckshot — The shot ranges from 0.24"to 0.33 inch in diameter and
obviously fewer in number in a shot. A standard 12-gauge shotgun contains
only nine shots.
3. Single Projectile (Rifled Slug) — There is only a single shot or slug in a shell.
Systems Employed in the Determination of the Diameter of the Barrel
of a Shotgun:
1. Gauge System — Determination of the number of lead balls, each fitting of
the bore totals to one pound in weight. The smaller the gauge
designation, the larger is the bore. If twelve balls can be made from one
pound of lead, each fitting the inside of the barrel of a shotgun, the gun is
called 12-gauge or 12-bore shotgun. 12-gauge shotgun is the most
commonly used.
GUNSHOT WOUNDS 375
2. Expression of the Bore Diameter in Inches — The 0.410 bore
shotgun is the only shotgun at present to be so designated.
3. Metric System — The bore is expressed in millimeters.
Length of the Barrel:
There is no standard length of the barrel but modern barrels measure
26, 28, and 30 inches in length.
Grade of Choke:
A shotgun is choked when the muzzle end of the barrel is a diameter
smaller than the rest of the barrel. The main purpose of the constriction is
to minimize the dispersal of the pellet or buckshots after the shot. It is
based on the presence or absence of choke and the degree of choking, that
shotguns are classified as:
1. Unchoke — The diameter of the barrel from the rear end up to the
muzzle is the same.
2. Choke — The diameter of the barrel at the muzzle end is smaller than
the rest of the barrel.
a. "Improved Cylinder" — The narrowing of the barrel by 3 to 5
thousands of an inch.
b. Half Choke — narrowing by 15 to 20 thousands of an inch.
c. Full Choke — narrowing from-35 to 40 thousands of an inch.
The lethal range is normally in an area of 30 inches in diameter at 30
to 40 yards according to the degree of choking.
Types of Shotgun:
1. As to the Number of Barrel:
a. Single Barrel Shotgun:
There is only one barrel and basically the original type.
b. Double Barrel Shotgun:
(1) Side-to-side barrel.
(2) Over-and-under barrel.
2. As to the Manner of Firing and Reloading:
a. Bolt Action:
The action of the bolt ejects the fired shell and loads the next
one.
b. Le ve r Action :
When the lever is swing down it ejects the fired shell and loads
the next shot.
c. Pump Action:
There is a cylindrical magazine which can accommodate up to
six shells, end to end, beneath the barrel.

376 LEGAL MEDICINE
d. Autoloading:
A pull of the trigger not only fires and ejects the shell b also reloads
the next shot and locks it for firing.
Shotgun Cartridge:
A shotgun cartridge is usually 2-3/4 or 3 inches long and the diameter
depends on the gauge of the firearm - . The base and t lower portion of the
cylindrical portion is made of brass with t primer cap at the center of the
base. Attached to the free end
its cylindrical portion is the cylindrical laminated paper tube t complete the
shell casing.
When the trigger is pulled, the firing pin activates the primer which in turn
ignites the powder charge. Explosion of the gun. powder will cause
propulsion of the wad and pellets (shot) in front
The muzzle velocity of the pellet is relatively smaller as compare from those
discharged from rifled firearms.
Except for the presence and nature of the slug, the component of the
shotgun blast is almost the same as that of a rifled firearm. It also consists of
gunpowder, flame, smoke, pellets and wad.
Shotgun Wound of Entrance:
1. Contact or Near Contact Shot (not more than 6 inches):
On account of the greater quantity of gunpowder in the shotgun
cartridge, there is relatively more damage due to muzzle
blast, flame and gunpowder at the site of the wound of entrance as
compared with rifled fire.
a. If the shot is made perpendicular to the skin surface, the wound of
entrance is round but if the shot is made with an acute angle
with the skin the wound is oval. In both instances, the wound border may
be smooth or slightly rugged.
b. The entrance wound is burned, the width of which increases
as the muzzle-skin distance increases but does not exceed 6 inches.
c. There is blackening due to smoke.
d. Gunpowder tattooing is densely located in a limited area. The
area of spread is directly proportional to the muzzle skin distance.
• of choke and the type of ammunition. However, it is highly recom -
e. There is contusion of the tissue that has been blackened by gunpowder.
f. There is singeing of the hair (less than 6 inches).
g. Subcutaneous and deeper tissues are severely disrupted.
h. Blood and other tissues along the bullet tract shows presence of carbon
monoxide.
GUNSHOT WOUNDS 377
i.. Wad or its fragments together with shot (pellets) may be re -
covered from the bullet tract.
2. Long Range Shot (more than 6 inches skin-muzzle distance):
a. At 2 to 3 feet muzzle-skin distance, there is still a single wound
of entry although there may be isolated shots causing independ -
ent entry.
b. At 3 to 4 feet distance the wound of entry is usually serrated
or scalloped circumference and often referred to as a "rat
hole".
c. At about 5 to 6 feet distance, the wad tends to produce an
independent injury usually an abrasion at the vicinity of entry
of the shots. The wounding capacity of the wad is very much
less as compared with the shot on account of its lightness a nd
size.
d. At 6 feet, the shots begins to separate from the conglomerate
shot and at 10 feet each shot already produces independent
wounds of entry.
As the shot begin to separate from one another, there is
the tendency for one shot to strike another causing changes
of the shot course. This phenomena is called "billiard ball
ricochette effect".
e. Smudging due to smoke may be observed up to 15 inches.
f. Gunpowder tattooing may be detected up to 24 inches.
g. In an unchoked shotgun, to estimate the muzzle-target distance,
the following rule must be applied.
Measure the distance between the two farthest shot (pellets)
in inches and subtract one, the number thus obtained will give
the muzzle-target distance in yards.
The character of the wound and the degree of dispersal is in -
fluenced by the muzzle-target distance, gauge of the shotgun, degree
mended to have an experimental shot with the firearm using similar
cartridge and under the same environmental conditions.
A close shot produces more serious injuries because the shots
are concentrated on a specific target and because of greater kinetic
energy of the pellets.
 376 LEGAL MEDICINE
DETERMINATION OF THE PRESENCE OF
GUNPOWDER AND PRIMER COMPONENTS
The Importance of Determining the Gunpowder on the Skin of the Victim:
1. Determination of the distance of the gun muzzle from the victim's
body when fired:
As discussed previously, the explosion of the powder in the cartridge
expels particles which may be embedded in the skin or just clinging on the
surface at a distance of not more than 24 inches. The distribution of the
gunpowder is more at the upper portion of the wound of entrance, due to
the upward position of the muzzle of the gun when fired. The presence of
gunpowder at or near the wound of entrance shows that the gun muzzle
when fired is not more than 24 inches but its absence will not preclude
near fire because other factors might have intervened. Less powder
particles at the wound of entrance is observed in smokeless powder as
compared with black powder.
2. Determining whether a person has fired a firearm:
The dorsum of the hands are the ones examined to deter mine the
presence of gunpowder. When a person fires a gun, the powder particles
which escape may cling on the dorsum of the hand. The presence of
gunpowder at the dorsum of the hand may infer that a person has fired a
gun.
Basis of the Tests:
When a gun is discharged two types of residues are liberated namely, the
metallic residues from the primer which is not only blown forward towards
the target from the muzzle but also backward in the direction of the
shooter, and also the particles of burned, burning and unburned gunpowder
(propellant) moving also in the same direction; as the metallic residue of
the primer. All of these residues are deposited on the back of the firing
hand of the shooter.
Detection of metallic residue of the primer on the palm of the hand may
also indicate that the individual was making a defensive movement, such as
trying to ward off or grab the weapon at the tittle of the discharge. In
suicide, residue may be deposited on the palm of the hand used to steady
the barrel at the time of the .discharge.
Procedures in Determining the Presence of Gunpowder:
1. Gross Examination or Examination with the Use of Hand Lens:
Fine black powder particles of varying sizes may be seen at the
GUNSHOTWOUNDS 379
region of the gunshot wound of entrance, on the dorsum of the
hands or at the outer surface of the wearing apparel of the victim.
This examination is not conclusive because other foreign particles
may be mistaken for gunpowder or primer components.
2. Microscopic Examination:
Fine particles may be magnified but there are no characteristic
shape, color or consistency of gunpowder.
3 Chemical Tests:
a. Laboratory Test to Determine Firearm Residues:
There is inference of contact or near distance of the gun muzzle
to the skin when there is burning, tattooing and smudging visible through
the naked eye. The burning and then the tattooing will gradually
disappears as the muzzle distance increases. The powder tattooing will
gradually spread out to a greater area until it is no longer detectible.
Minute particles of burning and unburned residues and the primer
constituents can be detected in the laboratory.
The same tests may also be applied on the dorsum of the hand
of the persons suspected to have fired the gun. Although the test is
not conclusive, it may be a corroborative evidence in the
determination as to whether a person has fired a gun.
The tests may involve the determination of the presence of
gunpowder residues of primer components.
Tests for the Presence of Powder Residues:
1. On the Skin (Dorsum of the Hand or Site of the Wound
of Entrance):
- Dermal nitrate test (Paraffin test, Diphenylamine test, Lung's
test or Gonzales' tests) — The back of the fingers and of the hand
up to the region of the wrist is coated with melted paraffin, heated
at a temperature of 150 degrees Fahrenheit. To avoid heat injury
to the skin, a low melting point paraffin is used. The melted
paraffin penetrates the minute crevices of the skin and when
hardened and cooled off, some of the powder particles will be
extracted and embedded in the paraffin cast. After the cast is
built with layers of cotton and paraffin to a thickness of about 1/8
inch and solidified, it is then removed from the hand or from the site
of the wound of entrance and the inner aspect of the cast is treated
by means of a dropper with Lung's reagent.
The presence of small particles containing either nitrate or nitrite
will be indicated by a blue reaction of the particles upon contact with
Lung's reagent.
380 LEGAL MEDICINE
The test is not conclusive as to the presence of gunpowder because
fertilizers, cosmetics, cigarettes, urine and other nitrogenous compounds
with nitrites and _nitrates will give a positive reaction. A negative result is
not also conclusive that the person did not fire a gun for a well constructed_
hand gun will not d' charge any residue on the hand or the hand might
have bee subjected to extensive washing.
The test usually gives a positive result even. after a large lap of three
days or even though the hand has been subjected t ordinary washing.
Subjection of a suspect to the test is not self-incriminatory the act is
purely mechanical and does not require the use o mental faculties.
2. On Clothings (Especially Colored Ones):
Walker's test (C-acid test, H-acid test) — A glossy photographic paper is
fixed thoroughly in hyposolution for 20 minutes to remove all the silver
salts and then washed for 45 ,minutes an dried.
The dried photographic paper may be treated with any of the following:
a. Warm 5% solution of "C" acid (2 naphthalamine 4-8 disulfonic acid) for 10
minutes and dry.
b. Warm 5% solution of "H" acid (1-amino-8-naphthol-3,6 disul fonic acid)
for 10 minutes and dry.
c. Warm 0.5% solution of sulfanilic acid for 10 minute ,dry and then swab
with a 0.5% solution of alpha naphthalamine in methyl alcohol and dry.
The sheet of the prepared paper of sufficient size is placed face up on a towel
or pad of. cotton and the material to be tested is placed on top, face down on
the paper.
The preparation is then covered with a thin dry cloth or towel slightly
moistened with 20% solution of acetic acid, and another layer of dry cloth.
The entire pack is pressed with a hot iron for two minutes.
The paper is removed, . washed with hot water and methyl alcohol to
remove excess reagent and dried.
If unburned powder grains are present, it will result to the production
of dark red or orange-brown spots on the prepared paper.
GUNSHOT WOUNDS 381
Tests for the Presence of Primer Components:
When an individual fixes a weapon, the metallic primer residue
(barium, antimony and lead) may be deposited on the back of the hand
with the residue most likely deposited on the skin web, the hand
between the thumb and index finger. The test for the presence of the
metallic constituent of the primer may be done throug h any of the
following:
1. Harrison and Gilroy Test:
A cotton swab moistened with 0.1 molar hydrochloric acid is used
to gather antimony, barium and lead.
The cloth is then treated with various reagents to detect the
presence of a primer component. The reagent sodium rhodisonate
yields a red color in the presence of lead and barium. Addition
of 1.5 hydrochloric acid to the red area that yields a blue -
violet color in the presence of lead while a bright pink color is
developed in the presence of barium.
The test is simply applied but does not enjoy substantial uti -
lization in forensic laboratory because:
a. It lacks specificity of the color reaction for the trace of the
element.
b. It is inadequately sensitive.
c. There is interference of the color reaction among the three
elements themselves.
d. There is instability of the color that developed.
2. Neutron Activation Analysis (NAA):
A sample is obtained from the hands by the use of paraffin or by
washing the hand with dilute acid. It is then exposed to
radiation from a nuclear reactor emitting neutrons. Secondary
radioactivity is induced in the materials removed from the hand. By
making an appropriate counts at different energy levels, the
elemental composition of the residues can be determined with
precision and accuracy.
The technique is extremely sensitive and a very small quantity can
be detected, but only few laboratories can afford to under take the
procedure because it is very expensive and the test is unable to
detect the presence of lead. The test requires access to a nuclear
reactor.
Principle: Barium and antimony are converted into isotopes by means
of neutron bombardment, afterwards their quantity is
measured.
382 LEGAL MEDICINE
3. Flameless Atomic Absorption Spectroscopy (FAAS):
The sample of handwashing is subjected to a high temperature to
vaporize the metallic elements of the primer residue. This in turn is
detected and quantitated by absorption spectrophotu metry.
This method is quick, sensitive and employs equipment within the
economic means of a modern -size crime laboratory. It can detect
the presence of barium, antimony and lead.
4. Use of Scanning Electron Microscope with a Linked X -ray
Analyzer:
Adhesive material is used to remove any residue particles from the
hand. The material is then examined under the scanning electron
microscope with a linked X -ray analyzer. Particles of the primer
residue have the characteristic size and shape which can easily be
distinguished from other materials. Analysis of the particles with X-
ray analyzer will confirm their identification.
While this method appears to be more specific than the pre viously
mentioned methods, it is seldom used because the initial equipment is
expensive and it requires a longer period of time to analyze a case.
FIREARM IDENTIFICARION
The following factors must be utilized in the identification of the
firearm used in the commission of crime:
1. Caliber of the Weapon:
A firearm may be identified by its caliber and it may be determined
from the firearm itself, from the shell, bullet, cartridge or from
the character of the wound of entrance.
2. Fingerprints:
Fingerprint marks may be found in the butt of the firearm or at
the trigger, and its guard. Care must be observed by the investigator
in handling the firearm at the scene of the crime. The fingerprints
found at the butt may distinguish homicidal or suicidal nature of
death.
3. Fouling of the Barrel:
The firearm which is recently fired ma y have a characteristic odor
of the smoke inside the barrel. Chemical analysis of the washing
from the interior of the barrel will show whether the weapon was
recently fired.
4. Serial Nurn ber:
All firearms bear serial numbers for purposes of identification.
The of fender may er ase t he number or may tr y to change it .
GUNSHOT WOUNDS 383
Procedure of Restoring Serial Number if Tampered:
T he pro ced ure o f restoring t he o b literated nu mb ers invo lve
three steps, namely:
a. Cleaning — The site of the number should be carefully cleaned; all
oil, dirt, grease, and paint should be removed with gasoline, xylol
and acetone.
b. Polishing — This operation is by far the most important. The
whole surface should be smoothly polished, using a fine fi le
followed by a medium to fine grade carborondum cloth. When the
area is large or the scratches are deep, a mechanical polisher ma y
b e used to save time. The time o f p olishing d ep end s o n the
hardness and granularity of the metal. However, the area should
always have the mirror-like surface.
c. Etching — For all iron or steel materials, the following etching
solution may be used:
Hydrochloric acid ...................... 8 0 cc.
Distilled water ............................. 6 0 cc.
Ethyl alcohol .............................. 5 0 cc.
Copper chloride .......................... 1 0 gr a ms
The solution is swabbed on continuously until the numbers
appear. • This may take several hours (Modern Criminal In-
vestigation by Harry Soderman, p. 229).
5. Ballistics Examination:
Ballistics is the study of physical forces reacting on projectiles or
missiles.
Forensic ballistics is conventionally known as firearm identi-
fication. It deals with the examination of fired bullets and cartridge
cases in a particular gun to the exclusion of all others.
Ballistics May Be Subdivided into Three Separate and Distinct Area of
Study, Namely:
1. Interior Ballistics (Internal Ballistics) — It is a branch of the
science of Ballistics wh ich deals with • what happened to the
cartrid ge and its b ullet fro m the time the trigger o f the gun is
p ulled until the b ullet exit s fro m t he b arrel. It d eals with t he
study of what happened in the chamber and gun barrel after the pull
of the trigger.
2 Exterior Ballistics (External Ballistics) — It deals with what
happened to the bullet or projectile from the moment it leaves the
gun barrel to the moment of impact on the target or object. It is
concerned with the flight of the bullet and the influence of all factors
in it flight.
384 LEGAL MEDICINE
Ballistic comparison microscope
Terminal Ballistics- This concerns with the effect of the bullet on the
target or until it comes to rest.
Medical Ballistics- A form of terminal ballistics wherein the target is a
person. It is concerned with the penetration, severity and appearance of
the wound due to bullet or missile.
Basic Principles Involved in Firearm Identification:
1. The quality of metal in the manufacture of the firearm is very much
harder and resistant to deformity as compared with the quality of metal
used in the manufacture of the car tridge, so that in the process of
contact between the part of the gun in volved and the cartridge, the
surface condition of the part of the gun can easily be impressed on the shell
or bullet.
2. For reasons known only to the manufacturer, firearms have
GUNSHOT WOUNDS 385
certain physical characteristics of certain type of caliber which
differentiate it from others. This includes the number of lands and
grooves, the direction of the twist, width of the individual land or
groove, style of the cannelure, etc., which become the basis of class
characteristics in firearm identification.
3. No two firearms can be manufactured with identical surface
characteristics. Each firearm on close examination will show the
differences. Marks on the different bullets or shells fired from one
firearm have similar characteristics when viewed in the com -
parison microscope. Marks on different bullets or shells fired from
different firearms will show variation in the f indings. This is
referred to as individual characteristics.
Instruments Use in Firearm Identification:
1. Comparison Microscope- This is an instrument which consists of
two compound microscopes which allows comparison of two
objects by looking through a single eyepiece. On each of the
stages, the compound microscope is placed on the object to be
compared and by manipulation of the mechanical rack and pinion
gear the class characteristics of the object may be observed. When two
objects are being compared, the individual or accidental
characteristics may be compared. There is an attachment for
photographic camera to facilitate the taking of pictures of the
findings.
2. Bullet Recovery Box- It is an instrument or device for the
purpose of recovering the test bullet and shell. In the N.B.I., it is
a long cylindrical container filled with cotton and an open
shooting end. The suspected firearm is fired at the open end and
the bullet may be recovered in the layers of cotton and the shell may
be found in the area where it is fired, in cases of automatic firearm
or in the cylindrical magazine inside the cases of the revolver.
The test shell and bullet may be used for compariso n with the
evidence bullet or shell.
There are other ways of recovering test bullet which are used
in other countries, it may be:
a. Shot may be fired on a box with oil and sawdust.
b. Vertical or horizontal shot on a water tank.
c. Shot-fired on a block of ice.
3. Hand lens.
4. Sharp pointed instrument for scraping ID marks.
5. Caliper.
6. Analytical Balance.