FORENSIC TRAUMATOLOGY MECHANICAL INJURIES CLASSIFICATION. BLUNT FORCE SHARP FORCE Pbraston contusion Lacuration Frockure Light auting — Ineized wound Heavy cutting > Chop Ingury Pointed end =F Stab ingury AERATION > peace scrape 7 only epidermis ie ‘involved No bleeding Typer pressure, Seer ertsene oro permit die tangential presse 1. serateh a Grae wh ernie ate perpendiculer preseure [epmeliam 1 Pressure 1 2. Palen Senne > single linear tine abrasion bby Neil, thorns pio Creseantie pall markt included simplest abrazion bag GRATED ABRASION 7 Moltiple Hiner of scratches over wide area > common t RTA oka GRAVEL RASH / BRUSH BURN dragged against a rough surrace 7 me pe. PRESSURE PRARSLON. PATTERNED] IMPRINT MBRASION > Ligakure mark Bile Mark > Rodiater Grill Mork Ligature mark alto produces. pattern) Tyre mark Berogions will lek vz Know > pirecr™ oF FoRcE Epitieliad 184 belpe Ty te > TIME SINCE INDURY | AGING OF ABRATION ~ calour of ScAB Carid Lymph] help to it ee Roo Raw Ro Reddish scab AB — Reddith Brown B= Brown =: Bink GRALED ABRASION = hrs - 28 Da TS aay = 6-7 Dug7 SITE helps to Know the TYPE OF CASE, genitalia > Sexual Assault Perioral Region + Gmokering Medico legal Importance > PAITERN OF WEAPON TYPE oF cate DIRECETON OF FORCE ‘Tue Stwce TNOORY Ail abrasiont ase SIMPLE HURT [Except corneal Abrasion] 4aag fcontoston | saurce. 9 ear fone uN Fone + seating 8 RS etter era vestele Rapture piecelorabion 4 Si colee® oF Blood CSRTRAAERTIOND RT ts et = Seeger Regins 4 ‘soeting & piclorat” oF Sun URGED Factors. thak influunce contusion L SITE (same Fore] Bony Prominence, > t locke stin > t Thick Gin, on Lv BLACK EYE, 2 pge Ceome Fore, J children, > t Elderly, - 4 3. comPLEXION foir > t a 6ex Females > t wees 1 Eeropre| megAATORY BRUISE + Bruige AORY FROM SLE OF Impact 7 eq. Black Eye | Racoon’s Eye! Pandas Eye! Spectacle Hamatoma. = dle OF Ankrior cranial Fossa. 2. PEVE PENNY BRUISE 7 sean in Throating, Bottered “Baby [shaken Baby syndrome 3. TRAMLINE | RATLWAY LINE BROTSE 7 Seen in _Lathi_BHick irguries:HEALING > colour cHange = + oxy Hb > rep > beoxy Hb, + ewe = hemoside BROWN > Biliverdin + Green > Bilirubin > Yeus > colour change starts from periphery > Mo colour chonge DiFferenbol Diagnosis of BROTSE AGING OF CONTUSION Fao Hours Fao Hous — 4-5 Dap 6-3 Dap 1 pays 3 oays fm SUB CONSUNCTIVAL HEMORRHAGE Bush ~ ts 30 HYPOSTASES ‘Sue, Dependent parts BLANCHENG, Present: COLOR, CHANGE, Absent MpRaENs. Requlor EXIRAVASBTION Absent INCISEGPOUR HO Wathed quay BRUISE fing vohere Posent Present Lerequlor Present: Perstts “TRUE _BRUISE PRTLETIBL BRUISE, ering ‘rawna vivant Pate sue Prepare pecesntle sitet colour All colours, Brown pussrens Pore presen scite eiood etd non ron cok Presa manaane regular Requlor Lncena tion > tncene > Tem en > involver Epidermiz & dermis > 3. GrRquBRInaRRE A an Floor > +. CFSSENIBHAGER) seen eprpenmts, eames Blood vessel Nessdls & Hoir bulb > GiUSHEBTYPES 1. SPLIT LnceRnTEON 7 ok bony prominences: 7 magnified Lenk helpe in IdenkiFicat” 2. STRETCH LACERRTION 7 seen ot Over Bhedhing OF Stin 7 producd by Ru over inguries, compound fracture. 3. AVULSION LACERATEON. Geen T Run over inguries [Rotational anguries) 7 FLBPPING | FLAYING Tf tne. — helps te Know the direction oF force 7 DeGUDVING TAOURY — Entire stin comes ouk 4. cor UncennTtON > Seen % theaaty Weapon % Sharp edge Care} = ooo } Present crushing Fradure oF underlying bone occurs RNCLSED WOUND / cur | éLASH] SLTCE INIURY 7 Produced by Light uulting weapon tke x blade ZA Surgical Blade Fy rorce Epidermit Incied “Nair Qub wound . Dermig. Blood vessels F Leng is more clean cot Margins 1m the floor Vesela & Hor bulb afe cut. 7% for Naked Eye — margins looks Regular > in floor, tissue CRUSHING tot. 7 Looks like tneized wound > ENEEESTNISORINGTLACERATION > seen on Scalp forehead ‘Tygorra Hic crest Shin, ee \ ie sxmere e DEGLOVING nal INCLSED WOUND‘TILING 7 Tele te direet” oF fort em > Feahure oF indeed toound AGING OF INGLEED ROUND Fresh > Naihophilt , Marginat® sabes * monooyter aubre > Endotfelial Layer oppearana Q-Spays Granular” Haru + nb. AS pay Fibnile tnt. Papup Sear SoteLOAL WOUNDS | HESLTRTEONAL CUIS | INTENTIONAL coTS. > Muntiple cabs. 7 superficial Uinear cake Fat accestible portt oF body > Diagnose OF Suicidal fenderey sme MOURY + Produced by Pointed end Lenn z pencil tip] Fe In more, Types Penetrating Purorabing, only Eniy wound ie tot Bok Entry 6 Exit founds ae present 2 ENTRY WOUND ett WOUND, ManeiNs inverted Everked sire. e sroall an sere Pear ‘STAB WOUND SHE + aivet tnformat abou TYPE OF WEAPON ~ Single edge Ledge / Triangle Cone end ik atuli., Oe end ix blunt) Double edgt + oval / Spindle C80m ends are atuh J LINES OF LANGER | CLEVAGE LINES > imaginary dines > made of collagen Sorex | 7 LF the Stob ingury iz lor $0 the liners GAPING is more. > af me stob ingury ix parallel to the linet, GAPING if tees a FISH TALLENG 7 Produced by Single alge weapon fers blunt end Fer TILINGnut @vARo. mr 4 > mit Guard can produce svane fatkmed abrasion Patkmed contusion + Anpurier produced called HLLT maRKs — indicales the COMPLETE PENETRATION Warp KIRE | SEPPORKU 7 onually practiced by DAPENESE SoLoLERS > Stab ingury fo abdomun > SelF inflicted 7 Evigceac” cccurk > Gralatory collapse > peat sa DEFENCE WOUNDS, 7 Retive defence aounde * 1¢F web space , Palm > passive defer wounds > medial ulnar margin of forearm > Homicidal angury = Nor mandatory + attacked from behind + atracted when uncondoat + attacd by surprice DEFENCE Wounds FreRtcareD intguates | Ferrous INDDRLES 7 Eimer, Self inFlicled > done by himseit Self Suffered > done & oe help of omer person 7 Fendures OF ELF INFLECTED INQURIES PE incised wounds ime) urns Sure > Accessible points cuorHs > Nor atecked DEFENCE THOURY > pgent: REGIONAL TNIURIES SKULL FRACTURES 1. FRACTURES OF KUL VAULT TL, FRACTURES OF SKULL BASE 7 mc bone undergoes Hip stall > TEMPORAL BONE \Vautt FRACTURES. ; 1 FISQURE FRACTURE | LINEAR PRREURE me type OF Stull 7 single linear jhachire assune2 DEPRESSED i / SIGNATURE # | FRAGURE ALA SLENTURE > couted by heavy weapon T small shiting surface [Hammer > and me type oF Stull # 3. commanureo | SPOER WEB # cated by repeated blows > multiple Lines Inlersecking eod) oer A. INDENTED # / Pon's # > occurs in) clngHte stuns C infants] > preduad during obsletric forupe dilivey 5. SuMRAL #/ DinsraTIC & > froture Line runt along sulure Lin, % more common T SAESITAL SuTURE 7 not common above Soqrs oF age commonly amotielid T young adullx 6. GUTTER FRACTURE + Produad by Glancing /obliqua bullet SkULL BASE # 3. RING FRACTURE 7 Associatid t fall from huight > #1 ti rung asound foramen Maghury ike @ ring > 4 OF Posterior cranial fossa 8 HING FRACTURE / moTOR CYCLIST FRACTURE + # tine biecks the stull Lone info a halves > commonly seen in motor cydliste 7 Frachire OF Middle cranial fosso Coup ANURY / CONTRE COUPE INJURY fh blow from side oF skull & Head is MOBTLE Ingury ot the point oF contact > coup anguay Angury Opporite to the print oF Coniadl -F CONTRE COUP INJURY > commonly ommotiatid t Head > utidely aaccepled theory ik SHEARING STRPIN THEORY DEPRESSED # SUTURAL me coup, conhe coupe ingury if nokd in Impact: @ occipital Region — Frontal lobes eolll be conhutedINTRA CRANIAL HAEMORRHAGES epipentradural ee bora mater Arachnoid mater RA Pia moter RRPPFF oxoin water eridging ‘subdural space. “——————_Veins + source oF EDM > middle meningeal Artery + CONTENT OF Sve CURAL SPACE > Bridging veins (source OF SoH) > CONTENT OF SAS (sub arachnoid Space) ose 4 Givcle oF willes (Source oF Sub arachnoid Haemorrhage) + eDH CeKtra dural Haemorrhage ) > Least common, most Fotal > SdH CSub dural Hasmorrhage > > SPH (Sub arachnoid Halmontog) > rc Cintra cerebral Haumorrhage) > me EH ( Exim DURAL HAEMORRHAGE] Blow trauma to the Side oF head (Pterion ) + Fracure oF temporal bone + Rupture oF MMA + Extva clurol Haamorrhage Fo ngury of the point oF contact > coup angury > Angry Opposite to the point of conta: CONTE Coup INJURY > eEpH is always a COUP INJURY a tuctD INTERVAL, + onconcious ttl "= > period oF conciouness bu A URCOndousress — —F LUCED ENTERVAL, > medio legal Relevance Patient Doctor a. Valid evidence in court Deal OF a patient dir a vad will medical Heqligence 3. Crime + criminally liable “F_ cP) 304 (A) 10SDH (SUB DURAL HREMORRHAGE) TYPES eute SoH > tin br Sub Rute SDH hy > Baus chronic SoH > > mons. Reason + Intense Shaking Rupture oF bridging veins PREOLSPOSING FACTORS 2 p6e Common in extremes of age a. ALcoHoutes children elderly shaken Raby Follows Syndrome | 2 minor tnfantile trauma, whiplash Syndrome, (most Constintent Feature) SPH (SUB ARACHNOLD HAECPORRHAGE) F dit rupture oF willis [trauma | Spontaneous 4 + to head | neck rupture OF aneurysm a SOB ARACHNOTO HAEMORRHAGE + ese + Blood % Lumbar puncture > xntHocHRomra [ Blood stained csr 7 — characteristic Fincling oF SAH coH cr SCAN > Giconvex| Lens shaped opacity % > Emergency craniotomy & removal oF clot sow er stant Concave Convex opacity PUNCH DRUNK SYNDROME, 7 seen in Boxers C Boxing profession)Repeated blows to head + minor hatmorrhaqes in Brain C Boxer's HAEMORRHAGE] PONCH BRONK SYNDROME | DEMENTIA PLATLESTECR / CHRONTC TRAUMATEC ENCEPHALOPATHY] 4% Parkinsonism > rigidity 4 dementia 4 dronken appearance FORENSIC BALLISTICS - Part I pauuisTecs, study OF Fire orm and Progestiles & ite effects PROXIMAL BRLLESTICS > Study oF Are am & its ammunubion + Inkmel Sallishes INTERMEDIATE BALLISTIS > Study of motion OF bullet > Exlenal Ballishes TERMINAL BALLISTICS > Study OF eFFeckt OF bullet on target + ioound Ballishes > cAwwIN GoppARD > Falher oF forensic Ballistics a bene - ot ; : ‘ a aa Soe > Ovier end OF Barrel +> mor2e END Ser od & tare > then BAB Components oF Flre fren Cexenci) xaung pm) PERCUSSION FON nem of CHAMBER vee Car / rope BRE Lend Femuttton — gnsoves rasan coe wot TheaaeClassineati engin mene Cran SORED/ Sher Gon ——) nan = tral grovingt = No Roa Riringe — User Bullets — Uses Lead shes | pellets = Rings vl Sin Me HME — sine bore * Speed Double bore. Range. es ce ra Range Wan Ried Suns ~ 64: Reravers Ps watery Rete + Helixometer is the instrument used for Smoot Bored Gun | Shor gun 7 se in dispersion decreann the range > cHoking > slarrexwing of muaale end oF barrel the exaMinaE? OF inner Surface OF Bore 7% Lses the dispersion % ser the Range 7 Gradings 1 Onchoked gun Leylinder] > max. dispers® + at. 2, Improved qylinder 3. Modified cylinder 4 Pally choked > least ditpers? tnt. Range 1. Revolver aoe yords R {spe = ter oe FRE 3. Military Rife 3000 yards 4. Shot Gun 80-60 yards REELED GON. ‘swor GON calibre Gauge /Bore Distance bind 2 Opposite Lands - cmtieRe © sat No. oF balls made from 4 pound oF Pb —GnUge: sBore @ 2 + 10.06 bale IF 10 ~ 10 bore gun 1B ~ 18 bore gun ok Sine LAND > Elevared Groove > depressed Le, OS bore size Ts, Sizess“SHOT GON CARTRIDGE RIFLED GUN BULLET 4 ‘eorking Primer | premen cop y es vino berks af lubricant Psion ke thy mm > mass only cause minor bruise Melotiy KE * rnaury V> Selecity uw Popes 1. tack Gun Powder ~ 9 Polassiom pita F357 (© Charcoal (lack) F181 )Sulphur > vt Temeke, 4 Power Igo S000 ~ 4000 ce! gon Lrower] A, SMOKELESS GUN POWDER Nitto cellulose Nitro Glycerine Nitro Guanidine ~ Single Bose > ited cellulose Double Bate Nitro calluloce + Nitro Glycerine Triple Bore > Nitto cellulose + Nitro Glycerine + Nitro Quanidine ~ fomeke 7 power gm 12,000 ~ 18000 laa 3. SEmr SMOKELESS GUN POLODER ~ Black C807) + Smokeless Lak] > eq F = Fineness FFG oo no.of F Tses, Fineness T —> Power tT FFG FFFEG,PRUMER, constituents Sorium Nihal Lead peroxide Bnkimont, Styphoali Claad Stuphnati] Tehazine Strike. [Pall he TRIggeR] — [FIRING PIN] —*> [PERCUSSION GOP] > [PRIMER] moves Forward Senpicde puscnances errects 2. Flame > Burns) charring OF Skin | Singeing OF hair 2. Smoke 7 Blackening 3. unburnt / partially burnt qun powder > Tattooing | peppering 4. Bullet +> Purmkured wood & collars > wiping the area € wet clo + Blackening will be Femoved Smoke) Tastoving cart be removed Cqun powder) Gallars produced by bullet Grease callar | dirt collar Spinning ~ abrasion collar DISTANCE TRAVELLED tei shor 6on lopSse Flame sem 15 em — Soin Tela smoke 30 em us em 2 easey er Yee Gun powder ¢0-40 em 60-90 om ’ * Sintra wad am Ser Gmevcr ew woe cnenct coun > inside ABRASION COLLAR 7 outside — en Cenc stele tee 2 conto shot > qun if held on igh contatt T skin a. close shot > person lies Lin range oF Flame 2 Near chot > person lies outside the range oF Flame but cin ‘the range oF gun powder & Distant Shot person lies Outside the range OF gunpowder4. CONTACT SHOT > eurns, blactening & tattooing i& Seen inside the Wound > stellate ( cruciate margins 44 Skin splits dit energy & expanding gases Creates stellate margins cherry red coloration con be seen b'tor oF 60 (Lorbor monoxide) a Close SHOT > AMI eFFects ore Sean NepR SHOT > EFFecE OF aun powder & bullet are seen 4 DISTANT SHoT > EFFeE OF bullet seem (puncture wound , Grease & abras" collar) nennsion couLne > circular > Formed by bullet hitting perpendicdarly ° > oval > Formed by bullet hiting obliquely strelerinc > direction of bullet can be found out by the shope of AC lovediad! SHOT qunt RANGES ® contae shot 7 tightly on sein & close shot > >am =) o o ® contaet close intermedialé—~pistant shot shot shoe hot ise | ameter Flame, smoke & Gun powder cUOFF ameters > dispersion stares (satellite holes seen) 4 meters > Spread oF dispersion Completed errers @ contaw: shot + stellate cruciate margin 7 Burns blackening E tattooing is Seen inside tre wound! ® close shot > All eFFeces can be seen © Near Shot + Single puncture Wound T irregular margin, Seen © termediate chot > central hole surrounded by Satellite holes Sean © distant shor > only pellet holes are seenENTRY WOUND Bar WOON Margins inverted margins everted margins Size Smaller except larger For contac: shot Erreus oF Flame Ceurné) seen not Seen, SmoKe (Biaceening) Seen not Seen Gunpowder Crattcoing) Sean, ot Seen ‘Beracion Collar present ‘absene Grease collar present absent gleeding relokively less relatively more BULLET FINGER PRINTING Primary markings + dt rifling > aka class characteristics > some for all guns prodveed by same manurouurer Secondary markings > dit irreguarities | CE) oe = = primary morn b. manufackwing process pene) > aka Individual charocteristics > different for each gun produced by same manufacture Bullet Finger printing done T compneiston microscope sa test C Gun shot Residue Test] “These tests confirms whether a person used a gun or not 4. Flameless atomic obsorpt? specerascopy Cenns] a Herrison & GitRoy Test 3. Akomic Absorption spetkrastopy CANS) Firing > eras A, Neutron AceivakiOn Analysis (NAR) 4 > Hee 5 Dermel Nitrare test a 7 pas 6. SEM - EoxR Cscanning & microscopy - " an energy dispersive x- Ray absorptive > > on 8 > sem - Apexn Spectroscopy ) most specific Test) ENTRY & EXIT WOUNDS IN SKULL BeEVELLING, 7 te its a entry wound, inner table show bevelling 7 Im the exit wound 5 te outer table «ill Show beveling PUPPE'S RULE = > proposed by George Puppe 7 Laker fracture will not oss prior Fracture > used for sequendng oF qun ShotsFORENSIC BALLISTICS - PART Il Types oF BULLETS pecee Neate eee rece ey leueteTela /oreecd (an0 om-o > one bullet follows omer bullet ware” a, TRACER BULLET > bultee glows in the air when it ie fired > erating the pom of bullet it possible 7 used in militory warfare 3 pum bum BULLET / MUSHROOMING BULLET > Seri gacketed bullet > whim it enters the Skin, it expands like & moshroom > MusHROOMING 4 PRANGIBLE | FRAGMENTED BULLET ae > bullet get fragmented on impatr > leo > made up oF zinc | copper Frogmented Bullet 5 Ricouler | oerLECTED auLLET > bullet tat gets derlected from a intermediate 22> care surface bine internal ricotheting occurs in Skull 7 creares irregular entry wourd 6 INCENDIARY BuLLEr > bullet cohich explodes on impott TUMBLING BULLET bulla Whidh Totares & hit the target 8 YAWNING BULLET > bullet Which moves in irrequiar fashion KENNEDY PHENOMENON > Gun shot victim, rmoitinle woynds 7 ding} larogene suturing J intervens? 4 Appearance altered + Range determinat” is difficult [KENNEDY'S PHENOMENON Buller Gance 7% Buller do not enter the stin 7 produce an abrasion & inused wound 9. Souventa BULLET / RetANE BULLET 7 retained bulla in the body > FibrOUS present around boiler can produce chronic lead poisoning (Plumbism), Oferwise it Is harmlessBILLIARD BALL EFFEC > seen in Shot gun ingury on entering the stin, lead shots collide T each oer & all lead shots disperse widely in a close range + resembles like a distant shot because OF billiard ball eFfed BOLLING or WELOING EFFECT Sean in Shot gun ingory > Few lead chots will combine togemer & enter the skin olong T omer lead shot creating a Central hole ¢ pellet holes + resembles like a TiFle gun &% Shot gun shot TYPES OF GUNS [omer man RiFle & Shot gun 2. PARADOX GUN > —SMOOT ored gun 7 im termine! port has riFling 2 CARBINE > Rifle gun 3 MuskeT > smooth bore gun iearoiartee BLAST INJURIES BoMe BLAST INJURIES PRODUCTS RELEASED FROM BLAST a. BLAST WAVE A. FLYING OBJECTS | PROJECITLES | musstLES 3. WIND > Couses victien displacement 4. MISCELLANEOUS a. BLAST Wave + pass through body oF persons 7% organs t oir ore affected ‘+ car > Tympanic membrane rupture Cme) % Lung > Blast tung C fatal] b qin > colonic perforar” > inguries called as PRIMARY BLAST INDURIES: AL FLYING OBJECTS | PROJECTILES | maussiLES 7 produce Abrasions MORSHAL'S TRIAD contusions ak some site Lacerations > inguries called as SeconoARY BLAST InguRIES 3. VICTIM OLSPLACEM ENT > couses ckeletal # J imgyries KMowA as TERITARY BLAST INJURIES 4. MISCELLANEOUS > Boulding collapse > Traurmatic Asphyxia Fire > Burns > inguries Known as QUARTENARY BLAST TNSUATESONDER LATER BLAST > ingery depends on me level oF head head below ime water level > Tymponic membrane Rupture head above the waber level > GIT Ingury Motorou's cock TAIL Petrol Bomb solro BLAST 7 Explosion oceuss OM omer Side OF Colid Surfatk , energy transfers into ‘tre person > couses skeletal # THERMAL INJURIES 1 AWauRrES ove TO HEAT > General heat > causes hea cramp, heat Syncope, heat Stroke > Local heat Cauuses Flame burns, Sealds corn > General cold > causes hypothermia Locot causes Frost bite, Trench Foot t GENERAL INCREASE IN HER! 7 Environmental Temp t Hypomolamus + Heok cramps @» + Sweating > Loss of eleurolytes + | Miners Cromps | Firemans cramps + sweating > toss of oe > [Heat Syncope ] + voseditakat® n + ody core temp > ens eymptoms > [Heat stom ] HEAT STROKE | THERMIC FEVER) SUN STROKE | HEAT HYPER PYREAIA 74 BCT + rectal temp > ic CNS. Symptoms arg Stin | absence oF Sweating miosis > Pm Finding — PME [POST mORTEM cALDRICITY] + body remains warm > Newsis | edema in puskingi loyersoF CerebellumTHERMAL INJURIES Loch INCREASE IN HEAT porns > dit. dry hear Scolds > dit moist heat BURNS, common CLASSLELCATTONS > OUPUYTREN'S cLASSEFFCATION, F TLSON"S CLASSIFICATION WELSON'S CLASSEFICATION 1e euRNs > Epidermal burns 3 BURNS > dermo Epidermal burns F GURNS > Deep BUMS 2° BURNS. a BURNS 3? BuRNS eryimema@ blister ® painless. pan =@ pan @ scar ® busters @ scar © RULE OF @ / WALLACE RULE CFOR ADULTS ) a +a] 4 4% > for head & neck 8% > For Front OF chest: 4% > For back oF chest 4 ar > For Front oF abdomen & ay > For back oF abdomen 4 a7 > For RE. Upper Limb 4 ar For Le. Upper Limb “+ qr > For Front oF Leq 4 at + For back oF Leg 4 an 9 For genital surrace 4 > yo - 507 involvement if Fatal LOND G BROWDER"S CHART (FOR CHELDREN C1-syrs)) 187 > For head & neck 1352 For Lower Limbs RULE OF PALM > Si2e OF bume area = size of palm ay FIN CASE OF PATCHY BURNS cause OF DEATH Immediate dea ~ neurogenic shock % co intoxicar” 2. Ist poy > hypovolemic shock 3 and Day > ARF Crcute Reno Foslured 4 3rd - Yt Cay > Sepkicemic shock > mec of dem > Septicemic chockPOST MORTEM FINDINGS SPECLEIC SEEN > pntemortem bum signs 2 BURNS Line of Redness > vital Reattion + > signs oF healing + CGvonular? Tissue ) > Signs OF infection + erayres in bumt area 2 BLISTERS > dik burns or decomposition Prtemortem Blister Postmortem Blister Edges Line of redness @® Line OF redness © content Inflammatory fluid air bubble (Fih In protein § chlorid) Base Eryhemic pale SIQNS OF RNTE MoRTEM BURNS | > soot: particles deposited in oirway A Tone Aeon corling ulcer Cot ast part 3 NTE moRTEM BURN SLENS 8 7 plbumin coMb| curling vler Healing 6igns infection Line OF Redress + Emaymes 500k deposition omruse ee SPECLFIC SIGNS | HEAT ARTEFACS HEAT STEFFENTNG, HEAT RUPTURE Heat HEMATOMA Hear # rpwee Flame emits > > wanide > Soot pasticles2. HEAT STIFFENTNG moscue f Hear a. Hepat RUPTURE Weak — > drying oF skin + Muscle proteins coagulation muscle stife > resemble incised wound > skin split FENCER'S ATTETUDE/ HEDT STEEFENENG | Pugrisstc arreruDe | BOKER S ATTETUDE J DEFENCE ATTETUDE, > Herr euprore HEAT RUPTURE INCISED WOUND sine multiple & large small margins rrreguloy regular Floor Nerves T antaut pense Tor vessels. Vescels Bleeding absent present Inflammatory react” absent present HEAT Hemproma > resembles EDH + Hear — rupture oF vessels = > Hemarome HEAT HEmaTomA eH DirFusely Qt the side OF head (Temporal ) Be one chocolate Brown Rect Honey comb appearance b cob 4. HRT FRACIURES > ae > non specific > Seen in skull & Skolt 4. T Intra ania) steam pressure + Seperate the Subure intense drying of bones Jong bones a Rapid drying q Contracr oF bone > # over Outer table LONG BONES 1 Hear t T shrinkage of muscle T Poll on the long bone + Fracture multiple # lines from a polat bo displacement seen in temporal bone STREET § BVENVE erwork OF #H Seen over the CortexoF burnt_bone > STELLATE # #moist HepT > ScALD > IE hot liquid & steam [eens die dry hear > dik moist heat > below upwards > above down wards | Line of Blister > vesicles at edges > vesicles oll over arrected ores > chasring} singeing + No charring | Singeing of haic > Gurnt clothes > wet clothes + soot co in blood 7 No soot in airway co in blood > thick scar > tin scar TRANSPORTATION INJURIES 7 36 deat occurs Tin 30 days OF RTA, it is attributed to RT re see ee 2 cuumersenrzon ‘ we: 4. PEORSTREAN aN2URIES a. OCCUPANT ENOURIES PRIARY tmpwer BHOVAES « 2. PEDASTREAN INaURIES | © PRIMARY TropACT INDURTES > dit ast impate OF the vehicle o> b. SecononRY EmPACT TNIURIES > dit APA impack oF Vehicle SEEONONEY pac ENOURIES &TERMEARY IMPACT ENDURTES| } dit Fall oF the person, SECONDARY INOURIES fon the ground q y) ‘a. PRERMARY IMPACT INGURIES > Level of inaury depends on height OF person & height of Vehicle “+ usually at the level oF legs > die eumper tmpncr Soar it isa > eumren # > Usually affects Tibia 7% helps in detecting direction oF force Cvehicle) TERTIARY LIOPACT CNDURIES b. SECONDARY ImpAET TNOUATES gle BONNET IMPACT GH) LIINID SHIELD ImPRCT 7 carn couse Head Tngury OF skeletal H OF cervical IngUriy + pattern inguries can be found ©. TERTERRY ImPAG | SECONDARY INDURIES > dit ground impact > can have head ingury or abrasions or lacerations + Head ingury Mead ang } ee : teownres Lecerations @ Person Uossing the road, hit by @Vehicley he was Moun On The Ground & Sustains: head ingury € ron over by anoiKer car, cause oF head Ensury? Secondary | Tertiary impact InporyOCCUPANT INJURY @. HEAD EmpAcT > Read hitting te Wind Screen 7 eroken wind sreen (glass pieces) 4 Mouiple cuts Sparrow foot marks * SPARROW FOOT INDURIES b WHrPLasH rNDURIES Neck goes into hyperFlexion & hyper extension > Spinal cord tnguries > sally lower cervical region is arrected + Hyperextension is more responsible for whiplash ingury STEERING WHEEL iNoURLES + patterned contusion > stemal # > rmultiple transverse tears LLnooeR Temes) seen t adta 4 sent eis rnovres + occurs dit hyperttexion on sear belt > causes sear GELT SYNOROME 2. Skin contusion C pattemed ervise] a ndominal organ Ingory Lme> mesenteric rupture] 3, Lumbar vertebra H > CHANCE H Céplits at posterior level) : GBs Seat Belt Ingo skin Bruise chance fracture Seat Galt Inoue ELECTRICAL INJURIES Forms 3 AC * more dangerous (4-5 times) than OC ‘TERMINOLOGY > Ampere > determines the Fatality in electrocution > 10-20 mA > couse Tetanoid convulsion > voltage > Resistance cop Ccause oF Death] tn Eleckricution + pepends on cireait Clow oF curent) F me couse > cardiac arrythmios > and me cause + Respiratory failure > pongerous Graut + From tt hand to AE footmortem FINOTNGS SKIN FINDINGS. MUSCLE PINOINGS BONE FINDINGS EROCOOTLE BURN. SOULE BURN [FESSUE WHICH GIVES THE mAAIMUM RESISTANCE TO ELECRICTTY > GONE ORDER OF RESISIACE TO ELECTROLUTEON BY THE TISSUES Dry skin > Bone > moist skin TSS rate” = Seorrant pears 2. GRIN, FINDINGS 7% 20uLe BURN 4 endogenous burn 4 central crater ¢ peripheral raised margin % dle Low voltage t tight contact ried nigh + merpursarion 4 Deposition oF metallic ions from the conduttor into skin 4+ AcRORERCTION TesT > detects metallisation > CORRENT PERRIS. 44 deposition of metallic ions into the tissues 7 HIgh VOLTAGE LoosE/No conTAcT produce FLASH BURNS + diffuse patchy burns 4% crocopile BURNS > multiple pitted lesions 2. MUSCLE FINDING 7 ZENKER'S DEGENERATION % coused by the passage of electricity through muscle 4 causes myolysis ———>_ myoglobinuria one pearls} 3. BONE FINDINGS. {eax dripping’ * BONE PEARL | WAX ORTPPINGS \ high voltage electricity produce radio opaque densities on x-rays. DUEIIAL ELECTROCUTION + practiced if US Conited States oF America) FLULGREE BURNS, > seen % lightening Coc] > aka PREORESCE NT MARKINGS 4 looks like a branch of a leaf 7% ara LcHENBERG FLOWERS > aKa FERNS F aka KERANOGRAPHIC MARKINGS > + FILEGREE GURN Seen in gq brs to 48 hrs THEORIES a. STTUC ELECTRIC OLSCHARGE 2. HAEMOGLOBIN STAENTNG 3. ELECTRON SHOWERSTORTURE METHODS LEGAL PROVISION AGAENST TORTURE 1. DECLARATION OF TOKYO gives the definition 7 prohibits the doctor to tating part in ang torture > mention the quidlines fora doctor to behave in case oF a torture 3 330 TRC FP) Hurt by torture 2331 IR) grievous hort by torture TORTURE METHODS 2. TELEFONO > Repeated slapping on tme ears 2. FaLANGe > beating over the Soles 3 aka Gnsizne0o 3. PyRROr's PERCH > TYING The limbs along horizontal pole 4 Shu HORSE 7 Forced straddling 5. pay SUBMARINE > plastic bag asphyxiation © WET SoBMARINE > forced Immersion of head under water 3. PICANA 7 Electric Shock torture ® cormue's PRoD > Electric shock to genitalia 9. PLANTON 4 prolonged standing fo DUNKING > forced immersion under water PARROT'S PERCH ORY SUBMARINE WET SUBMARINE PICRNAINDIAN LEGAL SYSTEM & LEGAL seerions MEDICAL JURISPRUDENCE IPE EINDIAL PENAL CODE J 1Beo > Defines OF Fence & punishment (D) = BeFinition (7) = Punishment ag >) angory any harm illegally dore to any person's bedy. mind, reputat”s, property las + or bite |a6 > () cea CRIMINAL RESPONSTOIUTY Depends on a age > HC G2 > KAYS > Not Hable For any crime ure €3 F 7- ays > Nobility depends on Maturity OF the person F maturity determined by cout a Insanity 7 IPC 84 > Insane + not liable to be punished T Unsovndness of mind ak the time oF doing er) unable fo know nakure & quality oF act con unable to Know What he was doing - wrong en unable to know Whar he was doing - contrary to La 3. intoxication ire 85 % Involuntory drunkenness + Not liable For Crime 7% me substance which intoxicated hin is given Cour is Knowledge ire 86 > vVoluntory drunkenness > liable to be punished CONSENT, ©} Minimum age for consent in mojor procedures is > IByrs 89 > Minimum age for consent for physical examination + 1a yrs IP child if consent given under insanity Intoxication Ga_> 1h emergency situations , no need to get the consent iss > @) Pergury > giving false evidence after taking oar 1984) Pergury 19% > Ce) False Certificates + moK punishment > 7 yrs imprisonment] a0 > ©) disappearance oF evidence intentionally Ext embalming of poisoning case _prior to abopsya>) Adviteration oF food 233 (PD Sale oF Noxious food a4 FP) Adulterakion oF drug 255 > (P) Sale oF adulterated druq any >) _negligent conduct poison, CULPABLE HOMECIDE 359% ©) culpable Homicide - not amounting fo murcier 300 4 ©) culpable Homicide ~ amounting to morder cH = Not murder cH ~ Murder likely to couse deam SufFident Eo Cause death (or = 299 (= 200 r= 304 (= 303 Attempt = 308 @tempe = 307 304 304 (8) (PF) causing deam due co rash] Neglegent act Ex: deam of © patient dit medical negligence yrs Imprisonment 304 Ce) > ) dowry deat 306 7G) _pbetment for svicide hurr & GREEvOUS HURT HuRT > any persOM causing bodily pain, disease . infirmity > all hures are ingurieé bur not all inguries are not hort MIND] REPuTITION! dpecr ‘TNGURY TNOURY > Ingury related to body , mind, reputition & property HorT > Injury telated to body Cphysical component) only Gerevous HURT 2. Pry hurt whidr cautes Emascvlation [loss of potency) Permanent loss oF Vision oF eye permanent loss of hearing oF elmer oF er permanent loss of joint | member Permanent loss OF power oF joint Or member Frackure or dislocation oF tooth | bone Rermanent disfiqurot” oF face | Head Lex i Lacerat® Gbrasion > Simple hurt cornea! abrasion + Grievous hurt C result in loss of vision) Ao wren& Any burt whith endangerous the life of a person cn I fora Person is in Severe bodily pain (on period oF Person unable to do Ordinary activities J > 20 days wort [StmPLE HURT “GRIEVOUS HURT (@) 5a tre ©) 3a0 1Fe @) 323 1FC 25 1Fe ()_& dangerous weopon = 234 ()_T dangerous weopon = 226 Ponishroent Cimprisonment) Bas > aye > Voluntarily cousing hut Bay > ayr > Voluntarily causing hwt dangerous weapon jas 7 +¥r > voluntarily causing grievous hurt bac 7 loyrs > voluntarily causing grievous hurt © dangerous weapon dangerous weapon 4% any weapon which is xed For culting, Stabbing Shooting,bire, bomb: % any weopon whith if ured as weapon OF OFFeNce| likely to couse dear 34 CP) hurt 08 provocation 225 __(P)_Grievous burt On provocation Due to rash | negligent att 26 7) endangering Ingury at > bert 238) Grievous hurt BGG) 7 © vitriologe [Acid attack 226 ©) > CA) _ Attempt oF _vitriolage sae « PY Adminiatering a poison % eo couse hurt eo 4 Fo fatlitake te Commission oF offence ageAULT 251 Gestrue jword that creating Fear oF criminal Force On a person -INOECENT ASSAULT 35% Fuse OF criminal force to oUbrage the modesty OF A Women 85a 6 > @) Sexvol Harrassment 254 B > criminal force to dicrobe a women 25a CF CP) Voyeurism Cuatching jeapturing the image > private aurs]] 254 0 > CP stalking 4 Follows a women | contacts | attempt to contac: Tepeatedly| Monitors a women 35g ¢ Ast offence > cognizable | bailable > Burs 3540 and offence > Cogniaable [non botloble 3 ursKIDNAPPING | REDUCTION KEDNOPPENG a. From india b from Lawful quordianship + 261 IPC Co) > 360 Ipc C0) by force compels | a person to rove by decier compels J from one place ees ’ a I from ft 5 araprng or by 363 pc > CP) _kidinapping From lasoful Quordionship (7 yrs) ABOUCTION + 362 IPC CD) > eepuctron SEKUAL OFFENCE 335 7 ©) Rope ae >) Rope > a CF LOYES CO Lite imprisonment > b @ > custodial rape > © HM > rape oF 2 women < Ie yes 36) FC) rope victim dies | persistent vegetative state a6 (B) > CY rope OF a Women < IRYrS a6 () > GO Forceful sexual intercourse by husband ONhis wife during Separation 2% ©) > CP Sexual Intercourse by a person in Aulfority 3% CO) > GO) Gang vope B36 Gon) FG) @anq wpe OM a women < l6yrE a6 (oe) GH GarQrape on a Wormen << Layrs 26 ©) > ©) sope by @ repeated ofFender aT > @ onnaburel sexual offences Forceful anal intercoure | ¢ minor bestiality 498 CPM Cruelty to a omen by husband | relatives cco) eee sord } insult the modesty oF a woman Gesture 510 >) _ misconduct in 0 public place under influence oF alcohol LEGAL SECTIONS RELATED TO POISONS aa > odviterat™ oF food 233%) Sale OF noxiout food 254 odutterar” oF druq a35 7) Sak oF adulterated drug 384 FP) Negligent conduc in relation to poison ane) Administering a poison 7 an intent to come hurt / to faclitake offenceCE@AL bortes (OF DOCTOR IN A CASE OF POISONING 1 POLICE TNTEMATION 34 expe > any person who aisare of crime Should intimate to police Homicidal Poisoning Intimate police Svicidal Poisoning 7 no need to inform me police > Attemp to Suicide is not punishable 136 1c + ©) Non compliance 144 PC > ©) False information la PRESERVATION: aol IPC > CP) disappearance of evidence 13. IF the patient is about to die, dottor con ourange for DYING DECLARATION paves & cosmetée RuLes C1945] ScHeDULES G rozonm seddees Biological Produces Poisons, Vaccines «, Sera Hormones drugs thar can be sold Only on the prescription oF Amp diseases for which no cure to be advertised Anti Biotics Anti Histamines Anti cancer drugs brogs oF abuse VOLONTARY Mis CARRIAGE 3a an 3M ato 236 yee 318 36 ee TRANSPLANTATION OF HUMAN ORSANS ACT CTHOA) + enauted in 1944 & Lotest amendment + aor, 7 ako Hummn ORGAN TRENSPLANTATTON Aer CHOTA J > enated For R > removal S > storage & T > Uronsplantakion of human organs also to prevent the commercial dealings of human organs + HUMAN ORGAN ny part oF human body, whith if removed can't be replicated by body @) miscarriage t conéent oF morn © miscarriage Tour te consent oF mother ©) death of mother dit Criminal abortion @ act done to prevent the child being born alive causing deom of Unborn child > capable homicide ©) Abandonment of child NM a3 > mid Brain a. vestibulo ocular reflex 7 CN 3, 6,6 > mid Brain & Pons 3 doll’s eye rerler 7 ON 3.6.¢ 7 mid Brain & pons 4. qagq reflex FN 410 > medulla 3 corneal reFlex > ew FF Pons 6. Apnoeic Test > Respiratory centre NOR I Living donor can donare to 1. Near Relatives 7 son & daughter Spouse Famer & momer Grond_ parents INDIAN LEGAL sySTen & COURT PROCEDURES sad FoRENsie MEDLCINE +> Medicine in Law INDIAN LEGAL SYSTEM BASED on 2. INOTBN PENAL CODE CrPC] enacced in 1860 contoins 911 Sections Contains definition & Punishment of offences Oldest code, thee @. CRIMINAL PROCEDURE CODE Cer Pc] ‘execution oF crime] + [Enquiry] > [arece] > ffrial] + [reraice] + [Punishment 7% enacted in 1934, % contains 46 settions 3 INDIAN EvIDENce Acr CrEAI > enocted in 1872 Tells about different tcRSES - TYPES 2. cIvEL cose 2. CREMINA, CASE > PUIRINTIFF ve AccusED + state vs accused > dispote blo a parties PLOINTEE > person who Files a case CREMENAL couRTS IN TNOTA L Hierarchy) TePRESONMENT [FINE cout orf Supreme court fonysentense Unlimited appeal { High cow pny sentense unlimited Sessions court enysentense Unlimited court of | Assistant sessions. to yrs. unlimited triad Chief adical magistrak Cmm) 5 ars rete) ast class gudidal magistrate (mm) 3. yrs ts 20,000 ard class audiciol magistrate (Mm) a gy 5 5,000 mM 4 Metropolitan magistrate apex court for country > Supreme court, apex court for Stare. > High coure apex court for districé > Sessions court DEATH SENTENCE + memod oF Judicial exewtion in india —* Hanging President, POWER OF AMNESTIY OF) CONFLRMATEON F Corgiving3 Supreme court] —-+ commurATION (surRC) (Of) CONELRMATION High court FY tD Life imprisonment @1) Confirmation 7 Forwarded Sessions court % PLL DEATH SENTENCES given by Sessions court are forwarded to High court Fer confirmation + Migher courts can either Contirm the death sentense or leawser the poni- Shrent: > Person can go for an appeal in Supreme court + Supreme court can eliher Conirm me death senkense of decrease It to Life imprisonment + commotarzon CBW 17°C] 7 President has power OF Amnesity [Forgiving 1 + 53 IPC > Talks about all punishments PREGNANT FEMALE + 4IG crPC % Postponement oF death sentense > eimer till delivery or 6 months after deliveryOFFENCES 1 COGNETABLE OFFENCE [2 CC) CrPCI 7 Police con arrest o person TOuL armrest worrant > EK: order © eccity Rape, Robbery 5 Raqqing Dowry death a NON Cognrznale OFFENCE [2 CL) cree] > arrest only T arrest warrant LILINESSES 2. COMMON, WHT NESS + person percieved by senses 7 Ex: Eye witness Hearsay witness + iret hand Knowledge lies € common witness 2. ExPeRT Wumness [Cs 45169 J > Expert + person who got experiente| Knowledge | training in a particular field & Con give his opinion & Conclusion + ex: 1. Finger print experts a. chemical examiner 3. Ballistic expert 4 volunteering of statement lies T Expert withess poctor = Gan be @ Common witness or expert witness inquest 7 Inquiry into the cause oF death Connatural deaths > Types 1, Pounce inavest (134 Cr PC] me inquest in sndia 7 minienor codve to conduur inquest > Stution officer Csenior head constable] > PANCHANAMA + enquiry report a. MaaisTRATE INQUEST [136 CrPCI TYPES OF MAGLSIRATES 1. dodicial magistrates a Executive maqistrares % om Coistrict magistrate ) 4% com C sub divisional Magistrate) 4 RDO Collector , Deputy collector > conducted in Asyllum Custodial Death | rape Exhumation] Bostal Dowry death Encounter deaths> Executive Magistrate COM condo inquest in dowry & exhumation | > Sudicial Magistrate can conduct inquest in Lockup deaths 7 inquests conducted in India > 2. POLICE tNavEsT 2. MAGISTRATE INQUEST 3. CORONOR System % abolished in Sndia > lost conducted in mumbai C1994) 4. MEDICAL EXAMINER SYSTEM 7% dovtor is a part oF inquest > west systers all over the world Best system im india + magistrate inquest RECORDING OF EVIDENCE IN couRT OF LAW comes onder Indian evidence nct Summon | SUBPOENA > pocument issued by preceding oFFicer OF Court 7 compels the attendance of witness > susPoena > under penalty Lif not amended 3 > bom For Civil & Criminal cases % civil cases. > > Fine 4 criminal cases > () > tazrant:, imprisonment > punishable under s 194 IPC Procedure of giving Summons it discussed under > 6i- 63 crPc > tees 2. AO TESTFFECANDUM > giving evidence a. Ducus TEcUMm = producing document + F PRIORITY TO THE SUMMONS, TO ATTEND ON SAME DAY civil court = @_—[Eriminal court Crinminal cours gg [Eritoinal Cour [rower court) Citigher court) [criminal cowe [equal stotws) Criminal court @® Cequal stots 1 List recieved Creceved Loter] wiTess CAN APPERR ON BEALE OF vier PccuseD | O€FENDENT F known as Prosecution witness > known as Cefence witness + Public prosecutor will assist * befence lawyer will assistonre (53 1c J > must be taken before giving evidence 7X do Swear in the name oF the god, Lihat 1 shall state shall be the Truss 4% whole trum 4 nothing bur the trash 7 IF False evidence given oFter taking Oa Is Known as PERIURY % @ > 191 IFC wy > 143. 2c > 0am is compulsory 4 instead oF god, it can be taken as “* I do Solemnly affirm thot” + Refusal Fo take cat punishable under 176 PC 4 exemption > any child done by Zome Side Lawyer 2. cress examination * done by opposite side Layer 3. Re examination > done by same Side Lawyer In case OF Prosecution witness > 0am > PP —> OL > PP im Case OF DeFence witness > oom 7 vt > PP > oO Th cross Examination > no lime limit present LEADENG QUESTIONS > answer for leading questions i either YES or NO > not permitted by same Side lomyer [ chief examinar® £, Re examinat” > permitted by Opposite side lawyer [ cross examination ] SECTIONS All Examinations ore discussed by > 137 IEA order of Trial given by > ag ten Leading questions derinit# by = > mi TER Leading questions not permined ya TER Leading questions permitted > wa tes Questions by the judge > 165 tee Mostile witness > 154 eR BUDGE Can ask questions GE any point oF time HOSTELE WITNESS > @ person taho contradicts his OWN staternent > here the Same Gide layer con osk leading questionsEXEMPTIONS FOR ORAL EVIDENCE dying declaration Text book authors chemical Examiner Bomb blast expert Mint officer Doctor Who has given evidence in the lower court: hopes MINTMUMm AGE TO GIVE EVIDENCE IN COURTOF LAW = NO mINEMUM AGE DYING DECLARATION (38 TEA 7 oral or written statement at the time OF dying, related to oFFence > prime duty of dottor > to certify Compos mENTIS (Sound minded] > recording done by > anyone can record in the presence OF 2 witnesses > order of preference -> Magistrate > Police > pouor > any oneehe No oath taken Leading questions are not permitted if @ person survives, dyieg decoration ack as corroborative evidence sey DYING DEPOSITFON = done in presence oF 2. Magistrate 2, Aecased| defence lawyer only me magistrate can record state ment derence lawyer Conduct cross examinat®, leading questions permitted foam ix taken ot practiced in India; prockiced in developed countries Dying deposition is superior tman dying declaration MEDICAL JURISPRUDENCE 1 eogus MEDICAL JURISPRUDENCE > talks about the legal responsibilities of a doctor in relaion to Stake, patient © omer doctor > Len IN meorciNe MEDICAL ErHIcs MeoxeaL ETrQuENE > moral principles > courtecy toward’ your colleaque > self imposed Cocr] > Violotion is punishable > net punishable 7 towords ALL > towards doctors VIOLATION OF ETHICS INFAMOUS CONDUCT | PROFESSIONAL MISCONDUCT 7% any act which is disgraceful or dishonourable is Infamous conduct 7 ARNENG NoTICE be List oF Infamous conduct given to all doctors 4 present in State Medical council C smc) 4+ ip incomplete7 ext ees eribery Adottery Covering [Commission ssodarion Dichotomy © Fee sphiting ) nbortion False medical certificates issuing p ddiction GiFES acceptance Alcohol) Advertisements > disiplinary action taken by sme ‘+ sme forms a Comrmitle OF ootkors For verification 4% Punishments 4 warning 2. Penal erasure 4 punishment Cnet Warning notice] 4+ Removal of name from State medical Register % con be temporary or permanent % Permanent erasure + PROFESSIONAL DEATH SENTENCE > doctor can appea to Centro! Health ministry > central Healm ministry forwards it co mer 7 Met Hill take the decision PROFESSTONAL SECRECY + patient information should be Confidential > disclosure Of patient information Tour consent is breach oF prof. seuey PREVILEGED COmMmUNECATEON + only exception to Professional Secrecy > applied when it is done For 2. Patient interest > In case oF Suicide! tendencies a. Sele interest > Gan reveal in court oF laws 3. Community interest % 2qcrPC > in case OF rime > inform Police % notifiable disease, infectious disease > ext enteric Fever of chef epilepsy oF © driver etc CONSENT + Treaking me patient LOUr consent + Assault (351 IPC) > can voluntary agreement | compliance | acceptance + comes under ICA CINOIAA CONTRACT ACK? wees 1 EXPRESS CONSENT > oral or written >. IMPLIED Conse NT > by means of ax 3. BLANKET OPEN CONSENT Y taken at the time OF admission into hospital % non specific % egally not valid » Specitic consent it required for specric procedure7 Best consent > writen informed consent > bocraine oF FULL DisctosuRE explaining every aspect to patient * DotrRINE OF THERAPEUTIC PRIVILEGE ‘4 exception Eo dottrine oF Full disclosure 4 dower can decide on how much of informat” can be discoved 7 voctRINE OF INFORMED REFUSAL “Patient has the right to refuse after every aspect is disclosed > NONEED OF CONSENT 2. Life Threatening | emergency Situations 2. Therapeutic wavier F AGE LImrTS minimum age required for giving Consent ) 2, Physical Examination > 12 yrs > given by 69 1c 2. Major procedwes = > 18 yrs > given by 64 1Pc > consent given under infivence | Insanity + invalid +> given by 90 1PC. Emergency procedures * ho need oF consent > given by 52 IPC PROFESSIONAL NEGLIGENCE | PROFESSTONAL MALPRACTICE + OMISSION OF Right things > commiston oF wrong thi 7 EssentiAL ‘Os required to File negligent case against a doctor a Duty a Deriliction oF duty 3. Damage > pain , monetory Ioss| disability | death A. Direct cousakion F all 4s must be present +e i sae “ a on Cenleon Darnge + res 1 a a Simple lack of Skill & com Gross negligence Doctor & patient + ouer carelessness! bof are negligent Darnage (monetary loss, will Ful negligence main ate) damage (dean) 4 KeRPORATE] Management 1g alto responsible for the negligent act oF empoyge1. CIVIL NEGLEGENCE > ex: uarong dose | pamage arong prescription burden of proof lies L the patient tried in civil courts ponshment > Fine damage thar car be Compensated by money is dvil negligence eyes 2. CRIMINAL NEGLIGENCE + ext 5 ot wrong site Sx to wrong pabient wrong Sx miSmatched blood transfusion > tried in criminal court + punishment + imprisonment Cayrs) + punished under 204 (9) irc 3. CONTRIBUTORY NEGLIGENCE > vector given corong dose & patient missed Fofow Up > burden oF proof lies t the doctor “> partial derence > applies only to civil cases LAST CLEAR CHANCE DOCTRINE Sake bite case T very bight ligature > gangrene 4+ doctor Failed to inform te patient ok Last chance % doctor is responsible F UOTOABLE CONSEQUENCES RULE Snake bite case T very tight ligaruse > gangrene 4 dottor informed to remove ligAtwet bu parient did n't removed it: patient is responsible MEDICAL JURISPRUDENCE 2 DEFENCES ABAINST MEOIEAL NEGLIGENCE 1. No duty owed to te patient 2 duty was dene according to prevailing standard 3. error OF gudqement 4 Res INoIATA 7 From the discovery oF negligent ad patient can File a case Tin ays Knew as Limitation PERIOD 5. RES guDIcATR > the things have been decided already © therapeutic misadventure > during ®%, dl mischance [accident damage hoppened to the patient + canbe a. diagnostic doctor 1b therapeutic ot liable © Experimental% contributory negligence ©, Avoidable consequences Rule Lost chance clear doctrine 8 Products Liability > during te ® OF a patient , doctor prestribes a drug & patient Surters damage > drug was found deFective > then the product Cdrog | instrument) defective | Faulty, then the responsibility lies T manufacturer of the product DOCTRINES 3. RES TSA Lo@UTTUR + Thing or fact Speaks itselF > Normally, In the case oF Professional negligence . the Standard OF care ik proven by expert titness 7 ot 2. Retaining a swab| forceps inside abdomen a. wrong blood transfusion 3 not giving TT Ingeckion to injury patient > conDtTtONS To Be FULFILLED 1. In the absence oF negligence, the damage would not have occured 2. The dottor hod exclusive control over the instrument 3. The patient is not contributing negligence 2 DOCTRINE OF COMMON KNOWLEDGE > Variant of Res Ipsa Loquitur expert opinion is not necessary 3 DOCTRINE OF CALCULATED RISK + inspite of reasonable core, damage is unavoidable > every procedure has inherent risk A MOVUS ACTUS INTERVENTUS > new act intervening > peso cut Carterial ingory) > wrong blood transfusion > death > burden oF responsibility ShiFES From actused to doctor \VicARIOUS LiReTLITY > respondent Soperior | let the master answer] master servant Rule t Superior is responsible for the mistake done by junior > APPLICABLE ONLY TF 1 2. Employee ~ Employer relationship 2 Employees conduct should be Tin the scope oF employment 3. @eé ShovId occur when he Was On the obDECLARATIONS 2 Geneva > a. GoKXO > A HeLsinKL + & O10 > & SIDNEY > 6 @ence > 7 sen > & onawe > @. Hong KONG > mera > MW. @IPSHINGION > modifved hippowratic oath Gorture ; gives quidlines for physician in case oF torture Homan experimentation RORENGERG CODE 4% Human regearch 4 eaiks about obligations of physicians to research} Subgecks to Safe gaurd the health OF Subgecrs Therapeutic abortion 4 abortion can be done by a competent person in ‘auutdriged institution declaration oF deah & Human organ harvesting ‘TeRRGIRSG IIness 4+ patient auxonomy to be respected 4 patient has right to refuse 4 patient has right to decide on palliative % % dottor should take ‘advance directive’ into considerat” Rights oF patients child heath Elderly abuse 4 duty oF dottor to prevent physical or psychologica? abuse of elderly person Hunger strike + dottor should not do Force Feeding Biological weaponVIOLENT pears HANGING & STRANGULATION Aseuvxin = Pulselessness stans 1. Congestion oF organs asrwyxran 2 cyanosis ran auenrer 3. Petechiol Haemorrhages OF ASPHYREA A. RE Ventricular enlargement 5. t Fluidity oF blood Viseerol eonges? cranosts > bluish discolourat® OF skin & mucous membranes + if reduced Hb it > smqidi > cyanosis + Pure qyanosis C peripheral) Seen in Asphyxia PETECHIAL HAEMORRHAGES | TAR DELL SPOIS | BAYARO'S SPOrs + occurs dit rupture oF copillories Q SS rerecrtn. wnemmonnnnse ovstruee? copltaries + sean Toe Fore head “visceral organs eye lids pleura 4 conjunctiva 4 meninges ete post aurientar > All above signs are not Specific For Asphyxia NECK CONSTRECTION. qos on ag pte Sees Bese ees 4 pressure oF 2h] > sugular vein Compressed > Venous Conlsestzons Pressure of 5 hq > Carotid ostery Ocleded — ccxeoaml rscHEmuR Pressure OF 1 kq > Trachea occluded > nspayxrA Pressure OF 30Kq > Vertebra involved along ¢ vertebra! artery ome structure affected in neck Compression > suqular Vein pressure OF 44.3kq > Tryroid compressed Pressure OF 18.3Kq > cricoid compressedHeNGING > me memod used for Suicide > Hanging > Poisons 7 neck compressed by the body Suspension TYPES, 1 GASED ON POSITION oF KNOT a2 TyetcaL knot placed on occipital region 2. prYPrcAL => Knot placed any where else TT BASED ON SUSPENSION 2. COMPLETE 7 body suspended T our touching the ground entire body weight atts as constricting force 2 PARTERL body past touthes the ground > constricting force it head weight AOE ‘Typical ‘Atypical Aeypical Partiol hanging — Farging hanging, hong 7 REMOVAL OF LIGATION MATERLAL 1. cut open the ligature material oppasite to the Side oF Knot 2. Cut opened ligature material can be tied t another small thread & preserved FATAL PERIOD + 3-5 minotes LigATURE MaTERIAL F depends on availability Y Removal + pattern of ligature materiol car be correlared ¢ pamern of ligature mark, So proper preservation of ligatwe material is important Post monrem FINDINGS EXTERNAL FINDINGS 2 Glove & Stocking Hypestasis a Seminal discharge a Foce congested (augular vein occlusion) pale Caugular vein & carotid artery occlusion ) protrusion OF tonque dribbling OF saliva + signifies ante mortem hanging > seen ot dependent side Ligature material] __. [stimolates 7 Salivery |, [dribbling oF constriction Salivary glands) Secretion Saliva% Le Facie Sympalhique > sign oF antemortem hanging gare) —» [presses cervical | _ [opening oF eystdl] } on same side roateriol Sympathetic. Chas dilation oF pupil 4. Neck Ligatwre mark + oblique front oF eck ack oF path above myroid (85%) incomplete | i pressure abrasion by itself Potierned abrasion ( iF it ik showing pattern) Skin under the ligokure mark + Pale , white & glistening INTERNAL FINDINGS 1. HYOID BONE FRACTURE + neen in 15-207 > Wres. ©. ABOUETEON #H | ANTERO POSTEROR COMPPRESSION 4 4+ dic AP compression + AP Compression H % Fractured seqment displaced oukwards + Abduce™ #4 bb ENUIARD COmPRESSCON #7 > Fractured Segment displaced inwards © SIDETOSEDE COMPRESSEON # > Fratkured seqments displaced inwards on one side & displaced outwards on omer Side me type OF a In henging + Abduaion # lac a eater 7 me seen > > Kors pe apres ( Ree ans ‘+ transverse intimal tears seen = AMUSSAT SIGN a VERTEBRAL INDURY % me vertebra ingured => Cy al spondyloligmesis oF €, over Cg > Hangrnan’s #7 7 occurs dit gudden buper extension cormmoniy alu Judicial hanging MONGmPA’S KNor > Sdeal position > Submentol > 9p sedi > below the angle of eter sumow’s Bleeding + bleeding present in anterior Surface OF Vertebra, > Sign oF ante mortem hangingMANNER OF HANGING 1. SUICIOAL HANGING > ligature material fibres can be found in the hands oF victien > no omer fakol Enzuries a PECIDENTAL HANGING > SEXUAL ASPHYXTA Neck —» [Portiol —, [coretid artery] —. [cerebral ee) — ee) ~ ee aaee JY - — [ee Raina] > perversion 7 seen in males > pradice Masochism | Tranvestism puro EROTIC DEATH | HYPOXIPHILTA | ASPHYXIOPHTLTA 4 accidental dears + no disturbance Sen 4% no suicidol core 3. HomreromL HANGING > any other fatal inuries ore present > signs oF struggle tnt > absence oF ligature materia) is present > LNCHING % capkain, willium Lynch Crori America ) “+ homicidal hanging by a mob In a public place M 4, JUDICEAL HANGING, > practiced in India = Long drop inguries occurs + Hongman's H manuel ees STRANGULATION + neck is constricted > by means oF 2. ligakure materia) + Migature stranguiat™ a. Fingers > Throttling | manval stranqular® 3 Bamboo stick > ®ANSDOLA 4 elbow > mugging 5, Thin ligature cord > GaRROTTING 4. LIGATURE STRANGULATION 4 ligature mark Frentice. nen’ ra > tronsverse 7 below thyroid Cmestiy? ee Teno > complete 4 skin under Ligature mork > contusion & Haemorrhage geen + face will be intensely congested2. MANUAL STRANGULATION | THROTTLING EXTERNAL FINDINGS 4 crescentic Finger nail scratches are geen % discoid bruises | Five penny bruise seen INTERNAL FINDINGS external Soft tissue contusions + nt \ hyoid bone # = > Adduction 4 cricoid cartiloqe #4 C Typical oF homicidal throttling ) Throttling 18 almost always homicidal GEA Higokure sereoquce™ ——igarure teranqe" Manvel strangularion manual strongutation manual strangulation Gaxroning SPANISH HIENDLAS TECHNIQUE > type oF garrolting + osed For yudicial execution in Spain DROLINING F aspiration oF Fluid into the airwouy > complete submersion is not necessary Types 4. WET DRODNING > Fvid enters the lungs 2 DRY OROWING «Fluid does not enter the lung 1. WET DROWNING, TYPES ©. Fresh water drowning &. S20 worer drowningQ. FRESH WATER DROWNING F Fresh water ig HYPOTONIC + dit osmosis, Fresh water enter into the lung FROM LUNG WIAMTER ENTER INTO B100D 4 Hemodilution, Hemolysis 4 1 Kt Cliyperkalemia 3 cardiac merymmnia C ventricular Fibrillaziond + Dea b SER WATER DROWNING 2. DRY DROWNING Seo water Crypertonic] enters airway & Fills the Tong 4 osmosis luiater moves from blood into : Pulmonary edema Respiratory failure 30 + Pharynx ¥ Reflex vocal cord gpasen J fcphyxia. v beam 5 Hemoconcentration Crelative t 4b 1 3. HNDROCUTLON | TmMERSION SYNDROME | SUBMERSION INHEBLTFON + cold water drowning cold H20 stimulate peripheral Epigastrium Skin receptors oe Vagus stimularion + cardiac arrest4 SECONDARY DROWNING | POST IMMERSTON SYNOROME + deat dit secondary complications after rescued From drowning > secondary complicatione 1. pneumonia a metabolic acidosis 2, eleckrolyte imbalance FATAL PERIOD 1. Fresh water Crowning > 4-5 minutes @ Sea Woker Drowning F G-10 minutes POST MORTEM FINDINGS spectere (Am drowning] Stans EXTERNAL FENOINGS 4. Cadaveric SPASM alive person ‘ go (drowning) ip struggle + cadaveric spasm Grasp the grass] weeds |stems EAOAVERTE SPASM + MmOSE SpetFic Sign OF AM drowning a FACE > FROATH t mos +] y, Fram sureackant + gore rom water agitaxs mou & nostis > Fine, tenaceous, Lathery & persistant Froot INTERNAL FINDINGS 3. LUNGS ‘voluminous edematous rib markings on lung seen EMPHYSEMA AavOsuM occurs when concious person drowns into Hp % crepitant & spongy lungs [ air + hyo in airway 7 Even” Asuosum occurs when unconcous person drowns into 1.9 + mirway filled & H39 (no Gir) > pattnurr's HAEMORRHAGES dic rupture oF alveolar copillories dit forced respirat + commonly seen on anterior Surface OF lower lobe OF lung yaay Noluminous Longe 4 > mud in airway upto the level of secondary bronchioles a stomoch > water in GtomachNON SPECIFIC Lam +Pm drowning] SI@Ns 2. WASHER WOMAN'S HAND > wrinkled > ahs bleached > sahrs Cia pay) soddened > 1 pay Peeling OF Stin tnt > 2-3 Days masher woman's Hand bIbIEN OF Hy0 into Skin layers > helps to determining Time since death A. CUTTS ANSERINA | Goose FLESH > dit contract” oF erector pilori muscles + dit rigor mortis involving erector pilori muscles rests 2. piATOm TEST > diatom unicelivlar algae varies in speces| sine| shape “-@r add & alkali resistant Cilia coated woll) yOOR ( cn Og. 4. oligohatophilic phey SO b. Polyhalophilic << @. Doroms CUES anserina ANTE MmoRTEM DROWNING Hao T diatoms, ‘ Birway 4 piveoli + Pulmonary capillary Coiatom <60 1) + Heart 1 i ative Distant Organs > Sigh oF _ AM drowning Bone morrow (best source > Femor Bm) Brain Spleen (Best source among visceral ovgans) kidney Liver 4+ Bone sample + HNO, > Diatoms can be seen Under microscopePOST MORTEM DROWNING Cpiakoms only present in lungs) Hao T piakoms 4 Airway 4 alveoli + Pulmonary copillary Coiatom <60 4) + Heart not beating ‘ DIATOMS ARSENT IN DISTONT ORGANS > otprom TEST Nor USEFUL IN 2. Dry drowning 2. Hydrecution a Gerrier's Tesr > compares the ct concentration between @ %&@ side oF the heort normal 5 re L_ot l Fwo > eb} > tc] & — Hemodilution sw wLiet] < Lite} pemoconcent rot + GETTLER’S TEST Nor USEFUL IN 1. Pakent foramen ovale a. ory drowning 2 Hydrocution 4 Putrefackion 2 senom mAGNEstum J t in sea water drowning 4 serum stroncrum — f Gerum étrentiom is best paramete? SUFFOCATION 1. SMOTHERENG F obstrudion is a the level of mou nostrils 2 GnastNG > caste” by stuFred cloath inside the mouk 3. CHOKING > obstruction by Food particles inside airway 4 POSITEONAL ASPHYXtA 5. TRAUMATIC ASPHY RIP mite chokingSMOTHERING 4% always homicidal > inner lip contusions seen abrasions in perioral region seen GAGGING + obstruction OF Upper airway by a piece OF Cloath CHOKING > Causes oF Dear 3. cardiac arrest Cmc) 2. LarynqoSpasm 3. Psphyxia F HEImUCH manvEvRE > First aid For chotting > cRFE @RONARY 4 coined by Ronald Hougen 6 Food bolus obtiruc- fing the airway suddenly becomes blue | dies + core coronary intoxicated person eating Food + 4 prTHoPHYstoLogy + in intoxicated persons , cough reflexes are Suppressed 7 large bolus completely obstructs airway & causes Psphyxia = Cause OF Dea all TRAUMATIC ASPHYXIA heavy weight _, chest _, Asphyxia _, peath Traumatic on chest Fixation Baahipese > can happen in 1 Stampade 2 motor vehicle accident 3 Building collapse Borking BURKING > combination oF Smomering & traumatic asphyxia POSITEONAL ASPHYXIA > person kept in head down position % all the abdominal organ compress diaphragm Positional Asphyxia 7 ancK KNTFE POSITION “> type OF positional asphyxia Besttion > OVERLAYING obese moter Shoring a Small bed Ta babyFORENSIC THANATOLOGY & FORENSIC IDENTITY POST-MORTEM TECHNIQUES AUTOPSY | POST MORTER EXAMINATION | NECROPSY > ase autopsy done by > VARI@NANA CItaly) in 1303, + Ast medico Legal Autopsy in Sndi > done ar chennai by EDLARD GUKLEY > done on a case of Arsenic poisoning TYPES 3. MEDIO LEGAL AUTOPSY done in unnatural deaths me type in gndia Gutmorisakion given by Investigating officer £10] relakives Consent ik not necessary, body will be handed over to 10 soggy 2. CLINTEAL | PATHOLOGLCAL AUTOPSY + done in natural dears > relatives consent 13 mandatory 3. VIRTUAL AUTOPSY | VIRTOPSY + whole body imaging done 7 cause of death can be found 4 PSYCHOLOGICAL AUTOPSY | VERBAL AUTOPSY, + done to find out mental status oF victim 7% done by Interviews < porents or friends > done in suicide! cases 5. NEGAITVE SuTDPSY 7 dissection chemical analysis Histo pathological examination Negative, > cause oF death cart be found cavity To srAeT T 4. POISONENG CASES > cranial cavity 2. New BORNS > abdominal cavity 4+ tp check the level oF diaphragm Clower level > baby respired ) 3, ASPHYXIAL DEATH > cranial + Abdominal > Thorax —> Nex > €0 achieve bloodless dissection oF neck > PRINsiod ~ GORDON ARTEFACT '% coring of venous blood T the prior dissect of skin oF neck.4 AIR EMBOLISM % ONDER WATER AUTOPSY 4 pericardium cuk open & filled 1 tho tren ventricle opened ‘> Im case oF air embolism, air bubbles are sean > PyROGALLOL Test ventricle is aspirated by @ Syringe T Pyrogaliol Solution ‘Sim cate OF air embolism, colour change in Colour 5 PNEUMOTHORAX 7 chest cavity opened first 44 skin Flop is reflected in thorax & Filled © Ha0 1% tren puncture the pleural cavity ta sx blade 4 im case oF preumomorax, air bubbles will be seen 6 NORMAL CASES > Thoracic Cavity TYPES OF SKIN INCISIONS 2. 'T INCISION Cee) _— From eck EO pubic symphysis & From xiphisternum to pubse symphysis, h, a 'Y inetston Straks from Shoulders. meets ak xiphisternum 3 ® 3. MODIFLEOY' INCISTON Start im mostoid procest, meets in Supra sternal notch & Continue to Pubic Symphysts 4 'T INctstON Start® in shoulder & moves tO ononer Shoulder & From mid point of inter Shoulder line tO pubic symphysis. T Incision, 5 ® INctston Inision on back oF body Preferred in custodial deaths TECHNIQUES OF ORGAN REMOVAL 1. ORGAN BY ORGAN /-VIRCHOW'S METHOD 2 EN MASSE /LETTULE'S METHOD. 3. EN BLOCK /@HoN'S METHOD ALIN SITU [ROKITANSKY me Organs are removed ar once perticular region is done done inside the body itself done in infections CHIV, Heparitis eee) & radiation bbgasDISSETION HePRT > R Fe >i FW > Inflow oUkFIOW method (Follow The blow Flow direction) BRON + ideal to Fix the brain ¢ 107 formalin for 1 week > Coronal cutting method SPENAL CORD 4 not routinely opened > done by 1. Pnterior dissection memod 2. Posterior dissection method (Best) STOMACH + stomoch ig dissected out T DOUBLE LIgMTTON meTHOD > open along greater curvoture EXHUMATION (196 (3) crPC) digging te body out oF earth * Sulforisation given Only by Magistrate > done in presence oF Magistrare Police boutor > preferred to Sart in early morning > no time limit for Exhumation mE metal EO go In PM imbibition > Arsenic > 500 gms oF Soil Sample Eaken THANATOLOGY 7 THANATOLOGY + Study OF dea > peer + trreversible stoppage oF respirat®, Grawat” & brain fund” > given by Declaration oF sydney > Somprie | CLINICAL DEATH > stoppage OF respirat”, Gruulat” & brain Funct” 7 MOLECULAR] CELLULAR DEATH + all Cells im the body are deod > SUPRA VITAL PERTOD + gap blw somatic & moleadlar death > important for Organ harvesting ore f——___,_ erstoris tatrop ‘OF LIFE frevlak® BOD, Respirae” Cireulat® BEiDq Respirat + * Syncope coma ASphYXiO el MODE OF DEATH ATAIA MORTIS | GATE WAY OF DEATHSUSPENDED ANIMATION | APPARENT DEATH > temporary stoppage OF life 6igns > person apparently dead Resuscitation Apporenty dead uve F BMA IY + clinical Signs are not detectable 7 SUSPENDED ANIMATLON IN NEW HO TY Lakrogeni¢ | rnsanity Newborns cme cause) Eteceroustion Wasting diseases Ccholera, 18) Hea stroke | Hypomernio Drowning ‘Typhoid voluntary Cyoqa practioners) POST mARTEM CHANGES > PM RESORPTION | TAPHONOMY LmMEDTATE CHANGES EARLY CHANGES Late CHANGES, Gin minutes) (hours to days) (Gays to mons) 1. 10S$ oF voluntary movement 3, Eye changes 2. petompasition a. 1085 OF respiration a. Rigor mortis (stiffening? 3. loss OF Cireulorion 4. Liver mortis (Staining) 4. Algor mortis (cooling ) EARLY CHANGES EYE CHANGES 4. Retina Railway racking | Cattle tracting | Kevorkian sign 4 segmentation oF retinal vessels 4+ seen cin Few minutes arter deat 4 helps to find Time since deat (7S0) earliest eye sign Railesay tracking 2 commen * @ 7% trorsparenc 2h, hay > helps to find out TSD 2 10P + @ F aommor ig 25S, 'O mm lig + help to Find our TSO 4, Sdlero, + dust deposition in Sclera in open eyes 4 a alors Shaped brownish opacities on either Side oF

comed Lin 3-GhrS > TACHE NOIRE ScLEROTICA + helps to find our Tso5. VETREOUS HUMOR > best medium for detecting 150 7 vitreous K+ level Keep on rising after death 4 best povameter for detecting TSD > srpener’s FORMULA , MADENS FORMULA OFe Uied to Find vitreous Kt ALGOR MORTIS Pm chill | Pm cooling 7 4 Body core temperatwe 7 common site for recording BCT > reutum > [deal cite for recording Bcl > Sub hepatic space > ip sodomy, rectum can't be used €O record ect > Thanatometer | chemical thermometer used ro record 8c 4 asam tong 4 calibrated From of — so°c ALQOR MORTES CURVE et phase — Grodual er nd phose — rapid rd prose ~ Gradual Teme, % 4 Ber starts in is minutes after death 4 shape > sigmoid > HENSGE Nomoganm 4 used t0 plot environmental temperature, Algor MoTEIS Bet to Find UF time since deats > Average Rake oF fall oF kemperature Summer > 0.8°C. winter > OFC < NOT - Normal body temperature Cc) rec ea yg tain aCRD) Ber ~ Cody core temperature Co) Rate oF Fall of Temp. RT - Reckal Temperature (°c) + Pre cetorrciry '% BoDY REMAINS waRM for the Ist a hrs after dea 44 tiherever there if 1 BCT ak the Hime OF death , PM collority will be seen 4 seen in a. ® Muscle contraction > Tetanus, nur vomica poisioning, 2 defective thermo requiation > Heat stroke, pontine Hemorthage 3 7 bacterial ackivity > septicemia 4 in Gurns , Pm calority is Dot Seen Cno TBC)LIVOR MORTES | Pr STAINING | Pro HYPOSTASTS | CRDAVERIC LIvrDTTY | Pm LIVEDETY | SAGGILATEON / VITILIS > Mecnpntsm Death —> Blood + Pools down in capillaries & venules in rete mucosa oF dermis 1 Ceopillo Venous. distention ) dependent parts ¥ SIPENTNG > yposrnsts Seen 1H OEPENOENT PRRs supine position 7 back oF body 4 prone position > Front oF body = ‘suspended + Glove & Stocting distribution Cle] > seen in hanging cases i coe > depending on situation position oF me body can be Known 7 DROWNING IN RIVER + PM Stoing is absent LIVOR MORTIS IS ABSENT AT PRESSURE POINTS | TEQHT CONTACTS ~ CONTACT PALIDR PRESSURE POINTS IN SUPINE POSLTION 2 Back oF head a. Shoulder blades 3, Back of Foor 7 srarning colour OF HYPOSTASIS 2. Normal F Bluish | puplish die deoxy Hb) 3 CO poisoning > cherry Red Cdit- excess oa) 3 cyanide poisoning > Brick Red C dit excess 02) A Has > Blvish green Cait 7 sviF HO) 5 f mem Hb > Brown Keto, ‘> Phosphorous er bo Nitrates - + pitine oreack pal > cause oF dea can be Known ag fom + Timing onset 30 minotes after deam Visible 7 hs ther morn morimom * 6-1 hrs. + FIXATION oF HYPOSTASES. % ime limit 6 hes + once Fixed, hypostasis donot chang ¢ changing position 4 ie blanching Is present, ten it if not fixed4 HyPosrASES TELLS peUT 4. Tso 3. Position of body 3 couse of deat Rigor mortss MUSCLE STATUS AFTER DERTH Relaxed — tire! — > Relaxed [primory Flaccidity] > [Rigor mortts} ——> [Secondary relaxat™] 857. pF) Secon oor, ATP — Decomposition ss onset maxima pesition [actin — myosin Actinomyosin ysis oF ore separate ‘complex proteins F depletion ATP couses stiffness RIGOR MORIES | CADAVERTC RIGIDITY J CADAVERIC SIEFFENTNG > generalized (seer io all muscles) > First geen 7 involuntary muscles. + First Seen in Myocardiom > eye lids % ast site > myocardium 4 Ast cite extemaliy > eye lids > ming conser +. SHaPERO'S RULE > RM Comes SimolEaneous ly in all muscles NYSTEN'S RULE > Rm Occurs Sequentially RULE oF 12 % ase prose > appearance > ahs 4 and phase > persistence > hs % ard phase 4 dlisappearane 9 Ja hrs 7 ORDER OF APPEARANCE CNYSTEN’S RULE) [end] — fGen) > [faced moscie] > [rec] —> for PaaS] + e<- ow “FORDER oF CISAPPEARANCE Follows the Order oF appearance PoFACTORS AFFECTENG REGOR MmORTIS CONDETLONS STEMULATENG RIGOR MORTIS a a 4. CADAVEREC SPASM Musete BULK 4 min > appeors Lote 4 mick > appears early AGE >< 4 monms «absent Muscle pertviry 4 muscle if active before death + Rm appears early > Seen in violent deams ( Fire arm deams, electrocution etc) > dit 4 arp POISONING aor > eorly b NUxvomica 4 early & longer Arsenic > delayed & Longer Cdit delay in putrefaition) LASTING, Drsenses ©. cholera occurs early b Tuberculosis | disoppears early © concer HEOT SITFEENING b ESC + muscle Protein coagulation + StiFFening > aka eoxer's arttrupe | Pugutstrc ATTITUDE COLD SITFFENING Frozen body > Body Fiuids becomes ice Uystal > stiFfening Gps sIrFFENTNG > seen t decomposition decomposition _, Gas accumulated _, stiFeness oF body ’ grass | weed in hands can be seen weapon in hand con be Seen ka INSTANTANEOUS REGOR Spasm OF GROUP of voluntory muscles Ante mortem sign m0 primary relaxation phase manner oF death can be Known besaLATE CHANGE — DECOmPost TION: ecuanisim purolysis > done by lysosomal enaymes Putrefaction > by boceeria puroLysts > ase site > glands | broin > 2st Site externally * clouding oF comec + mAceRmTION 4 takes place in top % exomple of autolysis PUTREFACIION > most important bacteria involved > clostridiom welehi + clostridium welchi produces LectTHINASE: also Known as chier destructive agent in putreraction + CHONGES seen ARE 2. colour change a. Gas production 3. Liquefaction oF tissues coLooR ewanse —e 1. Greenish disolouration in Re. thac Fossa + ast external sign of purreraction 7 dit caecum 4 Located Superficial to Skin 4 contains lots of bacteria + Hs +Hb > sub > green + uming 4 tm Summer > 18-18 hrs TD canbe encoun 4 tn winter 1-3 days 2. St Inkerod site > Portic lumen discolouration Cin intima) 3. MARBLING > Branching pattern in skin > portiouloriy over shoulder & chest F die Has + Hb Forming SuIF Hb in blood & deposit oF SuIFHb on vessel walls > bakes 26-42 hrs + TSD can be Known Gas PRODUCTION. + predominant qos + Has > gas in dermal epidermal junction + skrw BLISTERS SKEN BLISTERS Coecomposith) SKIN BUSTERS OF BURNS 4 content > dir 4 content - inflommatory Fluid pose + Pale % Base - erymhemicrue Abdomen blouked > antwe body bloated > Gas sTFFENING Bleeding From nostrils + POST MORTEM PURGE Pr DELIVERY car be Seen loosening oF hair @ nails 4 seen in 3-5 days 44 Known as DEGLOVENG & DESTDCKING PATIERN, LIQUEFACTION OF TESSUES > takes 510 doys ORDER OF PUTREFACTTON 2euor rere Lorynk | Trachea (ase site) Skomach | Intestine] spleen + srster Liver | Lung + uy brain + Brite Heore + Heart Prostate | uterus skin Tendon Bone (Last orgon) Honey come LIVER FonmY LIVER > dl gas pockets produced during putverace™ rn LUMINESCENCE Batreria > Photobacteriom 1 responsible for luminescence Fungus > Armelliria CASPER’S DicIUm > rake oF putrefaction comparision 7 For the same level OF putreraction , time taken in mot 2 pie F 1 week —Crastest) a water = 7 2 weeks 3. art FB weeks Cslowest) Csoil) DEFED FORMS OF PUTREFACTON ROTPOCERE > Hydrolysis & Hydrogenation oF fat for, Fatty Acid + att __, sone CPalmitic Acid cme) Caorpocere) 7 Pre requisites ‘ 1. foarm & mast environment Spponteicar? 2. Clostridiom welehi 3. intrinsic lipases > Adipocere inhibits Furmer putrerackion Palmitic add > 4 pn > inhibits > Body is mottiplicat oF preserved baceeria + smell oF adipocere > ammonia smell + Pppearame +> Fresh > wlhite & greasy > RANCID BUTTER tare > hard & brittle> 1st site > teming Normatily 3 weeks ~ 6 monins Qn India > 4-5 days Cearlese) + Subcuraneous Fat alipoce (ot F MEDICO LEGAL IMPORTANCE ‘MummiFLcAtzon 1. Identification | Ingories Ceouse oF death) a. Place oF disposal 3. Time since deom 2. MummLFLcAriON > drying & dehydration of body dry & hot climake predisposes to mummiFication body shrinks oy loss 0F body We +e odourless body will be preserved MEStCO LEGAL TMPORTANCE 2. Place of disposal 2. Time since deat takes 6 months C0 1 mons) ot) EMBALMING | THANATOPROXIA > artificial metod of preserving dead bodies J ontiseptics & preservatives are used > TYPLCAL EMBALMING SOLUTLON CONSTITUENTS 2. Preservative a germicide 3 welting agent (preserve moisture oF body) A Bufrer 5 dye 6. ANTE CONGULANT > PRESERVATIVE Formalin qlutoraldehyde methanol > Geamrcroe > phenol A WETTING AGENT — > glycerol > sureer + sodium carbonate > dye + eesiry + pnt congutanr =? EDTA > vuvenr > Hg0 Cupto 10 Uters) > Best memod discontinuous injection & drainage + Best vessel > Femoral artery > Erobalming prior to alitopsy > amounts to disappearance oF evidence > punishable onder a0) 1cHUMAN IDENTIFICATION - PART 1 ADEMMIFICATION BASED ON Race oe age STpTURE TA1T00 scp FINGER PRINTING | DACTYLOGRAPHY (mest reliable) DNA Finger printing Presumptive Cclentity Definitive Tdentity incomplete complete RACE, Tyres 2, Caueasor> a mongouoro 3. NegROtD RACE CETERMENATEON. Bones. SKULL, > best bone For > cepnaie INDEX manigouors race determination cephalic Inder Mon bread max length 44.9 744 - 85 indian skull is. Long Bones INoTcES, Dolicocephalic > Meraticephalic Brachy cephalic mesaticephalic tong head + Negroids + medium head > Couscasoids > Short, round head > Mongoloids Ceaucasoid T negroid Feature) BRACHIAL INDEX Lengim of Rodius Tengts oF humerus x (80 CRURAL INDEX Length of ibio Length of Femor x 100 INTER mEMBRAL INDEX Femor lengim + Tibial lengin ofS humeral length + Radius \engm TEETH 7 Gaucosoid mangoloid > Garabeni cusp L additional cusp in 15t molar] > Shovel shaped incisor Enomel pearl in premolar Tawrodontism Chul! Eooth - large wside pulp cavity 2 > megroid > more cusp in molor‘SEX DETERMINATION SECONDARY SEXUAL CHARACTERS (can differentiates S¢x) omomatin sruoy 2. BARR Boor > seen in Females 7 incceivared x chromosome > seen inside the nucteus > Somples taken From Buccal smear Hair Follicle Saliva a. pavrpson's Bony > Seem in neutrophil nucleus > additional drumstick Body + seen in Females SIRINING PROCEDUERES x cHROMOSOME @PEULGEN TEST) REACIEON 9 (McriFtowin reagent is added % & chromosome Y cinomosome DH Cavinacrine pihydro chloride ) Tesr | RERCIEON 4 by Fluorescence Y chromosome can be identified Sen FROM BONES o Go EXCEPTIONS mosde more Less, Frontal | markings | ridges prominent prominent Parietal eminence endices corporobasal Sciatic notch index index Tschio pubic (washburn index sternal index FEATURES: MALE SxuLk FEMALE skuLL Prehitecrure Rugged Smoorh Froneol eminence | Smal! Large Payietal eminence Small large Orbits: Ssquore t Smooth margin rounded ¢ Sharp Margin Fore head Steeper Vertical Palate Large, broader U shaped — Smatiier & porahola Occipital Condyle Large small Glabelia more pronounced Less pronounced Frentonadel zona” | distinct & angulated | emost Supra Orbital RidgeS prominent Less prominent asteid process Large & blunt Small & pointed Aygomatic arch __more_ prominent Less prominent: ‘occipital protuberonce well morked Less markedPELVIS (Best bone For sex determination) FERTURE MALE FEMALE Pre auricdar sulcus Norrow, shallow Broad, deep Cevidence oF pregnancy, not Frequent: more Frequent Sob pubic angle ‘V' shaped , acute \U' shaped , obtuse Greater scaric notch (757) narrower » cleeper wider & shallower Obuturator foramen Large & oval small & triangular Tschial tuberosity inverted everted Body OF pubis triangular squore Pelvic inlet heart shaped Ciradar Pelvie cavity eonical & Funnel Shaped Smooth ¢, rounded Stiakie notch Index a5 5-6 Ischio pubic index <30 +95 COOASH BURN ENDED west parameter + greater sciatic notch RULE OF ASHLEY > used For sex determination + based on stead lengh + > Ka mm + > ya mm > 9 KROGMAN'S AccURRCY For sexing oF Bones 4 pavis 795% Cmaximem accuracy ) skull > gor % Leng bones > e807. Pelvis + Skolt 9ar Pelvis + Long bones 1% complete Skeleton > t007 HUNAN IDENTIFICATION ~ PART 2 AGE DEFERMINATTON determined by 1. OssrFtecArton cenreRs 3. pensriti0n FETUS AGE DETERMINATION RULE OF HASSE > gestational age of ase 5 monms = And 5 mons, f= oF > MORRISON'S RULE FL > Fetus lengihom 4 cm 5 Limb burds oppear a oom Limbs { oe 39 Nails appear — “ "oom Lanugo hair apper 5 5 tm Scolp hair appear an 6 3o em Eye lids & eye lashes oppear 2 3 Bm Eyes open hoses 8 a0 cm Left testis tnt in scrotum 45 cm Right testis tne in Scrotum 0 oom 4 Sex determined by 4m month of gestation Primary Osstificabion center + Forms diophysis Fame CO) ity Secondary OsstiFication center > Forms epiphysis appears ar the end oF long bone & Fuses Cit ast osstification center to appear > clavicle Intra Uterine OSSIFICATION CENTERS Sm > calcaneum oppear er Bm Fm Sm im > Talus appear am > Lower end of femur appear Term + upper end of Tibia & cuboid appear CARPAL BONES ~ OSSLFICATEON capivate > am= 1yr > 16 bone to ossity Harsake 7a ys Wiquerral «= 7 2 ys Luncte > y ys Scaphoid 95 ts trapezium > 6 ys wopewid => 6 yrs JOINTS OSSIFICATION. vo Shoulder joint. > 18 yrs wrist Joint = > 18 yrs elbow goint «=F 16 ys uw Hip qoints Wr yes ‘ankle joints 1 Ys Knee geints 4 18 ys Normally, Ossificakion Centers Fuses T the yoints 4 year earler in Females thanSKULL SUTURES OSSIFLCATEON Posterior Fontanellae closure Fam - 6m Anterior Fontanellae closure > 2 yrs Metopic suture 7 2-8 ys Eogittal Suture Anterior tia > yo - Soyrs middle tard = > 50 - 6oyrs Posterior Uiard + 30 - 4oyrs coronal suture upper hale > yours Lower halt > 50 yrs Lomboid suture vpper holt > 60urs Lower hair > sours Base oF Sku. aunction bho basiocciput t basisphenoid — + 18 - aayrs. DENTETEON > ge determination done by 2. penta! eruption A Secondory changes DENTITION TEMPORARY | PRIMARY DENTITION Munk | DECIDUOUS TEETH SECONDARY / PERMANENT DENTETEON 20 3a Ro w Ro w © 8 @@| mL aw RL a sea = 2 Bx aca DENTAL ERUFITON SEQUENCE OF ERAUPTEON TEMPORARY TOOTH = oS 6m 4 7 am Rule oF = 2 ee Hale dozen m > aum 16E too to erupt > Lower central IncisorPERMANENT TOOTH Mamma m a a pm Pra © Ma iy 6 ys ve ys 89 ys a0 ys to-1 yrs Ui ys Bay gs. VF =a5 ye Ceoisdom toom) ehbagage TEMPORARY | PRIMARY DENTITION SECONDARY / PERMANENT DENTITION. Ro w 8OOO@) RL Soperodded successional ealh Cla) teeth (0d mL a minimum age to complete temporory dentition + a yrs Period oF mixed dentition > 6- ays Total no. oF teem From 6 lage > ay 4 no. oF permanent tom (age 5) xq SUCCESSTONAL TEETH Cla) 7 Set OF permanent teeth Comes in the place oF temporary teeth SUPERMDDED TEETH C20) Get OF perMANEnt teeth Comes by them Selves SECONDARY CHANGES 41. BOYDE'S merHon, > bosed on Incremental lines in toot > useful For neonates 2. SrAcK'S FORMULA based on height G weight oF toom > only Useful in infancy 3. QUSTRFSON'S CRITERIA + pttrition > Paradentosis > secondary dentin Root Resorption > “wonsporenty of root (most relioble ) > cementum apposition 7 used after secondary dentition ix completed4 DALETZ FORMULA ® > Perition P > Paradentosis S > Secondary dentin So Root Resorption DENTAL CHARTING, 1. ONTVERSAL | CUNNINGHAM METHOD 7 continuous adding of numbers From 1-32 For Permanent dentition parses se rslamuasysn 32 3) 30.4 AB 2 a6 35/24 Baa 0] 2. PALMER'S NOTATEON | 2tGmoNDY'S SYSTEM + addition of numbers From 1-€ in each quadrant for permanent dentit” EDCBA] ABCDE ale ala vie ale EDCBA|ABCDE > canine in Right upper quadrant specified as > 3) 2 > canine J > Right upper quadrane Lo > bere upper quad rant Flere tower quadrant 7 Right lower quadrant > For temporary dentition A,8, 6/0) Used instead oF 2-6 3. HADRUP'S EYSTEM BrP +S sea serenfrers srqesse rere — S+7H6r HES se4ssses748 BAe S-e Saat 3-4-S--w® Bags as casera * similar to palmar notation but “+ symbol is used for all teeth oF upper jaw & "symbol is used For all tee oF lower jou + ‘+! teeth + moxillary tee, "teeth + mandibular term5 FDI CFEDERATEON DENTATRE TNTERNATIONALE J System. > most widely used > Ako = TWO OIGTT SYSTEM eves wu nunia 2a ms ow yall 112) pretix nics ® #e SS W- 18 > Rt. Upper quadrant ane aa al~ 28 > Le. upper quadrant: eee eee ara ane eesti ee ee ee eee ee ae prerix H-¥5 > Le, Lower quodrant ® sie 61-85 > RL. Lower quadyant STATURE — height OF the person ond oe ee Seca rr 2. REGRESSION FORMULA > qiven by KORL PEARSON £, TROTTER GLESSOR > HepeuRN’s osrEomerRIC BORRD > Used ro measLre Ihe 7 bese estimate for stature given by > FEMUR 3. PERCENTILE FORMULA CONTRIBUTION TO STAURE Femur > 897 oF entire stature Tibia + aay OF entire storure Humerus > aor oF entire ctobure Vertebral column + 25% OF entire statue Skull height > 218m oF stature STATURE FROM FRAGMENTED BONE cALWIRTED BY + 2 STEELE | McKERN METHOD 2, BrDMeS meTHOD Diometer oF medulla MEDULLARY INDEX beh Diometer OF cortex + gender con be known DEFINITIVE] COMPLETE EDENTEFICATION ayy GERTELLON SYSTEM A“ 7 eased on Anmropometry o > Peremerens: y 2. DESCRIPTIVE DATA + color oF hair, eyes, Complexion 3. BODY MEASUREMENTS —F 11. measurements 3__BODY maARKS ‘A PHOTOGRAPHSDDACTYLOGRAPHY FINGER PRINTS — frmpressions produced by dermal papiliory ridges on the skin DAcrLOGRAPHY “F study OF Fingerprints World's 1st Finger print bureau present ar > Kolkatta (1897) LIELIEAM HERSHAL % ASE person used this memod GALTON 7 classified the Fingerprints oppeom by RQ Weeks OF TUL, Completely Formed by do weeks OF TUL Dattylography if most reliable method of ientiFication bcoz EPrints 1 Not inherited ip a. diFrerent even in twins 7 prrterns, enti ee oop most commen whorls arch composite + least common > Stes Nisie print kee print pose nl 2. visible Prints @ Latent Prints 4 need to develop to make it visible 2. Plastic Prints > impression oF FP con be Seen + PERMANENT ALTERATEON IN FINGER PRINTS SEEN TN 1. Leprosy 3. Rediation 2. Electrocution 4. chorring FINGER PRENT DEVELOPMENT FOR NON POROUS SURFACES 2. Vacuum METAL DEPOSITION Cymp) METHOD ‘+ thin metals like Zine or gold Used in Vacuum most sensitive metiod FINGER PRINT POWDERS FoR POROUS SURFACES OFO (1,8 -diarza -4 - Floorenone) (most Sensitive metod For porous surface Ninbydrin Superqlue fuming ope MENTMUM POLNTS OF COMPARISION > 1aLeeneD's FoROSOPY Sagar ands > opening OF Sweat glands om 7 arrange OF sweat glands ig Unique * invented by LOeARD a > LOCARD'S PRINCIPLE OF EXCHANGE 4 exchange OF materials present whenever a surfaces contott each oer cHIELOSCOPY > study oF lip prints F classified by SUZUKI into 5 types. RUGOSCOPY | PALATOSCOPY > study of rugae in hard palate Conterior ala rd) Fo rypEs oF RUGnE 2. a Rogae 2 a rugae Pooognam + study oF Foot prints + mainly used in hospitals to prove the exchange oF neisborns Podogram TOENTIFICATION GASEO ON FRONTAL SINUS PATTERN, TATTOO MARK J deposition oF dye into skin + Tattoo mark + dye deposited in Lymph node too = | % useedl in identiication + BYES Cpigments) COMMONLY USED ARE 1. Tndigo & cadmium 2. Indian ink 5. carton 3. cobalt 6. Purssian blue Tati marks > old tattoo marks can be visualised by UV/ Tnfro Red light 7 mentee LEGAL EmPORTANCE 3. Race identiFicat® Religion identificat™ Place identification Political interest identificat” Sexwad Interest identiffeat” IV brug abuse identificat” SUPER tmPOSITION Skull & photograph oF missing person are required need to Find out anatomical landmarks more OF NEGATIVE VALUE (exclusion can be done) Types Super ieppesition 1. Photographic. Superimposition 2 videographic Superimpositvon ropwee 44gs‘SEXUAL 3URISPRUDENCE SEXUAL OFFENCES CLASSIFICATION NATURAL SEXUAL UNNATURAL SEXUAL, SEXUAL PERVERSIONS| OFFENCES OFFENCES. PARAPHTLEA > natural route > unnatural route > no intercourse > Rope + sodomy > Sexval gratification Incest Bestiality by omer means Adoltery lesbianism Buccal coitus NATURAL SEXUAL OFFENCES. Rape ©) 335 1c 4 Penis into the Vagina, Uretra, anus or mou 4 okget into the Vagina, Uremra, ANUS or mou 1% any part of body into the Vagina, Uretmra, ANUS oF Mou application oF moum to vagina, Urethra or Anus 1. against her will a. without her consent & consent due to fear A Consent due to fraud consent due to insanity | intoxication & J CiWyrs OF age F nor able EO Commonicate consent 44 minimum age for consent for Sexual intercourse > 18 yrs 4 sex ca girl < teyrs , C] Cour consent statutory Rope 4 only a man con commit rape 4+ penetration to any extent amounts to rape 4 exceprtons a.m medical procedure will not be considered rope a Sexvol intercourse C wife not under IB Yrs, NOE considered rape EXAMINATEON OF RECUSSED > 3. @) CPC © Examination of rape accused under the request oF police 14 minimum cadre OF police > Sub Inspecror 4% even by using reasonable Force 4 54 crPC > examinakion oF rope accussed at his con request EXAMINATION OF VEER % Tour consents no examination can be done * ey cp) CrPc + exesminotion of vorTest FoR viertm TET Croludene Blue Test) > recent mio inguries con be Found Test FOR AcCUSSED Lugot's 10otNe TEST ko Find our vaginal epithelial cells in me genitalia oF accussed Swob From gions penis taken eapose the Swab to Todine Vopour Brown color > Postrive HN qt daw, test will be positive toosr IN CAMERA TRIPL + 327 CO CrPC 7 Burden of proof lies T Accussed PONISHMENT FOR RAPE = 335 TPC minimum 1oyrs imprisonment: B56) > CY rape viekiny dies] coma 36 (98) CH rape OF a g ©) custodial rape. a5) FF) gangrope Cupte a0 yrs imprisonment) BI Co) 4 @) gonqrape oF a g Cibyrs 3% 8) 4 CH) gangrape OF a g ©) repeated Offender (con be given death sentence) oULTERY + @ man having sexval intercourse ¢ onother married woman 7% yas tre > (FY Adultery Cearler) 4 Wa? EPC NOW SCRAPED BY suPREME COURT 4 violazed Articles ty & a! OF the EPC 4% onconstiturionel as it violates right to equality 4 can be ground for Civil issues including distolotion oF marriage 4+ it con not be a criminal offence 4 adultery will remain a ground for divorce rncest + Senval intercourse Tin blood relation not punishable in tdi as such > Wes, 1. GeDtPus comPLEX moter & Son, a. ELECTRA complex > Famer & daughter 3. PHAROAN Complex % Bromer € sister UNNATURAL SEXUAL OFFENCES > Punishable under 375 TPC 2. LESBLANtsm | TRIBAETSM F homo sexuality blo two Females + ACTIVE PARTNER > DYKE > _PASSIVE PARTNER > Femme@. SODOMY | BUEGERY | GREEK LOVE > Penile anol intercourse luhen the passive agent 18 elderly person -» GERONTOPHTLEA, when the passive agent if a child > pepARAsTY pediatric passive agent > carp mite IF consensval lw 2 adults + not punishable uF done t minor > punichable B37 LPC OECRIMINALISED BY SUPREME COUR 3447 TPC CAN BE STLLL TNVOKED UNDER FOLLOWING CLRCUMSTANCES a Bestiality A. with oUF Consent 4 ie a adults engage in &€ carnal intercousse against the order OF Nakure®? Tour the Consent Of One OF them, the Concerned individual can be charged under section 344 44 3x4 can be invoked by a wife against her husband in case be indulges her in non - consensual carn intercourse against the order of hakwe 3. BUCCAL corTUS | ORAL SEX| StH OF GomoROOH + oral stimulation oF penis FeLiarzo > oral stimulation oF vagina > CUNNTLENGUS 4 BesrtaLtry > sex T lower animals Ceheep | goat] cow) SEXUAL PERVERSIONS | PORAPHELIA 2. SADISMm sexval gratiFicot® by infliction oF pain 2 MASOCHTSM Sexual gratificat” by suffering OF pain 3. BONDAGE sadism + masochism A. EXHEGITIONLSM showing private pares punishable Tees a. Flashing b Streaking ©. mooning vourrsm |PEEPENG by wotching the privake acts oF ¢ yom) scoproPHiLA, punishable Under 354 Tre FeTcHtsm T inanimate obgects FROTTEURISM by rubbing the private parts oF 9 punishable TRANSVESTESM | CONTE > by wearing the dress oF Opposite Sex commonly Seen t males NECROPHAGTA, eaking the deod bodies } () onder a9 PC NECROPHELLA sex U dead bodies\ PARTERLESM 2 COPROPHILIA, 13, UROPHILTA | UNDTNTSM Wy. TPSATION | ONANTSM arfinity EO certain body parts by Sight oF Feces by Sight oF urine mastrubation public ipsation is punishable vohds "5 KLtsmppHTLA, We TRLOLSm . BoBBTT SYNDROME by Sel enema 3 people involved Female cuts me genitallo oF male partner 1 LUST MURDER by Killing the partner 1 SEKUAL ASPHYKEA common t males IMPOTENCY, VIRCINITY,PRECMANCY & ABORTION Heese Imporency inability OF @ person to achieve & maintain penile erection > me cause + Psychological F IMPOTENCE QUAD HANC > Impotency towards a particular women > aKa PSYCHOGENIC ImPOTENCY FRIGIOITY > Sexual coldness i Female Impotency v— SreRtiary + inability Fo beget children > applicable to both sexes + Sexual desire S > sarvriasis g NYMPHOMANTA, Artieicial ansemninot” ‘ies wi sin PRT [ ARTEFLCIAL REPRODUETION TECHNIQUES J 2 ORILFECEAL INSEMENATEON Cnn) soy oyna > optiFiciol ingeetion oF semen ae = py into female genitel Erace oom > semen can be from Husband > RTH Cer Husband) bonar > AID CAL Donar ) Pooled semen > Bor husband & donor semen INDICATIONS @) RELATED TO MALES 1. Incurable deFecks in the husband’ s semen 2 Heriditory diseoses 3. Rh incompatibility. 4. Irmpotent husband 5. Seerile husband (@) RELATED TO FEMALES 4. Unfevourable cervicod mucus 2, Anckomical defects oF uterus or CerviK thot prevents Sperm from reaching the ovumPREREQUISITES FOR AT 1. Consent of bom husband & wife as well as donar & his Wife Should be taker 2 Identity of donor should not be revealed & the donar ghould mot know the recipient's identity & results of te technique 3. Denar shovid be Less wan Hoyts UNrelated to me Couple & should have his Own children 4 Donar Should be of sound physical, mental € emotional heath & devoid oF any disease 5 Race & physical characteristics oF donar ghould resemble as closely as possible to thot of husband 6 Ovnar should be of the Same blood group as that oF hushand % There should not be any Rh incompatibity blu the donar 4 the recipient MEDECO LEGAL ASPECTS OF AL a 3 a 5 6 ie ig not adultery child is illegitimate Nullity oF movrioge & divorce Nokurol Birt & legitimate unmortied woman or women can undergo PI remote chances for Encest VIRGINITY > person who has not experienced sexual intercource StGNs 2. Intact hymen 2. @ fFovrchette & posterior commisure 3. Narrow vagina ¢ rugosity TYPES OF HYMEN 0o-n @ e620 Annvlar seritunatl cribriforen Fimbriated septate imperforate crescentic ‘mest compan CAUSES OF HYMEN RUPTURE 4. Sexual intercourse 2. mastrubation 3. Trauma & sumery 5. sanitory tampons 6 Solapim > OSed in Female child fT vaginal sine DeFLoRATtON, > loss oF virginity 7 absolute sign + Hymenol rupture > Hymenal rupture after intercourse not seen in 3. children > deep seoted | underdeveloped 2 False virgin > Female having intatk hymen after intercourse aie thier» loose or elastic hymenSUTE OF HYMENAL RUPTURE Q o Postero loteral Anterior PSEUDOCYESES | PHANTOM PREGNANCY > spurious, false pregnanuy All subjective Symptoms of pregnancy are geen abdominal distention iz dit fat deposition seen in 1. woman nearing menopause 2 In young woman who intensely desire o child A Tose T psychic or hormonal disorder the ff not diagnosed - patient may go through Full termoF pregnancy , may even have False labour pains SUPER FECUNDATEON. SUPERFOETATION > Fertilization oF 2 ove * Fertilization of 2 ova in fame ovarian cycle in different ovarian aycles by & Seperate acts of coitus > very rare phenomenon > @ fetuses ase born either or the game period showing dift- erent stages oF development Penile penetrat” Mastrubation | Le@urtmATe CHILD > sec, 11a 1€A > person who is born during the continuance oF @ lego! marriage 6 woman may pretend pregnancy & delivery and later produce a living child a8 her own PostHUmouS CHILD > child born arter the deat OF Famer aravesm > child resembles grand parents Loci sign oF recent delivery > ryees > onver 2. techie rubra 3. Lethia rubra + Republic oF A Lechia alba a Lochia serosa © sou, 3. Lothio serosa 2 Lochia alba = pFrica‘mBORTTON DEFINITION Medical DeFinit” 4 pontaneous or induced expuls’ oF products oF concept” berore Viablility G94) Legal Definition > Expulsion oF product oF conception from the uterus ‘or any period prior to full term Medical Abortion BB uxs Cviobility {+} —S_ a Tega) abortion ryPes 1, Legal Phortion > done Under the provision of MIP. 2. Tegal Abortion > done away From the provision OF MTP aka unlawful or Criminal abortion 4 MTP (MEDICAL TERMENATION OF PREGNANCY ) ACT 1941 INDICATIONS 2. Therapeutic 2 Eugenie 3. Humanitarian grounds Cpast rape) 4 Sodial grounds CONSENT FOR mre %& written consent is required 5 minimum age > 1B yrs % husband consent is not necessory DURATION OF PREGNANCY & < ueeks > single doctor 4 1a weeks - ao weeks + Two doctor 4 > a0 weeks > not done Exception > in cate oF emergency CRIMENAL ABORTION 4+ induced expulsion of the fetus from the mother’s Womb unlaofully § when there if no therapeutic indication METHOPS ADOPTED FOR CRIMINAL ABORTION, 1. Mechanical violence a. Pbortifacient Drugs 3, Tngtruments REORTIFACIENT ORUGS 3, EC@OLICS > aut directly on Uterus & 7 oterine Contratkion % Ext Ergot, quinine, Kino, tablets lead pills, strychnine3. EmmeNoGoGuES + produce * blood Flow + ack as abortifacient in large doses 4 Ex: savin, Borax , Prostaglandins 5 Estrogens Higginson Suringe INSTRUMENTS 2. Those causing rupture of membrane Thote Causing dilatation oF cervix (Slippery em bark) abortion Stick (13-15 can) Poste syringing > Higginsons syringe vrep CAUSES OF DEATH IN CRIMINAL ABORTION 1. tmmeormte 2 OktAYED + Hemorrhage + Generoliaed peritonitis > perforation > septicemia, pyemia * vago! shook > toxemia 7 Far embotisen > Bir embolism SECTIONS PUNTSHEMENT Woman | MOTHER CABORITON) Sec, 31a Consent Sec. 313 withour consent SEC Big Death oF me momer SEC 315 ue done Fo prevent the child From being born alive on cause it to die orter Birk SEC SIG Death OF @ quick UNborn child & Death oF the woman Corrender Known the ack was likely to cause death ) INFANT DEATHS Anfant 2 <16 TAPANTECEDE killing OF OH infant ; punishable under soa ihc MEONATEGIDE > Killing OF a neonate FrUCKOE * Killing OF Fetus by parents Minerury > ability oF Fetus to live a seperate existence apart from ite mother by Virtue OF the development > Period of viability > 8 weaks wo 4 intra orerine cea ; Fetvs dies in uterus crELL BIRTH Fetus dies in birth passage Live eretH Baby come out & shows Signs of lifeSIGNS OF vInBrLETY a 3 crown co Heel length = > TUD CINTRA UTERINE DEATHS) SIGNS Moceration Murami fication Rigor Mortis — membrone rupture Intod membranes 35 om eyelids open | pupillary membrane disappear OsscFication centers > Tallus & sternum } any one of These. indicetes 100 INTACT mEMmeRANE + NO Air No Air pir @ bacteria enters, ‘ 4 Lysis by amniotic Flvid scanty Fluid Very low blood. supply + bncenerton example oF autolysis ako Aseptic AurOLYSIS > sens L Skin slippage a skin blebs 3. bloared abdomen a hypermobile joints 5. Armonical Smet RADTOLOGICAL SIGNS 2. ROBERT Sign > a BALL'S SIGN > 3, DEVEL'S HALO SIGN 4. SPALDING SIGN > Cearliest sign) Carr? kim slippage ges shadow in ada earliest Sign Ciabrs) Spalding siqn hyperflexion of Spine Seen from 3rd day halo around the head oF the baby 100 4 Shrinkage OF cerebrum 4 Vault bones Override each OmerTests FOR Live BIRTH 2. LEVEL oF DIAPHRAGM + baby pot respired > aby respired > 3]4m rib > 6m rib 2 FODERE'S TEST 7 Weight oF bot lungs measured 44° waby not respirecl * 30 gms % aby respired > Go gms Chie is dle t vascularity) 2 Ploc@uer's Test ratio [HE OF ong ito > ras We of Boby ron Respired respiced 4 WREDEN"S TEST > presence of gelatin in ear > presente oF air in ear > baby not respired > baby respired 5S BRESLAU'S SECOND LIFE TeST/ STOMACH BOWEL TEST > Sinking oF Stomath In water > baby not respired Stomach will Float in water > baby respired 6 yOROSTATIE TEST | LUNG FLOATATION TEST | RAYGOT'S TEST residual air ig checked see oy 7 Specific qrowity of unrespired lung > 2.04 - »). > specific gravity OF respired lung > 0-440 LY” stent vest contnot Posty squere £00.05 ton » Liver Caimipanes Ca) sioxs +8 Vidal air) Floats > putre- foion FALSE Postreve 2. PuterFaction 3 A Prtificiol Respiration, FALSE NEGArtVE Atelectasis, Preumonia Pulmonary edema Feeble respiration a 3 “ VAGITUS VAgINALIS vagitus UTERINUS > cry oF the baby inside the vagina > cry OF ‘te baby inside the urerusUMBILICAL CORD CHANGES AFTER GERI a ahrs + clotted blood . 2 vay > shrunken 1 a pay > TAFlammatory Ring Foon let ” 3 Day 4% mummified a Falls, 3 vay > cord falls lo- pays > Scar CEPHALOHEMATON® (@APUT GuccADENEUM > die rupture oF vessels > dic edema F causes “Sub periosteal hematoma > seen on presenting part > po crossing oF sutuses resides in a day > eros Sutures BATTERED#8! 7 aka carFeY SyNOROME * aka Kempe SyNoROME 7% aka INFANT TRAUMATIC STRESS SYNDROME, > parreren cHrto 4+ one who received repetitive physical inguries 4 as © result oF non accidental violence % produced by a parent or quardian + renrores RELATED To CHTLO + age < 34 sex more Common i male 4% status vsvally, iNegirimake & Unwanted children position eldest or youngest RELATED TO PARENTS | GUARDIAN 4 status 2 unmarried couple Bo Age young % educat” Lower level of educat” 4+ childhood «Parents themselves ore the Victims oF batering History during childhood CLASSICAL FEATURES. gap blo the ingury & medical atent” which cost be explained SG _direrent stages of insuries discrepancy blu the noture oF ingUries Gexplanat” Offered by parentsTMDURIES 1, SOFT TISSUE TNOURTES % bruises, abrasions & lacerations % Loceration oF oral mucosa along t labial Frenulum oF lower Lip (characteristic feature) & Slop marks, lash mark Knuckle punchesy pinch marks, buiterély bruise q 6 pennie bruise are Seen 2. ENS TNOUALES 4+ shaken Gaby Syndrome | Infantile whiplash syndrome “occurs dit violent Shaking oF baby % Trea oF inouRTES 2. encephalopatry a velinal hemorrhoqes 2 subdural hemombages > Most consistent > 48€ clinical Sign on cr Seon 3. SKELETAL EngURTES Long Bone Ingories > highly suggestive oF aes > CORNER FARCTURE 7 BucKer HANDLE FRACTURE 7 dit aversion ingury in metaphysis SKULL FRACTURES > PeesuRE FRACTURE 7 EQG SHELL FRACTURE Fiswre # egg shell LE INDURIES. > 4 oF difterent stoges of healing > sratng of BEADS APPEARANCE Cealus) A OTHER TNDURIES VISCERAL INDURIES > inguries to spleen s liver oF hollow viscera, BURNS > small ciraalar pitted buns may indicate deliberoxe stubbing OF cigarette ends on skin + seals also commen MANCHAUSEN'S EYNIDROME BY PROXY + type of child abuse involving ‘he parent{ quardian > children ore brought to doutors , For induced Signs or symptoms OF illness Tt fictitious history> child is admitted Frequently in the hospitals for Non cxisting conditions “+ mother may prick the child’s Finger & adds blood to unne oF child & takes the gomple to dotor 4p pillow may be put on the Face OF child & them pushed Onto the bed 4+ she may give insulin to child & Eake him to doctor for hypoglycemia 4 che may also give emetics » laxokives ete > orngnosis 44 the illness does not confirm to the expected presentation 4 signe symptoms are not substantiated by laboratory or imaging Findings 4s Failure of wounds to heal 4 the child becomes ill Or worsens Lahen the porent oF guardian is present, T recovery when Seporared Finding that the patient hax been admitted to multiple hospitals « hos been geen by moltiple physicians ¥ SUDDEN ENFANT DEATH SYNDROME | cRIG DEATH | COT DEATH > sudden unexpected deat of healthy infant, whose death remains unexplained even after thorough investigation > reprures Incidence FOR - 0.4% OF all live birms ge > awks to ays Cam -am) sex > male: female ratio Twins 4 risk among twins Time of death > during steep § early morning Premakusity > higher risk Socio - economic status > Lower status > Cigarette srroting by mother has got higher Fisk > puroesy FINDINGS 4 usually negative autopsy Findings 4 milk Or blood stained Froth at moum & nostrils the only constant findings ase moltiple petechial hemorrhages on Visceral Surface OF heart » lungs & thymus which are agonal in nokwre b hands are clenched to bed sheets > PROPOSED THEORTES 1 Prolonged sleep apreo Cemost acceptable cause? 3. Respiratory, infection 3 Larungea! spasm A. Hypersensitivity to cou s milk 5. omer causes: canduaeh sustem anomalies mechonical upper airway obstruction Adrenal Insurticiency gastro - esophageal reflux Leading to bradycardia oteFORENSIC TOXICOLOGY INTRODUCTION > roxrcowoy > study of Poisors + Porson 4 any substance y in any form, given in any route eimer produce iM heal or deat by Local or remote attions EcoTORCoLosy Study OF poison in Fela? to environment 2 ToxrNoLoay > study OF toxins 3 OccuPATTONAL + study OF assodat” blo oceupar™ & poisons ToIcOLOGy PAULUS ZAccHIUs > Father OF toxicology MATHEW ORTELLA > Father OF modern coxicology CLASSIFICATION OF POISONS corrosives cardiotoxic irritants Psphyxrant Neurotoxic miscellaneous congostves > any substance Which can corrode 7 includes acids, alkalies TERRITANTS. any substances Lhich induces inflammation + Indodes Metalic > Arsenic, Srom, merairy , lead ete Non metallic > Phosphorous Plants + Ricinus, obrus, Crotin, Semicarpus , calotropis Animals > Smakes, Scorpions euRoroRte, + ads on Brain & somniferous > Sleep inducing ‘ 4 Ehebriants 4G detirients causes intoxicat” causes delirium ‘ > acts on Spinal cord = > St rychnos AUX Vomica acts on peripheral nerves + Conium mocolarom | Hemlock cARDEO ToxIe + induce axrytienios CAR > cyanide oF Digitans o> Olander N > Nicotine A > peoniteASPHYKTANIS Cgases) + <0 ths (SEWER GAS) memone, co, Induce asphyxia like Feotures MISCELLANEOUS 3. FOOD POISONING |. AGRICULTURAL POLSONS IDEAL HOMICIDAL POLSON eosily available ho color, no Smell, no toste symptoms should start after a qap symptoms should mimic natural disease No Specific Pm Finding: \s Poison Should not be detected by test Idea homicide poison most Commonly used TOEAL SUICIDAL POTSON 2. easily avoilable easily mixed & food pleasant | no taste poinless deat highly toxic Idea! svicdal poisons 2. cyanide > Thallium | fluorine + prsenic | peonite 2 Opium /Barbitwates. me used = oe. DIAGNOSIS OF PoIsowINc IN CASE OF DEAD 1. Smee 2 COLOUR OF HYPOSTASIS 3, CHEMICAL ANALYSIS. smeL garlic Prvity odour Rotten egg Burnt Rope il oF bitter almond Fishy beegae Arsenic 5 Phosphorous 4 AlUminivm phosphate Alcohol Mas cannabis cyanide ‘tine phosphide1 veey © 8 i ™ 1 Shoe polish > nitro bennene 8 Acid pear 7 chloral hydrate , poraldehyde 4, mombalt > Naphimalene 10, carrot like + Hemlock Cconivm maculatum HYPOSTASES & POISONS 1. cherry Red > co 2. Brick Red > cyanide 2, Brown > Kelog 5 all nitrates , aniline 5 bromides A Bluish green > ths 5. opivm > black CHEMICAL PNALYSES ROUTINE ORGANS Stomach Semall intestine Corgan oF absorption) Liver Corgan of metabolism) Kidney Corgan of excret) Blood > best sample > con qualify & quantify ali above organs can be preserved in GLASS CONTAINER SPECIFr® ORGANS 3. Strychnos > Heart, Spinal cord & Aconite > Hear 3. Metal > Bone, hair, nail sample 4 Gaseous poisons > whole lungs Criylon bag) 5. Bile > opium , Barbiturate Glutathione 6. Brain > cerebral poisons PREseav prives 2. Sakurated solution of Nal 4 commonly used a. Rectified Spirit (457 alcohol) + best preservative Avord SALTS IN AVOID RECITFIED SPRIT IN. 2. orrosives. except Phenol 2. pleohol a @conite 2 Formalin 3. 107% Formalin For Histopamological Examination 4 50% Glycerol > For virology 6 NF * For Bloods vitreous , csF FOr 0, Cyanide, #icohol poisoning Pcr NECROSIS > celg 5 Cadmion Acids Coxalic Acidy carbolic Acid) Lysol > mercuryGENERAL GUIDELINES IN THE MANAGEMENT OF A CASE OF POISONING DUTIES OF A DOCTOR 3. medical duty C prime priority) 2 Legal duty meorca ouTy TREATMENT OF POTSONING CASE Sequence ABCD > stapitizar™ Remove te unabsorbed poison Remove the absorbed poison Neutralize antidotes symptomatic Ry pees 1. SMBTLERATEON. 8 > pirwoy &@ 7 Greaming © > Greulation D> CNS Depression |. REMOVAL OF THE UNABSORGED POLSON COECONTAMINATION) > depends ory route oF exposure 21 skin > wash & #20 a tnbalation = > 03 3. Oral > gastric lavage , emesis , comarsis QRSTRIE LAVAGE > wimin Shs > very eFrective > Position > Lert lateral | trendelenberq ( 4 aspiratn) > wes > Ryue's use > Lovamaror Ceest) > Ewald | Boos tube Ccommonly used) 15 meters in length made Up of rubber mouth end has Funnel Fwale Tobe bolb helps in suction > Fluids + Tap woter Crormal saline) + 145000 KMnog > calcium todtate > Tannic Acid ters > Gastric Lavage is used For Following polsoning case Where route fx not oral 4 Poisons undergoing biliary secretion 2. Opium a Barbiturabes 3. Glutathione> CONTRRENDECATTONS OF @ASTALC LnvnGe Cv Pesolure cir 2, Corrosives except carbolic Reid Cr mucus thickening — leakery mUcosa) ReLorive OT 2. convulsants a comatose 3. vorices A volatile (kerosene) emesis + advocared in me absence oF gastric lavage tuhe % attempted only in conscious person + pecac syrup 4+ only me best emetic % aoml 5 cra 5 emesis cATHARSTS. >t purgation + b- sorerroL is used 3. REMOVAL OF POISONS TN THE BLOOD 1. pralysis 2. Divresis brurests, 7 acidic drugs 7 urine alkaline % parbitusates Forced alkaline diuresis salicylates > Plkaline drugs > brine should be acidic & uinine Forced acidic diuresis Hemo orALysts bo bonr B arbiturates DON 5 Digitalis Lithium 1S Insecticide A leohol 8 + Benzodiozepine Salicylate By Amphetamine Thiocyanate / Theophylline © Corrossives kK Kerosene 4. NEUTRALUTATEON ¢ AemTEDOTE MECHANTSMS 4. TNERT ComPLER FORMATION + chelaking agents ® +c —, O- ow Toxic, Non toxic woter insoluble, Woter SolubleA. REDUCED TOKIC mETABOLLTE icohol dehydrogtnast pormnie Acid Memanol FomePTaole 3 + peroxtexcarton cyanide Triosulphate Tio qyanate (non toxic) Corines A RECEPTOR BLOCKADE CHELATING AGENTS 2. AL COLMERCAPROL) > has —ash groups > attraus metals 7% given by deep im > CONTRA TNOICATIONS 2. Fe & Cadmium Ccomplex itselF is toxic) 3. @ePo veFiiency 3. Liver disease a. pms C succumeR) + can be given oratty > con be given in Gorn DeRdency 7 used For Mercury poisoning Lead poisoning Pesenic poisoning 2. Cq E07 CvERSENATE) 4 Ast tine drug for lead > 4 urinary excretion oF metals > conten INDICATED IN renal failure mercury Cnephrotoxic) poisoning 4. PeNTCELLAMINE + used in Mercury poisoning Leod poisoning Copper poisoning 5. DESPERRTOKAMINE > used in tron overloadPHYSECAL ANTIDOTE | MECHANICAL ANTIDOTE > RETIVATED CHARCOAL + acts by AOSORPTLON > dose > 1gmjKq soon Corrosives Hydrocarbons ron Metal Petrolieum products Sotiylares ONIVERSAL ANTEDOTE CazITI) a > eectivated charcoal > adsorbs the poison 10 > Tannic aud > oxidise potsons 1 > Magnesiom oxide neutralizes acid CARDIAC POISONS ACONITE | METHA BHUSH| mITA ZAHER] MONKS HOOD, > root 1S most toxic. > revive PRENCLPLES > Alkaloids. 4. Beonitine a. Pseudo Acdnitine. 3. indo Aconitine > tone errens. 1. Paragtmesia in perioral region a. HIPPUS 4 alternake pupillary constriction & dilatazion 2 cardic€ orrhymmia > Dean ‘Aconite root ‘aconite > IDEAL HomCEDAL POLSON 2. Small quantity can be Fatal a. Tasty 3. destroyed by putrefaction can't be detected by tests OLEANDER PINK OLEANOER/ KANER YELLOW OLEANDER | PILA KAMER NERTUM oDoRUM CERBERA THEVETIA PETIVE PRENCTPLES ReTIVE PRENCTPLES Nevin Thevetin Nerifolon. ‘Thevetoxin causes hyperkalemia + arrytimios (cardiac)[ANIMAL IRRITANTS SHAKES. + opuroiwey > study oF snakes VENomous SNAKES | NON VENOMOUS SNAKES Head scale smolt Large Belly scale | Large ‘Smal Toil Stole compressed nor compresied Fangs Fangs muitiple teeth fong morkS a Fang marks muriple small bite marks Habitat nocturnal not sO MEAD SCALES TN VENOMOUS SNAKES + NOrmoliy Small > Except 1. cobra + Srd supra labial is large a Krai > ym nea lobiol ix large 2. Pit Viper > pit behind eye FAMILTES OF SNAKES ELnproRE VEPERIDRE BYDROPIORE Neurotoxie ——vasculo| hemotoxic myotoxie King cobra russel viper Sea snake Comymon cobra sau Scaled viper Scnmete NAME FATAL post common cobra Noja. raja tamq + S00mq/ bite ‘erat Bongarus Coereleus mq > womg|bite russel viper Caboia russel saxo Scaled Vipef —_-EChiS Carinate common snakes in India Anti snake venom Ntutraliaes the above 4 Snake venoms most Fakal > kraie most mortality > Common cobra, SNAKE GITE ENVENOMATION COPHITORE MIA) Loni sYmproms more pronounced 7 vipers ot present > krait ELnpton€ VIPEREDAE SEA SHAKE & Posts & re 4 Rhobdomyol ysis 4 respirarory Failure 4% Renol Failure Ce yogtobind + Renal failure 1 crust eyNoROME Uwe FEATURES.MRNAGEMENT 1st 1D RrqUT Approach R Reassvvance 1 Immobilisabion CPressure immobilizakion > SUTHERLANG'S IRAP) Qh GO EO Hospital r Tell the doctor Speciere Ry 1 sv + developed by cALmeTE > prepared From Horse serum (responsible for allergic reactions) + dosage > 8 - 10 wials > in ahs > very effective 7 errective against era 4” 2. common cobra a. kralt 3. russel viper A. seu Scaled viper 2 ing. Neostigmine > for cob > reverses the nevropasalysis > no role in Kroit QO MINUTES WHOLE BLOOD CLOTTING TEST Ca0M WeCT) > screening test for viper + 2 ml of blood in test tube > wait For Ao minutes > ie cloned => Normal > nor clothed + pre Cviper) ASPHYXIANTS: CARBON MONOXIDE INTOXICATION PROPERTIES OF CO > gas > no smell > lighter than air > alo Fimes more affinity to Hb than 0, > Anemic anoxia, errects © - 10 > m0 symptoms lo 20 + mild headache 20-30 emotional instability 20-40 4 f Headache, Confusion 50-60 + mimics drunkenness y #0 > coma + dearTESTS FOR CO INTOXICATTON 1. SPECTROSCOPY (most definitive) 2. KUNKEL'S TEST 2 HOPPE SeYLER’S TEST 4 GAS CHROMATOGRAPHY Fenrures a, Cherry Red hypostosis A BIL necrosis OF Globus pallidus | putamen MANAGEMENT 1. High Flow 03 CyANTDE > ideal suicidal Poison Cmost rapid when inhaled? > oil oF bitter almonds smelt > compounns 2. Hydrogen ayonide } toxic 2 Hydro oyanic acid 3. Potassiom cyonide } non toxic + Hel —+ Hydrocyani¢ aud 4. Sodium gjanide Pehlorhydria protects From toxic eFredts Been in Almonds, apple, peach, linseed plont CYANIDE inhibits cytochrome Oxidase (ETO > _HESTOTOXLE PNOXIA MANAGEMENT 2. LILLY'S ANTIDOTE contains Sodium nitrite } induces emem -Hb > cyano - Mem Hb frny) nitrite Sodium thiosulfate + cyano -Meth Hb > Thyocyanate = non toxic — water soluble a. VITAMIN Big 3. pLCOBALT EDTA + Bright | Brick Red hypostasis seen > Bedside test for cyanide > Lee JONES TEST CORROSIVES > marimom tissue destruction Caused eros auKntss > causes coaqulotive necrosis couse liquerackive necrosis 4 spread: limited 4 spread 18 more % relatively less dangerous more dangerousetos Masoy } oniy tocal crvets 2. WNe3 3 CAROLE Acro | PHENOL } hove local & 4. Oxnue REL Systemic effects HaSoy (OTL OF VETREOL > conto ¢ teeth > stomach + + chalky white teem Black neerotle mucosa CdIt H,0 Absorpt") Blotting paper Stomarh Gastric perforotion > rreamenr 1. MAGNESIUM OXIDE, a. Gastric lavage ig cy 3. Poin Killers ‘ steroids ‘vitriolage > virrrotage + ® onder 3a6h & 2a6 B HNO3 CNETRIC AED) CAgUA FORTIS) + “KANTHOPROTEIC REACTION Hino, + Tissue 5 Picric Hud Cyeltowish staining) % 9m Findings 1. yellow beets 2 yellow stain over stin 3. yellowish brown stomach mucosa G@ARBOLTC ACED | PHENOL + used a8 disinfectant > phenol + Tissue ____LenTHERY conststenct + coreotrsm > Peete poisoning 7 PHENOLIC MARASMUS > chronie poisoning @nreoitsm Phenol, stomach Absorbed, Liver __, Pyrocoteatol oKiC a Hydroquingre, metals brown leamery stomach mucoso TORIC metabolite can deposit in cartilage 4 Ligament 4 Joints —* Cochronesis Blackish discolorat) constriction of pupil Corboluria tHe | —— colour OF Urine —> green colour Pyrocatecho! & hydroquinone causes PLT neurosis» Renal Failure add+ Phenol Inhibits potre Fackion > sumennny cAReOLEC ALCO Carbolisen corboluria cartilage deposition constriction oF pupil convoluted tubule damage Feros ‘oxatee ACO > used as ink remover solution > used in Forging signature ee coe eee L Brown Stomach mucosa, v coreee ground Voritus > Treatment = > ty Calcium BOREC ACID POISONING > desquamation of skin DELIRIENTS DELERIENT ATuR species data alba Dakwa nigra > Bonen Logsren’s Blood ____, Hypocalcemia ¢ Cretany) on + cart ' calcium oxalate 4 ‘oxalurig 4 Per damage a Renal Failure SXNoROME Thoms apple Satara alba, Hakusa stramonium C3ImSoNS WEED) + Fruit > THORN APPLE rere prs by hyoscine Se hSciMe as catinerte fit part. oe sone % seeds & root > most toxicStGNS G SymPrOMs CB 'D'S) 2 Dry Mou 5. Dilakakh oF pupil 2 pry skin 6 @elirium > moTTERING deLtRLEm 3. Dysarthria 3. Drunken gait A Dysphagia © Death Feral Dose =F 100 Seeds Seedt of dotura = chilli seeds DATURA SEEDS CHILLI SEEDS [Fares bose Brown yellow 2 Gan 28 cas (large small 3 vicinus communi > to ede C 6 4 Semcarpas anacardium > 510 grams Spat > top erect OTHER Names. TREATMENT Pry FINDINGS MyoRIATIC TesT RAILUAY POLSON ROADSLOE FOISON Physostigmine datura seeds resist putrerattion used for dotura Streening gdag cANners. > me abused substance + OTHER Names Rope Por Weed Moriguana, grass, frre > ACTIVE PRINCIPLE >THE Cetra Hydro cannabinol ) % po active principle in seeds > PREPARATIONS + Bhan + dried leaves 2. Gangs > dried Flowers 3 charas {hashish > Resin From root [stem 4 mayoon > Sweet From Bhang 5. Sinsemetia > Seediess cannabis > FATAL DOSE Cper kq Body weight) chang > logm soma = 7B gm chaos = Am Cmost potent Form) > cannabis smell 7 Burnt Rope smelt + chronic cannabis abuse 1. AMmeTEVATTONAL SyNOROME 2. RON AMOK Homicidal impulse | stabbing spreeCOCAINE | WHITE LADY | Sou | CRACK | COKE > sympamornimetic > Fatal cose > 1 gm oral ao mg W CHRONIC COCAINE ABUSE > Ulceration oF nasal septum | patare > Peripheral gangrene > black coer staining of tonque COCAINE BUGS | MAGHAN'S SYMPTOM | FORM FICATION 4 tactile haltudnk” be multiple insets crassling over skin TREATMENT + no specieic antidote > Anticonvulsants > esmolol COCAINOMANEA > can tolerate agmiday cocaine + irresistable impulse METALLIC POISONS MERCURY | QUICK SLLVER | HYORARGYRUM wees 2 ORGANEC MERCURY > most toxic (memyl mercury) 2. THORGANTC MERCURY FEATURES mercury = Tongue + stomach __, colon —_, kidney 4 + + Stroupberry slate diphiteria Pe Necrosis tongue qrey like colitis mucosa, OCCUPATEONAL ASSOCLATEON, 2. Hat Industries 2B. Glass blowing occupation CHRONIC MERCURIC POTSONING | HYDRARGYRESM s strawberry toque L > mercuria Lentis a > Perodynia a > tremor € > Erymism Cmad haters) arey > Gloss blower's Shakes Minamota diseaseMERCURIA, LENTES > dit mercurial vapour > mercury deposits in anterior lens Copsvle > Malt brown ReFiex seen ACRODYNTA > seen in children peeling OF skin proritis Plufty painful peripheries > PINK oxsense dag TREMOR > corse tremors > Hotter's shakes, Glass Biower's choke. All monifestations are dit inorganic merry Except Minamata Disease MINAMATA OTSERSE + die orgonic mercury dit consumption of Fish TREATMENT 2. Sodium formaldehyde suiphorylate Solution For gastric louage a BAL] Penicillamine CEDTA not Used) Leno | PLumaum Toxte seus, 2. Lead Acetate mo 2 Gad Sulphide Cheast toxic) 3 Lead tetroxide — Cmost toxic) 4 Tetra ety! lead > causes lead encephalopay PLumersm | SATURNTSM Anemia basophil’ Stippling, Burtonian line colics, constipation Drops Culrist Orop , Fook Drop) encephalopathy Facial pallor (aie vasospasrn) Govt Csarurine gout ) prmae oD tegsgse MICROCY TEE HYPOCHROMIC ANEMIA * ae Inhibition oF min dehucarase Yb synneit Ferro chelarase Iimbibit > 1 pe + cpu + ProtoporphyrinogenBASOPHELIC STTPPLING > seen TROL > aggreguted ribosome Cbive dots) F dit inhibition oF 5 Pyrimidine nudedtidase ‘o BURTONIAN LINES. sasorhile sipping + Blue deposits over the gums dit lead sulphide * coucs > dry belly ache ENCEPHALOPATHY (857) Burtonian line > seen C children > irreversible > Learning direicuities FACEAL PALLOR, > most consistent sign > earliest sign DIAGNOSIS Based on cpu rey Plumarse Proto porphyrinogen Lead levels 229? LEAD LINE Thick radio opaque band in the metaphyseal region oF tom bone oF x - Ray of Child TREATNENT 1, omsh @ EDTA 2 Lead encephalopathy > pra + BAL ARSENIC = Garlic odour > roxte saurs 1. Arsenic Trioxide | Somalkhar | sankhyo most toxic D. Copper Arsenite | Scheele’s green 3. Copper Aceto arsenite | Paris green > FrrAL pose 4 190 = 200 mq FULMENANT POLSONENG > Bars single dose + dies Cin shrs by cardio vasuar collapseACUTE POTSONENG + gastro enteritis > mimics cholera ARSENIC Sequence Cholera sequence Throat pain Pusging vomiting vomiting, purging ‘Throat pain, Tenes mos CHRONTE ARSENIC POISONING CARSENTCOSLS) [ SKIN > Raindrop pigmentation Croding measles rosh) 7 BIL hyperkeratosis oF palms | soles > neoplasm Nate > PLDRICH MEE'S LINE > Wansverse white line bare > plopecia 7 Golden hair Colso seen c copper) BONE > Bm depression > Ponaytopenia NERVES ~ predominantly aFrects Sensory nerves > symmetrical sensory nesropamy 4 Eingling & numbness in glove G stocking distribution 4 tattle hallucinations Loop vessers > Thrombosis 4 Gangrene (peripheral ) (BLACK Foor DISEASE) DIAGNOSIS SAmpLes Peure, > Blood & liver chronic > Bone, hair & noil vests 1 Marsh Test | Reinsch test Jautreit test + not Lted now 2 NAA Craton aczivakion ARES) |} presenty oted 3. BAS CAtomic absorption Spectrometry)DISADVANTAGES OF USING ARSENIC AS HOMICIDAL POISONING 1. decomposed body, 2 skeletal remains } freanic can be recovered 2. charred ports ashes PM FINDINGS 4. Red velvety stormmath mucosa 2. Sub endocardial hemorrhages TREATMENT 1. Ferrous hydroxide a BAL 3. mse AASENTC TOKECLTY SEGNS § SYMPTOMS Anemia/ Aldrich mee's line | Prsenophagist (tolerate upto 300mg) Rain drop pigmentakn /Reinschtest/ Red velvety mucosa Sub endocardial hemorrhages / Sensory neuropathy Eruptions Nap Imbibition OF Arsenic CArsenic imbibed From Surrounding Soils after death? Comvlative poison /cholera like symptom /chelation for hy THaLitum + deat Homicidal poison > sxmproms Plopesia Neuropathy larrhoea Abdominal pain (most common Syrptem) NONISIAi PHOSPHOROUS WHTIE PHOSPHOROUS RED PHOSPHOROUS garlic odour NO goslic Odour Toric hon toxic Lomintseene on luminescent alwoays Kept onder water he Heed to Kept Under water produce Smoke bo smoke produced ACUTE PHOSPHOROUS POISONING 2. Gastro Intestinal Phase > Luminescent vomiting > luminescent stools > smoKe' stool. SYNDROME, 2. Asymptomatic Phase 3. Liver cell foilure > resembles Yellow otrophy oF LiverTREATIDENT 2. GASTRIC LAVAGE > kong, 7 0.0% cuse, > caution 0 be taken 2. Ing. Vit K Cin case oF liver cell Failure) CHRONIC PHOSPHROUS POISONING | PHOSSY JRW | LUCIFER’S JAW + exposure to vapours oF phosphorous For tong time leads to Too pon 5 osteomyelitis _, sinuses t Pus, osteonecrosis oF mandible + Phosphorous ig 4 'p! poison 2. Protoplasmic poison >. Phossy Jaw 3) Photo luminescent a Purpura IODINE > protoplasmic poison > cironte IODINE POISONENG (tODESm? % ropenma > skin patches 4 LODENE mumPS > painful parotid enlargement: AGRICULTURAL POISONS + me used suicidal poison in Indio. + containg Rodenticides 4 Herbicides y tnsecticides ruseeretnet Sarena isl Pyreftroide ingt phaephakes 1 malathion ain 3. reve fry! phosphates 3. Paramion (Folido!) 2. Biazinon (rik ao) 3. chlormion 4. metry! paramion 2. Organo chiorines a, por a. endrio Cplant pencittin) 3. endosuiFon 3. carbomates 1. pldicare 2. PropixicarhORGAN PHOSPHOROUS POISONING 7 kerosene smelt dit Aromnx 7 mecHAnttsm oF ACTION ‘inhibits AChE Cacetyl choline Esterase) % cholinomimetic 7 ncrtons MUSCARENEC ACTIONS. NICOTENEC AcTTONS Salivation eopcene muscle factcvtations Lagi mation Treatment 2 gostric Lounge 2 Aeropine > blocKs muscarinic eFFects 3. Oximes C cholinesterase Reattivators) Pam C Pralidoxime) + Shovld be given a8 early as possible before AGETNG OF ENZYME (resistant to Oximes) Occors + Btropine + oximes 4 Synergistic ore caneamenes Trreversible inhibit” of Ache reversible inhibition of AChE R_by Atropine & oximes Oxims are not Used PLANT IRRITANTS ORGANIC IRRITANTS 2 PURNT IRRITANTS. 2. RNLMAL TRRETANIS PLANT ERRETANTS BERS PRECATORLUS SEEDS > GUNCHE ceEDS | RATE SEEDS | ROSARY BEES. each seed weighs 108 mg SUT NEEDLES 4% Heedles prepared From Crushed abrus seeds id > used as arrow poison rus precaroris 7 Ideal cattle poison Canima'! poison) resembles viperine snake venom pertve > Pbrin Cmost potent) PRINCLPLES > Abrine Abrus seeds a AbralincRoTON TEGLLLUM common NAMES. 2. TEMAL GoTA 2. Jemat BEAN 3. NEPALA croton seeds RCFEVE PRUNIPLES 1. crotin Cmost potent) 2. crotonoside causes Intense purqation RECINUS ComMUNTS | CASTOR PLANT | ARANDT ACTIVE PRENCLPLES castor seeds = _, castor oil 4 Residue carcrn) + Toxic Breen + causes bloody diarthoea castor seeds MECHANISM OF ACTION RECEN + 60S RIBOSOME ___, RNA Polymerase ___, Protein Synthesis. + Inflammarion <— Necrosis <—— Cell death TOKALBUMINS (PHYTO TOXINS) 4 causes REC agglutination > Toxalburnins crotin pbrin Ricin, SEMICARPUS ANACARDIUM | BHILAWA SEEDS seeps > BreLAWwA SEEDS > Black colour quice Obtained from seeds. 4 used to mark On cloms % pro inflammatory 4 contact T Skin cavses Blisters 4 ARITFICUAL BRUISE Can be produced 44 also causes intense diarrhoea pertve + Semi carpe! PRINCEPLES * Bhilawanol CHULAWA SEEDSSPANISH FLY| BLISTER BEETLE | CANTHARLDES ACTIVE PRINCIPLE > CANTHARIOTN 4 beetle contain 297. cantheridin 4 dry powder oF Canmaridin is APHRODISEAC( # libido) 4 skin contact causes blisters 4s omer Features > Loin pain Cnephrotoxic) hematuria > renal failure Spanish Fly CAPSECUM ANUM | CHELLT | MERCH ACTIVE PRINCIPLES > Cap: capsaicin -. HUNAN’S HAND / CHELLE URN . > chronic exposure to chilli powder couises contact dermatitis chili seeds Chilli Seeds resemble Dotwa seeds Embryo inside the chilli seeds > curved inwards CED Embryo inside the dakura seeds > open ovtwards CALOTROPES | MADAR/ AKOO RETLVE PRINCIPLES — + calotropin > calotoxin: 7 ushorin used as. calotropts: 4 Abortion stick 4 Infanticide 4 artificial bruise producer cattle poison FATAL DOSE 2. Abrus. a Seed a Crotin 5 seeds 3 Ricinus communis lo seeds 4. Semi carpus anacordium 5 = 10 grams CEREBRAL POISONS SOMNZFEROUS POTSONS ‘PLUM | AFI) MADAK | CHANDU > extracted From the capsule OF unripe fruit Juice oF Popaver somniferum > wice contain multiple alkaloids + capsule contain seeds + seeps «+ KHAS KHAS > non toxic> FATAL Dose ‘opivm > 2am morphine > 0. qr + moRPHINE derived From opium 4 epeects, miosis , Marquis test Orinastakic hypotension Respiratory depression Physical dependence CHord drug ) Histamine release r ree Nausea Euphoria eee dsge TREATMENT OF MORPHINE POISONING 1 Gastric lavage T 1 + 500 KMnog HEROIN | SMACK | JUNK | DOPE} BRON SUGAR > diacetyl morphine > speed ball Heroine + cocaine > Hor shoe > Heroine + strychnine + ROUTES OF HEROIN ABUSE 2. main lining > direuty sv 2 Skin popping > subuiraneous 2. chasing the dragon > inholakional INEGRIANTS. PLcoHOL. ETHANOL CEMmy)! Alcohol) > produced by Fermentation of sugars > water soluble Picohol =___, stomach ___, small Intestine coy) 807 absorption) absorpt? za te caneonaren raNKS 4 for Fined amount of altohol y Females have more effects alt lesser Hp concentration in body > compostrtow Absolute Alcohol = > aa. a5 Surgicol spirit 7 957 OF emanol + 57 Memano! (wood Napma)industrial Memylated Spirit» 40% Ethanol 9.57. Wood naptha 0.57 Pyridine ceolouring agent 5 pink) Mineralized memylated Spirit > q0x Emanol 9.57. wood napiha 0.5) Winker qreen RELATEONSHEP BETWEEN BLOOD ALCOHOL & BODY FLUID AlcoHOL Ron Blood alcohol + 2 orine alcohol = > 2.3 vitreous 7 ata se nae’ Alveolar air ~ 0.0021 (helpful in Breath analyzer) GHENRY'S LAW ix Used in breath analyzer) EFRECIS OF ALCOHOL, srages 1 Stage OF exdtement Cc BOM”) 1 stage OF incoordinakion (150 -300mgr.) _—F_RTA are more in this stage. 2. Stage oF coma (> 4oo mg7) > MC EWAN?S SIGN 4 differentiates between olcoholic coma £, comadit morphine, + Pleoholic qaze nystagmus (40-80mq7) > onder the influence OF alcohol CEO -100 m7) rests 1 kozetk® | HENE Test a caverr vest @ = amount oF alcohol 3. GAS CHROMATOGRAPHY P = Wwt-oF person © = alcohol concentration LEDmARK'S FORMULA r= constant a > 6 = Per 9 +) 06 LEGAL Limrr OF ALCOHOL TN A DRIVER > India > 30 mail > drunk & driving 18 punishable under 185 motor vehicle ou 7 1 any person causes public WUIBARCE Under the influence oF alcoho! + punishable onder 510 TPCMETHNOL | WOOD ALCOHOL Mernaotesm Metmanol shel , Formaldehyde SEE Formic acid aerydrogenase dehudrogerase \ optic neuritis metakolic Acidosis Hooch TRAGEDY = dit Lice liqour TREATMENT 4. Emano} Cacks by Competitive inhibition) 2 FoMEPIZOL — inhibits Moshe! dehydrogenase 3. FoLINre ACD helps in deqradation oF formic Aad A. ty Sodium bicarbonate SPINAL POISONS SIRYCHNOS NUX VORECA | KUCHTLA ACTIVE PRINCIPLES > _Strydhnin€ Cmose potent) 7 brucine > logonine seeos > Looks like ROC > 1 crushed eed ig foro! MECHANTSM OF ACTION > acts on anterior horn cells OF Spinal cord > inhibits glycine & causes veFlex excitation oF musues > leads to® muscle convulsions 7 resemble tetanus TONS 1. oprstHotonus + backward bending oF Spine 2. EMPROSTHOTONYS > Forward Flexion oF Spine 3. PLELROSTHOTONUS * Lateral Flexion oF Spine TREpTMENT > ANKiConvel Tans samete FOR THE TEST + URINE 4 R07 OF MUX vomica is excreted by Urine Tout change rests > WENZELS Test > outdated 4 Thin layer chromaroqraphy C1Lc] } used note high pressure liquid Chromaro qraphy HPLC} PoSTARVATION DEATHS beFinition TYPES ACUTE | ComPLETE 1 Actual withholding oF Food or food & water by on individual mecessory for the maintenance of the body > when Food is withheld suddenly & completely for a continuous period @ CHRONIC | PARTEAL] MALNUTRITTON, > When food intake ig deficient 5 either quantitatively or qualitatively for a continuous period causes 1 Famine a. being tropped in pits 5 land slides, mines 3. neglec On the part OF parents or guardians + Ex: child abuse A Willful witholding of food ; ex ~ elderly b. willful refusal Eo take Food 3 Ex - Religious rituals Crasting) hunger strikes TN STARVATION a Tere 18 severe redvcion in vitamins minerals energy intake me form of malnutritionFATAL PERIOD Food & 420 Stopped, deal occurs in 10 -la doys Food olone if stopped, deat occus in 6-8 weeks Loss oF 4ox OF body weight is Fatal Loss of 40% Far is Fatal Loss OF a07. protein is Fatal ivece CAUSE OF DEATH: cardiovascular Failure Enrections Dehydration occasionally dit Failure of other vital Functions oF the body rere PM FINDINGS ‘+ Emadation € loss oF body weight & orqan weight Cmain Finding) > complete loss OF Fak in the subcutaneous & deep Far depots > complete disoppearance oF body Far t pronounced ib Cage ‘4 Severe atrophy OF skeletal muscles 4 lungs , heart , liver, Spleen, Kidneys » endocrine & reproductive orqans Covaries, testes), except For the brain 15 Em ngonks , complete atrophy oF thymus is pathognomonic oF starvation 1% disuse abrophy oF the GIT ¢ translucent small intestinal walls Cin paper like) & Stomach & small bowel are empty along c presence of dry stoolt in the Colon. Even Foreign bodies may be Found in the colon Loss oF adipose tissue OF the mesentery Gall bladder bigger in size G distended t bile LEVER + ik may Show Centrilobulor netrosis dit protein deFiuency KEONEY > it may show obrophy OF nephrons prngnosts 4 based on History & Pm Findings 4 before opining on starvation as cause of death » Narurol dixentes causing cachexia should be ruled our MEDrco LEGAL ASPECTS surctoat Some starve voluntarily for Foifiliment oF their grievances 7 prisoners, mentally i! or hysterical woman Eo Homrcrpal > elderly person or Victims of child abuse ACCIDENTAL > Forsine, Shipwreck trapped in mines or landslides dering eastiquakes