August 19, 2019

Brief History of Legal Medicine

A. Worldwide setting

The earliest recorded medical expert was Imhotep (2980 B.C.). He

was the chief physician and architect of King Zoser of the third dynasty
in Egypt. He also built the first pyramid. During his time the first
recorded report of a murder trial was written in clay tablet.

The oldest code of law was the Code of Hammurabi (2200 B.C.). It
included legislation on adultery, rape, divorce, incest, abortion, and
violence.

Hippocrates (460-355 B.C.), also known as the father of medicine

discussed the lethality of wounds.

Aristotle (384-322 B.C.) fixed the animation of a fetus at the 40 th

day after conception.

About 300 B.C. the Chinese Materia Medica gave information on

poison including aconite, arsenic, and opium. Hashish (Marijuana) was
believed to have been used by the Chinese as a narcotic in surgery as
early as 200 B.C.

Roman Emperor Numa Pompilius (600 B.C.) decreed that bodies

of dying pregnant women should immediately be opened in order to
save the child’s life. It is believed that Julius Caesar (100-44 B.C.) was
born through this method, hence the procedure is now called
Caesarean Section.
 The first “police surgeon” or forensic pathologist was Antistius. He
performed the autopsy on Julius Caesar who was murdered in 44 B.C.

Antistius testified that Julius Caesar bore 23 wounds but only one
penetrated the chest cavity through the space between the first and
second ribs.

The first textbook in legal medicine was written in 1532 during the
reign of Emperor Charles V of Germany. It was included in “Constituto
Criminalis Carolina”.

Paulus Zacchias (1584-1659) – a papal physician, is regarded as

the “father of forensic medicine”. He published the “Questiones
Medico-legales” which dealt with the legal aspects of wounds, and the
detection of secret homicide.

In 1598, Severino Pineau, a French, published a work on virginity

and defloration. He confirmed the existence of the hymen and that it
may not rupture during sexual intercourse.

The combination of medical and legal approach to dealing with

crimes used in the United States today had its origin in England in the
12th century, when King Richard I established the Office of the Coroner.
Although – the coroner’s main duty was to keep a record of all criminal
matters in the country, he was also responsible for investigating all
deaths thought to be the result of suicide or homicide.

The early American colonists brought the coroner system with

them, including the appointment of coroners by a representative of the
crown. After the formation of the United States, elected officials
appointed coroners. As medical involvement in the investigations of
violent and unexplained deaths increased, communities began to
require that the individual in charge of such investigations have a
specific academic background. In 1877 Masachusetts adopted a
statewide system requiring that the coroner’s office be replaced by an
Office of the Medical Examiner, to be headed by a physician. A number
of other states also adopted this requirement. In 1915 New York City
established a comprehensive program in which the medical examiner
was specifically authorized to investigate all deaths resulting from
criminal violence, accidents, or suicides, and those that occurred
suddenly to people who appeared to be in good health.

In modern countries Legal Medicine is practiced today as a high-

technology field using electron microscopes, lasers, ultraviolet and
infrared light, advanced analytical chemical techniques, and
computerized databanks to analyze and research evidence.

B. In the Philippines

In 1858, the first medical textbook entitled “Manual de Medicina

Domestica” which included pertinent instructions related to medico-
legal practice was written by Spanish chief army physician Dr. Rafael
Genard y Mas.

In 1871, legal medicine was introduced as an academic subject in

the School of Medicine of the then Real y Pontifica Universidad de
Santo Tomas, now known as UST.

In March 31,1876, the King of Spain through Royal decree 188,

created the position of “Medico Titulares” and that officer was made in
charge of public sanitation and medico-legal aid in the administration of
justice.

In 1895, the first medico-legal laboratory was established in the

City of Manila and extended its services to the provinces.

In 1898, the American Civil Government preserved the Spanish

forensic medicine system.

In 1901, the Philippine Commission created the provincial, insular,

and insular Board of Health (Act Nos. 157,307 and 308). The Philippine
Legislature maintained the pre-existing medico legal system of the
Spanish Regime and assigned the duties of the “Medico Titulares” to
the Inspectors and Chairmen of this Board.

In 1908, Philippine Medical Schools incorporated the teaching

once a week of Legal Medicine as a separate subject to fifth year
medical students. This textbook does not have a record as to when the
subject was first offered to students of the College of Law.

After the liberation of the country from the Japanese, when

registered physicians were not available in remote rural areas, a non
medical graduate could perform medico-legal work and such was called
a ”Cirujano Ministrante”. It is unclear what qualified a person to be
appointed as cirujano ministrante but the position has been abolished
by the approval of Republic Act 1982 in June 15, 1954 which created a
Rural Health Unit to every municipality thus limited medico-legal
function to qualified physicians.
 In December 23, 1975, Presidential Decree 856 was promulgated
and Sec. 95 provides:

A. Persons authorized to perform autopsies:

Autopsy is defined as the examination of a body after death to

determine the cause of death or the character and extend of changes
produced by disease or injury. s

1. Health Officers

2. Medical Officers of Law enforcement agencies. (today these are the

PNP Crime Laboratory, NBI, Public Attorney’s Office Forensic
Laboratory)

3. Members of the Medical Staff of accredited hospitals

B. Autopsies shall be performed in the following cases:

1. Whenever required by special laws

2. Upon order of a competent court, a mayor, or a provincial or city

fiscal

3. Upon written request of police authorities

4. Whenever the solicitor general, provincial or city fiscal deem it

necessary to disinter and take possession of the remains for
examination to determine the cause of death. (Exhume for autopsy or
re-autopsy)

5. Whenever the nearest kin shall request in writing the authorities

concerned to ascertain the cause of death.