Ayurveda Library's Guide to Vyavahara Ayurveda

अगदतन्त्र
व्यवहार आयुवेद
एवुुं ववविवैद्यक
PART B
AYURVEDA LIBRARY
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CHAPTER i: introduction
 Definitions
 Vyavahara
- The factor which makes the person able to have the discrimination power
between true & false subjects which in turn enhances the faith of an individual
for Dharma and helps to achieve its goals & visions is called as Vyavahara.
- According to Acharya Manu, winning of justice during prosecution in the

court is known as Vyavahara.
- ‘Vyavahara Ayurveda’ is a coined term to imply the meaning of

‘Forensic Medicine’.
- ‘Vidhivaidyaka’ is a coined term to imply the meaning of
‘Medical Jurisprudence’.
 Forensic Medicine
Forensic medicine is defined as the application of medical & para-medical
knowledge in the administration of law and justice.
 Medical Jurisprudence
Medical jurisprudence is the subject dealing with the aspect of the law
concerning medical practice & knowledge.
 History of Vyavahara Ayurveda & Vidhivaidyaka

A) Ancient Era:
Medicine and law have been related from the earlies times.
References are found in the Vedas, Kautilya Arthashastra, Manusmriti, and also in
some Ayurvedic texts like Charaka Samhita & Sushruta Samhita.
i) Vedas: - (2000-1000 B.C.)

- Rudra & Varuna have implemented the law & order.
- Descriptions about the laws in relation to medicine.
- Atharvaveda gives details how to cure wounds, poisoning & snake bites.
ii) Kautilya Arthashastra: (300 B.C.)

It mainly explains about Danda niti which incorporates laws & disciplines which help
in the execution of punishment.
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iii) Manusmriti: (200 B.C.)
- Manu was the first and foremost traditional King who gave disciplined laws to the
country.
- He explained about:
Principles of the King, protection of the people, court laws, witness, false witness,
false statements, false oath, parameters for punishments for different types of
crimes.
- He also explained some subjects related to Vyavahara Ayurveda such as sexual
offences, rape and marital relations.
iv) Samhitas:
Ancient Ayurvedic texts such as Charaka Samhita & Sushruta Samhita have described
the ethical & social status, responsibilities, duties, qualities & skills of a good
physician.
B) Modern Era:
In 16th-century Europe, medical practitioners in army and university settings began
to gather information on the cause and manner of death. Ambroise Paré, a French
army surgeon, systematically studied the effects of violent death on internal organs.
Two Italian surgeons, Fortunato Fidelis and Paolo Zacchia, laid the foundation of
modern pathology by studying changes that occurred in the structure of the body as
the result of disease. In the late 18th century, writings on these topics began to
appear.
The first chair of professor Medical Jurisprudence in India was established in 1857 at
Madras Medical College.
The Indian Penal Code (IPC) came into existence in 1860, the Indian Evidence Act in
1872 and the Criminal Procedure Code (CPrC) in 1974.
 Indian Penal Code (IPC)

- Act ID = 186045
- Enactment Year = 1860
IPC is the official criminal code of India. It is a comprehensive code intended to cover
all substantive aspects of criminal law.
IPC has 23 chapters and comprises 511 sections.
 Indian Evidence Act

- Act ID = 18721
The Indian Evidence Act contains a set of rules governing admissibility of evidence in
the Indian courts of law. The enactment and adoption of the Indian Evidence Act was
a path-breaking judicial measure introduced in India, which changed the entire
system of concepts pertaining to admissibility of evidences in the Indian courts.
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Until then, the rules of evidences were based on the traditional legal systems of
different social groups and communities of India and were different for different
people depending on caste, community, faith and social position. The Indian
Evidence Act introduced a standard set of law applicable to all Indians.
Indian Evidence Act, 1872 has eleven chapters and 167 sections.
 Criminal Procedure Code (CrPC)

- Act ID = 19742
CrPC is the main legislation on procedure for administration of substantive criminal
law in India. It was enacted in 1973 and came into force on 1 April 1974. It provides
the machinery for the investigation of crime, apprehension of suspected criminals,
collection of evidence, determination of guilt or innocence of the accused person and
the determination of punishment of the guilty.
CrPC has 37 chapter and 484 sections, 2 schedules and 56 forms.
- Section 53: Examination of accused by medical practitioner at the request of

policer officer
i) When a person is arrested on a charge of committing an offence of such a nature
and alleged to have been committed under such circumstances that there are
reasonable grounds for believing that an examination of his person will afford
evidence as to the commission of an offence, it shall be lawful for a registered
medical practitioner, acting at the request of a police officer not below the rank of
sub-inspector, and for any person acting in good faith in his aid and under his
direction, to make such an examination of the person arrested as is reasonable
necessary in order to ascertain the facts which may afford such evidence, and to use
such force as is reasonably necessary for that purpose.
ii) Whenever the person of a female is to be examined under this section, the
examination shall be made only by, or under the supervision of, a female registered
medical practitioner.
- Section 53A: Examination of person accused of rape by medical practitioner

When a person is arrested on a charge of committing an offence of rape or an
attempt to commit rape and there are reasonable grounds for believing that an
examination of his person will afford evidence as to the commission of such offence,
it shall be lawful for a registered medical practitioner employed in a hospital run by
the Government or by a local authority and in the absence of such a practitioner
within the radius of sixteen kilometers from the place where the offence has been
committed by any other registered medical practitioner, acting at the request of a
police officer not below the rank of a sub-inspector, and for any person acting in
good faith in his aid and under his direction, to make such an examination of the
arrested person and to use such force as is reasonably necessary for that purpose.
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CHAPTER ii: legal procedures
 Inquest
Inquest is the inquiry of the cause of death which apparently did not occur naturally.
 Types: - 3
1) Coroner’s Inquest
2) Magistrate Inquest
3) Police Inquest
1) Coroner’s Inquest:
A special officer known as the Coroner is appointed by the government
who is an advocate with 5 years of experience. A Coroner is usually
present in metropolitan cities.
2) Magistrate Inquest:
Magistrate inquest is usually done by an executive magistrate such as
Collector, Deputy Collector, etc.
It is done in case of:
- Death in police custody
- Deaths due to police firing
- Death in prison
- Exhumation
3) Police Inquest:
The police officer on receipt of information of death has following duties:
- He should proceed to the place of occurrence, hold an enquiry into the
matter, in presence of the respectable men of the locality (Panchas).
- Investigation of the case.
- Report: Description of the body, weapon used, etc.
- All the facts & circumstances relating to the death, as observed by the
Panchas, is recorded on paper, which forms a document called the
Pancha-Nama / inquest report.
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 Evidence / Medical Evidence (Chikitsaka Sakshi)
 Types: - 2
1) Oral evidence:
a) Direct / First hand evidence
b) Indirect / Second hand evidence
Oral evidence is generally superior to documentary evidence.
2) Documentary evidence:
a) Medical certificate:
- Must be from a registered medical practitioner.
- It is an offence to issue false certificates; punishment for the doctor in
case where a false certificated is may lead to imprisonment up to 3
years; a registered medical practitioner issuing a document under his
name & authority or signed by him, which is false, misleading or
improper, is liable to have his name struck off from the medical register.
b) Medico-legal reports:
- It is drawn by a medical officer in compliance of a requisition received
from a Magistrate or a Police officer.
- Medico-legal report may pertain to injury, age, sexual offences or
death.
c) Dying declaration:
- It is a verbal or written statement made by a person narrating the cause
of his / her condition or any of the circumstances resulting in death.
 Witness
 Types: - 3
1) Common witness:
It is the person who narrates what he / she has perceived regarding the
ongoing case and states his / her observation.
2) Expert witness:
It is the person who, on account of his / her special professional training
& skill, is capable of giving an opinion or deducing inferences from the
available facts regarding the ongoing case.
3) Hostile witness:
It is the person who, with definite motive, gives only part of the truth or
false evidence regarding the ongoing case.
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 Courts & their Powers
The Criminal Courts in India are as follows:
a) The Supreme Court – it is the highest tribunal for the country and is established in
New Delhi. It can pass any sentence.
b) The High Court – it is the highest tribunal for the state and is situated generally in
the Capital of every state. It is empowered to trial any offence and pass any sentence
authorized by the law.
c) The Sessions Court – it is located in each head-quarter of a district and is therefore

also called the District Sessions Court. It can pass any sentence authorized by the law,
including death sentence which should be confirmed by the High Court.
d) The Courts presided over by Magistrates:

- Metropolitan Magistrate / Chief Judicial Magistrate – can pass imprisonment up to
7 years, fine without limit.
- First Class Magistrate – can pass imprisonment up to 3 years, fine up to Rs. 5000.
- Second Class Magistrate – can pass imprisonment up to 3 years, fine up to Rs. 1000.
 Oath (Shapatha)
- An oath is a commitment made to the witness’s deity or on their holy book.
- A witness must take the oath prior giving his / her statement. A statement given by
a person who did not take the oath is not admissible to the Court of Law, except
when a person is below 7 years of age or when the person is called for an expert
opinion.
- Oath:
“I do (swear in the name of God/solemnly affirm) that what I shall state shall be the
truth, the whole truth, and nothing but the truth.” (India)
“I solemnly affirm that the evidence that I shall give shall be the truth, the whole
truth, and nothing but the truth.” (South-Africa)
 Summon
A summon is a command issued by a Court generally to an accused person or to a
witness, whose attendance is required in the court.
It may also concern a registered medical practitioner (or any other individual) if his /
her special professional training & skill is required.
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CHAPTER iii: personal identity
 Identification
Identification is the determination or establishment of the identity of a person
whether living or dead.
Types: - 2
i) Complete / Absolute: Exact determination of the identity of a person.
ii) Incomplete / Partial: Incomplete determination of the identity of a person.
Medico-legal Aspects:
Identification is required in following circumstances or case:
- Suspected foul play resulting in death
- Assault or rape
- Disputed sex
- False personification (e.g. to secure property, insurance, pension)
- Fragmented remains of human bodies (e.g. mass fatalities – explosions,
accidents of railways, ships, airplanes)
Important Factors for the Establishment of Identification:
i) Race:
By following characters one can establish an idea of the person’s race:
Data for Identification Example

Clothes Dhoti, Kurta indicates towards Indian
Complexion Fair = Westerners, Black = Negros, Dark skin = Indian / Nepali / Sri Lanka, etc.
Scalp Hair Blonde = more common in western countries, Black = India, Dark & Curly = Negros
Eyes Blue = more common in western countries, Dark eyes of Indians
Lips Big full lips of a Negro
ii) Sex
- Sex determination seems easy, but may cause challenges in cases of
hermaphrodites, concealed sex, decomposed bodies & skeletal remains.
- The person having varying proportions of both male & female characters is called
hermaphrodite.
- Data for identification: Features & facial appearances, length of scalp hair, size &
shape of lips, clothes, breast, vagina, uterus, penis, prostate
- To determine true sex: External examination, Examination of internal organs,
Gonadal biopsy, Study of sex chromosomes
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iii) Age
For the determination of age, the following data should be collected:
▪ Height & weight:

These are no very reliable means of estimating the age of an individual.
Comparison of the person’s measurement with standard height & weight charts will
only give a rough idea of the age.
In case of foetus or newborn child, height & weight are of greater importance.
▪ Number of teeth:
Teeth form a reliable means of estimating the age of an individual up to 25 years
because different teeth erupt at different definite ages.
Types of teeth:
a) Temporary milk teeth (20)
b) Permanent teeth (32)
TEETH TEMPORARY PERMANENT

CENTRAL INCISORS Lower - 6th month 7th year
Upper - 7th month 8th year
LATERAL INCISORS Lower - 9th month 9th year
Upper - 10th month 9th year
CANINES 18th month 10th - 12th year
ANTERIOR PREMOLARS Absent 10th - 12th year
POSTERIOR PREMOLARS Absent 10th - 12th year
FIRST MOLARS 12th month 6th - 7th year
SECOND MOLARS 2nd year 12th - 14th year
THIRD MOLARS Absent 16th - 25th year
(WISDOM TEETH)
▪ Examination of lower jaw:

A lower jaw has 2 angles:
a) Medico-legal angle
It is obtuse in children, and about a right angle in adults. In old age, it becomes
obtuse due to loss of teeth & absorption of alveolar process.
b) Anatomical angle: It determines the sex.
- Mental foramen: It is close to the inferior border in infancy. It is midway between
upper and lower border in adults. It comes closer to the upper border in old age due
to alveolar process after falling of teeth.
▪ Stage of ossification of bones & epiphysio-diaphyseal union of long bones:

X-ray is one of the most important factors for the purpose of determination of age. It
helps to examine development of union between diaphysis & epiphysis of long bones
and ossification of bones.
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▪ Some other signs for determination of age are:
Hair in pubic region or axilla, moustache & beard, voice, menstruation, grey hair,
wrinkles on the face, etc.
Medico-legal importance of age

- Criminal responsibility and judicial punishment
- Marriage contract
- Kidnapping
- Rape
- Infanticide
- Criminal abortion
- Competency as witness
- Eligibility for employment
iv) Scars
A scar is the formation of fibrous tissue as an outcome of the repair process after an
injury. It has great value in identification of a person. Following factors of a scar
should be examined:
Anatomical situation, Size, Shape, Colour, Consistency, Tenderness
v) Anthropometry
The measurements of various parts of the body is called Anthropometry or Bertillon
system. It is based on the principle that after the age of 21 years, the skeleton stops
growing. Therefore, the measurements of the body parts remain constant and no
two persons will have bones of identical dimensions.
Disadvantages: Only applicable to adults, Errors in taking measurements,
Many instruments are required for recording the measurements.
vi) Dactylography
Dactylography is also known as Galton system or Finger Print system.
A finger print is the impression of the ball of the finger. It is based on the
arrangement of papillary ridges on the skin.
No two persons are having identical prints. These prints can easily be taken on paper
by ink.
Types: a) Plain finger print; b) Rolled finger print
By the finger print a complete & correct identification of the individual is possible.
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vii) Poroscopy
The papillary ridges of the skin of the fingers contain minute pores which are the
openings of the ducts of sweat glands. These are permanent and vary in size, shape,
portion & number over the given length of ridges in each individual which helps in
establishing identity.
This method of identification is known as Poroscopy.
viii) Foot prints

Just like a finger print, the foot also gives and impression called as foot print which is
useful in identification. The skin patterns of toes & heels are as distinctive as those of
the fingers.
While examining foot prints, deformities such as web feet, flat feet and
supernumerary toes, etc. help in identification of a person.
ix) Tattoo-marks
- Design, colour, size & exact anatomical situation of the tattoo should be examined.
- A tattoo may indicate towards the name of the person or a loved person.
- It may give suggestion about the person’s language.
- It may give a clue regarding race or religion.
- Figures of naked women or indecorous female figures indicate the interest of sex.
x) Deformities
Deformities are a burden for the individual, but they are useful for the purpose of
identification.
Types: - 2
a) Congenital: Cleft palate, hare lip, irregular or protruding teeth, moles,
supernumerary fingers or toes, flat feet, web feet
b) Acquired: Surgical wounds, amputations, mal-united fractures, filling of teeth
xii) Miscellaneous data

Laundry marks, tailors name marks on clothes, jewels, visiting card, watch, etc. may
help in identification of a person.
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 Forensic Odontology
Introduction:
- Forensic Odontology / Forensic Dentistry is a branch of forensic medicine dealing
with teeth and marks left by teeth for identifying criminal suspects or the remains of
a dead person.
- Forensic dentistry is the proper handling, examination and evaluation of dental

evidence, which will be then presented in the interest of justice.
Responsibilities:
- Forensic dentists are responsible for six main areas of practice:
i) Identification of found human remains
ii) Identification in mass fatalities
iii) Assessment of bite mark injuries
iv) Assessment of cases of abuse
v) Civil cases involving malpractice
vi) Age estimation
- The evidence that may be derived from teeth is the age (in children) and
identification of the person to whom the teeth belong. This is done by using dental
records including radiographs, ante-mortem (prior to death) and post-mortem (after
death) photographs and DNA.
The other type of evidence is that of bite marks, left on either the victim (by the
attacker), the perpetrator (from the victim of an attack), or on an object found at the
crime scene.
 Forensic Serology
Introduction:
- Forensic serology is the detection, identification, classification, and study of various
bodily fluids such as blood, semen, saliva, urine, breast milk, vomit, fecal matter and
perspiration, and their relationship to a crime scene.
- A forensic serologist may also be involved in DNA analysis and bloodstain pattern
analysis.
- Serology testing begins with presumptive tests which gives the analyst an indication
that a specific bodily fluid may be present, but cannot completely confirm its
presence. Following the presumptive tests, are the confirmatory tests that confirms
what the unknown substance actually is.
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 DNA Profiling
Introduction:
- DNA profiling (also called DNA fingerprinting) is the process of determining an
individual's DNA characteristics.
- DNA profiling is a forensic technique in criminal investigations, comparing criminal

suspects' profiles to DNA evidence so as to assess the likelihood of their involvement
in the crime.
- Although 99.9% of human DNA sequences are the same in every person, enough of
the DNA is different that it is possible to distinguish one individual from another,
unless they are monozygotic (identical) twins.
Process:
The process, developed by Glassberg and independently by Jeffreys, begins with a
sample of an individual's DNA (typically called a "reference sample"). Reference
samples are usually collected through a buccal swab. When this is unavailable other
methods may be needed to collect a sample of blood, saliva, semen, vaginal
lubrication, or other fluid or tissue from personal use items or from stored samples.
A reference sample is then analyzed to create the individual's DNA profile. The DNA
profile is then compared against another sample to determine whether there is a
genetic match.
Extraction of DNA:
When a sample such as blood or saliva is obtained, the DNA is only a small part of
what is present in the sample. Before the DNA can be analyzed, it must be extracted
from the cells and purified. There are many ways this can be accomplished, but all
methods follow the same basic procedure. The cell and nuclear membranes need to
be broken up to allow the DNA to be free in solution. Once the DNA is free, it can be
separated from all other cellular components. After the DNA has been separated in
solution, the remaining cellular debris can then be removed from the solution and
discarded, leaving only DNA. The most common methods of DNA extraction include
organic extraction (also called phenol chloroform extraction), Chelex extraction, and
solid phase extraction.
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CHAPTER iv: death & its medico-legal
aspects
 Death (Mrityu)
- Death is the permanent ending of vital processes in a cell or tissue.
- Death may be defined as completed and persistent cessation of circulation and
respiration.
- A somatic death is the condition in which there is complete stoppage of action of
heart, lungs and brain.
- A molecular death is the condition of individual cells of the tissues of the body,
which takes place after some time of somatic death.
Types of Death:
1) Syncope
- Failure of circulatory system
- Syncope death results from stoppage of heart’s action.
2) Asphyxia
- Failure of respiratory system
- Asphyxia is a condition arising when the body is deprived of oxygen, causing
unconsciousness or death; suffocation.
3) Coma
- Failure of brain function
- A coma is a deep state of prolonged unconsciousness in which a person
cannot be awakened; fails to respond normally to painful stimuli, light, or
sound; lacks a normal wake-sleep cycle; and does not initiate voluntary
actions. A coma patient is not termed as dead, but coma often leads to brain
death.
Modes of Death (Prakara):

1) Natural
2) Unnatural
3) Accidental
Signs of Death (Mrityu-Chihna):

1) Immediate signs (Changes occur up to 12 hours)
2) Early signs (Changes occur within 12-24 hours)
3) Late signs (Changes occur after 24 hours)
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1) Immediate signs of Death:
a) Absolute cessation of circulation for more than 5 minutes.
- It is tested by absence of pulse in the peripheral arteries & absence of heart sounds
on auscultation.
- Magnus test = When a ligature is tied tightly around the base of a finger, it does not
swell beyond the ligature or becomes blue and swollen if the circulation has ceased.
- Icardi test = Hypodermic injection of fluorescin does not produce any discolouraton
of the skin.
b) Diaphanous test = Webs of fingers in a living person appear to have a scarlet red
glow when held against strong light, while it is dull and yellow after death.
c) Absolute cessation of respiration for more than 5 minutes.

- Hold a cool bright mirror in front of the mouth and nose. If the person is breathing,
deposit of moisture of breath will make the surface of the mirror hazy.
- Winslow’s test = Place a basin of Hg or a mirror on the chest or abdomen and focus
light on its surface. The reflected spot of light will move up and down in a breathing
individual.
2) Early signs of Death:

a) Changes in the eyes:
Eyes lose their luster. The tension of eye balls is lost. Cornea becomes hard and
opaque. Pupillary corneal and conjunctival reflexes are lost.
b) Changes in the skin:

Skin loses its luster, elasticity, colour and becomes pale.
c) Loss of temperature and cooling of body:

-Once death occurs, the body heat decreases because of oxidation has stopped.
- The body assumes the temperature of the medium in which it is placed.
- Body temperature decreases by 0.4° C per hour after death.
- The term post-mortem caloricity is used when after death the body, instead of
coming down to normal temperature, shows a rise of temperature which persists for
1-2 hours.
This happens in conditions like tetanus, injury to nervous system, strychnine
poisoning, etc. due to the action of micro-organisms in the living tissues and body
fluids and the chemical changes after death.
d) Post-mortem (P.M.) stain:

- It is a purple discolouration appearing within 30 minutes to 2 hours after death as a
result of gravitational movement of blood within the vessels.
- The blood tends to go into the capillaries of the most dependent parts of the body
at the particular position and causes distension of the minute capillaries leading to
purplish-red areas on the skin.
- Synonyms: Post-mortem hypostasis, Post-mortem lividity, Post-mortem suggillation
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- Medico-legal importance:
P.M. stain generally first manifest after 1 hours of death; maximum manifestation
occurs between 4-6 hours.
During this time, alteration of the body’s position will change the position of P.M.
staining, but the area of staining does not shift after this period.
P.M. staining is a reliable sign of death. It indicates the time passed since death
occurred.
Sometimes the colour also indicates the cause of death; for example:
- Asphyxia = Bluish-violet or purple
- Carbon monoxide poisoning = Cherry red
-> Cadaveric Spam:

Cadaveric spasm, also known as post-mortem spasm, instantaneous rigor, cataleptic rigidity,
or instantaneous rigidity, is a rare form of muscular stiffening that occurs at the moment of
death and persists into the period of rigor mortis.
It is a dependable sign of death.
It gives information about time and mode of death.
It gives information about position of the body at the time of death unless disturbed.
-> Cadaveric changes in muscles:

a) Primary relaxation / Stage of flaccidity
Primary relaxation is the stage in which all the muscles of the body become flaccid,
extremities become soft and flabby, joints relaxed. However, the muscles are contractile to
external stimulus.
b) Rigor mortis (Latin: rigor "stiffness", mortis "of death"),

Rigor mortis or post-mortem rigidity, is one of the recognizable signs of death, characterized
by stiffening of the limbs of the corpse caused by chemical changes in the muscles post-
mortem. It takes 1-2 hours for the complete establishment of rigor mortis and continues for
a period of 24 hours.
c) Secondary relaxation
Secondary relaxation of muscles occurs after rigor mortis. The body becomes soft and flaccid
again, but does not respond to external stimulus.
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3) Late signs of Death:
a) Putrefaction:
- Putrefaction is also known as decomposition.
- It is a certain sign of death.
- It is the change of the body from organic state to inorganic state.
- It is done by two processes:
i) Autolysis:
After death, enzymes release from cells of the tissues. They soften and liquefy
the body. This is known as autolysis. It commences after 3-4 hours after death
and continues for 2-3 days or even longer.
ii) Bacterial action:

The large variety of enzymes produced by bacteria acts on carbohydrates,
proteins and fats. Conditions like warmth, moisture or air are favourable for
bacterial growth and accelerate the onset & progress of putrefaction.
Bacteria produce lecithinase which hydrolises all cell membranes, including
blood cells. Thus the putrefaction and hemolysis of blood initiates.
During life, micro-organisms are present in large number in the large
intestine. Short after death, they spread throughout the body. Organs which
are nearest to the bacterial source and have the greatest blood supply
putrefy first.
b) Saponification:
- Saponification is also known as adipocere.
- It appears like soft wax, so it is called adipocere (adipos = soft; cera = wax).
- It is a modification of putrefaction.
- It occurs due to conversion of unsaturated liquid fat to saturated solid fat.
- Warm temperature, air & moisture are required for saponification.
- Adipocere is a yellowish, white, greasy, wax-like substance with a rancid
smell. It floats on water.
- It helps in identification of a person because external features get preserved.
- It gives an indication of cause of death as injuries are preserved.
- It gives an indication on time passed since death.
c) Mummification:
- Mummification is a modification of putrefaction.
- After some time, putrefaction stops and the body undergoes
mummification.
- It is characterized by dehydration or desiccation of body tissues and viscera.
- High atmospheric temperature devoid of moisture, free circulation of air
around the body are required for the process mummification.
- A mummified body is shriveled, odourless, very dark in colour. Weight is lost,
skin becomes hard, dry & leathery. Viscera are also dark and shrunken.
- It gives an indication of cause of death as injuries are preserved.
- It gives an indication on time passed since death.
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Time since Death (Mrityu-Kala Nirnaya):
The time since death is determined by:
▪ Warmth or cooling of the body

Body temperature decreases by 0.4° C per hour after death.
▪ Post-mortem (P.M.) stain

- It is a purple discolouration appearing within 30 minutes to 2 hours after death as a
result of gravitational movement of blood within the vessels.
- The blood tends to go into the capillaries of the most dependent parts of the body
at the particular position and causes distension of the minute capillaries leading to
purplish-red areas on the skin.
- Synonyms: Post-mortem hypostasis, Post-mortem lividity, Post-mortem suggillation
P.M. stain generally first manifest after 1 hours of death; maximum manifestation
occurs between 4-6 hours.
During this time, alteration of the body’s position will change the position of P.M.
staining, but the area of staining does not shift after this period.
P.M. staining is a reliable sign of death. It indicates the time passed since death
occurred.
▪ Rigor mortis (Latin: rigor "stiffness", mortis "of death")

Rigor mortis or post-mortem rigidity, is one of the recognizable signs of death,
characterized by stiffening of the limbs of the corpse caused by chemical changes in
the muscles post-mortem. It takes 1-2 hours for the complete establishment of rigor
mortis and continues for a period of 24 hours.
▪ Decomposition
Progress of decomposition helps in determining the time passed since death.
Five stages of decomposition are typically recognized: fresh, bloat, active decay,
advanced decay, and dry/skeletonized.
▪ Saponification & Mummification give information about approximate time of death.

▪ Degree of digestion of stomach contents.
▪ Condition of bowl and bladder.
AYURVEDA LIBRARY
 Medico-Legal Autopsy
Autopsy is a post-mortem examination of a body to determine the cause of death or
the character and extent of changes produced by a disease.
It is also called Necropsy.
Chief Objectives:
▪ To establish identification.
▪ To know the time since death.
▪ To know the cause of death (natural or unnatural).
▪ To know the nature of death (accidental, suicidal, homicidal).
Rules:
▪ Autopsy should be conducted in a mortuary.
▪ Unauthorized persons are not allowed to be present.
▪ It should be conducted by an official order from police or magistrate.
▪ It should be done without much delay.
▪ It should be in during day time.
▪ A complete autopsy should be done in all cases and even when the body is
decomposed.
▪ Details of examination should be noted by an assistant during the autopsy.
▪ Identity should be established.
External examination:
▪ Age, sex, height, moles, tattoo marks, etc. should be noted.
▪ Clothes should be examined for stains, tears, etc.
▪ Time since death should be determined.
▪ Hands should be examined for cadaveric spasm.
▪ Presence of injection marks or indications of diseases must be noted.
▪ Natural orifices are examined for foreign bodies, injuries, etc.
▪ Presence of froth and smell about mouth and nose should be noted.
▪ Description of external wounds, fractures and dislocations.
▪ List of articles removed from the body.
Internal examination:
▪ Skin incision from chin to symphysis pubis in midline, recti muscles cut, cut costal
cartilages at their junction with ribs to open the chest.
▪ Stomach is removed after applying double ligatures at each end.
▪ Intestines are removed after tying both ends.
▪ Heart is removed and examined by opening in the direction of blood flow.
AYURVEDA LIBRARY
▪ Head incision is made in the scalp from behind one ear to the other, passing over
the vertex. Scalp is reflected forwards and backwards, and the skull is sawed
horizontally from the center of the forehead to the base of mastoid process, then to
a point a little above external occipital protuberance. The dura mater is cut at the
level of skull division. The falx cerebri is cut, the vessels and nerves at the base are
cut and then tentorium is cut. The cervical cord is cut and brain is removed. Brain is
cut by a single incision passing the midline of the cerebrum. It is then examined by
making anterior & posterior incisions.
Preservation:
Following structures must be preserved:
▪ Lungs, heart, stomach & its contents
▪ Upper part of small intestines & its contents
▪ Liver (1/2 kg)
▪ One kidney
▪ Blood (100 ml)
▪ Urine (100 ml)
Rectified spirit is the preservative which is used in all poisons except in cases of
alcohol, acetic acid, phenol, phosphorus, paraldehyde. In such conditions, saturated
solution of sodium chloride is used.
▪ Stomach & intestines are openly placed in one bottle.

▪ Liver & kidney are cut into small pieces and preserved separately.
▪ Blood & urine are filled in separated bottles.
▪ Bottles are labelled with data of the victim and are properly sealed.
▪ A sample of preservative is kept in a separate bottle.
▪ All kept in one box and locked.
▪ Viscera are sent to the chemical examiner. A copy of inquest letter and post-
mortem report are also to be sent.
▪ Viscera are analyzed only when the magistrate gives authorization to the chemical
examiner.
 Exhumation
Exhumation is a lawful act of taking out an already dead body from the grave for the
purpose of identification or autopsy with or without chemical examination of viscera.
▪ It is done under order of appropriate officers, in the presence of a police officer.

▪ It can be ordered by a coroner who is especially empowered to do so. No police
officer of any rank or grade can order an exhumation.
▪ It should be carried out during early morning.
▪ The body has to be identified by as many persons as possible before sending to
post-mortem examination.
▪ Medical officer is required for doing medico-legal, post-mortem examination.
AYURVEDA LIBRARY
CHAPTER v: injuries
 अभिघात
According to A. Sushruta, the types & description of wounds is as follows:
i) विन्न (Cut wound)

ii) विन्न (Perforated wound)
iii) वदद्ध (Punctured wound)
iv) क्षत (Lacerated wound)
v) विच्चित (Contusion / Bruise)
vi) घृष्ट (Abrasion wound)
The first two injuries are caused by edged weapons, the third by pointed ones, while
the remaining three are caused by trauma.
i) विन्न
It is the injury which is broad, either oblique or straight and causes falling of limbs.
ii) विन्न
It is the injury to an organ leading to discharge of blood, urine or stool depending on
the wounded viscus.
ii) वदद्ध
It is the injury of a body part by a pointy object.
iv) क्षत
It is an uneven injury which is neither excessively cut nor severely torn, but has
features of both.
v) विच्चित
It is the injury of tissue or skin in which blood capillaries have been damaged or
broken as a result of a blow to the skin.
vi) घृष्ट
It is the injury in which skin is removed by rubbing or any other cause associated with
burning sensation and discharge.
AYURVEDA LIBRARY
 Injuries / Wounds
- An injury, also known as physical trauma, is damage to the body caused by an
external force.
- A wound is an injury to the body that typically involves laceration or breaking of a
membrane (such as the skin) and usually damage to underlying tissues.
- An injury is also defined as:

“Any interruption of the continuity of an external or internal surface caused by
violence.”
“Any harm whatsoever illegally caused to any person in body, mind, reputation or
property.”
 Classification:
1) Slight
2) Dangerous
3) Grievous
1) Slight:
Slight or simple injury is an injury of a minor character such as a sprain, bruise
or cut which are not judged to be severe, or slight shock.
2) Dangerous:
Dangerous injury is an injury which endangers life due to damage to
important organs or structures.
3) Grievous:
Grievous injury is an injury which may or may not endanger life, but causes
severe bodily pain or deformity which interferes the individual’s normal
pursuits for 20 days or longer; it also includes permanent deformities or
damages of the body.
 Types:
1) Abrasion
2) Contusion
3) Laceration
4) Incised wound
5) Stab wound
6) Firearm wound
AYURVEDA LIBRARY
1) Abrasion
- An abrasion is an injury to the skin, resulting from scraping away of the
superficial layers of the skin.
- Depending on the manner in which abrasions are caused, they are classified
into the following varieties:
a) Scratch
b) Graze
c) Pressure abrasion
d) Impact abrasion
- Nature of injury, site of impact and direction of force can be identified.

- Nature of crime may be inferred from the site of injury.
- Patterned abrasions are useful to identify the causative object.
2) Contusion
- Contusions / Bruises are caused due to rupture of blood capillaries leading
to discolouration of skin / patch formation.
- Contusions may also be defined as an effusion of blood into the tissues due
to rupture of sub-cutaneous blood vessels.
- Contusions are generally caused by the impact of blunt force such as stones,
sticks, fist, etc.
- The size of contusion may vary largely depending on the impact area of the
object.
- The amount of effusion of blood depends on the site of wound, force of
impact, sex of the victim, age of the victim, etc.
- Bruises over the nose and mouth suggest smothering.
- Bruises over the neck suggest throttling.
- Bruises over the thigh and genitals suggest rape.
- Bruises around the anus suggest sodomy.
- The bruise may also give information about the object responsible for the
injury, and the time passed since injury occurred can be assessed.
3) Laceration
- Laceration / Lacerated wound is one in which the skin and sometimes the
deeper tissues are torn or lacerated as a result of blunt violence.
- It is the result of tearing or stretching of tissues.
- The edges of lacerated wounds are irregular.
- Laceration is of 4 types:
a) Split-lacerations
b) Stretch-lacerations
c) Avulsions
d) Tears
- Lacerations may be homicidal, suicidal, accidental or may be inflicted by

oneself or another person.
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4) Incised wound
Incised wounds are produced by objects having sharp cutting edges such as
knife, razor, etc.
- An incised wound can be caused by three ways:

a) Striking
b) Drawing
c) Sawing
- The edges of incised wounds are regular, clean-cut, retracted and everted,
except in neck and scrotum.
- Length is the greatest of the three dimensions.
- Incised wounds may be homicidal, suicidal, accidental or may be inflicted by
5) Stab wound
Stab wounds / Punctured wounds are a specific form of trauma which is
usually caused by the sharp-pointed piercing and stabbing weapons such as
knives, dagger, bayonet, spear, etc.
When a stab wound enters into a body cavity, it is called ‘penetrating wound’.
When a stab wound pierces through the body, it is called ‘perforating wound’.
- The depth of the wound is the greatest of the three dimension. Diameter of
the wound is less than that of the weapon used. The edges of the wound are
retracted, clean or lacerated and bruised depending on the used weapon.
- Stab wounds may be homicidal, suicidal, accidental or may be inflicted by

6) Firearm wound
Firearm wounds / Gun-shot wounds are produced by projectiles discharged
from fire-arms and present the general characteristics of lacerated wounds,
but the character varies according to the -
- Nature of the projectile.
- Velocity of the projectile at the moment of impact.
- Distance of the fire-arm from the body at the time of discharge.
- Angle at which it struck the body.
- Firearm wounds may be homicidal, suicidal, accidental or may be inflicted by

- Forensic ballistics is an elaborate science dealing with fire-arms.
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 Thermal Injuries
Thermal injuries are caused by excessive heat, typically from contact with hot
surfaces, hot liquids, steam, or flame.
Types of thermal injuries: - 6

i) Chemical burns
ii) Electrical burns
iii) Fire-related burns
iv) Radiation burns
v) Scalds (typically caused by steam or hot liquids)
vi) Contact burns
Classification of burns: - 6
i) First degree: Redness or simple hyperaemia
ii) Second degree: Vesication affecting the cuticle
iii) Third degree: Partial destruction of the skin
iv) Fourth degree: Total destruction of the skin
v) Fifth degree: Charring of muscles and other soft tissues
vi) Sixth degree: Charring of bones
Wilson’s simplified classification: - 3

i) Epidermal / Superficial: - Pain, redness, skin turns white when touched
ii) Dermo-epidermal: - Pain, redness, skin turns white when touched, blisters
iii) Deep: - Painless, no sensation to touch, skin area may be
whitish or charred dry and have leathery appearance.
Severe deep burns affect muscle tissue and/or bones.
Medico-legal classification: - 3
i) First degree: Burns producing mere redness
ii) Second degree: Burns producing mere vesication
iii) Third degree: Burns causing death of the affected part
Medico-legal aspects:
It is important to determine whether it is a case of ante-mortem or post-mortem
burns; whether death occurred due to burns or not; whether suicidal, homicidal or
accidental.
When death results from a thermal injury, the causes may be:
a) Primary shock (neurogenic shock)
b) Secondary shock due to exudation of serum from the burnt area and consequent
depletion of blood volume.
c) Asphyxia due to inhalation of fumes and smoke.
d) Fat embolism
e) Septic complications
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 Introduction of Weapons
A weapon, arm or armament is any implement or device that can be used with intent
to inflict damage or harm. Weapons are used to increase the efficacy and efficiency
of activities such as hunting, crime, law enforcement, self-defense, and warfare.
While ordinary objects such as sticks, rocks, bottles, chairs, vehicles, etc. can be used
as weapons, many are expressly designed for the purpose; these range from simple
implements such as knives, clubs, axes and swords, to complicated modern firearms,
tanks, intercontinental ballistic missiles, biological weapons, and cyber weapons.
Weapons can be used for inflicting injuries, suicidal or homicidal actions.
Examples:
a) Pistol
- Injuries produced by weapon: Firearm wounds
- Medico-legal aspects: Homicidal, suicidal and accidental
b) Kitchen knife
- Injuries produced by weapon: Incised wound, stab (punctured, penetrating,
perforating) wound
- Medico-legal aspects: Self- inflicted/fabricated wounds, accidental may
cause beveled cuts and used for homicide and
suicide
c) Hammer
- Injuries produced by weapon: Depressed fracture on the skull. Abrasion,
contusion, laceration & fracture
- Medico-legal aspects: Mostly homicidal, sometimes accidental
d) Motorcycle chain
- Injuries produced by weapon: Patterned abrasion, laceration, contusion
- Medico-legal aspects: Homicidal (strangulation), commonly used in
gang wars or riots
AYURVEDA LIBRARY
CHAPTER vi: dowry deaths
Introduction:
- Dowry deaths are deaths of married women who are murdered or driven to suicide by
continuous harassment and torture by their husbands and in-laws over a dispute about their
dowry, making the women's homes the most dangerous place for them to be.
- Dowry deaths are due to domestic violence which is violent or aggressive behaviour within
the home, typically involving the violent abuse of a spouse or partner.
- Dowry deaths are considered one of the many categories of violence against women,
alongside rape, bride burning, eve teasing, female genital mutilation, and acid throwing.
Occurrence:
- Dowry deaths are found predominantly in India, Pakistan, Bangladesh, and Iran. India
reports the highest total number of dowry deaths with 8,391 such deaths reported in 2010.
Female dowry deaths account for 40-50% of all female homicides recorded annually in India.
- Dowry deaths in India are not limited to any specific religion, but are much more common
in Hindu and Sikh communities in Northern India, particularly around Punjab, Haryana, Delhi,
Rajasthan and Uttar Pradesh.
Causes:
Most dowry deaths occur when the young woman, unable to bear the harassment and
torture, commits suicide. Most of these suicides are by hanging, poisoning or by fire.
Sometimes the woman is killed by being set on fire by her husband or in-laws; this is known
as "bride burning", and is sometimes disguised as suicide or accident. Death by burning of
Indian women has been more frequently attributed to dowry conflicts. In dowry deaths, the
groom's family is the perpetrator of murder or suicide.
Prohibitions & Laws:

Indian women's rights activists campaigned for more than 40 years for laws to contain dowry
deaths, such as the Dowry Prohibition Act 1961 and the more stringent Section 498a of
Indian Penal Code (enacted in 1983).
Under the Protection of Women from Domestic Violence Act 2005 (PWDVA), a woman can
put a stop to the dowry harassment by approaching a domestic violence protection officer.
However, effectiveness of these laws has been questioned.
Although Indian laws against dowries have been in effect for decades, they have been largely
criticized as being ineffective. The practice of dowry deaths and murders continues to take
place unchecked in many parts of India.
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Dowry Prohibition Act
The Dowry Prohibition Act of 1961 prohibits the request, payment or acceptance of a dowry,
"as consideration for the marriage", where "dowry" is defined as a gift demanded or given as
a precondition for a marriage.
Gifts given without a precondition are not considered dowry, and are legal. Asking or giving
of dowry can be punished by an imprisonment of up to six months, or a fine of up to ₹5,000.
IPC Section 304b

When the death of a married woman is caused by any burns or bodily injury or occurs under
abnormal or suspicious circumstances within seven years of her marriage duration and it is
clearly shown that prior to her death she was subjected to cruelty or harassment or torture
by her husband or any relative of her husband or in laws for, or in connection with, any
demand for dowry, such death shall be called as "dowry death", and such husband or
relative or in law shall be deemed to have caused her death. Whoever commits dowry death
shall be punished with imprisonment for a term minimum of seven years which may extend
to imprisonment for life.
IPC Section 498a

Whoever being the husband or the relative of the husband or in law of a woman, subjects
such woman to cruelty or harassment or torture shall be punished with imprisonment for a
term which may extend up to three years and shall also liable to pay fine. The cruelty can be
either mental or physical torture which drives the women to commit suicide or to cause
serious injury, or danger to life or health.
CrPC section 174(3)

When (i) The case involves suicide by a woman within seven years of her marriage (ii) The
case relates to the death of a woman within seven years of her marriage in any
circumstances raising a reasonable suspicion that some other person committed an offence
in relation to such woman, or (iii) The case relates to the death of a woman within seven
years of her marriage and any relative of the woman has made a request in this behalf, the
police officer will forward the body for autopsy to the nearest medical officer for opinion.
AYURVEDA LIBRARY
CHAPTER vii: asphyxial deaths
Asphyxia is the condition when the body is deprived of oxygen, leading to

unconsciousness or death; suffocation.
Stages of Asphyxia:
i) Stage of inspiratory dyspnoea
- Duration: 1 minute
- Anxiousness, Heaviness of head, ringing in the ears
- Lips are livid, eyes are prominent
- Respiration becomes deep, hurried and strenuous.
- BP rises, PR decreases
- Consciousness may be lost at the end.
ii) Stage of expiratory dyspnoea & convulsions

- Duration: 1-2 minutes
- Due to retention of carbon dioxide, respiration is more strenuous & spasmodic.
- Clouding of consciousness
- Convulsions, Relaxation of sphincters
- Face & hands are congested and cyanosis occurs.
- Tongue injury by teeth if protruded
- Increases salivation, heart rate & gastrointestinal mobility
iii) Stage of exhaustion & respiratory failure

- Duration: 2-3 minutes
- Cerebral anoxia leading to paralysis of respiratory and other nervous centers.
It causes permanent brain damage.
- BP falls, Pulse is scarcely perceptible
- Prolonged sighing inspirations occur at longer and longer intervals until they cease
altogether and death ensues.
The three stages last for about 3-5 minutes before death takes place.
Types of violent asphyxial deaths:

1) Hanging
2) Strangulation
3) Throttling
4) Suffocation
5) Drowning
AYURVEDA LIBRARY
1) Hanging
Hanging is a violent asphyxia death caused by either partial or complete suspension
of the body while a ligature is tied around the neck; the weight of the body is the
constricting force.
Types: - 2
a) Partial: Only the weight of the head is the constricting force.
b) Complete: The complete body is the constricting force. Feet do not touch the
ground.
Cause of death:
a) Constriction of carotid arteries causing obstruction of blood flow to the brain
leading to anoxia or cerebral ischemia.
b) Cerebral congestion due to compression of jugular veins.
c) Blockage of air passage due to upward pulled tongue.
d) Vagal inhibition due to fright.
e) Injury to spinal cord (judicial hanging).
Fatal period: 5-8 minutes. In judicial hanging, death is instantaneous.
Post-mortem appearance:
a) External:
- Neck is stretched and elongated. Face is pale and flaccid. Tongue & eye balls are
protruded. Pupils dilated, eyelids open. Finger nails show cyanosis. Streaks of saliva
may be seen trickling down from one angle of mouth down the chin and chest – this
is a sure sign of ante-mortem hanging.
- Seminal matter escapes through urethra.
- Onset of rigor mortis is slow. Post-mortem lividity is seen in hands & feet.
- Ligature mark on the neck – it depends on following factors:
Nature, lightness, thinness of the cord. Period of suspension. Weight of the subject.
Material intervention between skin and ligature.
b) Internal:
- Fracture of thyroid cartilage may be present.
- Carotid arteries may be ruptures transversely.
- Lymph nodes in the neck above and below of ligature shows congestions, stasis and
hemorrhage.
Lynching: Several persons forcefully capture an individual and hang him with a rope.
- Hanging is a common method to commit suicide, especially among men.
- Accidental and homicidal hanging is rare.
- Judicial hanging is the execution of death sentence.
AYURVEDA LIBRARY
2) Strangulation
Strangulation is a violent asphyxial death which results from constriction of air
passage at the neck by other forces than the weight of the body or head.
E.g.:
- By ligature (garrotte)
- By hands (throttling)
- By sticks from front & back (bansdola)
- By elbow (mugging)
Cause of death: Compression of windpipe and of cervical vasculature -> Asphyxia.
a) External:
- Tongue is swollen, bruised, bitten by teeth and protruded.
- Petechial hemorrhages are common into skin of eyelids, face, forehead, behind ears
and scalp.
- Injury on the neck depends on the means used for strangulation.
b) Internal:
- In ligature strangulation, deeper tissues of the neck are injured.
- Thyroid cartilage is commonly fractured.
- When stick is used, injury of internal cervical structures is common.
- Identification whether death occurred due to strangulation or not.
- Suicidal strangulation is uncommon.
- Homicidal strangulation is common.
- Accidental strangulation is rare.
Garrotte:
Garrotte is a form of strangulation done by throwing a rope from behind and tying it
tightly.
Bansdola:
It is a form of strangulation using two sticks or hard substances placed across the
neck in front and behind.
Mugging:
It is a form of strangulation by pressing the victims neck against the forearm. It will
not leave external or internal marks.
AYURVEDA LIBRARY
3) Throttling
Throttling is a form of strangulation by means of compression of neck with hands.
Cause of death:
Compression causes closure of glottis and tongue protrudes upwards and backwards
against posterior pharyngeal wall and causes complete occlusion to air passage, or
the branch of superior laryngeal vagus is injured by compression of larynx.
It leads to inhibition of respiration and asphyxia occurs within seconds.
a) External:
- All signs of asphyxia are seen.
- Injuries are seen in front & sides of the neck.
- If only one hand is used for throttling, the mark produced by thumb is seen on one
side of the neck. Bruises of fingers are on the opposite side.
- Finger marks are one below the other and all oblique in direction.
- If both hands are used for throttling, thumb marks are seen in front / back.
- Marks of nails may be seen. Scratch of thumb nail is deeper and wider.
b) Internal:
- Extravasation of blood in cutaneous tissues of the neck beneath the external
injuries.
- Fracture of hyoid bone and laryngeal cartilages.
Medico-legal aspects: Throttling is always homicidal and never suicidal.
AYURVEDA LIBRARY
4) Suffocation
Suffocation is a form of violent asphyxia caused by mechanical obstruction of the air
passages by smothering, chocking or traumatic asphyxia.
i) Smothering
It is caused by mechanical obstruction of external air passages.
E.g.: Nose & mouth are closed by hand, cloth, plastic bag, etc.
In homicidal smothering, abrasions and bruises are seen in the region of nose and
mouth; may be absent in case of pressing with soft material like pillow or clothes.
- Smothering is usually accidental in epileptics or drunken people.
- Accidental smothering of a baby may occur due to over laying of mother or another
person sharing the bed.
- Homicidal smothering is done by closing mouth & nostril by hand, clothing, pillow
use of plastic bag.
- Suicidal smothering by using one’s own hand is impossible; use of plastic bag is
common for suicidal purpose.
ii) Choking
Choking is a form of violent asphyxia caused by mechanical obstruction of air
passages by a solid object.
Causes of death:
- Asphyxia
- Vagal inhibition
- Laryngeal spasm
- Bronchospasm
Object responsible for choking is found in the respiratory passage.
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- Inhalation of vomited material under alcohol influence, during epileptic seizure or
coma, Food regurgitation in infants, coin, pea, fish bone, etc.
- Homicidal choking is usually confined to cases of infanticide.
- Accidental choking: Cut throat injury, tooth extraction, tonsillectomy, bleeding into
respiratory passages
- Suicidal choking is rare; except in prisoners.
Gagging:
Gagging is a method of preventing the air from entering through mouth or nose. The
commonly used gags are handkerchief, dhoti or scarve.
iii) Traumatic asphyxia

Traumatic asphyxia results from trauma to the chest or pressure on the abdomen,
chest or back which obstructs respiratory movements.
E.g.: Pinned down by car, less space in vehicle when compressed in accidents, house
collapse, etc.
- Deep cyanosis of face
- Numerous petechial hemorrhages
- Demarcation line
- Fracture of ribs, injuries to lungs, heart
- It is chiefly accidental.
- May be homicidal as in burking or bansdola.
Burking:
It is a form of violent asphyxia adopted by Burke and Hare. Burke used to sit on the
chest of his inebriate victim, covering with one hand the mouth and nostril and
pushing up the jaw with the other hand. Hare used to pull him round the room by the
feet. This is a mixture of smothering and traumatic asphyxia.
AYURVEDA LIBRARY
5) Drowning
Drowning is a form of violent asphyxial death caused due to submersion of nostril &
mouth in water or other fluids which prevents access of air to the lungs.
Types: - 2
i) Typical:
It is the obstruction of air passaged and lungs by water or fluid, also known as wet
drowning.
ii) Atypical:
a) Dry drowning = When water enters to the nasopharynx or larynx it activates
laryngeal spasm. Little or no water enters into lungs or air passages and death
occurs by asphyxia.
b) Vagal inhibition = Immersion syndrome; Death may result from cardiac

arrest due to vagal inhibition by sudden impact of cold water, diving or falling
in water, horizontal entry into water leading to impact on epigastrium.
c) Submersion of unconsciousness = If the victim suffers from epilepsy, heart

disease, is drunk or head injury occurs during fall in water, the rupture of
cerebral aneurysm or onset of cerebral hemorrhage may cause death.
d) Secondary drowning / Near drowning = If a person survived drowning, it is

called near drowning. After some time, the victim may die due to infection
from contaminated water or due to hypoxic encephalopathy.
Fata period: 5 minutes after complete submersion of nostrils & mouth
a) External:
- Face may or may not be cyanotic. Eyes are half closed or open, pupils dilated.
- Rigor mortis appears early. Post-mortem lividity may be absent.
b) Internal:
- Ballooning of lungs or emphysema aquosum due to accumulation of water.
- Biochemical changes in the blood.
- Diatoms; microscopic, unicellular algae present in most natural waters.
- Suicidal drowning: Common in India. Hands and legs may be tied together and
attached to a weight before immersion.
- Homicidal drowning: Not common.
- Accidental drowning: Common among fisherman, dock workers, intoxicated people
or epileptic persons.
AYURVEDA LIBRARY
CHAPTER viii: medico-legal importance
 Adultery
Adultery is explained under section 497 of I.P.C.:
“Whoever has sexual intercourse with a person who is and whom he knows or has
reason to believe to be the wife of another man, without the consent or connivance
of that man, such sexual intercourse not amounting to the offence of rape, is guilty of
the offence of adultery, and shall be punished with imprisonment of either
description for a term which may extend to five years, or with fine, or with both. In
such case the wife shall not be punishable as an abettor.”
 Pregnancy
Pregnancy is the physiological condition of a woman produced due to the
implantation of a fertilized ovum by a spermatozoon.
Medio-legal importance:
a) Civil cases:
- Nullity of marriage (Nullity of marriage is a declaration by a court that your supposed
marriage is null and void, and that no valid marriage exists between you and your partner. In
other words, it is a declaration that the supposed marriage never happened. Nullity /
Annulment is not the same as divorce.)
- Pregnancy & divorce
- To get more alimony, a woman may claim to be pregnant in case of divorce
- Inheritance of property
- Compensation cases; e.g.: In accidental death of husband
- Illegitimate child (A child of parents not lawfully married to each other.)
- Posthumous birth (A posthumous birth is the birth after the death of a biological parent.)
b) Criminal cases:
- Execution of death sentence
- Court procedure – suspended in advanced pregnancy
- Pregnancy claimed to be the result of rape
- Pregnancy in an unmarried girl of 16 years or less and in married girl of 15 years or
less is pointed toward the commission of the offence of rape.
- Suit for breach of promise of marriage.
- False blame by a girl against a man
- Blackmailing
- Charge of adultery against the man who is responsible for the woman’s pregnancy.
- Pregnancy may ascertain the motive behind suicide or homicide of an unmarried
woman or widow.
- Alleged concealment of pregnancy, birth and infanticide.
- Alleged criminal abortion.
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 Delivery
Delivery is defined as the complete evacuation of a foetus (that has attained viability)
and other products of conception from within the uterus and genital passage into the
external environment.
The legal issues linked with delivery are:
- Abortion, Infanticide, Concealment of birth
- Suppositious child (false delivery), Blackmailing, Contested legitimacy
- Nullity of marriage, Divorce, Chastity, Defamation, Inheritance
- Execution of death sentence, Homicide & suicide
- Delivery after being pregnant as a result of rape
- Delivery before 16 years is considered as evidence for rape.
- Leave after delivery
 Abortion (Garbhapata / Garbhasravana)

Abortion is defined as the premature expulsion of products of conception from the
uterus, at any time before complete period of gestation.
Strictly, the word ‘abortion’ refers to the termination of pregnancy during the first
trimester, while that occurring during the second trimester is called ‘miscarriage’ and
one taking place during the third trimester is termed ‘premature birth’. But in law, no
distinction is made.
Types:
1) Spontaneous a) Natural (High fever during 1st trimester, viral diseases)
b) Accidental (Injury, trauma, shock, etc.)
2) Induced a) Legal / Justifiable
b) Criminal
Legal / Justifiable abortion:

- Legal abortion is an induced abortion for justifiable or therapeutic reasons.
- Medical Termination of Pregnancy (MTP) Act, 1971 -> Refer to Chapter XV
Criminal abortion:
- Criminal abortion is defined as an abortion which is induced with criminal intent. It
refers to the unlawful and deliberate destruction and expulsion of the products of
conception.
- In case of criminal abortion, the person who induces the abortion and the woman
on whom it is induced are both guilty, and therefore liable to be punished.
- If it is done after 4th month of pregnancy, the punishment is greater.
- Attempted criminal abortion is also punishable.
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 Infanticide (Brhuna-Hatya)
Infanticide (or infant homicide) is the accidental or intentional killing of infants.
Parental infanticide researchers have found that mothers are far more likely than
fathers to be the perpetrators of neonaticide and slightly more likely to commit
infanticide in general.
Causes of infanticide:
1) Accidental causes
a) During birth: Prolonged labour, Pressure on or prolapsed cord,
Knot of the cord or twisting around the neck, Injuries,
Death of mother
b) After birth: Suffocation, Precipitated labour
2) Criminal causes: Infanticide
Reasons & Medico-legal importance:

- Extreme poverty with an inability to afford raising a child is one of the reasons given
for female infanticide in India. Such poverty has been a major reason for high
infanticide rates in various cultures, throughout history, including England, France
and India.
- The dowry system in India is another reason that is given for female infanticide.
Although India has taken steps to abolish the dowry system, the practice persists,
and for poorer families in rural regions female infanticide and gender selective
abortion is attributed to the fear of being unable to raise a suitable dowry and then
being socially ostracized.
- Other major reasons given for infanticide, both female and male, include unwanted
children, such as those conceived after rape, deformed children born to
impoverished families, and those born to unmarried mothers lacking reliable, safe
and affordable birth control. Relationship difficulties, low income, lack of support
coupled with mental illness such as postpartum depression have also been reported
as reasons for female infanticide in India.
- All cases of abandoned newborn deaths are to be reported to the police/coroner,

who must ask for a post-mortem examination because only this can establish the
viability of the infant, proof of separate existence, and the cause and manner of
death in such cases.
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 Battered Baby
- A battered bay is one who presents with signs of multiple injuries in its body which
are not accidental in nature, rather inflicted by its parents or foster parents.
- Battered baby syndrome refers to injuries sustained by a child as a result of physical

abuse, usually inflicted by foster parents or guardians.
- Battered baby (child) syndrome has been recognized for nearly half a century and is
defined as repeated non-accidental trauma of various ages. In medicolegal death
investigations, it is often avoided, due to its alleged controversy, or more accurately,
due to the challenges it presents in court.
 Virginity (Kaumarya)
Virginity (Virgo intacta) is the state of never having had sexual intercourse.
Defloration is the loss of virginity.
- Nullity of marriage, Divorce, Defamation, Chastity, Sexual offences
- Hymen: An undue emphasis is given to an intact hymen, but it is not intact in so
many cases as cycling, masturbation, accidents and injury to vulva. Even the hymen
can be ruptured due to passage of heavy clots of menstruation in severe puberty
menorrhagia. An Intact hymen can be taken for a virginity but broken hymen does
not signify that a girl is not virgin. Only in case of rape on a minor girl the importance
of freshly torn hymen with bleeding is helpful as an evidence of rape.
- Vaginal mucosa: Due to repeated sexual intercourse, the firmness of the vagina is
lost and rugosity is altered.
 Legitimacy
Legitimacy is the status of a child born during the continuance of a valid marriage
between the mother and any man, or within 280 days after its dissolution if the
mother remains unmarried, unless it is shown that the parties to the marriage had no
access to each other at any time when the child could have been conceived, his birth
is treated as a conclusive proof of being legitimate.
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 Impotence & Sterility (Napumsakata & Vandhyatva)
- Impotence is defined as the inability to perform sexual intercourse and to achieve
gratification.
- Sterility refers to the incapacity on the part of male to impregnate, and on the part
of female to conceive.
Causes:
- Age – poor physiological development before puberty; decreased sperm quality &
count in old age; before menarche; after menopause
- Developmental defects (absence of penis / vagina, imperforated hymen, etc.)
- Acquired abnormalities (amputation of penis; hysterectomy, tubectomy, etc.)
- Local diseases (elephantiasis, hydrocele; Bartholin’s cyst etc.)
- General diseases (infective, metabolic, hormonal diseases, etc.)
- Psychic causes (stress, pressure; fear, pain, etc.)
- Chronic exposure of poison (lead, arsenic, etc.)
- Alcohol
-> Quoad hanc: It is the term for an individual man who is impotent with one
particular female, but not with other partners.
Types of sterilization:
1) Compulsory May be ordered by the state; it may be carried out on mental
defectives & others from a strictly eugenic point of view or as a
punishment for sexual criminals.
2) Voluntary - Therapeutic: To prevent danger to the health of the woman.

- Eugenic: Sterilization to a physically or mentally defective person.
- Contraceptive: To limit the size of a family.
- Nullity of marriage, Divorce
- Adultery, Sexual offences
- Contested paternity in inherited cases
- Legitimacy
- Suit of adoption
- Claim for damages
Annulment or divorce can legally be claimed and granted on the ground of

impotence; when impotence is present before or at the time of marriage and
incurable or curable only by operation to which the individual refuses to submit.
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 Artificial Insemination
Artificial Insemination may be defined as the deposition of semen in the vagina, the
cervical canal or the uterus by instruments to bring about pregnancy which is not
attained by sexual intercourse.
Abstract:
In today’s fast life we see a number of cases of infertility. This is due to the increasing
stress factor and the changing lifestyle. With the increase in marital age and late
diagnosis of infertility, Artificial Insemination is a widely used method. Before
advising this method the doctors should be aware of its medico-legal aspects as it
may be troublesome for them later. Also the doctors should give the patient a clear
idea of the medico-legal aspects.
Indication:
1) When the husband is impotent but fertile.
2) When the husband is sterile.
3) When there is Rh incompatibility between husband and wife.
4) When the husband is suffering from some hereditary disease so as to prevent
mentally or physically handicapped child being born.
5) Incurable defects in husband’s semen rendering him incapable of procreation.
6) When a widow or unmarried women wants to have a child.
Types:
1) A.I.H or artificial insemination homologous:
When the husband’s semen is biologically normal but he either cannot pour the same
in the wife’s vagina by the way of intercourse or due to some defect with the cervical
opening of the wife or condition in the vagina, living sperms cannot enter inside the
uterus, semen from the husband is collected by way of masturbation & pushed inside
the uterus.
2) A.I.D or artificial insemination donor:

When the defect is in the seminal fluid of the husband, then semen from another
healthy suitable male is used & introduced inside the vagina or the uterus of the wife.
3) A mixture of husband’s semen as well as that of donor is used in cases where

motile spermatozoa count in husband’s semen is poor though present in semen.
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- Artificial insemination is not a ground for nullity of marriage, but it is for divorce if it
was without the consent of the husband. Even the doctor can get implicated in legal
complexities.
- The child inherits a remote chance of incestual relationship between the offspring
of the donor from his wife’s side & the recipient’s side as the identity of donor being
the father of the offspring of the recipient, remains secret.
- Family problems; including mental trauma of husband of recipient wife is possible,
even though he gives consent for artificial insemination of his wife.
- Donor should be of age below 40yrs & should not have any physical or mental
disease which may be transmitted to the child.
- Consent of both recipient wife and her husband is necessary.
- Consent of the donor & his wife is also needed.
- The donor must not be a relative of either the recipient or her husband.
- The donor should not know the identity of the recipient & the recipient also should
not know the identity of the donor.
- The donor should not know the outcome of artificial insemination.
- The donor should give a written declaration that he will not prefer parenthood
claim for any child on the ground of donation of semen.
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CHAPTER ix: sexual offences &
perversions
 Sexual Offences
Sexual offences are acts of illegal sexual intercourse with a second person or with an
animal to obtain sexual satisfaction.
 Types: - 2
1) Natural Sexual Offences
2) Unnatural Sexual Offences
1) Natural Sexual Offences:

a) Adultery: (Vyabhichara)
- Explained under section 497 of IPC:
Whoever has sexual intercourse with a person who is and whom he
knows or has reason to believe to be the wife of another man, without
the consent or connivance of that man, such sexual intercourse not
amounting to the offence of rape, is guilty of the offence of adultery, and
shall be punished with imprisonment of either description for a term
which may extend to five years, or with fine, or with both. In such case
the wife shall not be punishable as an abettor.
b) Rape:
- It is an unlawful sexual intercourse by an individual with another person
against his / her will, without his / her consent or with his / her consent
when it has also been obtained by unlawful means under 16 years of
age.
- Explained under section 497 of IPC.
A man is said to commit “rape” if he—
1. penetrates his penis, to any extent, into the vagina, mouth, urethra or anus of
a woman or makes her to do so with him or any other person; or
2. inserts, to any extent, any object or a part of the body, not being the penis,
into the vagina, the urethra or anus of a woman or makes her to do so with
him or any other person; or
3. manipulates any part of the body of a woman so as to cause penetration into
the vagina, urethra, anus or any part of body of such woman or makes her to
do so with him or any other person; or
4. applies his mouth to the vagina, anus, urethra of a woman or makes her to do
so with him or any other person, under the circumstances falling under any of
the following seven descriptions:
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a) Against her will.
b) Without her consent.
c) With her consent, when her consent has been obtained by putting her or
any person in whom she is interested, in fear of death or of hurt.
d) With her consent, when the man knows that he is not her husband and
that her consent is given because she believes that he is another man to
whom she is or believes herself to be lawfully married.
e) With her consent when, at the time of giving such consent, by reason of
unsoundness of mind or intoxication or the administration by him
personally or through another of any stupefying or unwholesome
Substance, she is unable to understand the nature and consequences of
that to which she gives consent.
f) With or without her consent, when she is under eighteen years of age.
g) When she is unable to communicate consent.
Exceptions: - A medical procedure or intervention shall not constitute rape.
- Sexual intercourse or sexual acts by a man with his own wife, the wife
not being under fifteen years of age, is not rape.
Punishment: - Explained under section 376 of IPC.
- Punishment for rape may extend from 7 years to life-imprisonment

including a fine.
c) Incest:
Incest is the act of sexual intercourse between people classed as being
too closely related to marry each other / closely related by blood.
E.g.: Sexual intercourse with a parent, child, sibling, etc.
2) Unnatural Sexual Offences:

- Explained under section 377 of IPC:
Whoever voluntarily has carnal intercourse against the order of nature
with any man, woman or animal, shall be punished with imprisonment
for life, or with imprisonment of either description for a term which may
extend to ten years, and shall also be liable to fine.
- Types: a) Sodomy (Anal sex)

b) Buccal coitus (Oral sex)
c) Tribadism (Lesbianism)
d) Bestiality (Sexual intercourse by a human being
with a lower animal)
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 Sexual Perversions
Sexual perversions are acts intended to result in sexual satisfaction without sexual
intercourse.
 Types: - 7
1) Sadism:
This is a sexual perversion in which infliction of pain is a necessary and
sometimes the sole factor for gratification.
2) Masochism:
This is a sexual perversion in which a person needs to receive painful
stimulus for gratification.
3) Fetishism:
This is a sexual perversion in which sexual gratification is associated with
contact and sight of certain parts of the female body, or even clothing, or
other articles known as fetish objects.
4) Exhibitionism:
This is a sexual perversion in which a person’s sexual desire consists
principally of the exhibition of genitals.
5) Transvestism:
This is a sexual perversion in which sexual pleasure is obtained by
wearing the clothes of the opposite sex.
6) Voyeurism:
This is a sexual perversion in which there is morbid desire to look at
sexual organs or clothed parts of body of the opposite sex or to watch
sexual intercourse to obtain sexual pleasure.
7) Indecent assault:
This is a sexual perversion in which there is any offence committed on a
person with intension to outrage him / her.
(E.g.: Kissing, pressing of breast, etc.)
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CHAPTER x: forensic psychiatry
Forensic psychiatry is a branch of psychiatry which is related to criminology.

It requires a sophisticated understanding of the links between mental health and the
law. A forensic psychiatrist provides services – such as determination of competency
to stand trial – to a court of law to facilitate the adjudicative process and provide
treatment, such as medications and psychotherapy, to criminals.
Forensic psychiatrists work with courts in evaluating an individual's competency to

stand trial, defenses based on mental disorders, and sentencing recommendations.
The two major areas of criminal evaluations in forensic psychiatry are competency to
stand trial (CST) and mental state at the time of the offense (MSO).
Competency to stand trial (CST) is the competency evaluation to determine that

defendants have the mental capacity to understand the charges and assist their
attorneys.
Mental state opinion (MSO) gives the court an opinion, and only an opinion, as to
whether a defendant was able to understand what he/she was doing at the time of
the crime.
The law presumes that every person is sane and accountable for his actions until the
contrary is proved.
A medical practitioner will have to certify a person with a ‘Lunacy certificate’ to prove
his / her insanity.
The law assumes that a person who is proved to be insane is not responsible for his /
her actions, as he / she is devoid of free will, intelligence and knowledge of the act.
The law of insanity and criminal responsibility is explained in section 84 of IPC.

It states that nothing is an offence which is done by an insane person.
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CHAPTER xi: forensic laboratory
A forensic laboratory is often referred to as a crime laboratory. A crime laboratory -

often shortened to crime lab - is a scientific laboratory, using primarily forensic
science for the purpose of examining evidence from criminal cases.
Evidence such as DNA evidence, fingerprints, used shell casings, or even tire tracks
are analyzed in forensic laboratories in an attempt to determine if a crime has
occurred and who the perpetrator is.
For example, everything gathered during our victim's sexual assault exam such as
bodily fluids, hairs, fibers, or anything found on the victim's clothing may be analyzed
at a forensic laboratory. The type of analysis will depend on the type of evidence
being analyzed.
A typical crime lab has two sets of personnel:
i) Field analysts - investigators that go to crime scenes, collect evidence, and process
the scene. Job titles include:
o Forensic evidence technician

o Crime scene investigator
o Scenes of crime officer (SOCO)
ii) Laboratory analysts - scientists or other personnel who run tests on the evidence
once it is brought to the lab. Job titles include:
o Forensic Technician (performs support functions such as making reagents)

o Forensic Scientist/Criminalist (performs scientific analyses on evidence)
o Fingerprint Analyst
o Forensic Photographer
o Forensic Document Examiner
o Forensic Entomologist
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CHAPTER xii: ethics as in classical
texts
 Types & Qualities of Vaidya

1) Trividha Bhishaja
2) Vaidya
3) Raja Vaidya
4) Pranabhisara & Rogabhisara Vaidya
5) Apujya Vaidya
1) Trividha Bhishaja
According to Charaka Samhita, Sutra Sthana, Adhyaya 11 / 50-53
i) Chadmachara / Bhishaka Veshachara:

They pose themselves as doctors by exhibiting a few books, medicines, fresh leaves in
a box, etc. These persons are devoid of knowledge.
ii) Siddha Sadhita:

Those who get the names of famous Vaidya, and boast about their relations with
accomplished physicians having wealth, fame and knowledge, these are ignorant and
feigned physicians.
iii) Vaidya Guna Yukta:

Those who are endowed with practical knowledge, scriptural knowledge,
accomplished in the administration of therapies, insight and knowledge of
therapeutics, are endowed with infallible success and can bring happiness to the
patient; they are Jivitabhisarah – saviours of life.
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2) Vaidya
A) According to Astanga Hridaya:
"दक्षस्तीर्ाा त्तशस्त्रार्ो दृष्टकर्ाा शुविविा षक् ।" (अ.हृ. - सू – १ / २८)
A physician should be:
i) दक्ष Wise, clever, efficient, skilled, alert, honest
ii) तीर्ाा त्तशस्त्रार्ा Knowledgeable about the Shastras
iii) दृष्टकर्ाा Experienced in practical application
iv) शुवि Pure in body & mind
B) According to Charaka Samhita:

a) Sutra Sthana, Adhyaya 1/121-123
A physician who knows the proper application of drugs is called Tattvavit.
He is the best and real physician who uses the drugs properly considering Desha, Kala
and Purusha.
b) Sutra Sthana, Adhyaya 1/125

Even though having knowledge of drug in regard of name, morphology and qualities;
if the physician does not know to formulate the medicines, his knowledge is
considered as useless and that physician is harmful to patients.

Bhishak Bubhurshu (one who desires to be a physician) should make special efforts to
maintain his Svaguna Sampada (good qualities) so that he can become Pranada (life-
giver) to human beings.
d) Sutra Sthana, Adhyaya 2/36

Characteristics of a good physician:
- Smrutiman Good memory
- Hetu yuktijna Knowledge about the cause of disease
- Jitatma Control over all Indriyas
- Pratipattiman Capable of using medicines in various combinations
e) Sutra Sthana, Adhyaya 4/29

The one who is acquainted with the internal use as well as external application and
prescription by combination of all these drugs (described in chapter 4), he alone is
the real physician.
f) Sutra Sthana, Adhyaya 9/6

Qualities of Vaidya:
i) Excellent medical knowledge
ii) Extensive practical knowledge and experience
iii) Dexterity, wisdom, cleverness
iv) Cleanliness
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g) Sutra Sthana, Adhyaya 9/21
Six qualities of Vaidya:
i) Knowledge of Ayurveda
ii) Analytical mind
iii) Proper understanding, special knowledge
iv) Good memory
v) Dedication
vi) Practical experience
h) Sutra Sthana, Adhyaya 9/22-23

Vidya (knowledge of Ayurveda), Mati (wisdom), Karma Drushti Abhyasa (practical
experience), Siddhi (expertise), Ashraya (guidance from expert teacher); these words
explain the qualities of Vaidya. The one who combines all these good qualities will
distribute happiness and comfort to all living beings.
i) Sutra Sthana, Adhyaya 16/3

A qualified physician is Dhimana (wise), Shastravan (well versed in classics), Karma
Tatpara (prompt in action). If Vamana-Virechana karma are adopted by such a
physician, the patient attains Samyaka Yoga which leads to Sukha and the patient
becomes free of Dukha.
j) Sutra Sthana, Adhyaya 30/83

One should approach those physicians who are endowed with tranquility and Jnana
& Vijnana.
k) Vimana Sthana, Adhyaya 8/86

Qualities of a physician:
- Excellent and pure knowledge of scriptures
- Practical experience; observation & individual performance of treatments
- Skill, dexterity
- Purity, cleanliness
- Possessing all the required equipment
- Excellence of all sense organs
- Knowledge about Prakruti
- Knowledge about the course of action
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C) According to Sushruta Samhita:
a) Sutra Sthana, Adhyaya 2/3
The preceptor should initiate a person belonging to Brahmana, Kshatriya, Vaishya or
any other family, who is endowed with proper age for study, chastity, bravery,
cleanliness, right conduct, politeness, strength, prowess, intelligence, courage,
memory, wisdom, ability to grasp the meaning of the words and interpret them;
whose lips, tongue and teeth are thin; mouth, eyes and nose are straight; whose
mind, speech and actions are pleasant and who is capable of withstanding strain.
He should not initiate any person who has qualities opposite to the above.

Next, going round the fire alter three times, and in the presence of fire, instruct the
pupils as follows:
“You should remain here, avoiding desires, anger, greed, infatuation, pride, egoism,
jealousy, harsh speech, finding fault in the speech of others, telling lies, laziness, and
acts of ill repute; keep yourself clean by cutting undesirable nails and hairs; put on
ochre coloured robes; maintain truthfulness; cultivate celibacy and habit of
prostrating to Gods, preceptors, elders, etc.
c) Sutra Sthana, Adhyaya 3/53

He who possesses good knowledge of both (theory & practice) and is intelligent, such
a physician only is capable of achieving the aims; just like a chariot of two wheels is
capable of performing all its functions in the battlefield.
d) Sutra Sthana, Adhyaya 4/6-7

He who studies any one science only will not be able to arrive at a correct decision;
hence, the physician should have knowledge of many sciences.
He who practices medicine, after learning the science from a preceptor and who
engages constantly in recapitulating it, such a person can only be called a physician,
whereas all others are impostors.
e) Sutra Sthana, Adhyaya 17/6

He who recognizes the Amapakva (unripe), Vipachyamapakva (ripening) and
Samyakpakva (ripe) stages clearly, can only be called the real physician, whereas all
others are swindlers.
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3) Raja Vaidya
A) According to Charaka Samhita, Sutra Sthana, Adhyaya 9 / 19-20

One who possesses the knowledge of the below four factors is fit to become a
Raja Vaidya (Royal Physician):
i) Hetu Causative factors for diseases
ii) Linga Characteristic features of diseases
iii) Prashamana Treatment methods for diseases
iv) Rogaanaam Apunarbhave Preventive methods for diseases
B) According to Sushruta Samhita, Sutra Sthana, Adhyaya 3/47

This treatise (Astanga Ayurveda by Adideva Dhanvantari) must be studied essentially;
after studying, it should be practiced diligently; he who does both these is eligible to
become a Royal Physician.
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4) Pranabhisara & Rogabhisara Vaidya
According to Charaka Samhita
Pranabhisara = Who saves lives and kills diseases.
Rogabhisara = Who worsen diseases and kills life.
A) Sutra Sthana, Adhyaya 9 / 18

A physician devoted and deeply engaged to the following four factors is known as
Pranabhisara Vaidya.
i) Shastra Scientific scriptures
ii) Artha Meaning (true sense of the scriptures)
iii) Vijnana Knowledge / Wisdom
iv) Karma Darshana Practical experience
B) Sutra Sthana, Adhyaya 11 / 52-53

Chadmachara / Bhishaka Veshachara, Siddha Sadhita, Vaidya Guna Yukta /
Jivitabhisarah -> Refer to 1) Trividha Bhishaja
C) Sutra Sthana, Adhyaya 29 / 6-9 (Refer for detailed description)
i) Pranabhisara:
- Born in noble family, well versed in science, practical experience, skillful,
clever, wise, pure in body & mind, control over mind, healthy sense organs
- Knowledge about Rachana & Kriya Shareera, Prakruti & Vikruti.
- Knowledge about Trividha Ayurveda Sutra (3 principles of Ayurveda)
a) Hetu; b) Linga; c) Prashamana
- Knowledge about Trividha Aushadha Grama (3 sources of medicines)

a) Jangama; b) Parthiva; c) Sthavara
- He should be an expert on various subjects such as:

Chatur-sneha, Pancha-lavana, Astha-mutra, Astha-ksheera, Shirovirechanadi
Panchakarmashraya Aushadha, Bhojana, Pana, Nyama, Sthana, Chankramana,
Shayana, Asana, Matra, Dravya, Anjana, Dhuma, Navana, Abhyanga,
Parimarjana, Vega Vidharana, Vyayama, Satmya, Indriya Pariksha Upakrama,
Sadvritta, Vyadhi, Dasha Pranayatana, etc.
ii) Rogabhisara:
- Opposite to Pranabhisara
- Moves about to search for patients
- Tries to find faults in other physicians
- Wins over friends of the patients by pleasing them
- Tries to cover his ignorance
- If disease does not get alleviated, the blame the patient for lack of proper
equipment, attendance and self-control, etc.
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5) Apujya Vaidya
Apujya Vaidya is the type of physician who should not be praised, followed or asked
for consultation due to improper qualities such as lack of knowledge, ignorance,
wrong intentions, etc.
A) According to Charaka Samhita:

a) Sutra Sthana, Adhyaya 9 / 17
Bhishangmani (one regarding himself as a physician) cures by chance a
diseased person whose life span is certain, but on the other hand, kills
hundreds having an uncertain life span.
b) Sutra Sthana, Adhyaya 11 / 50-52

Chadmachara / Bhishaka Veshachara & Siddha Sadhita
-> Refer to 1) Trividha Bishaja
c) Sutra Sthana, Adhyaya 29 / 9

Rogabhisara Vaidya -> Refer to 4) Pranabhisara & Rogabhisara Vaidya
d) Sutra Sthana, Adhyaya 30 / 82-83

Ajna Vaidya:
Those who are not well verse in the science of their own profession, resort to
false views, take excuses for lack of time or sudden illness, try to show their
ability by demonstrating books, equipment, etc., use harsh and abusive
language and speak ill of others during debates; they are similar to Kala
(death) and they abuse scriptures, hence they are to be avoided.
B) According to Sushruta Samhita:

Sutra Sthana, Adhyaya 3 / 48-52
He who knows the science only (in theory) but is not skilled in practice,
becomes confused on approaching the patient just like a coward in a
battlefield.
He who is skilled in practice through audacity and acts apart from the dictates
of the science, does not get respect from the wise and deserves killing by the
king.
Both these kinds of persons (physicians) are unqualified and incapable of
performing their duties, since they only possess half knowledge of the science,
like a bird with only one wing.
Medicine is like nectar, but when used by the ignorant, it acts like a sharp
weapon, fire or poison; hence, such persons (physicians) should be avoided.
Kuvaidya:
He who is not well versed in Snehana etc., and in Shastrakarma, kills the
people by his greed.
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 Chaturvidha Vaidyavrutti
Charaka Samhita, Sutra Sthana, Adhyaya 9/26
The 4 disciplines a Vaidya should follow are:

i) Maitri Equality / Friendliness
ii) Karunyam Arteshu Sympathy and kindness towards the patients
iii) Shakye Pritih Focus on curable diseases
iv) Upekshanam Prakuishteshu Neglect of incurable disease
 Vaidya Sadvrittam
Refer to:
a) Astanga Hridaya, Sutra Sthana, Adhyaya 2/21-48
b) Charaka Samhita, Sutra Sthana, Adhyaya 8/18-29
c) Charaka Samhita, Vimana Sthana, Adhyaya 8/13
d) Charaka Samhita, Chikitsa Sthana, Adhyaya 1:4/30-33
e) Sushruta Samhita, Sutra Sthana, Adhyaya 2/6
f) Sushruta Samhita, Sutra Sthana, Adhyaya 10/3
g) Sushruta Samhita, Sutra Sthana, Adhyaya 10/9
h) Chaturvidha Vaidyavrutti
i) Code of Conduct (following page)
j) International Code of Medical Ethics – Chapter XV
 Responsibilities of Vaidya & Duties of Vaidya to the Patient

Refer to:
a) Chapter XIII
b) Same references as Vaidya Sadvrittam
AYURVEDA LIBRARY
 Code of Conduct
Charaka’s oath of initiation
The teacher should instruct the disciple in the presence of the sacred fire, Brahmanas and Vaidyas:
“Thou shalt speak only the truth, . . . be free from envy… There shall be nothing
that thou oughtest not to do at my behest except hating the king or causing
another’s death or committing an act of unrighteousness or acts leading to
calamity.”
“Thou shalt behave and act without arrogance and with undistracted mind,
humility and constant reflection…”
“Thou shalt pray for the welfare of all creatures…”
“Day and night however thou mayest he engaged, thou shalt endeavour for the
relief of patients with all thy heart and soul. Thou shalt not desert or injure thy
patient even for the sake of thy life…
“Thou shalt not commit adultery even in thought. Even so, thou shalt not covet
others’ possessions… Thou shouldst speak words that are gentle, pure and
righteous, pleasing, worthy, true, wholesome and moderate. Thy behaviour must
be in consideration of time and place and heedful of past experience. Thou shalt
act always with a view to the acquisition of knowledge and the fullness of
equipment…”
“When entering the patient’s house, thou shalt be accompanied by a man known
to the patient and who has his permission to enter. Thou shalt be well clad and
bent of head, self- possessed and conduct thyself after repeated consideration…
Having entered, thy speech, mind, intellect and senses shall be entirely devoted
to no other thought than that of being helpful to the patient and of things
concerning him only.”
“The peculiar customs of the patient’s household shall not be made public. Even
knowing that the patient’s span of life has come to its close, it shall not be
mentioned by thee there, where if so done, it would cause shock to the patient or
to others.
“Though possessed of knowledge, one should not boast...”
(Charaka Samhita Vol. I, Shree Gulabkunverba Ayurvedic Society, Jamnagar, 1949. Pages 163-164)
AYURVEDA LIBRARY
CHAPTER xiii: laws in relation to
medical practitioners
 Introduction
Medical law is the branch of law concerning the rights and responsibilities of medical
professionals and their patients. The main areas of focus for medical law include
confidentiality, negligence and other torts related to medical treatment (especially
medical malpractice), and criminal law and ethics.
After medical qualification, a man / woman should get registered by the provincial
medical council. When he / she is registered to engage in the practice of medicine he
/ she presumed to be governed by law.
 Confidentiality
Medical doctors and mental health professionals have long had a tradition of
confidentiality with their patients. However, this tradition has been codified in
recent years, so that anything said by a patient to a doctor or mental health
professional in the course of diagnosis or treatment is privileged and
confidential unless the individual expresses an imminent intention to harm
himself or others.
 Negligence and Other Torts

Those diagnosing and treating others as a profession are held to a higher
standard than a passerby on the street who render aid.
Medical malpractice is one of the key focuses of medical law, and relates to
the liability of a medical professional for negligence in the diagnosis or
treatment of a patient resulting in injury or death.
But, other torts do cross over into the field of medical law. For example, it is
possible for a medical professional to defame a patient if they wrongfully
disclose untrue information about the patient's health.
 Crime and Ethics

Criminal law and ethics have taken a very large role in medical law in recent
years. The rise of so-called "pill mills" have raised issues about the role of
medical professionals in the trafficking of controlled substances, both from a
criminal and an ethical standpoint. Other examples have included famous
cases involving the euthanasia of terminally ill patients and sexual assaults
against anesthetized patients.
AYURVEDA LIBRARY
 Anti-Kickback Act
The Anti-Kickback Act of 1986 prohibits getting paid for referrals when federal
healthcare programs like Medicare and Medicaid are involved. Referrals can be for
drugs, supplies, or healthcare services, and payments can include cash, free rent,
vacation, dining, or excessive pay for consultancy or medical directorships.
“As a physician, you are an attractive target for kickback schemes because you can be
a source of referrals for fellow physicians or other healthcare providers and suppliers.
You decide what drugs your patients use, which specialists they see, and what
healthcare services and supplies they receive.”
“Many people and companies want your patients’ business and would pay you to
send that business their way. Just as it is illegal for you to take money from providers
and suppliers in return for the referral of your Medicare and Medicaid patients, it is
illegal for you to pay others to refer their Medicare and Medicaid patients to you.”
 EMTALA
Emergency Medical Treatment and Active Labor Act (EMTALA), which went into
effect in 1986, is a law that guarantees emergency health care by requiring
healthcare providers to deliver medical services regardless of the patient’s ability to
pay. The law requires caregivers to stabilize the patient and provide treatment until a
point that the patient remains stable, such as with injury or during child birth. If the
care provider is unable or unwilling to provide such service, the provider must
transfer the patient to a capable facility.
 Stark Law
The Physician Self-Referral Law, or Stark Law, bars a physician from referring patients
to receive Medicare or Medicaid services in which that physician has a financial
interest. For instance, a physician referring a patient to a home health business that
the physician owns is likely a violation of the Stark law. However, the law does allow
a few exceptions. For instance, a group practice may be able to make referrals for in-
office ancillary services, such as lab testing or radiology imaging, as long as the
arrangement doesn’t pose a risk of financial abuse.
AYURVEDA LIBRARY
 Indian Medicine Central Council Act
The Indian Medicine Central Council Act, 1970 created the Central Council of Indian
Medicine (CCIM) to regulate Ayurveda, Siddha, Unani and Sowa-Rigpa medicine, set
minimum standards for education, and maintain a register of all practitioners in
these fields.
- Matters regarding specification of professional qualifications in Indian medicine and

enrolment of the professionals are accordingly being dealt with under the Act and it
offers comprehensive schemes regarding the same.
- Under the Act, only such a person can be enrolled as a practitioner of Indian
medicine who possesses a recognized medical qualification. After enrolment, a
practitioner can practice Indian medicine in any state in India and is entitled to sign
or authenticate a medical or fitness certificate or any other certificate required by
any law to be signed or authenticated by a duly qualified medical practitioner.
- To maintain the quality of teaching and training in Indian medicine, the Central
Council can ask any university, board or medical institution in India which grants a
recognized medical qualification, to furnish information about its courses of study
and examination.
The Council can withdraw the recognition of an institution if it appears to it that the
required quality is not being maintained by a certain institution with respect to the
courses of study, examinations, proficiency, efficiency of staff, equipment,
accommodation and other facilities.
The purpose of the Act, therefore, is to produce sufficiently qualified and skilled
medical practitioners and to make qualitative health care available to the people of
the country.
AYURVEDA LIBRARY
WMA INTERNATIONAL CODE OF MEDICAL ETHICS
The Code of Medical Ethics formulated by the World Medical Association (WMA) brings together the
essential points that everyone should be aware of, in a concise, easily understood fashion, under
three heading: Duties of Physicians in General; Duties of Physicians to Patients; Duties of Physicians
to Colleagues.
‘Physician’ in this context refers to all medical practitioners, irrespective of their specialty or
seniority.
DUTIES OF PHYSICIANS IN GENERAL

A PHYSICIAN SHALL always exercise his/her independent professional judgment and maintain
the highest standards of professional conduct.
A PHYSICIAN SHALL respect a competent patient’s right to accept or refuse treatment.
A PHYSICIAN SHALL not allow his/her judgment to be influenced by personal profit or unfair
discrimination.
A PHYSICIAN SHALL be dedicated to providing competent medical service in full professional

and moral independence, with compassion and respect for human dignity.
A PHYSICIAN SHALL deal honestly with patients and colleagues, and report to the appropriate
authorities those physicians who practice unethically or incompetently or
who engage in fraud or deception.
A PHYSICIAN SHALL not receive any financial benefits or other incentives solely for referring
patients or prescribing specific products.
A PHYSICIAN SHALL respect the rights and preferences of patients, colleagues, and other health
professionals.
A PHYSICIAN SHALL recognize his/her important role in educating the public but should use due
caution in divulging discoveries or new techniques or treatment through
non-professional channels.
A PHYSICIAN SHALL certify only that which he/she has personally verified.
A PHYSICIAN SHALL strive to use health care resources in the best way to benefit patients and
their community.
A PHYSICIAN SHALL seek appropriate care and attention if he/she suffers from mental or
physical illness.
A PHYSICIAN SHALL respect the local and national codes of ethics.
AYURVEDA LIBRARY
DUTIES OF PHYSICIANS TO PATIENTS
A PHYSICIAN SHALL always bear in mind the obligation to respect human life.
A PHYSICIAN SHALL act in the patient’s best interest when providing medical care.
A PHYSICIAN SHALL owe his/her patients complete loyalty and all the scientific resources
available to him/her. Whenever an examination or treatment is beyond the
physician’s capacity, he/she should consult with or refer to another
physician who has the necessary ability.
A PHYSICIAN SHALL respect a patient’s right to confidentiality. It is ethical to disclose

confidential information when the patient consents to it or when there is a
real and imminent threat of harm to the patient or to others and this threat
can be only removed by a breach of confidentiality.
A PHYSICIAN SHALL give emergency care as a humanitarian duty unless he/she is assured that
others are willing and able to give such care.
A PHYSICIAN SHALL in situations when he/she is acting for a third party, ensure that the patient
has full knowledge of that situation.
A PHYSICIAN SHALL not enter into a sexual relationship with his/her current patient or into any
other abusive or exploitative relationship.
DUTIES OF PHYSICIANS TO COLLEAGUES

A PHYSICIAN SHALL behave towards colleagues as he/she would have them behave towards
him/her.
A PHYSICIAN SHALL NOT undermine the patient-physician relationship of colleagues in order to

attract patients.
A PHYSICIAN SHALL when medically necessary, communicate with colleagues who are involved
in the care of the same patient. This communication should respect patient
confidentiality and be confined to necessary information
AYURVEDA LIBRARY
CHAPTER xiv: medical records
 Introduction:
- Medical Records are compilation of facts about a patient.
- They include information about History of past & present illness, Treatment
schedule & Patient’s care.
- Medical Records must have sufficient data about the patient’s histories,
justification for the treatment and accurate documentation about the result.
 Objectives of Medical Records:

- Monitoring of the actual patient
- Medical research
- Medical/dental or paramedical education
- For insurance cases, personal injury suits, workmen’s compensation case, -
criminal cases, and will case
- For malpractice suits
- For medical audit and statistical studies
 Advantages of good Medical Records:

a) For the patients:
- A good MR has all details about the patient’s illness
- It may save time, repeated unnecessary examination & avoid discomfort.
- Protection in legal matters, compensation, injury, etc.
b) For the hospital:

- A good MR helps in evaluation of competency & performance of the clinical
staff.
- Result of treatment
- Defense in malpractice suits
c) For the physician:

- A good MR helps to get information about the patient & the treatment.
- Assessing the treatment methods & their results.
- Protection in legal matters
AYURVEDA LIBRARY
 Types of Medical Records:
i) Patient information leaflet:
A patient information leaflet can be found in any medicine bought at a
pharmacy. It contains important information about the product such as its
conditions, side effects, doses or conservation.
ii) Medical history record

A medical history record summarizes a patient’s medical history and also
includes some notes and remarks made by healthcare specialists. It can be
used in a clinical environment, and the medical and healthcare translator
should never misunderstand the contained information.
iii) Discharge Summary

A hospital discharge summary is prepared when a patient checks out of the
hospital. It normally explains the reasons for the hospital admission, the
results of the tests made, and how the patient feels after the discharge, along
with some medical advices.
iv) Medical test

A medical test includes: blood test, urine test, heart test, and many other
variants. Figures, chemical forms, molecules, quantities, etc. everything has to
be checked by the medical and healthcare translator.
v) Mental Status Examination

A mental status record contains details of the results of a mental examination
and the opinion of the medical practitioner regarding the same.
vi) Operative Report

It is a report prepared to detail the procedures and findings of a surgical
operation.
 Organizing the Medical Records Department (MRD):

- The MRD should be located adjacent to the Front Office.
- The MRD has to function 24 hours on all the days to provide required medical
records immediately.
- The MRD is governed by the Medical Records Committee.
- For the department to function efficiently, the medical record must be
accurate, complete and timely.
- The caregivers of MRD shall have legible handwriting.
- Medical records must be kept safe and issued on demand of eligible
authority.
AYURVEDA LIBRARY
 General Management of Medical Records
- Write legibly
- Include details of the patient, date, and time
- Avoid abbreviations
- Do not alter an entry or disguise an addition
- Avoid unnecessary comments
- Check dictated letters and notes
- Check reports
- Be familiar with the Data Protection Act
- Every physician shall maintain the medical records of pertaining to his / her
INDOOR patients for a period of 3 years from the date of commencement of
the treatment in a standard proforma laid down by the Medical Council of
India.
- If any request is made for medical records, either by the patient / authorized
attendant or legal authorities involved, the same may be duly acknowledged
and the documents shall be issued within the period of 72 hours.
- The expired medico-legal cases are kept permanently for legal purposes and
as a protection for the physician in legal matters.
- Efforts shall be made to computerize the medical records for quick retrieval.
AYURVEDA LIBRARY
CHAPTER xV: miscellaneous medico-
legal aspects
 Physician’s Responsibility in Criminal Matters

- In relation to legal procedures, a physician may be summoned by the court at any
time to give his specific professional opinion regarding the criminal matter at hand.
The physician must oblige and provide his/her expertise.
- In the following, various Sections of the Indian Penalty Code regarding criminal
matters are described which specifically may concern a physician.
A physician must be aware of these rules to not accidentally commit or participate in
such crimes, as well as to recognize a crime he/she may encounter in order to report
it to the authorities.
IPC Description
Section
52 Nothing is said to be done or believed in “good faith” which is done or believed without due care and attention.
88 Nothing is an offence which is done by accident or misfortune, and without any criminal intention or knowledge in
the doing of a lawful act in a lawful manner by lawful means and with proper care and caution.
90 A consent is not such a consent as is intended by any section of this Code, if the consent is given by a person under
fear of injury, or under a misconception of fact, and if the person doing the act knows, or has reason to believe, that
the consent was given in consequence of such fear or misconception; or
Consent of insane person if the consent is given by a person who, from unsoundness of mind, or intoxication, is
unable to understand the nature and consequence of that to which he gives his consent; or
Consent of child unless the contrary appears from the context, if the consent is given by a person who is under
twelve years of age.
176 Whoever, being legally bound to give any notice or to furnish information on any subject to any public servant, as
such, intentionally omits to give such notice or to furnish such information in the manner and at the time required
by law, shall be punished with simple imprisonment for a term which may extend to one month, or with fine which
may extend to five hundred rupees, or with both.
269 Whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely
to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description
for a term which may extend to six months, or with fine, or with both.
270 Whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the
infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term
which may extend to two years, or with fine, or with both.
AYURVEDA LIBRARY
272 Whoever adulterates any article of food or drink, so as to make such article noxious as food or drink, intending to
sell such article as food or drink, or knowing it to be likely that the same will be sold as food or drink, shall be
punished with imprisonment of either description for a term which may extend to six months, or with fine which
may extend to one thousand rupees, or with both.
273 Whoever sells, or offers or exposes for sale, as food or drink, any article which has been rendered or has become
noxious, or is in a state unfit for food or drink, knowing or having reason to believe that the same is noxious as food
or drink, shall be punished with imprisonment of either description for a term which may extend to six months, or
with fine which may extend to one thousand rupees, or with both.
274 Whoever adulterates any drug or medical preparation in such a manner as to lessen the efficacy or change the
operation of such drug or medical preparation, or to make it noxious, intending that it shall be sold or used for, or
knowing it to be likely that it will be sold or used for, any medicinal purpose, as it had not undergone such
adulteration, shall be punished with imprisonment of either description for a term which may extend to six months,
or with fine which may extend to one thousand rupees, or with both.
275 Whoever, knowing any drug or medical preparation to have been adulterated in such a manner as to lessen its
efficacy, to change its operation, or to render it noxious, sells the same, or offers or exposes it for sale, or issues it
from any dispensary for medicinal purposes as unadulterated, or causes it to be used for medicinal purposes by any
person not knowing of the adulteration, shall be punished with imprisonment of either description for a term which
may extend to six months, or with fine which may extend to one thousand rupees, or with both.
276 Whoever knowingly sells, or offers or exposes for sale, or issues from a dispensary for medicinal purposes, any drug
or medical preparation, as a different drug or medical preparation, shall be punished with imprisonment of either
description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or
with both.
304 Whoever commits culpable homicide not amounting to murder shall be punished with imprisonment for life, or
imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine, if the
act by which the death is caused is done with the intention of causing death, or of causing such bodily injury as is
likely to cause death.
306 If any person commits suicide, whoever abets the commission of such suicide, shall be punished with imprisonment
of either description for a term which may extend to ten years, and shall also be liable to fine.
307 Whoever does any act with such intention or knowledge, and under such circumstances that, if he by that act
caused death, he would be guilty of murder, shall be punished with imprisonment of either description for a term
which may extend to ten years, and shall also be liable to fine; and, if hurt is caused to any person by such act, the
offender shall be liable either to imprisonment for life, or to such punishment as is hereinbefore mentioned.
308 Whoever does any act with such intention or knowledge and under such circumstances that, if he by that act caused
death, he would be guilty of culpable homicide not amounting to murder, shall be punished with imprisonment of
either description for a term which may extend to three years, or with fine, or with both; and, if hurt is caused to
any person by such act, shall be punished with imprisonment of either description for a term which may extend to
seven years, or with fine, or with both.
309 Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished
with simple imprisonment for a term which may extend to one year or with fine, or with both.
AYURVEDA LIBRARY
312 Whoever voluntarily causes a woman with child to miscarry, shall if such miscarriage be not caused in good faith for
the purpose of saving the life of the woman, be punished with imprisonment of either description for a term which
may extend to three years, or with fine, or with both; and, if the woman be quick with child, shall be punished with
imprisonment of either description for a term which may extend to seven years, and shall also be liable to fine.
313 Whoever commits the offence defined in the last preceding section without the consent of the woman, whether the
woman is quick with child or not, shall be punished with imprisonment for life, or with imprisonment of either
description for a term which may extend to ten years, and shall also be liable to fine.
314 Whoever, with intent to cause the miscarriage of a woman with child, does any act which causes the death of such
woman, shall be punished with imprisonment of either description for a term which may extend to ten years, and
shall also be liable to fine.
315 Whoever before the birth of any child does any act with the intention of thereby preventing that child from being
born alive or causing it to die after its birth, and does by such act prevent that child from being born alive, or causes
it to die after its birth, shall, if such act be not caused in good faith for the purpose of saving the life of the mother,
be punished with imprisonment of either description for a term which may extend to ten years, or with fine, or with
both.
316 Whoever does any act under such circumstances, that if he thereby caused death he would be guilty of culpable
homicide, and does by such act cause the death of a quick unborn child, shall be punished with imprisonment of
either description for a term which may extend to ten years, and shall also be liable to fine.
319 Whoever causes bodily pain, disease or infirmity to any person is said to cause hurt.
320 The following kinds of hurt only are designated as “grievous”: 1) Emasculation 2) Permanent privation of the sight
of either eye. 3) Permanent privation of the hearing of either ear. 4) Privation of any member or joint. 5)
Destruction or permanent impairing of the powers of any member or joint. 6) Permanent disfiguration of the head
or face. 7) Fracture or dislocation of a bone or tooth. 8) Any hurt which endangers life or which causes the sufferer
to be during the space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits.
321 Whoever does any act with the intention of thereby causing hurt to any person, or with the knowledge that he is
likely thereby to cause hurt to any person, and does thereby cause hurt to any person, is said “voluntarily to cause
hurt”.
322 Whoever voluntarily causes hurt, if the hurt which he intends to cause or knows himself to be likely to cause is
grievous hurt, and if the hurt which he causes is grievous hurt, is said “voluntarily to cause grievous hurt”.
336 Whoever does any act so rashly or negligently as to endanger human life or the personal safety others, shall be
punished with imprisonment of either description for a term which may extend to three months or with fine which
may extend to two hundred and fifty rupees, or with both.
337 Whoever causes hurt to any person by doing any act so rashly or negligently as to endanger human life, or the
personal safety of others, shall be punished with imprisonment of either description for a term which may extend to
six months, or with fine which may extend to five hundred rupees, or with both.
338 Whoever causes grievous hurt to any person by doing any act so rashly or negligently as to endanger human life, or
the personal safety of others, shall be punished with imprisonment of either description for a term which may
extend to two years, or with fine which may extend to one thousand rupees, or with both.
AYURVEDA LIBRARY
 Duty of Care
Duty of care is a broad legal definition that protects individuals from others that
engage in activities that could potentially harm others if proper precautions are not
taken. This ranges from operating a moving vehicle to performing surgery. This also
covers situations where individuals may suffer economic or emotional damage due to
poor advice or conduct.
E.g.: A manufacturer has a duty of care to the consumer as the consumer will assume
that product he or she is buying is safe and adheres to standards set by the
government and common practices.
 Professional Negligence
Professional negligence is a breach of the duty of care between professionals and
their clients. The duty of care is a common law arrangement where the client expects
a level of professionalism and standards commonly held by those in the
profession. The most common term for medical professional negligence is medical
malpractice. For this instance, the patient expects the doctor and his subordinates to
adhere to standards that would prevent undue harm and distress to patients under
his or her care. Negligence on the part of the doctor while performing his duties as a
professional is malpractice, which breaches the duty of care that the patient has put
in the doctor and will involve legal penalties.
 Civil Negligence
Tort or civil negligence is the failure of one person to act with reasonable care in his /
her dealings with others so as not to cause injury or damage.
 Criminal Negligence
Criminal negligence occurs when someone acts in a way that is an extreme departure
from the way that a reasonable person would have acted in the same or similar
situation. Criminal negligence generally involves an indifference or disregard for
human life or for the safety of other individuals.
Criminal negligence is different from civil negligence in that it involves more extreme
behavior or actions. It requires more than a mere mistake in judgment, inattention or
ordinary carelessness and it refers to conduct that is so outrageous and reckless that
it is clear departure from the way an ordinary careful individual would have acted.
Civil negligence occurs when a person’s conduct falls short of how a “reasonable”
individual would act in the same or similar situation but the individual’s conduct may
not be considered a drastic departure from the way a reasonable person would have
acted.
AYURVEDA LIBRARY
 Medico-Legal Aspects of AIDS
- As with any other patient, an AIDS victim has the right to confidentiality. This right
to confidentiality in case of AIDS victim extends even after death.
However, this is not an absolute right. During life, notification to the public health
authorities is mandatory in many Indian states. Considering the danger of spread to
the sexual partner, partner notification is also allowed.
After death, autopsy report is submitted to the public health & registration
authorities, the funeral personnel are informed of the disease in the body.
Organ transplantation teams are informed, if such a procedure is being contemplated
and in case of third party insurance, the insurance company is entitled to the
information.
- The Indian Constitution guarantees right to liberty, freedom of movement and

employment to the AIDS victim, as to any other citizen. But these, at least some, are
not absolute rights. They can be demanded only when there is no conflict between
individual rights and public health.
- The AIDS patient of any social class and category has:

a) The right to be able to avoid infection.
b) The right to health care.
c) The right to be treated with dignity and without discrimination when sick and to
die with dignity.
- Section 51 of Goa Public Health Act is specific for notification of AIDS. In addition to
notification, the act has provision for obligatory medical examination of any suspect
of AIDS. Nobody including foreigners can refuse to undergo blood examination for
AIDS.
- Everyone has a right to receive safe blood and blood products. Considering the high
risk of transmission of AIDS through blood and blood products, the 11 July 1989 Govt.
of India circular makes it mandatory for all blood banks to adopt the WHO Biosafety
Guidelines. According to these guide-lines, it is mandatory that each bottle of blood
being issued from any blood bank should be tested and declared free of HIV
contamination. Even blood collected for auto transfusion is to be treated similarly.
Health care workers, especially those handling blood & blood products have the right
to be instructed in universal safety precautions and to be provided with the
essentials to follow these precautions.
- Before proceeding to the treatment and collection of blood sample of any patient,
the doctor must have valid expressed consent of the patient. This applies even to the
post-mortem collection of blood, where one of the decedent's relatives gives
consent. Overlooking this common law requirement may result in action for battery.
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- In many countries it is mandatory for immigrants and over-seas students to produce
HIV free certificate to obtain a Visa. In this connection, all members of our
contingents to UN Peace Keeping Missions were subjected to HIV testing before their
departure as well as on return.
- If any person leads to unlawful spread of any dangerous infection including AIDS-he
can be punished under Section 270 of IPC with 2 years of imprisonment.
- Under sections 269 & 271 of IPC any person causing spread of dangerous infection
unlawfully or negligently, knowing that the act can be dangerous to life, can be
punished with 6 months of imprisonment.
- In case the foetus is found HIV positive, Medical Termination of Pregnancy can be
undertaken. Similarly, AIDS in either spouse can be ground for divorce, like any other
STD.
- A woman has the right to confidentiality and freedom from discrimination when her
child is found infected.
AYURVEDA LIBRARY
 Rights of an Unborn Child / Foetal Rights
Foetal rights are the moral rights or legal rights of the human foetus under natural
and civil law.
The concept of foetal rights has evolved to include the issues of maternal drug and
alcohol abuse. The only international treaty specifically tackling foetal rights is the
American Convention on Human Rights which envisages the right to life of the foetus.
While international human rights instruments lack a universal inclusion of the foetus
as a person for the purposes of human rights, the foetus is granted various rights in
the constitutions and civil codes of several countries.
The expansion of foetal rights, including not only the right to live but also the right of
the fetus to be born healthy and to receive medical treatments, requires a reflection
on the need to identify limits in the protection of such rights.
In India, despite there not being any legislation or statute that specifically defines the
rights and the position of an unborn child under the law, several statutes recognize
and mention the unborn and defined it to be a legal person by fiction, but they too
mention that an unborn acquires rights only after being born. Thus, the state can and
is required to interfere in abortion matters only after the unborn child has attained
the stage of viability. To protect the right of a human being falls under the right to life
and hence has to be protected.
Examples of Foetal Rights in other countries:
Country Foetal Rights

Chile The Constitution guarantees all persons the right to life and to the physical and mental integrity of
the person. The law protects the life of the unborn.
Equatorial The State protects the person from its conception and fosters the minor in order for him to develop
Guinea normally and with security for his moral, mental, and physical integrity, as well as his life within the
home.
Germany Counselling of the pregnant woman in a situation of emergency or conflict. The counselling serves to
protect unborn life. It should be guided by efforts to encourage the woman to continue the
pregnancy and to open her to the prospects of a life with the child; it should help her to make a
responsible and conscientious decision. The woman must thereby be aware that the unborn child
has its own right to life.
Hungary Human dignity shall be inviolable. Every human being shall have the right to life and human dignity;
the life of the foetus shall be protected from the moment of conception.
Kenya Right to life: 1) Every person has the right to life. 2) The life of a person begins at conception.
Uganda Protection of right to life: No person has the right to terminate the life of an unborn child except as
may be authorized by law.
AYURVEDA LIBRARY
 Malingering of Feigned Diseases
- Malingering is the fabrication, feigning, or exaggeration of physical or psychological
symptoms designed to achieve a desired outcome, such as relief from duty or work.
- Malingering refers to producing false medical symptoms or exaggerating existing

symptoms in hopes of being rewarded in some way.
Causes:
Malingering is not caused by any physical factors. Rather, it is the result of someone’s
desire to gain a reward or avoid something.
However, there are certain psychological conditions that might cause someone to
unknowingly make up or exaggerate their symptoms.
That said, malingering is often accompanied by real mood and personality disorders,
such as antisocial personality disorder or major depressive disorder.
Symptoms:
Malingering does not have any specific symptoms. Instead, it is usually suspected
when someone suddenly starts having physical or psychological symptoms while:
- being involved with a civil or criminal legal action.
- facing the possibility of military combat duty.
- not cooperating with a doctor’s examination or recommendations.
- describing symptoms as being much more intense than what a doctor’s
exam reveals.
Diagnosis:
- Malingering is a medical diagnosis, but not a psychological condition. It is often hard
to diagnose because doctors do not want to overlook any real physical or
psychological conditions.
- The doctor should start with a thorough physical exam and open-ended interview to
get an idea of someone’s overall physical and mental health. This interview will cover
the ways a person’s symptoms impact their daily life. Then the doctor will also try to
get a timeline of any behavioural, emotional, or social events. A follow-up exam may
be done to check for inconsistencies between someone’s description of their
symptoms and what the doctor finds during an exam.
- If a doctor concludes that someone is likely malingering, they may reach out to
other doctors of the patient, family members, friends, or co-workers for more
information about the patient’s health.
AYURVEDA LIBRARY
 Medical Termination of Pregnancy Act, 1971
Medical Termination of Pregnancy (MTP) Act, 1971 is an Act to provide for the
termination of certain pregnancies by registered medical practitioners and for
matters connected therewith or incidental thereto.
When Pregnancies may be terminated by registered medical practitioners:
1) Notwithstanding anything contained in the Indian Penal Code (45 of 1860), a
registered medical practitioner shall not be guilty of any offence under that Code or
under any other law for the time being in force, if any pregnancy is terminated by
him in accordance with the provisions of this Act.
2) A pregnancy may be terminated by a registered medical practitioner:
(a) where the length of the pregnancy does not exceed twelve weeks if such
medical practitioner is.
(b) where the length of the pregnancy exceeds twelve weeks but does not
exceed twenty weeks, if not less than two registered medical practitioners
are. Of opinion, formed in good faith, that:
(i) the continuance of the pregnancy would involve a risk to the life of
the pregnant woman or of grave injury physical or mental health.
(ii) there is a substantial risk that if the child were born, it would suffer
from such physical or mental abnormalities as to be seriously
handicapped.
3) In determining whether the continuance of pregnancy would involve such risk of
injury to the health as is mentioned in sub-section (2), account may be taken of the
pregnant woman's actual or reasonable foreseeable environment.
4) (a) No pregnancy of a woman, who has not attained the age of eighteen years, or,
who, having attained the age of eighteen years, is a lunatic, shall be terminated
except with the consent in writing of her guardian. (b) No pregnancy shall be
terminated except with the consent of the pregnant woman.
Place where pregnancy may be terminated:
No termination of pregnancy shall be made in accordance with this Act at any place
other than:
(a) a hospital established or maintained by Government.
(b) a place for the time being approved for the purpose of this Act by Government.
When not to apply:
(1) Not less than two registered medical practitioners; it shall not apply to the
termination of a pregnancy by the registered medical practitioner in case where he is
of opinion, formed in good faith, that the termination of such pregnancy is
immediately necessary to save the life of the pregnant woman.
(2) Notwithstanding anything contained in the Indian Penal Code (45 of 1860), the
termination of a pregnancy by a person who is not a registered medical practitioner
shall be an offence punishable under that Code, and that Code shall, to this extent,
stand modified.
AYURVEDA LIBRARY
 Transplantation of Human Organs Acts
a) Transplantation of Human Organs (THO) Act, 1994 was initiated to provide for the
regulation of removal, storage and transplantation of human organs for therapeutic
purposes and for the prevention of commercial dealings in human organs and for
matters connected therewith or incidental thereto.
The Act contains detailed provisions relating to the authority for removal of human
organs, preservation of human organs, regulation of hospitals conducting the
removal, storage or transplantation of human organs, functions of appropriate
authority, registration of hospitals and punishment/penalties for offences relating to
aforesaid matters.
b) Transplantation of Human Organs (Amendment) Act, 2011 allows swapping of

organs and widens the donor pool by including grandparents and grandchildren in
the list.
c) Transplantation of Human Organs and Tissues (THOT) Rules, 2014 has many
provisions to remove the impediments to organ donation while curbing
misuse/misinterpretation of the rules.
 Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994

Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 is an Act of
the Parliament of India enacted to stop female foeticides and arrest the declining sex
ratio in India.
The act banned prenatal sex determination. Every genetic counselling centre, genetic
laboratory or genetic clinic engaged in counselling or conducting pre-natal
diagnostics techniques with the potential of sex selection* (Preimplantation genetic
diagnosis) before and after conception comes under preview of the PCPNDT Act and
are banned.
The main objective of the act is to ban the use of sex selection techniques after
conception and prevent the misuse of prenatal diagnostic technique for sex selective
abortions.
*Sex selection is any act of identifying the sex of the foetus and elimination of the
foetus if it is of the unwanted sex.
AYURVEDA LIBRARY
 Clinical Establishments Act, 2010
The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted
by the Central Government of India to provide for registration and regulation of all
clinical establishments in the country with a view to prescribe the minimum
standards of facilities and services provided by them.
The Act has taken effect in the four States namely, Arunachal Pradesh, Himachal
Pradesh, Mizoram, Sikkim, and all Union Territories except the NCT of Delhi since 1st
March, 2012 vide Gazette notification dated 28th February, 2012.
The Act is applicable to all types (both therapeutic and diagnostic types) of Clinical
Establishments from the public and private sectors, belonging to all recognized
systems of medicine, including single doctor clinics.
The only exception is Clinical Establishments run by the Armed forces.
 Consumer Protection Act, 1986

The Consumer Protection Act, 1986 (COPRA) is an Act of the Parliament of India
enacted in 1986 to protect the interests of consumers in India. It is replaced by The
Consumer Protection Act, 2019.
This statute is regarded as the 'Magna Carta' in the field of consumer protection for
checking unfair trade practices, ‘defects in goods’ and ‘deficiencies in services’ as far
as India is concerned. It has significantly impacted how businesses approach
consumer complaints and has empowered consumers to a greater extent.
The objective of the Central Council is to promote and to protect the rights of the
consumers such as:
▪ The right to be protected against the marketing of goods and services which are
hazardous to life and property.
▪ The right to be informed about the quality, quantity, potency, purity, standard and
price of goods or services, as the case may be so as to protect the consumer against
unfair trade practices.
▪ The right to be assured, wherever possible, access to a variety of goods and services
at competitive prices.
▪ The right to consumer education.
AYURVEDA LIBRARY
 International Code of Medical Ethics
A) Refer to Chapter XIII, WMA International Code of Medical Ethics
B) Declaration of Geneva; The Physician’s Pledge / Oath
The Physician’s Pledge
AS A MEMBER OF THE MEDICAL PROFESSION:
I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
I WILL RESPECT the autonomy and dignity of my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin,
gender, nationality, political affiliation, race, sexual orientation, social standing or any other
factor to intervene between my duty and my patient;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL PRACTISE my profession with conscience and dignity and in accordance with good
medical practice;
I WILL FOSTER the honour and noble traditions of the medical profession;
I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their
due;
I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of
healthcare;
I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the
highest standard;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even
under threat;
I MAKE THESE PROMISES solemnly, freely, and upon my honour.
AYURVEDA LIBRARY

Ayurveda Library's Guide to Vyavahara Ayurveda

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Ayurveda Library's Guide to Vyavahara Ayurveda

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अगदतन्त्र

- According to Acharya Manu, winning of justice during prosecution in the

- ‘Vyavahara Ayurveda’ is a coined term to imply the meaning of

 History of Vyavahara Ayurveda & Vidhivaidyaka

i) Vedas: - (2000-1000 B.C.)

ii) Kautilya Arthashastra: (300 B.C.)

 Indian Penal Code (IPC)

 Indian Evidence Act

 Criminal Procedure Code (CrPC)

- Section 53: Examination of accused by medical practitioner at the request of

- Section 53A: Examination of person accused of rape by medical practitioner

c) The Sessions Court – it is located in each head-quarter of a district and is therefore

d) The Courts presided over by Magistrates:

Important Factors for the Establishment of Identification:

Data for Identification Example

▪ Height & weight:

TEETH TEMPORARY PERMANENT

▪ Examination of lower jaw:

▪ Stage of ossification of bones & epiphysio-diaphyseal union of long bones:

Medico-legal importance of age

viii) Foot prints

b) Acquired: Surgical wounds, amputations, mal-united fractures, filling of teeth

xii) Miscellaneous data

- Forensic dentistry is the proper handling, examination and evaluation of dental

- DNA profiling is a forensic technique in criminal investigations, comparing criminal

Modes of Death (Prakara):

Signs of Death (Mrityu-Chihna):

c) Absolute cessation of respiration for more than 5 minutes.

2) Early signs of Death:

b) Changes in the skin:

c) Loss of temperature and cooling of body:

d) Post-mortem (P.M.) stain:

-> Cadaveric Spam:

-> Cadaveric changes in muscles:

b) Rigor mortis (Latin: rigor "stiffness", mortis "of death"),

ii) Bacterial action:

▪ Warmth or cooling of the body

▪ Post-mortem (P.M.) stain

▪ Rigor mortis (Latin: rigor "stiffness", mortis "of death")

▪ Saponification & Mummification give information about approximate time of death.

▪ Stomach is removed after applying double ligatures at each end.

▪ Intestines are removed after tying both ends.

▪ Heart is removed and examined by opening in the direction of blood flow.

▪ Stomach & intestines are openly placed in one bottle.

▪ It is done under order of appropriate officers, in the presence of a police officer.

i) विन्न (Cut wound)

- An injury is also defined as:

- Nature of injury, site of impact and direction of force can be identified.

- Lacerations may be homicidal, suicidal, accidental or may be inflicted by

- An incised wound can be caused by three ways:

- Stab wounds may be homicidal, suicidal, accidental or may be inflicted by

- Firearm wounds may be homicidal, suicidal, accidental or may be inflicted by

Types of thermal injuries: - 6

Wilson’s simplified classification: - 3

Prohibitions & Laws:

IPC Section 304b

IPC Section 498a

CrPC section 174(3)

Asphyxia is the condition when the body is deprived of oxygen, leading to

ii) Stage of expiratory dyspnoea & convulsions

iii) Stage of exhaustion & respiratory failure

Types of violent asphyxial deaths: