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FORENSIC MEDICINE
 Law- defined as a rule of conduct, just and obligatory, land down by legitimate authority for the
common observance and benefit.
 Medicine - A science and art of dealing with prevention, cure and alleviation of disease. It is that part
of science and art of restoring and preserving health.
 Legal- Refers to anything conformable to the letters or rules of law as it is administered by the court.
 Jurisprudence - A science of giving wise interpretation of the Laws.
 Legal Medicine - is that branch of medicine which deals with the application of medical knowledge to
the purposes of law and in the administration of justice.
 Forensic Medicine - use of medical science to elucidate legal problems in general without specific
reference or application to a particular case.
o It encompasses a variety of fields in forensic science such as pathology, anthropology,
odontology, toxicology, entomology, and others.
 Medical Jurisprudence - a branch of law which concerns with the aspects of law and legal concepts
to medical practice. It includes rights, duties, and liabilities of physician, patient and health
institution.

Medico-Legal Cases
1. Injuries or deaths involving persons who have no means of being identified.
2. Persons pronounced as “dead on arrival”
3. Death under the following circumstances:
a. Death occurring within twenty-four (24 hours) of admission when the clinical cause of death is
unknown or indeterminate:
b. Unexpected sudden death especially when the deceased was in apparent good health;
c. Death due to natural diseases but associated with physical evidence suspicious of foul play;
d. Death as a result of violence, accident, suicide or poisoning; and
e. Death due to improper or negligent act of another person’s.
4. Physical injuries caused by:
a. gunshot wound, stab wound etc.,
b. Vehicular accident;
c. Asphyxia
d. Electrocution, Chemical or thermal insult;
e. Accident, Attempted homicide or suicide; and
f. Poisoning
5. Cases of child abuse, domestic violence, rape alcoholism and drug addiction.
6. Cases involving the mental in competency of the patient.

Difference between a medical jurist and an ordinary physician

1. An ordinary physician ignores trivial injuries not needing treatment which a medical jurist records all
injuries to qualify the crime or justify the act.
2. An ordinary physician sees injury or disease to be able to treat while a medical jurist sees injury or
disease in order to find out the cause.
3. The purpose of an ordinary physician is to arrive at a definite diagnosis and institute proper treatment
while a medical jurist testifies on bodily lesion seen for justice.

Difference between Legal Medicine and Medical Jurisprudence

Legal medicine is a branch of medical Medical jurisprudence is a branch of law
science
It is a medicine applied to law and It is a law applied to the practice of medicine
administration of justice
It originates from the development of It emanates from the act of congress, executive orders,
medical science administrative circulars customs and usages and decisions of
tribunals which have relation to the practice of medicine
It is based on the principle of it is based on the principle of subordination; that is the duty of the
coordination; that legal medicine physician to obey the laws in as much as our government is
coordinate medicine to law and justice established on the principle of government of laws and not of men
and that no one is considered above the law.
The Medico-legal System

1. Medico-Legal Office System - The system used in the Philippines, which is handled by a medical
jurist who is a registered physician duly qualified to practice medicine in the Phils. The National
Bureau of Investigation and the Phil. National Police have their own medical jurist who
handles medicol-lagal cases. His duty is to examine the victim or assailant, to make report, and to
appear in court as an expert witness when summoned by the proper authorities.

2. Medical Examiner System - This is a system under the control of the Chief medical Examiner that
is a doctor of medicine and appointed by the mayor from the classified lists compiled by the
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civil service by the basis of competitive examination. The office of the chief medical examiner is on
24 hours work with clerical staff always present. His duty is to investigate the cause of death
especially violent death of the victim.

3. Coroner System - The coroner system is headed by a country coroner or borough coroner who may be
a barrister, solicitor or a legally qualified practitioner of not less than five (5) years standing in his
profession and is elected by the county council or borough council.
4. The coroner is an inquest officer whose duty is to inquire into the circumstances of certain medico-
legal deaths within his jurisdiction. Unlike the medico-legal officer or the medical examiner whose
qualifications, duties, and powers are practically the same, the coroner has investigative and judicial
functions.

Medical Evidence
 Evidence is the means, sanctioned by the Rules of the Court, of ascertaining in a judicial proceeding
the truth respecting a matter of fact

Types of Medical Evidence:

Autoptic or Real Evidence

 This is evidence made known or addressed to the senses of the court. It is not limited to that which is
known through the sense of vision but is extended to what the sense of hearing, taste, smell, and
touch is perceived.

Limitations to the presentation of Autoptic:

 Indecency and Impropriety – Presentation of evidence may be necessary to serve the best interest of
justice but notion of decency and delicacy may cause inhibition of its presentation.
 Repulsive Objects to those Offensive to Sensibilities- Foul Smelling objects, persons suffering from
highly infectious and communicable disease, or objects which when touch may mean potential danger
to the life and health of the judge may not be presented.

Testimonial Evidence
 A physician may be commanded to appear before a court to give his
testimony. While in the witness stand, he is obligated to answer the question propounded by the
counsel and presiding officer of the court. His testimony must be given orally and under oath or
affirmation.
o Ordinary Witness:
 A physician: who testifies in court on matters be perceived from his patient in the course of
physician-patient relationship is considered as an ordinary witness.
o Expert Witness:
 A physician on account of his training and experience can give his opinion on a set of
medical facts. He can deduce of infer something, determine the cause of death or render
opinion pertinent to the issue and medical in nature.
o Experimental Evidence:
 A medical witness may be allowed by the court to confirm his allegation or as a
corroborated proof to an opinion he previously stated.

Documentary Evidence: A document is an instrument on which is recorded by means of letters, figures or

marks intended to be used for purpose of recording that matter which may be evidentially used. The term
applies to writings, to words printed, lithographed or photographed; to seals, plates or stones on which
inscriptions are cut or engraved; to photographs and pictures; to maps or plans.

Physical Evidence: These are articles and materials which are found in connection with the investigation and
which aid in establishing the identity of the perpetrator or the circumstances under which the crime was
committed, or in general assist in the prosecution of a criminal.

Types of Physical Evidences:

a. Corpus Delicti Evidence - Objects or substance which may be a part of the body of the crime.
b. Associative Evidence - These are physical evidences which link a suspect to the crime.
c. Tracing Evidence - These are physical evidences which may assist the investigator in locating the
suspect.

MEDICO-LEGAL ASPECTS OF IDENTIFICATION

Law of Municipality of Evidence (is true in the case of identification.)

 The greater the number of similarities or dissimilarities, the greater is the probability for the
conclusion to be correct.
 The value of the different points of identification varies in the formulation of conclusion.
 The longer the interval between the death and the examination of the remains for purposes of
identification, the greater is the need for experts in establishing identity.
 It is necessary for the team to act in the shortest possible time especially in cases of mass disaster.
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 There is no rigid rule to be observed in the procedure of identification of persons.

Importance of Identification of Persons:

1. In Criminal case, the identity of the offender and that of the victim must be established; otherwise it
will be a ground for the dismissal of the charge or acquittal of the accused.
2. Identification of missing person or presumed dead will facilitate settlement of the estate, retirement,
insurance and other social benefits. It vests on the heirs the right over the properties of the identified
person.
3. Identification resolves the anxiety of the next-of-kin, other relatives and friends as to the whereabouts
of a missing person or victim of calamity or crime.
4. Identification may be needed in some transaction, like cashing of check, entering a premise, delivery of
parcels or registered mail in post office, sale of property, release of dead bodies to relatives, parties to a
contract, etc.

Methods of Identification:
1. By comparison – with the used of standard specimen, evidence under question can be compared in
order to effect identification.
2. By exclusion - is two or more persons have to be identified and all but one is not yet identified, then
the one whose identity has not been established may be known by the process of elimination.

Ordinary methods of Identification

 Points of Identification applicable to the living only:

o Characteristic that may easily be changed:
 Growth of chair, beard or mustache
 Clothing
 Frequent place of Visit
 Grade of profession
 Body ornamentation

o Characteristic that may not easily be changed:

 Mental memory
 Speech
 Gait a manner of walking or moving on food (Webster dic.)
1. Ataxic Gait- a gait which the foot is raised high, thrown forward and brought down
suddenly.
2. Cerebellar gait- a gait associated with staggering movement.
3. Cow’s Gait- a swaying movement due to knock-knee.
4. Paretic gait- a gait in which the steps are short, the feet dragged, the legs held more
or less widely apart.
5. Spastic gait- a gait in which the legs are held together and move in stiff manner, and
the toes to drag and catch.
6. Waddling gait- a gait resembling duck
7. Frog gait- a hoping gait in infantile paralysis.

 Points of identification applicable to both living and dead before onset of decomposition:
o Occupational Marks
o Race - In the living, race may be presumed on:
 Color of the skin
 Caucasians- fair
 Malayans- brown
 Negroes- Black
o feature of face:
o Caucasian - prominent sharp nose
o Malayan - flat nose with round face
o Mongolian - almond eyes such and prominent cheek bones.
o Negroes - thick spreading lips
o Shape of Skull
o Red Indians - Flat head
o Malayan - Round head

 Stature (height) - Methods of approximating the height of a person

o Measure the distance between the height of a person fingers of both hands with the arms
extended laterally and it will be equal to the height of the person.
o Two times the length of one arm plus 12 inches for the clavicle and 1.5inches for the
sternum is the approximate height.
o Two times the length from the vertex of the skull to the public symphyses.
 The distance from the sternal netch and the public symphyses is about one-hand of the
height.
 The distance from the base of the skull to the coccyx is about 44% of the height.
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 Teeth - The following points must be considered in the study of the teeth for
identification process:
o Determine whether it is temporary or permanent set;
o Number of teeth present;
o Number of teeth lost, including evidence of length of time lost;
o Nature of the teeth present, whether reverse, crooked, mal-aligned or straight;
o Condition of those present, whether carious, colored, presence of cavities, erosion, filling and
cleanliness;
o Presence of supernumerary teeth;
o Odontoid gum; and
o Extraction, dental fitting, permanent bridge work, fitting of crown and filling cavities.
 The most convenient way of identifying a person by means of the teeth is the use of
dental diagram or chart.

 Tattoo marks - Importance of Tattoo marks

o It may help in the identification of the person
o It may indicate memorable events in his life
o It may indicate the coial stratum to which the person belongs
o It implies previous commitment in prison or membership in a gang

Methods of Tattoo Removal

A. Excision = involves an injection of a local anesthetic to numb the area after which the tattoo is
removed surgically. The edges are then brought together and sutured.
B. Dermabrasion = a small portion of the tattoo is sprayed with a solution that freezes the area.
The tattoo is then “sanded” with rotary abrasive instrument causing the skin to peel. Because
some bleeding is likely to occur, a dressing is immediately applied to the area.
C. Laser = Laser surgery is considered to be one of the best methods of tattoo removal. The Q-
switched Nd: Yag, Q-switched Alexandrite and the Q-switched Ruby are among the most
frequently used lasers. If necessary, a cream to numb the skin can be applied prior to the
treatment. Pulse of light from the laser is directed unto the tattoo breaking up the tattoo
pigment. Over the next several weeks the body’s scavenger cells remove the treated pigmented
areas. More than one treatment is usually necessary to remove the entire tattoo.
D. Salabrasion = a centuries old procedure using local anesthetic applied around the tattoo area
after which a solution of ordinary tap water dipped in table salt is applied and an abrading
apparatus such as the one used in dermabrasion or even a simpler device is used such as a
wooden block wrapped in gauze.

 Deformities
 Birth marks
 Injuries leaving permanent result
 Moles
 Scars - they are composed of fibrous tissues which take the place of the original tissues
which have been injured or destroyed. They are devoid of specialized tissue so they do not contain
pigment layers, sweat or sebaceous glands.
a. Recent scars of two to three weeks old are vascular with red or pink color.
b. Contracted bloodless scars with white and glistering surfaces are usually more than six
months old;
c. Scars resulting from superficial wounds and from wounds healing by first intention develop
earlier.

SOME SCARS MAY SHOW CHARACTERISTICS APPEARANCE SUCH AS:

A. Surgical Operation = regular form and location with stitch marks.
B. Burns and sealds = scars are large, irregular in shape and may be keloid.
C. Gunshot wounds = disc like with depressed center. They may be adherent to the underlying
tissues.
D. Tuberculous sinus = irregular in shape, furrowed, with edges hardened and uneven.
E. Gumma = depressed scar following loss of tissue
F. Venesection = located at bend of elbow, dorsum of feet, or at the temporal region.
G. Lupus = bluish –white scar
H. Wet cupping = short parallel scars on the lower part of the back and loin.

 Tribal marks - A common practice of some tribes in Africa is to place some marks on the
exposed parts of the body.
 Sexual organs - Circumcision may help in identification. The uterus and breast may
indicate previous pregnancy. The best evidence of sexuality is the presence of Testes in Male and
Ovaries in the Female.
 Blood examination ( ABO grouping and MN typing)
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Extrinsic Factors in Identification:

1. Identification of ornamental wearing apparel
2. Personal Belongings
3. Clothing’s
4. Dust
5. Identification by close friend
6. Criminal Records
7. Photograph

Methods of Identification
1. Portrait Parle (Personal description) “speaking likeness”
Is a verbal, accurate and picturesque description of the person identified?
2. Photography
3. Anthropometry (Bertillion System)
 A system of identification based on the measurements of the various bony structure of the
human body came to be known when it was introduced in the police department in Paris,
France in 1882 by Alphonse Bertillon.
Bases of the Bertillon’s method of identification
a. Human skeleton does not change after 20 years.
b. It is impossible for two human beings to have bones alike.
c. Measurement easily taken with the aid of simple instrument.

West case:
In 1903, Will West arrived at the US Penitentiary at the Leavenworth, Kansas. While West was being
processed in through identification, a staff member said that there was already a photograph and
Bertillon measurement for him on the file. But a comparison on fingerprints showed that despite
identical appearances and nearly identical Bertillon measurements, the identification card on file
belonged to a William West, who had been in Leavenworth since 1901.
4. Fingerprint Identification
5. Handwriting Identification
6. Blood Grouping and Blood Typing
7. DNA Testing (Deoxyribonucleic acid) (A-adenine, C- cytosine, T- thymine, and G- guanine Sequence)

LIGHT AS A FACTOR IN IDENTIFICATION

Clearest moonlight or starlight - experiments have shown that the best known person cannot be recognized
under the clearest moonlight at a distance greater than 16 to 17 yards and by Starlight any further than
10 to 13 yards.
 Broad Daylight - a person can hardly recognized another person at a distance further than 100
yards if the person has never been seen before; but person who are almost stranger may be recognized
at a distance of 25 yards.
 Flash of Firearm - Although by experiment by experiment letters of two inches high can be read with
the aid of the flash of a caliber.22 firearm at a distance of two (2) feet it is hardly possible for a
witness to see the assailant in case of a holdup or a murder because:
a. Usually the assailant is hidden
b. The assault is unexpected and the intention of the person or witness is at its minimum.
 The flash of Lighting - produces sufficient light from the identification of individual provided that the
person’s eye is focused towards the individual he wishes to identify during the flash.
 In case of artificial light. The identification is relative to the kind and intensity of the light.

IDENTIFICATION OF THE SKELETON

Following points can be determined

 Whether the remains are of human origin or not.

o oval or round shape of the skull
o less prominent lower jaw and nasal bone

 Whether the remains come from a single individual or not

o Complete layout of the bones on a table in their exact locations in the human body is necessary.
o Any plurality denotes that the remains belong to more than one (1) person.

Height - Determination of the Sex of the skeleton

 the following bones must be studied
o pelvis
o skull
o sternum
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o femur
o humerous

DETERMINATION OF AGE - Legal Importance of Age Determination

1. For Identification
2. To Determine Criminal Liability
3. For Right of Suffrage or in the exercise of other political rights
4. For the exercise of civil rights
5. Determination of the capacity to contract marriage
6. Age is a factor by which the crime of rape is committed
7. The crime of infanticide can only be committed when the child killed is less than three days old.
8. Seduction is committed on a woman over twelve and under eighteen years of age

Determination of Age of the Fetus:

 For fetus less than 25 cm. Long - Find the square root of the length in centimeters and the result is
the age of the fetus in month.
 For fetus 25 cm. Long or more - Divide the length of the fetus in centimeters by 5, and the result will
be the age in months.

(Age as referred in this rule is lunar month, not calendar month. One lunar month is equivalent to 28
days)

Nature of the Intra-uterine product of conception corresponding to the age in months:

1 month - The Ovum is about 1.0 cm with limb buds only present.
2 months The ovum has a length of 2.5cm with an embryo about 1.0cm long with head, ears
and hands well formed.
3 months The length is 9.0 cm. With nails beginning to appear and the placenta can be
differentiated.
4 months The length is 16.0 cm. And the sex can be differentiated, with the fingers beginning to
open and hair beginning to appear on the head.
5 months Fetus processes hair on the head and Lanugo over body surfaces. Nails are distinct.
Skin shows sebaceous secretion. Dental gum appears at the mandible.
6 months Fetus weighs 2.5 kg. Lanugo and vernix present in the skin are dark and wrinkled.
Meconium is present in the small intestine and at the beginning of the large intestine.
Brain shows convolutions. The testis is found in the abdominal cavity. Hair of eyebrow
and eye-lashes begin to appear.
7 months The body is dark red and plump, with hair on the scalp. The testis begins to descend
towards the scrotum.
8 months Fetus has rosy skin, and nails reach the end of the finger-tips. Convolutions of the
brain are more distinct. Second piece of sternum ossified Papillary membrane
disappears.
9 months Brain convolutions reach the gray matter. The scrotum is occupied by the testis. The
body surface is now pale. Sebaceous secretion is formed at the flexures of joints. Nails
fully formed and developed.

Medico-Legal Aspects of Death

 Life – is the sum total of all vital processes by which the physical integrity of the body is maintained.
 Death- is the state of complete persistent cessation of the vital function of the body such as the
function of the heart, the lings and the brain.

Importance of Death Determination

1. The civil personality of a natural person is extinguished by death;
2. The civil personality is extinguished by death. The effect of death upon the rights and obligations of
the deceased is determined by law, by contract and by will.
3. The property of a person is transmitted to his heirs at the time of death.
4. The death of a partner is one of the causes of dissolution of partnership agreement.
5. The death of either the principal or agent is a mode of extinguishments of agency
6. The criminal liability of a person is extinguished by death.
7. The civil case for claims which does not survive is dismissed upon death of the defendant.

Kinds of Death
1. Clinical Death or Somatic Death - Is a type of death usually declare by members of the immediate
family of the diseased or by the physician. Immediate signs of the in a person are; Sudden cessation of
the upward and downward movement of the chest in the process of respiration (10-15 minutes),
sudden pale color of the faces and lips, pulse and heart beat stops, the jaw or head drops down
and flaccidity of muscles occur; presence of dilated pupil as well as loss of corneal and light
reflexes. Clinical types of death can either be: Sociologic, Psychic, Biologic or Physiologic.
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2. Molecular or Cellular Death - Is the type of death characterized by death of individual cells (one at a
time) after the somatic death. The nerve cells and brain cells die earlier at about 5 minutes due to
loss of food and oxygen while the muscles live longer until the onset of the rigor mortis which about two
to three hours after death.

3. Apparent Death/ State of Suspended Animation - A transient loss of consciousness of temporary

cessation of the vital function of the body on account of disease, external stimulus other forms of
influence.

Signs of Death
 Cessation of Respiration - Cessation of respiration in order to be considered as a sign of death must
be continuous and persistent. A person can hold his breath for a period of no longer than 3 – ½
minutes. In case of electrical shock, respiration may cease for some time but maybe restored by
continuous artificial respiration.
 Irregular Types of Respiration
o Cheyenne-Strokes respiration – interval is about fifteen to thirty seconds
o In drowning and electric shock
o In new born infants
o In the voluntary act of respiratory suspension.

Methods of Detecting Cessation of Respiration:

1. Expose the chest and abdomen and observe the movement during inspiration and expiration.
2. Examine the person with the aid of stethoscope which is placed at the base of the anterior
aspects of the neck and hear sound of the current of air passing through the trachea during
each phase of respiration.
3. Examination with a Mirror
4. Examination with a Feather or Cotton Fibers
5. Examination with a glass of water
6. Winslow’s test

 Cessation of Heart and Circulation - There must be an entire and continuous cessation of the heart
action and flow of blood in the whole vascular system,. A temporary suspension of the heart action is
still compatible with life. The length of time the heart may cease to function and life is still maintained
depends upon the length of time it is readily reestablished and upon the oxygenation of blood at the
time of the suspension. As a general rule, if there is no heart action for a period of five minutes death
is regarded as certain.

Cooling of the body (ALGOR MORTIS)

 After death the metabolic process inside the body ceases. No more heat is produced but the body loses
slowly its temperature by evaporation or by conduction to the surrounding atmosphere. The
progressive fall of the body temperature is one of the most prominent signs of death.
 Gradual decreasing of the body temperature until such time it assumes the temperature of the
environment which is faster during the first two (2) hours after death and slower during the next 6 to 9
hours and equal to the environmental temperature beyond 12 hours.
 The fall of temperature of 15 to 20 degrees Fahrenheit is considered s a certain sign of death.

Post Mortem Caloricity is the rise of temperature of the body after death due to rapid and early putrefactive
changes or some internal changes. It is usually observed in the first two hours of death. Occur in the
following condition:
a. Cholera
b. Tetanus
c. Small pox
d. Peritonitis

Insensibility of the body and loss of power to move - No kind of stimulus is capable to letting the body
have voluntary movement.

Changes in the Eyes

1. Loss of Corneal and light reflexes
2. Haziness of the cornea
3. Flaccidity of the eyeball
4. Finding inside the eye. (Ophthalmoscopy finding)

F. Changes in skin
1. Change of color
2. Loss of the elasticity of the skin
3. Opacity of the skin
4. Absence of reaction to injury
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CHANGES OF THE BODY AFTER DEATH

1. Primary Flaccidity (period of the muscle irritability)

 muscles are relaxed and capable of contracting when stimulated
 Pupil are dilated, incontinence of urination and defection.
 Lasts 3- 6 hours after death.

2. Stage of Post Mortem Rigidity (Rigor Mortis)

 3-6 hours after death and may last 24 to 36 hours
 body becomes rigid due to contraction of the muscles

 Conditions Simulating Rigor Mortis

o Heat Stiffening
 body is exposed to temperature above 77 degree Celsius
 Pugilistic attitude
 More or less permanent
o Cold Stiffening
 Due to solidification of fat when the body is exposed to freezing temperature.
3. Cadaveric Spasm or Instantaneous rigor.
 Rigidity of the muscles which occurs at the moment of death due to nervous tension, exhaustion and
injury to the nervous system.

DISTINCTION BETWEEN RIGOR MORTIS AND CADAVERIC SPASM

Rigor Mortis Cadaveric spasm
Time of Appearance 3- 6 hours after death Immediately after death
Occurance Natural May or may not appear
Medico-legal significance Time of death Cause of death
Muscle Involved All the muscles Certain muscle, asymmetric

4. Stages of Secondary Flaccidity or secondary relaxation

 due to the dissolution of the muscles protein
 onset of putrefaction
 The body becomes limp again and the muscles are no longer capable of responding to
mechanical or electrical stimulus.
 Noted about 48 hours after death

CHANGES IN THE BLOOD

 Coagulation of the blood - The stasis of the blood due to the cessation of circulation enhances the
coagulation of blood inside the blood vessel. Blood clothing is accelerated in cases of death by
infectious fevers and delayed in cases of asphyxia, poisoning by opium, hydraocyanic acid or carbon
monoxide poisoning.
 Blood may remain fluid inside the blood vessel after death for 6 to 8 hours.

Distinction between Ante-Mortem from Post-Mortem Clot:

Ante-Mortem Clot Post-mortem Clot
1. Firm 1. Soft in consistency.
in consistency 2. Surface of the blood vessels smooth and
2. Surface of the blood vessel raw after the healthy after the clots are removed.
clots are removed. 3. Clots can be stripped off in layers.
3. Clots homogenous in construction so it 4. Clot with distinct color
cannot be stripped into layers.
4. Clot with uniform color.

POST MORTEM LIVIDITY

 It is the discoloration of the body after death when the blood tens to pool in the blood vessels for
the most dependent portion to the pool in the blood vessels for the most dependent portion of the body.
 The blood remains fluid in the body after for 6-8 hours and gradually clot until it is fully
developed at about 12 hours, The appearance of Post Mortem lividity usually stars about 20-30
minutes after death, thus, it can also be a means in approximating the time of death of the person.
 But is more useful in determining the position of the body after death.
 The discoloration of the bloody may varies in color.
 Usually it is dull-red or Reddish-purple with some bluish-black petichiae due to rupture of small
engored capillaries.
 In carbon monoxide and cyanide poisoning as well as exposure to cold temperature, the color is
pink while lead color asphyxia. Although the color will become darker and permanent as it completes.
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Stages of Lividity or Livor Mortis

 Hypostactic Lividity - It is the lividity when the discoloration is due to the blood pooled in the
most dependent areas of the body.
 Diffusion Lividity - It is a fixed or permanent discoloration when the blood clotted, inside the
blood vessels or has diffused to different parts of the body.

Importance of Cadaveric Lividity

 It is one of the signs of death
 It may determine the position of the body after death or whether it was changes after its
appearance in the body.
 The color of the lividity may indicate the cause of death (e.g. Asphyxia – dark CO poisoning –
bright pink)

It gives us an idea as to the time of death.

Points to be considered which may infer the position of the body at the time of death:
1. Posture of the body when found
2. The body may become rigid in the position in which he died. Post-mortem lividity may develop in the
assumed position.
3. Post-mortem hypostasis
4. Hypostatic lividity will be found in areas of the body in contact with the surface where the body lies.
5. Cadaveric Spasm
6. In violent death, the attitude of the body may infer position on account of the spasm of the muscles. E.g.
In drowning the victim may be holding the seaweeds.

POST- MORTEM DECOMPOSITION

1. Autolysis or autodigestive changes after death
 After death, proteolytic glycolytic and lipolytic ferments of glandular tissues continue to act
which lead to the autodigestion of organs. This is facilitated by weak acid and higher
temperature.
 This is also seen in the maceration of the dead fetus inside the uterus. The stomach may be
perforated, glandular tissues become soft after death due to auto digestion and the action of
autolytic enzymes.
 decomposition by enzymes

2. Putrefaction
 It is the breaking down of the complex protein into simpler components associated with the
evolution of foul smelling gases and accompanied by the change of color of the body.
 decomposition by bacteria
 noted after 48 hours after death
 first appears as a greenish discoloration
 Generalized swelling and reddish discoloration along the lines of the superficial veins occur:
called Marbling.

Principal changes undergone by the soft tissues of the body during putrefaction:

a. Changes in the Color of the Tissue

a. A few hours after death, there is hemolysis of the blood within the blood vessel and as a result of
which hemoglobin is liberated. The hemoglobin diffuses through the walls of the blood vessels
and stains the surrounding tissues thereby imparting a reddish-brown color.
b. Tissue color gradually changed to greenish-yellow, greenish brown or greenish black color due to
chemical changes in hemoglobin.
b. Evolution of gases in the Tissues
a. Carbon dioxide, ammonia, hydrogen, sulphureted hydrogen, phosphoretted hydrogen, and
methane gases are formed. The offensive odor is due to these gases and also due to a small
quantity of mercaptans.
b. The formation of gases causes the distention of the abdomen and bloating of the whole body.
Gases formed in the subcutaneous tissues and in the face and neck cause swelling of the
whole body. Small gas bubbles are found in solid visceral organs and give rise to the “foamy”
appearance of the organs.

Effects of the pressure of gases of Putrefaction:

1. Displacement of the Blood
2. Bloating of the Body
3. Fluid Coming Out of Both Nostrils and Mouth
4. Extrusion of the Fetus in a Gravid Uterus
5. Floating of the Body
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c. Liquefaction of the Soft Tissues

a. As decomposition progresses, the soft tissues of the body undergo softening and liquefaction.
The eyeballs, brain, stomach, intestine, liver and spleen putrefy rapidly while highly muscular
organs and tissues relatively putrefy late.

Factors Affecting rate of Purification

I. Internal Factors
o Age
o Cause of Death
o Condition of the body

II. External Factors

o Air and Moisture
o Condition and type of Soil
o Presence of Water
o Effect of Clothing
o Effect of Coffin
o Depth of Burial
o Mass Grave

Special forms of Putrefaction

1. Mummification- a condition at which the body fluids are removed before decomposition sets in
resulting to shrunkening and preservation of the dead body. Mummification can be either natural of
artificial (embalming). Natural for the forces of nature such as sunlight, warm climate and hot dry soil
influence the dead body. Artificial when the preservation is done with the introduction of some
chemical like formalin, alcohol, phenol, mercury, arsenic and glycerine and covering the skin with the
Vaseling or Plaster of Paris before decomposition sets in.

2. Saponification (Adipocere formation) - is the formation of a soft, friable and brownish- white greasy
substance in the soft fatty tissues of the body after death. This substance is called ADIPOCERE that is
formed by hydrogenation of the body fats. It can be possibly being seen in the buttocks, trunk, limbs,
breast and cheeks. It prevents or delays the putrefaction of the body.

3. Maceration- It is a condition of the dead body, usually the fetus, characterized by the softening and
discoloration of the tissues as well as formation of blisters in the skin due to the action of autolytic or
proteolytic enzymes in the absence of utero is important in the consideration of legal live-birth which
shows evidence of maceration by the following manifestations: 1) Reddish green to reddish-brown
discoloration of skin; 2) Softness and limpness of the body; and 3) Blebs formation and separation of
the epidermis from the underlying tissues.

Classification of Death

1. Medico-legal classification of Death:

a. Natural Death- Due to disease or ailment.
b. Violent Death- Due to injuries of some outside force
c. Accident Death- Art 12, Par 4, RPC
d. Negligent Death
e. Infanticidal Death
f. Parricidal Death- Art 247, RPC
g. Homicidal Death- Art. 249, RPC’
h. Murder- Art 248, RPC
i. Euthanasia ( mercy Killing )
j. Suicidal Death- Art. 253, RPC

2. Pathological Classification
a. Death of Syncope (loos of consciousness, fall of blood pressure, Cardiac Standstill, cerebral
metabolism, hyperventilation, cardiac disease, Tussive Syncope Hysterical syncope
b. Death of Asphyxia (Respiratory Obstruction and Circulatory Arrest, Inhalation of obnoxious
gases fumes, drowning and electric shock, Compression of the neck and strangulation,
Compression of the chest and asphyxia in brain injury)
c. Death of Coma (Is a profound stupor in sickness or after severe injury)

DEATH BY ASPHYXIA
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 A condition resulting from a lack of oxygen in the air or from an obstructing mechanism to respiration.
 The general term applied to all forms of violent death which results primary from the interference with
the process of respiration or the condition in which the supply of oxygen to the blood or to the tissues
or both has been reduced below normal level.

TYPES OF MECHANICAL ASPHYXIA

 STRANGULATION (THROTTLING) may be with the use of hands or a ligature (such as rope)
 SMOTHERING OR SUFFOCATION occurs when entrance of air through the nose and mouth is
blocked or severely restricted.
 HANGING the neck is tied while the body is suspended common from suicide
 CHOKING there is blocking of the internal airway by a foreign object inside or outside of the victim’s
body.
 CRUSH OR TRAUMATIC ASPHYXIA brought about by the mechanical compression of the chest by
some heavy object
 DROWNING

Death as Punishment
1. Death by Lethal Injection
2. Death by Electrocution (used of about 2,00 to 5,000 voltages)
3. Death by Gas chamber
4. Death by hanging
5. Death by Musketry

AUTOPSY
 a comprehensive study of a dead body performed by trained physician
using recognized dissection procedures and techniques, primary to determine the true cause of death
 Indicates that, in addition to an external examination, the body is opened
and internal examination is conducted.

POST MORTEM EXAMINATION

 Refers to an external examination of a dead body without incision being made, although blood and
other fluids may be collected for examination.

KINDS OF AUTOPSIES

1. HOSPITAL OR NON-OFFICIAL done on a human body with the consent of the deceased person’s
relatives for the purpose of:
a. determining the cause of death
b. providing correlation of clinical diagnosis and clinical symptoms
c. determining the effectiveness of therapy
d. studying the natural course of disease process
e. Educating students and physicians.

2. MEDICO LEGAL OR OFFICIAL an examination performed on a dead body purpose of:

a. determining the cause, manner or mode and time of death
b. recovering, identifying and preserving evidentiary material
c. providing correlation of facts and circumstances related to death
d. providing a factual, objective medical report for law enforcement, prosecution and defense
agencies
e. Separating death due to disease from death due to external cause for protection of the innocent.

NEGATIVE AUTOPSY
 an autopsy which failed to establish cause of death after all efforts have
been exhausted
 An autopsy which after a meticulous examination with the aid of other
examination does not yield any definite cause of death.

NEGLIGENT AUTOPSY
 An autopsy wherein no cause of death is found on account of imprudence, negligence, lack of skill and
lack of foresight of the examiner.

Method of Disposal of the Dead Body

1. Embalming- Artificial Mummification

2. Burial- Inhumation or Interment
a. Is a method of placing the dead body in the grave?
b. Funeral- it is the procession of the dead body followed by grieving relatives, friends and
other persons to the place of burial in accordance with the religion, custom and
traditions.
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c. Persons in-charge; The Spouse (if married), The descendant of the nearest degree and
brother and sisters.

3. Cremation- Is the burning of the dead body into ashes or pulverization of the body into ashes by
the application of heat or flames. Requirement: permit for cremation, exact identification of the
deceased and exact cause of death has been ascertained.
4. Disposal of the dead body to the Sea.
5. Use of the Dead body for Scientific Purpose.
a. Exhumation- It is the raising or disinterring of the Dead body or remains from the grave.

EXHUMANTION (DESINTERRING)
 refers to the taking out of a body from its tomb or gravesite
 Can be done only upon a lawful order, with permission from the Department of Health.
 Remains of persons who died of non- dangerous, non-communicate diseases may be disinterred after
three (3) years.
 Remains of persons who died of dangerous communicable diseases may be disinterred after five (5)
years.

Physical Injury
 Injury- Is the scientific impairment of the body structure or function caused by outside force or
agent.
 Physical Injury- is an injury of the body caused by physical agents which is the application of
stimulus to the body producing damage or injury to the tissue.
 Wound - is a break or solution in the continuity of the skin or tissues of the body.
 Inflammation- Is a specific tissue response to injury by the living or inanimate agents, or to
electrical, chemical etc., characterized by vascular dilatation, fluid exudation and accumulation of
leukocytes in the tissues.

Classification of Wound or Physical injury

A. As to Severity
a. Mortal Wound
b. Non-Mortal Wound

B. As to Kind Instrument used

a. Blunt instrument – lacerated
b. Sharp-edge instrument – incised
c. Sharp-pointed instrument – punctured
d. Sharp-Edge and Sharp-Pointed – stab
e. Rough object – abrasion

C. As to Manner of Infliction
D. As to the depth of the Wound
E. As to the relation of the site of application of force and injury
a. Coup Injury- Injury at the side of application.
b. Contre coup- injury found opposite the side of application.
c. Coup Contre Coup- injury both at the side and opposite side of application.
d. Locus Minoris Resistencia- Injury is found on some area offering the least resistance to the
force applied.
e. Extensive Injury- involves a greater area of damage.

F. Medico-legal Classification
a. Mutilation
b. Slight Physical Injury (1-9 days)
c. Less Serious Physical Injury (10-30days)
d. Serious Physical Injury (more than 30 days)
e. Administration of injurious substance or beverages.

G. As to the type of the Wound

a. Closed Wound - superficial Closed wound and deep closed wound, petechiae, contusion or
bruise, hematoma or blood cyst, sprain, fracture, discoloration, Concussion, and Internal
Hemorrhage

b. Open Wound - Incised, Lacerated, Punctured, Stab Wound, Avulsion, and Gunshot and shotgun
Wound.

SEXUAL OFFENSES AND DEVIATION

Virginity = a condition of a female who has not experienced sexual intercourse and whose genital organs
have not been altered by carnal correction.
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Kinds of Virginity
1. MORAL VIRGINITY - state of not knowing the nature of sexual life and not having
experienced sexual relation.
2. PHYSICAL VIRGINITY - a condition whereby a woman is conscious of the nature of the
sexual life but not experienced sexual intercourse. Applies to women who have reached sexual
maturity but not experienced sexual intercourse.
3. DEMI-VIRGINITY - a condition of a woman who permits any form of sexual liberties as long
as they abstain from rupturing the hymen by sexual act.
4. VIRGO INTACTA - applied to women who have had previous sexual act but not yet given
birth.

DEFLORATION - the laceration or rupture of the hymen as a result of sexual intercourse.

SEXUAL DEVIATIONS
1. HOMOSEXUALITY - sexual desire towards the same sex.
2. INFANTOSEXUALITY - sexual desire towards an immature person. Also known as PEDOPHILIA.
3. BESTOSEXUAL - sexual desire towards animals; also known as bestiality.
4. AUTOSEXUALITY - self –gratification; also known as masturbation.
5. GERONTOPHILIA- sexual desire towards an older person.
6. NECROPHILIA - a sexual perversion characterized by erotic desire or actual sexual intercourse with a
corpse.
7. INCEST - sexual relations between people who, by reason of blood relationship cannot legally marry.
8. SATYRIASIS - excessive sexual urge of men.
9. NYMPHOMANIA - excessive sexual urge of women.
10. FELATTIO - the female agent receives the penis of a man into her mouth and by friction with the lips
and tongue coupled with the act of sucking initiates orgasm.
11. CUNNILINGUS - sexual gratification is attained by licking or sucking the external female genitalia.
12. ANILINGUS - a form of sexual perversion wherein a person derives sexual excitement by licking the
anus of another person of either sex.
13. COPROLARIA – saying dirty words during sexual intercourse to gratify their sexual pleasure
14. SADISM -(Active Algolagnia) = A form of sexual perversion in which the infliction of pain on another
is necessary for sexual enjoyment
15. MASOCHISM (passive Algolagnia) = A form of sexual perversion in which the infliction of pain by
another is necessary for sexual enjoyment.
16. FETISHISM - a form of sexual perversion wherein the real or fantasied presence of an object or bodily
part is necessary for sexual stimulation and gratification.
17. PYGMALIONISM - a sexual deviation whereby a person has sexual desire for statutes.
18. FROTTAGE - a form of sexual gratification characterized by the compulsive desire of a person to rub
his sex organ against some part of the body of another.
19. VOYEURISM - a form of sexual perversion characterized by a compulsion to peep to see persons
undress or perform other personal activities.