WHITE WEAPON WOUNDS: these are vehicles specially built for the offense.

In case they are

foreseenby law but it is forbidden to carry it we speak of typical sidearms (eg knives) while when they
are usable as sidearms but are not required by law we speak of atypical sidearms (eg scissors or
kitchen knives). The wounds are distinguished according to whether they are caused by the blade or by
the tip for which we will have: CUT INJURIES, POINT INJURIES, CUT AND POINT INJURIES, SLAWING
INJURIES.
CUT WOUNDS -> are solutions of continuous recurring on soft tissues, the sharp blade with edge presses
 on the skin and cuts the tissues with a pressure and sliding mechanism. The shape of the wound will be
"buttonhole" therefore linear with clear margins and clean bottom. Before continuously pressing and
forming the solution the blade it will cause a more superficial lesion called "codetta" (both at the
entrance and at the exit). On flat surfaces the the entrance tail will be shorter and deeper while the exit
tail will be long and shallow while in the curvilinear surfaces (eg wrists) will be the exact opposite.
POINT WOUNDS -> are caused by elongated circular or oval arms with a terminal tip, yes they are
divided into typical (eg. pin used in the Renaissance age to pierce the heart) and atypical (eg
screwdriver). They act with a wedge-like mechanism that reproduces the shape of the weapon up and
down.
POINT AND CUT WOUNDS -> produced by elements that have both points and edges (eg swords, knives,
daggers); there are also cases with: a rib + a thread, a tip plus a double thread, multi-cutting edges
(arrows). If we have a cutting edge and a back (typical weapon) we will have two angles: a sharp one
caused by the passage of the blade and one obtuse where the back passes (not sharp). If the weapon is
multi-edged, the wire will be reproduced by mold of the weapon.
SLAW INJURIES -> these are wounds inflicted by weapons with an important specific weight (eg
machete, ax) with blunt mechanism, in particular we will have wounds similar to those from cutting
(clear margins but more separated {diastased} due to the weight of the weapon) but with significant
depth and without skin sliding.

FIREARM INJURIES: they are devices capable of launching heavy bodies at a distance "Bullets" by
exploiting the thrust of the gases present in the barrel due to the explosion of heavy mixtures.
The severity of the injuries will depend on: speed of the bullet (higher speed higher shock wave higher
damage), injured region (e.g. chest). The study of the trajectory of the bullet is called ballistics, in we will
have: internal ballistics (path of the bullet inside the weapon), external ballistics (trajectory from shot up
to the body), terminal ballistics (escape of the bullet up to the actual perforation).
NB. The trajectory is conditioned by the weight of the bullet (which the air resistance will oppose) and
by the speed that the bullet takes.
There are essentially two types of firearms:
SINGLE AMMUNITION (pistols) -> are weapons that use shells formed by a cartridge case (falls and
remains near the weapon) and an ogive (part that affects the body); cause injury with a hole of entry
and usually have an exit hole (unless they have enough power). The wounds detectable penetrants are:
blind bottom, piercings, setons (entry and exit holes remain at the level of skin and subcutis), blast
wounds, spurious wounds (due to breakage of secondary elements e.g. glass of a window). Depending
on the distance at which the shot is fired, we will have wounds with different characteristics:
1. Hits at a distance (greater than 50cm) -> will cause an entrance hole with inverted edges (the skin
it tends to retract due to the elastic force), the shape of the wound will be round (if the entrance isp
erpendicular) or oval (if the entrance is oblique) we will also notice an ecchymotic or excoriatic border
typical of the hole which distinguishes it from the exit due to the hammer and wedge action of the bullet
(contusion then solution continuously with parchment and reddish edges).
 2. Close shots (less than 50cm) -> are divided into "in contact" and "near contact"; stands out: an
irregular entry hole due to the simultaneous presence of projectile and gas / dust exploded, possible
presence of a mold lesion around the wound, presence of a carriage that leaves the mark of
WERKGARTNER above the wound mouth, exit hole always present (unless it impacts a vertebra),
secondary effects of gases (burn halo, smoke halo, tattoo halo).
NB. During a shot it is distinguished: an entrance hole, a through (straight if it finds no obstacles,
curvilinear depending on the obstacle) and an exit hole that will have everted edges, no edges
(sometimes the protrusions are not seen since the body is already on the ground and the bullet stops
earlier to come out completely, it is “compressed” -> pseudo contusive hems are formed).
If you proceed with the histological examination of the tissues, the hematoxylin-eosin staining is used
and show peculiar characteristics: entrance hole -> you can see the various layers of skin unglued from
each other due to the passage of the bullet, to evaluate whether the hole is vital or not, the presence is
observed of blood. The GSR (Gun Short Residue) present only when in contact or very close are
evaluated to the shot fired. They are highlighted with particular immunohistochemical staining.

WITH BROKEN AMMUNITION (rifles) -> we are talking about cartridges formed by a rear part where
there are explosive gases and a front or plastic wad where the buckshot are present they affect the
body. Depending on the distance we will have a single hole or a group (the buckshot will tend to move
away). In case there is a single hole it will be very large and we will talk about BALL effect (between 0
and 2 meters), if the shot is exploded less than a meter away the wad is in the intracorporeal channel, if
it is greater than one meter, we will find it externally.
CHARACTERISTICS: within one meter you have the same characteristics as the shot at a short distance
seen first -> smoking halo, tattoo, etc., the way is multiple, the exit hole concerns a single dot (if they
move all together they cause collapse).
HOW DOES A BULLET WORK?
At the moment of impact on intact skin, it works with a triple mechanism: blunt effect (or a hammer) ->
hits the integument causing injuries and bruises; wedge effect -> will discontinue the integuments and
divides them in order to advance; drill effect -> the kinetic energy of the bullet whenis exploded is so
strong that it rotates on itself as it advances towards the target, this one movement also causes injury to
internal tissues and organs.
NB. The closer the projectile is, the more kinetic energy there will be, the more damage it will cause;
when the shot exploded closely GSR is evaluated -> powder residues left on the skin.

GREAT TRAUMATISMS: they are events of serious entity characterized by multiplicity, polydistrict and
 polymorphism of the lesions which almost always results in death. The most common cases for the
doctor legal are: traffic accidents, collapses, explosions, crushing, precipitation. Let us consider i
 most important cases:
 1. PRECIPITATION -> subjects subjected to falls which can be: falls to the ground (e.g. fainting
 of a person standing), falls from above (free body from variable height). The severity of the
consequences depends on several factors such as: height of the fall, nature of the impacting surface,
orientation of the body, primary or secondary impact (whether or not there is interposition of other
planes or objects before impact). It also depends on the weight of the body and its speed, as well as on
the intrinsic characteristics of the body tissues affected by the impact (hard or soft tissues). In particular,
it must be remembered that the injurious in the body's tissues it recognizes a double pathogenetic
moment: the direct impact against the impacting surface and full-body deceleration resulting in rapid
transmission of kinetic energy in different points of the body with as many potential injuries.
The body will therefore be subjected to a downward acceleration of gravity (g) equal to 9.8m / s2 with a
speed equal to v2 = 2gh. The instead, the value of the deceleration force will be G = Cv2/ d (where "C" is
a constant equal to 0.0039 and "d" represents the stopping distance after impact).
NB. Studies carried out on subjects who fell at different heights make it possible to distinguish the
incidence of injuries:  in particular it has been observed that in falls at heights of less than 12m there is a
higher incidence of injuries a load of the head, in the heights between 7 and 30 meters there are multi-
fragmented fractures while rib injuries they increase significantly for falls from 3 meters upwards.

 2. CRUSHING (crush injury) -> is the result of direct compressive forces on the body surface,
 typically present in road or rail accidents. Typical diagnostic criteria are: crush injuries, myoglobinuria /
haematuria, increased serum CK titre.
 
3. INJURIES FROM TRAFFIC ACCIDENTS -> occur precisely in the event of an accident; it is important to
frame the type of injury as it allows us to understand who the driver actually was and therefore to
understand who it falls on criminal liability, if any. The following are distinguished: driver injuries
(steering wheel and pedals with relative fractures or whiplash), injuries of the other occupants of the
vehicle (those who sit at the front usually impact the windshield while those who sit at the rear do not
have specific but very variable injuries eg. side windows o seat in front of you).

4. PEDESTRIAN INVESTMENT -> a situation that can have more or less serious connotations depending
on: dynamics of the accident, car characteristics, mass and speed of vehicles, position of the occupants
of the car. There are 5 phases in the investment of the pedestrian but they do not necessarily have to
follow each other in this order nor must all be present:
1) Collision; 2) Killing or projection (transmits the kinetic energy of the vehicle to the pedestrian that hits
the ground); 3) Loading (the body of the pedestrian is hit below the center of gravity and raised);
4) Overlapping (the vehicle overlaps the body it will have obvious crush injuries);
5) Dragging (the body gets caught on the vehicle and is dragged).
NB. The primary impact is always there, unless the body is already stretched out and there is only
overlap. In bumps atypical, the other phases do not follow the primary impact.

Generally a car hits below the center of gravity -> low injuries while a pickup truck above -> high injuries;
therefore we distinguish INJURIES: from primary impact = pedestrian who is hit and falls or is crushed
(crush injuries, figurative injuries, diaphragmatic hernias); from secondary impact = the pedestrian
comes surmounted and there are clear signs of the wheels (important to define the vitality of the
lesions); by impact tertiary = the pedestrian is loaded and we also find excoratory injuries following
contact with the mantle road or drag.
NB. A separate note deserve the injuries of motorcyclists in which the cyclist is subject to the two kinetic
forces that are collide and in the absence of protections and passenger compartment is much more
exposed to serious injuries. Mortality in cyclists is 26 times more than drivers of other cars.

BLUNT BODY INJURY:

Blunt instruments are objects with a flat surface or convex with blunt and non-cutting edges, without
edges. They can be both means of offense / defense such as hammers, sticks, metal bars etc both liquid
and gaseous media that impact at high pressure (eg. jet of water or bursting wheel). The severity of the
injuries depends on: the nature of the blunt instrument,intensity and mode of action. We therefore
speak of: superficial lesions, interstitial lesions, visceral lesions.
The blunt action modes are essentially three: compression / percussion, rubbing, traction.
In forensic medicine we are mainly interested in two things: 1. The shape of the lesion (which it could
recall the blunt instrument); 2. Understanding the vitality of the wounds (death occurring before or after
the blunt event).
Among the blunt force injuries we will have:
EXCORATIONS -> are the result of a rubbing of a tangent force that leads to de-epithelialization; the
epidermis is removed, revealing the underlying dermis. Excoriations (unlike bruises) they can also be
post-mortem phenomena, three degrees of excoriation are highlighted -> first degree layer epidermal =
yellowish color; second degree papillary dermis = clear lesion; third degree dermis reticular = red lesion.
In post-mortem lesions these stains will be much lighter.
ECCHIMOSIS -> are blunt areas characterized by a reddish or red-bluish color, indicated commonly
referred to as "bruises". Bruises are always a vital phenomenon, we distinguish them from hypostases
for they will never disappear. We can distinguish between: petechiae -> point-like bruising of origin
capillary and figured bruising -> take the mold that produced them (whips, fingertips, sucking). The
characteristic of bruising is superficiality, which is why we will talk about deep hemorrhagic foci instead
of hematomas. The color varies over time (due to the degradation of hemoglobin): initially red, then
purple, then green, then yellow (after at least 10 days).
CONTUSED LACERO WOUNDS -> this name refers to contusive lesions with skin wounds also deep. We
speak of tears if the pull + tear mechanism prevails while speaking of ragged bruises if you combine
traction + compression. They are solutions continuously but surrounded by bruising, have a number of
distinctive features from stab wounds: they present evident contusive component, have jagged margins,
have an ecchymotic and irregular background with intact tissue margins. Some particular lacerated-
bruised wounds are: fissure wounds (often level of the cranial theca with the skin that easily shows the
bony plane), crestal bone wounds (e.g. at the level of the elbow), bite wounds (reproducing the two
dental arches).
NB. Contused lacerated wounds are unable to mold the means that produced them.
CONTUSIONS -> are lesions that mainly involve deep structures, organs parenchymatous and
osteotendinous structures. They are divided into: simple, visceral lacerations and dislocations.

VIOLENT MECHANICAL ASPHYXIA:

They represent all those forms of respiratory insufficiency acute that are related to an action applied to
the respiratory tract that does not allow air to penetrate inside the respiratory tree. This action can be
external or mechanical.
THE TYPICAL SIGNS OF ASPHYSIA ARE: PETECCHIA -> explosion of the surface capillaries, especially at
conjunctival but also orbicular and peri-orbicular, the postpartum ones disappear after 12 hours instead
the death "fixes" them; HYPOSTATIC CYANOSIS -> typical bluish / bruise; CONGESTION AND EDEMA
 LUNG -> foamy fungus as a result of pulmonary edema and pulmonary fluid.
 We must refer essentially to 5 situations:
 1. STRANGULATION = use of a means around the neck that prevents the passage of oxygen and that it
will cause a vaso-vagal reflex resulting in bradycardia and death. Death can result from: purely
asphyxiated mechanism, peripheral nervous mechanism due to stimulation of the glomus carotid with
paradoxical arrhythmic reflex, mechanism of compression of the vagus with arrest of flow and brain
hypoxia.
NB. The typical finding is the sulcus -> that is, the lesion that reproduces the medium that produced it in
a mold. Hard groove or parchment in case of rope or other hard medium, soft groove in case of using
soft medium (ex. bathrobe, scarf). Usually there is a continuous or "complete" groove with a tangential
direction.
 2. CHOKING = it is a typically homicidal case, it involves the application of pressure exerted on the
victim's neck which will cause death from: neurogenic cardiac arrest that it occurs by vaso-vagal
stimulation and in particular because the compression of the neck above or below the baroreceptors
slow down the heart (until death) either by a purely asphyxiated mechanism or by both situations.
NB. The typical findings are: typing, finger marks, scratches as the victim will have the instinct to insert
their own fingers inside the killer's hand to try to remove it. The sulcus often has a ribbon-like and non-
ribbon shape keep on.

 3. SUFFOCATION = it can occur for three reasons:

 Pure obstruction of the airways (eg pillow) -> we speak of an uncomplicated obstruction that prevents
return venous at the thoracic level due to the increase in intrathoracic pressure. It will be difficult to see
the external signs for which an autopsy will be required.
 Confinement -> occurs if thoracic excursion is prevented with signs of obstruction of the return venous
or if you are stationary in a restricted area where there is no O2 or CO2 exchange so we will have an
increase of carbon dioxide concentration, lowering of blood pH to death.
From a foreign body (CHOCKING) -> the foreign body must first be looked for, the subjects at risk are
CHILDREN (who swallow everything especially small objects), ELDERLY (with swallowing problems), BIG
EATERS (with reflex problems at the epiglottic level). In the early stages, cough reflexes are triggered
and vomiting for which the latter is a finding that, if found, is worthy of consideration.

 4. HANGING = phenomenon due to the suspension of a body tied to a fixed point; the weight of the
body will cause the pressure of the medium used (eg rope) at the level of the neck resulting in death.
There death occurs for purely asphyxiated reasons, stimulation of the carotid glomas, encephalic
hypoxia (as in strangulation). If the knot of the loop is positioned posteriorly, it is referred to as hanging
typical, if the knot of the loop is positioned at any other point, we speak of atypical hanging. We
talk then of complete hanging if the body is completely suspended, of incomplete hanging if also a small
part rests on a solid base.
NB. A typical sign of hanging is: sign of the knot of the superficial loop posteriorly, sign of fullness of the
anteriorly with a deeper groove. The skin compression sulcus is of particular interest to us since it refers
to signs of vitality (de-epithelialized areas, serous vesicles, hemorrhagic crestolins) that allow the
differential diagnosis with the suspension of the cadaver.
DD with strangulation: the skin compression sulcus is not transverse but oblique; the groove is not
continuous but has greater compression at the node.
NB. HANGING differs from hanging because it is a hanging with fall in which due to traction
 we find the fracture or dislocation of the first cervical vertebrae which injure the bulb-medullary tract of
the neurasse.

 5. DROWING = death following aspiration of liquid material inside the airways. THE mechanisms that
cause death can be physical or neuro-vegetative. We speak of typical drowning or "Wet drowning" when
the whole body is immersed in liquid, we speak of atypical drowning or "dry drowning "the liquid
element is an indirect mechanism capable of triggering an asphyxiated mechanism (eg. in diving).
Brouardel in 1897 describes 5 stages in drowning: 1. Surprise; 2. Shutdown respiratory; 3. Deep
breathing; 4. Second respiratory arrest; 5. Gasping (concludes with death).
A drowning lasts on average from 3 to 4 minutes up to a maximum of 8.
The characteristics of the water will leave different traces: fresh water being hypotonic compared to the
blood causes severe hemolysis with triggering of ventricular fibrillation while sea water is hypertonic
 draws water from the capillaries and we will observe alveoli full of water.
The external signs of drowning are: foamy fungus, pinkish hypostasis, laundress skin, cold pale skin.
Moving forward with the processes putrefactive we will have: saponification and deglazing as well as
retraction of the penis, scrotum and nipples with release of the sphincters. The internal signs (visible at
the autopsy) are: water in the trachea, bronchi and lungs as well petechiae and haemorrhages in the
sternocleidomastoid muscles and also acute edema and emphysema.

How do you distinguish between: a drowned person, a person who died in water and a person who is
already a corpse?
 1. If the subject is drowned we will find the DIATOMEE circulating in the blood as the subject
has breathed.
 2. If the subject died in the water (eg due to a heart attack while swimming) then we will find the
 DIATOMEE only in the lungs.
 3. If the subject is already a corpse at the time of immersion in the liquid, we will not find DIATOMEE.
 NB. Diatoms are single-celled organisms present in ALL waters so they are the GOLD STANDARD for
diagnosis of drowning; if we have a water sample we can also distinguish whether the water in
which the individual is drowned whether the same or not (eg died elsewhere).

OTHER TYPES OF ASPHYSIA: sexual asphyxia (auto-eroticism or couples) due to the use of laces or
ligatures that increase the hypoxic stimulus; traumatic asphyxia from road accident, earthquake (dirt in
the lungs), crowd in panic (people trampled and surmounted).