Summary of Legal Medicine

FROGLETS NOTES Book by Solis

treatment
CHAPTER I Purpose in examining a Purpose in examining a
GENERAL CONSIDERATION patient is to arrive at a patient is to include those
definite diagnosis so that bodily lesions in his report
Legal Medicine- branch of which deals with application of appropriate treatment can and testify before the court
medical knowledge to the purposes of law and in the be instituted or before an investigative
administration of justice. It is the application of basic and body
clinical, medical and paramedical sciences to elucidate Minor or trivial injuries are Records all bodily injuries
legal matters. usually ignored inasmuch even if they are small or
as they do not require usual minor because these
 Concept and practice of Legal Medicine in the treatment. injuries may be proofs to
Philippines is of Spanish origin. qualify the crime or to justify
the act.
Legal Medicine Forensic Medicine
Application of medicine to Application of medical
legal cases science to elucidate legal Example:
problems
Presence of PHYSICAL INJURIES of a victim of sexual
abuse = presumes that force was applied; hence, crime
Medical Jurisprudence- knowledge of law in relation to committed must be RAPE.
the practice of medicine. It concerns with the study of the
rights, duties and obligations of medical practitioner with Presence of PHYSICAL INJURIES on the offender of the
particular reference to those arising from doctor-patient crime of physical injuries= proof that the victim acted in
relationship. SELF-DEFENSE.

NATURE OF THE STUDY OF LEGAL MEDICINE OTHER DEFINITIONS

 Knowledge of legal medicine means the ability to
acquire facts, the power to arrange those facts in
their logical order, and to draw a conclusion from
the facts which may be useful in the
administration of justice.
 Medical Jurist (medical examiner, medico-legal
officer, medico-legal expert) – a physician who
specializes or is involved primarily with medico-
legal duties. They are mostly in the service of the
government.
 It is the duty of every physician, when called
upon by the judicial authorities, to assist in the
administration of justice on matters which are
medico-legal in character.‖
 To be involved in medico-legal duties, a
physician must possess sufficient knowledge of:
o Pathology
o Surgery
o Gynecology
o Toxicology
o Other branches of Medicine germane
to the issues involved.
Ordinary Physician Medical Jurist
Sees an injury or disease Sees injury or disease on
on the point of view of the point of view of cause
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1. LAW- rule of conduct, just, obligatory, laid by
legitimate power for common observance and
benefit.
Characteristics of Law:
- It is a rule of conduct;
- It is dictated by legitimate power; and
- Compulsory and obligatory to all.
Forms of Law:
A. Written or Statutory Law (Lex
Scripta) – composed of laws which are
produced by the country’s legislations
and which are defined, codified and
incorporated by the law-making body.
Ex. Philippine Laws.
B. Unwritten or Common Law (Lex non
Scripta) – composed of unwritten laws
based on immemorial customs and
usages. Sometimes referred to as case
law, common law, jurisprudence or
customary law. Ex. Laws of England.
2. FORENSIC- denotes anything belonging to the
court of law or used in court or legal proceedings

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or something fitted for legal or public
argumentations.
3. MEDICINE- a science and art dealing with
preventation, cure and alleviation of disease. It is
that part of science and art of restoring and
preserving health. It is the science and art of
diagnosing, treating, curing and preventing
disease, relieving pain, and improving the health
of a person.
4. LEGAL- that pertains to law, arising out of, by
virtue of or included in law. Refers to anything
conformable to the letters or rules of law as it is
administered by the court.
5. JURISPRUDENCE- science of giving a wise
interpretation of the law and making just
application of them to all cases as they arise.
PRINCIPLE OF STARE DECISES
A principle that, when the court has once laid
down a principle of law or interpretation as applied to a
certain state of facts, it will adhere to and apply to all future
cases where the facts are substantially the same.
BRANCHES OF LAW WHERE LEGAL MEDICINE MAY
BE APPLIED
In CIVIL LAW, knowledge of legal medicine may be useful
on the following:
1. Determination and termination of civil personality
(Art.40-41);
2. Limitation or restriction of a natural person’s
capacity to act (Art. 23 and 29);
3. Marriage and legal separation
4. Paternity and filiation
5. Testamentary capacity of a person making a will.
In CRIMINAL LAW, legal medicine is applicable in the
following provisions of the Penal Code:
1. Circumstances affecting criminal liability;
2. Crimes against person;
3. Crimes against chastity.
In REMEDIAL LAW, legal medicine is applied in the
following provisions of the Rules of Court:
1. Physical and mental examination of a person
(Rule 28);
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2. Proceedings for hospitalization of an insane
person (Rule 101); and
3. Rules on evidences (Part IV).
In SPECIAL LAWS:
1. Dangerous Drug Act (RA 6425, as amended)
2. Youth and Child Welfare Code (PD 603)
3. Insurance Law (Act No. 2427 as amended)
4. Code of Sanitation (PD 856)
5. Labor Code (PD 442)
6. Employee’s Compensation Law
MEDICAL EVIDENCE
Evidence- the means, sanctioned by the Rules of Court, of
ascertaining in a judicial proceeding the truth respecting a
matter of fact.
If the means employed to prove a fact is medical
in nature then it becomes a medical evidence.
TYPES OF MEDICAL EVIDENCE
1. Autoptic or Real Evidence – 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.
(Sec.1, Rule 130)
Limitations to the Presentation of Autoptic
Evidence:
a) Indecency and Impropriety – presentation
of evidence may be necessary to serve the
best interest of justice but the notion of
decency and delicacy may cause inhibition
of its presentation.
Ex: Court may not allow exposure of the
genitalia of an alleged victim of sexual
offense to show the presence and degree of
the genitalia and extra-genitalia injuries
suffered.
b) Repulsive Objects and 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.
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However, if such evidence is necessary in 4.
the adjudication of the case, the question of
indecency and impropriety or the fact that
such evidence is repulsive or offensive to
sensibilities, it may be presented. This will
depend on the sound discretion of the court.
2. Testimonial Evidence – a physician may be
commanded to appear before a court to give his
testimony. His testimony must be given orally
and under oath or affirmation.
A physician may be presented in court as an
ordinary witness and/or as an expert witness: 5.
ORDINARY WITNESS EXPERT WITNESS
A physician who A physician on
testifies in court on account of his training
matters perceived from and experience can
his patient in the course give his opinion on a
of physician-patient set of medical facts.
relationship. He can deduce or
infer something,
(Sec. 20, Rule 130, determine the cause
Rules of Court) of death, or render
opinion pertinent to
Exception: Privilege of the issue and medical
Communication nature.
between physician and
patient. (Sec. 48-49, Rule
130)
(Sec. 24 c, Rule 130)
The probative value of
the expert medical
testimony depends
upon the degree of
learning and
experience on the line
of what the medical
expert is testifying, the
basis and logic of his
conclusion, and other The physical evidence recovered during medico-legal
investigation must be preserved to maintain their value
evidences tending to
show the veracity or when presented as exhibits in court.
falsity of his Methods of Preserving Evidence
testimony.
1.
3. Experimental Evidence – A medical witness 2.
may be allowed by the court to confirm his
allegation or as a corroborated proof to an
opinion he previously stated.
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Documentary Evidence- Medical Documentary
Evidence may be:
a. Medical Certification or Report on:
i. Medical examination
ii. Physical examination
iii. Necropsy/ autopsy
iv. Laboratory
v. Exhumation
vi. Birth
vii. Death
b. Medical Expert Opinion
c. Deposition
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.
Criminalistics - is the identification, collection,
preservation and mode of presentation of
physical evidence. It is the application of
sciences such as physics, chemistry, medicine
and other biological sciences in crime detection
and investigation.
Type of Physical Evidences:
a. Corpus Delicti Evidence – objects or
substances which may be a part of the
body of the crime.
b. Associative Evidence- these are
physical evidence which link a suspect
to the crime.
c. Tracing Evidence- these are physical
evidence which may assist the
investigator in locating the suspect.
PRESERVATION OF EVIDENCE
Photographs, audio and/or video tape, micro-
film, Photostat, Xerox, voice tracing, etc.
Sketching- rough drawing of the scene or object
to be preserve is done. It must be simple,
identifying significant items and with exact
measurement.

FROGLETS NOTES
Kinds of Sketch:
Rough Sketch- made at the crime scene or
during examination of living or dead body.
Finished Sketch- sketch prepared from the rough
sketch for court presentation.
Essential Elements to be Included in a
Sketch:
a. Measurement must be accurate;
b. Compass direction must always be
indicated to facilitate proper orientation
in the case of crime scene;
c. Essential item which has a bearing in
the investigation must be included;
d. Scale and proportion must be stated by
mere estimation;
e. There must be a title and legend to tell
what it is and the meaning of certain
marks indicated therein.
3. Description- putting into words the person or
thing to be preserved. It must cause a vivid
impression on the mind of the reader, a true
picture of the thing described.
Minimum Standard Requirements which must be
satisfied in the description of the person or thing
to make it complete:
a. Skin Lesion
b. Penetrating wound
c. Hymenal Laceration
d. Person
4. Manikin Method- miniature model of a scene or
of a human body indicating marks of a various
aspects of the things to be preserved.
5. Preservation in the Mind of the Witness
Drawbacks of preserving evidence in the mind of
the witness:
 The capacity of a person to remember
time, place and event may be
destroyed or modified by the length of
time, age of the witness, confusion with
other evidence, trauma or disease,
thereby making the recollection not
reliable;
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 The preservation is co-terminus with
the life of the witness.
 Human mind can easily be subjected to
too many extraneous factors that may
cause distortion of the truth.
6. Special Methods- Special way of treating certain
type of evidence may be necessary. Preservation
may be essential from the time it is recovered to
make the condition unchanged up to the period it
reaches the criminal laboratory for appropriate
examination.
Special Ways of Preservation:
a. Whole human body- embalming.
b. Soft tissues (skin, muscles, visceral
organs) – 10% formalin solution.
c. Blood- refrigeration, sealed bottle
container, addition of chemical
preservatives.
d. Stains (blood, semen) – drying, placing
in sealed container.
e. Poison- sealed container.
CHAPTER II
DECEPTION DETECTION
Methods of deception detection used by law
enforcement agencies:
1. Devices which record the psycho-physiological response
a. Polygraph or lie detector machine – records
physiological changes that occur in association with
lying in a polygraph.
Phases of Examination
i. Pre-test interview
ii. Actual interrogation and recording through the
instrument
Standard test questions:
1. Irrelevant questions – no bearing to the case
under investigation (ex: age, citizenship,
occupation, etc).
2. Relevant questions – pertaining to the issue
under investigation (ex: Did you shoot to death
Mr. X?).
3. Control questions – unrelated to the matter
under investigation but are of similar nature
although less serious as compared to those
relevant questions (ex: Have you ever used a
gun?).
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iii. Post-test interrogation
Supplementary tests:
i. Peak-of-tension test – may be given if subject is
not yet informed of the details of the offense for
which he is being interrogated by the investigator.
ii. Guilt complex test – applied when the response
to relevant and control questions are similar in
degree and consistency in a way that the
examiner cannot determine whether the subject is
telling the truth or not.
iii. Silent answer test – conducted in the same
manner as when relevant, irrelevant and control
questions are asked, but the subject is instructed
to answer the questions silently, to himself, without
making any verbal response.
Factors responsible for the 25% errors of the lie
detector:
1. Nervousness or extreme emotional tension
experienced by a subject who is telling the truth
regarding the offense in question
2. Physiological abnormalities
3. Mental abnormalities
4. Unresponsiveness in a living or guilty subject
5. Attempt to ―beat the machine‖ by controlled
breathing or by muscular flexing
6. Unobserved application of muscular pressure which
produces ambiguities and misleading indications in
the blood pressure tracing
b. Word association test – A list of stimulus and non-
stimulus words are read to the subject who is
instructed to answer as quickly as possible. The time
interval between the words uttered by the examiner
and the answer of the subject is recorded. The test is
not concerned with the answer, be it a ―yes‖ or ―no‖.
The important factor is the time of response in relation
to the stimulus or non-stimulus words.
c. Psychological stress evaluator (PSE) – detects,
measures, and graphically displays the voice
modulations that we cannot hear. When a person
speaks, there are audible voice frequencies, and
superimposed on these are the inaudible frequency
modulations which are products of minute oscillation
of the muscles of the voice mechanism. Such
oscillations of the muscles or microtremor occur at the
rate of 8 to 14 cycles per second and controlled by the
central nervous system.
2. Use of drugs that try to ―inhibit the inhibitor‖
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a. Truth serum – In the test, hyoscine hydrobromide is
given hypodermically in repeated doses until a state of
delirium is induced. When the proper point is reached,
the questioning begins and the subject feels a
compulsion to answer the questions truthfully.
b. Narcoanalysis or narcosynthesis – practically the
same as that of administration of truth serum. The
only difference is the drug used. Psychiatric sodium
amytal or sodium penthotal is administered to the
subject.
c. Intoxication – the apparent stimulation effect of
alcohol is really the result of the control mechanism of
the brain, so alcohol, like truth serum, and
narcoanalytic drugs ―inhibit the inhibitor‖. (In vino
veritas – in wine there is truth)
3. Hypnotism – the alteration of consciousness and
concentration in which the subject manifests a
heightened of suggestibility while awareness is
maintained.
4. By observation
Physiological and psychological signs and symptoms of
guilt:
a. Sweating – if accompanied with a flushed face
indicate anger, embarrassment or extreme
nervousness. If with a pallid face, may indicate shock
or fear. Sweating hands indicate tension.
b. Color change – flushed face may indicate anger,
embarrassment or shame. Pale face is sign of guilt.
c. Dryness of the mouth – nervous tension causes
dryness of the mouth which causes continuous
swallowing and licking of the lips.
d. Excessive activity of the Adam’s apple – on
account of dryness of the throat, subject will swallow
saliva which causes frequent upward and downward
movement of the Adam’s apple.
e. Fidgeting – constantly moving about in the chair,
pulling his ears, rubbing his face, picking and tweaking
the nose, etc. Indicative of nervous tension.
f. ―Peculiar feeling inside‖ – there is a sensation of
lightness of the head and the subject is confused.
Result of troubled conscience.
g. Swearing to the truthfulness of his assertion – ―I
swear to God I am telling the truth‖
h. ―Spotless past record‖ – subject may assert that it is
not possible for him to do ―anything like that‖
inasmuch as he is a religious man and that he has a
spotless record.
i. Inability to look at the investigator “straight in the
eye” – because of fear that his guilt may be seen in
his eyes.
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j. “Not that I remember” expression – resort to this
expression to avoid committing something prejudicial
to him.
5. Scientific interrogation – the questioning of a person
suspected of having committed an offense or of persons
who are reluctant to make a full disclosure of information
in his possession which is pertinent to the investigation.
Suspect – person whose guilt is considered on
reasonable ground
Witness – person other than the suspect who is
requested to give information
Different types of criminal offenders
a. Based on behavioral attitude:
i. Active aggressive offenders – commit crimes in
an impulsive manner
ii. Passive inadequate offenders – commit crimes
because of inducement, promise or reward.
b. Based on the state of mind
i. Rational offenders – commit crime with motive or
intention
ii. Irrational offenders – commit crime without
knowing the nature and quality of his act.
c. Based on proficiency
i. Ordinary offenders – engaged in crimes which
require limited skill
ii. Professional offenders – commit crimes which
require special skills rather than violence.
d. Psychological classification
i. Emotional offenders – commit crimes in the heat
of passion, anger, or revenge.
ii. Non-emotional offenders – commit crimes for
financial gain and are usually recidivist or
repeaters.
Techniques of Interrogation
a. Emotional appeal – interrogator must create a mood
that is conducive to confession
b. Mutt and Jeff technique – there must be at least 2
investigators with opposite character; one (Mutt) who
is arrogant and relentless, and the other (Jeff) who is
friendly, sympathetic and kind.
c. Bluff on split-pair technique – applicable where
there are two or more persons who allegedly
participated in the commission of a crime. While one
of them is interrogated, the interrogator may claim that
the subject was implicated by the author and that
there is no use for him to deny participation.
d. Stern approach – questions must be answered
clearly, and the interrogator utilizes harsh language.
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e. The subject is given the opportunity to make a
lengthy, time-consuming narration.
6. Confession – an expressed acknowledgment by the
accused in a criminal case of the truth of his guilt as to
the crime charged, or of some essentials thereof.
Requirement for the Admissibility of Evidence Obtained
Through Interrogation
 Custodial Investigation and Self-Incrimination
(1987 Constitution)
 Miranda v. Arizona (Miranda Rights)- safeguards
were established for the interrogation of
suspected persons.
Some Techniques of Interrogation
 Emotional Appeal- The interrogator creates a
mood that is conducive to confession. He may be
sympathetic or friendly to the subject.
 Mutt and Jeff Technique- One interrogator (Mutt)
is arrogant and relentless; he knows the subject
to be guilty. The other (Jeff) is friendly,
sympathetic, and kind. When Mutt is not present,
Jeff will advise the subject to make a quick
decision and plea for cooperation.
 Bluff on Split-Pair Technique- Applicable where
there are two or more persons who allegedly
participated on the commission of a crime. All of
them are interrogated separately and the
interrogator may claim that the subject was
implicated by the author and that there is no use
for him to deny participation.
 Stern Approach- Immediate and clear response
from the subject is demanded and the
interrogator uses harsh language.
 The subject is given the opportunity to make a
lengthy, time-consuming narration.
Basis of Interrogator’s Inference that the Subject is not
Telling the Truth
 The statements have many improbabilities and
gaps on its substantial parts.
 The statements are inconsistent with the material
facts.
 The statements are incoherent.
Confession
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FROGLETS NOTES
 Is an expressed acknowledgement by the
accused of the truth of his guilt as to the crime
charged, or of some essentials thereof.
 Confession is a statement of guilt while
admission is usually a statement of fact by the
accused which does not directly involve an
acknowledgment of guilt.
Kinds of Confession
 Extra-judicial Confession- is a confession made
outside of the court prior to the trial of the case.
o Under the Rules of Court, extra-judicial
confession is not a sufficient ground for
conviction unless corroborated by
evidence of corpus delicti.
o Extra-judicial confession may be:
 Voluntary- the accused
speaks on his free will and
accord, without inducement
of any kind, and with full and
complete knowledge of the
nature and consequence of
the confession.
 Involuntary- obtained through
force, threat, intimidation,
duress, or anything
influencing the voluntary act
of the confessor. Such are
inadmissible in evidence.
 Judicial Confession- is the confession of an
accused in court. It is conclusive upon the court
and may be considered to be a mitigating
circumstance.
o Under the Rules of Court, admissions
made by the parties in the pleadings, or
in the course of the trial or other
proceedings do not require proof and
cannot be contradicted unless
previously shown to have been made
through palpable mistake.
Maltreatment of Prisoners
 Elements (Art. 235, RPC)
o The offender is a public officer or
employee
o The offender has under his charge a
convicted or detention prisoner
o The offender maltreats the prisoner by
overdoing in the correction and
handling of the prisoner by the (1)
imposition of punishment not
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authorized by the regulation, or (2) by
inflicting such punishment in a cruel
and humiliating manner; or by
maltreating to extort a confession or
obtain information.
 Tokyo Declaration- provides guidelines to be
observed by physicians concerning torture and
other inhuman treatment
o The doctor shall not countenance,
condone, or participate in the practice
of torture or other forms of inhuman
procedures
o The doctor shall not provide premises,
instruments, substances, or knowledge
to facilitate such in practices
o The doctor shall not be present during
any procedure during which inhuman
treatment is used or threatened
o A doctor must have complete clinical
independence in deciding upon the
care of a person for whom he is
medically responsible
o Where the prisoner refuses
nourishment and is considered by the
doctor as capable of forming an
unimpaired and rational judgment
concerning the consequences of such
voluntary refusal of nourishment (as
confirmed by at least one other
independent doctor), he or she shall
not be fed artificially. Such
consequences of the refusal of
nourishment shall be explained by the
doctor to the prisoner
o The World Medical Association will
support and encourage the
international community, the national
medical associations, and fellow
doctors, to support the doctor as
his/her family in the face of threats or
reprisals resulting from refusal to
condone the use of torture and
inhuman treatment.
CHAPTER III
MEDICO-LEGAL ASPECTS OF IDENTIFICATION
Identification is the determination of the individuality of a
person or thing.
Importance of Identification
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 To establish the identity of the offender and that  Those which are based on scientific knowledge-
of the victim in the prosecution of the criminal made by trained men, well-seasoned by
offense. experience and observation
 To identify a person missing or presumed dead in
order to facilitate the settlement of the estate, Ordinary Methods of Identification
retirement, insurance, and other social benefits.
 Identification resolves the anxiety of the next-of-  Points of Identification Applicable to Living
kin, other relatives and friends as to the Persons Only
whereabouts of a missing person or victim of o Characteristics which may easily be
calamity or criminal act. changed
 Identification may be needed in some  Growth of hair, beard or
transactions like cashing of check, entering a mustache
premise, sale of property, release of dead bodies  Clothing- a person may have
to relatives, parties to a contract, etc.. a special preference for
certain form, texture or style
Rules in Personal Identification  Frequent place of visit- A
person’s special desire or
 Law of Multiplicity of Evidence in Identification- habit to be in a place if he
the greater the number of points of similarities has the opportunity to do so
and dissimilarities of two persons compared, the  Grade of profession- e.g. a
greater is the probability for the conclusion to be mechanic may be recognized
correct. by his tools, a clergy man by
 The value of the different points of identification his robe, or a nurse by her
varies in the formulation of conclusion (e.g. visual cap
recognition by relative or friends may be of lesser  Body ornamentations-
value as compared with fingerprints or dental earrings, necklaces, rings,
comparison). pins, etc. Usually worn by
 The longer the interval between the death and persons
the examination of the remains, the greater is the o Characteristics that may not be easily
need for experts in establishing identity. changed
 It is necessary for the team to act in the shortest  Mental memory- a
possible time specially in cases of mass disaster. recollection of time, place,
 There is no rigid rule to be observed in the and events.
 Speech- a person may
procedure of identification of persons.
stammer, stutter, or lisp;
Methods of Identification manner of talking and quality
of the voice.
 By comparison-Identification criteria recovered  Gait- a person, on account of
during investigation are compared with records disease or some inborn traits,
available in the file. may show a characteristic
 By exclusion- If two or more persons have to be manner of walking.
identified and all but one is not yet identified, then  Mannerism- stereotype
the one whose identity has not been established movement or habit peculiar
may be known by the process of elimination. to an individual. (E.g. way of
sitting, movement of hand,
Identification of Persons movement of body,
movement of facial muscles,
Classification of the Bases of Human Identification manner of leaning, etc.)
 Hands and feet- Size, shape,
 Those which laymen use to prove identity- no and abnormalities.
special training or skill required  Foot or hand
impression-
develops when a
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foot or hand is  Negro- Thick lips

pressed on
mouldable
materials like mud,
clay, cement
mixture, or other
semi-solid mass.
 Footprint or
handprint- a
footmark or
handmark on a
hard base
contaminated or
smeared with
foreign matters like
dust, floor, blood,
etc.
 Complexion
 Changes in the eyes- near-
sightedness, far-sightedness,
state of being color blind, etc.
 Facies- different kinds of
facial expressions brought
about by disease or racial
influence.
 Left- or right-handedness
 Degree of nutrition- in
relation to height and age.
 Points of Identification Applicable to Both Living
and Dead before Onset of Decomposition
o Occupational marks- certain
occupations may result in some
characteristic marks or identifying
guide
o Race
 Color of the skin
 Caucasian-Fair
 Malayan-Brown
 Mongolian-Fair
 Negro- Black
 Feature of the face
 Caucasian-
Prominent sharp
nose
 Malayan- Flat nose
with round face
 Mongolian- Almond
eyes and
prominent cheek
bone
and prominent
eyes
 Shape of the skull
 Caucasian-
Elongated skull
 Malayan- Round
head apparel
 Mongolian- Round
head
 Red Indians and
Eskimos- Flat head
 Wearing Apparel- Casual and
customary wearing may
indicate race as well as
religion, nationality, region,
and custom.
o Stature- change in height; rate of
growth
o Tattoo marks- introduction of coloring
pigments in the layers of the skin by
multiple puncture.
o Weight- not a good point of
identification for it is easily changed
from time to time.
o Deformities- may be congenital or
acquired
o Birth marks
o Injuries leaving permanent results- e.g.
amputation, improper union of fractured
bones
o Moles
o Scar- a remaining mark after healing of
the wound.
 Age of scar
 Recently formed-
slightly elevated,
reddish or bluish in
color, and tender to
touch
 Few weeks to two
months- scar has
inflammatory
redness, and it is
soft and sensitive
 Two to six months-
brownish or
coppery red, free
from contraction
and corrugation,
and soft

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 Six months or 3. Waering apparel

more- scar is white, 4. Foreign bodies
glistening, 5. Identification by close friends and relatives
contracted, and 6. Identification record
tough 7. Photographs

Anthropometry (Bertillon System)

- scheme utilizing anthropometrical measurement of the II. SCIENTIFIC METHODS OF IDENTIFICATION
human body as the basis of identification A. Fingerprinting
B. Dental identication
Basis C. Handwriting
1. The human skeleton is unchangeable after D. Identification of skeleton
twentieth year. E. Determination of sex
2. It is impossible to find two human beings having F. Determination of Age
bones exactly alike. G. Identification of Blood
3. The necessary measurement can easily be H. Identification of Hair and Fibers
taken.
A. Fingerprinting
Information included - considered to be the most valuable method of
1. Descriptive Data - color of hair, eyes Identification
2. Body marks - moles, scars - the finger may be wounded or burned, but the whole
3. Anthropometrical measurements pattern with all its details will reappear when the
A. Body measurement wound heals
B. Measurement of head 1. There is no two identical fingerprints
C. Measurement of the limbs 2. Fingerprints are not changeable

Portrait Parle (spoken picture) Practical uses

- verbal, accurate and picturesque description of 1. Help establish identity in cases of dead bodies
the person identified. Such information may be 2. Prints recoveres from crime scene associate person
given bybthe witness, relatives, or persons who 3. Prints on file are useful for comparative purposes
ate acquainted with the physical features of the 4. Among illiterates, right thumbprint is recognized as
person to be identified substitute for signature.
1. General impression
2. Age, sex Dactylography is the art and study of recording
3. Race or color fingerprints as a means of identification
4. Height
5. Weight Dactyloscopy is the art of identification by comparison of
6. Built fingerprints
7. Posture
8. Head Poroscopy is the study of the pores found on the
9. Hair pappillary or friction ridges of the skin
10. Face
11. Neck Merhods of Producing Impression
12. Shoulder 1. Plain method - bulbs of the last phalanges of the
13. Wrist fingers and thumb are pressed on
14. Hands the surface of the paper after
15. Fingers pressing them on ink
16. Arms 2. Rolled method - bulbs of the thumb and other fingers
17. Feet are rolled on the surface of the
paper after being rolled on an ink
Extrinsic Factors in Identification pad
1. Ornamentation
2. Personal belongings Kinds of Impression
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1. Real impression - impression of the finger bulbs with
the use of printing ink on the
surface of the paper
2. Chance impression - impresses by mere chance
without any intention to produce it
How to Get Fingerprint Impressions on Dead Bodies
- In case of fresh bodies, the fingers are
uncleanched and each one is inked individually
with the aid of small rubber roller.
- If the "floater" has been in the body if water for a
longer time and the friction ridges have
disappeared, the skin of the fingertips is cut
away. This area of the skin is placed in a small
labelled test tube containing formaldehyde
solution.
Types of Fingerprint Patterns
1. Arches - the ridgea go from one side of the
pattern to another, never turning back to make a
loop
A. Plain arches
B. Tented arches
2. Loops - one or more ridges enter on either side,
recurves and terminate on the same side from
which it entered
A. Ulnar loop
B. Radial loop
3. Whorls - patterns with two deltas and patterns
too irregular in form to classify
A. Simple whorl
B. Central pocket loop
C. Lateral pocket loop
D. Twin loop
E. Accidentals
Q: Can fingerprints be effaced?
A: No, as long as the dermis of the bulbs of the finger is not
completely destroyed, the fingerprints will always
remain unchanged and indestructible.
Q: Can fingerprints be forged?
A: There is considerable controversy as various
experiments could almost make an accurate
reproduction, still there is no case in record known or
have been written.
B. DENTAL IDENTIFICATION
1. The possibility of two persons to have the same
dentition is quite remote.
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2. The enamel of the teeth is the hardest substance
in the body. It may outlast all other tissues.
3. After death, the greater the degree of tissue
deatruction, the greater is importance of the
dental characteristic.
4. The more recent the ante-mortem records of the
person to be identified, the more reliable is the
comparative or exclusionary mode of
identification that can be done.
Causes of Unreliability of the Dental Records
1. The dentist may only concern himself with the
affected teeth and may not care to have a
detailed examination of the other teeth.
2. No uniformity in nomenclature in the charting of
teeth
3. Although there may be a law obligating dentists
to have a record of their patient, the law does not
mention the agency which will enforce it
4. Changes in the teeth which are not seen by the
dentist
C. HANDWRITING
- The handwriting of a person may be proved by a
witness who believes it to be the handwiting of
such person, and has seen the person write, or
has seen writing purporting to be his upon which
the witness has acted or been charged, and has
thus acquired knowledge of the handwriting of
such person.
The genuineness of any disputed writing may be
proven by any of the following ways
1. Acknowledgement of the alleged writer
2. Statement of the witness who saw the writing
3. Opinion of persons who are familiar with the
handwriting of the alleged writer
4. Opinion of an expert
Practical Uses of Handwriting Examination
1. Financial crime
2. Death inveatigation
3. Robberies
4. Kidnapping with ransom
5. Anonymous threatening letters
6. Falsification of documents
Bibliotics - science of handwriting analysis
Graphology - study of handwriting for the purpose of
determining the writer's personality,
character and aptitude.
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Handwriting - complex interaction of nerves c. Logwood ink

d. Carbon ink
Writing - conscious act, but on the account of repeated act e. Ballpoint ink
it becomes habitual and unconscious
CHAPTER III
Movements in Writing MEDICO-LEGAL ASPECTS OF IDENTIFICATION
1. Finger movement- letters are made entirely by
the action of the thumb, the pointing and middle Instruments Necessary in Questioned Document
fingers Examination:
2. Hand movement – letters are produced by the
action of the hand as a whole with the wrist as 1. Photographic instruments- to view the writing in
the center of action sufficient magnification for detail examination and
3. Arm movement – movement in writing is made preparation of evidence for presentation
by the hand and arm supported with the elbow at 2. Magnifying lend and stereoscopic binocular
the center of later swing microscope- to determine unusual appearances of
4. Whole arm movement – action is produced by writing. Obliterations, erasures and alterations may be
the entire arm without any rest more visible
3. UV lamp and infra red radiation- to mae visible the
chemical erasures
4. Measuring caliper
The Form, Style and Characteristics of the Handwriting 5. Good lighting facilities
of a Person are Basically Determined By:
Purpose of Handwriting Examination
Primary Factors
1. Survival of the letters are formed when a person 1. Whether the document was written by the suspect
begins to write 2. Whether the document was written by the person
2. Inclusion of some characteristics due to whose signature it bears
admiration of a peculiar design in writing 3. Whether the writing contains additions or deletions
3. Identifying characteristics may be the result of 4. Whether the document such as bills, receipts, suicide
the great volume of writing done notes or checks are genuine or a forgery
4. The presence or absence of physical
abnormalities or defects originating from illness, Points to Consider in Questioned Document Examination
injury, psychological variations and other similar
conditions  Slant, spacing, size, proportion of the letters, speed
and rhythm in writing, shading, pen strokes
Secondary Factors  The greater the variation in the way of writing, the
1. Position of writer greater the amount of standard of writing needed to
2. Temporary physical or psychological disturbance form a reliable impression
3. Other external temporary variables
4. Physical and chemical factors  To determine whether a certain instrument or
A. Writing instrument document has been written by a certain person,
a. Ballpen compare the writings with some standard of writings of
b. Fountain pen the same person
c. Steel pen o Two Types of Standard Writings:
d. Pencil  Collected Standards: handwriting
B. Paper by the person who is suspected to
a. Color have written the questioned
b. Surface appearance document; may be found in the
c. Watermarks private or public records of the
d. Weight and thickness persons
C. Ink  Requested Standard: standards
a. Iron gallotannate ink made by the alleged writer upon
b. Washable ink request of the examiner; usually
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applicable only to recently written
documents
Disguised writing
The deliberate attempt on the part of the writer to alter his
writing habit to invent a new writing style of by imitating the
writing of another person.
 Done by changing the direction of the slant,
changing the speed in writing, deliberate
carelessness
Signature forgery
Signature forgery examination is the most common activity
of a questioned document examiner
Classifications of Signature Forgery
1. Traced forgery: the outlining of a genuine signature
from one document onto another
2. Simulated forgery: an attempt to copy in freehand
manner the characteristics of a genuine signature
either from the memory of the signature or from as
model.
3. Spurious forgery: one prepared primarily in the
forger’s own handwriting wherein little or no attempt
has been made to copy the characteristics of the
genuine writing
7. Length of interment or length from the time of death
May be determined by the nature and presence of soft
tissues and the degree of erosion of the bones.
Ordinarily, all the soft tissues in a grave disappear
within a year.
8. Presence or absence of ante or post mortem injuries
9. Congenital deformities and acquired injuries on the
hard tissues causing permanent deformities
(pp. 86-102)
Procedure of the Test
Two Methods may be utilized and both should be
employed in the examination:
1. Detection of Agglutinins
2. Detection of Agglutinogens
Value of the Test
 It may solve disputed parentage (maternity or paternity).
 Positive result - not conclusive that the one in question is
the offspring
 Negative result - conclusive that he is not the child of the
alleged parents. Grouping is true not only with blood but
also with other body fluids like saliva, vaginal secretion,
seminal fluid, milk, urine and others

INHERITANCE PATTERNS OF ABO BLOOD GROUPS

Typewriter Identification
Group of Group of Exclusion
The identification of the typing machine used in a Parents Children Cases
questioned document OxO O A, B, AB
OxA O, A B, AB
IDENTIFICATION OF THE SKELETON
OxB O, B A, AB
In the examination of bones, the following points can be AxA O, A B, AB
determined: AxB O, A, B, AB
1. Whether the remains are of human origin or not: BxB O, B A, AB
Study the shape, size, and general nature of the O x AB A, B O, AB
remains, especially that of the skull A x AB A, B, AB O
2. Whether the remains belong to a single person or not: B x AB A, B, AB O
Any plurality or excess of the bones after a complete AB x AB A, B, AB O
lay out denotes that the remains belong to more than
one person
3. Height Different Characteristics of Blood from Different Sources:
4. Sex:
Study the pelvis, skull, sternum, femur and humerus 1. Arterial Blood – bright scarlet in color, leaves the blood
5. Race vessel with pressure, high oxygen contents
6. Age: 2. Venous Blood – dark red in color, does not spill far
Determined by the appearance of ossification centers from the wound, low oxygen content
and union of bones and epiphyses, dental 3. Menstrual Blood – does not clot, acidic in reaction
identification, and obliteration of cranial structures owing to mixture with vaginal mucous, on

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microscopic examination, there are vaginal epithelial same degree as

cells, contains large number of Deoderlein’s bacillus. human’s
4. Man’s or Woman’s Blood- no method of Note: Medullary index (I) is the relation between the
differentiating man and woman’s blood diameter of the medulla and the diameter of the whole hair.
5. Child’s Blood- at birth, it is thin and soft compared The hair and fiber may be examined microscopically in its
with that of adult, red blood cells are nucleated and cross-section and longitudinal aspect.Comparative study
exhibit greater fragility, red blood cells count more must be made to show similarity of the hair and fiber.
than in adult.
Other Points in the Identification of Hair:
Identification of Hairs and Fibers 1. Characteristics of the hair:
Hair on body surfaces is fine while those from the beard,
1. Addition of a substance that will coat the outer mustache and scalp are very thick.
surface of the hair so as to impart a different Hair from the eyebrows and lashes is tapering gradually to
color. finepoints.
Ex.: Salts of bismuth, lead, silver and pyrogallic
acid 2. Length of the Hair:
Hair from the scalp grows 2.5 cms. a month.
2. Addition of substances which bleach or Beard hair grows at the rate of 0.4 millimeter a day.
change the natural color of the fiber or 3. Color of the hair:
hair.  May be black, blonde or brunette.
Ex.: Hydrogen peroxide, chlorine and
 Hair from older persons may be white or gray.
diluted nitric acid
 The hair may be artificially colored by bismuth, lead or
silver salts.
Distinctions between Human and Animal Hair:
 It may be bleached by addition of hydrogen peroxide,
Human Animal chlorine or diluted hydrochloric or nitric acid.
Medulla Air network in fine Air network in
grains forms of large Male or a Female Hair
and small In many instances it is quite impossible to state the sex
sacks. from the hair, but certain points may be worthy of mention:
Cells invisible without  Hair on the scalp of male is shorter, thicker and more
treatment in water Cells easily wiry than that of female's.
visible  Eyebrow hair of a male is generally long and more wiry
Value of I lower than than that of a female's.
0.3
Value of I higher Estimation of Age Based on the Hair:
Fuzz without medulla than 0.5  Hair of children is fine, short, and deficient of pigments
and, as a rule, devoid of medulla.
Fuzz with  At the adolescent age, hair may appear at the pubis.
medulla Hair on the scalp becomes long, wiry, and thick.
Cortex Looks like a thick muff Looks like a  In the case of older persons, the color is usually white
fairly thin hollow or gray, with marked absorption of pigments and
Pigments in the form cylinder degenerative changes
of fine grains Pigments in the
form of irregular CHAPTER IV
grains larger MEDICO-LEGAL ASPECTS OF DEATH
than that of
human’s Importance of Death Determination
1. The civil personality of a natural person is extinguished
Cuticle Thin scales not Thick scales by death;
protruding, covering protruding, do 2. The property of a person is transmitted to his heirs at
one another to about not cover one the time of death;
4/5 another the

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FROGLETS NOTES
3. The death of the partner is one of the causes of
dissolution of partnership agreement;
4. The death of either the principal or the agent is a mode
of extinguishment of agency;
5. The criminal liability of a person is extinguished by
death;
6. The civil case for claims which does not survive is
dismissed upon the death of the defendant.
Death
 is the termination of life.
 it is the complete cessation of all the vital functions
without possibility of resuscitation.
 it is an irreversible loss of the properties of living matter.
 an event that takes place at a precise time.
 the ascertainment of death is a clinical and not a legal
problem.
Based on the Criterion Used in its Determination, death
may be:
1. Brain Death
 Death occurs when there is deep irreversible coma,
absence of electrical brain activity and complete
cessation of all the vital functions without possibility of
resuscitation.
2. Cardio-Respiratory Death
 Death occurs when there is a continuous and persistent
cessation of heart action and respiration.
 It is a condition in which the physician and the
members of the family pronounced a person to be dead
based on the common sense or intuition
3. Brain and Cardio-Respiratory Death
A person will be considered medically and legally dead if in
the opinion of a physician based on ordinary standards of
medical practice, there is:
 absence of spontaneous respiratory and cardiac
function, and because of the disease or condition which
caused, directly or indirectly, these functions to cease,
or because of the passage of time since these functions
ceased, attempts at resuscitation are considered
hopeless;
 absence of spontaneous brain function and if based on
ordinary standards of medical practice during
reasonable attempts to either maintain or restore
spontaneous circulatory or respiratory function in the
absence of aforesaid brain function, it appears that
further attempts at resuscitation or supportive
maintenance will not succeed.
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Death will have occurred when these conditions first
coincide. (Section 1, Chapter 378 of Kansas Statute)
Brain Death
1. According to Harvard Report of 1968, the following are
the characteristics of ―irreversible coma‖:
a. Unreceptivity and Unresponsibility
 There is a total unawareness to externally applied
stimuli and inner need and complete unresponsiveness
b. No movements or breathing
 Observation covering a period of at least l hour by
physicians is adequate to satisfy the criteria
c. No reflexes
Irreversible coma with abolition of central-nervous
system activity is evidenced in part by the absence of
elicitable reflexes.
 The pupil will be fixed and dilated and will not respond to
a direct source of bright light.
 Ocular movement (to head turning and to irrigation of the
ears with ice water) and blinking are absent.
 There is no evidence of postural activity (decerebrate or
other).
 Swallowing, yawning, vocalization are in abeyance.
 Corneal and pharyngeal reflexes are absent.
 As a rule, the stretch or tendon reflexes cannot be
elicited, i.e. tapping the tendons of the biceps, triceps
and pronator muscles, quadriceps and gastrocnemius
muscles with the reflex hammer elicits no contraction of
the respective muscles.
 Plantar or noxious stimulation gives no response.
d. Flat electro-encephalogram
 Of great confirmatory value is the flat or iso-electric
E.E.G. assuming that the electrodes have been properly
applied, that the apparatus is functioning normally, and
that the personnel in charge are competent.
Note: All of these tests shall be repeated at least 24
hours later with no change. It is emphasized that the
patient be declared dead before any effort is made to
take him off the respirator, if he is then on respirator.
2. In 1969, the Ad Hoc Committee of Human Transplantation
convened under the auspices of the Institute of Forensic
Sciences, Duquesne University School of Law adopted the
proposed criteriafor the determinationof death otherwise
known as
Philadelphia Protocol, and the following were considered:
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a. Lack of responsiveness to internal and external A. KINDS OF DEATH

environment;
b. Absence of spontaneous breathing movements for 3
minutes, in the absence of hypocarbia and while breathing
room air.
c. No muscular movements with generalized
flaccidity and no evidence of postural activity or shivering;
d. Reflexes and response:
d.1. Pupils fixed and dilated, non-reactive to strong
stimuli;
d.2. Corneal reflexes absent;
d.3. Supra-orbital or other pressure
response absent (both pain response
and decerebrate posturing);
d.4. Absence of snucking or snouting
response;
d.5. No reflex response to upper airway
stimulation;
d.6. No reflex response to lower airway
stimulation;
d.7. No ocular response to ice water
stimulation of the inner ear;
d.8. No deep tendon reflexes;
d.9. No superficial reflexes;
d.10. No plantar responses.
e. Falling arterial pressure without support by drugs or
other means.
f. Iso-electric electro-encephalogram (in the absence of
hypothermia, anesthetic agents and drugs intoxication)
recorded spontaneously and during auditory and tactile
stimulation.
It is further laid down that these criteria shall have been
present for at least 2 hours and that death should be
certified by two physicians other than the physician of a
potential organ recipient.
Other Set of criteria to Establish Brain Death:
1. Mohandas and Chou (1971) – standards of Brain Death
accepted at the University of Minnesota Science
Center.
2. The Ottawa General Hospital (1970) -
guidelines for the criteria of cerebral death.
3. In France (1968) - the Council of Ministers published a
decree which adopted the official definition of death on
recommendation of the French Academy of Medicine.
Note: The use of the criteria of brain death may only be
applied to those persons who are potential organ donors.
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1. SOMATIC DEATH OR CLINICAL DEATH
 state of the body in which there is complete, persistent and
continuous cessation of the vital functions of the brain,
heart and lungs which maintain life and death;
 hardly impossible to determine the exact time of death;
 immediately after death,
- the face and lips become pale
- the muscles become flaccid
- the sphincters are relax
- the lower jaw tends to drop
- the eyelids remain open
- pupils dilate
- skin loses its elasticity
- body fluids tend to gravitate to the most
dependent portions of the body
- body heat gradually assumes the
temperature of the surroundings
2. MOLECULAR OR CELLULAR DEATH
 After cessation of the vital functions, there is still animal life
among individual cells.
 About 3-6 hours later, there is death of individual cells
known as molecular or cellular death
 Exact occurrence cannot be definitely determined due to
several factors
3. APPARENT DEATH OR STATE OF SUSPENDED
ANIMATION
 This condition is not really death but merely a transient loss
of the vital functions of the body on account of disease,
external stimulus or other forms of influence.
 It may arise especially hysteria, uremia, catalepsy and
electric shock
B. SIGNS OF DEATH
1. CESSATION OF HEART ACTION AND CIRCULATION
 There must be continuous cessation of the heart action and
the flow of blood in the whole vascular system
Methods of Detecting the Cessation of Heart Action and
Circulation
a. Examination of the Heart
a.1. Palpation of the Pulse- may be made at the
region of the wrist or at the neck
a.2. Auscultation for the heart sound at the
precordial Area - the rhythmic contraction and
relaxation of the heart is audible through the
stethoscope. Heart sound can be audible
during life even without the aid of a stethoscope by
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FROGLETS NOTES
Difficulties in Auscultation may be encountered in:
(a) Stout person
(b) Fatty degeneration of the heart.
(c) Pericardial effusion.
a.3. Flouroscopic Examination- will reveal
the shadow of the heart in its rhythmic contraction and
relaxation. The shadow may be enlarged and the
excursion made less visible due to
pericardial effusion.
a.4. By the Use of Electrocardiograph
This is the best method of determining heart
action but quite impractical
b. Examination of the Peripheral Circulation:
b.1. Magnus’ Test:
 A ligature is applied around the base of a finger with
moderate tightness.
 In a living person there appears a bloodless zone at
the site of the application of the ligature and a livid
area distal to the ligature.
 If the ligature is applied to the finger of a dead man,
there is no such change in color.
b.2. Opening of Small Artery:
 Living: the blood escapes in jerk and at a distance.
 Dead: the blood vessel is white and there is no
jerking escape of blood but may only ooze towards
the nearby skin.
 When bigger arteries are cut, blood may flow
without pressure continuously.
b.3. Icard's Test
 This consists of the injection of a
solution of fluorescein subcutaneously.
 If circulation is still present, the dye will spread all
over the body and the whole skin will have a
gleenish-yellow discoloration due to flourescein.
 This test should be applied only with the use of the
daylight as the color is difficult to be appreciated
with the use of artificial light.
b.4. Pressure on the Fingernails:
 lf pressure is applied on the fingernails
intermittently, there will be a zone of paleness
at the site of the application of pressure which become
livid on release.
 There will be no such change of color if the test is
applied to a dead man.
b.5. Diaphanous Test
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 The fingers are spread wide and the finger webs are
viewed through a strong light.
 Living: the finger webs appear red
Dead: yellow
b.6. Application of Heat on the Shin
 If heated material is applied on the skin
Living: blister formation, congestion, and other vital
reactions of the injured area will be observed.
Dead: will not produce true blister, no
sign of congestion, or other vital reactions.
b.7. Palpation of the Radial Pulse With Fingers
 Living: will feel the rhythmic pulsation of the vessel due
to the flow of blood.
Dead: No such pulsation will be observed
b.8. Dropping of Melted Wax
Melted sealing wax is dropped on the breast of a person.
Dead: there will be no inflammatory edema
at the neighborhood of the dropped melted
wax.
2. CESSATION OF RESPIRATION
 must be continuous and persistent.
In the following conditions there may be suspension of
respiration without death ensuing:
a. In a purely voluntary act, as in divers, swimmers, etc. but
it cannot be longer than two minutes;
b. In some peculiar condition of respiration, like Cheyne-
Stokes respiration, but the apneic interval cannot be longer
than fifteen to twenty seconds;
c. In cases of apparent drowning;
d. Newly-born infants may not breathe for a time after birth
and may commence only after stimulation or
spontaneously later.
INTERNAL HYPOSTASIS IN VISCERAL ORGANS
Post-mortem lividity occurs in internal organs.
Post Mortem Lividity Simple Congestion
Staining in organs is Generally uniform and
irregular and occurs in most found all over the body.
dependent parts.
Dull and lustreless mucous Not so.
membrane
Imflammatory exudates is Not seen in simple
not seen, areas of redness congestion.
alternating with pale areas
found in a hollow viscus.
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3. Liquefaction of the Soft Tissues

Post Mortem Haemorrhage of Phosphorus

Lividity scurvy poisoning Factors Modifying the Rate of Putrefaction
Presence can be Presence can be
revealed in history. revealed in Internal Factors
history. Age
Skin lesion Skin lesion present Skin lesion Condition of the Body
appears after before death present before Cause of Death
death. death
Present in the May be found all May be found all External Factors
most dependent over the skin and over the skin and Free Air
portions of the organs. organs. Earth
body. Water
Clothings

FACTORS INFLUENCING THE CHANGES IN THE BODY

CHANGES IN THE BLOOD:
AFTER BURIAL
Hydrogen Ion Concentration
State of the Body before Death: An emaciated person at
Rise of non-protein nitrogen and free amino-acid
Chemical: Chloride in the plasma, Magnesium as the time of death will decompose slower than a well-
nourished individual. Skinny persons have more tendency
a result of diffusion, Potassium increases owing to
diffusion. to decompose.

Time elapsed between death and burial and

AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER
DEATH environment of the body.

Effect of Coffin: the use of a coffin will delay

After Death, proteolytic, glycolytic and lipolytic ferments of
glandular tissues continue to act which lead to the
autodigestion of organs. This action is facilitated by weak
acid and higher temperature and delayed by the alkaline
reaction of the tissues of the body and low temperature.
Their early appearance is observed in the parenchyatous
and glandular tissues.
decomposition if it is airtight and hard.
Clothing and Any other Coverings on the Body when
buried: Clothings retard decomposition because it affords
protection from insects and aids adipocere formation.
Depth at which Body is buried: the greater the depth the
body is buried the better the preservation.

Condition and type of soil: Dry, arid and sandy soil

PUTREFACTION OF THE BODY promotes mummification.
Putrefaction is the breaking down of the complex proteins Inclusion of something in the Grave which will hasten
into simpler components associated with the evolution of Decomposition
foul smelling gasses and accompanied by the change of
color of the body. Access of Air to the Body after Burial: Air may hasten
evaporation of the body fluid and promotes mummification.
Tissue changes in Putrefaction:
Mass Grave: There is relatively rapid decomposition of the
1. Changes in the color of the tissue bodies
2. Evolution of Gasses in the tissues
Trauma on the Body:
Effects of the Pressure of Gasses of Putrefaction
CHRONOLOGICAL SEQUENCE OF THE
Displacement of Blood, Bloating of the Body, Fluid Coming PUTREFACTIVE CHANGES OCCURING IN
out of both nostrils and mouth, Extrusion of the Fetus in a TEMPERATE REGIONS
gravid uters, floating of the body.

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Greenish Discoloration over the iliac fosae.
Eyeballs are soft and yielding.
Greenish discoloration spreading over the
while abdomen, external genitals and other
parts of the body. Frothy blood from the moth
and nostrils.
Abdomen distended with gas. Cornea fallen
in and concave. Purplish red streaks of veins
prominent on the extremities. Sphincters
relaxed. Nails firm.
Body greenish-brown. Blisters forming all
over the body. Skin peels off. Features
unrecognizable. Scrotum distended. Body
swollen up owing to distention. Maggots
found on the body. Nails and hair loose and
easily detached.
Soft parts changes into a thick, semi-fluid
black mass
CHRONOLOGICAL SEQUENCE OF THE
PUTREFACTIVE CHANGES OCCURING IN TROPICAL
REGIONS
Rigor mortis present all over. Hypostasis well
developed and fixed. Greenish discoloration
showing over the castum.
Rigor mortis absent all over. Green
discoloration over whole abdomen and
spreading to chest. Abdomen distended with
gasses.
Ova of flies seen. Trunk bloated. Face
discoloured. Blisters present. Moving maggots
seen.
Whole body grossly swollen and disfigured.
Hair and nails loose. Tissues soft and
discoloured.
Soft viscera putrefied.
Only more resistant viscera distinguishable.
Soft tissues largely gone.
Body skeletonised.
CHRONOLOGICAL SEQUENCE OF THE
PUTREFACTIVE CHANGES WHEN THE BODY HAS
BEEN SUBMERGED IN WATER
Very little change if water is cold. Rigor mortis
may persist.
The skin on the hands and feet became
sodden and bleached. The face appears
softened and has a faded white color.
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1-3 days Face swollen and red. Greenish discoloration 1 – 2 wks
on the eyelids, lips, neck and sternum. Skin
3-5 days of the hands and feet wrinkled. Upper surface
of brain greenish in color.
Skin wrinkled. Srotum and penis distended 4 wks
with gas. Nails and hair still intact. Lungs
8-10 days emphysematous and covered the heart.
Abdomen distended, skin of hands and feet 6 – 8 wks
come off with nails like a glove.
14 – 20
days Factors Influencing the Floating of the Body in Water
Age: Bodies of fully-developed and well-nourished newly-
born infants float rapidly.
2-5 mos Sex: Women float sooner than men.
after death Conditions of the body: Stout persons float quicker.
Season of the Year: The moist hot air of summer is very
favourable for putrefaction.
Water: Dead body floats in a shallow and stagnant water of
creeks or pond sooner than in deep water in running
12 hrs streams.
External Influence: the presence of heavy-wearing
24 hrs apparel or addition weight in the pockets or attached to the
body delays floating.
Order of putrefaction when body is in water: Face, neck
48 hrs. and sternum; shoulders; arms; abdomen; legs.
INFLUENCE OF BACTERIA IN DECOMPOSITION
72 hrs
Decomposition is due to action of bacteria in various
tissues of the body. Aerobic activities are present in the
1 wk early stages of decomposition, later on activities of the
2 wks anaerobes are the most prominent with the production of
gasses. Softening of tissues is the result of bacterial action,
1 mo. proteolytic and autolytic ferments.
The microorganism that plays an important role in
decomposition is Clostridium Welchii. It grows in the
parenchyatous organs and is responsible for the
disintegration of cytoplasm, destruction of nuclei and
generation of gasses in the cells.
4-5 days Other destructive agents during decomposition include flies
and maggots, reptiles, rodents, other mammals, fishes and
5-7 days crabs, and molds.
Special Modification of Putrefaction
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I. Mummification: the dehydration of the whole body
which results in the shivering and preservation of the
body. Mummification usually happens in warm
countries where evaporation of body fluids takes place
earlier and faster than decomposition.
Kinds of mummification:
Natural: the body will become dehydrated and mummified
due to the forces of nature.
Artificial: (1) acceleration of the evaporation of the tissue
fluids of the body before actual onset of decomposition; (2)
addition of preservatives to inhibit decomposition.
II. Saponification or Adipocere Formation: a condition
wherein the fatty tissues of the body are transformed
to soft brownish-white substance known as adipocere.
Factors Influencing Adipocere Formation
State of Health before Death, Time interval between death
and burial, effect of a coffin, presence of clothing, type of
soil, access of air to the body after burial, mass grave.
III. Maceration: the softening of the tissues when in a fluid
medium in the ansence of putrefactive microorganism
which is frequently observed in the death of the fetus
en utero.
Duration of Death
Presence of Rigor Mortis: in warm countries, rigor mortis
sets in from 2-3 hrs after death. It si fully developed in the
body after 12 hrs. It may last from 18 – 36 hrs and its
disappearance is concomitant with the onset of
putrefaction.
Presence of Post-mortem lividity: usually develops 3-6 hrs
after death. Appears as small petechia-like red spots which
later coalesce with each other to involve bigger areas in the
most dependent portions of the body.
Onset of Decomposition: In tropical areas, decomposition
is early and the average time is 24-48hrs after death.
Stage of Decomposition: the approximate time of death
may be inferred from the degree of decomposition.
Entomology of the Cadaver: to approximate the time of
death, the presence of flies in the cadaver is sometimes
used.
Stage of digestion in the stomach: it normally takes 3-4 hrs
for the stomach to evacuate its contents after a meal. The
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approximate time of death may be deduced from the
amount of food in the stomach in relation to his last meal.
Presence of live fleas in the clothing (drowning cases): a
flea can survive for approximately 24hrs submerged in
water. Fleas recovered, usually from the clothing of the
victim, is observed if it still living to approximate the time
when said was submerged in water.
Amount of urine in the bladder: the amount of urine in the
urinary bladder may indicate the time of death when taken
into consideration, he was last seen voiding his urine.
State of the clothings: a circumstantial proof of the time of
death is the apparel of the deceased
Chemical changes in the Cerebro-Spinal Fluid
Post-mortem clotting and decoagulation of blood: blood
clots inside the blood vessels in 6-8hrs after death.
Presence or absence of soft tissues in skeletal remains:
under ordinary conditions, the soft tissues of the body may
disappear 1-2yrs after burial.
Condition of the Bones: if all the soft tissues have already
disappeared from the skeletal remains, the degree of
erosion of the epiphyseal ends of long bones, pulverization
of flat bones and diminution of weight due to the loss of
animal matter may be the basis of the approximation.
PRESUMPTION OF DEATH
Rule 131 Section 5 Rules of Court
Article 390 Civil Code
 Disputable Presumption: not heard from for 7
years = DEAD
o Dead for all purposes. EXCEPT:
SUCCESSION
 Absentee shall not be presumed dead for the
purpose of opening his succession till after
absence of 10 years.
o If he disappeared after 75 years old:
Absence of 5 years SUFFICIENT to
open succession.
Article 391 Civil Code
 Presumed DEAD FOR ALL PURPOSES:
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o Lost on board a vessel lost during sea other, shall prove the same; in the absence of proof, it is
voyage, missing airplane, not been presumed that they died at the same time and there shall
heard of for 4 years since loss of be no transmission of rights from one to the other.
vessel or airplane.
o Person in armed forces who has taken CHAPTER VII
part in war, missing for 4 years SPECIAL DEATHS
o Person In danger of death other
circumstances and his existence not I. JUDICIAL DEATH
known 4 years.
METHODS
Article 392 Civil Code
1. Death by Electrocution
If absentee appears or without appearing his 2. Death by Hanging
existence is proved, he shall recover his property in the 3. Death by Musketry
condition in which it may be found, and the price of any 4. Death by Gas Chamber
property that may have been alienated or the property
acquired therewith; but he cannot claim either fruits or OTHER METHODS OF CAPITAL PUNISHMENT
rents.
1. Beheading
PRESUMPTION OF SURVIVORSHIP 2. Crucifixion
3. Beating
Rule 131 Section 5(jj) Rules of Court 4. Cutting Asunder
5. Precipitation from a height
When 2 persons die in same calamity, such as: 6. Destruction by a wild beast
7. Flaying
 Wreck 8. Impaling
 Battle 9. Stoning
 Conflagration 10. Strangling
11. Smothering
Not shown who died first; there are no particular 12. Drowning
circumstances from which it can be inferred, the
survivorship is presumed from the probabilities resulting II. EUTHANASIA
from the strength and age of the sexes, according to the ―Mercy Killing‖ – deliberate and
following: painless acceleration of death of a
person usually suffering from an
1. Both UNDER 15: Older presumed survived incurable and distressing disease.
2. Both ABOVE 60: Younger presumed
survived TYPES:
3. One UNDER 15, Other ABOVE 60: UNDER
15 presumed survived 1. Active Euthanasia
4. One OVER 15, Other UNDER 60, 2. Passive Euthanasia
a. Different Sex: Male presumed a. Orthothanasia
survived b. Dysthanasia
b. Same Sex: Older

5. One UNDER 15, or ABOVE 60, the other

BETWEEN those ages: latter presumed Ways of Performing Euthanasia
survived
1. Administration of a lethal dose of poison
Article 43, Civil Code: 2. Overdosage of sedatives, hypnotics, other
pain relieving drugs
If there is a doubt, as between 2 or more persons 3. Injection of air into bloodstream
who are called to succeed each other, as to which of them 4. Application of strong electric currents
died first, whoever alleges the death of one prior to the

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5. Failure to institute the necessary
management procedure which is essential
to preserve the life of the patient.
Ways of Performing Euthanasia
1. Patient himself
2. The physician, with or without the
knowledge and and consent of the patient
3. Poison was administered by the physician to
the patient without the knowledge and
consent of the patient, then it is murder.
Treachery is inherent to the act of poisoning
and treachery qualifies it to murder.
III. SUICIDE
Psychological Classification of Suicide
1. First degree – deliberate, planned,
premeditated, self-murder
2. Second degree – impulsive,
unplanned, under great provocation or
mitigating circumstances
3. Third degree – sometimes called
accidental suicide. This occurs when a
person puts his or her life into jeopardy
by voluntary self – injury
4. Suicide under circumstances which
suggest a lack of capacity for intention
as when the person was psychotic or
under influence and effects of drugs
and alcohol.
5. Self-destruction due to negligence
6. Justifiable suicide – self- destruction
action of a person with terminal illness.
Evidence that will infer death is suicidal:
1. History of depression, unresolved
personal problem, mental disease
2. Previous attempt of self-
destruction
3. If committed by infliction of
physical injuries, the wounds are
located in areas accessible to the
hand, vital parts of the body and
usually solitary.
4. Effects of act of self-destruction
found in the body of the victim
5. Presence of suicide note
6. Suicide scene in place not
susceptible to public view
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7. Evidence which will rule out
homicide, murder, parricide, and
other manner of violent death.
CHAPTER VIII
DISPOSAL OF THE DEAD BODY
Persons Charged with Duty of Burial:
1. If married: surviving spouse if possesses means to pay
the necessary expenses.
2. Unmarried or child: nearest kin if they be adults and
within the Philippines and in possession of means to pay
the necessary expenses.
3. Unmarried or no kin left with means: municipal
authorities
*Shall perform such duty within 48 hours after death, if able
to do so.
Right of Custody to body:
To the person charged with the duty of burying the body
except when inquest is required by law to determine cause
of death or cause of death is accompanied by
communicable disease, custody of which will remain to
local board of health or municipal council until buried.
Right of custody means possession, the holding of a thing
or the enjoyment of a right. Enjoyment of a thing could
either be in the concept of ownership or holder of a thing
while ownership belongs to another. The right of
possession of a corpse is equivalent to ownership and
unlawful interference is an actionable wrong.
Surviving spouse has the preferential right and duty to
make the arrangements but if deceased spouse left a will
stating among other things the manner his body will be
disposed, such provision will prevail over the provisions of
the Administrative Code.
Methods of Disposal of the Dead Body
1. Embalming
- Artificial way of preserving body be injecting
formalin and perchloride of mercury or arsenic in the
common arteries and the femoral arteries.
2. Burial or Inhumation
- Body must be buried within 48 hours after death
except when required for legal investigation or authorized
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FROGLETS NOTES
by local health authorities or when embalmed (impliedly
allowed). After 48 hours, new permit is needed. If with
communicable disease, within 12 hours after death unless
directed otherwise by local board of health.
In Philippines, body needs to be buried within 24
hours because of the climatic condition.
 Death Certificate necessary before burial except
in cases of emergency. Primary duty of physician
to furnish if available. If not, local health officer,
mayor, the secretary or of a councilor. Order is
successive and exclusive.
- It must be forwarded within 48 hours after death.
* The person who issued the death certificate shall notify
the justice of the peace or the auxiliary justice or the mayor
if neither of the two is available if he observed any
indication of violence or crime. Permission from the
provincial fiscal or mayor is necessary if death due to
violence or crime.
Burial and transfer Permits
Municipal secretaries, in the capacity of
secretaries of municipal boards of health or as clerks to
municipal councils as the case may be, shall issue burial or
transfer permits upon the presentation of the death
certificate. Copy of death certificate shall accompany
transfer permit if body will be transferred from one
municipality to another. Those bodies with dangerous
communicable disease shall not be carried from place to
place except for burial or cremation. It is the duty of the
local health authorities to cause such body to be thoroughly
disinfected before being prepared for burial. Only adult
members of the family may be permitted to attend the
burial.
Burial permit (death certificate) must be
presented before burial.
The Law Penalizes Desecration of Burial Premises
(Sec. 2695, Revised Administrative Code)
Burial Grounds Requirements (PD 856, Code of Sanitation)
Burial Grounds Requirements the following requirements
shall be applied and enforced:
(a) It shall be unlawful for any person to bury remains in
places other than those legally authorized in conformity
with the provisions of this Chapter.
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(b) A burial ground shall at least be 25 meters distant from
any dwelling house and no house shall be constructed
within the same distance from any burial ground.
(c) No burial ground shall be located within 50 meters from
either side of a river or within 50 meters from any source of
water supply.
The burial remain is subject to the following requirements:
(a) Shipment of remains abroad shall be governed by the
rules and regulations of the Bureau of Quarantine.
(b) The burial of remains in city or municipal burial grounds
shall not be prohibited on account of race, nationality,
religion or political persuasion.
(c) Except when required by legal investigation or when
permitted by the local health authority, no unembalmed
remains shall remain unburied longer than 48 hours after
death.
Study Articles 305, 306, 307, 309 and 2219 of the NCC
as well as Articles 132 and 133 of the RPC.
Limitations to the Funeral Rites
a. Will of the deceased
b. Burial of the person sentenced to death must not be held
with pomp (Art. 85, RPC)
c. Restrictions as to funeral in cases of deaths due to
communicable disease
When the cause of death is a dangerous
communicable disease, the remains shall be buried within
12 hours after death. They shall not be taken to any place
of public assembly. Only the adult members of the family of
the deceased may be permitted to attend the funeral.
3. Disposal of Dead Body to the Sea
Allowed when death is not due to dangerous
communicable disease. A special permit needs to be
secured from officers authorized to issue permits.
4. Cremation
Pulverization of the body into ashes by the
application of heat. Body must first be identified and there
must be a permit for cremation.
When not granted:
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1. If deceased left a written direction that he will not be Persons who can grants permission to used body parts of
cremated deceased:

2. Identity has not yet been definitely ascertained a. Before death:

3. Further inquiry needed to cause of death 1. Deceased during his lifetime

5. Use of Body for Scientific Purposes
Unclaimed remains may be used by medical
schools and scientific institutions for studies and research
subject to the rules and regulations prescribed by the
department.
Study RA 349 as amended by RA 1056 (Donations of
Human Body Parts)
Donation of Human Organs for Medical, Surgical and
Scientific purposes Any person may donate an organ or
any part of his body to a person, a physician, a scientist, a
hospital or a scientific institution upon his death for
transplant, medical, or research purposes subject to the
following requirements:
2. If minor, guardian with the approval of the
court or by the legitimate father or mother. Married woman
can give consent without husbands consent.
b. After death:
1. Nearest relative
2. Head of hospital or institution having custody
in the absence of relatives
Persons permitted to detach body parts:
1. License physician or surgeon
2. Known scientist

(a) The donation shall be authorized in writing by the donor
specifying the recipient, the organ or part of his body to be
donated and the specific purpose for which it will be
utilized.
(b) A married person may make such donation without the
consent of his spouse.
(c) After the death of a person the next of kin may
authorize the donation of an organ or any part of the body
of the deceased for similar purposes in accordance with
the prescribed procedure.
(d) If the deceased has no next of kin and his remains are
in the custody of an accredited hospital, the Director of the
hospital may donate an organ or any part of the body of the
deceased in accordance with the requirement prescribed in
this Section.
(e) A simple written authorization signed by the donor in
the presence of two witnesses shall be deemed sufficient
for the donation of organs or parts of the human body
required in this Section, notwithstanding the provisions of
the Civil Code of the Philippines on matters of donation. A
copy of the written authorization shall be forwarded to the
Secretary.
(f) Any authorization granted in accordance with the
requirements of this Section is binding to the executors,
administrators, and members of the family of the deceased.
24 By 4D2014-2015
3. Medical or scientific institutions including eye
banks.
Requirements:
1. Must be in writing
2. Specify the person/institution granted the
authorization
3. Specify the organ/part to be detached
4. Signed by the grantor and 2 disinterested
persons
5. Copy furnished to the Secretary of Health
Limitation to the Authorization
Not allowed when died with dangerous
communicable disease
Penal Provision
Imprisonment of not less than six months nor
more than one year.
Exhumation
The deceased buried may be raised or
disinterred upon lawful order from fiscals, court and any
entity vested with authority to investigate. It must be

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FROGLETS NOTES
identified by relatives, friends or by marks on the body.
Physician must describe the coffin, clothing and degree of
decomposition before stating the actual disease or violence
in his report. Even members of NBI are required to get
permit from the Director of Health for exhumation.
Person died with for a cause other than
dangerous communicable disease may be disinterred after
3 years of being buried or in special cases, shorter time
when in the opinion of Director of Health, the public health
will not be endangered. It will be immediately disinfected
and inclosed in a coffin, case or box.
Disinterment of remains is subject to the following
requirements:
(a) Permission to disinter remains of persons who died of
non-dangerous communicable diseases may be granted
after a burial period of three years.
(b) Permission to disinter remains of person who died of
dangerous communicable diseases may be granted after a
burial period of five years.
(c) Disinterment of remains covered in paragraphs "a" and
"b" of this Section may be permitted within a shorter time
than that prescribed in special cases, subject to the
approval of the Regional Director concerned or his duly
authorized representative.
(d) In all cases of disinterment, the remains shall be
disinfected and places in a durable and sealed container
prior to their final disposal.
Read article 308 of the NCC
 If the dead body is a subject matter of criminal
investigation, it may be exhumed anytime
1. There must be a formal request from any of the law
enforcement agencies authorized to make investigation
addressed to any establishment authorized to perform
medico-legal investigation. Reasons could be:
a. Determine cause of death
b. Determine identity
c. Recover organs or tissues for further
examination for:
- toxicology analysis
- histopathological examination
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- smears from vaginal canal and blood for alcohol
determination
d. Recover foreign bodies
- Metalic fragment or whole slug for ballistic
examinations
- Operative sponge, medical instrument to prove
medical negligence
2. If the next of kin refuses to give consent for exhumation
autopsy, a petition in court must be done.
How long can exhumation be done after interment:
Sec 92 Code of Sanitation, Disinterment Requirements:
1. Permission to disinter remains of persons who
died of non - dangerous communicable disease
may be granted after burial period of 3 years
2. If death is due to a communicable dangerous
disease, permission may be granted after a burial
period of 5 years
3. Shorter period may be granted in special cases,
subject to the approval of Regional Director
(Director of Health) concerned or his duly
authorized representative.
4. In all cases of disinterment, the remains shall be
disinfected and placed in a sealed container prior
to disposal.
 According to Art 305 of the Civil Code, no human
remains shall be retained, interred, disposed of
or exhumed without the consent of: spouse,
descendants of the nearest degree, ascendants
of the nearest degree, brothers and sisters
 Sec 1098 Revised Administrative Code Shipment
of remains at sea - no body or remains shall be
shipped to the US except under such conditions
as may be prescribed by the United States Public
Health Service. The outside box containing the
remains shall be plainly marked so as to show
the name, age, nationality, of the deceased
person, the cause of death, the destination and
remains.
 If dead body is a subject matter of criminal
investigation, it may be exhumed anytime.
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Requirements to be satisfied in exhumation: g. Actual autopsy and adoption of procedure is

needed to accomplish the purpose of exhumation
a. Duration of interment as required h. Disinfection of the body and all areas involved
b. Exhumation permit to be provided by the Director must be carried out with the assistance of the
of Health local health officer and return of the body to the
c. Compliance of sanitary requirements, such that burial place
the body or remains, after exhumation shall
immediately be disinfected and enclosed in a
coffin or box and this box shall be placed in an Included in the Exhumation Report:
outside box which shall also be securely
fastened. a. The name of the deceased person and
circumstances
b. Purpose of exhumation
Procedure in medico - legal exhumations c. Name address and designation of the requesting
party
a. There must be formal request from any law d. Date, time place of exhumation
enforcement agency to make an investigation e. Description of the burial place
addressed to any person authorized to perform f. Name and address of the persons who identified
medico - legal investigation. The request must the burial place
mention the name of the deceased, place and g. Condition of the body and coffin if there is
date of interment suspicion as to the cause of interment
death etc. Reasons for the request are: h. Name and address of the persons who identified
 To determine the cause of death the body of the deceased
 Determine the identity of the deceased i. The post-mortem examination and
 Recover organs for further examination accomplishment of the purpose of exhumation
 Recover foreign bodies j. Conclusions based on the findings and result of
b. If the physician found that there is justification to examination
the exhumation and a strong probability for the k. Remarks if any
purpose to be realized, he may set the date and l. Signature and designation of physician’
time for exhumation
c. A written request for exhumation must be sent to
the regional director or ministry of health stating: Problems in Exhumation:
 Name of deceased
 Place of exhumation a. identity of the deceased - often in disaster victims
b. refusal of the next-of-kin to give consent or to
 Date and time of exhumation
cooperate in the exhumation-autopsy - often
 Duration of interment when the next-of-kin is involved in the
 Purpose of exhumation investigation
Remedy: petition in court for an order to exhume body
The Ministry of Health, aside from issuing the CHAPTER IX
necessary permit, shall also infor the local health MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES
officer to assist the physician in the exhumation to
ensure that public health will not be prejudiced.  Physical injury is the effect of some stimulus on
the body
d. During exhumation, the grave must be properly
identified by the person who was present when  Effect is apparent: stimulus applied is insufficient
the body was interred to cause injury and body resistance is great
e. During disinterment, care and diligence must be  Effect is real: effect is visible
observed to avoid destruction, deformity,
contamination or such other effects
f. After opening the coffin, the body must be viewed  Effect of application of stimulus: Immediate
by any or more persons who can identify the (sharp object causing stab wound); Delayed
deceased (blunt object causing contusion)

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c. dolor - pain on account of involvement of sensory

nerve
Causes of Physical injuries: d. loss of function - on account of trauma, tissue
may not be able to function normally
a. Physical violence Vital reaction differentiates an ante-mortem from post-
b. Heat or cold mortem injury
c. Electrical energy
d. Chemical energy In the ff instances, vital reactions or changes may not be
e. Radiation by radio-active substances observes even if injury was inflicted during life:
f. Change of atmospheric pressure (barotrauma)
g. Infection a. If PI were inflicted during agonal state of a living
person - body cells during that period may not
have the potential capacity to react to trauma
A. PI by Physical Violence b. If death is so sudden as not to give the tissues in
the body the chance to react properly e.g. deaths
Effect is the production of wound. due to sudden coronary occlusion
Wound is the solution of the natural continuity of any tissue
of the living body. It is the disruption of the anatomic Classification of wounds:
integrity of tissue in the body.
1. As to severity:
Effect of physical violence may not always result to a. Mortal wound - capable of causing death
production of wound but wound is always an effect of immediately after infliction or shortly
physical violence. thereafter
Parts of body where wound is inflicted
Physics of wound production: considered mortal:
Wound is kinetic energy times time times area times ―other Heart and big blood vessel
factors‖
Brain and upper portion of
 Kinetic energy: mass X velocity (squared) divided spinal cord
by 2. Velocity component is the important factor.  Lungs
 Time: shorter period used for transfer of energy,  Stomach, liver, spleen and
greater likelihood of producing damage. intestine
 Area of transfer: The larger the area of contract b. Non - mortal wound - not capable of causing
between the force applied on the body the lesser death immediately
is the damage to the body.
 Other factors: the less elastic and plastic the 2. Kind of instrument used:
tissue, the greater the likelihood that a laceration a. blunt instrument (contusion, hematoma,
will result. Elasticity and plasticity refer to the lacerated wound)
ability of a tissue to return to its normal size and b. sharp instrument: sharp-edged instrument
shape after being deformed by pressure. (incised wound) sharp-pointed (puncture
wound) sharp - edged and sharp - pointed
(stab wound)
Vital Reaction: sum total of all reactions of tissue or organ
to trauma. c. tearing force (lacerated wound)
d. change of atmospheric pressure
Ff are common reactions of a living tissue to trauma: (barotrauma)
e. heat or cold (frostbite, burns or scald)
a. rubor - redness or congestion of the area due to f. chemical explosion (gunshot or shrapnel
an increase of blood supply as a part of wound)
reparative machine
b. calor - sensation of heat or increase in
temperature 3. As to manner of infliction:

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a. hit - means of bolo, blunt, instrument, axe
b. thrust or stab - bayonet, dagger
c. gunpowder explosion - projectile or shrapnel
wound
d. sliding or rubbing or abrasion
4. Depth of wound:
a. superficial - only layers of skin
b. deep - inner structure beyond layers of skin
 penetrating - wounding agent enters
the body but did not come out or mere
piercing of solid organ or tissue or body
Penetrating wound - wound where dimension of depth and
direction is an important factor in its description. It involves
the skin or mucous surface and the deeper underlying
tissues or organs caused directly by the wounding
instrument. Example: punctured, stab, gunshot wounds.
 Perforating - wounding agent produces
communication between the inner and
outer portion of the hollow organs.
Traversing pr piercing completely a
particular part of body
5. Relation of site of application of force and
location of injury:
a. coup injury - physical injury which is located
at the site of application of force
b. contre - coup injury - physical injury found
opposite the site of application of force
c. coup contre - coup injury - physical injury
located at site and also opposite the site of
application of force (fixed head is hit with
moving object then falls on another hard
object)
d. locus minoris Resistencia - PI located not at
the side or opposite the site of application of
force but in some areas offering the least
resistance to the force applied. Blow on
forehead may cause contusion at region of
eyeball because of fracture on the
papyraceous bone forming roof of orbit.
e. Extensive injury - PI involving greater area
of body beyond site of application of force -
not only wide are of injury but various types
of injury. (fall from height or run-over of
victim in vehicular accident)
*stationary head is hit by moving
object, contusion is with the site of impact.; when moving
head hits a firm fixed and hard object, Brain contusion may
develop at opposite side of impact.
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6. Special types of wounds:
a. Defense wound - result of person’s instinctive
reaction of self - protection; injuries suffered by a person to
avoid or repel potential injury from aggressor (injury on
flexed forearms when about to be hit by blunt object;
incised or stab wound on palm when about to be stabbed
by another)
b. Patterned wound - Wound in the nature and
shape of an object or instrument and which infers the
object or instrument causing it.
Ex. Impact of the face on the radiator grill of a car
may cause imprint of the radiator grill on the face.
c. Self-Inflicted Wound - Self inflicted wound is a
wound produced on oneself. As distinguished from suicide,
the person has no intention to end his life.
Motive of Producing Self-Inflicted Wounds:
(1) To create or deliberately magnify an
existing injury of disease for pension or
workman’s compensation;
(2) To escape certain obligations or
punishment. During war time soldiers may
cut their fingers to avoid frontline
assignments and prisoners may inflict
physical injuries on their body to avoid hard
labor and just be confined in a hospital to
receive food and rest.
(3) To create a new identity or destroy the
existing one. Fingerprints may be
destroyed by acid, by cutting or burning.
(4) To gain attention or sympathy.
(5) Psychotic behavior
Some Ways of Self-Mutilation:
(1) Head banging or bumping - this is
commonly observed in overactive children
and causes hematoma.
(2) Exposure of parts of the body to heat
radiation from open fires, radiators, or
protective grills over radiator thermophilia.
(3) Penetrating nail or spike to the chest wall or
insertion into the urinary bladder in a
female.
(4) Castration by amputation of the penis.
(5) Trauma inflicted on the female genitalia to
induce abortion or promotes hemorrhage
and creates an anemia.
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FROGLETS NOTES
(6) Subcutaneous injection of fecal matters to
promote abscess formation.
(7) Pricking of acne eruption to lead to a
severe facial disfigurement.
(8) Subcutaneous injection of air to create a
condition of emphysema.
(9) Nail-biting (onychophagia) which may lead
to maceration of the skin and an infection.
(10) Grinding of the teeth (bruxism) is frequently
seen in the mentally retarded and can lead
to abnormal tooth wear, a bilateral
hypertrophy of the masseter and a pain on
chewing.
(11) Pressure on the subcutaneous tissue by a
tightly applied cord or belt around the body:
(a) Tribal customs of metal band
around the neck or a leg by some
African tribes may cause a
permanent disfigurement.
(b) Use of shoes made of metal by
chinese women.
(12) Pulling of the body hair (Trichotillomania)
(Forensic Medicine a Study in Trauma &
Environment Hazards by Tedeschi, Eckert &Tedeschi, Vol,
1, p.496)
Legal Classification of Physical Injuries:
 Mutilation:
Art. 262, Revised Penal Code
Kinds of Mutilation Punishable Under the Code:
1. Intentionally depriving a person, totally or
partially of some of the essential organs for
reproduction, and
2. Intentionally depriving a person of any part
or parts of the human body other than the
organs for reproduction.
Mutilation is the act of looping or cutting off any part or
parts of the living body. In order to be punishable under the
Code, it must be intentional, otherwise it will be considered
as a physical injury.
 ―Mayhem‖ is the unlawful and violent
and deprival of another of the use of a
part of the body so as to render him
less able in fighting, either to defend
himself or to annoy his adversary.
Mutilation of other parts of the body
other than the organ of reproduction
may be classified as mayhem.
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However, if it is not deliberate then it
may fall on paragraph 2, Art. 263,
Revised Penal Code (Serious Physical
Injuries).
 Is vasectomy and tubal ligation within
the purview of mutilation as defined
and penalized by Art. 262 of the
Revised Penal Code?
The Secretary of Justice rendered an opinion that
vasectomy and tubal litigation are not mutilation and a
legitimate method of contraception despite the fact that it is
done intentionally and deprives a person of his power of
reproduction. Because: …these two methods of surgical
sterilization are affected by the closing of a pair of tubes in
either man or the woman so that the sperm and ovum
cannot meet; it does not involve the removal of
reproductive glands or organs as in the case of castration,
with which it is sometimes confused.
Serious Physical Injuries:
Art. 263, Revised Penal Code:
The Crime of serious physical injuries my be due
to:
1. Wounding;
2. Beating;
3. Assaulting (Art. 263); or
4. Administering injurious substances (Art.
264) without the intent to kill.
It may be committed through a simple negligence
or imprudence
The main purpose of dividing the provision into four
paragraphs is to graduate the penalties depending upon
the nature and character of the wound inflicted and their
consequences on the person of the victim.
In paragraph one, the injured person became insane,
imbecile, impotent, or blind.
Insanity has not been defined or qualified by the
Article.
Imbecility infers that the injured person must be
of the preadolescent age and that on account of the
physical injuries inflicted there is an arrest of mental
development.
Impotency is the inability to grant to the partner
sexual gratification.
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Blindness must be total or involvement of both
eyes. If only one eye became blind, then the physical injury
will fall in paragraph 2 of Article 263.
In paragraph two, the following nature and character of the
wound or consequences of the injuries inflicted must be
present:
a. Loss of the use of speech or the power to
hear or to smell, or loss of an eye, a hand, a
foot, an arm, or a leg;
b. Loss of the use of any such member; or
c. Becomes incapacitated for the work in which
he was therefore habitually engaged.
There must be total loss of hearing capacity. If
the loss of power to hear is only in one ear, it is a serious
physical injury under paragraph 3, article 263 (People v.
Hernandez, 94 Phil. 49)
Insofar as loss of a hand is concerned, the
prosecution must prove by clear and conclusive evidence
that the offended party cannot actually make use of his
hand and that such impairment is permanent (People V.
Reli. C.A. 53 O.G. 5695).
In paragraph 3, the following injuries of their
consequences are included:
a. Deformity;
b. Loss of any other member of his body;
c. Loss the use thereof; or
d. Becomes ill or incapacitated for the
performance of the work in which he was
habitually engaged for more than 90 days,
as a consequence of the physical injuries
inflicted.
Deformity is a condition of physical ugliness. It
must be a permanent and conspicuous. The loss of the
front teeth, the development of a pigmented scar on the
face, or the loss of the pinna of the ear is considered
deformities. However, the development of a scar in
covered parts of the body may not be considered deformity
because it is not a conspicuous and visible.
―The loss of any other part of his body‖ means
loss of the parts of the body not mentioned in paragraph 2,
Art. 263.
Incapacity means the inability of the injured
person to perform, or engage on a work or vocation before
he sustained injury.
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In paragraph four, the injured person becomes ill
or incapacitated for labor for more than thirty days and
impliedly less than 90 days.
It is noteworthy to mention that in paragraph 3
and 4 of article 263 there is no mention of periods of
medical attendance but merely incapacity.
Administering Injurious Substances or Beverages:
Art. 264, Revised Penal Code:
Elements of the Crime:
a. The offender inflicted upon another person
or any serious physical injury.
b. The infliction of physical injury was done
knowing that the substance or the beverage
administered is injurious or took advantage
of the victim’s weakness or credulity; and
c. There was no intent to kill on the part of the
offender.
If the offender does not know that the substance
administered is injurious, he cannot be held liable under
the above provision.
The throwing of acid on the face of someone
does not fall within the provision because what the
provision contemplates is administering or taking in the
injurious substance or beverages (U.S. Chiong Songco, 18
Phil 459).
The provision does not contemplate of sight or
less serious physical injuries are the consequence of
injurious substances of beverages, but results only in
serious physical injuries.
If the administration of injuries substances or
beverages is intentional, the crime committed is frustrated
murder. Treachery is inherent when injurious substances or
beverages are introduced into the body.
Less Serious Physical Injuries:
Art. 265, Revised Penal Code:
The basis to determine whether the physical
injury is less serious or not is by either the period of
medical attendance or period of incapacity; both of which is
ten days or more but not more than thirty days.
The fact that the injury only requires medical
attendance for two days but incapacitated the victim from
attending to his ordinary work for a period of 29 days
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makes the crime less serious physical injuries (U.S. v.  The stab wound is
Trinidad, 4 Phil. 152). accessible to the hand
of the victim
There must be proof as to the period of medical  The hand of the victim is
attendance. In the absence of such proof of medical smeared with blood
attendance or incapacity, although the wound actually  The wounding weapon
healed in more than 30 days, the crime committed is only is firmly grasped by the
slight physical injuries (People v. Penesa, 81 Phil. 398) hand of the victim
(cadaveric spasm)
The Crime of less serious physical injuries may
 If stabbing is
be qualified and a fine or a higher penalty imposed when: accompanied with
a. There is a manifest intent to insult or offend slashing movement, the
the injured person; wound tailing abrasion is
b. There are circumstances adding ignominy to seen towards the hand
the offense; inflicting the injury
c. The victim is the offender’s parents,  A suicide note may be
ascendants, guardian, curators or teachers; present
or  There is the presence of
d. The victim is a person of rank or person in a motive for self-
authority, provided that the crime is not destruction
direct assault.  No disturbance in the
death scene, wounding
instrument is found near
(pp.252-268) the victim

In the Description of a Stab Wound, the following must be

included: b. Homicidal – stabbing with homicidal intent is the most
common
a. Length of the skin defect
b. Condition of the extremities Characteristics:
c. Condition of the edges
d. Linear direction of the surface wound 1. Injuries other than stab wound may be present
e. Location of the stab wound 2. Stab wound located in any part of the body
f. Direction of penetration 3. Usually more than one stab wound
g. Depth of the penetration 4. There is a motive
h. Tissue and organs involved - If without motive offender is
insane or under the influence of
drugs
Stab Wound(s) may be Suicidal, Homicidal or Accidental: 5. There is a disturbance in the crime scene

a. Suicidal – Evidences showing that the stab

wound is suicidal: Medical evidences showing intent of the offender to kill the
 Located over vital parts victim:
of the body
 It is usually solitary. If a. More than one stab wounds
multiple, located on one b. Located on different parts of the body
part of the body or on parts where vital organs are
 If located on covered located
parts of the body, the c. Deep
clothing is not involved d. Stab wound with serrated or zigzag
borders
e. Irregular or stellate shape skin defects

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 Different measurement of the stab wounds may a. Located where vital organs are located
be produced by one weapon if it is tapering b. Usually singular but may be multiple but located
towards the sharp point in one area
 Withdrawal of the instrument not on the same c. Parts of the body involved is accessible to the
direction as when it was introduced may hand of the victim
increases length of the skin defect d. Clothing is usually not involved
 Three-cornered file when used as a stabbing e. Wounding is made while the victim is sitting or
weapon- three-cornered skin defect standing. There is bleeding towards the lower
 The most common immediate cause of death- part of the body
hemorrhage f. No disturbance of the crime scene
 Accidental stab wounds are rare g. Presence of suicide note
h. Wounding instrument found near the body

4. Punctured Wound
 A result of a thrust of a sharp pointed instrument
 External injury small but depth is to a certain
degree
 Produced by: icepick, needle, nail, spear, pointed
stick, thorn, fang of animal, hook
 External hemorrhage is limited but internal
injuries may be severe
 Direct involvement of blood vessels and bloody
organs may cause fatal consequences
 Site of external wound can be easily sealed
 Punctured would is usually accidental but in rare
instances it may be homicidal or suicidal
Characteristics:
1. The opening on the skin is very small and may
become unnoticeable because of clotted blood
and elasticity of the skin. The wound is much
deeper than it is wide.
2. External hemorrhage is limited although internally
severe
3. Sealing of the external opening will be favorable
for the growth of anaerobic microorganism
Medical Evidences that tend to show it is homicidal:
a. It is multiple and usually located on
different parts of the body
b. Deep
c. Defense wounds on the victim
d. Disturbance of the crime scene- sign of
struggle
Proof to show it is suicidal:
Punctured would with puncturing instrument loaded with
poison:
a. Poison dart- cyanide or nicotine
b. Fish spines
c. Dog bites with hydrophobia virus
d. Injection of air and poison as a way of
euthanasia
5. Lacerated Wound (Tear, Rupture, Stretch, ―Putok‖)
 A tear of the skin and the underlying tissues due
to forcible contact with a blunt instrument
 Produced by: wood, iron bar, fist blow, stone, butt
of firearm, others without sharp objects
 Force applied to tissue is greater than its
cohesive force and elasticity
 The tissue tears and laceration is produced
Characteristics:
a. Shape and size of the injury do not correspond to
the wounding instrument
b. Tear on the skin is rugged with extremities
irregular and ill-defined
c. Injury developed is at the site where the blunt
force is applied
d. Borders of the wound are contused and swollen
e. Usually on areas where the bone is superficially
located, like scalp, malar region on the face, front
part of the leg, dorsum of the foot
f. Examination shows bridging tissue joining the
edges and hair bulbs intact
g. Bleeding is not extensive because blood vessels
are not severed evenly
h. Healing process is delayed

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Classification of lacerated wounds:
a. Splitting caused by crushing of the skin between
two hard objects
- Best seen in laceration of the
scalp, cut eyebrow of boxer,
laceration of the chin of
motorcyclist
b. Overstretching of the skin
- When pressure is applied on one
side of the bone, the skin over the
area will be stretched up to a
breaking point to cause laceration
and exposure of the fractured
bone
- In avulsion, the edges of the
remaining tissue is that of
laceration
c. Grinding Compression
- Weight and grinding movement
may cause separation of the skin
d. Tearing
- Produced by semi-sharp-edged
instrument which causes irregular
edges on the would
- Hatchet and choppers
 Lacerated wounds may involve deeper tissues
like laceration of the muscles and fracture bones
 It may be homicidal or accidental but rarely
suicidal
Distinction between and incised wound and a lacerated
wound:
Incised Wound Lacerated Wound
-Edges are clean cut; - Edges are roughly cut;
regular; well-defined irregular; ill-defined
-No swelling or contusions - There is swelling and
around the incised wound contusion around the
lacerated wound
-Extremities of the wound - Extremities of the wound
are sharp or may be round are ill-defined and irregular
or contused
-Examination by means of a - Examination with a
magnifying lens shows that magnifying lens shows that
the hair bulbs are cut the hair bulbs are preserved
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-Healing is faster - Healing is delayed
-Scar is linear or spindle- - Scar is irregular
shaped
-Caused by a sharp-edged - caused by a blunt
instrument instrument
Gaping of Wound:
The separation of the edges especially in deep wound may
be due to the following:
1. Mechanical stretching or dilatation
- Presence of a mechanical device
on the edges to prevent
coaptation will cause separation
2. Loss of Tissue
- Separation of edges of a wound
may be on account of loss of
tissue bridging them. The loss of
tissue may be due to:
i. Destruction by pressure,
infection, cell lysis, burning or
chemical reaction
ii. Avulsion or physical or
mechanical stretching
resulting to separation of a
portion of the tissue
iii. Trimming of the edges
3. Retraction of the Edges
- Underneath the skin are dense
networks of fibrous and elastic
connective tissue fibers running
on the same direction and forming
a pattern more or less present in
all persons. This is called
cleavage direction or lines of
cleavage of the skin.
- If an incised wound or stab wound
was inflicted wherein the long axis
of the wound is parallel or on the
same direction as the cleavage
line of the part of the body
involved, the wound will appear
narrow or slit-like because the
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edges of the wound will not be Pudental areas 1% 1%

subjected to the lateral pull of the
severed connective tissue fibers Total 100%
- If the long axis of the wound is
perpendicular to or with an angle
with the lines of cleavage, the
tendency of the borders of the Factors responsible for the severity of wounds:
wound is to separate on account
of the retraction of the severed 1. Hemorrhage
fibers a. Hemorrhage may influence the severity of
wound by:

Practical ways of determining how much of the skin surface a.1. Loss of blood incompatible with
is involved in an injury or disease: blood:

 Skin serves as the mechanical protection of the  Blood constitutes about 1/20
body of the body weight of an adult
 It is punctuated with sensory nerve endings for  By volume, an average size
pain, temperature and touch adult has 5 to 6 quarts of
 It acts as thermo-regulator, storage of water, blood
excretor of sweat and organ for absorption  A loss of 1/3 to 2/5 of the
circulating blood may result
 Determination of how much skin is involved is
important to determine the mode of treatment to irreversible hypovolemic
shock and may be fatal
and prognosis
 The volume of blood lost may
 Significant in cases of: burns, contusion, dermal
manifestation of certain diseases be related to the rate or
space of time a certain
 Burns in children and old age persons, volume of blood has been
involvement of more than 70% of the body shed
surface- fatal
 Males can stand more lost of
 Estimation as to how much of the body surface blood than females
involved, the rule of the nine is used
a.2. Hemorrhage may result in an
increase in pressure in or on the vital
Body surface expressed as percentage using the rule of organs to affect the normal function:
nine:
 Intracranial hemorrhage may
Whole of head and neck 9% 9% cause compression of
the vital centers of the
Whole of one upper 9% 18% brain.
extremity  Hemopericardium may cause
embarrassment of the
Whole of front chest and 18% 18% contraction of the heart.
abdomen  Hemorrhage into the chest
cavity may cause diminution
Whole of posterior chest 18% 18% of the respiratory output with
and abdomen subsequent anoxia
a.3. Hemorrhage may cause
Whole of one lower 9% 18% mechanical barriers to the function of
extremity (front) organs:

Whole of one lower 9% 18%  Hemorrhage into the tracheo-

extremity (back) bronchial lumina can cause
asphyxia

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b. Cause of Hemorrhage: 3. Organs Involved

b.1. Trauma:
 Trauma on the vital organs of the body are
 Destruction of the blood always serious
vessel wall or increase  Crushing wounds of the heart, brain or longs are
permeability of its wall due to almost fatal
external force
b.2. Natural Causes:
4. Shock
 Common causes of
hemorrhage due to natural  May occur with or without violence
causes:  Slight blow on genitalia, slight burns in children or
o Intra-cerebral old persons, or slight violence on the head or
hemorrhage neck may cause severe shock
(apoplexy)  But violent traumas to healthy, strong persons
o Spontaneous may not produce shock
subarachnoid
hemorrhage
o Rupture of the 5. Foreign body or substance introduced into the body:
arteriosclerotic
aneurysm of the  Incision with an unsterilized scalpel may not be
aorta serious as the bite of a venomous snake
o Rupture of the  A foreign substance or body may be toxic by
esophageal varices itself or may act as a physical irritant
in cases of
cirrhosis of the liver
and bleeding of The foreign body or substance may be:
peptic ulcer of the
stomach and a. Bacterial:
duodenum
o Pulmonary - Tetanus
hemorrhage - Pathogenic microorganism
o Ruptured ectopic
pregnancy b. Viral:
o Spontaneous
rupture of - Hydrophobia
cavernous
hemangioma or - Hepatitis
hepatoma
o Rupture of the c. Foreign body:
enlarged spleen
- Bullet

2. Size of Injury: - Glass fragments

 Burns affecting 1/3 of the body surface of the - Shrapnel

third degree type is usually
fatal - Gauze or rubber drain
 Bigger wounds are more exposed to infection d. Chemical:
and other physical conditions
of the surroundings - Cyanide

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- Nicotine
e. Toxin
 Snake Venom
o Characterized as two
punctured wounds at the
center of the reddened
affected area
Snake venom toxicity will depend on:
a. Potency of venom injected
b. The amount of venom depends on the season
of the year and the length of time the
snake has eaten. If a snake has just killed his
prey, the toxic content is smaller
c. Size of Patient
d. The immediate treatment instituted
Snake venoms are of two principal classes:
a. Neurotoxic - primarily paralyzes the respiratory
and cardiac center of the
brain. May cause nausea,
vomiting, ascending
paralysis, coma,
convulsion, and cardiac
and respiratory arrest.
b. Hematoxic - affects particularly the blood. The
manifestations are pain and
swelling of the affected
area, intravascular
hemolysis, abdominal pain,
nausea, vomiting, petechial
hemorrhage on the gum,
pulmonary and cardiac
edema.
Emergency treatment may be:
a. Incision of the wound to promote more
external hemorrhage to
drain the venom
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b. Tourniquette above the site of the wound
c. Placing ice on the bite site
d. Sucking the wound to drain venom
e. Administration of anti-snake venom serum
 Scorpion Venom
o Has neurotoxic, hemolytic
and hemorrhagic effect
o Produces only one punctured
wound on the center of a
reddened area
o Main symptoms are pain
edema and reddening
 Coelenterate Sting (jellyfish)
o The tentacles penetrate into
the skin and cause explosion
of the nematocyst and
liberation of the venom
o Symptoms are extreme pain,
urticarial rash, abdominal
pain, dilated pupils, paleness
and labored breathing
6. Absence of medical or surgical intervention:
 A wound may not be fatal, but because of
neglect in its management it may become
serious or fatal
Fatal Effect of Wounds:
1. Wound may be directly fatal by reason of:
a. Hemorrhage
 Incised wound on carotid artery without
surgical intervention is fatal
b. Mechanical injuries on the vital organs
 Blow on the head may not necessarily
produce external lesions but may
produce severe meningeal hemorrhage
producing compression of the brain
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c. Shock 2. Changes producing

separate
 Disturbance of the balance of fluid in pathological lesions
the body capable of producing delayed which in turn
or immediate death proves to be fatal
Ex: Operation
performed on a
2. Wound may be indirectly fatal by reason of: patient to ligate
bleeding vessel
a. Secondary hemorrhage following sepsis inside the
abdominal cavity
 On account of infection that sets in, with reasonable
deeper tissues are involved skill and due
diligence but as a
b. Specific Infection result of which
peritonitis
 Pathogenic microorganisms may developed and
develop and multiply in the wound caused death of
causing septicemia, bacteremia, or patient
toxemia

3. Changes where a
c. Scarring Effect definite
 Chronic gonorrheal infection may pathological
condition was
cause stricture or urethra
present before the
injury
d. Secondary Shock Ex: A person
suffering from
Nature or death due to secondary shock tumor or cyst and
was stabbed by
- A person may have recovered someone. The stab
from the immediate effects of the is not capable of
trauma or violence, but may later producing death
die of its secondary effects or ordinarily. The
changes person may die of
the pathological
condition and the
These changes may be classified accused is liable
as follows: for his death

1. Changes whose
natural sequence
are direct and 4. Changes where a
obvious definite
Ex: Septicimia, pathological
tetanus or condition of totally
complications different nature
arising from arises after the
wounds wounding and the

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consequential  The extravasation or loss of blood from

sequence is the circulation brought about by wounds
doubtful in the cardio-vascular system.
Ex: Tuberculosis  The degree and nature of hemorrhage
meningitis that depends upon the size, kind and location
develops following of the blood vessel cut.
a blow on the head

Kinds of Hemorrhage:

Complication of trauma or injury: a. Primary Hemorrhage

 It is the bleeding which
1. Shock occurs immediately after
 The disturbance of fluid balance the traumatic injury of
resulting to peripheral deficiency which the blood vessel
is manifested by the decreased volume
of blood, reduced volume of flow,
hemoconcentration and rental b. Secondary Hemorrhage
deficiency  This occurs not
 Clinically characterized by severe immediately after the
depression of the nervous system infliction of the injury but
 Three major factors operate in the sometime thereafter on
production of shock and all are likely to or near the injured area
be associated together as the condition
develops
a. Injury to the receptive 3. Infection:
nervous system  Infection is the appearance, growth and
b. Anoxemia – reduction of development of microorganisms at the site
effective volume of of the injury
oxygen carrying
capacity of the blood
c. Endothelial damage, How injury or trauma acquires infections:
thus increasing capillary
permeability a. From the instrument or substance
which produces the injury
b. From the organs involved in the trauma
Kinds of Shock: applied
c. As an indirect effect of the injury which
a. Primary Shock creates a local area of diminished
 Caused by immediate nerve resistance causing the invasion and
impulse set up at the injured multiplication of microorganisms
area which are conveyed to d. Injury may depress the general vitality,
the central nervous system especially among the aged and the
young children and makes the patient
succumb to terminal disease
b. Delayed or Secondary Shock e. Deliberate introduction of
 Patient shows sign of general microorganisms at the site of the injury
collapse which develop some
time after the infliction of
injury 4. Embolism:
 A condition in which foreign matters are
introduced in the blood stream causing
2. Hemorrhage

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sudden block to the blood flow in the finer
arterioles and capillaries
The most common emboli in the blood
stream are:
a. Fat Embolus
 Causes of Fat Embolus:
o By injection of oily
substance into the
circulation
o By injury of the
adipose tissue
which forces fat
into the circulation
b. Air Embolism
 Causes of Air Embolism:
o Gaping incised
wound of the jugular
vein
o Injection of
soapsuds or air into
pregnant uterus for
the purpose of
tubal insuflation or
criminal abortion
o Injection of air into
the urinary bladder for
radiological study
o Insuflation of the
other non-potent tubes
or hollow organs
o Injection of air
under pressure into
the nasal sinus
after a therapeutic
lavage
Healing of Wounds
1. Power of the human tissue to regenerate
 Regeneration is the replacement of
destroyed tissue by newly formed similar
tissue
 The more highly specialized the tissue, the
less capacity for regeneration
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 Capacity for regeneration decreases as age
increases
 State of nutrition of the individual affects
capacity or regeneration
The following regenerates rapidly:
a. Connective tissues
b. Blood forming tissues
c. Surface epithelium of the skin
Those having no power or limited capacity to
regenerate:
a. Highly specialized glandular epithelium
b. Smooth muscle
c. Neurons of the central nervous system
 Small clean-cut wound is covered with
lymph in 36 hours
 The edges adhere in two days and wound
heals on the 7th day leaving a linear scar
 Larger incised wound shows swelling of the
edges 8 to 12 hours
 Blood-stained serum is present in 2 days
which afterwards become seropurulent on
the 3rd day, lasting in state from 4 to 5 days
 Small red granulation forms in 12 to 15 days
and the epithelium grows from the edges
 Scar develops later
Healing of Wounds
The time of healing wounds is dependent on the
following: vascularity, age of person, degree of rest or
immobilization and nature of the injury.
2. Kinds of Healing Wounds
a. Healing by Primary (First) Intention
It takes place when there is minimal tissue loss, more
approximation of the edges and without significant
bacterial contamination. Within 24 hours after the injury,
there is an acute neutrophilic response and scab will be
formed due to dehydration of the surface clot. After
three days, microphages and fribroblasts will appear.
Collagen fibers will bridge the raw area and
differentiated surface cells begin to proliferate to cover
the exposed area. The normal state of the area may
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return after a lapse of one month with or without the cuts, hair and other foreign bodies in the scene; (c)
formation of a scar. witnesses to the incident; (d) wounding instrument;
(e) photography, sketching or accurate description of
b. Healing by Secondary Intention the scene of the crime for preservation
It take place when the injury causes more extensive
loss of cells and tissues. Inflammatory reaction is more 2. Examination of the Wounded Body
intense and granulation tissue growth bears all the
responsibility for its closure. Production of a large scar
and greater loss of skin appendages (hair, sweat and Living Victim Dead Victim
sebaceous glands) and slower reparative process may Age of the wound from degree
occur. of healing
Weapon used
c. Aberrated Healing Process Reasons for multiplicity of
wounds
In some instances, healing process may deviate from Whether injury is accidental, suicidal
the normal way on a normal individual and may result or homicidal
to: Ante-mortem or post-
Dangerous to life of injury
(1) Formation of Excessive Granulation Tissue or mortem wound
"Proud Flesh" - It may prevent the closing of wound and Permanent deformity Mortal or non-mortal wound
can be remedied by excision or cautery. caused by injury
Presence of disease or
(2) Keloid Formation - It is the a large bulging tumorous abnormal development at
Shock produced by wounds time of wounding which
scar produced by an abnormal amount of collagen in the
connective tissue. may accelerate death
Complications produced by Cause of wound (accident,
(3) Stricture - It is the contraction of the fibrous tissue of injury suicide, homicide)
the scar formed.

(4) Fistula or Sinus Formation - Fistula is a 3. Examination of the Wound

communication between an inner cavity and the outside
while sinus is a tract of infection traversing the inner part
of the body. It may remain for a lone time unless the
causal factor (infection or foreign body) is removed.
CHAPTER X
MEDICO-LEGAL INVESTIGATION OF WOUNDS
Rules to observe by the physician in examining wounds:
 ALL injuries must be described.
 Description must be comprehensive with sketches or
photographs if possible.
 Examination must not be influenced by other
information obtained from others in making a report
or conclusion.
Outline of Medico-Legal Investigation of Physical Injuries
1. General Investigation of the Surroundings: (a) place
of the commission of the crime; (b) clothing, stains,
40 By 4D2014-2015
 Character - State the type of wound, characteristic
marks, presence of contusion collar, scab
formation, infection, surgical intervention, etc.
 Location - Region of the body where it is situated,
distance of the wound from some fixed point in the
body prominence. Location is important in
determining trajectory or course of the wounding
weapon
 Depth - It is measurable if the outer wound and inner
end is fixed. It must not be attempted in a living
subject if it will prejudice the health or life or in a
stabbed wound in the abdomen due to movability
of the abdominal wall
 Condition of Area Surrounding the Wound - Presence
of burning or tattooing in gunshot wounds by near
or contact fire, hesitation cuts in suicidal incised
wound or contusion in lacerated wound
 Extent - Extensive injury may show marked degree of
force applied
 Direction - It is material in determining the relative
position of the victim and offender.
 Number - Multiple wounds in different parts of the
body are generally indicative homicide or murder.

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 Conditions of the Locality - (a) degree of hemorrhage; and cellular tissues not clot
(b) evidence of struggle; (c) position of the body; removed by washing
(d) presence of suicide note; (e) condition of Edges and cellular tissues
weapon. Edges gape owing to the are not deeply stained and
reaction of the skin and can be removed by
muscle fibers washing.
Factors in Determining Whether Wounds were Inflicted
During Life or After Death Edges do not gape but are
closely approximated to
1. Hemorrhage is more profuse when the wound was Inflammation and reparative
processes each other unless wound is
inflicted during lifetime. If wounds are inflicted after caused within one or two
death, the amount of bleeding is comparatively less hours after death.
due to loss of tone of blood vessels, absence of heart No inflammation or
action and post-mortem clotting of blood. Violence reparative processes
upon a living body may not show bruise until after
death.
Factors in Determining Whether Wound is Homicidal,
Suicidal or Accidental
2. Signs of Inflammation such as pus, adhesion of the
edges and other vital reactions may be present 1. Nature of the wound inflicted
whenever the wound was inflicted during lifetime  Abrasions - extensive in accidental death, rare in
although they may be less pronounced when suicidal, not common in murder unless the
resistance of the victim is markedly weakened. Post- body is dragged on the ground, common in
mortem wounds do not show any manifesting signs homicide especially when victim offered some
of vital reaction. degree of resistance.
 Contusion - rare in suicide unless done by
jumping from a height, may be found in
3. Signs of Repair such as fibrin formation, growth of accidental death often due to a fall or forcible
epithelium, scab or scar formation conclusively show
contact with some hard object.
that wound was inflicted during lifetime. But absence  Incised wound - common in suicide and
of such does not show wound was inflicted after homicide. Accidental cuts are frequent
death since the tissue may not have been given everyday occurrences but rarely cause of
ample time to repair before death took place.
death.
2. External signs and position and attitude of the body
4. Retraction of the Edges of the Wound inflicted during when found
life cause gaping of the wound while in case of 3. Location of the weapon or manner it is held
wound inflicted after, edges do not gape and are 4. Motive
closely approximated to each other. 5. Personal character of the deceased
6. Other information such as:
 Signs of struggle - Its absence is more in suicide,
Distinction between Ante-Mortem and Post-Mortem accident or murder. Presence of hair or portion
Wounds of skin on nails of assailant or deceased
 Number and direction of wound - Multiple
Ante- Post- wounds in concealed parts of the body are
Mortem Mortem indicative of homicide. Single wound in a
Wound Wound position the deceased could have been
Hemorrhage more or less conveniently inflicted is suicidal. In cut-throat,
copious and generally Hemorrhage slight or none generally transverse in homicide while oblique
at all and always venous in suicide.
arterial
Marks of spouting of blood  Nature and extent of wound - Homicidal wounds
from arteries No spouting of blood may be caused by any wounding instrument
Deep staining of the edges Blood is not clotted or a soft while suicidal wounds are due to sharp
instruments.
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FROGLETS NOTES
 State of clothings - Usually no change in its
condition in suicide while it may be in disorderly
position due to struggle in homicide.
Factors in Determining Length of Time of Survival of the
Victim After Infliction of the Wound
1. Degree of Healing
Signs of repair appear in less than a day after
infliction of injury. By the degree of the granulation of
tissue formation and other reparative changes, the
age of the wound may be estimated.
2. Changes in the Body
Systemic changes such as degree of wasting,
anemia, condition of the face and bed sore formation
may provide for a basis.
3. Age of the Blood Stain
It may be determined from the physical color
changes of the skin although it is not reliable.
4. Testimony of the Witnesses
In cases where witnesses testify as to the exact
time, medical evidence as to duration of survival is
merely corroborative.
Possible Instruments Used by Assailant Inferred from
Nature of Wound
 Contusion - blunt instrument
 Incised wound - sharp-edged instrument inflicted by
hitting
 Lacerated wound - blunt instrument
 Punctured wound - sharp-pointed instrument
 Abrasion - body surface rubbed on rough hard
surface
 Gunshot wound - diameter of the wound of entrance
may approximate caliber of firearm
 A physician can only state that it is possible that a
certain injury is possibly caused by a certain
instrument presented. He must be cautious in making
categorical statements.
 In case of multiple offenders and there is conspiracy,
it is not necessary to determine who inflicted the fatal
blow. Where victim received multiple injuries,
determining which injury caused the death depends
on the testimony of the physician by examining which
of the wounds caused injury to some vital organs or
large vessels or led to secondary results causing
death.
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 Determining which of the wounds were inflicted first
depends on relative position of the parties, trajectory
of the wound inside the body, organs involved and
degree of injury, testimony of witnesses and
presence of defense wounds.
Effect of Medical and Surgical Intervention on the Death
1. If death occurred after medical intervention, offender is
still liable provided (1) death is shown to be inevitable and
even without intervention, death is a normal and direct
consequence; (2) physician must be competent and
exercised care and diligence.
2. Minor wounds were received by victim but death resulted
on account of gross incompetence or negligence of
physician, offender is liable only for the physical injuries
inflicted.
Effect of Negligence of the Injured on the Death
Negligence of the victim in the proper care and
treatment of the injury will not exonerate the offender since
he is not bound to submit himself to medical treatment. But
if negligence is deliberate and is really the cause of death,
offender can only be held liable for physical injuries.
Power of Volitional Acts of the Victim After Receiving a
Fatal Blow
The determination of the victim's capacity to perform
volitional acts rests upon the medical witness.
 Severe injury of the brain and cranial box -
usually produces unconsciousness but power
to perform volitional acts depends upon areas
of the brain involved.
 Wounds of big blood vessels (carotid, jugular,
even aorta) - not prevent performance of
voluntary acts
 Penetrating wound of heart - instantaneously
fatal but experience shows victim may still be
capable of locomotion
 Rupture of organs - victim may still move and
speak
Extrinsic Evidences in Wounds
1. From Wounding Weapon
(a) Position - Near the body of the victim in suicidal
and accidental death or firmly grasped by the victim
in case of suicide
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FROGLETS NOTES
(b) Presence of blood - In some cases, absence of
blood stains is due to the rapidity of the blow and
compression of the blood vessels or blood may be
wiped out by the clothings in the process of
withdrawal.
(c) Presence of hair and other substance
2. In the Clothings of the Victim
In gunshot wounds, holes in the clothing may
determine the wound of entrance whole presence of
gunpowder at the hole indicates distance. Clean-cut
tears indicates use of sharp-edged instrument.
Severe tearing may show struggle. The degree of
soaking of the clothing with blood may depict
hemorrhage.
3. From Examination of the Assailant
Determination of the degree of intoxication, mental
condition, physical power, etc of the offender may be
necessary.
4. From the Scene of the Crime
CHAPTER XIII
GUNSHOT WOUNDS
Death or physical injuries brought about by the powder
propelled substances may be due to the following:
 Firearm shot - The injury is caused by the missile
propelled by the explosion of the gunpowder in the
cartridge shell and at the rear of the missile. The
missile may be single as in the case of a pistol or
revolver or multiple shots or pellets in case of a
shotgun.
 Detonation of high explosives as in grenades, bombs
and mine explosion.
Firearm Wound
Definition
An instrument used for the propulsion of a projectile
by the expansive force of gases coming from the
burning of gunpowder
Includes rifles, muskets, shotguns, revolvers, pistols,
and all other deadly weapons from which a bullet,
ball, shot, shell, or other missile may be
discharges by means of gunpowder or other
explosives. it also includes air rifles except such
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as being of small caliber and limited range are
used a toys. The barrel of any firearm shall be
considered as complete firearm for all purposes
thereof (Section 877, Revised Administrative
Code)
Penal Provisions of Law Relative to Firearm
Alarms and Scandals (Art. 155, Revised Penal Code)
The penalty of arresto menor or fine not exceeding
200 pesos shall be imposed upon:
1. Any person who within any town or public place shall
discharge any firearm, rocket, firecracker, or other
explosive calculated to cause alarm or danger;
xxxxxxxxxx
Discharge of Firearms (Art. 254, Revised Penal Code)
Any person who shall shoot at another with any
firearm shall suffer the penalty of prision correccional in its
minimum and medium periods, unless the facts of the case
are such that the act can be held to constitute frustrated or
attempted parricide, murder, homicide or any other crime
for which higher penalty is prescribed by any of the articles
of the Code.
Classification of Small Firearms
Small firearms are those which will propel projectile of
less than one inch in diameter.
1. As to Wounding Power
a. Low Velocity Firearm - With muzzle velocity of not
more than 1,400 feet/second (i.e. revolver)
b. High Power Firearm - 2,200 - 2500 feet/second
(i.e. military riffle)
2. As to Nature of the Bore
a. Smooth Bore Weapon - Inside portion of the barrel
is perfectly smooth (i.e. shotgun)
b. Rifled Bore Firearm - The bore of the barrel has
spiral lands and grooves which run parallel with one
another but twisted spirally from breech to muzzle
(i.e. military rifle)
3. As to the Manner of Firing
a. Pistol - Fired only by a single hand (i.e. revolver)
b. Rifle - Fired from shoulder (i.e. shotgun)
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FROGLETS NOTES
4. As to the Nature of Magazine
a. Cylindrical Revolving Magazine - Cartridge is in a
cylindrical magazine which rotates at the rear portion
of the barrel (i.e. revolver)
b. Vertical or Horizontal Magazine - Cartridge is held
one after another vertically or horizontally by a spring
side to side or end to end (i.e. pistol)
Types of Small Firearms of Medico-Legal Interest
 Revolver - It has a cylindrical magazine at the rear of
the barrel capable of revolving motion and can
accommodate of five or six cartridges housed in
separate chamber. It has muzzle velocity of 600
feet/second.
 Automatic Pistol - More appropriately called "self-
loading firearm". Empty shell is ejected when the
cartridge is fired and a new one is slipped into the
breech automatically. It has muzzle velocity of
1,200 feet/second.
 Rifle - It has a long barrel and butt and is fired from a
shoulder. A military riffle has a magazine and volt
action. It has a muzzle velocity of 2,500
feet/second and a range of 3,000 feet. A miniature
riffle is a single self-loading weapon.
(pp.336-352)
6. Fragmentation of Hard Brittle Object in the Trajectory:
Bone involvement along the trajectory may cause
comminuted fracture and each bone fragment may cause
additional damage on the surrounding tissues and even in
the wound of exit.
7. Muzzle Blast in Contact Fire:
When gun muzzle is pressed on the skin when fired, all of
the products of combustion primarily the muzzle blast will
penetrate the tissues causing severe mechanical
destruction on account of pressure. The explosive effect
will cause extensive laceration of soft tissues and fracture
of bones.
8. Other Consequential Effects on the Body of the Victim:
Aside from direct involvement of vital structures of the
body, pressure to other organs and tissues, the gunshot
wound may be the source of hemorrhage, infection,
paralysis, shock, loss of functioning etc. which may cause
disability or death on the victim.
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Gunshot Wound of Entrance (Entrance Defect,
Inshoot):
The appearance of the gunshot wound of entrance
depends upon the following:
1. Caliber of the Wounding Weapon:
Excluding other factors which may influence the size
of the wound of entrance, the higher the caliber of the
wounding bullet the greater will be the size of the
wound of entrance.
2. Characteristics Inherent to the Wound of Entrance:
The wound of entrance, as a general rule, is oval or
circular with inverted edges, except in near shot or in
gazing or slap wound. The wound of exit is usually
larger than the wound of entrance.
3. Direction of the Fire:
A right angle approach of the bullet will make the
wound of entrance circular in shape, except when the
missile is deformed or the fire is in contact or near. In
cases of an acute angle of approach of the bullet, the
wound of entrance is oval in shape with the contusion
or abrasion collar widest on the side of the acute
angle of approach.
4. Shape and Composition of the Missile:
Deformity of the bullet modifies the shape of the
wound of entrance.
5. Range:
In close range fire, the injury is not only due to the
missile but also due to the pressure of the expanded
gases, flame and other solid products of combustion.
Distant fire usually produces the characteristic effect
of the bullet alone.
6. Kind of Weapon:
High power weapon has more destructive effect as
compared with low power one. The shape of the bullet
also plays an important role. Conical shape free end
bullets have more piercing power without marked
tissue destruction while missiles with hemispherical
free ends are more destructive.
Contact Fire:
The nature and extent of the injury is caused not only
by the force of the bullet but also by the gas of the
muzzle blast and part of the body involved. The
following factors must be taken into consideration:
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FROGLETS NOTES
1. The Effectiveness of the Sealing Between the Gun
Muzzle and the Shin:
If all the gaseous product of combustion is prevented
from being spilled out, there will be more destructive
effects on the tissues.
2. The Amount of Gas Liberated by the Combustion of
the Propellant:
The greater is the amount of gas in a confined area,
the greater will be the tissue destruction.
3. Nature of Bullet: Bigger caliber bullet is obviously
more destructive than smaller ones.
4. Part of the Body Involved: The nature, character
and extent of injury in contact fire is different
(1) when the bone is superficially located under the
skin, and (2) when the bone is deeply located in loose
or soft parts of the body.
Pressed and Firm Contact Fire:
1. On Parts of the Body Where Bone is Superficial:
This is commonly observed on the head where
the skull is just underneath the scalp. The
following are the characteristics of the injuries:
a. The wound of entrance is large, frequently
star-shaped
b. Edges of the wound may be everted.
c. Areas in the entrance wound is blackened by
burns, tattooing and smudging.
d. Muzzle imprint, Barrel impression (Profile of
the muzzle) on the skin
e. The bullet may cause radiating fracture
f. Blood and tissue become pink due to carbon
monoxide.
g. Fragments of lead and bullet jacket may be
found.
Metal Fouling - When the bullet travels the
whole length of the tight fitting barrel, it is rotated
by the lands and grooves. Its surface is scraped
by the lands and the scraping is ejected from the
barrel and strikes the target. It may lodge on the
clothings or may cause small abrasions or
superficial lacerations on the skin around the
main wound.
h. Singeing of hair.
2. Parts of the Body Where the Bone is Deeply Located:
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a. Wound of entrance is usually large, circular and without
radiating laceration.
b. Edges are everted due to outward slapping of the skin.
c. Singeing of the hair, blackening of the wound due to
fouling, burn, and tattooing.
d. Muzzle imprint due to outward slapping of the skin and
heat.
e. Pinkish color of the deeper structures due to carbon
monoxide.
Loose Contact or Near Fire:
1. Entrance wound may be large circular or oval depending
upon the angle of approach of the bullet.
2. Abrasion collar or ring is distinct.
3. Smudging, burning and tattooing are prominent with
singeing of the hair.
4. Muzzle imprint may be seen depending upon the degree
of slapping of the skin of the gun muzzle.
5. There is blackening of the bullet tract to a certain depth'
6.Carboxyhemoglobinispresentinthewoundandsurrounding
areas.
Short Range Fire (1 to 15 cm. distance)
Medium Range Fire (more than 15 cm. but less than 60
cm)
Fired More Than 60 cm. Distance
Instances When the Size of the Wound of Entrance Do
Not Approximate the Caliber of the Firearm:
In distant fire, the rule is that the diameter of the gunshot
wound of entrance is almost the same as the caliber of the
wounding firearm, but in the following instances, the rule is
not followed:
1. Factors which make the wound of entrance bigger than
the caliber:
a. In contact or near fire
b. Deformity of the bullet which entered
c. Bullet might have entered the skin sidewise
d. Acute angular approach of the bullet -
2. Factors which make the wound of entrance smaller than
the caliber:
a. Fragmentation of the bullet before penetrating
the skin
b. Contraction of the elastic tissues of the
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In shotgun fire, the size of the wound of entrance is when the victim is lying on his back on a hard object
dependent upon the distance of the fire. Near fire causes or in small caliber shots the wound of exit tends to be
concentration of entry of the pellets, and as distance circular or nearly circular with abrasion at its border. It
increases the pellets disperse with individual pellets is also observed that tight-fitting clothings, waist band,
causing individual wounds of entry. Only in this instance belt collar, brassiere may also support the skin to
may the wound of entrance of the same size as the gauge enhance formation of a circular wound of exit.
of the shotgun pellets.
Distinction Between Gunshot Wound of Entrance and
Other Pieces of Evidence or Findings Used to Wound ot Exit:
Determine Entrance of Gunshot:
Entrance Wound
1. Examination of the clothing, if involved in the Exit Wound
course of the bullet Appears to be smaller than Always bigger than the
2. Examination of the internal injuries caused by the the missile owing to the missile
bullet elasticity of the tissue
3. Testimony of witnesses: Edges are inverted. Edges are everted
Usually oval or round It does not manifest any
Determination of the Traiectory of the Bullet Inside the depending upon the angle definite shape
Body of the Victim: of approach finite shape of
the bullet.
1. External Examination : "Contusion collar" or ―Contusion‖ is absent
"Contact ring is present due
a. Shape of the Wound of Entrance to the invagination of the
b. Shape and Distribution of the Contusion or skin and spinning of missile
Abrasion Collar
c. Difference in Level Between the Entrance and Tattooing or smudging may Always absent..
Exit Wounds be present when firing is
d. By Probing the Wound of Entrance near
Underlying tissues are not Underlying tissues may be
2. Internal Examination : protruding. seen protruding from the
wound.
a. Actual Dissection and Tracing the Course of the
Wound at Autopsy Paraffin test may be positive Paraffin test always
b. Fracture of Bones and Course in Visceral Organs negative.
c. Location of Bone Fragments and Lead Particles
d. X-ray examination
The "Odd and Even Rule" in Gunshot Wounds:
Exit (Outshoot) Wound: An exit wound does not
show characteristic shape unlike the wound of If the number of gunshot wounds of entrance and exit
entrance. It may be slit-like, stellate, irregular or even found in the body of the victim is even the presumption is
similar to the wound of entrance. This is due to the that no bullet is lodged in the body, but if the number of the
absence of external support beyond the skin so the gunshot wounds of entrance and exit is odd, the
bullet tends to tear or shatter the skin while sufficient presumption is that one or more bullets might have been
amount of kinetic energy is still in the bullet during the lodged in the body. The rule is merely presumptive and
process of piercing the skin. actual inspection and autopsy will verify the truth of the
Variation on the shape of the wound of exit may be presumption. It may be possible that all of those wounds or
attributable to the deformity of the bullet in its passage a majority of them are entrance wounds with some bullets
in the body and to the wabbling and stumbling lodged, yet the number may still be even.
movement of the bullet during its course and
fragmentation of the missiles. How to Determine the Number of Fires Made by the
Offender:
Shored Gunshot wound of Exit - If the place where the
gunshot wound of exit is pressed on a hard object as
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l. Determination of the Number of Spent Shells:
2. Determination of Entrance Wounds in the Body of the
Victim
3. Number of Shots Heard by Witnesses
Instances when the Number of Gunshot wounds of
Entrance is Less than the Number of Gunshot Wounds
of Exit in the Body of the Victim:
1. A bullet might have entered the body but split
into several fragments, each of which made a
separate exit.
2. One of the bullets might have entered a natural
orifice of the body, e.g. mouth, nostrils, thereby making it
not visible and then producing a wound of exit.
3. There might be two or more bullets which
entered the body through a common entrance and later
making individual exit wounds.
4. In near shot with a shotgun, the pellets might
have entered in a common wound and later
dispersed while inside the body and making
separate wounds of exit.
Instances when the Number of Gunshot wounds of
Entrance is More than the Number of Gunshot Wounds
of Exit in the Body of the Victim:
1. When one or more bullets are not through and through
and the bullet is lodged in the bodY.
2. When alt of the bullets produce through and through
wounds but one or more made an exit in the natural orifices
of the body
3. When different shots produced different wounds of
entrance but two or more shots produced a common exit
wound
Instances when there is No Gunshot wound of Exit but
the Bullet is Not Found in the Body of the Victim:
1. When the bullet is lodged in the gastro-intestinal tract
and expelled through the bowel, or lodged in the pharynx
and expelled through the mouth by coughing.
2. Near fire with a blank cartridge produced a wound of
entrance but no slug may be recovered.
3. The bullet may enter the wound of entrance and upon
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hitting the bone the course is deflected to have the wound
of entrance as the wound of exit
Determining whether the wound is Ante mortem or
postmortem:
If the wounds inflicted after death show no evidence of
profuse hemorrhage, or there are signs of vital reactions in
the tissue, then the gunshot wound is ante-mortem.
Wounds inflicted after death show no evidence of profuse
hemorrhage, no retraction of the edges, and there are no
vital reactions.
Problems confronting Forensic physician in the
identification of Gunshot Wounds:
1. Alteration of the Lesion Due to Natural process
2. Medical and Surgical Intervention
3. Embalming
4. Problem Inherent to the Injury itself
6. X-ray Examination The use of an X-ray is almost
indispensable in the examination of gunshot injuries. The
use of the apparatus will facilitate recovery of the lodged
bullet together with the location of its fragments
Special Consideration on Bullets:
L. Souvenir Bullet: Bullet has been lodged and has
remained in the body. Its long presence causes the
development of a dense fibrous tissue capsule around the
bullet causing no untoward effect. It may be located just
underneath the skin to be easily palpated and may cause
'inconvenience and irritation. Deep seated location may not
cause any problem to warrant its immediate removal.
2. Bullet Migration: Bullet that is not lodged in a place
where it was previously located. A bullet which strikes the
neck may enter the air passage, and it may be coughed out
or swallowed and recovered in the stomach or intestine.
Bullets Embolism - a special form of bullet migration when
the bullet loses its momentum u'hile inside the charnber of
the heart or inside the big blood vessels and carried by the
circulating blood to some parts of the body where it may be
lodged. It may cause sudden loss of function of the area
supplied or death if vital organs are involved.
3. Tandem Bullet: Two or more bullets leaving the barrel
one after another. In cases of misfire or a defect in the
cartridge, the bullet may be lodged in ihe barrel and a
succeeding shot may cause the initial and the succeeding
bullet to travel in tandem. There is a strong possibility for
them to enter the target in a common hole. This might
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FROGLETS NOTES
create doubt to the statement made by the firer that he
made only a single shot, but ballistic examination can show
as to whether the bullet travelled in tandem.
GUNSHOT WOUNDS MAY BE SUICIDAL, HOMICIDAL
OR ACCIDENTAL
Pieces of evidence that tend to show that the Gunshot(s)
wound is Suicidal:
1. The shot was fired in a closed or locked room' usually in
the office or bedroom.
2. The death weapon is almost always found near the
place where the victim was found.
3. The strot was fired with the muzzle of the gun in contact
with the part of the body involved or at close range. The
wound of entrance may show signs of muzzle impression,
burning, smudging and tattooing.
4. The location of the gunshot wound of entrance is in an
accessible part of the body to the wounding hand. It may
be at the temple, roof of the mouth, precordial or epigastric
region. A person committing suicide wilI do the act in his
most convenient way, unless he has the intention of
deceiving the investigator.
5. The shot is usually solitary. If the shot is made on the
head involving the brain, the shocking effect of the injury
will not make him capable of firing another shot. However,
shots in some parts of the body which may not produce
immediate death cir sudden loss of consciousness, the
possibility of additional shots is not remote
6. The direction of the fire is compatible with the usual
trajectory of the bullet considering the hand used and the
part of the body involved.
7. Personal history may reveal social, economic, business
or marital problem which the victim cannot solve. He may
have history of mental disease, depression, severe
frustration or previous attempt of self-destruction.
8. Examination of the hand of the victim may show
presence of gunpowder.
9. Entrance wound do not usually involve clothings.
11. victim’s fingerprints on butt
12. place where the shot took place may reveal suicide
note
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13. no disturbance in the place of death
Russian Roulette:
-agreement among persons to load a revolver with live
cartridge; each member will cock and pull trigger with
muzzle directed to the temple or other vital parts; the
person who will pull trigger with live cartridge in the firing
chamber will suffer the fatal consequence
-may be considered suicidal
Evidences to show the gunshot wound is homicidal:
1. no point of election in he wound entrance
2. fire is made when victim is at some distance
3. defense wounds (signs of struggle)
4. disturbance of the surroundings
5. wounding firearm cannot be found at crime scene
6. witness testimony
Evidences to show that the wound is accidental:
1. usually one shot
2. no special area of body involved
3. determination of relative position of victim and
assailant
4. witness testimony
Points to be considered and included in the report of
the physician:
1. complete description of wound of entrance and exit
2. location of the wound
3. direction and length of bullet tract
4. organs or tissues involved
5. location of missile, if lodges in the body
6. diagram and other illustration showing location of
wounds
Questions that a physician is expected to answer in
court:
1. Could the wound be inflicted by the weapon?
2. At what range was it fired?
3. Direction of the fire
4. Possibility that gunshot wounds are self-inflicted
5. Signs of struggle
6. Possibility of the victim to fire or resist the attack after
being injured
7. Did the victim die instantaneously?
8. Relative position of assailant and victim
Can the Caliber of the Wounding Firearm be
determined from the size of the gunshot wound of
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entrance? Yes. The caliber may be inferred from the
diameter of the gunshot wound.
Determination of the Length of Survival of the Victim:
1. nature of wound
2. organs involved
3. presence or absence of infection
4. amount of blood loss
5. physical condition of victim
*It is not possible to determine the direction of the shot
from the direction of the sound UNLESS that flash or the
person firing the shot is seen at that time.
*It is impossible to distinguish and memorise the report
from two firearm of the came caliber.
*It may be possible for a person who is accustomed to
sound of firearms of different calibers to identify firearm by
the sound produced.

Capacity of the Victim to Perform Volitional Acts:
Depends upon the following:
1. area of body involved
2. vital organs involved
3. resistance of victim
*Injuries in the brain and spinal cord which cause
incapacity to do voluntary acts negates the capacity.
Determination as to length of time a firearm had been
fired:
1. Odor of the gas inside the barrel
*mixture of gases has peculiar characteristic
order which is noticeable several hours afar
discharge. Later, the odor will disappear as
gases usually evaporate or chemical transform to doorless
compounds
2. Chemical changes inside the barrel
3. Evidence that may be deduced from the wound
1. age of wound
2. degree of healing
3. degree of infection
Gunshot wound may not be a near fire:
1. when a device is set up to hold the firearm
2. clothings are interposed between the victim and the
firearm
3. failure of examining physician to distinguish between a
near or far shot wound
4. product of a near shot wound has been washed out of
the wound
X-ray examinations may:
1. facilitate location of bullet
2. reveal fragmentation and location
3. show bone involvement
4. reveal trajectory of bullet
5. show effects of bullet wound and other injuries
SHOTGUN WOUNDS
Shotgun- shoulder-fired firearm having a barrel that is
smooth-bored

Determination Whether the Wounding Weapon is an Classes of shot in a shotgun shell:

Automatic Pistol or Revolver: 1. Birdshot- shot are small (0.5 inch to 0.15 diameter);
1. Location of empty shells use for hunting fowls and small animals
revolver 2. Buckshot- shot ranges form 0.24 to 0.33 inch in
VS automatic pistol diameter; fewer in number of shots (9shots)
in clylindrical magazine chamber after fire 3. Single Projectile (rifled slug)- only a single or slug in a
driven out of weapon after shot shell
2. Nature of spent bullet
revolver Systems employed in the determination of the
VS automatic pistol diameter of barrel of a shotgun:
no coating
1. Gauge System - determination of number of lead
bullet is copper jacketed balls, each fitting of the bore totals to one pound in
3. Nature of base of cartridge or spent shell
weight
revolver
VS automatic pistol 2. Expression of the bore diameter in inches-0.410 bore
wider diameter than shotgun is the only shotgun at present designated
no such difference 3. Metric system - bore in millimeters
that of cylindrical body
*Not standard length of barrel.

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e. smudging due to smoke up to 15 inches

Grade of choke: f. gunpowder tattooing up to 24 inches
1. Unchoke- diameter of barrel from rear to muzzle is the g. in an unchoked shotgun, to estimate the
same distance: measure the distance between the
2. Choke- diameter of barrel at muzzle end is smaller farthest shot in inches and subtract one, the
than rest of the barrel number obtained will give the muzzle-target
distance in yards
*The lethal range is in an area of 30 inches in diameter at
30 to 40 yards according to degree of choking. *A close shot produces more serious injuries because of
concentration on specific target and greater kinetic energy
Types of shotgun: of pellets.
1. As to number of barrel
a. Single Barrel Shotgun DETERMINATION OF THE PRESENCE OF
b. Double Barrel Shotgun GUNPOWDER AND PRIMER COMPONENTS
2. As to manner of firing and reloading:
a. Bolt action The importance of determining the gunpowder on the
skin of the victim:
b. Lever Action
c. Pump action 1. Determination of the distance of the gun muzzle from
d. Autoloading the victim’s body when fired
*The presence of gunpowder at or near the
wound of entrance shows that the gun muzzle
*A shotgun cartridge is usually 2-3/4 or 3 inches long and when fired is not more than 24 inches but its absence will
diameter depends on the gauge of the firearm not preclude near fire because other factors
might have intervened
Shotgun wound of entrance: 2. Determining whether a person has fired a firearm
*When a person fires a gun, the powder particles
1. Contact or near contact shot - not more than 6 inches
which escape may cling on the
Indicators:
a. shape of wound dorsum of the hand
b. entrance wound is burned *Detection of metallic residue on the primer palm
hand may indicate that the individual
c. blackening due to smoke
d. gunpowder tattooing is densely located was making a defensive movement trying to ward off the
weapon
e. contusion of tissue
f. singeing of hair (less than 6 inches) *In suicide, residue may be deposited on the
palm of the hand used to steady the barrel at
g. disrupted deeper tissues
h. presence of carbon monoxide along the bullet the time of discharge
tract
i. recovery of wad together with shot (pellets) Procedures in determining the presence of gunpowder:
2. Long range shot - more than 6 inches skin-muzzle 1. Gross examination or examination with the use of
distance hand lens
Indicators *This examination is not conclusive because
a. 2-3 feet muzzle distance-> single wound of other foreign particles may be mistaken for
entry gun powder or other primer components.
b. 3-4 feet distance-> serrated wound of entry 2. Microscopic examination
referred to as ―rat hole‖ 3. Chemical tests
c. 5-6 feet-> wad tends to produce independent a. Laboratory test to determine firearm residues
injury, usually an abrasion *There is inference of contact or near
d. 6 feet-> shots begins to separate from distance of the gun muzzle to the skin when
conglomerate shot there is burning, tattooing, smudging visible
10 feet-> produces independent wounds of entry *The same test may be applied to
―Billiard ball ricochetted effect‖- tendency for one dorsum of hand of persons suspected to have
shot to stoke another causing changes of the shot fired the gun
course

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*The test may involve the bombardment, afterwards their quantity is

determination of presence of gunpowder residues of measured.
primer components 3. Flameless Atomic Absorption Spectroscopy (FAAS)
*Sample of hand washing is subjected to a high
Test for the presence of gunpowder residues: temperature to vaporise the metallic elements
1. On the skin (Dorsum of the hand or site of the wound of the primer residue.
of entrance): *This method is quick, sensitive and employs
1. Dermal nitrate test (Paraffin test, Diphenylamin equipment within economic means
test, Lung’s test or Gonzales’ test) *Can determine presence of barium, antimony
*The presence of small particles and lead
containing either nitrate or nitrite will be indicated 4. Use of Scanning Electron Microscope with a Linked X-
by a blue reaction of the particles upon contact ray Analyzer
with Lung’s reagent. *Adhesive material is used to remove any
*Test is not conclusive as to the residue particles from the hand. The material
presence of gunpowder because fertilizers, then examined under the scanning electron
cosmetics, cigarettes, urine and other microscope with a linked X-ray analyzer.
nitrogenous compounds with nitrites and
nitrates will give a positive reaction FIREARM IDENTIFICATION
*Subjection of suspect is not self- Factors:
incriminatory; act purely mechanical 1. Caliber of the weapon
2. On clothing's (Especially coloured ones) 2. Fingerprints
Walker’s tes (C-acid test, H-acid test) *may determine if homicidal or suicidal nature of
*A glossy photographic paper is fixed death
thoroughly in hypo solution for 20 minutes to 3. Fouling of the barrel
remove all silver salts and then washed for 45 *recently fired firearm may have a characteristic
minutes and dried. door smoke inside the barrel
*If unburned powder grains are 4. Serial number
present, it will result to production of dark red or
orange-brown spots on the prepared paper. Procedure of restoring serial number if tampered:
Test for the presence of Primer Components: 1. Cleaning
1. Harrison and Gilroy Test *All oil, dirt, grease and paint should be removed
*A cotton swab moistened with 0.1 molar with gasoline, xylol and acetone
hydrochloric acid is used to gather antimony, 2. Polishing (Most important)
barium and lead. *Whole surface should be smoothly polished
*The test does not enjoy substantial utilisation in using a fine file followed by a medium to fine grade
forensic laboratory because: carborondum cloth
1. lacks specificity of color reaction *The area should always have the mirror-like
2. inadequately sensitive surface
3. interference of color reaction among three 3. Etching
elements themselves *For all iron or steel materials, the following
4. development of instability of color etching may be used
2. Neutron Activation Analysis (NAA) Hydrochloric acid - 80 cc
*A sample is obtained from the hands by the use Distilled water - 60 cc
of paraffin or washing the hand with dilute acid. It is Ethyl alcohol - 50 cc
then exposed to radiation from a nuclear react emitting Copper chloride - 10 grams
neurons. *The solution is swabbed until the numbers
*The test requires access to a nuclear reactor appear.
(very expensive test) 4. Ballistic examination
*Unable to detect lead *Ballistics - study of physical forces reaction on
*Principle: Barium and antimony are converted projectiles
into isotopes by means of neutron *Foreign ballistics - also known as firearm
identification; deals with examination of fired bullets

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and cartridge cases in a particular gun to the exclusion of 3. Hand lens

all others 4. Sharp pointed instrument for scraping I.D. marks
5. Caliper
Three separate and distinct area of Ballistics: 6. Analytical Balance
1. Interior Ballistics - deals with what happened to the
cartridge and its bullet from the time trigger is pulled See illustration on page 386
until the bullet exits from the barrel
2. Exterior Ballistics - deals with what happened to the Types of marking on the examination through
bullet or projectile from the moment it leaves the gun Comparison Microscope:
barrel to the moment of impact on the target or object
3. Terminal Ballistics- concerns with the effect of the
bullet on the target or until it comes to rest 1. Impression type Mark (Stamp Mark) – the
4. Medical Ballistics- concerned with the penetration, forcible application of hard surface against the
severity and appearance of the wound due to bullet or softer one leaving an impression on the softer
missile surface. E.g. striking of the firing pin on the
percussion cup.
Basic Principles Involved in Firearm Identification: 2. Striation or serration mark – produced by a
1. Quality of metal in the manufacture of firearm is much harder surface scraping, dragging, siding or
harder and resistant to deformity than the quality of slipping cross the softer one leaving a series of
metal used n the manufacture of cartridge. In the abrasions, serrations and scrapes. E.g. bullet
process of contact between the part of the gun surface may show the rifling marks on its surface
involved and the cartridge, the surface condition of the of the barrel.
part of the gun can easily be impressed on the shell or
bullet. When the cartridge is fired from the firearm, the
2. Firearms have certain physical characteristics of following marks are found in the shell and from
certain type of caliber which differentiate it from the bullet:
others.
3. No two firearms can be manufactured with identical Marks found in the Shell:
surface characteristics; referred to as ―individual
characteristics‖ a. Marks of firing pin – impressions
in the percussion cap
Instruments Use in Firearm Identification: b. Marks from the extractor – marks
found in front of the rim of the
1. Comparison Microscopes- instrument consists of two shell
compound microscopes which allows comparison of c. Marks from the ejector- marks
two objects by looking through single eyepiece. The found in the head of the shell
individual or accidental characteristics of two objects
d. Marks from breechblock: the
may be compared. There is an attachment for impact of the shell in the
photographic camera to facilitate the taking of pictures bleechblock in the recoil
of the findings. impresses the ridges of the
2. Bullet Recovery Box- instrument for the purpose of bleechblock and often gives
recovering the test bullet and shell. It is a long identification mark characteristic of
cylindrical container filled with cotton and an open a firearm.
shooting end. *The test shell e. Marks on the cylindrical surface of
and bullet may be used for comparison with the the shell- mark brought about by
evidence bullet or shell. the magazine.
Other ways of recovering test bullet as used in
other countries:
1. Shot may be fired on a box with oil and Marks found in the bullet:
sawdust
2. Vertical or horizontal shot on water tank
3. Shot fired on a block of ice

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a. Number of lands and grooves- i. The refling barrel is reflected

number of grooves, depth, and in the bullet as it passes
width depend upon the through it.
manufacturer of the firearm. ii. Firing pin mark: when the
b. Direction of the twist of the Rifling base of the cartridge is hit by
Marks- the direction of the spiral the firing pi, the pin produces
lands and grooves may twist to the distinct markings which can
right or to the lest. be reproduced by succeeding
shots.
iii. Breechblock mark: as the
Each manufacturers of firearms make certain marks which bullet is propelled forward by
will distinguish firearms manufacturered by them and the force of the expanded
makes specific number of spiral grooves and direction of gas, the casing is forcibly
the twist in the brrel of the firearm. The bullet recovered moved backward against the
from the ody may show those marks in the examination breech force or recoil plate.
and the examiner may have the presumption where the The backward force transfers
firearm came. the marking on the
breechblock to the base of
In fire Arm Identification the Examiner must take into the cartridge.
consideration the following: iv. Extractor mark: mark made
by the extractor on the
1. gross examination or examination with cartridge rim when pulled
magnifying lense: away from the firing
a. caliber of the bullet chamber.
b. presence or absence of deformity or v. Ejector mark: mark produced
loss part by the ejector in the process
c. presence of foreign elements. E.g. of throwing away the spent
blood, flesh shell.
d. identity marks placed by previous
possessor.
GUNSHOT WOUNDS IN DIFFERENT
PARTS OF THE BODY
2. Examination with the use of comparison
microscope: this is the comparison between
evidence shell or bullet with the test shell or Head and Neck
bullet 1. Cranium:
a. Determination of the clss Close or near contact fire in the
characteristics: physical characteristics
head may produce marked
of certain caliber of firearm used by the laceration of the skin, burning and
manufacturer:
tattooing of the surrounding skin.
i. Number of rifling The skull is fractured without any
ii. Direction and rates of rifiling
definite shape with the linear
marks extensions to almost all of the
iii. Dimension of the lands and
bones comprising the cranial box.
grooves
iv. Depth of the grooves
Fire from distance with the
v. Style of the cannelure bullet having a right angle of
b. Determination of individual or approach to the skull, the fracture
is oval at the outer table. There
accidental characteristics:
will be radiating linear fractures
from point of entrance. The wound
exit will be clean-cut oval round
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opening at the inner table with
beveled fracture at the outer table.
Grazing approach of the bullet
may produce an elongated gutter-
like depressed fracture of the
cranium. The tangential impact
of the bullet may cause it to split
and it is not uncommon to see a
fragment lodging in the brain
substance while the other ricochet
outside hitting other objects
nearby.
2. Brain Substance:
Usually a rugged tunnel with a
diameter larger than that of the
caliber of the bullet, with mark
ecchymosis of the surrounding
area and filled with fresh and
clotted blood. Fragments of bones
may be felt in the tunneled bullet
tract. In jury of the brain causes
sudden loss of consciousness and
incapable of voluntary movement.
Injury in the cerebral hemispheres
is as a rule not immdediately fatal
and the victim may survive the
injury, however if the bullet
courses the medulla, pons, and
other vital centers causes the
immediate death. Some victims
may live for a while but developed
epileptiform convalsions as a
sequel.
3. Face
May noy cause serious trouble
except that it becomes potential
avenue for infection that may
cause deformity.
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4. Neck
The bullet may pierce the front
portion of the neck and may
involve the cervical portion of the
spinal cord; causing instantaneous
death if the upper portion is
involved. If involve the carotid or
jugular vessel and death may be
due to profused hemorrhage.
Injury to trachea and upper
bronchi may cause asphyxia or
aspiration pneumonia.
5. Chest:
1. Chest wall: usually has an
upward course and may
involve both sides. The bullet
may strike the rib, sternum or
the body of the vertebra and
may cause deformity or
deflection of its course. When
the intercostal or mammary
vessel are injured there will
be perfused hemorrhage.
2. Lungs: it produces a
cylindrical tunnel much larger
than the diameter of the
projectile with the bloody
contents and ecchymotic
borders. When the
pulmonary vessel is involved,
the profuse hemorrhage is
observe that produces death
before medical intervention
can be done. If only the lungs
is involve, the profuse
hemorrhage may cause
collapse of the lungs,
displacement of the heart.
Emphysema is present when
there is marked injury to the
air sacs. The victim may not
die immediately but later may
develop aspiration
pneumonia or cerebral
embolism.
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3. Heart: wound may be the spinal cord may be due

circular or stellate with to:
subepicardial hemorrhage in a. Bullet affects the
the surrounding tissue. As a canal and the
general rule does not prevent spinal cord causing
the victim from running, either partial or
walking or to do other forms complete
of volitional acts for death is severance
not usually instantaneous. b. Injury in the body of
wound of the auricle is more other parts of the
rapidly fatal as compared vertebra and
with the would of the ventricle contusion,
on the account of thickness concussion or
of the musculature of the compression on the
latter which produces account of impact.
temporary closure of the Injury of the upper
wound. cervical spinal cord
4. Abdomen: wounds are quite may cause
frequent but not as serious immediate death
as those of the chest and because the vital
head because of its ability to nerve tracts may
surgical operation. It is be involved. Lower
limited to one or several spinal cord injury
organs. Bullet wound of the may cause motor
liver and other or sensory
parenchymatous abdominal paralysis and may
organs may cause stellate later succumb to
perforations which are hypostatic
usually larger than the caliber pneumonia,
of the bullets that causes suppuration or
them. The tunnel may other
contain fragmented tissue, complications.
fresh and clotted blood. Loss 6. Extremities: it may show the
of function, of the kidney, characteristic lesion of
pancreas, etc may lead to gunshot wounds. Usually the
fatal resuls. Bullet wounds in wound is not so serious
the stomach and other hollow except when it involves the
areas are usually small on principal blood vessels and
the account of he contractility nerves. The bony tissue may
of the walls. The wound involves the principal blood
entrance is smaller than the vessels and nerves.
exit wound. Timely surgical
intervention may prevent
untoward complications.
However, death due to CHAPTER XVII
peritonitis is not rare on the DEATH BY ASPHYXIA
account of the spilling of its
contents into abdominal
cavity.
5. Spine or Spinal Cord: injury Asphyxia – general term applied to all forms of
of the spine may not involve violent death which results primarily from interference with
the spinal cord but injury of the process of respiration or the condition in which the

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supply of oxygen to the blood or to the tissues or both has
been reduced below normal level.
Types of death by Asphyxia:
1. Anoxic Death: associated with failure of the
arterial blood to become normally saturated with
oxygen may be due to :
a. High altitude
b. Traumatic crush asphyxia
c. Paralysis of the respiratory centerdue
to poisoning, injury or anesthesia, etc.
d. Mechanical interference with the
passage of air into or down the
respiratory tract due to:
i. Closure of external
respiratory ortifice
ii. Obstruction of air passage
iii. Respiratory abnormalities
e. shutting blood from the right side of the
heart to the left without passage
through the lungs
2. Anemic Anoxic Death: this is due to a
decreased capacity of the blood to carry oxygen.
This condition may be due severe hemorrhage,
poisoning, or low hemoglobin level in the blood.
3. Stagnant Anoxic Death: this is brought about by
the failure of circulation which may be due to
heart failure, shock, or arterial and venous
obstruction.
4. Histotoxic Anoxic Death: this is due o the
failure of the circulation of the cellular oxidatives
process, although the oxygen is delivered to the
tissues, it cannot be utilized properly. Cyanide
and alcohol is common agents responsible.
Phases of Asphyxial Death:
1. Dyspenic Phase: symptoms due to lack of
oxygen and retention of carbon dioxide in the
body tissue. Breathing becomes rapid and deep,
pulse rate increase and rise of blood pressure.
2. Convulsive phase: this is due to simulation of
the cntral nervous system by carbon dioxide. The
cyanosis becomes more pronounced and yes
becomes staring and pupils are dilated. Visceral
organs shows petechial hemorrhages known as
Tardieu Spots (caused by the hemorrhage
produced by the rapture of the capillaries on
account of the increase if intra-capillaries
pressure). The victim may become unconscious
in the convulsive stage.
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3. Apneic Phase: is due to the paralysis of the
respiratory center of the brain. The breathing
shallow and gasping and the rate becomes
slower till death. The heart later fails.
Classification of Asphyxia:
1. Hanging
2. Strangulation:
a. By ligature
b. Manual strangulation or throattling
c. Special forms of strangulations:
i. Palmar strangulation
ii. Garroting
iii. Mugging or yoking
iv. Compression of the neck with
stick
3. Suffocation:
a. Closing the mouth and nostrils by solid
object
b. Choking or closing of the air passage
by the obstruction of its lumen
4. asphyxia by submersion or drowning.
5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gases
Asphyxia By Hanging: is a form of violent death brought
about by the suspension of the body by a ligature which
encircles the neck and the constricting force is the weight
of the body. The victim may be sitting or lying with the face
down provided that the pressure is present in front or in the
side of the neck.
Classification of asphyxia by hanging:
1. as to location of the ligature and knot:
a. typical: ligature runs from the midline
above the thyroid cartilage
symmetrically encircling the neck on
both sides to occipital region.
b. Atypical: the ligature is tied or noosed
and present on one side of the neck, in
front or behind the ear or on the chin.
2. as to amount of constricting force:
a. complete: body is completely
suspended and he constricting force is
the whole weight
b. partial: body is partially suspended as
when the victim is sitting, kneeling,
reclining, prone or in any other
positions.
7

FROGLETS NOTES
3. as symmetry:
a. symmetrical: the knot or noose is at the
midline of the body either at the occiput
or just below the chin.
b. Asymmetrical: knot or noose is not is
not in the midline but on the one side,
with the head tilted to the side opposite
the location of the noose or knot.
Mechanism of Death:
There is a ligature around the neck with a knot or
with a sliding noose and the other end is fastened to an
elevated object like peg, nail, window casing, door knob,
tree, etc..
Upon suspension of the body, the weight causes
the noose or band to tighten, producing pressure at the
region of the neck.
The pressure of the band will cause the air
passage to constrict, the larynx is pushed backwards and
its opening is closed by the contact of the anterior to the
posterior laryngeal wall producing asphyxia.
Pressure of the ligature may also cause
compression of the superior laryngeal nerve, ceratoid
arteries and jugular veins producing cerebral anoxia.
Forms of furrow that develops in the neck
depends upon the type of ligature, the number of loops
around the neck and the point of suspension.
Protrusion of the tongue depends upon how
pressure is applied around the neck. If above the larynx
and in an upward direction, the tongue will be pushed
outward and will protrude from the mouth but if the
pressure is below, the tongue is kept inside the buccal
cavity.
Ligature in Hanging
1. Materials used in Ligature.
The thinner the ligature and the tougher the
material, the more pronounced will the the mark
on the skin of the neck. If the material is soft and
broad the ligature impression on the neck is less
marked. The rope is commonly used as ligature
because it is easily available and strong. Other
materials includes beddings, belts, electric wire
etc.
2. Noose
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There may be no sliding noose at the end of the
ligature. It may be tightened after it has been
encircled around the neck and the pressure on
the air passage, blood vessels and nerves of the
neck is established when the body is suspended.
3. Mode of Application of the Ligature
The ligature may be placed around the neck with
a single loop or with two or more hoops. This can
be distinguished on the nature of the ligature
marks. In single loop, there is but one ligature
furrow, but if there are several, there will be
several ligature marks with an intervening
redness between the furrow. There is more
pressure in a single loop ligature on account of
concentration of force at the weight compare to
several loops.
4. Position of the Knot
The knot or joint is usually located on either side
of the neck. The head is flexed opposite the
location of the knot. The level of the ligature
around the neck may differentiate hanging from
strangulation by ligature. In hanging, the ligature
is usually pull of the constricting force, while in
case of strangulation by ligature, the loop is
found below the thyroid cartilage. It is not easy to
retain the knot beneath the chin.
5. Course of the ligature around the neck
The usual appearance is that the groove or
ligature mark is deepest opposite the location of
the knot. However, if the not is just underneath
the chin, the groove at the back of the neck is not
deep on account of the firmer skin and muscular
tissue.
Symptoms
1. Gradual loss of sensibilities
2. Sensation of constriction of the neck
3. Loss of consciousness and muscular power
4. Numbness of the legs and clonic convulsion
5. Sensation of ringing inside the ear
6. Sensation of flash of light before the eyes
7. Face becomes red with eyes prominent and
feeling of heat in the head.
If the victim is timely rescued and revived after artificial
respiration, he will suffer the following symptoms:
1. Whistling sensation insede the ear
2. Watering of the eyes
7

FROGLETS NOTES
3. Difficulty of breathing and swallowing
4. Sensation of number ness of both legs.
All the above symptoms may last for 12 days after rescue.
Cause of Death in Hanging
1. Simple asphyxia by blocking the air passage
2. Congestion of the venous blood vessel in the
brain
3. Lack of arterial blood in the brain due to pressure
on the carotid arteries
4. Syncope due to pressure on the vagus and
carotid sinus which leads to reflex irritation and
paralysis of the medullary autonomic centers
5. Injury on the spinal column and spinal cord.
6. Any combination of the above
Time Required in the Process of Death
Time is influenced by the following:
1. Severity of the constricting force
If the constricting force is only sufficient to
occlude the windpipe, death may be delayed; but
if the pressure is sufficient to occlude the carotid
arteries, jugular veins and vagus nerve, then
unconsciousness develops immediately and
death is accelerated.
2. Point of application of the ligature
When the ligature is made below the larynx,
death is almost instantaneous, but when applied
above the larynx, death may not occur for three
to five minutes. Hanging with the knot situated on
one side of the neck may delay death because of
closure of cerebral vessels cannot be
maintained. If knot is below the jaw, maximum
pressure is at the back of the neck cause merely
partial occlusion of the windpipe and blood
vessels of the neck, thereby delaying death.
3. Other factors
a. Physical condition of the subject
b. The rate of consumption of oxygen in
the blood and tissues.
Treatment
1. Induce the natural act of respiration
a. Ligature must be loosened and mouth
msut be wiped to remove all obstacle
to free air.
b. Tongue must be pulled forward and the
body must be laid on back rest.
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c. Place the patient where there is free
current of fresh air
d. Electrical stimulation of the phrenic
nerve
e. Administration of respiratory stimulant,
like ammonia.
2. Stimulate the heart to renew action if it ceases to
beat.
a. Apply heat at the region of the
precordium
b. Hypodermic injection of coramine,
strychnine, or other stimulants
c. Administration of brandy.
3. Maintain the natural body temperature
a. Cover the body with blanket
b. Place the patient in a warm room
Post mortem findings in death by hanging
1. General External Appearance
a. Neck elongated and stretched with the
head inclined on the side opposite the
knot or noose
b. Eyes closed or partially opened with
pupils usually dialted on one side and
small on the other side (facies
sympathetic)
c. Lividity or pallor of the face with
swelling and protrusion of the tongue
d. Hands are clenched firmly and purple
colored fingernails
e. Lips livid or blue
f. Saliva dribbled from the mouth with
froth
g. State of erection or semi erection of the
penis with seminal flued in the urethral
meatus
h. Post mortem lividity with ecchymosis
are mostly marked at the legs
i. Urination or defecation due to the loss
of power of sphincter muscles.
2. Internal Findings:
a. Engorgement of the lungs
b. Venous system contains dark-colored
fluid blood.
c. Right side of the heart and the big
blood vessels connected with it are
distended with blood.
d. Blood vessels of the brain is generally
congested.
e. Kidneys are congested.
7

FROGLETS NOTES
f. Sub-pleural, sub-pericardial punction
hemorrhages
3. Findings on the neck:
a. Neck is flexed opposite the side where
the knot is located.
b. Ligature mark which forms groove is
about or rather leass than the knot.
c. The course of the ligature is inverted v-
shape with the apex of the v at the site
of the knot.
d. The skin at the site of the ligature is
hard with red line of congestion and
hemorrhage in some points.
e. Ecchymosis of the neck depends upon
the width and softness of the ligature.
f. There may be rapture of the underlying
blood vessels, muscles and other soft
tissue
g. The lining membrane of the blood
vessels may be lacerated.
h. Fracture of the hyoid bone or tracheal
rings.
Different diagnosis:
1. Fold markings on the neck of an obese individual
– the marks are not continuous and removed on
stretching the skin of the neck
2. Marks of tight neckwear – the location and
history will differentiate this from ligature marks.
Determinations Whether Hanging is Ante Mortem or Post
Mortem
The principal criterion is the vital reaction. But,
hanging made immediately after death may also show to a
certain extent vital reaction, while hanging of a living
subject whose bodily resistance has been markedly
weakened may show slight vital reaction
The following finding show that hanging is ante mortem
1. redness or ecchymosis at the site of ligature
2. ecchymosis of the pharynx and epiglottis
3. line of redness or rupture if the intima of the
carotid artery
4. subpleural, subepicardial punctiform
hemorrhages
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It is advisable to look for other injuries which are capable of
producing death to eliminate the possibility of hanging as
the cause of death.
Determinations whether hanging is accidental, homicidal or
suicidal
1. Evidence in support of homicidal hanging
a. Nature of windows and doors - whether
entrance was forcibly opened or have
been used as an escape by the
offender in homicide case
b. Presence of signs of struggle- furniture
and beddings may be disturbed
whenever there is a previous struggle.
c. Presence of stains, bodily injuries in
the body of the victim
d. Presence of defense wounds in the
body of the victim
―Lynching‖ a form of homicidal hanging usually
found in southern states of US. Usually practiced
by Americans against the Negros who commit
crime against the white American. Whenever
colored offenders are apprehended, they are
hanged by means of a rope on a tree or some
similar objects. The Negroes are executed
without due process of the law.
B. Asphyxia by Strangulation
Strangulation by Ligature:
It is produced by compression of the neck by
means of a ligature which is tightened by a force other than
the weight of the body.
It may be observed in infanticide using the
umbilical cord as the constricting material. This must be
differentiated from accidental strangulation during child
birth, the umbilical cord is abnormally long and there is no
disturbance in the wharton's jelly.
Strangulation by ligature is commonly observed
in rape cases, but the presence of findings in the genitalia
and other physical injuries are distinctive findings.
Causes of Death in Strangulation by Ligature
1. Asphyxia due to the occlusion of the windpipe.
2. Coma due to arrest of cerebral circulation.
3. Shock or syncope.
4. Inhibition of the respiratory center due to the pressure
on the vagus and sympathetic nerves.
Accidental, Homicidal or Suicidal Strangulation by Ligature
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FROGLETS NOTES
Homicidal strangulation is the most common of
the three forms of strangulation by ligature. Aside from the
ligature mark in the neck, there are evidence of struggle or
marks of violence in other parts of the body.
Suicidal strangulation by ligature is quite rare. It
may be done by placing a ligature around the neck and
tightened by means of twisting a piece of stick.
There are a few instances of strangulation which
are accidental and most of the victims are children or
epileptics who are helpless and incapable of extricating
themselves.
Manual Strangulation or Throttling
This is a form of asphyxial death whereby the
constricting force applied in the neck is the hand.
Methods of Throttling
1. Using one hand
2. Using both hands with assailant in front
3. Using both hands with assailant at the back
Manners of Death in Manual Strangling
1. The air passage may be blocked and death is due to
asphyxia
2. The pressure on the neck may cause compression of
the blood vessels and disturb the blood supply of the
brain
3. The nerves of the neck may be traumatized especially
the superior laryngeal branch of the glossipharyngal,
hypoglossal nerves and the plexus surrounding
Bifurcation of the common carotid artery or of the
vagus producing shock.
Accidental, Homicidal or Suicidal Manual Strangulation
1. Suicidal throttling is impossible because of the
pressure of the person's own hand must be
maintained for sometime but when unconsciousness
begins, the hands are relaxed and the victim recovers.
2. Accidental throttling may occur but the victim never
died of asphyxia but of other causes.
3. Homicidal manual strangulation is the most common.
It is a method of choice in infanticide.
Special Forms of Strangulation
1. Palmar Strangulation
The palm of the hand of the offender is pressed
in front of the neck without employing fingers.
2. Garroting
A ligature, a metal collar or a bowstring is placed
around the neck and tightened at the back.
3. Mugging (strangle-hold)
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This is a form of strangulation with the assailant
standing at the back and the forearm is applied in front of
the neck.
4. Compression of the Neck with a Stick
The victim may be forced to place his back
behind a post.
C. Asphyxia by Suffocation
Asphyxia by suffocation is exclusion of air from
the lungs by closure of air openings or obstruction of the air
passageway from the external openings to the air sacs.
Smothering
This is a form of asphyxial death caused by the
closing of the external respiratory orifices, either by the use
of the hand or by some other means. The nostrils and
mouth may be blocked by the introduction of foreign
substances, like mud, paper, cloth, etc.
Suicidal smothering by means of his own hand is
not possible
Homicidal and accidental smothering is frequent.
It may occur when a person is under the influence of
alcohol, epilepsy or in any other helpless state. It is
common among children.
Examples: overlaying, accidental smothering of epileptic,
gagging, plastic bag suffocation
Choking
This is a form of suffocation brought about by the
impaction of foreign body in the respiratory passage. Most
of suffocation by choking is accidental, although it may be
utilized in suicide or in homicide.
D. Asphyxia by Submersion or Drowning
This is a form of asphyxia wherein the nostrils
and mouth has been submerged in any watery, viscid or
pultaceous fluid for a time to prevent the free entrance of
air into the air passage and lungs.
Time Required for Death in Drowning
Submersion for 1-1/2 minutes is considered fatal,
if ordinary efforts for respiration is made, however, a
person may survive even after 4 minutes of submersion.
The average time required for death in drowning is 2 to 5
minutes.
Emergency Treatment in Drowning
Remove the bodily clothings especially the tight
ones and wrap the body with blanket. Place the face down
and perform artificial respiration, using any of the following
methods: Schaefer's Method or Sylvester's Method.
7
 Snake venom toxicity will depend on:
a. Potency of venom injected
b. The amount of venom depends on the season
of the year and the length of time the
snake has eaten. If a snake has just killed his
prey, the toxic content is smaller
c. Size of Patient
d. The immediate treatment instituted
Snake venoms are of two principal classes:
a. Neurotoxic - primarily paralyzes the respiratory
and cardiac center of the
brain. May cause nausea,
vomiting, ascending
paralysis, coma,
convulsion, and cardiac
and respiratory arrest.
b. Hematoxic - affects particularly the blood. The
manifestations are pain and
swelling of the affected
area, intravascular
hemolysis, abdominal pain,
nausea, vomiting, petechial
hemorrhage on the gum,
pulmonary and cardiac
edema.
Emergency treatment may be:
a. Incision of the wound to promote more
external hemorrhage to
drain the venom
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148
and hemorrhagic effect
o Produces only one punctured
wound on the center of a
reddened area
o Main symptoms are pain
edema and reddening
 Coelenterate Sting (jellyfish)
o The tentacles penetrate into
the skin and cause explosion
of the nematocyst and
liberation of the venom
o Symptoms are extreme pain,
urticarial rash, abdominal
pain, dilated pupils, paleness
and labored breathing
6. Absence of medical or surgical intervention:
 A wound may not be fatal, but because of
neglect in its management it may become
serious or fatal
Fatal Effect of Wounds:
1. Wound may be directly fatal by reason of:
a. Hemorrhage
 Incised wound on carotid artery without
surgical intervention is fatal
b. Mechanical injuries on the vital organs
 Blow on the head may not necessarily
produce external lesions but may
produce severe meningeal hemorrhage
producing compression of the brain
 Summary of Legal
FROGLETS NOTES Book by So

c. Shock 2. Changes producing

separate
 Disturbance of the balance of fluid in pathological lesions
the body capable of producing delayed which in turn
or immediate death proves to be fatal
Ex: Operation
performed on a
2. Wound may be indirectly fatal by reason of: patient to ligate
bleeding vessel
a. Secondary hemorrhage following sepsis inside the
abdominal cavity
 On account of infection that sets in, with reasonable
deeper tissues are involved skill and due
diligence but as a
b. Specific Infection result of which
peritonitis
 Pathogenic microorganisms may developed and
develop and multiply in the wound caused death of
causing septicemia, bacteremia, or patient
toxemia

3. Changes where a
c. Scarring Effect definite
 Chronic gonorrheal infection may pathological
condition was
cause stricture or urethra
7 present before the
148 injury
d. Secondary Shock Ex: A person
suffering from
 suffering from
Nature or death due to secondary shock tumor or cyst and
was stabbed by
- A person may have recovered someone. The stab
from the immediate effects of the is not capable of
trauma or violence, but may later producing death
die of its secondary effects or ordinarily. The
changes person may die of
the pathological
condition and the
These changes may be classified accused is liable
as follows: for his death

1. Changes whose
natural sequence
are direct and 4. Changes where a
obvious definite
Ex: Septicimia, pathological
tetanus or condition of totally
complications different nature
arising from arises after the
wounds wounding and the

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148
 Summary of Legal
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consequential  The extravasation or loss of blood from

sequence is the circulation brought about by wounds
doubtful in the cardio-vascular system.
Ex: Tuberculosis  The degree and nature of hemorrhage
meningitis that depends upon the size, kind and location
develops following of the blood vessel cut.
a blow on the head

Kinds of Hemorrhage:

Complication of trauma or injury: a. Primary Hemorrhage

1. Shock
 The disturbance of fluid balance
resulting to peripheral deficiency which
is manifested by the decreased volume
of blood, reduced volume of flow,
hemoconcentration and rental
deficiency
 Clinically characterized by severe
depression of the nervous system
 Three major factors operate in the
production of shock and all are likely to
be associated together as the condition
develops
a. Injury to the receptive
nervous system
b. Anoxemia – reduction of
effective volume of
oxygen carrying
capacity of the blood
c. Endothelial damage,
thus increasing capillary
permeability
Kinds of Shock:
a. Primary Shock
 Caused by immediate nerve
impulse set up at the injured
area which are conveyed to
the central nervous system
b. Delayed or Secondary Shock
 Patient shows sign of general
collapse which develop some
time after the infliction of
injury 148
 It is the bleeding which
occurs immediately after
the traumatic injury of
the blood vessel
b. Secondary Hemorrhage
 This occurs not
immediately after the
infliction of the injury but
sometime thereafter on
or near the injured area
3. Infection:
 Infection is the appearance, growth and
development of microorganisms at the site
of the injury
How injury or trauma acquires infections:
a. From the instrument or substance
which produces the injury
b. From the organs involved in the trauma
applied
c. As an indirect effect of the injury which
creates a local area of diminished
resistance causing the invasion and
multiplication of microorganisms
d. Injury may depress the general vitality,
especially among the aged and the
young children and makes the patient
succumb to terminal disease
e. Deliberate introduction of
microorganisms at the site of the injury
7
4. Embolism:
 A condition in which foreign matters are
introduced in the blood stream causing
2. Hemorrhage

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7
sudden block to the blood flow in148
the finer  Capacity for regeneration decreases as age
arterioles and capillaries increases
 State of nutrition of the individual affects

The most common emboli in the blood
stream are:
a. Fat Embolus
 Causes of Fat Embolus:
o By injection of oily
substance into the
circulation
o By injury of the
adipose tissue
which forces fat
into the circulation
b. Air Embolism
 Causes of Air Embolism:
o Gaping incised
wound of the jugular
vein
o Injection of
soapsuds or air into
pregnant uterus for
the purpose of
tubal insuflation or
criminal abortion
o Injection of air into
the urinary bladder for
radiological study
o Insuflation of the
other non-potent tubes
or hollow organs
o Injection of air
under pressure into
the nasal sinus
after a therapeutic
lavage
Healing of Wounds
1. Power of the human tissue to regenerate
 Regeneration is the replacement of
destroyed tissue by newly formed similar
tissue
 The more highly specialized the tissue, the
less capacity for regeneration
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148
capacity or regeneration
The following regenerates rapidly:
a. Connective tissues
b. Blood forming tissues
c. Surface epithelium of the skin
Those having no power or limited capacity to
regenerate:
a. Highly specialized glandular epithelium
b. Smooth muscle
c. Neurons of the central nervous system
 Small clean-cut wound is covered with
lymph in 36 hours
 The edges adhere in two days and wound
heals on the 7th day leaving a linear scar
 Larger incised wound shows swelling of the
edges 8 to 12 hours
 Blood-stained serum is present in 2 days
which afterwards become seropurulent on
the 3rd day, lasting in state from 4 to 5 days
 Small red granulation forms in 12 to 15 days
and the epithelium grows from the edges
 Scar develops later
Healing of Wounds
The time of healing wounds is dependent on the
following: vascularity, age of person, degree of rest or
immobilization and nature of the injury.
2. Kinds of Healing Wounds
a. Healing by Primary (First) Intention
It takes place when there is minimal tissue loss, more
approximation of the edges and without significant
bacterial contamination. Within 24 hours after the injury,
there is an acute neutrophilic response and scab will be
formed due to dehydration of the surface clot. After
three days, microphages and fribroblasts will appear.
Collagen fibers will bridge the raw area and
differentiated surface cells begin to proliferate to cover
the exposed area. The normal state of the area may
 Summary of Legal
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return after a lapse of one month with or without the cuts, hair and other foreign bodies in the scene; (c)
formation of a scar. witnesses to the incident; (d) wounding instrument;
(e) photography, sketching or accurate description of
b. Healing by Secondary Intention the scene of the crime for preservation
It take place when the injury causes more extensive
loss of cells and tissues. Inflammatory reaction is more 2. Examination of the Wounded Body
intense and granulation tissue growth bears all the
responsibility for its closure. Production of a large scar
and greater loss of skin appendages (hair, sweat and Living Victim Dead Victim
sebaceous glands) and slower reparative process may Age of the wound from degree
occur. of healing
Weapon used
c. Aberrated Healing Process Reasons for multiplicity of
wounds
In some instances, healing process may deviate from Whether injury is accidental, suicidal
the normal way on a normal individual and may result or homicidal
to: Ante-mortem or post-
Dangerous to life of injury
(1) Formation of Excessive Granulation Tissue or mortem wound
Permanent deformity
"Proud Flesh" - It may prevent the closing of wound and 7 Mortal or non-mortal wound
can be remedied by excision or cautery. 148 caused by injury
Presence of disease or
(2) Keloid Formation - It is the a large bulging tumorous abnormal development at

scar produced by an abnormal amount of collagen in the
connective tissue.
(3) Stricture - It is the contraction of the fibrous tissue of
the scar formed.
(4) Fistula or Sinus Formation - Fistula is a
communication between an inner cavity and the outside
while sinus is a tract of infection traversing the inner part
of the body. It may remain for a lone time unless the
causal factor (infection or foreign body) is removed.
CHAPTER X
MEDICO-LEGAL INVESTIGATION OF WOUNDS
Rules to observe by the physician in examining wounds:
 ALL injuries must be described.
 Description must be comprehensive with sketches or
photographs if possible.
 Examination must not be influenced by other
information obtained from others in making a report
or conclusion.
Outline of Medico-Legal Investigation of Physical Injuries
1. General Investigation of the Surroundings: (a) place
of the commission of the crime; (b) clothing, stains,
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148
Shock produced by wounds time of wounding which
may accelerate death
Complications produced by Cause of wound (accident,
injury suicide, homicide)
3. Examination of the Wound
 Character - State the type of wound, characteristic
marks, presence of contusion collar, scab
formation, infection, surgical intervention, etc.
 Location - Region of the body where it is situated,
distance of the wound from some fixed point in the
body prominence. Location is important in
determining trajectory or course of the wounding
weapon
 Depth - It is measurable if the outer wound and inner
end is fixed. It must not be attempted in a living
subject if it will prejudice the health or life or in a
stabbed wound in the abdomen due to movability
of the abdominal wall
 Condition of Area Surrounding the Wound - Presence
of burning or tattooing in gunshot wounds by near
or contact fire, hesitation cuts in suicidal incised
wound or contusion in lacerated wound
 Extent - Extensive injury may show marked degree of
force applied
 Direction - It is material in determining the relative
position of the victim and offender.
 Number - Multiple wounds in different parts of the
body are generally indicative homicide or murder.
 Summary of Legal
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 Conditions of the Locality - (a) degree of hemorrhage; and cellular tissues not clot
(b) evidence of struggle; (c) position of the body; removed by washing
(d) presence of suicide note; (e) condition of Edges and cellular tissues
weapon. Edges gape owing to the are not deeply stained and
reaction of the skin and can be removed by
muscle fibers washing.
Factors in Determining Whether Wounds were Inflicted
During Life or After Death Edges do not gape but are
closely approximated to
1. Hemorrhage is more profuse when the wound was Inflammation and reparative
processes each other unless wound is
inflicted during lifetime. If wounds are inflicted after caused within one or two
death, the amount of bleeding is comparatively less hours after death.
due to loss of tone of blood vessels, absence of heart No inflammation or
action and post-mortem clotting of blood. Violence reparative processes
upon a living body may not show bruise until after
death.
Factors in Determining Whether Wound is Homicidal,
Suicidal or Accidental
2. Signs of Inflammation such as pus, adhesion of the
edges and other vital reactions may be present 1. Nature of the wound inflicted
whenever the wound was inflicted during lifetime  Abrasions - extensive in accidental death, rare in
although they may be less pronounced when suicidal, not common in murder unless the
resistance of the victim is markedly weakened. Post- body is dragged on the ground, common in
mortem wounds do not show any manifesting signs homicide especially when victim offered some
of vital reaction. degree of resistance.
 Contusion - rare in suicide unless done by
jumping from a height, may be found in
3. Signs of Repair such as fibrin formation, growth of accidental death often due to a fall or forcible
epithelium, scab or scar formation conclusively show
contact with some hard object.
that wound was inflicted during lifetime. But absence  Incised wound - common in suicide and
of such does not show wound was inflicted after homicide. Accidental cuts are frequent
death since the tissue may not have been given everyday occurrences but rarely cause of
ample time to repair before death took place.
death.
2. External signs and position and attitude of the body
4. Retraction of the Edges of the Wound inflicted during when found
life cause gaping of the wound while in case of 3. Location of the weapon or manner it is held
wound inflicted after, edges do not gape and are 4. Motive
closely approximated to each other. 5. Personal character of the deceased
6. Other information such as:
 Signs of struggle - Its absence is more in suicide,
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Distinction between Ante-Mortem and Post-Mortem accident or murder. Presence of hair or portion
Wounds of skin on nails of assailant or deceased
 Number and direction of wound - Multiple
 Ante- Post- wounds in concealed parts of the body are
Mortem Mortem indicative of homicide. Single wound in a
Wound Wound position the deceased could have been
Hemorrhage more or less conveniently inflicted is suicidal. In cut-throat,
copious and generally Hemorrhage slight or none generally transverse in homicide while oblique
at all and always venous in suicide.
arterial
Marks of spouting of blood  Nature and extent of wound - Homicidal wounds
from arteries No spouting of blood may be caused by any wounding instrument
Deep staining of the edges Blood is not clotted or a soft while suicidal wounds are due to sharp
instruments.
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FROGLETS NOTES
 State of clothings - Usually no change in its
condition in suicide while it may be in disorderly
position due to struggle in homicide.
Factors in Determining Length of Time of Survival of the
Victim After Infliction of the Wound
1. Degree of Healing
Signs of repair appear in less than a day after
infliction of injury. By the degree of the granulation of
tissue formation and other reparative changes, the
age of the wound may be estimated.
2. Changes in the Body
Systemic changes such as degree of wasting,
anemia, condition of the face and bed sore formation
may provide for a basis.
3. Age of the Blood Stain
It may be determined from the physical color
changes of the skin although it is not reliable.
4. Testimony of the Witnesses
In cases where witnesses testify as to the exact
time, medical evidence as to duration of survival is
merely corroborative.
Possible Instruments Used by Assailant Inferred from
Nature of Wound
 Contusion - blunt instrument
 Incised wound - sharp-edged instrument inflicted by
hitting
 Lacerated wound - blunt instrument
 Punctured wound - sharp-pointed instrument
 Abrasion - body surface rubbed on rough hard
surface
 Gunshot wound - diameter of the wound of entrance
may approximate caliber of firearm
 A physician can only state that it is possible that a
certain injury is possibly caused by a certain
instrument presented. He must be cautious in making
categorical statements.
 In case of multiple offenders and there is conspiracy,
it is not necessary to determine who inflicted the fatal
blow. Where victim received multiple injuries,
determining which injury caused the death depends
on the testimony of the physician by examining which
of the wounds caused injury to some vital organs or
large vessels or led to secondary results causing
death.
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Summary of Legal
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 Determining which of the wounds were inflicted first
depends on relative position of the parties, trajectory
of the wound inside the body, organs involved and
degree of injury, testimony of witnesses and
presence of defense wounds.
Effect of Medical and Surgical Intervention on the Death
1. If death occurred after medical intervention, offender is
still liable provided (1) death is shown to be inevitable and
even without intervention, death is a normal and direct
consequence; (2) physician must be competent and
exercised care and diligence.
2. Minor wounds were received by victim but death resulted
on account of gross incompetence or negligence of
physician, offender is liable only for the physical injuries
inflicted.
Effect of Negligence of the Injured on the Death
Negligence of the victim in the proper care and
treatment of the injury will not exonerate the offender since
he is not bound to submit himself to medical treatment. But
if negligence is deliberate and is really the cause of death,
offender can only be held liable for physical injuries.
Power of Volitional Acts of the Victim After Receiving a
Fatal Blow
The determination of the victim's capacity to perform
volitional acts rests upon the medical witness.
 Severe injury of the brain and cranial box -
usually produces unconsciousness but power
to perform volitional acts depends upon areas
of the brain involved.
 Wounds of big blood vessels (carotid, jugular,
even aorta) - not prevent performance of
voluntary acts
 Penetrating wound of heart - instantaneously
fatal but experience shows victim may still be
capable of locomotion
 Rupture of organs - victim may still move and
speak
Extrinsic Evidences in Wounds
1. From Wounding Weapon
(a) Position - Near the body of the victim in suicidal
and accidental death or firmly grasped by the victim
in case of suicide

FROGLETS NOTES
(b) Presence of blood - In some cases, absence of
blood stains is due to the rapidity of the blow and
compression of the blood vessels or blood may be
wiped out by the clothings in the process of
withdrawal.
(c) Presence of hair and other substance
2. In the Clothings of the Victim
In gunshot wounds, holes in the clothing may
determine the wound of entrance whole presence of
gunpowder at the hole indicates distance. Clean-cut
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tears indicates use of sharp-edged instrument.
Severe tearing may show struggle. The degree of
soaking of the clothing with blood may depict
Summary of Legal
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as being of small caliber and limited range are
used a toys. The barrel of any firearm shall be
considered as complete firearm for all purposes
thereof (Section 877, Revised Administrative
Code)
Penal Provisions of Law Relative to Firearm
Alarms and Scandals (Art. 155, Revised Penal Code)
The penalty of arresto menor or fine not exceeding
200 pesos shall be imposed upon:
1. Any person who within any town or public place shall
 hemorrhage.
3. From Examination of the Assailant
Determination of the degree of intoxication, mental
condition, physical power, etc of the offender may be
necessary.
4. From the Scene of the Crime
CHAPTER XIII
GUNSHOT WOUNDS
Death or physical injuries brought about by the powder
propelled substances may be due to the following:
 Firearm shot - The injury is caused by the missile
propelled by the explosion of the gunpowder in the
cartridge shell and at the rear of the missile. The
missile may be single as in the case of a pistol or
revolver or multiple shots or pellets in case of a
shotgun.
 Detonation of high explosives as in grenades, bombs
and mine explosion.
Firearm Wound
Definition
An instrument used for the propulsion of a projectile
by the expansive force of gases coming from the
burning of gunpowder
Includes rifles, muskets, shotguns, revolvers, pistols,
and all other deadly weapons from which a bullet,
ball, shot, shell, or other missile may be
discharges by means of gunpowder or other
explosives. it also includes air rifles except such
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discharge any firearm, rocket, firecracker, or other
explosive calculated to cause alarm or danger;
xxxxxxxxxx
Discharge of Firearms (Art. 254, Revised Penal Code)
Any person who shall shoot at another with any
firearm shall suffer the penalty of prision correccional in its
minimum and medium periods, unless the facts of the case
are such that the act can be held to constitute frustrated or
attempted parricide, murder, homicide or any other crime
for which higher penalty is prescribed by any of the articles
of the Code.
Classification of Small Firearms
Small firearms are those which will propel projectile of
less than one inch in diameter.
1. As to Wounding Power
a. Low Velocity Firearm - With muzzle velocity of not
more than 1,400 feet/second (i.e. revolver)
b. High Power Firearm - 2,200 - 2500 feet/second
(i.e. military riffle)
2. As to Nature of the Bore
a. Smooth Bore Weapon - Inside portion of the barrel
is perfectly smooth (i.e. shotgun)
b. Rifled Bore Firearm - The bore of the barrel has
spiral lands and grooves which run parallel with one
another but twisted spirally from breech to muzzle
(i.e. military rifle)
3. As to the Manner of Firing
a. Pistol - Fired only by a single hand (i.e. revolver)
b. Rifle - Fired from shoulder (i.e. shotgun)

FROGLETS NOTES
4. As to the Nature of Magazine
a. Cylindrical Revolving Magazine - Cartridge is in a
cylindrical magazine which rotates at the rear portion
of the barrel (i.e. revolver)
b. Vertical or Horizontal Magazine - Cartridge is held
one after another vertically or horizontally by a spring
side to side or end to end (i.e. pistol)
Types of Small Firearms of Medico-Legal Interest
 Revolver - It has a cylindrical magazine at the rear of
the barrel capable of revolving motion and can
accommodate of five or six cartridges housed in
separate chamber. It has muzzle velocity of 600
feet/second.
 Automatic Pistol - More appropriately called "self-
loading firearm". Empty shell is ejected when the
cartridge is fired and a new one is slipped into the
breech automatically. It has muzzle velocity of
1,200 feet/second.
 Rifle - It has a long barrel and butt and is fired from a
shoulder. A military riffle has a magazine and volt
action. It has a muzzle velocity of 2,500
feet/second and a range of 3,000 feet. A miniature
riffle is a single self-loading weapon.
(pp.336-352)
6. Fragmentation of Hard Brittle Object in the Trajectory:
Bone involvement along the trajectory may cause
comminuted fracture and each bone fragment may148
cause
additional damage on the surrounding tissues and even in
the wound of exit.
Summary of Legal
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Gunshot Wound of Entrance (Entrance Defect,
Inshoot):
The appearance of the gunshot wound of entrance
depends upon the following:
1. Caliber of the Wounding Weapon:
Excluding other factors which may influence the size
of the wound of entrance, the higher the caliber of the
wounding bullet the greater will be the size of the
wound of entrance.
2. Characteristics Inherent to the Wound of Entrance:
The wound of entrance, as a general rule, is oval or
circular with inverted edges, except in near shot or in
gazing or slap wound. The wound of exit is usually
larger than the wound of entrance.
3. Direction of the Fire:
A right angle approach of the bullet will make the
wound of entrance circular in shape, except when the
missile is deformed or the fire is in contact or near. In
cases of an acute angle of approach of the bullet, the
wound of entrance is oval in shape with the contusion
or abrasion collar widest on the side of the acute
angle of approach.
4. Shape and Composition of the Missile:
Deformity of the bullet modifies the shape of the
wound of entrance.
5. Range:
7
In close range fire, the injury is not only due to the
missile but also due to the pressure of the expanded
gases, flame and other solid products of combustion.
the wound of exit.
7. Muzzle Blast in Contact Fire:
When gun muzzle is pressed on the skin when fired, all of
the products of combustion primarily the muzzle blast will
penetrate the tissues causing severe mechanical
destruction on account of pressure. The explosive effect
will cause extensive laceration of soft tissues and fracture
of bones.
8. Other Consequential Effects on the Body of the Victim:
Aside from direct involvement of vital structures of the
body, pressure to other organs and tissues, the gunshot
wound may be the source of hemorrhage, infection,
paralysis, shock, loss of functioning etc. which may cause
disability or death on the victim.
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Distant fire usually produces the characteristic effect
of the bullet alone.
6. Kind of Weapon:
High power weapon has more destructive effect as
compared with low power one. The shape of the bullet
also plays an important role. Conical shape free end
bullets have more piercing power without marked
tissue destruction while missiles with hemispherical
free ends are more destructive.
Contact Fire:
The nature and extent of the injury is caused not only
by the force of the bullet but also by the gas of the
muzzle blast and part of the body involved. The
following factors must be taken into consideration:

FROGLETS NOTES
1. The Effectiveness of the Sealing Between the Gun
Muzzle and the Shin:
If all the gaseous product of combustion is prevented
from being spilled out, there will be more destructive
effects on the tissues.
2. The Amount of Gas Liberated by the Combustion of
the Propellant:
The greater is the amount of gas in a confined area,
the greater will be the tissue destruction.
3. Nature of Bullet: Bigger caliber bullet is obviously
more destructive than smaller ones.
4. Part of the Body Involved: The nature, character
and extent of injury in contact fire is different
(1) when the bone is superficially located under the
skin, and (2) when the bone is deeply located in loose
or soft parts of the body.
Pressed and Firm Contact Fire:
1. On Parts of the Body Where Bone is Superficial:
This is commonly observed on the head where
the skull is just underneath the scalp. The
following are the characteristics of the injuries:
a. The wound of entrance is large, frequently
star-shaped
b. Edges of the wound may be everted.
c. Areas in the entrance wound is blackened by
burns, tattooing and smudging.
d. Muzzle imprint, Barrel impression (Profile of
the muzzle) on the skin
e. The bullet may cause radiating fracture
f. Blood and tissue become pink due to carbon
monoxide.
g. Fragments of lead and bullet jacket may be
found.
Metal Fouling - When the bullet travels the
whole length of the tight fitting barrel, it is rotated
by the lands and grooves. Its surface is scraped
by the lands and the scraping is ejected from the
barrel and strikes the target. It may lodge on the
clothings or may cause small abrasions or
superficial lacerations on the skin around the
main wound.
h. Singeing of hair.
2. Parts of the Body Where the Bone is Deeply Located:
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a. Wound of entrance is usually large, circular and without
radiating laceration.
b. Edges are everted due to outward slapping of the skin.
c. Singeing of the hair, blackening of the wound due to
fouling, burn, and tattooing.
d. Muzzle imprint due to outward slapping of the skin and
heat.
e. Pinkish color of the deeper structures due to carbon
monoxide.
Loose Contact or Near Fire:
1. Entrance wound may be large circular or oval depending
upon the angle of approach of the bullet.
2. Abrasion collar or ring is distinct.
3. Smudging, burning and tattooing are prominent with
singeing of the hair.
4. Muzzle imprint may be seen depending upon the degree
of slapping of the skin of the gun muzzle.
5. There is blackening of the bullet tract to a certain depth'
6.Carboxyhemoglobinispresentinthewoundandsurrounding
areas.
Short Range Fire (1 to 15 cm. distance)
Medium Range Fire (more than 15 cm. but less than 60
cm)
Fired More Than 60 cm. Distance
Instances When the Size of the Wound of Entrance Do
Not Approximate the Caliber of the Firearm:
In distant fire, the rule is that the diameter of the gunshot
wound of entrance is almost the same as the caliber of the
wounding firearm, but in the following instances, the rule is
not followed:
1. Factors which make the wound of entrance bigger than
the caliber:
a. In contact or near fire
b. Deformity of the bullet which entered
c. Bullet might have entered the skin sidewise
d. Acute angular approach of the bullet -
2. Factors which make the wound of entrance smaller than
the caliber:
a. Fragmentation of the bullet before penetrating
the skin
b. Contraction of the elastic tissues of the

FROGLETS NOTES
In shotgun fire, the size of the wound of entrance is
dependent upon the distance of the fire. Near fire causes
concentration of entry of the pellets, and as distance
increases the pellets disperse with individual pellets
148
causing individual wounds of entry. Only in this instance
may the wound of entrance of the same size as the gauge
Summary of Legal
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when the victim is lying on his back on a hard object
or in small caliber shots the wound of exit tends to be
circular or nearly circular with abrasion at its border. It
7 is also observed that tight-fitting clothings, waist band,
belt collar, brassiere may also support the skin to
enhance formation of a circular wound of exit.
of the shotgun pellets.
Distinction Between Gunshot Wound of Entrance and
Other Pieces of Evidence or Findings Used to Wound ot Exit:
Determine Entrance of Gunshot:
Entrance Wound
1. Examination of the clothing, if involved in the Exit Wound
course of the bullet Appears to be smaller than Always bigger than the
2. Examination of the internal injuries caused by the the missile owing to the missile
bullet elasticity of the tissue
3. Testimony of witnesses: Edges are inverted. Edges are everted
Usually oval or round It does not manifest any
Determination of the Traiectory of the Bullet Inside the depending upon the angle definite shape
Body of the Victim: of approach finite shape of
the bullet.
1. External Examination : "Contusion collar" or ―Contusion‖ is absent
"Contact ring is present due
a. Shape of the Wound of Entrance to the invagination of the
b. Shape and Distribution of the Contusion or skin and spinning of missile
Abrasion Collar
c. Difference in Level Between the Entrance and Tattooing or smudging may Always absent..
Exit Wounds be present when firing is
d. By Probing the Wound of Entrance near
Underlying tissues are not Underlying tissues may be
2. Internal Examination : protruding. seen protruding from the
wound.
a. Actual Dissection and Tracing the Course of the
Wound at Autopsy Paraffin test may be positive Paraffin test always
b. Fracture of Bones and Course in Visceral Organs negative.
c. Location of Bone Fragments and Lead Particles
d. X-ray examination
The "Odd and Even Rule" in Gunshot Wounds:
Exit (Outshoot) Wound: An exit wound does not
show characteristic shape unlike the wound of If the number of gunshot wounds of entrance and exit
entrance. It may be slit-like, stellate, irregular or even found in the body of the victim is even the presumption is
similar to the wound of entrance. This is due to the that no bullet is lodged in the body, but if the number of the
absence of external support beyond the skin so the gunshot wounds of entrance and exit is odd, the
bullet tends to tear or shatter the skin while sufficient presumption is that one or more bullets might have been
amount of kinetic energy is still in the bullet during the lodged in the body. The rule is merely presumptive and
process of piercing the skin. actual inspection and autopsy will verify the truth of the
Variation on the shape of the wound of exit may be presumption. It may be possible that all of those wounds or
attributable to the deformity of the bullet in its passage a majority of them are entrance wounds with some bullets
in the body and to the wabbling and stumbling lodged, yet the number may still be even.
movement of the bullet during its course and
fragmentation of the missiles. How to Determine the Number of Fires Made by the
Offender:
Shored Gunshot wound of Exit - If the place where the
gunshot wound of exit is pressed on a hard object as
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FROGLETS NOTES
l. Determination of the Number of Spent Shells:
2. Determination of Entrance Wounds in the Body of the
Victim
3. Number of Shots Heard by Witnesses
Instances when the Number of Gunshot wounds of
Entrance is Less than the Number of Gunshot Wounds
of Exit in the Body of the Victim:
1. A bullet might have entered the body but split
into several fragments, each of which made a
separate exit.
2. One of the bullets might have entered a natural
orifice of the body, e.g. mouth, nostrils, thereby making it
not visible and then producing a wound of exit.
3. There might be two or more bullets which
entered the body through a common entrance and later
making individual exit wounds.
4. In near shot with a shotgun, the pellets might
have entered in a common wound and later
dispersed while inside the body and making
separate wounds of exit. 148
Summary of Legal
Book by So
hitting the bone the course is deflected to have the wound
of entrance as the wound of exit
Determining whether the wound is Ante mortem or
postmortem:
If the wounds inflicted after death show no evidence of
profuse hemorrhage, or there are signs of vital reactions in
the tissue, then the gunshot wound is ante-mortem.
Wounds inflicted after death show no evidence of profuse
hemorrhage, no retraction of the edges, and there are no
vital reactions.
Problems confronting Forensic physician in the
identification of Gunshot Wounds:
1. Alteration of the Lesion Due to Natural process
2. Medical and Surgical Intervention
3. Embalming
4. Problem Inherent to the Injury itself
6. X-ray Examination The use of an X-ray is almost
indispensable in the examination of gunshot injuries. The
use of the apparatus will facilitate recovery of the lodged
7 bullet together with the location of its fragments
Special Consideration on Bullets:
Instances when the Number of Gunshot wounds of
Entrance is More than the Number of Gunshot Wounds
of Exit in the Body of the Victim:
1. When one or more bullets are not through and through
and the bullet is lodged in the bodY.
2. When alt of the bullets produce through and through
wounds but one or more made an exit in the natural orifices
of the body
3. When different shots produced different wounds of
entrance but two or more shots produced a common exit
wound
Instances when there is No Gunshot wound of Exit but
the Bullet is Not Found in the Body of the Victim:
1. When the bullet is lodged in the gastro-intestinal tract
and expelled through the bowel, or lodged in the pharynx
and expelled through the mouth by coughing.
2. Near fire with a blank cartridge produced a wound of
entrance but no slug may be recovered.
3. The bullet may enter the wound of entrance and upon
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L. Souvenir Bullet: Bullet has been lodged and has
remained in the body. Its long presence causes the
development of a dense fibrous tissue capsule around the
bullet causing no untoward effect. It may be located just
underneath the skin to be easily palpated and may cause
'inconvenience and irritation. Deep seated location may not
cause any problem to warrant its immediate removal.
2. Bullet Migration: Bullet that is not lodged in a place
where it was previously located. A bullet which strikes the
neck may enter the air passage, and it may be coughed out
or swallowed and recovered in the stomach or intestine.
Bullets Embolism - a special form of bullet migration when
the bullet loses its momentum u'hile inside the charnber of
the heart or inside the big blood vessels and carried by the
circulating blood to some parts of the body where it may be
lodged. It may cause sudden loss of function of the area
supplied or death if vital organs are involved.
3. Tandem Bullet: Two or more bullets leaving the barrel
one after another. In cases of misfire or a defect in the
cartridge, the bullet may be lodged in ihe barrel and a
succeeding shot may cause the initial and the succeeding
bullet to travel in tandem. There is a strong possibility for
them to enter the target in a common hole. This might

FROGLETS NOTES
create doubt to the statement made by the firer that he
made only a single shot, but ballistic examination can show
as to whether the bullet travelled in tandem.
GUNSHOT WOUNDS MAY BE SUICIDAL, HOMICIDAL
OR ACCIDENTAL
Pieces of evidence that tend to show that the Gunshot(s)
wound is Suicidal:
1. The shot was fired in a closed or locked room' usually in
the office or bedroom.
2. The death weapon is almost always found near the
place where the victim was found.
3. The strot was fired with the muzzle of the gun in contact
with the part of the body involved or at close range. The
wound of entrance may show signs of muzzle impression,
burning, smudging and tattooing.
4. The location of the gunshot wound of entrance is in an
accessible part of the body to the wounding hand. It may
be at the temple, roof of the mouth, precordial or epigastric
region. A person committing suicide wilI do the act in his
most convenient way, unless he has the intention of
deceiving the investigator.
5. The shot is usually solitary. If the shot is made on the
head involving the brain, the shocking effect of the injury
will not make him capable of firing another shot. However,
shots in some parts of the body which may not produce
immediate death cir sudden loss of consciousness, the
possibility of additional shots is not remote
6. The direction of the fire is compatible with the usual
trajectory of the bullet considering the hand used and the
part of the body involved.
7. Personal history may reveal social, economic, business
or marital problem which the victim cannot solve. He may
have history of mental disease, depression, severe
frustration or previous attempt of self-destruction.
7 4. Possibility that gunshot wounds are self-inflicted
8. Examination of the hand of the victim may show148
presence of gunpowder.
Summary of Legal
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13. no disturbance in the place of death
Russian Roulette:
-agreement among persons to load a revolver with live
cartridge; each member will cock and pull trigger with
muzzle directed to the temple or other vital parts; the
person who will pull trigger with live cartridge in the firing
chamber will suffer the fatal consequence
-may be considered suicidal
Evidences to show the gunshot wound is homicidal:
1. no point of election in he wound entrance
2. fire is made when victim is at some distance
3. defense wounds (signs of struggle)
4. disturbance of the surroundings
5. wounding firearm cannot be found at crime scene
6. witness testimony
Evidences to show that the wound is accidental:
1. usually one shot
2. no special area of body involved
3. determination of relative position of victim and
assailant
4. witness testimony
Points to be considered and included in the report of
the physician:
1. complete description of wound of entrance and exit
2. location of the wound
3. direction and length of bullet tract
4. organs or tissues involved
5. location of missile, if lodges in the body
6. diagram and other illustration showing location of
wounds
Questions that a physician is expected to answer in
court:
1. Could the wound be inflicted by the weapon?
2. At what range was it fired?
3. Direction of the fire
5. Signs of struggle
6. Possibility of the victim to fire or resist the attack after
9. Entrance wound do not usually involve clothings. being injured
7. Did the victim die instantaneously?
11. victim’s fingerprints on butt 8. Relative position of assailant and victim

12. place where the shot took place may reveal suicide Can the Caliber of the Wounding Firearm be
note determined from the size of the gunshot wound of

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148 Summary of Legal
FROGLETS NOTES Book by So
entrance? Yes. The caliber may be inferred from the *It is not possible to determine the direction of the shot
diameter of the gunshot wound. from the direction of the sound UNLESS that flash or the
person firing the shot is seen at that time.
Determination of the Length of Survival of the Victim:
1. nature of wound *It is impossible to distinguish and memorise the report
2. organs involved from two firearm of the came caliber.
3. presence or absence of infection
*It may be possible for a person who is accustomed to
4. amount of blood loss sound of firearms of different calibers to identify firearm by
5. physical condition of victim the sound produced.

Capacity of the Victim to Perform Volitional Acts:
Depends upon the following:
1. area of body involved
2. vital organs involved
3. resistance of victim
*Injuries in the brain and spinal cord which cause
incapacity to do voluntary acts negates the capacity.
Determination as to length of time a firearm had been
fired:
1. Odor of the gas inside the barrel
*mixture of gases has peculiar characteristic
order which is noticeable several hours afar
discharge. Later, the odor will disappear as
gases usually evaporate or chemical transform to doorless
compounds
2. Chemical changes inside the barrel
3. Evidence that may be deduced from the wound
1. age of wound
2. degree of healing
3. degree of infection
Gunshot wound may not be a near fire:
1. when a device is set up to hold the firearm
2. clothings are interposed between the victim and the
firearm
3. failure of examining physician to distinguish between a
near or far shot wound
4. product of a near shot wound has been washed out of
the wound
X-ray examinations may:
1. facilitate location of bullet
2. reveal fragmentation and location
3. show bone involvement
4. reveal trajectory of bullet
5. show effects of bullet wound and other injuries
SHOTGUN WOUNDS
Shotgun- shoulder-fired firearm having a barrel that is
smooth-bored

Determination Whether the Wounding Weapon is an Classes of shot in a shotgun shell:

Automatic Pistol or Revolver:
1. Location of empty shells
revolver
VS automatic pistol
in clylindrical magazine chamber after fire
driven out of weapon after shot
2. Nature of spent bullet
revolver
VS automatic pistol
no coating
bullet is copper jacketed
3. Nature of base of cartridge or spent shell
revolver
VS automatic pistol
wider diameter than
no such difference
that of cylindrical body
1. Birdshot- shot are small (0.5 inch to 0.15 diameter);
use for hunting fowls and small animals
2. Buckshot- shot ranges form 0.24 to 0.33 inch in
diameter; fewer in number of shots (9shots)
3. Single Projectile (rifled slug)- only a single or slug in a
shell
Systems employed in the determination of the
diameter of barrel of a shotgun:
1. Gauge System - determination of number of lead
balls, each fitting of the bore totals to one pound in
weight
2. Expression of the bore diameter in inches-0.410 bore
shotgun is the only shotgun at present designated
3. Metric system - bore in millimeters
*Not standard length of barrel.

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e. smudging due to smoke up to 15 inches

Grade of choke: f. gunpowder tattooing up to 24 inches
1. Unchoke- diameter of barrel from rear to muzzle is the g. in an unchoked shotgun, to estimate the
same distance: measure the distance between the
2. Choke- diameter of barrel at muzzle end is smaller farthest shot in inches and subtract one, the
than rest of the barrel number obtained will give the muzzle-target
distance in yards
*The lethal range is in an area of 30 inches in diameter at
30 to 40 yards according to degree of choking. *A close shot produces more serious injuries because of
concentration on specific target and greater kinetic energy
Types of shotgun: of pellets.
1. As to number of barrel
a. Single Barrel Shotgun DETERMINATION OF THE PRESENCE OF
b. Double Barrel Shotgun GUNPOWDER AND PRIMER COMPONENTS
2. As to manner of firing and reloading:
7 The importance of determining the gunpowder on the
a. Bolt action 148
skin of the victim:
b. Lever Action
c. Pump action 1. Determination of the distance of the gun muzzle from
 d. Autoloading the victim’s body when fired
*The presence of gunpowder at or near the
wound of entrance shows that the gun muzzle
*A shotgun cartridge is usually 2-3/4 or 3 inches long and when fired is not more than 24 inches but its absence will
diameter depends on the gauge of the firearm not preclude near fire because other factors
might have intervened
Shotgun wound of entrance: 2. Determining whether a person has fired a firearm
*When a person fires a gun, the powder particles
1. Contact or near contact shot - not more than 6 inches
which escape may cling on the
Indicators:
a. shape of wound dorsum of the hand
b. entrance wound is burned *Detection of metallic residue on the primer palm
hand may indicate that the individual
c. blackening due to smoke
d. gunpowder tattooing is densely located was making a defensive movement trying to ward off the
weapon
e. contusion of tissue
f. singeing of hair (less than 6 inches) *In suicide, residue may be deposited on the
palm of the hand used to steady the barrel at
g. disrupted deeper tissues
h. presence of carbon monoxide along the bullet the time of discharge
tract
i. recovery of wad together with shot (pellets) Procedures in determining the presence of gunpowder:
2. Long range shot - more than 6 inches skin-muzzle 1. Gross examination or examination with the use of
distance hand lens
Indicators *This examination is not conclusive because
a. 2-3 feet muzzle distance-> single wound of other foreign particles may be mistaken for
entry gun powder or other primer components.
b. 3-4 feet distance-> serrated wound of entry 2. Microscopic examination
referred to as ―rat hole‖ 3. Chemical tests
c. 5-6 feet-> wad tends to produce independent a. Laboratory test to determine firearm residues
injury, usually an abrasion *There is inference of contact or near
d. 6 feet-> shots begins to separate from distance of the gun muzzle to the skin when
conglomerate shot there is burning, tattooing, smudging visible
10 feet-> produces independent wounds of entry *The same test may be applied to
―Billiard ball ricochetted effect‖- tendency for one dorsum of hand of persons suspected to have
shot to stoke another causing changes of the shot fired the gun
course

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FROGLETS NOTES
*The test may involve the
determination of presence of gunpowder residues of
primer components
Test for the presence of gunpowder residues:
1. On the skin (Dorsum of the hand or site of the wound
of entrance):
1. Dermal nitrate test (Paraffin test, Diphenylamin
test, Lung’s test or Gonzales’ test)
*The presence of small particles
containing either nitrate or nitrite will be indicated
by a blue reaction of the particles upon contact
with Lung’s reagent.
*Test is not conclusive as to the
presence of gunpowder because fertilizers,
cosmetics, cigarettes, urine and other
nitrogenous compounds with nitrites and
nitrates will give a positive reaction
*Subjection of suspect is not self-
incriminatory; act purely mechanical
2. On clothing's (Especially coloured ones)
Walker’s tes (C-acid test, H-acid test)
*A glossy photographic paper is fixed
thoroughly in hypo solution for 20 minutes to
remove all silver salts and then washed for 45
minutes and dried.
*If unburned powder grains are
present, it will result to production of dark red or
orange-brown spots on the prepared paper.
Test for the presence of Primer Components:
1. Harrison and Gilroy Test
*A cotton swab moistened with 0.1 molar
hydrochloric acid is used to gather antimony,
barium and lead.
*The test does not enjoy substantial utilisation in
7
forensic laboratory because: 148
1. lacks specificity of color reaction
2. inadequately sensitive
Summary of Legal
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bombardment, afterwards their quantity is
measured.
3. Flameless Atomic Absorption Spectroscopy (FAAS)
*Sample of hand washing is subjected to a high
temperature to vaporise the metallic elements
of the primer residue.
*This method is quick, sensitive and employs
equipment within economic means
*Can determine presence of barium, antimony
and lead
4. Use of Scanning Electron Microscope with a Linked X-
ray Analyzer
*Adhesive material is used to remove any
residue particles from the hand. The material
then examined under the scanning electron
microscope with a linked X-ray analyzer.
FIREARM IDENTIFICATION
Factors:
1. Caliber of the weapon
2. Fingerprints
*may determine if homicidal or suicidal nature of
death
3. Fouling of the barrel
*recently fired firearm may have a characteristic
door smoke inside the barrel
4. Serial number
Procedure of restoring serial number if tampered:
1. Cleaning
*All oil, dirt, grease and paint should be removed
with gasoline, xylol and acetone
2. Polishing (Most important)
*Whole surface should be smoothly polished
using a fine file followed by a medium to fine grade
carborondum cloth
*The area should always have the mirror-like
surface
 3. interference of color reaction among three 3. Etching
elements themselves *For all iron or steel materials, the following
4. development of instability of color etching may be used
2. Neutron Activation Analysis (NAA) Hydrochloric acid - 80 cc
*A sample is obtained from the hands by the use Distilled water - 60 cc
of paraffin or washing the hand with dilute acid. It is Ethyl alcohol - 50 cc
then exposed to radiation from a nuclear react emitting Copper chloride - 10 grams
neurons. *The solution is swabbed until the numbers
*The test requires access to a nuclear reactor appear.
(very expensive test) 4. Ballistic examination
*Unable to detect lead *Ballistics - study of physical forces reaction on
*Principle: Barium and antimony are converted projectiles
into isotopes by means of neutron *Foreign ballistics - also known as firearm
identification; deals with examination of fired bullets

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and cartridge cases in a particular gun to the exclusion of 3. Hand lens

all others 4. Sharp pointed instrument for scraping I.D. marks
5. Caliper
Three separate and distinct area of Ballistics: 6. Analytical Balance
1. Interior Ballistics - deals with what happened to the
cartridge and its bullet from the time trigger is pulled See illustration on page 386
until the bullet exits from the barrel
2. Exterior Ballistics - deals with what happened to the Types of marking on the examination through
bullet or projectile from the moment it leaves the gun Comparison Microscope:
barrel to the moment of impact on the target or object
3. Terminal Ballistics- concerns with the effect of the
bullet on the target or until it comes to rest 1. Impression type Mark (Stamp Mark) – the
4. Medical Ballistics- concerned with the penetration, forcible application of hard surface against the
severity and appearance of the wound due to bullet or softer one leaving an impression on the softer
missile surface. E.g. striking of the firing pin on the
percussion cup.
Basic Principles Involved in Firearm Identification: 2. Striation or serration mark – produced by a
1. Quality of metal in the manufacture of firearm is much harder surface scraping, dragging, siding or
harder and resistant to deformity than the quality of slipping cross the softer one leaving a series of
metal used n the manufacture of cartridge. In the abrasions, serrations and scrapes. E.g. bullet
process of contact between the part of the gun surface may show the rifling marks on its surface
involved and the cartridge, the surface condition of the of the barrel.
part of the gun can easily be impressed on the shell or
bullet. When the cartridge is fired from the firearm, the
2. Firearms have certain physical characteristics of following marks are found in the shell and from
certain type of caliber which differentiate it from the bullet:
others.
3. No two firearms can be manufactured with identical Marks found in the Shell:
surface characteristics; referred to as ―individual
characteristics‖ a. Marks of firing pin – impressions
in the percussion cap
Instruments Use in Firearm Identification: b. Marks from the extractor – marks
found in front of the rim of the
1. Comparison Microscopes- instrument consists of two shell
compound microscopes which allows comparison of c. Marks from the ejector- marks
two objects by looking through single eyepiece. The found in the head of the shell
individual or accidental characteristics of two objects
d. Marks from breechblock: the
may be compared. There is an attachment for impact of the shell in the
photographic camera to facilitate the taking of pictures bleechblock in the recoil
of the findings. impresses the ridges of the
2. Bullet Recovery Box- instrument for the purpose of bleechblock and often gives
recovering the test bullet and shell. It is a long identification mark characteristic of
cylindrical container filled with cotton and an open a firearm.
shooting end. *The test shell e. Marks on the cylindrical surface of
and bullet may be used for comparison with the the shell- mark brought about by
evidence bullet or shell. the magazine.
Other ways of recovering test bullet as used in
other countries:
1. Shot may be fired on a box with oil and Marks found in the bullet:
sawdust
2. Vertical or horizontal shot on water tank
3. Shot fired on a block of ice

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a. Number of lands and grooves- i. The refling barrel is reflected

number of grooves, depth, and in the bullet as it passes
width depend upon the through it.
manufacturer of the firearm. ii. Firing pin mark: when the
b. Direction of the twist of the Rifling base of the cartridge is hit by
Marks- the direction of the spiral the firing pi, the pin produces
lands and grooves may twist to the distinct markings which can
7
right or to the lest. 148 be reproduced by succeeding
shots.
iii. Breechblock mark: as the
Each manufacturers of firearms make certain marks which
will distinguish firearms manufacturered by them and
makes specific number of spiral grooves and direction of
the twist in the brrel of the firearm. The bullet recovered
from the ody may show those marks in the examination
and the examiner may have the presumption where the
firearm came.
In fire Arm Identification the Examiner must take into
consideration the following:
1. gross examination or examination with
magnifying lense:
a. caliber of the bullet
b. presence or absence of deformity or
loss part
c. presence of foreign elements. E.g.
blood, flesh
d. identity marks placed by previous
possessor.
2. Examination with the use of comparison
microscope: this is the comparison between
evidence shell or bullet with the test shell or
bullet
a. Determination of the clss
characteristics: physical characteristics
of certain caliber of firearm used by the
manufacturer:
i. Number of rifling
ii. Direction and rates of rifiling
marks
iii. Dimension of the lands and
grooves
iv. Depth of the grooves
v. Style of the cannelure
b. Determination of individual
accidental characteristics:
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bullet is propelled forward by
the force of the expanded
gas, the casing is forcibly
moved backward against the
breech force or recoil plate.
The backward force transfers
the marking on the
breechblock to the base of
the cartridge.
iv. Extractor mark: mark made
by the extractor on the
cartridge rim when pulled
away from the firing
chamber.
v. Ejector mark: mark produced
by the ejector in the process
of throwing away the spent
shell.
GUNSHOT WOUNDS IN DIFFERENT
PARTS OF THE BODY
Head and Neck
1. Cranium:
Close or near contact fire in the
head may produce marked
laceration of the skin, burning and
tattooing of the surrounding skin.
The skull is fractured without any
definite shape with the linear
extensions to almost all of the
bones comprising the cranial box.
Fire from distance with the
bullet having a right angle of
or approach to the skull, the fracture
is oval at the outer table. There
will be radiating linear fractures
from point of entrance. The wound
exit will be clean-cut oval round
7

FROGLETS NOTES
opening at the inner table with
beveled fracture at the outer table.
Grazing approach of the bullet
may produce an elongated gutter-
like depressed fracture of the
cranium. The tangential impact
of the bullet may cause it to split
and it is not uncommon to see a
fragment lodging in the brain
substance while the other ricochet
outside hitting other objects
nearby.
2. Brain Substance:
Usually a rugged tunnel with a
diameter larger than that of the
caliber of the bullet, with mark
ecchymosis of the surrounding
area and filled with fresh and
clotted blood. Fragments of bones
may be felt in the tunneled bullet
tract. In jury of the brain causes
sudden loss of consciousness and
148
incapable of voluntary movement.
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4. Neck
The bullet may pierce the front
portion of the neck and may
involve the cervical portion of the
spinal cord; causing instantaneous
death if the upper portion is
involved. If involve the carotid or
jugular vessel and death may be
due to profused hemorrhage.
Injury to trachea and upper
bronchi may cause asphyxia or
aspiration pneumonia.
5. Chest:
1. Chest wall: usually has an
upward course and may
involve both sides. The bullet
may strike the rib, sternum or
the body of the vertebra and
may cause deformity or
deflection of its course. When
the intercostal or mammary
vessel are injured there will
be perfused hemorrhage.
7
2. Lungs: it produces a
cylindrical tunnel much larger

Injury in the cerebral hemispheres
is as a rule not immdediately fatal
and the victim may survive the
injury, however if the bullet
courses the medulla, pons, and
other vital centers causes the
immediate death. Some victims
may live for a while but developed
epileptiform convalsions as a
sequel.
3. Face
May noy cause serious trouble
except that it becomes potential
avenue for infection that may
cause deformity.
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than the diameter of the
projectile with the bloody
contents and ecchymotic
borders. When the
pulmonary vessel is involved,
the profuse hemorrhage is
observe that produces death
before medical intervention
can be done. If only the lungs
is involve, the profuse
hemorrhage may cause
collapse of the lungs,
displacement of the heart.
Emphysema is present when
there is marked injury to the
air sacs. The victim may not
die immediately but later may
develop aspiration
pneumonia or cerebral
embolism.
 Summary of Legal
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3. Heart: wound may be the spinal cord may be due

circular or stellate with to:
subepicardial hemorrhage in a. Bullet affects the
the surrounding tissue. As a canal and the
general rule does not prevent spinal cord causing
the victim from running, either partial or
walking or to do other forms complete
of volitional acts for death is severance
not usually instantaneous. b. Injury in the body of
wound of the auricle is more other parts of the
rapidly fatal as compared vertebra and
with the would of the ventricle contusion,
on the account of thickness concussion or
of the musculature of the compression on the
latter which produces account of impact.
temporary closure of the Injury of the upper
wound. cervical spinal cord
4. Abdomen: wounds are quite may cause
frequent but not as serious immediate death
as those of the chest and because the vital
head because of its ability to nerve tracts may
surgical operation. It is be involved. Lower
limited to one or several spinal cord injury
organs. Bullet wound of the may cause motor
liver and other or sensory
parenchymatous abdominal paralysis and may
organs may cause stellate later succumb to
perforations which are hypostatic
usually larger than the caliber pneumonia,
of the bullets that causes suppuration or
them. The tunnel may other
contain fragmented tissue, complications.
fresh and clotted blood. Loss 6. Extremities: it may show the
of function, of the kidney, characteristic lesion of
pancreas, etc may lead to gunshot wounds. Usually the
fatal resuls. Bullet wounds in wound is not so serious
the stomach and other hollow except when it involves the
areas are usually small on principal blood vessels and
the account of he contractility nerves. The bony tissue may
of the walls. The wound involves the principal blood
entrance is smaller than the vessels and nerves.
exit wound. Timely surgical
intervention may prevent
untoward complications.
However, death due to CHAPTER XVII
peritonitis is not rare on the DEATH BY ASPHYXIA
account of the spilling of its
contents into abdominal 7
148
cavity.
5. Spine or Spinal Cord: injury Asphyxia – general term applied to all forms of
violent death which results primarily from interference with
 of the spine may not involve violent death which results primarily from interference with
the spinal cord but injury of the process of respiration or the condition in which the

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supply of oxygen to the blood or to the tissues or both has 3. Apneic Phase: is due to the paralysis of the
been reduced below normal level. respiratory center of the brain. The breathing
 shallow and gasping and the rate becomes
Types of death by Asphyxia: slower till death. The heart later fails.
1. Anoxic Death: associated with failure of the
arterial blood to become normally saturated with Classification of Asphyxia:
oxygen may be due to :
a. High altitude 1. Hanging
b. Traumatic crush asphyxia 2. Strangulation:
c. Paralysis of the respiratory centerdue a. By ligature
to poisoning, injury or anesthesia, etc. b. Manual strangulation or throattling
d. Mechanical interference with the c. Special forms of strangulations:
passage of air into or down the i. Palmar strangulation
respiratory tract due to: ii. Garroting
i. Closure of external iii. Mugging or yoking
respiratory ortifice iv. Compression of the neck with
ii. Obstruction of air passage stick
iii. Respiratory abnormalities 3. Suffocation:
e. shutting blood from the right side of the a. Closing the mouth and nostrils by solid
heart to the left without passage object
through the lungs b. Choking or closing of the air passage
2. Anemic Anoxic Death: this is due to a by the obstruction of its lumen
decreased capacity of the blood to carry oxygen. 4. asphyxia by submersion or drowning.
This condition may be due severe hemorrhage, 5. Asphyxia by pressure on the chest
poisoning, or low hemoglobin level in the blood. 6. Asphyxia by irrespirable gases
3. Stagnant Anoxic Death: this is brought about by
the failure of circulation which may be due to
heart failure, shock, or arterial and venous Asphyxia By Hanging: is a form of violent death brought
obstruction. about by the suspension of the body by a ligature which
4. Histotoxic Anoxic Death: this is due o the encircles the neck and the constricting force is the weight
failure of the circulation of the cellular oxidatives of the body. The victim may be sitting or lying with the face
process, although the oxygen is delivered to the down provided that the pressure is present in front or in the
tissues, it cannot be utilized properly. Cyanide side of the neck.
and alcohol is common agents responsible.
Classification of asphyxia by hanging:

Phases of Asphyxial Death: 1. as to location of the ligature and knot:

a. typical: ligature runs from the midline
1. Dyspenic Phase: symptoms due to lack of above the thyroid cartilage
oxygen and retention of carbon dioxide in the symmetrically encircling the neck on
body tissue. Breathing becomes rapid and deep, both sides to occipital region.
pulse rate increase and rise of blood pressure. b. Atypical: the ligature is tied or noosed
2. Convulsive phase: this is due to simulation of and present on one side of the neck, in
the cntral nervous system by carbon dioxide. The front or behind the ear or on the chin.
cyanosis becomes more pronounced and yes 2. as to amount of constricting force:
becomes staring and pupils are dilated. Visceral a. complete: body is completely
organs shows petechial hemorrhages known as suspended and he constricting force is
Tardieu Spots (caused by the hemorrhage the whole weight
produced by the rapture of the capillaries on b. partial: body is partially suspended as
account of the increase if intra-capillaries when the victim is sitting, kneeling,
pressure). The victim may become unconscious reclining, prone or in any other
in the convulsive stage. positions.

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FROGLETS NOTES
3. as symmetry:
a. symmetrical: the knot or noose is at the
midline of the body either at the occiput
or just below the chin.
b. Asymmetrical: knot or noose is not is
not in the midline but on the one side,
with the head tilted to the side opposite
the location of the noose or knot.
Mechanism of Death:
There is a ligature around the neck with a knot or
with a sliding noose and the other end is fastened to an
elevated object like peg, nail, window casing, door knob,
tree, etc..
Upon suspension of the body, the weight causes
the noose or band to tighten, producing pressure at the
region of the neck.
148
The pressure of the band will cause the air
passage to constrict, the larynx is pushed backwards and
Summary of Legal
Book by So
There may be no sliding noose at the end of the
ligature. It may be tightened after it has been
encircled around the neck and the pressure on
the air passage, blood vessels and nerves of the
neck is established when the body is suspended.
3. Mode of Application of the Ligature
The ligature may be placed around the neck with
a single loop or with two or more hoops. This can
be distinguished on the nature of the ligature
marks. In single loop, there is but one ligature
furrow, but if there are several, there will be
several ligature marks with an intervening
redness between the furrow. There is more
pressure in a single loop ligature on account of
concentration of force at the weight compare to
several loops.
4. Position of the Knot
7 The knot or joint is usually located on either side
of the neck. The head is flexed opposite the
location of the knot. The level of the ligature
passage to constrict, the larynx is pushed backwards and
its opening is closed by the contact of the anterior to the
posterior laryngeal wall producing asphyxia.
Pressure of the ligature may also cause
compression of the superior laryngeal nerve, ceratoid
arteries and jugular veins producing cerebral anoxia.
Forms of furrow that develops in the neck
depends upon the type of ligature, the number of loops
around the neck and the point of suspension.
Protrusion of the tongue depends upon how
pressure is applied around the neck. If above the larynx
and in an upward direction, the tongue will be pushed
outward and will protrude from the mouth but if the
pressure is below, the tongue is kept inside the buccal
cavity.
Ligature in Hanging
1. Materials used in Ligature.
The thinner the ligature and the tougher the
material, the more pronounced will the the mark
on the skin of the neck. If the material is soft and
broad the ligature impression on the neck is less
marked. The rope is commonly used as ligature
because it is easily available and strong. Other
materials includes beddings, belts, electric wire
etc.
2. Noose
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around the neck may differentiate hanging from
strangulation by ligature. In hanging, the ligature
is usually pull of the constricting force, while in
case of strangulation by ligature, the loop is
found below the thyroid cartilage. It is not easy to
retain the knot beneath the chin.
5. Course of the ligature around the neck
The usual appearance is that the groove or
ligature mark is deepest opposite the location of
the knot. However, if the not is just underneath
the chin, the groove at the back of the neck is not
deep on account of the firmer skin and muscular
tissue.
Symptoms
1. Gradual loss of sensibilities
2. Sensation of constriction of the neck
3. Loss of consciousness and muscular power
4. Numbness of the legs and clonic convulsion
5. Sensation of ringing inside the ear
6. Sensation of flash of light before the eyes
7. Face becomes red with eyes prominent and
feeling of heat in the head.
If the victim is timely rescued and revived after artificial
respiration, he will suffer the following symptoms:
1. Whistling sensation insede the ear
2. Watering of the eyes

FROGLETS NOTES
3. Difficulty of breathing and swallowing
4. Sensation of number ness of both legs.
All the above symptoms may last for 12 days after rescue.
Cause of Death in Hanging
1. Simple asphyxia by blocking the air passage
2. Congestion of the venous blood vessel in the
brain
3. Lack of arterial blood in the brain due to pressure
on the carotid arteries
4. Syncope due to pressure on the vagus and
carotid sinus which leads to reflex irritation and
paralysis of the medullary autonomic centers
5. Injury on the spinal column and spinal cord.
6. Any combination of the above
Time Required in the Process of Death
Time is influenced by the following:
1. Severity of the constricting force
If the constricting force is only sufficient to
occlude the windpipe, death may be delayed; but
if the pressure is sufficient to occlude the carotid
arteries, jugular veins and vagus nerve, then
unconsciousness develops immediately and
death is accelerated.
2. Point of application of the ligature
When the ligature is made below the larynx,
death is almost instantaneous, but when applied
above the larynx, death may not occur for three
to five minutes. Hanging with the knot situated on
one side of the neck may delay death because of
closure of cerebral vessels cannot be
maintained. If knot is below the jaw, maximum
pressure is at the back of the neck cause merely
partial occlusion of the windpipe and blood
7 are mostly marked at the legs
148
vessels of the neck, thereby delaying death.
3. Other factors
Summary of Legal
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c. Place the patient where there is free
current of fresh air
d. Electrical stimulation of the phrenic
nerve
e. Administration of respiratory stimulant,
like ammonia.
2. Stimulate the heart to renew action if it ceases to
beat.
a. Apply heat at the region of the
precordium
b. Hypodermic injection of coramine,
strychnine, or other stimulants
c. Administration of brandy.
3. Maintain the natural body temperature
a. Cover the body with blanket
b. Place the patient in a warm room
Post mortem findings in death by hanging
1. General External Appearance
a. Neck elongated and stretched with the
head inclined on the side opposite the
knot or noose
b. Eyes closed or partially opened with
pupils usually dialted on one side and
small on the other side (facies
sympathetic)
c. Lividity or pallor of the face with
swelling and protrusion of the tongue
d. Hands are clenched firmly and purple
colored fingernails
e. Lips livid or blue
f. Saliva dribbled from the mouth with
froth
g. State of erection or semi erection of the
penis with seminal flued in the urethral
meatus
h. Post mortem lividity with ecchymosis
i. Urination or defecation due to the loss
of power of sphincter muscles.
 a. Physical condition of the subject 2. Internal Findings:
b. The rate of consumption of oxygen in a. Engorgement of the lungs
the blood and tissues. b. Venous system contains dark-colored
Treatment fluid blood.
c. Right side of the heart and the big
1. Induce the natural act of respiration blood vessels connected with it are
a. Ligature must be loosened and mouth distended with blood.
msut be wiped to remove all obstacle d. Blood vessels of the brain is generally
to free air. congested.
b. Tongue must be pulled forward and the e. Kidneys are congested.
body must be laid on back rest.
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FROGLETS NOTES
f. Sub-pleural, sub-pericardial punction
hemorrhages
3. Findings on the neck:
a. Neck is flexed opposite the side where
the knot is located.
b. Ligature mark which forms groove is
about or rather leass than the knot.
c. The course of the ligature is inverted v-
shape with the apex of the v at the site
of the knot.
d. The skin at the site of the ligature is
hard with red line of congestion and
hemorrhage in some points.
e. Ecchymosis of the neck depends upon
the width and softness of the ligature.
f. There may be rapture of the underlying
blood vessels, muscles and other soft
tissue
g. The lining membrane of the blood
vessels may be lacerated.
h. Fracture of the hyoid bone or tracheal
rings.
Different diagnosis:
1. Fold markings on the neck of an obese individual
– the marks are not continuous and removed on
stretching the skin of the neck
2. Marks of tight neckwear – the location and
history will differentiate this from ligature marks.
Determinations Whether Hanging is Ante Mortem or Post
Mortem
The principal criterion is the vital reaction. But,
hanging made immediately after death may also show to a
certain extent vital reaction, while hanging of a living
subject whose bodily resistance has been markedly
weakened may show slight vital reaction
The following finding show that hanging is ante mortem
1. redness or ecchymosis at the site of ligature
2. ecchymosis of the pharynx and epiglottis
3. line of redness or rupture if the intima of the
carotid artery
4. subpleural, subepicardial punctiform
hemorrhages
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Summary of Legal
Book by So
It is advisable to look for other injuries which are capable of
producing death to eliminate the possibility of hanging as
the cause of death.
Determinations whether hanging is accidental, homicidal or
suicidal
1. Evidence in support of homicidal hanging
a. Nature of windows and doors - whether
entrance was forcibly opened or have
been used as an escape by the
offender in homicide case
b. Presence of signs of struggle- furniture
and beddings may be disturbed
whenever there is a previous struggle.
c. Presence of stains, bodily injuries in
the body of the victim
d. Presence of defense wounds in the
body of the victim
―Lynching‖ a form of homicidal hanging usually
found in southern states of US. Usually practiced
by Americans against the Negros who commit
crime against the white American. Whenever
colored offenders are apprehended, they are
hanged by means of a rope on a tree or some
similar objects. The Negroes are executed
without due process of the law.
B. Asphyxia by Strangulation
Strangulation by Ligature:
It is produced by compression of the neck by
means of a ligature which is tightened by a force other than
the weight of the body.
It may be observed in infanticide using the
umbilical cord as the constricting material. This must be
differentiated from accidental strangulation during child
birth, the umbilical cord is abnormally long and there is no
disturbance in the wharton's jelly.
Strangulation by ligature is commonly observed
in rape cases, but the presence of findings in the genitalia
and other physical injuries are distinctive findings.
Causes of Death in Strangulation by Ligature
1. Asphyxia due to the occlusion of the windpipe.
2. Coma due to arrest of cerebral circulation.
3. Shock or syncope.
4. Inhibition of the respiratory center due to the pressure
on the vagus and sympathetic nerves.
Accidental, Homicidal or Suicidal Strangulation by Ligature