Essentials of Forensic Medicine and

Toxicology, 1st Edition Suresh Chand

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 TE
AINA

Essentials of

Forensic Medicine
&Toxicology

S.Chand

ELS4158594.

ELSEVIER
 ABBREVIATIONS
Td Increased
Decreased IUL Intrauterine life
Jd IVC
Lead(s) to/results into Inferior vena cava
1/V Intravenous
More than or equal to
JJB Juvenile Justice Board
Less than or equal to
LAMA Left against medical advice
um Micrometer
Airway, breathing and circulation LBW Low birth weight
ABC
Acetylcholine LMP Last menstrual period
Ach
LOC Loss of consciousness
AND Allow natural death
LQ Long question
ASIS Anterior superior iliac spine
LTI Left thumb impression
a/w Associated with
MCI Medical Council of India
BAC Blood alcohol concentration
mg% milligram percent) = mg/dL (milligram
BBB Blood-brain barrier
Body weight per decilitre) = mg per 100 mL
BW
MI Myocardial infarction
CCU Chaudhary Charan Singh University MIP Mentally ill person
CME Continuous medical education MLC Medicolegal case
CNS Central nervous system MLI Medicolegal importance
CO Carbon monoxide MLR Mediclolegal case report
COHb Carboxyhaemoglobin MOA Mechanism of action
COI Constitution of India nm Nanometer
CrPC Criminal Procedure Code, 1973 NREM Nonrapid eye movement
CVS Cardiovascular system N/V Nausea and vomiting
D/D Differential diagnosis OD Once a day
DIC Disseminated intravascular coagulation OIC Officer-in-charge
DMC Delhi Medical Council OT Operation theatre
DNR Do not resuscitate POCSO Protection of Children from Sexual
DU Delhi University Offences Act
D/W Difference between POTA Prevention of Terrorism Act
EDH Extradural haemorrhage PSIS Posterior superior iliac spine
EUL Extrauterine life PVS Persistent vegetative state
FD Fatal dose RMP Registered Medical Practitioner
FP Fatal period RTA Road trafic accident
FSL Subarachnoid haemorrhage
Forensic Science Laboratory SAH
FPs SDH Subdural haemorrhage
Finger prints
GA SIDS Sudden infant death syndrome
General anaestheticCS
h Hour/Hours SMC State Medical Council
Hb Haemoglobin SN Short note
HR Heart rate Sol Solution
HSR SVC
Hyper sensitivity reaction Superior vena cava
MR Indian Council of Medical Research TADA Terrorists and Disruptive Activities Act
ICP TBSA Total body surface area
Intracranial pressure
IEA TCAs Tricyclic antidepressants
Indian Evidence Act, 1872
IHD WMA World Medical Association
Ischaemic heart disease
IM Intramuscular ww-I
IPC and II World War-first and second
Indian Penal Code, 1860
 ABBREVIATIONS

PUNISHMENTS
P=110 rm +F: Punishment is 'imprisonment for
10 years which may extend to lifec' with fine.
P =
I,
or F (Rs 10) or both: Punishment is
mprisonment for 4 years or fine of Rs 10 or both. P RI + F: Punishment is 'rigorous imprison-
P 1, + F: Punishment is 'imprisonment ment' with fine.
for life P Punishment is 'rigorous inmpris.
smenths-2 years
with'fine.
onment extending from 6 months to 2 years.
 CONTENTS
Preface, vii
Acknowledgements, ix 7 Firearm Injury 191
Abbreviations, xi 7P Miscellaneous injuries (electrical
injurics and lightning) 207
8 Mechanical Asphyxia 211
SECTION Forensic Medicine 9 Sexual Jurisprudence 232
9A Impotence and Sterility 232
1 Introduction to Forensic Medicine 9B Virginity, Pregnancy, Delivery
3
2 Legal Procedures and Legitimacy
5 238
3 Medical Jurisprudence 22 9C Abortion 247
3A Code of Medical Ethics, Medical 9D Infanticide 253
Councils, Acts, Medical Records 9E Sexual Offences and Sexual
and Professional Misconduct 22 Perversions 263
3B Consent 33
10 Blood Stains 282
3C Medical Negligence 11 Forensic Psychiatry 289
37
4 Medicolegal Autopsy 12 Miscellaneous Topics 306
(Postmortem Examination) 49 12A Anaesthetic and Surgical Deaths 306
5 Identification 56 12B Torture and Custodial Deaths 308
5A Identification, Age, Race, Sex and 12C Recent Methods of Interrogation 310
Stature 12D Fall From Height 312
56
5B Forensic Osteology 12E Trauma and Disease 313
75
5C Forensic Odontology 12F Medicolegal Importance of
85
AIDS/HIV 314
5D Dactylography (Fingerprinting)
12G Starvation Deaths 315
and Other Prints 93
5E DNA Fingerprinting 97
5F Miscellaneous Methods of SECTIONII Forensic Toxicology
Identification: Forensic Trichology,
Marks and Deformities, 13 General Aspects of Forensic
Toxicology 319
Anthropometry, Superimposition
101 14 Corrosive Poisons 336
and Biometric methods 342
6 Thanatology 106 15 Inorganic Irritant Poisons
16 Organic Irritant Poisons 355
6A Death and Its Causes 106
17 Poisons Acting on Nervous System 368
6B Sudden Death and Unexpected
113 17A CNS Depressants 368
Death 381
115 17B Deliriants
6C Euthanasia 389
117 17C Spinal and Peripheral Nerve Poisons
Postmortem Changes
6D
135 18 Cardiac Poisons
394
7 Injuries 398
135 19 Asphyxiants
7A Medicolegal Aspects of Injuries 404
7B Mechanical Injuries
144 20 Agricultural Poisons 410
163 21 Drug Abuse 417
7C Regional Injuries
7D Thermal Injuries 180 22 Miscellaneous Poisons

xiii
xiv CONTENTS

SECTION I Practicals SECTION IV Appendix

MA Specimens 423 1 Weights and Measurements 491
(For Spotting and Grand Viva) 423 2 Important Sections in CrPC, IPC and IEA 492
IB Injury Examination Report 446 Sample Papers 496
IIC Age Estimation Report 455
IIID Grand Viva in Forensic Medicine 465 Index 499
IIIE Grand Viva in Forensic Toxicology 483
(Except Specimens) 483

Introduction to Forensic
INTRODUCTION TO FORENSIC
MEDICINE
term forensic has come from the Latin word
The
esis which means of the forun' or 'court of
ia. In ancient timmes, 1n Rome, forum was the
meeting place whe civic and legal matters
were
discussed by the conmpetent authorities.
Forensic medicine: It deals with the application
of medical knowledge to aid in administration of
justice; it also deals with the medical aspects of law
It is used by legal authorities to
solve legal prob-
lems.
Medical jurisprudence (Latn, Juris = law; pru-
dentia= knowledge): It deals with the legal aspects
of medicine, that is, the legal principles that guide
the medical personnel. It includes legal rights,
privileges, duties and obligations of a medical
practitioner, doctor-patient relationship, consent,
medical negligence, serious professional miscon-
ducts, medical ethics and so on.
Forensic science: It deals with the application of
scientific knowledge (e.g. physics, chemistry, biol-
ogy, etc.) for the purpose of law and administra-
tion of justice. The laboratory established to carry
out scientific examination and evaluation of evi-
dence for legal purpose is known as the forensic
science laboratory (FSL).
HISTORY OF FORENSIC MEDICINE
Imhotep (2980-2900 BC): He is considered as the
nrstmedicolegal expert. He was the chiet justice and
chief physician to Pharaoh Zoster, the king of Egypt.
Hippocrates (460-377 BC): The father of western
nedicine, Hippocrates was born and practised
medicine in the island of Kos in Greece. He
1
Medicine
discussed the lethality of wounds. Hippocrates was
the first to write the code of medical ethics.
Orfila (1787-1853, France): He is considered as
the founder and father of modern toxicology as
he introduced precise chemical methods into
toxicology.
First autopsy: (1) Outside India-Bartolomeo da
Varignana (AD 1302) performed the first medico-
legal autopsy in Bologna, Italy. Then in AD 1562,
Ambroise Paré performed an autopsy in France on
the dead body of King Henry II. (2) In India-Dr
Edward Bulkley (1693) performed the first med-
icolegal autopsy in Chennai on the dead body of
Mr Wheeler. Dr Hamilton (1725) performed the
first autopsy in Kolkata.
CRIME SCENE INVESTIGATION
Crime scene: It includes the actual location where
the crime was committed. The investigation of a
crime scene done by authorities to help in admin-
istration of justice is known as crime scene inves-
tigation.
Evidence: Anything which helps to support truth
is evidence. Anything which is in the form of an
identifiable object is physical evidence, for exam-
ple, hair, blood stains and so on. When phys-
ical evidence is present in very tiny quantities, it
is known as trace evidence. Trace evidence can
be thought as evidence occurring in such small
amounts that it can be transferred (or exchanged)
between two surfaces (or persons or bodies) with-
out being noticed. The evidence is collected from
crime scene and then preserved and transported to
laboratory or court. It is very important to main-
tain the chain of custody of evidence
Locard's principle of exchange [SN-1]
3
 SECTIONI Forensic Medicine
QUESTIONS-ANSWERS
SN-1: Locard's principle
Drnalist
Edmond Locard (1877-1966), a French crimi-
and
pioneer
in forensic science, described a
principle popularly known as Locard's exchange
principle. This principle constitutes the basis of the
concept of trace evidence and all crime detection.
It states that 'Every contact leaves a trace. It means
Examples:
when any two objects come into contact, there
is always a transfer of material from each object
onto the other.
In crime scene investigation, Locard's principle has
a very important role. The perpetrator after com-
mitting crime leaves the crime scene after destroy-
ing the evidence. But it is the principle of nature
that when a perpetrator touches something dur
ing crime, he leaves some evidence which is either
not visible to him or which he is not aware of. The
evidence left at crime scene may be grossly visible
to the naked eye (e.g. blood) or it may be invisible
(e.g. sweat, epithelial cells, saliva, semen, finger.
prints, etc.).
Nowadays, criminals are more aware about the sci-
entific investigation of crime, so the criminal after
mmitting crime tries to destroy the evidence,
but modern techniques recently developed in the
field of forensic science can detect trace evidence
at microscopic level.
1) Rape: The semen is transferred to the female
genitals, but vaginal cells are transferred to the
penis.
2) Homicide: Blood of the victim sticks to the
dagger and the dagger leaves its metallic traces
at the wound.
3) Fingerprints: The perpetrator touches a glass
by his hands to leave his fingerprint patterns.
4) Shoe marks: A criminal after committing crime
runs away but leaves his footprints on soil. The
soil sticks to the sole of his shoes.
,

INDIAN LEGAL SYSTEM
The Indian legal system was founded by the Colonial Brit-
ish, and after independence it was adopted by India after
making some amendments. The criminal justice in India
isgoverned by the Constitution of India (COI), CrPC,
IPC, IEA and various categories of criminal courts' (c.g.
Supreme Court, High Court, Session Court and so on)
which conduct trials and help incriminal justice.
It
Criminal Procedure Code, 1973 (CrPC): provides
themechanism for punishment of offences against
thesubstantivecriminallaw. It prescribes the proce
dures to be followed by the police in criminal cases,
forexample police duties in arresting.offenders, deal-
ingwith absconders. in production of documents and
investigating offences. It classifies courts and deals
with actual procedure in trial, appeals, references,
revisions and transfer of criminal cases,
Indian Penal Code, 1860 (IPC): It classifies all pos-
sible crimes and prescribes punishments for them.
Chapter XVI is the largest chapter in IPC, which con-
tains 78 sections [S.299-S.377]; it describes offences
affecting the human body, which include some of the
important sections relevant to medical practitioners.
Indian Evidence Act, 1872 (TEA): It deals with law of
evidence and prescribes rules regarding procedures
for tendering evidence in a court of law.
TYPES OF COURTS OF LAW IN INDIA
Ihere are two types of courts: civil courts and crim-
inal courts.
Civil courts: They dealonly with civil matters, for exam-
Ple, land and
property (eg. landlord/tenant disputes),
Industrial, financial, administrative, family matters (e.g.
avorce), etc. Examples include consumer protection
1orum, tribunals
and family courts. The punishment
8ven by these courts is in the form of compensation.
Conduct money is paid to witnesses for attending court.
Legal Procedures
Criminal courts: They deal with criminal offences
codified in IPC, for example, murder, rape, theft,
robbery, etc. and award punishment in the form of
imprisonment or sometimes death penalty with or
without fine. Examples include Supreme Court, High
Court, Session Court and Magistrate Court. Conduct
money is not paid to witnesses for attending the court
but they can get TA/DA.
Supreme Court (SC): It is the highest court of the
country situated in New Delhi.The Supreme Court
has been establishedunder Article 124 of COL It
is presided over by the Chief_Justice of India who
is appointed by the President of India. Article 145
empowers SC to frame its own rules for regulating
thepractice and procedure of the court as and when
required (with the approval of the President).
High Court (HC): It is the highest court of a state
usually located in thecapital of every state. Ithas been
established under Article 214 of COL. It is presided
over bythe Chief lustice of State whois appointed
by the President of India. Some states share a comn
mon HC for example, (1) Guwahati HC caters for all
seven states in the North East (Arunachal Pradesh,
ASsam Manipur Meghalaya, Mizoram, Nagaland
and Tripura), (2) Mumbai HC caters for the states
of Maharastra, Goa, Union Territories of Dadra and
Nagar Haveli and Daman and Diu.
Session Court (or District courts): It is the high:
est court of a district located at district headquar
ters, It is presided over by a "District Session ludge
DS) appointed by High Court. High Court may
LSO appont additional session judge and asSIstanE
Session_judge, to exercise_ jurisdiction in a court or
Session,DSI is also knownas district judge whenhe
when he
presiles over a civil case, and session judge
case, Fast track courts havE
presicles over a griminal are
Session Courts. They
ne_statuS of additional cases and tor ne
established to reduce long pending
speedy disposal of cases.
 SECTIONI Forensic Medicine

First information report (FIR): FIR is the first infor-

Magistrate Courts
are specialised in law mation report about the commission of a'cognisable
1) Judicial magistrate: They
are empow- offence, given either by the victim or any other person
(i.e. have LLB and LLM degree) and
ered to deliver judgment. They are of thrce
types. to the police. It is recorded in writing in FIR regis-
(a) Chiefjudicial magistrate (CJM): In
metropoli- ter by the officer-in-charge of a police station [S.154,
tan cities, CJM is known as Chief Metropolitan CrPC)
Magistrate.
(b) First-class judicial magistrate: In metropolitan INQUEST [SN-2]
cities, first-class judicial nagistrate is known as
Inquest: It is an inquiry by legal authorities into the
Metropolitan Magistrate cause of death in cases of sudden, unnatural and
(c) Second-class judicial magistrate.
suspicious deaths. Types of inquest are shown in
2) Executive magistrate: They are administrative Table 2.2
officials appointed either through a civil service
examination or through promotion. So, they may
have LLB degree but most often do not. They are TABLE 2.2 Types of Inquest [Mnemonic:
not authorised to deliver judgment because their Prime Minister Chief Ministerl
duties are of executive nature. They do not give any Medical
punishment. Examples, District Magistrate (DM), Magistrate Coroner's Examiner
Additional District Magistrate (ADM), Subdivi- Police Inquest Inquest System
Inquest ISN-3] [SN-4] [SN-5]
sional Magistrate (SDM), Collector, Tahsildar.
It It is It is It is
Powers of Various Criminal Courts [SN-1] conducted conducted conducted conducted
by police by by by 'medical
OFFENCE AND FIR magistrate. Coroner examiner

Offence is defined as 'any act or omission made pun-

ishable by law for the time being in force. Depending
on the nature and gravity of an offence, it may be clas- SUMMONS [SN-6]
sified as cognisable and noncognisable (Table 2.1).
Summons (or subpoena): t is a written document
TABLE 2.1 Cognisable Offences Versus issued by the court, compeling the attendance of
a witness in the court of law, to depose evidence,
Noncognisable Offences
Noncognisable Offences
at a particular date and time and purpose under
Cognisable Offences
penalty.
These are offences of such These are offences not
nature and such gravity that of such nature and such Conduct money [SN-7]
immediate arrest of the gravity as is cognisable
offender is necessary and offences and thus the Warrant: If a witness fails to attend the court due
thus the police officer may police officer firstly has to some reason (e.g. illness, emergency and so on),
arrest without warrant. to take warrant from he should convey the message to the court and then
These are serious offences magistrate to arrest the next date of hearing will be issued to him. If the
and so the punishment These are minor offences
for these offences is more and so the punishment for witness has no valid reason for not attending the
than that of noncognisablethese offences is less than court, a warrant for his arrest may be issued to secure
offences. that of cognisable offences. presence of the witness.
Examples: Murder, Examples: Adultery,
sexual offences, sexual bigamy, bribery, causing
harassment, voyeurism, miscarriage, etc. WITNESS [SN-8]
stalking, dowry death,
Kidnapping,etc. Witness: A person who provides evidence about a fact
An FIR can be filed only Here, the police will not file in the cort of law under oath is known as witness.
in the case of cognisable an FIR but it will register
offences
Types of witness (Table 2.3): There are three types of
the complaint in the dally
dlary report/register (DDR). witness: common witness, expert witness and hostile
witness.
 CHAPTER 2 Legal Procedur

According to S.226 of CrPC, public

TABLE 2.3 Vpes of WitneS prosecutor (PP)
tries to prove, on the basis of witnesses
Expert Witness Hostile Witness and evidence,
Common that the arrested person is an offender (accused)
[SN-9] [SN-10] in
Witness the concerned case.
common A person who A person who If Magistrate finds that there is no specific ground
A is skilled in a purposefully
person wno has (witness or evidence) to take any legal action
or particular field makes statements
actualy seen contrary to the against the accused then he can release the accused
(e.g. law, science
observed the facts IS. 227, CrPC|.
narrates or art) and fact or has some
and he
those facts in who provides
evidence about a
interest or motive
for concealing
If Session Court finds that arrested person is an
the witness
box offender, then court charges the accused [S.228,
common fact in the court truth.
is a
of law under Perjury ISN-11) CrPC). Session Court gives a charge sheet, recites
witness. He is not
allowed to draw oath is known as Wilfully giving it, and asks him whether he admits his guilt or
conclusions from expert witness. false evidence not. If Session Court finds (thinks) that the case
his observations.
under oath.
does not deserve to be heard, then the court sends
(hand-over) the case to the CJM.
According to S.229 of CrPC, if accused confesses
PROCEDURE IN COURT his guilt, then court punishes him, but if he refuses
his guilt, then the court does not admit him as an
When a witness appears in court, the court procedure
offender under S.229 of CrPC but gives another
starts in the following sequence.
date of hearing for statement of witnesses. Accord-
) Oath taking [SN-12]: Before giving evidence in ing to S.231 of CrPC, court proceeds with the testi-
the court, the witness has to take oath because it is
mony (statement) of witnesses on the fixed date of
presumed that after taking oath, witness will speak
hearing. The PP sums-up [presents the point (con-
the truth.
tents)] the case before the court and the accused or
2) Recording of evidence (i.e. examination of a wit-
the counsel of accused shall be entitled to reply. If
ness in the court): According to S.138, IEA, the
the counsel of accused raises any questions regard-
order of examination in the court of law is in the
ing the case, then PP answers those questions. After
following sequence.
that, a final argument takes place between coun-
A. Examination-in-Chief [SN-13] sels of both parties. On the basis of this argument
then and the witnesses and evidence, the judge gives his
B. Cross-examination [SN-14]
decision (judgement) regarding the case.
then
C. Reexamination
EVIDENCE
D. Questions put by the court (note: The court
can ask any question any time during the pro- Evidence: 'Anything which is presented in the court to
cedure.) support the truth' or 'anything presented in support
Summary trial [S.260-265, CrPC]: It means short of an assertion' is called evidence. According to S.3 of
and rapid trials avoiding the regular lengthy proce- IEA, evidence is of two types:
dure. Summary
trial aims at speedy/quick disposal 1) Oral evidence: It means 'all statements (oral or
minor offences. A summary case is one which can verbal) which the court permits or requires to de
tried and disposed made before it by witnesses, in relation to matters
De
of at once. In summary trial,
ence of imprisonment for a term more than
months can be imposed by the magistrate.
of fact under inquiry.
2) Documentary evidence: It means 'all documents
for the
Frocedure of criminal
trial: The proceedings of including electronic records produced
Estigation by the police in criminal offences are inspection of the court. 'acquisition
E udicial magistrate of that area. All offences Classification of evidence on the basis of
Punishable with death,
imprisonment of life or of evidence': directlyY
prisonment for >2 years are tried as warrant cases. evidence: When the witness had
A) Direct his senses, it
l other cases felt it by any of
are tried as summons cases. Seen the crime or had
 SECTIONI Forensic Medicine
is called direct evidence. Example, a street vendor
saw a murder in the street.
(B) Indirect: Witness did not directly see the crime. It
may be of two typeCS:
1) Circumstantial cvidence: The witness dicd
not
see actual crime; but some related act observed
by him indicates strongly the comnmision of
crime. For example, W committed murder of 13
C saw 'A'with knife in hand just bcfore the mur-
der. Here, since 'C' did not see the murder with
his eyes; the evidence of C is a circumstantial
evidence. If'C had actually seen the murder with
his own eyes, it would have been direct evidence.
2) Hearsay evidence: The witnes only heard
about the crime from someonc. Example, 'A
told that B had told him that he has seen 'C
while committing the crime. Here 'B' can give
direct evidence as he has seen C committing
the crime; however, the evidence of 'A will be
hearsay evidence. Generally, hearsay evidence
is not admissible in court.
Classification of evidence on the basis of 'presenta-
tion in the court':
1) Oral evidence (testimony):
All statements (oral or verbal) which the court
permits or requires to be made before it by
witnesses, in relation to matters of fact under
inquiry [S.3, IEA].
Oral evidence must be direct i.e. it must be
evidence of an eyewitness [S.60, IEA]. In other
words, a person must have himself seen or heard
something or perceived by some other sense.
Oral evidence is more important than docu-
mentary evidence because it permits cross-ex-
amination. Documentary evidence is accepted
by the court only after oral testimony by the
person concerned.
Oral evidence by a dumb witness is possible if
in the open court, he tries to do so by writing
by signs, or by an interpreter |[S.119, IEA].
Exceptions to oral evidence: Documentary evi
dence is accepted in the court only on oral tes-
timony (i.e. oral evidence). But in some cases,
documentary evidence is accepted in the court
without y oral testimony. These exceptions to
oral evidence are:
1) Statements of relevant facts made by
a per-
son who is dead (i.e. dying declaration)
or can't be found or is incapable of giving
evidence (S.32, IEA].
2) Evidence given by a witness in a previous
judicial proceeding is admissible in a subse-
quent judicial proceeding when the witness
is dead or can't be foun or is incapable
of
giving evidence [S.33, IEAJ.
3) Expert opinion expressed in a treatise:
Expert opinions printed in standard text.
books are accepted as evidence without oral
evidence of the author [S.60, IEA].
4) Deposition of a mental witness taken in
lower court: Evidence of a doctor recorded
and attested by a Magistrate in the presence
of accused who had an opportunity to cross
examine the witness, may be accepted as evi-
dence in a higher court [S.291, CrPC].
5) Reports of certain government scientific
experts e.g. (A) Chemical examiner, (B) Chief
controller of explosives, (C) Director of Finger
Print Bureau or Director of Haffkeine Insti
tute of Mumbai, (D) Director, Deputy direc
tor or Assistant director of Central or State
FSL, (E) Serologist [S.293(4), CrPC]. The
court may however summon and examine any
such expert if it thinks fit [S.293(2), CrPC].
6) Public records: Birth certificates, Death cer-
tificates, Marriage certificates.
7) Hospital records: Routine entries eg. date
& time of admission, discharge, vitals (e.g.
pulse, temperature, urine output, etc), etc.
2) Documentary evidence: All documents produced
before the court is called documentary evidence.
These may be (1) primary evidence (i.e. original
document itself produced for inspection by the
court) and (2) secondary evidence (i.e. the docu-
ments, which are not original, e.g., certified copies,
photocopies and so on). Documentary evidence
related to medical field are known as medical doc-
uments. Medical documents include (1) medical
certificates, (2) medicolegal case (MLC) reports,
(3) dying declaration [SN-16] and (4) dying
deposition [SN-17].
MEDICAL CERTIFICATES
wwww
They are the simplest form of documentary evi-
ence, issued by a registered medical practitioner
(RMP) at the request of the patient.
Examples: sickness certificate, fitness certificate,
disability certificate, unsoundness of mind certifi-
cate, age certificate, death certificate.
 accepted in the court of law as a piece of evi-
accepted
It is the RMP who has issucd it may be
dence Even
summoncd to the court of law to
l testify the con-
certificate on oath; it needed, cross-exami-
entsof done. So, RMP must take due care
nation can be certificates.
and skill in issuing such
signing false certificates: This is pun-
Issuing or S.193, IPC and the ctor can be
ishable under
atwarded 7 ycars of imprisonment
and fine. The
atient using
such ertificates will also be pun-
ished under S.198, 1PC with
similar punishment.
(DC)
Death Certificate
,According to Registration of Birth and
Death
all births and deaths are to be registered
Act, 1969,
throughout India.
must inspect the body
Before issuing DC, a doctor
and satisfy himself that the
person is dead.
the patient during his last
Ifa doctor has attended
illness, he must issue DC without charging any
fee [S.10(3), RBD Act, 1969]. The Brodrick Com-
mittee says that a doctor should not be allowed to
issue a DC unless he has attended the deceased at
least once during the 7 days preceding death. If the
doctor refuses to issue a DC even if the aforemen-
tioned conditions are satistied, he will be charged
Rs 50 [S.23(3), RBD Act].
A doctor cannot refuse or delay issue of DC. But
ome situations, such as the following, he must
refuse to issue DC and inform police: (1) when he is
not sure about the cause of death, (2) there is suspi-
cion of foul play, that is, doubtful cases, (3) death by
Violent and unnatural cause, drugs, poisoning, etc.
Relative of deceased may plead, persuade, pres-
Surise, offer a price and at times even threaten the
doctor to issue a false certificate.
WHO ([nternational) format of DC is in two parts.
Part I: There are three subsections for the
Sequence of events leading to death.
(a). Immediate cause of death: The disease
or condition directly leading to death.
It should not be the mode of death. 'Car
diopulmonary arrest or cardiorespira-
ory arrest or "cardiac arrest or caraiac
Talure or heart failure' or asphyxia are
Commonly seen written in death certifi-
cates as immediate cause of death, which
1S wrong.
These terms are actually the
modes of death. It is well known to all
medical practitioners that every one dies
of cardiopulmonary arrest or cardiac
failure.
It should be a discase, injury or complica-
tion, which caused death.
I(b). Antecedent cause (or intermediate
cause of death): The morbid condition
that caused the immediate cause of death.
I(c). Antecedent cause (or underlying cause
of death): The basic pathological condi-
tion present before the aforementioned
two causes [i.e. I(a) and I(b)] and lead-
ing to the aforementioned two causes. So,
I(a) must be caused due to I(b), and I(a)
and/or I(b) must be caused due to I(c).
Underlying cause of death is the disease,
which initiated the train of morbid events
leading directly to death.
Features of part I: If the sequence of events
in part I comprised more than three stages,
extra lines may be added in part I. Most
recent condition has to be written in the
top line and the earliest (i.e. the condition
that started the sequence of events between
normal health and death) in the last.
Part II: Contributory cause: The condition,
which contributes to death but not directly
related to the disease or condition causingit.
Conditions in part I should represent a distinct
sequence so that each condition may be regarded as
being the consequence of the condition entered imme
diately below it. Where a condition does not seem to fit
into such a sequence, it may belong to part II.
Examples:
A patient dies from myocardial infarction (MI)
due to coronary artery disease (CAD). Immediate
cause of death is MI; write it in part I(a). Anteced
ent cause of death is CAD; write it in part I(b).
2) A patient died from cerebral haemorrhage due to
hypertension. He had a history of diabetes. Inme-
diate cause of death is cerebral haemorrhage;
Write it in part l{a). Antecedent cause of death
Is
nypertension; write it in part 1(6). Contributory
cause of death is diabetes; write it in part l
days after
3) A man of 65 died of peritonitis a few
pertoration. e
noperation for duodenal duocdenal ulcerations.
had a history of chronic
death is peritonitis;
Here immediate cause of pertora
is duodenal
antecedent cause of death is chronic
contributory cause of death
tion and
duodenal ulceration.
10 SECTIONI Forensic Medicine
MEDICOLEGAL CASE AND
MEDICOLEGAL CASE REPORT
Medicolegal case (MLC): If an attending doctor
(in
casualty or OPD) after taking history and examining the
patient suspects foul play or has doubts about
the case
and/or thinks that some investigations by law enforcing
agencies are essential so as to fix responsibility regard-
ing the case, the case is regarded as medicolegal case.
It
is left to the doctor's judgment to label the case as
MLC
whether patient agrees or not. Sometimes, the patient
or relative may request or conmpel a doctor not to make
MLCbut the doctor has to be firm with his own decision.
Medicolegal case report (MLR): This includes the
legal documents prepared by a doctor at the request
of some investigating authority, for example, police,
magistrate. It is made on both living and dead patients.
Examples are (1) injury report, postmortem report,
vaginal swab report in case of sexual offences, etc.
Who can make MLC ?: A government as well as a pri-
vate practitioner can make MLC. It is very common
for private hospitals and private practitioners to avoid
MLC cases; they generally refer doubtful cases to gov-
ernment hospitals. If condition of such a patient is
serious and he dies on the way to hospital, the private
practitioner as well as the private hospital can be sued
under S.304A.
Following cases are labelled as MLC and the police
must be informed: (1) injury cases, (2) poisoning,
(3) burns, (4) sexual assault, (5) brought dead cases,
(6) brought unconscious, (7) road traffic accidents
(RTA), (8) fall from height, (9) factory accidents, (10)
death in OT during MTP, criminal abortion, delivery
or other surgical procedures, (11) suspected homicide
or suicide.
Precautions while preparing MLC
1) Consent for examination: If a patient is not
arrested, consent is required.
For the purpose of medicolegal examination,
consent can be given by any person of sound
mind and >12 years of age. If the person is
unconscious or insane or <12 years, the con-
sent can be obtained from the guardian.
Signature or left thumb impression (if illiterate) of
patient as well as witness must be taken. Witness
may be the police officer who brought the patient.
The purpose and outcome of such examination
should be explained to the victim before taking
the consent.
If the patient is not arrested, then for the exami-
nation, his or his relative's consent has to be
taken. If patient refuses, then under S.53, CrPC,
the medicolegal examination of accused can
be done at the request of police [not below the
rank of subinspector (SI)J by using reasonably
necessary force.
2) Labelling the case as MLC: It is left to the doctor's
judgment to label the case as MLC, whether patient
agrees or not. The patient or relatives may compel a
doctor not to make MLC but the doctor has to make
his own decision. If doctor delays in labellinga case
as MLC, it can be so labelled at any later date and
time. Consent of the patient/relative is not required
for labelling a case as MLC. Doctor has to decide.
3) Information to police: When there is a doubt
about a case, it is better to inform police. Police
must be informed as early as possible.
If a doctor in casualty does not inform police in
an MLC, he may be punished with month of
1
imprisonment or fine of Rs 500 or both [S.176,
IPC].
If adoctor furnishes information to police
which he knows or believes to be false, he shal
be punished with 6 months of imprisonment or
fine of Rs 1000 or both [S.177, IPC).
4) MLC reports must be made in triplicate and all
copies must be marked 'MLC. Original copy is
handed over to police and his signature must be
taken on an other copy, that is, the doctor's copy.
Doctor's copy is retained in medicolegal register.
The third copy may be given to the patient.
5) Investigation reports (e.g. X-rays/CT requisition
slip, laboratory report slips and so on) must be
marked 'MLC' and then handed over to the police.
They should never be given to patient.
6) MLC has to be attended round the clock without
delay. If delay has occurred initially in labelling a
case as MLC, it can be labelled as MLC at any later
date and time, but not after death of a patient.
What is more important, treatment or completion
of injury report?
It depends on seriousness of a patient. Injury
report can be completed after the enmergency treat-
ment. If the condition of the patient is very serious,
arrangement should be made for dying declaration. If
death occurs during treatment, the police should be
immediately informed and the body handed over only
to police, not relatives.
 CHAPTER 2 Legal Proced

If a case has been labelled as MLC PUNISHMENTS AUTHORISED BY THE

econd MLC: hospital (e.g. H1) but is referred
doctor in one. LAW [S.53, IPC]
byaanothecr hospital (e.g. H2) for proper treat-
to
a resh (i.e. second). MLC report can be made S.53 of IPC mentions five types of punishments:
ment, (1) Death sentence (also known as capital punish-
doctor in H2 at his discretion. The reason is
by the H1 may be MBBS and the findings ment)
doct
that the been explain properly but the doctor (2) Imprisonment for life-Life imprisonment
maynot have (i.e. MD) in forensic medicine means imprisonment for whole of the remain-
H2 may bean expert
in can interpret injuries in a better way. Addition- ing period of a person's natural life i.e. till the last
who
doctor from H2 is summoned in court, he breath of his life i.e. till death.
alls when findings. (3) Imprisonment
has to go
by his own
where a doctor has to wait to give opinion: (1) (i) Simple
Case
If the nature
of injury (simple, dangerous or grievous) (i) Rigorous
immediately apparent, the patient must be kept (4) Forfeiture of property
is not
investigation (e.g. X-ray (5) Fine
under observation. (2) If the
CTor blood) have been
sent and it will take a long time
for these to collect, the doctor
must wait to give opinion. EXHUMATION [SN-18]
Opinion: Opinion must be kept pending
till the
reports are available in cases where
necessary inves-
tigations are required. Negative results should
also be CONDUCT OF DOCTOR IN THE COURT
pointed out in the report.
Subsequent opinion: After observation period is over (1) After receiving summons, the doctor must
and all reports have been collected, the subsequent attend court. He should be punctual, carry all rel-
opinion is given based on the new findings. evant documents and be well prepared about the
MLC reports are produced in the court of law and case. (2) He must be well dressed. (3)) He should
if summoned, the doctor should attend the court. neither be nervous inside court nor lose his temper.
If thedoctor is not available, someone can attend He should remain calm, polite and courteous. (4)
He should address the judge as 'sir' or
your hon-
the court to testify his signature and handwriting as
our. (5) He should not be overconfident. If he does
evidence.
not know the answer, he can simply say 'Sir, don't
I
In poisoning case: Gastric lavage, vomitus, urine or
blood must always be preserved in a case of poison-
know. (6) He should listen and understand the
ing and these samples handed over to the concerned question, then answer. If not clear, he should ask for
police official. If a doctor fails to preserve these, he may the question to be repeated again. He should answer
be sued under S.201 of IPC for causing disappearance only what is asked. (7) He should speak audibly, and
of evidence with the intention to screen the offender
avoid technical terms. (8) He should not try to mem-
Trom legal punishment. The doctor may be punished orise any fact. The law allows the doctor to refresh
according to three situations. If the offence which he his memory from the records and he can consult any
Knows or believes to have been committed is as follows. book to check any point [S.159, IEA]. (9) He should
Punishable with 'death: The doctor will be pun- not leave the court without permission. He should
fine. always greet the judge before leaving the court.
Snea with imprisonment for 7 years and
Example in case of murder.
Funishable with imprisonment for life or>10 years: IMPORTANT QUESTIONS FOR
he doctor will be punished with 3 years of impris EXAMINATION
onment and fine.
Shable with imprisonment for <10 years: The SHORT NOTES (SN)
doctor will be punished with imprisonment for
1. Powers of various criminal courts
/4th of the longest term of imprisonment pro- 2. Inquest [CCU 2005, 2012]
Ided for the offence, or fine, or both. Example in
case of suicide. 3. Magistrate inquest
 Powers of Session Court
4. Coroner's inquest 1) Session Judge or
Additional Session Judge
5. Medical examiner's system pass any sentence authorisedibylaw,but can
Summons/Subpoena the'i
6. sentence' must be confirmed by High Court.
7. Conduct money 2) Assistant Session Judge may pass sentence
17]
8. Witness [DU 2005, CCU 2016, imprisonment for only <10 years. of
9. Expert witness [CCU 2003, 2010]
Powers of Magistrate Court (Table 2.4): Kecutive
10. Hostile witness [DU 2008] |CCU 2012]
magistrates are not authorised to leliver judgnm
11. Perjury (DU 2009, 2011) [CCU 2012] nent
because their duties are of executiv nature. They
12. Oath
Examination-in-clhief (direct examination) do not give any punishment.
13.
14. Cross-cxamination
15. Leading question [DU 2007] [CCU 2005, 2009] TABLE 2.4 Powers of Judicial
16. Dying declaration Magistrate [S.29, CrPC]
17. Dying deposition [CCU 2010]
Magistrate Imprisonment Fine
18. Exhumation [CCU 2003, 2004, 2009, 2010]
Chief Judicial Magistrate (CJM) 7 years Unlimited
DIFFERENCE BETWEEN (D/W) Judicial Magistrate of 3 years 10,000
first-class
inquest and magistrate inquest [DU 2011]
19. Police
Judicial Magistrate of 1
year 5,000
20. Coroner's Court and Magistrate Court second-class
21. Common witness and expert witness
22. Examination-in-chief and cross-examination
DU 2003, 2009] [CCU 2012] SN-2: Inquest
23. Oral evidence and documentary evidence
24. Dying declaration and dying deposition [CCU Inquest: It is an inquiry or investigation by legal
2003, 2004, 2012] authorities into the cause of death in cases of sudden,
unnatural and suspicious deaths. Types of inquest are

L ANSWERS as follows:
1) Police inquest
SN-1: Powers of various criminal 2) Magistrate inquest [SN-3]
3) Coroner's inquest [SN-4]
Courts
4) Medical examiner system [SN-5]
Powers of Supreme Court
1) The law declared by it is binding
on all courts Police Inquest [S.174, CrPC]
(Article 134, COI).
It is the most
common type of inquest in India.
2) It can try both civil as well as criminal
cases. Itis done in the following cases: (1) death due to 'sui-
3) It can pass any sentence including death
sentence. cide' or 'accident, (2) death in 'suspicious
4) It usually considers appeal from
lower courts.
circum-
stances, (3) killing by man
The parties dissatisfied with the or animal or machinery.
decisions Who conducts police inquest? An officer-in-charge
in High Courts may go for an appeal
in the (usually a police officer not below the
Supreme Court. rank of SI) of
Powers of High Court the police station in whose jurisdiction
the death has
1) It can try both civil as well occurred conducts the police inquest.
as criminal cases.
2) It can pass any sentence
authorised by law
What does officer-in-charge do on receipt Or
including death sentence. information? The officer-in-charge immedi-
3) It usually considers appeal ately informs the nearest executive
from lower magistrate
The parties dissatisfied with the decision courts. and then proceeds to the place
where the body
of Ses of such deceased person
sion Courts can appeal in the High Court, is. This police officer
4) Session Judge or Additional Session Judge who reaches the spot is
can now called investigat
pass any sentence authorised by law, but the 'death ing officer (10) who then
starts an inquiry into
sentence' must be confirmed by High Court. the cause of death. This
investigation or inquiry
by the police into
the cause of death is called
 9a OCtuits

It is done in the presence of two

police hauest. The proceedings of the magistrate are not judicial
respectable neighbours called panchas. procecdings; these proceeclings only try to find out
orm IO do?
does
,Whatinspects the cause of death.
the injurie present on the dead body After inqucst, the body is sent for postmortem
1) IO these injuries on paper with suitable
writes cxamination. The inquest papers must be handed
and mention the type of weapon
diagrams. He also Over to the autopsy surgeon for information. Dur-
responsible for these injuries and the anner of ing the investigation, the magistrate shall inform
dath (suicidal, accidental or homicidal). the relatives of the deceased and also allow them to
also writes the brief facts, views and infor- stay during investigation.
2) 1O papers.
mation from panchas on
arranges all these papers to prepare an SN-4: Coroner's inquest
3) Then he
inguest report (also known as panchnama').
panchnama is then signed by 1O himself Coroner's inquest: It is the inquiry into the cause
Thispanchas. of death conducted by coroner.
and
IO forwards this inquest report History:
5) Then,
(panchnama) to the magistrate. This type of inquest was followed earlier in Ko
kata and Mumbai. It was abolished in Kolkata
What does IO.do if any foul play or unnatural
in 1978 and in Mumbai in 1999. It no longer
death is suspected? IO torwards the body for post-
exists in India.
mortem examination (1.e. autopsy) to the near-
papers of Historically, the coroner (Latin, corona means
est government hospital along with the
crown' or 'king) was an officer appointed by
inquest report (panchnama). He then writes an
application requesting postmortem examination
the king to look into the cause of death.
At present, it is followed in countries such as
and attaches this application with the inquest
United Kingdom, United States, Canada and Aus-
papers. Finally, he presents these inquest papers
tralia.
along with application to the autopsy surgeon for
It is similar to magistrate inquest in quality.
conducting the postmortem examination.
Who is a coroner? He is an officer (a lawyer or a
lfpostmortem report confirms the unnatural cause doctor, or both) of the rank of first-class Judicial
of death, then further enquiry and trial of the case
is conducted by magistrate concerned, to whom
Magistrate, appointed by State Government.
the entire records of the case are transferred by 10.
The Coroner's Court is only a court of'inquiry, not
a court for'trial. It means the coroner is authorised
Magistrate Inquest [SN-3] only to conduct inquest; he is not authorised to
conduct trial. So, obviously he is not authorised to
Coroner's Inquest [SN-4J pass judgment on the case and thus has no power
Medical to pass a sentence.
Examiner's System [SN-5
After conducting inquest, if coroner finds ample
evidence against some suspect, he sends the culprit
SN-3:
Magistrate inquest to the judicial magistrate for trial.
If no culprit is identifiable, the coroner returns an
Magistrate inquest (S.176, CrPC]: The inquiry open verdict (i.e. no concliusion).
Ao the cause of death conducted by magistrate.
may be conducted by executive magistrate or SN-5: Medical examiner system
judicial magistrate.
into the
Indications: [Mnemonic. 3Ds Medical examiner system: It is an inquiry
examiner.
Dowry deaths (S.304B, IPC| use or death conducted by medical
Canada and Japan.
2) Death
occurring (1) in prison, jail or police cus- It exists in the United States, United
was first introduced in Massachusetts,
todys (2)
during police firing. (3) during police It
States in 1877.
Erogation/investigation, (4) in reformatories, legally and medically qual-
OTstal school or psychiatric hosplta Medical examiner is a
forensic pathologist.
He
3) especially a
igging out an already buried dead body from ifed expert,
grave lawfully, that is, 'exhumation performs two functions:
 SECTIONI Forensic Medicine
hand the court unless there are valid
valid and
and urgent
crime to get first attending.
1) He visits the scene of circumstances of
for not reas0ns

information regarding the 1) If the witness fails to attend

the cour
death.
conducts postmortem examination
(i.e. valid reason (e.g. ilness), he must
message to the court. A new date
e ey
2) He
after visiting crime
scene. ot hearingthe
autopsy) on dead bodies be issued to him. wi
district attorney for
submits his report to the 2) If the witness fails to attend the court
He further action. any valid reason, then
cour without
system. As a legally and
medi-
It is the best inquest scene of crime himself in civil cases, the court can issuewarrant
cally qualifed expert' visits the his arrest or he may be imposed a fine, of
and then conducts the
postmortem cxamination, he and
findings with the post- in criminal cases, the court can issue a
can correlate the crime scene noti
is no loss to him and asks the reason for nonattendan
mortem findings in a better way and there
is If there was no proper reason for not
of information. Hence, medical examiner system attend.
ing the court, he may De imposed a fine;
the best system and superior to that of other types ora
bailable/nonbailable warrant may be issued
of inquests in which nonmedical personnel (police,
magistrate or coroner) conduct an inquest. In other to procure his attendance in the court.
systems, inquest (including crime scene visit) is done If a witness receives tw0 summonses on the same
by a nonmedical person and the autopsy is done by date from the same type of court, he must attend
a medical professional, so a chain correlating crime the court from which he received the summons
scene findings with autopsy findings breaks and first and should inform the other court.
there are chances to loss information. If a witness receives two summonses on the same
The medical examiner does not have any judicial ate, one from criminal court and the other from
function. civil court, then he must attend the criminal court
first with intimation to the civil court as criminal
SN-6: Summons (or subpoena) courts have priority over civil courts. Similarly, the
higher court has priority over lower court.
Summons: It is a written document issued by the Conduct money [SN-7]: It is a certain amount of
court, compelling the attendance of the witness in money paid to the witness towards his expenses for
the court of law, to depose evidence, attending the court in civil case.
at a particular
date and time and purpose
under penalty. (Singu-
lar is'summons' and plural is
'summonses.)
It is also known as 'subpoena' (Latin, SN-7: Conduct money
poena = penalty). Types: sub = under
(1) subpoena ad testifi-
candum (to testify under It certain amount of money paid to the wit
is a
summoned to give his penalty)--a witness is
evidence. (2) subpoena ness to meet his travelling expenses (from his
tecum (bring with you duces residence to the court and back from the cour
under penalty)--a
is asked to produce
and submit a document. witness for attending the court. It is paid when a witnes
It is issued by the court in attends'civil court.
magistrate and bears duplicate, signed
the seal of the by the In a civil case, the conduct money is paid by tne
It is delivered to the witness court.
cer or an officer from through a police party who calls hinm. Conduct money 1s usu ly
the court or by offi
son specifically authorised any other
per- pad to the witness while serving the summons, Du
On getting the sümmons,for the purpose. at times, the money is paid in the court itsel
carbon copy of summons, the witness signs
relurns it to the If conduct money is insufficient: Even if the witness
not
son who provided the ninks that the amount paid is insufficient n
court) and keeps the
it (1.e, it 18
returned back per- according to the probable status and expenses
original copy. to the
After geting
the summons, then he should not ignore the mons; he shou
appear before the the witness attend the court, he can
time with proper
court on the specified must and before giving evidence,
records, A Witness date and inform the magistrate
must attend been paid that the conduct mone
to him by the party is insufficient. The mag
wOuld decide about the right quantum ot mo ney

conductt money is paid: Witness can ignore
Ifno summons if no conduct money is paid but the
the attend the court in the interest of the
witness must
justice Ifwitness does not attend the ourt,
stateor
charged for contempt of court.
can be
iminalcase: No conduct money is paid at the
summons, but after attending and giving
time f govern
rnment usually pays TA and
evidence, the
the courts [S.312, CrPC]. According
DA to
attend.such
CrPC, any crinminal court, if it thinks
S ofpayment ofreasonable expenses of any
foS.312
fAt, orders
mplainant or witness:attending the court for the
purpose of any inquiry trial or other proceeding.
a government servant, some courts
f a doctor iscertificate
only give a
mentioning that the doctor
had attended the court
and was paid nothing by
the court. On showing
this certihcate, the doctor
wOuld get reimbursement of his travelling and
other incidental expenses from
his institute. Pri-
vate institutes do not reimburse
this money, so
doctors working in a private hospital should
take
this money from the court before leaving the court.
SN-8:Witness
Witness: A witness is a person who provides evi-
dence about a fact in the court of law under oath.
After getting a summons from the court, the per-
son attends the court. He stands inside the witness
box, takes the oath and then gives evidence.
According to S.118, IEA, all persons are considered
competent to testify (i.e. to give evidence in tne
court of law) except when they do not understand
the question or do not give rational answers to the
question due to (1) tender years (e.g. a child of
1ature understanding), or (2) extreme old age
or (3) disease (mental/physical).
ypes of witnesses: Actually, the witnesses are of
WO types(e.g. common witness and expert wit
S but as both of these types of witnesses may
nOstile (i.e. unfavourable), hostile witness
nay be considered
as a third type of witness.
Common (ordinary) witness: A common per
SOn who has
actually seen or observed the facts
4a narrates those facts in the witness box 1s
4 Common
witness. He is not allowed to draw
Conclusions from
his observation.
Xample, Ram (a common man) saw a crim
nal stabbing someone else by a knife. The
CHAPTER 2 Legal Procedures
court asks him about the incidence and Ram
narrates the whole story in the court. The
court does not ask him his opinion or con-
clusion, so Ram is a common witness.
Pirst-hand knowledge rule' applies here, that
is, the common witness must demonstrate that
he actually observed the fact and was capable
of perceiving the facts by one of his senses.
2) Expert witness [SN-9]
3) Hostile witness [SN-10]
SN-9: Expert witness
Expert witness: A person who is skilled in a partic
ular field (e.g. law, science or art) and who provides
evidence about a fact in the court of law under
oath is known as expert witness.
S.45, IEA, deals with opinion of experts.
How does an expert witness help law?
1) Because of his professional training and experi
ence, an expert witness is capable of drawing a con-
clusion on the facts observed by him or by others.
2) He can give his expert opinion. He also gives
expert opinion on hypothetical questions as
well as on matters of common knowledge.
Who can be an expert witness? Doctor/medical
expert (e.g.general surgeon, autopsy surgeon and so
on), fingerprint expert, chemical examiner, hand-
writing expert or ballistic expert. He should give the
answer after understanding the question clearly.
Doctor as an expert witness: A doctor is an expert
witness to the court, not belonging to any party
even though one party has called him.
Paul Broussard (a French medicolegal expert,
1897) said If the law has made you a witness,
remain a man of science.
A doctor has to present his facts in the court
based on the science, which he has learnt in his
professional career.
as an expert
he conduct and duties of a doctor dressed
witness in the witness box: (1) be well
(2) be well prepared with al
doc-
andmodest, address the
uments and details of the case, (3) should be
(4) there
Judge as 'sir' or your honour, and testimonyy
nodiscrepancy between records (6)
anything and
memorise
(5) do not attempttto notlo5e temper.
and polite;do
De honest, pleasant forensic medi-
(i.e. MD in 1s usually
A forensic pathologist in mortuary
autopsy
Clne) who conducts
 SECTIONI Forensic Medicine
has to appear as an
summoned by the court and he
magistrate to give his opinion.
expert witness before
witness
SN-10: Hostile
makes
Hostile witness: A person wlho purposefully
statements contrary to the fact or las some interest
is known as hostilec
or motive for concealing truth
witness. In simple language, a person who knows the
truth but purposefiully does not tell the truth in the
court after taking oath is known as hostile witness.
Usually, these are witnesses who were completely
honest in the beginning but later on turn hostile.
Both the common as well as expert witness can be
hostile witness. The reason for turning hostile may
be bribery or threat.
Perjury [SN-11}: 'Wilfully giving false evidence
under oath or unable to tell what a witness knows
or believes to be the truth is known as perjury.
SN-11: Perjury
Perjury[S.191, IPC]: Wilfully giving false evidence
under oath is known as perjury. It means the wit-
ness knows the truth but does not tell the truth.
A witness has to take oath in the witness box before
giving evidence and it is compulsory. In oath, he
swears in the name of God that he will tell the truth
and only the truth in the court. So, he is legally
bound by an oath to state/speak the truth. Accord-
ing to S.191, IPC, *willfully giving false evidence
under oath or unable to tell what a witness knows
or believes to be the truh is known as perjury.
The term perjury has not been mentioned any-
where in Indian law. Indian law mentions the
terms
false evidence |S.191,IPC] which is synonymous
with the term perjury.
Motives behind perjury: The person intentionally
gives false evidence under oath due
to some rea-
sons, for example, (1) he might have taken
bribe,
or (2) he may be under threat, or (3) he may
biased towards one party due to personal be
relation.
Punishment for perjury [S.193,
IPC] is
P = 1, vars +E (i.e. imprisonment of up to 7
years
with fine).
SN-12: 0ath
[S.51, IPC) is a declaration required by
Oath the
law, which is compulsory for a witness before
he
gives evidence.
witness has to take an oath in the witnes
.
A
ess
before giving evidence and it is compulsory boy
By taking oath, the person becomes legallv
bound
to state/speak the truth«during the evidence
An oath holds the witnesS responsible for
Conse-
quences of his evidence.
Procedure:
While talking an oath, a Hindu usually
puts h
hands on Gita, a Muslim on Koran and a Chri
tian on Bible.
Declaration of oath |S.4 and 6, The Oaths Act
1969]: 'I swear in the name of God, that what
I shell tell, shall be truth, the whole truth
and
nothing but the truth.
Ifa witness is an atheist (1.e. he does not believe
in God), he has to solemnly affirm instead of
swearing in the name of God.
A child of <12 years of age is not required to take
an oath [S.4(1), The Oaths Act, 1969].
Punishment for refusal to take an oath: P = 6 months
or fine of Rs 1000 or both [S.178, IPC].
When a person gives false evidence under oath, it
is known as 'perjury [S.191, IPC). Its punishment
hasbeen given in S.193, IPC as P =I+E.
SN-13: Examination-in-chief
(direct examination)
According to S.138,IEA, the order of examination in
the courtoflaw is in the following sequence: Exanmi-
nation-in-Chief > Cross-examination Reex
amination
Examination-in-chief: After taking an oath, the
examination-in-chief is the first examination ofa
witness in the court of law. The witness is exam
ined by the lawyer of the party that has called him
to give evidence. In a criminal case, the PP first
examines the witness.
The main purpose of examination-in-chief is to
place all the facts known to the witness before the
court.
The doctor is summoned to the court as an exper
witness. He gives evidence from medical reports he
had submitted earlier. He is also testify that the
to
report submitted was prepared by
him and duly
signed by him. He is usually asked
questions such
as the following.
1) When he saw
the body.
2) Time of conduction
of postmortem examination.
3) Description
and/or duration of injuries.

4) Weapon of
offence.
5) Opinion regarding the
cause of death.
What should doctor do before giving evidence?
He should always
go through the previously pre-
nared report. He can even meet the PP and go
through the records.
,No leading questions' are allowed
[S. 142, 11EA] in
examination-in-chict except under two conditions.
1)If the court permits to ask leading question
during examination-in-chief, or
2) when the witness is declared 'hostile' by the
court.
SN-14: GrosS-examination
According to S.138, IEA, the order of examination
in the court of lawthe following sequence:
is in
Examination-in-chief> Cross examination
Reexamination
After examination-in-chiet, the crosS-examination
is the next procedure. The lawyer of the opposite
party, that is defence lawyer examines the witness.
Main objectives of cross-examination:
1) to elicit facts favourable to the cross-examining
party
2) to test the accuracy of the facts told by witness,
3) to find out the weak points in the case, and
4) to discredit the witness and prove that the
report given is not correct and is a biased one.
In cross-examination, the defence lawyer will try
to weaken the evidence given by the witness in
the examination-in-chief. He will elicit points
favourable to the defence side and for this, he
will try to establish that the evidence given by the
witness was conflicting and contradictory. So, the
witness must be very careful in answering ques-
tions during cross-examination.
Leading questions are allowed in cross-examina-
tion [SN-15].
SN-15: Leading
question
Leading question [S.141, IEA]: Any question sug-
gesting the answer, which the person putting it
wIshes or expects to receive. In simple language,
t is a question, which suggests the answer by itselt,
unat 15, the answer lies implied
in the question itsel.
he answer is expected as simply either 'yes' or'no.
Leading questions are asked during 'cross-exami-
nation' (S.143, IEA].
CHAPTER 2 Legal Procedures
Examples: Leading question for an expert witness
(c.g. doctor) may be as follows.
Q.1: Did you carry out postmortem examina-
tion?
Q.2: Did you find a 4 cm laceration on the fore-
head?
Q.3: Was the length of knife 10 cm?
They are not allowed in examination-in-chief
and reexamination [S.143, IEAJ. In 'chief exami-
nation, the leading questions may be asked uncler
two conditions:
1) if the court permits to ask leading question,
or
2) when the witness is declared 'hostile' by the
court.
Why are leading questions asked? To test the
truthfulness, skill and character of the witness.
So, witness must be very careful in answering the
questions.
SN-16: Dying declaration
Dying declaration [S.32(1), IEA] is a written or
verbal statement of a person who is dying as a
result of some unlawful act. If he dies, the docu-
ment containing the statement is produced in the
court as a dying declaration.
It is followed in India, that is, dying declaration is
legally accepted in the courts of law in India.
It is a type of hearsay evidence.
Dying declaration is considered legally relevant
because it is commonly believed that a dying per-
son always speaks the truth.
Who can record dying declaration? If possible,
it should be written by the dying person himself
and then signed by him. If impossible, it can be
recorded by the following.
1) Executive magistrate: The dying declaration
recorded by executive magistrate is preferred
and has more importance as compared to that
recorded by doctor or police officer or any other
person.
2) Other persons, for example, doctor, police ofn-
cer or even any lay person (like Panchayat head
declaration but
or relative) can record dying
It should be in
s evidential value will be less. should sign the
presence of two witnesses who
dying declaration.
of doctor:
Role
1) Stabilise the patient.
 SECTIONT
and then the police wil
2) Inform the police
inform the arca executive
magistrate to record
dying declaration.
if the life of patient
3) Write the dying declaration
delay in the arrival
is in danger or there is much
of magistrate.
state-
4) Compos mentis: Before recording the
ment, the doctor first has to certify that patient
is in perfect mental condition (i.e. compos men-
tis) to make a declaration. The doctor should be
there throughout the declaration to check the
mental condition of the patient.
5) Signature Magistrate signs the written declara-
tion on the paper and then the doctor signs. The
Signature by' the doctor signifies that the patient
was in a sound state of mind and was well ori-
ented in time, space and person while the state-
ment was being recorded.
Procedure:
If posible, it should be written by the dying
person himself and then signed by him. If not
possible, it should preferably be video recorded.
Record word to word: Dying declaration should
be recorded in declarant's own words without
any alteration of terms or phrases. If he is unable
to speak, the signs and gestures are recorded.
No oath and no leading question: The oath is not
administered while recording dying declaration
because of the belief that dying person tells the
truth. Léading questions should not be put.
Reading out and signature. If the statement is
written by declarant himself, it should be signed
by him with date and time. If the
recorded by any other person, it
statement is
should be read
out to the declarant and if he agrees, his
or thumb impressions are taken. It is also
signature
signed
by the magistrate, the doctor
and the witness.
Send declaration to magistrate:
When the dec-
laration is recorded by a person
other than the
magistrate, the declaration is
sent to the mag-
istrate in a sealed cover, The person
the declaration will have to give recording
evidence in the
court to prove it.
.FIR lodged by dying person to police is valid
declaration. dying
The person recording dying declaration should
be
present in the court to certify the fact.
Dying declaration is not admissible under two
conditions:
1) Ifthe person survives after makino.
laration, the dying declarat dying
de
Then he is called to the court
dence. The oral evidence givento give c
by this
by attending the court has
more impoperson
as compared to the dying declaration
carlier. The dying declaration record
recorded
acts as corroborative evidence. earle
If the dying person is not in a
soundstate
mind as certified by the doctor.
In Western countries, the concept of dying
depo
sition |SN-17] is followed.
Difference between dying declaration
and dying
deposition [D/W-24].
SN-17: Dying deposition
Dying deposition: It is a statement of a person
on oath, who is dying as a result of some unla
ful act; it is recorded by magistrate in presence of
accused or his lawyer.
It is followed in Western countries, for example
United States, where there is a provision for the
court to be brought to the dying person, that is a
magistrate comes to the bedside. Here in addition
to the magistrate, accused and his lawyer are alsa
present. Rest of the procedure is exactly the same s
in the court. This is called dying deposition; anda
it is a full-fledged court procedure at the bedside, t
is also known as 'court by the bedside.
In India, the procedure of dying declaration (n0t
dying deposition) is followed in which the stale
some
ment of a person, who is dying as a result of
unlawful act, is recorded [either written or veru
(oral)]. If he dies, the statement is produced in u
court as a dying declaration).
The oath is administered and then
magiStrde
records the evidence.
Unlike dying declaration, which is followed
in Inus
dying deposition is recorded always by a magistrvictim
The lawyer is allowed to eross- S-examine the
and so leading questions are also allowed. retains
t the victim survives, the dying deposition the
its value. If we compare both the statements,with
dying deposition has more value compared
the dying declaration.
Dying deposition is not followed in Inda. and dying
ilference between dying declaration and
deposition [D/W-24].
 CHAPTER 2 Legal Procedures

SN-18: Exhumation E. Identify the spot of buriat: The spot of burial

has to be identified with the help of relatives and
Exhumation S.176{3), CrPC): It is the lawful other persons related with the disposal. Besides,
digging out of an already buried body from the the location of the grave from some fixed objects
grave. (Latin ex= Out ot, humus= ground). such as road, tree, etc. is to be noted.
Scenario in world: In India, the bodics are mainly E. Photography and sketching. Photographs are
disposed of by cremation (i.e. burning), so exhu- taken from very beginning of the procedure till
mation is rarcly done in India. In Western coun cnd. Sketches may be drawn aboutthe position
tries, dead bodies are buried for disposal, so of coffin and body.
exhumation is more common. Digging out of body: (1) Removal of earth in lay-
Purposes: ers, (2) lifting out of bodycarefully to avoid artifacts,
identification (3) identification of body by relatives, (4) noting
2) For second autopsy when the first autopsy report the condition of soil and water, (5) collection of
is doubtful or has not been done properly. soil-about % kg of soil should be collected from
3) When the body has been disposed off without above, lateral sides and below the body for chemical
any autopsy and then after disposal, foul play is analysis in suspected poisoning. The soil from the
Suspected. control site should also be colleçted.
4) To determine cause of death, time since death, Autopsy: If the jintermenthas Been recent, autopsy
manner of death and to establish identity. should be conducted either in the open near thee
Prerequisites: graveyard but screened off from the public, or at
Writfen order of a first class magistrate. the mortuary. Injuries must be noted and inter-
B. Supervision of magistrate: The digging out of preted correctly.
buried dead body has to be done under thesuper- Preservation of viscera in suspected poisoning:
vision of magistrate. The police officer and med- If nothing found, then hair, soil, teeth and bones
is
ical officer also have to be at the spot, should be preserved. About % kg of soil should also
C. Early in the morning: Procedure of exhuma- be collected from the top, sides, bottom of the body
tion should be started early in the morning to and kept in dry clean bottles for toxicological analysis.
avoid publicexposure Time limit: Though there is no time limit for exhu-
D. Screening of the area: The area should be mation in India, the period is restricted to 10 years
screened off from the public. inFrance and 30 years in Germany.
DW-19: Police inquest and magistrate inquest (Table 2.5)
TABLE 2.5 Difference Between Police Inquest and Magistrate Inquest
Sr. No. Features Police Inquest [S.174, CrPC Magistrate Inquest [S.176, CrPC]
Conducted t is done in those cases where a person the following cases:
It is done in
in cases has committed suicide, or 1. Dowry death
2. has been killed by another man/animal 2. Death during police firing or poliço cdstody
machinery, or or prison or interrogation
3. has been killed in an accident,or 3. Death in reformatories, borstal sckod,
4. has died in suspicious circumstances. psychiatrjc hospital
4. Exhumation
Investigating officer Palice officer above the rank of head DM/SDM
constable (HC), that is, SI
Warrant Can not issue Can issuJe
Fine/Punishment Can not impose Can impose
Exhumation Can not allow Can allow
Value Inferior Superior
 SECTIONI Forensic Medicine

D/W-20: Coroner's court and magistrate court (Table 2.6)

Difference Between Coroner's Court andMagistrate
Court
TABLE 2.6
Magistrate Court
St. No. Coroner's Court
Presided by magistrate
1 Presided by coroner
It is a 'court of trial'
It is a 'court of inquiry
deaths Magistrate enquires dowry deaths, exhumation, deaths in
3. Coroner enquires into sudden, suspicious, unnatural
police firing/prison/custody
within his jurisdiction
Accused should be present during trial
Accused need not be present during trial
Magistrate can impose fine and give punishment
. Coroner has no power to impose fine or give
punishment
5.
Coroner can punish a person for contempt, committed
if Magistrate can punish whether the offence is committed
within the premises of his court within or outside the premises of court

D/W-21: Common witness and expert witness (Table 2.7)

TABLE 2.7 Difference Between Common Witness and Expert Witness
St. No. Common Witness Expert Witness
Legally defined in S.118, IEA Legally defined in S.45, IEA

2. A common person who has actually seen or observed An expert witness is a person who is skilled in a particular
perceived the facts and narrates those facts in the field (e.g. law, science or art) and he is capable of drawing
witness box is a common witness a conclusion on the facts observed by him or by others

He is not allowed to draw conclusion from his observation He can

He can not express opinion on the observations made by He can
others
Responsibility is less High
5

DW-22: Examination-in-chief and cross-examination (Table 2.8)

TABLE 2.8 Difference Between Examination-in-Chief and Cross-Examination

Sr. No. Examination-in-Chief Cross-Examination
In the order of sequence described in S.138, IEA, it is the 1. In the order described in S.138, IEA, it is the second
first examination ofa witness in the court of law examination of a witness in the court of law; it
means the examination-in-chief is followed by cross
examination
The witness is examined by the lawyer of the party that 2. Here the lawyer of the opposite party, that, is the
has called him lawyer of the accused (defence lawyer) examines the
witness
3 Leading questions must not be asked in chief 3. Leading questions' are asked in cross-examination
examination; however, they can be asked in IS.143, IEAI
chief-examination only
a) if the court permits, or
b) when the court suspects that the witness is a
hostlle
witness
 CHAPTER 2 Legal Procedures 21

Dw-23: Oral evidence and documentary evidence (Table 2.9)

TABLE 2.9 Difference Between Oral Evidence and Documentary Evidence
Oral Evidence Documentary Evidence
St. No.
Alloral/verbal statements under oath made before All documents including electronic records produced for the
the court inspection of the court

Types of oral evidence: Direct, indirect and hearsay Verities of docurnentary evidence: Medical certificate, death
evidencee certificate, medicolegal case (MLC) report, dying declaration,
dying deposition

More important because it permits cross Less impor tant

examination

D/W-24: Dying declaration and dying deposition (Table 2.10)

TABLE 2.10 Difference Between Dying Declaration and Dying Depositíon
Dying Declaration Dying Deposition
St. No.
Followed in India Followed in Western countries, for example United States
It ismerely the recording of a statement of a dying
It is a ful-fledged court procedure at the bedside, so aiso
person known as court by the bedside'

It can be recorded by a magistrate or doctor or Recorded always by a magistrate.

police officer or Panchayat head or relative
The accused and his lawyer need not be present The accused and his lawyer have to be present

Oath: Not administered Oath: Has to be administered

Cross-examination: Not allowed Allowed

Leading questions: Not allowed Allowed

Ifthe victim survives, it loses its value and is not f the victim survives, it retains its value
admissible in the court of law but it acts as
corroborative evidence
More value
Less value
 Medical Jurisprudence

Chapter 3A
Code of Medical Ethics, Medical Councils, Acts,
Medical Records and Professional Misconduct

INTRODUCTION Regulations 2002 (amended and then notified on

amananmanmoa
2009). The text of the code is actually prescribed
Medical jurisprudence (Latin juris = law; pru- in two parts: the declaration and the code proper.
dence = knowledge): It is the study of law in rela- Declaration of Helsinki (1964) prescribes ethical
tion to medical practice. principles for human experimentation.
Medical ethics: It means moral principles (code
of conducts) which should guide the members of
the medical profession in course of their practiceDUTIES OF A DOCTOR
of medicine and their dealings with patients and
other members of the profession. Medical eti- Duties and Responsibilities of Physician
quette means sense of courtesy and mutual respect in General
which should govern the conduct and relationship (1) He should be pure in character and modest and
among the members of the medical profession. pleasing in personality. He should be dedicated to
Hippocratic oath: It is earliest known code provide service to humanity and he should uphold
(4th-5th century BC), the modern version of the dignity and honour of his profession. (2) He
which is the Declaration of Geneva, 1948. should maintain good medical practice by contin-
International Code of Medical Ethics, 1949: uously improving his medical knowledge and skills.
World Medical Association (in 1949) adapted cer- (3) He should participate. in.continuing medical edu-
tain codes of medical ethics (solely based upon cation (CME) for at least 30 h every 5 years. (4) He
Declaration of Geneva), popularly known as Inter- should bea member of medical societies and should
national Code of Medical Ethics. attendtheir meetings.(5) He should maintain med-
Code of Medical Ethics las enumerated by Med- ical records for a period of 3 years fronm_ the date of
ical Council of India (MCI)] in India: It is a set commencement of treatment. He should maintain a
of regulations to maintain the professional con- register of medical certificates issued. (6) He should
duct and etiquette among the members of a sys- display his MCI/State Medical Council (SMC) reg
tem of medicine. It has eight chapters. In S.20A, istration number almost everywhere, for example,
Indian Medical Council Act, 1956, MCI brings in clinic, on prescriptions, money slips, certiicates
out regulations relating to the professional con
and so on. (7) He should use generic names of drugs,
duct, etiquette and ethics for registered medical
not brand names. (8) He should employ only qual
practitiopners (BMPs), but these regulations have
ified medical and paramedical personnels to attend
been now presented in Indian Medical Council
(Professional Conduct, Etiquette and Ethics) patients. (9) He should announce fees before starting
treatment.
22

Duties of Physicians to
Their Patients
exercis a reasonable degree of skill and
1) Duty to
knowledge. (2) Duty to tell about the prognosis of
to give legible prescription and
discase. (3) Duty
aboo the dosage and timing of
proper instruction
drugs. (4) Duty to warn the patient about side effects
to warn paticnt as well as closely
of drugs. (5) Duty
related people in case the paticnt is suffering from
infectious disease. (6) Protessional
secrecy [SN-1].
(7) Duty to immediately respond to any
emergency
(S) Therapeutic privilege lplease refer to Chapter
3B, SN-3].
Duties of Physician in Consultation
should be avoided. (2)
(1) Unnecesary consultation
Consultant should be punctual for consultation. (3)
a
Patient should be reterred to consultant with case
summary. (4) Fees and other charges should be dis-
played on the board of his room and in visiting room.
des-
(5) Prescription letter should contain name and
1gnation.
Duties of Physician Towards Professional
Coworkers
(1) Consultation fees should never be taken. It is
professional courtesy and a doctor should consider
it a pleasure and privilege to render service to all
fellow doctors and their family dependents. (2) An
RMP should never criticise his coworkers in front
of patient. (3) The doctor should always help his fel-
low coworkers, especially in professional matters. (4)
When a doctor requests his coworker to take over his
patients temporarily during his absence, the coworker
should agree only if he has the capacity to discharge
the additional responsibility.
Duties of Physician Towards State
(1) He should cooperate with_authorities in the
administration of sanitary or public health laws and
Tegulations. (2) During epidemic, (a) a doctor should
not.abandon his duty for fear of contracting disease
himself, (b) a doctor is bound to bring every case of
mmunicable disease under his care_to the notice
Opublic health authority. (3) The police should be
med about medicolegal cases brought to him. (4)
births and deaths should be brought to the notice
of authorities.
(5) The physician should respond to
emergen
military service when required.(6) A med
ical
practitioner bound to treat or proVide medical
Is
CHAPTER 3 Medical Jurisprudence
aid to persons wounded or sick in the armed forces,
ship-wrecked persons, prisoners of war or civilians of
cnemy nationality without any discrimination based
On sex, race, religion or nationality. (7) Privileged
communication |SN-2].
RIGHTS AND PRIVILEGES OFA DOCTOR
(1) A doctor has right to choose his patient except
in emergency. A doctor can refuse a patient (a) if
patient is unable to pay doctor's fees and (b) if the
condition of the patient does not belong to the pro-
fessional specialisation of the doctor. The right to
choose patients does not apply in case of emergency.
The doctor must attend every patient in emergency
even if he is not able to pay fees. After the manage-
ment of the case, the doctor can demand fees from
the patient. It is the right of the doctor to recover fees
from his patient. If the patient denies paying doctor's
fees, the doctor can sue the patient in the civil court
for recovery of his fees. (2) He has the right to prac
tice medicine and prescribe medicines. (3) The doc-
tor has the right to possess or prescribe drugs listed
in the Dangerous Drug Act. (4) He has the right to
add professional titles to his name (i.e. doctor) and
qualifications after his name (e.g. MBBS, MD). (5)
The doctor has the right to give evidence as an expert
in the court. (6) He has the right to issue medical
certificates. (7) The doctor has the right for appoint
ment to any public or government hospital.
DUTIES, RIGHTS AND PRIVILEGES
OF PATIENTS
Duties of Patient
(1) He should furnish the doctor with complete infor
mation about the facts and circumstances of his il-
ness. (2) He should strictly follow the instructions ot
the doctor. (3) He should pay reasonable fees to the
doctor. (4) lt a patient wishes to take second constt
tion/opinion, he has to inform the first doctor.
Rights and Privileges of a Patient
facilities and emer
(1) Right to access to healthcare social or
regardless of age, sex, religion,
gCncy services his own doctor
status. (2) Right to choose from another
cOnomic opinion
Right to seek second during consultation
Cly.3) privacy
doctor. (4) Right to have complain and redressal of
treatnnent. (5) Right to
Or
 SECTIONT Forensic Medicine
with dignity, with
grievances. (6) Right to be treated
discrimination. (7) Right of
care and respect without about
confidentiality. (8) Right to get information
treatment, alternatives,
his diagnosis, investigation,
to refuse
complications and sIde ettects. (9) Right
treatment. (10) Right to
any diagnostic procedure or
access his medical records.
UNETHICAL ACTS
1. Advertising: (a) A physician should not use an
unusually large signboard. The contents of his
signboard should be title, name and qualification.
Signboard should not be affixed on a chenmist shop,
tree or in places where he does not reside or work.
(b) Prescription paper should contain title, name,
qualification, address, registration number and
telephone number. (c) Consultation fees should
be clearly exhibited in consulting room or waiting
room. (d) A physician should not publish in press
the reports of cases treated by him. (e) A physi-
cian can announce in press, his starting of prac-
tice, interruption or restarting after a long interval,
a change of his address, temporary absence from
duty and so on.
2. A physician may patent surgical instruments/med-
icines/procedures. But it shall be unethical if the
benefits of such patents/copyrights are not made
available in situations where the interests of large
population are involved.
3. Running an open shop for dispensing of drugs and
appliances by physicians is unethical.
4. Dichotomy (fee-splitting), that is the practice of
sharing (e.g. offering, giving or receiving) fees for
the referral of a patient with professional coworkers,
is also unethical.
5. All drugs prescribed should always carry a propri-
etary formula and clear name. Prescribing a secret
remedy of which he does not know the composi-
tion, the manutacture or promotion of their use is
unethical.
6. Physician should not aid or abet torture.
7. Practicing euthanasia is unethical.
8. Code of conduct for doctors and professional
association of doctors in their relationship with
pharmaceutical and allied health sector indus-
try: Doctors should not take any gifts or mone-"
tary grants or avail any facility or seek any type of
hospitality from any pharmaceutical companies. A
physician may carry out, participate in, or work in
rescarch projects funded by pharmaceutical
allied healthcare industries. Doctors must main
and
tain professional autonomy.
PROFESSIONAL MISCONDUCT
(INFAMOUS CONDUCT) [SN-3]
MEDICAL COUNCIL OF INDIA (MCIY
CI is the statutory body tor establishing and
maintaining uniform standards of medical edu-
cation and recognition of medical qualifications
It grants registration to medical practitioners and
monitors medical practice in India. It was estab-
lished in 1934 under Indian Medical Council Act
1933. In 1956, this Act was repealed and a new Act,
known as Indian Medical Council Act, 1956, was
enacted.
Functions of MCI include (1) maintenance of a
medical register, (2) formulation of medical uni-
form standard of medical education, (3) recog
nition of medical qualifications, (4) registration,
(5) warning notice, (6) appeal against disciplinary
action, (7) CME programmes and (8) formulation
of code of medical ethics.
NITI Aayog has recommended the replacement of
MCI (IMCAct, 1956) with National Medical Com-
mission (NMC), and thus National Medical Com
mission Bill, 2017, has been drafted.
Indian government dissolved MCI and replaced
it with seven-member Board of Governors
(BoG) by bringing an ordinance [Indian Medical
Council (Amendment) Ordinance 2018] dated
26 September 2018.
The BoG has been appointed initially for a period
of 1 year, and will be the sole decision-making
body till the NMC Bill, 2017-meant to replace the
MCl-is cleared in Parliament. A similar BoG was
also appointed in May 2010.
NATIONAL MEDICAL COMMISSION (NMC)
NMC shall consist of total5 persons: a chair
person, 1#ex officio members, 21 part-time mem
bers anedan-ex-efficio member secretary.
A person who is aggrieved by any decision of NM
may preter an appeal to the Central Government
against such decision within 30 days.

Powers and functions of NMC: (1) To lay dowvn
policies for (1) maintaininga high quality and high
standards in medical education, (ii) regulating
medical institutions, medical researches and med-
ical professionals; (2) to assess the requirements
in health care, for example, human resources,
infrastructure; (3) to nmake necessary regulations
for the proper functioning of the Commission,
the Autonomous Boards and the State Medical
Councils; (4) to ensure compliance by the State
Medical Councils; (5) to ensure observance of
professional ethics in medical profession.
Medical Advisory Council (MAC): It shall be the
primary platform through which the states and
union territories nmay put forward their concerns
before the NMC. MAC shall advise the NMC on
the measures to maintain the minimum standards
in medical education, training and research.
National Eigibiity-cum-Entrance Test and
Examination (NEETE): There shall be a uniform
NEET for admission to UG medical education in
all medical institutions There shall be a uniform
National Licentiate Examination (NLE) tor the
studentsgraduating from medical institutions for
granting hcense to practise medicine.
Only the person enrolled in the State Register or
the National Register shall be allowed to practise
medicine and shall be entitled to sign or authenti-
catea medical certificat¢. Any person who contra-
venes shall be punished with fine of Rs 1-5 lakhs.
Autonomous Boards
Autonomous boards, which have been constituted,
are (1) UG-MEB (Undergraduate Medical Education
Board), (2) PG-MEB (Postgraduate Medical Education
Board), (3) MARB (Medical Assessment and Rating
Board) and (4) EMRB (Ethics and Medical Registra-
tion Board). A person who is aggrieved by any decision
o an autonomous board may prefer an appeal to the
Commission against such decision within 60 days.
Functions of UG-MEB: (1) To grant recognition to
a medical
qualification at the UG level; (2) to deter
ne standards of medical education at the UG level
develop competency-based dynamic curricu-
at the UG.level and (ii) for primary medicine
Community medicine to ensure health care; (3)Juvenile Justice(Care and Protection
Irame guidelines
tutione for setting up of medical insti-
tutions for
mparting UG courses; (4) to determine
dards and norms for infrastructure, faculty and
CHAPTER 3 Medical Jurisprudence
quality of education in medical institutions; (5) to
facilitate development and training of faculty mem-
bers teaching UG courses; (6) to specify norms for
compulsory annual disclosures, electronically or
otherwise, by medical institutions, in respect to their
functions.
Functions of PG-MEB: Almost same functions as that
of UG-MEB, but these functions are at the PG and
super-speciality levels.
Functions of MARB: (1) To carry out inspections of
medical institutions for their assessment and rating
(2) to grant permission for the establishment of a
new medical institution; (3) to determine the pro-
cedure for assessing and rating medical institutions
for their compliance with the standards laid down
by the UG-MEB or PG-MEB; (4) to make available
on its website the assessment and ratings of medical
institutions at regular intervals; (5) to impose mon-
etary penalty against a medical institution for failure
to maintain the minimum standards specified by the
UG-MEB or PG-MEB.
Functions of EMRB: (1) To maintain a National Reg-
ister: It should contain name, address and all recogg
nised qualifications possessed by a licensed medical
practitioner. It shall be a public document, and it shall
be made available to the public by placing it on the
website of EMRB. EMRB shall ensure electronic syn-
chronisation of National Register and State Register in
such a manner that any change in one register is auto-
matically reflected in the other registers (2) to regulate
professional conduct and promote medical ethics.
State Medical Council
If a doctor is aggrieved by any action taken by
SMC, he may prefer an appeal to the EMRB. If he
is aggrieved by the decision of EMRB, he may pre-
fer an appeal to the Commission within 60 days of
thedecision. If he is aggrieved by the decision of the
Commission, he may prefer an appeal to the entra
Government within 30 days of the decision.
SOME IMPORTANT ACTS
of Children) Act, 2015 and chil-
in conflict with law
children
addresses and protection.
dren in need of care
 Medicine
SECTIONI Forensic

a person bclow
below MEDICAL RECORDS
'child' as
It defines juvenile' or
years of age.
A medical record is a document containing all
law [S.2(13)] means 'a
18
Child in conflict with offence data regarding patients treatment in chronologi.
have conmitted an cal order. It includes history, consent, examination,
child who is alleged to
ageas on the date of commis- investigations, diagnostic modalities used, treat.
and was 18 ycars of
sion of such offence. consists
It
ment, operation notes, discharge summary and
Juvenile Justice Board ()]B) |S.4]: details of further visits.
first class judicial magis-
of three persons: One There is a Medical Record Department in most
magistrate) with 2 years
trate (or metropolitan hospitals which maintain medical records.
workers at least one
of experience and two social Medical records are actually the property of the
For every district,
of whom should be a woman. hospital but the personal data (i.e. the informa
there will be one or more JJBs. tion) contained in the record is the confidential
Action against the offender:law is apprehended by property of the patient. Thus, the patient has a legal
conflict with
Ifa child insuch child shall be placed under the
right to use that information for his benefit. The
the police,
patient pays for services (i.e. diagnosis and treat-
charge of Special Juvenile Police Unit or Child
Welfare Police Officer, who shall produce the
ment), not for medical records. Due to this reason,
child before JJB within 24 h of apprehending
if the patient requests for the medical records, the
the child. The child shall not be placed in a photocopy of the original medical records (not the
police lockup or jail. original records) can be given to the patient on
payment of cost of reproduction.
If any person of 18-21 yearsoffence of age is aPpre-
when he Medical records are required in case of accidental
hended for committing an
was below the age of 18 years, then, such per- death (e.g. traffic, fall from height), assaults (phys
son shall be treated as a child during the pro- ical or sexual), insurance (life and health) policies,
cess of inquiry. medical negligence and the claims under Work-
any person of >21 years of age is appre- men's Compensation Act.
If
hended for committing any serious or heinous Maintenance of hospital records: (1) Every doctor
offence when he was between the age of 16 should maintain medical records for a period of
and 18 years, then he shall be tried as an adult. 3 years from the date of commencement of treat-
Punishment: ment. (2) If patient asks for his records, it should
If the age of child is <16 years, he will be be supplied within 72 h.
sent to special home (not jail) for maximum Storage of medical records: Under the Directorate
3 years for providing reformative General of Health Services guidelines published in
services, for
example, education, counselling, behaviour hospital manual, OPD records have to be stored for
and psychiatric support. minimum 5 years. IPD records have to be stored
If the age of child is 16-18 years, he will be for minimum 10 years. There is no period men-
tried as adult for following three types of tioned for MLC cases.
offences:
False certification can invite not only criminal and civl
1) For heinous' offence, punishment s action against the doctor, but also disciplinary pro-
imprisonment of >7 years but he cannot ceedings of the medical council. According to S.197,
be sentenced to death or life imprisonment. IPC, issuing or signing false certifcate shall be pun-
2) For 'serious' offence, punishment is
impris- ished in the same nmanner as if he gave false evidence.
onment for 3-7 years.
3) For 'petty' offence, punishment is
impris-
onment for <3 years. SOME IMPORTANT TERMS
The children's court shall ensure
that the child Res judicata: It means once any court takes dec
who is found to be in conflict with law is
sent to a sion in a case, the case cannot be reopened in any
place of safety till he attains the age of
21 years and other court, that is, a person cannot be sued twice
thereafter, the person shall be transferred
to a jail. for the same crime.
Another random document with
no related content on Scribd:
Thomson, Wyville, on Calcaromma, 83
Thorax = second chamber of Monaxonic Radiolarian shell, 84
Thyone, 573
Tiara, 273
Tiarechinidae, 557
Tiarechinus, 557
Tiaridae, 273
Tick, intermediate host of Karyolysus, 102;
of Piroplasma, 120;
of Treponema, 121 n.;
Persian, 120;
Zambezian, 121 n.
Tick fever, 120
Tiedemann's bodies, 442, 444, 458;
represented by so-called Polian vesicles of Echinus esculentus,
516
Tinctin bodies, 161
Tinerfe, 417
Tintinnidae, 155;
tests of, 152
Tintinnus, 137
Tissues (definition), 3
Tolerance, induced, of a higher temperature, 118
Tone, 519
Tooth, of Ophiothrix fragilis, 482;
of Echinus esculentus, 505, 524, 525;
of Echinarachnius parma, 546
Tooth-papilla, of Ophiothrix fragilis, 482;
of Ophiocoma, 493;
of Ophiocomidae, 499
Topsent, 196, 218 n.
Tornaria, 616
Torquatella typica (= Strombidium), 155 n.
Torus angularis, of Ophiothrix fragilis, 482
Toxa (= a bow-shaped spicule without spiral twist), 222
Toxaspire (a spiral rod in which the twist a little exceeds a single
revolution. The pitch of the spiral being great the spicule
 appears bow-shaped), 222
Trabeculae, traversing ampullae of tube-feet of Echinus esculentus,
517;
traversing coelom of Echinarachnius parma, 545;
traversing coelom of Antedon rosacea, 585
Tracheae of Chondrophoridae, 309
Trachelius, 137, 152 n.;
T. ovum, 153;
endosarc of, 144
Trachelomonas, 110, 112;
galvanotaxy of, 22
Trachomedusae, 288 f.
Trachynema, 294;
T. funerarium, 294
Trachynemidae, 294
Tractellum, 18, 114
Tragosia, 224
Transverse fission, of Flagellata, 109 f.;
of Dinoflagellata, 110, 131;
of Polykrikos, 131;
of Ciliata, 147;
of Suctoria, 161
Transverse flagellum and groove, in Dinoflagellata, 110, 130 f.;
multiple, in Polykrikos, 132
Transverse (= tentacular) plane, 414
Transverse section, of the arm of an Asteroid, 443;
of the arm of an Ophiuroid, 480;
of the radius of an Echinoid, 518;
of the radius of a Holothuroid, 562;
of body of a Holothuroid, 563;
of arm of Antedon, 586
Trembley, 254, 255
Trepang, 571
Treponema, 111, 121;
T. obermeieri, 121;
T. pallidum, 121;
T. zeemannii, 120
Triaene, 183, 224, 233
Triaxon, 184
Trichaster, 501
Trichasteridae, 501
Trichites (hair-like spicules often occurring in sheaves or clusters),
234
Trichocysts, 142 f.;
of Chloromonadaceae, 113 n.;
Mitrophanow on, 142 n.;
adoral, of Gymnostomaceae, 145
Trichodina, 138, 158
Trichodragmata (a sheaf of straight spicules of hair-like fineness),
222
Trichogorgia, 355
Trichomonas, 111, 115;
conjugation, 116 n.;
T. vaginalis, 119
Trichonympha, 111
Trichonymphidae, 111, 123 f.;
flagella, 114
Trichosphaerium, 51, 53 f.;
test, 53;
life-cycle, 54, 56
Trichostemma, 216
Trichostomata, 137
Tridactyle pedicellariae, of Echinus esculentus, 506, 507;
of E. acutus, 509;
of E. elegans, 510;
of Echinarachnius parma, 544
Trifoliate pedicellariae, of Echinus esculentus, 507, 508;
of E. acutus, 509;
of E. alexandri, 510;
of Echinocardium cordatum, 550;
absent in Cidaridae, 534
Trigonocidaris arbacina, 539
Triloculina, 59, 66
Trimastigidae, 111, 112
Tripedalia cystophora, 319
Tripedaliidae, 319
Triplechinoid type of ambulacral plate, 531, 539
Tripod, 83;
-shaped spicule of Radiolaria, 76
Tripolis, 87
Tripylaea, 76
Trivium, of Echinarachnius parma, 543;
of Holothuria nigra, 561
Trochammina, 59
Trochocyathus, 399;
T. hastatus, 398
Trochocystis, 597;
T. bohemicus, 597
Trochoderma, 577
Trochodota, 577
Trochosmilia, 401
Trochostoma, 575;
T. violaceum, 575
Trophodisc, 284
Trophozooid, 388
Tropical Africa, Trypanosomic diseases of, 119 f.
Trout, black-spotted, destroyed by Hydra, 256 n.
Trypanosoma, 111, 115 f., 119 f., 120;
podoplast or blepharoplast of, 19 n., 109 n.;
undulating membrane of, 115;
Halteridium, a supposed state of, 103 n., 120;
affinities to Acystosporidae, 106;
morphology of, 120, 121;
T. brucei infests hoofed quadrupeds, 119;
T. evansii causes Surra disease in Ruminants, 119;
T. gambiense, cause of sleeping-sickness, 120;
T. lewisii, infests Rodents, 119;
T. noctuae, 120;
conjugation in, 116 n.
Trypanosomoid character of blasts of Acystosporidae, 106
Tsetse Flies, intermediate hosts of Trypanosomes of Nagana and
sleeping-sickness, 119 f.
Tube, of Phalansterium, 113;
of certain Ciliates, 152;
of Maryna socialis, 152;
of Schizotricha socialis, 152;
of Stentor, 154;
of Vorticellidae, 158;
fertilising in Chlamydomonas, 125
Tube-foot, 428;
of Asterias rubens, 441 f.;
of Echinus esculentus, 517 f.;
of Endocyclica, 532;
of Arbaciidae, 532;
of Cidaridae, 532;
of Diadematidae, 532;
of Echinothuriidae, 532;
of Echinocardium cordatum, 551;
of Echinarachnius parma, 545, 546, 547;
of Palaeodiscus, 557;
of Holothuria nigra, 561
Tubipora, 329, 336, 343, 344;
T. musica, 338, 343
Tubiporidae, 344
Tubularia, 268, 271;
T. larynx, 263;
T. parasitica, 268
Tubulariidae, 271
Tumour, malignant, associated with Leydenia, 91
Tunicata, 621
Tuning-fork, 192, 193
Turbellaria, fresh-water, distribution of, 48;
symbiotic with Zoochlorella, 126
Turbinaria, 396
Turbinolia, 399
Turbinoliidae, 398
Turritopsis, 273, 295
Tuscarora, 79, 85
Tylostyle (a style in which a knob surrounds the origin), 224
Tylote, 183, 224
Tylotoxea (a rhabdus of which one actine is tylote or knobbed, the
other oxeate, the latter directed towards the surface of the
Sponge), 224
Tyrosin, 15

Uexküll, on function of pedicellariae of Echinus, 508;

on physiology of nervous system of Echinoidea, 519;
on vision of Echinoidea, 522;
on respiratory function of Aristotle's lantern, 527;
on pedicellariae of Sphaerechinus, 541
Uintacrinus, 588
Ulmaridae, 324
Ulmaris, 314, 324;
U. prototypus, 315, 324
Umbellula, 331, 359, 360, 363;
U. gracilis, 359
Umbellulidae, 362
Umbrella of Medusae, 251
Uncinataria, 203
Under arm-plate of Ophiuroidea, 491
Under basal-plate of Crinoidea—see Infra-basal plate
Undulating membrane, of Flagellata, 111, 115, 123;
of Trypanosoma, 121;
of Dinenympha, 123;
of Stylonychia mytilus, 139 f.;
of Ciliata Trichostomata, 137 f., 145;
of Glaucoma, 153;
of Pleuronema chrysalis, 153, 154;
of Caenomorpha uniserialis, 155;
of Vorticella, 156, 157
Unequal fission in Spirochona, 147
Upper arm-plate, of Ophiuroidea, 491;
of Ophioteresis, 491;
absent in Cladophiurae, 491, 500
Urechinidae, 554 n.
Urine, 13
Urocentrum, 137, 141 n.
Uronema, 137, 141 n.
Urticina, 379, 382;
U. crassicornis, 379, 382
Ussov, 257 n.
Ute, 189, 190, 192, 221

Vacuole, 5 f.;
of Collozoum inerme, 76;
of Oikomonas, 112;
contractile or pulsatile, 14 f.—see Contractile vacuole;
formative, 14 f.—see Alveole, Food-vacuole, Formative vacuole,
Ingestion, vacuole of
Vaginicola, 138, 158
Valvata, 461, 471 f.
Valvate, pedicellariae, of Antheneidae, 456, 471
Vampyrella, 89
Vaney, 292 n.
Variation in character of Foraminiferal shell at different stages of
growth, 66
Vegetative, growth, in coloured Flagellates, 115;
rest, 37
Velata, 461, 464 f., 466
Velella, 301, 302, 309;
V. spirans, 304
Veley, Lilian, on Pelomyxa, 53 n.
Ventriculites, 208, 208
Venus's Flower-basket (= Euplectella aspergillum), 197
Venus's girdle, 420
Veretilleae, 364
Veretillum, 364
Vermicles, of Gaule, a name for Lankesterella, 102
Verrucae, 331
Verrucella, 357;
V. guadaloupensis, 357
Vertebra, of Ophiuroidea, 481, 491;
of Streptophiurae, 491, 494;
of Ophioteresis, 481, 491;
of Ophiohelus, 491, 493;
of Zygophiurae, 491;
of Ophiothrix fragilis, 480;
of Ophiarachna, 481;
of Cladophiurae, 491, 500;
of Astroschema, 481;
of Gorgonocephalus, 491;
of Astrophyton, 491;
of fossil Ophiuroidea, 501, 502
Vertebrates, cold-blooded, hosts of Haemosporidae, 102
Verticilladeae, 363
Verworn, on general physiology and protoplasm, 3 n.;
on protoplasmic movements, 16 n., 17;
on regeneration, 35 n.;
of Thalassicolla nucleata, 79 n.
Vesicular nucleus, 25
Vestibule, of Peritrichaceae, 145;
of Carchesium, 146;
of Vorticella, 156, 157
Vexillum, 421
Vibratile styles of Rotifers, 141
Villogorgia, 356
Virgularia, 339, 362;
V. juncea, 360;
V. mirabilis, 362;
V. rumphii, 330, 360
Virgulariidae, 362
Vision, of Asteroidea, 446;
of Echinoidea, 522
Vital forces, 12 f.;
processes, 11 f.
Vitreous Foraminifera, 58, 62
Voluntary muscles of Mammals infested by Sarcosporidiaceae, 108
Volvocaceae, 110, 111, 125 f.;
 literature of, 119
Volvocidae, 111, 126 f., 127, 129;
theca, 113
Volvox, plasmic cell connexions of, 37 n.;
a true vegetable Protist, 130;
V. globator, 127 f.
Vorticella, 138, 155 f., 157;
V. sertulariae, symbiotic Zooxanthella in, 125
Vorticellidae, 157 f.;
fission, 158;
colonies, 158
Vosmaer, 187 n., 212, 234 n., 237

Wager, on Euglenaceae, 125

Wagner, 256 n.
Wallich, on Protozoa, 45
Walteria, 199, 202;
W. flemmingi, 206;
W. leuckarti, 206
Wasielewski, on Sporozoa, 94 n.
Water in protoplasm, 12
Water-Fleas, Vorticellidae found on, 158;
rheotaxy of (small Crustacea), 21
Water-vascular system, 428;
of Asterias rubens, 441;
of Asteroidea, 457;
of Ophiothrix fragilis, 486;
of Echinus esculentus, 516;
of Echinarachnius parma, 546;
of Echinocardium cordatum, 551;
of Holothuria nigra, 564;
of Holothuroidea, 568;
of Synaptida, 568;
of Molpadiida, 568;
of Elasipoda, 568;
of Psolus, 569;
of Antedon rosacea, 583;
 of Carpoidea, 597
Weltner, 177, 178
White Ants, hosts of Trichonymphidae, 123
White Man's Grave, 106
Wille, on Volvocaceae, 119
Willey, 194 n., 248, 421, 422
Williams, on density of living protoplasm, 13 n.
Williamson, on structure of Foraminifera, 62
Wilson, on protoplasm, 3 n.;
on syngamy, 34 n.
Wilson, on Sponges, 171, 231
Woltereck, 302
Wolters, on reproduction of Monocystis, 96 n.
Woodcock, on association and conjugation in Gregarines, 99 n.;
on Haemoflagellates (= Trypanosomidae), 119 n.
Worms, Earth-, hosts of Monocystis, 95
Wreath, adoral, peristomial, of cilia or membranellae of Ciliata
Trichostomata, 137 f.;
of Stylonychia mytilus, 139 f.;
of Metopus, 154;
of Caenomorpha uniserialis, 155;
of Vorticella, 156, 157;
posterior, of Vorticella, 156, 157
Wrightella, 351
Wrisburg, on organisms of putrefaction, 43
Würmchen, of Gaule, a name for Lankesterella, 102

Xenaster, 476
Xenia, 331, 335, 346, 348
Xeniidae, 348
Xenospongia patelliformis, 216
Xiphacantha, 78, 78
Xiphigorgia, 357

Yaws, 121 n.
Yellow-cells (= Zooxanthella), 80, 86, 125, 261, 373, 396
Yolk-granules of ovum of Sea-urchin, 7
Young state of one pairing-nucleus essential, 34
Yvesia, 224

Zambezian Tick, infects man with Treponema, 121 n.

Zaphrentidae, 406
Zaphrentis, 407
Zederbauer, on syngamy in Dinoflagellates, 131 n.
Zittel, 241 n.
Zoantharia, 329, 365 f.;
age, 375;
food, 373;
form, 366;
gonads, 369;
mesenteries, 366 f., 368;
mesenteric filaments, 369;
reproduction, 371;
skeleton, 370;
stomodaeum, 369;
tentacles, 366
Zoanthidae, 404
Zoanthidea, 370, 404 f.
Zoanthus, 405;
Z. macgillivrayi, 406;
Z. sulcatus, 406
Zonarial Radiolaria, 75
Zoochlorella, 111;
a Chlamydomonad, 126;
symbiotic, in Heliozoa, 73;
in Paramecium bursaria, 153;
in Stentor polymorphus, 154;
in Ophrydium, 158;
in Ephydatia, 175;
in Hydra viridis (= chlorophyll corpuscles), 256
Zooids of Volvox globator, 127
Zoosporeae, 89
Zoospores, of Algae and Fungi, possess contractile vacuole, 15;
of Lower Plants, 17 f.;
of Sarcodina, 49;
of Trichosphaerium, 54;
of Microgromia socialis, 60;
of Foraminifera, 67 f.;
of Clathrulina, 73;
 of Radiolaria, 85 f.;
of Zooxanthella, 86;
of Acrasieae, 90;
of Didymium, 92;
of Paramoeba eilhardii, 116 n.
Zoothamnium, 138, 158
Zooxanthella, 110;
a Chrysomonad, 125;
in Radiolaria, 80, 86;
in Vorticella sertulariae, 125;
in Millepora, 261;
in Zoantharia, 373 f.;
in Madrepores, 396
Zopf, on Monadineae (Flagellates and Proteomyxa), 40
Zoroaster, 474
Zoroasteridae, 454, 474
Zostera, 422
Zygophiurae, 491, 494, 495 f., 502
Zygophylax, 280
Zygote, 37 f.;
Amoeba coli, 57;
Centropyxis aculeata, 57;
Chlamydophrys stercorea, 57;
Foraminifera, 69;
Actinophrys sol, 72;
Actinosphaerium, 75;
Gregarinidaceae, 95 f., 97;
Coccidiaceae, 97, 100 f.;
Coccidium, 100, 101 f.;
Acystosporidae, 97, 104 f.;
Flagellata, 116 n., 117 f.;
Bodo saltans, 117 f.;
Dinoflagellata, 131 n.;
Ciliata, 148 f.
—see also Coupled cell, Fertilised egg, Ookinete, Oosperm,
Oospore, Zygotospore
Zygotoblasts of Acystosporidae, 104 f.
Zygotomeres (= naked spores of Acystosporidae), 104 f.
Zygotonucleus (= Fusion-nucleus, a nucleus formed by fusion of two
gametonuclei), 33 f.
Zygotospore (= resting zygote), 97
Zykoff, 178
Zymase (= chemical ferment), 15;
in relation to brood-division, 32 f.
 END OF VOL. I
Printed by R. & R. Clark, Limited, Edinburgh.

[1]

For detailed studies of protoplasm see Delage, Hérédité, 2nd ed.

1903; Henneguy, Leçons sur la Cellule, 1896; Verworn, General
Physiology, English ed. 1899; Wilson, The Cell in Development
and Inheritance, 2nd ed. 1900. All these books contain full
bibliographies.

[2]

As we shall see later, it is by no means easy to separate sharply

Protozoa and Protophyta, the lowest animals and the lowest
plants; and therefore in our preliminary survey to designate lowly
forms of life, not formed of the aggregation of differentiated cells,
we shall employ the useful term "Protista," introduced by Haeckel
to designate such beings at large, without reference to this difficult
problem of separation into animals and plants (see also p. 35 f.).

[3]

The "micron," represented by the Greek letter µ, is 1⁄1000 mm.,

very nearly 1⁄25,000 of an inch, and is the unit of length commonly
adopted for microscopic measurements.

[4]

A solid substratum is required, to which the lower surface adheres

slightly: that movement is complicated by a sort of rolling over of
the upper surface, constantly prolonging the front of the
pseudopodium, while the material of the lower surface is brought
up behind. H. S. Jennings, Contr. to the Study and Behaviour of
the Lower Organisms, 1904, pt. vi. p. 129 f., "The Movements and
Reactions of Amoeba."
[5]

If the protoplasm contains visible granules, as it usually does,

within a clear external layer, we see that these stream constantly
forwards along the central axis of each process as it forms, and
backwards just within the clear layer all round, like a fountain
playing in a bell-jar. This motion is most marked when a new
pseudopodium is put forth, and ceases when it has attained full
dimensions.

[6]

We use as a corresponding adjective the term "plasmic."

[7]

For the study of the structure of protoplasm under the microscope

it is necessary to examine it in very thin layers, such as can for the
most part be obtained only by mechanical methods (section-
cutting, etc.). These methods, again, can only be applied to fixed
specimens, for natural death is followed by rapid changes, and
notably by softening, which makes the tissue less suitable for our
methods. We further bring out and make obvious pre-existing
differentiations of our specimens by various methods of staining
with such dyes as logwood and cochineal and their derivatives,
and coal-tar pigments (see also p. 11 n.).

[8]

In many Protista these granules have been shown by Schewiakoff,

in Z. wiss. Zool. lvii. 1893, p. 32, to consist of a calcium phosphate,
probably Ca3P2O8.

[9]

It is not always possible to tell how much of these structures

represents what existed in life (see p. 11).

[10]
The chromatin and nucleoles are especially rich in phosphorus,
probably in the combination nucleinic acid.

[11]

In chemical phrase the process is "exothermic."

[12]

The growth of crystals is a mere superficial deposit, and cannot at

all be identified with protoplasmic growth.

[13]

A. Bolles Lee, in his Microtomist's Vade Mecum, 1st ed. (1885),

pointed out that "Clearing reagents are liquids whose primary
function is to make microscopic preparations transparent by
penetrating amongst the highly refractive elements of which the
tissues are composed, having an index of refraction not greatly
inferior to that of the tissues to be cleared" (p. 213). We showed
later ("The State in which Water exists in Live Protoplasm," in Rep.
Brit. Ass. 1889, p. 645, and Journ. Roy. Micr. Soc. 1890, p. 441)
that since the refractivity of living protoplasm is only 1.363-1.368, it
follows that the water in the living protoplasm is in a state of
perfect physical combination, like the water of a solution of gum
[read a "mucilage"] or of a jelly. Now the phenomena of
protoplasmic motions as studied in the Rhizopoda and in the
vegetable cell, seem absolutely to preclude the jelly supposition,
and for these cases we must admit that living protoplasm is a
viscid liquid whose refractivity is probably the mean of the two
constituents separated by death, the one solid, the other a watery
solution: and death is for us essentially a process of precipitation
(or better, "desolution"). For further work on these lines see Hardy
in Journ. Physiol. vol. xxiv. 1899, p. 158, and Fischer, Fixirung u.
Färbung, 1900.

[14]

In its original use "automatism" designates the continuous

sequence and combination of actions, without external
interference, performed by complex machines designed and made
for specific ends by intelligent beings: thus we speak correctly of
"automatic ball bearings" that tighten of themselves when they
become loose; but even these cannot take up fresh steel and
redeposit it, either to replace the worn parts or to strengthen a tube
that is bending under a stress.

[15]

Proteids are organic compounds containing carbon, hydrogen,

nitrogen, and oxygen, of which white of egg (albumen) is a familiar
type. Nucleo-proteids are compounds of proteids with nucleinic
acid, which in addition to the above elements contain phosphorus.

[16]

The specific gravity of living protoplasm has been estimated by

determining the density of a solution of gum in which certain
Infusoria float freely at any depth. It was found by the concurrent
results of Julia B. Platt and Stephen R. Williams (see Amer.
Natural. xxxiii. 1899, p. 31, xxxiv. 1900, p. 95) to be from 1.014 to
1.019, while the Metazoon Hydra was found to give a density of
only 1.0095 to 1.0115. The difference of about 0.006, it is easy to
show, is of the correct "order of magnitude," if we admit that the
actual substance of the Hydra has about the same specific gravity
as the Infusorian, while the density of the whole is lightened by the
watery contents of the internal cavity, etc. Jensen obtained a much
higher result for Paramecium, using a solution of the crystalloid
substance, potassium carbonate; but it is almost certain that this
would be readily absorbed by the organism, and so raise its
density in the course of the experiment.

[17]

Energy may be derived from the mere splitting up of complex

substances within the cell: when such a splitting involves the
liberation of CO2 the process is (mis-)called "intramolecular
respiration."
[18]

A similar organ, but with cellular walls, is the bladder of the

Rotifers and certain Platyhelminthes, in connexion with their renal
system (vol. ii. pp. 53, 199, and especially pp. 213-5).

[19]

In Rep. Brit. Ass. 1888, p. 714; Ann. Mag. Nat. Hist. (6), iii. 1889,
p. 64. This view has been fully worked out, mainly on Ciliates, by
Degen in Bot. Zeit. lxiii. Abt. 1. 1905.

[20]

See Hartog, "On Multiple Cell-division, as compared with Bi-

partition as Herbert Spencer's limit of growth," in Rep. Brit. Ass.
1896, p. 833; "On a Peptic Zymase in Young Embryos," ibid. 1900,
p. 786; "Some Problems of Reproduction," ii. Quart. Journ. Micr.
Sci. xlvii. 1904, p. 583.

[21]

"On the Digestive Ferment of a large Protozoon." Rep. Brit. Ass.

1893, p. 801.

[22]

See for studies of the movements of Protoplasm, Berthold,

Protoplasmamechanik (1886); Bütschli, Investigations on
Microscopic Foams and on Protoplasm, English ed. 1894;
Verworn, General Physiology, 1899; Le Dantec, La Matière
Vivante, 1893?; and Jensen, "Unters. ueb. Protoplasmamechanik,"
in Arch. Ges. Phys. lxxxvii. 1901, p. 361; Davenport, Experimental
Morphology, i. 1897; H. S. Jennings, Contr. etc. 1904.

[23]

The terms "expansion" and "contraction" refer only to the

superficial area: it is very doubtful whether the volume alters
during these changes.
[24]

For discussions on the mechanism of ciliary action, see Schäfer,

Anat. Anz. xxiv. 1904, p. 497, xxvi. 1905, p. 517; Schuberg, Arch.
Protist. vi. 1905, p. 85.

[25]

Like the line of most rapid growth in a circumnutating plant-stem.

[26]

A similar body lies at the centre to which the axial filaments of the
radiating pseudopodia of the Heliozoa converge, and might be
termed by parity a "podoplast"; but "centrosome" is a convenient
general term to include all such bodies. It is clearly of nuclear
origin in Trypanosoma (Fig. 39, p. 120).

[27]

See for development of this view W. M‘Dougall in Journ. Anal.

Physiol. xxxi. 1897, pp. 410, 539. I put it forward in the first draft of
this essay in 1894.

[28]

The best general account is to be found in Davenport,

Experimental Morphology, 1897.

[29]

See Jennings in Woods Holl. Biol. Lect. 1899, p. 93.

[30]

It is not always easy to distinguish these two classes of

phenomena.

[31]

Jennings, in his studies on Reactions to Stimuli in Unicellular

Organisms (1899-1900), has shown that whatever be the nature of
the repellent stimulus, chemical or mechanical or thermal, the