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Legal Medicine 2 by Solis
Legal Medicine 2 by Solis
I do further order and decree that any violation of this Decree and/or the rules and
regulations which shall be promulgated by competent authorities in accordance
herewith, with malicious intent or gross negligence, shall suffer the penalty of
impritonment for not less than one year nor more than (3) years and/or a fine of not
2. Physical injuries which did not prevent the offended party from engaging a. Superficial — When the wound is just underneath the layers of the skin
in his or mucous membrane.
254 LEGAL MEDICINE habitual (1) Petechiae.
work or which did not require medical attendance. (2) Contusion.
(3) Hemotama.
If the victim merely suffered from small contusion or superficial abrasion
b. Deep.
which does not require medical attendance or incapacity, this falls in the
paragraph of slight physical injury. (1) Musculo-Skeletal Injuries.
2. Ill-treatment of another b y deed without causing any injury. (a) Sprain.
A slight slap on the face or holding tightly the arm of the victim which did ( b ) Dislocation.
not even develop redness of the skin may be a form of ill-treatment. (c) Fracture.
(d) Strain.
If there is no evidence to show actual injury, or incapacity for labor, or (f) Subluxation.
period of medical attendance, the accused can only be guilty of slight (2) Internal Hemorrhage
physical injuries (People v. Penesa, 81 Phil. 398; People v. Amarao et al., C.A.
(3) Cerebral Concussion.
36 O.G. 3462).
A tender slap on the face, holding the arm tightly, application of 2. Open Wound — There is a breach of continuity of the skin or mucous
pressure in some parts of the body, or mild blo w which show no sign of membrane.
physical violence may still be considered slight physical injuries or a. Abrasion.
maltreatment (3rd paragraph). b. In c is ed Wound.
c. S t a b Wo u n d .
Physical Injuries inflicted in a Tumultuous Affray: Art. d. Punctured.
252, Revised Penal Code: e. Lacerated.
When in a tumultuous affray as referred to in the preceding article, only
CLOSED WOUNDS:
serious physical injuries are inflicted upon the p articipants thereof and
the person responsible therefore cannot be identified, all tho se who ap p ear Petechiae:
This is a circumscribed extravasation of blood in the subcutaneous tissue or
to have used vio lence up o n the p er so n o f the offended party shall suffer underneath the mucous Membrane. The cause of passage of blood from the
the penalty next lower in degree than that provided for the physical injuries so capillaries may be due to the increase intra -capillary pressure or incr eas ed
inflicted. permeabilit y of the vess el. The hemorrhage may be small or pinhead sized
When the physical injuries inflicted are of a less serious nature than but several petechiae may coalesce to form a bigger hemorrhagic area.
the person responsible therefor e cannot be identified, all those who appear Mosquito or other insect bites may cause the formation of circumscribed
hemorrhages.
to have used any violence upon% the person of the of fended party shall be
punished by arresto from five to fifteen days. P et e chi a e is not a l wa ys a produ c t o f t r au ma. P et e chi al h e mo r rhage ma y
be a post -mortem finding in asphyxial death, coronary occlusion and blood
Elements of the Crime: diseases, It may also develop post -mortem in d e a t h b y h a n g i n g. T h e r e i s
a. T here is a t u mu l t uo us a f fr a y; g r a v i t a t i o n o f b l o o d i n t o t h e m o s t dependent part of the body which
b. Participant(s) suffered from serious physical injuries; eventually leads to the rupture of o ve r -di st end ed c api lla r ie s sp e ci all y s e en
c. The person(s) who inflicted such serious physical injuries cannot be a t th e l e gion o f the l e g.
identified; and
d. All those who appear to have used violence upon the person of the offended Contusion:
Contusion is the effusion of blood into the tissues underneath the skin on
party shall be penalized by arresto from five to fifteen days. account of the rupture of the blood vessels as a result of the application of blunt
force or violence.
TYPE OF WOUNDS (Medical Classification):
1. Closed Wound — There is no breach of continuity of the skin or mucous
membrane.
(h) Sphincters are relaxed perhaps with unconscious evacuation of the d. It is usually ignored by the attending physician for it does not require
bowel and bladder. medical treatment but it has far-reaching importance in the medico -
(i) Reflexes are present but sluggish and in severe cases may be absent. legal viewpoint.
Loss of memory for events just before the injury (retrograde amnesia) (1) Abrasions caused by fingernails may indicate struggle or assault
is a constant effect of cerebral concussion and is of medico-legal importance. and are usually located in the face, neck, forearms, and hands.
OPEN WOUNDS: (2) Abrasions resulting from friction on rough surfaces, either
L Abrasion (Scratch, Graze, Impression Mark, Friction Mark): intentional or accidental are located on bony parts of the body
and usually associated with contusion or laceration.
It is an injury characterized by the removal of the superficial epithelial
(3) Nature of the abrasion may infer degree of pressure, nature of
layer of the skin caused by a rub or friction against a hard rough surface.
the rubbing object and the direction of movement.
Whenever, there is forcible contact before friction occurs, there may be
e. Unless there is a supervening infection, abrasion heals in a short time
contusion associated with abrasion. The shape varies and the raw surface
and leaves no scar. If the whole thickness of the skin is involved,
exudes blood and lymph which later dries and forms a protective covering
healing may be delayed and occasionally with scar formation.
known as scab or crust.
Forms of Abrasion:
a. Linear:
An abrasion which appears as a single line. It may be a straight
or curved line. Pinching with the fingernails will pro duce a linear
curved abrasion, while sliding the point of a needle on the skin will
produce a straight linear abrasion.
b. Multi-Linear:
An abrasion which develops when the skin is rubbed on a hard
rough object thereby producing several linear marks parallel to
one another. This is frequently seen among victims of vehicular
accidents.
c. Confluent:
An abrasion where the linear marks on the skin are almost
indistinguishable on account of the severity of friction and
roughness o the object.
d. Multiple:
Several abrasions of varying sizes and shapes may be found in
Abrasions different parts of the body.
Characteristics of Abrasion: Types of Abrasions:
a. It develops at the precise point of impact of the force causing it. a. Scratch:
This is caused by a sharp-pointed object which slides across
b. Grossly or with the aid of a hand lens the injury consists of parallel the skin, like . a Pin, thorn or fingernail. The injury is always
linear injuries which are in line with the direction of the rub or friction parallel to the direction of slide. The commencement and
causing it. termination are well defined and the depth depends on the
c. It may exhibit the pattern of the wounding material. pressure applied. The fingernail scratch may be broad at the
p o i n t o f c o m m e n c e m e n t a n d m a y t e r m i n a t e wi t h a t a i l i n g .
Differential Diagnosis:
262 LEGAL MEDICINE MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 263
b. Graze: a. Dermal Erosion — A gradual breakdown or very shallow ulceration
These are usually caused by forcible contact with rough, hard objects of the skin which involves only the epidermis and heals withour
resulting to irregular removal of the skin surface. The nature of the injury scarring. It may appear in spots and with no previous history of
is dependent upon the degree of roughness of the object and the amount friction or sliding.
of pressure in the course of the sliding. The course will be indicated by a b. Marks of Insects and Fishes Bites — The skin injury is irregular with no vital
clean commencement and tags on the end.
reaction and usually found on angles of the mouth, margins of nose, eyelids
c. Impact or Imprint Abrasion (Patterned Abrasion, Stamping and forehead.
Abrasion, "Abrasion A La Signature"): c. Excoriation of the Skin by Excreta — This condition is only found among
Those whose pattern and location provides objective evidence to show infants and the skin lesion heals when the cause is removed. There is no
cause, nature of the wounding material or instrument and the manner of apparent history of rubbing trauma on the affected area.
assault or death. d. Pressure Sore — Usually found at the back at the region of bony prominence.
(1) Marks of the grid of the radiator may be imprinted on the .skin. His to ry of lon g st and in g il ln ess , b ed rid den
(2) Tire thread marks may be seen on the skin in vehicular accidents. condition although pressure sore may start as a previous area of abrasion.
(3) Muzzle imprint in contact fire gunshot wound of entrance.
Distinction Between Ante-mortem from Post-mortem Abrasions: Point of
(4) Teeth impression mark in skin bites.
Ante-mortem Post-mortem
d. Pressure or Friction Abrasion:
Distinction Abrasion Abrasion
Abrasion caused by pressure accompanied by movement usually
Color Reddish -bronze , in appear Yellowish and translu -
observed in hanging or strangulation. The spiral strands:' of the rope may
;
Hacked wound. The injury is quite severe, edges may or may not be MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 265
contused depending on the nature of the edge of the instrument used.
Characteristics of Incised Wound:
a. Edges are clean-cut and both extremities are sharp, except in areas
where the skin is loose or folded at the time of infliction.
b. The wound is straight and may be shelving if inflicted with the wounding
instrument applied with an acute angle to the surface of the body involved.
c. Usually the wound is shallow near the extremities and deeper at the
middle portion. However, this finding may be modified by the shape of
the wounding instrument and part of the body involved.
d. Because the blood vessels involved are clean-cut, profuse hemorrhage is
invariably a feature.
e. Gaping is usually present due to the retraction of the edges but its presence
and degree of retraction depends on the direction of the incised wound
with the line of cleavage (Langer's line).
f. If the incised wound is located in parts of the body covered with
clothes, the clothing itself will show clean -cut of its texture.
Multiple incised wounds (Homicidal).
g. In the absence of complication and/or when there is deeper involvement
present, healing is relatively fast and the scar may not or may develop Deep incised wound may cause clean-cut fracture of the bone,
conspicuously. severance of blood vessels and nerves or amputation. Paralysis may
develop on account of the severed nerve and profuse he morrhage
h. Incised wound caused by broken edge of glass may be irregular and may may result to death. Embolism or supervening infection may later
appear like a punctured or stab wound. Fragments of the glass may be develop.
removed from the incised wound. 'Examination with the aid of a Why a Person Suffers from Incised Wound:
magnifying lens is necessary to determine the presence and removal of
a. As a therapeutic procedure — Pyogenic abscess and cystic
particles of flakes of glasses in the wound.
conditions may be treated by incision.
Changes that occur in an Incised Wound: b. As a consequence of self-defense — The sharp-edged instrument may
After 12 hours — Edges are swollen; adherent with blood and be held by the victim in his attempt to avoid the offender to inflict
with leucocyte infiltration. more serious injuries on him.
After 24 hours — Proliferation of the vascular endothelium c. Masochist may self-inflict incised wound as a means of sexual
and connective-tissue cells. gratification.
d. Addicts and mental patients may suffer from incised wound
After 36-48 hours — Capillary network complete; fibrolasts running at irrationally.
right angles to the vessels. Incised Wounds may be Suicidal,4micidal or Accidental:
After 3-5 days — Vessels show thickening and obliteration. a. Suicidal 7 Located in peculiar parts of the body, like the neck, flexor
(From: Gradwohl's Legal Medicine by F.E. Camps ed., 3rd ed. p. 272). surfaces of the extremities (elbow, groin, knee), wrist, and
accessibly to the hand in inflicting the injury. The most common
instrument used is the barber's razor blade with an improvised
handle. There is usually superficial tentative cut (hesitation cuts)
and the direction varies with the location and the hand (left or right)
used in inflicting the injuries. The most
266 LEGAL MEDICINE MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 267
Body surface
Line of cleavage
Langer’s line
Det er mi n at io n wh e t h er t he i nj u r y wi l l p ro d uc e c o mp li cation as a
CHAPTER X consequence.
c. Examinations that are applicable to the dead victim:
MEDICO-LEGAL INVESTIGATION OF WOUNDS: (1) Determination whether the wound is ante-mortem or postmortem.
(2) Determination whether the wound is mortal or not.
The following rules must always be observed by the physician in the (3) Determination whether death is accelerated by a disease or some
examination of wounds: abnormal developments which are present at the time of the
infliction of the wound.
1. All injuries must be described, however small for it may be important later.
(4) Determination whether the wound was caused by accident, suicide
2. The description of the wounds must be comprehensive, and if possible a
or homicide.
sketch or photograph must be taken.
3. The examination must not be influenced by any other information obtained 8. Examinations of the Wound:
from others in making a report or a conclusion. The following must be included in the examinations of the wound.
The report made in connection with such examination must also include
Outline of the Medico-legal Investigation of Physical Injuries: in detail the following items:
a. Character of the Wound:
1. General Investigation of the Surroundings:
The description must first state the type of wound, e.g. abrasion,
a. Examination of the place where the crime was committed. contusion, hematoma, incised, lacerated, stab wound etc. It must
b. Examination of the clothings, stains, cuts, hair and other foreign include the size, shape, nature of the edges, ex tremities and other
bodies that can be found in the scene of the crime. characteristic marks. The presence of contusion collar in case of gunshot
c. Investigation of those persons who may be the witnesses to the incident or wound of entrance, scab formation in abrasion and other open wounds,
those who could give light to the case. infection, surgical intervention, etc., must also be stated.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime b. Location of the Wound:
for purposes of preservation. The region of the body where the wound is situated must be stated. It
is advisable to measure the distance of the wound from some fixed
2. Examinations of the Wounded Body: point of the body prominence to facilitate reconstruction. This is
a. Examinations that are applicable to the living and dead victim: important in determining the trajectory or course of the wounding
(1) Age of the wound from the degree of healing. weapon inside the body.
(2) Determination of the weapon used in the commission of the offense. c. Depth of the Wound:
(3) Reasons for the multiplicity of wounds in cases where there are more The determination of the exact depth of the wound must not be
than one wound. attempted in a living subject if in so doing it will pre judice the health
or life. Depth is measurable if the outer wound and the inner end is
(4) Determination whether the injury is accidental, suicidal or homicidal.
fixed. No attempt must be made in measuring the stabbed wound of the
b. Examinations that are applicable only to the living: abdomen because of the movability of the abdominal wall.
(1) Determination whether the injury is dangerous to life. Condition of the Surroundings:
(2) Determination whether the injury will produce permanent deformity. The area surrounding the wo und must be examined. In gunshot
(3) Determination whether the wound(s) produced shock. wound near or contact fire will produce burning or tattooing of the
surrounding skin. In suicidal incised wound,
288
290 LEGAL MEDICINE MEDICO-LEGAL INVESTIGATION OF WOUNDS 291
there may be superficial tentative cuts (hesitation cuts). La- the victim is markedly weakened. The vital reaction may als o
cerated wound may show contusion of the neighboring skin. indicate the time of infliction of the wound. Post-mortem wound s do
e. Extent of the Wound: not show any manifesting signs of vital reaction.
Extensive injury may show marked degree of force applied in the
production of the wound. In homicidal cut-throat cases, it is generally 3. Signs of Repair:
deeper than in cases of suicide. Homicidal wounds are extensive and Fibrin formation, growth or epithelium, scab or scar formation
numerous. conclusively show that the wound was inflicted during life. But
f. Direction of the Wound: the absence of signs of repair does not show that injury was
The direction of the wound is material in the determination of the inflicted after death. The tissue may not have been given ampl e time
relative position of the victim and the offender when such wound has to repair itself before death took place.
been inflicted. The direction of the incised wound of the anterior 4. Retraction of the Edges of the Wound:
aspect of the neck may differentiate whether it is homicidal or suicidal.
Owing to the vital reactions of the skin and contractility of the
g. Number of Wounds: muscular fibers, the edges of the wound inflicted during life
Several wounds found in different parts of the body are generally retract and cause of gaping. On the other hand, in the case of the
indicative of murder or homicide. wound inflicted after death, the edges do not gape and are closely
h. Conditions of the Locality: approximated to each other because the skin and the muscles
(1) Degree of hemorrhage. have lost their contractility.
(2) Evidence of struggle.
(3) Information as to the position of the body Distinctions between Ante-mortem and Post-mortem Wounds:
(4) Presence of letter or suicide note. Ante-mortem Wound Post-mortem Wound
(5) Condition of the weapon. 1. Hemorrhage more or less co - 1. Hemorrhage slight or
Determination Whether the Wounds were Inflicted During Life or After pious and generally arterial. none. at all and always
Death: venous.
In the determination whether the wounds were inflicted during life or 2. Marks of spouting of the edges 2. No spouting of blood.
after death, the following factors must be taken into consideration: from arteries.
3. Clotted blood. 3. Blood is not clotte d; if
1. Hemorrhage: at all, it is a soft clot.
As a general rule, hemorrhage is more profuse when the wound was 4. Deep staining of the edges 4. The edges and cellular
inflicted during the lifetime of the victim. In wounds in flicted after death, tissues and cellular tissues, are not de eply sta ined
the amount of bleeding is comparatively less if at all bleeding occurred. Which is not removed by The stain ing can be
This is due to the loss of tone of the blood vessels, the absence of heart re mo ved b y washing.
action and the post-mortem
clotting of blood inside the blood vessels. 5. The edges gape owing to the 5. The edges do not gape,
reactions of the skin and are a n d closely o t h e r ,
Violence inflicted on a living body may not show the formation of a unless the wound
bruise until after death. is caused within one
2. Signs of Inflammation: o r t w o hours after death
There may be swelling of the area surrounding the wound, effusion of
6. Inflammation and reparative 6. No inflammation or
lymph or pus and adhesion of the edges. Other vital reactions are present
reparative processes. processes.
whenever the wound was inflicted during life, although it may be less
pronounced when the resistance of (From: Medical Jurisprudence and Toxicology by N.J. Modi, 12th
ed,p. 237).
292 LEGAL MEDICINE MEDICO-LEGAL INVESTIGATION OF WOUNDS 293
wasting, anemia ; condition of the face, and bed sore formation may be a examining individually the wounds and note which of them are involved in
basis as to how long a person survived. the injury to some vital organs or large vessels, or led to secondary results
3. Age of the Blood Stain: causing death. When two or more wounds involved the vital organs, it is
The age of the blood stain may be determined from the physical color difficult to ascertain which among them caused the death. It is important to
changes of the skin, although it is not reliable. Al though there are some determine the degree of the damage of eAch of the wound caused on the
basis for such method, it must not be relied upon because the physical vital organ.
changes of the blood is modified by several external factors.
4. Testimony of the Witness When the Wound was Inflicted: Which of the wounds was inflicted first?
The actual witness may testify in court as to the exact time the wound was When there are several wounds present on the body of the victim, it is
inflicted by the offender. In this case, medical evidence as to the duration of important to determine which of them was inflicted first because it may be
survival is merely corroborative. necessary for the qualification of the offense committed. If the first wound
was inflicted in a treacherous way that the victim after receipt is incapable
Possible Instruments Used by the Assailant in Inflicting the Injuries: The of defense, then murder is committed, but if the fatal wound was inflicted
determination of the wounding instrument may be made from the nature of the last, it is possible that the crime committed is only homicide.
wound found in the body of the victim: In the determination as to which of the wounds present was inflicted
1. Contusion — produced by blunt instrument. first, the following factors must be taken into consideration:
2. Incised wound — produced by sharp-edged instrument inflicted by hitting. 1. Relative position of the assailant and the victim when the first injury
3. Lacerated wound -- produced by blunt instrument. was inflicted on the latter.
4. Punctured wound — produced by sharp-pointed instrument. 2. Trajectory or course of the wound inside the body of the victim.
5. Abrasion — body surface is rubbed on a rough hard surface.
3. Organs involved and degree of injury sustained by the victim.
6. Gunshot wound — the diameter of the wound of entrance may approximate
the caliber of the wounding firearm. 4. Testimony of the witness.
5. Presence of defense wounds on the victim. If the victim tried to make a
Could the injury have been inflicted by a special weapon? defensive act during the initial attack, then the defense wounds must
have been inflicted first.,
A physician cannot determine definitely that a certain specific weapon was Effect of Medical and Surgical Intervention on the Death:
used in inflicting a wound. He can only state that it is possible that a certain If the death of the victim followed a surgical or medical intervention,
injury is possibly caused by a certain instrument presented. He must be the offender will still be held responsible for the death of the victim if it
cautious in making a categoric statement. can be proven that death was inevitable and that even without the operation,
death is a normal and a direct consequence of the injuries sustained. It
Which of the injuries sustained by the victim caused death? must be shown that the physician treating the victim must be competent
If there are several offenders who conspired with one another in the commission of and that in spite his exercise of care and diligence, still death was the final
the offense, it is not necessary to determine who among them gave the fatal blow. outcome. A person committing a felony shall be responsible for whatever
In the crime of conspiracy, the act of one is the act of all. But if there is n o will be the outcome of his felonious act. The wound inflicted by him
conspiracy in the commission of the offense it is necessary to determine who must be the direct and proximate cause of the death of the victim.
among the offenders gave the fatal injury to the victim, because they are only On the other hand, if the victim merely received minor wounds but
responsible for their individual acts. death resulted on account of the gross incompetence or negligence of the
In a case wherein the victim is a recipient of multiple injuries, the determination physician, then the offender cannot be held responsible for the death. The
as to which of the injuries caused death is dependent on the testimo n y o f the offender can only be made responsible for the physical injuries inflicted
p h ysician . Th is c an b e a sc erta ine d b y on the victim and the physician must be made to answer for the death.
299
The most common lesion of the scalp is a lacerated wound. There may
or may not be involvement of the skull. Difficulty is some* times
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 301 experienced in differentiating a lacerated from an incised wound of
in some areas offering the least resistance, or in areas which have no relation the scalp. With the aid of a hand lens, the laceration shows irregular
borders and hair bulbs are preserved. Laceration of the scalp may be
with the site of the impact.
due to the impact. of a blunt force or to the sharp edges of the fractured skull. production of a pond or indented fracture is common. It may
Incised wounds of the scalp in general involve the cranium.
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 305
The force necessary may not be so strong as to produce a clean• cut
fracture of the cranium. be a result of a simple compression of the skull, as in a pingpong
ball. Fissure fracture is likely to develop around the periphery
Fractures.of the Skull:
of the dent.
Fractures of the skull may or may not be associated with injury on
the scalp, but usually there is an accompanying injury inside the cranial f. Gutter Fractures: A tangential or glancing approach of a bullet
may cause the
box. Meningeal vessels are so situated in the furrows of the cranium that production o f a furro w in the cranium. It may involve both
fracture of the cranium will always lead to laceration of the blood vessels.
the o uter and inner tables. The furro w may cause injury o n
a. Fissure Fractures:
the blood vessels causing intracranial hemorrhage or laceration
Fissure or linear fracture involves the inner and outer table. It is
of the brain.
usually caused by the impact of a blunt object and may appear as a
radiating crack from the site of the aiSplication of force and may involve g. Bursting Fractures: It is an extensive fracture running parallel
the base of the cranial fossae. to the two points
of contact, if mechanical force is applied on one side of the
b. Localized Depressed Fracture:
head, while it is pressed on the other side against a hard sub-
Localized depressed fracture is sothetimes called "Fracture a La stance, such as a wall, while the individual is standing, or against
Signature". It invariably shows the nature of the instrument that causes the hard ground or floor, when he is in a lying posture. In such
the fracture. The round face of the hammer may show a round cases the fracture may extend transversely to the base of the
depressed 'fracture in the cranium. skull. The passage of the wheel of a heavy vehicle over the head
c. Penetrating Injuries of the Skull: often causes a complete division of the skull into two parts.
Sharp-edged instrument produces clean-cut fracture of the skull. The T he d irectio n o f the b urst co rresp o nd to that in which t he
wheel passed over the head.
size and shape of the fracture may correspond to the shape of the (From: A Handbook of Medical Jurisprudence & Toxicology
wounding instrument. A gunshot produces an oval, or round hole with with State Medicine & Post-Mortem Techniques by C.C. Mallik, p.
bevelling of the inner table at the wound of entrance. The blade of
the wounding weapon may be left inside without causing trouble but 206).
complications like infection 4' Intracranial Hemorrhages:
ti Intracranial hemorrhages may occur even in the absence of a
may later develop and may cause a fatal consequence.
fracture. Hemorrhage may be present without trauma. The blood
d. Comminuted Fractures:
vessels of the brain may be diseased and may rupture spontaneously.
Comminution of the skull may develop as a result of a fissure
a. Extradural or Epidural Hemorrhage (almost exclusively due to
or a depressed fracture. The presence of comminuted fracture trauma):
is an indication of the severity of force applied or the use of a heavy Extradural hemorrhage is caused by a fracture of the skull.
weapon.
Majority o f co mminuted fractures are caused b y motor The fracture will cause laceration of the blood vessels which are
grooved at the inner table of the skull. The branches of the
vehicle accidents. In a near shot with a firearm, there is usually meningeal vessels are usually involved, the most frequent of
which are the branches of the middle meningeal vessels. The re
laceration is co mmo nly unilateral except when the fractu
extends to the opposite side.
d. Cerebral Hemorrhage:
Contre-coup laceration occurs usually directly across the point of
Cerebral hemorrhage may be traumatic or spontaneous in origin.. If
impact and fracture. Contre-coup injuries occur only when the
a person develops rupture of a blood vessel and suddenly collapses and
head is free to move at the time of the impact. If the head is held
falls on the ground producing a certain degree of head injury, it is quite
immovable the mechanism of contre-coup will not operate. A
difficult to ascertain the exact origin of the hemorrhage. A careful
frontal impact may pro-
dissection of the brain
308 LEGAL MEDICINE PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 309
II. Edemas of the Brain:
duce laceration of the cerebellum while an impact in the occipital Edema of the brain which is usually the effect of trauma may be
region may cause contre-coup laceration of the frontal. and temporal
localized or generalized.
lobes of the brain.
Brain laceration may lead to granulatio n tissue for mation and (1) Localized Edema:
ultimately to fibrosis in the absence of infection. Localized edema is observed in deep brain lacerations. The
edematous area is soft, swollen, gelatinous and yellowish -red in
Histo-pathological changes following contusion and laceration of the cerebral appearance. It is observe d in abscess and neoplasm.
cortex:
(2) Generalized Edema:
Within 3 hours — Minimal alteration of the cellular elements at the margin of This is usually associated with severe trauma of the head. The
the wound. Microglia may show slight swelling of the cytoplasm
of the dendrites. There is fracturing of the myelin sheath. Cortical brain has a swollen appearance, with flattening and b r o a d e n i n g
nerve cells may show pyknotic changes. o f t h e co n v o l u t i o n s an d d i mi n u t i o n o f t h e sizes of the
ventricle. Microscopically, t here is an intracellular, p ericellular
P y k n o t i c c e l l s b e c o m e m o r e a p p a r e n t a n d blood pigment is and p erivascular accu mu latio n o f fluid.
6 to 12 hours found between cortical neurons. Glial cells look swollen
E d e ma o f t h e b r a i n o f t h e g e n e r a l iz ed t yp e m a y a l s o be
especially oligodendroglia in the white matter and perineuronal
observed in a prolonged convulsive seizure, a sudden death due
satellite cells in the gray matter, as cerebral edema begins to
to tetanus antitoxin, an encephalitis, and in an excesssive
develop.
hydration,
Liver: Kidney:
Traumatic injury of the kidney may be due to a blow at the lumbar
The liver is one of the most vulnerable organs in the abdominal cavity region somewhere at the region of the 12th rib. It may be ruptured at the
because of its size, weight, location, friability, and fixed position. Injuries are slightest violence when it is diseased as in cases of hydronephrosis,
frequently met in cases of blow, kick, crush, fall or sometimes in sudden pyelonephritis, tuberculosis, abscess or tumo r. The kidney may also
contraction of the abdominal wall. The right lobe is more frequently be ruptured when the individual is run over by a vehicle or severely
involved than the left owing to its size and exposed location. Rupture is crushed from a fall.
usually transversely or anteroposteriorly. On account of its extreme
vascularity, the victim usually dies of severe hemorrhage, shock and very rarely Injury of the kidney is acco mpanied by perkenal hemato ma wh i c h
co n s is t s o f b lo o d a nd ur in e. D ea t h i s d ue to a se ver e he mo rrhage,
of supervening infection. Sometimes recovery occurs after slight laceration but
lo ss o f k id ne y functio ns a nd sho ck. Ab d o mi nal hemorrhage is
occasionally, abscess develops.
present only if there is injury to the peritoneum concomitant to the
lesions in the kidney.
The adrenals may be contused , crushed or lacerated by severe
violence. The right is more prone to injury of its vulnerable
location.
"Crush syndrome" -- These are secondary kidney changes in
crush injuries. Edema and anuria follow a crush. If death super-
320 LEGAL MEDICINE
venes, the kidneys are found to be swollen, pale with mark degeneration of the PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 321
cells lining the tubules (Taylor's Principles & Practice of Medical
Jurisprudence by Simpson, 12th ed., Vol.
p. 332). may be lacerated during parturition.
Pancreas:
3 EXTREMITIES:
The pancreas may be injured by a violent blow at the epigastric region. Death Physical injuries on both upper and lower extremities are usually
may be due to hemorrhage, shock, or insulin insufficiency. If death does due to direct violence, crushing or some indirect force.
not occur immediately, fat necrosis is observed in the abdominal cavity on
a. Direct violence will result in a contusion and when the force
account of the leakage the lipolytic enzyme.
applied is severe it may cause interstitial muscular hemorrhage and
Spontaneous hemorrhage of the pancreas is frequently observed in the tropics.
Its exact cause is still a matter of medical research fractures of the underlying bone. Direct violence may be due
to a fall, a vehicular accident, or a direct application of
4. PELVIC INJURIES: force.
Fracture of the pelvic bones, especially of the pubis, is common in vehicular b. Indirect violence, such as twisting or pathological fracture of the
accidents and crush injuries. Separation of the symphysis may be observed bone underneath, causes laceration of the muscles around with
without any external sign of injury. The patient may show difficulty of marked hemorrhage. A patient may suffer deformity,
locomotion, and to a certain degree, damage to the urinary bladder. shortening of the extremity and shock.
Urinary Bladder: c. Crushing injuries of the limb can result in severe soft tissue
The bladder may be involved in a blow, crush, or kick at the hypogastrium trauma and are most commonly caused by vehicular accidents
especially when distended with Urine. Among parturient women, the or fall of heavy materials. These are usually accompanied by
bladder may rupture in the course o delivery. It may also be involved in fractures marked swelling, comminution of the bone and extravasation
of the pubic bone Spontaneous rupture is rare when it is over-distended due to of the blood.
urethal stricture, enlargement of the prostate, or tumor. Symptoms of rupture of Contusions and abrasions are frequent lesions of the extremities.
the bladder are pain, tenderness at the lower portion of the abdomen, bloody Lacerated wounds are commonly observed in portion where the
urine, difficulty in urination and rigidity of the abdominal muscles. 'Death bones are superficially located as in the anterior aspect of the leg.
may be due to shock or super-imposed infection. Incised and punctured wounds of the hand are quite common on
Uterus: account of its utility and movability.
Crushing injury of the extremities may cause laceration of the
A non-gravid uterus is rarely involved in pelvic injuries, but a gravid uterus is
likely to be ruptured in a blow, kick, or crush injuries. Spontaneous rupture of the
blood vessels and nerves. Injury of the intima of the blood vessels
uterus is commonly observed among pregnant women due to the injudicious use causes thrombus formation and in severe cases aneurysm may
of drugs or abnormal presentation. Partial separation of the Placenta may be develop. Extravasation of the blood into the muscles causes swelling
spontaneous or due to trauma. Death is due to shock, hemorrhage, peritonitis or and pain.
septicemia. Fracture of the bones may be due to a direct violence, an
indirect violence or a muscular action.
Vagina
Injury of the extremities may cause shock, hemorrhage and
Laceration of the vagina may be due to a sexual act or a faulty instrumentation to infection. The shock is principally due to the injury on the nerve,
induce a criminal abortion. The vaginal wall hemorrhage and fracture of the boles. Infection may be severe
and may require amputation of the extremities.
DEATH OF PHYSICAL INJURIES CAUSED BY EXPLOSION 323
Classification of Explosion as to the Source of Energy: (1) Low Order Explosive (Deflagrating Explosive) — Those which
rel y on burning and confinement to produce ex plosions. When
1. Mechanical (Hydraulic) Explosion- This occurs when the pressure inside a the reaction is confined, the built-up of heat and pressure causes the
container exceeds its structural strength. Explosions of air pressure tanks for reaction rate to increase rapidly to an explosion. Gunpowder is the best
cleaning or paint spray, water pressure tanks to establish water pressure, known low order explosive. When sufficiently heated the nitrate
and the air pumped kerosene burner are examples of mechanical content is decomposed to nitrite and oxygen. The oxygen reacts
explosions. These explode when the pressures applied are in excess of the with sulfur and carbo n p rodu cin g su lfu r o xi de, su lfur d io xi de,
strength of the containers. As the container disintegrates, there is a rapid carbon mo no xi d e an d carb on di o xi d e in vari o u s
localized increase in pressure resulting in the characteristic explosive sound. co mb i n at io n s.
(2) High Order Explosive - This is the kind that detonates.
2. Electrical Explosion- When electricity arcs through the air, a phenomenon Detonation is a chemical process which results in the extremel y
that occurs when two objects of different electrical potential are brought close rapid decomposition of nitrogenous compounds. Releasing heat
to one another, a large amount of heat develops. This heat rapidly expands the and gas is its reaction by-product. It is the shock wave spreading
air in and around the arc which produces the popping sound of an arc. out of the explosion that causes the destructive effect of high
Lightning though it occurs in a much complex form with extremely high explosive. Dynamite is an example of a high order explosive.
temperature, may be an example of an electrical explosion. (a) S tabl e High Order Exp los ive - Th is co mpoun d wil l not
3. Nuclear Explosion- The release of a significant amount of energy by fusion detonate unless they are subjected to detonation. This
or fission and consequently with a significant increase of destructiveness. includes dynamite (nitroglycerin made stable by clay
absorption).
Atomic Explosion- Atomic nuclei can be regarded as stored condensed
(b) Unstable High Order Explosive- Easily detonates from heat,
energy. The uncontrolled release of this energy constitutes atomic
flame, spark or percussion. This includes trinitrob en zen e
explosion. (P i cri c aci d ), fu l mi n at e o f mercu r y, l ead , an t i mo n y o r
4. Chemical Explosion- Chemical explosion occurs when a chemical reaction b i s mu t h an d n i t ro g l yc e ri n e (C l i n i cs i n
produces heat and gas at a rate faster than the surroundings can dissipate. At
the start of the reaction the initial heat or gas
324 LEGAL MEDICINE
DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 325
million tons of TNT. It produces millions of pounds per square inch of in air can cause fire of up to a 10 miles radius. The pressure front of the
gas pressure, with heat comparable to the sun and light of more than 30 blast can be felt one mile away in 2 seconds time. The blast wave is of
times as bright as the sun at noontime. After ex plosion, it produces a sufficiently long duration which is accompanied by transient blast
luminous ball of fire containing radioactive fission products, which increases winds causing damages to the people and the sur rounding structures.
upward in size and creates shock waves moving sidewards in all directions. The Other effects of atomic explosion are the same as that of ordinary
fireball may have the diameter of 7,200 feet in ten seconds and in one minute chemical bomb explosion but of a much more severe intensity.
time it may reach a height of 4-1/2 miles. Aside from the immediate traumatic effects, the radiation emitted by the
Place of Atomic Explosion: radio-active substances can also have an effect which may be local or
1. Aerial Explosion — The bomb is made to explode on the air. general.
2. Ground Explosion — Explosion is made when the bomb reaches the 1. Gen e ra l Ef fec t s:
ground. Massive dose causes generalized erythema, disorientation
3. Submarine Explosion -- Explosion takes place underneath the surface of followed by coma and death.
a body of water. Lesser dose may-cause nausea, vomiting followed by prostration and
rapidly developing and persistent leukemia.
Rays Emitted by Radioactive Substances During Explosion:
Later symptoms may develop in the form of rise of temperature,
1. Alpha Rays — Composed of positively charged helium, having a high ulceration of lymphoid, easy fatigability, oro -pharyngeal ulceration
linear energy transfer and with a poor penetrating power that can be and severe leukopenia.
stopped by a sheet of paper.
2. Local Effects:
2. Beta Rays — Composed of positively or negatively charged electrons with a
a. Individual Cells — It causes retardation of cell division, structural changes
higher penetrating power than the alpha rays but the ionizing power is much
in the chromosomes and cytoplasm, vacuolization, and with evidence
less. The electrons are travelling at a very high velocity and in some cases of maturation. There is loss of the supporting mesenchymal cells.
approaching the speed of light. b. Skin — Epilation of the hair with the follicles remaining intact, sweat
3. Gamma. Rays — Composed of short rays with high energy and greater glands lose their function, erector pili muscles not much affected. The
penetrating power and like neutrons it extends a significant distance and skin become edematous and later disquamated and ulcerated.
causes much damage to the human body. Radiation dermatitis is persistent, usually painful with patchy
4. Neutron Rays — Uncharged and composed of highly penetrating particles keratitis and foci of ulceration. Hyperpigmentation or
and basic element in nuclei of atoms. depigmentation may later develop.
Characteristics of Nuclear Bomb Explosion that Distinguishes it from c. Bloofl Vessels — There is endothelial necrosis and localized
Conventional High Explosive Bomb Explosion: thrombosis. The blood vessels thicken because of the hyalinization
of the collagen. Some blood vessels are occluded with the loss of
1. It is many thousand times as powerful as a highly conventional. bomb the muscular layer.
explosion and the effects of the blast are very prominent. •
2. A large proportion of its energy is emitted as thermal radiation, causing d. Eye -- Cataract develops.
skin burns and it is capable of starting a fire at a con siderable distance. e. Genital Organ — In female it causes sterility, abortion or stillbirth. In
3. The explosion emits a highly penetrating and harmful radiation, '"and the men, it also causes sterility without loss of sexual potency.
substance vihich remains after the explosion continues to emit radiation over Factors Responsible for the Effects of Radiation:
a long period of time. 1. Age — Children and old persons are more susceptible to radiation.
(Forensic Medicine by Tedeschi, Eckert & Tedeschi, Vol. 1, p. 633). Dosage — Bigger dose of radiation will cause more damaging effects
Effects of Atomic Explosion to the Human Body: on the body tissues.
The effects of atomic explosion of the human body are inversely
proportional to the distance. One megaton of atomic bomb exploded
334 LEGAL MEDICINE b. Rifle — Firearm which may be fired from the shoulder. Example:
Shotgun.
4. As to the Nature of the Magazine:
a. Cylindrical Revolving Magazine Firearm — The cartridge is
Art. 155, Revised Penal Code: located in a cylindrical magazine which rotates at the rear
portion of the barrel.
Alarms and Scandals: Example: Revolver.
The penalty of arresto menor or fine not exceeding 200 pesos shall be b. Vertical or Horizontal Magazine — The cartridge is held one
imposed upon: after another vertically or horizontally and also held in place
1. Any person who within any town or public place, shall discharge any by a spring side to side or end to end.
firearm, rocket, firecracker, or other explosive calculated to cause alarm
Example: Automatic Pistol.
or danger;
2. . . . . . . . . . . . . . . . . . . . Types of Small Firearms which are of Medico-legal Interest:
1. Revolver — A revolver is a firearm which has a. cylindrical ma gazine
Art. 254, Revised Penal Code:
situated at the rear of the barrel, capable or revolving motion and
Discharge of firearms: which can accommodate five or six cartridges; each of which is
Any person who shall shoot at another with any firearm shall suffer the housed in a separate chamber. After a shot, the circular magazine
penalty of prision correctional in its minimum and medium periods, unless the ro tates b y the co ck in g o f the ha mmer in a wa y that t he next
facts of the case are such that the act can be held to constitute frustrated or cartridge is brought in the proper position for firing. The usual
attempted parricide, murder, homicide or any other crime for which a muzzle velocity of a revolver is 600 feet per second.
higher penalty is prescribed by any of the articles of the code: Kinds of Revolver as to Construction or Mechanism:
Classification of Small Firearms: a. Revo lver with the barrel firmly fixed to the frame and the
revolving cylinder may swing out to the side for the purpose
Small firearms are those which propel projectile of less than on e inch
of loading or extraction of the spent shell.
in diameter.
b . Revolver with the barrel hinged to the frame and the revolver
1. As to Wounding Power:
cylinder may be broken to load by releasing the barrel latch.
a. Low Velocity Firearm — These are firearms with muzzle velocity of
not more than 1,400 feet per second. c. Revolver with barrel firmly fixed to the frame and the revolving
cylinder may be remo ved by taking out the cylinder pin o n
Example: Revolver.
which it rotates.
b. High Power Firearm — These are firearms with muzzle velocity of more
2. Automatic Pistol — This is a firing weapon in which the empty
than 1,400 feet per second. The usual muzzle velocity is 2,200 to 2,500
shell is ejected when the cartridge is fired and a new cartridge is
feet per second or more.
slipped into the breech auto matically as a result of the recoil.
Example: Military Rifle. The cartridge is contained in a vertical magazine which holds six
2. As to the Nature of the Bore: to seven cartridges. It is not automatic in action in the sense that
a. Smooth Bore Weapon — This firearm has the inside portion of the barrel a continuous pressure o n the trigger will not make the f irearm
that is perfectly smooth from the firing chamber to the muzzle. fire co ntinuously. It is more correct to call it a "self -loading
firearm." It has a usual muzzle velocity of 1,200 feet or more per
Example: Shotgun, second.
b. Rifled Bore Firearm — This is a firearm with the bore of the barrel
with a number of spiral lands and grooves which run p arallel wi th 3. Rifle — A rifle is a firearm with a long barrel and butt. It may be a
o ne ano ther, b ut t wisted sp ir ally fr o m b reech to muzzle. military rifle or a miniature rifle. A military rifle has a magazine and
volt action of various types. The miniature rifle is a single self-
Example: Military Rifle. loading weapon. A military rifle usually has a muzzle velocity
3. As to the Manner of Firing:
a. Pistol - Firearm which may be fired only by a single hand. Example:
Revolver
336 LEGAL MEDICINE GUNSHOT WOUNDS 337
of 2,500 feet per second and a range of 3,000 feet. Unlike a revolver or d. Belted Cartridge — The cartridges are attached in a series in a canvass
automatic .pistol which can be fired by a single hand, a rifle is fired from a shoulder. belt for successive fires.
4. Shotgun — A shotgun is a firearm whose projectile is a collection of lead pellets 2. Primer:
which varies in sizes with the type of the cartridge applied. The primer compound is located and sealed at the cartridge base
A Weapon, In Order to Cause Injury -must have Two Principal Component Parts, covered by a small disc of soft metal, which is usually a lead-tin alloy known
Namely: as percussion cap or primer cap. The main function of the primer is the
1. The Cartridge or Ammunition — a complete unfired unit consisting of bullet, transformation of mechanical energy by the hit of the firing pin on the
primer, cartridge case and powder charge. percussion cap to chemical energy by its rapid combustion. As the
2. The Firearm — the instrument for the propulsion of a projectile by the expansive firing pin hits the primer cap (percussion cap), the primer compound hits
force of gases from a burning gunpowder. the anvil which causes the generation of a flash which in turn ignites the
powder. The time of the primer activation is approximately 0.00001
second.
CARTRIDGESORAMMUNITION
Although, there are variations in the chemical constituents of the
The Principal Parts of a Cartridge or Ammunition are: primer in the past, it is composed of a mixture of mercury fulminate,
1. The cartridge case or shell. stibnite (antimony sulfide), potassium chlorate and powdered glass.
2. Primer. Later, mercury fulminate is partially or completely replaced by lead
azide and lead stypnate together with potassium chlorate which are
3. Powder or propellant. replaced by barium nitrate to reduce the development of rust. Lead
4. Bullet or projectile. stypnate is utilized as base, tetracene is sometimes added to control
1. Cartridge Case or Shell: sensitivity and barium nitrate acts as moderator and oxidizer. The most
common constituents of primer are lead, antimony and barium.
The cartridge case or shell is a cylindrical structure with a base which houses
the powder, the primer at the base and with the bullet attached at the tip. In As to the location of the percussion cap at the base, cartridge may be:
ordinary hand guns the cylindrical structure is made of brass while in shotguns it a. Cartridge with Center Fire — The percussion cap is located at the
is usually made of cardboard. The base is always made of metal. Inscription at center of the base of the cartridge. This is the most com mon.
the base may show the manufacturer, the caliber and even the date it was b. Cartridge with Rim Fire -- The primer is placed inside the rim of the
manufactured. shell. This is common in 0.22 caliber firearms.
Depending upon the relationship of the diameter of the base with that of the
cylindrical portion, a cartridge may be classified as:
c. Firearm with Pin — The firing pin strikes a needle which is placed at
the rim of the shell. The needle will then press on the percussion cap
a. Cartridge With a Rim — The base of the cartridge has a diameter more than which is inside the cartridge. This type is obsolete and now rarely
the cylindrical portion. The rim is used to prevent cartridge from going found.
through the barrel. This is common among revolvers.
b. Rimless Cartridge — The base or head of the cartridge has the same diameter 3. Gunpowder or Propellant:
as that of the cylindrical body. There is a groove cut between the base and the The propellant is the primary propulsive force in a cartridge which
cylindrical body for the extractor to hook into. This is usually found in self- when exploded will cause the bullet to be driven forward towards the
loading firearms. gun muzzle.
c. Semi-rimless Cartridge — This looks like a rimless at first glance but actually There are Different Types of Powder Propellant Used:
the rim does project very slightly above the line of the cylindrical part. a,--Black Powder — A, mixture of potassium nitrate (75%), sulfur (15%)
and charcoal (10%).
GUNSHOTWOUNDS 339
338 LEGAL MEDICINE
Explosion of one grain of black powder (one grain= 0.065 gm.) will
produce 200 to 300 cc. of gas composed of carbon dioxide (50%),
carbon monoxide (10%), nitrogen (35%) , Hydrogen sulphide (3%) and
traces of methane and oxygen. The solid residues following its
combustion are pota-ssium sulphide, potassium carbonate together with
its original components.
b. Smoke Powder – It may be:
(1) Single base – When it contains either cellulose nitrate or
nitroglycerine.
(2) Double base- When the powder is composed of both cellulose nitrate
and nitroglycerine.
Explosion of one grain (one grain = 0.065 gm.) of smokeless powder
will cause the development of 800 to 900 cc. of gas consisting of carbon
dioxide, nitrogen, hydrogen with some unburnt powder in the form of
nitrate and cellulose nitrate which can be detected chemically.
c. Semi-smokeless Powder — This is a mixture of 80% of black and 20% of
the smokeless powder. Bullets lodged and extracted from a victim
Smokeless powder causes development of less flame and less powder of rubber, plastic, or even paraffin, but their uses are primarily
residue as compared with black powder. confined to target practice.
There is more complete burning of gunpowder in smokeless as
compared with the black powder. Classification:
Inasmuch as the gas produced by combustion of smokeless powder is a. Shape of the free end:
three times more than the black powder, the muzzle velocity of bullets with (1) Conical — The free end of the bullet is tapering and pointed.
smokeless powder is also approximately three times greater than the bullets The purpose is to minimize the resistance offered by the Atmosphere,
to increasing its penetrating power and to minimize deflection
using black-powder.
upon hitting the target.
Smokeless powder granules are usually coated with graphite and
(2) Hemispherical — The free end is dome-like and commonly
consequently form different shapes. They may appear as a ball, square,
observed in short firearms.
cylinder, disc or flakes. Consequently when discharged from the
(3) Wad-cutter (Square Nose) — The free end is flattened
firearm after explosion they will cause individual shapes of tattooing.
The flake or disc shape powder may cause varying shapes of the tattoos commonly used in target practices.
depending upon how the grain struck the skin. Ball powder may cause (4) Hollow-point — There is a depression at the tip to expand or
small, hemorrhagic punctate marks. The cylindrical shape powder "mushroom" at impact on hard object, to slow its speed in the
body so that more kinetic energy will be released thereby
grains may cause heavy tattooing with deposition of soot at 6 inches
increasing its shocking effect.
range.
b. As to presence or absence of jacket:
4. Bullet (Slug, Missile, Projectile): (1) Naked Lead Bullet — Bullet without outer coating.
It is the metallic object attached to the free end of the cylindrical tip (2) Jacketed Bullet — Bullet with external coating usually
of the cartridge case, propelled by the expansive force of the propellant, and copper, nickel, steel or zinc. The purpose of the coating are to:
responsible in the production of damages in the target. In some instances (a) To prevent fouling of the barrel;
bullets are not metallic but made
FIREARM
ola&
3. Breechblock — The steel block "Hair trigger" is a vague term used when the firearm trigg
which •
closes the rear of the bore against the pressure is 1.0 lb. (pound) or less. It is intrinsically unsafe an should
force of the . . . 0 " charge. The face of this block which comes in
...." only be used under rigorously controlled situations becau of the
.../.1
contact with the base of the cartridge is known as the possibility of unintended or accidental fire.
breech-face, In general, the single action firearm varies from 3-1/2 to 10
0.
4. Trigger Guard. pounds and in double action, it varies from 6 pounds to as much as
6. Front and Rear Sight. 18 pounds. The following are the approximate trigger pressures of
6. Safety Device like safety lock. certain types of firearms.
7. Sling. In a Self-loading Firearm, the following are the Additional a . S h o tg u n . . . . . . . . . . . . . . . . . . . . 4 lbs.
b . Self-loading pistol ...... 3 to 4 lbs.
Parts: c . Revo lver ................... 3 to 5 lbs.
d . Service rifle ................. 6 to 7 lbs.
1. Extractor — The mechanism by which the spent shell or ammunition is
withdrawn from the firing chamber. Cr 2. Barrel:
2. Ejector — The mechanism by akwhich the
0 U) empty shell or a. Riflings:
ammunition is thrown from the U) firearm. 0
MAGAZINE SPRING
Instances When the Size of the Wound of Entrance Do Not Approximate the GUNSHOT WOUNDS 359
Caliber of the Firearm:
In distant fire, the rule is that the diameter of the gunshot wound of Factors which 'make the wound of entrance smaller than the
entrance is almost the same as the caliber of the wounding firearm, but in the caliber:
following instances, the rule is not followed: a. Fragmentation of the bullet before penetrating the skin — If in the
1Factors which make the wound of entrance bigger than the calib,e1 flight of the bullet it hits a hard target which causes its
fragmentation and only the fragments pierce the skin, the
a. In contact or near fire- The size of the entrance wound in contact
wound produced will be smaller than the caliber of the firearm
and near fire is caused by the force of the expanded gases of explosion
which causes the fire.
and by the bullet.
b. Contraction of the elastic tissues of the skin The form of the —
b. Deformity of the bullet which entered- The bullet might have hit a hard bullet may be preserved but the entrance wound may be smaller
object before it pierces the skin thereby making the wound of entrance than the caliber on account of the contraction of the elastic
bigger than the caliber of the missile. tissues of the skin.
c. Bullet might have entered the skin sidewise- Ordinarily, it is the In shotgun fire, the size of the wound of entrance is dependent
ogival portion which pierces the skin first, but occasionally it may hit u p o n t h e d i s t a n c e o f t h e fi r e . N e a r f i r e c a u s e s c o n c e n t r a t i o n of
the skin sidewise on account of the inequality of resistance of the entry of the pellets, and as distance increases the pellets dis perse
surrounding media in its flight. The spinning movement and the tail wag with individual pellets causing individual wounds of entry. O nl y i n
(wobble) may cause the bullet to enter in as vertical axis. th i s i n st a nce ma y t he wo u nd o f e n tra nc e o f t he sa me size as the
gauge of the shotgun pellets.
d. Acute angular approach of the bullet - Due to the sliding trajectory
of the bullet, the wound becomes oval in shape with prominence of the
contusion collar at the side of the acute angle of approach. Other Evidences or Findings Used to Determine Entrance of Gunshot:
When the course of the bullet is through and through and there is
difficulty in the determinatio n as to which is the entrance because
it does not show characteristic findings, or it has been modified by
healing, infection or surgical intervention, the medical examiner must
resort to the following:
made another wound of entrance in some other parts of the Instances when the Number of Gunshot Wounds of Entrance is
body; thus a single shot may produce two wounds of entrance. More than the Number of Gunshot Wounds of Exit in the Body
3. Number of Shots Heard by Witnesses: of the Victim:
The witnesses might be able to count the number of shots heard I. When one or more bullets are not through and through and the
especially if the shots were made at sufficient intervals of succession. bullet is lodged in the body.
However in cases of machine gun fire, there is difficulty in ascertaining 2. When all of the bullets produce through and through wounds but
the number heard and the testimony of witness as to the number one or more made an exit in the natural orifices of the body, e.g.
of shots heard must be admitted with caution. eyes, mouth, nostrils.
3. When different shots produced different wounds of entrance
but two or more shots produced a common exit wound.
Instances when there is No Gunshot Wound of Exit but the
Bullet is Not Found in the Body of the Victim:
1. When the bullet is lodged in the gastro-intestinal tract and expelled
through the bowel, or lodged in the pharynx and expelled through
the mouth by coughing.
2. Near fire with a blank cartridge produced a wound of entrance
but no slug may be recovered.
3. The bullet may enter the wound of entrance and upon hitting
the bone the course is deflected to have the wound of entrance as
the wound of exit (cited by Modi, A Textbook of Medical Juris -
prudence & Toxicology, 10th ed.).
may nor cause any problem to warrant its immediate removal. of the mouth, precordial or epigastric region. A person
2. Bullet Migration: committing suicide will do the act in his most convenient way,
Bullet that is not lodged in a place where it was previously located. A unless he has the intention of deceiving the investigator.
bullet which strikes the neck may enter the air passage, and it may be coughed 5. The shot is usually solitary, If the shot is made on the head
out or swallowed and recovered in the stomach or intestine. involving the brain, the shocking effect of the injury will not
Bullets Embolism — a special form of bullet migration when the bullet make him capable of firing another shot. However, shots in some
loses its momentum while inside the chamber of the heart or inside the big parts of the body which may not produce immediate death Or
blood vessels and carried by the circulating blood to some parts of the body sudden loss of consciousness, the possibility of additional shots is
where it may be lodged. It may cause sudden loss of function of the area not remote. The victim may be determined to die and had fired
supplied or death if vital organs are involved. additional shots to insure realization of his intentioq.
6. The direction of the fire is compatible with the usual trajectory of
3. Tandem Bullet: the bullet considering the hand used and the part of the body
Two or more bullets leaving the barrel one after another. In • involved, A shot on the temple is usually directed towards the
cases of misfire or a defect in the cartridge, the bullet may be opposite temple and upwards, while a shot in the precordium and
lodged in the barrel and a succeeding shot may cause the initial and the epigastrium is usually backwards and downwards.
succeeding bullet to travel in tandem. There is a strong possibility for' 7. Personal history may reveal social, economic, business or marital
them to enter the target in a common hole. This might create doubt to the problem which the victim cannot solve ` He may have history
statement made by the firer that he made only a single shot, but ballistic of mental disease, depression, severe frustration or previous
examination can show as to whether the bullet travelled in tandem. attempt of self-destruction.
8. Examination of the hand of the victim may show presence of
gunpowder,
9. Entrance wound do not usually involve clothing
370 LEGAL MEDICINE GUNSHOT WOUNDS 371
10. Fingerprints of victim on the butt, 5. Location of the missile, if lodged in the body.
11. Search of the place where the shot took place may reveal a suicide 6. Diagram, photograph, sketch, or drawing showing the location and
note, which usually mentions among other things the reason why the number of wounds.
victim committed suicide.
12. No disturbance in the place of death. Questions that a Physician is Expected to Answer in Court:
Russian Roulette: 1. Could the wound or wounds be inflicted by the weapon presented to
him?
A group of persons may agree to load a revolver with a single live
cartridge and each member of the group will cock and pull the trigger with the 2. At what range was it fired?
muzzle pressed or directed to the temple or towards other vital parts of the 3. What was the direction of the fire?
body. The person who will pull the trigger with the live cartridge in the 4. May it be possible that those gunshot wounds are self-inflicted?
firing chamber will suffer the fatal consequence. Although it may be 5. Are there signs of struggle in the victim?
considered suicidal because any person who participates to such an 6. May it be possible for the victim to fire or resist the attack after the
agreement may have the desire to commit it, the unfortunate victim has injury was sustained by him?
no predetermined desire of self-destruction.
7. Did the victim die instantaneously?
Evidences to show that the Gunshot Wound is Homicidal: 8. Where was the relative position of the assailant and the victim when
1. The site or sites of wound of entrance has no point of election. the shot was fired?
2. The fire is made when the victim is usually at some distance from assailant.
3. Signs of struggle (defense wounds) may be present in the victim. Can the Caliber of the Wounding Firearm be Determined from the
4. There may be a disturbance of the surroundings on account of previous Size of the Gunshot Wound of Entrance?
struggle. Although the size of the gunshot wound of entrance is influenced by
5. Wounding firearm usually is not found at the scene of the crime. several factors, the caliber may be inferred from the diameter of the
gunshot wound. In most cases, especially when the 'wound is circular,
6. Testimony of witnesses.
the caliber is almost the same as the diameter of the wound of entrance.
Evidences to show that the Gunshot Wound is Accidental:
1. Usually there is but one shot. Determination of the Length of Survival of the Victim,:
2. There is no special area of the body involved. The length of survival of the victim may be inferred from the
3. Consideration of the testimony of the assailant, and determination as to following:
whether it is possible to be accidental by knowing the relative position of
1. Nature of the gunshot wound.
the victim and the assailant.
4. Testimony of witnesses. 2. Organs involved.
3. Presence or absence of infection or other complications.
•
Points to be Considered and Included in the Report by the Physician: 4. Amount of blood loss.
1. Complete description of the wound of entrance and exit. 5. Physical condition of the victim.
2. Location of the wound:
a. Part of the body involved. Capacity of the Victim to Perform Volitional Acts:
b. Distance of the wound from the mid-line. The power of the victim to perform voluntary acts depends upon the
c. Distance of the wound from the heel or buttock. area of the body involved, involvement of vital organs, and the resistance
of the victim. Injuries which will cause incapacity to do voluntary acts as
3. Direction and length of the bullet tract.
those involving the brain and the spinal cord definitely inhibits
4. Organs or tissues involved in its course.
volitional acts.
372 LEGAL MEDICINE GUNSHOT WOUNDS 373
Determination as to the Length of Time a Firearm had been Fired: Determining Whether the Wounding Weapon is an Automatic Pistol or
Physical and chemical examinations of the residue inside t barrel does a Revolver:
not give a conclusive evidence as to how long t firearm has been The following must be taken into consideration to determine
discharged. Most often the examiner does n know whether the barrel whether the wounding weapon is an automatic pistol or a revolver:
was cleaned immediately after the d charge. Smokeless powder which is 1. Location of the Empty Shells:
now commonly used does n leave much residue for such determination. In a revolver, the empty shells are found in the cylindrical
However, inference may be drawn from the following: , magazine chamber after the fire, but in cases of automatic pistol the
1. Odor of the Gas Inside the Barrel: empty shells are driven out of the weapon after the shot, to give
Explosion of the gunpowder produces considerable evolution o gases way to live cartridge to be in the firing chamber. Thus, in cases of
consisting of nitrogen, hydrogen sulfide, carbon dioxid carbon automatic pistol, the empty shells are found a few yards away from the
monoxide and methane. This mixture of gases has peculiar place of the firing.
characteristic odor which may be noticed several hour after the discharge. 2. Nature of the Spent Bullet:
Later, it will disappear as gases usually evapo rate or chemically As a general rule, in automatic firearm, the bullet is copper
transformed to other odorless compounds. jacketed or cupro-nickel jacketed, while in cases of revolver, no such
2. Chemical Changes Inside the Barrel: coating is observed. This is not true in all cases.
Black powder is a mixture of charcoal, sulfur and nitrates of sodium 3. Nature of the Base of the Cartridge or Spent Shell:
or potassium. One of the products of combustion is hydrogen sulfide.. The base of a revolver has a wider diameter than that of the
Hydrogen sulfide is rapidly converted to thiosulfate, thiocyanate and cylindrical body to keep the cartridge stay in the magazine chamber.
finally to sulfates of potassium or sodium. The absence of the peculiar There is no such difference in the diameter in case of shells of
characteristic odor and the presence of thiosulfate and thiocyanate automatic pistol.
which is increasing in amount shows that the discharge occurred in a
matter of few days. Later the thiosulfate and thiocyanate of sodium or Can the Direction of the Shot be Determined from the Direction from
potassium will be chemically transformed to sulfates and its presence which the Sound Came From?
shows that firing occurred for sometime, Not possible, unless the flash or the person firing the shot is seen at
The iron salts in the ferrous state are found during the early stage and the time e shot was fired. T e ear is usually at a loss as to where
may be transformed to ferric salt after a lapse of a certain period. the shot was fired.
The residue produced by smokeless powder explosion as nit rates are
not liable to undergo changes even after a lapse of time, hence Can the Firearm be Identified by the Sound of the Discharge?
approximation of the time of the discharge is much more difficult. It is impossible to distinguish and memorize the report from two
firearms of the same caliber. It may be possible for a person who is
The main difficulty in the determination is that the length of such accustomed to the sounds of firearms of different calibers to identify the
physical and chemical transformation of the residue of combustion firearm by the sound produced.
from one compound to another, cannot be definitely ascertained. It is Example: The sound of a shotgun may be distinguished from the
dependent upon several factors. sound of a caliber 0.22 pistol.
3. Evidences that may be Deduced from the Wound:
Approximation of the age of the wound also infers the time of Gunshot Wound may Not be a Near Fire or may Not Appear to be a
Near Fire:
discharge. The degree of healing in the absence of su bsequent infection
1. When a device is set up to hold the firearm and to enable it to be
must be considered. If an infection is present, then the degree of infection
discharged at a long range by the victim.
may be utilized in the approximation. 2. When the gunshot wound of entrance does not show characteristics of
a near shot because the clothings are interposed between the victim
and the firearm.
GUNSHOT WOUNDS 375
374 LEGAL MEDICINE
3. When the examining physician failed to distinguish between a ne or far shot 2. Expression of the Bore Diameter in Inches — The 0.410 bore
wound. shotgun is the only shotgun at present to be so designated.
4. When the product of a near shot has been washed out of th wound. 3. Metric System — The bore is expressed in millimeters.
DETERMINATION OF THE PRESENCE OF region of the gunshot wound of entrance, on the dorsum of the
GUNPOWDER AND PRIMER COMPONENTS hands or at the outer surface of the wearing apparel of the victim.
This examination is not conclusive because other foreign particles
The Importance of Determining the Gunpowder on the Skin of the Victim: may be mistaken for gunpowder or primer components.
1. Determination of the distance of the gun muzzle from the victim's 2. Microscopic Examination:
body when fired: Fine particles may be magnified but there are no characteristic
As discussed previously, the explosion of the powder in the cartridge shape, color or consistency of gunpowder.
expels particles which may be embedded in the skin or just clinging on the
surface at a distance of not more than 24 inches. The distribution of the 3 Chemical Tests:
gunpowder is more at the upper portion of the wound of entrance, due to a. Laboratory Test to Determine Firearm Residues:
the upward position of the muzzle of the gun when fired. The presence of There is inference of contact or near distance of the gun muzzle
gunpowder at or near the wound of entrance shows that the gun muzzle to the skin when there is burning, tattooing and smudging visible through
when fired is not more than 24 inches but its absence will not preclude the naked eye. The burning and then the tattooing will gradually
near fire because other factors might have intervened. Less powder disappears as the muzzle distance increases. The powder tattooing will
particles at the wound of entrance is observed in smokeless powder as gradually spread out to a greater area until it is no longer detectible.
compared with black powder. Minute particles of burning and unburned residues and the primer
2. Determining whether a person has fired a firearm: constituents can be detected in the laboratory.
The dorsum of the hands are the ones examined to deter mine the The same tests may also be applied on the dorsum of the hand
presence of gunpowder. When a person fires a gun, the powder particles of the persons suspected to have fired the gun. Although the test is
which escape may cling on the dorsum of the hand. The presence of not conclusive, it may be a corroborative evidence in the
gunpowder at the dorsum of the hand may infer that a person has fired a determination as to whether a person has fired a gun.
gun. The tests may involve the determination of the presence of
Basis of the Tests: gunpowder residues of primer components.
When a gun is discharged two types of residues are liberated namely, the Tests for the Presence of Powder Residues:
metallic residues from the primer which is not only blown forward towards
1. On the Skin (Dorsum of the Hand or Site of the Wound
the target from the muzzle but also backward in the direction of the
shooter, and also the particles of burned, burning and unburned gunpowder of Entrance):
(propellant) moving also in the same direction; as the metallic residue of - Dermal nitrate test (Paraffin test, Diphenylamine test, Lung's
the primer. All of these residues are deposited on the back of the firing test or Gonzales' tests) — The back of the fingers and of the hand
hand of the shooter. up to the region of the wrist is coated with melted paraffin, heated
Detection of metallic residue of the primer on the palm of the hand may at a temperature of 150 degrees Fahrenheit. To avoid heat injury
also indicate that the individual was making a defensive movement, such as to the skin, a low melting point paraffin is used. The melted
trying to ward off or grab the weapon at the tittle of the discharge. In paraffin penetrates the minute crevices of the skin and when
suicide, residue may be deposited on the palm of the hand used to steady hardened and cooled off, some of the powder particles will be
the barrel at the time of the .discharge. extracted and embedded in the paraffin cast. After the cast is
built with layers of cotton and paraffin to a thickness of about 1/8
Procedures in Determining the Presence of Gunpowder: inch and solidified, it is then removed from the hand or from the site
1. Gross Examination or Examination with the Use of Hand Lens: of the wound of entrance and the inner aspect of the cast is treated
by means of a dropper with Lung's reagent.
Fine black powder particles of varying sizes may be seen at the
The presence of small particles containing either nitrate or nitrite
will be indicated by a blue reaction of the particles upon contact with
Lung's reagent.
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GUNSHOT WOUNDS 381