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GENERAL CONSIDERATION
^EGALM^DIClNllis a branch of medicine which deals with the
application of medical knowledge to the purposes of law and in the
administration of justice. It is the application of basic and clinical,
medical and paramedical sciences to elucidate legal matters.
Originally the terms legal medicine, forensic medicine and medical
jurisprudence are synonymous and in common practice are used
interchangeably. This concept prevailed among countries under the
Anglo-American influence.
The concept and practice of legal medicine in the Philippines is
of Spanish origin. In modern times, especially in continental Euro-
pean countries, legal medicine has a similar meaning as the term
forensic medicine, although, strictly speaking, legal medicine is
primarily the application of medicine to legal eases while forensic
medicine concerns with the application of medical science to eluci-
date legal problems. On the other hand, .medical jurisprudence
(j'uris-law, prudentia-knowledge) denotes knowledge"of lawT in rela-
tion to the practice of medicine. It concerns with the study of the
rights, duties and obligations of a medical practitioner with parti-
cular reference to those arising from doctor-patient relationship.
According to the Rules of Court (Sec. 5, Rule 138) Medical
Jurisprudence is one of the subjects in the law course before ad-
mission to the bar examination. This is based on the original concept
but actually it must be the study of legal medicine as it was the
intention and practice in the past.
v Scope of Legal Medicine:
The scope of legal medicine is quite broad and encompassing. It
is the application of medical and paramedical sciences as demanded
by law and administration of justice. The knowledge of the nature
and extent of wounds has been acquired in surgery, abortion in
gynecology, sudden death and effects of trauma in pathology, etc.
aside from having knowledge of the basic medical sciences, like
anatomy, physiology, biochemistry, physics and other allied sciences.
^Nature of the Study of Legal Medicine:
A knowlege of legal medicine means the ability to acquire facts,
the power to arrange those facts in their logical order, and to draw a
1 Examples: a. The presence of physical injuries of a victim of
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conclusion from the facts which may be useful in the administration
of justice.
Aside from being a perceptor of fact, he must possess the power to
impart to others verbally or in writing all those he has observed.
A physician who specializes or is involved primarily with medico-
legal duties is known as medical jurist, (meoical examiner, medico-
legal officer, medico-legal expert). Inasmuch as administration of
justice is primarily a function of the state, physicians whose duties
are mainly medico-legal in nature are mostly in the service of the
government. /
Health officers, medical officers of Jaw enforcement agencies and
members of the medical staff of accredited hospital are authorized
by law to perform autopsies (Sec. 95, P.D. 856, Code of Sanitation).
However, "it is the duty of every physician, when called upon by the
judicial authorities, to assist in the administration of justice on
matters which are medico-legal in character" (Sec. 2, Art. Ill, Code
of Medical Ethics of the Medical Profession of the Philippines).
To be involved in medico-legal duties, a physician must possess
sufficient knowledge of pathology, surgery, gynecology, toxicology
and such other branches of medicine germane to the issues involved.
/Distinction Between an Ordinary Physician and a Medical Jurist:
1. An ordinary physician sees an injury or disease on the point of
view of treatment, while a medico-jurist sees injury or disease on
the point of view of cause.
2. The purpose of an ordinary physician examining a patient is to
arrive at a definite diagnosis so that appropriate treatment can be
instituted, while the purpose of the medical jurist in examining a
patient is to include those bodily lesions in his report and testify
before the court or before an investigative body; thus giving
justice to whom it is due.
3. Minor or trivial injuries are usually ignored by an ordinary clinician
inasmuch as they do not require usual treatment. Superficial
abrasions, small contusion and other minor injuries will heal with-
out medication. However, a medical jurist must record all bodily
injuries even if they are small or minor because these injuries may
be proofs to qualify the crime or to justify the act.
sexual abuse may be presumptive proof that force
was applied in the commission thereof, hence the
crime committed must be rape.
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b. The presence of physical injuries on the offender of 5. Jurisprudence:

the crime of physical injuries may be a proof that the
victim acted in self-defense.
Other Definitions:
yjl. Law is a rule of conduct, just, obligatory, laid by legitimate power
for common observance and benefit. It is a science of moral laws
founded on the rational nature of man which regulates free activity
for the realization of his individual and social ends under the
aspect of mutual demandable independence. (1 S.R.)
The word "law" includes regulations and circulars which are
issued to implement a law and have, therefore, the effect of law.
^Characteristics of Law:
a. It is a rule of conduct;
b. It is dictated by legitimate power; and
c. Compulsory and obligatory to all (Civil Code by Padilla).
Forms of Law:
' a. Written or Statutory Law (Lex Scripta):
This is composed of laws which are produced by the country's
legislations and which are defined, codified and incorporated
by the law-making body.
/ Example: Laws of the Philippines,
^ b . Unwritten or Common Law (Lex non Scripta):
This is composed of the unwritten laws based on immemorial
customs and usages. It is sometimes referred to as case law,
common law, jurisprudence or customary law.
Example: Laws of England
J
2. Forensic:
It denotes anything belonging to the court of law or used in
court or legal proceedings or something fitted for legal or public
argumentations (Black's Law Dictionary, 4th ed.)
i
3. Medicine:
Medicine is a science and art dealing with prevention, cure and
alleviation of disease. It is that part of science and art of restoring
and preserving health.
The term medicine is also applied to a science and art of diag-
nosing, treating, curing and preventing disease, relieving pain,
and improving the health of a person,
z 4. Legal:
Legal is that which pertains to law, arising out of, by virtue of
or included in law. It also refers to anything conformable to the
letters or rules of law as it is administered by the court.
It is a practical science which investigates the nature, origin,
development and functions of law. It is a science of giving a wise
interpretation of the law and making just application of them to
all cases as they arise.
Judicial decisions applying or interpreting the laws shall form a
part of the Philippine jurisprudence. The decisions contemplated
are those rendered by the Supreme Court which is the final arbiter
on legal issues. However, the decisions of the Court of Appeals
may serve as precedent for inferior courts on points of facts.
Principle of Stare Decisis:
A principle that, when the court has once laid down a principle of
law or intepretation as applied to a certain state of facts, it will
adhere to and apply to all future cases where the facts are sub-
stantially the same.
The principle is one of policy, grounded on the theory that
security and certainty require that accepted and established legal
principles, under which right may accrue, be recognized and fol-
lowed, though later found to be not legally sound, but whether
previous holding of court shall be adhered to, modified or over-
ruled is within the court's discretion under the circumstance of the
case before it (Black's Law Dictionary, 4th ed.).
Branches of Law Where Legal Medicine may be Applied:
1. Civil Law — Civil law is a mass of precepts that determines and
regulates the relation of assistance, authority, and obedience
between members of a family and those which exist among
members of a society for the protection of private interest (San-
chez Roman).
Our civil laws are scientifically and systematically compiled in
the Civil Code of the Philippines (Republic Act No. 386).
In civil law, knowledge of legal medicine may be useful on the
following:
a. The determination and termination of civil personality (Art. 40
and 41),
b. The limitation or restriction of a natural person's capacity to
act (Art. 23 and 39);
c. The marriage and legal separation (Book I, Title III & IV);
d. The paternity and filiation ^Book I, Title VIII); and
e. The testimentary capacity of a person making a will (Book III,
Title IV).
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2. Criminal Law — Criminal law is that branch or division of law
which defines crimes, treats of their nature and provides for their
punishment.
It is a body of specific rules regarding human conduct which have
been promulgated by political authority, which apply uniformly
to all members of the classes to which the rules refer, and which are
enforced by punishment administered by the state (Sutherland-
Cressey, Criminology, 7th ed„ p. 4).
Penal laws and those of public security and safety shall be
obligatory upon all who live or sojourn in the Philippine territory,
subject to the principles of public international law and to treaty
stipulations (Art. 14 Civil Code).
The Philippine criminal law is codified in the Revised Penal
Code and may also be found in the penal provisions of the special
laws.
Legal medicine is applicable in the following provisions of the
penal code:
a. Circumstances affecting criminal liability (Title I);
b. Crimes against person (Title VIII), and
c. Crimes against chastity (Title XI).
3. Remedial Law — Remedial law is that branch or division of law
which deals with the rules concerning pleadings, practices and
procedures in all courts of the Philippines.
It is the law which gives a party a remedy for a wrong. It is
intended to afford a private remedy to a person injured by the
wrongful act. It is a designed law, which redresses an existing
grievance or introduces regulation conducive to public good
(Black's Law Dictionary, 4th ed.).
Our remedial law is embodied in the Rules of Court of the
Philippines and also in the remedial provision of Special Laws.
Legal Medicine may be applied in the following provisions of
the Rules of Court:
a. Physical and mental examination of a person (Rule 28);
b. Proceedings for hospitalization of an insane person (Rule 101);
and
c. Rules on evidences (Part IV).
4. Special Laws:
a. Dangerous Drug Act (R.A. 6425, as amended)
b. Youth and Child Welfare Code (P.D. 603)
c. Insurance Law (Act No. 2427 as amended)
d. Code of Sanitation (P.D. 856)
e. Labor Code (P.D. 442)
f. Employee's Compensation Law
Some Bask Principles Governing Application and Effects of Laws:
1. Ignorance of the law excuses no one from compliance therewith
or "ignorantia legis nominem excusat" (Art 3, Civil Code):
The main reason for the provision is to prevent ignorance of
the law as a means of defense for violation of the law. The pro-
vision refers to all kinds of domestic laws on grounds of expe-
diency, policy and necessity.
"Ignorance of the law" may refer to the literal wordings of the
law and also to the meaning or interpretation given to the law.
But the rule is not inflexible. It may only be applied when it is
clearly manifested and inexcusably ignorant of the law.
Mere ignorance of the facts of the law would furnish immunity
from the punishment for violation of the penal code and immunity
from the liability for actual loss for violation of personal or prop-
erty right.
2. Laws shall have no retroactive effect, unless the contrary is pro-
vided (Art. 4, Civil Code):
A law can only be applied to cases after its promulgation arid
must not be given retroactive application.
A law, however, may be given retroactive effects in the follow-
ing instances:
a. When the law provides the contrary (Art. 4, Civil Code).
b. Penal laws shall be given retroactive effect if favorable to the
accused who is not habitually delinquent (Art. 22, Revised
Penal Code).
c. When the statute is remedial in nature because there is no vested
right in the rules of procedure.
d. When the law creates a new substantive right.
3. Rights may be waived, unless the waiver is contrary to law, public
order, public policy, morals or good customs, or prejudicial to a
third person with a right recognized by law (Art. 6, Civil Code):
A right is the power, privilege, faculty which entitles a man to
have, or to do, or to receive from another within the limits
prescribed by law. Waiving is the intentional or voluntary relin-
quishment, abandonment or throwing away, renunciation, sur-
rendering of a known right.
The rights granted to a person by law may be waived but in the
following cases, the law does not allow such waiver:
a. When such waiver will be contrary to the existing law.
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b. When it is against public order, public policy, morals and good
customs.
c. When in so waiving it is prejudicial to a third person with a right
recognized by law.
4. Customs which are contrary to law, public order or public policy
shall not be countenanced (Art. 11, Civil Code). A custom must
be proved as a fact according to the rules of evidence (Sec. 12,
Civil Code):
Custom is a usage or practice of the people, which by common
adoption and acquiescence and by long and unvarying habit, has
become compulsory and has acquired the force of a law with
respect to the place and subject-matter to which it relates (Black's
Law Dictionary, 4th ed.).
Customs constitute sources of supplementary law in default of
specific legislation.
However, if the custom is contrary to the existing law or to
' public order and policy, the law must prevail.
5. Laws are repealed only by subsequent ones, and their violation or
non-observance shall not be excused by disuse, custom or practice
to the contrary.
When the court declares a law to be inconsistent with the con-
stitution, the former shall be void and the latter shall govern.
Administrative or executive acts, orders and regulations shall
be valid only when they are not contrary to the laws or the con-
stitution (Art. 7, Civil Code):
The constitution is the fundamental law of the land. All acts,
administrative or executive orders contrary to the provision of
the constitution shall be deemed void.
Any existing law which is inconsistent with a subsequent law
is deemed repealed by the latter law.
Administrative or executive acts, orders and regulations are con-
sidered valid when they are not in contravention with the existing
laws.
BRIEF HISTORY OF LEGAL MEDICINE
1. IN WORLDWIDE SCALE:
The earliest recorded medico-legal expert was Imhotep (2980
B.C.). He was the chief physician and architect of King Zoser of
the third dynasty in Egypt and the builder of the first pyramid.
That time was the first recorded report of a murder trial written
on clay tablet.
The Code of Hammurabi, the oldest code of law (2200 B.C.)
included legislation on adultery, rape, divorce, incest, abortion and
violence.
Hippocrates (460-355 B.C.) in Greece discussed the lethality
of wounds. Aristotle (384-322 B.C.) fixed animation of fetus at
the 40th day after conception.
About 300 B.C. the Chinese materia medica gave information
on poison including aconite, arsenic and opium. Hashish was said
to have been used as a narcotic in surgery about 200 B.C.
That bodies of all women dying during confinement should
immediately be opened in order to save the child's life was pro-
mulgated during the reign of Numa Pompilius in Rome (600
B.C.).
The first "police surgeon" or forensic pathologist was Antis-
tius. Julius Caesar (100-44 B.C.) was murdered and his body was
exposed in the forum and Antistius performed the autopsy. He
found out that Julius Caesar suffered from twenty-three wounds
and only one penetrated the chest cavity through the space be-
tween the first and second ribs.
Justinian (483-565 A.D.), in his Digest, made mention that a
physician is not an ordinary witness and that a physician gives
judgment rather than testimony. This led to the recognition of
expert witness in court.
The first textbook in legal medicine was included in the Consti-
tute Criminalis Carolina which was promulgated in 1532 during
the reign of Emperor Charles V in Germany.
Pope Innocent III (1209) issued an edict providing for the
appointment of doctors to the courts for the determination of the
nature of wounds.
Pope Gregory IX, in 1234, caused the preparation of Nova
Compilatio Decretalium which concerned medical evidence, mar-
riage, nullity, impotence, delivery, caesarian section, legitimacy,
sexual offenses, crime against persons and witchcraft.
In the 14th century, Pope John XXII expressed the need of
experts in the ecclesiastical courts, in the diagnosis of leprosy and
many medico-legal documents.
In China, the Hsi Yuan Lu (Instructions to Coroner) was pub-
lished. It is a five volume book dealing with inquest, criminal
abortion, infanticide, signs of death, assault, suicide, hanging,
strangling, drowning, burning, poisoning and antidotes, and
examination of the dead.
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In 1575, Ambroise Pare considered legal medicine as a separate
discipline and he'discussed in his book, abortion, infanticide,
death by lightning, hanging, drowning, feign diseases, distinction
between ante-mortem and post-mortem wound and poisoning by
carbon monoxide and by corrosives.
Paulus Zacchias (1584-1659), a papal physician, is regarded as
the "father of forensic medicine." He published Questiones
Medico-legales which dealt with the legal aspects of wounds and
the first two chapter dealt with the detection of secret homicide.
In 1598, Severin Pineau published in Paris a work on virginity
and defloration. He confirmed the existence of the hymen and
that it may not rupture during sexual intercourse. - On January 10, 1922, the head of the Department of Legal
Orfila (1787-1853) introduced chemical methods in toxicology.
In his Traite' des Poison, he mentioned mineral, vegetable and
animal poison in relation with physiology, pathology and legal
medicine. He was considered later as the founder of modern
toxicology.
The period thereafter is characterized by an appreciable in-
crease in available publication on the subject dealing with modem
innovative findings and procedures related to medical progress and
changes in the laws.
2. IN THE PHILIPPINES:
In 1858, the first medical textbook printed including per-
tinent instructions related to medico-legal practice by Spanish
physician, Dr. Rafael Genard y Mas, Chief Army Physician,
entitled "Manual de Medicina Domestica."
In 1871, teaching of legal medicine, included as an academic
subject in the foundation of the School of Medicine of the Real
y Pontifica Universidad de Santo Tomas.
On March 31, 1876 by virtue of the Royal Decree No. 188, of
the King of Spain, the position of "Medico Titulares" was created
and made in charge of public sanitation and at the same time
medico-legal aid in the administration of justice.
In 1894, rules regulating the services of those "Medico Titular
y Forences" was published.
In 1895, medico-legal laboratory was established in the City of
Manila and extended at the same time its services to the provinces.
In 1898, American Civil Government preserved the Spanish
forensic medicine system.
In 1901, Philippine Commission created the provincial, insular
and municipal Board of Health (Act Nos. 157, 307 and 308) in
the Philippines and assigned to the respective inspectors and pres-
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idents of the same, medico-legal duties of the "Medico Titulares"
of the Spanish regime. The Philippine Legislature maintained the
pre-existing medico-legal system in full force in the Administrative
Code.
In 1908, the Philippine Medical School incorporated the teach-
ing of Legal Medicine, one hour a week to the fifth year medical
students.
In 1919, the University of the Philippines created the Depart-
ment of Legal Medicine and Ethics with the head having the salary
of 4,000.00 pesos per annum, half-time basis, with Dr. Sixto de
los Angeles as the chief.
Medicine and Ethics became the Chief of the Medico-Legal De-
partment of the Philippine General Hospital without pay.
On March 10, 1922,-the Philippine Legislature enacted Act. No.
1043 which became incorporated in the Administrative Code as
Section 2465 and provided that the Department of Legal Medicine,
University of -the Philippines, became a branch of the Department
of Justice.
On December 10, 1937, Commonwealth Act. No. 181 was
passed creating the Division of Investigation under the Department
of Justice. The Medico-Legal Section was made as an integral part
of the Division with Dr. Gregorio T. Lantin as the chief.
On March 3, 1939, the Department of Legal Medicine of the
College of Medicine, University of the Philippines was abolished
and its functions were transferred to the Medico-Legal Section of
the Division of Investigation under the Department of Justice.
On July 4, 1942, President Jose P. Laurel consolidated by
executive order all the different law-enforcing agencies and created
the Bureau of Investigation on July 8,1944.
In 1945 immediately after liberation of the City of Manila, the
Provost Marshal of the United States Army created the Criminal
Investigation Laboratory with the Office of the Medical Examiner
as an integral part and with Dr. Mariano Lara as Chief Medical
Examiner.
On June 28, 1945, the Division of Investigation, under the
Department of Justice was reactivated.
On June 19, 1947, Republic Act. No. 157 creating the Bureau
of Investigation was passed. The Bureau of Investigation was
created by virtue of an executive order of the President of the
Philippines. Under the bureau, a Medico-Legal Division was created
with Dr. Enrique V. de los Santos as the Chief.
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There exists a Medico-Legal Division in the Criminal Laboratory
Branch of the G-2 of the Philippine Constabulary. All provincial,
municipal and city health officers, physicians of hospitals, health
centers, asylums, penitentiaries and colonies are ex-officio medico-
legal officers.
In remote places where the services of a registered physician was
not available, a "Cirujano Ministrante" may perform medico-legal
work. However, after the approval of Republic Act 1982 on
June 15, 1954 which provided for the creation of rural health
unit to each municipality composed of municipal health officer, a
public nurse, a midwife and a sanitary inspector virtually abolished
the appointment of Cirujano Ministrante thereby making qualified
physicians to perform medico-legal functions.
June 18, 1949, Republic Act 409 which was later amended by
Republic Act 1934 provides (Sec. 38) for the creation of the of-
fice of the Medical Examiners and Criminal Investigation Labo-
ratory under thej^jice Department of the City of Manila.
On December 23, 1975, Presidential Decree 856 was promul-
gated and Sec. 95 provides:
A. Persons authorized to perform autopsies:
1. Health officers
2. Medical officers of law enforcement agencies
3. Members of the medical staff of accredited hospitals
B. Autopsies shall be performed in the following cases:
1. Whenever required by special laws;
2. Upon order of a competent court, a mayor and a provin-
cial or city fiscal;
3. Upon written request of police authorities,
4. Whenever the Solicitor General, provincial or city fiscal
deem it necessary to disinter and take possession of the
remains for examination to determine the cause of death;
and
5. Whenever the nearest kin shall request in writing the
authorities concerned to ascertain the cause of death.
V MEDICAL EVIDENCE
Evidence is the means, sanctioned by the Rules of Court, of
ascertaining in a judicial proceeding the truth respecting a matter of
fact (Sec. 1, Rule 128, Rules of Court).
It is the species of proof, or probative matter, legally presented at
the trial of an issue by the act of the parties and through the medium
of witnesses, records, documents, concrete objects, etc., for the pur-
pose of inducing belief in the minds of the court as to their content-
i o n (Black's Law Dictionary, 4th ed.).
If the means employed to prove a fact is medical in nature then it
becomes a medical evidence.
Same rules in all cases — The rules of evidence shall be the same in
all courts and on all trials and hearings, whether civil or criminal
(Sec. 2, Rule 128, Rules of Court).
Admissibility of evidence — Evidence is admissible when it is
relevant to the issue and is not excluded by these rules (Sec. 3, Rule
128, Rules of Court).
It is considered relevant when it has the tendency to prove any
matter of fact. It is something which by the process of logic, an
inference may be made as to the existence or non-existence of a fact
at issue.
Relevancy of evidence (collateral matters) — Evidence must have
such a relation to the fact in issue as to induce belief in its existence
or non-existence; therefore, collateral matters shall not be allowed,
except when they tend in any reasonable degree to establish the
probability or improbability of the fact at issue (Sec. 4, Rule 130,
Rules of Court).
Collateral matters are those different from those or do not cor-
respond with the matters in issue.
Types of Medical Evidence:
. /I. Autoptic or Real Evidence:
This is an evidence made known or addressed to the senses of the
court. It is not limited to that which is known through the sense
of vision but is extended to what the sense of hearing, taste, smell
and touch is perceived.
Sec. 1, Rule 130, Rules of Court — View of an object — When-
ever an object has such a relation to the fact in issue as to afford
reasonable ground of belief respecting the latter, such object may
be exhibited to or viewed by the court, or its existence, situation,
condition, or character proved by witnesses, as the court in its
discretion may determine.
The court may require the physician to present the skeleton of
the victim of a criminal act exhumed and examined for the judge
to see the presence and degree of the ante-mortem fracture.
Limitations to the Presentation of Autoptic Evidence:
a. Indecency and Impropriety — Presentation of an evidence may
be necessary to serve the best interest of justice but the notion
of decency and delicacy may cause inhibition of its presentation.
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The court may not allow exposure of the genitalia of an
alleged victim of sexual offense to show the presence and degree
of the genital and extra-genital injuries suffered by the victim.
There are other ways for the court to know the facts other than
actual exhibition.
b. Repulsive Objects and those Offensive to Sensibilities — Foul
smelling objects, persons suffering from highly infectious and
communicable disease, or objects which when touch may mean
potential danger to the life and health of the judge may not be
presented.
However, if such evidence is necessary in the adjudication of
the case, the question of indecency and impropriety or the fact
that such evidence is repulsive or offensive to sensibilities, it
may be presented. This will depend on the sound discretion of
the court.
-2. Testimonial Evidence:
A physician may be commanded to appear before a court to
give his testimony. While in the witness stand, he is obliged to
answer questions propounded by counsel and presiding officer of
the court. His testimony must be given orally and under oath or
affirmation.
A physician may be presented in court as an ordinary witness
and/or as an expert witness:
a. Ordinary Witness:
A physician who testifies in court on matters he perceived
from his patient in the course of physician-patient relationship
is considered as an ordinary witness.
Sec. 18, Rule 130, Rules of Court — Witnesses. Their quali-
fication — Except as provided in the next succeeding section,
all persons who, having organs of sense, can perceive, and per-
ceiving, can make known their perception to others, may be
witnesses. Neither parties nor other persons interested in the
outcome of a case shall be excluded; nor those who have been
convicted of crime; nor any person on account of his opinion
on matters of religious belief.
One of the^exceptions to the ordinary witness rule is the
privilege j>fcommunication (confidential) between physician
and patient. Although the physician perceived something
through his organ of sense and has the power to transmit to
others what he perceived, he is not allowed to disclose those
informations to others as regards to matters he perceived from
his patient during the physician-patient relationship.
Sec. 21(c), Rule 130, Rules of Court — Privileged communi-
cation — A person authorized to practice medicine, surgery or
obstetrics cannot in a civil case, without the consent of the
patient, be examined as to any information which he may have
acquired in attending such patient in a professional capacity,
which information was necessary to enable him to act in that
capacity, and which would blacken the character of the patient.
A medical witness can only testify on matters derived by his
own perception. Hearsay informations are as a rule not ad-
missible in court. Hearsay evidences are those not proceeding
from the personal knowledge of the witness but from mere
repetition of what he has heard others say. It is a, "second
hand" evidence which rest mainly on the veffdty and com-
petence of its source.
Sec. 30, Rule 130, Rules of Court — Testimony generally
confined to personal knowledge — A witness can testify only
to those facts which he knows of his own knowledge; that is,
which are derived from his own perception, except as other-
wise provided in these ruje:
One of the exceptions to the non-admissibility of hearsay
evidence is dying declaration. The declaration of a dying person
under the consciousness of his impending death as regards
circumstance regarding his impending death is admissible in
spite of the fact that it is a hearsay, it is made so because of
necessity and it is trustworthy.
Exceptions to the hearsay rule. Sec. 31, Rule 130, Dying
declaration — The declaration of a dying person, made under a
consciousness of an impending death, may be received in a
criminal case wherein his death is the subject of inquiry, as
evidence of the cause and surrounding circumstances of such
death.
Physicians are frequent recipients of dying declaration in the
medical clinics and emergency rooms of hospitals. To be ad-
missible it must be shown that the declarant was conscious of
his impending death, that the declaration must be with regards
to his impending death; that the declarant was in full possession
of his mental faculties when he made the declaration; and that
such evidence is presented in court in a case of homicide,
murder or parricide wherein the declarant was the victim,
b. Expert Witness:
A physician on account of his training and experience can
give his opinion on a set of medical facts. He can deduce or
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infer something, determine the cause of death, or render opinion
pertinent to the issue and medical in nature.
Sec. 42, Rule 130, Rulesof^Court — Opinion Rule — General
Rule — The opinion of^witness is not admissible, except as
indicated in the following section.
Sec. 43, Rule 130, Rules of Court — Expert Evidence — The
opinion of a witness regarding a question of science, art or
trade, when he is skilled therein, may be received in evidence.
The probative value of the expert medical testimony depends
upon the degree of learning and experience on the line of what
the medical expert is testifying, the basis and logic of his con-
clusion, and other evidences tending to show the veracity or
falsity of his testimony.
3. Experimental Evidence:
A medical witness may be allowed by the court to confirm his
allegation or as a corroborated proof to an opinion he previously
stated.
The issue as to how long a person can survive, after the ad-
ministration of lethal dose of poison can be shown by the ad-
ministration of the said poison to experimental animals within
the view of the court.
4. Documentary Evidence:
A document is an instrument on which is recorded by means of
letters, figures, or marks intended to be used for the purpose of
recording that matter which may be evidentially used. The term
applies to writings, to words printed, lithographed or photo-
graphed; to seals, plates or stones on which inscriptions are cut
or engraved; to photographs and pictures; to maps or plans
(Black's Law Dictionary, 4th ed.).
Medical Documentary Evidence may be:
a. Medical Certification or Report on:
(1) Medical examination.
(2) Physical examination.
(3) Necropsy (autopsy).
(4) Laboratory.
(5) Exhumation.
(6) Birth.
(7) Death.
b. Medical Expert Opinion.
c. Deposition — A deposition is a written record of evidence
given orally and transcribed in writing in the form of questions
by the interrogator and the answer of the deponent and signed
by the latter.
5. Physical Evidence:
These are articles and materials which are found in connection
with the investigation and which aid in establishing the identity
of the perpetrator or the circumstances under which the crime was
committed, or in general assist in the prosecution of a criminal.
The identification, collection, preservation and mode of pre-
sentation of physical evidence is known in modern parlance as
criminalistics. Criminalistics is the application of sciences such
as physics, chemistry, medicine and other biological sciences in
crime detection and investigation.
On the investigator's viewpoint, the following are the different
types of physical evidences:
a. Corpus Delicti Evidence — Objects or substances which may be
a part of the body of the crime. The body of the victim of
murder, prohibited drugs recovered from a person, dagger with
blood stains or fingerprints of the suspect, stolen motor
vehicle identified by plate number and by body or engine
serial numbers are examples of corpus delicti evidence.
b. Associative Evidence — These are physical evidences which link a
suspect to the crime. The offender may leave clues at the scene
such as weapon, tools, garments, fingerprints or foot impression.
Broken headlights glass found at the crime scene in "hit and
run" homicide may be associated with the car found in the
repair shop. Wearing apparel of the offender and other articles
of value may be recovered where the crime of rape was com-
mitted.
c. Tracing Evidence —These are physical evidences which may assist
the investigator in locating the suspect. Aircraft or ship manifest,
physician's clinical record showing medical treatment of suspect
for injuries sustained in an encounter; blood stains recovered
from the area traversed by the wounded suspect infer direction
of the movement are examples of tracing evidence.
Preservation of Evidences:
The physical evidences recovered during medico-legal investi-
gation must be preserved to maintain their value when presented as
exhibits in court. Most medical evidences are easily destroyed or
physically or chemically altered unless appropriate preservation
procedure are applied. This problem is further compounded by the
long space of time the evidence was recovered and its presentation in
court. From its recovery and from becoming a part of the inves-
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tigation report, a preliminary investigation will be made by the
prosecuting fiscal to prove that there is a prima facie evidence to
warrant filing of the case in court. While in court, the case further
suffers delays because of postponement of the hearings, preferential
trials of other cases, raising of prejudicial issues to higher courts, etc.
Preservation of evidence is indeed vital in medico-legal investigation.
-Methods of Preserving Evidences:
1. Photographs, audio and/or video tape, micro-film, photostat,
xerox, voice tracing, etc.
Photography is considered to be the most practical, useful and
reliable means of preservation.
a. Photo-camera are available in many places.
b. The object preserved is reduced in size in the picture propor-
tionately with other objects adjacent or near it.
c. An unlimited number of copies can be reproduced, each of
which is identical to one another.
In colored photographs variation may occur in the choice
of the kind of film and printing paper used.
Identification of voice from the recording instrument may
sometimes be difficult. Audio-recording may be dependent on
the speed, volume, pitch and timbre which may be changed by
the instrument used in the recording and replaying.
2. Sketching — If no scientific apparatus to preserve evidence is avail-
able then a rough drawing of the scene or object to be preserve is
done. It must be simple, identifying significant items and with
exact measurement.
-Kinds of Sketch:
a. Rough Sketch — This is made at the crime scene or during
examination of living or dead body. On the latter, an anatomic
figure of the front, back and side part of the body must be
made and the bodily lesions indicated.
b. Finished Sketch — A sketch prepared from the rough sketch for
court presentation.
J Essential Elements to be Included in a Sketch:
a. Measurement must be accurate.
b. Compass direction must always be indicated to facilitate proper
orientation in the case of crime scene. A ./£may influence a witness to serve the interest of another or state
c. Essential item which has a bearing in the investigation mus. oe
included.
d. Scale and proportion must be stated by mere estimation.
e. There must be a title and legend to tell what it is and the mean-
ing of certain marks indicated therein.
3. Description — This is putting into words the person or thing to be
preserved. Describing a thing requires keen observation and a
good power of attention, perception, intelligence and experience.
It must cause a vivid impression on the mind of the reader, a true
picture of the thing described.
The following are the minimum standard requirements which
must be satisfied in the description of the person or thing to make
it complete:
a. Skin Lesion — kind, measurement, other descriptive infor-
mation of the lesion itself, location, orientation.
b. Penetrating Wound (Punctured, Stab or Gunshot) — kind,
shape, other information from the wound itself, location,
orientation, direction, other structures involved, complications
and foreign elements that may be present.
c. Hymenal laceration — location, degree, duration, complication.
d. Person — those requirement in portrait parle (see p. 53 supra).
4. Manikin Method — In a miniature model of a scene or of a human
body indicating marks of the various aspects of the things to be
preserved. An anatomical model or statuette may be used and
injuries are indicated with their appropriate legends. Although it
may not indicate the full detail of the lesion, it is quite impressive
to the viewer as to the nature and severity of the trauma.
5. Preservation in the Mind of the Witness — A person who perceived
something relevant for proper adjudication of a case may be a
witness in court if he has the power to transmit to others what he
perceived. He would just have to make a recital of his collection.
Principal drawbacks of preserving evidence in the mind of the
witness:
a. The capacity of a person to remember time, place and event
may be destroyed or modified by the length of time, age of the
witness, confusion with other evidences, trauma or disease,
thereby making the recollection not reliable.
b. The preservation is co-terminus with the life of the witness. If
the witness dies, then the evidence is lost.
c. Human mind can easily be subjected to too many extraneous
factors that may cause distortion of the truth. Other persons
untruthful facts to justify an end.
6. Special Methods — Special way of treating certain type of evidence
may be necessary. Preservation may be essential from the time it
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is recovered to make the condition unchanged up to the period it
reaches the criminal laboratory for appropriate examination.
Preservation may be needed for the remaining portion of the
evidence submitted for future verification and/or court pre-
sentation.
Some of the Special Ways of Preservation are:
a. Whole human body — embalming.
b. Soft tissues (skin, muscles, visceral organs) — 10% formalin
solution.
c. Blood — refrigeration, sealed bottle container, addition of
chemical preservatives.
d. Stains (blood, semen) — drying, placing in sealed container.
e. Poison — sealed container.
Kinds of Evidence Necessary for Conviction:
1. Direct Evidence:
That which proves the fact in dispute without the aid of any
inference or presumption. The evidence presented corresponds to
to the precise or actual point at issue.
2. Circumstantial Evidence:
The proof of fact or facts from which, taken either singly or
collectively, the existence of a particular fact in dispute may be
inferred as a necessary or probable consequence.
When is circumstantial evidence sufficient to produce conviction?
a. When there is more than one circumstance;
b. When the facts from which the inferences are derived are
proven; and
c. When the combination of all the circumstances is such as to
produce a conviction beyond reasonable doubt (Sec. 4, Rule
123, Rules of Court).
bility or improbability of their testimony, their interest or want of
interest, and also their personal credibility so far as the same may
legitimately appear upon the trial. The court may also consider the
number of witnesses, though the preponderance is not necessarily
with the greatest number.
From the foregoing provision of the Rules of Court, the following
factors must be considered which party's evidence preponderate.
a. All the facts and circumstances of the case.
b. The witnesses' manner of testifying, their intelligence, their
means and opportunities of knowing the facts to which they are
' testifying.
c. The nature of the facts to which the witnesses testify.
d. The probability and improbability of the witnesses' testimony.
e. The interest or want of interest of the witnesses.
f. Credibility of the witness so far as the same may legitimately
appear upon the trial.
g. The number of witnesses presented, although preponderance is
not necessarily with the greatest number.
Section 2 — Proof beyond reasonable doubt — In a criminal case,
the defendant is entitled to an acquittal, unless his guilt is shown
beyond reasonable doubt. Proof beyond reasonable doubt does not
mean such a degree of proof as, excluding possibility of error,
produces absolute certainty. Moral certainty only is required, or that
degree of proof which produces conviction in an unprejudiced mind.
It is presumed that a person is innocent of a crime until the con-
trary is proven beyond reasonable doubt. The doubt, the benefit of
which an accused is entitled in a criminal case, is a reasonable doubt,
and not a whimsical or fanciful doubt, based on imagined and wholly
improbable possibilities and unsupported by evidence.

Weight and Sufficiency of Evidence:

Rule 133, Rules of Court:
Section 1. Preponderance of evidence, how determined. — In
civil cases, the party having the burden of proof must establish his
case by a preponderance of evidence. In determining where the
preponderance or superior weight of evidence on the issues involved
lies, the court may consider all the facts and circumstances of the
case, the witnesses' manner of testifying, their intelligence, their
means and opportunity of knowing the facts to which they tire
testifying, the nature of the facts to which they testify, the proba
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The autonomic nervous system is composed of two complimentary

^'fjECEPTION DETECTION
The knowledge of the truth is an essential requirement for the
administration of criminal justice. The success or failure in making
decisions may rest solely on the ability to evaluate the truth or
falsity of the statement given by the suspect or witness. The task
for its determination initially lies on the hand of the investigator.
Modern scientific methods have been devised utilizing knowledge
of physiology, psychology, pharmacology, toxicology, etc. in deter-
mining whether a subject is telling the truth or not. Although the
scientific methods of deception detection have not yet attained
legal recognition to have their results admissible as an evidence in
court, they have been considered very useful as aids in criminal
investigation.
1
Methods of deception detection which are currently being used or
applied by law enforcement agencies may be classified as follows:
1. Devices which record the psycho-physiological response:
a. Use of a polygraph or a lie detector machine
b. Use of the word association test
c. Use of the psychological stress evaluator
Use of drugs that try to "inhibit the inhibitor":
a. Administration of "truth serum''
b^Narcoanalysis or narcosynthesis
c. Intoxication
3. Hypnotism
4. By observation
5. Scientific interrogation
jo. Confession
i I. RECORDING OF THE PSYCHO-PHYSIOLOGICAL RESPONSE
The nervous control of the human body includes the central
nervous system (the brain and the spinal cord) and the autonomic
or regulating nervous system (sympathetic and parasympathetic).
The central nervous system primarily controls the motor and sensory
functions that occur at or above the threshold. It may be voluntary.
The autonomic nervous system acts as a self-regulating autonomic
response of the body.
21
branches: the sympathetic and the parasympathetic nervous system,
acting opposite each other. The fibers of both enervate are all or-
gans where self-regulation is essential.
When a person is under the influence of physical (exertion) or
emotional (anger, excitement, fear, lie detection, etc.) stimuli, the
sympathetic will dominate and over-ride the parasympathetic, thus,
there will be changes in the heart rate, pulse rate, blood pressure,
respiratory tracing, psychogalvanic reflexes, time of response to
question, voice tracing, etc. The parasympathetic nervous system
works to restore things to normal when the conditions of stress have
been removed. It is the dominant branch when the condition is
normal and the subject is calm, contented and relaxed.
«/ The recording of some of the psycho-physiological reaction of a
subject when he is subjected to a series of questions, and the scien-
tific interpretation by trained experts are the basis of the tests.
A. Use of a Lie Detector or Polygraph:
It is not appropriate to call a lie detector a polygraph. A lie
detector records physiological changss that occur in association
with lying in a polygraph. It is the fear of detection of the subject
which allows the determination. The fear of the subject when not
telling the truth activates the sympathetic nervous system to a
series of automatic and involuntary physiological changes which
are recorded by the instrument.
The instrument (lie detector) is like an electrocardiogram or
electroencephalogram with recording stylets making tracings on
moving paper at the rate of 6 inches per minute.
The test must be made in a room especially built for the pur-
pose. It must be quiet, private, sound-proof and free from any
disturbances and distractions. Extrenuous noises, like blowing of
horns, ringing of bells or telephone and loud conversations of
persons must be avoided.
The subject is seated on a chair beside a table where the instru-
ment is located. The pneumograph tubes are placed around the
chest and abdomen, the blood pressure cuff around the upper
right arm, and the electrodes are attached to the two fingers of
the other hand. The back of the chair is equipped with an infla-
table rubber bladder for the purpose of recording the muscular
contraction and pressure. All the gadgets attached are connected
to the recording instrument. The subject must be placed in. a
position so that he looks straight ahead.
The subject is instructed to remain as quiet as possible, to
answer all questions by "yes ' or "no", and to refrain from other
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verbal responses during the test. If any explanations are to be
made, the subject is instructed to wait until the termination of
the test.
Phases of the Examination:
1. Pre-test interview
2. Actual interrogation and recording through the instrument
3. Post-test interrogation
1. Pre-test interview:
Before the actual testing is done, the examiner must first
make an informal interview of the subject which may last from
20 to 30 minutes,
a. Purpose of the interview:
(1) To determine whether the subject has any medical or
psychiatric condition or has used drugs that will prevent
the testing;
(2) To explain to the subject the purpose of the examination;
(3) To develop the test questions, particularly those of the
types to be asked;
(4) To relieve the truthful subject of any apprehension as
well as to satisfy the deceptive subject as to the efficiency
of the technique;
(5) To know any anti-social activity or criminal record of
the subject.
2. Actual interrogation and recording:
With all the gadgets attached to the body of the subject, the
instrument will start running by applying pressure on a button.
The subject then will be asked to answer the following standard
test questions:
a. Irrelevant questions — These are questions which have no
bearing to the case under investigation. The question may
refer to the subject's age, educational attainment, marital
status, citizenship, occupation, etc. The examiner asks these
types of questions to ascertain the subject's normal pattern
of response by eliminating the feeling of apprehension.
b. Relevant questions — These are questions pertaining to the
issue under investigation. They must be unambiguous,
unequivocal and understandable to the subject. They must
all be related to one issue or one criminal act. It is equally
important to limit the number of relevant questions to avoid
discomfort to the subject. Relevant questions must be very
specific to obtain an accurate result.
Examples of relevant questions are "Did you shoot to
death Mr. "X''? "Did you take the ring, wrist watch, and
wallet of Mr. "X" after his death? "
c. Control questions — These are questions which are unrelated
to the matter under investigation but are of similar nature
although less serious as compared to those relevant questions
under investigation.
If someone is being investigated for murder by shooting,
the control questions may be "Have you ever used or fired
a gun? ", "Do you have a gun? ", "Have you killed someone
with a gun? ", etc.
In practice, the relevant — irrelevant question technique is
used. The responses to the two types of questions are com-
pared, if there is no significant difference between the relevant
and irrelevant questions, the subject is reported to be truthful.
However, if the subject responds more to the relevant questions,
he is considered as not telling the truth.
The use of control questions is considered by many poly-
graphists to be the most reliable and effective questioning tech-
nique. These are usually asked if there is doubt in the inter-
pretation of the subject's response to relevant and irrelevant
questions.
3. Post-test interrogation:
The purposes of further questioning after the test are:
a. To clarify the findings;
b. To learn if there are any other reasons for the subject's
responding to a relevant question, other than the knowledge
of the crime;
c. To obtain additional information and an admission for law
enforcement purposes, if the results suggest deception.
4. Supplementary tests:
Aside from the standard tests described above, the following
special tests may be performed and incorporated as a part of the
standard procedure or may be used as supplementary tests
depending upon the result of the standard test in order to draw
a better conclusion.
a. Peak-of-tension test — The subject may be given this test if
he is not yet informed of the details of the offense for which
he is being interrogated by the investigator, or by other
persons or from other sources like the print media.
The examiner will prepare several questions, about seven,
and one of them has a specific bearing on the matter under
investigation. The specific question must refer to some
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details of the incident which could not have been known to
the subject.
A truthful subject, not aware of any question referrable
to the subject of investigation, will respond by not building
up tension. However, when the question which refers to a
detail of the incident is asked, a guilty subject will develop
a ''peak of tension'' which will be recorded in the tracing.
b. Guilt complex test — This test is applied when the response
to relevant and control questions are similar in degree and
consistency and in a way that the examiner cannot determine
whether the subject is telling the truth or not.
The subject is asked questions aside from the irrelevant,
relevant and controlled questions; a new series of relevant
questions dealing with a real incident and that which the
subject could not have committed. If the subject does not
respond to the added relevant questions, it indicates that the
subject was being deceptive as to the primary issue under
investigation. However, no conclusion can be drawn if the
response to the added guilt complex question is similar to
the real issue questions.
c. Silent answer test — This test is conducted in the same
manner as when relevant, irrelevant and control questions
are asked, but the subject is instructed to answer the ques-
tions silently, to himself, without making any verbal re-
sponse. This test is effective when the subject's verbal
response causes distortion in the tracing such as sniff or
clearing of the throat. (Modern Legal Medicine, Psychiatry
and Forensic Sciences by William Curran, Louis McGarry
& Charles Petty, F. A. Davis Company, Philadelphia, 1980
p. 1187-1205).
Reasons for the Inadmissibility To the Court of the Result of
Polygraph Examination:
1. The polygraph techniques are still in the experimental stage and
have not received the degree of standardization of acceptance
among scientists.
In a series of decisions of the state supreme courts in the
United States (Fyre v. U.S., State v. Bonner (Wis.), People v.
Becker (Mich.), People v. Forte, State v. Cole (Mich., (Beech v.
State (Neb.), People v. Wechnick (Calif.), etc.), non-admis-
sibility of the lie detector test was uniformly ruled. The com-
mon reason given was that, according to physiological and
psychological authorities, the test has not gained a degree of
development beyond the experimental stage. Until it is es-
tablished that reasonable certainty follows from such a test, it
would be an error to admit the results as evidence. The test
is useful in the investigation of a crime but it has no place In
the courtroom.
2. The trier of fact is apt to give almost conclusive weight to the
polygraph expert's opinion.
3. There is no way to assure that a qualified examiner admin-
istered the test. The polygraph is capable of a high degree of
accuracy only when conducted under controlled conditions by
an examiner who is highly qualified due to his ability, ex-
perience, education and integrity.
"The important areas that may affect the accuracy of the
reported test result. . . .would be (1) his polygraphy training
(2) the extent of his experience with respect to the years and
number of tests he has conducted, (3) the operation of the
polygraphy instrument itself (4) the accuracy of the polygraph
technique. In addition, special consideration should be given
to the number of tests and the number of questions asked
during the test. . . (Modern Legal Medicine, Psychiatry and
Forensic Sciences, by Curran, et. al, p. 1203).
4. Since the polygraph involves a certain unconscious quality of
the examinee, he may unwittingly waive his or her right against
self-incrimination. It becomes necessary to determine the
scope of the defendant's waiver if he voluntarily submits to
the test. (Am. J. of Trial Advocacy, Vol. 4, p.593).
5. The test itself cannot be relied upon because it has many errors.
The factors that are responsible for the 26% errors of the lie
detector are as follows:
1. Nervousness or extreme emotional tension experienced by a
subject who is telling the truth regarding the offense in ques-
tion but who is nevertheless affected by:
a. Apprehension induced by the mere fact that suspicion or
accusation has been directed against him;
b. Apprehension over the possibility of an inaccurate lie-
detector test result;
c. Over-anxiety to cooperate in order to assure an accurate
test result;
d. Apprehension concerning possible physical hurt from the
instrument;
e. Anger resentment over having to take a lie-detector test;
f. Over-anxiety regarding serious personal problems unrelated
to the offense under investigation;
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g. Previous extensive interrogation, especially when accom-
panied by physical abuse; and
h. A guilt-complex or fear of detection regarding some other
offense which he had committed.
2. Physiological abnormalities such as:
a. Excessively high or excessively low blood pressure;
b. Diseases of the heart; and
c. Respiratory disorder.
3. Mental abnormalities such as:
a. Feeblemindedness, as in idiots, imbeciles and morons;
b. Psychosis or insanities, as in manic-depressives, paranoids,
schizophrenics, paretics, etc.
c. Psychoneurosis and psychopathia, as among the so-called
"peculiar" or "emotionally stable" persons — Those who
are neither psychotic or normal, and those from the border-
line between these two groups.
4. Unresponsiveness in a living or guilty subject, because of:
a. No fear of detection;
b. Apparent inability to consciously control response by means
of certain mental sets of attitudes;
c. A condition of "sub-shock" or "adrenal exhaustion" at the
time of the test;
d. Rationalization of the crime in advance of the test to such an
extent that lying about the offense arouses little or no emo-
tional disturbance.
e. Extensive interrogation prior to the test.
5. Attempt to "beat the machine" by controlled breathing or by
muscular flexing.
6. Unobserved application of muscular pressure which produces
ambiguities and misleading indications in the blood pressure
tracing (Lie Detection and'Criminal Interrogation by Fred
Imbau and John Reid, The Williams & Wilkins Co., p. 65).
However, the results of the lie detector test may be admissible if
there is a stipulation of the parties and counsels that they will
accept said results. The reason is that if the defendant agrees to
the admission of the polygraph result, then he should not be able
to object if the subsequent result turns out to be unfavorable to
him (State v. Valdez, 91 Ariz. 274, 371 p. 2d 894 (1962). The
judge may have the discretion as to whether it is to be admitted or
not. For example, it may not be admitted if done by an incom-
petent polygrapher.
Can a person be compelled to be subjected to the lie-detector
test?
Inasmuch as the test requires the subject to answer the ques-
tions either by "yes" or "no", it infers the use of intelligence and
attention or other mental faculties which is self-incriminatory.
Therefore, a person cannot be compelled to be subjected to the
test.
B. Use of the Word Association Test:
A list of stimulus and non-stimulus words are read to the sub-
ject who is instructed to answer as quickly as possible. The
answers to the questions may be a "yes" or a "no". Unlike the
lie detector, the time interval between the words uttered by the
examiner and the answer of the subject is recorded.
When the subject is asked questions with reference to his name,
address, civil status, nationality, etc. which has no relation to the
subject-matter of the investigation, the tendency is to answer
quickly. But when questions bear some words which have to do
with the criminal act the subject allegedly committed, like knife,
gun or hammer which was used in the killing, the tendency is to
delay the answer.
The test is not concerned, with the answer, be it a "yes" or
"no". The important factor) is the time of response in relation
to stimulus or non-stimulus words.
Like the use of the lie detector, the subject cannot be com-
pelled to be subjected to the test without his consent.
C. Use of the Psychological Stress Evaluator (PSE):
When a person speaks, there are audible voice frequencies, and
superimposed on these are the inaudible frequency modulations
which are products of minute oscillation of the muscles of the
voice mechanism. Such oscillations of the muscles or micro tre-
mor occur at the rate of 8 to 14 cycles per second and controlled
by the central nervous system.
When a person is under stress as when he is lying, the micro-
tremor in the voice utterance is moderately or completely sup-
pressed. The degree of suppression varies inversely to the degree
of psychologic stress in the speaker.
The psychological stress evaluator (PSE) detects, measures, and
graphically displays the voice modulations that we cannot hear.
/ When a person is relaxed and responding honestly to the ques-
tions, those inaudible frequencies are registered clearly on the instru-
ment. But when a person is under stress, as when he is lying,
these frequencies tend to disappear.
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1. Procedure:
a. The examiner meets the requesting party to determine the
specific purpose of the examination and to begin formula-
tion of relevant questions.
b. A pre-test interview is conducted with the subject to help
him or her feel at ease with the examiner, to provide an
opportunity to specify matters, to eliminate outside issues,
and to review questions that will be asked.
c. An oral test of about 12 to 15 "yes* or "no" questions is
given which is recorded on a tape recorder. The questions
are a mixture of relevant and irrelevant questions.
d. Immediately following the test or at a later time, the tape is
processed through the Psychological Stress Evaluator for
analysis of the answers.
e. If stress is indicated, the subject is given opportunity to
provide additional clarification. A retest is given to verify
correction and clarification (Legal Medicine 1980, Cyril
Wecht, ed. p. 58).
2. Advantages of Psychological Stress Evaluator over the Lie
Detector Machine:
a. It does not require the attachment of sensors to the person
being tested.
b. The testing situation need not be carefully controlled to
eliminate outside distraction; and
c. Normal body movement is not restricted.
/ II. USE OF DRUGS THAT "INHIBIT THE INHIBITOR"
A. Administration of Truth Serum:
The term "truth serum" is a misnomer. The procedure does not
make someone tell the truth and the thing administered is not a
serum but is actually a drug.
In the test, hyoscine hydrobromide is given hypodermically in
repeated doses until a state of delirium is induced. When the
proper point is reached, the questioning begins and the subject
feels a compulsion to answer the questions truthfully. He forgets
his alibi which he may have built up to cover his guilt. He may
give details of his acts or may even implicate others.
j The drug acts as depressant on the nervous system. Clinical
evidence indicates that various segments of the brain particularly
the cortex and diencephalon are selectively depressed in the
reversed order of their evolutionary development.
The use of drugs for the purpose is not without the element of
danger and should not be attempted except by a physician who
has had experience in using the drug. Scopolamine may sometime
cause psychotic reactions.
Statements taken from the subject while under the influence of
truth serum are evolutionarily obtained hence they are not admissi-
ble as evidence. Because of the potential risks involved in the appli-
cation of the procedure, it is seldom used by law-enforcement
agencies.
B. Narcoanalysis or Narcosynthesis:
This method of deception detection is practically the same as
that of administration of truth serum. The only difference is the
drug used. Psychiatric sodium amytal or sodium p'enthotal is
administered to the subject. When the effects appear, questioning
starts. It is claimed that the drug causes depression of the inhi-
bitory mechanism of the brain and the subject talks freely.
The administration of the drug and subsequent interrogation
must be done by a psychiatrist with a long experience on the line.
Like the administration of truth serum, the result of the test is
not admissible in court. I
C. Intoxication with alcohol:
The apparent stimulation effect of alcohol is really the result of
the control mechanism of the brain, so alcohol, like truth serum,
and narcoanalytic drugs "inhibit the inhibitor".
The ability of alcohol to reveal the real person behind the
mask which all of us are said to wear ("mask of sanity") is reflec-
ted in the age-old maxim, "In vino Veritas" ("In wine there is
truth"). (Pathology of Homicide by Lester Adelson, Charles
Thomas, 1974, p. 895).
The person whose statement is to be taken is allowed to take
alcoholic beverages to almost intoxication. At this point the power
to control diminishes and the investigator starts pounding ques-
tions and recording answers.
The questioning must start during the excitatory state when the
subject has the sensation of his well-being and when his action,
speech and emotions are less strained due to the lowering of the
inhibition normally exercised by the higher brain centers. When
the subject is already in the depressive state due to the effect of
alcohol, he will no longer be able to answer any question.
Confessions made by the subject while under the influence of
alcohol may be admissible if he is physically capable to recollect
the facts that he has uttered after the effects of alcohol have
disappeared. 3ut in most instances, the subject cannot recall
everything that he had mentioned or he may refuse to admit
the truth of the statement given.
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III. HYPNOSIS
Hypnosis is the alteration of consciousness ^nd concentration in
which the subject manifests a heightened of suggestibility while
awareness is maintained.
Not all persons are susceptible to hypnotic induction. Subjects
who are compulsive-depressive type, strong-willed like lawyers,
accountants, physicians and other professionals are usually non-
hypnotizable.
Reasons Why Deception Detection Obtained Through Hypnosis Is
Not Admissible in Court:
1. It lacks the general scientific acceptance of the reliability of
hypnosis per se in ascertaining the truth from falsity;
2. The fear that the trier of fact will give uncritical and absolute
reliability to a scientific device without consideration of its flaw
in ascertaining veracity.
3. The possibility that the hypnotized subject will deliberately
fabricate;
4. The prospect that the state of heightened suggestibility in which
the hypnotized subject is suspended will produce distortion of the
fact rather than the truth; and
5. The state of the mind, skill and professionalism of the examiner
are too subjective to permit admissibility of the expert testimony
(Am. J. of Trial Advocacy, 1981, p. 603).
Confession while under hypnotic spell is not admissible as
evidence because such "psychiatric treatment" is involuntary and
mentally coersive (Leyra v. Demro, 347 U.S. 556, 74 S. Ct. 716,
98, 948 (1954).
Although hypnosis may not yield admissible evidence it may be
of some use during investigation as a discovery procedure.
IV.^SERVATION
A good criminal investigator must be a keen observer and a good
psychologist. A subject under stress on account of the stimulation of
the sympathetic nervous system may exhibit changes which may be
used as a potential clue of deception. And since just one or a com-
bination of the following signs and symptoms is not conclusive or a
reliable proof of guilt of the subject, their presence infers further
investigation to ascertain the truth of the impression.
Physiological and Psychological Signs and Symptoms of Guilt:
1. Sweating — Sweating accompanied with a flushed face indicate
anger, embarrassment or extreme nervousness. Sweating with a
pallid face may indicate shock or fear. Sweating hands indicate
tension.
2. Color cnange — If the face is flushed, it may indicate anger, em-
barrassment or shame. A pale face is a more common sign of
guilt.
3. Dryness of the mouth — Nervous tension causes reflex inhibition
of salivary secretion and consequently dryness of the mouth.
This causes continuous swallowing and licking of the lips.
4. Excessive activity of the Adam's apple — On account of the dry-
ness of the throat aside from the mouth, the subject will swallow
saliva from the mouth and this causes the frequent upward and
downward movement of the Adam's apple. This is observed in
many guilty subjects.
5. Fidgeting — Subject is constantly moving about in the chair,
pulling his ears, rubbing his face, picking and tweaking the nose,
crossing or uncrossing the legs, rubbing the hair, eyes, eyebrows,
biting or snapping of fingernails, etc. These are indicative of
nervous tension.
6. "Peculiar feeling inside" — There is a sensation of lightness of
the head and the subject is confused. This is the result of his
troubled conscience.
7. Swearing to the truthfulness of his assertion — Usually a guilty
subject frequently utters such expression. "I swear to God I am
telling the truth" or "I hope my mother drops dead if I am
lying", "I swear to God". . . etc. Such expressions are made to
make forceful and convincing his assertion of innocence.
8. "Spotless past record" — "Religious man" — The subject may
assert that it is not possible for him to do "anything like that"
inasmuch as he is a religious man and that he has a spotless record.
9. Inability to look at the investigator "straight in the eye" — The
subject does not like to look at the investigator for fear that his
guilt may be seen in his eyes. He will rather look at the floor or
ceiling.
r
10. "A or that I remember" expression — The subject will resort to
the use of "not that I remember" expression when answering to
be evasive or to avoid committing something prejudicial to him.
V. SCIENTIFIC INTERROGATION
Interrogation is the questioning of a person suspected of having
committed an offense or of persons who are reluctant to make a full
disclosure of information in his possession which is pertinent to the
investigation. It may be done on a suspect or a witness.
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1. A suspect is a person whose guilt is considered on reasonable
ground to be a practical possibility.
2. A witness is a person, other than the suspect, who is requested to
give information concerning the incident. He may be a victim
a complainant, an accuser, a source of information, an observer
of the occurrence, a scientific specialist who has examined physical
evidence or a custodian of official document.
Attitude and Conduct of an Investigator:
In the course of an interrogation of a suspect or witness, the inter-
rogator must observe the following:
1. The interrogator should avoid creating an impression that he is an
investigator seeking a confession or conviction. It is better for him
to appear in the role of one who is merely seeking the truth.
2. Such realistic words or expressions as "kill", "steal", "confess"
your crime, etc. should not be used by the interrogator. It is more
desirable, from the psychological standpoint, to employ a milder
terminology like "shoot", "take", "tell the truth", etc.
3. The interrogator should sit fairly close to the subject and between
the two, there should not be a table or other pieces of furniture.
4. The interrogator should avoid pacing about the room. To give an
undiverted attention to the person being interrogated, make it as
such that will be more difficult for him to evade detection of
deception or conceal his guilt-
5. The interrogator should avoid or at least minimize smoking, and
he should also refrain from fumbling with a pencil, pen or other
room accessories, for all these tend to create an impression of lack
of interest or confidence.
6. The interrogator should adapt his language to that used and under-
stood by the subject himself. In dealing with an uneducated and
ignorant subject, the interrogator should use simple words and
sentences.
7. Since the interrogator should always occupy a fearless position
with regards to his subject and to the condition and circumstances
attending the interview, the subject should not be handcuffed or
shackled during his presence in the interrogation room. The
interrogator should face the subject as "man to man" and not as
policeman to prisoner.
For Purposes of Investigation the Following are the Different Types
of Criminal Offenders:
1. Based on behavioral attitude:
a. Active aggressive offenders — They are persons who commit
crime in an impulsive manner usually on account of their
aggressive behavior. Such attitude is clearly shown in crimes of
passion, revenge or resentments,
b. Passive inadequate offenders — Persons who commit crimes
because of inducement, promise or reward. They are gullible
and easily persuaded to perform acts in violation of the penal
laws.
2. Based on the state of mind:
a. Rational offenders — Those who commit crime with motive or
intention and with full possession of their mental faculties.
Example: Killing with evident premeditation.
b. Irrational offenders — They commit crime without knowing
the nature and quality of his act.
Example: Mad killer.
3. Based on proficiency:
a. Ordinary offenders — These are the lowest form of criminal
career. They are only engaged in crimes which require limited
skill. They lack the capacity to avoid arrest and conviction.
a. Professional offenders — They are highly skilled and able to
perform criminal acts with the least chance of being detected.
They commit crimes which require special skill rather than
violence.
Example: Pick-pocketing, shop-lifting.
4. Psychological classification:
a. Emotional offenders— These are persons who commit crimes
in the heat of passion, anger, or revenge, and also who commit
offenses of accidental nature. Emotional offenders usually have
feeling of remorse, mental anguish or compunction as a result of
their acts. They have the sense of moral guilt. Their conscience
"bother" them and they have difficulty resting or sleeping
because of their feeling of guilt. The most effective interro-
gation approach to use for them is based upon sympathetic
consideration regarding their offense and present difficulty.
b. Non-emotional offenders — These are persons who commit
crimes for financial gain and are usually recidivist or repeaters.
Sympathetic approach is not effective. The interrogator should
make a factual analysis of the suspect's predicament and appeal
to his common sense and reasoning rather than to his emotion.
Requirement for the Admissibility of Evidence Obtained Through
Interrogation:
Sec. 20 Art. IV, Bill of Rights, Philippine Constitution:
No person shall be compelled to be a witness against himself.
Any person under investigation for the commission of an offense
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shall have the right to remain silent and to counsel, and be informed
of such right. No force, violence, threat, intimidation, or any other
means which vitiates the free will shall be used against him. Any
confession obtained in violation of this section shall be inadmissible
in evidence.
In compliance with the above provision of the constitution and
the decision of the U.S. Supreme Court, in Miranda v. Arizona, 384
U.S. 436 (1966) safeguards were established for the interrogation of
suspected (accused) person. If a person is to be interrogated, he
must first be warned and advised that:
a. He has the right to remain silent;
b. Anything he says can be used against him in court of law;
c. He has the right to consult with an attorney and to have the
attorney present during the questioning; and
d. If he cannot afford an attorney, one will be appointed for him
prior to any questioning if he so desires.
After such warning and in order to secure a waiver, the following
questions should be asked. An affirmative answer to each question
constitutes a waiver to the rights:
a. Do you understand each of these rights I have explained to
you?
b. Having these rights in mind, do you wish to talk to us now?
Some Techniques of Interrogation:
The choices of methods of questioning depend on the personal
and psychological evaluation of the subject by the interrogator, the
nature of the crime under investigation, previous criminal record, and
the social and educational background of the subject.
1. Emotional appeal — The interrogator must create a mood that is
conducive to confession. He may be sympathetic and friendly to
the subject. The subject may be willing to disclose more infor-
mation if he is treated in a kind spirit.
2. Mutt and Jeff technique — In this technique there must be at least
two investigators with opposite character; one (Mutt) who is
arrogant and relentless who knows the subject to be guilty and
will not waste time in the interrogation, and the other (Jeff) who
is friendly, sympathetic and kind. When Mutt is not present Jeff
will advice the subject to make a quick decision and plea for
cooperation.
3. Bluff on split-pair technique — This is applicable where there are
two or more persons who allegedly participated in the commission
of a crime. All of them are interrogated separately and the results
of their individual statements are not known to one another.
While one of them is under interrogation, the interrogator may
claim that the subject was implicated by the author and that there
is no use for him to deny participation.
4. Stern approach — The questions must oe answered clearly, and the
interrogator utilizes harsh language. Immediate response from the
subject is demanded.
5. The subject is given the opportunity to make a lengthy, time-
consuming narration. There may be a moment when the subject
becomes confused and desists from making further statement for
fear of contradicting his previous statement.
Basis of the Investigator's Inference that the Subject is Not Telling
the Truth:
1. The subject's statement have many improbabilities and gaps on
its substantial parts.
2. The subject's statements are inconsistent with the material facts.
3. The subject's statements are incoherent, conflicting with one
another.
VI. CONFESSION
Confession is an expressed acknowledgment by the accused in
a criminal case of the truth of his guilt as to the crime charged, or of
some essentials thereof.
Confession is different from admission, although admission in-
cludes, as one of its species, confession. Confession is a statement of
guilt while admission is usually a statement of fact by the accused
which does not directly involve an acknowledgement of guilt of the
accused.
The defendant stated in the preliminary investigation that he
had inflicted upon the deceased the wounds -in question. It was
held that such statement was not a confession of guilt but only an
admission, inasmuch as the defendant might have inflicted the
wound in self-defense (U.S. v. Team, 23 Phil. 64).
An admission by one accused of rape that he had carnal inter-
course with the complaining witness at the time and place men-
tioned in the information is not a confession of guilt of the crime
charged unless he further admits that he cohabited with the
woman without her consent, or by the use of force or threat
(U.S. v. Flores, 26 Phil. 262).
Kinds of Confession:
1. Extra-judicial Confession:
This is a confession made outside of the court prior to the
trial of the case.
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Sec. 3, Rule 133, Rules of Court — Extra-judicial confession, not
sufficient ground for conviction:
An extra-judicial confession made by an accused, shall not be
sufficient ground for conviction, unless corroborated by evidence
of corpus delicti.
Qbrpus delicti means the body of the crime or fact of specific
loss or injury sustained. It may not necessarily be the body of
the crime but may consist of facts and circumstances tending to
corroborate the confession.
The reason for the above rule is to guard against conviction
based upon false confession of guilt. It is possible that a person
might have confessed his guilt regarding an offense which some-
one has committed and when asked of his victim on the nature of
the injuries inflicted by him, it does not coincide with the identity
or nature of the injuries received by the victim.
a. Extra-judicial confession may be:
/ ( l ) Voluntary extra-judicial confession:
L
The confession is voluntary when the accused speaks on
his free will and accord, without inducement of any kind,
and with a full and complete knowledge of the nature and
consequence of the confession, and when the speaking is
so free from influences affecting the will of the accused, at
the time the confession was made that it renders it ad-
missible in evidence against him.
(2) Involuntary extra-judicial confession: lA ^ C A W * * A M -
V
?
' Confessions obtained through force, threat, intimi-
dation, duress or anything influencing the voluntary act of
the confessor.
Confessions obtained from the defendant by means of
force and violence is null and void, and cannot be used
against him at the trial. (U.S. v. Lozada, 4 Phil. 266; U.S.
v. Felipe, 5 Phil. 333).
If a confession was made when a threat or promise was
made by, in the presence of a person in authority, who has,
or is supposed by the accused to have power or opportunity
to fulfill the threat or promise, then the confession of the
accused will be presumed to be the exclusive effect of
inducement and therefore inadmissible (Early v. Com., 86
Va. 921).
A confession made under the influence of spiritual advice
or exhortation is not admissible.
A confession made under the influence of parental
sentiment is not admissible (People v. Martinez, 42 Phil.
853).
In confession through a "third degree", the duty of the
physician is to determine the presence and extent of phy-
sical injuries on the subject.
A physician must be cautious concluding that if physical
injuries are present, they were inflicted in the course of a
"third degree". It could be possible that the subject has
self-inflicted those wounds in the guise that the confession
was not voluntary.
Maltreatment of Prisoners for the Purpose of Exhorting Confession
or To Obtain Some Information is a Crime.
Art. 235, Revised Penal Code — Maltreatment of prisoners:
The penalty of arresto mayor in its medium period to prision
correccional in its minimum period, in addition to his liability for the
physical injuries or damaged caused, shall be imposed upon any public
officer or employee who shall overdo himself in the correction or
handling of a prisoner or detention of a prisoner under his charge, by
the imposition of punishments not authorized by the regulations, or
by inflicting such punishments in a cruel and humiliating manner.
If the purpose of the maltreatment is to extort a confession, or to
obtain some information from the prisoner, the offender shall be
punished by prision correccional in its minimum period, temporary
special disqualification, and a fine not exceeding 500 pesos, in
addition to his liability for the physical injuries or damage caused.
Elements of the crime:
1. The offender is a public officer or employee;
2. The offender has under his charge a (convicted) prisoner or a de-
tention prisoner;
3. The offender maltreats the prisoner in any of the following way:
a. By overdoing in the correction or handling of prisoner, either
by (1) imposition of punishment not authorized by the regula-
tion, or (2) by inflicting such punishment in a cruel and humil-
iating manner; or
b. By maltreating such prisoner to extort a confession or to
obtain some information from the prisoner.
THE TOKYO DECLARATION
The Tokyo Declaration which was endorsed by the World Medical
Association in 1975 contains guidelines to be observed by physicians
concerning torture and other cruel, inhuman, and degrading treat-
ment or punishment in relation to detention and imprisonment.
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Preamble the face of threats or reprisals resulting from a refusal to condone

It is the privilege of the medical doctor to practice medicine in the use of torture and other forms of cruel, inhuman or degrading
the service of humanity, to preserve and restore bodily and mental treatment.
health without distinction as to persons, to comfort and ease the (The New Police Surgeon by S.H. Burgress, pp. 134-136; JAMA Vol.
suffering of his or her patients. The utmost respect for human life is 255, No. 20 May 23,1986, p. 2800)
to be maintained even under threat, and no use made of any medical 2. Judicial Confession:
knowledge contrary to the laws of humanity.
This is the confession of an accused in court. It is conclusive
For the purpose of this Declaration torture is defined as the upon the court and may be considered to be a mitigating circum-
deliberate, systematic or wanton infliction of physical or mental stance to criminal liability.
suffering by one or more persons acting alone or on the orders of A plea of guilty when formally entered on arraignment is
any authority, to force another person to yield information, to make sufficient to sustain a conviction of any offense, even a capital
a confession, or for any other reason. one, without further proof.
Declaration Sec. 2, Rule 129, Rule of Court — Judicial admissions:
1. The doctor shall not countenance, condone or participate in the Admissions made by the parties in the pleadings, or in the
practice of torture or other forms of cruel inhuman or degrading course of the trial or other proceedings do not require proof and
procedures, whatever the offense of which the victim of such can not be contradicted unless previously shown to have been
procedures is suspected, accused or guilty, and whatever the made through palpable mistake.
victim's beliefs for motives, and all the situations, including
armed conflict and civil strife.
2. The doctor shall not provide any premises, instruments, substances
or knowledge to facilitate the practice of torture or other forms
of cruel, inhuman or degrading treatment or to diminish the
ability of the victim to resist such treatment.
3. The doctor shall not be present during any procedure during
which torture or other forms of cruel, inhuman or degrading
treatment is used or threatened.
4. A doctor must have complete clinical independence in deciding
upon the care for a person for whom he or she is medically respon-
sible.
The doctor's fundamental role is to alleviate the distress of his
or her fellow men, and no motive — whether personal, collective
or political — shall prevail against his higher purpose.
5. Where a prisoner refuses nourishment and is considered by the
doctor as capable of forming an unimpaired and rational judgment
concerning the consequences of such voluntary refusal of nourish-
ment, he or she shall not be fed artificially. The decision as to the
capacity of the prisoner to form such a judgement should be
confirmed by at least one other independent doctor. The con-
sequences of the refusal of nourishment shall be explained by the
doctor to the prisoner.
6. The World Medical Association will support, and should encourage
the international community, the national medical associations
and fellow doctors, to support the doctor and his or her family in
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MEI31G0-LEGAL ASPECTS OF IDENTIFICATION
- identification is the determination of t h e i n d i v i d u a l i t y nt
or thing.
importance of Identification of Person:
1. In the prosecution of the criminal offense, the identity of the
offender and that of the victim must be established, otherwise it
will be a ground for the dismissal of the charge or acquital of the
accused.
2. The identification of a person missing or presumed dead will
facilitate settlement of the estate, retirement, insurance and other
social benefits. It vests on the heirs the right over the properties
of the identified person.
If identity cannot be established, then the law on presumption
of death (Art. 390, Civil Code) must be applied which requires the
lapse of seven years before a person can be presumed dead. In
special instances, the seven years period may be reduced to four
years (Art. 391, Civil Code).
3. Identification resolves the anxiety of the next-of-kin, other rela-
tives and friends as to the whereabouts of a missing person or
victim of calamity or criminal act.
4. Identification may be needed in some transactions, like cashing of
check, entering a premise, delivery of parcels or registered mail in
post office, sale of property, release of dead bodies to relatives,
parties to a contract, etc.
Rules in Personal Identification:
1. The greater the number of points of similarities and dissimilarities
of two persons compared, the greater is the probability for the
conclusion to be correct. This is known as the TJIW of Multipli-
city of Evidence in Identification.
2. The value of the different points of identification varies in the
formulation of conclusion. In a fresh cadaver, if the fingerprints
on file are the same as those recovered from the crime scene, they
will positively establish the identity of the person while bodily
3. The longer the interval between the death and the examination
of the remains for purposes of identification, the greater is the
ajTimn need for experts in establishing identity. The process of taking
fingerprints and its examination under a magnifying lens requires
the services of an expert. When putrefaction has set in, the ex-
ternal bodily marks useful in identification might be destroyed
so that it is necessary to resort to an anatomical or a structural
examination of the body which requires knowledge of medicine'
and dentistry.
4. Inasmuch as the object to be identified is highly perishable, it is
necessary for the team to act in the shortest possible time special-
ly in cases of mass disaster.
5. There is no rigid rule to be observed in the procedure of identi-
fication of persons.
Methods of Identification:
l.By comparison — Identification criteria recovered during investi-
gation are compared with records available in the file, or post-
mortem finding are compared with ante-mortem records.
Examples:
a. Latent fingerprints recovered from the crime scene are com-
pared with the fingerprints on file of an investigating agency.
b. Dental findings on the skeletal remains are compared with the
dental record of the person in possession of the dentist.
2. By exclusion — If two or more persons have to be identified and
all but one is not yet identified, then the one whose identity has
not been established may be known by the process of elimination.
/ IDENTIFICATION OF PERSONS
The bases of human identification may be classified as:
X- Those which laymen used to prove identity — No special training
or skill is required of the identifier and nc instrument or pro-
cedure is demanded.
2 JPhose which are based on scientific knowledge — Identification is
<

marks, like moles, scars, complexion, shape of nose, etc. are
merely corroborative. Visual recognition by relative or friends
may be of lesser value as compared with fingerprints or dental
comparison.
41
made by trained men, well-seasoned by experience and obser-
vation, and primarily based on comparison or exclusion.
V L ORDINARY METHODS OF IDENTIFICATION
Points of Identification Applicable to the Living Person Only:
1. Characteristics which may easily be changed:
(j^ Growth of hair, beard or mustache — This may easily be shaved
or grown within a short time. Arrangement may be changed.
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artificial hair may be worn or ornamentation may be placed to
changed its natural condition.
^b^Clothing — A person may have special preference for certain
form, texture, or style. Certain groups of people are required
to have specific cut, color or design, as in uniforms, worn by
students, employees of commercial or industrial establishment,
or groups of professionals.
/c.^'requent place of visit — A person may have a special desire or
^ " n a b i t to be in a place if ever he has the opportunity to do so.
"Sari-sari" stores, barber shops, coffee shops, beer gardens and
recreation halls are common venues of visit of certain class of
people. A wanted criminal may suddenly prevent himself from
going to the place he used to visit for fear that he may be
apprehended.
^^Grade of profession — A medical student of the upper clinical
year may be recognized by the stethoscope; a graduate or
student nurse by her cap, a mechanic by his tools, a clergyman
by his robe, etc. A change of grade, trade, vocation or profes-
sion may be resorted to as a means of concealing identity.
(eJBody ornamentations — Earrings, necklaces, rings, pins, etc.
^-^usually worn by persons may be points to identify a person
from the rest.
2.\£haracteristics that may not easily be changed:
a. Mental memory — A recollection of time, place and events
may be a clue in identification. Remembering names, faces
and subjects of common interest may be initiated during inter-
view to see how knowledgeable a person is.
b. Speech — A person may stammer, stutter or lisp. However,
if the manner of talking is due to some physical defects, like
harelip and cleft palate, that have been corrected by surgery,
there may be a change in his manner of speech.
The manner of talking and the quality of the voice are
dependent on the vocal cavities (throat, mouth, nose and
•inuses) and his manner of manipulating the lips, teeth, tongue,
soft palate, and jaw muscles. The chances of two or more
persons having the same size of vocal cavities and the same
manner of articulation are remote and unlikely. Whispering,
muffling and nose-holding do not change the speech charac-
teristic. The speech may be recorded and preserved in a good
tape recorder. A known standard may also be recorded for
purposes of comparison. Identification can be achieved through
the sound spectrographs analysis.
c. Gait — A person, on account of disease or some inborn traits,
may show a characteristic manner of walking.
(1) Ataxic gait — A gait in which the foot is raised high, thrown
forward and brought down suddenly is seen in persons
suffering from tabes dorsalis.
(2) Cerebellar gait — A gait associated with staggering move-
ment is seen in cerebellar diseases.
(3) Cow's gait — A swaying movement due to knock-knee.
(4) Paretic gait — Gait in which the steps are short, the feet are
dragged and the legs are held more or less widely apart.
(5) Spastic gait — A gait in which the legs are held together and
move in a stiff manner and the toes dragged.
(6) Festinating gait — Involuntary movement in short accele-
rating steps.
(7) Frog gait — A hopping gait resulting from infantile paralysis.
(8) Waddling gait — Exaggerated alternation of lateral trunk
movement similar to the movement of the duck.
In the normal process of walking the rear portion of the
heel is placed on the ground. This is subsequently followed by
the other parts of the heel and the sole of the foot is pressed on
the ground. The toes are the last to be pressed followed by the
lifting of the foot making another step forward. The pressure at
the rear portion of the heel and in the region of the toes is the
most forceful, hence the impression is the most.
During the process of running the foot marks are less dis-
tinct because of the slipping of the foot and the sand or soil
thrown into the marks by the pressure of the tip of the toes.
Gait Patterns:
A scientific investigation of the gait pattern may be useful
for purposes of identification and investigation of the crime
scene. Gait pattern is the series of foot marks by a person
walking or running. Examination of the gait includes the
direction line, gait line, foot angle, principal angle and the
length and breadth of the steps.
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e. Hands and feet — Size, shape and abnormalities of the hands

at..
Gait pattern. A: direction line; B: gait line; C: foot line; D: foot angles;
E: principal angle; F: length of step; G: breadth of step.
(A) Direction line — Expresses the path of the individual.
(B) Gait line — The straight line connecting the center of the
succeeding steps. It is more or less in zigzag fashion es-
pecially when the legs are far apart while walking. Stout,
elderly people and those who want stability while walking
have a more zigzag gait line.
(C) Foot line — The longitudinal line drawn on each foot mark.
There may be a difference in the foot line of the left and
right foot.
(D)Foot angle — The angle formed by the foot line and the
direction line. In normal walking the foot angle is very
characteristic of a person and cannot be altered immediate-
ly. However, it may be altered when a person is running,
carrying a heavy weight or moving on a rugged terrain.
(E) Principal angle — The angle between the two succeeding
foot angles.
(F) Length of step — When the distance between the center
points in two successive heel prints of the two feet exceeds
40 inches, there is a strong presumption that the person
is running.
(G) Breadth of step — The distance between the outer contours
of two succeeding foot marks or steps. The more apart the
legs are while walking, the greater is the breadth of the step.
(Crime Detection by Ame Svensson & Otto Wendel, p. 58)
dr.'Mannerism — Stereotype movement or habit peculiar to an
individual. It may be:
(1) Way of sitting.
(2) Movement of the hand.
(3) Movement of the body.
(4) Movement of the facial muscles.
(5) Expression of the mouth while articulating.
(6) Manner of leaning.
and feet may be the bases of identification. Some persons have
supernumerary fingers or toes far apart with bony prominence.
Some fingers or toes are with split nails.
Foot or hand marks found in the investigation of the crime
scene may be:
(1) Foot or hand impression — This develops when the foot or
hand is pressed on mouldable materials like mud, clay,
cement mixture, or other semi-solid mass. The impression
can be preserved by making a cast of it with plaster of Paris.
(2) Footprint or handprint — This is a footmark or handmark
on a hard base contaminated or smeared with foreign
matters like dust, flour, blood, etc.
t. Complexion — Complexion can be determined when the whole
body is exposed preferably to ordinary sunlight. Dark com-
plexion may be found fair with the use of bleaching chemicals,
while fair complexion may temporarily be made dark with the
use of an ointment with a dark pigment. Exposed parts of the
body usually appear darker than those covered with clothing.
g. Changes in the eyes — A person identified because he is near-
sighted, far-sighted, color blind, astigmatic, presbyopic, or cross-
eyed. The eye may have arcus senilis, artificial pupils, irregular
marks of the spectacles or cataract. Color of the iris, shape
of the eyes, deformity of the eyeball and the presence of
disease are useful bases of identification.
h. Facies — There are different kinds of facial expressions brought
about by disease or racial influence.
(1) Hippocratic facies— The nose is pinched, the temple hollow,
eyes sunken, ears cold, lips relaxed and skin livid. The
appearance of the face is indicative of approaching death.
(2) Mongolian facies — Almond eyes, pale complexion, pro-
minence of cheek bones.
(3) Facies Leonine — A peculiar, deeply furrowed, lion-like
appearance of the face. This may be observed in leprosy,
elephantiasis and ,leontiasis ossia.
(4) Myxedemic facies — Pale face, edematous swelling which
does not pit on pressure, associated with dullness of in-
tellect, slow monotonous speech, muscular weakness and
tremor.
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a. A shoemaker develops depressed sternum.

2. Race — In the living, race may be presumed in:
*^a. Color of the skin:
Base up Base down
Triangular face
The face may be round, oval, triangular or slightly
square.
Distinct identifying marks may be present on the face,
such as, peculiarly attractive scars, moles, hair, nose and con-
dition of the skin which an identifier may specially notice,
i. Left— or right-handedness — The preferential use of one hand
with skill to the other in voluntary motor acts. Ambidextrous
people can use their right and left hands with equal skill.
The best way to determine whether a person is left— or
right-handed or ambidextrous is to observe him during his
unguarded moments.
j. Degree of nutrition — The determination must be in relation
to the height and age. A person may be thin, normal or stout.
This point of identification easily changes by refraining from
/ intake of fatty foods. Some persons are inherently skinny
/ inspite of heavy intake of nutritive food.
^Points of Identification Applicable to Both Living and Dead before
-Ouaul of Lrecomposition:
l^Oeeupatirnttl Marfrff — Certain occupations may result in some
characteristic marks or identifying guides:
b. Painters have stains on the hands and fingernails.
c. Engineers and mechanics may have grease on their hands.
d. A dressmaker develops multiple punctured marks on finger
tips.
e. Baker and miller may have flour dust on their clothings and
on their bodies.
f. Mason have callosities on the palms of the hands.
g. Scars caused by burns produced by scales or sparks or red hot
iron may be seen at the back of the hands of blacksmiths.
h. Involuntary tattooing of particles of coal may be seen on the
hands of miners.
i. Chemical stains may be present on the hands of dyers, photo-
graphic developers and printers.
Caucasian — Fair
Malayan — Brown
Mongolian — Fair
Negro — Black
b. Feature of the face:
Caucasian — Prominent sharp nose
Malayan — Flat nose with round face
Mongolian — Almond eyes and prominent cheek bone
Negro — Thick lips and prominent eyes
c. Shape of the skull:
Caucasian — Elongated skull
Malayan — Hound head
Mongolian — Round head
Ked Indians and Eskimos — Flat head
d. Wearing apparel — Casual and customary wearing apparel
may indicate race as well as religion, nationality, region and
custom.
3. Rtntiijp - A person ceases to increase in height after the age of
"25. There is apparent shrinkage in height after a long standing
debilitating disease. There is actual shrinkage in old age on
account of the compression of the inter-vertebral and also the
curvature of the spinal column. The growth of a person rarely
exceeds five centimeters after the age of 18.
The rate of growth is variable but it is most active from 5 to
7 and from 13 to 16 years of-age. When the rate of growth is
increased, the horizontal growth is relatively retarded.
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Methods of Approximating the Height of a Person: Importance of Tattoo Mark:

If the body is complete the height can be determined by actual a. It may help in the identification of the person. The image
measurement. Sometimes some part of the body is missing and inscribed may reflect the name, date of birth, language spoken,
the actual measurement may not be possible. The following are religion, name of spouse, etc.
the methods to be used to approximate the height: b. It may indicate memorable events in his life.
a. Measure the distance between the tips of the middle fingers of c. It may indicate the social stratum to which the person belongs.
both hands with the arms extended laterally and it will ap- Generally, tattooing is practiced by the members of the lower
proximately be equal to the height. economic class.
b. Two times the length of one arm plus 12 inches from the d. Lately, the presence of tattoo implies previous commitment
clavicle and 1.5 inches from the sternum is the approximate in prison or membership in a criminal gang.
height. Factors Responsible for the Permanency of Tattoo:
c. Two times the length from the vertex of the skull to the pubic a. Whether the punctures are superficial or deep to reach the true
symphysis is the height. skin;
d. The distance between the supra-sternal notch and the pubic
symphysis is about one-third of the height. b. Nature and solubility of the pigment used. Ordinary pen ink
disappears in a short time while carbon introduced to the true
e. The distance from the base of the skull to the coccyx is about
skin layer is usually permanent. Soluble pigments easily dis-
44% of the height. appear and may be seen in the lymph glands.
f. The length of the forearm measured from the tip of olecranon
process to the tip of the middle finger is 5/19 of the height. Methods of Removing Tattoos:
g. Eight times the length of the head is approximately equal to a. By surgical excision - Shallow tattoo may disappear by simple
the height of the person. rubbing or superficial incision and may leave no scar. Deep-
seated tattoo may be excised and usually leaves a scar.
4. Tattoo marks — Introduction of coloring pigments in the layers
_1,
of the skin by multiple puncture. Tattoo marks may be in the b. By electrolysis — The needle is inserted into the tattoo mark in
form of initials, names, images or views. a sufficient number of times using a current of 5 to 8 milliam-
peres. This forms a superficial eschar, which drops off in a
week or so taking the pigment with it and leaving a superficial
scar.
c. By application of caustic substance — The caustic substance is
applied to the tattoo mark and the pigment is removed with
the eschar after inflammatory reaction.
h.Wejghtr— This is not a good point of identification for it is
""""easily changed from time to time.
6. Deformities — Congenital or acquired — deformities may cause
^-Peculiar way -of walking, body movement, facial expression,
mannerisms, etc. Deformity like clubfoot, harelip, cleft palate,
cystic conditions, bony prominence, etc., may be corrected
surgically.
Acquired deformities in the form of amputation, improper
union of bones, depressed fracture, deforming scars may be
the bases for identification.
T_Birth marks — Birth marks may be a spot naevi, port wine, or a
Mongolianblue spot. They may be removed by carbon dioxide
Tattoo marks snow, electrocautery, or by excision. The marks must be des-
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cribed as to shape, location, dimension, color and degree of
pigmentation.
rnj»riv>fl leaving permanent results — Amputation, improper
union of fractured bones.
Q M o f g « — O r d i n a r i l y they are permanent but can be removed by
'""""electrolysis, by radium or by carbon dioxide snow.
10^Jfcgc--==--A-^maining mark after healing of the wound. The
fibrous tissue takes the place of the original tissue which has
been injured or destroyed. A scar is devoid of specialized tissues
so it does not contain pigment, sweat or sebaceous glands. Its
number, exact location, size and shape, and whether it is elevated
or depressed should be noted.
Faint scars may be made visible by making the surrounding
skin red upon applying friction with hand or by heat.
Scar which develops after a secondary infection is usually
marked.
Scar increases in size in proportion with the growth of the
person.
Age of the Scar — A recently formed scar is slightly elevated,
reddish or bluish in color, and tender to touch.
In a few weeks to two months, the scar has inflammatory
redness and it is soft and sensitive.
Two to six months later, it becomes brownish or coppery red
in color, free from contraction and corrugation, and soft.
When the scar is white, glistening, contracted and tough, it
is not less than six months.
The period of scar formation may be delayed by sepsis, poor
vascularity of the part involved, age, depth of the wound, mo-
bility, presence of foreign body and health condition of the
victim. Scar may or may not develop if the wound is small,
superficial and healed by first intention.
Characteristics of the scar may show the cause of the previous
lesion:
a. Surgical operation — Regular form and situation with stitch
marks.
b. Bums and scald — Scars are large, irregular in shape, and may
be keloid. Scar of scald may show stippled surface.
c. Gunshot — Disc-like, depressed at center and may be adherent
to the underlying tissue.
d. Tuberculosis sinus — Irregular in shape furrowed, with edges
hardened and uneven.
e. Flogging — Fine white lines diagonally across back, depressed
small spot at interval.
f. Gumma — Depressed scar following loss of tissue.
g. Lupus — Bluish-white scar.
h. Venesection — At bend of elbow, on dorsum of foot, or on
temporal region.
i. Wet cupping — Short parallel scars on lower part of the back
and loin.
11. Tribal marks — Marks on the skin by tattooing or branding. In
CliiratrdtngTheated metal is pressed on the skin and during the
healing process a scar develops as a mark. The tribal marks are
placed in the exposed parts of the body and used to identify
person or membership of a tribe or social group.
12. Sexual orggjL=.Male organ may show previous circumcision. In
lale"the uterus and breasts may show signs of previous preg-
nancy. Previous gynecological operation may be seen in the
abdomen.
13. Blood examination — Blood type, disease, parasitic infection or
-to~xic substances piesent may be utilized to distinguish one per-
son from another.
/ ^ I H R O P O M E T R V (Bertitton Systemy
Alphonse Bertillon, a French criminologist, devised a scheme
utilizing anthropometrical measurement of the human body as the
basis of identification.
Basjs'of the Bertillon System of Identification:
l.X'he' human skeleton is unchangeable after the twentieth year. The
igh bone continues to grow somewhat after the period, but this
'is compensated by the curving of the spine which takes place at
aboia the same age. /
2. It/is impossible to find two Jjuman beings having bones exactly
like.
3/The necessary measurement can easily be taken with the aid of a
simple instrument.
Information Included in the System:
1. Descriptive data — Color of the hair, eyes and complexion, shape
„<of the nose, ear, etc;
Igdymarks — moles, scars, tattoo marks, deformities, etc.
3 .An thropoineti ivul measu remen ts:
"a.~Sotfy Mrasuromentii - Height^ width of outstretched arms, and
sitting height.
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c. Mustache — Length, color, shape

Side-view shapes of noses
b. Measurement of the head — Length and breadth of head, bizy-
f —gouiatkal diameter, and length of the right ear.
"of the left foot, length of
the left middle and left little fingers, and length of left arm and
hand from the elbow to the tip of the oustretched middle
finger.
In many instances an investigator does not have a picture of the
wanted or missing person. The only way to have an idea of the
prominent physical features is for the witnesses or someone who has
knowjeiig£_af-±h*jdentity to tell him.
<^Portrait parte' (spoken picture) is a verbal, accurate and pictures-
queoescTlptioii o t t h e person identified. „ Such information may be
given by the witness, relatives, or other persons who are acquainted
with the physical features of the person to be identified.
The following basic requirements must be included in the verbal
description:
1. General impression: type, personality, apparent social status
2. Age and sex
3. Race or color
4. Height
5. Weight
6. Built — Thin, slender, medium or stout
7. Posture — Erect, slouching, round shoulder
8. Head — size, shape
9. Hair — Color, length, baldness
10. Face — General impression
a. Forehead — High, low, bulging or receding
b. Eyebrows — Brushy or thin, shape
d. Ears — Size, shape, size of lobe, angle of set
e. Eyes — Small, medium or large; color; eyeglasses
f. Cheeks — High, low or prominent medium cheek bones; flat or
sunken.
g. Nose — Short, medium or big; or long; straight, aquiline or
flat or pug.
h. Mouth — Wide, small or medium; general impression
i. Lips — Shape; thickness; color
j. Teeth — Shade, condition, defect; missing elements
k. Chin — Size, shape, general impression
1. Jaw — Length, shape, lean, heavy or medium
11. Neck — shape, thickness, length; Adam's apple
12. Shoulder — Width and shape
13. Wrist — Size, shape
14. Hands — Length; size; hair; condition of the palms
15. Fingers — Length; thickness; stains; shape of nails; condition
of the nails.
16. Arms — Long, medium or short; muscular; normal or thin;
thickness of the wrist.
17. Feet — Size, deformities
If a skilled investigative illustrator is available, a picture of the
person to be identified may be drawn or sketched. As a check to
the sketch or drawing made, it must be shown to the person(s) who
gave the information to see whether it tallies with the person to be
identified.
If available, the investigator may look at what is commonly
called rougue's galary or photographic files of wanted or missing
persons for comparison with the cartographic sketch.
EXTRINSIC FACTORS IN IDENTIFICATION
1. Ornamentations — Rings, bracelet, necklace, hairpin, earrings,
lapel pin, etc.
2. Personal belongings — Letters, wallet, driver's license, residence
certificate, personal cards, etc.
3. Wearing apparel — Tailor marks, laundry mark, printed name of
owner, size, style, and texture, footwear, socks.
4. Foreign bodies — Dust in clothings, cerumen in the ears, nail
scrapping may show occupation, place of residence or work, habit,
etc.
5. Identification by close friends and relatives.
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6. Identification records on file at the police department, immi- A. FINGERPRINTING

gration bureau, hospitals, etc.
7. Identification photograph.
LIGHT AS A FACTOR IN IDENTIFICATION
1. Clearest moonlight or starlight:
Experiments have shown that the best known person cannot be
recognized by the clearest moonlight at a distance greater than 16
to 17 yards and by starlight any further than 10 to 13 yards.
a. Broad daylight:
A person can hardly recognized another person at a distance
farther than one hundred yards if the person has never been
seen before, but persons who are almost strangers may be
recognized at a distance of twenty-five yards.
b. Flash of firearm:
Although by experiment, letters of two inches high can be
read with the aid of the flash of a caliber .22 firearm at a
distance of two feet it is hardly possible for a witness to see the
assailant in case of a hold-up or a murder because:
(1) Usually the assailant is hidden.
(2) The assault is unexpected and the attention of the person or
witness is at its minimum.
c. The flash of lighting produces sufficient light for the identifi-
cation of an individual provided that the person's eye is fo-
cused towards the individual he wishes to identify during the
flash.
d. In case of artificial light, the identity is relative to the kind and
intensity of the light. Experiments may be made for every
particular artificial light concerned.
/ JH. SCIENTIFIC METHODS OF IDENTIFICATION
Aspects o t Identification Requiring Scientific Knowledge:
^printing
^jS^Denfal Identification
.^^Handwriting .
Dudentification of Skeleton
E<^5etefmination of Sex .
F/f5e^0rfmnation of Age ,
G^iaentiflcation of Blood and Blood Stains
H. Identification of Hair and Fibers
Fingerprinting is considered to be the most valuable method of
identification. It is universally used because:
1. There are no two identical fingerprints:
Fingerprints show unlimited and infinite varieties of form.
Two or more fingerprints may grossly appear to be seemingly
alike but under a microscope or the magnifying lens, the dif-
ference may be proven. The chances of two fingerprints being
the same are calculated to be 1 to 64,000,000,000 which is ten
times the number of fingers existing in the world.
2. Fingerprints are not changeable:
Fingerprints are formed in the fetus in the fourth month of
pregnancy. During the latter stage of pregnancy as well as after
birth, the pattern enlarges, but no changes take place in the number
and arrangement of the friction ridges.
The finger may be wounded or burned, but the whole pattern with
all its details will reappear when the wound heals. If the injury is
deep or beyond the layers of the skin and scar develops, it will not
deter identification. On the contrary, the scar will make a much
deeper impression of the pattern. It can be said that fingerprints
are an indelible signature which a person carries from the cradle to
the grave.
* Practical Uses of Fingerprints:
•fTHelp establish identity in cases of dead bodies and unknown
or missing persons.
2. Prints recovered from the crime scene associate person or weapon.
3. Prints on file are useful for comparative purposes and for the
knowledge of previous criminal records.
Among illiterates, right thumbprint is recognized as a substitute
for signature on legal documents. Countries differ as to which
finger is used for the purpose. India uses the left thumb, Spain
uses the right pointing finger.
^ / Dactylography is the art and study of recording fingerprints as a
means of identification.
f Dactyloscopy is the art of identification by comparison of finger-
prints. It is the study and utilization of fingerprints.
f -^Poroscopy is the study of the pores found on the pappillary or
friction ridges of the skin for purposes of identification.
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Advantages of Using Fingerprinting as a Means of Identification:
1. Not much training is necessary for a person to take, classify and
compare fingerprints.
2. No expensive instrument is required in the operation.
3. The fingerprint itself is easy to classify.
4. Actual prints for comparative purposes are always available and
suspected errors can easily be checked.
Methods of Producing Impressions:
r Jt. Plain method — The bulbs of the last phalanges of the fingers and
thumb are pressed on the surface of the paper after pressing them
/ o n an ink pad or ink plate with printing ink.
^ Rolled method — The bulbs of the thumb and other fingers are
rolled on the surface of the paper after being rolled on an ink pad
or ink plate with printing ink.
A Kinds of Impressions:
1. Real impression — Impression of the finger bulbs with the use of
^printing ink on the surface of the paper. Other coloring materials
may be used but they are less visible and indelible.
k 2. Chance impression — Fingerprints which are impressed by mere
chance without any intention to produce it. Chance impression
maybe:
o
A Fingerprint
a. Visible print — Impression made by chance and is visible with-
out previous treatment. Impression made by the fingers smeared
with some colored substances, like black ink, vegetable juice,
may be visible immediately after impression.
b. Plastic print — Impression made by chance by pressing the
finger tips on melted paraffin, putty, resin, cellophane, plastic
tape, butter, soap, etc.
c. Latent print — Prints which are not visible after impression but
made visible by the addition of some substances. Latent prints
develop because the fingers are always covered with colorless
residue of oil and perspiration which when pressed on smooth
and non-absorbent material will cause the production of the
prints.
ir How to Develop Latent Prints:
(1) Application of fine powder — The choice of substance to
be used to make the latent prints visible depends upon the
texture and color of the material where the suspicious prints
are located. The color of the substances to be used must be
in contrast with that material.
Characteristics of a good powder:
(a) It should be adhesive to the extent that it clings readily
to the edges of the fingerprints.
(b) It should not absorb water.
(c) It should provide good contrast to the place where the
latent print is impressed.
The following substances are commonly used to make
latent prints visible:
(a) Graphite for spraying
(b) Aluminum powder
(c) Plaster of Paris
(d) Copper powder for latent prints on leather
(e) Metallic antimony
(2) Chemical development by fuming and immersion:
Fuming by iodine or arsenic acid or immersion in a
solution of silver nitrate may develop latent prints.
How to Get Fingerprint Impressions on Dead Bodies:
In cases of fresh dead bodies, the fingers are unclenched and each
one is inked individually with the aid of a small rubber roller. The
paper where the print will be impressed will be placed in a spoon-
shaped piece of wood and slowly and evenly rolled over the pattern.
If the fist is too tightly clenched, a small incision may be made at
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the base of the fingers. The contraction may also be overcome by Four Primary Types of Fingerprint
dipping the hands in hot water.
If the so-called washerwoman's skin is not too marked on the
fingerprints of dead bodies recovered shortly from bodies of water
(floaters), the fingers may be dried off with a towel and glycerin is
injected with a syringe under the skin of the finger tips in order to
smoothen the surface. The fingerprints are then taken like that of a
fresh dead body.
If the "floater" has been in a body of water for a longer time and
the friction ridges have disappeared, the skin of the fingertips is cut
away. This area of skin from each finger is placed in a small labelled
test tubes containing formaldehyde solution. If the papillary ridges
are still preserved on the outer surface, the person taking the prints
places a portion of the skin on his right index finger protected by a
rubber glove and then takes the print after inking the finger tip.
The same procedure as described may be applied to putrefied or
burned bodies according to circumstances.

^Fypes of Fingerprint Patterns:

1. Arches — The ridges go from one side of the pattern to another,
never turning back to make a loop.
a. Plain arches — The ridges on one side of the impression and
flow or tend to flow out the other side with rise or wave in the
center.
b. Tented arch — One or more ridges at the center to form a
definite angle of 90 degrees or less than 45 degrees from the
horizontal plane.
2. Loops — One or more ridges enter on either side, recurves and
terminate or tend to terminate on the same side from which it
entered.
a. Ulnar loop — Recurves towards the ulnar side of the hand or
little finger.
b. Radial loop — Recurves towards the radial side of the hand or
thumb.
3. Whorls — Patterns with two deltas and patterns too irregular in
form to classify:
a. Simple whorls — Consist of two deltas with a core consisting of
circles, ellipses, or spiral turning to the right or left.
b. Central pocket loop- — It is like simple loop but in the core, one
may find one ridge which forms a convex towards the opening
of the loop.
c. Lateral pocket loops — There are at least two loops opening at
the same side.
> Whorl 4 Composite
d. Twin loop — There are at least two loops opening at the dif-
ferent sides.
e. Accidentals — There are no rules that can be made in this pat-
tern. They are rare and often with more than two deltas.
/Poroscopy (Locard's method of identification):
Examination of the ridges of the hands and fingers reveal to be
studded with minute pores which are the openings of ducts or sweat
glands. These pores are permanent as the ridges are and differ in
number and shape in a given area in each person. Poroscopy, as a
means of identification, is applied when only a part of the finger-
print is available for proper means of identification.
Can fingerprints be effaced?
John Dillinger, a notorious gangster and a police character at-
tempted to erase his fingerprints by burning them with acid, but as
time went by, the ridges were again restored to its "natural" feature.
The acid he applied temporarily destroyed the epidermis of the
bulbs of his fingers.
As long as the dermis of the bulbs of the finger is not completely
destroyed, the fingerprints will always remain unchanged and in-
destructible.
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Can fingerprints be forged? NOW, THEREFORE, I, FERDINAND E. MARCOS, President

There is a considerable controversy regarding the possibility of
forging fingerprints or making a simulated impression or a perfect
replica of impression of fingers. Various experiments were con-
ducted by authorities and although they could almost make an
accurate reproduction, still there is no case on record known or
have been written that forgery of fingerprints has been a complete
success. The introduction of modern scientific equipment, new
techniques and up-to-date knowledge in crime detection will always
foil the attempt. / Section 2. Upon the lapse of ten years from the last entry,
The role of the teeth iri human identification is important for the
following reasons:
1. The possibility of two persons to have the same dentition is quite
remote. An adult has 32 teeth and each tooth has five surfaces.
Some of the teeth may be missing, carious, with filling materials,
and with abnormality in shape and other peculiarities. This will
lead to several combinations with almost infinite in number of
dental characteristics.
2. The enamel of the teeth is the hardest substance of the human
body. It may outlast all other tissues during putrefaction or
physical destruction.
3. After death, the greater the degree of tissue destruction, the
greater is the importance of dental characteristics as a means of
identification.
4. The more recent the ante-mortem records of the person to be
identified, the more reliable is the comparative or exclusionary
mode of identification that can be done.
In order to make an accurate dental record available for purposes
of comparison with that of the person to be identified, Presidential
Decree No. 1575 was promulgated, requiring practitioners of dentist-
ry to keep records of their patients. It provides the following:
"Whereas, the identification of persons is a necessary factor in
solving crimes and in settling disputes such as claims for damages,
insurance, and inheritance; _ 4. The dentist may have a record but may no longer be reliable on
Whereas, in these cases where the identification of persons
cannot be established through the regular means, identification
through dentition has been proven to be necessary and effective;
Whereas, however, records of dentition of persons are often
not available due to the lack of systematic recording of dental
practitioners of the dental history of their patients.
of the Philippines, by virtue of the powers vested in me by the
Constitution, do hereby order and decree the following:
Section 1. It shall be obligatory upon all practitioners of
dentistry to keep and maintain an accurate and complete record
of the dentition of all their patients which shall include a
history and description of the patient's dentition and the
treatment made thereon.
dental practitioners shall turn over the dental records of their
patients to the National Bureau of Investigation for record
purposes: Provided, that the said practitioner may retain
copies thereof for their own files.
Section 3. Any violation of the provisions of this Decree
shall be punishable by a fine of not less than one hundred
pesos but not more than one thousand pesos.
Section 4. This Decree shall take effect immediately.
Done in the City of Manila, this 11th day of June, in the year of
Our Lord, nineteen hundred and seventy-eight."
However, the absence of dental records will not absolutely negate
dental identification. Members of the family, close associates and
friends may be witnesses to prove identity of dentition.
Causes of Unreliability of the Dental Records:
An ante-mortem dental record may be available but may be in-
sufficient, and in some instances unreliable for purposes of com-
parison with the post-mortem findings because:
1. The dentist, in the course of diagnosis and treatment of the
patient, may only concern himself with the affected teeth and
may not care to have a detailed examination of the other teeth.
2. There may be no uniformity in nomenclature of the location and
condition in the charting of the teeth.
3. Although there may be a law obliging dentists to have a record of
their patient, the law does not mention the agency which will
enforce it.
account of the lapse of time. There may be changes in the teeth
which are not seen by the dentist.
For purpose of uniformity, the following are the description of
location for dental identification:
1. Teeth position:
a. Anterior — From cuspid to cuspid inclusive (it includes cuspid,
lateral and central incissor).
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b. Posterior — All bicuspid and molar teeth. Dental Chart

2. Surface:
Occlosal — O — Surface which is in contact with the opposing
teeth when jaws are in occlusion (closed).
Mesial — M — Surface in direct contact with the adjacent
tooth towards the midline.
Distal — D — Surface in direct contact with the adjacent
teeth away from the midline.
Buccal — B — Surface facing the lip or cheek.
Lingual — L — Inward directed surface of the teeth.
3. Restoration:
Amalgam (silver filling), gold inlay, gold foil, silicate, acrylic,
c - Caries AB - Bridge Abutment
temporary cement, crown. X — Indicated for Extraction P Pontic
RF — Retained Root Fragment Gold Clasp
4. Prosthesis: AM — Amalgam Filling Gl -
- Gold Inlay
a. Fixed prosthesis — bridge S - Silicate Filling M - Missing due to Extraction
b. Removable prosthesis: CG — Gold Crown U N - Unerupted
(1) Complete denture
(2) Partial denture Other Aspects of Identification Which May Be Reflected in Dentition:
5. Root canal treatment (endodentia). 1. Personal, occupational and cultural traits:
Dental Features Which May Be Included in the Description for a. Cigarette smokers may have smoke marks mainly on the lingual
Identification: surface of the anterior upper teeth.
b. Seamstress, carpenter, cobblers may hold pins or nails between
1. Malposition, overlapping, crowding and spacing teeth.
incissors and may cause formulation of groove.
2. Number and location of deciduous or permanent teeth. c. Wind instrument musicians may have altered position of their
3. Missing (unerupted or extracted) or supernumerary teeth. teeth due to mouth formation necessary for playing the instru-
ment.
4. Peculiar shape, size, direction of growth of individual teeth. d. Pipe smokers may develop an oval-shape notch at the occlusal
5. Missing piece or fragment due to decay or trauma. surface or irregular gaps located at the angle of the mouth.
e. Sandblasters and stone mason may cause abrasions on the
6. Restoration, prosthesis (surface, morphology, configuration labial or occlusal surface of their teeth.
and material). f. Poor oral hygiene, with many decayed teeth and no restorations
7. Root canal therapy on x-ray examination. infers individual of low economic status. Extracted teeth are
also not replaced by bridgework.
8. Bone pattern on x-ray examination. g. Excessive fruit juice drinker or carbonated drinks may cause
9. Complete denture (type, shade and material). dissolution of the enamel structure of the front teeth.
h. Mutilation of teeth by filing or inlaying with precious metals
10. Relationship of bite. or stone, not done professionally, may indicate tribal customs
11. Oral pathology (tore, gingival hyperplasia, etc.). and cultural peculiarities.
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2. Age
9 yrs 12 permanent teeth (8 incisors and 4 molars).
11 yrs 20 permanent teeth (8 incisors, 8 premolar
and 4 molar).
13 yrs 28 permanent teeth and no deciduous teeth.
8 to 10 yrs Calcification begin at the 3rd molar.
25 yrs Root-ends of 3rd molar completely calcified.
Beyond 25 yrs. . . . Ends of the root of the 3rd molar have been
completely calcified.
After 30 yrs Carries frequently develop at the cementum.
There may be gingival recession, decay attack
of the root surface.
3. Sex
Examination for the presence of Barr bodies from palatal
scrappings. j Falsification of documents (deeds of conveyance, receipts).
y/C. HANDWRITING
A person may be identified through his handwriting, handprinting
and handnumbering.
Sec. 23, Rule 132, Rules of Court — Handwriting, how proved:
The handwriting of a person may be proved by any witness who
believes it to be the handwriting of such person, and has seen the
person write, or has seen writing purporting to be his upon which
the witness has acted or been charged, and has thus acquired know-
ledge of the handwriting of such person. Evidence respecting the
handwriting may also be given by a comparison, made by the witness
or the court, with writings admitted or treated as genuine by the
party against whom the evidence is offered, or proved to be genuine
to the satisfaction of the judge.
The genuiness of any disputed writing may be proven by any of
the following ways:
JL. Acknowledgement of the alleged writer that he wrote it;
Statement of witness who saw the writing made and is able to
identify it as such;
By the opinion of persons who are familiar with the handwriting
of the alleged writer, or
4r^By the opinion of an expert who compares the questioned writing
with that of other writings which are admitted or treated to be
genuine by the party against whom the evidence is offered.
Sec. 44, Rule 130, Rules of Court — Opinion of ordinary witnesses:
The opinion of a witness regarding the identity of handwriting of
a person, when he has knowledge of the person or handwriting; the
opinion of a subscribing witness to a writing; the validity of which is
in dispute, respecting the mental sanity of the signer; and the opinion
of an intimate acquaintance respecting the mental sanity of a person,
the reason for the opinion being given, may be received as evidence.
In order for an ordinary witness to be qualified to express his
opinion, it must be shown that he has some familiarity with the
handwriting of the person in a way recognized by law.
Some Practical Uses of Handwriting Examination:
(^Financial crimes (bogus checks, cr'xlit card fraud, embezzlement).
/fjDeath investigation (suicide notes, hotel registration cards, letter
af explanation),
obberies (pawnshop notes, cashing of stolen checks),
idnapping with ransom (demand note, threatening letter).
'Anonymous threatening letters.
A \Bibliotics is the science of handwriting analysis. It is the study of
documents and writing materials to determine its jgerqjineness or
authorship. One who had acquired special knowledge of the science
of handwriting for purposes of identification is known as JZibliotisl
or more commonly known as handwriting expert or qualified ques-
tion document examiner.
<A Graphology is the study of handwriting for the purpose of deter-
mining the writer's personality, character and aptitude. It is a
pseudo-science and merely explains the characteristics of the hand-
writing reflecting the character, weakness, personal idiosyncracies,
mannerisms and ambition of the writer. It must not be confused
with bibliotics.
Handwriting is a complex interaction of nerves, memory and
muscular movement. It is influenced by several factors and may be
changed or modified during the life-span of a person.
Writing is a conscious act, but on account of a repeated act it
becomes habitual and unconscious. The writer concentrates more
on the subject-matter of the writing than on the way the letter are
formed which make up the writing.
.Worry, anxiety, anger, fegling of insecurity, age, and drunkenness
may cause variation of a person's handwriting. ~
k Movements in Writing:
1. Finger movement — The letters are made entirely by the action of
the thumb, the pointing and middle fingers. Such is found among
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children, illiterates and those to whom writing is an unfamiliar
process.
2. Hand movement — The letters are produced by the action of the
hand as a whole with the wrist as the center of action and with some
action of the fingers. Most of the illegible, scratchy and angular
writings of women are produced by such movement.
3. Arm movement — The movement in writing is made by the hand
and arm supported with the elbow at the center of the lateral
swing. Many of the good writings are written in this manner.
There is more speed, rhythm and freedom in this way of writing.
4. Whole arm movement — The action is produced by the entire
arm without any rest. The source of motion comes from the
shoulder. Writing on a blackboard is a good example of whole
arm movement.
The Form, Style and Characteristics of the Handwriting of a Person
are Basically Determined By:
A.Primary factors:
1. Survival of the letters are formed when a person begins to write.
Children who were under the same tutelage during their initial
period of learning how to write have the tendency to develop
similar writing habits.
2. Inclusion of some characteristics due to admiration of a peculiar
design in writing.
3. Identifying characteristics may be the result of the great volume
of writing done.
4. The presence or absence of physical abnormalities or defects
originating from illness, injury, psychological variations and
other similar conditions.
B. Secondary factors:
1. The position of the writer, e.g. sitting, standing, lying, arm
high or low, and other similar variations not normally ob-
served in his ordinary writing habit.
2. Temporary physical or psychological disturbances, such as
excitement, fear, pain, exhaustion, injury to thd hand or arm,
etc.
3. Other external temporary variables, such as writing without
glasses, bad lighting, irregular surface, external interference.
4. Physical and chemical factors:
a. Writing instrument:
(1) Ballpen — It. usually leaves rounded line showing no tip
separation even when pressed heavily. Smudge may be
deposited on the line. The ink, not being a true liquid,
does not flow into the fibers and spread in the same way
as fluid ink does.
(2) Fountain pen — The lines are more or less round but
when pressure is increased there is separation of the nib
which is easily detected. There is evenness in the flow
of ink.
(3) Steel pen — There is unevenness in the flow of ink and
leaves a scratchy appearance.
(4) Pencil — Lead of pencils is compose of graphite and
clay with kaolin as binder. Soft pencils have greater
proportion of graphite while hard ones have relatively
more clay. Cheap quality pencils have frequently gritty
impurities which scratch the paper, while high-grade
pencils are free from such grit.
Paper:
(1) Color — Color can be well appreciated with a good light.
Dirt, stain or fading condition may not show the true
color of the paper.
(2) Surface appearance — It may be smooth or rough. The
surface may be damaged or wrinkled.
(3) Watermarks - Exposure of the paper to a strong light may
reveal the watermarks of the manufacturer or the type of
paper.
(4) Weight and thickness — The thickness may be measured
by means of the paper micrometer. Papers are designated
in weight which is in turn related to the thickness of the
sheet.
Ink:
(1) Iron gallotannate ink — Commonly used in "blue-black"
ink and still the basis of the greatest number of commer-
cial ink. The changes in the paper may provide some
indications of the age of the writing.
(2) It may be a solution of a single or a mixture of dyes.
This is a common constituent of "washable" inks.
(3) Logwood ink — Made of logwood extract with salts of
iron, copper, or chromium.
(4) Carbon ink — It is a fine suspension in water of carbon
with stabilizing agent. India ink is an example of this
type of ink.
(5) Ballpoint ink — A thick suspension of dye in a liquid
which is usually a drying oil (Crime Investigation, Phy-
sical Evidence and the Police Laboratory by Paul L. Kirk,
p. 446).
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Instruments Necessary in Questioned Document Examination:

l j Photographic instruments are primarily used to view the writing
in sufficient magnification for detail examination and preparation
of evidence for presentation in an investigative or judicial body.
2^Magnifying lens and stereoscopic binocular microscope — These
two instruments are useful to determine line quality, quaver,
uncertainty, patching, over-writing, crowding, and other unusual
appearances of writing. Presence of obvious obliteration, erasure
or alteration may become more visible.
3JUltraviolet lamp and infra-red radiaton — Chemical erasures may
be made visible, invisible ink, writing may be made legible, iden-
tification of paper and resealing of the envelopes with different
mucilage can be seen through these instruments,
feasuring caliper,
lighting facilities.
>se of Handwriting Examination:
LUWhether the document was written by the suspect.
[2) Whether the document was written by the person whose signature
it bears.
3JWhether the writing contains additions or deletions.
^ W h e t h e r the document such as bills, receipts, suicide notes or
checks are genuine or a forgery.

Points to be Considered in Questioned Document Examination:

Size, slant, spacing, proportion of the letters, speed and rhythm in
writing, shading and change of position in pen hold, pressure, pen-
lift, initial and terminal strokes, alignment, etc.
Inasmuch as handwriting examination is basically comparative,
the standard for such comparison must be suitable and sufficient.
The greater the variation in a way of writing, the greater is the
amount of standard writing needed to form a reliable impression.
Handwriting examination done by comparison with known standards:
To determine whether a certain instrument or document has been
written by a certain person, it is necessary to compare the writings
on such instrument or document with some standard writings of the person or from other possible sources. Provided it is clear
the same person for the purpose of comparison and determine the and sufficient, it is the most appropriate standard.
similarities. 2. Requested standard — These are standards made by the alleged
The standard (exemplar) writings with which the questioned writer of the document in question upon request of the examiner
writing has to be compared are of two types: or the persons interested in the examination. Inasmuch as one
1. Collected (procured) standards — These consist of handwriting of the characteristics of good exemplar is that it must be con-
by the person who is suspected to have written the questioned temporaneous with the date the questioned document was made,
document. It may be found in the private or public records of the use of the requested standards is applicable only to recently
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written questioned documents, like extortion letter, "poison"
notes, letter of threat or ransom, etc.
Considering that it is a request from a suspected maker of the
questioned document, there is a strong possibility for it to be
written in a disguised way.
Steps to be Undertaken to Minimize Conscious Efforts to Disguise
the Requested Standard:
1. The writer should be allowed to write sitting comfortably at a
desk or table and without distraction.
2. The suspect should not, under any condition, be shown the
questioned document or be provided with instructions on how
to spell certain words or what punctuation to use.
3. The suspect should be furnished with a pen and a paper similar
to those used in the questioned document.
4. The dictated text may be the same as the contents of the ques-
tioned document, or at least should contain many of the same
words, phrases, and letter combinations found in the document.
In handwriting cases, the suspect must not be given any instruction
on whether to use upper-case (capital) or lower-case lettering.
5. Dictation of the test should take place at least three times. If the
writer is making a deliberate effort to disguise his writing, notice-
able variations should appear between the three repetitions. Dis-
covering this, the investigator must insist upon continued repe-
titive dictation of the text.
6. Signature exemplars can best be obtained when the suspect is
required to combine other writings with a signature. For example,
instead of compiling a set of signatures alone, the writer must be
asked to completely fill out twenty to thirty separate checks or
receipts, each of which includes a signature.
7. Before requested exemplars are taken from the suspect, a docu-
ment examiner should be consulted and shown the questioned
specimens (Criminalistics by Richard Saferstein, p. 336).
Handwriting Characteristics of Illiterates:
1. They seldom follow any rule or baseline although at the beginning
a position above the baseline is taken which continues in an
ascending or descending course. Baseline is the ruled or ima-
ginary line upon which the writing rests.
2. The tendency of the writing is to be raised involuntarily in the
last letters of the word made by the extension of the fingers
while the hand is being held in a fixed position.
3. The loop letters are often slanted too much because the up-
strokes are made too long or nearly straight.
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4. Very unlikely to produce facsimile signatures in size, arrange-
ment and proportion of parts.
5. The writing is not rhythmic, but made up of disconnected un-
skilled movement impulses which are not likely to be related in
an exactly identical way.
6. Tremor or involuntary trembling is seen due to inability to
control the pen in motion because of not being familiar with and
self-conscious to the process of writing.
7. Formation and angle of letters are irregular and definitely show
lack of knowledge of size and proportion.
8. Same speed is utilized from beginning to end and seldom is the
pen raised to get a new adjustment.
9. Illiterate pencil-writing is usually produced with much pressure
and may show the habit of wetting the pencil lead frequently.
10. In anonymous writing, illiteracy is indicated by faulty arrange-
ment of words, lines, paragraphs and pages.
11. Combination of script forms and Roman capitals, or pen or
pencil printing, containing freak forms, abbreviations or punc-
tuation marks are individual creations.
Handwriting Characteristics of Old Aged Persons:
X^Due to lack of muscular control, the handwriting will not usually
show fine lines continuously but the strokes are mostly rough
and made with considerable pressure.
2^With the presence of tremor, the changes of direction are nume-
rous and omission of parts of letters of strokes are common.
Z. The concluding parts are often made with a nervous haste and
carelessness and they may be much distorted.
A\ Even with much tremor, the handwriting will usually show free
connecting and terminal strokes made by the momentum of the
hand.
J£ Often shows very uneven alignment and may disregard entirely a
line near which they are written.
-o. Usually shows an unusual and erratic departure from its intended
movement, particularly in the downward strokes.
"7. There is a loss of individual departure from its intended move-
ment, particularly in the downward strokes.
,-8TThere is a loss of individual rhythm as indicated by malformation
and irregularity of speed in the writing of small letters.
Disguised Writing:
Disguised writing is the deliberate attempt on the part of the
writer to alter his writing habit by endeavoring to invent a new writing
style or by imitating the writing of another person.
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Physical Methods of Disguising Handwriting:
a. By changing the direction of the slant. The forger may employ
a backhand slant, instead of the usual forehand slant.
b. By increasing or decreasing the speed in writing.
c. By deliberate carelessness that will produce inferior style of
writing.
d. By making the letters unusually large or small.
e. The forger may use the left hand instead of the right hand.
f. Hand printing may be substituted for script.
Characteristics of Disguised Writing:
a. Inconsistent slant
b. Inconsistent letter formation
c. Change of capital letters
d. Lack of free-flowing movement
e. Lack of rhythm
f. Unnatural starts and stops
g. Irregular spacing
h. Writing with unaccustomed hand (Criminalistics by Richard
Saferstein, p. 692).
Signature forgery:
Signature forgery examination is the most common activity of a
questioned document examiner. A signature may be found on a
document which appears that a person has participated in its exe-
cution and the person denied that he had signed it. Such signature
may be found in checks, deeds of conveyance, anonymous letters,
receipts, etc.
Classification of Signature Forgery:
a. Traced forgery — The outlining of a genuine signature from one
document onto another where the forger wishes it to appear.
Traced forgery is basically drawing and consequently lacks free
natural movement inherent in a person's normal writing.
Ways of Achieving Traced Forgery *
(1) The paper wherein the signature is to be copied is placed
on top of the document containing the signature. By means
of a strong light underneath, the forged signature is traced
from the genuine, either directly or lightly by a pencil
outline and then over-writing the pencil outline.
(2) By placing the paper to receive the signature tracing under-
neath the document bearing the genuine signature and by
indented outline on the underneath page, or by inter-
weaving the documents with carbon paper to produce a
carbon outline on the forged paper.
b. Simulated forgery — An attempt to copy in a freehand manner
the characteristics of a genuine signature either from memory of
the signature or from a model. It is accomplished without
outline.
The quality of the simulated signature varies with the writer's
skill as a penman, the difficulty of the signature being imitated,
the writer's ability to recognize and incorporate the details, his
ability to concentrate on the important feature of the signature
and his ability to discard all of his own natural habit of writing.
c. Spurious forgery — One prepared primarily in the forger's own
handwriting wherein little or no attempt has been made to copy
the characteristics of the genuine writing.
(Modern Legal Medicine, Psychiatry and Forensic Medicine by
W. Curran et ai, p. 1235).
The principle of identification of handwriting is also applicable to
handprinting and handnumbering.
Typewriter Identification:
The identification of the typing machine used in a questioned
document, like that in ballistics examination, may be on the basis of:
1. Class characteristics — those characteristics which serve to dis-
tinguish it from any other machine, such as:
a. Manufacturer's characteristics
b. Size and design of the type
c. Line and letter spacing
2. Individual characteristics:
a. Defects in the type face — Unusual manner of letter formation
due to factory defect, misuse of the machine or wear and tear.
b. Defects in the alignment — Malpositioning, spacing and align-
ment may be modified by loosening of the hinges and position-
ing of the letters on account of wear and tear and changes in
the spring pressure.
c. Other machine defects:
(1) Skipping space
(2) Irregular margin stops
(3) Improper letter spacing
(4) Improper ribbon actions
A typewriter has 44 keys with 88 characters, each operating
independently of one another and each being capable of damage or
having inherent defects. Consequently, a variety of combinations of
these defects may be the basis of typewriter identification.
The questioned document may be compared with those made by
the suspected typewriters.
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human remains. A complete lay-out of the whole bones found and

placing each of them on their corresponding places in the human
body will be helpful. The presence of dental fixtures, rings on the
fingers, earrings in the case of women, hair and other wearing ap-
parels, together with the remains are strong presumption of human
remains.
How to Determine Whether the Remains Comes from a Single
Individual or Not:
A complete lay-out of the bones on a table in their exact locations
in the human body is necessary. Any plurality or excess of the bones
after a complete lay-out denotes that the remains belong to more
than one person. However, congenital deformities as supernumery
fingers and toes must not be forgotten. The unequality in sizes,
especially of the limbs may be ante-mortem.
Height:
Several formulae using different constants have been forwarded in
the approximation of the height of a person by measuring the long
bones of the body.
Examination of Bones — Complete lay-out of the bones to determine duplicity A. Actual measurement of the skeleton — To the actual length of the
i and missing ones. skeleton add 1 to 1-1/2 in. for the soft tissue. •,
V D. IDENTIFICATION OF THE SKELETON B. Pearson's Formulae for the reconstruction of the living stature of
long bones, whose animal matters have disappeared and which are
Occasionally, before a physician is called to examine a dead body, in a dry state.
the soft tissues have already disappeared and only the skeletal system Males Females
remains. Ail the external identifications have already disappeared. S = 81.306 plus 1.880 F S = 72.844 plus 1 . 9 4 5 F
In this particular case we resort to the study of bones. = 70.641 plus 2.894 H = 71.475 DIUS 2 . 7 5 4 H
hi the examination of bones, the following points can be determined = 78.664 plus 2.376 T = 74.774 plus 2 . 3 5 2 T
approximately: = 89.925 plus 3.271 R = 81.224 plus 3 . 3 4 3 R
1. Whether the remains are of human origin or not. S = Stature
2. Whether the remains belong to a single person or not. F = Femur
3. Height. H = Humerus
4. Sex. T = Tibia
5. Race. R = Radius
6. Age. Remarks:
7. Length of interment or length of time from date of death.
8. Presence or absence of ante-mortem or post-mortem bone injuries. 1. The femur is measured from the head to the apex of the inner
9. Congenital deformities and acquired injuries on the hard tissues condyle. If the femur has been measured in the oblique position
and not straight, add 0.23 for male and 0 . 3 3 for female to the
causing permanent deformities. length before using the above formulae.
How to Determine Whether the Remains Are of Human Origin or
Not: 2. The tibia is measured from the upper articular surface to the tip of
The shape, size and general nature of the remains, especially that the malleolus. If the tiDia has been measured with, and not with-
out, the spine, subtract 0.96 for male, and 0 . 8 7 cm. for female,
of the head, must be studied. The oval or round shape of the skull
from the length before using the above formulae.
and the less prominent lower jaw and nasal bone are suggestive of
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3. The humerus and radius are measured in their greatest length. (From: Forensic Medicine by Keith Simpson, 7th ed., p. 25.)
(Taylor's Principles and Practices of Medical Jurisprudence, S. D.Topinard and Rollet, two French anatomists devised a formula fo'
Smith, 10th ed., Vol 1, p. 155). the determination of the height for males and females.
4. Inasmuch as the formulae for male and female skeletons are Male Female
different, it is necessary to determine the sex of the skeleton
before the formulae may be applied. Length of Femur x 3.66 or 3.71 equals height
Length of Humerus x 5.06 or 5.22 equals height
Length of Tibia x 4.53 or 4.61 equals height
C. Stature from bone:
Length of Radius x 6.86 or 7.16 equals height
Dupertuis and Hadden's General Formulae For Reconstruction of (These formulae do not hold good in mixture of races.)
Stature From Lengths of Dry Long Bones Without Cartilage (Con-
stant Terms in Metric and Adapted to English System) E. Humphrey's Table:
Constant term to be Humphrey made a table of the different height of bones for
added after calculations different ages and their corresponding statures.
in previous column F. Lacassagne made the following coefficient for the determination
Stature-bone length of height:
armula coefficient(s) Centimeters Inches
Bone Male Female
Male
Femur 3.66 3.71
(a) 2.238 (femur) 69.089 27.200 Tibia 4.53 4.61
(b) 2.392 (tibia) 81.688 32.161 Fibula 4.58 4.66
(c) 2.970 (humerus) 73.570 28.965 Humerus 5.06 5.22
(d) 3.650 (radius) 80.405 31.655 Radius 6.86 7.16
(e) 1.255 (femur + tibia) 69.294 27.281 Ulna 6.41 6.66
(f) 1.728 (humerus + radius) 71.429 28.112
(g) 1.422 (femur) + 1.062 (tibia) 66.544 26.198 E.Manouvrier made a formulae based on length of tibia, fibula,
(h) 1.789 (humerus) + 1.841 (radius) 66.400 26.142 radius and ulna for the determination of height.
(i) 1.928 (femur) + 0.568 (humerus) 64.505 25.396 MANOUVRIER'S STATURE TABLE FOR FEMALES
(k) 1.442 (femur) + 0.931 (tibia) ftbula Tibia Femur Cadaver Humerus Radius Ulna
+ 0.083 (humerus) Length
+ 0.480 (radius) 56.006 22.050
Mm. Mm. Mm. Cm. Mm. Mm. Mm.
Female 283 284 363 / 140.0 263 193 203
(a) 2.317 (femur) 61.412 24.178 288 289 368^ 142.0 266 195 206
(b) 2.533 (tibia) 72.572 28.572 293 294 , 373 144.0 270 197 209
(c) 3.144 (humerus) 64.977 25.581 298 299 378 145.5 273 199 212
(d) 3.876 (radius) 73.502 28.938 303 304 383 147.0 276 201 215
(e) 1.233 (femur + tibia) 65.213 25.674 307 309 388 148.8 279 203 217
(f) 1.984 (humerus + radius) 55.729 21.941 311 314 393 149.7 282 205 219
(g) 1.657 (femur) + 0.879 (tibia) 59.259 23.330 316 319 398 151.3 285 207 222
(h) 2.164 (humerus) + 1.525 (radius) 60.344 23.757 320 324 403 152.8 289 209 225
(i) 2.009 (femur) + 0.566 (humerus) 57.600 22.677 325 329 408 154.3 292 211 228
(k) 1.644 (femur) + 0.764 (tibia) 330 334 415 155.6 297 214 231
+ 0.126 (humerus) 336 340 422 156.8 302 218 235
+ 0.296 (radius) 57.495 22.636 341 346 429 158.2 307 222 239
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346 352 436 159.5 313 226 243 F. Estimations of Total Foetal Length from One or More Bones (C.H.
351 358 443 161.2 318 230 247 length)
356 364 450 163.0 324 234 251 Diaphysis of femur x 6.71 = Total height
361 370 457 165.0 329 238 254 Diaphysis of tibia x 7.63 = Total height
366 376 464 167.0 334 242 258 Diaphysis of humerus x 7.6 = Total height
371 382 471 169.2 339 246 261 Diaphysis of radius x 9.2 = Total height
376 388 478 171.5 344 250 264 Diaphysis of clavicle x 11.3 = Total height
Coefficients for smaller bone lengths than given above. Diaphysis of lower jaw x 10.0 = Total height
x4.88 x4.85 x3.87 x5.41 x7.44 x7.00 (The lower jaw is measured from the symphysis menti to the
tip of the condyle, the whole breadth of the mandibular symphy-
Coefficients for greater bone lengths than given above.
seal surface placed flat along the blade of the calipers; Smith,
x4.52 x4.42 x3.58 x4.98 x7.00 x6.49 1943).
MANOUVRIER'S STATURE TABLE FOR MALES These ratios have been checked against the material recently
Fibula Tibia Femur Cadaver Humerus Radius Ulna obtained and have been found useful; they are not accurate during
Length the early stage of embryonic life (Practical Forensic Medicine by
Camp and Purchase, 1957, p. 29).
Mm. Mm. Mm. Cm. Mm. Mm. Mm.
318 319 392 153.0 295 213 227 Determination of the Sex of the Skeleton:
323 324 398 155.2 298 216 231 In determining the sex of the skeleton, the following bones must
328 330 404 157.0 302 219 235 be studied:
333 335 410 159.0 306 222 239 A. Pelvis D. Femur
338 340 416 160.5 309 225 243 B. Skull E. Humerus
344 346 422 162.5 313 229 246 C. Sternum
349 351 428 163.4 316 '232 249
353 357 434 164.4 320 236 253 A. Pelvis:
358 362 440 165.4 324 239 257 Differences Between a Male and a Female Pelvis:
363 368 446 166.6 328 243 260 Male Female
368 373 453 167.7 332 246 263 1. Heavier construction wall 1. Lighter construction wall less
373 378 460 168.6 336 249 266 more pronounced. pronounced.
378 383 467 169.7 340 252 270
2. Height greater and flays off 2. Height lesser and flays off its
383 389 475 171.6 344 255 273
its wall more pronounced. wall less pronounced.
388 394 482 173.0 348 258 276
393 400 490 175.4 352 261 280 3. Pubic arch narrow and less 3. Pubic arch wider and
398 405 497 176.7 356 264 283 round. rounder.
403 410 504 178.5 360 267 287 4. Diameter of the true pelvis 4. Diameter of the true pelvis
408 415 512 181.2 364 270 290 less. greater.
413 420 519 183.0 368 273 293 5. Curve of the iliac crest 5. Curve of the iliac crest is of
reaches a higher level. the lower level.
Coefficient for smaller bone lengths than given above. 6. Narrow greater sciatic notch. 6. Wide greater sciatic notch.
x4.82 x4.80 X3.92 ... x5.25 x7.11 x6.66 7. Body of the pubis narrow. 7. Body of the pubis wider.
Coefficients for greater bone lengths than given above. 8. Iliopectineal line sharp. 8. Iliopectineal line rounded.
x4.37 x4.32 x3.53 . .. x4.93 x6.70 x6.26 9. Obturator foramen egg- 9. Obturator foramen tri-
(From: Medical Jurisprudence by Gordon, Turner and Price, 3rd ed., shaped. angular.
pp. 354-355.) 10. Sacrum short and narrow. 10. Sacrum long and wide.
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B. Sternum: 9. Face larger in proportion to 9. Face smaller in proportion to

t n e
Length of body the cranium. cranium.
Length of manubrium x 100 = 46.2 (male and
Determination of the Race of the Skeleton:
54.3 (female) It is becoming more difficult to determine the race because of the
C. Femur: amalgamation of races. For practical consideration there is hardly no
Pearson and Bell made a study of the sex difference in the race that is absolutely pure.
femur:
Male Female The following points may be used in determining the race in the
Right Left Right Left remains of a person:
1. Bicondylar width 80.147 79.404 70.123 69.886 A. Extrinsic Factors:
2. Vertical diameter 1. Color of the skin
of head 47.059 46.769 41.123 40.765 2. Facial features
3. External condyle 3. Nature of the hair
oblique length 61.846 61.048 55.804 55.176 4. Mode of dressing
4. Vertical diameter B. Indices:
of neck 33.849 34.337 29.337 29.520 1. Skull:
D. Humerus: Maximum width of the skull „ - n n
X 1 0 0
Dwight gives the following measurement for male and female a. Cephalic Index = axunum length of the skuLl
M

bones (humerus): Below 70 — Hyperdolico-cephalic

Male Female 70 — 74.9 — Dolico-cephalic — Semato — Caucasian
1. Vertical diameter of head 48.7 42.6 75 — 79.0 — Mesaticephalic — Mongolian
2. Transverse diameter of head 44.6 38.9 80 — 84.9 — Brachycephalic — Malayan
E. Cranium: u o u-4. i A Height of the orbit
b. Orbital Index = w,.T..—ttt
T
x 100
Width of the orbit
Male Female
1. Less curve of shaft. 1. More curve of shaft. Above 89 — Megasemes — Mongolian
84 — 89 — Mesosemes — Semato-Caucasian
2. Mastoid process larger. 2. Predominance of cranial roof
Below 84 — Microsemes — Malayan
over cranial base Mastoid pro-
cess smaller. , , T Breadth of the base , n n
c. Nasal Index = • —r—r *~ x 100
3. Cranium placed horizontally 3. Cranium placed horizontally Length of the nose
rests on mastoid process. rests on the occipital and Above 53 — Platyrrhine — Malayan
maxilliary bones. 48 — 53 — Mesorrhine — Mongolian
4. Styloid process shorter. 4. Styloid process longer and Below 48 — Leptorrhine — Semato — Caucasian
slender. TT ;„u „ . Height of the skull , _
5. Forehead higher and more 5. Forehead less high and more Height Index = z—~———.—.—_ 100
0 f T A

Length of the skull x

oblique. vertical.
2. Pelvis:
6. Superciliary ridges less sharp 6. Superciliary ridges sharper,
or more rounded. Pelvic Index = Anteroposterior diamete^ x 1 Q Q

7. Zygomatic arches and frontal 7. Zygomatic arches and frontal Transverse diameter
sinuses more prominent. sinuses less prominent. Below 85 — Platypellic — Semato — Caucasian
8. Lower jaw larger and wider. 8. Lower jaw narrower and 86 — 95 — Dolicopellic — Malayan
lighter and chin not projecting. Above 95 — Mesopellic — Negroes
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.c MEDICO-LEGAL ASPECTS OF IDENTIFICATION 83 LEGAL MEDICINE

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, . .. , Pubis length x 100 1. Appearance of the ossification centers:

b. Ischium-pubis Index = —=——
T L T
:———
Ischium length External cuneiform, capitate, hamates heads of
Caucasians (200 cases): <90=Male; 90-95=Sex?; > 95= Female 1 year humerus, femur, tibia.
Negroes (100 cases): < 84= Male; 84-88=Sex? ; > 88= Female. Lower epiphysis of tibia, lower epiphysis of fibula,
(GradwohVs Legal Medicine by Camps, Lucas & Robinson, 2 years capitulum of humerus, first four metacarpal heads.
3rded.,p. 112). Internal cuneiform, tarsal, navicular, triquetrum
3 years phalanges, patella.
3. Extremities:
Midcuneiform, lunate, upper end of fibula, greater
, , Length of the lower leg .. _ rt 4 years trochanter of femur.
a. Crural Index = 7 — * . .. x 100r Scaphoid, trapezium, carpal, navicular, greater
Length of the upper leg 5 years tubercle of the humerus, lower end of the fibula.
95 — 98 — Semato-Caucasian Upper end of the radius, lower end of ulna, trape-
98 —102 — Mongolian and Malayan 6-7 years zoid, scaphoid.
,, _ Length of humerus + length of radius x 100 Internal epicondyle of the humerus, rami of
b. IntermembralIndex = — — — — 7 7 — — — — . . . . . 8-9 years ischium and pubis, olecranon.
Length of femur + Length of tibia Epiphysis of os calcis, pisiform, trochlea of hu-
(Modi p. 22) 10-11 years merus, lesser trochanter of femur.
Indian — 67.27 External epicondyle of the humerus, patella com-
European - 70.4 12-14 years plete.
Negroes —70.3 14-16 years Acromion, iliac crest.
,t j Length of humerus „„ Tuber ischia.
c. Humero-femoral Index = -=— .. x 100 1
17-19 years
Length of femur 20-21 years Inner clavicle.
(A Simplified Textbook of Medical Jurisprudence Toxicology by
Other Differential Racial Characteristics of Skeletons: C.K. Parikh, p. 39).
Caucasian Mongolian Negro 2. Union of Bones and Epiphyses:
1. Skull Elongated Square Narrow and elongated Anterior fontanelles should be closed.
1-1/2 years
2. Forehead Raised inclined Small and compressed

CO
years The condylar portion of the occipital bone fuses
3. Face Proportion- Small Malar bones and jaw with the squama; the metopic suture also closes.
ately small projecting; teeth set 4 years The greater tubercle fuses with the head of the
obliquely humerus.
4. Upper Small Small Long in proportion to 5 years The condylar portion of the occipital bone fuses
Extremity body; forearm large in with the basi-occiput.
proportion to arm; 9 years The ilium, pubes and ischium should meet in the
hand small acetabulum, rami of ischium and pubis fuse.
13 years Ilium and pubes should be united but still separable
5. Lower Normal Small Leg6 large in propor-
tion to thighs; feet on maceration.
Extremity 15 years The epiphysis of os calcis (calcaneum) joins the
wide and flat, heel-
bones projecting back- bone; the coracoid should be united to the scapula.
16 years The olecranon should be united to the ulna.
wards. The head of the radius and the lower end of the
16-17 years
AGE: humerus should be joined to their respective shaft.
Aside from the size of the bones and dental examination, the age 17-18 years The internal condyle should be united to the
of the person to whom the skeleton belongs may be determined by: humerus.
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.c MEDICO-LEGAL ASPECTS OF IDENTIFICATION 85 LEGAL MEDICINE

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18-20 yean The head of the femur should have joined diaphy-
sis; the epiphysis of long bones of the hand and
foot should have united to the diaphyses; the basi-
occiput should be fused with the basisphenoid.
20 years The epiphyses of the fibula should be united to the
diaphysis. Distal radius unites.
22 years The inner (secondary) epiphysis of the clavicle fuses.
25 years The crest of the ilium and the articular facts of the
ribs should be united, if all the epiphysis have
united, the person is above 25 years of age.
(A Simplified Textbook of Medical Jurisprudence & Toxicology by
C.K. Parikh, p. 40).
3. Dental Identification (supra p. 61).,
4. Obliteration of cranial sutures (see illustration).

4U-50 20-3Q

Fragmentation and erosion of bones after a long burial

The Bases of the Estimate for Duration of Interment are:

1. Presence or absence of soft tissues still adherent to the bones.
2. Firmness and weight, brittleness, dryness of the bones.
3. The degree of erosion of the surface of the bones.
4. The changes in the clothings, coffin, and painting.
Determination of the Presence or Absence of Ante-Mortem or Post-
mortem Injuries:
Individual bones must be examined in detail for possible fractures.
MOLAR Importance must be laid on whether these injuries in the bones
root calcification
more important occurred during life or in the process of exhumation. Note the pre-
than eruption sence of vital reaction, principally the signs of repairs.
Superimposed Photography:
This is a special method of determining the person to whom the
Approximate time of closure of cranial sutures. The inner aspect closes
several years before the outer as a rule. Molar tooth root calcification is also
skull belongs. The negatives of the picture of the skull and the
noted. suspected individuals are superimposed and printed. This will show
whether the contour of the skull fits the contour of the face of the
suspected person.
Determination of the Duration of Interment:
The period from the time of death up to the time of examination
E DETERMINATION OF SEX /
may be determined by the nature and presence of the soft tissues
and the degree of erosion of the bones. Ordinarily, all the soft Legal Importance of Sex Determination:
tissues in a grave disappear within a year. However, it is influenced 1. As an aid in identification:
by several factors. Habit, social life, manner of dressing, physical features and
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inclination are generally dependent on the sex. These points are
useful in identification.
2. To determine whether an individual can exercise certain obli-
gations vested by law to one sex only:
V
above, ^AA^H
3. Marriage or the union of a man and a woman:
Any male of the age of sixteen years or more, and any female
at the age of fourteen years or more, not under any of the im-
pediments mentioned in articles 80 to 84, may contract marriage
(Art. 54, Civil Code).
4. Rights granted by law are different io different sexes:
Majority commences upon the attainment of the age of twenty-
one years (Art. 402, Civil Code).
Notwithstanding the provisions of the preceding article, a
daughter above twenty-one but below twenty-three years of age
cannot leave the parental home without the consent of the father
or mother in whose company she lives, except to become a wife,
or when she exercises a profession or calling, or when the father
or mother has contracted a subsequent marriage (Art. 403, Civil
Code).
5. There are certain crimes wherein a specific sex can only be the
offender or victim:
a. In rape (Art. 335, Revised Penal Code), seduction (Art. 337 &
338, Revised Penal Code), abduction (Art. 342 & 343, Revised
Penal Code) or abuse against chastity (Art. 245, Revised Penal
Code) a woman is the victim.
b. In case of prostitution, the offender must be a woman:
For purposes of this article, women who, for money or
profit, habitually indulge in sexual intercourse or lascivious
conduct, are deemed to be prostitutes (Art. 202, No. 5, Revised
Penal Code).
c. In adultery the offender is a married woman and in concubinage
the offender is a husband.
(sts to Determine the Sex:
pocial test:
Differences in the social role of the sexes used to be clearly
marked but now they are less than they used to be. Dress, hair-
style, general bodily shape provide an immediate and accurate
answer to the vast majority of cases.
Genital test:
The presence of penis indicates a male, its absence and the
presence of a vaginal opening, indicates a female. We may look
for the testes in the scrotum and if they are absent we must not
conclude that the individual is not a male. They may be in the
abdomen or inguinal canal undescended.
3. Gonadal test:
Presence of testes in male and ovary in female. This will in-
volve exploration of the abdomen and in some cases a histolo-
gical examination of the gonad to see whether its microscopic
structure is characteristically ovarian or testicular.
4. Chromosomal test: f^-^t* *~W-cT
Shortly after the war, Barr noticed that there was a difference
between cells derived from men and women suitably stained and
examined under the microscope. The nucleus of the cells is a
densely staining area in the cell itself and Barr noticed that there
was a small part of nucleus which stained deeply than the rest
in woman's cells but not in cells from men. He observed this in
white cells from the blood and cells obtained by scraping the
mucous membrane of the mouth. This is called Barr bodies.
(Medico-Legal Journal, Part 3, Vol. 40, p. 79).
Problems in Sex Determination:
Sex determination may be possible and can scientifically be
distinguished on account of the biological structure differences;
however, in the following instances there will be no way to deter-
mine the sex:
1. Gonadal agenesis — Sex organs (testes or ovaries) have never devel-
oped.
2. True hermaphrodism — A state of bisexuality. The gonads of both
sexes are present which may be separated or combined as ovotestis.
<fc Evidences of Sex:
1. Presumptive evidences:
(a) General features and contour of the face.
cK^Presence or absence of hair in some parts of the body.
@ Length of the scalp hair. Generally, the female has long hair in
the scalp than that of the male.
(ji/Clothes and other wearing apparel, but not in a transvestite.
Transvestism is a form of sexual deviation characterized by
an overwhelming desire to assume the attire and be accepted as
a member of the opposite sex.
f eJ Figure — Females have prominent pelvis, while those of the
males are slender.
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(P Habit or inclination — Pseudohermaphrodite* are persons who Evidence of Sex in Mutilated or Decomposed Body:
have the gonadal tissue of one sex and the behavior of the 1. General physical and muscular development.
opposite sex, 2. Hairiness of the scalp, face, chest, pubes and other parts of the
g} Voice and manner of speech.
body.
The Important Distinguishing Presumptive Characters between the 3. Prominence of the Adam's apple.
Two Sexes are as follows: 4. Amount of subcutaneous fat in specific parts of the body.
Female Male 5. Presence of linea albicantes, enlarged nipple, cutex in fingernails
a. Hips are broader in rela- Shoulders are broader than and lipstick or coloring materials.
tion to shoulders. hips. 6. Presence of prostate gland in male or uterus and ovary in female.
If in doubt, a microscopic examination must be made on the
b. Generally smaller build. Larger build. suspicious ovarian or testicular tissue.
c. Breasts developed. Generally not developed,
very rarely and may be F. DETERMINATION OF AGE ^
developed in cases like
gynaecomazia. Legal Importance of Determination of Age:
d. Adam's apple (Thyroid Adam's apple prominent. jtAs an aid to identification:
cartilage) not prominent. Mention of the age of the wanted or missing person will create
e. Striae present on breasts, e. Striae absent. an impression of the physical characteristics, social life and psy-
abdomen and buttocks in chic and mental behavior of that person. Although it may only
ladies who have borne be presumptive, it may be useful in identification.
children. '^Determination of criminal liability:
f. Pubic hair straight and Pubic hair thick, curved Art. 12, Revised Penal Code — Circumstances which exempt
stop short above the mons- upward extending up to from criminal liability — The following are exempted from criminal
veneris. umbilicus. liability:
g. Hair absent on face, abdo- g Hair present on chest and 1
men and chest. face moustaches, beard, 2. A person under nine years of age.
etc. 3. A person over nine years of age and under fifteen, unless he
h. Female skull is smaller h Male skull is longer, heavier has acted with discernment, in which case, such minor, shall
lighter, and has thin bones and of thick bones. be proceeded against in accordance with the provisions of
and smooth, article 80 of this code.
i- Trunk abdominal segment i Trunk abdominal segment ^DiDetermination of right of suffrage:
larger. smaller.
Suffrage shall be exercised by citizens of the Philippines not
j . Thighs conical. j Thighs cylindrical. otherwise disqualified by law, who are eighteen years of age or
(From: Handbook of Forensic Medicine and Toxicology by Dr. P. V. over, and who shall have resided in the Philippines for at least
Chadha, IVth ed., p. 68). one year and in the place wherein they propose to vote for at least
six months preceding the election. No literacy, property, or other
2. Highly probable evidences of sex: substantive requirement shall be imposed on the exercise of
(a^Possession of vagina, uterus and accessories in female, and penis suffrage. The Batasan Pambansa shall provide a system for the
, in male. purpose of securing the secrecy and sanctity of the vote (Art.
( j p Presence of developed and large breasts in female. VI, Sec. 1, Philippine Constitution as amended in 1984).
c. Muscular development and distribution of fat in the body. Ji. Determination whether a person can exercise civil rights:
3. Conclusive evidence: Majority commences upon the attainment of the age of twenty-
( paJi Presence of ovary in female and testis in males. one years.
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The person who has reached majority is qualified for all acts
of civil life, save the exceptions established by this Code in special
cases. (Art. 402, Civil Code).
^.Determination of the capacity to contract marriage:
Any male of the age of sixteen years or upwards, and any
female of the age of fourteen years or upwards, not under any
of the impediments mentioned in articles 80 to 84 may contract
marriage (Art. 54, Civil Code).
<As a requisite to certain crimes:
ArRape — Rape is committed by having carnal knowledge of a
woman under any of the following circumstances:
1. By using force or intimidation;
2. When the woman is deprived of reason or otherwise un-
conscious; and —^
3. When the woman is under/twelve years of agej even though
neither of the circumstanceTm^ntioned in the two preced-
ing paragraphs shall be present (Art. 335, Revised Penal
Code).
^Infanticide — The penalty provided for parricide in article 246
and for murder in article 248 shall be imposed upon any person
who shall kill any child less than three days of age (Art. 255,
Revised Penal Code). ^ », JLIH^
prSeductions:
(lyGualified seduction — The seduction of a virgin over twelve
years and under eighteen years of age, committed by any
person in public authority, priests, house-servant, domestic,
guardian, teacher, or any person who, in any capacity, shall
be entrusted with the education or custody of the woman
seduced, shall be punished by prision correccional in its mini-
mum and medium periods (Art. 337, Revised Penal Code).
(2^imple seduction — The seduction of a woman who is
single or a widow of good reputation, over twelve but
under eighteen years of age, committed by means of deceit,
shall be punished by arresto mayor (Art. 338, Revised
Penal Code.
d. Consented abduction — The abduction of a woman victim over
twelve and under eighteen years of age, carried out with her
consent and with lewd designs shall be punished by the penalty
of prision correccional in its minimum and medium period
(Art. 343, Revised Penal Code).
' Determination of the Age of the Fetus:
1. Application of the Hess's Rule or Haase's Rule:
a. For fetus of less than 25 cm. long (Crown-feet length) — Get
the square root of the length in centimeter and the result is
the age of the fetus in months.
Example: If the length of the fetus is 16 cm., the age is 4
months.
b. For fetus 25 centimeters or more — Divide the length of the
fetus by 5, and the result is the age in month.
Example: If the length of the fetus is 40 cm., the age is 8
months.
(The age referred to in this rule is lunar month, not calendar
month. One lunar month is equivalent to 28 days.)
2. Examination of the product of conception:
Age Nature of the product of conception
1 month — Ovum is about 1.0 cm. long, weighing about 2.6 gm.
The eyes are seen as two dark spots and limb buds
present.
2 months — The ovum is about 4.0 cm. long and weighs about 10
gram. Eyes and nose are recognizable. Clavicle,
mandible, ribs and vertebra show the center of
ossification. Anus is seen as a dark spot.
3 months — Length is 8 cm. weighing 30 gms. Nails begin to
appear as thin membrane on the fingers and toes.
Fiacenta is formed. Sex organs have appeared
Ossification has begun in most of the bones.
4 months — Length is 13 cm. weight 204 gm. Sex can be dis-
tinguished; Skull is partly ossified, with wide sutures
and f ontanelles.
Lanugo hair is visible on the body. Convolution of
the brain begins to appear.
5 months — Length is 23 cm. and weight is 450 gm. Skin begins
to be covered with vernix caseosa. Ossification
center in os calcis. Dental gum appears at the
mandible.
6 months — Length is about 30 cm.; weight is about a kilo. Skin
is still wrinkled but subcutaneous fat is beginning to
form. Hair appears on the head. The eyebrows and
eyelashes are beginning to form. The eyelids are
adherent. The testicles lie close to the kidneys.
Meconium is seen in the upper part of the large
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intestine. The centers of ossification are seen in Lanugo hair almost disappeared.
the four divisions of the sternum. Limbs and body plump.
7 months — Length is 18 cm. Weight is 1.5 kg. Eyelids are open. Scalp hair about 2 inches long ( 5 cm.).
Testicle is beginning to descend into the scrotum. Nails After 24 — Skin firm and less red.
do not reach the tips of the fingers. Lanugo hair is dis- hours Umbilical cord shrivelled, soft and bluish in
appearing from the face. Primary center of ossification color. Lungs more or less distended with air.
of talus has appeared. Body is dark red and plump, 2nd to 3rd — Skin with yellowish tinge.
with hair on the scalp. The child is viable (28 weeks). day Skin sometimes with cracks and with sepa-
8 months — Length is 42 cm. Weight is 2 to 2-1/5 kg. Skin is ration of the scales. Umbilical cord brown and
only slightly wrinkled and flesh-colored. Lanugo hair dry.
is beginning to be shed. Testicle is generally in the 3rd to 4th —Skin becomes more yellow. Umbilical cord
scrotum. Nails reach the end of fingers. Convolu- day brownish-red, flattened, semi-transparent and
tions of the brain are more distinct. Pappillary twisted.
membrane disappears. The skin is red but not wrinkled. 4th to 6th — Umbilical cord separates from abdomen,
9 months — The length is about 45 to 50 cm. and weighs about 3 day Foramen ovale partly close.
to 3.5 kg. Skin is with slight wrinkles. Scalp is covered 6th to 12th — Cicatrization of the umbilical cord.
with dark hair. Nails have grown over finger tips. Ductus arteriosus close.
Testes have descended to the scrotum. Vemix Age Determination in Childhood and Adulthood:
caseosa present over flextures of joints and neck
folds. Meconium is seen at the end of the large 1. Age based on the eruption of teeth:
intestine. Ossification center appears at the lower a. Temporary (deciduous or milk) teeth:
end of the femur. Signs of maturity is present. Central incisor (lower) 6th month
Age Determination During Infancy: Central incisor (upper) 7th month
1. Age based on height or weight: Lateral incisor (upper) 9th month
a. Height: Lateral incisor (lower) 1 Oth month
New bom full term child — 50 cm. First molars 12th month
After 6 months — 60 cm. Canines 18th month
After one year — 68 cm. Second molars 2nd year
After 4 years — Double the birth height (one b. Permanent teeth:
meter) First molar 6th year
b. Weight: Central incisors 7th year
Newly born full term child — 2.5 to 3 kg. Lateral incisors 8th year
Roughly a child increases in weight by 0.5 kg. per month. First bicuspid 9th year
At the end of 6th month — Child doubles the birth weight. Second bicuspid 10th year
At the end of one year — Child weighs three times the
Canines 11th year
birth weight.
second molars 11th-12th year
The estimation of the age utilizing the weight and/or the height Third molars 17th-18th year or at
is not quite useful inasmuch as there is a difference in the rapidity any period later
of growth not only in children of different sex, but also in child-
ren of the same sex. 2. Appearance of ossification centers (Supra p. 84).
2. Physical characteristics of infant:
Newly bom — Skin covered with vernix caseosa and red. 3. Union of epiphysis with shaft of bones (Supra p. 84).
Meconium present in the rectum. 4. Obliteration of cranial sutures (Supra p. 85).
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Other Points to Consider in the Determination of Age:
1. Growth of pubic hair, beard and mustache:
The pubic hair begins to appear at the age of 13 in female and
14 in male. The growth of thick dark hair is well marked on the
pubes, scrotum and in the axillae at about 16 to 17 years of age.
Mustache and beard begin to appear in male at the age of 16 to
18.
2. Changes of the breast in female:
The development of the breast in female commences at the
age of 13 to 14. The degree and the commencement of develop-
ment may be influenced by habit and social environment.
3. Development of the voice:
Males develop low tone voice between the age of 16 to 18,
while females change their voice on the same period. Males
become low pitch while females become high pitch.
4. Changes in color of the hair:
The black color of the hair becomes gray after forty. Silvery-
white color may be seen in advanced old age. Sometimes gray
hair appears in younger people or may appear suddenly after
extreme terror, grief or shock. Localized areas of gray hair may
be due to neuralgia or other diseases of the fifth cranial nerve.
Pubic hair may turn gray at the age of 50.
5. Grade or year in school or college:
Usually children enter the primary school at the age of 7.
They finish high school at the age of 17. Graduation in a col-
legiate course depends on the number of years required for the
course.
6. Menstruation in women:
Menstruation usually commence at the age of 12 but in warm
countries it may start at an earlier age.
7. Degree of mental development.
8. Manner of dressing, self-beautification and social life.
9. Atheromatous changes of blood vessels, opacity of the lens
and cornea (arcus senilis).
10. Wrinkleness of the skin usually appears after forty.
IDENTIFICATION OF BLOOD AND BLOOD STAINS
Legal Importance of the Study of Blood:
Y^For disputed parentage (maternity nnd paternity):
a. Disputed paternity may arise:
(1) When the wife committed adultery and the husband denied
to be the father of the child.
{2) When a child was born out of lawful wedlock and the
mother claimed someone to be the father but he vehe-
mently denied it.
(3]T In a claim for support or right of succession of the alleged
illegitimate child,
b. Disputed maternity may arise:
fflTTn case of allegation of jnterchange of children in a hospital
or nursery home, either accidentally or deliberately.
(•2ffn cases of wayward or stray children being claimed by two
or more women.
(-SfFor ownership of dead fetus or newly born child found in
street trash.
tSC'vrcumstantial or corroborative evidence against or in favor of the
perpetrator of a crime:
Example:
"A" was found dead with a deep stab wound on the chest. "B"
was found with a kitchen knife in his hand stained with blood.
Examination of the weapon showed that the stain was blood of
human origin and belonging to the same group as that of the
deceased "A". With such result of the examination, the investigating
authorities have a very strong presumption that " B " was the one
who committed the crime.
^Determination of the cause of death:
The amount of blood or blood stains found in the scene of the
crime or found inside the body of the deceased outside the blood
vessels may imply that the cause of death of the person is he-
morrhage.
^Determination of the direction of^ escape of the victim or the
assailant:
The shape of the blood or blood stains will give the investi-
gator an idea on the direction of the source of blood. Usually,
in small drops, the tapering end of the blood spot is towards the
direction of the moving source of blood.
^Determination of the approximate time the crime was committed:
Although there are variations as to the color and soluble
changes as to regards the age of the stain, we can only say that
when there is too much change, it is not very recent.
•^Determination of the place of commission of the crime.
^Determination of the presence of certain diseases.
Problems to be Answered in the Examination of Blood:
-tTDetermine whether the stain is due to blood.
Aril due to blood, determine whether it is of human origin or not.
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3flf it is of human origin, to what group does it belong? serologic test. (Lyon's Medical Jurisprudence for India by S.P.S.
4rDoes it belong to the person in question? Greval, 1953, p. 303).
grThe manner, degree and condition of the article which have been CHEMICAL EXAMINATIONS:
stained. 1. Saline extract of the blood stain plus ammonia will give a brown-
fVAge of the stain. ish tinge due to the formation of alkaline hematin.
PRELIMINARY OR GROSS EXAMINATION OF THE STAIN: 2. Benzidine test:
1. Determine the material, make, color of the article stained. A piece of white filter paper is pressed firmly on the suspected
2. Note which surface has been stained and the color of stain. Recent stain. Benzidine reagent is dropped on the paper, then followed
blood stains are dark-red. by drops of active hydrogen peroxide. A positive result will show
3. Study the direction of the origin of the blood stain. The spot of blue color. A positive result is not conclusive, because an oxi-
blood is usually tapering towards the direction of the source. A dizing agent will give a positive blue color reaction. Benzidine
fall will give a splash appearance. test has the sensitivity up to 1:300,000 dilution.
4. For small and discolored stains, the use of a lens or ultra-violet Benzidine reagent:
light may be useful. Benzidine sulphate is dissolved in glacial acetic acid to form
5. Determine the amount by the degree of soaking, size and intensity 10% solution.
of color. 3. Guaiacum test (Van Deen's Dyas' or Schombein's Test):
PHYSICAL EXAMINATIONS: To a white filter paper pressed and rubbed on the surface of the
1. Solubility test: stain, the solution of the alcoholic tincture of guaiacum is added
Recent blood shed is soluble in saline solution and imparts a and then hydrogen peroxide or ozonic ether is applied by drops.
bright red color. If blood is present, a blue color is imparted by the mixture. It
Stains which have been exposed to air become dry; hemoglobin is not conclusive like the benzidine test because potato skin,
is transformed to meth-hemoglobin or hematin. If the stain has iron rust, cheese, blue and indigo may give a positive reaction to
been kept in damp places for a long time; hemoglobin is trans- the test. The guaiacum test is positive up to 1:5,000 dilution.
formed to hematin. 4. Phenolphthalein test (Kastle-Meyer Test):
2. Heat test: A drop of the Kastle-Meyer's reagent is dropped on a white
Solution of the blood stain when heated will impart a muddy filter paper with the stain and left for at least ten seconds. A
precipitate. positive result will show a pink color after the addition of hy-
drogen peroxide. This test is not conclusive but sensitive up to
3. Luminescence test: 1:80,000,000 dilution. This test proves only the presence of
Stains on dark fabric mixed with mud, paint, etc. emit bluish- peroxidase.
white luminescence in a dark room when sprayed with one of the
Kastle-Meyer's reagent:
two solutions:
Phenolphthalein . .2 grams
a. 3-amino-phthalic-acid-hydrazide-HCL 1 gram Potassium hydroxide .20 grams
Sodium peroxide 5 grams Distilled water 100 cc.
Distilled water 1,000 cc. 5. Leucomalachite Green test:
b. 3-amino-phthalic-acid-hydrazide-HCL 1 gram This test which was recommended by Adler in 1904 is quite
Sodium carbonate 50 grams useful, but it is not so sensitive as the benzidine test. It depends
Hydrogen peroxide (10 Vol.) 50 grams upon the fact that leucomalachite green is oxidized to malachite
Distilled water 1,000 cc. green with a bluish-green or peacock-blue color by hydrogen
The substance responsible for the reaction is hematin. Older peroxide solution. The reaction occurs also with a solution of
stains therefore react better than new ones. the blood pigment previously boiled. On the other hand, the
Although the solutions are said not to interfere with further reaction is negative when iron is removed from hemoglobin
tests, unsprayed specimen of the material must be kept for the forming hematoporphyrin.
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MICROSCOPIC EXAMINATIONS: 2. Teichmann's blood crystals or Hemin crystals test:

Saline extract of the stain is examined under the microscope.
Note the presence of red blood cells, leucocytes, epithelial cells and
microorganisms. The presence of red blood cells will conclusively
show that the stain is blood. By microscopic examination, we can
differentiate the origin or the part of the body it came from. Men-
strual blood will show abundance of vaginal epithelial cells and Doe-
derlein's bacilli.
MICRO-CHEMICAL TESTS:
1. Hemochromogen crystal or Tokayama test:
A fragment of the suspected material is placed on a slide glass and
a drop of hemochromogen reagent is added. A cover glass is
placed on top and heated gradually for a time, then examined
under the microscope. Crystals varying from salmon color to
dark brown and pink and which are irregular rhomboids or in
clusters, may be seen. This test is positive to any substance
containing hemoglobin.
Hemochromogen solution:
Sodium hydroxide (10%) 3 cc.
Pyridine 3 cc.
Glucose (saturated solution).. .3 cc.
Distilled water 7 cc.
Hemochromogen crystals hemin crystal*
On the microscopic slide is placed fragments of the stain and a
drop of water with trace of sodium chloride added. Add glacial
acetic acid and evaporate to dryness under a cover slip. Dark
Drown rhombic prisms of chloride of hematin are formed. This
is considered as the best of the micro-chemical test.
3 . Acetone-haemin of Wagenhaar test:
A particle of dried stain or a fiber of the stained fabric is placed
on a glass slide and covered with a cover slip with a needle inter-
posed to prevent direct contact of the cover slip with the slide.
A drop of acetone is run under the cover slip so that the material
is surrounded and a drop of diluted oxalic or acetic acid is then
added. When examined under high power microscope, small
dark, dichroic acicular crystals of acetone-haemin are seen.
SPECTROSCOPIC EXAMINATIONS:
This examination depends on the principle that blood pigments
have the power to absorb light of certain wave length and produce
certain characteristic absorption bands on the spectrum. By means
of the spectroscope we can determine the presence of the following
substances:
1. From fresh blood stains:
a. Oxyhemoglobin
b. Hemoglobin
c. Reduced hematin or hemochrogen
2. From older stains:
a. Methemoglobin
b. Alkaline hematin
c. Hematoporphyrin
d. Reduced hematin
3. Other blood preparations:
a. Acid hematin
b. Alkaline hematin
c. Carboxyhemogiobin
d. Hematin
BIOLOGIC EXAMINATIONS:
1. Precipitin test:
This test is to determine whether the blood is of human origin
or not.
Principle of the test:
By injecting an animal, usually, a rabbit, with defibrinated blood
of unrelated animal, an anti-serum is produced in the blood of
the animal injected. The serum of this animal injected is capable
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specifically of precipitating the serum of the unrelated animal
whose blood serum has been injected. However, closely related
animals may also give the same response.
Preparation of the anti-human serum:
A dose of 1.5 cc. to 2.0 cc. per kilogram body weight of human
defibrinated blood is injected intravenously in the marginal vein
of the rabbit's ear. The dose is then repeated every third day with
three or five injections. The titre of the rabbit serum is tested
with the human serim. If the anti-human rabbit serum has
sufficient power to produce a ring of haziness at the junction of
the two sera, then the titre is sufficient for the examination of
the unknown.
Some biologists prefer combined intravenous and intraperi-
toneal injection of the serum but the result is the same.
If the titre is sufficiently strong the rabbit is bled to death and
the serum is oollected for the examination of the unknown.
Procedure of the test:
A normal saline extract must be made on the stain to be exam-
ined. The saline extract must be diluted from 1:10 up to 1:100,000.
At least capillary glass tubes, clean and dry on a rack, are used
in the examination. The following are the series of mixtures
including the controls:
1. Extract 1:100,000 + Anti-human serum
2. Extract 1:10,000 + Anti-human serum
3. Extract 1:1,000 + Anti-human serum
4. Extract 1:100 + Anti-human serum
5. Extract 1:10 + Anti-human serum
6. Extract 1:100 + Normal Rabbit serum
7. NaCl + Anti-human serum
8. Substrate extract + Anti-human serum
9. Heterogenous blood 1:1,000 + Anti-human serum
^10. Known human 1:1,000 + Anti-human serum
s 6 to 10 are controls. Normally, there must be positive
\readticm in No. 10 even if the rest are negative.
A\ positive reaction is manifested as an area of haziness in the
form* of a white ring at the point of contact between the two
solutions mixed. Animals of the allied specie may also give a
positive reaction to sheep and goat.
Substances responsible for a false positive reaction:
The following common substances, if present in the extract,
will precipitate the anti-serum and thus produce the semblance of
a positive reaction:
a. Soap. This is of special importance in washed stains.
b. Rancid oil is found sometimes in pillow cases and head dresses.
The soluble fraction of the oil prevents frothing yet the extract
gives a sharp and quick reaction.
Two errors are introduced, namely:
(1) False positive reaction from the rancid oil itself.
(2) Failure of foam test and danger of group reaction — mon-
key blood in high concentration will act like human blood.
c. Alum. This is used as a household remedy in gargles and mouth
washes and may stain any article.
d. Tannin and allied substances derived from vegetable tissue. The
stain of saliva of the betel chewer not only looks like blood-
stain but by virtue of the tannin present in most of the con-
stituents of the prepared betel it also acts on the antisera.
Stains on leather and plant tissue should be removed by apply-
ing moist filter paper to the surface (leather contains tannin).
(From: Lyon's Medical Jurisprudence for India, S.P.S. Greval,
10 in ed., 1953, p. 315)
Substances responsible for a false negative reaction:
a. Mineral acids
b. Corrosive sublimate
c. Chloride of lime
d. Sulfate of copper and iron
e. Bisulphide of carbon and sodium
f. Nitrate of silver
g. Thymol
h. Permanganate of potassium
Value of the precipitin test:
If positive result is obtained, we can tell in a more or less
conclusive way that the blood stain is of human origin; although
anthropoid ape may give the same result.
The same test and technique may be made to determine whe-
ther muscles, secretions, bones and other body fluids are of
human origin or not.
Certain materials like alcohol, formaldehyde, corrosive subli-
mate, lysol, creoline, carbolic acid, acids and alkalies destroy the
property of blood to react with precipitin.
2. Blood grouping:
Principle of the test:
All human beings have their blood belonging to any of the four
principal blood groups. A normal suspension of human red blood
cells when mixed with its own serum or serum of a similar group
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will make the red blood cells suspension remain even. But if Bx AB A, B, AB O
suspended in the serum of another group, the red blood cells ABx AB A, B, AB O
clump with one another and this is called agglutination. The red Inheritance of M—N type
blood cells contain agglutinogens and the serum contains agglu- Parents Possible Children
tinins. MxM M
Procedure of the test: MxMN M, MN
Two methods may be utilized and both should be employed MxN MN
in the examination: MN x MN M, N, MN
MN x N MN, N
a. Detection of agglutinins NxN N
b. Detection of agglutinogens
Grouping is true not only with blood but also with other fluids
a. Detection of agglutinins: of the body like saliva, vaginal secretion, seminal fluid, milk, urine
A saline extract is made on the stain. The solution is then and others.
mixed on a slide glass with A, B, and O cell suspensions. The
Age of the Blood Stains:
results should be examined after agitation for several hours until
When blood is exposed to the atmosphere or some other influ-
a decisive reading is possible.
ences, its hemoglobin is converted to meth-hemoglobin or hematin.
b. Detection of agglutinogens: The color is changed from red to reddish-brown. The presence of
Agglutinogens cannot be detected in dried stains since the acid accelerates the formation of hematin. These changes take place
red blood cells lose this power on drying, but the presence may in warm weather within 24 hours. Blood of one week old and that
be shown by their ability to absorb agglutinins A and B and of six weeks may not present a difference in physical and chemical
their power to inhibit the action of the sera containing these properties.
agglutinins from the test sera. When these are subsequently
tested against known test corpuscles, the absorption which has Differential Characteristics of Blood from Different Sources:
taken place will become apparent. Corresponding absorption 1. Arterial Blood:
will result if only agglutinogen A' or B is present in the stain. a. Bright scarlet in color.
The portion of stained material should be mixed with Group b. Leaves the blood vessel with pressure.
O serum. (Medical Jurisprudence and Toxicology by Glaister, c. High oxygen contents.
8th ed., p. 308). 2. Venous Blood:
Value of the test: a. Dark red in color.
It may solve disputed parentage (paternity or maternity). A b. Does not spill far from the wound.
positive result is not conclusive that the one in question is the c. Low oxygen content.
offspring, but a negative result is conclusive that he is not the child 3. Menstrual Blood:
of the alleged parents. a. Does not clot.
b. Acidic in reaction owing to mixture with vaginal mucous.
Inheritance Patterns of ABO Blood Groups: c. On microscopic examination, there are vaginal epithelial cells.
Group of Group of Exclusion d. Contains large number of Deoderlein's bacillus.
Parents Children Cases 4. Man's or Woman's Blood:
OxO O A, B, AB There is no method differentiating a man's blood from a wo-
Ox A O.A B, AB man's blood. Probably, the presence of sex hormone in female
OxB 0,B A, AB blood may be a point of differentiation.
Ax A O, A B, AB 5. Child's Blood:
AxB O, A, B, AB
BxB O, B A, AB a. At birth, it is thin and soft compared with that of adult.
O x AB A, B 0 , AB b. Red blood cells are nucleated and exhibit greater fragility.
A x AB A, B, AB 0 c. Red blood cells count more than in adult.
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H. IDENTIFICATION OF HAIR AND FIBERS
How the Hair and Fibers Change Color:
1. Addition of a substance that will coat the outer surface of the
hair so as to impart a different color.
Example: Salts of bismuth, lead, silver and pyrogallic acid.
2. Addition of substances which bleach or change the natural
color of the fiber or hair.
Example: Hydrogen peroxide, chlorine and diluted nitric
acid.
Characteristics of the Different Kinds of Fibers:
1. Cotton Fibers:
Flattened, twisted fibers with thickened edges. Irregularly
granulated cuticle. No transverse markings. Fibers show spiral
twist. Fibers swell in a solution of copper sulphate and sodium
carbonate dissolved in ammonia. It is insoluble in strong sodium
hydroxide but soluble in strong sulfuric acid and partially dis-
solved in hot strong hydrochloric acid.
2. Flax Fibers: > 7. Silk Fibers:
Apex tapering to fine point. Transverse sections are polygonal
and show a small cavity.
The fibers consist of cellulose and give blue or bluish-red color
when treated with a weak solution of potassium iodide saturated
in iodine and sulfuric acid.
The fibers which show transverse lines and are usually seen in
group formation, dissolve in a solution composed of copper
sulphate and sodium carbonate in ammonia.
3. Hemp Fibers:
Fibers show transverse lines and consist of cellulose.
Large oval cavities are seen in transverse sections. The end is
usually blunt, and there is often a tuft of hair at the knots.
Stains are bluish-red with phloroglucin, and yellow with both
aniline sulphate and weak solution of potassium iodide saturated
in iodine with sulfuric acid.
4. Abaca Fibers:
Fibers are smooth without transverse or longitudinal markings.
The cavities are large and uniform.
The walls are lignified.
The tips are fine points.
5. Jute Fibers:
Fibers are quite smooth without either longitudinal or transverse
markings.
The fibers have typical large cavities which are not uniform but
vary with the degree of contraction of the walls of the fibers
which are lignified.
The ends are blunt.
The fibers are stained red with phloroglucin and yellow with
aniline sulphate, also with iodine and sulfuric acid.
6. Wool Fibers:
These fibers can easily be distinguished from vegetable fibers
since the former show an outer layer of flattened cells and im-
bricated margins.
The interiors are composed of fibrous tissues but sometimes
the medulla is present.
They do not dissolve in a solution composed of copper sulphate,
sodium carbonate and ammonia.
Stain is yellow with iodine and sulfuric acid and also with
picric acid.
Do not dissolve in sulfuric acid.
Smell of singeing on burning.
Manufactured silk is almost structureless, microscopically.
Fibers stain is brown with iodine and sulfuric acid and yellow
with picric acid.
They dissolve slowly in a mixture of copper sulphate, sodium
carbonate and ammonia.
8. Linen Fibers:
Fibers are straight and tapering to a point.
Cortical area shows transverse lines which frequently intersects,
simulating a jointed appearance.
The medullary region shows a thin dense line.
They do not dissolve in concentrated sulfuric acid.
If placed in 1% alcoholic solution of fuchsin and then in a
solution of ammonium hydroxide, they assume a bright red
color (Medical Jurisprudence and Toxicology by Glaister, 8th ed„
P. 110).
The Vegetable and Animal Fibers may be Differentiated as Follows:
1. Ignition test:
a. Animal fibers — Burn and fuse; smell of burnt hair, fused
and globular; fume turns red litmus to
blue.
b. Vegetable fibers — Rapid combustion, end charred and break
sharply; smell of burning wood; vapor
turns blue litmus to red.
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2. Chemical tests: Use of concentrated nitric acid: Cortex

a. Animal fibers — Turn yellow. Looks like a thick muff. Looks lixe a fairly thin
b. Vegetable fibers — No change in color. hollow cylinder.
3. Picric acid test: Pigments in the form of fine Pigments in the form of
a. Wool and silk — Yellow. grains. irregular grains larger
b. Cellulose — No change. than that of human's.
4. Millon's Reagent test: Cuticle
a. Wool and silk — Turn brown. Thin scales not protruding, co- Thick scales protruding,
b. Cellulose fibers — Turn black. vering one another to about do not cover one ano-
5. Soaked in tannic acid: 4/5. ther to the same degree
a. Wool and silk — No change. as the human's.
b. Cellulose fibers — Black.
6. Heated with 10% NaOH:
a. Wool and silk — Dissolve.
b. Cellulose — Not affected.
Once the fibers are found to be of animal origin, the next step
is the examination to determine whether these fibers are human
hair or hair of other animals:

Parts of the Hair:

1. Cuticle — The outer layer of the hair.
2. Cortex or middle layer — Consists of longitudinal fibers bearing
the pigment.
3. Medulla or core — Contains air bubbles and some pigments.
Differences Between Hair Forcibly Extracted and Naturally Shed Hair:
If a hair-root has been extracted forcibly, the bulb is irregular in
form due to rupture of the sheath and shows an undulating surface,
together with excrescences of different shapes and sizes. A naturally
shed bulb has a rounded extremity, a smooth surface, and most
probably show signs of atrophic or fatty degeneration, especially Hair and blood in the victim's hand showing struggle
in an elderly person (Medical Jurisprudence and Toxicology by
Glaister, 8th ed., p. 99) Note: Medullary index (I) is the relation between the diameter of
the medulla and the diameter of the whole hair. (Soderman,
Distinctions between Human and Animal Hair p. 176).
Human Animal The hair and fiber may be examined microscopically in its
Medulla cross-section and longitudinal aspect.
Air network in fine grains. Air network in forms of
large or small sacks. Comparative study must be made to show similarity of the
Cells invisible without treatment hair and fibers in question to the known where they are al-
Cells easily visible. leged to belong.
in water.
Value of I lower than 0.3. Value of I higher than 0.6 (From: — Modern Criminal Investigation by Harry Soderman,
Fuzz without medulla. Fuzz with medulla. 4th ed., p. 191).
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Differentiation Between Sections of Gorilla, Chimpanzee and 4. Does the Hair Belong to a Male or a Female?
Human Hair: In many instances it is quite impossible to state the sex from the
Gorilla Chimpanzee Human hair, but certain points may be worthy of mention:
Medulla very con- Constantly present. Very frequently ab- Ha& on the scalp of male are shorter, thicker and more wiry than
stantly present. sent. that of female's.
Medulla of small Small but slightly Small size, slightly Eyebrow hair of a male is generally long and more wiry than that
size. larger than hu- smaller than goril- of a female's.
man's or gorilla's. la's or chimpan- (From: Recent Advances in Forensic Medicine by Sydney Smith and
zee's. Glaister, p. 121).
Granular cortical Centrally placed. Granules less coarse,
pigment, central peripheral, near Estimations of Age Based on the Hair:
around medulla. cuticular margins. This is quite difficult and the examiner hesitates in giving his
Cuticular margins Less regular than in Cuticular margins, opinion. However, there are some points of distinction:
regular, but less human hair. extremely regular. Hair of children are fine, short, deficient of pigments and, as a
tnan in human rule, devoid of medulla.
hair. At the adolescent age, hair may appear at the pubis. Hair on the
(From: Recent Advances in Forensic Medicine by Sydney Smith scalp becomes long, wiry, and thick.
& Giaister,p. 109). In the case of older persons, the color is usually white or gray,
with marked absorption of pigments and degenerative changes.
Other Points in the Identification of Hair:
1. Characteristics of the hair:
Hair on body surfaces is fine while those from the beard,
mustache and scalp are very thick.
Hair from the eyebrows and lashes is tapering gradually to fine
points.
2. Length of the hair:
Hair from the scalp grows 2.5 cms. a month.
Beard hair grows at the rate of 0.4 millimeter a day.
3. Color of the hair:
The color of the hair may be black, blonde or brunette.
Hair from older persons may be white or gray.
The hair may be artificially colored by bismuth, lead or silver
salts. It may be bleached by addition of hydrogen peroxide,
chlorine or diluted hydrochloric or nitric acid.
How to detect presence of coloring or bleaching material in hair:
a. Examination of hair may show pigments at nodes.
b. The new portion of the hair recently grown has a different color
from the treated part.
c. The hair in other parts of the body may not correspond in
color.
d. The scalp may be dyed.
e. The texture of the hair may be altered.
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Chapter IV ^ LEGAL MEDICINE

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Notice to creditor to be issued by court — Immediately after

MEDICOLEGAL ASPECTS OF DEATH
Importance of Death Determination: £f P ^ * ^
yThe civil personality of a natural person is extinguished by death:
The civil personality is extinguished by death. The effect of
death upon the rights and obligations of the deceased is deter-
mined by law, by contract and by will (Art. 42, Civil Code).
£ The property of a person is transmitted to his heirs at the time of
death:
Succession is a mode of acquisition by virtue of which the
property, rights and obligations to the extent of the value of the
inheritance of a person are transmitted through his death to
another or others either by will or by operation of law (Art. 774,
Civil Code).
3<The death of a partner is one of the causes of dissolution of
partnership agreement:
Dissolution (of a partnership) is caused. . . (5) by the death of
any partner;. . (Art. 1830, Civil Code).
4\77ie death of either the principal or agent is a mode of extinguish-
ment of agency:
Agency is extinguished. . . (3) By death, civil interdiction,
insanity or insolvency of the principal or of the agent. . . (Art.
1919, Civil Code).
f/The criminal liability of a person is extinguished by death:
How criminal liability is totally extinguished — Criminal liability
is totally extinguished:
1. By death of the convict, as to the personal penalties; and as
to pecuniary penalties, liability therefore is extinguished
only when the death of the offender occurs before judg-
ment.
(Art. 89, Revised Penal Code).
The civil case for claims which does not survive is dismissed upon
death of the defendant:
When the action is for recovery of money, debt or interest
thereon, and the defendant dies before the final judgment in the
court of the First Instance, it shall be dismissed to be prosecuted
in the manner especially provided by these rules (Rule 3, Sec. 21,
Rules of Court).
Ill
granting letters, testamentary or of administration, the court shall
issue a notice requiring all persons having money claims against the
decedent to file them in the office of the clerk of said court (Rule
86, Sec. 1, Rules of Court).
ieath is the termination of life. It is the comrjjgte_cessation of all
the vital functions without possibility of resuscitatioriJ It is an irre-
versible loss of the properties of living matter. Dying is a continuing
process while death is an event that takes place at a precise time.
The ascertainment of death is a clinical and not a legal problem.
Previously, complete and persistent cessation of heart action and
respiration (cardio-respiratory) is the standard criteria in the deter-
mination of death, but the following events in the recent years led to
the development of uncertainty of the moment of death:
1. The increasing use of mechanical resuscitative devices which can
maintain respiration and cardiac functions almost indefinitely.
Heart vitality may be maintained by coronary perfusion or its
rhythm by defibrillation or pace maker. Breathing can be sus-
tained by a respirator or pulmonator.
2. There is an increasing demand of organs for transplantation. Vital
organs can now be transplanted and the shorter the time space be-
tween the death of the donor and the transplantation process, the
more is the chance of success of surgery. It becomes a problem as
to when the donor dies for the immediate removal of the organ to
be transplanted. The surgeon must see to it that the donor is dead
before the organ to be transplanted is removed, otherwise he may
be held liable if done prematurely.
3. Coma following administration of excessive doses of modern
sedatives and hypnotics could be mistaken for death. Coma
induced by barbiturates could be mistaken for death because it
clinically appears to have eliminated breathing and heart action,
chill the body and makes reflexes weak or totally non-existent.
Based on the Criterion Used in its Determination, Death may be:
1. Brain Death — Death occurs when there is deep-'Irreversible coma,
^absence of electrical brain activity and complete cessation of all
the vital functions without possibility of resuscitation.
2. Cardio-Respiratory Death — Death occurs when there is a>con-
tinuous and persistent cessation of heart action and respiration.
Cardio-respiratory death is a condition in which the physician and
the members of the family pronounced a person to be dead based
on the common sense or intuition.
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3. Some countries or states provide both brain and cardio-respiratory
bases in an alternative or eclectic way in the determination of the
moment of death. In 1970, the state of Kansas became the first
to enact a statute which specifies more clearly the accepted
alternatives for defining death. Section 1, Chapter 378 of the
Kansas Statute provides the following:
"A person will be considered medically and legally dead if, in
the opinion of a physician, based on ordinary standards of medical
practice, there is the absence of spontaneous respiratory and
cardiac function and, because of the disease or condition which
caused, directly or indirectly, these functions to cease, or because
of the passage of time since these functions ceased, attempts at
resuscitation are considered hopeless; and, in this event, death will
have occurred at the time these functions ceased.
Second, a person will be considered medically or legally dead if,
in the opinion of a physician, based on ordinary standards of
medical practice, there is the absence of spontaneous brain func-
tion; and if based on ordinary standards of medical practice,
during reasonable attempts to either maintain or restore spon-
taneous circulatory or respiratory function in the absence of afore-
said brain function, it appears that further attempts at resusci-
tation or supportive maintenance will not succeed, death will have
occurred at the time when these conditions first coincide. Death
is to be pronounced before artificial means of supporting res-
piratory and circulatory function are terminated and before any
vital organ is removed for purposes of transplantation."
Brain Death:
Inasmuch as there are no universally accepted criteria yet to
establish a condition of brain death, the following proposal or
recommendations are made by different committees or bodies:
1. According to the Harvard Report of 1968, the following are the
characteristics of "irreversible coma":
a. Unreceptivity and unresponsibility — There is a total unaware-
ness to externally applied stimuli and inner need and complete
unresponsiveness — our definition of irreversible coma. Even the
most intense painful stimuli evoke no vocal or other response,
not even a groan, withdrawal of his limb, or quickening of
respiration.
b. No movements or breathing — Observations covering a period of
at least 1 hour by physicians is adequate to satisfy the criteria
of no spontaneous muscular movements or spontaneous res-
piration or response to stimuli such as pain, touch, sound, or
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LEGAL MEDICINE
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light. After the patient is on a mechanical respirator, the total
absence of spontaneous breathing may be established by turning
off the respirator for three minutes and observing whether there
is any effort on the part of the subject to breath spontaneously.
(The respirator may be turned off for this time provided that at
the start of the trial period the patient's carbon dioxide tension
is within the normal range, and provided also that the patient
had been breathing room air for at least 10 minutes prior to the
trial).
c. No reflexes — Irreversible coma with abolition of central
nervous system activity is evidenced in part by the absence of
elicitable reflexes. The pupil will be fixed and dilated and will
not respond to a direct source of bright light. . . Ocular move-
ment (to head turning and to irrigation of the ears with ice
water) and blinking are absent. There is no evidence of postural
activity (decerebrate or other). Swallowing, yawning, vocal-
ization are in abeyance. Corneal and pharyngeal reflexes are
absent. As a rule the stretch or tendon reflexes cannot be
elicited, i.e. tapping the tendons of the biceps, triceps and
pronator muscles, quadriceps and gastrocnemius muscles with
the reflex hammer elicits no contraction of the respective
muscles. Plantar or noxious stimulation gives no response.
d. Flat electro-encephalogram — Of great confirmatory value is
the flat or iso-electric E.E.G. We must assume that the elec-
trodes have been properly applied, that the apparatus is func-
tioning normally, and that the personnel in charge are com-
petent.
All of these tests shall be repeated at least 24 hours later with
no change. It is emphasized that the patient be declared dead
before any effort is made to take him off the respirator, if he is
then on a respirator.
2. In 1969, the Ad Hoc Committee of Human Transplantation
convened under the auspices of the Institute of Forensic Sciences,
Duquesne University School of Law adopted the proposed criteria
for the determination of death otherwise known as Philadelphia
Protocol, and the following were considered:
a. Lack of responsiveness to internal and external environment.
b. Absence of spontaneous breathing movements for 3 minutes,
in the absence of hypocarbia and while breathing room air.
c No muscular movements with generalized flaccidity and no
evidence of postural activity or shivering,
d. Reflexes and response:
(1) Pupils fixed and dilated, non-reactive to strong stimuli.
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(2) Corneal reflexes absent. f A. KINDS OF DEATH ^ j j ^

(3) Supra-orbital or other pressure response absent (both pain
response and decerebrate posturing).
(4) Absence of snouting or sucking response.
(5) No reflex response to upper airway stimulation.
(6) No reflex response to lower airway stimulation.
(7) No ocular response to ice water stimulation of the inner
ear.
(8) No deep tendon reflexes.
(9) No superficial reflexes.
(10) No plantar responses.
e. Falling arterial pressure without support by drugs or other
means.
f. Iso-electric electro-encephalogram (in absences of hypothermia,
anesthetic agents and drugs intoxication) recorded sponta-
neously and during auditory and tactile stimulation.
It is further laid down that these criteria shall have been
present for at least 2 hours and that death should be certified
by two physicians other than the physician of a potential
organ recipient (Gradwohrs Legal Medicine, Francis Camps,
Ann Robinson & Bernard Lucas, ed. 3rd ed. p. 51-52).
Other Set of Criteria to Establish Brain Death:
1. Mohandas and Chou (1971) made a summary of the criteria of
brain death which was accepted by the University of Minnesota
Science Center.
2. The Ottawa General Hospital (1970) set up guidelines for the
criteria of cerebral death.
3. In France (1968) the Council of Ministers published a decree
which adopted the official definition of death on recommen-
dation of the French Academy of Medicine.
Although the consideration of brain death is the most ideal
criteria, the difficulty and practicability of its application is a prob-
lem. Electro-encephalogram which is the most reliable instrument
to determine brain activities is not available in many places. Even
if available, the number of competent persons to apply the instru-
ment and the interpretation of the results is quite limited.
The use of the criteria of brain death may only be applied to
those persons who are potential organ donors.
)MATIC DEATH OR CLINICAL DEATH:
This is the state of the body in which there is ^complete, per-
sistent and continuous cessation of the vital functions of the
brain, heart and lungs which maintain life and health^ It occurs
the moment a physician or the other members of the family
declare a person has expired, and some of the early signs of
death are present. It is hardly possible to determine the exact
time of death.
Immediately after death the face and lips become pale, the
muscles become flaccid, the sphincters are relax, the lower jaw
tends to drop, the eyelids remain open, pupils dilate and the
skin losses its elasticity. The body fluid tends to gravitate to the
mostf dependent portions of the body and the body heat gradually
assiimes the temperature of the surroundings.
(OLECULAR OR CELLULAR DEATH:
After cessation of the vital functions of the body there is still
^animal life among individual cells. This is evidence by the pre-
sence of/excitability of muscles and^ciliary movements and other
functions of individual cells.
About three to six hours later, there is death of individual cells.
This is known as molecular or cellular death. Its exact occurrence
cannot be definitely ascertained because its time of appearance is
influenced by several factors. Previous state of health, infection,
climatic condition, cellular nutrition, etc. influence its occurrence.
^APPARENT DEATH" OR "STATE OF SUSPENDED ANIMATION":
This condition is not really death but merely aCtransient loss of
consciousness or temporary cessation of the vital functions of the
body on account of disease, external stimulus or other forms of
influence.^ It may arise especially in hysteria, uremia, catalepsy
and electric shock.
It may be induced voluntarily as has been cited by foreign
authors (Col. Townshend who could be able to pass into a state
of pulselessness for half an hour). Involuntary suspension is
shown in still-birth. A newly born child may remain at the state
of suspended animation and may die unless prompt action is
taken. A person who has been rescued from drowning may
appear dead but life is maintained after continuous resuscitation.
It is important to determine the condition of suspended ani-
mation to prevent premature burial. There are records of cases
wherein a person was pronounced dead, placed in a coffin and
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later angrily rise from it and walk unaided. The relative has sent
death notice and placed wreaths near his coffin (Daily Mail
England, 1948).
ji B. SIGNS OF DEATHS ^XC^®
CESSATION OF HEART ACTION AND CIRCULATION: tl R C I ^ A "
There must be anfentire and continuous cessation of the heart
action and flow of blood in the whole vascular system^ A tem-
porary suspension of the heart action is still compatible with life.
The length of time the heart may cease to function and life is still
maintained depends upon the length of time it is readily re-
established and upon the oxygenation of blood at the time of the
suspension. \As a general rule, if there is no heart action for a
period of five minutes death is regarded as certain^
Respiration ceases frequently before the stoppage of heart
contraction and circulation. Usually the auricle of the heart
contracts after somatic death for a longer period than the ventricle.
And the auricle is the last to stop, hence called ultimen martens.
In judicial hanging, the heart continues to beat for twenty
minutes or half an hour after the individual has been executed
although its beating is irregular and feeble. In decapitation of
criminals, heart beating is present for an hour after decapitation
has taken place.
Methods of Detecting the Cessation of Heart Action and Circu-
lation:
a. Examination of the Heart:
(1) Palpation of the Pulse:
Pulsation of the peripheral blood vessels may be made at
the region of the wrist or at the neck. The pulsation of the
vessels is synchronous with the heart beat. Occasionally the
pulsation is very imperceptible and irregular that the exa-
miner experience much difficulty.
(2) Auscultation for the Heart Sound at the Precordial Area:
The rhythmic contraction and relaxation of the heart is
audible through the stethoscope. Heart sound can be
audible during life even without the aid of a stethoscope by
placing the ear at the precordial area.
Errors in the Method of Determining Heart Action:
(a) The heart itself may, like other muscles, be in a state of
apparent and not real death.
(b) The heart sound may not always be appreciable to the
ear even with the aid of the stethoscope.
Difficulties in Auscultation may be Encountered in:
(a) Stout person.
(b) Fatty degeneration of the heart.
(c) Pericardial effusion.
(3) Flouroscopic Examination:
Fluoroscopic examination of the chest will reveal the
shadow of the heart in its rhythmic contraction and relaxa-
tion. The shadow may be enlarged and the excursion made
less visible due to pericardial effusion.
(4) By the Use of Electrocardiograph:
The heart beat is accompanied by the passage of electri-
cal charge through the impulse conducting system of the
heart which may be recorded in an electrocardiograph
machine. The electrocardiograph will record the heart beat
even if it is too weak to be heard by auscultation. This is
the best method of determining heart action but quite
impractical,
b. Examination of the Peripheral Circulation:
(1) Magnus'Test:
A ligature is applied around the base of a finger with
moderate tightness. In a living person there appears a
bloodless zone at the site of the application of the liga-
ture and a livid area distal to the ligature. If such ligature
is applied to the finger of a dead man, there is no such
change in color. The color of the area where the ligature
is applied will be the same as that one distal to it. There
may be no appreciable change of color if a living person
is markedly anemic.
( 2 ) Opening of Small Artery:
In the living, the blood escapes in jerk and at a distance.
In a dead man, the blood vessel is white and there is no
jerking escape of blood but may only ooze towards the
nearby skin. When bigger arteries are cut, blood may flow
without pressure continuously.
(3) Icard's Test:
This consists of the injection of a solution of fluorescein
subcutaneously. If circulation is still present, the dye will
spread all over the body and the whole skin will have a
greenish-yellow discoloration due to flourescein. In a dead
man, the solution will just remain at the site of the injection.
This test should be applied only with the use of the daylight
as the color is difficult to be appreciated with the use of
artificial light.
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(4) Pressure on the Fingernails: Methods of Detecting Cessation of Respiration:

If pressure is applied on the fingernails intermittently,
there will be a zone of paleness at the site of the appli-
cation of pressure which become livid on release. There
will be no such change of color if the test is applied to a
dead man.
(5) Diaphanous Test:
The fingers are spread wide and the finger webs are
viewed through a strong light. In the living, the finger webs
appear red but yellow in the dead. The finger webs may
appear yellow in a strong light even if living in cases of
anemia or carbon monoxide poisoning.
(6) Application of Heat on the Skin:
If heated material is applied on the skin of a dead man,
it will not produce true blister. There is no sign of con-
gestion, or other vital reactions. But if applied to a living
person, blister formation, congestion, and other vital
reactions of the injured area will be observed.
(7) Palpation of the Radial Pulse:
Palpation of the radial artery with the fingers, one will
feel the rhythmic pulsation of the vessel due to the flow of
blood. No such pulsation will be observed in a dead man.
(8) Dropping of Melted Wax:
Melted sealing wax is dropped on the breast of a person.
If the person is dead, there will be no inflammatory edema
y at the neighborhood of the dropped melted wax.
CESSATION OF RESPIRATION:
Like heart action, cessation of respiration in order to be con-
sidered as a sign of death must be continuous and persistent. A
person can hold his breath for a period not longer than 3-1/2
minutes. In case of electrical shock, respiration may cease for
sometime but may be restored by continuous artificial respiration.
In the following conditions there may be suspension of res-
piration without death ensuing.
a. In a purely voluntary act, as in divers, swimmers, etc. but it
cannot be longer than two minutes.
b. In some peculiar condition of respiration, like Cheyne-Stokes
respiration, but the apneic interval cannot be longer than
fifteen to twenty seconds;
c. In cases of apparent drowning;
d. Newly-born infants may not breathe for a time after birth and
may commence only after stimulation or spontaneously later.
a. Expose the chest and abdomen and observe the movement
during inspiration and expiration.
b. Examine the person with the aid of a stethoscope which is
placed at the base of the anterior aspect of the neck and hear
sound of the current of air passing through the trachea during
each phase of respiration.
c. Examination with a Mirror:
The surface of a cold-looking glass is held in front of the
mouth and nostrils. If there is dimming of the mirror after
a time, there is still respiration. The dimming of the cold
mirror is due to the condensation of the warm moist air exhaled
from the lungs if respiration is still going on. However, it must
not be forgotten that the dimming of the mirror may be due to
the expulsion of the air from the lungs due to the contraction
of the diaphragm in rigor mortis. Ordinarily there is no dimming
of the mirror when the subject is dead.
d. Examination with a Feather or Cotton Fibers:
Place a fine feather or a strip of cotton in front of the lips
and nostrils. If there is movement of the feather or cotton not
due to external air, respiration is present. The feather or cotton
fibers will be blown away during expiration and towards the
nose and mouth during inspiration. This is not a reliable test
as the slightest movement of outside air or nervousness of the
observer will move the feather or cotton fibers.
e. Examination with a Glass of Water:
Place a glass half full of water at the region of the chest. If
the surface of the water is smooth and stable, there is no
respiration taking place, but if it waves or water movement is
observed, then respiration is taking place. This is not a good
test because of the difficulty of preventing movement of the
place where the body lies.
f. Winslow's Test:
There is no movement of the image formed by reflecting
artificial or sun light on the water or mercury contained in a
saucer and placed on the chest or abdomen if respiration is
not taking place. The reflection is utilized to magnify the
/ movement of the surface of mercury or water.
. COOLING OF THE BODY (ALGOR MORTIS):
'After death the metabolic process inside the body ceases, yj No
more heat is produced but the body loses slowly its temperature
by evaporationJor by conduction to the surrounding atmosphere.
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The progressive fall of the body temperature is one of the most b. Conditions that are connected with the surroundings:
prominent signs of death. /' (1) Factors Delaying Cooling:
The rate of cooling of the body is not uniform. It is rapid (a) Clothings.
during the first two hours after death and as the temperature of (b) Want of access of air to the body.
the body gradually approaches the temperature of the surround- (c) Small room.
ings, the rate becomes slower. (d) Warm surroundings.
It is difficult to tell exactly the length of time the body will (2) Factors Accelerating Cooling:
assume the temperature of the surroun Several factors (a) Unclothed body.
influence the rate of fall of the body temperature. (b) Conditions allowing the access of air.
The fall of temperature may occur before death in the follow- (c) Large room permitting the dissipation of heat.
ing conditions: ( (d) Cooling more rapid in water than in air.
a. Cancer Methods of Estimating How Long a Person Has Been Dead From
b. Phthisis the Cooling of the Body:
c. Collapse a. When the body temperature is normal at the time of death,
The fall of temperature of 15 to 20 degrees fahrenheit is con- the average rate of fall of the temperature during the first two
sidered as a certain sign of death. hours is one-half of the difference of the body temperature and
that of the air.
Post-mortem Caloricity is the rise of temperature of the body
after death due to rapid and early putrefactive changes or some During the next two hours, the temperature fall is one-half of
internal changes. It is usually observed in the first two hours the previous rate, and during the succeeding two hours, it is
after death. one-half of the last mentioned rate.
Post-mortem caloricity may occur in the following conditions: As a general rule the body attains the temperature of the
a. Cholera. surrounding air from 12 to 15 hours after death in tropical
b. Yellow fever. countries (Medical Jurisprudence and Toxicology by Modi,
c. Liver abscess. 12th ed.,p. 121).
d. Peritonitis. b. To make an approximate estimate of the duration of death
e. Cerebro-spinal fever. from the body temperature, the following formula has been
f. Rheumatic fever. suggested:
g. Tetanus.
(Normal Temperature) 98.4°F — (Rectal Temperature)
h. Smallpox.
i. Strychnine poisoning.
Factors Influencing the Rate of Cooling of the Body: Approximate number of hours
a. Conditions that are connected with the body: after death
(1) Factors Delaying Cooling: This formula is only applicable to cases where the rectal
(a) Acute pyrexia! diseases. temperature has not yet assumed the temperature of the sur-
(b) Sudden death in good health.
roundings, otherwise, the result will be constant.
(c) Obesity of person.
(d) Death from asphyxia. c. Chemical Method:
(e) Death of the middle age. Schourup's formula for the determination of the time of death
(2) Factors Accelerating Cooling: of any cadaver whose cerebro-spinal fluid is examined for the
concentrations of lactic acid (L.A.), non-protein nitrogen
(a) Leanness of the body. (N.P.N.) and amino acid (A.A.) and whose axillary temperature
(b) Extreme age. has been taken at the time the cerebro-spinal fluid has been
(c) Long-standing or lingering illness. removed.
(d) Chronic pyrexial disease associated with wasting.
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36— T + antilog, L.A. + N.P.N. — 15 + A.A. — 1 S ^ HMANGES

180 16.7 7.35
4 a. The skin may be observed to be-pale and vgaxy-looking due to
T — temperature 1 = axillary temperature
The lactic acid content of the cerebro-spinal fluid rises from
15 mg. to over 200 mg. per 100 cc. The rise is rapid during the
first 5 hours following death.
The non-protein nitrogen (N.P.N.) increases from 15 to 40
mg. per 100 cc. during the first 15 hours. This test is modified
by ante-mortem anemia and rapid cooling of the body.
Amino-acids (A.A.) increases from 1 mg. to 12 mg. percent
during the first 15 hours, but the result is modified by rapid
cooling of the body.
Limitations of the Schourup's Formula:
a. The method is only applicable to adults, as the rate of bio-
chemical change in a child is far more rapid than in adult. It is
the value to person over the age of 15 years.
b. The cerebrospinal fluid must be free of blood, the presence of
which raises the lactic concentration.
c. Injuries must not have allowed the escape of cerebrospinal
fluid.
d. Death must have occurred' within a period 15 hours prior to
the withdrawal of the sample of cerebrospinal fluid, as after
that time the changes in the concentration per time unit be-
come irregular (Modern Trend in Forensic Medicine by Keith
. Simpson, 1953, pp. 83-84).
INSENSIBILITY OF THE BODY AND LOSS OF POWER TO MOVE:
After death the whole body is insensible. No kind of stimulus
is capable of letting the, body have voluntary movement.
This condition must be observed in conjunction with cessation
of heart beat and circulation and cessation of respiration.
The insensibility and loss of power to move may be present
although living, in the following conditions:
a. Apoplexy.
b. Epilepsy.
c. Trance.
d. Catalepsy.
e. Cerebral concussion.
f. Hysteria.
AN IN THE SKIN:
The following are the changes undergone by the skin after death:
the absence of circulation. Areas of the skin specially the most
dependent portions will develop livid discoloration on account
of the gravitation of blood.
bsLoss of Elasticity of the Skin:
Normally when the body surface is compressed, it readily
returns to normal shape. After death, application of pressure
to the skin surface will make the surface flattened. Applica-
tion of pressure with the finger tip will produce fitting impres-
sion like one observed in edema.
Post-mortem Contact Flattening — On account of the loss
of elasticity of the skin and of the post-mortem flaccidity of
muscles, the body becomes flattened over areas which are in
contact with the surface it rests. This is observed at the region
of the shoulder blades, buttocks and calves if death occurs
while lying on his back. Certain degree of pressure may be
applied on the face immediately after death and may be mis-
taken for traumatic deformity.
c. ppacity of the Skin:
Exposure of the hand of a living person to translucent
light will allow the red color of circulation to be seen under-
neath the skin. The skin of a dead person is opaque due to the
absence of circulation.
d. Effect of the Application of Heat:
Application of melted sealing wax on the breast of a dead
person will not produce blister or inflammatory reaction on
the skin. In the living, an inflammatory edema will develop
about the wax.
6. CHANGES IN AND ABOUT THE EYE:
a. Loss of Corneal Reflex:
The cornea is not capable of making any reaction to what-
ever intensity of light stimulus. However, absence of corneal
reflex may also be found in a living person the following condi-
tions:
(1) General anesthesia.
(2) Apoplexy.
(3) Uremia.
(4) Epilepsy.
(5) Narcotic Poisoning.
(6) Local Anesthesia.
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b. Clouding of the Cornea:
The normal clear and transparent nature of the cornea is
lost. The cornea becomes slightly cloudy or opaque after death.
If the cornea is kept moist by the application of saline solution
after death, it will remain transparent. Opacity of the cornea
may be found in certain diseases, like cholera, and therefore
is not a reliable sign of death.
c. Flaccidity of the Eyeball:
After death, the orbital muscles lose their tone making the
intra-orbital tension rapidly fall. The eyeball sinks into the
orbital fossa. Intra-orbital tension is low.
^l^CHANGES IN THE MUSCLE: p f £
d. The Pupil is in the Position of Rest:
• After death, there is complete relaxation of the whole muscular
The muscle of the iris loses its tone. The pupil can not
react to light. The size of the pupil varies at the time of death,
however, if contracted, it may infer poisoning by narcotic
drugs. A relaxed iris may be found in life in the following
conditions:
(1) Action of drugs like atropine.
(2) Uremia.
(3) Tabes dorsalis.
(4) Apoplexy.
e. Ophthalmoscopic Findings:
(1) The optic disc is pale and has the appearance of optic
atrophy.
(2) The remaining portion of the fundus may have a yellow
tinge which later changes to a brownish-gray or slate color.
(3) The retina becomes pale like the optic disc.
(4) The retinal vessels become segmented, no evidence of blood
flow.
The retinal veins and arteries are indistinguishable :
lt
f. Tache noir de la sclerotique":
After death a spot may be found in the sclera. The spot
which may be oval or round or may be triangular with the base
towards the cornea and may appear in the sclera a few hours after
death. At the beginning it is yellowish but later it becomes
brown or black. This is believed to be due to the thinning of
the sclera thereby making the pigmented choroid visible.
7 .'ACTION OF HEAT ON THE SKIN:
This test is useful to determine whether death occurred before
or after the application of heat.
The heat is applied to a portion of the leg or arm. If death is
real, only a dry blister is produced. The epidermis is raised but
on pricking the blister, no fluid is present. There is no redness of
the surrounding skin. In the living, the blister contains abundant
serum and area of vital reaction (congestion) on the skin around
is present.
The Following Combinations of Signs Show Death has Occurred:
a. Loss of animal heat to a point not compatible with life.
b. Absence of response of muscle to stimulus.
c. Onset of rigor mortis.
^O^C. CHANGES IN THE BODY FOLLOWING DEATH
system. The entire muscular system is contractile for three to six
hours after death, and later rigidity sets in. Secondary relaxation
of the muscles will appear just when decomposition has set in.
The Entire Muscular Tissue Passes Three Stages After Death:
Stage of primary flaccidity (post-mortem muscular irritability):
The ^nuscles are relaxed and capable of contracting when
stimulated^ The pupils are dilated, the sphincters are relaxed,
^-"Shd there is incontinence of urination and defecation.
b. Stage of post-mortem rigidity (Cadaveric rigidity, or Death
struggle of muscles or Rigor Mortis):
The^whole body becomes rigid due to the contraction of the
muscles."!This develops three to six hours after death and may
last frorfftwenty-f our to thirty-six hours.
Jc. Stage of secondary flaccidity or commencement of putrefaction
(Decay of the muscles):
The muscles become flaccid, noJonger capable of responding
to mechanical or electrical stimulus and the reaction becomes
alkaline. ~
/a. Stage of Primary Flaccidity or Period of Muscular Irritability:
Immediately after death, there is complete relaxation and
softening of all the muscles of the body. The extremities may
be flexed, the lower jaw falls, the eyeball loses its tension, and
there may be incontinence of urination and defecation.
To determine whether the muscles are still irritable, apply
electric current and note whether there is still irritability of the
muscles. Normally during the stage of primary flaccidity, the
muscles are still contractile and react to external stimuli,
mechanical or electrical owing to the presence of molecular
life after somatic death.
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This stage usually lasts about three to six hours after death.
In warm places, the average duration is only one hour and fifty-
one minutes (Mackenzie cited by Modi, p. 122).
Chemically, the reaction of the muscle is alkaline and the
normal constituents of the individual muscle proteins are the
same as in life.
b. Stage of Post-mortem Rigidity, or Cadaveric Rigidity, or Death
Stiffening, or "Death Struggle of Muscles" or rigor mortis:
Three to six hours after death the muscles gradually stiffen.
It usually starts at the muscles of the neck and lower jaw and
spreads downwards to the chest, arms, and lower limbs. Usually
the whole body becomes stiff after twelve hours. All the
muscles are involved — both voluntary and involuntary. In the
heart, rigor mortis may be mistaken for cardiac hypertrophy.
Chemically, there is an increase of lactic acid and phosphoric
content of the muscle. The reaction becomes acidic. There is
no definite explanation as to how such contraction of muscles
occurs although it has been proven that there is coagulation of
the plasma protein.
In the medico-legal view point, post-mortem rigidity may be
utilized to approximate the length of time the body has been
dead. In temperate countries it usually appears three to six
hours after death, but in warmer countries it may develop
earlier.
In temperate countries, rigor mortis may last for two or
three days but in tropical countries the usual duration is
twenty-four to forty-eight hours during cold weather and
eighteen to thirty-six hours during summer. When rigor mortis
sets in early, it passes off quickly and vice versa.
Factors Influencing the Time of Onset of Rigor Mortis:
(1) Internal Factors:
(a) State of the Muscles:
Rigor mortis appears late and the duration is longer
in cases where the muscles have been healthy and at
rest before death, It has been observed that in the
following deaths, the onset of rigor mortis is hastened:
i. Animal having been hunted to death.
ii. Prolonged convulsion and lingering illness.
iii. Death from typhoid fever, typhus, cholera and
phthisis.
(b) Age:
Rigor mortis has early onset in the aged and new-born.
The onset is delayed in good health and good muscular
development.
(c) Integrity of the Nerves:
Section of the nerve will delay onset of rigor mortis
as shown in paralyzed muscles.
(2) External Factors:
(a) Temperature:
The development of rigor mortis is accelerated by
high temperature but a temperature above 75°C will
produce heat stiffening.
/
(b) Moisture:
Rigor mortis commences rapidly but the duration is
short in moist air.
^ Conditions Simulating Rigor Mortis:
(1) Heat Stiffening:
If the dead body is exposed to temperatures above
75°C it will coagulate the muscle proteins and cause the
muscles to be rigid. The stiffening is more or less perma-
nent and may not be easily affected by putrefaction. The
body assumes the "pugilistic attitude" with the lower and
upper extremities flexed and the hands clenched because
the flexor muscles are stronger than the extensors.
Heat stiffening is commonly observed when the body of
a person is placed in boiling fluid or when the body is
burned to death.
J@) Cold Stiffening:
The stiffening of the body may be manifested when
the body is frozen, but exposure to warm condition will
make such stiffening disappear. The cold stiffening is due
to the solidification of fat when the body is exposed to
freezing temperature. Forcible stretching of the flexed
extremities will produce a sound due to the frozen synovial
fluid.
J$) Cadaveric Spasm or Instantaneous Rigor:
This is the instantaneous rigidity of the muscles which
occurs at the moment of death due to extreme nervous
tension, exhaustion and injury to the nervous system or
injury to the chest. It is principally due to the fact that the
last voluntary contraction of muscle during life does not
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stop after death but is continuous with the act of cadaveric capable of restoration city and readily main-
rigidity. to its original form as tains a distorted posi-
In case of cadaveric spasm, a weapon may be held in the soon as the distorting tion.
hand before death and can only be removed with difficulty. force has ceased to act.
For practical purposes it cannot be possible for the mur- (3) In reaction to litmus, it (3) It is distinctly and con-
derer or assailant to imitate the condition. In cadaveric is either neutral or slight- stantly acid (until de-
spasm, only group of muscles are involved and they are ly alkaline, and any re- c o m p o s i t i o n is ad-
usually not symmetrical. duction in this alkali- vanced) owing to the
nity is very speedily development of sarco-
The findings of weapon, hair, pieces of clothing, weeds
removed. latic and other acid
on the palms of the hands and firmly grasped is a very
important medico-legal point in the determination whether metabolites.
it is a case of suicide, murder or homicide. The presence (4) If the contraction be (4) If rigor mortis be over-
of weeds held by the hands of a person found in water overcome by mechani- come by mechanical
shows that the victim was alive before disposal.. cal force, the muscles force, absolute flaccidity
though they may re- corresponding in degree
Instantaneous rigor may also be found following inges-
main for a time un- with the amount of
tion of cyanide but usually it is generalized and symmetrical.
contracted, possess still mechanical movement,
Strychnine may produce the same but rigidity appears
their inherent power at once ensues, and
/^sometime after ingestion. there is no power to
of contraction; they
/Distinctions Between Rigor Mortis and Cadaveric Spasm: may then keep the limb resume the old position
( i f Time of Appearance: ^ i v t . K M ^ affiles-opY 1
fixed in a new position nor any new one, except
Rigor mortis appears three to six hours after death, or allow a return to so far as gravity may
while cadaveric spasm appears immediately after death. the old position. cause a new position.
{^Muscles Involved: This flaccidity is per-
manent till decompo-
Rigor mortis involves all the muscles of the body
sition destroys the
whether voluntary or involuntary, while cadaveric spasm
muscles.
involves only a certain muscle or group of muscles and
are asymmetrical.
(3^0ccurrence: (From: Taylor's Principles and Practice of Medical Jurispru-
Rigor mortis is a natural phenomena which occurs dence, 11th ed.. Vol I, p. 179).
after death, while cadaveric spasm may or may not appear c. Stage of Secondary Flaccidity or Secondary Relaxation:
on a person at the time of death. After the disappearance of rigor mortis, the muscle becomes
(^Medico-Legal Significance: soft and flaccid. It does not respond to mechanical or electrical
Rigor mortis may be utilized by a medical jurist to stimulus. This is due to the dissolution of the muscle proteins
approximate the time of death, while cadaveric spasm may which have previously been coagulated during the period of
be useful to determine the nature of the crime. rigor mortis.
This body while at the stage of rigor mortis, if stretched or
Distinctions Between Muscular Contraction and Rigor Mortis: flexed to become soft, will no longer be rigid. This condition
Muscular Contraction Rigor Mortis f the muscles is not secondary flaccidity.
(1) Contracted muscle is (1) Muscle in rigor mortis CHANGES IN THE BLOOD:
more or less transparent, losses this translucency,
or rather translucent. and becomes opague. a. Coagulation of the Blood:
(2) It has lost this elasti- The stasis of the blood due to the cessation of circulation
(2) It is very elastic, i.e.,
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enhances the coagulation of blood inside the blood vessels.
Blood clotting is accelerated in cases of death by infectious
fevers and delayed in cases of asphyxia, poisoning by opium,
hydrocyanic acid or carbon monoxide poisoning. The clotting
of blood is a very slow process that there is a tendency for the
blood to separate forming a red clot at the lower level and
above it is a white clot known as chicken-fat clot.
Blood- may remain fluid inside the blood vessels after death
for (Ho 8 hours.
^distinctions Between Ante-mortem from Post-mortem Clot:
Ante-mortem Clot
Post-mortem Clot
1 S o f t i n
(1) Firm in consistency.^- l ^ u^ ) consistency.
0
(2) Surface of the blood"^ ' (2) Surface of the blood
vessel raw after the ^ " ^ - v e s s e l s smooth and
clots are removed. p£v t l f *Thealthy after the clots
are removed.
(3) Clots homogenous in (3) Clots can be stripped
construction so it can- off in layers.
not be stripped into
layers.
(4) Clot with uniform color. (4) Clot with distinct layer.
bfPost-mortem Lividity or Cadaveric Lividity, or Post-mortem
Suggillation or Post-mortem Hypostasis or Livor Mortis:
The stoppage of the heart action and the loss of tone of
blood vessels cause the blood to be under the influence of
gravity. Blood begins to accumulate in the most dependent
portions of the body. The capillaries may be distended with
blood. The distended capillaries coalesce with one another
until the whole area becomes dull-red or purplish in color
known as post-mortem lividity.* If the body is lying on his
back, the lividity will develop on the back. Areas of bone
prominence may not show lividity on account of the pres-
sure.
If the position of the body is moved during the early stage
of its formation, it may disappear and develop again in the
most dependent area in the new position assumed. But if
the position of the body has been changed after clotting or
the blood has set in or when blood has already diffused into
the tissues of the body, a change of position of the body will
not alter the location of the post-mortem lividity.
Ordinarily, the color of post-mortem lividity is dull-red or
pink or purplish in color, but in death due to carbon monoxide
poisoning, it is bright pink. Exposure of the dead body to cold
or hot may cause post-mortem lividity to be bright-red in
color.
The lividity usually appears three to six hours after death
and the condition increases until the blood coagulates. The
time of its formation is accelerated in cases of death due to
cholera, uremia and typhus fever. Twelve hours after death,
the post-mortem lividity is already fully developed. It also
involved internal organs.
Physical Characteristics of Post-mortem Lividity:
(1) It occurs in the most extensive areas of the most dependent
portions of the body.
(2) It only involves the superficial layer of the skin.
(3) It does not appear elevated from the rest of the skin.
(4) The Color is uniform but the color may become greenish
at the start of decomposition.
(5) There is no injury of the skin.
Kinds of Post-mortem (Cadaveric) Lividity:
Hypostatic Lividity:
The blood merely gravitates into the most dependent
portions of the body but still inside the blood vessels and
still fluid in form. Any change of position of the body
leads to the formation of the lividity in another place.
This occurs during the early stage of its formation.
This appears during the later stage of its formation
when the blood has coagulated inside the blood vessels
or has diffused into the tissues of the body. Any change
of position will not change the location of the lividity.
Importance of Cadaveric Lividity:
(1) It is one of the signs of death.
(2) It may determine whether the position of the body has
been changed after its appearance in the body.
(3) The color of the lividity may indicate the cause of death.
Example: a. In asphyxia, the lividity is dark.
b. In carbon monoxide poisoning, the lividity
is bright pink.
Hemorrhage, anemia — less marked.
Hydrocyanic acid — bright red.
Phosphorus — dark brown.
Potassium chlorate, Potassium bichromate —
chocolate or coffee brown.
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c. If the body is found for considerable time in c. A bruise appears at the seat Always in a part which for
snow or ice the lividity is bright red. of and surrounding the injury. the time of formation is
(4) It may determine how long the person has been dead. This may or may not be a dependent, i.e., at a place
(5) It gives us an idea as to the time of death. dependent part. where gravity ordains it.
d. Often elevated, because the Not elevated, because either
Points to be considered which may infer the position of the body extravasated blood and sub- the blood is still in the vessels
at the time of death: sequent inflammation swell or, at most, has simply soaked
a. Posture of the body when found: the tissues. into and stained the tissues.
The body may become rigid in the position in which he e. Incision shows blood outside Incision shows the blood is
died. Post-mortem lividity may develop in the assumed posi- the vessels. This is the most still in its vessels; and if any
tion. This condition may occur and is of value if the state and certain test of difference, and oozing occurs drops can be
position of the body was not moved before rigidity and lividity can be observed even in very seen issuing from the cut
took place. small bruises. mouths of the vessels.
b. Post-mortem Hypostasis (Lividity): f. Colour variegated. This is Colour uniform. The well-
Hypostatic lividity will be found in areas of the body which only true of bruises that are known change in colour
comes in contact with the surface where the body lies. If there some days old; it is due to (green, yellow, etc.) pro-
is already coagulation of blood or if blood has already diffused the changes in the haemoglo- duced in blood extravasted
into the tissues of the body, a change of position will not alter bin produced during life. into living tissues does not
the location of the post-mortem lividity. occur in dead tissues with
c. Cadaveric Spasm: the same regularity.
In violent death, the attitude of parts of the body may infer g. If the body happens to be In a place which would other-
position on account of the spasm of the muscles. constricted at, or supported wise be the seat of a hypos-
Example: (1) In drowning, the victim may be holding the on, a bruised place, the tasis pressure of any kind,
sea weeds. actual surface of contact even simple support (the
(2) In suicide, the wounding weapon may be grasped may be a little lighter than wrinkling of a shirt or neck-
tightly by the hands. the rest of the bruise, but tie, garters, etc.) is sufficient
will not be white. to obliterate the lumen of
Distinctions Between Contusion (Bruise) and Post-mortem Hy- venules and capillaries, and
postasis: so to prevent their filling
Contusion (Bruise) Post-mortem Hypostasis with blood. White lines
or patches of pressure bor-
a. Below the epidermis in the a. In the epidermis or in the
dered by,the dark color of a
true skin in small bruises or cutis, as a simple stain or
hypostasis are produced and
extravasations, below this in a showing through the epi-
larger ones, and often much dermis of underlying en- marks of floggings, strang-
deeper still. The reason is gorged capillaries, ulation, etc., are thus some-
obvious, viz., that the epider- times simulated.
mis has no blood-vessels to (From: — Taylor's Principles and Practice of Medical Jurispru-
be ruptured. dence, 11th ed. 1949, Vol I, p. 175-176.
b. Cuticle was probably abraded b. Cuticle unabraded, because
by the same violence that pro- the hypostasis is a mere Internal Hypostasis in Visceral Organs:
duced the bruise. In small sinking of the blood; there Post-mortem lividity also occurs in the internal organs. The
punctures, such as flea bites, is no trauma. ^ principal organs affected are the lungs, loops of the intestine
this is not observed. and brain. It may in some instances be mistaken for disease.
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Post-mortem hypostasis in the organs may have the pathological
appearance in the visceral organs. In the heart, it may simulate
coronary occlusion while in the lungs it may appear like pneu-
monic changes. The intestine may be reddened to appear like
strangulation.
Differences between Post-mortem Lividity of Organs and Simple
Congestion:
a. Post-mortem staining in organs is irregular and occurs in the
most dependent parts, while congestion is generally uniform
and found all over the organs.
b. The mucous membrane in post-mortem staining (lividity) is
dull and lusterless, but not so in congestion.
c. In post-mortem staining (lividity) inflammatory exudate is not
seen, and areas of redness alternating with pale areas will be
found if a hollow viscus is stretched out and held in front of
a light. This is not seen in cases of simple congestion.
Distinctions between Post-mortem Lividity from Hemorrhage
of Scurvy, Phosphorus Poisoning, or Purpura:
a. History Before Death:
History will reveal the presence of scurvy, phosphorus
poisoning or purpura.
b. Time of Appearance:
In cases of scurvy, purpura or phosphorus poisoning, the
skin lesion is present even before death, while in cases of post-
mortem lividity it only appears after death.
c. Location:
In post-mortem lividity, it is only present in the most de-
pendent portions of the body, while in purpura, scurvy or phos-
phorus poisoning, the lesions may be found and distributed
all over the skin or organs.
Other Changes in the Blood:
a. Hydrogen ion Concentration — After death the Ph of the blood
and tissues drops because of the terminal accumulation of C O 2 ,
glycogenolysis and glycolysis with accumulation of phosphoric
acid and lactic acid, and splitting off of amino-acid and fatty
acids.
After about 24 hours, the reaction become alkaline due to
the production of ammonia from enzymatic protein breakdown
and the rise of serum concentration of nonprotein nitrogenous
components.
b. The breakdown of liver glycogen leads to the accumulation of
dextrose in the inferior vena cava and right side of the heart.
c. There is a rise of non-protein nitrogen and free amino-acid.
d. Chemical — The chloride in the plasma and red blood cells falls
due to the extravascular diffusion so that after 72 hours it is
only 1/2 of its content.
Magnesium content increases as a result of diffusion from
without.
Potassium increases owing to diffusion from the vascular
endothelium.
3. AUTO LYTIC OR AUTODIGESTTVE CHANGES AFTER DEATH:
After death, proteolytic, glycolytic and lipolytic ferments of
glandular tissues continue to act which lead to the autodigestion
of organs. This action is facilitated by weak acid and higher
temperature. It is delayed by the alkaline reaction of the tissues of
the body and low temperature. Their early appearance is ob-
served in the parenchymatous and glandular tissues.
Autolytic action is seen in the maceration of the dead fetus in-
side the uterus. The stomach may be perforated, glandular tissues
become soft after death due to autodigestion and the action of
autolytic enzymes.
Microscopic examination of the tissues under the influence of
autolytic enzymes shows disintegration, swelling or shrinkage,
vacuolization and formation of small granules within the cyto-
plasm of the cells. There is also a change in the staining capacity
and become desquamated from the underlying layers (Legal
Medicine by Gradwohl, p. 135).
4. PUTREFACTION OF THE BODY:
Putrefaction is the breaking down of the complex proteins into
simpler components associated with the evolution of foul smelling
gasses and accompanied by the change of color of the body.
Tissue Changes in Putrefaction:
The following are the principal changes undergone by the soft
tissues of the body in the process of putrefaction:
a. Changes in the Color of the Tissue:
A few hours after death, there is hemolysis of the blood
within the blood vessels and as a result of which hemoglobin is
liberated. The hemoglobin diffuses through the walls of the
blood vessels and stains the surrounding tissues thereby im-
parting a red or reddish-brown color.
While in the tissues, the hemoglobin undergoes chemical
changes and various derivatives of hemoglobin are formed. On
account of these chemical changes the tissue color is gradually
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changed to greenish-yellow, greenish-blue, or greenish-black event is quite doubtful when the product of conception is
color. nearing full term because of the difficulty of expulsion.
The earliest change is greenish color of the skin seen at the There is more likelihood for the uterus to rupture inside
region of the right iliac fossa and it gradually spreads over the the abdominal cavity.
whole abdominal wall. Blood later extravasates into the cavities (5) Floating of the Body:
of the body.
The specific gravity of a decomposed body is much less
Marbolization — It is the prominence of the superficial veins as compared with a recently dead. This is brought about by
with reddish discoloration during the process of decomposition the increase of gaseous content and increase in volume due
which develops on both flanks of the abdomen, root of the neck
to bloating without any increase in weight,
and shoulder and which makes the area look like a "marbled"
c. Liquefaction of the Soft Tissues:
reticule of branching veins. This is observed easily among dead
persons with fair complexion. As decomposition progresses, the soft tissues of the body
undergo softening and liquefaction. The eyeballs, brain, stomach,
b. Evolution of Gases in the Tissues:
intestine, liver and spleen putrefy rapidly, while highly muscular
One of the products of putrefaction is the evolution of gases.
organs and tissues relatively putrefy late.
Carbon dioxide, ammonia, hydrogen, sulphurated hydrogen,
phosphoretted hydrogen, and methane gases are formed. The
offensive odor is due to these gases and also due to a small
quantity of mercaptans.
The formation of gases causes the distention of the abdomen
and bloating of the whole body. Gases formed in the subcu-
taneous tissues and in the face, and neck cause swelling of the
whole body. Small gas bubbles are found in solid visceral
organs and give rise to the "foamy" appearance of the organs.
Effects of the Pressure of Gases of Putrefaction:
(1) Displacement of the Blood:
There may be post-mortem bleeding in open wounds on
account of the increased pressure inside the body brought
about by the accumulation of gases. The post-mortem
lividity may be shifted to other parts of the body. The
heart may empty itself of blood.
(2) Bloating of the Body:
On account of the accumulation of gas, the body is
blown-up and swollen. The eyes may be protruding from
its sockets, the tongue may come out of the mouth, and
the face is black with thick lips having the appearance of Decomposition in water with bloating of the whole body, blackening of the face and
attitude of the extremities at the time of recovery.
a negro (tete de negri).
( 3 ) Fluid Coming Out of Both Nostrils and Mouth:
Fluid coming out of both nostrils and mouth is usually Factors Modifying the Rate of Putrefaction:
in the form of froth. It is due to the putrefaction of the a. Internal Factors:
upper gastro-intestinal and respiratory tracts. (1) Age:
( 4 ) Extrusion of the Fetus in a Gravid Uterus: Healthy adults decompose later than infants. It may be
On account of the increased intra-abdominal pressure, late in a newborn infant who have not yet been fed. Marked-
the contents of the gravid uterus may be expelled, but this ly emaciated person has the tendency to mummify.
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(2) Condition of the Body:
Those of the full-grown and highly obese persons decom-
pose more rapidly than skinny ones. Bodies of still-born
are usually sterile so decomposition is retarded.
( 3 ) Cause of Death:
Bodies of persons whose cause of death is due to in-
fection decompose rapidly. This is also true when the
diseased condition is accompanied with anasarca. Bodies
whose sudden death is not due to microorganism decom-
pose late.
b. External Factors:
(1) Free Air:
(a) Air — The accessibility of the body to free air will
hasten decomposition.
(b) Moderate Moisture — Moderate amount of moisture will
accelerate decomposition, but excessive amount will
prevent the access of air to the body thereby delaying
decomposition. Moisture is necessary for the growth
and multiplication of bacteria, however, if the eva-
poration of fluid is marked, there will be mummifica-
tion of the tissues and putrefaction will be retarded.
(c) Condition of the Air — If the air is loaded with septic
bacteria, decomposition will be hastened.
(d) Temperature of the Air — The optimum temperature
for specific decomposition is 70°F to 100°F. Decom-
position does not occur at temperatures below 32°F
or about 212°F.
(e) Light — The organism responsible for the putrefaction
prefers more the absence of light.
(2) Earth:
Dry absorbent soil retards decomposition while moist
fertile soil accelerates decomposition.
( 3 ) Water:
Decomposition in running water is more rapid than in
still water. Bacteria-laden pools will accelerate decom-
position.
( 4 ) Clothings:
Clothings initially hasten putrefaction by maintaining
body temperature but in the later stage, clothings delay
decomposition by protecting the body from the ravages
of flies and other insects. Tight clothings delay putrefaction
due to the diminution of blood in the area on account
of pressure.
Physical Changes of the Body during Putrefaction in Chronological
Order:
a. External Changes:
(1) Greenish discoloration over the iliac fossa appearing after
one to three days.
(2) Extension of the greenish discoloration over the whole
abdomen and other parts of the body.
(3) Marked discoloration and swelling of the face with bloody
froth coming out of the nostrils and mouth.
(4) Swelling and discoloration of the scrotum, or of the vulva.
(5) Distention of the abdomen with gases.
(6) Development of bullae in the face of varying sizes.
(7) Bursting of the bullae and denudation of large irregular
surfaces due to the shedding of the epidermis.
(8) Escape of blood-stained fluid from the mouth and nostrils.
(9) Brownish discoloration of the surface veins giving an
arborescent pattern on the skin.
(10) Liquefaction of the eyeballs.
(11) Increased discoloration of the body generally and progres-
sive increase of abdominal distention.
(12) Presence of maggots.
(13) Shedding of the nails and lossening of the hairs.
(14) Conversion of the tissue into semi-fluid mass.
(15) Facial feature unrecognizable.
(16) Bursting of the abdomen and thoracic cavities.
(17) Progressive dissolution of the body.
b. Internal Changes:
(1) Those which Putrefy Early:
(a) Brain.
(b) Lining of the trachea and larynx.
(c) Stomach and intestines.
(d) Spleen.
(e) Liver.
(f) Uterus (if pregnant or in puerperal stage).
(2) Those which Putrefy Late:
(a) Esophagus.
(b) Diaphragm.
(c) Heart.
(d) Lungs.
(e) Kidneys.
(f) Urinary bladder.
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(g) Uterus (if not gravid).
(h) Prostate gland.
Organs rich in muscular tissues resist putrefaction longer than the
parenchymatous organs with the exception of the stomach and
intestines which by reason of their contents at the time of death
decompose quickly.
Factors Influencing the Changes in the Body after Burial:
a. State of the Body Before Death:
An emaciated person at the time of death will decompose
slower as compared with well-nourished individual when placed
under the same conditions and circumstances. Skinny person
has more tendency to mummify, especially at the regions of
the extremities.
b. Time Elapsed between Death and Burial and Environment of
the Body:
If the temperature of the surroundings at the time of death is
conducive for the growth and multiplication of bacteria, then
the longer the time such body is exposed to such condition
the faster is the decomposition. However, if the body has been
frozen to death for quite a time, there will be retardation of
body decomposition. The presence of filthy, pultaceous and
organic materials in the surroundings coupled with the presence
of light and optimum temperature will enhance the decom-
position.
c. Effect of Coffin:
The use of a coffin will delay decomposition if it is air-
tight and hard. If soft and weak, water can easily percolate at
the floor and top, thus it will not serve the purpose. The body
in a coffin usually decompose later as compared with the body
which is coffinless.
d. Clothings and Any Other Coverings on the Body when Buried:
Clothings and other body coverings delay decomposition.
Most often the covered portions of the body are well preserved
for sometime. The most probable reasons why clothings
retard decomposition are:
(1) It affords some protection from insects and aids adipocere
formation keeping the body under it continuously moist by
absorbing water from the soil.
(2) The pressure of the clothings on the body.
e. Depth at which the Body was Buried:
As a general rule, the greater the depth the body has been
buried, the better is the preservation. There is aeration in
shallow grave and this is a conducive invitation for injects and
other animals. The changes of temperature of the body on
account of the changing weather conditions is more marked
in shallow graves.
f. Condition and Type of Soil:
Dry, arid and sandy soil promotes mummification of the
body. The presence of straw or other organic matters that will
introduce more bacteria will accelerate decomposition.
g. Inclusion of Something in the Grave which will Hasten Decom-
position:
Some organic materials, like food are sometimes included
with the dead body inside the coffin because of their super-
stition that it will be utilized by the departed soul in its life
hereafter. Its presence inside the coffin will accelerate pu-
trefaction.
h. Access of Air to the Body After Burial:
Air may hasten evaporation of the body fluid and promotes
mummification. Bacteria-laden air will promote decomposition.
Humid air will enhance adipocere formation. However, acces-
sibility of air means also accessibility of insects and other
scavengers which will promote destruction of the soft tissues of
the body.
i. Mass Grave:
This is seldom seen, except in mass massacre, war and in
plane crash. There is relatively rapid decomposition of the
bodies,
j. Trauma on the Body:
Persons dying from infection decompose rapidly while those
dying of violent death decompose relatively slow.
On account of the presence of several factors which modify
decomposition of the body after death, it is quite difficult to
make an estimate as to the duration of death of a decomposed
body without considering those different elements influencing it.
Chronological Sequence of Putrefactive Changes Occurring in
Temperate Regions:
Putrefactive Changes Time
a. Greenish discoloration over the
iliac fossae. The eyeballs are soft
and yielding. 1 to 3 days after death.
b. Greenish discoloration spreading
over the whole abdomen, external
genitals and other parts of the
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body. Frothy blood from the (From: — Lambert's Medico-Legal Post-mortem in India, 2nd ed.,
mouth and nostrils. 3 to 5 days after death. p. 25).
Abdomen distended with gas. Body decomposition in warm countries, according to Lambert,
Cornea fallen in and concave. will reduce the whole body to a skeleton in a month's time when
Purplish red streaks of veins exposed to air. In water, putrefaction proceeds twice as slowly
prominent on the extremities. as it is in air. When the body is buried, the rate depends on the
Sphincters relaxed. Nails firm. 8 to 10 days after death. mode of burial. In deep burial with coffin, putrefaction proceeds
Body greenish-brown. Blisters from four to six times as slowly as compared with that one in
forming all over the body. Skin air, but with shallow coffinless burial, it is very slightly retarded.
peels off. Features unrecog-
nizable. Scrotum distended.
Body swollen up owing to
distention. Maggots found on the
body. Nails and hair loose and
easily detached. 14 to 20 days after death.
Soft parts changes into a thick,
semi-fluid black mass. Skull
exposed. Orbits empty. 2 to 5 months after death.
(Casper, Forensic Medicine, cited by Modi, Medical Jurispru-
dence and Toxicology, 12 ed., 157, p. 134).
Chronological Sequence of Putrefactive Changes Occurring in
Tropical Region:
Time Since Death Condition of the Body
12 hours Rigor mortis present all over. Hypostasis
well-developed and fixed. Greenish dis-
coloration showing over the caecum. Decomposition - Soft tissues of the chest and head have disappeared while
24 hours Rigor mortis absent all over. Green dis- those of the abdomen and extremities are mummified.
coloration over whole abdomen and
spreading to chest. Abdomen distended Chronological Sequence of Putrefactive Changes When the Body
with gases. Has Been Submerged in Water:
48 hours Ova of flies seen. Putrefactive Changes Time
Trunk bloated. Face discolored and a. Very little change if water is
swollen. Blisters present. Moving cold. Rigor mortis may persist. First four or five days.
maggots seen. b. The skin on the hands and feet
72 hours Whole body grossly swollen and dis- became sodden and bleached.
figured. Hair and nails loose. Tissues The face appears softened and
soft and-discolored. lias a faded white color. From five to seven days.
One week Soft viscera putrefied. c. Face swollen and red. Greenish
Two weeks Only more resistant viscera distinguish- discoloration on the eyelids, lips,
able. Soft tissues largely gone. neck and sternum. Skin of the
One month Body skeletonized. hands and feet wrinkled. Upper
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surface of brain greenish in c. Arms.

color. One to two weeks. d. Abdomen.
d. Skin wrinkled. Scrotum and penis e. Legs.
distended with gas. Nails and
hair still intact. Lungs emphy-
sematous and covered the heart. Four weeks.
e. Abdomen distended, skin of
hands and feet come off with
nails like a glove. Six to eight weeks.
(Observation of Devergie, cited by Modi, Medical Jurisprudence
and Toxicology, 12th ed. 1957, p. 138).
Factors Influencing the Floating of the Body in Water:
a. Age:
Bodies of fully-developed and well-nourished newly-born
infants float relatively rapid.
b. Sex:
Women float sooner than men. This is due to the lightness of
female bones and greater porportion of fat, hence lesser specific
gravity.
c. Conditions of the Body:
Stout persons float quicker than skinny, lean and thin
bodies. Bodies with loose clothings will soon come to the Decomposition — The whole body almost skeletonized
surface.
d. Season of the Year: Influence of Bacteria in Decomposition:
The moist hot air of summer is very favorable for putre- Decomposition is due to action of bacteria in various tissues of
faction. Putrefaction makes the body bloat on account of gas the body. During the early period of decomposition, aerobic
formation, hence it will accelerate floating of the body. activities are prominent. Later, the facultative aerobes and anae-
robes are present. In the advanced stage, the activities of the
e. Water: anearobes are the most prominent with the production of gasses.
Dead body floats in a shallow and stagnant water of creeks The softening of the tissues is the result of bacterial action,
or pond sooner than in deep water of running stream. The stag- proteolytic and autolytic ferments.
nant water has higher specific gravity than clear water, so it is
easy for the dead body to overcome it by gas formation. Body The microorganism that plays an important and dominant
floats sooner in sea than in fresh water on account of the high role in decomposition is Clostridium welchii. This bacteria starts
specific gravity of sea water. to grow in parenchymatous organs. It is responsible for the dis-
integration of cytoplasm, destruction of nuclei and generation of
f. External Influence: gases in the cells.
The presence of heavy-wearing apparel or the addition of
weight in the pockets or attached to the body by means of Other bacteria which participate in tissue destruction during
rope or string will delay the floating of the body. the period of decomposition are:
a. Bacillus coli.
Order of Putrefaction When the Body is in Water: b. Bacillus proteus vulgaris.
a. Face and neck or sternum. c. Bacillus mesentericus.
b. Shoulders. d. Bacillus aerogenes capsulatus.
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Other Destructive Agents During Decomposition: weight and erosion of the epiphysis. Flat bones disintegrate
a. Flies: faster than round bones. The degree of ossification is also a
(1) Maggots (Larvae): factor in the bone destruction.
The presence of maggots is dependent upon the acces-
sibility of the body to adult flies. The flies lay eggs which
after a time is hatched to form maggots. The maggots have
a strong desire to live in damaged skin surface. Maggots
may also be observed in bodies buried in shallow graves
and even in floating decomposed bodies in water pools.
(2) Adult Flies:
The common house flies are carnivorous.* They devour
the juicy areas of exposed portions of the body. Destruction
by adult flies is observed better when the body is found on
surface ground.
b. Reptiles:
Lizards and snakes are attracted to dead bodies and eat the
soft tissues. Small bones may be fractured in the process and
may be mistaken for injuries during the life time of the de-
ceased.
c. Rodents:
Rats and mice will nibble the skin and other tissues and may Death in the sea with post-mortem erosion of the face due to the activities
show unexplainable injuries. The bones may also be attacked of the fishes and other aquatic animals.
and showed certain degree of erosions.
d. Other Mammals: SPECIAL MODIFICATION OF PUTREFACTION:
The dogs may participate in the destruction of the soft a. Mummification:
tissues especially in cases where the victim is lying on the Mummification is the dehydration of the whole body which
ground. In most instances, the different parts of the body is results in the shivering and preservation of the body. It usually
scattered and separated from one another. A part may be occurs when a dead body is buried in a hot, and arid place with
missing or seen in some far distant places. In India, jackals dry atmosphere and with free access of hot air. In most cases,
also participate in the destruction of decomposed tissues. the natural physical appearance is not modified, hair may be
e. Fishes and Crabs: kept intact although there may be change in color of the skin.
If the body is in water, fish of almost all species and crus- The internal organs may be shrunken, hard and with a dark-
tacean will be feeding on the soft tissues. Man-eating fishes brown or black color. If the whole fluid contents of the body
like sharks may devour the whole body of a person. has evaporated, preservation is for an indefinite time but the
whole body may become brittle, weight markedly reduced
f. Molds: and may later be destroyed by pulverization.
As a general rule, molds do not destroy the dead bodies but
Mummification is observed in warm countries where eva-
their growth cause disfigurement and minor superficial lesions
poration of body fluid takes place earlier and faster than
on the skin. decomposition. Death in deserts, like in Egypt, the body has
After a period of time, all of the soft tissues of the body will more tendency to mummify. However, a mummified body
disappear. Only the teeth, bones and hair will remain. These may after a time be attacked by moths and verm ins causing
tissues will remain undestroyed for an indefinite time. The destruction.
bones may show signs of disintegration by the diminution of
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Kinds of Mummification: pocere to develop in the state of extreme emaciation.

(1) Natural Mummification;
When a person is buried in hot, arid, sandy soil, there will
be insufficient moisture for the growth and multiplication
of putrefactive bacteria. The body will become dehydrated
and mummified which is caused by the forces of nature.
(2) Artificial Mummification:
The principles involved in artificial mummuification are:
(a) Acceleration of the evaporation of the tissue fluid of
the body before the actual onset of decomposition.
(b) Addition of some body preservatives to inhibit decom-
position and to allow evaporation of fluid. This is made
by treatment of the body with arsenic, formalin, resin-
ous or tarry materials.
b. Saponification or Adipocere Formation:
This is a condition wherein the fatty tissues of the body are
transformed to soft brownish-white substance known as adi-
pocere. The layer of subcutaneous tissue is the frequent site of
its formation. It occurs naturally in the visceral organs and
even in non-fatty tissues of the body like the muscles.
Adipocere is a waxy material, rancid or moldy in odor,
floats in water, and dissolves in ether and alcohol. With diluted
solution of copper sulfate, it gives a light greenish-blue color. It
is inflammable and burns with a faint yellow flame. When
distilled it produces a dense oily vapor.
Some Theories on the Formation of Adipocere:
(1) The fats of the body split into glycerol and fatty acids.
The fatty acids combine with calcium, magnesium, potas-
sium, sodium, and ammonium salts to form an insoluble
soap. These ester of fatty acid somehow delay body de-
composition and make the body surface greasy to touch.
(2) There is gradual hydrogenation of pre-existing fat in the
body like olein to higher fatty acids. Hydrogenation
causes remarkable swelling and stiffening of the fats. The
new hydrogenated fat is quite stable but on exposure to
air becomes yellow, hard and brittle.
Factors Influencing Adipocere Formation in Earth Burial:
(1) State of Health Before Death:
Adipocere formation depends primarily on the presence
of fat in the body of the deceased. It is difficult for adi-
Areas of the body where fat is abundant develop adipocere
recognizable through the naked eye rapidly as compared
with the other areas. The amount of water in the surround-
ings is not very essential to the phenomena. Water of the
body may be drawn from the muscles and internal organs.
(2) Time Interval between Death and Burial:
Generally, the longer the space of time interval between
death and burial, the greater is the degree of adipocere
formation. This is further accelerated when the body is
subjected to autopsy. Exposure of the internal organs
to external elements promotes enzymatic and bacterial
actions in the process of hydrolysis and glycerol formation.
(3) Effect of the Coffin:
The coffin has air space and if crudely made, it may
allow water to come in contact with the body surface
thereby enhancing hyrolysis of fat. If water has been freely
admitted, colliquative putrefaction will develop for a
longer time thus making adipocere formation scanty.
(4) Presence of Clothings and Other Coverings of the Body:
Adipocere formation is found to be more advanced
under clothings or other body coverings, especially if the
clothings are tight.
(5) Type of Soil:
Dry soil is conducive to mummification. Sufficiently
moist soil accelerates adipocere formation.
(6) Access of Air to the Body After Burial:
The disturbance of a body in the grave shortly after
burial or before the formation of adipocere prolongs its
formation.
(7) Mass Grave:
There is more tendency for adipocere formation when
several bodies are located in a grave because of the abun-
dance of moisture.
Maceration:
This is the softening of the tissues when in a fluid medium
in the absence of putrefactive microorganism which is frequent-
ly observed in the death of the fetus en utero.
When the fetus dies en utero, provided that the death of the
fetus is not due to attempted abortion or rupture of the mem-
brane, the child is enclosed by the membrane in sterile con-
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dition. Putrefaction does not take place and the fetus becomes
soft. The softening of the body may be due to the action of
the autolytic and proteolytic enzymes and ferments. /
The appearance of the fetus is typical. The hody is disco-
lored either reddish or greenish with the skin peeling off and
the arms flaccid and frail. As maceration advances, there is
brownish-red discoloration of the skin. There may be blister
formation and the odor is somewhat rancid. For a definite and
appreciable degree of maceration to take place, it requires about
twenty-four hours.
DURATION OF DEATH
In the determination as to how long a person has been dead from
the condition of the cadaver and other external evidences, the
following points must be taken into consideration:
1. Presence of Rigor Mortis:
In warm countries like the Philippines, rigor mortis sets in
from 2 to 3 hours after the death. It is fully developed in the
body after 12 hours. It may last from 18 hours to 36 hours
and its disappearance is concomitant with the onset of put-
refaction.
2. Presence of Post-mortem Lividity:
Post-mortem lividity usually develops 3 to 6 hours after
death. It first appears as a small petechia-like red spots which
later coalesce with each other to involve bigger areas in the
most dependent portions of the body depending upon the
position assumed at the time of death.
3. Onset of Decomposition:
In the Philippines like other tropical countries, decompo-
sition is early and the average time is 24 to 48 hours after death.
It is manifested by the presence of watery, foul-smelling froth
coming out of the nostrils and mouth, softness of the body and
presence of crepitation when pressure is applied on the skin.
4. Stage of Decomposition:
The approximate time of death may be inferred from the
degree of decomposition, although it must be made with extreme
caution. There are several factors which modify putrefaction of
the body. For the stage of decomposition and the approximate
time after death, see tabulations (supra p. 143).
5. Entomology of the Cadaver:
In order to approximate the time of death by the use of the
flies present in the cadaver, it is necessary to know the life cycle
of the flies. The common flies undergo larval, pupal and adult
stages. The usual time for the egg to be hatched into larva is
24 hours so that by the. mere fact that there are maggots in the
cadaver, one can conclude that death has occurred more than
24 hours.
6. Stage of Digestion of Food in the Stomach:
It takes normally 3 to 4 hours for the stomach to evacuate its
contents after a meal. The approximate time of death may be
deduced from the amount of food in the stomach in relation to
his last meal. This determination is dependent upon the amount
of food taken and the degree of tonicity of the stomach.
The extent of the gastric emptying and the progression of the
meal in the gastro-intestinal tract can be useful in estimating the
time of death. However, the position and condition of the dece-
dent's last meal is influenced by the following factors:
a. Size of the Last Meal — The stomach usually starts to empty
within ten minutes after the first mouthful has entered. A
light meal leaves the stomach within 1-1/2 to 2 hours after
being eaten. A medium-sized meal will require 3 to 4 hours.
A heavy meal is entirely expelled into duodenum in 4 to 6
hours.
b. Kind of Meal — Liquid move more rapidly than semi-solid and
the latter more rapidly than solids.
c. Personal Variation — Psychogenic pylorospasm can prevent
departure of the meal from a stomach for several hours, contra-
riwise, a hypermotile stomach may enhance entry of food into
the duodenum.
d. Other Factors:
(1) Kinds of Food Eaten — Vegetables may require more time
for gastric digestion. The less fragmentation of the food
will require more time to stay in the stomach. The ab-
sence or insufficiency of pepsin and other digestive fer-
ments will delay the food in the stomach. Absence or
insufficiency of the gastric hydrochloric acid content
and lesser amount of liquid consumed with solid food
will likewise delay gastric evacuation.
The head of the meal ordinarily reaches the distal ileum and
cecum between 6 and 8 hours after eating.
The conclusion may be of value in the estimation of death if
one is familiar with the decedent's eating habit and meal time,
quantity of the last meal and the interval between the last two
meals.
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7. Presence of Live Fleas in the Clothings in Drowning Cases:
A flea can survive for approximately 24 hours submerged in
water. It can no longer be revived if submerged more than that
period. In temperate countries, people use to wear woolen
clothes. If the body is found in water, the fleas may be found
in the woolen clothings. The fleas recovered must be placed in
a watch glass and observed if it is still living. If the fleas still
could move, then the body has been in water for a period less
than 24 hours. Revival of the life of the fleas is not possible if
they are in water for more than 24 hours.
8. Amount of Urine in the Bladder:
The amount of urine in the urinary bladder may indicate the
time of death when taken into consideration, he was last seen
voiding his urine. There are several factors which may modify
urination so it must be utilized with caution.
9. State of the Clothings:
A circumstantial proof of the time of death is the apparel
of the deceased. If the victim is wearing street clothes, there
is more likehood that death took place at daytime, but if in
night gown or pajama, it is more probable that death occurred
at night time.
10. Chemical Changes in the Cerebrospinal Fluid (15 Hours Fol-
lowing Death):
a. Lactic acid increases from 15 mg. to 200 mg. per 100 cc.
b. Non-protein nitrogen increases from 15 to 40 mg. (
c. Amino-acid concentration rises from 1 to 12% following death.
11. Post-mortem Clotting and Decoagulation of Blood:
Blood clots inside the blood vessels in 6 to 8 hours after death.
Decoagulation of blood occurs at the early stage of decom-
position. The presence of any of these conditions may infer
the approximate duration of death.
12. Presence or Absence of Soft Tissues in Skeletal Remains:
Under ordinary condition, the soft tissues of the body may
disappear 1 to 2 years time after burial. The disappearance of
the soft tissues varies and are influenced by several factors.
When the body is found on the surface of the ground, aside
from the natural forces of nature responsible for the destruction
of the soft tissues, external elements and animals may accelerate
its destruction.
13. Condition of the Bones:
If all of the soft tissues have already disappeared from the
skeletal remains, the degree of erosion of the epiphyseal ends of
long bones, pulverization of flat bones and the diminution of
weight due to the loss of animal matter may be the basis of the
approximation.
Post-mortem Conditions Simulating Disease, Poisoning or Injury:
a. Post-mortem hypostasis simulating contusion or inflammation
or poisoning.
b. Blister of the cuticle simulating scalds or burns.
c. Swelling, detachment or splitting of the skin simulating
injury.
E. PRESUMPTION OF DEATH
Rule 131, Sec. 5(x), Rules of Court:
Disputable Presumption:
That a person not heard from for seven years, is dead.
Presumption of Death:
Art. 390, Civil Code and Sec. 5(x), Rule 131, Rules of Court:
After an absence of seven years, it being unknown whether or not
the absentee still lives, he shall be presumed dead for all purposes,
except for those of succession.
The absentee shall not be presumed dead for the purpose of
opening his succession till after an absence of ten years. If he dis-
appeared after the age of seventy-five years, an absence of five years
shall be sufficient in order that his succession may be opened.^
Art. 391, Civil Code and Sec. 5(x), Rule 131, Rules of Court:
The following shall be presumed dead for all purposes, including
the division of the estate among the heirs:
(1) A person on board a vessel lost during a sea voyage, or an
aeroplane which is missing, who has not been heard of for
four years since the loss of the vessel or aeroplane.
(2) A person in the armed forces who has taken part in war, and
has been missing for four years:
(3) A person who has been in danger of death under other circum-
stances and his existence has not been known for four years.
Art. 392, Civil Code:
If the absentee appears, or without appearing his existence is
proved, he shall recover his property in the condition in which it
may be found, and the price of any property that may have been
alienated or the property acquired therewith; but he cannot claim
either fruits or rents
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F. PRESUMPTION OF SURVIVORSHIP MEDICO-LEGAL INVESTIGATION OF DEATH

Sec. 5(jj), Rule 131, Rules of Court:
When two persons perish in the same calamity, such as wreck,
battle, or conflagration, and it is not shown who died first, there
are no particular circumstances from which it can be inferred, the
survivorship is presumed from the probabilities resulting from the
strength and age of the sexes, according to the following:
1. If both were under the age of fifteen years, the older is pre-
sumed to have survived;
2. If both were above the age of sixty, the younger is presumed
to have survived;
3. If one is under fifteen and the other above sixty, the former
is presumed to have survived;
4. If both be over fifteen and under sixty, and the sexes be dif-
ferent, the male is presumed to have survived; if the sexes be the
same, then the older;
5. If one be under fifteen or over sixty, and the other between
those ages, the latter is presumed to have survived.
Art. 43, Civil Code:
If there is a doubt, as between two or more persons who are called
to succeed each other, as to which of them died first, whoever
alleges the death of one prior to the other, shall prove the same; in
the absence of proof, it is presumed that they died at the same time
and there shall be no transmission of rights from one to the other.
An inquest officer is an official of the state charged with the duty
of inquiring into certain matters. In a medico-legal investigation,
an inquest officer is the one charged with the duty of investigating
the manner and cause of death of a person. He is authorized to
summon witnesses and direct any person to perform or assist in the
investigation when necessary.
The following officials of the government are authorized to make
death investigations:
1. The Provincial and City Fiscals:
Sec. 983, Revised Aministrative Code:
The district health officer, upon the request of any provin-
cial fiscal of a province within his district, or of any judge of
a Court of the First Instance (now Regional Trial Court), or of
any justice of the peace (now, Municipal Trial Court), shall con-
duct in person, when practicable, investigations in cases of death
where there is suspicion that death was caused by the unlawful act
or omission of any person, and shall make such other inves-
tigations as may be required in the proper administration of
justice.
Sec. 38, Rep. Act 409 as amended by Rep. Act. 1934 (Revised
Charter of the City of Manila):
The City Fiscal shall also cause to be investigated the cause of
sudden deaths which have not been satisfactorily explained and
when there is suspicion that the cause arose from the unlawful
acts or omissions of other person, or from foul play, and, in
general, victims of violence, sex crimes, accidents, self-inflicted
injuries, intoxications, drug addiction, states of malingering and
mental disorders, which occur within the jurisdiction of the
City of Manila, and the examination of evidences and telltale
marks of crimes. For that purpose, he may cause autopsies to
be made and shall be entitled to demand and receive for pur-
poses of the office of the medical examiner, or the criminal
investigation laboratory of the Manila Police Department, or
subject to the rules and conditions previously established by
the Secretary of Justice, the aid of the medico-legal section
of the National Bureau of Investigation. If in case the fiscal

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of the city deems it necessary to have further expert assistance for
the satisfactory performance of his duties in relation with medico-
legal matters or knowledge, including the giving of medical tes-
timony in the courts of justice, he shall request the same, in the
same manner and subject to the same rules and conditions as
above specified, from the office of the medical examiner, or from
the criminal investigation laboratory of the Manila Police Depart-
ment, or from the medico-legal officer of the said bureau, who shall
thereupon furnish the assistance required in accordance with
his powers and facilities. He shall at all times render such pro-
fessional services as the Mayor or board may require and shall
have such powers and perform such other duties as may be pre-
scribed by law or ordinance.
2. Judges of the Courts of the First Instance (now Regional Trial
Courts) Sec. 983, Revised Administrative Code (Supra).
3. Justice of the Peace (now Municipal Trial Courts) Sec. 983,
Administrative Code (Supra).
4. The Director of the National Bureau of Investigation — Rep. Act.
157 (An act creating the National Bureau of Investigation).
Sec. 1. — There is hereby created a Bureau of Investigation
under the Department of Justice which shall have the following
functions:
(a) To undertake investigations of crimes and other offenses
against the laws of the Philippines, upon its own initiative and
as public interest may require;
(b) To render assistance, whenever properly requested in the in-
vestigation or detection of crimes and other offenses;
(c) To act as a national clearing house Of criminal and other
information for the benefit of all prosecuting and law-en-
forcement entities of the Philippines, identification records of
all persons without criminal convictions, records of identify-
ing marks, characteristics, and ownership or possession of all
firearms as well as the test bullets fired therefrom;
(d) To give technical aid to all prosecuting and law-enforcement
officers and entities of the Government as well as courts that
may request its services;
(e) To extend its services, whenever properly requested in the
investigation of cases of administrative or civil nature in which
the government is interested;
(f) To undertake the instruction and training of a representative
number of city and municipal peace officers at the request
of their respective superiors along effective methods of crime
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investigation and detection in order to insure greater efficiency
in the discharge of their duties;
(g) To establish and maintain an up-to-date scientific crime
laboratory and to conduct researches in the furtherance of
scientific knowledge in criminal investigation;
(h) To perform such other related functions as the Secretary (now
Minister) of Justice may assign from time to time.
Sec. 5. — The members of the investigation staff of the Bureau
of Investigation shall be peace officers, and as such have the
following powers:
(a) To make arrests, searches, and seizures in accordance with
existing laws and rules;
(b) To issue subpoena or subpoena duces tecum for the appearance
at government expense of any person for investigation;
(c) To take and require sworn truthful statements of any person
or person so summoned in relation to cases under investigation,
subject to constitutional restrictions;
(d) To administer oaths upon cases under investigation;
(e) To possess suitable and adequate firearms for their personal
protection in connection with their duties and for the proper
protection of witnesses and persons in custody; Provided, that
no previous special permit for such possession shall be required;
(f) To have access to all public records and, upon authority of
the President of the Philippines in the exercise of his visitorial
powers, to record of private parties and concerns.
5. The Chief of Police of the City of Manila:
Sec. 34, Rep. Act 409 (Revised Charter of the City of Manila)
as amended by Sec. 1, Rep. Act. 1934 — Chief of Police:
There shall be a chief of police. . . (who) shall cause medico-
legal examination by the medical examiner of the Manila Police
Department of victims of violence or foul play, sex crimes, acci-
dents, sudden death when the cause thereof is not known, self-
inflicted injuries, intoxication, drug addiction, states of malinger-
ing and mental disorders, which are being investigated by the
Manila Police Department or, in exceptional cases, by other
agencies requesting assistance of the Manila Police Department;
and shall cause examination by the medical examiner of the Mani-
la Police Department or by a criminal investigation laboratory
established within said department, or evidences and telltale
marks of crime. He shall have such powers and perform such
further duties as may be prescribed by law or ordinances.
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6. Solicitor General: Crime scene investigation includes appreciation of its condition

Sec. 95 (b) P.D. 856 (Code of Sanitation of the Philippines)
Autopsies shall be performed in the following cases:
3 other things that may be useful in the prosecution of the case.
4. Whenever the Solicitor General, provincial or city fiscal
as authorized by existing laws, shall deem it necessary to
disinter and take possession of remains for examination to
determine the cause of death.
Stages of Medico-Legal Investigation:
1. Crime Scene Investigation (Investigation of the place of com-
mission of the crime).
2. Autopsy (Investigation of the body of the victim).
1. CRIME SCENE INVESTIGATION:
The crime scene is the place where the essential ingredients of
the criminal act took place. It includes the setting of the crime
and also the adjoining places of entry and exit of both offender
and victim.
Not all crimes have a well-defined scene, like estafa, malver-
sation, continuing crimes, etc. However, where medical evidence
may be present, like murder, homicide, physical injuries, sex
crime, crime scene is almost invariably present.
and drawing an inference from it. It also includes the collection of
the physical evidences that may lead to the identity of the per-
petrator, the manner the criminal act was executed, and such
Importance of Crime Scene Investigation:
A great amount of physical evidence may be lost or unrecovered
if the investigation merely starts at the autopsy table or in the medi-
cal examining room. Blood, semen and other stains, latent finger
and foot prints, and articles of value that may lead to the identifica-
tion of the offender and victim may be beyond the comprehension
of the investigator if the crime scene is not investigated.
In violent death.cases, the manner and cause of death may be
inferred from the condition of the crime scene. The condition of
the crime scene may indicate struggle, handgun firmly grasped in
the palm of the hand of the deceased may indicate suicide, the
presence of a great quantity of shed blood may infer hemorrhage
as the cause of death of the victim.
The investigator has the earliest possible opportunity to inter-
view persons who have knowledge of the circumstances of actual
events in the commission of the criminal act. The proximity of
the narration to the actual occurrence makes it reliable than those
given after a lapse of time. ^

Persons to Compose the Search Team:

a. A physician who has had previous knowledge and training in
medico-legal investigation must direct the search and assume
responsibility for an effective search.
b. A photographer who will take pictures of the scene and the
pieces of evidence recovered. He may also act as sketcher and
measurer.
c. An assistant who will act as the note taker, evidence collector
and helper. He must have previous knowledge and training
in evidence collection.

Equipment Needed in Crime Scene Investigation:

a. Those needed in the search of physical evidence — Flashlight
and magnifying lens.
b. Those needed in the collection of evidence — forceps, knife,
screw driver, scalpel, cutting instruments like plier, pair of
scissors and fingerprint kit.
Violent death in a vehicular accident scene.
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c. Those needed in the preservation and transportation of evidence

collected — Bottles, envelopes, test tubes, pins, thumb tacks,
labelling tag and pencil.
d. Those necessary for the documentation of the scene — Photo-
graphic camera, sketching kit, measuring tape, compass, chalk or
any writing instrument.
Methods of Conducting a Search:
Before the actual performance of the search, it is advisable to
stand aside and make an estimate of the situation. A picture of
the whole area must be taken and the area must be cordoned or
bystanders must not be allowed to get in. Depending upon the
size, terrain and condition of the crime scene, the following
methods of search may be applied:
a. Strip Method — The area is blocked out in the form of a rect-
angle. The searcher proceeds slowly at the same pace along the
path parallel to one side of the rectangle.
b. Double Strip or Grid Method — The searchers will traverse first
parallel to the base and then parallel to the side.
c. Spiral Method — The searchers follow each other in the path in
the spiral manner beginning from the center towards the outside
or vice versa.
d. Wheel Method — The searchers gather at the center and proceed
outwards along radii or spokes.
e. Zone Method — Whole area is divided into subdivisions or
quadrants and search is made in the individual quadrants.
Disposal of the Collected Evidence:
All evidences collected must be protected, identified and
preserved. Reasonable degree of care must be exercised to pre-
serve shape, to minimize alterations due to contamination, che-
mical changes, addition of extreneous substances. In the process
of transferring of the evidences, the number of persons who
handle them must be kept at a minimum and each transfer should
be receipted.
Examination of the Dead Body in the Crime Scene:
After a complete search, the investigating physician must make
a thorough inspection of the dead body. Special consideration
must be made on the following:
a. Evidences which will tend to prove identity.
b. Position of the victim.
D. WHEEL METHOD E. ZONE METHOD
c. Condition of the apparel worn.
METHODS OF SEARCH AT THE CRIME SCENE. d. Approximate time of death.-
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e. Presence of wounding instrument and its approximate distance
from the body.
f. Potential cause of death.
In a death by gunshot, the clothing must be left Undisturbed
at the crime scene. A lot of information may be gathered from
it:
a. The bullet might have produced an exit on the skin but failed to
cause mark or tear on the clothings which through improper
handling may not be recovered.
b. Examination "in situ" may be useful in the determination of
the site of entrance and exit of the bullet and also the trajectory
of the shot.
2. AUTOPSIES:
An autopsy is a comprehensive study of a dead body, per-
formed by a trained physician employing recognized dissection
procedure and techniques. It includes removal of tissues for
further examination.
Autopsies vs. Post-mortem Examination:
Post-mortem examination — refers to an external examination
of a dead body without incision being made, although blood and
other body fluids may be collected for examination.
Autopsy — indicates that, in addition to an external exami-
nation, the body is opened and an internal examination is con-
ducted.
(Modern Legal Medicine Psychiatry and Forensic Science by
Curran, McGarry and Petty, p. 51 footnote).
Kinds of Autopsies:
a. Hospital or Non-official Autopsy
b. Medico-legal or Official Autopsy
a. Hospital or Non-official Autopsy:
This is an autopsy done on a human body with the consent
of the deceased person's relatives for the purposes of: (1) deter-
mining the cause of death; (2) providing correlation of clinical
diagnosis and clinical symptoms; (3) determining the effective-
ness of therapy; (4) studying the natural course of disease pro-
cess; and (5) educating students and physicians (Forensic
Pathology, A Handbook for Pathologists, Fisher and Petty, July
1977, p. 1).
Inasmuch as previous consent of the next of kin is necessary
before a non-official autopsy can be performed, the Civil
Code states who is the rightful person to give such consent.
The order is provided in Articles 294 and 305.
The consent shall be obtained from: (1) The spouse; (2) the
descendants of the nearest degree; (3) the ascendants, also of
the nearest degree; (4) the brothers and sisters (Art. 294,
Civil Code).
In case of descendants of the same degree, or of brothers
and sisters, the oldest shall be preferred. In case of ascendants,
the paternal shall have a better right (Art. 305, Civil Code).
b. Medico-Legal or Official Autopsy:
This is an examination performed on a dead body for the
purposes of: (1) determining the cause, manner (mode), and
time of death; (2) recovering, identifying, and preserving
evidentiary material; (3) providing interpretation and cor-
relation of facts and circumstances related to death; (4) pro-
viding a factual, objective medical report for law enforce-
ment, prosecution, and defense agencies; and (5) separating
death due to disease from death due to external cause for
protection of the innocent (Forensic Pathology, A Hand-
book for Pathologists, Fisher and Petty, July 1977, p. 1).
In cases which require a medico-legal autopsy, the dead
body belongs to the state for the protection of public interest
until such time as a complete and thorough investigation into
the circumstances surrounding the death and the cause thereof
has been completed. The physician entasked to perform such
autopsy is considered to be the authoritative agent and re-
presentative of the state who has the "property right" of the
dead body.
All that need to be turned over to the next of kin respon-
sible for burial of the deceased is that remaining portion or
portions of the body not needed for any medicolegal purposes
(Forensic Medicine by Tedeschi, Eckert & Tedeschi, Vol. II,
p. 972).
Sec. 983, Revised Administrative Code — Investigation into
cause of death (supra p. 156).
Sec. 1089, Revised Administrative Code — Proceedings in cases
of suspected violence or crime:
If the person who issues a death certificate has any reason
to suspect or if he shall observe any indication of violence or
crime, he shall at once notify the justice of the peace (now
Municipal Trial Judge), if he be available, or if neither the
justice of the peace nor the auxiliary justice be available, he
shall notify the municipal mayor, who shall take proper steps
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to ascertain the circumstances and cause of death; and the
corpse of such deceased person shall not be buried or interred
until permission is obtained from the provincial fiscal, if he be
available, and if he be not available, from the mayor of the
municipality in which the death occurred.
When shall an Autopsy be Performed on a Dead Body:
Sec. 95 (b), P.D. 856, Code of Sanitation:
a. Whenever required by special laws;
b. Upon order of a competent court, a mayor and a provincial or
city fiscal;
c. Upon written request of police authorities;
d. Whenever the Solicitor General, Provincial or city fiscal as
authorized by existing laws, shall deem it necessary to disinter
and take possession of the remains for examination to determine
the cause of death; and
e. Whenever the nearest kin shall request in writing the authorities
concerned in order to ascertain the cause of death.
Persons who are Authorized to Perform Autopsies and Dissections:
The following are authorized to perform autopsies and dissections:
a. Health Officers;
b. Medical officers of law enforcement agencies; and
c. Members of the medical staff of accredited hospitals.
(Sec. 95 (a) P.D. 856).
a. Health officers:
The health officers referred to by the Sanitation Code are
the district health officer (now provincial health officer) and
local health officer (now the rural health officer).
(1) District Health Officer (see Sec. 983, Revised Administrative
Code (supra, p. 156).
(2) Local Health Officer:
Sec. 984, Revised Administrative Code —Person to make
investigation — When it is not practicable for the district
health officer to conduct such investigation in person, he
may require any local health officer or member of a muni-
cipal board of health who is a registered physician to
perform such duty; and where the services of a registered
physician in the Government service cannot be thus ob-
tained, he may require a "cirujano ministrante" who is a
member of the board or a sanitary inspector to act in the
matter.
b. Medical Officers of Law Enforcement Agencies:
(1) Medical examiner of the City of Manila (See Sec. 34 and
38 of Rep. Act 409 as amended by Rep. Act. 1934).
(2) Medical staff of the National Bureau of Investigation
which is composed of those assigned in the central office
in Manila under the Medico-Legal Section and those
assigned in the regional offices of the Bureau in ac-
cordance with the administrative plantilla implementing
Rep. Act. 157.
(3) Medico-Legal officers of the Philippine Constabulary
assigned in the Philippine Constabulary Crime Laboratory
(PCCL) and those assigned in different regional com-
mands.
Insofar as medico-legal investigation of criminal cases
occurring within the jurisdiction of the City of Manila is
concerned, there are two officers qualified to make the
investigation:
(a) The medical examiners of the Manila Police Depart-
ment; and
(b) The Medico-Legal Officers of the National Bureau of
Investigation.
The Medical examiner or medico-legal officer "may
investigate cases of sudden deaths, which have not
been satisfactorily explained and when there is
suspicion that the case arose from unlawful acts or
omissions of other persons, or from foul play, and in
general victims of violence, sex crimes, accidents,
self-inflicted injuries, intoxication, drug addiction,. .
." (Sec. 38, Act. 409 as amended by Rep. Act. 1934).
c. Members of the medical staff of accredited hospitals.
Distinction between Pathological (Non-official) and Medico-
legal (Official) Autopsies:
Pathological Autopsy Medico-legal Autopsy
a. Requirement Must have the consent It is the law that gives
of the next of kin. the consent. Consent of
relatives are not needed.
b. Purpose Confirmation of clini- Correlation of tissue
cal findings of re- changes to the criminal
search. act.
c. Emphasis Notation of all ab- Emphasis laid on effect
normal findings. of wrongful act on the
body. Other findings
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may only be noted in PROCEDURE OF AUTOPSY

mitigation of the cri-
minal responsibility.
Summation of all ab- Must be specific for the
e. Conclusion
normal findings irre- purpose of determining
spective of its corre- whether it is in relation
lation with clinical to the criminal act.
findings.
f. Minor or Need not be men- If the investigator
non-patho- tioned in the report. thinks it will be useful
logical in the administration of
justice, it must be in-
cluded.
Other Salient Features Peculiar to Medico-Legal Autopsies:
a. Clinical history of the deceased in most instances absent,
sketchy or doubtful.
b. The identity of the deceased is the responsibility of the foren-
sic pathologist.
c. The time of death and the timing of the tissue injuries must
be answered by the forensic pathologist.
d. The forensic pathologist must alert himself of the possible
inconsistencies between the apparent cause of death and his
actual findings in the crime scene.
e. A careful examination of the external surface for possible
trauma including the clothings to determine the pattern of
injuries in relation to the injurious agent.
f. The autopsy report is written in a style that will make it easier
for laymen to read and more clearly organized insofar as the
mechanism of death is concerned.
g. fhe professional and environmental climate of a forensic
pathologist is with the courts, attorneys and police who make
scrutiny of the findings and conclusion.
The following Manner of Death should be Autopsied:
a. Death by violence.
b. Accidental death.
c. Suicides.
d. Sudden death of persons who are apparently in good health.
e. Death unattended by physician.
f. Death in hospitals or clinics (D.O.A.) wherein a physician was
not able to arrive at a clinical diagnosis as the cause of death.
g. Death occurring in an unnatural manner.
Guidelines in the Performance of Autopsies:
1. Be it an official (medico-legal) or non-official autopsy, the patho-
logist must be properly guided by the purposes for which autopsy
is to be performed. In so doing the purpose of such dissection will
be served.
2. The autopsy must be /comprehensive and must not leave some
parts of the body unexamined. Even if the findings are already
sufficient to account for the death, these should not be a suf-
ficient reason for the premature termination of the autopsy. The
existence of a certain disease or injury does not exclude the pos-
sibility of another much more fatal disease or injury. The findings
of coronary disease does not exclude the probability of injury or
poisoning.
3. Bodies which are severely mutilated, decomposing or damaged by
fire are still suitable for autopsy. No matter how putrid or
fragmentary the remains are, careful examination may be pro-
ductive of information that bears the identity and other physical
trauma received. Frequently a pathologist's reluctance to per-
form an autopsy on decomposed body is due to the odor or
vermin rather than to his belief that the examination would not
be productive.
4. All autopsies must be performed in a manner which show respect
of the dead body. Unnecessary dissection must be avoided.
A wife consented to the performance of an autopsy but
specifically stated that it must be performed in a "decent"
manner. The autopsy was done in broad daylight in the ce-
metery in full view of all the neighborhood residents. Thetourt
held that the condition was violated and she was awarded
damage even though she has consented to the examination
(Hill V. Travelers Ins. Co. 294 S.W. 1097, Tenn. 1927).
5. Proper identity of the deceased autopsied must be established in
non-official autopsy. An autopsy on a wrong body may be a
ground for damages.
Two patients occupying adjoining beds died within a five-
minute interval. There was authorization to perform an autop-
sy on one of them but the nurse interchanged the tags. The
deceased wherein there was no authorization given was autop-
sied. The next of kin brought an action against the hospital
administrator, the pathologist and the coroner for unauthor-
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ized autopsy. The liability was made on the nurse who un-
fortunately was not made as one of the defendants (Schwalb
v. Connely, 179p. 2d 667, Colo.).
The award for damages for wrongful autopsy is not on account
of the mutilation of the deceased body but for the injury to the
feelings and mental suffering of the living because of the illegal
act.
After the death of the husband and without the consent of
the wife, an autopsy was performed on the body of the de-
ceased. The widow filed a suit for unlawful autopsy and failure
to replace the brain, heart and organs. The court held that
there is no justification for the autopsy and dismemberment
and have injured the feelings of the widow. The sum of $1,000
was awarded as reasonable damages (Gould v. State of New
York, 181 Misc. 884, 46 N. Y.S. 2d 313).
6. A dead body must riot be embalmed before the autopsy. The
embalming fluid may render the tissue and blood unfit for toxico-
logical analyses. The embalming may alter the gross appearance
of the tissues or may result to a wide variety of artifacts that tend to
destroy or obscure evidence. An embalmer who applied embalming
fluid on a dead body which in its very nature is a victim of vio-
lence is liable for his wrongful act.
7. The body must be autopsied in the same condition when found
at the crime scene. A delay in its performance may fail or modify
the possible findings thereby not serving the best interest of
justice.
5. All external findings must be properly described and if possible a
sketch must be made or photograph must be taken to preserve the
evidence.
6. All steps and findings in the examination must be recorded.
Rules in the Examination:
1. Look before you cut.
2. Never cut unless you know exactly what you are cutting.
3. Weigh and measure everything that can be weighed or measured.
Stages in the Post-mortem Examination of the Dead Body:
1. Preliminary Examination:
a. Examination of the Surroundings (Crime Scene):
Attention must be focused on the furniture; bullet holes on
the ceiling, floor and walls; amount, color, shape and degree of
spread of the blood stains, position of the wounding weapon;
foot and fingerprints and hairs and clothes.
b. Examination of the Clothings:
Look for marks to establish identity, kind and quality of the
garment, stains, grease, cut and "tear or other marks of resistance
and violence.
c. Identity of the Body:
Determine the height, weight, color of the hair and eyes,
complexion, condition and number of teeth, bodily deformity,
scars and tattoo marks, clothings, dog tag and fingerprints.

Precautions to be Observed in Making Medico-Legal Post-mortem 2. External Examination:

Examination:
1. The physician must have all the necessary permit or author-
ization to perform such an examination. Such permit must be
issued by the inquest officer. The absence of such authorization
may hold the physician civilly and criminally liable.
2. The physician must have a detaUed'liistory of the previous symp-
toms and condition of deceased to be used as his guide in the
post-mortem examination.
3. The true^fuentity of the deceased must be ascertained. If no one
claims the body, a complete date to reveal his identity must be
taken.
4. Examination must be made in a Well-lighted place and it is ad-
visable that no unauthorized person should be present.
a. Examination of the Body Surfaces:
Inspect the natural orifice of the body. All wounds must be
described in detail, blood stains and foreign bodies.
b. Determination of the Position and Approximate Time of Death:
In this stage, the presence and degree of hypostasis, rigor
mortis and putrefaction and color of the blood stain must be
noted. Examination of the hands for the presence of cadaveric
spasm and wounding weapon may be necessary for the proper
solution of the crime.
3. Internal Examination:
Examine all body orifices for blood and foreign bodies. Blood
coming out of the nostrils may imply fracture on the base of the
anterior cranial fossa. Hemorrhage of the ears may imply fracture
of the middle cranial fossa.
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Advantages of Starting Autopsy on the Head: See a tabulation regarding the weight of the thymus gland with
1. If the autopsy starts on the chest or abdomen, excision of the respect to age.
organs will cause the blood content of the brain and the meninges Open the pericardial sac and examine its contents, principally the
to necessarily lose its original pattern; heart. The normal pericardial fluid is from 5 cc. to 6 cc. and yel-
2. There is the unavoidable contamination of the body associated lowish in color. Remove the heart by cutting the root of the blood
with the autopsy, which prevents liable culturing of microor- vessels connected with it. Examine the heart on the following
ganisms from the cranial contents; points:
3. Manipulation of other blood vessels, specially at the neck may Weight —
Normal in men — 300 grams; wo-
result in air bubbles' being artificially drawn into the cerebral men 250 grams.
vessels, impairing fair evaluation of air embolism that might have External — Size, shape, consistency, contrac-
occurred during life (Forensic Medicine, Vol. 1, by Tedeschi, tion or relaxation of the ventricle.
Eckert and Tedeschi, p. 35).
A primary incision must be made from the suprasternal notch to Epicardium — Adhesions, amount of fat, luster,
petechial hemorrhages, milky
the pubic symphysis passing to the left of the umbilicus. Cut the
patches.
rectus abdominis muscle at several points to expose the abdominal
cavity and flap the skin at the region of the chest from the primary Cavities — Amount of blood, blood clots,
incision to the lateral aspect of the chest exposing the ribs. Dis- emboli, dilatation.
articulate the sterno-clavicular joint and cut the ribs medial to the Measure of the Orifices — Normal: Tricuspid — 12 cm.;
costo-chondral junction. Remove the breast and begin examining pulmonary — 8.0 cm.; mitral —
the following: 10.0 cm.; aortic — 7.0 om.
Thickness of the Ventricle — Normal: left — 1.4 cm.; right —
Abdominal and Chest Wall: 0.4 cm.
Fat — Amount, color, moisture, fibrosis. Endocardium — Ulceration, vegetation and sclerosis
Musculature — Development, color, thickness, of the valves, mural endocardium,
atrophic changes. thrombi, cordae tendinae, trabe-
Peritoneal Cavity: c u l e , papillary muscles. Mottling
Fluid — Amount, character, color, consis- (Tigroid heart).
tency, purulent or bloody material. Myocardium — Color, consistency, resistance to sec-
Omentum — Amount of fat, extent, adhesions, tion infraction, sclerosis, fibrosis
blood distribution. edema.
Liver — Level of the anterior border, ad- Coronary Vessels — Special attention must be made to
hesions, blood distribution, color, the anterior branch of the left
fatty or atrophic changes. coronary artery, sclerosis, atheroma,
Chest Cavity: embolism.
Fluid — Amount, color, character, con-
sistency, purulent or bloody ma- Removed both lungs by cutting the region of the hilus. After
terial. examining the fluid or adhesions within the chest wall, the following
Adhesions — Kind, extent, concommitant di- points must be considered in the examination:
sease, distribution. Weight — Normal: right — 400 grams; left —
Pleura — Luster, hemorrhage, disease. 350 grams.
— Enlargement of the lymph nodes, External Examination — State of collapse, size, consistency,
Mediastinum tumor. color, crepitation, consolidation,
— Weight, lobulation, fatty degener- luster, exudate, anthracosis, pete-
Thymus ation. chiae, blood distribution.
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1. Size: External Examination — Size, color, consistency, thickness

Larger — Emphysema, pneumonia, edema. of the capsule, smoothness or
Smaller — Compression, atelectasis. wrinkling of the capsule.
2. Shape: Cut Surface — Resistance to cutting, bulging of
Congenital changes — Abnormal furrows, increased num- cut surface, color, prominence of
ber of lobes. the Malphigian corpuscles, and
Acquired changes — Pleuritis deformans, retractions due trabeculae, consistency of the pulp
to fibrosis in the lung itself, furrows by scraping with sharp edge of
corresponding to the first rib, knife.
partial enlargement due to localized Separate the intestine by cutting the mesentery near its attach-
emphysema, change due to ad- ment with the intestine from the jejenum downward. Open the
hesions. duodenum and verify the potency of the common bile duct. Se-
3. Weight: parate the stomach, duodenum, and pancreas by cutting at the
cardiac end of the stomach.
Increased — Edema, inflammation, congestion,
induration. Stomach — Distention, shape, contents, con-
Diminished — Emphysema. dition of the mucosa, post-mortem
4. Color: changes.
Grayish-red — Variation due to age, occupation, Small Intestine — Length, external appearance, con-
content of air and blood. tents, mucosa, lymphoid follicles
Slaty-black — Anthracosis. and Peyer's patches, obstruction,
Bluish-red — Atelectasis. Merkel's diverticulum, parasites.
Light-brownish — Hemosiderin brown induration. Large Intestine — Length, external appearance, con-
tents, mesocolic glands, epiploic
5. Air content and consistency: appendages, thickness of the walls,
Note the softness, crepitancy, and compressibility. condition of the mucosa, inflam-
Marked softness — Formation of cavity or post- mation, ulcerations, condition of
mortem decomposition. the appendix, parasites.
Firm consistency — Consolidation. Rectum — New growth, hemorrhoid, dysen-
Compressibility — Emphysema. teric ulcers, fistulae.
Cut Surface — Color, condition of consolidation,
amount of air and fluid exuding on The liver is removed by separating it from the diaphragm, but
pressure, bronchi, blood vessels. avoid cutting the suprarenal glands at the upper pole of the kid-
Bronchial Lymph Nodes — Enlargement, anthracosis, tubercu- neys. The following points must be taken into consideration in the
losis. examination of the liver:
Examine the mediastinum for enlargement of the lymph glands, Weight Male — 1,400 grams; Female:
hemorrhage, inflammatory conditions and other pathology. 1,200 grams (Filipino).
Size, color, consistency, sharpness
Abdominal Cavity: of the edges, rib markings, scars,
External Examination
Go to the abdominal cavity and remove the spleen by pulling it thickness of the capsule, lobulation,
and cutting the vessels at the region of the hilus. Examine the spleen granulation.
on the following points: Resistance to cutting, amount of
Weight — Very variable, approximately 150 Cut Surface blood vessels, condition of the bile
grams. duct.
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Gall Bladder — Adhesions, distention, color and Cardio-Vascular System:

consistency ^>f the bile, condition
and staining of the mucosa, thick-
ness and adhesions of the walls,
concretion, obstruction of the
cystic, hepatic and the common
bile duct.
The kidneys must be removed after the removal of the adrenals
and examine them on the following points:
Weight — 120 to 150 grams. The left is
heavier than the right.
External Examination — Perirenal tissue, size, shape and
consistency, color, thickness and
adherence of the capsule, external
surface of the cortex, granulation,
cyst, fetal lobulation, condition
of the veins.
Cut Surface — Condition of the cut edges (everted
or not). Proportionate thickness
of the cortex and the medulla
(normal — 1.3), cortical striation,
pyramidal striation.
Pelvis — Pelvic fat, stones, inflammatory
changes.
Ureter — Obstruction, dilatation, inflam-
matory changes.
Bladder — Distention and contents, condition
of the mucosa and trigonum,
opening of the ureter.
Genital Organs:
Male Remove the prostate and the seminal vesicle with
the urinary bladder. The testicle and the epi-
didymis is removed by pushing through the in-
guinal glands and opening the internal inguinal
ring. Note the condition of the testicle, epididy-
mis, seminal vesicle and prostate.
Female Remove the uterus and its adnexa together with
the upper portion of the vagina.
Ovary — Corpus luteum, hydatid cyst, tumor.
Fallopian Tube — Distention, hydrosalpinx, pyosal-
pinx, hematosalpinx adhesions.
Uterus — Resting, menstruating, gravid, in-
voluting, atrophic, tumor.
Aorta Sclerosis, atheroma, syphilis, aneu-
rysm.
Veins Thrombosis, phlebitis.
Neck Organs:
Remove the larynx, pharynx and tongue including the tonsils.
The condition of the lymph glands, obstruction and edema of the
glottis, foreign body and materials in the larynx and trachea, condi-
tion of the thyroid gland, and condition of the tongue and tonsils
should be noted.
Head:
The scalp is incised from the mastoid process of one side passing
the vertex to the mastoid process on the opposite side. The flaps
are turned down to the back and to the front. Note the presence
of hemorrhage, bruise, hematoma and fracture of the skull. Open
the skull by sawing at the forehead above the eyebrow to the region
of the upper portion of the ear and another vertically a little behind
the vertex and meeting the horizontal cut at the region of the upper
portion of the ear. Remove the flap of bone and note the condition
of the meninges. Remove the brain after cutting it from its attach-
ment and the tentorium cerebelli. Examine the brain for patholo-
gical condition, hemorrhage, laceration, softening, and the base and
side of the cranial box for hemorrhage and fracture. Make several
incisions on the brain and study the injury or disease.
Examination of the Extremities:
There is no technical incision for the extremities. Just open what
is deemed necessary and appropriate for the occasion.
Weight and Measure of the Organs Removed:
The specimen which are collected for further study must be placed
in clean jars and brought to the laboratory are:
LjOrgans for toxicological examination.
2. Slices of organs for histopathologic^ study.
(For a more detailed examination of post-mortem examination,
consult any textbook on pathology.)
AVERAGE MEASUREMENT OF INDIVIDUAL
ORGANS
HEART: Male Both Female
Weight of heart 300 gms. 250 gms.
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Relative weight of ADRENALS:

heart to body 1 to 169 1 to 162 Weight 4.8 — 7.3 gms.
Length of heart 8.5 — 9 8-8.5 Measurement 40 x 20 x 2 mms.
Circumference of
Mitral orifice 10.9 cms. 10.4 cms. WEIGHT OF THYMUS: Both
Tricuspid orifice 12.7 cms. 12.0 cms. Newborn 13.26 gms.
Aortic orifice 8.0 cms. 7.7 cms. I - 55 years
j 22.08 gms.
Pulmonary orifice 9.2 cms. 8.9 cms. 6 - l10 O years
j 26.18 gms.
Pulmonary artery 8.0 cms. 5 3years
I I - 115 37.52 gms.
Circumference base 16 - 2020 years
j 25.52 gms.
of ventricle 28.8 cms. 21 - 25253years 24.73 gms.
Thickness of the wall of 26 - 35353years 19.8 gms.
Left ventricle 1.1 —1.4 cms. 36 - 45453years 16.27 gms.
Right ventricle 0.5 — 0.7 cms. 46 - 55553years 12.85 gms.
SPLEEN: 56 - 65653years 6.08 gms.
6 6 - 775
5 3years 6.00 gms.
Weight of spleen 150 —250 gms.
Measurement 12.0 x 4.5 x 3.0 cms. Mistakes in Autopsies:
PANCREAS: 1. Error or omission in the collection of evidence for identification:
Weight of pancreas 90 — 120 gms. a. Failure to make frontal, oblique and profile photographs of the
Measurement 23.0 x 4.5 x 2.8 cms. face;
b. Failure to have fingerprints made;
LIVER: c. Failure to have a complete dental examination performed.
Weight 1500 to 1800 gms. 2. Errors or omission in the collection of evidence required for
Measurement establishing the time of death:
Length from right to left 25 — 32 cms. a. Failure to report the rectal temperature of the body;
Width of right lobe 18 — 20 cms. b. Failure to observe changes that may occur in the intensity and
Vertical diameter of right lobe 20 — 22 cms. distribution of rigor mortis — before, during and after autopsy.
Vertical diameter of left lobe 15 —16 cms.
c. Failure to observe the ingredients of the last meal and its
location in the alimentary tract.
KIDNEYS: Male Both Female 3. Errors or omission in the collection of evidence required for other
Weight 150 gms. medico-legal examination:
Measurement 11 x 5 x 4.5 cms. a. Failure to collect specimens of blood and brain for deter-
Thickness of: mination of the contents of alcohol and barbiturates;
Cortex 4.6 cms. b. Failure to determine the blood group of the dead person if
Medulla 1 — 3 cms. death by violence was associated with external bleeding;
Relation to body weight 1:200 c. Failure to collect nail scrapings and samples of hair if there is
Relation to weight of heart 1:1.1 reasonable chance that death resulted from assault.
OVARY: d. Failure to search for seminal fluid if there is a reasonable
Weight chance that the fatal injuries occurred incident to a sexual
7.0 gms.
crime;
BRAIN: e. Failure to examine clothings, skin and the superficial portion
Weight 1,358 gms. 1,234 gms. of the bullet tract for residue of powder, and the failure to
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collect samples of any residue for the purpose of chemical
identification;
f. Failure to use an X-ray for locating a bullet or fragments of
bullet if there is any doubt with regard to their presence and
location;
g. Failure to protect bullet from defacement, such as is likely
to occur if they are handled with metal instruments.
h. Failure to collect separate specimens of blood from the right
and left sides of the heart in instances in which the body was
recovered from water.
i. Failure to strip the dura mater from the calvaria and base of the
skull. Many fractures of the skull have been missed because the
pathologist did not expose the surface of the fractured bone.
4. Errors or omission result in the production of undesirable artifacts
or in the destruction of valid evidence:
a. Opening of the skull before blood is permitted to drain from
the superior vena cava. If the head is opened before the blood
drained from it, blood will almost invariably escape into the
subdural and subarachnoidal space, and such an observation
may then be interpreted as evidence of ante-mortem hemorrhage.
b. The use of a hammer and chisel for opening the skull. A
hammer and chisel should never be used for the purpose in a
medico-legal autopsy. Fracture produced by the chisel are
frequently confused with ante-mortem.
c. Failure to open the thorax under water if one wishes to obtain
evidence of pneumothorax.
d. Failure to tie the great vessels between sites of transection and
the heart when air embolism is suspected.
e. Failure to open the right ventricle of the heart and the pul-
monary artery in situ if pulmonary thrombo-embolism is
suspected.
f. Failure to remove the uterus, vagina and vulva en masse if rape
or abortion is suspected.
(From the American Journal of Forensic Medicine and Pathology,
Vol. 2, No. 4 (Dec. 1981) p. 306).
Negative Autopsies — An autopsy is called a negative autopsy if after
all efforts, including gross and microscopic studies and toxicological
analyses, fail to reveal a cause of death. It is an autopsy which
after a meticulous examination with the aid of other examinations
does not yield any definite cause of death.
There are reports that approximately 2 to 10% of the total autopsy
cases in medico-legal centers yield a negative result although theo-
retically there must be a cause of death.
Negligent Autopsy — An autopsy wherein no cause of death is found
on account of imprudence, negligence, lack of skill or lack of fore-
sight of the examiner. The act or omission which may be inadvertent
or deliberate may be:
1. Failure to have an adequate history or facts and circumstances
surrounding the death. Special circumstances surrounding death
may require special autopsy techniques which the pathologist may
fail to do during the autopsy. Air embolism, drug reaction, vagal
inhibition may be left unnoticed because of absence of history.
2. Failure to make a thorough external examination — Animal bites,
injection marks, electrical necrosis may be overlooked in a hasty
external examination.
3. Inadequate or improper internal examinations — Condition of
the organs, presence of air in pneumothorax or bubbles of air in
the circulatory system may remain unnoticed by the pathologist.
4. Improper histological examination — Tissue blocks may not be
taken in the proper areas, poor preparation of the microscopic
slides and improper lighting during the process of examination
may lead to an erroneous interpretation.
5. Lack of toxicological or other laboratory aids — A qualitative and
quantitative determination of toxic materials or its metabolites
must be shown. Sometimes difficulty is encountered by the
forensic chemist because of the lapse of time and rapid elimination
of the drug.
6. Pathologist incompetence — The examiner must have had vast
experience in autopsy investigation and must have the capacity
to distinguish pathological changes in the body tissues.
(Handbook of Forensic Pathology by Abdullah Fatteh, pp. 254-
255).
Religious Objections to Autopsies:
There is no place in the Bible, in the Talmudic or Post-Talmud ic
writings, is there evidence that post-mortem examination is pro-
hibited. According to traditional interpretation, which is not neces-
sarily accepted by all Jewish groups, autopsies and transplantation of
organs are permitted only in those cases where the decendants gave
consent.
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There is no definite statement by the Catholic Church which can

be construed as prohibiting autopsies. Autopsies have been encour-
aged when it appeared that benefit would accrue from them. Simi-
larly, there appears to be nothing in the writings of the Protestant
nation of the cause of death. It must further be shown that the
clergy to point to the prohibition of autopsies.
death is the direct and proximate consequence of the criminal or
negligent act of someone. If death developed independent of an
unlawful act, then the person who committed the unlawful act
cannot be held responsible for the death.
However, there are some post-mortem findings of a physician
which may be useful in the proper adjudication of the case. The
presence of defense wounds on the victim may qualify the crime to
homicide. The presence of serration or series of cuts in the borders
of a stab wound may infer multiple thrusts of the wounding instru-
ment and show the manifest intent of the offender to kill.
The cause of death is the injury, disease or the combination of
both injury and disease responsible for initiating the trend or
physiological disturbance, brief or prolonged, which produce the
fatal termination. It may be immediate or proximate.
Cause of Death — This applies to cases
when trauma or disease kill quickly that there is no opportunity
for sequelae or complications to develop. An extensive brain
laceration as a result of a vehicular accident is an example of
immediate cause of death.
2/The Proximate (Secondary) Cause of Death — The injury or
disease was survived for a sufficiently prolonged interval which
permitted the development of serious sequelae which actually
caused the death. If a stab wound in the abdomen later caused
generalized peritonitis, then peritonitis is the proximate cause of
death.
The mechanism of death is the physiologic derangement or bio-
chemical disturbance incompatible with life which is initiated by the
cause of death. It may be hemorrhagic shock, metabolic disturbance,
respiratory depression, toxemic condition, cardiac arrest, tamponade,
etc.
Cardiorespiratory arrest is a terminal mechanism of most causes
of death and can never stand independently as a reasonable ex-
planation for the fatality. The cause of such arrest must be stated,
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like hemorrhage, skull fracture, sepsis, trauma on the chest, etc. to
make it valid as specific cause of death.
The manner of death is the explanation as to how the cause of
death came into being or how the cause of death arose. The manner
of death may be natural or violent.
V.Natural Death — It is natural when the fatality is caused solely
by disease (lobar pneumonia, ruptured tubal pregnancy, cancerous
growth, cerebral hemorrhage due to hypertension, etc.).
2/violent or Unnatural Death — Death due to injury of any sort
(gunshot, stab, fracture, traumatic shock, etc.). A physician must
not include in the consideration of the manner of death that such
violent death is suicidal, accidental or homicidal.
Such conclusion cannot be determined in the post-mortem
examination. It requires a thorough investigation of all possible
clues in which medico-legal findings are only a part of.
Medico-legal masquerade — Violent deaths may be accompanied by
minimal or no external evidence of injury or natural death where
signs of violence may be present. In a case of homicide, the medical
findings may tend to favor suicide or accidental death, and visa
versa. Cases of such nature infer that the medical examination and
police investigation is far from being complete. There is a need for
further investigation and evaluation to unravel the truth.
Degree of Certainty to the Cause of Death:
1. When the structural abnormalities established beyond doubt the
identity of the cause of death (Ex.: Intracerebral spontaneous
hemorrhage, stab wound with profuse hemorrhage, crushing head
injury in vehicular accident, etc.).
2. When there is that degree of probability amounting to almost
certainty the cause of death. (Ex.: Lobar pneumonia, electrical
shock).
3. When the cause of death is established primarily by historical facts
which are confirmed or supported by positive or negative ana-
tomic or chemical findings (Ex.: Tetanus, hydrophobia, drug
reaction).
4. When neither history, laboratory and anatomic findings, taken
individually or in combination is sufficient to determine the cause
of deathr.but merely speculate as to the cause of death (Ex.: Crib
death among infants, Iatrogenic diseases).
Use of the Term "Probably":
As much as possible the use of the term "probably" as a quali-
fication to a cause of death must be discouraged inasmuch as it is
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not definite. In the prosecution of a criminal case if the resulting
cause of death is merely a probable consequence of a criminal act,
such situation will fall short of "proof beyond reasonable doubt"
and may lead to the acquital of the accused.
If sometime after painstaking effortB the examiner cannot ascribe
a definite cause of death on the body lesions found, the use of the
"probably" in the cause of death may be tolerated.
Steps in the Intellectual Process in the Determination of the Cause
of Death:
1. Recognition of the structural organic changes or chemical abnor-
malities responsible for cessation of vital functions.
2. Understanding and exposition of the mechanism by which the
anatomic and other deviations from normal actually caused the
death, or how the deviation created or initiated the train of suf-
ficiently potent functional disturbance which led ultimately either
to cardiac standstill or to respiratory arrest.
(The Pathology of Homicide by Lester Adelson (1974) p. 15).
Instantaneous Physiologic Death (Death from Inhibition, Death from
Primary Shock, Syncope with Instantaneous Exitus):
This is sudden death which occurs within seconds or a minute or
two (no more) after a minor trauma or peripheral stimulation of
relatively simple and ordinarily innocuous nature. The peripheral
irritation or stimulation initiates the cardio-vascular inhibitory reflex.
The fulminant circulatory failure is caused by (vagocardiac) slowing
or stoppage of the heart, reflex dilatation with profound fall in blood
pressure or a combination of both mechanisms.
A blow to the larynx or solar plexus, a kick in the scrotum,
pressure on the carotid sinus, etc. can cause such death.
Death by inhibition can be made only by exclusion and is com-
pletely dependent on the availability of accurate information. After
serious natural disease has been eliminated by autopsy and toxi-
cological analyses are noncontributory, then only the physiologic
death may be entertained (Medico-legal Investigation of Death by
Werner Spitz and Russel Fisherm, p. 93).
Among the diseases wherein there are no specific finding, pathog-
nomic of a disease still determined are:
1. Sudden Infant Death Syndrome (Crib Death) — This is the unex-
pected death of infants, usually under six months of age, while in
apparently good health. The sudden death cannot be predicted
and there is no way to prevent or foretell on the basis of present
knowledge. Although autopsies in some of the cases revealed the
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presence of congenital heart disease or abnormality, contagious
disease, nutritional deficiency and other pathological conditions,
no consensus has yet been arrived at as to the definite cause of
death.
/2. Sudden Unexplained Nocturnal Death (SUND) — This is known as
"pok-kuri" disease in Japan and "bangungut" in the Philippines.
It is the sudden death of healthy men of young age seen in East
Asian countries. Awareness of relatives and the prompt delivery
of resuscitation are the only effective means of treatment.
The term Dead on Arrival (DOA) must not be construed literally.
It may mean that the patient was actually dead on arrival or was
dying on arrival. Death occurs on a precise time while dying is a
continuing process. If a patient is dead then the procedure of
management is resuscitative or to let him return to life again, while
if the patient is dying, the procedure is to apply emergency measures
to prevent death from ensuing.
DOA may be placed in the item "cause of death" in the death
certificate even if the patient has stayed alive in the hospital or clinic
for sometime provided the attending physician had not been given
ample opportunity to arrive at a working diagnosis as to the cause of
death. The working diagnosis need not be precise and exacting. It
is sufficient that there are some bases to such conclusions.
If the attending physician cannot determine the cause of death, it
will be much more appropriate to place under "Cause of Death" in
the Death Certificate "undetermined" rather than DOA. It is more
responsive to the purpose why such item is included in the certificate.
MEDICO-LEGAL CLASSIFICATION OF THE CAUSES OF
DEATH:
a. Natural Death.
b. Violent Death:
(1) Accidental death.
(2) Negligent death.
(3) Infanticidal death.
(4) Parricidal death.
(5) Murder.
(6) Homicidal death.
Natural Death:
This is death caused by a natural disease condition in the
body. The disease may develop spontaneously or it might have
been a consequence of physical injury inflicted prior to its
development. If a natural disease developed without the
intervention of the felonious acts of another person, no one can
be held responsible for the death.
"Sudden death" is the termination of life which comes
quickly under circumstances when its arrival is not expected.
It may be due to natural or violent cause. Heart diseases and
cerebral apoplexy are the most common causes of deaths due to
natural causes, while poisoning, asphyxia and severe trauma are
frequent causes of violent death.
The natural death may or may not be associated with vio-
lence. Although the history and external findings may show
that death is due to natural cause, a complete autopsy must be
made to determine exactly the cause of death and exclude the
possibility of violent cause.
If signs of violence are associated with the natural cause of
death, the physician must be able to answer the following
questions:
Did the Person Die of a Natural Cause and were the Physical
Injuries Inflicted Immediately After Death ?
If violence was applied on a dead person, the person inflicting
the physical injuries cannot be guilty of murder, homicide or
parricide. The act is considered to be an impossible crime and
is penalized as such. In order that it may be considered an
impossible crime, the person inflicting the physical injuries must
have no knowledge that the victim is already dead at the time of
infliction.
Criminal liability shall be incurred by any person who per-
forms an act which would be an offense against persons and
property, were it not for the inherent impossibility of its ac-
complishment. . . (Art. 4, No. 2, Revised Penal Code). The
court having in mind the social danger and the degree of cri-
minality shown by the offender shall impose upon him the
penalty of arresto mayor or a fine ranging from 200 to 500
pesos. (Art. 59, Revised Penal Code).
"A" has a grudge and wanted to kill "B". One night "A"
entered the bedroom of "B", and without knowing that "B"
died of heart failure an hour ago, inflicted several stab wounds
on " B " "A" cannot be held liable for murder because it is an
impossible crime. " B " was already dead when the stab wounds
were inflicted. However, the law still imposes penalty for such
act depending upon the degree of criminality and social danger
of the offender (Art. 59, Revised Penal Code).
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Was the Victim Suffering from a Natural Disease and the
Violence Only Accelerate the Death ?
If the violence inflicted on a person suffering from a natural
disease only accelerated the death of the victim, the offender
inflicting such violence is responsible for the death of the
victim. It is immaterial as to whether the offender has no
intention of killing the victim. The fact that the victim died,
the offender must be held responsible to whatever be the
consequence of his wrongful act.
Criminal liability shall be incurred by any person committing
a felony although the wrongful act done be different from
which he intended (Art. 4, No. 1, Revised Penal Code).
Example:
"A" gave a blow in the abdomen of "R". Unfortunately
" B " died of severe abdominal hemorrhage due to the trau-
matic rupture of the liver which was severely diseased. "A"
is liable for the death of "B", even if "A" has no intention to
kill "B". "A" must be held liable for consequences of his
felonious act. However, he may avail himself of the miti-
gating circumstance that he had no intention to commit so
grave a wrong as that committed (Art. 13, Revised Penal
Code).
A blow with a fist or a kick, although it did not produce
external injuries but inflammation of the spleen and peri-
tonitis and although the victim was previously affected with
the disease, the accused must be responsible for the death
because he accelerated the time of death by his voluntary
and unlawful act (U.S. v. Rodriguez, 23 Phil. 22).
The deceased was suffering from tuberculosis. The ac-
cused gave fist blows in the hypochondriac region which
caused bruising of the liver, followed by internal hemorrhage
and death. The accused is liable for homicide (People v.
Ilustre, 54, Phil. 544).
Did the Victim Die of a Natural Cause Independent of the
Violence Inflicted?
If a person died of a natural cause and the physical injuries
inflicted is independent of the cause of death, the accused will
not be responsible for the death but merely for the physical
injuries he had inflicted.
Example:
"A" and "B" are sweethearts. "A" at the fit of anger
slapped " B " in the face. "B" is suffering from severe heart
disease. After the slapping, " B " died of heart failure. "A"
cannot be held responsible for the death of "B". He can
only be held for slight physical injury brought about by the
slapping.
The defendant struck a boy with the back of his hand on
the mouth. Although the mouth was bleeding, he was able
to work. A few days later, he developed fever and died. The
court believed that the fever which caused the death was not
the direct consequence of the injury inflicted. It was not
denied that malaria fever was prevalent in the locality, so it
was quite probable that the death was due to a natural cause.
The defendant was acquitted (U.S. v. Palaton, 49 Phil. 117).
To make the offender liable for the death of the victim, it
must be proven that the death is the natural consequence of the
physical injuries inflicted. If the physical injuries is not the
proximate- cause of death of the victim, then the offender can-
not be held liable for such death. Proximate cause is that cause,
which in natural and continuous sequence, unbroken by an
efficient intervening cause, produces injury or death, and with-
out which the result would not have occurred.
So in natural death with concomitant physical injuries, it is
necessary for the physician to determine whether the physical
injuries would accelerate the death, or the injuries itself devel-
oped independently and produced the death or that the person
died absolutely of a natural cause.
A physician must determine for the interest of justice with
absolute care at autopsy and laboratory examination the real
cause of death. Opinion evidence must be given with caution
and must be made after a thorough deliberation of the facts
and other findings.
The Following are Deaths Due to Natural Cause:
(1) Affection of the central nervous system:
(a) Cerebral Apoplexy:
The sudden loss of consciousness followed by paraly-
sis or death due to hemorrhage from thrombosis or
embolism in the cerebral vessels.
i. Cerebral Hemorrhage:
This is brought about by the breaking or rupture
of the blood vessels inside the cranial cavity.
ii. Cerebral Embolism:
This is the blocking of the cerebral blood vessels
by bolus or matters in the circulation.
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iii. Cerebral Thrombosis: (4) Affection of the Gastro-Intestinal Tract:

This is the occlusion of the lumen of the cerebral (a) Ruptured peptic ulcer.
vessels by the gradual thickening of its wall thereby (b) Acute intestinal obstruction.
preventing the flow of blood peripheral to it. (5) Affections of the Genito-Urinary Tract:
(b) Abscess of the Brain: (a) Acute strangulated hernia.
A circumscribed accumulation of infective materials (b) Ruptured tubal pregnancy.
in certain areas of the brain. It may produce coma or (c) Ovarian cyst with twisted pedicle.
death when it ruptures or when it produces acute edema (6) Affection of the Glands:
of the brain. (a) Status thymico-lymphaticus:
(c) Meningitis of the Fulminant Type: This is a condition associated with the enlargement
There is inflammation of the covering membranes of of the thymus and hyperplasia of the lymphoid tissues
the brain due to infection or some other causes. in general.
(2) Affection of the Circulatory System: (b) Acute Hemorrhagic Pancreatitis:
(a) Occlusion of the Coronary Vessels: An acute inflammation of the pancreas accompanied
The occlusion may be due to embolism, thrombosis with hemorrhages and in some cases suppuration and
or stenosis of the coronary openings. This is the most gangrene.
common cause of sudden death due to natural cause. (7) Sudden Death in Young Children:
(b) Fatty or Myocardial Degeneration of the Heart: (a) Bronchitis.
The heart muscles may gradually degenerate and (b) Congestion of the lungs.
replaced by fatty or fibrous tissues such that extra strain (c) Acute broncho-pneumonia.
put on the heart may produce sudden heart failure. (d) Acute gastro-enteritis.
(e) Convulsion.
(c) Rupture of the Aneurysm of the Aorta. , (f) Spasm of the larynx.
(d) Valvular Heart Diseases:
The valves of the heart may be diseased either to Violent Death:
become insufficient or stenotic and may produce sud- Violent deaths are those due to injuries inflicted in the body
den death. by some forms of outside force. The physical injury must be
(e) Rupture of the Heart: the proximate cause of death.
This is found in severe cardiac dilatation with fibrosis The death of the victim is presumed to be natural conse-
of the myocardium. quence of the physical injuries inflicted, when the following
(3) Affections of the Respiratory System: facts are established:
(a) Acute edema of the larynx: (1) That the victim at the time the physical injuries were in-
This may develop from acute infection or from flicted was in normal health.
swallowing irritant substance. (2) That the death may be expected from physical injuries
(b) Tumor of the larynx. inflicted.
(c) Diphtheria. (3) That death ensued within a reasonable time (People v.
(d) Edema of the lungs. Datu Baginda, C.A. 44 O.G. 2287).
(e) Pulmonary embolism. Classification of Trauma or Injuries:
(f) Lobar pneumonia.
(g) Pulmonary hemorrhage: (1) Physical injury — Trauma sustained thru the use of physical
Severe coughing or slight exertion may rupture a force.
normal or diseased pulmonary vessel causing severe (2) Thermal injury — Injury caused by heat or cold.
hemorrhage. (3) Electrical injury — Injury due to electrical energy.
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(4) Atmospheric injury — Those due to the change of atmos-
pheric pressure.
(5) Chemical injury — Those caused by chemicals.
(6) Radiation injury — Those brought about by radiation.
(7) Infection — Those caused by microbic invasion.
In violent death, the death of the victim is not due to the natural
and direct consequence of the injuries inflicted. If there is an
intervening cause other than the physical injuries, then the of-
fender cannot be held liable for the death of the patient.
Refusal of the victim to submit to a surgical operation do not
relieve the accused from the natural and ordinary result of the
felonious act and does not relieve him of his criminal liability
(U.S. v. Marasigan, 27 Phil. 504).
The presence of infection on the wounds inflicted if not deli-
berately induced by the victim makes the offender also responsible
for it (People v. Red, C.A. 43 O.G. 5072).
The accused inflicted physical injuries to the victim. While the
victim was undergoing medical treatment, he removed the drain-
age from his wound and as a result of which he died of peritonitis.
The defense made by the offender is that the deceased could not
have died had he not removed the drainage. HELD: Death was
the natural consequence of the mortal wound. The victim in
removing the drainage from his wound did not appear as acting
voluntarily and with knowledge that he was performing an act
prejudicial to his health (People v. Quiamon, 62 Phil. 162).
Penal Classification of Violent Deaths:
(^Accidental Death:
Death due to misadventure or accident. An accident is
something that happens outside the sway of our will, and
although it comes about through some act of will, lies
beyond bounds of human forseeable consequences.
In a pure accidental death, the person who causes the
death is exempted from criminal liability.
Art. 12, No. 4, Revised Penal Code:
Exempting Circumstances:
The following are exempt from criminal liability:
Elements of the Provision:
(a) A person is performing a lawful act.
(b) He performed it with due care.
(c) He caused injury to another by mere accident.
(d) He is without fault and with no intention of causing it.
Example:
A patient died a few minutes after the administration of
penicillin by injection. The physician took the history from
the patient as to the presence of allergic diseases, made the
necessary tests and took other necessary precautions to
prevent any untoward reaction. The physician cannot be
held liable for the death of the patient because it is purely
accidental.
A driver who, while driving his automobile on the proper
side of the road at a moderate speed and with due diligence,
suddenly and unexpectedly sees a man in front of his
vehicle coming from the sidewalk and crossing the street
without any warning that he would do so, but because it is
not physically possible to avoid hitting him, the said driver
runs over the man. He is not criminally liable, it being a
mere accident (U.S. v. Tayongtong, 21 Phil. 476, cited by
L. Reyes).
The accused was a driver of a loaded truck. While driving
at a curve the front tire exploded and as a consequence of
which the truck fell in a ditch and pinned one of the pas-
sengers. The tire, engine, brake and wheel were in good
condition before the incident. HELD: There being no
proof of excessive speed, the accident under consideration
caused by the blow-out of the tire cannot give rise to
liability of the driver (People v. Hatton (C.A.) 49 O.G.
1866).
The accused while hunting saw wild chickens and fired a
shot. He heard a human being cry and found that the
victim was hit. There was no evidence of the intention of
the accused to kill the deceased. HELD: If life is taken by
misfortune while the actor is in the performance of a lawful
act executed with due care and without intention of doing
harm, there is no criminal liability (U.S. v. Tanedo, 15
Phtf 196).

4. Any person who, while performing a lawful act with (2yNegligent Death:
due care, causes an injury by mere accident without Death due to reckless imprudence, negligence, lack of
fault or intention of causing it. skill or lack of foresight.'
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The Revised Penal Code provides that felonies may be
committed when the wrongful act results from impru-
dence, negligence, lack or foresight or lack of skill.
If death occurred due to the recklessness of someone,
he may be charged for homicide through reckless impru-
dence.
Example:
A surgeon while performing a laparotomy to arrest
bleeding, left foreign bodies (forcep or gauze) inside the
abdominal cavity and as a result of which the patient died.
The surgeon is liable for homicide through reckless impru-
dence.
A physician is equally liable for the same offense if the
untoward effects of the administration of drug administered
is due to the want of the necessary precautionary measures
in the administration of the drug.
If a person does an act and death of the victim is a plain
foreseeable consequence, then it is not accidental but homi-
cidal through simple negligence or reckless imprudence.
The defendant fired a shot on the ground to pacify a
quarrel. The bullet ricochetted and hit a bystander who
died thereafter. The defendant is guilty of homicide though
reckless imprudence. It is apparent that he did not exercise
precautionary measures, considering that the place is
populated and there is likelihood to hit the bystander
(People v. Nocum, 77 PhU. 1018).
(^Suicidal Death (Destruction of One's Self):
The law does not punish the person committing suicide
because society has always considered a person who at-
tempts to kill himself as an unfortunate being, a wretched
person deserving more of pity than of penalty.
But, a person who gives assistance to the commission of
suicide of another is punishable because he has no right to
destroy or assist in the destruction of the life of another.
Art. 253, Revised Penal Code:
Giving assistance to suicide:
Any person who shall assist another to commit suicide
shall suffer the penalty of prision mayor; if such person
lends his assistance to another to the extent of doing the
killing himself, he shall suffer the penalty of reclusion
temporal. However, if the suicide is not consummated
the penalty of arresto mayor in its medium and maximum
periods shall be imposed.
Acts Punishable in Giving Assistance to Suicide:
(a) The offender assisted in the commission of suicide of
another which was consummated.
(b) The offender gave assistance in the commission of
suicide to the extent of d6ing the killing himself which
is consummated.
(c) The offender assisted another in the commission of
suicide which is not consummated.
(4fParricidal Death (Killing of One's Relative):
Art. 246, Revised Penal Code:
Parricide:
Any person who shall kill his father, mother, or child,
whether legitimate or illegitimate, or any of his ascendants
or descendants, or his spouse, shall be guilty of parricide
and be punished by the penalty of reclusion perpetua
to death.
Requisites of the Crime:
(a) A person was killed by the offender.
(b) The person killed was the father, mother, or child,
whether legitimate or illegitimate in relation with the
offender, or other legitimate ascendants, or descendants
or spouse of the offender.
The father, mother or child killed must either be legi-
timate or illegitimate to make it parricide, so that the
killing of one's illegitimate father is parricide.
But, insofar as with the other ascendants or descend-
ants or spouse, it must be legitimate to make it parricide.
Thus, the killing of a common-law wife or one's illegitimate
grandfather is not parricide.
A moro who has three wives and killed the last married
to him cannot be guilty of parricide (People v. Subano,
73 Phil. 692).
A stranger who cooperated and took part in the com-
mission of the crime of parricide is not guilty of parricide
but only of homicide or murder as the case may be
J (People v. Patricio, 46 Phil. 875).
(Sr) Infanticidal Death (Killing of a child less than three days
old):
Art. 265, Revised Penal Code:
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Infanticide: upon a street car or locomotive, fall of an airship, by

The penalty provided for parricide in article 246 and for
murder in article 248 shall be imposed upon any person
who shall kill any child less than three days of age.
If the crime penalized in this article be committed by the
mother of the child for the purpose of concealing for
dishonor, she shall suffer the penalty of prision correccional
in its medium and maximum periods, and if said crime be
committed for the same purpose by the maternal grand-
parents or either of them, the penalty shall be prision
mayor.
Requisites of the Crime:
(a) A person was killed.
(b) The person killed was a child less than three days old.
The penalty to be imposed depends upon the killer of
the child. If the killer is the father, mother or any of the
legitimate ascendants, the penalty corresponding to parri-
cide shall be imposed. If the killing is made by any other
persons, the penalty for murder shall be imposed.
There is no medical explanation why three days is made
to distinguish infanticide from murder and parricide.
Concealment of the dishonor is not an element of the
crime but only mitigates penalty. So that if the mother or
the maternal grandparents killed the child to conceal the
dishonor the penalty for parricide is not imposed but only
that jone provided in the second paragraph of Art. 255.
(6TMurder:
Art. 248, Revised Penal Code:
Murder:
Any person who, not falling within the provisions of
article 246 shall kill another, shall be guilty of murder and
shall be punished by reclusion temporal in its maximum
period of death, if committed with any of the following
circumstances:
1. With treachery, taking advantage of superior strength,
with the aid of armed men, or employing means to
weaken the defense or of means or persons to insure
or afford impunity.
2. In consideration of a price, reward or promise.
3. By means of inundation, fire, poison, explosion,
shipwreck, stranding of a vessel, derailment or assault
means of motor vehicles, or with the use of any other
means involving great waste and ruin;
4. On occasion of any of calamities enumerated in the
preceding paragraph, or of an earthquake, eruption of
a volcano, destructive cyclone, epidemic, or any other
public calamity;
5. With evident premeditation;
6. With cruelty, by deliberately inhumanly augmenting
the suffering of the victim, or outraging or scoffing at
his person or corpse.
Requisites for the Crime of Murder:
(a) The offender killed the victim;
(b) The killing is attended by any of the qualifying circum-
stances mentioned;
(c) There was the intent of the offender to kill the victim;
(d) The killing is not parricide or infanticide.
Whenever the killing is attended by more than one of
the qualifying circumstances mentioned, only one of them
will make the killing, murder and the rest will be considered
as generic aggravating circumstances.
The presence of several wounds inflicted by the of-
fender prove murder because there is cruelty if the victim is
alive, or scoffing or outraging at the corpse if inflicted after
death.
The presence of gunshot wound of entrance at the back
as a general rule qualifies act to murder because there was
treachery, i There is treachery when the offender commits
any of the crimes against person, employing means, or
method, or form in its execution thereof which tend direct-
ly or specially to insure its execution, without risk to
himself arising from the defense which the offended party
may make (Art. 14, Par. 16, Revised Penal Code).
(7-Hlomicidal Death:
Art. 249, Revised Penal Code:
Homicide:
Any person who, not falling within the provisions of
article 246 shall kill another without the attendance of any
of the circumstances enumerated in the next preceding
article, shall be deemed guilty of homicide and be punished
by reclusion temporal.
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Requisites of the Crime of Homicide:
(a) The victim of a criminal assault was killed;
(b) The offender killed the victim without any justification;
(c) There is the intention on the part of the offender to kill
the victim and such presumption can be inferred from
the death of the victim;
(d) That the killing does not fall under the definition of the
crime of murder, parricide or infanticide.
If a pharmccist wrongly compound a prescription cor-
rectly prescribed by the physician and lethal dose of poison-
ous drugs were included and as a result of which the patient
almost died, the crime committed is physicial injuries
through reckless imprudence. It cannot be frustrated
homicide through reckless imprudence because of the
absence of intent to kill by the pharmacist (People v.
Castillo, 76 Phil. 72).
Frustrated homicide is distinguished from physical
injuries in that in the commission of the latter there is no
intent to kill.
Death under Special Circumstances:
(1) Death Caused in a Tumultuous Affray:
Art. 251, Revised Penal Code:
When while several persons, not composing groups
organized for the common purpose of assaulting and at-
tacking each other reciprocally, quarrel and assault each
other in a confused and tumultuous manner, and in the
course of affray someone is killed, and it cannot be as-
certained who actually killed the deceased, but the person
or persons who inflicted serious physical injuries can be
identified, such person or persons shall be punished by
prision mayor.
If it cannot be determined who inflicted the serious
physical injuries on the deceased, the penalty of prision
correccional in its medium and maximum periods shall be
imposed upon all those who shall have used violence upon
the person of the victim.
Requisites of the Crime:
(a) The person was killed in a confused or tumultuous
affray;
(b) That the actual killer is not known; and
(c) That the person or persons who inflicted the serious
physical injuries or violence are known.
(2) Death or Physical Injuries Inflicted under Exceptional
Circumstances:
Art. 247, Revised Penal Code:
Any legally married person who, having surprised his
spouse in the act of committing sexual intercourse with
another person, shall kill any of them or both of them in
the act or immediately thereafter, or shall inflict upon
them any serious physical injury, shall suffer the penalty
of de8tierro.
If he shall inflict upon them physical injuries of any
other kind, he shall be exempt from punishment.
These rules shall be applicable, under the same circum-
stances, to parents with respect to their daughters under
eighteen years of age, and their seducers, while the daughters
are living with their parents.
Any person who shall promote or facilitate the pros-
titution of his wife or daughter, or shall otherwise have
consented to the infidelity of the other spouse shall not
be entitled to the benefits of this article.
Requisites of the Crime:
(a) Surprise of the spouse:
i. There must be valid marriage.
ii. That the guilty spouse was caught by surprise in
the act of committing sexual intercourse with
another person.
iii. That the killing or the injury was inflicted to either
or both at the very act or immediately thereafter.
(b) Surprise of a daughter:
i. The daughter is below 18 years of age.
ii. The daughter is living with the parents.
iii. The parents caught her by surprise committing
sexual intercourse with the seducer.
iv. The killing was done at the very act of sexual
intercourse or immediately thereafter.
2. PATHOLOGICAL CLASSIFICATION OF THE CAUSES OF
DEATH:
An analysis of all deaths from natural causes will ultimately
lead to the failure of the heart, lungs, and the brain, so that
death due to pathological lesions may be classified into:
a. Death from Syncope
b. Death from Asphyxia
c. Death from Coma.
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All of the above mentioned conditions invariably produce the
so-called sudden death. Sudden death is the termination of life
which comes quickly when it is not expected.
a. Death from Syncope:
This is death due to sudden and fatal cessation of the action
of the heart with circulation included. , (4) Pressure on the respiratory tract due to tumor, or intra-
Causes of Death from Syncope:
(1) Coronary disease, as embolism or thrombosis.
(2) Rupture of the heart through softened infarct.
( 3 ) Myocardial degeneration.
(4) Valvular diseases.
(5) Rupture of the aortic and other aneurysm.
(6) Systemic embolism occurring in bacterial endocarditis.
( 7 ) Congenital heart diseases of the newborn.
(8) Reflex inhibition of the heart or of the cardiac center,
as in shock, emotion or blow over the area of some of
the sensory nerve.
( 9 ) Arterial hypertension with sclerosis.
(10) Deficiency cf blood as in profused hemorrhage, especially
if sudden.
(11) Exhaustive diseases.
(12) Extensive injury to the body from mechanical cause.
Symptoms of Syncope:
(1) Person falls and remains motionless.
(2) Face is pale.
( 3 ) Pulse at the wrist disappears or is filiform.
( 4 ) Respiration ceases.
In non-fatal cases, consciousness returns in a few second,
but in fatal ones, the following other symptoms appear:
(5) Person breaks out into cold sweat.
(6) Dimness of vision.
( 7 ) Pulse rapid and filiform.
( 8 ) There may be vomiting and involuntary movement of the
limbs.
( 9 ) The person may be passing into the state of delirium.
(10) Death may be preceded by convulsion.
b. Death from Asphyxia:
Asphyxia is a condition in which the supply of oxygen to
the blood or to the tissues or to both has been reduced below
normal working level.
Gauges of Death from Asphyxia:
(1) Diseases of the respiratory system, as pneumonia, acute
bronchitis, bronchitis in infancy, rupture of the blood
vessels in pulmonary tuberculosis with cavitation.
(2) Impaction of foreign bodies in the larynx.
(3) Compression of the larynx.
cranial hemorrhage.
(5) Strangulation, suffocation, hanging, drowning, inhalation
or irritant gases.
(6) Refraction of the atmosphere.
(7) Causes operating in the nervous system:
(a) Paralysis of the respiratory muscles or respiratory
center from injury or disease or action of poison.
(b) Fixation of the respiratory muscles from over stimu-
lation of the spinal cord as in strychnine poisoning.
(8) Causes operating from the lung or pulmonary circulation:
(a) Pleurisy with effusion.
(b) Emphysema.
(c) Pulmonary embolism.
(d) Pulmonary thrombosis.
Symptoms of Asphyxia:
(1) Stage of Increasing Dyspnea :
This stage usually lasts from 1/2 to 1 minute:
(a) Increased rate and depth of respiration, leading to
difficulty of breathing (dyspnea).
(b) Exaggerated movement of inspiratory muscles soon
replaced by exaggerated expiration.
(c) Rise of blood pressure, consequently the heart beat
becomes quicker and more forcible.
(d) Person becomes bluish and consciousness is lost.
(e) Pupils are contracted.
(2) Stage of Expiratory Convulsion:
(a) This stage lasts for about a minute:
i. Marked expiratory effort.
ii. Convulsive movement of the limbs accompanied by
expiratory effort.
iii. Blood pressure gradually lowers owing to the failure
of the heart due to lack of oxygen.
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(3) Stage of Exhaustion: (e) Ingested alcohol.

This stage lasts for about three minutes. The person lies Symptoms of Coma:
still except for occasional deep inspiration. Blood pressure (1) Person unconscious.
falls and pupils are dilated. (2) Breathing is stertorous.
Post-mortem Findings in Death from Asphyxia: (3) Pulse is full but intermittent.
(1) External Findings: (4) Cold, clammy perspiration.
(a) Lividity of the hps, fingers and toenails. (5) Imperfect perception of sensory impression.
(6) Delirium.
(b) Livid markings on the skin. (7) Relaxation of all sphincter muscles.
(c) Marked post-mortem lividity. (8) Accumulation of mucous in the respiratory passages.
(2) Internal Findings: Post-mortem Findings:
(a) Lungs: The findings in coma are the same as in asphyxia, and
i. Lungs engorged with dark blood. addition, there is congestion of the brain and the spinal cord.
ii. On section, there is dark color frothy exudation.
iii. Punctiform hemorrhages of the pleura (Tardieu
Spots).
iv. Reddish discoloration of the trachea and bronchial
mucous membrane.
(b) Heart:
i. Subpericardial petechial hemorrhages.
ii. Right ventricle of the heart dilated and engorged.
iii. Left side of the heart and arterial system empty.
(c) Abdominal viscera congested.
(d) Brain congested and may show punctiform hemorrhages.
(e) Blood dark in color.
(f) Rigor mortis has slow onset.
c. Death from Coma:
Coma is the state of unconsciousness with insensibility of the
pupil and conjunctivae, and inability to swallow, resulting from
the arrest of the functions of the brain.
Causes of Coma:
(1) Gross lesions of the brain:
(a) Depressed fracture.
(b) Apoplexy.
(c) Embolus.
(d) Abscess.
(e) Tumor.
(2) Poisons:
(a) Uremia.
(b) Cholemia.
(c) Acetonemia.
(d) Ingested morphine.
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Chapter VII
^S^ECIAL DEATHS
1. JUDICIAL DEATH:
Modern methods in the execution of death sentences have
abandoned inhuman, cruel and barbarous means. Executions by
garroting, decapitation by means of the guillotine and by drowning
which were common during the medieval days are no longer
practiced. The statutes of all countries state the legal procedure
for the execution of death penalties. The constitution, like that
of the Philippines, imposes certain limitations to the law-making
body as to the method to be established.
Art. Ill, Sec. 1, Par. 19, of the Philippine Constitution provides
that "cruel and unusual punishment shall not be inflicted." The
wait for the provision of the new constitution punishment pro-
hibited must not only be cruel but also unusual or vice versa.
Banishment may be unusual but not cruel and therefore valid.
Death penalty is not cruel and unusual whether it be by hanging,
shooting, or electrocution (Legarda v. Valdez, 1 Phil 146).
Punishments are cruel when they involved torture or a lingering
death, but the punishment of death is not cruel because it is not
barbarous and inhuman.
The purpose of the guaranty by the constitution is to eliminate
many inhuman and uncivilized punishments formerly known,
the infliction of which tend to barbarize present civilization
(McElvaine v. Brush, 142 U.S. 155).
Death Penalty:
1. Arguments in Favor of the Death Penalty:
( 1 ) It is the only method of eliminating the hopeless enemy
of society — Escape from prison, commutation of sentence
and pardon are ways that criminals, helped by their friends,
escaped life imprisonment.
( 2 ) It deters potential criminals as no other form of punish-
ment does.
(3) Its brutalizing effect is an unproven assumption. — It is
contended that if capital punishment is properly carried
out, instead of brutalizing society, it satisfies the sense of
justice and provides social satisfaction and a sense of pro-
tection.
203
(4) It is the only means whereby society is relieved of the
support for those who continually war upon it. Society
will be relieved of- expenses of maintaining the irreformable
criminals who prey upon it.
(5) It is a positive selective agency to wipe out the stock of
irreformable criminals — Killing the hopeless criminals will
eliminate some of the degenerated stock of society.
2. Arguments Against Death Penalty:
(1) It is an irreversible penalty. — Mistaken judgments as to
guilt can no longer be remedied.
(2) It is not reformative. — Capital punishment indicates im-
possibility of reformation of offenders. No one is incor-
rigible sociologically.
(3) Capital punishment is not a deterrent in effect. — There is
no country where death penalty is imposed and criminality,
diminished.
(4) Capital punishment diminished the certainty of punishment.
— It is a common experience that the court will not convict
a person when the penalty to be imposed is death. If capital
punishment is done away entirely, the court is more likely
to convict and thus society is protected in greater measure.
(5) Capital punishment violates humanitarian sentiments. —
Men can take a life in self-defense or in the heat of passion,
and have a relieving sense of justification, but to take in
cold blood the life of a prisoner causes all the humanitarian
sentiments developed in thousands of years to revolt.
( 6 ) Capital punishment is retributive — Revengeful acts of
society is already an out of fashion philosophy. The test
is to have a corrective approach.
( 7 ) It is a cold-blooded and deliberate kind of murder. — The
executioner has no passion to justify the performance of
his act. It is, however, a question whether a man who pulls
the trap may not feel he is doing a public service that is
even greater than a policeman who shoots a fleeing mur-
derer or robber.
Methods of Judicial Death:
1. Death by Electrocution:
A person is made to sit on a chair made of electrical con-
ducting materials with straps of electrodes on both wrists,
ankles, and head. An alternating current voltage of more than
1,500 volts is put on until the convict dies.
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If the convict does not die after a few minutes that the current
was put on, it is necessary to apply another current until he is
pronounced dead by the physician. The law states that the
penalty is death by electrocution so that the convict must be
put to death. It is the duty of the administrator of the peni-
tentiary to mitigate as much as possible the sufferings of the
convict in the execution of death sentence.
Art. 81, Revised Penal Code — When and how the death
penalty is to be executed. — The death sentence shall be exe-
cuted with preference to any other and shall consist in putting
the person under sentence to death by electrocution. The
death sentence shall be executed under the authority of the
Director of Prisons, endeavoring so far as possible to mitigate
the sufferings of the person under sentence during electro-
cution as well as during the proceedings prior to the execution.
If the person under sentence so desire, he shall be anesthe-
sized at the moment of the electrocution.
Art. 82, Revised Penal Code — Notification and execution of
the sentence and assistance to the culprit. — The court shall
designate a working day for the execution, but not the hour
thereof, and such designation shall not be communicated to
the offender before sunrise of said day, and the execution shall
not take place until after the expiration of at least eight hours
following the notification, but before sunset. During the
interval between notification and the execution, the culprit
shall, in so far as possible, be furnished with assistance as he
may request in order to be attended in his last moments by
priests or ministers of the religion he professes and to consult
lawyers, as well as in order to make a will and confer with
members of his family or persons in charge of the management
of his business, of the administration of his property, or of the
care of his descendants.
Art. 83, Revised Penal Code — Suspension of the execution
of the death sentence. — The death sentence shall not be in-
flicted upon a woman within the three years next following
the date of the sentence or while she is pregnant not upon any
person over seventy years of age. In this last case, the death
sentence shall be commuted to reclusion perpetua with the
accessory penalties provided in article 40.
and by his lawyers and by his relatives, not exceeding six, if
he so request, by the physician and the necessary personnel
of the penal establishment, and by such persons as the Director
of Prisons may authorize.
Death by electrocution is the only method recognized by
our civil law. There is a growing sentiment to remove capital
punishment although it is a means to discourage future wrong-
doers.
Death may be due to shock; respiratory failure due to bulbar
paralysis or asphyxia;and due to prolong and violent convulsion.
2. Death by Hanging:
The convict is made to stand in an elevated collapsible flat-
form with a black hood on the head, a noose made of rope
around the neck and the other end of which is fixed in an elevated
structure above the head. Without the knowledge of the con-
vict, the flatform suddenly collapses which causes the sudden
suspension of the body and tightening of the noose around the
neck. Death may be due to asphyxia or injury of the cervical
portion of the spinal cord.
In the Philippines, this method of death execution is only
allowed on death penalties imposed by military tribunals or
court marshals. It is considered to be the most gruesome
means of death and is imposed primarily to those who have
been found guilty of very grave offenses.
In the Philippines, death penalty that are imposed by the civil
court must only be by electrocution. Hanging is not recognized as
a means of executing death sentence, although the decision of the
military tribunals may impose death by hanging.
The following are the causes of death in judicial hanging:
a. Dislocation or fracture of the upper cervical vertebrae.
b. Partial or complete severance of the spinal cord.
c. Rupture of the cervical muscles.
d. Asphyxia due to the pressure on the vagus nerve.
e. Syncope due to the pressure on the vagus nerve.
f. Cerebral anemia which results to an inhibition of the vital
centers of the brain.

Art. 84, Revised Penal Code — Place of execution and per- 3. Death by Musketry:
sons who may witness the same. The execution shall take place The convict is made to face a firing squad and is put to death
in the penitentiary of Bilibid in a space closed to public view by a volley of fire. The convict may be facing or with his back
and shall be witnessed only by the priests assisting the offender towards the firing squad.
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This method of execution of death penalty is applied to
military personnel and decided by the court marshals. Death
by musketry is considered less heinous than death by hanging.
4. Death by Gas Chamber:
The convict is enclosed in a compartment and an abnoxious
or asphyxiating gas is introduced. The most common gas
used is carbon monoxide. The convict will not be removed
from the gas chamber unless he is pronounced dead by the
penitentiary physician.
This method is not recognized by the Philippine civil or
military law. In some states of the United States, it is a legal
means of judicial death execution.
Other Methods of Capital Punishment:
1. Beheading — The most common way of beheading is with the
use of the guillotine. The device is something like a file-driver
with a heavy axe to severe the head. The descent of the blade
strikes the neck from behind and the head falls into a basket.
2. Crucifixion — Nailing the person on a cross and death develops
by traumatic asphyxia.
3. Beating — A hard object is forcibly applied to the head to
crush the skull.
4. Cutting asunder — Mutilating the body usually with sharp
heavy instrument until death ensues.
5. Precipitation from a height.
6. Destruction by wild beast.
7. Flaying — skinning alive.
8. Impaling.
9. Stoning.
10. Strangling.
11. Smothering.
12T Drowning.
Euthanasia or "mercy killing" is the deliberate and painless
acceleration of death of a person usually suffering from an in-
curable and distressing disease.
It is universally condemned but some advocate its legalization
based on humanitarian sentiments.
In the Philippines there is no law dealing specifically with the
matter but the general sentiment is that it is contrary to the
principle that "no person has the right to end his own life, much
less can he delegate such right to another." Medical ethics states
that the duty of a physician is to save life, not to end it.
Philosophically — It is the proper function of society to safe-
guard man's right to die when he chooses to, provided it will not
prejudice the rights of others.
Churches — All churches are against euthanasia because an in-
dividual does not have the full dominion over his life to the extent
of determining whether or not he will continue to live. Only
God who created mankind has the sole right to extinguish it.
Medicine — There is no sense in performing euthanasia inas-
much as there is no physical pain so severe that modern medi-
cation available today cannot substantially provide relief.
The physician may be mistaken in the diagnosis of impending
death. Recovery, of the kind bordering closely on a miracle,
may occur. There is belief in the saying, "While there is life,
there is hope."
Sociologically — The practice of euthanasia is an endorsement
or toleration of society to suicide and a general approval of crime
committed for a benevolent motive.
Types of Euthanasia:
1. Active Euthanasia — Intentional or deliberate application of
the means to shorten the life of a person. It may be done with
or without the consent or knowledge of the person. Active
euthanasia on demand is the putting to death of a person in
compliance with the wishes of the person (patient) to shorten
his sufferings.
2. Passive Euthanasia — There is absence of the application of
the means to accelerate death but the natural course of the disease
is allowed to have its way to extinguish the life of a person.
Consequently the concept of orthothanasia and dysthanasia
was adopted.
a. Orthothanasia — When an incurably ill person is allowed to
die a natural death without the application of any operation
or treatment procedure.
b. Dysthanasia — When there is an attempt to extend the life
span of a person by the use of extraordinary treatments
without which the patient would have died earlier.
Note: Dysthanasia does not comply with the definition of
euthanasia.
(Report on the 4th World Congress on Medical Law, Manila,
March 16-17, 1976, p. 57).
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Ways of the Performing Euthanasia:
1. Administration of a lethal dose of poison.
2. Overdosage of sedatives, hypnotics or other pain relieving drugs.
3. Injection of air into the blood stream.
4. Application of strong electric currents.
5. Failure to institute the necessary management procedure which
is essential to preserve the life of the patient.
a. Failure to perform tracheostomy when there is marked dis-
tress in breathing due to laryngeal obstruction.
b. Failure to give transfusion in severe hemorrhage.
c. Depriving the child of nutrition.
d. Removal of patient from a respirator when voluntary breath-
ing is not possible.
Who May Perforin Euthanasia:
1. The patient himself:
A n y person who deliberately puts an end to his life commits
suicide. Suicide is not a crime in our jurisdiction because a
person committing suicide is a moral wreck and he must be
given an eye of pity or sympathy rather than an eye of penalty
by law. This is also based on a philosophy that a person has a
complete dominion over his own body.
2. The physician, with or without the knowledge and consent of
the patient:
Even if a physician has humanitarian or merciful motive in
putting to death a patient, his act his punishable in spite of the
patient's consent.
c. If the suicide with the assistance of the physician is not
consummated, the penalty of arresto mayor (1 month and
1 day to 6 months) in its medium and maximum period shall
be imposed; and
3. If poison was administered by the physician to the patient
without the knowledge and consent of the patient, then it is
murder. Treachery is inherent to the act of poisoning and treach-
ery qualifies the killing to murder.
In other jurisdictions, the modern attitude is to allow phy-
sicians to perform euthanasia in some special cases.
In the case of Dr. Adams who was charged for murder by
administering a pain-killing drug to a patient suffering from a
painful and- incurable disease, which he was then acquitted,
the court held that "If the first purpose of medicine (the
restoration of health) could no longer be achieved, there was
much for the doctor to do, and he was entitled to do all
that was proper and necessary to relieve pain and suffering
even if the means he took might incidentally shorten life by
hours or perhaps even prolong it. The doctor who decides
whether or not to administer the drug would not do his
job if he were thinking in terms of hours or even in months.
The defense in the present case was that the treatment
given by Dr. Adams was designed to promote comfort,
and if it was the right ana proper treatment the fact that it
shortened life did not convict him of murder" (R. v. Adams,
Crim., L.R. 365, 1957).

Art. 253, Revised Penal Code — Giving assistance to suicide —
A n y person who shall assist another to commit suicide shall
suffer the penalty of prision mayor; if such person lends his
assistance to another to the extent of doing the killing himself,
he shall suffer the penalty of reclusion temporal. However, if
the suicide is not consummated, the penalty of arresto mayor
in its medium and maximum periods shall be imposed.
The above provision contemplates the following situations:
a. If a physician assists a person in the commission of suicide
(by giving him a lethal dose of poison, for example) without
actually administering it, the law imposes upon him the
penalty of prision mayor (6 yrs. and 1 day to 12 yrs. im-
prisonment).
b. If the physician lends his assistance to another to the extent
of doing the killing himself, he shall be punished by reclusion
temporal (12 yrs. and 1 day to 20 yrs.);
In a recently decided case (In the matter of Karen Quin-
lan, N.J. Sup. Ct. Mar. 3 1 , 1 9 7 6 ) , Karen Quinlan had been in
coma for almost a year and has been kept alive by a res-
pirator. The father petitioned the court to authorize
discontinuation of the respirator because there is no "reason-
able possibility" that she would recover and to allow her to
die "with grace and dignity". The court allowed such re-
moval provided it is with the consent of the attending phy-
sician and a panel of hospital staff. The court based it on
the right of privacy of the patient or the right of the patient
to make life— sustaining medical decision and that since
the patient was incompetent to make such decision, it be-
longed to her father acting as a guardian. The court does not
question the "state's undoubted power to punish the taking
of human life, but that power does not encompass individ-
uals terminating treatment pursuant to their right of privacy".
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3. SUICIDE: voluntary self-injury, but where we infer that the intention

Suicide or self-destruction is usually the unfortunate conse-
quence of mental illness and social disorganization. Societal
reaction to suicide varies in different jurisdiction. Some consider
suicide a crime (Maryland, N e w Jersey, North Carolina, Oklahoma,
South Dakota); others impose no penalty for suicide but suicide
attempts are considered felonies or misdemeanors and could result
to jail sentences.
In criminal statistics there is under-reporting of suicide cases
because of the following reasons:
1. Even if the facts are clear to support suicide, the strong opposi-
tion of the family, the physician, attorney and friends may
cause a certification that it is accidental, because they are not
only bereaved but also stigmatized. The legal and moral impli-
cations of suicidal death prevent certification of such manner
of death. If insured may deprive the beneficiary from receiving
the full value of the policy, the usual religious rites may not be
accorded the deceased, and other benefits provided by law
which the heirs are entitled may not be received.
2. There is a lack of generally accepted standards for deter-
mining death by suicide. To make death suicidal, it must
be the direct, conscious, intentional act of self-destruction.
Subconscious or sub intended acts which directly or indirectly
cause or hasten death is not considered to be suicide. No
single finding in the investigation of death is an absolute criterion
of suicide.
Suicide rarely occurs during the pre-addescent age. The in-
cidence increase with the age but more in the elderly. There is
more incidence in male than in female. Most victims have ex-
perienced depression of long duration prior to dying.
to die was relatively low because the method of self-injury was
relatively harmless, or because provisions for rescue were made.
The person was "unlucky" actually to die.
4. Suicide under circumstances which suggest a lack of capacity
for intention, as when the person was psychotic or highly
intoxicated from the effects of drugs, including alcohol.
5. Self-destruction due to self-negligence — for example, such
self-destructive behaviors as chronic alcoholism, reckless driving,
ignoring medical instructions, cigarette smoking, and similar
dangerous activities. In general, such deaths are not at present
classified as "suicide."
6. Justifiable suicide — for example, the self-destructive action of
a person with a terminal illness. This last category is of con-
siderable current interest to philosophers, theologians and
social psychologists.
(From: Psychological Aspects of Suicide by Robert Litman,
Modern Legal Medicine Psychiatry and Forensic Science, Curran,
McGarry & Petty, ed. 19, 980, F. A. Davis Co., p. 843).
Common Methods of Commiting Suicide:
1. Drugs and poisons — Barbiturates, non-barbiturate sedatives,
acids and other irritants, carbon monoxide, pesticides and
herbicides, other organic and inorganic poisons.
2. Hanging.
3. Firearm.
4. Jumping from a height.
5. Drowning.
6. Cutting and stabbing.
7. Suffocation by plastic bag.
8. Electrocution.

Suicide occurs in almost every conceivable location but a vast
majority of cases occur at home. It may occur in other places
like hotel, automobile, jails, hospitals and mental institutions.
The bodies of victims may be found in rivers, lakes, open fields.
The scene of death is orderly.
Psychological Classification of Suicide:
1. First degree — deliberate, planned, premeditated, self-murder.
2. Second degree — impulsive, unplanned, under great provocation
or mitigating circumstances.
3. Third degree — sometimes called "accidental" suicide. This
occurs when a person puts his or her life into jeopardy by
Suicide and Drug:
"Automatism" due to drug may be considered as accidental
rather than suicidal. A patient develops a state of toxic delirium
after ingesting one or several doses of tlffe drugs, alcohol or a com-
bination thereof and while in the delirious or automatism stage,
takes much more of the drug unintentionally.
Evidences That Will Infer Death is Suicidal:
1. History of depression, unresolved personal problem, or mental
disease;
2. Previous attempt of self-destruction;
3. If committed by infliction of physical injuries, the wounds are
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located in areas accessible to the hand, vital parts of the body
and usually solitary.
4. The effects of the act of self-destruction may be found in the
body of the victim:
a. Hand may be blood-stained if suicide was done by inflicting
wound;
b. Wounding hand may be positive to paraffin test in gunshot.
The wound of entrance may show manifestation of a contact
or near shot.
c. Empty bottle or container of poison may be present at the
suicide scene;
d. Absence of signs of struggle; or
e. Cadaveric spasm present in the wounding hand holding the
weapon.
5. Presence of suicide note;
6. Suicide scene in a place not susceptible to public view, and
7. Evidences that will rule out homicide, murder, parricide, and
other manner of violent death.
DEATH FROM STARVATION
Starvation or inanition is the deprivation of a regular and constant
supply of food and water which is necessary to normal health of a
person.
Types of Starvation:
1. Acute starvation — is when the necessary food has been suddenly
and completely withheld from a person.
2. Chronic starvation — is when there is a gradual or deficient supply
of food.
Causes of Starvation:
1. Suicidal:
a. People deprived of liberty or prisoners may go in a "hunger
strike" to create sympathy.
b. Mistaken belief that people can live without food for a pro-
longed period.
c. Excessive desire to lose weight.
d. Lunatics during depressive state.
e. As an expression of political dissent.
2. Homicidal:
a. Deliberate deprival of food for helpless illegitimate children,
feeble-minded and old persons.
b. Punishment or act of revenge by deliberate incarceration in
an enclosed place without food m water.
3. Accidental:
a. Scarcity of food or water during famines or draught.
b. Shipwreck, entombment of miners caused by landslides, ma-
rooned sailors, or fall in a pit.

Length of Survival:
The human body without food loses l/24th of its weight daily,
and a loss of 40% of the weight results to death.
The length of survival depends upon the presence or absence of
water. Without food and water, a person cannot survive more than
10 days, but with water a person may survive without food for 50
to 60 days.

Factors that Influence the Length of Survival:

a. Age — Children suffer earlier from the effects of starvation
than old aged people. A child demand more food for growth
and development. Assimilation and utilization of food elements
is slowed and weakened in old age.
b. Condition of the body — During starvation, fat stored up in the
body is the one utilized to maintain life. It is but natural that
a healthy person with more fat deposit can resist more deprival
Death b y itarvation of food.
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c. Sex — Women can withstand starvation longer because they
have relatively more adipose tissues than men.
d. Environment — Exposure to higher temperature will accelerate
death. Suitable clothings will delay death. Active physical
exertion will hasten death. Severe cold will also hasten death.
The Length of Survival Depends Upon the Following:
a. Presence or absence of water.
b. Partial or complete withdrawal of food.
c. Surroundings.
d. Females survive better than males, but children and older
persons die quickly.
e. Condition of the body.
Symptoms:
1. Acute feeling of hunger for the first 30 to 48 hours and this is
succeeded by localization of the pain at the epigastrium which
can be relieved by pressure.
2. A feeling of extreme thirst.
3. The face is pale and cadaverous.
4. Four or five days later, there is a general emaciation and absorp-
tion of the subcutaneous fat.
5. The eyes are sunkened, glistening dilated pupils and with anxious
expression.
6. The lips and tongue are dry and with cracks, while the breath is
foul and offensive.
7. The voice becomes weak, faint and inaudible.
Post-mortem Findings:
1. External Findings:
a. Body greatly emaciated and emitting a peculiar offensive odor.
b. The eyes are dry, red and open with the eyeballs sunkened.
c. The skin is dry, shrivelled and sometimes with secondary skin
infection.
d. Bed sores may be present.
2. Internal Findings:
a. The muscles are pale, soft, wasted with the subcutaneous fat
almost completely disappeared.
b. There is a general reduction in the size and weight of all organs,
except the brain.
c. The brain is pale and soft, while meningeal vessels are congested
and frequently, there is a serous effusion in the ventricle.
d. The heart is small, with flabby and pale muscles and generally
empty chambers (brown atrophy).
e. The lungs are edematous with hypostatic congestion.
f. The stomach is small, contracted and empty with the mucous
membrane less stained with bile.
g. The intestine is thin, empty, with its thin and translucent wall
and with the disappearance of the mucosal folds.
h. There may be superficial or extensive ulceration of the colon as
in ulcerative colitis.
i. The liver, spleen, kidneys and pancreas are small and shrunken.
Microscopically, the liver shows necrosis of the central zone.
The liver damage was due to protein deficiency.

8. The skin is dry, rough, wrinkled and emitting a peculiar dis-
agreeable odor.
9. The pulse is weak and the temperature is subnormal.
10. The abdomen is sunkened and the extremities are thin, flaccid
with marked loss of muscular power.
11. The intellect may remain for sometime, later becomes delirious
and convulsion or coma appears before death.
12. Symptoms of secondary infection may later appear on account
of the weakened resistance of the body.
Cause of Death:
1. Inanition
2. Circulatory failure due to brown atrophy of the heart
3. Intercurrent infection
j. The gall bladder is distended with bile while the urinary bladder
is empty.
k. There is demineralization of bones and in pregnant women, it
may produce osteomalacia.
1. Findings are refenable to concomitant disease which may
develop on account of the diminished resistance.
Effects of Chronic Starvation:
Incomplete withdrawal of food to the body may cause a different
effect. The person will manifest symptoms referrable to the food
deficiency.
1. Deprivation of protein in the diet reduces the amount of protein
in the serum and edema, anemia, leucopenia and weakened
cardiac function develop.
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Chapter VIII

DISPOSAL OF THE DEAD BODY

SPECIAL DEATHS Sec. 1103, Revised Administrative Code:

217
2. Absence of various vitamins in the food for a long period of time
may cause nutritional disturbance:
a. Deficiency in Vitamin A will cause hyperkeratosis of the skin
atrophy of the mucous membrane, drying up of the salivary
and lacrimal glands and night blindness.
b. Deficiency of Vitamin B will cause neuritis, sore tongue, hyper-
trophy of the heart, and other manifestations of beri-berL
c. Deficiency of Vitamin C will cause hemorrhage in various parts
of the body, kidneys, periosteum. Massive hemorrhage in the
gums is observed in adults.
d. Deficiency of Vitamin D and calcium may be followed by
respiratory catarrh, anemia, osteomalacia and skeletal de-
formities.
3. Deficiency of sugar, fat and minerals produce various disturbance
in the body.
Medico-Legal Questions in Death Due to Starvation:
1. Determination whether death was caused by starvation:
It is necessary to examine carefully the internal organs and to
search for the existence of any disease which may possibly be the
cause of death. Some diseases may also lead to pathological
emaciation, like malignant disease, tuberculosis, diabetes mellitus,
anemia and chronic diarrhea. Absence of any disease which may
cause severe emaciation and the presence of a cause for the de-
privation of food are the basis for the diagnosis of death by
starvation.
2. Determination of the cause of the starvation:
Starvation may be suicidal, homicidal or accidental. The
condition of the surroundings, history and previous life of the
victim and his mental condition before he starved must be taken
into consideration in the determination of the cause.
Persons Charged with Duty of Burial:
The immediate duty of burying the body of a deceased person,
regardless of the ultimate liability for the expense thereof, shall
devolve upon the persons hereinbelow specified:
(a) If the deceased was a married man or woman, the duty of
burial shall devolve upon the surviving spouse if he or she
possesses sufficient means to pay the necessary expenses.
( b ) If the deceased was an unmarried man or woman, or a child,
and left any kin, the duty of burial shall devolve upon the
nearest kin of the deceased, if they be adults and within the
Philippines and in possession of sufficient means to defray the
necessary expenses.
(c) If the deceased left no spouse or kindred possessed of suf-
ficient means to defray the necessary expenses, as provided in
the two foregoing subsection, the duty of burial shall devolve
upon the municipal authorities.
Any person upon whom the duty of burying a dead body is im-
posed by law shall perform such duty within forty-eight hours after
death, having ability to do so.
Sec. 1104, Revised Administrative Code:
Right of Custody to body:
A n y person charged by law with the duty of burying the body of a
deceased person is entitled to the custody of such body for the
purpose of burying it, except when an inquest is required by law for
the purpose of determining the cause of death; and, in case of death
due to or accompanied by a dangerous communicable disease, such
body shall until buried remain in the custody of the local board of
health or local health officer, or if there be no such, then in the
custody of the municipal council.
C O N C E P T O F POSSESSION:
The right of custody over a dead body means possession. Posses-
sion means the holding of a thing or enjoyment of a right. The
possession of a thing means two things: either in the concept of

218
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ownership or the holder of a thing keeping it while the ownership
belongs to another.
Literally speaking, the right of custody does not -mean ownership
of a dead body. The possessor cannot exercise the full rights of
ownership.
Kenny (Canada), in his Outlines of Criminal Law (15 ed. p. 219)
cited a case of a group of individuals known as "resurrection men"
who used to disinter dead bodies from cemeteries and sell them to
the anatomy departments of medical colleges. Since the law pro-
vides that the crime of theft or robbery cannot be committed on
things which have no owner, these people were not successfully
prosecuted for theft.
In the case of Philips v. Montreal General Hospital (33 S.C. 483;
14 R . L . 159) decided in Quebec, Canada, it has been held that there
is a right of property in human remains, at least in a limited sense.
The right of possession of a corpse is equivalent to ownership and
any unlawful interference with that right is an actionable wrong.
The surviving spouse has the preferential right and duty to make
arrangements, for the funeral of the deceased spouse and to decide
how the remains should be disposed of. This is also the rule in the
United States, where the superior and preferred right of the surviving
spouse to the burial and any other legal disposition of the remains of
the husband is undisputed (Ameida Vda. de Carillo v. Carillo, 67
Phil. 92).
Executor's Right of Custody Superior to the Right of Spouse Dead
Body:
If ever the deceased left a will stating among other things the
manner his body will be disposed, such provision of the will
if validly executed and allowed, will prevail over the provisions of
the Administrative Code.
An executor is the person mentioned in a will who will carry on
the provision of the will. He is duty-bound to execute whatever is
stated in the will after the death of the decedent. But, in the ab-
sence of a testamentary disposition, the right of the surviving spouse
is paramount.
In the case of Hunter v. Hunter, decided in Ontario, Canada (65
O . L . R . 586), the deceased had been a staunch and devout Pro-
testant and an Orangeman. His wife is an equally devout Catholic.
At the time of his last illness he expressed a wish to be buried in
the place where his wife would be buried, which was taken to
mean, in a Roman Catholic cemetery. He was then received into
the Roman Catholic Church and died about three weeks later.
One of the deceased's son-the plaintiff in the case-has been named
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executor of the will, and claimed the body for burial, which he
intended should be in a Protestant cemetery. This was resisted
by the widow who contended that her husband should be buried
in a cemetery of the church he had joined recently. The court
maintained the son's claim holding that, as executor, he had a right
to have the body for the purpose of burial. The wife was pre-
vented from interfering with that right (Cited by Meridith).
METHODS OF DISPOSAL OF THE D E A D B O D Y :
1. Embalming:
Embalming is the artificial way of preserving the body after
death by injecting 6 to 8 quarts of antiseptic solutions of formalin,
perchloride of mercury or arsenic, which is carried into the com-
mon carotid and the femoral arteries. Usually, alcohol is added
to minimize the strong odor of the chemical and glycerine to
lessen the evaporation of water from the tissues of the body. If
the preservation of the body is for a longer time, the abdominal
and thoractic viscera are removed, washed and soaked in strong
antiseptic solution before they are returned. The skin is painted
with vaseline or covered with plaster of Paris to prevent too much
evaporation.
2. Burial or Inhumation:
a. The body must be buried within forty-eight hours after death:
Sec. 1092, Revised Administrative Code:
Time within which body shall be buried:
Except when required for the purposes of legal investigation
or when specifically authorized by the local health authorities, no
unembalmed body shall remain unhurried longer than forty-
eight hours after death; and after the lapse of such period the
permit for burial, interment, or cremation of any such body
shall be void and a new permit must be obtained.
When it has been certified or is known that any person died
of, or with a dangerous communicable disease, the body of such
person shall be buried within twelve hours after death, unless
otherwise directed by the local board of health or other health
authority.
The dead body must be buried within forty-eight hours after
death except:
( 1 ) When it is still a subject matter of legal investigation;
( 2 ) When it is specifically authorized by the local health author-
ities that the body may be buried more than 48 hours
after death;
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( 3 ) Impliedly when the body is embalmed.
If the person died of communicable disease, the body must
be buried within 12 hours unless the local health officer permits
otherwise.
If the body is not buried within 48 hours after death, the
permit previously issued is deemed cancelled and there is a
need of a new permit.
Considering the climatic conditions in the Philippines, the
time limit provided for by law regarding burial time should be
reduced to 24 hours instead of 48 hours. Decomposition of
the body in tropical countries, like the Philippines, is relatively
rapid.
b. Death Certificate Necessary before Burial:
Sec. 1087, Revised Administrative Code:
Requirement of Certificate of Death — By whom to be issued:
Except in cases of emergency, no dead body shall be buried
without a certificate of death. If there has been a physician in
attendance upon the deceased, it shall be the duty of the said
physician to furnish required certificate. If there has been no
physician in attendance, it shall be the duty of the local health
officer or of any physician to furnish such certificate. Should
no physician or medical officer be available, it shall be the duty
of the mayor, the secretary, or of a councilor of the munici-
pality to furnish the required certificate.
Sec, 91, P.D. 856 Code of Sanitation — Burial Requirement:
The burial of remains is subject to the following requirements:
( a ) No remains shall be buried without a death certificate.
This certificate shall be issued by the attending physician.
If there has been no physician in attendance, it shall be
issued by the mayor, the secretary of the municipal
board, or a councilor of the municipality where the death
occurred. The death certificate shall be forwarded to
the local civil registrar within 48 hours after death.
The death certificate shall be forwarded by the person issuing
it to the municipal secretary within forty-eight hours after death.
The law requires the necessity of a death certificate before
burial, except in emergency cases. The following may sign the
death certificate:
( 1 ) The attending physician, if there is any;
( 2 ) The local health (municipal health officer) if there is no
physician in attendance;
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(3) The municipal mayor, if there is no local health officer and
no physician in attendance;
(4) The municipal secretary, in the absence of the mayor;
( 5 ) Any councilor.
The order in the enumeration is exclusive and successive.
The presence of the preceding person will exclude the
succeeding person in the enumeration.
Inasmuch as almost all municipalities of the Philippines
have municipal health officers; the municipal mayor,
secretary and any of the councilors are practically inhibited
to sign the death certificate.
It appears unusual and contrary to the intent and purpose
of the death certificate when persons not qualified to know
the cause of death, are authorized by law to sign it.
This provision of the Administrative Code was pro-
mulgated during the time when physicians were quite
scarce.
c. Permission from the Provincial Fiscal or from the Municipal
Mayor is Necessary if Death is Due to Violence or Crime:
Sec. 1089, RevisedAdministrative Code:
Proceedings in case of suspected violence or crime:
If the person who issues a death certificate has any reason to
suspect or if he shall observe any indication of violence or
crime, he shall at once notify the justice of the peace, if he be
available, or if neither the justice of the peace nor the auxi-
liary justice be available, he shall notify the municipal mayor,
who shall take proper steps to ascertain the circumstances and
cause of death; and the corpse of such deceased person shall
not be buried or interred until permission is obtained from the
provincial fiscal, if he be available, and if he be not avail-
able, fjom the mayor of the municipality in which the death
occurred.
Sec. 91 ( f ) , P . D . 856 Code of Sanitation:
If the person who issues a death certificate has reasons to
believe or suspect that the cause of death was due to violence
or crime, he shall notify immediately the local authorities
concerned. In this case the deceased shall not be buried until
a permission is obtained from the provincial or city fiscal. If
these officials are not available, permission shall be obtained
from any government official authorized by the law.
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In cases of death wherein violence or crime is suspected, it is
necessary to notify the following in order to determine the
circumstances and nature of death:
( 1 ) Justice of the peace.
( 2 ) Auxiliary justice of the peace, if the former is not available.
But the permission for burial may only be granted by:
(1) Provincial fiscal.
( 2 ) Municipal mayor if the fiscal is not available.
Sec. 1090, Revised Administrative Code:
Burial and transfer permits:
Municipal secretaries, in the capacity of secretaries of munici-
pal boards of health in places where such boards have been
organized, or, in places where there are no municipal boards of
health, in the capacity of clerks to municipal councils, shall,
upon the presentation of death certificates, issue permits for
the burial or transfer of the dead and shall record on said certi-
ficates the place of interment and when practicable the number
of the grave from which the body or remains have been trans-
ferred, and the disposition that is to be made of such body or
remains. No permit shall be granted by any municipal secretary,
or by any other person, to inter or disinter, bury or remove for
burial, any human body or remains until a certificate of death,
as hereinbefore required, shall have been filed; when it is
impossible to secure a death certificate in the form and manner
hereinbefore provided, municipal secretaries may issue the same
upon such data as may be obtainable.
In case of the transfer of bodies or remains from one munici-
pality to another municipality, a copy of the death certificate
shall accompany the transfer permit.
Sec. 1094, Revised Administrative Code:
Disposition of body and belonging of person dying of dangerous
communicable disease:
The body of a person dead of any dangerous communicable
disease shall not be carried from place to place, except for the
purpose of burial or cremation. It shall be the duty of the local
health authorities to cause such body to be thoroughly dis-
infected before being prepared for burial and the house, fur-
niture, wearing apparel, and everything capable of conveying
or spreading infection shall also be disinfected or destroyed £ y
fire. The local health authority, if there be any, subject to the
approval of the Director of Health, shall,consistently with the
provisions hereof, prescribe the conditions under which the
bodies of persons dying of a dangerous communicable disease
shall be buried or cremated.
Sec. 91 ( h ) , P.D. 856 Code of Sanitation:
When the cause of death is a dangerous communicable
disease, the remains shall be buried within 12 hours after death.
They shall not be taken to any place of public assembly. Only
the adult members of the family pf the deceased may be per-
mitted to attend the funeral.
Sec. 1091, Revised Administrative Code:
Burial permit (Death Certificate) must be presented before
burial:
No sexton, superintendent, or other person having charge of
a burial ground or cemetery shall assist in, assent to or allow
any interment, disinterment or cremation to be made until a
permit from the municipal secretary, authorizing the same, has
been presented.
Placing of body in overground tomb:
Sec. 1099, Revised Administrative Code:
Exhibition of permit to sexton:
The placing of the body of any deceased person in an un-
sealed overground tomb is prohibited, unless the coffin, or
casket containing the remains shall be permanently sealed.
The provision shall not apply to tombs and vaults which are
strictly receiving vaults for bodies or remains awaiting final
disposition, nor to embalmed bodies awaiting final disposition.
The depth of the grave must be at least 1-1/2 meters:
Sec. 1100, Revised Administrative Code:
Depth of grave:
A grave shall be dug, when practicable, to a depth of one and
one-half meters and after the implacement of the body shall be
well and firmly filled.
Sec. 91 ( c ) , P.D. 856 Code of Sanitation:
Graves where remains are buried shall be at least one and one-
half (1-1/2) meters deep and filled well and firmly.
The Law Penalizes Desecration of Burial Premises:
Sec. 2695, Revised Administrative Code:
Desecration of burial premises:
Any person who wantonly or maliciously defaces, breaks, or
destroys any tomb, ornament, or gravestone erected to any
deceased person, or any momento or memorial, or any plant,
tree or shrub pertaining to places of burial of a dead body, or
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Att. 306, Civil Code:

who shall wantonly or maliciously remove any fence, post, or
wall or any burial ground or cemetery, shall be punished by a
fine of not more than two hundred pesos or by imprisonment
for not more than six months, or both.
Although it did not totally repeal the provision of the Ad-
ministrative Code, The Code of Sanitation provides:
Burial Grounds Requirements: (Sec. 90, Code of Sanitation,
P.D. 856)
The following requirements shall be applied and enforced:
a. It shall be unlawful for any person to bury remains in
places other than those legally authorized in conformity
with the provisions of the Chapter.
b. A burial ground shall at least be 25 meters distant from any
dwelling house and no house shall be constructed within
the same distance from any burial ground.
c. No burial ground shall be located within 50 meters from
any source of water supply.
Other Burial Requirements:
The burial of remains is subject to the following requirements:
( 1 ) Shipment of remains abroad shall be governed by the rules
and regulations of the Bureau of Quarantine.
( 2 ) The burial or remains in city or municipal grounds shall not
be prohibited on account of race, nationality, religious or
political persuasion.
( 3 ) Except when required by legal investigation or when per-
mitted by the local health authority, no unembalmed
remains shall remain unburied longer than 48 hours after
death.
FUNERALS:
Art. 305, Civil Code:
The duty and the right to make arrangements for the funeral of
a relative shall be in accordance with the order established for
support, under article 294. In case of descendants are of the same
degree, or of brothers and sisters, the eldest shall be preferred. In
case of ascendants, the paternal shall have a better right.
The order mentioned in the article 294 is as follows:
a. The spouse;
b. The descendants of the nearest degree;
c. The ascendant, also of the nearest degree;
d. The brothers and sisters.
Every funeral shall be in keeping with the social position of the
deceased.
Art. 307, Civil Code:
The funeral shall be in accordance with the expressed wishes of
of the deceased. In the absence of such expression, his religious
belief or affiliation shall determine the funeral rites. In case of
doubt, the form of funeral shall be decided upon by the person
obliged to make arrangement for the same, after consulting the
other members of the family.
Art. 309, Civil Code:
Any person who shows disrespect to the dead, or wrongfully
interferes with a funeral shall be liable to the family of the de-
ceased for damages, material or moral.
This provision is further implemented by the Revised Penal
Code by considering it a criminal act. The funeral rite is a reli-
gious ceremony or manifestations of any religion.
Art. 132, Revised Penal Code:
Interruption of religious worship:
The penalty of prision correccional in its minimum period shall
be imposed upon any public officer or employee who shall prevent
or disturb the ceremonies or manifestations of any religion.
If the crime shall have been committed with violence, or threat,
the penalty shall be prision correccional in its medium and maxi-
mum periods.
Art. 133, Revised Penal Code:
Offending the religious feeling:
The penalty of arresto mayor in its maximum period to prision
correccional in its minimum period shall be imposed upon anyone
who, in a place devoted to religious worship or during the cele-
bration of any religious ceremony shall perform acts notoriously
offensive to the feeling of the faithful.
Art. 2219, Civil Code provides that moral damages may be
recovered for acts mentioned in Art. 309, Civil Coda)
Limitations to the Funeral Rites:
a. Will of Deceased:
The deceased during his lifetime may have made a will or
expressly stated to his next of kin that his body after his death
must be disposed in the manner he desires.
b. Burial of the person sentenced to death must not be held with
pomp:
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Art. 85, Revised Penal Code:
Provision relative to the corpse of person executed and its
burial:
Unless claimed by his family, the corpse of the culprit shall,
upon the completion of the legal proceedings subsequent to the
execution, be turned over to the institute of learning or scien-
tific research first applying for it, for the purpose of study and
investigation, provided that such institute shall take charge of
the decent burial of the remains. Otherwise, the Director of
Prisons shall order the burial of the body of the culprit at
government expense, granting permission to be present thereat
to the members of the family of the culprit and the friends of
the latter. In no case, shall the burial of the body of the person
4. Cremation:
sentenced to death be held with pomp.
c. Restriction as to funeral ceremonies in cases of deaths due to
communicable disease:
Sec. 1105, Revised Administrative Code:
Restrictions as to funeral ceremonies in certain cases:
In case of death due to dangerous communicable disease or
due to any epidemic recognized by the Director of Health, the
body of the deceased shall not be taken to any place of public
assembly, nor shall any person be permitted to attend the
funeral of such deceased person, except the adult members of
the immediate family of the deceased, his nearest friends, not
exceeding four, and other persons whose attendance is absolute-
ly necessary. After the deceased shall have been buried for a
period of one hour, a public funeral may be held at the grave
or in a place of public assembly or elsewhere.
not suffering from dangerous communicable disease. Such manner
of disposal may be the will of the deceased or a part of religious
practice.
Sec. 1093, Revised Administrative Code:
Permit for conveyance of body to sea for burial:
Where death is not due to a dangerous communicable disease a
special permit may, upon written request, be issued, by the
officer authorized to issue burial permits, for the conveyance of
a dead body to sea for burial. In such cases, the body must be
transported in the manner prescribed by the municipal board of
health, if such there be, and the marine laws governing burial at
sea must be complied with.
Cremation is the pulverization of the body into ashes by the
application of heat.
The body must first be identified before cremation, and no
cremation must be made unless there is a permit to do so. Cre-
mation must be made in a crematory made for the purpose.
The time required to transform the human body to ashes is
dependent upon the degree or intensity of heat applied, duration
of the application of heat, physical condition of the body and the
presence of clothings and other protective materials in the body.
In a gas incinerator, it usually requires about four hours to trans-
form the whole body into ashes.
Instances When Permission for Cremation Must N o t Be Granted:
a. If the deceased left a written direction that he or she must not
be cremated.

In case of death due to other causes the right to hold public
funerals in an orderly manner and to take the remains of the
deceased into churches or other places for this purpose shall not
be interferred with.
Sec. 91 ( h ) , P.D. 856 Code of Sanitation:
When the cause of death is a dangerous communicable
disease, the remains shall be buried within 12 hours after death.
They shall not ba taken to any place of public assembly. Only
adult members of the family of the deceased may be permitted
to attend the funeral.
3. Disposing of the Dead Body in the Sea:
Some dead bodies are not buried, embalmed or cremated but
thrown over board in an open sea provided that the deceased is
b. If the exact identity of the deceased has not yet been definitely
ascertained.
c. When the exact cause of death cannot be definitely ascertained
and further inquiry or examination may be needed (Forensic
Medicine by Kerr, 4th ed., p. 22).
5. Use of tiie Body for Scientific Purposes:
Sec. 97, P.D. 856, Code of Sanitation:
Use of remains for medical studies and scientific research:
Unclaimed remains may be used by medical schools and scien-
tific institutions for studies and research subject to the rules and
regulations prescribed by the Department.
Sec. 1107, Revised Administrative Code:
Use of dead body for scientific purposes:
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The body of any deceased person which is to be buried at
public expense and which is unclaimed by relatives or friends for
a period of twenty-four hours after death shall be subject to the
disposition of the Bureau of Health, and, by order of the Director
of Health, may be devoted to the purposes of medical science and
to the advancement and promotion of medical knowledge and
information, subject to such regulations as said Director of Health,
with the approval of the Department Head, may prescribe. The
regulations of the Director of Health shall provide for the decent
burial of the remains of such bodies and for defraying the neces-
sary expenses incident thereto. Except as herein provided, it shall
be unlawful for any person to make use of any dead body for any
scientific investigation other than that of performing an autopsy.
Corpse of prisoners after judicial execution may be turned over to
institution of learning or scientific research:
Art. 85, Revised Penal Code:
Provisions relative to the corpse of the person executed and its
burial:
Unless claimed by the family, the corpse of the culprit shall
upon completion of the legal proceedings subsequent to the
execution, be turned over to the institute of learning or scientific
research first applying for it, for the purpose of study and inves-
tigation, provided that such institution shall take charge of the
decent burial of the remains. Otherwise, the Director of Prisons
shall order the burial of the body of the culprit at government
expense, granting permission to be present thereat to the members
of the family of the culprit and the friends of the latter. In no
case shall the burial of the body of a person sentenced to death
be held with pomp.
Sec. 98, P.D. 856, Code of Sanitation:
Special precautions for safe handling of cadavers containing
radioactive isotopes:
a. Cadavers containing only traces (very small dose) of radioactive
isotope do not require any special handling precautions.
b. Cadavers containing large amounts of radioactive isotopes
should be labelled properly identifying the type and amount of
radioactive isotopes present and the date of its administration.
c. Before autopsy is performed, the Radiation Health Officer or
his duly authorized representative should be notified for proper
advice. The pathologist and/or embalmer should be warned
accordingly of the radioactivity of the cadaver so that radiation
precautions can be properly enforced.
d. Normal burial procedures, rules and regulations may be carried
out on the above-mentioned cadaver provided that their amount
of radioactivity has decayed to a safe level which will be deter-
mined by the Radiation Health Officer or his authorized re-
presentative.
e. Cremation — If cremation is performed without autopsy, there
is no handling problem; otherwise, autopsy precautions should
be strictly enforced. Precautions should be taken to prevent
any possible concentration of radioactivity at the base cf the
stack of the crematorium.
DONATION OF PART(S) OF HUMAN BODY
PERMISSIONS T O USE H U M A N O R G A N S O R P O R T I O N S O F
THE H U M A N B O D Y F O R M E D I C A L , S U R G I C A L , O R SCIEN-
TIFIC PURPOSES, U N D E R C E R T A I N C O N D I T I O N S
Republic Act N o . 349 as amended by
Republic Act 1056
A N A C T T O L E G A L I Z E P E R M I S S I O N S T O USE H U M A N OR-
G A N S O R A N Y P O R T I O N O R P O R T I O N S O F THE H U M A N
B O D Y F O R M E D I C A L , S U R G I C A L , O R SCIENTIFIC PUR-
POSES, U N D E R C E R T A I N C O N D I T I O N S
Sec. 1. Any person may validly grant to a licensed physician,
surgeon, known scientist, or any medical or scientific institution,
including eye banks and other similar institutions, authority to
detach at any time after the grantor's death any organ, part or parts
of his body and to utilize the same for medical, surgical or scien-
tific purposes.
Similar authority may also be granted for the utilization for
medical, surgical, or scientific purposes, of any organ, part or parts
of the body which, for a legitimate reason, would be detached
from the body of the grantor.
Sec. 2. The authorization referred to in section one of this Act
must: be in writing; specify the person or institution granted the
authorization; the organ, part or parts to be detached, the specific
use or uses to which the organ, part or parts are to be employed;
and, signed by the grantor and two disinterested witnesses.
If the grantor is a minor or an incompetent person, the author-
ization may be executed by his guardian with the approval of the
court; in default thereof, by the legitimate father or mother, in the
order named. Married women may grant the authorization re-
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b. A married person may make such donation without the consent

ferred to in section one of this Act, without the consent of the of his spouse.
husband.
c. After the death of a person the next of kin may authorize the
After the death of the person, authority to use human organs donation of an organ or any part of the body of the deceased
or any portion or portions of the human body for medical, sur- for similar purposes in accordance with the prescribed procedure.
gical or scientific purposes may also be granted by his nearest
d. If the deceased has no next of kin and his remains are in the
relative or guardian at the time of his death or in the absence
custody of an accredited hospital, the Director of the hospital
thereof, by the person or head of the hospital, or institution
may donate an organ or any part of the body of the deceased
having custody of the deceased. Provided, however, that the said
in accordance with the requirements prescribed in this Section.
person or head of the hospital or institution has exerted reason-
able efforts to locate the aforesaid guardian cr relative.
e. A simple written authorization signed by the donor in the
presence of two witnesses shall be deemed sufficient for the
A copy of every such authorization must be furnished the donation of organs or parts of the human body required in this
Secretary of Health. Section, notwithstanding the provisions of the Civil Code of the
Sec. 2-A. The provisions of sections one and two of this Act Philippines on matters of donation. A copy of written author-
notwithstanding, it shall be illegal for any person or any insti- ization shall be forwarded to the Secretary.
tution to detach any organ or portion of the body of a person
f. A n y authorization granted in accordance with the requirements
dying of a dangerous communicable disease even if said organ or
of this Section is binding to the executors, administrators, and
portions of the human body shall be used for medical or scientific
members of the family of the deceased.
purposes. A n y person who shall violate the provisions of this
section shall be punished with an imprisonment of not less than Persons w h o can grant permission to detach, after death, human
six months nor more than one year. If the violation is com- organs or part or parts of the human body for medical, surgical
mitted by an institution, corporation or association, the director, and other scientific purpose:
manager, president, and/or other officials and employees who,
a. Before Death:
knowingly or through neglect, perform the act or acts resulting
( 1 ) By the deceased during his lifetime.
in said violation shall be held criminally responsible therefore.
( 2 ) If the deceased is a minor or incompetent, permission may
Sec. 3. An authorization granted in accordance with the provi-
be executed by the guardian with the approval of the court
sions of this Act shall bind the executors, administrators and
or by the legitimate father or mother. A married woman
successors of the deceased and all members of his family.
may give consent without the consent of the husband.
Sec. 4. Any law or regulation inconsistent with the Act are
b. After Death:
hereby repealed.
(1) The nearest relative.
Sec. 5. This Act shall take effect upon its approval.
(2) In the absence of the nearest relative, permission may be
A P P R O V E D , May 17, 1949, Amendment Approved June 12,
given by the head of the hospital or institution having
1954.
custody of the deceased.
Sec. 96, Code of Sanitation ( P . D . 856).
Persons permitted to detach human organs, or parts of the human
Donation of Human Organs for Medical, Surgical and Scientific
Purposes According to the Sanitation Code ( P . D . 856):
body for medical, surgical and other scientific use:
Any person may donate an organ or any part of his body to a a. Licensed physicians and surgeons.
person, a physician, a scientist, a hospital or a scientific institu- b. Known scientists.
tion upon his death for transplant, medical, or research purposes c. Medical or scientific institutions including eye-banks.
Bubject to the following requirements:
Requirements for a Valid Authorization:
a. The donation shall be authorized in writing by the donor
specifying the recipient, the organ or part of his body to be a. It must be in writing.
donated and the specific purpose for which it will be utilized. b. It must specify the person or institution granted the author-
ization.
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c. It must specify the organ or part of the body to be detached.
d. It must be signed by the grantor and two disinterested persons.
e. A copy of the authorization must be furnished to the Secretary
of Health.
Limitation to the Authorization:
It will be illegal to removed organs or portions of the human
body if the deceased died of a dangerous communicable disease.
Penal Provision:
Imprisonment of not less than six months nor more than one
year. If committed by an institution, the director, manager,
president or other officials or employees who knowingly or
through neglect performed an act or acts resulting in said violation
shall be criminally responsible.
EXHUMATION:
The deceased buried may be raised or disinterred upon the
lawful order of the proper authorities. The order may come from
the provincial or city fiscals, from the court, and from any entity
vested with authority to investigate.
If the body is exhumed for the purpose of performing post-
mortem examination, no deodorant must be applied to the body
for it might interfere in the detection of, chemicals. After the
body has been disinterred, it must be identified by relatives,
friends, or by marks on the body. The physician must describe
the coffin, clothings, degree of decomposition before stating the
actual disease or violence in his report.
Sec. 1082, Revised Administrative Code:
Cemetery permits — It shall be unlawful to establish, maintain,
enlarge, reopen, or remove any burial ground or cemetery, or to
disinter a human body or human remains, until a permit therefor,
approved by the Director of Health, shall have been obtained.
Questions: Is the National Bureau of Investigation required to
obtain a permit from the Director of Health for exhumation of a
dead body in the course of a legal investigation conducted by it?
The query was made on the presumption that the one to perform
the exhumation is a physician who is in a capacity to protect
public health.
Answer: In the opinion rendered by the Secretary of Justice the
answer is yes. Sec. 1082 and 1095 of the Revised Administrative
Code requiring a permit in disinterring a human or human remains
from the Director of Health also extends to cases where exhu-
mation has to be done for an autopsy by any person authorized
to do so in the course of a legal investigation. The language of
those two sections are clear and absolute in terms and admits of
no exception. Nor any exception to the said requirement be
found in any of the provisions dealing with legal investigations.
This is so because the purpose of the requirement of said permit is
the protection of health which may not be sacrificed where a
legal investigation is being conducted (Opinion of the Secretary of
Justice, No. 26, series of 1954).
Sec. 1095, Revised Administrative Code:
Permit to disinter after three years — Treatment of remains:
Permission to disinter the bodies or remains of persons who
have died of other dangerous communicable disease, may be
granted after such bodies had been buried for a period of three
years; and, in special cases, the Director of Health may grant
permission to disinter after a shorter period when in his opinion
the public health will not be endangered thereby.
The body or remains of any such deceased person, upon ex-
humation, shall be immediately disinfected and inclosed in a
coffin, case, or box, securely fastened, and this coffin, case, or
box shall be placed in sn outside box which shall also be securely
fastened.
Sec. 1096, Revised Administrative Code:
Special permit to disinter embalmed body or to remove from
receiving vault for transfer:
Special permits may be issued at any time for the disinterment
or exhumation of remains of persons, dying of other than danger-
ous communicable disease, that have been properly embalmed
by an undertaker or embalmer, or for the transfer or removal of
bodies that have been placed in a receiving vault awaiting trans-
portation from the Philippines. Boxes containing the bodies
or remains shall be plainly marked so as to show the name of the
deceased, place of death, cause of death and the point to which
such bodies or remains are to be shipped.
Sec. 1097, Administrative Code:
Exhumation in case of death from dangerous communicable
disease:
Bodies or remains of persons who have died of any dangerous
communicable disease may be exhumed only after the lapse of five
years from burial, though in special cases the Director of Health
may grant a permit to disinter after a shorter period when in his
opinion the public health will not be endangered thereby.
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DISPOSAL OF THE DEAD BODY 236 LEGAL MEDICINE
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In every such case, the body or remains, after being disinfected
must be placed in a suitable and hermetically sealed container!
Sec. 92, Code of Sanitation — Disinterment Requirements:
Disinterment of remains is subject to the following requirements;
a. Permission to disinter remains of persons who died of non-
dangerous communicable diseases may be granted after a burial
period of three ( 3 ) years.
b. Permission to disinter remains of persons who died of dangerous
communicable diseases may be granted after a burial period of
five ( 5 ) years.
c. Disinterment of remains covered in paragraphs "a" and " b " of
this Section may be permitted within a shorter time than that
prescribed in special cases, subject to the approval of the
Regional Director concerned or his duly authorized represen-
tative.
d. In all cases of disinterment, the remains shall be disinfected and
placed in a durable and sealed container prior to their final
disposal.
Art. 308, Civil Code:
No human remains shall be retained, interred, disposed of or
exhumed without the consent of the persons mentioned in articles
294 and 305.
The persons mentioned in articles 294 are:
( 1 ) Spouse;
( 2 ) Descendants of the nearest degree;
( 3 ) Ascendants of the nearest degree; and
( 4 ) Brothers and sisters.
Sec. 92 (b & c), ( P . D . 856) Code of Sanitation — Disinterment
requirements:
a
b. Permission to disinter remains of persons who died of
dangerous communicable diseases may be granted after
burial period of five ( 5 ) years.
c. Disinterment of remains covered in paragraphs "a" and " b "
of this Section may be permitted within a shorter time than
that prescribed in special cases, subject to the approval of
the Regional Director concerned or his duly authorized
representative.
b. If a person died of a cause other than dangerous communicable
disease, permission for exhumation may be granted after such
body had been buried for a period of three ( 3 ) years. However,
in special cases the Director of Health may grant permission
after a shorter period when in his opinion the public health will
not be endangered thereby.
Sec. 1095, Revised Administrative Code — Permit to disinter
after three years — Treatment of Remains — Permission to
disinter the bodies or remains of persons who have died of other
than dangerous communicable disease, may be granted after
such bodies had been buried for a period of three years; and, in
special cases, the Director of Health may grant permission to
disinter after a shorter period when in his opinion the public
health will not be endangered thereby.
Sec. 92 ( a ) , ( P . D . 856) Code of Sanitation — Disinterment
requirement — Permission to disinter remains of person who
died of non-dangerous communicable diseases may be granted
after a burial period of three ( 3 ) years.

How Long Can Exhumation Be Done After Interment:
a. If the person died of dangerous communicable disease, the dead
body may be exhumed only after a lapse of five years from the
date of burial. However, permit to disinter may be given after
a shorter period when in the opinion of the Director of Health
it will not endanger public health.
Sec. 1097, Administrative Code — Exhumation in case of death
from dangerous communicable disease — Bodies or remains of
persons who have died of any dangerous communicable disease
may be exhumed only after the lapse of five years from burial,
though in special cases the Director of Health may grant a
permit to disinter after a shorter period when in his opinion
the public health will not be endangered thereby.
c. Sec. 1098, Revised Administrative Code — Shipment of remains
by sea — No body or remains shall be shipped to the United
States except under such conditions and regulations as may be
prescribed by the United States Public Health Service. The
outside box containing the body or remains of a deceased
person intended for shipment by sea shall be plainly marked so
as to show the name, age, nationality of the deceased person,
the cause of death, and the destination of the remains.
d. If the dead body is a subject matter of criminal investigation it
may be exhumed anytime.
Sec. 95 ( b ) , ( P . D . 856) Code of Sanitation — Autopsy shall be
performed in the following cases — ( 4 ) Whenever the Solicitor
General, Provincial or city fiscal as authorized by existing laws,
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DISPOSAL OF THE DEAD BODY 238 LEGAL MEDICINE
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shall deem it necessary to disinter and take possession of the
remains for examination to determine the cause of death.
Requirements to be Satisfied in Exhumation:
a. Duration of interment as required (supra).
b. Exhumation permit:
Sec. 1082, Revised Administrative Code — Cemetery permits
— It shall be unlawful to establish, maintain, enlarge, reopen,
or remove any burial ground or cemetery, or to disinter a
human body or human remains, until a permit therefor, ap-
proved by the Director of Health, shall have been obtained.
c. Compliance of the sanitary requirements:
Sec. 1095,2nd. par., Revised Administrative Code —Permit to
disinter after three years — The body or remains of any such
deceased person, upon exhumation, shall be immediately
disinfected and inclosed in a coffin, case, or box, as securely
fastened, and this coffin, case, or box shall be placed in an
outside box which shall also be securely fastened.
Sec. 92 ( d ) , ( P . D . 856) Code of Sanitation — In all cases of
disinterment, the remains shall be disinfected and placed in a
durable and sealed container prior to their final disposal.
Procedures Followed in Medico-Legal Exhumations:
a. There must be a formal request from any of the law enforce-
ment agency or any entity or person authorized by law to make
investigation addressed to any establishment or person author-
ized to perform medico-legal investigation. The request must
mention the name of the deceased, place of interment, date of
interment, suspicion as to the cause of death, etc. The reason
for the request may be:
( 1 ) To determine the cause of death;
( 2 ) To determine the identity of the deceased;
( 3 ) To recover organs or tissues for further examination:
( a ) For toxicological analysis,
( b ) For histopathological examination,
(c) Smears from vaginal canal and blood for alcohol deter-
mination; or
( 4 ) To recover foreign bodies:
( a ) Metallic fragment or whole slug for ballistic examination.
( b ) Operative sponge, medical instrument to prove neg-
ligence of surgeon.
b. If the physician found out that there is justification to the
exhumation and a strong probability for the purpose to be
realized, he may then set the date and time of the exhumation.
c. A written request for exhumation of the body of the deceased
must be sent to the Ministry of Health or the Regional Director
concerned, mentioning among other things:
(1) Name of the deceased.
(2) Place of exhumation.
( 3 ) Date and time of exhumation.
( 4 ) Duration of interment.
( 5 ) Purpose of exhumation.
The Ministry of Health aside from issuing the necessary
permit together with the conditions to be complied with, will
inform the local health officer concerned to assist the physician
to perform the exhumation to see to it that public health will
not be prejudiced.
d. During actual exhumation, the grave must be properly iden-
tified by the person who was present when the body was
interred.
e. During the process of disinterment care and diligence must be
observed to avoid destruction, deformity, contamination or
such other effects that will prevent the realization of its ob-
jectives.
f. After opening the coffin, the body must be viewed by any or
more persons who can identify the deceased. The names of the
person who identified the grave, who viewed and identified the
deceased must be included in the report. The exhuming physi-
cian must describe the coffin, wearing apparel and condition of
the body.
g. Actual autopsy and adoption of the procedure is needed to
accomplish the purpose of the exhumation.
h. Disinfection of the body and all the areas involved must be
carried out with the assistance of the local health officer and
return of the body to the burial place.
What must be Included in the Exhumation Report:
a. The name of the deceased and the personal circumstances (age,
sex, civil status, address, occupation, etc.).
b. The purpose(s) of exhumation;
c. The name, address and designation of the requesting party;
d. The date, time and place of exhumation;
e. The description of the burial place;
f. The name and address of person(s) who identified the burial
place;
g. The condition of the body and coffin (if there is) after dis-
interment.
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Chapter IX

DISPOSAL OF THE DEAD BODY
239
h. The name and address of the person(s) who identified the body
of the deceased;
i. The post-mortem examination and accomplishment of the
pnrpose(s) of the exhumation;
j. The conclusion(s) based on the findings and result of the
examination;
k. Remarks (if any); and
1. The signature and designation of the physician.
Some Problems in Exhumation:
a. Identity of the deceased:
The exhumed buried deceased might not be subject-matter
of exhumation especially when the burial ground is a cemetery.
Mass burial of "salvaging" victims or disaster victims may cause
serious problem to the physician. There must be a meticulous and
time consuming attempt of the exhuming physician to establish
identity in order that his report may be of some value in the
investigative or judicial proceedings.
b. Refusal of the next-of-kin to give consent or to cooperate in the
exhumation-autopsy:
This situation is frequently observed when the next-of-kin
has a strong possibility to be involved in the investigation.
The proper remedy to this situation is to petition the court
to issue an order to exhume the body stating the specific
reasons why exhumation-autopsy will serve the best interest
of justice.
MEDICO-LEGAL ASPECTS OF
PHYSICAL INJURIES
Physical injury is the effect of some forms of stimulus on the body.
The effect may only be apparent when* the stimulus applied is
insufficient to cause injury and the body resistance is great. It may
be real when the effect is visible.
The effect of the application of stimulus may be immediate or
may be delayed. A thrust to the body of a sharp pointed and sharp
edged instrument will lead to the immediate production of a stab
wound, while a hit by a blunt object may cause the delayed produc-
tion of a contusion.
^ C a u s e s of Physicial Injuries:
A^Thysical Violence
J Br Heat or Cold
J Or Electrical Energy
A ECChemical Energy
\ E. Radiation by Radio-Active Substances
V F Change of Atmospheric Pressure (Barotrauma)
G. Infection
A. PHYSICAL INJURIES BROUGHT ABOUT
BY PHYSICAL VIOLENCE
The effect of the^apphcation of physical violence on a person is
the production ofTwojund: ) f\
A wound is the solution of the natural continuity of any tissue of
the living body. It is the disruption of the anatomic integrity of a
tissue of the body. In several occasions, the word physical injury is
used interchangeably with wound. However, the effect of the phy-
sical violence may not always result to the production of wound, but
the wound is always the effect of physical violence.
Physics of Wound Production:
Wound = Kinetic energy X time X area X "other factors"
2
MV M=Mass V=Velocity
Kinetic Energy =

240
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d. Loss of function — On account of the trauma, the tissue may

Kinetic energy:
Inasmuch as kinetic energy is based on the mass and velocity
factors and that the velocity is squared, the velocity component is
the important factor. This explains why an M-16 bullet which has a
speed or 3,200 ft/sec. will do more damage than a 0.38 caliber bullet
which is heavier but has a much slower velocity.
Time:
The shorter the period of time needed for the transfer of energy,
the greater the likelihood of producing damage. If a person is hit on
the body and the body moves towards the direction of the force
applied, the injury is less as when the body is stationary. The longer
the time of contact between the object or instrument causing the
injury, the greater will be the dissipation of energy.
Area of Transfer:
The larger the area of contact between the force applied on the
body, the lesser is the damage to the body. By applying an equal
force, the damage caused by stabbing is greater compared to a blunt
instrument.
"Other Factors":
The less elastic and plastic the tissue, the greater the likelihood
that a laceration will result. Elasticity and plasticity refer to the
ability of a tissue to return to its "normal" size and shape after being
deformed by a pressure.
The movement of the parts of the body as a result of the force
being applied to them and the local stretching of tissue during
acceleration and deceleration cause most of the internal injuries seen
in traumatized individuals.
A force transmitted through a tissue containing fluid will force the
fluid away from the area of contact in all directions equally, fre-
quently causing the tissue to lacerate (Legal Medicine Annual 1980,
Cyril Wecht ea\, p. 36).
Vital Reaction:
It is the sum total of all reactions of tissue or organ to trauma.
The reaction may be observed macroscopically and microscopically.
The following are the common reactions of a living tissue to trauma:
a. "Rubor" — Redness or congestion of the area due to an in-
crease of blood supply as a part of the reparative mechanism.
b. "Calor" — Sensation of heat or increase in temperature.
c. "Dolor" — Pain on account of the involvement of the sensory
nerve.
not be able to function normally.
The presence of the vital reaction differentiates an ante-mortem
from a post-mortem injury.
In the following instances vital reactions or changes may not be
observed even if injury was inflicted during life:
a. If physical injuries are inflicted during the agonal state of a
living person. The body cells or tissue during the period may no
longer have the potential capacity to react to the trauma; and
b. If death is so sudden as not to give the tissues of the body, the
chance to react properly. This is commonly observed in deaths
due to sudden coronary occlusion.
t / c L A S S I F I C A T I O N OF WOUNDS:
cV^fs to Severity:
&S&ortal Wound — Wound which is caused immediately after
infliction or shortly thereafter that is capable of causing death.
Parts of the Body where the Wounds Inflicted are Considered
Mortal:
(a) Heart and big blood vessels.
(2) Brain and upper portion of the spinal cord.
(3) Lungs.
(4) Stomach, liver, spleen and intestine.
J^f Non-mortal wound — Wound which is not capable of producing
death immediately after infliction or shortly thereafter.
3^. As to the Kind of Instrument Used:
a. Wound brought about by blunt instrument (contusion, hema-
toma, lacerated wound). ~~
b. Wound brought about by sharp instrument:
( 1 ) Sharp-edged instrument~(incised wound).
( 2 ) Sharp-pointed instrument (punctured wound).
( 3 ) Sharp-edged and sharp pointed instrument (stab wound).
c. Wound brought about by tearing force (lacerated wound).
d. Wound brought about by change of atmospheric pressure
(barotrauma).
e. Wound brought about by heat or cold (frostbite, burns or scald).
f. Wound brought about by chemical explosion (gunshot or
shrapnel wound).
g. Wound brought about by infection,
ifc As to the Manner of Infliction:
a. Hit — by means of bolo, blunt instrument, axe.
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b. Thrust or stab — bayonet dagger. accident may suffer from multiple fractures, laceration of
c. Gunpowder explosion — projectile or shrapnel wound. organs, and all types of skin injuries.
d. SlidingTor rubbing or abrasion. When a stationary head is hit by a moving object, there is the
^4^s regards to the Depth of the Wound: tendency for the development of contusion of the brain at the site
of impact.
a. /Superficial — When the wound involves only the layers of the
skin. When the moving head hits a firm, fixed and hard object, brain
contusion may develop at the opposite of the site of impact.
iyDeep — When the wound involves the inner structure beyond
the layers of the skin. A coup-contra-coup location of brain injury may be found
when a fixed head is hit with a moving object and then falls on
{Impenetrating — one in which the wounding agent enters the
another hard object.
body but did not come out or the mere piercing of a solid
organ or tissue of the body. ( ^ 4 s to the Regions or Organs of the Body Involved:
"Penetrating Wound — Wound where the dimension of The wounds of the different organs and regions of the body will
depth and direction is an important factor in its descrip- be discussed separately under "Injuries in Various Parts of the Body.'
tion. It involves the skin or mucous surface and the
deeper underlying tissues or organs caused directly by the 7. Special Types of Wounds:
wounding instrument. Punctured, stab and gunshot wounds a. Defense Wound — Wound which is the result of a person's
/ usually belong to this type of wound." instinctive reaction of self-protection. Injuries suffered by a
(£) Perforating — When the wounding agent produces com- person to avoid or repel potential injury contemplated by the
munication between the inner and outer portion of the aggressor.
hollow organs. It may also mean piercing or traversing A person w h o is conscious that he is going to be hit by a
completely a particular part of the body causing commu- Qblnni instrument on the head may raise his flexed forearms over
nication between the points of entry and exit of the in- his head, causing injuries on the forearms.
strument or substance producing it. f^i^
>. As regards to the Relation of the Site of the Application of Force
and the Location of Injury:
a. Coup Injury — Physical injury which is located at the site of the
application of force, -y. k***'
s
b. Contre-Coup Injury — Physical injury found opposite the site
of the application force.
c. Coup Contre-Coup Injury — Physical injury located at u\e site
and also opposite the site of application of force.

d. "Locus Minoris Resistencia" — Physical injury located not at

the site nor opposite the site of the application of force but in
some areas offering the least resistance to the force applied.
A blow on the forehead may cause contusion at the region of
the eyeball because of the fracture on the papyraceous bone
forming the roof of the orbit.

e. Extensive Injury — Physical injury involving a greater area of

the body beyond the site of the application of force. It has
not only the wide area of injury but also the varied types of
injury. A fall from a height or a run-over victim of a vehicular Incised ( d e f e n s e ) w o u n d
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If someone is going to stab another with Psharp instrument
the tendency of the potential victim is to ta^e~Hbld of the
instrument thus causing the production of an incised or a stab
wound on the palm of the hand. vn-UAj„L
\yPatterned Wound — Wound in the nature and shape of an
object or instrument and which infers the object or instrument
causing it.
Impact of the face on the radiator grill of a car may cause
imprint of the radiator grill on the face.
A person run over by a wheel of a car, tire marks are shown on
the body.
Due to hanging, the nature of the abrasion mark on the neck
may infer material used.
Contusion produced by belt, branch of tree, metallic rod,
etc. may have the shape of the wounding instrument.
jtf Self-inflicted Wound—Self-inflicted wound is a wound produced
on oneself. As distinguished from suicide, the person has no
intention to end his life.
Motive of Producing Self-inflicted Wounds:
(1) To create or deliberately magnify an existing injury or
disease for pension or workman's compensation;
( 2 ) To escape certain'obligations or punishment. During war
time soldiers may cut their fingers to avoid frontline
assignments and prisoners may inflict physical injuries on
their body to avoid hard labor and just be confined in a
hospital to receive food and rest.
( 3 ) To create a new identity or destroy the existing one. Finger-
prints may be destroyed by acid, by cutting or burning. A
person may even Request for the services of a plastic
surgeon to create a new identity or destroy existing ones.
(4) To gain attention or sympathy.
( 5 ) Psychotic behavior.
(5) Trauma inflicted on the female genitalia to induce abor-
tion or promotes hemorrhage and creates an anemia.
( 6 ) Subcutaneous injection of fecal matters to promote
abscess formation.
( 7 ) Pricking of acne eruption to lead to a severe facial dis-
figurement.
( 8 ) Subcutaneous injection of air to create a condition of
emphysema.
( 9 ) Nail-biting (onychophagia) which may lead to maceration
of the skin and an infection.
(10) Grinding of the teeth (bruxism) is frequently seen in the
mentally retarded and can lead to abnormal tooth wear, a
bilateral hypertrophy of the masseter and a pain on
chewing.
(11) Pressure on the subcutaneous tissue by a tightly applied
cord or belt around the body:
(a) Tribal customs of metal band around the heck or a
leg by some African tribes may cause a permanent
disfigurement.
( b ) Use of shoes made of metal by Chinese women.
(12) Pulling of the body hair (Trichotillomania).
(Forensic Medicine A Study in Trauma & Environmental
Hazards by Tedeschi, Eckert & Tedeschi, Vol. 1, p. 496).
LEGAL CLASSIFICATION OF PHYSICAL INJURIES:
utilation:
Art. 262, Revised Penal Code:
The penalty of reclusion temporal to reclusion perpetua shall be
imposed upon any person who shall intentionally mutilate another
by depriving him, either totally or partially, of some essential organ
for reproduction.
A n y other intentional mutilation shall be punished by prision
mayor in its medium and maximum periods.

Some Ways of Self-Mutilation: Kinds of Mutilation Punishable Under the Code:

(1) Head banging or bumping — This is commonly observed
in overactive children and causes hematoma.
(2) Exposure of parts of the body to heat radiation from open
fires, radiators, or protective grills over radiator (thermo-
philia).
(3) Penetrating nail or spike to the chest wall, or insertion into
the urinary bladder in a female.
(4) Castration by amputation of the penis.
1. Intentionally depriving a person, totally or partially of some of
the essential organs for reproduction, and
2. Intentionally depriving a person of any part or parts of the human
body other than the organs for reproduction.
Mutilation is the act of looping or cutting off any part or parts
of the living body. In order to be punishable under the Code, it
must be intentional, otherwise it will be considered as a physical
injury.
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The loss of an eye due to stabbing is not mutilation. It is evident
that the putting out of an eye does not fall under the definition
(U.S. v. Bogel, 7Phil 285).
"Mayhem " is the unlawful and violent deprival of another of the
use of a part of the body so as to render him less able in fighting,
either to defend himself or to annoy his adversary. Mutilation of
other parts of the body other than the organ of reproduction may be
classified as mayhem. However, if it is not deliberate then it may fall on
paragraph 2, Art. 263, Revised Penal Code (Serious Physical Injuries).
Is vasectomy and tubal ligation within the purview of mutilation as
defined and penalized by Art. 262 of the Revised Penal Code?
On September 1973 upon the request of the Executive Director of
the Population Commission, the Secretary of Justice rendered an
opinion that vasectomy and tubal ligation are not mutilation and a
legitimate method of contraception despite the fact that it is done
intentionally and deprives a person of his power of reproduction
because:
"1. In the case of U.S. v. Bogel et. aL 5 Phil. 285 (1907) the Supreme
Court, in holding that the putting out of an eye is not mutilation
under Article 415 of the Spanish Penal Code which penalized
intentional mutilation, stated "Viada in his commentary on
Article 415 which penalized intentional mutilations, points out
that by mutilation (mutilacion) is understood, according to the
"Diccionario de la Lengua Espahola", the looping or clipping
off (ceranamiento) of one part of the body. As this provision
of the Spanish Penal Code was the source of the above quoted
provision of the Revised Penal Code, it is the same expounded
by Viada that the prohibition in the latter provision should be
understood.
Y o u stated that tubal ligation and vasectomy "do not involve
looping or clipping off of the organs of reproduction of both
sexes". I understood that these two methods of surgical steril-
ization are affected by the closing of a pair of tubes in either man
or the woman so that the sperm and ovum cannot meet; it does
not involve the removal of reproductive glands or organs as in
the case of castration, with which it is sometimes confused.
{Encyclopedia Americana, Sterilization, Human Vol. 25, p. 269;
an article written by the Executive Director of the Human
Betterment Association of American, I.C.) Such being the case,
I do not think that these method of contraception could be
regarded as mutilation within the contemplation of Article 262,
Supra."
/ Serious Physical Injuries:
Art. 263, Revised Penal Code:
Any person who shall wound, beat, or assault another, shall be
guilty of the crime of serious physical injuries and shall suffer:
1. The penalty of prision mayor, if in consequence of the physical
injuries inflicted, the injured person shall become insane, imbecile,
impotent, or blind;
2. The penalty of prision correccional in its medium and maximum
periods, if in consequence of the physical injuries inflicted, the
person injured shall have lost the use of speech or the power to
hear or to smell, or shall have lost an eye, a hand, a foot, an arm,
or a leg or shall have lost the use of any such member, or shall
have become incapacitated for the work in which he was thereto-
for habitually engaged;
3. The penalty of prision correccional in its minimum and medium
periods, if in consequence of the physical injuries inflicted, the
person injured shall have become deformed, or shall have lost any
other part of his body, or shall have lost the use thereof, or shall
have been ill or incapacitated for the performance of the work in
which he was habitually engaged for a period of more than ninety
days;
4. The penalty of arresto mayor in its maximum period to prision
correccional in its minimum period, if the physical injuries in-
flicted shall have caused the illness or incapacity for labor of the
injured person for more than thirty days.
If the offense shall have been committed against any of the
persons enumerated in article 246, or with attendance of any of
the circumstances mentioned in article 248, the case covered by
subdivision number 1 of this article shall be punished by reclusion
temporal in its medium and maximum periods; the case covered
by subdivision number 2 by prision correccional in its maximum
period to prision mayor in its minimum period; the case covered
by subdivision number 3 by prision correccional in its medium
and maximum periods; and the case covered by subdivision
number 4 by prision correccional in its minimum and medium
periods.
The provisions of the preceding paragraph shall not be appli-
cable to a parent who shall inflict physical injuries upon his child
by excessive chastisement.
The crime of serious physical injuries may be due to:
(1) Wounding;
( 2 ) Beating;
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Deformity is a condition of physical ugliness. It must be per-

( 3 ) Assaulting ( A r t . 263); or
( 4 ) Administering injurious substances (Art. 264) without the in-
tent to kill.
It may be committed through a simple negligence or impru-
dence.
The main purpose of dividing the provision into four paragraphs
is to graduate the penalties depending upon the nature and cha-
racter of the wound inflicted and their consequences on the
person of the victim.
In paragraph one, the injured person became insane, imbecile,
impotent, or blind.
Insanity has not been defined or qualified by the article.
Imbecility infers that the injured person must be of the pre-
adolescent age and that on account of the physical injuries in-
flicted there is an arrest of mental development.
Impotency is the inability to grant to the partner sexual gratifi-
cation.
Blindness must be total or involvement of both eyes. If only
one eye became blind, then the physical injury will fall in para-
graph 2 of Article 263.
In paragraph two, the following nature and character of the
wound or consequences of the injuries inflicted must be present:
a. Loss of the use of speech or the power to hear or to smell, or
loss of an eye, a hand, a foot, an arm, or a leg;
b. Loss of the use of any such member; or
c. Becomes incapacitated for the work in which he was therefore
habitually engaged.
There must be a total loss of hearing capacity. If the loss of
power to hear is only in one ear, it is a serious physical injury
under paragraph 3, article 263 (People v. Hernandez, 94 Phil. 49).
Insofar as loss of a hand is concerned, the prosecution must
prove by clear and conclusive evidence that the offended party
actually cannot make use of his hand and that such impairment is
permanent (People v. Reli. C.A. 53 O.G. 5695).
In paragraph three, the following physical injuries or their con-
sequences are included:
a. Deformity;
b. Loss of any other member of his body;
c. Loss the use thereof; or
d. Becomes ill or incapacitated for the performance of the work
in which he was habitually engaged for more than 90 days, as
a consequence of the physical injuries inflicted.
manent and conspicuous. The loss of the front teeth, the develop-
ment of a pigmented scar on the face, or loss of the pinna of the
ear are considered deformities. However, the development of a
scar in covered plots of the body may not be considered deformity
because it is not conspicuous and visible.
"The loss of any other part of his body" means loss of the parts
of the body not mentioned in paragraph 2, Art. -263.
Incapacity means the inability of the injured person to perform,
or engage on a work or vocation before he sustained injury.
In paragraph four, the injured person becomes ill or incapacitated
for labor for more than thirty days and impliedly less than 90
days.
It is noteworthy to mention that in paragraphs 3 and 4 of
article 263 there is no mention of periods of medical attendance
but merely incapacity.
Administering Injurious Substances or Beverages:
Art. 264, Revised Penal Code:
The penalties established by the next preceding article shall be
applicable in the respective cases to any person who, without intent
to kill, shall inflict upon another any serious physical injury, by
knowingly administering to him any injurious substances or beve-
rages or by taking advantages of his weakness of mind or credulity.
Elements of the crime:
a. The offender inflicted upon another person any serious physical
injury.
b. The infliction of physical injury was done knowing that the
substance or beverage administered is injurious or took advantage
of the victim's weakness or credulity; and
c. There was no intent to kill on the part of the offender.
If the offender does not know that the substance administered is
injurious, he cannot be held liable under the above provision.
The throwing of acid on the face of someone does not fall within
the provision because what the provision contemplates is administer-
ing or taking in the injurious substance or beverages (U.S. Chiong
Songco, 18 Phil. 459).
The provision does not contemplate of slight or less serious
physical injuries which is the consequence of injurious substances
or beverages, but results only in serious physical injuries.
If the administration of injurious substances or beverages is
intentional, the crime committed is frustrated murder. Treachery is.
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inherent when injurious substances or beverages are introduced into

the body.
/ L e s s Serious Physical Injuries:
Art. 265, Revised Penal Code:
A n y person who shall inflict upon another physical injuries not
described in the preceding articles, but which shall incapacitate
the offended party for labor ten_days„or more, or shall require
medical attendance for the same period, shall be guilty of less serious
physical injuries and shall suffer the penalty of arresto mayor.
Whenever less serious physical injuries shall have been afflicted
with the manifest intent to insult or offend the injured person, or
under circumstances adding ignominy to the offense, in addition to
the penalty of arresto mayor, a fine not exceeding 500 pesos shall
be imposed.
A n y less serious physical injury inflicted upon the offender's
parents, ascendants, guardians, curators, teachers, or persons of rank
or persons in authority, shall be punished by prision correccional in
its minimum and medium periods, provided that, in the case of
persons in authority, the deed does not constitute the crime of
assault upon such person.
The basis to determine whether the physical injury is less serious
or not is by either the period of medical attendance or period of
incapacity; both of which is ten days or more but not more than
thjrty days.
The fact that the injury only requires medical attendance for two
days but incapacitated the victim from attending to his ordinary
work for a period of 29 days makes the crime less serious physical
injuries (U.S. v. Trinidad, 4 Phil. 152).
There must be proof as to the period of medical attendance. In
the absence of such proof of medical attendance or incapacity,
although the wound actually healed in more than 30 days, the crime
committed is only slight physical injuries (People v. Penesa, 81 Phil.
398).
The crime *of less serious physical injuries may be qualified and a
fine or a higher penalty is imposed when:
a. There is a manifest intent to insult or offend the injured person;
b. There are circumstances adding ignominy to the offense;
c. The victim is the offender's parents, ascendants, guardian,
curators or teachers; or
d. The victim is a person of rank or person in authority, provided
that the crime is not direct assault.
Obligation Imposed on Physicians W h o have Treated Persons Suffer-
ing From Serious and Less Serious Physical Injuries:
P R E S I D E N T I A L D E C R E E N O . 169
W H E R E A S , Pursuant to Proclamation N o . 1081, dated September
21, 1972 and N o . 1104, dated January 17, 1973, martial law has
been declared throughout the Philippines to, among other goals,
restore and maintain peace and order;
W H E R E A S , for the attainment of the aforesaid goal, and to enable
the law-enforcement agencies to keep track of all violent crimes,
conduct timely investigation thereon and effect the immediate arrest
of the perpetrators thereof, it is necessary that all persons treating
physical injuries resulting from any form of violence be required to
report such fact to said agencies;
W H E R E A S , while some of the victims of violent crimes, or those
who may have sustained physical injuries in the act of committing
or as a result of the commission of a crime submit themselves for
medical treatment in hospitals, medical clinics, sanitariums, or
other medical establishments or to medical practitioners, they do
not report their injuries to the law-enforcement agencies for one
reason or another;
N O W , T H E R E F O R E , I, F E R D I N A N D E. M A R C O S , pursuant to
Proclamation N o . 1081, dated September 21, 1972 and N o . 1104,
dated January 17, 1973 and in my capacity as Commander-in-Chief
of all the Armed Forces of the Philippines, do hereby order and
decree that:
1. The attending physician of any hospital, medical clinic, sani-
tarium or other medical establishments, or any medical prac-
titioner, who has treated any person for serious or less serious
physical injuries as those injuries are defined in Articles 262,
263, 264 and 265 of the Revised Penal Code shall report the
fact of such treatment personally or by the fastest means of
communication to the nearest Philippine Constabulary unit
without delay: provided, that no fee shall be charged for the
transmission of such report thru government communication
facilities; and
2. The report called for in this Decree shall indicate when prac-
ticable the name, age, address and nearest of kin of the patient;
the nature and probable cause of the injury; the approximate
time and date when, and the place where the injury was sus-
tained; time, date and nature of treatment; and the physical
diagnosis and/or disposition of the patient.
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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 imprisonment for not
less than one year nor more than ( 3 ) years and/or a fine of not less
than 1,000 nor more than 3,000 pesos, as a military tribunal may
direct. In addition, the government license or permit of the attend-
ing physician to practice his profession shall be cancelled by the Civil
Service Commission after the sentence imposed by the military
tribunal become final and executory.
The Secretary of Health and the Secretary of National Defense
shall promulgate the necessary rules and regulations to carry out the
purpose of this Decree.
Done in the City of Manila, this 4th day of April, in the Year of
Our Lord, nineteen hundred and seventy-three.
(SGD) F E R D I N A N D E. MARCOS
President
Republic of the Philippines
Slight Physical Injuries and Maltreatment:
Art. 266, Revised Penal Code:
The crime of slight physical injuries shall be punished:
1. By arresto menor when the offender has inflicted physical injuries
which shall incapacitate the offended party for labor from one to
nine days, or shall require medical attendance during the same
period;
2. Physical injuries which did not prevent the offended party from
engaging in his habitual work or which did not require medical
attendance.
If the victim merely suffered from small contusion or superficial
abrasion which does not require medical attendance or incapacity,
this falls in the paragraph of slight physical injury.
3. Ill-treatment of another by deed without causing any injury.
A slight slap on the face or holding tightly the arm of the victim
which did not even develop redness of the skin may be a form of
ill-treatment.
If there is no evidence to show actual injury, or incapacity for
labor, or period of medical attendance, the accused can only be
guilty of slight physical injuries (People v. Penesa, 81 Phil. 398;
People v. Amarao et al., C.A. 36 O.G. 3462).
A tender slap on the face, holding the arm tightly, application
of pressure in some parts of the body, or mild blow which show
no sign of physical violence may still be considered slight physical
injuries or maltreatment (3rd paragraph).
Physical Injuries Inflicted in a Tumultuous Affray:
Art. 252, Revised Penal Code:
When in a tumultuous affray as referred to in the preceding article,
only serious physical injuries are inflicted upon the participants
thereof and the person responsible therefor cannot be identified, all
those who appear to have used violence upon the person of the
offended party shall suffer the penalty next lower in degree than that
provided for the physical injuries so inflicted.

2. By arresto menor or a fine not exceeding 200 pesos and censure
when the offender has caused physical injuries which do not
prevent the offended party from engaging in his habitual work nor
require medical attendance;
3. By arresto menor in its minimum period or a fine not exceeding
50 pesos when the offender shall illtreat another by deed without
causing any injury.
Kinds of Slight Physical Injuries Punishable by the Code:
1. Physical injuries which incapacitate the victim for labor from one
to nine days, or require medical attendance for the same period.
This kind of slight physical injuries will require medical certifi-
cation as to the duration of medical attendance, or period of
incapacity. In case of divergency in the duration of medical
attendance and incapacity, the physician must always consider the
best interest of the victim in the determination of the period.
When the physical injuries inflicted are of a less serious nature
than the person responsible therefor cannot be identified, all those
who appear to have used any violence upon the person of the of-
fended party shall be punished by arresto from five to fifteen days.
Elements of the Crime:
a. There is a tumultuous affray;
b. Participant(s) suffered from serious physical injuries;
c. The person(s) who inflicted such serious physical injuries
cannot be identified; and
d. All those who appear to have used violence upon the person
of the offended party shall be penalized by arresto from five to
fifteen days.
/ T Y P E OF WOUNDS (Medical Classification):
\/Closed Wound — There is nojareach of continuity of the skin or
mucous membrane.
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a. Superficial — When the wound is just underneath the layers of When a blunt force is applied, it momentarily compresses the
the skin or mucous membrane. blood vessels at the point of contact, thereby temporarily forcing the
(1) Petechiae. r***-*"** blood out of the area and setting up a fluid wave under pressure.
( 2 ) Contusion. \ - * * - « \ . When the pressure exceeds the cohesive force of the cells forming
( 3 ) Hematoma. £ i M the capillary, arteriole, or venule wall, the vessel ruptures.
b. Deep. Inasmuch as it used to take more time for the blood to get out of
the blood vessels, contusion does not immediately develop after the
(1) Musculoskeletal Injuries. application of force. It may develop after a lapse of minutes or
( a ) Sprain. even hours after the application of force. The variation depends on
( b ) Dislocation. the part of the body injured, tenderness of the tissues affected,
(c) Fracture. condition of the blood vessels involved, and natural disease. Women
( d ) Strain. are much more easily bruised than men while boxers are less prone
( f ) Subluxation. to suffer contusion inspite of heavy punishment.

(2) Internal Hemorrhage.

( 3 ) Cerebral Concussion.

2^. Open Wound — There is a breach of continuity of the skin or

mucous membrane. ~~ "
1
a. Abrasion, q*!*-
b. Incised Wound, h-'iva
c. Stab Wound.
d. Punctured.
e. Lacerated.

CLOSED WOUNDS:
Petecbjaej_^___
This is a circumscribed extravasation of blood in the subcutaneous
tissue or underneath the mucous membrane. The cause of passage of
blood from the capillaries may be due to the increase intra-capillary
pressure or increased permeability of the vessel. The hemorrhage
may be small or pinhead sized but several petechiae may coalesce to
form a bigger hemorrhagic area. Mosquito or other insect bites may
cause the formation of circumscribed hemorrhages. C o n t u s i o n of the right eyelids

Petechiae is not always a product of trauma. Petechial hemor-

rhage may be a post-mortem finding in asphyxial death, coronary
occlusion and blood diseases. It may also develop post-mortem in
death by hanging. There is gravitation of blood into the most
dependent part of the body which eventually leads to the rupture of
over-distended capillaries specially seen at the region of the leg.
Contusion:
Contusion is the effusion of blood into the tissues underneath the
skin on account of the rupture of the blood vessels as a result of the
application of blunt force or violence.
The size of the contusion is usually greater than the size of the
object causing it. The location of the contusion may not always
indicate the site of the application of force. For instance, a blow
on the forehead may cause black-eye or contusion around the tissues
of the eye-ball, or a kick on the leg may cause appearance of con-
tusion at the region of the ankle on account of the gravitation of the
effusion, between muscles and fascia.
On the medico-legal viewpoint, a contusion as indicated by its
external pattern may correspond to the shape of the object or
weapon used to produce it; its extent may suggest the possible degree
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of violence applied; and its distribution may indicate the character
and manner of injury as in manual strangulation around the neck.
It may infer grave complications and consequences on account of
serious injuries of the underlying tissues.
Age of Contusion:
The age of contusion can be appreciated from its color changes.
The size tends to become smaller from the periphery to the center
and passes through a series of color changes as a result of the
disintegration of the red blood corpuscles and liberation of hemo-
globin.
The contusion is red sometimes purple soon after its complete
development.
In 4 to 5 days, the color changes to green.
In 7 to 10 days, it becomes yellow and gradually disappears on
the 14th or 15th day.
The ultimate disappearance of color varies from one to four
weeks depending upon the severity and constitution of the body.
The color changes start from the periphery inwards.
Distinction Between Contusion and Post-mortem Hypostasis
(Supra p. 133).
Factors Influencing the Degree and Extent of Contusion:
(a) General condition of the victim — Some healthy persons are
easily bruised.
( b ) Part of the body affected — Bloody parts of the body produce
larger contusion, specially where subcutaneous tissue is loose.
In areas of the body with excessive fat, contusion easily devel-
ops, while parts of the body with abundant fibrous tissue and
good muscle tone, bruising is less.
(c) Amount of force applied — Other factors being equal, the
greater the force applied the more effusion of blood will
develop.
(d) Disease — Contusion may develop with or without the appli-
cation of force. Examples: Purpura, Hemophilia, Aplastic
anemia, Whooping cough, even vicarious menstruation.
(e) Age — Children and old age persons tend to bruise more easily.
Children have loose and tender skin. Old people have less
flesh and the blood vessels are more fragile.
(f) Sex — Women, specially if obese, easily develop contusion.
Athletes, like boxers do not develop contusion easily.
(g) Application of heat and cold — If immediately after injury
cold compress is applied the production of contusion will be
minimized. After it has already developed, application of
warm compress will hasten its disappearance.
The distinction between ante-mortem and post-mortem contusions
in an undecomposed body is that in ante-mortem bruising, there is
swelling, damage to epithelium, extravasation, coagulation and infil-
tration of the tissues with blood, while in post-mortem bruising there
are no such findings.
/ H e m a t o m a (Blood Cyst, Blood Tumor, "Bukolg):
/Hematoma is the extravasation or effusion of blood in a newly
formed cavity underneath the skin. It usually develops when the
blunt instrument is applied in part of the body where bony tissue is
superficially located, like the head, chest and anterior aspect of the
legs. The force applied causes the subcutaneous tissue to rupture on
account of the presence of a hard structure underneath. The des-
truction of the subcutaneous tissue will lead to the accumulation of
blood causing it to elevate.
Distinction Between Contusion and Hematoma:
(a) In contusion the effused blood are accumulated in the inter-
stices of the tissue underneath the skin, while in hematoma
blood accumulates in a newly formed cavity underneath the
skin.
( b ) In contusion, the skin shows no elevation and if ever ele-
vated, the elevation is slight and is on account of inflammatory
changes, while in hematoma the skin is always elevated.
(c) In contusion, puncture or aspiration with syringe of the
lesion no blood can be obtained, while in hematoma, as-
piration will show presence of blood and subsequent depres-
sion of the elevated lesion.
Abscess, gangrene, hypertrophy, fibroid thickening and even
malignancy are potential complications of hematoma.
/Musculo-Skeletal Injuries:
(1) Sprain — Partial or complete disruption in the continuity of a
muscular or ligamentous support of a joint. It is usually caused
by a blow, kick or torsion force.
(2) Dislocation — Displacement of the articular surface of bones
entering into the formation of a joint.
( 3 ) Fracture — Solution of continuity of bone resulting from vio-
lence or some existing pathology.
(a) Close or Simple Fracture — Fracture wherein there is no
break in continuity of the overlying skin or where the ex-
ternal air has no point of access to the site of injury.
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( b ) Open or Compound Fracture — The fracture is complicated
by an open wound caused by the broken bone which pro-
truded with other tissues of the broken skin.
(c) Comminuted Fracture — the fractured bone is fragmented
into several pieces.
( d ) Greenstick Fracture — A fracture wherein only one side of
the bone is broken while the other side is merely bent.
( e ) Linear Fracture — When the fracture forms a crack commonly
observed in flat bones.
( f ) Spina/ Fracture — The break in the bone forms a spiral
manner as observed in long bones.
(g) Pathologic Fracture — Fracture caused by weakness of the
bone due to disease rather than violence.
• ( 4 ) Strain — The over-stretching, instead of an actual tearing or
the rupture of a muscle or ligament which may not be associated
with the joint.
/ ( 5 ) Subluxation — Incomplete dislocation.
(h) Sphincters are relaxed perhaps with unconscious evacuation of
the bowel and bladder.
( i ) Reflexes are present but sluggish and in severe cases may be
absent.
Loss of memory for events just before the injury (retrograde
amnesia) is a constant effect of cerebral concussion and is of medico-
legal importance.
/ O P E N WOUNDS:
^ A b r a s i o n (Scratch, Graze, Impression Mark, Friction Mark):
[ i t is an injury characterized by the removal of the superficial
epithelial layer of the skin caused by a rub or friction against a
hard rough surface.! Whenever, there is forcible contact before
friction occurs, there may be contusion associated with abrasion.
The shape varies and the raw surface exudes blood and lymph
which later dries and forms a protective covering known as scab
or crust.

/Internal Hemorrhage:
Rupture of blood vessel which may cause hemorrhage may be due
to the following:
(a> Traumatic intracranial hemorrhage.
(b)- Rupture of parenchymatous organs.
(c)-Laceration of other parts of the body.

Cerebral Concussion (Commotio Cerebri):

Cerebral concussion is the jarring or stunning of the brain cha-
racterized by more or less complete suspension of its functions, as
a result of injury to the head, which leads to some commotion of
the cerebral substance.
Cerebral concussion is much more severe when the moving or
mobile head struck a fixed hard object as compared when the head
is fixed and struck by a hard moving object.

s^Signs and Symptoms:

(a) Unconsciousness which is more or less complete.
( b ) Muscles are relaxed and flaccid.
(c) Eyelids are closed and the conjunctivae are insensitive.
(d) Surface of the body is pale, cold and clammy.
(e) Respiration is slow, shallow and sighing.
( f ) Pulse is rapid, weak, faltering and scarcely perceptible to the
fingers.
(g) Temperature is subnormal.
Abrasions
Characteristics of Abrasion:
a. ft develops at the precise point of impact of the force causing it.
b. Grossly or with the aid of a hand lens the injury consists of
parallel linear injuries which are in line with the direction of the
rub or friction causing it.
c. It may exhibit the pattern of the wounding material.
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d. It is usually ignored by the attending physician for it does not b. Graze:

require medical treatment but it has far-reaching importance in These are usually caused by forcible contact with rough,
the medico-legal viewpoint. hard objects resulting to irregular removal of the skin surface.
The nature of the injury is dependent upon the degree of rough-
( 1 ) Abrasions caused by fingernails may indicate struggle or
ness of the object and the amount of pressure in the course of
assault and are usually located in the face, neck, forearms,
the sliding. The course will be indicated by a clean commence-
and hands. ment and tags on the end.
( 2 ) Abrasions resulting from friction on rough surfaces, either
c. Impact or Imprint Abrasion (Patterned Abrasion, Stamping
intentional or accidental are located on bony parts of the
Abrasion, "Abrasion A La Signature"):
body and usually associated with contusion or laceration.
Those whose pattern and location provides objective evidence
( 3 ) Nature of the abrasion may infer degree of pressure, nature
to show cause, nature of the wounding material or instrument
of the rubbing object and the direction of movement.
and the manner of assault or death.
e. Unless there is a supervening infection, abrasion heals in a short
(1) Marks of the grid of the radiator may be imprinted on the
time and leaves no scar. If the whole thickness of the skin is
skin.
involved, healing may be delayed and occasionally with scar
(2) Tire thread marks may be seen on the skin in vehicular
formation.
accidents.
Torms of A brasion: (3) Muzzle imprint in contact fire gunshot wound of entrance.
a. Linear: \MOA (4) Teeth impression mark in skin bites.
An > abrasion which appears as a single line. It may be a d. Pressure or Friction Abrasion:
straight or curved line. Pinching with the fingernails will pro- Abrasion caused by pressure accompanied by movement
duce a linear curved abrasion, while sliding the point of a needle usually observed in hanging or strangulation. The spiral strands
on the skin will produce a straight linear abrasion. of the rope may be reflected on the skin of the neck. The
lesion may dry up and assume a papyraceous or parchment-
b. Multi-Linear: like consistency.
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
different parts of the body.
Types of Abrasions:
a. Scratch:
This is caused by ajsharp-pointed object which slides across
the skin, like a pin, thorn or fingernail. The injury is always
parallel to the direction of slide. The commencement and
termination are well defined and the depth depends on the
pressure applied. The fingernail scratch may be broad at the
point of commencement and may terminate with a tailing.
A b r a s i o n in the f o r m of tire marks in a victim of vehicular accident
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Differential Diagnosis: Hacked wound. The injury is quite severe, edges may or may not
a. Dermal Erosion — A gradual breakdown or very shallow be contused depending on the nature of the edge of the instru-
ulceration of the skin which involves only the epidermis and ment used.
heals withour scarring. It may appear in spots and with no Characteristics of Incised Wound:
previous history of friction or sliding. a. Edges are clean- both extremities are sharp, except in
b. Marks of Insects and Fishes Bites — The skin injury is irregular areas where the skin is loose or folded at the time of infliction.
with no vital reaction and usually found on angles of the mouth, b. The wound is straight and may be shelving if inflicted with the
margins of nose, eyelids and forehead. wounding instrument applied with an acute angle to the surface
c. Excoriation of the Skin by Excreta — This condition is only of the body involved.
found among infants and the skin lesion heals when the cause is c. Usually the wound is shallow near the extremities and deeper
removed. There is no apparent history of rubbing trauma on at the middle portion. However, this finding may be modified
the affected area. by the shape of the wounding instrument and part of the body
involved.
d. Pressure Sore — Usually found at the back at the region of bony
prominence. History of long standing illness, bed ridden d. Because the blood vessels involved are clean-cut, profuse he-
condition although pressure sore may start as a previous area of morrhage is invariably a feature.
abrasion. e. Gaping is usually present due to the retraction of the edges but
^Distinction Between Ante-mortem from Post-mortem Abrasions: Its presence and degree of retraction depends on the direction
of the incised wound with the line of cleavage (Langer's line).
Point of Ante-mortem Post-mortem
Distinction Abrasion Abrasion f. If the incised wound is located in parts of the body covered
Color Reddish-bronze. in appear- Yellowish and translu- with clothes, the clothing itself will show clean-cut of its
ance due to slight exu- cent in appearance. texture.
dation of blood. g. In the absence of complication and/or when there is deeper
Location Any area. Generally occurs over involvement present, healing is relatively fast and the scar may
bony prominence, such not or may develop conspicuously.
as elbow, and attributed
to rough handling of the h. Incised wound caused by broken edge of glass may be irregular
cadaver. and may appear like a punctured or stab wound. Fragments of the
glass may be removed from the incised wound. Examination
Vital With intravital reaction Shows no vital reaction
with the aid of a magnifying lens is necessary to determine the
reaction and may show remains of and is characterized by a
presence and removal of particles of flakes of glasses in the
damaged epithelium. separation of the epider-
wound.
mis from complete loss
of the former. Changes that occur in an Incised Wound:
After 12 hours — Edges are swollen; adherent with blood and
2. Incised Wound (Cut, Slash, Slice):
with leucocyte infiltration.
This is produced by a sharp-edged (cutting) or ^sharp-linear edge
After 24 hours — Proliferation of the vascular endothelium
of the instrument, like a knife, razor, bolo, edge of oyster shell,'
and connective-tissue cells.
metal sheet, glass, etc. It may be an impact cut when there is
forcible contact of the cutting instrument with the body surface, After 36-48 hours — Capillary network complete; fibrolasts run-
or slice cut when cutting injury is due to the pressure accompanied ning at right angles to the vessels.
with movement of the instrument. After 3-5 days — Vessels show thickening and obliteration.
When the wounding instrument is a heavy cutting instrument, (From: Gradwohl's Legal Medicine by F.E. Camps ed., 3rd ed.,
like axe, big bolo, saber, the wound produced is called Chopped or p. 272).
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common site of suicidal incised wounds are on the wrist with

involvement of the radial artery and the neck.
^Homicidal — The incised wounds are deep, multiple and involve
both accessible and non-accessible parts of the body to the
hands of. the viGtim. "defense and other forms of wounds may
be present. Clothings are always involved.
ytil Accidental — Multiple incised wound isjoommonly observed on
the passengers and _driver of vehicular accidents on account of
the broken windshield and glass parts of windows. Stepping on
oyster shell, broken glassesTsharp edges of metal sheets are
common causes of incised wound on the sole of the foot.
Those associated in the use of kitchen knives in the preparation
of food, carpenters and handicraft workers who use sharp edged
instruments are frequent victims of accidental incised wounds.
Distinction Between Suicidal and Homicidal Cut-throat
Suicidal Homicidal
Direction Oblique, from* Below left Usually horizontal below
ear, downwards, .across tho "Adam's'apple.
M u l t i p l e Incised w o u n d s ( H o m i c i d a l ) . front ^ e c k just .above
Adam's apple.
Deep incised wound may cause clean-cut fracture of the bone,
Severity Usually _noi_so deep and Usually deep and may
severance of blood vessels and nerves or amputation. Paralysis
may only involve trachea cause involvement of the
may develop on account of the severed nerve and profuse he-
carotid and sometimes the cartilage and bones.
morrhage may result to death. Embolism or supervening in-
fection may later develop. esophagus is involved.
Superficial Usually present before Practically jibsent but
^ Why a Person Suffers from Incised Wound:
Cut the commencement of may rarely be present
a. As a therapeutic procedure — Pyogenic abscess and cystic deeper wound. when the victim strug-
conditions may be treated by incision. gled when attacked.
b. As a consequence of_self-defense — The sharp-edged instrument Position May be__sjtting facing a Usually victim _lying on
may be held by the victim in his attempt to avoid the offender of the mirror or standing, bed or in other place.
to inflict more serious injuries on him. body
c. Masochist may self-inflict incised wound as a means of sexual Weapon is jjbsent.
Wounding Firmly grasped (Cadaveric
gratification.
weapon spasm) or found lying
d^Addicts and mental patients may suffer from incised wound beside victim.
irrationally.
Blood Blood found in front part Blood found at the back
Incised Wounds may be Suicidal, Homicidal or Accidental: distri- of the body. Hand gen- of the neck. JIands
Suicidal — Located in peculiar parts of the body, like the jjeck, bution erally smeared with clean.
flexor surfaces of the extremities (elbow, groin, knee), wrist, blood.
and accessible to the hand in inflicting the injury. The most
Motive History of mental depres- Absence of such history.
common instrument used is the Jaarber's razor blade with an
improvised handle. There is usually superficial tentative cut sion, domestic, financial
(hesitation cuts) and the direction varies with the location and social problems, alcohol-
the hand (left or right) used in inflicting the injuries. The most ism etc. may prove sui-
cide.
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MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES 267 268 LEGAL MEDICINE
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Previous May be present. Always absent,
history
of self-
destruc-
tion
Stab Wound:
Stab wound is produced by the penetration of a sharp-pointed
and sharp edged instrument, like a^knjfe, saber, dagger, scissors. It
may involve the skin or mucous surface. IftRe sharp edgTportion
of the wounding instrument is the first to come in contact with
the skin, the wound produced is an incised wound, but if the
sharp-pointed portion first come in contact, then the wound is a
stab wound. As a general rule, like an incised wound, the edges
are cleanzcut, regular and distinct.
The surface length of a stab wound may reflect the width of
the wounding instrument. It may be smaller when the wound is
not so deep inasmuch as it is only caused by the penetration of
the tapering portion of the pointed instrument. It may be made
wider if the withdrawal is not on the same direction as when it
was introduced or the stabbing is accompanied by a slashing move-
ment. In the latter case the presence of an abrasion from the
extremity of the skin defect is in line with direction of the slashing
movement.
The extremities of stab wound may show the nature of the
instrument used. A double-bladed weapon may cause the pro-
duction of both extremities sharp. A single bladed instrument
may produce as one of its extremities rounded and contused. This
distinction may not be clearly observed if the instrument is quite
thin.
The direction of the surface defect may be useful in the deter-
mination of the possible relative position of the offender and
the victim when the wound was inflicted.
As to whether the wound is a slit-like or gaping depends on the
looseness of the skin and the direction of the wound to the line
of cleavage (Langer's line).
The depth may be influenced by the size and sharpness of the
instrument, area of the body involved, and the degree of force
applied. Involvement of the bones may cause clean-cut fracture
on it. A portion of the wounding instrument, usually the tapering
part, may remain in the body. X-ray examinations may be needed
to reveal its location.
Hemorrhage is always the most serious consequence of a stab
wound. This is due to the severance of blood vessels or involve-
ment of bloody organs.

M u l t i p l e stab w o u n d s

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

Incised and stab w o u n d s of the face and neck. included:
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a. Length of the skin defect — The edges must be coaptated before (10)-No disturbance in the death scene, wounding instrument
the length is measured. If the abrasion tailing is present in one is found near the victim.
of the extremities, it must not be included in the measurement. b. Homicidal — Stabbing with homicidal intent is the most common.
The length of the tailing must be mentioned separately. The Characteristics:
tailing infers the direction of withdrawal of the wounding
(1) Injuries other than stab wound may be present.
weapon.
(2) Stab wound may be located injmy part of the body.
b. Condition of the extremities — A sharp extremity may infer the ( 3 ) Usually there are ©ore than one stab wound.
sharpness of the edge of the instrument used. If both extre- (4) There is a motive for the stabbing. If without motive, the
mities are sharp, it may be inferred that a double-bladed weapon offender must be insane or under the influence of drugs.
was used. ( 5 ) There is disturbance in the crime scene.
c. Condition of the edges — If the injury is due to one stabbing
act, the edges are regular and clean-cut. However if the wound
is caused by several stabbing acts (series of thrusts and with-
drawal), the edges may be serrated or zigzag in appearance.
d. Linear direction of the surface wound — It may be running
vertically, horizontally, or upward medially or laterally.
e. Location of the stab wound — Aside from mentioning the
region of body where it is located, its exact measurement to
some anatomical landmarks must be stated.
f. Direction of penetration — This must be tri-dimensional (back-
wards or forwards, upwards or downwards, and medially or
laterally).
g. Depth of the penetration.
h. Tissue and organs involved.
^Stab Wound(s) may be Suicidal, Homicidal or Accidental:
a. Suicidal — Evidences showing that the stab wound is suicidal:
( l ) - r t is located over the .vital parts of the body.
(2) It is usually solitary. If multiple, they are located on one
part of the body. S t a b w o u n d w i t h intestinal herniation.

(3) If located on covered parts of the body, the clothings are
not involved.
(AyThe stab wound is accessible to the hand of the victim.
(5)-The hand of the victim is smeared with blood.
(6)/The wounding weapon is firmly grasped by the hand of the
victim (cadaveric spasm).
( 7 ) If stabbing is accompanied with slashing movement, the
wound tailing abrasion is seen towards the hand inflicting
the injury,
(a HA suicide note may be present.
(9)/There is the presence of a motive for self-destruction.
^Medical evidences showing intent of the offender to kill the victim:
a. There are more than one stab wounds.
b. The stab wounds are located in different parts of the body or
on parts of the body where vital organs are located.
c. Stab wounds are_deep.
d. Stab wound with serrated or zigzag borders infers alternative
thrust and withdrawal of the wounding weapon to increase
internal damages.
e. Irregular or stellate shape skin defects may be due to changing
direction of the weapon with the portion of the instrument at
the level of the skin as the lever. In this way a greater area of
involvement internally will be realized.
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c. Sealing of the external opening will be favorable for the growth

Different measurement of the stab wounds may possibly be
and multiplication of anaerobic microorganism like bacillus
produced by one weapon if it is tapering towards the sharp point.
tetani.
Withdrawal of the instrument not on the same direction as when
it was introduced may increase the length of the skin defect. Medical evidences that tend to show it is Homicidal: pppp
M

A sharpened three-cornered file (tres-cantos) when used as a
stabbing weapon will produce three-cornered (extremities) skin
defect.
The most common immediate cause of death is hemorrhage
particularly when located in the chest or abdomen.
Accidental stab wounds are quite rare and are usually caused by
falling against a projecting sharp object like broken pieces of glass
or flattened and_pointed iron bars.
x^Tpunctured Wound: ^ > '#^J£ . •
Punctured wound is the result of a thrust 6f'a jharp pointed
instrument. The external injury is quite small but the depth is
to a certain degree. It is commonly produced by an icepick, needle,
nail, spear,jJointed stick, thom, fang of animal ancfhook.
The nature of the external injury depends on the sharpness
and shape of the end of the wounding instrument. Contusion of
the edges may be present if the end is not so sharp. The opening
may be round, elliptical, diamond-shape or cruciate. An accurate
cross-section nature of the wounding object may well be appre-
ciated when there is involvement of flat hard parts of the body
especially the skull.
External hemorrhage is quite limited although internal injuries
may be severe. However, direct involvement of blood vessels and
bloody organs may cause fatal consequence unless appropriate
medical intervention is applied.
The site of the external wound can be easily sealed by the
dried blood, serum or clotted blood so that introduction of
pathogenic microorganism which does not require the presence
of air in its growth and multiplication may find the place favor-
able, and may produce fatal consequences.
/ P u n c t u r e d wound is usually accidental but in rare instances it
may be homicidal or suicidal.
Characteristics:
a. The opening on the skin is very small and may become un-
noticeable because of clotted blood and elasticity of the skin.
The wound is much deeper than it is wide.
b. External hemorrhage is limited although internally it may be
severe.
a. It is multiple and usually located in different parts of the body.
It may however be found in certain areas of the body.
b. The wounds are deep.
c. There are defense wounds on the victim.
d. There is disturbance in the crime scene (sign of struggle).
Proof to show it is Suicidal:
a. Located in areas of the body where the vital organs are located.
b. Usually singular but may be multiple but located in one area of
the body.
c. Parts of the body involved is accessible to the hand of the
victim.
d. Clothings usually is not involved.
e. Wounding is made by the weapon while the victim is in sitting
or standing position. There is bleeding towards the lower part
of body or clothing.
f. No disturbance of the crime scene.
g. Presence of suicide note.
h. Wounding instrument found near the body of the victim.
Punctured wound with puncturing instrument "loaded" with
poison:
a. Poison dart — cyanide or nicotine.
b. Fish spines.
c. Dog bites with hydrophobia virus.
d.Jnjection of air and poison as a way of euthanasia.
Lacerated Wound (Tear, Rupture, Stretch "Pulok."): $
Lacerated wound is a tear of the skin and the underlying tissues
due to forcible contact with a blunt instrument. It may be pro-
duced by a hit with a piece of .wood, iron bar, fist blow, stone,
butt of firearm, or other objects without sharp objects.
If the force applied to a tissue is greater than its cohesive force
and elasticity, the tissue tears and a laceration is produced.
Since the skin is composed of several types of tissues, namely
epidermis, connective tissue, fat, blood vessels, nerves, glandular
cells, etc. each having its own breaking point, the laceration will
be irregular and having strands of tissues bridging. The rupture of
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continuity may only extend deeper to the stronger layer like that pistinctions Between an Incised Wound and a Lacerated Wound:
of the galea aponeuritica in case of scalp injury. Incised Wound Lacerated Wound
Characteristics: CJ*Edges are clean-cut, regular AUtfges are roughly cut, irregular
a. The shape and size of the injury do not correspond to the and well-defined. and ill-defined.
wounding instrument. M& There is no swelling or con- S There is swelling and contusion
b. The tear on the skin is rugged with extremities irregular and tusion around the incised around the lacerated wound.
ill-defined. wound.
c. The injury developed is at the site where the blunt force is cj* Extremities of the wound are ^.Extremities of the wound are
applied. sharp or may be round or ill-defined and irregular,
contused.
d. The borders of the wound are contused and swollen.
Examination by means of a Examination with a magnifying
e. It is usually developed on the areas of the body where the bone magnifying lens shows that lens shows that the hair bulbs are
is superficially located, like the scalp, malar region of the face,
the hair bulbs are cut. preserved,
front part of the leg, dorsum of the foot, etc.
f Healing is faster. n Healing is delayed.
f. Examination with the aid of the hand lens shows bridging tissue
joining the edges and hair bulbs intact. Vt Scar is linear or spindle-shaped. X Scar is irregular.
St, It is caused by a sharp-edged 0 It is caused by a blunt instru-
g. Bleeding is not extensive because the blood vessels are not
instrument. ment.
severed evenly.
h. Healing process is delayed and has more tendency to develop GAPING OF W O U N D :
scar. The separation of the edges especially in deep wound may be due
to the following:
Classification of Lacerated Wounds
a. Splitting caused by crushing of the skin between two hard
objects. This is best seen in laceration of the scalp caused by a
hit of a blunt instrument, cut eyebrow of boxer and laceration
of the chin of motorcyclist.
b. Overstretching of the skin. When pressure is applied on one side
of the bone, the skin over the area will be stretched up to a
breaking point to cause laceration and exposure of the fractured
bone. In avulsion, the edges of the remaining tissue is that of
laceration.
c. Grinding compression — The weight and the grinding movement
may cause separation of the skin with the underlying tissues.
d. Tearing — This may be produced by a semi-sharp-edged in-
strument which causes irregular edges on the wound, like
hatchet and choppers.
Lacerated wounds may involve deeper tissues like laceration of
the muscles and fracture of bones depending upon the degree of
force applied in causing it.
It may be homicidal or accidental but rarely it is suicidal.
An insane person may hit his head on a concrete wall but when
loss of consciousness develops he will not be able to continue Avulsion of the skin at the forehead with e x p o s u r e of the fractured skull and
further his act of self-destruction. part of the brain.
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1. Mechanical stretching or dilatation — The presence of a mechani-

cal device on the edges to prevent coaptation will cause separation.
The presence of a canula in tracheostomy, drain (rubber or gauze)
in an incised abscess, or a retractor during a surgical operation are
examples of this type of gaping.

2. Loss of tissue — Separation of the edges of a wound may be on

account of loss of tissue bridging them. The loss of tissue may be
due to:
a. Destruction by pressure, infection, cell lysis, burning or che-
mical reaction.
b. Avulsion or physical or mechanical stretching resulting to
separation of a portion of the tissue.
c. Trimming of the edges. Debridment of the skin which came in
contact with the bullet at the gunshot wound of entrance and
the removal of necrotic material in an infected wound may
cause separation of the edges.

3. Retraction of the edges — Underneath the skin are dense networks

of fibrous and elastic connective tissue fibers running on the same
direction and forming a pattern more or less present in all persons.
This pattern of fiber arrangement is called cleavage direction or
lines or cleavage of the skin and their linear representation on the
skin is called Langer's line. These lines of cleavage are different in
different parts of the body.
If an incised wound or stab wound was inflicted wherein the
long axis of the wound is parallel or on the same direction as the
cleavage line of the part of the body involved, the wound will
appear narrow or slit-like because the edges of the wound will not
be subjected to the lateral pull of the severed connective tissue
fibers.
If the long axis of the wound is perpendicular to or with an
angle with the lines of cleavage, the tendency of the borders of
the wound is to separate on account of the retraction of the
severed fibers.

Practical Ways of Determining How Much of the Skin Surface is

Involved in an Injury or Disease:
The skin serves as a mechanical protection to the body. It is
punctuated with sensory nerve endings for pain, temperature and
touch. It also acts as a thermo-regulator, storage of water, excre-
tor of sweat and also an organ for absorption.
The determination of how much skin involvement is important Line of cleavage
Langer's line
in the mode of treatment and prognosis. Such determination may
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MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES
be significant in cases of burns, contusion and dermal manifes-
tation of certain diseases.
In cases of burns in children and old age persons, involvement
of more than 70% of the body surface are almost invariably fatal.
In the estimation as to how much (by percentage) of the body
surface is involved, the rule of nine is used.
Body surface expressed as percentage using the rule of nine:
Whole of head and neck 9% 9%
Whole of one upper extremity 9% 18%
Whole of front chest and abdomen 18% 18%
Whole of posterior chest and abdomen 18% 18%
Whole of one lower extremity (front) 9% 18%
Whole of one lower extremity (back) 9% 18%
Pudental area 1% 1%
Total 100%
Factors Responsible for the Severity of Wounds:
1. Hemorrhage:
a. Hemorrhage may influence the severity of wound by:
( 1 ) Loss of blood incompatible with life:
Blood constitutes about 1/20 of the body weight of an
adult. By volume, an average size adult has 5 to 6 quarts
of blood (one quart is 946 c c ) . A loss of one tenth of its
volume may not cause any significant clinical change. A
loss of one quart may cause fainting even if the subject is
lying down. But a loss of 1/3 to 2/5 of the circulating
blood may result to irreversible hypovolemic shock and may
be fatal.
The volume of blood lost may be related to the rate or
space of time a certain volume of blood has been shed.
The blood loss may be massive but if it occurred for a long
period of time, the hemopoietic organs may be able to
replace it thereby preventing the development of any
untoward effects.
Males can stand more lost of blood than females. Hy-
pertension may cause excessive and rapid bleeding from an
arterial wound. Persons suffering from hemophilia and
other clotting disorders and those being treated by anti-
coagulants can cause prolonged bleeding.
( 2 ) Hemorrhage may result in ah increase in pressure in or on
B o d y surface
the vital organs to affect the normal function:
Intracranial hemorrhage may cause compression of the
vital centers of the brain. Hemopericardium (pericardial
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tamponade) may cause embarrassment of the contraction vii. Spontaneous rupture of cavernous hemangioma or
of the heart. Hemorrhage into the chest cavity may cause hepatoma.
diminution of the respiratory output with subsequent viii. Rupture of the enlarged spleen (malaria, infectious
anoxia. mononucleosis, typhoid fever).
(Medico-legal Investigation of Death by Fischer, p. 102).
(3) Hemorrhage may cause mechanical barriers to the function
of organs: 2. Size of Injury:
Burns affecting one-third of the body surface of the third
Hemorrhage into the tracheo-bronchial lumina can cause
degree type is usually fatal. Bigger wounds are more exposed
asphyxia. Interstitial hemorrhage into the muscles may
to infection and other physical conditions of the surroundings.
cause disturbance in the contractility.
3. Organs Involved:
b. Causes of Hemorrhage:
Trauma on the vital organs of the body are always serious.
( 1 ) Trauma — Destruction of the blood vessel wall or increase Crushing wounds of the heart, brain or lungs are almost fatal.
permeability of its wall due to external force.
4. Shock:
( 2 ) Natural Causes:
Shock may occur with or without violence. A slight blow on
(a) Common causes of hemorrhage due to natural causes: the genitalia, slight bums in children or old persons, or slight
i. Intra-cerebral hemorrhage (apoplexy): violence on the head or neck may cause severe shock. However,
The most common blood vessel involved is the violent traumas to healthy, strong persons may not produce shock.
lenticulostraite branch of the middle cerebral 5. Foreign Body or Substance Introduced into the Body:
artery with subsequent bleeding into the basal Incision with an unsterilized scalpel may not be serious as the
ganglia and adjacent structure. bite of a venomous snake. A foreign substance or body may be
ii. Spontaneous subarachnoid hemorrhage: toxic by itself or may act as a physical irritant.
Usually due to rupture or perforation of a sac- The Foreign Body or Substance may be:
cular berry aneurysm, commonly located at the
a. Bacterial:
bifurcation of one of the constituent vessels of
Tetanus b~1f
the circle of Willis or one of its major branches.
Pathogenic microorganism
This is usually a congenital focal defect of the mus-
cular layer with subsequent over stretching and b. Viral:
degeneration of the internal elastic layer of the HydrophobiaW-H|f
blood vessel wall. Hepatitis
iii. Rupture of the arteriosclerotic aneurysm of the c. Foreign body:
Bullet F- *>ZS (,
aorta:
Glass fragments
The weakening and thinning of the aortic wall
Shrapnel
may lead to fusiform or saccular aneurysm usually
Gauze or rubber drain
located at the abdominal portion.
iv. Rupture of esophageal varices in cases of cirrhosis d. Chemical:
Cyanide o- ^
of the liver and bleeding of peptic ulcer of the
Nicotine
stomach and duodenum.
v. Pulmonary hemorrhage may be due to tubercu- e. Toxin-: j-fr
losis, lung abscess, or bronchiectasis. The hemor- ( 1 ) Snake Venom — Snake bite is characterized as two punc-
rhage may be profused to cause severe anemia or tured wounds at the center of the reddened affected area.
may be small to cause asphyxia. The venom is injected through its fangs which is connected
vi. Ruptured ectopic pregnancy. to the poison gland.
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Snake Venom Toxicity will Depend on: FATAL EFFECT OF WOUNDS: p M r V

(a) Potency of venom injected.
( b ) The amount of venom injected by the fang depends on
the season of the year and the length of time the snake
has eaten. If a snake has just killed his prey, the toxic
content of its bite is smaller.
( c ) Size of the patient.
( d ) The immediate treatment instituted.
Snake Venoms are of Two Principal Classes:
( a ) Neurotoxic — It primarily paralyzes the respiratory and
cardiac center of the brain. Absorption of the venom
may cause nausea, vomiting, ascending paralysis, coma,
convulsion, and cardiac and respiratory arrest.
( b ) Hematoxic — Which affects particularly the blood. The
manifestations are pain and swelling of the affected
area, intravascular hemolysis, abdominal pain, nausea,
vomiting, petechial: hemorrhage on the gum, pulmonary
and cardiac edema.
Emergency Treatment may be:
(a) Incision of the wound to promote more external hemor-
rhage to drain the venom.
( b ) Tourniquette above the site of the wound.
(c) Placing ice on the bite site.
( d ) Sucking the wound to drain venom with the mouth.
(e) Administration of anti-snake venom serum.
( 2 ) Scorpion Venom — The venom of the scorpion has neuro-
toxic, hemolytic and hemorrhagic effect. A scorpion sting
produces only one punctured wound on the center of a red-
dened area. The main symptoms are pain, edema and
reddening.
( 3 ) Coelenterate Sting (Jellyfish) — The tentacles penetrate into
the skin and cause explosion of the nematocyst and libera-
tion of the venom. The symptoms are extreme pain of the
affected area, urticarial rash, abdominal pain, dilated pupils,
paleness and labored breathing.
Absence of Medical or Surgical Intervention:
A wound may not be fatal but on account of the neglect or ig-
norance in its management, it may become serious and fatal.
1. Wound may be Directly Fatal by Reason of:
a. Hemorrhage: 7p~£*SS
An incised wound at the lateral aspect of the neck involving
the carotid artery without surgical intervention is fatal due to
hemorrhage. While wounds in some areas of the body where big
blood vessels are not present and the retraction of tissues are
strong, death will not be a direct consequence due to hemor-
rhage in the absence of complication that may set in.
b. Mechanical Injuries on the Vital Organs:
A blow on the head may not necessarily produce external
lesions but may produce severe meningeal hemorrhage pro-
ducing compression of the brain. A punctured wound of the
heart, even though how small, may produce death on account
of the tamponade of the heart.
c. Shock:
This is the disturbance of the balance of fluid in the body
capable of producing delayed or immediate death.
2. Wound may be Indirectly Fatal by Reason of:
a. Secondary Hemorrhage Following Sepsis:
A wound because of its nature and location is not capable of
producing severe hemorrhage, but on account of infection that
sets in, deeper tissues are involved including big blood vessels
thereby producing severe hemorrhage.
b. Specific Infection:
Pathogenic microorganisms may develop and multiply in the
wound causing septicemia, bacteremia, or toxemia. Tetanus, gas
gangrene infection are common in open wounds.
c. Scarring Effect:
Chronic gonorrheal infection may cause stricture of the
urethra. Stricture of the esophagus may follow ingestion of
irritant poison. Keloid formation in burns may not only cause
deformity but disturbance of the normal respiration of loco-
motion.
d. Secondary Shock:
Nature of Death Due to Secondary Causes:
A person may have recovered from the immediate effects of the
trauma or violence, but may later die of its secondary effects or
changes.
These changes may be classified as follows:
1. Changes whose natural sequence are direct and obvious.
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Example: Septicemia, tetanus or complications arising from the
wounds.
2. Changes producing separate pathological lesions which in turn
proves to be fatal.
Example: Operation performed on a patient to ligate bleeding
vessel inside the abdominal cavity with reasonable
skill and with due diligence but as a result of which
peritonitis developed and caused death of the patient.
3. Changes where a definite pathological condition was present
before the injury.
Example: A person suffering from tumor or cyst and was stabbed
by someone. The stab is not capable of producing
death ordinarily. The person may die of the patholo-
gical condition and the accused is liable for his death.
4. Changes where a definite pathological condition of totally dif-
ferent nature arises after the wounding and the consequential
sequence is doubtful.
Example: Tuberculosis meningitis that develops following a
blow on the head.
COMPLICATIONS OF TRAUMA OR INJURY:
1. Shock:
Shock is the disturbance of fluid balance resulting to peri-
pheral deficiency which is manifested by the decreased volume of
blood, reduced volume of flow, hemoconcentration and renal
deficiency. It is clinically characterized by severe depression of
the nervous system. Three major factors operate in the produc-
tion of shock and all are likely to be associated together as the
condition develops.
a. Injury to the receptive nervous system.
b. Anoxemia — Reduction of effective volume of oxygen carrying
capacity of the blood.
c. Endothelial damage, thus increasing capillary permeability.
Kinds of Shock:
a. Primary Shock:
This is caused by immediate nerve impulse set up at the in-
jured area which are conveyed to the central nervous system.
The impulse may also whelm the vital centers in the medulla
thereby shock develops within a short time due to vasomotor
collapse. If the reaction is not intense, the patient may live
longer or may recover completely from the effect of the shock.
b. Delayed or Secondary Shock:
Patient shows signs of general collapse which develop some-
time after the infliction of injury. It is characterized by a low
blood pressure, subnormal temperature, cold clammy perspira-
tion, muscular incoordination, rapid and shallow respiration.
The shock may be severe to produce death or the patient may
recover completely from its effects.
2. Hemorrhage:
Hemorrhage is the extravasation or loss of blood from the
circulation brought about by wounds in the cardio-vascular
system. The degree and nature of hemorrhage depends upon
the size, kind and location of the blood vessel cut.
Kinds of Hemorrhage:
a. Primary Hemorrhage:
It is the bleeding which occurs immediately after the trau-
matic injury of the blood vessel.
b. Secondary Hemorrhage:
This occurs not immediately after the infliction of the
injury but sometime thereafter on or near the injured area.
3. Infection:
Infection is the appearance, growth and development of micro-
organisms at the site of injury:
How Injury or Trauma Acquires Infections:
a. From the instrument or substance which produces the injury.
b. From the organs involved in the trauma applied. A bullet
wound may involve the intestine and causes its contents to spill
out in the peritoneal cavity causing peritonitis.
c. As an indirect effect of the injury which creates a local area of
diminished resistance causing the invasion and multiplication
of microorganisms.
d. Injury may depress the general vitality, especially among the
aged and the young children and makes the patient succumb to
terminal disease.
e. Deliberate introduction of microorganisms at the site of injury.
4. Embolism:
This is a condition in which foreign matters are introduced in
the blood stream causing sudden block to the blood flow in the
finer arterioles and capillaries.
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The Most Common Emboli in the Blood Stream are:
a. Fat Embolus:
( 1 ) Causes of Fat Embolus:
(a) By injection of oily substance into the circulation.
( b ) By injury of the adipose tissue which forces fat into the
circulation.
b. Air Embolism:
(1) Causes of Air Embolism:
2. Kinds of Healing of Wounds:
(a) Gaping incised wound of the jugular vein.
( b ) Injection of soapsuds or air into pregnant uterus for the
purpose of tubal insuflation or criminal abortion.
(c) Injection of air into the urinary bladder for radiological
study.
( d ) Insuflation of the other non-potent tubes or hollow
organs.
( e ) Injection of air under pressure into the nasal sinus
after a therapeutic lavage.
HEALING OF WOUNDS:
1. Power of the Human Tissue to Regenerate:
Regeneration is the replacement of destroyed tissue by newly
formed similar tissue. The more highly specialized the tissue, the
less is the capacity for regeneration. Capacity for regeneration
decreases as age increases. The state of nutrition of the individual
aifects the capacity of regeneration.
The Following Regenerates Rapidly:
a. Connective tissues.
b. Blood forming tissues.
c. Surface epithelium of the skin.
Those Having No Power or Limited Capacity to Regenerate:
a. Highly specialized glandular epithelium.
b. Smooth muscles.
c. Neurons of the central nervous system.
Small clean-cut wound is covered with lymph in 36 hours.
The edges adhere in two days and the wound heals on the 7th
day leaving a linear scar.
Larger incised wound shows swelling of the edges 8 to 12
hours. Blood-stained serum is present in 2 days which afterwards
become seropurulent on the 3rd day, lasting in state from 4 to 5
days. Small red granulation forms in 12 to 15 days and the
epithelium grows from the edges. Scar develops later.
In cases wherein a definite infection is present, the time of
healing is very indefinite, however, at the advent of antibiotic and
sulfa drugs, healing is somewhat accelerated.
The Time of Healing of Wounds is Dependent on the following:
a. Vascularity
b. Age of the Person
c. Degree of Rest or Immobilization
d. Nature of the Injury
a. Healing by Primary (First) Intention:
This type of healing takes place when there is minimal
tissue loss, more approximation of the edges and without
significant bacterial contamination.
Histologically, within 24 hours following injury, there is
an acute neutrophilic response, the epidermal layer thickened
on account of the mitotic activities of the basal cells. Scab will
be formed on the surface on account of the dehydration of the
surface clot.
After three days, the neutrophils will be replaced by the
macrophages and fibroblasts will appear in the epithelial layer.
Collagen fibers will bridge the raw area and epithelial proli-
feration will then cover the raw area. Newly formed capil-
laries sprout on all sides to form the vascular network and
collagen fibrils become abundant and differentiated surface
cells begin to proliferate to cover the exposed area.
Complete return of the area to its normal state may appear
after a lapse of one month with or without the formation of a
scar.
b. Healing by Secondary Intention:
This takes place when the injury causes a more extensive loss
of cells and tissues. Inevitably, there is more necrotic debris
and exudate that has to be removed. Inflammatory reaction is
more intense as compared with healing by primary intention.
Granulation tissue growth bears all the responsibility for its
closure. Healing process may result to the production of a
large scar and greater loss of skin appendages such as hair, sweat
and sebaceous glands, and slower reparative process.
c. Aberrated Healing Process:
In some instances healing process deviates from the normal
way on a normal individual. Healing may result to:
( 1 ) Formation of Exuberant Granulation or "Proud Flesh" —
Excessive amount of granulation tissue may protrude and
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Chapter X

MEDICO-LEGAL INVESTIGATION OF WOUNDS:

MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES
prevent closing of the wound.
excision or cautery.
287
The following rules must always be observed by the physician in
This can be remedied by the examination of wounds:
1. All injuries must be described, however small for it may be im-
portant later.
2. The description of the wounds must be comprehensive, and if
possible a sketch or photograph must be taken.
3. The examination must not be influenced by any other information
obtained from others in making a report or a conclusion.

Outline of the Medico-legal Investigation of Physical Injuries:

1. General Investigation of the Surroundings:
a. Examination of the place where the crime was committed.
b. Examination of the clothings, stains, cuts, hair and other
foreign bodies that can be found in the scene of the crime.
c. Investigation of those persons who may be the witnesses to the
incident or those who could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of
the crime for purposes of preservation.

2. Examinations of the Wounded Body:

Keloid f o r m a t i o n after a severe acid b u m s .
( 2 ) Keloid Formation — There is abnormal amount of collagen
formed in the connective tissue thus producing a large
bulging tumorous scar, commonly known as keloid. It has
been claimed to be hereditary.
(3) Stricture — This is due to the contraction of the fibrous
tissue of the scar formed.
(4) Fistula or Sinus Formation — A fistula is a communication
between an inner cavity and the outside. Sinus is a tract
of infection traversing the inner part of the body. Unless
the causal factor, usually infection or foreign body is
removed, the condition may remain for a long time.
a. Examinations that are applicable to the living and dead victim:
(1) Age of the wound from the degree of healing.
( 2 ) Determination of the weapon used in the commission of the
offense.
( 3 ) Reasons for the multiplicity of wounds in cases where there
are more than one wound.
( 4 ) Determination whether the injury is accidental, suicidal or
homicidal.
b. Examinations that are applicable only to the living:
( 1 ) Determination whether the injury is dangerous to life.
( 2 ) Determination whether the injury will produce permanent
deformity.
( 3 ) Determination whether the wound(s) produced shock.

288
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(4) Determination whether the injury will produce compli-
cation as a consequence,
c. Examinations that are applicable to the dead victim:
( 1 ) Determination whether the wound is ante-mortem or post-
mortem.
(2) Determination whether the wound is mortal or not.
( 3 ) Determination whether death is accelerated by a disease or
some abnormal developments which are present at the time
of the infliction of the wound.
(4) Determination whether the wound was caused by accident,
suicide or homicide.
3. Examinations of the Wound:
The following must be included in the examinations of the
wound. The report made in connection with such examination
must also include in detail the following items:
a. Character of the Wound:
The description must first state the type of wound, e.g.
abrasion, contusion, hematoma, incised, lacerated, stab wound
etc. It must include the size, shape, nature of the edges, ex-
tremities and other characteristic marks. The presence of con-
tusion collar in case of gunshot wound of entrance, scab for-
mation in abrasion and other open wounds, infection, surgical
intervention, etc., must also be stated.
b. Location of the Wound:
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 point of the body prominence to facilitate
reconstruction. This is important in determining the trajectory
or course of the wounding weapon inside the body.
c. Depth of the Wound:
The determination of the exact depth of the wound must
not be 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 fixed. No attempt must be made in
measuring the stabbed wound of the abdomen because of the
movability of the abdominal wall.
c. Condition of the Surroundings:
The area surrounding the wound must be examined. In
gunshot wound near or contact fire will produce burning or
tattooing of the surrounding skin. In suicidal incised wound,
there may be superficial tentative cuts (hesitation cuts). La-
cerated wound may show contusion of the neighboring skin.
e. Extent of the Wound:
Extensive injury may show marked degree of force applied in
the production of the wound. In homicidal cut-throat cases, it
is generally deeper than in cases of suicide. Homicidal wounds
are extensive and numerous.
f. Direction of the Wound:
The direction of the wound is material in the determination
of the relative position of the victim and the offender when
such wound has been inflicted. The direction of the incised
wound of the anterior aspect of the neck may differentiate
whether it is homicidal or suicidal.
g. Number of Wounds:
Several wounds found in different parts of the body are
generally indicative of murder or homicide.
h. Conditions of the Locality:
(1) Degree of hemorrhage.
(2) Evidence of struggle.
(3) Information as to the position of the body
(4) Presence of letter or suicide note.
(5) Condition of the weapon.
Determination Whether the Wounds were Inflicted During Life or
After Death:
In the determination whether the wounds were inflicted during
life or after death, the following factors must be taken into con-
sideration:
1. Hemorrhage:
As a general rule, hemorrhage is more profuse when the wound
was inflicted during the lifetime of the victim. In wounds in-
flicted after death, the amount of bleeding is comparatively less if
at all bleeding occurred. This is due to the loss of tone of the
blood vessels, the absence of heart action and the post-mortem
clotting of blood inside the blood vessels.
Violence inflicted on a living body may not show the formation
of a bruise until after death.
2. Signs of Inflammation:
There may be swelling of the area surrounding the wound,
effusion of lymph or pus and adhesion of the edges. Other vital
reactions are present whenever the wound was inflicted during
life, although it may be less pronounced when the resistance of
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Determinations whether the wounds are homicidal, suicidal or

the victim is markedly weakened. The vital reaction may also
accidental:
indicate the time of infliction of the wound. Post-mortem wounds
1. As to the Nature of the Wound Inflicted:
do not show any manifesting signs of vital reaction.
a. Abrasions:
3. Signs of Repair: Extensive abiasions on the body are always suggestive of
Fibrin formation, growth or epithelium, scab or scar formation accidental death, especially in death due to traffic accident. In
conclusively show that the wound was inflicted during life. But suicidal death, abrasions are rarely observed. In case of murder,
the absence of signs of repair does not show that injury was abrasions are not common except when the body is dragged on
inflicted after death. The tissue may not have been given ample the ground. In homicide, abrasions may commonly be ob-
time to repair itself before death took place. served especially when the victim offered some degree of
resistance to the attacker.
4. Retraction of the Edges of the Wound:
b. Contusion:
Owing to the vital reactions of the skin and contractility of the Contusion is rarely observed in suicidal death, except when
muscular fibers, the edges of the wound inflicted during life
the suicidal act was done by jumping from a height. A person
retract and cause of gaping. On the other hand, in the case of the
contemplating to commit suicide will not choose a blunt
wound inflicted after death, the edges do not gape and are closely
instrument.
approximated to each other because the skin and the muscles
Contusion in accidental death may also be found in any
have lost their contractility.
portion of the body. It is often due to a fall and due to a
sanctions between Ante-mortem and Post-mortem Wounds: forcible contact with some hard objects.

Ante-mortem Wound Post-mortem Wound c. Incised Wounds:.

U- ok* Incised wounds are commonly observed in suicide and
. Hemorrhage slight or none at homicide. The depth, location and other surrounding cir-
1. Hemorrhage more or less co-
all and always venous. cumstances will differentiate one from the other. Accidental
pious and generally arterial.
(AC cuts are frequent everyday occurrences, but rarely as a cause of
. No spouting of blood.
2. Marks of spouting of blood death.
from arteries. auc
3. Clotted blood . Blood is not clotted; if at all, Points to be Considered in the Determination as to whether the
it is a soft clot. Wound is Homicidal, Suicidal or Accidental:
4. Deep staining of the edges . The edges and cellular tissues 1. External signs and circumstances related to the position and
and cellular tissues, which are not deeply stained. The attitude of the body when found.
is not removed by washing. staining can be removed by 2. Location of the weapon or the manner in which it was held.
washing. 3. The motive underlying the commission of the crime and the like.
EfcrThe edges gape owing to the . The edges do not gape, but are 4. The personal character of the deceased.
reaction of the skin and closely approximated to each 5. The possibility for the offender to have purposely changed the
muscle fibers. other, unless the wound is truth of the condition.
caused within one or two 6. Other information:
hours after death.
3* a. Signs of Struggle:
. Nd^mflammation or reparative
6. Inflammation and reparative 6 Absence of signs of struggle is more in suicide, accident or
processes.
processes. murder.
Toxicology by N.J. Modi, 12th
(From: Medical Jurisprudence and Contusion or abrasion may indicate trauma due to fist,
ed. p. 237).
y finger or feet of the assailant.
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Presence of hair or portion of the skin (epidermis) on the
nails of the assailant or deceased may be a clue in the deter-
mination whether death is suicidal, homicidal or accidental.
b. Number and Direction of Wounds:
Multiple wounds in concealed portions of the body are
generally indicative of homicide.
Single wound located in a position that the deceased could
have been conveniently inflicted is usually suicidal.
c. Direction of the Wound:
This is important in the case of cut-throat. It is generally
transverse in case of homicide while it is oblique in case of
suicide.
d. Nature and Extent of the Wound:
Homicidal wounds may be brought about by any wounding
instrument. Suicidal wounds are frequent due to sharp instru-
ments. Accidental physical injuries may be of any kind.
e. Stare of the Clothings:
There is usually no change in the condition of the clothings
in suicide case. In homicidal death, on account of the struggle
which took place before death, the clothings of the victim are
in a disorderly fashion.
Length of Time of Survival of the Victim After Infliction of the
Wound:
In the approximation of the length of survival of the victim after
receipt of the physical injury, the following factors must be taken
into consideration:
1. Degree of Healing:
The injured portion of the body undergoes certain chemical
and physical changes as a normal course of repair. The capillaries
are dilated and edema develops at once. This is followed by the
migration of the white cells from the capillaries to the damaged
area. Fibroblasts begin to proliferate later with the formation of
the granulation tissues.
Signs of repair of the wound appear in less than a day after the
infliction of injury. By the degree of granulation tissue formation
and other reparative changes, the age of the wound may be esti-
mated.
2. Changes in the Body in Relation to the Time of Death:
The length of time in the survival of the victim may be approxi-
mated from the systematic changes in the body. The degree of
wasting, anemia, condition of the face, and bed sore formation
may be a basis as to how long a person survived.
3. Age of the Blood Stain:
The age of the blood stain may be determined from the phy-
sical color changes of the skin, although it is not reliable. Al-
though there are some basis for such method, it must not be
relied upon because the physical changes of the blood is modified
by several external factors.
4. Testimony of the Witness When the Wound was Inflicted:
The actual witness may testify in court as to the exact time the
wound was inflicted by the offender. In this case, medical evi-
dence as to the duration of survival is merely corroborative.
Possible Instruments Used by the Assailant in Inflicting the Injuries:
The determination of the wounding instrument may be made from
the nature of the wound found in the body of the victim:
1. Contusion — produced by blunt instrument.
2. Incised wound — produced by sharp-edged instrument inflicted
by hitting.
3. Lacerated wound — produced by blunt instrument.
4. Punctured wound — produced by sharp-pointed instrument.
5. Abrasion — body surface is rubbed on a rough hard surface.
6. Gunshot wound — the diameter of the wound of entrance may
approximate the caliber of the wounding firearm.
Could the injury have been inflicted by a special weapon?
A physician cannot determine definitely that a certain specific
weapon was used in inflicting a wound. He can only state that it is
possible that a certain injury is possibly caused by a certain instru-
ment presented. He must be cautious in making a categoric state-
ment.
Which of the injuries sustained by the victim caused death?
If there are several offenders who conspired with one another in the
commission of the offense, it is not necessary to determine who among
them gave the fatal blow. In the crime of conspiracy, the act of one
is the act of all. But if there is no conspiracy in the commission of
the offense it is necessary to determine who among the offenders
gave the fatal injury to the victim, because they are only responsible
for their individual acts.
In a case wherein the victim is a recipient of multiple injuries, the
determination as to which of the injuries caused death is dependent
on the testimony of the physician. This can be ascertained by
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examining individually the wounds and note which of them are in-
volved in the injury to some vital organs or large vessels, or led to
secondary results causing death. When two or more wounds involved
the vital organs, it is difficult to ascertain which ^mong them caused
the death. It is important to determine the degree of the damage of
each of the wound caused on the vital organ.
Which of the wounds was inflicted first?
When there are several wounds present on the body of the victim,
it is important to determine which of them was inflicted first because
it may be 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 of defense, then murder is committed, but
if the fatal wound was inflicted last, it is possible that the crime
committed is only homicide.
In the determination as to which of the wounds present was
inflicted first, the following factors must be taken into consideration:
1. Relative position of the assailant and the victim when the first
injury was inflicted on the latter.
2. Trajectory or course of the wound inside the body of the victim.
3. Organs involved and degree of injury sustained by the victim.
4. Testimony of the witness.
5. Presence of defense wounds on the victim. If the victim tried to
make a defensive act during the initial attack, then the defense
wounds must have been inflicted first.
Effect of Medical and Surgical Intervention on the Death:
If the death of the victim followed a surgical or medical inter-
vention, the offender will still be held responsible for the death of
the victim if it 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 must be shown that the physician
treating the victim must be competent and that in spite his exercise
of care and diligence, still death was the final outcome. A person
committing a felony shall be responsible for whatever will be the
outcome of his felonious act. The wound inflicted by him must be
the direct and proximate cause of the death of the victim.
On the other hand, if the victim merely received minor wounds
but death resulted on account of the gross incompetence or negli-
gence of the physician, then the offender cannot be held responsible
for the death. The offender can only be made responsible for the
physical injuries inflicted on the victim and the physician must be
made to answer for the death.
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Effect of Negligence of the Injured Person on the Death:
If death occurred from complications arising from a simple in-
jury owing to the negligence of the injured person in its proper care
and treatment, the offender is still held responsible for the death.
A person is not bound to submit himself to medical treatment for
the injuries received during the assault.
The fact that the victim would have lived had he received ap-
propriate medical attention, is immaterial. Hence, the refusal of
the deceased to be operated does not relieve the offender of the
criminal liability for his death (People v. Sto. Domingo, C.A. —
G.R. No. 3783, May 1939).
But, if it could be proven that the negligence of the victim is
deliberate and that this intention is really the cause of death on
himself, then the offender cannot be held responsible for the death
but only for the physical injuries he had inflicted.
Power of Volitional Acts of the Victim after Receiving a Fatal
Injury:
Sometimes it is necessary to determine whether a victim of a fatal
wound is still capable of speaking, walking or performing any other
volitional acts. A dying declaration may be presented by the pro-
secutor mentioning the accused as the assailant; the offender may
allege that the physical injuries inflicted by him while the victim was
inside his house and that he walked for some distance where he fell,
or that the victim after the fatal injury made an attempt to inflict
injuries to the accused which justified the latter to give another fatal
blow. The determination of the victim's capacity to perform voli-
tional acts rests upon the medical witness.
As a general rule, severe injury of the brain and the cranial box
usually produces unconsciousness, but after a while.the victim may be
capable of performing volitional acts. The power to perform volitional
acts is dependent upon the areas of the brain involved. Wounds of
the big blood vessels, like the carotid, jugular or even the aorta, do
not prevent a person from exercising voluntary acts or even from
running a certain distance. Penetrating wound of the heart is often
considered to be instantaneously fatal but experience shows that the
victim may still be capable of locomotion. Rupture of the organs
is not always followed by death. The victim has for sometime still
retains the rapacity to move and speak.
Extreme caution must be exercised by the physician in expressing
his opinion as to the limitation of powers possessed by the injured
person to perform acts of volition, locomotion, or speech subsequent
to receipt of extensive or fatal injury or wound.
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Relative Position of the Victim and Assailant When Injury Was

Inflicted:
In the determination of the relative position of the victim and the
assailant when the wound was inflicted, the following points must be
considered by the physician:
1. Location of the wound in the body of the victim.
2. Direction of the wound.
3. Nature of the instrument used in inflicting the injury.
4. Testimony of witnesses.
Extrinsic Evidences in Wounds:
1. Evidences from the Wounding Weapon:
a. Position of the Weapon:
The location and position- of the weapon at the scene of the
crime may afford strong evidence in the court. As a rule, in
cases of accidental or suicidal death, the wounding weapon is
found near the body of the victim, but it is not uncommon to
find the victim at some distance from the weapon when the
victim is capable of walking. If the wounding instrument is
firmly grasped by the victim, it is a strong presumption that it
is a suicidal case.
b. Blood on Weapon:
The weapon responsible for the production of wound may be
stained with blood. In some instances, the wounding weapon
does not show blood stains because of the rapidity of the blow
and compression of the blood vessels. Even if the weapon is
stained with blood, it may be wiped out by the clothings in the
process of withdrawal.
The weapon must be subjected to a complete examination to
determine whether it is the one used in the commission of the
offense.
c. Hair and Other Substance on Weapon:
Hair or fibers of cotton, silk, linen and other fabrics may be
found adhering on the weapon. It must be preserved and sub-
mitted for comparison with the clothings or hair found at the
site of the injury on the victim's body.
298 LEGAL MEDICINE
are produced on the dress by a single wound. This can be explained
by the presence of folds on the clothings.
In gunshot wound, determination of the presence of gunpowder
at the hole of entrance may show distance. The presence of clean-
cut tear in the clothings shows that a sharp-edged instrument was
used. The presence of severe tearing of the clothing shows struggle.
The degree of soaking of the clothings with blood may depict the
degree of hemorrhage.
3. Evidences Derived from the Examination of the Assailant:
The clothings of the assailant may be stained with blood from
the victim. Tear may be present on account of the struggle which
existed at the time of the commission of the offense. The finger-
nails may show foreign substances coming from the body of the
victim.
The offender may also show to a certain degree marks of vio-
lence. Paraffin test of the assailant's hands may be useful to
determine whether he fired the gun in case of shooting.
Determination of the degree of intoxication, mental condition,
physical power, etc. of the offender may be necessary in the
solution of the crime.
4. Evidences Derived from the Scene of the Crime:
The condition of the surrounding objects, the amount of
hemorrhage, the presence of identifying articles belonging to the
victim or assailant, the wounding instrument, all these must be
observed or collected by the investigator.

2. Evidences in the Clothings of the Victim:

Injuries inflicted on the covered portions of the body may also
show injury on the covered apparel. In gurrhot wound, the hole
in the clothings may be a factor in the determination of the site of
the wound of entrance. Occasionally, two or more tears or holes
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Chapter XI b. Intensity of the Force:

PHYSICAL INJURIES IN THE DIFFERENT
PARTS OF THE BODY:
1. HEAD AND NECK INJURIES:
Injuries of the head must not be underestimated. They must
be treated with extreme care. The absence of an external wound
on the head does not itself permit a conclusion that there is no
internal damage. Contusion and hematoma of the scalp may only
be appreciated during the post-mortem examination. The pre-
sence of hair further augments the difficulty of appreciating
head injuries.
The presence of bleeding from the ear, nostrils and mouth may
be associated with basal fracture. Fracture of the vault and other
portions of the cranial box may cause unconsciousness and this
may be mistaken for simple intoxication. It is preferable to have
the patient under careful, intelligent and continuous observation
for at least twelve to twenty-four hours to avoid risk to the life
of the patient. X-ray examinations may be useful in order to
determine the presence of fracture. However, it is not uncommon
that no fracture is observed, and yet the intracranial injury is
quite severe.
Factors Influencing the Degree and Extent of Head Injuries:
a. Nature of the Wounding Agent:
Weapons with a small striking face usually produce a local-
ized depressed fracture with laceration of the scalp. The degree
of injury depends upon the degree of violence applied, the
thickness of the scalp struck and the weight of the weapon.
Violent contact with the wheel of a motor vehicle causes
fissure or comminuted fracture of the cranial box. There is
always an associated injury of the brain substance and lace-
ration of the meninges.
Penetrating injuries of the skull like those caused by a dagger,
a nail or a bullet, may leave a clean-cut opening with the shape
and size of the wounding weapon. A glancing hit of a bullet
may cause a gutter-like depressed fracture of the vault of the
skull.
As a general rule, the intensity of force is proportional
to the degree of damage it will produce. However, in cases
where the striking face is small, the amount of force which
produces the same injury is smaller. This is, however, qualified
by the part of the skull involved. For example, less force is
required to produce injury when applied at the temple than
when it is applied elsewhere in the exposed surface of the skull.
Heavy agents may require less force to produce extensive
damage to the skull although the point of impact is wide.
c. Point of Impact:
There are areas in the cranium wherein if force is applied to
them, the injuries are extensive. Fractures of the vaults, either
on the side or at the back, usually causes a stellate comminution
at the point of impact with linear extensions to some other areas.
Basal fractures are often caused by transmitted force from some
points of impact.
d. Mobility of the Skull at the Time of the Application of Force:
If the head is mobile, unsupported and free, the principal
effects on the brain is due to the shearing movement imparted
to the brain. It may produce contusion, laceration or hemor-
rhage without any fracture on the skull.
If the head is fixed and supported, as when the head is caught
by the wheel of a vehicle, jarring movement of the brain is
absent but the fracture is extensive. Usually the fracture forms
a line from the point of contact with the wheel up to the point
of support of the head. There may be complete separation of
the naso-facial mass from the rest of the skull.
Head Injuries are Classified as to the Site of the Application of
Force:
a. Direct or Coup Injuries:
These are injuries which occur at the site of the application
of force and will develop as a natural consequence of the force
applied.
Direct Injuries may Result to:
( 1 ) In compression of the head by the wheel of a vehicle.
( 2 ) When the head strikes an object in motion, as bullets.
( 3 ) When the head is in motion and strikes an object, as in
vehicular accidents.

299 b. Indirect Injuries:

These are injuries in the head which are not found at the site
of the application of force. The injury may be at the opposite, or
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in some areas offering the least resistance, or in areas which have
no relation with the site of the impact.
( 1 ) Contre Coup Injuries:
These are injuries which develop opposite the site of the
application of force. A blow on the occiput may produce
laceration or contusion of the frontal lobe of the brain.
This is observed when the head is free and mobile.
( 2 ) Remote Injuries:
Remote injuries are produced in cases where the force is
applied in some areas of the body which have no relation to
the head. A fall on the feet or buttocks may cause basal
fracture of the skull.
( 3 ) "Locus Minoris Resistencia":
The injury sustained in the head may not be at or op-
posite the application of force but may be found in some
areas of the skull offering the least resistance. A blow on
the head may cause a linear fracture of the roof of the orbit
on account of the papyraceous nature of the bone.
c. Coup-contre-coup Injuries (Direct and Indirect Injuries):
The injuries may be at the site of impact and at the same
time found in some other pafts of the head which may be
opposite the site of application of force, or elsewhere. A
hammer blow in the frontal portion of the head may cause
depressed fracture of the frontal bone and at the same time
fracture of the roof of the orbit and laceration of the posterior
lobe of the cerebrum.
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 experienced in differentiating a lacerated from an incised
wound of 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 due to the impact of a blunt force or to the
sharp edges of the fractured skull.
Incised wounds of the scalp in general involve the cranium.
The force necessary may not be so strong as to produce a clean-
cut fracture of the cranium.
Fractures of the Skull:
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 box. Meningeal vessels are so situated in the
furrows of the cranium that fracture of the cranium will always
lead to laceration of the blood vessels.
a. Fissure Fractures:
Fissure or linear fracture involves the inner and outer table.
It is usually caused by the impact of a blunt object and may
appear as a radiating crack from the site of the application of
force and may involve the base of the cranial fossae.
b. Localized Depressed Fracture:
Localized depressed fracture is sometimes called "Fracture a
La Signature". It invariably shows the nature of the instrument
that causes the fracture. The round face of the hammer may
show a round depressed fracture in the cranium.

Wounds of the Scalp: c. Penetrating Injuries of the Skull:

A wound of the scalp although small and negligible is always
potentially serious because:
a. It is difficult to prevent the spread of infection.
b. There is proximity of the scalp to the brain.
c. There is a free vascular connection between the structures inside
and outside the cranium.
d. It is frequently difficult to determine the extent of damage of
the skull.
Abrasion of the scalp is commonly unnoticed because of the
protective covering of the hair. Contusion may not be visible
because of the thick resistant scalp and may only be noticed on
autopsy.
Hematoma easily develops in the scalp because the cranium is
located superficially and the subaponeurotic tissue is loose.
Sharp-edged instrument produces clean-cut fracture of the
skull. The size and shape of the fracture may correspond to the
shape of the wounding instrument. A gunshot produces an oval
or round hole with bevelling of the inner table at the wound
of entrance. The blade of the wounding weapon may be left
inside without causing trouble but complications like infection
may later develop and may cause a fatal consequence.
d. Comminuted Fractures:
Comminution of the skull may develop as a result of a fissure
or a depressed fracture. The presence of comminuted fracture
is an indication of the severity of force applied or the use of a
heavy weapon.
Majority of comminuted fractures are caused by motor
vehicle accidents. In a near shot with a firearm, there is usually
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a radiating fissure fracture from the point of impact which

forms a "spider w e b " comminution of the cranium.

e. Pond or Indented Fracture:

In the skull of infants wherein there is undue elasticity, the
production of a pond or indented fracture is common. It may
be a result of a simple compression of the skull, as in a pingpong
ball. Fissure fracture is likely to develop around the periphery
of the dent.

f. Gutter Fractures:
A tangential or glancing approach of a bullet may cause the
production of a furrow in the cranium. It may involve both
the outer and inner tables. The furrow may cause injury on
the blood vessels causing intracranial hemorrhage or laceration
of the brain.
g. Bursting Fractures:
It is an extensive fracture running parallel to the two points
of contact, if mechanical force is applied on one side of the
Severe extra-dural h e m o r r h a g e w i t h compression of the brain
head, while it is pressed on the other side against a hard sub-
stance, such as a wall, while the individual is standing, or against Hemorrhage at the region of the vault produces a discus-
the hard ground or floor, when he is in a lying posture. In such shaped clot with compression of the brain substance and this
cases the fracture may extend transversely to the base of the may cause neurologic disturbance. If the patient lives for
skull. The passage of the wheel of a heavy vehicle over the head sometime, there will be an organization of the clot and a
often causes a complete division of the skull into two parts. fibrous thickening of the dura.
The direction of the burst correspond to that in which the
A person suffering from extradural hemorrhage may com-
wheel passed over the head.
plain of headache, vomiting and drowsiness. The pupils may be
(From: A Handbook of Medical Jurisprudence & Toxicology dilated on the side of the hemorrhage. Examination of the
with State Medicine & Post-Mortem Techniques by C.C. Mallik, cerebro-spinal fluid shows absence of blood, unless it is com-
p. 206). plicated with hemorrhage in other regions in the cranial cavity.
Intracranial Hemorrhages:
b. Subdural Hemorrhage:
Intracranial hemorrhages may occur even in the absence of a
Unlike extradural hemorrhage, subdural bleeding is essential-
fracture. Hemorrhage may be present without trauma. The blood
ly venous or capillary. It is the most common cause of cerebral
vessels of the brain may be diseased and may rupture spontaneously,
compression. It may be a consequence of fracture of the skull,
a. Extradural or Epidural Hemorrhage (almost exclusively due to laceration of the brain, spontaneous rupture of the blood vessels
trauma): on the surface of the brain or laceration of the dura and me-
Extradural hemorrhage is caused by a fracture of the skull. ningeal vessels. It usually comes from the small blood vessels
The fracture will cause laceration of the blood vessels which are which cross the subdural space to the subarachnoidal area.
grooved at the inner table of the skull. The branches of the
meningeal vessels are usually involved, the most frequent of Majority of subdural hemorrhages are traumatic in origin
which are the branches of the middle meningeal vessels. The although a few may be due to a natural disease of the blood
laceration is commonly unilateral except when the fracture vessels of the brain. There are difficulties in ascertaining the
extends to the opposite side. cause and source of such hemorrhage.
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15th day - Membrane has formed on the undersurface

Extensive s u b d u r a l h e m o r r h a g e
Ageing Subdural Hematoma Munro-Merritt Method:
In the determination as to how long subdural hematoma
existed, the study of the structure of its membrane is made as
a basis (Munro-Merritt Method).
1st 24 hours — Deposit of fibrin at the margin of the clot
with red blood cells and leucocytes well
preserved.
24 — 36 hours — Fibroblast found at the junction of the
dura mater and the blood clot.
4 days — Definite histological evidence of 2 to 3
layers of cell thickness neomembrane. The
red blood cells have begun to lose their
sharp contour.
4 to 5 days — Increasingly prominent membrane with ex-
tension of the fibroblasts into the underlying
clot.
8th day — The membrane has become 12 — 14 cells in
thickness. Pigment-laden phagocytes are
found.
11th day — Clot broken up into islands by the invasion
of strands of fibroblasts.
of the clot and strands of fibroblasts. Red
blood cells have broken up. The outer layer
of the neomembrane is 1/3 to 1/2 the thick-
ness of the overlaying dura.
26th day — Neomembrane is about the thickness of the
overlying dura. Blood has liquified. Red
blood cells not clearly apparent.
1 to 3 months — Progressive decrease in the number of nuclei
of the fibroblasts and progressive hyalinization
of the membrane. Large blood spaces ("sinu-
soidal vessels") filled with red blood cells
have become increasingly prominent in the
new-formed connective tissue.
6 to 12 months — Neomembrane has become thick and fibrous,
blood has disappeared leaving only a few
scattered pigment-laden phagocytes.
1 to 2 years — The new-formed membrane is distinguishable
from the overlying dura only by the parallel
arrangements of the connective tissue fibers
which have become more or less completely
hyalinized.
(GradwohVs Legal Medicine by F.E. Camps ed., 3rd ed., p. 316).
c. Subarachnoidal Hemorrhage:
Subarachnoidal hemorrhage may be due to trauma or to
spontaneous rupture of blood vessels. Its causes may be sum-
marized as follows:
( 1 ) It may be produced by severe head injury especially in
contre coup kind.
(2) It may be due to ruptured cerebral aneurysm and is com-
monly seen at the base of the brain.
(3) It may be an extension of the spontaneous hemorrhage of
the brain which extends to the subarachnoid space.
(4) In asphyxia there may be subarachnoidal hemorrhage in the
form of petechial hemorrhage.
d. Cerebral Hemorrhage:
Cerebral hemorrhage may be traumatic or spontaneous in
origin. If a person develops rupture of a blood vessel and
suddenly collapses and falls on the ground producing a certain
degree of head injury, it is quite difficult to ascertain the exact
origin of the hemorrhage. A careful dissection of the brain
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 307 308 LEGAL MEDICINE
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tissue involved is necessary to determine the presence of patho-
logy of the blood vessel.
Traumatic cerebral hemorrhage is usually due to laceration or
contusion of the brain in contre-coup injuries. Severe crushing
of the skull in vehicular accident cases may cause the sharp
fractured edges of the bone to lacerate the brain and produces
severe cerebral hemorrhage. It may involve the gray matter
only but in severe cases the hemorrhage extends up to the white
matter.
Distinction between Cerebral Apoplexy and Post-traumatic Intra-
cerebral Hemorrhage:
a. In traumatic intracerebral hemorrhage the interval between the
injury and onset of "stroke" (symptoms) is usually a week or
less.
b. In traumatic intracerebral hemorrhage, the injury to the head
must be sustained when the head is in motion and the hemor-
rhage is the result of the coup-contre-coup mechanism.
c. The location of traumatic intracerebral hemorrhage is in the
central white matter of the frontal or temporo-occipital region.
Cerebral apoplexy is usually at the basal ganglia, a very uncom-
mon site of traumatic intracerebral hemorrhage.
d. History of hypertension prior to the "stroke" and evidence of
degenerative disease are present in cerebral apoplexy. There
is a history of head trauma in traumatic intracerebral hemor-
rhage.
(Gradwohl's Legal Medicine, 2nd ed. by F.E. Camps, p. 312).
Brain:
a. Laceration of the Brain:
Lacerations of the brain may be:
(1) Direct or Coup Laceration:
This is produced by the fracture of the skull. The edges
of the fractured bone lacerate the arachnoid and the under-
lying brain tissue. It may occur any where in the brain but it
usually follows the line of fracture. The most frequent
sites are the parietal and the frontal lobes.
( 2 ) Contre-coup Laceration:
Contre-coup laceration occurs usually directly across the
point of impact and fracture. Contre-coup injuries occur
only when the head is free to move at the time of the
impact. If the head is held immovable the mechanism of
contre-coup will not operate. A frontal impact may pro-
duce laceration of the cerebellum while an impact in the
occipital region may cause contre-coup laceration of the
fronta-. and temporal lobes of the brain.
Brain laceration may lead to granulation tissue for-
mation and ultimately to fibrosis in the absence of infection.
Histo-pathological changes following contusion and laceration of
the cerebral cortex:
Within 3 hours — Minimal alteration of the cellular elements at
the margin of the wound. Microglia may show
slight swelling of the cytoplasm of the dendrites.
There is fracturing of the myelin sheath. Cortical
nerve cells may show pyknotic changes.
6 to 12 hours — Pyknotic cells become more apparent and
blood pigment is found between cortical neu-
rons. Glial cells look swollen especially oligo-
dendroglia in the white matter and perineuronal
satellite cells in the gray matter, as cerebral
edema begins to develop.
12 — 24 hours — Cortical nerve fibers show fairly numerous
end-bulbs and early degeneration of the inter-
rupted fibers. Microglia continue to show early
swelling of their processes. Pyknotic change and
pigmentary infiltration of the nerve cells are still
present at the margin of the contusion. Loss of
Nissl substance may be detected in larger nerve
cells.
1—2 weeks — Increase in the number of granular corpuscles in
activity of phagocytic action. Astrocytes are
plump and the nuclei are very prominent.
Cerebral edema is well shown by the spongy
appearance of the white matter. Nerve cells
in the border zone may show fatty degeneration
or cytoplasmic vacuolation.
1 month — Scarring process becomes fairly static. The
gliotic astrocytic scar shrinks and appears gray
or brownish in color. Blood vessels are thick-
ened, hyalinized coats owing to increased
density of astrocytic end-process attached to
them.
(GradwohVs Legal Medicine by F.E. Camps ed., 2nd ed., pp. 317-
319).
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b. Edemas of the Brain: In traumatic compression, the symptoms do not appear

Edema of the brain which is usually the effect of trauma may immediately after the injury. The symptoms depend upon the
be localized or generalized. area of the brain involved but signs of increased intracranial
pressure are always present. Vomiting, headache, irregular
( 1 ) Localized Edema:
breathing, incontinence of urination and defecation, and
Localized edema is observed in deep brain lacerations. paralysis are usually present. Recovery develops when the cause
The edematous area is soft, swollen, gelatinous and yellowish- is completely removed but usually the patient has loss of
red in appearance. It is observed in abscess and neoplasm. memory, epilepsy, paralysis, or insanity as a sequelae.
( 2 ) Generalized Edema:
Medico-Legal Questions in Intracranial Injuries:
This is usually associated with severe trauma of the head.
a. Is the origin of the intracranial hemorrhage due to trauma or
The brain has a swollen appearance, with flattening and
disease?
broadening of the convolutions and diminution of the
Extradural or epidural hemorrhage is always caused by
sizes of the ventricle. Microscopically, there is an intra-
trauma. The blood vessels causing the hemorrhage which are
cellular, pericellular and perivascular accumulation of
grooved at the inner table of the skull are usually lacerated by
fluid.
the fractured skull.
Edema of the brain of the generalized type may also
be observed in a prolonged convulsive seizure, a sudden Subdural hemorrhage is, as a rule, traumatic in origin but it
death due to tetanus antitoxin, an encephalitis, and in an may also be caused by some diseased condition of the blood
excesssive hydration. vessels or by a local inflammatory process.

c. Concussion of the Brain:
Concussion of the brain is a transitory period of unconscious-
ness resulting from a blow on the head, unrelated to any injury
to the brain which is apparent to the unaided eye. The cause of
cerebral concussion is still undetermined. Some authorities
consider it to be a rotational injury as it will occur only when
the head is free to move but not when it is fixed.
The symptoms of concussion vary upon the degree of injury.
In a severe injury the patient may fall down and becomes un-
conscious. There is flaccidity of the muscles and sphincters are
relaxed. The face is pale, pupils are dilated and insensible, skin
is cold and clammy, the pulse is rapid, the respiration is slow,
irregular and sighing and the temperature is subnormal.
In cases of recovery, there is usually a retrograde amnesia of
the accident and even events before and after it. The patient
may also develop automatism and may perform criminal acts
which may be mistaken to be volitional or voluntary.
d. Compression of the Brain:
On account of the severe intracranial hemorrhage, depressed
fracture of the skull, or edema of the brain, compression of
some vital areas of the brain may lead to paralysis or loss of
consciousness. Natural diseases, like newgrowth, abscess and
hydrocephalus may also cause compression of the brain.
Subarachnoidal hemorrhages are usually spontaneous and are
usually caused by ruptured aneurysm or sclerotic vessels at the
circle of the Willis.
Hemorrhage in the brain substance is usually spontaneous
and usually involves the deep tissues of the brain, pons and
cerebellum. Age, blood pressure, chronic alcoholism, kidney
disease must be taken into account to determine whether it is
traumatic or spontaneous in origin.
b. In cases of cerebral concussion, can the victim remember the
incidents before, during or after the accidents?
In mild form of cerebral concussion or after a psychological
treatment, 'the victim may be able to recall the incident. A
person may suffer from severe concussion and still retain a
good memory of the past. In severe form of concussion, the
victim may totally lose the recollection'of past events.
c. Can the victim of head injuries still retain voluntary move-
ment and speech?
In severe head injuries with comminuted fracture of the skull
there is immediate loss of consciousness such that voluntary
movement and speech are no longer possible. Depressed frac-
ture of the skull may cause also immediate loss of consciousness
that may develop sometime after the impact.
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 311 312 LEGAL MEDICINE
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The capacity of the victim to retain voluntary movements
and speech depends upon the loss of consciousness and the
area of the brain involved.
d. Post-traumatic Automatism:
A person while under the state of post-traumatic automa-
tism may commit a crime while in an unconscious state. He is
considered to be exempted from criminal liability because he
did not act with intelligence. There can be criminal intent if
a person acted with voluntariness or with intelligence. A
person under the state of post-traumatic automatism acted
involuntarily.
e. In gunshot wounds of the head, how can the point of entrance
be determined?
In some instances the gunshot wound on the head may not
clearly show characteristic findings of a wound of entrance. The
examiner must resort to the examination of the fracture of the
skull. At fhe point of entrance, the injury at the outer table is
oval or round while there is bevelling fracture at the inner table.
The opposite is true at the point of exit.
f. Post-traumatic Irritability:
The victim of a head injury may suffer post-traumatic irri-
tability and may lead to do acts of impulsive violence. If
irritability develops after a head injury, it is doubtful if it will
be a valid defense following the doctrine of acting under an
irresistible impulse. But, if genuine traumatic psychosis develops
later, the responsibility is evaluated in accordance with the
general principle of appraisal of responsibility of insanity
(Medical Trial Technic, Mar. 59, p. 32).
Face:
Generally, wounds on the face heal relatively faster as compared
with wounds of the other parts of the body on account of its great
vascularity. Most often, injuries on the face are serious because
they produce ugly scars or other forms of deformity. Because of
their proximity to and the presence of free communication with
the brain, facial injuries are always a threat to life. As a whole,
wounds on the face may be due to a blow, vehicular accident,
kick, sharp instrument, gunshot, or a blunt weapon. Fractures of
the facial bones, especially of the nasal bone and mandible, are
quite frequent,
a. Eye:
Contusion of the soft tissue about the eyes is sub-conjunc-
tival. Hemorrhage is frequently observed in a fist blow. Fracture
of the base of the anterior cranial fossa may also produce con-
tusion of the eyelids, and this may be distinguished from con-
tusion due to a blow by the absence of swelling and skin injuries
in the former.
The eye may be lacerated by a blunt weapon or by a piece of
stone. Acute inflammatory changes usually occur with injury
of the cornea, iris and lens and may require total enucleation of
the eyeball. Penetrating wounds due to sharp instruments or
bullets may cause meningitis or total blindness.
b. Nose:
Fracture of the nasal bone is a common sequelae of fist blows,
and may cause severe epistaxis and facial deformity. The nose
may be bitten in a quarrel, cut with a sharp-edge instrument,
and contused, abraded or lacerated by a blow. In suicide, the
muzzle of the death gun might be placed in the nostril and may
cause no visible wound of entrance.
Injuries of the nose are usually dangerous to life on account
of the extension of infection to the brain.
c. Ear:
A blow on the ear may produce a rupture of the tympanic
membrane leading to permanent or temporary deafness. Hemor-
rhage coming from the ear may suggest fracture of the base of
the middle cranial fossa. In a quarrel, the pinna of the ear may
be cut off or markedly lacerated or contused by a strong blow.
The trauma in the ear may cause septic infection and may
extend to the brain and causes death.
d. Mouth:
Contusion, laceration and swelling of the lips are usually
observed in a fist blow, kick or bite. It may or may not be
associated with fracture of the teeth or injury of the gum.
Fracture of the lower jaw is usually due to direct violence
and the most common site is at the region of the insertion of
the canine and at the region of the condyle. Fracture of the jaw
is always associated with laceration of the gums which may
extend to the floor of the buccal cavity.
Occasionally a gunshot wound in suicidal case is found
inside the mouth and investigators are usually at a loss in the
examination and location of the wound of entrance.
Infections following injury of the mouth may extend to the
upper respiratory system and cause edema or gangrene of the
glottis.
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314 LEGAL MEDICINE
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY
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Neck: Recovery from spinal fracture may cause deformity or

Abrasions of the neck may be present in cases of manual
strangulation. Ligature marks are present in death by hanging or
strangulation by ligature. Incised wounds may be homicidal or
suicidal. Suicidal cut-throat wounds are usually diagonal while
homicidal wounds are usually horizontal. Incised and stab wounds
of the neck may involve the trachea and the big blood vessels and
nerves and in most cases, end fatally. Asphyxia, pneumonia,
hemorrhage and shock are the common causes of death from
neck injuries.
Wounds of the esophagus are not common. They are usually
accompanied by wounds of the trachea and large blood vessels
of the neck. Severance of the recurrent laryngeal nerve causes
aphonia.
Contusion or rupture of the muscles, severance of the nerves are
2. INJURIES IN THE CHEST:
sometimes observed in severe trauma applied to the neck. For-
cible blow in the anterior portion of the neck may cause un-
consciousness or even death due to reflexed inhibitory action on
the vagus nerve.
paralysis of certain areas of the body. Injury of the spine is
usually associated with considerable, pain.
b. Concussion of the Spine:
Concussion or jarring of the spinal cord may occur even
without any visible signs of external injuries. A physician
usually has much difficulty making diagnosis of concussion of
the spine.
The usual complaints are headache, restlessness, pain and
tenderness over the spine, loss of sexual power, irritability of
the bladder, inability to walk, weakness of the limbs, and
derangement of the special senses.
Concussion of the spine may be sustained in a motor vehicle
collision and in a railway accident.
Injuries in the chest are important because vital organs are
inside the chest cavity, namely: the heart, lungs and the principal
blood vessels.

Vertebral Column and Spinal Cord: Injuries to the Chest Wall:

a. Fracture of the Vertebrae:
Fracture of the vertebrae is dangerous to life because of the
involvement of the spinal cord. Injury of the cord due to
fracture of the upper four cervical vertebrae causes paralysis of
the phrenic nerve, while those due to fractures of the fifth cervi-
cal vertebra to the first dorsal vertebrae may cause paralysis of
all the extremities. Injury of the cord at other levels may not
cause immediate death but complications like hypostatic
pneumonia, bed sores and other secondary infections may set
in and cause death.
The causes of the fracture of the spine may be:
( 1 ) Direct Violence:
The fracture of the spine may be due to a blow by a
heavy instrument coming from the back, fall from a height,
collision with motor vehicles and hit of a projecting instru-
ment.
(2) Indirect Violence:
Indirect violence may be due to a fall on the feet or
buttocks, forcible bending of the body as in wrestling, a
blow on the chin or forehead, forcible bending of the head
towards the sternum, and slight twist of the body if the
person is suffering from Pott's disease.
The chest wall is easily contused by the application of moderate
force on account of the superficial location of the ribs. Lacerated
wounds are rarely observed as a direct effect of violence, but are
observed when the fractured ends of the ribs pierce the skin in
severe crush injuries due to motor vehicle accidents.
Stab wounds on the chest are quite common on account of its
accessibility when both the assailant and the victim are in a stand-
ing position. The intercostal vessels may be involved, causing
considerable hemorrhage. Stab wounds of the chest, as a general
rule, involve the lungs, heart and the big blood vessels in the chest
cavity.
Bullet wounds of the chest may be superficial or may involve
the pleural viscera. Hemorrhage, collapse of the lungs due to the
removal of the negative intrathoractic pressure and pneumonia
may develop if the victim does not die immediately.
Fracture of the ribs causes severe pain during each phase of
respiration and if complete, it may be associated with laceration of
the parietal pleura or of the skin. The lungs and the heart may
also be lacerated when there is an inward displacement of the
fractured ends.
Fracture of the Ribs may be Caused by:
a. Direct Violence:
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 315 316 LEGAL MEDICINE
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The fracture of the ribs is at the site of the application of
force as in cases of blow, stab, or bullet wounds,
b. Indirect Violence:
The fracture of the ribs is not at the point of the application
of force, as in crush injuries in vehicular accidents, a pressure on
the chest by heavy objects, a fall of earth or pressure with the
knee. Fracture of the ribs is usually along the mid-axillary line
or may run obliquely in the chest depending upon the manner
the force was applied.
Fracture of the ribs lacerates the parietal pleura and the sharp
ends of the ribs cause injury to the lungs, heart and big blood
vessels. The laceration of the skin may cause collapse of the
lungs and the victim dies of asphyxia.
The usual site of fracture of the sternum is the junction of
the manubrium and the gladiolus. The fracture is usually
transverse and most often associated with fracture of the ribs.
It results from a sudden impact of heavy, blunt object or
compression of the chest due to a fall or a vehicular accident.
Fracture of the sternum may be associated with laceration of
the pericardium and injury to the heart.
Injuries to the Lungs:
Hemorrhage in the pleural cavity coming either from the inter-
costal vessels or from the lung tissue itself may cause compression
and collapse of the lungs and the patient may die of respiratory
embarrassment or anemia.
Contusion of the lungs may be caused by a blunt instrument
with or without fracture of the ribs, or by compression of the
chest. The lungs may be injured by a sharp-pointed instrument or
by a bullet. Injury of the lungs may cause bloody froth coming
out of the mouth.
Severe traction exerted at the region of the hilus may tear the
lungs at the point of attachment. Death is usually due to a severe
shock or a rapid hemorrhage.
Application of a severe crushing or grinding force in the chest
wall causes extensive fracture of the ribs and may results to
contusion and crushing injury to the lungs. The laceration may not
be so severe but later the victim succumbs to lobar pneumonia.
b. Compression of the lungs — The hemorrhage or the compression
of the chest wall may cause limitation of the excursion of the
lungs during respiration and ultimately the victim dies of
asphyxia.
c. Severe Pneumothorax — Laceration of the bronchi leads to the
escape of air into the pleural cavity and embarrasses the res-
piration.
d. Cerebral air embolism — Laceration of the lungs may also cause
laceration of the pulmonary veinB and causes cerebral air em-
bolism.
e. Hemoptysis — The blood from the injured lungs may find its
way to the bronchial tubes to the trachea and be spilled out
through the mouth. If hemorrhage is severe, the blood may
clot inside the bronchial tubes and causes acute asphyxia.
f. Subcutaneous emphysema — Laceration of the parietal pleura
and the lung tissue may cause the escape of air which finds its way
into the subcutaneous tissue causing crepitation of the skin.
Injuries to the Heart:
The heart may fail and causes death due to an existing natural
disease independent of trauma. Coronary insufficiency, myocardial
fibrosis, valvular lesion or tamponade due to the rupture of the
ventricle are common lesions.
Wounds of the heart are produced by sharp instruments, bullets
or the sharp ends of the fractured ribs. Contusion of the heart is
easily produced on slight trauma on account of its vascularity.
Wounds of the ventricle if small and oblique are less dangerous
than those of the auricle because of the thickness of its wall. The
right ventricle is the most common site of the wounds due to
external violence, because it is the most exposed part of the heart.
Foreign bodies like bullets, shrapnels, fragments of a shell may be
embedded in the myocardium without any cardiac embarrassment.
The person may live for a long time and may die of some other
causes.
Tearing of the heart from its attachments may be due to violent
compression of the chest with the pressure forcing the organ
downward and away from the neck The severe traction may
v

cause the laceration of the aorta.

Complications of Lung Injuries: Rupture of the heart is usually produced by a blunt instrument
a. Hemorrhage — Injury to the lung may cause severe hemorrhage or by a crushing injury due to vehicular accidents. The heart is
and about 1,500 cc. of blood may be recovered free in the commonly ruptured at the right side towards the base. Death is
pleural cavity. due to severe hemorrhage, cardiac tamponade or shock.
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 317 318 LEGAL MEDICINE
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Crushing injuries of the heart are due to compression of the Stomach:

chest with the fractured fragments injuring the heart as in vehi-
cular accidents, violent dynamite blast, or crushing of the chest
between hard object.
Wounds of the aorta and pulmonary vessels are rapidly fatal.
Rupture of the aorta may be traumatic or spontaneous. Spon-
taneous rupture may be due to aneurysm. The cause of death is
either the profuse hemorrhage or cardiac tamponade.
Injuries of the Diaphragm:
Wounds of the diaphragm due to a sharp instrument and bullets
are caused by injuries either of the chest or abdomen. Their fatal
effect is not on the injury to the diaphragm but on the accom-
panying injuries to the other organs. A n y penetrating wound in
the diaphragm may cause a potent rent for diaphragmatic her-
niation.
Rupture of the diaphragm is due to a sudden increase of intra-
abdominal pressure crushing injuries caused by vehicular accidents
or traumatic compression of the chest.
Death in diaphragmatic injuries may be due to shock, hemor-
rhage, intestinal obstruction caused by herniation, or the accom-
panying injuries.
3. ABDOMINAL INJURIES:
Abdominal Wall:
The skin may remain unmarked inspite of extensive internal
injuries with bleeding and disruption of the internal organs. The
areas most vulnerable are the point of attachment of internal
organs, especially at the source of its blood supply and at the
point where blood vessels change direction.
The area in the middle superior half of the abdomen, forming
a triangle bounded by the ribs on the two sides and a line drawn
horizontally through the umbilicus forming its base, is vulnerable
to trauma applied from any direction. In this triangle are found
several blood vessels changing direction, particularly the celiac
trunk, its branches (the hepatic, splenic and gastric arteries) as
well as the accompanying veins. The loop of the duodenum, the
ligament of Treitz and the pancreas are in the retroperitoneal
space, and the stomach and transverse colon are in the triangle,
located in the peritoneal cavity. Compression or blow on the area
may cause detachment, laceration, stretch-stress, contusion of
the organs (Legal Medicine 1980, Cyril H. Wecht ed., p. 41).
Spontaneous rupture of the stomach may be observed in cases
of gastric ulcer or new growth. A blunt force applied at the upper
portion of the abdomen may cause bruising or even rupture. The
pyloric end and the greater curvature are the most frequent sites
of a rupture.
Penetrating stab wounds of the stomach are dangerous to life
on account of a hemorrhage, infection and injury to the adjacent
organs like the liver. Tearing of the stomach is common when
the person is run over by a motor vehicle at the region of the
abdomen.
Intestine:
Ulcer at the duodenum may rupture spontaneously. The same
is true in cases of tuberculous, amoebic, cancerous or typhoid
ulcerations. Peritonitis and hemorrhage are the common causes
of death.
Traumatic rupture may be due to a blow, kick, fall or vehicular
accident. When force is applied to the front portion of the ab-
dominal wall, the intestine may be pressed between the vertebral
column and the force applied, producing either partial or complete
severance or laceration. Its septic contents will scatter in the
abdominal cavity and cause generalized peritonitis.
Injuries caused by sharp instruments or by gunshots usually
cause multiple lesions in the intestine and may also involve other
visceral organs. The intestine may be involved in vehicular acci-
dents and on account of the grinding force of the wheel, severe
hemorrhage, laceration and herniation in the abdominal wall are
usually observed.
The mesentery may be contused, lacerated or crushed but in
most cases its involvement is secondary to lesion in the intestine.
Liver:
The liver is one of the most vulnerable organs in the abdominal
cavity because of its size, weight, location, friability, and fixed
position. Injuries are frequently met in cases of blow, kick, crush,
fall or sometimes in sudden contraction of the abdominal wall.
The right lobe is more frequently involved than the left owing to
its size and exposed location. Rupture is usually transversely or
anteroposteriorly. On account of its extreme vascularity, the
victim usually dies of severe hemorrhage, shock and very rarely of
supervening infection. Sometimes recovery occurs after slight
laceration but occasionally, abscess develops.
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PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 319 320 LEGAL MEDICINE
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Stab and gunshot wounds of the abdomen may involve the liver.
Severe hemorrhage or shock usually causes the death. It may be
lacerated by the fractured ends of the lower ribs in crush injuries.
The gall bladder may be ruptured as a result of a kick, blow or
crush injury. It may be inju*ed-by penetrating weapons. Death
is due to hemorrhage and the effusion of bile into the peritoneal
cavity.
Spleen:
The spleen usually suffers traumatic rupture resulting from the
impact of a fall or blow and from the crushing and grinding
effects of wheels of motor vehicles. Although the organ is pro-
tected at its upper portion by the ribs and also by the air-con-
taining visceral organs, yet on account of its superficiality and
fragility, it is usually affected by trauma. Congestion and diseased
condition of the spleen, as in malaria, typhoid, kala-zar, make it
more easily susceptible to slight trauma.
Laceration of the spleen is more common at the region of the
hilus and the lesion may be longitudinal or transverse. Lesion on
the convex surface is also common especially when the force is
applied to the left flank. On account of the vascular nature of
the organ and its proximity to the plexuses of nerves, the victim
usually dies of severe shock or hemorrhage.
Penetrating stab wounds of the spleen are common but most
often other visceral organs are also involved. Death is due to
hemorrhage.
Kidney:
Traumatic injury of the kidney may be due to a blow at the
lumbar region somewhere at the region of the 12th rib. It may be
ruptured at the slightest violence when it is diseased as in cases of
hydronephrosis, pyelonephritis, tuberculosis, abscess or tumor.
The kidney may also be ruptured when the individual is run over
by a vehicle or severely crushed from a fall
Injury of the kidney is accompanied by peri-renal hematoma
which consists of blood and urine. Death is due to a severe
hemorrhage, loss of kidney functions and shock. Abdominal
hemorrhage is 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-
venes, the kidneys are found to be swollen, pale with marked
degeneration of the cells lining the tubules (Taylor's Principles
& Practice of Medical Jurisprudence by Simpson, 12th ed.. Vol II,
p. 332).
Pancreas:
The pancreas may be injured by a violent blow at the epigastric
region. Death may be due to hemorrhage, shock, or insulin
insufficiency. If death does not occur immediately, fat necrosis
is observed in the abdominal cavity on account of the leakage of
the lipolytic enzyme.
Spontaneous hemorrhage of the pancreas is frequently observed
in the tropics. Its exact cause is still a matter of medical research.
4. PELVIC INJURIES:
Fracture of the pelvic bones, especially of the pubis, is common
in vehicular accidents and crush injuries. Separation of the sym-
physis may be observed without any external sign of injury.
The patient may show difficulty of locomotion, and to a certain
degree, damage to the urinary bladder.
Urinary Bladder:
The bladder may be involved in a blow, crush, or kick at the
hypogastrium especially when distended with urine. Among
parturient women, the bladder may rupture in the course of
delivery. It may also be involved in fractures of the pubic bones.
Spontaneous rupture is rare when it is over-distended due to
urethal stricture, enlargement of the prostate, or tumor. Symp-
toms of rupture of the bladder are pain, tenderness at the lower
portion of the abdomen, bloody urine, difficulty in urination
and rigidity of the abdominal muscles. Death may be due to
shock or super-imposed infection.
Uterus:
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 uterus is commonly observed
among pregnant women due to the injudicious use of drugs or
abnormal presentation. Partial separation of the placenta may be
spontaneous or due to trauma. Death is due to shock, hemor-
rhage, peritonitis or septicemia.
Vagina:
Laceration of the vagina may be due to a sexual act or a faulty
instrumentation to induce a criminal abortion. The vaginal wall
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Chapter XII

PHYSICAL INJURIES IN THE DIFFERENT PARTS OF THE BODY 321 DEATH OR PHYSICAL INJURIES
CAUSED BY EXPLOSION
may be lacerated during parturition.
Explosion is the sudden release of potential energy producing a
5. EXTREMITIES: localized increase in pressure.
Physical injuries on both upper and lower extremities are usual- Investigation of death or physical injuries that is produced by ex-
ly due to direct violence, crushing or some indirect force. plosion must be concerned in determining the following:
a. Direct violence will result in a contusion and when the force 1. What exploded?
applied is severe it may cause interstitial muscular hemorrhage 2. What caused it to explode?
and fractures of the underlying bone. Direct violence may be
3. H o w it produced the injury?
due to a fall, a vehicular accident, or a direct application of
force. 4. H o w was it initiated?

b. Indirect violence, such as twisting or pathological fracture of
the bone underneath, causes laceration of the muscles around
with marked hemorrhage. A patient may suffer deformity,
shortening of the extremity and shock.
c. Crushing injuries of the limb can result in severe soft tissue
trauma and are most commonly caused by vehicular accidents
or fall of heavy materials. These are usually accompanied by
marked swelling, comminution of the bone and extravasation
of the blood.
Contusions and abrasions are frequent lesions of the extremities.
Lacerated wounds are commonly observed in portion where the
bones are superficially located as in the anterior aspect of the leg.
Incised and punctured wounds of the hand are quite common on
account of its utility and movability.
Crushing injury of the extremities may cause laceration of the
blood vessels and nerves. Injury of the intima of the blood vessels
causes thrombus formation and in severe cases aneurysm may
develop. Extravasation of the blood into the muscles causes swelling
and pain.
Fracture of the bones may be due to a direct violence, an
indirect violence or a muscular action.
Injury of the extremities may cause shock, hemorrhage and
infection. The shock is principally due to the injury on the nerve,
hemorrhage and fracture of the bones. Infection may be severe
and may require amputation of the extremities.
Classification of Explosion as to the Source of Energy:
1. Mechanical (Hydraulic) Explosion — This occurs when the pres-
sure inside a container exceeds its structural strength. Explosions
of air pressure tanks for cleaning or paint spray, water pressure
tanks to establish water pressure, and the air pumped kerosene
burner are examples of mechanical explosions. These explode
when the pressures applied are in excess of the strength of the con-
tainers. As the container disintegrates, there is a rapid localized
increase in pressure resulting in the characteristic explosive sound.
2. Electrical Explosion — When electricity arcs through the air, a
phenomenon that occurs when two objects of different electrical
potential are brought close to one another, a large amount of heat
develops. This heat rapidly expands the air in and around the arc
which produces the popping sound of an arc. Lightning though
it occurs in a much complex form with extremely high temperature,
may be an example of an electrical explosion.
3. Nuclear Explosion — The release of a significant amount of energy
by fusion or fission and consequently with a significant increase of
destructiveness.
Atomic Explosion — Atomic nuclei can be regarded as stored
condensed energy. The uncontrolled release of this energy con-
stitutes atomic explosion.
4. Chemical Explosion — Chemical explosion occurs when a chemical
reaction'produces heat and gas at a rate faster than the surroundings
can dissipate. At the start of the reaction the initial heat or gas

322
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DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 324 LEGAL MEDICINE
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pressure increases the rate of reaction, which progresses at a faster
rate until the explosion results.
Types of Chemical Explosion:
a. Diffused Reactant Explosion — This is caused by the mixture
of gas and air. If the gas and air are mixed in correct pro-
portion, product of heat and subsequent pressure is produced.
Explosion of diffused reactants must be initiated by flame,
spark or sometimes heat. Mixture of gases with other materials
may cause production of flame. The most common example
of dispersed gas explosion is in the internal combustion engine.
b. Condensed Reactant Explosion — This chemical explosion
occurs when large quantity of heat and gas is produced as a
result of rapid chemical reaction in a solid or liquid material. It
has a point of origin so that the most severe damage is closest to
the source and the effects diminish as the distance from the
center increases. There is no need of atmospheric oxygen and
if oxygen is required in the reaction it is incorporated into the
explosive. Condensed reactant explosives may be classified as:
Laboratory Medicine by V. Di Maio, Vol. 3, No. 2,
June 1983, pp. 309-314).
Death or physical injuries due to detonation of high explosives
may be due to the following causes:
The destructive effects varies with the kind and amount of
explosive used and the location of the victim at the time of the
explosion. The explosion is accompanied by blast, flame and
fragment primarily. The nature and extent of the injuries
suffered by the victim may be:
(a) If the victim is in contact with the explosive, as when he is
manipulating, carrying or sitting on it at the time of the
explosion, there is complete disruption or fragmentation of
the body. Pieces of the body may be found several meters
away from the site of explosion. Some parts of the body may
be found hanging on the electric power line, bones completely
shattered, skin and other soft tissues may be found scat-
tered at a certain distance from the site of the explosion.

( 1 ) Low Order Explosive (Deflagrating Explosive) — Those

which rely on burning and confinement to produce ex-
plosions. When the reaction is confined, the built-up of heat
and pressure causes the reaction rate to increase rapidly to an
explosion. Gunpowder is the best known low order explosive.
When sufficiently heated the nitrate content is decomposed
to nitrate and oxygen. The oxygen reacts with sulfur and
carbon producing sulfur oxide, sulfur dioxide, carbon
monoxide and carbon dioxide in various combinations.
( 2 ) High Order Explosive — This is the kind that detonates.
Detonation is a chemical process which results in the ex-
tremely rapid decomposition of nitrogenous compounds.
Releasing heat and gas is its reaction by-product. It is the
shock wave spreading out of the explosion that causes the
destructive effect of high explosive. Dynamite is an example
of a high order explosive.
(a) Stable High Order Explosive — This compound will
Burns a n d other injuries b r o u g h t a b o u t b y d y n a m i t e e x p l o s i o n .
not detonate unless they are subjected to detonation.
This includes dynamite (nitroglycerin made stable by The explosion causes sudden increase of atmospheric
clay absorption). pressure which is immediately followed by a sudden fall.
( b ) Unstable High Order Explosive — Easily detonates from This compression-decompression effect causes displacement,
heat, flame, spark or percussion. This includes trinitro- distortion and bursting effects on body parts, especially in
benzene (Picric acid), fulminate of mercury, lead, the brain and abdominal visceral organs. Aside from these
antimony or bismuth and nitroglycerine (Clinics in injuries, there is rapid development of scattered foci or small
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hemorrhages mostly in organs which easily change in shape
and which are rich in blood supply.
( b ) If the victim is not so close to the site of explosion, the
body though badly injured may remain in one piece. Some
parts may be dismembered but may be recovered within a
few meters. Certain areas of the body may show severe
injury, but the triad of punctate bruises, abrasions and
lacerations may be found distributed all over the body.
(All of these injuries have still the effect of the blast wave
with a diminishing intensity.)
(c) The peppering kind of injuries may be observed as the
distance from the site of explosion increases. The density
and severity becomes less until it disappears. However, one
or more metallic fragments travelling with moderate
velocity may strike the vital parts of the body and may
cause death.
( d ) Other effects of the blast wave:
i. The impact of the high pressured wave can knock down
the person.
ii. In the respiratory organ, the bronchus may be lacerated
or the mucosa of the trachea may develop petechial
hemorrhages. This effect is not due to the entry of the
high pressured wave along the trachea and bronchi but
by its passing directly on the body wall.
iii. The ear is the organ most vulnerable to the blast. Most
person at the vicinity of the explosion may suffer from
slight reddening of the tympanic membrane which
signifies that the cochlea has been damaged
(e) Burns from the flame or heated gas — The instantaneous or
momentary flame of high intensity during explosion may
cause singeing of the eyebrow, scalp hair and eyelashes.
Clothings may also be burned. Body surface in contact with
the flame or exposed to the heated air may develop burns,
the degree of which depends upon the intensity and duration
of exposure.
(f) Asphyxia due to lack of oxygen — Explosion causes con-
sumption of oxygen in the surrounding atmosphere, thereby
limiting the amount available for human consumption.
(g) Poisoning by inhalation of carbon monoxide, nitrous or
nitric gases, hydrogen sulfide, sulfur dioxide, or hydro-
cyanic gas — The by-products of combustion may be proto-
plasmic poison or may cause death by interfering with the
normal transportation and utilization of air by the tissues
of the body.
(h) Direct injury by the flying missiles — The injury due to
flying missiles is influenced by the proximity of the in-
dividual to the site of explosion, velocity of the missiles,
manner or approach of the missiles on the body surface
involved and the subsequent complications arising from
such injuries.
The shrapnel wound may go much deeper or the foreign
body may lodged inside the body. The edges of the missiles
may be irregular or smooth so that the lesion on the skin
may appear like an incised wound. If lacerated, the sur-
rounding tissues may be contused.
The following explosives may cause shrapnel wound:
Grenade — Rifle or hand.
Bomb — Demolition or incendiary.
Mine.s — Underground or submarine.
Exploding missiles — Anti-aircraft
( i ) Injuries from the falling debris — If the explosion took place
in a building the victim may be injured and buried under the
rubbles. The victim may suffer from multiple injuries of
whatever description or die of traumatic or crash asphyxia.
Identification of the Site of Explosion and Collection of Evidences:
The site of explosion may be identified by the presence of a crater.
The original location of other objects located near the blast may be
useful clues in the determination of the site of explosion. Soil and
other debris may be collected for laboratory examination.
The entire area must be systematically searched for traces of the
detonation mechanism. All blown out materials must be tested for
explosive residues.
If the investigator arrived at the site immediately after the explo-
sion, he may be able to smell the odor of the gas. One of the simplest
way of collecting gas samples for analysis is to take a bottle full of
water in the area where odor is the strongest and pour the water out
of the container. The surrounding air will immediately replace the
water removed from the bottle. Then the bottle must be tightly
sealed and sent to the laboratory for examination.
Scrapings from the debris and other materials at or near the site of
the explosion may be subjected to extensive stereoscopic and micro-
scopic examination. Particles of unconsumed explosive may be
recovered.
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DEATH OR PHYSICAL INJURIES CAUSED BY EXPLOSION 328 LEGAL MEDICINE
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Fragments of the explosive materials and debris recovered may be million tons of T N T . It produces millions of pounds per square
rinsed with hot water so that water-soluble inorganic substances inch of gas pressure, with heat comparable to the sun and light of
(nitrates and chlorates) may be extracted. The materials may be more than 30 times as bright as the sun at noontime. After ex-
rinsed with acetone inasmuch as most explosives are highly soluble plosion, it produces a luminous ball of fire containing radioactive
to acetone. The extract is concentrated and analyzed. fission products, which increases upward in size and creates shock
waves moving sidewards in all directions. The fireball may have the
Color Spot Tests for Common Chemical Explosives: diameter of 7,200 feet in ten seconds and in one minute time it may
Griess reach a height of 4-1/2 miles.
Substances Diphenylamine Alcoholic KC
Chlorate No color Blue No color Place of Atomic Explosion:
Nitrate Pink to red Blue No color 1. Aerial Explosion — The bomb is made to explode on the air.
Nitrocellulose Pink Blue-black No color 2. Ground Explosion — Explosion is made when the bomb reaches
Nitroglycerin Pink to red Blue No color the ground.
PETN Pink to red Blue No color 3. Submarine Explosion — Explosion takes place underneath the
RDX Pink to red Blue No color surface of a body of water.
TNT No color No color Red
Rays Emitted by Radioactive Substances During Explosion:
Tetryl Pink to red Blue Red-violet
1. Alpha Rays — Composed of positively charged helium, having a
Griess Reagent: high linear energy transfer and with a poor penetrating power
Solution 1 — Dissolve 1 mg. sulfanilic acid in 100 ml. of 30% acetic that can be stopped by a sheet of paper.
acid. 2. Beta Rays — Composed of positively or negatively charged elec-
Solution 2 — Dissolve 1 g. alpha-naphthylamine in 230 ml. of boiling trons with a higher penetrating power than the alpha rays but the
distilled water, cool. ionizing power is much less. The electrons are travelling at a very
Decant the colorless supernatant liquid and mix with 110 ml. of high velocity and in some cases approaching the speed of light.
glacial acetic acid. A d d solutions 1 and 2 and a few milligrams of 3. Gamma Rays — Composed of short rays with high energy and
zinc dust to the suspect extract. greater penetrating power and like neutrons it extends a significant
Diphenylamine Reagent: distance and causes much damage to the human body.
Solution 1 — Dissolve 1 g. diphenylamine in 100 ml. concentrated 4. Neutron Rays — Uncharged and composed of highly penetrating
sulfuric acid. particles and basic element in nuclei of atoms.

Alcoholic KOH Reagent: Characteristics of Nuclear B o m b Explosion that Distinguishes it from

Solution 1 — Dissolve 10 g. of potassium hydroxide in 100 ml. of
absolute alcohol.
(Criminalistics by Richard Saferstein, p. 242).
Other Tests on Extract:
1. Infra-red spectrophotometry.
2. X-ray diffraction.
3. Gas chromatographic analysis.
ATOMIC B O M B E X P L O S I O N :
Atomic nuclei can be regarded as storage of highly condensed
energy and that the uncontrolled release of this energy constitute an
atomic explosion. The explosion is caused by the fission of about
100 pounds of uranium and liberates energy equal to that of a
Conventional High Explosive B o m b Explosion:
1. It is many thousand times as powerful as a highly conventional
bomb explosion and the effects of the blast are very prominent.
2. A large proportion of its energy is emitted as thermal radiation,
causing skin burns and it is capable of starting a fire at a con-
siderable distance.
3. The explosion emits a highly penetrating and harmful radiation,
and the substance which remains after the explosion continues to
emit radiation over a long period of time.
(Forensic Medicine by Tedeschi, Eckert & Tedeschi, Vol. 1, p. 633).
Effects of Atomic Explosion to the Human Body:
The effects of atomic explosion of the human body are inversely
proportional to the distance. One megaton of atomic bomb exploded
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in air can cause fire of up to a 10 miles radius. The pressure front of
the blast can be felt one mile away in 2 seconds time. The blast
wave is of sufficiently long duration which is accompanied by
transient blast winds causing damages to the people and the sur-
rounding structures.
Other effects of atomic explosion are the same as that of ordinary
chemical bomb explosion but of a much more severe intensity.
Aside from the immediate traumatic effects, the radiation emitted
by the radio-active substances can also have an effect which may be
local or general.
1. General Effects:
Massive dose causes generalized erythema, disorientation
followed by coma and death.
Lesser dose may-cause nausea, vomiting followed by prostration
and rapidly developing and persistent leukemia.
Later symptoms may develop in the form of rise of temperature,
ulceration of lymphoid, easy fatigability, oro-pharyngeal ulce-
ration and severe leukopenia.
2. Local Effects:
a. Individual Cells — It causes retardation of cell division, structural
changes in the chromosomes and cytoplasm, vacuolization, and
with evidence of maturation. There is loss of the supporting
mesenchymal cells.
b. Skin — Epilation of the hair with the follicles remaining intact,
sweat glands lose their function, erector pili muscles not much
affected. The skin become edematous and later disquamated
and ulcerated. Radiation dermatitis is persistent, usually pain-
ful with patchy keratitis and foci of ulceration. Hyperpigmen-
tation or depigmentation may later develop.
c. Blood Vessels — There is endothelial necrosis and localized
thrombosis. The blood vessels thicken because of the hyalin-
ization of the collagen. Some blood vessels are occluded with
the loss of the muscular layer.
d. Eye — Cataract develops.
e. Genital Organ — In female it causes sterility, abortion or still-
birth. In men, it also causes sterility without loss of sexual
potency. • d. Radiation sources used in industry, like nuclear power plant
Factors Responsible for the EffectB of Radiation:
1. Age — Children and old persons are more susceptible to radiation.
2. Dosage — Bigger dose of radiation will cause more damaging
effects on the body tissues.
3. Kind of Radiation — The biological damage is not always pro-
portional to the energy absorbed, but it depends on the kind of
energy emitted. Gamma and neutron radiations are most destruc-
tive.
4. Fractional Doses — A single dose may be lethal when administered
fractionally over a long interval of time.
5. Sensitivity — Muscles and connective tissue are radioresistant while
actively dividing tissues like blood forming organs, intestinal
epithelium are quite radiosensitive.
Other Sources of Radiation:
1. Natural Source:
a. Cosmic Origin — Radiation from the sun or from outer space.
b. Terrestial Origin — Chiefly from radiothorium series of granite
rocks.
2. Man-made Source:
a. Diagnostic X-ray Equipment:
The filament inside a vacuum tube is heated by a strong
electric current so that it will emit electrons. The electron is
driven on an anode target (Rhenium and molybdenum) which
causes the development of electromagnetic energy, the wave
length and the ability to penetrate depends on the kilovoltage
applied. The higher the voltage, the shorter is the wave length
and the more penetrating are the X-rays.
As the X-ray passes the tissues of the body, the degree of
absorption depends on the density. The bones absorb more
X-ray than the air containing tissues. Naturally the film behind
receives a differential amount of X-ray. The denser substance
like the bone, will be represented by a lighter image while the
less denser organs will have a darker image.
In a fluoroscope, the X-ray after passing the body goes to a
screen and the differential absorption of X-ray by the body is
reflected in the fluoroscopic screen (Legal Medicine by Tadeschi
p. €86).
b. Clinical nuclear pharmaceutical agents.
c. Therapeutic radiation apparatus.
The problem of the use of nuclear power in generating plants
is the disposal of the radioactive waste which may be in the
form of:
( 1 ) Gases chiefly emitted from the vapor.
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Chapter XIII

/ G U N S H O T WOUNDS

D E A T H O R P H Y S I C A L INJURIES B R O U G H T A B O U T B Y
POWDERED PROPELLED SUBSTANCES

Death or physical injuries brought about by the powder propelled

substances may be due to the following:
1. Firearm Shot — The injury is caused by the missile propelled by
the explosion of the gunpowder located in the cartridge shell and
at the rear of the missile. The direction of the movement of the
missile is influenced by the desire of the person firing the fire-
arm. The missile may be single as in the case of a pistol or revolver
or may be of multiple shots or pellets as in the case of a shotgun.
The cartridge shell is physically preserved after the fire.
2. Detonation of high explosives, as in grenades, bombs and mine
explosion. Explosion of the gunpowder inside the metallic con-
tainer will cause fragmentation of the container. Each fragment or
shrapnel is moving with certain velocity without any predeter-
mined direction.

I. FIREARM W O U N D

Definition of Firearm:
1. Technical Definition:
A firearm is an instrument used for thejpropulsion of a projectile_7
by the^expansive force of gases^coming from the burning of gun-
powder.
2. Legal Definition:
Section 877, Revised Administrative Code — "Firearm" defined:
"Firearm" or "arm", as herein used, includes.jrifles,^muskets,
shotguns, revolvers,^pistols, and jill other deadly weapons from
w

"which a bullet, > a l l , shot, shell, or pfher missile may be discharged

by means of gunpowder or other explosives. The term also
includes air rifles except such as being of small caliber and limited
range are used as toys. The barrel of any firearm shall be con-
sidered as a complete firearm for all purposes thereof.

Penal Provisions of Laws Relative to Firearm:

Section 2692, Revised Administrative Code:

332
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Unlawful manufacture, dealing in acquisition, disposition, or Art. 155, Revised Penal Code:
possession of firearms, or ammunitions therefor, or instrument Alarms and Scandals:
used or intended to be used in the manufacture of firearms or The penalty of arresto menor or fine not exceeding 200 pesos shall
ammunition: yj<KL be imposed upon:
A n y person who manufactures, deals in, acquires, disposes, or 1. Any person who within any town or public place, shall discharge
.possesses any firearm, parts of firearms, or ammunition therefor, or any firearm, rocket, firecracker, or other explosive calculated to
instrument or implement used or intended to be used in the manu- cause alarm or danger;
facture of ammunition in violation of any provision of sections eight ^To-ltfv 2
hundred seventy-seven to nine hundred and six, inclusive, of the Art. 254, Revised Penal Code:
code, as amended, .shall, upon conviction, be punished by imprison- Discharge of firearms:
ment for a period of not less than pjie year and one day nor more*^' \^<ku\
A n y person who shall shoot at another with any firearm shall
than five years, or both such imprisonment and a fine of not less^^* R
suffer the penalty of prision correccional in its minimum and medium
than one thousand pesos nor more than five thousand pesos, in the
periods, unless the facts of the case are such that the act can be held
discretion of the court. If the article illegally possessed is a rifle,
to constitute frustrated or attempted parricide, murder, homicide or
carbine, grease gun, bazooka, machine gun, submachine gun, hand
any other crime for which a higher penalty is prescribed by any of
grenade, bomb, artillery of any kind or ammunition exclusively
the articles of the code:
intended for such weapons, such period of imprisonment shall be not
less than five years nor more than ten years. A conviction under this Classification of Small Firearms: y

section shall carry with it the forfeiture of the prohibited article or
articles by the Philippine Government.
Section 2690, Revised Administrative Code: ^
Selling of firearms to unlicensed purchaser:
It shall be unlawful for any dealer in firearms or ammunition to
sell or_deliver any firearms or ammunition or any part of a firearm
to a purchaser or other person until such purchaser or other person
shall have obtained the necessary license therefor. A n y person
violating the provisions of this section, upon conviction in a court of
competent jurisdiction, shall be punished by a fine not exceeding
two thousand pesos, or by imprisonment not exceeding two years,
or both. U 11**
Section 2691, Revised Administrative Code: /
Failure of personal representative of deceased licersee to surrender
firearm:
When a holder of any firearm license shall .dfc ° r become subject
to legal disability and any of his relatives, or his legal represenative,
or any other person shall knowingly come into_j>ossession of any
firearm or ammunition covered by such license, such person, upon
failure to deliver the same to the Chief of .Constabulary in Manila
or to the senior officers of Constabulary in the province, shall be
punished by a fine not exceeding five hundred pesos or by imprison-
ment not exceeding six months, or both. If £r**
Small firearms are those whichQpropel projectile] of less than one
inch in diameter.
1. As to Wounding Power:
a. L o w Velocity Firearm — These are firearms with muzzle velo-
city of not more than 1,400 feet per second.
Example: Revolver,
b. High Power Firearm — These are firearms with muzzle velocity
of more than 1,400 feet per second. The usual muzzle velocity
is 2,200 to 2,500 feet per second or more.
Example: Military Rifle.
2. As to the Nature of the Bore:^*-
a. Smooth Bore Weapon — This firearm has the inside portion of
the barrel that is perfectly smooth from the firing chamber to
the muzzle.
Example: Shotgun,
b. Rifled Bore Firearm — This is a firearm with the bore of the
barrel with a number of spiral lands and grooves which run
parallel with one another, but twisted spirally from breech
to muzzle.
Example: Military Rifle.
3. As to the Manner of Firing:
a. Pistol — Firearm which may be fired only by a single hand.
Example: Revolver.
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b. Rifle — Firearm which may be fired from the shoulder. of 2,500 feet per second and a range of 3,000 feet. Unlike a
Example: Shotgun. revolver or automatic pistol which can be fired by a single hand,
a rifle is fired from a shoulder.
4. As to the Nature of the Magazine:
4. Shotgun — A shotgun is a firearm whose projectile is a collection
a. Cylindrical Revolving Magazine Firearm — The .cartridge is of lead pellets which varies in sizes with the type of the cartridge
located in a cylindrical magazine which ^ t a t e s at the rear applied.
portion of the barrel.
Example: Revolver. A Weapon, In Order to Cause Injury must have T w o Principal Com-
ponent Parts, Namely:
b. Vertical or Horizontal Magazine — The cartridge is held one
1. The Cartridge or Ammunition — a complete unfired unit con-
after another vertically or horizontally and also held in place
sisting of bullet, primer, cartridge case and powder charge.
by a spring side to side or end to end.
2. The Firearm — the instrument for the propulsion of a projectile by
Example: Automatic Pistol.
the expansive force of gases from a burning gunpowder.
Types of Small Firearms which are of Medico-legal Interests
1. Revolver — A revolver is a firearm which has a cylindrical maga- CARTRIDGES OR AMMUNITION
zine situated at the rear of the barrel, capable or revolving motion The Principal Parts of a Cartridge or Ammunition are:
and which can accommodate five or six cartridges; each of which 1. The cartridge case or shell.
is housed in a separate chamber. After a shot, the circular magazine 2. Primer.
rotates by the cocking of the hammer in a way that the next
3. Powder or propellant.
cartridge is brought in the proper position for firing. The usual
muzzle velocity of a revolver is 600 feet per second. 4. Bullet or projectile.

Kinds of Revolver as to Construction or Mechanism: 1. Cartridge Case or Shell:

a. Revolver with the barrelffirmly fixed to the frame and the
revolving cylinder may swing oufjto the side for the purpose
of loading or extraction of the spent shell.
b. Revolver with the barrel Vhinged to the frame and the revolver
cylinder may be brokerfjto load by releasing the barrel latch.
c. Revolver with barrel£firmly fixed to the frame and the revolving
cylinder may be removed} by taking out the cylinder pin on
which it rotates.
2. Automatic Pistol — This is a firing weapon in which the empty
shell is ejected when the cartridge is fired and a new cartridge is
slipped into the breech automatically as a result of the recoil.
The cartridge is contained in a vertical magazine which holds six
to seven cartridges. It is not automatic in action in the sense that
a continuous pressure on the trigger will not make the firearm
fire continuously. It is more correct to call it a "self-loading
firearm." It has a usual muzzle velocity of 1,200 feet or more per
second.
3. Rifle — A rifle is a firearm with a long barrel and butt. It may be
a 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-loading weapon. A military rifle usually has a muzzle velocity
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 ordinary hand guns the cylindrical
structure is made of brass while in shotguns it is usually made of
cardboard. The base is always made of metal. Inscription at the
base may show the manufacturer, the caliber and even the date it
was manufactured.
Depending upon the relationship of the diameter of the base
with that of the cylindrical portion, a cartridge may be classified
as:
a. Cartridge With a Rim — The base of the cartridge has a dia-
meter more than the cylindrical portion. The rim is used to
prevent the cartridge from going through the barrel. This is
common among revolvers.
b. Rimless Cartridge — The base or head of the cartridge has the
same diameter as that of the cylindrical body. There is a groove
cut between the base and the cylindrical body for the extractor
to hook into. This is usually found in self-loading firearms.
c. Semi-rimless Cartridge — This looks like a rimless at first glance
but actually the rim does project very slightly above the line of
the cylindrical part.
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d. Belted Cartridge — The cartridges are attached in a series in a
canvass belt for successive fires.
2. Primer:
The primer compound is located and sealed at the cartridge
base covered by a small disc of soft metal, which is usually a lead-tin
alloy known as percussion cap or primer cap. The main function
of the primer is the transformation of mechanical energy by the
hit of the firing pin on the percussion cap to chemical energy by
its rapid combustion. As the firing pin hits the primer cap (per-
cussion cap), the primer compound hits 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.
Although, there are variations in the chemical constituents of
the primer in the past, it is composed of a mixture of mercury
fulminate, stibnite (antimony sulfide), potassium chlorate and
powdered glass. Later, mercury fulminate is partially or com-
pletely replaced by lead azide and lead stypnate together with
potassium chlorate which are replaced by barium nitrate to
reduce the development of rust. Lead stypnate is utilized as base,
tetracene is sometimes added to control sensitivity and barium
nitrate acts as moderator and oxidizer. The most common consti-
tuents of primer are lead, antimony and barium.
As to the location of the percussion cap at the base, cartridge
may be:
a. Cartridge with Center Fire — The percussion cap is located at
the center of the base of the cartridge. This is the most com-
mon.
b. Cartridge with Rim Fire — The primer is placed inside the rim
of the shell. This is common in 0.22 caliber firearms.
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 which is inside the cartridge. This type is
obsolete and now rarely found.
3. Gunpowder or Propellant: ^
The propellant is the primary propulsive force in a cartridge
which when exploded will cause the bullet to be driven forward
towards the gun muzzle.
There are Different Types of Powder Propellant Used:-
a. Black Powder — A mixture of potassium nitrate (75%), sulfur
(15%) and charcoal (10%).
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 sulfide (3%) and traces of methane and oxygen. The
solid residues following its combustion are potassium sulfate,
potassium sulfide, potassium carbonate together with its original
components.
b. Smokeless 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.
Smokeless powder causes development of less flame and less
powder residue as compared with black powder.
There is more complete burning of gunpowder in smokeless
as compared with the black powder.
Inasmuch as the gas produced by combustion of smokeless
powder is three times more than the black powder, the muzzle
velocity of bullets with smokeless powder is also approximately
three times greater than the bullets using black-powder.
Smokeless powder granules are usually coated with graphite
and consequently form different shapes. They may appear as
a ball, square, cylinder, disc or flakes. Consequently when
discharged from the firearm after explosion they will cause
individual shapes of tattooing. The flake or disc shape powder
may cause varying shapes of the tattoos depending upon how the
grain struck the skin. Ball powder may cause small, hemor-
rhagic punctate marks. The cylindrical shape powder grains
may cause heavy tattooing with deposition of soot at 6 inches
range.
4. Bullet (Slug, Missile, Projectile):
It is the metallic object attached to the free end of the cy-
lindrical tip of the cartridge case, propelled by the expansive force
of the propellant, and responsible in the production of damages
in the target. In some instances bullets are not metallic but made
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( b ) To withstand deformity in automatic loading process;

Bullets lodged and extracted from a victim
of rubber, plastic, or even paraffin, but their uses are primarily
confined to target practice.
Classification:
a. Shape of the free end:
(1) Conical — The free end of the bullet is tapering and pointed.
The purpose is to minimize the resistance offered by the
atmosphere, to increasing its penetrating power and to
minimize deflection upon hitting the target.
( 2 ) Hemispherical — The free end is dome-like and commonly
observed in short firearms.
( 3 ) Wad-cutter (Square Nose) — The free end is flattened
commonly used in target practices.
(4) Hollow-point — There is a depression at the tip to expand
or "mushroom" at impact on hard object, to slow its speed
in the body so that more kinetic energy will be released
thereby increasing its shocking effect.
b. As to presence or absence of jacket:
(1) Naked Lead Bullet — Bullet without outer coating.
(2) Jacketed Bullet — Bullet with external coating usually
copper, nickel, steel or zinc. The purpose of the coating
are to:
(a) To prevent fouling of the barrel;
and
(c) To prevent deformity when carried and exposed to
rough handling.
A jacketed bullet may be:
i. Full Jacketed Bullet — the whole bullet up to the
base is enveloped with a metallic jacket.
ii. Semi-jacketed Bullet — The nose or free end is partly
or fully exposed while there is relatively thin but
tough coating of the base and the cylindrical portion.
This is made to permit expansion of the bullet when
it hits hard objects. Semi-jacketed bullets may be
hollow-point.
The general rule is that soft-metal, round nose
bullets are fired from a revolver; full-jacketed bullets
are fired from a rifle and self-loading firearm; semi-
jacketed bullets are fired from an automatic (self-
loading) firearm or rifle.
Special Bullets:
a. Armour Piercing Bullet — made of steel with copper coating
(jacket).
b. Phosphorus Flare or Tracer Bullet — This consists of an alu-
minum tip and is packed with incendiary (phosphorus) which
burns during flight. It is used to determine the direction of the
fire. The speed of sound in air is 1,087 feet per second or 331.3
meters per second.
c. Plastic Bullet — used for target practice.
d. Bullet with Plastic Sabot — The bullet together with the sabot
travel up to the bore. The bullet never comes in contact with
the barrel and therefore there will be no rifling marks imparted
in the bullet but on the sabot. The front half of the sabot has
six slits. As the sabot leaves the barrel it offers resistance and
the slit part of the sabot will fold backward, causing resistance
and falls away.
At three feet, the sabot and bullet are still in line.
At 6 to 7 feet, they strike the target separately.
The sabot itself travels approximately 50 feet.
e. Bullet with Secondary Explosion — The bullet may leave the
barrel and upon reaching a certain distance it produces second-
ary explosion and shrapnel splinters.
f. Soft Point Bullet — A bullet which is easily flattened upon
hitting the target to increase the wounding effect.
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FIREARM (1) Single Shot Firearm — A pull or pressure on the trigger will
cause only one shot.
For purposes of Medico-legal Investigation, the following Parts of a Example: Revolver.
Firearm are important: (2) Automatic Firearm — A continuous pressure on the trigger
1. The trigger with the firing pin. will cause a series of shots until the trigger pressure is
2. The barrel. released.
Other Parts of a Firearm: Example: Machine gun.

1. Handle or Butt — The portion of the firearm used for handling it.
It may house the magazine.
2. Firing Chamber — The place where the cartridge is held in position
before the fire mechanism starts.
3. Breechblock — The steel block which closes the rear of the bore
against the force of the charge. The face of this block which comes
in contact with the base of the cartridge is known as the breech-
face.
4. Trigger Guard.
5. Front and Rear Sight.
6. Safety Device like safety lock.
7. Sling.
In a Self-loading Firearm, the following are the Additional Parts:
1. Extractor — The mechanism by which the spent shell or ammu-
nition is withdrawn from the firing chamber.
2. Ejector — The mechanism by which the empty shell or ammu-
nition is thrown from the firearm.
1. Trigger:
This is a part of the firearm which causes firing mechanism.
Except in a single action firearm, pressure on the trigger is the
commencement of the whole firearm mechanism. To avoid acci-
dental firing, the trigger is surrounded by a trigger guard.
Classification of Firearm Based on Trigger Mechanism:
a. Relation of Cocking and Trigger Pressure:
(1) Single Action Firearm — The firearm is first manually
cocked then followed by pressure on the trigger to release
the hammer.
Example: Home-made "Paltik".
( 2 ) Double Action Firearm — A pressure applied on the trigger
will both cock and fire the firearm by release of the hammer.
Example: Standard Revolver.
b. Number of Shots on Pressure on the Trigger:
Trigger pressure is the amount of force (pressure) on the trigger
necessary to fire a gun. Its determination is necessary in the
assessment of whether the firing can possibly be accidental.
"Hair trigger" is a vague term used when the firearm trigger
pressure is 1.0 lb. (pound) or less. It is intrinsically unsafe and
should only be used under rigorously controlled situations because
of the possibility of unintended or accidental fire.
In general, the single action firearm varies from 3-1/2 to 10
pounds and in double action, it varies from 6 pounds to as much
as 18 pounds. The following are the approximate trigger pressures
of certain types of firearms.
a. Shotgun 4 lbs.
b. Self-loading pistol 3 to 4 lbs.
c. Revolver 3 to 5 lbs.
d. Service rifle 6 to 7 lbs.
2. Barrel:
a. Riflings:
The inner surface of a shotgun and that of a home-made
gun is smooth while single shot standard firearms are with
riflings.
The inner surface of the barrel has a series of parallel spiral
grooves on the whole length called riflings. The space between
the two grooves is the land. The riflings are made to have a
strong barrel grip on the bullet, to stabilize its movement and
to impart a rotational movement on the bullet. Incidentally,
the rifling reflected on the bullet becomes an important factor
in the identification of firearms.
Gun manufacturers vary the way the riflings are imprinted
in the inner surface of the barrel on the following aspects:
(1) Number — The number of lands and grooves varies from 2
to 12.
Most high velocity firearms have 4 to 6 grooves. Some
firearms have multiple shallow grooves and this is known
as microgroove6 rifling.
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( 2 ) Twist or Rate — This is the expression for one complete mutable only after the manufacture. They have characteristics whose
turn of the rifling on a certain length of the barrel. We say existence is beyond the control of men and which have a random
the twist rate is 1:12 when there is one complete spiral distribution. Their existence in a firearm are brought about through
groove in 12 inch of the barrel. Spiral groove twist or rate the failure of a tool in its normal operation, through wear, abuse,
may be: mutilation, corrosion, erosion, or other fortuitous causes. Those
marks may be imprinted in the bullet or shell and may be used for
(a) Fast Twist — When the number of inches of the barrel
identification purpose.
required for a complete turn is small, like 1:8.
When the bullet or the shell or both has been recovered and a
( b ) Slow Twist — When a greater number of inches in the suspected firearm has been found in the possession of a person, the
barrel is necessary to have one complete turn, like procedure is to fire the suspected firearm at a recovery box and com-
1:14. pare the shell and bullet in the comparison microscope with the one
( 3 ) Direction — The direction of rifling may either be righ£ in question.
(clockwise) or left (counterclockwise).
How to Determine the Caliber of Firearm:
( 4 ) Width of the Groove and Land — The width of the groove
varies with the manufacturer and caliber. Some have The caliber is the diameter of the barrel between two lands.
the width of the groove different with that of the land while Table showing the relation between American, English and Con-
others are the same or equidistant. tinental Caliber:
Example: American Caliber English Caliber Continental Caliber in Mm.
Colt 0.32 has 6 lands and grooves, twist to the left, the .22 Inch .220 Inch 5.6
width of the land and groove are 0.048 and 0.108 respect- .25 " .250 M
6.5(6.35)
ively. .28 M
.280 M
7.0
Smith and Wesson 0.32 has 5 lands and grooves, twist to .30 M
(.32 Rev.) .300 " (.303) 7.65
the right and are equidistant at 0.095 inch. .32 .320 " 8.0
Table of Number of Grooves and the Direction of Riflings .35 •• (.351) .350 9.0
.38 » .360 " 9.3
No. of Direction of
.38 .370 » 9.5
Grooves Riflings
.38-.40-.41 Inch 410 •• 10.0
1. Revolvers: .405 Inch 10.5
- Webley, 455, .38, .32 7 right .44 " .440 " 11.0
— Colt, all calibers 6 left .45 M
.450 " (.455) 11.25
— Smith and Wesson, .45, .32 5 right (From: Modern Criminal Investigation by Harry Soderman and
- J.T. & S. & W. model 4 right
John O'Connell, 4th ed., p. 201).
2. Automatic Pistols: To convert millimeter calibration to inches, multiply the caliber
- Webley, .455, .32, .25 6 right
6 right in millimeters by 0.03937 or divide by 25.4.
— Browning
— Mauser, .25 6 right To convert inches calibration to millimeters, multiply by 25.4 or
- Colt, .45, .38, .25 6 left divide by 0.03937.
— Delta 6 left
— Victoria (Spanish make) 6 left MECHANISM OF FIREARM ACTION:
— Luger P-08, 9 mm. (German) 6 right Generally, the principles involved in all firearm actions are the
— Fibrique National, 9 mm. (Belgian) 6 right same. When the firearm is cocked and ready to fire, a pull on the
Aside from those marks previously mentioned, the bullet or the trigger will cause the firing pin of the hammer to hit the percussion
shell shows individual or accidental characteristics which are deter- cap of the cartridge in the firing chamber which is aligned with rear
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portion of the barrel. The hit by the firing pin on the percussion
cap will cause generation of a sufficient heat capable of igniting the
primer. The primer will in turn ignite the gunpowder or propellant
which will cause evolution of gases under pressure and temperature.
The marked expansion of the gases will force the projectile forward
with certain velocity. Owing to the presence of the rifling at the
inner wall of the bore, the barrel offers some degree of resistance
to the projectile. Inasmuch as the rifling marks are arranged in a
spiral manner, the projectile will produce a spinning movement as
it comes out of the muzzle.
Together with the bullet passing out of the barrel are the high-
pressured heated gases, unbumt powder grains with flame and
smoke.
During explosion, there is a backward kick of the firearm which
in an automatic firearm causes the cocking and the empty shell thrown
out by the ejector. The backward movement is called recoil of the
firearm.
Things Coming Out of the Gun Muzzle After the Fire: ^
1. Bullet.
2. Flame.
3. Heated, compressed and expanded*gas.
4. Residues coming from:
In ballistics, the wounding power of a bullet is due to the mass
(weight) and its velocity, with the velocity playing a very important
role.
M = Mass (Weight)
MV 2
V = Velocity
Kinetic Energy = G = Gravity
2G
Tissue damage of a bullet of a very high velocity is very much
greater than those with much less velocity.
The damage cause by a bullet with impact velocity similar to
muzzle velocity is greater than when the impact occurred at a re-
duced speed after the bullet has travelled a distance.
Bullet Efficiency:
The cartridge powder charge can be burned in approximately
0.00001 second. The conversion rate by combustion of the gun-
powder to bullet energy is about 30 to 32 percent. The loss of
some energies from the gunpowder explosion may be due to:
a. Loss of energy to force the bullet out of the cartridge case,
rifling and friction in the barrel.
b. Heating of the barrel and chamber.
c. Escape of some of the compressed gasses at the breech and
barrel.

a. Bullet: d. N o t all gunpowder are ignited.

(1) Fragment (jacket, lead). Obturation:
(2) Lubricant. This is the sealing or prevention of gunpowder gas after ex-
b. Powder particles: plosion from escaping so as to maintain high pressure in the
( 1 ) Powder grains (unbumed, burning). firing chamber thereby increasing the propulsive power on the
(2) Soot. bullet. This is maintained:
(3) Graphite. a. By insuring that the bullet tightly fits the bore throughout its
c. Primer: entire length;
( 1 ) Lead, barium, antimony, etc.. b. By sealing the cartridge case to the chamber wall; and
d. Barrel: c. By preventing leakage between the primer cap and its retaining
(1) Lubricant. wall in the cartridge.
(2) Rust, dust, etc..
(3) Scraping from bullet by previous fire. Ballistics Coefficient:
e. Cartridge case: This describes the ability of a bullet to maintain its velocity
( 1 ) Copper, zinc. against air resistance. It may be expressed in the following formula:

Bullet's Kinetic Energy: C — ballistic coefficient

Kinetic energy is energy associated with motion. In the English m — mass
system it is express in foot pound or the work of a force resulting i — form factor
when a weight of one pound is brought to a height of one foot. d — diameter
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The larger the coefficient, the more efficient is the bullet or
projectile. The better the ballistic coefficient of a bullet, the less
velocity loss it will suffer over a given resistance.
Movements of the Bullet as it Moves Out of the Muzzle:
1. Forward Movement — The velocity depends upon the propulsion
created by the ignition of the propellant.
2. Spinning Movement — This is due to the passage of the bullet at
the spiral landings and groovings of the barrel. The ratio depends
on the twist and length of the barrel.
3. Tumbling Movement (End-over-end flotation/-The bullet may be
rotating on the long axis of its flight while the nose and the base
are alternating ahead in its flight. This accounts why in some
instances, the bullet hits the skin with its base.
4. Wabbling Movement (Tailwag) — The rear end of the bullet aside
from spinning may also vibrate vertically or sidewise in its flight.
Like tumbling movement, it may cause hitting the target sidewise.
5. Pull of Gravity — As the bullet is moving forward, it gradually
goes downward on account of the pull of the force of gravity.
As the bullet looses its kinetic energy, the pull of the force of
gravity becomes dominant until it falls on the ground.
Flame:
Ignition of the propellant will cause the production of flame. It
is conical in shape with the vertex located at the gun muzzle. The
flame does not usually go beyond a distance of 6 inches and in pis-
tols or revolvers the flame is often less than 3 inches.
The flame causes scorching or burning of the skin and searing of
the hair at the target in a very near shot. In contact fire, the edges of
the wound of entry may be burned.
Heated, Compressed and Expanded Gas:
Ignition of the gunpowder will cause production of heat and gas.
Considering the limited space of the firing chamber and barrel, the
compressed gas propels the bullet to move forward. The volume
of the gas generated is dependent on the nature and quantity of the
propellant. Thus a 50 grain gunpowder in a cartridge with black
powder (one grain producing 200 to 300 cc. of gas) will cause the
production of 10 to 15 liters of gas while the same amount of
cartridge with smokeless powder (one grain producing 800 to 900 cc.
of gas) will cause production of 40 to 45 liters of gas confined in a
very limited space. This is on the presumption that all of the gun-
powder were ignited.
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The sudden release of the expanded gas from the muzzle follow-
ing the bullet is known as a muzzle blast.
Smoke (Soot, Smudging, Fouling, Smoke Blackening):
This is one of the byproducts of complete combustion of the
gunpowder and other elements with the propellant. It is light,
almost black, and lack sufficient force to penetrate the skin. It is
merely deposited on the target and readily wiped off. It may be seen
with a distance of up to 12 inches.
The presence of smudging at the wound of entrance infers
a near shot. The shape may also be useful in determining the tra-
jectory. A circular shape deposition may be typical of a perpen-
dicular approach of the bullet while in case of an acute angle the
deposition may appear to be elliptical.
Powder Grains:
This consists of the unburned, burning and partially bumed
powder, together with graphite which come out of the muzzle.
Inasmuch as it is relatively heavier than smoke, it leaves the barrel
with appreciable velocity and in near shot, it is responsible to the
production of tattooing (stippling, peppering) around the gunshot
wound of entrance.
In close range, the powder grains penetrate the dermal and epider-
mal layers of the skin and may cause hemorrhage in deeper tissue
which cannot be removed by ordinary wiping. Microcontusion may
be observed around the punctured area and the shape of the puncture
may denote the shape of the penetrating grain. As the distance of
the gun muzzle to the target increases, the area of destruction in-
creases, but the density of tattooing decreases.
In case of black powder, the residue is composed of nitrates,
thiocyanates, thiosulphates, potassium carbonates, potassium sulphate
and potassium sulphide, while in smokeless powder, the residue is
composed of granules with nitrites and cellulose nitrates with graphite.
The presence of tattooing or stippling may be seen around the
wound of entrance up to a distance of 24 inches, although there may
be considerable variation from gun to gun.
Powder Burns:
Powder burns is a term commonly used by physicians whenever
there is blackening of the margin of the gunshot wound of entrance.
The blackening is due to smoke smudging, gunpowder tattooing and
to a certain extent burning of the wound margin. It is the combined
effects of these elements that are considered to be powder bums.
Actually, such blackening is primarily due to smoke smudging and
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gunpowder tattooing so that the term sotting of the target rather
than powder bums is more appropriate to describe the condition.
Factors Responsible for the Injurious Effects of Missile:
1. Factors Inherent on the Missile:
a. Speed of the Bullet — The greater the muzzle velocity, the
greater is the destruction inasmuch as more kinetic energy
can be liberated.
b. Size and Shape of the Bullet — The bigger the diameter or the
more deformed the bullet is, the greater are the injuries in the
body tissues.
c. Character of the Missile's Movement in Flight — Spinning move-
ment will increase the wounding power; "Yawing" and stumbling
movement may cause sidewise penetration and entry and cause
more destruction; and ricochette may alter tissue involvement
in its course.
2. Nature of the Target:
a. Density of Target — The greater the density of the tissue struck,
the greater will be the damage. More energy will be spent by
the bullet in its course in penetrating skin, bones and clothes.
Heavy thick clothes may prevent penetration of missile; fragile
bone may fragment when hit and each fragment may act as a
secondary splinter to cause further injuries.
b. Length of Tissue Involvement in its Course — The longer the
distance of travel of the missile in the body, the more kinetic
energy it liberates, and the more destruction it will produce.
c. Nature of the Media Traversed — Bullet passing air spaces is less
destructive inasmuch as air is relatively compressible however,
bullet traveling in a liquid or solid media may accelerate trans-
mission of force to the surrounding tissue thus, causing more
destruction.
d. Vitality of the Part Involved — There is more likelihood for a
fatal consequence when vital organs are involved than those in
other parts of the body.
Abrasion Collar (Contuso-abradded Collar, Marginal Abrasion):
The pressure of the bullet on the skin will cause the skin to be
depressed and as the bullet lacerates the skin, the depressed portion
will be rubbed with the rough surface of the bullet. A perpendicular
approach will produce an even width of the collar. An acute angle
of approach will cause an abrasion collar wider at the acute angle of
approach.
Destructive Mechanism of Gunshot:
The following physical phenomena are responsible for the causation
of injury in the body of the victim:
1. Laceration and Permanent Cavity in the Bullet Trajectory:
The pressure of the speeding bullet produces severe pressure on
the tissues and organs causing laceration and mechanically creates
a permanent cavity. High velocity bullets can cause bigger damage
and wider cavity formation.
2. Temporary Cavity:
This is the instantaneous radial displacement of the soft tissues
during the passage of the bullet due to the liberation of kinetic
energy. The size of the cavity is dependent on the velocity of the
bullet and elasticity of the tissues. The greater the velocity, the
larger the temporary cavity formed. The diameter and volume
of the temporary cavity are many times greater than the diameter
and volume of the projectile that produces it. Although the
development is transient during the passage of the missile, it causes
loss of function to the part involved and further act as a secondary
missile to involve other areas.
3. Hydrostatic Force:
When the bullet traverses organs filled with fluid, like a full
stomach, cerebral ventricle, heart chambers, the liquid contents
within the lumen of these organs are displaced radially away from
the bullet path producing extensive laceration. The displaced
fluid carries with it the kinetic energy which in turn acts as a
secondary projectile causing destruction of tissues not on the path
of the bullet.
4. Shock Wave:
This is the dissipation of kinetic energy in a radial direction
perpendicular to the path of the bullet when the bullet velocity is
more than the speed of sound (the speed of sound is 1,087 feet
per second). The severe intensity of the wave causes severe
shocking effect on the adjacent tissues and may cause actual
destruction or lessening of function.
5. Fragmentation or Disintegration of the Bullet:
When the bullet hits a hard object (bone), it fragments to
several pieces. When the bullet velocity is more than 2,000
ft/sec. it disintegrates and each fragment has sufficient kinetic
energy to cause injuries similar to the mother bullet. It may cause
laceration, fracture and shocking effect, thus increasing the
destructive effect of gunshot. This causes more "shocking power"
or "knockdown power" of the bullet.
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6. Fragmentation of Hard Brittle Object in the Trajectory: collar. In most cases,' the size of the wound of entrance is smaller
Bone involvement along the trajectory may cause comminuted than the caliber of the wounding bullet'on account of the retraction
fracture and each bone fragment may cause additional damage on of the connective tissues.
0

the surrounding tissues and even in the wound of exit.
Passage of the bullet causes a clean-cut hole at the point of initial
contact and beveling at the point of exit. The beveling is due to
the absence of a hard support as the bullet leaves the bone.
In the skull a through and through wound will produce a round
or oval hole at the outer table with leveling of the inner table and
at the point when a bullet makes the exit, the clean cut hole will
be at the inner table and beveling will be at the outer table.
7. Muzzle Blast in Contact Fire:
When the gun muzzle is pressed on the skin when fired, all of
the products of combustion primarily the muzzle blast will pene-
trate the tissues causing severe mechanical destruction on account
of pressure. The explosive effect will cause extensive laceration of
soft tissues and fracture of bones.
8. Other Consequential Effects on the Body of the Victim:
Aside from direct involvement of vital structures of the body,
pressure to other organs and tissues, the gunshot wound may be
the source of hemorrhage, infection, paralysis, shock, loss of
functioning etc. which may cause disability or death on the
victim.
/ also due to the pressure of the expanded gases, flame and other
Gunshot Wound of Entrance (Entrance Defect, Inshoot):
The appearance of the gunshot wound of entrance depends upon
the following:
1. Caliber of the Wounding Weapon:
Excluding other factors which may influence the size of the
wound of entrance^ the higher the caliber of the wounding bullet
the greater will be the size of the wound of entrance'/ It must not
be overlooked that the manner of approach of the bullet to the
skin, the distance of the muzzle of the firearm to the skin surface,
the deformity or splitting of the bullet and the portion of the skin
surface involves modification of the size and shape of the entrance.
2. Characteristics Inherent to the Wound of Entrance:.
The wound of entrance, as a general rule, is»'oval or circular
with inverted edges,' except in near shot or in grazing or slap
wounaT'^ATUieTDuiret approaches the skin, there is an indentation
of the skin surface but later, on account of the extreme pressure;
the skin tissues give way. The rough surface of the bullet comes
in contact with the skin thereby producing a contusion or abrasion
The wound of exit is usually larger than the wound of entrance*—'
It may be stellate, slit-like, cruciform, or markedly lacerated. The
deformity of the bullet in its course inside the body, the lack of
support beyond the skin, and the velocity of the missile are
responsible for the increase in size of the exit wound.
3. Direction of the Fire:
A* right angl£ approach of the bullet will make the wound of
entrance circular in shape, except when the missile is deformed
or the fire is in contact or near. In cases of an acute angle of ap-
proach of the bullet, the wound of entrance is oval in shape with the
contusion or abrasion collar widest on the side of the acute angle
of approach. There is more likelihood for deflection of the bullet
course wherever it hits the bony tissue.
4. Shape and Composition of the Missile:
Deformity of the bullet modifies the shape of the wound of
entrance. Some missiles are purposely made to enhance deformity
upon hitting hard objects like hollow-point, dum-dum and soft
point bullets. Hard or armor-piercing bullets are not usually
deformed on account of their hard metallic constituents.
5. Range:
In close range fire, the injury is not only due to the missile but
solid products of combustion. Distant fire usually produces the
characteristic effect of the bullet alone.
6. Kind of Weapon:
High power weapon has more destructive effect as compared
with low power one. The shape of the bullet also plays an im-
portant role. Conical shape free end bullets have more piercing
power without marked tissue destruction while missiles with
hemispherical free ends are more destructive.
Contact F i r e : ^
The nature and extent of the injury is caused not only by the
force of the bullet but also by the gas of the muzzle blast and part of
the body involved. T h e following factors must be taken into con-
sideration:
1. The Effectiveness of the Sealing Between the Gun Muzzle and the
Skin:
If all the gaseous product of combustion is prevented from
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being spilled out, there will be more destructive effects on the (2) The gun muzzle is pressed on the body, pushed momen-
tissues. tarily away and then hit the body again because of the
continuous inward pressure.
2. The Amount of Gas Liberated by the Combustion of the Pro-
pellant: ( 3 ) When the gun is fired on areas of the body where bony
tissue is superficial, like the scalp, the muzzle blast has the
The volume of gas liberated after explosion of the propellant is
tendency to creep in the loose connective tissue between
dependent on the amount and nature of the powder, and the
the skull and the skin thereby pushing the skin outward
extent of powder combustion. The greater is the amount of gas in
to press on the gun muzzle.
a confined area, the greater will be the tissue destruction.
e. The bullet may cause radiating fracture and the pressure of the
3. Nature of Bullet:
gases may cause fragmentation of the skull and a severe lacera-
Bigger caliber bullet is obviously more destructive than smaller tion of the brain and its meninges.
ones. Soft or hollow point bullet has the tendency to flatten and
f. Blood and tissue become pink due to carbon monoxide.
causes more damage to tissues.
g. Fragments of lead and bullet jacket may be found.
4. Part of the Body Involved:
Metal Fouling — When the bullet travels the whole length of the
The nature, character and extent of injury in contact fire is
tight fitting barrel, it is rotated by the lands and grooves. Its surface
different ( 1 ) when the bone is superficially located under the
is scraped by the lands and the scraping is ejected from the barrel and
skin, and ( 2 ) when the bone is deeply located in loose or soft
strikes the target. It may lodge on the clothings or may cause small
parts of the body.
abrasions or superficial lacerations on the skin around the main
Pressed and Firm Contact Fire: S wound.

1. On Parts of the Body Where Bone is Superficial: h. Singeing of hair.

This is commonly observed on the head where the skull is just
underneath the scalp. The following are the characteristics of the
injuries:
a. The wound of entrance is* large," frequently star-shaped due to
tear radiating from the entrance wound caused by the blast
effect which follows the sudden release of gases into a confined
area between the skin and the underlying bone.
b. Edges of the wound may be" everted.' The creeping of the gases
between the skull and the scalp causes the skin to move towards
the muzzle.
c. Areas in the entrance wound is^ blackened by burns, tattooing
1 1
and smudging . Singeing of the hair is confined only at the site
of wound of entrance.
d. Muzzle imprint, Barrel impression (Profile of the muzzle) on the
skin — The outward movement of the skin caused by the im-
prisoned gas will add more pressure to the gun muzzle coupled
with the heat of the explosion and will cause iron-like effect on
the pressed skin.
Causes of Muzzle Imprint: Gunshot wound of entrance with contusion collar, powder burns and tattooing.
(1) The gun muzzle is pressed on the body at the time of the
fire and the heated muzzle during the blast produced an 2. Parts of the Body Where the Bone is Deeply Located:
ironing effect on the skin. a. Wound of entrance is usually large, circular and without radiating
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laceration. The gas from the muzzle can easily penetrate
deeper structures.
b. Edges are everted due to outward slapping of the skin. In some
instances, soft tissues (blood, fibrous and muscular tissues)
may be found inside the gun barrel. This is due to the negative
pressure created in the barrel after the blast.
c. Singeing of the hair, blackening of the wound due to fouling,
burn, and tattooing.
d. Muzzle imprint due to outward slapping of the skin and heat.
e. Pinkish color of the deeper structures due to carbon monoxide.
Loose Contact or Near F i r e : ^
1. Entrance wound may be^large circular or oval depending upon the
angle of approach of the bullet.
Fired More Than 60 cm. Distance: /
1. Gunshot wound is'circular or ovaf depending on the angle of
approach with abrasion collar.
2. Wound of entrance has°no* burning, smudging or tattooing.
3. Contact ring is present.
Microscopic Examination of Gunshot Wound of Entrance:
1. In Contact or Near Contact Fire:
a. Epithelial damage and powder residue deposit are present.
b. Massive heat may carbonize the epithelial cells.
c. The hot bullet may produce coagulation necrosis.
d. Basilar cells are swollen and vacuolated.
e. The corium may show thermal changes manifested by nuclear
shrinkage, pyknosis and vacuolization.

2^Abrasion collar**or ring is distinct. 2. In far Distant Fire:

3^Smudging, burning and tattooing are prominent with singeing of
the hair.
4. Muzzle imprint may be seen depending upon the degree of slap-
ping of the skin of the gun muzzle.
^instances When the Size of the Wound of Entrance Do N o t Approxi-
5. There is^blackening of the bullet tract to a certain depth.
' m a t e the Caliber of the Firearm:
6.TJarboxyhemoglobin is present in the wound" and surrounding areas.
Short Range Fire ( 1 to 15 cm. distance): ^
1. Edges of the entrance wound is inverted.
2. If within the flame reach (about 6 inches in rifle and high powered
firearms and less than 3 inches from an ordinary handgun), there is
an area of burning.
S.^mudging is present'due to smoke.
4. "Powder tattooing* is present (dense and limited dimension of
spread).
S.'vAbrasion ring'br collar is present (contact ring).
a. There may be a spotty deposit of powder on skin and subcu-
taneous tissue.
b. There is cellular destruction along the course of bullet.
In distant fire, the rule is that the diameter of the gunshot wound
of entrance is almost the same as the caliber of the wounding firearm,
but in the following instances, the rule is not followed:
1. Factors which make the wound of entrance bigger than the caliber:
a. In contact or near fire — The size of the entrance wound in
contact and near fire is caused by the force of the expanded
gases of explosion and by the bullet.
b. Deformity of the bullet which entered — The bullet might have
hit a hard object before it pierces the skin thereby making the
wound of entrance bigger than the caliber of the missile.

c. Bullet might have entered the skin sidewise — Ordinarily, it is

Medium Range Fire (more than 15 cm. but less than 60 c m . ) : ^
the ogival portion which pierces the skin first, but occasionally
1. Gunshot wound with* inverted edges'and with abrasion collar is it may hit the skin sidewise on account of the inequality of
present. resistance of the surrounding media in its flight. The spinning
T
movement and the tail wag ( w o b b l e ) may cause the bullet to
2. Burning effects (skin bum and hair singeing) is absent.
enter in its vertical axis.
3. Smudging may be present if less than 30 cm. distance.
c
d. Acute angular approach of the bullet — Due to the sliding
4. Gunpowder tattooing" is present but of lesser density and has a trajectory of the bullet, the wound becomes oval in shape with
wider area of distribution. prominence of the contusion collar at the side of the acute
o. Contact ring is present. angle of approach.
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2. Factors which make the wound of entrance smaller than the k e r- s o ft w a

caliber: 3. Testimony of witnesses:

a. Fragmentation of the bullet before penetrating the skin — If in
the flight of the bullet it hits a hard target which causes its
fragmentation and only the fragments pierce the skin, the
wound produced will be smaller than the caliber of the firearm
which causes the fire.
b. Contraction of the elastic tissues of the skin — The form of the
bullet may be preserved but the entrance wound may be smaller
than the caliber on account of the contraction of the elastic
tissues of the skin.
In shotgun fire, the size of the wound of entrance is dependent
upon the distance of the fire. Near fire causes concentration
of entry of the pellets, and as distance increases the pellets dis-
perse with individual pellets causing individual wounds of entry.
Only in this instance may the wound of entrance of the same
size as the gauge of the shotgun pellets.
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 determination 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:
1. Examination of the clothings, if involved in the course of the
bullet:
a. The fabric of the clothings may show punch in destruction at
the site of the wound of entrance.
b. Examination for particles of gunpowder on the clothings at the
site near the wound in question. If the clothings give a positive
test for gunpowder, then it must be the wound of entrance.
This is only true if the fire is near.
2. Examination of the internal injuries caused by the bullet:
a. In case where the missile hits a bone, the bone fragments are
driven away from the wound of entrance.
b. Destruction of the bone at the surface facing the wound of
entrance is oval and with sharp edges, while the surface facing
the wound of exit is bigger, irregular and bevelled.
c. Direction of the cartilage and other soft tissues will be driven
away from the gunshot wound of entrance.
The testimony of the witness as to the position of the victim
and the assailant when the firearm was fired may determine which
of the wounds is the entrance wound.
Determination of the Trajectory of the Bullet Inside the Body of
the Victim:
The following must be taken into consideration to determine the
course of the bullet inside the body of the victim:
1. External Examination:
a. Shape of the Wound of Entrance — When the bullet is fired at
right angle with the skin the wound of entrance is circular
except in cases of near fire. If fired at another angle, the wound of
entrance is usually oval in shape. When the bullet is deformed,
no such characteristic findings will be observed.
b. Shape and Distribution of the Contusion or Abrasion Collar —
As a general rule, the contusion (abrasion) collar is widest at
the side of the acute angle of approach of the bullet. If the
bullet hits the skin perpendicularly, then the collar will have a
uniform width around the gunshot wound, except when the
bullet is deformed or in near fire.
c. Difference in Level Between the Entrance and Exit Wounds —
The difference in height between the gunshot wound of entrance
and exit may be determined by measuring those wounds from the
fixed references in the body, e.g. sole of the foot, or by drawing
a horizontal line across the body and using it as a reference
point.
d. By Probing the Wound of Entrance — The probe must be
applied without too much force so as not to create a new
course in the soft tissues. Care must be observed in cases of
deflection of the course due to some hard objects that might
have been involved.
2. Internal Examination:
a. Actual Dissection and Tracing the Course of the Wound at
Autopsy:
The tissues involved are hemorrhagic and bone spicules and
lead particles may be seen or felt.
b. Fracture of Bones and Course in Visceral Organs:
Occasionally, the nature of the bone fracture may show the
direction, especially when the bullet is not deformed before
causing the fracture. Injuries in solid visceral organs may clearly
manifest the course because of the absence of contractility.
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c. Location of Bone Fragments and Lead Particles:
The bone spicules and lead fragments go with the flight of
the bullet and may be utilized in the determination of the
trajectory.
d. X-ray Examination:
Bone spicules and lead fragments may be observed and their
exact location determined in relation with the wound of en-
trance.
3. Other Evidences to Show Trajectory:
a. Relative difference in the vertical location of the entrance from
the exit in the clothings.
b. Relative position and distance of the assailant from the victim
in the reconstruction or reenactment of the crime.
xi. Testimony of witnesses.
of a circular wound of exit. This is known as a shored gunshot
wound of exit.
Shored gunshot wound of exit is produced when the outstretched
skin is impaled, sandwiched and crushed between the outgoing bullet
and the unyielding object is over the exit site, thus making the
wound to be circular with abrasion collar at its margin. Proper coap-
tation of the wound margin is impossible because of the loss of
skin just like those observed in entrance wound. In contrast with
the entrance wound, the supported exit wound shows a scalloped or
punched-out abrasion collar and sharply contoured skin in between
the radiating skin lacerations marginating the abrasion (Journal of
Forensic Medicine and Pathology, Vol. 4, Sept. 1983, p. 99).

Exit (Outshoot) Wound: ^

An exit wound does not show characteristic shape unlike the
wound of entrance. It may be slit-like, stellate, irregular or even
similar to the wound of entrance. This is due to the absence of
external support beyond the skin so the bullet tends to tear or
shatter the skin while sufficient amount of kinetic energy is still
in the bullet during the process of piercing the skin.
^ • T h e edges of the wound are everted and occasionally portions of the
inner tissues are protruding. Aside from the bone, the skin is one of
the most resistant to penetrate in the course of the bullet so that
most often the bullet is lodged just underneath the skin. It may
only be noticed by the presence of contusion over the area wherein
it is lodged or its presence may be noticed by palpitation. The bullet
may have lost its^monierj^um after piercing_the_skin and just fall
without perforation of the clothing.
G u n s h o t w o u n d o f exit o f the skull w i t h p u n c h out edges
Bones may be involved in the trajectory and its spicules may
stinction Between Gunshot Wound of Entrance and Wound of
create additional injury to the wound of exit.
Exit:
Variation on the shape of the wound of exit may be attributable to Exit Wound
Entrance Wound
the deformity of the bullet in its passage in the body and to the wab-
bling and stumbling movement of the bullet during its course and 1. Appears to be smaller than the 1. Always bigger than the missile.
fragmentation of the missiles. missile owing to the elasticity
of the tissue.
Shored Gunshot Wound of Exit — If the place where the gunshot
2. Edges are inverted. 2. Edges are everted.
wound of exit is pressed on a hard pbject as when the victim is lying
on his back on a hard object or in small caliber shots (like 0.22) the 3. Usually oval or round depend- 3. It does not manifest any de-
wound of exit tends to be circular or nearly circular with abrasion at ing upon the angle of approach finite shape.
its border. It is also observed that tight-fitting clothings, waist band, of the bullet.
belt collar, brassiere may also support the skin to enhance formation 4. "Contusion collar" or "Con- 4. "Contusion collar" is absent.
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tact ring" is present, due to
invagination of the skin and
apiInning of the missile.
4. Tattooing
Tat or smudging may be
present when firing is near.
6. Underlying tissues are
protruding.
7. Always present after fire.
8. Paxaffin test may be positive.
3. Number of Shots Heard by Witnesses:
.5v Always absent.
not 6. Underlying tissues may be seen
protruding from the wound.
7. May be absent, if missile is
lodged in the body.
8. Paraffin test always negative.
made another wound of entrance in some other parts of the
body; thus a single shot may produce two wounds of entrance.
The witnesses might be able to count the number of shots
heard especially if the shots were made at sufficient intervals of
succession. However in cases of machine gun fire, there is difficulty
in ascertaining the number heard and the testimony of witness
as to the number of shots heard must be admitted with caution.

The "Odd and Even Rule" in Gunshot Wounds: ^

If the number of gunshot wounds of entrance and exit found in
the body of the victim is even, the presumption is that no bullet is
lodged in the body, but if the number of the gunshot wounds of
entrance and exit is odd, the presumption is that one or more bullets
might have been lodged in the body.
The rule is merely presumptive and actual inspection and autopsy
will verify the truth of the presumption. It may be possible that all
of those wounds or a majority of them are entrance wounds with
some bullets lodged, yet the number may still be even.

Sometimes it is difficult to locate the lodged bullet but with the

help of a portable X-ray, its location and extraction can be facilitated.

How to Determine the Number of Fires Made by the Offenderrr

1. Determination of the Number of Spent Shells:
Search must be made at the scene of the crime or at the place
where the offender made the fire, for spent shells, if the weapon
used is an automatic pistol or rifle. In case of revolver fire, the
empty shells may be found still inside the cylindrical magazine.
In machine gun fire, the spent shells may still be attached to the
cartridge belt.
2. Determination of Entrance Wounds in the Body of the Victim:
Although most often erroneous, the investigator may be given
an idea as to the minimum number of shots made. The number of
wounds of entrance may not show the exact number of fire
because:
a. Not all the fire made may hit the body of the victim.
b. The bullet may in the course of its flight hit a hard object
thereby splitting it and each fragment may produce separate
wounds of entrance.
c. The bullet may have perforated a part of the body and then
Mutilating gunshot wound of exit
^Distances when the Number of Gunshot Wounds of Entrance is Less
than the Number of Gunshot Wounds of Exit in the Body of the
Victim:
1. A bullet might have entered the body but split into several frag-
ments, each of which made a separate exit.
2. One of the bullets might have entered a natural orifice of the
body, e.g. mouth, nostrils, thereby making it not visible and then
producing a wound of exit.
3. There might be two or more bullets which entered the body
through a common entrance and later making individual exit
wounds.
4. In near shot with a shotgun, the pellets might have entered in a
common wound and later dispersed while inside the body and
making separate wounds of exit.
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Determining Whether the Wound is Ante-mortem or Post-mortem:

yInstances when the Number of Gunshot Wounds of Entrance is More
than the Number of Gunshot Wounds of Exit in the Body of the
Victim:
1. When one or more bullets are not through and through and the
bullet is lodged in the body.
2. When all of the bullets produce through and through wounds but
one or more made an exit in the natural orifices of the body, e.g.
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 N o t 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.).
If the wound indicates that there has been profuse hemorrhage, or
there are signs of vital reactions in the tissue, then the gunshot
wound is ante-mortem. The presence and degree of vital reactions
depends upon the period of survival of the victim. It may be mani-
fested in the form of swelling, effusion of lymph or other evidences
of repair. Microscopically, there is congestion and leucocytic in-
filtration.
Wounds inflicted after death show no evidence of profuse hemor-
rhage, no retraction of the edges, and there are no vital reactions.
Problems Confronting Forensic Physician in the Identification of
Gunshot Wounds:
1. Alteration of the Lesion Due to Natural Process:
The drying of the margins of the wound opening may modify
measurements. The size and shape is considerably altered by
decomposition. Healing process and infection may modify its
appearance and it may be mistaken for some other types of injuries.
2. Medical and Surgical Intervention:
The wound may be scrubbed, medication applied, or surgically
debridded, extended, excised or sutured. This problem is properly
solved by having access to the clinical record of the patient.
3. Embalming:
Embalming trocar may be introduced on the gunshot wound it-
self or the trocar mark itself may be mistaken for a gunshot wound.
The gunshot wound may be extended to reach the principal artery
for the embalming fluid to enter. The passage of the embalming
fluid may wash out the product of the gunpowder combustion,
The trajectory of the bullet may be modified by the trocar thrust.
The suturing of the gunshot wound and the application of "make-
u p " may modify the actual appearance of the wound.

4. Problem Inherent to the Injury Itself:

The gunshot wound may be covered with clotted blood or with
scab to make it not visible. Grazing injury caused by glancing of
the bullet on the skin may appear like abrasions or lacerations.
Wound brought about by screw drivers, icepicks or other sharp
pointed instruments might be considered to be gunshot wounds.
Bullet might have entered or made its exit in the natural openings,
like mouth, nostril, ear, etc. making its identification difficult.
The wound may be located in thick haired scalp, skin fold and
Trajectory of a gunshot w o u n d In the head.
make visibility difficult.
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5. X-ray Examination: 2. It may be useful in the determination as to which is the point of

The use of an X-ray is almost indispensable in the examination
of gunshot injuries. The use of the apparatus will facilitate re-
covery of the lodged bullet together with the location of its
fragments.
The body might have been X-rayed with unspent and spent
ammunition clinging on the clothings and may be mistaken to
be inside the body; teeth fillings or crown may resemble bullet on
X-ray examination of the skull. "Migratory" bullets may be found
in some parts of the body away from the bullet tract. Victim
may have "bullet souvenir" on account of a previous gunshot
injury and may confuse the examiner as to be an effect of recent
shot.
entry and of exit of the bullet:
The direction of the fibers will be inward or inverted at the
point of entry, while it is outward or everted at the point of
exit. Care must be exercised in making the inference inasmuch
as improper handling may change the direction of the fibers.
3. It may be useful in locating the bullet:
The clothings, like skin and bone are not easily perforated. It
is frequently observed that the bullet is recovered just underneath
the clothings of a dead victim at the crime scene.
Special Consideration on Bullets:

Clothings: 1. Souvenir Bullet:

The effects of the garments on the movement of the bullet depend
upon:
1. The number of layers of fabric between the muzzle and subjacent
skin;
2. Nature of the fabric which may be closely woven or loose mesh,
light or heavy, cotton or synthetic fibers.
3. Muzzle-clothings distance.
Examination of the External Wearing Apparel of the Victim of
Gunshot maybe Significant in Investigation because:
1. It may establish the possible range of the fire:
a. Contact Fire:
(1) There is a tear of the clothings covering the skin at the site
of the gunshot wound with fusion of its fibers in case of
artificial fabric. Fibers are turned outward away from the
body.
(2) Soot deposit and gunpowder tattooing around the torn
fabric. Burning of the fibers are visible.
(3) Muzzle imprint (profile of the muzzle) especially in arti-
ficial fabric may be present.
(4) Dirt and greasy deposit is carried by the bullet and may be
wiped out and be visible on the torn clothing.
b. Not Contact but Near Shot:
The same findings as in contact shot except when it is be-
yond the flame range and absence of muzzle imprint.
c. Far Fire:
There is a hole tear with inward direction of the thread.
Bullet has been lodged and has remained in the body. Its long
presence causes the development of a dense fibrous tissue capsule
around the bullet causing no untoward effect. It may be located
just underneath the skin to be easily palpated and may cause
inconvenience and irritation. Deep seated location may not cause
any problem to warrant its immediate removal.
2. Bullet Migration:
Bullet that is not lodged in a place where it was previously
located. A bullet which strikes the neck may enter the air passage,
and it may be coughed out or swallowed and recovered in the
stomach or intestine.
Bullets Embolism — a special form of bullet migration when
the bullet loses its momentum while inside the chamber of the
heart or inside the big blood vessels and carried by the circulating
blood to some parts of the body where it may be lodged. It may
cause sudden loss of function of the area supplied or death if vital
organs are involved.
3. Tandem Bullet:
T w o or more bullets leaving the barrel one after another. In
cases of misfire or a defect in the cartridge, the bullet may be
lodged in the barrel and a succeeding shot may cause the initial and
the succeeding bullet to travel in tandem. There is a strong
possibility for them to enter the target in a common hole. This
might create doubt to the statement made by the firer that he
made only a single shot, but ballistic examination can show as
to whether the bullet travelled in tandem.
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)<GUNSHOT WOUNDS MAY BE SUICIDAL, . 10. Fingerprints of victim on the butt.

HOMICIDAL OR ACCIDENTAL
Evidences that tend to show that the Gunshot(s) Wound is Suicidal.
1. The shot was fired in a closed or locked room, usually in the
office or bedroom. If in the bedroom, the shot was fired while
the victim was lying in bed and the weapon covered with pillow
or bedding to muffle the sound. It may be committed in an
open isolated or uninhabited place.
2. The death weapon is almost always found near the place where
the victim was found. When a light, low caliber hand firearm was
used and the shot was made in parts of the body where death
may develop almost instantaneously, the victim may be seen with
the grip of the firearm firmly held in the palm of the wounding
hand (cadaveric spasm).
3. The shot was fired with the muzzle of the gun in contact with
the part of the body involved or at close range. The wound of
entrance may show signs of muzzle impression, burning, smud-
ging and tattooing.
4. The location of the gunshot wound of entrance is in an accessible
part of the body to the wounding hand. It may be at the temple,
roof of the mouth, precordial or epigastric region. A person
committing suicide will do the act in his most convenient way,
unless he has the intention of deceiving the investigator.
5. The shot is usually solitary. If the shot is made on the head
involving the brain, the shocking effect of the injury will not
make him capable of firing another shot. However, shots in some
parts of the body which may not produce immediate death or
sudden loss of consciousness, the possibility of additional shots is
not remote. The victim may be determined to die and had fired
additional shots to insure realization of his intention.
6. The direction of the fire is compatible with the usual trajectory
of the bullet considering the hand used and the part of the body
involved. A shot on the temple is usually directed towards the
opposite temple and upwards, while a shot in the precordium
and epigastrium is usually backwards and downwards.
7. Personal history may reveal social, economic, business or marital
problem which the victim cannot solve. He may have history
of mental disease, depression, severe frustration or previous
attempt of self-destruction.
8. Examination of the hand of the victim may show presence of
gunpowder.
9. Entrance wound do not usually involve clothings.
11. Search of the place where the shot took place may reveal a
suicide note which usually mentions among other things the
reason why the victim committed suicide.
12. No disturbance in the place of death.
''Russian Roulette:
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 muzzle pressed or directed to the temple or towards
other vital parts of the body. The person who will pull the trigger
with the live cartridge in the firing chamber will suffer the fatal
consequence. Although it may be considered suicidal because any
person who participates to such an agreement may have the desire
to commit it, the unfortunate victim has no predetermined desire
of self-destruction.
idences to show that the Gunshot Wound is Homicidal:
1. The site or sites of wound of entrance has no point of election.
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.
4. There may be a disturbance of the surroundings on account of
previous struggle.
5. Wounding firearm usually is not found at the scene of the crime.
6. Testimony of witnesses.
-Evidences to show that the Gunshot Wound is Accidental:
1. Usually there is but one shot.
2. There is no special area of the body involved.
3. Consideration of the testimony of the assailant and determination
as to whether it is possible to be accidental by knowing the rela-
tive position of the victim and the assailant.
4. Testimony of witnesses.
Points to be Considered and Included in the Report by the Physician:
1. Complete description of the wound of entrance and exit.
2. Location of the wound:
a. Part of the body involved.
b. Distance of the wound from the mid-line.
c. Distance of the wound from the heel or buttock.
3. Direction and length of the bullet tract.
4. Organs or tissues involved in its course.
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5. Location of the missile, if lodged in the body. (

6. Diagram, photograph, sketch, or drawing showing the location
and number of wounds.
Questions that a Physician is Expected to Answer in Court:
1. Could the wound or wounds be inflicted by the weapon presented
to him?
2. At what range was it fired?
3. What was the direction of the fire?
4. May it be possible that those gunshot wounds are self-inflicted?
5. Are there signs of struggle in the victim?
6. May it be possible for the victim to fire or resist the attack after
the injury was sustained by him?
7. Did the victim die instantaneously?
8. Where was the relative position of the assailant and the victim
when the shot was fired?
Can the Caliber of the Wounding Firearm be Determined from the
Size of the Gunshot Wound of Entrance?
Although the size of the gunshot wound of entrance is influenced
by several factors, the caliber may be inferred from the diameter of
the gunshot wound. In most cases, especially when the wound is
circular, the caliber is almost the same as the diameter of the wound
of entrance.
Determination of the Length of Survival of the Victim:
The length of survival of the victim may be inferred from the
following:
1. Nature of the gunshot wound.
2. Organs involved.
3. Presence or absence of infection or other complications.
4. Amount of blood loss.
5. Physical condition of the victim.
Capacity of the Victim to Perform Volitional Acts:
The power of the victim to perform voluntary acts depends upon
the 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 those involving the brain and the spinal cord
definitely inhibits volitional acts.
Determination as to the Length of Time a Firearm had been Fired s
Physical and chemical examinations of the residue inside the
barrel does not give a conclusive evidence as to how long the
firearm has been discharged. Most often the examiner does not
know whether the barrel was cleaned immediately after the dis-
charge. Smokeless powder which is now commonly used does not
leave much residue for such determination. However, inferences
may be drawn from the following:
1. Odor of the Gas Inside the Barrel:
Explosion of the gunpowder produces considerable evolution of
gases consisting of nitrogen, hydrogen sulfide, carbon dioxide,
carbon monoxide and methane. This mixture of gases has a
peculiar characteristic odor which may be noticed several hours
after the discharge. Later, it will disappear as gases usually evapo-
rate or chemically transformed to other odorless compounds.
2. Chemical Changes Inside the Barrel:
Black powder is a mixture of charcoal, sulfur and nitrates of
sodium or potassium. One of the products of combustion is
hydrogen sulfide. Hydrogen sulfide is rapidly converted to thio-
sulfate, thiocyanate and finally to sulfates of potassium or sodium.
The absence of the peculiar characteristic odor and the presence
of thiosulfate and thiocyanate which is increasing in amount
shows that the discharge occurred in a matter of few days. Later
the thiosulfate and thiocyanate of sodium or potassium will be
chemically transformed to sulfates and its presence shows that
firing occurred for sometime.
The iron salts in the ferrous state are found during the early
stage and may be transformed to ferric salt after a lapse of a
certain period.
The residue produced by smokeless powder explosion as nit-
rates are not liable to undergo changes even after a lapse of time,
hence approximation of the time of the discharge is much more
difficult.
The main difficulty in the determination is that the length of
such physical and chemical transformation of the residue of
combustion from one compound to another, cannot be definitely
ascertained. It is dependent upon several factors.
3. Evidences that may be Deduced from the Wound:
Approximation of the age of the wound also infers the time of
discharge. The degree of healing in the absence of subsequent
infection must be considered. If an infection is present, then the
degree of infection may be utilized in the approximation.
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Determining Whether the Wounding Weapon is an Automatic Pistol
or a Revolver:
The following must be taken into consideration to determine
whether the wounding weapon is an automatic pistol or a revolver:
1. Location of the Empty Shells:
In a revolver, the empty shells are found in the cylindrical
magazine chamber after the fire, but in cases of automatic pistol
the empty shells are driven out of the weapon after the shot, to
give way to live cartridge to be in the firing chamber. Thus, in
cases of automatic pistol, the empty shells are found a few yards
away from the place of the firing.
2. Nature of the Spent Bullet:
As a general rule, in automatic firearm, the bullet is copper
jacketed or cupro-nickel jacketed, while in cases of revolver, no
such coating is observed. This is not true in all cases.
3. Nature of the Base of the Cartridge or Spent Shell:
The base of a revolver has a wider diameter than that of the
cylindrical body to keep the cartridge stay in the magazine cham-
ber. There is no such difference in the diameter in case of shells
of automatic pistol.
Can the Direction of the Shot be Determined from the Direction
from which the Sound Came From?
Not possible, unless the flash or the person firing the shot is «een
at the time the shot was fired. The ear is usually at a loss as to
where the shot was fired.
Can the Firearm be Identified by the Sound of the Discharge?
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
accustomed to the sounds of firearms of different calibers to identify
the firearm by the sound produced.
Example: The sound of a shotgun may be distinguished from
the sound of a caliber 0.22 pistol.
Gunshot Wound may Not be a Near Fire or may Not Appear to be a
Near Fire:
1. When a device is set up to hold the firearm and to enable it to be
discharged at a long range by the victim.
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.
3. When the examining physician failed to distinguish between a near
or far shot wound.
4. When the product of a near shot has been washed out of the
wound.
X-ray:
The use of the x-ray must not be overlooked in a gunshot wound
investigation. Several exposures at different angles must be made to
determine the precise location of the bullet, trajectory, position of
the slug, and other injuries.
X-ray Examinations may:
a. Facilitate location and extraction of the bullet lodged.
b. It will reveal fragmentation and their location.
c. It will show bone involvement like fracture.
d. It will reveal trajectory of the bullet.
e. It will show the effects of the bullet wound, like hemorrhage,
escape of air, laceration and other injuries.
SHOTGUN WOUNDS
A shotgun is a shoulder-fired firearm having a barrel that is smooth-
bored and is intended for the firing of a charged compound of one or
more round balls or pellets-
Classes of Shot in a Shotgun Shell:
1. Birdshot — The shot are small ranging in sizes from 0.05 inch to
0.15 diameter and loaded from 200 to 400 shots in the shell.
Birdshots are small and are commonly used for hunting fowls
and other small animals.
2. Buckshot — The shot ranges from 0.24 to 0.33 inch in diameter
and obviously fewer in number in a shot. A standard 12-gauge
shotgun contains only nine shots.
3. Single Projectile (Rifled Slug) — There is only a single shot or slug
in a shell.
Systems Employed in the Determination of the Diameter of the
Barrel of a Shotgun:
1. Gauge System — Determination of the number of lead balls, each
fitting of the bore totals to one pound in weight. The smaller
the gauge designation, the larger is the bore. If twelve balls can
be made from one pound of lead, each fitting the inside of the
barrel of a shotgun, the gun is called 12-gauge or 12-bore shot-
gun. 12-gauge shotgun is the most commonly used.
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2. Expression of the Bore Diameter in Inches — The 0.410 bore d. Autoloading:

shotgun is the only shotgun at present to be so designated.
3. Metric System — The bore is expressed in millimeters.
Length of the Barrel:
There is no standard length of the barrel but modem barrels
measure 26, 28, and 30 inches in length.
Grade of Choke:
A shotgun is choked when the muzzle end of the barrel is a dia-
meter smaller than the rest of the barrel. The main purpose of the
constriction is to minimize the dispersal of the pellet or buckshots
after the shot. It is based on the presence or absence of choke and
the degree of choking, that shotguns are classified as:
1. Unchoke — The diameter of the barrel from the rear end up to
the muzzle is the same.
2. Choke — The diameter of the barrel at the muzzle end is smaller
than the rest of the barrel.
a. "Improved Cylinder" — The narrowing of the barrel by 3 to 5
thousands of an inch.
b. Half Choke — narrowing by 15 to 20 thousands of an inch.
c. Full Choke — narrowing from"35 to 40 thousands of an inch.
The lethal range is normally in an area of 30 inches in diameter
at 30 to 40 yards according to the degree of choking.
Types of Shotgun:
1. As to the Number of Barrel:
a. Single Barrel Shotgun:
There is only one barrel and basically the original type.
b. Double Barrel Shotgun:
(1) Side-to-side barrel.
(2) Over-and-under barrel.
2. As to the Manner of Firing and Reloading:
a. Bolt Action:
The action of the bolt ejects the fired shell and loads the
next one.
b. Lever Action:
When the lever is swing down it ejects the fired shell and
loads the next shot.
c. Pump Action:
There is a cylindrical magazine which can accommodate
up to six shells, end to end, beneath the barrel.
A pull of the trigger not only fires and ejects the shell but
also reloads the next shot and locks it for firing.
Shotgun Cartridge:
A shotgun cartridge is usually 2-3/4 or 3 inches long and the
diameter depends on the gauge of the firearm. The base and the
lower portion of the cylindrical portion is made of brass with the
primer cap at the center of the base. Attached to the free end of
its cylindrical portion is the cylindrical laminated paper tube to
complete the shell casmg.
When the trigger is pulled, the firing pin activates the primer
which in turn ignites the powder charge. Explosion of the gun-
powder will cause propulsion of the wad and pellets (shot) in front.
The muzzle velocity of the pellet is relatively smaller as compared
from those discharged from rifled firearms.
Except for the presence and nature of the slug, the component
of the shotgun blast is almost the same as that of a rifled firearm.
It also consists of gunpowder, flame, smoke, pellets and wad.
Shotgun Wound of Entrance:
1. Contact or Near Contact Shot (not more than 6 inches):
On account of the greater quantity of gunpowder in the shot-
gun cartridge, there is relatively more damage due to muzzle
olast, flame and gunpowder at the site of the wound of entrance
as compared with rifled fire.
a. If the shot is made perpendicular to the skin surface, the wound
of entrance is round but if the shot is made with an acute angle
with the skin the wound is oval. In both instances, the wound
border may be smooth or slightly rugged.
b. The entrance wound is burned, the width of which increases
as the muzzle-skin distance increases but does not exceed 6
inches.
c. There is blackening due to smoke.
d. Gunpowder tattooing is densely located in a limited area. The
area of spread is directly proportional to the muzzle skin
distance.
e. There is contusion of the tissue that has been blackened by
gunpowder.
f. There is singeing of the hair (less than 6 inches).
g. Subcutaneous and deeper tissues are severely disrupted.
h. Blood and other tissues along the bullet tract shows presence
of carbon monoxide.
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i..Wad or its fragments together with shot (pellets) may be re- I / D E T E R M I N A T I O N O F T H E PRESENCE O F
covered from the bullet tract. G U N P O W D E R A N D PRIMER C O M P O N E N T S

2. Long Range Shot (more than 6 inches skin-muzzle distance):
a. At 2 to 3 feet muzzle-skin distance, there is still a single wound
of entry although there may be isolated shots causing independ-
ent entry.
b. At 3 to 4 feet distance the wound of entry is usually serrated
or scalloped circumference and often referred to as a "rat
hole".
c. At about 5 to 6 feet distance, the wad tends to produce an
independent injury usually an abrasion at the vicinity of entry
of the shots. The wounding capacity of the wad is very much
less as compared with the shot on account of its lightness and
size.
d. At 6 feet, the shots begins to separate from the conglomerate
shot and at 10 feet each shot already produces independent
wounds of entry.
As the shot begin to separate from one another, there is
the tendency for one shot to strike another causing changes
of the shot course. This phenomena is called "billiard ball
ricochette effect".
e. Smudging due to smoke may be observed up to 15 inches.
f. Gunpowder tattooing may be detected up to 24 inches.
g. In an unchoked shotgun, to estimate the muzzle-target distance,
the following rule must be applied.
Measure the distance between the two farthest shot (pellets) in
inches and subtract one, the number thus obtained will give the
muzzle-target distance in yards.
The character of the wound and the degree of dispersal is in-
fluenced by the muzzle-target distance, gauge of the shotgun, degree
of choke and the type of ammunition. However, it is highly recom-
mended to have an experimental shot with the firearm using similar
cartridge and under the same environmental conditions.
The Importance of Determining the Gunpowder on the Skin of the
Victim:
1. Determination of the distance of the gun muzzle from the victim's
body when fired:
As discussed previously, the explosion of the powder in the
cartridge 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 gunpowder is more at the upper
portion of the wound of entrance, due to the upward position
of the muzzle of the gun when fired. The presence of gunpowder
at or near the wound of entrance shows that the gun muzzle
when fired is not more than 24 inches but its absence will not
preclude near fire because other factors might have intervened.
Less powder particles at the wound of entrance is observed in
smokeless powder as compared with black powder.
2. Determining whether a person has fired a firearm:
The dorsum of the hands are the ones examined to deter-
mine the presence of gunpowder. When a person fires a gun, the
powder particles which escape may cling on the dorsum of the
hand. The presence of gunpowder at the dorsum of the hand
may infer that a person has fired a gun.
Basis of the Tests:
When a gun is discharged two types of residues are liberated
namely, the metallic residues from the primer which is not only
blown forward towards the target from the muzzle but also
backward in the direction of the shooter, and also the particles
of burned, burning and unburn ed gunpowder (propellant) moving
also in the same directioni as the metallic residue of the primer.
All of these residues are deposited on the back of the firing hand
of the shooter.
Detection of metallic residue of the primer on the palm of the
hand may also indicate that the individual was making a defensive
movement, such as trying to ward off or grab the weapon at the
time of the discharge. In suicide, residue may be deposited on
the palm of the hand used to steady the barrel at the time of the
discharge.

A close shot produces more serious injuries because the shots Procedures in Determining the Presence of Gunpowder:
are concentrated on a specific target and because of greater kinetic 1. Gross Examination or Examination with the Use of Hand Lens:
energy of the pellets. Fine black powder particles of varying sizes may be seen at the
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region of the gunshot wound of entrance, on the dorsum of
the hands or at the outer surface of the wearing apparel of the
victim. This examination is not conclusive because other foreign
particles may be mistaken for gunpowder or primer components.
2. Microscopic Examination:
Fine particles may be magnified but there are no characteristic
shape, color or consistency of gunpowder.
3. Chemical Tests:
a. Laboratory Test to Determine Firearm Residues:
There is inference of contact or near distance of the gun
muzzle to the skin when there is burning, tattooing and smudging
visible through the naked eye. The burning and then the
tattooing will gradually disappears as the muzzle distance in-
creases. The powder tattooing will gradually spread out to a
greater area until it is no longer detectible. Minute particles of
burning and unburned residues and the primer constituents can
be detected in the laboratory.
The same tests may also be applied on the dorsum of the
hand of the persons suspected to have fired the gun. Although
the test is not conclusive, it may be a corroborative evidence
in the determination as to whether a person has fired a gun.
The tests may involve the determination of the presence of
gunpowder residues of primer components.
Tests for the Presence of Powder Residues:
l.On the Skin (Dorsum of the Hand or Site of the Wound of
Entrance):
Dermal nitrate test (Paraffin test, Diphenylamine test, Lung's
test or Gonzales* tests) — The back of the fingers and of the hand
up to the region of the wrist is coated with melted paraffin, heated
at a temperature of 150 degrees fahrenheit. To avoid heat injury
to the skin, a low melting point paraffin is used. The melted
paraffin penetrates the minute crevices of the skin and when
hardened and cooled off, some of the powder particles will be
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 inch and solidified, it is then removed from the hand or from
the site of the wound of entrance and the inner aspect of the
cast is treated by means of a dropper with Lung's reagent.
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.
The test is not conclusive as to the presence of gunpowder
because fertilizers, cosmetics, cigarettes, urine and other nitro-
genous compounds with nitrites and .nitrates will give a positive
reaction. A negative result is not also conclusive that the person
did not fire a gun for a well constructed hand gun will not dis-
charge any residue on the hand or the hand might have been
subjected to extensive washing.
The test usually gives a positive result even, after a large lapse
of three days or even though the hand has been subjected to
ordinary washing.
Subjection of a suspect to the test is not self-incriminatory as
the act is purely mechanical and does not require the use of
mental faculties.
2. On Clothings (Especially Colored Ones):
Walker's test (C-acid test, H-acid test) — A glossy photographic
paper is fixed thoroughly in hyposolution for 20 minutes to
remove all the silver salts and then washed for 45 minutes and
dried.
The dried photographic paper may be treated with any of the
following:
a. Warm 5% solution of " C " acid (2 naphthalamine 4-8 disulfonic
acid) for 10 minutes and dry.
b. Warm 5% solution of " H " acid (l-amino-8-naphthol-3,6 disul-
fonic acid) for 10 minutes and dry.
c. Warm 0.5% solution of sulfanilic acid for TO minutes,,dry and
then swab with a 0.5% solution of alpha naphthalamine in
methyl alcohol and dry.
The sheet of the prepared paper of sufficient size is placed face
up on a towel or pad of cotton and the material to be tested is
placed on top, face down on the paper.
The preparation is then covered with a thin dry cloth or towel
slightly moistened with 20% solution Of acetic acid, and another
layer of dry cloth.
The entire pack is pressed with a hot iron for two minutes.
The paper is removed, washed with hot water and methyl
alcohol to remove excess reagent and dried.
If unburned powder grains are present, it will result to the
production of dark red or orange-brown spots on the prepared
paper.
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Tests for the Presence of Primer Components:
When an individual fires a weapon, the metallic primer residue
(barium, antimony and lead) may be deposited on the back of the
hand with the residue most likely deposited on the skin web, the
hand between the thumb and index finger. The test for the presence
of the metallic constituent of the primer may be done through any
of the following:
1. Harrison and Gilroy Test:
A cotton swab moistened with 0.1 molar hydrochloric acid is
used to gather antimony, barium and lead.
The cloth is then treated with various reagents to detect the
presence of a primer component. The reagent sodium rhodi-
sonate yields a red color in the presence of lead and barium.
Addition of 1.5 hydrochloric acid to the red area that yields
a blue-violet color in the presence of lead while a bright pink
color is developed in the presence of barium.
The test is simply applied but does not enjoy substantial uti-
lization in forensic laboratory because:
a. It lacks specificity of the color reaction for the trace of the
element.
b. It is inadequately sensitive.
c. There is interference of the color reaction among the three
elements themselves.
d. There is instability of the color that developed.
2. Neutron Activation Analysis (NAA):
A sample is obtained from the hands by the use of paraffin or
by washing the hand with dilute acid. It is then exposed to
radiation from a nuclear reactor emitting neutrons. Secondary
radioactivity is induced in the materials removed from the hand.
By making an appropriate counts at different energy levels, the
elemental composition of the residues can be determined with
precision and accuracy.
3. Flameless Atomic Absorption Spectroscopy (FAAS):
The sample of handwashing is subjected to a high temperature
to vaporize the metallic elements of the primer residue. This in
turn is detected and quantitated by absorption spectrophoto-
metry.
This method is quick, sensitive and employs equipment within
the economic means of a modern-size crime laboratory. It can
detect the presence of barium, antimony and lead.
4. Use of Scanning Electron Microscope with a Linked X-ray
Analyzer:
Adhesive material is used to remove any residue particles from
the hand. The material is then examined under the scanning
electron microscope with a linked X-ray analyzer. Particles of
the primer residue have the characteristic size and shape which
can easily be distinguished from other materials. Analysis of the
particles with X-ray analyzer will confirm their identification.
While this method appears to be more specific than the-pre-
viously mentioned methods, it is seldom used because the initial
equipment is expensive and it requires a longer period of time to
analyze a case.
FIREARM IDENTIFICATION
The following factors must be utilized in the identification of the
firearm used in the commission of crime:
1. Caliber of the Weapon:
A firearm may be identified by its caliber and it may be deter-
mined from the firearm itself, from the shell, bullet, cartridge
or from the character of the wound of entrance.
2. Fingerprints:
Fingerprint marks may be found in the butt of the firearm or
at the trigger and its guard. Care must be observed by the inves-
tigator in handling the firearm at the scene of the crime. The
fingerprints found at the butt may distinguish homicidal or
suicidal nature of death.

The technique is extremely sensitive and a very small quantity
can be detected, but only few laboratories can afford to under-
take the procedure because it is very expensive and the test is
unable to detect the presence of lead. The test requires access
to a nuclear reactor.
Principle: Barium and antimony are converted into isotopes by
means of neutron bombardment, afterwards their
quantity is measured.
3. Fouling of the Barrel:
The firearm which is recently fired may have a characteristic
odor of the smoke inside the barrel. Chemical analysis of the
washing from the interior of the barrel will show whether the
weapon was recently fired.
4. Serial Number:
All firearms bear serial numbers for purposes of identification.
The offender may erase the number or may try to change it.
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Procedure of Restoring Serial Number if Tampered:

The procedure of restoring the obliterated numbers involve
three steps, namely:
a. Cleaning — The site of the number should be carefully cleaned;
all oil, dirt, grease, and paint should be removed with gasoline,
xylol and acetone.
b. Polishing — This operation is by far the most important. The
whole surface should be smoothly polished, using a fine file
followed by a medium to fine grade carborondum cloth. When
the area is large or the scratches are deep, a mechanical polisher
may be used to save time. The time of polishing depends on
the hardness and granularity of the metal. However, the area
should always have the mirror-like surface.
c. Etching — For all iron or steel materials, the following etching
solution may be used:
Hydrochloric acid 80 cc.
Distilled water 60 cc.
Ethyl alcohol 50 cc.
Copper chloride 10 grams
The solution is swabbed on continuously until the numbers
appear. This may take several hours (Modern Criminal In-
vestigation by Harry Soderman, p. 229).

5. Ballistics Examination:
Ballistics is the study of physical forces reacting on projectiles
or missiles.
Forensic ballistics is conventionally known as firearm identi-
fication. It deals with the examination of fired bullets and cart- Ballistic c o m p a r i s o n m i c r o s c o p e

ridge cases in a particular gun to the exclusion of all others.

Ballistics May Be Subdivided into Three Separate and Distinct Area
of Study, Namely:
1. Interior Ballistics (Internal Ballistics) — It is a branch of the
science of Ballistics which deals with what happened to the
cartridge and its bullet from the time the trigger of the gun is
pulled until the bullet exits from the barrel. It deals with the
study of what happened in the chamber and gun barrel after the
pull of the trigger.
2. Exterior Ballistics (External Ballistics) — It deals with what
happened to the bullet or projectile from the moment it leaves
the gun barrel to the moment of impact on the target or object.
It is concerned with the flight of the bullet and the influence of
all factors in its flight.
3. Terminal Ballistics — This concerns with the effect of the bullet
on the target or until it comes to rest.
Medical Ballistics — A form of terminal ballistics wherein the
target is a person. It is concerned with the penetration, severity
and appearance of the wound due to bullet or missile.
Basic Principles Involved in Firearm Identification:
1. T h e quality of metal in the manufacture of the firearm is very
much harder and resistant to deformity as compared with the
quality of metal used in the manufacture of the cartridge, so
that in the process of contact between the part of the gun in-
volved and the cartridge, the surface condition of the part of the
gun can easily be impressed on the shell or bullet.
2. For reasons known only to the manufacturer, firearms have
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certain physical characteristics of certain type of caliber which

differentiate it from others. This includes the number of lands
and grooves, the direction of the twist, width of the individual
land or groove, style of the cannelure, etc., which become the basis
of class characteristics in firearm identification.
3. No two firearms can be manufactured with identical surface
characteristics. Each firearm on close examination will show the
differences. Marks on the different bullets or shells fired from one
firearm have similar characteristics when viewed in the com-
parison microscope. Marks on different bullets or shells fired from
different firearms will show variation in the findings. This is
referred to as individual characteristics.

Instruments Use in Firearm Identification:

1. Comparison Microscope — This is an instrument which consists of
two compound microscopes which allows comparison of two
objects by looking through a single eyepiece. On each of the
stages, the compound microscope is placed on the object to be
compared and by manipulation of the mechanical rack and pinion
gear the class characteristics of the object may be observed. When
two objects are being compared, the individual or accidental
characteristics may be compared. There is an attachment for
photographic camera to facilitate the taking of pictures of the
findings.

2. Bullet Recovery Box — It is an instrument or device for the

purpose of recovering the test bullet and shell. In the N.B.I., it
is a long cylindrical container filled with cotton and an open
shooting end. The suspected firearm is fired at the open end and
the bullet may be recovered in the layers of cotton and the shell
may be found in the area where it is fired, in cases of automatic
firearm or in the cylindrical magazine inside the cases of the
revolver. The test shell and bullet may be used for comparison
with the evidence bullet or shell.

There are other ways of recovering test bullet which are used
in other countries, it may be:
a. Shot may be fired on a box with oil and sawdust.
b. Vertical or horizontal shot on a water tank.
c. Shot-fired on a block of ice.
3. Hand lens.
4. Sharp pointed instrument for scraping I.D. marks.
5. Caliper.
6. Analytical Balance.
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(5) Marks on the Cylindrical Surface of the Shell:

Types of Marking on the Examination through the Comparison
Microscope:
1. Impression Type Mark (Stamp Mark) — This is the forcible appli-
cation of a hard surface against a softer one leaving an impression
on the harder surface.
Example:
a. The striking of the firing pin on the percussion cap.
b. The impact of the base of the cartridge on the breach block of
the gun.
2. Striation or Serration Mark — These are produced by a harder
surface scraping, dragging, sliding or slipping across a softer one
leaving a series of abrasions, serrations and scrapes.
Example:
a. The bullet surface may show rifling marks on its surface as it
passes the spiral landings and groovings of the inner surface of
the barrel.
b. The extractor produces striations as it slips over the cartridge
groove.
c. The ejector may cause striation markings on the cartridge case
in the process of ejection of the spent shell.
When a cartridge is fired from a firearm, the following marks
may be found in the shell and from the bullet,
a. Marks Found in the Shell:
(1) Marks of the Firing Pin:
The firing pin leaves impressions in the percussion cap.
The depth, location and the size may be the individual
characteristic of a firearm, although the hardness of the
metal in the cap may cause certain degree of variation of
the impression.
(2) Marks from the Extractor:
The extractor mark is found in front of the rim of the
shell. The scratch impressed by the extractor is a charac-
teristic in a particular firearm.
( 3 ) Marks of the Ejector:
This mark is found at the head of the shell. Generally
the ejector mark has a position opposite the extractor
mark, although it is not always the case.
(4) Marks from the Breechblock:
The impact of the shell to the breechblock in the recoil
impresses the ridges of the breechblock and often gives
identification marks characteristic of a firearm.
The marks are brought about by the surface of the firing
chamber or by the magazine,
b. Marks Found in the Bullet:
(1) Number of Lands and Grooves:
The number of grooves, depth, and width depend upon
the manufacturer of the firearm.
( 2 ) Direction of the Twist of the Rifling Marks:
The direction of the spiral lands and grooves may be a
twist to the right or to the left.
Manufacturers of firearms made certain marks which may dis-
tinguish firearms manufactured by them from that of the other
manufacturers. Each manufacturer makes specific number of spiral
grooves and direction of the twist in the barrel of the firearm. A
bullet recovered at the scene of the crime or from the body of the
victim may show those marks in the examination, the examiner may
have a presumption to where the firearm came from. Thus, if in
the examination of the recovered bullet, it was found out that there
are 6 grooves and the rifling marks are twisted to the left, then it is
possible that it came from a Colt firearm.
In the firearm identification, the examiner must take into con-
sideration the following:
1. Gross examination or examination with the use of magnifying
lens:
a. Caliber of the bullet — this may be determined by:
(1) Simple inspection by an experienced examiner.
( 2 ) Weighing of the bullet.
( 3 ) Determining the diameter of the bullet by the use of a
caliper.
b. Presence or absence of deformity or loss of part.
c. Presence of foreign elements, like blood, flesh, connective
tissues, soil, etc.
d. Identifying marks placed by previous possessor.
2. Examination with the use of comparison microscope:
This is a comparison between evidence shell or bullet with the
test shell or bullet.
a. Determination of the class characteristics — Physical charac-
teristics of a certain caliber of firearm used by the manufacturer:
( 1 ) Number of riflings.
(2) Direction and rate of the rifling marks.
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(3) Dimension of the lands and grooves. 2. Brain Substance:

(4) Depth of the grooves. Bullet wound in the brain substance is usually a rugged tunnel
( 5 ) Style of the cannelure. with a diameter larger than that of the caliber of the bullet, with
marked ecchymosis of the surrounding area and filled with fresh
b. Determination of individual or accidental characteristics:
and clotted blood. Fragments of bones may be felt in the tun-
(1) The rifling of the barrel is reflected in the bullet as it passes nelled bullet tract. In most cases, injury of the brain causes
through it. Repetition of the fire will cause the same sudden loss of consciousness and incapable of voluntary move-
marking, except those where the rifling of the barrel has ment.
been changed.

( 2 ) Firing Pin mark — When the base of the cartridge is hit by

the firing pin, the pin produces distinct markings which can
be reproduced by succeeding shots.

(3) Breechblock Mark — As the bullet is propelled forward by

the force of the expanded gas, the casing is forcibly moved
backward against the breech face or recoil plate. The back-
ward force transfers the marking on the breechblock to
the base of the cartridge.
(4) Extractor Mark — The mark made by the extractor on the
cartridge rim when pulled away from the firing chamber.
( 5 ) Ejector Mark — Mark produced by the ejector in the process
of throwing away the spent shell.

GUNSHOT WOUNDS IN DIFFERENT

PARTS OF THE B O D Y

Head and Neck:

1. Cranium:
Close or near contact fire in the head may produce marked
laceration of the skin, burning and tattooing of the surrounding
skin. The skull is fractured without any definite shape with
linear extensions to almost all of the bones comprising the cranial
box.
Fire from a distance with the bullet having a right angle of
approach to the skull, the fracture is oval at the outer table.
There will be radiating linear fractures from the point of entrance.
The wound of exit will be clean-cut oval or round opening at the
inner table with a bevelled fracture at the outer table.
Grazing approach of the bullet may produce an elongated
gutter-like depressed fracture of the cranium. The tangential
impact of the bullet may cause it to split and it is not uncommon
to see a fragment lodging in the brain substance while the other
ricochette outside hitting other objects nearby:
L a c e r a t i o n of the brain en route of a gunshot
Injury of the cerebral hemispheres is as a rule not immediately
fatal and the victim may survive the injury, however, a bullet
course which includes the medulla, pons and other vital centers
causes immediate death. Some victims may live for sometime
but may develop epileptiform convulsions as a sequela.
3. Face:
Firearm wound on the face may not cause serious trouble
except that it becomes a potential avenue of infection and may
cause marked deformity.
In suicidal shot, the muzzle of the firearm may be placed inside
the mouth or nostrils that no visible wound of entrance is ap-
preciable. The course of the bullet is usually upwards and in
most cases the brain is involved.
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4. Neck:
The bullet may pierce the front portion of the neck and may
involve the cervical portion of the spinal cord; thus causing instan-
taneous death if the upper portion is involved. The course of the
bullet may involve the carotid or jugular vessels and death may be
due to profused hemorrhage. The anterior wall of the esophagus
may be perforated and the bullet may enter into the gastro-
intestinal tract and expelled through the bowel. Injury to the
trachea and upper bronchi may cause asphyxia or aspiration
pneumonia.
Chest:
1. Chest Wall:
The bullet wound on the chest wall usually has an upward course
and may involve both sides. The bullet may strike the rib, ster-
num or the body of the vertebra and may cause deformity or
deflection of its course. When the intercostal or mammary vessels
are injured, there will be profused hemorrhage. Hemothorax of
more than a liter is observed in fatal cases.
2. Lungs:
The passage of a bullet in the lungs produces a cylindrical tunnel
much larger than the diameter of the projectile with bloody
contents and ecchymotic borders. When the pulmonary vessels
are involved, profused hemorrhage is observed which produces
death before medical or surgical intervention can be instituted.
If only one lung is involved, the profuse hemorrhage may cause
collapse of the lung, displacement of the heart, and mediastinum
towards the uninjured side. Emphysema is present when there is
marked injury to the air sacs. Involvement of the bigger bronchi
may cause asphyxia with the lung partially atelectatic and emphy-
sematous. The victim may not die immediately but later may
develop aspiration pneumonia or cerebral embolism.
3. Heart:
Bullet wound of the heart may be circular or stellate witn
subepicardial hemorrhage in the surrounding tissue. The course
may be of any direction but the right ventricle is often involved
because of the large surface area of exposure in front.
Gunshot wound of the heart as a general rule does not prevent
the victim from running, walking, climbing stairs, or do other
forms of volitional acts for death-is not usually instantaneous.
Wound of the auricle is more rapidly fatal as compared with the
wound of the ventricle on account of the thickness of the muscu-
lature of the latter which produces temporary closure of the
wound. Bullet may lodge in the musculature of the ventricle and
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becomes encapsulated by fibrous tissue. Death in firearm wound
of the heart may be due to the loss of blood or tamponade.
Abdomen:
Abdominal gunshot wounds are quite frequent but not as serious
as those of the chest and head because of its amenability to surgical
operation. In most cases injuries are not only limited to one organ
but to several organs. Injuries to the visceral organs may not be
found along the course of the bullet on account of their mobility
and their capacity to change their forms. Involvement of the ver-
tebral column may cause injury to the spinal cord. The mesenteric
vessels, aorta, vena cava, and other big abdominal blood vessels
may be lacerated and cause severe hemorrhage.
Bullet wound of the liver and other parenchymatous abdominal
organs may cause stellate perforations which are usually larger than
the caliber of the bullets that cause them. The tunnel which is also wide
may contain fragmented tissue, fresh and clotted blood. On account
of the richness of the blood supply of the parenchymatous organs,
profuse hemorrhage is the natural sequela. Loss of function, es-
pecially of the kidneys, pancreas, etc. may lead to fatal results.
Bullet wounds of the stomach and other hollow organs are usually
small on account of the contractility of the walls. The wound of
entrance is smaller than the wound of exit. Grazing injury may
simulate a lacerated wound. Injury of the viscus is usually multiple
and with less hemorrhage except when it involves the mesenteric
vessels. Timely surgical intervention may prevent untoward com-
plications. However, death due to peritonitis is not rare on account
of the spilling of its contents into the abdominal cavity.
Spine and Spinal Cord:
Injury of the spine may not involve the spinal cord, but injury
of the spinal cord may be due to:
1. The bullet may directly affect the canal and the spinal cord
causing either partial or complete severance.
2. The bullet may not hit directly the spinal cord but may cause
injury in the body or other parts of the vertebra and contusion,
concussion or compression on account of the impact. Injury
of the upper cervical spinal cord may cause immediate death
because the vital nerve tracts may be involved. Lower spinal
cord injury may cause motor or sensory paralysis and may later
succumb to hypostatic pneumonia, suppuration or other com-
plications.
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Chapter XIV

THERMAL INJURIES OR DEATHS

^ffiermal injuries are those caused by an appreciable deviation
from normal temperature, capable of producing cellular or tissue
changes in the body. Thermal death is one primarily caused by
thermal injuries.
Exposure to severe cold may cause frost-bite, while exposure to
high temperature may cause burning or scalding.

I. DEATH OR INJURY FROM COLD

GUNSHOT WOUNDS 393
Extremities:
Bullet wounds in the extremities may show the characteristic lesion
of gunshot wounds. Usually the wound is not so serious except
when it involves the principal blood vessels and nerves. The bony
tissue may be involved producing comminuted fracture of the bone
and deflection of the course of the bullet. Septic infection, throm-
bosis, hemorrhage, deformity are not unusual after-effects.
Death or injury due to a cold is not common in tropical countries.
The primary cause of death is attributed to the decreased dissocia-
tion of oxygen from hemoglobin in the red blood cells and diminished
power of the tissue to utilize oxygen. Cold produces a vascular
spasm which results to anemia of the skin surface followed by
vascular dilatation with paralysis and increased capillary perme-
ability. Prolonged exposure may cause necrosis and gangrene.
The degree of damage depends upon the severity of the cold, the
duration of exposure, area of the body involved, sex and humidity.
Cold damp air is more fatal than cold dry air. A short exposure to
cold temperature may not be deleterious to the body as long ex-
posure to low but not to freezing temperature. Children and aged
individuals are more susceptible to cold weather on account of their
limited thermotaxic reserved. Individuals whose vitality have been
diminished by fatigue, lack of food, alcoholism, and previous ill-
health are less able to withstand the effects of cold. Women are
more resistant to cold than men on account of their greater deposits
of subcutaneous fat.
The action of cold in the body is partly local and partly reflex in
the circulatory system. Exposure to cold will diminish the disso-
ciation power of oxygen from hemoglobin, thus starving the brain
and other nervous center with oxygen.
The effect of low temperature consists of a local damage to the
exposed tissue and systemic change involving the whole body
Effects of Cold:
y . Local Effect (Frostbite; Immersion foot; Trench foot):
First — There is blanching and paleness of the skin due to
vascular spasm.
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Second — The vascular spasm is followed by erythema, edema and
swelling due to vascular dilatation, paralysis and in-
creased capillary permeability.
Third — In advanced stage of vascular paralysis, there will be
blister formation.
Fourth — Continued exposure to severe cold will later lead to
necrosis, vascular occlusion, thrombosis and gangrene.
On account of the expansion of the tissue and individual cells
in the process of solidification, the cell membrane may rupture,
tissue and organ may rupture, and the skull may be fractured.
Microscopically:
There is vacuolization and degeneration of the epidermal cells,
necrosis of the collagen of the subcutaneous tissue, perivascular
exudates of red and white cells, occlusion of vessels lumen by
clump of red blood cells, and prolification of the endothelium.
2. Systematic Effects:
The systemic effects are reflex in nature brought about by the
stimulation and paralysis of the nerves. Respiration, heart action,
metabolic processes are slowed down on account of cerebral
anoxia. There is a cold stiffening of the body with blister for-
mation and gangrene of the exposed part of the body.
Signs and Symptoms:
1. Gradual lowering of the body temperature is accompanied by
increasing stiffness (cold stiffening), weariness and drowsiness.
2. The person may be lethargic, passing the stage of coma to death.
3. Person may suffer from delusion, convulsion and delirium.
4. Palpation of the cutaneous surface shows hardening and coldness.
Post-mortem Findings:
1. Externally: Nothing characteristic.
a. Cold stiffening.
b. Surface of the body is pale.
c. Reddish patches especially in exposed portions of the body
(frost-erythema).
d. Onset of rigor mortis delayed.
2. Internally: Nothing characteristic.
a. Blood is generally fluid in the heart and blood vessels with a
bright red color.
b. Parenchymatous organs are congested with occasional petechial
hemorrhage.
c. Audible cracking sound on flexing the knee and other big joints
apparently due to the breaking down of the frozen synovial
fluid.
d. Petechial hemorrhage in the lungs, brain and kidneys.
e. If death occurs after sometime, pathological findings related to
complications, like bronchopneumonia, toxemia due to gan-
grene, etc. may be found.
The body tissue fluid evaporates slowly if the body is frozen,
hence, mummification develops later. However, the individual
cell, tissues and organs are well-preserved.
II. DEATH OR INJURY FROM HEAT
The effects of heat in the body may be local at the application, or
general when the whole body is affected.
Classifications of Heat Injury:
1. General or Systemic Effects:
a. Heat cramps.
b. Heat exhaustion.
c. Heat stroke.
2. Local Effects:
a. Scald.
b. Burns.
( 1 ) Thermal.
( 2 ) Chemical — acids and alkalies.
( 3 ) Electrical and lightning.
( 4 ) Radiation — X-ray, ultraviolet, etc.
G E N E R A L OR SYSTEMIC EFFECT:
1. Heat Cramps (Miner's Cramp, Fireman's Cramp, Stoker's Cramp):
This is the involuntary spasmodic painful contraction of muscles
essentially due to dehydration and excessive loss of chlorides by
sweating. This is seen among laborers working in rooms with high
temperature and with profused perspiration.
Symptoms:
a. The -onset is usually sudden as muscles cramp with agonizing
pain.
b. The cramp is accompanied by headache, dizziness and vomiting.
c. The face is flushed, pupils are dilated with tinnitus and ab-
dominal pain.
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d. The amount of chloride excretion through the urine is markedly

diminished.
Usually, the condition does not end fatally. A liberal adminis-
tration of fluid with chlorides relieves the patient. However, intra-
venous administration of saline solution rapidly restores the patient
to normal.
2. Heat Exhaustion (Heat Collapse, Syncopal Fever, Heat Syncope,
Heat Prostration):
This is due to a heart failure primarily caused by heat and
precipitated by muscular exertion and warm clothing.
Symptoms:
a. Sudden attack of syncope, general body weakness, giddiness
and staggering movement.
b. The face is pale, the skin is cold, and the temperature is sub-
normal.
c. The pupils are dilated, pulse weak and thready, and respiration
is sighing.
d. There may be diarrhea, dimness of vision and dilated pupils.
e. Exhaustion comes gradually with throbbing in the temple.
f. The patient usually recovers, if made to rest, but occasionally
the condition may become worse and the patient dies of heart
failure.
The treatment is purely symptomatic and removal from heated
area.
Post-mortem finding is nothing typical, except probably cloudy
swelling of the heart musculature.
3. Heat Stroke (Sunstroke, Heat Hyperpyrexia, Comatous Form,
Thermic Fever):
This usually occurs among those working in ill-ventilated
places with dry and high temperatures or due to a direct exposure
to the sun.
Symptoms:
a. Sudden onset that may be followed by premonitory symptoms
of headache, malaise, giddiness and weakness of the legs.
b. Temperature rises suddenly and the skin becomes dry, with
burning sensation and flushed skin and complete cessation of
sweating.
c. Face is congested.
d. Pulse is full and pounding .
e. Respiration later becomes irregular.
f. The pupils are usually contracted.
g. Death occurs in 1/2 to 1 hour after the onset of symptoms.
Post-mortem Findings:
a. Cadaveric rigidity comes soon and passes off soon.
b. Putrefaction occurs early.
c. Lividity is marked.
d. Petechial hemorrhages may be found in the brain and in the
heart.
e. Congestion of the internal organs.
f. The temperature may rise after death.
Medico-Legal Importance of Heat Cramps, Heat Exhaustion and
Heat Stroke:
If ever death occurs, it is most often accidental. Laborers
who are working under the sunshine, in a heated room, or in a
poorly ventilated place may suffer from any of the conditions.
Alcoholism, ill-health, disease and fatigue may be some of the
predisposing factors. Although mostly accidental, physician must
perform the necessary post-mortem examination in the bodies
to eliminate the possibility of foul play. However, it may be
homicidal or suicidal in rare instances. Children may be victims
of infanticidal acts when subjected to conditions promoting
their development.
L O C A L EFFECTS OF HEAT:
Scald (caused by hot liquid):
Scalds are injuries produced by the application to the body,
liquids at or near boiling point, or in its gaseous state. The term
applies to tissue destruction by moist heat. The injury by scalding
is not as severe as burns because ( a ) the scalding liquid or vapor runs
on the body surface, thereby distributing its heat, ( b ) the scalding
material easily cools off, and (c) the temperature of the scalding
substance is not as high as those producing burns, except oils and
molten metals. The effect on scalding is the same as burns.
icteristics of Scalds:
a. Scalds often have a distribution called a "geographical lesion."
It follows the portion involved in the splashing of the scalding
fluid together with the rule of gravity.
b. The skin lesion may be located in covered portions of the body
without affecting the clothings.
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Scalding is usually accidental in kitchens. Homicidal scalding

caused by throwing boiling water on the face and body is quite rare.

2. Thermal Burns (dry heat):

Burns are lesions which are caused by the application of heat or
chemical substances to the external or internal surfaces of the
body, the effect of which is destruction of the tissue of the body.
It includes all lesions produced by fire, radiant heat, solid sub-
stances, fire, friction and electricity.
Most burns caused by localized source of heat are accidental.
It may occur in the kitchen, by contact with heated solids or
live flame.
Most of the victims of burns are recovered in conflagration of
buildings which are either accidental or intentional.

Purposes of Intentional Fire:

a. Destruction of the victim of a criminal act to conceal identity
and true cause and manner of death.
Extensive scalding
b. The building was set on fire to kill or with homicidal intent
(torch murder).
c. There is neither burning of the hair nor deposit of carbonaceous
material on the skin surface. c. To perpetuate insurance fraud both property and life.
d. The lesion is usually first, second or third degree, except in d. A person might have committed suicide by other means and
cases of heated oil or molten metals. tried to hide the cause and manner of death by setting fire on
the surroundings.
e. Inhalation of the heated vapor may lead to inflammatory
reaction in the air passage which may lead to respiratory ob- e. Victim might have been trapped in the building set afire ac-
struction due to edema of glottis. cidentally or intentionally.
f. Usually, there is redness of the skin immediately after the f. A person in pursuance of a cause may soak himself with an
application, later a blister is formed. Pricking of the blister and inflammable substance (accelerant) and burn himself to death.
removal of the epidermis will show a pink raw surface from
which the fluid will ooze. The base will later become red in Classification of Bums:
about six hours. There will be leucocytic infiltration and a. Thermal
granulation tissue will develop. b. Chemical
g. Sepsis with development of pus may appear in one or two days. c. Electrical
Healing may be accompanied by the formation of scars, which d. Radiation
may result in contracture or keloid formation. e. Friction

Scalds are usually painful specially the second and third degree
types.
It is less fatal as compared with burns except when it involves
a great area of the body surface.
Death is usually due to septic complications which occur
after a day.
Characteristics of Bums:
a. The lesion varies from simple erythema to complete carbon-
ization of the body.
b. Usually, there is singeing of the hair and carbon deposits on the
area affected.
c. The area involved is general and usually without any demar-
cation line of the affected and unaffected parts.
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endings. Healing may leave a scar which contains all the ele-
ments of the true skin, consequently without contracture.
d. Fourth Degree:
The whole skin is destroyed with formation of slough which is
yellowish-brown or parchment-like. The surface is ulcerated and
on healing a dense fibrous scar tissue develops. The scar may
subsequently contract and cause deformity of the part. On
account of the complete destruction of the nerve endings, this
kind of burn is not very painful.
e. Fifth Degree:
There is involvement of the deep fascia and muscles. This
may result to severe scarring effect and deformity.
f. Sixth Degree:
There is charring of the limb involving subjacent tissues,
organs and bone. If death does not ensue immediately in-
flammatory changes may develop in the surrounding tissues.

Distinctions Between Burns and Scald:

Burns w i t h c a r b o n i z a t i o n o f the b o d y
Burns Scalds
d. Lesions in covered portions of the body, also involved burning a. Caused by dry heat (flame, a. Caused by application of moist
of the clothings over it. heated solid or radiant heat). heat (liquid, steam at or near
e. In death by burning in a conflagration, it is necessary to identify boiling point).
the victim and determine whether burns are ante-mortem or b. Occurs at or above the site b. Occurs at or below the site of
post-mortem. of contact of the flame. the application or contact
with liquid.
Classification of Bums by Degree (Dupuytren's Classification):
c. Singeing of hair is present. c. Singeing of hair is absent.
a. First Degree:
d. Boundary of the affected d.-Boundary distinct, usually like
There is erythema or simple redness of the skin associated
and unaffected area is not a geographical relief map of
with superficial inflammation and slight swelling which may
so clear. the affected area.
subside after a few hours or may last for several days. It may
be produced by momentary application of flame, or hot solid e. Injury may be severe. e. Usually, limited on account of
or liquid much below boiling point. It is also produced by the dissipation of heat in the
mild irritant. tissue.
b. Second Degree: f. Clothings are involved. f. Clothings are not usually
There is vesicle formation with acute inflammation. If the burned.
burns are caused by flame or heated solid substance, the skin Factors Influencing the Effect of Bums in the Body:
is blackened and the hair singed at the seat of lesion. The
a. Degree of Heat Applied:
vesicle can be produced by strong irritants or vesicants. Scars
The effect in body tissue by heat varies with the temperature
are not present after healing. The superficial layers of the epi-
of the heated object causing it. The effect will be more severe,
thelium are destroyed,
if the heat applied is great.
c Third Degree:
There is destruction of the cuticle and part of the true skin. b. Duration of Exposure or Contact:
The burned area is very painful owing to exposure of the nerve The longer is the time of exposure or contact, the greater
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will be the destruction. The underlying tissue will be liable to Causes of Death in Bums and Scalds:
be subjected to the high temperature. a. Immediate Fatal Result:
c. Extent of the Surface Involved: (1) Death from shock.
Involvement of more than one-third of the body surface to (2) Death from concomittant physical injuries with burns.
a second and third degree burns usually ends fatally. This is (3) Suffocation.
due to pain, hemoconcentration and shock. b. Delayed Fatal Result:
d. Portion of the Body Involved: (1) Exhaustion.
Burns of the extremity is not as serious as that of the head, (2) Dehydration with hemoconcentration.
neck and trunk. Burns of the genital organs and that of the (3) Secondary shock.
lower portion of the abdomen are usually serious. Burns in ( 4 ) Hypothermia.
serous cavities are graver than in the skin. (5) Complications:
e. Age of the Victim: (a) Septicemia.
Adults can withstand burns longer than the children and ( b ) Pneumonia.
the aged individuals. Children can withstand suppuration. (c) Nephritis.
( d ) Inflammation of serous cavities and internal organs.
f. Sex of the Victim:
( 6 ) Changes in the blood due to heat:
Men can resist burns better than women.
In conflagration, the early death is due to a primary or
g. Septic Infection: neurogenic shock, following a painful irritation of the
This may bring about complication in other parts of the multiple nerve endings in the skin.
body and may lead to death.
The suffocation is brought about by the formation of
h. Depth of Burns:
carbon monoxide, hemoglobin or by the action of other
In 6th degree burns, whereby the muscles and bones are noxious gases of the fume.
involved, it is more likely that a person is terminated due to
Death may occur from an accident occurring in an
shock.
attempt to escape from the burning house or from in-
juries inflicted by the wall and timbers falling on the body.
The loss of body fluid, blood plasma, chlorides and
other substances of the blood is due to evaporation from
the raw skin surface.
Absorption of toxic materials from the site of the injury
may lead to necrosis of the liver, renal tubular degeneration,
and cloudy swelling of other organs.
Inhalation of the fumes may cause inflammatory reaction
of the respiratory passages.
Secondary infection of the wound may lead to septicemia
and inflammation of other organs and serous cavities.
Time Required to Completely B u m a Human Body:
The time required to transform the human body to ashes is
dependent upon several factors, namely:
a. Degree or intensity of heat applied.
b. Duration of the application of heat.
Healing of extensive burns with leucoderma, epidermal desquamation and
formation. c. Physical condition of the body.
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d. Presence of clothings and other protective materials.
About 72% of the human body weight is. water and this is
responsible for the delay in its combustion, however, there is
about 5% fat which may enhance combustion on account of
its combustibility.
In a gas furnace incinerator, it requires about four hours of
continuous application of heat to transform the body into ashes.
Age of the Burns:
A very recent burn will show no pus, or much healing, or
edema.
When the pus is already present and the red inflammatory zone
has disappeared, it is about 36 hours or a few days old.
There is a superficial sloughing in a third degree burn in about
a week.
The deeper sloughs are thrown off in two weeks and are at-
tended with suppuration.
When the red granulation tissue is present, it is about two
weeks old.
The age of older burns is estimated by the amount of granu-
lation tissue present, by its depth, and by the extent of the growth
of epidermis from circumference.
Proofs that the Victim was Alive Before Bumed to Death:
a. Presence of smoke in the air passage — There is grayish-black
or black amorphous material adherent to the mucosa of larynx,
trachea, and bronchi. The quantity of the soot in the air
passage depends on the type of fuel, amount of smoke pro-
duced and duration of survival in the smoke contaminated
atmosphere.
b. Increase carboxy-hemoglobin blood level — Carbon monoxide
enters the body through the respiratory tract. The presence
of carboxy-hemoglobin is responsible for the cherry-red color
of the fire victim.
c. Dermal erythema, edema and vesicle formation — Erythema
and edema show that circulation was present when heat was
applied.
d. Subendocardial left ventricular hemorrhage.
Is Burning the Cause of Death?
The physician must determine whether the lesions due to
burning are by themselves sufficient to cause death. He must
also determine whether there are evidences of other lesions which
may account for the death.
The following findings may prove that death is due to burning:
a. Presence of vital reaction at the heated areas.
b. Presence of carboxyhemoglobin in the blood.
c. Presence of carbon particles in the tracheo-bronchial lumina.
Scars of Bums:
Scars of superficial burns are thin and pliant. In severe burns,
these are irregularly thick with patches and bonds of fibrous
tissue causing contractions. Keloid formation is common in scars
from burns.
Distinction Between Ante-mortem from Post-mortem Bums:
The principal basis of the distinction is the presence or absence
of vital reaction, like inflammation, vesicle formation, congestion
and granulation tissue. The principal points of distinctions are:
a. The blister formed in ante-mortem burns contains abundant
albumen and chlorides, while in post-mortem burns, the blister
contains scanty albumen and chlorides.
b. There is an area of inflammation around an ante-mortem bum
which is not present in the case of post-mortem bums.
c. The base of the vesicle is red in ante-mortem bums while there
is not much change in color in the case of post-mortem burns.
d. In burns due to conflagration, the tracheo-bronchial lumina
may contain particles of soot or carbon, while in the case of
post-mortem burns there is no finding.
e. Blood will show presence and abundance of carboxyhemoglobin
in cases of ante-mortem burns, but not in cases of post-mortem
burns.
The absence of signs of vital reactions at the site of the bums
does not necessarily indicate that the lesion is post-mortem.
Death may have occurred too quickly for those changes to develop,
or the injuries might be ante-mortem but the body resistance is
so diminished to produce the vital reactions.
Distinctions Between Ante-mortem from Post-mortem Blisters:
a. Ante-mortem blisters contain fluid rich with albumen and
chlorides, while post-mortem blisters may contain air or scanty
amount of albumen and chlorides.
b. Heating the fluid contents of an ante-mortem blister will cause
solidification, while heating of a post-mortem blister will show
slight cloudening but not solidification.
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c. The base of an ante-mortem blister is reddish with signs of
inflammatory changes in the periphery, but there is no such
finding in case of post-mortem blister.
d. Fluid content of an ante-mortem blister is abundant, while in
the case of post-mortem blister is scanty.
Differential Diagnosis of Blister Due to Heat:
a. Blister Due to Putrefaction:
The fluid content is blood-stained watery fluid and accom-
panied by putrefactive changes in other parts of the body.
b. Blister Due to Disease:
This can be differentiated from blister due to heat by the
size, distribution and absence of other signs of the effect of
heat application.
c. Blister Due to Friction:
History and absence of signs of the application of heat in the
neighborhood will differentiate it from blister due to burns.
Heat Rupture:
This is the splitting of the soft tissues of the body, like the skin,
due to exposure before or after death of the body to considerable
heat.
Differential Diagnosis:
a. Incised Wound — A heat rupture may be mistaken for an
incised wound. It may be distinguished by the absence of
blood inasmuch as heat coagulates blood inside the blood
vessels. In heat rupture, the blood vessels and nerves are kept
intact at the point of the rupture. On close inspection, the
margins are irregular unlike those in the case of incised wounds.
b. Lacerated Wound — In lacerated wound, there is contusion and
other vital reactions at the margin, which is not present in
cases of heat rupture. The roasted condition of the skin is
prominent in cases of heat rupture.
Heat Stiffening:
This condition is found in dead bodies which have been sub-
jected to heat. The heat coagulates the albuminous materials
inside the muscle making it stiff and contracted. The limbs are
flexed and the fingers partially clenched simulating a "pugilistic"
position of a boxer. There is flexion of the limbs and fingers on
account of the fact that the flexor muscles are stronger than the'
extensors. The heat stiffening remains for sometime until the
body softens due to the onset of decomposition.
Investigation of Death in a Conflagration:
Examination of the burnt body should be directed to obtain
the following informations:
a. Identity, which may be established from:
Clothing. Careful handling must be stressed, as charred
materials can yield considerable information in expert hands,
but can also be easily destroyed. The size of footwear may be
of importance.
Property in the pockets such as key, money, papers and the
like.
Height — Sex — Age — Color of eyes — Color of hair.
Natural disease or stigmata such as scars, old deformities or
injuries and dentition.
b. Whether the person was alive in the fire, which can be decided
from the presence of carbon particles in the air passages, and
the estimation quantitatively of carbon monoxide in the blood.
c. Cause of death.
d. Information indicating a possible cause of the fire, as shown
by examination of the deceased. Evidences of the following
should be noted.
Alcoholic intoxication (Blood and urine estimation for
alcohol).
Natural disease which might have caused collapse, such as
epilepsy, hypertension, myocardial fibrosis.
Site of origin of the fire, as shown by maximal effects in
relation to position of the body.
Demonstration of injuries which could have been sustained
before the fire commenced.
(From: Practical Forensic Medicine by Camp & Purchase, p.
236).
Post-mortem Findings (Burns and Scald):
a. External Findings:
( 1 ) Presence of external lesion depending upon the degree of
burning and scalding of the body.
(2) "-Pugilistic position" or "fencing posture" of the body.
(3) Blackening of the body surface in case of burns.
( 4 ) Rupture of skin, muscles, or destruction of limbs or skull.
(5) Exposure of internal organs.
( 6 ) Singeing of the scalp and other hairs of the body.
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b. Internal Findings:
( 1 ) Blood is cherry-red in color owing to the presence of
carboxyhemoglobin.
( 2 ) Increase in the lymphoid tissue, especially of the intestine
and lymph glands.
( 3 ) Marked dehydration.
( 4 ) Hemoconcentration with increased capillary permeability.
( 5 ) Congestion of visceral organs.
( 6 ) Cloudy swelling of liver and kidneys.
(7) Enlargement of the adrenal glands with hemorrhagic
infarcts.
( 8 ) Lungs are shrunken, mucous membrane of the bronchi
are congested and sub-serous hemorrhages present.
( 9 ) Intestinal mucous membrane are congested especially
the Brunner's glands of the duodenum.
(10) Spleen enlarged and soft.
(11) Brain and spinal cord shrunken and hyperemic.
(12) Presence of carbon particles in the respiratory tract.
(13) Fatty degeneration in the liver.
Medico-Legal Aspect of Burns and Scalds:
During the ancient and medieval times, branding is a means to
secure identity. Red-hot metals shaped in letters or figures are
pressed in the arm and thigh. With the improvement of the
present method of identification, branding is now only made on
domestic animals.
Extraction of confession by burning the fingers, application of
heated metals on the skin, or pouring boiling water on the body is
now punishable.
Killing of a person and setting afire the building for the purpose
of concealing the crime or for the purpose of destroying the body
of the victim is quite common. It is in this connection that the
physician must exert all efforts to determine the true nature of
the case.
Burning and scalding is usually accidental, but occasionally
homicidal or suicidal.
Accidental cases are common among women and children on
account of their loose garments which easily catch fire. Child-
ren, mentally deficient persons and intoxicated individuals may
expose their bodies to boiling water or live flame.
A number of persons may die from burns when fire breaks out
in an inhabited house, or when an explosion occurs in a factory.
The Revised Penal Code considers the killing of a person by
means of fire as murder. The setting of a building on fire must be
an intentional means to kill the person inside the building to make
it a murder (Art. 248). There should be the actual design to kill
and that the use of fire should be purposely adopted as a means
to that end (People v. Burns 41 Phil. 418).
ontaneous Combustibility:
It is claimed by some authorities that the human body can
ignite itself spontaneously and b u m itself to death. This is hardly
possible on account of the high percentage of water in the human
body. Spontaneous combustibility may be utilized as a defense
in cases of homicidal burns if it is really probable.
-eternatural Combustibility:
It is claimed that the human body is inflammable on account of
the presence of gases which easily ignite. The gases are said to be
the products of the action of microorganisms in the body. This
explains the presence of phosphorescent light in the graveyard
during night time. If ever the theory is true, then there can only
be a partial combustion of the human body.
Chemical Burns (Corrosive Burns):
Chemical burns are the action of strong acids and alkalies and
other irritant chemicals which cause extensive destruction of the
tissue. Healing is quite slow and may require plastic surgery. The
most common of the chemicals are concentrated sulfuric acid,
nitric acid, hydrochloric acid, caustic soda and potash, lysol, etc.
Chemical burns may be followed by keloid scars.
Characteristics of Lesions:
a. Absence of vesication.
b. Staining of the skin or clothing by the chemical.
c. Presence of the chemical substance.
d. Ulcerative patches of the skin.
e. Inflammatory redness of the skin surface.
f. Healing is quite delayed on account of the action of the che-
micals to the underlying tissue.
Distinctions Between Thermal and Chemical Burns:
a. There is an absence of blister in case of chemical bums while
blister may be present in thermal burns.
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d. Caustic Soda and Potash have a corrosive action on the tissues,

giving a bleached appearance and greasy feeling to the skin.
The skin subsequently becomes brown and parchment-like.
(From: Taylor's Principles & Practice of Medical Jurisprudence
by S. Smith, 10th ed., p. 327).

Extensive b u r n s by strong acid

b. The skin and clothings may be stained with chemical in case

of chemical burns, but there is no such staining in thermal
burns.
c. Analysis of the substances around the lesion will show the
chemical causing the corrosion. Nothing of this nature is found
in thermal burns.
d. In thermal burns, the lesion is diffused while in chemical burns
the borders are distinct and simulating a geographic appearance.
Characteristic Lesions by Different Chemicals:
a. Sulphuric Acid (Oil of Vitriol), which has the most intense
action, causes a considerable amount of destruction of the
tissues with the formation of a blackish-brown sloughs. The
face or other part will show splash marks where the acid has
fallen, and usually there will be lines of ulceration where the
acid run down the surface of the body.
The clothing will be destroyed in the places where the acid
has spilled.
b. Nitric Acid causes a yellow or yellowish-brown slough, and the
spot of yellow color will be seen .on the skin. The clothing is
destroyed and the color becomes brown. 4. Electrical Bums:
c Hydrochloric Acid, though not so destructive as either sul-
phuric or nitric acid, causes as intense irritation and localized
ulceration of a red or reddish-gray color.
Severe burning and staining of the skin of the face in suicidal poisoning
b y muriatic acid.
Treatment:
a. Neutralization of the corrosive substances.
b. Protection of the eye from involvement.
c. Prevention of infection of the lesion.
d. Other supportive or symptomic treatments.
Burns from corrosive fluids are quite rare and are usually due to
accidents in chemical laboratories. Vitriol throwing is common in
England. Intentional spilling or throwing of corrosive fluid causes
physical injury and on account of the deforming scar it produces,
it becomes a serious physical injury. Corrosive burns are com-
monly observed in suicidal ingestion with spilling of the chemical
around the mouth and neck.
There are three kinds of electrical burns, namely: — contact
burns, spark burns, and flash burns. The characteristic feature of
all of them is that their depth is greater than the surface appear-
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Chapter XV

PHYSICAL INJURIES OR DEATH BY LIGHTNING

THERMAL INJURIES OR DEATHS 413
ance this would suggest that severe sloughing of the tissues may
occur later.
a. Contact Burn — due to a close contact with an electrically live
object, and the degree will vary from small and superficial
lesion to charring of skin if contact is maintained.
b. Spark Burn — due to a poor contact and the resistance of dry skin
and shows a pricked appearance with a central white zone
(parchment) and surrounding of hyperemia. This burn, which
may be essential to the proof of electrical contact, can be very
difficult to identify, and sections should be cut in an attempt
to establish their nature.
c. Flash Burn — the appearance varies from the arborescent
pattern of lightning burns to the "crocodile skin" appearance
of high voltage flash (From: Practical Forensic Medicine by
Camp and Purchase, p. 238-239)
5. Radiation Burns:
a. Burns from X-ray:
The burns from X-ray depends upon the degree of intensity
and period of exposure. Slight-exposure will produce redden-
ing and inflammation of the skin which will pass away within
a short period of time leaving a bronze color on the skin.
Higher degree of over-exposure may produce blister, atrophy
of the superficial tissue and obliteration of the superficial blood
vessels. In very severe cases, there may be ulceration of the
tissue which may later lead to malignancy.
b. Ultraviolet Light Burns:
Overdose of ultraviolet light may lead to severe and per-
sistent dermatitis. There is uncomfortable irritation of the skin
and may later develop into a blister.
AND ELECTRICITY
DEATH OR PHYSICAL INJURY BY LIGHTNING:
slAghtning is an electrical charge in the atmosphere. Its place of
occurrence and intensity are unpredictable. The flash of lightning is
due to the passage from a thunder cloud to the earth of a direct
electric current of enormous potential, amounting to something
like 1,000 million volts and about 2,000 amperes. Along the path
of the current, a great portion of its energy is liberated, most of
which is converted into heat. The size of the tract is variable and
may produce branching flash along its course. Because of the enor-
mous power of destruction, it is capable of producing injury to
the human body.
Elements of Lightning that Produce Injury:
1. Direct effect from the electrical charge:
The electrical charge of lightning may pass to the body pro-
ducing electrocution. The human body especially its nerves, is a
good conductor of electric current.
2. Surface "flash" burns from the discharge:
Some of the electrical energy in a lightning is transformed to
heat energy. The superheated air may cause burning of the skin
of the victim. The flash burn may produce arborescent marking
but are by no means typical.
3. Mechanical effect:
The expansion of the air on account of the superheated atmos-
phere may bring about mechanical injury. It may result to lacera-
tion of the body surface, severe tearing of the clothings and
displacement of parts of the body.
4. Compression effect:
The compressed air pushed before the current with super-
heated atmosphere may produce a backward wave. This causes
the "sledge hammerblow" on the body of the victim, thereby
producing concussion, shock, or unconsciousness to the victim.

414
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Points to be Considered in Making a Diagnosis of Death from Light-

ning:
1. History of a thunderstorm that took place in the locality.
2. Evidences of the effects of lightning are found in the vicinity,
like damages to houses, trees, and other objects; death of other
person and animals nearby.
3. Metallic articles are fused and magnetized.
4. Fusion of glass materials on account of severe heat.
5. Absence of wound and other injuries indicating suicidal or homi-
cidal death.
6. Skin often shows arborescent markings due to superficial ery-
thema which disappear in a day or two if the person lives.
7. Burns may be present, but may be limited to the part under the
pieces of metals such as watch, knife or bunch of keys. The burns
are superficial or may be very deep.

Classes of Burns Due to Lightning:

1. Surface burns — These are superficial burns usually seen under
metallic objects worn or carried by the victim. A victim of lightning

2. Linear burns — These are found where areas of the skin offer
less resistance, notably in the moist creases and folds of the skin
and may vary in length from one to twelve inches.
3. Arborescent or filigree burns — These are radiating burns from a
point, similar to electrocution.
g. Headache, dizziness and noise in the ears.
h. In severe cases, it may lead to blindness, deafness and loss of
speech.

Effects of Lightning in the Human Body: 2. Delayed Effects:

Death is usually the immediate effect due to the involvement of a. Insomnia and defective memory.
the central nervous system. The shock is produced by the instan- b. Irritability and inability to concentrate.
taneous anemia of the brain brought about by the spasmodic con-
c. Paralysis or an increasing weakness of the limbs with pro-
traction of the cerebral vessels. The lightning may cause immediate
gressive wasting of the muscles.
loss of consciousness and because of the intense disturbance of the
air, the clothings may be removed from the body or severely torn. d. Hemiplegia, aphasia, deafness, epilepsy.
Occasionally, a person may recover from the effect of the light- e. Progressive cerebellar syndrome.
ning stroke but in most cases suffer from certain degree of neuro-
logical disturbances. Treatment:
1. Symptoms of Mild Attack: 1. Artificial respiration.
a. External lesion of almost any description. 2. Air passage must be kept free.
b. Unconsciousness. 3. Lumbar puncture to release the tension in the cerebrospinal
c. Slow, deep and interrupted respiration. fluid.
d. Pulse is slow and weak. 4. Rectal hypnotic to combat delirium.
e. Pupils are dilated and sensitive to light. 5. Treatment to combat shock.
f. Relaxation of the entire muscular system. 6. Treatment to build resistance of the victim.
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Post-mortem Findings: 3. Anticipation of a shock — When a person is aware of the possibility

1. External:
— Marked tearing of the wearing apparel.
— Burns of different degrees on the skin surface.
— Wounds of almost any description.
— Magnetization of metals in the wearing apparel.
— Fusion of metals and glasses.
— Singeing of the hair of the scalp and other parts of the body.
2. Internal:
— Fracture of bones.
— Hemorrhage due to the laceration or the rupture of organs.
— Petechial hemorrhages of the lungs, pericardium, brain.
— Rupture of the blood vessels and the internal organs.
Medico-Legal Aspect:
Investigation of death due to lightning is not by itself of any
medico-legal interest for it is an accidental death. No one can be
held responsible to the effect of a fortuitous event. However, its
investigation may be useful to eliminate the possibility that death is
due to the felonious act of another person.
DEATH OR PHYSICAL INJURIES F R O M ELECTRICITY:
The main cause of death in electricity is shock. Ordinary domestic
line is from 100 to 250 volts and it is sufficient to produce death.
The effect of 300 volts and above may be similar to lightning stroke.
Voltage is not only the factor causing the injury. As a matter of fact,
amperage or intensity of the electrical current is the principal factor.
The damage to the body by an electrical discharge depends upon
several factors which may increase or decrease the electrical con-
ductivity of the body. The presence of moist skin, wet floor, bare-
foot and proximity of metals, increase the conductivity of the body
to electricity. Dryness of the skin, presence of rubber boots or
shoes, dryness of the floor and better insulation of the metallic
conductor increase the resistance. An increase in the conductivity
of the body will promote more injury.
Factors which Influence the Effect of Electrical Shock:
1. Personal idiosyncracy — Individual personality, physical con-
dition, and the existence of mental or bodily distress at the time,
influence the effect of a shock.
2. Disease — A person suffering from cardiac disease is predisposed
to death from electrical shock.
of a shock, the victim can withstand one which might otherwise
be dangerous.
4. Sleep — Sleep increases the resistance to an electrical current.
5. Electrical voltage or tension — Most fatalities are followed by a
shock from a current at a tension of 220 — 250 volts, although
50 volts which are used for therapeutic purpose also show
fatality.
6. Amperage or intensity of electric current — This is the principal
factor. This is determined by dividing the voltage with the resist-
ance of the conductor. Amperage of 70-80 in alternating current
or 250 in direct current is dangerous to man.
7. Density of the current.
8. Resistance of the body — Factors that will reduce the resistance
of the body to electrical flow will promote more injury.
9. Nature of the current — It is claimed that the alternating current
is more dangerous than direct current.
10. Earthing— The development of shock is enhanced, if the victim
is grounded or earthed. Earthing will promote continuous flow
of electric current.
11. Duration of contact — L o w tension may kill when contact is
maintained for several minutes. A shorter duration of contact
is enough for high tension to produce death.
12. Kind of electrodes — Some electrodes conduct a free flow of
electric current while others do not.
13. Point of entry — Contact of the left side of the body is claimed
to be more dangerous than that of the right side.
Mechanism of Death in Electrical Shock:
1. Ventricular fibrillation which may lead to the rupture of some of the
muscle fibers and focal hemorrhages in low voltage.
2. Respiratory failure due to bulbar paralysis in high voltage.
3. Mechanical asphyxia due to violent and prolonged convulsion.
Nature of Electrical Burns:
The electrical burns is sometimes called "electrical necrosis/'
Some calls it electric marks or "current markings," and may be seen
at the point of entrance and exit to the current. The skin is puckered
with gray color and traversed by deep impressions arranged at right
angle.
The electric marks are painless and show no vital reaction. When
unaccompanied by burns, the hair in the region of the mark is intact.
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Repair is by a process of aseptic necrosis, followed by luxuriant

granulation and healing leaves a smooth, thin, pink scar.
The absence of mark does not exclude electrocution but the
presence raises a strong presumption of death from electrocution.
Microscopically:
There is compression of the stratum corneum. There is also
superficial carbonization. It is deeper in the epidermis and there is
a focal cavitation due to the sudden production of steam by the
current. The papillae of the corium are flattened with vascular 420 LEGAL MEDICINE
contraction, especially at the center of the mark.
— Electrical arborization.
— Bums with metallization.
Symptoms:
— Intense vascular congestion of the dura mater.
If death does not occur after contact, the person may show the — Eyes congested and pupils dilated.
following symptoms: — Trachea may be congested.
— Surface of the body is cold and moistened. — Lungs deeply engorged and edematous.
— Breath is stertorous. — Congestion of visceral organs.
— Pulse is rapid, filiform and may be irregular.
— Pupils are dilated and insensitive. Treatment:
— Pale face. 1. Remove the victim from live wire installations. Close the switch
and remove the victim and in which case, care must be exercised
Metallization: by the rescuer.
This is claimed to be a specific feature of electrical injury. The 2. Artificial respiraton which must continue for about an hour until
metal of the conductor is volatilized and particles of the metal are positive proof of death is present.
driven into the epidermis. Extensive areas of the body may be 3. Treatment of shock or coma. As soon as spontaneous respiration
darkened by metallization. The color may vary from brown to is established, raise the temperature of the patient by the appli-
black. If the conductor is iron, it is usually yellow-brown while if cation of hot water in bottles and blankets. Cerebral edema may
it is copper, copper salts may be produced to yield a blue mark. be treated by lumbar puncture. Stimulant may be given to im-
prove the health.
Delayed Effects of Electrical Injuries:
Medico-Legal Aspect:
Necrosis of the area involved, may later develop into gangrene.
Because of the arterial damage, the gangrenous area may be far Death by electrocution is mostly accidental. They are very
more extensive than the electrical injury. rarely, suicidal or homicidal. Accidental electrocutions usually
occur in grounded laundry line, electric stoves and outlets.
The damaged arteries may become brittle and friable that it is
liable to a rupture at a slight provocation causing a severe hemor-
rhage.
The late nervous injuries may be manifested in the form of retro-
grade amnesia, changes in personality, hemiplegia, aphasia, and post-
concussional syndrome.
The current might have entered the head and produce cataract
of the lens in the form of flaky opacities.

Post-mortem Findinge:
There is nothing specific, or may show no lesion at all.
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Chapter XVI
DEATH OR PHYSICAL INJURIES DUE TO CHANGE
OF ATMOSPHERIC PRESSURE (BAROTRAUMA)
The normal atmospheric pressure at sea level is 760 millimeters
of mercury. A person is subjected to an increase of atmospheric
pressure as he goes deeper in a body of water and a decrease as he
ascends higher in the atmosphere.
I N C R E A S E O F A T M O S P H E R I C P R E S S U R E (Hyperbarism):
The ear drum may bulge inward resulting to stretching, pain,
hemorrhage and ultimate perforation of the tympanic membrane.
Aside from the effects of the increase atmospheric pressure, the
diver may suffer from:
1. Cerebral anoxia due to a prolonged stay under water;
2. Muscular cramp;
3. Physical injuries in the process of diving and hitting hard objects;
4. Injuries caused by aquatic animals, like shark or stings of veno-
mous fish and coelenterates;
5. Effects of the changes of atmospheric pressure in a pre-existing
disease like hypertension or a coronary affection.

This condition is observed underwater by scuba divers, pearl
divers, salvage divers, treasure hunters, pleasure swimmers, etc..
Henry's law provides that "at constant temperature, the amount
of gas dissolved in a liquid is directly proportional to the pressure."
As the diver goes deeper into the body of water, the atmospheric
pressure he is subjected to increases. The atmospheric pressure is
doubled at 10 meters and this increases further as he goes deeper.
As a consequence of this, there is an increase in the amount of gas
dissolved in the blood and other body fluids.
Before a diver enters a body of water he breaths deeply to fill
up his lungs with an estimated volume of six liters. This air is grad-
ually absorbed by the body fluid so that at a depth of six meters the
diver needs twice the volume of air normally required when on the
surface with an increase fourfolds at a depth of 33 meters.
The longer the diver remains under pressure and the deeper is
the descent, the greater is the degree of gas saturation of the tissue
and the greater the length of time required for subsequent decom-
pression.
In the process, nitrogen, an inert gas which constitute approxi-
mately 80% of the air in the lungs is also dissolved in the body fluid
and this causes the so-called "nitrogen narcosis" (rupture or drunken-
ness of the deep). This condition is preceded by a feeling of euphoria.
The absorption of gas in the lungs will cause decrease pressure on
the pulmonary tissue as compared with that of the pulmonary
circulation and this difference in pressure will cause transfer of
fluid from the pulmonary capillaries into the alveolar space causing
pulmonary edema. A rapid descent may cause rupture of the blood
vessels and hemorrhage.
During Ascent from a High Atmospheric Pressure of the Deep Sea
to the Surface Atmosphere:
If ascent is made gradually, the chances of untoward effects may
not be observed. However, if ascent is made rapidly, the diver may
suffer from the effects of the sudden release of the gases from the
body fluid. Released air bubbles may be present in the circulation
and become potent emboli in different parts of the body.
In the chest, it may cause interstitial emphysema at its wall and
also at the neck and face. Pneumothorax and pulmonary air em-
bolism may also be present.
Air emboli during decompression may lodge in the capillaries of
the big joints causing it to adopt a semi-flex position, hence called
"bends." The affected areas by the air embolism cause ischemia,
pruritus and pain. Air embolism may be fatal if it lodges in the vital
organs of the body.
Post-Mortem Findings:
1. If Death has been Immediate:
Subcutaneous emphysema, generalized visceral congestion and
the presence of gas bubbles.
Extra-vascular bubbles and hemorrhages in adipose tissues, like
the mesentery and omentum.
2. If Death Occurred After a Lapse of Several Days.
Degeneration and softening of the white matter of the spinal
cord.
Fat necrosis of the liver.
Osteonecrosis.

421 D E C R E A S E O F A T M O S P H E R I C P R E S S U R E (Decompression):
1. Hypobarism — At a higher altitude the atmospheric pressure
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becomes lower and more gas will be liberated by the body fluid.
The release of gases from the body fluid will cause:
a. "Bends" — Joint and muscular pain due to the presence of air
bubbles.
b. "Chokes" — Substernal distress, a non-productive coughing and
respiratory distress. This is the result of bubble formation in
the pulmonary capillaries or from the effects of extravascular
mediastinal bubbles exerting pressure on the mediastinal con-
tents and adjacent pulmonary tissue.
c. Substernal emphysema — Accumulation of bubbles underneath
the skin and is observed as a crepitation on palpation of the
skin.
d. Trapped gas — may result in the doubling of the size of hollow
viscus, like the stomach and intestine at 18,000 feet level. The
size quadruples at 33,000 feet. Expansion of the size of the
stomach may cause diaphragmatic herniation.
Modern aircraft flying at high altitude have been pressurized to
remove the ill-effects of low atmospheric pressure.
2. Anoxia — At higher altitude the oxygen content of the atmos-
phere becomes lesser and lesser. Hypoxia will be felt between
8,000 to 15,000 feet level. Aircraft flying beyond 34,000 feet
above sea level must be provided with oxygen to maintain the
human demand.
A I R C R A F T INJURIES A N D F A T A L I T I E S :
Causes of Injuries and Fatalities in Aircraft are:
1. During the Flight:
a. Altitude:
Hypobarism (Decompression).
b. Speed — Passengers and crew may suffer from spatial dis-
orientation and windblast.
The sudden change of direction at a speed of 500 miles
tends to drain blood from the brain to the lower parts of the
body resulting to a momentary black-out or unconsciousness.
c. Toxins — Carbon dioxide, carbon monoxide, and other irres-
pirable gases may saturate the cabin compartment and cause
asphyxia.
d. Temperature — At high altitude, the temperature falls and at
the height of 25,000 feet, it is 40° below zero.
Death may be due to frostbite or freezing of the body.
e. Pre-existing disease — Coronary disease or hypertension may
cause fatality due to the sudden change of environment.
2. During the Crash:
Most of the aircraft fatalities occur during the take-off and
landing. During the crash, the whole plane bursts into flame due
to its high octane fuel content. If a passenger or crew survives
the crash, he will suffer from severe thermal injuries.
Modern high speed turbojet or jet aircraft have a velocity of
not less than 500 miles per hour as much as that of the terminal
velocity at the time of the impact which causes widespread de-
struction of the aircraft and also of the ground. Potential survivor
may be those who were trapped within the cabin but are rescued
before a fire develops or those who are fortuitously thrown from
the aircraft.
a. Fracture of the tibia and fibula is due to the presence of the
horizontal bar at the rear of the front seat;
b. Fracture of the femur is due to the high vertical force and the
front bar of the seat;
c. In the chest, the common site is the upper half and is fre-
quently associated with sternal injuries indicating that it is of a
flexion type;
d. Cranio-facial injuries is due to the impact of the head to the
seat in front when subjected to a vertical hit. There may be a
fracture of the classical ring type surrounding the foramen
magnum due to the vertical force.
e. Rupture of the heart or aorta is quite common as this is due to
compression of the heart between the sternum and spine
during the flexion or the mobile heart is torn from the static
aorta during deceleration of the body in the vertical fall of the
body.
HELICOPTER:
A helicopter is a rotary-wing airplane. The rotor is the source of
power and its aerodynamics causes its lift. The bulk of its weight is
on the rotor, gear box and gear train and* engine. All of these parts
are located above the center of gravity of the helicopter so that when
the helicopter drops down, the aircraft will be in an inverted position.
Most of the helicopter accidents are due to structural failure,
engine and control failure. Other causes are the unseen obstacles
such as wire, weather and error of judgment.
Because of the low speed, accidents do not take place during take
off or landing, but during flight.
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Chapter XVII

DEATH BY ASPHYXIA
'•Asphyxia is the general term applied to all forms of violent death
which results primarily from the interference with the process of
respiration or the condition in which the supply of oxygen to the
olood or to the tissues or both has been reduced below normal level.

Types of Asphyxial Death:

1. Anoxic Death:
This is associated with the failure of the arterial blood to
become normally saturated with oxygen. It may be due to:
a. Breathing in an atmosphere without or with insufficient oxygen,
as in high altitude.
b. Obstruction of the air passage due to pressure from outside, as
in traumatic crush asphyxia.
c. Paralysis of the respiratory center due to poisoning, injury or
anesthesia, etc.
d. Mechanical interference with the passage of air into or down
the respiratory tract due to:
( 1 ) Closure of the external respiratory orifice, like in smother-
ing and overlaying.
( 2 ) Obstruction of the air passage, as in drowning, choking with
foreign body impact, etc.
( 3 ) Respiratory abnormalities, like pneumonia, asthma, emphy-
sema and pulmonary edema.
e. Shutting of blood from the right side of the heart to the left
without passage through the lungs as in congenital anomalies
like potent foramen ovale.
2. Anemic Anoxic Death:
This is due to a decreased capacity of the blood to carry
oxygen. This condition may be due to:
a. Severe hemorrhage.
b. Poisoning, like carbon monoxide.
c. L o w hemoglobin level in the blood.
3. Stagnant Anoxic Death:
This is brought about by the failure of circulation. The failure
of circulation may be due to:

426
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a. Heart failure. c. Special forms of strangulations:

b. Shock.
c. Arterial and venous obstruction, incident to embolism, vascular
spasm, varicose veins, or the use of tourniquet.
4. Histotoxic Anoxic Death:
This is due to the failure of the cellular oxidative process, al-
though the oxygen is delivered to the tissues, it cannot be utilized
properly. Cyanide and alcohol are common agents responsible for
histotoxic anoxic death.
Phases of Asphyxial Death:
1. Dyspneic Phase:
The symptoms are due to the lack of oxygen and the retention
of carbon dioxide in the body tissue. The breathing becomes
rapid and deep, the pulse rate increases, and there is a rise in the
blood pressure. The face, hands and fingernails become bluish,
especially in the case of infants.
2. Convulsive Phase:
This is due to the stimulation of the central nervous system by
carbon dioxide. The cyanosis becomes more pronounced and the
eyes become staring and the pupils are dilated. Examination of the
visceral organs shows small petechial hemorrhages, commonly
known as Tardieu Spots. The TardieuSpots are caused by the
hemorrhage produced by the rupture of the capillaries on ac-
count of the increase of intra-capillary pressure. It usually appears
in places where the tissue is soft and the capillaries are not well
supported by the surroundings, as in visceral organs, skin, con-
junctivae, and capsules of glands.
The victim may become unconscious during the convulsive
stage.
3. Apneic Phase:
The apnea is due to the paralysis of the respiratory center of
the brain. The breathing becomes shallow and gasping and the
rate becomes slower till death. The heart later fails.
Recovery at this stage is almost nil due to the permanent
damages inside the brain on account of prolonged cerebral anoxia.
Classifications of Asphyxia:
1. Hanging.
2. Strangulations:
a. Strangulation by ligature.
b. Manual strangulation or throttling.
(1) Palmar strangulation.
(2) Garroting.
( 3 ) Mugging or yoking.
(4) Compression of the neck with stick.
3. Suffocation:
a. Smothering or closing of the mouth and nostrils by solid
objects.
b. Choking or closing of the air passage by obstruction of its
lumen.
4. Asphyxia by submersion or drowning.
5. Asphyxia by pressure on the chest (Traumatic crush asphyxia).
6. Asphyxia by irrespirable gases.
A. ASPHYXIA BY HANGING
Asphyxia by hanging is a form of violent death brought about by
the suspension of the body by a ligature which encircles the neck and
the constricting force is the weight of the body.
It is not necessary that the whole body will be left suspended.
The victim may be sitting or lying with the face downward provided
that the pressure is present in front or in the side of the neck.
Classification of Asphyxia by Hanging:
1. As to the location of the Ligature and Knot:
a. Typical — When the ligature runs from the midline above the
thyroid cartilage symmetrically encircling the neck on both
sides to the occipital region.
b. Atypical — When the ligature is tied or noosed and present on
one side of the neck, in front or behind the ear, or on the chin.
2. As to the Amount of Constricting Force:
a. Complete — When the body is completely suspended and the
constricting force is the whole weight.
b. Partial — When the body is partially suspended as when the
victim is sitting, kneeling, reclining, prone or in any other
positions.
3. As to Symmetry:
a. Symmetrical — When the knot or noose is at the midline of the
body either at the occiput or just below the chin.
b. Asymmetrical — When the knot or noose is not in the midline
but on one side, with the head tilted to the side opposite the
location of the noose or knot.
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Suicidal hanging w i t h the use of b a r b e d w i r e
Mechanism of Death:
There is a ligature around the neck with a knot or with a sliding
noose, and the other end is fastened to an elevated object like peg,
nail, window casing, door knob, tree, etc..
Upon suspension of the body, the weight causes the noose or band
to tighten, producing pressure at the region of the neck.
The pressure of the band will cause the air passage to constrict, the
larynx is pushed backwards and its opening is closed by the contact
of the anterior to the posterior laryngeal wall producing asphyxia.
The pressure of the ligature may also cause compression of the
superior laryngeal nerve, carotid arteries and jugular veins producing
cerebral anoxia.
The form of furrow that develops in the neck depends upon the
type of ligature, the number of loops around the neck and the point
of suspension.
Protrusion of the tongue depends upon how pressure is applied
around the neck. If above the larynx and in an upward direction,
the tongue will be pushed outward and will protrude from the mouth,
but if the pressure is below the larynx, the tongue is kept inside the
buccal cavity.
Ligature in Hanging:
1. Materials used in Ligature:
The thinner the ligature and the tougher the material, the more
pronounced will be the mark on the skin of the neck. If the
material is soft and broad the ligature impression on the neck is
less marked.
If hanging is done with evident premeditation as in the case of
suicide, a special quality of material may be used. Rolled bed-
dings, leather belts joined together, rope, electric wire and vines
are oftenly used. The rope is commonly used as a ligature because
it is easily available and strong.
2. Noose:
There may be no sliding noose at the end of the ligature. It
may be tightened after it has been encircled around the neck and
the pressure on the air passage, blood vessels and nerves of the
neck is established when the body is suspended. Metal buckle,
ring, or sliding noose may be attached to the end to make it slide.
3. Mode of Application of the Ligature:
The ligature may be placed around the neck with a single loop
or with two or more loops. This can be distinguished on the
nature of the ligature marks. In single loop, there is but one
ligature furrow, but if there are several loops, there will be several
ligature marks with an intervening redness between the furrows.
There is more tendency to have more pressure in single loop ligature
on account of the concentration of force at the weight as com-
pared with two or more loops.
4. Position of the Knot:
The knot or joint is usually located on either side of the neck.
The head is flexed opposite the location of the knot. The level
of the ligature around the neck may differentiate hanging from
strangulation by ligature. In hanging, the ligature is usually
found above the thyroid cartilage on account of the upward
pull of the constricting force, while in case of strangulation by
ligature, the loop is found below the thyroid cartilage. It is not
easy to retain the knot beneath the chin."
5. Course of the Ligature around the Neck:
The .usual appearance is that the groove or ligature mark is
deepest opposite the location of the knot. However, if the knot
is just underneath me chin, the groove at the back of the neck is
not deep on account of the firmer skin and muscular tissue. The
course of the ligature forms an inverted V-shape with the vertex as
the location of the knot.
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Symptoms: unconsciousness develops immediately and death is accelerated.

2. Point of Application of the Ligature:
1. Gradual loss of sensibilities.
When the ligature is made below the larynx, death is almost
2. Sensation of constriction of the neck.
instantaneous, but when applied above the larynx, death may not
3. Loss of consciousness and muscular power. occur for three to five minutes. Hanging with the knot situated
4. Numbness of the legs and clonic convulsion. on one side of the neck may delay death because the closure of
5. Sensation of ringing inside the ear. the cerebral vessels cannot be completely maintained. If the knot
6. Sensation of flash of light before the eyes. is just below the jaw, maximum pressure is at the back of the
neck causing merely partial occlusion of the windpipe and blood
7. Face becomes red, with eyes prominent and feeling of heat in the
vessels of the neck, thereby delaying death.
head.
3. Other Factors:
If the victim is timely rescued and revived after artificial respiration,
a. Physical condition of the subject.
he will suffer the following symptoms:
b. The rate of consumption of oxygen in the blood and tissues.
1. Whistling sensation inside the ear.
The loss of sensibility is due to the pressure of the ligature on
2. Watering of the eyes.
the blood vessels causing disturbance in the cerebral circulation.
3. Difficulty of breathing and swallowing. Ordinarily'respiratory movement may persist one to two minutes
4. Sensation of numbness of both legs. and the heart action for 15 to 30 minutes so that artificial res-
All of the above symptoms may last for 12 days after the rescue. Diration mav successfully revive the victim.

Amount of tension in the ligature sufficient to occlude the vital

structures of the neck:
Jugular veins 2 kilos (4.4. lbs.).
Carotid artery 5 kilos (11.0 lbs.).
Trachea 15 kilos (33.0 lbs.).
Vertebral artery 30 kilos (66.0 lbs).

Causes of Death in Hanging:

1. Simple asphyxia by blocking the air passage.
2. Congestion of the venous blood vessels in the brain.
3. Lack of arterial blood in the brain due to pressure on the carotid
arteries.
4. Syncope due to pressure on the vagus and carotid sinus which
leads to reflex irritation and paralysis of the medullary autonomic
centers.
5. Injury on the spinal column and spinal cord.
6. It may be any combination of the above-mentioned causes.
Time Required in the Process of Death: Ligature mark in hanging with the use of thin tough material.
The time required to produce death in hanging is influenced by
the following factors. Treatment:
1. Severity of the Constricting Force: 1. Induce the Natural Acts of Respiration:
If the constricting force is only sufficient to occlude the wind- a. Ligature must be loosened and the mouth must be wiped to
pipe, death may be delayed; but if the pressure is sufficient to
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remove all obstacles' to free air.
3. Findings in the Neck:
b. Tongue must be pulled forward and the body must be laid on a. Neck is flexed opposite the side where the knot is located.
back rest.
b. Ligature mark which forms a groove and deepest mark opposite
c. Place the patient where there is a free current of fresh air. the knot. The width of the groove is about or rather less than
d. Electrical stimulation of the phrenic nerve. the width of the ligature. The skin of the groove is pale o'r
e. Administration of respiratory stimulant, like ammonia. parchment-like. Microscopically, there is a characteristic
abrasion with slight desquamation and flattening of the cells
2. Stimulate the Heart to Renew Action if it Ceases to Beat:
of the epidermis.
a. Apply heat at the region of the precordium.
c. The course of the ligature is inverted V-shape with the apex of
b. Hypodermic injection of coramine, strychnine, or other sti- the " V " at the site of the knot. There may be an interruption
mulants. of the ligature marks.
c. Administration of brandy. d. The skin at the site of the ligature is hard with red line of
3. Maintain the Natural Body Temperature: congestion and hemorrhage in some points.
a. Cover the body with blanket. e. Ecchymosis of the neck depends upon the width and softness
b. Place the patient in a warm room. of the ligature.
f. There may be rupture of the underlying blood vessels, muscles
Post-mortem Findings in Death by Hanging:
and other soft tissues.
1. General External Appearance:
g. The lining membrane of the blood vessels may be lacerated.
a. Neck elongated and stretched with the head inclined on the
h. The fracture of the upper cervical vertebrae and the injury of
side opposite the knot or noose.
the spinal cord is due to long drop hanging or to judicial hang-
b. Eyes closed or partially opened with pupils usually dilated on ing.
one side and small on the other side (facies sympathetic). i. Fracture of the hyoid bone or the tracheal rings.
c. Lividity or pallor of the face with swelling and protrusion of
the tongue.
d. Hands are clenched firmly and purple colored fingernails.
e. Lips livid or blue.
f. Saliva dribbled from the mouth with froth.
g. State of erection or semi-erection of the penis with seminal
fluid in the urethral meatus.
h. Post-mortem lividity with ecchymosis are mostly marked at the
legs.
i. Urination or defecation due to the loss of power of the sphincter
muscles.
2. Internal Findings:
a. Engorgement of the lungs.
b. Venous system contains dark-colored fluid blood.
c. Right side of the heart and the big blood vessels connected with
it are distended with blood.
d. Blood vessels of the brain is generally congested.
e. Kidneys are congested.
f. Sub-pleural, sub-pericardial punctiform hemorrhages (Tardieu
Ligature m a r k in hanging with the use of soft and b r o a d ligature.
spots).
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j . Contusion of the inner wall of the trachea.
Differential Diagnosis:
1. Fold markings on the neck of an obese individual — In this case
the marks are not continuous and removed on stretching the skin
of the neck.
2. Marks of tight neckwear — The location and history will dif-
ferentiate this from ligature marks.
Determinations Whether Hanging is Ante-mortem or Post-mortem:
The principal criterion in the determination whether hanging is
ante-mortem or post-mortem is the vital reaction. But, hanging made
immediately after death may also show to a certain extent vital
reaction, while hanging of a living subject whose bodily resistance has
been markedly weakened may show only slight vital reaction.
The Following Findings Show that Hanging is Ante-mortem:
a. Redness or ecchymosis at the site of ligature.
b. Ecchymosis of the pharynx and epiglottis.
c. Line of redness or rupture of the intima of the carotid artery.
d. Subpleural, subepicardial punctiform hemorrhages.
It is advisable to look for other injuries which are capable of
producing death to eliminate the possibility of hanging as the cause
of death.
Determinations Whether Hanging is Accidental, Homicidal or
Suicidal:
1. Evidence in support of homicidal hanging:
a. Nature of the windows and doors — See whether the entrance
was forcibly opened or have been used as an escape by the
offender in homicidal case.
b. Presence of signs of struggle in the clothings, furniture, and
beddings — The furniture and beddings may be disturbed
whenever there was previous struggle before hanging.
c. Presence of stains, bodily injuries in the body of the victim.
d. Presence of defense wounds in the body of the victim.
"Lynching" is a form of homicidal hanging usually found in
southern states of the United States. It is usually practiced by
Americans against the Negroes who commit crime against the
white-American. Whenever, the colored offender are apprehended,
they are hanged by means of a rope on a tree or some similar
objects. The Negroes are executed without due process of the
law.
2. Evidences in support of suicidal hanging:
a. Findings at the place where the dead body was found is com-
patible with self-suspensions.
A chair may be found where he can stand to tie the rope at
a higher level. The chair or stool may be kicked away and the
body becomes suspended on a rope. A hammer to fix the nail
may be found near the place where the body was found.
b. Unusual position of the body when found:
The feet or the knees may be found partially touching the
floor if the body was found in a reclining position to make part
of the body weight as the constricting force on the neck. The
clenching of the hand and absence of signs of struggle to free
himself from the effects of ligature may infer the desire of
self-destruction.
c. Absence of signs of struggle:
There are no marks on the body that may cause unconscious-
ness to infer homicidal hanging.
d. Signs of vital reaction in the ligature marks around the neck:
The furrow may be deep, congested and papyraceous with
abrasions on account of the slide of the ligature as pressure on
the neck is produced by the weight of the body.
e. Signs of previous ineffective suicide attempt.
Like incised wound at the wrist, cutting the throat, ingestion
of poison may be present.
f. Presence of a suicide note written by the victim.
g. The materials used are those that are easily accessible, like
handkerchief, mosquito net, beddings, etc..
h. The history of reverses in life, like financial loss, love, studies,
etc. his mental condition,
i. The presence of suicidal note infer that hanging is suicidal,
j . No disturbance in the place where death took place.
k. The rule is that hanging is suicidal unless there are evidences to
show that it is not.
3. Accidental hanging is very rare.
B. ASPHYXIA BY STRANGULATION
STRANGULATION BY LIGATURE:
Strangulation by ligature is produced by compression of the neck
by means of a ligature which is tightened by a force other than the
weight of the body. Usually, the ligature is drawn tight by pulling
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the ends after crossing at the back or front of the neck, or several 2. Artificial respiration, and if there is a block in the laryngeal
folds of the ligature may be around the neck tightly placed and the passage, tracheotomy must be performed.
ends are knotted, or a loop is thrown over the head and a stick 3. Prevention of complications:
inserted beneath it and twisted till the noose is drawn tight. a. Edema of the glottis.
If the ligature is made of a soft material and is applied smoothly b. Pneumonia.
around the neck, no visible mark will be observed after death. Hard c. Abscess formation at the site of injury.
rough ligature applied with force more than that required to kill may
Post-mortem Findings:
produce extensive abrasion and contusion at the area of application.
1. External Examination:
Strangulation by ligature may be observed in infanticide using the
umbilical cord as the constricting material. This must be differ- a. Face is livid and swollen.
entiated from accidental strangulation by- the umbilical cord during b. Eyes are wide open, prominent, congested and pupils are dilated.
child birth. In accidental strangulation during child birth, the um- c. Tongue swollen, dark colored and protruded.
bilical cord is abnormally long and there is no disturbance in the d. Bloody froth may escape from the mouth and nostrils.
wharton's jelly. e. Tardieu's Spots are found beneath the conjunctivae, face, neck,
Strangulation by ligature is commonly observed in rape cases, but chest and lungs.
the presence of findings in the genitalia and other physical injuries
are the distinctive findings. 2. Internal Examination:
a. Intense venous congestion of both lungs with numerous pete-
Distinctions in the Post-mortem Findings in the Neck between Death chial hemorrhages.
by Hanging and Death by Strangulation with Ligature: b. Blood-stained froth is found in big bronchi.
c. Right side of the heart is filled with dark fluid blood.
Hanging Strangulation with Ligature
d. Congestion of the brain.
1. Hyoid bone is frequently 1. Hyoid bone is frequently
e. Congestion of the visceral organs.
injured. spared.
2. Direction of the ligature mark 2. Ligature mark is usually hori- 3. Examination of the Localized Lesion in the Neck:
is inverted V-shape with the zontal and knot is on the a. Mark of violence on the neck is in the form of ligature mark,
apex as the site of the knot. same horizontal plane. abrasion, or ecchymosis.
3. Ligature is usually at the level 3. Ligature is usually below the
b. Fracture of the larynx or tracheal rings.
of the hyoid bone. larynx.
c. Laceration of the tunica intima of the carotid and jugular
4. Ligature groove is deepest 4. Ligature groove is uniform in
vessels.
opposite the site of the knot. depth in its whole course.
5. Vertebral injury is frequently 5. Vertebral injury is not ob- Accidental, Homicidal or Suicidal Strangulation by Ligature.
observed. served.
Homicidal strangulation is the most common of the three forms of
Causes of Death in Strangulation by Ligature: strangulation by ligature. Aside from the ligature mark in the neck,
1. Asphyxia due to the occlusion of the windpipe. there are evidences of struggle or marks of violence in other parts of
the body. A person may be rendered helpless by a blow, intoxicating
2. Coma due to arrest of cerebral circulation.
liquor or by initial throttling. The ligature may be passed around the
3. Shock or syncope. neck and then the feet and hands are bound together. Smothering
4. Inhibition of the respiratory center due to the pressure on the may be done by placing a handkerchief gag in the mouth.
vagus and sympathetic nerves.
Suicidal strangulation by ligature is quite rare. It may be done by
Treatment: placing a ligature around the neck and tightened by means of twist-
1. Removal of the ligature. ing a piece of stick.
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There are a few instances of strangulation which are accidental
and most of the victims are children or epileptics who are helpless
and incapable of extricating themselves.
MANUAL STRANGULATION OR THROTTLING:
This is a form of asphyxial death whereby the constricting force
applied in the neck is the hand.
Methods of Throttling:
1. Using one hand, the neck may be grasped in front with the
thumb exerting pressure on one side and the other fingers on the
other side. The palm may exert pressure in front of the neck.
2. Using both hands with assailant in front. The thumbs digging in
over the anterior part of the larynx and pressing the air passage
back while the rest of the fingers are pressing on the sides and
back of the neck.
3. Using both hands with the assailant at the back. The fingers of
both hands grasp the throat in front and exerting a backward and
medial compression while the thumbs press against the side and
back of the neck.
Manners of Death in Manual Strangulation:
1. The air passage may be blocked and death is due to asphyxia.
2. The pressure on the neck may cause compression of the blood
vessels and disturb the blood supply of the brain.
3. The nerves of the neck may be traumatized especially the superior
laryngeal branch of the glossopharyngeal, hypoglossal nerves and
the plexus surrounding the bifurcation of the common carotid
artery or of the vagus producing shock.
Post-mortem Findings:
1. Cyanosis of the face.
2. Subpleural and subpericardial hemorrhage is not so conspicuous.
3. Heart, especially the right side is distended with blood.
4. Overdistention of the lungs with interstitial emphysema is oc-
casionally observed in children.
5. Findings on the neck:
a. There may be no external injury on the skin but there may be
contusion with the form and shape of the fingers.
b. With curved thumb nail or a group of fingernails, abrasions may
be found in front or at the back of the neck.
c. Interstitial hemorrhages in the muscles of the neck.
d. Fracture of the laryngeal cartilage may occasionally be found.
e. Petechial hemorrhages and congestion of the larynx and pharynx.
f. There may be bruising of the tongue at its anterior border and
the tongue itself may be bitten and protruded.
g. Hemorrhages present in the capsule of the thyroid, submaxillary
and even in the parotid glands.
Accidental, Homicidal or Suicidal Manual Strangulation:
1. Suicidal throttling is not possible because the pressure of the
person's own hand must be maintained for sometime but when
unconsciousness begins, the hands are relaxed and the victim
recovers.
2. Accidental throttling may occur but the victim never died of
asphyxia but of some other causes. A sudden application of
manual pressure in the neck during the moments of excitement
or passion may cause cardiac inhibition or cerebral apoplexy.
3. Homicidal manual strangulation is the most common. It is a
method of choice in infanticide. In most cases there are evident
signs of struggle.
Special Forms of Strangulation:
a. Palmar Strangulation:
The palm of the hand of the offender is pressed in front of the
neck without employing the fingers. The pressure must be suf-
ficient to occlude the lumen of the windpipe.
2. Garroting:
A ligature, a metal collar or a bowstring is placed around the
neck and tightened at the back. The subject may be placed with
the back to the post and a spike may be placed in the post to
force into the nape of the neck when the constricting band is
tightened.
Garroting is a mode of judicial execution during the 19th
century and it is still being practiced in Spain and Turkey.
3. Mugging (Strangle-hold):
This is a form of strangulation with the assailant standing at
the back and the forearm is applied in front of the neck. The
pressure on the neck is brought about by the pressure of the
flexed elbow.
Mugging may be the cause of death in wrestling. The knee
may also be used and it will produce the same effect as that of
the elbow. The foot or knee may be applied on the victim's
neck.
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4. Compression of the Neck with a Stick;
The victim may be forced to place his back behind a post.
The assailant with a piece of stick placed in front of the neck
pulls with two hands passing on both sides of the post backwards
with sufficient strength to occlude the trachea.
C. ASPHYXIA BY SUFFOCATION
Asphyxia by suffocation is exclusion of air from the lungs by
closure of air openings or obstruction of the air passageway from
the external openings to the air sacs.
SMOTHERING:
This is a form of asphyxial death caused by the closing of the
external respiratory orifices, either by the use of the hand or by
some other means. The nostrils and mouth may be blocked by the
introduction of foreign substances, like mud, paper, cloth, etc..
If the buccal and nasal orifices are occluded by the hand, there
may be abrasion and contusion of the nose and mouth. The findings
in death by smothering will be that of asphyxia.
Suicidal smothering by means of his own hand is not possible.
The moment the victim becomes unconscious, the instinctive release
of the pressure will save him.
Homicidal and accidental smothering is frequent. Accidental
smothering may occur when a person is under the influence of
alcohol, epilepsy or in any other helpless state. Accidental smother-
ing is common among children.
Overlaying is the most common accidental smothering in children.
The children may be suffocated either from the pressure of the
beddings and pillows or from the pressure of unconscious or a
drunk mother.
Accidental smothering of epileptic — A person may suffer from
epileptic or epileptiform fit and accidentally bury his face on soft
object like pillow, bedding or sand and die.
The same is true with pregnant women who may suffer from
eclamptic fit.
Gagging — The application of materials, usually handkerchief-,
linen or other clothing matters to prevent air to have access through
the mouth or nostrils. The pressure might be so severe that it may
cause injury to the buccal mucosa arfd teeth. It is homicidal.
Plastic bag suffocation — Plastic bags are made of synthe'tie
polyethylene that is transparent, tough and waterproof material
commonly used as a container. Children may place the bag over
their head and go down to the face covering the nostrils and mouth
and consequently cause suffocation because of the inability of the
children to extricate themselves by tearing it.
CHOKING:
This is a form of suffocation brought about by the impaction of
foreign body in the respiratory passage.
The most common foreign bodies impacted are:
a. Vomitus, especially when the person is under the influence of
alcohol.
b. Regurgitation of food from the stomach, as coagulated milk in
children.
c. Bolus of food.
Cafe' coronary — A restaurant patron apparently has a
sudden heart attack in the middle of his dinner and dies without
much untoward symptoms. Autopsy may reveal a large mass of
food lodged in his throat and the cause of death is in.fact
asphyxia by choking. This usually happens when the person has
a high blood alcohol level which apparently anesthetized his
gag reflex. It is an accidental rather than a natural death.
d. Detached membrane in diphtheria.
e. False set of teeth.
f. Blood in tonsillectomy operation.
g. Respiratory hemorrhage as in tuberculosis.
Most of suffocation by choking is accidental, although it may be
utilized in suicide or in homicide.
The post-mortem finding in suffocation by choking is the same as
other forms of asphyxia plus the presence of the foreign body in the
respiratory tract.
D. ASPHYXIA BY SUBMERSION OR DROWNING
This is a form of asphyxia wherein the nostrils and mouth has
been submerged in any watery, viscid or pultaceous fluid for a time
to prevent the free entrance of air into the air passage and lungs. It
is not necessary for the whole body to be submerged in fluid. It is
sufficient for the nostrils and mouth to be under the fluid. Children
may be drowned in an ornamental pool or "tilapia" pond, and an
epileptic or a drunk person may be found drowned in a shallow
creek.
Mechanism of Drowning:
When a person does not know how to swim and falls into a deep
body of water, his body will sink on account of the momentum of
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the fail and because the specific gravity of the human body is slightly
more than that of the water. Later, the body will be buoyed because
of the instinctive movement of the individual, coupled with the
presence of air underneath his clothings. While under water, the
breath is held but upon reaching the surface there i6 an attempt to
breathe. Air and water then gets into the mouth and nostrils. Then,
he will endeavor to raise his hand which will cause him to sink under
water. He then alternately appears and disappears on the surface and
everytime he attempts to breathe, water will get in. Because of the
entrance of the fluid, there will be violent coughing which will expel
the air in the lungs and creates an imperative desire to breathe,
during which more water is drawn in. The drawn-in water may go to
the lungs or to the stomach. The water fills the bronchioles forcing
the residual air to be in the lung surface and causing the lungs to
balloon and become soggy and edematous. Death usually occurs 2
to 5 minutes later.
Phases of Drowning:
1. "Respiration de surprise" occurring at the moment when the
mouth and nose are covered with fluid consisting of one deep
inspiration.
2. Phase of resistance which consists* of a short period of apnea due
to the irritation of the sensory laryngeal nerve endings by the cold
water.
3. Dyspneic phase with a forceful respiratory movement.
4. Another apneic phase.
5. Terminal respiration, after which the breathing stops permanently.
(Brouandel cited on Gradwohl's Legal Medicine by Camps, p.
277).
Causes of Death in Drowning:
1. Typical Drowning:
The primary cause of death in ordinary submersion in water is
asphyxia. The water interferes with the free exchange of air in the
air sacs.
2. Atypical Drowning:
In atypical drowning cases, the causes of death may be due to
the following:
a. Cardiac inhibition following submersion due to the stimulation
of the vagus nerve.
b. Laryngeal spasm due to submersion. The inhaled water may
cause spasm of the larynx.
c. Submersion when unconscious. A person may be drunk, or
suffering from cerebral aneurysm, cerebral hemorrhage, heart
disease, and suddenly collapse and falls in a body of water and
be unconscious when submerged. A complete picture of
drowning may not be found at the autopsy table.
3. Other Conditions Associated with Drowning:
a. The person might have fallen into the water and his body strikes
on a solid hard object which is capable of producing death by
itself.
b. The person might be under the influence of alcohol or other
depressants and incapable of helping himself.
c. Cramps might have prevented him from saving himself.
d. Shock due to fright or sudden exposure to cold might have
caused sudden heart failure.
e. The person might have died of some other causes independent
of drowning, like apoplexy, cardiac failure, etc..
f. The person might have been dead and thrown into the water.
Time Required for Death in Drowning:
Submersion for 1-1/2 minutes is considered fatal, if ordinary
efforts for respiration is made, however, a person may survive even
after 4 minutes of submersion. The average time required for death
in drowning is 2 to 5 minutes. It has been claimed that the length of
survival in drowning is proportional to the amount of froth in the
respiratory tract.
The power of recovery of human beings in drowning is inversely
proportional to the amount of froth in the air passage and the
penetration of water into the lung tissue. The amount of mucous
froth and the degree of penetration of water into the lungs as well
as the degree of subpleural ecchymosis is proportional to the effort
made to save himself.
If a dead body was recovered in water, the physician must be able
to answer the following questions:
1. Did death occur prior to entry in the water? If so, what was the
cause of death?
2. Did drowning cause death? If so, was it fresh or salt water?
3. Were there any ante-mortem injuries? If so, did they play any part
in the death?
4. Were there any post-mortem injuries? If so, did they play any part
in the death?
5. Was there any natural disease or any evidence of poisoning? If so,
did the findings contribute to the death in any way?
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6. What was the manner of death?
Emergency Treatment in Drowning:
Remove the bodily clothings especially the tight ones and wrap
the body with blanket.
Place the face down and perform artificial respiration, using any
of the following methods:
1. Schaefer's Method:
With the face down, the patient must be in a prone position.
The operator kneels astride the body and exerts pressure on the
lower ribs at the rate of 12 to 15 times a minute.
2. Sylvester's Method:
With the patient lying on his back, and the operator astriding
over the body, swinging the arms forward up and then pressing the
chest wall. This is repeated every 3 to 5 seconds.
2. Internal Findings:
Administration of stimulants as ammonia, aromatic vinegar, etc..
Injection of strychnine, coramine, caffeine, etc..
Inhalation of oxygen combined with 5% to 8% carbon dioxide
to stimulate respiration.
Post-mortem Findings:
1. External Findings:
a. Clothes are wet, face is pale and with foreign bodies clinging
on the skin surface.
b. Skin is puckered, pale, contracted in the form of "cutis anse-
rina," or "goose-skin," or "gooseflesh" particularly those of the
extremities and when the body is submerged in cold water. This
is due to the contraction of the arector pili muscles. This is not
diagnostic of drowning because it may appear before or after
death. The arector pili muscles may contract during the
process of rigor mortis so that "cutis anserina" may develop
after death.
c. Penis and scrotum may be contracted and retracted especially
when the body is found in cold water.
d. Washerwoman's hand and feet. The skin of the hands and feet,
is bleached, corrugated and sodden in appearance. This is not
diagnostic of drowning but proves only that the body has re-
mained in water for some time without reference as to the cause
of death.
e. Eyes are half-opened or closed, with eyelids livid, conjunctivae
injected and pupils dilated.
f. The mouth may be closed or half-opened with the tongue
protruding.
g. Post-mortem lividity is mostly marked in the head, neck and
chest. This is due to the gravitation of blood in those areas
when the body was immersed in water.
h. Presence of firmly-clenched hands with objects as weeds, stones,
sand, etc., indicative that the person was alive when placed in
the water (cadaveric spasm). This is also indicative that there
was struggle of the victim for life.
i. Physical injuries may be present on the body surface which may
be indicative of previous struggle with an offender, effort of the
victim to save himself, hitting on hard and rough objects while in
water by the force of the current, or some other causes.
j. In suicidal drowning, pieces of stone or other heavy objects may
be recovered in pockets or clothings to facilitate submersion.
a. Respiratory System:
(1) "Emphysema aquosum" — The lungs are distended like
balloons, overlapping the heart, with rib markings on the
surface and protruded out of the chest upon removal of the
sternum. This is due to the irritation made by the inhaled
water on the mucous membrane of the air passage which
stimulate the secretion of mucous. The lungs are progres-
sively distended and the emphysema is due to the fact that
the air is driven by the fluid on the lung surface.
( 2 ) "Edema aquosum" — This is due to the entrance of water
into the air sacs which makes the lung doughy, readily pits
on pressure, and exudes water and froth on section.
( 3 ) "Champignon d'ocume" — This is the whitish foam which
accumulates in the mouth and nostrils. It is due to the
abundant mucous secretion of the respiratory passage which
by respiratory movement whips up the substance into foam.
Removal of the foam and followed by pressure on the chest
will produce further foam in the mouth and nostrils. This
finding is considered to be one of the indications that death
was due to drowning.
( 4 ) Tracheo-bronchial lumina is markedly congested and filled
with fine froth with foreign bodies that are also found in
the fluid medium where the body is recovered.
( 5 ) Blood-stained fluid may be found inside the chest cavity
and this is due to the permeation of water trapped inside
the air sacs.
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(6) The whole lung field may be congested but if there is an
abundance of water in the air sacs, it may appear pale.
(7) Section of the lungs shows the presence of fluid with bloody
froth.
b. Heart:
( 1 ) Both sides of the heart may be emptied or filled with blood.
The right side may be distended with blood while the left
may be emptied on the account of the distention of the air
sacs, thereby limiting the capillary flow.
(2) If drowning took place in salty water, the blood chloride
content is greater in the left side of the heart than in the
right, but if drowning took place in fresh water, the blood
chloride is more in the right than in the left. This is one
way to determine the place where a victim was drowned.
Gettler's Test:
This is a quantitative determination of the chloride content
of the blood in the right and left ventricle of the heart. The
demonstration of the difference of at least 25 mg. proves that
death occurred in fresh or salt water pool and drowning is the
cause of death.
Basis of the Test:
Normally, the chloride contents of the blood is the same in
both sides of the heart. But when water enters the alveoli it
goes with the circulation and is diffused with the blood. So
that if drowning took place in salty water pool the chloride
content in the right side of the heart will be less as compared
with the left, and the reverse is true when the victim was
drowned in fresh water. The test will not only determine the
cause of death as drowning but also where such drowning
took place — in fresh or salty water pool.
Fallacies of the Test:
(1) The victim might have been drowned in a salty water pool
where the chloride content of the water is quantitatively
similar as that of the blood. Inhalation of such fluid will
not make any difference in the chloride contents of the
left or right side of the heart. However, the cellular
count and hemoglobin percentage may be different.
(2) Reduction of blood chloride after death is a common
post-mortem phenomena. It could be possible that the
rate of reduction may not be the same on the right and
on the left side of the heart, thereby producing a differ-
ence although death was not due to drowning.
(3) Blood chloride estimation obtained twelve or more
hours after death from drowning in fresh water are of
little diagnostic value on account of the diffusion of the
fluid on both chambers of the heart.
c. Stomach:
There are plenty of fluid and other foreign materials that are
also found in the case of drowning. The absence of water shows
that death is rapid or submersion is made after death. It is
impossible for water to get into the stomach if the body is
submerged after death.
d. Brain:
The brain is congested and the big blood vessels are engorged.
e. Blood:
Aside from the difference in the chloride contents, the blood
becomes dark on account of the absorption of all its available
oxygen. There is a reduction of its hemoglobin contents on
account of dilution. The red blood cells may be crenated.
f. Other Organs:
The liver is engorged with dark fluid blood. The spleen and
the kidneys are dark in color and congested. Water may be
present in the middle ear due to violent inspiration when the
mouth is full of water.
Findings Conclusive that the Person Died of Drowning:
1. The presence of materials or foreign bodies in the hands of the
victim. The clenching of the hands is a manifestation of cadaveric
spasm in the effort of the victim to save himself from drowning.
2. Increase in volume (emphysema aquosum) and edema of the lungs
(edema aquosum).
3. Presence of water and fluid in the stomach contents corresponding
to the medium where the body was recovered.
4. Presence of froth, foam or foreign bodies in the air passage found
in the medium where the victim was found.
5. Presence of water in the middle ear.
Floating of the Body in Drowning:
The body may not immediately be recovered after drowning
because it is under the water. The specific gravity of the human
body is slightly more than that of the water. Within 24 hours, on
account of the decomposition which causes the accumulation of gas
in the body, the body floats. The floating of the body is markedly
influenced by the weather, condition of the fluid medium where
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DEATH BY ASPHYXIA
drowning took place, presence of wearing apparel, age, sex and body
built. The body when recovered, floats usually with flexed extre-
mities. This is due to the dominance of the flexor muscles over the
extensors in the process of rigor mortis. The head is submerged
because it has a higher specific gravity than the rest of the body.
And because the head is now the most dependent portion of the
body, more blood accumulates in the face. This explains the dark
bloated condition of the face during the early stage of decomposition,
otherwise known as "fete de negri" or the bronze color of the head
and neck of a person who died in water during the process of decom-
position.
Determinations Whether Drowning is Suicidal, Homicidal
Accidental:
1. Suicidal Drowning:
a. Heavy articles or weight may be found in the pocket of cloth-
ings.
b. Presence of a suicidal note.
c. Determination of the strong reason for him to commit suicide.
d. Mentality of the person.
e. Study of the character and manner of the person previous to
the commission of suicide.
f. History of previous attempt to commit suicide.
2. Homicidal Drowning:
a. There are evidences of struggle like physical injuries and de-
struction of the clothings of the victim.
b. Articles belonging to the assailant may be found near the place
where the deceased was recovered.
c. Presence of a motive for the killing.
d. Presence of ligature on the hands or legs which could not
possibly be applied by the victim himself.
e. Presence of physical injuries which could not have been self-
' inflicted, like gunshot wound at the back, severe injuries in the
head, etc..
J f. Testimony of witnesses.
I 3. Accidental Drowning:
\ a. Absence of mark of violence on the body surface.
\ b. Condition and situation of the victim immediately before death
which may make one inclined to believe that it is accidental.
c. Exclusion of suicidal or homicidal nature of the drowning.
d. Testimony of a witness or witnesses who saw the incident
happened.
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449
E. COMPRESSION A S P H Y X I A , (TRAUMATIC
OR CRUSH ASPHYXIA)
This is a form of asphyxia whereby the free exchange of air in the
lungs is prevented by the immobility of the chest and abdomen due
to external pressure or crush injury.
In homicidal cases, the assailant may kneel on the chest of the
victim or squeeze the victim between the arms and legs as in wrest-
ling.
In accidental cases, the body may be pinned between two big
objects or collapsing building on the ground.
Very rarely is traumatic asphyxia attempted in suicide.
It may be caused by:
or
1. Sudden fall of earth or masonry or when the victim is buried
under a pile of sand.
2. The victim might be pinned under the rubble of a collapsed
building.
3. Crushed in a highway accident.
4. Sudden fall of materials from the roof of a road in mines.
5. Crushed in a crowd, usually accidental.
Post-mortem Findings:
1. The body exhibits a purplish-black cyanosis of the face and neck.
2. Clothings may produce irregular pattern on the skin and areas
where buttons are located may look pale.
3. Small subcutaneous petechial hemorrhages on the skin of the
face, chest, shoulder and neck.
4. Congestion and petechial hemorrhages of the sclera and con-
junctiva.
5. Compression might be sufficient to fracture the ribs.
6. Heart and big blood vessels engorged with dark fluid blood.
7. Contusion with petechial hemorrhage of the lungs.
8. Other signs of physical injuries brought about by the compressing
material.
Burking:
This is a form of traumatic asphyxial death invented by Burke and
Hare for the purpose of murdering people to be sold to medical
schools for dissection. The murderer kneel or sit on the chest and
with his hands close the nostrils and mouth of the victim. By this
method, there will be no external marks to indicate how respiration
has been obstructed. Internal examination may show signs of
asphyxia.
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Death by Crucifixion — When a person is nailed on a cross the weight 20-30 Throbbing headache, emotional instability,
is supported by the nailed feet. In order to breathe, the person had irritability, fatigue, lethargy (may be mistaken
to raise his body and then throw his weight on his feet. When on for intoxication).
the cross, the intercostal muscles are stretched and the chest cage is 30-40 Severe headache, nausea and vomiting, dizziness
fixed. The alternative raising and lowering of the body lead to ex- and confusion, ataxia, dyspnea.
haustion, unconsciousness and death from asphyxia. Because of the 50-60 Syncope, coma with convulsion, tachycardia.
difficulty of the chest movement, this type of death may be classified 60-70 Increasing coma with incontinence.
as traumatic asphyxia. Profound coma with convulsion.
70-80
F. A S P H Y X I A BY B R E A T H I N G IRRESPIRABLE GASES Above 80 Rapid death from a respiratory arrest.
(From: GradwohVs Legal Medicine by Camps, Robinson & Lucas,
CARBON MONOXIDE (CARBONIC OXIDE GAS, CO "SILENTKILLER "): 3rd ed., 1976, John Wright & Sons Ltd.).
Carbon monoxide is formed from the incomplete combustion of
Qualitative Test for Carbon Monoxide in the Blood:
carbon fuel. The fatal carbon monoxide poisoning usually involves
burning of wood, oil, coal, kerosene and charcoal used in heating 1. KunkeVs Test — The suspected blood, diluted with 4 volume of
or cooking, or gasoline engines in cars. water is mixed with three times its volume of 1% tannic acid
solution and shaken well. If carbon monoxide is present, a crim-
Carbon monoxide, is sometimes called the "silent killer", it is a
son-red coagulum which retains its color for several months will
colorless gas, insoluble in water and alcohol. When inhaled it com-
develop. Normal blood forms a coagulum, which is, at first red,
bines with hemoglobin to form carboxyhemoglobin. Carboxy-
and becomes brown in the course of one to two hours and then
hemoglobin is 250 times more stable than oxyhemoglobin. When
gray up to 24 to 48 hours.
carbon monoxide is in circulation, aside from limiting the oxygen
carrying capacity of the blood, it further prevents the release of oxygen 2. Potassium Ferrocyanide Test — 15 cc. of blood is mixed with
from oxyhemoglobin, thereby increasing the insufficient oxygen equal amounts of 20% potassium ferrocyanide solution and 2 cc.
supply to the tissue. The occurrence of symptoms in carbon mon- of dilute acetic acid and shaken gently. A bright red coagulum
oxide poisoning depends on the rapidity of intoxication, ability of will be formed if the blood contains a carbon monoxide, while a
the individual to tolerate the lack of oxygen and the presence of dark brown coagulum will be formed if the blood is normal.
other depressant drugs, usually alcohol. The main action of carbon 3. Examination Through a Spectroscope — The characteristic bands
monoxide is oxygen deprivation and not its toxic manifestation, of car boxy hemoglobin will be shown.
so the oxygen deprivation of the tissue is the degree of saturation of 4. Gas Chromatograph.
hemoglobin with the gas. 5. Infra-red Analysis.
Accidental and suicidal death by carbon monoxide poisoning is
common. Victims may be accidentally imprisoned or deliberately CARBON DIOXIDE (C0 , CARBONIC ACID GAS):
2

enclose themselves in a room or garage with motor engine running Carbon dioxide is the gas blown out of the lungs during respiration,
or slow burning is present. product of complete combustion of carbon containing compounds,
Judicial death execution by gas chamber is utilized in some states and the end result of fermentation and decomposition of organic
of the United States. Sudden exposure to high concentration of the matters.
gas will cause almost a painless death.
It is a colorless, heavy gas often mixed with carbon monoxide and
Relationship of Carboxyhemoglobin and Symptoms: hydrogen sulfide and is often found in drainage pipes, deep wells,
Level of CO-H in a Symptoms sewage taftks and other places where decomposing organic matters
are present. Some refrigerants and dry ice is composed of carbon
% Saturation
dioxide.
Less 10 None.
10 — 20 Tightness across the forehead, mild headache, A small amount of gas which is mixed with air (2%) is a potent
breathlessness on exertion. stimulant to increase rate and depths of breathing, however, stronger
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concentration (10% or more) may cause ataxia, fall of blood pressure,
loss of reflexes, anesthesia, diminished respiration, dyspnea, dis-
comfort and muscular weakness. Greater concentration (60%) may
cause immediate loss of consciousness, with or without convulsion
and death. The inhalation of pure carbon dioxide may cause imme-
diate vagal inhibition with spasm of the glottis and death. Ordinarily,
the cause of death is asphyxia due to deficiency of oxygen supply to
the brain (anoxia).
The concentration of carbon dioxide is more in manhole, deep
well, brewery bat and poorly ventilated rooms.
Tests for the Presence of Carbon Dioxide:
1. Barium nitrate gives a white precipitate of barium carbonate with
carbonic acid.
2. Silver nitrate gives a white precipitate of silver carbonate when
carbonic acid is added.
Post-mortem Appearance:
Face is cyanosed, markedly blue and may be swollen, mouth may
be frothy and with congestion of the eyes.
Pupils are dilated and lungs is markedly congested.
Right side of the heart contains dark fluid blood with venous
engorgement.
Ecchymotic patches in small intestine, pericardium, pleura and
galea of the scalp.
Internal organs are dark in color and congested.
Blood examination shows quantitative increase of carbon dioxide
content.
Blood shows an increase amount of carbon dioxide.
HYDROGEN SULFIDE (SULPHURETTED HYDROGEN, H£):
Hydrogen sulfide is formed during a decomposition process of
organic substances containing sulphur. It is found in large quantities
in a sewer, septic tanks, drainage pipes, and deep wells. It may be a
by-product in some industries, like tannery, rayon factories, petro-
leum refineries, sulfur dye work, etc..
It is a colorless, transparent gas, sweetish taste and emiting an odor
similar to a rotten egg. The gas is soluble in water to form carbonic
acid and it burns in the air with a pale blue flame.
A dilute solution produces irritation of the eyes, nose, throat
and air passages, followed by dizziness, headache, nausea, vomiting,
abdominal pain, cyanosis, dilated pupils, cold extremities and labored
breathing. Prolonged exposure on a diluted atmosphere may cause
tetanic convulsion, delirium, stupor, coma and death.
Inhalation of a very dilute amount of gas may pass into solution
in the blood where it is rapidly oxidized by the oxygen of hemo-
globin to form a harmless or relatively non-toxic substance. Con-
centrated solution may cause immediate death.
Detection:
1. The offensive odor may be recognized even if the dilute gas is
one part in 10,000 part of air.
2. A piece of filter paper moistened with lead acetate will turn black
if it was brought in contact with the stomach or other organs
containing the gas.
Post-mortem Findings:
Putrefaction sets rapidly.
Offensive odor is noticed on opening the body.
Blood in fluid state, dark-brown in color is due to conversion of
hemoglobin to sulmethemoglobin.
Lungs are congested and edematous.
Other organs are congested and dark colored.
HYDROGEN CYANIDE:
Hydrogen cyanide is one of the most toxic and rapid acting gases.
It is formed by addition of acid to potassium or sodium salt of
cyanide. It is naturally found in leaves of cherry-laurel, in bitter
almond, in kernels of common cherry, plum, peaches, in ordinary
bamboo shoots, and in certain oil seed and beans. These plants
contain a crystalline glucoside known as amygdalin which, in the
presence of water and natural enzyme, called emulsin, is readily
decomposed into hydrocyanic acid, glucose and benzaldehyde.
Orally, the equivalent of 60 — 90 mg. of hydrogen cyanide is
fatal. As a vapor cyanide produces the following symptoms at
different level:
Amount in ppm Effect and Duration of Life
10 ppm Maximum permissible concentration.
20 ppm Slight symptoms after several hours.
100 ppm Very dangerous within 1 hour.
200 — 400 ppm Lethal within 30 minutes.
2,000 ppm Lethal immediately.
In a large dose, the symptoms appear within a few seconds or even
during the act of swallowing. It is rarely delayed beyond one or two
minutes.
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In smaller dose, the patient may be able to walk and speak or
perform volitional acts before death takes place.
In still smaller dose, the patient may still manifest symptoms such
as loss of muscular power, giddiness, slow and stertorous breathing,
with loss of consciousness which may or not be preceded by con-
vulsion before death. The average span of life after partaking the
drug is two to ten minutes. It is possible that life may be prolonged
for two to three hours, but in most cases the patient will recover,
if death does not occur within an hour.
For reasons that only a small quantity is needed to end ones life,
hydrogen cyanide is often used for suicide purpose.
Post-mortem Findings:
Body is livid or violet in color.
Post-mortem lividity is bright red or pink due to the formation of
cyanmethhemoglobin.
Fingers are clenched, fingernails are blue and jaws are firmly
closed.
Eyes are bright and glistening and pupils are dilated.
Odor of the acid may be noticed on opening the body.
Heart is engorged with bright red blood.
If the chemical is taken orally, mucous membrane of the esophagus
and the stomach may be congested and covered with froth.
Although, the term signifies true gas it may be a smoke, volatilized
liquid or finely divided solids.
Essential Characteristics of a Substance to be Considered as War Gas:
1. It must be a substance heavier than air. If it is lighter than air then
it will have the tendency to concentrate at a higher level of the
atmosphere, thereby it serves not its purpose.
2. It must be capable of spreading rapidly on the area where the
chemical effects is desired.
3. It must be capable of producing effect even in low concentration
on a specified area.
4. It may be a true gas, smoke, volatilized liquid or finely divided
solid.
5. It can be manufactured in big quantity in a relatively cheap price.
6. It must be a stable substance or not easily made non-toxic by
rapid chemical reaction.
7. It is capable of storage for an ample length of time. It must not
react freely with the container in which it is stored.
Classification Based on the Physiological Action:
1. Lacrimator or Tear Gas:
An exposure of the eye to the substance will cause irritation
with copious flow of tears. The most commonly used during the
last wars were:

SULFUR DIOXIDE: a. Chloracetophenone ( C . A . P . ) — Finely divided powder with sour

Sulfur dioxide is a colorless gas, which is heavier than air and with
pungent odor. It is employed as a disinfectant, as a bleaching agent,
a powerful reducing agent, and found usually in eruption of vol-
canoes.
The gas produces irritation of the respiratory passage, thus causes
sneezing, coughing, spasm of the glottis and suffocation.
It also irritates the eyes and causes congestion and lacrimation.
Post-mortem findings is not characteristic. There may be cyanosis,
with signs of asphyxia.
W A R GASES
Although, the term signifies its use in time of war, it may be also
used in riots, mobs or in any other situation where control or sup-
pression of the activities of the people on a specific area is desired.
Some of the agents included may cause death, however, when
applied in a lesser concentration it may only cause irritation, in-
convenience, weakening of resistance of defense and physical damages
on the victims.
fruit odor;
b. Bromobenzyl Cyanide ( B . B . C . ) — Heavy oily, dark brown
liquid with penetrating bitter-sweet odor;
c. Ethyl Iodoacetate ( K . S . K . ) — Dark brown, oily liquid with pear
odor.
They are fired from an artillery shell and an exposure to the
substance causes severe lacrimation, spasm of the eyelids, congestion
of the conjunctivae and temporary blindness.
In high concentration, the vapor causes irritation of the res-
piratory passages and lungs and produces a burning sensation in
the throat and discomfort on the chest.
A lo"rjg time exposure may cause vomiting, nausea, bronchitis
and blistering of the skin.
Gas mask may be used as a preventive measure and washing of
the affected eyes with boric acid solution. Sodium bicarbonate
solution may be applied in other affected areas.
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2. Vesicant or Blistering Gas:
Contact with the skin may cause bleb or blister formation.
a. Mustard Gas (Diehlordiethyl Sulfide, Yellow Cross, "Yperite"):
It is a heavy, oily liquid, having a mustard-like or garliky
odor and gives vapor at an ordinary air temperature. It is
insoluble in water but dissolves freely in paraffin, ether, ben-
zene, alcohol, acetone and carbon disulfide and it readily
penetrates clothings, leather, wood or brick, etc..
Contact with the liquid or vapor causes profuse lacrimation
and nasal secretion, laryngitis, nausea, vomiting and gastric pain.
It enters deeply into the clothings and skin causing intense
itching, redness, vesication and ulceration. Axilla, groin,
perineum and scrotum which are moist due to perspiration were
chiefly attacked. Exposed parts of the body, like the face,
neck and hands are also affected.
b. Lewisite (Chlorovinyl-dichlorarsine):
This is a heavy liquid having an odor of geraniums. It is
insoluble in water but rapidly dissolves in benzene, oil and other
organic solvents.
Contact with the skin causes erythema, vesicle with cloudy
fluid containing arsenic and leucocytes. As an asphyxiant it
acts more rapidly than mustard gas and produces more dis-
comfort.
3. Lung Irritants (Asphyxiant or Choking Gas):
These substances are released from tanks, canisters and gas
shells. When inhaled, they cause dyspnea, tightness of chest and
coughing, varying degree of conjunctival irritation, vomiting, coma
and death.
a. Chlorine (Cty ~~ A yellowish-green gas, about 2-1/2 times
heavier than air, with pungent and irritating odor.
Exposure to the gas produces irritation of the conjunctivae.
It causes laryngeal spasm, irritative cough, dyspnea, pain in the
chest, cyanosis, asphyxia, weak pulse and collapse. Death may
occur rapidly due to the spasm of the larynx.
Autopsy reveals massive edema of the lungs, with scattered
areas of pneumonic process. Pulmonary edema may cause
obstruction of the pulmonary circulation. Mucous membrane
of the air passage may show catarrhal inflammation.
b. Phosgene (COCI2) — It is a colorless gas, 3-1/2 times heavier
than air, decomposed in water into hydrochloric acid and
carbonic acid. It is ten times more toxic than chlorine, but
owing for its poor solubility its action is delayed.
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458 LEGAL MEDICINE
c. Chloropicrin — An oily liquid, smells like chlorine and about
four times more toxic than chlorine.
d. Dipho&gene — An oily liquid, heavier than phosgene and an
intense lacrimator.
Treatment consists of the removal of the victim from the
vitiated atmosphere, absolute rest, administration of oxygen
by inhalation aside from the symptomatic approach.
4. Sternutator (Nasal Irritants or Vomiting Gases):
Any person inhaling the air or swallowing food or water con-
taminated with the chemical would be stricken with coryza, nausea,
malaise, headache, vomiting, salivation and pain in the chest,
and prostration.
Some of the Compound Used During War Time are:
a. Diphenyl chlorarsine (D.A.) — Colorless, crystalline solid,
slightly soluble in water but dissolves in diphosgene and dichlo-
ropicrin.
b. Diphenylamine chlorarsine (D.M.) or Diphenylarsine-chlorasine
— yellowish crystalline solid.
c. Diphenyl (cyanarsine (D.C.) — White, odorless crystalline solid.
5. Paralysants (Nerve Gas):
N e w drugs which cause inactivation of cholinesterase and con-
sequent increase of acetylcholine causing paralysis at the myo-
neural junction. The manner of action is similar to organophos-
phates and carbamates insecticides.
6. Blood Poisons:
a. Hydrocyanic Acid (Hydrogen Cyanide or Prussic Acid) — a
powerful protoplasmic poison that prevents the tissue from
utilizing the oxygen of the blood.
b. Hydrogen Sulfide (Sulphurated Hydrogen) — When inhaled,
it passes into solution in the blood to form a harmless and
relatively non-toxic substance. If in a pure form or at a higher
concentration, it causes paralysis of the respiratory center,
giddiness, nausea, abdominal pain and irregular heart action.
c. Carbon Monoxide (Carbonic Oxide, CO) — This gas is combined
with hemoglobin of the red blood cells to form a stable com-
pound known as carboxyhemoglobin and reduces the oxygen-
carrying capacity of the blood.
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Chapter XVIII to the occurrence of crash. In highways, the absence of railing on

DEATH OR PHYSICAL INJURIES DUE TO
AUTOMOTIVE CRASH OR ACCIDENT
AUTOMOTIVE CRASH:
Factors Responsible to an Automotive Crash:
1. Human Factor (Driver):
a. Mental Attitude — reckless driving, showing of, inattention,
fatigue, inexperience.
b. Perceptive Defect — Defective vision incapable of seeing an
impending crash or defective hearing, unable to perceive whistle
of train or automotive horn.
c. Delayed or Sluggish Reaction Time — Reaction time is the
space of time the driver perceives an impending danger and the
actual application of the brake. A quick reaction time may
prevent the occurrence of a crash by sudden deceleration before
the impact occurs.
d. Disease — The driver may develop an epileptic fit or suffer
from a heart attack while on the steering wheel.
e. Chemical Factor — Alcohol is the most common. It blurs and
diminishes the field of vision, blunts the senses of hearing and
makes sluggish response to an impending danger.
Depressant drugs, like sedatives, tranquilizers, and narcotics
do prolong the reaction time, impairs the power of decision and
rational thinking.
Smoking marijuana may interfere with time and space per-
ception, and attention to complicated task of driving.
A leak in the exhaust system of the vehicle may cause entry
of carbon monoxide into the passengers compartment, especial-
ly in the air-conditioned cars, and may cause unconsciousness
of the occupants including the driver due to poisoning.
Other drugs, especially psychotrophic, may cause delirium,
unconsciousness which may cause impairment of reaction to a
traffic situation.
2. Environmental Factor:
Bad or poorly maintained roads, poor visibility, atmosphere,
rain, blind intersection, parked vehicle obstructing the view, trees
too close to the road, absence of road signs, etc. have contributed
459
the side of the road beside a deep ravine, precaution signs and
speed limits, curve or narrow strip have been responsible for
many fatalities.
Stiff and slippery road may prolong the sked time. Sked time
is the space of time between the actual application of the brake and
the stopping of car. Sked time is influenced by the condition of
the tire, condition of the ground and the amount of weight of
the load. Cars moving with worn out tires, on a sloping and slip-
pery road have the tendency to prolong the sked time.
3. Mechanical Factor:
Defect in the steering wheel, poor brake, transmission failure,
worn out tires, unstable body are potential source of vehicular
crash. The advent of modern high power engine and high octane
fuel are conducive to high speed sometimes beyond the control
of the driver. This is further enhanced with automatic trans-
mission which diminishes human factor in the control of the
vehicle.
4. Social Factor:
a. Speed is an added dimension in our life. Modern car manufac-
turers develop high compression, fuel economy and high speed
which are improvements of their new cars.
b. Does car insurance develop "devil may care" attitude on the
driver inasmuch as he will not be financially held liable for
damages as a consequence of a crash? Statistics has shown
that automotive accidents have increased tremendously recently.
5. Pedestrian.
Injuries and Death on the Driver and Passengers.
In automotive crash, there are two collisions that take place, namely:
1. First Collision — the impact of the moving vehicle with another
vehicle or a fixed object. The moving vehicle rapidly decelerates
and stops after the impact. The degree of damage on the vehicle
depends on the speed and part of the vehicle involved.
2. Second Collision — This is the impact of the unrestrained occu-
pants with the interior of the vehicle. Immediately, after the first
collision, the occupants move in the same direction and at the
same velocity towards the point of impact. That is, in the front
impact, the occupants moves forward and in the side impact the
passengers or driver moves towards the side that was involved
in the first collision. If the vehicle is not put into a stop after the
first collision, the unrestrained occupants will continue to strike
to some parts of the interior of the vehicle.
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Factors Responsible for Passenger and Driver Injury:
1. Displacement of the occupants within the vehicle with impact
against structures.
2. Ejection.
3. Distribution of the passengers in the compartment resulting in
direct impact injuries.
Front Impact Crash:
1. Driver — The driver may strike, the steering wheel, the hub of the
steering column, the windshield, the rear view mirror, the column
between the windshield and the side window, or the dashboard.
Severe impact of the driver's head on the windshield may cause
laceration of the scalp, face or neck. Skull fractures are often
observed.
The windshield glass is manufactured as two glass shields
separated by and adherent to a sheet of plastic. It is so made to
prevent breaking into pieces when force is applied on it.
Impact of the lower extremities against the dashboard may
cause fracture of the tibia, fibula, femur or pelvis as well as lacer-
ations and abrasion of the skin of (he area.
When the car is running with a high velocity before the im-
pact, the front portion of the car may be shortened or "accor-
dioned" and the steering wheel may be driven back into the
passenger compartment. As a result this may cause severe chest,
neck or facial injury. The impact of the face to the circular
rim of the steering wheel may cause fractures of the teeth, jaw and
facial bones.
2. Front Seat Passenger — Like the driver, the front seat occupant
may strike the dashboard, windshield, rear view mirror, radio,
air conditioner or the windshield wiper knobs which may protrude
from the dashboard.
Pattern of Injuries on the Front Occupants:
a. Abrasion of the face and scalp.
b. Laceration of the face and scalp.
c. Fracture of the skull.
d. Crashing injury of the neck.
e. Laceration or rupture of the heart.
f. Laceration and contusion of the lungs.
g. Fracture of the ribs and sternum.
h. Laceration of the liver and/or spleen.
3. Rear Seat Occupants:
They may strike the back of the front seat, the pillar between
the front and rear side doors, or may be propelled over the front
seat striking the front seat passenger and driver, dashboard or
windshield.
Side Impact Crash:
Side impact crash may occur when a vehicle strikes on the side of
another vehicle or when a vehicle 6kids sideways into another fixed
object. This is a common impact in street intersections. The in-
juries are more severe because the car has less crushable structural
components to absorb the force of the impact and the side of the car
are less rigid to prevent intrusion into the passenger compartment.
Since the side glass windows are not laminated with plastic control
layer, any force applied on it will result to large pieces of glasses
which cause laceration of the skin area in contact with it.
Since the passengers during the impact move towards the side of
the impact, the passenger nearest to it will suffer most. The lateral
impact to the chest may cause fracture of the ribs, contusion with
laceration of the lungs. Laceration of the spleen and kidneys and
pelvic fracture may also be observed in side impact.
Rear Impact Crash:
High velocity rear impact may occur following change of lane in
an express way or crash at the rear of a parked vehicle. With the
impact at the rear, the head moves backward or hyperextended.
Then, the head will move forward until the chin strikes the front
portion of the chest and with the neck hyperflexed. The backward
and forward movement of the head is known as "acceleration-decelera-
tion injury" or "whiplash". It may result to muscle spasm or
injury to the ligament of the neck resulting to pain.
The rear impact crash may involve the gas tank. It may deform
or puncture the tank, dislodges its connection and causes spillage of
the gas on the road. The spark from a metal part dragging on the road
may ignite the leaking fuel and consequently burns the car.
The striking vehicle may intrude into the passenger compartment
and causes injury to the persons at the back seat.
Roll Over Crash (Tum-turtle Impact):
In the process of rolling, the occupants may be pinned, crushed
or may be thrown away and fall on the ground.
On account of the long period of the process of rolling, the
passenger usually does not sustain severe injuries. The rolling process
causes the different sides of the vehicle to absorb the force of the
impact.
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While rolling, the unrestrained passenger may tumble inside the scars at the wrist or stab wounds in the chest and abdomen. Prior
vehicle and may sustain injuries from striking the interior of the psychiatric evaluation may reveal pathological findings and suicidal
vehicle. tendency.

Ejection of the Occupant: Homicide by Motor Vehicle:

The primary impact of the vehicle may forcibly open the unlocked
door. Ejection may increase further the injury sustained by the
occupant. The acceleration of the body after the second collision
may subject a person to his impact on the ground.
Means Employed to Minimize Injury to Driver and Passenger:
1. The interior surface of the car is so designed to be less hostile to
the person striking them. The use of soft padded dashboard,
windshield safety glass, dashboard with perforation to allow
metal to deform easily, enlarged and padded central steering
wheel hub and collapsible steering column are now parts of
modern built cars.
2. The interior of the passenger compartment, including the steering
wheel, dashboard, side doors are prevented from intruding into
the passenger compartment and strike the occupants.
3. The fender, bumper and other parts of the car commonly involved
in the impact are made of metal which can absorb energy, dis-
sipate such force and prevent its transmission to the driver and
passengers.
4. Special restraint to the occupants are being applied to reduce the
severity of the second collision in the forms of lap and shoulder
belt and air bag.
But, the use of seat belt is not absolutely considered as a safety
device. It may cause injuries to the abdominal wall, visceral
organs and vertebral column. The acute flexion of the trunk
(jacknifing) with the belt as the central fulcrum may cause frac-
ture of the trunk with the visceral organs in forward motion, may
stretch the mesentery and causes injury to the intestine and
mesentery itself. There may be abrasion, contusion and hema-
toma of the lower portion of the abdomen. All of these possible
injuries is known as seat belt syndrome.
Suicidal Crash:
This i6 usually a single vehicle and single occupant crash. It is a
head on collision with roadside object, pole or bridge support at a
high speed. There is no evidence of any effort to apply the brake or
to avoid striking the object. Crime scene investigation may show the
foot still on the accelerator pedal. History may reveal previous
attempts to commit suicide, as the presence of incised wounds,
Death by motor vehicle is usually on account of negligence and
rarely intentional. The driver may be reckless, lack the necessary
skill, aggressive, under the influence of drugs as the proximate cause
of the crash.
The simulation of a crash may occur to conceal a prior homicide.
Victim of other means of violent death (stabbing, shooting, mauling)
may be placed on the road to simulate that he is a victim of "hit and
run".
The driver may be shot while driving and lost control of the
vehicle to crash with another vehicle or fixed objects.
A careful investigation and post-mortem examination will reveal
the manner of death.
PEDESTRLAN-VEHICLE COLLISION:
Death or Physical Injuries to Pedestrian:
Pedestrian's injury or death is usually the result of two impacts
both of which are capable of causing severe trauma.
1. Primary Impact:
This is the first violent contact between the pedestrian and the
motor vehicle. Usually, the front bumper hits the leg of the victim.
The severity of the injury depends on the position of the victim
when the impact occurred, speed of the moving vehicle, and the
amount of bodily support (clothings and other apparel the victim
was wearing).
The movement of the body after the primary impact depends
on the location of the impact. If the contact is below the center
of gravity, the tendency of the body is to move backwards to
hit the hood, windshield or even the top of the car. The average
height of the bumper is 40 to 60 cms. from the ground and
considering the pedestrian with shoes on, the most common site
of the impact is the upper portion* of the leg. However, if the
driver had effectively applied the brake before the impact oc-
curred, the place of contact will be on a much lower level. This
is due to the downward dive of the front end of the vehicle
immediately following the application of the brake.
Fracture of the leg bones as a consequence of the primary
impact is called bumper fracture. The leg carrying the body
weight has more tendency to be fractured. If the victim is stand-
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ing and the body weight is supported by both legs, there is more
chance for the bones of both legs to be fractured. The end of the
fracture usually protrudes through the skin opposite the place
of contact of the leg with the bumper.
If the primary impact is above the center of gravity of the
pedestrian, the tendency of the body is to move away from the
vehicle and fall on the ground.
If the brake was applied during or immediately after the crash
the car slow down faster than the movement of the pedestrian
who continues moving forward and land on the road. If no
brake was applied during the accident and at high speed, the
pedestrian will pass over the top of the hood, windshield and
windshield frame.
2. Secondary Impact:
This is the subsequent impact of the pedestrian to .the ground
after the first impact. The injury sustained by the pedestrian
depends mostly on the force of the ground impact, nature of the
road and part of the body involved. It is the secondary impact
that accounts for the multiple abrasions and contusions on the
body of the pedestrian-victim.
3. Run Over Injuries:
Children who receive the primary impact above the center of
gravity may fall on the ground with the car wheel passing over
the body. The pedestrian may be run over by the moving vehicle
during the initial impact or thereafter. Crash fracture, skid or tire
marks, rupture of organs and internal hemorrhage may be seen at
autopsy. Usually, the victim dies of shock and death that in most
cases it is instantaneous, especially when there is a crashing injury
on the head.
4. Hit-and-run Injuries:
A fast moving vehicle may run over, hit or side-swipe a pedestrian
or collide with another vehicle or fixed object and get away from
the scene without regard to the unfortunate victim. This usually
happens when the driver is drunk or "high", at night time, in an
isolated road and with no eyewitnesses or someone who could
take note of the identity of the vehicle.
Tire thread marks, abrasion prints of parts of the vehicle in
contact with the victim and paint detached from the vehicle found
in the crime scene or body of the victim may be submitted for
laboratory analysis, for comparison with that one of the suspect
car.
The suspected car may be examined for the presence of blood
stains, hair or clothings of the victim for comparison with that
one of the victim.
If the car has been damaged as a result of the impact, the
investigator must make a diligent search of it in the motor shops.
Eyewitness may be able to take note of the plate number and the
identity of the vehicle can be checked at the Land Transportation
Commission.
Evidences in Vehicular Crash:
1. From the Scene of the Crime:
a. The area of the road where the collision took place and the
point of impact on the vehicle. A photograph or sketch must
be taken to determine who violated the traffic rules and regu-
lation.
b. The skid and tire marks on the road must be noted and pre-
served to determine identity of the vehicle and whether the
driver stepped on the brake immediately before the crash.
c. Condition and position of the victim (pedestrian or occupants).
d. Condition of the vehicle involved in the crash and of other
structures in the vicinity.
e. Blood, paint stains, pieces of clothings that may be found in the
body of the victim, ground or on the vehicle.
f. Narrations of witnesses as to how the incident took place
including the identity of the vehicle and the victims.
2. From the Driver:
a. Fitness to drive — Capacity to manipulate the steering wheel,
step on the brake and accelerator, visual and hearing percep-
tion, reflex time, heart condition, history of epileptic seizure,
etc..
b. Alcoholic drunkenness — A person with at least 0.15% alcohol
in the blood is considered drunk. Some countries consider it
a crime driving with only 0.05% blood alcohol.
Examination for the presence of psychotropic, sedative or
narcotic drugs in the blood may be useful.
c. Injuries due to second collision — Like steering hub imprint,
fractured skull, multiple abrasions and laceration of the face
and scalp, fracture of the leg bones, ribs and sternum.
3. From the Victim in Vehicle-Pedestrian Collision:
a. Crush Injury:
The victim may manifest crushing injuries on the head with
multiple fractures at different parts of the body. Usually, the
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injuries are localized in certain areas of the body, especially

when the victim is run over by the vehicle. All ribs may be
fractured. Injuries of whatever description may be found.
b. Tire Thread Marks:
The pressure of the tire on the body surface may produce
abrasion marks. This may be utilized in the identification
of the vehicle in "hit and run" cases.
c. A brasion Marks:
The most common is the mark of the radiator, if the portion
of the body of the victim hits the radiator of the vehicle.
d. Paint Marks:
Occasionally, the portion of the car that produces the injury
leaves its paint on the skin or clothings of the victim. The paint
may be scraped for the purpose of comparing it with the sus-
pect's car.
e. Blood, Hair or Clothings of the Victim:
These may be found sticking on the part of the vehicle which
hit the victim. A careful removal and submission to the labora-
tory for comparison with that of the victim's is important.
f. Physical Defects of the Victim:
This may diminish the power of the victim to prevent the
injury like poor eyesight, sluggish response to a given stimulus,
etc..
g. Inebriation of the Victim:
The victim might have been under the influence of alcohol
and other depressant drugs. If dead, the organs principally the
blood and brain must be submitted for quantitative deter-
mination of alcohol.
Purposes of the Autopsy of Victims of Vehicular Accidents:
Although, it may appear incontrovertibly clear as to the cause of
death of a victim of vehicular crash, it is still imperative to perform
the routine post-mortem examination for the following reasons:
1. The examiner can give his opinion as to the deceased's position in
the vehicle or the pattern of the injuries correlated to the point
of contact with the vehicle.
2. Examination will determine whether death occurred as a result
of the crash and not due to a natural disease, poisoning, gunshot
wound or other causes prior to the crash.
3. In cases when more than one member of the family died in a
crash, the examiner can form an opinion as to who from among
468 LEGAL MEDICINE
them survived the longest. The question of survivorship may be
important in the settlement of the estate.
4. The size of the monetary reward in a civil suit may depend on the
nature and extent of the injuries suffered. The injuries that was
found will determine the pain and suffering of the victim and
may be one of the basis of damages.
MOTORCYCLE CRASH:
Reasons Why there is a High Percentage of Motorcycle Crash:
1. A motorcycle can attain a high speed compared with other or-
dinary road vehicle.
2. It has a small profile that the driver of other vehicles may fail to
see it.
3. At high speed and frequently in curves, the cyclist may lose con-
trol of the bike. It may hit a fixed object, the tire may skid, or
the cyclist may be drunk.
Whenever the motorcycle strikes another vehicle or a fixed object
the injuries is quite severe because:
1. There are so little crushable materials to absorb the impact that
the motorist himself is subjected to the severe force.
2. No restraint system is available to keep the operator and the
passenger on the bike and as a result, ejection from the motorcyle
is common.
The most common injuries sustained are on the head and legs.
Fracture of the skull and fractures of the leg bones are quite com-
mon. Most of the injuries are caused by the impact of the cyclist
on other objects.
Inasmuch as the cyclist i6 exposed to crashes, the only alternative
approach is the protective wearing apparel.
1. Leather jacket, thick pants, and gloves to protect the skin from
injuries that result from ejection.
2. Leather boots to protect from injuries of the bones of the feet
and legs.
3. Motorcyclist helmet which must be buckled to protect the head.
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Increase glycogen storage in muscle results in an increase of

Chapter XIX
DEATH OR PHYSICAL INJURIES
DUE TO ATHLETIC SPORTS
In line with the physical fitness program, an appreciable number
of people are now involved in athletic sports of their own choice.
This incidentally increases the number of injuries and fatalities.
Although most injuries and fatalities are, as a rule, due to accident
or from natural cause, inquiries as to the adequacy of the medical
supervision, sufficiency of training of the contestants, utilization of
the safety measures and proper observation of the rules may be the
subject-matters of medico-legal investigation.
muscle endurance.
The pre-game meal should be eaten 3 to 5 hours before com-
petition. The liver can store enough glycogen to last for 12 to
15 hours. Skipping breakfast before competition can result in
hypoglycemia and tiredness during competition.
Food should be eaten within 3 hours before competition
because postprandial hyperinsulinemia last for 2 to 3 hours.
Hyperinsulinemia at the start of exercise can cause hypoglycemia
and fatigue. Athletes' greatest nutritional need is fluid. Athletes
should drink cold water because it is absorbed faster and less likely
to produce cramps ( J A M A , Oct. 25, 1985).
A. BOXING

Some Aspects of Sport Development:
1. Training Method:
To develop weight-lifting, a lifter must lift a very heavy
weight during his practice. To develop speed, a runner must run
very fast during his practice.
Besides, two or three intense workout each week, an athlete
also needs one endurance workout.
2. Injuries:
If the athlete is injured, he is rehabilitated by not allowing him
to participate in the sport that caused the injury and by finding
another sport that does not cause pain.
Every time the muscles are exercised intensely, injuries occur
and it will take at least 48 hours for the muscles to heal.
Future recurrence is being prevented by correcting the cause
of the injury. Although, continuous exercise despite the pain
will result in further injury, neither is it necessary to stop exer-
cising altogether. For in every week without exercise, it may
take several weeks of training to regain prior condition.
3. Nutrition:
Muscle endurance depends on how much glycogen can be
stored in the muscle cells. The glycogen storing capacity can be
increased by exercising the muscles until most of the glycogen is
depleted. Depletion, in the average top runner, occurs at 1-1/2
to 2 hours while on a bicycle racer it is 3 to 5 hours.
Competitive athletes need to eat large amount of carbohydrate-
rich foods to help them store glycose as liver and muscle elvrn«w»n
Boxing as a sport is sometimes described as an "organized bru-
tality", "slaughter" and "carnage". Unlike other sports, the primary
objective of the combatants is to knock out or win by decision by
delivering a stunning or weakening punches. Generally, in most
6ports, the infliction of physical injuries are purely accidental but in
boxing, it is the direct and primary objective of the combatants.
So in this respect, boxing is considered to be one of the most brutal
among the athletic sports.
Consequently, the public has a varied reaction as to whether it
must be legalized or prohibited a6 an athletic sport.
1. Reasons W h y Boxing Should N o t Be Prohibited:
a. It takes wayward youths who are victims of the educational
system off the streets;
b. It teaches them self-discipline and controls and reinforces the
adage that nothing of value is acquired without hardwork and
sacrifice.
c. Self-confidence can only be promoted through an individual
sport where the athlete must rely in his own talent and believes
in his own ability. Only through conflict can hidden resources
surface.
2. Reasons Why Boxing Should be Prohibited:
a. There is too much risk of death or injury to the participants.
b. Unlike other sports, the intention of the combatants is to
produce injury as a principal way to win the contest. So,
young men should be discouraged from a pugilistic career.
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DEATH OR PHYSICAL INJURIES DUE TO ATHLETIC SPORTS 471
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3. Potential Injuries Suffered by Combatants in Boxing:

a. Inasmuch as the face is the target of the attack by the com-
batants, the most common site of lacerated wound is the
region of the eyebrow and the cheek (malar region). Bleeding
comes from the small blood vessels which are crushed between
the superficial bone and the force applied. Bleeding from the
eyebrow may drip downwards to the eye and causes irritation
and blurring of vision. If bleeding cannot be controlled on
A account of the severity of the injury, the referee may stop the
Rotational bout.
Acceleration
Protagonist may be knocked down or accidentally fall on
the canvass causing laceration of the scalp.
b. Serous effusion on the loose tissue around the eyeball and in
the eyelid may cause puffiness and closing of the eye. Hemor-
rhage due to the rupture of the blood vessels or the fracture of
the orbital plate of the frontal bone may cause swelling and
discoloration in or around the eye, known as spectacle hema-
toma may develop.
c. Trauma on the pinna of the ear may produce hematoma with
B subsequent necrosis of the auricular cartilage. After healing
Linear
Acceleration
and scarring process, the pinnas appear to be thick and irregular,
known as cauliflower ears.
d. Fracture of the nasal septum, mandible and maxillary bone
may develop as a consequence of a hard hook or a straight
blow. Fracture of the skull is quite unusual to develop because
of the difficulty to do so with a gloved fist. However, an
unconscious fall on the canvass may cause it.
e. Retinal detachment is one of the serious hazards of boxing
as it may cause partial or complete loss of vision.
f. Muscle cramps, sprain and dislocation may occur and may
C force the boxer to give up the fight.
Injury to Carotid
g. A kidney punch may cause peri-renal hemorrhage or laceration
of the kidney that causes it to lose its function and subsequent
uremia.
h. A blow on the face may cause laceration of the lip and buccal
mucosa with loosening or detachment of the teeth.

i. Intracranial injuries may cause serious sequelae of death to the

boxer.

( 1 ) Cerebral concussion or the transitory period of unconscious-

ness is a result from a blow on the head that may last for
a few seconds or longer. The loss of consciousness should
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never be dismissed lightly because recovery may only be an
interlude to some serious intracranial changes.
( 2 ) Subdural hemorrhage is the most common injury which
may be localized or extensive. The most common site of
hemorrhage is the middle cranial fossa. A blow on the jaw
is transmitted to the temporo-mandibular joint and then to
the middle cranial fossa. Repeated trauma on the skull
cause tearing of the dural emmissary veins.
( 3 ) Pontine hemorrhage, known to some as boxers hemorrhage
may be the result of severe beating. The acute flexion
and extension of the head during a series of blows may
cause the brain stem to be pinched over the tentorium
causing hemorrhage.
The effect on the brain of a boxing blow depends on the
location, direction, intensity, velocity and number of blows.
(1) Rotation (angular) Acceleration:
A blow which causes the rotation of the movable head
will cause the inert brain to lag behind the accelerated skull.
This is particularly true to a groggy fighter who has lost
control of his neck muscles in the head which is most
susceptible to sudden acceleration. The effects are:
(a) Subdural Hematoma — The bridging veins that connects
the brain with the superior saggital sinus of the dura
mater is tightly bound to the skull. These veins are
stretched when the skull accelerates. In turn, blood
accumulates in the subdural space causing compression,
edema and herneation of the brain.
(2) Linear (Translational Acceleration):
A straight blow on the face may cause focal ischemic
lesions, notably in the cerebellum. Vascular spasm as-
sociated with focal ischemia are known to occur after
subarachnoid hemorrhage and often manifest themselves
a few days after bleeding. In groggy boxers, sudden linear
acceleration also may produce hyperextension of the neck,
which is known to damage axons of the medullary-pontine
angle and the reticular substance, resulting to a knockout.
( 3 ) Injury to the Carotid:
Blows to the neck can damage the carotid. Dissecting
aneurysm or occlusion by thrombus may follow. Pressure
on the carotid sinus induces reflex mechanism that causes
hypotension and bradycardia associated with decrease
bloodflow to the brain. A loss of muscle tone and brief
fainting spell will contribute to a boxer's groggyness, and
increases his susceptibility to head acceleration by successive
blows.
( 4 ) Impact Deceleration:
After a knockout, the boxer hits the rope or mat. Fall on
the back produces rapid deceleration which typically results
in contre-coup contusions of the orbital surface of the
frontal lobes and the tips of the temporal lobes. The crest
of the convolutions are torn apart, which is associated with
parenchymal and sub-arachnoidal hemorrhage. Further-
more, the inert brain will glide within the cranial cavity,
causing para-saggital gliding contusion (small hemorrhage in
the cortical and subcortical white matter as well as sub-
dural hematomas).

( b ) Intracerebral Hemorrhage — The rotational movement
of the brain within the accelerated skull may tear vessels
within the brain. Such hemorrhage may develop in the
para-saggital regions of the cortex and subcortical white
matter. It may develop in the deeper white matter, the
corpus callosum and the cerebral peduncle.
(c) Diffused Axonal Injury — Damage to the axqn of the
white matter is common to head trauma. Microscopi-
cally, it is recognized by spherical enlargement of the
proximal and distal stumps. A few severed axons may
not be sufficient to produce clinical symptoms but their
number will increase with each bout and eventually
clinical deficits become apparent..
Cerebral Edema, Ischemia and Herneation:
Severe trauma on the head is usually followed by cerebral
edema. It increases pressure on the swollen brain within a
confined space of the cranial cavity which affects the blood
flow. The vessels are squeezed resulting in ischemia which
further contributes to edema.
The mounting pressure intracranially causes the brain to
herneate over the edge of the tentorium and through the
foramen magnum. Hemorrhagic necrosis of the brain at the
point of herniation (inferior temporal lobes and cerebellar
tonsils) develops rapidly. Death results from ischemia and
hemorrhage in the midbrain and upper pons after such her-
niation.
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Cerebral Atrophy, Enlarged Ventricle and Septal Cavum:
Gross examination of the brain from punch-drunk boxer
reveals enlarged ventricle, widened sulci and narrowed gyri.
The most typical finding is the presence of a large cavum
septi pellucidi with multiple fenestration. The septal cavum
is not infrequently observed as an incidental finding in autopsy,
but in boxers the width of the cavum is much larger, and
fenestrations are unusual in non-boxers. The repetitive rota-
tional acceleration of the head, in boxers, is believed to tear
the septal wall and causes spinal fluid to collect within the
cavum. Ventricular engorgement and atrophy are expected
to develop as a consequence of axonal and neural degeneration
(JAMA, Vol. 251, No. 20, p. 2676 (May 25, 1984).
Delayed Consequence of Brain Damage:
The delayed sequelae of intracranial damages in boxing is
summed up to what is commonly known as punch-drunkenness
or traumatic or pugilistic encephalopathy. This is characterized
by slurred speech, slow clumsy movement, unsteadiness of gait,
tremor, progressive dementia, poor tolerance to alcohol and
symptoms of progressive ventricular dilatation.
In case of thr> hypothalamus, and the pituitary gland are in-
volved on account of the fracture of the base of the skull, the
boxer may suffer from diabetes inspidus when the neuro-
pituitary gland is involved and hypothermia if the hypothalamus
suffered injury.
Post-Mortem Findings:
( 1 ) In case of death after the injury due to intracranial hemor-
rhage:
(a) Generalized edema of the brain.
( b ) Presence of intracranial hemorrhage usually subdural.
(c) Compression of the brain on account of massive hemor-
rhage.
( d ) Petechial hemorrhage in the white matter.
(e) Compression of the brain stem at the region of the
foramen magnum.
(f) Small areas of contusion on the brain surface.
(g) Histologically:
i. Perivascular and pericellular space.
ii. Capillaries show congestion with endothelial
swelling.
iii. Axons are swollen and poorly stained.
iv. Astrocytes appear swollen and nerve cells show
chromatolysis and cytoplasm vacuolated.
( 2 ) In case of death after a chronic sequelae:
(a) Abnormality in the septum pellucidum.
( b ) Cerebellar and other scarring.
(c) Small areas of scarring in the cerebellar tonsil and
medulla oblongata.
(d) Reduction of the brain weight.
(e) Lateral ventricle widely dilated with thinning of the
corpus callosum.
(f) Loss of pigmented nerve cells in the substantia nigra.
4. Measures Which Are Adapted to Minimize Injuries in Boxing:
a. Use of an effective gum shielding to avoid injury to the struc-
tures of the buccal cavity.
b. Use of heavier or well-padded gloves.
c. Use of preliminary binding of the hands with cotton or zinc
oxide adhesive plaster to reduce incidence of fracture and
displacement of the metacarpal bones.
d. A boxer who is "knocked out" or is stopped from fighting to
prevent further punishment must be thoroughly examined with
an electrocardiogram and his license to participate in any ring
combats must be suspended until a new certificate of fitness
is issued.
e. Spacing between matches, usually not less than a month, to
avoid too much muscular strain and it should be a part of the
regulation.
f. Amateur bout must not last more than five minutes and there is
a move to reduce title bout from fifteen to only ten rounds.
g. Blow on the genital region is considered a foul.
h. The use of stimulants is prohibited.
B. WRESTLING
1. Common Injuries Suffered by Combatants:
a. Injury to the cervical spine (fracture and/or dislocation) especial-
ly when the wrestler forms a bridge during the contest. There is
a bridge when the trunk and neck is hyper-extended and the
D o d y weight is supported by the head which touches the
ground and the feet.
b. Knee injury, usually meniscus or ligament tear that follows
hyperextension and rotation of the leg.
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Chapter XX

CHILD ABUSE OR NEGLECTED CHILD

DEATH OR PHYSICAL INJURIES DUE TO ATHLETIC SPORTS 477
c. Injuries to the shoulder joint and a rotator cuff result from
twisting of the trunk and upper extremities.
d. Facial injuries and mat burns due to contact of the face to the
floor.
e. Abdominal hemorrhage due to rupture of organs in violent
fall.
2. Regulations to Minimize Injuries:
a. Pulling of hair, ears and genitals, twisting of the digits, blows
with the fist, and kicking are forbidden.
b. Each contestant must have a medical examination immediately
before the combat.
c. A five minutes rest period must be allowed after any fall on the
head or any sign of bleeding from the nose.
d. The competitors must be freshly shaven, the hair must be short
and no grease or lubricant may be used in the body.
(Battered child, Battered child syndrome, Maltreatment syndrome,,
Maltreated child, Physically abused child, ni-treated syndrome.)
It is the physical and mental injury or maltreatment of a child by
a person who is responsbile for the child's welfare, under circum-
stances which will indicate that the child's health or welfare is
harmed or threatened thereby. The infliction must be willful and
not accidental.
The victim is of tender age, usually less than 3 years old. It occurs
in all levels of the economic strata. Usually, only one child is in-
volved. Parents are frequently immature, self-centered, impulsive
and with poorly controlled aggression.
Duties of Parents:
Art. 46, The Child and Youth Welfare Code — General Duties:
Parents shall have the following general duties toward their children:
(1) To give him affection, companionship and understanding;
( 2 ) To extend to him the benefits of moral guidance, self-discipline
and religious instruction;
(3) To supervise his activities, including his recreation;
(4) To inculcate in him the value of industry, thrift and self-
reliance;
(5) To stimulate his interest in civic affairs, teach him the duties
of citizenship, and develop his commitment to his country;
( 6 ) To advise him properly on any matter affecting his develop-
ment and well-being;
(7) To always set a good example;
(8) To provide him with adequate support, as defined in Article
290 of the civil Code:
Support is everything that is indispensible for sustenance,
dwelling, clothing and medical attendance, according to the
social position of the family.
Support also includes the education of the person entitled
to be supported until he completes his education or training
for some profession, trade or vocation, even beyond the age
of majority. (Art. 290, Civil Code).

478
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(9) To administer his property, if any, according to his best
interest, subject to the provision of Article 320 of the Civil
Code:
The father, or in his absence the mother, is the legal ad-
ministrator of the property pertaining to the child under
parental authority. If the property is worth more than two
thousand pesos, the father or mother shall give a bond subject
to the approval of the Court of First Instance (Art. 320,
Civil Code).
Rights of Parents:
1. Under the Child and Youth Welfare Code:
Art. 45, Right to Discipline the Child — Parents have the right
to discipline the child as may be necessary for the formation of
his good character, and may therefore require from him obedience
to just and reasonable rules, suggestions and admonitions.
2. Under the Civil Code:
Art. 316 — The father and the mother have, with respect to
their unemancipated children:
( 1 ) The duty to support them, to have them in their company,
educate, and instruct them in keeping with their means, and
to represent them in all actions which may redound to their
benefit;
(2) The power to correct them and to punish moderately.
Act or Omission Affecting the Child's Health or Welfare:
1. Physical Abuse — The law allows chastisement for discipline but
it may be physical abuse when it involves the use of instrument or
fist blow. It may include the act of physical or emotional persua-
sion that forces or places the child in a potentially dangerous
situation in which the subsequent and significant physical injuries
are severe enough to require medical treatment.
2. Physical Neglect — It is the failure to provide the child with the
necessities of life. It may include inadequate or insufficient
medical care, nourishment, clothings, supervision, housing, or the
like. The failure to provide must be willful.
(3) Child born as a consequence of rape.
c. Congenital or acquired deformity of the child.
d. Child allegedly giving "bad luck" to the family.
2. Abusive Parent:
a. Uncontrollable abuse by psychotic, pervasively angry or tem-
peramental parent.
b. Controllable abuse by compulsive disciplinarian or impulsive
but generally inadequate parents.
3. Child as a center of a triangle — In the case of a couple or mother
"live-in" boyfriend, more often the child is placed in the middle
of an emotional triangle. When resentment builds between them,
the child commonly becomes the target of man's hostility.
4. Child may be a hindrance to the socio-economic activities of the
parents.
Classification of Child Abuser:
1. Intermitent Child Abuser — Parents who periodically batter a child
with periods of proper care between battering. They do not
intend to hurt the child, but they are driven by panic or com-
pulsion into abusive behavior. Apparently they become sincerely
remorseful afterwards.
2. One-time Child Abuser — Parents who manhandle their children
for a time and never repeat the act. However, there is more
likehood for a one-time abuser to repeat the act until the child
is killed or had experienced a sudden surge or self-restraint.
3. Constant Child Abuser — Parent who actually hates his or her
child and callously and deliberately beats and miscares for it.
Parent had the intention to hurt the child and be indifferent to
the child's sufferings. These parents often have personality
disorders and are cooly indifferent to the destructive nature of
their action.
4. Ignorant Abuser — This group is perhaps the most tragic because
the parents "mean" well, but their attempts at rearing their
children result in a permanent injury or death of their children,
and they are "truly sorry" when the child dies (Battered Child
Syndrome, Legal Medicine 2980 Wecht & Lorkins, p. 32).

Causes of Child Abuse or Neglect: Medical Evidence Tending to Show Injuries Due to Abuse:
1. Unwanted Child: 1. Skin imprints from forcefully striking objects — Hand, cord, chain.
a. Husband disputing the paternity of the child. 2. Multiple bruises and/or scars, particularly on the trunk, head and
b. Illegitimacy: face.
(1) Child born of unmarried woman. 3. Multiple small burns or emersion burn levels — cigarette. i ™ n

(2) Wife committed adultery. boilir>tr n r a + m .

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4. Multiple fresh healing fractures; "twist" fractures.
5. Trauma to the mouth, nose, ears and eyes.
6. In case of sexual abuse, injuries to the genitalia, peri-rectal and
peri-vaginal may be present.
7. In case of child neglect, signs of mainourishment, poor hygiene,
infection, poor growth and development may be observed.
Facts to be Considered to Suspect that a Child is a Victim of Abuse:
1. The child is emotional, fearful and with a vague history of injury.
2. The parents present a vague and defensive detail of the child's
"illness" or "injury".
3. Too many previous unexplained signs of injuries or history of
previous illness.
4. Parents have extended delay in seeking medical cure.
5. Poor growth and development of the child.
Social Reaction To Child Abuse and Neglect:
1. Report of Maltreated or Abused Child:
Art. 166, Child and Youth Welfare Code ( P . D . 603):
All hospitals, clinics and other institutions as well as private
physicians providing treatment -shall, within forty-eight hours
from knowledge of the case, report in writing to the city or
provincial fiscal or to the Local Council for the Protection of
Children or to the nearest unit of the Department of Social
Welfare (Ministry of Social Service and Development), any case
of a maltreated or abused child, or exploitation of an employed
child contrary to the provisions of labor laws. It shall be the
duty of the Council for the Protection of Children or the unit of
the Department of Social Welfare to whom such a report is made
to forward the same to the provincial or city fiscal.
Violation of this provision shall subject the hospital, clinic,
institution, or physician who fails to make such report to a fine of
not more than two thousand pesos.
According to Administrative Order No. I — A, series of 1981 of
the Ministry of Health, dated July 6, 1981:
The report shall be submitted directly to the nearest Ministry
of Social Services and Development Office copy furnished the
police authority concerned and the Provincial/City Fiscal.
The report shall include the following information:
a. Name of child.
b. Date of birth, age and sex.
c. Date and time of admission.
d. Name of person who brought the child to the health institution.
e. Address and relationship to the child.
f. Name and address of the father /mother /guardian of the child
if other than the person who brought the child.
g. Tentative date of discharge.
h. Medical findings/case summary relative to the maltreatment/
abuse/exploitation of the child.
i. Evidence of parent's/employer's negative attitude towards the
incident.
The health authority concerned shall ensure that the report is
acknowledged in writing by the Ministry of Social Services and
Development Office within 24 hours."
Art. 167, Child and Youth Welfare Code — Freedom from Lia-
bility of the Reporting Person or Institution:
Persons, organizations, physicians, nurses, hospitals, clinics and
other entities which shall in good faith report cases of child abuse,
neglect, maltreatment or abandonment or exposure to moral danger
shall be free from any civil or criminal liability arising therefrom.
The provision of the Child and Youth Welfare Code ( P . D . 603),
Art. 166 requiring mandatory reporting of child abuse by phy-
sician and medical institution has its advantages and disadvantages.
a. Advantages:
(1) It compels the hesitant physician or medical institution to
report such child abuse or neglect so that proper remedial
measures can be applied to protect the child.
( 2 ) The fact that the child under treatment due to the act of the
parent(s) was known by the physician in the process of
history taking, makes such information privileged or con-
fidential and the physician normally has no right to disclose
such information. But Art. 167 of the Code provides for
freedom from liability of the reporting person, thereby
placing the traditional right of the child above the parent's
right to the privileged communication.
b. Disadvantages:
(1) It increases the health hazard of the child as the abusing
parents will be reluctant to seek medical aid for the abused
child.
( 2 ) The law's concentration on one child as seen by a physician
fails to concern itself with the possibility of danger to the
other siblings within the family.
(3) If the reported parents are exonerated, released and re-
united with the family, the pent-up anger felt against the
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authority may be released against the vulnerable child.

2. The court may deprive parents of their authority over the child
484 LEGAL MEDICINE
or adopt other measures for the welfare of the child:
Art. 332, Civil Code:
When the death of the minor shall result from such
The court may deprive the parents of their authority or suspend abandonment, the culprit shall be punished by prision
the exercise of the same if they should treat their children with correccional in its medium and maximum periods; but if
excessive harshness or should give them corrupting orders, coun- the life of the minor shall have been in danger only, the
sels or examples, or should make them beg or abandon them. penalty shall be prision correccional in its minimum and
In these cases, the court . . . or adopt such measures as they may medium periods.
deem advisable in the interest of the child.
The provisions contained in the preceding paragraphs
The court has a wide range of powers designed to give the shall not prevent the imposition of the penalty provided
highest practicable degree of flexibility in making dispositional for the act committed, when the same shall constitute
decision. a more serious offense.
The judge may simply warn parents or counsel them. He may ( 2 ) Art. 277, Revised Penal Code — Abandonment of minor by
order medical and psychiatric treatment for the child and/or person entrusted with his custody; indifference of parents:
for the parents. He may order the child to be in a protective
The penalty of arresto mayor and a fine not exceeding
supervision in a welfare home. Although the parents have the
500 pesos shall be imposed upon anyone who, having
right of custody of their children, the children have also the right
charged with the rearing or education of a minor, shall
to live. The judge must exercise sound discretion in balancing
deliver the said minor to a public institution or other
their respective interests.
persons, without the consent of the one who entrusted
such child to his care or in the absence of the latter, with-
3. Establishment of public and private welfare institutions for the
out the consent of the proper authorities.
care of abused, neglected, abandoned, infirmed, or other con-
ditions which require aid, support or treatment. The same penalty shall be imposed upon the parents
who shall neglect their children by not giving them the
4. Abuse, neglect or abandonment of children is made a criminal act education which their station in life requires and their
or omission: financial condition permits.
a. If the child dies, then the offender is guilty of parricide:
Other Battered Victims:
Art. 246, Revised Penal Code — Parricide:
1. Battered wife — The wife may be periodically subjected to mal-
A n y person who shall kill his father, mother or child, whether treatment by the husband on the account of jealousy, infidelity,
legitimate or illegitimate, or any of his ascendants, or his or incompatability of character. Attempt of the husband on the
spouse, shall be guilty of parricide and be punished by the life of the wife is one ground for a legal separation.
penalty of reclusion perpetua to death.
2. Battered grannies (battered grandfather or battered grandmother)
b. If the child did not die but was a victim with physical injuries,
— Elderly persons may be extremely demanding, seeking more
the offender can be charged with frustrated parricide, or phy-
attention from the caring descendant or with child-like behavior
sical injuries: which may be irritating and which may cause infliction of physical
c. If the child is abandoned or neglected, the offender can be injuries. The same situation may happen where an over-demand-
charged for abandonment of minors: ing boarder may suffer maltreatment from the overworked care-
(1) Art. 276, Revised Penal Code —Abandoninga minor: taker of the home for the aged.
The penalty of arresto mayor and a fine not exceeding
500 pesos shall be imposed upon anyone who shall abandon
a child under seven years of age, the custody of which is
incumbent upon him.
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Chapter XXI
MEDICO-LEGAL ASPECTS
OF
SEX CRIMES
VIRGINITY A N D DEFLORATION
A. VIRGINITY
Virginity is a condition of a female who has not experienced
sexual intercourse and whose genital organs have not been altered
by carnal connection.
A woman is a "virtuous female" if her body is pure and if she has
never had any sexual intercourse with another, though her mind and
heart is impure (Thomas v. State, 19 Ga. App. 104, 91 S.E. 247,
250).
3. Demi-Virginity — This term refers to a condition of a woman who
The presumption of a woman's virginity arises whenever it is
shown that she is single and continuous until overthrown by proof
to be contrary (U.S. V. Alvarez, 1 Phil. 242). A woman is presumed
to be a virgin when unmarried and of good reputation.
A defendant has the previous sexual intercourses with the
victim before he was charged'with consented abduction for acts
committed thereafter. The woman was considered "virgin" within
4. "Virgo Intacta" — Literally the term refers to a truly virgin
the meaning of the law (U.S. v. Casten, 34 Phil. 808). However, in
another case, it was established that the defendant's character,
before the alleged seduction, was opened to question. The woman
considered no longer a virgin (U.S. v. Suan, 27 Phil. 12).
of Virginity:
1. Moral Virginity — The state of not knowing the nature of sexual
life and not having experienced sexual relation. Moral virginity
Parts of the female body to be considered in the determination of
applies to children below the age of puberty and whose sex
the condition of virginity:
organs and secondary sex characters are not yet developed.
1. Breasts — The breasts (mammary glands) are functionally related
2. Physical Virginity — A condition whereby a woman is conscious
of the nature of the sexual life but has not experienced sexual
intercourse. The term applies to women who have reached sexual
maturity but have not experienced sexual intercourse.
There are no conclusive medical findings to show that a woman
is physically virgin. Reliance is given to the absence of laceration
of the hymen, but a woman might have had previous sexual
485
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intercourse and yet the hymen was unruptured while others might
not have the experienced of sexual relations but have laceration
of the hymen.
If the findings show absence of laceration of the hymen, dis-
tinction should be drawn between true and false physical virginity.
a. True Physical Virginity — A condition wherein the hymen is
intact with the edges distinct and regular and the opening small
to barely admit the tip of the smallest finger of the examiner
e. n if the thighs are separated.
b. False Physical Virginity — A condition wherein the hymen is
unruptured but the orifice is wide and elastic to admit two or
more fingers of the examiner with a lesser degree of resistance.
The hymen may be laxed and distensible and may have previous
sexual relation. In this particular instance the physician may
not be able to make a convincing conclusion that the subject
is virgin.
permits any form of sexual liberties as long as they abstain from
rupturing the hymen by sexual act. The woman may be embraced,
kissed, may allow her breasts to be fondled, her private organ to
be held and other lascivious acts. The woman allows sexual
intercourse but only "inter-femora" or even "inter-labia" but not to
the extent of rupturing the hymen.
woman; that there are no structural changes in her organ to infer
previous sexual intercourse and that she is a virtuous woman. In-
asmuch as there are no conclusive evidences to prove the existence
of such condition, liberal authorities extend the connotation of
the term to include women who have had previous sexual act or
even habitually but had not given birth.
to the reproductive system since they secrete milk for nourish-
ment of the young child. At their inner structures are 15 to 20
lobes of glandular tissues supported by conr>active tissue name-
work with variable amount of adipose tissue.
On the ventral surface of each breast is a cylindrical projection
called nipple and at its rounded tip are perforations which are the
openings of the ducts draining the milk glands. The nipple is
surrounded by a pigmented area called areola which becomes dark
brown during pregnancy.
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The size, consistency and shape of the female adult breast
varies with age, degree of physical development, stage in the
menstrual cycle, pregnancy, nutrition and hormonal factors.
A fully developed breast may be classified according to shape
as follows:
a. Hemispherical Breast — The breast is like a hemisphere. The
contour lines are not straight but form part of a circle or half
of a sphere.
b. Conical Breast — The breast has the shape similar to a cone.
The outline consists of two converging lines which meet at the
region of the nipple.
c. Infantile or Flat Breast — The breast is only slightly elevated
from the chest without distinct boundary and showing no
definite shape.
d. Pendulous Breast — The skin of the breast is loose making it
capable of swinging in any direction. This is commonly ob-
served among parturient breast-feeding mothers. A pendulous
breast may be:
( 1 ) Hemispherical pendulous breast — It has the shape of a
hemisphere but with loose skin.
( 2 ) Conical pendulous breast — It has the shape of a cone and is
capable of swinging sidewise.
The condition of the breast is not a reliable evidence to deter-
mine virginity. The size, shape and consistency of the breast may
be hormonal or hereditary. The advent of artificial feeding makes
it possible for parturient women to preserve the condition of the
breast.
2. Vaginal Canal:
As a general rule, the vaginal canal of a virgin is tight and the
rugosities are sharp and prominent. Insertion of a finger or
instrument may show certain degree of resistance. The wall of
the vagina is composed of smooth muscle and fibroelastic con-
nective tissue so that its tightness and degree of resistance on
insertion of a finger or an instrument depends on the integrity of
its wall, as well as on the potency of its lubricating secretion. The
sharpness of the wall's rugosities may be diminished by insertion
of foreign bodies, passage of clotted blood, self-manipulation, etc.
and not by sexual intercourse. The canal may be inherently lax
and rugosities not prominent since "birth.
3. Labia Majora and Labia Minora.
The labia majora is firm, elastic and plump and its medial borders
are usually in close contact with each other so as to cover the labia
minora and the clitoris. The labia minora is soft, pinkish in close
contact with one another, and its vestibule is narrow. Entry of the
male organ may cause the labia to gape due to stretching of their
borders.
The condition of both labia is not a reliable basis in determining
virginity. A woman may be a virgin but with a gaping labia, while
others might have had previous delivery but the labia are still
coaptated. The condition of the labia is much more related to the
general physical condition of the woman rather than the absence
or the presence of previous sexual intercourse. A stout woman
usually can preserve the plump, coaptated and firm labia while
skinny women usually have gaping labia.
4. Fourchette:
The fourchette present a V-shape appearance as the two labia
minora unite posteriorly. After severe distention, the sharpness
of the acute angle may become rounded with retraction of the
edges.
The rounding of the fourchette and the retraction of the edges
can be a consequence of so many causes. Stretching apart of the
thighs, instrumentation, horse or bicycle riding may produce the
condition other than sexual intercourse.
5. Hymen:
Physicians give much attention in the examination of the
hymen in the determination of virginity.
Classification of Hymen:
a. As to shape and size of the opening:
(1) Annular or circular — The opening is oval or circular located
at the center of the hymen. There may be indentation of
the borders.
(2) Infantile — The opening is small, usually linear, fleshy and
resistant.
(3) Semilunar or crescentric — The concavity may be facing
either side or upwards or downwards. The tapering ends of
the crescent may be the frequent sites of laceration.
( 4 ) Linear — The opening is slit-like and usually running ver-
tically.
(5) Cribiform — The hymen presents several openings instead of
a single one. In several instances the openings are quite
small and will require the use of a hand lens to make them
visible.
( 6 ) Stellate — hymenal opening is like a star.
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(7) Septate — There are two openings which may be of equal

or different sizes separated by a bridge of hymenal tissue.
After a sexual act there may be complete rupture of the
bridging tissue or marked distention of one to make the
other opening almost invisible.

(8) Fimbriated — The border of the opening shows small ir-

regular protrusion towards the opening. In some instances
the fimbriation may be big enough that the examiner may
mistake it to be a superficial laceration.

( 9 ) Imperforate — There is no opening on the hymen. When a

woman starts to menstruate, surgery may be necessary to
open the hymen to allow free passage of menstrual blood.

b. As to structure and consistency:

(1) Firm and with strong connective tissue and plenty of blood
vessels — This type has more tendency to lacerate during
the first sexual act and the laceration may produce relative-
ly more hemorrhage. Thin hymen

( 3 ) Membranous hymen — Hymen is parchment-like, may be

transparent and may lacerate without pain or appreciable
bleeding.
c. As to number of opening:
(1) Single orifice — Having one opening.
(2) Septate — Having two openings.
(3) Multiple — Having several openings.
(4) Imperforate — Without orifice.

Virginity is N o t Synonymous with Chastity:

A woman may resort to many forms of homosexual as well as
heterosexual practices without losing her virginity, yet she may be
unchaste.
A woman may have a ruptured hymen and other signs of loss of
physical virginity, yet she is chaste.
She may resort to masturbation with rupture of the hymen and
dilatation of the vaginal canal causing it to appear that she has had
several sexual intercourses, yet she may still be a virgin.

B. DEFLORATION

'efloration is the laceration or rupture of the hymen as a result of

sexual intercourse. All other lacerations of the hymen which are not
caused by sexual act are not considered as defloration.
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Parts of the female genitalia that must be examined to determine
defloration:
1. Condition of the Vulva:
Normally the labia majora and minora are in close contact with
one another covering almost completely the external genitalia.
After defloration, the labia may gape exposing the introitus
vulvae.
The finding may not be relied upon because some females may
have inherently gaping labia, especially, asthenic women although
there is no history of previous sexual act, while others may preserve
the coaptated labia even if there has been previous sexual act.
2. Fourchette:
The normal V-shape of the fourchette is lost on account of the
previous stretching during insertion of the male organ. With-
drawal of the stretching force will cause retraction of its walls
with rounding of the base.
Retraction of the fourchette is not a good sign of defloration
inasmuch as it can be due to other causes. Ballet dancing, sepa-
ration of the thighs, tree climbing, cycling, horse riding, insertion
of foreign body, etc. may cause retraction of the fourchette
without previous sexual act.
The fourchette, together with the perineum and lower portion
of the posterior vaginal wall, may be lacerated by sexual act or
some other causes.
3. Vaginal canal:
After repeated sexual acts, there is diminution of the sharpness
or obliteration of the vaginal rugosities. There will be laxity of
its wall so that insertion of a medium size tube during the medical
examination can be done with slight resistance.
c. Genital disproportion — The male organ is unusually big or
female organ infantile in size in spite of adult age.
d. Unprepared or unaroused female — The vaginal secretion is
absent, causing more friction.
e. Position during the sexual act — Dorsal decubitus position with
the thighs hyperflexed predisposes to deep penetration by the
male organ and is contributory to vaginal vault lacerations.
Vaginal position may not be in harmony with the movement
of the penis.
f. Brutality of the male partner during the sexual act.
g. Recent vaginal surgery — The canal may become narrow and
fibrous scar may replace the muscular vaginal wall at the site of
surgery.
h. Excessive active involvement of the female partner.
i. Multiple sexual act among sex deviates (Nymphomaniac or
satyriatic) or multiple consort — Continuous stretching and
friction may weaken its wall.
j . Renewed sexual activity after prolonged abstinence.
k. Post-menopause.
1. Uterine retroversion.
4. Hymen:
The hymen is lacerated during the initial sexual act. However,
it is not always the case. Some hymen are thick, elastic and
fleshy such that they can resist certain degree of distention with-
out causing laceration. Some women may inherently have lacer-
ated hymen probably on account of previous trauma during the
early age. The fact that the hymen is intact does not prove
absence of previous sexual intercourse and the presence of lacer-
ation does not prove defloration.

The changes in the vaginal rugosities or the laxity of its wall Other Causes of Hymenal Laceration:
cannot be relied upon as a proof of defloration because instru- a. Passage of clotted blood during menstruation.
mentation during medical examination, masturbation or insertion b. Ulceration due to disease, like diphtheria.
of foreign bodies or other similar or related acts will cause the c. Jumping or running.
development of such condition. d. Falling on hard and sharp object.
The vaginal wall, together with the vulva, may suffer injury e. Medical instrumentation.
during defloration or some other causes. f. Local medication.
g. Self-scratching due to irritation.
Predisposing causes of vulvo-vaginal injuries during sexual act: h. Masturbation.
a. Virginity — Sex organ does not have previous experience to i. Insertion of foreign bodies,
stretching or coital act. j. Previous operation.
b. Prepuberty — The genital organ is not yet fully developed to In the medical examination of the hymen, the following facts
subject it to full physiological function. must be included:
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a. General condition of the hymen:
This includes the width, thickness, elasticity, vascularity, and
laxity. It may include pathological condition, like inflam-
matory changes, signs of previous trauma, developmental
abnormality and foreign elements.
b. Original shape of the orifice (opening):
In case laceration is present, try to reconstruct the hymen by
means of a probe and determine the original shape of the open-
ing. It may be linear, circular, stellate, cresentric, septate,
cribiform, imperforate and fimbriated.
c. If lacerated, the following must be noted:
( 1 ) Degree of laceration:
This refers to the extent of damage to the hymen which
may be:
(a) Incomplete laceration — Rupture or laceration of the
hymen is considered incomplete when it does not in-
volve the whole width or height of the hymen. In-
complete laceration may be:
i. Superficial — The laceration does not go beyond
one-half of the whole width of the hymen.
ii. Deep — The laceration involves more than one-half
of the width of the hymen but not reaching the
base.
( b ) Complete laceration — The hymenal laceration involves
the whole width but not beyond the base of the hymen.
(c) Compound or complicated laceration — The laceration
involves the hymen and also the surrounding tissues.
It may involve the perineum, vaginal canal, urethra or
rectum.
Notches — Indentation of the hymen simulating
lacerations. They may be symmetrical and may extend
to the vaginal wall. The mucous membrane over the
notch is intact. Notches may be mistaken for laceration.
(2) Location of laceration:
For the purpose of locating the site of the laceration, the
hymenal orifice is related to the face of a watch while the
subject is in lithotomy position. With the examiner facing
the female genitalia, the location of the laceration will be
described corresponding to the time in the face of a watch.
By this procedure, a laceration at the region of the four-
chette may be described as a laceration at 6:00 o'clock
position in the face of a watch while on the horizontal
sides may be termed 9:00 (left side) and 3:00 (right side)
positions.
(3) Duration of the laceration:
The determination as to how long the laceration took
place can be approximated by the changes observed in the
lacerated tissue.
(a) Fresh bleeding laceration — The laceration is of recent
origin.
( b ) Fresh healing with fibrin formation and with edema of
the surrounding tissue — Usually after 24 hours.
(c) Healed laceration with congested edges and with sharp
coaptible borders — Depending upon the degree of
laceration and the presence or the absence of com-
plications, the said laceration could have occurred
4 to 10 days. Sometimes, the said finding is termed
"recently healed" laceration.
( d ) Healed laceration with sharp coaptible borders without
congestion — Some times have passed by after the lacera-
tion has healed. Ordinarily it can be inferred that
hymenal laceration took place approximately more than
ten days or 2 to 3 weeks.
( e ) Healed laceration with rounded non-coaptible borders
and retraction of the edges — Laceration took place long
before the date of the examination which is probably
more than a month's time.
( 4 ) Complications of laceration:
A vast majority of laceration of the hymen healed un-
eventfully, although in rare instances complications set in.
The following are the possible complications:
( a ) Secondary infection — There may be activation of the
bacterial flora in the vaginal canal or a superimposed
infection may set in, especially among women with
poor hygienic habit. Gonorrheal infection is not un-
common when the offender is suffering from the disease
at the time of the sexual act.
( b ) Hemorrhage — This is a rare complication but this may
be present in severe compound laceration of the hymen.
Surgical intervention may' be necessary to control the
bleeding. Blood analysis to determine the presence of
blood disease may be indicated when there is dispro-
portion between the injury and the amount of hemor-
rhage. Blood transfusion may be required when the
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condition of the patient demands replacement of the 2. Systemic Effects:

blood loss.
(c) Fistulae formation — Recto-vaginal or vesico-vaginal
fistula may develop in the case of compound laceration.
This may require the services of a competent gynecolo-
gist to subject the patient to surgery.
( d ) Stricture — Hymenal laceration alone will not produce
stricture but in case of involvement of the vaginal wall
it may consequently result in narrowing of the canal on
account of the scar formation.
( e ) Sterility — Trauma and infection may further involve
the upper part of the female generative organ and may
cause loss of procreation power.
PHYSIOLOGIC CONSIDERATION:
A. During Sexual Excitement:
1. Local Changes:
The parasympathetic innervation of the sex organ is from
the 2nd, 3rd and 4th spinal sacral segments, and the sympathetic
innervation is from the 11th thoracic down to the 1st lumbar. In
the male, the stimulus may be central or somesthetic or local
tactile in origin.
In the male, stimulation will cause erection of the penis due
to active dilatation of the arteries through the nervus origentis.
The erection is also brought about by the contraction of the
ischiocavernous muscle producing compression of the dorsal
vein of the penis, thus causing accumulation of blood under
pressure.
More sexual stimulus will be attained through friction during
the sexual act coupled with the physical activities of the partner.
In the female, sexual stimulation will cause tomescence of
the clitoris, vestibule and labia minora.
There is spontaneous vulvar lubrication. The lubricant is a
transudate coming from the vaginal wall and its production
ceases when the stimulus is removed. The lubricant dries
quickly.
There is labial engorgement and vaginal lengthening and
widening. During the excitement, the vaginal canal increases
in length from 7 to 8 cm. to 9.5 to 10.5 cm. At the level of
the cervix there is a transverse expansion of the vaginal canal
from 2 cm. to 4 cm. to 6.25 to 6.75 cm.
a. An increase in the pulse rate;
b. Marked increased in blood pressure making its peak during
orgasm;
c. An increase of peripheral flow of blood experienced as an
increase of body warmth;
d. Tomescence (engorgement of blood), which is the consequence
of this peripheral flow concentrating on erectile tissue;
e. Increased respiration;
f. A decrease in bleeding during arousal, which is reversed
subsequently;
g. A decrease in sensory perception;
(1) There is blunting of the sense of touch.
( 2 ) Pain may be largely lost; sensation which could be
sharply painful may only be experienced as no more
than a mild touch stimulation.
( 3 ) Alertness of hearing and vision is clearly decreased.
B. During Orgasm:
In the male, orgasm is the sensation resulting from the con-
traction of the smooth muscles of the genitalia and the striated
muscles of the pelvic floor coinciding with ejaculation.
Seminal emission is carried on by the peristaltic action of the
vas deferens, seminal vesicle and prostate.
Ejaculation results from the contraction of the pelvic floor
muscle and the bulbospongiosus and ischiocavernosus muscles.
In the female, during orgasm, there is contraction of the smooth
muscles of the uterus and rhythmic contraction of the vaginal
sphincter, the ischiocavernosus and the pelvic floor musculature.
The physiological changes are similar in both male and female.
The difference is only in the speed of response. In the male,
sexual arousal is psychological followed by physical, while in the
female it is primarily physical.
DEATH RELATED TO SEXUAL ACT
1. Death of the Male Partner:
a. Death from natural cause:
During sexual intercourse, the male as an active subject
develops increase blood pressure, tachycardia and hyper-
ventilation due to emotional response and muscular exertion.
If he is suffering from cardio-vascular disease or insufficiency
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e. Death of the female partner may be deliberately done by the

of cardiac reserve, the increase demand on the cardiovascular
system may not be met and he may die. This is also true in
masturbation.
If a person died outside his conjugal home, the dead is gen-
erally referred to as "D.I.S." or "death in the saddle". Some-
times it is jokingly claimed that "he died with his boots on" or
"he died planting the Philippine flag". If death took place in a
prostitution house, the children's comment is "Daddy died in
the arms of a scarlet woman".
b. Death may be due to the defensive act of the woman-victim:
In cases of rape, the victim may be able to take hold of a
sharp instrument and inflict injuries to the offender which may
cause his death.
2. Death of the Female Partner:
Women almost never suffer death from natural causes during
the normal sexual act. The reason may be that they are less
susceptible to cardio-vascular disease and that they play a
passive role in sexual intercourse. Women can control their
tendencies to over-excitement and they exert less physical effort
in a sexual act than men do.
Death of the female partner is usually accidental and not on
account of a natural disease:
a. The sexual intercourse might be done in a relatively confined
space like the back seat of a car. Accidental strangulation or
suffocation of the female partner may be due to the undue
pressure applied on the chest, neck or face. The struggle of
the female partner may remain unnoticed on account of the
height of sexual excitement, and this may cause her death.
b. In case of oral sex (fellatio) wherein the male penis is placed in
the mouth of the female partner, the size and length of the
penis may cause partial or total block of the air passage, causing
asphyxia. Ejaculation of seminal fluid may oclude the lumen
of the respiratory tract as in drowning.
c. In case of cunnillingus (a perverted sexual act wherein the male
licks the female genital organ), the male partner may blow air
in the vulva and may cause air embolism especially when the
woman is pregnant. The air may enter the blood circulation
and causes immediate death.
d. Saddists who may not be sexually satisfied by sexual inter-
course but by inflicting physical injuries to the partner may
cause death of the female partner.
male to conceal the crime of rape he has committed. The
male partner may inflict physical injuries, or may cause asphy-
xiation by strangulation or by other means.
f. The female partner may die of shock as a result of extreme
physical and mental trauma in case of rape.
g. Hemorrhage.
h. Infection.
3. Death of Both Partners:
a. Almost simultaneous death of both partners during sexual
intercourse may be due to the performance of the sexual act
in an enclosed place with carbon monoxide or other asphyxiant
gas. Examination of their respective blood will reveal the pre-
sence of the gas incompatible with life.
b. Homicide— suicide pact.
^SEX CRIMES
Criminological Characteristics:
1. It is one of the ancient and universal crimes. It existed since the
dawn of history. Although considered a crime by almost all
countries of the world, society's reaction to its repression depends
on the moral value and its gravity as a social problem.
2. There is a close physical contact between the offender and the
victim. Murder and homicide may be committed with the
offender at a distance from the victim. Estafa and many other
crimes may be committed even without the physical presence
of the victim.
3. As a general rule, it is a crime committed by one sex against
the opposite sex.
4. Sex is an inborn instinct. A n y person without sex desire is
considered abnormal. Satisfaction of the sexual instinct must
be, in a way, acceptable by the moral standard. What is punish-
able is the anti-social means of attaining sexual gratification.
In other crimes, no man is normally born with such criminal
instinct. Murderers, defrauders, and other violators of the
criminal law are not inborn characters of individuals.
5. Except probably the crime of rape and forcible abduction, most
of the sex crimes do not belong to the so called conventional
crimes. Considering other sex acts as crime depends on the
moral value existing in a society. Seduction and consented
abduction are considered as crimes in the Philippines but not in
other countries.
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6. Many sex crimes are committed but not reported; if reported

not investigated; if investigated, not prosecuted. This is on
account of the fact that undue publicity may be prejudicial to
the reputation of the victim.
7. It is a crime committed in strict privacy. If committed in public
the offender must be a mental deviate. Reliance must therefore
be made by the investigating officer or court on the testimony
of the victim corroborated by the medical findings.
8. Although it is more frequent among the lower socio-economic
class those who belong to the middle and upper classes are not
immune in the commission of the crime.
9. Unlike other crimes, pardon, forgiveness or marriage between
the offender and the victim will extinguish the criminal liability
of the offender.
10. There is a seasonal variation in the frequency of commission. It
is not the season that causes the variation but the social forces
that may be present in a specific season. The month of May,
for example, has more cases of sex offenses because Mayflower
festivals, fiestas, picnics, excursions, etc. are frequent during
this month.
11. The severity of punishment does not deter its commission. Its
frequency has not been appreciably reduced by Martial law.
12. Its occasional consequence (pregnancy) becomes a legal problem,
e.g. support, abortion, legitimacy, unwanted child, inability to
find a means of livelihood, etc.
13. If the offender is of past middle age, usually the victims are
children. The primary reason is that old men will be ignored
by elderly women so they focus their attention on children who
can easily be enticed by candies or other things of value.
14. The psychic trauma suffered by the victims of sex crimes varies
with the moral standard of the victim. Women of the "Maria
Clara" type with morality of the Puritan Standard, may inflict
fatal or serious injuries on the offender. Some may develop a
feeling of worthlessness and as a consequence, may lead to self-
destruction, while others may be mentally deranged. Others
may have a strong belief in the machinery of justice and file
the complaint, but a great number of those who seek justice
later become amenable to an amicable settlement.
i
Other victims suffer from fear of unfavorable consequence,
like pregnancy, social degradation and maltreatment by parents
and other relatives.
When and H o w Rape is Committed — Penalties:
Art. 335, Revised Penal Code:
Rape is committed by having carnal knowledge of a woman under
any of the following circumstances:
1. By using force or intimidation;
2. When the woman is deprived of reason or otherwise unconscious;
and
3. When the woman is under twelve years of age, even though neither
of the circumstances mentioned in the two next preceding para-
graphs shall be present :
The crime of rape shall be punished by reclusion perpetua.
Whenever the crime of rape is committed with the use of a
deadly weapon or by two or more persons, the penalty shall be
reclusion perpetua to death.
When by reason or on the occasion of rape, the victim becomes
insane, the penalty shall be death.
When the rape is attempted or frustrated and homicide is
committed by reason or on the occasion thereof, the penalty
shall be likewise death.
When by reason or on the occasion of the rape, a homicide is
committed, the penalty shall be death ( A s amended by Rep.
Act 2632 and Rep. Act. 4111).
Elements of the crime:
a. The offender had carnal knowledge of the woman. The victim
of the crime must always be a woman while the offender must
inferentially be a man because sexual act must be done by a
man and a woman.
b. The carnal relation must be made under any of the following
circumstances:
(1) Use of force or intimidation;
( 2 ) The woman is deprived of her reason or otherwise made
unconscious; or
(3) The woman-victim is less than 12 years of age.
Meaning of Carnal Knowledge:
Carnal knowledge is the act of a man in having sexual bodily
connection with a woman. There is carnal knowledge if there is the
slightest penetration in the sexual organ of the female by the sexual
organ of the male. It is not necessary that the vagina be entered or
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that the hymen be ruptured (Black's Law Dictionary by Henry C.
Black, 4th ed., p. 268).
For the consummation of the crime of rape, it is not necessary
that there is rupture of the hymen. It is enough that the labia of
the female organ was penetrated (People v. Oscar, 48 Phil. 527).
Slightest penetration is enough, proof of emission is not necessary.
The absence of spermatozoa in the vagina does not negate the com-
mission of the crime of rape (People v. Canastre, 82 Phil. 480).
Character of the Offended Party:
The fact that the offended party may have been unchaste before
alleged sexual act was consummated with force and intimidation
constitute no defense. The person is guilty of rape if force and
violence were used regardless of the good or bad morals of the
offended party (People v. Blance, 45 Phil. 13).
Evidences of Force or Intimidation:
The mere initial reluctance of the offended party or verbal refusal
alone will not prove force. It must be a manifested and tenacious
resistance that is required by law (People v. Lago, C.A. 45 O.G.
1356).
When force is an element in the crime of rape, it need not be
irresistible. As long as it brings about the desired result, all con-
sideration whether it is more or less irresistible are beside the point.
When the offeflftied girl stated that she defended herself against
the accused as long as she could, but he overpowered her and held
her till her strength yielded, then accomplished his desire, there is
evidence of sufficient force (People v. Mono, 56 Phil. 86).
The offended woman shouted, struggled and kicked the accused
but the offender pressed a hunting knife on her throat, overcame
her resistance and succeeded in having sexual intercourse with her.
Rape was committed (People v. Lago, C.A. 45 O.G. 1356).
If the offender is the father of the girl who is of a tender age, it
is not necessary that there are signs that she put up a determined
resistance (People v. Alinea, C.A. 45 G. 140).
The employment of force is established not only by the testimony
of the injured girl but also by the signs of finger grips on the front
part of her neck, on the arms and the fact that the garments worn
at the time were torn and heavily stained with blood (People v.
Lucero, 61 Phil. 361).
A strong evidence of force is the presence of physical injuries
found on the person of the victim in the course of medical exami-
nation. Contusions may be found on the face, arms and thighs.
When a woman has been forcibly made to lie down, she will utilize
her elbow as the fulcrum so that abrasions will be observed on both
elbows. In the attempt of the victim to stand, she will flex her neck
forward. The offender will then push her head backwards, causing
hematoma at the region of the occiput. To prevent penetration of
the male organ she will try to flex her thighs and knees. The offender
will give a strong blow to the inner aspects of both thighs so that the
victim will be compelled to straightened them.
The victim may suffer all types of physical injuries depending
upon the resistance offered by her and the degree of force applied
by the offender.
Rape Committed by Employment of Intimidation:
The application of threat will cause fear in the victim of the
untoward consequence. If she will not accede to the will of the
offender, the crime may constitute intimidation.
Inasmuch as intimidation is purely subjective it cannot be proven
by medical evidence.
Rape Committed by Depriving the Victim of Her Reason or Other-
wise Made Unconscious:
1. Deprival of Reason:
a. Rape committed on insane or mentally deficient woman:
The fact that the victim is a woman, 14 years of age, feeble-
minded and can only speak mono-syllables is sufficient to
constitute the act committed to be rape (People v. Doing, C.A.
49 O.G. 2331).
Sexual intercourse with an insane woman is considered rape
(People v. Layson, C.A. 37 O.G. 318).
But, sexual intercourse with a deaf-mute woman is not rape,
in the absence of proof that she is an imbecile (People v. Nava,
C.A. 40 O.G. 4237).
The proof of the mental condition of the victim is the
medical findings of the physician who must certify whether the
woman-victim of rape is suffering from insanity or mental
deficiency which is sufficient to deprive her of her reason.
b. Rape committed while the woman is under the influence of
alcohol or other depressant drugs:
Inasmuch as the woman is not in possession of her rational
mental faculties, in the absence of a decided case, this may also
be rape.
c. Sexual act on a woman under the influence of sex stimulating
drugs:
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In the case of U.S. v. Lung (28 p. 235, 37 A.M. St. Rep. 505),
cited by Reyes, where the consent of the woman was induced
by the administration of drugs which incited her passion and
the drug dose did not deprive her of her reason, the accused
was not guilty of rape. But if this case should happen in the
Philippines and would be decided by our local court, I think it
would be a rape case because the stimulating drug actually
deprived her of her reason.
The reason for penalizing carnal relation is that one must not
take advantage of the meager intelligence and incomplete physical
development of a child below the age of 12.
When the offended party is a girl less than 12 years old, rape is
committed although she consented to the sexual act (People v.
Villamora C.A. 37 O.G. 497). It is also rape even if the girl less
than 12 years of age is a prostitute (People v. Perez, C.A. O.G.
6337).

2. The woman-victim is unconscious:

a. Sexual act committed while the woman is on her natural sleep:
The woman while asleep felt the weight of a man in carnal
relation with her. Believing that he was her husband, she called
him by his name but received no answer. She again called him
and found out that the voice was different from that of her
husband. She then pushed him and then ran after him. The
offended party was a deep sleeper in the first hour of the night
and it was not impossible for the accused to insert his organ
into her genitalia before she awoke. The crime of rape was
committed (People v. Gorcino, 53 Phil. 234).
b. Sexual act on a woman suffering from sleeping sickness is also
rape because the woman is unconscious.
c. Sexual act on a woman who is unconscious because she was
knocked-out:.
If the offender inflicted physical injuries on a woman suf-
ficient to make her unconscious before the sexual act was done,
it is rape.
Perineal laceration on a sexually a b u s e d child
On seeing a lavishing figure of a woman taking a bath, the
accused hit her and after she became unconscious, he had sexual Multiple rapes committed by each accused was independent
intercourse with her. The accused was found guilty of rape of the others, because the essence of the crime of rape consists
(People v. Sanico, C.A. 46 O.G. 98). of carrying out carnal act of the offender with a woman against
d. Sexual act after administration of narcotics or other "knock- her will and each carnal access consummated is a complete attack
out" drugs: on the honor, person and liberty of the offended woman (People
The sexual act made on a woman while she is under the in- v. Bernardo, 38 O.G. 3479).
fluence of narcotics or other depressant drugs is rape because The victim and the accused must immediately be examined by
the woman is unconscious. the physician to have a strong medical evidence of rape, but the
lack of medical examination of the victim is not an indispensible
3. When the woman is under 12 years of age:
element in the prosecution of the crime of rape. Whether or not it
If the carnal relation is made on a female below 12 years of
will prosper will depend upon the evidences offered. As long as
age, it is always rape regardless of whether or not force or in-
the evidences convince the court, a conviction of the crime of rape
timidation is applied or the child is.not deprived of her reasons or
is proper (People v. Suarez, C.A. 40 O.G. 28).
otherwise unconscious. Rape of a woman below 12 years old is
also called statutory rape. The sexual act is still rape even if the When the defendant has sexual intercourse twice in succession
child consented or even if the child is a prostitute. with the complainant, no evidence having been presented that
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strual history. It may be used as a guide to the examining physician

there was any resistance on her part or that the defendant had
used force, violence and intimidation, the defendant was acquitted
(U.S. v. DeDios, 8 Phil. 279).
The defendant attempted to commit the crime of rape in an
open field on a woman whom he has courted for 2 years and in
the presence of other persons. The offended party allowed the
defendant to visit her after the attack. The defendant was ac-
quitted (U.S. v. Estacio, 18 Phil. 432).
A complaint in the prosecution of rape is not valid unless it is a
complaint of the offended party. The complaint signed and sworn
to by the chief of police is not valid in the prosecution for rape
(People v. Manaba, 58 Phil. 665). An information not signed by
the offended party is insufficient to confer jurisdiction on the
court to hear and determine a charge of attempted rape (People
v. Trinidad, 59 Phil. 163). The filing of the complaint by the
father of the offended party who is a girl only fourteen years of
age which alleges the commission of the offense is a sufficient
compliance of the Revised Penal Code to confer jurisdiction for
trial of the offense charged (People v. Imas, 65 Phil. 419).
i
as to the different points that must be emphasized in the course
of the examination. Aside from the history, the following points
must also be recorded by the physician.
a. Date, time and place of alleged commission of rape:
This is necessary in order to determine how long a time has
elapsed after alleged commission of the offense before the
victim filed the necessary complaint or subjected herself to the
medical examination. If several days have gone by before the
filing of the complaint, let her explain the cause of the delay.
The place where the alleged offense was committed is neces-
sary to determine which court can acquire jurisdiction over the
case.
b. Date, time and place of the examination:
The date of the examination is material to the determination
of the possible findings of the physician on the victim. A long
interval of time between tha date of commission and the
examination will remove the possibility of finding the effects of
a recent sexual intercourse.

Instances When Rape is Punishable by Death: c. Condition of the clothings:

1. When by reason or on the occasion of the rape, the victim be-
comes insane;
2. When the rape is attempted or frustrated and a homicide is com-
mitted by reason or on the occasion thereof; and
3. When by reason or on the occasion of the rape, a homicide is
committed.
Death of a woman from peritonitis as a result of having been
infected with a venereal disease by a man having sexual intercourse
with her against her will, will constitute the complex crime with
homicide (People v. Acosta, 60 Phil. 158).
Medical Evidences in Rape:
1. Evidences from the victim:
Before actual examination is made on the subject, it is necessary
to have a written consent from the subject herself or from her
guardian if the victim is not of age. If the woman is confined in a
correctional institution the consent may be given by the head of
the institution.
A short history of the alleged rape must be taken and it is
advisable to reduce it in writing. The history must include all the
circumstances leading to the abuse, the age of the victim at the
time of the alleged commission of the offense and also the men-
If force is applied in the commission of the offense, there
will be tearing, staining with blood and semen, and soiling of the
clothings. The clothings must be preserved after they have been
thoroughly dried for further laboratory examination.
d. The physician must observe the gait, the facial expression and
the bodily and mental attitude of the subject. If the victim
suffered from genital injuries she may walk with legs apart
and slowly, with the face manifesting signs that she is suffering
from pain.
e. Physical and mental development of the victim:
The height, strength and degree of muscular development of
the woman must be noted to determine whether she has the
capacity to resist any unlawful aggression. If the victim is a
child, examination of the physical condition is usually not
necessary because it is apparent to the age. In most cases,
children are "bribed" or lured by attractive articles such as
candies by the offender.
The examiner must observe the mental state of the victim.
She may be in the state of mental shock, under the influence of
depressant drugs, alcohol or sex stimulants. The offender might
have taken advantage of her insanity or mental deficiency.
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The victim may appear exhausted, despondent on ac-
count of the public humiliation she will suffer, or may be
hostile to the investigator. Care and more psychologic approach
is necessary in order to get her full cooperation and consent.
f. Examination of the body for signs of violence:
If actual force was applied in the commission of the crime,
there must be signs of physical violence on the body of the
victim. Her whole body must be subjected to inspection.
Physical injuries must be described and the exact location must
be determined. Areas of tenderness or swelling must not be
overlooked and if necessary X-ray pictures must be taken to
determine bone lesions.
Determination of the probable age of the physical injuries
found is material. Does it correspond to the alleged date of
commission? .
g. Examination of the genitalia, including the breast:
The breasts must be examined for the presence of finger
marks or application of pressure. They might have been rough-
ly handled or the nipples bitten.
The vulva may show swelling, tenderness, contusion, abrasion,
laceration or may be smeared with blood, semen and other
foreign bodies.
The hymen may show fresh laceration, swelling or bruising.
There may be healed lacerations or signs of physical virginity.
In the pubic hair, the following medical evidence may be
gathered:
( 1 ) Pubic hair of the offender.
(2) Semen and spermatozoa.
( 3 ) Blood stains.
( 4 ) Body louse.
Abrasion which is normally found in the posterior commis-
sure is usually brought about by friction or a violent attempt of
insertion. The vaginal canal may show obliteration of the
rugosities or even purulent discharge.
2. Examination of the alleged offender:
a. Physical development, mental condition and strength:
The relative physical development and strength of the victim
and the offender must be compared to determine whether the
offender can overpower the resistance offered by the victim.
Fingernail marks on the neck, arms and chest may be found.
The frenum of the penis may be abraded or lacerated on account
of the violent insertion on a relatively small vulvar or vaginal
opening.
c. Condition of the sex organ:
Aside from the examination of the frenum, washing from the
surface of the penis may reveal blood, seminal stain, vaginal
epithelium and doderleins bacillus. The urethral meatus may be
moist on account of the recent discharge.
d. Evidence from the pubic hair:
The pubic hair may be matted together due to blood stains
or from seminal fluid discharge. Examine carefully for the
presence of body louse.
e. Potency of the offender:
The offender may put up a defense that he is impotent and
that it could have been hardly possible that he had committed
the crime. It may be necessary to subject the offender to a
strong sex stimulus sufficiently under normal condition to
produce erection.
f. Evidence of genital infection — If the offender is suffering from
venereal disease which is transmitted to the victim during the
criminal act, the crime committed is rape with physical injuries
because infection in law is a physical injury.
3. Evidences from the companion of the victim:
a. A history of the incident must be taken from the companion
of the victim. Try to see whether they are consistent with the
narration of facts by the victim.
b. If the companion helped the victim when force was applied by
the offender, the companion must be subjected to a physical
and medical examination for physical injuries.
c. Examination of the clothings may be necessary for signs of
struggle.
d. Investigation must be made to determine whether the com-
panion might have participated as an accomplice to the crime.
e. The mental condition, physical power, age and emotional
state must be taken into consideration to determine the capa-
city to resist unlawful aggression from the offender.

b. Evidence of physical injuries: f. Examination must be made as to the presence of alcohol or

The whole body must be examined. The victim, in the other depressants which may diminish the companion's capacity
course of the struggle, may inflict bodily harm to the offender. to defend the victim from the offender.
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Investigation of the Crime Scene: b. Inspection by means of Ultraviolet light:

1. Disturbances in the place of commission may infer or affirm the
statement of the victim that she did offer resistance.
2. Strands of hair, blood, seminal and other stains may be recovered
to prove consummation and struggle.
This method is resorted to in order to make visible, small
seminal stains or patches. Determine the side of the clothings
where the stains are located. Under ultraviolet radiation, the
seminal discharge shows bluish fluorescence.

3. Pieces of personal belongings of the offender and /or victim may be
recovered to prove identity and physical struggle.
4. Investigation of witnesses who may possibly be material to the
prosecution of the case may be conducted.
EXAMINATION FOR SEMINAL FLUID
AND SPERMATOZOA
The semen is the viscid, albuminous fluid with faint grayish-
yellow color, having the characteristic fishy odor, and containing
spermatozoa, epithelial cells, lecithin bodies and other substances.
Spermatozoon is a living organism, normally present in the seminal
fluid consisting of a head, neck and tail. It is from 50 to 55 microns
in length. The head is ovoid and flattened when viewed in front and
pearshape when viewed on the profile. The head is about 5 microns
in length while the neck is very short. The tail is the longest part of
the spermatozoon and consists of a long slender filament with tapering
end. The ciliary movement of the tail is responsible for the forward
movement of the spermatozoon.
There are 2.5 to 5.0 cubic centimeters of semen per ejaculation.
The semen contains 60 million spermatozoa per cubic centimeter,
80% of which are motile after 45 minutes. After 3 hours not more
than 20% become abnormal in forms.
The following specimens may be examined for seminal fluid and
spermatozoa:
1. Wearing apparel of the victim and of the alleged accused.
2. Vaginal smear from the victim.
3. Stains on the body of the victim and of the accused.
4. Stains found at the site of the commission of the offense.
PROCEDURE:
1. Gross Examinations:
a. Inspection by means of the naked eye or with the use of the
hand lens:
The stain is grayish-white to faint yellow in color. In fabrics,
the area occupied is slightly depressed. It usually has a map-
like contour with silvery appearance of the surface. It is hard-
ened with shiny borders.
2. Micro-Chemical Examinations:
Moisten a portion of the stained fabric with very diluted hydro-
chloric acid solution (one drop in 50 cc. of water) and let the
soaking stay for 1/2 to 5 hours depending upon the age of the
stain. Allow the liquid portion to dry on the slide. Perform any
of the following:
a. Florence Test:
Place a cover slip over the dried stain on the slide glass.
Allow a drop of Florence solution to run under the slip.
Place the preparation under the microscope and if semen is
present, a group of crystals appears similar in color and in shape
as the hemin, but larger in size. The crystals are dark brown,
in clusters, rosettes, crossing over the microscopic field.
Composition of the Florence Solution:
Potassium iodide 1.65 gms.
Iodine 2.54 gms.
Distilled water 30.00 cc.
Value of the Test:
This test is produced by the action of iodine on choline, a
natural base found in many cells. It is not a specific test for
spermatic fluid. The test is not a proof of seminal fluid but
only of the presence of some vegetable or animal substance.
A positive result is merely a presumptive evidence of seminal
fluid; a negative result means, in all probability, it is not that of
the seminal fluid.
b. Berberio's Test:
To the spermatic stain on the slide glass, a saturated solu-
tion (alcoholic or aqueous) of picric acid is added.
The preparation is placed under the microscope and needle-
shape crystals with yellow color is produced.
Some allege that this test is specific for spermatic fluid.
The reaction probably depends-on the presence of spermatic
secretion.
c. Puramen Reaction:
This is based on the presence of spermine in the prostatic
fluid. A small part of the stain is extracted with a few drops
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of saline and put into a micro tube and to the extract is added a
few drops of Puramen's reagent (5% solution of 2.4 dinitro
l-naphthol-7-sulfonic acid, flavianic acid). The tube is then
placed in a refrigerator for a few hours. In a positive reaction, a
yellow precipitate of spermine flavianate can be seen at the
bottom of the tube. When examined microscopically, the
precipitate is found to consist of small cross-like crystals of a
characteristic shape. Puramen reaction is found to be very
reliable and rather characteristic of seminal fluid (Modern
Criminal Investigation by Soderman, p. 250).
d. Acid Phosphatase test:
The semen produces a very high acid phosphatase activity as
compared with other body fluids (saliva, perspiration, urine,
etc.) and common vegetable and fruit juice stains. The method
of estimating the activity of a stain on clothings or other
materials is to extract with distilled water and perform the acid
phosphatase determination on the filtered extract.
The following solutions are necessary in the performance of
the test:
(1) Citrate buffer solution — pH 4.9 to 5.2:
Citric acid monohydrate 18.9 g. dissolve in 500 ml. distilled
water.
Sodium hydroxide 1 N 180 ml.
Hydrochloric acid 0.1 100 ml.
The pH adjusted sodium hydroxide and hydrochloric
acid to 4.9 to 5.2. A liter is prepared and stored in a
refrigerator. The solution is stable for six months.
(2) A suitable substrate:
A saturated solution of sodium alpha-naphthanil phosphate.
(3) A diazonium salt (Naphthanil Diazo Blue B)
Reaction: If acid phosphatase is present, the substrate is
hydrolized to produce alpha-naphthol, which is coupled with
a diazonium salt to produce a highly colored dye. In the
absence of the enzyme, the reaction does not appear.
Procedure:
There are three glass slides placed side by side on top of a
white paper.
Slide one (1) is the negative control with filter paper.
Slide two ( 2 ) is the positive control with filtered paper
impregnated with seminal stain.
Slide three (3) is with the suspected material.
To each is added a drop of buffer solution followed by a
drop of the substrate solution and finally a drop of the
diazonium salt in solution.
Result — The negative control 1 will remain yellow;
Slide two with known seminal stain will turn deep purple
immediately;
Slide three will also become deep purple if semen is present
but will have no change in color if semen is absent.
The test is conclusive of the presence of semen.
3. Microscopic Examinations:
a. A dried spermatic fluid stain on the slide is stained with hema-
toxylin or methylene blue and counter-stained with eosin.
Examined under the microscope, under high power and under
oil immersion, spermatozoa and bacterial infection can be
seen. The presence of a complete spermatozoon will undoubted-
ly infer the presence of seminal fluid, although semen may be
present without spermatozoa, such as in cases of aspermia
(semen without spermatozoa) or oligospermia (semen with few
spermatozoa).
b. Dr. Hankin's Method:
The fabric with seminal stain is boiled with tannin solution
before dissolving in a solution of potassium cyanide so as to
render the spermatozoa capable of removal. The fabric is then
placed on a slide, teased with carbol-fuchsin. This is examined
with a medium power lens.
c. GangulCs Method:
The same procedure as that of Dr. Hankin but the staining
is with erythrocin and malachite green. This is claimed to be
the best way to stain spermatozoa in India.
4. Biological Examinations:
a. Precipitin Test (Biological test of Farnum):
This is a test to determine whether the semen is of human
origin or not. A rabbit is immunized with human semen for
four to six weeks. After a time the blood is drawn and the
blood serum is taken and its potency made at different dilu-
tions.
This is used for the test of unknown semen in the same way
as blood precipitin is done.
The presence of a white ring at the point of contact between
unknown semen extract and the anti-human semen serum shows
that the unknown is of human origin.
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b. Seminal Grouping:
Specific agglutinable substances A and B are present in the
semen, like that of the blood. Seminal grouping is similar to
that of the blood. The test is of value for elimination. A
positive result does not definitely imply that the person is the
owner of the semen in question. A negative result will totally
exclude the alleged accuse as the possible owner of the semen.
The mere presence of speunatozoa on the stain shows the
presence of spermatic fluid, but the absence of spermatozoa does
not prove that the stain is not seminal. The semen may be present
without spermatozoa.
The presence of one complete, unbroken spermatozoon is suf-
ficient to make the conclusion that the stain or fluid is seminal.
It is quite necessary also to examine for infectious disease in
connection with the laboratory examination for semen and
spermatozoa.
How long after sexual intercourse can spermatozoa be found in the
vaginal canal?
Authorities differ in their opinions in this respect:
1. ". . . but, there is every reason to believe that the life of the
effective sperm in the maternal passage is very short, probably
less than thirty hours" (Taylor's Principles and Practice of Medi-
cal Jurisprudence by K. Simpson, 12th ed.. Vol 2, p. 32).
the upper recesses of the vagina for more than two weeks" (Coy\
p. 246).
6. "Some observers have reported finding spermatozoa in the vagina
after seven hours while others have reported finding them as long
as 48 hours after intercourse" (Homicide Investigation by L.
Snyder, 1st ed., p. 327).
Can a woman be raped while she is on her natural sleep?
Occasionally, it may happen, but highly improbable. To a normal
virgin it is hard to conceive that such act could ever be committed
without her knowledge, inasmuch as she has never experienced it.
But, such act may be possible to a woman who has had several
sexual intercourses and to those who have given birth.
Can a woman commit the crime of rape on a man?
In the definition of the crime of rape, it is "committed by having
carnal knowledge of a woman." The law specifically states that it
can only be committed on a woirian and not on a man (inclusio
unius et exclusion alterios). She committed acts of lasciviousness.
Can rape cause death?
Although it may not be usual, the introduction of a matured male
sex organ into the vagina of a young girl may produce local injury
sufficient to produce death. The death may be due to hemorrhage
brought about by the laceration of the vaginal canal, shock, sub-
sequent infection such as gangrene or peritonitis.

2. "There has been a great number of observations this latter point,
and the evidence points to a comparatively short life of the sperm
in the female tract and the period appears shorter with the number
of observations. It is a present belief that the life of the sperm in
the vagina is a matter of hours and its total life in the female tract
is a matter of two or three days at most" (Forensic Medicine by
S. Smith, 10th ed., p. 311).
3. ". . . that spermatozoa may survive less than two hours in the
vagina, but tfiey live as long as forty-three hours both in the cervix
and uterus where the secretion are more favorable" (Medical
Jurisprudence & Toxicology by J. Glaister, 12th ed., p. 325).
4. "Spermatozoa may remain motile in the vagina up to 17 days"
(A Synopsis of Forensic Medicine & Toxicology by C. Thomas,
2nd ed., p. 97).
5. "Fertilization of the ovum does not necessarily occur immediately
after coitus, as it is known that spermatozoa can remain alive in
Laceration of the vagina with accompanying hemorrhage can also
occur even in adult women if the man's sex organ is exceptionally
big, especially when the sexual act was done roughly.
Can the husband commits the crime of rape on his wife?
The husband cannot be guilty of rape committed on his wife.
Marriage is a license of the husband to have sexual intercourse with
his wife. The purpose of marriage is procreation and there can be
no procreation if there is no sexual intercourse.
However, if there is a decree of legal separation by the court, the
husband may be guilty of rape on his wife. Legal separation does
not dissolve the matrimonial tie between the husband and wife, but
merely separation in bed.
The husband may be guilty also of rape on his wife if he is a
principal by cooperation or by inducement for the act committed
by another man.
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OTHER CRIMES A G A I N S T CHASTITY
A. SEDUCTION
Seduction is the act of a man enticing women to have unlawful
intercourse with him by means of persuasion, solicitation, promises,
bribes, or other means without employment of force (Van de Velde
v. Colle, 8 N.J. Misc. 782, 152 A. 615, 646).
Not all countries recognize seduction as a criminal act but only a
ground for civil liability.
There are two kinds of seduction punishable under the Revised
Penal Code:
1. Qualified seduction
2. Simple seduction
*• Art. 337, Revised Penal Code — Qualified seduction — The
seduction of a virgin over twelve years and under eighteen years
of age, committed by any person in public authority, priests,
house-servant, domestic, guardian, teacher, or any person who, in
any capacity, shall be entrusted with the education or custody of
the woman seduced, shall be punished by prision correccional in
its minimum and medium periods.
The penalty next higher in degree shall be imposed upon any
person who shall seduce his sister or descendant, whether or not
she be a virgin or over eighteen years of age.
Under the provisons of this Chapter, seduction is committed
when the offender has carnal knowledge of any of the persons
and under the circumstances described herein.
/Types of Qualified Seduction:
1. Ordinary Qualified Seduction:
Seduction of a virgin over twelve years and under eighteen
years of age, committed by any person in public authority,
priest, house-servant, domestic, guardian, teacher or any person
who in any capacity, shall be entrusted with the education or
custody of the woman seduced.
2. Incestuous Qualified Seduction:
This includes seduction wherein there is blood relationship
between the seducer and the seduced. Father seducing daugh-
ter or other descendants, or brother seducing sister.
In this type of seduction, the woman seduced need not be a
virgin or may be more than eighteen years of age. T h e penalty
imposed is one degree higher than that of ordinary qualified
seduction.
The reason for the reduction of the requirements and the
imposition of a higher penalty is that the father or ascendant
and the brother are obliged to lead the descendant or sister to
the path of rectitude and morality, but instead virtually per-
suaded her to become immoral or be a party to the condemn-
able act.
Elements of ordinary qualified seduction:
a. The offended party must be a virgin;
b. The offended party must be over twelve but under eighteen
years of age;
c. There must be sexual intercourse between the offender and
the offended party; and
d. The sexual act was done through abuse of authority or
confidence.
( 1 ) Those who acted with abuse of authority:
(a) Person in public authority
( b ) Guardian
( c ) Teacher
( d ) Person who in any capacity is entrusted with the
education or custody of the woman seduced.
( 2 ) Those who seduced through abuse of confidence:
( a ) Priest
( b ) House-servant
( c ) Domestics
Elements of incestuous qualified seduction:
a. Sexual act between the offender and offended party; and
b. Blood relation between the offender and offended party.
(1) Brother who seduces his sister, or
(2) Ascendant who seduces his descendant.
A public school teacher who is in charge of education
had sexual intercourse with a student, is guilty of qualified
seduction (People v. Cariaso, 50 Phil. 884). The accused
need not be the teacher of the woman seduced. Suffice
it is if the accused is a teacher in the same school who has
moral influence over the student (Santos u. People, 40
O.G. supp. 6, 23).
The offended party went to the catholic church to
confess. The accused priest embraced and kissed her and
in spite of her resistance she was brought to the store-
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d. A promise made without any intention of fulfillment.

room of the convent where he was able to have sexual
intercourse with her. The acts of the priest were proven
in the trial court to constitute the crime of qualified
seduction (U.S. v. Santiago, 41 Phil. 1 793).
Sexual intercourse with the cousin of the wife who is
living in the house and a virgin, under 18 but over 12 is
guilty of qualified seduction because he took advantage
of his authority and there is abuse of confidence (People
v. Lauchengco, C.A. 45 O.G. 3845).
B. •E S E D U C T I O N :
Art, 338, Revised Penal Code — Simple seduction — The seduc-
tion of a woman who is single or a widow of good reputation, over
twelve but under eighteen years of age, committed by means of
deceit, shall be punished by arresto mayor.
Elements of the Crime:
1. The offended party is over twelve but less than eighteen years
of age;
2. The offended party must be single or a widow of good repu-
tation;
3. There must be sexual intercourse done by the offender with
her; and
4. The sexual act was committed by means of deceit.
The statute making simple seduction a crime is not to punish
illicit intercourse, but to punish the seducer who by means of his
promise of marriage, destroyed the chastity of an unmarried
female of previous chaste character, and who thus draws her aside
from the path of virtue and rectitude, and then fails or refuses
to fulfill his promise, a character so despicable in the eye of every
decent honorable man (People v. Iman, 62 Phil. 92).
Deceit is a fraudulent and cheating misrepresentation, artifice,
or device, used by one or more persons to deceive and trick
another, who is ignorant of the true facts, to the prejudice and
damage of the party imposed upon (French v. Vining, 102 Mass.
132, 3 Am Rep. 440). Deceit may be:
a. Suggestion, as a fact, of that which is not true, by one who
does not believe it to be true;
b. The assertion, as a fact, of that which is not true, by one who
has no reasonable ground for believing it to be true;
c. The suppression of a fact, by one who is bound to disclose
it, or who gives information of other facts which are likely
to mislead for want of communication of that fact; or
, The most common form of deceit is the promise of marriage,
but if the seducer is known to the victim to be married, even if
the previous promise of marriage cause her to accede to the sexual
act, the crime of simple seduction is not committed.
Virginity is not an element of simple seduction. It is sufficient
that the victim is a single or a widow of good reputation.
Medical Evidences in the Crime of Seduction:
Medico-legal investigation of a victim of seduction is practically
the same as in the case of rape insofar as proof of sexual inter-
course is concerned. However, medical proofs on account of the
application of force, and conditions that will cause the victim to
be deprived of her reason or otherwise unconscious are no longer
relevant.
Sometimes, the issue of the age of the victim becomes a problem
and its determination through medical proofs may be necessary.
The woman may claim to be less than 18 years old although she
is more than that at the time of the alleged commission of the
offense.
If the alleged criminal act developed into pregnancy and birth
of the child, the question of paternity may be necessary.
CTS OF LASCIVIOUSNESS
Acts of lasciviousness are acts which tend to excite lust; con-
duct which is wanton, lewd, voluptuous or lewd emotion (Black's
Law Dictionary).
Acts Considered Lascivious:
1. Embracing, kissing and holding the woman's breast (People v.
Collado, 60 Phil. 610).
2. Placing of the man's private organ over a girl's genital organ
(People v. Domondon, C.A. 364 O.G. 1977).
There are two articles in the Revised Penal Code penalizing
acts of lasciviousness, namely:
3. Art. 336, Revised Penal Code — Acts of lasciviousness.
4. Art. 339, Revised Penal Code — Acts of lasciviousness with the
consent of the offended party.
A. ACTS OF LASCIVIOUSNESS:
Art. 336, Revised Penal Code — Acts of lasciviousness — Any
person who shall commit any act of lasciviousness upon other
persons of either sex, under any of the circumstances mentioned
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in the preceding article (rape), shall be punished by prision cor-
reccional.
Elements of the Crime:
1. The offender commits any act of lasciviousness;
2. The lascivious act is done under any of the following circum-
stances
a. By using force or intimidation.
b. By depriving her of her reasons or otherwise unconscious.
c. When the woman is under 12 years of age.
3. The offended party must be a person of either sex.
The victim owed the defendant one peso. The defendant
sent policemen to her house and arrested her. The victim was
brought to the house of the accused and after beating her with
a stick, the defendant compelled her to take off her clothes
and dance before the defendant and many other persons. Such
acts constitute the crime of acts of lasciviousness (U.S. v.
Bailoses, 2 Phil. 49).
Acts of lasciviousness had been committed by the defendant
who held the offended party by the waist, touched her breast,
hugged her with the intention of kissing her, and touched her
private part against her will (People v. Famularcano, C.A. 43
O.G. 1721).
The accused went to the house of the woman and found
her to be alone. The accused gained admission to the house
under the pretext of asking for a drink of water, and while
inside the house, he embraced her against her will. The de-
fendant threatened to kill her if she refused to submit to his
desire. The acts constitute the crime of acts of lasciviousness
(People v. Collado, 60 Phil. 610).
B . A C T S O F L A S C I V I O U S N E S S W I T H T H E C O N S E N T O F THE
OFFENDED PARTY:
A. Forcible Abduction:
Art. 339, Revised Penal Code — Acts of lasciviousness with the
consent of the offended party — The penalty of arresto mayor
shall be imposed to punish any other acts of lasciviousness com-
mitted by the same persons and under the same circumstances
as those provided in article 337 (qualified seduction) and 338
(simple seduction).
age, except when the Victim is the sister or descendant of the
offender;
3. The offender commits the act by abuse of authority, confi-
dence, relationship or deceit;
4. The victim must be a woman, virgin, single, or widow of good
reputation, except when she is the sister or descendant of the
offender where virginity is not required.
A man who embraced and kissed his girlfriend (lover) is not
guilty of the crime of acts of lasciviousness with the consent of
the offended party because consent was not obtained through
abuse of confidence, authority, relationship, or by means of
deceit.
Medical Evidences in the Crime of Acts of Lasciviousness:
Like in the crimes of rape and seduction, medico-legal in-
vestigation is involved in proving the lascivious act itself and the
other elements to constitute the crime. Physical injuries may be
suffered by the victim on the part of the body where the lasci-
vious act was committed by insertion of his finger into the private
part of the victim or through the application of bodily force with
the consequent production of physical injuries.
Abduction is the carrying away of a woman by an abductor
with lewd design.
Lewd design is the intent of the abductor to have sexual inter-
course with the woman abducted. This can be inferred from the
acts of the offender.
There are two types of abduction punishable under the Revised
Penal code:
1. Forcible abduction ( A r t . 342)
2. Consented abduction ( A r t . 343)
Art. 342, Revised Penal Code — Forcible abduction — The
abduction of any woman against her will and with lewd designs
shall be punished by reclusion temporal.
The same penalty shall be imposed in every case, if the female
abducted is under twelve years of age.

Elements of the Crime: Elements of the Crime:

1. The offender commits acts of lasciviousness; 1. The victim abducted is a woman;
2. The offended woman must be over 12 but under 18 years of 2. The abduction is against her will; and
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3. The abduction is with lewd design.
The civil status, reputation and age of the woman abducted are
not the ingredients of the crime, however, in case the woman is
under 12 years of age, the crime committed is still forcible ab-
duction even if the woman consented.
If there are several abductors, it is sufficient that one of them
had lewd design.
Inference of lewd design may be deduced when the offender
kissed and embraced the offended party, took the victim farther
to an uninhabited place to perform lascivious acts on her.
In forcible abduction, the act of the offender is violative of the
personal liberty of the woman abducted, her honor and repu-
tation, and of public order (U.S. v. de Vivar, 29 Phil. 458).
Adultery 6hall be punished by prision correccional in its
medium and maximum periods.
If the person guilty of adultery committed this offense while
being abandoned without justification by the offended spouse,
the penalty next lower in degree than that provided in the next
preceding paragraph shall be imposed.
Elements of the Crime:
1. The woman is married;
2. She has had sexual intercourse with a man not her husband; and
3. The man with whom she had sexual intercourse knows her to
be married even if the marriage has subsequently been declared
void.

Reason for the Provision:

B. Consented Abduction:
Art. 343, Revised Penal, Code — Consented abduction — The
abduction of a virgin over twelve and under eighteen years of age,
carried out with her consent and with lewd designs, shall be
punished by the penalty of prision correccional in its minimum
and medium periods.
^Elements of the Crime:
1. The offended party must be a virgin;
2. The offended party must be over 12 but under 18 years old;
3. The carrying away of the offended party is with her consent;
and
4. The taking away must be with lewd design.
Rationale of the Provision:
The purpose of the law is not to punish the wrong done to the
girl, because she consents thereto, but to prescribe punishment for
the disgrace to her family and the alarm caused therein by the
disappearance of the one who is, by her age and sex, susceptible
to cajolery and deceit (U.S. v. Reyes, 20 Phil 510).
Adultery is made a crime to avoid introduction of foreign blood
in the family. Adultery may cause introduction of spurious heirs
into the family wherein the right of the real heirs may be impaired
(U.S. v. Mata, 18 Phil. 490).
Blood examination of the children born by such adulterous act
may be material in the presecution of the crime.
If the married woman and the paramour were caught "in flag-
rante delicto", medical examination of the woman may be neces-
sary to determine the presence of semen and spermatozoa in the
vaginal canal. Biological seminal grouping may be done to prove
the identity of the semen found.
B. Concubinage:
Art. 334, Revised Penal Code — Concubinage — A n y husband
who shall keep a mistress in the conjugal dwelling, or, shall have
sexual intercourse, under scandalous circumstances, with a woman
who is not his wife, or shall cohabit with her in any other place,
shall be punished by prision correccional in its minimum and
medium periods.
The concubine shall suffer the penalty of destierro.

^ a . ADULTERY AND CONCUBINAGE Ways of Committing the Crime:

A. Adultery:
Art. 333, Revised Penal Code — Who are guilty of adultery —
Adultery is committed by any married woman who shall have
sexual intercourse with a man not her husband and by the man
who has carnal knowledge of her, knowing her to be married, even
if the marriage be subsequently declared void.
1. Keeping a mistress in the conjugal dwelling; or
2. Having sexual intercourse, under scandalous circumstances,
with a woman who is not his wife; or
3. Cohabiting with her in any other place.
A married man committing concubinage violates the marital
vow.
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PROSTITUTION
Prostitutes are women who, for money or profit, habitually
indulge in sexual intercourse or lascivious conduct (Art. 202,
N o . 5, Revised Penal Code).
Requirements to be satisfied before a woman may be con-
sidered a prostitute:
1. She habitually indulges in sexual intercourse or lascivious acts.
A single isolated sexual intercourse or lascivious act for
money profit will not make a woman a prostitute. There
must be habituality or repeated acts. This makes prosecution
for the crime difficult. Medical evidence on this matter is pure-
ly presumptive.
A woman may still be considered a prostitute although she
does not indulge in the habitual sexual intercourse because
habitual indulgence in lascivious acts also makes her a prostitute.
2. When the habitual sexual intercourse or lascivious act is done
for money or profit.
Habitual sexual intercourses with several men but not for
money or profit will not make a woman a prostitute.
The penalty imposed on a woman who has been proven to
be a prostitute is arresto menor or a fine not exceeding 200
pesos, and in case of recidivism, by arresto mayor in its medium
period to prision correccional in its minimum period, or a fine
ranging from 200 to 2,000 pesos, or both, in the discretion of
the court (Art. 202, last par., Revised Penal Code).
Reasons why some women become prostitutes:
1. Physiological and psychological traits — Prostitutes are seldom
nymphomaniac, although nymphomaniacs may become pros-
titutes. Some of them are found to be emotionally unstable,
psychopathic, neurotic, suggestible, or addicted to the use of
tobacco, alcohol and narcotic drugs. They may be lonely and
may lack association with the intimate family circle.
2. Economic factors — They are financially hard up and indulge
in the business for fear of starvation. Their earnings are meager
and cannot maintain a decent life or cope with the domestic
needs.
3. Home and neighborhood — A great number of them comes
from broken homes, over-crowded homes with members of
both sexes sleeping in the same room, or having a male border
or roomer. In some instances the mother is a prostitute, and
the father is a pimp and their daughters are allowed to roam
in the streets and being initiated in sexual intercourse.
4. Influence of contraceptives — The availability of contraceptives
and prophylactic treatment for infection make it possible to
indulge in sexual relationship without fear of pregnancy and
infection.
(Criminology by Taft and England, p. 266).
Medico-legal Aspects of Prostitution:
1. Prostitution is one of the venues in spreading venereal and other
diseases.
2. Evidences may be gathered to prove sexual or lascivious acts.
Types of Prostitutes:
1. Call Girl — Receives telephone calls from the selected group of
customers and makes arrangements to meet them at a designated
place.
2. Hustler:
a. Bar or tavern "pick-up" — Frequent places where liquor is
sold, sometimes with the knowledge of the management,
b. Street walker — She finds her customers in various places and
makes the contact herself, but she may walk with taxicab
drivers.
3. Door Knocker — A newcomer in the field of prostitution. She
frequents small hotels and furnished rooms or roams in the
hall room of these places.
4. Factory Girl — She works in regular house of prostitution. She
accepts all comers and has nothing to do with the selection
and solicitation of customers. She is under the direct super-
vision of a "madam" or "mama-san" (Criminology by R.G.
Caldwell, 2nd ed., p. 125).
Personnel Associated with Prostitution:
1. "Madam" or "Mama-san" — She is the general manager of the
prostitution den. She handles cash, meets customers and
transacts all business for the house.
2. Procurer — The person is charged with the duty of getting
girls to work as prostitutes.
3. Transporter — The man or woman who takes prostitutes from
town to another.
4. Pimp or "Bugao" — one who gets customers. He may be a
taxicab driver, bartender, or a girl's own husband. He earn's
by percentage basis.
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Types of Prostitution Houses:

1. Disorder House - Employs only 4 to 8 girls in the business
This type is gradually disappearing as it is an easy target of
organized program against prostitution.
2. Furnished Room House — This is operated by experienced
madams. The house has 2 to 3 girls and also rooms for rent
to legitimate roomers in order to maintain the appearance of
respectability.
3. Call House — It is merely a place where a telephone is main-
tained by a madam. The customer calls, and the madam sends
the girl out to meet him.

Other Reasons for Indulging in Prostitution:

1. Poor social background with personality handicaps.
2. Previous sexual experience in or out of wedlock.
3. Contact with a person in or in the fringe of prostitution.
4. Desire for money or forced by loneliness, desertion or broken
promises. V u l v a o f prostitute w i t h l e u c o d e r m a

Effects of Prostitution: Methods of Control:

1. Arrest and imprisonment. 1. Legalized but regulated:
2. Venereal infection. a. Segregation of prostitute in a restrictive area.
3. Social ostracism. b. License given to the house of prostitution.
4. Poor personal hygiene. c. Periodic examination ol the prostitutes.
5. Excessive use of alcohol.
6. Irregular habit of eating and sleeping. Defects of the Method:
7. Demoralization and physical deterioration. a. Segregation does not segregate.
b. Many prostitutes fail to register, either through negligence
Medical Evidence in Prostitution: or desire to avoid the stigma which registration creates.
Genital examination required is the same as in any other sexual
c. The medical inspection does not protect.
offense.
d. Regulations create a false sense of security (overconfidence).
e. Regulations promote prostitution, foster immorality, corrupt
Can rape be committed on a prostitute?
officials and increase crime.
Yes, virginity or chastity of character is not a necessary element
of the crime of rape. However, medical proof of sexual inter- 2. Strict prohibition:
course is not a legal proof of the commission of rape.
a. Strict enforcement of legislation against prostitution and all
The fact that the offended person has been a person of un- activities connected with it.
chaste character constitutes no defense to the charge of rape,
b. Education of the public regarding sex, prostitution and
provided that it is proven that the illicit relations complained of
were committed with violence or force. The defendant in a venereal disease.
criminal action for rape is guilty of the crime if force or violence c. Adoption of medical measures and establishment of medical
was used, regardless of the good or bad character of the offended facilities for the diagnosis and treatment of venereal disease.
party (People v. Blance, 45 Phil. 113). d. Rehabilitation of prostitutes.
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e. Adoption of codes of self-regulation and organization of
community cooperation.
Other persons involved in the business of prostitution are
punished by the following provisions of the Revised Penal Code:
A. Corruption of Minors:
Art. 340, Revised Penal Code:
A n y person who shall promote or facilitate the prostitution or
corruption of persons under age to satisfy the lust of another, shall
be punished by prision correccional in its minimum and medium
periods, and if the culprit be a public officer or employee, includ-
ing those in government owned or controlled corporations, he
shall also suffer the penalty of temporary absolute disqualification
(as amended by B.P. 92).
Habitually or with abuse of authority or confidence was re-
moved from the original provision as an element in promoting or
facilitating the prostitution or corruption of persons under age to
satisfy the lust of another. A single act without abuse of authority
or confidence is now a crime. A mere proposal to promote or
facilitate the prostitution or corruption of a person under age is
already a consummation of the crime.
The term under age presumably means below the age of 18,
inasmuch as 18, insofar as sexual offenses are concerned, is the
age of legal consent.
B. White Slave Trade:
Art. 341, Revised Penal Code:
The penalty of prision correccional in its medium and maxi-
mum periods 6hall be imposed upon any person who, in any
manner, or under any pretext, shall engage in the business or shall
profit by prostitution or shall enlist the services of women for the
purpose of prostitution.
Ways of Committing the Crime:
a. Engaging in the business of prostitution.
b. Profiting by prostitution.
c. Enlisting the services of women for the purpose of prosti-
tution.
Any one of the above mentioned act is sufficient to constitute
offense which need not be habitual.
Abuse Against Chastity
Art. 245, Revised Penal Code:
The penalties of prision correccional in its medium and maxi-
mum periods and temporary special disqualification shall be
imposed:
1. Upon any public officer who shall solicit or make immoral or
indecent advances to a woman interested in matters pending
before such officer for decision, or with respect to which he is
requested to submit a report to, or consult with, a superior
officer;
2. Any warden or other public officer directly charged with the
care and custody of prisoner or persons under arrest who shall
solicit or make immoral or indecent advances to a woman under
his custody.
If a person solicited by the wife, daughter, sister or relative
within the same degree by affinity of any person in the custody
of such warden or officer, the penalties shall be prision cor-
reccional in its minimum and medium periods and temporary
special disqualification.
Ways of Committing Abuse Against Chastity:
1. By soliciting or making immoral or indecent advances to a
woman interested in matters pending before the offending
officer for decision or with respect to which he is required to
submit a report to, or consult with a superior officer.
2. By soliciting or making immoral or indecent advances to a
woman under the offender's custody.
3. By soliciting or making immoral or indecent advances to the
wife, daughter or relatives with the same degree by affinity of
any person in custody of the offending warden or officer.
Solicit means to propose earnestly and persistently something
immoral or indecent. Mere proposal is sufficient. It is not neces-
sary that the woman solicited yields to the solicitation of the
offender.
But proof of solicitation may no longer be necessary when
there is sexual intercourse. A warden of a woman prisoner entered
the cell and had illicit relation with her. On appeal the appellant
argued there was no proof of solicitation. Absence of sufficient
solicitation is not necessary when the act solicited was consumated
(U.S. v. Morales, 29 Phil. 572).
U N N A T U R A L SEXUAL OFFENSES
AND SEXUAL ABNORMALITIES
Unnatural sexual offenses are not only a deviation to the normal
course of nature but also uncommonly observed manifestations of
sexual perversion. Most of those persons suffering from the con-
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ditions do not exhibit criminal intent but manifesting mental aber-
rations which may be a subject-matter for the psychiatrist to treat.
Environment, degree of education, degree of morality, habits, etc.
are some of the factors responsible for such sexual maladjustments.
There is no specific provision of our Revised Penal Code on any of
the unnatural sexual offenses, although certain provisions of the code
may be made applicable.
Municipal ordinances of cities and towns may penalize unnatural
sexual offenses in consonance with the power to promulgate rules
and regulations necessary for the promotion of public safety, moral
and welfare.
Provisions of the Penal Code which may be Applicable to Unnatural
Sexual Offenses:
1. Grave Scandal:
Art. 200, Revised Penal Code:
The penalties of arresto mayor and public censure shall be
imposed upon any person who shall offend against decency or
good customs by any highly scandalous conduct not expressly
falling within any other article of the code.
Requisites of the Crime:
a. The offender performs act or acts;
b. Such act or acts is/are highly scandalous and offending against
decency and good customs;
c. It is also necessary that the act or acts be committed in a public
place or within the view or knowledge of the public (U.S. v.
Samaniego, 16 Phil. 663).
3. Vagrants and Prostitutes:
Art. 202, Revised Penal Code:
The following are vagrants:
1
2. Prostitutes.
For the purposes of this article, women who, for money or
profit, habitually indulge in sexual intercourse or lascivious
conduct, are deemed to be prostitutes.
Any person found guilty of any of the offenses covered by this
article shall be punished by arresto mayor or a fine not exceeding
200 pesos, and in case of recidivism, by arresto mayor in its
medium period to prision correccional in its minimum period or a
fine ranging from 200 to 2,000 pesos, or both, in the discretion of
the court.
4. Unjust vexation or any other coercion:
Art. 287, 2nd paragraph, Revised Penal Code:
Any other coercions or unjust vexations shall be punished by
arresto menor or a fine ranging from 5 to 200 pesos, or both.
Unjust vexation includes any human conduct, although not
productive of some physical or material harm would, however,
unjustly annoy of vex an innocent person (Guevarra).
SEXUAL ABNORMALITIES:
As to the Choice of Sexual Partner:
1. Heterosexual — Sexual desire towards the opposite sex. This is
a normal sexual behavior, socially and medically acceptable.

2. Immoral doctrines, obscene publications and exhibitions:
Art. 201, Revised Penal Code:
That penalty of prision correccional in its minimum period or a
fine ranging from 200 to 2,000 pesos, or both, shall be imposed
upon:
a. Those who shall publicly expound or proclaim doctrines openly
contrary to public morals;
b. The authors of obscene literature, published with their know-
ledge in any form, and the editors publishing such literature;
c. Those who in theaters, fairs, cinematographs or any other place
open to public view, shall exhibit indecent or immoral plays,
scenes, acts or shows; and
d. Those who shall sell, give away or exhibit prints, engravings,
sculptures or literature which are offensive to morals.
2. Homosexual — (Michaelangelo, Shakespeare, Oscar Wilde, Waltz
Whiteman), — Sexual desire towards the same sex.
a. Kinds of Homosexuals:
(1) Overt — Persons who are conscious of their homosexual
cravings, and who make no attempts to disguise their
intention. They make advances towards members of their
own sex.
( 2 ) Latent — Persons who may or may not be aware of the
tendency in that direction but are inclined to repress the
urge to give way to their homosexual yearning.
Tribadism (Lesbianism) — A special name for female
homosexuals wherein a woman has the desire to have
sexual intercourse with another woman. The "masculine
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woman may be the active subject during the sexual act.
Most lesbians have antipathy towards men.
3. Infanto8exual — Sexual desire towards an immature person.
a. Pedophilia — A form of sexual perversion wherein a person has
the compulsive desire to have sexual intercourse with a child of
either sex. Children of various ages participate in sexual activities,
like fellatio, cunnilingus, fondling with sex organs, or anal
sexual intercourse. Usually committed by a homosexual,
between a man and a boy the latter being a passive partner.
A Pedophile may be:
a. Homosexual pedophile — may attempt either oral or anal
intercourse with his victim.
b. Heterosexual pedophile — may attempt either oral, vaginal,
anal, intracrural intercourse as well as cunnilingus, but attempts
at vaginal penetration are most common.
Offenders entice their victim through promise of money,
candy, etc.
Reasons Why Physicians Fail to Detect Child Sexual Abuse:
a. The lack of "hard" physical evidence of abuse;
b. A belief that sexual abuse does not exist;
c. A fear of antagonizing parents; and
d. Ignorance of how to obtain a detailed sexual history from the
child.
Theories Why Adults become Interested in Children:
a. Emotional congruence — Children are sexually attractive to
adult for a number of reasons:
(1) Children are nondominant;
(2) Adults have low self-esteem, immaturity, socialization to
male dominance or narcissism; and
(3) Unconscious impulse, compulsively to repeat child-adult
sex contact to master, and his or her own early experience
of child-adult sexual abuse.
b. Conditioning Modeling — Behavioral modeling begins with early
childhood experience, positive or negative, and is conditioned
by hormonal abnormalities, child pornography and the mis-
attribution of arousal as being only from children.
c. Blockage — Alternative sexual gratification may become blocked
due to poor social skills with adults of the opposite sex, anxiety
about sex, unresolved oedipal conflicts, unavailability of or
conflict with a committed partner, as well as repressive social-
sexual norms.
d. Disinhibition — Sexual controls may become disinhibited due
to senility, dementia, mental retardation, psychosis, drug or
alcohol, impulse disorders, situational stress, failure of incest
avoidance, a general cultural acceptance.
(JAMA, Vol. 254, No. 16, Oct. 25, 1985).
4. Bestosexual — Sexual desire towards animals.
a. Bestiality (Zoophilia) — Sexual gratification is attained by
having sexual intercourse with animals.
5. Autosexual (Self gratification or masturbation) — It is a form of
"self-abuse" or "solitary vice" carried without the cooperation
of another person.
Relation of Masturbation to Health and Sex Crime:
a. It serves as a sedative for a variety of neurotic disposition.
Many persons who suppress the urge to masturbate and give up
the habit often develop an anxiety neurosis.
b. It serves as an adequate form of sexual gratification.
c. It prevents the development of homosexuality.
d. It prevents the development of suicidal tendency on account of
the absence of sexual gratification.
e. It protects certain persons from committing sex crimes.
Types of Masturbation:
a. Conscious Type — The person deliberately resorts to some
mechanical means of producing sexual excitement with or with-
out orgasm:
Ways of Masturbation:
(1) In male:
(a) By manual manipulation to the point of emission.
( b ) Ejaculation produced by rubbing his sex organ against
some part of the female body without the use of the
hand (frottage).
( 2 ) In female:
(a) Manual manipulation of the clitoris.
( b ) Introduction of the penis-substitute.
Medical evidences cannot go beyond to prove the emission of
semen, and unless caught "in flagrante delicto," it is not likely
that a person could be brought to trial. It may be a criminal act
if done in public places or within the knowledge and view of the
public. Psychiatric evaluation of the offender may be necessary.
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Flagellation — A sexual deviation associated specifically with

b. Unconscious type — The release of sexual tension may come
about via the mechanism of nocturnal stimulation with or
without emission, which may also be considered as "mas-
turbation equivalent". The explanation is that the conscious
urge to masturbate is repressed during the waking state and
expressed during the sleep when we are less apt to censor our
thoughts and desires.
7. Gerontophilia — Sexual desire with elder person.
8. Necrophilia — A sexual perversion characterized by erotic desire
or actual sexual intercourse with a corpse.
9. Incest — Sexual relations between persons who, by reason of
blood relationship cannot legally marry.
As to Instinctual Strength of Sexual Urge:
1. Over Sex:
a. Satyriasis — Excessive sexual desire of men to intercourse.
b. Nymphomania — Strong sexual feeling of women. They are
commonly called "hot" or "fighter". Both satyriasis and
nymphomania are general expression of compulsive neurosis.
2. Under-sex (Sexual frigidity):
a. Sexual anesthesia — Absence of sexual desire or arousal during
sexual act in women.
b. Dyspareunia — Painful sexual act in women.
o. Vaginisimus — Painful spasm of the vagina during sexual act.
d. Old age — Weakening of sexual feeling in the elderly. There
may be the desire but there is difficulty of accomplishment. It
may be accompanied by aberrant behavior, like exhibitionism,
incest, or homosexuality.
As to Mode of Sexual Expression or Way of Sexual Satisfaction:
1. Oralism — The use of the mouth as a way of sexual gratification.
a. Fellatio (Irrumation) — The female agent receives the penis of
a man into her mouth and by friction with the lips and tongue
coupled with the act of sucking initiates orgasm.
b. Cunnilingus — Sexual gratification is attained by licking or
sucking the external female genitalia.
c. Anilism (anilingus) — A form of sexual perversion wherein a
person derives excitement by licking the anus of another person
of either sex.
2. Sado-masochism (Algolagnia) — Pain or cruel act as a factor for
gratification.
the act of whipping or being whipped.
a. Sadism (Active Algolagnia) — A form of sexual perversion in
which the infliction of pain on another is necessary or some-
times the sole factor in sexual enjoyment.
(1) Cannibalism — Sexual gratification attained by biting
without flesh eating but with presumed unconcious wish
to consume.
(2) Love bites — These are superficial punctate contusions seen
most frequently at the side of the neck, overlying or anterior
to the sternomostoid muscle, breast and other parts of the
body. The bitten tissue must be loose and the mark is
caused by forcible sucking applied to tissue seized by the
mouth. Usually during the act the teeth are guarded by the
lips. Because of the sucking, contusion develops.
The infliction of such injury although amorous may be
a part of the sadistic attitude of the offender.
It is called necrosadism or lust murder if the victim dies.
The deviate has a strong homicidal urge, quite often suffer-
ing from organic brain disease or may be schizophrenic,
epileptic or psychopath.
b. Masochism (Passive algolagnia) — The pain and humiliation
from the opposite sex is the primary factor for sexual gratifica-
tion.
3. Fetishism — A form of sexual perversion wherein the real or
fantasied presence of an object or bodily part is necessary for
sexual stimulation and/or gratification.
Kinds of Fetishes:
a. Anatomic — Where particular portions of the anatomy, such as
the breasts, or buttocks are the target of interest for sexual
stimulation.
b. Clothing — The deviate may have interest centered on shoes,
handkerchief, undergarments, either on a sexual partner or
stolen from a neighborhood washline.
c. Necrophilic — The deviate has the desire to be near a dead body
and may or may not violate the dead person for sexual grati-
fication.
d. Odor (Ospresiophilia) — Fetish whose stimulus is pleasant odor
or foul odor for sexual stimulation or gratification.
(1) Urolagnia — A sexual deviation in which sexual excitement
is associated with the sight of women urinating. In some
instances, there is a desire to drink the urine.
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( 2 ) Coprolognia — A form of sexual deviation wherein sexual As to Visual Stimulus:

gratification is attained by seeing women defecate.
(3) Mysophilia — Sexual response to filth or excretion.
e. Pygmalionism — A sexual deviation whereby a person has
sexual desire for statues.
f. Mannikinism — Sexual desire with mannikins.
g. Narcissism — A person has extreme admiration and love of one's
self. Sexual gratification is attained by looking at the mirror
and appreciating his or her own self.
h. Negative fetish — The marked dislike for things, like eyeglasses,
beard, hair cut, as the sole stimulus for gratification.
i. Saboteur fetish — A deviate does damage while he gets satis-
faction, like cutting clothes or hair.
j. Incendiarism — Deviate derives sexual pleasure from setting fire.
(Did Nero belong to this category? ).
k. Vampirism — Deviate attains sexual stimulation or gratification
at the sight of blood.
As to the Part of the Body:
1. Sodomy — Sexual act through the anus of another human being.
2. Uranism — Sexual gratification attained by fingering, fondling
with the breast, licking parts of the body, etc.
3. Frottage — A form of sexual gratification characterized by the
compulsive desire of a person to rub his sex organ against some
parts of the body of another. They generally achieve their erotic
gratification by rubbing or pressing their organs against the but-
tocks of women in crowded subways, buses, theaters, or street-
cars. The frotteur often pretends that the rubbing is accidental.
4. Partialism — A form of sexual deviation wherein a person has
special affinity to certain parts of the female body. Sexual libido
may develop in the breast, buttock, foot, legs, etc. of women.
Usually, sexual intercourse is merely secondary to satisfy the
sexual desire.
A person may prefer rubbing his penis against the woman's
breast or may prefer his partner to lie prone and kiss the buttocks
or perform cunnilingus.
1. Voyeurism — A form of sexual perversion characterized by a com-
pulsion to peep to see persons undress or perform other personal
activities. The offender is sometimes called "Peeping Tom".
Usually after peeping, he masturbate in excess.
2. Mixoscopia (Scoptophilia) — A perversion wherein sexual pleasure
is attained by watching couple undress or during their sex in-
timacies.
As to Number:
Normal sexual relation is only between a man and a woman, but
deviation in sexual behavior may attain gratification when more than
two persons are participating.
1. Troilism (Menage a trois') — A form of sexual perversion in which
three persons are participating in the sexual orgies. The com-
bination may consist of two men and a woman or two women and
a man. The usual activity may be fellatio, kissing the buttock,
sucking the breast, a "suixante-neuf" (sixty-nine) arrangement,
or coitus combined with other sexual practices. Sexual gratification
is attained in the "eternal triangle".
A husband may request his wife to invite another woman
and spend their night in a room. In their nude condition, the
husband may perform cunnilingus to the woman and at the same
time performing coitus with his wife. The invited woman may
remain doing nothing other than kissing the buttock of the husband.
2. Pluralism — A form of sexual deviation in which a group of
person participate in the sexual orgies. T w o or more couples
may perform sexual act in a room and they may even agree to
exchange partners for "variety sake" during the "sexual festival".
Other Sexual Deviates:
1. Coprolalia — A form of sexual deviation characterized by the need
to use obscene language to obtain sexual gratification. Sometimes
they go beyond uttering profane words by making some writings
and sketches on the walls of toilets.
2. Don Juanism — The term applied by psychiatrists to describe a
form of sexual deviation characterized by promiscuity and making
seduction of many women as a part of his. career. The pervert
cannot find anyone to be a permanent companion.

Frottage differs from partialism in the sense that in the former 3. Indecent exposure (Exhibitionism) — This is the willful exposure
there must be rubbing at certain parts of the body to arouse in public places of one's genital organ in the presence of other
sexual stimulation, while in the latter the act may not only be persons, usually of the opposite sex. Usually, the exhibitionist is
rubbing but actual intercourse. naked. It is the act of men whose sexual satisfaction is attained
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principally by exhibition with or without performance of mas-

turbatory act. Women may expose themselves naked in public
as in "bubble and fan" dances and the "strip tease" acts in night
clubs.
In civilized society, exhibitionism committed in public places
is harmful to the sense of decency and good morals, hence it is
punishable.
One evening two detectives and a reporter with a camera
entered one of the burlesque shows and they found the theater
dark with a dim light in the stage where a woman was seen
swaying her hip to and fro and sometimes raising her feet
one after another. She had on an "abbreviated" nylon panty
and patches on her breasts to interrupt her stark nakedness.
There were about 100 people inside the theater and while the
girl (accused) was dancing the people shouted in Tagalog
"Sigue, muna, sigue, nakakalibog".
The dancer was later apprehended and charged for immoral
exhibition. H E L D : She was found guilty, because the act
deprived or corrupted those minds which were susceptible to
immoral influence. The object of the law is to protect the
public. The reaction of the public during the show showed
the act to be immoral (People v. Aparici, G.R. 13375).
Sexual Reversal:
1. Transvestism ("Sexo-esthetic inversion", "Psychical hemaphro-
ditism" or "Metamorphosis sexualis paranoica") — A form of
deviation wherein a male individual derives pleasure from wearing
the female apparel. This condition is found sometimes in females
who desire to dress themselves in male attire. The transvestite has
a psychic identification with the opposite sex. A female trans-
vestite may imagine that she possesses a penis. It is quite difficult
to detect a female transvestite, since it is quite common for
women to wear slacks or dress in masculine tailored ways.
Transvestites are, as a rule harmless insofar as they have no
desire to assault anyone. Like exhibitionists they are merely
interested in attracting attention. Transvestitism is a symptomatic
expression of some deep underlying sexual maladjustment amen-
able to psychotherapy.
2. Transexualism — There is a dominant desire in some persons to
identify themselves with the opposite sex as completely as possible
and to discard forever their anatomical sex. So strong is the com-
pulsion to have the opposite sex that they hate their genitalia as
a persistent evidence that they are not what they want to be, and
538 LEGAL MEDICINE
sometimes attempt to castrate themselves or mutilate their ex-
ternal genitalia. They may go to the extreme of taking for a long
period of time sex hormones to develop secondary sex charac-
teristics of the opposite sex. They may go to the extent of sub-
jecting themselves to surgery to change their anatomical sex.
3. Intersexuality — A genetic defect wherein an individual show
intermingling, in varying degrees, of the characteristics of both
sexes including physical form, reproductive organs, and sexual
behavior.
Classification of Intersexuality:
a. Gonadal agenesis — The sex organs (testes or ovaries) have never
developed. This condition can be determined very early in
fetal life.
b. Gonadal dysgenesis — The external sexual structures are present
but at puberty the testes or the ovaries fail to develop.
( 1 ) Klenefetter's syndrome — A male type of dysgenesis in
which although the anatomical structure is entirely male,
the nuclear sexing is female (Chromatin positive), charac-
terized by the presence of small testes with fibrosis and
hyalinization of the seminiferous tubules. It is associated
with X X Y chromosomes.
( 2 ) Turner's syndrome — Structurally and phenotypically
female but the ovaries are small. There is sterility with the
absence of the second X chromosomes.
c. True hermaphroditism — A state of bisexuality, having both
ovaries and testicles. The nuclear sex is usually female. The
character may be neutral or whichever is dominant.
d. Pseudohermaphrodite — Sex organ is anatomically of one sex
but the sex characters is that of the opposite sex.
( 1 ) Male pseudohermaphrodite — Gonads are testicles but the
character is effeminate.
( 2 ) Female pseudohermaphrodite — Gonads are ovaries but
with masculine character.
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Chapter XXII
PREGNANCY
Pregnancy is the state of a woman who has within her body the
growing product of conception or a fecundated germ. It commences
from the time the egg cell is fertilized and terminates at the time
such product of conception is expelled or delivered. The average
duration of pregnancy is 270 to 280 days from the first day of the
last menstruation. There is no perfect way of determining its du-
ration, although several methods are employed, none of the methods
are perfectly reliable.
Legal Importance of the Study of Pregnancy:
1. Pregnancy is a ground for the suspension of the execution of the
death sentence in a woman:
Art. 83, Revised Penal Code:
Suspension of the execution of the death sentence:
The death sentence shall not be inflicted upon a woman within
the three years next following the date of the sentence or while
she is pregnant, nor upon any person over seventy years of age.
In this last case, the death sentence shall be commuted to the
penalty of reclusion perpetua with the accessory penalties in
article 40.
2. A conceived child is capable of receiving donation:
Art. 742, Civil Code:
Donations made to conceived and unborn children may be
accepted by those persons who would legally represent them if
they were already born.
3. A conceived child may exercise civil rights:
Art. 40, Civil Code:
Birth determines personality; but the conceived child shall be
considered born for all purposes that are favorable to it, provided
it be born later with the conditions specified in the following
article.
Art. 41, Civil Code:
For civil purposes, the foetus is considered born if it is alive at
the time it is completely delivered from the mother's womb.
However, if the foetus had an intrauterine life of less than seven
539
months, it is not deemed born if it dies within twenty-four hours
after its complete delivery from the maternal womb.
4. Concealment of the woman that she is pregnant at the time of
marriage is a ground for the annulment of marriage:
Art. 85, Civil Code:
A marriage may be annulled for any of the following causes,
existing at the time of the marriage:
( 4 ) That the consent of either party was obtained by fraud,
unless such party afterwards, with full knowledge of the
facts constituting the fraud, freely cohabited with the other
as her husband or his wife, as the case may be.
Art. 86, Civil Code:
Any of the following circumstances shall constitute fraud
referred to in number 4 of the preceding article:
(3) Concealment by the wife of the fact that at the time of
the marriage, she was pregnant by a man other than her
husband.
No other misrepresentation or deceit as to character, rank,
fortune or chastity shall constitute such fraud as will give grounds
for action for the annulment of marriage.
Art. 87, Civil Code:
The action for annulment of marriage must be commenced
by the parties and within the periods as follows:
( 4 ) For causes mentioned in number 4, by the injured party
within four years after the discovery of the fraud.
Instances W h y Some Women Claim Pregnancy Even if None Exists:
1. Pregnancy is a ground for the suspension of the death sentence
in a woman:
If a woman claims that she is pregnant at the time of execution,
she may file for a motion or petition in court for the suspension of
the execution of the death sentence, and if found to be pregnant,
the execution will be deferred until she has delivered.
2. A lawful plea in mitigation when charged with theft:
A woman may be accused of the crime of theft. She may
raise the plea in mitigation of kleptomania brought about by her
temporary insanity due to conceptfon.
3. A ground for widow's larger claim:
A widow may claim larger damages as a result of the recent
death of her husband on account of the negligence of another.
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4. Claim for the posthumous child:
A widow may ask or petition the court for the share of the
posthumous child in the estate of the deceased husband.
5. F o r black-mailing purpose:
A woman may claim that she is pregnant for the purpose of
black-mailing a man or for the purpose of inducing a man to marry
her.
Instances W h y Some Women Deny the Existence of Pregnancy:
1. When there is no ground for them to become pregnant:
Women who are unmarried, or divorced, or who are living
separately from their husbands for a time may be accused by
someone that they are pregnant. To defend their moral and
social reputation, they deny the existence of pregnancy.
2. Defense when accused of infanticide or abortion:
The absence of previous pregnancy may be used as a defense
when a woman is accused of infanticide or abortion. Infanticide
cannot be committed unless there has been previous pregnancy.
3. Marriage inducement:
A woman may deny the existence of pregnancy by another
man, to induce the man to marry her.
MEDICAL EVIDENCES OF PREGNANCY:
Signs and symptoms of pregnancy may be divided into presump-
tive or probable and positive or certain:
A. Presumptive or Probable Signs and Symptoms:
1. Cessation of Menstruation:
A married woman who missed her menstruation is presumed
to be pregnant, however, cessation of menstruation may be
due to some other causes other than pregnancy. Emotional
disturbance, anemia, systemic infection, disturbance in the
function of the ovary, may bring about amenorrhea. It is also
worthy of mention that a woman is capable of menstruating
even though she is pregnant. This is possible during the first
three months of pregnancy, but no longer possible during the
later period on account of the fusion of the decidua vera to
the decidua capsularis. A nursing mother may not menstruate
during the period she is nursing the child.
2. Morning Sickness:
This is the pernicious vomiting of a pregnant woman more
manifest in the morning. Although this is a frequent pheno-
mena in the early stage of pregnancy, other conditions may
also give rise to the same symptoms. The hypertonicity of the
stomach, peptic ulcer, gastric hyperacidity may simulate
morning sickness of pregnancy.
3. Changes in the Breast:
There is increase in size and sensation of tightness of both
breasts. The pinkish-brown color of the areolae are changed
into dark-brown or black. The tubercles of Montgomery are
developed and the tissues are erectile. Colostrum is found on
the third month. Secretion of milk may occur in a non-preg-
nant woman, as in tumor of the ovary.
4. Progressive Enlargement of the Abdomen:
At the end of the third month, the fundus of the uterus is
at the level of the brim of the pubic bone. At later periods,
there is gradual increase in size of the uterus capable of percep-
tion by palpation on the abdominal wall. The enlargement of
the abdomen may be due to tumor of the uterus or ovarian
cyst, or other abdominal pathology.
The relation between the age of the fetus and the level of
the fundus of the uterus is as follows:
3 calendar months (complete) — 3 fingers above the pubic bone.
4 calendar months " — Between the symphysis and
umbilicus.
5 calendar months — 3 fingers below the umbilicus.
6 calendar months — At the level of the umbilicus.
7 calendar months — 3 fingers above the umbilicus.
8 calendar months — 6 fingers above the umbilicus.
9 calendar months — More than 8 fingers above the
umbilicus.
Note: In some women the 9th month has the same level as the
8th month because sometimes the head of the fetus
approximates the pelvic cavity so that fundus does not
go so high.
5. Changes in color of the vagina and softening of the cervix:
There are different signs to show change in color of the
vaginal wall and softening of the cervix.
a. Jacquemin-Chadwick's Sign:
There is a pale violet discoloration of the anterior wall of
the vagina below the urethral meatus. The color changes to
bluish as pregnancy advances and in some cases it becomes
later very dark or black in color.
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d. GoodelVs Sign:
When the cervix of the uterus feels as hard as the tip of
the nose, pregnancy does not exist, but when it is as soft as
the lips, the uterus is gravid.
6. Funic Souffle or Umbilical Souffle:
Funic souffle, sometimes called umbilical souffle, is the
whistling sound synchronous with the fetal heart beat and is
only of subordinate value owing to the possibility of other
sounds being mistaken for it.

7. Ballottement:
This is the feeling perceptible to the fingers on giving
sudden impulse to the child through the neck of the uterus.
The child floating in liquor amnii is driven by the impulse
against the other side of the uterus, and it is this blow against
the womb that is perceptible to the hand placed on the ab-
domen.

8. Braxton-Hick's Sign:
This is the rhythmical contraction and relaxation of the
uterus, perceptible to the hand when resting on the abdomen.
The interval of contraction is usually five to twenty minutes
and lasting from two to five minutes. Fibroid uterus may
also give this sign.

9. Bladder Irritability :
Irritability of the bladder is a common occurrence among
pregnant women. This is noticeable at the second month of
pregnancy, manifested as frequent urination. However, it has
of no diagnostic value because even a non-pregnant woman
may manifest the same symptom.

10. Capricious Appetite:

b. Hegar's Sign:
Bi-manual examination of the gravid uterus shows ex-
treme softening of the cervix.
c. MacDonald's Sign:
On account of the softening of the isthmus, the fundus of
the uterus is anteflex, so by bi-manual examination, there is
an easy approximation of the fundus and the cervix.
Women during the early stage of pregnancy or even there-
after may have specially capricious appetite. The desire for a
particular class or kind of food is shown by a conceiving
woman. Not all women do manifest this sign and its pre-
sence will not conclusively show the presence of pregnancy.
11. Abnormality in Pigmentation:
The pregnant woman usually manifest pigmentations in
some parts of the body especially in the abdomen and peri-
neum. It may not be very prominent among colored people.
Pigmentation may be present in some diseases, like Addison's
disease.
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12. Easy Fatigability: 2. Reagents:

A pregnant woman easily gets tired on slight effort. This
may be due to the weight of the gravid uterus and insuf-
ficiency of nutrient and oxygen supply to the tissues of the
body due to the deviation of a portion to the growing fetus.
Easy fatigability is present also in cardiac and pulmonary
diseases, debilitating affection and old age.
B. Positive Signs and Symptoms of Pregnancy:
The finding of any of the following signs or symptoms of
pregnancy will show conclusively its existence:
1. Hearing of the Fetal Heart Sounds (Mayor's Sign):
The heart beat of the fetus is compared to the ticking of a
watch under the pillow. The rate is 120 to 140 beats per
minute. The location is at the anterior abdominal wall and is
dependent upon the presentation and position of the fetus.
Fat and amniotic fluid may interfere with the intensity of the
sound,
2. Outlining of the Fetal Parts:
By palpation, we can determine the head, neck, arm, back
and buttocks. If these parts could be outlined, the pregnancy
is sure, however, it may be confused with irregular ovarian
cyst.
3. Movement of the Fetus (Quickening):
The movement of the fetus may be felt by the woman and
may be visible to other observers. This is an indisputable
evidence of life, and is observed at the fifth month of pregnancy.
4. X-ray Examination:
Fetal skull and vertebra are visible with x-ray examination.
This is positive at the fifth month of pregnancy. X-ray is also
valuable to determine the presence of plural pregnancy, mal-
formation and death of the fetus. However, this must not be
used injudiciously for diagnostic purpose only on account of its
bad effect on the fetus.
Laboratory Test for Pregnancy:
A.Pregnancy Slide Test:
1. Principle — An agglutination-inhibition reaction is used to
demonstrate the hormone human chorionic gonadotropin
( H C G ) which is excreted into the urine during pregnancy.
H C G which is chemically bound to latex particles is agglutinated
by HCG antibodies in the presence of free HCG, this reaction
is inhibited because the antibodies are neutralized.
a. Pregnancy Slide Test antiserum (human H C G antiserum from
rabbit)
b. Pregnancy Slide Test antigen ( H C G latex suspension, che-
mically bound)
3. Procedure:
Place 1 drop of urine, then 1 drop of Pregnancy Slide Test
antiserum 1 in one of the circles on the test slide and mix
thoroughly with a disposable stirring rod.
A d d 1 drop of Pregnancy Slide Test antigen 2 (shake well).
Mix well with the stirring rod, distributing the mixture over the
whole area of the circle.
Carefully agitate the slide with a circular motion to ensure
that the fluid revolves slowly within the circle.
Read the result after two minutes.
4. Interpretation of result — If there is no agglutination (homoge-
neous) the urine tested came from a pregnant woman. If there
is agglutination (granular), the urine came from a non-pregnant
woman.
5. Sensitivity — H C G concentration of 1.5-2.4 IU/ml urine and
over are detectable with "Pregnancy Slide Test". A positive
reaction is often possible within 5 days of the missed menstrual
period. Usually the pregnancy will be diagnosed 12 days
after the missed menstrual period.
6. Remarks — Fresh urine preferably morning urine is suitable
for use.
It is advisable to have controlled urine from known positive
or negative subjects.
If the result is doubtful, it is advisable to repeat the test a
few days later.
B. Gravindex HCG Slide Test — The principle involved and procedure
is practically the same as the Pregnancy Slide Test. Gravindex is
merely a trade name.
Characteristics of the fetus in various periods throughout pregnancy
(Calendar Months):
End of first month —Length — 1.0 cm.; Diameter — 2.0 cm.;
Eyes, ears and mesodermic segments are dis-
tinguishable; Limb buds are present.
End of second month—Length — 3.0 cm.; Diameter — 6.5 cm.;
Weight — 15.5 gm.
End of third month —Length — 8.0 cm.; Weight — 85.0 gm.;
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Chorion laeve has lost most of its villi, neck
is develop, oral and nasal cavities are se-
parated by the development of the paint*
Sexual organs have appeared, fingers and
toes are present, and nails can just be detec-
ted. Ossification has begun in most of the
bones.
End of fourth month — Length — 13 cm.; Weight — 204 gm.; Sex
can be distinguished; Skull partly ossified,
with wide sutures and fontanelles.
End of fifth month —Length — 22.5 cm.; Weight — 450 gm.;
Hair and lanugo have appeared; Skin begins
to be covered with vernix caseosa.
End of sixth month — Length — 30 cm.; Weight — 900-1,100 gm.;
Skin is still wrinkled, but subcutaneous fat
is beginning to form; Eyebrows appear;
End of seventh month— Length — 37.5 cm.; Weight — 1 Vt kg.;
Eyelids open; Testicle is beginning to des-
cend unto the scrotum; nails do not reach
the tip of fingers; Lanugo disappearing from
the face; Child is viable (28 weeks).
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End of eight month — Length — 42 cm.; Weight — 2 to 2 A kg.;
Skin is only slightly wrinkled, and flesh
colored; Lanugo beginning to be shed;
Left testicle is generally in scrotum.
At term — Length — 50 cm.; Weight — 3 to Z A kg.; l
Nails beyond or at the level of the finger
tips; Hair of the scalp is 5 cm. long; Lanugo
is only seen on the shoulder.
(Obstetrics and Gynecology by Aleck Bourne, 10th ed., p. 21-22).
Signs of Pregnancy in the Dead:
In addition to the objective signs already mentioned, the follow-
ing additional findings are present if the pregnant woman dies:
1. Presence of Ovum or Fetus:
Examination of the uterine content will reveal the product of
conception together with the placenta, amniotic fluid, and mem-
brane.
2. Findings on the Uterus Itself:
There is thickening, increase in size and capacity of the uterus.
The mark of placental attachment may be seen.
3. Corpus Luteum:
Corpus luteum may be well-developed and attains a certain
size, however, it may gradually retrogress, but it is usually well-
developed at the time of delivery. The changes in the corpus
luteum may also be found in fibroid tumor or other pathological
condition and even in cases of congestion.
Duration of Pregnancy:
The average duration of pregnancy is 270 to 280 days from the
onset of the last menstruation. There is no means of determining it
with certainty. The evidence derived from pregnancy following a
single coitus is trustworthy, but inasmuch as some authorities
consider more than two weeks as the life span of the spermatozoa
in the vaginal canal, it is hard to ascertain the exact date of fertili-
zation. There is no synchrony between coitus and fertilization.
Abnormally Prolonged Gestation:
Cases in which pregnancy extends to 300 days can now be regarded
as well established. Many examples of longer duration have been re-
corded, but most of them are doubtful. Eden quotes sex cases which
have been accepted as authentic in which the calculated period of ges-
tation lay between 311 and 336 days, the weights of the infant ranging
from 12-3/4 to 13-1/4 pounds. In all cases where the gestation much
over 300 days is alleged, confirmatory evidence should be expected
in the exceptional weight and size of the child (A Handbook of
Medical Jurisprudence and Toxicology by W. Brend, 8th Rev. ed.,
p. 113).
Minimum Period of Gestation Compatible with Viability of the Child:
Most authors hold that a child born at one hundred and eighty
days of gestation may live. A child may be born alive before this
period, but it is not viable or capable of living. A fetus of three
or four months development may exhibit signs of life, movements
of the limbs, etc., but cannot continue to live, owing to the want of
development of the breathing muscles and breathing center. Most
6 months old infants die immediately or within a few days of birth;
occasionally one has been reared (Cox's Medico-Legal Court Com-
panion by Bhattacharyya, 4th Revised ed., p. 248).
Methods of Estimating the Date of Expected Delivery:
1. From the date of the first day of the last menstruation, add seven
days and count three months backwards.
2. Count forward nine calendar months from the date of the first
day of the last menstruation and add one week.
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3. Count forty weeks or ten lunar months from the date of the first
day of the last menstruation.
4. Determination of the level of the fundus of the uterus, (supra,
p. 542)
5. MacDonald Method:
Measure the distance from the symphysis pubis up to the fundus
of the uterus in centimeters divided by 3.5 gives the age in month
of gestation.
6. Date of the quickening. It is customary to count ahead 24 weeks
in multigravidas and 22 weeks in primagravidas from the date of
the quickening. This has been found not to be reliable.
Proofs of Previous Pregnancy:
1. Laxity of the abdominal wall.
2. Presence of striae of pregnancy on the abdominal wall.
3. Perineum is lax with a scar if there was previous laceration. Four-
chette is markedly retracted.
4. Vestige only of the hymen is present (caruncula myrtiformis).
5. Breast is lax with enlarged nipples.
6. Vaginal examination shows previous laceration of the cervix.
Diagnosis of Fetal Death:
The fetus inside the uterus must be presumed to be alive unless
there are evidences to the contrary. The following are proofs that
the fetus is dead:
1. Repeated examinations of the uterus show that the size remains
stationary even after a lapse of a number of weeks and months.
2. Endocrine test for pregnancy is negative on more than one oc-
casion. Moreover, death of the fetus may not mean death of the
placental tissue which manufacture gonadotrophin. As long as the
placental tissue continues to manufacture the trophic hormone,
it will be positive in the urine.
During the later months of pregnancy, the following are the addi-
tional proofs of death of the fetus:
3. Cessation of the fetal movement after they have been felt.
4. Absence of fetal heart sounds after a repeated and prolonged
examination.
5. Positive signs of fetal death as shown by the palpation of softened
macerated fetal head, with bones freely movable on each other
and the scalp hanging over a loose sac.
6. The breasts cease to enlarge and become soft and flabby.

Super fecundation:
This is the fertilization made by separate intercourses of two
ova which have escaped at the same act of ovulation.
Superfoetation:
This is the fertilization of two ova which have escaped at dif-
ferent acts of ovulation. This is possible before the time the decidua
vera has united with the decidua reflexa; that is, before the end of
the third month of pregnancy.
Pseudocyesis or Spurious Pregnancy:
It is an imaginary pregnancy usually observed among women
nearing menopause or in younger women who are very desirous of
having children. The patient will present all the subjective symptoms
of pregnancy, associated with an increase in the size of the abdomen
due frequently to abnormal and rapid deposition of fat or to tym-
panism. The menses may not totally disappear but may present
abnormalities which the patient may attribute to her supposed con-
dition. The patient may imagine fetal movement which in reality
is muscular contraction. There is great difficulty in persuading the
woman to believe that she is not pregnant.
May a Woman W h o Is Pregnant Be Unconscious of Her Condition?
It is hardly credible but may happen in rare instances. A woman
after being married for several years and has dismissed in her mind
the possibility of being pregnant may grow stouter or may entertain
the possibility that the enlargement of the abdomen is due to some
internal pathology or disease.
Is It Possible for a Child to be Born Without Human Form?
Following the principles of heredity, no child can be born without
human form. Hereditary qualities are transmitted from parents to
offsprings. Monstrosities and other forms of abnormalities of a child
does not divorce from the child the human form. Close inspections
of the monsters and congenitally deformed children will show
human form. Our present civil code eliminated "human form" as a
requisite for the personality of a new-born child.
Can Impregnation Occur When the Woman Is Unconscious?
This has been proven in many cases. A woman may be under
the influence of narcotics, anesthesia, alcohol or other knock-out
drugs during the sexual intercourse which resulted in her pregnancy.
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Chapter XXIII

DELIVERY

Delivery is the process by which a woman gives birth to her

offspring.
Puerperhun is the interval between the termination of labor
(delivery) to the complete return of the reproductive organ to its
normal nonpregnant state. Puerperium usually lasts from 6 to 8
weeks.
The study of delivery is important because proof of delivery is
necessary in judicial action on the following:
PREGNANCY 551 1. Legitimacy
2. Abortion
When Does Menstruation Commence? 3. Infanticide
In the Philippines, menstruation used to commence at the age of 4. Concealment of birth
twelve to fourteen. In colder countries, it may be established at the 5. In slander or libel
age of fourteen to sixteen.
Methods of Delivery:
When Does Menstruation Cease? 1. Natural Route:
The average age when menstruation ceases is forty-five. However, Expulsion of the products of conception through the normal
there are records in literature wherein women menstruate at the age passage; that is, through the vaginal canal.
of seventy-three. The cessation of menstruation is also called climac-
terium or menopause. a. Spontaneous:
When the products of conception passed out of the vagina
What Is The Earliest Age When Pregnancy Is Possible? without the aid of physician, midwife, instrumentation or
As long as the woman is menstruating, she has also the potential surgical intervention.
capability of being pregnant. Some women have preconscious sexual b. Surgical Intervention:
development. Anna Mumenthaler menstruated regularly at the age
When delivery is effected with the aid of surgery, e.g., Sym-
of two, and gave birth to a full term child at the age of nine.
physiotomy.
c. Instrumentation:
The second stage of labor is modified by the use of instru-
ments. Example: Forceps application.
2. Surgical Route:
The expulsion of the products of conception is not through
normal openings of the female generative tract but through some
artificial openings brought about by surgery,
a. Abdominal Caesarian Section:
The child is delivered by opening the abdominal wall and the
anterior wall of the uterus.
552
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b. Vaginal Caesarian Section: 7. Uterus is enlarged and palpable:

Immediately after delivery, the uterus does not return to
The child is delivered thru the surgical opening made through
the vagina. its original size. It takes time for its sub-involution. Due to
the flaccidity of the abdominal wall, the enlarged uterus is
c. Post-mortem Caesarian Section:
easily palpable.
When the pregnant woman meet sudden death either natural- 8. Laxity of the perineum with possible tear:
ly or through violence and there is no chance of life, any person
The perineum is elastic and may yield to distention pro-
may open the abdomen to get the viable fetus en utero.
vided it is given ample time to stretch and provided the fetus
A. SIGNS OF RECENT D E L I V E R Y : is not so big in size. The passage of the fetus at the outer end
1. Languid look, with pulse and temperature slightly increased: of the birth canal is responsible for the relaxation of the con-
nective tissue and muscles of the perineum. If there is abrupt
This usually disappears normally in two or three days after
distention, a perineal laceration may be produced. Laceration
delivery. However, these symptoms may be present in other
of the perineum is frequent when the second stage of labor
conditions or sickness, hence cannot be conclusive.
is accentuated by push from the fundus of the uterus.
2. Peculiar odor:
The characteristic odor of the lochial discharge is present
up to the tenth day of confinement. The odor is fishy but
sometimes the said odor is present on women who are men-
struating normally.
3. Changes in the breast:
There is a sensation of tightness of the breasts and milk
may be expressed. The presence of colostrum corpuscles in
the milk suggests that parturition has just taken place.
4. Flaccidity of the abdominal wall:
The laxity of the abdominal wall is due to the distention
when the uterus is gravid to accommodate the growing pro-
duct of conception en utero. However, a previous ascites or
cystic condition of the ovary or other internal pathology
causing enlargement of the abdomen will also give rise to
laxity of the abdominal wall.
5. Linea Albicantes present in the abdominal wall:
At first it is reddish in color and is called linea rubra. It
is brought about by the breaking of the capillaries when the Vulva after Drevious childbirth and laceration of the perineum.
abdomen is distended. Later, a scar-like tissue develops from
the area and is called "Linea albicantes." This is also called 9. Vaginal canal is lax and with possible lacerations:
striae of pregnancy. The normal rugosities of the wall of the vaginal canal is
6. Presence of Linea Nigra: lost due to severe distention. Occasionally, in severe perineal
During the course and development of the gravid uterus, laceration, there is also involvement of the wall of the vaginal
there develops on the abdominal wall from the region of the canal.
symphysis pubis to the umbilicus or even above it a dark 10. Cervix of the uterus is flabby, patulous and may be torn:
pigmentation of the skin. This pigmentation which is usually The normal hard, doughly consistency of the cervix is lost,
in the form of a straight line in the median line persists up to but instead it is soft "and flabby. In most cases there is lacera-
delivery. The origin of linea nigra is most probably hormonal.
tion of the orifice.
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11. Presence of lochial discharge:

Lochia is the discharge from the vagina after delivery. First
it is bloody but later it is almost colorless. When bloody, it
is called "lochia rubra" and when colorless, it is called "lo-
chia serosa." When there is infection of the uterus after
delivery, the odor of the lochial discharge is foul and usually
black.
12. Evidence of placenta, umbilical cord and new-born child.
13. Positive Pregnancy Slide Test (supra p. 545).

B . SIGNS O F R E M O T E D E L I V E R Y I N T H E L I V I N G :
1. Changes in the breast:
The breast becomes pendulous and linea albicantes are found
on the skin on account of the retraction of its size. There is
dark color of the areolae and the consistency is soft. The nipples
are prominent due to the sucking of the child.
2. Vulva and perineum:
Scar of the previous laceration may be present. There is
marked retraction of the fourchette and perineum.
3. Hymen:
Remains of the hymen may only be present in the form of
carunculae myrtiformis. Very rarely is the hymen preserved
after delivery.
4. Signs of previous laceration of the cervix:
The opening of the cervical canal may no longer be seen as
a round hole but slit-like on account of the previous laceration
during delivery.
5. Presence of striae of pregnancy or linea atrophica on the ab-
dominal wall.
556 LEGAL MEDICINE
2. Findings in the ovary:
There is presence of corpus luteum.
3. Findings in the other organs:
a. Hydremia of the blood.
b. Slight anemia. depending upon the amount of hemorrhage in
the delivery and immediately thereafter.
c. Congestion and hypertrophy of the milk glands of the breast.
4. Pathology accountable for the cause of death:
a. Signs of eclampsia.
b. Findings of endometritis, peritonitis, toxemia, etc.
c. Signs of cardiac, renal or pulmonary affection.
d. Findings of rupture of the uterus.
e. Signs of severe loss of blood during delivery.

POST-MORTEM F I N D I N G S I N A W O M A N W H O D I E D R E C E N T L Y
AFTER D E L I V E R Y :
1- Findings in the uterus:
a. Laceration or contusion of the cervix.
b. Uterus is enlarged and flabby.
c. The inner surface of the uterus is bloody and rugged-looking.
d. Dark color sloughy and gangrenous sinuses are evident at the
endometrial lining at the site of the former placenta.
e. There is relative hypertrophy and increase in thickness of the
uterine wall.
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Chapter XXIV expulsion of the product of conception or may require medical

ABORTION
The Revised Penal Code does not define abortion, but merely
mentions circumstances which makes abortion criminal and punish-
able. Authorities differ as to the length of intra-uterine existence
which may be considered abortion. Some define abortion as the
expulsion of the contents of a gravid uterus anytime before full term
while others consider it as the forcible expulsion of the product of
conception anytime before the age of viability.
intervention. Hemorrhage and infection are the potential com-
plications.
A. Incomplete Abortion — Not all the product, of conception has
been expelled from the uterus; fragments or portions of which is
retained. This will prevent contraction of the uterus and con-
sequently uncontrolled bleeding will develop. Removal of the
retained fragment must be done to avoid too much loss of blood
and potential infection. j ^ * W * nj^^^
r
^Complete Abortion — The whole product of conception is ex-
pelled.

Viability is the point at which the fetus is "potentially able to live
outside the mother's w o m b " , albeit with respiratory aid. And, later,
as when it is capable of meaningful life outside the mother's womb
(The Rights of Doctors, Nurses and Allied Health Professionals by
Annas and Glantz, p. 202).
In the legal viewpoint, abortion is the willful killing of the fetus in
( 3. Emotional condition — Fright, grief and anger.
the uterus, or violent expulsion of the fetus from the maternal womb
and which results to the death of the fetus. According to Viada, as
long as the fetus dies as a result of violence used or of the drug ad-
ministered, the crime of abortion exists, even if the fetus is full term.
Whichever be the definition of abortion, the following are the
principal elements of the crime:
1. That the expulsion of the product of conception is induced.
2. That the fetus dies either as an effect of the violence used, drug
administered or the fetus was expelled before the term of its
viability.
Clinical Types of Abortion: V *"uj V* **wi
Ic Missed Abortion — An ovum destroyed by hemorrhage into the
choriospace, usually before the fourth month of pregnancy. The
hemorrhage takes place from maternal sinuses into the decidua.
/This is usually followed by the death with maceration or absorp-
tidfTof the product of the conception. J'^A
^Threatened Abortion — Hemorrhage without dilatation of the
internal os. Hemorrhage in early stage of pregnancy may be due
to causes other than a threatened abortion, e.g., ectopic pregnancy,
cervical polyp, extensive erosion of the cervix, etc.
^inevitable Abortion — Hemorrhage with dilatation of the internal
os and presence of rhythmical pain. It may end by spontaneous
557
Causes of Abortion:
1. Death of the fetus — Congenital abnormality, poisoning by
minerals like lead, disease of the decidua, chorion, placenta,
amnion, etc.
2. Abnormality of the uterus.
4. Abortificient drugs — Ergot, purgatives,
5. Trauma — Direct or indirect.
6. Hormonal deficiency.
7. Acute specific fever and high temperature.
Provisions of the Revised Penal Code on Abortion:
1. Intentional Abortion:
Art. 256, Revised Penal Code:
Any person who shall intentionally cause an abortion shall
suffer:
1. The penalty of reclusion temporal, if he shall use any violence
upon the person of the pregnant woman.
2. The penalty of prision mayor if, without using violence, he
shall act without the consent of the woman.
3. The penalty of prision correccional in its medium and maxi-
mum periods, if the woman shall have consented.
Elements of Intentional Abortion:
a. That the woman is pregnant.
b. That violence was applied, or drug was administered, or a person
acts upon such pregnant woman.
c. That the effect of such violence, drug or acts of the offender,
the fetus dies or is expelled.
d. That the offender has the intention to abort the pregnant
woman.
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Ways of Committing Intentional Abortion: woman for the purpose of concealing her dishonor, the offenders
shall suffer the penalty of prision correccional in its medium and
a. By application of violence on the pregnant woman.
maximum periods.
b. By acting, but without use of violence, without the consent of
the pregnant woman. This applies to the administration of Elements of the Crime:
drugs or beverages without her consent. a. The woman is pregnant.
b. Abortion is intended to be committed.
c. By acting, with the consent of the pregnant woman. This applies
c. Abortion is induced by:
to the administration or use of drugs or beverages with the full
knowledge and consent of the pregnant woman herself. (1) The pregnant woman herself.

The purpose of the division of the crime into three paragraphs is
to graduate the penalties depending upon the use of violence and
knowledge of the pregnant woman. It is not based upon medical
science.
The accused gave herb extract in order to induce abortion on
a woman. The woman aborted at about two hours after the
administration. The accused burned the product of conception
because of the belief that it is a fish-demon. It was held that
the act constitutes prima facie proof of the intent of the
accused in aborting the woman (U.S. v. Boston, 12 Phil. 134).
(2) Other persons with the consent of the pregnant woman
herself.
(3) The parents of the woman, or either of them for the pur-
pose of concealing her dishonor and with the consent of the
woman herself.
If a woman does an act of inducing abortion on herself, there is
mitigation of criminal liability if the purpose is to conceal her
dishonor. Concealment of dishonor is not mitigating if the abor-
tion was committed by the parents of the pregnant woman or
either of them.

If the intentional abortion resulted to the death of the pregnant
woman, then the crime of abortion with homicide was committed.
2. Unintentional Abortion:
Art. 2B7, Revised Penal Code:
The penalty of prision correccional in its minimum and medium
periods shall be imposed upon any person who shall cause an
abortion by violence, but unintentionally.
Elements of Unintentional Abortion:
a. The woman must be pregnant;
b. Violence was applied on such pregnant woman without the
intention of aborting her;
c. The woman aborted as a result of the violence.
3. Abortion practiced by the woman herself or by her parents:
Art. 258, Revised Penal Code:
The penalty of prision correccional in its medium and maxi-
mum periods shall be imposed upon a woman who shall practice
an abortion upon herself or shall consent that any other person
should do so.
Any woman who shall commit this offense to conceal her
dishonor, shall suffer the penalty of prision correccional in its
minimum and medium periods.
If this crime be committed by the parents of the pregnant
woman or either of them, and they act with the consent of said
If a woman took poison for the purpose of committing suicide
and because of the timely intervention of a physician she did not
die but instead she aborted, she cannot be guilty of abortion
because of the absence of intention to commit abortion.
4. Abortion practiced by a physician or midwife and dispensing of
abortives:
Art. 259, Revised Penal Code:
The penalties provided in article 256 shall be imposed in its
maximum period, respectively, upon any physician or midwife
who, taking advantage of their scientific knowledge or skill,
shall cause an abortion or assist in causing the same.
Any pharmacist who, without the proper prescription from a
physician, shall dispense any abortive shall suffer arresto mayor
and a fine not exceeding 1,000 pesos.
Requisites of the Crime:
a. The woman is pregnant.
b. The physician induced or assisted in causing the abortion with
the use of scientific knowledge.
c. The acts done by the physician or midwife was intended to
cause an abortion.
There must be the intention of the physician to produce
abortion and the absence of intention will not make the phy-
sician criminally liable for such consequence.
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Problems Confronting the Provision of the Revised Penal Code
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Regarding Abortion:
1. If a woman or a third person induces abortion when pregnancy
is beyond the period of viability. The child born as a result of
such criminal act lives. Can there be a crime of abortion com-
mitted?
2. If a woman is not actually pregnant but she or a third person
believes that she is pregnant. Abortion was induced on her by the
third person and as a result of which she died. Is there a crime of
homicide with intentional abortion?
Kinds o f Abortion: — •
^Spontaneous or Natural Abortion:
Abortion which occurs without any form of inducement or
intervention.
^Induced Abortion:
Abortion which will not take place had it not been for some
form of inducement or intervention. Induced abortion may be:
X- Therapeutic Abortion:
Abortion purposely done to preserve the life of the mother.
Preservation of the health of the mother may also be a ground
to induce therapeutic abortion. The phrase "to preserve the life
of the woman" does not only mean to preserve the life of the
woman from death.
b\ Criminal Abortion:
Abortion done without any therapeutic indication but with
criminal intent is punishable by law.
Post-mortem Abortion:
This is the expulsion of the product of conception after death of
the pregnant woman brought about by the post-mortem contraction
of the uterine muscles. It is possible during the early stage of preg-
• nancy when the fetus is small. During the later stage, the contrac-
tion of the uterus may cause its rupture and expel its contents of
pregnancy into the abdominal cavity.
Reasons Why Some Women Procure Abortion:
1. To preserve the life and health of the pregnant woman.
2. To terminate prematurely illegitimate pregnancy in order to con-
i;
ceal the dishonor of the woman.
3. Financial difficulty. Additional m e m b e r means an added expense
in the family.
4. To preserve body form. Some women do not wish to make their
pregnancies advance to full terms on fear that their bodies might
be deformed.
H o w Abortion is Induced or Procured:
1. By General Violence:
This includes intentional violence, as exerting strong physical
efforts in golf, horse riding, cycling, strong pressure applied on
the abdomen, and other forms of strenuous and exhaustive
exercises.
Modi (Medical Jurisprudence and Toxicology, 12th ed., p.
336) mentioned the following methods employed to induce
abortion:
a. Severe pressure on the abdomen by kneading, blows, kicks,
jumping and tight lacing.
b. Violent exercise, such as riding on horseback, cycling, jump-
ing from a height, jolting caused by driving on rough roads, long
walks, running up and down the stairs, and carrying or lifting
heavy weights.
c. Cupping, usually by placing a lighted wick on the hypogastric
region and turning a big glass bottle mouth downwards over it.
It probably causes separation of the placenta or possibly injury
to the uterine paries.
d. Application of leeches to the pudenda, perineum and the inner
surface of the thighs.
2. By Means of Local Violence:
Local violence may be applied in any portion of the generative
organ. This is usually resorted to when general violence and the
use of drug fails to give the desired result.
Local violence may be applied by the pregnant woman herself,
by the physician, midwife, or by the parents. The most common
methods applied are:
a. Use of douche of warm and cold water.
b. Injection of fluid into the uterine cavity.
c. Use of luminaria tent or tangle tent to promote dilatation of
the cervix.
d. Use of soft rubber inserted into the cervix.
e. Dilatation of the cervix by instrumentation.
3. By the Use of Drugs:
This is the most common method resorted to by women to
produce abortion. There is no drug or combination of drugs
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which when taken by mouth or parenterally will definitely cause
the healthy uterus to empty itself without endangering the life of
the woman.
Factors Responsible for Abortion After Ingestion or Administration
of Poisonous Substances:
a. General severe intoxication of the mother resulting in impair-
ment of her circulation, metabolism and vital functions, or
producing anemia and hemorrhage.
b. Interruption or impairment of the placental blood circulation
as a result of hemorrhage, vaso-spasm, thrombosis, lowering of
the blood pressure, necrosis, and inflammation of endometrium
and placenta.
c. General convulsion of the body.
d. Severe gastro-enteritis with vomiting and diarrhea.
e. Irritation of automatic and peripheral nerves leading to uterine
contraction.
(2) Ecbolics:
Ecbolics are substances which when taken cause death or
expulsion of the product of conception by stimulation of
the uterine muscles.
The Most Common Ecbolics are:
(a) Ergot
( b ) Quinine
(c) Pituitary Extract
(d) Lead and Mercury
b. Drugs acting reflexly through the genito-urinory tract:
These are drugs which produce irritation of the genito-
urinary tract and reflexly incite uterine contraction. Large
dosage of the drug may cause severe inflammatory changes in
the kidney and may cause uremia due to suppression of its
function. Diuretics may also cause reflex contraction of the
uterus but in a very mild way.

f. Direct transmission of the poison from the maternal through
the placenta into the fetal circulation, thus damaging the fetus
(Legal Medicine by R.H. Gradwohl, 1954, p. 812).
Drugs Commonly Used for Abortion:
a. Drugs acting directly on the uterus:
(1) Emmenagogues:
Emmenagogues are substances which increases the men-
strual flow. The manner it promotes menstrual flow may be
its direct effect on the uterus or indirectly by increasing
bodily tone.
(a) Direct Emmanagogues — These are substances which
act directly on the uterus or on the nervous system in
close relation to it.
Examples:
Ergot Potassium permanganate
Apiol Aloes
Pennyroyal Tamsy
Cantharides Borax
( b ) Indirect Emmenagogues — These are substances which
induce or increase menstrual flow by promoting and
building the health of the person as a whole.
Indirect Emmenagogues may be Classified as:
i. Tonic — as iron, arsenic, strychnine.
ii. Hematinics — as iron, copper, liver extracts.
iii. Purgative — as magnesium sulfate, castor oil.
The following drugs may act on the genito-urinary tract and
may reflexly make the uterus to contract:
(1) Oil of Pennyroyal
( 2 ) Oil of Tamsy
( 3 ) Oil of Turpentine
c. Drugs acting reflexly through the gastro-intestinal tract:
These are drugs whose principal site of action is the gastro-
intestinal tract but may cause uterine contraction due to its
reflex action. The following drugs may fall under this category:
( 1 ) Castor oil (4) Gamboge
( 2 ) Magnesium sulfate ( 5 ) Aloes
( 3 ) Croton oil ( 6 ) Elatrium
d. Drugs having poisonous effects in the whole body:
These are drugs whose manner of action is not localized in
certain tissues or organs but in the whole body. To this group
are the animal, vegetable and mineral irritant poisons.
4. By Surgical Intervention:
This is a method of abortion by the application or the use of
instrument by gynecologist or by surgeon. Surgical intervention
may be:
a. Dilatation and curettage.
b. Surgical abdominal route (hysterolaparotomy).
5. Modern methods of inducing or procuring abortion:
a. Amniocentesis — Intrauterine injection of hypertonic saline
or glucose solution (20% saline or 50% glucose). The needle is
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inserted in the abdominal wall or vaginal route. This method
is applied when pregnancy is beyond 2 months. Expulsion of
the uterine content usually occur 24 to 48 hours after injection,
b. Vacuum suction (commonly known as menstrual regulation)
may be applied through the cervix. The suction apparatus will
create a negative pressure of 0.4 — 0.6 kg. per cm. sufficient
to detach and brake up the products of conception. The pro-
cedure is quite simple and usually applied to 12 — 14 weeks of
pregnancy.
Complications of Abortion:
1. Immediate Untoward Effects:
a. Shock:
The shock may be due to the laceration of the uterus or the
adjacent organ, like the bladder, rectum, intestine or blood
vessels. The injury may be due to the introduction of instru-
ments or the application of hot fluid or corrosive substances.
No definite autopsy findings may be seen, except the pre-
sence of the gravid uterus, remnants of the fetus and placenta,
and the laceration or perforation. Secondary shock may
develop later and may be due to hemorrhage, infection or
corrosions.
b. Hemorrhage and Anemia:
Occasionally, big pelvic vessels are injured or failure of the
uterine wall to contract is observed in abortion. The rupture
of the blood vessels may be due to the injury of the uterine
and vaginal wall of injudicious instrumentation. Adherent
placental tissue, infection, presence of foreign bodies and atony
of the uterus may cause hemorrhage for failure of the uterine
muscles to contract.
c. Embolism:
(1) Air Embolism:
The air may enter the lacerated vessels of the vagina and
uterine wall and carried by the blood to the inferior vena
cava, heart and block the pulmonary circulation. In cases
wherein the foramen ovale is potent, the air may escape
pulmonary circulation and block the cerebral circulation.
(2) Fat Embolism:
The injection of oily fluid or laceration of the adipose
tissue may cause the formation of fat emboli in the blood
stream which may lodge in the heart, lungs and brain. Fat
emboli may be observed in the renal glomeruli, coronary
vessels and also in the vessels of the choroid plexus of the
brain.
(3) Thromboembolism:
Injury of the uterine wall may cause the formation of
thrombus which may be detached and carried by the cir-
culation to different parts of the body.
(4) Bacterial Embolism:
Infection of the uterus after an abortion may cause lump
of bacteria to enter the circulation in the form of an em-
bolus.
d. Infection:
Pathogenic organism may be introduced into the uterus and
produce systemic symptoms. If death occurs, signs of toxemia
may be observed at autopsy.
Causes of Death in Infection:
(1) Rapid development of bacteremia.
( 2 ) Thrombophlebitis of uterine, pelvic and femoral veins with
multiple infarctions and abscesses (pyemia).
( 3 ) Bacterial endocarditis with multiple septic infarctions.
( 4 ) Purulent metritis, parametritis, localized or generalized
peritonitis, ileus.
(5) Purulent salphingitis, tubal or ovarian abscesses followed by
peritonitis.
( 6 ) Diffusely spreading retroperitoneal cellulitis, toxemia and
cachexia.
e. Poisoning:
Abortifacent irritants which may be locally applied may be
absorbed into the circulation and produce systemic effects.
Lysol, corrosive sublimate, iodine solution are frequently used
for vaginal douche and may cause systemic poisoning.
f. Vagal inhibition:
Sudden dilatation of the cervix due to the introduction of
some objects may cause sudden collapse due to reflex inhi-
bition of the vagus nerve.
g. Perforation of the bladder or any of the neighboring organs:
In the insertion of the uterine sound to determine the
position of the uterus or in the process of curretting, the
bladder or the other surrounding organs may be perforated
' and which may eventually result to death due to hemorrhage
or shock.
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( 6 ) Palpability of the uterus and laceration of the cervix and

2. Delayed Untoward Effects:
perineum.
a. Infection:
f. Examination of the expelled product of conception:
Infection may develop immediately or later on account of (1) Blood examination for maternity and paternity.
septic care. The infection may originate from the vaginal canal (2) Marks of instrumentation.
or from the blood stream coming from a focus of infection in (3) Signs of physical violence.
the body. ( 4 ) Proof of viability or non-viability of the fetus.
b. Fistula Formation: ( 5 ) Presence of abortives and other toxic materials in the fetal
Communication between the vagina or the uterus with the blood.
rectum or bladder may be an after effect of perforation due to (6) Presence or absence of malformation.
instrumentation. ( 7 ) Completeness of the placenta.
c. Sterility: (8) Other identifying marks.
Plugging of the fallopian tubes, infection of the ovaries may
cause sterility,
d."Pelvic Adhesion:
Infection and trauma may cause the uterus or vagina to
become adherent to the surrounding organs or tissues.

MEDICAL EVIDENCES OF ABORTION:

1. Medical Evidences of Abortion in the Living:
a. Presence of external signs of violence in the form of contusions,
abrasions, hematoma, open wounds of whatever form on the
body surface if induced by general violence. If violence is
applied locally in the generative tract, injuries of whatever form
or description may be seen therein.
b. Examination of the generative tract: ,
( 1 ) Appearance of the external genitalia and vagina may show
laceration, contusion, abrasions and other marks of instru-
mentation.
( 2 ) Examine the external os for softness, tear, and discharge.
A criminally a b o r t e d fetus a b o u t 5 to 6 m o n t h s of i n t r a u t e r i n e life.
( 3 ) Note the size of the uterus, its consistency and location.
c. Examination of the instrument used for the presence of blood, g. Laboratory test for pregnancy.
placental tissue or fetal parts. h. Testimony of the physician who completed the abortion or of
d. History — Note the state of health beforehand after abortion. other persons who witnessed the criminal act.
Inquire as to the motive of the abortion and history of having
ingested or injected with abortives. 2. Medical Evidences of Abortion in the Dead:
e. Signs of previous pregnancy: Aside from the evidences of abortion in the living which may
( 1 ) Condition of the breasts. be found in the dead, the following may be observed at autopsy:
( 2 ) Laxity of the abdominal wall. a. Evidence of instrumentation:
(3) Paleness of integument. This will include the presence of punctured wounds in the
(4) General body weakness. placenta, presence of remnants of the placenta inside the
(5) Presence of characteristic lochial discharge and odor. uterine cavity, presence of perforation of the uterus.
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b. Examination of stomach and its contents:
Abortifacent. drugs and other irritants may be found inside
the stomach upon chemical examination. It is advisable to sub-
mit the whole of the stomach with its contents to a chemical
laboratory examination for such determination.
c. Examination of the kidneys and other organs for irritants:
Like the stomach and its contents, other organs like the
kidneys, liver, spleen must be subjected to a qualitative and
quantitative chemical examination for the presence of irritant
poisons.
d. Examination of the uterine contents:
Remnant of the product of conception for the following:
( 1 ) Infection.
( 2 ) Stage of pregnancy.
( 3 ) Other complication of abortion.
e. Biological test:
( 1 ) Paternity test.
( 2 ) Test for pregnancy.
f. Examination of some untoward effects of abortion:
(1) Infection, toxemia or bacteremia.
( 2 ) Embolism.
(3) Fistulae formation.
(4) Pelvic adhesions.
THERAPEUTIC ABORTION:
Therapeutic abortion is an abortion which the law allows under
some specific justifications.
Legal Justification to Therapeutic Abortion:
Art. 11, N o . 4, Revised Penal Code:
Any person who, in order to avoid an evil or injury, does an act
which causes damage to another, provided that the following requi-
sites are present:
First. That the evil sought to be avoided actually exists;
Second. That the injury feared be greater than that done to avoid
it;
Third. That there be no other practical and less harmful means of
preventing it.
In the performance of an abortion, Iwo lives are involved, namely,
! the life of the mother and the life of the fetus. One life must be
• sacrificed to save the life of another in case of therapeutic abortion.
If both lives can be saved in accordance with the present state of
medical science, then there is no justification to such abortion,
hence the physician must be criminally liable.
A physician in performing a therapeutic abortion is doing an act
to save the life or to preserve the health of the mother. In so doing,
damage is done to the conceived child. The child is deprived of its
future existence.
The evil sought to be avoided is the danger on the life of the mother
if such pregnancy will be allowed to continue. Such evil may be
infection, organic condition or abnormality existing on the person
of the woman and which under ordinary course of event will cause
death.
There is no practical and less harmful way of saving the life of the
mother other than sacrificing the life of the conceived child. If there
are other methods which may save both life, then the abortion can-
not be considered justifiable.
In the evaluation as to whose life must be spared, it is a common
concept that the life of the mother must be preferred than that of
the unborn child. A conceived child is not definitely sure of its
independent existence while the mother has already manifested real
life.
Grounds for Therapeutic Abortion:
The following conditions have been considered by some authori-
ties to be a justifiable ground for therapeutic abortion:
1. Cardio-vascular conditions as congestive heart failure, auricular
fibrillations, repeated hemoptysis, paroxysmal tachycardia.
2. Renal conditions as chronic nephritis, previous eclampsia, pye-
litis, tuberculosis.
3. Pulmonary conditions as advanced tuberculosis.
4. Blood condition as severe anemia.
5. Gynecological conditions as refractory chorea gravidarum.
6. Organic nervous conditions as psychosis.
7. Miscellaneous conditions as diabetes, exophthalmic goiter.
8. Hereditary conditions as insanity.
Modern diagnostic procedure can determine whether the con-
ceived fetus en utero is suffering from defect or abnormality which
may be severed to make independent existence not possible or ample
assistance from other person during his lifetime is necessary. New
drugs ( L S D , thalidomide, etc.) and non-conventional methods of
reproduction ( in vitro fertilization, artificial ovulation ) may
lead to the development of an abnormal fetus. If it can be proven
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that the fetus is abnormal, will it not be a justifiable situation to
induce an abortion? If the physician failed to induce abortion and
the child born is abnormal, will it not be a ground for civil action
against the physician for wrongful life?
I . U . D . (intrauterine device) as a method of contraception which
allows the fertilization of the egg cell by the sperm cell but prevent
the implantation of the zygote into the uterus because of the mecha-
nical device. Abortion is the premature expulsion of the product of
conception. If it were so, then I . U . D . is an abortive. Why is it
allowed as a contraceptive method and not prohibited like another
way of committing an abortion?
Is the eminent danger of committing suicide on account of her
existing pregnancy be a ground to induce therapeutic abortion to
save the life of the woman?
Occasionally, on account of her disgrace in society, fear of violent
reactions from her parents for the sinful and immoral acts she has
committed, or for some other reasons that may be prejudicial to her
future life, a woman may attempt in several occasions to commit
suicide. In this instance, may a physician institute necessary meas-
ures to deliberately terminate the existing pregnancy to save her
life? There are divergent decisions on this point.
In the case of Hatchard v. State (48 N.W. 380 Wis.) a woman
who threatened to commit suicide unless she could be relieved of
the child with which she was pregnant does not present such a
necessity for the performance of the operation to save the life of
the woman. The intention of the law applies only to cases where
death of the mother might reasonably be anticipated from natural
causes unless the product of conception is destroyed.
However, in a case cited by Camp and Purchase (Practical Forensic
Medicine, p. 32, 1957), a married woman with unstable character
finding herself pregnant, threatened to commit suicide. The phy-
sician whom she repeatedly made her threat during her unexpected
visits referred her to a psychiatrist who recommended abortion.
The operation was carried on by a reputed gynecologist but un-
fortunately, the patient died of gangrene of the uterus. The coroner
did not recommend prosecution because the operation was done
to save the life of the mother.
Safeguards to be Observed by Physician in Performing Therapeutic
Abortion:
1. The lawful abortion must be performed by a licensed physician or
surgeon.
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2. Abortion in order to be justifiable must be performed to save the
life or to preserve the health of the mother. But modern ad-
vancement of medical science has reduced the number of diseases
which will endanger the life and health if pregnancy is allowed
to progress to full term. A physician must exercise due diligence
in considering a disease or a combination of diseases or conditions
as grounds for the therapeutic abortion.
3. Abortion must be performed openly in a hospital to avoid sus-
picion that it was done for some cause other than to save the life
of the mother. Abortion performed in a private clinic wherein
there are no sufficient facilities to cope with emergency which
may arise in the course of the operation may be a ground for
malpractice.
4. It is advisable to have the opinion of other competent physicians
as to the justifiability of such therapeutic abortion. The opinion
of one might be influenced by prejudice and misjudgment.
5. Enlightened and expressed consent must be obtained from the
woman herself if she has no impediment to give consent. It is
advisable to have also the consent of the husband, inasmuch as
abortion will affect marital relationship.
Reasons W h y It Is Difficult to Prosecute Physicians Committing
the Crime of Abortion:
1. The crime is performed clandestinely by an intelligent being who
is fully aware of his criminal act.
2. The physician has several medical reasons to justify his act. There
is no hard and fast rule in medicine. He may claim that there is
medical justification to such abortion because the woman is
suffering from a disease which might imperil her life if pregnancy
will be allowed to progress to full term.
3. In most cases, the products of conception removed which may be
utilized as corpus delicti in the crime is lost.
4. The pregnant woman herself is in connivance with the physician
and it is quite difficult to let her testify truthfully as to the actual
happening. She, herself, is in pari delicto to the crime of criminal
abortion.
5. Medical society seems to have a lukewarm attitude in helping the
state prosecute the abortionist.
Pros and Cons — Restrictive Abortion Law:
A. Reason Justifying Restrictive Abortion Law:
1. From the moment of conception life begins to start and de-
struction of the growing product of conception will be con-
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trary to the law of mankind. This is in line with the philosophy

that God created man and only God can destroy it.

B. Reasons for Liberal Abortion Law:

1. Where abortion is illegal, the rich can resort to high-cost and
illegal but safe abortion at home or to a pleasure trip abroad
combined with an abortion. The poor can only stay at home
and face the consequence of high-risk and illegal abortion. 574 LEGAL MEDICINE
This causes discrimination against the poor and favor the rich.
It raises the serious issue of justice and equal protection under countries where abortion law is liberal. This trend is incon-
the law. sonance to solve a future problem of an over-populated world.

2. It is no secret, in countries forbidding abortion under any Religious Consideration of Abortion:

circumstances, abortion operations continue to exist with very
few or non-prosecution. In the Philippines, the draconian and
* restrictive abortion law has been accompanied in the recent
years by non-prosecution, either of the woman or of the abor-
tionists (In-depth Study on Law and Fertility Behavior: Pre-
liminary Observation by Lee and Bulatao, 1972, p. 40).
3. Statistics has shown that children born as a consequence of
denied abortion to terminate unwanted pregnancy are mentally
and physically impaired. A n y unsuccessful illegal attempt to
cause on her abortion, may cause trauma to the developing
product of conception. An overburdened multipara or a single
girl without support may cause psychiatric disturbance and
the children may be a social welfare problem. The children are
abandoned by parents in overcrowded orphanage.
4. A strict anti-abortion law is violative of the right of privacy of
a person. The right of privacy means the right of the individual
to the possession and control of his own person free from all
restraints or interference of others. A woman should have the
right to decide whether or not to bear children and that this
right includes the right to have an abortion.
5. Modern advances in medical diagnostic procedures can deter-
mine whether a developing fetus inside the uterus is suffering
from physical abnormalities. Allowing such product of con-
ception to reach full term will cause sufferings on the part of
the parents and an overburdened social welfare institution of
the government. It is also a factor for the deterioration of the
genetic stock if the defective factor is familiar thus making an
abnormal stock proliferate further.
6. Recent trend in Central Europe and in America is towards
liberalization of their restrictive abortion laws. At present
more than 70% of the total world population are living in
As a general rule, all induced abortion are considered sinful,
illicit and against the tenets of the Catholic Church even if sanctioned
by law. The principal basis is that every human being, even the
child in the mother's womb, has the right of existence directly from
God and that no human being has the right to destroy it. A con-
ceived child has the right of existence as that of the mother.
However, the Catholic Church classified abortion into two main
categories for the purpose of determining whether it may be allowable
or not:
1. Direct A bortion — Deliberate expulsion of the product of con-
ception. This is never permitted by the Catholic Church even if
the purpose is to save the life of the mother.
2. Indirect Abortion — When the expulsion of the product of con-
ception is not the primary objective of an operation to save the
life of the mother, but merely incidental or unavoidable to an
operation. This type of abortion is qualifiedly permitted to
some extent by the Catholic Church. Thus, the abortion which
occurred incidental to an operation to suppress hemorrhage or
removal of new growth is permissible.
Among the Jews, destruction of the fetus for the purpose of saving
the life of the mother is not only permissible but obligatory. To the
Protestants, abortion is generally considered sinful.
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Chapter X X V A. STILL-BIRTH:
When the child has not breathed or has not shown any sign
BIRTH of life after being completely born.

Legal Importance of the Study of Birth: Causes of Still-birth:

1. Birth determines personality: 1. Immaturity.
Art. 40, Civil Code: 2. Congenital diseases or malformation.
Birth determines personality; but the conceived child shall be
3. General debilitating diseases:
considered born for all purposes that are favorable to it, provided
it be born later with the conditions specified in the following a. Acute specific infection.
article. b. Toxemia.
c. Kidney disease.
Art. 41, Civil Code:
d. Acute liver disease.
For civil purposes, the foetus is considered born if it is alive at
e. Septicemia.
the time it is completely delivered from the mother's womb.
However, if the foetus had an intra-uterine life of less than seven 4. Local disease of the generative organ:
months, it is not deemed born if it dies within twenty-four hours a. Syphilis.
after its complete delivery from the maternal w o m b .
b. Ablatio placenta, intra-placental hemorrhage, or extensive
2. Appearance of a child is a ground for the revocation of donation: infarction.
Art. 760, Civil Code:
c. Kind of the cord.
Every donation inter vivos, made by a person having no children d. Placenta previa.
or descendants, legitimate or legitimated by subsequent marriage,
or illegitimate, may be revoked or reduced as provided in the next 5. Accidents in the delivery:
article, by the happening of any of these events. a. Disproportion of the birth canal and the fetus.
b. Injudicious forcep application.
(1) If the donor, after the donation has legitimate or legitimated c. Prolapse of the cord or strangulation of the cord.
or illegitimate children, even though they be posthumous. d. Hemorrhage.
3. Proof of live-birth must first be shown before death of the child e. Abnormal presentation.
by the prosecution in the case of infanticide: f. Influence of narcotics, anesthesia or intoxicating liquor.
g. Puerperal insanity.
Art. 255, Revised Penal Code — Infanticide:
h. Prolonged labor.
The penalty provided for parricide (reclusion perpetua to death) i. Hasty parturition.
in article 246 and for murder (reclusion temporal in its maximum j . Spasm of the larynx,
period to death) in article 248 shall be imposed upon any person k. Hemorrhage of the cord.
who shall kill any child less than three days of age. 6. Violence, either deliberate or accidental at birth.
In medicine, birth is the entire delivery of a child with or without
its separation from the body of the mother. It is not necessary that B. L I V E - B I R T H .
the cord should have been cut or the placenta expelled. It is the In live-birth the child after birth exhibited clear signs of vitality
cessation of the symbolic relation between the mother and the fetus. and viability is not necessary. In law, the presumption is every new-
Birth may be: born child found dead was born dead. The burden of proof lies on
those who declare otherwise. To have a child acquire personality
575
distinct as that of the mother, there must be proof of life after
complete separation from the mother's womb.
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Proofs of Live-Birth: Hydrostatic Test (Fodere's Test; Static Test):

1. Presence of Heart Action and Circulation:
The presence of heart sound when the new-born is examined
by means of a stethoscope is a sign of life. Sometimes the pulse
is imperceptible by palpation especially when the child suffered
much during labor.
2. Movement of the Child and Crying:
The first instinct of the child after birth is restlessness and
crying. Children born after severe and prolonged second stage
of labor, may be too weak to move or cry. After a while, they
begin to move and later cry upon application of bodily stimulus.
3. Presence of Respiration:
Proofs that respiration has taken place:
a. There is arching of the chest.
b. Fall of the level of the diaphragm:
Before birth, the diaphragm reaches the level of the 4th
or 5th rib, but if respiration has taken place, it reaches
to the level of the 6th or 7th ribs. This test is not con-
clusive but merely corroborative.
c. Expansion of the lungs:
Appearance of the lungs if respiration has taken place:
(1) The lungs fill the thoracic cavity and overlapping the
heart and thymus gland.
(2) The lungs are voluminous, with rounded edges and pink-
mottled color.
(3) The surface is covered with mosaic of expanded air
vesicles, giving a marble appearance.
(4) On pressure, they crepitate, and on section they exude
froth.
Appearance of the lungs before respiration has taken place:
(1) The lungs are found at the back of the thoracic cavity
behind the heart and thymus gland.
(2) The lungs are smooth, small, of a uniform dark blue-red
color, with sharp edges and present the appearance of a
piece of liver.
(3) When squeezed between the finger and thumb they do
not crepitate.
(4) On section they appear solid and exude blood but not
froth.
Hydrostatic test is one of the tests to determine whether respira-
tion took place on a newborn child before death. This test is based
upon the principle that the specific gravity of the lungs becomes
less as a result of the introduction of air in the air passages and air
sacs.
Procedure of the Test:
Remove the entire lungs from the thoracic cavity and immerse
them in water en bloc. If it floats, it shows that air has been
driven in and the child has breathed; but if it sinks, the air sacs are
not expanded and therefore breathing has not yet taken place.
The lung is cut in small pieces and again placed in water. If it
floats, air has entered into the air sacs.
Value of the Test:
The hydrostatic test is not conclusive that respiration took
place when it is positive (when the lungs float) or when it is
negative (when the lungs did not float), because there are several
fallacies attached to the test.
However, it is corroborative to other existing evidences.
Fallacies of the Hydrostatic Test:
a. Unexpanded lung may float if the child is subjected to artificial
respiration or if gases due to putrefaction are present, even if
the child is born dead.
b. The child may have respired or breathed before it is completely
born if the head is at the external os, or if the head protrudes
on the outlet in head presentation, but dead at birth.
c. The child may have breathed, but the lungs may not float on
account of disease (atelectasis), or from' imperfect respiration,
or on absolute persistency of foetal condition.
d. The child may utter audible cry while inside the uterus or in the
vagina. In cases of vagitus uterinus, the child is usually born
dead but the lungs are perfectly expanded.
To differentiate a naturally expanded lung from an artificially
expanded lung, it is necessary to know the level of the diaphragm.
If due to natural breathing, the level of the diaphragm reached the
level of the 6th or 7th rib, while if artificially expanded, it may
reach only the 5th rib.
To differentiate whether the floating of the lungs is due to
putrefaction, note the color, consistency and condition of the
bubbles. In putrefaction, the lung is green, soft with bubbles at
edges, while a naturally expanded lung is bright vermillion in color,
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The normal content before birth is albuminous substances
mottled appearance, bright-red alternating with bluish patches and mucous. The presence of sugar, starch or milk indicates
with air cells on surface in groups of four. live-birth.
When is Hydrostatic Test Not Necessary: b. Stomach-Bowel Test or Floatation Test or Breslau's Second
Hydrostatic test is no longer necessary in the following in- Life Test:
stances because of the presence of stronger proofs of live-birth Ligate the cardiac end of the stomach and the lower end
or still-birth. of the intestine and remove. Place the whole mass of organs
a. When the fetus is born less than 180 days of intrauterine life. in water. If the organs float, breathing has taken place. Dip
b. When the fetus is a monster which is not capable of living the organs under water and open the stomach and intestine.
a separate existence. Note the liberation of air bubbles going up the surface of the
water, if breathing has taken place.
c. When the umbilical cord is separated and the umbilicus is
cicatrized. 5. Changes in the Middle Ear (Wredin's Test):
d. When the stomach on dissection contains coagulated or half- The middle ear of a child before birth is filled with gela-
coagulated milk as a result of digestion. tinuous, embryonic connective tissue. This disappears after
the birth of the child.
e. When the fetus shows signs of intrauterine maceration.
6. Condition of the Skin:
Differences Between Unexpanded and Expanded Lung The skin of a newly born infant is bright red in color. This
Unexpanded Lung Expanded Lung gradually changed to a lighter one. In 2 to 4 days, it darkens
to brick-red, but may be yellow due to physiological jaundice.
a. Volume is small. a. Volume is greater and fills
The normal appearance of the skin appears after a week.
the chest cavity.
b. Edges are more or less b. Edges are rounded and 7. Marks of Violence:
sharply projected beyond cover the thymus and heart. Violence applied to a child while living will show some degree
the thymus and heart. of vital reactions. Such reaction will not be seen in cases of
c. Color is dark brown or uni- c. Color is bright vermillion still-birth.
form purplish gray with and lungs show mottled 8. Changes in the Umbilical Cord:
no mottling. appearance with bright red The portion of the cord attached to the skin of the child
part alternating with bluish begins to shrink and dry within 12 to 24 hours. There is in-
patches. flammatory redness of the base from 36 to 48 hours. By the
d. Feels solid. d. Feels spongy and crepitant. second or third day it shrivels up, mummifies, and falls on the
e. On section, a very little e. On section, blood stained fifth or sixth day. The healed cicatrix is seen within 10 to 12
blood exudes. frothy serum exudes on days.
squeezing.
Pulsation seen or felt in the cord indicates live-birth. In 12
f. Absolute weight is 450-650 f. Absolute weight is 900- to 24 hours it dries and slowly becomes shrivelled in 3 to 5
gms. 1,000 gms. days%ind the cord separates with cicatrization of the wound. The
g. Hydrostatic test — Negative. g. Hydrostatic test —Positive. surrounding skin shows capillary congestion. The ring of in-
h. Microscopic examination h. Microscopic examination flammation around the site is an evidence of life of at least
shows collapsed air sacs. shows expanded air sacs and 36 hours duration. The wound heals in 2 or 3 days and the scar
with blood vessels engorged. develops within 10-12 days.
4. Examination of the Stomach and Intestine: Prolonged soaking of mummified umbilical cord can cause
a. On opening the stomach of a still-born child, it contains only it to swell but not to return to its natural condition. If the
mucous, but after respiration, the stomach will contain child and the cord are submerged in a body of water after birth
mucous, air bubbles and saliva. the cord will undergo liquifaction on account of decomposi-
tion.
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9. Condition of the Heart and Blood Vessels:

Ductus arteriosus closes within 3 days. Ductus venosus also
closes within 3 days after birth. The foramen ovale may close
on the second or third month.

Proof of Live-Birth can be deduced in the following:

1. Well-developed signs of breathing.
2. Presence of air or food in the stomach.
3. Changes having taken place in the region of the umbilicus.

If Born Alive, H o w Long Did the Child Survive?

It is not possible to determine the exact length of time the child
has lived after birth, but an approximate idea may be formed
after consideration of the following points:
1. Changes in the Skin:
At birth the body of the new-born child is bright-red in
color and covered with vernix caseosa which may be present up 582 LEGAL MEDICINE
to two days. The normal color of the skin is resumed after a
week's time. The exfoliation of the skin in the abdomen 8. Nails project from the fingers but the toe-nails reach only to
occurs on the first three days after birth. the end.
2. Presence of Caput Succedaneum: 9. One or both testes are in the scrotum, or labia have close the
The caput succedaneum when present shows that the child vulva.
was born with head presentation. There are color changes in 10. Lower end of femur may show center of ossification about 0.6
the course of its absorption. The caput used to last up to the cm. in diameter.
seventh day. (Gradwohl's Legal Medicine by Camps, 3rd ed., p. 416).
3. Changes in the Umbilical Cord:
The mummification of the cord does not occur if the child
is submerged in water after birth. An already mummified cord
may again become soft after continuous soaking in water.
4. Changes in the Circulation:
The umbilical artery begins to contract at about ten hours
after birth. The umbilical vein and the ductus venosus obli-
terate on the 4th or 5th day and the ductus arteriosus on the 3rd
day. The foramen ovale closes on the second or third month.

Signs of Maturity of the Child at Birth:

1. Length of the fetus — 50 centimeters.
2. Weight - 3.0 kilos.
3. Lanugo hair almost disappeared.
4. Limbs and body plump.
5. Face lost its wrinkles.
6. Skin covered with vernix caseosa.
7. Head covered with hair about 2 inches long.
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Chapter XXVI
/ I N F A N T I C I D E (Neonaticide)
InpaHticide is the killing of a child less than three days old.
Art. 255, Revised Penal Code, Infanticide:
The penalty provided for parricide in article 246 and for murder
in article 248 shall be imposed upon any person who shall kill any
child less than three days of age.
Jf the crime penalized in this article be committed by the mother
of the child for the purpose of concealing her dishonor, she shall
suffer the penalty of prision correccional in its medium and maxi-
mum periods, and if said crime be committed for the same purpose
by the maternal grandparents or either of them, the penalty shall be
prision mayor. '
If the~killing was done by the parents, grandparents or other
direct ascendants, or either of them, the penalty to be imposed is
the same as that of__parricide. However, if the killing was done by
any other person, the penalty is the same as that of murder.
Lenient penalty is to be imposed when the killing was done by
the mother or by the maternal grandparents, or either of them for
the purpose of concealing her dishonor.
Problems:
lylnfancy is the period in the life of a child from birth up to one
year.. Thereafter, it is called _childhood. This distinction is made
on account of physiologic changes undergone by the child during
infancy and childhood. Why is the crime of infanticide applied
only to the killing of less than a three-day-old infant rather than
within the first year of the life of the child?
2. During the process of delivery when the head and neck of the
child are already out of the birth canal and the child has breathed
spontaneously through the lungs, the child was deliberately put to
death before expulsion of the other parts of the body. What crime
was committed by the offender? The child was not yet capable
of independent existence inasmuch as placental circulation was
still maintained. Ideally it is foeticide, but it is not a crime in the
Philippines. Can it be considered infanticide?
3. A child was born less than 7 months of uterogestation. Under
ordinary condition, considering prematurity and underdevelop-
583
ment, there is more chance for the child to die, but with modern
neonatal management the child had all the chances to live.
A few hours after birth the child was deliberately killed. Is
the killing a case of infanticide? According to Art. 41, Civil
Code . . If the foetus had an intra-uterine life of less than
seven months, it is not deemed born if it dies within twenty-
four hours after its complete delivery from the maternal womb",
and birth determines personality. Can the crime of infanticide
be committed on someone who is not yet a person as con-
templated by law?
Motives for Committing Infanticide:
1. To conceal dishonor especially when there is no reason for her to
give birth to a child. She may be single, widowed, estranged from
the husband or living separately where access is not possible.
2. Financial reason — An added member to the family may cause
increased financial burden. Care of the child may prevent the
mother to pursue her means of livelihood.
3. Desired number of children has already been attained. Infanticide
is made as a substitute for ineffective family planning.
4. Congenital abnormality of the child.
5. Parent is suffering from mental abnormality.
6. Belief that the child will bring bad luck to the family.
Criminological Characteristics:
1. It is most often committed by the mother.
2. The criminal act is almost always committed in the home.
3. The crime scene shows no manifest disturbance, no witnesses and
no noise or outcry.
4LThe trauma applied is so minimal that when applied to an adult
it will not even produce lethal effect.
5. A newly born child found dead was born dead. The burden of
proof that a living child has been killed is placed on the prosecu-
tion.
Type of Evidences in Infanticide:
In cases of alleged infanticide the prosecution must show the
following proofs:
1. That the child was born alive.
2. That the child was deliberately killed.
3. That the child killed was less than three days old.
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H o w the Crime of Infanticide is Committed:

The crime of infanticide may be committed in two ways^JKimely:
1. By omission or neglect:
a. Failure to ligate the umbilical cord:
If the umbilical cord is not ligatecUafter it is cut, the child
may bleed to death. Fatal hemorrhage may also occur, if the
cord is not tightly ligated.
ifTFailure to protect the child from heat and cold:
The exposure of the child to heat and cold may cause the
death of the child without leaving any mark of violence. This
is usually done by depriving the child of necessary clothings.
Failure to take the necessary help of a midwife or a skilled
physician.
dr. Failure to supply the child with proper food:
The child may be deliberately starved to death. The stomach
and intestine must be examined'for the presence of food,
e. Failure to remove the child from the mother's discharge which
resulted to suffocation.
2. By Commission:
a. Inflicting physical injuries:
A person with the use of kitchen utensils or any other hard
or sharp objects may traumatize a child.
b. Suffocation:
The face of the child may be pressed into some soft tissues
like a bed-sheet or a pillow.
c. Strangulation:
This is commonly made by placing a tight cord or rope
around the neck. Manual strangulation is also common.
d. Drowning:
The child may be disposed of in a sewerage disposal in a
creek, or in a deeper body of water with weight attached to
the body to prevent floating.
586 LEGAL MEDICINE
f. Burning:
This form of killing an infant is not common. This may be
resorted to with the simultaneous burning of the dwelling place
to conceal offense.
g. Deliberate exposure to heat or cold:
The child may be exposed to direct sunshine or may be
placed in a basin of cold water until death.
Post-mortem Findings in Cases of Infanticide:
1. Complete examination of the skin surfaces may show presence of
marks of physical violence in the form of fingernail marks especial-
ly at the neck. There may be other forms as abrasion, contusion,
hematoma, or lacerated wounds; ligature or pressure marks on the
neck.
2. Examination of the mouth and upper portion of the alimentary
tract may show signs of irritation if death is due to poisoning.
3. Laceration or other forms of injury of the upper portion of air
passage with deformity of the trachea and larynx.
4. The lungs may show petechial hemorrhages, emphysema, or signs
of drowning.
5. There may be fracture of the bones, laceration of the internal
organs, cerebral hemorrhages, etc.
6. In cases of poisoning, the organs must be preserved and sent to a
competent toxicologist for proper analysis.

e. Poisoning:
Denatured alcohol, tincture of iodine, or any other drugs
which form a part of the household-remedies may be administered
to the child. A thorough examination of the gastro-intestinal
tract for irritation and an examination of the organs and its
contents by a toxicologic are necessary to determine the kind
of poison and the quantity taken.
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Chapter XXVII A. LEGITIMATE CHILDREN

A legitimate child is one who is born in lawful wedlock, or within

PATERNITY AND FILIATION a competent time afterwards.
Paternity is the civil status of the father with respect to the child 1. Legitimate Children (Proper):
begotten by him. Filiation is the civil status of the child in relation Legitimate children (proper) are those who were born in lawful
to its mother or father (2 Sanchez Roman 952),
wedlock or within 300 days after the dissolution of marriage.
Legal Importance of Detemining Paternity and Filiation: Presumption of legitimacy:
1. For Succession: Art. 255, Civil Code:
In legal succession, the right of the legitimate children is dif- Children born after one hundred and eighty days following the
ferent from that of the illegitimate children. The law give more celebration of the marriage, and before three hundred days follow-
ing its dissolution or the separation of the spouses shall be pre-
rights in the property of the deceased parent to legitimate child-
sumed to be legitimate.
ren.
Against this presumption no evidence shall be admitted other
2. For Enforcement of the Naturalization and Immigration Laws:
than that of the physical impossibility of the husband's having
Naturalized citizens give "ipso facto" Philippine citizenship to access to his wife within the first one hundred and twenty days
their minor children at the time of their naturalization under of the three hundred which preceded the birth of the child.
certain qualifications. Thus, the* minors, in order to avail them-
selves of the effects of naturalization, must prove that they are The physical impossibility may be caused by:
legitimate children of the naturalized citizen at the time of natural- (1) The impotence of the husband;
ization.
( 2 ) The fact that the husband and wife were living separately
A minor child of a naturalized or permanent resident alien may in such a way that access was not possible; and
be given the right to land into our shores upon proofs that such
(3) By the serious illness of the husband.
minor is a legitimate child of a naturalized Filipino or that of a
permanent resident alien. Requisites of the presumption:
a. There is a valid marriage.
Kinds of Children:
b. The birth of the child took place after 180 days following the
A. Legitimate Children: celebration of marriage or within 300 days following its dis-
1. Legitimate children (proper). solution or separation of the spouse.
2. Legitimated children. c. There is no physical impossibility of the husband having access
3. Adopted children. to the wife during the first 120 days of the 300 days preceding
B. Illegitimate Children: the birth of the child.
1. Natural Children: The presumption of legitimacy under Art. 255, Civil Code is
a. Natural children (proper). conclusive:
b. Natural children by presumption.
The presumption of legitimacy above-mentioned (Art. 255,
c. Natural children by legal fiction.
Civil Code) is conclusive because:
2. Spurious Children:
a. Sec. 4(a) of Rule 131 of the Rules of Court is a repetition of
a. Adulterous children.
Art. 255 of the Civil Code.
b. Incestuous children.
c. Manceres children. Sec. 4, Rules of Court — Quasi-conclusive presumptions of
d. Sacrilegious children. legitimacy:
( a ) Children born after one hundred eighty days following the
celebration of marriage, and before three hundred days
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following its dissolution or the separation of the spouses
shall be presumed legitimate.
Against this presumption no evidence shall be admitted
other than that of physical impossibility of the husband's
having access to his wife within the first one hundred and
twenty days of the three hundred which preceded the birth
of the child.
b. The presumption in Art. 255, Civil Code is not qualified, while
the presumptions in Art. 257, 258 and 259 of the same code
qualified the presumption to be "prima facie" which infer that
the presumption under Art. 255 is conclusive.
Children born after 180 days following the celebration of marriage:
a.JExample:
A and B were married in Jan.l, 1980. A child was born after
180 days following their marriage. If there is no impossibility
of access between A and B, the child is conclusively presumed
to be legitimate.
h/Reason for the presumption:
The law considers that in order that a child beviable, it
must have at least 180 days of development from fertilization
to birth. Ar child born before 180 days after the celebration
of marriage is not viable, it must have been brought about by
a sexual act which occurred before the celebration of marriage.
A child born before 180 days following the celebration of
marriage is premature and underdeveloped to withstand ex-
ternal environment. - -
Child born within 300 days following its dissolution or separation
of spouse:
a. Example:
A and B are legally married. On Jan. 1,1980, B, the husband
died. 230 days after A became a widow, a child was born.
The child is conclusively presumed to be legitimate insofar as
the deceased husband provided there was no physical im-
possibility of access between A and B during the latter's life-
time.
b. Reason for the presumption:
The law based on medical science considers 300 days as the
length of uterine development of a child. Normally, it is 280
days as the period of utero-gestation. But, it is not uncommon
for pregnancy to be prolonged up to 300 days or even more,
although there may be signs of post-maturity. To include those
children who may be born more than the average duration of
utero-gestation, the law extended the limit to 300 days.
M was married with X on September 28, 1944. The husband,
M, died on October 11, 1944. A child was born on April 24,
1945 or 208 days after the celebration of marriage and within
300 days following its dissolution. There being no showing that
M is impotent, the court held that the child born is conclusively
legitimate (Menciano v. Neri San Jose, G.R. No. L-1967, May
1951).
Only evidence sufficient to rebutt the above presumption:
That there is "physical impossibility of the husband's having
access to his wife within the first one hundred and twenty days
of the three hundred days which preceded the birth of the child."
Example:
(1) A and B were married and 7 months after marriage a child
was born. Considering that each month has thirty days,
the child is considered legitimate if, anytime three months
before up to one month after the marriage, there was
possibility of access between A and B.
(2) A and B were legally married. Six months after A became a
widow, a child was born. The child is presumed to be
legitimate if B, the husband had access with his wife during
the four months period before his death. If during the
whole period of four months before he died he was living
in a far distant place whereby access was not possible, then
the child is not his own.
.Causes of physical impossibility:
(1) By the impotence of the husband.
(2) By the fact that the husband and wife were living separately,
in such a way that access was not possible.
(3) By the serious illness of the husband (Art. 255, Civil Code).
The impossibility of access must not be construed in its literal
sense. It means inability to perform sexual intercourse.
Impotency of the husband must be present during the first
120 days of the 300 days preceding the birth of the child. It
must be an absolute impotency and not a relative one. It must
be complete not partial.
The serious illness suffered by the husband must occur during
the period of conception of the child. Serious illness means
such condition which will prevent the husband to perform
sexual act with his wife. The fact that the husband is suffering
from tuberculosis does not prevent him from performing the
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carnal act. The reputation of the tuberculosis towards eroticism
(sexual propensity) is probably more dependent upon con-
finement than the consequences of the disease (Andal V
Macaraig, G.R No. L-2474).
Art. 258, Civil Code:
A child born within one hundred eighty days following the
celebration of marriage is prima facie presumed to be legitimate.
Such a child is conclusively presumed to be legitimate in any of
these cases:
(1) If the husband, before the marriage, knew of the pregnancy
of the wife;
(2) If he consented, being present, to the putting of his surname
on the record of birth of the child; and
(3) If he expressly or tacitly recognized the child as his own.
Prima facie means the presumption is true and correct unless it
can be shown by other proofs to the contrary.
A husband who knew of the existence of pregnancy of his
wife before marriage and still married her, impliedly shows that he
is the author of such pregnancy. If he is not responsible for such
pregnancy, then he waived his right to contest its legitimacy.
The consent of the husband to place his surname on the record
of birth of the child is also a recognition that the child is his own.
A man with a normal sense will not allow his surname be attached
to one with a blood foreign to his.
Expressed recognition may be made by the father of the child
by telling other people that the child is his legitimate child. Tacit
or implied recognition may be made by inference from the acts of
the husband wherein recognition may be deduced. Allowing the
child to live in the conjugal dwelling, giving the necessary support,
furnishing the child of his daily needs imply that the child is his
own.
Recognition shall be made in the record of birth, a will, a
statement before a court or record, or in any authentic writing
(Art. 278, Civil Code).
Art. 256, Civil Code:
The child shall be presumed legitimate, although the mother
may have declared against its legitimacy or may have been sen-
tenced as an adulteress.
Reasons for the provision:
a. The status of a child must not be left at the mercy or the
passion of the parents. A wife may while in the fit of her
anger declare that the child is not that of the husband although
it is not true.
b. The husband may connive with the wife and let her declare the
child as illegitimate and thus decrease his right over the proper-
ties of the husband.
c. Between legitimacy and illegitimacy, the law is in favor of
legitimacy. A child must not be punished by the wrongful
acts of his parents.
Presumption of illegitimacy based on ethnic reasons:
Art. 257, Civil Code:
Should the wife commit adultery at or about the time of the
conception of the child, but there was no physical impossibility
of access between her and her husband as set forth in article 255,
the child is prima facie presumed to be illegitimate if it appears
highly improbable, for ethnic reasons, that the child is that of the
husband. For the purposes of this article, the wife's adultery need
not be proved in a criminal case.
Example:
A and B, both white-Americans were legally married. During
the period of conception for the child C, the wife had an illicit
relation with X, a negro. The child born has dark skin, wiry and
curly hair and with thick lips. There is no ancestor in A and B
who is negro. The child C is prima facie presumed illegitimate.
Marriage of women within 300 days following death of husband,
annulment of marriage or other forms of marital dissolution:
Art. 84, Civil Code:
No marriage license shall be issued to a widow till after three
hundred days following the death of her husband, unless in the
meantime she has given birth to a child.
The Revised Penal Code penalizes a widow re-marrying before
the expiration of 301 days following her widowed:
Art. 351, Revised Penal Code — Premature marriages:
A widow who shall marry within three hundred and one days
from the date of the death of her husband, or before having
delivered if she shall have been pregnant at the time of his death,
shall be punished by arresto mayor and fine not exceeding 500
pesos.
The same penalties shall be imposed upon any woman whose
marriage shall have been annulled or dissolved, if she shall marry
before her delivery or before the expiration of the period of
three hundred and one days after the legal separation.
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The purpose of the above provisions of law is to prevent dis-
puted paternity of the child born after the subsequent marriage
celebrated within the three hundred days following the dissolution
of the first marriage.
However, where deceased husband was proven to be impotent
or sterile, the widow who contracted a premature marriage was not
held criminally liable (People v. Masinsin, C.A. G.R. 9157, June
1953).
Presumption of legitimacy if the widow marries within three
hundred days following the death of the husband:
Art. 259, Civil Code:
If the marriage is dissolved by the death of the husband, and the
mother contracted another marriage within three hundred days
following such death, these rules shall govern:
(1) A child born before one hundred eighty days after the
solemnization of the subsequent marriage is disputably
presumed to have been conceived during the former mar-
riage, provided it be born within three hundred days after
the death of the former husband;
( 2 ) A child born after one hundred eighty days following the
celebration of the subsequent marriage is prima facie
presumed to have been conceived during such marriage,
even though it be born within the three hundred days
after the death of the former husband.
is legitimate insofar as the second husband. But the child is born
only 250 days after the death of the first husband. It is possible
that the widow was pregnant for one month at the time of death
of the first husband, yet the presumption made the child prima
facie legitimate as that of the second husband.
Duty of a woman after annulment of marriage when she becomes
a widow and pregnant:
Art. 260, Civil Code:
If after a judgment annulling a marriage, the former wife should
believe herself to be pregnant by the former husband, she shall,
within thirty days from the time she became aware of her preg-
nancy, notify the former husband or his heirs of that fact. He or
his heirs may ask the court to take measures to prevent a simulation
of birth.
The same obligation shall devolve upon a widow who believes
herself to have been left pregnant by the deceased husband, or
upon the wife who believes herself to be pregnant by her husband
from whom she has been legally separated. —.
The Revised Penal Code impose penalty for simulation of birth
and usurpation of the civil status:
Art. 347, Revised Penal Code — Simulation of births, substitution
of one child for another and concealment or abandonment of a
legitimate child:

Example of N o . ( 1 ) :
A widow married 100 days after the death of her first hus-
band. A child is born 175 days after the celebration of the
second marriage. The child is disputably presumed to be
legitimate insofar as the first husband because the child is born
within 180 days following the celebration of the second mar-
riage and within 300 days after the death of the first husband.
Example of N o . ( 2 ) :
A widow married 80 days after the death of the first husband.
A child is born 200 days after the celebration of the second
marriage. The child born is prima facie presumed to be le-
gitimate child of the second husband because the child was
born after 180 days following the celebration of the second
marriage.
Flaw of the presumption:
A widow married 50 days after the death of the first husband.
A child was born 200 days following the celebration of the second
marriage. Following the provision of the presumption, the child
The simulation of births and the substitution of one child for
another shall be punished by prision mayor and a fine of not
exceeding 1,000 pesos.
The same penalties shall be imposed upon any person who shall
conceal or abandon any legitimate child with intent to cause such
child to lose its civil status.
Any physician or surgeon or public officer who, in violation of
the duties of his profession or office, shall cooperate in the exe-
cution of any of the crimes mentioned in the two next preceding
paragraphs, shall suffer the penalties therein prescribed and also
the penalty of temporary special disqualification.
Usurpation of Civil Status:
Art. 348, Revised Penal Code:
The penalty of prision mayor shall be imposed upon any person
who shall usurp the civil status of another, should he do so for the
purpose of defrauding the offended party or his heirs; otherwise,
the penalty of prision correccional in its medium and maximum
periods shall be imposed.
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Child born after 300 days following dissolution of marriage
or separation of the spouse:
Art. 261, Civil Code:
There is no presumption of legitimacy or illegitimacy of a
child born after three hundred days following the dissolution
of the marriage or the separation of the spouses. Whoever alleges
the legitimacy or the illegitimacy of such child must prove his
allegation.
2. Legitimated Children:
Legitimation is defined as a remedy or process by which a child
born out of lawful wedlock and are therefore considered ille-
gitimate are by fiction of law considered legitimate by subsequent
valid marriage of the parents.
3. Adopted Children:
Adoption is defined as the act or proceeding by which relations
of paternity and filiation are recognized as legally existing between
persons not so related by nature. The purpose of adoption is to
establish a relationship of paternity and filiation and to afford
persons who have no child of their own consolation of having one
by legal fiction. The child wherein paternity and filiation is es-
tablished is an adopted child and with all the legal rights as a
legitimate child in relation to the adopting parents.
Persons who may be adopted:
a. The natural child, by the natural father or mother;
b. Other illegitimate children, by the father or mother;
c. A step-child, by the step-father or step-mother (Art. 338,
Civil Code); and

Art. 270, Civil Code: d. A n y person, even if of age, provided the adopter is sixteen
years older (Art. 337, Civil Code).
Legitimation shall take place by the subsequent marriage
between the parents.
Persons who cannot be adopted:
Art. 272, Civil Code: a. A married person, without the written consent of the other
Children who are legitimated by subsequent marriage shall spouse;
enjoy the same rights as legitimate children. o. An alien with whose government the Republic of the Philip-
Children can be legitimated: pines has broken diplomatic relations; and
a. Natural children (proper): c. A person who has already been adopted (Art. 339, Civil Code).
Natural children are those born outside lawful wedlock of
Persons who may adopt:
parents who, at the time of the conception of the former, were
not disqualified by any impediment to marry each other (Art. a. Every person of age, who is in full possession of his civil rights.
269, Civil Code). (Art. 334, Civil Code)

Example: Persons who cannot adopt:

A and B are both single and are of age. There are no other
impediments for them to marry one another. Although
unmarried, they had sexual intercourse and as a result of
which a child is born. The child is considered to be natural.
If the child is acknowledged by the parents to be then-
own, then the child becomes an acknowledged natural child,
and if the parents after acknowledgement subsequently
married one another, the child becomes a legitimated child.
a. Those who have legitimate, legitimated, acknowledged natural
children or natural children by legal fiction;
b. The guardian, with respect to the ward, before the final ap-
proval of his accounts;
c. A married person, without the consent of the other spouse;
d. Non-resident aliens,

Requisites for legitimation of natural child (proper):
a / T h e child must be natural.
b/The child must be acknowledged by both parents before mar-
riage.
c^There must be subsequent marriage of the parents.
e. Resident aliens with whose government the Republic of the
Philippines has broken diplomatic relations, and
f. Any person who has been convicted of a crime involving moral
turpitude, when the penalty imposed was six months' im-
prisonment or more (Art. 335, Civil Code).
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B. ILLEGITIMATE CHILDREN
Illegitimate children are those who were born out _of lawful
wedlock or after a competent time after its dissolution.
1. Natural Children:
a. Natural Children (Proper):
Natural children are those born outside wedlock of parents
who, at the time of the conception of the former, were not
disqualified by any impediment to marry each other (Art. 269,
Civil Code).
b. Natural Children by Legal Fiction:
Natural children by legal fiction are those children born of
void marriages or those born of voidable marriages after the
decree of annulment.
Example:
A was married with B, his o w n step-daughter. The mar-
riage is void. A child was born thereafter. The child is
natural by legal fiction.
c. Natural Children by Presumption:
Natural children by presumption are those natural children
acknowledged by the father or the mother separately if the
acknowledging parent was legally competent to contract mar-
riage at the time of conception (Borres and Barza v. Mun. of
Panay, 42 Phil. 643).
Example:
A, a married woman who is living separately from his
husband, had an illicit relation with B. The child born has
been recognized by B to be his own. The child is considered
to be natural by presumption.
2. Spurious Children:
Illegitimate children who are not natural are considered spurious.
Spurious children may be:
a. Adulterous Children:
These are children conceived in an act of adultery or con-
cubinage.
b. Sacrilegious Children:
These are children born of parents who have been ordained
in sacris. In civil law, there is no such kind of illegitimate
children because a priest or a nun can marry. There is no
impediment in law for them to marry. It is only the regula-
tion of the church that prohibits it. In the Philippines, there
is separation between the church and the state.
c. Incestuous Children:
These are children born by parents who are legally incapable
of contracting valid marriage because of their blood relationship
as marriage between brothers and sisters, father and daughter,
etc..
d. Manceres:
These are children conceived by prostitutes. It is very
difficult to determine the father because of the nature of the
business.
Civil Liability of Persons Guilty of Crimes Against Chastity:
Art. 345, Revised Penal Code:
Persons guilty of rape, seduction or abduction shall also be
sentenced:
1. To indemnify the offended woman.
2. To acknowledge the offspring, unless the law should prevent him
from so doing.
3. In every case to support the offspring.
The adulterer and the concubine in the case provided for in articles
333 and 334 may also be sentenced, in the same proceeding or in
a separate civil proceeding, to indemnify for damages caused to the
offended spouse.
In cases of multiple rape, when three persons, one after another
raped a woman, the offenders may not be required to recognize
the offspring as it is impossible to determine the paternity of the
child (People v. Pedro de Leon, et. al, G.R. No. L-2094).
If the woman abused is married, the child born subsequently can-
not be recognized by the offender (People v. Sanico, C.A. 46 O.G.
98) and if the woman who was raped was married and pregnant, the
child born thereafter cannot be recognized and support cannot be
demanded from the offender. The reason behind is that to allow
the offender to give support and recognize the offspring will allow
the offender to periodically visit the home of the offended party in
order to comply with his duty and it will enhance disturbance in
the family who are living in peace and tranquility (U.S. v. Yambao,
4 Phil. 204).
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EVIDENCE OF PATERNITY A N D FILIATION

A. Medical Evidences:
Is Parental Likeness:
Heredity transmits traits and characteristics from parents to
the offsprings. There must be some gross manifestation of the
children which may be in common with the father.
The following points may be considered by the examining
physician to determine physically whether paternity and
filiation exists between persons in question: 600 LEGAL MEDICINE
a. General feature p. Gait, speech, and movement
b. Manner of gesture fr Color and texture of the hair 4. Evidences from the Father:
c. Personal peculiarities gc Color of the eyes a. Proof of Physical Potency and Fertility:
di Personal deformities K. General built and size Medical examination must be done whether the husband
is capable of erection. A quantitative and qualitative exam-
2. Blood Grouping Test:
ination of spermatozoa in the seminal fluid is necessary to
The fact that the blood type of the child is a possible pro- determine fertility. The presence of disease, congenital
duct of the parents, does not conclusively show that the child or acquired abnormalities, etc. may be factors that may bring
is born by such parents. But, if the blood type of the child is about impotency or sterility.
not the possible blood type when the blood of the parents are b. Proof of Access:
cross-matched, it shows definitely that the child is not that of The physician must determine the health and vigor of the
the husband. A positive result is not conclusive, but a negative father, the presence of disease, which may bring about his
result is conclusive. incapacity to perform sexual intercourse.

3. Evidences from the Mother: B. Non-medical Evidences:

a. Proofs of Previous Delivery: 1. Record of birth in the Civil Registrar, or by an authentic
The supposed mother may be subjected to an exami- document or a final judgment (Art. 265, Civil Code).
nation to determine the presence of signs of previous child- 2. Continuous possession of the status of a legitimate child (Art.
birth and which are compatible with the age of the child. 266, Civil Code).
3. Any other evidences allowed by the Rules of Court and special
b. Proofs of Physical Potency and Fertility:
laws (Art. 267, Civil Code).
Although it is difficult to determine the physical potency
in women inasmuch as a woman is a passive subject to a
sexual act, the woman may be manifesting some acquired or
congenital defect wherein impotency may be inferred.
Atresia of the vaginal canal, imperforate hymen, etc. may be
present. Fertility may be inferred from the presence of other
pregnancies and the absence of organic abnormalities of the
generative system.
c. proof of Capacity to have Access with the Husband:
A general physical examination of the woman is necessary
to determine whether she is physically capable of having
sexual intercourse with her husband.
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Chapter XXVffl difficulties on the part of either husband or wife;

PATERNITY A N D FILIATION ON
NON-CONVENTIONAL METHODS OF PROCREATION
The standard method of reproduction is the introduction of the
male sperm into the generative organ of a female through sexual inter-
course followed by fertilization, growth and development of the
conceptus and its subsequent delivery. No technical manipulation or
medication is employed as it is a physiologic process.
However, modern advancement of medicine modified the con-
ventional method as a solution to some specific problems of repro-
duction. Artificial Insemination and In Vitro Fertilization as a
modality of management has gone beyond the experimental stage of
procreation and now recognized and used to solve problems. Other
methods are still in their experimental stage and whatever problems
(medical, legal or moral) that may develop will depend and will be
solved in the future.
A. ARTIFICIAL INSEMINATION
Artificial insemination is a medical procedure by which the
semen is introduced into the vagina by means other than copulation
for the purpose of procreation. Some physicians consider the term
"therapeutic insemination" as a more suitable term for the pro-
cedure (Sagall).
Artificial Insemination Classified According to the Source of Semen:
1. A . I . H . (Artificial Insemination Homologous, Artificial Insemination
Husband) — When the sperm comes from the husband.
2. A . I . D . (Artificial Insemination Donor, Artificial Insemination
Heterologous) — When the sperm comes from a donor other than
the husband.
3. A . I . H . D . (Artificial Insemination Husband Donor, Polled Donor
Semen) — When the donor semen comes from the husband and a
third party donor.
Medical Indications for Artificial Insemination :
1. For A.I.H.:
a. When the deposition of the husband's semen within the vagina is
by coitus, this is prevented because of anatomic or psychologic
601
b. When the infertility is due to poor motility, paucity or otherwise
defective sperm cells or too small a volume of the ejaculant.
2. ForA.I.D. or A.I.H.D.:
a. Absolute male sterility (Azoospermia);
b. Oligospermia — Less than 10 to 15 million sperm per cc. of
semen with infertility of long duration;
c. Hereditary disease in the husband making propagation in-
advisable for eugenic reason; or
d. An Rh blood incompatibility is expected to cause an abnormal
baby in situations where other techniques to overcome such
incompatibility are not applicable.
Selection of Donor of Semen:
In A . I . D . the selection of the appropriate donor of semen resides
in the physician. If the child born becomes defective which can be
traced from a physician's negligence or carelessness in choosing the
donor, the physician may be held liable.
The following are the obligations imposed on a physician in the
selection of donors:
1. Proper screening must be made of the donor including chromo-
somes for genetic defects.
2. The donor must have the racial characteristic and physical pro-
portion as those of the husband and wife and the blood type must
be compatible with A . B . O . and Rh genotype of the wife.
3. The physician must ensure that the identity of the donor is not
known to the parents and vice versa.
4. Complete physical examination with standard test for syphilis
and gonorrhea is obtained not more than one week before the
seminal fluid is collected.
Precautions to be Observed by the Physician in Performing Artificial
Insemination:
1. The physician should make certain by reasonable testing that the
procedure is medically indicated for the couple who has requested
conception by this method. The husband is infertile and such
condition is permanent.
2. The physician should establish by proper evaluation that the cou-
ple requesting artificial insemination is emotionally stable and
psychologically suited for this type of parenthood, which carries
with it the responsibilities of the very presence of the child. This
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will constantly attest to both partners and the husband's in-
capacity for biologic fatherhood.
3. The physician must use all reasonable precautions in selecting the
donor; with thorough medical, psychologic and social screening
to exclude donor with potential transmissible undesirable traits,
features and details.
4. The physician must, under no circumstances except by court
order, reveal the fact of artificial insemination or 'the identity
of the donor or of the couple to each other or to other persons.
5. The physician must use freshly donated sperm or frozen semen
that has been prepared and stored according to currently accepted
methods with the source properly identified.
6. The insemination procedure must be performed by the physician
in accordance with the currently accepted techniques.
7. Full and valid consents and releases should be obtained in writing
from all parties involved, and each consent must be an "informed
consent," particularly on the part of the prospective parents, who
should be fully appraised of the psychologic and legal compli-
cation and the possibility of the birth of a defective child (Legal
Medicine Annual 1973 by C. Wecht, p. 483).
Status of the Child Born by Artificial Insemination:
Artificial insemination as a remedy for reproductive infertility has
been developed and recognized recently. The issue as to the status
of the children born as a consequence of artificial insemination has
never been brought squarely in our court. The following may be the
possible status of the child born as a consequence of artificial in-
semination :
1. In A . I . H . , there is no doubt that the child is a legitimate child of
the husband because the semen came from him. No foreign blood
is introduced into the family.
2. In A . I . D . , with the consent of the husband, the child born must
also be considered legitimate although the fertilization semen is
not from the husband. His consent to the artificial insemination
may be considered as a waiver to the illegitimate status of the
child. Even if the child is considered illegitimate, the child can
be adopted by him making the child's status legitimate.
3. In A . I . D . , without the consent or if it is against the will of the
husband, the child must be considered illegitimate, specifically
a child born because of adultery. This is an intrusion into the
conjugal home of a foreign element against the will of the husband.
If the child is considered born because of adultery, did the wife
commit adultery? Adultery is committed by "having sexual
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intercourse with a man not her husband", but there is no sexual
intercourse in artificial insemination and therefore no such crime
is committed by the wife.
There are different ways a wife can commit adultery, like if she
lies side by side with a man, kissing him, embracing and doing
lascivious acts. But, the only lascivious act punishable by law is
when sexual intercourse was done.
Consent on A . L D . :
In A . I . D . the consent and release for any future claim must be
obtained by the physician from all parties in writing.
The consent of the wife is necessary to avoid being held liable for
an assault.
The consent of the husband is necessary to avoid the wife being
charged with adultery, or to ward the question of legitimacy of the
child, issues of divorce, separation or inheritance.
The consent and release of the donor should be obtained for the
unrestricted use of the semen supplied and he should also certify
in writing that he will make no effort to ascertain the identity of
the couple involved. If the donor is married, the consent of the
wife must also be obtained to the giving of semen because her marital
interest may be affected by the donation.
Foreign Court's Decisions:
Child born by artificial insemination without the consent of the
husband constitutes adultery:
A woman attempted to obtain alimony from her divorced hus-
band. The latter contended that his former wife committed adultery
because the child born is not his biological child. The former wife
claimed the child to he a product of artificial insemination. The
court held that the artificial insemination without the husband's
consent constitutes moral turpitude and adultery with the latter
being defined as "the voluntary submission to another person of the
reproductive powers or faculties of guilty person" (Osford v. Osford,
68Dom Law Reports, 251 Ont. Sup. Ct. 1921).
The British House of Lords concurred with a ruling that the
conception of a child by a man other than the husband constituted
adultery and that, therefore, the resulting offspring was illegitimate
(Russel v. Russel, A.C. 687 (1924) at 148).
Child born by artificial insemination is legitimate:
In a decree to a separation previously granted by the court, the
husband was granted to have a weekend custody of the child born
during the marriage. The wife petitioned for an amendment of the
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decree arguing that because the child has resulted from A . I . D . , the
husband is not the father of the child and therefore he is not entitled
to visitation right. The court, however, predicted on the assump-
tion that the procedure had been performed with the consent of the
husband, rules that "the child has been potentially adopted or semi-
adopted by the defendant and with the particular reference to
visitation, he is entitled to the same right as those to which a natural
parent under the circumstances would be entitled (Strand v. Strand
78N.Y.S. 2d 390(1918).
In an action for a divorce, the Wife alleged that her husband had
no visitation right since the child had been conceived from a donor
sperm. The court upheld an axiomatic legal principle: "When a
child is born within marriage by whatever legal method, there is
legal presumption that both marriage partners are its parents (Ohlson
v. OhlsonNo. 54, S. 138, 875 (Super. Ct. Cook Country, Sept. 1955).
Child born by artificial insemination is illegitimate:
The trial judge granted the divorce but denied the husband of
visitation rights and the custody of an A . I . D . child declaring that
"Heterologous artificial insemination", with or without the consent
of the husband, is contrary to public policy and good morals, and
constitutes adultery on the part of the mother. A child so conceived
is not a child born in wedlock and therefore illegitimate. As such,
the mother and the father have no rights or interests of the said
child (Dornbus v. Dornbus, No. 51, S. 13 875 (Super Ct. Cook
Country, No. 1954, appeal dismissed 12 III. App. 2d 473 (1956).
A child conceived by A . I . D . is illegitimate, but the husband at
the time of birth was obliged to give support. The trial judge ruled
that because the husband had consented to the artificial insemi-
nation procedure there arose "an implied contract to support the
child although the court considered the child illegitimate (Gursky
v. Gursky, 242 NnYlS. 2d 406, 39 Misc. 2d 1083 Sup. Ct. 1936).
Child born by artificial insemination is entitled for support:
The husband consented in writing for artificial insemination of
the wife. A male child was conceived and born. The spouse later
had a divorce and the wife was given custody of the child. The
wife later became ill and disabled so she applied for a state support
of the child. The District Attorney brought a criminal action against
the husband to force him to provide for the child's support. The
court ruled that "reasonable man who, because of his inability to
procreate, actively participates and consents to his wife's artificial
insemination, knows that such behavior carries with it legal res-
ponsibilities of fatherhood and criminal responsibility of non-
support (People v. Sorenson, 66 Cal. Rptr. 7, 437 P. 2d 499 (1968).
B. IN VITRO FERTILIZATION
In Vitro Fertilization (test tube baby) is the fertilization of the egg
cell by the sperm cell extracted from the respective donors placed in
an artificial medium and after reaching a certain stage of cellular
division and development:
1. Implanted into a woman's uterus, or
2. Gestation (development of the embryo to a child) in an artificial
womb.
Whenever the embryo is allowed to develop in an artificial
womb, it is know as ectogenesis (extra corporeal gestation).
The first recorded child born by In Vitro Fertilization was Louise
Brown who was born in England on July 24, 1978 (London Daily
Mail). This was followed by the birth of the second in vitro fertil-
ization child in Calcutta, India on October 6, 1978. Subsequent
report followed from Scotland and Australia. In the United States,
the first reported case was on February 1980 in Norfolk, Virginia.
At present the total number is more than 2,000 children are already
born through In Vitro Fertilization.
Procedure of In Vitro Fertilization:
The In Vitro Fertilization process begins with injections into the
oocyte (ovum) donor of a hormone known as gonadotropin, which
induces super-ovulation. Approximately 30 hours later, the oocytes
are removed from the ovary by laparoscopy, a surgical procedure
accomplished by inserting two thin glass tubes into the ovary
through a small incision in the abdomen. The removed oocytes
are placed in a Petri dish or a test tube containing growth medium
simulating the environment of the woman's body. The medium
is composed of a woman's blood, fluids from her reproductive
tract, and nutrients. The oocytes are then fertilized by a sperm
which has been held in vitro. The resulting conceptus is kept in
a moist environment at room temperature where it divides and grows
for a few days until it reaches the blastocyst stage, the stage at
which the embryo normally enters the uterus. The conceptus is
then picked up with a small hollow tube, inserted through the
vagina and cervix into the uterus where it is implanted at a proper
time in the menstrual cycle. After successful transplantation, the
woman carried the blastocyst to term (Legal Medicine by Cyril
Wecht, 1982, p. 240).
Possible Situations in In Vitro Fertilization:
1. The ovum removed from the wife is fertilized by sperm from the
husband and the resulting zygote is implanted into the wife's uterus.
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This process is done because ( a ) the wife cannot conceive on
account of the occlusion of the fallopian tube, or ( b ) although the
couple can possibly have a child through normal intercourse but
they want early screening of the conceptus for genetic defects,
control the timing of the pregnancy or select a blastocyst with
certain characteristics.
The closure of the fallopian tube may be due to complication of
a pelvic inflammatory disease, bilateral salpingectomy on account
of repeated caesarian section or ectopic pregnancy, tuboplasty
failure or unsuccessful tubal anastomosis, or congenital aplasia
or hypoplasia of the fallopian tube.
2. The ovum removed from the wife is fertilized by the sperm
coming from a third party (sperm donor) and is implanted into the
wife's uterus.
This situation may arise when (a) the husband is sterile, ( b ) the
husband does not wish to transmit to the child a genetic defect, or
(c) the wife cannot conceive through Artificial Insemination
Donor ( A I D ) .
3. The ovum coming from a third party (ovum donor) is fertilized by
the husband's sperm and the blastocyst is implanted into the
wife's uterus.
This situation is necessary when (a) the wife is sterile or ( b )
the wife does not like to transmit genetic defect to the child.
4. The ovum taken from a third party (ovum donor) is fertilized by
the sperm coming from a third party (sperm donor) and the
blastocyst is implanted into the wife's uterus.
This procedure may be adopted when (a) both husband and
wife are sterile, or ( b ) both of them refuse to transmit to the child
their genetic defects.
5. The ovum removed from a single woman is fertilized by the sperm
taken from a male donor; the blastocyst is implanted into the
single woman's uterus.
The procedure may be done when the single woman wishes to
have a child but she cannot conceive naturally or by artificial in-
semination.
6. The ovum removed from the wife is fertilized by the husband's
sperm and the blastocyst is implanted to a "host" or surrogate.
There is genetic link of the child to the parents by the gestational
link with a third party.
7. The ovum coming from the wife is fertilized artificially by the
sperm coming from a third party (sperm donor) and the blastocyst
is implanted into the surrogate's uterus.
8. The ovum coming from a third party (ovum donor) is fertilized
by the sperm coming from the husband and the blastocyst is
placed into the uterus of the surrogate's uterus.
9. The ovum coming from a third party (ovum donor) is fertilized
by the sperm coming from a third party (sperm donor) and the
blastocyst is implanted into the uterus of a surrogate.
Basis of Legality of In Vitro Fertilization:
The constitution provides that "No person shall be deprived of
life, liberty, or property without due process of law, nor shall any
person be denied the equal protection of the laws." (14th amend-
ment of U.S. and Article IV, Sec. 1, Philippines).
From the term "liberty" emanates the right of privacy.
In Meyer v. Nebraska (262 U.S. 390), the right of privacy denotes
not only freedom from bodily restraints but also the right of the
individual to contract, to engage in any of the common occu-
pations of life, to acquire useful knowledge, to marry, to establish a
home and bring up children, to worship G o d according to the dictate
of his own conscience, and generally to enjoy those privileges long
recognized by law as essential to the orderly pursuit of happiness as
a free man.
In Griswold v. Connecticut (381 U.S. 479, 1965), the right of
privacy means the right to be left alone. It is the right of an individ-
ual to the possession and control of his own person, free from all
restraints or interference of others, unless by clear and unquestion-
able authority of law. It is the right of parents or guardians to
establish their family life as they see fit.
Other implications of the right of privacy which may be the basis
of legality of in vitro fertilization:
a. Right of procreation — Procreation is fundamental to the
very existence and survival of a race. A ban on the use of in
vitro fertilization would prevent an individual from using means
to fulfill his or her procreative mission. Inability to procreate
is a malady and it is the duty of medicine to alleviate or cure
the condition so as to make him enjoy life and realize his
desire.
b. Right of marital privacy — Prohibition of in vitro fertilization
as a way to have children will mean government intrusion into
the marital bedroom in search of evidence for violating the law.
The freedom of personal choice in matters of marriage and
family life is one of the basic liberties protected by the due
process of law clause.
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c. Right to decide whether to bear or beget — This is the right of a
person to determine whether to carry or not to carry a product
of conception, to be or not to be a mother or to raise or not to
raise a family.
d. Right of self-determination — "Every human being of adult age
and of sound mind has the right to determine what shall be
done on his own body (Schloendorff v. Society of New York
Hospital 195 N.E. 92 N. Y. 1914). A modern definition of this
concept is expressed in the case of Natanson v. Kline (350 P. 2d
1093 Kan. 1960) which stated that "a man is the master of his
own body and he may expressly prohibit the performance of
life-saving surgery..."
Problems in In Vitro Fertilization:
1. The probability that the child to be born will be defective:
Although there is no actual substantial proof that a child born
through in vitro fertilization will in greater probability be de-
fective, physicians are seemingly apprehensive to perform this
non-standard procedure of procreation on fear that a civil suit for
damage may be filed against them.
A couple embarked in "in vitro fertilization" with their obste-
trician initiating a culture combining sperm and oocytes, but
later, destroyed the culture when he was convinced that the
risk of the procedure was too great. The plaintiff sued to re-
cover for their emotional pain and sufferings and a $50,000
verdict was awarded the couple (Del Zio v. Presbyterian Hospital,
74 Civ. 3588, U.S. Dis. Ct., SouthernDis. NY. 1978).
Some of the probable causes of the birth of a defective child may
be:
a. Administration of hormone to the prospective source of ovum:
A gonadotropic hormone is administered to induce more
production of oocytes to give the physician the privilege of
selecting which among is the best for fertilization. This may
cause production of chromosomal abnormality (trisomy). Inas-
much as the oocyte is mixed with a pool of sperm, a single
ovum maybe fertilized by multiple sperm and lead to the
production of an abnormal embryo (triploidy).
b. Mechanical manipulation of the oocyte and embryo:
The mechanical removal from the ovum donor, the actual
fertilization process in an artificial medium and the physical act
of insertion into the uterus may cause injury or deformity on
the cells or zygote.
c. Mistake in the "screening process' or selection of the best ovum
for fertilization.
d. Defective donors (sperm and ovum).
A physician need not fear too much of the possible liability on
account of a defective child because:
a. The plaintiff will find difficulty in proving negligence. The
plaintiff will have a hard time establishing connection between
physician's negligence and infant's defect because birth defects
are well known to occur in normal or natural pregnancies.
b. Prospective parents are normally briefed of the potential risks
of the procedure before their consent is obtained.
c. In vitro fertilization is still in the experimental stage and has yet
to evolve a clearly defined standard of care by which to deter-
mine whether the action of the physician is negligent.
d. The plaintiff is required to meet the difficult task of proving
negligence.
Social Problem in In Vitro Fertilization:
The probability for a child born by in vitro fertilization to be
defective is not remote for reasons stated (supra). Is our society
willing to have this world to be inhabited by android, monsters,
cyclopes, defectives and other forms of abnormalities? The pro-
gress of science must be geared towards improvement in the
quality of men and not towards retrogression or deterioration.
2. Problem of surrogate mother:
A surrogate mother is a woman who is not the source of the
ovum and in whose uterus the in vitro fertilized egg is implanted
to develop up to full term and delivered child. The term also applies
when fertilized egg is removed from the uterus of a woman and
implanted to the surrogate mother. The surrogate become the
gestational mother of the child.
Reasons why the services of a surrogate mother may be necessary:
a. Necessity:
(1) The genetic mother is unable to carry the child to term
because of disease or injury.
( 2 ) The genetic mother may believe either that she is too old to
safely carry a child to term, or that the child may be born
with abnormalities.
(3) The genetic mother may possess deleterious genetic traits
which may be passed on to the child.
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( 4 ) Couple is unable to adopt a child. Adoption is expensive and
time consuming process. There is shortage of available
3. Problem of the status of the child born by in vitro fertilization
children ready for adoption. The couple may express
preference as to the age, race or religion they wish to adopt.
These diminish the likelihood of having a child by adoption,
b. Convenience:
A woman may not want to interrupt her career during the
gestational period and therefore seek a more convenient method
of having one without changing her actual way of life.
Motivation of a woman to become a surrogate mother:
a. Altruistic motive — A woman may be willing to be a surrogate
mother for the sake of humanity.
b. Material consideration — If the surrogate mother merely re-
ceives all expenses incurred in carrying the fetus to term and then
delivered then the motive is altruistic. On the other hand, if the
payment agreed upon is beyond the reasonable cost of pregnancy
then it is tantamount to "rental" for the use of the uterus.
Problems that may arise in the agreement in the use of surrogate
mother for gestational purpose:
a. If the surrogate mother decided to abort the child contrary to
the wish of the genetic parents;
b. The surrogate mother may decide to keep the child after birth
rather than surrender him to the genetic parents;
c. The parents may decide to abort the child because of the fear
that abnormality may be present but the surrogate mother
refuses to do so;
d. If the child was born with abnormality and the parents refused
to take the child from the surrogate mother;
e. Can the couple enforce the contract in the event that the
surrogate mother committed other breaches? ; and
f. Is there a need to go through the procedure of adoption in
order to legitimatize the child at birth?
Potential solution to the problems of surrogate mother:
a. By contract — There must be a contract specifically mentioning
the rights and duties of each party. But the mere fact that the
rights and duties are specified do not guarantee that the speci-
fications will judicially be recognized. Any term that the court
finds to be contrary to public policy will be striken out. It
cannot be assured that all specified term will be judicially
enforced.
b. By legislation — The court is bound to enforce the legislation
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unless found to be unconstitutional. This method provides a
better solution to the problem.
(supra p. 607):
a. Situation 1 — There is no doubt that the child is legitimate
because the wife is genetically and gestationally the mother and
the sperm came from the husband. In case of situation 5, the
child born must be considered illegitimate in view of the ab-
sence of marriage between the single woman source of the ovum
and the sperm donor.
b. Situation 2 and 3 — Although one of the elements (ovum or
sperm) in the fertilization process did not come from one of the
spouses, the child may still be legitimate if there is consent of
the sterile party to the in vitro fertilization. If the child is not
considered legitimate, then the process of adoption may be
done.
The status that the child may be a problem may change if the
in vitro fertilization was done with the knowledge and consent
or against the will of the sterile spouse.
c. Situation 4, 6, 7, 8 and 9 — The genetic parents are different
f r o n the gestational mother. Adoption may be a legal remedy
provide' there is no impediment to the application of the pro-
cedure, otherwise a special legislation may be necessary.
C. OTHER NON-CONVENTIONAL METHODS OF PROCREATION
1. Artificial Inovulation — The removal of an unfertilized egg from
a woman and placing it on the reproductive tract of another
woman.
2. Embryo Transplantation — The removal of a fertilized egg from
a woman's uterus to transfer to that of another woman's uterus.
3. Parthenogenesis ("Virgin Birth") — A type of sexual repro-
duction whereby the unfertilized egg with 23 chromosome com-
pliment doubled its content to become a diploid cell that starts
dividing as if it is a fertilized egg without the intervention of
a male sperm cell, the resulting offspring is thus a female. It has
been speculated that virgin birth occurs naturally in human being
at the rate of one per three billion pregnancies.
4. Cloning — A type of a sexual reproduction whereby the nucleus
of a female egg is removed (enucleation) which contains the
genetic material and replaced with the nucleus of a body
(somatic) cell of the same or another woman (renucleation).
The renucleated egg is then placed in a uterus for gestation and
normal development. The resulting offspring is genetically
identical to the parent.
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Chapter XXIX
MEDICO-LEGAL ASPECT OF MARITAL
UNION A N D DISSOLUTION
A. AS TO REQUISITES OF A V A L I D M A R R I A G E :
Art. 52, Civil Code:
Marriage is not a mere contract but an inviolable social institu-
tion. Its nature, consequences and incidents are governed by law
and not subject to stipulation, except that the marriage settle-
ments may to a certain extent fix the property relations during
the marriage.
Art. 53, Civil Code:
No marriages shall be solemnized unless all these requisites are
complied with:
(1) Legal capacity of the contracting parties;
(2) Their consent, freely given;
(3) Authority of the person performing the marriage; and
(4) A marriage license, except in a marriage of exceptional
character (Sec. l a , Art. 3613).
Art. 54, Civil Code:
A n y male of the age of sixteen years or upwards, and any fe-
male of the age of fourteen years or upwards, not under any of the
impediments mentioned in articles 80 to 84, may contract mar-
riage. (Arts. 80 to 84 refer to void and voidable marriages).
Art. 61, Par. 2, Civil Code:
In case either or both of the contracting parties, being neither
widowed nor divorce, are less than twenty years of age as re-
gards the male and less than eighteen years as regards the
female, they shall, in addition to the requirements of the preced-
ing articles, exhibit to the local civil registrar, the consent to their
marriage, of their father, mother or guardian, or persons having
legal charge of them, in the order mentioned. Such consent shall
be in writing, under oath taken with the appearance of the in-
terested parties before the proper local civil registrar or in the
form of an affidavit made in the presence of two witnesses and
attested before any official authorized by law to administer oaths.
B. AS TO M A R I T A L RELATION:
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Art. 62, Civil Code:
Males above twenty but under twenty-five years of age, or
females above eighteen but under twenty-three years of age, shall
be obliged to ask their parents or guardian for advice upon the
intended marriage. If they do not obtain such advice, or if it be
unfavorable, the marriage shall not take place till after three
months following the completion of the publication of the appli-
cation for marriage license. A sworn statement by the contracting
parties to the effect that such advice has been sought, together
with the written advice given, if any, shall accompany the appli-
cation for marriage license. Should the parents or guardian
refuse to give any advice, this fact shall be stated in the sworn
declaration.
A physician may be required to determine the ages of the con-
tracting parties whenever the question of the validity of marriage
is at issue. Such determination of the age may be made by the
analysis of the peculiarities connected with the age, e.g., growth
of the pubic hair, presence of the third molar, development of
the breast, height, character, and educational attainment of the
person.
Art. 81, Civil Code:
Marriages between the following are incestuous and void from
their performance, whether the relationship between the parties
be legitimate or illegitimate.
(1) Between ascendants and descendants of any degree;
( 2 ) Between brothers and sisters, whether of the full or half
blood;
( 3 ) Between collateral relatives by blood within the fourth
civil degree.
Art. 82, Civil Code:
The following marriages shall also be void from the beginning:
(1) Between stepfathers and stepdaughters, and stepmothers
and stepsons,-
( 2 ) Between the adopting father or mother and the adopted,
between the latter and the surviving spouse of the former,
and between the former and the surviving spouse of the
latter;
( 3 ) Between the legitimate children of the adopter and the
adopted.
Art. 109, Civil Code:
The husband and wife are obliged to live together, observe mutual
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respect and fidelity, and render mutual help and support.

3. Desired number of children already born.

Art. 110, Civil Code: 4. Medical condition of the wife does not warrant pregnancy,
e.g., hyperthyroidism, nephritis, tuberculosis, diabetes, heart
The husband shall fix the residence of the family. But the court
disease, deaf-mutism, blindness or convalescence after acute
may exempt the wife from living with the husband if he should
illness such as typhoid fever or pneumonia, or after acute
live abroad unless in the service of the Republic.
surgical procedure as appendectomy or rectal fistula.
Art. I l l , Civil Code:
The husband is responsible for the support of the wife and the 5. Mental illness or emotional disturbance of husband and wife.
rest of the family. These expenses shall be met first from the con- 6. Economic conditions:
jugal property, then from the husband's capital, and lastly from
a. Unemployment of the husband.
the wife's paraphernal property. In case there is a separation of
b. Wife sole or co-wage earner.
property, by stipulation in the marriage settlements, the husband
c. Support or dependents.
and wife shall contribute proportionately to the family expenses.
d. Desire to complete education or professional training.
Art. 112, Civil Code:
The husband is the administrator of the conjugal property, 7. Dissatisfaction of either or both partners with method of
unless there is a stipulation in the marriage settlements conferring contraception employed.
the administration upon the wife. She may also administer the 8. Failure of other methods used.
conjugal partnership in other cases specified in this Code.
Causes of Non-consummation of the Sexual Act:
Causes of Sexual Dissatisfaction After Marital Union:
1. Septate hymen.
1. Fear of consequence of repeated abortion.
2. Tight thick hymen.
2. Fear of unwanted pregnancy.
3. Fear of pain or inability to stand pain.
3. Faulty contraceptive methods. There is inadequate oppor-
4. Ignorance of genital anatomy.
tunity for orgasm.
5. Ignorance of sex technique.
4. Dyspareunia (Vaginisimus, or improper sex technique).
6. Fear of pregnancy.
5. Fear of coitus.
7. Sense of shame regarding genitals and coitus.
6. Emotional frustration due to fertility.
7. Ignorance of the reproductive process and genital anatomy. Contraceptive Methods:
8. Aversion to coitus (frigidity). 1. Contraceptive Methods in General
9. No sex desire (low basal metabolic rate found). Contraceptive jelly alone
Condom
10. Anatomic cause of unsatisfaction in coitus: Coitus interruptus Coitus interruptus and
a. Tight resistant septate hymen. Douche douche
b. Size and location of the clitoris. Suppository Condom and pessary
c. Extreme obesity of either husband or wife. Safe period Condom and douche
d. Infantile genital development. Nothing Condom and jelly
e. Pelvic abnormality, e.g., parametritis, torn perineum. External coitus
Gold-stem wishbone pessary
11. Disparity in age. Vaginal diaphragm (rubber) Lactation
12. Venereal disease. French pessary (cervical Suppository and douche
13. Masturbation preferred to coitus. Abstinence
type)
14. Infidelity.
Lanteen pessary
Reasons Why Patients Requested Contraceptive Advice: 2. Male Method of Contraception:
1. Recent childbirth. Condoms with jelly, suppository or douche.
2. Desire to space offspring. Coitus interruptus with douche.
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3. Female Methods of Contraception: (2)

Douche alone Jelly with diaphragm (3) That either party was of unsound mind, unless such party,
Douche and condom Jelly with cervical type after coming to reason, freely cohabited with the other
Douche with coitus pessary as husband or wife;
interruptus Jelly with condom (4) That the consent of either party was obtained by fraud,
Douche with pessary Suppository with douche unless, such party afterwards, with full knowledge of the
Douche with diaphragm Safe period facts constituting the fraud, freely cohabited with the other
Vaginal diaphragm Lactation as her husband or his wife, as the case may be;
Cervical type pessary (5)
Stem pessary (intracervical)
(6) That either party was, at the time of marriage, physically
Jelly alone incapable of entering into the married state, and such
4. Other Methods: incapacity continues, and appears to be incurable.
External coitus
Abstinence Art. 86, Civil Code:
Nothing used Any of the following circumstances shall constitute fraud
referred to in number 4 of the preceding article:
Some Common Complaints After Marital Union: (1)
1. Male sex inadequacy. (2)
2. Prolonged debilitating disease of one of the partners. ( 3 ) Concealment by the wife of the fact that at the time of the
3. Anxiety over economic security. marriage, she was pregnant by a man other than her husband.
4. Manual clitoral stimulation preferred to coitus. There are several grounds for the annulment of marriage which
5. Too frequent pregnancy. are of medico-legal interest. A physician may be requested to
6. Lack of privacy (poor housing). determine the ages of the contracting parties, if the ground for
7. Husband's preference to perversion. the annulment of marriage is age. He may be required to examine
8. Cultural aesthetic inequalities between parties. the mentality of the party and to determine whether she or he
9. Faulty attitude of husband and wife toward normal sex and could have been of unsound mind at the time of the celebration
marriage intimacies. of marriage. The phrase "physically incapable of entering into
(From: JAMA, Vol 115, No. 4, July 27, 1949, pp. 270-285, married state" includes impotency of a party. The court or any
by Mario Pichel Warner, M.D.). of the parties in interest to the contract of marriage must deter-
mine whether or not she is pregnant at the time of the celebration
C. A S T O A N N U L M E N T O F M A R R I A G E : of marriage.
Art. 85, Civil Code:
D. AS TO LEGAL SEPARATION:
A marriage may be annulled for any of the following causes,
existing at the time of the marriage: Our law recognizes only relative divorce but not absolute divorce.
(1) That the party in whose behalf it is sought to have the mar- Art. 97, Civil Code:
riage annulled was between the ages of sixteen and twenty A petition for legal separation may be filed:
years, if male, or between the ages of fourteen and eighteen ( 1 ) For adultery on the part of the wife and for concubinage
years, if female, and the marriage was solemnized without on the part of the husband as defined in the Penal Code; or
the consent of the parent, guardian or person having author-
(2) An attempt by one spouse against the life of the other.
ity over the party, unless after attaining the ages of twenty
or eighteen years, as the case may be, such party freely Art. 333, Revised Penal Code — Who are guilty of adultery?
cohabited with the other and both lived together as husband Adultery is committed by any married woman who shall have
and wife; sexual intercourse with a man not her husband and by the man
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Chapter XXX

IMPOTENCY AND STERILITY

I. IMPOTENCY

Impotency is the physical incapacity of either sex to allow or

grant to the other legitimate sexual gratification. A person may be
impotent but not sterile, or sterile but not impotent although both
conditions may exist at the same time.

Legal Importance of Impotency:

MARITAL UNION AND DISSOLUTION
who has carnal knowledge of her, knowing her to be married, even
if the marriage be subsequently declared void.
Adultery shall be punished by prision correccional in its
medium and maximum periods.
If the person guilty of adultery committed this offense while
being abandoned without justification by the offended spouse,
the penalty next lower in degree than that provided in the next
preceding paragraph shall be imposed.
Art. 334, Revised Penal Code — Concubinage:
A n y husband who shall keep a mistress in the conjugal dwelling,
or, shall have sexual intercourse, under scandalous circumstances,
with a woman who is not his wife, or shall cohabit with her in any
other place, shall be punished by prision correccional in its mini-
mum and medium periods.
The concubine shall suffer the penalty of destierro.
A. Impotency, if proven, will overthrow the presumption of
619 legitimacy:
Art. 255, Civil Code:
Children born after one hundred and eighty days following the
celebration of marriage, and before three hundred days following
its dissolution or the separation of the spouses shall be presumed
to be legitimate.
Against this presumption no evidence shall be admitted other
than that of physical impossibility of the husband's having access
to his wife within the first one hundred and twenty days of the
three hundred days which preceded the birth of the child.
This physical impossibility may be caused:
(1) By the impotence of the husband;
( 2 ) By the fact that the husband and wife were living separate-
ly, in such a way that access was not possible; and
( 3 ) By the serious illness of the husband.
B. Impotency may be a ground for the annulment of marriage:
Art. 85, Civil Code:
Marriage may be annulled for any of the following causes
existing at the time of marriage:
(5)
( 6 ) That either party was, at the time of marriage, physically
incapable of entering into the married state, and such
incapacity continues, and appears to be incurable.

The physical incapacity referred to in the above provision

includes impotency.

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In order that such impotency may be a ground for the annul-
ment of marriage, the following requisites must be present:
1. One of the parties to the marriage is not aware of the existing
impotency of the other party. If the other party to the mar-
riage know of the impotency of the future spouse before the
marriage, then it is considered a waiver on his part.
2. The impotency must be present at the time of the celebration
of marriage.
3. The impotency suffered by the party must be incurable. If the
impotency can be remedied by medical or surgical intervention,
then it cannot be a ground for the annulment of marriage.
4. Such impotency must be absolute.
3. Emotion:
Some females manifest vaginismus due to actual pain on
contact or to the fear of pain on sexual intercourse. This con-
dition is usually common among virgins. This is produced by
the violent contraction of the constrictor muscles of the vaginal
orifice and may also be brought about by the contraction of
the adductor muscles of the thighs. Anesthesia may cure the
condition and pregnancy may produce a permanent cure. In
the male, emotion may lead or produce temporary impotency.
4. Hormonal dysfunction may also lead to temporary or permanent
impotency.
B. Local or Organic, in Direct Connection with the Sexual Organs:

C. Impotency may be a defense in rape: 1. Congenital Defects:

An accused in the crime of rape may claim of his inability to a. In Males:

commit the offense on account of his impotency. Medical evi- (1) Nondevelopment of the penis.
dence must be shown in support of his allegation. (2) Maldevelopment of the penis.
(3) Penis adherent to the scrotum.
D . Impotency may be a cause to the development of abnormal
(4) Duplex organ.
sexual behavior:
b. In Females:
An impotent may resort to uranism, cunnilingus, homosexuality
or other lascivious acts to satisfy the sexual partner. (1) Absence of vagina.
( 2 ) Vagina ill-developed, e.g., may be too small.
E. Impotency may be a cause for the development of suicide tendency:
( 3 ) Vagina occluded by intrauterine disease.
A person who is not in a capacity to give gratification to the
2. Disease or Accident:
sexual partner may consider himself to be "biologically dead".
This results in humiliation, or a feeling of uselessness. He may a. In the Males:
then resort to self-destruction. (1) Penis:
( a ) Acute diseases of the penis, as gonorrhea.
Causes of Impotency: ( b ) Chronic diseases as epithelioma.
A. General or Functional, Not Connected Directly with the Sexual ( c ) Complete amputation of the penis.
Organs:
( 2 ) Testis:
Any of the following factors lead to, cause, or produce per-
(a) Removal of the testis.
manent or temporary impotency.
( b ) Sexual abuse.
1. Age:
b. In the Females:
Inasmuch as the female is the passive agent in the sexual
intercourse, there is no limit for her age, except when she is ( 1 ) Vaginal ulceration.
( 2 ) Diseases of the vulvae.
below the age of sixteen. As long as there is erection in the
( 3 ) Obstruction of the vaginal canal due to tumor, cyst or
male, he is considered to be potent.
fibroid.
2. Illness:
Diseases attended by general debility may temporarily re- II. STERILITY
move the sexual power on the part of the male. Diseases of Sterility is the loss of power of procreation and is absolutely
the brain and of the spinal cord may yield to permanent loss independent of whether or not impotence is present. A man or a
of potency. Mumps occasionally leads to the atrophy of the woman may be sterile and yet not impotent, and impotent yet not
sex organs. sterile.
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Causes of Sterility:
A. General or Functional, Unconnected Directly with the Sexual
Organs:
Before puberty there is no spermatozoa in the seminal fluid,
hence sterile, but as age increases, fertility also increases.
B. Local Causes of Sterility:
1. Congenital Conditions:
a. In the Male:
( 1 ) Absence or nondevelopment of testicle.
( 2 ) Absence or nondevelopment of penis.
(3) Maldevelopment of the testicle.
( 4 ) Misplacement of the testicle.
( 5 ) Malformation of the penis, as in epispadias or hypospadias.
b. In the Female:
624 LEGAL MEDICINE
(1) Absence or maldevelopment of the ovary.
(2) Absence or maldevelopment of the uterus.
(3) Absence of the vagina. B. On the part of the female:
1. The source of eggs (ovary) can be removed (oophorectomy).
2. Acquired Conditions: 2. The tubular appendages of the uterus (Fallopian tube) through
a. In the Male: which the eggs enter the uterine cavity where fertilization takes
(1) Complete amputation of the penis. place, can be divided and the cut ends tied (Tubal ligation or
(2) Excision of the testicle. salpingectomy), preventing newly produced eggs from reaching
(3) Diseases of the testicle. the uterus for fertilization.
(4) Atrophy of the testicle. 3. The uterus ( w o m b ) itself can be removed (hysterectomy),
b. In the Female: thereby eliminating the site of fertilization and pregnancy.

(1) Excision of the ovaries.

(2) Diseases of the ovary.
(3) Occlusion of the vagina from diseases.
(4) Diseases of the vagina.
(5) Occlusion of the Fallopian Tubes.

Methods of Sterilization:
A. On the part of the male:
1. The source of sperm production can be eliminated by removing
both testicle (Orchiectomy).
2. The tubular passage (vas deferens) through which the sperm are
transported from the testicle to the urethra where they com-
bined with the seminal fluid elaborated by the prostrate gland
to form the ejaculant, can be divided and the cut ends tied
(vasectomy); thus newly produced sperm cannot join the
ejaculant and the ability of the male to fertilize the female
is lost.
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c. Insanity at the time of marriage of any or both parties is a

Chapter XXXI
MEDICO-LEGAL ASPECT
OF
DISTURBANCE OF MENTALITY
I. INSANITY
Insanity may be defined in its sociological, medical and legal
concept.
In the sociological viewpoint, insanity is the persistent inability
through mental causes to adapt oneself to the ordinary environment.
It is the loss of power of the individual to regulate his actions and
conduct according to the rules of society in which he moves.
Insanity in medicine is the prolonged departure of the individual
from his natural mental state arising from bodily disease.
Insanity in law covers nothing more than the relation of a person
and the particular act which is the subject of judicial investigation.
The term insanity is commonly used to be synonymous with
lunacy, madness, unsoundness of mind, mental derangement, mental
disorder or mental aberration or alienation.
Legal Importance of the Determination:
1. In the Civil Code:
a. Insanity is a restriction on the capacity of a natural person to
act:
Art. 38, Civil Code — Minority, insanity or imbecility, the
state of being a deaf-mute, prodigality and civil interdiction are
mere restrictions on capacity to act, and do not exempt the
incapacitated person from certain obligations, as when the
latter arise from his acts or from property relations, such as
easements.
b. Insanity modifies or limits the capacity of a natural person to
act:
Art. 39, Civil Code — The following circumstances, among
others, modify or limit capacity to act: age, insanity, imbecility,
state of being a deaf-mute. . . . The consequences of these
circumstances are governed in this Code, other codes, the Rules
of Court and in special laws. Capacity to act is not limited on
account of religious belief or political opinion.
625
ground for the annulment of marriage:
Art. 85, Civil Code — A marriage may be annulled for any of
the following causes; existing at the time of marriage:
(2)
( 3 ) That either party was of unsound mind, unless such party,
after coming to reason, freely cohabited with the other as
husband or wife.
d. A testator must be of sound mind at the time of execution of a
will:
Art. 7y8, Civil Code — In order to make a will it is essential
that the testator be of sound mind at the time of its execution.
Art. 799, Civil Code — To be of sound mind, it is not neces-
sary that the testator be in full possession of all his reasoning
faculties, or that his mind be wholly unbroken, unimpaired, or
unshattered by disease, injury or other cause.
It shall be sufficient if the testator was able at the time of
making the will to know the nature of the estate to be disposed
of, the proper objects of his bounty, and the character of the
testamentary act.
Art. 800, Civil Code — The law presumes that every person is
of sound mind, in the absence of proof to the contrary.
Succession is a legal mode by virtue of which the property,
right and obligations which in life belong to a person is acquired
by his heirs.
A will is a specie of conveyance whereby a person is permit-
ted, with the formalities prescribed by law, to dispose of his
property after his death with more or less freedom but limited
to a certain degree by law (Riera v. Palmaroli, 40 Phil. 105).
A codicil is an addition or supplement to a will either to add
to or to take from the provisions of the principal disposition of
the will. It must be executed with the same formalities as the
will itself and when admitted to probate, forms a part of the
will. It is derived from the Latin "codex''.
e. A witness to* a will must be of sound mind:
Art. 820, Civil Code — A n y person of sound mind and of the
age of eighteen years or more, and not blind, deaf or dumb, and
able to read and write, may be a witness to the execution of a
will
f. Insanity of the testator is a ground for disallowance of a will:
Art. 839, Civil Code — The will shall be disallowed in any of
the following cases:
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(1) 3. In the Rules of Court:

( 2 ) If the testator was insane, or otherwise mentally in-
capable of making a will, at the time of its execution.
g. An insane cannot give consent to a contract:
Art. 1327, Civil Code — The following cannot give consent to
a contract:
( 1 ) Unemancipated minors:
( 2 ) Insane or demented persons, and deaf-mutes who do not
know how to write.
h. The guardian or the insane himself, if there is no parent or
guardian shall be held liable for damages due to his insanity:
Art. 2180, Par. 3, Civil Code — Guardians are liable for
damages caused by the minors or incapacitated persons who
are under their authority and live in their company.
Art. 2182, Civil Code — If the minor or insane person causing
the damage has no parents or guardian, the minor or insane
person shall be answerable with his own property in an action
against him where a guardian ad litem shall be appointed.
A guardian ad litem is a guardian appointed by the court to
prosecute or defend a suit on behalf of a party incapacitated
because of minority or insanity.
2. In the Revised Penal Code:
a. Insanity exempts a person from criminal liability:
Art. 12, Revised Penal Code — Circumstance which exempt
from criminal liability — The following are exempt from cri-
minal liability:
( 1 ) An imbecile or an insane person, unless the latter has
acted during lucid interval.
b. A person who becomes insane after final sentence:
Art. 79, Revised Penal Code — Suspension of the execution
and service of the penalties in case of insanity — When a
convict shall become insane or an imbecile after final sentence
has been pronounced, the execution of said sentence shall be
suspended only with regard to the personal penalty, the pro-
visions of the second paragraph of circumstances number 1 of
article 12 being observed in the corresponding cases.
If at any time the convict shall recover his reason, his sen-
tence shall be executed, unless the penalty shall have prescribed
in accordance with the provision of this Code.
The respective provisions of this section shall also be ob-
served if the insanity or imbecility occurs while the convict is
serving his sentence.
a. A guardian on the person of the insane must be appointed:
Rule 92, Sec. 2, Rules of Court — Meaning of word "in-
competent" — Under this rule, the word 'incompetent" in-
cludes. . . .those who are of unsound mind, even though they
have lucid intervals.
Rule 93, Sec. 1, Rules of Court — Who may petition for ap-
pointment of guardian for resident — Any relative, friend, or
other person on behalf of a resident minor or incompetent who
has no parent or lawful guardian. . . .An officer of the Federal
Administration of the United States in the Philippines may also
file a petition in favor of a ward thereof, and the Director of
Health, in favor of an insane person who should be hospitalized,
or in favor of an isolated leper,
b. An insane cannot be a witness in court:
Rule 130, Sec. 19 ( a ) , Rules of Court — Physical disquali-
fication — The following persons cannot be a witness:
(a) Those who are of unsound mind at the time of their pro-
duction for examination, to such a degree as to be incapable
of perceiving and making known their perception to others.
Factors Having Positive Correlation with the Development of Mental
Disorder:
1. Heredity — This is the most frequent and history reveals mental
illness manifested by ascendants.
2. Incestuous marriage, blood incompatability of parents, maternal
infection during the early stage of pregnancy.
3. Impaired vitality — Mental worry, grief, physical strain, unhygienic
surroundings, infection, birth trauma may predispose a person to
mental disorder.
4. Poor moral training and breeding — Improper breeding and moral
training according to the social status, particularly on free will and
self-control, undesirable association, etc.
5. Psychic factors — Emotional disturbance, such as love, hatred,
passion, disappointment.
6. Physical factors:
a. Non-toxic — Exhaustion resulting from severe physical and
mental strain, illness, cerebral hemorrhage, trauma on the skull
affecting the brain.
b. Toxic — This may be produced by excessive formation or defi-
cient elimination of waste product of metabolism; by microbic
infection, or excessive use of certain drugs.
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Some Manifestation of Mental Disorders:
The condition of insanity cannot be considered clinically by the
manifestation of one sign or symptom, but it is essential to appre-
ciate the condition of the mind as a whole. Although certain be-
havior may be observed in certain types of insanity, they may also be
observed in the clinically non-insane.
1. Disorder of Cognition (Knowing):
a. Disorder in Perception:
( 1 ) Illusion — a false interpretation of an external stimulus. It
may be manifested with the sense of sight, hearing, taste,
touch and smell.
Example: A dragonfly may be considered a vampire bat.
A whistle sound may be considered a bomb
explosion.
A normal person may also suffer from illusion
but further investigation by oneself may prove
that his judgement is wrong.
( 2 ) Hallucination — An erroneous perception without external
c. Disorder of Content of Thought:
object of stimulus.
Some Types of Hallucination:
(a) Visual — Seeing things although not present.
(b) Auditory — Hearing voice in absolute silence.
(c) Olfactory — False perception of smell.
(d) Gustatory — False perception of taste.
(e) Tactde — False perception of touch, as feeling that
a worm is creeping on the skin.
(f) Kinesthetic — False perception of movement.
( g ) Hypnagogic — False sensory perception occurring mid-
way between falling asleep and being
awake.
( h ) Lilliputian — Perception of object as reduced in its
size.
b. Disorder of Memory:
( 1 ) Dementia — A form of insanity resulting from degeneration
or disorder of the brain characterized by general mental
weakness, forgetfulness, loss of coherence, and total ina-
bility to reason but not accompanied by delusion or un-
controllable impulse (Hibbard v. Baker, 104 N.W. 339, 141
Mich. 124).
Some Types of Dementia:
(a) Acute Dementia — a form of temporary dementia,
occurring in young people and induced by conditions
likely to produce that state, like malnutrition, over-
work, dissipation or too rapid growth.
( b ) Dementia Paralytica(General Paralysis of the Insane) —
Degeneration of physical, intellectual and moral power
leading to paralysis ("cirrhosis of the brain").
( c ) Dementia Praecox (Schizophrenia) — Dementia of the
adolescence and characterized by loss of memory.
( d ) Senile Dementia — Occurring in advanced age and
characterized by loss of memory, with childish and silly
behavior and physical degeneration.
(e) Toxic Dementia — Characterized by weakness of mind
or feeble cerebral activity resulting from continuous
administration or use of toxic chemicals.
( 2 ) Amnesia (Loss of Memory):
(a) Anterograde Amnesia — Loss of memory of recent
event.
( b ) Retrograde Amnesia — Loss of memory of past events
and observed in trauma of the head.
( 1 ) Delusion — A false or erroneous belief in something which is
not a fact. A person suffering from delusion is not always
insane. If he can correct his wrong belief by later experi-
ences, by logic or information from other sources, then
such delusion is not a proof of insanity.
Some Types of Delusion:
( a ) Delusion of Grandeur ("Delirium of Grandeur', Mega-
lomania or "folie de grandeur") — Erroneous belief that
he is in possession of great power, wealth, wisdom,
physical strength, etc. It is not always a sign of insanity.
A person may think he is a king and dresses and acts
as such.
( b ) Delusion of Persecution — A false belief that one is
being persecuted. A person may feel that he is being
poisoned and prepares for his coming end.
(c) Delusion of Reference — One thinks that he is always
the subject-matter of conversation, news, speech or
action although it is not a fact.
( d ) Delusion of Self-accusation — A false belief to have
committed a crime or hurt the feeling of others.
(e) Delusion of Infidelity — A false belief derived from
pathological jealousy that one's lover is unfaithful
although she is chaste, and tries to assault her.
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sical health is not greatly affected. (Forensic Medicine,

( f ) Nihilistic Delusion — A false belief that there is no
world, that one does not exist, and that his body is
dead. This condition may occur in involutional melan-
cholia.
( g ) Delusion of Poverty — A false belief that one is finan-
cially ruined and that he has no money, is starving, sick
or even dead.
( h ) Delusion of Control — A false feeling that one is being
controlled by other persons.
(i) Hypochondriacal Delusion — A false feeling that one is
suffering from an incurable disease, some parts of his
body are not functioning, or that he is not physically
capacitated to do a thing on account of the disease.
(j) Delusion of Depression — patient experiences feelings of
uneasiness, worthlessness and futility.
( k ) Delusion of Negation — feeling that some parts of the
body are missing.
( 2 ) Obsession — Thought and impulse which continually occur
in the person's mind despite all his attempts to keep them
out. It is an idea constantly obtruding on the consciousness
inspite of efforts to drive them away from his mind.
Sydney Smith and Frederick Fiddes, 10th ed., p. 387).
(2) Melancholia — Intense feeling of depression and misery
which is unwarranted by his physical condition and ex-
ternal environment. He is absorbed by his miserable thought.
Aural hallucination is common. Every patient suffering
from melancholia is a potential suicide case.
The alternative condition of mania and melancholia is
known as manic-depressive psychosis, hence called "folie
circulaire." In between attacks of mania and depression is
a period of cessation of symptoms of psychosis known as
lucid interval. A n y person who committed a criminal act
during lucid interval is criminally liable.
2. Disorder of Emotion (Feeling):
a. Exaltation — Feeling of unwarranted well-being and happiness.
b. Depression — Feeling of miserable thought, that a calamitous
incident occurred in his life, something has gone wrong with his
body functions and prefers to be quiet and in seclusion.
c. Apathy — Serious disregard of the surrounding environment.
d. Phobia — Excessive, irrational and uncontrollable fear of a
perfectly natural situation or object.

A person may lock the door of his bedroom and go to Some Types of Phobia:
bed. While in bed he may get up to see if he has locked the ( 1 ) Fear of Specific Objects:
door. He may go to bed again and again think and see Birds — Ornithophobia Robbers — Harpaophobia
whether the door is locked. He may repeat the act the Blood — Hematophobia Sacred things — Hierophobia
whole night. Books — Bibliophobia Sharp objects — Belonophobia
Flowers — Anthophobia Sun — Heliophobia
Obsession is a condition of the mind bordering on sanity
Men — Andro phobia Trees — Dendrophobia
and insanity. It is sometimes associated with some sort of
fear and usually occurs in persons suffering from nervous ( 2 ) Fear of Specific Situation:
exhaustion. Childbirth — Tocophobia Going to bed — Clinopbobia
d. Disorder on the Trend of Thought: Crossing a bridge — Marriage — Gamophobia
( 1 ) Mania — A state of excitement accompanied by exaltation Gephyrophobia Open space — Agarophobia
or a feeling of well-being which is out of harmony with the Daylight — Phengophobia Pregnancy — Maieusiophobia
surrounding circumstances of the patient. The mind is Drinking — Dipsophobia Sexual intercourse —
hyperactive, with "flight of ideas" which may amount to Height — Acrophobia Coitophobia
incoherency. Delusion may be present, but it is usually
fleeting in character. The increased mental activity also ( 3 ) Fear of Place:
finds expression in increased muscular activity; the patient Churches — Ecclasiophobia Crowds — Ochlophobia
is restless and always occupied. His finer instincts are Empty room — Kenophobia Sea — Thalassophobia
blunted; he becomes untidy with his clothing even to the Enclosed room — Home surroundings —
extent of indecency. He is impatient, irritable, antagonistic Claustrophobia Ecophobia
and violent if interfered with. He is sleepless but his phy- School — Scholionophobia _ River — Potamophobia
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Railways — Siderodro 13 at table — Trikaideka-
mophobia phobia
(4) Fear of Illness or Death:
Death — Thanatophobia
Inf ection — Mysophobia
Disease — Pathophobia Infirnity — Apeirophobia
Germs — Spermophobia Microbes — Bacilliphobia
Heart disease — Cardio- Snakes — Ophidiophobia
phobia Veneral Disease —
Illness — Nosemaphobia
Cypridophobia
The fear of specific objects, situations, or places may develop
as a result of an incident, while the fear of illness may start when
a friend contracted an illness. Fear of death may develop when
one nursed a dying patient and became morbidly convinced
that he will in the future be in the same condition.
3. Disorder of Volition or Conation (Doing):
a. Impulsion or Impulse (Compulsion) — Sudden and irresistible
force compelling a person to the conscious performance of
some action without motive or forethought. The person has
no power to control it, however bad the consequence may be.
Some Types of Impulsion (Compulsion Neurosis):
(1) Pyromania — An irresistible impulse to set things afire.
(2) Kleptomania — An irresistible impulse to steal articles of
not much value.
( 3 ) Mutilomania — An irresistible impulse to maim animals.
( 4 ) Dipsomania — An irresistible impulse to indulge in intoxi
cation either in alcohol or drugs. Repeated intoxication
for a number of years with alcohol or drugs which is volun-
tary is not dipsomania. One having power to refrain from
the use of intoxicating liquor or drugs and who becomes
intoxicated voluntarily is not a dipsomaniac (Black's Law
Dictionary by H. C. Black, 3rd ed., p. 933).
(5) Homicidal Impulse — An irresistible inclination or impulse
to commit homicide prompted usually by insane delusion
either as a necessity of self-defense or avenging for justice,
or as to the patient being the appointed instrument of a
superman justice (Com. v. Sayre, 5 Wkly Notes Cas (Pa)
452).
(6) Sex Impulse — This includes all irresistible acts of sexual
perversion.
( 7 ) Suicidal Impulse — A strong desire to terminate one's life.
This impulse may be present in acute depression.
Distinction between Feigned and True Insanity:
1. Feigned insanity develops suddenly while true insanity develops
insidiously, usually with the observance of some predisposing to an
exciting cause if careful history of the case is taken.
2. There is no peculiar facial expression in feigned insanity which is
commonly observed in true insanity.
3. Symptoms of insanity may only be observed in feigned insanity
when he is conscious that he is under observation and becomes
normal when he is alone and unobserved. There is such remission
of symptoms in true insanity.
4. In feigned insanity the symptoms may be complete, numerous
and may clinically refer to a specific clinical disease. In true
insanity, although in some instances the symptoms may not refer
to a specific clinical disease, there is more tendency to point to
a specific clinical entity.
5. Violent exertion of feigned insanity usually leads to an early
exhaustion while in true insanity the patient can withstand violent
exertion without any sign of exhaustion and fatigue.
6. A feigned insane usually observes rules of personal hygiene and
does not look dirty and filthy. A true insane is filthy, dresses
dirtily and does not observe hygiene.
(From: Medical Jurisprudence A Textbook of Toxicology by
Modi, 12th ed., p. 382).
Steps in the Diagnostic Procedure of Mental Affection:
1. Anamnesis:
a. Family History:
( 1 ) Inquire on the medical condition of the parents and other
ascendants, uncles, brothers, and sisters.
( 2 ) Inquire whether anyone of them suffered from nervous
diseases, cerebral affection, suicide, syphilis, etc.
b. Personal History:
(1) Detailed characteristic from childhood to his present state.
( 2 ) Determine excess use of intoxicating drugs.
(3) Sexual life, occupation, mental strain, head injury and early
nervous affection.
c. Information from relatives, friends and neighbors:
Change of conduct and behavior, habit, previous conduct or
maniacal episode.
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2. Physical Examination.
3. Instrumentations:
X-ray, electroencephalogram, scanning and other modern
apparatus.
4. Mental Examination:
Psychologic Testing
Psychiatric Evaluation
INSANITY A N D CRIMINAL RESPONSIBILITY:
Fundamental Principles in Criminal Responsibility:
1. A sane man is assumed to be wholly responsible for the con-
sequence of his criminal act.
2. A person who commits a criminal act is presumed to be sane. The
burden of proof lies on the accused to prove that he is not sane
and cannot be held responsible for his criminal act.
3. The crime is always considered to be an affair of the mind as well
as the body and to make an act or omission of a crime, there must
be a criminal act (actus reus) and a criminal mind (mens rea). This
is inconsonance with the legal maxim that "actus facit reum nisi
mens sit rea" (There cannot be a guilty act unless there is a guilty
mind).
Mental Illness may be an Exempting or Mitigating Circumstance to
Criminal Liability:
1. As an Exempting Circumstance:
Art. 12, Revised Penal Code — Circumstances which exempt
from criminal liability — The following are exempt from criminal
liability:
1. An imbecile or an insane person, unless the latter has acted
during a lucid interval.
When the imbecile or an insane person has commited an
act which the law defines as a felony (delito), the court shall
order his confinement in one of the hospitals or asylums
established for persons thus afflicted, which he shall not be
permitted to leave without first obtaining the permission of
the same court.
Case Where Defense of Insanity were Upheld by Court:
An accused who committed homicide and has been known to be
suffering from dementia praecox with delusions that he was being
molested sexually, or that his property was being taken, was con-
sidered insane and exempted from criminal liability (People v.
Bonoan, 64 Phil. 87).
The wife of the accused and her cousin testified that the ac-
cused was continuously out of his mind for many years. The
assistant district health officer who examined the accused testified
that he was suffering from violent mania and that condition could
be present at the time he killed the deceased. There was no
motive for the accused to kill the deceased. The court considered
the accused insane (People v. Bascos, 44 Phil. 204).
The accused was suffering from malignant malaria when she
attacked, wounded and killed her husband. It has been shown
that malaria affected the nervous system and caused complications
like acute melancholia and insanity at times. The accused was
considered not criminally liable (People v. Lucena, 69 Phil. 350).
2. As a Mitigating Circumstance:
Art. 13, Revised Penal Code — Mitigating circumstances — The
following are mitigating circumstances:
8. That the offender is deaf and dumb, blind or otherwise
suffering from physical defect which thus restricts his
means of action, defense, or communication with his
fellow beings.
9. Such illness of the offender as would diminish the exercise
of the will-power of the offender without however de-
priving him of consciousness of his acts.
10. A n d , finally, any other circumstance of a similar nature
and analogous to those above mentioned.
The fact that the accused is suffering from a mild behavioral
disorder as a consequence of an illness she had in early life is
regarded as mitigating circumstance under Art. 13, Par. 8 or in
Par. 9 of the Revised Penal Code (People v. Amit. 82 Phil. 820).
One who was suffering from acute neurosis which made him
ill-tempered and easily angered was entitled to the mitigating
circumstance because illness diminished his exercise of will power
(People u. Carpenter C.A. G.R. 4168 Apr. 22, 1940).
Phase In The Criminal Act Where The Evidence Of Insanity Of
The Accused Must Be Established:
The evidence of insanity must be referred to at the time preceding
the act under prosecution or to the very moment of its execution.
In order to ascertain a person's mental condition at the time of the
act, it is permissible to receive evidence of the condition of his mind
during a reasonable period both before or after that time. To prove
insanity, circumstantial evidence, if clear and convincing, will suffice
(People v. Bonoan, 64 Phil. 93).
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Rules Utilized By Courts to Determine Whether The Mental Con-
dition Of An Accused Exempts Him From His Criminal Liability:
Art. 12 ( 1 ) of the Revised Penal Code provides that "an imbecile
or an insane person, unless the latter has acted during lucid interval"
is exempt from criminal liability.
In the medical viewpoint a person is insane when he is suffering
from mental derangement or confusion or a condition which prevents
a person from orienting himself. It is a prolonged departure of the
individual from his natural mental state arising from bodily disease.
The legal definition of insanity by which the court is guided is
more of an intellectual and moral concept rather than medical. It
is a defect of the mind which renders a person incapable of enter-
taining a criminal intent. The law further presumes every person to
be sane and to possess a sufficient degree of reason to be responsible
for his act unless the contrary can be proven.
The following rules have been adopted by courts to determine
whether an accused is suffering from insanity to exempt him from
criminal liability :
1. Earlier Test for Insanity:
a. "Wild Beast Rule":
A person is exempted from criminal liability if he is totally
deprived of his understanding and memory and knows no more
than an infant, a brute, or a wild beast of what he is doing.
The rule has been applied in England (Arnold case, 1724)
and in the United States (State v. Pike, 49 N . H . 399), but was
not universally accepted because:
a. Its application is limited to violent crimes against a person;
and
b. It is quite hard to measure the aggressive behavior of a wild
beast.
b. Delusion Rule:
A person is not responsible for his act if he is suffering from
delusion although he knows that his act is wrong.
This rule was applied to the James Hadfield case wherein the
accused attempted to kill King George III of England while
entering the Drury Lane Theater. Hadfield was found to be
suffering from a delusion although he knew at the time that he
was actually firing a gun at the King.
A person with delusion may be insane but his suffering from
delusion may not necessarily affect his judgement in a particular
act. If a person who is suffering from delusion commits an
illegal act which has no relation to the particular delusion from
which he is suffering he must be considered responsible for such
an act as if he were sane.
2. Later Tests for Insanity:
a. McNaghten's Rule (1843):
A defense on the ground of insanity can be established if it
can be proven that at the time of committing the act:
(1) The accused was laboring under such defect of reason or
from a disease of the mind as not to know the nature and
quality of the act he was doing, or
( 2 ) If he did know, he did not know that what he was doing
was wrong.
Under the rule, before an accused can be exempted from
criminal liability, it must be proven first.
(a) That the accused was suffering from the disease of the
mind.
It is the psychiatrist who must determine the pre-
sence of the disease of the mind, although what consti-
tutes the disease is not entirely clear.
An accused was held to be suffering from the disease
of the mind when he attacked a person during a tempo-
rary loss of consciousness caused by congestion of the
brain due to arteriosclerosis (Bratty v. Atty. Gen. of
Northern Ireland, 1963).
A person who is suffering from malignant malaria
when she killed her husband was held not criminally
liable because of insanity due to disease of the mind
(People v. Lacena, 69 Phil. 330).
( b ) It must be proven that the accused did not know the
nature and quality of the act he was doing. A person
who, on account of mental disease, did not know the
nature and quality of his act does not have criminal
intent (mens rea).
(c) If the accused knew the nature and quality of the act,
then it must be proven that he did not know that what
he was doing was wrong. "Wrong", insofar as McNagh-
ten's Rule is concerned, means contrary to law. The
knowledge that the act was in violation of criminal
law has been held to be sufficient to justify holding
the accused reponsible.
The accused's delusion that the killing in question
has been directed by God was not sufficient to excuse
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him in view of the showing that he knew it was against
the law (McElroy v. State, 146 Tenn. 422).
One who commits bigamy under the delusion that
the act has been directed by a vision from God was
held to be responsible when he admitted he knew at the
time that the act was punishable by law of the State
(People v. Schmidt, 216 N. Y. 324).
Criticisms to the McNaghtensRule:
(1) The rule is too rigid and strict that it unjustly subjects the
insane to punishment.
( 2 ) It is based solely on cognitive factor and ignores emotion
and will.
( 3 ) The test is unintelligible to psychiatrists because it requires
a moral judgment by the physician; a judgment outside of
his professional training, experience and competence.
In the United State 36 states adopt the rule.
b. Irresistible Impulse Rule:
A person is considered insane when mental disease has
rendered him incapable of restraining himself, although he
understands what he is doing and knows it is wrong.
Criticisms to the Irresistible Impulse Rule:
(1) On account of its laxity it opens the door for the escape of
many persons who are sane and should be prosecuted as
criminals.
(2) There is difficulty in differentiating irresistible impulse from
impulse which can be actually resisted.
( 3 ) It fails to differentiate between real insanity and mere
impulsive condition.
c. Durham Rule:
The accused is not criminally responsible if his act was the
product of mental disease or mental defect.
The determination of criminal responsibility is based on the
answer to two questions:
(1) Is the defendant suffering from a mental disease or defect?
(2) If so, was his crime a product of the mental disease or
defect?
Criticisms to the Durham Rule:
(1) There seems to be uncertainties in the definition of "mental
disease or defect". Does it include personality disorders,
character defect, sociopathic disorder which are clinically
true mental diseases?
(2) There is ambiguity of the term "product". When is an act
the "product" of the diseased mind or deranged mental
condition within the scope of the rule?
(3) The application of the rule will create a fear that all cri-
minals would be regarded by psychiatrist as mentally ill,
and hence, no one will be subjected to criminal prosecu-
tion or conviction.
d. Currens Rule:
In order to make the accused not responsible for his act it
must be proven that at the time of committing the prohibited
act the defendant, as a result of mental disease or defect, lacked
substantial capacity to conform his conduct to the requirements
of the law which he has allegedly violated.
Criticisms to the Currens Rule:
Like the Durham Rule, a large number of the prison popula-
tion will be considered not guiltv by reason of insanity.
e. American Law Institute Rule:
In 1955, The American L a w Institute with the support of
the American Bar Association, formulated the following rule of
criminal responsibility:
(1) A person is not responsible for his criminal conduct if at the
time of such conduct as a result of mental disease or defect
he lacks essential capacity to appreciate the criminality of
his conduct or to conform his conduct to the requirements
of the law;
( 2 ) TVie term "mental disease or defect" does not include an
abnormality manifested only by repeated criminal or
otherwise anti-social conduct.
Criticisms to the American Law Institute Rule:
( 1 ) Some authorities, even psychiatrists, objected to the inclu-
sion of item ( b ) of the rule. It has been pointed out that
such exclusionary division discriminates between the poor
and the well-to-do offenders. The poor defendants cannot
avail themselves of a more rigid and more searching inquiry
into their mental state but merely superficial, one done by
government physicians.
( 2 ) It does not give the court a simple, helpful guide in their
effort to decide whether the accused was insane at the time
of his act.
( 3 ) The phrase "or to conform his conduct to the requirement
of the law" permits the defendant to find refuge in what is
equivalent to the "irresistible impulse" test.
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timid and easily irritated. He cannot guard himself against com-

There is a need of insanity defense in a civilized society to
show that insane people who do not have criminal intent while
performing a criminal act are not penalized.
Recent court decisions are moving to a broader definition of
mental illness. Some rules now even define mental disease and
mental defect to include addiction, alcoholism and conceivably
even the slightest abberation of the mind. The expansive
meaning of insanity cannot always be tolerated by law. Law
and psychiatry have been in collision in the recent past.
No matter how mentally ill a person is, he may still pro-
bably be responsible to some degree. Psychiatrists should offer
medical diagnosis and interpretation of signs of mental illness
but not give legal judgment.
The assassination attempt by Hinkley to President Ronald
Reagan of the United States wherein the court considered
Hinkley to be insane has caused the development of a strong
public opinion of re-examination or restructuring of our law
on defense of insanity. There is now a strong public opinion
not to consider insanity as an exempting circumstance to
criminal liability. The following proposition are suggested
for future action:
( 1 ) An accused may be pronounced to be mentally ill. He can
be treated in a mental hospital until recovery. After recovery
he may then be transferred to prison to serve cut the
remaining term.
( 2 ) The accused may be pronounced guilty with diminished
responsibility. His mental condition may be considered
only as a mitigating circumstance to his criminal liability.
Or he may be convicted if found insane for a lesser offense
because of emotional disturbance.
II. MENTAL DEFICIENCY
Mental deficiency (mental subnormality, mental retardation) is
the below-normal intellectual functioning which originates from the
arrest or incomplete development of the mind during the develop-
ment period below the age of 18 which may be induced by various
factors associated with the impairment of learning, social adjustment
or maturation.
Classical Classification:
1 Idiot - Usually congenital and due to defective development of
the mental faculties. An idiot is wanting in memory, will power
and emotion. He cannot express himself by language, is quiet,
mon physical dangers. The deficiency is usually associated with
physical abnormalities like microcephaly and mongolism. Men-
tality never exceeds that of a normal child over 2 years old. The
I.Q. is between 0 — 20.
2. Imbecile — Although the mental defect is not as severe as that of
idiots, he cannot manage his own affairs. He may be able to speak
but with poor command of the language. He can easily be aroused
to passion and may show purposeful behavior. He may be trained
to do simple work under supervision. The mental age may be
compared to a normal child from 2 to 7 years old and the I.Q. is
20 - 40.
3. Feeble-minded — Person whose mental defect, although not
amounting to imbecility, is pronounced such that he requires care,
supervision, and control for his protection and for the protection
of others. He is incapable of receiving proper benefit from instruc-
tions in ordinary school. He lacks initiative and ability for any
work or responsibility. He has a mentality similar to that of a
normal child between 7 to 12 years old and an I. Q. of 40-70.
Moron — A feeble-minded person of considerably higher in-
telligence as that of an imbecile but his intellectual faculties and
judgment are not as well developed as in a normal individual.
He can carry routine duties in civilized society as long as the
demands made upon his mental capacity is not too discretionary.
He is amenable to the customs of the community and may not
present so much of a social problem.
4. Moral Defective — In addition to the mental defect, there are
strong vicious and criminal propensities, so that the person re-
quires care, supervision and control for the protection of others.
He is devoid of moral sense and often shows intellectual deficiency,
though he may be mentally alert. He is careless; pleasure loving;
and a devil-may-care sort of young man or woman who adheres to
the principles of "live today for tomorrow we die", "live fast and
die young" and "it is only happiness that counts".
(A Sypnosis of Forensic Medicine & Toxicology by C. Thomas,
2nd ed., p. 125).
Because of the stigma that may likely be attached to the child if
the classical classification (idiot, imbecile, feeble-minded) is used,
new classifications have been adopted by some countries. Mental
retardation is classified as follows:
1. Profound — I.Q. is under 20, and capable at most to limited
self-help. There is most likely a need for hospitalization or some
type of environment in which care is available throughout his
life-time.
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2. Severe — I.Q. is between 20 and 35 and capable of habit training
as a child. As an adult he is likely in need of a controlled environ-
ment.
3. Moderate — I . Q . is 36 to 51 and can develop academic skill equal
to about the second grade level. As an adult he will most pro-
bably need a sheltered environment.
4. Mild — I.Q. is 52 — 67 and constitutes the greatest group of
mentally retarded. He can develop academic skill to about the
sixth grade level. As an adult he can develop social and vocational
skills. Whether he is to be institutionalized or not depends more on
his social skill and on the range of alternatives available to him
than on his intellectual functioning.
Although it is not a part of the original standard classification,
a fifth degree known as borderline retardation with an I.Q. of
68 — 83 may be added.
In England, under the Mental Health Act 1959, Part I, N o . 4, mental
deficiency is simply classified as:
1. Severe Abnormality — A state of arrested or incomplete develop-
ment of mind which includes abnormality of intelligence and is of
such a nature or degree that the patient is incapable of living an
independent life or of guarding himself against serious exploi-
tation, or will be incapable when of an age to do.
2. Subnormality — A state of arrested or incomplete development
of mind (not amounting to severe abnormality) which includes
subnormality of intelligence and is of a nature or degree v/hich
requires or is susceptible to medical treatment or other special care
or training of the patient.
Methods of Estimating Mental Capacity:
1. Intelligence Tests:
At the age of 18 the human mind is presumed to have attained
its full development. Knowledge acquired after such age comes
from experience, memory and study.
Intelligence testing may be used to (a) diagnose the degree of
mental retardation, ( b ) study the ways in which the individual's
intellectual ability is threatened by personality problems, and
(c) as a means to understand personality dimensions.
There are many different tests used by psychometrists and it is
sufficient to mention some of them.
a. Performance Tests (Don't Require the Use of Language):
(1) Good Enough Draw-a-person Test — A subject is asked to
draw a person and a number of corresponding points are
given to different parts of the body and clothings. The
total number of points is then converted into a quantitative
measure of intelligence. The test can provide evidence for
personality functioning and conflicts as well as intelligence
estimate.
(2) Raven Progressive Matrices Test: — A series of designs in
which a part is removed from each member of the series, and
the individual is presented with six alternative parts from
which to choose the part which is missing in the original
design. This test is useful in measuring the person's ability
to reason by analogy, for comparison and to indicate the
logical method of thinking.
b. Verbal Test — This depends essentially on words and numbers.
c. Mixed (Verbal and Non-verbal) Test:
(1) Binet Test — The individual is given credits in months for
task completed successfully, and the individual's total score
is the sum of the months of credit received for items passed.
The total credit in months (mental age) in conjunction with
the individual's chronological age is converted into an
intelligence quotient ( I . Q . ) . The test is valuable for children
under 10 years old.
Example: If a person at the age of 20 was able to answer
all the questions up to the age of 12, 2 in 8, 1 in 9 and 1
in 10 and each of the answers is equivalent to 2 months,
then the person has an intelligence or mental age of 12 years
and 8 months.
( 2 ) Wechsler Tests — (Wechsler Intelligence Scale for Children —
Revised, WISC-R, and Wechsler Adult Intelligence Scale,
W A I S ) : This consists of 12 subtests (six verbal and six
non-verbal). The verbal test may consist of information,
general comprehension, similarities and vocabulary. The
performance test includes a variety of scales, like pictures,
arrangements, block design, etc. The row for each subtest
is converted to an equivalent weight score permitting
comparison with other subtests. When the different
weighed scores are added together, the clinician can obtain
three different intelligence quotients: verbal, performance
and full scale.
2. Intelligence Quotient (I.Q.):
Several test types are prepared corresponding to every age in
months and these are answered by the person examined. The
age of the person examined is determined in terms of months.
The number of months corresponding to the test type answered
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divided by the age of the person in months is the intelligence
quotient (I.Q.)-
Example: A child at the age of 8 years and 4 months was able
to answer the test for 7 years and 6 months. 8 years and 4 months
is equivalent to 100 months, while 7 years and 6 months is equi-
valent to 90 months. 90 divided by 100 equals 90 as I.Q.
/. Q. Classification
Above 140 "Near" genius or genius
1 2 0 - 140 Very superior intelligence
1 1 0 - 120 Superior intelligence
90 - 110 Normal or average intelligence
80 - 90 Dullness, rarely classified as feeble-minded
7 0 - 80 Borderline deficiency, sometimes classified
as dullness, often as feeble-minded
Below 70 Definitely feeble-minded
Principal Drawbacks to Different Intelligence Tests:
1. The tests seem to give undue weight to memory.
2. The tests do not take into consideration the vision or hearing of
the subject.
3. The tests overlooked the fact that some persons are inattentive or
nervous.
4. Cooperation of the person tested is absolutely necessary.
Mental Deficiency and Criminal Responsibility:
Imbecility, according to Article 12, par. 1 of the Revised Penal
Code, is an exempting circumstance to criminal liability. Inferential-
ly the condition of idiocy is also an exempting circumstance inasmuch
as it is of a much more deficient degree as compared to imbecility.
Feeble-mindedness is a mitigating circumstance provided in Article
13 par. 8, 9 or even 10 of the Revised Penal Code.
Art. 13, Revised Penal Code — Mitigating Circumstances — The
following are mitigating circumstances:
8. That the offender is deaf and dumb, blind or otherwise suffer-
ing from some physical defect which thus restricts his means
of action, defense, or communication with his fellow beings.
9. Such illness of the offender as would diminish the exercise of
will-power of the offender without however depriving him of
consciousness of his acts.
10. And, finally, any other circumstance of a similar nature and
analogous to those above mentioned.
The fact that the accused is feeble-minded warrants the findings
in his favor of the mitigating circumstance provided for in either par.
8 or 9 of Art. 13 of the Revised Penal Code, namely, that the ac-
cused is "suffering from some physical defect which thus restricts
his means of action, defense or communication with his fellow
beings" or "such illness as would diminish the exercise of his will-
power" (People v. Formigones, 48 O.G. 1772).
H o w the Court Becomes Aware of the Mental Condition of a Person:
1. Any party in a proceeding may present evidences to show the
mental condition of a person. He who alleges something must
prove the same by presentation of evidence in support of his
allegation.
In a criminal proceeding wherein the defense of insanity is
invoked, the party must present proofs that the accused is insane
and does not know the nature and quality of his act. In the
probate of a will, the petitioner must present evidence to show
that the testator is of a sound and disposing mind at the time of
execution of a will.
2. Upon motion of one of the parties, the court may issue an order
to submit a person to a physical and mental examination.
Rule 28, Rules of Court:
Physical and mental examination of person:
Sec. 1. When examination may be ordered — In an action in which
the mental or physical condition of a party is in controversy, the
court in which the action is pending may in its discretion order
him to submit to a physical and mental examination by a phy-
sician.
Sec. 2. Order for Examination — The order for examination may
be made only on motion for good cause shown and upon notice
to the party to be examined and to all other parties, and shall
specify the time, place, manner, conditions and scope of the
examination and the person or persons by whom it is to be made.
Sec. 3. Report of findings — If requested by the person examined,
the party causing the examination to be made shall deliver to him
a copy of a detailed written report of the examining physician
setting out his findings and conclusions. After such request and
delivery the party causing the examination to be made shall be
entitled upon request to receive from the party examined a like
report of any examination, previously or thereafter made, of the
same mental and physical condition. If the party examined
refuses to deliver such report the court on motion and notice may
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make an order requiring delivery on such terms as are just, and if
a physician fails or refuses to make such a report the court may
exclude his testimony if offered at the trial.
Ways of Hospitalizing an Insane Person:
1. Judicial Method:
a. Upon petition by the Director of Health.
b. The court upon knowledge that the imbecile or insane com-
mitted a felony.
2. Extra-judicial method:
a. Voluntary.
b. Involuntary.
1. Judicial Methods:
a. Rule 101, Rules of Court:
Proceedings for hospitalization of insane persons:
Section 1. Venue. Petition for commitment — A petition for
the commitment of a person to a hospital or other place for the
insane may be filed with the Court of First Instance (Regional
Trial Court) of the province where the person alleged to be
insane is found. The petition shall be filed by the Director of
Health in all cases where, in his opinion, such commitment is
for the public welfare, or for the welfare of said person who, in
his judgement, is insane, and such person or the one having
charge of him is opposed to his being taken to a hospital or
other place for the insane.
Section 2. Order for hearing — If the petition filed is suf-
ficient in form and substance, the court, by an order reciting
the purpose of the petition, shall fix a date for the hearing
thereof, and copy of such order shall be served on the person
alleged to be insane, and to the one having charge of him, or
on such of his relatives residing in the province or city as the
judge may deem proper. The court shall furthermore order the
sheriff to produce the alleged insane person, if possible, on the
date of the hearing.
Section 3. Hearing and judgment — Upon satisfactory proof,
in open court on the date fixed in the order, that the commit-
ment applied for is for public welfare or for the welfare of the
insane person, and that his relatives are unable for any reason
to take proper custody and care of him, the court shall order
his commitment to such hospital or other place for the insane
as may be recommended by the Director of Health. The court
shall make proper provisions for the custody of property or
money belonging to the insane until a guardian be properly
appointed.
Section 4. Discharge of insane — When, in the opinion of
the Director of Health, the person ordered to be committed to
a hospital or other place for the insane is temporarily or per-
manently cured, or may be released without danger he may file
the proper petition with the Court of First Instance (Regional
Trial Court) which ordered the commitment.
Section 5. Assistance of fiscal in the proceeding — It shall be
the duty of the provincial fiscal or in the City of Manila the
fiscal of the city, to prepare the petition for the Director of
Health, and represent him in court in all proceedings arising
under the provisions of this rule.
2. The court may order confinement of insane or imbecile upon
knowledge that he has committed^ felony:
Art. 12, Par. 2, Revised Penal Code:
When the imbecile or an insane person has committed an act
which the law defines as a felony (delito), the court shall order
his confinement, in one of the hospitals or asylums established
for persons thus afflicted, which he shall not be permitted to
leave without first obtaining permission of the same court.
2. Extrajudicial Methods:
a. Voluntary:
The insane person himself or with the assistance of the
relatives or guardian during the lucid intervals or during such
time that he is still normal may request his confinement in a
hospital or asylum. This is common among persons who are
afflicted with the disease and are aware of the advantage of
hospitalization.
b. Involuntary:
The immediate relatives, the peace officer or other per-
sons who are concerned with the welfare of the society may
force the insane to be confined in a hospital. Such coersive
confinement may be in accordance with the valid exercise of
police power of the state or by virtue of ordinance.
Police power is the power inherent in a government to enact
laws within constitutional limitations, to promote order, safety,
health, morals, and the general welfare of society.
Sec. 2238, Revised Administrative Code — General power of
council to enact ordinances and make regulations: —"The
municipal council shall enact such ordinance and make such
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regulations, not repugnant to law, as may be necessary to carry Types of Malingering:

into effect and discharge the powers and duties conferred upon
it by law and such as shall seem necessary and proper to provide
for the health and safety, promote the prosperity, improve
the morals, peace, good order, comfort and convenience of the
municipality and the inhabitants thereof, and for the protection
of property therein".
III. MALINGERING
Malingering is the feigning or simulation of a disease or injury
characterized by ostentation, exaggeration and inconsistency.
Causes of Malingering:
1. To Avoid Military or Naval Training:
A person may feign disease or injury because he is required by
law to undergo military or naval training. Under the National
Defense Act (Commonwealth Act N o . 1) all male citizens of the
Philippines who have reached 20 years of age must undergo
military training under penalty of law for failure to do so. All
male college students enrolled must have at least two years of
military training as a requisite for graduation. For some reason
or cause, a person may malinger disease or injury so that he will
not be subjected to such a requirement.
2. To Avoid Court Summons:
A person may have received a summon from a court requiring
him to appear on a specified date, time and place but refuses to
appear because he is a defendant in the case wherein he wants to
delay the proceeding, or he is afraid to be subjected to the ordeal
of direct and cross examination. He may simulate that he is
suffering from a disease or injury which incapacitate him to attend
the trial.
3. As a Defense to a Criminal Prosecution:
Impotency may be utilized by the defendant in the prosecution
of the crime of rape. An accused while on trial may allege that it
is not possible for him to commit the crime of rape because he is
impotent.
4. To Increase Civil Liability:
A plaintiff in a civil action for the recovery of damages and for
the injury sustained may exaggerate the physical disability so that
he may receive bigger award from the court.
5. To Promulgate Sympathy:
A beggar may exaggerate incapacity or simulate disease or injury
so that the public may be more sympathetic towards him and give
him more alms.
1. "Feigned or Fictitious" Malingering:
Malingering is built up out of pure imagination and does not have
the slight basis of fact. The disease or injury which a person
allegedly is suffering from does not exist at all.
Example: A person may simulate that he is totally blind while
in fact both eyes are normal.
2. "Factitious" Malingering:
This is a form of malingering whereby something really exists as
a fact but is converted to a more serious disability or injury, or
to an exaggeration of the real complaint. Here the person is really
suffering from an injury or disease but he may exaggerate or
amplify the seriousness of the complaint or nature of the injury or
disease.
Example: A person might have received a small superficial
scratch but complained of severe and unbearable pain
and incapacity to move.
Points which Make a Physician Suspect that a Person is Malingering:
1. Presence of a Cause for the Subject to Malinger:
A person may feign disease or injury because he wants to avoid
something, like military training, court trial or other obligations
which he does not like, or he wants to get something, like sym-
pathy or greater civil damages.
2. Inconsistency Between the Injuries or Disease Suffered from and
the Symptoms or Disability Manifested:
In factitious malingering the subject may show certain mani-
festations which, in the ordinary course of life, are inconsistent
or not proportionate to the actual physical disability present.
3. Symptoms Not Supported with Organic Lesion:
A woman may allege that she has been abused by force and that
she bied profusely, but on physical examination a few hours after
the alleged assault, no sign of physical injury was noticed on her
private organ.
4. Abrupt Onset of Symptoms:
If a person feigns insanity or some other diseases, he may
manifest abrupt symptoms which are incompatible with the
normal course of disease.
5. Refusal to be Subjected to Painful or Annoying Treatment:
A person may feign that he is suffering from sprain or fracture
of his upper or lower extremities. The physician may suggest the
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Then all of a sudden aim the firearm towards him. If the

placing of the injured portion under plaster cast and the patient
may refuse because it may put him to some inconvenience.
A person may complain of some disturbance in the gastrointes-
tinal tract but when prescribed magnesium sulfate, he refused to
take it.
Whenever a physician is requested to examine a patient to
determine whether he is malingering or not, he must utilize all
of his senses, have a keen observation and apply methods of
detection appropriate for the occasion.
Ways to Determine Malingering:
There is no specific test for a specific form of malingering. The
test applicable depends upon the demand of the occasion consider-
ing the attitude of the subject and the nature of the malingering.
The tests may be:
1. General Procedure — The method is applicable to all forms of
malingering:
a. Observation of the subject during his unguarded moments:
A person cannot always be conscious that somebody is
observing him. He may for some moments unconsciously show
his normal condition and not exhibit the disability feigned.
b. Complete history and physical examination:
The history that may be narrated by the subject may not be
compatible with the result of the physical examination and the
manifesting symptoms are common among malingerers.
c. Application of general anesthesia.
d. Application of sudden unexpected minimal amount of electrical
stimulus.
2. Specific Procedure:
a. Feigning Blindness:
(1) Place a convex 12D lens before the "good" eye and a weak
concave lens (say 0.25D) before the "blind" eye and ask the
patient to read Snellen's test types from a distance of 6
meters. If he succeeds in reading it is a definite proof that
he is malingering, since it is impossible to read the type
through such convex lens.
(2) Place a lighted candle at a distance of 6 meters from the
patient, and a prism with base upwards or downwards,
before the good eye. If the patient can see two flames it
means that good vision is present on both eyes.
(3) Take a firearm and with the patient focusing his eyes
towards the revolver, fire three or four shots in the air.
patient is blind there will be no instinctive act of dodging.
b. Feigning Deafness:
(1) This is a method to determine whether only one of the ears
is allegedly deaf. Place a loud tickling watch in the sup-
posed sound ear and ask if he is able to hear the tickling.
If he answers in the affirmative, gradually withdraw the
watch and ask him when he can no longer hear the tick.
Place the watch on the "deaf" ear and ask him if he
hears the tick. He will certainly give a negative answer.
N o w let him close both eyes and you place something
metallic (which will make him believe it to be a watch)
against the back of the deaf ear, at the same time hold the
watch behind (but not touching) the sound ear and ask
him if he is able to hear the tick.
If he says no, then he is malingering.
( 2 ) Close the sound ear with cotton. Make a loud noise on the
"deaf" ear. Notice the expression of the face.
c. Feigning Insanity:
There is no specific test or procedure to determine feigning
insanity. A keen observation of the behavior coupled with the
history and physical findings probably are the most reliable.
IV. OTHER CONDITIONS MANIFESTING OR SIMULATING
DISTURBANCE OF MENTALITY
1. Somnambulism:
This is an abnormal mental condition whereby a person is
performing an act while in the state of natural sleep. A somnam-
bulist might be concentrated in a particular train of idea or ob-
sessed by certain thoughts which baffled his mind that he tried to
execute it while in the state of sleep. He may commit the crime
of murder, infanticide, or parricide while under the influence of
the fit. A somnambulist has no recollection of the events occur-
ring during the fit and in several courts of different countries
somnambulists are exempted from criminal liability.
In a case cited by Modi, Marggie Alexander was charged of
having killed her child with a razor while in the state of sleep.
The jury gave a verdict of guilt but insane because the somnambulist
did not know what she was doing nor was capable of appreciating
the nature and quality of the act.
In the Philippines, in the case of People v. Gimena (55 Phil-
604) the defendant attacked his wife with a bolo. The defense
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was that he was in the state of somnambulism when he attacked
his wife. The court held that the offense charged was committed
by the accused while in the state of somnambulism. Somnam-
bulism is recognized by the court as an exempting circumstance as
a manifestation of insanity. Here the defendant was placed under
observation for sometime but it was not shown that he was suffer-
ing from somnambulism.
2. Semisomnolence or Somnolencia:
A person is in a semisomnolence state when he is half asleep or in
a condition between sleep and waking. A person may be suddenly
aroused and may unconsciously commit a criminal act, like
murder, infanticide or parricide, or some other crimes, while his
mind is at the state of confusion.
Criminal acts committed in this state do not show manifestations
to justify insanity. There is no jurisprudence in the Philippines
deciding squarely whether it will exempt a person from criminal
liability.
3. Hypnotism or Mesmerism:
A person is made unconscious by the suggestive influence of the
hypnotist. He may commit a criminal act while under the influence
of hypnotism which he may not be capable of doing while under
a normal state.
A person cannot be hypnotized against his will, and if a person
volunteers to be hypnotized he must anticipate all the conse-
quences of his acts while under the hypnotic spell.
Hypnotism as a defense to a criminal act is not accepted with
favor in the court. A person cannot take advantage of his own
misconduct.
However, under the Civil Code (Art. 1328) contracts agreed to
during hypnotic spells are voidable. The Civil Code seems to
acknowledge the absence of the normal state of mind of a person
under the influence of hypnotism.
4. Delirium:
Delirium is a state of confusion of the mind. It is characterized
by incoherent speech, hallucination, illusions, delusions, restless-
ness, and apparently purposeless motions. A person may, when
under the state of delirium, commit a crime.
It may be advanced that a person committing a felonious act
while in a delirious state may be exempted from criminal liability
although there is no jurisprudence in the issue yet.
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Chapter XXXII
DRUG DEPENDENCE
1. Biosocial Factors Responsible for the Emergence of Drug Problems:
a. It is less than three hours flight westward from the Philippines
to the Golden Triangle, the primary source of opium supply
for legitimate and illegitimate use. From this source narcotics
have been transported all over the world and in some instances
the Philippine ports are used for transshipment. There are
several instances where opium has been discovered and con-
fiscated in the airports allegedly en route to a foreign port.
b. The Philippines is endowed by nature with a humid, warm
tropical weather most conducive to luxuriant propagation and
growth of marijuana plant. This accounts for vast tracks of
land in the mountain region of the north yielding vigorous
plants and bountiful harvest.
c. A demographic study of our population revealed that a greater
part of our population is getting younger and younger. A great
number of our citizenry belongs to the age group most suscep-
tible to marijuana.
d. The Philippines is a mirror image of America. There are reports
that in some states of the Union one out of four children is
drug dependent. This prevailing situation in the United States
is seemingly brought to our shores.
e. Men are by nature pleasure loving or hedonistic. The feeling
of euphoria, well-being, day-dreaming, hallucination, vigor,
illusion, develops whenever a person is under the influence of
drug. Whenever a man intends to do something, he always
measures the amount of pleasure and pain that accompanies it.
f. The profit motive of the pushers, planters, and retailers is
another factor. In any human activity, profit and risk go hand
in hand. More risk — more profit principles dominate human
action in periods of economic difficulties.
g. The gradual disappearance of the olden nuclear nature of the
the Philippine family and the emergence of a permissive society
. have contributed to the rise in drug problems.
( 1 ) The western system of less control of parents over children
has gradually become a fashion of time.
654
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( 2 ) The world's clamor to respect human rights has rever-
berated in all corners of the world.
( 3 ) The constitutional provision that "no person shall be
deprived of his right, liberty or property without due
process of law" has been extended in its application to
include almost everything.
h. As we enter another decade, we begin to feel the impact of the
discoveries, explorations, and researches done in the past.
Scientists have discovered new drugs for the purpose of alle-
viating human diseases or symptoms of diseases. Pain, a scourge
of mankind, is now a thing of the past. Exploration of the
deeper structure of man, organ transplantation, and control
of human behavior are now of common occurrence. Botanists,
pharmacologists, and pharmacognosists have delved deeper
into structures, contents, manner and site of action of the
potent, contents of the members of the plant kingdom. New
drugs have been synthesized, and have produced beneficial, as
well as deleterious effects on mankind.
D A N G E R O U S D R U G ACT
The provisions of the Revised Penal Code on crimes relative to
opium and other prohibited drugs (Art. 190 — 194) have been
repealed by Republic Act N o . 6425 as amended, otherwise known
as Dangerous Drug Act of 1972.
During the past decades opium and other allied drugs have been
considered to be the only drugs found to be harmful to mankind and
society so that they are the ones subjected to social control. But, in
the recent past, new drugs have been discovered to be naturally
existing while others have been synthesized which are equally or even
more harmful than opiates. It is therefore imperative to enact new
laws to include and intensify control on all drugs deleterious to
human beings and to society as a whole. In response to the social
demand, the Dangerous Drug Act of 1972 was passed by the de-
funct Congress of the Philippines.
A dangerous drug is a drug whose use is attended by risk and
therefore unsafe, perilous and hazardous to people and/or to a
society. A drug is any substance, vegetable, mineral or animal in
origin, used in the composition or preparation of medicine or any
substance used as medicine.
The Dangerous Drug Act has classified drugs which are subject to
control into prohibited drugs and regulated drugs. It did not define
what is a prohibited or what is a regulated drug. It merely enume-
rates the drugs which are included in the category of prohibited and
those considered regulated drugs for the purpose of graduating
penalties. Violation of different acts relative to prohibited drugs has
higher penalties as compared with the same acts committed in vio-
lation of the regulated drugs. The classification is not based on their
pharmacologic effects but on societal reaction in the control on
specific acts of specific drugs. If society has a strong adverse attitude
against any drug, then it will be included in the enumeration of
prohibited drugs. The following drugs or group of drugs are con-
sidered dangerous and are governed, by the Dangerous Drug Act.
1. Prohibited Drugs:
a. Opium and its active components and derivatives, such as heroin
and morphine;
b. Coca leaf and its derivatives, principally cocaine;
c. Alpha and beta cocaine, hallucinogenic drugs, such as mescaline,
lysergic acid diethylamide ( L S D ) and other substances pro-
ducing similar effects;
d. Indian hemp and its derivatives;
e. All preparations made from any of the foregoing; and
f. Other drugs, whether natural or synthetic, with the physio-
logical effects of a narcotic drug (Sec. 2.2, N o . 1, R . A . 6425).
2. Regulated Drugs:
a. Self-inducing sedatives, such as secobarbital, phenobarbital,
pentobarbital, barbital, amobarbital and any other drug which
contains salt or a derivative of a salt of barbituric acid;
b. A n y salt, isomer or salt of an isomer, of amphetamine, such as
benzedrine, or any drug which produces a physiological action
similar to amphetamine; and
c. Hypnotic drugs, such as methaqualone or any other compound
producing similar physiological effects (Sec. 2. No. (2), R. A.
6425).
Any drug or group of drugs included in the classification may
cause a user to be drug dependent. Drug dependence means a state
of psychic or physical dependence, or both, on a dangerous drug,
arising in a person following administration or use of that drug on
a periodic or continuous basis (Sec. 2(g), R . A . 6425). Drug depend-
ence may either be a condition of drug addiction or drug habituation.
1. Drug addiction is a state of periodic or chronic intoxication pro-
duced by the repeated consumption of a drug, whether synthetic
or natural, and found to be detrimental to the individual and to
the society ( W H O ) .
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Characteristics of Drug Addiction: 7 — Manufacture of prohibited Life imprisonment to

drugs. death and a fine of
a. An overpowering desire or need (compulsive) to continue taking
the drug or to obtain it by any means; 20,000 to 30,000
pesos.
b. A tendency to increase the dose; Possession or use of pro- 6 yrs. & 1 day to 12
c. A psychological and physical dependence on the effects of the hibited drug. yrs. imprisonment and
drug; and a fine of 6,000 to
d. A detrimental effect to the society and to the individual. 12,000 pesos.
Cultivation of plants which 14 yrs. & 1 day to
2. Drug habituation is the desire to have continuous use of the drug
are sources of prohibited life imprisonment, re-
but with the capacity to refrain physically from using it.
drugs. vocation of license,
Characteristics of Drug Habituation: and a fine of 14,000
a. The desire to use the drug is not compulsive but merely psy- to 30,000 pesos.
chical; 10 Failure to record prescrip- 1 yr. & 1 day to 6
b. There is little or no tendency to increase the dose; tions, sales, purchases, ac- yrs. imprisonment, re-
c. The dependence is not physical but merely psychical; and quisitions and/or deliveries vocation of license,
d. The detrimental effect, if any, is primarily on the individual. of prohibited drugs. and a fine 1,000 to
6,000 pesos.
PROHIBITED ACTS A N D RESPECTIVE PENALTIES UNDER 11 Unlawful prescription of 8 yrs. & 1 day to 12
THE D A N G E R O U S D R U G S A C T : prohibited drugs. yrs. imprisonment, re-
vocation of license,
1. Prohibited Drugs
and a fine of 8,000 to
Section Prohibited Act Penalty 12,000 pesos.
3 Importation of prohibited 14 yrs. & 1 day to life
12 Unnecessary prescription of 4 yrs. & 1 day to 12
drugs. imprisonment and a
prohibited drugs. yrs. imprisonment, re-
fine of 14,000 to
vocation of license,
30,000 pesos.
and a fine of 4,000 to
4 Sale, administration, deli- 12 yrs. & 1 day to 12,000 pesos.
very, distribution and trans- 20 years imprisonment
and a fine of 12,000 13 Possession of opium, pipe 6 mos. & 1 day to 4
portation of prohibited
to 20,000 pesos. and other paraphernalia for yrs. imprisonment and
drugs.
If the victim died, life prohibited drugs. a fine of 600 to 4 000
:

imprisonment to death pesos.

5 Maintenance of a den, dive
or resort for prohibited
drugs.
6 Employees and visitors of a
prohibited drug's den.
& a fine of 20,000 to 2. Regulated Drugs
30,000 pesos. 14 Importation of regulated 6 yrs. & 1 day to 12
12 yrs. & 1 day to drugs. yrs imprisonment and
20 yrs. imprisonment a fine of 6,000 to
and a fine of 12,000 12,000 pesos.
to 20,000 pesos. 15 Sale, administration, dispen- 6 yrs. & 1 day to 12
2 yrs. & 1 day to 6 sing, delivery, transporta- yrs. imprisonment, re-
yrs. imprisonment and tion of regulated drugs. vocation of iicense,
a fine of 2,000 to and a fine of 6,000 to
6,000 pesos. 12,000 pesos.
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16 Possession or use of reg- 6 mos. & 1 day to 4 b. Dihydromorphinone (Hydromorphine, Dilaudid).

ulated drugs. yrs. imprisonment and c. Methyl dihydromorphinone (Metaphon).
a fine of 600 to 4,000 d. Apomorphine.
pesos. Synthetic:
17 Failure to record prescrip- 6 mos & 1 day to 4 a. Methadone Dolophine.
tion, sales, purchases, ac- yrs. imprisonment and b. Pethidine (Meperidine, Demerol).
quisitions, and/or deliveries a fine of 600 to 4,000 Heroin and dehydromorphinone are approximately five times as
potent as morphine. Heroin is poorly absorbed after oral dosage
of regulated drugs. pesos.
and is usually given parenterally. Synthetic compounds are
18 Unlawful prescription of 4 yrs. & 1 day to 6 effective by mouth and methadone has more prolonged effect
regulated drugs. yrs. imprisonment, re- than pethidine.
vocation of license,
Chronic administration of the majority of opium and its deri-
and a fine of 4,000
vatives causes tolerance and an increasing dose is necessary to pro-
to 8,000 pesos.
duce effect. Dependence is physical and psychical and one is
19 Unnecessary prescription of 6 mos. & 1 day to 4 likely to develop into a chronic user and withdrawal of the drug
regulated drugs. yrs. imprisonment, re- may precipitate the symptoms of the withdrawal syndrome.
vocation of license,
2. Derivatives of Opium Commonly Used:
and a fine of 600 to
a. Morphine (sulfate, hydrochloride, acetate or tartrate) — Average
4,000 pesos.
dose 1/6 to 1/4 gr. given by mouth or by subcutaneous in-
Pharmacologic Classification of Dangerous Drugs: jection.
1. Hypnotics. b. Heroin — Therapeutic dose is 1/2 to 1/6 gr. and may be given in
2. Sedatives and Tranquilizers. the same way as morphine. It may be sniffed with or without
3. Hallucinogens and Psychomimetics. cocaine.
4. Stimulants. c. Dionine — Therapeutic dose 1/10 to 1/2 gr.
5. Deliriants and Intoxicants. d. Dihydromorphinone (Dilaudid) — Therapeutic dose 1/20 gr.
Taken like morphine or as suppositories.
HYPNOTIC DRUGS e. Metaphon — Effective dose is by mouth 1/20 gr.
f. Pantopon — A propriety medicine containing all the alkaloids
OPIATES AND THEIR DERIVATIVES:
of opium and may be taken by mouth or by injection.
Opium is obtained from the milky exudate of the incised unripe
g. Codeine — Therapeutic dose is 1/2 gr. and may be taken by
seed capsules of the poppy plant, Papaver Somaiferum. The milky
mouth.
juice is dried in the air and forms a brownish gummy mass which
h. Synthetic preparations.
contains 25% opium by weight.
( 1 ) Demerol — Therapeutic dose is 50 — 100 mg. and resembles
1. Classification of Opium Alkaloids: morphine and atropine in action.
Those that are naturally existing in the poppy plant: ( 2 ) Methadone — Given by mouth or hypodermically. The
a. Morphine — Name derived from Morpheus, the God of Dream. therapeutic dose is 5 mg.
b. Codeine 3. Signs and Symptoms of Opium Administration:
c. Thebaine Stage of Excitement:
d. Papaverine a. There is an increase in mental activity, restlessness or even
e. Nescapine hallucination.
Those derived by chemical manipulation of the naturally occur- b. There is flushing of the face and increased action of the heart.
ring alkaloid: This state is of short duration and in big dosages it may be
a. Heroin (diamorphine, diacetylmorphine). absent.
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Stage of Stupor: g. Some manifest suicidal tendencies or maniacal symptoms.

a. The person suddenly becomes quiet.
b. There may be headache, giddiness, lethargic condition and
uncontrollable desire to sleep.
c. When asleep, he can be aroused by external stimuli.
d. Pupils are contracted, face and lips are cyanosed.
e. There is itching sensation all over the skin.
f. Pulse and respiration are still normal.
Stage of Narcosis:
a. The patient passed into a deep coma.
b. He cannot be aroused by external stimuli.
c. Muscles are relaxed and reflexes are lost.
d. Skin secretion is completely suspended although the skin feels
cold and clammy.
e. The face is pale, the lips are livid and there may be a drop of
the lower jaw.
f. The pupils are contracted to almost a pinpoint and they're
insensible to light.
g. Conjunctivae are injected.
h. The pulse is slow, small and compressible.
i. Respiration is slow, labored and stertorous.
If dosage is lethal and no prompt and proper treatment is given,
the following symptoms of the toxicity may be observed:
j. Lividity of the face increases and pulse becomes slower, irreg-
ular and imperceptible,
k. Respiration becomes slower, feeble and later Cheyne-Stokes
and the patient may die of asphyxia.
1. The heart may beat for a while but later stop,
m. Convulsion may occur with the pupils dilated immediately
after death.
4. Consequences of Continuous Use of the Drug:
a. Development of tolerance to the drug. The drug is taken in
large quantity without producing any effect or without fatal
consequence.
b. Physical and moral deterioration.
c. Untruthfulness, dishonesty and mental deterioration.
d. When under the influence of the drug, he is calm and com-
posed, but becomes restless and irritable when deprived of
the drug.
e. May develop constipation and intercurrent infection, like
tuberculosis.
f. Those who try to inject themselves develop scars and abscesses
in the skin.
5. Early Presumptive Signs that a Person is Taking any Addictive
or Habit Forming Drugs:
At Home:
a. Unaccountable change in habit and mode.
b. Loss of appetite and weight.
c. Sudden development of clandestine friendship especially with
elder boys.
d. Personality change for which the parents can find no rational
explanation.
e. Unexpected discovery of the tablet, capsule or peculiar smelling
cigarette in the home.
f. Unexpected neglect of personal appearance and hygiene.
At School:
a. Sudden loss of interest and performance in studies and sports.
b. General evasiveness, truancy and problems over discipline.
c. Unconscious depression and cheerfulness at work or play over
a period should lead to suspicion.
At Work:
a. Late time-keeping.
b. Frequent change of occupation.
c. Problem with employer.
d. Failure to settle down.
6. Evidences of Opium Addiction:
a. Presence of symptoms as mentioned.
b. History of partaking of drugs.
c. Addict is skinny or asthenic — He prefers to buy drug than
food.
d. "Main liner" — Multiple pigmented punctured marks along the
course of the superficial veins.
e. "Skin popper" — Scars of previous subcutaneous abscesses
also along the course of the superficial veins.
f. Fresh needle puncture marks with underlying hemorrhage can
be demonstrated in recent intravenous injection.
g. Constriction of the pupil of the eyes.
h. Weakness and paleness due to malnutrition.
i. Blood examination reveals presence of the drug,
j . Presence of the drug in the urine.
k. Presence of paraphernalia for the administration of the drug.
( 1 ) "Cooker" — a bottle toy or spoon.
(2) Syringe — usually an eye dropper.
( 3 ) Tourniquet — usually belt, shoelace or stocking.
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(4) "Spike" - a needle. i. Pupils are pinpoint-size.

1. Withdrawal syndrome develops when deprived of the drug.
7. Withdrawal Syndrome:
If an addict is suddenly deprived of opiate, the following symp-
toms may be observed:
Objective Signs:
a. 8 to 16 hours after withdrawal — nervousness, restlessness and
anxiety.
b. 14 hours later — frequent yawning, sweating, running of nose
and lacrimination.
c. 24 hours later — symptoms increase, pupils are dilated, goose-
flesh develops and shivering attack.
d. 36 hours — severe twisting of muscles, painful cramps of legs
and abdomen, vomiting and diarrhea.
e. 3 — 4 days — blood sugar rises; patient becomes sleepy on the
3rd day.
Subjective Symptoms:
a. Pain.
b. Hallucination.
c. General body weakness.
d. Suicidal impulse.
e. Depression.
f. Criminal propensities.
g. Colic.
8. Elimination of Opium:
a. Through the stomach and intestine irrespective of whether the
drug is administered by mouth or by injection.
b. A great portion of the drug is oxidized in the liver.
c. A small portion is eliminated through the urine.
9. Post-mortem Findings in Opium Poisoning:
Nothing characteristic but signs of asphyxia are most pro-
minent:
a. Face and fingernails are livid.
b. Froth comes out of both nostrils and mouth.
c. Dark fluid blood is found in the heart and big blood vessels.
d. Trachea is congested and filled with froth.
e. Lungs are engorged, edematous and exudes frothy fluid.
f. Stomach may contain brownish lump of opium mixed with
brownish viscid fluid, if opium was ingested.
g. Odor of opium may be present in the stomach content.
h. There is brain congestion.
j. Multiple scars and abscesses along the course of the superficial
veins in the arms and forearms are observed,
k. Chemical examination of the blood shows the presence of the
drug.
SEDATIVES
BARBITURATES:
Barbituric acid or malonyl carbamide was the product of the
synthesis of malonic acid and urea allegedly on St. Barbara day.
Small dose has sedative effects while bigger dose may induce sound
sleep.
1. Common Preparations and their Slang Equivalents:
Short-acting preparation:
a. Secobarbital (Seconal) — "red devil".
b. Pentobarbital (Nembutal) — "yellow jackets", "nemmies".
Intermediate acting preparation:
a. Amobarbital (Amytal) — "blue heavens", "blue dragon".
Long-acting preparations:
a. Phenobarbital (Luminal) — "purple heart", "barbs".
Combination:
a. Secobarbital — amobarbital (Tuinal) — "tooies", "christmas
trees", "rainbow".
Barbiturates in general — "goofballs", "footpills".
2. Use of Barbiturates:
Medicinal:
a. Prescribed in the treatment of high blood pressure, insomnia
and epilepsy.
b. Used in the diagnosis and treatment of mental illness.
c. Given to relax patient before and during surgery.
Non-medicinal:
a. To escape personal problems — usually insecurity, failure or
frustration.
b. A substitute for heroin when the supply of their preferred
drugs runs short to intensify the effect of heroin.
c. To quiet oneself down (Amphetamine abusers).
d. Some patients have increased their prescribed dosage to the
state of dependence.
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3. Signs and Symptoms: Most fatal poisoning results from the ingestion of drug in com-
In ordinary dose: bination with other drugs. It is possible that the combination made
on the drug is more toxic than methaqualone alone due to potentia-
a. Sedation without analgesia. tion.
b. Decrease in mental acuity.
Excretion of the drug is relatively slow so it is inevitable that the
c. General sluggishness and slowed speech and comprehension.
drug will accumulate during multiple dosing.
d. Emotional liability.
Post-mortem findings are not specific and similar to barbiturate
e. Poor memory and faulty judgment.
poisoning.
f. Exaggeration of basic personal traits.
Mandrax, a proprietary medicine commonly used by adolescent
In toxic dose:
drug dependents and contains 250 mg. of methaqualone with 25 mg.
a. Ataxia and diplopia.
of diphenhydramine, an anti-histaminic drug. The combination has a
b. Positive Romberg sign.
powerful hypnotic effect and it is alleged to produce its effect by
c. Respiratory depression.
selective action of the thalamico-cortical part of the ascending
d. Perceptual time distortion.
reticular-activating system by reducing the inflow of sensory impulse
e. Suicidal tendencies.
to an otherwise unaffected cortex. This results into a state of
f. Dysarthria (slurred speech).
indistinguishable form of normal sleep. The drug can also produce
g. Toxic psychosis.
anti-histaminic effect.
h. Coma or death.
Psychological rather than physical dependence tends to occur
Continuous administration will cause a marked degree of physical after several dosage. Dependents sometimes complain about an
1

dependence and tolerance to all the barbiturates, and when suddenly effect called "Stonewalling '. This means that several mandrax tablets
withdrawn, Withdrawal Symptoms may be experienced, which taken may cause insensitivity and drowsiness to such an extent that
include: the individual may walk into a wall or barrier or crash a motor
a. Anxiety. vehicle into a wall, an embankment or other obstacle.
b. Involuntary twitching of the muscles. The effect of mandrax is potentiated by alcohol. The drug is
c. Tremor of the hands and fingers. contra-indicated in epilepsy, eclampsia and marked hepatic dys-
d. Progressive weakness. function. Mandrax has been implicated as a cause of peripheral
e. Dizziness. neuropathy.
f. Distortion of visual perception.
g. Nausea and vomiting.
H A L L U C I N O G E N S OR PSYCHOMIMETIC D R U G S
h. Insomnia and loss of weight.
i. Precipitated drop of blood pressure on standing, 1. Classification:
j. Convulsion of the grand mal type.
a. Natural

METHAQUALONE: Source Active principle

Methaqualone is a sedative drug in a smaller dose and a hypnotic Amanita muscaria — Mushroom Unknown
in a bigger dose. The effect is similar to barbiturates and action is Banisteria caapi — vine Harmine
within 30 minutes after administration; the effect is for 6 to 10 Cannabis sativa — Hemp Cannabinols
hours. It has no analgesic effect but can potentiate the analgesic Catnip — plant Unknown
effect of other drugs like codeine. The hypnotic dose is 150 — Datura — plant Scopolamine
500 mg. and the fatal dose is probably 5 grams. Epena — tree bark Unknown
The symptoms of poisoning are nausea, gastric irritation, vomiting Iboga — plant root Ibogaine
muscle twitching, hypertonia, cardiac arrhythmia, tachycardia and Kaba — Piper M. plant Unknown
respiratory depression. Nutmeg — tree seeds Myristicine
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Ololiuqui — Morning glory Lysergic acid 4. Which portion of the plant has relatively more THC content?
Peganum harmala — plant Harmine 5. Which type of plant is more toxic, the mature? or the immature
Peyote — cactus Mescaline plant?
Piptadenia peregrina Bufotenin Other Names for Marijuana:
Psilocybe — Mushroom Psilocybin Pot, grass, Indian hemp, "damu", weed, bhang, ganja, chards,
Virola — Nutmeg family Elemicin dagga, kif hash, hashish, tea, reefers, cigarette, stick, joint, smoke,
b. Synthetic straw, live, ped, Acapulco gold, bush, butter flower, muggles, griffe,
Indian hay, loco weed, MJ, Mary Jane, love weed, Mary Warner,
Name Chemical Name Mehasky, Sativa, reach.
DET Diethytrytamine pipidylbenzilate
Classification of Marijuana:
DITRAN Pipidylbenzilate
According to the U.S. Army Chemical Laboratory in Japan,
DMT Dimethyl tryptamine
Marijuana may be classified as:
DPT N ( 1 ) N dipropyltryptamine
LBJ N ( C H 3 ) 3 piperidylbenzilate H C L 1. "Vietnam Green" — Coming from southeast Asia and found to be
LSD D Lysergic Acid Diamide twice as potent as those varieties grown in the United States.
MDA 3, 4 Methylenedioxyamphetamine 2. "Acapulco G o l d " — Grown in southern Mexico and may contain
MMDA 5 methoxymethlenedioxyamphetamine as much as 2 to 4% T H C .
PCP Phencyclidine 3. "Panama R e d " — Grown in the canal zone and is reputedly the
PCPA p-chlorophenylalanine strongest of all.
STP-DOM 2, 5 dimethoxy 4 methylamphetamine
Special Preparations of Marijuana:
TMA 3, 4, 5, trimethoxyamphetamine
1. Hashish or Charas— A preparation obtained by separating the pure
MARIJUANA. resin from the tops, leaves and stem of the plant. It is dark green
Marijuana is a Mexican term meaning "pleasurable feeling". or brown and is smoked with tobacco in pipe. It is the most
Marijuana is a mixed preparation of the flowering tops, leaves, seeds potent of all cannabis preparations.
and stem of the hemp plant, Cannabis sativa. The plant may grow 2. Bhang — The dried leaves and fruit shoots are used as an infusion
from 3 to 10 feet high, but may grow as tall as 16 feet. The highest in the form of beverage. It is the least potent of all preparations.
quality of marijuana is derived from choice hemp grown in hot, and 3. Ganja — This consists of dried flowering tops of female plant with
humid places and from the mixture containing mostly of resin rusty green color and characteristic odor. It is mixed with tobacco
covered tops and upper leaves. The flowering tops of both male and smoked in pipe.
and female plants produce a sticky resin which contains Tetrahydro-
4. Majun — Infusion of dried leaves and tops mixed with flour,
cannabinol or T H C , the major pharmacological active ingredient.
milk, butter and sugar. Sometimes dhatura seeds are added to
The potency of the mixture depends on the resin content and this
increase potency.
is determined mainly by the plant strain and also by the factors
involved in cultivation, harvesting and preparation of the crop. 5. Reefers — Dried leaves and stem are sliced and made into cigarettes
There are many species of cannabis and other plants reported to and smoked.
contain T H C . On a study, it's been reported that 117 of 350 plants In addition to being an extractable active principle from cannabis
of cannabis contains 0% of T H C . Another study showed that the resin, tetrahydrocannabinol can be synthesized. It can be ingested
THC content ranges from 0.04% to 6.1%. or smoked, but smoking provides rapid induction of the drug effects.
Questions: Ingestion delays the onset of action from 45 to 60 minutes.
1. Does our local marijuana plant contain THC? Synthetic tetrahydrocannabinol is more effective when smoked
2. If so, how much does it averagely contain? than when ingested. The reason probably is that the synthetic THC
3. What will be the effect on the toxic contents if grown in high undergo heat-isomeration to a more potent compound with the
mountain or in the lowland? combustion or smoking.
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Natural tetrahydrocannabinnol ingestion makes the power effect e. Tremor and muscular incoordination.
long lasting and there is more hang-over than when smoked. There is f. In high dosage it may cause:
a strong possibility that certain toxic constituents of natural cannabis (1) Frank hallucination, delusion and paranoid feeling.
resin which entered the body when eaten are destroyed by heat com- ( 2 ) Confused and disorganized thinking.
bustion. (3) Toxic psychosis.

Factors Influencing the Effects of Marijuana: 3. Other Undesirable Effects:

1. Dosage of the drug and modes of administration:
2. Potency of the preparation.
3. Period of use (short or long term).
4. Expectations and mood of the user.
5. Environmental or social setting.
6. Personality and psychology of the user.
Effects of Marijuana:
1. Subjective Effects (after a number of inhalation):
a. A feeling of lightness of the extremities, followed by "rushes"
of warmth and well-being that eventually lead to a sense of
relaxation and mild euphoria.
b. A distortion of sense of time, distance, vision and hearing.
( 1 ) A minute seems like an hour.
( 2 ) Eyes tend to focus on one object to the exclusion of others.
( 3 ) Certain sounds become striking in character and music
takes on a new dimension.
c. Whetted appetite. Food and drink taste especially good.
d. A tendency to be confused about the past, present and future.
e. Impaired short-term memory. There is a deterioration in the
capacity to carry out task requiring multiple mental steps to
reach specific goals.
f. Tendency to be easily distracted.
g. The suggestibility and release of inhibition.
h. Increased sense of sociability and hilarity.
These effects are at peak, shortly after smoking and fade
away after a few hours, leaving a desire to sleep.
2. Objective Effects:
a. Moderate increase in resting pulse rate.
b. Reddening of the eyes due to dilatation of the conjunctival
blood vessels.
c. Difficulty of speech and of remembering the logical trend of
what was being said.
d. Neurological and EEG examinations show slight increase in
cortical functions.
a. Bronchitis and asthma may occur in susceptible individuals
and may be treated symptomatically.
b. Nausea and vomiting occasionally develop when a novice
smokes too much but disappear as the effect of the drug wears
off.
c. Panic reaction occurs when the individual becomes frightened
about the effects of the drug and starts to doubt that the
changes are irreversible. It is more common among novice users
and more frequently observe in areas where people believe that
smoking marijuana causes deviant behavior, but rare where
it is accepted as a recreational intoxicant.
d. Amotivational Syndrome — This is characterized by a progres-
sive change from conforming, achievement-oriented behavior to
a state of relaxed drifting. As a result, the person affected
seems unwilling to follow routines, endures frustrations or
carry out long-ranged plans. In extreme cases, greater intro-
version is exhibited with the subject becoming totally involved
with the present, while disregarding the future goal. He tends
toward child-like magical thinking and reports greater creativity
but less objective productivity. The condition is reversible and
if smoking is discontinued the user returns to his pre-drug
level of functioning.
e. Acute toxic psychosis — A temporary malfunction or less in
reality, this is self-limited and usually no drug is necessary.
The patient must only be protected from injury for the duration
of his disorientation.
Marijuana is not addictive. Physical dependence and dose tolerance
do not develop with its use and withdrawal symptoms are not seen
when usage is discontinued. Psychic dependence may occur among
marijuana users.
Marijuana is a non-lethal drug to human subject. A high degree of
safety has also been demonstrated in animal experiments. A dose
of 150 mg. per kilo body weight in mice and huge dose have been
given to dogs without causing death. There has been no reported
case of fatal marijuana overdosage in man. (Historical Aspect of
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Cannabis Sativa in Western Medicine by T.H. Mikuriya. The New
Physician, 1656).
The fact that many heroin addicts have smoked marijuana does
not establish a casual relationship between marijuana smokers and
opium addiction. The "stepping stone theory" is considered invalid
and that the progression to stronger drugs that occurs is a result of
personality and environmental factors and not dependent on the
pharmacological properties of marijuana (Acute and Chronic Toxi-
city of Marijuana by D.E. Smith, U. of California Press, 1969).
Marijuana does not cause aggressive criminal behavior. The
pacifying effect of marijuana makes the individual non-aggressive
rather than cause violent crime (Marijuana Problem by W.R. Mc-
Glothis, AmJ of Psychiatry, 125, 370, 1958).
There is no evidence that marijuana leads to sexual debauchery.
Marijuana is not an aphrodisiac. There were reports of greater
sexual enjoyment while high and the possible explanation is the
increase sensory awareness and the distortion of time which would
seem to prolong the duration of orgasm (Cannabis by W.H. Mc-
Glothin, The Marijuana Paper, Indianapolis, 411, 1966).
However, recent findings revealed that cannabis may act on
hormone regulators and produces impotence and temporary sterility.
Heavy marijuana smokers have lowered sperm counts and impotence.
Hormones such as leuteihizing hormone, anti-diuretic hormone,
growth hormone, and prolactin are also affected by marijuana
(Marijuana by Gabriel G. Nahas, JAMA Vol. 233, No. 1, Jul. 1975).
Marijuana also affects the body's cellular processes which include
reduction of the number of T-lymphocytes with the resultant inter-
ference in the immune process. There is also increase in the number
of cells with broken chromosomes (JAMA, Vol. 232,No. 9 June 2,
1975, p. 923).
Metabolism:
Marijuana has three major components: T H C , cannabidiol and
cannabinol. All of them have pharmacologic activity. Variance in
the amount of the active constituents has some bearing in the dif-
ference in pharmacologic activities.
The metabolism of cannabinoid takes place in the liver and pos-
sibly on other site, like the lung. The cannabinoids are rapidly
hydrolyzed into some form of 11-hydroxy compounds. A small
amount is found in the blood and there is a major metabolites
in the feces.
There is a rapid elimination of T H C from the blood during the
first 40 minutes, then a much slower elimination in the next 24
hours.
L Y S E R G I C A C I D D I E T H Y L A M I D E ( L S D - 2 5 ; D ) — Lysergic acid
diethylamide tartrate.)
The drug was first synthesized by Dr. Albert Hoffman and Dr.
Arthur Stell while working in a Swiss pharmaceutical firm. LSD is
synthesized from the alkaloids or ergot (Claviceps purpurea), a
fungus that parasitizes rye and other grains in Europe and America
and diethylamide portion of ergotamine ergonevine, the active
oxytocic and vasoconstrictor drugs. The synthesis was found to
have strange and potent central effects.
It may be medicinally used in the treatment of alcoholism and
opium addiction and is the drug of choice to induce tranquility and
reduces the need for analgesic in cases of terminal cancer.
L S D is colorless, tasteless, odorless, usually in liquid form and
taken orally.
1. Symptoms:
a. Physiological — Dilatation of the pupils, over-activity of reflexes,
increase of muscle tension, lack of coordination, visual dis-
turbance, laughter.
b. Somatic — Dizziness, weakness, tremor, nausea, drowsiness,
parasthesia (sensation of pricking, tingling or creeping of the
skin) and blurred vision.
c. Perceptual — Alteration of shapes and color; music appre-
ciation with abnormal intensity; focusing difficulty; sharpen-
ing of the hearing sense, recurrent voice accompanied by
brilliant hallucinatory color sensation (synesthesia or seeing
sound, hearing color, etc.).
d. Psychic — M o o d alteration, tension, distortion of time sense,
difficulty in thought expression, depersonalization, dream-
like feeling and visual hallucination. Delusion of omnipotence
is common such that a user thinks he can fly from a high build-
ing. A number of deaths occur in this manner.
2. Dose and Tolerance:
It is more than 100 times more potent than psilocybin and
4,000 times more potent than mescaline in producing psycholo-
gical effect.' L S D is a very potent drug. A dose of 15 microgram
can produce psychological effects. The normal dose is from 100
to 250 microgram.
L S D has the capacity to develop rapid tolerance. In a few days
of repeated use, a formerly effective dose will no longer cause a
response but physical and psychological dependence does not
develop.
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3. Untoward Effects: euphoria instead of psychic depression as the "coming down"

a. Acute panic reaction ("Bad trip", "freak-out") as a frequent
complication may lead to suicide attempts.
b. L S D removes the usual intrinsic restraints causing uncontrol-
lable violence or aggression.
c. It causes chromosomal breaks and/or chromosomal rearrange-
ments which may persist as long as 15 months. This may cause
malformation of the children to be born.
Thalidomide is another allied drug which produces a broadly
defined syndrome of limb, cranial nerve, heart, eye, ear and
reproductive system defects of varying degree of severity. The
fetus is susceptible to thalidomide only for 14 days; that is
between the 36th to the 50th day following the last menstrual
period.
Absence of ears and paralysis of the cranial nerves is usually
caused by thalidomide intake on the 35th to 36th day after the
last menstruation. The arms are affected 3 to 5 days later. The
legs are usually affected before the 43rd day. The 40th to 50th
day marked the end of the sensitive period. Thalidomide
given on these last days does no more than producing hypo-
plastic thumbs with three joints or anorectal stenosis.
d. Damage on the white blood cells may cause leukemia.
4. Treatment:
Phenothiazines and barbiturates, singly or in combination, have
sometimes been found effective in treating an acute intoxicated
state. The regular L S D user knows this well and may keep a
supply of chlorpromazine on hand.
OTHER H A L L U C I N O G E N S A N D PSYCHOMIMETIC DRUGS:
DMT, DET and DPT are tryptamine derivatives which produce a
syndrome similar to that of LSD but differ in the following ways:
1. The onset is more rapid, increasing the likelihood of a panic
reaction;
2. The duration of action is only 1 to 2 hours; and
3. The autonomic effects consisting of pupil dilatation and elevation
of blood pressure are more marked than in LSD.
STP and DOAf induce an LSD-like reaction lasting for 72 hours
or longer. Because of their long effect they are less popular than
LSD.
AfDA or "love pill" induce a relatively mild LSD-like reaction
lasting 6 to 10 hours. The amphetamine-like effect it produces
tends to persist longer than the psychomimetic effect. This causes
effect.
MORNING GLORY (Ololiuqui, "HeavenlyBlue", "Pearly Gates"
— The seeds contain compounds similar to L S D . Symptoms include
drowsiness, perceptual distortion, confusion, liability of effect,
hallucination, giddiness and euphoria may alternate with intense
anxiety. The common side effect in oral ingestion includes nausea,
vomiting and diarrhea.
CACTUS-PEYOTE (Active principle-Mescaline) — The protu-
berance atop the plant are cut off and dried in the sun to form
peyote or mescal buttons which contain the active drug, mescaline.
They are made into cakes, tablets or powder and used by Indians
in Northern Mexico in ceremonies.
Mescaline produces effects similar to L S D but less potent. Al-
though it may produce vivid hallucination, psychotic reactions are
far less common as compared with L S D .
MUSHROOM-PSILOCYBIN - This is available in powder and
liquid form and extracted from mushroom (psilocybe) which grows
in Mexico. The effect is similar to mescaline.
DATURA — An anti-cholinergic agent and a constituent of "Asth-
mador", an over the counter preparation for asthma. High dose
induces disorientation, confusion, hallucination and eventually coma.
Other signs of mydriasis, tachycardia, decreased salivary action,
urinary retention and warm, flushed skin are also observed.
NUTMEG (Myristica) — It is the powdered seed kernel of the East,
Indian Tree, Myristica fragrans, which contains a hallucinogenic
substance thought to be myristicin. When ingested it produces
euphoria, hallucination and acute psychotic reaction. The side
effects are similar to that of atropine, but nutmeg produces early
pupillary constriction.
STIMULANTS
AMPHETAMINES:
Amphetamine was first synthesized in 1927 as a substitute for
epinephrine which was isolated from the adrenal gland and from
ephedrine obtained from the Chinese herb ephedra vulgaris.
The Most Common Preparations of Amphetamine in the Market are:
1. Dextreamphetamine (Dexedrine) also called "co-pilot", "dexies",
or "orange".
2. Amphetamine (Benzedrine) also called "bennies", "splash",
"peaches".
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3. Methamphetamine (Methedrine: Desexyn) also called "meth" 3. Shock and collapse following amphetamine usage and excessive
"speed", "crystal", "crank", "white cross tablets". physical exertion.
4. Dextroamphetamine plus amphetamine (Dipetamine; Bipheta- 4. May lead to habituation.
mine) also called "footballs". 5. Risk of suicide during the withdrawal phase.

Amphetamine acts on the cerebral cortex causing alertness, Withdrawal Symptoms:

excessive self-confidence and feeling of well-being. Drowsiness and
sleep are prevented. Mood elevation and fantasy thinking are com-
mon effects and sexual excitation has been described.
Medicinally, amphetamines are used ( 1 ) to curb the appetite in
overweight persons, ( 2 ) to relieve mild depression such as accom-
panying grief, senility, menopause and convalescence, and ( 3 ) to
keep patient awake in narcolepsy, a disorder characterized by brief
attacks of deep sleep.
Reasons Why Some Persons Abuse the Use of Amphetamine:
1. For thrill.'
2. As a substitute when other narcotic supplies are temporarily cut
off.
3. To give a feeling of increased strength and endurance.
4. To reduce fatigue during athletic performance.
5. To ward a sleep among students cramming for the examination.
6. To effect a prolonged high when used in combination with other
drugs, like alcohol, heroin or barbiturates.
7. As a body reducer by reducing appetite.
Types of Amphetamine Abusers:
1. Adaptive abusers —Those who take amphetamine to bolster their
functioning within conventional, interpersonal and social activities.
2. Excapist abuser — Those who abuse amphetamine to avoid such
interpersonal and social activities. This type of abuser has a cycle
having two phases of approximately equal duration.
a. "Up" or active phase — The subject is given the drug, usually
methamphetamine, at two to four hours interval for four to five
days. During the time he remains awake.
b. "Down" or reactive phase — After being awake and continuous-
ly active four or five days, the abuser then collapses from
exhaustion, remaining in a semi-comatose state and sleeping
intermittently for the next four or five days.
Danger of Amphetamine Misuse:
1. Overactivity leading to social consequence (car accident) or aggres-
sive behavior; stealing and murder may have been associated with
excessive amphetamine taking.
2. Production of a psychotic illness of the schizophrenic type.
Initially there is a sensation of chilliness, uneasiness and yawning.
This symptom will be followed by rhinorrhea, lacrimation and
mydriasis. Respiration will become labored and short with a feeling
of anorexia. Later the person will fall asleep and if awakened the
symptoms will become pronounced with tachycardia, fever and
hypertension. Pain and cramp of the legs and abdomen will be
observed. Perspiration, vomiting, diarrhea and tremor will be ob-
served.
Psychological dependence develops among chronic abusers only
and may lead to social, economic and emotional deterioration.
Possible complications that may develop in the course of continuous
and excessive use of amphetamine:
1. Development of a syndrome resembling heat stroke with coagu-
lopathy and renal failure.
2. Necrotizing angilitis,
3. Fatal collapse associated with marked fatigue and nervous tension.
4. Widespread hemorrhage, especially in the endocardium and
myocardium and rapid development of myocardial fiber necrosis.
5. Psychosis and other permanent brain damages.
6. Frequent accidents in highway driving.
Excretion:
50% of amphetamine is destroyed in the liver by dissemination and
the rest in the kidneys at a slower rate. The drug use to appear in
the urine 3 hours after administration.
The presence of amphetamine is detected in body fluid by (1) gas
chromatography with hydrogen flame detector or by ( 2 ) thin layer
chromatography.
COCAINE:
Cocaine is an alkaloid from the leaves of the coca shrub cul-
tivated extensively in Bolivia and Peru. It is also grown in Java,
Taiwan and Sri Lanka. The leaves are harvested from the plant not
less than 10 months old. The matured leaves are plucked, dried and
packed in bales.
Cocaine may be taken by injection, by chewing or by sniffing of
crystals through the nostrils. The coca leaf is chewed by many
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Indians of the Andes for its stimulating effects and also for depres- ages are fed to camels or ducks. In the case of ducks they are slaugh-
sing appetite. Repeated sniffing of cocaine crystals into the nasal tered to retrieve the drug. Rupture of the container while in the
passage may cause gradual erosion and perforation of the nasal alimentary tract with consequent cocaine poisoning has been reported
membrane. in literature.

Cocaine stimulates the sympathetic system causing increased DRUG DEATH:

pulse rate, dilatation of the pupils and perspiration. It is a eupho-
riant and speedily relieves fatigue. Cocaine is said to cause sexual
excitement and the drug therefore is popular among the undersexed
or sexual perverts.
Tolerance to the drug is slow and dependence tends to be psycho-
logical rather than physical.
If cocaine is taken for a period of time, especially in excessive
dosage, it may cause pallor, poor appetite, salivation, loss of weight,
and damage to the nasal membrane and cartilage in sniffers. Cuta-
neous scars of old injection sites may be evident and habitual cocaine
eaters develop black teeth and tongue.
Magnan's Symptom or the feeling as if grains of sand are lying under
the skin or small insects (cocaine bugs) are creeping on the skin is
the most characteristic symptom.
It has been reported that cocaine leads to erotic tension in women.
Death may be due to epilepsy or respiratory failure.
The drug when withdrawn from the user may cause withdrawal
symptoms in the form of insomnia, reactive depression, and paranoid
attitudes which may lead to paranoid psychosis.
Users of cocaine recently combine it with heroin called "mixing
the gravy" to counteract lethargy and social isolation effect of
heroin.
Medically the use of cocaine has markedly declined and its major
use is only as anesthesia of the nose and throat. On account of the
disadvantages observed in the use, the synthetic procaine becomes
the wildly used substitute under the trade name of novocain.
Prostitutes inject a solution of cocaine into the vagina. This
gives the individual a sense of local constriction and exhilarating
systemic feeling. In men cocaine is applied locally to the glans
penis to increase the duration of the sexual act. It may cause sexual
perversion especially in homosexuality or in libidinous outrages.
In fatal dose, death is due to cardiac or respiratory failure.
Cocaine "body packer" Syndrorpe refers to the ingestion of
multiple small packages of cocaine for the purpose of transporting
the contraband. The drug is placed in a durable, non-digestible
container, taken by mouth to be recovered at the place of desti-
nation in the fecal discharge. Aside from human beings, the pack-
Drug related death may be classified into three categories:
1. Primary drug fatalities — those which death is due to the toxic
or adverse effect of the chemical agent, with or without the con-
tributory influence of pre-existing, unrelated natural disease.
2. Secondary drug fatalities — those arising from medical compli-
cations of drug abuse, such as viral hepatitis and bacterial endo-
carditis.
3. Drug-associated fatalities — those caused by homicidal, accidental
and suicidal violence stemming directly or indirectly from acti-
vities related to the obtaining and use of illicit drugs.
The qualitative and quantitative determination of the dangerous
drug in the human body or the pathologic changes in organs cannot
be utilized as the basis of the cause of death. There are other
factors to be considered which may be responsible for the death:
1. The decedent may be usually susceptible to the deleterious effect
of the drug;
2. The combination of the drugs taken can interact in an additive
fashion;
3. Some pre-existing natural disease may have contributed to the
death;
4. The rapid absorption of large quantity of the drug can kill prior to
complete absorption of all the substance from the gastro-intestinal
tract;
5. Normal metabolic degradation of the chemical can reduce its
blood concentration during the prolonged survival interval in
which respiratory complications and hypoxic encephalopathy
maintain coma and act as the immediate cause of death.
(Modern Legal Medicine, Psychiatry and Forensic Science by
Curran, et. at., p. 1129).
Identification of Some Dangerous Drugs:
1. Gross and Microscopic:
Inasmuch as marijuana is smoked as leaf fragments, its iden-
tification may be used on the botanical features, grossly and
microscopically by trained experts. A complete leaf may be
identified by the characteristic irregular shape. Microscopically,
identification depends largely on observation of short hair on the
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upper side of the leaf known as cystolith and the presence of
longer nonglandular hair on the opposite side.
2. Micro-crystalline Test:
A drop of chemical reagent is added to a small quantity of the
drug on a microscopic slide. After a short time, a chemical reaction
ensues producing a crystalline precipitate. It is the size and shape
of the crystal under the microscopic examination that is character-
istic of the drug.
3. Color Test:
a. Opium and its derivative together with amphetamine:
( 1 ) Marquis test — (2% formaldehyde in sulfuric acid) — Turns
purple in the presence of heroin and morphine as well as
most opium derivatives. The test will also produce an
orange-brown color when mixed with amphetamine and
methamphetamine.
b. Barbiturates:
( 1 ) Dillie Koppanyi test — (1% cobalt acetate in methanol is
first added to the suspected material followed by 5% iso-
prophylamine in methanol). A violet-blue color is produced.
This is a valuable screening test for barbiturates.
( 2 ) Zwikkers test — A d d approximately 0.5 ml. of 0.5% aqueous
solution of copper sulfate to a small amount of sample.
Mix gently and add an equal volume of a 5% solution of
pyridine in chloroform. Shake first the layers, separate and
observe the color of the chloroform layer.
If the sample contains the free acid or sodium salt of a
barbiturate, the chloroform layer will be purple. If the
sample contains the free acid or sodium salt of a thio-
barbiturate, the chloroform layer will be bright green.
Addition of one drop of glacial acetic acid to the chlo-
roform, water system will:
(a) Destroy the purple color of the chloroform layer and
change it to a very weak blue if the sample contains the
free acid or sodium salt of a barbiturate:
( b ) Reduce the color of the chloroform layer to a faint
green if the sample contains the free acid or sodium
salt of a thiobarbiturate. On further addition of the
acid the color will change to a light yellow green.
c. Marijuana:
Duquenois-Levine test — Solution A is a mixture of 2%
vanillin and 1% acetaldehyde in ethyl alcohol; solution B is
concentrated hydrochloric acid; and solutions A , B and C are
added respectively to the suspected material. A positive result
is shown by purple color in the chloroform layer.
d. LSD:
Van Urk test (1% p-dimethylaminobenzaldehyde and 10%
concentrated hydrochloric acid in ethyl alcohol). This reagent
turns blue-purple in the presence of L S D . However, owing to
the extremely small quantities of L S D in illicit preparations,
this test is difficult to conduct under field conditions.
e. Cocaine:
Cobalt Thiocynate test — (2% cobalt thiocyanate in water).
This reagent produces a blue flaky precipitate in the presence
of cocaine. The test is not reliable as many other drugs and
diluents respond in the same manner.
4. Chromatography:
a. Thin layer chromatography.
b. Gas chromatography.
In both methods the drug is separated from the diluent while
providing for its identification.
5. Spectrometry:
Selective absorption of light by drugs in the UV (Ultra-violet)
and IR (Infra-red) regions of the electromagnetic spectrum. UV
spectrum is not conclusive for the positive identification of drug
because other drugs may very well produce an indistinguishable
spectrum, but may be useful to establish the probable identity
of the drug.
IR spectrophotometry can specifically identify substances, but
the substance to be identified must be in pure form. A com-
bination of preliminary screening by UV followed by verification
through infra-red spectrophotometry is the most ideal approach to
drug identification.
DELIRIANTS
Drugs which cause delirium, intoxication and other mental and
psychic disturbances when the toxic vapors and fumes are inhaled
are not covered by the Dangerous Drug Act of 1972 as amended,
hence Presidential Decree N o . 1619 was promulgated on July 23,
1979.
Drugs included in P.D. 1619:
Volatile substances including any liquid, solid or mixed substance
having the property of releasing toxic vapors or fumes containing
one or more of the following chemical compounds:
Methanol Stryene
Ethanol Napthalone
Isopropanol N-pentane
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Ethyl acetate N-hexane
N-propyl acetate N-heptane
N-butyl acetate Methylene Chloride
Acetone Trichloroethylene
Methyl ethyl ketone Tetrachloroethylene
Methyl butyl ketone Nitrous oxide
Benzene Dichlorodiflouremethane
Tolouene Isoamyl nitrate
Xylene Chloroform
or other chemical substance which when sniffed, smelled, inhaled, or
introduced into the physiological system of the body produces or
induces a condition of intoxication, inebriation, excitement, stupe-
faction, dulling of the brain or nervous system, depression, giddiness,
paralysis, or irrational behavior or in any manner changing, disturb-
ing or distorting the auditory, visual and mental processes (Sec. 1).
Acts which are Punishable:
1. The use or possession of volatile substances for the purpose of
inhalation to induce or produce intoxication or any of the con-
ditions described in Sec. 1 (Sec. 2).
2. The sale, administration, delivery, or giving away to another on
any term whatsoever, or distribution, dispatch, transaction or
transportation or acting as a broker in any such transaction, any
substance or mixture or substances containing one or more of the
chemical compounds mentioned in Sec. 1 (Sec. 4).
3. Maintenance of a den, dive or resort where any substance or
mixture of substances containing one or more chemical com-
pounds mentioned in Sec. 1 (Sec. 5).
4. The sale or offer to sell volatile substances to minors without
requiring the written consent of their parents or guardians as a
condition for such sale or offer to sell, provided that when the
minor is 18 years or over and is duly licensed to drive a motor
vehicle, such written consent shall not be necessary when the
volatile substance sold or offered for sale is gasoline or any other
motive fuel for vehicles.
5. The sale of, or offer to sell, to minors of liquors or beverages
containing an alcoholic content of thirty percentum or above
(60% proof or above) (Sec. 6).
For public information the Dangerous Drug Board is obliged to
publish the list of dangerous drugs and any subsequent changes in
the list.
"The Board shall give notice to the general public of the reclassi-
fication, addition to or removal from the list of any drug by publish-
ing such notice in any newspaper of general circulation once a week
for two consecutive weeks (Sec. 40, Dangerous Drugs Act of 1972
as amended — Reclassification, addition or removal of any drug from
the list of Dangerous Drugs.)
Effects of such Reclassification, Addition or Removal:
1. In the case of prohibited drug reclassified as regulated, the penal-
ties for violation of this Act involving the latter shall, in case of
conviction, be imposed in all pending criminal prosecutions.
2. In the case of regulated drug reclassified as prohibited, the penal-
ties for violation of this Act involving regulated drugs shall, in case
of conviction, be imposed in all pending criminal prosecutions.
Present State of the Drug Problem in the Philippines:
1. Marijuana is now planted in almost every province of the country.
a. The profit aspect is comparatively great.
b. Local and foreign demand are probably more.
c. The Philippine climate is most conducive to favorable growth.
2. There is an increasing number of our youth who are prospective
users.
3. Pushers motivated by profit although unquantifiable are seeming-
ly increasing in number.
4. Property offense can be directly correlated with drug depend-
ence. "High" with the drug means high in crime. The effects of
the drugs responsible are:
a. Toxic psychotic effect.
b. Release of inhibition.
c. Confusion of thought and disorganization of ideas.
d. Suggestibility.
5. There is an increase in vehicular accidents with the driver under
the influence of drug due to:
a. Distortion of time, distance, vision and hearing.
b. Aggressiveness.
c. Lack of inhibition.
d. Deterioration of the capacity to carry out task requiring multi-
ple steps to reach a specific goal.
e. Mental confusion and psychosis.
f. Desire to sleep during the later part.
6. Suicide is more common among drug users. This may be attri-
buted to:
a. Frank hallucination, delusion or paranoid feeling.
b. Confused or disorganized thinking.
c. Panic syndrome — feeling of worthlessness.
d. Suggestibility and release of inhibition.
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7. Mental affection, like psychosis among drug users is on the rise.
8. Truancy and drop-out in schools among users are rampant.
9. The socio-economic condition of the family is affected.
10. The socio-economic progress of our country has been markedly
prejudiced.
Ways of Controlling or Combating the Drug Problem:
1. By preventing users to further use the drug.
a. Counseling.
b. Treatment and rehabilitation.
c. Destruction of the source of the drug.
d. Instilling into the mind the philosophy that "It is better late
than never".
2. By preventing non-users from starting a life of drug dependence.
a. Medical means:-
( 1 ) Research on the causes, epidemiology, symptomatology,
prevention and cure. Drug dependence is a social malady
and like any human disease can only be minimized, if
not eradicated, by means of a scientific approach.
( 2 ) Formation and implementation of medical hypothesis:
( 1 ) Attentuation
( 2 ) Fortification
b. Concerted social action:
( 1 ) Instilling the maxim that "drug dependence does not pay."
( 2 ) Preventive education:
( a ) Group counselling
( b ) Individual case study
3. In case of addition of a new drug to the list of dangerous drugs,
no criminal liability involving the same under this Act shall arise
until the lapse of fifteen (15) days from the last publication of such
notice; and
4. In case of removal of a drug from the list of dangerous drugs, all
pending criminal prosecution involving such a drug under the
Act shall forthwith be dismissed (Sec. 40(4) D D A of 1972).
PRESCRIPTION OF D A N G E R O U S D R U G S
Prescription Forms:
For the purpose of this Act, all prescriptions issued by physicians,
dentists, veterinarians or practitioners shall be made out on forms
exclusively issued by and obtained from the Board. Such forms shall
be made of a special kind of paper and shall be distributed in such
quantities and contain such information and other data as the Board
may, by rules and regulations, require. Such forms shall not be issued
by the Board or any of its employees except to licensed physicians,
dentists, veterinarians and practitioners in such quantities as the
Board may authorize (Sec. 25 ( b ) , par. 2, D D A of 1972 as amended).
However in emergency cases, the required prescription form may not
be used:
In such emergency cases, however, as the Board may specify in the
public interests, prescriptions need not be accomplished on such
forms (Sec. 25 ( b ) , 2nd par., Dangerous Drug Act of 1972 as
amended).
The following specific conditions fall within the category of emer-
gency wherein the required form may not be used:
1. Where the prescription has to be used on a patient whose need for
dangerous drugs is immediate and urgent and has been brought by
the effects, or during the course of natural or other calamities,
such as typhoons, earthquakes, conflagrations, etc., of such a
magnitude as to preclude prompt access to the official prescrip-
tion forms of dangerous drugs.
2. Where the need for prescribing the dangerous drugs has arisen as
a result of a serious accident necessitating the administration of
the drugs at the scene or in the vicinity of the accident and the
required prescription forms are not readily available.
3. Where the need for the dangerous drug is urgent and its ready
availability may, in the opinion of the prescribing physician,
spell the difference between life and death of the patient, and
for unavoidable and justifiable reasons the prescribed prescrip-
tion form is not within access (Board Regulation N o . 4, Series
of 1973).
Obligations Imposed on Physician when Prescription Was Not Made
on the Required Form:
1. The prescribing physician shall certify at the back of the ordinary
prescription form utilized, as to the nature, time and place of the
emergency conditions and the name and address of the patient,
and shall see to it that his (physician's) full name and address is
indicated in printed form beneath his signature. (Sec. 2, Board
Regulation N o . 4, 8. 1978).
2. The prescribing physician shall, within three ( 3 ) days after issuing
such prescription, inform the Board of the same in writing (Sec.
25 ( b ) D D A of 1979 as amended and Board Regulation N o . 4,
series of 1973).
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685
Loss^of Prescription Forms for Dangerous Drugs (DDR Form No.

Sec 1. It shall be the duty of every physician, dentist, veterinarian

or other practitwner to whom prescription form ( D D B FomTES
for the dangerous drugs have been issued, to report any to* thereof
to the Dangerous Drugs Board within twenty-four (24) hours from
the discovery of such loss, indicating the circumstances surrounding
the loss. Upon, receipt of said report, the Board shall cause the
publication of the loss in a newspaper of general circulation.
Sec. 2. Every loss of prescription forms for dangerous drugs shall
be referred for investigation to any police or investigative agency as
the Board shall determine. Whenever necessary the police or in- 686 LEGAL MEDICINE
vestigative agency may take possession of the prescription forms
remaining in the possession of the physician, veterinarian, dentist 1. Name and address of the pharmacist;
or other practitioner. Should the findings of the police or investi- 2. The name, address and license of the manufacturer, importer or
gative agency show negligence on the part of the physician, vete- wholesaler from whom dangerous drugs have been purchased;
rinarian, dentist or practitioner, the loss shall be reimbursed to the 3. Quantity and name of the dangerous drugs so purchased or ac-
Board by the. negligent physician, veterinarian, dentist or practi- quired;
tioner, and he may be barred from further purchasing prescription 4. The date of acquisition or purchase;
forms (Board Regulation N o . 10, s. 1973). 5. The name, address and class A residence certificate of the buyer;
6. The serial number of the prescription and the name of the doctor,
How to Make the Prescription:
dentist, veterinarian, or practitioner issuing the same;
A physician, dentist, veterinarian or practitioner authorized to 7. The quantity and name of the dangerous drugs so sold or delivered;
prescribed any dangerous drug shall issue the prescription therefor 8. The date of sale or delivery.
in one original and two duplicate copies. The original after the
A certified true copy of such record covering a period of three
prescription has been filled, shall be retained by the pharmacist for
calendar months, duly signed by the pharmacist or the owner of the
a period of one year from the date of sale or delivery of such drug.
drug store or pharmacy, shall be forwarded to the city or municipal
One copy shall be retained by the buyer or by the person to whom
health officer within fifteen days following the last day of every
the drug is delivered until such drug is consumed, while the second
quarter of each year (Sec. 25 ( a ) , 2nd par., Dangerous Drug Act
copy shall be retained by the person issuing the prescription (Sec.
of 1972 as amended).
25 ( b ) , Dangerous Drug Act of 1972 as amended).

Duty of the Drugstore Owner in Filling Prescription:

Whenever a prescription for dangerous drugs is filled by a drug-
store, it shall be the duty of the drugstore owner to use the words
" U S E D IN F U L L " to be stamped in bold prints diagonally across
the original copy of said prescription in case the full quantity of
the drug therein stated is sold, and the words "USED FOR
O N L Y " in case the quantity of the drug therein stated is not fully
m c<i&e m i m •> n v /
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7 T h e

sold (Board Regulation N o . 11, s. 197d) U n e d a n * y

indicate the number of tablets, capsules, etc. actually sold).
Every pharmacist dealing in dangerous drugs shall
keep a ? original record of sales, purchases, acquisitions and deliveries
of dangerous drugs indicating therein:
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Chapter XXXIII
ALCOHOLISM
Ethyl alcohol ( C H O H , Ethanol, grain alcohol) i> a colorless
2 5
transparent, volatile liquid with aromatic odor and with boiling
point at 7 8 ° C . Like any other types of alcohol, it is formed out
of the fermentation of various carbohydrates in grains, fruits or
flowers, and from other materials subjected to and isolated by
distillation.
Ethyl alcohol is commonly used as solvents, antiseptic and beve-
rage. When ingested, it does not require digestion before absorption.
Although the word "alcohol" refers to a large group of chemical
compounds in possession of hydroxyl radical ( O H ) , whenever al-
cohol is used as part of a beverage, it refers to ethyl alcohol.
Alcoholic beverages are primarily a mixture of water and ethyl
alcohol with small amount of other substances which impart the
characteristic odors and tastes. These substances are called "con-
geners" since they are simultaneously produced during the fer-
mentation process. The congeners consist of organic acids and
esters or even other types of alcohol. It is the congener content
that imparts the so called "odor of alcohol" among drinkers.
A drunkard is a person who habitually takes or uses any in-
toxicating alcoholic liquor and while under the influence of such,
or in consequence of the effect thereof, is either dangerous to
himself and to others, or is a cause of harm or serious annoyance
to his family or his affair, or ordinary proper conduct.
A habitual drunkard is one who excessively uses intoxicating
drink. Habit should be actual and confirmed, but it is not necessary
that it be continuous or of daily occurrence. It lessens individual
resistance to evil thought and undermines will power, making its
victim a potential evil doer. (People v. Amenamon, 37 O.G. No.
114, p. 2324).
Classification of Commercially Available Alcoholic Beverages:
1. Wine — A product of natural alcoholic fermentation with wide
variety of sugary materials including fruit juices and contains not
less than 7% but not more than 17% of alcohol by volume. In
fermented beverages the alcohol content is expressed in volume
percent.
687
a. Red Wine — The wine contains the extracted pigments from
the skin, stem and seed of the fermented fruit juice. The color
ranges from pale straw to pale pink.
b. White Wine — The product of fermentation of fruit juices only
after removal of the skin and stem. They are not really color-
less but impart a pale straw or green to gold or amber color.
c. Dry Wine — Wine wherein practically all the sugar contents
are fermented into alcohol.
d. Sweet Wine — Wine which contains not less than 1 gram of
sugar per 100 milliliter.
e. Still Wine — Wine in which fermentation has been completed
before bottling so that it contains only such properties of
carbon dioxide produced in the fermentation which can be dis-
solved in the liquid in equilibrium with air under conditions
of manipulation.
f. Sparkling Wine — Wine that is bottled before fermentation
has ceased so that it contains C O 2 gas in solution at greater
than atmospheric pressure. The wine may also be impregnated
with C O 2 b y allowing it t o undergo fermentation i n closed tanks
and bottling under pressure or by simply carbonating the bot-
tled wine under pressure.
g. Fortified Wine — Wine whose alcoholic contents are derived
partly from fermentation and partly from the addition of
distilled spirit. This includes cherries, port and vermouth.
h. Chinese Medicinal Wine — Wine which is a mixture of refined
alcohol and Chinese herbs and contains not less than 2 0 %
alcohol.
i. "Ztosi" — Composed of fermented juice of sugar with the
characteristic brown color, bitter taste and aroma imparted by
dried leaves, bark, twigs and flowers of a tree called "samak"
(Macaranga Tanarius).
j. "Lambanog" — Native wine produced by distillation of fer-
mented coconut sap ("tuba") and bottled at not less than
80% proof.
2. Distilled Liquor — Distilled liquors are alcoholic beverages pro-
duced from distillate of wines, distilled from grains or starch
solution or distillate from aromatic substances. In distilled beve-
rages the alcohol contents are expressed in proofs. "Proof" is
approximately twice the percentage of alcohol by volume.
The sole purpose of the distillation process is to increase the
concentration of alcohol in the finished product. This is neces-
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sary because fermentation ceases when the alcohol concentration
is approximately 12% to 14% by volume.
a. Whiskey — An alcoholic distillate from mass of cereal grains
or cereal grain products saccharified by the action of yeast
distilled at less than 74.7°C and aged at least three years and
may contain a flavoring of caramel.
b. Gin — The distilled product obtained from the original dis-
tillation of mash or by redistillation of distilled spirits with or
over juniper berries and may contain other aromatic botanical
substances or sugar.
c. Rum — A distilled alcoholic beverage prepared by fermen-
tation, distillation and aging of sugar cane products, e.g. sugar
cane juice, molasses. It is a yellow-brown liquor of fine bou-
quet and sweet, smooth alcoholic taste. It may contain caramel
and may be flavored with fruit or other flavoring from other
botanical substances.
d. Alcoholic Cordials and Liquors — These are distillates obtained
by mixing or redistillating neutral spirits, usually brandy, with
or over fruits, flowers, leaves, seeds or other botanical substances
or their juices or with extracts derived from infusion, perco-
lation or maceration of such botanical substances and to which
sugar or dextrose or both have been added in an amount not
less than 2.5% of the finished product and contain not less
than 23% of absolute alcohol by volume. These may also
contain natural or artificial coloring material.
e. Vodka — Distilled liquor from grain spirit, filtered through
activated carbon (charcoal) so as to render the product with-
out distinctive character, aroma or taste.
3. Malt Liquors — Alcoholic beverages brewed from malt or from a
mixture of malt and malt substitute, like rye, and may contain
other cereal grains and starchy saccharine matters. A charac-
teristic bitter flavor is imparted by the addition of hops. The
amount of alcohol need not be stated in the label.
a. Ale — a malt liquor brewed in such a manner as to possess the
aroma, taste and character commonly attributed to ale and shall
contain not less than 3.2% absolute alcohol. In its fermentation,
top yeasts are utilized instead of bottom yeasts the latter being
utilized in beer.
shall contain not less than 2% and not more than 10% by
volume of alcohol.
c. Stout — A malt liquor brewed in such a manner as to possess
the aroma, taste and character commonly attributed to stout
and, to a marked degree, the flavor of hops.
d. Porter — Malt liquor brewed in the manner used in brewing of
stout but having in comparison with stout a less marked flavor
of hops.
An alcoholic beverage shall possess the characteristic attributed
to the type of drink that is stated in the definition and standard of
identification. The preparation must be free from any ingredient
injurious to health, free from sediment of any kind, and shall be
manufactured in premises built and maintained under hygienic
condition.
Causes of Drinking Alcoholic Beverages:
1. Curiosity — Children prefer to experience the pleasant and un-
pleasant effects rather than being told.
2. It is being served as a symbol of friendship and sociability. Social
gathering with alcoholic beverages served becomes lively. Drinking
is a part of our culture.
3. As an escape from unpleasant realities, it suppresses inner tension,
deadens the pain of failure, frustration and anxieties.
4. Alcohol is a part of religious ceremonies.
5. As a stimulant to combat shyness, inferiorities and to suppress
strong inhibition.
6. It is a source of heat and energy. One gram of alcohol may yield
7 calories, by the process of oxidation. One ounce of 100 proof
whiskey may yield 100 calories.
Provisions of L a w Regarding Alcoholism:
1. Intoxication is an alternative circumstance to criminal liability:
Art. 15, Revised Penal Code — Their concept:
Alternative circumstances are those which must be taken into
consideration as aggravating or mitigating according to the nature
and effects of the crime and the other conditions attending its
commission. They are the relationship, intoxication, and the
degree of instruction and education of the offender.

b. Beer — The product of alcoholic fermentation of a mash in pota- The intoxication of the offender shall be taken into consider-
ble water of malted barley, hop and/or hop preparation with ation as a mitigating circumstance when the offender has com-
or without the addition of starchy and saccharine material and mitted a felony in a state of intoxication, if the same is not
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habitual or subsequent to the plan to commit said felony; but
when the intoxication is habitual or intentional it shall be con-
sidered as an aggravating circumstance.
1. Mitigating:
a. If intoxication is not habitual; or
b. If intoxication is not subsequent to the plan to commit the
felony.
2. Aggravating:
a. If intoxication is habitual; or
b. If intoxication is subsequent to the plan to commit the
felony.
2. Public scandal committed by a person while drunk is punishable:
To be drunk is not punishable, but if alarm and scandal happens
in a public place while at the state of intoxication, it is punishable.
Art. 155, Revised Penal Code — Alarms and scandals — The
penalty of arresto menor or fine not exceeding 200 pesos may be
imposed upon:
4. A n y person who while intoxicated or otherwise, shall
cause any disturbance or scandal in public places.
3. Contracts agreed to in a state of drunkenness are voidable-
Art. 1328, Civil Code:
Contracts entered into during a lucid interval are valid. Con-
tracts agreed to in a state of drunkenness or during a hypnotic
spell are voidable.
4. The law penalizing manufacture of liquor without license is valid:
If a person administers beverages to another which is injurious
to the latter without intent to kill, he is punished for his wrongful
act.
Art. 264, Revised Penal Code:
Administering injurious substances or beverages:
The penalties established in the next preceding article (arresto
mayor in its maximum period to prision correccional in its mini-
mum period) shall be applicable in the respective cases to any
person who, without intent to kill, shall inflict upon another any
serious physical injury, by knowingly administering to him any
injurious substances or beverages or by taking advantage of his
weakness of mind and credulity.
5. The state may prevent some people from drinking highly spirited
wine:
The state may promulgate laws which may prevent people of
lower degree of civilization from drinking scientifically manu-
factored, highly spirited liquor. The reason is to promote peace
and order.
The accused was prosecuted and convicted for violation of
Act 1639, which prohibits any native of the Philippine Islands,
who is a member of the non-Christian tribes to buy, receive, have
in possession, or drink any intoxicating liquor other than the
native wine or liquor which the tribe has been accustomed to
take. The accused attacks the legality of the law on the ground
that it denies him of the equal protection of tr^e law. H E L D :
Act 1639 is valid. The use of "non-Christian tribes" is not based
upon accident or birth or parentage but upon the degree of
civilization. The members of the non-Christian tribes have a
low degree of civilization. The purpose of the prohibition is to
insure peace and order in and among the people. It has been
experienced in the past that people of a lower degree of civili-
zation taking scientifically distilled wine with a high percentage
of alcohol resulted to lawlessness and crimes thereby hampering
the effort of the government to raise the standard of life and
civilization (People v. Cayat, 68 Phil. 12).
Absorption and Distribution of Alcohol:
Inasmuch as alcohol when ingested does not require digestion, it
is immediately absorbed in the walls of the stomach and duodenum.
The maximum period of absorption occurs thirty to sixty minutes
after the initial intake.
The rate of absorption of alcohol in the stomach and intestine
depends upon the following :
1. Concentration and total quantity of alcohol taken. The higher
the percentage of alcohol taken, the greater is the volume of
alcohol per unit of time. The greater the volume of alcohol
consumed will likewise enhance the absorption.
2. Nature of the food in the stomach and intestine. Fatty food
makes absorption slower as compared with sugar and other carbo-
hydrates and proteins.
3. Volume of gastric content — The presence of sufficient amount of
food and water in the stomach may delay the rate of absorption.
4. Diseased condition of the stomach and intestine. Achlorhydria,
gastric atony and chronic gastritis cause slower absorption, how-
ever subtotal gastrectomy or a gastroenterostomy may cause
abnormally early intoxication because of its early evacuation of
food to the duodenum where absorption is more rapid.
5. Length of time the gastric content is held in the stomach prior
to the opening of the pylorus and permeability of the stomach or
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intestinal wall. Warm drinks dilate gastric capillaries to cause
more absorption.
6. The optimum concentration of alcohol in beverages between 10
to 20% is the most rapidly absorbed.
After absorption, alcohol is distributed throughout the body in
proportion to the water contents. Parts of the body with more
water content (blood, urine, brain, liver, kidney) have the highest
concentration while those with low water contents (fat, bone) have
the lowest concentration.
Pharmacologic Effects of Alcohol:
Ethyl alcohol depresses the central nervous system in descending
order from the cerebral cortex to the medulla oblongata. It causes
depression or temporary functional paralysis of the ganglionic cells.
The more specialized the cells are, as in the cerebral cortex, the more
sensitive they are to alcohol. A moderate dose will cause disturbance
in the intellect and fine muscular movement, but bigger doses will
involve depression of the ganglion cells of the lower brain centers in
the basal ganglia and brain stem causing the person to be stuporous
and even comatose.
5. Smell — The perception of smell is depressed by alcohol. Mal-
odorous substances may be undetected by those under the in-
fluence of alcohol.
"Proprioception" or the so-called "sixth sense" is also impaired.
Blunting of judgment is one of the first mental functions affected
by alcohol. This leads to automobile accidents, poor business
decisions, gambling losses, fights and injuries.
The faculty of attention deteriorates rapidly and this is the prin-
cipal reason why individuals even with low level of alcohol end up
as traffic victims.
Motor skills are also impaired progressively with increasing amount
of blood alcohol. Reaction time is prolonged.
Ability to hear is blunted and recall memory is often markedly
disturbed.
Moral standard is blunted and lowered, and there is a tendency to
distort reality.
It increases the desire for sex but markedly impairs the perfor-
mance; a prolonged intercourse without ejaculation is often the
result (Legal Medicine Annual 1969, pp. 241-268).

Effects on the Special Senses: Other Effects:

1. Vision — With increasing amount of alcohol intake the acuity is
progressively diminished to the point where vision to obscure to a
degree comparable to wearing dark sunglasses at night. There is
diminution of the peripheral vision similar to that of a person
viewing an object by means of a binocular (tunnel vision), the
amount of blood alcohol is somewhere between 100 to 200 mg.,
ocular coordinator is impaired and diplopia develops.
2. Hearing — The increasing amount of alcohol intake diminishes the
ability of the individual to perceive and appreciate varying inten-
sities of sound. This is the very reason why in a drinking party at
the start of the drinking the conversation is in a low tone, but as
the alcohol level in the blood increases the group tends to talk
louder. This also accounts for the tendency of drivers not to per-
ceive the sound of horns and train whistles when intoxicated and
to become more prone to vehicular accidents.
3. Touch — The sense of touch is diminished with the increased
amount of alcohol intake. The blunting of touch sensation is
responsible for frequent cigarette burns on the hand of chronic
alcoholics.
4. Taste — There is a decrease in the sense of taste. When a person is
drunk, all food taste good.
1. Dilatation of the blood vessels of the cutaneous surface.
2. Increase in the pulse rate.
3. Weaker cardiac systole which tend to cause cardiac dilatation.
4. Locally, it has direct irritation effect on the mucous membrane
of the stomach and intestine.
5. Slight depression of the liver functions as indicated by the de-
crease in hepatic oxygen consumption and decrease in glycogen
storage.
6. Fall of the blood pressure.
Clinical Signs and Symptoms in Relation to Blood Alcohol Level:
Blood Alcohol Clinical Signs and Symptoms
10 mg % Pleasant clearing of the head.
20 mg %, Physical feeling of well-being.
50 mg % The individual feels on top of the world and has
the wisdom of Solomon and the talkativeness of
Senator Claghorn. Increased self-confidence;
decreased inhibitions; diminution of attention,
judgment, and control.
100 mg % The individual is intoxicated and "under the in-
fluence". Experts in the field believe that no
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innocent person would be convicted of being
"under the influence" if he had a blood alcohol
level of 100. Some mental confusion, incom-
petency; drowsiness; emotional instability; de-
creased inhibitions; loss of critical judgment;
impairment of memory and comprehension.
150 mg % At this level all individuals are intoxicated, and
deterioration in performance of acts of skill or
judgment are present.
150-300 mg % Somewhere between these figures all individuals
lose some degree of muscular coordination,
including the ability to walk properly and
coordinate other body movements. Disorien-
tation; mental confusion; dizziness; sensory
disturbances; deceased sense of pain; slurred
speech; exaggerated emotional (state of grief,
anger and fear).
300 mg % At this level most individuals become stuporous,
incoordinated, and may even lose sphincter
control. Apathy; general inertia; decreased
response to stimuli; impaired consciousness;
sleep or stupor.
400 mg % This is the anesthetic level. Alcohol is not a
good anesthetic because there is a narrow
margin between the anesthetic and the death
level. Death from alcohol per se may occur at
any level above 400 mg%. Complete uncons-
ciousness; coma; depressed or abolished reflexes;
embarrassment of circulation and respiration;
incontinence of urine and feces.
(From Legal Medicine Annual 1969, p. 254).
Symptomatic Changes Following Ingestion of Alcoholic Beverages:
Although human reaction varies from person to person, the
clinical signs and symptoms following ingestion of alcohol may be
divided into three stages, namely:
1. Stage of Excitement — This develops a few minutes after the
initial dose of alcoholic drink has been absorbed and has reached
the central nervous system. It is characterized by a feeling of well-
being and slight excitation. The actions, speech and emotion are
less strained. Self-confidence develops, as well as blunting of self-
criticism, self-consciousness and self-control.
It is the manifestation during this state that makes the people
entertain the erroneous belief that alcohol is a stimulant rather
than a depressant. Alcohol does not stimulate the brain centers
but rather "inhibits the inhibition" causing it to act freely with-
out constraints.
2. Stage of Incoordination or Confusion — As the effects of alcohol
become more pronounced, the nervous control of the body
gradually diminishes. There is blunting of all perceptive mecha-
nism. Muscular coordination is lost. The irritating effects of
alcohol, like nausea and vomiting, confusion, cardiac and res-
piratory symptoms appear.
3. Stage of Narcosis or Coma — The person passes into a deep sleep
and may only respond to strong stimuli. Pupils are dilated,
breathing is slow and stertorous, pupils are dilated and reflexes,
abolished. Death may ensue from paralysis of the cardiac or
respiratory center.
Degree of Intoxication:
1. Slight Inebriation — There is flushing of the face, with exaggerated
mood, but a person is able to control his behavior. He shows no
signs of mental impairment, incoordination of movement and
difficulty of speech.
2. Moderate Inebriation — Person is talkative, argumentative and
over-confident. There is slight impairment of mental faculties,
difficulty of articulation, and loss of coordination to finer move-
ments. The face is flushed with eyeballs congested. He is reckless
and shows motor incoordination. He may be certified as being
"under the influence of alcohol".
3. Drunk — The mind is confused, behavior is irregular and move-
ment is uncontrolled. The speech is thick and incoordinated.
Behavior is uncontrollable.
4. Very Drunk, "Dead drunk" — The mind is confused and dis-
oriented. There is difficulty in speech and marked motor incoor-
dination and often walking is impossible.
5. Coma — The subject is stuporous or comatose. Sometimes it is
difficult to differentiate this condition with others having coma.
Diagnostic Points of Drunkenness:
1. Alcoholic smell of the breath or of the vomitus.
2. Dry furred tongue or with excessive salivation.
3. Irregular behavior.
4. Congestion of the conjunctivae.
5. Hesitancy or thickness of speech with impaired articulation.
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6. Tremor or error of coordination and orientation.
7. Examination of the blood and the urine shows the presence of
alcohol.
8. History of having taken alcoholic beverages.
Physical Tests to Determine Drunkenness:
1. Romberg's test — Let the subject stand straight with heels together
and with closed eyes for at least one minute. If he is not drunk,
he will not sway to the front or to the sides, but if he is drunk the
body will not be stable in the absence of any existing disease.
2. Let the subject stand straight with one foot ahead of the other so
that the toes of one foot touch the heel of the other. This will
remove the brace to prevent side sway. If drunk, there is more
likelihood that the subject will sway sidewise and fall. The test is
repeated after the subject is free from the effect of alcohol and
make a comparison of stability.
3. Let the subject sit comfortably in a desk and get samples of his
handwriting. Compare these writings, with those taken when he
is free from the effects of alcohol.
4. Let the subject bend down and pick up a small object from the
floor. If he stumbles, then his nervous system is not stable and
that he may be drunk.
5. Let the subject walk straight forward to a comer of a room and
rapidly turn around without stopping. Tell him to walk back.
Y o u will notice that the subject may have uncertainty of steps,
side steps, or he staggers while making the turn and in walking.
Conditions Simulating Alcoholic .Intoxication:
1. Severe head injuries.
2. Metabolic disorders — e.g. hypoglycemia, diabetes precoma,
uremia, hyperthyroidism.
3. Neurological conditions associated with dysarthria, ataxia, tremor,
drowsiness — e.g., disseminated sclerosis, intracranial tumors,
Parkinson's disease, epilepsy, acute aural vertigo.
4. The effect of a drug is unlikely to be confused with the effect of
alcohol unless the drug has been taken for the first time and has
produced an unexpected reaction, or unless it has been in an un-
usually large dose. (Some drugs whose effects simulate alcoholic
intoxication are: insulin; the barbiturates; most of the antihis-
tamine group of drugs; morphine; the new analgesics which tend
to cause giddiness; certain drugs used in the treatment of asthma —
e.g. remedies containing atropine; drugs used in the treatment of in-
voluntary movement — e.g. hyoscine.)
5. Certain pre-existing psychological disorder — e.g. hypomania,
general paresis.
6. Prodromata of cerebral vascular emergencies, which may show
themselves as confusional states, amnesia, or aphasia. The history
may enable the doctor to settle any doubt.
7. High fever.
8. Exposure to carbon monoxide in sufficient concentration to give
significant anoxemia.
(Taylor's Principles and Practice of Medicine Jurisprudence by K.
Simpson, 12th ed.. Vol. 2, p. 392).
On account of a number of conditions simulating the condition of
intoxication, a physician must exercise due care and diligence in the
history taking, physical examination and in the observation of the
signs and symptoms coupled with appropriate and available labora-
tory examination before the diagnosis of drunkenness is entertained.
A patient became nauseated while driving his car and got out to
vomit. A passing policeman arrested him for drunkenness. He
went into a spasm in the cell and the defendant physician was
called and saw the patient twice for five minutes each time. He
adviced the policeman that the man was drunk. The patient died
a few hours.
An autopsy revealed that there was no alcohol in his blood and
that he had coronary occlusion. The court found that a cause of
action in the widow's complain properly pointed out that cursory
examination fell below the reasonable standard of due care (John-
son v. Borland, 26 NW 2d 755, Mich. 1947).
Relation of the Blood Alcohol Level to the Degree of Intoxication:
1. Persons with blood alcohol below 0.05% are not considered
intoxicated.
2. The majority of persons (80-90%) with blood alcohol levels
between 0.1% and 0.15% will have their faculties so impaired
as to render them unfit to drive motor cars with reasonable
safety.
3. The majority of young people who are not habitual drinkers will
be intoxicated to the extent of staggering when the blood level is
about 0.15%.
4. The majority of all persons (80-90%) including habitual drinkers
will be intoxicated to the extent of staggering when the blood
alcohol level is approximately 0.2%.
5. The majority of persons will be in a coma when the blood alcohol
level is approximately 0.5%
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The American Medical Association and the National Safety Council Conversely, the amount of alcohol consumed may be determined
of the United States recommended the following presumptive from the blood alcohol concentration by applying the Widmarks
limits of intoxication: formula, as follows:

1. Persons who have 0.05% alcohol or less in their blood are pre-
sumed to be uninfluenced by an alcohol.
2. Persons who have 0.05% to 0.10% alcohol in the blood are con-
sidered to possibly be under the influence of alcohol.
3. Blood alcohol level of 0.10% to 0.15% or more gives rise to the
presumption that the person is drunk.
The percentages of alcohol in the blood and in the urine are, on
the average, parallel so that the determination of alcohol level in
the urine will indicate the amount of alcohol in the blood.
Amount of alcoholic beverage consumption to reach the level of
0.15% or higher:
As a general rule, it is not the quantity of alcohol consumed that
determines the degree of intoxication, although there is an existing
relationship, but rather the amount that actually gets into the blood
stream. It may require many times more alcohol to raise the blood
level in an individual to a given point than is required for another
individual. Likewise, it may take more alcohol to raise the blood
alcohol in the same individual to a given point on different occasions.
It has been found that the blood alcohol level of 0.15% or higher
is considered definitely intoxicating, and to have such concentration
in the blood will depend on the alcoholic beverage taken.
The following are among the alcoholic beverages consumed
necessary to bring its level to 0.15% in the blood:
1. Whiskey (distilled spirit) — It requires the consumption of 8 oz.of
whiskey to bring a blood level of 0.15%. The body eliminates
about 1 oz. of whiskey per hour. Thus, if a person were to drink
over a period of three hours, he would have consumed 11 oz. of
whiskey to reach and maintain a blood level of 0.15%.
2. Wine (fermented spirit) — Wine with 20% alcohol requires 16 oz.
to cause intoxication. The body eliminates 2 oz. per hour for
every hour spent in the consumption of the wine in order to reach
the level of 0.15%.
3. Beer (malt liquor) — With beer containing 3.7% by weight of
alcohol, the amount required is 80 oz. plus 10 oz. for every hour
spent in the consumption.
The above consideration is dependent on the proof of the case of
distilled spirit or the percent by volume in wine and beer, of a certain
specific beverage manufacturer, actually contained in the bottle.
Ounces of Blood alcohol
„. . . * , u i body weight x 0.68 x concentration
Fluid ounces of alcohol =
0.8
For a quick and easy consolidation of the formula the following
may be used: 13.6 x weight in pounds x concentration of blood
alcohol = minimum fluid ounces of pure alcohol (200 proof) to
achieve the blood concentration. Double this and one has the fluid
ounces equivalent to 100-proof whiskey.
(Modern Legal Medicine, Psychiatry and Forensic Science by Curran,
McGarry and Petty, p. 316).
Factors Responsible for the Tolerance and Susceptibility to Alcohol:
1. Tolerance to Alcohol:
T w o or more persons of the same age, sex, weight and environ-
mental up-bringing may react differently to alcohol. One may be
tolerant while others may be sensitive.
Tolerance of a person to alcohol may be a result of two different
factors namely:
a. Consumption Tolerance — A person who has developed tole-
rance may have lesser percentage of blood alcohol as compared
with another person who is not used to it when given the same
quantity at the same time. The reason is that those habituated
eliminate faster as compared with non-habitual drinkers.
b. Constitutional Tolerance — If a person habitually drinks alco-
holic beverages there develops a certain degree of adaptation by
the body, thereby increasing the body threshold to it. Later,
greater quantity and percentage will be tolerated and will lead
to the diminution of its effects.
2. Susceptibility to Alcohol:
The following factors render a subject unduly susceptible to the
effects of alcohol:
a. Exposure to extreme cold; or fatigue.
b. Pre-existing post-concussional state.
c. Chronic cerebral vascular state — e.g. hypertension, advanced
cerebral arteriosclerosis.
d. Cerebral depression caused by drugs, like barbiturates.
e. Neurological disorders, like disseminated sclerosis, intracranial
tumor.
f. Psychological disorders.
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H o w Alcohol Influences the Production of Trauma:
Alcohol enhances the production of trauma in the following ways:
1. Alcohol increases the irritability and decreases the sense of res-
ponsibility of a person which, in effect, may cause him to become
involved in quarrels or accidents.
2. If a person is under the influence of alcohol, the anesthetic effect
of alcohol may obscure pain and other symptoms of injury so that
serious trauma may be overlooked.
3. Alcohol, being a depressant, renders the individual susceptible to
the effects of traumatic shock or hemorrhage.
(Legal Medicine, Pathology and Toxicology by Gonzales, Vance,
Helpern and Umberger, 2nd ed., p. 183).
H o w Alcohol Diminishes the Driving Skill:
The basic of the maxim that "Don't drive when drunk and don't
drink when driving" is that alcohol deteriorates the driving skill in
the following ways:
1. It increases the reaction time. The driver becomes sluggish in his
reaction in an impending danger.
2. It creates a false feeling of confidence.
3. It impairs concentration, dulls judgment and degrades muscular
coordination.
4. It decreases visual and auditory acuity.
(Pathology of Homicide by Adelson, p. 910).
Fate of Alcohol in the Body:
After absorption of alcohol in the alimentary tract, it reaches the
liver by way of the portal circulation. It is then eliminated from the
body through two mechanisms, namely:
1. Oxidation — Approximately 90% of the blood alcohol is meta-
bolized by the enzyme Alcohol Dihydrogenase ( A D H ) and the co-
enzyme Nicotinamide-adenine Dinucleotide ( N A D ) into aldehyde
and acetate and finally converted into carbon dioxide and water. A
major portion of the process occurs in the liver although it may
occur in other parts of the body inasmuch as A D H is also present
in the kidney and retina from birth. This is the basis of enzymatic
method of alcohol determination on body fluid.
2. Excretion — The remaining portion of the blood alcohol (approxi-
mately less than 10%) remains as such excreted through the urine,
lungs, saliva and perspiration.
During the early period of the drinking, blood alcohol con-
centration is more than that of urine alcohol concentration.
When the blood alcohol level is stabilized, the blood level is
almost the same as that of the urine alcohol level. However,
at the period after termination of the drinking, the urine alcohol
level is higher than the blood alcohol level.
The elimination of alcohol through the alveolar sacs follows
the physical phenomena of diffusion. The amount of alcohol
in the breath is proportional to the concentration of alcohol
in the blood.
The rate of elimination of alcohol varies in different individ-
uals. As a general rule, a person of average weight (150 lbs.)
eliminates approximately 10 cc. of alcohol per hour.
Causes of Death in Alcoholics:
1. Acute Alcoholic Intoxication:
a. Paralysis of the medullary center — Alcohol depresses the
nervous system by affecting the cerebral cortex, basal ganglia,
cerebellum, and finally the brain stem and medulla.
b. Cardiac myopathy — The heart muscles may suffer direct
damage from the high concentration of blood alcohol.
c. Ingestion of alcohol and synergistic drugs, like barbiturates and
tranquilizers may cause fatality. Potentiation of alcohol by
psychotrophic drugs has been reported to have caused death.
A blood level of 0.45% or greater is generally accepted as a fatal
level, although death has occurred at a level below 0.35%.
2. Hidden Trauma:
Alcoholics are prone to be victims of traffic accidents or other
traumatic injuries. Acute intoxication produces considerable
analgesia and may deceptively conceal physical injuries. They may
suffer from subdural hematoma, brain concussion or abdominal
injuries which may be considered symptoms of drunkenness.
3. Unexpected Aspiration of Food ("Cafe Coronary"):
Aspiration of food into the respiratory passage may cause
severe asphyxia. The sudden death in this case is characterized by
the rapid onset of shortness of breath, choking on mealtime or
vomiting and the presence of food particles on the respiratory
system on post-mortem examination.
4. Poisoning by Congener or Contaminants in Alcoholic Beverages:
Alcoholic beverages may accidentally contain toxic substances
which may cause injury or death of the drinker. There is a wide
variety of impurities that may be found but the following con-
taminants in bootleg liquors are quite common:
a. Methyl Alcohol (CH OH, Methanol,
3 Wood Alcohol) - The
mechanism of methanol poisoning is its conversion to formal-
dehyde and formic acid which consequently causes acidosis.
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In the eye, it may cause blindness. The symptoms start as
photophobia, followed by blurred vision to permanent blind-
ness. This is due to the action of the poison on the ganglionic
cells of the retina with subsequent atrophy of the optic nerve.
If blindness is not total, there is considerable contraction of
the field of vision and an impairment of the color sense.
b. Isopropyl Alcohol (Rubbing Alcohol) — The compound is
converted in the body to acetone and excreted as such. Ace-
tone is excreted through the lungs and produces hemorrhagic
tracheobronchitis, bronchopneumonia and hemorrhagic pul-
monary edema. It also causes lower nephron nephrosis, hemo-
globinuria, fatty changes in the liver, respiratory paralysis and
death.
c. Ethylene glycol and/or Diethylene glycol — Either or both are
present in industrial antifreeze mixture but may become con-
taminant to the alcoholic beverages.
Ethylene glycol is marked central nervous system depressant
and is oxidized in the body to toxic oxalic acid. The oxalic acid
crystals plug the excretory tubules of the kidneys causing
marked functional impairment and nephrosis. In the brain it
may cause chemical meningitis and meningoencephalitis.
Diethylene glycol is also a central nervous depressant and
causes centrolobular hydropic degeneration and necrosis of the
liver as well as bilateral cortical necrosis.
5. Diseases Associated with/or as a Complication of Alcoholism:
The most frequent effect of continuous consumption of alcohol
is that the development of fatty liver may ultimately become a
condition of cirrhosis. A cirrhotic liver may cause rupture of the
esophageal varices.
Alcoholism may also cause hemorrhagic pancreatitis, broncho-
pneumonia and development of other infectious diseases.
An alcoholic who is suddenly withdrawn from alcohol may
suffer a state of excitement with hallucination known as delirium
tremens. It is characterized by an attack of acute insanity with
sleeplessness, marked tremors, excitement, fear and sometimes
with strong suicidal tendencies.
An alcoholic may develop Korsakow's psychosis. It is a syn-
drome characterized by hallucination, disorientation and multiple
neuritis, and the loss of memory for recent events. Cortical
atrophy is the main alteration grossly observed in fatal cases.
Alcoholic Polyneuritis may also develop as a complication of
alcoholism. There is a combined degeneration of the nerve fibers
and myelin sheaths.
Post-mortem Findings in Death Due to Alcoholism:
Gross post-mortem findings are not characteristic. Most often the
pathological findings were associated with or have developed a
complication of alcoholism that had been observed. However, the
following are some of the most common findings:
1. Presence of "alcoholic odor" of the stomach contents. The odor
emitted is not due to alcohol but most often to that of the con-
gener.
2. Congestion of the mucosa of the stomach.
3. Congestion of brain and its meninges.
4. Heart may be dilated and flabby and lungs congested and frothy,
otherwise normal.
5. Blood, alveolar air and urine examinations reveal the presence of
alcohol.
Pathological Drunkenness:
A condition wherein a small amount of alcohol intake may be
sufficient to make a person drunk on account of an existing patho-
logical condition of the body. Brain concussion, sun-stroke, epilepsy
and other conditions may predispose a person to the effects of
alcohol.
Punch Drunkenness:
This is not a condition of drunkenness. It may be observed
among professional boxers who may have developed a peculiar
physical and mental condition on account of repeated trauma on the
head. The individual begins to have lack of concentration. He may
change the subject-matter of a conversation abruptly and may ask
the same question for several times. He has a bad memory of recent
events. He is not too sociable, garrulous and boastful but rather timid
and shy. His articulation may be glazed and slurring. Romberg's sign
may be positive and locomotion may be ataxic and unsteady. In-
voluntary movement of a boxic nature may be present. He simulates
continuously a person who is drunk.
Laboratory Examination in Alcoholism:
For the qualitative and quantitative determination of alcohol,
blood, urine and respired air may be used from a living subject.
Blood preferably extracted from the heart, and urine taken directly
from the urinary bladder may be used to determine the presence of
alcohol in the dead.
The legal issue confronting physicians in the taking of specimens
of blood, urine and breath has been resolved in the decision of the
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U.S. Supreme Court in the case of Schmerber v. California (34 U.S.
757, 16 L. Ed. 908) where it was held that:
1. There was no violation of the defendant's constitutional privilege
against self-incrimination because the privilege applies only to
testimonial compulsion and does not apply to the taking of
physical evidence from an accused.
2. The taking of a blood specimen by a physician in a simple medical-
ly acceptable manner of a hospital environment was not brutal
and offensive.
It did not constitute a violation of the due process clause of
the constitution.
3. The taking of a blood specimen under such circumstances, despite
the fact that the accused had objected and protested because his
lawyer had advised him not to submit to any chemical test, did
not deprive him of his constitutional right to counsel. The fact that
his counsel had erroneously advised him that he could assert
his privilege against self-incrimination with respect to a chemical
test did not give him any greater rights to which he was entitled.
1. Analysis of Blood:
Analysis of the blood is probably the most widely accepted
way to determine the concentration of alcohol in the body.
It is a direct method of estimation although the subject may
refuse blood extraction for such analysis.
Alcohol should not be used to sterilize the skin before with-
drawal for it might possibly give a false high reading. The blood
sample must be drawn by a physician, nurse or other competent
technician under sterile condition. On account of the great
number to be tested, especially those traffic violators, it makes
the blood analysis quite impractical.
2. Analysis of the Breath:
The concentration of alcohol in the blood can be determined
indirectly by making a quantitative determination of alcohol in
the respired air. The basis of the analysis is that there is a constant
ratio between the concentration of alcohol in the blood stream
and in the alveolar air.
Gms. of Alcohol in breath x 2
Percentage of blood alcohol =
Gms. of Carbon dioxide x 100

4. While the taking of breath or bodily fluid specimens from an
accused for the purpose of analysis to determine blood alcohol
concentration does come within the scope of the constitutional
protection against unreasonable searches, the accused had been
lawfully arrested before the blood specimen has been withdrawn.
Under these circumstances the withdrawal was reasonable as an
incident to a lawful arrest.
Withdrawal of Blood from a Dead Body Cannot be a Ground for
Civil Damage:
A man was killed in an automobile accident. Because there was
a reasonable cause to believe that he had been driving while in-
toxicated, the policeman in charge of the investigation asked the
embalmer to draw a blood sample prior to the embalming of the
body. The embalmer complied with the request. There was a very
high alcohol level in the blood. The test result was admitted in
evidence in suits brought by others injured in the accident against
the driver's estate and they were awarded very substantial damages.
The widow sued the embalmer for mental anquish for his disturbance
of her husband's body. The court dismissed her complaint, holding
that removal of blood did not disfigure the corpse, thus, she had
no cause to a legal action (Hazelwood v. Stokes 483 SW 2d 576, Ky
1972).
3. Analysis of the Urine:
Urine as a specimen for alcohol determination has not gained
widespread use because of variability in the different periods of
alcohol intake.
4. Analysis of Body Tissue:
This method is applicable in death cases. Examination of the
brain for its alcohol content is a reliable diagnostic procedure.
Other bloody organs like the liver, spleen, kidney may also be
examined for alcohol contents.
5. Analysis of Saliva, Perspiration and Spinal Fluid:
Although it may be done, examination of these fluids is seldom
done.
Objectives of Alcohol Examination:
1. For Screening — This is done to determine whether alcohol is
present in the sample. The sample may be blood, urine, saliva,
vitreous humor, stomach content or respired air (alveolar air).
The instrument and the procedures must be simple for an or-
dinary layman or a police officer to perform the job. The ap-
paratus must be portable so that the result will be available in the
shortest possible time. The apparatus may be placed in a mobile
laboratory for the purpose of screening drivers of motor vehicles.
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ALCOHOLISM 707 708 LEGAL MEDICINE
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Insofar as breath alcohol determination is concerned, the follow- Withdrawal of Blood for Alcohol Determination N o t Giving Evidence
ing are the available instruments. Against the Defendant:
Withdrawal of blood from a person suspiciously drunk to deter-
Device & Method of Indicator mine the alcohol concentration in the blood is not self-incriminatory.
Manufacturer Detection Response The act is purely mechanical and it does not utilize the mental
faculties of the subject.
Alcolyzer Chromate salt in acid Color Change
The defendant having been convicted of causing a death by
(Intoximeters, Inc.) Orange-yellow
driving an automobile while under the influence of intoxicating
to green
liquor, appealed to the Supreme Court of Colorado.
Bect-ton-D ickenson Chromate salt in acid Color change
(Becton-Dickenson) Orange-yellow to The defendant contented on appeal that he was required to
green give evidence against himself by the admission of the result of a
test of blood to determine the alcoholic content. H E L D : The
Kitigawa Drunk-O- Chromic Acid Color change
original intent of the constitutional provision was to prevent the
Tester Orange-yellow to
defendant being forced to give testimonial evidence against him-
( K o m o Chemical blue-gray
self and did not contemplate the exclusion of evidence of physical
Industrial Company) facts relating to the defendant. The defendant is not deprived of
Sober-Meters SM-1, Chromate salt in acid Color change any of his constitutional right by the admission of the testimony
SM-6 SM-9 and SM-9A Orange-yellow to here in question. He is not compelled to testify against himself
(Luckey Laboratories) green (Block v. People, 240 p. (2d) Colo. 1951).
Alco-Halt Catalytic combustion Lights-pass or fail
(Mine Safety Appliance Chemical Test for Intoxication Admissible in Evidence:
Co.) A n y chemical test for alcohol to determine whether a person is
Catalytic combustion Pointer-warn under the influence of alcohol is admissible as evidence in court.
Bat III or
The tendency of our modern court is to accept scientific methods
(Century Systems, fail
in crime detection provided that it has gone beyond the experi-
Inc.)
mental stage and has already been perfected.
A . L . E . R . T . , Model Taguchi Mos Conduc- Lights-Pass, warn
The defendant was charged with the offense of driving his
J3A (Alcohol Counter tor or fail
automobile when drunk and was found guilty by a jury in the trial
Measures, Inc.)
court. He appealed to the criminal court of appeals of Oklahoma.
Alco-Sensor Fuel cell Lights-Pass, warn
(Intoximeters, Inc.) or fail The defendant contented that the drunkometer and urine
analysis tests for the determination whether the defendant was
Alco-Sensor II Fuel cell Digital readout
under the influence of intoxicating liquor have not gained such
(Tntoximeters, Inc.)
scientific standing for infallibility as to justify admission of the
(Forensic Science Handbook by Richard Saferstein, p. 626). expert testimony on it. H E L D : The court is of the opinion that
2. For Evidentiary Purpose — If in the screening process the sample we should favor the adoption of scientific methods for crime
had a positive result, the next procedure to be applied is the detection, where the demonstrated accuracy and reliability has
determination of the quantity of alcohol. The report is to be become established and recognized. Justice is truth in action, and
submitted in connection with such examination to be used as an any instrumentality that aid justice in the ascertainment of truth
evidence as to the presence and actual amount of alcohol in the should be embraced without delay. We believed that chemical
submitted specimen. The procedure requires the use of precision tests of such body fluids as blood, urine, breath, spinal fluid gained
instrument and should be performed in a regular chemical labora- that scientific recognition for infallibility as to be admissible in
tory. evidence.
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Methods Used in Alcohol Detection:
At present there are many kinds of apparatus perfected and
laboratory procedures adopted in alcohol detection, but these
different methods are actually based on any of the following princi-
ples:
1. Chemical Method — The sample is distilled and later allowed to
react with a known quantity of oxides, usually chromate, and it
determines the amount of chromate which has not reacted to
alcohol. By computation the amount of alcohol in the sample can
be determined.
This is the principle involved in the use of breath alcohol deter-
mination with the use of Alco-tester (500), Breath analyzer
(900A, 1000) and Alcometer ( A E - D 1 ) .
2. Enzymatic Method — A known quantity of purified alcohol
dehydrogenase and its coenzyme nicotamide adenine nucleotide
( N A D ) is allowed to react to the sample. Alcohol is oxidized to
aldehyde the coenzyme nicotinamide adenine dinucleotide ( N A D ) ,
and this can be measured colorimetrically or spectophotometrically.
The dipstick method or quick quantification of ethanol in the
body fluid is based on this principle:
"A quarter-inch cellulose pad at one end of the strip is impreg-
nated with a buffered solution containing yeast alcohol dehydro-
genase ( A D H ) , nicotinamide — adenine dinucleotide, pyrazole
iodonitrotetrazolium chloride ( I N T ) and deaphorase. When the
strip is dipped into saliva, urine or serum that contains ethanol,
it turns various shades of pink instantly because of a reaction
between, on the one hand, the N A D H that is produced and, on
the other, diaphorase and I N T . on the other. The amount of
ethanol present can be quantitated by comparison with a color
chart.
By this method, ethanol concentrations in body fluids can be
measured in only 60 seconds, a considerable savings in the time
over methods that require the delivery of a sample to a laboratory
plus testing time. In an emergency situation in which the patient
cannot be tested by breath analysis, this is an obvious advantage
(JAMA, Vol. 250, No. 13, Oct. 7, 1983).
3. Gas Chromatographic Method — The specimen may be first
purified or injected directly to the apparatus.
4. Infrared Absorption Method — Alcohol is present as a vapor in
breath. It absorbs specific wave lengths of infrared. An intoxi-
lyzer measures alcohol by detecting the decrease in the intensity
of infrared energy as it passes through the cell.
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Effect of Delayed Examination or Putrefaction of Sample:
To have an accurate determination as to the quantity of alcohol in
a specimen, immediate examination must be done. Fermentation of
the alcohol present may take place and transforms it to acetaldehyde
and ultimately to carbon dioxide and water. The sugar and other
forms of carbohydrates and protein in the sample may also go
through the action of enzymes, bacteria and fungi acting singly or
in a combination that may be transformed into alcohol. The alcohol
to be oxidized to form carbon dioxide and water is comparatively
very much less than the amount of carbohydrates and protein
material to be transformed into alcohol. Consequently, the longer
the time interval between extraction and examination, the more it
increases the alcohol contents of the sample. This condition is also
true when extraction of body fluid is done a long time after death.
"It, nevertheless, is worthwhile to do an alcohol analysis in such
putrid sample despite the fact that it will not give a true picture of
the state of intoxication of the deceased at the time of death. Al-
cohol concentration in excess of 0.20% would indicate alcohol
consumption prior to death, while levels below 0.20% may be
ascribed to possible putrefactive alcohol production" (Medico-
Legal Investigation of Death by Spitz and Fisher, p. 482).
Societal Reaction to the Problem of Alcoholism:
1. Promulgation of laws and regulations:
a. Manufacturing of liquor only to a certain percentage of alcohol
in beverages.
b. Restricting the time and place of drinking and the availability of
liquor to a particular age, sex and other socio-economic group.
c. Subjecting drivers at random to an alcohol screening test, and if
found positive, it is to be followed by a quantitative deter-
mination of blood alcohol. If blood alcohol exceeds the maxi-
mum tolerable limit prescribed, the driver can be arrested.
2. Various indoctrination methods may be employed to encourage
moderation or abstinence, like education in schools and churches.
3. An institutional-organization approach, introduces substitute form
of tension relief into the social structure. Subsequent removal of
the cause of tension and diverting attention to something else can
also be looked into.
4. A variety of therapeutic approaches are taken under the concept
that an alcoholic is a patient:
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Chapter XXXIV

MEDICO-LEGAL ASPECT OF POISONING

Definition of Poison:
A poison is anything other than physical agencies which is capable
of destroying life, either by chemical action on the tissues of the
living body, or by physiological action by absorption into the living
system.
Legally, a poison is a substance which, if applied or administered
internally, has been applied or administered with the intention to kill
or to do harm.
The intent in the administration is the essential element in law.
The quantity does not affect culpability, nor is the law concerned
with the quantity in which the substance acts.
(From: A Synopsis of Forensic Medicine & Toxicology by E. W.
ALCOHOLISM 711 Caryl Thomas, 2nd ed., p. 142).

In cases of suspected poisoning, it is not advisable to confine the

a. Therapy combines medicine with psychiatry, psychology, social
case work and alcoholic anonymous.
b. Pastoral counseling are given in churches.
c. Half-way houses are built to bridge the gap between the penal
institution and the community.
toxicological analysis to the stomach and its contents because:
1. The gastrointestinal tract is only one of the means of entry of
poison into the body. It is possible for poisonous substances to
gain entry by inhalation, by absorption through the skin, by in-
travenous, intramuscular and subcutaneous injection, or by intro-
duction into the vagina or rectum. Analysis of the gastric content
would not eliminate poisoning as a factor when poison gains
entrance into the body via other route.
2. Even if the poison was taken orally, after a significant period of
time (4 to 6 hours) has elapsed from ingestion to death, the
poison might have passed out of the stomach and could no longer
be present in identifiable amount.
3. If analysis of the gastric contents disclosed presence of possible
toxic substance, it is possible that the said poison could have been
introduced post-mortem to conceal the real cause of death.
4. Except in cases of poisoning by strong corrosive agent, there must
be a demonstration of absorption of the poisonous agent. This
can be shown by the presence of the toxic materials in other
organs or parts of the body.

712
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3. Both Local and Remote:

Site of Action of Poison:
The poison may act at the site of application and in some dis-
1. Local Action:
tant place.
The poison may act on the skin or on the mucous membrane or
Example: Carbolic acid is an irritant to the alimentary tract and
on any part of the body where it is applied. also toxic when absorbed.
Example: Sulfuric acid.
Condition of the cadaver when the organs or other tissues are
2. Remote Action: removed which makes the examination difficult or the result mean-
The poison may act remotely in any of the following ways: ingless:
a. By the production of shock. 1. Embalming: — A dead body must be autopsied and organs and
Example: Poisoning by strong acid. other tissues saved for toxicological analysis before embalming
because:
b. By absorption into the blood and being carried to the organs
they affect. a. Fixation of tissues by formaldehyde makes them more resistant
to the action of organic solvents used for the extraction of non-
Example: Morphine is absorbed by the blood and carried to the
volatile organic substances, such as most drugs, leading to low
brain and depresses it.
recovery of these substances.
c. By transmission through the nerves of local parts affected going
b. It is extremely difficult, if not impossible, to detect and identify
to the nerve centers and then reflected to the organs on which
most volatile poisons. Cyanide, for example, reacts chemically
they act.
with formaldehyde so that it is no longer identifiable in an
Site of Remote Actions of the Different Poisons are: embalmed body.
a. On the Brain: c. Many embalming fluids contain methyl alcohol or ethyl alcohol
Narcotics, alcohols, cerebral stimulants like caffeine. or both so that analysis of these substances is rendered meaning-
less.
b. On the Cord:
Strychnine. 2. Putrefaction:
c. On the Peripheral Nerves: a. Most volatile compounds are lost as a result of putrefaction.
Conium, curare. b. Putrefaction of normal tissue components may produce sub-
d. On the Alimentary Tract*. stances which yield chemical reactions similar to those obtained
Corrosives. from toxic compounds.
c. Some substances, like alcohol and cyanide, may be produced
e. On the Kidneys:
in the process of putrefaction of normal components.
Cantharides.
d. Many substances which might be present in the tissue may
f. On the Salivary Glands:
undergo chemical changes and may no longer respond to the
Mercury.
identifying test made for them.
g. On the Liver:
Phosphorus. Minimum Amount of Autopsy Specimens for Toxicological Exa-
h. On the Mucous Membrane: mination:
Arsenic 1. Brain — One hemisphere
i. On the Heart: 2. Liver — 500 gms.
Digitalis, 3. Kidney — One whole kidney
4. Stomach content — 50 gms.
j. On the Blood Vessels:
5. Spleen — Whole spleen
Ergot, nitrites,
6. Urine — All avilable up to 100 cc.
k. On the Blood Cells: 7. Blood — 100 cc.
Snake venom. 8. Bile — AH available
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Recommended Organs to be Saved for Suspicious Poisoning 2. Idiosyncrasy:

Poison to be Tested Organs to be Submitted Some persons possess sensitivity to certain foods or drugs. The
most common drugs are potassium iodide, arsenical preparations,
1. Arsenic (Acute poisoning) Liver, kidney, stomach contents
aspirin and the sulfas. As to foods, the most common are fish,
2. Arsenic (Chronic poisoning) Liver, urine, hair
shrimps, eggs and oysters.
3. Alcohol Blood, liver, kidney, urine, brain
3. Age:
4. Cyanide or H C N Stomach and liver
5. Carbon monoxide Blood placed in a sealed container There are substances which are considered poison for babies but
6. Alkali Stomach and contents, esophagus wholesome for adults, while the opposite is true for other sub-
stances.
7. Morphine and other Stomach and contents, liver, urine
alkaloids There are substances which children can take more than the
8. Barbiturates Brain, liver, kidney, urine proportionate dose in adults, like mercury and belladonna. In case
of some other drugs, children may be so sensitive that they cannot
9. Phosphorus Stomach, liver, kidney
take the proportionate dose for their age, like opium preparations.
10. Lead Kidney, liver, bone
11. Phenol Liver, kidney, stomach 4. Habit:
12. Pesticide (insecticide) Stomach and contents, liver, blood The body may acquire tolerance to some drugs. Habit diminishes
13. Antibiotic Liver, blood the effect of certain poisons. Tobacco, alcohol, opium, barbi-
14. Kerosene, gasoline Brain, liver, lungs, blood turates, arsenic are good examples of this.
5. Dose:
Circumstances Affecting Action of Poison:
The effect of drugs and poisons in the body is usually propor-
1. Method of Administration:
tional to the dose taken.
Poisons may enter the body in the following ways:
Example: Alcohol, when taken in small dose, stimulates body
a. Orally: reflexes and tone, while large amount depressed the
Except irritants and corrosives, poisons must be digested or whole body.
absorbed in the gastric or intestinal mucosa before producing
effect. Fatal Dose:
b. Hypodermically: This is the smallest dose known to cause death: not the
Poison reaches the blood stream without passing the digestive smallest amount which will certainly cause death.
organs. This method is only available for such substances that
are soluble in the lymph and tissue juices. Guide in Detennining the Single Dose of Drugs Suitable for
Children:
c. Intramuscularly:
Clark's Rule:
Absorption is faster than in the hypodermic method.
Divide the weight of the child in pounds by the average weight
d. Endodermically: of the adult (150 lbs.) and take the fraction of the adult dose.
The poison may be rubbed into and absorbed through the Example: The weight of the child is 50 lbs. then 50/150 equals
skin.
1/3. So the child can take 1/3 of the adult dose.
e. By Rectum, Vagina or Bladder:
Young's Rule:
Absorption through the rectum is about twice as much as
Divide the age of the child by the age of the child plus 12, and
absorption through the mouth.
the resulting fraction is the portion of the adult dose which
f. By the Lungs: may be used.
Poison through this route may be made of a substance which Example: If the child is 6 years old, then 6/6+12 equals 6/18 or
can be transformed to gaseous state. 1/3 of the adult dose.
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718 LEGAL MEDICINE
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a. The poison might have already been eliminated.

Cowling's Rule:
b. The material examined may not contain the poison.
Divide the age of the child on his next birthday by twenty-four
c. The procedure applied is not delicate enough to detect small
and the fraction of the adult dose is to be used.
quantity of the drug.
Example: If the child is 8 years old, then 8/24 equals 1/3 of
d. The poison might have already been transformed to another
the adult dose.
state in the body before detection.
Gabius stated a series of fractions of the adult dose which may be
In order to confirm the suspicion that it is a case of poisoning, the
used for different ages:
following must be done:
For a child one year or less 1/12
1. Obtain information from:
2 years 1/8
a. The victim himself.
3 years 1/6
b. Member or members of the family.
4 years 1/4
c. Police or other peace officers.
7 years 1/3
2. Obtain sample of the vomitus, urine and other bodily discharges
14 years 1/2
for analysis.
20 years 2/3
Above 20 years For adult dose 3. Observe the patient as to other developments of the symptoms
and progress of the condition.
6. Stare of the Stomach and Kidneys:
4. Request a fellow physician to assist and observe the patient if
Since the stomach is the first organ where the ingested food
necessary.
stays for a time, so it must be the first organ to be affected by the
action of poison. If the organ is diseased or abnormal, it has less
resistance to the effect of poison. A healthy person is usually DIFFERENTIAL DIAGNOSIS OF POISONING
more resistant to the action of the ingested poison in insoluble
Signs Poison Disease
form.
Coma Opium, Chloral, Alcohol Apoplexy, Brain injury,
SIGNS A N D SYMPTOMS THAT M A Y LEAD ONE TO SUSPECT Uremia, Diabetes, Epilep-
POISONING: sy, Fever.
1. The complaints and symptoms appear suddenly like an acute Collapse Corrosives, Arsenic, A n - Diphtheria, Cholera,
abdomen, apoplexy, heart failure or cholera. timony,. Aconite, To- Fever,
2. The symptoms appear when the individual is at the state of health. bacco, Antipyrine.
3. The symptoms usually appear after a meal or after taking some Delirium Belladonna, Hyoscya- Pneumonia, Phthisis, Fe-
food or medicine. The onset of the symptoms is influenced by mus, Cannabis, Alcohol, ver, Acute mania, Me-
the modifying factors mentioned, but it appears within an hour Camphor. ningitis.
in most cases. Paralysis Conium, Aconite, Gelse- Injury of cord or brain,
4. When several persons partake the food or drug at the same time, mium, Eserine, Arsenic, Apoplexy, Hysteria.
the approximate occurrence of the symptoms is at the same time. Lead.
5. The course of the symptoms may either be getting severe or having Convulsion N u x vomica, Arsenic, Tetany, Hysteria, Epi-
steady improvement. Antimony. lepsy.
6. The detection of the poison can be done on any of the following: Cyanosis Analine, Antifibrin Vulvar heart diseases.
a. food taken c. vomitus Enlarged pupil Atropine, Hyoscyamus, Paralysis of the 3rd nerve,
b. container <i. excretions Aconite, Alcohol, Co- Paralysis of sympathetic,
Failure to detect poison does not show that the substance is nium, Chloroform.
absent because: Dry skin Belladonna,Hyoscyamus Fever, Pneumonia.
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MEDICO-LEGAL ASPECT OF POISONING 719 720 LEGAL MEDICINE
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Moist skin Opium, Aconite, Anti- Acute rheumatism. c. Physical Reaction:

mony, Tobacco, Alco- This is the formation of a non-soluble compound thereby
hol. preventing absorption.
Vomiting Corrosives and irritants Gastric ulcer, Acute gas- Examples: (1) Tannic acid precipitates Strychnine.
tritis, etc. ( 2 ) Egg albumen precipitates mercuric chloride.
Purgation Irritants, Digitalis, Col- Dysentery, Cholera, Ty- When the exact nature of the poison is unknown, a mixture
chicum. phoid Fever, Tuberculo- composing of the following substances may be used:
sis. Powdered charcoal 2 parts
Colic Lead, Copper, Arsenic Volvulus, Obstruction. Magnesia 1 part
Tannic acid 1 part
Cramp Lead, Arsenic, Anti- Cholera, Diarrhea.
The following formula is advanced by Murrel to be used in cases
mony.
of poisoning of any kind, although it may be incomplete:
(From: A Synopsis of Forensic Medicine & Toxicology by E. W.
Caryl Thomas, 2nd ed., p. 147). Saturated solution of sulphate of iron 100 parts
Calcined magnesia 88 parts
TREATMENT OF PATIENT SUFFERING FROM ACUTE Animal Charcoal 40 parts
Water 100 parts
POISONING:
The above formula is indicated in case of arsenic, zinc salts,
1. Evacuation of the Stomach:
digitalis, acids of ordinary types, mercury salts, morphine and
This may be done by: strychnine poisoning; but this is of no use for alkalies, phos-
a. Stomach Tube: phorus, tin salts, or hydrocyanic acid poisonings.
A long rubber tube is introduced to the mouth and allowed 3. Application of Physiological Antidotes:
to reach the stomach. Fluid must first be introduced into the
a. Strychnine may be used to stimulate respiration.
stomach to prevent the tube to come in close contact with its
wall. Fluid is withdrawn and introduced until traces of the poison b. Depression of the heart by aconite may be counter-acted by
are removed. The procedure is contra-indicated in poisoning by digitalis.
corrosives on account of the danger of tear or laceration of the c. Blood vessels may be constricted by ergot, suprarenal extracts,
stomach wall. digitalis and dilated by amyl nitrate and sodium nitrite.
d. Morphine, bromides or barbiturates may be given for poisoning
b. Administration of Emetics:
by stimulants.
(1) Zinc Sulfate — 30 grs.
( 2 ) Ipecacuanha — 20-30 grs. in two six drachms of wine. 4. Keep the patient alive by general measures, while his organs of
(3) Mustard and Water — One tablespoon in one tumbler of elimination are getting rid of the poison. Treat any urgent and
water. dangerous symptoms.
( 4 ) Salt and Water.
5. Eliminating the Poison:
(6) Apomorphine — 1/10 gr. hypodermically.
The elimination of the poison is aided by purgatives, sudori-
2. Neutralization of the Poison that Remains in the Stomach: fics, and diuretics.
a. Neutralization by Direct Chemical Reaction: Sweating may be encouraged by hot bath, warm packing, and
injection with apomorphine.
Examples: ( 1 ) Acids neutralize alkalies.
(2) Alkalies neutralize acids. Symptomatic Treatments:
b. Neutralization by Physiochemical Reaction: Pain may be relieved by the injection of morphine.
Examples: (1) Silver nitrate is precipitated by common salt. Absorption from the stomach may be hindered by adrenalin and
(2) Iodine reacts with starch. the use of demulcent like oil, starch, egg-albumen and water.
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a. External Post-mortem Examination:

In some cases, it is advisable to administer glucose either by mouth
or intravenously to restore the depleted glycogen.
Diffusive stimulants, artificial respiration, inhalation of oxygen
and carbon dioxide, and application of heat on the skin surfaces may
be adopted.
MEDICAL EVIDENCES IN CASE OF POISONING
b. Internal Post-mortem
In the trial of a case of poisoning, the defense counsel will prove:
1. That the death of the victim was not due to poisoning but to some
natural cause.
2. That the victim did not suffer from poisoning of the particular
poison mentioned in the complaint or information.
3. That there was no intent on the part of the defendant to poison
the victim.
For the purpose of clarification and in the best interest of justice,
the medical witness must answer the following questions:
1. What is the actual cause of the death?
2. Why is death attributable to poisoning rather than to disease?
3. What is the maximum fatal dose of the poison alleged to have
caused the death?
4. If the symptoms which appeared do not resemble the typical
symptoms of poisoning by the alleged poison, what explanation
can he give?
5. Was the dose taken by the victim necessarily fatal?
In order that the physician may be able to answer the above
questions, he must know and report on the following points:
1. History and Symptoms During Life:
a. History of any previous suicidal attempts.
b. History of his mental condition.
c. History of business, marital and social failures.
d. Presence of persons having grudge against him.
e. Possible source of the poison.
f. Time of actual administration of the poison.
g. Nature and actual time of occurrence of the symptoms.
h. Order of occurrence of the symptoms.
i. If the victim died, note the exact time of death and the period
of time from ingestion to death.
j . Inquire about the presence of vomitus, urine, and other bodily
discharges for analysis,
k. Date, time and place where the victim was last seen alive.
2. Post-mortem Examination:
(1) Note the attitude of the body and dress, especially for
stains.
( 2 ) External signs of physical violence.
(3) The expression of the face. Some poison, with convulsion
as the symptom, may be inferred from the expression of
the face.
(4) Approximation of the time of death.
Examination:
(1) The bodily openings must be noted for any peculiar smell
characteristic of some poisons.
Examples: Carbolic acid, hydrocyanic acid, phosphorus,
chloroform, etc.
(2) The tongue, mouth and esophagus must be examined for
inflammation, erosions and stainings.
( 3 ) The larynx, trachea and bronchi must be opened to see the
effect of volatile irritants.
( 4 ) Examination of the stomach:
(a) The color of the stomach wall may sometimes indicate
poisoning by certain drugs.
Examples:
— Mercury usually produces a slate-color stain.
— Arsenic may produce white particles adherent to
possible yellow sulfides.
— Strong sulfuric acid and concentrated oxalic acid
may produce blackened or charred wall.
— Hydrochloric and carbolic acids produce white wall.
However, the color changes may be due to food,
bile or post-mortem changes.
( b ) Ulceration:
Strong corrosive may produce ulceration of the wall.
This must be differentiated with simple ulcer and can-
cerous growth.
(c) Actual perforation:
This may be found in poisoning by strong mineral
acids, especially sulfuric acid. It must also be dif-
ferentiated from perforation brought about by disease
of the wall.
( d ) Softening:
Usually found in poisoning by strong alkaline irri-
tants. It must be differentiated from post-mortem
digestion of the stomach wall.
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MEDICO-LEGAL ASPECT OF POISONING 723
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( 5 ) Examination of the stomach contents: Suggested Autopsy Specimens and Quantities To be Submitted
for Toxicologic Examination
(a) Quanity.
( b ) Nature of food. Specimen Minimum Amounts Indications
(c) Color. Bile All available Valuable in narcotic cases.
( d ) State of digestion. Blood 20 to 30 ml. For all types of determina-
(e) Presence of matters not commonly considered as food. tions.
( f ) Odor. Brain 100 gm. For fat-soluble drugs.
( g ) Reaction. Fat 100 gm. For insecticides and other
(6) Examination of the duodenum and its contents. fat-soluble drugs (thio-
(7) Condition of the rest of the small intestine. pental).
Hair About 0.5 gm. Chronic (not acute) arsenic
( 8 ) Examination of the large intestine and its contents.
poisoning.
( 9 ) Examination of other visceral organs. Fingernail clip- As much as possible Chronic arsenic poisoning.
(10) Examination of the bladder and the vagina, in the case of a p i n gs or
female, for poison that might have been introduced into whole nails
the body through these channels. I n t e s t i n a l con- 30 gm. In instances in which
tents poison presumably was
(11) Saving of organs for chemical analysis.
taken orally.
For the purpose of chemical analysis of the visceral organs, the Kidney 100 gm. For all types of poison-
Forensic Chemistry Division of the National Bureau of Investigation ing, especially heavy
Department of Justice have recommended the following organs to metals and narcotics.
be saved by the physician for the quantitative and qualitative Liver 100 gm. For all types of poisoning,
determination of poisons and offer poisonous substances as enu- especially heavy metals
merated below: and alkaloids.
Lung 1 lobe For inhaled poisons and
Poison to be Tested Organs Required
basic drugs.
Arsenic (Acute poisoning). . . Liver, kidneys, stomach contents. Muscle 100 gm. In instances in which inter-
Arsenic (Chronic poisoning) . Hair, urine, liver.
nal organs are badly
Mercury Liver, kidneys, stomach, intestines. putrefied.
Phenol Liver, kidneys, stomach.
Spinal fluid All available All types of poisoning
Alcohol Blood, liver, kidneys, urine, brain.
when blood is not avail-
Cyanide or H C N Stomach and liver.
able.
Phosphorus Stomach, liver, kidneys.
Carbon monoxide Spleen 25 gm. Carbon monoxide determi-
Blood (placed in sealed container).
Veronal, luminal, amytal . . . Urine, brain, liver, kidneys. nation when blood is
Strychnine Stomach, stomach contents, liver,
not available.
kidneys, urine. Stomach con- All available In instances in which
Morphine Stomach and contents, liver, urine. tents poison presumably was
Other alkaloids Same as morphine. taken orally.
Lead (chronic) Bone, kidneys, liver. Urine All available Valuable in nearly all types
Mineral acids Stomach and contents, esophagus. of poisonings.
Oxalic acid Same as morphine. Vitreous humor From both eyes Most drugs and alcohol.
Alkalies Stomach and contents, esophagus. (about 5 ml.)
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•Italicized specimens are considered to be the most significant for 4. Animal Irritants:
toxicological examination. a. Cantharides
(From: Clinics in Laboratory Medicine, Vol. 3, No. 2 by DiMaio 5. Food Irritants
ed., 1983, p. 368).
C. Narcotics:
3. Chemical Analysis: 1. Somniferous Group:
This portion of criminal investigation is beyond the scope of a a. Opium c. Synthetic Hypnotics
physician's duty. The expert analyst or a toxicologist is much b. Chloral
more in the position to perform the work. 2. Deliriant:
The expert chemist, analyst or toxicologist must be able to a. Belladonna c. Stamonium
answer the following questions: b. Hyoscyamus d. Cocaine
a. When, where and from whom did you receive the article which D. Depressants:
you have analyzed? 1. Neural Depressant: Paralysis of the spinal cord.
b. In what state were they received? a. Aconite
c. When did you analyze it, and where? b. Conium
d. Did you analyze it alone, or were you assisted?
2. Cerebral Depressants: Inhibiting the brain functions.
e. What test did you employ?
a. Hydrogen Cyanide c. Laurel Water
CLASSIFICATION OF POISONS b. Oil of Bitter Almond
3. Cardiac Depressants:
Poisons may be classified in different ways. Some authors classify
poisons based on the manner of action and effect on the body, while a. Digitalis c. Camphor
b. Strophanthus
chemists usually classify them from the purely chemical standpoint.
The following are the classifications of poisons based on the E. Poisons which are Exito-Motor in Action:
manner of action and effect in the body: 1. Strychnine
A Corrosives: 2. Brucine
3. Thebaine
1. Strong Acids:
a. Sulfuric Acid d. Carbolic Acid F. Poisonous and Irrespirable Gases:
b. Nitric Acid e. Oxalic Acid 1. Poisonous Gases:
c. Hydrochloric Acid a. Carbon Dioxide d. Arseniureted Hydrogen
2. Caustic Alkalies: b. Carbon Monoxide e. Carbon Disulfide
a. Potassium Hydroxide c. Hydrogen Sulfide
b. Sodium Hydroxide 2. Irrespirable Gases:
c. Ammonia a. Chlorine c. Hydrogen Cyanide
3. Compounds: b. Benzene
a. Zinc Chloride
G. Contact Poisons:
b. Antimony Trichloride
1. Vegetable Irritants
B. Irritants:
2. Animal Irritants
1. Non-metals 3. Chemical Irritants
2. Salts of Metals
3. Vegetable Irritants: H. Vulnerants:
a. Castor oil c. Belladonna 1. Nails 3. Dust
b. Digitalis d. Croton Oil, etc. 2. Broken Glasses
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MEDICO-LEGAL ASPECT OF POISONING 727
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The Forensic Chemistry Division of the National Bureau of In-
vestigation, Department of Justice made the following classification
based on the Chemical Standpoint:
A . Gaseous Poisons (Poisons Present in the Gaseous State):
Carbon dioxide; Carbon monoxide; Hydrocarbons; Hydrogen
sulfide; Sulfur dioxide; the Oxides of nitrogen (Nitrous oxide,
Nitric acid and Nitrogen dioxide); war gases.
B. Inorganic Poisons:
1. Corrosives (Poisons characterized principally by an intense and
destructive action — a few organic corrosives are included in
this group for the sake of completeness):
a. Acid; Mineral and Organic:
Sulfuric acid; Hydrochloric acid; Nitric acid; Oxalic acid;
Acetic acid.
b. Alkaline Corrosives:
Potassium hydroxide; Sodium hydroxide; Calcium oxide;
Ammonium hydroxide.
c. Halogens:
Chlorine; Bromine; Iodine; Fluorine.
d. Corrosive Metallic Salts:
Silver; Zinc.
e. Organic Corrosives:
Phenol; Pyrogallol; Formaldehyde.
2. Metallic Poisons and Salts: (These chemicals are protoplasmic
irritants, but their chief action is the deleterious effect pro-
duced after absorption into the system.)
a. Heavy Metals:
Phosphorus; Antimony; Arsenic; Bismuth; Mercury; Lead;
Radioactive substances; Thallium; Gold; Osmium; Platinum;
Nickel; Chromium; Tin; Vanadium.
b. Inorganic Salts:
Alum; Alkaline earths; Magnesium sulfate; Lithium salts;
Potassium salts; Boric acid and borax; Tellurium; Sodium
silicate.
C. Organic Poisons:
1. Volatile Poisons (Volatile liquids or easily sublimated solids
many of which are irritants; their chief action occurs after
absorption):
a. Alepathic Compounds:
Methyl alcohol; Ethyl alcohol; Fuel oil; Amyl alcohol;
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Tertiary or Dimethyl carbinol; acetaldehyde; Paraldehyde;
Methyl chloride; Methyl bromide; Tribromoethanol; Ethyl
chloride; Ethyl bromide; Ether; Chloroform; Bromofonn;
Chloral hydrate; Carbon tetrachloride; Tetrachlorethane;
Amyl nitrite; Nitroglycerin; Carbon bisulfide; Hydrocyanic
acid and the cyanides; Paraffin hydrocarbons.
b. Atomic Compounds:
Benzene series; Essential oils.
2. Alkaloidal Poisons: (These substances are toxic principles of
plants which have a characteristic action on some parts of the
central nervous system; they are a well-defined group).
a. Volatile Alkaloidal Poisons:
Nicotine and tobacco; Conine and poison hemlock.
b. Non-volatile Alkaloids:
Opium and morphine; Aconitum and aconitine; Atropine
and related alkaloids; Epicac and emetine; Cocaine and allied
alkaloids; N u x vomica and its alkaloids strychnine and
Brucine; Physostigmine; Alkaloids of the veratrum species;
Gelsenium and its alkaloids; Colchicum and Colchicine;
Ergot and its alkaloids; Cinchona and quinine; Pilocarpus
Jaborandi and pilocarpine; Caffeine; Curare.
3. Non-alkaloidal Poisons (A conglomerate collection of other
organic toxic substances, non-volatile and non-alkaloidal):
a. Hypnotics:
Alepathic series; Aromatic series.
b. Aromatic Compounds:
Naphthol; Salicylic acid; Picric acid; Dinitrophenol;
Trinitrotoluene; Acetanilid; Antipyrine; Atophan; and the
Cinchopen group.
c. Glucosides:
Digitalis, Strophanthus; Oleander; Hellebore; Gossypium;
Locust; Scilla; Cannabis indica.
d. Organic Purgatives:
Purgative oils; anthracene group; Jalap; purgatives.
e. Essential Oils:
Aspidium; Abortifacients; Oil of chenopodium; Apiol;
Affion; Turpentine.
f. Picrotoxin Group:
Picrotoxin; Water of hemlock.
g. Miscellaneous Group:
Taxus; Sparteine; Abrus; Laburum; Larkspur; Health
family; Santonin; Cantharides.
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D. Miscellaneous Poisons: (Associated with botulism; food poison- Symptoms:

ing; mushroom poisoning; snake venom poisoning). a. Vomiting and diarrhea.
1. Food Poisoning: b. Abdominal pain.
Toxic substances in the food; Abnormal hypersensitivity to c. Prostration.
normal constituents of food. d. Collapse with cold sweating.
e. Rigor with pain at the back and limbs.
2. Poisonous Plants.
f. Headaches and dizziness.
3. Poisonous Animals and Their Poisons:
Arachnids; Centipedes; Insects; Caterpillars; Vertebrates. Post-mortem Examination:
4. Biological Products. a. Congestion of mucous membrane of the stomach and intestine.
b. Petechial hemorrhages of the visceral organs.
5. Ground Glass.
c. Cloudy swelling of the kidneys.
FOOD POISONING d. Congestion of the liver and spleen.
e. Isolation of the specific organism.
Food poisoning is a state of ill-health resulting from food which
has some abnormal or noxious content. Bacteriology:
The members of the salmonella group which may cause food
Food May Cause Disease in the Following Ways:
poisoning are:
1. Lack or excess.
a. B. Enteritidis e. B. Suipestifer
2. Unbalance proportion of proper constituents. b. B. Paratyphosus A f. B. Psittacosis
3. Absence of certain constituents, including vitamins and specific c. B. Paratyphosus B g. B. Abortus equi
proteins. d. B. Aertryke
4. Idiosyncracy. The most common reaction occurs in the gastro-
intestinal tract in the form of nausea and vomiting. The sensitivity Botulism:
may be manifested in the form of rashes. This is a specific infection in which symptoms arises from the
5. Presence of abnormal constituents: ingestion of a very potent exotoxin of anerobic Clostridium botu-
linum. Poisoning is usually due to ingestion of food stored and
a. Products of putrefactive bacteria.
b. Specific bacteria. prepared in unsatisfactory conditions and eaten without cooking.
c. Parasites.
LAWS O N POISONS A N D O T H E R POISONOUS
d. Molds.
SUBSTANCES IN THE PHILIPPINES
e. Vegetable substances as ergot in rye or solanin in potatoes.
f. Chemicals. Provisions Relative to Dispensing of Violent Poisons:
6. Food inherently poisonous as fungi, horse raddish, water hem- Sec. 755, Revised Administrative Code:
lock. Every person who dispenses, sells, or delivers any of the following
violent poisons, to wit, arsenic, arsenical solutions, phosphorus,
Bacterial Food Poisoning: corrosive sublimate, cyanide of potassium or other cyanide, atropine,
1. Food Poisoning of Non-specific Bacterial Origin: cocaine, morphine, strychnine, or any of their salts, and all other
This is sometimes called ptomaine poisoning and is probably poisonous vegetable alkaloids or any of their salts, hydrocyanic acid,
caused by the degradation products of the protein molecules or prussic acid, oil of bitter almonds containing hydrocyanic or
occurring in the decomposition of food when they have reached prussic acid, oil of mirbane (nitro-benzene), opium and its prepa-
an advanced stage. rations, except paregoric and such others as contain less than four
2. Specific Bacterial Food Poisoning: hundred and fifty milligrams of opium per one hundred cubic
This is brought about by infection with the salmonella group of centimeters (two grains to the ounce), shall make or cause to be
microorganisms. made in a book kept for the purpose of recording the sale of such
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poisons an entry stating the date of each sale and the name and
address of the purchaser, the name and quantity of the poison
sold, and the purpose for which it was claimed to be purchased,
A. Sulfuric Acid:
before delivering it to the purchaser. He shall not deliver any such
poison to any person without satisfying himself that such person is
aware of its poisonous character, and that the poison is to be used
for a legitimate purpose, and he shall affix to every box, bottle, or
other package containing any dangerous or poisonous drug, a label of
red paper upon which shall be printed in large black letters the word
"poison" and a vignette representing a skull and bones, before deli-
vering it to any person. Books kept for the purpose of recording
the sale of poisons shall be open at all times to the inspection of the
Board of Pharmaceutical Examiners, and of health officers or officers
of the law, and every such book shall be preserved for at least five
years after the last entry in it has been made.
Provisions Relative to Dispensing of Less Violent Poisons:
Sec. 756, Revised Administrative Code:
Every person who dispenses, sells or delivers any aconite, bella-
donna, cantharides, colchicum, conium, cotton root, digitalis, ergot,
hellebore, henbane, phytolaca, strophanthus, oil of tansy, veratrum
viride, or their pharmaceutical preparations, carbolic acid (Phenol),
chloral hydrate, chloroform, creosote, croton oil, mineral acids,
oxalic acid, paris green, salts of lead, salts of zinc, tartar emetic,
white hellebore, or any drug, chemical, or preparation which accord-
ing to standard works of medicine or materia medica is liable to be
destructive to human adult life in quantities of four grams (sixty
grains) or less, without the prescription of a physician, shall label
the receptacles containing them as is above provided for violent
poisons, but shall not be required to register the same.
Nothing in this section shall be construed as applying to the
dispensing of medicines, drugs, or poisons on physicians' prescrip-
tions, but no prescription the prescribe dose of which contains a
dangerous quantity of poison shall be filled without first consulting
the prescribing physician and verifying the prescription.
Receptacle for Poisonous Drugs:
Sec. 757, Revised Administrative Code:
The poisonous drugs specified in the two next preceding sections
shall be kept in a cabinet to be provided in every pharmacy carrying
such drugs in stock for the retail trade; and the same shall be kept
securely locked when not in use.
POST-MORTEM F I N D I N G S IN SOME
CHEMICAL POISONING
1. External Appearance:
a. Putrefaction is frequently delayed.
b. There are cutaneous stains in areas where the corrosive liquid
has been spilled. The stains are frequently found in the angles
of the mouth and running in a linear fashion from the pos-
terior part of the lips to the chin.
c. The outer layers of the skin are destroyed and the derma is
parchmentized, while the deepest layer is reddish-brown in
color.
d. The lips may be blackened.
e. The tongue and mucous membrane of the mouth may be
softened, corroded and white in color.
2. Internal Appearance:
a. Internal findings are usually confined to the changes due to
the local action of sulfuric acid.
b. Cardio-Vascular System:
( 1 ) The aorta may be found with the outer wall blackened
and corroded.
( 2 ) The blood in the vessels may be coagulated and hard-
ened. This produces black arborescent cast in the smaller
vessels and in their branches and larger cylindrical casts
in the vessels of greater caliber.
c. Respiratory System:
( 1 ) The epiglottis may be blackened and shrunkened.
( 2 ) The mucous membrane of the larynx and trachea may be
swollen and congested.
( 3 ) Death may be due to asphyxia when acid has been
inspired.
( 4 ) The diaphragm may be perforated after the escape of the
acid into the peritoneal cavity.
(5) The surface of the lungs and pleura is then tough, leathery
and stained brown.
d. Digestive System:
( 1 ) Mucous membrane of the pharynx is gray and may be
softened. Patches of brownish color are scattered in the
pharynx due to the effusion of dark-colored blood.
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( 2 ) The stomach, if not perforated, shows an injected surface 2. Internal Appearance:

and the contents are coffee-ground color.
( 3 ) The mucous membrane of the stomach is brown or
black with some thin or perforated areas. If perforated,
the edges of the perforation are black and irregular.
(4) The intestine has a dark-brown content. The pylorus
may be hardened and constricted. Mucous membrane of
the duodenum is usually congested and swollen.
B. Hydrochloric Acid:
1. External Appearance:
a. External staining is absent.
b. The angle of the mouth may be whitish, opaque and may be
inflamed.
2. Internal Appearance:
a. Blood is darkened but not as a rule coagulated by the action
of acids.
b. Edema of the glottis.
c. Larynx and trachea are congested and the mucous membrane
is converted into whitish-gray opaque layer which can be
rubbed off.
d. There may be congestion and edema of the lungs.
e. Mucous membrane of the mouth and pharynx is opaque and
grayish-white.
f. Esophagus is dilated with the mucous membrane reddened
and inflamed.
g. The liver is pale and fatty.
C. Nitric Acid:
The lesions produced by nitric acid are similar to hydrochloric
acid except that the cutaneous stains are distinctly yellow.
D. Caustic Alkalis (Potassium Hydroxide, Sodium Hydroxide):
1. External Appearance:
a. Dirty yellow color stains at the angle of the mouth and on
the chin.
b. Swelling of the tissues in contact with the alkali.
c. Surface of the tongue, mouth and lips becomes slightly
reddened or dark and eroded.
d. The membrane may be detached exposing the submucous
layer which may be chocolate in color or sometimes black.
The only changes are those due to the local action of the
alkali.
a. Pharynx is lined by softened and hyperemic mucous mem-
brane.
b. Edema may be considerable especially at the opening of the
larynx.
c. Esophagus is corroded in its upper part.
d. Peritoneal surface is pale and blood vessels are filled with
dark fluid blood.
e. Stomach contents are viscid, turbid fluid.
f. The mucous membrane of the stomach at the region of the
cardiac end is brownish-red in color, uneven and hardened.
g. The wall of the stomach is edematous and with a soapy feel.
h. The entire length of the intestine is congested.
i. Larynx and trachea are inflamed and congested.
j . Bronchial tree is congested and contains viscid mucous.
E. Ammonia (Ammonium Hydroxide):
1. External Appearance:
Lips, mouth, pharynx and larynx are inflamed with patchy
erosion of the mucous membrane.
2. Internal Appearance:
The only characteristic changes are those in the respiratory
and digestive systems:
a. Digestive System:
(1) The tongue is swelling with the mucous membrane
softened and peeled off.
( 2 ) The mucous membrane of the esophagus and the lower
portion may be detached and it is intensely inflamed.
( 3 ) The mucous membrane of the stomach may be with
dark-colored blood, thinned, or perhaps destroyed at
the point of contact with the chemical. Perforation
may be present. The whole membrane is edematous
and congested, and may show petechial hemorrhages.
There may be a strong odor of ammonia.
( 4 ) The duodenum and jejenum may contain blood but
are usually unaffected.
b. Respiratory System:
(1) The epiglottis may be very swollen and eroded. There is
a considerable edema of the vocal cords.
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( 2 ) The laryngeal and tracheal mucosa are swollen.
(3) Trachea and bronchi are lined with a fibrinous membrane
which can be easily stripped off leaving a raw surface.
( 4 ) The lungs may be congested and edematous.
( 5 ) Broncho-pneumonia may be present in those cases which
survived for a time.
Death may be due to suffocation brought about by the
gas or edema of the glottis or pulmonary changes, if the
victim does not die immediately.
F. Phenol and its Derivatives (Lysol, Cresol, Carbolic A c i d ) :
1. External Appearance:
a. Brownish and shrunken stains at the angles of the mouth,
chin and cheeks.
b. Characteristic odor of phenol is perceptible.
2. Internal Appearance:
a. The blood is dark and fluid.
b. The lungs are congested and sometimes edematous. If the
victim lived for sometime, broncho-pneumonia may be
found.
c. There may be edema of the glottis and of the vocal cord.
d. Digestive System:
(1) The tongue is swollen with white fur and the mucous
membrane is hardened.
(2) The esophagus is contracted and the mucous membrane is
thrown into ridges. It is grayish-white in color and the
longitudinal fissures running between the ridges are
hyperemic.
(3) The stomach may contain blood-stained mucous with a
characteristic smell. The mucosa may be thrown into
longitudinal ridges. The muscular and subserous coats
are edematous and with small hemorrhagic patches. The
peritoneal surface is congested.
(4) The upper portion of the intestine may show similar,
changes as that of the stomach.
e. The liver is large, pale, and fatty in those cases which have
survived for a length of time.
f. The kidneys are congested and swollen.
g. The urinary bladder contains greenish smoky urine.
h. The meninges and brain are usually congested.
G. Acute Arsenic Poisoning:
1. External Appearance:
a. The whole body may have a shrunken appearance.
b. The cutaneous surfaces, especially the hands and feet are
cyanotic.
c. Putrefaction of the body is quite delayed.
2. Internal Appearance:
a. Cardio-Vascular System:
(1) Heart contains coagulated blood.
(2) Ecchymosis is frequently observed underneath the peri-
cardium.
b. Respiratory System:
(1) The lungs are congested and sometimes edematous.
(2) Subpleural hemorrhages may be present.
c. Digestive System:
(1) Changes in the mouth, pharynx and esophagus are rare.
( 2 ) The mucous membrane of the stomach is swollen and
spongy with tenacious mucous adhering. The mucous
membrane may be thrown into rugae, often with a dark
red color. There may be petechial hemorrhages distri-
buted all over. Crystals of arsenic may be present.
( 3 ) If death is delayed there may be inflammatory changes
in the duodenum. The solitary and Peyer's patches are
swollen.
d. The liver may show cloudy swelling. If death did not occur
within 24 hours, the organ may be enlarged and pale.
e. There may be cloudy swelling of the cortex of the kidneys
with numerous small hemorrhages.
H. Chronic Arsenic Poisoning:
1. External Appearance:
a. Bo'dy is emaciated.
b. Hair is scarce.
c. There is pigmentation of the skin with eczematous eruptions.
d. There is a yellowish-brown color of the skin.
e. Localized thickening of the epidermis is present.
2. Internal Appearance:
a. Car dio-Vascular System:
(1) Diffused fatty degeneration of the myocardium.
( 2 ) Musculature is flabby, pale and friable.
(3) Blood vessels are thick and dark in color.
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b. Respiratory System: b. Renal System:

( 1 ) There may be ulceration of the nasal septum.
(2) Bronchitis may be present.
c. Digestive System:
( 1 ) Tongue may be coated.
( 2 ) Mucous membrane of the stomach is inflamed with
ulcerative patches. The whole surface is covered with
tenacious mucous with blood or blood streaks.
( 3 ) Mucous membrane of the duodenum and upper part of
the jejenum, ascending colon and rectum are inflamed.
( 4 ) Peyer's patches are swollen and minute ulcerative areas
are common.
d. The liver is enlarged and shows advanced fatty changes.
e. The kidneys are enlarged. On section, the cortex is swollen
and pale.
L Mercury (Perchloride and Nitrate Salts):
1. External Appearance:
If the salts (perchloride or nitrate) of mercury has been taken
by mouth, it produces corrosion of the epithelium and swelling
of the lips.
2. Internal Appearance:
a. Digestive System:
(1) The mucous membrane of the mouth is softened, whitish
and sodden-looking.
( 2 ) The esophageal mucosa is corroded, softened and in-
flamed in patches.
(3) The muscular coat of the stomach is contracted and the
mucous membrane is thrown into folds. The surface is
converted into a grayish-white layer. The mucous mem-
brane is reddened and with dark ecchymosis. There are
areas of necrosis with white color and those that are
found at the cardiac and pyloric end are easily detached.
(4) The small intestine shows severe inflammation. It takes
the form of diphtheritic enteritis and this is most pro-
minent at the cecum.
(5) The whole of the large intestine shows severe inflam-
mation. The mucous membrane is thickened and' the
contraction of the muscles made it thrown into folds.
The summit of the folds is converted into a grayish-
white necrotic layer. The rest of the mucosa is deep red,
swollen and soft.
Both kidneys are enlarged. Section shows that the cortex
is pale, yellowish, and swollen. The capsule strips easily
and leaves a smooth pale surface. Hemorrhagic spots may be
seen in the cortex and on the outer surface.
If the victim survived for a time, he will later succumb to
renal insufficiency. The pale cortex is streaked with yellow
due to fatty changes in the section, owing to the deposit
of calcium carbonate and phosphate.
c. When poisoning is due to mercurials administered by in-
jection or absorbed through the skin or mucous membrane,
the changes in the stomach are slight although intense con-
gestion may be found.
J. Lead (Chronic poisoning):
1. External Appearance:
a. Emaciation.
b. Skin shows icterus.
c. Parotid glands are sometimes enlarged.
d. Wasting of the muscles of the shoulder, arm and forearm.
e. Gouty tophi and arthritis or simple effusion of fluid may be
found in joints.
2. Internal Appearance:
a. Blood is thin and watery.
b. Cardio-Vascular System:
(1) Fibrosis of the myocardium.
( 2 ) Interior of both auricles and ventricles is whitish and
opaque in appearance.
(3) There may be some degree of atheroma of the aorta and
large blood vessels.
c. Digestive System:
(1) Teeth are discolored and brown.
( 2 ) Gums may show bluish line in their edges near the lower
canines and incisors. The gums may be ulcerated and
softened.
( 3 ) Stomach shows chronic gastric catarrh.
( 4 ) Intestine is inflamed, contracted and thickened.
( 5 ) Patches of pigmentation may be present in the mucous
membrane of the large intestine.
d. Renal System:
Kidneys resemble that of arteriosclerosis. They are smaller
than their normal size. The surface is granular, the granules
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are yellow separated by reddish depressions. The capsule is
opaque, thickened and possibly adherent. The cortex is
somewhat reduced in size. There is an increase in the pelvic
fat.
e. Nervous System:
(1) The meninges of the brain are thickened.
( 2 ) The pia-arachnoid is opaque and shows hemorrhagic
spots.
(3) Convolutions of the brain are atrophied.
(4) Section of the brain shows that the gray matter of the
cortex is narrowed.
( 5 ) The blood vessels at the base of the brain show some
thickening and are sometimes rigid.
f. Hematopoietic Organs:
(1) The spleen may be somewhat atrophied and fibrotic.
( 2 ) The bone marrow in the shaft of long bones is red owing
to hyperplasia.
K. Phosphorus (Rat-poison, fireworks, match stick):
1. Cardio-Vascular System:
a. Heart is flabby and the musculature is pale, friable and
fatty.
b. The blood is dark and fluid.
2. Respiratory System:
a. Blood-stained fluid may be effused into the pleural cavity.
b. The lungs are congested.
c. There may be a subpleural hemorrhages.
3. Digestive System:
a. The stomach may show swollen grayish-white mucosa.
b. The intestine may also show the same changes as that of the
stomach.
4. The liver may be enlarged, soft and doughy. The lobules may
be easily seen. There is necrosis of the liver cells and intense
fatty changes.
5. There may be small hemorrhages in the omentum.
6. Renal System:
a. The kidneys are enlarged and soft.
b. The cortex is swollen, thickened and pale yellowish-gray in
color.
c. Hemorrhagic! areas are present.
7. Meninges and brain are congested.
8. The skeletal system may show fatty changes, being pale and
brownish.
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L. Hydrocyanic Acid (Potassium and sodium cyanide):
1. External Appearance:
a. Rigor mortis sets in early and persists longer than usual.
b. Skin is bright pink in color.
c. Cyanosis of the skin may be present due to asphyxia.
d. Hypostasis is distinctly lighter in color than normal.
e. Face is pale.
f. Eyes are prominent and pupils are dilated.
g. Mouth and nostrils may show froth.
2. Internal Appearance:
a. Characteristic odor is emitted on opening of the abdomen.
b. Blood is bright red in color and coagulated.
c. Cardio-vascular System:
(1) Right side of the heart is distended with blood.
(2) Left ventricle is contracted and empty.
(3) Venous system is engorged with blood.
(4) Pericardium may show petechial hemorrhages.
d. Respiratory System:
(1) Larynx and trachea contain blood-tinged froth.
(2) Lungs are congested and edematous.
(3) Odor of bitter almond is perceptible.
(4) Subpleural petechial hemorrhages.
e. Digestive System:
( 1 ) Mucous membrane of the pharynx, esophagus and
stomach is apparently normal, but may be congested.
(2) Subserous ecchymosis is present.
(3) If potassium cyanide is taken, the stomach may be
wrinkled, reddish-brown in color and the blood vessels in
the wall are distended.
f. Congestion with edema of the brain.
g. Other organs do not show any gross changes.
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APPENDIX
BASIC PRINCIPLES OF PHILIPPINE CRIMINAL L A W
C R I M I N A L O R PENAL L A W DEFINED:
Criminal or Penal L a w is defined as that branch or division of law
which defines crimes, treats of their nature and provides for their punish-
ment.
The Philippine criminal law is embodied in the R E V I S E D P E N A L
CODE and in the penal provision of other statutes.
The Revised Penal Code took effect on January 1, 1932. ( A r t . 1) It
consists principally of three parts, namely:
( a ) Principles affecting criminal liability (Arts. 1-20)
( b ) Provisions on penalties including criminal and civil liability (Arts.
21-113)
( e ) Felonies defined under different title ( A r t . 114-367).
Characteristics of Penal Laws:
( 1 ) It must be general:
The penai law must apply to all person within a territory, ir-
respective of sex, race, nationality, and other personal circumstances;
with certain exceptions.
( 2 ) It must be territorial:
As a general rule, penal laws are enforcible within the terri-
torial jurisdiction of a state. It is inherent upon a state to pro-
mulgate such laws which it thinks best for its self-preservation.
( 3 ) It is prospective:
No person can be penalized for a crime which is not punishable
at the time of commission.
A P P L I C A T I O N OF THE PROVISIONS OF THE REVISED PENAL CODE:
Except as provided in the treaties and laws of preferential application,
the provisions of this Code shall be enforced not only within the Philip-
pine Archipelago, including its atmosphere, its interior waters and maritime
zone, but also outside its jurisdiction against those who:
1. Should commit an offense while on a Philippine ship or airship.
2. Should forge or counterfeit any coin or currency note of the Philip-
pine Islands or obligations and securities issued by the Government
of the Philippine Islands.
3. Should be liable for acts connected with the introduction into this
Islands of the obligations and securities mentioned in the preced-
ing number.
4. While being public officers or employees, should commit an offense
in the exercise of their functions; or
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5. Should commit any of the crimes against national security and law
of nations, defined in Title One of Book Two of this Code. (Art. 2).
Exceptions to the Rule that the Penal Laws are Strictly Territorial:
I. Provisions of treaties and Laws of -preferential application:
The Philippines accepted the principles of international law as a
part of the law of the land. The generally accepted principles of
International Law must prevail over the existing municipal laws in
case of conflict between the two laws.
1. Provision of Treaty:
The Philippine-United States Base Agreement:
a. The Philippine consents that the United States shall have the
right to exercise jurisdiction over the following offenses:
(1) Any offense committed by any person within any base ex-
cept:
(a) Where the offender and the offended parties are citizens
of the Philippines, and
(b) The offense is against the security of the Philippines.
(2) Any offense committed outside the bases by any member
of the armed forces of the United States in which the of-
fended party is also a member of the armed forces of the
United States.
(3) Any offense committed outside the base by member of the
armed forces of the United States against the security of
the United States.
b. The Philippines shall have the right to exercise jurisdiction over
all other offenses committed outside the bases by any member
of the armed forces of the United States.
2. Operation of International Law (Exterritoriality):
The right of exterritoriality is the right to be exempted from
local jurisdiction granted to citizen or subjects of another state
by operation of International Law.
Exterritoriality embraced the following immunities and privileges
of diplomats and members of the suite:
a. Exemption from criminal and civil jurisdiction.
b. Immunity of domicile and diplomatic premises from local juris-
diction (franchise de l'hotel).
The diplomatic envoy and his residence is considered to be an
extension of the territory and person of the country wherein he is
a citizen of.
I I . Statutory Exceptions:
Article 2 of the Revised Penal Code mentioned specific instances
wherein the provision may also be applied.
1. Should commit an offense while on a Philippine ship or airship.
This is based on the theory that the vessel or airship of local
registry is an extension of the territory of the Philippines.
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If the offense is committed within the Philippine maritime zone
on board foreign ships, the following are the theories as to juris-
diction:
a. French Rule — If the crime is committed on board a foreign
vessel in Philippine water, it should not be prosecuted in our
local court, except when the offense affects the peace, security
and safety of the Philippines. This theory emphasizes nationality.
b. English Rule — If a crime is committed on board a foreign
vessel in Philippine water, the case is triable in our local court,
except when it merely affects internal discipline and manage-
ment of the vessel.
2. Should forge or counterfeit any coin or currency not of the Philip-
pine Islands or obligations and securities issued by the government
of the Philippine Islands.
S. Should be liable for acts connected with the introduction into this
Islands of the obligations and securities mentioned in the preceding
number.
4. While being public officers or employees, should commit an offense
in the exercise of their function; or
5. Should commit any of the crimes against national security and laws
of national.
The reason for this is to safeguard the State from acts of
treason and espionage based upon the inherent right of a state
to self-defense.
DEFINITION OF FELOND2S:
Acts and omissions punishable by law are felonies (delitos).
Felonies are committed not only by means of deceit (dolo) but also
by means of fault (culpa).
There is deceit when the act is performed with deliberate intent; and
there is fault when the wrongful act results from imprudence, negligence, lack
of foresight, or lack of skill. (Art. 3).
Elements of a Felony:
1. There must be an act or omission:
By act is meant the positive action on the part of a person
doing a thing which he must not lawfully do, while omission is
failure of a person to do a thing which he is legally obliged to do.
2. Such act or omission must be done voluntarily:
There must be free and voluntary act or omission on the part
of the person committing the felony. If the act or omission is done
due to the compulsion of an irresistible force or due to an impulse
of an uncontrollable fear or an equal or greater injury, then the
person is exempted from criminal liability.
3. Such act or omission must be punishable by law at the time of the
commission:
No felony shall be punishable by any penalty not prescribed
by law prior to its commission. (Art. 21). Penal laws shall have
• a retroactive effect in so far as they favor the person guilty of
a felony, who is not habitual criminal, although at the time of the
publication of such laws a final sentence has been pronounced and
the convict is serving; the same.
CRIMINAL INTENT:
As a general |rule, intent is necessary in a felony, for an act does not
make a person a criminal unless he possesses a criminal mind.
Requisites of Criminal Intent:
1. There must be freedom of the person committing the felony:
There is no freedom to act in the following instances:
a. Any person who acts under the compulsion of an irresistible
force. ( N o . 5, Art. 12).
b. Any person who acts under the impulse of an uncontrollable
fear or an equal or greater injury. ( N o . 4, Art. 12).
2. There must be intelligence on the part of the person committing
the felony:
In the following instances a person is exempted from criminal
liability because of the lack of intelligence:
a. An imbecile or an insane, unless the latter has acted during
a lucid interval. ( N o . 1, Art. 12).
b. Persons under nine years of age.
c. A person over nine years of age and under fifteen, unless
he has acted with discernment ( N o . 3, Art. 12).
For crimes defined under the Revised Penal Code, criminal intent is
necessary, however in other statutory crimes, the intent is immaterial,
provided that the prohibited act is committed.
CRIMINAL LIABILITY:
Criminal liability shall be incurred:
1. By any person committing a felony (delito) although the wrongful
act done be different from that which he intended.
2. By any person performing an act which would be an offense against
persons or property, were it not for the inherent impossibility of its
accomplishment or on account of the employment of inadequate or ineffectual
means. ( A r t . 4).
This includes the impossible crimes. Although the wrongful act
was made with evil intent, it does not produce the desired injury
on account of either of the following:
1* Inherent impossibility of accomplishing it.
2. Employment of inadequate or ineffectual means.
There is inherent impossibility of accomplishing the felony, when
the very nature of the act, it is impossible to consummate it.
Example:—Stabbing a person with intent to kill who has been long
long dead.
Employment of inadequate or ineffectual means implies that the
offended performs an act which is not capable of producing the de-
sired effect.
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Example: — When a person tries to kill another by putting arsenic
in the drinking water when in fact it is table salt.
The provision only refers to acts which would have been an offense
against persons or property. It does not refer to other crimes de-
scribed in the Revised Penal Code.
The penalty imposed in the commission of the impossible crimes
depends upon the social danger and the degree of criminality of the
offender and shall impose upon him the penalty of arresto mayor
or a fine ranging from 200 to 500 pesos ( A r t . 59).
I. By any person committing a felony (delito) although the wrongful act
done be different from that which he intended:
A person is responsible for all the natural and logical consequences
of his felonious act even if the wrongful act done is different from
that which he intended to commit.
The following requisites must concur before a person can be held
responsible for the felony if the wrongful act done is different from
that one intended:
1. That a felony was committed.
2. That the wrongful act done to the aggrieved party is a direct
and natural consequence of the crime committed by the offender.
Exceptions:
1. When the injury suffered by the offended party is due to some
causes or accident foreign to the facts constituting the felony.
Example: — If the offender inflicted slight physical injuries
to the offended, and later the offended died of heart failure.
The offender cannot be liable for homicide or murder but
only for slight physical injuries.
2. When the injury suffered by the offended party is due to his
inexcusable negligence or deliberate misconduct.
Example: — If the offended party received slight physical in-
juries from the offender and later the offended party deliber-
ately contaminated the wounds which later become serious,
the offender is only liable for slight physical injuries.
3. When the injury suffered by the offended party is due to the
lack of skill, lack of foresight, or gross carelessness or negligence
of a third person.
Example: — If the offender inflicted less serious physical in-
juries to the offended and due to the gross negligence of the
attending physician, the offended died, the offender is only
liable for less serious physical injuries.
I I . By any person performing an act which would be an offense against
persons or property, where it not for the inherent impossibility of its
accomplishment or on account of the employment of inadequate or in-
effectual means ( P a r . 2, Art. 4 ) .
STAGES OF EXECUTION OF A CRIME:
Consummated, as well as those which are frustrated and attempted,
are punishable.
A felony is consummated when all the elements necessary for its execu-
tion and accomplishment are present; and it is frustrated when the offender
performs all the acts of execution which would produce a felony as a
consequence but which, nevertheless, do not produce it by reason of causes
independent of the will of the perpetrator.
There is an attempt when the offender commences the commission
of a felony directly by overacts, and does not perform all the acts of
execution which should produce the felony by reason of some causes or
accident other than his own spontaneous desistance. (Art. 6).
1. Attempted crime:
In attempted felony, the offender never goes beyond the sub-
jective phase of the crime. The following are the requisites:
a. The offender commences directly or by overt acts the execu-
tion of the crime.
b. The external acts must have direct connection with the crime.
Overt act means the act which followed by another act will
commit the felony.
c. The offender fails to perform all the acts of execution by
reason or cause other than his spontaneous desistance.
In attempted felony, the offender fails to perform all the acts
of execution of the crime due to external interventions or causes.
If the offender desisted later because of fear or remorse, there
would be no attempted felony and such act is not punishable by law.
The reason of the law for exempting him from any criminal liability
is to reward him for having been at the verge of a crime, heed
to the call of his conscience and return to the path of righteousness.
(Guevarra)
Example: The offender with intent to kill tried to aim his gun
against another person, but fortunately the gun was grabbed
by another.
2. Frustrated Crime:
There is frustrated felony when the offender has performed all
the acts of execution which will produce the felony, but it did not
produce the crime because of some causes independent of the will
of the offender. The subjective phase of the crime is complete
but fails to realize the objective phase for reason independent of
the will of the offender.
The subjective phase of the crime begins from the moment the
offender thought of committing the felony or from the commence-
ment of the overt acts to the last act of the offender to produce
the desired effect. The objective phase starts beyond the last act
of the offender up to the time the desired effect has been produced.
Requisites:
a. The offender has done all the acts of execution which would
produce the felony.
b. The desired effect was not produced by reason or causes
independent of the will of the offender.
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If the desired felony was not produced because of the
voluntary will of the perpetrator, then there is no frustrated
crime.
Example: The offender with intent to kill stabbed a person
in the abdomen and because of the timely intervention by
a surgeon, the offended did not die.
3. Consummated Crime:
There is consummated crime when the offender has done all
CIRCUMSTANCES AFFECTING C R I M I N A L LIABILITY:
of the acts of execution necessary for a felony and the desired
result as a direct and natural consequence of which was produced.
The crime is complete in its subjective and objective phase.
Example: An offender stabbed treacherously another person with
intent to kill and as a result of which the victim died. The
offender may be charged for consummated murder.
the life of the Chief Executive, or is known to be habitually
guilty of some other crimes. ( A r t . 19).
The penalty prescribed by law for the commission of a felony
shall be imposed upon the principals in the commission of the felony.
Whenever the law prescribes a penalty for a felony in general
terms, it shall be understood as applicable to the consummated
felony. ( A r t . 46).
I. Justifying Circumstances:
A person who acted by virtue of a justifying circumstance does not
commit a crime in the eye of the law. In as much as no crime is
committed then it follows that there is no criminal. The person is
exempted from criminal and civil liability.

PERSONS CRIMINALLY LIABLE:
1. Principals:
The following are considered principals:
a. Those who take a direct part in the execution of the act
(Principal by direct participation);
b. Those who directly force or induce others to commit it
(Principal by inducement);
c. Those who cooperate in the commission of the offense by
another act without^ which it would not have been accomplished
(Principal by cooperation). (Art. 17)
2. Accomplices:
Accomplices are those persons who, not having included in Article
17 (Principals), cooperate in the execution of the offense by pre-
vious or simultaneous acts. (Art. 18).
The presence of an accomplice although necessary is not indis-
pensable. The accomplice in order to be criminally liable must
have a common criminal purpose with the principal. The accom-
plice must have the intention to help morally or materially in
the commission of the crime.
3. Accessories:
The following do not incur any criminal liability:
1. Anyone who acts in defense of his person or rights, provided that
the following circumstances concur:
First. Unlawful aggression;
Second. Reasonable necessity of the means employed to prevent
or repel it;
Third. Lack of sufficient provocation on the part of the person
defending himself.
2. Anyone who acts in defense of the person or rights of his spouse,
ascendants, descendants, or legitimate, natural or adopted brothers
or sisters, or of his relatives by affinity in the same degrees, and
those by consanguinity within the fourth civil degree, provided that
the first and second requisites prescribed in the next preceding cir-
cumstance are present, and the further requisite, in case the pro-
vocation was given by the person attacked, that the one making
defense had no part therein.
3. Anyone who acts in defense of the person or right of a stranger,
provided that the first and second requisites mentioned in the first
circumstance of this article are present and that the person defend-
ing be not induced by revenge, resentment, or other civil motive.

Accessories are those who, having knowledge of the commission
of the crime, and without having participated therein, either as
principals or accomplices, take part subsequent to its commission
in any of the following manners:
a. By profiting themselves or assisting the offenders to profit
by the effect of the crime.
b. By concealing or destroying the body of the crime, or the
effects or instruments thereof, in order to prevent its dis-
covery.
c. By harboring, concealing, or assisting in the escape of the
principal of the crime, provided the accessory acts with abuse
of his public functions or whenever the author of the crime
is guilty of treason, parricide, murder, or an attempt to take
4. Any person who, in order to avoid an evil or injury, does an act
which causes damage to another, provided that the following re-
quisites are present:
First. That the evil sought to be avoided actually exists;
Second. That the injury feared be greater than that done to
avoid it;
Third.- That there be no other practical and less harmful means
of preventing it.
5. Any person who acts in the fulfillment of a duty or in the lawful
exercise of a right or office.
6. Any person who acts in obedience to an order issued by a superior
for some lawful purposes. ( A r t . 11).
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II. Exempting Circumstances: Circumstances which Mitigate Criminal Liability:

In exempting circumstances, there is a crime committed but there
is no criminal on account of the absence of free will and voluntariness
to act. The offender although exempted from the criminal liability
may be civilly liable for his felonious act.
Circumstances which exempt from Criminal Liability:
1. An imbecile or an insane person, unless the latter has acted during
, a lucid interval.
When the imbecile or an insane person has committed an act
which the law defines as a felony (delito), the court shall order
his confinement in one of the hospitals or asylums established for
persons thus afflicted, where he shall not be permitted to leave
without first obtaining the permission of the* same court.
2. A person under nine years of age.
3. A person over nine years of age and under fifteen unless he has
acted with discernment, in which case, such minor shall be pro-
ceeded against in accordance with the provision of article 80 of
this Code.
When such minor is adjudged to be criminally irresponsible, the
court, in conformity with the provisions of this and the preceding
paragraph, shall commit him to the care and custody of his family
who shall be charged with his surveillance and education; other-
wise, he shall be committed to the care of some institution or person
mentioned in said article 80.
4. Any person who, while performing a lawful act with due care,
causes an injury by mere accident without fault or intention of
causing it.
5. Any person who acts under the compulsion of an irresistible force.
6. Any person who acts under the impulse of an uncontrollable fear
of an equal or greater injury.
7. Any person who fails to perform an act required by law, when
prevented by some lawful or insuperable cause. (Art. 12).
III. Mitigating Circumstances:
These are circumstances which lessen the penalty. The penalty
may be the minimum within a degree provided there are no aggravating
circumstances to off-set them or the penalty will be lowered one or
two degrees from that one prescribed by law.
Kinds of Mitigating Circumstances:
1. Privileged mitigating circumstances:
This kind of mitigating circumstances cannot be off-set by ag-
gravating circumstances. It lowers the penalty one or two degrees.
2. Ordinary mitigating circumstances:
This can be off-set by the aggravating circumstances and lower
only the penalty to the minimum period within a degree. (Padilla).
1. Those mentioned in the preceding chapter, when all the requisites
necessary to justify the act or to exempt from criminal liability
in the respective cases are not attendant.
2. That the offender is under eighteen years of age or over seventy
years. In the case of the minor, he shall be proceeded against
in accordance with the provisions of Art. 80.
3. That the offender had no intention to commit so grave a wrong
as that committed.
4. That sufficient provocation or threat on the part of the offended
party immediately preceded the act.
5. That the act was committed in the immediate vindication of a
grave offense to the one committing the felony (delito), his spouse,
ascendants, descendants, legitimate, natural or adopted brothers
or sisters, or relatives by affinity within the same degrees.
6. That of having acted upon an impulse so powerful as naturally
to have produced passion or obfuscation.
7. That the offender had voluntarily surrendered himself to a person
in authority or his agents, or that he had voluntarily confessed
his guilt before the court prior to the presentation of the evidence
for the prosecution.
8. That the offender is deaf and dumb, blind or otherwise suffering
some physical defect which thus restricts his means of action,
defense, or communication with his fellow beings.
9. Such illness of the offender as would diminish the exercise of the
will-power of the offender without however depriving him of con-
sciousness of his acts.
10. And, finally, any other circumstance of a similar nature and
analogous to those above mentioned. (Art. 13).
IV. Aggravating Circumstances:
Aggravating circumstances increase the penalty or qualify a crime
to a graver one. The basis is the moral perversion of the offender is
dangerous to the state and justify longer confinement.
Kinds of Aggravating Circumstances:
1. Generic — Those aggravating circumstances that may be applied
to all crimes. Example: recidivism, night time.
2. Specific — Those that may only be applied to a particular crime.
Example: Cruelty can only be applied to crime against person.
3. Qualifying — These are aggravating circumstances that change the
nature of the crime. Example: Treachery qualifies homicide to
murder.
4. Inherent — Those that are considered to be a party of the crime
itself. Example: Breaking of the wall in robbery. (Padilla).
Circumstances Which Aggravate Criminal Liability:
1. That advantage be taken by the offender of his public position.
2. That the crime be committed in contempt of or with insult to the
public authorities.
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3. That the act he committed with insult or in disregard of the respect
due the offended party on account of his rank, age, or Bex or
that it be committed in the dwelling of the offended party, if the
latter has not given provocation.
4. That the act be committed with abuse of confidence or obvious
ungratefulness.
5. That the crime be committed in the palace of the Chief Executive,
or in his presence, or where public authorities are engaged in the
discharge of their duties, or in place dedicated to religious worship.
6. That the crime be committed in the night time or in an un-
inhabited place, or by a band, whenever such circumstances may
facilitate the commission of the offense.
7. That the crime be committed on the occasion of a conflagration,
shipwreck, earthquake, epidemic, or other calamity or misfortune.
8. That the crime be committed with the aid of armed men or persons
who insure or afford impunity.
9. That the accused is a recidivist.
A recidivist is one who, at the time of his trial for one crime,
shall have been previously convicted final judgment of another
crime embraced in the same title of this Code.
10. That the offender has been previously punished for an offense
to which the law attaches an equal or greater penalty or for two
or more crimes to which it attaches a lighter penalty.
11. That the crime be committed in consideration of a price, reward,
or promise.
12. That the crime be committed by means of inundation, fire, poison,
explosion, stranding of a vessel or intentional damage, thereto, de-
railment of a locomotive, or by the use of any other artifice in-
volving great waste and ruin.
13. That the act be committed with evident premeditation.
14. That craft, fraud, or disguise be employed.
15. That advantage be taken of superior strength, or means be em-
ployed to weaken the defense.
16. That the act be committed with treachery (alevosia). There is
treachery when the offender commits any of the crimes against
the person, employing means, methods, or form in the execution
thereof which tend directly and specially to insure its execution,
without risk to himself arising from the defense which the offended
party might make.
17. That means be employed or circumstances brought about which add
ignominy to the natural effects of the act.
18. That the crime be committed after an unlawful entry.
There is an unlawful entry when the entrance is effected by
a way not intended for the purpose.
19. That as a means to the commission of a crime a wall, roof, floor,
door, or window be broken.
20. That the crime be committed with the aid of persons under fifteen
years of age or by means of motor vehicles, airships, or other
similar means.
21. That the wrong done in the commission of the crime be deliberately
augmented by causing other wrong not necessary for its commission
(Art. 14, Revised Penal Code).
V. Alternative Circumstances:
Alternative circumstances are those which must be taken into con-
sideration as aggravating or mitigating according to the nature and
effects of the crime and the other conditions attending its commission.
They are the relationship, intoxication and the degree of instruction and
education of the offender.
The alternative circumstance of relationship shall be taken into con-
sideration when the offended party is the spouse, ascendant, descendant,
legitimate, natural, or adopted brother or sister, or relative by affinity
in the same degrees of the offender.
The intoxication of the offender shall be taken into consideration as
a mitigating circumstance when the offender has committed a felony
in the state of intoxication, if the same is not habitual or subsequent
to the plan to commit said felony; but when the intoxication is habitual
or intentional it shall be considered as an aggravating circumstance.
(Art. 15).
PENALTIES:
No felony shall be punishable by any penalty not prescribed by law
prior to its commission (Art. 21). Penal laws shall have a retroactive
effect in so far as they favor the person guilty of a felony, who is not
a habitual criminal, as this term is defined in rule 5 of article 62 of this
code, although at the time of the publication of such laws of final sentence
has been pronounced and the convict is serving the same. (Art. 22). For
purposes of this article, a person shall be deemed to be habitual delinquent,
if within a period of ten years from the date of his release or last con-
viction of the crimes of serious or less serious physical injuries, robo, hurto,
estafa, or falsification, he is found guilty of any of said crimes a third
time or offender. (Rule 5, Art. 62).
Theories Justifying Penalties:
1. As a preventive measure of the State:
The state is obliged to punish the criminals to prevent or sup-
press the danger to the State and to the public arising from the
criminal acts of the offender.
2. As a measure of self-defense:
The State has the right to punish the wrong-doer to protect
society from the threat and wrong inflicted by the criminal.
3. To reform the criminal:
It is the prime duty of the State to correct or reform the
criminals.
4. For exemplarity:
The wrong-doer is punished to be made as an example to dis-
courage others committing crimes.
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5. To do justice: 3. Prision mayor and temporary disqualification:

The criminals are punished by the State as a n act o f retributive The duration of the penalties of prision mayor and temporary
disqualification shall be from six years and one day to twelve yean
justice, a vindication of absolute right a n d moral l a w violated by
except when the penalty of disqualification imposed as an accessory
the criminal. penalty, in which case its duration shall be that of the principal
Classification of Penalties:
penalty. (Art. 27>
4. Prision correccional, suspension and destierro:
I . Principal Penalties:
The duration of the penalties of prision correccional, suspension
1. Capital punishment: and destierro shall be from six months and one day to six years,
death except when suspension is imposed as an accessory penalty; in which
2. Afflictive penalties: case, its duration shall be that of the principal penalty. (Art. 27)
Reclusion perpetua 5. Arresto Mayor:
Reclusion temporal The duration of the penalty of arresto mayor Bhall be from one
Perpetual or temporary absolute disqualification month and one day to six months. (Art. 27)
Perpetual or temporary special disqualification 6. Arresto Menor:
Prision mayor
The duration of the penalty of arresto menor shall be from one
3. Correctional penalties: day to thirty days. (Art. 27)
Prision correccional 7. Bond to keep the peace:
Arresto mayor The bond to keep the peace shall be required to cover such period
Suspension of time as the court may determine. (Art. 27)
Destierro
Effects of the Penalties:
4. Light penalties:
1. Perpetual or temporary absolute disqualification:
Arresto menor
Public censure a. The deprivation of the public offices and employments which
the offender may have held, even if conferred by popular election.
5. Penalties common to the three preceding classes: , b. The deprivation of the right to vote in any election for any
Fine, and popular elective office or to be elected to such office.
Bond to keep the peace.
c. The disqualification for the offices or public employment and
II. Accessory Penalties: for the exercise of any of the rights mentioned.
1. Perpetual or temporary absolute disqualification In case of temporary disqualification, such disqualification as
2. Perpetual or temporary special disqualification is comprised in paragraphs 2 and 3 of this article shall last
3. Suspension from public office, the right to vote and to be voted during the term of the sentence.
for, the profession or calling. d. The loss of all rights to retirement pay or other pension for any
4. Civil interdiction office formerly held. (Art. 30)
5. Indemnification 2. Perpetual or temporary special disqualification:
6. Forfeiture or confiscation of instruments and proceeds of the of- a. The deprivation of the office, employment, profession or calling
fense affected.
7. Payment of costs. (Art. 25) b. The disqualification for holding similar offices or employments
either perpetually or during the term of the sentence, according to
Duration of Penalties: the extent of such disqualification. (Art. 31)
1. Reclusion perpetua: 3. Suspension from any public office, profession or calling, or right
Any person sentenced to any of the perpetual penalties shall be of suffrage:
pardoned after undergoing the penalty for thirty years, unless such The suspension from public office, profession or calling, and the
person by reason of his conduct or some other serious cause shall exercise of suffrage shall disqualify the offender from holding Buch
be considered by the Chief Executive as unworthy of pardon.
office or exercising such profession or calling or right of suffrage
(Art. 27)
during the term of the sentence.
2. Reclusion temporal: The person suspended from holding public office shall not hold
The penalty of reclusion temporal shall be from twelve years another having similar functions during the period of his suspension.
and one day to twenty years. (Art. 27) (Art. 33)
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4. Civil Interdiction:
Civil interdiction shall deprive the offender during; the time of
his sentence of {he rights of parental authority, or guardianship,
either as to the person or property of any ward, of marital au-
thority, of the right to manage his property and of the right to
dispose of such property by any act or any conveyance inter vivos.
( A r t 34)
5. Bond to keep the peace:
It shall be the duty of any person sentenced to give bond to
keep the peace, to present two sufficient sureties who shall under- 758 LEGAL MEDICINE
take that such person will not commit the offense sought to be
prevented, and that in case such offense be committed they will A consipracy exists when two or more person come to an agreement
pay the amount determined by the court in its judgment, or other- concerning the commission of a felony and decide to commit it
wise to deposit such amount in the office of the clerk of the court, There is proposal when the person who has decided to commit a felony
to guarantee said undertaking. proposes its execution to some other person or persons. (Art. 8)
The court shall determine, according to its discretion, the period
of duration of the bond. EXTINCTIONS OF CRIMINAL LIABILITY:
Should the person sentenced fail to give the bond as required
I . Total Extinction:
he shall be detained for a period which shall in no case exceed
1. By the death of the convict, as to the personal penalties; and as to
six months, if he shall have been prosecuted for a grave or less grave
felony, and shall not exceed thirty days for a light felony. (Art. 35) pecuniary penalties, liability therefore is extinguished only when
death of the offender occurs before final judgment.
6. Destierro: 2- By service of the sentence.
Any person sentenced to destierro shall not be permitted to enter 3. By amnesty, which completely extinguishes the penalty and all its
the place or places designated in the sentence, nor within the radius effects.
therein specified, which shall not be more than 250 and less than 4. By absolute pardon.
25 kilometers from the place designated. (Art 87)
6. By prescription of the crime.
EFFECT OF PARDON: 6. By prescription of the offense.
A pardon shall not work the restoration of the right to hold public 7. By the marriage of the offended woman, as provided in article 344
office, or the right of suffrage, unless such rights be expressly restored of this Code. (Art. 89)
by the terms of the pardon. I I . Partial Extinction:
A pardon shall in no case exempt the culprit from the payment of 1. By conditional pardon.
the civil indemnity imposed upon him by the sentence. (Art. 36)
2. By commutation of the sentence.
DIVISION OF THE DEGREE OF PENALTY INTO PERIODS: 3. For good conduct' allowances which the culprit may earn while he is
Each degree of penalty is further subdivided into three periods, namely: serving his sentence. (Art. 94)
maximum, medium, and minimum periods, except the indivisible penalties, 4. Special time allowance for loyalty (Art. 98)
like death. As to what period within a degree shall be imposed upon a 5. Preventive imprisonment.
convict depends upon the mitigating and aggravating circumstances present
which must offset one another.

DEFINITION OF COMPLEX CRIME:

When a single act constitutes two or more grave felonies, or when
an offense is a necessary means for committing the other, the penalty for
the most serious crime shall be imposed, and the same to be applied in
its maximum period (Art. 48)

CONSPIRACY AND PROPOSAL TO COMMIT FELONY:

Conspiracy and proposal to commit felony are punishable only in
cases in which the law specially provides a penalty therefor.
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REFERENCES
Adelson, Lester, THE PATHOLOGY OF HOMICIDE , 1974, Charles C. Thomas
Publisher, Springfield, Illinois, USA.
Anderson, W. A. D., SYNOPSIS OF PATHOLOGY, 9th ed., 1967, The C.V. Mosby
Co., St. Louis.
Beall, Walter C, WRONGFUL DEATH AND SURVIVORSHIP, 1958, The W.H. An-
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Bhattacharyya, Rai Saheb Nagendar Kumar, COX'S MEDICO-LEGAL COURT COM-
PANION, 4th Rev. ed., 1950, Eastern Law House Ltd., Calcutta.
Biglieri, Edward G., PHYSICIAN'S HANDBOOK, 18th ed., 1976, Lange Medical
Publishing Maruzes Co., Ltd.
Black, Henry Campbell, BLACK'S LAW DICTONARY, 4th ed, 1951,West Pub-
lishing Co, St. Paul, Minnesota.
Boas, Ernst P., CARDIAC INJURY RESULTING FROM EFFORT OR TRAUMA:
CLINICAL AND LEGAL ASPECTS, 1955, Edwards Brothers, Inc., Ann
Arbor, Michigan.
Bowden, Keith Macrae, MOLLISON'S FORENSIC MEDICINE, LECTURES, 5th
ed., 1949, W. Ramsay (Surgical) Property Ltd., Melbourne.
Brend, William A., A HANDBOOK OF MEDICAL JURISPRUDENCE & TOXI-
COLOGY, 8th Rev. ed., 1941, Charles Griffin & Co., Ltd. London.
Brown, Kent Louis, MEDICAL PROBLEMS AND THE LAW, 1971, Charles C.
Thomas. Publisher, Springfield, Illinois, USA.
Bryan, James E., PUBLIC RELATIONS IN MEDICAL PRACTICE, 1954, The
Williams and Wilkins Co., Baltimore.
Surges, S. H. &Hlton, J.E., eds., THE NEW POLICE SURGEON, 1978, Hutchinson
Benham Ltd., London.
Camps, Francis E. & Purchase, W.B., PRACTICAL FORENSIC MEDICINE, 1957,
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Camps, Francis E., ed., GRADWOHL'S LEGAL MEDICINE, 3rd ed., 1976, John
Wright & Sons Ltd., Bristol.
Carpio, Frank S., VARIATIONS IN SEXUAL BEHAVIOR, 1955, John Calder
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Chadha, P. Vijay, HANDBOOK OF FORENSIC MEDICINE & TOXICOLOGY
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Cherasken, E., L L Langley & Ruth Slerper, DYNAMIC ANATOMY & PHYSIO-
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Child, Charles Gardner, STERILITY & CONCEPTION, Vol. I, 1931, D. Appleton
& Co., New York & London.
Cotran, Ramzi S. & Stanley L Robbins, PATHOLOGIC BASIS OF DISEASE, 2nd
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Curran, William J., LAW & MEDICINE TEXT & SOURCE MATERIAL ONM-L
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Curran, William J. & A. Louis McGarry, MODERN LEGAL MEDICINE, PSYCHI-
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Davidson, Henry A., FORENSIC PSYCHIATRY, 2nd ed., 1965, The Ronald Press
Co., New York.
Davidson, Maurice, MEDICAL ETHICS, 1957, Lloyd-Luke (Medical Books) Ltd.,
London.
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5
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I N D E X procedures, 168 recovery box, 385
when required, 165 special bullets, 340
-A- Ammunition, 336 Autosexual, 532 Burial requirements, 220
Amnesia, 630 Avulsion, 275 Burking, 450
Abduction, 520 Amphitanunes, 674 Burns, 400
Anamnesis, 634 - B -
Abortion, 557 age of, 405
causes, 558 Anemic Anoxic death, 426 ante-mortem, 405
Ballistic coefficient, 348
clinical types, 557 Anilingus, 533 cause of death, 404
Ballistic examination, 383
complications, 565 Anoxic death, 426 chemical burns, 410
Barbiturates, 664
medical evidences, 567 Anthropometry, 52 differential diagnosis, 407
Barotrauma, 421
methods of, 562 Apathy, 632 electrical burns, 412, 418
Barrel riflings, 344
penal provisions, 558 Apparent death, 116
Benzidine test, 98 - C -
practiced by physicians, 560 Arresto mayor, 756
Berberio's test, 510
pros and cons, 572 Arresto menor, 756
Bestosexual, 532 Cadaveric lividity, 131
Abrasion, 260 Arsenic poisoning, 736
Bibliotics, 66 Cadaveric rigidity, 126
Abrasion collar, 351 Artificial msemination, 601
Biological test of Farnum, 512 Cadaveric spasm, 128
Abuse against chastity, 527 classification, 601 Birth, 575 Cafe' coronary, 442
Accessories, 749 precaution, 602 causes of still-birth, 576 Cannibalism, 534
Accomplices, 749 status of the child, 603 importance of the study, 575 Carbolic acid poisoning, 735
Acetone-haemin or Wagenhaar test, 100 Asphyxia, 426 Black powder, 337 Carbon dioxide, 452
Acid phosphatase test, 511 classification, 427 Blistering gas, 457 Carbon monoxide, 451, 458
Active aggressive offender, 33 death from, 199 Blood grouping, 102 Cardio-respiratory death, 112
Adipocere formation, 149 mechanism of death, 429 Blood identification, 95 Carnal knowledge, 500
Adopted children, 596 phases, 427 biological examination, 100 Cartridge, 336
Adultery, 521 Asphyxiant gas, 457 chemical examination, 98 Cauliflower ear, 472
Age determination, 90 Associative evidence, 16 legal importance of the study, 95 Caustic alkali poisoning, 733
Aircraft injuries and fatalities, 423 Athletic sports, 469 micro-chemical examination, 99 Cephalic index, 82
Alcohol, 687 Atmospheric pressure injuries, 421 microscopic examination, 99 Cerebral hemorrhage, 306
absorption, 692 Atomic bomb explosion, 327 physical examination, 97 Champignon d'ocume, 446
concentration in blood, 694 effects to human body, 328 preliminary or gross examination, 97 Chemical burns, 410
effects, 693 place of, 328 problems in the examination, 96 Chemical explosion, 322
fate of alcohol in the human body, 701 Attempted crime, 748 spectroscopic examination, 100 Child abuse, 478
susceptibility, 700 Autolytic changes after death, 136 Blood poison gas, 458 causes, 479
symptoms, 695 Automatism, 212 Botulism, 730 classification of abuser, 480
tolerance, 700 Automotive crash, 459 Boxing, 470 other battered victims, 484
Alcoholic beverages, classified 687 factors responsible, 459 Brain death, 112 presumptive proof, 481
Alcoholism, 687 purpose of autopsy, 467 Braxton-Hick's sign, 544 social reaction, 481
causes, 690 Autopsies, 163 Breast, classified 487 Chlorine gas, 457
chemical test for intoxication, 708 hospital autopsies, 163 Breath analysis for alcohol, 706 Choking, 442
societal reaction, 710 kinds of, 165 Bullet, 338 Choking gas, 457
Algolagnia, 533 medico-legal autopsies, 164 classification, 339 Civil law, 4
Algor mortis, 120 mistakes, 178 efficiency, 348 Circumstances affecting criminal
American Law Institute rule, 640 persons authorized to perform, 165 embolism, 368 liability, 750
Ammonia poisoning, 734 preliminary stages, 170 kinetic energy, 347 aggravating, 752
767 migration, 368 alternative, 754
movement, 349 exempting, 751
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justifying, 750 requisites, 746 special death, 203 Dupertuis and Hadden's formulae, 77
mitigating, 751 Criminal law, 5, 743 under exceptional circumstances, 198 Dupuytren's classification, 401
Circumstantial evidence, 19 application, 743 violent cause, 183 Duquenois-levine test, 679
Clark's rule, 716 characteristics, 743 Death penalty, other methods 207 Duration of interment, 85
Criminal liability, 746 Death struggle of muscle, 126 Durham rule, 639
Cobalt thiocynate test, 680
Criminal offenders, types 33 Deception detection, 21 Dying declaration, 14
Cocaine, 676
Crural index, 83 hypnotism, 31 Dyspareunia, 533
Cocaine "body packer" syndrome, 677
Culpa, 745 intoxication with alcohol, 30 Dysthanasia, 208
Codicil, 626
Cunnilingus, 533 lie detector, 22
Cognition, disorder in 629 - E -
Currenslaw, 640 narcoanalysis, 30
Cold, local and systemic effect 394
observation, 31
Cold stiffening, 128 Ecbolics, 564
truth serum, 29
Coma, death from 201 - D - Edema aquosum, 446
word association test. 28
Comparison microscope, 385 Electrical burns, 412
Decompression, 422
Complex crime, 757 Dactylography, 56 nature, 418
Defense wound, 244
Compression, asphyxia by 450 Dactyloscopy, 56 Electrical explosion, 322
Defloration, 490
Compression, brain 309 Dangerous drug, 655 Electrical shock, 417
Deformity, legal meaning 250
Concubinage, 522 legal classification, 656 Electricity, 417
Deliriants, 680
Concussion, brain 309 pharmacological classification, 659 Electrocution, death by 204
Delirium, 653
Concussion, cerebral 259, 309 prescription, 683 Embalming, 220
Delivery, 552
Condensed reactant explosion, 323 Dead body disposal, 218 Emmenagogues, 563
signs of, 553
Confession, 36 donation of dead body, 230 Emotion, disorder 632
Delusion, 630
Consented abduction, 521 executor's right of custody, 219 Emotional offender, 34
types, 630
Conspiracy, 757 methods of disposal, 220 Emphysema aquosum, 446
rule, 637
Constitutional tolerance, 700 requirements, 221 Euthanasia, 207
Dementia, 629
Consummated crime, 749 right of possession, 218 criminal liability, 209
Demi-virginity, 486
Consumption tolerance, 700 scientific purpose and use, 228 Dental identification, 61 types, 208
Content of thought, disorder 630 Dead on arrival ( D O A ) , 185 Deposition, 15 who may perform, 209
Contraceptive methods, 616 Death, 111 Depression, 632 Evidence, 11
Contre-coup injury, 243, 301 autopsy, 163 Diaphanous test, 119 admissibility, 12
Contusion, 255 basis in death determination, 112 Diffused reactant explosion, 323 kinds, 19
Contuso-abradded collar, 351 body changes following death, 126 Dillie Koppanyi test, 679 preservation, 16
Coprolagnia, 535 causes of death, 182 Direct evidence, 19 weight and sufficiency, 19
Coprolalia, 536 degree of certainty, 183 Distilled liquor, 688 Exaltation, 632
Corpus delicti, 37 duration of, 151 Exhibitionism, 536
immediate cause, 182 Doctor Hankin's method, 512 Exhumation, 233
Corpus delicti evidence, 16
importance of determination, 111 Dolo, 745
Corruption of minors, 527 Explosion, 322
judicial death, 203 Donation of organs, 230
Coup injury, 243, 300 classification, 322
kinds of death, 116 Donjuanism, 536
Cowling's rule, 717 collection of evidence, 326
mechanism, 182 Drowning, 442
Crash asphyxia, 450 explosion site identification, 326
Cremation, 228 medico-legal classification, 185 cause of death, 443
types of chemical explosion, 323
Crib death, 184 medico-legal investigation, 156 phases of, 443
Eye changes following death, 124
Crime scene investigation, 159 natural cause, 183 post-mortem findings, 445
Crime scene methods of search, 161 pathological classification, 198 Drug addiction, 656 - F -
Crime stages of execution, 747 penal classification, 191 Drug defendence, 654, 656 Facies, 46
Criminals, persons criminally liable 749 presumptions, 154 Drug habituation, 656 Factitious malingering, 650
Criminal intent, 746 proximate cause, 182 Drunkard, 687 Fatal dose, 716
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Feeble-minded, 642 Grave scandal, 529 Harvard report of 1968, 113 Idiot, 641
Felonies, 745 Gravindex slide test, 546 Heat collapse, 397 Illusion, 629
elements, 745 Guaiacum test, 98 Heat cramps, 396 Imbecile, 642
Fetishism, 534 Gunpowder, 337 Heat exhaustion, 397 Immersion foot, 394
Fiber identification, 105 identification, 378 Heat hyperpyrexia, 397 Impossible crime, 746
Fictitious malingering, 650 residue determination, 378 Heat, local and systemic effect 396 Impotency, 620
Fingerprints, 56 Gun smoke, 350 Heat rupture, 407 causes, 621
kinds of impression, 57 Gunshot, 369 differential diagnosis, 407 Impression mark, 260
floaters, 58 accidental, 370 Heat stiffening, 128, 407 Impulsion, 633
types, 59 destructive effects, 352 Heatstroke, 397 Incendiarism, 535
Firearm, 332 effects on clothings, 367 Heat syncope, 397 Incest, 533
caliber, 346 factors affecting entrance, 367 Hegar's sign, 543 Incestuous seduction, 515
classification of small firearms, 334 from revolver or automatic, 373 Height index, 82 Incised wound, 263
parts, 343 homicidal, 370 Helicopter injuries, 424 Indecent exposure, 536
Firearm action, mechanism 346 suicidal, 369 Hematoma, 258 Infanticide, 194, 583
Firearm cartridge, 336 Gunshot wound, 353 Hemin crystals test, 100 how committed, 585
Fire investigation, 408 bigger than caliber, 358 Hemochromogen crystal test, 99 motives for committing, 584
Fireman's cramp, 396 contact fire, 354 Hemorrhage, 278 post-mortem findings, 586
Florence test, 510 determination of trajectory, 360 Hess or Haase's rule, 92 types of evidence, 584
Fodere's test, 578 entrance, 353 High order explosion, 323 Infantosexual, 531
Food poisoning, 729 evidence of entry, 359 Histotoxic anoxic death, 427 Inhibition, death by 184
Foot and hand impression, 46 Homicide, 196 Injurious substances, administration 250
exit, 361
Forcible abduction, 520 Homosexuals, 530 Injury, complications 283
far range, 358
Forensic, 3 Hospitalization of insane, 647 Inquest officer, 156
loose or near contact fire, 357
Fourchette, 488, 491 Humphrey's table, 78 Insanity, 625
medium range, 357
Fracture, skull 302 Hymen, classified 488, 492 Insanity and criminal responsibility, 635
short range, 357
Fracture a la signature, 302 laceration, 492 Instantaneous physiologic death, 184
smaller than caliber, 359
Friction mark, 260 Hypnotic drugs, 659 Instantaneous rigor of muscles, 128
Gutter fracture, 303
Frostbite, immersion foot 394 Hypnotism, 653 Intelligence test, 643
Frottage, 535 - H - Hypnosis, 31 Intentional abortion, 558
Funeral, 225 Hypobarism, 422 Intermembral index, 83
Hair identification, 107 Hydrochloric acid poisoning, 733 Interrogation, 32
limitations, 226 Hallucination, 629 Hydrogen cyanide, 454, 458 techniques, 35
requirements, 225 Hallucinogens, 666
Hydrogen sulfide, 453, 458 Intersexuality, 538
Handgun, 334
- G - Hyperbarism, 421 Intoxication, cause of death 702
automatic pistol, 335 Hydrostatic test, 578
Gagging, 441 conditions simulating, 697
revolver, 335 fallacies, 578
Gait, 44 Handwriting, 65 degree, 696
procedures, 578 test, 697
Gait pattern, 44 factors which determine, 67
Ganguli's method, 512 forgery, 73 Intoxication with alcohol, 30
Garroting, 440 movements, 66
I - Intracranial hemorrhage, 303
Gas, heated and compressed 349 Hanging, asphyxia by 428 Investigation, crime scene 160
Gas chamber, death by 207 cause of death, 431 Icard'stest, 118 composition, 160
Gerontophilia, 533 death by, 206 Identification, 41 equipments, 160
Gettler's test, 447 ligature, 430 importance, 41 importance, 160
Gonadal agenesis, 538 post-mortem finding, 433 methods, 42 methods, 161
Graphology, 66 treatment, 432 rules in personal identification, 41 techniques, 35
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Investigator's attitude & conduct, 33 Lewisite, 457
special preparation, 668 Missile, 338
In vitro fertilization, 606 Lie detector, 22
Marital dissatisfaction, 615 Mixoscopia, 536
basis of legality, 608 errors, 26
Marriage, 613 Molecular or cellular death, 116
possible situations, 607 inadmissibility, 25
incestuous, 614 Moral defective, 642
procedure of, 606 phases, 23
non-consummation, 616 Moron, 642
problems of surrogate mother, 610 Light factor in identification, 55
requirements, 613 Motorcycle crash, 468
status of the child, 612 Lightning, 414
Marquis test, 679 Mugging, 440
Irrational offender, 34 classes of burns, 415 Masochism, 534 Mummification, 148
Irresistible impulse rule, 639 diagnostic point, 415 Mayor's sign, 545 Munro-merritt, ageing subdural
Irrespirable gas, asphyxia by 451 effect in the body, 415 McNaghten's rule, 638 hematoma 305
Ischium-pubis index, 83 Line of cleavage, 276 Mechanical explosion, 322 Murder, 195
Live-birth, 576 Medical evidence, 11 Muscle changes following death, 126
- J - proof of, 577 autoptic, 12 Musculoskeletal injuries, 258
signs of maturity, 581 documentary, 15 Musketry, death by 206
Jacquemin-Chadwick's sign, 542
Livor mortis, 131 experimental, 15 Mustard gas, 457
Judicial death, 203
Locus rninoris resistencia, 243 physical, 16 Mutilation, 246
methods, 204
Low order explosion, 323 testimonial, 13 Mysophilia, 535
Jurisprudence, 4
Luminaria tent, 562 Medical jurist, 2
Lung irritant gas, 457 Medicine, 3 - N -
- K -
Lysergic acid diethylamide, ( L S D ) 672
Medico-legal autopsy, 164
Lysol poisoning, 735 Narcissism, 535
Kansas statute on death, 113 cases to be autopsied, 167
Narcoanalysis, 30
Kastle-Meyer's test, 98 peculiarities, 167
- M - Narcosynthesis, 30
Kidney punch, 472 persons authorized, 165
Nasal index, 82
Klenefetter syndrome, 538 precautions, 169
MacDonald's sign, 543 Natural child, 595
procedures, 168
Maceration, 150 Necrophilia, 533
- L - purpose, 164
Magnan's symptom, 677 Negative autopsy, 179
religious objections, 180 Neglected child, 478
Lacerated wound, 272 Magnus test, 118
stages, 170 Negligent autopsy, 180
Laceration, brain 307 Malingering, 649
Medico-legal v. hospital autopsies, 166 Negligent death, 192
Lacrimator, 456 causes, 649
Medico-legal investigation of death, 156 Nerve gas, 458
Langer's line, 276 types, 650 Medico-legal masquerade, 183
Malt liquor, 689 Nitric acid poisoning, 733
Lascivious acts, 518 Medullary index, 108
Maltreated child, 478 Non-emotional offender, 34
Law, 3 Memory, disorder 629
Mandrax, 666 Nuclear explosion, 322
Lead poisoning, 738 Mental deficiency, 641
Legal medicine, 1 Mania, 631
classification, 641
history, 7 Mannikinism, 535 - O -
criminal responsibility, 645
nature of study, 1 Manouvrier's formulae, 78
method of estimating mental Observation, 31
scope, 1 Manual strangulation, 439
capacity, 643 Obsession, 631
Legal separation, 618 manner of death, 439
Mesmerism, 653 Occupational marks, 47
grounds for, 618 methods, 439
Mercury poisoning, 737 Opium, 659
Legitimate children, 588 post-mortem findings, 439
Metal fouling, 356 derivatives, 660
presumption, 588 Marbolization, 137
Legitimation, 595 Metallization, 419 symptoms, 660
Marginal abrasion, 351
Length of survival, child 581 Marijuana, 667 Methaqualone, 665, 656 Opium addiction, evidence 662
Less serious physical injuries, 251 classification, 668 Methods of search, 161 post-mortem findings, 663
Leucomalachite green test, 98 effects, 669 Micro-crystalline test, 679 Orbital index, 82
Miner's cramp, 396 Organs, average measurement 176
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donations, 230 medical evidence, 721 - Q - Self-inflicted wound, 245

Orthothanasia, 208 site of action, 713 Self-mutilation, ways 245
Ospresiophilia, 534 treatment, 719 Qualified seduction, 515 Seminal fluid and spermatozoa, 509
Overlaying, 441 - R - Semisomnolence, 653
Poroscopy, 56, 60
Serious physical injuries, 248
- P - Portrait parle, 53
Race determination, 82 Severe abnormality, 643
Possession, concept of 218
Radiation, 328 Sex crimes, criminological
Palmar strangulation, 440 Post-mortem caloricity, 121
factors responsible for the effects consideration 498
Paralyzant gas, 458 Post-mortem contact flattening, 124
of, 329 Sex determination, 86
Pardon, effect 757 Post-mortem lividity, 131
rays emitted by radioactive evidence of, 88
Parricide, 194 Post-mortem rigidity, 126
substances, 328 Sexual abnormalities, 528, 530
Partialism, 535 Post-mortem suggilation, 131
other sources, 330 Sexual act, death due to 496
Passive inadequate offender, 34 Powder grains, 350 Sexual orgasm, 496
Paternity, proof 599 Rape. 500
Powder burns, 350
Pathological drunkenness, 704 elements of the crime, 500 Sexual physiological consideration, 495
Precipitin test, 100
Patterned wound, 245 evidence, 501, 505 Sexual reversal, 537
Pregnancy, 539
Pearson's formulae, 76 Rational offender, 34 Shored gunshot, 361
importance of determination, 539 Shotgun, range of fire 377
Pedestrian-vehicle collision, 464 Reclusion perpetua, 755
positive signs, 545 Shotgun wound, 374
Pedophilia, 531 Reclusion temporal, 755
presumptive signs, 541 Signature forgery, 73
Pelvic index, 82 Regulated drug, 656
Penalties, 754 Pregnancy slide test, 545 Remedial law, 5 Skeletal age determination, 83
Presumption of death, 154 Rigor mortis, 126 Skeleton identification, 75
classification, 755
Preternatural combustibility, 410 Rule of nine 278 Sketching, 17
effects, 756
Primer, 337 Russian roulette, 370 Slash injury, 263
Personal identification, 42
Prision correccional, 756 Slight physical injuries, 253
ordinary methods, 42 - S -
Prision mayor, 756 Slug, 338
scientific methods, 55
Prisoners, maltreatment 38 Sadism, 534 Smokeless powdei, 338
Petechiae, 255
Prohibited drugs, 656 Sado-masochism, 533 Smothering, 441
Phenolphthalein test, 98
Projectile, 338 Saponification, 149 Snake venom, 280
Phenol poisoning, 735
Propellant, 337 Satyriasis, 533 Sodomy, 535
Philadelphia protocol, 114
Prostitute, 523 Scald, 398 Somatic or clinical death, 116
Phobia, 632
Phosgene, 457 methods of control, 526 Scar, 51 Somnambulism, 652
Phosphorus poisoning, 739 type, 524 Schombein's test, 98 Sound and disposing mind, 626
Physical injuries, 246 Schourup's formula, 122 Souvenir bullet, 368
Prostitution house, 525
administration of injurious Scratch, 260 Special death, 203
Pseudocyesis, 549
substances, 250 Scientific identification, 55 Spermatozoa, 509
Psychological stress evaluator (PSE), 28
examination of wounded body, 288 age, 90 microscopic examination, 512
Psychomimetic drugs, 666
less serious, 251 blood, 95 Spontaneous combustibility, 410
Pugilistic encephalopathy, 475
mutilation, 246 dental, 61 Spurious children, 597
Punch drunkenness, 475, 704
serious, 248 fingerprint, 56 Stab wound, 267
Punctured wound, 271
slight, 253 handwriting, 65 Stagnant anoxic death, 426
Puramen reaction, 510
under exceptional circumstances, 198 Putrefaction, 136 hair and fibers, 107 Stare decisis, principle 4
Plastic bag suffocation, 441 skeleton, 75 Starvation. 213
Pluralism, 536 changes in, 140 sex, 86 causes, 214
Poison, 712 effect of pressure gases of, 137
Sea disposal, 227 causes of death, 215
classification, 725 modification to, 148
Sedatives, 664 survival, 214
laws, 730 Pygmalionism, 535 Seduction, 515 symptoms, 215
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State of suspended animation, 116 Tattoo marks, 49

Static test, 578 Tattooing, gunpowder 350
Stature, 48 Tear gas, 456
Statutory rape, 503 Thalidomide, 673
Sterility, 622 Thermal burns, 400
causes of, 623 Thermal injuries, 394
Sterilization, methods 623 Thermic fever, 397
Sternutator gas, 458 Throttling, 439
Still-birth, 576 Tokyo declaration, 38
778 L E G A L MEDICINE
causes, 576 Topinard and Rollet formula, 78
Stimulants, 674 Tracing evidence, 16 Volition or conation, disorder 633 investigation of, 288
Stoker's cramp, 396 Transexualism, 537 Voyeurism, 536 legal classification, 246
Strain, 259 Transvestism, 537 length of survival, 293
Trench foot, 394 - W - medical classification, 254
Strangulation, asphyxia by 436
Trend of thought, disorder 631 penetrating wound, 243
cause of death, 437
Trigger, 343 War gases, 455 perforating wound, 243
post-mortem findings, 438
White slave trade, 527 physics of, 240
treatment, 437 classification, 343
Wild beast rule, 637 possible instrument used, 294
Subarachnoidal hemorrhage, 306 Trigger pressure, 344
Will, 626 power to perform volitional act, 296
Subdural hemorrhage, 304 Troilism, 536
Wine, 687 regional injuries, 298
Subluxation, 259 Truth serum, 29
Winslow's test, 120 severity, 278
Submersion, asphyxia by 442 Tumultuous affray, 197, 254
Witness, 33 superficial wound, 243
Subnormality, 643 Turner's syndrome, 538
ordinary, 13 which cause death, 294
Succession, 626 Typewriter identification, 74
expert, 14 which was inflicted first, 295
Sudden infant death syndrome, 184 Wrestling, 476
Word association test, 28
Sudden unexplained nocturnal death, 185 - U -
Wound, 240
Suffocation, asphyxia by 441 ante- or post-mortem, 290 - X -
Suicide, 193, 211 Unintentional abortion, 559
cause of, 282
evidence, 212 Unnatural sexual offenses, 528
classification, 242 - Y -
methods employed, 212 Uranism, 535
deep wound, 243
psychological classification, 211 Urolagnia, 534
effect of medical and surgical Young'srule, 716
Suicide automotive crash, 463
intervention, 295
Sulfur dioxide, 455 - V -
extrinsic evidence, 297 - Z -
Sulfuric acid poisoning, 732
fatal effect, 282
Superfecundation, 549 Vaginal canal, 487, 491
gaping,of, 274 Zoophilia, 531
Superfoetation, 549 Vampirism, 535
healing of, 285 Zwikker's test, 679
Survivorship, presumption of 155 Van deen's test, 98
Suspect, 33 Vehicular crash evidence, 466
Suture obliteration, 85 Vehicular run over injury, 465
Syncope, death from 199 Vehicular turn-turtle impact, 462
Vesicant, 457
- T - Violent death, 190
Virginity, 485
Tache noir de la sclerotique, 125 determination of, 486
Takayama test, 99 kinds of, 485
Tandem bullet, 368 Virgo intacta, 486
Tardieu spot, 433 Vital reaction, 241
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LEGAL MEDICINE By
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PEDRO P. SOUS

PEDRO P. SOUS, M.D., Ll.B., D. Crim.

Professorial lecturer in Legal Medicine and Medical
Jurisprudence, University of the Philippines, Far
Eastern University, University of the East, Fatima
College of Medicine.
Medico-Legal Consultant, Makati Medical Center,
Manila Medical Center, U.E.-R.M. Memorial Hospital, All rights reserved
Manila Central University Hospital.
Retired Deputy Director For Technical Services,
National Bureau of Investigation.

P R I N I E U BY

R. P. GARCIA Publishing Co.,

903 Quezon Avenue, Quezon City
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like antibiotics and other potent bactericidal drugs. Injuries which
The professions of Medicine and Law, together with Theology have produced permanent deformity as a consequence, no longer do
are considered the most ancient and most learned of professions as so because of plastic surgery. The moment of death which was
they have commanded respect since the dawn of history. Both considered an uncertain future event can now be predetermined if a
Medicine and Law are dedicated to the service of humanity; Medicine, patient is hooked to a mechanical life-saving apparatus.
which its goal is to preserve lives and maintain the health of the It is essential that the professions of Medicine and Law com-
people while Law has as its goal to promote peace and order and give plement each other to be able to serve the best interest of the people.
justice to one whom justice is due. Both professions are involved in A connecting link must be built to bring them closer. This indeed is
the pursuance of truth. A medical practitioner is trained to diagnose the primordial objective of Legal Medicine. Legal Medicine is the
the true ailment the patient is suffering so as to institute the appro- proper venue or forum which will both harmonize and serve the
priate treatment, while a lawyer is concerned with the true nature purposes of the two disciplines. There is an increasing need for
of the law and the basis for its promulgation in consonance with the scientific medical facts in the field of Law and the administration of
demands of society. Practitioners of both professions have to justice. Substantive and procedural laws must also be made to
respect the right of their clients or patients. In so far as the infor- conform with established medical facts.
mation gathered by the physician from his patient is concerned, it
must be held in confidence by the former. In the same manner the It has never been the intention of the author to include all
lawyer cannot disclose information which he gathered from his aspects of Medicine which has to do with the legal issues. The subject
client. of Legal Medicine is quite pervasive and encompassing that a com-
prehensive treatment is not possible considering the time allocated
However, there are appreciable divergencies between Law and to the subject in the undergraduate courses. What are included
Medicine, the main purpose of Law is to maintain peace and order, herein are some of its basic principles. Details of specific subject
respect human rights and promote equality, while that of Medicine matters may be studied in textbooks of the different specialties
is to save the lives and preserve the health of the people. In the if Medicine.
doctor-patient relationship, the physician has the right to diagnose
and treat patients with limited interference from outside influences,
while in the lawyer-client relationship, external interference is in-
evitable. In defending a client-complainant, the lawyer is confronted
by the defendant, cross-party complainant or a third party defendant.
In the area of investigation or research; in Medicine, substantial
correlation between a scientific fact and a specific social factor is
considered sufficient, while in Law, there must be preponderance or
absolute correlation between a crime and its effects.
There is an aphorism which states that "people follow Medicine
and Law follows people". The stride of Law has a slower pace than
that of Medicine. Because of the advancement of Medicine, crimes
which would have been consumated in the past, can now become
frustrated. In criminal acts which would formerly have resulted in
deaths, the victims may, with the application of modern medical
management procedures, be able to live. Physical injuries can now be
classified of the lesser serious type on account of modern medicines
iii
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CHAPTER Page
INTRODUCTION 111
Types of Death 112
I. GENERAL CONSIDERATION 1 Kinds of Death 116
Signs of Death 117
Scope and Nature of Legal Medicine 1 ^Changes in the Body following Death 126
History 7 Changes in the Muscles 126
V Medical Evidence 11 Changes in the Blood 130
Methods of Preservation 17 Autolytic or Autodigestive 136
Weight and Sufficiency of Evidence 19 Putrefaction 136
II. DECEPTION DETECTION 21 Special Modification to Putrefaction 148
Duration of Death 151
Polygraph 22 Presumption of Death 154
Word Association Test 28 Presumption of Survivorship 155
Psychologic Stress Evaluator 28
Truth Serum 29 V. INVESTIGATION OF DEATH 156
Narcoanalysis or Narcosynthesis 30 Inquest Officer 156
Intoxication with Alcohol 30 Crime Scene Investigation 160
Observation 31 Autopsies 163
Scientific Interrogation 33
Admissibility of Evidence through Interrogation 34 VI. CAUSES OF DEATH 182
Confession 36 Immediate or Primary Cause of Death 182
Tokyo Declaration 38 Proximate or Secondary Cause of Death 182
Mechanism of Death 182
IDENTIFICATION Manner of Death 183
HI. MEDICO-LEGAL ASPECTS OF IDENTIFICATION 41 Instantaneous Physiologic Death 184
Medico-legal Classification of Death 185
Identification of Persons 42
Anthropometry 52 Penal Classification of Death 191
Portrait Parle S3 Pathological Classification of Death 198
Extrinsic Factors in Identification 54 VII. SPECIAL DEATHS 203
Light Factor in Identification 55 Judicial Death 203
'Fingerprinting 56 Euthanasia 207
Dental Identification 61 Death by Starvation 213
Handwriting 65
Identification of Skeleton 75 VID. DISPOSAL OF DEAD BODIES 218
Determination of Sex 86 Methods of Disposal of Dead Body 220
Determination of Age 90 Embalming 220
Identification of Blood and Blood Stains 95 Burial or Inhumation 220
Identification of Hair and Fibers 105 Disposal into the Sea 227
Cremation 228
v Use of Dead Body for Scientific Purposes 228
Donation of Parts of the Human Body 230
Exhumation 233
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PHYSICAL INJURIES Atomic Bomb Explosion 327

LX^MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES
Physical Injuries brought about by Physical Violence 240
^Classification of Wounds 242
. Legal Classification of Physical Injuries 246
< Mutilation 246
Serious Physical Injuries 248
Administering Injurious Substances or Beverages 2S0
Less Serious Physical Injuries 251
Slight Physical Injuries or Maltreatment 253
^Medical Classification of Wounds 254
Factors Affecting the Severity of Wounds 278
Fatality of Wound 282
Complication of Wound 283
Healing of Wounds 285
x. INVESTIGATION OF WOUNDS
Outline of Investigation of Physical Injuries 288
Determination Whether the Wounds were Inflicted
During Life or After Death 290
Length of Survival of the Victim 293
Possible Instruments Used by Assailant 294
Which Injuries Sustained Caused Death 294
Which of the Wounds was Inflicted First 295
Effect of Medical and Surgical Intervention 295
Volition Power of the Victim 296
Relative Position of the Victim & Assailant 297
Extrinsic Evidences in Wounds 297
XI. PHYSICAL INJURIES IN DIFFERENT PARTS
OF THE BODY
Head and Neck Injuries 299
Injuries in the Chest 314
Abdominal Injuries 317
Pelvic Injuries 320
Extremities 321
DEA TH OR PHYSICAL INJURIES
XII. DEATH OR PHYSICAL INJURIES CAUSED
BY EXPLOSION
Mechanical Explosion 322
Electrical Explosion 322
Chemical Explosion 322
Identification of the Site of Explosion
and Collection of Evidences 326
Other Sources of Radiation 330
XIII. GUNSHOT AND SHRAPNELS 332
Classification of Small Firearms 334
Cartridges or Ammunition 336
"'Firearm 343
Other Parts of Firearm 343
Mechanism of Firearm Action 346
Things Coming Out of the Gun Muzzle after the Fire 347
Bullet Kinetic Energy 347
Bullet Efficiency 348
Bullet Coefficient 348
Flame 349
Heated, Compressed and Expanded Gas 349
Factors Responsible for the Injurious Effects of Missile 351
/Gunshot Wound of Entrance 353
^Exit (Outshoot) Wound 361
Effects of Clothings in Gunshot 367
Special Consideration on Bullets 368
/Gunshot Wound - Suicidal, Homicidal or Accidental 369
Determination How Long a Firearm Has Been Fired 372
Determining Whether the Firearm is an Automatic
Pistol or a Revolver 373
Shotgun Wounds 374
" Determination of the Presence of Gunpowder and
Primer Components 378
Firearm Identification 382
Gunshot Wounds in Different Parts of the Body 389
XTV. THERMAL INJURIES OR DEATHS 394
Death or Injury from Cold 394
Local Effect 394
Systemic Effect 395
Death or Injury from Heat 396
General or Systemic Effect 396
Local Effects of Heat 398
XV. DEATH OR PHYSICAL INJURIES BY LIGHTNING
AND ELECTRICITY 414
rhor Physical Injury by lightning 414
Elements of lightning that Produce Injury 414
Points to be Considered in Making Diagnosis 415
th or Physical Injury from Electricity 417
Factors which Influence the Effect of
Electrical Shock 417
Mechanism of Death 418
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XVI. DEATH OR PHYSICAL INJURIES DUE TO CHANGE Adduction 520

OF ATMOSPHERIC PRESSURE (BAROTRAUMA) 421 Adultery and Concubinage 521
Effect of Increase of Atmospheric Pressure 421 Prostitution 523
Effect of Decrease of Atmospheric Pressure 421 Abuse Against Chastity 527
Aircraft Injuries and Fatalities 423 Unnatural Sexual Offenses and Sexual Abnormalities 528
Helicopter Injury 424
PREGNANCY AND DELIVER Y
XVII. DEATH BY ASPHYXIA 426
XXII. PREGNANCY 539
^Pypes of Asphyxial Death 426
Asphyxia by Hanging 428 Legal Importance of the Study 539
Asphyxia by Strangulation 436 Medical Evidences of Pregnancy 541
Asphyxia by Suffocation 441 Signs and Symptoms of Pregnancy 541
Asphyxia by Submersion or Drowning 442 Laboratory Tests 545
Asphyxia by Breathing Irrespirable Gases 451 Signs of Pregnancy in the Dead 547
War Gases 455 Duration of Pregnancy 548
Proofs of Previous Pregnancy 549
XVIII. DEATH OR PHYSICAL INJURIES DUE TO AUTOMOTIVE
CRASH OR ACCIDENT 459 XXIII. DELIVERY 552
Automotive Crash 459 Methods of Delivery 552
Pedestrian-Vehicle Collision 464 Signs of Recent Delivery 553
Motorcycle Crash 468 Signs of Remote Delivery in the Living 555
Post-mortem Finding in a Woman who Died Recently
XIX. DEATH OR PHYSICAL INJURIES DUE TO ATHLETIC After Delivery 555
SPORTS 469
Some Aspects of Sports Development 469 ^ ABORTION, BIRTH AND INFANTICIDE
Boxing 470 XXIV. ABORTION 557
Wrestling 476 /Clinical Types 557
XX. CHILD ABUSE OR NEGLECTED CHILD 478 Causes of Abortion 558
Duties of Parents 478 ^ Kinds of Abortion 561
Rights of Parents 479 How Abortion is Induced or Procured 562
Classification of Child Abuser 480 Medical Evidences 567
Social Reaction to Child Abuse and Neglect 481 Therapeutic Abortion 569
Other Battered Victims 484 Religious Consideration 574
XXV. BIRTH 575
Legal Importance of the Study 575
XXI. Still-Birth 576
Live-Birth 576
Proofs of Live-Birth 577
Hydrostatic Test 578
Signs of Maturity of the Child 581
Rape 500 XXVI. INFANTICIDE 583
Examination for Seminal Fluid and Spermatozoa 509
Other Crimes Against Chastity 515 Motives for Committing Infanticide 584
.Seduction 515 Criminological Characteristics 584
A6ts of Lasciviousness 518 Type of Evidences in Infanticide 584
Post-Mortem Findings 586
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PATERNITY AND FILIATION XXXII. DRUG DEPENDENCE AND DANGEROUS DRUG ACT 654
XXVH. CONVENTIONAL METHOD OF PROCREATION 587 Biosocial Factors Responsible for the Emergence
Kinds of Children 587 of Drug Problems 654
Legitimate Children 588 Dangerous Drug Act 655
Illegitimate Children 597 Prohibited 656
Evidences of Paternity and Filiation 599 Regulated 656
Medical Evidences 599 Hypnotic Drugs 659
Non-Medical Evidences 600 Sedatives 664
Hallucinogens or Psychomimetic Drugs 666
XXVIII. NON-CONVENTIONAL METHOD OF PROCREATION 601 Stimulants 674
Artificial Insemination 601 Deliriants 680
In Vitro Fertilization 606 Prescription of Dangerous Drugs 683

Other Non-Conventional Methods of Procreation 612 XXXIII. ALCOHOLISM 687

Classification of Commercially Available
MARITAL RELATION Alcoholic Beverages 687
XXLX. MARITAL UNION AND DISSOLUTION 613 Absorption and Distribution of Alcohol 692
Requisites of a Valid Marriage 613 Effects of Alcohol 693
Marital Relation 614 Degree of Intoxication 696
Annulment of Marriage 617 Physical Tests to Determine Drunkenness 697
Legal Separation 618 Factors Responsible for the Tolerance and
Susceptibility to Alcohol 700
XXX. IMPOTENCY AND STERILITY 620 Causes of Death in Alcoholics 702
Impotency 620 Chemical Test for Intoxication Admissible in
Legal Classification 620 Evidence 708
Causes of Impotency 621 Methods Used in Alcohol 708
Sterility 622 Societal Reaction to the Problem of Alcoholism 710
Causes of Sterility 622
Methods of Sterilization 623 TOXICOLOGY
DISTURBANCE OF MENTALITY XXXTV. POISONING 712
XXXI. INSANITY AND MENTAL DEFICIENCY 625 Definition 712
Site of Action of Poisons 713
Legal Importance 625 Signs and Symptoms That May Lead One to Suspect
Some Manifestations of Mental Disorders 629 Poisoning 717
Insanity and Criminal Responsibility 635 Differential Diagnosis of Poisoning 718
Mental Deficiency 641 Treatment of Patient Suffering from Acute Poisoning 719
Classical Classification 641 Medical Evidences 721
Methods of Estimating Mental Capacity 643 Classification of Poisons 725
Ways of Hospitalizing an Insane Person 647 Food Poisoning 729
Malingering 649 Laws on Poisons and Other Poisonous Substances
Causes of Malingering 649 in the Philippines 730
Types of Malingerer 650 Post-mortem Findings in Some Chemical Poisoning 732
Ways of Determining Malingering 651
Other Conditions Manifestating or Simulating
Disturbance of Mentality 652
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APPENDIX - Basic Principles of Philippine Criminal Law 743

REFERENCES 759
INDEX 767