LESSON 5: -An amber watery body fluid produced by serous

membranes
Medico-legal importance of blood
-The liquid part of the blood.
1. Blood can be a circumstantial or corroborative
evidence against or in favor of the accused
2. Settlement of disputed parentage (Civil Cases)
3. Determination of the cause of death
4. Determination of time of the victim survived the
attack.
5. Determination of the direction of escape of the victim
or the assailant
6. Determination of the origin of the flow of blood
7. Determination of the approximate time of the crime BLOOD SERUM
was committed -This term actually refers to plasma without the clotting
proteins

SEROLOGY -The branch of medicine concerned with -Most of the proteins remaining are albumin and
the study of blood serum and its constituents, especially immunoglobins
its role in protecting the human body against disease. "Consist of salts, sugar, vitamins, minerals, fats,
hormones, and waste products.

BLOOD
-The only circulating tissue in the human body
-Vital fluid found in human body that provides important
nourishment to all body organs and tissues and carries
away waste materials.
-7-8% of total body weight
-Composed of blood cells suspended in a liquid called
blood plasma
-Bright red when its hemoglobin is oxygenated.
-Color of blood is red because of the Hemoglobin. PROBLEMS ENCOUNTERED IN STUDYING BLOOD
SPECIMENS

2 main components of blood: -Where to search blood specimens

PLASMA -Establishing the origin of blood or bloodstain, whether

from human or not
-55% of total blood volume
-Collection, preservation, and transportation of
-Liquid portion of the blood specimen suspected to contain blood

-Help body to recover from injuries -Determination of blood stain pattern

-Determination if stain is caused by blood or another
substance
SOLID ELEMENTS (CELLS)
-45%
Flow of medico-legal examination involving blood
Consist of and blood stains:
 Red blood cells 1. Determining whether a stain is caused by blood or
 White blood cells not
 Blood platelets
2. Is it is blood, determine whether human blood or not
Flow of medico-legal examination involving blood and
THE SERUM blood stains
3. Determining whether a stain is caused by blood or
not
4. Is it is blood, determine whether human blood or not.
HUMAN BLOOD CLASSIFICATION:
2 most significant blood group systems:
ABO SYSTEM - Developed by Karl Landsteiner in 1901
RHESUS GROUP - Introduced in 1937 by Landsteiner
in co-operation with Alexander S. Wiener. Both of the
two replace by Genetic Fingerprinting
Determining the age of Blood stain:
-Aging of stain can be estimated from its color and
hemoglobin characteristics
-The red color of the blood is due to the presence of
hemoglobin in the RBC
How long last the dry blood spots?
Depends on preservation. Mostly 1 month or indefinite.
HEMOGLOBIN
-Iron-protein compound in red blood cells gives blood its
red color
-Transports oxygen, carbon dioxide, and nitric oxide
-Composed of 2 substance:
1. Globin - protein
2. Hematin - organic compound of iron
What must be done to determine whether stain is
caused by blood or by another substance?
1. Perform PRELIMINARY TESTS
-Physical test
-Color test
-Presumptive test
2. Conduct CONFIRMATORY TEST
PRELIMINARY TEST
-AKA presumptive tests and color tests.
-A positive result is not conclusive that specimen is
blood.
-A negative result is conclusive that specimen is blood.
 1. BENZIDINE TEST
-A preliminary test if a stain is caused by blood
-A delicate test that can detect blood even
when present in a dilution of 1:300,000 parts
-Endpoint: Blue color if positive for blood
-Note: May give false positive reaction to apple,
potatoes, brain tissue, bone marrow, spinal
fluid, saliva, and mucus.
 2. GUAIACUM TEST (VAN DEEN'S OR
SCHOBEIN TEST)
-Another preliminary test for blood.
-If blood is present, a blue color
imparted by the mixture.
-Note: This test gives false positive
reaction to saliva, pus, bile, iron, milk,
potatoes, perspiration, gluten, gum
acasia and oxidizing agents.
 3. PHENOLPHTHALEIN TEST (kastle-meyer
test)
-Another preliminary test for blood
-Reagent used is phenolphthalein
solution plus hydrogen peroxide.
-Positive result will show a pink color
after the addition of hydrogen peroxide.
 4. LEUCOMALACHITE GREEN TEST
-Recommended by Adler in 1904, but
not sensitive as the benzidine test.
-Reagent used is leucomalachite green
plus hydrogen peroxide
-Cannot differentiate human from
animal blood
-Positive result is bluish-green or
peacock-blue color
 5. LUMINOL TEST
-Can be used when the bloodstain is
apparently absent, even if an attempt to
clean and remove the bloodstain was
made.
-Basic idea: Reveal blood traces with a
light-producing chemical reaction
between a reagent and hemoglobin.
CONFIRMATORY TEST
MICRO-CHEMICAL TESTS
 -Teichmann test
-Also called Haemin test
-Test is positive if dark room rhombic crystals of
haemin or haematin chloride are seen singly or
in clusters.
-Takayama's test
• Also called Haemochromogen test.
• A confirmatory test for
haemochromogen crystals
• Test is positive when there is a
presence of large rhombi crystals of
haemochromogen, salmon pink in color
and arranged singly or in clusters.
-Acetone-Haemin test
BIOLOGICAL TESTS
-Precipitin test
• A biological test that is used to
confirm if blood belongs to human.
• A test from proteins contained in
human blood can be also used to
determine whether or not muscles
secretions, bones, seminal fluid and
other body fluids are of human origin.
-Blood typing
LESSON 6 - MEDICO LEGAL SYSTEM
ROLE OF MEDICAL DOCTORS IN LEGAL
PROCEEDING
-Usually, doctors become involved with the law simply
because they have professional skills or experience.
-Forensic matters, like in court proceedings, the medical
doctor may have one of these 2 roles:
-Professional witness
• Is one who gives factual evidence.
• This role is equivalent to a simple witness of an
event, but occurs when a doctor is providing
factual medical evidence.
• A primary care physician may confirm that a
patient has been diagnosed as having epilepsy
or angina.
• No comment or opinion is generally given and
any report or statement deals solely with the
relevant medical findings (Simpson 2011)
-Expert Witness
• One who expresses an opinion about medical
facts.
• Before forming an opinion, an expert witness
ensures that the relevant facts about a case are
made available to them and they may also wish
to examine the patient (Simpson 2011)
MEDICO-LEGAL PRACTICE
-The practice of medicine in relation to legal matters
depends on the laws observed in their country.
-The laws in a particular country define the medico-
legal system being practiced.
-The commonly used systems are:
- Medical Examiner system
- Coroner System
MEDICAL EXAMINER SYSTEM
- In some parts of the US, this is the preferred system
although the coroner system is still used in some states.
- In this system, MLC is handled by a Chief Medical
Examiner who is a Doctor of Medicine and appointed by
the mayor from the classified list of qualified medical
practitioners.
- The duty of medical examiner is to investigate the
cause of death especially violent death or other
circumstances leading to the death of the victim.
- "The medical examiner on duty after being informed
by the police officer of a certain crime that needs to be
investigated will go to the place of the crime, interview
the witnesses, examine the victim and then take
specimens if any for examination.
CORONER SYSTEM
- Coroners are elected lay people who often do not
have professional training, whereas medical examiners
are appointed and have board-certification in a medical
specialty.
- As an elected official, a coronel has the power to
make decisions and has equal footing with other local
elected officials.
- Derive from the word "Custodes Placitorum Corrone"
-This is a system adopted by the Philippine government
when it become a republic.
-Medical cases that requires investigation for forensic
reasons are handled by a Medical Jurist or Medico-
legal officer who is registered physician duly qualified to
practice medicine this country.
Problems encountered when using this system in
the Philippines are as follows:
1. Lack of proficiency by the physician in medico- legal
work
2. Inadequate facilities
3. Inadequate means training in medico-legal work by
the police investigator and other law enforcement
agents
4. Insufficient physician and personnel to handle
medico-legal cases.
MEDICAL CONFIDENTIALITY
- Patient have a right to expect that information about
them will be held in confidence by their doctors.
-Confidentiality is a primary, but not an absolute duty.
- Doctors must use their own judgement to apply the
principles of confidentiality and be prepared to later
explain and justify any decisions or actions taken when
they have apparently breached that confidentiality.
ABSOLUTE PRIVILEGED COMMUNICATION
-It means that under no circumstances can be a
medical professional be forced to reveal communication
on the following matters
1. Information that is passed on by a client to him or her
2. His or her advice to the client
3. His or her files where the information regarding the
case of the client is being kept
4. Secret or confession of a client
QUALIFIED PRIVILEGED COMMUNICATION
-Refers to the communication given by a patient to a
doctor in the course of a patient- doctor relationship.
-If there is a court order to reveal such communication,
the only information that cannot be revealed are matters
that tend to taint the reputation of the patient.
LESSON 7 - MEDICAL EVIDENCE
EVIDENCE
-Means, sanctioned by rules of court, of ascertaining in
judicial proceeding the truth respecting a matter of fact
(Section 1, 128, Rules of Court)
-Medical evidence can be or it can take many forms
which includes doctors clinical notes or records it can
also be a form of medical opinions that comes from a
physicians specialist in a particular field of medicine or
an independent health profession.
-Therefore, medical evidence is a kind of evidence,
sanctioned by law, of ascertaining in a judicial
proceeding the truth respecting a matter of facts
wherein scientific medical knowledge will be used
(Maligaya 2007:134)
When is medical evidence admissible in court?
-Use of Medical Evidence
•Medical literature, research, and articles are
not medical evidence, but they may help the
court and other concerned people understand
medical evidence.
•If non-criminal cases, you may need medical
evidence if the evidence already on your
medical claim file is not sufficient or you
disagree with it.
What is the nature and extent of you injury or
disease?
-Did your employment cause, activate, aggravate, or
accelerate the injury or disease?
- Are you disabled from working because of the injury or
disease?
-If you are disabled from working, is the disability
temporary or permanent?
-If you were temporary disabled, has the disability
resolved or plateaued? When?
-What limitations (things a worker cannot do) and or
restrictions (things a worker should not do) arise from
the injury?
-If your injury or disease is permanent, what is the
nature and extent of the permanent impairment
(disability)?
KINDS/TYPES OF MEDICAL EVIDENCE
-Medical evidence can be in the form of any of the
following:
-Real or autoptic evidence
-Testimonial evidence
-Documentary evidence
-Experimental evidence
DOCUMENTATION OF MEDICAL EVIDENCE
-Methods of recording medical evidence:
-Narrative description (Written)
-Photographic documentation
-Audio recording
-Sketching
-Testimony of witness
Documentation in hospital may become medical
evidence later on. Such as hospital records include
but not limited to the following:
-Patient's clinical record/chart
-Operating room logbook
-Admission and discharge books
-Official receipts of hospital bills
- File copies of laboratory reports
-Reports of diagnostic procedures.
TESTIFYING ON MEDICAL FACTS
-Anyone appearing before any court either as
professional or expert witness in relation to a medical
fact should ensure that their dress and are compatible
with the role of an authoritative professional demeanor
and give their evidence in a clear, balanced, and
dispassionate manner.
LESSON 8:
MEDICAL REPORTS
-Any medical report or statement submitted to courts
should always be scrutinized by the author prior the
signing and submitting it to avoid factual errors
(identifying the wrong site of an injury or sloppy
typographical errors).
-However, any comments or conclusions within the
reports are based upon a set of facts of hypotheses are
suggested by the lawyers in court during their
examination, a doctor should reconsider the medical
evidence in the light of these new facts or hypotheses
and, if necessary, should accept that, in view of
different basis his conclusions may be different.
PREPARATION OF MEDICAL REPORTS
The diversity of uses of a report is reflected in the
individuals or groups that may request one: a report
may be requested by the:
-Police
-Prosecutors
-Coronels
-Judges
-Medical administrators
-Government departments
-City authorities
- Or lawyers of all types
EXPERTISE AND AUTHORITY
-The rule of thumb on this matter is to ensure that,
when medical records will need to be reviewed, written
permission to access and use those records has been
given, either by the individual themselves, or by an
individual or body with the power to give that consent.
STRUCTURE OF MEDICAL REPORTS
-The date of the reports and time, place of any
examination should be listed, as should the details of
any other person who was present during the
examinations.
-Indicate the requested statement and when
-Confirm your understanding of your role at the time
-Confirm that the patient has given consent for the
release of the medical information
-By referral to contemporaneous notes outline the
history that you were aware of
-In a simple term, summarize your medical findings
-If information other than observation during a physical
examination forms part of basis of the report, it must be
recorded.
CLARITY AND SIMPLICITY
-Of expression make the whole process simpler.
-Statements can be constructed along the same lines
as the clinical notes- they should be constructed,
detailed and accurate.
-Do not include every single aspect of medical history
unless it is relevant, and consent has been given to
disclosure.
AUTOPSY REPORTS
-Are specialist type of a report and may commissioned
by the coroner, the police or any other legally
competent person or body.
-An autopsy report is confidential and should only be
disclosed to the legal authority who commissioned the
examination.
CARDINAL POINTS IN REPORT WRITING
One of the basic principles is the basic fact that report
writing applies the six cardinal points of investigation-
5W and 1H.
BASIC PRINCIPLES IN REPORT WRITING
1. ACCURACY
• This principle emphasizes that report must be
precisely explain the facts discovered during the course
of the investigation.
2. BREVITY
• By excluding unnecessary details, the firearm
examiner can make a concise report.
3. COMPLETENESS
• This can be achieved by narrating the facts
discovered during the course of the investigation and
how were the facts discovered.
4. IMPARTIALITY
• As a rule, this is achieved by reporting facts without
any addition or deduction
5. FORMAT/FORM
• The front of the report be presentable enough to
convince the reader that the report was prepared by
competent officer.
LESSON 9
WHAT IS DEATH
- Death represents the cessation of life medically and
scientifically.
- Death is not an event-it is a process in which cellular
metabolic processes in different tissues and organs
cease to function at different rates.
- An organism is dead if it returns to a stable
equilibrium, chemically and physically.
- Death, on the other hand, is a state of complete and
persistent cessation of respiration, circulation and other
vital functions of the body (Solis 1987)
- Death entails the irreversible loss of those essential
characteristics which are necessary to the existence of
a living human person and, thus, the definition of death
should be regarded as the irreversible loss of the
capacity to breathe.
IMPORTANCE OF DEATH DETERMINATION
-The civil personality of a natural person is extinguish
by death.
-The property of a person is transmitted to his heirs at
the time of death.
-The criminal liability of a person is extinguished by
death.
-The civil case for claims which does not survive is
dismissed upon death of the defendant.
Based on the criterion used in its determination,
death may be:
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.
CARDIO-RESPIRATORY
*Death occurs when there is a continuous and
persistent cessation of heart action and respiration.
KINDS OF DEATH:
SOMATIC DEATH or CLINICAL DEATH
-This is the state of the body in which there is complete,
persistent and continuous cessation of the vital
functions of the brain, heart and lungs which maintain
life and 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.
MOLECULAR 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 presence of excitability of
muscles and ciliary movements and other functions of
individual cells.
-About 3-6 hours later there is death of individual cells.
EARLY CHANGES (molecular death)
-Changes in the skin and facial pallor
-Primary relaxation or flaccidity of the muscles
-Contact flattening and pallor
•Changes of the eye
•Loss of corneal and pupillary reflexes
•Pupils
 •Opacity of the cornea
•Changes of retina
APPARENT DEATH OR STATE OF SUSPENDED
ANIMATION
-This condition is not really death but merely a transient
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
SIGNS OF DEATH:
-The length of time the heart may cease to function and
life is still maintained depends upon the length of time it
is readily reestablished and upon the oxygenation of
blood at the time of the suspension.
(Kapag walang ng heart action for a period of 5
minutes, death is death is regardless certain.)
1. CESSATION OF HEART ACTION AND
CIRCULATION
Methods of detecting the cessation of heart action and
circulation
A. EXAMINATION OF THE HEART
1. Palpation of the heart- Pulsation of the
peripheral blood vessels may be made at the
region of the wrist or at the neck.
2. Auscultation for the heart sound at the
precordial area- The rhythmic contraction and
relaxation of the heart is audible through the
stethoscope.
B. EXAMINATION OF THE PERIPHERAL
CIRCULATION:
1. MAGNUS' TEST - A ligature i applied around
the base of a finger with moderate tightness.
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.
3. ICARD'S TEST
- This consists the injection of a solution of
fluorescein subcutaneously.
-If the circulation is still present, the dye will
spread all over the body and the whole skin will
have a greenish-yellow discoloration due to
fluorescein.
- In dead man, the solution will just remain at
the site of the injection.
4. PRESSURE IN THE FINGERNAILS
-If pressure is applied on the fingernails
intermittently, there will be a zone of paleness
at the site of the application of pressure which
become livid on release.
There will be no such change of color if the test
is applied to a dead man.
5. DIAPHANOUS TEST
-The fingers are spread wide and the finger
webs are viewed through a strong light.
-In living, the finger webs appear 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
dead man, it will not produce true blisters
-There is no sign of congestion, 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 palpation of the vessel
due to the flow of blood.
-No such pulsation will be observed in a dead
man.
2. CESSATION OF RESPIRATION
Conditions there may be suspension of respiration
without death ensuring
A. In 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 15-20 minutes.
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.
METHODS OF DETECTING OF RESPIRATION
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
D. Examination with a feather or cotton fiber
E. Examination with a glass of water
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.
3. COOLING OF THE BODY (ALGOR MORTIS)
-After death the metabolic process inside the body
ceases.
-No more heat is produced but the body loses slowly its
temperature by evaporation or by conduction to the
surrounding atmosphere.
-The fall of temperature of 15-20 degrees Fahrenheit is
considered as a certain sign of death.
POST-MORTEM CALORICITY
-Is the rise of temperature of the body after death due to
rapid and early putrefactive changes or some internal
changes.
-It is usually observed in the first 2 hours after death.
CONDITIONS THAT ARE CONNECTED WITH THE
SORROUNDINGS
1. Factors Delaying Cooling
a. Clothing
b. Want of access of air the body
c. Small room
d. Warm surrounding
2. Factors Accelerating Cooling
a. Unclothed body
b. Conditions allowing the access of air
c. Large room permitting the dissipation of heat
d. Cooling more rapid in water than in air
98.6 F - Normal Temperature
1.4 F - (D) Decrease power of the Death
Example:
83.2 F - Temperature or Cadaver
"Minus the Normal Temperature to temperature of
Cadaver"
83.2
-98.6
------
15.4 F ÷ 1.4 F = 11 hours the person is death.
"Divide it to the Decrease power of the death."
5. CHANGES OF THE SKIN
The following are the changes undergone by the skin
after death:
A. The skin may be observed to be pale and waxy-
looking due to the absence of circulation. Areas of the
skin specially the most dependent portions will develop
livid discoloration on account of the gravitation of blood.
B. Loss of elasticity of the skin
C. Opacity of the skin
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.
CHANGES IN THE BODY FOLLOWING DEATH:
1. CHANGES IN THE MUSCLE
-After death, there is complete relaxation of the whole
muscle system.
-The whole muscular system is contractile foe 3-6 hours
after death, and later rigidity set in.
-Secondary relaxation of the muscle will appear just
when decomposition set in.
ENTIRE MUSCULAR TISSUE PASSES THREE
STAGES AFTER DEATH:
1. Stage of primary flaccidity (Post- mortem
muscular irritability)
-The muscles are relaxed and capable of contracting
when stimulated.
-The pupils are dilated, the sphincters are relaxed, and
there is incontinence of urination and defecation.
(Flaccidity or If the body of a person is relaxed it means
the person died in 1 to 2 hours)
2. STAGE OF POSTMORTEM RIGIDITY (Cadaveric
rigidity or Death struggle of muscle or Rigor Mortis)
-The whole body becomes rigid due to the construction
of the muscles.
-This develops three to six hours after death and may
last from 24-36 hours
3. Stage of secondary flaccidity or commencement
of putrefaction (Decay of the muscles)
-The muscles become flaccid, no longer capable of
responding to mechanical or electrical stimulus and the
reaction becomes alkaline.

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.
3. 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.

CHANGES OF THE BLOOD (LIVOR MORTIS)

STAGE OF POSTMORTEM RIGIDITY OR DEATH
A. Coagulation of the blood
STIFFENING OR DEATH STRUGGLE OF MUSCLE
OR RIGOR MORTIS -The stasis of the blood due to the cessation of
circulation enhances the coagulation of blood inside the
-3-6 hours after death the muscles gradually stiffen.
blood vessels.
-Many starts at the muscles of the neck and lower jaw
-The blood clotting is accelerated in cases of death by
and spread downwards to the chest, arms and lower
infectious fevers and delayed in case of asphyxia,
limbs.
poisoning by opium, hydrocyanic acid or carbon
-Usually whole body becomes stiff after 12 hours monoxide poisoning.

-All the muscles are involve- both involuntary and -Blood may remain fluid inside the blood vessels after
voluntary. death for 6 to 8 hours.

-In temperature countries, rigor mortis may last for 2-3

days but in tropical countries the usual duration is 24 to
48 hours during cold weather and 18-36 hours during
summer.
CONDITIONS STIMULATING RIGOR MORTIS
1. HEAT STIFFENING
If the dead body is exposed to temperature above 75°C
it will coagulate the muscle proteins and cause the
muscles to be rigid.
B. Post-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.

2. COLD STIFFENING -The distended capillaries coalesce with one another

The stiffening of the body may be manifested when the
body is frozen, but exposure to warm condition will
make such stiffening disappear.
until the whole are 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.
(In the Philippines there's 2 to 3 hours after death)
-If the position of the body is moved during the early
stage of its early 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 change after
the clotting or the blood has set in or when blood is
already diffused into the tissues of the body, a change
of position in the body will not alter the location of the
post-mortem lividity.
-Appears 3-6 hours after death
-12 hours after death, the post-mortem lividity is already
fully developed.
(Color of post-mortem lividity or Ligor Mortis, Dull Red,
Pink.)(If he/she is poisoned or he/she inhaled the
carbon monoxide the lividity is Bright Red)
PHYSICAL CHARACTERISTICS OF POST-MORTEM
LIVIDITY:
1. It occurs in the most extensive areas of the most
dependent portion 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
HYPOSTASIS LIVIDITY
The blood merely gravitates into the most dependent
portions of the body but still inside the blood vessels but
still fluid in form.
DIFFUSION LIVIDITY
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.
(Fix discoloration, so any change of positition of the
body will not change the position of 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
EX: a. In Asphyxia the lividity is - dark
b. Carbon monoxide poisoning - bright pink
c. Hemorrhage, anemia - less marked
d. Phosphorus - Dark brown
e. Potassium chlorate, potassium bichromate -
Chocolate or coffee brown
4. If the body is found for considerable time in snow or
ice the lividity is bright red
5. It may determine how long the person has been dead
6. It gives us an idea as to the time of death.
PUTREFACTION OF THE BODY
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.
LIQUEFACTION OF THE SOFT TISSUES
-As decomposition progresses, the soft tissues of the
body undergo softening and liquefaction.
-The eyeballs, brain, stomach, intestine, liver and
spleen putrefy rapidly
-Highly muscular organs and tissues relatively putrefy
late
CHRONOLOGICAL SEQUENCE OF PUTREFACTIVE
CHANGES OCCURRING IN TROPICAL REGION
12 HOURS
-Rigor Mortis present all over
-Hypostasis well- developed and fixed
-Greenish discoloration showing over the caecum
24 HOURS
-Rigor mortis absent all over.
-Green discoloration over the whole abdomen and
spreading chest
-Abdomen distended with gases
48 HOURS
-Ova of flies seen KINDS OF MUMMIFICATION:
-Trunk Bloated NATURAL MUMMIFICATION
-Face discolored and swollen -When a person is buried in hot, arid, sandy soil there
will be insufficient moisture for the growth and
-Blisters present multiplication of putrefaction bacteria.
-Moving Maggots seen ARTIFICIAL MUMMIFICATION
-Body preservation to inhibit decomposition and to allow
72 HOURS evaporation of fluid.

-Whole body grossly swollen and disfigured

-Hair and nails loose SAPONIFICATION OR ADIPOCERE FORMATION

-Tissues soft and discolored -This is a condition wherein the fatty tissues of the body
are transformed to soft. brownish- white substance
known as adipocere.

1 to 2 WEEKS -The layer of subcutaneous tissue is the frequent site of

its formation.
-Soft viscera putrefied
-It occurs naturally in the visceral organs and even in
-Only more resistant viscera distinguishable non-fatty tissues of the body like the muscles.
-Soft tissues Largely gone

MACERATION
1 MONTH -This is the softening of the tissues when in fluid
medium in the absence of putrefactive microorganism
-Body skeletonized
which is frequently observed in the death of the fetus en
utero.

SPECIAL MODIFICATION OF PUREFACTION: (Within 24 hours)

Stages of Decomposition: -When the fetus dies en utero, provided that the death
of the fetus is not due to attempted abortion or rupture
1. INITIAL DECAY of the membrane, the child is enclosed by the
membrane in sterile condition.
-cells self digest and bacteria proliferate.
-The softening of the body may be due to the action of
2. BLOAT the autolytic and proteolytic enzymes and ferments.
-gases accumulate due to bacterial activity sulfur atoms (Maceration has absence of micro organism)
altar color of blood and skin
-maggots catch and feed on tissues
DURATION OF DEATH:
3. PURGE
PRESENCE OF RIGOR MORTIS
-skin ruptures, fluid and gas leak out-of-body
-In warm countries like the Philippines, rigor mortis sets
4. ADVANCED DECAY in from 2-3 hours after death.
-body shrinks as maggots finish eating; nearby -It is fully developed in the body after 12 hours.
vegetation dies.
-It may last from 18-36 hours and its disappearance is
concomitant with the onsent of putrefaction.
Changes of Putrefaction:
MUMMIFICATION
-Is the dehydration of the whole body which results in
the shivering and preservation of the body.
-It usually occurs when a dead body is buried in a hot,
and arid place with dry atmosphere and with free
access of hot air.
 -This determination is dependent upon the amount of
food taken and the degree of tonicity of the stomach.
PRESENCE OF POST-MORTEM LIVIDITY
Light Meal - 1 hours and 30 minutes
-Post-mortem lividity usually develops 2-6 hours after
death. Medium Meal - 3 to 4 hours
-It first appears as a small petechia-like red spots which Heavy Meal - 4 to 6 hours
late 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. AUTOPSIES VERSUS POST-MORTEM
EXAMINATION:

ONSET OF DECOMPOSITION AUTOPSY

-In the Philippines like other tropical countries, -Indicates that, in addition to an external examination,
decomposition is early and the average time is 24-48 the body is opened and an internal examination is
hours after death. conducted.

-It is manifested by the presence of watery, foul-

smelling froth coming out the nostrils and mouth, POST-MORTEM EXAMINATION
softness of the body and presence of crepitation when
pressure is applied on the skin. -Refers to an external examination of the dead body
without incision being made, although blood and other
body fluids may be collected for examination.
STAGE OF DECOMPOSITION:
-The approximate time of death may be inferred from 4 POST-MORTEM STAGES OF THE DEATH:
the degree of decomposition, although it must be made
with extreme caution. PALLOR MORTIS
-There are several factors which modify putrefaction of -Paleness of a person's skin associated with death.
the body.
ALGOR MORTIS
*Fresh
-Refers to the coldness, while mortis refers to the death.
*Bloat
RIGOR MORTIS
*Active Decay
-Refers to the contraction of muscles after death.
*Advance Decay
LIVOR MORTIS
*Dry Remains
-Refers to the gravitational pooling of blood in the
dependent portions of the blood.

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 known
the life cycle of the flies.
(Usual egg of a larva to be hatch is 24 hours so the
death occurred more than 24 hours)

- How long does it take a blowfly to find a dead body.

(15 minutes)

STAGE OF DIGESTION OF FOOD IN THE STOMACH

-It takes normally 3-4 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.