1. State M.P.C section 377.

Describe the examination of the passive and active

agent in sodomy. List the unnatural sexual behavior.

MPC Section 377

Whoever voluntarily has carnal intercourse against the order of nature with any man;

woman or animal shall be punished with transportation for life or imprisonment extending to ten

years and also fined.

Explanation:– If any part of the visiting organ is within the visited organ, it constitutes sexual

intercourse necessary for the crime of unnatural sexual offences

Examination of the passive agent

Proof of penetration is the keystone of a successful plea for the prosecution of a case of

sodomy as well as of rape.

The lithotomy position affords ready access for both examination and the collection of

specimens.

Examination of the anus and anal canal is accomplished by: -

1. Direct observation of the undisturbed anal orifice

2. Radial and tangential retraction of the anus and buttocks using one or more fingers in

apposition

3. Digital examination

4. Instrumentation with proctoscope

It is convenient to divide the subjects into two main groups: -

1. The occasional or 'virginal' homosexual

2. The experienced practicing homosexual (habitual)

Examination of the occasional or virginal homosexual

1. Lubricant around the anus – such as cooking oil, hair cream.

2. Semen and spermatozoa may be found in or around the anus.

3. Pubic hair in the anus – in a boy who has no pubic hair.

4. Abrasions on the skin around the anus (anal verge skin).

5. Peri-anal bruising – small bruises due to penile intrusion are often seen around the anal

margin. This is more marked in children where there is disproportion in size.

6. Anal fissure – There may be single or multiple fissuring (tearing) of the anal margin, they are

very superficial, tender and visualized only when the epithelium is stretched radially.

7. Presence of gonorrhea – transmitted from the active agent.

8. Gait – The gait may be affected.

9. Proctitis – This may be present at the anal canal and lower rectum.

10. Blood from active and passive agents.

Examination of the experienced practicing homosexual (habitual)

1. Anal fissures – these may be acute or chronic. (healed scars)

2. Skin at anal verge becomes thickened. (sometimes keratinized)

3. Skin folds at anal verge become smoothed out.

4. Anal columns tend to become flat.

5. Lax external anal sphincter – loss of gripping action on the examining finger (loss of muscle

tone of sphincter)

6. Presence of lubricant around anus.

7. Semen and spermatozoa may be found in or around the anus.

8. Presence of gonorrhea discharge, chancre or condylomata.

9. Proctitis – The anal canal and lower rectum may be the site of either specific or non-specific

inflammation.

10. Blood from active and passive agents.

11. Bilateral buttock separation test is often positive with relaxation of anal sphincter. (Reflex anal

dilatation) (Gaping anus sign)

Left lateral position is preferred. Buttocks are separated gently. In a positive test, within a

short time, the external sphincter relaxes so that the interior of the anal canal and lower

rectum can be seen. The dilatation should remain for 2-3 seconds and should be distinguished

from reflex puckering of the anus which occurs momentarily – the winking anus – which is a

natural phenomenon especially if the rectum is full.

- Due to injury of internal sphincter

- Not pathognomonic / previously thought to be pathognomonic

- If positive – high suspicion

12. Funnel-shaped depression of the anus – very rare; usually an anatomical variant

Note – In a dead body, all the muscles and sphincters may be relaxed and fecal matter in the

rectum and sigmoid colon may be seen. Such a situation should not be confused with that of a

habitual passive agent.

Examination of the active agent

1. Lubricants – on the penis

2. Anal hair – on the penis

3. Fecal stain – on the penis or trousers

4. Blood – from the passive agent

5. Abrasion on the prepuce, glans penis or frenulum. If the active is habitual there may be some

constriction of the penis one third of the way from the tip of glans due to forcible constriction

of anal sphincter.

6. Gonorrhea or syphilis

7. Spermatozoa and seminal stains are corroborative evidence

Unnatural Sexual Behaviors

Tribadism (Lesbianism): It is a form of love making between one woman and another. It consists in

friction of the external genital organs by mutual contact – for sexual gratification.

Sadism: This is a form of sexual perversion in which sexual gratification is obtained by inflicting

pain

upon the partner. It is more commonly seen in the males. In order to obtain sexual pleasure he may
bite her severely, beat her with a whip or a stick, cut her with a knife, burn her with a cigarette end

or treat her in other cruel ways.

Masochism: This is the opposite of sadism. Sexual pleasure is obtained from the desire to be beaten,

tormented, or humiliated by the sexual partner. It is generally found in males, but it also occurs in

females. Sometime sadism and masochism may be present in the same person.

Fetishism: This form of sexual perversion is found only in males. The man experiences sexual

excitement leading to orgasm on touching some part of the woman's body or some article belonging

to her. e.g., clothes or shoe or panties

Transvestism (Eonism): The transvestite finds pleasure in wearing clothes of the opposite sex. They

occur in homosexuals – and occur in both sexes.

Trans-sexualism: They describe themselves as they were trapped in the bodies of opposite sex. So

they usually seek surgery for anatomical alteration.

Exhibitionism: It is indecent exposure of the genital in public. It occurs mostly in males. It is

accompanied by obscene gesture – and even masturbation may be done.

Voyeurism (Scoptophilia or Peeping Tom): To obtain sexual gratification by the passive observation

of sexually stimulating actions of others, live or recorded, is known as voyeurism.

Paedophilia or Paederasty: An abnormal sexual attraction for sexually immature children as part of

a homosexual or heterosexual relationship is known as paedophilia or paederasty.

Gerontosexualty (Gerontophilia): The predilection of a youth for an old person as a sexual object.

Fellatio: The erotic stimulation of the male genitals by the mouth.

Cunnilingus: It is an erotic stimulation of the female external genitals by means of the tongue.

Necrophilia: It means performance of sexual intercourse on dead body. It is usually found in male.

Incest: This is carnal knowledge by a man with a woman who is closely related to him. A male

person over 14 years of age may not have sexual intercourse with a woman he knows to be his

grand-daughter, daughter, sister, half-sister, or mother. A female person over the age of 16 may not

consent to sexual intercourse with a man whom she knows to be her: grand-father, father, brother,

half-brother, or son.

2. What is the medicolegal importance of pregnancy. Describe the sign of

delivery in living and dead person.

The medicolegal importance of pregnancy

1. In a case of alleged abortion, it may be necessary to show that the woman has recently been pregnant

and has aborted.

2. When a woman is charged with infanticide, or concealment of birth, it is necessary to show that the

woman had been pregnant and had delivered a child.

3. Pregnancy may increase the damages in an action for breach of promise of marriage.

4. In an action for defamation (or) slander, in an unmarried woman, a widow or wife separated from her

husband, evidence of pregnancy will be necessary to prove or disprove the charge.

5. A woman in advanced pregnancy may be excused from attending the court as a witness. The mere fact

of pregnancy is not sufficient. The doctor must certify that the woman is on the verge of delivery or that

her health would suffer if she attend the court.

6. Evidence of pregnancy is a bar to execution of a woman sentenced to death.

7. The distribution of the properties of a dead husband may be affected by the expectation of a son from a

pregnant wife.

8. Concealment of pregnancy and concealment of birth.

9. For purpose of maternity leave.

10. As a motive for suicide or homicide.

Signs of recent delivery in living person

Within 8 - 10 days after delivery, the following signs will be seen: -

1. Breast changes

1.1. Breast will be enlarged, firm and turgid

1.2. Surface veins are ramifying

1.3. Nipple will be enlarged

1.4. Dark color pigmentation around the nipple

1.5. Montgomery tubercles present

1.6. A milky fluid can be expressed from the nipple

2. Abdomen changes
2.1. The anterior abdominal wall will be flaccid and wrinkled

2.2. Striae gravidarum will be present

2.3. Fundus level

Uterine involution ½ inch per day

1st day after delivery, the fundus of uterus lies ½ inch below umbilicus

10th day after delivery, the fundus lies at the brim of pelvis

3 week after delivery, the uterus becomes pelvic organ

3. Face – general pallor and slight anaemia

4. External genitalia

4.1. Lochia discharge

- Blood stained for 4-5 days (lochia serosa, L. rubra)

- Yellowish or pink by the end of 1st week

- White and turbid by 10-14 days (lochia alba)

4.2. Swollen vulva, bruising or laceration of external genitalia

4.3. Evidence of episiotomy wound

5. Cervical os

Cervical lips are swollen and there may be cervical tear with bruising. The os could permit one or

two fingers.
 6.Gait – typical gait due to pain and swollen vulva.

Signs of recent delivery in dead person

In addition to the changes seen in the breast, anterior abdominal wall, external genitalia, cervix and

os, the following features must be looked for: -

1. Uterus

1.1. Products of conception

Microscopic examination for chorionic villi and placental tissue

1.2 Placental attachment site – rough and reddish dark color; it is recognizable up to 8-10 weeks after

delivery.

1.3.Length

Immediately after full term delivery, the uterus is 9-12 inches long.

2-3 days after full term delivery, the uterus is 7-9 inches long.

1st week after full term delivery, the uterus is 5-6 inches long.

2nd week after full term delivery, less than 5 inches long.

6th week after full term delivery, normal length

1.4.Weight

Immediately after full term delivery, the uterus weight is 28 ounces.

One week after full term delivery, the uterus weight is 12 ounces.
One month after full term delivery, the uterus weight is 1 ½ ounces.

Normal weight:- Multiparous uterus = 1 ½ ounces

Nulliparous uterus = 1 ounce

2. Ovaries

A large corpus luteum is present in one of the ovaries.

4. State M.P.C section 312 and explain the relevant causes. Describe the

methods and dangers of criminal abortion.

M.P.C Section 312

Whoever voluntarily causes a woman with child to miscarry, shall, if such miscarriage be not

caused in good faith for the purpose of saving the life of the woman, be punished with imprisonment of

either description for a term which may extend to three years, or with fine, or with both; and if the woman

be quick with child, shall be punished with imprisonment of either description for a term which may

extend to seven years, and shall also be liable to fine.

Explanation – A woman, who causes her-self to miscarry, is within the meaning of this section.

1. Natural Abortion(Spontaneous abortion)

(A) Maternal causes:

1. Infections such as smallpox, rubella, influenza, malaria, syphilis, poisons such as lead, copper, mercury

2. Diseases affecting the circulation of the blood such as anaemia, jaundice, chronic nephritis, heart and

lung diseases.
3. Those acting through the nervous system, e.g. sudden shock, fear, joy, sorrow and reflex action from

irritation of bladder or rectum.

4. Local conditions; inflammations, tumour, malformation of the uterus and excessive coitus.

5. Physical causes which separate the ovum. e.g., a blow or a fall or some trivial

(B) Foetal causes: -

1.Death of the foetus from faulty development, syphilis, anaemia

2. Diseases of decidua and inflammation of placenta

2. Therapeutic Abortion (Justifiable abortion)

The induction of abortion is justifiable only when caused in good faith to save the life of the

woman. (not to save the family honour or for economical reasons.)

Indications: -

1. Threatened abortion with persistent or severe hae’ge

2. Hydatiform mole

3. Infected uterus after attempt at criminal abortion

4. Malignancy of the genital tract

5. Repeated Caesarians

6. Heart disease with failure or hypertension, severe nephritis, severe active tuberculosis

7. Metabolic diseases – severe diabetes, hyper-thyroidism, severe toxemia of pregnancy

8. Epilepsy, mental disease associated with suicidal tendency

3. Criminal Abortion

The most common reason for abortion is financial difficulty in the family.

The poor mothers are very much preoccupied with daily chores for living and the problem of unplanned

pregnancy is dealt with only when the issue arises.

In a few instances unmarried woman or women separated from their husbands tried to get rid of the

pregnancy resulting from illicit intercourse.

Criminal abortion is generally induced between 6 to 12 weeks of pregnancy.

Methods of inducing criminal abortion

1. The first period (to the end of first month)

The woman is apprehensive due to the possibility of pregnancy and absence of normal menstruation.

She may take violent exercises, hot baths, and purgatives.

2. The second period (to the end of second month)

Suspicion of pregnancy is becoming a certainty.

The women frequently use drugs reputed to be abortificient.

Types of Abortificients: -

(a) Substances applied locally include phenols and lysol, potassium permanganate, arsenic,

formaldehyde and oxalic acid.

Potassium permanganate –when introduced into the vagina, causes corrosive action leading to severe

necrosis and bleeding. If absorbed, it can have fatal systemic effects including renal failure.
Permanganate can cause profuse vaginal bleeding from the necrosis, which may give the impression that

abortion is threatened and lead an unsuspecting doctor to carry out a currettage.

(b) These acting directly on the uterus.

Ecbolics are drugs, which increase uterine contractions; the chief of these are ergot, quinine, pituitary

extract and oxytocin. Ergot produces powerful uterine contractions, but acts better if administered when

the uterus is contracting. Danger –vasoconstriction leading to gangrene / death.

Emmenagogues promote the menstrual flow and acts as an abortificients when administered in large,

frequent doses.

Examples are – oil of savin, borax and apriol.

This old classification is now quite redundant and most of the substances are of historical interest only.

(b) These acting directly on the uterus.

Ecbolics are drugs, which increase uterine contractions; the chief of these are ergot, quinine, pituitary

extract and oxytocin. Ergot produces powerful uterine contractions, but acts better if administered when

the uterus is contracting. Danger –vasoconstriction leading to gangrene / death.

Emmenagogues promote the menstrual flow and acts as an abortificients when administered in large,

frequent doses.

Examples are – oil of savin, borax and apriol.

This old classification is now quite redundant and most of the substances are of historical interest only.

(e)Those having poisonous effects on the system generally.

These are animal, vegetable and metallic irritant poisons.

Dangers of Criminal Abortion

1. Immediate

(a) Air or soap embolism (pulmonary or systemic)

This is associated with introduction of fluid or air from a syringe under pressure into the uterus.

Air is blown through the placental sinuses into the venous circulation, passing up the inferior vena cava

into the right side of the heart.

Soap or antiseptic such as Lysol can also lead to embolism to the lungs.

(b) Haemorrhage and shock

Unskilled abortionist and self-manipulation may cause severe lacerations or perforations if sharp

instruments are used.

These lacerations may be found in the vagina with severe external haemorrhage or with concealed

bleeding into the broad ligament, or in the cervix or uterine wall, or even into the peritoneal cavity with

concealed internal haemorrhage.

(c) Vagal Inhibition

Sudden dilatation of the cervical canal by introduction of objects can cause rapid death.

The nervous tension in the woman makes her hypensensitive to relatively small stimuli, causing

collapse. (Importance of going to the scene of crime as quickly as possible.)

2. Intermediate

a) Acute Infections

The partly detached placenta, or its damage site with blood clot, forms an excellent anaerobic culture

medium.
 Local tissue necrosis by strong antiseptic still leaves a suitable medium.

Common organisms are Staphylococcus aureus, anaerobic Streptococcus, Escherichia coli and

Clostridium welchii.

Clostridium welchii infection is capable of causing death within a period of 12 hours.

(b) Bacterial endocarditis and septicaemia may be due to Staph pyogenes, E. coli.

(c) Late haemorrhage may occur from retained products or a torn cervix.

(d) Acute renal failure is associated with tubular necrosis. It is seen in clostridial infection, and soap or

antiseptic entering the blood stream.

3. Late

(a) Pyaemia, Pelvic cellulitis

The commonest initial site of infection is the placental site with subsequent spread, producing

necrosis of the uterine wall, infection of the Fallopian tubes and ovaries and spreading pelvic cellulitis

associated with pelvic thrombophlebitis. In some cases direct invasion of the blood stream occurs.

Perforation of the uterus causing peritonitis can also occur following necrosis of the uterine wall.

Coils of small intestine may adhere to the peritoneal surface of a necrotic area causing intestinal

obstruction.

(b) Pulmonary embolism. (thrombo-embolism, septic embolism)

It follows either septic thrombophlebitis of the pelvic veins or phlebo-thrombosis of calf veins from

lying in bed.

(c) Tetanus.