Is branch of medicine which deals with the application of medical

knowledge for the purpose of law and in the administration of

justice.

- Forensic Medicine
- Medical Jurisprudence
MEDICAL JURISPRUDENCE
denotes knowledge of Law in relations to the
practice of medicine

its concerns with the study of the rights, duties

and obligations of a medical practitioner with
particular reference to those arising from
doctor-patients relationship
 Broad and encompassing
 It is the application of medical and paramedical science
knowledge as demanded by law and administration of justice
 Knowledge to the nature and extent of wounds, death, effects
on trauma, among others
 Aside from the knowledge to the basic medical science like
anatomy, physiology, biochemistry, physics, and other allied
sciences
 CRIMINAL LAW

 Circumstances affecting criminal liability

 Crimes against person

 Crimes against chastity

 REMEDIAL LAW

 Physical and mental examination of a person

 Proceedings for hospitalization of an insane person

 Rules on Evidence
 sanctioned by the Rules of Court, of ascertaining in a judicial
proceeding the truth respecting a matter of fact

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 witness, records, documents, concrete
objects, etc; for the purpose of inducing belief in the minds of the
court as to other contention
AUTOPTIC OR REAL EVIDENCE
an evidence made known or addressed to the
senses of the court.
not limited through the sense of vision
extended to hearing, taste, smell and touch

LIMITATIONS
indecency and impropriety
repulsive objects and those offensive in the
sensibilities
TESTIMONIAL EEVIDENCE
a physician may be commanded to appear before the court to give
his testimony

ORDINARY WITNESS
MD testifies in court on matters he perceived from his patient in the
course of doctor-patient relationship

EXPERT WITNESS
in account to his training and expertise can give his opinion on a set
of medical facts
 These are the articles and materials which was found in
connection with the investigation and aid in which establishing the
identity of the perpetrator or the circumstances under which the
crime was committed.

CORPUS DELICTI EVIDENCE

ASSOCIATIVE EVIDENCE

TRACING EVIDENCE
 The term given to the testimony that is given by the
physician

evidence that is obtained from the application of medically

acceptable clinical or laboratory diagnostic technique

should be objective
 b. Unexpected death especially when the deceased was
in apparent good health

c. Death due a natural cause but associated with physical

evidence of foul play

d. Death as a result of violence, accident or poisoning

e. Death due to improper or negligent act of another

person
a. Physical violence such as gunshot wound, stab
wounds, mauling, etc.

b. Vehicular accident

c. Asphyxia

d. Electrocution, chemical and thermal insult

e. Accident, “attempted” homicide or suicide

f. Poisoning
 5. Cases of child abuse, domestic violence, sexual
abuse, alcoholism, drug abuse

 6. Cases involving mental competency of the patient

 7. Iatrogenic causes brought about by negligent act or

omission of the hospital staff resulting in violation of
rights of the patients or leading to physical or mental
incapacitation.
  is the effect of some form 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 force maybe immediate or
may be delayed.
A thrust to the body of a pointed or sharp instrument will lead
to the immediate production of a wound,
while a hit by a blunt instrument may cause the delayed
production of contusion.
Physical Injury is the effect of some forms of stimulus on the body.
 The effect of the application of physical violence on
a person is the production of wound.

A wound is the solution of the natural continuity of

any tissue of the living body.

It is the distraction of anatomic integrity of the body.

a. “Rubor” – redness or congestion of the area due
to an increase of blood supply as part of reparative
process
b. “calor” – sensation of heat or increase in
temperature
c. “Dolor” – pain on account of the involvement of
the sensory nerve
d. Loss of function – tissue may not able to function
normally
1. As to Severity:
a. Mortal Wound – wound that can caused immediately
after infliction or shortly thereafter that is capable of causing
death.
Parts of the body where wound is considered mortal:
1. Heart and big blood vessels
2. Brain and upper portion of the spinal cord
3. Lungs
4. Stomach, liver, spleen, kidney, intestine

b. Non Mortal wound – wound which is not capable of

producing death immediately after infliction or shortly
thereafter.
2. As to Kind of Instrument used

a. Blunt Instrument (contusion, hematoma, lacerated wound)

b. Sharp instruments

i. Sharp edged – incised wound

ii. Sharp pointed – punctured wound
iii. Sharp edged and sharp pointed
instrument – stab wound
c. By tearing force (lacerated wound)

d. Change in atmospheric pressure – barotrauma

e. By heat and cold (frostbite, burn)

f. Chemical – chemical explosions, e,g, gunshot

g. Infection
3. As to Manner of Infliction

a. Hit – by means of bolo, blunt instrument

b. Thrust or stab

c. Gunpowder explosion

d. Sliding or rubbing
a. Superficial – when the wound involves only the layer of skin

b.Deep – wounds involve the inner structure beyond the layer of

skin.
i. PENETRATING
one in which the wounding agent enters the body but did
not come out or the mere piercing of a solid organ or tissue
of the body.
Punctured, gunshot, stab usually belongs to this type of
wound
Dimension of depth and direction is an important factor in its
description.
ii.PERFORATING
when the wounding agent produces communication
between inner and outer portion of the hollow organs.

It also may mean piercing and traversing completely a particular

part of the body causing communication between the points of
entry and exit of the instrument or substance producing it.
a. Coup Injury
– physical injury which is located at the site of the application
of force

b. Contre-coup Injury
– injury found at the opposite site of the application of force

c.Coup Contre-Coup Injury

– injury located at the site and the opposite site of the
application of force.
d. “Locus Minoris Resistencia” – physical injury located not at the
site or the opposite site of the application of force but in some
areas offering the least resistance to the application of force.

e. Extensive injury – physical injury involving a greater area of the

body beyond the site of the application of force.
6. As to the Regions or Organs of the body involved

7. Special Types of Wounds

a. Defense Wound – wounds which is the result of a

person’s instinctive reaction of self-protection. Injuries
suffered by a person to avoid or repel potential injury.
b. Patterned Wound – wound in the nature and shape of
object or instrument causing it.
8. Self-Inflicted Wounds
– is the wound produced on oneself.
Motives of Producing Self-Inflicted Wounds
a. To create or deliberately magnify an existing
injury or disease for compensation.
b. To escape certain obligations or punishment.
c. To create new identity or destroy existing
one.
d. To gain attention or sympathy.
e. Psychotic behaviour
Closed Wound
there is no breach of continuity of the skin or mucus
membrane

a. Superficial – when the wound is just underneath the layers of

skin or mucous membrane
1. Petechiae
2. Contusion
3. Hematoma
b. Deep
1. Musculo-skeletal Injuries
a. Sprain
b. Dislocation
c. Fracture
d. Strain
e. Subluxation

2. Internal Hemorrhage

3. Cerebral Concussion
Open Wound
there is a breach of continuity of the skin or mucous
membrane
a. Abrasion
b. Incised wounds
c. Stab Wounds
d. Punctured Wounds
e. Lacerated Wounds
PETECHIAE
this is a circumscribed extravasation of blood in the subcutaneous
tissue or underneath the mucous membrane.
On 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 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 can be appreciate from its color changes.
The size tends to become smaller from the periphery to the center
passes through a series of color changes as a result of the
disintegration of the red blood corpuscles and liberation of the
haemoglobin.
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 of
the 14th or 15th day.
The ultimate disappearance of color varies from 1 to 4 weeks
depending upon the severity and constitution of the body.
The color changes changes starts from the periphery to the center.
INTERNAL HEMORRHAGE
Rupture of blood vessel which may cause haemorrhage 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
is the jarring or stunning of the brain characterized by more or
less complete suspension of functions, as a result of injury to the
head, which leads to some commotion of the cerebral
substance.
ABRASIONS – (graze, scratch, impression mark, friction mark) it is
an injury characterized by the removal of the superficial epithelial
layer of the skin caused by rub or friction against a rough surface.

Characteristics of Abrasion
1. It develops at the precise point of impact of the force causing
it.
2. Grossly the injury consists of parallel linear injury which are
in line with the direction of rub or friction causing it.
3. It may exhibit the pattern of the wounding material.
4. It is usually ignored by the attending physician for it does
not require medical treatment but it has far-reaching importance in
the medico-legal viewpoint.
a. Abrasions caused by fingernails may indicate
struggle or assault and are usually located in the face, neck,
forearms or hands
b. Abrasions resulting from friction on rough surfaces,
either intentional or accidental are located on a bony surface and
usually associated with contusion or lacerations.
c. Nature of abrasion may infer degrees of pressure,
nature of the rubbing object and direction of movement.

5. Unless there is a supervening infection, abrasion heals in a

short period and usually leaves no scar. If the full thickness of the
skin is involved, healing may be delayed and occasionally with
scar formation.
1. Linear – an abrasion where there is a single line of injury
which may be straight or curved.
2. Multi-linear – a form of abrasion where there are several
lines of injury which are parallel to one another. Frequently seen
among victims of vehicular accidents.
3. Confluent – abrasion wherein the lines of injury are arranged
in haphazard manner, linear marks are almost indistinguishable on
account of the severity of friction and roughness of the object.
4. Multiple - several abrasions of varying sizes and shapes may
be found in different part of the body.
1. Scratch – an abrasion brought about by the stroke of sharp
pointed instrument over the skin producing injury, e.g. pin,
fingernails, thorn.
2. Grazes – an abrasion caused by forcible contact with rough,
hard objects resulting to irregular removal of the skin surface.
3. Impact or imprint Abrasion – (patterned abrasion, stamping
abrasion, Abrasion a La Signature) an abrasion due to contact with a
rough, hard surface in which the structural form of the object is
reflected over the skin.
4. Pressure or Friction Abrasion – abrasion caused by pressure
accompanied by movement
Point of distinction Ante-mortem abrasion Post-mortem abrasion
Color Reddish-bronze in appearance Yellowish and translucent in
due to slight exudation of appearance
blood
Location Any area Generally occurs over bony
prominence, such as elbow,
and attributed to rough
handling of the cadaver

Vital reaction With intravital reaction and Shows no vital reaction and is
may show remains of characterized by a separation
damaged epithelium of the epidermis from
complete loss of the former
This is produced by a sharp-edged (cutting) or Sharp-
linear edge of an instruments, like knife, razor, bolo, metal
sheets, glass, edge of a shell etc.

It maybe an impact cut when there is forcible contact of

the cutting instrument with the body surface, or slice cut
when cutting injury is due to the pressure accompanied
with movement of the instrument.
1. Edges are clean cut and both extremities are sharp,
except where the skin are loosened or folded.

2. Usually wounds are shallow at the extremities and

deeper at the middle portion

3. The wounds is straight and may be shelving if inflicted

with the instrument applied with an acute angle to the
surface of the body involved.
4. Blood vessels involved are clean cut, profuse bleeding is
invariably a feature.

5. Gaping is usually present due to the retraction of the edges

but degree of retraction depends on the direction of the
incised wound with the line of cleavage (Langer’s Line).

6. In the absence of complication and/or deeper involvement

present, healing relatively fast and the scar may not
develop conspicuously.

7. Incised wound caused by a broken glass may appear

irregular and may appear like punctured wound.
a. Suicidal Incised Wound – located at a peculiar parts of the body
and accessible to the hand in inflicting the injury. There is
usually superficial tentative cut and direction varies with the
location and the hand used. Common body area are the wrist
and the neck.

b. Homicidal Incised Wound – incised wounds are deep, multiple

and involve both accessible and non-accessible parts of the body.
Defense and other types of wound may be present, clothing are
usually involved.
1. Splitting caused by crushing if the skin between two hard
objects. This is best seen in laceration in the scalp caused by a hit
of a blunt instrument, cut eyebrow of boxer.

2. Overstretching of the skin. When pressure is applied on one side

of the bone, the skin over the area will be stretched up to the
breaking point.

3. Grinding compression. The weight and the grinding movement

may caused separation of the skin with the underlying tissues.

4. Tearing this may be produced by a semi sharp

Stab wound is produced by the penetration of a sharp-pointed and
sharp-edged instruments.

If the sharp edge portion is the first come in contact with the skin
it produces incised wound,

if the sharp pointed portion of the wounding instrument first

come in contact with the skin, then the wound is stab wound.
1. Suicidal
a. It is usually located over the vital part of the body.

b. Usually solitary, if multiple, usually located at the

same area

c. Clothing are usually not involved

d. Stab wound are accessible to the hands

e. The hands are smeared with blood

f. Wounding instrument is firmly grasped by the hand

g. If stabbing is accompanied with slashing movement,
the wound tailing abrasion is seen towards the hand
inflicting the injury

h. Suicide note may be present

i. There is motive for self destruction

j. No disturbance in the death scene, wounding

instrument is found near the victim.
2. Homicidal

a. Injuries other than stab wound may be present

b. Stab wound may be located in any part of the body

c. Usually there are more than one wound

d. There is disturbance of the crime scene