CSPELCRIME angles of the mouth, margins of nose, eyelids and

WEEK 13 - OPEN WOUNDS forehead.

Abrasion (Scratch, graze, impression mark, friction mark) 3. Excoriation of the skin by excreta – found in infants
➢ it is an injury characterized by the removal of the and the skin lesions heals when the cause is
superficial epithelial layer of the skin caused by a rub removed.
r friction against a hard rough object. ❖ No apparent history of rubbing trauma on the affected
➢ Contusion with abrasion = forcible contact before area.
friction occurs. 4. Pressure sore – usually
➢ The shape varies and the raw surface exudes blood found at the back at the region
and lymph which later dries and forms a protective of bony prominence. ➢
covering as SCAB or CRUST. History of longstanding illness,
bed ridden.
Characteristics of abrasion:
1. It develops at the precise point of the force causing it. Incised wound (cut, slash, slice)
2. Grossly or with the aid of a hand lens the injury consists ➢ Produced by a sharp-edged (cutting) or sharp-linear
of parallel linear injuries which are in line with the edge of the instrument like a knife, razor, bolo, glass
direction of rub or friction causing it. etc.
3. It may exhibit the pattern of the wounding material. ➢ Impact cut > when there is forcible contact of the
cutting instrument with the body surface.
4. Usually ignored by attending physician. Medico-legal
viewpoint ➢ Slice cut > when cutting injury is due to the pressure
accompanied with movement of the instrument
➢ Abrasions caused by fingernails may indicate
struggle or assault and are usually located in the ➢ Chopped or Hacked wound > when the wounding
face, neck, forearms and hands. instrument is a heavy cutting instrument like saber >
injury is severe
➢ Abrasions resulting from friction on rough surfaces
are located in bony parts and are usually
Characteristics of incised wound:
associated with contusion or laceration.
➢ Nature of the abrasion may infer degree of 1. Edges are clean cut.
pressure, nature of the rubbing object and the 2. The wound is straight
direction of movement. 3. Usually the wound is shallow near the extremities and
5. Abrasion heals in a short time and leaves no scar unless deep at the middle portion.
if not infected or if the whole thickness of the skin is 4. Profuse hemorrhage because of the clean cut on the
involved. vessels.
5. Gaping is usually present due to the retraction of the
Forms of abrasion edges.
1. Linear abrasion – appears as a single line, straight or curve. 6. Clothes will also show a clean cut if cut by the
➢ Pinching with fingernails = curve a. instrument.
➢ Sliding the point of a needle = straight linear ab. 7. Faster healing if without complications.
2. Multi-linear – develops when the skin is rubbed on a hard 8. Incised wound made by broken glasses maybe
rough object producing several linear marks parallel to one irregular, needs to be removed.
another.
Example: MVA Changes that occur in an incised wound:
3. Confluent – linear marks in the skin are almost 1. After 12 hours – edges are swollen, adherent with
indistinguishable on account of the severity of friction and blood and with leukocyte infiltration.
roughness of the object. 2. After 24 hours – proliferation of the vascular
4. Multiple – several abrasions of varying sizes and shapes endothelium and connective tissue cells.
may be found in different parts of the body. 3. After 36 to 48 hours –capillary network complete,
fibroblasts running at right angles to the vessels.
Types of abrasion
4. After 3 to 5 days – vessels show thickening and
1. Scratch – caused by sharp pointed object which slides obliteration.
across the skin, like pin, thorn or fingernail.
➢ Injury usually parallel to the direction of slide. Why a person suffers from incised wound:
➢ Fingernail scratch > broad at point of commencement 1. As a therapeutic procedure.
with tailing at the end. 2. As a consequence of self-defense
2. Graze – usually caused by forcible contact with rough, hard 3. Masochist may self-inflict incised wounds for self-
objects resulting to irregular removal of the skin surface. gratification.
➢ Course indicated by a clean commencement and tags 4. Addicts and mental patients.
on the end.
3. Impact or imprint abrasion (patterned abrasion, stamping Suicidal wounds
abrasion, abrasion a la signature) ➢ Usually located in peculiar parts of the body,
➢ Those whose pattern and location provides objective accessible to the hand. ➢ The most common site is
evidence to show cause, nature of the wounding the wrist, radial artery and the neck.
instrument and the manner of assault or death.
➢ Marks of grid of radiator, thread marks of wheel, teeth Homicidal wounds
marks. ➢ Usually deep, multiple and involves both accessible
4. Pressure or friction abrasion – caused by pressure and non-accessible parts.
accompanied by movement usually observed in hanging or ➢ clothing are usually involved
strangulation.
➢ Defense and other forms of wounds are present.
➢ Spiral strands of the rope as seen in the skin in
hanging. Accidental wounds
➢ Multiple incised wounds observed on the passenger
Differential diagnosis:
and driver of MVA due to broken windshields. ➢
1. Dermal erosion - gradual breakdown or very shallow Kitchen knives in the preparation of food.
ulceration of the skin which involves only the
epidermis and heals without scarring.
2. Marks of insects and fishes bites – skin injury is
irregular with no vital reaction and usually found on
STAB WOUNDS B. Homicidal – stabbing with
➢ is produced by the penetration of a sharp and a sharp homicidal intent is the most
edged instrument like a knife, scissors. common Characteristics: 1.
➢ if the sharp edge is the one that comes in contact with Injuries other than stab wound
the skin then it is an incised wound. may be present.
➢ If the sharp pointed portion first come in contact, it is a 2. Stab wound may be located in
stab wound. o Surface length may reflect the width of any part of the body.
the wounding instrument. o Smaller when the wound 3. Usually more than one stab
is not so deep. o Wider if upon withdrawal is not in the wound
same direction as seen in slashing movement. The 4. A motive for stabbing, if none
presence of an abrasion from the extremity of the skin then the offender either
defect is in line with direction of the slashing insane/drugs
movement. 5. Disturbance in the crime scene
The extremities of stab wound may show the nature of the Medical evidence showing the intent of the offender to kill
instrument used. the victim:
➢ A doubled bladed weapon shows both extremities to 1. there are more than one stab wounds
be sharp.
2. stab wounds located in different parts of the body
➢ A single bladed weapon – one of its extremities as
rounded and contused, not seen if instrument is quite 3. stab wounds are deep
thin. 4. Serrated stab wounds means thrust and withdrawal of
❖ The direction of the surface defect may be useful in the wounding weapon to increase internal damages.
the determination of the possible relative position of 5. Irregular or stellate shape skin defects> due to
the offender and the victim when the wound was changing direction of the weapon with the portion of
inflicted. the instrument at the level of the skin as the lever.
The depth of the wound may be influence by:
1. Size and sharpness of the instrument. PUNCTURED WOUND- is the result of a thrust of a sharp
pointed instrument.
2. area of the body involved
➢ External injury is quite small but the depth is to a
3. the degree of force applied certain degree.Ice-pick, nail
➢ Nature of the external injury depends on the
❖ Hemorrhage is always the most serious
sharpness of the end of the wounding instrument:
consequence of stab wound due to the severance
of blood vessels or involvement of bloody organs. ➢ contusion of the edges> if end is not sharp
➢ Opening may be> round, elliptical, diamond shaped
How to describe stab wound: or cruciate.
1. Length of the skin defect ➢ External hemorrhage is limited although internal
➢ Edges must be coaptated first injuries may be severe.> bloodvessels and bloody
organs is fatal if no intervention applied.
➢ Tailing – the direction of withdrawal of the
wounding weapon.
➢ Site of external wound can be easily sealed by dried
blood, serum, or clotted blood. ➢ Punctured wounds
2. Condition of the extremities
are usually accidental
➢ Sharp extremity > sharpness of the
instrument used. Characteristics:
➢ If both extremity are sharp > double bladed 1. The opening of the skin is very small, wound
weapon is used. is much deeper than it is wide.
3. Condition of the edges. 2. External hemorrhage is limited than internally
➢ Edges are regular and clean cut> due to may be severe.
one stabbing act. 3. Sealing of external opening is favorable for the
➢ Serrated or zigzag in appearance > growth and multiplication of anaerobic
several stabbing wounds (series of thrust organism like bacillus tetani.
and withdrawal.)
4. Linear direction of the wound – it may be running Homicidal
vertically, horizontally, or upward medially or laterally. 1. Multiple and usually located in different parts of
5. Location of the stab wound – to include exact the body.
measurement from anatomical landmarks. 2. wound are deep
6. direction of the penetration – must be tridimensional 3. There are defense wounds on the victim.
7. depth of the penetration 4. Signs of struggle in the crime scene.
8. tissue and organs involved
Suicidal
Stab wounds may be: 1. Located in areas of the body where the vital
A.Suicidal organs are located.
1. Located over vital parts of the body. 2. Usually singular, if multiple located in one area.
2. Usually solitary 3. Parts of body involved are accessible by the
3. Located over covered parts of the body, the clothing is not hand of the victim.
involved 4. Clothing usually not involved.
4. Stab wound is accessible to the hand of the victim 5. Wounding is made while the victim is in sitting
5. Hand of victim is smeared with blood or standing position, bleeding is towards the
6. Wounding weapon is firmly grasp by the hand of the lower part of the body or clothing.
victim. 6. No disturbance in the crime scene.
7. If stabbing is accompanied with slashing movement. The 7. Wounding instrument found near the body.
wound tailing abrasion is seen towards the hand inflicting
the injury.
8. Suicide not may be present
9. Presence of a motive for self-destruction. Puncturing wound with puncturing instrument loaded with
poison:
10. No disturbance in the death scene with wounding
instrument found near the victim.
1. poison dart – cyanide or nicotine
2. fish spines
 3. dog bites with hydrophobia virus
4. Injection of air and poison as a way of Practical ways of determining how much of the skin
surface is involved in an injury or disease:
euthanasia.
➢ Skin functions as a mechanical protection of the body,
LACERATED WOUNDS (TEAR, RUPTURE, STRETCH storage of water.
“PUTOK”) ➢ Determination of how much skin is involved is
➢ Is a tear of the skin and the underlying tissues due to important in the mode of treatment and prognosis
forcible contact with a blunt instrument. especially in burns, contusion.
➢ May be produced by a hit with a piece of wood, iron ➢ Burns of 70% in children and older age group are
bar, fist, stone, butt. fatal.
➢ If the force is applied to a tissue is greater than its ➢ Rule of nine is used. Head and neck
cohesive force and elasticity> the tissue tears and a 9% 9%
laceration is produced. One upper extremity 9% 18%
Front chest and abdomen 18% 18%
Characteristic: Posterior chest and abdo 18% 18%
One lower extremity front 9% 18%
1. shape and size of the injury does not
One lower ext. (back)
correspond to the wounding instrument
9% 18%
2. Tear on the skin is rugged with extremities Pudendum 1% 1%
irregular, ill-defined.
3. Injury developed where the blunt force is Factors responsible for the severity of the wound:
applied. 1. Hemorrhage may influence the severity of wound by:
4. Borders of the wound are contused and a. loss of blood incompatible with life
swollen. ➢ blood constitutes 1/20 of the body weight of
5. Developed in areas where the bone is an adult.
superficially located. Like scalp. ➢ 5 to 6 quarts of blood ( one quart is 946 cc)
6. Examination with the aid of hand lens shows ➢ loss of 1/10th of its volume will cause no
bridging tissues joining the edges and hairs significant change.
bulbs are intact. ➢ loss of one quart> fainting
7. Bleeding is not extensive due to blood vessels ➢ loss of 1/3rd to 2/5th> irreversible shock
are not severed evenly. ➢ males can withstand more loss of blood than
8. Healing process is delayed and has a females.
tendency to develop a scar. ➢ hypertension causes more excessive and
rapid bleeding.
Classification of lacerated wounds:
b. Hemorrhage may result in an increase in pressure in or
1. Splitting caused by crushing of the skin between two hard on the vital organs to affect the normal function.
objects.
Ex: laceration of scalp hit by a bunt instrument, cut ➢ Intracranial hemorrhage cause compression
eyebrow of a boxer. of the vital centers of the brain.
2. Overstretching of the skin - When pressure is applied on ➢ hemopericardium > pericardial tamp
one side of the bone> the skin over the area will be ➢ Hemorrhage to the chest> diminution of the
stretched up to a breaking point to cause laceration and respiratory output>anoxia.
exposure of the fractured bone.In avulsion: the edges of c.. Hemorrhage may
the remaining tissue are that of laceration. cause
mechanical
3. Grinding compression - The weight and the grinding
barriers to
movement may cause separation of the skin with the
the function
underlying tissues.
of organs.
4. Tearing -This may be produced by a semi-sharped edged
➢ Into
instrument which causes irregular edges on the wound
tracheo-
like hatchet and choppers. Lacerated wounds are rarely
bronchial
suicidal.
lumina>
asphyxia
GAPING OF WOUND ➢ Into
muscles >
➢ Separation of the edges especially in deep wound
disturbance
may be due to thefollowing:
in their
1. Mechanical stretching or dilatation contractility.
➢ The presence of a mechanical device on the edges to
prevent coaptation will cause separation. Causes of hemorrhage:
Example: drain in an abscess, retractor during a. trauma - destruction of its blood vessel wall
operation.
b. natural causes
2. Loss of tissue due to: ➢ intracerebral hemorrhage(apoplexy)>
a. Destruction due to pressure, inf’tion, cell lysis, lenticulostraite br. MCA
burning, chemical reaction. ➢ Spontaneous subarachnoid hemorrhage >
b. Avulsion or physical or mechanical stretching saccular berry aneurysm
resulting to separation of a portion of the tissue. ➢ rupture of arteriosclerotic aneurysm
c. Trimming of the edges – debridement of the skins ➢ rupture of esophageal varices
which come in contact with the bullet at the entrance
➢ pulmonary hemorrhage due to PTB, lung
and exit of GSW and removal of necrotic materials.
abscess, bronchiectasis
3. Retraction of the edges
➢ Underneath the skin are dense networks of fibrous ➢ ruptured ectopic pregnancy
and elastic connective tissue fibers running on the 2. Size of injury - burns greater than 1/3rd of the body are fatal
same direction and forming a pattern more or less 3. Organs involved – usually fatal to heart, brain, lungs.
present in all persons. 4. Shock – blow to genitalia, slight burns to young and old.
➢ This pattern of fiber arrangement is called cleavage 5. Foreign body or substance introduced into the body -
direction or lines of cleavage of the skin and their bacterial, viral, foreign body, chemical,
linear representation on the skin is called Langers
line.
TOXIN - snake bites> 2 punctured wds at the center of the COMPLICATIONS OF WOUNDS
reddened affected area. The venom is injected through its
fangs which are connected to the poison gland. COMPLICATIONS OF TRAUMA OR INJURY
Snake venom toxicity will depend on: 1. Shock due to injury to nervous system, anoxemia, and
1. potency of venom injected endothelial damage
2. amount of venom injected by the fang will depend on 2. Hemorrhage
➢ Season of the year 3. Infection
➢ The length of time the snake has eaten. a. from the instrument
➢ If a snake has just killed its prey> toxic b. from the organs involved in trauma ex. Bowels
content is smaller. injured
3. size of the patient c. injury may depress general vitality
4. Immediate treatment instituted. d. deliberate intro of micro-organism
4. Embolism
Snake venoms are two principal classes: HEALING OF WOUNDS
1. Neurotoxic – primarily paralysis the respiratory and cardiac 1. Power of the human tissue to regenerate –
center of the brain. replaced the destroyed tissue by newly formed
- may cause N,V, ascending paralysis, coma, similar tissue.
convulsion, c/p arrest Regenerates rapidly: C.T., blood forming tissues,surface
2. Hematoxic - affects particularly the blood epith. Skin
- manifestations are pain, swelling on the affected Slow to regenrate:sm. Muscles, neurons of CNS, highly
area, IV hemolysis, N,V, pulmonary and cardiac edema. specialized glandular tiss.

Emergency treatment may be: Time of healing is dependent on:

1. Incision of the wound to promote more external a. vascularity c. degree
hemorrhage to drain the venom. b. age of person d. nature
2. tourniquets above the site of the wound
3. placing ice on the bite site 2. Aberrated healing process:
4. sucking the wound to drain venom with the mouth a. formation of exuberant granulation or proud flesh
5. Administration of anti-snake venom serum. b. keloid formation
c. stricture
Scorpion venom
d. fistula or sinus formation
➢ venom has toxic, hemolytic, hemorrhagic
➢ one punctured wound on the center of a reddened MEDICO-LEGAL INVESTIGATION OF WOUNDS
area
➢ pain, edema and reddening Rule to follow by a physician:
1. all injuries must be described
Coelenterate sting (jellyfish)
2. description of wound must be comprehensive,
➢ Tentacles penetrate into the skin and cause explosion sketch/photograph
of the nematocyst and liberation of the venom.
3. Examination must be influenced be any other information
➢ Extreme pain. Urticarial rash, dilated pupils, paleness, obtained from others in making a report or a conclusion.
labored breathing
4.0.1 OUTLINE OF THE MEDICO-LEGAL INVESTIGATION
Absence of medical or surgical intervention OF PHYSICAL INJURIES
-Wound may not be fatal butdue to neglect or ignorance
of its management, may be serious and fatal. 1. General investigation of the surroundings:
FATALITY OF WOUNDS
a. Examination of place where crime is
committed.
1. Wounds may be directly fatal by reason of:
b. Examination of clothing, stains, cuts, hair, f.b.
a. Hemorrhage – neck due to carotid in the crime scene
bleed.
c. Investigations on possible witnesses to the
b. Mechanical injuries on vital organs incident
c. shock d. Examination of the wounding instrument
2. Wounds may be indirectly fatal by reason of: e. Photography, sketching, accurate description
a. secondary hemorrhage following of the crime scene.
sepsis
b. specific infection 2. Examination of the wounded body
c. scarring effect a. examinations applicable to living or the dead
d. secondary shock - Age of the wound from the degree of
healing
NATURE OF DEATH DUE TO SECONDARY CAUSES - Determination of the weapon used
1. Changes whose natural sequence are direct & - Reasons for the multiplicity of wounds
obvious – sepsis, tetanus - Determination if the wound is accidental,
2. Changes producing separate pathological lesions suicidal or homicidal
which in turn proves to be fatal
Ex: operation to ligate vessel but died of peritonitis b. examination applicable only to the living
despite diligence/skill - Determination if injury is fatal
3. Changes where a definite pathological condition was - Determination if injury will produce
present before the injury. Ex. Person with tumor and permanent deformity
stabbed, stab is not capable of death but accused is - Determination if wound produces shock
responsible for his death.
- Determination if wound produces
4. Changes where a definite pathological condition of complications
totally different nature arises after the wounding and
the consequential sequence is doubtful. Ex. TB c. examination applicable to a dead victim only
meningitis ffg blow to the head
- Determination if wound is pre-mortem or post-
mortem
 - Determination whether wound is mortal or not explosion. Examples include an overheated boiler or a simple
- Determination whether death is accelerated by a tin can of beans tossed into a fire.
Boiling liquid expanding vapor explosions are one type of
disease present at time of injury. -
mechanical explosion that can occur when a vessel containing
Determination whether wound cause by A, S, H
a pressurized liquid is ruptured, causing a rapid increase in
volume as the liquid evaporates. Note that the contents of the
3. Examinations of wound
container may cause a subsequent chemical explosion, the
- Character of wound: abrasion, hematoma, effects of which can be dramatically more serious, such as a
laceration etc propane tank in the midst of a fire. In such a case, to the
- Location of wound: from some fixed area effects of the mechanical explosion when the tank fails are
>To determine trajectory/course added the effects from the explosion resulting from the
- Depth of wound: not in the living, only if the outer released (initially liquid and then almost instantaneously
and inner are fixed gaseous) propane in the presence of an ignition source. For
- Conditions of the surroundings of the wound - this reason, emergency workers often differentiate between the
= near GSW – burning, tattooing two events.
= suicidal cuts – superficial tentative cuts or hesitation cuts 2. Electrical and magnetic
= lacerated wounds – contusion on neighboring A high current electrical fault can create an electrical explosion
skin by forming a high energy electrical arc which rapidly vaporizes
metal and insulation material. This arc flash hazard is a danger
WEEK 14 to persons working on energized switchgear. Also, excessive
PHYSICAL INJURIES IN THE DIFFERENT PARTS OF magnetic pressure within an ultrastrong electromagnet can
THE BODY cause a magnetic explosion.
1. HEAD AND NECK 3. Nuclear
= not be underestimated In addition to stellar (star) nuclear explosions, a man-made
= bleeding from ears, nose, mouth > basal fractures nuclear weapon is a type of explosive weapon that derives its
= may have normal x-rays yet with severe head injury destructive force from nuclear fission or from a combination of
fission and fusion. As a result, even a nuclear weapon with a
Factors influencing the degree and extent of head small yield is significantly more powerful than the largest
injuries: conventional explosives available, with a single weapon
a. Nature of the wounding weapon> degree of capable of completely destroying an entire city.
violence applied depends on the thickness of the 4. Chemical
scalp and the weight of the weapon. The most common artificial explosives are chemical
b. Intensity if the force > intensity and heavy agent explosives, usually involving a rapid and violent oxidation
c. point of impact >extensive in fx of vaults at side or reaction that produces large amounts of hot gas. Gunpowder
back was the first explosive to be discovered and put to use. Other
notable early developments in chemical explosive technology
d. mobility of the skull at the application of force were Frederick Augustus Abel's development of nitrocellulose
if head is mobile, free> effect on the brain is due to the
in 1865 and Alfred Nobel's invention of dynamite in 1866.
shearing movement imparted to the brain.> may produce
Chemical explosions (both intentional and accidental) are often
contusion, laceration without fx. If head is fixed and
initiated by an electric spark or flame. Accidental explosions
unsupported> jarring movement of the brain is absent but the
may occur in fuel tanks, rocket engines, etc.
fracture is extensive.
Types of Chemical Explosion:
Head injuries are classified as to the site of the application
of force: a. Diffused Reactant Explosion – This is caused by the
mixture of gas and air. If the gas and air are mixed in
1. Direct or Coup injuries correct proportion, product of heat and subsequent
2. Indirect injuries pressure is produced.
a. contr-coup injuries b. Condensed Reactant Explosion – This chemical
b. remote injuries – fall hitting buttocks> basal explosion occurs when large quantity of heat and gas
fx is produced as a result of rapid chemical reaction in a
c. locus minoris resistencia - injury in areas solid or liquid material.
with less resistance
3. Coup-contre-coup injuries (direct and indirect injuries) IDENTIFICATION OF THE SITE OF EXPLOSION AND
COLLECTION OF EVIDENCES
Wounds in the Scalp:
The site of explosion may be identified by the
1. it is difficult to prevent the spread of infection pressure of the crater. The original location of other
2. there is proximity of the scalp to the brain objects located near the blast may be useful clue in
3. there are free vascular connection between the determination of the site of explosion. Soil and other
structures inside and outside the brain debris may be collected for laboratory examination.
4. it is frequently difficult to determine the extent of
damage of the skull. EFFECTS OF NUCLEAR EXPLOSIONS ON HUMAN
HEALTH AND BODY

DEATH OR PHYSICAL INJURIES CAUSED BY 1. Radiation poisoning, also called "radiation sickness" or
EXPLOSION a "creeping dose", is a form of damage to organ tissue due
An explosion is a rapid increase in volume and to excessive exposure to ionizing radiation. The term is
release of energy in an extreme manner, usually with the generally used to refer to acute problems caused by a large
generation of high temperatures and the release of gases. dosage of radiation in a short period, though this also has
Supersonic explosions created by high explosives are known occurred with long term exposure to low level radiation.
as detonations and travel via supersonic shock waves. Many of the symptoms of radiation poisoning occur as
Subsonic explosions are created by low explosives through a ionizing radiation interferes with cell division. There are
slower burning process known as deflagration. numerous lethal radiation syndromes including prodromal
syndrome, bone marrow death, central nervous system
CLASSIFICATION OF EXPLOSION AS TO THE SOURCE OF death and gastrointestinal death.
ENERGY 2. Prodromal syndrome
In prodromal (initial) syndrome, a dose of 1.5 gray or less is not
1. Mechanical and vapor lethal, but causes gastrointestinal distress such as anorexia,
Strictly a physical process, as opposed to chemical or nuclear, nausea, fatigue and possibly diarrhea. Short term effects (6-8
e.g., the bursting of a sealed or partially sealed container under weeks) a.Skin
internal pressure is often referred to as a 'mechanical
The skin is susceptible to beta-emitting radioactive fallout. The 5. Sensitivity – Muscles and connective tissue are radio
principal site of damage is the germinal layer, and often the resistant while actively dividing tissues like blood
initial response is erythema (reddening) due to blood vessels forming organs, intestinal epithelium are quite
congestion and edema. Erythema lasting more than 10 days radiosensitive.
occurs in 50% of people exposed to 5-6 gray.
Other effects with exposure include: GUNSHOT INJURIES OR DEATHS
• 2-3 gray—temporary hair loss Death or physical injuries brought about by powdered
• 7 gray—permanent epilation occurs propelled substances:
• 10 gray—itching and flaking occurs 1. Firearm shot
• 10-20 gray—weeping blistering and ulceration will = the injury is caused by the missile propelled by the
occur explosion of the gunpowder located in the cartridge shell and
b.Lungs the rear of the missile. 2. detonation of high explosives -
The lungs are the most radiosensitive organ, and radiation grenades
pneumonitis can occur leading to pulmonary insufficiency and = explosion inside the metallic container will cause
death (100% after exposure to 50 gray of radiation), in a few fragmentation of the container.
months. Radiation pneumonitis is characterized by:
• Loss of epithelial cells I. FIREARM WOUND
• Edema = Firearm: is an instrument used for the propulsion of a
projectile by the expansive force of gasses coming from the
• Inflammation burning of gunpowder. (Technical definition)
• Occlusions of airways, air sacs and blood vessels = includes rifles, muskets, shotguns, revolvers, pistols, other
• Fibrosis deadly weapons which a bullet, ball, shell or other missile may
c.Ovaries be discharged by means of gunpowder or other explosives.
A single dose of 1-2 gray will cause temporary damage and = includes air rifle except of small calibers and limited range.
suppress menstruation for periods up to 3 years; a dose of 4 = the barrel of any firearm shall be considered as a complete
gray will cause permanent sterility. d.Testicles firearm for all purposes thereof.
A dose of 0.1 gray will cause low sperm count for up to a year;
2.5 gray will cause sterility for 2 to 3 years or more. 4 gray will Penal provisions of laws relative to firearm:
cause permanent sterility. a. Sec. 2692 RAC – unlawful manufacture,
Long term effects
dealing in acquisition, disposition or
a.Cataract induction
possession of firearms or ammunitions
The timespan for developing this symptom ranges from 6
therefore or instrument used or intended to
months to 30 years to develop but the median time for
be used in the manufacture of firearms or
developing them is 2–3 years.
ammunition.
• 2 gray of gamma rays cause opacities in a few
percent
b. Sec. 2690 RAC – selling of firearms to
unlicensed purchaser.
• 6-7 gray can seriously impair vision and cause
cataracts c. Sec. 2691 RAC - failure of personal
b.Cancer induction representative of deceased licensee to
Cancer induction is the most significant long term risk of surrender firearm.
exposure to a nuclear bomb. Approximately 1 out of every 80 d. Art. 155 RPC - Alarms and Scandals
people exposed to 1 gray will die from cancer and 1 in 40 e.Art. 254 RPC – Discharge of firearms
people will get cancer. Different types of cancer take different
times for them to appear: CLASSIFICATION OF SMALL FIREARMS:
• 2 years for leukemia to appear Small firearms - are those which propel projectile of less than 1
• 20 or more years for skin cancer or lung cancer inch in diameter.
c.In utero effects 1. as to wounding power:
1 gray dose of radiation will cause between 0 and 20 extra = low velocity firearm >muzzle velocity of not more than
cases of perinatal mortality, per 1,000 births and 0-20 cases of 1400 ft per sec.
severe mental sub normality. 0.05 gray will increase death due Ex. Revolver
to cancer 10 times, to 5 per 1,000. An antenatal dose of 1 gray = high power firearm > muzzle velocity
in the first trimester causes the risk of fatal cancer to increase more than 1400 ft. per second >Usual is
to 100%. 2200 to 2500 ft per second or more.
2.as to nature of the bore:
d.Transgenerational genetic damage = smooth bore weapon >inside portion of the barrel that is
Exposure to even relatively low doses of radiation generates perfectly smooth from the firing chamber to the muzzle. Ex.
genetic damage in the progeny of irradiated rodents. This shotgun
damage can accumulate over several generations. In humans = rifled bore firearm > the bore of the barrel with a number
however, Microcephaly is the only proven malformation, or of spiral lands and grooves which run parallel with one another
congenital abnormality, found in the in Utero developing but twisted spirally from breech to muzzle.Ex. Military rifle
Human fetuses present during the Hiroshima and Nagasaki 3. as to manner of firing
bombings. No statistically demonstrable increase of congenital = pistol – fired with a single shot Ex. Revolver
malformations was found among the later conceived children = rifle – may be fired from the shoulder Ex. Shotgun
born to survivors of the Nuclear weapons at Hiroshima and
Nagasaki. The surviving women of Hiroshima and Nagasaki, 4. As to the nature of the magazine
that could conceive, who were exposed to substantial amounts = cylindrical revolving magazine – the cartridge is
of radiation, went on and had children with no higher incidence located in a cylindrical magazine which rotates at the rear
of abnormalities than the Japanese average. portion of the barrel Ex. Revolver
= vertical or horizontal magazine – the cartridge is held
FACTORS RESPONSIBLE OF THE EFFECTS OF one after another vertically or horizontally and also held in
RADIATION place by a spring side to side or end to end.Ex. Automatic
1. Age – Children and old persons are more susceptible pistol
to radiation.
2. Dosage – Bigger dose of radiation will cause more Types of small firearms which are of medico-legal interest:
damaging effects on the body tissues. 1. revolver – usual muzzle velocity is 600 feet per
3. Kind of Radiation – The biological damage not always second
proportional to the energy absorbed, but it depends 2. automatic pistol – self-loading firearm, muzzle
on the kind of energy emitted. Gamma and neutron velocity of 1200 feet per second 3. rifle - muzzle
radiations are most destructive. velocity of 2500 feet per second and a range of
4. Fractional Doses – A single dose may be lethal when 3000 feet.
administered fractionally over a long period of time. 4. shotgun - projectile is a collection of pellets
A weapon in order to cause injury must have two principal Shored GSW of exit: if pressed on a hard
component parts: object like when victim is lying: Wound of
1. the cartridge or ammunition - bullet primer, cartridge case, exit is circular or nearly circular with abrasion.
powder charge
2. firearm – instrument for the propulsion of a projectile force ODD AND EVEN RULE IN GSW
= If the number of entrance and exit wound is
of gases from aburning powder.
even so presumption that no bullets lodge in the
body.
INSTANCES WHEN THE SIZE OF THE WOUND OF
= verified by x-ray
ENTRANCE DO NOT APPROXIMATE
THE CALIBER OF THE FIREARM
How to determine the number of fires made by the
In distant fire, the rule is that the diameter of the GSW of
offender:
entrance is almost the same as the caliber of the wounding
firearm except: 1. determination of the number of spent shells
1. Factors which make the wound of entrance bigger than 2. determination of entrance wounds in the body of the
the caliber: victim – number of entrance wounds may not show
a. in contact or near fire the exact number of fire:
b. deformity of the bullet which entered a. not all fire made may hit the body of the
victim
c. bullet might have entered the skin sidewise
b. The bullet may in the course of its flight hit a
d. acute angular approach of the bullet hard object thereby splitting it and each
2. Factors which make the wound of entrance smaller fragment may produce separate wounds of
than the caliber entrance.
a. fragmentation of the bullet before penetrating c. Bullet may have perforated a part of the
the skin body and then made another wound in some
b. contraction of the elastic tissues of the skin other parts of the body.
c. 3. Number of shots heard by the witness
Other evidences or findings
used to determine entrance of Instances when the number of GSW of entrance is less
GSW 1. examination of the than the number of GSW of exit in the body of the victim:
clothing, if involved in the course 1. a bullet might have entered the body but split into
of the bullet several fragments, each of which made separate exit.
a. fabric shows punch in destruction 2. one of the bullets might have entered a natural orifice
b. particle of gunpowder of the body. Ex. nose
2. examination of the internal injuries caused by the bullet 3. there might be two or more bullets which entered the
a. bone fragments, cartilage, soft tissues are body through a common entrance and later making
driven away from entrance wound individual exit wounds .
b. destruction of the bone is oval, with sharp 4. in near shot with a shotgun, the pellets might have
edges at the exit it is irregular, bigger and entered in a common wound and later dispersed while
bevelled inside the body and making separate wounds of exit.
c. testimony of witness
Instances when the number of GSW of entrance is more
Determination of the trajectory of the bullet inside the than the number of GSW of exit in the body of the victim:
body of the victim 1. when one or more of the bullet is not through and through
1. external examination and the bullet is lodged in the body.
a. shape of wound of entrance 2.when all of the bullets produce through and through
= when bullet is fired at right angle with the skin> the wounds but one or more made an exit in the natural
wound of entrance is circular except in case of near fire. orifices of the body.
= if fired at another angle, it is oval 3. when different shots produced different wounds of
= when the bullet is deformed no such characteristics entrance but two or more shots produced a common exit
findings will be observed. wound.

Instances when there is no GSW of exit but the bullet is

b. shape and distribution of the contusion collar not found in the body of the victim:
= contusion collar is widest at the side of the acute
angle of approach of the bullet. 1. when the bullet is lodged in the GIT and expelled
= if the bullet hits the skin perpendicularly> collar will through the bowel or lodged in the pharynx and
have a uniform width around the GSW except when bullet is expelled through the mouth.
deformed or in near fire. 2. near fire with a blank cartridge produced a wound of
c. difference in level between the entrance and exit wounds entrance but no slug may be recovered.
d. by probing the wound of entrance – not with too much force 3. the bullet may enter the wound of entrance and upon
2. internal examination hitting the bone the course is deflected to have the
wound of entrance as the wound of exit.
a. actual dissection and tracing the course of the wound at
autopsy
Antemortem GSW – hemorrhage, swelling, vital reaction.
b. fracture of bones and course in visceral organs - microscopically: congestion and leucocytic
c. location of bone fragments and lead particle infiltration.
d. x-ray exam
3. other evidences to show trajectory Problems confronting Forensic Physician in the
a. relative difference in the vertical location of entrance and identification of GSW:
exit in the clothing 1. alteration of the lesion due to natural
b. relative position and distance of the assailant from the process:drying of wound, infn, healing
proc..
victim in the reconstruction of reenactment of the crime. c.
testimony of witness 2. medical and surgical intervention: refer to
clinical record of patient 3. embalming
EXIT WOUNDS OR OFFSHOOT WOUND 4. problems inherent to the injury itself.
Does not show characteristic shape unlike the entrance 5. x-ray exam – migratory, external souvenirs
wound due to the absence of external support beyond the skin
so the bullet tends to tear or shatter the skin. The effects of the clothing on the movement of the bullet
depend on:
 1. number of layers of fabric between the muzzle and 3. direction and length of the bullet track
subjacent skin 4. organs or tissues involved in its course
2. nature of the fabric; closely woven 5. location of the missile, if lodged in the body
3. muzzle- clothing distance 6. diagram. Photograph, sketch or drawing showing the
location and number of wounds.
Examination of the external wearing apparel of the victim
of GSW may be significant in investigation because: QUESTIONS THAT A PHYSICIAN IS EXPECTED TO
1. it may establish the possible range of the fire: ANSWER IN COURT;
a.contact fire 1. COULD WOUND THE WOUND BE INFLICTED BY
=tear in the clothing covering the skin, fibers turn THE WEAPON PRESENTED TO HIM?
outward away from body 2. AT WHAT RANGE WAS IT FIRED?
= soot deposit, gunpowder tattooing,
burning of fibers around the turned fiber = 3. WHAT WAS THE DIRECTION OF THE FIRE?
muzzle imprint 4. IS IT SELF-INFLICTED?
= dirt and greasy deposit may be wipe out and 5. ARE THERE SIGNS OF STRUGGLE?
visible in the torn clothing b.not contact but near 6. DID THE VICTIM DIE INSTANTANEOUSLY?
shot
= same with (a) except for absence of muzzle
7. IS IT POSSIBLE FOR THE VICTIM TO FIRE OR
RESIST THE ATTACK AFTE THE INJURY WAS
imprint and beyond flame range c. far fire
SUSTAINED?
= there is a hole tear with inward direction of the thread
2. it may be useful in the determination as to which is the point 8. WHERE WAS THE POSTION OF THE ASSAILANT
AND THE VICTIM WHEN THE SHOT WAS FIRED?
of entry and of exit of the bullet. Entry- the fiber are
inverted.
The caliber may be inferred from the diameter of the wound of
3. it may be useful in locating the bullet entrance.
Special consideration on bullets Determination of the length of survival of the victim:
1. souvenir bullet 1. nature of the GSW
2. bullet migration 2. organs involved
3. tandem bullet 3. presence or absence of infection
EVIDENCES SHOWING THAT THE GUNSHOT WOUNDS
4. amount of blood loss
MAY BE SUICIDAL 5. physical condition of the patient
1. shot fired in a closed locked room, or open
Capacity of a victim to perform volitional acts – depends
uninhabited place.
upon the area of the body involved, involvement of vital organs
2. death open near the place victim was found and the resistance of the victim.
3. shot fired with the muzzle of the gun in contact with
the part of body involved DETERMINATION AS TO THE LENGTH OF TIME A
4. location of entrance wound accessible part of body FIREARM HAD BEEN FIRED
5. shot usually solitary 1. odor of the gas inside the barrel
6. direction of fire is compatible with the trajectory of 2. chemical changes inside the barrel
bullet 3. evidences that may be deduced from the wound
7. personal history may reveal social, economic,
business or marital problem which cannot be solve. DETERMINING WHETHER THE WOUNDING WEAPON IS
8. gunpowder presence in the hand of the victim AN AUTOMATIC PISTOL OR A REVOLVER
9. entrance wound usually does not contain clothing 1. location of the empty shells – revolver the empty
shells are found in the cylindrical magazine
10. fingerprints of victim on the butt chamber after the fire
11. suicide note at the vicinity 2. nature of the spent shell – automatic firearm =
12. no disturbance in the place of death bullet is copper jacketed
3. nature of the base of the cartridge or spent shell
Russian roulette = unfortunate victim has no predetermined
= base of a revolver has a wider diameter than
desire of self-destruction
that of the cylindrical body to keep the cartridge
stay in the magazine chamber.
EVIDENCES THAT GSW IS HOMICIDAL
1. site of wound of entrance has no point of election It may be possible for a person who is accustomed to the
2. fire is made when the victim is at some distance sounds of firearms of different calibers to identify the firearm by
3. signs of struggle or defense wounds the sound produced.
4. disturbance in the surroundings
It is not possible to determine the direction of the shot by
5. wounding firearm usually not found in the scene of the determining the direction of the sound except when the flash or
crime the person firing the shot is seen at the time the shot was fired.
6. testimony of witness
GSW may not be a near fire or may not appear to be near
EVIDENCES TO SHOW THAT GSW IS ACCIDENTAL fire:
1. usually one shot 1. when a device is set up to hold the firearm and to
2. no special area of body involved enable it to be discharged at a long range by the
3. consideration on the testimony of the assailant and victim.
determination as to whether it is possible by knowing 2. when the GSW of entrance does not show
the relative position of the victim characteristics of a near shot because the clothing are
4. testimony of the witness interposed between the victim and the firearm.
3. when the examining physician failed to distinguish
POINTS TO BE CONSIDERED AND INCLUDED IN THE between a near or far shot wound
REPORT OF THE PHYSICIAN 4. when the product of a near shot has been washed out
1. complete description of the wound of entrance and of the wound.
exit
2. location of the wound; part of body involved, distance X-ray
of wound from midline, distance of wound from heel 1. facilitate the location and extraction of the wound
or buttock. 2. reveals fragmentation and its location
 3. shows bone involvement like fracture b. evidence of struggle
4. reveal trajectory of the bullet c. information as to the position of the body
5. shows effect of the bullet wound, like hemorrhage, d. presence of suicide note
escape of air, laceration e. condition of the weapon

SHOTGUN WOUNDS 4.0.2 DETERMINATION WHETHER THE WOUNDS WERE

Is a shoulder fired firearm having a barrel that is smooth-bored INFLICTED DURING OR AFTER DEATH
and is intended for the firing of a changed compound of one or Points to consider in the determinant’s as to whether the
more balls or pellets. wounds is A, S, H.

Measure the distance between the two farthest shot(pellets) in 1. External signs and circumstances related to the
inches and subtract one, the number obtained will give the
position and attitude of the body when found.
muzzle-target distance in yards.
2. location of the weapon or the manner in which it was
Determination of the presence of gunpowder and primer held
components: 3. the motive in the commission of the crime
Importance: 4. the personal character of the deceased
1. Determination of the distance of the gun muzzle from 5. The possibility for the offender to have purposely
the victim’s body when fired. Usually not more than 24 changed the truth of the condition.
inches when fired. 6. other information
2. Determining whether a person has fired a firearm. – a. signs of struggle
dorsum of the hand
= metallic residues, burning and unburned
b. number and direction of wounds
gunpowder c. direction of wound
= in suicide found in the palm d. nature and extent of the wound
e. state of clothing
Procedures in determining the presence of gunpowder:
1. Gross examination use of hand lens – LENGTH OF TIME OF SURVIVAL OF THE VICTIM AFTER
Fine black powder – not conclusive 2. INFLICTION OF THE WOUND
Microscopic examination 1. degree of healing> signs of repair of wound appear in
3. Chemical test:
less than a day after the infliction of injury.
Tests for the Presence of Powder residues 2. changes in the body in relation to the time of death
>systematic changes in the body = wasting, anemia,
1. On the skin – Dorsum of the hand or Wound of entrance bed sore.
Dermal nitrate test (Paraffin test, Diphenylamine test, 3. age of blood stain – not reliable
Lung’s test Gonzales’ test) 4. testimony of witness when the wound was inflicted.
= melted paraffin heated at 150 degrees fahrenheit
– Lung’s reagent POSSIBLE INSTRUMENTS WHEN USED BY THE
= small particles with nitrate or nitrite > blue ASSAILANT IN INFLICTING THE INJURIES
reaction 1. contusion – blunt
= not conclusive: fertilizers, cosmetics, cigarettes, 2. incised wound – sharp-edged instrument
urine
= Negative is not conclusive: thorough washing
3. lacerated wounds- blunt
4. punctured wounds – sharp pointed
2. On clothings 5. abrasion – body surface is rubbed on a hard surface
Walker’s test (C-acid test, H-acid test) 6. GSW – the diameter of the wound of entrance may
= glossy photographic paper fixed in approximate the caliber of the wounding instrument.
hyposolution for 20 min to remove the silver salts
and washed for 45 min. and dries. Could the injury have been inflicted by a special weapon?
A physician can’t determine that a specific
Tests for the presence of Primer Components – metallic weapon was used in inflicting a wound. It is
primer residues like barium, antimony, and lead. possible that it is caused by a certain instrument
1. Harrison and Gilroy test: Cotton swab moistened with 0.1 presented. He must be cautious in giving
molar HCl to gather the primer component. categorical statements
= Reagent sodium rhodisonate yields red color with the
primer components. WHICH OF THE INJURIES SUSTAINED BY THE VICTIM
= Add 1.5 HCl to the red area> blue-violet or pink in lead CAUSED DEATH?
or barium If with conspiracy – no need coz the act of one is the act of
all.
= lacks specificity, sensitivity If none- offenders are only responsible for their individual
2. Neutron Activation Analysis (NAA) acts.
= Sample obtained by paraffin or by washing with dilute
If multiple injuries: which of the wound injured a vital organ.
acid
Or if same organ which caused the degree of damage.
= Extremely sensitive, even with small quantity
3. Flameless Atomic Absorption Spectroscopy (FAAS) WHICH OF THE WOUNDS WAS INFLICTED FIRST?
4. Use of Scanning electron microscope with a Linked X-ray If multiple for the qualification of the offense committed.
analyzer First – treachery , murder

- Extent of the wound 1. relative position of the assailant and the victim when
= extensive injury – marked degree of force the first injury was inflicted on the latter.
applied in the production of the wound. 2. trajectory/course of the wound inside the body of the
= homicidal cutthroats are deeper, extensive, victim
numerous than suicide
3. organs involved and the degree of injury
- Direction of the wound > impt. in the position of the victim to
the offender
4. testimony of witness
- Number of wounds – several> homicidal 5. presence of defense wounds – inflicted first.
- Conditions of locality EFFECT OF MEDICAL AND SURGICAL INTERVENTION ON
a. degree of hemorrhage THE DEATH
 If death followed after operation> offender is responsible if 2nd – Erthyma, edema, swelling due to vascular
death was inevitable and that even with operation death is dilatation, paralysis and increased capillary
normal and direct consequence of the injury, and the physician permeability.
is competent and in spite of exercise of degree of diligence still 3rd - Blister formation
death is the outcome. 4th– Necrosis, vascular occlusion,
If death ensued even the wounds are minor, and death due thrombosis and gangrene.
to the negligence or incompetence of the physician then the
offender can’t be responsible. Microscopically: Vacuolization,
degeneration of epidermal cells
Effect of negligence of the injured person on the death : Necrosis of the collage of
the SQ tissue
If death occurred from complications arising from a simple : Occlusion of
injury owing to the negligence of the injured person in its the vessels due to clumping of RBC
proper care and treatment B. Systemic effects:
= the offender is responsible for the death - Reflex in nature due to the
= a person is not bound to submit himself to medical tx stimulation and paralysis of
for the injuries received during the assault. the nerves - Pulmonary,
= unless if it is proven that the negligence of the victim is Cardiac action is slowed
deliberate so offender is not responsible but only for physical down due to cerebral
injuries. anoxia> Resulting to
lethargy, delirium,
POWER OF VOLITIONAL ACTS OF THE VICTIM AFTER convulsions, coma or death.
RECEIVING A FATAL INJURY
= dying declaration, attempt to kill the offender after the first DEATH OR INJURY FROM HEAT
blow of the offender Effect may be local or general

RELATIVE POSITION OF THE VICTIM AND ASSAILANT Classifications of Heat Injury:

WHEN INJURY WAS INFLICTED a) General or Systemic effects:
1. location of the wound a.1 Heat cramps
2. direction of the wound a.2 Heat exhaustion
3. nature of instrument used in inflicting the injury a.3 Heat stroke
4. testimony of the witness b) Local effects:
b.1 Scalding
EXTRINSIC EVIDENCES OF THE WOUNDS
1. evidences from the wounding weapon b.2 Burns
= position of the weapon - near or grasp by victim = Thermal
= blood on weapon - may be stained with blood = Chemical
= hair and other substance on weapon = Electrical, lightning
= Radiation
2. Evidences in the clothing of the victim GENERAL OR SYSTEMIC EFFECT: death usually
= soaked with blood - hemorrhage
accidental
= gunpowder - distance
= tears - struggle 1. Heat cramps ( Miner’s Camp, Firemans Camp,
Stroker’s camp)
3. Evidences derived from the examination of the assailant - Involuntary spasmodic painful
= paraffin test, tears in clothing, blood stains, contraction of muscles due to
intoxication etc. dehydration and excessive loss of
chlorides by sweating
4. Evidences derived from the crime scene - Tx: Fluids with chlorides
= amount of hemorrhage, wounding instrument etc. 2. Heat Exhaustion (Heat collapse, Syncopal
Fever, Heat syncope,
WEEK 15 Heat prostration)
THERMAL INJURIES OR DEATHS - Due to heart failure, cause:Heat precipitated by
MEANING exertion/warm clothes
-Are those caused by deviation from normal temperature, = Sudden syncope, face turns pale, dim vision
capable of producing cellular or tissue changes in the body - Tx: removal from the heated area
- Exposure to severe cold = Frost bite 3. Heat stroke (Sunstroke,Heat
- Exposure to high temperature = burning scalding Hyperpyrexia,Comatous form,Thermic Fever)
- Working in ill-ventilated places with dry
4.4.2 DEATH OR INJURY FROM COLD temperature or exposure to the sun
- Not common in the Philippines
LOCAL EFFECTS OF HEAT
- Primary cause of death: Decrease dissociation of
O2 from Hgb in the RBC 1. Scald: Caused by hot liquid
: The injury by scalding is not severe as burns:
Diminished power of the tissue to a. Scalding liquid runs on the body surface
utilize O2 - Cold damp air is – distributing the heat
more fatal than cold dry air. b. Easily cools off
- Women are more resistant to cold > greater c. Temperature not as high except : oils
deposits of SQ fats. and molten metals
2. Thermal burns: Caused by heat or chemical
Effects of COLD: substances like fire, radiant heat, friction, solid
A. Local effect substances, electricity.
( Frostbite, : Classification of burns/
Immersion foot, DUPUYTREN’S CLASSIFCATION
Trench foot ) 1st – 1st Degree –erythema
Blanching, 2nd - vesicle formation
paleness of the 3rd - destruction of the cuticle, part of true
skin due to skin, painful
vascular spasm. 4th - whole skin is destroyed, ulceration, not
painful
5th – deep fascia, muscles 2. Respiratory failure due to bulbar paralysis
3. Mechanical asphyxia due to violent and
Proofs that the victim was ALIVE BEFORE burned to
prolonged convulsion.
DEATH:
1. Presence of carbon particles in the air Metallization: - specific feature of electrical injury.
passage. = the metal of the conductor is volatilized and
2. Increase carboxy-hemoglobin blood level. particles of the metal are driven into the epidermis
3. Dermal erythema, edema and vesicle causing darkening of the skin
formation.
4. Subendocardial left ventricular Delayed effects of electrical injuries:
= necrosis of the area develops into gangrene
hemorrhage.
= Damaged arteries becomes brittle, friable
and liable to rupture
= Nervous injuries – retrograde amnesia,
Differential diagnosis of blisters:
hemiplegia
1. Due to putrefaction – fluid content is blood = May enter the head > cataract
stained watery fluid
- asso. with putrefactive WEEK 16
changes in other parts of body. DEATH OR PHYSICAL INJURIES DUE TO CHANGE
2. Due to disease - heat by the size, AF ATMOSPHERIC PRESSURE
distribution (BAROTRAUMA)
3. Due to friction - Hx of application of heat Increase of atmospheric pressure (Hyperbarism)
4. Chemical burns -Normal atmospheric pressure at sea level is 760 millimeters of
Hg.
Characteristics of lesions: - Henry’s Law = “At constant temperature, the amount of gas
dissolved in a liquid is directly proportional to the pressure”
a. Absence of vesication = As he goes deeper there will be an increase in the amountof
b. Staining of the skin or clothing by the gas dissolved in the blood and other body fluids.
chemical = If ascent is made rapidly, the diver will suffer from the effects
c. Presence of the chemical substance of the sudden release of the gasses from the body fluids.
d. Ulcerative patches of the skin = released of air bubbles in the circulation and act as emboli in
e. Inflammatory redness of the skin surface different parts of the body causing interstitial emphysema,
pulmonary embolism, in big joints called bends.
f. Delayed healing
Decrease of atmospheric pressure (Decompression)
PHYSICAL INJURIES OR DEATH BY LIGHTNING AND
1. Hypobarism – at high altitudes the atmospheric
pressure is lower and more gas will be liberated by the
ELECTRICITY
body fluid.
= release of gasses results to:
PHYSICAL INJURIES OR DEATH BY LIGHTNING
Lightning – is an electrical charge from the a) Bends – joint and muscular pain
atmosphere. b) Chokes – Substernal distress, non-
- 1 million volts/ 2000 amperes productive coughing
c) Substernal emphysema –
Elements of lightning that produces injury: d) Trapped gas
1. Direct effect from the electrical charge. 2. Anoxia- Hypoxia felt at 8000-15,000 feet level
2. Surface flash burns from the discharge - - Aircrafts greater than 34,000 feet be provided
electrical into heat energy. with O2.
3. Mechanical effect – expansion of air >
laceration AIRCRAFT INJURIES AND FATALITIES
4. Compression effect – 1. during the flight
“sledgehammer blow” a) Altitude: Hypobarism (Decompression)
Spasmodic contraction of cerebral vessels > shock b) Speed – spatial disorientation; sudden
change of direction at a speed of
PHYSICAL INJURIES OR DEATH BY ELECTRICITY
500 miles drains brain from blood to the
Electricity - main cause of death is shock
lower parts> unconsciousness c)
- Above 300 volts are like the effect of
Toxins – CO, CO2 saturates cabin
lightning,
resulting to asphyxia
Factors which influence the effect of electrical shock: d) Temperature - At 25,000 feet 40 degree below
zero: frost bite, freezing
1. Personal idiosyncracy –
personal condition e) Pre-existing disease – Coronary dis./Hpn fatal due
to sudden change env.
2. Disease – cardiac dis. Is prone
2. During crash – fatalities occur us. during
3. Anticipation of shock – Can
take-off and landing. - Fx, Rupture of the
withstand
heart due to cmpression.
4. Sleep – increases resistance
5. Amperage or intensity of the DEATH BY ASPHYXIA
electrical current – principal factor
= 70-80 in AC and 250 in DC. CONCEPT
6. Resistance of the body
7. Nature of current – AC is more Asphyxia – Applied to all forms of violent death
due to interference with process of respiration
dangerous
- Conditions in which the supply of
8. Earthing- shock is enhanced O2 to the blood or tissues or both has been
9. Duration of contact reduced below normal level.
10. Point of entry – left more
dangerous than the right TYPES AND CLASSIFICATION OF ASPHYSIA

Mechanism of death in electrical shock: Types of asphyxial death:

1. Ventricular fib – leads to rupture of muscle 1. Anoxic death
fibers
Failure of arterial blood to be normally saturated with O2 due - Occlusion of air from the lungs by closure of air openings
to: or obstruction of the air passageway from the external
a) Breathing in an atmosphere with insufficient O2- openings to the air sacs.
High altitude
b) External obstruction of the air passage – traumatic Smothering:
crush asphyxia - A form of asphyxial death cause by closing the external
c) Paralysis of the respiratory center – poisoning, respiratory orifices.
injury, anesthesia Overlaying – most common inchildren: pressure of pillows
d) Mechanical interference of the passage of air- Gagging – application of materials to prevent air to have
access to mouth and nostrils.
drowning, asthma
Plastic bag suffocation
e) Shunting of blood Choking- Form of suffocation by the impaction of F.B. in the
2. Anemic anoxic death respiratory passage.
Decrease capacity of the blood to carry O2 due to Hge, CO
poisoning, Low Hgb ASPHYXIA BY SUBMERSION OR DROWINING
3. Stagnant anoxic death
Failure of circulation due to Heart failure, shock, arterial - Form of asphyxia where the nostrils and mouth has
venous obstruction submerged in watery fluid.
4.Histotoxic anoxic death
Failure of the cellular oxidative process, cannot be utilized in Time required for death in drowning:
the tissues. Cyanide - Submersion for 1 ½ minutes considered fatal.
Phases of asphyxial death:
- Average time required for death in drowning is 2 to 5
minutes.
1.Dyspneic phase – Breathing is rapid and deep, PR inc., Rise
of BP
Emergency treatment in Drowning
- due to lack of O2 and retention of CO2
2. Convulsive phase – Cyanosis more pronounced, pupils 1. Schaefer’s method–Face down, prone position:operator
exerts pressure in ribs
dilated, unconscious
- Tardieu spots =petechia /hges in the 2. Sylvester’s method- Lying on his back, astride over body,
swinging arms
visceral organs
- due to stimulation of CNS by CO2 Post-mortem findings:
3. Apneic phase – Breathing is shallow, gasping 1. External findings
- Due to paralysis of respiratory center

Classification of Asphyxia:
a) Wet clothes, pale face, F.B. clinging on skin
surface
1. Hanging
b) “Cutis anserine” or “goose flesh” – skin is pale ,
2. Strangulations: by ligature, manual strangulation, spl contracted NOT Dxtic
forms –palmar
c) Washerwoman’s hands and feet – skin of hands &
3. Suffocation: choking feet: bleached NOT Dxtic
4. Asphyxia by drowning d) Postmortem lividity – marked in the head, neck
5. Asphyxia by pressure on the chest and chest.
6. Asphyxia by irrespirable gasses e) Presence of firmly-clenched hands with objects –
Person was alive at first
ASPHYXIA BY HANGING f) Physical injuries for struggle
= Not necessary the whole body is suspended:
g) Suicidal drowning – Pieces of stone
Pressure at side of neck
= Mechanism of death: Air passage is constricted by 2. Internal findings
pressure of the rope
; Compression of carotids, jugs, Sup. Laryng A. RESPIRATORY SYSTEM
nerve> Cereb. anoxia
1. “Emphysema aquosum” – Lungs are distended overlapping
Causes of death in hanging: the heart
1. Simple asphyxia by blocking the air passage. = Due to irritation made by the inhaled water on the mucous
2. Congestion of the venous blood vessels in the membrane of the air passage which stimulate the secretion of
mucous.
brain.
3. Lack of arterial blood in the brain. 2. “Edema aquosum”– Due: Entrance of water into air sacs,
Lungs are doughy
4. Syncope due to pressure on the vagus and carotid
sinus.
3. “Champignon d’ocume” – whitish foam accumulates in the
mouth/nostrils
5. Injury in the spinal column 6. Combination of the = Due: abundance of mucous secretion
above. = One of the
indications that death
Hanging is ante-mortem: Vital reaction= principal was due to drowning.
criterion 1. Redness or ecchymosis at the site of 4. Tracheo-bronchial
ligature. lumen – congested,
2. Ecchymosis of the pharynx and epiglottis. filled with froth
3. Line of redness or rupture of the intima of the 5. Blood stained fluid found inside chest cavity.
carotid artery 6. Section lungs shows fluid with bloody froth.
4. Subpleural hges.
B. HEART
Manual strangulation or throttling: 1. Both sides of heart may be filled or emptied with
- form of asphyxial death where the constricting force is blood.
the hand.
2. Salt water drowning – Blood chloride content is
greater than left side. Fresh water- Blood
ASPHYXIA BY SUFFOCATION
chloride is more I the right side. FRESH-
RIGHT Gettler’s Test:
- Quantitative determination of the chloride content of the blood 2. silver nitrate – white ppt. of silver carbonate when carbonic
in the right and left ventricle of the heart. : Difference of at acid is added.
least 25 mg. 3. Hydrogen sulfide (H2S, Sulphuretted hydrogen) = rotten
C. STOMACH
egg odor
- Presence food in the stomach but absence of water.> Death
is rapid or submersion made after death. Impossible for water - Formed during decomposition process of organic
to get into the stomach if body is submerged after death. substances containing sulphur
- Causes titanic convulsion, delirium, coma, death
FINDINGS CONCLUSIVE THAT THE PERSON DIED OF 4. Hydrogen cyanide – one of the most toxic, rapid acting gas
DROWNING - Formed by the addition of acid to potassium or
1. The presence of F.B. in the hands of the victim. sodium salt of cyanide
The clenching of the hands is a manifestation of - Found in plants; leaves of cherry laurel, bitter
cadaveric spasm in the effort of the victim to save almond, kernels of common cherry, plum, peaches,
himself from drowning. ordinary bamboo shoots, certain oil seed and beans
2. Increase in volume (emphysema aquosum) edema of the - Contains AMYGDALIN which in the presence of
lungs ( edema aquosum) water and natural enyzme
3. Presence of water in the stomach EMULSIN is readily decomposed to HYDROCYANIC
4. Presence of froth, foam, F.B. in the air passage found in ACID, glucose and benzaldehyde.
the medium where the victim was found. = 60-90 mg of Hydrogen cyanide is fatal, death in 2 to
5. Presence of water in the middle ear due to violent 10 min.
inspiration when the mouth is full of water. 5. Sulfur dioxide - Heavier than air, pungent odor
- employed as disinfectant, bleaching agent,
Floating of the body in drowning: - found in eruption of volcano
-Within 24 H due to the decomposition which causes the
accumulation of gas in the body, the body floats. WAR GASES
- Body is flexed because of the dominance of the flexor Classification based on the physiological action
muscles
-“tete de negri” – bronze color of head and neck; face as the
1. Lacrimator or Tear gas – causes irritation with copious flow
of tears
most dependent portion of the body.
Homicidal D. = struggle, motive, articles found near the place, a) Chloracetphene (C.A.P.)
phys. injuries b) Bromobenzyl cyanide (B.B.C.)
Suicidal D. = note, heavy objects, mentality, Hx of previous c) Ethyl Iodoacetate (K.S.K.)
attempt High concentration – irritation of respiratory passages,
Accidental = Absence of violence in the body.,exclusion of lungs, V, N
suicide, witnesses 2. Vesicant of Blistering Gas – contact with skin cause bleb or
blister formation
COMPRESSION ASPHYXIA ( TRAUMATIC CRUSH
ASPHYXIA) a) Mustard gas (Dichlordiethyl sulfide, yellow cross,
Yperite)
- Form of asphyxia where the free exchange of air in the lungs b) Lewisite (Chlorovinyl-dichlorarsine) 3. Lung
is prevented by the immobility of the chest and abdomen due irritants ( Asphyxiant or choking gas)
to external pressure or crush injury. - Dysnea,
tightness of the
- Homicidal =offender kneels on the chest chest, coughing,
- Accidental = pinned between two big objects coma, death a)
Burking – invented by Burke and Hare= murder for the sale to Chlorine (Cl2) –
medical schools yellowish green gas
- Kneels or sits on the chest and the hands close the mouth b) Phosgene (COCl2)
and nostrils c) Chloropicrin
Death by crucifixion- alternative raising and lowering of the
body leads to exhaustion, unconsciousness and death from d) Diphosgene
asphyxia = IC mm are stretched 4. Sternutator – nasal irritants of vomiting gases
5. Paralysants – Nerve gas - like organophosphates
ASPHYXIA BY BREATHING IIRESPIRABLE GASES 6. Blood poisons – CO, H2S, and Hydrogen cyanide
1. Carbon monoxide “silent killer”, colorless, DEATH OR PHYSICAL INJURIES DUE TO AUTOMOTIVE
insoluble in water and alcohol. - formed by CRASH OR ACCIDENT
the incomplete combustion of carbon fuel.
-Main action is O2 deprivation AUTOMOTIVE CRASH
Qualitative test for CO in the blood
a) Kunkel’s test – 4 volume of water + 3x its volume of Factors responsible to an Automotive Crash
1% tannic acid A. HUMAN FACTOR (DRIVER)
- Crimson red if positive 1. Mental attitude: reckless driving, fatigue, inexperience
b) Potassium Ferrocyanide test – bright red 2. Perceptive defect
c) Spectroscope exam 3. Delayed reaction time
d) Gas chromatograph 4. Disease
e) Infra-red analysis 5. Chemical factor
2. Carbon dioxide – CO2, Carbonic acid gas B. ENVIRONMENTAL FACTOR
- Blown out of the lungs during respiration - Poor visibility, poorly maintained roads, rain, blind
- Product of complete combustion of carbon intersection
containing compounds C. MECHANICAL FACTOR: Poor brake, worn out tires
- End result of fermentation & decomposition of D. SOCIAL FACTOR: Speed, insurance
organic matters.- septic tank E. PEDESTRIAN
= The inhalation of pure CO2 may cause immediate
vagal inhibition with spasm of the glottis and death. = Injuries and Death on the Driver and Passengers:
manhole, poorly ventilated rooms
1. First collision: the impact of the
moving vehicle with another or fixed
Tests for the presence of CO2
object = The MOVING VEHICLE –
1. Barium nitrate – white precipitate of Barium carbonate with
carbonic acid
rapidly decelerates and stops after 2. Reasons Why Boxing Should Be Prohibited:
impact. a. There is too much risk of death or injury to the
= The degree of damage depends: a) speed b) part of participants.
vehicle involved b. Unlike other sports, the intention of the combatants is
2. Second collision: Impact of to produce injury as a principal way to win the contest.
unrestrained occupants with the vehicle So, young men should be discouraged from a
interior = 1st Col., Occupants move pugilistic career.
same direction/velocity towards point of
impact a) Front impact> Occupants WRESTLING
move forward.
b) Side impact ( severe) > moves to the side that was 1. Common Injuries Suffered By Combatants:
involved in the 1st Col. >The passenger nearest a. Injury to the cervical spine (fracture and/ or
to it will suffer the most.
dislocation) especially when the wrestler forms a
c) Rear impact crash – Acceleration-deceleration bridge during the contest. There is a bridge
injury or whiplash when the trunk and neck is hyperextended and
d) Roll over crash ( Turn turtle impact ) the body weight is supported by the head which
= If vehicle is not put into a stop after the 1 st Col. > the touches the ground and the feet.
unrestrainedoccupants will continue to strike to some parts of b. Knee injury, usually meniscus or ligament tear
the vehicle interior. that follows hyperextension and rotation of the
leg.
PEDESTRIAN-VEHICLE COLLISION c. Injuries to the shoulder joint and a rotator cuff
result from twisting of the trunk and upper
Death or Physical Injuries to pedestrian
extremities.
1. Primary impact – Contact with vehicle d. Facial injuries and mat burns due to contact of
2. Secondary impact – Subsequent impact of the pedestrian to the face to the floor.
the ground e. Abdominal hemorrhage due to rupture of organs
- Accounts for the multiple injuries
in violent fall.
3. Run over Injuries 2. Regulations to Minimize Injuries:
4. Hit and run Injuries a. Pulling of hair, ears and genitals, twisting of the
digits, blows with the fist, and kicking are
MOTORCYCLE CRASH
forbidden.
Reason why there is high percentage of motorcycle crash
b. Each contestant must have a medical
1. Motorcycle can attain high speed examination immediately before the combat.
compared with other ordinary road
vehicles. c. A five minutes rest period must be allowed after
any fall on the head or any sign of bleeding from
2. Has a small profile that the driver of the nose.
other vehicles may fail to see it.
d. The competitors must be freshly shaven, the hair
3. At high speed and frequently in must be short and no grease or lubricant may be
curves, the cyclist may lose control of
used in the body.
the bike. It may hit a fixedobject,the
tire may skid, or the cyclist maybe
drunk.

DEATH OR PHYSICAL INJURIES DUE TO ATHLETIC WEEK 17

SPORTS MEDICO – LEGAL ASPECT OF SEXUAL CRIME
SOME ASPECTS OF SPORT DEVELOPMENT:
VIRGINITY AND DEFLORATION
1. Training Method:To develop weight lifting; a lifter lift
a very heavy weight during his practice. A. Virginity – is a condition of a female who has not
2. Injuries: If the athlete is injured, he is rehabilitated by experienced sexual intercourse.
not allowing him to participate in the sport that caused 1. Kinds of virginity:
the injury and by finding another sport that does not
cause pain. Every time the muscles are
a. Moral virginity
exercised intensely, injuries occur and it will take at b. Demi- virginity
least 48 hours for the muscles to heal. c. Virgo- intacta
3. Nutrition: Muscle endurance depends on how much d. Physical virginity
glycogen can be stored in the muscle cells. The 2. Points to be considered in the determination of the
glycogen storing capacity can be increased by
condition of virginity.
exercising the muscles until most of the glycogen is
depleted. Depletion, in the average top runner, occurs a. Breast
at 1-1/2 to 2 hours while on a bicycle racer it is 3 to 5 b. Vaginal canal
hours. c. labia majora/ minora
BOXING
d. Fourchetta to perineum
Boxing as a sport is sometimes described as an e. Hymen
“organized brutality”, “slaughter” and “carnage”. Unlike others f. Neugeosities
sports, the primary objective of the combatants is to knock out
or win by decision by delivering a stunning or weakening
punches.
B. DEFLORATION – laceration or rupture of the hymen as a
result of sexual intercourse.
1. Reasons Why Boxing Should Not Be Prohibited:
a. It takes wayward youths who are victims of the
educational system off the streets. 1. Classification of hymenal laceration
b. It teaches them self-discipline and controls and a. Incomplete Laceration
reinforces the adage that nothing of value is Superficial
acquired without hardwork and sacrifice. Deep
c. Self-confidence can only be promoted through an b. Complete
individual sport where the athlete must rely in his
c. Complicated or compound
own talent and believes in his ability. Only though
conflict can hidden resources surface.
2. Healing time of hymenal laceration e. Super fecundation – fertilization made by separate
Superficial- 2to 3 days intercourse of two ova which have escaped at the same act
Extensive tears – 7 to 10 days of.
Completed – if with intervening infection will f. Super faction – fertilization of two ova which have escapade
require longer to heal at different acts of ovulation.
g. Psuedocyesis or Spurious pregnancy- imaginary
3. Duration of laceration of the hymen pregnancy.
a. Fresh bleeding laceration- rupture quite recent
within 24 hrs. MEDICO-LEGAL ASECT OF DELIVERY
b. Healing – after 24 to 7 days
c. Recently healing – 7 days to 3 mons. 1. Delivery is the process by which a woman gives birth to her
offspring.
d. Old healing- 3 mons. To year
2. Puerperium – Is the interval between the terminations of
labor (delivery) to the complete return of the reproductive
4. Medical Evidence to consider in sexual crimes organ to it normal- pregnant state-last from 6 to 8 weeks.
a. Evidence from the victim 3. The study of delivery is important because proof of
1) Alleged time and place of the delivery is necessary in judicial on the following:
commission of the crime 1. Legitimacy
2) Date, time and placed of the 2. Abortion
examination
3. Infanticide
3) Condition of clothing
4. Concealment of birth
4) Physical and mental development
of victim 5) Goit, facial expression
5. In slander or libel
etc.
METHODS OF DELIVERY
6) Examination of the body for sign of
violence A. Natural Route- thru normal passages
7) Examination of genitalia 1. Spontaneous
a) Hymen 2. Surgical intervention
b) Hymenal orifice 3. Instrumentation
c) Vaginal orifice
d) Reugosities B. Surgical Route
e) Fourchette 1. Abdominal cesarean section
f) Pubic hair 2. Vaginal cesarean section
g) Labias 3. Post- mortem cesarean section
h) Presence of spermatozoa MEDICO-LEGAL ASPECT OF ABORTION
b. Sexual Crimes
a. Rape Willful killing of the fetus in the uterus, or violent
b. Seduction expulsion of the fetus from the natural womb which results to
the death of the fetus.
1. qualified
2. Simple
A. Principal elements of the crime:
c. Acts of lasciviousness
1. That the expulsion of the products of conception is
d. abduction induced.
1. Forcible 2. That the fetus dies either as an effect of the
2. Consented violence used, drugs administered or fetus was
e. White slave crude expelled before the term of its viability.
a. Adultery
b. Concubine B. Provision of the revised Penal code on abortion
c. Unnatural sexual offenses 1. Intentional abortion elements
d. Abused against CHASTITY a. That the woman is pregnant
b. Violence was applied on such pregnant woman
without the intention of abortioning her.
MEDICO-LEGAL ASPECT OF PREGNANCY
c. The woman aborted as a result of the violence: 2.
Pregnancy - is the state of a woman who has within her body Unintentionalabortion Elements:
the going products of conception. The woman must be pregnant
Violence was applied on such pregnant woman
LEGAL IMPORTANCE OF THE STUDY OF PREGNANCY without the intention of abortionist her: The woman
aborted as a result of the violence.
3. Abortion practiced by the woman herself or by her
a. Pregnancy is ground for the suspension of the execution of parent elements:
the death sentence in the woman. A conceived child is
capable of receiving donation a. The woman is pregnant
1. Archeim- Zondel Test b. abortion is intended to be committed
2. Friedman test c. Abortion is induced by
3. Xenopus o Hogben test 1. The pregnant woman
4. Qualitative color test for pregnancy 2. other person with the consent of the
pregnant woman
5. Estrone administration
3. The present of the woman, or either of
b. Duration of pregnancy – 270- 280 days from onset of last
them for the purpose of concealing her
menstruation
dishonor and with the consent of the
c. Abnormally prolonged gestation – beyond 300 days. woman herself.
d. Minimum period of gestation – compatible with viability of
the child born at 180 days may live.
 4. Abortion practiced by a physician or a. Whiskey – an alcoholic distillate from mass of
midwife and dispensing of abortion cereal grains or cereal grain product saccharified
elements. by the action of yeast, distilled at less than 74.7%
a. The woman pregnant and aged at least three years and may contain a
flavoring of caramel.
b. The physician induced or assisted in
causing the abortion b. Gin – the distilled product obtained from the
original distillation of mash or by redistillation of
c. The act done by the physician or midwife
distilled spirits with or over juniper berries and
was intended to cause an abortion.
may contains other aromatic botanical
substances or sugar.
There must be the intention of the physician to produced
abortion and the absence of intention will not make the c. Rum – a distilled alcoholic beverage prepared by
physician criminally liable. fermentation, distillation and aging of sugar cane
product, e.g. sugar cane juice, molasses. It is a
yellow-brown liquor of fine bouquet and sweet,
C. Kinds of abortion: Spontaneous or natural smooth alcoholic taste. It may contain caramel
Induced and may be flavored with fruit or other flavoring
Therapeutic from other botanical substances.
Criminal d. Alcoholic Cordial and Liquors – these are
distillates obtained by mixing or redistillating
ALCOHOLISM neutral spirits, usually brandy, with or over fruits,
flowers, leaves, seeds or other botanical
CLASSIFICATION OF COMMERCIALLY AVAILABLE substances or their juices or with extracts derived
ALCOHOL BEVERAGES from infusion, percolation or maceration of such
botanical substances and to which sugar or
1. Wine -- a product of natural alcoholic fermentation dextrose or both have been added in an amount
with wide variety of sugary materials including fruit not less than 2.5% of the finished product and
juices and contains not less than 70% but not more contains not less than 23% of absolute alcohol by
than 17% of alcohol by volume. volume. These may also contain natural or
artificial coloring material.
a. Red wine — the wine contained the extracted
pigment from the skin, stem and seed of the e. Vodka – distilled liquor from grain spirit, filtered
fermented fruit juice. The color ranges from pale through activated carbon (charcoal) so as to
straw to pale pink. render the product without distinctive character,
aroma or taste.
b. White wine — the product of fermentation of fruit
juices only after removal of the skin and stem.
They are not really colorless but impact a pale 3. Malt Liquors – alcoholic beverages brewed from malt
straw or green to gold or amber color. or from a mixture of malt and malt substitute, like rye,
and may contain other cereal grains and starchy
c. Dry wine — wine wherein practically all the saccharine matters. A characteristic bitter flavor is
sugar contents are fermented into alcohol. imparted by the addition of hops. The amount of
d. Sweet wine — wine which not contains not less alcohol need not be stated in the label.
than 1 gram of sugar per 100 milliliter. a. Ale – a malt liquor brewed in such a manner as
e. Still wine — wine in which fermentation has to possess the aroma, taste and character
been completed before bottling so that it contains commonly attributed to ale and shall contain not
only such properties of carbon dioxide product in less than 3.2% absolute alcohol. In its
the fermentation which can be dissolved in the fermentation, top yeasts are utilized instead of
liquid in equilibrium with air under conditions of bottom yeasts the latter being utilized in beer.
manipulation.
b. Beer – top product of alcoholic fermentation of a
f. Sparkling wine — wine that is bottled before mash in potable water of malted barley, hop
fermentation has ceased so that it contains CO 2 and/or hop preparation with or without the
gas in solution at greater than atmosphere addition of starchy and saccharine material and
pressure shall contain not less than 2% and not more than
g. Fortified wine — wine whose alcoholic contents 10% by volume of alcohol.
are derived partly from fermentation and partly c. Stout – a malt liquor brewed in such a manner
from the addition of distilled spirit. as to possess the aroma, taste and character
h. Chinese medicinal wine — wine which is a commonly attributed to stout and, to a marked
mixture of refined alcohol and Chinese herbs and degree, the flavor of hops.
contains not less than 20% alcohol. d. Porter – malt liquor brewed in the manner used
i. “Basi” – composed of fermented juice of sugar in brewing of stout but having in comparison with
with the characteristics brown color, bitter taste stout a less marked flavor of hops.
and aroma imparted by dried leaves, bark, twigs An alcoholic beverage shall possess the
and flowers of a tree called “samark” (Macaranga characteristic attributed to the type of drink that is
Tanarius). stated in the definition and standard of identification.
j. “Lambanog” – native wine produced by The preparation must be free from any ingredient
distillation of fermented coconut sap (“tuba”) and injurious to health, free from sediment of any kind,
bottled at not less than 80% proof. and shall be manufactured in premises built and
maintained under hygienic condition.
2. Distilled Liquor – are alcoholic beverages produced
from distilled of wines, distilled from grains of starch ABSORPTION AND DISTRIBUTION OF ALCOHOL
solution or distilled from aromatic substances. In
distilled beverages the alcohol contents are In as much as alcohol when ingested does
expressed in proofs. “Proof” is approximately twice not require digestion, it is immediately absorbed in the
the percentage of alcohol by volume. walls of the stomach and duodenum. The maximum
The sole purpose of the distillation process is to period of absorption occurs thirty to sixty minutes
increase the concentration of alcohol in the finished after the initial intake.
product. This is necessary because fermentation
ceases when the alcohol concentration is The rate of absorption of alcohol in the stomach
approximately 12% to 14% by volume. and intestine depends upon the following:
1. Concentration and total quantity of alcohol taken. Other effects:
The higher the percentage of alcohol taken, the 1. Dilatation of the blood vessels of the cutaneous
greater is the volume of alcohol per unit of time. surface.
The greater the volume of alcohol consumed will 2. Increase in the pulse rate.
likewise enhance the absorption.
3. Weaker cardiac systole which tend to cause
2. Nature of the food in the stomach and intestine. cardiac dilatation.
Fatty food makes absorption slower was
compared with sugar and other carbo-hydrates
4. Locally, it has direct irritation effect on the
mucous membrane of the stomach and intestine.
and proteins.
3. Volume of gastric content. The presence of
5. Slight depression of the liver functions as
indicated by the decrease in hepatic oxygen
sufficient amount of food and water in the
consumption and decrease in glycogen storage.
stomach may delay the rate of absorption.
4. Diseased condition of the stomach and intestine.
6. Fall of the blood pressure.
Achlorhydria, gastric atony and chronic gastritis
cause slower absorption, however subtotal DEGREE OF INTOXICATION
gastrectony or a gastroenterostomy may cause 1. Slight inebriation – there is flushing of the face,
abnormally early intoxication because of its early with exaggerated mood, but a person is able to
evacuation of food to the duodenum where control his behavior. He shows no sign of mental
absorption is more rapid. impairment, incoordination of movement and
5. Length of time the gastric content is held in the difficulty of speech.
stomach prior to the opening of the pylorus and 2. Moderate inebriation – person is talkative,
permeability of the stomach or intestinal wall. argumentative and over-confident. There is slight
Warm drinks dilate gastric capillaries to cause impairment of mental faculties, difficulty of
more absorption. articulation, and loss of coordination of finer
6. The optimum concentration of alcohol in movements. He may be certified as being “under
beverages between 10 to 20% is the most rapidly the influence of alcohol”.
absorbed. 3. Drunk – the mind is confused, behavior is
irregular and movement is uncontrolled. Behavior
PHARMACOLOGICAL EFFECT OF ALCOHOL is uncontrollable.
4. Very Drunk, “Dead drunk” – the mind is
Ethyl alcohol depresses the central nervous confused and disoriented. There is difficulty in
system in descending order from the cerebral cortex speech and marked motor incoodination and
to the medulla oblongata. It causes depression or often walking is impoosible.
temporary functional paralysis of the ganglionic cell. 5. Coma – the subject is stuporous or comatose.
The more specialized the cells are, as in the cerebral Sometimes it is difficult to differentiate this
cortex, the more sensitive they are to alcohol. condition with others having coma.

Effects on the special senses: PHYSICAL TEST TO DETERMINE DRUNKENNESS

1. Vision – with increasing amount of alcohol intake 1. Romberg’s test – lets the subject stand straight
the acuity is progressively diminished to the point with heels together and with closed eyes for at
where vision to obscure to a degree comparable least one minute. If he is not drunk, he will not
to wearing dark sunglasses at night. The amount sway to the front or to the sides, but if he is drunk
of blood alcohol is somewhere 100 to 200 mg. the body will not be stable in the absence of any
ocular coordinator is impaired and diplopia existing disease.
develops. 2. Let the subject stand straight with one foot ahead
2. Hearing – the increasing amount of alcohol of the other so that the toes of one foot touch the
intake diminishes the ability of the individual to heel of the other. This will remove the brace to
perceive and appreciate varying intensities of prevent side sway. If drunk, there is more
sound. likelihood that the subject will sway sidewise and
3. Touch – the sense of touch is diminished with fall.
the increased amount of alcohol intake. The 3. Let the subject sit comfortably in a desk and get
blunting of touch sensation is responsible for samples of his handwriting. Compared these
frequent cigarette burns on the hand to choric writings, with those taken when he is free from
alcoholics. the effect of alcohol.
4. Taste – there is a decrease in the sense of taste. 4. Let the subject bend down and pick up a small
When a person is drunk, all food taste good. object fron the floor. If he stumbles, then his
5. Smell – the perception of smell is depressed by nervous system is not stable and that he may be
alcohol. Malodorous substances may be drunk.
undetected by those under the influence of 5. Let the subject walk straight forward to a corner
alcohol. of a room and rapidly turn around without
“Proprioception” or the so-called “six sense” stopping. Tell him to walk back. The subject may
is also impaired. have uncertainty of steps, side steps, or he
Blunting of judgment is one of the first staggers while making the turn and in walking.
mental functions affected by alcohol.
The faculty of attention deteriorates rapidly CAUSES OF DEATH IN ALCOHOLICS
and this is the principal reason why individuals 1. Acute Alcoholic Intoxication:
even with low level of alcohol end up as traffic a. Paralysis of the medullary center – alcohol
victims. depresses the nervous system by affecting
Ability to hear is blunted and recall memory the cerebral cortex, basal ganglia,
is often markedly disturbed. cerebellum, and finally the brain stem and
Moral standard is blunted and lowered, and medulla.
there is a tendency to distort reality. It increases
b. Cardiac myopathy – the heart muscles may
the desire for sex but markedly impairs the
suffer direct damage from the high
performance; a prolonged intercourse without
concentration of blood alcohol.
ejaculation is often the result (Legal Medicine
Annual 1969, pp. 241-268). c. Ingestion of alcohol and synergistic drugs,
like barbiturates and tranquilizer may cause
fatality. Potentiation of alcohol by
 psychotrophic drugs has been reported to An alcoholic who is suddenly withdrawn from
have caused death. alcohol may suffer a state of excitement with
A blood level of 0.45% or greater is generally hallucination known as delirium tremens. It is
accepted as a fatal level, although death has characterized by an attack of acute insanity with
occurred at a level below 0.35%. sleeplessness, marked tremors, excitement, and
2. Hidden Trauma: fear and sometimes with strong suicidal
Alcoholics are prone to be victims of traffic tendencies.
accidents or other traumatic injuries. Acute An alcoholic may develop Korsakow’s
intoxication produces considerable analgesia and psychosis. It is a syndrome characterized by
may deceptively conceal physical injuries. They hallucination, disorientation and multiple neuritis,
may suffer from subdural hematoma, brain and the loss of memory for recent events.
concussion or abdominal injuries which may be Cortical astrophy is the main alteration grossly
considered symptoms of drunkenness. observed in fatal cases.
Alcoholic polyneuritis may also develop as a
3. Unexpected aspiration of food (“café
complication of alcoholism. There is a combined
coronary”):
degeneration of the nerve fibers and myelin
Aspiration of food into the respiratory
sheaths.
passage may cause severe asphyxia. The
sudden death in this case is characterized by the
rapid onset of shortness of breath, choking on Post-mortem Findings in Death Due to
mealtime or vomiting and the presence of food Alcoholism:
particles on the respiratory system on post- Gross post-mortem findings are not
mortem examination. characteristic. Most often the pathological findings
were associated with or have developed a
4. Poisoning by congener or Contaminants in complication of alcoholism that had been observed.
alcoholic beverages: However, the following are some of the most common
Alcoholic beverages may accidentally findings:
contain toxic substances which may cause injury
or death in this drinker. There is a wide variety of 1. Presence of “alcoholic odor” of the stomach
impurities that may be found but the following contents. The odor emitted is not due to alcohol
contaminants in bootleg liquors are quite but most often to that of the congener.
common: 2. Congestion of the mucosa of the stomach.
a. Methyl alcohol (CH3OH, Methanol, 3. Congestion of brain and its meninges.
Wood alcohol) – the mechanism of 4. Heart may be dilated and flabby and lungs
methanol poisoning is its conversion to congested and frothy, otherwise normal.
formaldehyde and formic acid which 5. Blood, alveolar air and urine examinations
consequently causes acidosis. In the reveal the presence of alcohol.
eye, it may cause blindness. Symptoms
start as photophobia, followed by
CHEMICAL TEST FOR INTOXICATION
blurred vision to permanent blindness.
ADMISSIBLE IN EVIDENCE
Due to the action of the poison on the
Any chemical test for alcohol to determine
ganglionic cell of the retina.
whether a person is under the influence of alcohol is
b. Isopropyl alcohol (Rubbing Alcohol) admissible as evidence in court. The tendency of our
– the compound is converted in the modern court is to accept scientific methods in crime
body to acetone and excreted as such. detection provided that it has gone beyond the
Acetone is excreted through the lungs experimental stage and has already been perfected.
and produces hemorrhagic
tracheobronchitis, bronchopneumonia The defendant was charged with the offense of
and hemorrhagic pulmonary edema. It driving his automobile when drunk and was found
also causes lower nephron nephrosis, guilty by a jury in the trial court. He appealed to the
hemoglobinuria, fatty changes in the criminal court of appeals of Oklahoma.
liver, respiratory paralysis and death.
c. Ethylene glycol and/or diethylene The defendant contented that the drunkometer and
glycol – either or both are present in urine analysis tests for the determination whether the
industrial antifreeze mixture but may defendant was under the influence of intoxicating of
become contaminant to the alcoholic liquor have not gained such scientific standing for
beverages. infallibility as to justify admission of the expert
Ethylene glycol is marked central testimony on it. HELD: The court is of the opinion that
nervous system depressant and is we should favor the adoption of scientific methods for
oxidized in the body to toxic oxalic acid. crime detection, where the demonstrated accuracy
Oxalic acid crystals plug the excretory and reliability has become established and
tubules of the kidneys causing marked recognized. Justice is truth in action, and any
functional impairment and nephrosis. In instrumentality that aid justice in the ascertainment of
the brain it may cause chemical truth should be embraced without delay. We believed
meningitis and meningo-encephalitis. that chemical tests of such body fluids as blood,
Diethylene glycol is also a central urine, breath, spinal fluid gained that scientific
nervous depressant and causes recognition for infallibility as to be admissible in
centrolobualr hydropic degeneration and evidence.
necrosis of the liver as well as bilateral
cortical necrosis.
5. Diseases associated with/or as a METHODS USED IN ALCOHOL DETECTION
Complication of alcoholism:
The most frequent effect of continuous At present there are many kinds of apparatus
consumption of alcohol is that the development perfected and laboratory procedures adopted in
of fatty liver may ultimately become a condtion of alcohol detection, but these different methods are
cirrhosis. A cirrhosis liver may cause rupture of actually based on any of the following principals:
the esophageal varices.
1. Chemical Method – The simple is distilled and
Alcoholism may also cause hemorrhagic
later allowed to react with a known quantity of
pancreatitis, bronchopneumonia and
oxides, usually chromate, and it determines the
development of other infectious disease.
amount of chromate which has not reacted to
 alcohol. By computation the amount of alcohol in c. Half-way houses are built to bridge the gap
the sample can be determined. between the penal institution and the
This is the principle involved in the use community.
of breath alcohol determination with the use of
Alco-tester (500). Breath analyzer (900A, 1000)
and Alcometer (AE-D1).
MEDICO-LEGAL ASPECT OF POISONING
2. Enzymatic Method – A known quantity of
purified alcohol dehydrogenase and its DEFINITION OF POISON
coenzyme nicotamide adenine nucleotide (NAD)
is allowed to react to the sample. Alcohol is A poison is anything other than physical agencies which is
oxidized to aldehyde the coenzyme nicotamide capable of destroying life, either by chemical action on the
adenine dinucleotide (NAD), and this can be tissues of the living body, or by physiological action by
measured colorimetrically or absorption into the living system
spectophotommetrically.
Legally, a poison is a substance which, if applied or
The dipstick method or quick administered internally, has been applied or administered with
quantification of ethanol in the body fluid is based the intention to kill or to do harm.
on this principle:
The intent in the administration is the essential element in law.
“A quarter-inch cellulose pad at one end The quantity does not affect culpability, nor is the law
of the strip is impregnated with a buffered concerned with the quantity in which the substance acts.
solution containing yeast alcohol dehydrogenase
(From: A Synopsis of forensic Medicine & Toxicology by E. W.
(ADH), nicotamide – adenine dinuleotide,
Caryl Thomas, 2nd ed., p. 142). In cases of suspected
pyrazole iodonitrotetrazolium chloride (INT) and
poisoning, it is not advisable to confine the toxicological
deaphorase. When the strip is dipped into saliva,
analysis to the stomach and its contents because:
urine or serum that contains ethanol, it turn
various shades of pink instantly because of a 1. The gastrointestinal tract is only one of the means of
reaction between, on the one hand, the NADH entry of poison into the body. It is possible for
that is produced and, on the other, diaphorase poisonous substances to gain entry by inhalation, by
and INT, on the other. The amount of ethanol absorption through the skin, by intravenous,
present can be quantitated by comparison with a intramuscular and subcutaneous injection, or by
color chart. introduction into the vagina or rectum. Analysis of the
By this method, ethanol concentrations gastric content would not eliminate poisoning as a
in body fluids can be measured in only 60 factor when poison gains entrance into the body via
seconds, a considerable savings in the time over other route.
methods that require the delivery of a sample to 2. Even if the poison was taken orally, after a significant
a laboratory plus testing time. In an emergency period of time (4 to 6 hours) has elapsed from
situation in which the patient cannot be tested by ingestion to death, the poison might have passed out
breath analysis, this is an obvious advantage of the stomach and could no longer be present in
(JAMA, Vol. 250, No. 13, Oct. 7, 1983). identifiable amount.
3. Gas Chromatographic Method – the specimen 3. If analysis of the gastric contents disclosed presence
may be first purified or injected directly to the of possible toxic substance, it is possible that the said
apparatus. poison could have been introduced post-mortem to
4. Infrared Absorption Method – alcohol is conceal the real cause of death.
present as a vapor in breath. It absorbs specific 4. Except in case of poisoning by strong corrosive
wave lengths of infrared. An intoxilyzer measures agents, there must be a demonstration of absorption
alcohol by detecting the decrease in the intensity of the poisonous agent. This can be shown by the
of infrared energy as it passes through the cell. presence of the toxic materials in other organs or
parts of the body.
SOCIETAL REACTION TO THE PROBLEM OF
ALCOHOL SITE OF ACTION OF POISON
1. Promulgation of laws and regulations:
a. Manufacturing of liquor only to a certain 1. Local action:
percentage of alcohol in beverages. The poison may act on the skin or on the
mucous membrane or on any part of the body where
b. Restricting the time and place of drinking
it is applied. Example: Sulfuric acid.
and the availability of liquor to a particular
age, sex and other socio-economic group. 2. Remote action:
c. Subjecting drivers at random at an alcohol The poison may act
remotely in any of the
screening test, and if found positive, it is to
following ways: a. By
be followed by a quantitative determination
the production of shock.
of blaood alcohol. If blood alcohol exceeds
the maximum tolerable limit prescribed, the Example: poisoning by strong acid.
driver can be arrested. b. By absorption into the blood and being
2. Various indoctrination methods may be employed carried to the organs they affect.
to encourage moderation or abstinence, like Example: Morphine is absorbed by the
education in school and churches. blood and carried to the brain and
depresses it.
3. An institutional-organization approach, introduces
substitute from of tension relief the social c. By transmission through the nerves of
structure. Subsequent removal of the cause of local parts affected going to the nerve
tension and diverting attention to something else centers and then reflected to the organs
can also be looked into. on which they act.
Site of Remote Actions of the Different
4. A variety of therapeutic approaches are taken Poison are:
under the concept that an alcoholic is a patient:
a. On the Brain: Narcotics,
a. Therapy combines medicine with psychiatry, alcohols, cerebral
psychology, social case work and alcoholic
stimulants like caffeine.
anonymous.
b. On the Cord: Strychnine.
b. Pastoral counseling are given in churches.
c. On the Peripheral Nerves:
Conium, curate.
 d. On the Alimentary Tract: Collapse Corrosive, Arsenic, Antim
Corrosives. Aconite, Tobacco, Antipyrine
e. On the Kidneys:
Cantharides. Delirium Belladonna, Hyoscyamus, Cann
f. On the Salivary Glands: Alcohol, Camphor.
Mercury.
g. On the liver: Phosphorus.
Paralysis Conium, aconite, Gelsem
h. On the Mucous
Eserine, Arsenic, Lead.
Membrane: Arsenic.
i. On the heart: Digitalis.
j. On the Blood Vessels: Convulsion Nux vomica, Ars
Ergots, nitrites. Antimony.
k. On the Blood Cells: Snake
venom. Cyanosis Analine, Antifibrin

3. Both Local and Remote: Enlarge pupil Atropine, Hyoscyamus, Aco

The poison may act at the site of application Alcohol, Conium, Chloroform.
and in some distant place.
Example: carbolic acid is an irritant to the alimentary tract and
also toxic when absorbed.
Dry skin Belladonna, Hyoscyamus.
SIGNS AND SYMPTOMS THAT MAY LEAD ONE TO
SUSPECT POISONONG:
1. The complaints and symptoms appear suddenly like MEDICO-LEGAL ASPECT OF POISONING
an acute abdomen, apoplexy, heart failure or cholera. Moist skin Opium, Aconite, Antimony, Toba
2. The symptoms appear when the individual is at the Alcohol.
state of health.
3. The symptoms usually appear after a meal or after Vomiting Corrosive and irritants
taking some food or medicine. The onset of the
symptoms is influenced by the modifying factors
mentioned, but it appears within an hour in most
cases. Purgation Irritants, Digitalis, Colchicum.
4. When several persons partake the food or drug at the
same time, the approximate occurrence of the
symptoms is at the time.
Colic Lead, Copper, Arsenic.
5. The course of the symptoms may either be getting
severe or having steady improvement.
Cramp Lead, Arsenic, Antimony.
6. The detection of the poison can be done on any of the
following:
a. Food taken c.
vomitus (From: A Synopsis of Forensic Medicine & Toxicology by E. W.
Caryl Thomas, 2nd ed., p. 147).
b. Container d. excretion
Failure to detect poison does not show that the substance TREAMENT OF PATIENT SUFFERING FROM ACUTE
is absent because: POISONING:
a. The poison might have already been eliminated. 1. Evacuation of the stomach: This may be done by:
b. The material examined may not contain the a. Stomach Tube:
poison. A long rubber tube is introduced to the
c. The procedure applied is not delicate enough to mouth and allowed to reach the stomach.
detect small quantity of the drug. Fluid must first be introduced into the
d. The poison might have already been transformed stomach to prevent the tube to come in
to another state in the body before detection. close contact with its wall. Fluid is withdrawn
In order to confirm suspicion that it is a case of poisoning, and introduced until traces of the poison are
the following must be done: removed. The procedure is contra-indicated
in poisoning by corrosives on account of the
1. Obtain information from: danger of tear or laceration of the stomach
a. The victim himself. wall.
b. Member or members of the family.
c. Police or other peace officers. b. Administration of Emetics:
2. Obtain sample of the vomitus, urine and other (1) Zinc Sulfate – 30 grs.
bodily discharges for analysis. (2) Ipecacuanha – 20-30 grs. in two six drachms
3. Obtain the patient as to other development of the of wine.
symptoms and progress of the condition. (3) Mustard and Water – one tablespoon in one
4. Request a fellow physician to assist and observe tumbler of water.
the patient if necessary. (4) Salt and Water.
(5) Apomorphine – 1/10gr. hypodermically.
DIFFERENTIAL DIAGNOSIS OF POISONING 2. Neutralization of the Poison that Remains in the
Signs Poison Stomach:
a. Neutralization by Direct Chemical Reaction:
Coma Opium, Chloral, Alcohol Examples: (1) Acids neutralize alkalies.
(2) Alkalies neutralize acids.

b. Neutralization by Physiochemical Reaction:

 Example: (1) Silver nitrate is precipitated by (4) If the symptoms which appeared do not
common salt. resemble the typical symptoms of poisoning
(2) Iodine reacts with starch. by the alleged poison, what explanation can
he give?
c. Physical Reaction: (5) Was the dose taken by the victim necessarily
This is the formation of a non-soluble fatal?
compound thereby preventing absorption. In order that the physician may be able to answer the
Examples: (1) tannic acid precipitates Strychnine. above questions, he must know and report on the
following points:
(2) Egg albumen precipitates mercuric
chloride. 1. History and Symptoms During Life:
When the exact nature of the poison is a. History of any previous suicidal attempts.
unknown, a mixture composing of the following
substances may be used: b. History of his mental condition.
1. Powdered c. History of business, marital and social failures.
charcoal. . . . . . . . . . . . 2 parts d. Presence of persons having grudge against him.
2. Magnesia. . . . . . . . . . . . . . . . . e. Possible source of the poison.
. 1 part f. Time of actual administration of the poison.
3. Tannic acid. . . . . . . . . . . . . . . . g. Nature and actual time of occurrence of the
. 1 part symptoms.
The following formula is advanced by murrel h. Order of occurrence of the symptoms.
to be used in cases of poisoning of any kind,
although it may be incomplete:
i. If the victim died, note the exact time of death and
the period of time from ingestion to death.
(1) Saturated solution of sulphate of iron. . . . .
. . . . . . . 100 parts
j. Inquire about the presence of vomitus, urine, and
other bodily discharges for analysis.
(2) Calcined magnesia. . . . . . . . . . . . . .
. . . . . . . . . 88 parts
k. Date, time and place where the victim was last
seen alive.
(3) Animal
Charcoal. . . . . . . . . . . . . . . . . . . .
2. Post-mortem Examination:
. . . . . 40 parts a. External Post-mortem Examination:
(4) Water. . . . . . . . . . . . . . . . . . . . (1) Note the attitude if the body and dress,
. . . . . . . . . 100 parts especially for stains.
The above formula is indicated in case of (2) External signs of physical violence.
arsenic, zinc salts, digitalis, and acids of ordinary (3) The expression of the face. Some poison, with
types, mercury salts, morphine and strychnine convulsion as the symptom, may be inferred
poisoning; but this is of no use for alkalies, from the expression of the face.
phosphorus, tin salts, or hydrocyanic acid poisonings.
(4) Approximation of the time of death.
3. Application of physiological Antidotes: b. Internal Post-mortem Examination:
a. Strychnine may be used to stimulate respiration. (1) The bodily opening must be noted for any
b. Depression of the heart by aconite may be peculiar smell characteristic of some poison.
counter-acted by digitalis. Examples: carbolic acid,
c. Blood vessels may be constricted by ergot, hydrocyanic acid, phosphorus,
suprarenal extracts, digitalis and dilate me amly chloroform, etc.
nitrate and sodium nitrite. (2) The tongue, mouth and esophagus must be
d. Morphine, bromides or barbiturates may be given examined for inflammation, erosions and
for poisoning by stimulants. staining.
4. Keep the patient alive ne general measures, while (3) The larynx, trachea and bronchi must be
his organs of elimination are getting rid of the opened to see the effect of volatile irritants.
poison. Treat any urgent and dangerous (4) Examination of the stomach:
symptom:
(a) The color of the stomach wall may
5. Eliminating the poison: sometimes indicate poisoning by
The elimination of the poison is aided but certain drugs.
purgatives, sudorifics, and diuretics. Examples:
Sweating may be encouraged by hot bath,
◼ Mercury usually produces
warm packing, and injection with
a slate-color stain.
apomorphine.
◼ Arsenic may produce
MEDICAL EVIDENCE IN CASE OF POISONING white particles adherent to
In the trial of a case of poisoning, the defense counsel will possible yellow sulfides.
prove: ◼ Strong sulfuric acid and
concentrated oxalic acid
1. That the death of the victim was not due to
may produce blackened of
poisoning but to some natural cause.
charred wall.
2. That the victim did not suffer from poisoning of ◼ Hydrochloric and carbolic
the particular poison mentioned in the complaint
acids produce white wall.
or information.
However, the color
3. That there was no intent on the part of the changes may be due to
defendant to poison the victim. food, bile or post-mortem
For the purpose of clarification and in the best interest of changes.
justice, the medical witness must answer the following (b) Ulceration:Strong corrosive may
questions:
produce ulceration of the wall. This must
(1) What is the actual cause of the death? be differentiated with simple ulcer and
(2) Why is death attributable to poisoning rather cancerous growth.
than to disease? (c) Actual perforation:This may be found
(3) What is the maximum fatal dose of the in poisoning by strong mineral acids,
poison alleged to have caused the death? especially sulfuric acid. It must also be
 differentiated from perforation brought a. Congestion of mucous membrane of the stomach and
about by disease of the wall. intestine.
(d) Softening: Usually found in poisoning b. Petechial hemorrhages of the visceral organs.
by strong alkaline irritants. It must be c. Cloudy swelling of the kidneys.
differentiated from post-mortem
digestion of the stomach wall. d. Congestion of the liver and spleen.
(5) Examination of the stomach contents: (a) e. Isolation of the specific organism.
Quanity.
(b) Nature of food. Bacteriology: The members of the salmonella group which
may cause food poisoning are:
(c) Color.
a. B. Enteritidis e. B. Suipestifer
(d) State of digestion.
b. B. Paratyphosus A f. B. Psittacosis
(e) Presence of matters not
commonly considered as food.
c. B. Paratyphosus B g. B. Abortus equi
(f) Odor. d. B. Aertryke
(g) Reaction. Botulism:This is a specific infection on which symptoms arises
(6) Examination of the duodenum and its contents from the ingestion of a very potent exotoxin of anerobic
(7) Condition of the rest of the small intestine. Clostridium botulinium. Poisoning is usually due to ingestion of
(8) Examination of the large intestine and its food stored and prepared in unsatisfactory conditions and
contents. eaten without cooking.
(9) Examination of other visceral organs.
(10) Examination of the bladder and the vagina,
in the case of a female, for poison that might POST-MORTEM FINDINGS IN SOME CHEMICAL
have been introduced into the body through POISONING
these channels.
A. Sulfuric Acid:
(11) Saving of organs for chemical analysis.
1. External Appearance:
FOOD POISONING a. Putrefaction is frequently delayed.
Food poisoning is a state of ill-health resulting from b. There are cutaneous stains in areas where the
food which has some abnormal or noxious content. corrosive liquid has been spilled. The stains
are frequently in the angles of the mouth and
Food May Cause Disease in the Following Ways: running in a linear fashion from the posterior
1. Lack or excess. part of the lips to the chin.
2. Unbalance proportion of proper constituents. c. The outer layers of the skin are destroyed and
the derma is parchmentized, while the deepest
3. Absence of certain constituents, including vitamins and layer is reddish-brown in color.
specific proteins.
d. The lips may be blackened.
4. Idiosyncracy. The most common reaction occurs in the
gastrointestinal tract in the form of nausea and e. The tongue and mucous membrane of the
vomiting. The sensitivity may be manifested in the form mouth may be softened, corrode and white in
of rashes. color.
5. Presence of abnormal constituents: 2. Internal Appearance:
a. Products of putrefactive bacteria. a. Internal finding are usually confined to the
changes due to the local action of sulfuric acid.
b. Specific bacteria.
b. Cardio-Vascular System:
c. Parasites.
(1) The aorta may be found with the outer
d. Molds. wall blackened and corroded.
e. Vegetable substances as argot in rye or (2) The blood in the vessels may be
solanin in potatoes.
coagulated and hardened. This produces
f. Chemicals. black arborescent cast in the smaller
6. Food inherently poisonous as fungi, horse raddish, vessels and in their branches and larger
water hemlock. cylindrical casts in the vessels of greater
caliber.
Bacteria Food Poisoning: c. Respiratory System:
1. Food Poisoning of non-specific Bacteria Origin: (1) The epiglottis may be blackened and
This is sometimes called ptomaine shrunkened.
poisoning and is probably caused by the (2) The mucous membrane of the larynx and
degradation products of the proteins trachea may be swollen and congested.
molecules occurring in the
decomposition of food when they have
(3) Death may be due to asphyxia when acid
has been inspired.
reached an advanced stage.
2. Specific Bacteria Food Poisoning: (4) The diaphragm may be perforated after
the escape of the acid into the peritoneal
This is brought about by infection
cavity.
with the salmonella group of
microorganism. (5) The surface of the lungs and pleura is
Symptoms: then tough, leathery and stained brown.
d. Digestive System:
a. Vomiting and diarrhea.
(1) Mucous membrane of the pharynx is gray
b. Abdominal pain. and may be softened. Patches of
c. Prostration. brownish color are scattered in the
d. Collapse with cold sweating. pharynx due to the effusion of dark-
e. Rigor with pain at the back and limbs. colored blood.
f. Headaches and dizziness. (2) The stomach, if not perforated, shows an
injected surface and the contents are
coffee-ground color.
Post-mortem Examination:
 (3) The mucous membrane of the stomach is 1. ABRASION - An injury characterized by the removal of
brown or black with some thin or the superficial of the skin or epileptically layer of the skin.
perforated areas. If perforated, the edges It is caused by scraping off of superficial skin due to
of the perforated are black and irregular. friction against a rough surface.
(4) The intestine has a dark-brown content. 2. ACCIDENTAL DEATH- Death resulting from an
The pylorus may be hardened and accident/misadventure from an unusual event that was
constricted. Mucous membrane of the unanticipated by everyone involved. A death may be
duodenum is usually congested and considered” even if it was intentional or expected.
swollen. 3. ACTIVE EUTHANASIA- The active acceleration of a
"good" death by use of drugs etc.; whether by oneself or
B. Hydrochloric Acid: with the aid of a doctor.
1. External Appearance: 4. ADIPOCERE- A grayish-white colored substance that
a. External staining is absent. forms under conditions of high humidity and high
b. The angle of the mouth may be whitish, environmental heat on a dead body. It is a peculiar waxy
opaque and may be inflamed. substance consisting of salts and fatty acids and formed
from the decomposition of corpse tissues, especially in
2. Internal Appearance: moist habitats, also called grave-wax.
a. Blood is darkened but as a rule 5. ALGOR MORTIS - After death, the metabolic process
coagulated by the action of acids. inside the body decreases.
b. Edema of the glottis. 6. ANILINGUS - Sexual perversion wherein a person
c. Larynx and trachea are congested and derives sexual excitement by licking the anus of another.
the mucous membrane is converted into 7. ANOXIC DEATH – Associated with the failure of the
whitish-gray opaque layer which can be arterial blood to become normally saturated with oxygen.
rubbed off.
8. ANTIBODY – A protein produced for body defense in
d. There may be congested and edema of response to an antigen. An antibody is a substance that
the lungs. appears in the plasma or body fluids as a result of
e. Mucous membrane of the mouth and stimulation by an antigen and will react specifically with
pharynx is opaque and grayish-white. that antigen in some observable way.
f. Esophagus is dilated with the mucous 9. ANTIDOTE - Any agent which neutralizes poison or
membrane reddened and inflamed. otherwise counter act poison.
g. The liver is pale and fatty. C. Nitric 10. APPARENT DEATH - This condition is not really death
Acid: but merely a transient loss of consciousness or
The lesions produced by nitric acid are temporary cessation of the vital functions of the body on
similar to hydrochloric acid except that the account of disease, external stimulus or other forms of
cutaneous stains are distinctly yellow. stimulus.
11. ASPHYXIA - Death due to lack of oxygen due to sudden
MEDICO -LEGAL ASPECT OF BIRTH cessation of oxygen intake. Asphyxia may lead to
A. legal importance of the study of birth. unconsciousness, seizures, damage to various sensory
1. Birth determines personality systems and death.
2. Appearance of a child is a ground for the 12. ASSOCIATIVE EVIDENCE- Is evidence that links two
revocation of donation. separate entities, whether they are people or objects. In
other words, associative evidence relates to the evidence
3. Proof of life-birth must first be shown before
that links a person (or object) to the scene of the crime.
death of the child by the prosecution in the case
of infanticide 13. AUTOPSY- Is the examination of a body after death,
which may also be referred to as a postmortem.
MEDICO-LEGAL ASPECT OF INFANTICIDE 14. AUTOPTIC OR REAL EVIDENCE – This is evidence
Infanticide is the killing of a child less than three (3) days old. made known or addressed to the senses of the court. It is
not limited to that which is known through the sense of
1. How the crime is committed: vision but is extended to what the sense of hearing,
taste, smell, and touch is perceived.
a. By omission or neglect
15. BIOMETRICS - The identifications of individuals based
1. Failure to ligate the umbilical cord on their finger, hand, voice, retina and vein prints.
2. Failure to protect the child from heat and cold 16. BLOAT - The transient phase in corpse decomposition
3. Omission to take the necessary help of a midwife that follows the fresh phase and is characterized by
or skilled physician. excessive swelling, produced by gases trapped
4. Omission to supply the child with proper food internally.
5. Omission to remove the child from the mother’s 17. BOTULISM – This is a specific infection on which
discharge with resulted to suffocation. symptoms arises from the ingestion of a very potent
exotoxin of anerobic Clostridium botulinium. Poisoning is
b. By Commission usually due to ingestion of food stored and prepared in
unsatisfactory conditions and eaten without cooking.
1. By inflicting physician injuries
18. BRAIN DEATH- Death occurs when there is irreversible
2. By suffocation coma absence of electrical brain activity and complete
3. By strangulation By drowning cessation of all the vital functions without the possibility
4. By poisoning of resuscitation.
5. By burning 19. CADAVERIC SPASM - Is the instantaneous rigidity of
6. By deliberate exposure to heat and cold muscles which occurs at the moment of death due to
extreme nervous tension.
c. Other allied cause 20. CARDIO RESPIRATORY DEATH- Death occurs when
there is a continuous and persistent cessation of heat
1. Abandoning a minor action and respiration.
2. Abandoning a minor by person entrusted with 21. CARNAL KNOWLEDGE– Is the act of a man in having
custody, indifference of parents. sexual bodily connection with a woman. There is carnal
knowledge if there is the slightest penetration in the
DEFINITION OF TERMS sexual organ of the female by the sexual organ of the
male.
22. CELLULAR DEATH - About three to six hours of death, 47. DEFENSE WOUNDS - Wounds which is the result of a
there is death of individual cells. person instinctive reaction of selfprotection usually found
23. CEREBELLAR GAIT – A gait associated with staggering in upper extremities.
movement. 48. DEFLORATION - The laceration or raptures of the
24. CEREBRAL CONCUSSION - Is the stunning of the brain hymen as a result of sexual intercourse.
characterized by more or less complete suspension of as 49. DEHYDRATION - The lessening of body fluids from the
a result of injury to the head which leads to some raw surface id the born area secondary exploration
convection of cerebral substances. 50. DELIRIUM - Extreme mental excitement marked by
25. CHOKING– There is blocking of the internal airway by a defective perception, impaired memory, and rapid
foreign object inside or outside of the victim’s body. succession of confused and unconnected ideas, often
26. CIRCUMSTANTIAL EVIDENCE - Evidence from which a with illusions and hallucinations.
logical and reasonable inference of another fact may be 51. DELUSION - Firm belief opposed to reality but
drawn. The proof of fact or facts from which, taken either maintained in spite of strong evidence to the contrary.
singly or collectively, the existence of a particular fact in 52. DEMENTIA - A form of insanity resulting from generation
dispute maybe inferred as a necessary or probable or disorder of the brain characterized by general disorder
consequence. o mental weakness, loss of coherence and total mobility
27. CIRRHOSIS- A chronic disease of the liver marked by reason but not accompanied by delusion or
degeneration of cells, inflammation, and fibrous uncontrollable impulse.
thickening of the tissue, can be caused by long term 53. DEMI-VIRGINITY - Refers to a woman who permits men
alcoholism, viral infections, and metabolic disease. on any form of sexual relation as long as they abstained
28. CLITORIS- Erectile tissue in female analogous to male from rupturing the hymen.
penis located above the urethra and covered by the 54. DEOXYRIBONUCLEIC ACID (DNA) - The genetic
clitoral hood. material of organisms. It is composed of two
29. CLINICAL DEATH OR SOMATIC DEATH– Is a type of complementary chains of nucleotides in the form of a
death usually declare by members of the immediate double helix.
family of the diseased or by the physician 55. DIAPHANOUS TEST - The fingers are spread wide and
30. CLOSED WOUND- No break in the continuity of the skin the finger webs are viewed through a strong light.
or mucus membrane. There is no breach in the continuity 56. DIPSOMANIA- An irresistible desire for alcoholic drinks
of the skin or mucus membrane. at periodic intervals.
31. CLOT– A thick mass of coagulated liquid, ex. blood. A 57. ECCHYMOSIS- Is the medical term for a subcutaneous
blood clot is formed by a complex mechanism involving purpura larger than 1 centimeter or a hematoma,
plasma protein, fibrinogens, platelets, and other clotting commonly called a bruise.
factors. 58. ELECTROPHORESIS - A technique in which molecules
32. COMA- State of profound unconsciousness from which are separated by their rate of movement in an electric
the patient cannot be aroused. field; in the case of DNA the fragments are separated
33. CONICAL BREAST– The breast has a shape similar to a according to size.
cone. The outline consists of two converging lines which 59. EUTHANASIA - (mercy killing) it means producing
meet at the region of the nipple. painless death of a person suffering from hopelessly
34. CONTACT WOUND– A wound that results when a small incurable and painful disease.
weapon is fired in contact with the skin. May divided into 60. EVIDENCE - Is the means sanctioned by the rules of
tight or loose contact wounds based on the amount of court, of ascertaining in a judicial proceeding the truth
pressure used against the skin. respecting a matter of fact. Specifies of proof or probative
35. CONTRE-COUP-INJURY- Physical injury found at the matter legally presented at the trial of an issue by the act
opposite site of the application of force. of the person.
36. CONVULSION– Is medical conditions where the body 61. EXCLUSION - If two or more persons have to be
muscle contract and relax rapidly and repeatedly, identified and all but one is not yet identified then the one
resulting in an uncontrolled shaking of the body. whose identity has not been established may be known
37. CORPSE- Is relevant for medicine in general and most by the process of elimination.
particularly so for forensic medicine, as it has direct 62. EXHUMATION – It is the raising or disinterring of the
consequences on practical work: legally, postmortems dead body or remains from the grave.
and autopsies may only be performed on corpses. 63. EXPLOSION– Is the sudden release of potential energy
38. CORPUS DELICTI EVIDENCE - Objects or substances producing a localized increased in pressure.
which may be part of the body of the crime. 64. FALSE PHYSICAL VIRGINITY - A condition wherein the
39. COUP-CONTRE-COUP-INJURY - Physical injury which hymen is ruptured but the orifice is elastic and permitting
is located at the site of the application of force. two or more fingers of examiner with a degree of
40. COW’S GAIT - A swaying movement due to knock-knee. resistance.
41. CREMATION – Is the burning of the dead body into 65. FELLATIO- The female agent receives the pennies
ashes or pulverization of the body into ashes by the necessary for sexual gratification.
application of heat or flames. Requirement: permit for 66. FETISHISM- A form of sexual perversion the real or
cremation, exact identification of the deceased and exact fantasized presence of an object. Sexual satisfaction by
cause of death has been ascertained. contact with articles of opposite sex.
42. CRIMINALISTICS - Is the application of sciences in 67. FILIATIONS – Is the civil status of the child in relation to
crime detection and investigation. its mothers or fathers.
43. CRUSH OR TRAUMATIC ASPHYXIA – Brought about 68. FORENSIC ANTHROPOLOGY- The identification of
by the mechanical compression of the chest by some human remains in medico legal cases.
heavy object 69. FORENSIC ARCHAEOLOGY- Technique used in the
44. CUNNILINGUS- Sexual gratification is attaining by excavation of human skeletal remains.
sucking the external female genital. 70. FORENSIC ENTOMOLOGY- The study of insects
45. CYANOSIS - Bluish discoloration on the face and or (arthropods) occurring on and around dead bodies.
fingernails due to insufficient oxygen of the blood caused 71. FORENSIC MEDICINE - Branch of medicine that deals
by increase in carbon dioxide in the body. with legalimplications of healthcare, and determines and
46. DEATH - Total termination of life. The loss of life interprets causes of disease, injury, or death.
characterized by clinically by combined failure of
respiratory, cardiovascular, and nervous system activity.
72. FORENSIC ODONTOLOGY- The study of human teeth in the consideration of legal live-birth which shows
in medico legal cases. The identification of human evidence of maceration
remains by using the teeth. 97. MAGGOT- The larva of a higher fly. It sheds its skin
73. FORENSIC PATHOLOGIST- Is a medical detective who twice and has three growth instars prior to pupariation. A
investigates deaths that may be sudden, unexpected, legless larva without a well-developed head capsule.
unexplained, or violent. 98. MANNER OF DEATH - A typology of deaths according to
74. FROG GAIT – A hoping gait in infantile paralysis. whether they are due to homicide, suicide, accident, or
natural causes. Death occurs in one of four manners:
75. FROTTEURISM - Contact with other persons to obtain
natural, if caused solely by disease; accidental, if it
sexual gratification.
occurs without apparent intent; suicidal, if caused by the
76. GAIT LINE– The straight line connecting the center of deceased; and homicidal, if someone other than the
the succeeding steps. It is more or less in zigzag fashion deceased caused it.
especially when the legs are far apart while walking.
99. MASOCHISM - Opposite of sadism, derived from the
77. GRAZE– Usually caused by forcible contact with rough, name of Leopold Von Sacher-Masoch, an Austrian
hard objects resulting to irregular removal of the skin novelist, being whipped by his wife used to be a stimulant
surface. for his literary work.
78. HEMISPHERICAL BREAST – The breast is like 100. NATURAL DEATH - Death cause by natural disease
hemisphere. The contour lines are not straight but form condition in the body.
part or half circle or half of a sphere.
101. NECROPHILIA - Actual sexual intercourse with a dead
79. HEREDITY - The transmission of genetic characteristics person.
from parent to offspring.
102. PATERNITY– Is the civil status of the father with respect
80. HISTOTOXIC ANOXIC DEATH– Due to the failure of the to the child be gotten by him.
cellular oxidative process, although the oxygen is
delivered to the tissues, it cannot be utilized properly.
103. PENDULOUS BREAST – The skin of the breast is loose
making of capable of swinging in any direction.
81. HOMOSEXUALITY- Means persistent emotional and
physical attraction to members of same sex.
104. PENETRATING - One in which the wounding part on an
object enters the body but did not come out or mere
82. HYPOSTATIC LIVIDITY - A blood merely gravitates into piercing of a solid organ or tissue of the body.
most dependent portion of the body but still inside the
blood vessels and still fluid.
105. PERFORATING - When the wounding agent produces
communication between the inner and outer portion of
83. HYPOTHERMIA- This situation occurs when the core the hollow organs.
temperature of one's body falls below normal. It is the
failure of the body to maintain adequate production of
106. PETECHIAE – Are minute, pin point, circumscribed
extravasation of blood in the subcutaneous tissues or
heat under conditions of extreme cold. In short, it is
underneath the mucous membrane.
having a body temperature below normal.
84. IMMEDIATE (PRIMARY) CAUSE OF DEATH - This
107. PHOBIA - it is an excessive or irrational fear of a
particular object or situation.
applies to cases when trauma or disease kills quickly that
there is no opportunity for squealed or complications to 108. PHYSICAL VIRGINITY - A condition whereby or the
develop. woman is conscious of the nature of sexual life but not
yet experience sexual intercourse. Physically transmitted
85. IMPACT OR IMPRINT ABRASION(patterned abrasion,
from one generation to the next; the organelle that
stamping abrasion, abrasion a la signature) – Those
carries the genes.
pattern and location provides objective evidence to show
cause, nature of the wounding instrument and the 109. POST-MORTEM EXAMINATION - An external
manner of assault or death. examination of a dead body with internal examination.
86. IMPOTENCY– Is the physical incapacity of either sex to 110. PROXIMATE (SECONDARY) CAUSE OF DEATH - The
allow or grant to the other legitimate sexual satisfaction. injury or disease was survived for a sufficiently prolonged
interval which permitted the development of serious
87. INCISED WOUND- This was produced when sharp edge
squealed which actually caused the death.
of instrument like knife, scissor or oyster shell etc. It is
also an Injury produced by a sharp instrument and 111. PUNCTURED WOUND- Is the result of sharp pointed
characterized by lack of surface abrasion and absence of instrument; the external injury is quite small.
bridging vessels, nerves, and smooth margins. 112. PUTREFACTION - Is the breaking down of the complex
88. INJURY – Is the scientific impairment of the body proteins into simpler components associated with the
structure or function caused by outside force or agent. evolution of low small gasses. The foul-smelling,
anaerobic decomposition of moist or wet organic matter
89. LABIA MAJORA - Are firm, elastic and well rounded.
by microorganisms. The breakdown of tissues,
These lies in close contact with each other so as not to
particularly proteins, due to enzyme action
cover completely the labia minora and clitoris.
90. LABIA MINORA - Are soft, pinkish in close opposition
113. SMOTHERING OR SUFFOCATION – Occurs when
entrance of air through the nose and mouth is blocked or
with one another and the vestibules is narrow.
severely restricted.
91. LACERATED WOUND - Is the tear of the skin and the
underlying tissue due to rupture of the skin.
114. STAGE OF PRIMARY FLACCIDITY- The muscles are
relax and capable of responding to mechanical or
92. LAW – Defined as a rule of conduct, just and obligatory, electrical stimulus and the reaction become alkaline.
land down by legitimate authority for the common
observance and benefit.
115. STAGE OF SECONDARY FLACCIDITY - The muscles
become flaccid no longer capable of responding to
93. LEGAL MEDICINE - A branch of medicine which deals mechanical and reaction becomes alkaline.
with the application of medical knowledge to the purpose
of law and administration of justice.
116. STAGNANT ANOXIC DEATH– Brought about by the
failure of circulation.
94. LIFE– Is the sum total of all vital processes by which the
physical integrity of the body is maintained.
117. Sterility – Is the loss of power of procreation and is also
man or a woman may be sterile & yet impotent, impotent
95. LIVOR MORTIS - A coloration of the skin of the lower yet not sterile.
parts of a corpse caused by the settling of the red blood
cells as the blood ceases to circulate.
118. SUDDEN DEATH- Is the termination of life which comes
quickly under circumstances when its arrival is not
96. MACERATION – It is a condition of the dead body, expected.
usually the foetus, characterized by the softening and
discoloration of the tissues as well as formation of
119. TATTOOING - A characteristic pattern in the skin caused
by particles of unburned and partially burned powder
blisters in the skin due to the action of autolytic or
from a shotgun blast at very close range.Also may be
proteolytic enzymes in the absence of utero is important
called stippling.
120. TRUE PHYSICAL VIRGINITY - A condition where in the
hymen is intact with edges distinct and regular and with
the opening small barely admitting the tip of the smallest
finger of the examiner even if the thighs are separated.
121. UNNATURAL DEATH- Death due to injury of any sort
(gunshot, stab, fracture, traumatic shock, etc.)
122. VIRGINITY - Is a condition of a female who has not
experience sexual intercourse and whose genital organs
have not altered by carnal knowledge.
123. VOYEURISM- A form of sexual perversion characterized
by a compulsion to see or peep another person who
perform other personal activities, also called “peeping
tom”. 124. WADDLING GAIT – A gait resembling duck.
125. WOUND– Is a break or solution in the continuity of the
skin or tissues of the body.