CRIMINOLOGY BOARD REVIEW

( Legal Medicine )
LEGAL MEDICINE
(FORENSIC MEDICINE)

Legal medicine and forensic medicine are synonymous and commonly used
interchangeably;

A branch of medicine means which deals with the application of medical knowledge
to the purposes of law and justices;

Strictly, legal medicine means medicine applied to legal cases, while forensic
medicine refers to the use of medical science to elucidate or clarify legal problems;

Medical jurisprudence is that branch of law which deals with the organization and
regulation of the medical profession, with the contractual obligations existing
between practitioner and his patient, and with the duties imposed on the practitioner
by the state.

Purpose of the Study of Legal Medicine

To acquaint medical and law students and practitioners of the recent advances of the
forensic medicine and the medico-legal system and procedure adapted in different
countries;

Students of criminology and police sciences must be acquainted/informed with the

medical aspect of criminal investigation, their significance, interpretation and
probative value in court.

Reasons for the Insufficiently of Medico-Legal Investigation in the Philippines

Lack of sufficient training of our physicians in medico-legal work

Lack of adequate facilities e.g. remote areas without proper equipment and supplies

Untrained police investigators

- They dont know in what phase of the investigation they need the services of a
physician
- They do not appreciate the value of medical evidence in the solution of crimes;
- They often rely too much on testimonial evidence

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- They are not conscious yet of the value of scientific evidences.

Inadequacy of our system of transportation and communications

- Most medical evidences are destroyed by time because of the difficulty of
preservation.

Medical Evidence

This is the means, sanctioned by law, of ascertaining in a judicial proceeding that

truth respecting a matter of fact wherein scientific medical knowledge is necessary.

Forms of Medical Evidence

Real or Autopic Evidence evidence perceived by the senses

Testimonial Evidence testimony given orally in open court and under oath or
affirmation; ordinary and expert witness
Experimental Evidence e.g. demonstration of a lethal drug on an animal
Documentary Evidence any written evidence presented in court relevant to the case;
e.g. formal written reports such as medical exam, lab. exam, necropsy report, etc.,
written opinions, certificates, dying declaration.

Method of Preserving Evidence (medical evidence)

1.
2.
3.
4.

Photography and sound recording.

Sketching
Description descriptive narration of the evidence
Testimony of witness

Kinds of Evidence Necessary for Conviction

1. Direct Evidence proves the facts in dispute without the aid of any inference or
presumptions;
2. Circumstantial Evidence the proof of facts from which taken either singly or
collectively, the existence of a particular fact in dispute may be inferred as a
necessary or probable consequence.
Medico-legal Aspect of Identification
I.

Identification of person and remains

- When an unknown body is found, the following should be noted by the
investigator to facilitate identification
1. place where the body was found
2. time when found
3. cause of death
4. time when death occurred

5. approximate age
6. supposed profession
7. description of the body
The Law of Multiplicity of Evidence is true in the case of
identification. The greater the number of similarities or dissimilarities,
the greater is the probability for the conclusion to be correct.

Identification of Person

Points of Identification Applicable to the Living Only

a. Characteristics that may easily be changed:
Growth of hair, beard, mustache
Clothing
Frequent place or visit
Grade or profession
Body ornamentation
b. Characteristics that may NOT easily be changed:
Mental memory
Speech
Gait
Mannerisms
Hands and feet

Complexion
Changes in the eyes
Facie
Left or right handedness
Degree or nutrition

Points of Identification Applicable to both Living and Dead before Onset of

Decomposition
a. Occupational Marks e.g. masons have callosities at the base of the thumbs.
b. Race in the living, race may be presumed on:
Color of the skin
- Caucasians
- Fair
- Malayan
- Brown
- Negroes
- Black
Feature of the face
- Caucasians
- Flat nose with round face
- Malayan
- Almond eyes and prominent cheek bones
- Mongolian
- Thick spreading lips
- Negroes
- Prominent sharp nose
Shape of the skull

c.

d.
e.
f.
g.
h.
i.
j.
k.
l.
m.

- Red indians
- Flat head
- Malayan
- Round head
Stature a person ceases to grow after the age of 25.
- method of appropriating the height of a person
e.g. measure the distance between the tips of the middle fingers of both
hands with the arms extended laterally will equal the height.
Teeth most convenient of identifying a person is with the use of a dental diagram or
chart.
Tattoo marks
Deformities congenital or acquired, e.g. harelip, cleft pal.
Birthmarks- e.g. Mongolian blue sports, nevus sports
Injuries leaving permanent result- amputations, improper union of fractured bones
Moles
Scars- recent (2-3 weeks) vascular, red to pink color more than 6 months oldbloodies, while glistening surface, e. g. surgical scar, gunshot wound, burns
Tribal marks
Sexual organs circumcision, uterus and breast my indicate previous pregnancy
Blood group especially if unusual

Anthropometry (Bertillions System)

Basis of Bertillions method of Identification:
1. human skeleton does not change after 20 years
2. it is impossible for two human beings to have bones alike
3. measurement easily taken with the aid of simple instrument
Dactylography the art and study of recording and studying fingerprints as a means of
identification
Dactyloscopy the art of identification by comparison of fingerprints; it is the study and
utilization of fingerprints
Poroscopy the study of the pores found on the papillary or friction ridges of the skin for
the purpose of identification

Reasons Why Fingerprinting Is One 0F The Most Infallible Means of Personal

Identification
1. Fingerprints( papillary ridges are already found formed about 3. Months of the
intrauterine life and remain unchanged throughout life until the final stages of
decomposition after death.
2. The pattern formation formed by the papillary ridges contains peculiar characteristics
upon which a person can always be identified by fingerprint examiners.
3. Almost every police and law- enforcing agencies throughout the whole world accept,
adapt and utilize the fingerprint system as a means of absolute identification of a
person.

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4. The courts \and others authorized had, since the immemorial, taken cognizance of its
importance and reliability as a means of identification.
Handwriting

Graphology is the study of the handwriting especially as it is to indicate writers

personality, character, aptitude, etc.

II. Identification of the Skeleton

In the study or examination of bones, the following points can be determined

approximately:

1.
2.
3.
4.
5.
6.
7.
8.
9.

whether the remains is of human origin or not

whether the remains belong to a single person or not
height
sex
race
age
length of internment or length of time from date of death
presence or absence of ante- marten or post-mortem bone injuries
other points of identification as congenital deformities and acquired injuries
on the hard tissues causing permanent deformities

Human origin or not?

Size, shape and general nature of the remains especially of the head must be studied
Oval/ round shape of the skull and less prominence of the lower jaw and nasal bones
are suggestive of human remains
Presence of dental fixtures, rings on fingers, earnings, hair and other wearing apparels
are strong presumptions of human remains

Single Individual or not?

a complete layout of the bones on a table in their exact locations in the human body
is necessary any plurality or excess of the bones after the complete lay out denotes
that the remains belong to more than one person; but congenital abnormalities must
be considered. e.g. supernumerary toes and fingers)

Height- by measuring the longer bones of the body

e.g. Pearsons Formula S (stature) F (Femur) H (Huerus)
T (Tibia) R (Radius)

Sex- the following must be studied:

* pelvis
* skull

* femur
* humerus

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Determination of the Duration of Internment

Determined by the nature and presence of the soft tissues and the degree of erosions
of the bones
Ordinarily, all the soft tissues in a grave disappear within a year.
Others:
presence or absence of soft tissues still adherent to the bones
Firmness and weight, brittleness, dryness of the bones
Degree of erosion of the surface of the bones
By the changes in the clothing, coffin and painting

Presence or absence of anti-mortem or post mortem injuries

Presence of vital reaction principally signs of repair
MEDICO-LEGAL ASPECT OF SEXUAL CRIMES

Virginity- a condition of the female who has not experienced sexual intercourse and
who genital organs have not been altered by carnal connection.
Defloration- is the laceratin or rupture of the hymen as a result of sexual intercourse.
Carnal Knowledge- the act of a man in having sexual bodily connection with a
woman.
RAPE- elements of the crime
1. the offender had carnal knowledge of a woman
2. the carnal relation was made by the offender with the offended under any of
the following circumstances:
offender under any of the following circumstances :

use of force or intimidation

the woman is deprived of her reason or otherwise unconscious
the woman-victim is less than 12 years old

MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES

Physical injuries are the effects of the application of stimulus to the body. These injuries
can be caused by:
1. physical violence
2. heat or cold
3. electrical energy

4. Chemical energy
5. Radiation/ radioactive substance
6. Atmospheric pressure change

Physical Injuries rough About By Physical Violence

the effect of application of physical violence on a person is the production of

wound
wound is the solution of the natural continuity of any tissue of the living body:

vital reaction- the sum total of all reactions of tissues and organs for which
activities of living cells are necessary. It is the response of living tissue to an existing
stimulus; this differentiates ante- mortem from post- mortem bodily injuries
defense wounds- the results of a persons instinctive reaction of self-protection

Classification of WOUNDS
1. As to Severity:
a. Mortal wounds- death follows immediately after infliction or shortly
thereafter
wounds involving the heart and large blood vessels

wounds involving the brain and upper part of the spinal cord
wounds involving the lungs
wounds involving the stomach, liver spleen and intestine

b. non- mortal wounds- wounds which by themselves are not capable of

producing death immediately after infliction or shortly afterward.
2. As to the Kinds of instruments Used:
a. blunt instrument
b. sharp instrument- sharp- edged/ sharp/- pointed/ sharp edge- pointed
c. tearing force
d. change of atmospheric pressure
e. brought about by heat and cold
f. brought about by infection
3. As to the Manners of Infliction
a. hit- by means of a bolo, blunt, instrument, axe, etc.
b. thrust or stab- by dagger, knife, saber, bayonet
c. tearing or stretching
d. gunpowder explosion- projectile, shrapnel
e. sliding or rubbing
4. As Regards Age Depth of the Wound
a. superficial- involved only the layer of the skin
b. deep- involves the inner structures of the body:
b.1. penetrating- pieced a solid organ or tissue
b.2. perforating- communication between inner and outer portions of hollow
organ
5. As Regards the Relation of the Site of Application of Forces and Locations of Injury:
a. coup injury- injury found at the site of applied force
b. contre coup- injury found opposite the site of applied force
c. coup contre coup injury- injury found at the site of applied force and also at
the opposite side
d. locus minoris resistance- injury found in some areas with least resistance and
not at the site of or opposite the site of applied force

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e. extensive injury- involves a greater area beyond the site of applied force with
manifest extension from the location of the place where force was applied.
6. As to the Regions or Organs of the Body Involved:
a. head and neck
b. chest, etc.
7. Legal Classification
a. mutilation- the intentional act of lopping or cutting off any part or parts of the
living body: if without intent, classify as physical injury
b. serious physical injuries- shall be committed by wounding beating or
assaulting another so that if any one of the three acts is not present, there can
be no serious physical injury.
c. Administering injuries substance or beverages- no intent to kill.
d. Less serious physical injuries and maltreatment- incapacitated for labor or
require medical attendance for 10 days or more but no more than 30 days
e. Slight physical injuries and maltreatment- incapacitated for labor or require
medical attention from one to nine days

8. As to the Types of the Wound

a. close wounds- no breach in continuity of skin or mucous membrane
1. superficial- petechiae, conclusion or bruise, hematoma or blood cyst
2. deep- sprain, dislocation, simple fracture, rupture of organs, concussion,
internal hemorrhage
b. open wound- break in skin or mucous membrane
1. abrasion or scratch
2. incised wound
3. lacerated wound

4. Punctured wound
5. Wound by powder explosion
6. Mutilation
7. avulsion

Possible instruments Used by the Assailant in inflicting the Injuries

1.
2.
3.
4.
5.
6.

contusion- produced by blunt instruments

incised wound- produced by sharp-edged instrument inflicted by hitting
lacerated wound- produced by blunt instrument
punctured wound- produced by sharp- pointed instrument
abrasion- body surface is rubbed on a rough hard surface
gunshot wound- the diameter of the wound of entrance may approximate the caliber
of the wounding firearm

GUNSHOT WOUNDS

wound of ENTRY
-

usually small/ smaller than missile due to skin elasticity

edges are inverted with some degree of conclusion or abrasion of the
periphery; contusion collar/ abrasion collar/ contuso- abraded collar of
the wound which is due to the spinning movement and to the rough
surface of the bullet and invagination of the skin

Contact fire: bursting of wound of entrance, wound is burned because

it is within the flame zone with marked smudging of the skin and
singeing of the hair around, possible separation of the skin on account
of the blast, blasted tissue may appear cherry red due to carbon
monoxide, an abrasion or conclusion mark of the barrel may be
imprinted at the wound of entrance.

Near contact to six inches fire: severe tearing, bursting and blackening
of the wound, of entrance, gunpowder tattooing much more prominent,
surrounding area may be contused, shape may be stellate, cruciform or
with severe laceration and do not show any manifestation of the
gunshot wound, the diameter is very much larger than the diameter of
the missile.

Distance more than 6 inches up to twenty-four inches: as the distance

of the muzzle of the firearms increases the burning, powder tattooing
and smudging gradually diminishes until it disappears at a distance
beyond 24 inches, the wound gradually approximates the size of the
missile which entered.

wound of EXIT

no characteristics shape, may be circular, slit-like or lacerated

depending on the momentum of the missile when leaving the body

- edges of the wound everted, and occasionally, portions of inner tissue

are protruding
- aside form the bone, the skin offers the most resistance to the course of
the bullet is lodged just underneath the skin: it may be noticed by the
presence of a hard object on palpation; the bullet may lose its
momentum after piercing the skin and just fall without perforating the
clothing. Bones may be involved in the course of the trajectory of the
bullet and the bones spicules may create additional injury to the exit
wound

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The ODD AND EVEN RULE in Gunshot Wounds
-

if the number of gunshot wounds of entrance and exit found in the

body of the victim is even, the presumption is that no bullet is lodged
in the body, is old, the presumption is that no bullet is lodged in the
body, is odd, the presumption is that one or more bullets might have
been lodged in the body. This is a presumptive rule. It may be possible
that all of those wounds or a majority of them are entrance wound with
some bullets lodged yet the number may still be even.

Thermal Injuries or Deaths - from Colds

-

Primary cause of death is attributed to the decreased dissociation of

oxygen from hemoglobin in the red blood cells and diminished power
of the tissue to utilize oxygen.
Prolonged exposure may cause necrosis and gangrene
Cold damp air is more fatal than cold dry air
Children and aged individuals are more susceptible to cold weather on
account of their limited thermotaxic reserves

Thermal Injuries from heat

-

General or systemic heat cramps, exhaustion, stroke; deaths most

often accidental
Local effects scalding, thermal, burns, 1st to 6th degree
Gas furnace incinerator- it requires about four hours continuous
application to transform the body into ashes

Physical injuries by Lighting and Electricity

-

A flash of lighting may generate up to million volts and around 2000

amperes most of which is converted into heat
Death is usually immediate due to the effects on the central nervous
system
Generally accidental but eliminate the possibility or the felonious act
of another person

Death by Asphyxia
- Asphyxia is the general term applied to all forms of violent death which
results primarily from the interference with the process of respiration
or to the tissue or both has been reduced to below normal level.

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- Asphyxia by hanging : asphyxia by strangulation: asphyxia by
suffocation; asphyxia by submersion or drowning; asphyxia by
compression; asphyxia by breathing irreparable gases.
Abortion
-

From level viewpoint, abortion is the willful killing of the fetus in the
uterus, or violet explosion of the fetus from the maternal womb and
which results to the death of the fetus.

Principal elements of the crime:

That the expulsion of the product of conception is induced

That the fetus dies either as an effect of the violence used, drug
administered or the fetus expelled before the term of its viability.
Kinds of Abortion:
1. Spontaneous or natural abortion- occurs without any form of
inducement or intervention
2. Induced abortion- abortion which will not take place had it not
been for the some form of inducement or intervention

therapeutic abortion- done purposely to save life of mother

criminal abortion- done without any therapeutic indication, with
criminal intent.

Reason why it is Difficult to prosecute physicians committing the Crime of Abortion

1. The crime is performed clandestinely by an intelligent being who is fully aware of
his criminal act.
2. The physician has several medical reasons to justify his act. There is no hard and fast
rule in medicine. He may claim that there is medical justification to such abortion
because the woman is suffering from a disease which might imperil the life if
pregnancy will be allowed to progress to full term.
3. In most cases, the products of conception removed which may be utilized as corpus
delicti in the crime is lost.
4. The pregnant woman herself is in connivance with the physiolan and it is quite
difficult to let her testify truthfully as to the actual happening. She herself is in pari
delicto to the crime of criminal abortion.
5. Medical society seems top have a lukewarm attitude in helping the state prosecute
the abortionist.
Infanticide

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-

the killing of child less than three days old; must be the result of a voluntary,
conscious and free act commission.

HOW THE CRIME OF INFANTICIDE IS COMMITTED:

1. by OMMISSION or NEGLECT
- failure to ligate the umbilical cord
- failure to protect the child from heat or cold
- omission to take the necessary help of a midwife or a skilled physician
- omission to supply the child with proper food
- omission to remove the child from the mothers discharge which resulted to
suffocation
2. by COMMISSION
-

By Inflicting physical injures kitchen utensils traumatized the child

By suffocation the face of the child pressed into pillow
By strangulation manual strangulation, cord/ rope around neck
Drowning disposed in a sewer
Poisoning denatured alcohol, tincture of iodine administered to child
By burning not common but usually done with burning of house
By deliberate exposure to heat or cold direct sunshine, exposure to cold water

Paternity and Filiation

-

Paternity is the civil status of the father with respect to the child begotten by
him;
Filiation I the civil status of the child in relation to its mother or father

Kinds of children:
-

Legitimate children (proper) those born in lawful wedlock or within 300 days
after the dissolution of marriage
Legitimated children legitimization is defined as a remedy or process by which
a child born out of lawful wedlock and are therefore considered illegitimate are
by fiction of law considered legitimate.

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