History and development of medical jurisprudence

History of any discipline, including medical sciences, is really valuable for us to

understand the evolution of the subject through different stages of existence, how the present
state of development has been achieved and finally allow us to learn through the mistakes.
1. Ancient History
Judicial inquiries and postmortem examinations were required in certain deaths in Ancient
Egypt. Some historians have regarded Imhotep (2650-2600 BC) as the first medicolegal expert
because he was both chief justice and personal physician to pharaoh Zoser who has treated
over hundreds of diseases and performed surgeries and practised dentistry as well. The oldest
known surviving law code is the Code of Ur-Nammu, which is a reflection of Mesopotamian
laws written in the Sumerian Language (2100-2050 BC). It predated the better-known code,
the Code of Hammurabi by approximately three hundred years. It is considered a casuistic form
of laws, i.e. if you commit this offense, then you receive this punishment. The Code of
Hammurabi was written in approximately 1790 BC. This was written in the Akkadian language
in ancient Babylon. This code reflexes the principal of ‘an eye for an eye,’ which was
fundamental to Babylonian Law. The code is also noted for its provisions concerning improper
treatment given by physicians.
2. Hellenistic Period
Hippocrates (460-377 BC), the ancient Greek physician, is regarded by most as the ‘Father
of Medicine.’ He is considered one of the greatest physicians of the world and who was first to
attempt to separate the practice of medicine from religion and superstition. Hippocrates taught
against such improper conduct and taught his students to treat everyone with dignity and in a
professional manner. The basic principles of Hippocratic Oath are admired in all parts of the
world even after 25 centuries and serve as fundamentals of medical ethics in the modern world.
3. Roman Law
The most important of the pre-Christian legal codes was the Roman law, which governed
the Roman Empire for 900 years, beginning in 451 BC. The basis of Roman law was the
concept that the exact form, not the intention, of words or actions produced legal consequences.
To ignore intention may appear to be unfair to our way of thinking, but the Romans understood
there are witnesses to actions and words, but not to intentions. Medicolegal history in Roman
Empire is a Julius Caesar who was stabbed and killed by his ministers. Antistius, an ancient
physician who examined Caesar’body concluded that out of 23 stabs, only one wound, the one
in the chest between 1st and 2nd ribs found to be fatal. The postmortem examination of
Caesar’s body is the earliest recorded incident of examination of a dead body of a murder
victim. The Justinian Code, was the result of Emperor Justinian’s desire that existing Roman
law be collected into simple and clear system of laws, or “code.” Included within the Justinian
Code was a provision directed toward the use of medical experts. In contradistinction to Roman
law, a medical expert would not be used to advantage if he were used as an ordinary witness,
appearing for one side or the other. The code stated that the function of such an expert was
really to assist the judiciary through impartial interpretation and opinion, based on his
knowledge.
 4. Development of the Forensic Sciences in China
During the Han Dynasty, cases of rape, physical abuse and murder were prosecuted in
court. Women were permitted to file civil and criminal charges against men, despite their lower
cultural status. Although a suspect could be jailed, a convicted criminal was not imprisoned.
Instead those found guilty of an offense could receive a monetary fine or a period of forced
hard labor. If one received the death penalty, they were beheaded.
A book entitled the His Yuan Lu (Record of the Washing Away of Wrongs) written by
Song Ci in 1247 (Song Dynasty, 960-1279) addressed methods to be utilized in the
investigation of suspicious deaths. In the book Song Ci writes: “A forensic medical doctor must
be serious, conscientious, and highly responsible, and must also personally examine each dead
body or that of a wounded person. The particulars of each case must be recorded in the doctor’s
own handwriting. No one else is allowed to write his autopsy report.
5. Development of Forensic Science in Europe in the Early Modern Period
In 1530, Emperor Charles V, ruler of the Holy Roman Empire, issued ‘The Carolina’
(Constitutio Criminalis Carolina), which was an edict, doing so at the request of various states
in his empire, to reform abuses that had occurred in the administration of justice. This is
regarded as the first body of German Criminal Law. Under the ‘Carolina’ actions such as
murder, manslaughter, robbery, arson, homosexuality and witchcraft were defined as severe
crimes.
French surgeon, Ambroise Paré (1510-1590) wrote a treatise on fatal wounds, entitled “De
rapports et des maijens d’embaumer Les corps mortis,” published in Paris in 1575. Ambroise
Paré is considered one of the fathers of surgery.
The first systemic manual on forensic medicine, “Quaestiones medico-legales” a three-
volume publication was authored by leading Italian forensic medical expert Paolo Zacchia
(1584-1659).
In 1663, Hydrostatic Test for respired lungs was described by Thomas Bartholin, Danish
Physician.
6. Development of Forensic Medicine in Europe in the Modern Period
The most prominent early name in forensic medicine was that of Alfred Swaine Taylor who
was appointed as the first Professor of Medical Jurisprudence at Guy’s Hospital Medical
School in 1834. He was the author of “Principles and Practice of Medical Jurisprudence,”
which was published in 1865.
France established the first department of forensic medicine and the first chair of Legal
Medicine at the University of Paris in 1794. The University of Lyon was one of the first
academic institutions to recognize forensic medicine as a subject. The world’s first forensic
science laboratory, the Institute de Medicine Legale de Paris, was established in 1863. Dr,
Edward Locard, who is regarded as the first true forensic scientist, established the Lyon Police
Laboratory in 1912.
Dr. Locard was the first to define the rules for the application of Galton Points.
Identification by fingerprints relies on pattern matching followed by the detection of certain
ridge characteristics referred to as Galton Points. He however, is best known for establishing
“The Locard Exchange Principal,” which holds that every contact leaves a trace.
 7. Development of Forensic Medicine in America in the Modern Period
Dr. Benjamin Rush (1745-1813) was one of the leading physicians of the time and is
regarded as the “Father of American Psychiatry.”
The first recognized textbook in forensic medicine in this country was by Theodoric Beck
(1791-1855) who published “Elements of Medical Jurisprudence” in 1823.
The American Academy of Forensic Science was founded in 1948.
The American Board of Pathology commenced board certification in Forensic Pathology
in 1959.
8. Development of Forensic Medicine in Myanmar
8.1 History of medicolegal system prior to colony period
In ancient times, during the reigns of the Burmese kings, there was no obvious application
of medicolegal science in the old Burmese judicial system. There seems to be no records of
autopsies nor any records of medical practitioners appearing as witnesses and giving evidence
in trial courts.
8.2 The Colonial Period (1885-1948)
Burma became a colony of the British Empire in 1885 and since then western medical
science was introduced into the country. Government hospitals were set up in the major cities
of Burma and western medical science became slowly established. There was no coroner or
medical examiner system in Burma. The Burma Penal Code, which was mainly adopted from
the Indian Penal Code, defines the procedures for the investigation of criminal or suspicious
deaths. Hospital medical officers, usually British or Indian doctors at that time, had to assist
the police in their investigations as medico legal experts. A Civil Surgeon, usually the senior
medical officer, is responsible for all the medico legal work within his health care area. Usually
it is the police who initiate the investigations in the case of murder or suspicious death, except
on rare occasions, when a Magistrate or Judge ordered an inquest in a case of suspicious death.
8.3 After the Colonial Period
In lower Burma, a Police Surgeon was appointed at the Rangoon General Hospital and he
had to handle all the medico legal problems that needed expert opinion. Similarly, another
Police Surgeon was appointed at the Mandalay Burma. Elsewhere, Civil Surgeons had to deal
with local medico legal cases and seek advice and help, if necessary, from the Police Surgeons,
of the capital cities.
8.4 History of the Department of Forensic Medicine at the Institute of Medicine (1)
Rangoon
Since the founding of the Department of Forensic Medicine, University of Rangoon, in
1927, the Head of the Department has traditionally been the Police Surgeon of the Rangoon
General Hospital. The founder of the Department, Professor Lieutenant Colonel Owens, was
an expert in medico legal matters and was the author of the book entitled: “Lyon’s Medical
Jurisprudence for India.”
After Professor Owen’s retirement in 1933, Dr. David, a Surgeon of the Rangoon
General Hospital, succeeded as the Head of Department unit 1938. From 1938 to 1947,
including the years of the Second World War, during which time the Medical College
continued to function for three years diploma course, Dr. Ba Than was the Head of the
Department. For some years prior to 1978, before the present incumbent Dr. Bah Choon was
appointed as Head of the Department, Dr. D. M. Nandy, Dr. Sein Maung, and Dr. Mg Mg Taik,
who acted as Police Surgeons, were Heads of the Department. From 18.11.1988, Dr. Bah
Choon was given a personal Professorial Chair and since then the Department was raised to a
professorial status for the first time.
8.5 Teaching of Forensic Medicine in Burma
There are six medical universities in Myanmar. In each university, Forensic Medicine
is taught as one major subject in the fourth year of the M.B., B.S. course, for one full academic
year. At the end of the academic year, students have to pass an examination which includes
written papers and oral examinations based on forensic specimens, photographs and
radiographs of forensic interest. The examination is conducted jointly by examiners from the
Department of Forensic Medicine of the six medical institutes.
8.6 The Medicolegal Service in Burma
Forensic pathologist in each city of Myanmar have to perform all the medicolegal
autopsies as well as clinical forensic casework such as examination of rape cases, assessment
of age, examination of injured persons etc. with the added duties of going to trial courts and
giving expert medicolegal evidence and opinions.
9. Future of forensic
As history has shown, the forensic sciences and pathology have made substantive
contributions to society throughout the centuries. So, we must continue to strive for the highest
standards in the practice of forensic pathology and in the application of the various
subspecialties of forensic science in the resolution of cause and manner of death.

Dr Myo Zaw Thu