LEGAL MEDICINE

Prelims Exam
Atty. Empaces
Wed 8:00-9:00 PM

I. INTRODUCTION
Definition, history, scope and nature of Legal Medicine

Legal Medicine is a branch of medicine which deals with the application of medical knowledge to the purposes of law and
in the administration of justice. It is the application of basic and clinical, medical and paramedical sciences to elucidate legal
matters.

History:
 Imhotep-the earliest recorded medico-legal expert. Chief physician and architect of King Zoser, 3 rd dynasty Egypt
and the builder of the 1st pyramid. That time was the first recorded report of a murder trial written on a clay tablet.
 The Code of Hammurabi, the oldest code of law (2200 B.C.) included legislation on adultery, rape, divorce, incest,
abortion and violence.
 Hippocrates (460-355 B.C.) in Greece discussed the lethality of wounds. Aristotle (384-322 B.C.) fixed animation of
fetus at the 40th day after conception.
 ~300 B.C. the Chinese materia medica gave information on poison including aconite, arsenic and opium. Hashish
was said to have been used as a narcotic in surgery about 200 B.C.
 That bodies of all women dying during confinement should immediately be opened in order to save the child's life
was promulgated during the reign of Numa Pompilius in Rome (600 B.C.).
 The first "police surgeon" or forensic pathologist was Antistius. Julius Caesar (100-44 B.C.) was murdered and his
body was exposed in the forum and Antistius performed the autopsy. He found out that Julius Caesar suffered from
twenty-three wounds and only one penetrated the chest cavity through the space between the first and second ribs.
 Justinian (483-565 A.D.), in his Digest, made mention that a physician is not an ordinary witness and that a physician
gives judgment rather than testimony. This led to the recognition of expert witness in court.
 The first textbook in legal medicine was included in the Constitute Criminalis Carolina which was promulgated in
1532 during the reign of Emperor Charles V in Germany.
 Pope Innocent III (1209) issued an edict providing for the appointment of doctors to the courts for the determination
of the nature of wounds.
 Pope Gregory IX, in 1234, caused the preparation of Nova Compilatio Decretalium which concerned medical
evidence, marriage, nullity, impotence, delivery, caesarian section, legitimacy, sexual offenses, crime against persons
and witchcraft.
 In the 14th century, Pope John XXII expressed the need of experts in the ecclesiastical courts, in the diagnosis of
leprosy and many medico-legal documents.
 In China, the Hsi Yuan Lu (Instructions to Coroner) was published. It is a five volume book dealing with inquest,
criminal abortion, infanticide, signs of death, assault, suicide, hanging, strangling, drowning, burning, poisoning and
antidotes, and examination of the dead.
 In 1575, Ambroise Pare considered legal medicine as a separate discipline and he discussed in his book, abortion,
infanticide, death by lightning, hanging, drowning, feign diseases, distinction between ante-mortem and post-
mortem wound and poisoning by carbon monoxide and by corrosives.
 Paulus Zacchias (1584-1659), a papal physician, is regarded as the "father of forensic medicine." He published
Questiones Medico-legales which dealt with the legal aspects of wounds and the first two chapter dealt with the
detection of secret homicide.
 In 1598, Severin Pineau published in Paris a work on virginity and defloration. He confirmed the existence of the
hymen and that it may not rupture during sexual intercourse.
 Orfila (1787-1853) introduced chemical methods in toxicology. In his Traite' des Poison, he mentioned mineral,
vegetable and animal poison in relation with physiology, pathology and legal medicine. He was considered later as
the founder of modern toxicology.
 The period thereafter is characterized by an appreciable increase in available publication on the subject dealing with
modern innovative findings and procedures related to medical progress and changes in the laws.

IN THE PHILIPPINES
 In 1858, the first medical textbook printed including pertinent instructions related to medico-legal practice by
Spanish physician, Dr. Rafael Genard y Mas, Chief Army Physician, entitled "Manual de Medicina Domestica."
 In 1871, teaching of legal medicine, included as an academic subject in the foundation of the School of Medicine of
the Real y Pontifica Universidad de Santo Tomas.
 On March 31, 1876 by virtue of the Royal Decree No. 188, of the King of Spain, the position of "Medico Titulares"
was created and made in charge of public sanitation and at the same time medico-legal aid in the administration
of justice.
 In 1894, rules regulating the services of those "Medico Titular y Forences" was published.

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  In 1895, medico-legal laboratory was established in the City of Manila and extended at the same time its services to
the provinces.
 In 1898, American Civil Government preserved the Spanish forensic medicine system.
 In 1901, Philippine Commission created the provincial, insular and municipal Board of Health (Act Nos. 157, 307 and
308) in the Philippines and assigned to the respective inspectors and presidents of the same, medico-legal duties
of the "Medico Titulares" of the Spanish regime. The Philippine Legislature maintained the pre-existing medico-
legal system in full force in the Administrative Code.
 In 1908, the Philippine Medical School incorporated the teaching of Legal Medicine, one hour a week to the fifth
year medical students.
 In 1919, the University of the Philippines created the Department of Legal Medicine and Ethics with the head having
the salary of 4,000.00 pesos per annum, half-time basis, with Dr. Sixto de los Angeles as the chief.
 On January 10, 1922, the head of the Department of Legal Medicine and Ethics became the Chief of the Medico-
Legal Department of the Philippine General Hospital without pay. On March 10, 1922, the Philippine Legislature
enacted Act. No.1043 which became incorporated in the Administrative Code as Section 2465 and provided that the
Department of Legal Medicine, University of the Philippines, became a branch of the Department of Justice.
 On December 10, 1937, Commonwealth Act. No. 181 was passed creating the Division of Investigation under the
Department of Justice. The Medico-Legal Section was made as an integral part of the Division with Dr. Gregorio T.
Lantin as the chief.
 On March 3, 1939, the Department of Legal Medicine of the College of Medicine, University of the Philippines was
abolished and its functions were transferred to the Medico-Legal Section of the Division of Investigation under the
Department of Justice.
 On July 4, 1942, President Jose P. Laurel consolidated by executive order all the different law-enforcing agencies
and created the Bureau of Investigation on July 8,1944.
 In 1945 immediately after liberation of the City of Manila, the Provost Marshal of the United States Army created
the Criminal Investigation Laboratory with the Office of the Medical Examiner as an integral part and with Dr.
Mariano Lara as Chief Medical Examiner.
 On June 28, 1945, the Division of Investigation, under the Department of Justice was reactivated.
 On June 19, 1947, Republic Act. No. 157 creating the Bureau of Investigation was passed. The Bureau of Investigation
was created by virtue of an executive order of the President of the Philippines. Under the bureau, a Medico-Legal
Division was created with Dr. Enrique V. de los Santos as the Chief.
 There exists a Medico-Legal Division in the Criminal Laboratory Branch of the G-2 of the Philippine Constabulary.
All provincial, municipal and city health officers, physicians of hospitals, health centers, asylums, penitentiaries and
colonies are ex-officio medicolegal officers.
 In remote places where the services of a registered physician was not available, a "Cirujano Ministrante" may perform
medico-legal work. However, after the approval of Republic Act 1982 on June 15, 1954 which provided for the
creation of rural health unit to each municipality composed of municipal health officer, a public nurse, a midwife
and a sanitary inspector virtually abolished the appointment of Cirujano Ministrante thereby making qualified
physicians to perform medico-legal functions.
 June 18, 1949, Republic Act 409 which was later amended by Republic Act 1934 provides (Sec. 38) for the creation
of the office of the Medical Examiners and Criminal Investigation Laboratory under the Department of the City of
Manila.
 On December 23, 1975, Presidential Decree 856 was promulgated and Sec. 95 provides:
Persons authorized to perform autopsies:
o Health officers
o Medical officers of law enforcement agencies
o Members of the medical staff of accredited hospitals
Autopsies shall be performed in the following cases:
o Whenever required by special laws;
o Upon order of a competent court, a mayor and a provincial or city fiscal;
o Upon written request of police authorities,
o Whenever the Solicitor General, provincial or city fiscal deem it necessary to disinter and take possession of
the remains for examination to determine the cause of death;
o Whenever the nearest kin shall request in writing the authorities concerned to ascertain the cause of death.
Scope:
 Broad and Encompassing.
 It is the application of medical and paramedical sciences as demanded by law and administration of justice
 Knowledge of the nature and extent of wounds has been acquired in surgery, abortion in gynecology, sudden death and
effects of trauma in pathology, etc. aside from having knowledge of basic medical sciences (e.g. anatomy, physiology,
biochem, physics, other allied sciences)

Nature:
 Knowledge of legal medicine means the ability to acquire facts, the power to arrange those facts in their logical order,
and to draw a conclusion from the facts which may be useful in the administration of justice.

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  Medical Jurist (medical examiner, medico-legal officer, medico-legal expert) – a physician who specializes or is involved
primarily with medico-legal duties. They are mostly in the service of the government.
 It is the duty of every physician, when called upon by the judicial authorities, to assist in the administration of justice on
matters which are medico-legal in character.
 To be involved in medico-legal duties, a physician must possess sufficient knowledge of Pathology, Surgery, Gynecology,
Toxicology, and other branches of Medicine germane to the issues involved.

Legal Medicine and the Philippine Legal System

Branches of Law Where Legal Medicine may be Applied

In CIVIL LAW, knowledge of legal medicine may be useful on the following:

1. Determination and termination of civil personality (Art.40-41);
2. Limitation or restriction of a natural person’s capacity to act (Art. 23 and 29);
3. Marriage and legal separation
4. Paternity and filiation
5. Testamentary capacity of a person making a will.

In CRIMINAL LAW, legal medicine is applicable in the following provisions of the Penal Code:
1. Circumstances affecting criminal liability;
2. Crimes against person;
3. Crimes against chastity.

In REMEDIAL LAW, legal medicine is applied in the following provisions of the Rules of Court:
1. Physical and mental examination of a person (Rule 28);
2. Proceedings for hospitalization of an insane person (Rule 101); and
3. Rules on evidences (Part IV).

In SPECIAL LAWS:
1. Dangerous Drug Act (RA 6425, as amended)
2. Youth and Child Welfare Code (PD 603)
3. Insurance Law (Act No. 2427 as amended)
4. Code of Sanitation (PD 856)
5. Labor Code (PD 442)
6. Employee’s Compensation Law

PRINCIPLE OF STARE DECISES

A principle that, when the court has once laid down a principle of law or interpretation as applied to a certain state of facts,
it will adhere to and apply to all future cases where the facts are substantially the same.

Application of Legal Medicine to Law

Legal Medicine also supplies for evidence which, when admissible and satisfies the quantum of evidence required, may result
to conviction or acquittal of defendant.

Evidence- the means, sanctioned by the Rules of Court, of ascertaining in a judicial proceeding the truth respecting a matter
of fact.
If the means employed to prove a fact is medical in nature then it becomes a medical evidence.

TYPES OF MEDICAL EVIDENCE

1. Autoptic or Real Evidence – evidence made known or addressed to the senses of the court. It is not limited to that which
is known through the sense of vision but is extended to what the sense of hearing, taste, smell and touch is perceived. (Sec.1,
Rule 130)
Limitations to the Presentation of Autoptic Evidence:
a) Indecency and Impropriety – presentation of evidence may be necessary to serve the best interest of justice but the notion
of decency and delicacy may cause inhibition of its presentation.
Ex: Court may not allow exposure of the genitalia of an alleged victim of sexual offense to show the presence and degree of
the genitalia and extra-genitalia injuries suffered.
b) Repulsive Objects and those Offensive to Sensibilities – foul smelling objects, persons suffering from highly infectious
and communicable disease, or objects which when touch may mean potential danger to the life and health of the judge
may not be presented.
However, if such evidence is necessary in the adjudication of the case, the question of indecency and impropriety or the fact
that such evidence is repulsive or offensive to sensibilities, it may be presented. This will depend on the sound discretion of
the court.

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2. Testimonial Evidence – a physician may be commanded to appear before a court to give his testimony. His testimony
must be given orally and under oath or affirmation.

A physician may be presented in court as an ordinary witness and/or as an expert witness:

ORDINARY WITNESS - A physician who testifies in court on matters perceived from his patient in the course of physician-
patient relationship.
(Sec. 20, Rule 130, Rules of Court)
Exception: Privilege of Communication between physician and patient (Sec. 24 c, Rule 130).

EXPERT WITNESS -A physician on account of his training and experience can give his opinion on a set of medical facts. He
can deduce or infer something, determine the cause of death, or render opinion pertinent to the issue and medical nature.
(Sec. 48-49, Rule 130)
The probative value of the expert medical testimony depends upon the degree of learning and experience on the line of
what the medical expert is testifying, the basis and logic of his conclusion, and other evidences tending to show the veracity
or falsity of his testimony.

3. Experimental Evidence – A medical witness may be allowed by the court to confirm his allegation or as a corroborated
proof to an opinion he previously stated.

4. Documentary Evidence- Medical Documentary Evidence may be:

a. Medical Certification or Report on:
i. Medical examination
ii. Physical examination
iii. Necropsy/ autopsy
iv. Laboratory
v. Exhumation
vi. Birth
vii. Death
b. Medical Expert Opinion
c. Deposition

5. Physical Evidence – these are articles and materials which are found in connection with the investigation and which aid
in establishing the identity of the perpetrator or the circumstances under which the crime was committed, or in general
assist in the prosecution of a criminal.

Criminalistics - is the identification, collection, preservation and mode of presentation of physical evidence. It is the
application of sciences such as physics, chemistry, medicine and other biological sciences in crime detection and
investigation.

Type of Physical Evidences:

a. Corpus Delicti Evidence – objects or substances which may be a part of the body of the crime.
b. Associative Evidence - these are physical evidence which link a suspect to the crime.
c. Tracing Evidence - these are physical evidence which may assist the investigator in locating the suspect.

PRESERVATION OF EVIDENCE
The physical evidence recovered during medico-legal investigation must be preserved to maintain their value when
presented as exhibits in court.

Methods of Preserving Evidence

1. Photographs, audio and/or video tape, micro-film, Photostat, Xerox, voice tracing, etc.
2. Sketching- rough drawing of the scene or object to be preserve is done. It must be simple, identifying significant items
and with exact measurement.
Rough Sketch- made at the crime scene or during examination of living or dead body.
Finished Sketch- sketch prepared from the rough sketch for court presentation.

Essential Elements to be Included in a Sketch:

a. Measurement must be accurate;
b. Compass direction must always be indicated to facilitate proper orientation in the case of crime scene;
c. Essential item which has a bearing in the investigation must be included;
d. Scale and proportion must be stated by mere estimation;
e. There must be a title and legend to tell what it is and the meaning of certain marks indicated therein.
3. Description- putting into words the person or thing to be preserved. It must cause a vivid impression on the mind of the
reader, a true picture of the thing described.
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Minimum Standard Requirements which must be satisfied in the description of the person or thing to make it complete:
a. Skin Lesion
b. Penetrating wound
c. Hymenal Laceration
d. Person

4. Manikin Method - miniature model of a scene or of a human body indicating marks of a various aspects of the things to
be preserved.

5. Preservation in the Mind of the Witness

 Drawbacks of preserving evidence in the mind of the witness:
 The capacity of a person to remember time, place and event may be destroyed or modified by the length of time,
age of the witness, confusion with other evidence, trauma or disease, thereby making the recollection not reliable;
 The preservation is co-terminus with the life of the witness.
 Human mind can easily be subjected to too many extraneous factors that may cause distortion of the truth.

6. Special Methods - Special way of treating certain type of evidence may be necessary. Preservation may be essential from
the time it is recovered to make the condition unchanged up to the period it reaches the criminal laboratory for appropriate
examination.

Special Ways of Preservation:

a. Whole human body- embalming.
b. Soft tissues (skin, muscles, visceral organs) – 10% formalin solution.
c. Blood- refrigeration, sealed bottle container, addition of chemical preservatives.
d. Stains (blood, semen) – drying, placing in sealed container.
e. Poison- sealed container.

Medical Jurisprudence, its definition and nature

Medical jurisprudence (juris – law, prudentia – knowledge) denotes the knowledge of law in relation to the practice of
medicine.

It concerns with the study of the rights, duties, and obligations of a medical practitioner with particular reference to those
arising from doctor-patient relationship.

Rules of Court (Sec. 5, Rule 138): Medical Jurisprudence is one of the subjects in the law course before admission to the bar.
This is based on the original concept but actually it must be the study of legal medicine as it was the intention and practice
in the past.

Distinction between Legal Medicine and Medical Jurisprudence

 Originally, legal medicine, forensic medicine, and medical jurisprudence are used interchangeably
 In modern times, Legal Medicine has a similar meaning as the term in forensic medicine, although, strictly speaking,
legal medicine is primarily the application of medicine to legal cases while forensic medicine concerns with the application
of medical science to elucidate legal problems.
 Medical jurisprudence denotes the knowledge of law in relation to the practice of medicine. It concerns with the study
of the rights, duties, and obligations of a medical practitioner with particular reference to those arising from doctor-
patient relationship.

Ordinary Physician v. Medical Jurist

Ordinary Physician Medical Jurist
Sees an injury or disease on the point of Sees injury or disease on the point of
view of treatment view of cause
Purpose in examining a patient is to Purpose in examining a patient is to
arrive at a definite diagnosis so that include those bodily lesions in his
appropriate treatment can be instituted report and testify before the court or
before an investigative body
Minor or trivial injuries are usually Records all bodily injuries even if they
ignored inasmuch as they do not require are small or minor because these
usual treatment. injuries may be proofs to qualify the
crime or to justify the act.
Example:
Presence of PHYSICAL INJURIES of a victim of sexual abuse = presumes that force was applied; hence, crime committed
must be RAPE.
Presence of PHYSICAL INJURIES on the offender of the crime of physical injuries = proof that the victim acted in SELF
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 DEFENSE.

II. CIVIL PERSONALITY

Definition and concept of civil personality
Civil personality is merely the external manifestation of either juridical capacity or capacity to act. Consequently, it may be
defined as the aptitude of being the subject of rights and obligations.

Attainment of Civil personality:

Birth determines personality

Art. 40, Civil Code:
Birth determines personality; but the conceived child shall be considered born for all purposes that are favorable to it,
provided it be born later with the conditions specified in the following article.

Personality begins at conception. This personality at conception is called presumptive personality. It is essential that birth
should occur later, otherwise the foetus will be considered as never having possessed legal personality.

Art. 41, Civil Code:

For civil purposes, the foetus is considered born if it is alive at the time it is completely delivered from the mother's womb.
However, if the foetus had an intra-uterine life of less than seven months, it is not deemed born if it dies within twenty-four
hours after its complete delivery from the maternal womb.

Two kinds of Children:

A. Ordinary - with an intra-uterine life of at least seven months.
B. Extraordinary - if the intra-uterine life has been less than seven months.

Terrmination of civil personality

Article 42 of Civil Code:
Civil personality is extinguished by death.
The effect of death of death upon the rights and obligation of the deceased is determined by law, by contact and by will.
Death by means of Physical Death compared to civil interdiction (civil death) merely restricts, not extinguishes civil
personality.

Legal Importance of the Study of Birth:

In medicine, birth is the entire delivery of a child with or without its separation from the body of the mother. It is not
necessary that the cord should have been cut or the placenta expelled. It is the cessation of the symbolic relation between
the mother and the fetus.

Importance:
1. Birth determines personality.( Refer to first question)
2. Appearance of a child is a ground for the revocation of donation:

Art. 760, Civil Code:

Every donation inter vivos, made by a person having no children
or descendants, legitimate or legitimated by subsequent marriage, or illegitimate, may be revoked or reduced as provided
in the next article, by the happening of any of these events.
(1) If the donor, after the donation has legitimate or legitimated or illegitimate children, even though they be posthumous.
3. Proof of live-birth must first be shown before death of the child by the prosecution in the case of infanticide:

Art. 255, Revised Penal Code — Infanticide: The penalty provided for parricide (reclusion perpetua to death) in article 246
and for murder (reclusion temporal in its maximum period to death) in article 248 shall be imposed upon any person who
shall kill any child less than three days of age.

Full tern baby /Still-birth

Birth may be:
A. STILL-BIRTH:

When the child has not breathed or has not shown any sign of life after being completely born.

Causes of Still-birth:
1. Immaturity.
2. Congenital diseases or malformation.
3. General debilitating diseases:
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a. Acute specific infection.
b. Toxemia.
c. Kidney disease.
d. Acute liver disease.
e. Septicemia.

4. Local disease of the generative organ:

a. Syphilis.
b. Ablatio placenta, intra-placental hemorrhage, or extensive infarction.
c. Kind of the cord.
d. Placenta previa.

5. Accidents in the delivery:

a. Disproportion of the birth canal and the fetus.
b. Injudicious forcep application.
c. Prolapse of the cord or strangulation of the cord.
d. Hemorrhage.
e. Abnormal presentation.
f. Influence of narcotics, anesthesia or intoxicating liquor.
g. Puerperal insanity.
h. Prolonged labor.
i. Hasty parturition.
j . Spasm of the larynx,
k. Hemorrhage of the cord.

6. Violence, either deliberate or accidental at birth.

B. LIVE-BIRTH
In live-birth the child after birth exhibited clear signs of vitality and viability is not necessary. In law, the presumption is every
new-born child found dead was born dead. The burden of proof lies on those who declare otherwise. To have a child acquire
personality distinct as that of the mother, there must be proof of life after complete separation from the mother's womb.

Proof of live birth/ burden of proof

In live birth the child after birth exhibited clear signs of vitality and viability is not necessary. In law, the presumption is every
new-born child found was born dead. The burden of proof lies on those who declare otherwise. To have a child acquire a
personality distinct as that of the mother, there must be proof of life after complete separation from mother’s womb.

Proofs of live-birth
1. Presence of Heart Action and Circulation:
The presence of heart sound when the new born is examined by means of a stethoscope is a sign of life.
Sometimes the pulse is imperceptible by palpation especially when the child suffered much during labor.
2. Movement of the child and crying:
The first instinct of the child after birth is restlessness and crying. Children born after severe and prolonged
second stage of labor, may be too weak to move or cry. After a while, they begin to move and later cry
upon application of bodily stimulus.
3. Presence of respiration:

Proofs that respiration has taken place:

a. There is arching of the chest.
b. Fall of the level of the diaphragm:
Before birth, the diaphragm reaches the level of the 4th or 5th rib, but if respiration has taken place,
it reaches to the level of the 6th or 7th ribs. This test is not conclusive but merely corroborative.

c. Expansion of the lungs:

Appearance of the lungs if respiration has taken place:
(1) The lungs fill the thoracic cavity and overlapping the heart and thymus gland.

(2) The lungs are voluminous, with rounded edges and pink-mottled color.

(3) The surface is covered with mosaic of expanded air vesicles, giving a marble appearance.
(4) On pressure, they crepitate, and on section they exude froth.

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 Appearance of the lungs before respiration has taken place:

(1) The lungs are found at the back of the thoracic cavity behind the heart and thymus gland.
(2) The lungs are smooth, small, of a uniform dark blue-red color, with sharp edges and present the
appearance of a piece of liver.
(3) When squeezed between the finger and thumb they do not crepitate.
(4) On section they appear solid and exude blood but not froth.
Hydrostatic Test
Hydrostatic test is one of the tests to determine whether respiration took place on a newborn child
before death. This test is based upon the principle that the specific gravity of the lungs becomes less as a
result of the introduction of air in the air passages and air sacs.
Hydrostatic test is no longer necessary in the following instances because of the presence of
stronger proofs of live-birth or still-birth.
a. When the fetus is born less than 180 days of intrauterine life.
b. When the fetus is a monster which is not capable of living a separate existence.
c. When the umbilical cord is separated and the umbilicus is cicatrized.
d. When the stomach on dissection contains coagulated or half-coagulated milk as a result of digestion.
e. When the fetus shows signs of intrauterine maceration.

Unexpanded Lung Expanded Lung

a. Volume is small. a. Volume is greater and fills the chest cavity.
b. Edges are more or less sharply projected beyond b. Edges are rounded and cover the thymus and
the thymus and heart. heart.
c. Color is dark brown or uniform purplish gray with c. Color is bright vermillion and lungs show mottled
no mottling. appearance with bright red part alternating with
bluish patches.
d. Feels solid. d. Feels spongy and crepitant.
e. On section, a very little e. On section, blood stained frothy serum exudes
blood exudes. on squeezing.
f. Absolute weight is 450-650 gms. f. Absolute weight is 900-1,000 gms.
g. Hydrostatic test — Negative. g. Hydrostatic test —Positive.
h. Microscopic examination shows collapsed air h. Microscopic examination shows expanded air
sacs. sacs and with blood vessels engorged.

4. Examination of the Stomach and Intestine:

a. On opening the stomach of a still-born child, it contains only mucous, but after respiration, the
stomach will contain mucous, air bubbles and saliva.
The normal content before birth is albuminous substances and mucous. The presence of sugar, starch
or milk indicates live-birth.
b. Stomach-Bowel Test or Floatation Test or Breslau's Second Life Test:
Ligate the cardiac end of the stomach and the lower end of the intestine and remove. Place the whole
mass of organs in water. If the organs float, breathing has taken place. Dip the organs under water and
open the stomach and intestine.
Note the liberation of air bubbles going up the surface of the water, if breathing has taken place.
5. Changes in the Middle Ear (Wredin's Test):
The middle ear of a child before birth is filled with gelatinuous, embryonic connective tissue. This disappears
after the birth of the child.
6. Condition of the Skin:
The skin of a newly born infant is bright red in color. This gradually changed to a lighter one. In 2 to 4 days, it
darkens to brick-red, but may be yellow due to physiological jaundice.
The normal appearance of the skin appears after a week.
7. Marks of Violence:
Violence applied to a child while living will show some degree of vital reactions. Such reaction will not be seen
in cases of still-birth.
8. Changes in the Umbilical Cord:
The portion of the cord attached to the skin of the child begins to shrink and dry within 12 to 24 hours.
There is inflammatory redness of the base from 36 to 48 hours. By the second or third day it shrivels up,
mummifies, and falls on the fifth or sixth day. The healed cicatrix is seen within 10 to 12 days.
Pulsation seen or felt in the cord indicates live-birth. In 12to 24 hours it dries and slowly becomes shrivelled
in 3 to 5 days and the cord separates with cicatrization of the wound. The surrounding skin shows capillary
congestion. The ring of inflammation around the site is an evidence of life of at least 36 hours duration. The
wound heals in 2 or 3 days and the scar develops within 10-12 days.

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 Prolonged soaking of mummified umbilical cord can cause it to swell but not to return to its natural
condition. If the child and the cord are submerged in a body of water after birth the cord will undergo
liquifaction on account of decomposition.
9. Condition of the Heart and Blood Vessels:
Ductus arteriosus closes within 3 days. Ductus venosus also closes within 3 days after birth. The foramen
ovale may close on the second or third month.

Proof of Live-Birth can be deduced in the following:

1. Well-developed signs of breathing.

2. Presence of air or food in the stomach.
3. Changes having taken place in the region of the umbilicus.

Signs of Maturity of the Child at Birth:

1. Length of the fetus — 50 centimeters.
2. Weight - 3.0 kilos.
3. Lanugo hair almost disappeared.
4. Limbs and body plump.
5. Face lost its wrinkles.
6. Skin covered with vernix caseosa.
7. Head covered with hair about 2 inches long.
8. Nails project from the fingers but the toe-nails reach only to the end.
9. One or both testes are in the scrotum, or labia have close the vulva.
10. Lower end of femur may show center of ossification about 0.6 cm. in diameter.

Presumptive or presumed personality of an unborn child – see art. 40-41, NCC

III. PATERNITY AND FILIATION

Definition: Relation of parents on one hand and their children on the other. This relation may arise from nature, that is, when
it derived from generation or it may arise by fiction of law, in imitation of natures, as in adoption. (Tolentino, Civil Code).

Paternity- civil status or relationship of the father /mother to the child

Filiation- civil status or relationship of the child to the father/mother

A. What is the legal importance of determining paternity and filiation?

Paternity and filiation serve to establish legal parenthood (usually fatherhood). They are the gateway to creating and
enforcing the legal rights and responsibilities arising from parenthood.

A child's paternity may be relevant in relation to issues of legitimacy, inheritance and rights to a putative father's title or
surname, as well as the biological father's rights to child custody in the case of separation or divorce and obligations for
child support.

B. KINDS OF FILIATION OF CHILDREN

Classified by:
b.1. Nature:
 Legitimate- children conceived or born during the marriage of the parents
Note: also children conceived as a result of artificial insemination of the wife with the sperm of:
a. husband; or b. donor; or c. both; provided, the husband and wife authorized or ratified such insemination in a written
instrument executed and signed by them before the birth of the child.

 Illegitimate- children conceived and born outside a valid marriage

 Legitimated- children conceived and born outside of wedlock of parents who, at the time of the conception of the
former, were not disqualified by any impediment to marry each other may be legitimated.
b.2. Adoption-
 Adopted- through a legal proceeding (adoption) that creates a parent-child relation between persons related or
not related by blood; the adopted child is entitled to all privileges belonging to a natural child of the adoptive
parents (including the right to inherit)
How can filiation be proven? (Art. 172 , Family Code of the Philippines)
Filiations of legitimate (or illegitimate) children are established by any of the following:
 The record of birth appearing in the civil registry or a final judgment
 An admission of legitimate (or illegitimate) filiation in a public document or a private handwritten instrument and
signed by the parent concerned.
What if the child has no such proofs to prove his filiation to his biological father?
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In the absence of any of the above evidence, such legitimate or illegitimate filiation may be proved by:
 Open and continuous possession of the status of a legitimate or illegitimate child;
 Any other means allowed by the Rules of Court and special laws. (Article 172 of the Family Code)

C. MEDICAL EVIDENCE OF PATERNITY & FILIATION

 Genetic test results (DNA TESTING), weighted in accordance with evidence, if available, of the statistical
probability of the alleged father's paternity
Some other tests to determine paternity and filiation:
 Non-Invasive Prenatal Paternity (NIPP). NIPP testing is considered to be the best option for prenatal paternity
testing, as it is both non-invasive and 99.9% accurate. In this test, a blood sample is taken from the mother, and the
baby’s DNA that is naturally circulating in the bloodstream is isolated through proprietary, state-of-the-art
techniques.
This test can be performed any time after the eighth week of pregnancy, and requires only a simple blood
collection from the mother and potential father. It therefore poses no risk to the developing baby.
 Amniocentesis. Amniocentesis is performed in the second trimester of pregnancy, ranging from the 14th to the
20th week. In this test, the physician uses an ultrasound to guide a fine needle into the mother’s uterus through the
abdomen. The physician then draws out a small amount of amniotic fluid, which is DNA-tested.
Unfortunately, amniocentesis is associated with significant risks to the baby, including birth defects,
infection, impaired lung development, and increased risk of miscarriage. It is also an uncomfortable procedure for
the mother, and may result in vaginal bleeding. Because of these drawbacks, NIPP is now the preferred method for
prenatal paternity testing.
 Chorionic Villus Sampling (CVS). In chorionic villus sampling, the physician, guided by an ultrasound, inserts a thin
needle or tube into the vagina and the cervix to obtain a chorionic villus sample. In some cases a needle may also
be inserted through the abdomen.
Chorionic villi are branch-like pieces of tissue attached to the uterine wall. They have the same DNA as the
fertilized egg, so can be used to establish paternity. This is done somewhere between the 10th and 13th weeks of
pregnancy.
Chorionic villus sampling is associated with some risk of adverse effects. The primary risk is miscarriage, which occurs
in 1% of procedures. It is not recommended for women who are carrying twins, have uterine fibroids, a tilted uterus,
or have experienced any other complications during pregnancy.
 Postnatal Testing. Postnatal testing is more cost-effective than prenatal testing. If the testing is done directly after
birth, blood is collected from the baby’s umbilical cord. If testing is done later on, a blood sample or cheek swab
may be collected from the child.
Lifted from : https://www.floridafamilylawclinic.com/four-types-of-tests-used-to-prove-paternity/

D. PROCREATION
Reproduction (or procreation) is the biological process by which new “offspring” (individual organisms) are produced from
their “parents. ” It is a fundamental feature of all known life that each individual organism exists as the result of reproduction.
Most importantly, reproduction is necessary for the survival of a species. The known methods of reproduction are broadly
grouped into two main types: sexual and asexual.
Human Procreation
 Sexual Intercourse- During sexual reproduction, the male gamete (sperm) may be placed inside the female’s body
for internal fertilization. Also called as natural insemination.
A. Other Human Reproduction Techniques
1. Artificial Insemination by Husband (AIH)
AIH is used when the husband can produce semen, but his semen is not quite adequate to achieve fertilization. The
inadequacy of semen can be attributed to low number of active sperms or the inability of sperms to swim fast enough
towards the ovum. AIH can also be used when the husband is suffering from premature ejaculation.
In AIH, the sperm is obtained from the husband by his masturbation and is then concentrated and 'improved' in the
laboratory. This semen is then introduced into the wife's cervix at the best fertile days. The semen is introduced by an
injection. Depending on the regulations of each institute, the injection can be carried out by a doctor or a nurse, or by the
couple themselves
2. Artificial Insemination by Donor (AID)
AID is very similar to AIH. However, AID is used in cases where the husband's semen is definitely inadequate in quantity or
quality. In the Western society, some single women who wish to remain unmarried but have a child also use this method to
become pregnant. In England, two to four thousand births in a year are attributed to AID.
3. In Vitro Fertilization (IVF)
The first two methods were for cases where the husband's sperm lacked in quality or quantity. IVF is a technique used mostly
for women whose fallopian tubes are blocked and cannot be remedied by surgical procedures. Also for those who fail to
conceive despite having normal fallopian tubes and when all possible causes of infertility have been excluded. "In vitro"
means a test-tube.
In IVF, one or more ova are removed from the mother through a small syringe and placed in a test-tube. Then the sperm of
the husband is used to fertilize the ovum. After fertilization, the ovum is allowed to develop in the test-tube till the eight-
cell stage. Then it is implanted into the mother's womb.
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IVF may also be used in cases where the husband's semen contains so few sperms that it becomes difficult for them to
fertilize an ovum in the fallopian tube. By IVF, sperm of such a person is used to fertilize the ovum in a test-tube.
4. Surrogate Motherhood
Surrogate motherhood is a by-product of the artificial insemination. It has created great controversy in the legal and ethical
circles around the world, especially so after the baby 'M' case of 1987.
Surrogate motherhood means that a woman allows a fertilized ovum of another couple to be injected into her womb. Then
she carries the child to its full term for the other couple. This can be done free or in exchange for some money as was the
case in baby M's birth. This procedure of human reproduction is adopted when a woman has a problem in carrying her child
to its full term.

Presumption of legitimacy
-Children conceived or born during the marriage of the parents
-Children conceived as a result of artificial insemination of the wife with the sperm of the husband or that of a donor or both
are likewise legitimate children of the husband and his wife, provided, that both of them authorized or ratified such
insemination in a written instrument executed and signed by them before the birth of the child. The instrument shall be
recorded in the civil registry together with the birth certificate of the child.

Medical evidence of paternity and filiation

1. Parental Likeness:
-Heredity transmits traits and characteristics from parents to the offsprings.
-There must be some gross manifestation of the children which may be in common with the father.

2. Blood Grouping Test:

-blood type of the child is a possible product of the parents not conclusively show that the child is born by such parents.
-blood type of the child is not the possible product of the parents conclusively show that the child is not that of the
husband.

3. Evidences from the Mother:

a. Proofs of Previous Delivery:
-supposed mother may be subjected to an examination to determine the presence of signs of previous childbirth and which
are compatible with the age of the child.
b. Proofs of Physical Potency and Fertility:
-the woman may be manifesting some acquired or congenital defect wherein impotency may be inferred.
-fertility may be inferred from the presence of other pregnancies and the absence of organic abnormalities of the generative
system.
c. Proof of Capacity to have Access with the Husband:
-general physical examination of the woman is necessary to determine whether she is physically capable of having sexual
intercourse with her husband.

4. Evidences from the Father:

a. Proof of Physical Potency and Fertility:
-medical examination must be done whether husband is capable of erection.
-examination of spermatozoa in the seminal fluid is necessary to determine fertility.
-presence of disease, congenital or acquired abnormalities, etc. may be factors that may bring about impotency or sterility.
b. Proof of Access:
-physician must determine the health and vigor of the father, the presence of disease, which may bring about his incapacity
to perform sexual intercourse.

Grounds to impugn or question legitimacy of a child

i. That it was physically impossible for the husband to have sexual intercourse with his wife within the first 120 days of the
300 days which immediately preceded the birth of the child because of:
1. the physical incapacity of the husband to have sexual intercourse with his wife;
2. the fact that the husband and wife were living separately in such a way that sexual intercourse was not possible; or
3. serious illness of the husband, which absolutely prevented sexual intercourse;
ii. That it is proved that for biological or other scientific reasons, the child could not have been that of the husband, except
in the instance provided in the second paragraph of Article 164; or
iii. That in case of children conceived through artificial insemination, the written authorization or ratification of either parent
was obtained through mistake, fraud, violence, intimidation, or undue influence.

Status of child born after termination of marriage

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-A child born before one hundred eighty days after the solemnization of the subsequent marriage is considered to have
been conceived during the former marriage, provided it be born within three hundred days after the termination of the
former marriage;

-A child born after one hundred eighty days following the celebration of the subsequent marriage is considered to have
been conceived during such marriage, even though it be born within the three hundred days after the termination of the
former marriage.

-The legitimacy or illegitimacy of a child born after three hundred days following the termination of the marriage shall be
proved by whoever alleges such legitimacy or illegitimacy.

-Children conceived and born outside a valid marriage are illegitimate, unless otherwise provided in this Code.

IV. DEATH
Definition – Termination of life; complete cessation of all the vital functions of the body without possibility of
resuscitation; its ascertainment is a medical problem not a legal problem
DEATH MAY BE:
- Brain death – absence of electrical brain activity and complete cessation of all vital functions
- Cardio-respiratory death - condition in which the physician and the members of the family pronounced a person
to be dead based on the common sense or intuition.

Medico-legal aspects
KINDS OF DEATH
1. Somatic or clinical death – complete, persistent and continuous cessation of the vital functions of the brain, heart
and lungs which maintain life and health; occurs when the physician declares that such person has expired

2. Molecular or cellular death - there is still animal life among individual cells; evidenced by the presence of
excitability of muscles and ciliary movements and other functions of individual cells.

3. Apparent death (or state of suspended animation) - not really death; merely a transient loss of consciousness or
temporary cessation of the vital functions of the body on account of disease, external stimulus or other forms of
influence. (MAY arise in hysteria, uremia, catalepsy and electric shock.)

SIGNS OF DEATH
 CESSATION OF HEART ACTION AND CIRCULATION - entire and continuous cessation of the heart action and flow
of blood in the whole vascular system; if there is no heart action for a period of five minutes death is regarded as
certain
 CESSATION OF RESPIRATION
 COOLING OF THE BODY (ALGOR MORTIS)
 INSENSIBILITY OF THE BODY AND LOSS OF POWER TO MOVE
 CHANGES IN THE SKIN
 CHANGES IN AND ABOUT THE EYE:
 ACTION OF HEAT ON THE SKIN

DURATION OF DEATH
1. Presence of Rigor Mortis – sets in 2-3 hours after death; full developed in body after 12 hours
2. Presence of post-mortem Lividity - develops 3 to 6 hours after death.
3. Onset of decomposition – early and average time is 24 – 48 hours after death
4. Stage of decomposition – inferred from the degree of composition which must be made with extreme caution
5. Entomology of the cadaver – time of death by the use of the flies present in the cadaver; The common flies
undergo larval, pupa and adult stages; usual time for the egg to be hatched into larva is 24 hours so that by the.
mere fact that there are maggots in the cadaver, one can conclude that death has occurred more than 24 hours.

6. Stage of digestion of food in the stomach - deduced from the amount of food in the stomach in relation to his
last meal
7. Presence of Live Fleas in the Clothings in Drowning Cases:
A flea can survive for approximately 24 hours submerged in water. It can no longer be revived if submerged more
than that period. In temperate countries, people use to wear woollen clothes. If the body is found in water, the fleas
may be found in the woolen clothings. The fleas recovered must be placed in a watch glass and observed if it is still
living. If the fleas still could move, then the body has been in water for a period less than 24 hours. Revival of the life
of the fleas is not possible if they are in water for more than 24 hours.
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 8. Amount of Urine in the Bladder:
The amount of urine in the urinary bladder may indicate the time of death when taken into consideration, he was
last seen voiding his urine. There are several factors which may modify urination so it must be utilized with caution.
9. State of the Clothings:
A circumstantial proof of the time of death is the apparel of the deceased. If the victim is wearing street clothes,
there is more likehood that death took place at daytime, but if in night gown or pajama, it is more probable that
death occurred at night time.
10. Chemical Changes in the Cerebrospinal Fluid (15 Hours Following Death):
a. Lactic acid increases from 15 mg. to 200 mg. per 100 cc.
b. Non-protein nitrogen increases from 15 to 40 mg.
c. Amino-acid concentration rises from 1 to 12% following death.

11. Post-mortem Clotting and Decoagulation of Blood:

Blood clots inside the blood vessels in 6 to 8 hours after death. Decoagulation of blood occurs at the early stage of
decomposition. The presence of any of these conditions may infer the approximate duration of death.

12. Presence or Absence of Soft Tissues in Skeletal Remains:

Under ordinary condition, the soft tissues of the body may disappear 1 to 2 years time after burial. The
disappearance of the soft tissues varies and are influenced by several factors. When the body is found on the
surface of the ground, aside from the natural forces of nature responsible for the destruction of the soft tissues,
external elements and animals may accelerate its destruction.

13. Condition of the Bones:

If all of the soft tissues have already disappeared from the skeletal remains, the degree of erosion of the epiphyseal
ends of

Medico-legal investigation
Inquest officer – official of the state charged with duty of inquiring into certain matters;
- One charged with the duty of investigating the manner and cause of death of a person;
- Authorized to summon witnesses & direct any person to perform or assist in the investigation when needed
The following officials of the government are authorized to make death investigations:
1. The Provincial and City Fiscals
2. RTC judges
3. Justice of the Peace (now MTC)
4. Director of the National Bureau of Investigation (NBI)
5. Chief of Police of the City of Manila
6. Solicitor General

STAGES OF MEDICO-LEGAL INVESTIGATION

1. Crime scene investigation - place where essential ingredient of the criminal act took place
2. Autopsy – on the body of the victim

The investigator has the earliest possible opportunity to interview persons who have knowledge of the circumstances of
actual events in the commission of the criminal act. The proximity of the narration to the actual occurrence makes it
reliable than those given after a lapse of time.

 Persons to Compose the Search Team:

a. A physician who has had previous knowledge and training in medico-legal investigation must direct the search and
assume responsibility for an effective search.
b. A photographer who will take pictures of the scene and the pieces of evidence recovered. He may also act as sketcher
and measurer.
c. An assistant who will act as the note taker, evidence collector and helper. He must have previous knowledge and
training in evidence collection.

Equipment Needed in Crime Scene Investigation:

a. Those needed in the search of physical evidence — Flashlight and magnifying lens.
b. Those needed in the collection of evidence — forceps, knife, screw driver, scalpel, cutting instruments like plier, pair of
scissors and fingerprint kit.
c. Those needed in the preservation and transportation of evidence collected — Bottles, envelopes, test tubes, pins, thumb
tacks, labelling tag and pencil.

d. Those necessary for the documentation of the scene — Photographic camera, sketching kit, measuring tape, compass,
chalk or any writing instrument.

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Methods of Conducting a Search:
Before the actual performance of the search, it is advisable to stand aside and make an estimate of the situation. A picture
of the whole area must be taken and the area must be cordoned or bystanders must not be allowed to get in. Depending
upon the size, terrain and condition of the crime scene, the following methods of search may be applied:

a. Strip Method — The area is blocked out in the form of a rectangle. The searcher proceeds slowly at the same pace
along the path parallel to one side of the rectangle.
b. Double Strip or Grid Method — The searchers will traverse first parallel to the base and then parallel to the side.
c. Spiral Method — The searchers follow each other in the path in the spiral manner beginning from the center towards
the outside or vice versa.
d. Wheel Method — The searchers gather at the center and proceed outwards along radii or spokes.
e. Zone Method — Whole area is divided into subdivisions or quadrants and search is made in the individual quadrants.

Disposal of the Collected Evidence:

All evidences collected must be protected, identified and preserved. Reasonable degree of care must be exercised to pre-
serve shape, to minimize alterations due to contamination, chemical changes, addition of extreneous substances. In the
process of transferring of the evidences, the number of persons who handle them must be kept at a minimum and each
transfer shouldbe receipted.

Examination of the Dead Body in the Crime Scene:

After a complete search, the investigating physician must make a thorough inspection of the dead body. Special
consideration must be made on the following:
a. Evidences which will tend to prove identity.
b. Position of the victim.
c. Condition of the apparel worn.
d. Approximate time of death.

Provisions of law on death

What are the rules in ordinary presumption of death?
In case of:
1. Disappearance upon or before reaching the age of seventy five (75) years:
a. After an absence of seven (7) years?
The absentee is presumed dead for all purposes except, succession.
b. After an absence of ten (10) years?
The absentee is presumed dead for all purposes including succession.

2. Disappearance at the age of seventy six (76) years or older: a. After an absence of five (5) years?
The absentee is presumed dead for all purposes including succession.
When is the absentee presumed to have died under an ordinary presumption?
At the end of the five, seven or ten year period as the case may be.

Who are presumed dead for all purposes including the division of estate among heirs in case of extraordinary
presumption of death?
1. Person on board a Vessel lost during a sea voyage, or an airplane which is missing, who has not been heard of for four
(4) years since the loss of the vessel or airplane;
2. Person in the Armed forces who has taken pat in war, and has been missing for four (4) years;
3. Person who has been in Danger of death under other circumstances and his existence has not been known for four (4)
years.

Legal presumption of death

RULE 131 Sec. 5 (x), Rules of Court
DISPUTABLE PRESUMPTION – that a person not hear for seven (7) years, is dead.

PRESUMPTION OF DEATH
After an absence of seven years, it being unknown whether or not the absentee still lives, he shall be presumed dead for
all purposes, except for those of succession.
The absentee shall not be presumed dead for the purpose of opening his succession till after an absence of ten years. If he
disappeared after the age of seventy-five years, an absence of five years shall be sufficient in order that his succession may
be opened. (Art. 390, Civil Code and Sec. 5(x), Rule 131, Rules of Court)

The following shall be presumed dead for all purposes, including the division of the estate among the heirs:
14
(1) A person on board a vessel lost during a sea voyage, or an aeroplane which is missing, who has not been heard of for
four years since the loss of the vessel or aeroplane.
(2) A person in the armed forces who has taken part in war, and has been missing for four years:

(3) A person who has been in danger of death under other circumstances and his existence has not been known for four
years. (Art. 391, Civil Code and Sec. 5(x), Rule 131, Rules of Court)

If the absentee appears, or without appearing his existence is proved, he shall recover his property in the condition in
which it may be found, and the price of any property that may have been alienated or the property acquired therewith; but
he cannot claim either fruits or rents. (Art. 392, Civil Code)

When two persons perish in the same calamity, such as wreck, battle, or conflagration, and it is not shown who died first,
there are no particular circumstances from which it can be inferred, the survivorship is presumed from the probabilities
resulting from the strength and age of the sexes, according to the following:

1. If both were under the age of fifteen years, the older is presumed to have survived;
2. If both were above the age of sixty, the younger is presumed to have survived;
3. If one is under fifteen and the other above sixty, the former is presumed to have survived;

4. If both be over fifteen and under sixty, and the sexes be different, the male is presumed to have survived; if the sexes be
the same, then the older;
5. If one be under fifteen or over sixty, and the other between those ages, the latter is presumed to have survived. [Sec.
5(jj), Rule 131, Rules of Court]

If there is a doubt, as between two or more persons who are called to succeed each other, as to which of them died first,
whoever alleges the death of one prior to the other, shall prove the same; in the absence of proof, it is presumed that they
died at the same time and there shall be no transmission of rights from one to the other. [Art. 43, Civil Code]

V. TRAUMA
Definition and types of trauma
trauma [traw´mah] (pl. traumas, trau´mata) (Gr.)
1. injury.
2. psychological or emotional damage. adj., adj traumat´ic.
birth trauma
an injury to the infant during the process of being born. 2. in some psychiatric theories, the psychic shock produced in an
infant by the experience of being born.
psychic trauma a psychologically upsetting experience that produces an emotional or mental disorder or otherwise has
lasting negative effects on a person's thoughts, feelings, or behavior.

Medico-legal aspects of injuries

*Physical injury is the effect of some forms of stimulus on the body. The effect may only be apparent when the stimulus
applied is insufficient to cause injury and the body resistance is great. It may be real when the effect is visible.
*The effect of the application of stimulus may be immediate or may be delayed.

Legal classification of injuries

*Mutilation is the act of looping or cutting off any part or parts of the living body. In order to be punishable under the RPC,
it must be intentional, otherwise it will be considered as a physical injury.
Art. 262, Revised Penal Code
Kinds of Mutilation Punishable Under the Code:
1. Intentionally depriving a person, totally or partially of some of the essential organs for reproduction, and
2. Intentionally depriving a person of any part or parts of the human body other than the organs for reproduction.
"Mayhem " is the unlawful and violent deprival of another of the use of a part of the body so as to render him less able in
fighting, either to defend himself or to annoy his adversary. Mutilation of other parts of the body other than the organ of
reproduction may be classified as mayhem. However, if it is not deliberate then it may fall on paragraph 2, Art. 263, Revised
Penal Code (Serious Physical Injuries).

*Serious Physical Injuries:

Art. 263, Revised Penal Code
The provisions of the preceding paragraph shall not be applicable to a parent who shall inflict physical injuries upon his
child by excessive chastisement.
The crime of serious physical injuries may be due to:
(1) Wounding;
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(2) Beating;
(3) Assaulting (Art. 263); or
(4) Administering injurious substances (Art. 264) without the intent to kill.
It may be committed through a simple negligence or imprudence.
*Administering Injurious Substances or Beverages:
Art. 264, Revised Penal Code:
any person who, without intent to kill, shall inflict upon another any serious physical injury, by knowingly administering to
him any injurious substances or beverages or by taking advantages of his weakness of mind or credulity.
Elements of the crime:
a. The offender inflicted upon another person any serious physical injury
b. The infliction of physical injury was done knowing that the substance or beverage administered is injurious or took
advantage of the victim's weakness or credulity; and
c. There was no intent to kill on the part of the offender.
If the offender does not know that the substance administered is injurious, he cannot be held liable under the above
provision.
The throwing of acid on the face of someone does not fall within the provision because what the provision contemplates is
administering or taking in the injurious substance or beverages

*Less Serious Physical Injuries:

Art. 265, Revised Penal Code:
The basis to determine whether the physical injury is less serious or not is by either the period of medical attendance or
period of incapacity; both of which is ten days or more but not more than thjrty days.
The fact that the injury only requires medical attendance for two days but incapacitated the victim from attending to his
ordinary work for a period of 29 days makes the crime less serious physical injuries
There must be proof as to the period of medical attendance. In the absence of such proof of medical attendance or
incapacity, although the wound actually healed in more than 30 days, the crime committed is only slight physical injuries
The crime of less serious physical injuries may be qualified and a fine or a higher penalty is imposed when:
a. There is a manifest intent to insult or offend the injured person;
b. There are circumstances adding ignominy to the offense;
c. The victim is the offender's parents, ascendants, guardian, curators or teachers; or
d. The victim is a person of rank or person in authority, provided that the crime is not direct assault.

*Slight Physical Injuries and Maltreatment:

Art. 266, Revised Penal Code:
A slight slap on the face or holding tightly the arm of the victim which did not even develop redness of the skin may be a
form of ill-treatment.
If there is no evidence to show actual injury, or incapacity for labor, or period of medical attendance, the accused can only
be guilty of slight physical injuries

*Physical Injuries Inflicted in a Tumultuous Affray:

Art. 252, Revised Penal Code:
Elements of the Crime:
a. There is a tumultuous affray;
b. Participant(s) suffered from serious physical injuries;
c. The person(s) who inflicted such serious physical injuries
cannot be identified; and
d. All those who appear to have used violence upon the person
of the offended party shall be penalized by arresto from five to
fifteen days.

Medico-legal investigation of trauma

1. General Investigation of the Surroundings:
a. Examination of the place where the crime was committed.
b. Examination of the clothing, stains, cuts, hair and other foreign bodies that can be found in the scene of the crime.
c. Investigation of those persons who may be the witnesses to the incident or those who could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime for purposes of preservation.

2. Examinations of the Wounded Body:

a. Examinations that are applicable to the living and dead victim:
(1) Age of the wound from the degree of healing.
(2) Determination of the weapon used in the commission of the offense.
(3) Reasons for the multiplicity of wounds in cases where there are more than one wound.
(4) Determination whether the injury is accidental, suicidal or homicidal.
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b. Examinations that are applicable only to the living:
(1) Determination whether the injury is dangerous to life.
(2) Determination whether the injury will produce permanent deformity.
(3) Determination whether the wound(s) produced shock. (4) Determination whether the injury will produce complication as
a consequence,
c. Examinations that are applicable to the dead victim:
(1) Determination whether the wound is ante-mortem or postmortem.
(2) Determination whether the wound is mortal or not.
(3) Determination whether death is accelerated by a disease or some abnormal developments which are present at the time
of the infliction of the wound.
(4) Determination whether the wound was caused by accident, suicide or homicide.

3. Examinations of the Wound:

The following must be included in the examinations of the wound. The report made in connection with such examination
must also include in detail the following items:
a. Character of the Wound:
The description must first state the type of wound, e.g. abrasion, contusion, hematoma, incised, lacerated, stab wound etc.
It must include the size, shape, nature of the edges, extremities and other characteristic marks. The presence of contusion
collar in case of gunshot wound of entrance, scab formation in abrasion and other open wounds, infection, surgical
intervention, etc., must also be stated.
b. Location of the Wound:
The region of the body where the wound is situated must be stated. It is advisable to measure the distance of the wound
from some fixed point of the body prominence to facilitate reconstruction. This is important in determining the trajectory
or course of the wounding weapon inside the body.
c. Depth of the Wound:
The determination of the exact depth of the wound must not be attempted in a living subject if in so doing it will prejudice
the health or life. Depth is measurable if the outer wound and the inner end is fixed. No attempt must be made in measuring
the stabbed wound of the abdomen because of the movability of the abdominal wall.
c. Condition of the Surroundings:
The area surrounding the wound must be examined. In gunshot wound near or contact fire will produce burning or tattooing
of the surrounding skin. In suicidal incised wound, there may be superficial tentative cuts (hesitation cuts). Lacerated wound
may show contusion of the neighboring skin.
e. Extent of the Wound:
Extensive injury may show marked degree of force applied in the production of the wound. In homicidal cut-throat cases, it
is generally deeper than in cases of suicide. Homicidal wounds are extensive and numerous.
f. Direction of the Wound:
The direction of the wound is material in the determination of the relative position of the victim and the offender when such
wound has been inflicted. The direction of the incised wound of the anterior aspect of the neck may differentiate whether it
is homicidal or suicidal.
g. Number of Wounds:
Several wounds found in different parts of the body are generally indicative of murder or homicide.
h. Conditions of the Locality:
(1) Degree of hemorrhage.
(2) Evidence of struggle.
(3) Information as to the position of the body
(4) Presence of letter or suicide note.
(5) Condition of the weapon.

Classification of wounds:
As to Severity:
a. Mortal Wound — Wound which is caused immediately after infliction or shortly thereafter that is capable of causing death.
Parts of the Body where the Wounds Inflicted are Considered Mortal:
(a) Heart and big blood vessels.
(2) Brain and upper portion of the spinal cord.
(3) Lungs.
(4) Stomach, liver, spleen and intestine.
b. Non-mortal wound — Wound which is not capable of producing death immediately after infliction or shortly thereafter.
As to the Kind of Instrument Used:
a. Wound brought about by blunt instrument (contusion, hematoma, lacerated wound).
b. Wound brought about by sharp instrument:
(1) Sharp-edged instrument~(incised wound).
(2) Sharp-pointed instrument (punctured wound).
(3) Sharp-edged and sharp pointed instrument (stab wound).
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c. Wound brought about by tearing force (lacerated wound).
d. Wound brought about by change of atmospheric pressure (barotrauma).
e. Wound brought about by heat or cold (frostbite, burns or scald).
f. Wound brought about by chemical explosion (gunshot or shrapnel wound).
g. Wound brought about by infection.

As to the Manner of Infliction:

a. Hit — by means of bolo, blunt instrument, axe.
b. Thrust or stab — bayonet dagger.
c. Gunpowder explosion — projectile or shrapnel wound.
d. Sliding or rubbing or abrasion.

As regards to the Depth of the Wound:

a. Superficial — When the wound involves only the layers of the skin.
b. Deep — When the wound involves the inner structure beyond the layers of the skin.
1. Penetrating — one in which the wounding agent enters the body but did not come out or the mere piercing of a
solid organ or tissue of the body.
"Penetrating Wound — Wound where the dimension of depth and direction is an important factor in its description.
It involves the skin or mucous surface and the deeper underlying tissues or organs caused directly by the wounding
instrument. Punctured, stab and gunshot wounds usually belong to this type of wound."
2. Perforating — When the wounding agent produces communication between the inner and outer portion of the
hollow organs. It may also mean piercing or traversing completely a particular part of the body causing communication
between the points of entry and exit of the instrument or substance producing it.

As regards to the Relation of the Site of the Application of Force and the Location of Injury:
a. Coup Injury — Physical injury which is located at the site of the application of force.
b. Contre-Coup Injury — Physical injury found opposite the site of the application force.
c. Coup Contre-Coup Injury — Physical injury located at site and also opposite the site of application of force.
d. "Locus Minoris Resistencia" — Physical injury located not at the site nor opposite the site of the application of force but
in some areas offering the least resistance to the force applied. A blow on the forehead may cause contusion at the region
of the eyeball because of the fracture on the papyraceous bone forming the roof of the orbit.
e. Extensive Injury — Physical injury involving a greater area of the body beyond the site of the application of force. It has
not only the wide area of injury but also the varied types of injury. A fall from a height or a run-over victim of a vehicular
accident may suffer from multiple fractures, laceration of organs, and all types of skin injuries.
When a stationary head is hit by a moving object, there is the tendency for the development of contusion of the brain at
the site of impact.
When the moving head hits a firm, fixed and hard object, brain contusion may develop at the opposite of the site of impact.
A coup-contra-coup location of brain injury may be found when a fixed head is hit with a moving object and then falls on
another hard object.

As to the Regions or Organs of the Body Involved:

The wounds of the different organs and regions of the body will be discussed separately under "Injuries in Various Parts of
the Body.
Type of wounds (medical classification)
Close wound: There is no breach of continuity of the skin or mucous membrane
a.Superficial — When the wound is just underneath the layers of the skin or mucous membrane.
(1) Petechiae - This is a circumscribed extravasation of blood in the subcutaneous tissue or underneath the mucous
membrane.
(2) Contusion - is the effusion of blood into the tissues underneath the skin on account of the rupture of the blood vessels
as a result of the application of blunt force or violence.
(3) Hematoma – is the extravasation or effusion of blood In a newly formed cavity underneath the skin
b. Deep
(1) Musculoskeletal Injuries.
(a) Sprain – Partial or complete disruption in the continuity of a muscular or ligamentous support of a joint. It is usually
caused by a blow, kick or torsion force.
(b) Dislocation – Displacement of the articular surface of bones entering into the formation of a joint.
(c) Fracture – Solution of continuity of bone resulting from violence or some existing pathology.
(d) Strain – The over-stretching, instead of an actual tearing or the rupture of a muscle or ligament which may not be
associated with the joint.
(f) Subluxation – incomplete or partial dislocation
(2) Internal Hemorrhage – rupture of blood vessel which may cause hemorrhage may due to the following:
a.Traumatic intracranial hemorrhage
b. Rupture of parenchymatous organs
c. Laceration of other parts of the body.
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(3) Cerebral Concussion – is the jarring or stunning of the brain characterized by more or less complete suspension of its
functions, as a result of injury to the head, which leads to some commotion of the cerebral substance.
Open wound
1. Abrasion – It is an injury characterized by the removal of the superficial epithelia layer of the skin caused by a rub or
friction against a hard rough surface. (Scratch, Graze, Impression Mark, Friction Mark)
2. Incised – produce by a sharp-edge (cutting) or sharp-linear edge of the instrument like a knife, razor, bolo, edge or oyster
shell, metal sheet, glass etc. (Cut, slash, slice).
3. Stab wound – is produced by the penetration of a sharp-pointed and sharp edge instrument like a knife, saber, dagger,
scissors. If the sharp edge portion of the wounding instrument is the first to come in contact with the skin, the wound is an
incised wound
4. Punctured – is the result of a thrust of a sharp pointed instrument. The external injury is quite small but the depth is to a
certain degree.
5. Lacerated – is a tear of the skin and the underlying tissue due to forcible contact with a blunt instrument. It may be
produced by a hit with a piece of wood, iron, bar , fist blow, stone, butt of firearm, or other objects without a sharp part.

Medico-legal investigation of wounds

1. General investigation of the surroundings:

a. Examination of the place where the crime was committed.
b. Examination of the clothing, stains, cuts, hair, and other foreign bodies that can be found in the scene of
the crime.
c. Investigation of those persons who may be the witnesses to the incident or those who could give light to
the case.
d. Examination of the wounding instrument.
e. Photograph, sketching, or accurate description of the scene of the crime for purposes of preservation.

2. Examination of the Wounded body:

a. Examination that are applicable to the living and dead victim:
i. Age of the wound from the degree of healing.
ii. Determination of the weapon used in the commission of the offense.
iii. Reasons for the multiplicity of wounds in cases where there are more than one wound.
iv. Determination whether the injury is accidental, suicidal or homicidal.
b. Examination that are applicable only to the living:
i. Determination whether the injury is dangerous to life.
ii. Determination whether the injury will produce permanent deformity.
iii. Determination whether the wound(s) produced shock.
iv. Determination whether the injury will produce complications as a consequence.
c. Examination that are applicable to the dead victim:
i. Determination whether the wound is ante-mortem or post-mortem.
ii. Determination whether the wound is mortal or not.
iii. Determination whether death is accelerated by a disease or some abnormal developments which
are present at the time of the infliction of the wound.
iv. Determination whether the wound was caused by accident, suicide or homicide.

3. Examination of the Wound:

The following must be included in the examination of the wound. The report made in connection with such
examination must also include in detail the following terms:

a. Character of the Wound:

i. The description must first state the type of wound.

Ex. Abrasion, contusion, hematoma, incised, lacerated, stab wound, etc.

ii. It must include the size, shape, nature of the edges, extremities and other characteristic marks.
iii. The presence of contusion collar in case of gunshot wound of entrance, scab formation in
abrasion and other open wounds, infection, surgical intervention, etc., must also be stated.

b. Location of the Wound:

The region of the body where the wound is situated must be stated. It is advisable to measure the
distance of the wound from some fixed point of the body prominence to facilitate reconstruction. This is
important in determining the trajectory or course of the wounding weapon inside the body.

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 c. Depth of the Wound:

The determination of the exact depth of the wound must not be attempted in a living subject if in
so doing it will prejudice the health or life. Depth is measurable if the outer wound and the inner end is
fixed. No attempt must be made in measuring the stabbed wound of the abdomen because of the
movability of the abdominal wall.

d. Condition of the Surroundings:

The area surrounding the wound must be examined. In gunshot wound near or contact fire will
produce burning or tattooing of the surrounding skin. In suicidal incised wound, there may be superficial
tentative cuts (hesitation cuts). Lacerated wound may show contusion of the neighboring skin.

e. Extent of the Wound:

Extensive injury may show marked degree of force applied in the production of the wound. In
homicidal cut-throat cases, it is generally deeper than in cases of suicide. Homicidal wounds are extensive
and numerous.

f. Direction of the Wound:

The direction of the wound is material in the determination of the relative position of the victim
and the offender when such wound has been inflicted. The direction of the incised wound of the anterior
aspect of the neck may differentiate whether it is homicidal or suicidal.

g. Number of Wounds:

Several wounds found in different parts of the body are generally indicative of murder or homicide.

h. Conditions of the Locality:

i. Degree of hemorrhage.
ii. Evidence of struggle.
iii. Information as to the position of the body
iv. Presence of letter or suicide note.
v. Condition of the weapon.

Determination whether the wounds were inflicted during life or after death
If the wound indicates that there has been profuse hemorrhage, or there are signs of vital reactions in the tissue,
then the gunshot wound is ante-mortem. The presence and degree of vital reactions depends upon the period of survival
of the victim. It may be manifested in the form of swelling, effusion of lymph or other evidences of repair. Microscopically,
there is congestion and leucocytic infiltration.
Wounds inflicted after death show no evidence of profuse hemorrhage, no retraction of the edges, and there are
no vital reactions.

Points to be considered in determination as to whether the wound is homicidal, suicidal, or accidental

1. External signs and circumstances related to the position and attitude of the body when found.
2. Location of the weapon or the manner in which it was held.
3. The motive underlying the commission of the crime and the like.
4. The personal character of the deceased.
5. The possibility for the offender to have purposely changed the truth of the condition.
6. Other information:
a. Signs of Struggle: Absence of signs of struggle is more in suicide, accident or murder. Contusion or abrasion may indicate
trauma due to fist, finger or feet of the assailant. MEDICO-LEGAL INVESTIGATION OF WOUNDS Presence of hair or portion
of the skin (epidermis) on the nails of the assailant or deceased may be a clue in the determination whether death is suicidal,
homicidal or accidental.
b. Number and Direction of Wounds: Multiple wounds in concealed portions of the body are generally indicative of homicide.
Single wound located in a position that the deceased could have been conveniently inflicted is usually suicidal.
c. Direction of the Wound: This is important in the case of cut-throat. It is generally transverse in case of homicide while it is
oblique in case of suicide.
d. Nature and Extent of the Wound: Homicidal wounds may be brought about by any wounding instrument. Suicidal wounds
are frequent due to sharp instruments. Accidental physical injuries may be of any kind.
e. Stare of the Clothings: There is usually no change in the condition of the clothings in suicide case. In homicidal death, on
account of the struggle which took place before death, the clothings of the victim are in a disorderly fashion.

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Possible instruments used by the assailant in inflicting the injuries
The determination of the wounding instrument may be made from the nature of the wound found in the body of the victim:
1. Contusion — produced by blunt instrument.
2. Incised wound — produced by sharp-edged instrument inflicted by hitting.
3. Lacerated wound — produced by blunt instrument.
4. Punctured wound — produced by sharp-pointed instrument.
5. Abrasion — body surface is rubbed on a rough hard surface.
6. Gunshot wound — the diameter of the wound of entrance may approximate the caliber of the wounding firearm.

Which of the wounds was inflicted first?

In the determination as to which of the wounds present was inflicted first, the following factors must be taken into
consideration:
1. Relative position of the assailant and the victim when the first injury was inflicted on the latter.
2. Trajectory or course of the wound inside the body of the victim.
3. Organs involved and degree of injury sustained by the victim.
4. Testimony of witness.
5. Presence of defense wounds on the victim. If the victim tried to make a defensive act during the initial attack, then the
defense wounds must have been inflicted first.

It is important to determine which of the wounds was inflicted first because it may be necessary for the qualification of the
offense committed. If the first wound was committed in a treacherous way that the victim after receipt is incapable of
defense, then murder is committed, but if fatal wound was inflicted last, it is possible that the crime committed is only
homicide.

Effect of Medical and Surgical Intervention on Death:

If the death of the victim followed a surgical or medical intervention, the offender will still be held responsible for the
death of the victim if it can be proven that death was inevitable and that even without operation, death is normal and a
direct consequence of the injuries sustained. It must be shown that the physician treating the victim must be competent
and that in spite his exercise of care and diligence, still death was the final outcome.

On the other hand, if the victim merely received minor wounds but death resulted on account of the gross incompetence
or negligence of the physician, then the offender cannot be held responsible for the death. The offender can only be made
responsible for the physical injuries inflicted on the victim and the physician must be made to answer for the death.

Gunshot wound

Death or physical injuries brought about by the powder propelled substances may be due to the following:
1. Firearm shot - the injury is caused by the missile propelled by the explosion of the gunpowder located in the cartridge
shell and at the rear of the missile.
2. Detonation of high explosives, as in grenades, bombs and mine explosion. Explosion of the gunpowder inside the
metallic container will cause fragmentation of the container. Each fragment or shrapnel is moving with certain velocity
without any predetermined direction.

1. Firm contact fire- commonly observed on the head characterized by the ff:
i. the wound of entrance is large frequently star shaped
ii. Edged of the wound maybe everted
iii. Entrance wound is blackened by burns, tattooing and smudging
iv. muzzle imprint
v. The bullet may cause a radiating fracture
vi. Fragments of lead and bullet maybe found
2.LOOSE CONTRACT FIRE
i. entrance wound maybe large circular or oval depending upon the angle of approach
ii. abrasion collar or ring is different
iii. Smudging, burning and tattooing are prominent with singeing of the hair
iv. Muzzle imprint maybe seen
v.There is blackening of the bullet tract to certain depth
3. SHORT RANGE FIRE
i. entrance would show inverted edges
ii. if within the flame reach, which is less than 3 inches in ordinary handguns, there is an area of burning
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 iii. smudging is present due to smoke
iv. powder tattooing is present
v.presence of an abrasion ring or collar
4. MEDIUM RANGE FIRE
i. gunshot wound with inverted edges and with abrasion collar is present
ii. no burning effects
iii.smudging maybe present if less than than 30 cm.
iv. gunpowder tattooing is present with a wider area of distribution
v. contact ring is present
5. FAR DISTANCE FIRE
i. circular gunshot wound with abrasion collar
ii. no burning,smudging tattooing
iii. a contact ring is present

DISTINCTION BETWEEN GUNSHOT WOUNDS OF ENTRANCE AND EXIT:

ENTRANCE EXIT
Smaller than the missile due to elasticity of tissues Always bigger than missile
Edges are inverted Everted edges
Oval or round depending upon angle of approach of bullet No definite shape
Contusion collar or contract ring is present due to
Absent
invagination of the skin
Tattooing or smudging maybe present when firing is near Always absent
Underlying tissues do not protrude beyond the skin Protrusion maybe seen

TESTS FOR THE PRESENCE OF POWDER RESIDUES:

1. Paraffin tests or Dermal Nitrate Test- present on the skin of the hand dorsum or site of the wound of entrance. The test
usually gives a positive result even after a lapse of three days or even if hands are subjected to ordinary washing
2. Use of Scanning Electron Microscope with a linked X-ray analyzer- more specific but seldom used because the instrument
is expensive

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