Dr. Marvin V.

Isidro

LEGAL MEDICINE
LEGAL MEDICINE

 A branch of medicine which deals with the

application of medical knowledge for the
purposes of law or simply put, medicine
applied to legal cases.
 Synonymous with Forensic medicine
although strictly speaking, refers to the use of
medical science to elucidate legal problems.
Functions

1. Perform autopsy to determine the cause,

manner, mechanism of death.
2. Perform examination of human skeletal
remains to determine the sex, age, race, and
body built in order to establish the identity
and to determine the cause of death.
3. Conduct exhumation of human remains.
4. Perform physical examination on victims of
physical injuries.
Functions (cont.)

5. Perform genital and extra-genital

examinations on victims of sexual abuse.
6. Perform physical examination on suspects
prior to detention or release.
7. Perform forensic odontology examinations
8. Perform histopathological examination.
9. Perform serological and microbiological
examinations.
Functions (cont.)

10. To conduct DNA Analysis and paternity

determination.
11. Psychiatric evaluation.
Medico-legal Investigation
A. CRIMINAL INTERROGATION
- good observer
Physiological and
Psychological Symptoms of
Guilt
 Sweating
 Colour change
 Dryness of the mouth
 Excessive activity of Adam’s apple
 Fidgeting
 “Peculiar Feeling Inside”
Signs of Guilt (cont’d)
Swearing
Spotless Past record
Inability to look at the investigator “straight in
the eye”.
“Not that I remember” expression
Different Types of Criminal
Offenders
 Based on Behavioural Attitude

a. Active Aggressive Offenders

- impulsive manner

b. Passive Inadequate Offenders

- because of inducement, promise or
reward
Criminal Offenders (cont.)

 Based on State of Mind

a. Rational Offenders
- those who commit crime with motive or
intention and with full possession of their
mental faculties.

b. Irrational Offenders
- they don’t know the nature and quality
of his act. Ex. Mad killer
Criminal Offenders (cont.)

 Based on Proficiency

a. Ordinary
- lowest form of criminal career

b. Professional Offenders
- highly skilled
ex. Pickpockets, shoplifters
Criminal Offenders (cont.)

 Psychological Classification
a. Emotional
- in the heat of passion, anger
- with sense of moral guilt
b. Non-emotional
- for financial gain
- usually repeaters
- sympathetic approach ineffective
Some Techniques of
Interrogation
 Emotional Appeal
- sympathetic and friendly to the subject
 Mutt and Jeff Technique
- Mutt-arrogant
- Jeff- friendly, kind
 Bluff on Split-pair technique
 Stern approach
 Time-consuming narration
Medico-legal Investigation
(cont.)
A. CRIMINAL INTERROGATION
B. DECEPTION DETECTION
B. Deception Detection

1. Lie Detector Test

2. Administration of Truth Serum
3. Narcoanalysis or Narcosynthesis
4. Intoxication with Alcohol
5. Hypnosis
Lie Detector Test

 Records physiologic
changes.
 It is the fear of
detection which allows
detection.
 Changes occur within
the body that could be
recorded by a
polygraph machine
and evaluated by the
polygraph.
Lie Detector Test (cont.)

 Phases of Examination:
a. Pre-test interview
- informal interview (20-30 mins.)
- to determine whether subject has any
medical or psychiatric condition
- to develop the test questions
Lie Detector Test (cont.)

 Phases of Examination (cont.):

b. Actual Interrogation and Recording
- irrelevant questions to get normal
pattern of response
-relevant questions
-control questions
c. Post test
-to clarify findings
-to obtain additional information
Lie Detector Test

 Phases of Examination
d. Supplementary test
- Peak of Tension test
- Guilt Complex test
- Silent answer test
Administration of Truth Serum

 Hyoscine
hydrobromide
 Acts as depressant on
nervous system
Narcoanalysis / Narcosynthesis

 Sodium amytal or
sodium pentothal
 depressant
Intoxication with Alcohol

 In Vino Veritas
 In wine there is Truth
 Excitatory state start
questioning
 Depressive state
Hypnotism

 Alteration of
consciousness and
concentration
 Not all are hypnotized
 Non admissible
IDENTIFICATION OF PERSONS
Importance
“Law of Multiplicity of Evidence”
Ordinary method in Identification
Scientific method of Identification
Anthropometry (Bertillon’s system)
Fingerprinting
Importance of Identification

1. In the prosecution of a criminal offense, the

identity of the offender and that of the
victim must be established, otherwise it will
be a ground for dismissal of the charge or
acquittal of the accused.
2. The identification of a person missing or
presumed dead will facilitate settlement of
the estate, retirement or insurance.
Importance (cont.)

3. Identification resolves the anxiety of the

next of kin, other relatives and friends as to
the whereabouts of a missing person or
victim of calamity or criminal act.
4. Identification may be needed in some
transactions.
ex. Entering a premise, encashment of
checks etc.
Law of Multiplicity of
Evidence

The greater the number of points of

similarities and dissimilarities of two persons
compared, the greater is the probability for
the conclusion to be correct.
Ordinary Methods of
Identification- LIVING ONLY
Characteristics EASILY Characteristics NOT EASILY
changed changed
 Growth of hair, beard or  Mental memory
moustache  Speech
 Clothing  Gait
 Frequent place of visit  Mannerism
 Hands and feet
 Grade of profession
 Complexion
 Body ornamentations
 Changes in the eyes
 Facies
 Left or right handedness
Ordinary methods applicable
to BOTH LIVING and DEAD
 Occupational marks
 Race
 Stature
 Tattoo marks
 Weight- not good, easily changed
 Deformities- harelip, cleft palate
 Birth marks
 Injuries leaving permanent results- amputation
 Moles
 Scars- burns
 Tribal marks- branding
 Blood examination-paternity disputes
 Sexual organ- circumcision, previous operation
Stature

 Measure the distance between the tips of the

middle fingers of both arms with the arms
extended laterally and it will approx the
height.
 Two times the length from the vertex of the
skull to the pubic symphysis is the height.
 Eight times the length of the head is
approximately equal to the height of the
person.
Anthropometry Bertillon System

 Alphonse Bertillon,
French Criminologist
 Based on
anthropometrical
measurements
Anthropometry (cont.)

Basis:
a. Human skeleton does not change after 20
years.

b. It is impossible for 2 human beings to have

bones alike.

c. Measurement easily taken with the aid of

simple instrument
Anthropometry (cont.)
-1903 Will West
- 1901 William
West
- almost
identical
except
fingerprints
Scientific Methods of
Identification
 Fingerprinting
 Dental identification
 Handwriting
 Identification of skeleton
 Determination of Sex
 Determination of Age
 Identification of Blood and Blood stains
Fingerprinting

 There are no two

identical fingerprints.
 Formed in the fourth
(4th) month of
pregnancy
 Not affected by
physical growth,
damage, wounds and
burns
Fingerprinting (cont.)

 Dactylography – art and study of recording

fingerprints as a means of identification.
 Dactyloscopy- art of identification by
comparison of fingerprints
 Poroscopy (Locard’s method of Identification)
- study of the pores found on the papillary
ridges.
- applied when only a part of the
fingerprint is available for identification.
Methods of producing
impression
Plain Method Rolled Method
Advantages of Fingerprinting

 Not much training is necessary in taking,

classifying and comparing fingerprints.
 No expensive instruments.
 The system itself is easy to classify.
 Actual prints are always available for
reference and suspected errors can easily be
checked.
DENTAL IDENTIFICATION

 Possibility of two persons to have the same

dentition is remote.
 Enamel is the hardest substance of the
human body.
 After death, the greater the degree of tissue
destruction, the greater importance of dental
characteristics.
 Somewhat unreliable dental records in the
Philippines.
HANDWRITING IDENTIFICATION

 Bibliotics- science of handwriting analysis.

 Graphology- study of handwriting for
purpose of determining the writer’s
personality, character, aptitude etc.
- pseudo-science
Handwriting (cont.)

Movements in Writing:
1. Finger movement- illiterates
2. Hand movement – wrist as center of action/
illegible and scratchy
3. Arm movement- elbow as center of action/
beautiful writings written this way
4. Whole arm movement- shoulder as center of
action/ blackboard
SKELETON IDENTIFICATION

1. Identification and examination of skeleton

2. Determination of sex, race, age, height from
the skeleton.
3. Determination of plurality or missing bone
4. Determination of ante or post mortem
bones or teeth.
5. Identification of hair and other fibers.
6. Identification of sex, age in living person.
SEX DETERMINATION
Tests to determine sex

 Social test
 Genital test
- penis , vagina
 Gonadal test
- testes, ovary
 Chromosomal test
- Barr bodies
- stains deeply in nucleus
of females only
A. Presumptive evidence

Female Male
 Hips broader than  Shoulders broader than
shoulders hips
 Breasts developed  Not (gynecomastia)
 Adam’s apple not  Adam’s apple prominent
prominent
 Striae present  Striae absent
 Hair absent on face  Hair present on face
abdomen and chest abdomen and chest
Highly probable evidence

 Possession of vagina, uterus in females and

penis in males
 Developed and large breasts in females
 Muscular development and distribution of fat
in the body
Conclusive evidence of sex

 Ovary in females
 Testes in males
FETUS- determination of age
Less than 25cm long
 Find the square root of the
length in centimeters and
the result is the age of the
fetus in months
For 25cm or longer
 Divide the length of the
fetus in centimeters by five
(5) and the result is the age
of the fetus in months
 Ex. Fetus is 40cm
= divide by 5
= 8 months of age
* Lunar month= 28 days
PHYSICAL INJURIES
Physical violence
Heat or cold
Electrical energy
Chemical energy
Physical Violence

CLASSIFICATION OF WOUNDS:
1. As to severity
a. Mortal wound
b. Non-mortal wound
2. As to the kind of instrument used
 Blunt instrument (contusion, hematoma,
lacerated wound)
Physical violence (cont.)
 Wound brought by SHARP instrument
(1) sharp-edged (incised)
(2) sharp pointed (punctured)
(3) sharp edged and sharp pointed (stab)
 Wound by TEARING force ( lacerated
wound)
 Wound by HEAT or COLD (frostbite,
burns, scald)
 Wound by CHEMICAL explosion
(gunshot or shrapnel)
Physical injuries (cont.)

 As regards to DEPTH of the wound

a. Superficial
b. Deep
1.Penetrating- wounding agent pierced a
solid organ
2. Perforating- communication between
the inner and outer
portion of hollow organs
Physical injuries (cont.)

 SPECIAL types of wounds:

a. Defense wounds
b. Patterned wound
c. Self-inflicted wound
1. Magnify an existing injury
2. To escape certain obligations /punishment
3. To create new identity/ create new one
4. To gain attention or sympathy
5. Psychotic behaviour
TYPES OF WOUNDS
1. Closed Wounds (2) Internal hemorrhage
a. Superficial (3) Cerebral Concussion
(1) Petechiae
(2) Contusion 2. Open Wounds
(3) Hematoma a. Abrasion
b. Deep b. Incised wound
(1) Musculo-skeletal c. Stab wound
-sprain d. Punctured
-dislocation e. Lacerated
-fracture
-strain
-subluxation
CLOSED WOUNDS

 Petechiae
- this is circumscribed
extravasation of blood
in the subcutaneous
tissue or underneath
the mucous membrane
CLOSED WOUNDS (cont.)

 Contusion
- 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 trauma.
CLOSED WOUNDS (cont.)

 Hematoma
- extravasation of
blood in a newly
formed cavity
underneath the skin.
Musculo-skeletal Injuries
1. Sprain
2. Dislocation
3. Fracture
a. Closed or simple
b. Open or compound
c. Comminuted
4. Strain
5. Subluxation
MUSCULO-SKELETAL Injuries

 Sprain-partial or complete disruption in the

continuity of a muscular or ligamentous
support of a joint.
 Dislocation- displacement of the articular
surface of bones entering into the formation
of a joint.
 Fracture-break in the continuity of the bone
resulting from violence or existing pathology.
Fracture (cont.)

1. Closed or Simple- no
break in the
continuity of the skin.
2. Open or Compound-
fracture is
complicated by an
open wound.
3. Comminuted-
fragmented into
several pieces.
OPEN WOUNDS

 Abrasion
-superficial removal of
epithelial layer of skin.
Forms of Abrasion:
-Linear
-Multi-linear
-Confluent
-Multiple
OPEN WOUNDS

 Incised wounds
-produced by sharp-
edged instruments
-clean-cut, slice, cut,
slash
-suicidal, homicidal,
accidental
Incised Wounds
Suicidal
 Direction oblique, above
Adam’s apple
 Severity is not so deep
 Superficial cuts usually
present
 Blood found in front of
body. Hand smeared with
blood.
 Weapon firmly grasped
Homicidal
 Horizontal below the
Adam’s apple
 Usually deep
 Practically absent
 Blood found at the back of
neck
 Weapon is absent
Incised Wounds (cont.)
OPEN WOUND (cont.)

 STAB WOUND
-Sharp-pointed and
sharp-edged instrument
like dagger, knife,
scissors
-hemorrhage is always
the most serious
consequence .
-suicidal, homicidal,
accidental- are quite rare
STAB WOUND
OPEN WOUND (cont.)

 PUNCTURED
Wound
-sharp-pointed
instrument
-usually accidental, can
also be suicidal and
homicidal
OPEN WOUND (cont.)

 LACERATED
Wound
-caused by blunt
instruments.
-tear, rupture, “putok”
-rough, irregular edges
-hair bulbs preserved
-healing is delayed
Physical Injuries to the
Different Parts of the Body
 HEAD and NECK
Cranium
- Direct or Coup
- Contre coup
- Remote
- Locus Minoris
Resistencia
GUNSHOT WOUNDS
Characteristics
Wound of Entrance
Wound of Exit
GUNSHOT WOUND

 CONTACT or NEAR
FIRE
- entrance is inverted
- abrasion collar distinct
- burning tattooing with
singeing of hair
- muzzle imprint may be
seen
- carboxyhemoglobin
present
GUNSHOT WOUND (cont.)

 NEAR CONTACT
- entrance wound
inverted
-tattooing present
(dense and limited
spread)
-abrasion ring present
-burning present if
within flame reach
GUNSHOT WOUNDS (cont.)

 MORE THAN 60cm

- circular or oval
depending on angle of
approach
- entrance has no
burning, tattooing or
smudging
- abrasion
collar/contact ring
present
GUNSHOT WOUND (cont.)
Entrance Exit
 Smaller than missile  Bigger than missile
 Inverted edge  Everted edge
 Round or oval shape  No definite shape
 Contact ring present  Absent
 Tattooing in contact and  Absent
near present
 Protrusion absent  May be present
 Paraffin positive in contact  Absent
or near fire
Gunshot is SUICIDAL

 Accessible to the hand

 Usually solitary shot
 Muzzle in contact with the part of the body
involved or at close range
 Death weapon found near victim or grasped
in hand
 In a closed or locked room, no disturbance,
may reveal suicide note
 Personal history
Gunshot is HOMICIDAL

 Wound of entrance has no point of election

 Usually at some distance from assailant
 Signs of struggle may be present
 Wounding firearm not found in the scene
 Testimony of witnesses
Gunshot is ACCIDENTAL

 Usually there is but one shot

 No special area in the body involved
 Testimony of witnesses
Gunshot wound (cont.)
THERMAL INJURIES
I. Death or Injury from Cold
II. Death or Injury from Heat
A. General/ Systemic Effects
a. Heat cramps
b. Heat exhaustion
c. Heat stroke
B. Local Effects
a. Scalds
b. Burns
(1) Thermal
(2) Chemical
(3) Electrical and Lightning
(4) Radiation
Thermal Injuries

I. COLD
- frostbite,immersion
foot,trench foot
Thermal Injuries

II. Heat
A. General /Systemic
1. Heat cramps-due to dehydration and loss
of chlorides, does not end fatally
2. Heat exhaustion-due to heart failure,
warm clothing
3. Heat stroke- ill ventilated places or direct
exposure to the sun, may cause death
Thermal burns (cont.)
B. Local Effects
1. Scalds- caused by hot liquids
-”geographical lesion”
2. Burns
a. Thermal- dry heat
b. Chemical- corrosive burns, acids
c. Electrical
Heat stiffening- “pugilistic” position of a
boxer
-found in dead bodies subjected to heat
Electrical burn Scalding burn
ASPHYXIA

- Normal exchange of respiratory gases is

impaired due to interference in respiration.
- Two main classes of Asphyxia:
- 1. Respiratory obstruction
- 2. Circulatory arrest
In both of these, there is hypoxia, reduction in
oxygen content of blood and hypercapnea,
elevation of carbon dioxide content.
Asphyxia

A. Asphyxia by
HANGING
B. Asphyxia by
STRANGULATION
1. By Ligature-
compression of the
neck tightened by a
force other than the
weight of the body
Asphyxia (cont.)

2. Manual strangulation or Throttling

- constricting force applied in the neck is the
hand.
a. Suicidal throttling is not possible.
b. Accidental throttling may occur but the
victim never dies of asphyxia but from some
other cause.
c. Homicidal throttling is the most common.
- the method of choice in Infanticide.
Asphyxia (cont.)

3. Special forms of Strangulation

a. Palmar strangulation
b. Garroting- ligature or metal band is
tightened at the back
c. Mugging (strangle-hold)
4. Suffocation
a. Smothering
b. Choking
Asphyxia (cont.)

5. Asphyxia by Drowning
-” cutis anserina” or goose-skin or goose-flesh
-” washerwoman’s” hands and feet
- “champignon d’ocume”- whitish foam in the
mouth and nostrils. One of the indicators that
death was due to drowning.
-”tete de negri”- bronze color of the head and
neck during decomposition
Tete de Negri
THANK YOU!!!
Capabilities

1. Autopsy 6. Serological
2. Exhumation examination
3. Physical examination 7. DNA examination
4. Skeletal remains 8. Lectures/
exam Demonstrations/
Seminars
5. Histopathological
examination 9. Court duties
10. Scene of the crime
operations (SOCO)