LEGAL MEDICINE

PROF. KAROLINA ERIKA A. BUTED, RCRIM

TOP 5, DECEMBER 2021 CLE
HISTORY OF LEGAL MEDICINE
 IMHOTEP - earliest medico-legal expert; first to record a report of a
murder trial written on a clay tablet; builder of the first pyramid.

 HIPPOCRATES – discussed the lethality of wounds; also known as the

Father of Medicine

 ARISTOTLE – fixed animation of fetus at the 40th day after conception

 NUMA POPILIUS (in Rome) – all women dying during confinement

should immediately be opened to save the child’s life.
HISTORY OF LEGAL MEDICINE
 ANTISTIUS – was the first Police Surgeon or Forensic Pathologist

 JUSTINIAIN – in his Digest, he made that a physician is not an

ordinary witness and that a physician gives judgment rather than
testimony. This led to the reorganization of expert witness in court.

 POPE INNOCENT III – issued an edict providing for appointment of

doctors to the court for determination of the nature of wounds.

 AMBROISE PARE - considered legal medicine as separate discipline

HISTORY OF LEGAL MEDICINE
 PAULUS ZACCHIAS – Father of Forensic Medicine; He
published Questiones Medico Legales, which dealt with the legal
aspects of wound and the first two chapter dealt with the detection
of secret homicide,

 MATHIEU ORFILA – introduced chemical method in toxicology,

Father of Modern Toxicology

 DR. RAFAEL GENARD y MAS – wrote the first medical

textbook, Manual De Medicina Domestica, which includes
pertinent instruction in the practice of forensic medicine.
 
1895 – Medico-legal laboratory was established in the City of Manila
 
1919 – the Department of Legal Medicine and Ethics of the University
of the Philippines was created under Dr. Sixto delos Angeles as the
first chief.
 
1945 – after the liberation of the City of Manila, Criminal Investigation
Division was created with Dr. Mariano Lara as the chief.
 
DR. GREGORIO LANTIN – CA 181 was passed creating the division of
investigation under the DOJ. He was the chief of the medical section.
 
DR. ENRIQUE DELOS SANTOS – RA 157 creating the Bureau of
Investigation. Under this, a medico legal office was created, and he
was the chief.
 
1895 – Medico-legal laboratory was established in the City of Manila
 
1919 – the Department of Legal Medicine and Ethics of the University
of the Philippines was created under Dr. Sixto delos Angeles as the
first chief.
 
1945 – after the liberation of the City of Manila, Criminal Investigation
Division was created with Dr. Mariano Lara as the chief.
 
DR. GREGORIO LANTIN – CA 181 was passed creating the division of
investigation under the DOJ. He was the chief of the medical section.
 
DR. ENRIQUE DELOS SANTOS – RA 157 creating the Bureau of
Investigation. Under this, a medico legal office was created, and he
was the chief.
Legal Medicine = is that branch of medicine which deals with
the application of medical knowledge to the purposes of law
and in the administration of justice.

Forensic Medicine - use of medical science to elucidate legal

problems in general without specific reference or application
to a particular case.

Medical Jurisprudence - a branch of law which concerns with the

aspects of law and legal concepts to medical practice. It includes
rights, duties, and liabilities of physician, patient, and health
institution.
Difference Between Legal Medicine and Medical
Jurisprudence

1. Legal medicine is a branch of

1. Medical jurisprudence is a branch of law
medical science
2. It is a medicine applied to law and
2. It is a law applied to the practice of medicine
administration of justice

3. It emanates from the act of congress, executive orders,

3. It originates from the development administrative circulars customs and usages and decisions
of medical science of tribunals which have relation to the practice of medicine
 

4. it is based on the principle of subordination; that is the

4.It is based on the principle of
duty of the physician to obey the laws in as much as our
coordination; that legal medicine
government is established on the principle of government
coordinate medicine to law and
of laws and not of men and that no one is considered above
justice
the law.
Evidence

 Evidence is the means, sanctioned by the Rules of

the Court, of ascertaining in a judicial proceeding
the truth respecting a matter of fact
Types of Medical Evidence:

 I. Autoptic or Real Evidence:

 This is 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.
 II. Testimonial Evidence:
A physician may be commanded to appear
before a court to give his testimony. While in the
witness stand, he is obligated to answer the question
propounded by the counsel and presiding officer of the
court. His testimony must be given orally and under
oath or affirmation.
a. Ordinary Witness:
A physician: who testifies in court on matters be perceived
from his patient in the course of physician-patient
relationship is considered as an ordinary witness

b. Expert Witness:
A physician on account of his training and experience can
give his opinion on a set of medical facts. He can deduce of
infer something, determine the cause of death, or render
opinion pertinent to the issue and medical in nature.
 III. 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.
 
IV. Documentary Evidence:
A document is an instrument on which is recorded by
means of letters, figures or marks intended to be used for
purpose of recording that matter which may be evidentially
used. The term applies to writings, to words printed,
lithographed, or photographed; to seals, plates or stones on
which inscriptions are cut or engraved; to photographs and
pictures; to maps or plans.
 II.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.
Types of Physical Evidence:
a. Corpus Delicti Evidence- Objects or substance 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
 Law of Multiplicity of Evidence – the greater the
number of similarities and dissimilarities; the greater is
the probability for the conclusion to be correct.
 Comparison – with the use of standard specimen,
evidence under question can be compared in order to
effect identification
 Exclusion – if two or more persons have to be identified
and all but one is yet to be identified, then one whose
identity has not been established may be known by the
process of elimination.
Ordinary Methods of Identification

 Points of identification applicable to living only:

 Characteristics that may easily be changed
 Growth of hair, beard, or mustache
 Clothing
 Frequent place of visit
 Profession
 Body ornament
 Characteristics that may not be easily changed:
 Mental memory
 Speech
 Mannerisms – characteristic movements of the body peculiar to
a person.
 Way of sitting
 Movement of body, hands, facial muscles, expression, and
manner of learning
 Gait – manner of walking or moving on foot
 Gait Line – the straight line connecting the center of the
succeeding steps (measured from heel to heel). It is more or
less in zigzag fashion especially when the legs are far apart
while walking.
 Foot Line – the longitudinal line drawn on each foot mark.
KINDS OF GAIT
 Ataxic Gait – foot is raised high, thrown forward and brought down
suddenly.
 Cerebral Gait – gait associated with staggering movement.
 Cow’s Gait – a swaying movement due to knock-knee.
 Paretic Gait – gait in which steps are short, feet dragged, and legs are held
more or less widely apart.
 Spastic Gait – gait in which legs are held together and more in stiff manner
and the toes to drag and catch.
 Waddling Gait – gait resembling duck.
 Frog Gait – a hopping gait in infantile paralysis.
IDENTIFICATION OF THE
SKELETON
 The oval or round shape of the skull and the less
prominent lower jaw and nasal bone are suggestive
of human remains.
 Thefemale’s pelvic bone is wider and rounder than
the males to permit childbearing.
POINTS TO CONSIDER IN THE DETERMINATION OF
AGE

 pubic hairs: 13 y/o (f) 14 y/o (m);

 mustache & beard: 16 – 18 y/o (m);
 breasts: 13 – 14 y/o (f);
 change in voice: 16 – 18 y/o (m&f);
 menstruation: 11 – 12 y/o (f)
 Hair turns to gray after 40 years old
 Pubic hair may turn gray after the age of 50 yo
BLOOD
 It is the circulating tissue of the body, which refers to a high complex
mixture of cells.
 GLOBIN – kind of protein found in blood
 HEMATIN – organic compound of iron
 HEMOGLOBIN - found in the red blood cells is responsible for the
transporting oxygen to tissues and carbon dioxide to the lung. It is
responsible for the reddish color of the blood.

 The normal amount of hemoglobin for an adult is 14 to 17 grams for

each 100cc of blood.
 THROMBOCYTES – components of the solid part of the
blood that assist in the clotting process.
 ERYTHROCYTES – they carry the supply of oxygen
throughout the body
 LEUKOCYTES – they serve as the fighting mechanism of the
body against unwanted foreign microorganisms.

 SEROLOGY – a science which deals with the study of human

body fluid, which is the result of secretion and excretion.
BLOOD EXAMINATION
 PRELIMINARY TEST – determine whether the stain contains blood
or another substance.

 CONFIRMATORY TEST – test that positively identifies blood

 PRECIPITIN TEST – determines whether blood is a human or non-

human origin, and if not human, the specific animal family from which
it originated.

 BLOOD GROUPING TEST – determines the blood group of humans

CHEMICAL EXAMINATION
 Salineextract of the bloodstain plus ammonia will give a
brownish tinge due to the formation of alkaline hematin.
 Benzidine Test – positive result: blue (1:300,000 dilution)
 Guaiacum Test (Van Deen’s Dya’s or Schombien’s Test) –
positive result: blue (1:50,000)
 Phenolphthalein Test (Kastle-Meyer Test) – positive result:
pink color (1:80,000 dilution)
 LEUCOMALACHITE GREEN TEST by Alder – positive
result: peacock blue or bluish green.
MICRO CHEMICAL TESTS FOR BLOOD

 HEMOCHROMOGEN CRYSTAL OR TAKAYAMA

TEST – positive result: Salmon color to dark brown and
pink
 TEICHMANN’S OR HEMIN CRYSTAL TEST -
positive result: dark brown rhomboid crystals
 ACETONE HEMIN OR WAGENHAAR TEST –
positive result will show small, dark, dichroic acicular
crystal of acetone haemin are seen.
THE HAIR
Parts of shaft:
 Cuticle – outer layer of the
hair
 Cortex/Middle Layer –
consists of longitudinal fibers
bearing the pigment.
 Medulla/Core – contains air
bubbles and some pigments
MEDULLA INDEX

 Relationship of the features of the medulla with the

diameter of hair
 Humans have smaller MI than animals
 Tooth Eruption Periods:
 TEMPORARY: 0.5 – 2 y/o (m & f);
 PERMANENT: 6 – 18 y/o (m & f).

 Number of Bones:
 CHILD: 200 pieces (m & f);
 ADULT: 206 pieces (m & f);
 Source of the additional six (6) bones: 3 pairs of
ossicles or tiny bones found in both middle ears.
 
SEMEN AND SEMINAL STAINS

 Semen is a viscid, gelatinous, sticky, whitish fluid, which

has a fish-like odor and is slightly alkaline. It is ejaculated
by male species and appears grayish white in color.
 Seminal fluid contains certain substance called flavins
which help give a yellowish color to semen and cause it to
fluoresce under UV lights.
TYPES OF EXAMINATION CONDUCTED FOR SEMEN
AND SEMINAL STAINS

 PHYSICAL EXAMINATION – it is also visible to the

UV rays, and it exhibit bright bluish fluorescence.

 MICROSCOPIC EXAMINATION – detect the presence

of spermatozoa
 Theonly specific test for semen is the identification of a
sperm cell under the microscope
 FlorenceTest – it has the characteristics and a formation of
choline periodide crystals which are observed under the
microscope
 Barberio’s test – it appears as slender, yellow-tinted
rhomboid needles with obtuse angles almost the same as the
Florence test result.
 Acid Phosphate test – is an enzyme found in both animal
and plant cells, but in large concentration of human cells.
 P30 test – a test conducted using a protein called P30.
Medico-Legal Aspects of Death

 Life – is the sum of all vital processes by which the

physical integrity of the body is maintained.

 Death- is the state of complete persistent cessation of the

vital function of the body such as the function of the heart,
the lungs and the brain.
B. Kinds of Death
Clinical Death or Somatic Death
 there is a complete, persistent, and continuous cessation of the vital
functions of the brain, heart, and lungs which maintains life and health.

Molecular or Cellular Death

 Is the type of death characterized by death of individual cells (one at a
time) after the somatic death.

Apparent Death/ State of Suspended Animation

 A transient loss of consciousness of temporary cessation of the vital
function of the body on account of disease, external stimulus other forms
of influence.
Signs of Death
 Cessation of Respiration
• Cessation of respiration in order to be considered as a sign
of death must be continuous and persistent.
• A person can hold his breath for a period of no longer than
3 – ½ minutes.
• In case of electrical shock, respiration may cease for some
time but maybe restored by continuous artificial
respiration.
Methods of Detecting Cessation of Respiration:
• Expose the chest and abdomen and observe the movement during
inspiration and expiration.


Examine the person with the aid of stethoscope which is placed at the
base of the anterior aspects of the neck and hear sound of the current
of air passing through the trachea during each phase of respiration.


Examination with a Mirror



Examination with a Feather or Cotton Fibers



Examination with a glass of water



Winslow’s test
 Cessation of Heart and Circulation
• There must be an entire and continuous cessation of the heart action
and flow of blood in the whole vascular system.
• As a general rule, if there is no heart action for a period of five minutes
death is regarded as certain.

 Methods of Detecting the Cessation of heart Action and circulation:

A. Examination of the heart:
 Palpation of the pulse and heartbeat.
 Auscultation with the aid of stethoscope or placing the ear at the
    region of the heart.
. Examination of the Peripheral Circulation:
Magnus’ Test – ligature is applied in the finger with moderate
tightness
Icard’s test – by application of injection of a solution of fluorescence
subcutaneously. If dead, the solution will just remain at the site of
the injection
Pressure on the fingernails
Diaphanous Test – fingers are spread wide and finger webs are
viewed through a strong light.
Application of heat on the skin – a dead man will not produce blister
Palpation of the radial pulse
Dropping of Melted Wax
