Prof.

Roberto Magbojos
Chapter 1
• Legal medicine – is a branch of
medicine which deals with the
application of medical knowledge to the
purpose of law and in the
administration of justice.
Legal medicine has a similar meaning as
the term forensic medicine.
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 ( juris – law,
prudentia – knowledge). It concerns with
the study of the rights, duties and
obligation of medical practitioner.
A physician who specializes or is involved
primarily with medico legal duties is known
as medical jurist. (medical examiner, legal
officer, medico legal expert).
1. Health officer
2. Medical officer of law enforcement agencies
3. Members of the medical staff of accredited
hospital are authorized by law to performed
autopsies. (Sec. 95, PD 856, code of
sanitation).
Law – is a rule of conduct just,
obligatory, laid by legitimate power for
common observance and benefits.
Forms of law:
a. Written or statutory law (lex scripta) –
this is composed of laws which are
produced by the countries legislations
and which are defined, codified and
incorporated by the law making body.
Example: laws of the Philippines.
b. Unwritten or common law (lex non
scripta).
this is composed of unwritten laws
based on immemorial customs and
usage.
Example: laws of England.
• Forensic - denotes anything belonging
to the court of law use in court or
legal proceedings or something fitted
for legal or public argumentations
(Black's Law dictionary, 4th ed.)
• Medicine – is a science and art dealing
with the prevention, cure and
alleviation of disease.
• Legal – is that which pertains to law,
arising out of, by virtue of included in
law.
• Jurisprudence – it is a practical science
which investigates the nature, or the
development and function of law.
 Branches of Law
Civil Law

Criminal Law

Remedial Law

Special Laws
Branches of Law Where Legal Medicine
maybe Applied.
1. Civil Law – is a mass of precepts that
regulates the relation of assistance,
authority between members of a family
and those which members of a society for
the protection of private
2. Criminal Law – is that branch or division
or law which defines crimes, treats of
their nature and provides for their
punishment.
3. Remedial Law – is that branch or division
of law which deals with the rules
concerning the pleadings, practices and
procedures in all courts if the Philippines.
4. Special Laws:
a. Dangerous Drug Act (R.A. 6425, as
amended)
b. Youth and Child Welfare Code (P.D.
603)
c. Insurance Law (Act No. 2427 as
amended)
d. Code of Sanitation (P.D. 856)
e. Labor Code (P.D. 442)
f. Employees Compensation Law
BRIEF HISTORY OF
LEGAL MEDICINE
1. IN WORLD WIDE SCALE
Imhotep – the earliest recorded
medical expert (2980 B.C.) he was
the chief physician and architect
of King Zoser of the third dynasty
in Egypt and the builder of the
first pyramid. That time was the
first recorded report of a murder
trial written on clay tablet.
Code of Hammurabi – 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 in
40th day after conception.
Numa Pompilius – that bodies
of all women dying during
confinement should be
immediately be opened in
order to save the child's life
was promulgated during the
reign of Numa Pompilius in
Rome.
Antistius – the first "police
surgeon" or forensic pathologist.
Julius Caesar (100 – 44 B.C.) was
murdered and his body was
exposed in the forum and
Antistius performed the autopsy.
Justinian – (483 – 565 A.D.) in his
Digest, mention that a
physician is not an ordinary
witness and that a physician
gives judgment rather than
testimony.
Pope Gregory IX – in 1234
caused the preparation of the
Nova Compilatio Decretalium
which concerned medical
evidence , marriage, nullity,
impotence, delivery, caesarian
section, legitimacy, sexual
offenses, crime against
persons and witchcraft.
Pope John XXII – in 14th century
expressed the need of experts
in the ecclesiastical court, in the
diagnosis of leprosy and many
medico legal documents.
Pope Innocent III
Ambroise Pare – in 1557
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.
Paulus Zacchias (1584 – 1659) –
a papal physician and the
“father of forensic
medicine“.
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.
Severin Pineau –
In 1598published in Paris a
work on virginity and
defloration.
Orfila - (1787 – 1853) introduced
chemical methods in
toxicology,. He was consider
later as the “founder of modern
toxicology“.
 IN THE PHILIPPINES
Dr. Rafael Genard y Mas - made the
“Manual de Medicina Domestica“
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.
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.
 In 1919, UP created the Dept.
of Legal Medicine and Ethics
with Dr Sixto delos Angeles as
the chief. With a salary of
4000 pesos per annum.
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.
July 4, 1942 – Pres. Jose P. Laurel
consolidated by executive order all
the different law enforcing agencies
and created the Bureau of
Investigation on July 8 1944.
June 28 , 1945 – the Division of
Investigation under the Department
of Justice was reactivated.
June 19, 1947 – Republic Act. No.
157 creating the Bureau of
investigation was passed. Under
the bureau a Medico Legal
Division was created with Dr.
Enrique V. de los Santos as the
chief.

Cirujano Ministrante – in remote

places where the services of a
physician was not available a
“Cirujano Ministrante“ may
perform medico legal work.
 Evidence

 Autoptic or Real Evidence

 Testimonial Evidence

 Documentary Evidence

 Physical Evidence
MEDICAL 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.
Autoptic or Real Evidence:
this is an evidence made known or
addressed to the senses of the
court. It is not limited to that
which is known through the
senses of vision but is extended to
what the sense of hearing, taste,
smelling and touch perceive.
Testimonial Evidence:
A physician maybe commanded to
appear
before a court to give his testimony.
His testimony must be given orally
and under oath or affirmation.
Ordinary Witness:
A physician who testifies in court on
matters be perceive from his
patient in the course of physician-
patient relationship is considered as
an expert witness.
Expert Witness:
A physician on account of his
training and experience can give his
opinion on a set of medical facts.
Documentary Evidence:
A document is an instrument
on which is recorded by
means of letters, figures or
marks intended to be used
for the purpose of recording
that matter which may be
evidentially used.
Medical Documentation Evidence
may be:
a. Medical Certification or Report on:
1. Medical examination.
2. Physical examination.
3. Necropsy (autopsy).
4. Laboratory.
5. Exhumation.
6. Birth.
7. Death.
 Corpus Delicti Evidence

 Associative Evidence

 Tracing Evidence
Types of Physical Evidences
a. Corpus Delicti Evidence – objects
or substances in which may
be a part of the body of the
crime.
b. Associative Evidence – these are
physical evidences which link
a suspect to the crime.
c. Tracing Evidence – these are
physical evidences which
may assist the investigator in
locating the suspect.
Sketching
If no scientific
apparatus to preserve
evidence is available then
a rough drawing of the
scene or object to be
preserve is done. It must
be simple, identifying
significant items and with
exact measurement.
Kinds of Sketch

a) Rough Sketch – this is made at

the crime scene or during
examination of living or dead
body.

b) Finished Sketch – a sketch

prepared from the rough
sketch for court presentation.
Kinds of Evidence Necessary for
Conviction
1. Direct Evidence:
That which proves the in
dispute without the aid of
any inference or
presumption.
2. Circumstantial Evidence:
the proof of fact or facts from
which, taken either singly or
collectively, the existence of
a particular fact in dispute
may be inferred as a
necessary or probable
consequence.
Chapter III
MEDICO LEGAL ASPECTS OF
IDENTIFICATION

Methods of Identification:
1. By comparison – identification criteria
recovered during investigation are
compared with records available in
the file or post – mortem investigation
findings are compared with ante –
mortem records.
2. By exclusion – if two or more persons
have to be identified and all but one is
not yet identified, then the one whose
identity has not been established may
be known by the process of
elimination.
ORDINARY METHODS OF
IDENTIFICATION
 Growth of hair, beard or mustache

 Clothing

 Frequent place of visit

 Grade of profession

 Body ornamentations
ORDINARY METHODS OF
IDENTIFICATION
a. Growth of hair, beard or mustache –
this may easily shaved or grown
within a short time.
b. Clothing – a person may have
special preference for certain form,
texture, or style.
c. Frequent place of visit – a person
may have a special desire or habit
to be in a place if ever he has the
opportunity to do so.
d. Grade of profession – a medical
student of the upper clinical year
may be recognized by the
stethoscope; a graduate or student
nurse by her cap, a mechanic by his
tool, a clergyman by his robe, etc.

e. Body ornamentations – earrings,

necklaces, rings, pins, etc. usually
worn by persons may be points to
identify from the rest.
Gait

A person, on account of
disease or some inborn
traits, may show a
characteristic manner of
walking.
Gait
1. Ataxic gait
2. Cerebellar gait
3. Cow‘s gait
4. Paretic gait
5. Spastic gait
6. Festinating gait
7. Frog gait
8. Waddling gait
1.Ataxic gait – in which the foot is
raised high, thrown forward and
brought down suddenly is seen in
persons suffering from tabes
dorsalis.
2.Cedrebellar gait – a gait associated
with staggering movement is seen
in cerebellar diseases.
3.Cow's gait – a swaying movement
due to knock-knee.
4.Paretic gait – gait in which the steps
are short, the feet are dragged and
the legs are held more or less
widely apart.
5. Spastic gait – a gait in which the
legs are held together and move in
a stiff manner and the toes
dragged.
6. Festinating gait – involuntary
movement in short accelerating
steps.
7. Frog gait – a hopping gait
resulting from infantile paralysis.
8. Waddling gait – exaggerated
alteration of lateral trunk
movement similar to the
movement of the duck.
Examples of Gait
Gait Patterns
A scientific investigation of
the gait pattern may be useful for
purposes of identification and
investigation of the crime scene.

Gait pattern is the series of foot

marks by a person walking or
running.
Gait patterns

a. Direction line
b. Gait line
c. Foot line
d. Foot angle
e. Principal angle
f. Length of step
g. Breadth of step
f. Length of step – the distance between
the center points in two successive heel
prints of the two feet exceeds 40 inches,
there is a string presumption that the
person is running.

g. Breadth of step – the distance between

the outer contours of two succeeding
foot marks or steps.
Mannerism
Stereo type movement or
habit peculiar to an individual. It
may be:
1. Way of sitting.
2. Movement of the hand.
3. Movement of the body.
4. Movement of the facial muscles.
5. Expression of the mouth while
articulating.
6. Manner of leaning.
 Alphonse Bertillion, a
French criminologist, devised a
scheme utilizing
anthropometrical measurement
of the human body as the basis
of identification.
Basis of the Bertillion System of
Identification.
1. The human skeleton is
unchangeable after the twentieth
year.

2. It is impossible to find two human

beings having bones exactly alike.

3. The necessary measurement can

easily be taken with the aid of a
simple instrument.
Information Included in the
System
1. Descriptive data – color of the hair,
eyes and complexion, shape of
the nose, ear, etc.

2. Body marks – moles, scars, tattoo

marks, deformities, etc.

Portrait Parle – (spoken picture) is a

verbal, accurate and
picturesque description of the
person identified.
LIGHT AS A FACTOR IN
IDENTIFICATION
1. Clearest moonlight or starlight:
Experiments have shown
that the best known person
cannot be recognized by the
clearest moonlight at a distance
greater than 16 to 17 yards and
by the starlight any further
than 10 to 13 yards.
a. Broad daylight:
a person can hardly
recognized another person at a
distance farther than one
hundred yards if the person has
never been seen before, but
persons who are almost
strangers may be recognized at a
distance of twenty-five yards.
Chapter IV
MEDICO LEGAL ASPECTS OF DEATH

Importance of the Death

Determination:
1. The civil personality of a natural
person is extinguished by
death:
The civil personality is extinguished
by death. The effect of death upon
the rights and obligations of the
deceased is determined by law, by
contract and by will. (Art. 42, Civil
Code.)
2. The property of a person is
transmitted to his heirs at the time
of death:
Succession is a mode of
acquisition by virtue of which the
property, rights and obligations to the
extent of the value of the inheritance of
a person are transmitted through his
death to another or others by will or by
operation of law (Art. 774, Civil Code).
3. The death of a partner is one of the
cause of dissolution of partnership
agreement:
Dissolution (of a partnership) is
caused. . . (5) by the death of any
partner;. . (Art. 1830, Civil Code).
Death – is the termination of life.
It is the complete cessation of all the vital
functions without possibility of
resuscitation.
Dying is a continuing process while death
is an event that takes place at a precise
time.
Death may be:

1. Brain death – death occurs when

there is deep irreversible coma
absence of electrical brain activity
and complete cessation of all the
vital functions without possibility of
resuscitation.
2. Cardio Respiratory Death - death
occurs when there is a continuous
and persistent cessation of heart
action and respiration.
KINDS OF DEATH

 SOMATIC OR CLINICAL
DEATH

 MOLECULAR OR CELLULAR
DEATH

 APPARENT DEATH OR STATE

OF SUSPENDED ANIMATION
KINDS OF DEATH
1. SOMATIC OR CLINICAL DEATH:
This is the state of the body in
which there is complete, persistent and
continuous cessation of the vital
functions of the brain, heart and lungs
which maintain life and health.
2. MOLECULAR OR CELLULAR DEATH:
after cessation of the vital
functions of the body is still animal life
among individual cells.
3. "APPARENT DEATH" OR “STATE OF
SUSPENDED ANIMATION“:

This condition is not really death

but 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.
1. CESSATION OF THE HEART
ACTION AND CIRCULATION:
There must be an entire
and continuous cessation of the
heart action and flow of blood
in the whole vascular system.
Examination of the Peripheral
Circulation:
1. Magnus Test
2. Opening of Small Artery
3. Icard's Test
4. Pressure on the fingernails
5. Diaphanous Test
6. Application of Heat on the Skin
7. Palpation of the Radial Pulse
8. Dropping of Melted Wax
Examination of the Peripheral
Circulation:
1. Magnus Test:
A ligature is applied around the base
of a finger with moderate tightness.
2. Opening of Small Artery:
In the living, the blood escapes in jerk
and at a distance.
3. Icard's Test:
This consist of the injection on a
solution of fluorescein subcutaneously.
4. Pressure on the fingernails:
If pressure id applied on the
fingernails intermittently there will
be a zone of paleness at the site of
the application of pressure which
become livid on release.

5. Diaphanous Test:
The fingers are spread wide and the
finger webs are viewed through a
strong light.
6. Application of Heat on the Skin:
If heated material is applied on the skin of a
dead man, it will not produce blister.
7. Palpation of the Radial Pulse:
Palpation of the radial artery with the fingers,
one will feel the rhythmic pulsation of the vessel
due to the flow of blood.
8. Dropping of Melted Wax:
Melted sealing wax is dropped on the breast of
a person. If the person is dead there will be no
inflammatory edema at the neighborhood of
the dropped melted wax.
Methods of Detecting Cessation of
Respiration:
 Examination with a Mirror

 Examination with a Feather or

Cotton Fibers

 Examination with a Glass of

Water

 Winslow’s Test
 CESSATION OF RESPIRATION
Like heart action, cessation of
respiration in order to be
considered as a sign of death must
be continuous and persistent.
Methods of Detecting Cessation of
Respiration:
a. Expose the chest and abdomen and
observe the movement during
inspiration and expiration.
b. Examine the person with the aid of a stethoscope
which is placed at the base of the anterior
aspect of the neck and hear sound of the
current of air passing through the trachea
during each phase of respiration.

c. Examination with a Mirror:

The surface of a cold-looking glass is
held in front of the mouth and nostrils.

d. Examination with a Feather or Cotton

Fibers:
Place a fine feather or a strip of cotton in front
of the lips and nostrils.
e. Examination with a Glass of Water:
Place a glass half full of water at the
region of the chest.

f. Winslow’s Test :
There is no movement of the image
formed by reflecting artificial sun light
on the water or mercury contained in a
saucer and placed on the chest or
abdomen if respiration is not taking
place.
CHANGES IN THE SKIN
 Loss of Elasticity of the Skin

 Opacity of the Skin

 Effect of the Application of Heat

COOLING OF THE BODY
(ALGOR MORTIS)
After death the metabolic process
inside the body ceases.
CHANGES IN THE SKIN:
a. The skin may be observe to be pale and
waxy looking due to the absence of
circulation.
b. Loss of Elasticity of the Skin:
Normally when the body surface is
compressed, it readily returns to
normal shape.
c. Opacity of the Skin:
Expose of the hand of a living person to
translucent lights will allow the red
color of circulation to be seen
underneath the skin.

d. Effect of the Application of Heat:

Application of melted sealing wax on
the breast of a dead person will not
produce blister or inflammatory
reaction on the skin.
CHANGES IN AND ABOUT
THE EYE
 Loss of Cornea Reflex

 Clouding of the Cornea

 Flaccidity of the Eyeball

 The Pupil is in the Position of Rest

 Tache noir de la sclerotique

CHANGES IN AND ABOUT THE EYE
a. Loss of Cornea Reflex:
The cornea is not capable of
making any reaction to what ever
intensity of light stimulus.
b. Clouding of the Cornea:
The normal clear and transparent
nature of the cornea is lost.
c. Flaccidity of the Eyeball:
After death, the orbital muscles
lose their tone making the intra-
orbital tension rapidly fall.
d. The Pupil is in the Position of Rest:
The muscle of the iris loses its
tone.
"Tache noir de la sclerotique“ – after
death a spot may be found in the
sclera.
CHANGES IN THE BODY
FOLLOWING DEATH
CHANGES IN THE MUSCLE:
After death there is complete
relaxation of the whole muscular
system.

The Entire Muscular Tissue Passes Three

Stages After Death.
a. Stage of primary flaccidity
b. Stage of post mortem rigidity
c. Stage of secondary flaccidity
The Entire Muscular Tissue Passes
Three Stages After Death.
a. Stage of primary flaccidity:
The whole body becomes rigid due to the The
muscare relaxed and capable of contracting
when stimulated.
b. Stage of post mortem rigidity:
contraction of the muscles.
c. Stage of secondary flaccidity:
The muscle become flaccid no longer capable of
responding to mechanical or electrical stimulus
and the reaction becomes alkaline.
a. Stage of primary flaccidity or period
of muscular irritability:
Immediately after death, there
is complete relaxation and softening
of all the muscles of the body.
b. Stage of postmortem rigidity or
cadaveric rigidity:
(death struggles of the muscles) or
Rigor mortis.
Three to six hours after death
the muscles gradually stiffen.
Conditions stimulating Rigor
Mortis
1. Heat Stiffening

2. Cold stiffening

3. Cadaveric Spasm or Instantaneous

Rigor
Conditions stimulating Rigor
Mortis
1. Heat Stiffening – if the dead body is
exposed to temperatures above 75°C it
will coagulate the muscle protein and
cause the muscles to be rigid.

2. Cold Stiffening – the stiffening of the

body may be manifested when the
body is frozen, but expose to warm
condition will make such stiffening
disappear.
3. Cadaveric Spasm – this is the
instantaneous rigidity of the
muscle which occurs at the
moment of death due to
extreme nervous tension,
exhaustion and injury to the
nervous system or injury to the
chest.
Kinds of Post Mortem
(cadaveric lividity)
1. Hypostatic Lividity – the blood
merely gravitates into the most
dependent portions of the body but
still inside the blood vessels and still
fluid in form.
2. Diffusion Lividity – this appears
during the later stage of its formation
when the blood has coagulated inside
the blood vessels or has diffused into
the tissues of the body.
AUTOLYTIC OR AUTO DIGESTIVE
CHANGES AFTER DEATH

After death proteolytic,

glycolytic and lipolytic ferments
of glandular tissues continue to
act which lead to the auto
digestion of organs.
FUTREFACTON OF THE
BODY
 PUTRE FACTION – is the
breaking down of the complex
proteins into simpler
components associated with the
evolution of foul smelling gasses
and accompanied by the change
of color of the body.
Marbolization

it is the prominence of the

superficial veins with reddish
discoloration during the process
of decomposition which
develops on both flanks of the
abdomen, root of the neck and
shoulder which makes the area
look like “marbled“ reticule or
balancing.
Factors Influencing the Float
of the Body in Water
a. Age
b. Sex
c. Conditions of the body
d. Season of the year
e. Water
f. External influence
Factors Influencing the Float of
the Body in Water
a. Age – bodies of fully developed and well
nourished newly born infants float
relatively rapid.
b. Sex – women float sooner than men.
c. Conditions of the body – stout persons
float quicker than skinny, lean and thin
bodies.
d. Season of the year – the moist of hot air
of summer is very favorable for
putrefaction.
e. Water – dead body in a shallow and
stagnant water of creeks or pond sooner
than in deep water of running stream.

f. External Influence – the presence of

heavy wearing apparel or the addition
of weight in the pockets or attached to
the body by means of rope or string will
delay the floating of the body.
Body Decomposition in
Water
Other Destructive Agents
During Decomposition
a. Flies:
b. Maggots (larvae)
c. Adult flies
d. Reptiles
e. Rodents
f. Other mammals
g. Fishes and crabs
h. Molds
Other Destructive Agents
During Decomposition
a. Flies:
1. Maggots (larvae)
The presence of maggots is dependent
upon the accessibility of the body to
adult flies
2. Adult flies
The common house flies are
carnivorous.
b. Reptiles – lizards and snakes are
attracted to dead bodies and eat the
soft tissues.
c. Rodents – rats and mice will
nibble the skin and other tissues
and may show unexplainable
injuries.
d. Other mammals – the dogs may
participate in the destruction of the
soft tissues especially in cases where
the victim is lying on the ground.
e. Fishes and crabs – if the body in
the water, fish of almost all species
and crustacean will be feeding on
the soft tissues.
f. Molds –
as a general rule, molds do
not destroy the dead bodies but
their growth cause disfigurement
and minor superficial lesions on the
skin.
SPECIAL MODIFICATION OF
PUTREFACTION
a. Mummification

b. Saponification or Adipocere
Formation

c. Maceration
Mummification is the
dehydration of the whole
body which results in the
shivering and preservation of
the body.
Kinds of Mummification

1. Natural mummification

2. Artificial mummification
Kinds of Mummification

1. Natural mummification –
When a person is buried in
hot, arid, sandy soil, there
will be insufficient moisture
for the growth and
multiplication of
putrefactive bacteria.
2. Artificial mummification –
a. Acceleration of the
evaporation of the tissues
fluid of the body before the
actual onset of
decomposition.
b. Addition of some body
preservatives to inhibit
decomposition and allow
evaporation of fluid.
B. Saponification or Adipocere
Formation
 This is a condition wherein the
fatty tissues of the body are
transformed to soft brownish-
white substance known as
adipocere.
 Adipocere is a waxy material,
rancid or moldy in odor, floats
in water and dissolves in ether
and alcohol.
C. Maceration
this is the softening of the
tissues when in fluid medium in
the absence of putrefactive
microorganism which is
frequently observed in the death
of fetus in utero.
DURATION OF DEATH

In the determination as to
how long a person has been
dead from the condition of the
cadaver and other external
evidences.
PRESUMPTION OF DEATH
Disputable Presumption:
That a person not heard from seven 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
AUTOPSIES
An autopsy is a
comprehensive study of a dead
body, performed by a trained
physician employing recognized
dissection procedure and
techniques.
Autopsies vs. Post-mortem
Examination:
 Post-mortem examination –
refers to an external
examination of a dead body
without incision being made.
 Autopsy – indicates that, in
addition to an external
examination, the body is
opened and an internal
examination is conducted.
CAUSES OF DEATH
The primary purpose of a
medico-legal autopsy is the
determination of the cause of
death.
Cause of death – is the injury, disease
or the combination of both injury
and disease responsible for
initiating the trend or physiological
disturbance, brief or prolonged,
which produce the fatal
termination.
Immediate (primary) cause of
death – this applies to cases when
trauma or disease kill quickly that
there is no opportunity for sequelae
or complications to develop.
The proximate (secondary) cause
of death – the injury or disease
which permitted the development of
serious sequelae which actually
caused the death.
Manner of death
Is the explanation as to how
the cause of death came into being
or how the cause of death arose.
Natural death – it is when the fatality
is caused solely by disease.
(pneumonia, hypertension)
Violent death or unnatural death –
death due to injury or any sort
(gunshot, stab, fracture etc.)
Instantaneous Physiologic Death
(death from primary shock)
This is sudden death
which occurs within seconds or
a minute or two, after a minor
trauma or peripheral
stimulation of relatively simple
and ordinarily innocuous
nature.
Sudden Infant Death Syndrome(crib
death):
This is the unexpected death
of infants, usually under six
months of age, while in apparent
good health.
Sudden Unexplained Nocturnal
Death (SUND):
Known as “pok-kuri”
diseasein Japan and “bangungut”
in the Philippines.
MEDICO LEGAL
CLASSIFICATION OF THE
CAUSES OF DEATH
a.Natural death
b. Violent death
c. Accidental death
d. Negligent death
e. Infanticidal death
f. Parricidal death
g. Murder
h. Homicidal death
a. Natural death – this is caused by a
natural disease condition in the body.
b. Violent death – are those due to
injuries inflicted in the body by some
forms of outside force.
Penal classification of violent death:
1. Accidental death – death due to
misadventure or accident.
2. Negligent death – death due to reckless
imprudence, negligence, lack of skill.
3. Suicidal death – a person who attempts
to kill himself as an unfortunate being,
wretched person.
4. Parricidal death – (killing of one’s
relative)

5. Infanticidal death – (killing of a child

less than three days old)

6. Murder – Art. 248, Revised Penal Code

7. Homicidal death – Art. 249, Revised

Penal Code.
PATHOLOGICAL
CLASSIFICATION OF THE
CAUSES OF DEATH
a. Death from Syncope

b. Death from Asphyxia

c. Death from Coma

PATHOLOGICAL
CLASSIFICATION OF THE
CAUSES OF DEATH
a. Death from syncope – this is due
to sudden and fatal cessation of
the action of the heart with
circulation included.

b. Death from asphyxia – is a

condition in which the supply of
oxygen to the blood or to the
tissues or to both has been reduced
to below normal working level.
c. Death from Coma -is the state of
unconsciousness with insensibility
of the pupil and conjunctivae and
inability to swallow, resulting from
the arrest of the functions of the
brain.
JUDICIAL DEATHS

Modern methods in the

execution of death sentences
have abandoned inhuman,
cruel and barbarous means.
Executions by garroting,
decapitation by means of the
guillotine and by drowning
which are common during the
medieval days are no longer
practiced.
Methods of Judicial Death

1. Death by Electrocution

2. Death by Hanging

3. Death by Musketry

4. Death by Gas chamber

1. Death by Electrocution – a person is
made to sit on a chair made of
electrical conducting materials
with straps of electrodes on both
wrists, ankles and head.
2. Death by Hanging – the convict is
made to stand in an elevated
collapsible flat form with a black hood
on the head, a noose made of rope
around the neck and the other end of
which is fixed in an elevated structure
above the head.
3. Death by Musketry – the convict
is made to face a firing squad and
is put to death by a volley of fire.
4. Death by Gas Chamber – the convict is
enclosed in a compartment and an obnoxious
or asphyxiating gas is introduced, most
common gas used is carbon monoxide.
Other Methods of Capital Punishment
1.Beheading
2. Crucifixion
3. Beating
4. Cutting asunder
5. Precipitation from height
6. Destruction by wild beast
7. Flaying
8. Impaling
9. Stoning
10. Strangling
11. Smothering
12. Drowning
 Beating – a hard object is forcibly
applied to the head to crush the
skull.
 Cutting asunder – mutilating the
body usually with sharp heavy
instrument until death ensures.
Beheading – the most common way of
beheading is with the use of the
guillotine.
Crucifixion – nailing the person on a
cross and death develops by traumatic
asphyxia.
Impaling
Destruction by wild beast
Flaying
Precipitation from Height
Stoning
Garroting/Strangling
Smothering
Drowning
EUTHANASIA
Euthanasia or “mercy
killing” is the deliberate and
painless acceleration of death on
a person usually suffering from
an incurable and distressing
disease.
Types of Euthanasia

Active Euthanasia

Passive Euthanasia

a) Orthothanasia
b) Dysthanasia
Types of Euthanasia
1. Active Euthanasia – intentional or
deliberate application of the means
to shorten the life of a person.
2. Passive Euthanasia – there is
absence of the application of the
means to accelerate but the natural
course of the disease is allowed to
have its way to extinguish the life
of a person.
3. Orthothanasia – when an
incurably ill person is allowed to die
a natural death.

4. Dysthanasia – when there is an

attempt to extend the life span of a
person by the use of extraordinary
treatments without which the
patient would have died earlier.
DEATH FROM
STARVATION

Starvation or inanition is the

deprivation of a regular and constant
supply of food and water which is
necessary to normal health of a person.
Types of Starvation

1. Acute Starvation

2. Chronic Starvation
Types of Starvation

1. Acute Starvation – is when the

necessary food has been suddenly
and completely withheld from a
person.
2. Chronic Starvation – is when
there is a gradual or deficient
supply of food.
Causes of Starvation

1. Suicidal – people deprived of

liberty or prisoners may go in a
“hunger strike” to create sympathy.
2. Homicidal – deliberate deprival of
food for helpless illegitimate
children, feeble-minded and old
persons.
3. Accidental – scarcity of food or
water during famine or draught.
Length of Survival

Without food and water a

person cannot survive more
than 10 days, but with water a
person may survive without
food for 50 to 60 days.
METHODS OF DISPOSAL OF
THE DEAD BODY
1. Embalming

2. Burial or Inhumation

3. Disposing of the Dead Body in the Sea

4. Cremation

5. Use of the Body for Scientific Purposes

METHODS OF DISPOSAL OF
THE DEAD BODY
1. Embalming – is the artificial way if
preserving the body after death by
injecting 6 to 8 quarts of antiseptic
solutions of formalin per chloride of
mercury or arsenic, which is carried
into the common carotid and
femoral arteries.
2. Burial or Inhumation – the body
must be buried within forty eight
hours after death; Sec. 1092, Revised
Penal Code.
3. Disposing of the dead body in the sea
– some dead bodies are not buried,
embalmed or cremated but thrown
over board in an open sea provided
that the deceased is not suffering from
dangerous communicable disease.
4. Cremation – is the pulverization of
the body into ashes by the application
of heat.
5. Use of the body for scientific purposes
– Sec. 97, P.D. 856 code of sanitation.
EXHUMATION

The deceased buried may

be raised or disinterred upon
the lawful order of the proper
authorities.
CLASSIFICATION OF WOUNDS
1. As to severity:
a. Mortal wound
b. Non-mortal wound
2. As to the Kind of Instrument Used:
3. As to the Manner of Infliction
4. As regards to the Depth of the wound:
5. As regards tot eh Relation of the Site of
the Application of Force and the
Location of Injury:
6. As to the Regions or Organs of the Body
Involved:
7. Special Types of Wounds:
 1.As to Severity
a. Mortal wound – wound which is
caused immediately after infliction
or shortly thereafter that is capable
of causing death.

b. Non-mortal wound – wound

which is not capable of producing
death immediately after infliction
or shortly thereafter.
2. 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 edge instrument (incised
wound)
2. Sharp edge pointed instrument
(punctured wound)
3. Sharp edge and sharp pointed
instrument (stab wound)
 Contusion

Hematoma

a. Wound brought about by blunt

instrument (contusion, hematoma,
lacerated wound)
 Blunt instrument
(Lacerated wound)
Sharp edge instrument
(incised wound)
Sharp edge pointed instrument
(punctured wound)
Sharp edge and sharp pointed instrument
(stab wound)
Wound brought about by heat and cold
(frostbite, burn, scald)
Wound brought about by chemical explosion
(gunshot shrapnel wound)
c. Wound brought bout by tearing force
(lacerated wound)
d. Wound brought about by change of
atmospheric pressure (barotraumas)
e. Wound brought about by heat and
cold (frostbite, burn, scald)
f. Wound brought about by chemical
explosion (gunshot shrapnel wound)
g. Wound brought about by infection.
3. 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.

4. 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 which in the
wounding agent enters the body
but did not come out or the mere
piercing of a solid organ or tissue
of the body.
2. Perforating –when the wounding
agent produces communication
between the inner and outer portion
of the hollow organs.
5. As regards to the relation of the sight of the
application of force and the location of injury.

a. Coup injury – physical injury

which is located at the site of
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 the 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.
e. Extensive injury – physical injury
involving a greater area of the body
beyond the site of the application of
force.
6. 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”.
7. Special types of wounds
a. Defense wound – wound which is the
result of a person’s instinctive reaction
of self protection.

b. Patterned wound – wound in the

nature and shape of an object or
instrument and which infers the
object or instrument causing it.
c. Self inflicted wound – is a wound
produced on oneself. As distinguish
from suicide.
Self inflicted wound – is a wound
produced on oneself. As distinguish
from suicide.
1. Closed wound:
a. Superficial
b. Deep
2. Open wound
a. Abrasion
b. Incised wound
c. Stab wound
d. Punctured wound
e. Lacerated
Open Wound
(abrasions)
TYPES OF WOUNDS

1. Closed wound – there is no reach

of continuity of the skin or mucous
membrane.

2. Superficial – when the wound id

just underneath the layers of the
skin or mucous membrane.
a. Deep
1. Musculo skeletal injuries
a. Sprain
b. Dislocation
c. Fracture
d. Strain
e. Subluxation
2. Internal hemorrhage
3. Cerebral concussion.
 Asphyxia is the general
term applied to all forms of
violent death which results
primarily from the interference
with the process of respiration
or the condition in which the
supply of oxygen to the blood or
to the tissues or both has been
reduced below normal level.
1. Anoxic death – is associated with the
failure of the arterial blood to become
normally saturated with oxygen.
2. Anemic anoxic death – is due to a
decreased capacity of the blood to carry
oxygen.
3. Stagnant anoxic death – brought by the
failure of circulation.
4. Historic anoxic death – is due to the
failure of the cellular oxidative process,
although the oxygen is delivered to the
tissues, it cannot be utilized properly.
CLASSIFICATIONS OF ASPHYXIA
1. Hanging
2. Strangulations:
a. Strangulation by ligature.
b. Manual strangulation or throttling.
c. Special forms of strangulations:
1. Palmar strangulation
2. Garroting
3. Mugging or yoking
4. Compression of the neck with stick.
3. Suffocation

4. Asphyxia by submersion or drowning

5. Asphyxia by pressure on the chest

(traumatic crush asphyxia)

6. Asphyxia by irrespirable.
 Is a form of violent death
brought about by the suspension of the
body by a ligature which encircles the
neck and the constricting force is the
weight of the body.
 Classification of asphyxia by
Hanging
1. As to the location of the ligature and
knot:
a. Typical
b. Atypical
2. As to the amount of constricting force:
a. Complete
b. Partial
3. As to symmetry:
a. Symmetrical
b. asymmetrical
Classification of asphyxia by
Hanging
1. As to the location of the ligature and
knot:
a. Typical – when the ligature runs from
the midline above the thyroid
cartilage symmetrically encircling the
neck on both sides to the occipital
region.
b. Atypical – when the ligature is tied or
noosed and present on one side of
the neck, in front or behind the ear
or on the chin.
2. As to the amount of
constricting force”
a. Complete – when the body is
completely suspended and the
constricting force is the whole
weight.

b. Partial - when the body is

partially suspended as when
the victim is sitting, kneeling,
reclining, prone in any other
positions.
3. As to symmetry

a. Symmetrical – when the knot or

noose is at the midline of the body
either at the occipital or just below
the chin.
b. Asymmetrical – when the knot or
noose is not in the midline but on
one side, with the head tilted to the
side opposite the location of the
noose r knot.
ASPHYXIA BY STRANGULATION

Strangulation by ligature
is produced by compression of
the neck by means of a ligature
which is tightened by a force
other than the weight of the
body.
MANUAL STRANGULATION OR
THROTTLING:
This is a form of asphyxial death
whereby the constricting force applied
in the neck is the hand.
Methods of throttling:
1. Using one hand, the neck may be
grasped in front with the thumb
exerting pressure on one side and the
other on the fingers on the other side.
2. Using both hands with assailant in
front.
3. Using both hands with the assailant at
the back.
1. Palmar strangulation – the
palm of the hand of the
offender is pressed in front of
the neck without employing the
fingers.

2. Garroting – a ligature, a metal

collar or a bowstring is placed
around the neck and tightened
at the back.
3. Mugging (strangle hold)-This a
form of strangulation with the
assailant standing at the back and
the forearm is applied in front of
the neck.

4. Compression of the neck –

the victim may be force to place his
back behind a post.
 C. ASPHYXIA BY SUFFOCATION

Is exclusion of air from the

lungs by closure of air openings or
obstruction of the air passageway
from the external openings to the air
sacs.
Smothering – a form asphyxial death
caused by the closing of the external
respiratory orifices, other by the use
of the hand or by some other means.
Homicidal and accidental smothering
is frequent.
Overlaying – is the most common
accidental smothering in children.

Accidental smothering of epileptic –

a person may suffer from epileptic
or epileptiform fit and accidentally
bury his face on soft object like
pillow, bedding or san and die.
Accidental smothering of epileptic – a
person may suffer from epileptic or
epileptiform fit and accidentally bury his
face on soft object like pillow, bedding or
san and die.
Gagging – the applications of
materials, usually handkerchief;
linen or other clothing matters to
prevent air to have access through
the mouth or nostrils.
Plastic bag suffocation – plastic bags
are made of synthetic polyethylene
that is transparent, tough and
waterproof material commonly used
as container.
Plastic bag suffocation – plastic bags are made
of synthetic polyethylene that is transparent,
tough and waterproof material commonly
used as container.
CHOKING

This is a form of
suffocation brought about by
the impaction of foreign body in
the respiratory passage.
D. ASPHYXIA BY
SUBMERSION OR
DROWNING
This is a form of asphyxia
wherein the nostrils and mouth
has been submerged in any
watery, viscid or pultaceous
fluid for a time to prevent the
free entrance of air into the air
passage and lungs.
Submersion for 1 ½ minutes is
considered as fatal.
Chapter XXI
VIRGINITY AND
DEFLORATION
Virginity – is a condition of a
female who has not
experienced sexual intercourse
and whose genital organs have
not been altered by carnal
connection.

A woman is a “virtuous female” if

her body is pure and if she has
never had any sexual
intercourse with another,
though her mind and heart is
impure.
Kinds of Virginity

1. Moral virginity

2. Physical virginity

3. Demi-virginity

4. “Virgo intacta”
Kinds of Virginity

1. Moral virginity – the state of

not knowing the nature of
sexual relation.

2. Physical virginity – a condition

whereby a woman is conscious
of the nature of the sexual life
but does not experienced sexual
intercourse.
3. Demi-virginity – this term refers
to a condition of a woman who
permits any form of sexual
liberties as long as they abstain
from rupturing the hymen by
sexual act.

4. “Virgo intacta” – the term refers

to a truly virgin woman; that there
are no structural changes in her
organ to interfere previous sexual
intercourse and that she is a
virtuous woman.
Parts of the female body to
be considered in the
determination of the
condition of virginity:
1. Breast

2. Vaginal canal

3. Labia majora and Labia

minora

4. Fourchette

5. Hymen
Breast
a. Hemispherical breast

b. Conical breast

c. Infantile or flat breast

d. Pendulous breast
A fully develop breast may be
classified according to shape
as follows.
a. Hemispherical breast –
the breast is like a
hemisphere.

b. Conical breast – the

breast has the similar to a
cone. The outline consist of
two converging lines meet at
the region of the nipple.
c. Infantile or flat breast – the
breast is only slightly elevated from the
chest without distinct boundary and
showing no definite shape.
d. Pendulous breast – the skin of
the breast is loose making it capable of
swinging in nay direction.
1. Hemispherical pendulous
breast – it has the shape of a
hemisphere but with loose skin.

2. Conical pendulous breast –

it has the shape of a cone and is
capable of swinging sidewise.
Hemispherical breast – the
breast is like a hemisphere.
Conical breast – the breast has
the similar to a cone. The outline
consist of two converging lines
meet at the region of the nipple.
c. Infantile or flat breast
– the breast is only slightly
elevated from the chest
without distinct boundary
and showing no definite
shape.
Pendulous breast – the skin of
the breast is loose making it
capable of swinging in nay
direction.
 Parts of the female body to be
considered in the determination of
the condition of virginity:

1. Breast – the breast or mammary

glands are functionally related to the
reproductive organ system since
they secrete milk for nourishment of
the young child.
2. Vaginal gland – as a general
rule, the canal of virgin is tight and
the rugosities are sharp and
prominent.
3. Labia Majora and Labia
Minora – the labia minora is
firm, elastic and plump and
its medial borders are usually
in close contact with each
other so as to cover the labia
minora and the clitoris.
4. Fourchette – it present a V-
shape appearance as to the
labia minora unite
posteriolry.
5. Hymen – physicians give
much attention in the
examination of the hymen in
the determination of
virginity.
 Fourchette – it present a V-
shape appearance as to the
labia minora unite
posteriolry.
 Labia Majora and Labia Minora
– the labia minora is firm, elastic
and plump and its medial borders
are usually in close contact with
each other so as to cover the labia
minora and the clitoris.
As to shape and size of opening:
1. Annular or circular
2. Infantile
3. Semilunar or crescentrio
4. Linear
5. Cribform
6. Stellate
7. Septate
8. Fimbriated
9. imperforate
1. Annular or circular – the
opening is oval or circular located at
the center of the hymen.

2. Infantile – the opening is small,

usually linear, fleshy and resistant.

3. Semilunar or
crescentrio – the concavity
may be facing either side or upward
or downwards.
 Annular or circular –
the opening is oval or circular
located at the center of the
hymen.
Semilunar or
crescentrio – the
concavity may be facing either
side or upward or downwards.
4. Linear – the opening is slit likeand
usually running vertically.

5. Cribform – the hymen presents

several instances the openings instead
of a single one.

6. Stellate – hymenal opening is

like a star.
 Cribform – the hymen presents
several instances the openings
instead of a single one.
7. Septate – there are two
openings which may be of equal
or different sizes separated by a
bridge of hymenal tissue.

8. Fimbriated – the border of the

opening shows small iregular
prostrusion towards the opening.

9. Imperforate – there is no
opening on the hymen.
1. Firm
and with strong
connective tissue and plenty of
blood vessels – this type has
more tendency to lacerate
during the first sexual act and
the laceration may produce
relatively more hemorrhage.
2. Thick yielding hymen with
scarce blood vessels – the
hymen is distensible, easily
penetrated and when lacerated
will cause less bleeding.

3. Membranous hymen – hymen

is parchment, like may be
transparent and may lacerate
without pain or appreciable.
As to number of
opening:
1. Single crifice

2. Septate

3. Multiple

4. Imperforate
As to number of
opening:
1. Single crifice – having one
opening

2. Septate – having two

openings

3. Multiple – having several

openings

4. Imperforate – without orifice.

Imperforate – without
orifice.
Virginity is not
synonymous with chastity
A woman may resort to many
forms of homosexual as well as
heterosexual practices without losing her
virginity, yet she may be unchaste.
a woman may have ruptured
hymen and other signs of loss of physical
virginity, yet she is chaste.
she may resort to masturbation
with rupture of the hymen and dilatation
of the vaginal canal causing it to appear
that she has had several sexual
intercourses, yet she may still be a virgin.
Defloration
Is the laceration or
rupture of the hymen as a
result of sexual intercourse.
All other lacerations of the
hymen which are not
caused by sexual act are
not considered as
defloration.
1. Condition of the vulva

2. Fourchette

3. Vaginalcanal
Parts of the female genitalia that must
be examined to determined
defloration.
1. Condition of the vulva –
normally the labia majora
and minora are in close
contact with one another
covering almost completely
the external genitalia.
2. Foruchette – the normal V-
shape of the fourchette is
lost on account of the
previous stretching during
insertion of the male organ.
3. Vaginal canal – after
repeated sexual acts, there is
diminution of the sharpness or
obliteration of the vaginal
rugosities.
Can a woman be raped
while she is on her natural
sleep?
Occasionally it may happen, but
highly improbable. To a normal virgin it
is hard to conceive that such act could
ever be committed without her
knowledge, in as much as she never
experienced it. But, such act may be
possible to a woman who has had
several sexual intercourses and tot hose
who have given birth.
Can a woman commit the
crime of rape in a man?
In the definition of the crime of
rape, it is “committed by having a carnal
knowledge of a woman.” the law
specifically states that it can only be
committed to a woman and not on a man
(Lat. inclusio unius est exclusio alterios
means the expression of one thing is the
exclusion of another). She committed acts
of lasciviousness.
 The husband cannot be
guilty of rape committed on his
wife. Marriage is a licensed of the
husband to have sexual
intercourse with his wife. The
purpose of marriage is procreation
and there can be no procreation if
there is no sexual intercourse.
 The husband may be guilty also
of rape on his wife he is a principal
by cooperation or by inducement for
the act committed by another man.
Prostitution

Prostitutes - are women

who, for money or profit,
habitually indulge in
sexual intercourse or
lascivious conduct (Art.
202, No. 5, Revised
Penal Code).
1. Call girl

2. Hustler
a. Bar or tavern “pick-up”
b. Street walker

3. Door knocker

4. Factory girl
1. Call girl – receives
telephone calls from the
selected group of customers
and makes arrangements to
meet them at a designated
place.
2. Hustler:
a. Bar or tavern “pick
up” –frequent places where liquors is
sold, sometimes with the knowledge of the
management.

b. Street walker – she finds her

customers in various places and makes the
contact herself, but she may walk with
taxicab drivers.
3. Door knocker – a newcomer in
the field of prostitution

4. Factory girl – she works in

regular house of prostitution.
1. Madam or “mama-san”

2. Procurer

3. Transporter

4. Pimp or “bugao”
Personnel associated with
prostitution:
1. Madam or “mama-san” – she is the
general manager of the
prostitution den.
2. Procurer – the person is charge
with duty of getting girls to work
as prostitutes.
3. Transporter – the man or woman
who takes prostitutes from town
to another.
4. Pimp or “bugao” – one who gets
customers.
Types of prostitution
house:
1. Disorder house

2. Furnished room
house

3. Call house
1. Disorder house – employs
only 4 to 8 girls in the business.

2. Furnished room house –

this is operated by experienced
madams.

3. Call house – it is merely a place

where a telephone is maintained by
a madam.
As to the choice of partner:
1. Heterosexual

2. Homosexual
SEXUAL
ABNORMALITIES:
As to the choice of partner:
1.Heterosexual – sexual desire
towards the opposite sex.

2.Homosexual – (Michael Angelo,

Shakespeare, Oscar Wilde, Waltz
Whiteman)
1. Overt

2. Latent

3. Infantosexual
 Kinds of Homosexuals:

1. Overt – persons who are conscious

with their homosexual cravings and
who make no attempts to disguise
their intention.

2. Latent –persons who may or may

not be aware of the tendency in that
direction but are inclined to repress
the urge to give way to their
homosexual yearning.
Tribadism (lesbianism) – a
special name for female
homosexuals where in a
woman has the desire to have
sexual intercourse with
another woman.

3. Infantosexual – sexual desire

towards an immature person.
1. Homosexual Pedophile

2. Heterosexual Pedophile
A Pedophile may be:

1. Homosexual Pedophile – may attempt

either oral or anal intercourse with his
victim.

2. Heterosexual Pedophile – may attempt

either oral, vaginal, anal, intracrural
intercourse as well as cunnilingus, but
attempts at vaginal penetration are
most common.
INSANITY
Insanity may be defined in its
sociological, medical and legal
concept.

In sociological viewpoint, insanity

is the persistent inability
through mental causes to adapt
oneself to the ordinary
environment.
Insanity in medicine is the prolonged
departure of the individual from his
natural mental state arising from
bodily disease.

Insanity in law covers nothing more

than the relation of the a person and
the particular ac which is the subject
of judicial investigation.
Factors having positive correlation
with the development of mental
disorder.

1. Heredity
2. Incestuous marriage
3. Impaired vitality
4. Poor moral training and breeding
5. Psychic factors
6. Physical factors
a. Non-toxic
b. Toxic
1. Heredity – this is the most
frequent and history reveals
mental illness manifested by
ascendants.

2. Incestuous marriage – blood

incompatibility of parents,
maternal infection during the
early stage of pregnancy.
3. Impaired vitality – mental worry,
grief, physical strain, unhygienic
surroundings, infection, birth
trauma may predispose a person to
a mental disorder.

4. Poor moral training and

breeding – improper breeding and
moral training according to the
social status, particularly on free
will and self-control, undesirable
association, Etc.
5. Psychic factors – emotional
disturbance, such as love, hatred passion,
disappointment.
6. Physical factors:
a. Non-toxic – exhaustion resulting from
severe physical and mental strain, illness,
cerebral hemorrhage, trauma on the skull
affecting the brain.
b. Toxic – this may be produce by excessive
formation or deficient elimination of waste
product of metabolism; by microbic
infection, or excessive use of certain drugs.
Disorder of Memory

Dementia – a form of insanity

resulting from degeneration
or disorder of the brain
characterized by general
mental weakness,
forgetfulness, loss of
coherence and total inability
to reason but not
accompanied by delusion or
uncontrollable impulse.
Types of Dementia
1. Acute dementia

2. Dementia paralytical

3. Dementia praecox

4. Senile dementia

5. Toxic dementia
Types of Dementia

1. Acute dementia – a from of

temporary dementia,
occurring in young people
induced by conditions likely
to produced that state, like
malnutrition, over work,
dissipation or too rapid
growth.
2. Dementia paralytical – (general
paralysis of the insane)degeneration
of physical, intellectual and moral
power leading to paralysis (“cirrhosis
of the brain”).

3. Dementia praecox (schizophrenia) –

dementia of the adolescence and
characterized by loss of memory.
4. Senile dementia – occurring in
advance age and characterized by loss
of memory, with childish and silly
behavior and physical degeneration.

5. Toxic dementia – characterized by

weakness of mind or feeble cerebral
activity resulting from continuous
administration or use of toxic
chemicals.
Amnesia (loss of
memory)
a. Anterograde amnesia

b. Retrogarde amnesia
a. Anterograde amnesia –
loss of memory of recent
event.

b. Retrogarde amnesia –
loss memory of past events
and observed in trauma of
the head.
Disorder content of thought:

Delusion – a false or
erroneous belief in something
which is not a fact. A person
suffering from delusion is not
always insane.
Types of Delusion
a. Delusion of grandeur (“delirium of
grandeur”, megalomania or “folie
de grandeur”)
b. Delusion of persecution
c. Delusion of reference
d. Delusion of self accusation
e. Delusion of infidelity
f. Nihilistic delusion
g. Delusion of poverty
h. Delusion of control
i. Hypochondriacal delusion
j. Delusion of depression
k. Delusion of negation.
a. Delusion of grandeur
(“delirium of grandeur”,
megalomania or “folie de
grandeur”) – erroneous belief
that he is in possession of great
power, wealth, wisdom, physical
strength, etc.
b. Delusion of persecution – a
false belief that one is being
persecuted.
c. Delusion of reference – one
thinks that he is always the
subject matter of conversation,
news, speech, or action
although it is not a fact.
d. Delusion of self
accusation – a false belief to
have committed a crime or hurt
the feeling of others.

e. Delusion of infidelity – a
false believe derived from

f. Nihilistic delusion – a false

belief that there is no world, that
one does not exist and that his
body is dead.
g. Delusion of poverty – a false
belief that one is financially
ruined that he has no money, he
is starving, sick or even dead.

h. Delusion of control – a false

feeling that no one is being
controlled by other persons.
i. Hypochondriacal delusion –
a false feeling that one is
suffering from an incurable
disease, some parts of his body
are not functioning, or that he is
not physically capacitated to do
a thing on account of the
disease.
j. Delusion of depression –
patient experiences feelings of
uneasiness, worthlessness and
futility.
k. Delusion of negation –
feeling that some parts of the
body are missing.
Obsession

Thought and impulse

which continually occur in the
person’s mind despite all his
attempts to keep them out.
A person may lock the door of his
bedroom and go to bed. While
in bed he may get up to see if he
has locked the door. He may go
to bed again and again think and
see whether the door is locked.
He may repeat the act the whole
night.
Disorder of the trend of
thought:
1. Mania

2. Melancholia
Disorder of the
trend of thought:
1. Mania – a state of
excitement accompanied by
exaltation or a feeling of well
being which is out of
harmony with the
surrounding circumstances
of the patient.

2. Melancholia – intense
feeling of depression and
misery which is unwarranted
by his physical condition and
external environment.
Disorder of emotion:

a. Exaltation

b. Depression

c. Apathy

d. Phobia
Disorder of emotion:

a. Exaltation – feeling of
unwarranted well being and
happiness.
b. Depression – feeling of
miserable thought, that a
calamitous incident occurred
in his life, something has
gone wrong with his body
functions and prefers to be
quiet and seclusion.
c. Apathy – serious disregard
of the surrounding
environment.

d. Phobia – excessive,
irrational and uncontrollable
fear of a perfectly natural
situation or object.
Types of Phobia
1. Fear of specific objects:
Birds – ornithophobia
Blood – hematophobia
Books – bibliophobia
Flowers – anthophobia
Men – androphobia
Robbers – harpaphobia
Sacred things – hierophobia
Sharp objects – belonophobia
Sun – heliophobia
Trees – dendrophobia
Fear of specific
situation:
Childbirth – tocophobia
Crossing a bridge –
gephyrophobia
Daylight – phengophobia
Drinking – dipsophobia
Height – acrophobia
Going to bed – clinophobia
Marriage – ganophobia
Open space – agarophobia
Pregnancy – maieusiophobia
Sexual intercourse - coitophobia
Fear of place:
Churches – ecclasiophobia
Empty room – kenophobia
Enclosed room –
claustrophobia
School –scholionophobia
Crowds – ochlophobia
Sea – thalassophobia
Home surroundings –
ecophobia
River – potamophobia
Railways – sidedrophobia
At table – trikaideka phobia
Fear of illness death:

Death – thanatophobia
Disease – pathophobia
Germs – spermophobia
Heart disease – cardiophobia
Illness – nosemaphobia
Infection – mysophobia
Infirnity – apeirophobia
Microbes – bacilliphobia
Snakes – ophidiophobia
Veneral disease -
cypridophobia
Disorder of volition or
Conation (doing):
a. Impulsion or impulse
(compulsion) – sudden and
irresistible force compelling a
person to the conscious
performance of some action
without motive or
forethought.
Some types of impulsion
(compulsion neurosis):

1. Pyromania
2. Kleptomania
3. Mutilomania
4. Dipsomania
5. Homicidal impulse
6. Sex impulse
7. Suicidal impulse
Some types of
impulsion
(compulsion
neurosis):
1. Pyromania – an irresistible
impulse to set things a fire.

2. Kleptomania – an
irresistible impulse to steal
articles of not much value.

3. Mutilomania – an
irresistible impulse to indulge
in maim animals.
4. Dipsomania – an irresistible
impulse to indulge in
intoxication for a number of
years with alcohol or drugs.

5. Homicidal impulse – an
irresistible inclination or impulse
to commit homicide prompted
usually by insane delusion
either as a necessity of self
defense or avenging for justice
or as to the patient being the
appointed instrument of a
superman.
6. Sex impulse – this includes
all irresistible acts of sexual
perversion.

7. Suicidal impulse – a
strong desire to terminate
one’s life.
Steps in diagnostic
procedure of mental
affection:
1. Anamnesis
a. Family history
b. Personal history
c. Information from relatives,
friends and neighbors.
2. Physical examination
3. Instrumentations (x-rays,
scanning and other modern
apparatus.)
4. Mental examination.
Psychologic testing
Psychiatric evaluation
a. Family history:
1. Inquire on the medical condition
of the parents and other
ascendants, uncles, brothers
and sisters.

2. Inquire whether anyone of them

suffered from nervous diseases,
cerebral affection, suicide,
syphilis, etc.
b. Personal History:
1. Detailed characteristics from childhood
to his present state.
2. Determine excess use of intoxicating
drugs.
3. Sexual life, occupation, mental strain,
head injury and early nervous affection.
c. Information from relatives, friends and
neighbors:
Change of conduct and behavior,
habit, previous conduct or maniacal
episode.
Earlier test for insanity:
a. Wild beast rule

b. Delusion rule

Later test for insanity:

a. McNaghten’s rule
b. Irresistible impulse rule
c. Durham rule
d. Currens rule
e. American Law institute rule
Earlier test for insanity:
a. Wild beast rule – a person is
exempted from criminal liability
if he is totally deprived of his
understanding and memory and
knows no more than in infant, a
brute, or a wild beast of what he
is doing.
b. Delusion rule – a person is not
responsible for his act if he is
suffering from delusion although
he knows that his act is wrong.
Later test for insanity:
a. McNaghten’s rule
1. The accuse was laboring under
such defect of reason or from a
disease of the mind as not to know
the nature and quality of the act
he was doing, or

2. If he did know, he did not know

that what was doing was wrong.
a. Irresistible impulse rule – a
person is considered insane
when mental disease has
rendered him incapable of
restraining himself, although he
understands what he is doing
and knows it is wrong.

b. Durham rule – the accused is

not criminally responsible if his
act was the product of mental
disease or mental defect.
d. Currens rule – it must be
proven that at the time of
committing the prohibited act the
defendant, as a result of mental
disease or defect, lacked
substantial capacity to conform
his conduct to the requirements
of the law which he has allegedly
violated.
e. American Law Institute
Rule
1. A person is not responsible for his
criminal conduct as a result of
mental disease or defect he lacks
essential capacity to appreciates
the criminality of his conduct or to
conform his conduct to the
requirements of the law.
2. The term “mental disease or
defect” does not include an
abnormality manifested only by
repeated criminal or otherwise
anti-social conduct.
MENTAL DEFICIENCY
Mental deficiency (mental sub normality,
mental retardation) is the below normal
intellectual functioning which originates
from the arrest or incomplete
development of the mind during the
development period below the age of 18
which may be induced by various factors
associated with the impartment of
learning, social adjustment or maturation.
Classical classification:
1. Idiot

2. Imbecile

3. Feeble minded

4. Moral defective
1. Idiot – usually congenital and due to
defective development of the mental
faculties.

2. Imbecile – although the mental

defect is not as severe as that of idiots,
he cannot mange his own affairs.
3. Feeble minded – a person who
has his mental defect, although
not amounting to imbecility, is
pronounced such that he requires
care supervision and control for
his protection and for the
protection of others.
Moron – a feeble minded person of
considerably higher intelligence
as that of an imbecile but his
intellectual faculties and
judgment are not as well develop
as in normal individual.
4. Moral defective – in
addition to the mental defect,
there are strong vicious and
criminal propensities, so that
the person requires care,
supervision and control for
the protection of others .
Mental retardation is classified as
follows:

1. Profound

2. Severe

3. Moderate

4. Mild
1. Profound – I.Q is under 20 and
capable at most to limited self-
help.

2. Severe – I.Q. is between 20 and

35 and capable of habit training
as a child.

3. Moderate – I.Q. is 36 to 51 and

can develop academic skill equal
to about the second grade level.

4. Mild – I.Q. is 52 to 67 and

constitutes the greatest group
of mentally retarded.
MALINGERING
Is the feigning or simulation of
disease or injury characterized by
ostentation, exaggeration and
inconsistency.
1. To avoid military or naval training
2. To avoid court summons

3. As a defense to a criminal
prosecution

4. To increase civil liability

5. To promulgate sympathy
1. To avoid military or naval
training:
A person may feign
disease or injury because he is
required by law to undergo
military or naval training.
2. To avoid court summons:
A person may have
received a summon from a court
requiring him to appear on a
specified date, time and place
but refuses to appear because
he is a defendant in the case
wherein he wants to delay the
proceeding or he is afraid to be
subjected to the ordeal of direct
and cross examination.
3. As a defense to a criminal
prosecution:
Impotency may be utilized
by the defendant in the
prosecution of the crime of rape.

4. To increase civil liability:

A plaintiff in a civil action
for the recovery of damages and
for the injury sustained may
exaggerate the physical
disability so that he may receive
bigger award from the court.
5. To promulgate sympathy:
A beggar may exaggerate
incapacity or simulate disease or
injury so that the public may be
more sympathetic towards him and
give him more alms.
 Types of Malingering
1. “feigned or fictitious” Malingering:
Malingering is built up out of
pure imagination and does not
have the slight basis of fact.
2. “factitious” Malingering:
This is a form of malingering
whereby something really exist as
a fact but is converted to a more
serious disability or injury, or to an
exaggeration of the complaint.
MANIFESTING OR
SIMULATING
DISTURBANCE
1. Somnambulism

2. Semi somnolence or Somnolencia:

3. Hypnotism or Mesmerism:

4. Delirium
1. Somnambulism – this is
abnormal mental condition whereby a
person is performing an act while in
the state of natural sleep.

2. Semi somnolence or
Somnolencia – a person is in a
semi-somnolence state when he is half
asleep or in a condition between sleep
waking.
3. Hypnotism or Mesmerism –
a person is made unconscious by
the suggestive influence of the
hypnotist.

4. Delirium – is a state of
confusion of the mind. It is
characterized by incoherent
speech, hallucination, illusions,
delusions, restlessness and
apparently purposes motions.