FMT:

Forensic medicine/ legal medicine/ state medicine is the application of medical knowledge for the
purposes of law and administration of justice.
Briefly: Medicine (as applied to) ⇒ Law
Forensic=of court of law
Toxicology is the analysis of biological samples (e.g. body fluids, tissues and organs) for the
presence of drugs & toxins for the purpose of determining their influence on human behaviour. .
Forensic Toxicology is the application of toxicology for the purpose of the law.

Medical Jurisprudence:
Medical jurisprudence [Latin juris, law; prudentia knowledge] is the study of legal principles that
guide medical personnel.
Briefly: Law (as applied to) ⇒ Medical personnel
Ex: (i) Doctor gives penicillin injection to patient without testing for sensitivity " Patient dies " Laws
under which the doctor may be sued and the defences available to him are studied under medical
jurisprudence.
In short, it deals with legal aspects of practice of medicine.

Professional misconduct (Infamous conduct):

Professional misconduct (syn. Infamous conduct, ethical misconduct, ethical negligence, ethical
malpraxis) is that act of a medical man which would be reasonably regarded as disgraceful or
dishonourable by his professional brethren of good repute and competence.
or
Any conduct on part of doctor which is considered disgraceful or dishonourable as judged
by professional men of good repute and competence.
e.g. dichotomy, putting up an extra large signboard, employment of touts, issuance of false
certificates, reports , Adultery, Addiction, Sex determination test, illegal abortion etc.

Professional/Medical Negligence:
It is defined as lack of reasonable care and skills on part of a doctor that resulted in injury/death of
the patient.
Components of Medical Negligence (4D’s):
1. Duty of doctor
2. Dereliction of duty
3. Damage to patient
4. Direct causation
For a case of medical negligence to be established, all four conditions must be present.
Types of Negligence:
1. Civil negligence Injury or damage is mild. e.g. Failure to take consent for blood transfusion
2. Criminal negligence More serious than civil negligence as injury is very serious.
e.g. Operation on wrong limb. Sec. 304 A IPC deals with criminal negligence.
Death:
Death is the irreversible cessation of all biological functions that sustain an organism.
Death is the permanent cessation of life/ all vital bodily functions.
An individual who has sustained either (1) irreversible cessation of circulatory and respiratory
functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem is
dead.
Injury:
As per Section 44 IPC, injury is defined as any harm, whatever illegally, caused to any person in
Mind, Reputation, Body or Property.

Classification of Injury:

Wound: Clinically, it means any injury where there is breach of natural continuity of skin or mucous
membrane. Wound will include any lesion, external or internal, caused by violence, with or without
breach of continuity of skin.
Hurt: Hurt means any bodily pain, disease or infirmity caused to any person (Sec. 319 IPC).
It is of two types:
i. Simple “simple injury” is used as a synonym of hurt.
ii. Grievous Grievous hurt would fall u/s 320, IPC. All injuries which are not simple are grievous.
Clauses of Grievous Hurt:
A grievous injury is one
1. Which is extensive or serious
2. Which does not heal rapidly and
3. Which leaves a permanent deformity or disfiguration.

Definition of Contusion/Bruise:
It is defined as extravasation of blood in the subcutaneous/subepithelial tissues due to rupture of
blood vessels as a result of blunt force impact.
Classification of bruise: Bruise is classified into three types:
i. Intradermal bruise lies in the immediate subepidermal layer. Made by impact with a patterned
object, and hemorrhage is sharply defined.
ii. Subcutaneous bruise is situated in subcutaneous tissue, often in the fatty layer, and the edges
are blurred. Most common type of bruise.
iii. Deep bruise: Bleeding deeper to the subcutaneous tissues. It may take hours to 1–2 days to
appear at the surface (delayed bruising).

Age of Bruise:
Age of bruise can be estimated
by:
1. Colour changes
2. Histological changes
3. Spectrophotometry
Laceration:- it is the tearing or splitting of the skin, mucous membrane and surfaces of any internal
organs caused by application of blunt force.

An abrasion is an injury involving destruction of epidermal layers of the skin and dermal papillae.
Salient features:
(1) Force - producing abrasions can be of two types (a) tangential (b) perpendicular
(2) EFFECTS - TANGENTIAL FORCE GENERALLY PRODUCES SCRATCH AND GRAZE
ABRASIONS, WHILE PERPENDICULAR FORCE PRODUCES PRESSURE AND IMPRINT
ABRASIONS. MOST COMMONLY THE FORCE INVOLVES A MIXTURE OF THE TWO.
(3) Healing - Abrasions always heal without scarring.
(4) Weapons - with rougher surfaces and with more movement produce more severe abrasions.
(5) On a wet skin – difficult to see. Become more prominent after the skin dries.
(6) On drying – abrasions become dark brown or black.
Types of Abrasions:
1. Scratch abrasions are abrasions with appreciable length, but no significant width. They are
typically produced by sharp, pointed objects such as fingernails, pins or thorns. When produced by
tip of knife or razor, they are called point scratches. (b) Nails produce typically curved scratch
abrasions, known as semilunar abrasions.
2. Graze abrasions is essentially a collection of innumerable scratch abrasions. Most common
abrasions. Comprise of uneven, longitudinal parallel lines (grooves or furrows) with the epithelium
heaped up at the ends of these lines. This heaping up indicates the direction in which force was
applied.
3. Pressure abrasions are abrasions produced by crushing of epithelium, when a relatively
small force is applied perpendicularly to the skin for large time periods.
Fracture:- It is the breach of continuity of bone or tooth caused by application of blunt force. Clinical
features and X-ray findings are considered to diagnose this type of lesion. e.g. Corneal abrasion,
Nappy abrasions (nappy rashes), Ligature marks of hanging and strangulation, Shoe bite,Teeth bite
marks.
4. Impact abrasions are abrasions produced by crushing of epithelium, when a relatively large
force is applied perpendicularly to the skin for minuscule time periods.
e.g. Headlamp rim marks, or radiator grille marks - in head-on vehicular collisions, Recoil/muzzle
impression - in tight contact wounds, Shoe sole marks – in kicking, Tire marks of a car, bus or truck
on pedestrian - in run over accidents.
5. Miscellaneous
(1) Tattooing and pseudo-tattooing
(2) Dicing injuries
Age of abrasions by Gross examination
(1) Fresh – Bright red
(2) 1 day – Blood and lymph dries up. Bright red scab forms
(3) 2-3 days – Reddish brown scab
(4) 4-7 days – (i) Scab becomes dark brown (ii) Epithelium grows under the scab and covers
defect. Scab becomes ready to fall
(5) >7days – Scab dries, shrinks and falls off, leaving depigmented area. Gradually the area would
get pigmented.

Incised wound: It is caused by the sharp edge of the weapon applied to the skin perpendicularly or
obliquely making regular clean edges of the wound. It is called a slash wound when the length of
the wound is greater than its depth.

Stab wound: when wound's depth is greater than its length and usually caused by pointed
knife or dagger.
A puncture wound is produced when a pointed thin bodied weapon is pushed into the body. Its
depth is also greater than its diameter.
A penetrating wound is produced when a bigger type of pointed weapon like teta is pushed into the
body making a greater depth.
When puncture or penetrating wound is such that it has an entry and an exit and a tract through the
tissue it is called perforating wound.
Legally puncture and penetrating wounds are also considered as stab wounds.

Chop wounds: These are deep gaping wound caused by a blow with the sharp cutting. edge of a
fairly heavy weapon like axe, hatchet, sword, chopper or meat cleaver.
Salient features of chop wound:
[Link] dimension of the wound corresponds to the cross section of the penetrating portion of the blade.
2. The margins are usually sharp cut along with associated abrasion and contusion of the margins with marked
destruction of the underlying organs and tissues. If the edge is partially blunt the margins are ragged and bruised.
3. Undermining of the edge occurs in the direction to which the chop wound is made.
4. The depth of the wound stays same throughout, when whole blade strikes the body.

Firearm wounds: These wounds are produced by bullet or pellets fired from guns. Bullet
usually causes perforation and pellets cause penetrating wounds. Firearm entry wounds are
associated with burning, blackening, tattooing of the surrounding skin.

Blast wounds: These are produced by explosion of bombs and are due to blast pressure wave
(shock wave), blast winds, heat, splinters, shrapnels, surrounding small fragments propelled by blast
winds.
Burns: are caused by flame, heated objects and Scalds by hot liquids and vapours or gases.

Definition of Identification:
Determination of the individuality of a person by recognizing certain characteristics that are unique
to that person.
Types:
1. Complete/absolute identification: Dactylography
2. Incomplete/partial identification: Race, age, sex, height.

Definition of Dactylography
• It is the study of fingerprints as method of identification.
Fingerprints are impression of the patterns as a result of secretion of oils from the glands in the skin.
• It is the surest data of identification/most reliable method of identification as
a. Patterns are not inherited
b. Different even in identical twins

Consent: Consent means voluntary agreement, compliance, or permission.

• Consent is defined under Section 13 of Indian Contract Act, 1872 as “Two or more persons are
said to consent when they agree to the same thing in the same sense."
• Consent is the concurrence of ‘wills’, and its chief essential constituent is the consciousness or
knowledge of the act consented to.
• Section 90 of IPC explains that if the consent is obtained by coercion (under fear of injury), undue
influence, fraud, misrepresentation or misconception of fact, the consent gets vitiated.
• Consent should be clear, direct, free, informed, intelligent, personal and voluntary.
Types of Consent:
1. Express consent: It is given explicitly either in writing or verbally (e.g. the patient expressly
states that they agree, or signs a form indicating agreement). This is recommended when initially
seeking informed consent for a treatment intervention e.g. cervical manipulation, as it provides the
clearest form of consent and often fulfils legal obligations.
2. Implied consent is not specifically indicated as in express consent, but is implied by some action
which suggests consent (e.g. after having a discussion with the physical therapist regarding
treatment, the patient lays down on the treatment bed signalling that they are a willing participant).
This form of consent is open to interpretation and is therefore less reliable upon legal scrutiny.

Informed consent is comprised of both ethical and legal components. Patient consent to treatment
is a standard of physical therapy practice.
Informed consent is an agreement by a person to a proposed course of treatment after the doctor
has communicated adequate information and explanation about the material risks of and reasonably
available alternatives to the proposed course of treatment.
All information should be explained in comprehensive, non-medical terms preferably in patient’s own
language about the,
i. Nature of the illness.
ii. Nature of the proposed treatment or procedure.
iii. Alternative procedure.
iv. Risks and benefits involved in both the proposed and alternative procedure.
v. Potential risks of not receiving the treatment.
vi. Relative chances of success or failure of both procedures.

Posthumous Child:
• Posthumous = Occurring or appearing after death.
• A birth is said to be posthumous when the alleged father is dead and the child born is called
Posthumous Child.
• A posthumous child is a child born after the death of one of their biological parents.
• Posthumous Child is An infant who is born subsequent to the death of the father or, in certain
cases, the mother.
• Child will be considered legitimate even if born >280 days after death of husband.

Cause, Mechanism and Manner of death:

A. Cause of death - is the disease or injury responsible for starting the sequence of events, which
produce death [e.g. bronchopneumonia, trauma].
(1) Immediate cause – It is the final disease or injury causing the death. It is listed as I (a) in the
death certificate. A common error is to list a mechanism of death (e.g. cardiac arrest) rather than a
disease (myocardial infarction).
(2) Intermediate cause - Disease or condition that preceded and caused the immediate cause of
death. Listed as I (b).
(3) Underlying cause - A disease or condition present before, and leading to, the intermediate or
immediate cause of death. It can be present for years before the death. Usually listed as I (c).
(4) Contributory cause - conditions contributing to the death but not directly causing death. Listed
as II. Ex - A death may be due to a pulmonary embolus, as a consequence of hip surgery, resulting
from a injury from a fall, resulting from a cerebral infarction.
Cause according to autopsy findings:
(a) Natural causes (b) Unnatural causes (c) Obscure causes
B. Mechanism of death - is the physiological, biochemical or pathological process produced by the
cause of death, which is incompatible with life, e.g. metabolic acidosis and alkalosis, respiratory
paralysis, sepsis, shock, toxemia and ventricular fibrillation.
C. Manner of death – Whether the death was (i) natural (ii) accidental (iii) homicidal or
(iv) suicidal. (v) undetermined if manner can not be made out
.
Definition of asphyxia: It is a condition when there is reduced or no supply of oxygen to body
tissues. Trachea is occluded"No air supply to lungs""No oxygenation"Death.
Hypoxia is deprivation of adequate oxygen supply at tissue level that results from asphyxia.
Anoxia is complete deprivation of adequate oxygen supply at tissue level.
Asphyxial deaths:
Classification of Asphyxial Deaths:
1. According to Mechanism of production:
Mechanical causes:

(A) When exclusion of air from lungs is by ligature around the neck:
(i) Constriction force of ligature is weight of the body Hanging
(ii) Constriction force of ligature is anything other than the weight of the bodyStrangulation
(B) When exclusion of air from lungs is by any means other than ligature around the neck
Suffocation:
(i) External orifices of respiration (mouth, nose) are blockedSmothering
(ii) Foreign object is pushed through mouth up to posterior pharyngeal wallGagging
(iii) Foreign object enters tracheaChoking
(iv) Chest is prevented from expansion by external pressureTraumatic asphyxia
(v) Chest is prevented from expansion by internal pressure (eg body is placed in such a position
that abdominal organs press upon the diaphragm upwards) Positional or postural asphyxia
(C) When exclusion of air from lungs is by mechanical entry of liquid into lungsDrowning
Other causes:
Pathological causes: When oxygen is not able to enter lungs due to diseases of URT/ lungs; e.g.,
laryngeal edema, stridor, tumor, etc.
Environmental causes: Asphyxia due to lack of oxygen. Seen in high altitude, inhalation of CO,
sewer gas
Positional asphyxia: Asphyxia due to abnormal position. Seen in jack-knife position.
Traumatic: (i) Bilateral pneumothorax (ii) Pulmonary embolism [blood clot, amniotic fluid, fat, air etc]
Iatrogenic - (i) Anesthetic deaths.
Toxic: (i) Hb binding of oxygen lowered [CO] (ii) Tissues unable to utilize oxygen [CN]
(iii) Respiratory center paralyzed [barbiturates, opium, strychnine] (iv) Muscles of respiration
paralyzed [Gelsemium]
2. According to time of survival:
(1) Rapid asphyxia [survival <15 min] – Hanging, throttling, choking
(2) Slow or protracted asphyxia [survival >30 min] – CO intoxication, opiates, initial resuscitations
followed by death.
Definition of Hanging
It is a form of violent asphyxial death produced by suspending the body with ligature tied around the
neck. The constricting force is the weight of the body or part of body weight.
Classification of hanging:
1. According to position of knot
(i) Typical hanging – if knot is at occiput (ii) Atypical hanging – if knot is at any other position
2. According to position of feet
(i) Complete hanging – if feet do not touch ground (ii) Incomplete or partial hanging – if feet or
other parts of the body touch ground.
3. According to manner of hanging
(i) Suicidal (ii) Homicidal [eg lynching] (iii) accidental [eg autoerotic asphyxia] (iv) Judicial

Definition of Drowning
It is a type of violent asphyxial death where entry of air into lungs is prevented due to submersion of
mouth and nostrils into water or any liquid medium.

Definition of atypical drowning: It is a type of drowning in which water or fluid does not enter the
lungs but death of the person occurs immediately.
1. Dry drowning: As soon as water enters the lungs, laryngeal spasm occurs leading
to asphyxia
2. Immersion syndrome (hydrocution): Cold water stimulates the vagus resulting in cardiac arrest
3. Near drowning (2° drowning): Person does not dies of drowning, rather dies of complications like
pneumonia, electrolyte imbalance
4. Shallow water drowning: When an unconscious person drowns even when there is little amount of
water.

Definition of Strangulation
It is a form of violent asphyxial death caused by constriction of air passage at the neck
by any means other than suspension of the body.

Definition of Smothering
It is a form of violent asphyxia caused by mechanical obstruction of nose and mouth by hand, cloth,
plastic bag or other materials.
Lynching
• Lynching is a type of homicidal killing in which an angry mob kills an alleged offender in public
often by hanging, without a legal trial.
• It was prevalent in North America, where it was practiced by whites on colored people.
• Usual methods used to kill an offender are hanging, burning, beating, etc
• Inquest in a case of lynching is done by police.
• Cause of death in lynching is asphyxia when person is hanged.
Burking :
• Burking is a combination of homicidal smothering and traumatic asphyxia.
[Traumatic Asphyxia It is a form of violent asphyxia resulting from respiratory arrest due to mechanical fixation of
chest preventing normal chest wall movements.]
• William Burke and William Hare killed many persons in Scotland and sold their bodies to Medical
College in UK.
• Method: Invited the victim to the house and offered him alcohol. When drunk, he was thrown on
the ground and Burke would sit on the chest and close the nostrils and mouth with his hands, while
Hare used to pull the body by the feet till he is dead.
Paltauf’s hemorrhage:
• Paltauf’s hemorrhages are multiple, large, bluish reddish colored subpleural hemorrhages of
variable size seen in case of wet drowning.
Hanging Vs Strangulation:

Fresh water drowning and sea water drowning

Murders & Homicides:
Murder as defined under Sec. 300 IPC is killing of a person with malice aforethought.
If the act by which death is caused:
• With the intention of causing death.
• With the intention of causing such bodily injury which is likely to cause death of the person or
sufficient in ordinary course of nature to cause death.
In murder, the mens rea (guilty mind) should be there, i.e. the mental element of a person’s intention
to commit a crime.
Homicide is the killing of a human being as a result of conduct of the other. It may be lawful or
unlawful.
a. Lawful homicide: It can be justifiable by the circumstances that led to killing of the person (like
judicial execution, self-defence, etc) or excusable and caused unintentionally (like causing death by
accident/misadventure or death following lawful operation).
b. Unlawful homicide: Implies both, the fact of death and an accompanying state of mind known as
‘malice aforethought’ on the part of the killer (murder).
Hence, all murders are homicides but all homicides are not murder.
(Culpable =deserving blame for a crime or wrongdoing. Degrees of culpability =degrees of
fault)
(1) Culpable homicide amounting to murder – [Culpable – blamable, censurable] Person wants
to take revenge against his enemy "Deliberately plans his murder" follows him to a lonely place and
kills him (cold blooded murder). This homicide has highest culpability. In India, this is culpable
homicide amounting to murder (u/s 300), and the sentence is death (u/s 302).
(2) Culpable homicide not amounting to murder - Upon sudden arrival at home, person sees his
wife in bed having illicit relations with his friend. He temporarily loses control of his mind and shoots
both of them (hot blooded murder). This homicide has lesser culpability than the first case,
because the culprit did not plan murder; it happened in the heat of the moment. In India, this is
culpable homicide not amounting to murder (u/s 299), and the sentence is imprisonment for life
(u/s 304).
(3) Causing death by rash and negligent act - Person is late for airport; he has to take a flight
"Drives rashly and negligently" kills a person. Here the killing was neither planned, nor unplanned.
He never wanted to kill anybody; he merely wanted to reach airport. But he killed because of
negligence. This homicide has no culpability, and thus it is not a culpable homicide. In India, this
is covered under “causing death by rash and negligent act” (S.304A).
The sentence is 2 years imprisonment, or fine, or both
IPC:
1. S.44 - Definition of Injury

2. S.299 - Definition of culpable homicide

3. S.300 - Definition of murder

4. S.302 - Punishment for murder

5. S.304 - Punishment for culpable homicide

6. S.304A - Causing death by rash and negligent act [including death by medical negligence]

7. S.304B - Dowry death

8. S.307- Attempt to murder

9. S.308 - Attempt to commit culpable homicide

10. S.309 - Attempt to commit suicide

11. S.320 - Definition of Grievous Hurt

12. S.375 - Definition of Rape

13. S.376 - Punishment for Rape

14. S.377 - Unnatural offences

Infanticide:
• Infanticide is unlawful destruction of a child under the age of one year by anyone.
• Infanticide does not include the death of fetus during labor, or when it is destroyed by craniotomy
or decapitation.
• It is killing of an infant at any time from birth up to the age of 12 months.
• It is punishable under Sec. 302 IPC.

Stillbirth
• A stillborn child is one which is born after 28th week of pregnancy and which did not breathe or
show any other signs of life at any time after being completely born.
• Stillbirth has been called the Sudden Antenatal Death Syndrome or SADS.
• The child was alive in utero [(i) its heart sounds could be heard by the examining doctor;
(ii) movements could be felt by mother; (iii) echocardiography showed beating heart], but dies
during the process of birth [eg by aspiration, strangulation by cord etc].
• Causes: Anoxia, Birth trauma, Congenital defects, Erythroblastosis fetalis, Placental abnormalities,
Prematurity, Toxemia of pregnancy.
Dead birth: Deadborn child
A deadborn child is one, which has died in utero, and shows one of the following signs after it is
completely born
(1) maceration degenerative change occurring in a fetus retained in utero after death. It occurs
due to the softening effect of soaking on solid tissues (pulpy fetus).
(2) rigor mortis
(3) putrefaction
(4) Adipocere
(5) mummification
Rigor mortis is a usual change after death. Putrefaction occurs if air enters the liquor amnii after
death. Adipocere would occur if sufficient liquor amnii is there. Mummification would occur if all
liquor amnii has drained out.
Live birth: A child is “live born”, if any part of that child has been brought forth, even though the
child may not have breathed or been completely born [Explanation 3 of S.299, IPC].
Indian civil law “live-birth” means the complete expulsion of fetus from its mother, irrespective
of the duration of pregnancy, and who after such expulsion breathes or shows any other evidence of
life. Possible evidences of life are (1) Cry. (2) Movement of body or limbs.
Sexual Offences: Sexual offences are criminal forms of human sexual behavior.
Classification:
I. Natural sexual offences (Offences involving natural penile-vaginal penetration)
A. Violent – Done without consent e.g. rape
B. Non violent – done with consent e.g. incest, adultery
II. Unnatural sexual offences (Offences involving penetrations other than penile-vaginal)
A. Sodomy
B. Buccal coitus
C. Tribadism
D. Lesbianism
E. Sodomy
III. Sexual perversions (sexual psychiatric disorders. Classified by DSM-IV-TR as paraphilias)
A. Pedophilia (sexual intercourse with children);
B. Exhibitionism;
C. Voyeurism;
D. Sadism;
E. Masochism;
F. Frotteurism;
G. Necrophilia;
H. Undinism;
I. Miscellaneous

Rape:
Rape (Latin rapio; seize, snatch) is an assault by a person involving sexual intercourse with another
person without that person’s consent.
Definition of rape as per Section 375 IPC:
A man is said to commit rape, if there is:
a. Penetration of penis into vagina, anus, urethra or mouth
b. Insert any object or body part (not being his penis) into mouth, vagina, urethra or anus
c. Applies mouth to vagina, urethra or anus
d. Manipulates any part of victim’s body for penetration into vagina, anus or urethra.
If any of the above act is done:
1. Against her will
2. Without her consent
3. With her consent, if consent is obtained by
• Fear of death or hurt
• Impersonation or fraud
• Insanity or intoxication
4. With or without consent when she is <18 years of age: Statutory rape
5. When she is unable to communicate her consent.
Exception: Any medical intervention shall not constitute rape. Sexual intercourse by a man with his
own wife (even without her consent) is not rape, if she is > 15 years of age.
Salient features:
(i) In western countries there may be male-female rape, female-male rape, male-male rape and
female-female rape. In India however only male-female rape is possible legally.
(ii) No other form of rape is recognized in India, i.e. a female cannot rape either a male or a female;
a male cannot rape a male.
Legal provisions regarding rape in India:
S.228A, IPCWhoever prints or publishes the name or any matter which may make known the
identity of victim of rape shall be punished with imprisonment of up to 2 years and fine.
Publication is possible only under following circumstances (i) a police officer publishes name for
investigation, or (ii) victim (>18 years) authorizes in writing, or (iii) if victim is dead, minor or of
unsound mind, next of kin has authorized in writing.
S.327, 329 causing hurt, Grievous hurt, to constrain to an illegal act.
S.328Causing hurt by means of poison, with intent to commit an offence – Drug Facilitated
Sexual Assault.
S.375, IPC Definition of rape
S.376Punishment of rape
Examination of Rape Victims:
1. General particulars:
• Preliminary particulars: Name, height, weight, brought by, marital status, two identification marks.
• Informed consent

• Victim is preferably examined by or under supervision of female doctor.

• Examination is carried out with minimum delay.
2. History
a. Medical and surgical history
b. Sexual history—any history of sexual intercourse, if yes, then date of last consensual sexual intercourse
c. Menstrual history
d. Obstetric history e. Physical violence
Specific history about the incident:
• Date, time and place of commencement of act
• Any physical violence
• Details of events—bathing, cleaning, changing clothes, etc.
Examination of victim of rape–under Section 164-A CrPC

Evidences to be preserved:
Clothes Worn at time of alleged incident to detect
blood/ semen
Swabs 1. Soiled areas 2. Anal swab 3. Buccal swab
Hair 1. Loose hairs on the body 2. For comparison—
pubic hair 3. Matted pubic hair
Fingernail clippings Tissue sample, blood of the
accused
Blood 1. ABO blood grouping 2. Alcohol/drugs
3. HIV/Hepatitis
Scrapping 1. Dried blood stain 2. Dried seminal stain
Saliva  Secretor grouping
 WEAPONS

Semiautomatic rifled firearm

Description of weapon – Shoulder arm with long rifled

barrel, magazine and bolt action.

Injuries produced by weapon – Firearm wounds, fracture

by butt.

Medicolegal aspects – Mostly

used for homicidal.

Pistol

Description of weapon – Hand arm, small rifled barrel,

semiautomatic.

Injuries produced by weapon – Firearm wounds.

Medicolegal aspects – Homicidal, suicidal and accidental.

Kitchen knife

Description of weapon – Light sharp cutting weapon

with pointed tip, metal blade with two edges. One
edge is sharp cutting, serrated and other edge is
blunt. Handle is made up of plastic.

Injuries produced by weapon – Incised wound, stab

(punctured, penetrating, perforating) wound.

Medicolegal aspects – homicidal, suicidal, accidental &

Self- inflicted/fabricated wounds.

Kitchen knife

Description of weapon – Light sharp cutting weapon with

pointed tip, metal blade with two edges. One edge is
sharp cutting with serrated margins and other edge is
blunt. Handle is made up of wood.

Injuries produced by weapon – Incised wound, stab

(punctured, penetrating, perforating) wound

Medicolegal aspects – Self- inflicted/fabricated wounds, accidental may cause beveled

cuts and used for homicide and suicide
 Kitchen knife

Description of weapon – Light sharp cutting weapon with

blunt tip, metal blade with two edges. One edge is sharp
cutting and other edge is blunt. Handle is made up of
wood.

Injuries produced by weapon – Incised wound.

Medicolegal aspects – Self- inflicted/fabricated wounds,

accidental may cause beveled cuts and used for homicide and suicide.

Hunting Sickle

Description of weapon – Heavy sharp cutting weapon,

two edges, one edge is sharp and concave. Other edge
is blunt and convex thicker than the sharp edge.
Wooden handle is fitted with the metal part.

Injuries produced by weapon – Chop wound, cut

fractures of the bones, abrasion, contusion and
lacerated wounds by the handle.

Medicolegal aspects – Mostly used for homicidal purpose.

Hammer

Description of weapon – Heavy hard blunt weapon,

striking surface is circular on one side and other side is
knob like. In between there is hole/loop to
accommodate the handle.

Injuries produced by weapon – Depressed fracture on the

[Link], contusion, laceration & fracture

Medicolegal aspects – Mostly homicidal – ‘Fracture –a-la-signature’.Sometimes

accidental.

Wooden Log

Description of weapon – Moderately heavy hard

blunt,made of wood, non flexible weapon, elongated
roller, with smooth surface all around.

Injuries produced by weapon – Lacerated wound on the skull may resemble incised
wound so called incised-looking wound. Contusion & abrasions, fracture &
dislocations.

Medicolegal aspects – Mostly homicidal head injuries.

 Screwdriver

Description of weapon – Moderately heavy blunt weapon,

long circular shaped one end with sharp edges and other
end fixed with the handle.

Injuries produced by weapon – Punctured, perforating,

penetrating wound.

Medicolegal aspects – Accidental and homicidal.

Motorcycle chain

Description of weapon – Made of iron screws and bolts

which are arranged in a regular pattern.

Injuries produced by weapon – Patterned abrasion,

laceration, contusion.

Medicolegal aspects – Homicidal (strangulation). Used in gang wars & riots.

STONE

Blunt weapon causing abrasion, contusion and laceration type of mechanical injuries.

BRICK: Blunt weapon causing abrasion, contusion

and laceration type of mechanical injuries.
WEAPONS:
These are the means or mechanical devices which when applied in a hostile manner (violently) will
produce lesions or wounds.
They can be-
1)Hard blunt weapons
2)Sharp cutting weapons
3)Mixed variety
DANGEROUS WEAPONS
 Any instrument which can be used for cutting, stabbing or shooting; or which when used as a
weapon of offence is likely to cause death.
 Fire or any heated substance, any explosive substance, poison or any corrosive substance, any
substance which is deleterious to human body to ingest, to inhale or to be received in the blood.
BULLET CASE
Starvation is a severe reduction in nutrient, vitamin and energy intake that occurs either from
withholding of food or from administration of unsuitable food.
Types:
(i) Acute starvation - withholding of food is sudden and complete.
(ii) Chronic starvation - withholding of food is gradual. Chronic malnutrition, as occurs in poor, deprived sections of
society.
Causes:
1. Circumstantial causes
(1) Poverty [most common cause in India]
(2) Fasting
(3) Accidental: (i) earthquakes (ii) famine [failure of crops, overpopulation, war]
(iii) landslides (iv) lost in desert or jungle (v) marooned on island (vi) shipwrecks (vii) trapped in mines and pits etc.
2. Medical causes
(1) Ankylosis of jaw
(2) Alcohol and drug addicts [partial starvation only. Food is ignored due to overwhelming desire for drug. In
alcoholics calories are supplied by alcohol, so no food intake " protein malnutrition]
(3) Anorexia nervosa
(4) Bulimia nervosa
(5) cancer and stricture of esophagus
(6) Coma
(7) Diabetes mellitus
(8) Digestive diseases
(9) Mental illness [Major depressive disorder, paranoid schizophrenia, senile dementia].
3. Miscellaneous
(1) Eccentrics may refuse to eat food for no reason.
(2) Ignorance, witchcraft etc –parents either do not provide food, or do not provide food of right kind.
4 . Suicidal starvation
(i) Fasting - (a) political reasons [fast unto death] (b) purely exhibition.
(ii) Mentally ill and hysterical persons - often do not take food.
5. Homicidal starvation
Withholding of food from unwanted children, step children, illegitimate children, child abuse, elderly people, feeble
minded, jail inmates etc.
Causes of death are:
(i) Circulatory failure due to brown atrophy of heart
(ii) Exhaustion
(iii) Intercurrent infections
(iv) Contributing factors: (i) Dehydration (ii) Hypothermia.
PM Appearances
(1) General:
(i) Ascites [in 10% cases]
(ii) Edema - under the eyelids, cheeks and chin, inside the thigh and around ankles
(iii) loss of s/c fat and emaciation – extreme. Gives rise to (a) sunken eyes and cheeks, (b) bony prominences [eg
clavicles, tips of shoulders, ribs, anterior superior iliac spine] are more prominent.
(c) Chest - ribs prominent, concavities in intercostal spaces, supraclavicular fossae sunken (d) Abdomen - concave
and scaphoid
(e) Limbs – thin, flaccid (f) Wt - . ed more than 40%
(iv) Intercurrent diseases, superadded infections due to loss of
vitality (e) Odor – offensive, especially towards death
(2) Rigor mortis – sets in and disappears early
(3) Face – pale
(4) Dermatological:
(i) Skin – dry, inelastic, pigmented, rough, thin, wrinkled. Shows follicular hyperkeratosis and trophic skin changes
(ii) hair and nails– brittle, dry, lusterless
(5) Fat:
(i) complete absent from around internal organs, and in mesentery,
omentum, and s/c tissues. This is never seen in wasting diseases eg
cachexia and tuberculosis.
(ii) disappears late from – fat of female breast, around orbit
(iii) subepicardial fat – replaced by watery gelatinous material
(6) Muscular system:
(i) Muscles - atrophied and dark due to - in lipochrome
(ii) Fibres – (a) lose striations, (b) become more uniform due to
granular degeneration
(7) Skeletal system:
(i) Children - (a) Dental defects [eg caries, decalcification] (b)
Rickets (c) Spinal curvature
(ii) Adults - (a) Osteomalacia
(iii) in both – (a) Demineralization of bone (b) stress fractures
(8) Viscera [general]: (i) Great . in size and wt of all organs, except
brain [changes similar to those in senility]
(9) Heart:
(i) small [due to brown atrophy]
(ii) chambers empty
(10) Lungs:
(i) collapsed
(ii) edematous
(iii) pale
(iv) on cut section – exude very little blood, show hypostatic basal
congestion
(11) GIT:
(i) Lips – cracked, dry
(ii) Tongue – coated, dirty
(iii) stomach and intestines show atrophy of all layers
(iv) intestines – (a) walls appear like tissue paper, very friable to
touch and break easily (b) mucosa – shows extensive non-specific
ulceration as seen in ulcerative colitis (c) contents – offensive
watery fluid and gas
(v) mucosa – stained with bile
(12) Liver:
(i) atrophied
(ii) shows necrosis due to protein deficiency
(13) Gall bladder – distended with bile [no food in duodenum " no
cholecystokinin " no contraction of GB].
(14) Spleen – shrunken
(15) Renal system:
(i) kidneys – atrophied
(ii) urinary bladder – empty [cf gall bladder].
(16) Brain – wt retained [unlike other organs], pale, soft
(17) Blood:
(i) Volume – marked reduced
(ii) anemia – hypochromic microcytic

Diseases which cause loss of wt - Addison’s disease, AIDS, anorexia nervosa, chronic diarrhea, diabetes mellitus,
food intolerance, hyperthyroidism, malabsorption syndromes, malignancy, pernicious anemia, progressive muscular
atrophy, pyloric stenosis and tuberculosis.
Abortion (miscarriage) is premature expulsion of fetus from the mother’s womb at any time of
pregnancy, before full term of pregnancy is completed (S.312, IPC). [ Legal definition]

Abortion is premature expulsion of fetus from the mother's womb before the age of viability (28
weeks). After this period, it is stillbirth. [Medical definition.]

The Medical Termination of Pregnancy: MTP Act, 1971

Indications:
(1) Therapeutic – When the continuance of the pregnancy would involve a risk to the life of the
pregnant woman or of grave injury to her physical or mental health [S.3(2)(i)].
(2) Eugenic - There is a substantial risk that if the child were born, it would suffer from such physical
or mental abnormalities as to be seriously handicapped [S.3(2)(ii)].
(3) Humanitarian - When pregnancy is caused by rape [s3(2), Explanation 1].
(4) Social -
(A) When pregnancy has resulted from failure of contraceptive methods in case of a married woman
[S.3(2), Explanation 2].
(B) When social or economic environment, actual or reasonably expected may result in injury to
mother’s health [S.3(3)].

Who can terminate pregnancy: [rule 4 of MTP Rules, 2003] – Any one who has following
experience and qualifications:-
(i) 6 months house job in G&O
(ii) 1 year experience in the department of G&O
(iii) holds MD or diploma in G&O
(iv) If registered as a doctor before 1971 [i.e. commencement of the Act], must have experience of 3
years in practice of G&O [such cases are rare now due to passage of time]
(v) Has assisted in performance of 25 MTPs of which at least 5 must have been performed
independently [with this experience, doctor can terminate pregnancy only up to 12 wks].

Up to what period pregnancy may be terminated -

(vi) up to 12 wks – Opinion regarding existence of indications maybe expressed by 1 doctor
[S.3(2)(a)]
(vii) 12-20 wks – Opinion must be 2 doctors or more [S.3(2)(b)].
(viii) >20 wks –Pregnancy cannot be terminated as per MTP Act, except in case of emergency when
continuation of pregnancy is a risk to life of the mother.
Signs of death and changes following death:
Signs of death appear in the following order:
(I) Immediate:
(1) Insensibility and loss of voluntary power
(2) Cessation of respiration
(3) Cessation of circulation
(II) Early:
(1) Changes in the skinSkin becomes ashy-white, pale and loses elasticity, within a few minutes
of death. Lips are dry, brownish and hard due to drying.
(2) Changes in the eyeLoss of corneal reflex, Cornea becomes opaque about 6 hours after death,
the eyes look sunken, Retina becomes pale after death.
(3) Supravital reaction of the skeletal muscles
(4) Cooling of the body (Algor mortis)
(5) Postmortem lividity (Livor mortis)
(6) Changes in the muscles (Rigor mortis, RM)
(III) Late Post-mortem change :
(1) Decomposition (combination of autolysis and putrefaction):
• Decomposition involves two processes: (i) Autolysis and (ii) Putrefaction.
• Autolysis is the breakdown of cells and organs through an aseptic chemical process caused by
intracellular enzymes.
• Putrefaction is due to fermentation by bacteria. After death, the bacterial flora of the GIT spread
throughout the body, producing putrefaction.
 Chief external phenomena of putrefaction are (i) Color changes and (ii) Development of foul
smelling gases.
 Greenish discoloration of right iliac fossa (RIF) is the earliest sign of putrefaction.
 Time - Occurs in 18 hrs in summer and 36 hrs in winter.
(2) Modifications of putrefaction (adipocere, mummification)

Color changes:
(1) Greenish discoloration of right iliac fossa (RIF) – This is the earliest sign of putrefaction
(2) Marbling - Marbling is greenish brown staining of superficial veins. [linear branching
pattern, resembling branches of a tree] Time:36-48 hrs
(3) Skin:
(i) Macerated like appearance; Reddish-green [36-48 h].
(ii) In 3-4 days dark green or almost black.
(4) Poisoning: (i) Antimony poisoning"orange
Development of foul smelling compounds:
(A) Chemical processes in putrefaction are those of reduction. Proteins and carbohydrates are reduced to simpler
compounds (amino acids, CH4, CO, CO2, H2, H2S, mercaptans, NH3 and PH3).
(B) Foul smell – Foul smell from the cadaver is mainly due to decarboxylation of the amino acids, ornithine and
lysine, which yields carbon dioxide and the foul-smelling ptomaines putrescine
[NH2(CH2)4NH2] and cadaverine [NH2(CH2)5NH2].
(C) Effects of gases:
(1) Postmortem blisters-Time Summers-36 h, Winters-48 h.
(2) Bloating of features [2-3 d]: (i) Eyes – softened. May bulge from sockets
(ii) Lips – swollen and discolored
(iii) Tongue – blackened and thrust between the teeth
(iv) Face – swollen and discolored. Identification. In late stages, face is transformed into a bulbous green mass.
(3) Blood stained fluid from natural orifices and wounds
(4) Dehiscence of remote surgical incisions
(5) Distention of abdomen:
(i) Occurs because of collection of gases in the intestines [12-18 hours in summers; 1-2 days in winters].
(6) Dilatation of anal canal and vagina – May appear like a case of genuine antemortem anal or vaginal
penetration [sexual assault].
(7) Distension of breasts and genitalia – Breasts, penis and scrotum may become swollen and stiff.
(8) Emptying of heart – Blood is pushed out; blood for analysis not available in heart.
(9) Expulsion of fetus from uterus [postmortem delivery]– may be seen in pregnant women in 2-3 d. Rigor mortis
of uterus may be an additional reason.
(10) Expulsion of urine and feces – in 2-3 d. Due to formation of gas and relaxation of sphincters.
(11) Floatation of body in water – In drowned bodies, formation of gases cause the body to come up and float
(12) Postmortem aspiration – Gases in the stomach force the food up in the throat, from where it may fall into
larynx
(13) Shifting of the position of PM staining [36-48 h] – PM Staining displaced in any direction.
(14) Skin slippage:
(i) Epidermis becomes loosened, and separated.
(ii) Skin of hands and feet may come off in a “glove and stocking” fashion.
(iii) Exposed subdermal tissue dries giving a yellow parchment like appearance.
(15) Skull – Sutures of skull [especially of children] separated, with flowing out of liquified brain [3-5 d]
(16) Soft tissues become crepitant – Entire body swells due to collection of gases in the tissues. If a suitable area,
say, chest is pressed, the crepitant collection of gases can be felt. Feels like a sponge.
(17) Swelling of entire body – May make even a thin body appear obese.
(18) Microscopically – Breakdown of vessel walls and cell membranes leads to water logging of tissues with protein
rich fluid. This helps in the growth of bacteria.
Other changes
(1) Cornea – becomes white, flattened or compressed [12-18 h in summers; 1-2 d in winters]
(2) Fingertips –become leathery and wrinkled. Nails become prominent [36-48 hours]
(3) Fat – Body fat, especially omental and mesenteric liquefies into a translucent yellow fluid.
(4) Loosening of appendages - Loosened and can be easily pulled out (i) Hair [3d] (ii) Nails [4d] (iii) Teeth [5d]
(5) Postmortem luminescence - Body may start emanating light in the dark. The light comes not from the body, but
from luminescent bacteria [Photobacterium fisherii] and fungi [Armillaria mellea].
(6) Fissures or splits – may form in skin. May simulate antemortem incised wounds or lacerations [artifact of
decomposition.
(7) Miliary plaques:
(i) These are small white granules, which are seen on serous or endothelial surfaces of the body eg pleura,
endocardium, pericardium and peritoneum
(ii) Size - 0.5-1.5 mm.

Internal phenomena
(1) 36 h - Inner surfaces of vessels are discolored reddish brown, especially the aorta.
(2) 36-48 hours:
(i) Clotted blood becomes fluid.
(ii) Fluid blood starts collecting in serous cavities.
(3) 48-72 hours - Viscera are discolored dark red to greenish yellow, greenish blue, greenish black and finally black.
They are softer and greasier to touch
(4) 5-10 days:
(i) Colliquative putrefaction begins.
(ii) Abdomen – Bursts. Stomach and intestines protrude Thorax – bursts especially in children.
(iii) Tissues – become loose and soft. Converted into a thick, semifluid, black mass. Separated from bones and fall of
(iv) Body fat – especially mesenteric, omental and perirenal liquefies into a translucent yellow fluid, which fills the
abdominal cavity between organs.
(v) Cartilages and ligaments – softened towards the final stages
Order of Putrefaction(1) Larynx and trachea (2) Brain of infants (3) Stomach, intestines (4) Spleen (5) Omentum
and Mesentery (6) Liver (7) Adult Brain (8) Heart (9) Lungs (10) Kidneys (11) Adrenals (12) bladder (13) Esophagus
(14) Pancreas (15) Diaphragm (16) Blood vessels (17) Gall bladder (18) Skin, muscle, tendons (19) Prostate, virgin
uterus (20) bones