Forensic_Medicine___Toxicology_-_Last_Moment_Revision

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FORENSIC MEDICINE & TOXICOLOGY Forensic medicine: is the application of medical and paramedical knowledge in the administration of law and justice. Legal medicine and state medicine are other names for it.

Medical jurisprudence:

deals with the legal rights, privileges, duties and obligations of medical

practitioner.

Points to remember 1. Pin – point pupils = Opium 2. Dilatation of pupils = Dhatura, Cyanide 3. Constriction of pupils = Opium, phenol, organo-phosphorus, physostigmine, chloral hydrate. 4. Cumulative poisons are: Barbiturates, and methyl alcohol 5. Habit forming poisons are: Caffeine and Nicotine. 6. Addiction drugs are: Alcohol, Barbiturates, Coccaine, Cannabis, Chloral hydrate, Opium, Pethidine. 7. Hemodialysis is good value in: Salicylate, methanol, barbiturate, and aspirin (except kerosene oil and diazephem) 8. 1st sign of intra-uterine death: Gas shadow in aorta (as early as 12 hours). 9. Increased anion gap is seen in Salicylate poisoning, lactic acidosis, starvation. 10. Ideal suicide poison = Cyanide 11. Ideal homicide poison = Thallium, fluoride compounds. 12. Commonly used homicidal poisons: Arsenic, aconite 13. Commonly used suicidal poisons: Endrine, Opium, Barbiturates, Organophosphorus compounds. 14. Poison resembling cholera = Arsenic 15. Poison resembling tetanus = Strychnine 16. Poison resembling natural death = Thallium 17. Poison resembling fading measles = Arsenic 18. Poison resembling thyrotoxicosis = Bi-nitro compounds.

Tests for detecting poisons: Arsenic = Marsh’s test, Reinsch’s test Opium = Marquis test Alcohol = Mc’evan’s test Datura = Mydriatic test Phenol = Green urine.

1

IMPORTANT POINTS TO REMEMBER 1

The Percentage of blood alcohol in the stage of "dead drunk" is 0.5%.

2

Pisiform gets ossified by 12 yrs of age.

3

By 14 yrs. patella gets ossified.

4

Anterior fontanelle closes by 18 months of age.

5

The height of a child is double of birth height by 4 years of age,

6

Under IPC, a person below 7 years is not criminally responsible.

7

Fatal period of Datura poisoning is 24 hours.

8

In India, rigor mortis sets within 1-2 hours.

9

While dispatching blood and urine for chemical analysis, sodium fluoride is added as preservative in concentration of 50 mg/10ml.

10

Critical level of alcohol in blood is 0.15%.

11

The minimum age for giving consent for surgery is 18 years.

12

In fractured ends of bone, soft provisional callus is formed by 15 hours.

13

The minimum time required for adipocere formation in a dead body is 21 days.

14

Indian Medical Council Act was enacted in 1956.

15

Mental retardation is I.Q. Below 70.

16

Ratio between ethyl alcohol in blood to urine is 1:1.33

17

Gas rigidity appears after 72 hours.

18

Marbling is noticed by 36 hours.

19

Full development of rigor mortis takes about 12 hours.

20

In exhumation, 6-7 samples of earth are collected.

21

Intercourse with wife below 15 years of age is considerable rape.

22

Fatal period of aconite isusually 1-5 hours.

23

Cooling of body is gradual upto 1-3 hours.

24

Hypostasis is mottled within first 3 hours of death.

25

Killing range of a militry rifle is 3000 yards.

26

Juvenile offender is a person under 16 years

27

The dispersion of pellets is seen usually at distance beyond 10 feet.

28

In a gunshot wound, the presence of singeing of hair or charring of skin denotes a fire up to 18 inches.

29

Dispersion of pellets in shotgun injury is calculated as dispersion in inches = 1.5 times the dispersion in yards.

30

An infant born before 210 days is not legally considered capable of maintaining a separate existence.

31

A bruise showing bluish black discolouration is 4 days old.

32

The upper limit of safety for carbon monoxide in air is 0.01%.

33

Rh positivity in India is 93%.

34

In an abrasion, the scab usually dries and falls between 4-6 days.

35

Fatal dose of opium is 2 gm.

2

36

The range of an air rifle is about 90 yards.

37

Mixed dentition is seen in children between 6-12 years of age.

38

Basisphenoid unites the basi-occiput at the age to 22 years.

39

First permanent molar appears at age of 6-7 years.

40

Judicial first class Magistrate can pass a sentence of imprisonment upto 3 years.

41

Age of maturity for those under court of wards is 21 years. In India, sexual maturity is gained at 14 years of age.

42

The degree of accuracy in determining sex from long bones is 80%.

43

Fatal period of sulphuric acid poisoning is 18-24 hours.

44

Multiplying factors for estimating stature from humerus and femur in males are 55.3 and 3.6-3.8 respectively.

45

Colliquative liquefaction is seen within 1 week after death.

46

A contusion assumes green colour by 6 days.

47

Marriage age for boys and girls are 21 years and 18 years respectively.

48

Internal organs take 24 hours to cool. A person becomes major at the age of 18 years. Eruption of temporary teeth is completed by 2 to 2.5 years.

49

Foetal parts can be detected on plain X-ray usually by 16 weeks.

50

Child below 12 years is not required to take an oath.

51

Xiphoid process unites with sternum at age of 40 years.

52

Cranial capacity is 10% less in females.

53

Nuclear features persist in decomposition for a period of 2-3 years.

54

Precipitin test is positive to be opium in dead body upto 10 years.

55

56

After death, benzidine test is positive upto 150 years. Bones begin to decompose after death in 3-10 years. Less than 7 aminoacids in bone suggest age of bone after death as more than 100 years. The rate of cooling of body in first 6 hours is 2.5°F and in next 6 hours as 1.5"-2.0cF. Victim of drowning in a state of suspended animation can be revived as long as 10-20 minutes.

57

Centre of ossification for pisiform bone appears at an age of 10-12 years.

58

The floatation time in summer for a dead body after drowning is one day.

59

The age of 15 years old female is best determined by the radiography of upper end of radius and ulna.

60

Maggots in a dead body do not appear before 48 hours.

61

Hairs become loose after 72 hours of death.

62

Epiphyseal union of sternal end of clavicle occurs at age of 22 years.

63

Washer woman's hands and feet usually occur within 12-18 hours.

64

Saponification in drowning occurs in about 5 weeks.

65

Death ensues in about 5 mts. of complete submersion.

66

By ABO.RH, MN systems the exclusion of Paternity is about 50%.

67 68

Estimation of Age from eruption of teeth is possible upto 17 to 21 years of age. Gustafson's method for estimation age of adult over 21 years. In poisoning by salicylates, the Gastric lavage is useful upto 24 hours.

3

69 70

The age of consent for medical examination in cases of rape is minimum 12 years. If a person is absent from his usual haunts, and has not been heard for 7 hears, he is presumed to be dead.

71

Infanticide means unlawful destruction of child below 1 year of age.

72

By ABO, Rh, MN systems the exclusion of Paternity is about 50%

73

Estimation of Age from eruption of teeth is possible upto 17 to 21 years of age

74

In poisoning by salicylates, the Gastric lavage is useful upto 24 hours

75

The age of consent for medical examination in cases of rape is minimum 12 years

76 77

In sin of Gomorrah, buccal swabs are useful upto 9 hours In most countries, breath alcohol concentration 35 mg/100 ml is considered an offence After absorption, the ratio of alcohol in blood and urine is constant and is 1:1.31 Histologically, reticulum fibres in an abrasion are seen on 8 days

78

Widmark's formula for urine analysis of alcohol is 3/4 prq

79

Pancreas constitute 0.1% of body weight

80

Punishment for false evidence is given under section 193 of IPC

81

Length of a female larynx is about 3.8 cm

82

Calcification of third molar begins at 8-10 years.

83

Lip prints on cheiloscopy are divided into 8 patterns

84

?gm tablet of aluminium phosphide is able to liberate 1.0 gm

85

The diameter of "human hair at 15 years of age is 0.053 ram *

86

Alcohol gaze nystagmus is produced at an average blood levels of 80 mg%

87 88 89

The residual alcohol in mouth takes about 20 min to disappear and within this period breath analyser test may be false positive Skeletal muscles constitute about 29% of body weight Term 'under the influence' of alcohol is used when blood concentration is 80100mg%

90

Statutory rape is rape under 15 years of age

91

Weight for occluding internal jugular vein hanging is 2 kg

92

Majority of deaths due to Aluminium phosphide occurs in within 24 hours

93

During sleep, rectal temperature is 0.5-1.0°C lower

94

Drowned body floats in about 12-18 hours in summer S

95 96

Bones constitute about 12% of body weight Absence of III molar tooth indicates that the person is definitely under the age of 17 years

97

In a dead body, maggots in rainy day are seen in 6 hours.

98

Arsenic, Aconite and Dhatura are generally used as homicidal poisons.

99

Ricin is the active principle of croton oil seed.

100

Abrin is the active principle of abrus precatorius.

101

Soneryl is a coloured babriturate.

102

Breath alcohol can be measured by Alcometer or Drunkometer.

103

The fatal dose of Dhatura is about one grain.

4

104

Physostigmine can be regarded as the specific antidote of Dhatura.

105

Amygdaline is the glucosides of vegetable origin found in cyanides.

106

The process of putrefaction can be retarded by carbon monoxide gas.

107

Euthanasia means "Mercy killing".

108

Joule burn is seen in electrocution.

109 110 111 112 113

Amyl nitrate is an antidote for poisoning due to hydrocyanic acid. Olive green discoloration of urine on exposure to air is seen in poisoning due to carbolic acid. Overlying is a type of smothering. Optic atrophy is the characteristic feature of poisoning by methyl alcohol. Dryness of mouth, dilated pupils and delirium are symptoms of Dhatura poisoning. (All 'D's)

114

The first permanent tooth to erupt is first molar.

115

Dying declaration can be recorded by a medical officer.

116

Presence of fine white leathery froth in mouth and nostrils is seen in drowning.

117

Privation of any member of joint is a grievous hurt.

118

Pugilistic attitude is seen in burn death due to coagulation of proteins.

119

Dying declaration should be recorded by Magistrate.

120

Nalorphine is an antidote for morphine.

121

Locard's principle states that every contact leaves a trace.

122

The strongest corrosive poison is sulphuric acid.

123 124 125 126 127

Arborescent markings are seen in lightening. Before performing Postmortem examination, body should be identified by Policemen. Warrant case means a case relating to an offence punishbale with death, imprisonment for life or for a term exceeding two years. In civil cases, a reasonable sum for travelling expenses is generally tendered when the summons is served. This is known as conduct money. It is paid by the party that has called his as a witness. Hair cells are of special interest in cell sexing since both Barr body and Y chromosome can be demonstrated.

128

Nails, hairs and long bones are preserved in cases of chronic arsenic poisoning.

129

Postmortem fibrinous clots in heart are known as "Cardiac polyp".

130

The surest sign of death is putrefaction.

131 132 133 134

The rigor mortis start first at upper eye-lids. Dribbling of saliva from the angle of the mouth is generally considered as the surest sign of hanging. Presence of soot in respiratory tract is the surest sign of burn. Strong sulphuric acid when thrown on the face of a person is known as "Vitreol throwing".

135

Black gun powder consists of potassium nitrate, sulphur, and charcoal.

136 137

Nitrocellulose or Nitroglycerine is used as a smokeless gun powder. Richochette bullet is one which strikes any other surface before striking the

5

object. 138

The pulmonary lesion in the injury of air blast is called "Blast lung".

139

Loss of virginity is called defloration.

140

The Buccal coitus is called "Sin of Gomorrah".

141

The commission of sexual assalut upon a dead body is called "Necrophily".

142

"Testamentary capcity" is the capacity of a person to make a valid will.

143 144 145 146

Malpraxis is defined as want of reasonable skill and or willful negligence on the part of doctor resulting in deterioration of patients' health or his death. Copper sulphate is used as an antidote to phsophorus. 'Gyroget' are cartridges or miniature rockets driven by solid fuel, which produces considerable heat and smokeless gas on burning. Forensic means courts of law.

147

Deposition means a statement on oath made by a witness in a judicial proceeding. It is taken down in writing and signed by the witness and magistrate.

148

Document means any matter expressed or described upon any substance by means of letters, figures or marks, or by more than one of these means.

149

Evidence includes all legal means which help to prove or disprove any matter of fat, the truth of which is submitted to judicial investigation. It can be oral (direct, indirect or hearsay), documentary & circumstantial.

150 151 152 153 154 155

Hurt is defined as bodily pain, disease or infirmity caused to any person. Injury includes every inquiry other than a trial, conducted by a Magistrate or court. Investigation includes all the proceedings for the collection of evidence conducted by a Police officer or by any person other than a magistrate who is authorised by a magistrate on his behalf. Jury means a body of persons sworn to render verdict in a court of justice. It is composed of uneven number and not less than 7 and more than 9 persons. Metropolitan area means any area in the state comprising a city or a town whose population exceeds one millin. Offence means any act of omission made punishable by law for the time being in force.

156

Perjury means wilful utterance of falsehood under oath.

157

Plantiff is one who brings an action in a court of law.

158 159 160 161 162

Summons case means a case relating to an offence punishable with imprisonment for a term not exceeding two years Testimony means the evidence, oral or written, of a witness under under oath. Warrant means a written authority under "hand and seal". It is used for the arrest of persons or for their forcible production in a court of law Traumatic rupture of hymen is seen on posterolateral aspect. Taylor gave a formula on rate of decomposition of dead body in air, water and earth.

163

Most reliable method of determining personal identity is Dactylography.

164

Contre-Coupe injury is seen in head injury.

165

Strychnine acts on anterior horn cells.

6

166

Last organ to putrefy in mate is prostate whereas in female it is ungravid uteus.

167

In Carboluria, urine turns green on exposure to air.

168

Cyanide poisoning produces cherry red colour.

169

McEwen's sign is seen in alcoholism.

170

Cutis anserina is seen in drowning.

171

Shaking palsy or 'mad Hatters' is seen with mercury poisoning.

172

Poison which can be detected in burnt bodies in arsenic.

173

Cepahlic index helps in identification of race.

174

Tentative cuts are seen in suicides.

175

Pugilistic attitude is seen in antemortem or postmortem burns.

176

Death in police custody is investigated by Magistrate.

177

Precipitin test is used to identify human blood in stains.

178

Gelsimium is a spinal cord poison.

179

Desferroxamine is antidote used in iron poisoning.

180

Spalding's sign is seen in maceration.

181

Impotence is inability to perform the sexual act.

182

Smack is crude form of heroin.

183

Ganja is obtained from flowering tops.

184

Stomach may be greenish in poisoning due to nitric acid.

185

Lines of Zahn are present in antemortem clots.

186

Conium is a peripheral poison.

187

Emphysema aqueosum is seen in wet drowning.

188

Formication (Magnan's symptom) is seen in cocaine dependence.

189

Rigor mortis is simulated by cadaveric spasm.

190

Thorn apple is Datura stramonium.

191

Dirt collar is seen in fire arm entry wound.

192

Apoplexy is cerebral congestion.

193

Feminine of impotence is frigidity.

194

In oath taking, a medical man does not require to keep his hands on a holy book.

195 196 197 198 199

Thanatology is science that deals with death. Number of hours since death is calculated by multiplying the fall in rectal temperature with 0.67. Dichotomy is related to splitting of fees. Fracture of hyoid bone in a case of strangulation is commonly seen in the greater horn. In a fresh case of death due to ventricular fibrillation, heart at postmortem will be flabby.

200

Punctate basophilia is seen in lead poisoning.

201

Felony is a category of rape, murder or burglary.

202

Testamentary capacity is related to will.

7

203

McNaughten was an accused.

204

Accepted procedure of first aid for cafe coronary is Heimlich manoeuvre.

205

Mode of death from obstruction of air passages from within is anoxic anoxia.

206

Brain may be preserved in normal saline or rectified spirit.

207

CSF is preserved in poisoning due to alcohol.

208

Long bones are preserved inpoisoning due to arsenic, lead or antimony.

209

Exhumation is usually done in the early morning.

210

In India, Exhumation is done for Mohammadans and Christians.

211

Macroscopically and microscopically, there will not be any change to the heart in case of myocardial infarction death up to 8 hours.

212

Foamy liver is due to bubbing up of gas.

213

Leukocyte alkaline phosphatase level is low in CML.

214

The essential lesion of coronary atherosclerosis is found in intima.

215

The classical site of ischaemic colitis is splenic flexure.

216

The rigor mortis disappears in the order of eyelids, neck, thorax, lower lumbs (in the order of appearance).

217

Primary relaxation is stage of somatic death.

218

After death, the onset of putrefaction is in the stage of secondary relaxation.

219 220

Species of origin of blood is determined by precipitin test. It is a criminal offence in India, for a person to drive a motor vehicle after consuming alcohol.

221

Dum dum bullet is so called because tip is chiselled off.

222

Cyanides mainly affect Cytochrome oxidase.

223

In electrocution, death is most often due to ventricular fibrillation.

224

Le facies sympathique is seen in hanging.

225

The characteristic sign of Korsakoff psychosis is amnesia.

226

Aconite is most commonly used as a homicidal poison.

227

Alcohol is maximally absorbed from small intestine.

228

Absolute alcohol has 99.95% alcohol.

229

Visceras obtained from a body due to death from alcoholic intoxication are preserved is suprasaturated saline.

230

In strychnine poisoning, rigor mortis sets in early and lasts shortly.

231

A short barreled rifle is called carbine.

232

The most fragile bone in skull to get fractured is temporal

233

The most common type of skull fracture is fissure.

234

Rigor mortis sets early in cases with deaths due to apoplexy.

235

In cadaveric spasm, stage of primary relaxation is missing.

236

Heat stiffening is due to exposure of body to temperature above 75°C.

237 238

The presence of blackening, tatooing and scortching in a shotgun injury indicates distance of fire upto 3 feet. Lucid interval is seen in extradural haemorrhage and insanity.

8

239

In forgeries, oxalic acid is used as ink remover solution.

240

Pond fracture (of skull) is found in children.

241

Blasting effect is usually seen in a firearm injury from point blank range.

242

Olive oil is used in stomach wash in carbolic acid poisoning.

243

Fracture of middle cranial fossa causes injury to VII and VIII cranial nerves.

244

Histologically amyloid deposits always begin intercellularly.

245

Ischiopubic index is significantly more in females.

246

Unconsciousness occurs immediately after head injury due to concussion.

247

A female has more sternal index, ischiopubic index and sciatic notch index.

248

Ewings postulates refer to accidents as a cause of death.

249

Loss of muscular coordination and staggering gait are seen in patient with blood alcohol concentration of 150-300

250

Dinitro compounds poisoning resembles thyrotoxicosis.

251

Aconite is known as Sweet poison.

252

CuSO4 is antidote of Phosphorus.

253

Foder's test compares weight of lungs to the body.

254

Diaphanus test denotes that after death, finger webs lose their lusture.

255

Gaping of deep incised wound is dependent on cleavage lines of Langer.

256

When a patient is injured or dies due to some unintentional act during treatment by a doctor or agent of the doctor or known as therapeutic misadventure.

257

Glass blowers shakes are seen with poisoning due to mercury.

258

'Run amok' is sometimes seen with cannabis.

259

Abrus is viper-like poison.

260

Bluish green hypostasis is seen in H2S poisoning

261

Marquis test is used in opium poisoning.

262

Datura is also known as 'Road poison'.

263

Marsh's test and Reinsch test are used in arsenic poisoning.

264

Exposure to nickel causes carcinoma nasopharynx.

265

Best test for seminal stain is Florence test.

266

Fall of a tooth is grievous injury.

267 268

To conduct a postmortem, an authorisation letter is necessary from police officer, magistrate and coroner. A consent is invalid of obtained from a person who is intoxicated, insane or under threat.

269

In India, exhumation has no time limit.

270

Colour changes of putrefaction are first observed in iliac fossa.

271

Dipsomania is seen with alcohol.

272

Subpoena is a seen kind of document.

273

In exhumated bodies, the poison likely to be detected most significantly is arsenic.

274

Postmortem in a newborn is done by opening first the abdominal cavity.

9

275

Tests for circulation are Magnus, Diaphanous and Icard's.

276

Compressed air is used to fire lead slugs in air rifle.

277

Most important sign of defloration is ruptured hymen.

278

Cafe coronary occurs when a person is intoxicated.

279

Overlying is a type of smothering.

280

Death in fresh water in comparison to salt water is earlier.

281

Bevelling of inner table of skull is seen in fire arm entry wound.

282

In burking, cause of death is traumatic asphyxia.

283

Bansdola is a form of homicidal strangulation.

284

Convincing proof of burial alive is sand in trachea and bronchi.

285

In India. Coroner's courts are held in Bombay.

286

Corpus delict deals with body of crime.

287

Burking is a name derived from person.

288

Bullet is picked up with hands.

289

The process which causes the drying up of tissues and internal viscera to a sufficient degree to halt putrefaction is called

290

mummification.

291

The most important cause of temporary impotence is fear.

292

Minimum quantity of blood required to be preserved to mineral poisoning.

293

Superimposition is technique most useful for identification from skull.

294

Brown atrophy of heart is seen in starvation deaths.

295

Most common type of finger impression is loop.

296

Lead poisoning is common in children.

297

Presence of alveolar duct membrane in foetal autopsies in indicative of live birth.

298

The science of finger print was first demonstrated by Francis.

299

Karl Pearson formula is used to calculate stature of the individual from long bones.

300

Filigree burns are due to lightening.

301

The commonest homicidal poison used in India is Arsenic.

302

BAL is contraindicated in liver damage.

303

KCN is ineffective as a poison if kept for long time, patient takes excess of carbohydrate or suffers from achlorhydria.

304

Inquiry into circumstances of death is called inquest report.

305

Non-poisonous pure metals are mercury, copper and lead.

306

Phossy Jaw is produced by chronic white phosphorus poisoning.

307

Ptysalism is seen in copper poisoning.

308

Chloral hydrate is also called knockout drops or Micky Finn.

309

Chromodacryorrhoea is sometimes preapilated by organophosphorus

310

Rape is a cognizable offence.

311

To make a positive identification with the help of a partial finger print, the points of similarity should be at least 16.

10

312 313 314

The most striking symptoms of pregnancy is cessation of menstruation. The most reliable chemical test for blood is benzidine test. The position colour of tests for blood are —Benzidine test (Blue), Guiacum test (deep blue), Kastle Meyer test, Leucomalachite test (Peacock blue), Haemin Crystal (dark brown).

315

Takayama reagent is used in haemochromogen test.

316

Heat stiffening is due to coagulation of albumin.

317

Term immerssion foot is used for cases with frost bite.

318

Boxer's attitude is seen in persons dying of burns.

319

III and IV degree of burns are most painful. •

320

Smokeless gun powder is composed of nitrocellulose.

321

Gunshot wound is a type of perforated wound.

322

Supreme Court is purely an appellate Court.

323

Police inquest can be done by a person not below the rank of sub-inspector.

324

Haemodilution occurs in fresh water drowning.

325

In chronic mercury poisoning, face is first affected.

326

Wrist drop and foot drop may be seen in poisoning with lead.

327

After taking cyanide, patient first feels numbness in extremities.

328

Nux vomica seeds contain 2 alkaloids, strychnine and brucine.

329

Lynching is a form of homicidal hanging.

330

'Arrow poison' is nux vomical (also called Kuchila).

331

Commonest industrial metal poisoning is by lead.

332

Haemorrhagic spots are found in poisoning by thallium.

333

Amyl nitrate is antidote of cocaine poisoning.

334

In sea water drowning, there is steep rise in Na+ and Mg++.

335

Cadaveric spasm occurs immediately after death.

336

Least common type of finger prints is composite.

337

Preauricular sulcus is useful for identification of sex.

338 339

Seminal emission is common in hanging. In methyl alcohol poisoning treatment recommended is ethyl alcohol and sodium bicarbonate.

340

The presence of fine white leathery froth in mouth indicates drowning.

341

Lower end of femur can help to determine the age.

342

Resipsa Loquitur means evidence speaks for itself.

343

Resorption elution technique is used for detection of blood stains.

344

In females, obturator foramen is triangular shaped.

345

Absorption of lead is mainly through lung.

346 347

Incised like lacerated wound appears at forehead. Medical jurisprudence is the subject concerned with knowledge of law in relation to the practice of medicine. In a nutshell, it deals with legal aspects of medical practice.

11

348 349

350 351 352 353 354

Crime means a social harm which has been defined and made punishable by law. No conduct money is paid in criminal cases, however, provision is made by the Govt under sec. 312 Cr PC for payment of reasonable expenses of an expert witness attending before any criminal court. The body is exhumed only when there is a written order issued by 1st class Chief Judicial or Executive magistrate or the Coroner. There is not time limit for exhumation in India. Puterfaction is the surest sign of death. The earliest sign is manifested as greenish discoluration in the right ilic fossa. Heat stiffening is due to coagulation of albumin and muscle proteins. Cold stiffening is due to solidfication of fats when body is exposed to very low temperatures Presence of blood stained froth in the air passage and diatoms in internal visceras and bone marrow is considered surest sign of drowning.

355

The chief post mortem finding in case of starvation is distended gall bladder.

356

Heat exhaustion is caused by dehydration and salt deficiency. Presence of soot in the respiratory passage is the surest sign of ante-mortem burn.

357 358 359 360 361

Diatoms resist putrefaction. About 1900 cals is the minimum daily dieteic requirement below which manifestations of starvation appear. For estimating surface area in burnt patient "Wallace's Rule of Nine" has been employed. The Taser Gun is a device for immoblizing vicitims by using electric current without causing death or serious injury.

362

In drowning, Paltauf 's haemorrhages are seen subpleurally in the lungs

363

Molecular death is more significant medico-legally than somatic death.

364 365

Semen contains more than double quantity of CPK than any other body fluid. Levels over 400 units are almost diagnostic. The enzyme is stable and can be demonstrated as late as 6 months after soiling. Hanging is one of the common forms of suicide among men.

366

Judicial hanging is the official method of execution of death sentence. The dislocation often takes place between the 2nd & 3rd cervical vertebra.

367

Dribbling of saliva is the vital sign of ante-mortem hanging and is due to stimulation of salivary glands by ligature.

368

Lynching is homicidal hanging where several persons acting jointly overpower an individual and hang him by means of a rope to a tree or like object.

369

370

371

Strangulation is almost always homicidal. In strangulation, ligature completely encricles the neck horizontally below thyroid cartilage. Injury to carotid arteries common. Bleeding from nose, mouth and ears. Emphysematous patches on lungs are commonly seen during postmortem examination, fracture of hyoid bone commonly occurs in throttling (near the greater cornua). Smothering is a form of asphyxia caused by mechanical occlusion of the external air passages viz. the nose and the mouth by hands, cloth or any other material.

12

372 373 374 375 376 377

Overylaying or compression suffocation results due to compression of the chest so as to prevent breathing. It is common method of infanticide. Burking is a method of homicidal smothering and traumatic asphyxia. Drowning is a form of asphyxia due to aspiration of fluid into air passage, caused by submersion in water or other fluid. Death ensues rapidly in fresh water than in salt water or sea water. The fine froth at the mouth and nose in pathognomonic of drowning. Cutis anserina or goose skin has no value as a diagnostic sign of death from drowning. Diatoms test is negative in dead bodies thrown in water or in dry drowning.

378

In a typical case of drowning, diatoms are found in brains and bone marrow.

379

Drowning is one of the commonest form of suicide amongst females.

380

Buccal coitus is Sin of Gomorrah.

381

Strychnine poisoning resembles tetanus / epilepsy / hysteria.

382

Thallium resembles natural death.

383

Exhumation is done: In presence of police officer. In the supervision of Medical Officer. Written order from 1st class Magistrate or coroner.

384

Most common mode of death in strangulation is Asphyxia.

385

The common mode of choking is Accidental.

386 387 388 389 390 391

Caffey syndrome is Battered baby syndrome. In judicial hanging, fracture/dislocation of the vertebrae at the level of C3 and C4 vertebra. In Asphyxia, the place where the Tardieu spots occur in lung is interlobar fissures. Forensic thanatology deals with Medicolegal study of death. In dental fluorosis, the teeth are characterised by mottled enamel. Wreden's test—for deleting the presence of air in middle ear for determining live birth or dead foetus. The rules for criminal responsibility of Insane:

392

Mc Naughten's rule

393

Durham's rule

394

Current's rule

395

Blood group of Parents, Child group possible:

396

§ OxO i.e 00x00 = 0

397

§ A x B i.e OA x OB = O, A, B, AB. All are possible

398

§ OxA i.e OOxOA = O, A.

399

Macerated body of a foetus indicates—dead-born.

400

Cadaveric spasm (Instantaneous rigor) affects voluntary muscles only.

401 402

The most dependent means of identification of persons is finger prints. If a person survives after giving dying declaration, it can be used as corroborative evidence.

403

Paraffin test or dermal nitrate test detects Gunpowder residue on hands.

404

Knockout agents: Chloral hydrate, Potassium bromide

13

405

Saturday night paralysis due to pressure on the Radial nerve.

406

Leading questions are permissible in cross-examination.

407

Preservation used to preserve the urine for chemical analysis is Thymol crystals.

408

In Arsenic poisoning, putrefaction is delayed.

409

Arsenic is employed for embalming of Cadaver.

410 411

Subendocardial haemorrhages in Arsenic poisoning. The poison which is found in maximum quantities in various organs in Postmortem is —Arsenic.

412

Poisoning resembling fading measles — Arsenic.

413

Optic atrophy occurs in Methyl Alcohol poisoning.

414

Minimum Alcohol consumed by person, estimated by — Widmarks formula.

415 416

Widmark's formula, to determine — Quantity of Alcohol consumed. The preservative used for viscera in Alcohol poisoning—Saturated sodium chloride solution.

417

Barbiturates increase the toxicity of Alcohol by Synergism.

418

Methylated spirit contains—95% Rectified spirit and 5% Methyl alcohol.

419

The common preservative for viscera—Rectified spirit

420

The organs that resist putrefaction—uterus (Non pregnant); Prostate.

421

The poisons which Resist putrefaction—Arsenic, Edrin, Datura, Strychnine.

422

Thick and leathery stomach wall in —Phenol poisoning.

423

Ochronosis (Pigmentation of skin and cartilages) in — Phenol poisoning.

424 425

In Phenol poisoning —Urine is green coloured. Delicate and reliable test for Blood stains—Takayama's test (Hemochromogen crystal test).

426

Teichman test for blood stains is —Haemin Crystal test.

427

Extremely delicate test for Blood stains—Phenophthalein test (Kastle-Mayer test).

428

The best test for Blood stains—Chromatography absorption spectroscopy.

429

Leukomalachite green test is a chemical test for —Blood.

430

In severe burns, remnant indicative of Male sex—Inguinal canal.

431 432

Carbonaceous soot particles in Respiratory tract suggesive of—Antemortem burns. Lichetenberg's flowers or filigree burns or Arborescent markings is seen in Lightening.

433

In chemical burns by Corrosives—Vesication does not occur.

434

Paltauf's haemorrhages (usually in lower lobes of lungs) in —Drowning.

435

Immersion syndrome is due to—Vagal inhibition

436

Froth may be absent in case of death due to — Dry drowning.

437

The specimen used for Diatom's test—Sternal bone marrow.

438

Salt water drowning —Increased.

439

Postmortem staining:

440

Usually mistaken for —Contusion.

441

Can occur before death in —Cholera.

14

442

§ Hypostasis or cadaveric lividity — Postmortem staining.

443

§ Purple colour in —Asphyxia.

444

§ Blue green colur in —Hydrogen sulphide poisoning.

445

Blue vitreol—Copper sulfate.

446

Verdigris—Copper subacetate.

447

Green line on the gums in —Copper poisoning.

448

Most potent of all preparations of cannabis is —Charas.

449

Stomach wash in opium poisoning, done with —Potassium permanganate.

450

In opium poisoning, there is loss of all secretions except sweat.

451

In opium poisoning, atropine is contraindicated.

452 453

Methaemoglobinaemia is caused by poisoning due to Nitrates. Antidote used in common types of poisonous shakes, in India includes polyvalent antisnake venom.

454

Viperbite like poison—Abrus.

455

Sea snake venom—Myotoxic.

456

Diwali poisons are —Mercury, phosphorous.

457

Nephrotoxic poisons—Phenol, Oxalicacid, Mercury.

458

Blotting paper like stomach in sulphuric acid poisoning.

459

Sodium nitrate looks and tastes like common salt.

460

Tingling of skin and tongue by Aconite poisoning.

461

Tannic acid precipitates alkaloids.

462

Physiological antidote produce symptoms opposite to those of poison is:

463

Atropine—Physostigmine

464

Cyanide—Amyl nitrite

465

Strychnine—Barbiturate

466

In phosphorous poisoning, avoid oil and fats as they increase absorption.

467

In Endrin poisoning, the pupils are dilated.

468

Albumin helps to precipitate in Mercury poisoning.

469

Lead poisoning, causes constipation.

470

In Potassium permanganate poisoning, lesions resemble Tertiary syphilis.

471

Symptoms of Abrus precautorius poisoning resemble viperine snake bite.

472

Cocaine acts as an Aphrodisiac.

473 474

Charas is known as Hashish. In treatment of Nuxvomica poisoning, most important is I.V. injection of Barbiturates.

475

Pupils show alternate contraction and dilatation in Aconite poisoning.

476

Charcoal acts as a mechanical Antidote.

477 478

Potassium ferrocyanide solution is used as gastric lavage solution of poisoning due to copper sulphate. Skin and mucous membranes are colored yellow in poisoning due to nitric acid.

15

479

Delayed poisoning by oxalic acid is characterised by —Uraemia.

480

Large amount of water is contraindicated in —Oxalic acid poisoning.

481

Hypocalcemia can occur in —Oxalic acid poisoning.

482

Hypocalcemia can occur in —Oxalic acid poisoning.

483

Oxalic acid resembles—Magnesium sulfate.

484

Coffee ground vomitus is seen in Oxalic acid poisoning.

485

Datura seeds look like—Brinjal seeds capsicum seeds or Tomato seeds.

486

Physiological antidote for Datura poisoning—Pilocarpine

487

Stupefying poison—Datura.

488 489 490 491 492 493 494

Road poison—Datura. If a person survives after giving dying declaration, it can be used as corroborative evidence Arsenic is employed for embalming of Cadaver Subendocardial haemorrhages are seen in Arsenic poisoning The poison which is found in maximum quantities in various organs in Postmortem is - Arsenic Poisoning resembling fading measles - Arsenic The preservative used for viscera in Alcohol poisoning - Saturated sodium chloride solution

495

Barbiturates increase the toxicity of Alcohol by Synergism

496

Methylated spirit contains 95% Rectified spirit and 5% Methyl alcohol

497

The poisons which Resist putrefaction are— Arsenic, Edrin, Datura, Strychnine

498

Thick and leathery stomach wall is seen in Phenol poisoning

499

Ochronosis (Pigmentation of skin and cartilages) is seen in Phenol poisoning

500

Extremely delicate test for Blood stains - Phenophthalein test ('Kastle-Mayer test).

501

The best test for Blood stains is Chromatography absorption spectroscopy

502 503

In severe burns, remnant indicative of Male sex is inguinal canal Lichetenberg's flowers or filigree burns or Arborescent markings are seen in Lightening

504

In chemical burns by Corrosives Vesication does not occur

505

Immersion syndrome is due to Dry drowning

506

Rule of House is used for calculating age of the fetus-

507

PM staining usually mistaken for -Contusion

508

PM staining can occur before death in - Cholera

509

Most potent of ail preparations of cannabis is Charas

510

Amenorrhoea and infertility can occur in Chronic lead poisoning

511

If a person is absent from his usual haunts, and has not been heard for at least 7 years, he is presumed to be dead

512

In opium poisoning there is loss of all secretions except sweat

513

In opium poisoning, atropine is contraindicated

514

Strongest corrosive poison is sulphuric acid

16

515

Antidote used in common types of poisonous snakes in India includes polyvalent antisnake venom

516

Viperbite like poison is Abrus

517

Sea snake venom is Myotoxic

518

Diwali poisons are - Mercury, phosphorus

519

Blotting paper like stomach is seen in sulphuric acid poisoning

520

Spinal poisoning may be mistaken commonly for Tetanus

521

Sodium nitrate looks and tastes like common salt

522

Tingling of skin and tongue is seen in Aconite poisoning

523

In phosphorous poisoning, avoid oil and fats as they increase absorption

524

In Endrin poisoning, the pupils are dilated

525

Albumin helps to precipitate poison in Mercury poisoning

526

Lead poisoning causes constipation

527

In Potassium permanganate poisoning, lesions resemble Tertiary syphilis

528 529 530 531 532

Cocaine acts as an Aphrodisiac In treatment of Nux vomica poisoning, most important is I.V. injection Barbiturates Pupils show alternate contraction and dilatation in Aconite poisoning Charcoal acts as a mechanical antidote. Delayed poisoning by oxalic acid is characterised by Uraemia Large amount of water is contraindicated in Oxalic acid poisoning Hypocalcemia can occur in Oxalic acid poisoning

533

Coffee ground vomitus is seen in Oxalic acid poisoning

534

Datura seeds look like- Brinjal seeds, capsicum seeds or Tomato seed

535

Antidote for chlorpyriphos poisoning is. PAM.

536

Prussian blue is used in poisoning by thallium.

537

In gastric lavage, tube is passed upto 50 cm mark

538

Oleander causes heart block

539

Puppe's rule is used for bullet injuries

540

Wredin's test detects changes in middle ear

541

Rain drop pigmentation of skin is seen is arsenic poisoning

542

Algor mortis refers to cooling of body

543

American Law Institute Test is related to criminal responsibility

544

Poroscopy was described by Locard

545

Burrowed servant doctrine is related to vicarious liability

546

Wax-drippings or bone pearls are due to thermal injuries

547

Lichtenberg's flowers refers to Filigree burns

548

Cutis anserina is due to exector pilae

549

Cupping' is a method of criminal abortion

550

Crocodile flash burns are due to antemortem electric burns

17

551 552 553

Hospital providing defective equipment or drugs is causing Corporate, negligence Contusion collar is a proof of Gun shot entrance In 'Commando punch', injury usually occur in neck Blast lung is seen due to air explosion Thereapeutic orphans result due to experimentation

554

Thee name hatters shake is given because it is common in hat making industry

555

Trotter and Glesser's formulae are used for estimating stature

556

Rachiotomy saw is used to remove spinal cord

557 558 559 560

In cases of increased intracranial pressure, Kernhan's notch is seen on midbrain In artificial insemination of Donor without husband's consent, if the legal presumption of legitimacy be rebutted, parental rights will be vested in mother only Agonal period is period between lethal occurrence and death K master is responsible for the faults of his servants is known as Vicarious liability, Biliard ball ricochet effect is seen in firearm injuries

561

Cavett test is used for determing blood alcohol

562

Dactylography was first used in India by Sir W. Herschel

563

Huffling is common solvent abuse

564

Sewer gas contains CO2, methane and H25

565

Stomach-bowel test' is used for knowing if infant respiration occurred

566

‘Swallow tails’ are seen in lacerated wound

567

Most common type of abrasions of grazes

568

Osteometric board is used to estimate stature

569

Skull is square in Mongolians

570

In human head hair, bar bodies are found in hair follicles in a proportion of 29± 5% in females and 6+2% males

571

Curator bonis is person appointed to manage the affairs of mentally incompetent

572

"Crib deaths' are due to asphyxia

573

Commoriants' literally means dying together

574

For identification, palatoprints are taken from anterior part

575

Pink teeth are seen in death due to asphyxia

576

The order of appearance of rigor mortis follows Nysten's law

577

Postmortem lividity in a case of hanging is most prominent over lower extremities

578

Postmortem staining of a dead body lying undisturbed persists till it merges with discolouration of putrefaction

579

Bleeding from nostrils, mouth and ears is relatively common in strangulation

580

Contre coup injury is seen in brain

581

In deep incised wounds, Langer's lines determine gaping

582

Mugging by definition is homicidal

583

Ligature mark in hanging is an example of imprint abrasion

584

Immediate cause of death in burns is neurogenic shock

18

585

Common cause of death in crush syndrome is acute renal failure

586

Abrasion is seen in injury with rifled arm

587

Spermin in semen is detected by Barberio test

588

The impotent quoad is impotent to a particular woman

589

Seminal fluid choline originates from Leydig cell

590

To establish diagnosis of feigned insanity, the person can be observed for a maximum period of 30 days

591

Incessant sexual desire is known as satyriasis

592

Dhatura poisoning is due to intake of seeds

593

Mercury damages glomeruli and renal tubules

594

Cyanide poisoning kit contains amyl nitrite, Sodium nitrite and sodium thiosulfate

595

Chromolachryorrhoea in organophosphorus poisoning is due to porphyrin

596

A green line in gums in copper poisoning is Clepten line

597

In Eonism, there is cross dressing

598

Garrotting is used as a method of execution in some countries

599

Tardieu spots are numberous in thymus, AV junction and conjunctiva

600

In body packer syndrome, person dies of abused drug overdose

601

In drowning, emphysema aquosum is seen in 80% cases

602

In embalming fluid, the concentration of formaldehyde and methyl alcohol are 40% and 10% respectively

603

Emmenagogues are used for criminal abortion

604

McNaughten rule has been included in India in section 84 of IPC

605

Hydrocution is another term for immersion syndrome

606

Diminished responsibility is a term used for borderline mental state

607

Minisatellite or stutters are terms used for DNA finger printing

608

Section 312 IPC is related to abortion

609 610

Sankya or somalkhar is a compound of lead The compounds used for taking finger prints are French chalk, lead carbonate and mercury

611

'Central pocket loop' is a variety of Composite finger print

612

Reaction phenomenon is seen drowning

613

Alcoholic palimpsests are a type of blackout

614

Arsenic poisoning may lead to thrombocytopenia, leukemia and BM suppression

615

In arsenic poisoning, bands of opacity in finger nails are called Aldrich-Mees lines

616

Affiliation cases are related to paternity dispute

617 618

Kennedy phenomenon results due to surgical alteration Incineration, dismembement and advanced putrefaction are methods of effacement of identity

619

Moletova cocktail is a bomb

620

Medullary index is used to determine sex

19

621 622 623

Harrison and Gilroy test is used for firearm injury After respiration, the weight of lungs increases by about 30 gm The most characteristic defence injuries are those sustained during an attack by knife

624

Ploucquet's test is used to estimate live birth

625

Weight of pineal gland is 0.1 to 0.2 gm

626

In smothering, there is abrasion on the inner side of upper lip

627

Death during anaesthesia, D.C. to be written by anaesthesist

628 629 630 631 632

Privileged communication may be used by a doctor to blackmail his patients Repeated intentional advertisement by a doctor in newspaper is professional misconduct Oath taking in the court is court formality The inquiry into the circumstances of death is inquest report 16 years age of female is an age to give valid consent for lawful sexual intercourse

633

Age of consent for medical examination is after eruption of III molar

634

Fragmentary medulla is seen in Negroid

635

For saliva, test used is alpha amylase test

636

Rule of Haase is used for estimation of foetal age

637

Wilson's classification is used to classify burns

638

Drugs interfering in blood grouping are barbiturate, aspirin and heparin

639

Phenol also retards putrefaction

640 641

In strangulation, neck muscle rupture is common In fresh water poisoning, there may be hyperkalemia, hemolysis and ventricular fibrillation

642

Brain stem death occurs in encephalomyelitis

643

Postmortem examination is done for all organ of the body

644 645

Historical milestones

646

Code of Hammurabi—oldest known medico-legal code.

647

Hippocrates (father of Medicine)

648

—discussed lethality of wounds

649

— formulated medical ethics. Manu law's — medical ethics— many sexual matters — most scientifically discussed. Justinian code

650 651

—regulated the practice of medicine & surgery.

652

— established the function of the medical expert for legal procedure.

653

Bartolomeo De Varignana — first medicolegal autopsy done by him in Italy.

654

Paulus Zacchias — written "medico-legal questions", questions Medico legalis." Fortunato Fedele—written first book on Forensic medicne.

655

Orfil—considered as father of Modern Toxicology.

20

656

a. In the 18th century, study in legal Medicine as a subject was established by appointing professorship in Germany.

657

b. In England Me Naughten's (who was aschizophrenic) rule has been established to deal with legal matters in cases of insanity or like situations whatsoever

658 659

Sec 118 IPC—Concealing design to commit offence punishable with death or improsonment for life.

660

Sec 176, IPC—Omission to give notice or information to public servant by person legally bound to give it.

661

Sec 177 IPC—Furnishing false information.

662

Sec 182 IPC—False information with intent to cause public servant to use lawful power to the injury of another person. .--Sec 191 IPC—Giving false evidence

663

Sec 192 IPC—Fabricating false evidence.

664

Sec 193 IPC—Punishment for false evidence.

665

Sec 194 IPC—Giving or fabricating false evidence with intent to procure conviction of capital offence.

666

Sec 195 IPC — Giving or fabricating false evidence with intent to procure conviction of offence punishable with imprisonment for life or imprisonment.

667

Sec 197 IPC—Issuing or signing false certificates.

668

Sec 201 IPC—Causing disappearance of evidence of offence, or giving false information to screen offenders.

669

Sec 203 IPC—Giving false information respecting an offence committed.

670

Sec 204 IPC—Destruction of document to prevent its production as evidence.

671

Sec 284 IPC —Negligent conduct with respect to poisonous substances.

672

Sec 304 IPC—Causing death by negligence.

673

Sec 309 IPC—Attempt to commit suicide

674

Sec 313 IPC—Causing miscarriage without woman's consent.

675

Sec 318 IPC—Concealment of birth by secret disposal of dead body.

676

Sec 319 IPC—Hurt.

677

Sec 320 IPC—Grievous hurt.

678

Sec 351 IPC—Assault.

679

Sec 362 IPC—Abduction.

680

Sec 375 IPC —Rape.

681

Sec 376 IPC—Punishment for rape.

682

Sec 377 IPC—Unnatural offences.

683

Sec 497 IPC—Adultery. Sec 39 Cr. P.C—Every person, aware of the commission of or of the intention of any other person to commit any offence is punishable under I.P.C. shall forthwith give information to the nearest magistrate of police officer of such commission or intention.

684

Sec 84 IPC—Nothing is an offence which is done by a person who at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act or what he is doing is either wrong or contrary to law.

21

Confabulation—Pathological loss of memory, e.g. — Korsakoff s psychosis. — Early stages of dementia.

22