Practical Forensic Medicine & Toxicology
WOUNDS
Theoretical parts:
* Parts required to be written in some reports.
1. Causes of subendocardial hemorrhage: "5Bs"
a) Blow b) Burn c) Blood loss : Hge
e) Poisoning: as phosphorus, As d) Blood diseases: as hemophilia
2. Characters of homicidal cut throat:
a) In the lower port of the neck b) transverse
c) deep from the start to the end d) Mot surrounded by hesitation marks
3. Causes of death from cut throat
a) Hemorrhage (Artery) b) venous air embolism (Vein)
c) Parasympathetic shock (sinus) d) asphyxia by choking (Trachea)
e) pneumania & sepsis (infection)
4. Differences between traumatic & pathological rupture of abdomen: BEB
Traumatic rupture Pathological rupture
Bruises present absent
irregular
Edge regular
Bulging of normal absent (but if excised, atrophic
present & normal
mucosa or diseased)
5. Differences between cut & contused wound in scalp:
Cut wounds Contused wounds
Abrasions & bruises absent present
Hair tip sharply cut crushed tip
6. Human bite mark & difference bet It & animal one:
Human bite animal bite
Shape elliptical 2 parallel lines
7. Definition & medicolegal importance of defensive wounds:
* Definition: wounds in the victim during defense for catching weapon or pushing
the weapon away
* Medicolegal importance:
a) Homicidal wounds b) victim was conscious
c) Victim was partially mobile (at least, can move hand)
d) Victim was not taken by surprise
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 Practical Forensic Medicine & Toxicology
Report:
* This part discusses items required in writing a report.
1. Identification:
* Anatomical part (write the anatomical part as you see it.)
e.g. scalp - abdomen - part of skin - duodenum 6V skin etc
Ä… * Sex : - whether male or female
- For example, if you see small nipple, hairy skin or bulky muscle, so it will be male
- If the jar shows uterus, so it is female
- If no thing determines sex, don't comment
Ä… * Age : - whether adult or young
- For example, if there is a large hand, it will be adult
- If there is a small heart, so it is for child
Ä… * Race : - all jars of wounds are for non negroid
- The jar must show die skin, DO NOT say for example, "lung of non negroid"
1 2 3 1 2
2. Injury description: T E N S A D + C C
Type : T E N S A D + C C
* Possibilities: abrasions - bruises - cut - contused - stab
* How to know? from titles of jars (see after)
Edge : T E N S A D + C C
* Possibilities:
- regular edge - irregular edge
- in stab, the injury with one acute angle & the other rounded
- surrounded by bruises 6c abrasions
- surrounded by hesitation marks
Number : T E N S A D + C C
* Possibilities: - single or - multiple
Size : T E N S A D + C C
* Possibilities: as you see it For example: 2 cm, 10 cm, 5X8cm (if with dimensions)
2
Size : T E N S A D + C C
* Possibilities: - Linear - Rounded - Oval - Triangular
3
Size : T E N S A D + C C
* Try to give full comment
* For example: - Lower part of RT forearm, at the lateral aspect of wrist joint
- RT chest, 4 cm below the nipple
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 Practical Forensic Medicine & Toxicology
Antemortem or postmortem : T E N S A D + C C
* Possibilities: all jars (wounds) are Antemortem except one which has a postmartem
wound ( )
* Why the wound is antemortem?
1- Hyperemia or blood clots (there are dark spots)
2- Healing or sepsis (in sepsis, (there is yellowish staff)
3- Gapping of the wound (the wound is opened)
* If you saw nothing of the causes, say "antemortem due to hyperemia" or "antemortem" only
1
Direction : T E N S A D + C C
* Possibilities : - transverse - oblique - longitudinal
* Direction is not a very important item
2
Depth : T E N S A D + C C
* Possibilities: deep or superficial
* All wounds are deep except :
Abrasions & bruisess or defensive cut wounds which are superficial
Causal instruments : T E N S A D + C C
* Possibilities: blunt sharp or sharp penetrating
* All are blunt except :
- Cut wounds are caused by sharp instruments
- Stab wounds are caused by sharp penetrating instruments
Cause of death : T E N S A D + C C
* Possibilities:
- Hemorrhage: as in cut wrist or in scalp
- Sepsis (if there is yellowish staff)
- Cut throat in this case, you must enumerate causes of death from cut throat
3. Conclusion:
* First part to be read by the examiner, so you must write it correct
* How to write conclusion?
Conclusion = identification + T A C C
Conclusion= identification + T A C C
Conclusion = identification + T A C C
Conclusion = identification + T A C C
Anatomical part Age Sex Race Type Antemortem Causal instrument Causes of death
- For example:
Rt hand of adult male non negroid, showing cut wrist, antemortem (due to
gapping), caused by sharp instrument, cause of death is hemorrhage
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 Practical Forensic Medicine & Toxicology
How to write a long report ??
* you should fulfill all items in "report"
* in injury description, each item must be in a separate line
* for example, give a long report on jar 117, p20, in museum specimens book ,this
jar is with title "stab wound (healing & sepsis)"
Identification: Rt chest of male, adult, non negroid
Injury description:
Type : stab wound
Edge : regular
Number : single
Site: below Rt nipple by 4 cm
Size : 3cm
Shape: linear
Antemortem : due to healing & sepsis
Direction: transverse
Depth: deep
Causal instrument: Sharp penetrating instrument
Cause of death: injury to internal organs & sepsis
Conclusion :
Rt chest of male, adult, non negroid, showing stab
wound, antemortum due to healing & sepsis , caused by
sharp penetratin instrument, cause of death is sepsis
How to write a short Report ??
* you must write it in a paragraph
* it includes Conclusion + comment on the items on the "Title of the Jar"
For example: give a short report on jar 117, p20. This jar is with title "Stab wound
(healing & sepsis)"
Rt chest of male, adult, non Negroid, showing stab wound, antemortem due to
healing & sepsis caused by sharp penetrating instrument, cause of death is
hemorrhage
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 Practical Forensic Medicine & Toxicology
Page Number Jar Number TITLE Notes
Dragging abrasion,
18 76 below 21 years, short
Car accident.
Pressure abrasion,
19 72-80 Iron door mat, short
Human bite mark.
Suicidal cut wrist,
20 88 Hesitation marks, long
Left handed.
21 89 Defensive cut wound (MLI) long
Cut wound in scalp
22 115 short
(DD from contused)
Stap (healing, sepsis) one
23 117 long
week
Contused wound (DD from Long
24 122
cut) 1 ' # **
Homicidal cut throat
40 311 long
(characters, cause of death)
Stab in rt. Long (single
42 340 long
sharp bladed)
41 329 Sub endocardial hge (5B) short
Traumatic Rupture of
43 369 Duodenum (BEB,DD from
pathological)
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 Practical Forensic Medicine & Toxicology
INFANTICIDE
Items to comment on:
1- Identification:
2- Describe 4
1Day 2Day 1Week 2Week
Mature or not ?
Umbilicus
Wounds
Live birth or still birth? Ext. Signs
Skin (maceration & desq.)
Int. Signs L I V
Lactate Inspired lung Vascular changes
5C Inspired lung Non inspired lung
1- Color mosaic patches of blood and air uniform pink
not fill chest cavity
2- Cavity fill chest cavity
(not cover the heart)
3- Consistency (if felt) crepitus (if felt) firm
4- Counter (edge) rounded sharp
5- Compressed
bubbling no bubbling
(under water)
How long he lived?? 1 Day (hyperemia around umbilicus)
Cause of death
a- Hemorrhage Pallor Cut throat
b- IC hge : 1 - Scalp bums
2 - Skull fracture
3 - Cavity: Big haematoma
c- Ashyxia :
1- Signs:
Ext. Blue extremities (eyelids, lips, nails)
Bulging tongue
Int . Tardieu spots
2-Causes:
1-smothering: nail abrasions around mouth and nose.
2-strangulation: umbilical cord around the neck.
3-Conclusion: Identification + Title of Jar
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 Practical Forensic Medicine & Toxicology
Page Number Jar Number TITLE Notes
Still
P.55 Jar 408 Birth( Stomach &
Lung)
Live
P.56 Jar 412 Birth [Asphyxia
(Tardieu Spots)]
Live
P.57 Jar 422 Birth.(Asphyxia by
Smothering)
Live Birth (Asphyxia
P.58 Jar 423 by Smothering +PM
wound)
Live Birth
* Turn the
P.59 Jar 429 (Strangulation by UC
jar *
[+placental)
Live birth (Infanticide
P.60 Jar 433 By Head Injury) To see * Turn the jar *
long hair Mature
Cut Throat.(1 day,
P.61 Jar 439
pallor,TAC)
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 Practical Forensic Medicine & Toxicology
TOXICOLOGY
* Items to comment on: 4Ds
1. Destruction
2. Diagnosis
3. cause of Death
4. Differential diagnosis
Jars titles and comments:
1) P.76: Alkaline potash ( stricture / cachexia)
- Diagnosis - Destruction - cause of Death - & no D.D.
Comment:
Destruction:
*stomach : a) necrosis and destruction of mucosa (ulceration)
b) grayish altered blood (alkaline haematin) digested blood
*oesophagus: stricture of lower end of oesophagus
Diagnosis : alkaline potash
Cause of Death : cachexia (emaciation)
2) P.77 Carbolic acid (superficial ulcers & exaggerated rugae)
- Diagnosis - Destruction - cause of Death
Comment:
Destruction:
*stomach : a) superficial mild ulcers
b) thick mucosa
c)hypertrophied wall
d)exaggerated rugae
Diagnosis: Carbolic acid from smell
green urine on exposure to air Confirmation
Cause of Death : Respiratory failure & Renal failure 2 RF
4) P.79Carbon monoxide (3Cs) (Turn Jar)
- Diagnosis - Destruction - cause of Death
Comment:
Destruction:
* Brain and kidney
Crimson red discoloration of vessels (carboxyhaemoglobin)
Diagnosis: carbon monoxide poisoning (spectroscope)
Cause of Death: Red asphyxia
DD: Cyanide, Cold
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superficial mild ulcers with
abnormal mucosa in between
Turn the jar to see kidney to
differentiate this jar from jars page
23,24 ( brain only : cerebral
conclusion) or traumatic IC hge..
 Practical Forensic Medicine & Toxicology
5) P79: Cocaine (3Cs)
- Diagnosis - Destruction - D.D.
Comment:
Destruction :
* nasal septum with perforation due to cocaine which:
- causes vasoconsbiction
- is adulterated with salicylic acid powder necrosis ulcer perforation
Diagnosis : Cocaine
DD : chromium " chronic arsenic poisoning
Miscellaneous
Scalds & Burns
l) Scalds 1st & 2nd degree
Hyperemia Vesicles
2)P.M Burn no V. H. H.
Vesicles Hyperemia Healing or sepsis
Singed hair
3)Pathological rupture of duodenum B E B
D.D.
12 Days
1) Burn Toxins
2) Bacterial Toxins
3) VC ( Stress ulcer (Curlings ulcer))
Page Number Jar Number Title Notes
Scalds
62 447 (lst & 2nddegree)
Hyperemia ruptured vesicle
P.M bum to hide the crime
63 459 (P.M: NO V.H.H)
(Burn: singing hair)
Pathological rupture of duodenum (Burn.
64 469
BEB. D.D, 12 days)
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 Practical Forensic Medicine & Toxicology
P. 67: 5Ps Probable , Peeling , Putrefaction , Pair weeks , Prints
Probable sign Def by putrefactive Submersion MLI
of asphyxia gases under water
Comment:
Hand showing probable sign of drowning because of peeling which is separation of
epidermis from dermis caused by putrefactive gases in between them .
This peeling is due to submersion under water for pair weeks.
MLI is that finger prints are preserved In both fingers and peeled skin
Cause of death: No air entry
P. 68: choking (melon seed) + tracheostomy (contraction of air passages)
(Turn Jar)to see tracheostomy - cause of Death
Comment:
Air passages and chest organs of a young boy who died from asphyxia by choking
due to inhalation of a melon seed.
There was a tracheostomy operation which couldn't save his life as cause of death is
contraction of air passages (or impaction in It bronchus) which is in a lower level
than the operation.
P. 69: choking (meat)
Comment:
Upper part of air passages from a case of asphyxia by choking due to impaction of
a piece of meat causing complete obstruction
Cause of death:
1) CVS (parasympathetic chock)
2) Closure of air passages
3) contraction of larynx ( laryngo~spasm )
Hymen
How to comment on hymen?
*why the female is virgin?
because of intact hymen
*why this genitalia from female after puberty?
because of hair on labia majora
*how to determine type of hymen?
crescentic with anterior opening Cresentic Hymen
if hymen is
with central opening with serrations Dentate Hymen
Titles and comments on Jars:
P.75 Crescentic hymen (Anterior opining virgin)
Comment:
Virginic genitalia (intact hymen) of a female after puberty (hair on labia majora),hymen is
crescentic with anterior opening (or with opening in upper margin of membrane)
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Probable peeling/ Putrefaction
pair weeks prints
choking/melon seed tracheostomy
contraction of larynx
chokig meat
 Practical Forensic Medicine & Toxicology
Asphyxia: Jars P. 60, 61 62, 63, 64, 65
* Theoretical part
1.Types of asphyxia:
strangulation " drowning " hanging " choking
2.Causes of death in asphyxia:
*In strangulation and Hanging: 3Cs :
1) CNS (cerebral anaemia and ischaemia due to pressure on carotid)
2) CVS (parasympathetic shock due to stimulation of vagal receptors)
3) Closure of air passages:
*In choking: 3Cs :
1) CVS (parasympathetic chock)
2) Closure of air passages
3 )Contraction of larynx (laryngospasm)
*In drowning: No air entry
How to comment on asphyxia?
1-discuss the jar from the title of Jar
2-cause of death
Titles of jars of asphyxia:
P. 64 : Homicidal strangulation (part of ligature + hyoid) PM burn
- Diagnosis -why strangulation - why P.M.? - Why P.M. burn??
Comment:
Skin of neck showing homicidal strangulation (part of ligature mark + AM fractured hyoid
bone to the inside ).
There's PM burn to hide the crime (no vesicles, no hypraemia no healing nor sepsis)
Cause of death is:
1)CNS (cerebral anaemia and ischaemia)
2) CVS (parasympathetic shock)
3)Closure of air passages
P. 66: Sure sign of drowning (larynx, lung & spleen)
Comment:
Lung, spleen & larynx showing sure signs of drowning as:
*lung: pale , ballooning (large or voluminous), petichial hge (Tradieu & silvery spots)
*spleen: contracted with corrugate capsule
P. 74: Dentate Hymen: intact (control opening)
Comment:
Virginic genitalia (intact hymen) of a female after puberty (hair on labia majora ),
Hymen is dentate (with central opening and small serrations), misdiagnosed with
ruptured hymen
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 Practical Forensic Medicine & Toxicology
FIREARM
* Cartridge Rifled
Non rifled
* Missile bullet
shots
* Wads external wad
Internal wad
* Powder black powder
Smokeless powder
Theoretical part: 2 types of cartridges
1) Rifled cartridges: 2) non Rifled cartridge:
*Tube containing a bullet *Tube containing shots
*Made of cupper *made of cartoon(card board)or plastic
*Shots are lodged bet. External & Internal wads
Cartidge:
*Items to comment on:
1) Rifled or non
2) Long or short
3) Automatic or non
4) Fored or not
5) Caliber
6) Loaded or empty (extras)
Ò! Scheme for cartridges:
1) Look at the cartridge: If the cartridge
is made of cupper is made of cartoon or plastic
Contains a bullet
Rifled Cartridge Non-Rifled Cartridge
2) If the cartridge is 2) it must be:
Long
Long with
Short with
tapering end
stunted bullet
Short
Long
3) Groove or constriction rim 3) It must be:
near the base
Non-Automatic
rim
Automatic Non-Automatic
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 Practical Forensic Medicine & Toxicology
4) Look at the under surface:
A- Look at the percussion cap,
If there is :
Depression No Depression
Fired Not Fired
B- Caliber
In rifled cartridge In non-rifled cartridge
*In rifled cartridge only, you must Say the definition: *look at the No. written on the under surface & write it
Caliber = diameter of the base of the bullet Caliber = 12/20 (most common no.)
Then
*look at the base of the cartridge, search for
numbers with: Point(e.g. 0.45or 2.34) 0.88 Inch *DO NOT EVER : write the definition in non rifled
Unit (e.g. 9 mm) 8.88 mm cartridges have SHOTS not bullet
Examples:
39
*Caliber = diameter of & ... = 2.34 mm
32
2.34 mm
39
*caliber = diameter of & = 0.45 inch
32
Inch
0.45
39
*caliber = diameter of & =9 mm 32
mm
9
If U found a
number without
39
32
*caliber = diameter of... (Only)
point , U should
9
only write the
definition
5) Look at the upper surface:
If the cartridge is
N.B. "loaded or empty" has nothing
to do with "fired or not" as bullet
Full or with a Bullet Empty
may be removed from the cartridge,
So it is empty but the cartridge is
Still not fired as there is no depression
Loaded
Empty
on the percussion cap
Ò! How to comment on cartridge ??
In non rifled cartridge: In rifled cartridge:
Empty/loaded cartidge of long/short, rifled
Empty/loaded cartridge of long, non rifled
(cupper), non automatic (rim) /automatic
(plastic/cartoon), non automatic (rim), fired
(groove), fired (depression at the PC) /not
(depression at the PC) /not fired (no depression
fired (no depression at the PC), Caliber =
at the PC) /misfired (depression at the PC but
diameter of the base of the bullet (=8.88
still loaded), caliber=12/20
mm/8mm/0.88 inch)
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 Practical Forensic Medicine & Toxicology
Missile:
Bullets :
Ò! Items to comment on:
2C Cartridge 2F Fired
Caliber Fur (Jacket)
Ò! Scheme for missile:
1) Cartridge:
*it is rifled
*if the bullet is Short So Cartridge is short
Long So Cartridge is long
2) Caliber :
*Write "caliber equals diameter of the base of the bullet"
3) Fired or not:
*if the bullet shows deformity or rifling marks Fired
Doesn t show deformity or rifling marks not fired
4) Fur (jacket )
*If the bullet
Its color is black or grey not jacketed
Is covered with cupper (yellow color) completely jacketed with cupper
Is covered with Nickel (silver color) completely jacketed with silver
Is covered with both cupper & nickel (part yellow & part silver) composite
Ò! How to comment on bullet??
Long/short, rifled, Automatic/non-automatic, Caliber = diameter of the base of the bullet,
Fired (deformity/rifling marks)/not fired (no deformity/ no rifling marks),
not jacketed/completely jacketed with Cupper/Nickel/Composite jacket.
Ò! If Cartridge & Bullet:
*you will comment on the cartridge + jacket of bullet
*Example:
Loaded cartridge of short, rifled (cupper), not fired (no depression
at PC), Caliber = diameter of base of the bullet= 9 mm, bullet
completely jacketed with cupper
Shots :
Ò! How to identify shots?
*Look at the diagram
Ò! How to comment on shots?
*Only one comment
Shots of sporting gun (long, non rifled & non automatic) (shots small rounded lead balls)
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 Practical Forensic Medicine & Toxicology
Wads :
Ò! Theoretical part :
Internal wad External wad
Thick Thin
Made of felt Made of cartoon
10 m 1-3 m
Ò! Scheme of wads
*If the wad is Thick Internal wad
Thin External wad
Ò! How to comment on wad?
Internal wad, Thick, disc in shape, External wad, thin, made of cartoon,
made of felt, present in long, non present in long, non rifled, non
rifled, non automatic weapon. automatic weapon.
Powder:
Ò! Items to comment on:
1) Types: black or smokeless
2) From:
- Granules for black powder
- Cordite, rods, scales, or granules for smokeless powder
3) Made of & & . .
Ò! Scheme for powder
1) Look at the tube if :
Cotton stained black Cotton is clean
Black Powder Smokeless Powder
2) for Form :
Granules Cordite Rods Scales Granules
Ò! How to comment on powder?
Black powder, Smokeless powder,
Granules, Cordite/Rods/Scales/Granules,
made of Carbon 15%, Sulphur 10% & K made of Nitroglycerine &
nitrate 75% Nitrocellulose
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 Practical Forensic Medicine & Toxicology
1- Scalp
HEAD INJURIES
2- Dura
3- Brain
Ò! Theoretical part:
4- Skull
1- P.M.P of extracranial Hge :
a) Scalp: wound
b) Skull: fissure fracture
c) DURA: hge
d) Brain: compression
e) Central asphyxia (written in jar of extradural & subdural He if come as long jar, p.22)
2- Fate of concussion:
a) Complete recovery (most common)
b) Incomplete recovery (post concussion stage)
c) Concussion passing to compression directly
d) Concussion passing to compression with lucid interval
e) Death due arrest of vital centers (write it in jar of fatal concussion if come as long jar )
3- D.D. of Traumatic & Pathological I.C. Hge :
(write it in jar of Traumatic I.C. Hge if come as long jar P.27)
Trumatic Pathological
*Brain is lacerated due to penetrating puncture *Brain is not lacerated
*Haemetoma from outside to inside *Haematoma from inside to outside
Ò! How to identify the jar ??
a) Scalp: One jar in wound s mentioned before
b) Dura: One jar showing dura with a big dark haematoma
c) Brain: You will find a brain tissue but 1st you should rotate the jar & look for kidney
- If present CO poising
- If absent Fatal concussion
- In jar of Traumatic I.C. He, you will find a brain heamatoma
d) Skull: - Usually skull cap & showing a fissure depression or other wound, but take care in jar
(245 page 28) it is a depressed fracture & not firearm
- Any Triangle Head Injury
Ò! Items to comment on in jars:
A- For Dura : ( jar page 25)
Identification:
*Extradura: - opaque surface - Middle Menenigeal Vessels
*Subdural: - glistening - Falx cerebri
Description:
a)Bleeding*extradura :big haematoma *subdural: blood spots
b)cause: extradural & subdural Hge due to trauma
c)cause of death :central asphyxia
Conclusion:
Identification + positive finding + title of jar
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 Practical Forensic Medicine & Toxicology
B- For Brain:
Patholgcal
Item Fatal concussion(P.26) Traumatic I.C. Hge (P.27)
cerebral Hge (P.28)
identification T.S. in Brain T.S. showing lower half of brain T.S. in the brain
lacerated due to penetrating
Brain tissue
punctured wound in frontal lobe
Brain vessels Congested congested
Didn't reach the
surface of the brain
peticheal Hge scattered big haematoma extending from
Bleeding & its main bulk lies
in Brain substance outside to inside
within brain
substance
Cause falling from height (22m) trauma by iron bar Pathological
Cause of death fatal concussion Hge Hge
If the jar is long. other fates of concussion D.D. from pathological I.C. Hge
C- Skull :
Identification:
* anatomical part + age, sex, race
* any age, any sex, race is non Negroid except only in :
jar 221 page 25 which is for Negroid
description (injury):
* TEN SAD + 2C +2Pe
Type: T E N S A D + C C + Pe Pe
1. Fissure
2. Communicated
3. Depressed
4. Cut with gap due to loss of bone
Edge: T E N S A D + C C + Pe Pe
* If Healing Regular
* If Sepsis Irregular (worm eaten appearance)
Number: T E N S A D + C C + Pe Pe
Size: T E N S1 A D + C C + Pe Pe
Shape: T E N S2 A D + C C + Pe Pe
* In fissure: Linear with no loss of bone
* In cut: Linear with loss of substance
* In depressed: Spherical or triangular or rectangular (signature fracture )
* In communicated: It is "mosiac shaped" or "spider web shaped" or "multiple lines
communicating with each other"
Site: T E N S3 A D + C C + Pe Pe
* you must mention in which cranial bone & the relation to sutures
* Ex: in Rt parietal bone 2 cm behind coronal suture & # cm from the sagittal suture
Antemortem or postmortem: T E N S A D + C C + Pe Pe
*all are antemortem due to:
1- Blood clots
2- Surgical interference (trephine) clearly cut edge widened by bone nibbling
forceps
3- Sepsis
4- Healing (smoothing of edge : live 3 months) (membranes formation: live 12
months)
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 Practical Forensic Medicine & Toxicology
Depth : T E N S A D + C C + Pe Pe
*all are deep.
Cause of Death : T E N S A D + C C + Pe Pe
1- Hge & central asphyxia .
2- Healing (permenant infirmity): extremes of weather, trauma, jacksonian
epilepsy, infection.
3- Sepsis: meningitis, encephalitis, brain abscess, cavernous sinus thrombosis.
Causal instrument : T E N S A D + C C + Pe Pe
Low momentum High momentum
Wide
Striking
Fissure Comminuted
Surface
Localized
Depressed Firearm
Striking
Surface
For example: depressed fracture is caused by blunt instrument with localized
striking surface & low momentum
NB.: cut fracture is caused by sharp instrument with moderate momentum
Permanent infirmity : T E N S A D + C C + Pe Pe
*There must be a gap of the fracture &
*He must have lived (not died shortly) this means that there must be healing or tissue
formation or sepsis
Period between trauma & death: T E N S A D + C C + Pe Pe
*We know it by:
1- If smooth lived > 3 months
2- If tissue (membrane) formation lived > 12 months
3- If sepsis lived 4-6 months
4- If you find nothing died shortly
Ò! Conclusion = Identification + TACC+ 2Pe + title of jar
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 Practical Forensic Medicine & Toxicology
Page Jar
Title Notes
Number Number
25 159 Extradural & Subdural Hge If Long report + p.m.p
Rotat jar {no kidney }&
Fatal concussion with
26 174 Long report + other fate
petechial Hge
concussion
Long report + D.D of
Traumatic I C He+ punctured
27 176 Traumatic &
wound
Pathological I.C Hge
Terphine + smoothing+
29 221 lived>3m+ negroid fronta +
suture + old depressed
Comminuted fracture & intra &
30 241
extracranial Hge
Depressed fracture + Ox +
31 242
sepsis
Depressed fracture+ He +
32 245
temporal bone
Cut fracture& Depression +
33 253
fissure Due to falling
Comminuted depressed
34 254
Fracture + fragemented bone
Cut fracture+sepsis+4-6
35 261
Weeks
Trephine + smothering +
36 295 lived>3months,old depressed
,bone nibbling
Trephine + membrane,
37 298 lived>12 months, old
depressed, old fissure
38 305 Trephine+sepsis+4-6 weeks
Septic lacerated wound in
39 309
scalp + parietal eminence
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 Practical Forensic Medicine & Toxicology
MICROSCOPE
Reinsch test: *Mercury *Arsenic *Antimony
Semen analysis: *Complete sperms
Blood: *Human blood *Animal blood (mammalian) *Animal blood (non mammalian)
Hair: 1-Stem: *Human hair *Animal hair
2-Root: *pulled by force *fallen by itself
3-Tip: *sharply cut *crushed *tapering with a pointed end *rounded
Fibers: *Collagen fibers *Wool *Silk *Linen
Reinsch test:
Ò! How to identify Reinsch test?
*Look at the microscope from outside, if there is a tube Reinsch test
Ò! Scheme for Renisch test:
*Look at the eye piece
Mercury
If you find Spherical or rounded
globules
Octa- or Tetra-hedral
Arsenic
crystals
Antimony
Amorphous crystals
Ò! How to comment on Renisch test?
Renisch test (for metallic poisons) showing black spherical globules of MERCURY
Renisch test (for metallic poisons) showing Octa- or Tetra-hedral crystals of ARSENIC
Renisch test (for metallic poisons) showing amorphous crystals of ANTIMONY
Semen Analysis:
Ò! How to identify semen analysis?
*You must find complete sperms (formed of head, neck & tail)
Ò! How to comment on semen analysis?
Semen analysis film showing complete sperm s (each is formed of head, neck & tail)
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 Practical Forensic Medicine & Toxicology
Blood:
Blood film:
Ò! Scheme for blood films: Look at the eye piece
Human Blood
If you find Rounded RBCs with NO nuclei
BBloodoodBlood
Animal blood
Oval RBCs with NO nuclei
Mammalian e.g. camel
Animal blood
Oval RBCs + Nucleated
Non- Mammalian e.g. Hen
Ò! How to comment on blood films?
*Describe the slide as follows then write
*It is confirmatory micro chemical for dried blood(blood stain)
Blood film showing HUMAN blood; rounded, anucleated RBCs, it is confirmatory
microscopical for fresh blood
Blood film showing ANIMAL blood (mammalian e.g. camel; oval, anucleated RBCs, it is
confirmatory microscopical for fresh blood
Blood film showing ANIMAL blood (Non mammalian e.g. camel; oval, nucleated RBCs,
it is confirmatory microscopical for fresh blood
Blood test:
Ò! Scheme for Blood test: Look at the eye piece
If you find Rosette or feather- shaped
Takayama test
Crystals
Rhombic brownish crystals
Teichman test
Ò! How to comment on blood test?
*Describe the slide as follows then write
*It is confirmatory micro chemical for dried blood (blood stain)
Takayama test showing pink crystals of alkaline reduced haemin arranged in rosette shaped
or feathery shaped crystals . It is confirmatory micro chemical for dried blood (blood stain)
Takayama test showing rhombic crystals of acidic haemin (or Haemin HCL). It is
confirmatory micro chemical for dried blood (blood stain)
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 Practical Forensic Medicine & Toxicology
Hair:
Stem:
Ò! Theoretical part:
Histology of Hair:
Hair is formed of cuticle, cortex & medulla.
Difference between human & animal hair:
Human hair Animal hair
Cuticle 1 layer of cells >1 layer of cells
Medulla Interrupted & thin Continuous & thick
Cortex Continuous & thick Interrupted & thin
Ò! Scheme for hair stem: Look at the eye piece
Stem of human hair
If you find Interrupted & Thin
Stem of animal hair
Continuous & Thick
Ò! How to comment on stem of hair?
*from theoretical part
Stem of HUMAN hair: Stem of ANIMAL hair:
- Cuticle: one layer of cells - Cuticle: more than one layer of cells
- Medulla: interrupted + thin - Medulla: thick and continuous
- Cortex: continuous + thick - Cortex: thin + interrupted
Root:
Ò! Scheme for hair root: Look at the eye piece
Hair fallen by force
If you find bulking root + ruptured sheath
Flattened atrophic root + absent sheath
Hair fallen by itself
Ò! How to comment on root?
Ruptured sheath of root i.e. pulled by force; Degenerated root i.e. fallen by itself;
bulky healthy root with ruptured sheath, flattened atrophic degenerated root with
denting sign of struggle & resistance absent sheath
Tip:
Ò! Scheme for hair tip: Look at the eye piece
If you find
Crushed tip of hair
Sharply cut tip of hair
Rounded tip of hair
Tapering tip with pointed end
Ò! How to comment on tip?
Sharply cut tip of hair with angular tip, denoting: Crushed tip of hair, denoting:
1-Recently cut (2-3days) 1-Around contused wound
2-Around cut wound 2-Caused by blunt instrument
3-Caused by sharp instrument
Rounded tip of hair, denote cut < 2 weeks
Tapering tip of hair with pointed end,
denoting cut > 2 weeks
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 Practical Forensic Medicine & Toxicology
Fibers:
Ò! Scheme for fibers: Look at the eye piece
If the fibers are curved & twisted Cotton Fibers
Straight lines Several animal hair Wool
(with thick continuous medulla)
smooth, no segments& shiny Silk
Segments & swelling Linen
&grouped in bundles
Ò! How to comment on fibers?
Cotton fibers; curved & twisted ribbons
Wool; scales with animal hairs (the hair is with thick continuous medulla)
Silk; smooth, shiny with NO segments
Linen; segments & swellings, & grouped in bundles (bamboo shaped)
Seeds
Ò! Scheme for seeds
If the seed (s) is / are
Large in size (one large seed)
Strychnos nux vomicus
like a button with 2 ridges
on its surface
3Cs
Castor oil seeds
Medium in size seeds
D ' I2
+ Lustrous
& mosaic
D ' I2 + not lustrous
Croton oil seeds
& no mosaic
Colocynth seeds
' I2
Datura fastiosa seeds
Small in size
If the seeds are
Both are kidney-shaped
If the seeds are Datura Stramonium seeds
!'/
Atropa Belladona Seeds
Very Small in size
Brown sand
like sand
Yellow sand
Papaver somniferum seeds
Ò! How to comment on seeds?
Strychnous nux vomica Castor oil seeds
- Description - Description
Color: grayish Color: brown
Shape: circular Shape: oval
Surface: umbilicus + 2ridges + hairy surface Surface: lustrous and mosaic
- Active principle: Strychnine - Active principle: Castor
- Action: Decrease synaptic resistance - Action: Abortion + purgative
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 Practical Forensic Medicine & Toxicology
1- Capsule
Toxic spots
2- Root
3- Seed
Two rules for toxic spots:
Rule 1: items to comment on: Rule 2: the 3C + J have the same action:
A) Describe color, shape, surface Abortion + purgative
B) Active principle A) Castor oil B) Croton oil
C) Action C) Colocynth D) Jalap
Capsules
Ò! Scheme for capsules
Datura capsule
If you see F *
Like orange
Colocynth capsule
Ò! How to comment on capsules?
Datura capsule Colocynth
Description: Description:
- Color: green(fresh), yellow(dry) - Color: yellowish
- Shape: berry like(oval) - Shape: rounded(like an orange)
- Surface: thorns(called thorn apple) - Surface: smooth
Active principle: atropine, hyoscine and hyocyamine Active principle: Colocynthin
Action: Atropine and hyocyamine: Action: Purgative + abortion
a) CNS stimulation then depression
b) Peripheral antimuscaranic
Hyoscine: central depression from the start
Root
Ò! Scheme for roots:
If you see 2 pieces in the jar Aconite root
1 piece in the jar
Jalap root
Ò! How to comment on roots?
Aconite root Jalap root
Description: Description:
- Color: brown - Color: brown
- Shape: conical with WHITE cut section - Shape: fusiform with BROWN cut-section
- Surface: wrinkled - Surface: wrinkled
Active principle: aconitine Active principle: Jalapine
Action:
Action: purgative and abortion
1- cardiotoxic
2- CNS stimulation then depression
Datura Fastiosa seeds
3- coupled nerves (sensory & motor):
Description:
stimulation then depression
- Color: BROWN
- Shape: kidney shaped
Croton oil seeds
- Surface: mammilated & another ridge at the
Description:
of convex border
- Color: BROWN
Active principle: atropine, hyoscine,hyocyamine
- Shape: Oval
Action: Atropine and hyocyamine:
- Surface: NOT lustrous and NOT mosaic
a) CNS stimulation the depression
Active principle: croton
b) peripheral antimuscaranic
Action: abortion & purgative
Hyoscine: central depression from the start
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 Practical Forensic Medicine & Toxicology
Datura Stramonium seeds Atropa Belladonna seeds
Description: Description:
- Color: BLACK - Color: BROWN
- Shape: kidney shaped - Shape: kidney shaped
- Surface: mammilated & another ridge at - Surface: mammilated & another ridge at
the of convex border the of convex border
Active principle: atropine, hyoscine, hyocyamine Active principle: atropine, hyoscine, hyocyamine
Action: Atropine and hyocyamine: Action: Atropine and hyocyamine:
a) CNS stimulation the depression a) CNS stimulation the depression
b) peripheral antimuscaranic b) peripheral antimuscaranic
Hyoscine: central depression from the start Hyoscine: central depression from the start
Colocynth oil seeds Papavera somniferum seeds
Description: Description:
- Color: GREY - Color: YELOWISH
- Shape: Oval + pointed end - Shape: kidney-shaped
- Surface: smooth - Surface: honey comb reticulations
Active principle: colocynthin Active principle: traces of morphine
Action: abortion & purgative
Ò! N.B. How to differentiate between & & & ..
Strychnos nux vomicus & External wad
* * F ' G
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 Practical Forensic Medicine & Toxicology
BONES
Identification:
Bones Jars L.L.
33 y
1) Calc.: 5m
2) Talus: 7m
3) Femur: 8m
4) Knee: 9m
Medullary Cavity Ossific center
(if @& : -2 years)
3 Jars are present
1) 9m
2) 2y > - > 1y
3) 7 years: (Age of discrimination)
Page Jar
TITLE Notes
Number Number
O.C-ossification
1 8 Full term (O.C)
center
ly< - <2y
2 9
O.C of upper & lower limbs
7 years
4 13
Age of discrimination
Bone
Ò! Points to talk about: 2A,2N,2S,2D
1. Animal All human
2. Number 1, unless if there's 2 sternums
3. Stature femur 18%, humerous 9%
4. Death Why? Not known
When? (No soft) & (no ligaments)
5. Deformity All normal except sterna fracture
1) Frontal suture
6. Niqroid or not (in skull only & comment on
2) Pterion
7. Sex
8. Age
Ò! 7) Sex :
l) Supraciliary ridge (bulge & prominent = B& )
a- Skull
2)Mastoid process (large =B& )
- Body > 2 X manubrium = B& )
b- Sternum
- Body < 2 X manubrium =@& )
c- Hip
l) Greater Sciatic Notch
2) Iliac Crest
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 Practical Forensic Medicine & Toxicology
Ò! 8) Age :
Rt arm
Rt Leg
18y
20y
17y
16y
21y
18y
Ò! Long Bones Age & Stature
3 Jars are present
1. 14 < - <15
2. 12 < - <14
3. > 21
Page Number Number Title Notes
I4y < - < l5y
6 16
Age & stature
>21y
7 23 If female -2
I2y< - <15y age & stature
5
15 O.C of upper limb
(Age & Sex)
Body > 2 X manubrium = B&
Body < 2 X manubrium = @&
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 Practical Forensic Medicine & Toxicology
Hip (Age & Sex)
4
1) Greater Sciatic Notch
2) Iliac crest
Page
Number Title Notes
Number
The 1st two sterni Female
N.B the 2nd
2- Age & sex
9 32,33 sternum of the
The 3rd .. male > 40 yr
female is fractured
The 4th .. male > 60 yr
Female >23
8 25,26
Age & sex
Skull ( Age & Sex & Nigroid )
Age : 1 ) All permanent teeth are erupted >18 y
2 ) Basi sph. & basi occip. >23 y
3 ) Coronal suture ( C ' ) > 40 y
  O
 ^ O O
 O
 O
If Child Milk Teeth : 6 - 9 - 18 - 1 yr - 2 yr
Sex : Talk about :
l) Supra ciliary ridge
2) Mastoid process
Negroid : Talk about :
l) Frontal suture
2) Pterion
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 Practical Forensic Medicine & Toxicology
Page Jar
Title Notes
Number
Number
1.5y < - < 2y
3 12
Teeth Ant. fontanelle
Sex cannot be identified
Non-negroid
Age & sex & race
8y < - < 9y
10 37
Sex cannot be identified
Non-negroid
1 1 40 Male negroid > 40y
Female negroid
12 46 Non-negroid
23y < - < 30y
Medullary cavity
13 47 30y < - < 33y
If female - 2
Negroid
29 221 Trephine + smothering > 3ms
N.B. old depressed fracture
Comminuted fracture
30 241
Intra & extra cranial Hge
Depressed fracture
Any triangle is
31 242 Sepsis 6 weeks
depressed fracture
( O .X )1
Any triangle is
32 245 Depressed fracture & Hge
depressed fracture
Cut fracture & depression
33 253
N.B. Fissure fracture
34 254 Depressed fracture with comminution
Cut fracture
35 261
Sepsis 6 weeks
Trephine & smothering > 3ms
36 295
N.B. old depressed fracture
Trephine & membrane > 12ms
37 298
N.B. old depressed fracture
Trephine
38 305 Sepsis 6 weeks
N.B. Old depressed fracture
Septic perforation
39 309
after lacerated wound 6 weaks
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 Practical Forensic Medicine & Toxicology
Firearm Injuries
Theoretical parts
1) Direction :
- If the powder marks are present ALL around the inlet so direction is Perpendicular firing
2) Distance :
- If the weapon is rifled & there are powder marks around the inlet so distance is < 1.5m.,
if long weapon < 25 cm if short weapon
- If the weapon is non-rifled :
" Shots are with no dispersion, so distance is < 1 m.
" Shots are with starting dispersion, so distance is 1 - 4 m.
" Shots with full dispersion, so distance is > 4 m.
3) Beveling : (in bone, not in soft tissue) :
- If beveling is internal, from inside, so this is inlet
- If beveling is external from out side, so this is exit
4) Characters of inlet :
* Small * Regular * Inverted edge
* Marked loss of substance * Surrounded by powder marks
5) Characters of exit :
* Large * Irregular * Everted edge
* Minimal loss of substance * Not surrounded by powder marks
6) Two exceptions for characters of inlet & exit :
a) Inlet of shots:
* Large * Irregular * Everted edge
b) exit in jar of Atypical Exit:
* Large * Marked loss of substance
Report
" This part discusses items required in writing a report
1- Identification :
" Anatomical part :
* If it is skull, you should specify "complete skull" or "part of skull" "skull cap"
-Age: > 40 years
-Sex: male or female
-Race: non negroid except skull which is for negroid
{ you must comment on these items it is not a problem to do a mistake in those items}
2- Injury Description :
F R D
- Distance
- Direction
Firearm Rifled or Non-rifled
- Death (cause of Death)
Inlet Exit
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 Practical Forensic Medicine & Toxicology
" Firearm : Discuss Inlet +/- Exit or Both
- It is a fire arm injury . Why ??
- Soft Tissue :
1) Penetration :
* Because of inlet (discuss characters) or
* Because of exit (discuss characters)
2) Powder Marks :
* because it is surrounded by powder marks
- Bone :
3) Beveling:
* Inlet with internal beveling or
* Exit with external beveling
* Rifled or non rifled: F R D
" Rifled or Non-Rifled : All are Rifled Except
" Shots are with no dispersion, so distance is < 1 m
" Shots are with starting dispersion, so distance is l-4m
" Shots with full dispersion, so distance is > 4 m
" Distance : as before
" Direction : as before
" Brain (In Skull Injury)
" Cause of Death: Rupture of
" Chest Organs (In Chest Injury)
" Abd.Organs (In Abdo. Injury)
3- Conclusion :
* Conclusion = identification + F R D
Jar Number Page Number Title Notes
Inlet : in form of linear abrasion
44 375 Tangential firing
surr. By powder marks
45 381-383 Shots with full dispersion
-Shots with no dispersion -Clothes ,so no powder marks
46 388
-Heart - Distance < l meter
47 394 Inlet + exit
-shots with starting dispersion - Clothes ,so no powder marks
46 395
-Abdomen - Distance 1 - 4 meters
Inlet +atypical exit
49 400
(back of chest >> sternum)
Death >> cerebral laceration &
50 401 Inlet (int. beveling)
hge
- Inlet (int. beveling)
51 402
- manubrium
- 2 inlets (int. beveling)
52 403
- temporal
-2 inlets (int. beveling) Dolichocephalic skull >>
53 405
-Rt &Lt parietal negroid
-exit (ext. beveling)
54 407 Inlet >>> where ???
-Rt frontal
Ò! The newest added jars are :
Jar 52 & Page 14, Jar 61 & Page , Jar 450 & Page67, Jar587 & Page74
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