Forensic Medicine Notes
THORN
Thorn is a short spike of plant and can cause scratch, abrasion. It is a linear injury produced by the spike end of thorn running across the skin.
The prick or injury caused by thorn is the ideal site for the anaerobic bacteria (clostridium tetani) which can enter into the human body through wound and can cause medical condition known as Tetanus which is characterized by titanic muscle contractions, hyperreflexia, lock jaw (trismus), glottal spasm, generalized muscle spas, respiratory muscles spasm, seizures and paralysis.
The risk of tetanus after an injury by thorn can be prevented by Anti tetanus serum (A.T.S.)
KNIFE
Knife is commonly used object, it can cause variety of wounds as scratches, incised wounds, tentative cuts and stab perforated wounds.
Features
Different type of knife exists and all have different features. Some common features are
· Pointed and sharp tip
· Both end may be sharp
· A handle
Characteristics of wounds
Shape: tip corn cause linear scratch
Having one sharp end: injury spindle shaped
Size: length is greater than depth and breadth
Angels: mostly clean cut
Margins: incised wounds: straight
Stab wounds: slant
Direction: incised wounds —–> Straight
Stab wounds——————–> slant
Medico legal aspects :
Wounds may be
Suicidal: incised wounds are mostly suicidal with multiple tentative cuts and anywhere on body.
Homicidal: incised and stab wounds are commonly homicidal injuries and are multiple deep and anywhere on body.
Accidental: are less common
BLADE
Blade is a tool or instrument with cutting action. it can cause incised wound, tentative cuts or self inflicted wounds
Characteristics of wounds
the wound produced by blade have the following characters
· Wounds are normally straight
· Cuts cleanly
· Spindle shaped
· Having everted and smooth margins
· Clean cut angels
· No bruising over surrounding tissue
· Profuse bleeding
· Hair and hair bulb cleaned
Medico legal aspects :
Wounds may be
Suicidal: common and are superficial with tentative cuts .present on approachable parts of body and on opposite side of inflicted hands
Homicidal: also common and mostly deep and multiple and present anywhere on the body.
Accidental: less common and may be multiple and present anywhere on body.
OPIUM
It is the dried juice obtained by the incision of unripe capsule of white poppy. Its main alkaloids are morphine and codeine , used as narcotic and seductive .Apormorphine is used as an emetic. The users of opium can suffer from withdrawal syndrome which is treated with methadone. Other opiates are synthetic congeners of morphine i.e. heroin, pethidine, etraphine etc
Opium poisoning
Majority of cases are consequences of drug abuse .Opiods are most commonly ingested but heroin taken orally or is sniffed like cocaine .heroin has more euphoric effects
Signs and symptoms:
Pulmonary edema: this is commonest cause of sudden death (collapse before completing the injection)
Neurological effects: BP falls, respiratory depression, coma, cerebral edema, patients surviving from coma may suffer delirium, dementia and hypothermia
Infections: drug abusers share needles, syringes with others so there is high chance of injections like tetanus, hepatitis B, C , HIV etc
Differential diagnosis:
Opium poisoning resembles coma, intracerebral lesions, uremic and diabetic coma, and alcohol poisoning
Fatal dose is 200 mg for non abusers
Fatal period is 9 to 12 hours
Treatment of opium poisoning :
· Gastric lavage with tepid water than potassium permanganate of 1: 1000 strength
· Use of enema and purgative
· Intravenous saline
· Nalorphine and antiphenazine for respiratory depression
· Keep the body warm
· Artificial respiration in case of coma
Postmortem appearance:
External: smell of opium, cyanosed nail and face, distended neck veins, froth at mouth and nose
Internal: stomach shows brownish lump of opium .trachea, lungs, bronchi and brain shows venous congestion .lungs are edematous, blood will be dark.
Medico legal aspect:
It is poison of choice for suicidal purposes .due to its black color, it is not chosen for homicidal use. Homicidal purpose may include inducing abortion. Accidental poisoning is common. Rural Working women use it to make their children sleep while they are on work.
Kerosene oil
It is petroleum distillate used for heating purposes. It’s irritant and dissolve fat
Sign and symptoms of poisoning
Kerosene taste in mouth, a sensation of burning in throat .nausea, vomiting, colicky pain, and diarrhea. the breath, vomitus and urine smell kerosene .slow, shallow respiration, cyanosis, bronchopneumonia, depression of CNS, convulsions, coma and death
Sign and symptoms of chronic poisoning include weakness, pain in limbs, peripheral numbness and parasthesia
Fatal dose id more than 10 ml and fatal period is few hours
Treatment
To dissolve kerosene and slow its absorption, give 250 ml of liquid paraffin and saline orally.