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Medico-Legal aspect of Wounds

 Medico-Legal Aspect of Wounds is one of the prime areas of Forensic studies. 

Examination of injuries and wounds help a great deal in the discovery of the method of crime and the time of death (if any) and nature of weapon used in the crime. The examination of an injured person is a complex process and requires great care and caution as in many cases, whole investigation may depend on it. 

After the examination of an injured person, the examining doctor prepares an injury certificate wherein he chalks out all the details regarding the nature, age, size and grievousness of injury. Along with it, the injury certificate also contains the details of the weapon used and other details as the doctor deems fit with regard to the injury. 

NATURE OF INJURY  

While describing the injuries in the form, the doctor should carefully note their nature and number, the character of their edges, their size as regards length, breadth and depth, the line of direction and their situation.  The presence of any extraneous material in the wound should be carefully noted and carefully preserved, to be handed over to the police later.  All the injuries should be measured and the exact measurements in centimeters must be given; they should never be guessed.  While mentioning the exact situations, a reference to some bony prominences or anatomical landmarks should be made, as for example, so many centimeters above or below the front or back of the left or right wrist, and elbow. In describing these points, technical terms should be avoided, as far as possible.

TYPES OF INJURIES

Wounds are typed on the basis of their appearance and the method of causation. 

  • Abrasion-  It  is  the  damage  occurring  in  the epidermis;  some  dermal  papillae  may  also  be damaged. It is caused by rough hard blunt objects or  surfaces  or  by  drawing  the  tip  of the pointed objects against the skin or mucous membrane. Most abrasions are caused by rubbing effect and others are caused by vertical pressure. Pattern of the impacting object may be retained at the abraded area. 
  • Bruise- It is the extravascular collection of blood in the tissue, viz, dermis of the skin, subcutaneous tissue and other deeper tissues due to rupture of blood vessels caused by application of blunt force with overlying tissue remaining intact so that blood cannot escape outside. When the lesion is visible from outside it is called bruise and if not visible from outside it is called contusion. Bruises may be of different  sizes,  viz,  petechial  haemorrhage  of  pin  head  size,  purpura  of  size  2  to  5  mm, echymosis of more than 5 mm, haematoma causing local swelling. 
  • Laceration- It is the tearing or splitting of the skin, mucous membrane and surfaces of any internal organs caused by application of blunt force. Blood escapes from the wound to the exterior or any body cavity.
  • Fracture- It is the breach of continuity of bone or tooth caused by application of blunt force. Clinical features and X-ray findings are considered to diagnose this type of lesion. In dislocation of joint the bone ends get displaced completely from their normal anatomical positions with damage to the adjacent tissues. 
  • Incised wound- It is caused by the sharp edge of the weapon applied to the skin perpendicularly or obliquely making regular clean edges of the wound. It is called a slash wound when the length of the wound is greater than its depth.
  • Puncture wound- A  puncture  wound  is  produced  when  a  pointed  thin bodied weapon is pushed into the body. Its depth is also greater than its diameter. A penetrating wound is produced when a bigger type of pointed weapon like teta is pushed into the body making a greater depth.
  • Firearm wounds- These wounds are produced by bullet or pellets fired from guns. Bullet usually causes perforation and pellets cause penetrating wounds. Firearm entry wounds are associated with burning, blackening, tattooing of the surrounding skin
  • Burns- are caused by flame, heated objects and scalds by hot liquids and vapours or gases. 
  • Blast wounds- are produced by explosion of bombs and are due to blast pressure  wave  (shock  wave),  blast  winds,  heat,  splinters,  shrapnels, surrounding small fragments propelled by blast winds. 

Simple, grievous or dangerous hurt

A simple or slight injury is one which is neither extensive nor serious, and which heals rapidly without  leaving  any  permanent  deformity  or  disfiguration.  
Grievous  hurt  as  described  in Section 320 of the IPC, refers to the following: 
(a) emasculation; 
(b) permanent privation of the sight of either eye; 
(c) permanent privation of the hearing of either ear; 
(d) privation of any member or joint; 
(e) destruction or permanent impairing of the powers of any member or joint; 
(f) permanent disfiguration of the head or face; 
(g) fracture or dislocation of a bone or tooth; 
(h) any hurt, which endangers life or which causes the sufferer to be, during the space of 20 days, in severe bodily pain, or unable to follow his ordinary pursuits.

  • It must be remembered that a mere stay in a hospital for 20 days, does not constitute a grievous hurt as some doctors and even lawyers are inclined to believe. It must be proved that during that period, the injured man was in severe bodily pain or unable to follow his ordinary pursuits
  • Danger to life should be imminent before the injuries are designated ‘dangerous to life’. Such injuries are extensive, and implicate important structures or organs, so that they may prove fatal in the absence of surgical aid. For instance, a compound fracture of the skull, a wound of a large artery, or rupture of some internal organ, such as the spleen, should be considered ‘dangerous to life’. There is a fine distinction in the degree of body injury between ‘dangerous to life’ and ‘likely to cause death’ which is another type of bodily injury, which is sufficient in the ordinary course of nature to  cause death, however, the injuries which prove fatal remotely by inter-current diseases, such as tetanus, and erypsipelas should not be considered dangerous.
  • If an opinion as regarding the nature of a particular injury cannot be formed at the time of the examination, as in the case of an extensive swelling of a limb when its fracture cannot be detected, or in the case of a head injury where the symptoms are obscure, the injured person must be either re-examined 24-48 hours after the initial clinical examination or admitted under observation until a definite opinion can be formed, and the police would be notified of the fact.
  • As important as the nature of injury, is the need to elicit from the circumstances the intention of the accused. Where the accused did not carry any deadly weapon and after a trifle of a quarrel during a village festival, carried out lathi blows that landed on the liver that proved fatal, the intention to cause death was found to be lacking and the accused was convicted under Section 304-part II IPC.

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