The document discusses various topics in forensic medicine including judicial hanging, brain stem death, and tests for determining live birth. It describes how judicial hanging is carried out through different methods like the short drop or long drop that result in fracture or rupture of the vertebrae or brainstem. It also outlines the legal process and medical tests required in India to diagnose brain stem death. Finally, it lists physical signs examined to determine if respiration occurred after birth, such as chest shape, lung size and color, and changes to the stomach, that could indicate a live birth.

1. A few short notes in forensic
medicine
M. Harini Priyadharshini
II MBBS

2. JUDICIAL HANGING

3. Judicial hanging
 Hanging is the suspension of a person
by a ligature.
 Hanging has been a common method
of capital punishment since medieval
times, and is the official execution
method in many countries and regions
today.

4.  In India legal death sentence is carried
out by hanging the criminal.
 A rope to allow a drop of 5 to 7 meters
(according to the person’s build and
age) is looped around the neck.
 The placement of the knot in the sub-
mental position is said to be more
effective
 Death is usually by a fracture
dislocation noramlly at the leve of C2
and C3 or C3 and C4 vertebrae.

5. Contd.,
 With proper judicial hanging there is a
rupture of brainstem between Pons
and medulla.
 This results :
1. Instantaneous and irreversible loss of
consciousness
2. Irreversible apnea.
 Heart beats and respiratory
movements may continue for 15 min
approx.
 The victim is found to have a
epileptic attack due to a sudden and

6. Classification of hanging
Complete
• When the whole
body hangs off the
ground and the
entire weight of the
victim is suspended
at the neck, the
hanging is said to
be complete
Incomplete
• Incomplete
hangings imply that
some part of the
body is touching the
ground and that the
weight of the victim
is not fully
supported by the
neck

7. Methods of judicial hanging
Suspension
Short drop
Standard drop
Long drop

8. Suspension
 Suspension, like the short
drop, causes death by using the
weight of the body to tighten the
trachea with the noose.

9. Short drop
 The short drop is performed by placing
the condemned prisoner on the back
of a cart, horse, or other vehicle, with
the noose around the neck.
 The object is then moved away,
leaving the person dangling from the
rope

10. Death by hanging -
Mechanisms
 Closure of carotid arteries causing
cerebral ischemia
 Closure of the jugular veins
 Induction of carotid sinus reflex
death, which reduces heartbeat when
the pressure in the carotid arteries is
high, causing cardiac arrest
 Breaking of the neck (cervical fracture)
causing traumatic spinal cord injury or
even decapitation
 Closure of the airway

11. BRAIN STEM DEATH

12. Brain stem death ?
 Brain stem death is a clinical
syndrome defined by the absence of
reflexes with pathways through the
brain stem in a deeply comatose,
ventilator-dependent, patient.

13. The concept of brain stem death
legally accepted in India
 permits the diagnosis and certification
of death on the premise that a person
is dead when consciousness and the
ability to breathe are permanently
lost, regardless of continuing life in the
body and parts of the brain, and that
death of the brain stem alone is
sufficient to produce this state

14. Transplantation of Human Organ
Act of 1994
 to make a diagnosis of brainstem death
requires a panel of four doctors
consisting of:
1. the doctor in charge of the patient,
2. the doctor in charge of the hospital where the
patient was treated
3. independent specialist of unspecified specialty
4. neurologist or a neurosurgeon
 The burden of proof rests with the
specialist of the neurosciences, with the
other members confirming the
diagnosis

15. Tests done to document absence
of brainstem function
 pupillary reflex
 doll’s head eye movement
 corneal reflex (both sides)
 gag reflex
 cough (tracheal)
 eye movements on caloric testing
bilaterally
 absence of motor response in any
cranial nerve distribution
 apnea test.

17. SECTION 84 IPC

18. Section 84 IPC
 Act of a person of unsound mind.--
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 that he is doing
what is either wrong or contrary to law.

20. TEST FOR LIVE BIRTH

21. Live birth ?
 In human reproduction, a live birth
occurs when a fetus, whatever its
gestational age, exits the maternal
body and subsequently shows any
sign of life, such as voluntary
movement, heartbeat, or pulsation of
the umbilical cord, for however brief a
time and regardless of whether the
umbilical cord or placenta are intact.

22. Tests for live birth
 Shape of chest :
before respiration the chest is
flat, after respiration the chest
becomes arched of drum shaped
 Position of the diaphragm
4th or 5th rib – before respiration
6th or 7th rib after respiration

23.  Lungs:
 Volume: unrespired lungs appear smaller
 Margin: before respiration margins are sharp
 Consistency: before respiration lungs are
dense and firm
 Colour and expansion of air vesicles
 Gas
 Blood in the lung beds
 Weight

24.  Changes in the stomach and intestine:
they float in water if respiration has
taken place.
 Changes in the middle ear:
before birth the middle ear
contains gelatinous embryonic
connective tissue

25.  Other signs:
Blood: nucleated RBC usually
disappear within 24 hrs
Meconium: completely excreted within
24 to 48 hrs
Caput succedaneum: gradually
disappears within a week after birth
Skin: skin becomes darker on 2nd or 3rd
day
Umbilical cord: blood clots in the cut
end 2hrs after birth
Circulation: contraction of umbilical
arteries starts in 10 hours and are
completely closed by 3rd day.

26. Live birth is probable when
 All lobes of lung are fully expanded
 There is edema of lung especially
gross
 An alveolar duct membrane is present
and has widespread distribution in the
lungs.
 Contusions of the lung are present