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CHAPTER 1 LEGAL MEDICINE - testamentary capacity of a person making

a will
Legal Medicine - the right to hereditary succession
- Is that branch of medicine that applies, medical
and surgical concepts, scientific knowledge and 2. Criminal Law
skills to medico legal issues, in order to assist the - Felonies and circumstances which affect criminal
trier of facts in the proper dispensation of justice. liability
Medical Jurisprudence - Civil liability ex delictu
- is the study of the Medical Law and its applicable - Crimes relative to opium and prohibited drugs
Jurisprudence that governs, regulates and - Crimes against persons
defines the practice of medicine. - Crimes against chastity
- Crimes against civil status of persons
 In the Philippines, Legal Medicine is the appropriate - Quasi – offenses
name for Forensic Medicine.
 Modern Legal medicine has a broad range of 3. Remedial Law
applications, it is used in civil cases such as paternity - Physical and Mental Examination of a person
and filiation, annulment of marriage, DNA testing , etc. - Hospitalization of insane persons
 In all cases the medical examiner must conduct an - Rules of Evidence
investigation of the crime scene and also an autopsy.
4. Special Laws
TECHNIQUES OF LEGAL MEDICINE: - Dangerous Drug Act
- Legal Medicine uses sophisticated laboratory - Youth and Child Welfare Code
techniques to detect the presence of substances - Sanitation Code
in the victim, in the suspected criminal, or at the - Insurance law
crime scene. - Labor Code
- Forensic examination of substances found at a - Employees Compensation Law
crime scene can often establish the presence of
the suspect at the crime scene. 5. CORPUS DELICTI
- Is the body or substance of the crime and
LEGAL MEDICINE AND THE LEGAL SYSTEM is defined as the fact that a crime actually has been
- Courts routinely call upon physicians to give committed. In all criminal prosecutions, the burden is
expert testimony in a trial, especially concerning on the prosecution to prove the corpus delicti.
the findings of an autopsy and the results of
laboratory tests. QUANTUM OF PROOF
- As an expert witness he is allowed to express an
opinion about the validity of the evidence in a 1. In Civil Cases – the quantum of proof necessary to
case and may quote the statements of other prove a civil complaint is a PREPONDERANCE OF
experts in support of an opinion. EVIDENCE. The party filing or bringing a civil
- Ordinary testimony is restricted to statements complaint has the burden of proof and must establish
concerning what the witness actually saw or the truth and righteousness of his allegations by a
heard. preponderance of the evidence admitted by a
- The evidence to be presented by the legal competent court.
medicine expert must signify a relation between
the facts called the “ Factum Probandum” or 2. In Criminal Cases
proposition to be established and the “ factum – the quantum is proof beyond reasonable doubt.
Probans” which is the material evidencing the - In a criminal case the accused is entitled to an
proposition. acquittal, unless his guilt is shown beyond
- The Physician must present RELEVANT, reasonable doubt
MATERIAL AND COMPETENT EVIDENCE. - Presumption of INNOCENCE is a conclusion
drawn by the constitution and the law in favor of
HISTORY OF LEGAL MEDICINE: the accused , while REASONABLE DOUBT, is a
- Paulus Zacchias ( 1584 – 1659 ) is the ‘ Father of condition of mind produced by proof resulting
Forensic Medicine”. He was the first to describe from evidence in the case.
the importance and application of medicine to the
proper administration of justice. 3. To establish matters of defense
- The doctrine of reasonable doubt applies
- In the Phil. , the father of Legal Medicine can be only to incriminative facts.
rightfully bestowed to Dr. Pedro P. Solis. His book
on Legal Medicine copyrighted in 1987, contains 4. To establish self defense
the most extensive treatise and teachings in - One who sets up SELF DEFENSE “ must
Philippine Legal Medicine. rely on the strength of his own evidence and not on
APPLICATION OF LEGAL MEDICINE TO LAW: the weakness of that of the prosecution”.
Legal Medicine is Applied to Law
1. Civil law 5. To establish Alibi
- the determination and termination of civil - It must be proved by positive, clear and
personality satisfactory evidence. “ Oral Evidence” of alibi is so
- the limitation or restriction of a natural easily manufactured and usually unreliable that it can
person’s capacity to act rarely be given credence.
- marriage and legal separation
- paternity and filiation
6. In Administrative Complaints
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- In cases filed before administrative or 7. The right to privacy and confidentiality.
quasi judicial bodies, a fact maybe deemed 8. The right to a second or third opinion.
established if it supported by “ substantial evidence” 9. The right to leave.
which means that amount of relevant evidence which 10. The right to information.
a reasonable mind might accept as adequate to justify 11. The right to self determination.
a conclusion. 12. The right to refuse participation in medical research
13. The right to express grievance
CHAPTER 2 MEDICAL AND HOSPITAL 14. The right to be informed of his rights and obligations.
JURISPRUDENCE

Medical Jurisprudence:  Obligations of the Patients to their Physicians ( Refer


- Is the study of the Medical Law and its applicable to Book )
Jurisprudence, that governs, regulates, and
defines the practice of medicine.  SOCIATAL RIGHTS OF THE PATIENTS FROM THE
- It includes the rights, duties, obligations and GOVERNEMNT ( Refer to Book )
liabilities of both physician and patient to each RIGHTS INHERENT IN THE PRACTICE OF MEDICINE:
other in a physician patient professional contract. 1. The right to choose his patients
2. The right to limit the practice of his profession
The Following Acts Constitute the Practice of 3. The right to determine appropriate treatment procedures
Medicine: in the discretion and judgment of the physician.
1. To physically examine and diagnose a patient. 4. The right to avail of hospital privileges after being
2. To physically examine and treat a patient qualified.
3. To physically examine and perform surgery in a 5. The right to receive just and fair compensation from his
patient patients.
4. To physically examine and prescribe any remedy to
a patient. Liabilities of a Physician Which May Arise from His
Negligent or Wrongful Acts or Omissions:
 Any person who practice any of the above acts
enumerated, without any valid certificate of 1. Administrative Liability
registration as a physician, is practicing illegal - A complaint under oath can be filed before the
medicine. Professional Regulation Commission Board of Medicine,
for reprimand, of the license to practice medicine.
The Nature of the Physician Patient Professional 2. Criminal Liability
Relationship is - When an act or omission constitutes a crime, the
1. Consensual: physician can be imprisoned or fined or both, as any other
- based on mutual consent of both patient and profession.
physician. 3. Civil Liability
- Contracts that are consensual in nature, are - The aggrieved party can be awarded monetary
perfected upon mere meetings of the minds damages for any wrongful or negligent act or omission,
when the professional is found guilty.
2. Fiduciary:
- founded in trust, faith, and confidence reposed by CASES ( Refer to Book )
one person in the integrity and fidelity of another.  Ex. Negligent or Wrongful Act

DUTIES AND OBLIGATIONS OF THE PHYSICIAN Medical malpractice is a particular form of negligence
TOWARDS HIS PATIENTS: which consists in the failure of a physician or surgeon
1. He must possess that knowledge and skill possessed by to apply to his practice of medicine that degree of care
an average physician. and skill which is ordinarily employed by the
2. He must use such knowledge and skill with ordinary care profession generally, under similar conditions, and in
and due diligence. like surrounding circumstances
3. He is obliged to exercise his best judgment
in good faith. There are Four Elements involved in medical
4. He has the duty to keep the secrets and confidentialities negligent cases:
of his patients. 1. Duty
2. Breach
 The Terms and Conditions not included in the 3. Injury
Physician Patient Professional Relationship Contract ( 4. Proximate Causation – It has been recognized that
refer to book ) expert testimony is usually necessary to support the
conclusion as to causation.
 The only promise or guaranty that the law requires is
that, the physician will treat the patient in accordance  Ex. Whether A Hospital may be Held Liable for the
with the standards of medical care. Negligence of Physicians – Consultants allowed to
Practice in its Premises.
PATIENTS RIGHTS RESPECTED BY PHYSICIANS:
1. The right to appropriate medical care and humane
treatment.
2. The right to his religious belief.
3. The right to refuse treatment.
4. The right to Informed Consent. CHAPTER 3
5. The right to choose his physician.
6. The right to medical records. DEATH
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Stage 2 - Cerebellum – It deals with the function
Legal Presumption of Death: of equilibrium. It follows the death of the cerebral
- If absent without explanation from his or her cortex.
usual or last place of residence for a long
continuous period. Stage 3 – Brainstem and Vital centers – These
- centers controlling respiration, heart rate and
- Circumstantial proof of death blood pressure, ultimately die. When it does, the
patient is, Brain Stem Dead.
Ex. a passenger on an airplane that crashed is - If the brain stem is damaged, then the vital
considered to have died even if no remains can centers in the medulla maybe destroyed, causing
be recovered. the respiratory center to fail.
- The occurrence of brain stem death is equivalent
 Rules of Evidence in Rule 131, section 5 paragraph X, to Legal Death, so that Doctors can now issue a
paragraph JJ, and paragraph KK. Death Certificate, even though the heart is still
 In common law the presumption of death does not beating, and make arrangements to harvest
arise until the expiration of seven years of continuous donor organs and tissues at this stage.
absence. - Further, in the presence of brain stem death,
artificial respirators only achieve the maintenance
DEATH – IS THE COMPLETE CESSATION OF ALL THE VITAL of an oxygenated circulation through a corpse or
FUNCTIONS OF THE BODY WITHOUT POSSIBILITY OF cadaver.
RESUSCITATION.
CRITERIA FOR DIAGNOSING BRAIN STEM DEATH.
THE ASCERTAINMENT OF DEATH IS A MEDICAL AND NOT ( refer to textbook )
A LEGAL PROBLEM. Persistent Vegetative State ( PVS )
- This condition exists, when irreversible
Death maybe destruction of the Cortex of the brain occurs
without damage to the vital centers , and there
A. Brain Death – occurs when there is a deeply irreversible are permanent eyes – open state of
coma, and absence of electrical brain activity. unconsciousness, but cardio respiratory functions
continue, sometimes without respiratory
B. Cardio Respiratory Death – occurs when there is continuous assistance, but most often with respiratory
and persistent cessation of heart action and respiration. support.
- They do not however match the clinical criteria of
4 Kinds of Death: Brain Death, in as much as they have elicitable
1. Clinical or Somatic Death reflexes, spontaneous respirations and reactions
2. Brain Death to external stimuli.
3. Biological Death
4. Cellular Death HARVARD CRITERIA OF WHOLE BRAIN DEATH:
1. Unreceptivity and Unresponsitivity
Clinical or Somatic Death 2. No spontaneous movements or breathing
- This particular kind of death occurs when in the 3. No reflexes
judgment of the physician with the use of his 4. Flat EEG of Confirmatory value
clinical eye the body’s vital signs of life cease to
exist continuously and permanently. WHOLE BRAIN DEAD
- The clinical death is verifiable only by a physician - When the brain ceased all functions, even though
after he observes that the patient no longer has a the heart continues to beat. As a rule doctors can
heart beat no pulse rate, no spontaneous legally declare whole brain death twelve hours
breathing and movement, with the pupils of the after they have corrected all treatable medical
eye widely dilated and not reactive to light and problems, but the brain still doesn’t respond even
accommodation. to induced pain , they eyes do not react to light
- When a clinically dead person is brought to the and the person doesn’t breath without a
morgue the generalized contraction of the respirator.
muscles or Rigor Mortis of the body within 3 to 6
hours, may simulate a return to life, because of BIOLOGICAL DEATH
the motion or movement of the body. - All the components of the brain are dead
- There is also permanent extinction of bodily life.
BRAIN DEATH - It is cardiorespiratory and brain death altogether
- This kind of death follows clinical death – almost with permanent cessation of all the anatomic and
immediately unless resuscitative procedures are physiological functions of the body organs.
started promptly, because the human brain under
normal conditions cannot survive loss of oxygen CELLULAR DEATH:
for more than 6 to 10 minutes. - The death of the different parts of the body
- occurs at different times and stages.
- Brain Death may occur in the - This is the reason why such organs as the
Stage 1 – Cerebral Cortex- the highest center of corneas and the kidneys can be removed
the brain that is most sensitive to changes in the immediately after biological death and
supply of oxygen and blood to the brain. When transplanted successfully.
the cerebral cortex dies, the patient is in cortical
death. SIGNS OF DEATH:
1. Cessation of heart action and circulation
2. Cessation of respiration
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3. Cooling of the body ( Algor Mortis ) 2. Cadaveric spasm – Death due to violence or inflicted
- The temperature of 15 – 20 degrees physical injuries, usually manifest the position of the body at the
Fahrenheit is considered as a certain sign of death. time of death.
4. Loss of motor power Ex. In suicide by gunshot wound, the gun maybe tightly grasped
5. Loss of sensory power in the hand of the deceased
6. Changes in the skin In drowning, the victim maybe holding objects that
7. Changes in and about the eye come in contact with his hands to cling to life.
- There is loss of corneal reflex
MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS AND
CHANGES IN THE BODY FOLLOWING DEATH CADAVERIC SPASM:
1. Changes in the Muscle
a. Stage of primary flaccidity Rigor mortis is utilized to approximate the time of death.
b. Cadaveric rigidity or rigor mortis Generalized muscular contractions occur from 3 to 6 hours until
- muscular contraction which 36 hours.
develops 3 – 6 hours after death
and may last for 24 – 36 hours. Cadaveric spasm occurs immediately after death and is useful
- may also be utilized to to ascertain the circumstances of death.
approximate the length of time the
body has been dead from 3 to 36 Medico Legal Investigation of Death
hours - Deaths which are not obviously due to natural
c. Stage of secondary flaccidity or causes, but are criminal, suspicious, accidental,
commencement of putrefaction suicidal, murderous, homicidal, sudden or
unexpected, or unexplained, need medico legal
Cadaveric Spasm- is the immediate or instantaneous spasm or investigation.
rigidity of the skeletal muscles occurring at the moment of death
due to exhaustion, etc. The Death Certificate
- The death certificate is a legal document
Medico legal Importance of Cadaveric Spasm necessary for burial of the dead, as it certifies the
( Refer to Book ) occurrence of death. It is a document from the
Office of the Civil Registrar General, listing the
2. Changes in the Blood particulars of an individual’s death.
a. Coagulation of the blood - It contains the Immediate Cause or Primary
b. Postmortem lividity or Livor Mortis cause of death, the antecedent causes and
3. Autolytic or Auto Digestive Changes After Death underlying cause of death

4. Putrefaction of the Body Immediate Cause or Primary Cause of Death


Ex. Suffocation due to drowning
PUTREFACTIVE CHANGES OCCURING AFTER DEATH Asphyxia
( Refer to Book ) Cardio – Respiratory Arrest
Kinds of Putrefaction:
1. Mummification Antecedent Cause of Death are events or
2. Saponification – This is also called Adipocere Formation. conditions that substantially contribute to the
3. Maceration immediate cause of death
Ex. Acute peritonitis, Acute Hypovolemic shock,
Factors to Consider in Approximating the Duration of Death in a Acute Septic Shock,
Cadaver
1. Entomology – The presence of maggots in the cadaver Underlying Cause of Death is the basic cause or
indicates duration of death for more than 24 hours bottom line cause of death. It is the diagnosis of
2. Presence of live Fleas in clothing – in death by drowning, a the patients or victim’s illness or sickness that
flea can survive for about 24 hours submerged in water. After 24 resulted to his death
hours submersion in water the fleas die. Ex. Acute Appendicitis, Hepatocarcinoma, Pelvic
3. Blood vessel clots – blood clotting occurs in 6 -8 hours after Fracture, Stab or Gunshot Wound to the chest.
death.
4. Post Mortem lividity – develops in 3 to 6 hours after death. Non Natural Causes of Death
5. Rigor Mortis- begins to develop in 3 to 6 hours after death Ex. Murder, Homecide, Suicide, Accident
and may last for 24 to 36 hours after death.
6. Onset of decomposition – Decomposition takes place within
24 – 48 hours after death. Death Warrant – is a warrant from the proper executive authority
7. Food in the stomach appointing the time and place for the execution of the sentence
8. Skeletal soft tissues – soft tissues may disappear from 1.5 of death upon a convict judicially condemned to suffer death.
years to 2 years after burial.
Manner of Death
- Is the explanation as to how the cause of death
arose, and maybe either Natural Death or Violent
Death

Position of the Body at the time of Death

1. Post Mortem lividity Lazarus Syndrome

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- Is also called Lazarus Phenomenon is the 3. Several days to weeks of Injury – these are due to sepsis or
spontaneous return of circulation after failed organ failure.
attempts at resuscitation.
SPECIFIC INJURIES
Implications of Lazarus Syndrome 1. Head
- raise ethical and legal issues for doctors, who a. Types of Head Injuries:
must determine when medical death has a.1 Hematoma
occurred, when resuscitation efforts should end, a.2 Contusions
and post mortem procedures such as autopsies a.3 Skull fractures
and organ harvesting may take place. a.4 Hemorrhage
2. Spine and Spinal Cord Injuries
Lazarus Sign The most common causes of severe spinal trauma
- Lazarus sign or Lazarus reflex is a reflex are motor vehicular accidents, falls, diving accidents, and
movement in brain dead patients, which causes gunshot wounds.
them to briefly raise their arms and drop them 3. Chest
crossed on their chests. a. Life Threatening Injuries
- The phenomenon has been observed to occur Pnumothorax
several minutes after the removal of medical Hemothorax
ventilators used to pump air in and out of brain Flail chest as in multiple rib fractures
dead patients to keep their bodies alive. Cardiac tamponade due to penetrating
injuries
NEAR DEATH EXPERIENCE b. Potentially Lethal Injuries
- Refers to a broad range of personal experiences b.1. Pulmonary Contussion with or without
associated with impending death, encompassing flail chest
multiple possible sensations including b.2. Thoracic Aortic Tear or Rupture – the
detachment from the body; feelings of levitation most common cause of sudden death after
etc. a vehicular accident or fall ( major
decelaration injury )
EUTHANASIA c. Serious Chest Injuries
- Meaning good death ( well or good ) 4. Abdomen
- Refers to the practice of ending life in a painless Types of Injuries:
manner. a. Penetrating
- Gunshot wounds of the abdomen carry
- Deliberate intervention undertaken with the
95% probability of significant visceral injury
express intention of ending life, to relieve
- A bullet when it hits the abdomen will
intractable suffering
penetrate the abdominal wall, enter the
abdominal cavity and most likely injure more
Classification of Euthanasia:
than one organ.
1. Voluntary euthanasia – is euthanasia conducted with consent
- The incidence of abdominal injury is
strikingly higher in gunshot wounds than in
2. Involuntary euthanasia
stab wounds.
– is euthanasia conducted without consent.
- The major cause of death is hemorrhage
-is conducted where an individual makes a decision for another
and this occurs within the first 24 hours
person incapable of doing so.
- In stab wounds of the abdomen , only 2/3
- also known as physician assisted death, physician assisted
penetrate the peritoneal cavity; of these only
suicide or mercy killing.
½ cause significant visceral injury that
requires surgical repair.
3. Passive euthanasia – entails withholding of common
b. Blunt
treatments
- The spleen and liver are the most
commonly injured organs due to blunt
4. Active euthanasia – entails the use of lethal substances or
trauma.
forces to end life and is the most controversial means.
- Their frequent incidence also explains why
the mortality rate following blunt trauma is
CHAPTER 4 REGIONAL TRAUMA
higher than that of penetrating injury.
Trauma
5. Fractures and Dislocations
– is the leading cause of death in the first four decades of life
The word fracture comes from the Latin word
and the 3rd leading cause of death in all age groups today.
“fractura” which means a break in the continuity of the bone. It is
also a combination of a break in the bone and soft tissue injury
-Penetrating trauma particularly handguns is becoming common
in nearly all areas of the country.
A. Open Fractures - 90% of open fractures are caused
by vehicular accident.
Trimodal Distribution of Death from Trauma:
B. Hip fractures are very common in elderly people
and are usually caused by minor falls. It is the most common
1. Seconds to minutes of injury – due to the injury to the
cause of traumatic death after the age of 75.
brain, high spinal cord, heart, aorta and other large
vessels. These patients can rarely be salvaged.
6. Urologic
2. Minutes to Few hours from injury ( The Golden Hour )
- Hematuria following trauma
- It is in this period that Advanced Trauma Life Support ( ATLS )
techniques are important.

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- Blunt kidney injury is usually due to motor - When the offender has inflicted physical injuries which shall
vehicular accidents which account for 70 – incapacitate the offended party for labor from one to nine days,
90 % of kidney trauma. or shall require medical attendance during the same period.
- Penile injury:
The erect penis is usually 6 – 8 inches long Chapter 3, RAPE – When and How rape is committed
and 1 -2 inches in diameter. 1. By a man who shall have carnal knowledge of a woman
- Avulsion of the prepuce – this may follow under any of the circumstances
accidents where the foreskin called prepuce a. Through force, threat, or intimidation
is detached or lacerated by a blunt force. b. When the offended party is deprived of reason or
- Fracture of the penis – this is the traumatic otherwise unconscious
rupture of the corpora cavernosa penis c. By means of fraudulent machinations or grave
resulting from a forceful trauma to the abuse of authority
flaccid organ. d. When the offended party is under twelve ( 12 )
- Amputated penis – the penis of an avid years of age or is demented, even though none of the
womanizer is sometimes intentionally cut or circumstances mentioned above is present.
amputated by a jealous derange wife or
lover. 2. By any person who, under any of the circumstances
mentioned in paragraph 1 hereof, shall commit an act of sexual
7. Arterial trauma assault by inserting his penis into another person’s mouth or
8. Burns anal orifice or any instrument or object into the genital or anal
orifice of another person.
CLASSIFICATION OF WOUNDS
1. AS TO LEGAL CLASSIFICATION Classification of Wounds
Chapter 1 2. AS TO THE DEPTH OF THE WOUND
DESTRUCTION OF LIFE a. Superficial – When the wound involves only the layer of the
a. Article 246. Parricide skin
b. Article 247. Death or Physical Injuries Inflicted Under b. Deep – When the wound involves the structures beyond the
Exceptional Circumstances layers of the skin.
c. Article 248. MURDER
- Any person who, not falling within the provisions of b.1 Penetrating – the wound enters the body but does not come
Article 246 shall kill another, shall be guilty of murder and shall out. Punctured, stab and gunshot wounds usually belong to this
be punished by Reclusion Perpetua, to death if committed with type of wound.
any of the following attendant circumstances; b.2 Perforating – there is a communication between the outside,
1. With treachery inner and the outer side. There is both a point of entry and exit.
2. In consideration of a price , reward or promise
3. By means of inundation etc. Classification of Wounds
4. On occasion of any of the calamities etc. 3. AS TO MORTALITY
5. With evident premeditation a. Deadly Wound- Death results immediately, after the infliction
6. With cruelty etc of the wound. Deadly wounds though mortal, maybe prevented
with prompt medical treatment.
Article 249 HOMICIDE
Article 251. Death Caused in a Tumultous Affray b. Non Deadly Wounds – Does not result to death immediately,
Article 252. Physical Injuries Inflicted In a Tumultuous Affray after the wound is inflicted. A non deadly wound may cause
Article 253. Giving Assistance to Suicide death later, due to complications i.e. tetanus, septicemia
Article 254. Discharge of Firearms
Article 255. Infanticide Classification of Wounds:
Article 256. Intentional Abortion 4. AS TO THE WOUNDING INSTRUMENTS USED:
Article 257. Unintentional Abortion – who shall caused an a. Sharp Instruments – Ex. incised wound, punctured wound,
abortion by violence but not intentional. stab wound dagger or kitchen knife
Article 258. Abortion Practiced by the Woman Herself or By Her b. Blunt Instruments – A block of wood or iron produces
Parents contusion, hematoma, abrasions, lacerated wound when used
Article 259. Abortion Practiced by a Physician or Midwife and to strike, attack, wound, beat or assault another
Dispensing of Abortives
Article 260. Responsibility of Participants in a Duel Classification of Wounds:
Article 261. Challenging to a Duel 5. AS TO THE CONSEQUENTIAL INJURY AFTER THE
APPLOCATION OF FORCE
CHAPTER 2 a. Coup Injury -
PHYSICAL INJURIES b. Coup Centre Coup Injury
a. Article 262. Mutilation – Any person who shall intentionally c. Contre Coup Injury
mutilate another by depriving him, either totally or partially , of d. Locus Minoris resistancia
some essential organ of reproduction. e. Extensive injury
b. Article 263. Serious Physical Injuries – Any person who shall
wound, beat, or assault another, shall be guilty of the crime of Classification of Wounds:
serious physical injuries 6. AS TO THE INTEGRITY OF THE SKIN
c. Article 264. Administering Injurious Substances or Beverages A. CLOSED WOUNDS – Presents no break in the integrity or
d. Article 265. Less Serious Physical Injuries – Any person who continuity of the skin. There maybe only outward manifestations
shall inflict upon another physical injuries which shall of injury internally.
incapacitate the offended party for labor for 10 days or more, or Ex. of closed wounds:
shall require medical attendance for the same period 1. petechiae – a circumscribe extravasation of blood in the
e. Article 266. Slight Physical Injuries and Maltreatment. subcutaneous tissue.

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2. contusion – effusion of blood into the tissues underneath the 4. Self – Inflicted wounds – these are wounds self inflicted by
skin as a result of a blunt force. Ex. black eye the person on himself. The wounds are usually found on the
3. Hematoma accessible parts of the body, usually with no intention to kill
4. Blunt injury himself. Unless the victim is insane, self inflicted wounds are for
5. Musculoskeletal injuries a fraudulent or self serving purpose.
Ex. Sprain, Dislocation, Fracture, Strain 5. Homicidal wounds – these are the serious wounds sustained
by the victim resulting to his death, from the criminal assailant.
Cerebral Concussion – there is a brief loss of consciousness Usually the wounds are situated in the areas of the neck, chest,
and sometimes memory after a head injury that doesn’t cause the abdomen and the skull.
obvious physical damage. 6. Accidental wounds – these wounds are sustained by the
victim, without any fault or intention whatsoever on the part of
Cerebral Contusion – they are bruises to the brain, usually the accused to inflict the wounds on the victim. The wounds are
caused by a direct, strong blow to the head. They are more usually located on any part of the victim’s body.
serious than concussions. 7. Suicidal wounds – these are wounds self inflicted by the
victim on himself, and usually seen on the temple, the roof of
B. OPEN WOUNDS the mouth, and other fatal body areas, accessible to the hand of
- There is a break in the continuity of the skin the victim.
Examples:
1. Abrasion CHAPTER 5 COMPREHENSIVE DANGEROUS DRUGS ACT
2. Bruise OF 2002
3. Incised wound
4. Stab wound REPUBLIC ACT 9165
5. Punctured wound
6. Perforating wound A DANGEROUS DRUG is a drug whose use is attended by risk
7. Lacerated wound and therefore is unsafe, perilous and hazardous to people and
8. Bites society.
9. Gunshot wounds
A DRUG is any substance , vegetable, mineral or animal in
B. OPEN WOUNDS – there is a break in the continuity of the origin, used in the composition or preparation of medicines or
skin any substance used as medicines.
B.1. Abrasion – Scratch, friction mark
B.2. Bruise – cause by a blunt injury to the tissues which The Dangerous Drug Act of 1972, include the following
damage blood vessels beneath the surface, allowing blood to Dangerous Drugs as follows:
extravasate or leak into the surrounding tissues. A. PROHIBITED DRUGS
B.3. Incised wound 1. Opium and its active components and derivatives
B.4. Stab wound such as heroin and morphine.
B.5. Punctured wound 2. Coca leaf and its derivatives, principally cocaine.
B.6. Perforating wound 3. Hallucinogenic drugs such as mescaline, lysergic
B.7. Lacerated wound – result of an injury from a blunt acid diethylamide ( LSD ) and other substances
instrument. In cerebral laceration, the brain tissue is torn often producing similar effects.
with an accompanying visible head wounds and skull fractures. 4. Other drugs whether natural or synthetic with the
B.8. Bites – they maybe abraded, bruised or rarely lacerated. physiological effects of a narcotic drug.
They are usually seen in sexual assaults and in child abuse and
also by animal bites B. REGULATED DRUGS
B.9. Gunshot wounds 1. Self inducing sedatives such as secobarbital,
phenobarbital, pentobarbital, barbital and any drug
TEST FOR THE PRESENCE OF POWDER RESIDUES: which contains salt or derivative of a salt of barbituric
1. Paraffin test or Dermal Nitrate test – present on the skin of acid.
the hand dorsum or site of the wound of entrance. This test is 2. Any salt of amphetamine such as Benzedrine or
not conclusive because fertilizers, cosmetics, cigarettes, urine any drug which produces a physiological action similar
and other nitrogenous compounds with nitrates will give a to amphetamine.
positive reaction. A negative test is also not conclusive . The test 3. Hypnotic drugs, such as methaqualone producing
usually gives a positive result even after a lapse of 3 days or similar physiologic effects.
even if the hands are subjected to ordinary washing
IMPORTANT TERMS in the DANGEROUS DRUG
2. Use of Scanning Electron Microscope with a linked X – ray ACT OF 2002
analyzer. This method appears to be more specific but seldom 1. Drug Syndicate
used because the instrument is expensive. 2. Illegal Trafficking
3. Chemical Diversion
SPECIAL TYPES OF WOUNDS 4. Planting Evidence
1. Assailant’s wounds – these wounds are sustained by the 5. Drug Dependence
assailant from the victim, while the former is in the process of
attacking, wounding, assaulting, beating or killing his victim. Two Classes of Drug Dependence:
2. Defense wounds – in the process of defending himself from a. Drug Addiction – is a state of periodic or chronic
the attacks, assault, wounding, beating or violence of the intoxication produced by the repeated consumption of
assailant, the victim sustains defensive wounds usually in the a drug, whether synthetic or natural and found to be
upper extremities. detrimental to the individual and to the society.
3. Victim’s wounds – these are wounds sustained by the victim,
from the assailant, the former not having the chance or Characteristics of Drug Addiction:
opportunity to defend himself. The victim’s wounds maybe
located in any part of the body.

7
A. An overpowering desire or need to PRECURSORS AND ESSENTIAL CHEMICALS,
continue taking the drug or to obtained it by any INSTRUMENTS AND PARAPHERNALIA AND OR
means. LABORATORY EQUIPMENT – The PDEA shall take
charge and have custody of all dangerous drugs, plant
- a tendency to increase the dose. sources of dangerous drugs, controlled precursors
-a psychological and physical dependence and essential chemicals, as well as Instruments
on the effects of the drug. paraphernalia and laboratory equipment so
- a detrimental effect to the society and to confiscated, seized and or surrendered, for proper
the individual disposition in the following manner ( Refer to Book ).

B. Drug Habituation – is the desire to have a IMPORTANT PROVISIONS OF R.A. 9165 OR THE
continuous use of the drug but with the capacity to COMPREHENSIVE DANGEROUS DRUGS ACT OF
refrain physically from using it. 2002

Characteristics of Drug Habituation: Section 22. Grant of Compensation, Reward and


- The desire to use the drug is not Award
compulsive but merely psychical. Section 23. Plea Bargaining Provision
Section 36. Applicants for Driver’s License
- There is little or no tendency to increase Section 38. Laboratory Examination or test on
the dose Apprehended / Arrested Offenders
Section 39. Accreditation of Drug Testing Centers and
- The detrimental effect if any, is primarily on Physicians
the individual. Section 40. A physician, dentist, veterinarian or
practitioner authorized to prescribe any dangerous
6. Protector drug shall issue the prescription therefore in one
7. Pusher original and 2 duplicate copies.
8. Controlled Delivery Section 54. Voluntary Submission of a Drug
9. Den, Dive or Resort Dependent to Confinement, Treatment and
10. PDEA – The Philippine Drug Enforcement Agency, Rehabilitation
which is the implementing arm of the Dangerous Section 55 Exemption from Criminal Liability
Drugs Board. Under the Voluntary Submission Program
Section 56. Temporary Release from the Center; After
UNLAWFUL ACTS AND PENALTIES IN THE Care and Follow up Treatment Under the Voluntary
DANGEROUS DRUGS ACT OF 2002 ( R.A. 9165: Submission Program
1. Importation of Dangerous Drugs and or Controlled Section 58. Filing of Charges Against a Drug
Precusors and Essential Chemicals. Dependent who is not rehabilitated Under the
2. Sale, Trading, Administration, Dispensation, Voluntary Submission Program.
Delivery, Distribution and Transportation of Dangerous Section 61. Compulsory Confinement of a drug
Drugs and or Controlled Precursors and essential dependent who refuses to apply under the Voluntary
Chemicals. Submission Program
3. Maintenance of a Den, Dive or Resort Section 62. Compulsory Submission of a Drug
4. Employees and Visitors of a Den, Dive or Resort Dependent Charged with an Offense, to Treatment
5. Manufacture of Dangerous Drugs and or Controlled and Rehabilitation
Precursors and Essential Chemicals Section 70. Probation or Community Service for a
6. Illegal Chemical Diversion of Controlled Precursor First Time Minor Offender In Lieu of Imprisonment
and Essential Chemicals Section 73. Liability of a Parent, Spouse or Guardian
7.Manufacture or Delivery of Equipment , Instrument, Who refuses to Cooperate with the Board or any
Apparatus and Other paraphernalia for Dangerous Concerned Agency
Drugs and or Controlled Precursors and Essential Section 77. The Dangerous Drugs Board
Chemicals Section 82. Creation of the Philippine Drug
8. Possession of Dangerous Drugs Enforcement Agency ( PDEA )
9. Possession of Equipment, Instrument , Apparatus Section 85. The PDEA Academy
and Other Paraphernalia for Dangerous drugs. Section 90. Jurisdiction
10. Possession of Dangerous D During Parties, Social Section 91. Responsibility and Liability of Law
Gatherings or Meetings Enforcement Agencies and Other Government
11. Possession of Equipment, Instrument, Apparatus Officials and Employees in Testifying as Prosecution
and Other Paraphernalia for Dangerous Drugs During Witnesses in Dangerous Drug Cases
Parties, Social Gatherings or Meetings Section 92. Delay and Bungling in the Prosecution of
12. Use of Dangerous drugs Drug Cases
13. Cultivation or Culture of Plants Classified as
Dangerous Drugs or are Sources thereof PHARMACOLOGIC CLASIFICATION OF
14. Failure to Maintain and Keep the Original Records DANGEROUS DRUGS
of transactions on Dangerous drugs and or Controlled 1.Hypnotics
Precursors and Essential chemicals 2. Sedatives and Tranquilizers
15. Unnecessary Prescription of Dangerous Drugs 3. Hallucinogens and Psychomimetics
16. Unlawful Prescription of Dangerous drugs 4. Stimulants
5. Depressants
THE CUSTODY AND DISPOSITION OF 6. Deliriants and Intoxicants
CONFISCATED, SEIZED AND OR SURRENDERED
DANGEROUS DRUGS, PLANT SOURCES OF A.Hypnotics:
DANGEROUS DRUGS, CONTROLLES

8
Opiates and Their Derivatives – Opium is obtained
from the milky exudates of the unripe seed capsules Coccaine – is an alkaloid from the leaves of the coca
of the poppy plant, Papaver Sornoiferum. shrub cultivated in Bolivia and Peru.
- It produces effects similar to amphetamines, but
Derivatives of opium commonly used are morphine, is a much more powerful stimulant.
heroin, and codeine. - Is used to excite the undersexed.
- Is a euphoriant and readily relieves fatigue
Its synthetic preparation are Demerol and Methadone.
Untoward Effects:
Narcotics that have a legitimate medical used as - Same as amphetamine
powerful pain relievers are called Opioids, and include
codeine, oxycodone, meperidine, morphine and E. DEPRESSANTS:
hydromorphone. - Angel dust
- Depresses the brain and abusers usually
Heroin which is prohibited is a very strong pain become confused and disoriented shortly after
reliever and narcotic taking the drug.
- Can be combative and because they don’t feel
Signs and Symptoms of Opium Administration: the pain they may continue fighting even when hit
1. Stage of Excitement hard.
2. Stage of Stupor
3. Stage of Narcosis CHAPTER 6 SEXUAL DYSFUNCTIONS AND SEXUAL
CRIMES
B. SEDATIVES:
Barbiturates: - are the products of malonic acid and SEXUALITY – IS A NORMAL BIOLOGICAL URGE AND AN
urea, synthesized on St. Barbara day. IMPORTANT PART OF THE HUMAN EXPERIENCE.
- Used to treat anxiety and to induce sleep can
cause both psychologic and physical 4 Stages of a Sexual Response:
dependence. 1. Desire
2. Arousal
C. HALLUCINOGENS OR PSYCHOMIMETIC 3. Orgasm
DRUGS: 4. Resolution
Marijuana – ( Cannabis Sativa ) is a Mexican term for
pleasurable feeling. Marijuana is not addictive. SEXUAL DYSFUNCTIONS ( Classification )
Physical dependence and dose tolerance do not A. As to choice of sexual partners
develop with its use. Psychic dependence may occur. 1. Homosexual
2. Infanto sexual
Subjective effects of Marijuana: 3. Besto sexual
- There is a feeling of lightness of the extremities 4. Auto sexual
followed by rushes of warmth and well being that 5. Gerontophilia
eventually lead to a sense of relaxation, mild 6. Necrophilia
euphoria and a dreamy state where ideas are 7. Incest
disconnected.
Objective Effects of Marijuana: B. As to instinctual strength of the sexual urge:
- Moderate increase in resting pulse rate, 1. Over sex
reddening of the eyes due to dilatation of the 2. Under sex or sexual frigidity
conjunctival blood vessels. Difficulty of speech a. Sexual anesthesia
and of remembering of the logical trend of what b. Dyspareunia
was being said. c. Vaginismus
d. Old age
Lysergic Acid Dsethylamide ( LSD ) C. As to the mode of sexual expression
- These drugs are false hallucinogens. 1. Oralism
- It produces impaired judgement so that a user a. Fellatio
might think that he can fly, and may even jump b. Cunnilingus
out a window to prove it, resulting in severe injury c. Analism
or death.
2. Sado – masochism
D.STIMULANTS: a. Sadism
Amphetamines – methamphetamines ( Shabu, b. Masochism
speed ); methylenedioxymethamphetamine ( MDMA, 3. Fetishism
ecstasy or Adam ) a. Anatomic
- Acts on the cerebral cortex causing alertness, b. Clothing
excessive self confidence and feeling of well .
being. Physical performance may to some c. Necrophilic
degree temporarily improve. d. Odor ( ospresiophilia )

Untoward Effects: Kinds of Ospresiophilia


- They increase the blood pressure and heart rate. 1. Urolagnia
Fatal heart attacks have occurred even in 2. Coprolagnia
healthy, young athletes. The blood pressure 3. Mysophilia
maybe so high that a blood vessel in the brain a. Narcissism
ruptures causing a stroke. b. Saboteur Fetish
9
c. Vampirism abnormalities of the penis or psychological
problems that interfere with sexual arousal.
D. As to the part of the body - These includes injury, diabetes mellitus, stroke
1. Sodomy and drugs like all antihypertensive and
2. Uranism psychotics, antidepressants and some sedatives.
3. Frottage - Alcohol can also cause impotence and also low
4. Partialism levels of testosterone
E. As to visual stimulus
1. Voyeurism SEX CRIMES IN THE REVISED PENAL CODE:
2. Scoptophilia A. Rape
F. As to number B. Carnal Knowledge
1. Troilism - is the act of a man in having sexual bodily
2. Pluralism connection with a woman. There is carnal
G. Other sexual deviates. knowledge if there is the slightest penetration in
1. Don Juanism the sexual organ of the female by the sexual
2. Indecent exposure organ of the male.
3. Coprolalia
H. Disorders of sexual function: C. Seduction
1. Premature ejaculation - is the art of a man enticing women to have
2. Retarded ejaculation unlawful intercourse with him by means of
3. Low sexual desire disorder persuasion, solicitation, promises, bribes or other
4. Sexual aversion disorder means without employment of force
5. Sexual arousal disorder in women
6. Inhibited orgasm D. Acts of Lasciviosness
7. Dyspareunia E. Acts of Lasciviousness with Consent of the
8. Vaginismus Offended Party
I. Sexual reversal F. Abduction
1. Transvertism 1. Forcible Abduction
2. Transexualism 2. Consensual Abduction
3. Intersexuality G. Adultery
H. Concubinage
SEXUAL CRIMES: I. Bigamy
Chaste – An unmarried woman who has had no carnal J. Marriage Contracted Against the Provisions of
knowledge with men or that she never voluntarily had unlawful Law
sexual intercourse. These also denotes purity of mind and K. Premature Marriage
innocence of heart. L. Performance of Illegal Marriage Ceremony
M. Prostitution
Virgin – A woman who has had no carnal knowledge of man. N. Corruption of Minors
Her genital organs have not been altered by carnal connection. O. White Slave Trade
P. Abuse Against Chastity
Kinds of virginity
1. Moral virginity – the state of not knowing the nature of sexual PROVISIONS OF THE REVISED PENAL CODE
life and not having experience sexual relation. APPLICABLE TO UNNATURAL SEXUAL OFFENSES
2. Physical virginity – A condition whereby a woman is
conscious of the nature of sexual life but has not experienced 1. Grave Scandal ( Art. 200 )
sexual intercourse. 2. Immoral Doctrines, Obscene Publications and Exhibitions
3. Demi – virginity – This term refers to a condition of a woman ( Art. 201 )
who permits any form of sexual liberties as long as they abstain 3. Vagrants and Prostitutes ( Art. 202 )
from rupturing the hymen by sexual act. The woman allows 4. Grave Threats ( Art. 282 )
sexual intercourse, but only inter femora or even inter labia, but 5. Light Threats ( Art. 283 )
not to the extent of rupturing the hymen. 6. Other Light Threats ( Art. 285 )
4. Virgo intacta – A truly virgin woman. There is no structural 7. Grave Coercions
change in her organ, notwithstanding the fact of a previous 8. Unjust Vexation or Any Other Coercion ( Art. 287 )
sexual intercourse.
CHAPTER 7 MENTAL HEALTH DISORDERS
DEFLORATION – This is the laceration or rupture of the hymen,
as a result of sexual intercourse. All other lacerations which are Mental Health Disorders – include disturbances in thinking,
not due to coitus are not considered defloration. emotion, and behavior. There is a complex interaction between
the physical, psychologic, social, cultural and hereditary
SEMEN AND SPERMATOZOA: influences.

ERECTILE DYSFUNCTION ( Impotence ) Factors that Contribute to the Development of Mental Disorders:
- The diagnosis of Erectile Dysfunction is important
especially in complaints of rape. It must be 1. Heredity – the most frequent factor that contributes to insanity
proven convincingly that the accused is and a good history will reveal the ascendants afflicted with the
permanently impotent, so that the crime of rape same.
cannot be proved beyond reasonable doubt. 2. Incestous Marriage – The mental illness is accentuated when
they are blood relatives.
- Impotence usually results from vascular 3. Impaired Vitality – Stress, tension, worry, grief may
impairment, neurologic disorders, drugs, predispose to insanity

10
4. Poor Moral Training and Breeding – Corrupt moral upbringing b. Delusion of persecution
in the family due to immorality of the parents c. Delusion of reference
5. Psychic Factors – Factors like love, hate, rage, anger, d. Delusion of Self – Accusation
passion disappointments e. Delusion of infidelity
6. Physical Factors f. Nihilistic delusion
a. Non toxic factors – exhaustion resulting from g. Delusion of poverty
severe physical and mental strain and traumatic injuries to the h. Delusion of control
head. i. Delusion of depression
b. Toxic factors – drug addiction, infections of the B. Obsession
brain 4. Disorders in the trend of thought
Types:
KINDS OF MENTAL HEALTH DISORDERS: a. Mania
1. Psychosomatic disorders – physical disorders caused by b. Melancholia
psychologic factors.
2. Somatiform disorders – encompasses several psychiatric 5. Disorders of Emotions or Feelings – a disorder in the state of
disorders in which people report physical symptoms but deny mind, fervor, or sensibility, not in accord with reality.
having psychiatric problems. 6. Disorders of volition or conation ( doing )
3. Generalized Anxiety Disorders Kinds of Conation:
4. Panic Attacks and Panic Disorder A. Impulsion or Impulse ( Compulsion ) – a sudden
and irresistible force compelling a person to the
5. Phobic Disorders conscious performance of some action without motive
a. Agoraphobia or forethought.
b. Specific phobias
c. Social phobia Types of Compulsion:
6. Obsessive Compulsive Disorder a. Pyromania
7. Post Traumatic Stress Disorder b. Kleptomania
8. Depression and Mania c. Dipsomania
9. Bipolar Disorder d. Homicidal impulse
10. Suicidal Behavior e. Sex impulse
11. Eating Disorders f. Suicidal impulse
a. Anorexia nervosa
b. Bulimia nervosa DISTINCTIONS BETWEEN TRUE AND FALSE
c. Binge eating disorder INSANITY:
12. Personality Disorders 1. True insanity develops insidiously usually with the
a. Paranoid existence of some predisposition to an exciting cause
b. Schizoid if careful history is taken, while false insanity develops
c. Histrionic suddenly with no existing predisposition.
d. Narcissistic
e. Antisocial 2. In true insanity, there is a peculiar facial expression,
f. Borderline which is absent in false insanity
g. Avoidant
h. Dependent 3. In true insanity, there is a continuous and persistent
manifestation of insanity, which is only present in false
i. Obsessive – Compulsive insanity when the pretender is under observation, and
j. Passive Aggressive absent when not under observation.
k. Dissociative
4. In true insanity, there is a clinical entity of a specific
13. Schizophrenia – a serious mental disorder characterized by mental disorder, which is absent in false insanity.
loss of contact with reality ( psychosis ) , hallucinations,
delusions ( false beliefs ) , abnormal thinking, disrupted work 5. In true insanity, the patient can endure a violent or
and social functioning stressful activity without fatigue, which is not present
in false insanity
Types of Schizophrenia:
a. Paranoid 6. In true insanity, the patient does not observe
b. Hebephrenic personal hygiene, in false insanity, the pretender
c. Catatonic observes hygiene

14. Delusional Disorder Insanity or Mental Illness is an exempting or mitigating


15. Psychological Incapacity – a waste basket diagnosis circumstance to Criminal Liability as provided in the
because it is so broad a term, that it covers all possible Mental following:
Disorders. 1. As an exempting Circumstance
Article 12 of the Revised Penal Code
SOME MANIFESTATIONS OF MENTAL DISORDERS: provides, “ When the imbecile or an insane person
1. Disorders of Cognition ( Knowing ) has committed an act which the law defines as felony,
a. Illusion the court shall order his confinement in one of the
b. Hallucination hospitals or asylums established for persons thus
2. Disorders of Memory afflicted and he shall not be permitted to leave without
a. Dementia first obtaining the permission of the same court.
3. Disorders in the Content of Thought
A. Delusion 2. As a mitigating Circumstance
a. Delusion of grandeur

11
Article 13, of the Revised Penal Code
provides, the following are mitigationg circumstances:
a. That the offender is deaf and dumb, blind
or otherwise suffering from physical defect which thus
restricts his means of action, defense or
communication with his fellow beings

The American Law Institute formulated the following


Rules on Criminal Responsibility and states that;
1. A person is not responsible for his criminal conduct
if at the time of such conduct as a result of mental
illness or defect, he lacks essential capacity to
appreciate the criminality of his conduct or to conform
his conduct to the requirement of the law.

2. The term “ mental disease or defect “ does not


include an abnormality manifested only by repeated
criminal or otherwise anti social conduct

Fundamental Principles of Insanity and Criminal


Responsibility:
1. A sane man is assumed to be wholly responsible for
the consequence of his crime.
2. A person who commits a criminal act is presumed
to be sane.
3. Crime is always considered as an affair of the mind
as well as the body and to make an act or omission a
crime, there must be a criminal act ( actus reus ) and
an criminal mind ( mens rea ) . Actur facit reum, nisi
mens sit rea.

Mental Deficiency – or mental retardation, is sub


average intellectual ability present from birth or early
infancy. Intelligence is both determined by heredity
and environment. In most cases of mental deficiency,
the cause is unknown.

Classification of mental deficiency:


1. Idiot – The idiot’s intelligence never exceeds that of
a normal child over 2 years old. The IQ is between 0 –
20. This is usually congenital.
2. Imbecile – the imbecile’s intelligence is compared
to a normal child from 2 – 7 years old and the IQ is 20
– 40.
3. Feeble Minded – his mentality is similar to that of a
normal child between 7 – 12 years old and an IQ of 40
– 70.

The Legal Importance of determining the person’s


state of mind are the following

In Criminal law, insanity exempts a person from


criminal liability

In Civil law, Insanity is a restriction of the capacity of a


natural person to act as provided in Article 38 of the
Civil Code.

Insanity modifies or limits the capacity of a natural


person to act as providedin Article 39, also of the Civil
Code.

Insanity at the time of marriage of any or both parties


is a ground for the annulment of marriage.

12