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1.Introduction to Forensic Medicine

The word Forensic has been derived from the Latin word “forensis” means related to “forum”. In ancient Rome, forums were the meeting places for people of responsibility where all the civic and legal matters were discussed upon, and various problems were solved. So, the word “Forensic” means any issue pertaining to the court of law. The word “medicine” has wide implications when used next to the word “forensic” relating to using the vast medical knowledge in solving medicolegal problems like finding out the exact cause of death or time since death etc.

In other words, Forensic Medicine is the branch of medical science which deals with the application of medical knowledge to aid in the administration of Justice.

Forensic Medicine previously also known as Medical Jurisprudence which is derived from the Latin word “jurisprudentia” (juris=law; prudence=knowledge) meaning “knowledge or science of law”. In United States it was more broadly associated with “the philosophy of law”.

Definition: Forensic Medicine is an application of medical knowledge for the purpose of law both civil and criminal for example in cases of assault, vehicular accidents. The Forensic expert can opine if the said injuries have been caused due to vehicular accident or not, duration of injuries, nature of injuries and cause of death etc. The forensic expert has to possess the basic knowledge of other branches of medical sciences so as to solve the problems related to medicolegal issues for example; death due to anesthesia, alleged negligence, criminal abortion and sudden death due to various causes.

Medical Jurisprudence deals with legal responsibilities of the physician with particular reference to those arising from doctor- patient relation, such as medical negligence cases, ethical conducts on the part of a doctor, professional misconducts etc.Precisely,it deals with legal aspects of practice of medicine.

Medical Jurisprudence found its chair in 1807 at University of Edinburgh, first to be occupied by Andrew Duncan the junior (1773 to 1832) who was a Scottish physician and professor at University of Edinburgh, imposed thereby during the era of prominent British statesman Charles James Fox. Forensic Medicine was also termed as State medicine which was recommended by Dr Stanford Emerson Chaille in 1949(Father of Hygiene and Health education in America) and was developed to regulate and guide the code of conduct of registered medical practitioners and to supervise the allied medical practice. Legal Medicine term is also used for Forensic Medicine in many parts of world.

Medical Ethics deals with moral principles which should guide members of medical profession in their dealings with each other, their patients and the state.

Medical Etiquette deals with conventional law of courtesy observed between members of medical profession. This is self-imposed behavior of the doctor towards his colleague and as such not punishable. However, it is implied that a doctor should behave with his colleague in a way he should behave with himself and should not demean or degrade a fellow professional while dealing with patient.

History: At about 7th century BC the Charaka Samhita elaborately described regarding code of medical ethics, training duties, social status and privileges of a physician, including description of various poisons and the possible treatment. Even in earliest literature, the word “Mithya” has been used to describe negligent treatment and has been used in Charak Samhita to describe the same. Sushruta Samhita used “Mithyopchara” to describe improper conduct on the part of physician. Manu Smriti was laid down in 4th century BC by king Manu, who was considered as the law giver where various laws were described including punishments of offences like sexual assault etc. Manu Smriti even recognized mental incapacity due to alcohol intoxication or old age or insanity. The Manu Smriti, Kautilya’s Arthasashtram , Yajnavalkya Smriti also have described regarding compensation given to the victim in medical negligence cases as high as 1000 Pana (silver coins). Kautilya’s Arthsashtra defined various torture guidelines and methods of torture of a convict as well as regulation of medical practice.

Machiavelli from India described numerous topics including dark occult arts and foreign policies. Imhotep who was the Grand Vazir, Chief justice and Chief physician of king Zoser of Egypt during 27th century BC had enacted rules for medical practice. Oldest medicolegal code goes as far back as 2200 BC and is described under “Code of Hammurabi”. In Jewish tradition, dead bodies were respected, and they believed in the fact that handling a dead body makes a man unclean for days. Emphasis was given on the prompt and respectful burial of the dead body. Laws were implemented by rabbis who forbid postmortem dissection of the body. But however, as per records, at around 100 AD students of Rabbi Ismael obtained the body of a young harlot and boiled off the soft tissue in order to count the number of bones present in the body. Autopsies were not permitted in the orthodox Jewish community until the late 20th century, when Knesset, the Israeli parliament passed law permitting autopsy under strict limited conditions.

First medicolegal autopsy was done in Bologna (Italy) in the year 1302 AD by Bartolomeo De Varignana. The first book on forensic medicine was published in 1602 by an Italian physician Fortunato Fedele. But Paulo Zacchias, who was principal physician to pope Innocent X, Alexander VII and expert before Rota Romana, the court of appeal, his works are considered the greatest and described in “Questiones Medicolegales”. This was published in seven volumes spanning over a period of 1621 to 1635 along with two additional volumes in 1666 at Amsterdam.

Until the beginning of 19th century his works were considered to be pioneer. Paulo Zacchias is considered as father of legal medicine as well as father of forensic psychiatry. Around the end of 16th century, autopsies were generally practiced in medicolegal cases and in 18th century professorships were founded in legal medicine by the state of Germany.In India,the first recorded medicolegal autopsy was done by Dr. Edward Bulkley on the afternoon of 28th August 1693 over the dead body of Mr.Wheeler,amember of council and chief justice of Choultry in Chennai.

India’s first medical school was established in Kolkata in the year 1822 and the same was converted into Medical college in 1835 along with inception of Madras Medical College. Afterwards it was same college where first chair of professor of medical jurisprudence was established in 1857.

Primitive man was aware of natural poisons from animals and plants and wisely used them on his weapon. The history of poisons is described in the ancient Indian Shastras as well as Egyptian papyri,Babylonian,Hebrew and Greek records. Menes pharaoh I (3000 BC) is said to have studied many poisons. The Ebers papyrus (1500 BC) contains information extending back many centuries. Atharva Veda (1500) BC describes poisons. The Italian brought the art of poisoning to its zenith prior to renaissance period and extended into that period.

Development of Forensic Medicine in India:The first medical school established in Calcutta in 1822 and converted into medical college in 1835.Following which medical school in Madras established in 1835 and transformed into medical college in 1850. In Bombay the first medical college established in 1850. In 1857 AD the first distinct lead in medical jurisprudence was created in Madras Medical College.

Dr.Urguhart,a private practitioner and coroner of Madras was the first professor.The books that were followed were brought from England.