CHAPTER 1 LEGAL MEDICINE
a will
Legal Medicine
- Is that branch of medicine that applies, medical
and surgical concepts, scientific knowledge and
skills to medico legal issues, in order to assist the
trier of facts in the proper dispensation of justice.
Medical Jurisprudence
- is the study of the Medical Law and its applicable
Jurisprudence that governs, regulates and
defines the practice of medicine.
 In the Philippines, Legal Medicine is the appropriate
name for Forensic Medicine.
 Modern Legal medicine has a broad range of
applications, it is used in civil cases such as paternity
and filiation, annulment of marriage, DNA testing , etc.
 In all cases the medical examiner must conduct an
investigation of the crime scene and also an autopsy.
TECHNIQUES OF LEGAL MEDICINE:
- Legal Medicine uses sophisticated laboratory
techniques to detect the presence of substances
in the victim, in the suspected criminal, or at the
crime scene.
- Forensic examination of substances found at a
crime scene can often establish the presence of
the suspect at the crime scene.
LEGAL MEDICINE AND THE LEGAL SYSTEM
- Courts routinely call upon physicians to give
expert testimony in a trial, especially concerning
the findings of an autopsy and the results of
laboratory tests.
- As an expert witness he is allowed to express an
opinion about the validity of the evidence in a
case and may quote the statements of other
experts in support of an opinion.
- Ordinary testimony is restricted to statements
concerning what the witness actually saw or
heard.
- The evidence to be presented by the legal
medicine expert must signify a relation between
the facts called the “ Factum Probandum” or
proposition to be established and the “ factum
Probans” which is the material evidencing the
proposition.
- The Physician must present RELEVANT,
MATERIAL AND COMPETENT EVIDENCE.
HISTORY OF LEGAL MEDICINE:
- Paulus Zacchias ( 1584 – 1659 ) is the ‘ Father of
Forensic Medicine”. He was the first to describe
the importance and application of medicine to the
proper administration of justice.
- In the Phil. , the father of Legal Medicine can be
rightfully bestowed to Dr. Pedro P. Solis. His book
on Legal Medicine copyrighted in 1987, contains
the most extensive treatise and teachings in
Philippine Legal Medicine.
APPLICATION OF LEGAL MEDICINE TO LAW:
Legal Medicine is Applied to Law
1. Civil law
- the determination and termination of civil
personality
- the limitation or restriction of a natural
person’s capacity to act
- marriage and legal separation
- paternity and filiation
- testamentary capacity of a person making
- the right to hereditary succession
2. Criminal Law
- Felonies and circumstances which affect criminal
liability
- Civil liability ex delictu
- Crimes relative to opium and prohibited drugs
- Crimes against persons
- Crimes against chastity
- Crimes against civil status of persons
- Quasi – offenses
3. Remedial Law
- Physical and Mental Examination of a person
- Hospitalization of insane persons
- Rules of Evidence
4. Special Laws
- Dangerous Drug Act
- Youth and Child Welfare Code
- Sanitation Code
- Insurance law
- Labor Code
- Employees Compensation Law
5. CORPUS DELICTI
- Is the body or substance of the crime and
is defined as the fact that a crime actually has been
committed. In all criminal prosecutions, the burden is
on the prosecution to prove the corpus delicti.
QUANTUM OF PROOF
1. In Civil Cases – the quantum of proof necessary to
prove a civil complaint is a PREPONDERANCE OF
EVIDENCE. The party filing or bringing a civil
complaint has the burden of proof and must establish
the truth and righteousness of his allegations by a
preponderance of the evidence admitted by a
competent court.
2. In Criminal Cases
– the quantum is proof beyond reasonable doubt.
- In a criminal case the accused is entitled to an
acquittal, unless his guilt is shown beyond
reasonable doubt
- Presumption of INNOCENCE is a conclusion
drawn by the constitution and the law in favor of
the accused , while REASONABLE DOUBT, is a
condition of mind produced by proof resulting
from evidence in the case.
3. To establish matters of defense
- The doctrine of reasonable doubt applies
only to incriminative facts.
4. To establish self defense
- One who sets up SELF DEFENSE “ must
rely on the strength of his own evidence and not on
the weakness of that of the prosecution”.
5. To establish Alibi
- It must be proved by positive, dear and
satisfactory evidence. “ Oral Evidence” of alibi is so
easily manufactured and usually unreliable that it can
rarely be given credence.
6. In Administrative Complaints
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 - In cases filed before administrative or
quasi judicial bodies, a fact maybe deemed
established if it supported by “ substantial evidence”
which means that amount of relevant evidence which
a reasonable mind might accept as adequate to justify
a conclusion.
CHAPTER 2 MEDICAL AND HOSPITAL
JURISPRUDENCE
Medical Jurisprudence:
- Is the study of the Medical Law and its applicable
Jurisprudence, that governs, regulates, and
defines the practice of medicine.
- It includes the rights, duties, obligations and
liabilities of both physician and patient to each
other in a physician patient professional contract.
The Following Acts Constitute the Practice of
Medicine:
1. To physically examine and diagnose a patient.
2. To physically examine and treat a patient
3. To physically examine and perform surgery in a
patient
4. To physically examine and prescribe any remedy to
a patient.
 Any person who practice any of the above acts
enumerated, without any valid certificate of
registration as a physician, is practicing illegal
medicine.
The Nature of the Physician Patient Professional
Relationship is
1. Consensual:
- based on mutual consent of both patient and
physician.
- Contracts that are consensual in nature, are
perfected upon mere meetings of the minds
2. Fiduciary:
- founded in trust, faith, and confidence reposed by
one person in the integrity and fidelity of another.
DUTIES AND OBLIGATIONS OF THE PHYSICIAN
TOWARDS HIS PATIENTS:
1. He must possess that knowledge and skill possessed by
an average physician.
2. He must use such knowledge and skill with ordinary care
and due diligence.
3. He is obliged to exercise his best judgment
in good faith.
4. He has the duty to keep the secrets and confidentialities
of his patients.
 The Terms and Conditions not included in the
Physician Patient Professional Relationship Contract (
refer to book )
 The only promise or guaranty that the law requires is
that, the physician will treat the patient in accordance
with the standards of medical care.
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.
5. The right to choose his physician.
6. The right to medical records.
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7. The right to privacy and confidentiality.
8. The right to a second or third opinion.
9. The right to leave.
10. The right to information.
11. The right to self determination.
12. The right to refuse participation in medical research
13. The right to express grievance
14. The right to be informed of his rights and obligations.
 Obligations of the Patients to their Physicians ( Refer
to Book )
 SOCIATAL RIGHTS OF THE PATIENTS FROM THE
GOVERNEMNT ( Refer to Book )
RIGHTS INHERENT IN THE PRACTICE OF MEDICINE:
1. The right to choose his patients
2. The right to limit the practice of his profession
3. The right to determine appropriate treatment procedures
in the discretion and judgment of the physician.
4. The right to avail of hospital privileges after being
qualified.
5. The right to receive just and fair compensation from his
patients.
Liabilities of a Physician Which May Arise from His
Negligent or Wrongful Acts or Omissions:
1. Administrative Liability
- A complaint under oath can be filed before the
Professional Regulation Commission Board of Medicine,
for reprimand, of the license to practice medicine.
2. Criminal Liability
- When an act or omission constitutes a crime, the
physician can be imprisoned or fined or both, as any other
profession.
3. Civil Liability
- The aggrieved party can be awarded monetary
damages for any wrongful or negligent act or omission,
when the professional is found guilty.
CASES ( Refer to Book )
 Ex. Negligent or Wrongful Act
Medical malpractice is a particular form of negligence
which consists in the failure of a physician or surgeon
to apply to his practice of medicine that degree of care
and skill which is ordinarily employed by the
profession generally, under similar conditions, and in
like surrounding circumstances
There are Four Elements involved in medical
negligent cases:
1. Duty
2. Breach
3. Injury
4. Proximate Causation – It has been recognized that
expert testimony is usually necessary to support the
conclusion as to causation.
 Ex. Whether A Hospital may be Held Liable for the
Negligence of Physicians – Consultants allowed to
Practice in its Premises.
CHAPTER 3 DEATH
Legal Presumption of Death:
- If absent without explanation from his or her
usual or last place of residence for a long
continuous period.
- Circumstantial proof of death
 Ex. a passenger on an airplane that crashed is
considered to have died even if no remains can
be recovered.
 Rules of Evidence in Rule 131, section 5 paragraph X,
paragraph JJ, and paragraph KK.
 In common law the presumption of death does not
arise until the expiration of seven years of continuous
absence.
DEATH – IS THE COMPLETE CESSATION OF ALL THE VITAL
FUNCTIONS OF THE BODY WITHOUT POSSIBILITY OF
RESUSCITATION. THE ASCERTAINMENT OF DEATH IS A
MEDICAL AND NOT A LEGAL PROBLEM.
Death maybe
A. Brain Death – occurs when there is a deeply irreversible
coma, and absence of electrical brain activity.
B. Cardio Respiratory Death – occurs when there is continuous
and persistent cessation of heart action and respiration.
4 Kinds of Death:
1. Clinical or Somatic Death
2. Brain Death
3. Biological Death
4. Cellular Death
Clinical or Somatic Death
- This particular kind of death occurs when in the
judgment of the physician with the use of his
clinical eye the body’s vital signs of life cease to
exist continuously and permanently.
- The clinical death is verifiable only by a physician
after he observes that the patient no longer has a
heart beat no pulse rate, no spontaneous
breathing and movement, with the pupils of the
eye widely dilated and not reactive to light and
accommodation.
- When a clinically dead person is brought to the
morgue the generalized contraction of the
muscles or Rigor Mortis of the body within 3 to 6
hours, may simulate a return to life, because of
the motion or movement of the body.
BRAIN DEATH
- This kind of death follows clinical death – almost
immediately unless resuscitative procedures are
started promptly, because the human brain under
normal conditions cannot survive loss of oxygen
for more than 6 to 10 minutes.
- Brain Death may occur in the
Stage 1 – Cerebral Cortex- the highest center of
the brain that is most sensitive to changes in the
supply of oxygen and blood to the brain. When
the cerebral cortex dies, the patient is in cortical
death.
Stage 2 - Cerebellum – It deals with the function
of equilibrium. It follows the death of the cerebral
cortex.
Stage 3 – Brainstem and Vital centers – These
centers controlling respiration, heart rate and
blood pressure, ultimately die. When it does, the
patient is, Brain Stem Dead.
- If the brain stem is damaged, then the vital
centers in the medulla maybe destroyed, causing
the respiratory center to fail.
- The occurrence of brain stem death is equivalent
to Legal Death, so that Doctors can now issue a
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Death Certificate, even though the heart is still
beating, and make arrangements to harvest
donor organs and tissues at this stage.
- Further, in the presence of brain stem death,
artificial respirators only achieve the maintenance
of an oxygenated circulation through a corpse or
cadaver.
CRITERIA FOR DIAGNOSING BRAIN STEM DEATH.
( refer to textbook )
Persistent Vegetative State ( PVS )
- This condition exists, when irreversible
destruction of the Cortex of the brain occurs
without damage to the vital centers, and there
are permanent eyes – open state of
unconsciousness, but cardio respiratory functions
continue, sometimes without respiratory
assistance, but most often with respiratory
support.
- They do not however match the clinical criteria of
Brain Death, in as much as they have elicitable
reflexes, spontaneous respirations and reactions
to external stimuli.
HARVARD CRITERIA OF WHOLE BRAIN DEATH:
1. Unreceptivity and Unresponsitivity
2. No spontaneous movements or breathing
3. No reflexes
4. Flat EEG of Confirmatory value
WHOLE BRAIN DEAD
- When the brain ceased all functions, even though
the heart continues to beat. As a rule doctors can
legally declare whole brain death twelve hours
after they have corrected all treatable medical
problems, but the brain still doesn’t respond even
to induced pain , they eyes do not react to light
and the person doesn’t breath without a
respirator.
BIOLOGICAL DEATH
- All the components of the brain are dead
- There is also permanent extinction of bodily life.
- It is cardiorespiratory and brain death altogether
with permanent cessation of all the anatomic and
physiological functions of the body organs.
CELLULAR DEATH:
- The death of the different parts of the body
occurs at different times and stages.
- This is the reason why such organs as the
corneas and the kidneys can be removed
immediately after biological death and
transplanted successfully.
SIGNS OF DEATH:
1. Cessation of heart action and circulation
2. Cessation of respiration
3. Cooling of the body ( Algor Mortis )
- The temperature of 15 – 20 degrees
Fahrenheit is considered as a certain sign of death.
4. Loss of motor power
5. Loss of sensory power
6. Changes in the skin
7. Changes in and about the eye
- There is loss of corneal reflex
CHANGES IN THE BODY FOLLOWING DEATH
1. Changes in the Muscle
a. Stage of primary flaccidity
b. Cadaveric rigidity or rigor mortis
 - muscular contraction which
develops 3 – 6 hours after death
and may last for 24 – 36 hours.
- may also be utilized to
approximate the length of time the
body has been dead from 3 to 36
hours
c. Stage of secondary flaccidity or
commencement of putrefaction
Cadaveric Spasm- is the immediate or instantaneous spasm or
rigidity of the skeletal muscles occurring at the moment of death
due to exhaustion, etc.
Medico legal Importance of Cadaveric Spasm
( Refer to Book )
2. Changes in the Blood
a. Coagulation of the blood
b. Postmortem lividity or Livor Mortis
3. Autolytic or Auto Digestive Changes After Death
4. Putrefaction of the Body
PUTREFACTIVE CHANGES OCCURING AFTER DEATH
( Refer to Book )
Kinds of Putrefaction:
1. Mummification
2. Saponification – This is also called Adipocere Formation.
3. Maceration
Factors to Consider in Approximating the Duration of Death in a
Cadaver
1. Entomology – The presence of maggots in the cadaver
indicates duration of death for more than 24 hours
2. Presence of live Fleas in clothing – in death by drowning, a
flea can survive for about 24 hours submerged in water. After 24
hours submersion in water the fleas die.
3. Blood vessel clots – blood clotting occurs in 6 -8 hours after
death.
4. Post Mortem lividity – develops in 3 to 6 hours after death.
5. Rigor Mortis- begins to develop in 3 to 6 hours after death
and may last for 24 to 36 hours after death.
6. Onset of decomposition – Decomposition takes place within
24 – 48 hours after death.
7. Food in the stomach
8. Skeletal soft tissues – soft tissues may disappear from 1.5
years to 2 years after burial.
Position of the Body at the time of Death
1. Post Mortem lividity
2. Cadaveric spasm – Death due to violence or inflicted physical
injuries, usually manifest the position of the body at the time of
death.
Ex. In suicide by gunshot wound, the gun maybe tightly grasped
in the hand of the deceased
In drowning, the victim maybe holding objects that
come in contact with his hands to cling to life.
MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS AND
CADAVERIC SPASM:
Rigor mortis is utilized to approximate the time of death.
Generalized muscular contractions occur from 3 to 6 hours until
36 hours.
Cadaveric spasm occurs immediately after death and is useful
to ascertain the circumstances of death.
Medico Legal Investigation of Death
- Deaths which are not obviously due to natural
causes, but are criminal, suspicious, accidental,
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suicidal, murderous, homicidal, sudden or
unexpected, or unexplained, need medico legal
investigation.
The Death Certificate
- The death certificate is a legal document
necessary for burial of the dead, as it certifies the
occurrence of death. It is a document from the
Office of the Civil Registrar General, listing the
particulars of an individual’s death.
- It contains the Immediate Cause or Primary
cause of death, the antecedent causes and
underlying cause of death
Immediate Cause or Primary Cause of Death
Ex. Suffocation due to drowning
Asphyxia
Cardio – Respiratory Arrest
Antecedent Cause of Death are events or
conditions that substantially contribute to the
immediate cause of death
Ex. Acute peritonitis, Acute Hypovolemic shock,
Acute Septic Shock,
Underlying Cause of Death is the basic cause or
bottom line cause of death. It is the diagnosis of
the patients or victim’s illness or sickness that
resulted to his death
Ex. Acute Appendicitis, Hepatocarcinoma, Pelvic
Fracture, Stab or Gunshot Wound to the chest.
Non Natural Causes of Death
Ex. Murder, Homecide, Suicide, Accident
Death Warrant – is a warrant from the proper executive authority
appointing the time and place for the execution of the sentence
of death upon a convict judicially condemned to suffer death.
Manner of Death
- Is the explanation as to how the cause of death
arose, and maybe either Natural Death or Violent
Death
Lazarus Syndrome
- Is also called Lazarus Phenomenon is the
spontaneous return of circulation after failed
attempts at resuscitation.
Implications of Lazarus Syndrome
- raise ethical and legal issues for doctors, who
must determine when medical death has
occurred, when resuscitation efforts should end,
and post mortem procedures such as autopsies
and organ harvesting may take place.
Lazarus Sign
- Lazarus sign or Lazarus reflex is a reflex
movement in brain dead patients, which causes
them to briefly raise their arms and drop them
crossed on their chests.
- The phenomenon has been observed to occur
several minutes after the removal of medical
ventilators used to pump air in and out of brain
dead patients to keep their bodies alive.
NEAR DEATH EXPERIENCE
- Refers to a broad range of personal experiences
associated with impending death, encompassing
multiple possible sensations including
 detachment from the body; feelings of levitation 4. Abdomen
etc. Types of Injuries:
a. Penetrating
EUTHANASIA - Gunshot wounds of the abdomen carry
- Meaning good death ( well or good ) 95% probability of significant visceral injury
- Refers to the practice of ending life in a painless - A bullet when it hits the abdomen will
manner. penetrate the abdominal wall, enter the
- Deliberate intervention undertaken with the abdominal cavity and most likely injure more
express intention of ending life, to relieve than one organ.
intractable suffering - The incidence of abdominal injury is
strikingly higher in gunshot wounds than in
Classification of Euthanasia: stab wounds.
1. Voluntary euthanasia – is euthanasia conducted with consent - The major cause of death is hemorrhage
and this occurs within the first 24 hours
2. Involuntary euthanasia - In stab wounds of the abdomen , only 2/3
– is euthanasia conducted without consent. penetrate the peritoneal cavity; of these only
-is conducted where an individual makes a decision for another ½ cause significant visceral injury that
person incapable of doing so. requires surgical repair.
- also known as physician assisted death, physician assisted b. Blunt
suicide or mercy killing. - The spleen and liver are the most
commonly injured organs due to blunt
3. Passive euthanasia – entails withholding of common trauma.
treatments - Their frequent incidence also explains why
the mortality rate following blunt trauma is
4. Active euthanasia – entails the use of lethal substances or higher than that of penetrating injury.
forces to end life and is the most controversial means.
5. Fractures and Dislocations
CHAPTER 4 REGIONAL TRAUMA The word fracture comes from the Latin word
“fractura” which means a break in the continuity of the bone. It is
Trauma also a combination of a break in the bone and soft tissue injury
– is the leading cause of death in the first four decades of life
and the 3rd leading cause of death in all age groups today. A. Open Fractures - 90% of open fractures are caused
-Penetrating trauma particularly handguns is becoming common by vehicular accident.
in nearly all areas of the country. B. Hip fractures are very common in elderly people
and are usually caused by minor falls. It is the most common
Trimodal Distribution of Death from Trauma: cause of traumatic death after the age of 75.
1. Seconds to minutes of injury – due to the injury to the brain,
high spinal cord, heart, aorta and other large vessels. These 6. Urologic
patients can rarely be salvaged. - Hematuria following trauma
2. Minutes to Few hours from injury ( The Golden Hour ) - Blunt kidney injury is usually due to motor
- It is in this period that Advanced Trauma Life Support9 vehicular accidents which account for 70 –
( ATLS ) techniques are important. 90 % of kidney trauma.
3. Several days to weeks of Injury – these are due to sepsis or - Penile injury:
organ failure. The erect penis is usually 6 – 8 inches long
and 1 -2 inches in diameter.
SPECIFIC INJURIES - Avulsion of the prepuce – this may follow
1. Head accidents where the foreskin called prepuce
a. Types of Head Injuries: is detached or lacerated by a blunt force.
a.1 Hematoma - Fracture of the penis – this is the traumatic
a.2 Contusions rupture of the corpora cavernosa penis
a.3 Skull fractures resulting from a forceful trauma to the
a.4 Hemorrhage flaccid organ.
2. Spine and Spinal Cord Injuries - Amputated penis – the penis of an avid
The most common causes of severe spinal trauma womanizer is sometimes intentionally cut or
are motor vehicular accidents, falls, diving accidents, and amputated by a jealous derange wife or
gunshot wounds. lover.
3. Chest
a. Life Threatening Injuries 7. Arterial trauma
Pnumothorax 8. Burns
Hemothorax
Flail chest as in multiple rib fractures CLASSIFICATION OF WOUNDS
Cardiac tamponade due to penetrating 1. AS TO LEGAL CLASSIFICATION
injuries Chapter 1
b. Potentially Lethal Injuries DESTRUCTION OF LIFE
b.1. Pulmonary Contussion with or without a. Article 246. Parricide
flail chest b. Article 247. Death or Physical Injuries Inflicted Under
b.2. Thoracic Aortic Tear or Rupture – the Exceptional Circumstances
most common cause of sudden death after c. Article 248. MURDER
a vehicular accident or fall ( major - Any person who, not falling within the provisions of
decelaration injury ) Article 246 shall kill another, shall be guilty of murder and shall
c. Serious Chest Injuries
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be punished by Reclusion Perpetua, to death if committed with
any of the following attendant circumstances;
1. With treachery
2. In consideration of a price , reward or promise
3. By means of inundation etc.
4. On occasion of any of the calamities etc.
5. With evident premeditation
6. With cruelty etc
b.2 Perforating – there is a communication between the outside,
inner and the outer side. There is both a point of entry and exit.
Classification of Wounds
3. AS TO MORTALITY
a. Deadly Wound- Death results immediately, after the infliction
of the wound. Deadly wounds though mortal, maybe prevented
with prompt medical treatment.

Article 249 HOMICIDE b. Non Deadly Wounds – Does not result to death immediately,
Article 251. Death Caused in a Tumultous Affray after the wound is inflicted. A non deadly wound may cause
Article 252. Physical Injuries Inflicted In a Tumultuous Affray death later, due to complications i.e. tetanus, septicemia
Article 253. Giving Assistance to Suicide
Article 254. Discharge of Firearms Classification of Wounds:
Article 255. Infanticide 4. AS TO THE WOUNDING INSTRUMENTS USED:
Article 256. Intentional Abortion a. Sharp Instruments – Ex. incised wound, punctured wound,
Article 257. Unintentional Abortion – who shall caused an stab wound dagger or kitchen knife
abortion by violence but not intentional. b. Blunt Instruments – A block of wood or iron produces
Article 258. Abortion Practiced by the Woman Herself or By Her contusion, hematoma, abrasions, lacerated wound when used
Parents to strike, attack, wound, beat or assault another
Article 259. Abortion Practiced by a Physician or Midwife and
Dispensing of Abortives Classification of Wounds:
Article 260. Responsibility of Participants in a Duel 5. AS TO THE CONSEQUENTIAL INJURY AFTER THE
Article 261. Challenging to a Duel APPLOCATION OF FORCE
a. Coup Injury -
CHAPTER 2 b. Coup Centre Coup Injury
PHYSICAL INJURIES c. Contre Coup Injury
a. Article 262. Mutilation – Any person who shall intentionally d. Locus Minoris resistancia
mutilate another by depriving him, either totally or partially , of e. Extensive injury
some essential organ of reproduction.
b. Article 263. Serious Physical Injuries – Any person who shall Classification of Wounds:
wound, beat, or assault another, shall be guilty of the crime of 6. AS TO THE INTEGRITY OF THE SKIN
serious physical injuries A. CLOSED WOUNDS – Presents no break in the integrity or
c. Article 264. Administering Injurious Substances or Beverages continuity of the skin. There maybe only outward manifestations
d. Article 265. Less Serious Physical Injuries – Any person who of injury internally.
shall inflict upon another physical injuries which shall Ex. of closed wounds:
incapacitate the offended party for labor for 10 days or more, or 1. petechiae – a circumscribe extravasation of blood in the
shall require medical attendance for the same period subcutaneous tissue.
e. Article 266. Slight Physical Injuries and Maltreatment. 2. contusion – effusion of blood into the tissues underneath the
- When the offender has inflicted physical injuries which shall skin as a result of a blunt force. Ex. black eye
incapacitate the offended party for labor from one to nine days, 3. Hematoma
or shall require medical attendance during the same period. 4. Blunt injury
5. Musculoskeletal injuries
Chapter 3, RAPE – When and How rape is committed Ex. Sprain, Dislocation, Fracture, Strain
1. By a man who shall have carnal knowledge of a woman
under any of the circumstances Cerebral Concussion – there is a brief loss of consciousness
a. Through force, threat, or intimidation and sometimes memory after a head injury that doesn’t cause
b. When the offended party is deprived of reason or obvious physical damage.
otherwise unconscious
c. By means of fraudulent machinations or grave Cerebral Contusion – they are bruises to the brain, usually
abuse of authority caused by a direct, strong blow to the head. They are more
d. When the offended party is under twelve ( 12 ) serious than concussions.
years of age or is demented, even though none of the
circumstances mentioned above is present. B. OPEN WOUNDS
- There is a break in the continuity of the skin
2. By any person who, under any of the circumstances Examples:
mentioned in paragraph 1 hereof, shall commit an act of sexual 1. Abrasion
assault by inserting his penis into another person’s mouth or 2. Bruise
anal orifice or any instrument or object into the genital or anal 3. Incised wound
orifice of another person. 4. Stab wound
5. Punctured wound
Classification of Wounds 6. Perforating wound
2. AS TO THE DEPTH OF THE WOUND 7. Lacerated wound
a. Superficial – When the wound involves only the layer of the 8. Bites
skin 9. Gunshot wounds
b. Deep – When the wound involves the structures beyond the
layers of the skin. B. OPEN WOUNDS – there is a break in the continuity of the
skin
b.1 Penetrating – the wound enters the body but does not come B.1. Abrasion – Scratch, friction mark
out. Punctured, stab and gunshot wounds usually belong to this
type of wound.

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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 A. An overpowering desire or need to
located in any part of the body. continue taking the drug or to obtained it by any
4. Self – Inflicted wounds – these are wounds self inflicted by means.
the person on himself. The wounds are usually found on the
accessible parts of the body, usually with no intention to kill - a tendency to increase the dose.
himself. Unless the victim is insane, self inflicted wounds are for -a psychological and physical dependence
a fraudulent or self serving purpose. on the effects of the drug.
5. Homicidal wounds – these are the serious wounds sustained - a detrimental effect to the society and to
by the victim resulting to his death, from the criminal assailant. the individual
Usually the wounds are situated in the areas of the neck, chest,
the abdomen and the skull. B. Drug Habituation – is the desire to have a
6. Accidental wounds – these wounds are sustained by the continuous use of the drug but with the capacity to
victim, without any fault or intention whatsoever on the part of refrain physically from using it.
the accused to inflict the wounds on the victim. The wounds are
usually located on any part of the victim’s body. Characteristics of Drug Habituation:
7. Suicidal wounds – these are wounds self inflicted by the - The desire to use the drug is not
victim on himself, and usually seen on the temple, the roof of compulsive but merely psychical.
the mouth, and other fatal body areas, accessible to the hand of
the victim. - There is little or no tendency to increase
the dose
CHAPTER 5 COMPREHENSIVE DANGEROUS DRUGS ACT
OF 2002 - The detrimental effect if any, is primarily on
the individual.
REPUBLIC ACT 9165
6. Protector
A DANGEROUS DRUG is a drug whose use is attended by risk 7. Pusher
and therefore is unsafe, perilous and hazardous to people and 8. Controlled Delivery
society. 9. Den, Dive or Resort
10. PDEA – The Philippine Drug Enforcement Agency,
A DRUG is any substance , vegetable, mineral or animal in which is the implementing arm of the Dangerous
origin, used in the composition or preparation of medicines or Drugs Board.
any substance used as medicines.

7
UNLAWFUL ACTS AND PENALTIES IN THE
DANGEROUS DRUGS ACT OF 2002 ( R.A. 9165:
1. Importation of Dangerous Drugs and or Controlled
Precusors and Essential Chemicals.
2. Sale, Trading, Administration, Dispensation,
Delivery, Distribution and Transportation of Dangerous
Drugs and or Controlled Precursors and essential
Chemicals.
3. Maintenance of a Den, Dive or Resort
4. Employees and Visitors of a Den, Dive or Resort
5. Manufacture of Dangerous Drugs and or Controlled
Precursors and Essential Chemicals
6. Illegal Chemical Diversion of Controlled Precursor
and Essential Chemicals
7.Manufacture or Delivery of Equipment , Instrument,
Apparatus and Other paraphernalia for Dangerous
Drugs and or Controlled Precursors and Essential
Chemicals
8. Possession of Dangerous Drugs
9. Possession of Equipment, Instrument , Apparatus
and Other Paraphernalia for Dangerous drugs.
10. Possession of Dangerous D During Parties, Social
Gatherings or Meetings
11. Possession of Equipment, Instrument, Apparatus
and Other Paraphernalia for Dangerous Drugs During
Parties, Social Gatherings or Meetings
12. Use of Dangerous drugs
13. Cultivation or Culture of Plants Classified as
Dangerous Drugs or are Sources thereof
14. Failure to Maintain and Keep the Original Records
of transactions on Dangerous drugs and or Controlled
Precursors and Essential chemicals
15. Unnecessary Prescription of Dangerous Drugs
16. Unlawful Prescription of Dangerous drugs
THE CUSTODY AND DISPOSITION OF
CONFISCATED, SEIZED AND OR SURRENDERED
DANGEROUS DRUGS, PLANT SOURCES OF
DANGEROUS DRUGS, CONTROLLES
PRECURSORS AND ESSENTIAL CHEMICALS,
INSTRUMENTS AND PARAPHERNALIA AND OR
LABORATORY EQUIPMENT – The PDEA shall take
charge and have custody of all dangerous drugs, plant
sources of dangerous drugs, controlled precursors
and essential chemicals, as well as Instruments
paraphernalia and laboratory equipment so
confiscated, seized and or surrendered, for proper
disposition in the following manner ( Refer to Book ).
IMPORTANT PROVISIONS OF R.A. 9165 OR THE
COMPREHENSIVE DANGEROUS DRUGS ACT OF
2002
Section 22. Grant of Compensation, Reward and
Award
Section 23. Plea Bargaining Provision
Section 36. Applicants for Driver’s License
Section 38. Laboratory Examination or test on
Apprehended / Arrested Offenders
Section 39. Accreditation of Drug Testing Centers and
Physicians
Section 40. A physician, dentist, veterinarian or
practitioner authorized to prescribe any dangerous
drug shall issue the prescription therefore in one
original and 2 duplicate copies.
Section 54. Voluntary Submission of a Drug
Dependent to Confinement, Treatment and
Rehabilitation
Section 55 Exemption from Criminal Liability
Under the Voluntary Submission Program
8
Section 56. Temporary Release from the Center; After
Care and Follow up Treatment Under the Voluntary
Submission Program
Section 58. Filing of Charges Against a Drug
Dependent who is not rehabilitated Under the
Voluntary Submission Program.
Section 61. Compulsory Confinement of a drug
dependent who refuses to apply under the Voluntary
Submission Program
Section 62. Compulsory Submission of a Drug
Dependent Charged with an Offense, to Treatment
and Rehabilitation
Section 70. Probation or Community Service for a
First Time Minor Offender In Lieu of Imprisonment
Section 73. Liability of a Parent, Spouse or Guardian
Who refuses to Cooperate with the Board or any
Concerned Agency
Section 77. The Dangerous Drugs Board
Section 82. Creation of the Philippine Drug
Enforcement Agency ( PDEA )
Section 85. The PDEA Academy
Section 90. Jurisdiction
Section 91. Responsibility and Liability of Law
Enforcement Agencies and Other Government
Officials and Employees in Testifying as Prosecution
Witnesses in Dangerous Drug Cases
Section 92. Delay and Bungling in the Prosecution of
Drug Cases
PHARMACOLOGIC CLASIFICATION OF
DANGEROUS DRUGS
1.Hypnotics
2. Sedatives and Tranquilizers
3. Hallucinogens and Psychomimetics
4. Stimulants
5. Depressants
6. Deliriants and Intoxicants
A.Hypnotics:
Opiates and Their Derivatives – Opium is obtained
from the milky exudates of the unripe seed capsules
of the poppy plant, Papaver Sornoiferum.
Derivatives of opium commonly used are morphine,
heroin, and codeine.
Its synthetic preparation are Demerol and Methadone.
Narcotics that have a legitimate medical used as
powerful pain relievers are called Opioids, and include
codeine, oxycodone, meperidine, morphine and
hydromorphone.
Heroin which is prohibited is a very strong pain
reliever and narcotic
Signs and Symptoms of Opium Administration:
1. Stage of Excitement
2. Stage of Stupor
3. Stage of Narcosis
B. SEDATIVES:
Barbiturates: - are the products of malonic acid and
urea, synthesized on St. Barbara day.
- Used to treat anxiety and to induce sleep can
cause both psychologic and physical
dependence.
C. HALLUCINOGENS OR PSYCHOMIMETIC
DRUGS:
 Marijuana – ( Cannabis Sativa ) is a Mexican term for 4. Resolution
pleasurable feeling. Marijuana is not addictive.
Physical dependence and dose tolerance do not SEXUAL DYSFUNCTIONS ( Classification )
develop with its use. Psychic dependence may occur. A. As to choice of sexual partners
1. Homosexual
Subjective effects of Marijuana: 2. Infanto sexual
- There is a feeling of lightness of the extremities 3. Besto sexual
followed by rushes of warmth and well being that 4. Auto sexual
eventually lead to a sense of relaxation, mild 5. Gerontophilia
euphoria and a dreamy state where ideas are 6. Necrophilia
disconnected. 7. Incest
Objective Effects of Marijuana:
- Moderate increase in resting pulse rate, B. As to instinctual strength of the sexual urge:
reddening of the eyes due to dilatation of the 1. Over sex
conjunctival blood vessels. Difficulty of speech 2. Under sex or sexual frigidity
and of remembering of the logical trend of what a. Sexual anesthesia
was being said. b. Dyspareunia
c. Vaginismus
Lysergic Acid Dsethylamide ( LSD ) d. Old age
- These drugs are false hallucinogens. C. As to the mode of sexual expression
- It produces impaired judgement so that a user 1. Oralism
might think that he can fly, and may even jump a. Fellatio
out a window to prove it, resulting in severe injury b. Cunnilingus
or death. c. Analism

D.STIMULANTS: 2. Sado – masochism

Amphetamines – methamphetamines ( Shabu, a. Sadism
speed ); methylenedioxymethamphetamine ( MDMA, b. Masochism
ecstasy or Adam ) 3. Fetishism
- Acts on the cerebral cortex causing alertness, a. Anatomic
excessive self confidence and feeling of well b. Clothing
being. Physical performance may to some .
degree temporarily improve. c. Necrophilic
d. Odor ( ospresiophilia )
Untoward Effects:
- They increase the blood pressure and heart rate. Kinds of Ospresiophilia
Fatal heart attacks have occurred even in 1. Urolagnia
healthy, young athletes. The blood pressure 2. Coprolagnia
maybe so high that a blood vessel in the brain 3. Mysophilia
ruptures causing a stroke. a. Narcissism
b. Saboteur Fetish
Coccaine – is an alkaloid from the leaves of the coca c. Vampirism
shrub cultivated in Bolivia and Peru.
- It produces effects similar to amphetamines, but D. As to the part of the body
is a much more powerful stimulant. 1. Sodomy
2. Uranism
- Is used to excite the undersexed.
3. Frottage
- Is a euphoriant and readily relieves fatigue
4. Partialism
E. As to visual stimulus
Untoward Effects:
1. Voyeurism
- Same as amphetamine 2. Scoptophilia
F. As to number
E. DEPRESSANTS: 1. Troilism
- Angel dust 2. Pluralism
- Depresses the brain and abusers usually G. Other sexual deviates.
become confused and disoriented shortly after 1. Don Juanism
taking the drug. 2. Indecent exposure
- Can be combative and because they don’t feel 3. Coprolalia
the pain they may continue fighting even when hit H. Disorders of sexual function:
hard. 1. Premature ejaculation
2. Retarded ejaculation
CHAPTER 6 SEXUAL DYSFUNCTIONS AND SEXUAL 3. Low sexual desire disorder
CRIMES 4. Sexual aversion disorder
5. Sexual arousal disorder in women
SEXUALITY – IS A NORMAL BIOLOGICAL URGE AND AN 6. Inhibited orgasm
IMPORTANT PART OF THE HUMAN EXPERIENCE. 7. Dyspareunia
8. Vaginismus
4 Stages of a Sexual Response: I. Sexual reversal
1. Desire 1. Transvertism
2. Arousal 2. Transexualism
3. Orgasm 3. Intersexuality

9
 I. Bigamy
SEXUAL CRIMES: J. Marriage Contracted Against the Provisions of
Chaste – An unmarried woman who has had no carnal Law
knowledge with men or that she never voluntarily had unlawful K. Premature Marriage
sexual intercourse. These also denotes purity of mind and L. Performance of Illegal Marriage Ceremony
innocence of heart. M. Prostitution
N. Corruption of Minors
Virgin – A woman who has had no carnal knowledge of man. O. White Slave Trade
Her genital organs have not been altered by carnal connection. P. Abuse Against Chastity

Kinds of virginity PROVISIONS OF THE REVISED PENAL CODE

1. Moral virginity – the state of not knowing the nature of sexual APPLICABLE TO UNNATURAL SEXUAL OFFENSES
life and not having experience sexual relation.
2. Physical virginity – A condition whereby a woman is 1. Grave Scandal ( Art. 200 )
conscious of the nature of sexual life but has not experienced 2. Immoral Doctrines, Obscene Publications and Exhibitions
sexual intercourse. ( Art. 201 )
3. Demi – virginity – This term refers to a condition of a woman 3. Vagrants and Prostitutes ( Art. 202 )
who permits any form of sexual liberties as long as they abstain 4. Grave Threats ( Art. 282 )
from rupturing the hymen by sexual act. The woman allows 5. Light Threats ( Art. 283 )
sexual intercourse, but only inter femora or even inter labia, but 6. Other Light Threats ( Art. 285 )
not to the extent of rupturing the hymen. 7. Grave Coercions
4. Virgo intacta – A truly virgin woman. There is no structural 8. Unjust Vexation or Any Other Coercion ( Art. 287 )
change in her organ, notwithstanding the fact of a previous
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
not due to coitus are not considered defloration.
SEMEN AND SPERMATOZOA:
ERECTILE DYSFUNCTION ( Impotence )
- The diagnosis of Erectile Dysfunction is important
especially in complaints of rape. It must be
proven convincingly that the accused is
permanently impotent, so that the crime of rape
cannot be proved beyond reasonable doubt.
- Impotence usually results from vascular
impairment, neurologic disorders, drugs,
abnormalities of the penis or psychological
problems that interfere with sexual arousal.
- These includes injury, diabetes mellitus, stroke
and drugs like all antihypertensive and
psychotics, antidepressants and some sedatives.
- Alcohol can also cause impotence and also low
levels of testosterone
SEX CRIMES IN THE REVISED PENAL CODE:
A. Rape
B. Carnal Knowledge
- is the act of a man in having sexual bodily
connection with a woman. There is carnal
knowledge if there is the slightest penetration in
the sexual organ of the female by the sexual
organ of the male.
C. Seduction
- is the art of a man enticing women to have
unlawful intercourse with him by means of
persuasion, solicitation, promises, bribes or other
means without employment of force
D. Acts of Lasciviosness
E. Acts of Lasciviousness with Consent of the
Offended Party
F. Abduction
1. Forcible Abduction
2. Consensual Abduction
G. Adultery
H. Concubinage
Mental Health Disorders – include disturbances in thinking,
emotion, and behavior. There is a complex interaction between
the physical, psychologic, social, cultural and hereditary
influences.
Factors that Contribute to the Development of Mental Disorders:
1. Heredity – the most frequent factor that contributes to insanity
and a good history will reveal the ascendants afflicted with the
same.
2. Incestous Marriage – The mental illness is accentuated when
they are blood relatives.
3. Impaired Vitality – Stress, tension, worry, grief may
predispose to insanity
4. Poor Moral Training and Breeding – Corrupt moral upbringing
in the family due to immorality of the parents
5. Psychic Factors – Factors like love, hate, rage, anger,
passion disappointments
6. Physical Factors
a. Non toxic factors – exhaustion resulting from
severe physical and mental strain and traumatic injuries to the
head.
b. Toxic factors – drug addiction, infections of the brain
KINDS OF MENTAL HEALTH DISORDERS:
1. Psychosomatic disorders – physical disorders caused by
psychologic factors.
2. Somatiform disorders – encompasses several psychiatric
disorders in which people report physical symptoms but deny
having psychiatric problems.
3. Generalized Anxiety Disorders
4. Panic Attacks and Panic Disorder
5. Phobic Disorders
a. Agoraphobia
b. Specific phobias
c. Social phobia
6. Obsessive Compulsive Disorder
7. Post Traumatic Stress Disorder
8. Depression and Mania
9. Bipolar Disorder
10. Suicidal Behavior
11. Eating Disorders
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge eating disorder

10
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 Article 13, of the Revised Penal Code
b. Delusion of persecution provides, the following are mitigationg circumstances:
c. Delusion of reference a. That the offender is deaf and dumb, blind
d. Delusion of Self – Accusation or otherwise suffering from physical defect which thus
e. Delusion of infidelity restricts his means of action, defense or
f. Nihilistic delusion communication with his fellow beings
g. Delusion of poverty
h. Delusion of control The American Law Institute formulated the following
i. Delusion of depression Rules on Criminal Responsibility and states that;
B. Obsession 1. A person is not responsible for his criminal conduct
4. Disorders in the trend of thought if at the time of such conduct as a result of mental
Types: illness or defect, he lacks essential capacity to
a. Mania appreciate the criminality of his conduct or to conform
b. Melancholia his conduct to the requirement of the law.

5. Disorders of Emotions or Feelings – a disorder in the state of 2. The term “ mental disease or defect “ does not
mind, fervor, or sensibility, not in accord with reality. include an abnormality manifested only by repeated
6. Disorders of volition or conation ( doing ) criminal or otherwise anti social conduct
Kinds of Conation:
A. Impulsion or Impulse ( Compulsion ) – a sudden Fundamental Principles of Insanity and Criminal
and irresistible force compelling a person to the Responsibility:
conscious performance of some action without motive 1. A sane man is assumed to be wholly responsible for
or forethought. the consequence of his crime.
2. A person who commits a criminal act is presumed
Types of Compulsion: to be sane.
a. Pyromania 3. Crime is always considered as an affair of the mind
b. Kleptomania as well as the body and to make an act or omission a
c. Dipsomania crime, there must be a criminal act ( actus reus ) and
d. Homicidal impulse an criminal mind ( mens rea ) . Actur facit reum, nisi
e. Sex impulse mens sit rea.
f. Suicidal impulse
Mental Deficiency – or mental retardation, is sub
DISTINCTIONS BETWEEN TRUE AND FALSE average intellectual ability present from birth or early
INSANITY: infancy. Intelligence is both determined by heredity

11
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