Forensic Medicine: Clinical and Pathological AspectsEditors: Payne-JamesJason, SmockWilliam, BusuttilAnthony 832 pp Price £135 ISBN 1-84110-026 (h/b) London: Greenwich Medical Media, 2002
Authors: P D Lumb
Journal: Journal of the Royal Society of Medicine (2003)

There is much overlap between the activities of forensic physicians and pathologists, and legal-medical work can demand the interaction of a plethora of different specialists. With this in mind, the editors have brought together 76 acknowledged specialists to create a heavyweight forensic publication. Its main aim is to be a source of information for all practitioners.

The book is divided into four main sections—General Issues, Causes and Investigation of Death and Injury, Practical Investigations, and Management and Related Specialties. The pages are easy on the eye, with clear images and diagrams interspersed gently within the text. Each chapter ends with a plentiful list of references. The first section begins with general concepts and nomenclature, with a smattering of historical perspectives, taking a brief tour of the development of legal systems. The coronial system and medical examiner systems are also discussed in some depth. A separate chapter is dedicated to Shari'ah law, the reason being that one-fifth of the world's population is Muslim. This was an enlightening chapter for myself a non-Muslim. An expansion upon how Shari'ah law nestles within a multicultural society would have made the chapter still more informative, although perhaps going beyond the design of the book. Scene investigation is also discussed in a short chapter, with more specific scene management dealt with in other chapters.

The second section comprises a traditional classification of the circumstances in which one becomes deceased. The to-be-expected (and essential) chapters include gunshot trauma, falls from height, drowning and diving deaths. Although some of the forensic techniques are not used in day-to-day work, the short chapter on the pathophysiology of wound healing touches upon the modern developments in dating wounds. This is a step in the right direction, for forensic textbooks traditionally have not been forward-looking. Pearls of wisdom exude from the chapter by Stephen Cordner (Victorian Institute) on ways to distinguish suicide, accident, murder and natural death from each other. My only criticism is that it is not long enough; indeed, the content deserves a stand-alone book. Any forensic practitioner can deal with the straightforward case, but the difficult case requires not just fact but also skilled interpretation and experience. One omission I did note in the section concerning head injury was discussion of the utility of beta amyloid precursor protein and cluster designation number 68 in head injury. This will need to be addressed in future editions of the textbook. I also note a faux pas in this chapter—a stab injury causing a laceration. Well in a big book like this, c'est la vie.

Section three starts with a fascinating un-put-downable chapter, as R J Levin dips into the physiology of male and female sexuality. This is most relevant to the police surgeon, especially in explaining to a victim of rape why his or her body responded in the way it did. This chapter gives answers to vital questions such as to why a male victim of rape (by another male) may get an erection. Also noteworthy is the presence of a chapter dedicated to elder abuse. This difficult subject is dealt with well. A transportation-medicine chapter focuses upon the road traffic accident, and is impressively illustrated. Only a short section deals with air traffic accidents, although one could consider this as part of the mass disaster chapter. Fitness to be interviewed is examined in depth, with an expansive discussion concerning the problem of false confession.

The final section deals with the related specialties, including anthropology, haematogenetics, odontology, psychology, psychiatry, imaging, entomology and statistics. These chapters are precis of much larger subjects. They do, however, introduce one to unfamiliar techniques such as cheiloscopy and rugoscopy. The imaging chapter is particularly useful, detailing techniques and guiding the reader.

This is a thorough book, touching upon and delving deeply into most of the subjects encountered by those who engage in medicolegal work. It is a perfect reference for those practitioners who deal with both the living and the dead. I also recommend it to those sitting exams, particularly those set by the Society of Apothecaries, London.