Sexual Assaults

Written by Dr. D. Rao

A man is said to commit rape, who has sexual intercourse with a woman against her will, without her consent with her consent, when her consent has been obtained by putting her in fear of death, or of hurt, with her consent when the man knows that he is not her husband and that her consent is given because she believes that he is another man to whom she is or believes that he is another man to whom she is or believes herself to be lawfully married (as unsoundness of mind or intoxication), with or without her consent, when she is under 16 years of age.Subject to changes regarding age in different countries.

Under the law rape can only be committed by a man. The slightest penetration of the penis with in the vulva, with or without emission of semen or rupture of hymen constitutes rape. It is not necessary that there should be complete penetration of the penis. Rape can be committed even when there is inability to produce a penile erection.


Examination of the victim:


Objects:

  1. To search for physical signs that will corroborate the history given by the victim.
  2. To search for, collect and preserve all trace evidence for laboratory examination.
  3. To treat the victim for any injuries and any venereal disease or pregnancy.

Preliminary steps:

  1. The victim should be examined only when asked by the Police Officer or the Magistrate.
  2. Obtain written consent for:
    1. Examination,
    2. Collection of specimens,
    3. Photographs
    4. Release of information to proper authorities.

If she is under 12 years, or an sane person obtain written consent from her parents or guardians.

  1. The victim should be identified by the escorting police constable, whose name and number should be recorded. Note tow identification marks. The name of the victim and her parent, address, occupation, marital status, time, date, year, place of examination and by whom examination is requested should be noted.
  2. The examination should be carried out without delay, as minor degrees of injuries may fade rapidly, and detection of sperms from the genital tract also diminishes with delay.
  3. Obtain and write history in the patient’s words:
    1. Preliminary affairs,
    2. Time and place of alleged offence,
    3. Exact relative positions of the parties,
    4. Details of struggle or resistance,
    5. Pain
    6. Hemorrhage,
    7. Sensation as to penetration and emission.
    8. The appearance of any discharge,
    9. Details of the events after the alleged assault
    10. Calls for help,
    11. Whether the bath was taken after the assault.

The degree of agreement of various statements will be strong proof of their truth or the contrary.

  1. Obtain previous history with regard to sexual experience, menses, vaginal discharge, venereal diseases,  pregnancies, pelvic operations, etc.
  2. Photograph the victim with clothing as it was at the time of recovery to know the position and condition of the clothes.
  3. Ask the victim to undress herself on a plastic or paper sheet or a piece of cloth. All foreign objects should be retained.
  4. Photograph the injuries.
  5. Determine the age
  6. Examine the victim in the presence of a third person, preferably a female nurse or a female relative of the victim.
  7. Note the physical development in order to determine her capacity for struggle and resistance.
  8. Note the victim’s emotional state, eg., distressed, calm, tearful, aggressive, hysterical, alcoholic, stoic, etc.
  9. Observe her gait; whether she complains of pain on walking or micturation or defecation.
  10. If the victim is in menstrual period, a second examination should be done after the termination of the period.

Examination of clothes: Ascertain whether the clothes are those worn at the time of attack. They are examined for:

  1. Blood stains,
  2. Seminal stains,
  3. Mud and other stains,
  4. Tears and loss of buttons, etc.

Vuval pads and vaginal tampons should be preserved. Whether worn at or after the time of incident. The clothing should be retained if possible and labeled and handed over to police. Foreign hair, fibers, etc., must be preserved.

General examination: The whole body must be examined for marks of violence especially scratches, or bruises resulting from struggle as regards their appearance, extent, situation and probable duration. They are usually found

  1. around the mouth and throat inflicted while preventing her from calling for help,
  2. about wrists and arms where the man seized her,
  3. about inner sides of thighs and kness caused by forcing her legs apart,
  4. on the back from pressure on hard ground, and
  5. on breast’s by rough handling

Rape on a Virgin: The hymen shows tears. Soon after the act, the magins of the torn hymen are sharp and red which bleed on touch. After 2 or 3 days the edges of laceration are congested and swollen, which heal in a week, but they do not unite. Tearing usually occurs posteriorly at the sides, or on midline of the hymen. The semilunar hymen usually ruptures on both sides. The posterior commissure may be ruptured and fossa navicularis may disappear. Bruising and laceration of external genitals may be present with redness, swelling and inflammation. With violent intercourse laceration of the vaginal wall may occur posteriorly. If there are no fresh injuries, vaginal examination should be carried out if the state of hymen permits. In most young women a finger may be passed into the vagina, although the hymen is intact. If the vaginal opening is enough to admit two fingers easily, the possibility f sexual intercourse having taken place may be inferred.

Signs of Virginity:

  1. An intact hymen,
  2. A normal condition of the fourchette and posterior commissure.
  3. A narrow vagina with rugose walls.

Rape on Defloration Women: In a married woman marks of violence to the genitalia are less likely to be found. In cases of resistance, the vagina may show some deep injury, laceration or bruising with effusion of blood and swelling and inflammation of the vulva. Such injuries usually disappear or become obscure in 3 or 4 days. The only proof of penetration is presence of sperms in the vagina. The presence of signs of violence in other parts of the body is the chief evidence of the crime.


Rape on Children: Usually the penis is placed either within the vulva or between the thighs. As such, the hymen is usually intact and there may be little redness and tenderness of the vulva. In forceful penetration there may be:

  1. Reddening or frank inflammation with abrasion, bruising or laceration of external genitals or vagina.
  2. Muco-purulent discharge of yellowish or greenish yellow color from the vagina staining the clothing.
  3. The hymen may show several lacerations.
  4. In recent cases, blood may be oozing from the injured parts or clots of blood ma be found in the vulva.
  5. Tearing of the perineum into the anus.

Laboratory Specimens:

  1. Comb the pubic hair.
  2. Obtain samples of pubic and scalp hair with roots by plucking.
  3. Clip off the free ends of the finger nails or scrape the undersurface of the free ends with a blunt object.
  4. Obtain vaginal swabs and aspirants. Make smears on labeled microscopic slides.
    1. Examine an unstained slide for motile sperms.
    2. Fix the smear and stain with H & E and Grams.
    3. Examine for acid phosphate activity.
    4. Blood group antigen.
    5. Precipitin test against human sperms and blood.
    6. Take anal, oral or other swab as indicated.
    7. Suspicious stains from the vulva, thighs or other areas should be collected by swabbing to examine for the presence of sperms and acid phosphate. If stains are dry scrape them by a scalpel.
    8. Take blood for grouping and toxicological analyses.
    9. Blood stains on clothing should be grouped to know whether they are from the victim or assailant.
    10. Take smears from the cervix and urethra for gonococci.
  5. Obtain a blood sample for serological examination.

Identity of the Assailant: Blood, semen, urine, saliva, hair and general debris present on the clothing or person of the victim may help the identity of the accused by comparing with the known materials from the accused. The presence of V.D. is also helpful.


Positive signs of Rape:

  1. Marks of violence on the person of the victim and the accused.
  2. Marks of violence about the genitals.
  3. The presence of stains, semen or of blood on the clothes and the body of the victim or accused.
  4. The presence of seminal matter in the vagina.
  5. The existence of gonorrhoea or syphilis in both the parties.

Opinion: Rape can occur without causing any injury and hence negative evidence is not exclusive. Negative findings are as important as positive ones and may assist in the protection of analleged assailant who has been falsely accused. The doctor should mention only the negative facts but should not give his opinion that rape has not been committed. In such cases corroboration of eye witnesses or circumstantial evidence is necessary.

Rape is not medical diagnosis; it is only a legal definition: No conclusions, opinions or diagnoses should be written in the report. The doctor may give opinion that there are signs of recent vaginal penetration, recent sexual intercourse, general physical injury, and/or intoxication, and that the signs are consistent with the history given.


Special Procedures:

  1. Look for and protect trace evidence which may be vital.
  2. Take specimens to ascertain if rape occurred.
  3. Preserve ligature material; do not unite.
  4. Cut neck vessels longitudinally to show intimal laceration.
  5. Obtain fingernail scrapings.