History of Forensic Medicine in Sri Lanka | Sunday Observer
Dr. C. G. Uragoda Lecture:

History of Forensic Medicine in Sri Lanka

7 March, 2021
A forensic investigation
A forensic investigation

The Dr. C. G. Uragoda Lecture 2021 on the “History of Forensic Medicine in Sri Lanka” to honour the lasting contribution made by Dr. C. G. Uragoda to document the History of Medicine in the country, was delivered by Professor Ravindra Fernando.

Forensic Medicine is the branch of medical sciences where medical knowledge and expertise is applied to the processes of law to assist in the administration of justice.

The word ‘Forensic’ originates from the Latin word ‘forensis’ or ‘forum’. Forum is a place of assembly for judicial and other business or a place of public discussion. In ancient Rome, this was the market place.

Forensic Medicine deals with all branches of medicine. Knowledge of all medical subjects is essential to practise Forensic Medicine.

Sub-specialties of Forensic Medicine include Forensic Pathology, Forensic Toxicology, Forensic Histopathology, Clinical Forensic Medicine, Forensic Psychiatry, Forensic Toxicology, Forensic Serology, Forensic Odontology, Forensic Anthropology, Forensic Genetics, Forensic Entomology and Forensic Chemistry.

In Sri Lanka, we have seen interesting developments in relation to death investigation system even before the onset of the colonial period.

Death investigation is an age old concept which has its roots extending into all primary civilisations. Sri Lanka is no difference

According to reliable narrations and descriptions of the ancient history of Ceylon relating to the period of the monarchy, throughout the several kingdoms of ancient Ceylon, there had been a well-defined and structured system of administration of justice, with the King at the helm of affairs as the source of all laws and as the sole judge of the apex court. During the Kandyan Kingdom (1469-1815), in addition to courts and officials, there had also been several tribunals.

Among these tribunals, had been a panel referred to as the Saakki Balanta or ‘looking for evidence’, which had comprised principal public functionaries of the district, such as the Lekam, Korala and the Vidane. It had been empowered to inquire into the cause of death when the body of a dead person was discovered. An analysis of the categories of deaths in respect of which the Saakki Balanta was required to inquire into reveals that their role was confined to inquire into ‘sudden unnatural death’. Saakki Balanta was a ‘court of inquiry’, and that it was somewhat similar to English Coroner’s Courts.

John Davy provides a detailed and interesting account relating to the tribunal called Saakki Balanta.

“When a dead body was found,no one should touchit, till it had been examined by the Sake-ballanta, not even if the body was hanging, though by cutting it down, suspended animation might possibly be restored. It was the business of these officers to endeavour to ascertain the ‘cause of death’, and all the circumstances connected with it. In a case of suicide occurring in a village, had the suicide been of sound mind, or subject to temporary fits only of insanity, the sakki-ballanta inflicted a fine on the inhabitant of fifty rides (about 29 hillings),which were to be divided between these officers and the Disave. The body could not be burnt or buried till the fine was paid, a heavier fine was imposed on those who allowed a corpse to decay unburied orun-burnt. If the suicide were a confirmed idiot or lunatic, no fine was inflicted.”

These historical accounts show the degree of sophistication our ancient indigenous judicial system possessed. It is also evident that, somewhat parallel to the birth of the English Coroner System, in Sri Lanka too, there was a system to collect evidence with a view to determining the cause of death of any person who had come by his death suddenly. This also shows the importance placed even in ancient times, to the need to independently determine the cause of death of a person who had died suddenly.

English Coroner System

The ‘Coroner’ is known to be a uniquely English institution and is one of the oldest public services. The history of the coroners, originally known as the “Crowners”, dates back to ninth and 10th Century England. They have been formalised in to law in the 12th century under King Richard the first, who was known to dispatch coroners to death scenes to protect the crown’s interest and collect the duties. Thus, the Coroners or ‘crowners’ were ‘guardians of the crown’s pleas.’ The office was created to provide a local official whose primary duty was to protect the financial interest of the crown in criminal proceedings. On behalf of the crown, the crowner was responsible for inquests to confirm the identity of the deceased, determine the cause and manner of death, confiscate property, collect death duties and also investigate treasure troves.

The coroners as we know them today had been formally established by Article 20 of the “Articles of Eyre” in September 1194, which is said to be the only statutory basis for the coroner. Article 20 of the “Articles of Eyre” states, “In every county of the king’s realm shall be elected three knights and one clerk, to keep the pleas of the crown.”

The title coroner, is thus, derived from the original Latin term “custos placitorum coronas” meaning the keeping of the pleas of the crown. However, the complexity and importance of the modern coroner is said to bear little relationship to his historical predecessor though always connected in some way with sudden or unnatural death. Today’s coroner is expected to perform a wide range of duties involving investigatory, administrative, judicial, preventative and educational functions. England exported her coroner system all over the world, Sri Lanka being one such country. The English coroner system has found its way in to its legal system formally through several statutory enactments.

English Coroner System in Sri Lanka

In 1796, when the Maritime Provinces under the Dutch were ceded to the British, the coroner system of England was introduced to the country. The first statutory enactment of the British relating to the investigation of death in Ceylon was regulation No. 1 of the British Government in 1819 which sets out the duties of the Magistrates and others in cases of homicide and sudden violent deaths. This required the Magistrate and if possible, a medical officer to inspect the bodies personally.

The Code of Criminal Procedure enacted in 1883 described the procedure to be observed when investigating cases of suicides, sudden deaths, accidental deaths, violent deaths, suspicious deaths and deaths in an asylum or prison. The Administration of Justice Law of 1973 repealed the 1883 Code and thereafter, a new Code of Criminal Procedure was introduced in 1979 which is in force up to now. The legal provisions with regard to the death investigation have not undergone any significant changes with the introduction of any of these statutes.

At the commencement of the British period, the doctors were military officers who were normally exempted from medico-legal work. Armitage, an unofficial member of the Legislative Council, declared in1844:

‘Except in Colombo and Kandy, there is scarcely a duly qualified private practitioner so that over the remainder of the island, where they might be advantageously made use of for the ends of justice (for instance, around Galle, Jaffna, Trincomalee, Badulla, Nuwara Eliya, etc.)., no competent medical evidence will be available to the coroners in consequence of the exemption of the military. If it were not for the evidence of the military men at outstations, many cases of murder could never have gone to trial’. Probably the first scientific paper on a medico-legal topic was published in the 1860s. It was written by Dr.

W.C. Ondaatje, Assistant Colonial Surgeon and concerned the death of a man who died in Chilaw. The stomach and intestines with their contents were sent to Ondaatje for examination in March 1864. The salient fact of the case was that the deceased had been given an emetic containing wara (Calotropis gigantea) by an ayurvedic physician. Immediately afterwards, he developed incessant vomiting and died. As wara was not considered a poison up to that time, Ondaatje carried out an experiment with it on a dog, who died two hours later. The ayurvedic physician was tried for manslaughter and sentenced to two years imprisonment on the strength of Ondaatje’s evidence, which was based on experimental findings. In presenting this case report to the Royal Asiatic Society (Ceylon Branch), he commented that it was ‘the only literary and scientific body in Ceylon, through which the fact can be communicated.”

This remark underlined the acute need for a medical association, a void which was later filled by the Sri Lanka Medical Association. About the same time, Dr. Green of Manipay was involved as an expert witness in another type of case. Some Englishmen, offended by the odour of rotting coconut husks opposite their houses, had filed action in the District Court against some local inhabitants. The Englishmen argued that this industry was a nuisance. Green, whose sympathies were with the thousands of local people who earned a living by working in the coir industry, gave evidence for the defence.

In 1817, on the recommendation of Charles Farell, Deputy Inspector General of Hospitals, British Governor Robert Brownrigg authorised the establishment of a hospital for the poor. Thus Colombo’s first modern hospital was established in 1819 at Prince Street in Pettah. The birth of the General Hospital, Colombo, at its current location took place in 1864 as the ‘successor’ to the first civilian hospital under the charge of a single doctor in British Ceylon in 1861.

The Colombo Medical School was opened in 1870, adjacent to the main hospital by the then Governor Sir Hercule Robinson. In 1873, with the introduction of the new prospectus for undergraduate training, Dr. Vanderstraaten took over the lecturing on Materia Medica and Medical Jurisprudence. The proper death investigation system in Sri Lanka was established in 1883 and was a modified model of the British coroner system.

With the establishment and expansion of the state-owned hospital network in Sri Lanka, the doctor-in-charge [District Medical officer (DMO)] of the medical establishment became a virtual expert on medico-legal matters as well. During the early nineties, due to lack of infrastructural and transport facilities, at times, DMO supposed to travel considerable distances after clinical work and conduct postmortem examinations at the scene. Dr. S. Sinnathurai MD, Judicial Medical Officer, Colombo, from 1935 to 1945, was the first qualified medico-legal expert of the country.

The establishment of the Medico-Legal Society of Ceylon in December 1937, an umbrella for all the stakeholders involved in criminal justice, is a landmark event of the development of Sri Lankan forensics. The establishment of the College of Forensic Pathologists of Sri Lanka in 2000 was another landmark event of the Forensic Medicine in Sri Lanka.

There are reliable historical accounts that flickers of legal medicine existed even in olden human societies dated 1500 BC. The examination of corpses has been instituted by ancient scientists and physicians mainly for the morbid anatomical and clinic-pathological purposes and then have been adapted for legal requirements. In ancient Sri Lanka, since 500 BC, many years prior to the invasion of western colonial rulers, there were common laws to maintain good governance and social order. However, legal matters appeared to be settled by persons with judicial power applying evidence based common sense, and native physicians were never called upon as experts until the establishment of Roman-Dutch legal framework.

Before the appointment of judicial medical officers to large towns, medico-legal work was shared by the doctors. This system still prevails in rural areas, where district medical officers are called upon to do forensic work. Dr. J. Carberry, demonstrator in anatomy at the Ceylon Medical College, was, for example, sent out of Colombo to perform autopsies at coroner’s inquests.

It is difficult to trace when the first medico-legal autopsy was done in Sri Lanka. However, we could track its initial days up to the late 1880s. This is possible due to another great medical personality of Sri Lanka who lived in the early 19th century. He was Dr. Richard Lionel Spittel.

It was documented that in the late 1880s, a young boy with a burning ambition to become a doctor stood in a jungle clearing, watching his surgeon-father perform an autopsy. This is the first recorded instance of a post-mortem examination in our country during the colonial period.

Sir Marcus Fernando was a pioneer physician who contributed so much to understanding Tropical Diseases. He was the first student from Ceylon to study Medicine at University College, London, arriving in England in 1883. Having acquired his B.Sc., he qualified in 1888 with the M.B, obtaining the university Gold medal in Medicine and in Forensic Medicine. He also became a licentiate of the Worshipful Society of apothecaries.

According to the current records, he is the first Sri Lankan born doctor to receive an overseas qualification in Forensic Medicine in the United Kingdom.

Dr. Marcus Fernando was SLMA’s 12thPresident in the 1905. He was re-elected as the 21stPresident in 1915.

The present medico-legal system in Sri Lanka was established during the British colonial period in the late 19nth century. The Sri Lankan medico-legal system to a great extent was influenced by the nature and the investigation structure that existed in Britain at that time. The English Coroner System of investigating death was established in Ceylon in the same period. In Sri Lanka, the medico-legal services are mainly provided by the medical officers employed by the Ministry of Health and the medical academic staff of Departments of Forensic Medicine in state university medical faculties. Sri Lanka is among the few countries where both Forensic Pathology and Clinical Forensic Medicine services are provided by the specialist forensic practitioners.

Office of JMO, Colombo

The first appointment of a Judicial Medical Officer (JMO) was made way back in 1880 when Dr. Gratian, who was the Medical Officer to the Prisons, was appointed to perform the Medico-legal duties in addition. However, Forensic Medicine was not recognised as a specialty until 1935. The medico-legal work in the provinces was shared by the district medical officers like other clinical medicine practice. The post of Prison Medical Officer cum Judicial Medical Officer was given to the most senior medical officer. As he was paid an additional fee for the medico-legal work, this post had been financially attractive.

However, no formal training was given to the medical officers who engaged in the medico-legal work. In the late 1930’s, the then head of the Department of Health in Ceylon, Sir Rupert Briarcliff, who was dissatisfied with the status of affairs in the medico-legal services, after consultation with Sir Sydney Smith, who was the Professor of Forensic Medicine of the University of Edinburgh, Scotland, made arrangement for special training in Forensic Medicine for JMOs.

As a result, in 1939, Dr. N. Sinnadurai was sent on a Government scholarship to the University of Edinburgh for training in Forensic Medicine under the guidance of Sir Sydney Smith. Dr. Sinnadurai returned to the country after post graduate training and higher qualifications. He was appointed as the JMO Colombo and part time lecturer in Forensic Medicine in the Medical College, when the Medical College was under the purview of the Department of Health.

Dr. Sinnadurai, the first JMO Colombo was provided with a well-equipped laboratory and other facilities by the Department of Health to carry out his duties. However, this facility was housed in the Medical College. Dr. Sinnadurai who covered the medico-legal work for the entire country was highly appreciated by the bench and the bar for his work. During Dr. Sinnadurai’s tenure, he made an attempt to initiate a judicial medical service in the provinces, which was to be managed by trained medical officers. However, he was not fully successful in this endeavour and the Department of Health continued to appoint medical officers who had no special training, to the provincial JMO posts.

In 1940, the post of JMO Colombo, which was a part time post until then, was made a fulltime post in the Health Service of Sri Lanka.

Dr. G.S.W. de Saram succeeded Dr. Sinnadurai as the JMO Colombo. He was also trained in University of Edinburgh by Sir Sydney Smith. Dr. de Saram did the postmortem of the driver who was killed in the Ceylon Turf Club Robbery of Rs. 400,000 in 1949. Having tied to a tree in the Puttalam jungle, John Silva was murdered by suffocation covering the face using a gas mask. This was the first and perhaps the only case where murder was committed using a gas mask in Sri Lanka. With the appointment of Professor de Saram as the first chair in 1951, the post of the JMO Colombo was filled by Dr. P.S. Goonewardena. He served as the JMO Colombo for three years figured in the famous trials, such as ‘Ratnapura Taxi Club murder’, ‘Wellawatte dispensary double murder’ and the ‘Thenuwara murder case’.

After the sudden death of Dr. Goonewardena, Dr. W.D.L. Fernando succeeded Dr. Goonewardena as the JMO, Colombo in 1956. Dr. Fernando continued in this capacity up to his retirement in 1970. The complex at 111, Francis Road, Colombo 8, became fully functional during this time. The complex was named as the Medico-Legal Morgue and the Office of the JMO, Colombo. Dr. W.D.L. Fernando was involved in some famous criminal cases, such as ‘Adeline Witharane murder case’ where he used dental evidence and facial superimposition to identify a dead person for the first time in Sri Lanka. Convictions of Alfred de Zoysa, murder of Lillian Perera and the ‘Dodampe mudalali’s case’ (a death in Police custody) were a few of the notable cases where his work played an important role.

Dr. W.D.L. Fernando who retired in 1970 was succeeded by Dr. Chandra Amarasekara, who held the office till 1977. He later joined the Department of Forensic Medicine, University of Peradeniya, as a Professor in Forensic Medicine. Dr. S. Subramanium held the office from 1978 to 1982. During his tenure, he performed the post-mortem examinations of Russel Ingram and Eunice Peiris murdered by Rev. Mathew Peiris by giving Glibenclamide (Daonil). This was the first time in the world, glibenclamide, an anti-diabetic drug used to murder two persons.

Dr. M.S.L. Salgado assumed duties as the JMO Colombo in 1982. During his tenure of eight years up to 1990, the medico-legal morgue was metamorphosed into a fine forensic facility with modern infrastructure as well as with human resources. Forensic radiology and forensic photography facilities were introduced during this time. Maradana and Pettah bomb blasts and the attack on Air Lanka Tri-Star at Katunayake were disasters that were handled successfully during his tenure in office. After his retirement, Dr. Salgado joined the Department of Forensic Medicine, North Colombo Medical College as a Professor in Forensic Medicine, where he served for five years.

Dr. Sydney Premathirathne then occupied the post for a short period in 1991 before Dr. L.B.L. de Alwis was appointed in 1992. Dr. de Alwis served 15 years until his retirement in 2007. During his tenure, several terrorist bombings were investigated, including the assassination of President Premadasa by a suicide bomber.

Dr. de Alwis was succeeded by Dr. Ananda Samarasekara in 2008.He held the office for five years until his retirement in 2013. Dr. Ajith Tennakoon was appointed as the JMO Colombo in 2013.

The facility at 111, Francis Road, Colombo, which is commonly known as the JMO office, Colombo, has been renamed as the Institute of Forensic Medicine and Toxicology (IFMT) in 2014 and is the premier centre for providing medico legal services to the country. It also functions as the main teaching and training centre for postgraduate studies in forensic medicine.

The IFMT has developed sub-departments in forensic toxicology, forensic histopathology, forensic odontology and forensic photography. The JMO’s Office Colombo, which was the main medico-legal service provider for the Ministry of Health became an academic hub. Sri Lanka was the venue of the Second Asia-Pacific Congress on Legal Medicine and Science, held in Colombo from August14 to 18,1986. Dr. Salgado was the Chairman of the Congress. The Indo-Pacific Association of Legal Medicine and Science (INPALMS) was inaugurated on August 16, 1986.

Teaching of Forensic Medicine

The lectures in Forensic Medicine were conducted by the Judicial Medical Officer, Colombo, from the inception of the Colombo Medical School in 1870 up to 1951. The Department of Forensic Medicine functioned as a subunit of the office of the JMO, Colombo. Among others, Dr. N. Sinnadurai, Dr. P. S. Goonawardena and Dr. G. S. W. de Saram performed the duties of the Judicial Medical Officer, Colombo, and delivered lectures in Forensic Medicine. The first Faculty of Medicine in the then University of Ceylon was established in 1942.

In 1951, a separate Department of Forensic Medicine was created in the Faculty. This could be considered as the beginning of the present era of formal undergraduate forensic medicine teaching programs in Sri Lanka.

The then JMO Colombo, Dr. G.S.W de Saram, MBBS (London), MRCS (England), LRCP (London), LMS (Ceylon), OBE, was appointed as the first Professor of Forensic Medicine, in the University in 1951. Professor de Saram was well known to the Forensic Medicine community as well as to bar for his research work to determine the “Time since Death” using prisoners who were hanged to death and also for leading the forensic examination in the Sathasivam case.

This case was unique because it was the first time a Professor of Forensic Medicine from abroad was summoned by the defence to give evidence. He was none other than Sir Sydney Smith, Professor of Forensic Medicine from the University of Edinburgh. When he was in the King’s College,Dr. de Saram contributed an article on “Pulmonary Aspergillosis Following Post-influenzal Bronchopneumonia Treated with Antibiotics” with his colleagues to the prestigious British Medical Journal in 1952. Only a few Sri Lankans are fortunate enough to get an article published in the prestigious British Medical Journal.  

An obituary of Professor G.S.W. de Saram, who passed away in 1963, was published in The Journal of Pathology and Bacteriology of the United Kingdom in 1965. It was written by G. R. Cameron, Professor of Morbid Anatomy in the University of London. It was great honour to a Sri Lankan.