BECAUSE MOST VICTIMS OF CHILD ABUSE ARE LESS THAN 2 YEARS OLD AND CANNOT SPEAK FOR THEMSELVES, IT IS THE DUTY OF THE PHYSICIAN TO CAREFULLY ASSESS ANY SUSPICIOUS CASE AND TO TAKE APPROPRIATE ACTION TO PROTECT THE CHILD FROM FURTHER DANGER. PHOTOGRAPHS AND X RAYS ILLUSTRATE BRUISES IN VARIOUS STAGES OF HEALING, EVIDENCE OF MULTIPLE FRACTURES OVER A PERIOD OF TIME, AND THE TYPES OF MARKS OFTEN FOUND ON AN ABUSED CHILD. THE DOCTOR IS WARNED TO BE SUSPICIOUS WHENEVER THE INJURY TO THE CHILD DOES NOT COINCIDE WITH THE STORY TOLD BY THE PARENTS. DETAILED EXAMINATION WITH FULL PHOTOGRAPHY AND RADIOGRAPHY IS CALLED ESSENTIAL FOR ANY AUTOPSY OF A CHILD, ESPECIALLY WHERE ABUSE IS SUSPECTED. TECHNIQUES FOR DISTINGUISHING BETWEEN ACCIDENTAL DEATH AND INFLICTED DEATH ARE GIVEN. FULL HISTOLOGICAL EXAMINATION IS URGED TO EXCLUDE NATURAL DISEASE. COMMON PATHOLOGICAL FINDINGS IN ABUSE CASES DESCRIBED INCLUDE INJURIES TO THE HEAD AND NECK, INTRACRANIAL HEMORRHAGE, SKULL FRACTURES, CHEST INJURIES, INJURIES ON THE LIMBS, ABDOMINAL INJURIES, BITES, AND BURNS. POISONING IS ALSO A COMMON OCCURRENCE IN GREAT BRITAIN. MANY PARENTS GIVE THEIR CHILDREN WHATEVER MEDICATION THEY THEMSELVES ARE TAKING AND HIGH BLOOD ALCOHOL LEVELS ARE OFTEN FOUND. A TABLE SUMMARIZES THE CHARACTERISTICS OF PARENTS AND CHILDREN AS FOUND IN A NUMBER OF STUDIES OF CHILD ABUSE. A SIMILAR TABLE IS PRESENTED FOR ABUSING HUSBANDS. THE BRIEF SECTIONS ON WIFE ABUSE AND ABUSE OF THE ELDERLY POINT OUT THAT NONACCIDENTAL INJURIES TO WIVES PARALLEL THOSE FOUND IN ANY OTHER ASSAULT CASE. IN ELDERLY PERSONS, HOWEVER, MINOR ASSAULTS ARE DIFFICULT TO DETECT BECAUSE AGED SKIN BRUISES QUITE EASILY AND OLD PERSONS ARE SUBJECT OT FALLS AND OTHER TRAUMA. MORE RESEARCH IS NEEDED IN THIS CATEGORY. REFERENCES ARE APPENDED. (GLR)