Dytham attended Nancy Kissel just 36 hours after what Kissel said was a furious struggle that resulted in the death of her husband.

The physician testified Friday that on November 4, a tearful and distressed Kissel, moving slowly and in pain, left her with the impression she had been assaulted.

When prosecutors showed CCTV pictures of the accused going in and out of the Parkview apartment complex, Dytham said she couldn't judge the speed of movement from the still pictures, and could not see Kissel's facial expressions, but she was ``a little surprised'' to see the accused with the rug and the suitcase.

However, she added that ``people are known to struggle through all sorts of injuries.''

Dytham told the High Court Friday that she thought the accused to be a ``normal mother, good with her children and who communicated well with her children.''

She attended the accused on October 23 and 28 for insomnia, and on November 4 carried out a medical check up on the injuries the accused claimed were caused by her husband.

During cross-examination, Dytham said she never discussed sodomy with the accused, that there was no mention of a baseball bat when Kissel described the assault.

She also remembered feeling frustrated with the patient as ``everywhere I touched seemed painful,'' and that the pained reactions seemed ``disproportionate to the actual injury.''

Kissel, 41, is accused of serving her husband a pink milkshake laced with sedatives which left him unconscious at the foot of the bed as she bludgeoned him to death with a heavy metal ornament on November 2, 2003 in their Parkview apartment. She denies a charge of murder.

She has testified that there was a furious fight that night, in which she feared for her life as her husband bore down on her swinging a baseball bat, repeatedly saying: ``I'm going to kill you, you bitch.''

Kissel has accepted that she killed her husband, but said she cannot recall how she came to inflict five fatal wounds to the side of his head.

She has testified that her husband routinely subjected her to violence and forceful sodomy.

The prosecution has suggested that Kissel's secret lover in the United States, an electrical repairman living in a trailer, considered her a ``goldmine'' and noted their frequent communication in the days leading up to the murder and which continued until her arrest. Kissel testified that she had chosen Dytham as one of the first people in Hong Kong to talk to about her marital problems because she was a woman and a professional.

Reading from notes, Dytham said she heard the accused describe on October 23, 2003, how she had been subjected to violence by her husband after an incident a year ago.

She had noted, ``alleged assault and subsequent violations.''

During that visit, Kissel told her that she hadn't slept for many nights and that other sleeping pills had so far been ineffective and requested something stronger.

Dytham said it was not her usual practice to prescribe Rohypnol, but that she believed the accused did not drink alcohol and prescribed her 10 tablets.

Rohypnol, the infamous ``date-rape'' drug, was one of five sedatives and hypnotics found in the body of the deceased. Dytham's notes say that the accused had described a fight in which her drunken husband chased her around the room, ``kicking and grabbing'' after she refused him sex.

Dytham had notes saying she was holding a fork upside down and a glass and that the ``puncture wounds'' on the right hand seemed to correspond with wounds that may have come from the points of a fork.

She found various bruises around the body as well as suspected fractures in the ribs and the right hand, although they did not show up in subsequent X-rays. Her conclusion from her notes was that the accused was ``slow to move [because of] total body pain.''

Using notes from Dytham's previous medical examinations, Senior Assistant Director of Public Prosecutions Peter Chapman noted that in 2002 the accused had filled a form saying she experienced no painful intercourse, was sexually active and had no physical or emotional problems with sex.

albert.wong@singtaonewscorp.com