Department of Forensic Medicine, University of Dundee

Lecture Notes
Time of Death
Quotations
Time of Death
Post mortem changes: Cooling, Rigor Mortis, Post Mortem Lividity, Putrefaction, Adipocere,
Mummification, Maceration, itreous potassium
POSTMORTEM CHANGES AND TIME OF DEATH
Quotations
!The time of death is sometimes e"tremely important# $t is a %uestion almost invaria&ly as'ed &y
police officers, sometimes (ith a touching faith in the accuracy of the estimate# Determining the
time of death is e"tremely difficult, and accuracy is impossi&le!# )Ref# * at p# ++,#-
!.o pro&lem in forensic medicine has &een investigated as thoroughly as that of determining the
time of death on the &asis of post mortem findings# Apart from its o&vious legal importance, its
solution has &een so elusive as to provide a constant intellectual challenge to (or'ers in many
sciences# $n spite of the great effort and ingenuity e"pended, the results have &een meagre!#
)Ref# +, at p# //#-
!Repeated e"perience teaches the investigator to &e (ary of relying on any single o&servation
for estimating the time of death )or !duration of the post mortem interval!-, and he (isely avoids
ma'ing dogmatic statements &ased on an isolated o&servation!# )Ref# +0 at p# +,+#-
!Considering the varia&les (hich influence the rate of &ody heat loss, the &est one can say a&out
the relia&ility of algor mortis as a post mortem cloc' is that it permits a rough appro"imation of
the time of death# 1rrors in over2estimating and under2estimating the post mortem interval &ased
on &ody cooling are common, even in the face of considera&le e"perience &y those ma'ing the
estimate# 3ody temperature as an indicator of the post mortem interval should &e correlated (ith
all other phenomenon and o&servations utilised in esta&lishing the time of death!# )Ref# +0 at p#
+45#-
!6ormerly, it (as a hallo(ed !rule of thum&! that the rectal temperature dropped at an average
of ++70o6 per hour, rather faster during the first fe( hours# This method (as a guarantee of
inaccuracy, &ut little has &een found to replace it# $n previous editions of this &oo' a simple
calculation &ased on the drop in centrigrade from /8o related to a factor for environmental
temperature (as advocated, &ut further e"perience has sho(n serious errors in the method, and
it is no( no longer recommended!# )Ref# * at p# ++92+0:#-
!;ome difference of opinion e"ists over the use of a thermometer at the scene of a suspicious
death# Considera&le caution must &e employed (hen considering the ta'ing of a rectal
temperature (ith the &ody in situ# $f there is any possi&ility at all of some se"ual interference,
(hether homose"ual or heterose"ual, no intereference (ith the clothing or perineum must &e
made until all forensic e"aminations have &een completed# Certainly, no instrument should &e
inserted into the rectum &efore trace evidence has &een sought!# )Ref# +: at p# 92+:#-
!<hatever method is used to calculate the estimated time since death from &ody temperature, all
the varia&le factors must &e ta'en into account to modify any &asic formula, though this
ad=ustment is very ar&itrary and can only &e attempted in the light of previous e"perience# <hen
a !favoured! time of death is decided upon this should never &e offered to the investigating
authorities as a single point in time# $t must &e used to construct a !&rac'et of pro&a&ility!,
giving an earliest and latest time &et(een (hich the doctor feels that death must have occurred#
The (idth of this time &rac'et (ill depend upon the num&er and uncertainty of the varia&le
factors 'no(n to the doctor and is li'ely to &e longer the more remote the death (as from the
time of e"amination of the corpse# $t is futile mentioning any time in units of less than an hour,
even (hen the death (as %uite recent# A medical (itness (ho attempts to determine the time of
death from temperature estimation in minutes or fractions of hours is e"posing himself to a
severe challenge to his e"pertise (hich may (ell amount to near ridicule, thus denegrating the
rest of his evidence!# )Ref# +: at p# +0#-
!The timing of the se%uence of events concerned in the dissolution of the &ody cannot &e done
(ith accuracy and one must &e cautious never to pronounce too readily that the decomposed
state of the &ody is inconsistent (ith the time interval alleged!# )Ref# 4 at p# 9+#-
TIME OF DEAT
A recurring pro&lem in forensic medicine is the need to fi" the time of death (ithin the limits of
pro&a&ility# $t is self2evident that the longer the interval of time &et(een death and the
e"amination of the &ody, the (ider (ill &e the limits of pro&a&ility# The longer the post mortem
interval, the more li'ely it is that associated or environmental evidence (ill furnish more
relia&le data on (hich to estimate the time of death than (ill anatomical changes#
$t is necessary to &e alert to the possi&ility that the post mortem interval )the time elapsed from
death until discovery and medical e"amination of the &ody- may &e preceded &y a significant
survival period )the time from in=ury or onset of the terminal illess to death-# The survival
interval is &est esta&lished &y evaluating the types, severity and num&er of in=uries present and
the deceased>s response to them, ta'ing into account pre2e"isting natural disease# At autopsy it is
necessary to assess the evolution of the inflammatory response and repair process in s'in and
viscera#
1sta&lishing the times of an assault and death has a direct &earing on the legal %uestions of ali&i
and opportunity# $f the suspect is a&le to prove that he (as at some other place (hen the fatal
in=ury (as inflicted then he has an ali&i and his innocence is implicit# Conversely, if the time of
a lethal assault coincides (ith the time (hen the suspect (as 'no(n to &e in the vicinity of the
victim, then the suspect clearly had an opportunity to commit the crime# $n cases of infanticide,
it is necessary for the prosecution to esta&lish that the child (as &orn alive and (as 'illed
after(ards# $n the a&sence of proof that death occurred after a live &irth, there can &e no
prosecution for infanticide# ;imilarly, in &odies recovered from fires, it is critical to esta&lish
(hether death occurred &efore or during the fire and this necessitates correlating information
relevant to esta&lishing &oth the time of death and the cause of death# <hen a &ody is recovered
from (ater, a critical %uestion is (hether the person (as alive or dead (hen they entered the
(ater# Determining (hether specific in=uries (ere inflicted &efore or after death is another
important e"ample of esta&lishing temporal relationships#
!ources of Evidence
1vidence for estimating the time of death may come from three sources:
+# Corporal evidence, i#e# that present in the &ody#
0# 1nvironmental and associated evidence, i#e# that present in the vicinity of the &ody,
/# Anamnestic evidence, i#e# that &ased on the deceased>s ordinary ha&its, movements, and
day to day activities#
All three sources of evidence should &e e"plored and assessed &efore offering an opinion on
(hen death or a fatal in=ury occurred#
There are t"o methods for estimatin# the time of death$
+# The rate method# Measuring the change produced &y a process (hich ta'es place at a
'no(n rate (hich (as either initiated or stopped &y the event under investigation, i#e#
death# 1"amples include the amount and distri&ution of rigor mortis, the change in &ody
temperature, and the degree of putrefaction of the &ody#
0# The concurrence method# Comparing the occurrence of events (hich too' place at
'no(n times (ith the time of occurrence of the event under investigation, i#e# death# 6or
e"ample, a (rist (atch stopped &y a &lo( during an assault, the e"tent of digestion of the
last 'no(n meal#
%ostmortem chan#es and time of death
Many physico2chemical changes &egin to ta'e place in the &ody immediately or shortly after
death and progress in a fairly orderly fashion until the &ody disintegrates# 1ach change has its
o(n time factor or rate# ?nfortunately, these rates of development of post mortem changes are
strongly influenced &y unpredicta&le endogenous and environmental factors# Conse%uently, the
longer the post mortem interval, the (ider is the range of estimate as to (hen death pro&a&ly
occurred# $n other (ords, the longer the post mortem interval, the less precise is the estimate of
the time of death#
&' AL(O) MO)TI! *+OD, -OOLIN(.
This is the most useful single indicator of the time of death during the first 05 hours post
mortem# ;ome (riters (ould regard it as the only (orth(hile corporal method#
$t is of some importance to note that the use of &ody temperature estimations to assess
time of death applies only to cool and temperate climates since in tropical regions there
may &e a minimal fall in &ody temperature post mortem and in some e"treme climates,
)e#g# central Australia- the &ody temperature may even rise after death#
The assessment is made on the &asis of measurement of the &ody core temperature
(hich, post mortem, re%uires a direct measurement of the intra2a&dominal temperature#
$n practice either the temperature is measured per rectum or the intra2hepatic7su&2hepatic
temperature is measured via an a&dominal sta&# @ral and a"illary temperatures should
not &e used# An ordinary clinical thermometer is useless &ecause its range is too small
and the thermometer is too short# A chemical thermometer +:2+0! long (ith a range
from :2,:o Celsius is ideal# Alternatively a thermo2couple pro&e may &e used and this
has the advantage of a digital readout or a printed record#
<hether the temperature is measured via an a&dominal sta& or per rectum is a matter of
professional =udgement in each case# $f there is easy access to the rectum (ithout the
need to seriously distur& the position of the &ody and if there is no reason to suspect
se"ual assault, then the temperature can &e measured per rectum# $t may &e necessary to
ma'e small slits in the clothing to gain access to the rectum, if the &ody is clothed and
the garments cannot &e pushed to one side# The chemical thermometer must &e inserted
a&out /25! into the rectum and read in situ# The alternative is to ma'e an a&dominal sta&
(ound after displacing or slitting any overlying clothing# The sta& may &e over the lo(er
ri&s and the thermometer inserted (ithin the su&stance of the liver or alternatively a
su&costal sta& (ill allo( insertion of the thermometer onto the undersurface of the liver#
The &ody temperature should &e recorded as early as conveniently possi&le# The
environmental temperature should also &e recorded and a note made of the
environmental conditions )see &elo(- at the time the &ody (as first discovered and any
su&se%uent variation in these conditions# $f a method of se%uential measurement of &ody
temperature is use then the thermometer should &e left in situ during this time period#
This latter method is much easier to underta'e (hen using a thermo2couple (ith an
attached print2out device#
Temperature readings of the &ody and o&servations made at the scene &y one physician
are al(ays availa&le for evaluation &y an e"pert at a later time#
The normal oral temperature fluctuates &et(een /,#9oC )94#8o6- and /8#0oC )99o6-#
The rectal temperature is from :#/2:#5oC ):#,o2:#8,o6- higher )cited in reference +9 at p#
+0-# ;ince heat production ceases soon after death &ut loss of heat continues, the &ody
cools#
During life the human &ody loses heat &y radiation, convection, and evaporation# Aeat
loss &y conduction is not an important factor during life, &ut after death it may &e
considera&le if the &ody is lying on a cold surface# The fall in &ody temperature after
death mainly depends upon a loss of heat through radiation and convection, &ut
evaporation may &e a significant factor if the &ody or clothing is (et# The cooling of a
&ody is a predominantly physical process (hich, therefore, is predominantly determined
&y physical rules#
.e(ton>s la( of cooling states that the rate of cooling of a &ody is determined &y the
difference &et(een the temperature of the &ody and that of its environment#
Conse%uently, a plot of temperature against time gives a curve (hich is e"ponential#
Ao(ever, .e(ton>s la( applies to small inorganic &odies and does not accurately
descri&e cooling of the human &ody (hich has a large mass, irregular shape, and is
composed of tissues of different physical properties# Practical o&servations indicate that
the cooling of a human &ody is &est represented &y a sigmoid curve (hen temperature is
plotted against time# Thus, there is an initial maintenance of &ody temperature (hich
may last for some hours 2 the so2called !temperature plateau! 2 follo(ed &y a relatively
linear rate of cooling (hich su&se%uently slo(s rapidly as the &ody approaches the
environmental temperature# The initial lag in cooling (as first descri&ed &y Rainy,
Regius Professor of 6orensic Medicine in Blasgo(, in +*49# )$t (as independently
descri&ed in the Berman literature in the same year &y ;eydeler-# The post mortem
temperature plateau is physically determined and not a special feature of the dead human
&ody# Post mortem heat production is said to contri&ute appro"imately one2si"th to the
plateau# Any inert &ody (hich has a lo( thermal conductivity has such a plateau during
its first cooling phase# $t is this plateau (hich produces the sigmoid shape of the resultant
cooling curve# The post mortem temperature plateau generally lasts +70 to one hour &ut
may persist as long as three hours )Ref# +, at p# /5- and some authorities claim that it
may persist as long as five hours );hapiro cited in Ref# * at p# ++*2++9-#
$t is usually assumed that the &ody temperature at the time of death is normal, &ut in
individual cases it may &e su&normal or mar'edly raised# As (ell as in deaths from
hypothermia, the &ody temperature at death may &e su&2normal in cases of congestive
cardiac failure, massive haemorrhage, and shoc'# Ao(ever, the claim that severe agonal
&leeding lo(ers the &ody temperature is said to &e (ithout foundation# )Ref# +: at p# +0-#
The &ody temperature may &e raised at the time of death in heat stro'e, some infections,
and pontine haemorrhage# ;impson )Ref# ++ at p# 8- cites a personal o&servation of a
case of pontine haemorrhage (ith an initial temperature at death of 50#*oC )+:9o6- and
another instance of a temperature of /8#5oC )99#5o6- a&out three hours after death in a
case of manual strangulation# Ao(ever, another author claims that there is no convincing
proof that asphy"ia &y strangulation leads to a raised agonal temperature# )Ref# +: at p#
+0-# <here there is a fulminating infection, e#g# septicaemia, the &ody temperature may
continue to rise for some hours after death )Ref# +9 at p# +/-#
Thus the t(o important un'no(ns in assessing time of death from &ody temperature are
)+- the actual &ody temperature at the time of deathC and )0- the actual length of the post
mortem temperature plateau# 6or this reason assessment of time of death from &ody
temperature clearly cannot &e accurate, )even appro"imately-, in the first four to five
hours after death (hen these t(o un'no(n factors have a dominant influence# ;imilarly,
&ody temperature cannot &e a useful guide to time of death (hen the cadaveric
temperature approaches that of the environment# Ao(ever, in the intervening period,
over the linear part of the sigmoid cooling curve, any formula (hich involves an
averaging of the temperature decline per hour may (ell give a reasona&ly relia&le
appro"imation of the time of death# $t is in this limited (ay that the cadaveric
temperature may assist in estimating the time of death in the early post mortem interval,
provided the sigmoid nature of the relationship &et(een the temperature of the cooling
&ody and that of its environment is 'ept in mind#
The linear rate of post mortem cooling is affected &y environmental factors and
cadaveric factors other than the environmental temperature and the &ody temperature at
the time of death# These include:
+# The !siDe! of the &ody# The greater the surface area of the &ody relative to its mass,
the more rapid (ill &e its cooling# Conse%uently, the heavier the physi%ue and the
greater the o&esity of the &ody, the slo(er (ill &e the heat loss# ;ome authors claim that
in o&ese individuals the fat acts as an insulator, &ut for practical purposes &ody mass,
(hether from muscle mass or adipose tissue, is the most important factor# Children lose
heat more %uic'ly than adults &ecause their surface area7mass ratio is much greater#
Prominent oedema in individuals (ith congestive cardiac failure is said to retard cooling
&ecause of the large volume of (ater present (ith a high specific heat (hilst dehydration
has the opposite effect# The effect of oedema fluid is said to &e more potent than &ody
fat# )Ref# +: at p# ++-# The e"posed surface area of the &ody radiating heat to the
environment (ill vary (ith the &ody position# $f the &ody is supine and e"tended, only
*:E of the total surface area effectively loses heat, and in the foetal position the
proportion is only 4:E# )Ref# 4 at p# **-#
0# Clothing and coverings# These insulate the &ody from the environment and therefore
cooling is slo(er# ;impson states that cooling of a na'ed &ody is half again as fast as
(hen clothed )Ref# ++ at p# 9-# Aenssge )see &ac' of nomogram- has graded the effect of
clothing &y the num&er of layers and thic'ness# Ae states that only the clothing or
covering of the lo(er trun' is relevant#
/# Movement and humidity of the air# Air movement accelerates cooling &y promoting
convection and even the slightest sustained air movement is significant# Cooling is said
to &e more rapid in a humid rather than dry atmosphere &ecause moist air is a &etter
conductor of heat# The humidity of the atmosphere (ill affect cooling &y evaporation
(here the &ody or its clothing is (et#
5# $mmersion in (ater# A cadaver cools more rapidly in (ater than in air &ecause (ater
is a far &etter conductor of heat# 6or a given environmental temperature, cooling in still
(ater is a&out t(ice as fast as in air, and in flo(ing (ater, a&out three times as fast#
Clearly the &ody (ill cool more rapidly in cold (ater than (arm (ater# $t has &een said
that &odies (ill cool more slo(ly in (ater containing se(age effluent or other putrefying
organic matter than in fresh (ater or sea (ater# )Ref# +9 at p# +*-# The author does not
state (hether this factor is claimed to &e independent of (ater temperature#
;imple formulae for estimating the time of death are no( regarded as naive# These
include the formula of ;impson )Ref# ++ at p# 4- 2 !under average conditions the clothed
&ody (ill cool in air at the rate of a&out +#,oC an hour for the first 4 hours and average a
loss of some +oC for the first +0!# Also the formula of Camps )Ref# , at p# +:/- 2
!pro&a&ly the &est rough estimate is afforded &y the formula 9*#5 minus To7+#, F
num&er of hours dead up to si" hours, &ased upon s'in and rectal readings, (hilst
corrections must &e made for readings ta'en under the liver!# Gnight devised a formula
in (hich the fall in temperature in degrees Celsius (as multiplied &y a factor of +, ++75,
++70, + /75 or 0 for air temperatures of Dero, ,, +:, +,, or 0:oC respectively# Ais o(n
e"perience (ith this formula has sho(n serious errors and he no( no longer
recommends it# )Ref# * at p# +0:-#
The &est researched and documented method for assessing time of death from &ody
temperature is that of Aenssge )6orensic ;cience $nternational +9**, ol# /*, pp# 0:92
0/4-# This is a nomogram method rather than a formula# The nomogram corrects for any
given environmental temperature# $t re%uires the measurement of deep rectal temperature
and assumes a normal temperature at death of /8#0
o
C #
Aenssge>s nomogram is &ased upon a formula (hich appro"imates the sigmoid shaped
cooling curve# This formula has t(o e"ponential terms (ithin it# The first constant
descri&es the post mortem plateau and the second constant e"presses the e"ponential
drop of the temperature after the plateau according to .e(ton>s la( of cooling#
$ntroducing more than t(o e"ponential terms complicates the theoretical model (ithout
producing &etter results in practice# $n an individual case, the constant e"pressing the
e"ponential drop of the temperature after the plateau is simply calculated from the &ody
(eight# The first constant (hich descri&es the post mortem temperature plateau (as
found to &e significantly related to the second constant in that &odies (ith a lo( rate of
cooling, )i#e# having a high &ody (eight- also had a longer plateau phase than &odies
(ith a high rate of cooling, )i#e# a lo( &ody (eight-# ?sing previously pu&lished data
(hich esta&lishes that the relative length of the post mortem temperature plateau depends
upon the environmental temperature &ut is non2linear and pronounced in environmental
temperatures a&ove 0/oC, Aenssge evolved t(o nomograms, the one for am&ient
temperatures a&ove 0/oC and the other for am&ient temperatures &elo( 0/oC# <ithin
each of these t(o nomograms there is a differing allo(ance for the effect of
environmental temperature on the rate of cooling as (ell as an allo(ance for the effect of
&ody (eight#
$t is (ell recognised that the presence of layers of clothing, (etting of the clothing, and
air movement, all influence the rate of &ody cooling# ;imilarly, &odies in still and
flo(ing (ater cool more rapidly than in air# Aenssge conducted e"periments and derived
empiric corrective factors to allo( for the effect of these varia&les )see &ac' of
nomogram sheet (hich reproduces the data in his articles-#
$n using the nomogram, Aenssge emphasised !Hou can use right rules, &ut get (rong
results if the points of contact are (rong# The most important thing, and 2 certainly 2
often the most difficult one, is to analyse carefully the points of contact at the scene of
crime# 3y using the nomogram you can %uic'ly calculate some different times since
death &y ta'ing some different points of contact as a &asis# This is recommended if the
points of contact are not closely defined and a range of any point of contact must &e
ta'en into account!# 3y !point of contact! Aenssge means one of the varia&le elements
for (hich he has derived corrective factors# Ae specifically recommends !$t is a good
strategy to evaluate an upper and a lo(er limit of the mean am&ient temperature (hich
might &e possi&le on the &asis of &oth the am&ient temperature actually measured and the
pro&a&le changes of it!# And, !The choice of a corrective factor of the &ody (eight of
any case is really only an appro"imation# $t re%uires personal e"perience# ### Again it is a
recommended strategy to select an upper and a lo(er corrective factor (hich might &e
possi&le!# !$t must &e emphasised that this method cannot &e used in every case# ?nder
some circumstances )reproduced on the &ac' of the nomogram provided- this method
must not &e used &ecause the points of contact are really un'no(n#!
/' )I(O) MO)TI!
@rdinarily, death is follo(ed immediately &y total muscular rela"ation 2 primary
muscular flaccidity 2 succeeded in turn &y generalised muscular stiffening 2 rigor mortis#
After a varia&le period of time rigor mortis passes off spontaneously to &e follo(ed &y
secondary muscular flaccidity# The first investigation of rigor mortis is attri&uted to
.ysten in +*++ )Ref# +: at p# +,-#
.o measura&le shortening of muscle occurs during rigor mortis unless the muscles are
su&=ected to tension# <hen rigor is fully developed, the =oints of the &ody &ecome fi"ed,
and the state of fle"ion or e"tension of these =oints depends upon the position of the
trun' and lim&s at the time of death# $f the &ody is supine then the large =oints of the
lim&s &ecome slightly fle"ed during the development of rigor# The =oints of the fingers
and toes are often mar'edly fle"ed due to the shortening of the muscles of the forearms
and legs# ;ince significant muscle shortening is not a normal concomitant of rigor, it is
unli'ely that rigor mortis (ould cause any significant change in the attitude adopted &y
the corpse at death# The vie( that the development of rigor mortis could produce
significant movements of the &ody (as promoted &y ;ommer, in a&out +*//, and the
postulated movements &ecame 'no(n as !;ommer>s movements!# )Ref# +: at page +8-# $t
is no( accepted that movements of a corpse due to the development of rigor mortis can
only occur in special circumstances, such as an e"treme position of the &ody at the
moment of death# $f a &ody is moved &efore the onset of rigor then the =oints (ill &ecome
fi"ed in the ne( position in (hich the &ody is placed# 6or this reason, (hen a &ody is
found in a certain position (ith rigor mortis fully developed, it cannot &e assumed that
the deceased necessarily died in that position# Conversely, if the &ody is maintained &y
rigor in a position not o&viously associated (ith support of the &ody, then it can &e
concluded that the &ody (as moved after rigor mortis had developed#
Rigor involves voluntary and involuntary muscles# Rigor of the myocardium should not
&e mista'en for myocardial hypertrophy# Li'e(ise secondary muscular flaccidity of the
atria and ventricles should not &e mista'en for ante2mortem dilatation or interpreted as
evidence of myocardial dysfunction# $nvolvement of the iris muscles means that the state
of the pupils after death is not an indication of their ante2mortem appearance# Different
degrees of rigor development may give rise to irregularity and ine%uality of the pupils#
Contraction of the arrectores pilorum muscles during rigor may result in !goose2flesh! or
!cutis anserina!# The phenomenon is commonly seen in cases of dro(ning (here it is
thought to result from an agonal contraction of the muscles# $nvolvement of the (alls of
the seminal vesicles &y rigor may lead to discharge of seminal fluid at the glans penis#
Rigor mortis results from a physico2chemical change in muscle protein, the precise
nature of (hich is un'no(n# <hen the muscle tissue &ecomes ano"ic and all o"ygen
dependent processes cease to function, then the level of ATP is maintained &y anaero&ic
glycolysis (hich results in increasing levels of pyruvic and lactic acids# 1ventually, the
muscle glycogen is depleted, the cellular pA falls to around 4, and the level of ATP falls
&elo( a critical level &eyond (hich rigor rapidly develops# .ormally ATP inhi&its the
activation of the lin'ages &et(een actin and myosinC a fall in the level of ATP allo(s the
irreversi&le development of these lin'ages# $n individuals (ho have &een e"hausted or
starved &efore death, the glycogen stores in muscle are lo(, so that rigor may develop
rapidly# )Ref# +9 at p# 0,-# ;ome authors have simplified the concept of the development
of rigor mortis &y ta'ing the vie( that a fall in the muscle pA to around 4#4 2 4#/ results
in coagulation of the actinomyosin# )Ref# +0 at p# +4,-#
Classically, rigor is said to develop se%uentially, &ut this is &y no means constant,
symmetrical or regular# Ante2mortem e"ertion usually causes rigor to develop first in the
muscles used in the activity# Typically, rigor is first apparent in the small muscles of the
eyelids, lo(er =a( and nec', follo(ed &y the lim&s, involving first the small distal =oints
of the hands and feet and then the larger pro"imal =oints of the el&o(s, 'nees and the
shoulders and hips# ;hapiro )Ref# +9 at p# /:-, has suggested that this apparent
progression through the muscles of the &ody reflects the fact that although rigor &egins to
develop simultaneously in all muscles, it completely involves small masses of muscle
much more rapidly than large masses# Conse%uently, differences in the siDes of the
=oints, and in the muscles (hich control them, determine the development of =oint
fi"ation &y rigor and produce the o&served pattern of progression in the &ody# $t is
generally accepted that rigor mortis passes off in the same order in (hich it develops#
The forci&le &ending of a =oint against the force of rigor results in tearing of the muscles
and the rigor is said to have &een !&ro'en!# Provided the rigor had &een fully esta&lished,
it (ill not reappear once &ro'en do(n &y force# $n temperate climates rigor (ill typically
start to disappear at a&out /425* hours after death# Ao(ever, if the environmental
temperature is high then the development of putrefaction may completely displace rigor
(ithin 92+0 hours of death# )Ref# +5 at p# +5-# Accelerated putrefaction resulting from
ante2mortem septicaemia may also lead to a rapid displacement of rigor#
There is great variation in the rate of onset and the duration of rigor mortis#
.ider'orn>s )+*80- o&servations on ++/ &odies provides the main reference data&ase for
the development of rigor mortis and is commonly cited in te"t&oo's# Ais data (as as
follo(s )Ref# +9 at p# /+-:
Num0er of -ases ours %ost Mortem at "hich
)i#or "as -omp1ete
0 0
+5 /
/+ 5
+5 ,
0: 4
++ 8
8 *
5 9
8 +:
+ ++
+ +0
0 +/

$n this series, rigor (as complete in +5E of cases at / hours post mortem and this
percentage had risen to 80E at 4 hours and to 9:E at 9 hours# 3y +0 hours post mortem
rigor (as complete in 9*E of cases# ).ote that this data is presented in a some(hat
confusing (ay in Ref# +: at p# +,-# Against the &ac'ground of this data it can &e readily
appreciated that the generally %uoted rule of thum& that rigor commences in 4 hours,
ta'es another 4 to &ecome fully esta&lished, remains for +0 hours and passes off during
the succeeding +0 hours, is %uite misleading#
The intensity of rigor mortis depends upon the decedent>s muscular developmentC
conse%uently, the intensity of rigor should not &e confused (ith its degree of
development# $n e"amining a &ody &oth the degree )complete, partial, or a&sent- and
distri&ution of rigor should &e assessed after esta&lishing that no artefact has &een
introduced &y previous manipulation of the &ody &y other o&servers# Attempted fle"ion
of the different =oints (ill indicate the amount and location of rigor#
As a general rule (hen the onset of rigor is rapid, then its duration is relatively short# The
t(o main factors (hich influence the onset and duration of rigor are )a- the
environmental temperature, and )&- the degree of muscular activity &efore death# @nset
of rigor is accelerated and its duration shortened (hen the environmental temperature is
high# $f the temperature is &elo( +:oC it is said to &e e"ceptional for rigor mortis to
develop, &ut if the environmental temperature is then raised, rigor mortis is said to
develop in a normal manner# )Ref# +9 at p# /+-# Rigor mortis is rapid in onset and of short
duration after prolonged muscular activity, e#g# after e"haustion in &attle, and follo(ing
convulsions# Conversely, a late onset of rigor in many sudden deaths might &e e"plained
&y the lac' of muscular activity immediately prior to death#
$n addition to these t(o principal factors, other endogenous and environmental factors
are claimed to influence the onset of rigor# @nset is relatively more rapid in children and
the aged than in muscular young adults# $t develops early and passes %uic'ly in deaths
from septicaemia or from (asting diseases# $t is delayed in asphy"ial deaths, nota&ly &y
hanging or car&on mono"ide poisoning, and also (hen death has &een immediately
preceded &y severe haemorrhage# )Ref# +: at p# +,-#
The opinion of Gnight that !it is e"tremely unsafe to use rigor at all in the estimation of
time since death! is some(hat e"treme# )Ref# * at p# +0/#- Ao(ever, the rule of thum&
offered &y Camps is overly simplistic 2 !corpses can usually &e divided into those, still
(arm, in (hich no rigor is present, indicating death (ithin a&out the previous three
hours# Those in (hich rigor is progressing, (here death pro&a&ly occurred &et(een 0
and 9 hours previouslyC and those in (hich rigor is fully esta&lished, sho(ing that death
too' place more than 9 hours previously!# )Ref# 4 at p# *,-# Gnight states that !the only
possi&le use is in the period around the second day, (hen &ody temperature may have
dropped to environmental &ut putrefaction has not yet occurred# $f full rigor is present,
then one might assume that this is a&out the second day follo(ing death, depending upon
the environmental conditions!# )Ref# * at p# +0/-#
1"posure of a &ody to intense heat results in heat stiffening due to coagulation of the
muscle proteins# ?nli'e rigor mortis, heat stiffening is associated (ith muscle shortening
resulting in the characteristic pugilistic posture of &urned &odies# Aeat stiffening
o&scures rigor mortis (ith (hich it should not &e confused# 6reeDing of a &ody (ill
cause stiffening of the muscles, postponing the development of rigor (hich is said to
develop as soon as tha(ing of the &ody permits#
Cadaveric spasm )synonyms: instantaneous rigor, instantaneous rigidity, cataleptic
rigidity- is a form of muscular stiffening (hich occurs at the moment of death and (hich
persists into the period of rigor mortis# $ts cause is un'no(n &ut it is usually associated
(ith violent deaths in circumstances of intense emotion# $t has medico2legal importance
&ecause it records the last act of life# Cadaveric spasm may affect all the muscles of the
&ody &ut it most commonly involves groups of muscles only, such as the muscles of the
forearms and hands# ;hould an o&=ect &e held in the hand, then cadaveric spasm should
only &e diagnosed if the o&=ect is firmly held and considera&le force is re%uired to &rea'
the grip# Cadaveric spasm involving all the muscles of the &ody is e"ceedingly rare and
most often descri&ed in &attle situations# )Ref# 4 at p# *,, and Ref# +: at p# +9-#
Cadaveric spasm is seen in a small proportion of suicidal deaths from firearms, incised
(ounds, and sta& (ounds, (hen the (eapon is firmly grasped in the hand at the moment
of death# $n such circumstances the gripping of the (eapon creates a presumption of self2
infliction of the in=uries# This state cannot &e reproduced after death &y placing a (eapon
in the hands# $t is also seen in cases of dro(ning (hen grass, (eeds, or other materials
are clutched &y the deceased# $n this circumstance, it provides proof of life at the time of
entry into the (ater# ;imilarly, in mountain fatalities, &ranches of shru&s or trees may &e
seiDed# $n some homicides, hair or clothing of the assailant may &e found in the hands of
the deceased#
2' LI3O) MO)TI! *,%O!TA!I!, %O!T MO)TEM LI3IDIT,,
%O!TMO)TEM !U((ILLATION!.
Lividity is a dar' purple discolouration of the s'in resulting from the gravitational
pooling of &lood in the veins and capillary &eds of the dependent parts of the &ody
follo(ing cessation of the circulation# The process &egins immediately after the
circulation stops, and in a person dying slo(ly (ith circulatory failure, it may &e
pronounced very shortly after death# Lividity is present in all &odies, although it may &e
inconspicuous in some and thus escape notice#
Lividity is a&le to develop post mortem under the influence of gravity &ecause the &lood
remains li%uid rather than coagulating throughout the vascular system# <ithin a&out /:2
4: minutes of death the &lood in most corpses, dead from natural or non2natural causes,
&ecomes permanently incoagula&le# This is due to the release of fi&rinolysins, especially
from small cali&re vessels, e#g# capillaries, and from serous surfaces, e#g# the pleura#
Clots may persist (hen the mass of clot is too large to &e li%uified &y the fi&rinolysin
availa&le at the site of clot formation# $n some deaths associated (ith infection and
cache"ia, this fi&rinolytic effect may fail to develop, e"plaining the presence of a&undant
clot in the heart and large cali&re vessels# Thus, in cases of sudden death the &lood
remains spontaneously coagula&le only during a &rief period immediately follo(ing
deathC it then &ecomes completely free from fi&rinogen and (ill never again clot# This
incoagula&ility of the &lood is a commonplace o&servation at autopsy# The fluidity of the
&lood is not characteristic of any special cause or mechanism of death although many
te"ts state that the &lood remains li%uid longer in asphy"ial deaths# )Ref# +9 at p# /*25:-#
The &luish colour of post mortem lividity does not have the same connotation as
cyanosis produced during life# The term !cyanosis!, (hich means a &luish discolouration
of the s'in or mucous mem&ranes, should &e confined to clinical descriptions and not
used for corpses# $n the living, the cyanotic colour of the &lood re%uires the presence of
at least , g of reduced haemoglo&in per cent in the capillary &lood# Ao(ever, in the
corpse, o"ygen dissociation continues and there may &e reflu" of deo"ygenated venous
&lood into the capillaries# 6or these reasons, the &lood of a cadaver &ecomes purplish2
&lue, &ut this is not the result of a pathophysiological change occurring during life, e#g#
strangulation# The normal colour of areas of post mortem lividity is a cyanotic hue, &ut
this description should not &e used since it is misleading# )Ref# +9 at p# 5:25/-#
The medico2legal importance of post mortem lividity lies in its colour and in its
distri&ution# The development of lividity is too varia&le to serve as a useful indicator of
the time of death#
Typically, lividity has a purple or reddish2purple colouration# Lividity in &odies e"posed
to the air may ac%uire a pin' colour at the sides, &ut not, as rule, at the &ac' or other
areas (hich are close to the ground# $n deaths from car&on mono"ide poisoning, it is
classically descri&ed as !cherry red!C in cases (here methaemoglo&in is formed in the
&lood during life )e#g# potassium chlorate, nitrates, and aniline poisoning- it appears
chocolate &ro(nC in deaths from e"posure to cold, it is &right pin', and a similar
colouration is seen in &odies refrigerated very soon after death# Refrigeration of a &ody
already displaying typical purple lividity (ill cause it to turn pin'# ;imilarly, lividity in
parts of the &ody covered (ith moist clothes appears pin', (hereas it is the usual purple
colour in other areas# Cyanide poisoning results in lividity (hich is descri&ed &y
different authors as pin', &right scarlet, and violet#
Lividity is first apparent a&out 0:2/: minutes after death as dull red patches or &lotches
(hich deepen in intensity and coalesce over the succeeding hours to form e"tensive areas
of reddish2purple discolouration# ;light lividity may appear shortly &efore death in
individuals (ith terminal circulatory failure# Conversely, the development of lividity
may &e delayed in persons (ith chronic anaemia or massive terminal haemorrhage# After
a&out +:2+0 hours the lividity &ecomes !fi"ed! and repositioning the &ody, e#g# from the
prone to the supine position, (ill result in a dual pattern of lividity since the primary
distri&ution (ill not fade completely# 6i"ation of lividity is a relative, rather than an
a&solute, phenomenon, &ut nevertheless, (ell developed lividity fades very slo(ly and
only incompletely# 6ading of the primary pattern of lividity and development of a
secondary pattern of lividity (ill &e %uic'er and more complete if the &ody is moved
(ithin, say, the first si" hours after death, than at a later period# )Ref# 4 at p# *0-# 1ven
after 05 hours, moving the &ody (ill result in a secondary pattern of lividity developing#
Duality of the disti&ution of lividity is important &ecause it sho(s that the &ody had &een
moved after death# Ao(ever, the timing of this movement of the &ody is ine"act# Polson
)Ref# +: at p# +5- claims !it sho(s that the &ody had &een moved ### (ithin * to +0
hours!# Camps )Ref# 4 at p# *0- states more convincingly that !for the hypostasis of have
value in this (ay, the &ody must have first remained in one position for a length of time,
perhaps a&out +: hours, sufficient for the lividity to have &ecome (ell developed and it
must then &e e"amined early enough after &eing moved &efore much of the hypostasis
has &ecome redistri&uted!# The &lanching of post mortem lividity &y thum& pressure
indicates that the lividity is not fully fi"ed#
Pressure of even a mild degree is sufficient to prevent gravitational filling of the vessels
and this is so in the compressed areas of s'in in contact (ith the underlying supporting
surface# The result is that these compressed areas of !contact flattening! also sho(
!contact pallor! )or !pressure pallor!-# A supine corpse (ill display contact pallor over
the shoulder&lades, &uttoc's, calves and heels# @ther areas of contact pallor (ill
correspond (ith the location of firm fitting clothing, e#g# elasticated under(ear, &elts and
collars, and any firm o&=ect lying &eneath the &ody, e#g# the arm of the decedent# Thus,
the distri&ution of lividity depends upon the position of the &ody after death#
<ithin intense areas of lividity, the accumulated &lood may rupture small vessels to
produce a scattering of punctate purple2&lac' haemorrhages &et(een one and several
millimetres in diameter# These haemorrhages are seen most commonly over the lo(er
legs of victims of suicidal hanging (ith complete suspension# These haemorrhagic loci
should &e distinguished from ante2mortem petechial haemorrhages#
Lividity is usually (ell mar'ed in the earlo&es and in the fingernail &eds# $n a supine
corpse there may &e isolated areas of lividity over the front and sides of the nec'
resulting from incomplete emptying of superficial veins# $f the head is slightly fle"ed on
the nec', then lividity may have a linear distri&ution corresponding to the s'in folds#
)Ref# +9 at p# /4-# $solated patches of hypostasis may &e due to &lood in the deeper veins
&eing s%ueeDed, against gravity, to the s'in surface &y the action of muscles developing
rigor mortis )Ref# 4 at p# */-# Differentiation of lividity from &ruising can &e made &y
incising the s'in# $n areas of lividity the &lood is confined to the dilated &lood vessels
(hilst, in areas of &ruising, the &lood infiltrates the tissues and cannot &e readily (ashed
a(ay under running tap (ater# Microscopic e"amination (ill resolve any dou&ts and
provide a permanent record# $n a decomposing &ody it may &e impossi&le to definitively
distinguish &et(een livid staining of the tissues and a putrefying area of &ruising# Areas
of lividity are overta'en early in the putrefactive process# The red cells haemolyse and
the haemoglo&in diffuses into the surrounding tissues (here it may undergo secondary
changes such as sulphaemoglo&in formation# $n &ruised areas similar putrefactive
changes occur and it may &e impossi&le to determine (hether the pigment in the stained
putrefied area originated from an originally intravascular or e"travascular collection of
&lood, i#e# from a patch of congestion or from a &ruise#
Lividity occurs in the viscera as (ell as the s'in and this provides some confirmation of
the e"ternal o&servations# $n the myocardium lividity may &e mista'en for an acute
myocardial infarction, and in the lungs may &e misdiagnosed as pneumonia# Livid coils
of intestine may falsely suggest haemorrhagic infarction# Lividity developing in the
viscera of a &ody lying prone and resulting in a purplish congestion of organs usually
found pale at autopsy can &e disconcerting to those unaccustomed to these changes#
Most te"ts agree that lividity attains its ma"imum intensity at around +0 hours post
mortem, &ut there is some variation in descriptions of (hen it first appears, and (hen it
is (ell developed# Adelson )Ref# +0 at p# +4*- states that lividity !ordinarily &ecomes
percepti&le (ithin +70 to 5 hours after death, is (ell developed (ithin the ne"t / or 5
hours, and attains its ma"imum degree &et(een * and +0 hours post mortem!# Polson
)Ref# +: at p# +/- states that !it varies in its time of onset, is ordinarily apparent (ithin
+70 to 0 hours after death, and its complete development is attained in from 4 to +0
hours!# Camps )Ref# 4 at p# *+- states that it !first appears a&out 0:2/: minutes after
death as dull red patches (hich deepen, increase in intensity, and coalesce to form,
(ithin 4 to +: hours, an e"tensive area of reddish2purple colour!# ;pitD and 6isher )Ref#
+5 at p# +8- state that its !formation &egins immediately after death, &ut it may not &e
percepti&le for as much as t(o hours# $t is usually (ell developed (ithin 5 hours and
reaches a ma"imum &e(een * and +0 hours# ### After * to +0 hours lividity &ecomes
!fi"ed! and (ill remain (here it originally formed!# ;impson )Ref# ++ at p# 9- states that
!it commences to develop (ithin an hour or so of death, &ecoming mar'ed in , or 4
hours!#
4' %O!TMO)TEM DE-OM%O!ITION *%UT)EFA-TION .
Putrefaction is the post mortem destruction of the soft tissues of the &ody &y the action of
&acteria and enDymes )&oth &acterial and endogenous-# Tissue &rea'do(n resulting from
the action of endogenous enDymes alone is 'no(n as autolysis# Putrefaction results in the
gradual dissolution of the tissues into gases, li%uids and salts# The main changes (hich
can &e recognised in the tissues undergoing putrefaction are changes in colour, the
evolution of gases, and li%uefaction#
3acteria are essential to putrefaction and commensal &acteria soon invade the tissues
after death# The organisms most commonly found are those normally present in the
respiratory and intestinal tracts, namely anaero&ic spore2&earing &acilli, coliform
organisms, micrococci, diphtheroids and proteus organisms# The mar'ed increase in
hydrogen2ion concentration and the rapid loss of o"ygen in the tissues after death favour
the gro(th of anaero&ic organisms# )Ref# +9 at p# 5/-# The ma=ority of the &acteria come
from the &o(el and Clostridium (elchii predominates# Any ante2mortem &acterial
infection of the &ody, particularly scepticaemia, (ill hasten the onset and evolution of
putrefaction# 1nvironmental temperature has a very great influence on the rate of
development of putrefaction so that rapid cooling of the &ody follo(ing a sudden death
(ill mar'edly delay its onset# $n the temperate climate of the ?nited Gingdom the degree
of putrefaction reached after 05 hours in the height of summer may re%uire +: to +5 days
in the depth of (inter# A high environmental humidity (ill enhance putrefaction#
Putrefaction is optimal at temperatures ranging &et(een 8:2+::o6 )0+2/*oC- and is
retarded (hen the temperature falls &elo( ,:o6 )+:oC- or (hen it e"ceeds +::o6
)/*oC-# )Ref# +: at p# 0:-#
The rate of putrefaction is influenced &y the &odily ha&itus of the decedentC o&ese
individuals putrefy more rapidly than those (ho are lean# Putrefaction (ill &e delayed in
deaths from e"sanguination &ecause &lood provides a channel for the spread of
putrefactive organisms (ithin the &ody# Conversely, putrefaction is more rapid in
persons dying (ith (idespread infection, congestive cardiac failure or anasarca#
Putrefaction is accelerated (hen the tissues are oedematous, e#g# in deaths from
congestive cardiac failure, and delayed (hen the tissues are dehydrated# $t tends to &e
more rapid in children than in adults, &ut the onset is relatively slo( in unfed ne(2&orn
infants &ecause of the lac' of commensal &acteria# <hereas (arm temperatures enhance
putrefaction, intense heat produces !heat fi"ation! of tissues and inactivates autolytic
enDymes (ith a resultant delay in the onset and course of decomposition# Aeavy clothing
and other coverings, &y retaining &ody heat, (ill speed up putrefaction# Rapid
putrefactive changes may &een seen in corpses left in a room (hich is (ell heated, or in
a &ed (ith an electric &lan'et# $n=uries to the &ody surface promote putrefaction &y
providing portals of entry for &acteria and the associated &lood provides an e"cellent
medium for &acterial gro(th#
After normal &urial, the rate at (hich the &ody decomposes (ill depend to a large e"tent
on the depth of the grave, the (armth of the soil, the efficiency of the drainage, and the
permea&ility of the coffin# The restriction of air, in deep &urials, particularly in clay soil,
(ill retard decomposition, &ut never prevent it altogether# 3uried in (ell drained soil, an
adult &ody is reduced to a s'eleton in a&out +: years, and a child>s &ody in a&out , years#
)Ref# 4 at p# 9+-# $mmersion of the &ody in faeces2contaminated (ater, such as se(age
effluent (ill enhance putrefactionC ho(ever, it is generally accepted that in the first 5*
hours after death changes are in the main due to organisms already present in the &ody#
)Ref# , at p# +:,-# According to an old rule of thum& )Casper>s dictum- one (ee' of
putrefaction in air is e%uivalent to t(o (ee's in (ater, (hich is e%uivalent to eight
(ee's &uried in soil, given the same environmental temperature# )Ref# , at p# +:*-#
Typically, the first visi&le sign of putrefaction is a greenish discolouration of the s'in of
the anterior a&dominal (all# This most commonly &egins in the right iliac fossa, i#e# over
the area of the caecum, )(here the contents of the &o(el are more fluid and full of
&acteria-, &ut occasionally, the first changes are peri2um&ilical, or in the left iliac fossa#
The discolouration, due to sulph2haemoglo&in formation, spreads to involve the entire
anterior a&dominal (all, and then the flan's, chest, lim&s and face# As this colour change
evolves, the superficial veins of the s'in &ecome visi&le as a purple2&ro(n net(or' of
ar&orescent mar'ings, (hich tend to &e most prominent around the shoulders and upper
chest, a&domen and groins# This change, o(ing to its characteristic appearance, is often
descri&ed as !mar&ling!# The s'in, (hich no( has a glistening, dus'y, reddish2green to
purple2&lac' appearance, displays slippage of large sheets of epidermis after any light
contact (ith the &ody, e#g# during its removal from the scene of death# 3eneath the shed
epidermis is a shiny, moist, pin' &ase (hich dries, if environmental conditions permit, to
give a yello( parchmented appearance# This putrefactive !s'in2slip! superficially
resem&les ante2mortem a&rasions and scalds# $ndeed, post mortem scalding of a &ody
(ith (ater at 4,oC )+59o6- produces s'in slip of the same type as in putrefaction# )Ref#
4 at p# *9-#
;u&se%uently, s'in &listers varying in siDe from less than + cm to &et(een +: and 0: cm
in diameter develop# These &listers are filled (ith dus'y, sanguinous fluid and putrid
gases# They &urst on the slightest contact leaving the same slippery, pin' &ase (hich
underlies s'in2slip# Putrid gas formation also occurs in the stomach and intestines
causing the a&domen to distend and &ecome tense# The increased pressure (ithin the
torso causes a purge of putrid, &lood2stained fluid from the nose, mouth and vagina, and
e"pulsion from the rectum of similar fluid admi"ed (ith faeces# Bas formation (ithin
the tissues causes generalised s(elling of the &ody (hich is crepitant on palpation# The
distention is greatest (here the tissues are loose, particularly involving scrotum, penis,
la&ia ma=ora, &reasts, and face# The gases produced include hydrogen sulphide, methane,
car&on dio"ide, ammonia and hydrogen# The offensive odour is caused &y some of these
gases and &y small %uantities of mercaptans# )Ref# +9 at p# 55-#
The dus'y, greenish2purple face appears &loated (ith the eyelids s(ollen and tightly
closed, the lips s(ollen and pouting, the chee's puffed out, and the distended tongue
protruding from the mouth# The head hair and other &ody hair is loose at its roots and can
&e easily pulled out in large clumps# The finger and toenails detach, often (ith large
sheets of contiguous epidermis forming complete !gloves! or !soc's! 2 a process
descri&ed as !degloving!# The nec', trun' and lim&s are massively s(ollen, giving a
false impression of gross o&esity# 6inally, the putrid gases, (hich are under considera&le
pressure, find an escape and the (hole mass of decomposing soft tissues collapses#
Putrefaction progresses internally &eginning (ith the stomach and intestine# The gastric
mucosa and the intestines are discoloured a &ro(nish2purple# The mucosa of the air(ays
is a deep red and there is haemolytic plum2coloured staining of the endocardium and the
vascular intima (hich is most readily appreciated in the aorta and its ma=or &ranches#
;mall (hite granules 2 so2called !miliary pla%ues! 2 are seen rarely over the endocardium
and epicardium# )Ref# +: at p# 00-# The heart &ecomes fla&&y, the (all thinned, and the
myocardium a deep dirty red# A similar discolouration is seen in the liver and 'idneys#
The spleen &ecomes mushy and fria&le# The liver develops a honey2com& pattern
resulting from gas formation and similar changes may &e seen in the &rain, most readily
if it is fi"ed in formaldehyde prior to cutting# ;u&se%uently the &rain &ecomes semi2
li%uid# The lungs, loaded (ith sanguinous fluid, appear dar' red and are fria&le#
Bradually a great part of this sanguinous fluid is lost &y diffusion into the pleural
cavities# Diffusion of &ile pigments from the gall &ladder discolours the ad=acent liver,
duodenum and transverse colon# The capsules of the liver, spleen and 'idneys resist
putrefaction longer than their parenchymatous tissues (ith the result that these organs
are often converted into &ags of thic', tur&id, diffluent material# Progression of
decomposition is associated (ith organ shrin'age# The more dense fi&ro2muscular
organs such as the prostate and uterus remain recognisa&le until late in the process, thus
aiding in the identification of se"#
Perforation of the fundus of the stomach or lo(er oesophagus into the left pleural cavity
or the a&domen may occur (ithin a fe( hours of death# This is the result of autolysis
rather than &acterial putrefaction# An uncommon finding, it is most fre%uently associated
(ith cere&ral in=uries and terminal pyre"ias# )Ref# +5 at p# +9-# $t is occasionally
characterised as !neurogenic perforation of the oesophagus!#
There is considera&le variation in the time of onset and the rate of progression of
putrefaction# As a general rule, (hen the onset of putrefaction is rapid then the progress
is accelerated# ?nder average conditions in a temperate climate the earliest putrefactive
changes involving the anterior a&dominal (all occur &et(een /4 and 80 hours after
death# Progression to gas formation occurs after a&out one (ee'# The temperature of the
&ody after death is the most important factor generally determining the rate of
putrefaction# $f it is maintained a&ove 04oC )*:o6- after death then putrefactive changes
&ecome o&vious (ithin 05 hours and gas formation (ill &e seen in a&out 02/ days# )Ref#
4 at p# 9+-#
The putrefactive changes (hich have ta'en place up to this time are relatively rapid
(hen contrasted (ith the terminal decay of the &ody# <hen the putrefactive =uices have
drained a(ay and the soft tissues have shrun', the speed of decay is apprecia&ly reduced#
5' ADI%O-E)E
;aponification or adipocere formation is a modification of putrefaction characterised &y
the transformation of fatty tissues into a yello(ish2(hite, greasy, )&ut fria&le (hen dry-,
(a"2li'e su&stance, (ith a s(eetish rancid odour# Mant states that (hen its formation is
complete it has a s(eetish smell, &ut during the early stages of its production a
penetrating ammoniacal odour is emitted and the smell is very persistent# )Ref# 9 at p#
0,-# $t floats on (ater, and dissolves in hot alcohol and ether# <hen heated it melts and
then &urns (ith a yello( flame# @rdinarily it (ill remain unchanged for years#
Adipocere develops as the result of hydrolysis of fat (ith the release of fatty acids
(hich, &eing acidic, then inhi&it putrefactive &acteria# The lo( ):#,E- level of free fatty
acids in fat at the time of death may rise to 8:E or more &y the time adipocere is o&vious
to the na'ed eye# )Ref# 4 at p# 9/-# Ao(ever, fat and (ater alone do not produce
adipocere# Putrefactive organisms, of (hich Clostridium (elchii is most active, are
important, and aipocere formation is facilitated &y post mortem invasion of the tissues &y
endogenous &acteria# A (arm, moist, anaero&ic environment thus favours adipocere
formation# $t (as once thought that adipocere re%uired immersion in (ater or damp
conditions for its development# Ao(ever, the (ater content of a &ody may &e sufficient
in itself to induce adipocere formation in corpses &uried in (ell sealed coffins# )Ref# 9 at
p# 08-#
Adipocere develops first in the su&cutaneous tissues, most commonly involving the
chee's, &reasts and &uttoc's# Rarely, it may involve the viscera such as the liver# )Ref# 4
at p# 9/-# The adipocere is admi"ed (ith the mummified remains of muscles, fi&rous
tissues and nerves# The final product is of a larger &ul' than the original fat (ith the
result that e"ternal (ounds may &ecome closed and the pattern of clothing or ligatures
may &e imprinted on the &ody surface#
?nder ideal (arm, damp conditions, adipocere may &e apparent to the na'ed eye after /2
5 (ee's# )Ref# 9 at p# 08 and Ref# +0 at p# +8,-# @rdinarily, adipocere formation re%uires
some months and e"tensive adipocere is usually not seen &efore , or 4 months after
death# )Ref# +5 at p# 0/-# @ther authors suggest that e"tensive changes re%uire not less
than a year after su&mersion, or up(ards of three years after &urial# )Ref# +: at p# 0,-#
The medico2legal importance of adipocere lies not in esta&lishing time of death &ut
rather in its a&ility to preserve the &ody to an e"tent (hich can aid in personal
identification and the recognition of in=uries# The presence of adipocere indicates that the
post mortem interval is at least (ee's and pro&a&ly several months#
6' MUMMIFI-ATION
Mummification is a modification of putrefaction characterised &y the dehydration or
dessication of the tissues# The &ody shrivels and is converted into a leathery or
parchment2li'e mass of s'in and tendons surrounding the &one# The internal organs are
often decomposed &ut may &e preserved# ;'in shrin'age may produce large artefactual
splits mimmic'ing in=uries# These are particularly seen in the groins, around the nec',
and the armpits# )Ref# +5 at p# 0/-#
Mummification develops in conditions of dry heat, especially (hen there are air currents,
e#g# in a desert or inside a chimney# .e(2&orn infants, &eing small and sterile, commonly
mummify# Mummification of &odies of adults in temperate climates is unusual unless
associated (ith forced air heating in &uildings or other man2made favoura&le conditions#
The forensic importance of mummification lies primarily in the preservation of tissues
(hich aids in personal identification and the recognition of in=uries# The time re%uired
for complete mummification of a &ody cannot &e precisely stated, &ut in ideal conditions
mummification may &e (ell advanced &y the end of a fe( (ee's# )Ref# +: at p# 08-#
7' MA-E)ATION
Maceration is the aseptic autolysis of a foetus (hich has died in utero and remained
enclosed (ithin the amniotic sac# 3acterial putrefaction plays no role in the process# The
changes of maceration are only seen (hen a still2&orn foetus has &een dead for several
days &efore delivery# .ormally the changes ta'e a&out one (ee' to develop# )Ref# +: at
p# /+ and Ref# +9 at p# ,5-#
1"amination of the &ody needs to &e prompt since &acterial putrefaction (ill &egin
follo(ing delivery# The &ody is e"tremely flaccid (ith a flattened head and undue
mo&ility of the s'ull# The lim&s may &e readily separated from the &ody# There are large
moist s'in &ullae (hich rupture to disclose a reddish2&ro(n surface denuded of
epidermis# ;'in slip discloses similar underlying discolouration# The &ody has a rancid
odour &ut there is no gas formation#
8' 3IT)EOU! UMOU) %OTA!!IUM
The relationship &et(een the rise of potassium concentration in the vitreous humour and
the time since death has &een studied &y several (or'ers and recently revie(ed &y
Madea et al#, )6orensic ;cience $nternational )+9*9- ol# 5:, pp# 0/+205/-# An o&stacle
to using potassium concentration in vitreous humour as an aid in estimating the time
since death are the different 9,E confidence limits given &y different authors# ?p to +::
hours post mortem, the 9,E confidence limits of different authors vary &et(een I 9#,
hours up to I 5: hoursC in the early post mortem interval up to 05 hours, the 9,E
confidence limits of different authors varies from I 4 hours up to I +0 hours# There are
also sampling pro&lems in that the potassium concentration may differ significantly
&et(een the left and right eye at the same moment in time# ;imultaneous sampling of
&oth eyes has sho(n that the potassium concentration in one eye can deviate &y up to
+:E from the mean value of &oth eyes# $n order to improve the accuracy of the method
cases (ith possi&le ante2mortem electrolyte distur&ances can &e e"cluded &y eliminating
all cases (ith a vitreous urea a&ove an ar&itrary level of +:: mg7dl# )Aigh urea values in
vitreous humour al(ays reflect ante2mortem retention and are not due to post mortem
changes-# Aaving eliminated these cases (ith possi&le ante2mortem electrolyte
im&alance, there is a linear relationship &et(een potassium concentration and time after
death up to +0: hours, &ut the 9,E confidence limits are I 00 hours
)eferences
+# Gerr, 6orensic Medicine, 0nd edition, )+9/4-, A# J C# 3lac', Ltd#, London#
0# Rentoul and ;mith, Blaister>s Medical Kurisprudence and To"icology, +/th edition,
)+98/-, Churchill Livingstone, 1din&urgh#
/# <atson, 6orensic Medicine: A Aand&oo' for Professionals )+9*9-, Bo(er Press,
Aldershot#
5# Mason, 6orensic Medicine for La(yers, 0nd edition, )+9*/-, 3utter(orths, London#
,# Camps and Cameron, Practical 6orensic Medicine )+98+-, Autchinson Medical
Pu&lications, London#
4# Camps, Lucas, Ro&inson, Brad(ohl>s Legal Medicine, /rd edition, )+984-, Kohn
<right J ;ons, 3ristol#
8# Bee and <atson, Lecture .otes on 6orensic Medicine, ,th edition, )+9*9-,
3lac'(ell ;cientific Pu&lications, @"ford#
*# Gnight, Legal Aspects of Medical Practice, 5th edition, )+9*8-, Churchill
Livingstone, 1din&urgh#
9# Mant, 6orensic Medicine )+94:-, Lloyd2Lu'e )Medical &oo's- Ltd#, London#
+:# Polson, Bee and Gnight, The 1ssentials of 6orensic Medicine, 5th edition, )+9*,-,
Pergamon Press, @"ford#
++# ;impson and Gnight, 6orensic Medicine, 9th edition, )+9**-, 3utler J Tanner Ltd#,
London#
+0# Adelson, The Pathology of Aomicide, )+985-, Thomas, ;pringfield, $llinois#
+/# BonDales, ance, Aelpern, ?m&erger, Legal Medicine, Pathology and To"icology,
0nd edition )+9,5-, Appleton2Century Crofts, .e( Hor'#
+5# ;pitD and 6isher, Medicolegal $nvestigation of Death, 0nd edition, )+9*:-, Thomas,
;pringfield, $llinois#
+,# Kaffe, A Buide to Pathological 1vidence : 6or La(yers and Police @fficers, 0nd
edition, )+9*/-, Cars(ell Criminal La( ;eries, Cars(ell Ltd#, Toronto#
+4# 6isher and Petty )eds-, 6orensic Pathology: A Aand&oo' for Pathologists )+9*:-,
Castle Aouse Pu&lications, Tun&ridge <ells#
+8# 3o(den, 6orensic Medicine )+940- The Kacaranda Press, Mel&ourne#
+*# Pluec'hahn, 1thics, Legal Medicine and 6orensic Pathology )+9*/-, Mel&ourne
?niversity Press#
+9# Bordon, ;hapiro, 3erson, 6orensic Medicine: A Buide to Principles, /rd edition,
)+9**-, Churchill Livingstone, 1din&urgh#
0:# Pari'h, Pari'h>s Te"t&oo' of Medical Kurisprudence and To"icology : 6or
Classrooms and Courtrooms, 5th edition, )+9*4-, C3; Pu&lishers and Distri&utors, 3om&ay#
Time of Death 9 )ecent %u01ications:
+# <illey, P#, Aeilman, A#, 1stimating Time ;ince Death ?sing Plant Roots and ;tems,
Kournal of 6orensic ;ciences )+9*8- ol# /0, .o# ,, pp# +0452+08:#
0# Morgan, C#, .o'es, L#D#M#, <illiams, K#A#, and Gnight, 3#A#, 1stimation of the
Post Mortem Period &y Multiple2site Temperature Measurements and the ?se of a .e(
Algorithm, 6orensic ;cience $nternational )+9**- ol# /9, .o# +, pp# *929,#
/# ;par's, D#L#, @eltgen, P#R#, Gryscio, R#K#, and Aunsa'er, K#C#, Comparison of
Chemical Methods for Determining Post Mortem $nterval, Kournal of 6orensic ;ciences )+9*9-,
ol# /5, .o# +, pp# +9820:4#
5# Gominato, H#, Gumada, G#, HamaDa'i, G#, and Misa(a, ;#, 1stimation of
Postmortem $nterval ?sing Ginetic Analysis of the Third Component of Complement )C/-
Cleavage, Kournal of 6orensic ;ciences )+9*9-, ol# /5, .o# +, pp# 0:820+8#
,# Madea, 3#, Aenssge, C#, Aonig, <#, Ber&racht, A#, References for Determining the
Time of Death &y Potassium in itreous Aumor, 6orensic ;cience $nternational )+9*9- ol# 5:,
pp# 0/+205/#
4# Kaffe, 6#A#, ;tomach Contents and the Time of Death: Ree"amination of a Persistent
Question, American Kournal of 6orensic Medicine and Pathology )+9*9- ol# +:, .o# +,
pp# /82 5+#
8# Aenssge, C#, Death Time 1stimation in Case <or': $# The Rectal Temperature Time
of Death .omogram, 6orensic ;cience $nternational )+9**- ol# /*, pp# 0:920/4#
*# ;tephens, R#K#, Richards, R#B#, itreous Aumour Chemistry: The ?se of Potassium
Concentration for the Prediction of the Postmortem $nterval, Kournal of 6orensic ;ciences
)+9*8- ol# /0, .o# 0, pp# ,:/2,:9#
Copyright +99,# Derric' K# Pounder, ?niversity of Dundee