STUDY UNIT 4:

FORENSIC PATHOLOGY

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 FORENSIC PATHOLOGY FIELD OF

STUDY

Forensic pathology entails the study of the effects of:

 trauma;
 injury; and
 unnatural diseases on the human body.

The experts who work in forensic pathology are forensic pathologists; they
are particularly interested in accidental, suicidal and homicidal deaths
where tissue damage is the main finding.

It should be noted that cases of poisoning are also part of the field of
forensic pathology – it is highlighted separately because not all poisons
cause tissue damage.

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 CIRCUMSTANCES UNDER WHICH
DEATHS ARE SEEN AS
UNNATURAL

Based on the above study field demarcation forensic pathologists are

interested in deaths that could be classified as possibly unnatural.

Before we examine the circumstances under which deaths are considered

as unnatural, take note of the types of deaths that are considered natural,
such as dying of a heart attack, a stroke, kidney failure or complications
related to Covid-19.

Circumstances under which deaths are seen as unnatural (please note

that legal liability for an unnatural death is not what is relevant here; the
circumstances are):

 Deaths due to violence and the consequences of the injuries that

result in death. This could be cases of homicide (murder or culpable
homicide), suicide, or accidents (including a person who dies as a
result of hitting their head against an object after being playfully
pushed by a friend). Consequences of injuries that may result in
death include infections such as lung infections, blood clots through
the lungs and tetanus or rabies after a dog bite.

 Deaths resulting from external physical factors that impact on the

body, for example when individuals die in a vehicle accident, when

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 they are struck by lightning, or die during a natural disaster such as
a flood (e.g. drowning).

 Deaths resulting from the effect of a chemical substance, for

example when individuals die as a result of poisoning or a drug
overdose.

 When an anaesthetic was administered or the person had a surgical

procedure shortly before death. It includes all types of anaesthetic
(local or general) from for example deaths after administration of
local anaesthetic for tooth extraction to administration of a general
anaesthetic for large surgical procedures such as heart surgery.

 When a person dies suddenly without pre-existing illness or if the

death is unexplained. For example, a 23-year old person is required
by an insurance company, prior to selling a life insurance policy to
them, to go for a general medical check-up and tests. The person
receives a clean bill of health, but one week later dies of a heart
attack.

 Any death, including deaths that would otherwise be classified as

being "natural" where it is suspected that the death was due to an
act or neglect to act by any person including medical staff. An
example of omission to act is a person with no medical aid who
reports at a private hospital with severe chest pain, but is refused
medical assistance; the person subsequently dies of a heart attack
upon leaving the hospital. An example of an act is when a person
dies as a result of medication which is injected intravenously (in the
blood vessels) and it was meant to be injected into the muscle, such
a Bentyl which is used to treat stomach cramps.
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Importantly, in all of the above circumstances a post mortem
examination (autopsy) will be performed by a forensic pathologist

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 ROLE OF THE FORENSIC
PATHOLOGIST AT THE SCENE OF
DEATH

When a forensic pathologist attends a scene of death, their role is to:

 Pronounce/confirm the death.

 Determine the manner of death, which can be judged:

- natural;
- accidental;
- homicidal;
- suicidal; or
- undetermined.

 Determine the time of death, also known as the post mortem

interval, through studying the post mortem changes, which are:
- rigor mortis;
- hypostasis;
- cooling;
- decomposition; and
- insects which start a life cycle on the body.

 Obtain clues and information at the scene to clarify what occurred

at the scene of death.

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 OBJECTIVE INVESTIGATION OF THE
SCENE OF DEATH BY THE FORENSIC
PATHOLOGIST

First, the forensic pathologist must make sure all photographs have been
taken and sketches made (documentation).

Overall, looking for signs of a struggle is important, for example broken

objects, overturned furniture, broken branches and twigs, or trampled
ground.

In terms of a weapon the following observations are important:

1. If an obvious weapon is present:

 Note the position of the weapon in relation to the body as this

clue may be important to determine whether it was suicide or
homicide.
 Handle weapons with extreme care (preserve fingerprints,
blood, hair, fibres etc.)
 If a weapon is found in the hand of the deceased, note if it is
loosely held or tightly grasped. A very tight grasp may be
cadaveric spasm, which is crucial to decide if it was suicide.
Cadaveric spasm is explained later in the study unit.

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 2. If no obvious weapon is present at the scene:

 Homicide should be suspected.

 The forensic pathologist can also assist in determining the
most likely weapon by studying the wound characteristics, for
example a knife with a specific type of blade.

One of the important tasks of the forensic pathologist is to assist the

investigative process with an opinion about the cause of death and the
manner of death. At the scene of death, the cause of death may appear
to be due to a gunshot wound, stab wound, or blunt force trauma to the
head, which can only be confirmed after a complete autopsy at the
mortuary, including toxicological and other relevant microscopic
examinations to reveal the real cause of death. In terms of manner of
death, the pathologist will express an opinion based on their professional
experience and judgement if the death was natural, accidental, suicidal,
homicidal, or undetermined. Ultimately it remains the prerogative of the
prosecuting authority what steps need to be taken in terms of charging
and prosecuting someone. However, the forensic pathologist can be of
enormous help to reach a conclusion whether the death scene points to a
homicide or a suicide. Family members may want to conceal a suicide,
because some life insurance policies do not pay benefits when a policy
holder commits suicide. At the same time a murderer may attempt to
conceal homicide by staging a death scene to make the death appear like
a suicide. The forensic pathologist should therefore be aware of possible
signs at the death scene that individuals may have attempted to conceal
the manner of death for various reasons.

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The position of the body should be noted and whether the rigor mortis
and hypostasis match this position. This is also explained later in the study
unit.

Clothing should be examined with care:

 Tears, missing buttons, blood stains, and gunshot residue should

be observed. The distribution of gunshot residue and the measure
to which it is absorbed by clothing are of great importance to
determine the distance and direction from which a person was shot.
The position of bullet holes in clothing should also correspond with
the location of bullet wounds.
 Take note of buttons fastened incorrectly/awkwardly, unzipped
pants or underwear which was removed (also partially).
 Take note whether wounds were inflicted through clothes or on
bared skin. In general, it is accepted that suicide victims would inflict
wounds on their bare skin.

The amount of blood at the scene should be noted:

 This should be interpreted with great care (the average person has
4.7 – 5.5 litres of blood inside the body).
 The amount of blood should later make sense when an autopsy is
conducted.
 The amount of blood at the scene may indicate that the location
where the body is found is a secondary dumping site for the body,
and that there is a primary site where the murder actually occurred
where blood loss initially took place.

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 Preliminary examination of body:

 Look for self-defence wounds, which are usually inflicted on the

back of the forearms, arms, as well as palms of the hands and
fingers.
 Paper bags should be placed over the hands for possible biological
material under the nails.
 The body should be transported to the mortuary in a clean white
sheet and washed body bag to avoid cross-contamination of trace
materials between different bodies.

Although proper examination of internal and external genitalia to confirm

sexual assault (including swabs) takes place at mortuary, the forensic
pathologist should look for signs of sexual assault, such as removed
underwear, partially removed underwear and garments which are
awkwardly position or buttoned on the body.

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 TIME OF DEATH/POST MORTEM
INTERVAL
One of the tasks of the forensic pathologist is to assist in determining the
time of death as explained before (see p. 5 of this study unit).

Specific post mortem changes to the body assist with determining the time
of death, because the changes under normal circumstances occur quite
predictably (this means that the period of development can be foretold;
therefore, it assists the pathologist in estimating the time of death):
1. Post mortem changes used 0 - 48 hours after death:
 Rigor mortis (see pp. 12 – 18)
 Hypostasis (see pp. 19 – 22)
 Cooling of the body (see pp. 23 - 24)

2. Post mortem changes used after 48 hours:

 Decomposition (see pp. 25 – 31)
 Insects that start a life cycle on the body (see pp. 32 - 36)

Each of these post mortem changes will be discussed in the section which
follows. It should be noted that all the timelines for the post mortem
changes are heavily dependent on the deceased person’s physiology and
anatomy as well as their immediate environment. The post mortem
interval is of great concern in murder investigations, because establishing
a window period for death, excludes possible perpetrators and
substantiates witness testimony.

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 RIGOR MORTIS (RM)
Immediately after death there is first general muscle flaccidity in the body;
this means that at first the muscles are soft and limp/relaxed – this is
referred to as primary relaxation/flaccidity.

The period of flaccidity is followed by a period of rigidity in the muscles

called rigor mortis (RM) and is a standard occurrence after death (in other
words, it always occurs).

RM occurs as a result of the formation of lactic acid in the muscles and

causes the body to stiffen and limbs to be locked “in place”.

Study the first two photographs uploaded as separate files on ClickUP.

Photograph 1 titled “Rigor mortis (homeless person on bench)” depicts a
deceased homeless person on a park bench. RM has developed in the
deceased’s body. Should he, for example, be pushed over, the body will
remain in the position it is locked into.

Also peruse photograph 2 titled “Rigor mortis (in mortuary)”. The

deceased person observed in this photograph died of carbon monoxide
poisoning. He made a fire in a tin with coals in a poorly ventilated room,
drank too much alcohol and did not notice that he was slowly being
poisoned by the fumes caused by the burning coals. He was sitting on the
floor supporting his chin and arms on objects (table, bed and footstool)
next to him. The posture you observe him sitting in, is what RM looks like
(limbs locked into a specific position as a result of lactic acid formation in
the muscles).

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Under normal circumstances in South Africa (summer average
temperatures) the period of development, which is also known as the
“march of rigor mortis”, is as follows:

 2 – 4 hours after death: the first signs of RM become visible in

smaller muscle groups in the eyelids, facial muscles, neck, and
lower jaw.
 4 – 12 hours after death: RM develops throughout the body. The
order wherein it develops after the smaller muscle groups in the
stated order is the wrists and ankles, knees, elbows and hips.
 12 - 36 hours after death: The maximum peak of RM is reached
within 12 hours and persists (remains constant) in the body for
approximately 12 - 36 hours depending on circumstances.
 Over the course of the next 12 hours: RM gradually disappears
again in the same order it appeared; thus RM disappears in the
small muscle groups first. This period is also known as secondary
relaxation/flaccidity, and it occurs because the contacted muscles
begin to break down due to decomposition.

The period of development (onset and persistence) is subject to a number

of factors, but environmental temperature is the most important, for
example:

 If it is extremely hot, RM develops and disappears within 9-12

hours (because decomposition sets in earlier).
 If it is very cold, RM lasts for 3 - 4 days.

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Other factors than environmental temperature which may influence the
RM period of development (onset and persistence) are:

 In malnourished and severely underweight individuals, RM sets in

more rapidly, while in individuals with a high body mass (e.g.
morbidly obese individuals), RM will slow down.
 The onset of RM is accelerated in individuals who engaged in
strenuous physical activity immediately before death (e.g. a gym
workout).
 Any disease which raised the body’s temperature before death
accelerates the onset of RM (e.g. infections which caused fever).
 Rapid onset of RM is indicative of possible brain haemorrhaging,
epileptic seizure before death and strychnine poisoning.

RM can be manipulated by force (e.g. a hardened/stiff/rigid arm can be

pushed into a different position with the application of slight force).

The criminalistic value of RM is therefore the following:

 The pathologist can estimate the time of death because RM

develops (appears, persists and disappears) according to a
predictable timetable, which is also known as Nysten’s Law - see
the period of development under normal summer temperatures as
explained above.

 The pathologist can, by studying the posture of the body, determine

if there was movement of the body. If a body is found in an
unnatural position, movement of the body may be assumed after

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 RM had developed. Examine photograph 3 titled “Rigor mortis to
illustrate movement”. Note the left arm across the chest of the
deceased. The position of the arm is not natural and it may be
deduced that the body was moved after RM had developed (e.g.
approximately 12 hours after death). Remember that after death
there is first a period of flaccidity (limpness) in the muscles. The
arms across the chest is an indication that RM developed while the
deceased was lying on the right side of the body with the left arm
across the chest. The body was then picked up and perched against
a wall after RM developed (e.g. approximately 12 hours after death).
The arm in an unnatural position across the chest bears testimony
to the movement of the body.

A phenomenon that is not related to RM (and should not be confused with

RM) is the pugilistic posture, which quite commonly occurs in bodies that
were charred in a fire.
Exposure to severe heat causes coagulation of the muscle protein, which
results in the contraction (stiffening and shortening) of the muscles.
Such bodies assume a pugilistic posture, which looks like the position
boxers would take when defending themselves during a fight.
What is typically seen in charred bodies are arched backs, elevation of
the arms, flexed elbows, clenching hands into fists, and mild flexion of the
knees and hips.
The skin is leathery, hard and frequently presents with long splits, which
resemble incised wounds (caused by a sharp instrument).
It is important to note is that the body would assume this posture even if
death occurred before being exposed to the extreme heat source.

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RM should also not be confused with cadaveric spasm (CS); although it
is also a state of rigidity/stiffness, it is much more intense in rigidity than
RM.

It should be noted from the onset that CS is a very rare phenomenon;

therefore, because of its rarity it is very valuable when it does occur; more
specifically it tells an important story about the circumstances under which
a person died.

CS is also called instantaneous rigor mortis, cataleptic rigidity, or the

death grip.

CS occurs when the tense muscles at the time of death, retain their tense
state immediately after death and persists into the period of RM.

In other words, there is no period of development (rigidity in specific

muscles is immediate).

It is most often observed in the isolated muscles of the arm and hand;
therefore, CS is also called the death grip

If CS occurs, an object being clenched in a hand, will be very difficult or

mostly impossible to release from the hand

In other words, manipulation of the muscles in cases of CS would be

impossible.

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CS is linked to some traumatic deaths (not all, remember it is a very rare
phenomenon) during which intense physical and emotional strain are
experienced.

When CS is identified in a body, it tells an important story about the

circumstances a person died under.

CS has been documented before under the following circumstances:

 If a victim is thought to have committed suicide, and the weapon is

grasped so tightly in the hand that it is not possible to remove the
weapon, it is taken as sufficient proof that it was suicide (it should
be noted that it does not occur in all suicides, it remains a very
uncommon phenomenon). Examine photograph 4 titled “Cadaveric
spasm” carefully. It depicts an older person who committed suicide
by cutting his own throat. Note the one blade in his right hand is still
inserted into the neck. Further examination will reveal another knife
in his left hand. This is what cadaveric spasm looks like. It would not
be possible to loosen the grip of his hands on the knives to
retrieve the two weapons through manipulation of the muscles (thus
the death grip).

 Homicides where buttons, hair or pieces of clothing (e.g. a pocket

torn off a shirt) are found grasped tightly in victims’ hands.

 Drowning and mountain accidents where stones, grass and

branches are found grasped tightly in victims’ hands

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  Car, airplane and train accidents where victims are found grasping
onto objects (e.g. steering wheel, seats, cell phones etc.).

 Deaths on the battlefield in wartime.

A further important aspect to note is that RM still develops independently

from the CS in the body as normal.

CS will disappear when the full effect of decomposition sets in (thus under
normal circumstances after approximately 48 hours).

Critical thinking activity: Based on the above, can you distinguish

between RM and CS? When you answer this question, reflect on the
following and contrast the differences in a table – see below (NB! Write
full explanatory sentences in the table to highlight the differences).

 Can both be used to determine time of death (explore the period of

development)?
 Can both be manipulated (e.g. force hardened/rigid arm or hand
open or into different position)?
 Are both equally common? Under which circumstances do RM and
CS occur?
 Where in the body does the two phenomena occur?

Rigor mortis Cadaveric spasm

Time of death? Time of death?
Manipulation? Manipulation?
How common? How common?
Body parts? Body parts?

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 HYPOSTASIS

Hypostasis is also called livor mortis or hypostatic congestion.

Before hypostasis is explained, reflect on the following:

 The function of a beating heart in a living person is to circulate

blood.
 A deceased person’s heart does not beat.
 What happens to the blood in the blood vessels of the deceased
person if the heart is not circulating the blood any longer?

With the above in mind, hypostasis is described as the purplish-red

discoloration of the most dependent parts of the body (lowest points) after
the heart stopped beating, where blood settles/pools in the blood vessels
under the influence of gravity.

The purplish-red discolouration occurs because the haemoglobin in the

blood is not carrying oxygen anymore (deoxygenated blood).

Where pressure is exerted by the weight of the body against a surface,

the blood vessels are compressed and consequently blood cannot flow
into those areas of the body.

These compressed areas on the body will turn pale next to the purplish-
red areas where the blood accumulates/pools (e.g. a body lying on its

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back will have pale patches where the body is making contact with the
floor). These pale patches are called contact pallor or contact blanching.

Examine photograph 5 titled “Hypostasis colour”. Take note of the pale

patches on the deceased’s chest and the purplish-red accumulation of the
deoxygenated blood alongside the pale patches. The pale patches
illustrate the areas of the body that were in contact with the surface (blood
vessels under pressure due to weight of body) when hypostasis
developed. The photograph illustrates that the deceased was lying on his
stomach and chest when hypostasis developed.

Also study photograph 6 titled “Hypostasis pale patches on chest”.

Although the purplish-red colour is not observable in a person with a dark
skin, the pale patches are noticeable. Judging by the pale patches on the
deceased’s chest in this photograph, it is also evident that he was lying
on his stomach and chest when hypostasis developed.

Similarly, in a hanging body hypostasis would be most pronounced in the

legs and feet due to the force of gravity.

For hypostasis there is also a predictable period of development:

 1 – 2 hours after death the first signs will be noticed.

 4 hours after death hypostasis will be well developed.
 8 – 12 hours after death hypostasis will reach a maximum peak.
 After 12 hours, hypostasis will fixate due to the coagulation (clotting)
of the blood (explained below).

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If the body is moved between 6 – 10 hours after death, the blood has not
coagulated yet (in other words the blood is still fluid).

This means that blood will flow away to the new dependent areas (the
blood will re-pool), if the body is moved into a new position; thus signs of
primary and secondary hypostasis will be observed.

Whether or not hypostasis is fixed can be determined by the so-called

blanching test, which entails that the thumb of the observer is pressed on
the livid area (where the blood pooled) for approximately a minute and ten
released. If the area becomes pale after the thumb is removed, the
hypostasis is not fixed, whereas if the area remains purplish-red the
hypostasis is fixed.

However, after 12 hours the blood coagulates and hypostasis becomes

fixated (does not change); thus if a body is found with hypostasis
development and pale patches that do not match the position the body is
found in, it is assumed that the body was moved after 12 hours into a new
position. Revert to photograph 3 titled “Rigor mortis to illustrate
movement” – note the pale patches (indicated with small arrows) on the
right upper and lower arm, right side of the stomach area, and the right
thigh. Besides the RM observed in the left arm across the chest, bearing
testimony to movement of the body, the pale patches and hypostasis on
the right side of the body also testify to the movement of the body.

The criminalistic value of hypostasis therefore is as follows:

 Because there is a predictable period of development, it can be used

to estimate the time of death.
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  It is helpful to determine movement of the body when hypostasis
development does not correspond with the position the body is
discovered in.

 Additionally, the colour of hypostasis can be indicative of the cause

of death, for example:

- Cherry-red hypostasis is usually observed in cases of carbon

monoxide.
- Pink hypostasis is usually observed in cases of cyanide
poisoning and deaths as a result of hypothermia (cold
temperatures).
- Brown hypostasis is typically seen in cases of nitrate poisoning
(e.g. strychnine).

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 COOLING OF THE BODY

The post mortem cooling of the body is also called algor mortis.

During algor mortis the body temperature lowers until it matches

environmental temperature.

Three distinct periods of algor mortis are identified:

1. The initial phase or temperature plateau when the temperature

remains relatively stable for 30 minutes to three hours.
2. The intermediate phase in which the body cools rapidly and at a
relatively linear rate.
3. The terminal phase when the rate of body cooling slows as the core
temperature reaches the environmental temperature

The rate of cooling down is subject to variation; this means that several
factors can influence the rate at which a body cools down, for example:

 The difference between body temperature and environmental

temperature - the greater the difference between the temperature of
the body and the environment, the faster the cooling rate.
 The body will cool down faster if the surrounding area is well
ventilated or humid.
 Clothing will isolate the body and slow the rate down.
 Body weight – in the absence of fatty tissue the rate will accelerate.

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Therefore, a fully clothed obese person will cool down slower than a naked
thin person in the same environment.

It should be noted that after the body has cooled down to reach
environmental temperature, the cooling rate is no longer useful to
estimate the time of death.

What is also important is that the post mortem interval cannot be

accurately estimated during the first three to five hours after death due to
the effect of the actual body temperature at death and the length of the
temperature plateau following death.

However, models to calculate the post mortem interval are very accurate
within the first 18 hours after death (one-hour accuracy either side of the
actual time of death).

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 DECOMPOSITION
Decomposition involves two different processes namely:

 Autolysis, or aerobic decomposition, which begins immediately

after death is not visible to the naked eye and is also known as the
fresh stage of decomposition. During autolysis the cells inside the
body begin to leak enzymes into the surrounding tissue, and the
bacteria, which are still living in the intestines, begin to consume the
internal organs. As a result, blisters filled with fluid appear on the
skin several hours after death. Insects (the most common being
blowflies) have a very keen sense of smell and will be attracted to
the body because of these chemical processes – see the next
section.

 Putrefaction, or anaerobic decomposition, which is the process of

decomposition that is visible to the naked eye. This process is
separated into the bloating phase, the decay phase, the post decay
phase, and the dry stage.

The first phase of putrefaction is known as the bloating phase. The first
noticeable sign is 2 - 3 days after death when a greenish discolouration
appears on the lower abdomen in the vicinity of the right hipbone where
most of the bacteria in the intestines are present in the caecum (the first
part of the large intestines in the abdomen). The superficial blood vessels
also appear green through the skin, taking on a mosaic-like appearance
and named the marbling effect. This greenish discoloration spreads over
the entire abdomen soon and later the entire body. Also, gas formation

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as a result of the chemical changes inside the body, causes the stomach
to start bloating. It is these gasses, mainly hydrogen sulphide, ammonia,
carbon monoxide, and methane, which cause the unpleasant smell of
death. The tongue and eyes may also protrude as a result of the pressure
of the gasses inside the body and the intestines may be pushed out of the
rectum. As a result of the pressure on the diaphragm, it pushes upwards
resulting in the lungs being squeezed to the extent that froth oozes from
the mouth and nose. The abdomen may burst as a result of the pressure
exerted by the gasses. This bloating process continues for approximately
5 – 6 days.

The phase which follows bloating is the decay phase and lasts for
approximately 11 days. During this time the body takes on a wet
appearance as fluids start to drain from the natural body orifices (e.g.
eyes, ears, nose, mouth, and rectum), and the sweat pores. The internal
organs have broken down (also known as liquefaction), which produces
the fluids which drain from the body. The drainage of fluids is called post
mortem purging.

The decay phase is followed by the post decay phase and begins around
the 12th day after death. Most of the flesh would have been consumed (by
insects or other animals) or have decomposed. Therefore, this phase is
also known as the start of skeletonisation.

The last phase of decomposition is known as the dry stage and begins
approximately 3 to 4 weeks after death. It involves the decomposition of
the dry remains, usually the bones, nails, hair, cartilage, and dehydrated
skin. Specific insects start a life cycle on the remains at this stage, in
particular beetles, which use the remains as a source of food. Other

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insects like house moths will also start a life cycle on the dry tissue of at
mummified body and the hair, being particularly interested in feeding on
the keratin in hair.

It should be noted that the time it takes for a body in open air to be reduced
to a skeleton varies between three weeks up to several years depending
on circumstances like environmental temperature, humidity, and the
presence of insects and other animals which use the body as a source of
food.

In terms of insects and animals that feed on an unburied body, thus

contributing to faster skeletonisation, the following should be noted
(however, it is important to understand that these insects and animals do
not start a life cycle on the body like the blow fly):

 Cockroaches and ants produce post mortem injuries to bodies when

using the body as a source of food. Cockroaches in infested and
unhygienic dwellings cause superficial erosion of the upper layers
of the skin. Bodies disposed of in sandy areas are attacked by ants
that also eat the upper layers of the skin, producing injuries which
look like abrasions. This may be misinterpreted as a sign that the
body was dragged over a rough surface. However, the absence of
linear patterns, and presence of clear circular bites, assist in making
a finding.
 Terrestrial animals like rats, dogs and cats choose to eat soft
exposed tissue around the eyes, ears, lips, and genitals. Moreover,
they tend to choose areas to eat areas of the body where the skin
is already broken; thus, wounds sustained ante mortem (before
death) will be enlarged. However, the fact that this occurs post
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 mortem (after death) results in no active haemorrhaging (bleeding).
Therefore, it is not difficult to determine that wounds were enlarged
post mortem by such animals; however, the wound characteristics
which contribute to identifying a weapon, is destroyed.
 Bodies disposed of in water are also used as a source of food by
aquatic animals. Leeches in particular attach themselves around the
eyes which produce lesions that resemble a black eye (looks like
the person received a severe beating to the eyes). Similar to
terrestrial animals, turtles, crabs, and fish eat tissue around the
eyes, nose, ears, and genitals, as well as around ante mortem
wounds where the skin is already broken. The injuries produced by
turtles are misleading in particular as they resemble wounds that
look like abrasions caused by a blunt instrument. Carnivorous sea-
birds (e.g. seagulls) produce small holes on the skin with their beaks
which looks like shotgun wounds.

There is much disagreement about the timeline for decomposition,

because there are so many internal and external factors which can affect
the rate of decomposition.

A number of factors can either speed decomposition up or delay it, for

example:

 Sepsis (severe infection throughout body) before death may cause

faster decomposition.
 The hotter and more humid the environmental temperature, the
faster decomposition will occur. Optimal temperature for
accelerated decomposition is between 25 and 38 degrees Celsius.

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  In bodies with multiple external open injuries, decomposition is
accelerated.
 A body in open-air will putrefy faster than one which is buried or
submerged in water. “Casper’s dictum” states that a body
decomposes twice as fast in open air than a body submerged in
water; and eight times faster than one buried in soil.
 If the temperature of the body is low, the onset and rate of autolysis
will be retarded, while higher temperature caused by fever or high
levels of exertion prior to death, will accelerate the rate and onset of
decomposition.

The criminalistic value is that a pathologist can study the above stated
phases of decomposition to assist in determining the post mortem interval.

Two phenomena that may arrest the progression of putrefaction and are
both tied to the rapid drying of the body (loss of fluids/dehydration) in the
first few days after death, are mummification and adipocere, which will be
discussed below:

1. Mummification

The below process should not be confused with the deliberate

mummification of bodies by the Egyptians, because it is a natural
process.
In a dry atmosphere, a body may lose fluids so rapidly (dehydrate), that
it dries out before normal decomposition can proceed as discussed
previously.
The rapid elimination of fluids from the tissue, circumvents the process
of bacterial putrefaction explained earlier.

29
 In such instances the skin shrinks and is converted into a parchment-
like mass of skin which surrounds the bones – mummified tissues are
rigid and hard.
The natural mummification process takes approximately 6 to 12 months
to conclude; but in extreme conditions the time can be rapidly reduced.
Mummification persists for decades, and even centuries; therefore, the
body goes into a state of preservation.
Of significance is that external marks on the skin, such as strangulation
marks, remain preserved in the skin which becomes like leather.
What may complicate findings is that as a result of the shrinking of the
skin, large tears/splits may occur in the groin and neck-area, which
mimic injuries sustained before death and may lead to
misinterpretation.

2. Adipocere
Under moist conditions, body fat (triglycerides in paricicular) converts
into a substance which is described as soapy, waxy, greasy, cheese-
like.
The process of conversion is defined as the saponification of body fats
into grave wax or corpse wax, and the colour is typically off-white to
grey.
Adipocere can persist for decades, even centuries; therefore, the body
goes into a state of preservation.
Burial ground which is acidic, where enough moisture is present, and
oxygen absent (exposure to oxygen inhibits adipocere), can result in
adipocere.
Types of soil where bodies may develop adipocere are peat bogs
(characterised by acidic soil), which are wetlands where dead plant

30
 material accumulates; for this reason, such bodies are also called bog
bodies.
Similar to mummification, it allows for the preservation of marks and
injuries on the skin.
The phenomenon is most pronounced in body parts which contain more
fat, such as the cheeks, buttocks, and breasts of women.
Adipocere is also more common in women, toddlers, and obese
individuals, because they have more body fat.
Adipocere formation in the cheeks of a deceased can assist in personal
identification of a body years after burial.
It is seen as a complicating factor because once it sets in, it becomes
very difficult to estimate the post mortem interval.
Depending on environmental conditions, adipocere may be observed
as early as five weeks after death; however, as a rule the presence of
adipocere is usually an indication of a post mortem interval of at least
three to six months.
The manifestation of adipocere in buried bodies depends on a variety
of factors such as the geographical location of the burial site; the
season of the burial; vegetation surrounding the burial site; depth of the
grave; insect infestation before burial (a body that is accessible to
insects is unlikely to form adipocere); the composition of a coffin, if
used; and the chemical and physical soil properties.
Adipocere is also often observed in bodies that were submerged in
water for a long period of time (e.g. bodies captured in shipwrecks).

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 INSECTS THAT START A LIFE CYCLE
ON THE BODY
It should be noted that the word “blowfly”, is a colloquial name used to
describe a number of flying insects in the Diptera family and comprises of
mainly bluebottles, greenbottles, and houseflies.

The most common blowfly which invades human remains in South Africa,
is the bluebottle.

The below life cycle is generic (depending on circumstances) for the

Diptera family of flying insects, and therefore the colloquial name blowfly
will be used in the discussion below.

The blowfly has a keen sense of smell for the gasses of decomposition.
See photograph 7 titled “Blowfly”.

Blowflies start to deposit their eggs within minutes after death around the
eyelids, nose, mouth, ears, genitals, anus and open wounds thus
choosing the moist and warm spaces of the body; the eggs are visible as
yellowish-white collections of eggs.

Eggs may even be deposited on the living if they are weakened or injured
severely and cannot move to chase the blowflies away from them.

Each fly can deposit up to 300 eggs – see photograph 8 titled “Blowfly
eggs”.

32
The eggs hatch within 12 - 24 hours in optimal environmental
temperatures; hence when estimating the post mortem interval, the
meteorological (weather conditions) conditions should, subsequent to the
crime, be studied with great care as the life cycle can be dramatically
altered by climatic conditions.

The eggs hatch into maggots that use body as a source of food – see
photograph 9 titled “Maggots feeding on flesh”.

The maggots go through three phases (called instars) during an eating

frenzy; their anterior ends (front) are fortified with mouth hooks with which
they rake in decaying flesh shredded from the body:

 Instar 1: maggots grow to 5mm long within 1.8 days.

 Instar 2: maggots grow to 10mm long within 2.5 days.
 Instar 3: maggots grow to 14 -16mm long within 4 to 5 days.

Between each instar the maggots shed their skins, because they grow so
fast.

The maggots develop spiracles (rings) around their posterior side (back)
after each instar.

After instar 3 (in other words 4 – 5 days), the maggots become too heavy
to hold on to the body and fall to the ground; at this stage they have grown
to 17mm long and have reached maturity.

They now migrate in a pre-pupal phase to a suitable site (usually the soil
around the body); they stop feeding; and develop into pupae within
33
approximately 4 days - this means the maggots develop a hard brown
shell around them – see photograph 10 titled “Pupal phase of the blowfly”

In favourable conditions (warm temperatures), an adult blowfly emerges

from the pupal phase within 6 to 8 days.

In less favourable conditions (in winter in countries where very cold

temperatures prevail), the pupal phase can last the entire winter season.

The blowfly which emerges from the pupal phase is ready to start the
whole cycle from afresh within 2 days after emerging from the pupal phase
(start laying eggs again).

The absence of eggs or maggots on a body is also very useful as this can
indicate that a body was sheltered in a place which was inaccessible to
flies – for example, on partially buried body, maggots may be found only
on the protruding parts of the body.

The criminalistic value of studying the insects which start a life cycle on
the body is as follows:

 The forensic pathologist can study this life cycle to assist in

determining the post mortem interval and in particular, the
minimum time the person has been dead. If needed, the help of a
forensic entomologist should be enlisted to assist with the
interpretation of the findings. An example where a forensic
entomologist’s help was enlisted is explained below (this case is
considered a watershed moment for forensic entomology in South
Africa):
34
 In July 1999 in Johannesburg, Gauteng, the decomposing body of a young girl
was found in the veld seven weeks after she went missing. The 8-year-old girl
had disappeared while being looked after by her neighbour. The suspect, Albert
du Preez Myburgh, the neighbour's son, was charged with the girl's abduction
shortly after she disappeared. When the body was discovered he was also
charged with indecent assault and murder of the victim. Although Myburgh
admitted to kidnapping the girl and "fondling" her, he pleaded not guilty to
murder, maintaining that he was in jail when she died. This claim was refuted
by evidence presented in court by Dr Mervyn Mansell, a forensic entomologist,
who was able to determine the post mortem interval from insect specimens
collected from the girl's body. One of the flies found, namely the winter blowfly,
is unique in that it has a long lifecycle (up to eight weeks) and it lays eggs only
in the shade. This insect evidence enabled Dr Mansell to determine the time of
death, which happened to correlate with the time the girl went missing. These
findings, combined with other evidence, was used to convict Myburgh of
murder. You can read more about this case by clicking on the following link:

https://www.servamus.co.za/index.php/component/content/article/170-
servamus-sept-2020/570-forensic-entomology-using-bugs-to-solve-
crime?Itemid=109

 Maggots on a decomposing body can also contribute to identifying

that the deceased person ingested specific drugs prior to their death
– barbiturates (sleep-inducing and anxiety decreasing drugs),
morphine, benzodiazepines (psycho-active drugs to treat anxiety),
and antidepressants have amongst other been identified in
maggots, which may serve as pointers to intoxication by these
agents prior to death. In her research, Eunice Musvasva, a
postgraduate scholar at Rhodes University, determined that if
maggots are fed barbiturates, they grow slower, and if they are fed
steroids, they grow faster than usual. It has also been established

35
 that if a person dies from a cocaine overdose that was snorted, the
maggots in the nasal cavities of the body, will be larger than usual.

36
 NORMAL LEGAL PROCEDURE FOR A
POST MORTEM EXAMINATION
(AUTOPSY)

Revert to the circumstances under which a death will be considered

possibly unnatural as explained at the start of the study unit (pp. 3-4) to
remind yourself when an autopsy will be performed.

 An autopsy is performed by a forensic pathologist appointed by the

Department of Health.

 An autopsy is performed at a mortuary of the Forensic Pathology

Service of the Department of Health.

 The criminal investigator who is in charge of an investigation is

allowed to attend an autopsy.

 An autopsy is performed with the express request of a criminal

investigator or on instruction by a magistrate.

 The permission of family members is not required to perform an

autopsy, and they may also not deny the procedure.

 An autopsy is performed as soon as possible.

 An unidentified body remains in the freezers at the mortuary for 30

days, after which the municipal council under whose authority the

37
 mortuary is, has to ensure a pauper’s burial takes place for the
deceased.

38
WHAT OCCURS DURING A COMPLETE
POST MORTEM EXAMINATION OR
AUTOPSY?

All autopsies start with a description of the deceased’s physical

characteristics (external examination first), which includes
documentation of age, height, weight, sex, nutritional state, muscular
development, scars, and tattoos.

Injuries are documented, including the amount, size, characteristics,

shape, course, direction, depth and location of injuries. The following are
broadly the types of injuries/wounds observed in victims of trauma:

1. ABRASIONS
Abrasions are caused when the upper layers of the skin (epidermis) are
removed as a result of friction against a rough surface or compression.
Abrasions produced ante mortem (before death) are reddish-brown in
colour, and in a living person heal without scarring.
Abrasions produced post mortem (after death) are yellow, translucent,
and have a parchment-like appearance (hard and stiff).
It is not possible to determine whether superficial abrasions were
produced shortly before death or at some time thereafter.
Subtypes of abrasions are the following:
 Scratches caused by a sharp object passing across the skin moving
the epidermis in front of it and causing a heaped-up area of
epidermis, which indicates the direction of movement. The neck is
of particular importance in cases of strangulation. Manual
39
 strangulation is characterised by a series of linear or curved
abrasions caused by fingernails. Abrasions caused by fingernails
associated with throttling and strangulation are quite common and
are present in two types:
(i) Abrasions caused by the assailant’s fingernails appear as half-
moon configurations on the skin; and
(ii) Scratches in an irregular pattern caused by the deceased
approximately 2mm in width while struggling to release the neck-
grip.
Moreover, strangulation with a ligature (e.g. rope) typically produces
a linear mark which encircles the neck horizontally and may be
accompanied by fingernail abrasions as a result of the victim
struggling to remove the ligature. In contrast, in cases of hanging,
groove abrasions are produced in a V-shape rising towards the point
of suspension. During dissection later, the hyoid bone and cartilages
in the larynx are examined for signs of fracture, which can
strengthen the finding of manual strangulation. Haemorrhaging will
be noted at the site of the bone and radiographic examination can
confirm the fracture.
 Scrape or brush abrasions, also known as grazes, are caused when
a rough object comes into contact with the wider surface of the skin,
for example, when a body is dragged over rough ground.
 Impact, impression or pressure abrasions occur when blunt force
trauma is applied to the skin, thereby crushing the skin. A patterned
abrasion occurs when an object stamps, with enough severity, its
impression on the surface of the skin, which is useful to identify the
object which caused the abrasion. Examples are a shoe imprint
identified on the skin or vehicle tyre which runs over the skin.

40
  Friction abrasions are caused by linear pressure on the skin
accompanied by movement, which are often seen in cases of
hanging or strangulation. In cases of strangulation with a ligature
(e.g. rope), a linear mark which encircles the neck horizontally is
produced. In cases of hanging, groove abrasions are produced in a
V-shape rising towards the point of suspension.

2. CONTUSIONS
Contusions, also known as bruises, are blunt force injuries which cause
the veins and capillaries under the skin to rupture resulting in blood
escaping into the tissue beneath the skin.
The blood released from the veins and capillaries may travel a distance
from the site where the skin was struck by an object; therefore, the shape
of a contusion rarely reflects the shape of the object that impacted on the
skin.
Contusions become more obvious as time passes, which means that
contusions may not always be visible when pathologists first examine a
body.
It is further important to note that even microscopic examination of
contusions is inaccurate and unreliable to date the age of a contusion
(how long ago).
The degree of force required to produce a contusion is variable; for
example, a firm grip, a heavy blow with a fist, a kick with a heavy shoe, or
a blow with a blunt object can all cause contusions.
The amount of force applied and the agent/object used both influence the
appearance of contusions; however, certain other factors may also have
an effect on the appearance of a contusion, more specifically the
following:

41
  The location and tissue characteristics: Loose skin (e.g. around the
eyes) produces contusions more easily and more extensively.
Contusions are produced more readily over bony areas, where the
veins and capillaries are crushed between the object and the bone.
 Age: Older persons (as a result of poorly supported blood vessels)
and infants (as a result of the delicacy and looseness of the skin)
bruise easily.
 Sex: Women sustain contusions more easily than men as a result
of the fact that they have more fat under their skin. For the same
reason, obese people bruise more easily than individuals who are
not overweight.
 Texture and colour of the skin: Individuals with naturally blonde and
red hair are fair-skinned in general, and therefore contusions are
more obvious than in dark-skinned individuals.
 Disease: Chronic alcoholics suffering from liver disease, and
individuals suffering from leukaemia, haemophilia, Vitamin C
deficiency (i.e. scurvy), and degenerative cardiovascular disease
(which make the blood vessels more fragile) bruise more easily.

3. LACERATIONS
Lacerations are produced when the skin and tissue below the skin tears
as a result of excessive stretching.
It is often difficult to determine the type of instrument/weapon which
caused a laceration.
Lacerations can be produced as follows:
 Splitting of the skin occurs when the skin is crushed between two
hard objects (e.g. a heavy blunt instrument against the hard bone
of the skull will produce a laceration on the scalp).

42
  Overstretching of the skin produces lacerations when the skin is
stretched beyond the capability of the tissues to withstand the force
being applied. This type of laceration is often seen in victims of
vehicle accidents. A tear laceration is caused when during the
mechanism of overstretching, a body part touches a protruding
object (e.g. if a body is ejected from a vehicle in an accident and a
body part is thrown against a door handle).
 Grinding compression lacerations occur when the weight of a
rotating object against the skin, tears then skin off from the
underlying tissues and produces a pocket of fat and blood on the
site of the compression (e.g. when a tyre of a moving vehicle
passes over the abdomen of a person lying in the road).

4. INCISED WOUNDS
An incised wound, or cut, is caused by a sharp-edged instrument, such as
a knife, blade or shattered glass, which is drawn against the skin.
The length is usually greater than the depth of the wound.
As a rule, incised wounds have smooth, clean-cut edges.

5. PENETRATING WOUNDS
Penetrating wounds are caused by sharp or pointed instruments (e.g. a
knife or a sharp thin object like a needle or hatpin).
The depth of the wound is greater than the surface breadth of the wound.

6. CHOP WOUNDS
Chop wounds are produced by heavy sharp-edged instruments like axes,
hatches and pangas.

43
A cut is produced in the skin by the edge of the weapon, but the weight
thereof, and the force with which it is impacts on the skin, also produce
contusions at the margins of the wound.

Subsequent to the documentation of the wounds as explained above, the

autopsy proceeds with photographs being taken of the body for
identification purposes and to demonstrate external injuries.

Radiographic examination of the body is also part of a full autopsy (e.g.

to find broken bones and examine bullet wounds by following the bullet
track through the body and locating a bullet if still lodged somewhere
inside the body).

This is followed by the opening of the major body cavities (also known
as dissection), namely the cranium/skull, chest, abdomen, and spinal
canal, at which time the internal organs are inspected.

The following are of particular importance during the dissection

procedure:
 Inspection of the under-surface of the scalp after it was removed
from the skull. Bruises in this area give an indication of the
application of blunt force to the head.
 After removal of the roof of the skull, blood clots should be noted.
 The skull should be inspected for fractures.
 The eyes, and upper and lower eyelids should be examined for
petechial haemorrhages (tiny pinhead sized points of bleeding
which occur in cases of hanging and strangulation).

44
  The interior of the mouth, lips, cheeks, and ear canals should be
examined for signs of trauma. Blood in the ear canals may indicate
a fracture to the base of the skull.

Organs are removed for separate examination and dissection.

Abnormal sized organs are weighed.

Laboratory specimens are taken for further analysis (e.g. suspected

poisoning).

Abnormal collections of fluid are measured (e.g. blood collected and

measured in chest cavity if deceased bled internally).

45