In cases of homicide or suspicious death, in medieval England, the coroner, an appointed official who had no medical training, was required to make "a view of the body," a legal, visual inspection. Since then, medical professionals have played an increasingly important role in making views of the body. Physicians and surgeons have developed methods of seeing into the body through autopsy and post-mortem examination—making visible what the untrained, unequipped eye cannot see.

Preliminary incision from Post-mortem Manual: A Handbook of Morbid Anatomy and Post-mortem Technique, Charles Richard Box, M.D., 1910 Courtesy National Library of Medicine

Post-mortem Examination

Post-mortem dissection, or autopsy, was among the earliest scientific methods to be used in the investigation of violent or suspicious death. Autopsy remains the core practice of forensic medicine. The postmortem examiner surveys the body's surface, opens it up with surgical instruments, removes parts for microscopic inspection and toxicological analysis, and makes a report that attempts to reconstruct the cause, manner, and mechanism of death. These clips from training films show some of the procedures of postmortem examination. Tools of the trade The post-mortem examiner visually surveys the body's surface before opening and entering the body with the help of a scalpel and other instruments. After visual examination of the body cavities, the examiner removes parts for chemical analysis, inspection with a microscope, and other tests. Tools and tool kits specially adapted for use in autopsy first appeared in the early 19th century. Forensic specimens For centuries, anatomical specimens from the bodies of crime victims have been used as teaching tools and souvenirs of interesting or important cases. These specimens demonstrate various types of traumatic wounds of the heart, kidney, and stomach. They were prepared in the 1930s by the New York City Medical Examiner's Office.

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The autopsy of President Abraham Lincoln

On April 14, 1865, the assassin John Wilkes Booth shot President Abraham Lincoln during a performance at Ford's Theatre in Washington, DC. After the President passed away on the following morning, his body was placed in a temporary coffin covered with an American flag, and returned by hearse to the White House, accompanied by a cavalry escort. At the White House, an autopsy was performed by Army Surgeons Edward Curtis and Joseph Janvier Woodward. Also in attendance were Surgeon General Joseph K. Barnes and a few military officers, medical men and friends. During the autopsy Mary Todd Lincoln sent a messenger to request a lock of hair; a tuft was clipped from the head for her. Dr. Curtis described the autopsy in a letter to his mother: Dr. Curtis described the autopsy in a letter to his mother: "The room…contained but little furniture: a large, heavily curtained bed, a sofa or two, bureau, wardrobe, and chairs….Seated around the room were several general officers and some civilians, silent or conversing in whispers, and to one side, stretched upon a rough framework of boards and covered only with sheets and towels, lay—cold and immovable—what but a few hours before was the soul of a great nation. The Surgeon General was walking up and down the room when I arrived and detailed me the history of the case. He said that the President showed most wonderful tenacity of life, and, had not his wound been necessarily mortal, might have survived an injury to which most men would succumb….Dr. Woodward and I proceeded to open the head and remove the brain down to the track of the ball. The latter had entered a little to the left of the median line at the back of the head, had passed almost directly forwards through the center of the brain and lodged. Not finding it readily, we proceeded to remove the entire brain, when, as I was lifting the latter from the cavity of the skull, suddenly the bullet dropped out through my fingers and fell, breaking the solemn silence of the room with its clatter, into an empty basin that was standing beneath. There it lay upon the white china, a little black mass no bigger than the end of my finger—dull, motionless and harmless, yet the cause of such mighty changes in the world's history as we may perhaps never realize.…[S]ilently, in one corner of the room, I prepared the brain for weighing. As I looked at the mass of soft gray and white substance that I was carefully washing, it was impossible to realize that it was that mere clay upon whose workings, but the day before, rested the hopes of the nation. I felt more profoundly impressed than ever with the mystery of that unknown something which may be named 'vital spark' as well as anything else, whose absence or presence makes all the immeasurable difference between an inert mass of matter owning obedience to no laws but those covering the physical and chemical forces of the universe, and on the other hand, a living brain by whose silent, subtle machinery a world may be ruled. "The weighing of the brain…gave approximate results only, since there had been some loss of brain substance, in consequence of the wound, during the hours of life after the shooting. But the figures, as they were, seemed to show that the brain weight was not above the ordinary for a man of Lincoln's size." Dr. J.J. Woodward's autopsy report, April 15, 1865 [A]ided by Assistant Surgeon E. Curtis, U.S.A., I made…this morning an autopsy on the body of President Abraham Lincoln, with the following results: The eyelids and surrounding parts of the face were greatly ecchymosed and the eyes somewhat protuberant from effusion of blood into the orbits. There was a gunshot wound of the head around which the scalp was greatly thickened by hemorrhage into its tissue. The ball entered through the occipital bone about one inch to the left of the median line and just above the left lateral sinus, which it opened. It then penetrated the dura matter, passed through the left posterior lobe of the cerebrum, entered the left lateral ventricle and lodged in the white matter of the cerebrum just above the anterior portion of the left corpus striatum, where it was found. The wound in the occipital bone was quite smooth, circular in shape, with bevelled edges. The opening through the internal table being larger than that through the external table. The track of the ball was full of clotted blood and contained several little fragments of bone with small pieces of the ball near its external orifice. The brain around the track was pultaceous and livid from capillary hemorrhage into its substance. The ventricles of the brain were full of clotted blood. A thick clot beneath the dura matter coated the right cerebral lobe. There was a smaller clot under the dura matter [sic] of the left side. But little blood was found at the base of the brain. Both the orbital plates of the frontal bone were fractured and the fragments pushed upwards toward the brain. The dura matter [sic] over these fractures was uninjured. The orbits were gorged with blood….

Instruments used in President Abraham Lincoln's autopsy, April 15, 1865

Courtesy National Museum of American History, Behring Center, Smithsonian Institution From top to bottom: metacarpal saw, double-ended probe, tongue tie, artery forceps

Autopsy kit used in President Abraham Lincoln's autopsy, April 15, 1865

Courtesy National Museum of American History, Behring Center, Smithsonian Institution

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The 19th-century revolution in forensic imaging

In the 19th century, forensic pathologists began using pictures and words to show how various conditions appear in the cadaver, and to teach students and colleagues new methods of analysis. Line drawings, half-tone photography, and chromolithography, which could render coloration, texture, and subtle shading, became increasingly common as improvements in print technology made detailed illustrations cheaper to produce.

“Murder the Result of Various Injuries,” Atlas of Legal Medicine, Eduard Ritter von Hofmann, M.D., chromolithograph by A. Schmitson, 1898

Courtesy National Library of Medicine Plate 15, Figure 101. Murder the Result of Various Injuries Inflicted with Different Instruments. On January 5th, at midday, B.K. , aged 38 years, after having been heard screaming, was found in her room lying in a pool of blood and dying. Beside her stood her lover, with a bloody carving knife in his hand....The evidence collectively considered justifies the assumption that the deceased was first felled with a flat-iron, and that as she lay prostrate upon the floor she was struck numerous additional blows with it; that at the same time her ribs were fractured by her chest being knelt upon or by her being kicked; that directly thereafter the injuries to the neck were produced by blows with the carving-knife; and that death resulted from hemorrhage. The culprit was condemned to death by hanging, but his sentence was commuted to imprisonment for life.

“Suicide by Cutting the Throat,” Atlas of Legal Medicine, Eduard Ritter von Hofmann, M.D., chromolithograph by A. Schmitson, 1898

Plate 16. Suicide by Cutting the Throat. The case was that of a young man in his twentieth year, who cut his throat in his room with a sharpened pocket-knife. He was found dead, on his back, in a moderate-sized pool of blood, his right hand covered with blood, and beside this a bloody pocket-knife. After cleansing the body the skin was not especially anemic, the post-mortem lividity fairly well developed, the visible mucous membranes not particularly pale, the wound of the neck running transversely from the middle of one sterno-cleido-mastoid muscle to the other.... [D]eath was not due to a fatal hemorrhage, but resulted from suffocation consequent upon entrance of the blood from the wound into the larynx and the lower respiratory passages.

“Encircling Gunshot Wound in Brain,” Atlas of Legal Medicine, Eduard Ritter von Hofmann, M.D., chromolithograph by A. Schmitson, 1898

Courtesy National Library of Medicine Plate 20. Encircling Gunshot-wound. An interesting example of deflection of the projectile from the direction of the shot, or of the so-called ricochet-shot, within the body, is the so-called encircling-shot. This is produced when a shot, striking an arched bone obliquely, travels around it. Such gun-shot wounds have been observed not only on the convexity of arched bones...but also on their concavity. The case illustrated in Plate 20 belongs to the latter category. The case was that of a young man who had killed himself with a shot from a revolver of 7 mm. caliber. The projectile perforated the skin of the right temporal region directly in front of the line of the growth of the hair, making a pea-sized blackened opening. It then coursed obliquely upward and backward through the temporal muscles and the great wing of the sphenoid bone into the outer part of the right Sylvian fissure; thence to the concavity of the right frontal vault. From this point it became directed anteroposteriorly around the entire convexity of the brain...

“Carbonic-oxide [carbon monoxide] Poisoning with agonal injuries due to a fall,” Atlas of Legal Medicine, Eduard Ritter von Hofmann, M.D., chromolithograph by A. Schmitson, 1898

Courtesy National Library of Medicine Plate 51. Carbonic-oxid Poisoning (Charcoal-fumes). On the morning of November 6th, the woman [pictured here], clothed only in a chemise and petticoat, was found dead before her bed, lying with her face downward. In her small room there was a basin containing half-consumed charcoal, by burning which she was accustomed to warm herself. At first view the peculiar color of the body is remarkable. As a consequence of the abdominal posture...this color has developed more especially on [the body's] anterior surface.... These lesions...rendered clear the diagnosis of carbonic-oxid poisoning; and this diagnosis was confirmed by an examination of the blood. Spectroscopic examination of the blood diluted with water revealed indeed two absorption-lines in the green part of the spectrum, and these were not essentially different from those of oxy-hemoglobin....

“Suicide through Stabbing,” Atlas of Legal Medicine, Eduard Ritter von Hofmann, M.D., chromolithograph by A. Schmitson, 1898

Courtesy National Library of Medicine This case is that of a physician who had taken his life in a hotel. His body was found lying upon the left side, behind and across the doorway of the room, so that at first it was not possible to open the barred door. The body was almost entirely covered with freshly coagulated blood, and clothed only with a shirt, which was saturated with blood, opened from the front, and thrown backward. Extensive blood-marks reached from the body to the bed, the covering of which was likewise saturated with blood, and beside which a large, open pocket-knife lay.... After cleansing the body six stab-wounds were recognized. Of these one was situated in the right side of the neck, the other five on the anterior surface of the chest. All of the wounds had a slit-like form, and showed throughout sharp, arched, separated edges, which on both sides joined to form acute angles and between which there was a collection of coagulated blood�. The uppermost [wound] was situated three fingers' breadth below the middle of the left clavicle. It penetrated directly anteroposteriorly the second intercostal space and ended in the lung, which was tuberculous.... That it was a case of suicide was demonstrated by the external circumstances and all the postmortem findings. It was clear that the deceased had produced the wounds while in bed, and that he had then attempted to arise and go to the door, where he fell.... [T]he opened and uninjured shirt, the symmetric disposition of the openings of the stab-wounds and of the course of the canal of the wounds, and the proximity of the wounds of the chest...were more indicative of suicide than of murder... The motive for committing the deed may have been the tuberculous disease.

“Bloodstain, blisters, and bullet holes,” Atlas zum Handbuch der gerichtlichen Medicin [Atlas for the Manual of Legal Medicine], Johann Ludwig Casper, M.D., Artist: Hugo Troschel, Lithographer: Winckelmann & Sons, 1864

Courtesy National Library of Medicine Medical professor Johann Ludwig Casper was perhaps the first author to use richly colored lithographs to illustrate forensic pathology. The plates show specific postmortem examinations, some of them experiments on cadavers.

“Head and Hand of Drownee,” Atlas zum Handbuch der gerichtlichen Medicin [Atlas for the Manual of Legal Medicine], Johann Ludwig Casper, M.D., Artist: Hugo Troschel, Lithographer: Winckelmann & Sons, 1864

Courtesy National Library of Medicine In atlases and manuals of legal medicine, 19th-century forensic pathologists used pictures and words to show students and colleagues their methodology—a precise inventorying of the condition of the victim's body. The chromolithograph, which could render coloration, texture and subtle shading, was particularly well suited to the task.

“Decomposed stomach,” Atlas zum Handbuch der gerichtlichen Medicin [Atlas for the Manual of Legal Medicine], Johann Ludwig Casper, M.D., Artist: Hugo Troschel, Lithographer: Winckelmann & Sons, 1864

Courtesy National Library of Medicine Medical professor Johann Ludwig Casper's richly colored lithographic plates illustrate specific postmortem examinations, some of them experiments on cadavers.

“Rope marks and upper thigh,” Atlas zum Handbuch der gerichtlichen Medicin [Atlas for the Manual of Legal Medicine], Johann Ludwig Casper, M.D., Artist: Hugo Troschel, Lithographer: Winckelmann & Sons, 1864

Courtesy National Library of Medicine Medical professor Johann Ludwig Casper's richly colored lithographic plates illustrate specific postmortem examinations, some of them experiments on cadavers.

“The color of the lungs of dead newborn children: stillborn, newborn who have taken a breath, newborn whose lungs have been artificially inflated,” Atlas zum Handbuch der gerichtlichen Medicin [Atlas for the Manual of Legal Medicine], Johann Ludwig Casper, M.D., Artist: Hugo Troschel, Lithographer: Winckelmann & Sons, 1864

Courtesy National Library of Medicine Medical professor Johann Ludwig Casper's richly colored lithographic plates illustrate specific postmortem examinations, some of them experiments on cadavers.

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Reading gunshot patterns

The mass manufacture of guns in the 19th century led to an epidemic of gunshot wounds incurred in wars, violent crimes, suicides, and accidents. The study of gunshot wounds became an integral part of criminal investigation and forensic pathology.

Skull showing gunshot trauma Male profile, 1950s

Courtesy National Museum of Health and Medicine

Skull showing keyhole gunshot trauma, about 1861-1865

Courtesy Civil War Collection, National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.

Heart of a 26-year-old man, perforated by a bullet, New York, 1937

Courtesy New York City Medical Examiner's Collection, National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C. Death attributed to homicide

Leg bone from the Ragsdale Gunshot Wound Study, 1984

Courtesy National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C. Human distal femur shot with a 510-grain lead Minié ball fired from a .58 caliber Springfield Model 1862 rifle.

Leg bone from the Ragsdale Gunshot Wound Study, 1984

Courtesy National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C. Human distal femur shot with a 55-grain, fully jacketed (M193) ball round fired from a 5.56 mm M16 A1 rifle.

Chest plates commissioned by Frances Glessner Lee, about 1940

Glessner Lee, about 1940 Courtesy Office of the Chief Medical Examiner, Baltimore, MD Mrs. Frances Glessner Lee, the heiress to the International Harvester fortune, had a passion for forensic science. As a teaching and reference tool, she made a series of ceramic plates that illustrate the typical wound patterns caused by gunshots fired from a variety of weapons at different distances. The six ceramic "chest plates" here, part of a much larger collection, show the wound patterns caused by a Smith & Wesson .38 revolver, with lead bullet, shot at various distances. The chest plates are used as teaching aids and for reference. From top to bottom and left to right the distances are: Contact, 1 inch, 3 inches, 6 inches, 18 inches and exit wound.

Ragsdale gunshot wound study

Pathologist Bruce D. Ragsdale conducted experiments in the 1980s to show the effects of different types of gunshots on human bone and tissue. He encased leg bones from cadavers in blocks of transparent gelatin and then fired different types of guns into the blocks. Each trial was filmed in slow motion so that the path of the bullet, shattering of bone, and shock waves could be analyzed in detail.

Beginning an Autopsy

New York University Medical Center, The Forensic Autopsy

Dissecting and Analyzing Body Parts

University of Calgary and the Office of the Alberta Attorney General, Investigating Sudden Death, vol. 1

Changes After Death

Physicians and surgeons first gained practical knowledge of death and decomposition through handling and dissecting bodies obtained for anatomical study. Over the course of the 19th and 20th centuries, the study of the decomposed body and body parts—the effects of time, environment, and manner of death—became a vital part of forensic science.

Fauna of the cadaver and time of death

In the 19th century, medico-legal researchers began studying patterns of insect colonization of the cadaver. Entomology, the study of insects, became one of the forensic sciences. By identifying the particular stages that insects go through as they develop on a dead body, and the succession of different species, forensic investigators attempt to determine where a victim died and estimate the time elapsed since death. These adult specimens represent some of the different insect species that colonize a cadaver.

The body farm: studying the science of decay

The Forensic Anthropology Center, at the University of Tennessee, Knoxville, conducts research into the postmortem decomposition of the human body. At the Center scientists study how variations in temperature, exposure, humidity and other environmental conditions affect cadavers and body parts. Their research has helped improve investigators' ability to estimate time of death and to identify individuals from skeletal remains. The Center also maintains a collection of documented human skeletons and has developed software that uses data from thousands of skeletons. Statistics from the database give investigators baselines that help them estimate the race, sex, and stature of unidentified bodies.

Partially decomposed corpse, 2003

Copyright Jon Jefferson, used by permission.

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Life Cycle of the Black Blow Fly

Adult female blow flies arrive within minutes to lay eggs on a cadaver. Each deposits about 250 eggs in the natural openings of the body and open wounds. The eggs hatch into first-stage maggots within 24 hours. These feed and then molt into second-stage maggots, which feed for several hours, and then molt into third-stage maggots. Masses of third-stage maggots may produce heat, which can raise the temperature around them more than 10° C. After more feeding, the third-stage maggots move away from the body and metamorphize into adult flies.

Life cycle of a black blow fly

Courtesy Cleveland Museum of Natural History

Blow fly maggot

Courtesy Cleveland Museum of Natural History

Blow fly puparium

Courtesy Cleveland Museum of Natural History

Larvae of different species move different distances from the body prior to pupariation, some as much as 8 meters. The larvae becomes shorter and stouter and the outer cuticle (skin layer) of the larvae hardens into the puparium and slowly darkens over a period of about 10 hours. Adults will emerge between 77 and 134 hours after pupariation depending on the temperature.

Blow fly (Phaenicia sericata)

Courtesy Cleveland Museum of Natural History

strong>Adult Black Blow Fly and Puparia (Phormia regina)

Courtesy Division of Entomology, Peabody Museum of Natural History, Yale University

Photomicrograph of mandibular sclerite of a maggot taken from remains, 1935

Courtesy University of Glasgow

Photomicrograph of left posterior stigma of a maggot taken from remains, 1935

Courtesy University of Glasgow

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Insect testimony

On September 21, 1986, the decomposing body of a 26-year-old woman was found inside a foul-smelling carpet near I-95 in Greenwich, Connecticut. Blow fly larvae were feeding on, and moving in and around, the body. Pale and dark brown blow fly puparia were recovered, along with 4,000 larvae, for laboratory study.

An autopsy revealed that the victim, Sylvia Hunt, had been stabbed 15 times. Forensic entomologist William Krinsky determined from climate and insect evidence that blow flies had deposited eggs on the corpse seven days earlier. The carpet pattern matched one in the room occupied by a suspect. The insect and carpet evidence helped convict him of first-degree murder.

Entomological evidence, September 22, 1986

Courtesy William L. Krinsky, MD, PhD

These third stage black blow fly (Phormia regina) larvae were recovered from the body of Sylvia Hunt, a murder victim found wrapped in a carpet on a Connecticut roadside.

strong>Dr. Krinsky's notes, Sylvia Hunt case, September 1986 - February 1987

Courtesy William L. Krinsky, MD, PhD

Dr. Krinsky's findings, Sylvia Hunt case, February 2, 1987

Courtesy William L. Krinsky, MD, PhD

Jurors Shown Result of Stabbing, August 4, 1990

Courtesy New Haven Advocate

Killer of Prostitute Faces 60 Years in Prison, August 29, 1990

Courtesy New Haven Register

Entomological evidence, September 22, 1986

Courtesy William L. Krinsky, MD, PhD

 

These black blow fly larvae were recovered in 1986 from the body of Sylvia Hunt, a murder victim found wrapped in a carpet on a Connecticut roadside.

Letter from Sgt. M. A. Ohradan, Connecticut State Police, to Dr. William Krinsky, Yale University, concerning timetable relating to the murder of Sylvia Hunt, September 30, 1986

Courtesy William L. Krinsky, MD, PhD

Letter from Sgt. M. A. Ohradan, Connecticut State Police, to Dr. William Krinsky, Yale University, concerning climatological data relating to the murder of Sylvia Hunt, September 24, 1986

Courtesy William L. Krinsky, MD, PhD

Climatological data chart relating to the murder of Sylvia Hunt, September 1986

Courtesy William L. Krinsky, MD, PhD

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Laboratory Views

Upon a View of the Body
Free Captivating portrait of a black pug gazing curiously, captured in monochrome. Stock Photo
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