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Eponyms in forensic pathology


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The phenomenon of eponymous terms in forensic pathology is described in this paper. The authors analyzed representative textbooks (monographs) dealing with forensic pathology in both English and German and identified several eponymous terms. The paper aims to present to the reader the most important eponymous terms in forensic pathology. Included in the paper are the following terms: Beckwith's Sign, Casper's Rule, Krönlein's Shot, Lichtenberg's Figures, Nysten's Law, Paltauf's Spots, Puppe's Rule, Sehrt's Sign, Simon's Sign, Sveshnikov's Sign, Tardieu's Spots, Wischnewski Spots, Wydler's Sign. The spread of eponymous terms throughout various languages is mentioned. The linguistic basis of such terms as well as their advantages and disadvantages in specialist fields, and indeed in even wider circles, is discussed. The authors state that the main function of these terms is to facilitate the open flow of unambiguous information among scholars. Eponymous terms in forensic pathology are characteristic for the German speaking countries and for all countries influenced by the German school of forensic pathology. Their usage in the Anglo-Saxon world is much less widespread, meaning they do not occur very often in English monographs and textbooks.
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Eponyms in forensic pathology
Pavel Nec
ˇas Petr Hejna
Accepted: 27 February 2012
ÓSpringer Science+Business Media, LLC 2012
Abstract The phenomenon of eponymous terms in forensic
pathology is described in this paper. The authors analyzed
representative textbooks (monographs) dealing with forensic
pathology in both English and German and identified several
eponymous terms. The paper aims to present to the reader the
most important eponymous terms in forensic pathology. Inclu-
ded in the paper are the following terms: Beckwith’s Sign,
Casper’s Rule, Kro
¨nlein’s Shot, Lichtenberg’s Figures, Nysten’s
Law, Paltauf’s Spots, Puppe’s Rule, Sehrt’s Sign, Simon’s Sign,
Sveshnikov’s Sign, Tardieu’s Spots, Wischnewski Spots,
Wydler’s Sign. The spread of eponymous terms throughout
various languages is mentioned. The linguistic basis of such
terms as well as their advantages and disadvantages in specialist
fields, and indeed in even wider circles, is discussed. The authors
state that the main function of these terms is to facilitate the open
flow of unambiguous information among scholars. Eponymous
terms in forensic pathology are characteristic for the German
speaking countries and for all countries influenced by the
German school of forensic pathology. Their usage in the Anglo-
Saxon world is much less widespread, meaning they do not
occur very often in English monographs and textbooks.
Keywords Forensic pathology Terminology Eponym
Communication Language for special purposes
Eponyms are terms of designation derived from proper
names. In medical terminology, they occur in all branches,
thus they occur in designations for anatomical structures,
surgery, methods of treatment, various pathological states,
symptoms, syndromes, examinations, laboratory methods,
drugs, instruments etc. [1].
The aim of this text is to present basic eponymous terms
used in the literature of forensic pathology.
Materials and methods
Representative textbooks (monographs) dealing with forensic
pathology were analysed. We concentrated on books in
English and German, namely Knight’s forensic pathology [2],
Spitz and Fisher’s medicolegal investigation of death [3],
Sudden death in the young [4], Handbuch gerichtliche Med-
izin [5], Vademecum Gerichtsmedizin [6], Forensische Med-
izin fu
¨r Studium und Praxis [7]andPraxis Rechtsmedizin [8].
In this study, only eponymous terms specific for forensic
pathology were described; eponymous terms typical for
general pathology and other branches were omitted.
In the textbooks, we identified several eponymous terms
that are commonly used. Their occurrence in the mono-
graphs varies.
Representative monographs in English (Knight’s foren-
sic pathology,Spitz and Fisher’s medicolegal investigation
P. Nec
ˇas (&)
Department of Languages, Faculty of Medicine
in Hradec Kra
´, Charles University in Prague,
ˇimkova 870, 500 38 Hradec Kra
´, Czech Republic
P. Hejna
Institute of Legal Medicine, Faculty of Medicine and University
Hospital in Hradec Kra
´, Charles University in Prague,
ˇimkova 870, 500 38 Hradec Kra
´, Czech Republic
Forensic Sci Med Pathol
DOI 10.1007/s12024-012-9328-z
of death,Sudden death in young) present the terms Beck-
with’s Sign,Lichtenberg’s Figures,Puppe’s Rule,Pal-
tauf’s and Tardieu’s Spots. Fundamental monographs in
German (Handbuch gerichtliche Medizin,Vademecum
Gerichtsmedizin and Forensische Medizin fu
¨r Studium und
Praxis) present these terms: Casper’s,Nysten’s,Puppe’s
¨nlein’s Shot,Paltauf’s,Tardieu’s,Wischnewski
Spots,Sehrt’s,Simon’s,Sveshnikov’s and Wydler’s Sign.
Presentation of eponymous terms
Beckwith’s Sign (Beckwith Zeichen)
John Bruce Beckwith (1933) is an American pediatrician
and pediatric pathologist. Beckwith is renowned for his
description of certain congenital disorders (including tha-
lidomide embryopathy) and he is the author of the first
definition of SIDS. In 1988, Beckwith described a reduced
number of petechiae in the rear upper part of the thymus in
dying children in relation to SIDS in the study Intratho-
racic petechial hemorrhages: a clue to the mechanism of
death in sudden infant death syndrome? published in the
journal Annals of the New York Academy of Sciences.
Beckwith’s sign (ecchymoses subcapsulares partis superi-
oris posterioris thymi irrepertae/nullae) indicates a
reduced amount, or a complete absence of, petechiae in the
rear upper part of the thymus over the course of the
brachiocephalic vein in SIDS (Fig. 1). This phenomenon is
explained by the local protective role of the above-men-
tioned vein prior to changes in intra-thoracic pressure [4].
Casper’s Rule (Casper Regel)
Johann Ludwig Casper (1796–1864) was a German med-
ical examiner. In 1858, he explained patterns of putrefac-
tive decomposition in the human body in his publication
Praktisches Handbuch der gerichtlichen Medizin,2Ba
(Berlin 1858). His nephew was the famous German med-
ical examiner Carl Liman (1818–1891). Casper’s rule
determines the speed ratio of human body putrefaction in
the air, in water and underground (approximately 8:2:1).
The differences in the speed of putrefactive changes are
based on the dissimilar amount of oxygen in the air, water
and underground [9].
¨nlein’s Shot (Kro
Rudolf Ulrich Kro
¨nlein (1847–1910) was a prominent
German surgeon. Brain evisceration of a gunshot wound to
the head by a military rifle was described by prof. Kro
in 1899 in his publication Beitrag zur Lehre der Scha
¨sse aus unmittelbarer Na
¨he mittels des schwe-
izerischen Repetier-Gewehrs Model 1889.Kro
¨nlein’s shot
(evisceratio cerebri sclopetaria totalis) indicates a prolapse
of an intact brain hemisphere or, more rarely, of both brain
hemispheres in high velocity missile injuries to the brain
(muzzle velocity [600–800 m/s) during close-range
shooting (Fig. 2). Originally, this phenomenon was
described in wartime gunshot injuries to the head. Kro
lein’s shot is explained by fierce expansion of muzzle gases
in the skull cavity [10].
Lichtenberg’s Figures (Lichtenberg Blitzfiguren)
Georg Christoph Lichtenberg (1742–1799) was a German
physicist and scientist. In 1799, Lichtenberg described the
specific branching pattern found in solid materials when
exposed to high voltage levels. Lichtenberg’s figures (also
called lightning figures or keraunographic signs) are typi-
cal for injuries inflicted by high voltage lightning or elec-
tric shock (Fig. 3). These figures are specific skin lesions in
the form of tree-like reddish-brown patterns (maculas)
arranged on the surface of the skin. Their formation is
explained by the paralysis of capillaries and the thermal
denaturation of erythrocytes. In survivors these figures
usually disappear within 24 h [11,12].
Fig. 1 Beckwith’s sign, showing decreased numbers of petechiae in
the posterior cervical portion of the thymus gland in a SIDS case
(interrupted line)
Forensic Sci Med Pathol
Nysten’s Law (Nysten Regel)
Pierre Hubert Nysten (1771–1818) was a French pediatri-
cian and physiologist. In 1811, Nysten scientifically
described the postmortem muscle stiffness phenomenon in
his publication Recherches de physiologie et de chimie
pathologique (Paris 1811). Postmortem muscle stiffness,
according to Nysten’s Law, proceeds from the head
downwards (in craniocaudal direction). The stiffness first
develops in masticatory muscles and then continues to the
facial and neck muscles. Finally, the stiffness develops in
the upper and lower extremities. This type of muscle
stiffness, known as ‘‘descendent,’’ is common [13].
Paltauf’s Spots (signum Paltaufi; Paltauf Flecken)
Arnold Paltauf (1860–1893) was an Austrian medical
examiner. From 1891 to 1893, Paltauf worked in Prague as
a professor at the German Charles-Ferdinand University.
Arnold Paltauf described petechial hemorrhages in the
publication U
¨ber den Tod durch Ertrinken in 1888.Pal-
tauf’s spots (suffusiones subpleurales pulmonum)
petechial hemorrhages located beneath the pulmonary
pleuras in both lungs, and appear in wet drowning (Fig. 4).
Compared to Tardieu’s spots, Paltauf’s spots are larger and
not as sharply defined due to hemolysis. In the literature,
they are also referred to as Rasskazov-Lukomskij spots,
named after the two authors who described them 28 and
19 years, respectively, prior to Paltauf. Lukomskij
(1841–1876) defined this phenomenon in the file O pjatn-
ach Tardmje pri zadus
ˇenii in 1869 [14].
Puppe’s Rule (Puppe’s Sign; Puppe Regel)
Georg Puppe (1867–1925) was a notable German social
physician and medical examiner. Puppe explained the
importance of fracture principles as they relate to the skull
in the text Traumatische Todesursachen in the publication
Gerichtliche Medizin in 1903. Puppe’s rule applies in cases
of skull injuries (a flat bone) caused by several shots. In
such cases the fracture lines created by every other shot
extend only up to the fractured lines produced by the
previous shot(s) (Fig. 5) without intersecting or continuing
over them (this generally applies to injuries inflicted by
blunt objects) [15].
Sehrt’s Sign (Sehrt Magenschleimhautrisse)
Sehrt Ernst (born in 1879) was a German physician. Sehrt
discussed the issue of micro-ruptures of gastric mucosa in
the articles Vorgang des Ertrinkens,seine Beka
¨mpfung und
¨tung and Zur Frage des Ertrinkungstodes und seiner
¨mpfung, published in the journal Mu
¨nchener Mediz-
inische Wochenschrift in 1932 and 1933, respectively.
Sehrt’s micro-ruptures of gastric mucosa (rupturae parv-
ulae mucosae curvaturae ventriculi minoris) are considered
a secondary corroborative finding in wet drowning.
Fig. 2 Bursting of the skullcap with complete exenteration of the
¨nlein’s shot (in a case of a suicidal contact shot to the right
temple inflicted by a hunting rifle)
Fig. 3 Lichtenberg’s figures (keraunographic markings) of the left
arm in a case of lightning strike
Alternatively, more explicit suffusiones subpleurales loborum
omnium pulmonum.
Forensic Sci Med Pathol
Typically, these ruptures are arranged radially and found
with predilection in the lesser curvature of the stomach.
Their formation accounts for the stretching of the stomach
due to the swallowed liquid (water). The diagnostic sig-
nificance of this sign is questionable [7,14].
Simon’s Sign (Simon Zeichen)
Axel Simon (1931) is a German medical examiner.
Simon described hemorrhages in intervertebral discs in an
original study entitled Vitale Reaktionen im Bereich der
¨ule beim Erha
¨ngen in 1968, published
in the proceedings Wissenchaftliche Zeitschrift der
¨t Halle-Wittenberg. Simon’s sign
(haemorrhagiae subligamentales parvae ligamenti longi-
tudinalis anterioris) is a designation for minor hemor-
rhages beneath the anterior longitudinal ligament in the
intervertebral discs of the lower thoracic and lumbar spine
(Fig. 6). These hemorrhages occur typically in hanging.
Their formation is associated with rostrocaudal elongation
of the spine due to the neck’s suspension in the noose,
agonal spasms, and decorticate rigidity with extension of
the trunk and lower extremities. Simon’s signs are not
specific for asphyxia. They may also occur in violent
deaths associated with direct or indirect injuries involving
hyperextensive spinal injuries. In cases of natural death,
Simon’s sign rarely occurs [1618].
Sveshnikov’s Sign (Sveschnikov Zeichen)
ˇeslav Alexandrovic
ˇ(1918–1988) was a
Russian medical examiner. Sve
ˇnikov described his find-
ings in the article U
¨ber ein neues Zeichen zur Diagnostik
des Ertrinkens in 1965, published in the proceedings
Fig. 4 Blurred petechial hemorrhages located beneath the pleura of
the left lung in a case of hypotonic drowning—Paltauf’s spots
Fig. 5 Illustration of Puppe’s rule—three gunshot injuries to the skull
with fracture lines
Fig. 6 Simon’s sign—hemorrhages beneath the anterior longitudinal
ligament in the intervertebral discs of the lumbar spine in a case of
complete hanging
English spelling Sveshnikov or German spelling Sweschnikov can
be also used.
Forensic Sci Med Pathol
Berichte der 2. erweiterten Konferenz des Gerichtsmediz-
iner des no
¨rdlichen Kaukasus. Sveshnikov’s Sign (liquor
sinuum paranasalium) is an additional diagnostic finding in
wet drowning and indicates the presence of free liquid in
the paranasal sinuses (most commonly in both the maxil-
lary and sphenoid) [19,20].
Tardieu’s Spots (or Ecchymoses; Tardieu Flecken)
Auguste Ambroise Tardieu (1818–1879) was a French
pathologist and medical examiner. Tardieu systematically
described petechial hemorrhages beneath the pulmonary
pleura and the parietal pleura in asphyxia in 1859. Tar-
dieu’s spots (ecchymoses subpleurales pulmonum) desig-
nate petechial hemorrhages beneath the pulmonary and
parietal pleura developing in mechanical asphyxia (Fig. 7).
It should be emphasized that these small petechiae can also
be found beneath the epicardium (ecchymoses subepicar-
diales) and beneath the thymus capsule (ecchymoses sub-
capsulares thymi—generally beneath serous membranes).
These ecchymoses are not pathognomonic exclusively in
mechanical forms of asphyxia but form a typical part of the
so-called visceral congestion syndrome. In Anglo-Saxon
medico-legal literature, vibices on the skin are often
incorrectly identified as Tardieu’s spots. In addition, bat-
tered child syndrome (CAN) is also sometimes identified as
(Ambroise) Tardieu syndrome in the literature.
The synonym for the Tardieu’s Spots is the term
Bayard’s ecchymoses (Henri-Louis Bayard, 1812–1852, a
French medical examiner). Petechial hemorrhages
beneath the pulmonary pleura and the parietal pleura in
asphyxia had already been explained by Ambroise
Tardieu [21].
Wischnewski Spots (signum Visnevski; Wischnewski Fleck)
Semen Matvejevic
(1849–1922) was a Russian
medical examiner. Hemorrhages and erosion of the gastric
mucosa in deaths associated with hypothermia were
described in the journal Newsletter for Hygiene, Legal and
Practical Medicine in 1895. Vis
ˇnevskij had already dis-
covered the connection between hypothermia and the
presence of these erosions in 1886. Wischnewski spots
(haemorrhagiae punctatae mucosae ventriculi) are pete-
chial hemorrhages and erosions in the gastric and duodenal
mucosa characteristic of death due to hypothermia (Fig. 8).
These erosions may occur in ectopic gastric mucosa, e.g. in
the esophagus or small intestine. The spots are not entirely
specific for hypothermia; they are found in 40–90 % of
hypothermia cases [2225].
Wydler’s sign (Wydlers Zeichen)
Ferdinand Wydler was a medical examiner. Wydler pub-
lished his findings in the file Zur Diagnose des Ert-
rinkungstodes in 1869.Wydler’s sign is an auxiliary
diagnostic autopsy sign found in relation to wet drowning.
It indicates the presence of the foamy, liquid stomach
content of a drowned person (Fig. 9). After the collection
and sedimentation of the gastric content in a positive
finding, this sign typically consists of three basic compo-
nents, or levels—foam on the top, liquid in the middle and
a solid component at the bottom [14].
Eponymous terms have their appropriate place in forensic
science, especially traditional eponymous terms with fixed
meanings which have been recorded in representative
textbooks and encyclopaedias.
The creation and use of these eponymous terms is
determined by the historical conditions of each country.
Eponymous terms in forensic pathology are character-
istic for the German speaking countries and for all coun-
tries influenced by the German school of forensic
pathology. Their occurence in the Anglo-Saxon language is
much smaller, meaning they do not occur very often in
English monographs and textbooks. This fact influences
not only their distribution but also the stabilization of their
meanings among scholars [26].
The economical nature of eponyms and their simple
form in terms of being able to recall them are their biggest
Fig. 7 Sharply demarcated petechial hemorrhages beneath the pleura
of both lung (Tardieu’spots) in a case of ligature strangling
The spelling Wischnewski can also be used.
Forensic Sci Med Pathol
linguistic advantages, i.e. Simon’s Sign instead of haem-
orrhage beneath the ligamentum longitudinale anterius.
Eponymous terms stand out in texts as a result of the
capital letters used in proper names as well as the use of
italics and bold-print. Their unusual form when compared
with general terms also makes them stand out.
Special eponymous terms are used mostly by erudite
scholars who are accustomed to using them on a daily
basis. Outside of this group of scholars, explicit explana-
tory terms are preferred [27,28].
The main function of eponymous terms is to facilitate the
open flow of unambiguous information among scholars.
Eponymous terms must not be a communication barrier
when used by non-medical scholars interacting with forensic
pathology (judges, police, prosecutors, lawyers etc.).
Key points
1. Eponymous terms in forensic pathology occur both in
textbooks and papers.
2. Eponymous terms are characteristic for the German
literature of forensic pathology.
3. Eponymous terms must not be a communication
barrier when used by non-medical scholars.
4. Eponymous terms have an appropriate place in scien-
tific communication.
Acknowledgments The authors wish to acknowledge Prof. Roger
W. Byard (University of Adelaide, Australia) for providing Fig. 1,
and Olga Bukac
´(Charles University, Prague, Czech Republic) and
Jana Hercova
´(National Medical Library, Prague, Czech Republic) for
their kind help.
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Forensic Sci Med Pathol
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An accident occurred at a construction site and a 27-year-old worker was fatally injured. Equipped with personal protective equipment (helmet and a safety belt), he was standing on an 8-meter-high platform holding a large hose that was attached to a pipe connected to a concrete pump truck. Whilst in use the pipe broke and the hose sent the man flying with force, knocking down the platform railing. Autopsy examination showed that man fell to the ground landing on his head. Prominent Simon’s hemorrhages were noted on the L5-S1 and L4-L5 intervertebral discs. When the hose threw the man from the platform, for one brief moment he was suspended in the air, with the safety belt tied firmly to his waist. Simon’s hemorrhages most probably emerged at that moment, due to forceful hyperextension and traction of the body in the upside-down position. A relatively unexpected appearance of Simon’s hemorrhages contributed to the reconstruction of the injury mechanism.
... Das Trommelfell, dem N. laryngeus superior, dem N. trigeminus [Ebbe cke-Reflex], der Nasenschleimhaut [Goltz-Reflex] und/oder Wasserdruck auf den Bulbus [Aschner-Bulbusdruck-Reflex]). Tödliche, beimter agonaler Atemanstrengungen [25] (● " Abb. 4c), Tab. 1 u Lebzeiten entstandene vitale äußere und innere makromorphologische Befunde bei aus dem asser geborgenen Leichen als Hinweis für Ertrin- kungstod. ...
Ertrinkungsunfalle stellen die weltweit dritthaufigste Ursache unfallbedingter Todesfalle in allen Altersklassen dar; die Dunkelziffer ist moglicherweise noch erheblich hoher. Entsprechend haufig sind derartige Ereignisse in der notfallmedizinischen und rechtsmedizinischen Routine zu beobachten. Die Stadien und Begrifflichkeiten, welche die pathophysiologischen Vorgange beim Ertrinkungsunfall beschreiben, variieren allerdings erheblich innerhalb der beteiligten Fachdisziplinen. In der vorliegenden Arbeit werden entsprechende Unterschiede und Gemeinsamkeiten, nicht nur bezuglich der Stadieneinteilungen, sondern auch der fur relevant erachteten Pathophysiologie, aufgezeigt.
Nach der Feststellung von Schleimhautrissen im Magen bei 4 Ertrunkenen hat sich Erich Fritz im Jahr 1931 zur Veröffentlichung seiner systematischen Beobachtungen und einer ersten Erklärung für das Zustandekommen dieser Läsionen entschlossen. Innerhalb weniger Jahre folgten weitere gleichlautende Fallberichte, und schon bald stand fest, dass es sich um einen neuen Ertrinkungsbefund handelt. Heute werden Entstehung, Lage und Gestalt dieser Zerreißungen im Wesentlichen übereinstimmend beschrieben. Es ist höchste Zeit, den sich ausbreitenden falschen Begriff „Sehrt’sche Schleimhautrisse“ zu eliminieren und durch den korrekten Terminus Fritz-Zeichen für Risse der Magenschleimhaut bei Ertrunkenen zu ersetzen.
We have investigated the usefulness of elemental analysis by energy-dispersive X-ray spectroscopy (EDX) in the examination of free liquid from the sphenoid sinus of drowning victims. We detected both chlorine and bromine in liquid taken from the sphenoid sinus of seawater drowning victims. Because these elements were below the quantification limit in freshwater cases, we could easily distinguish seawater from freshwater drowning cases. Detection of these elements from the liquid in the sphenoid sinuses of drowning victims may be useful as a supportive measure for seawater drowning.
Die Praxis der Rechtsmedizin – das erfolgreiche Praxisbuch für Gerichtsmediziner, Juristen, Kriminologen, Medizinstudenten und Ärzte aller Fachrichtungen jetzt in der 2. Auflage! Ein Kind kommt zur Welt – der Vater ist unbekannt. Menschen kommen zu Schaden – oftmals bleibt der Tathergang ungeklärt. Die moderne Gerichtsmedizin ermöglicht es dem Arzt, Licht in das Dunkel zu bringen. Die 2. Auflage der "Praxis der Rechtsmedizin" bietet Ihnen eine nach aktueller Gesetzeslage und neuestem Stand der gerichtsmedizinischen Praxis einen umfassenden Überblick über Methodik und rechtliche Grundlagen des Fachs. Durchweg farbig gestaltet und mit zahlreichen Fallbeispielen und Checklisten ausgestattet, ist der Madea ein praktischer Leitfaden und eine erhellende Lektüre für alle, die beruflich oder auch im Studium mit der Gerichtsmedizin in Berührung kommen. Praxis der Rechtsmedizin – geballte Information für ein spannendes Fach!
Determining the cause of death in children and young adults can pose considerable challenges. Professor Byard provides for the first time a complete overview of pathological aspects of sudden death in the young, from before birth to middle adult life. Highly illustrated with more than 800 colour figures, this third edition contains new sections on sexual abuse, pregnancy-related deaths and rare natural diseases, as well as expanded coverage of unexpected death in young adults up to the age of 30 years. Chapters are organised by systems and cover all aspects of natural death, as well as accidents, suicides and homicides. Supported by extensive referencing and numerous tables, the book can also be used as a practical autopsy manual. An encyclopaedic overview and analysis of sudden death in the young, this is a key text for pediatric and forensic pathologists, pediatricians, and lawyers and physicians involved in medicolegal cases.
Morphologische Befunde des Todes durch Unterkühlung variieren von Fall zu Fall und sind überwiegend unspezifisch. Wesentliche Determinante für den Ausprägungsgrad morphologischer Unterkühlungszeichen scheint die Expositionsdauer zu sein. Typische Unterkühlungsbefunde sind Kälteerytheme, hämorrhagische Magenschleimhauterosionen, Nierentubulusverfettungen, Pankreasblutungen usw., die als Einzelmerkmale, insbesondere aber in der Kombination von Kälteerythemen und Magenschleimhauterosionen, trotz ihrer Unspezifität geradezu unterkühlungstypisch sind und in anderem Zusammenhang nicht gefunden werden. Bei Fällen von Trockenhypothermie kann man in 2/3 der Fälle mit positiven Befunden rechnen, während bei Auskühlung im Wasser der Obduktionsbefund häufig negativ ist. Wesentliche pathogenetische Mechanismen der Unterkühlungsbefunde sind Störungen der Mikrozirkulation, rheologische Veränderungen durch Anstieg des Hämatokrit, Kältestress sowie Hypoxidose.
Anatomic lesions in fatalities due to hypothermia are variable and unspecific. If the body cooling is rapid and the duration of the cooling process until death short, necropsy findings can be scarce or even completely missing. Typical morphological signs in hypothermia are frost erythema, hemorrhagic gastric erosions, lipid accumulation in epithelial cells of renal proximal tubules, and pancreatic hemorrhage, which are—although unspecific as single findings—diagnostic regarding the circumstances of the case, especially when they are found together. Typical morphological findings can be found in two-thirds of cases. The main pathogenetic mechanisms are disturbances of microcirculation, changes of rheology, cold stress, and hypoxydosis.
Deaths due to the passage of electric current through the body are most often accidental, although suicides and homicides may occasionally occur. Electrical energy represents electron flow, or current, between two points with different potentials, measured in voltage. The amount of current is determined by the resistance of the conducting material. Electrocutions involving humans may be due to low voltages (<1000 V), high voltage (>1000 V), or to lightning. Deaths are caused by a direct effect of current on the heart, resulting in ventricular fibrillation, on respiratory muscles resulting in respiratory paralysis or on the brainstem respiratory centers. Deaths may also be caused by thermal effects of current, or by trauma or drowning associated with exposure to an electrical current, or to multiorgan failure complicating initial injuries. The autopsy assessment of possible electrocution is complicated by the non-specificity and subtlety of lesions. Victims may have classical targetoid electrical burns of the skin with central charring, surrounding pallor and hyperemic rims. There may also be adjacent nodules of burnt keratin due to arcing of current. Victims of lightning strikes may demonstrate the typical ferning pattern of Lichtenberg figures. Conversely, other cases, e.g., electrocutions occurring in water, may have no pathological indicators of electrical injury. For this reason, the investigation of possible electrocution requires careful evaluation of the death scene and assessment of the electrical safety of the building and any electrical equipment that had been used. Meticulous examination of all body surfaces for subtle electrical burns with histological sampling is also required. KeywordsElectrocution–Lightning–Electrical burn–Entry mark–Metallization–Forensic pathology