Low Down

  Though the majority of missile wounds are caused by firearms, other devices such as crossbows, captive-bolt guns, air weapons and even catapults can launch lethal projectiles. In the bombing deaths now so commonly associated with terrorism, missile fragments cause more deaths than the blast effects, so, overall, an understanding of projectile trauma is essential. With the exception of deceleration injuries, all mechanical trauma, whether punching, stabbing or kicking, is caused by the transfer of energy from an external moving object to the tissues and nowhere is this more obvious than in shooting. For damage to occur, some or all of the kinetic energy of the missile has to be absorbed by the target tissues, where it is dissipated as heat, noise and mechanical disruption. When a missile passes completely through soft tissues, it may retain much of its original kinetic energy and fail to transfer any appreciable amount to the tissues, which may remain relatively intact apart fro...

    Though nor usually a forensic problem, deaths associated   with pregnancy (other than criminal abortions) are intensively investigated in a-number of countries. In Britain, the Department of Health has had an ongoing 'Confidential Enquiry into Maternal Deaths' running for many years, which publishes valuable reports at 3-yearly intervals that have helped to clarify both the clinical and pathological aspects of the problem. The pathologist has an important role in furthering the understanding of the causes of death in pregnancy and after childbirth. A good autopsy is essential, with full histological examination and other ancillary investigations where necessary. Only in this way can the full range of causes of death be recognized, especially amniotic fluid embolism, which is a histological diagnosis. According to a recent estimation, about 26 million legal and 20 million illegal abortions are carried out yearly throughout the world. Forensic pathological interest ...

  The examination of living victims of sexual assaults is the province of the forensic physician or 'police surgeon', in places where such doctors exist. In many countries, any physician may be asked by the police to examine the victim of an alleged sexual offence, but this difficult and onerous task in the living victim is outside the experience of many pathologists - though in some jurisdictions, this function is combined with that of the forensic pathologist. Regrettably, a significant proportion of non-domestic homicides are associated with sexual offences, death occurring either because the woman rejects the sexual approaches or because a sadosexual motive colours an intended murder. The most common mode of killing is either pressure on the neck, head injuries, or, less often, stabbing. In some instances death may be the result of violence associated with the sexual activities themselves, especially in child victims when pelvic trauma may be the immediate cause of death. A...

  The major categories of wound previously described can be inflicted on any part of the body. In forensic practice certain areas are particularly vulnerable or have special medico-legal significance. Head injuries are so important that will be presented in sets of articles, but here consideration will be given to other regions, especially the chest and abdomen. The most important aspect is the relationship of the visceral contents to external landmarks. This is best described by reference to diagrams, where the relationship of pleural cavities, lungs, heart, mediastinum and diaphragm is depicted. It should be appreciated that, from the forensic aspect, the spleen and most of the liver and stomach are thoracic organs in that they lie largely beneath the costal margin, and are vulnerable to both stabbing and blunt injury to the chest. Penetrating injuries, especially by knife to the lower lateral wall of the thorax, may enter the peritoneal cavity as well as the pleural spaces, perf...