Forensic Anthropology and Medicine || Decay Process of a Cadaver

Decay Process of a Cadaver

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Chapter 5

Decay Process of a Cadaver
João Pinheiro
Summary
Because forensic anthropologists and pathologists can be confronted in their professional practices with bodies or mortal remains in different states of preservation
and/or decay, it is essential for this book to have a chapter that fully documents the
pathway of a body from its death until disintegration.
The different ways a corpse can progress from putrefaction directly (or not) to
skeletonization, passing through conservation processes such as saponification or mummification are presented here, always taking into account the forensic relevance of each
stage, the time and conditions needed, as well as the duration. Full, illustrated examples
of cases that have contributed to solve forensic questions are provided. Factors that
might influence the speed of putrefaction and the interrelations—through chemical
reactions between these processes—are also debated.
Key Words: Decay; decomposition; putrefaction; saponification; adipocere; mummification; skeletonization; disarticulation; forensic; autopsies.

1. INTRODUCTION
It is common for forensic anthropologists and pathologists to be confronted in their professional practice with bodies or human remains states of
preservation and/or decay that are not entirely to their liking, such states being
outside their knowledge and experience. The forensic pathologist generally
feels more at ease with a fresh body, whereas the forensic anthropologist would
certainly prefer to work with dry bones. Ideally, the forensic anthropologist

From Forensic Anthropology and Medicine:
Complementary Sciences From Recovery to Cause of Death
Edited by: A. Schmitt, E. Cunha, and J. Pinheiro © Humana Press Inc., Totowa, NJ

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should always be called whenever a body appears whose morphological characteristics do not permit any identification. Such cases are usually in an
advanced state of decay: with adipocere, mummified, carbonized, skeletonized, or with a mixture of all of the; se. Indeed, the same cadaver may reveal
various states of preservation at the same time. This fact is closely connected
to the different transformations that may take place in a body from the moment
of death to skeletonization, upon the action of various extrinsic and intrinsic
factors, which are analyzed here.
For this reason, it is fundamental that the pathologist has prior knowledge of the various alterations that take place postmortem (the object of the
study of forensics called taphonomy). These alterations particularly affect the
soft tissues, and are decisive not only for the time taken for skeletonization to
occur, but also for the state of preservation of the cadaver (1). Between a
fresh cadaver and a heap of loose bones, there are a series of stages of decomposition and/or preservation that may occur when the environmental conditions are right. Various authors have drawn attention to the need to understand
this process (2,3), whereas some of the definitions of forensic anthropology
itself, such as the one of Bass (4), presuppose the existence of cases other
than those skeletonized: “…the science that focuses principally on the identification of remains that are more or less skeletonized, in the legal context.”
This journey along the taphonomic process will certainly be useful in its
earlier stages for anthropologists that are not used to working with almostfresh cadavers, and in the final phase (skeletonization) for pathologists, who
are normally not too fond of working with bones.

2. DECOMPOSITION
The process by means of which a cadaver becomes a skeleton, through
the destruction of the soft tissue, is quite complex. In discussing the decomposition process, it is important to remember that, as with everything in biology, the exception is the rule, or rather, that there are no two individuals
alike, nor any two decomposition processes alike. This is why this stage can
be difficult.
The decomposition of a body is a mixed process that varies from cellular autolysis by endogenous chemical destruction to tissue autolysis, by either
the release of enzymes or external processes, resulting from the bacteria and
fungus in the intestines or from outside (5). Predators, ranging from insects to
mammals, participate in the process and may accelerate it. It can therefore be
said, with Di Maio (6), that decomposition involves autolysis (the destruction
of cells and organs by an aseptic chemical process) and putrefaction (because

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of bacteria and fermentation). Thus, whereas common sense understands
decomposition to be synonymous with putrefaction, in the forensic context, it
has a much broader meaning, covering all stages from the moment of death to
the dissolution of all body parts.
It is a process that varies greatly from body to body, environment to
environment, according to whether the body is clothed or naked, the circumstances of the death and the place where the body is found, the climate, and so
forth. For example, it is known that putrefaction occurs much faster in bodies
that are left in the open air than those immersed in water, whereas buried
bodies decay at a much slower rate (7–9). In these cases, factors such as the
length of time before the body was buried (thus allowing putrefaction to begin), the temperature at the site, the presence or absence of oxygen, the depth
of the body, topography of the soil (rather than its composition), and the type
of coffin used, considerably affect the speed of decomposition (6). However,
whereas many exhumations have little to offer to certain investigations, this
should not devalue their importance. Indeed, this can never be anticipated,
because there are cases in which bodies are in truly surprising states of conservation. In an autopsy performed by the author, it was possible, some months
after the burial, to undertake a detailed examination, entirely unexpectedly,
of a spontaneous brain hemorrhage in a body that had been buried in winter in
an area of harsh climate (atmospheric temperatures between –3 and 10qC).
Decomposition may also vary within the same cadaver, with some parts
of the body showing adipocere, other parts mummified, and still others only
putrefied (Fig. 1). This will depend on the different “microenvironments”
that develop around them, in accordance with the place where they are found.
There are also various possible interconnections between these states, which
makes it difficult to estimate the date of death.
The calculation of the postmortem interval (PMI), one of the most controversial and difficult problems in legal medicine, becomes more acute in cases of
decomposition. Excluding the precious assistance provided by forensic entomology (a separate discipline that is not dealt with here), various methods have been
used to calculate this interval, while of course taking into account the subjective
nature of the individual assessment. Prieto (9) lists the evaluation of biomarkers
like lipids, nitrogen, amino acid content, neurotransmitters, decompositional
byproducts, persistence of blood remnants in bone tissue; extent of DNA deterioration; changes sustained by microanatomical skeletal structure; and carbon 14.
Others have tried to study the variations of factors that influence decomposition
in certain cases, either prospectively (through the formation of adipocere [10,11])
or retrospectively (by analyzing cases that have already been solved in order to
study particularly extrinsic factors that affect it [9,12]).

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Fig. 1. Coexistence of three states of decomposition in the same body:
skeletonization of the head, adipocere in the trunk organs, and mummification
of the limbs. Note skin’s leathery appearance. The body belongs to a 93-yr-old
woman found facedown in the countryside, whose positive identification was
achieved. Cause of death was ascertained.

In all cases, and despite the relevance of some of these methods, the
establishment of PMI continues, for most pathologists, to be based on individual analysis and experience obtained in similar cases. And, whereas it is
legitimate to suggest a date for past populations with some margin of variation, it is always very difficult to risk a prognosis in forensic cases, because
there are so many factors involved, and the range of variation is so broad.
This is supported by a number of authors (8,10–13), who, because of the
multiplicity of factors involved, find it impossible to attribute a credible time
interval for each of the stages of decomposition.

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Fig. 2. Steps of body decomposition. (Adapted from ref. 5.)

What can be done, of course, when required for a particular decomposition process, is to indicate the time suggested in the literature and validated
by experience as necessary for each of the processes to take place, and from
this, it is possible to get an idea of the PMI.
After death, most bodies that have not been embalmed will start putrefying quickly and will liquefy in some time, leaving only the skeleton
(Fig. 2). Others, however, may pass through some of the preservation processes mentioned previously (mummification, saponification), interchangeable among themselves, which will lead eventually to skeletonization. A
skeletonized body will tend to disintegrate, or alternatively, to fossilize, a
process that may take millions of years. Figure 2 shows this process of decomposition, which will be discussed, as far as disaggregation or fossilization is
concerned.

2.1. Putrefaction
Putrefaction is usually the first stage of decomposition, although it is not
always found, and consists of the gradual dissolution of the tissues to gases,

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liquids, and salts (7). Not only is it the subject of numerous publications, it is
also covered in any book about legal medicine and forensic pathology.
Many authors distinguish phases and stages in the putrefaction process,
some of which are based on the study of the decomposition of animal carcasses. For example, Shean et al. (14) distinguish 4 phases (decomposition of
the soft tissue, exposure of bone, remains only with connective tissue, and
bone only) that are broken down into 15 stages, whereas Galloway et al. (15)
distinguish 5 phases and 21 stages, to cite only some. Others describe these
stages with great temporal precision, which, although revealing great erudition and being very successful in lessons or lectures, are inadequate for practical application given the enormous variability of the development of this
process. These discrepancies between suggested periods and phases of decomposition, along with the study of animals, naturally limit the value of
these findings. In the author’s opinion, what is much more important than
knowing the stage of putrefaction, or how long it has taken to get there, is the
ability to recognize the elements that characterize clearly and objectively the
stage of putrefaction, and the artifacts that this may induce, and to know its
potential and limits in terms of thanatological research.
Therefore, described here chronologically are the alterations undergone
by a body after the death, in a place with temperate weather. It should be
emphasized that the times mentioned are merely indications and in no way
exact because some of the characteristics described may appear considerably
earlier or later than suggested.

2.1.1. FIRST WEEK
One of the earliest signs of putrefaction is the discoloration of the lower
abdominal wall in the right iliac fossa because of the proximity of the cecum
to the surface. Intestinal bacteria break down the hemoglobin into
sulfohemoglobin and other colored pigments (the “green abdominal stain,”
as it is known in some countries), which extends from the right iliac fossa to
the whole of the abdomen and thorax (Fig. 3). These bacteria are also responsible for the formation of gases, provoking edema of the face and neck. The
gases released in this process (sulfuretted hydrogen, phosphoretted hydrogen, methane, carbon dioxide, ammonia and hydrogen (7), and some mercaptans) are responsible for the unpleasant odor that is characteristic of these
bodies. Other effects produced by gases include a marked increase in the
volume of the abdomen, which is under tension, and of the scrotum and
penis, which may gain extraordinary dimensions. The face and neck also
increase greatly, with protrusion of the eyes and tongue, making identification difficult.

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Fig. 3. The colors of putrefaction: abdominal green, which had begun in the
right inguinal region; red marbling, typically on the lateral part of the trunk,
shoulders, and upper limbs; reddish, purplish of the putrefactive phlyctenae.
Note the skin slippage. (See ebook for color version of this figure.)

The phenomenon known as “marbling” in Anglo-Saxon literature (or
Brouardel’s “posthumous circulation,” as it is better known in the Latin countries), which results from the colonization of the venous system by intestinal
bacteria that hemolyze the blood, is very characteristically found at this time.
It appears on the thighs and sidewalls of the abdomen, chest, and shoulders
(see Fig. 3), first with a reddish color and, later, green.
Skin blisters containing reddish purplish serous liquid erupt in the sloping regions (see Figs. 3 and 9). These should be distinguished from the
phlyctenae that result from burns; phlyctenae containing a serous liquid are
of course characteristic of second-degree burns, but they are usually surrounded
by an erythematous ring, something that is not found in putrefactive blisters.
The epidermis becomes fragile and tears easily, which means that it may
come off in large areas, leaving the red dermis visible, similar to what happens with first- and second-degree burns (Fig. 4). Such patches may also be
caused by the bursting of the phlyctenae, when these are large and contain
liquid under pressure. The skin may also come off on the fingertips, which, of
course, hinders the taking of fingerprints.

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Fig. 4. Skin slippage, leaving the dermis visible. For the inexperienced, this
can be confused with second-degree burns. On both hands and feet, and like
burns or drowning, the skin can be removed like a glove. Fingerprints will then
be difficult to obtain.

In hairy areas, hairs will come off at the slightest pressure. This phase of
putrefaction may also provide some curious aspects, such as the “gloves”
made of skin on the hands (see Fig. 4), or the use of the hair by birds for nest
building (6).

2.1.2. SECOND AND THIRD WEEKS
The increase of pressure on the abdomen produced by putrefactive gases
leads to the ejection of feces and urine, and there have been cases described
of uterine prolapse, and even of a postmortem birth (5,7). This pressure also
leads to the expulsion of liquids from any orifice, particularly in the early
stages, from the mouth and nostrils. As this liquid is often bloody, it can
lead to complications for differential diagnosis because inexperienced pathologists may confuse these cases with cases of violent death (Fig. 5). Tracheobronchial foam may also be produced by the same mechanism that
creates a mixture of air with the tracheobronchial liquids. Internally, small
gas bubbles are frequently found in the soft viscera, giving these organs a
“foamy” appearance.

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Fig. 5. Purging of a bloody liquid from nostrils because of the gaseous dilatation of the abdomen. Note the abrasions under the breasts, which could be
erroneously considered antemortem, but were produced, in fact, by skin pressure with postmortem exsiccation.

2.1.3. FOLLOWING WEEKS
The green color gradually darkens to black, making identification even
more difficult. The association of this with edema and the formation of gas in
the head lead to an increase in its size and the flattening of anatomical prominences, causing an “africanization” of features, known in some places as
“blackman’s head” (Fig. 6). This phenomenon may arise, however, much earlier. The swelling of the face, in fact, begins immediately in the first week,
depending on environmental conditions, and is accompanied by protrusion of
the tongue between the dental arches.

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Fig. 6. Stage of advanced putrefaction with gaseous bloating and larval
infestation, causing obvious problems in the identification of the victims.

The cadaver in this state gives the impression of being a very heavy
individual. However, this is a false impression because it is effectively the
volume that is increased and not the weight, which may even be reduced
because of the presence of the gases (6).
This phase coincides with infestation by maggots, which dig holes and
pathways in the skin and tissues, opening up routes for other bacteria from
the environment (Fig. 7). The combined action of the proteolytic enzymes of
the maggots and the voracious appetite of other predators greatly accelerates
putrefaction at this stage.

2.1.3.1. Organs
Internal decomposition takes place at a slower pace, and it is sometimes
surprising how many diagnostic elements may be collected from a cadaver
whose state of putrefaction appears to have little to reveal. It is commonplace
to say that putrefaction is the greatest enemy of the pathologist. However,
this unquestionable truth is often counteracted by fortunate exceptions, which
justifies using all the rigor and detail normally demanded by a standard autopsy for these cadavers as well. The frequently given excuse that there is no
point in taking the necropsy or dissection much further because the putrefied

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Fig. 7. Maggots digging holes and sinuses via proteolytic enzymes, opening
the access to external bacteria that will speed up the putrefaction process.

body has little forensic value, is largely the result of the chronic laziness of
some professionals.
The proliferation of microbes leads the internal organs and internal vessels to acquire a winey purplish hue, although some organs, such as the liver
or stomach, may more commonly be a dark brownish green.
Putrefaction takes place at this level at different speeds:
1. The intestines, suprarenal glands, and spleen may putrefy in hours.
2. The encephalon discolors, becoming grayish pink and liquefies in about 1 mo
(Fig. 8); signs of brain disease disappear (e.g., meningeal hemorrhages, tumors).
3. The heart is moderately resistant. The coronary arteries remain visible for many
months, allowing the diagnosis of valve and coronary disorders, and coronary
thromboses in necropsies that seem doomed to failure, a circumstance that is well
known among pathologists that work daily in the autopsy rooms.
4. Kidneys, lungs, and bladder are also resistant (Fig. 8).
5. The prostate and uterus are the least vulnerable.

The capsules of the kidney, spleen, and liver resist putrefaction more
than their respective parenchymas, and these organs transform into sacs

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Fig. 8. Encephalon (from another case) discolors (grayish) and liquefies in 15 d
to 1 mo, depending on the conditions involved. However, heart, lungs, and (especially) kidneys moderately resist putrefaction. These belong to the body of a girl in
adipocere, buried in soil for approx 2.5 mo (the same as in Fig. 11).

containing a pasty liquid, winey red in color, which will later burst, making it
then impossible to recognize the organs.
These different rates of decay of the organs may be proportional to the
amount of muscular and conjunctive tissue they contain, according to some
authors, cited by Gordon et al. (7).

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2.1.4. LATER ALTERATIONS (MONTHS)
The viscera and soft tissues disintegrate, whereas organs such as the
uterus, heart, and prostate last longer, as do tendon tissues and ligaments attached to the bones.
The body will then finally enter into the phase of skeletonization, depending on the place where it is found and the season of the year. Some fragments
of skin, protected by clothing or that come between the body and the support
surface, may remain preserved, mummified, or with adipocere (see Fig. 1).

2.1.5. PUTREFACTION OF A BODY EXPOSED TO THE AIR
The rate at which a body decomposes is extremely variable. In the
author’s experience, for the bodies of patients who have died in the hospital
in the summer and are not refrigerated (Portugal has a temperate, Mediterranean climate), a single afternoon is enough for the process to start. In fact, the
earlier it starts, the faster it will be.
Various factors influence the speed of putrefaction: the atmospheric temperature and humidity level (10), the movement of air, state of hydration of
the tissues and nutritional state of the victim, age, and respective cause of
death (5,7). Thus, low temperatures, which inhibit the growth of bacteria,
retard the process considerably. The optimum temperature for the activation
of bacteria responsible for putrefaction is 37.5qC (7). In a simultaneous double
homicide autopsied by the author, the effect of temperature on the rate of
putrefaction in each of the corpses found at home was clearly perceptible
(Fig. 9). Exposure to warm humid air, and the movement of this, also accelerates putrefaction (7).
In tissues that are greatly hydrated, with a higher liquid content, such as
occurs in cases of deaths through chronic congestive heart failure, putrefaction is faster. Victims who are dehydrated or who had suffered from vomiting
and diarrhea resist much longer.
The process is faster in children than in adults and also in more obese
people than in thinner individuals (6,7). However, newborn infants show some
resistance to the start of the process.
Di Maio (7) claims that bodies wearing heavy clothes putrefy more
quickly than those that are more lightly dressed, whereas other authors stress
that a clothed body decomposes less quickly than a naked one (15). It is also
necessary to take into account the kind of fiber that is used in the clothing,
whether natural or synthetic.
Of course, someone who dies of septicemia or from some acute infection will already contain a proliferation of bacteria, which means that the

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Fig. 9. Different stages of putrefaction observed in two bodies, both shot at
home and recovered 3 d after the crime, on a moderate winter day. The man on
the top had a heater working near him; the girl lay on the floor of her bedroom,
without any source of heating.

process will be significantly accelerated. This acceleration will be greater in
the trunk than in the limbs, certainly for the same reason (that is, the absence
of bacteria in the muscular tissue of the limbs, as opposed to the abundance in
the organs of the trunk, especially the abdomen).
The presence of traumatic lesions caused by a blunt instrument or firearm may also affect the speed of decomposition (15), in that they open up
holes through which air and insects may enter. Flies, however, tend to prefer
the natural openings.

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Fig. 10. Decomposition in water showing the first signs of adipocere in a
victim drowned in the central Atlantic Ocean for 8 d: a white, waxy appearance, complete slippage, without hair. Note the little injuries on the posterior
head, without bloody infiltration, meaning a postmortem lesion by teeth of
marine predators. The detail shows the colonization of the larynx by known
comestible marine predators: mussels, goose barnacles, crabs.

2.1.6. DECOMPOSITION OF AN IMMERSED BODY
As has already been mentioned, decomposition is slower in water than
for a body exposed to the air, because of both the lower temperatures and
degree of protection that the water offers from insects and predatory mammals. However, one should not forget that there are also sea and bird predators whose action, in exposing areas of adipose tissue to the water, also
promotes adipocere (Fig. 10).
Normally, a body floats head down because the head does not develop
gas formation as easily as the abdomen or thorax, which causes fluids to
gravitate to the head. This means that putrefaction is more visible on the
face and front of the neck, making identification more difficult. The appearance is also significantly different from a putrefied body because it is frequently associated with saponification, with a general peeling of the skin,
and accentuated white coloring (see Fig. 10). Bodies acquire a waxy white

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Fig. 11. Buried corpses decay at much slower rate than immersed or air exposed
bodies. Observe the excellent preservation of the body of a girl, after 2.5 mo of
burying, conserved in adipocere. Note the unexpected detail of the toes.

hue, and the appearance of the head without hair makes it difficult to identify; indeed, some professionals have been ill advisedly led to believe that
such cases had been subjected to oncological therapies. Because of the
putrefactive process, the bodies float continuously, even when they have
been attached with stones for example, to make them sink to the bottom
(see Fig. 12).
Putrefaction is also faster in warmer stagnant waters that contain decomposing organic matter, such as industrial effluents, and so forth. It is also
faster in fresh water than in saltwater (7). Some authors (5,8) contest this last
point, however, on the grounds that bacterial colonization results much more
from bacteria in the digestive tract and airways of the victim than from the
aquatic flora. Finally, as soon as the body has been removed from the water,
putrefaction accelerates considerably.

2.1.7. DECOMPOSITION AFTER BURIAL
It has been demonstrated that this is the process in which putrefaction
advances least, in relation to bodies left in the open air or in the water
(Fig. 11). For this reason, in some Brazilian states with scarce resources where
there are no conditions of refrigeration, the medicolegal services bury the
bodies in order to prevent them from decaying, exhuming them some days

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later when the autopsy may be carried out. Thus, the soil functions as a kind
of primitive refrigeration chamber.
This slower rate of decomposition is for obvious reasons: the absence of
air, inaccessibility to predators, and low temperature. The time taken before
burial also affects the whole process. If putrefaction had not yet begun, the
body will remain in a better state of preservation than if the process had already
gotten underway.
The kind of soil and depth at which a body is buried are also factors to
be taken into account. The process is faster in damp, porous soils and in bodies that are buried near the surface (5,7,8). The topography of the land is,
however, more important than the type of terrain. If the body is buried in a
valley or below the water table, the action of water will also be felt (5,8).
Bodies buried deeply in coffins decompose more slowly that when they
are in shallow graves—the temperatures are lower, there is less air, and they
are less affected by water (5,7,8). The type of coffin also influences the decomposition process. Laminated wooden coffins rot quickly, whereas those
made of zinc or lead offer better protection.

2.2. Adipocere
The formation of adipocere is a natural preservation process that has
been known for centuries. Its name, attributed to Fourcroy in 1789, comes
from the combination of the Latin adipo- (fat) and cera (wax) (5). This process, which some wrongly consider as a part of putrefaction (6,7), is known
as saponification.
It is a variable and irregular process, only occasionally involving the
whole body, which results from the hydrolysis and hydrogenation of the adipose tissue. This produces a waxy, fatty substance that is brittle; in color, it is
yellowish off-white (see Figs. 11 and 12), although when stained by decayed
matter or blood, may acquire reddish, grayish, or gray-green tones (see Fig. 10).
It also gives off a characteristic “earthy, cheesy, and ammoniacal” odor, which
may be recognized by dogs trained to discover human remains (11).
Despite some points that are controversial and unclear, the biochemical
sequence of the formation of adipocere is, today, largely well established.
The process begins immediately after death (10,11), with the hydrolysis (mediated by enzymes) of the triglycerides, which cleave the fatty acids from the
glycerol molecules, giving rise to a mixture of unsaturated (palmitoleic acid,
oleic acid, linoleic acid) and saturated (myristic acid, palmitic acid, stearic
acid) fatty acids (16). As the process advances, the quantity of fatty acids
increases, and the triglycerides diminish until they disappear completely (11).
When there are sufficient enzymes and water, decomposition will continue

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Fig. 12. Saponified body of a woman (both women and children are more
likely to saponify) attached to stones to sink in a domestic well (suicide). Note
the discoloration and the fat appearance of the skin.

with the hydrogenization of unsaturated fatty acids into saturated, after which
the process is considered complete and stable. However, during hydrolysis
and hydrogenization, some other products are formed. Free fatty acids may
attach to sodium and potassium ions of the interstitial liquid and cellular
water, and later, to calcium ions, forming fatty acid salts. The subsequent action
of some microorganisms leads to the formation of 10-hydroxy fatty acids—the
most common of which is 10-hydroxy stearic (11,16,17)—and, according to
Takatori (17) of 10-oxo fatty acids. This author has shown that bacteria, such as
Pseudomonas, Staphylococcus aureus, and Clostridium perfringens, produce
10-hydroxystearic acid from oleic acid, whereas Micrococcus luteus produces
oxo fatty acids (17). These acids, and their respective soaps, as well as participating in the formation of adipocere, also help to stabilize it. This stability may
be attributed to the action of ionic, covalent, hydrogen bonds between the carboxyl terminal of the fatty acids and the hydroxyl groups (16). These substances
and glycerol form a matrix with fiber residues, nerves, and muscles, which
gives a degree of solidity to the saponified mixture (5).
At the moment of death, the body’s fatty acid content is 1%, but with
adipocere, in the first month, it goes up to 20%, and at 3 mo is 70% (5). It is
thought that the process is only superficial and therefore does not involve the
viscera (7). However, whereas subcutaneous fat is the most affected, internal
structures containing adipose tissue, such as the mesentery, epiploon (omentum), perirenal fat, or organs with pathological processes involving a lipidic
metabolism, may also be involved.

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2.2.1. CONDITIONS
Saponification requires some heat, necessary for the development of the
microbes referred to in the previous subheading, as well as water, which may
be exogenous or from the organism itself (1,5). For this reason, it generally
appears in damp environments (5) in bodies immersed in cold water with a
low oxygen content (1,10). Pfeiffer (16) associates the persistence of adipocere to the presence of Gram-negative microorganisms, which are known to
develop in anaerobic environments.
However, saponification is also found—much more often than is
thought—in tombs, crypts, and graves, even dry ones, in a few days; the water
from the organism is enough to set in motion the chemical transformations
necessary for the process. Adipocere benefits from a process of self-promotion,
because it inhibits putrefaction, increasing acidity and dehydration, thus reducing the growth and spread of putrefactive organisms.
Women (see Fig. 8) and children are much more likely to undergo this
preservation process because they have a greater fat content. For the same
reasons, the parts of the body that tend most to saponification are the cheeks,
eye sockets, chest, abdominal wall, and buttocks.

2.2.2. CHRONOLOGY
Adipocere may last for decades, even centuries. It can form between 3
and 12 mo (5–7,11,10,18), although this is variable; the first signs may be
visible as early as the third week after death (5,11,10,19) or even earlier (8 d),
as was the case of a victim of drowning in the central Atlantic Ocean (Portuguese coast) autopsied by the author,* where atmospheric temperatures ranged
from 16 to 30qC (average of 20qC), and the average of sea water temperature
was 18qC (see Fig. 10).
Studies carried out in the area of marine taphonomy cited by Kahana
(12) consider that, in cold waters (4qC), some 12–18 mo are required for saponification, whereas in waters of between 15 and 22qC, only 2–3 mo are needed;
very high temperatures are necessary for the process to be evident in 1–3 wk.
However, other reports are highly contradictory. The same author reports
bodies recovered from a wreck of a Belgian ship in the China Sea, saponified
at 38 d in water temperatures of between 10 and 12qC, among other discrepancies. It should be emphasized that in the same sample, three bodies were
* During the period this body was submersed, weather was similar, with the exception of a day when meteorological conditions had suffered a sudden change, with
an increase of both atmospheric temperature (to 35qC) and the temperature of the
sea water, which ranged from 19 to 36qC.

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found later (after 433 d) with adipocere, but with some parts skeletonized.
Studies of controlled decomposition in samples of pig carcasses (11) in shallow graves have shown that there is no correlation between stages of saponification and the period of decomposition, which once more confirms the
variability of the whole process and the probable intervention of other factors
as yet unstudied, such as temperature, humidity, pH, clothing, and soil type.
These findings reinforce the idea that has been argued consistently in
this text as to the lack of confidence in estimates of PMI based on states of
decomposition of the body.
The decay of the adipocere is not completely clarified because it has
been alleged that soil microbiota including bacteria, fungus, and algae may
play a role in this decomposition. Pfeiffer (16) suggests that the maintenance
of adipocere is associated with the development of Gram-negatives in a slightly
anaerobic environment, and that its decay has to do with exposure to conditions of aerobiosis and to the presence of Gram-positive bacteria. This fact
has been confirmed for many by practical experience, because a saponified
body that has been removed from its environment for autopsy starts to decay
much more rapidly than it did before its removal.

2.2.3. FORENSIC VALUE
The medicolegal interest of saponification lies not only in the possibilities it offers for identification because it conserves some bodily forms, but
also in determining the cause of death. It is, however, rare for a body conserved only through adipocere to be recognized by the face, given the physiognomic distortions that are common despite preservation (see Fig. 10).
In Portugal, an eminently maritime country, it is curious to note that the
majority of saponified bodies come from domestic wells because of either
suicide (a very common method in the elderly rural population) (see Fig. 12)
or accidental falls. This state of conservation of the body often permits medicolegal determination of the cause of death. For this purpose, saponification
may be very important, particularly in situations of death by firearm because
the preserved fatty organs may reveal the bullet’s trajectory (Fig. 13). The
author performed an autopsy on a victim of the Balkan War of the 1990s in
Kosovo, where it was possible to reconstruct approximately the paths of two
projectiles in a body that was completely saponified, but where the organs
were difficult to distinguish.
Lakes, rivers, seas, and wells are also often used to hide murder victims,
for which reason great attention should be paid to bodies recovered from water;
one should not, as so many experts unfortunately do, leap to the easy conclusion of death by drowning. A body recovered from the water may have died of

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Fig. 13. A saponified head of a homicide victim, found closed inside the
back of his car, sunk in a lake to hide the body. The author could recover the
four bullets and determine its pathway. Two of the shots penetrated the body
through the same hole seen on the face (arrow). Another entrance hole can be
noted below the ear (circle). Note the preserved aspect of the face that could
lead, but with some difficulty, to a positive identification. (See Fig. 3, Chapter 7
to observe the X-ray.)

anything, even drowning. Among many examples present in the literature,
Dix (19) tells of four separate cases of homicides, accidentally collected from
Lake Missouri, all saponified.

2.3. Mummification
This is a process of natural or artificial conservation, which consists of
the dehydration and exsiccation (the process of drying up) of tissues. It may
be partial and coexist with other forms of conservation and/or putrefaction
(see Fig. 1). It extends more easily to the whole body than other processes,
such as saponification (8).
It is characterized by dryness and brittle, torn skin on the prominences
(cheeks, forehead, sides of the back, and hips), generally brown in color, though
coexisting with white, green, or black zones because of colonization by fungus (see Fig. 1), just as leather jackets look after they have been left for some
time in a musty wardrobe and start to become mildewed.
As for the internal organs, the process varies in relation to the time since
death, and they may be partially mummified, putrefied, with adipocere, or

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even absent. Radanov et al. (20) describe an extreme and unique case of the
natural mummification of a brain, which was surprising, taking into account
the softness of brain tissue, as well its fatty composition. The body had come
from a mass grave with 39 other bodies and had been buried for 40–50 yr, at
a shallow depth in a stony terrain, exposed to sunlight.
It is common for there to be slight adipocere in mummified bodies.
Indeed, there is a close interconnection between these two processes; the use
of the water from the body for hydrolysis of fats contributes also to the exsiccation of tissues (5,8). This relationship is extendable to the biochemical level,
as has been demonstrated by Makristathis et al. (21), who detected in mummies the same constituents of saponification: palmitic, oleic, and 10-hydroxystearic acid, among other substances.

2.3.1. CONDITIONS
As is to be expected, mummification is found in dry, ventilated environments (1,5) and generally, though not always, in warm places where the body
loses fluids through evaporation (5,6): closed rooms, attics, wardrobes and pantries, barns, stairwells, and so on. More extensive and complete mummification
occurs in desert environments; indeed, this preservation process was practiced
by the ancient Egyptians, who added spices and herbs to the heat (1,5,8).
Mummification also takes place in icy environments, not only because
of the dryness of the air, but also because of the low growth of bacteria at
such temperatures. A frozen mummy approx 5000 yr old (known as the
Tyrolean Iceman) discovered in the Alps in 1991 has become famous as a
veritable star of anthropology, like others from Peru that are also thousands
of years old (21). The former, however, raises the question of knowing whether
mummification, which is by definition related to exposure to dry air, may
take place in the snow. Ambach and Ambach (22) justify this from a physical
point of view, given that evaporation may occur from a frozen body through
a superficial covering of snow (porous and air-permeable), if the weather conditions establish a water vapor pressure gradient between the snow layers.
Makristathis et al. (21) compared the composition of the fat of mummified bodies from different parts of the world: the Tyrolean Iceman; two bodies
found in alpine glaciers near to this; a body that had been immersed for 50 yr in
an Austrian mountain lake; two bodies buried in the permafrost of Siberia; two
Peruvian mummies, one from the Andes (500 yr old) and one from the Peruvian desert (1000 yr old); and three fresh bodies as a control. The composition
of fatty acids was very similar between the samples of fresh bodies and those
from the dry mummification of Peru, in which no significant concentrations of
10-hydroxystearic acid were found, with oleic acid predominating. These were

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also the best preserved bodies. In addition, all those conserved in ice or in contact with water showed a high concentration of 10-hydroxystearic acid, suggesting the association of this acid with conditions of conservation in water. The
Tyrolean Iceman was situated somewhere between the mummies conserved dry
and those from the ice, and was in a much better state of preservation than many
more recent bodies, only tens of years old, also from glaciers. This can be explained
by the rapid initial desiccation caused by the cold mountain winds, followed by a
burial in ice with periods in water.
Dehydration before death may also favor this process. Indeed, this is
similar to an ancient Japanese practice of natural self-mummification, according to which bonzes (Buddhist monks), nearing the end of their lives, would
progressively reduce their solid food intake, then the liquid, so that they were
practically desiccated at the moment of death. They were buried, and then
exhumed 3 yr later, when they were found to be already mummified, without
any other kind of intervention (23).

2.3.2. CHRONOLOGY
The time necessary for mummification to take place is not well documented because of the long periods that usually occur before the body is discovered. It certainly takes some weeks (5,7,8) and, in the early stages, is mixed
with putrefactive alterations, especially in the internal organs. In the deserts
of Arizona, corpses exposed to the air require between 11 d and 1 mo to mummify (15). After they are dry, they may last years, even centuries (5,7,8).
The action of predators (see Fig. 2) in this phase may accelerate the
disintegration of the exsiccated tissues, which are fragile and brittle; fragments of parchment-like skin, tendons, and ligaments attached to the bones
may remain for much longer, however.

2.3.3. FORENSIC VALUE
Mummification can have significant medicolegal relevance for the two
great objectives of forensic anthropology, identification of the body and establishing cause of death. Concerning the former, mummies are often found in a
surprising state of preservation (Fig. 14), and it is usually much easier to
investigate the victim’s identity in these situations than with adipocere. Concerning the latter, large lesions may be preserved. However, the detection of
ecchymosis or wounds may be made difficult or impossible because of discoloration, artifacts, and the action of fungus.
Cadavers in this state are sometimes the victims of homicides that have
been left in a place propitious to mummification. It can also be found in cases
of natural death of people that live alone. It is a very common process in

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Fig. 14. The hands of a clerical mummified in a crypt (18th century). The
perfection of the details is surprising.

fetuses or newborn infants, who mummify much more rapidly and completely,
often because of the types of graves or ventilated domestic locations where
they are deposited (Fig. 15).
Autopsies in these cases require particular dexterity because the skin,
which is brittle and disintegrates easily, is difficult to dissect. Some methods
of softening the tissues to permit better observation and histological study (5)
have been described; one of these involves the use of a solution of 20% polyethylene glycol, with controlled pH of 8.0 and the addition of 1% Stericol to
inhibit the growth of bacteria and fungus (24).

2.4. Skeletonization
As the name suggests, this consists of the removal of all soft tissue from
the bone, and is the field par excellence of the forensic anthropologist.
A body that has been reduced merely to its bones may be, however,
present in its totality, thus constituting a complete skeleton (Fig. 16). Different states of preservation may nonetheless coexist, as mentioned previously,
of which one may be skeletonization, which will be, in this case, partial. When
this happens, the classic scenario is skeletonization of the cranium (which has
the least soft tissues), mummification of the extremities, and saponification
of the back (see Fig. 1). The natural and most frequent tendency, if conditions
are propitious, is for complete skeletonization.
In the certain (and very frequent) case of a group of bones (Fig. 17)—
sometimes already eroded, found in a church cemetery, obviously in a phase
subsequent to skeletonization, when the bones are completely disarticulated
and fragmented—it seems incorrect to designate this as a skeleton or body in

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Fig. 15. A mummified fetus of approx 28 wk found in a crypt after rebuilding a
cemetery. The attachment of the umbilical cord suggests a probable live-born infant.

Fig. 16. A complete skeletonized body at the autopsy room after the inventory.

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Fig. 17. Ossuary (and not a skeletonized body) containing more than one
individual.

skeletonization. The term ossuary, frequently used in forensic practice, would
seem to be more suitable. It should be noted that these piles may include
bones that have been disturbed and mixed up, and therefore belong to different individuals; this naturally requires specific methods of analysis (25).

2.4.1. CONDITIONS
The time required for a body to become a skeleton is very variable because
skeletonization is a complex phenomenon involving the intervention of multiple factors. Many studies have been carried out (often based on the decomposition of animals) to assess the influence of each of the taphonomic variables
(26) on the preservation of the body and to quantify the average time taken
for each phase of decomposition of the cadaver (15,27,28). Recall that the
higher the temperature and humidity, the greater the rate of decomposition
and skeletonization, and that it is also important whether or not the body is
buried, among many other factors already described in relation to general
decomposition. Clark et al. (1) point out that a body buried in a warm environment may skeletonize as quickly as a body exposed to the air in a temperate environment, always depending on factors like the depth at which it is
found, soil type, and so on.

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As was mentioned with regard to mummification, the ligaments and some
tendons are the soft tissues that most resist leaving the bone. Skin, soft tissues, and organs are lost much earlier. Disarticulation consists in the disappearance of the soft tissues, which, in living beings, hold bones together within
a joint (3). Thus, even when each bone is in the right place, the skeleton is
considered disarticulated whenever the soft tissues do not join the bones
together.
Disarticulation is very common in skeletonization and, in unburied bodies, takes place in a cephalic–caudal direction, and from the center to the
periphery, that is to say, the head (without the jaw) usually separates first
from the spine and then, the other limbs (29). Dirkmaat and Sienickis (30)
have proposed the following sequence for human disarticulation in bodies
exposed to the air: first the head, because of the accessibility of its cavities to
insects, followed by the sternum and clavicle; the upper limbs decompose
much faster than the lower ones; the pelvis separates much later than the trunk,
and the ribs do so in different degrees; the feet, often in socks and shoes, last
much longer than the rest. The vertebral column, although exposed early, is
one of the last to break up because of the strong costovertebral and intervertebral ligaments. Unprotected hands and feet are, however, the first to disarticulate, sometimes even before the head separates (3). For bodies that have
come out of water, Haglund (31) established that the areas that lose their soft
tissues first, leaving the bones visible, are those covered by soft layers of
tissue like the head, hands, and front of legs. Disarticulation begins with the
bones of the hand and wrists, bones of the feet and ankles, jaw, and cranium.
Finally, the legs and arms separate.

2.4.2. CHRONOLOGY
The skeletonization process varies greatly in accordance with the place
where the body is found (in the open air, it is much faster than in an enclosed
environment) and the season of the year (the autumn conserves better than the
peak of summer). Various authors (6,27,32) have documented that, in a warm,
damp environment, complete skeletonization may occur between 1 and 2 wk.
The author performed an autopsy on a homicide victim that had skeletonized
completely in 15 d at home (33). The most extreme case is reported by Clark
et al. (1), in which skeletonization occurred in 3 d in a very humid environment where there was great insect activity; at the other extreme, there are
cases of freezing that may take thousands of years. Knight (5) estimates, however, that in temperate climates, a period of 12–18 mo is normal for
skeletonization with tendons, periosteum, and ligaments present, and around
3 yr for a “clean” skeleton.

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Fig. 18. Blunt trauma of the head on a skeletonized body of a murder victim,
hidden in a ditch for 5 yr. With only the bones, the forensic pathologist and
anthropologist arrive to the presumable cause of death.

The bone gradually wears away in the meantime, with fractures, decalcification, and dissolution because of the combined action of various factors,
such as acidic soils and water, in a process that begins, for some authors (15),
after 9 mo of exposure. After the complete separation of the bony parts, this
disaggregation accelerates markedly, until the body may even disappear
completely.

2.4.3. FORENSIC VALUE
Despite being the most impoverished stage of decomposition from the
point of view of legal medicine, skeletonization is undoubtedly an important,
and sometimes unique, source of information for determination of violent
death by firearms, or blunt or sharp instruments. Furthermore, there are a
number of examples that demonstrate the relevance of skeletons for the identification process.
The author’s experience includes the case of a skeletonized body found
in a ditch at the person’s home, after being hidden 5 yr, killed with a blunt
instrument (Fig. 18). In another situation in which the author participated
concerning a multiple murder in an African country, it was possible, based on

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a multidisciplinary study of the mostly skeletonized remains, to solve questions of identification and to determine the cause of death, which the case had
raised (34).
Finally, it is in this state of skeletonization that most victims of political
genocide and/or crimes against humanity across the world are found, such as
in the Balkans, East Timor, Latin America, Africa, and Iraq. The International Criminal Tribunal for the former Yugoslavia, in the trial at The Hague
of those presumed responsible for the abuse of human rights in the Balkan
conflicts, made use of this kind of expertise in decomposed bodies. The investigations were carried out by multidisciplinary teams under the auspices of
the United Nations, which included forensic pathologists and anthropologists
from around the world, some from organizations like the Equipo Argentino
de Antropologia Forense or Physicians for Human Rights, which have proven
essential for the demonstration of these crimes. These missions have truly
galvanized this common adventure of forensic pathology and forensic anthropology—well documented in an article by Steadman (2)—which has not only
efficiently resolved questions that were raised, but has also established some
highly stimulating challenges for the future, permitting a more effective administration of justice and thus, the pacific cohabitation of peoples in a happier,
healthier, and less violent world.

3. CONCLUSION
At the end of this chapter, the hope is to have given a perspective of the
main alterations a human body might suffer until it is found or even completely disappears. Forensic anthropologists as well as forensic pathologists
must be familiarized with these processes in order to be prepared to get
involved as experts in cases for which they are called. Nobody ever knows in
which state a cadaver will be presented. Thus, it is good practice that immediate and midputrefaction is not an unknown matter for forensic anthropologists. In the same way, forensic pathologists should also know how to deal
with bare bones.
Interdisciplinarity is then essential. Referred everywhere (2,33,35–37)
and permanently requested, it will be the issue of Chapter 7, and mentioned
often in other chapters of this book.
This type of multidisciplinary experience has been conducted in Portugal in the last 5 yr, using the knowledge of these concepts and processes, with
significant success both in terms of civil purposes and even for the administration of the justice regarding the penal law. An example of the first is, among
some cases of successful identification and distinction between more than an

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individual in cemeteries graves, the identification of an old female (who
disappeared after a family quarrel and was found decapitated in a river) partially by personal belongings, but confirmed trough exuberant pathological
vascular disorders of the leg bones (38). Concerning criminal justice, the author
and forensic anthropologist Eugénia Cunha (two coeditors of this book) performed some successful cases on victims of homicides already presented
(33,34).
This spirit, embodied by the whole philosophy of this book, must be
kept and developed, not only in the international situations in which forensic
professionals can be asked to participate, but also in routine cases in each
country, as is shown, in Chapter 7.

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