Comparison of the battles at the Little Bighorn and at Isandhlwana. Medicolegal and forensic aspects.

Compared are two great and remarkably similar battles that occurred less than 3 years apart: the U.S. Cavalry versus the Plains Indians in the battle at the Little Bighorn in Montana Territory of the United States, and the British-Zulu battle at Isandhlwana in the Natal Province of South Africa. Computer evaluation, which was especially helpful in evaluating artifacts at the Montana site, could be an excellent tool to use in other such large-scale investigations.

Medicolegal aspects of tornadic storms in Kansas, U.S.A.

Kansas is known for its fierce whether, including tornados in the spring and fall and blizzards in the winter. A recent series of tornados cut a path of destruction a mile wide for greater than 40 miles (64 km), killed 20 people, and caused several hundred casualities on the evening of April 26, 1991, in Tornado Alley, which runs from the northern border of Oklahoma through southern Kansas past Wichita toward Emporium, Kansas. The wind velocity was greater than 200 mph. Twenty people were killed, 17 of these in Andover, Kansas, a small town east of Wichita. Injuries caused by the tornados and the excellent emergency response and care provided by medical, law-enforcement, and volunteer personnel in the wake of the storms are described here.

The unusual accidental death of a pregnant woman by sexual foreplay.

This is the case of a young pregnant black woman who died during foreplay when her male partner with his hands accidentally forced air from her vaginal cavity into her uterine cavity, causing air embolization in the veins on the surface of her heart and her brain. Her premature infant was removed by cesarean section by emergency-room personnel after she died. The infant survived for 12 days before being declared brain dead.

Mass deaths by gas or chemical poisoning. A historical perspective.

This review chronicles the characteristics of deliberate and accidental mass poisonings that occurred in World Wars I and II, in Bhopal, and in other historical cases up to and including modern wars. It also considers approaches to the investigation of such cases from the medicolegal as well as general standpoints.

The pathology and medicolegal aspects of sexual activity.

The pathology of injury and its complications related to sexual activities has changed remarkably when compared with that of the past, which usually involved assaults or murders of female victims of varying ages, with moderate to serve beatings that may have accidentally resulted in the victim's death. Serial murderers, serial rapists, and molesters of both boys and girls have become much more prevalent in the last two decades in the United States. Unorthodox sexual behavior, such as "fisting," has increased in frequency, as has sexual violence related to cults, such as satanism. All of these present many challenges to medicolegal investigators. This report describes general and specific pathological sexual activities and injuries, some characteristics and methods of the perpetrators, and some specific cases as examples.

Forensic sciences and medicine. The clinical or living aspects.

This presentation of information regarding the application of the forensic sciences and medicine to the evaluation of living persons and its related problems is based on the case experience of a private practitioner of forensic medicine and pathology. Lawyers, law-enforcement personnel, and fellow physicians must be educated regarding the potential role of the forensic physician in the examination of living people. Many examples of the application of forensic expertise to the solution of crimes and civil problems involving living persons are included.

The Lockerbie disaster and other aircraft breakups in midair.

This is a review of the experiences and activities of various specialty groups that constituted the organization developed to investigate the Lockerbie air disaster. Circumstances surrounding other aircraft midair breakup crashes are also discussed.

Disinterments. Their value and associated problems.

This article presents our experience with several cases of disinterment, including reasons for disinterment, the methodology involved, and the value of this activity in solving medicolegal problems.

The Ripper Project. Modern science solving mysteries of history.

Modern scientific techniques may be applied to solve historical--even ancient--mysteries. Many such mysteries have been studied by forensic scientists, including anthropologists. One example is the recent examination of the artifacts and grave sites at the Little Bighorn in Montana, the scene of the battle between General George A. Custer's troops and the Northern Plains Indian tribes. Similarly, skeleton remains of the Indian tribes of the Pre-Columbian and Columbian periods have been studied to answer many questions regarding life and death in those early civilizations. The Ripper Project began as a research activity of the Milton Helpern International Center for the Forensic Sciences at Wichita State University Wichita, Kansas, in 1981, after the concept had been discussed in a night session during the annual meeting of the American Academy of Forensic Sciences in Los Angeles. These century-old serial murders of five prostitutes--The Whitechapel Murders--in London in 1888 were discussed in great detail from the standpoints of the forensic pathologist, the forensic psychiatrist, the criminalist, the forensic historian, and the forensic dentist. The information gained during this phase of the project plus the advances made possible by the development of criminal personality profiling by the FBI led to the present status of this project, which was recently discussed in a live telecast, and which is the subject of this article.

Anorectal trauma. Medicolegal and forensic aspects.

A review of both deliberate and accidental anorectal trauma is presented. The mechanisms and types of injuries as well as the complications are discussed. Injuries resulting from sexual assaults are discussed in detail.

The forensic or medicolegal autopsy. Friend or foe?

The major issue in questioning the performance of general pathologists doing medicolegal or forensic autopsies is that they are very often without a firm basis for performing this task. With minimal training in medical school and minimal exposure during their residency, practicing general pathologists, although expected or even forced to do these cases, may face criticism after their performance in a case. The necessity for teaching forensic medicine and pathology in medical schools is obvious, and the necessity of there being more forensic pathology exposure in residency training programs in the United States and overseas is also obvious. Medical educators are responsible for all phases of medicine being taught to medical undergraduates and graduates and must be pressured to support the practice of all kinds of medicine in American communities, including legal or forensic medicine, in those cases in which questions arise that lead to the performance of postmortem examination.

Investigation of cremations and severely burned bodies.

Among the most difficult cases for law enforcement and medicolegal investigators to investigate are those in which victims have been deliberately burned to cover up a crime, or those in which cremation has resulted from an accident or suicide. This difficulty arises from the fact that the bodies may be destroyed or fragmented. The major objective in these investigations are twofold: The first task is to identify the body using every means available, including the aid of such experts as forensic pathologists, forensic anthropologists, dentists, toxicologists, and serologists as well as fire investigators, who can contribute to the investigation by providing information about the course of the fire.

The forensic pathology specialty certifications.

The subspecialty of pathology known as forensic pathology has been certified by the American Board of Pathology since 1959, when the first examinations were offered in New Orleans, Louisiana, U.S.A. This article provides information on those who have been certified since 1959 and also the requirements for this certification by the American Board of Pathology.

Charles Norris (1868-1935) and Thomas A. Gonzales (1878-1956), New York's forensic pioneers.

American forensic medicine is forever indebted to pioneers like George Magrath of Boston, Milton Helpern of New York, LeMoyne Snyder of Michigan, and others, but the organizing of forensic medicine in the formal sense is due to the efforts of Charles Norris (Figure 1) and his successor Thomas A. Gonzales (Figure 2). These men were instrumental in developing the subspecialty as an extension of clinical medicine in which information derived from study of the dead was applied to benefit the living. Their combined efforts between 1918 and 1954 represent the epitome of the application of scientific expertise to medicolegal investigation of deaths in America. Their collaboration from 1918 to 1935 was particularly fruitful. The support of Dr. Alexander Gettler and, in 1938, the addition of Dr. Wiener to the Office of the Chief Medical Examiner made this period a golden era for forensic medicine.

Clinical forensic medicine.

This article discusses the merits of participation by medical examiners in the area of clinical forensic medicine. The present connotation that we deal after the fact should be abandoned with enhanced involvement in assisting the living. The paper focuses on a broad range of categories where forensic scientists by virtue of their training and experience could be most helpful in the application of medical knowledge to the solution of questions of law.

Identification by Identi-Kit composite from skull appearance. Combined efforts of the anthropologist, forensic pathologist, and criminal investigators.

It is always difficult to succeed in identifying skeletal remains unless one has good anthropological, dental, and investigative support. This case adds a new dimension, involving a law enforcement expert who was skilled with the use of the Identi-Kit. The picture of the victim, as developed by the Identi-Kit expert with the recommendation and support of the anthropologist, was shown on a television news program and was identified within 15 min of the show by a relative as the likeness of a missing 17-year-old black girl who was last seen months before. The combined expertise was instrumental in identifying a person who otherwise would have been recorded as another "Jane Doe."