Legal Medicine 11 (2009) 111–117

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Legal Medicine
journal homepage: www.elsevier.com/locate/legalmed

Review Article

Estimation of the time of death based on the assessment of post mortem

processes with emphasis on body cooling
Michał Kaliszan a,b,*, Roman Hauser b, Gerhard Kernbach-Wighton a
a
Forensic Medicine Section, Division of Pathology, University of Edinburgh, Teviot Place, EH8 9AG Edinburgh, UK
b
Department of Forensic Medicine, Medical University of Gdańsk, ul. De˛bowa 23, 80-204 Gdańsk, Poland

a r t i c l e i n f o a b s t r a c t

Article history: This paper presents a review of the literature referring to the estimation of the time of death (TOD) over
Received 27 October 2008 nearly 200 years. Emphasis is put on the development of the methods taking advantage of the decrease in
Received in revised form 29 November 2008 body temperature after death, measured in various body sites. The review is complemented by the first
Accepted 9 December 2008
authors’ own experiences on TOD estimation based on post mortem temperature measurements in the
Available online 5 February 2009
eyeball and orbit soft tissues.
Ó 2008 Elsevier Ireland Ltd. All rights reserved.
Keywords:
Time of death (TOD)
Post mortem processes
Body temperature after death
Eye

Introduction
Precise estimation of the TOD is a difficulty accompanying
forensic medicine from its very beginning. It is one of the funda-
mental tasks of the forensic pathologist summoned to the scene
where a body was found. Following a preliminary diagnosis of
the cause of death, the pathologist decides on the course of inves-
tigative actions. In situations with suspected crime the pathologist
supports the prosecutor’s office and the police by leading investi-
gations to the appropriate direction.
From the point of view of criminal law, a precise estimation of
the TOD enables to verify witnesses’ statements, limit the number
of suspects and assess their alibis, especially since nowadays it
takes less time to travel even long distances. Not precise or incor-
rect estimation of the TOD may cause wrong statements by a sus-
pect, e.g. of being far away from the locus at the time of the crime
difficult to disprove.
Determination of the TOD sometimes also gains relevance
regarding civil law, since it may have impact on the order of inher-
itance or possible commitments resulting from the order of deaths.
Such problems may occur if corpses of two or more related persons
are found simultaneously (e.g. in case of multiple homicide or acci-
dent with several deceased).
Despite attempts over a hundred years to develop methods for
precise estimation of the TOD, the accuracy of these methods, both
* Corresponding author. Tel.: +44 1316502962; fax: +44 1316511345.
E-mail addresses: mkalisza@staffmail.ed.ac.uk, michalkal@amg.gda.pl (M. Kalis-
zan).
when using one of them or combining several of them, still leaves a
margin for improvement. During the first 6 h after death, there is at
least a 2 h margin of error, but in the next 14 h, the margin of error
increases to at least 3 h, and during the following 10 h this margin
of error increases to approximately 4.5 h. The precision of the con-
ventional methods decreases significantly with time. Therefore,
usually since about 24 h post mortem all estimations are rather
rough approximations [1–3]. Nonetheless, there is a potential to
decrease the time of death estimation error, in particular regarding
the very early post mortem period, by choosing eye as the temper-
ature measurement site.
Currently known methods of TOD estimation can be divided
into two groups:
1. The first group comprises methods based on analysis of the pro-
cess of cooling of corpses and the body temperature is mea-
sured (temperature-based methods). Methods based on the
body cooling process are deemed to be more precise when used
in the early post mortem period (first 24 h).
2. The second group consists of methods based on assessment of
post mortem processes occurring in corpses. Some of them, deal-
ing with the early changes, can be applied when the time since
death is counted in hours and others, based on late changes,
even if the post mortem interval is counted in months or years.
Methods based on the body cooling process
One of the first authors to publish important work on the esti-
mation of TOD based on post mortem decrease in body temperature

1344-6223/$ - see front matter Ó 2008 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.legalmed.2008.12.002
112 M. Kaliszan et al. / Legal Medicine 11 (2009) 111–117
was Harry Rainy, Professor at the University of Glasgow [4].
Reviewing the literature, one can find also articles dating earlier.
Davey’s work is cited [1], describing measurement of temperature
in eight corpses of British soldiers who had died in Malta in 1828,
and then another 10 who had died in a colder climate (i.e. Great
Britain). However, Davey did not manage to assess the TOD based
on his examinations. Other reports from this time include papers
by Dowler (or Fowler) from 1844 and 1845, and by Hensley dated
1846 [1], who discussed measurements of temperatures in various
parts of corpses. Conclusions from this research were limited to
recording the increase in temperature that occurred immediately
after death in some cases. Taylor and Wilkes [5] reported on mea-
surements of body temperature using a clinical thermometer ap-
plied to the skin of the abdomen. From the present point of view,
this method of examination does not provide an acceptable reli-
ability of results due to the influence of external factors and the
manner of applying the thermometer. Nevertheless, Taylor and
Wilkes observed a post mortem increase in body temperature,
and a slower decrease in temperature soon after death, although
they did not yet introduce the term plateau. Moreover they ob-
served that tissues located deeper in the corpse showed elevated
temperatures at the time when skin temperatures already dropped
to the ambient temperature, but the results obtained by these
authors were not used to elaborate any method of TOD estimation.
In 1863, Richardson [1] observed that in cases of fatal haemor-
rhage the corpse cools down faster and that the TOD may be esti-
mated erroneously, which subsequently might lead to accusation
of an innocent person as being involved in a crime. In 1866, Erb
[6] described several cases of post mortem increase in body temper-
ature, followed by stabilisation and slow decrease. Nysten [1]
found in case of strangulation, the corpse cooling down over a
longer period (up to 3 days), compared to death caused by other
factors. This was criticized by Taylor and Wilkes [5], who stated
that a body always cools down with the same velocity, indepen-
dent from the cause of death.
In 1868, already mentioned Professor Harry Rainy [4], being the
first to apply Newton’s law of cooling to the process of cooling of a
corpse, considered the ambient temperature as an influencing fac-
tor. By repeatedly measuring temperatures in the rectum of de-
ceased individuals he managed to establish experimentally the
gradient of the curve of temperature decrease versus time, accord-
ing to Newton’s cooling coefficient. Moreover, he confirmed the
existence of an initial phase of slower temperature decrease, later
described by Shapiro [7] as plateau phase. Rainy defined the calcu-
lated TOD to be the minimum period using his logarithmic calcula-
tions enabling to determine the probable range for the TOD.
Furthermore, Rainy stressed the uselessness of measurements of
skin temperature in the determination of the TOD, as well as the
influence of ambient temperature on the reliability of body tem-
perature measurements.
Soon after Rainy’s report, Seydeler [8] observed an irregular
post mortem decrease in temperature measured in the armpit,
i.e. slowly at the beginning, then faster, and slower again. He also
stated that clothes would not have significant influence on the
cooling of a body and he proposed to determine the TOD based
on tables drawn up by himself showing these times to be accurate
within the range of one hour.
In 1880 Burman [9] published in the Edinburgh Medical Journal,
temperatures measured within armpit using a self-made ther-
mometer (allowing to read temperatures without removing the
probe from an armpit), drawing the conclusion that the decrease
of temperature in the first 12 h post mortem is linear and equiva-
lent to 1.6 F/h (i.e. approximately 0.9 °C/h). An initial slower cool-
ing process was not observed by Burman.
Womack [10] in 1887 carried out a series of experiments using
a clinical thermometer. He positioned this thermometer by a tape
to the surface of the abdomen and claimed being able of readings
with an accuracy of 1/4 of a degree, which actually seems to be
highly unlikely. Neither did he observe a post mortem plateau of
temperature. Complex mathematical calculations were supposed
to allow determination of TOD with an accuracy of several minutes,
what – similarly to the precision of measurements done with his
thermometer – appears to be impossible.
In the 1930s Mueller [11,12] published experiments he per-
formed using very modern device as for those times, i.e. a ther-
mo-resistor. Body temperature was continuously recorded on
constantly moving paper tape. This equipment enabled him to per-
manently monitor the temperature in the rectum in a way unat-
tainable before. Mueller published diagrams regarding the
variability of temperatures, taking into account the thickness of
fatty tissue. He also presented tables allowing determination of
the TOD at different ambient temperatures. He noted, however,
that the TOD should be determined not only based on his own re-
sults, but also by other methods not connected with temperature
measurements. Mueller did not observe the plateau of temperature
decrease.
Following an interruption of research on methods for the esti-
mation of TOD, most likely due to WW II, in 1953 Schwarz and
Heidenwolf [13] presented the first standardised sigmoidal curve,
showing a significant slowdown in cooling of a corpse in the initial
period post mortem. This curve was supposed to be applicable
within a limited temperature range (around 17 °C) for any body
weight and any clothes on the deceased. However, Schwarz and
Heidenwolf’s curve never gained practical use.
In 1955 De Saram et al. [14] recorded temperatures in the rec-
tum of hanged criminals immediately after execution. This specific,
however controversial, situation gave the opportunity to start tem-
perature measurements very shortly after death. Examinations
were done in a hot climate (ambient temperature approximately
30 °C), limiting the applicability of the calculated curves to the ac-
tual climatic conditions, which are rather rare in Europe. Neverthe-
less, De Saram et al. [14] added an important factor to the one-
exponential model of temperature decrease previously proposed
because they took into account the post mortem slowdown of tem-
perature decrease (named later as plateau). Therefore, calculations
of TOD benefitted from a relatively small range of error.
In a further study, De Saram [15] measured temperatures in liv-
ers and showed that during the first few hours post mortem tem-
peratures in this organ are similar to those taken in the rectum.
In 1956 Lyle and Cleveland [16], taking advantage of technolog-
ical progress, used a 6-channel thermometer allowing continuous
recording of temperatures in six different locations: chest and fore-
head skin, rectum, liver, brain and thigh muscles. Although, they
did not develop any useful methods for determination of the
TOD, they observed some interesting facts. It turned out that tem-
perature–time curves for the brain are the most regular, and such
curves for skin are the least regular ones. Lyle and Cleveland also
pointed out that time elapsed since death cannot reliably be deter-
mined over 24 h from the moment of death or when body temper-
ature decrease approaches the ambient temperature.
In 1958 Fiddes and Patten [17] published a kind of breakout in
research on TOD estimation based on body temperatures. They
tried to determine the rate of post mortem temperature decrease
by at least double measurements within certain time intervals.
They standardised the decrease of temperature, assuming that at
the moment of death it is 0, and after finishing the process of cool-
ing increasing to 1. They expressed the decrease in temperature
from the standard initial one (37 °C) to the ambient temperature
as a proportional difference. A disadvantage of this method was
the requirement of at least double temperature measurements at
defined time intervals without moving the body, assuming that
the ambient temperature post mortem was stable during examina-
 M. Kaliszan et al. / Legal Medicine 11 (2009) 111–117
tions. However, in 1965, James and Knight [18] verified this meth-
od on own cases but did not confirm its higher value compared to
methods based on single temperature measurement.
In 1958, Sellier [19] presented a different approach to describe
the body temperature decrease using a thermodynamic model of
an infinitely long cylinder being a theoretical model of the human
body. For mathematical calculations, Sellier used data obtained by
De Saram et al. [14]. He proved mathematically that the body ra-
dius is the most important factor characterising curves of cooling.
Factors such as clothes and body covering were classed as addi-
tional and less important. Sellier also observed slower body cooling
during the early post mortem interval. He assumed it was not a re-
sult of the thermo-insulating properties of the fatty tissue, but that
this tissue is equivalent to a higher volume and hence greater body
radius (cylinder). The equation describing this model allows to
determine the temperature gradient and the influence of the
peripheral conditions of cooling. Nevertheless, the author himself
thought that his model might turn out to be too complicated to
be used in everyday practice.
As can be seen, the mentioned studies in the field of TOD esti-
mation presented above, resulting from analyses of the process
of body cooling, were only partially successful, and in some cases
seemed to be even a step back.
Important progress was made in 1962, i.e. about 100 years after
Rainy’s elaboration of a model based on Newton’s law of cooling,
when Marshall and Hoare [20] proposed a two-exponential model
showing that during the first 12 h post mortem a body does not cool
down according to Newton’s law, but slightly slower. The course of
the temperature decrease curve turned out to be of sigmoid char-
acter. The study focused on the causes for slower decrease in tem-
perature during the initial period after death regarding post
mortem metabolism and production of heat, and possible influence
of surface tissues with limited thermal conductivity. Marshall and
Hoare also elucidated that the model they worked out could also
be used for clothed bodies. However, if the corpse is moved or ro-
tated in any way etc., this may result in increasing the error in TOD
assessment. Summarising their research, Marshall [21] concluded
that assessment of the TOD on the basis of temperature measure-
ments of a body will ever be only an approximation.
As mentioned before, the first author, who used the term pla-
teau in relation to post mortem temperature decrease and pub-
lished on this issue, was Shapiro [7]. He emphasised that any
method of estimation of the TOD has to take into account the ini-
tial, slower decrease of temperature. On the basis of this discovery
a simple method for estimation of the TOD was created and named
as ‘‘rule of thumb” which states that the body cools down approx-
imately 1 °C per h, but one needs to add 3 h to the calculated TOD
because of the plateau period.
In 1974, Brown and Marshall [22] showed that use of more than
two exponential equations only complicated the model without
increasing the precision of the results. However, use of a two-expo-
nential model might individually determine the TOD by measuring
temperature in the rectum only once and taking into account body
proportions and ambient temperature in standardised conditions
for cooling. The formula describing the two-exponential model
was first used in the 1980s, being modified by Henssge [23]. He
presented a simplified method to calculate Newton’s cooling coef-
ficient and determined statistical values of deviation between cal-
culated and actual TOD for the process of cooling under
standardised conditions. Based on examination of the process of
body cooling on numerous corpses and also using special phan-
toms (filled with gel to simulate a human body), Henssge et al.
broadened the range of applications of the method to encompass
various conditions of cooling. They also introduced empirical cor-
rective multipliers for body mass, various types of clothing and
conditions at the scene of death. As a result they created nomo-
113
grams, used as a standard method by forensic medicine specialists,
which allow to read instead of calculating the TOD [23–25]. Com-
puter software created from this research is also helpful and used
for TOD estimations [26].
Further experiments in order to widen the range of applications
for the ”nomogram method” focused on various conditions of cool-
ing, e.g. bodies submerged in water [27] or exposed to sudden
changes of ambient temperature [28,29]. For such conditions, pos-
sible variations between read time and actual TOD were addition-
ally included in the nomogram. The applicability of Henssge’s
nomogram, considering corrective factors according to different
environmental conditions, was confirmed by other studies [30,31].
The phantoms (artificial bodies) designed by Henssge et al. [32]
can also be used for reconstruction of the course of body cooling
under any conditions, including the actual scene where a body
was found. Further examinations, using phantoms and real bodies,
confirmed the ‘‘nomogram method”, which has been generally ac-
cepted (and is currently widely used) as the leading method for
determination of the TOD in the early post mortem interval
[1,23,24].
In the 1980s, Hiraiwa [33] also worked on the determination of
the TOD based on temperature measurements by developing the
conception of Sellier [19], who assumed the human body to be a
cylinder with infinitive length. Hiraiwa’s work taking temperature
measurements in the rectum showed the error of method to be less
than 1 h. To facilitate readings of the TOD he developed special
software, but he was not able to avoid some simplifications, which
in practice may have significantly increased the declared rather
low error in assessment of the TOD.
In 1985 Green and Wright [34] published a method for estima-
tion of the TOD ignoring body mass parameters, but only based on
double temperature measurements in the rectum at 1 h intervals
and records of ambient temperatures. The time after death was cal-
culated by coefficient read from a graph established by using a the-
oretical cooling curve.
Attempts were also undertaken to use other body sites to record
body temperature. The brain turned out to be a possibility for rel-
atively precise assessment of TOD, especially in the first 6 h post
mortem (accurate to ±1.5 h). Brinkmann, Henssge et al. [35–37]
developed a nomogram for the brain which enabled easy reading
of time passed since death using the same standards as for temper-
atures in the rectum. An advantageous factor regarding the brain is
the lack of influence by the body mass on its temperature. How-
ever, the error of TOD estimation may increase e.g. because of vary-
ing amounts of hair or covering of head (i.e. cap, hat) influencing
the thermal isolation of the brain. A factor contributing to making
the use of brain temperature measurements more difficult is the
necessity to insert a probe inside the skull. However, current tech-
nical development also allows to record brain temperature by non-
invasive methods such as magnetic resonance spectroscopy [38].
In the mid 1980s, Miścicka-Śliwka and Śliwka published a series
of papers [39–44], describing own examinations on the usefulness
of corpse temperature measurements at several body sites to as-
sess the TOD. It was found that the heart might be a reliable site
for temperature measurements. Miścicka-Śliwka and Śliwka devel-
oped a nomogram enabling reading the TOD based on heart tem-
perature measurement, taking into account the circumference of
the chest. They also expressed, similar to German researchers
[35–37], the usefulness of brain temperature measurements and
their high correlation with the TOD.
In the 1990s, Baccino et al. [45] performed a series of experi-
ments based on outer ear temperature measurement. Tempera-
tures were recorded by a probe inserted into the ear, its tip with
contact to the tympanic membrane. A plateau of post mortem de-
crease was not observed in outer ear temperature. The method
was proposed to be usable in ambient temperatures between
114 M. Kaliszan et al. / Legal Medicine 11 (2009) 111–117
16 °C and 23 °C. According to the authors, tympanic temperature
closely reflects the cerebral temperature and the results were
therefore characterised by an accuracy similar to that of the nomo-
gram method by Henssge. Besides, in the initial period after death
the accuracy was even better. Additionally, an important advan-
tage was this possibility represents an alternative method when
suspecting a sexual background of a crime (no infringement of
the rectum). Baccino et al. are continuing their experiments and
have recently published about the use of a pig model to study
the ear and brain cooling processes in pig heads submerged in
water or kept in air with a temperature between 0 and 20 °C, indi-
cating a very high correlation coefficient of cooling regarding pig
brains and ears and also the exponential character of cooling pro-
cesses [46]. Measurements of the temperature in the auditory ca-
nal were also of interest of Japan researchers [47]. Moreover,
they observed that the estimation of the TOD might be influenced
by rounding errors caused by thermometer resolution.
A discussion of the latest research on body temperature mea-
surements to assess the TOD should also include a method devel-
oped by Al-Alousi et al. [48,49], based on microwave
thermography in three body sites: brain, liver and rectum. These
authors calculated curves of the average course of cooling within
certain body regions, separately for naked and covered bodies
resulting in a triple-exponential equation including temperatures
from these sites. However, this method requires basic knowledge
of organ temperatures at the moment of death, and inaccuracy in
this matter may result in wide errors in TOD estimation [1].
Mall et al. [50] attempted to determine the TOD in cases when
conditions regarding the scene of death were incomplete. Based on
the model of infinitive elements, continuous monitoring of body
temperature to determine the velocity of cooling, lasting for sev-
eral hours, was carried out. On this basis, firstly the ambient con-
ditions had to be determined, and only then the TOD.
In 2005 Kaliszan et al. [51] reported about temperature mea-
surements in the eyeball and soft tissues of the orbit as of possible
usefulness in determination of the post mortem interval. Experi-
ments were conducted on pigs, as their eyeballs, in terms of anat-
omy and physiology, are most similar to human ones.
Temperatures were taken continuously starting 75 min after bring-
ing pigs to death in eyeballs, orbit soft tissues, muscles and recta.
The results confirm the validity of using the eyeball and the orbit
soft tissues as measurement sites in the early post mortem period.
Kaliszan et al. found that, cooling of the eyeballs and orbit soft tis-
sues does not show a temperature plateau phenomenon. This
means that a single-exponential equation can describe the de-
crease of temperature in the eyeball over time achieving the most
precise estimation of the TOD within a period up to 13 h post mor-
tem. Precision of TOD estimation based on temperatures of the or-
bit soft tissues is more reliable than that by measurements taken in
muscles and in rectum up to 10 h after death. However, better
assessment is ensured by data obtained from temperature mea-
surements in muscles and in the rectum in the later post mortem
interval.
In a further study in pigs, using the same methods, tempera-
tures were recorded continuously starting already 30 min after
pigs’ death. Kaliszan et al. [52–54] confirmed the lack of a temper-
ature plateau for the cooling of eyeballs and orbit soft tissues and
introduced a double-exponential equation allowing for even more
accurate estimations of the post mortem interval during the first
hours after death. It was also shown that a moderate air flow in
the room where the body is situated (wind below 2 degrees on
the Beaufort scale) does not have a significant influence on the rate
of body cooling. The experiment furthermore demonstrated that
the intensity of an airflow in the experimental room, however en-
forced by ventilation equipment, was different in various room
locations. Even if an airflow was significant in the centre of the
room, what was in fact very low close to the pigs’ bodies, lying
on the floor. Therefore it turned out that the ambient temperatures
(which obviously can be affected by the airflow) are a crucial factor
at the scene of death.
Based on their own examinations, Kaliszan et al. [51–54] con-
cluded that implementation of the method of the TOD estimation,
developed from experiments in pigs, based on temperature moni-
toring in the eyeball and orbit soft tissues, into forensic medical
practice (relating to humans) is well-founded. Therefore, there
may be a real possibility to introduce this method to the forensic
practice after verification on human bodies using the methodology
developed on pigs.
The more important contributions to the development of temper-
ature based TOD estimation methods are summarized in Table 1.
Methods based on assessment of other post mortem changes
Among methods for estimation of the TOD being based on post
mortem changes in the body during the first few days following
death, the following appear to be noteworthy: assessment of inten-
sity and movability of hypostasis (lividity), development and
receding of rigor mortis, and drying out of the cornea. Examination
of supra-vital reactions may be also important, namely assessment
of response of skeletal muscles to mechanical stimulus (Zsako’s
phenomenon) or electrical stimulus, the reaction of face muscles
(orbicular muscles of eye and mouth) to electric excitation or phar-
macological reaction of the pupils to either pilocarpine (contract-
ing the pupil) or atropine (dilating the pupil) when being applied
to the conjunctival sac or injected into the anterior chamber of
the eyeball [1–3,55,56]. In the later post mortem period, an indica-
tion helping pathologists to approximate the TOD (up to several
days, weeks or even months) can be drawn from the degree of pro-
gress of so-called late changes, i.e. putrefaction, formation of adi-
pocere, mummification or even peaty transformations [2,3].
In cases where a skeleton represents the only remains, the pre-
cision of TOD estimation becomes considerably worse. Assessment
of the post mortem interval can only be based on appearances,
weights or fragility of bones. Ultraviolet fluorescence or determi-
nation of amino-acids present in bones can help to make the esti-
mation of the TOD more precise. However, this method can only
assist to estimate the minimum post mortem period within a range
of several dozen years. A procedure based on determining the C14
carbon activity, quite common in the field of archaeology, may
be used only if the remains are expected to be at least a couple
of hundreds of years old and hence has no practical value in foren-
sic medicine.
Methods allowing estimation of the TOD also comprise analyses
of biochemical processes occurring in corpses, i.e. examination of
enzymes in tissues and body fluids, determination of organic and
non-organic compounds, including products of degradation of pro-
teins [2,57–61]. Among such methods using biochemical processes,
worthy of note for the TOD estimation is the method consisting in
examination of the liver enzymes’ activity: lactate dehydrogenase
and malate dehydrogenase. It enables assessment of the TOD with
a precision range of several days, even as long as 35 days after
death [62].
In assessing the TOD another rapidly developing area of forensic
medicine, namely forensic entomology, seems to gain increasing
importance. It is based on revealing the presence and determining
the stage of development of insects and their larvae found on a
corpse. This method is particularly valuable if a body is found out-
doors in warm climate, but recent experiments have shown that
entomological methods can also be applied during the cold (win-
ter) season [63]. Moreover, entomological procedures can help to
determine whether a body was moved to the place where it was
found from another environment, being typical for a certain spe-
 M. Kaliszan et al. / Legal Medicine 11 (2009) 111–117 115

Table 1
Most significant contributions to the development of methods of TOD estimation based on body temperature measurements.

Year Authors [Ref. no.] Basic novelty Precision of TOD determination (with 95% confidence)
1868 Rainy [4] Application of the Newton’s law of cooling d.u.
1958 Fiddes and Patten [17] Double or multiple temperature measurements ±3 h*
1962 Marshall and Hoare [20] Double exponential model of body cooling ±2 h*
1965 Shapiro [7] ‘‘Plateau” of temperature decrease d.u.
1980 Hiraiwa et al. [33] Development of the concept of ‘‘infinite cylinder” ±1 h*
1980s Henssge et al. [23,37] Nomogram method for rectum and brain ±1.5 h up to 6 hpmbrain ±3 h up to 24 hpmrectum
1980s Miścicka-Śliwka and Śliwka [42,44] Nomogram method for heart ±3 h up to 24 hpm
1985 Green and Wright [34] Development of double exponential model of cooling ±3 h up to 23 hpm
1990s Baccino et al. [45,46] Outer ear temperature measurements ±2 h up to 15 hpm
2000s Al-Alousi et al. [48,49] Application of microwave thermography ±3 h*
2005 Kaliszan et al. [51–54] Eye temperature measurements ±0.5-2 h up to 13 hpm

d.u. – data unavailable.

*
- no precise time range known.

cies of insects [64–66]. Recognising an increasing relevance of
entomology in forensic medicine an example regarding best prac-
tice including an overview of equipment used for collection of
entomological evidence and detailed description of the methods
has recently been published [67]. A combination of entomology
and genetics (insect gene expression) has also showed its useful-
ness in estimation of the post mortem interval even in the earliest
phases of fly development. The final outcome of these procedures
is a more precise age given by development of blow flies, resulting
in more accurate estimation of the death time [68].
Research on use of assessment of DNA decomposition in order
to estimate the TOD has also been carried out, showing that the ex-
tent of DNA decomposition may be measured by flow cytometry.
This is, however, still an experimental method requiring further re-
search, so that it has not yet widely been applied in the field of
forensic medicine [69,70].
One of the latest attempts regarding TOD estimation uses one of
the most modern analytical techniques, i.e. H-MRS (1H-magnetic
resonance spectroscopy). It is based on the principle to identify
products of brain tissue decomposition. According to its inventors,
H-MRS allows to estimate the TOD within a period of time from 30
to 400 h post mortem [71].
There have also been published other methods involving analy-
ses of necrochemical processes, but until today these are recogni-
sed to be of less relevance due to their insufficient precision. The
following analytical methods should be mentioned: concentration
of potassium or hypoxanthine in the vitreous body of the eye
[1,58,70,72,73], chlorides in blood plasma [74], biochemical exam-
ination of synovial fluid [75] or cerebrospinal fluid [72,76,77] and
concentrations of electrolytes in pericardial fluid [78]. There have
also been made experimental attempts to estimate TOD based on
presence of gastric contents, assuming that food usually remains
in the stomach approximately 2–3 h after ingestion, but that
‘‘hard-digestive” meals may stay in the stomach for up to several
hours [79]. The use of measurements of electrical impedance of tis-
sues and in this way assessing the TOD within a period up to the
twentieth day post mortem was also studied but appeared to have
very limited accuracy [80].
Methods combining body temperature measurements and
observation of post mortem changes
A number of authors recommend that determination of the TOD
should be based on combined application of different methods in
order to increase the overall accuracy. Body temperatures may be
taken from more than one site (e.g. rectum, brain [81] and liver
[48,49]), and body temperature assessment can be complemented
by other methods of TOD estimation [25,82] or several different
non-temperature related methods can be used as well [83,84].
According to Henssge and Madea [25], particularly a combination
of body temperature measurements together with the assessment
of intensity and movability of hypostasis, development of rigor
mortis, assessment of response of skeletal muscles to mechanical
and electrical stimuli and the pharmacological reactivity of the pu-
pils turned out to be the most reliable spectrum allowing to assess
the TOD much more accurately than with any other of the previ-
ously described methods alone. These authors also definitely
encourage to focus the research on the later post mortem interval,
because it is currently already hard to improve the estimation of
the TOD in the early post mortem period [85].
In some situations the range between the lower and upper lim-
its of the post mortem interval, calculated from recorded tempera-
tures, may significantly be narrowed by taking into account one or
more of the additional parameters, above mentioned. This state-
ment has also been supported by the study of Honjyo et al. [86]
demonstrating the usefulness of non-temperature based post mor-
tem changes being supportive factors to rectal temperature mea-
surements concerning a most precise estimation of the TOD.
Conclusions
As pointed out, there have been invented numerous tempera-
ture-based methods during the last 100 years in order to estimate
the TOD, but none of them alone allows to define the post mortem
interval with absolute precision. Therefore, during the early post
mortem period (up to 24 h) one simple method as above mentioned
‘‘rule of thumb” or the more detailed Henssge nomogram is used in
practice, complemented by assessment of hypostasis and rigor
mortis, sometimes also together with regard to some of supra-vital
reactions. However, recent studies including examinations of eye
or ear temperatures can be the source of new impulses to possibil-
ities of TOD estimation in the early post mortem period.
Obviously, there are more difficulties to recalculate the TOD
during the later post mortem period, i.e. when a body is decom-
posed or even only skeletal remains are found. In such situations
and scenarios the precision to estimate a post mortem interval
can be limited to days, weeks or even years depending on the con-
ditions of the corpse and environment, and practically also consid-
erably on the forensic pathologist’s experience. This type of cases
would therefore require other e.g. entomological or biochemical
methods to have additional data available to reach the most possi-
ble precision regarding the TOD.
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