The Forensic Doctor Better Than a Detective

"According to the conventional corpse phenomenon analysis process, this is indeed the standard manifestation of blood pooling."

"So, how is blood pooling defined in forensic medicine?"

"Blood pooling occurs after a person’s death, where gravity causes blood to gradually settle in the lower parts of the body and accumulate in areas that are not under pressure."

"Therefore, there are two conditions for the appearance of blood pooling: first, it must be located in the lower part of the body, and second, that area must not have been subjected to external pressure."

"Considering this corpse, the sides of the abdomen, from the appearance, indeed are in the lower part of the body and are areas of the abdomen not subjected to pressure, seemingly perfectly matching the above definition."

At this point, he paused slightly, letting his gaze sweep across the room, and his tone became more serious: "However, everyone should pay special attention to a key detail—in this case of autopsy, I believe the responsible forensic pathologist performed a very important and excellent operation: the abdominal incision was not the conventional longitudinal cut but rather an exploratory, gradually advancing dissection method."

"It is precisely this extra cautious exploratory cutting technique that fully exposed the situation within the abdominal cavity, clearly presenting the uterine morphological characteristics, thereby providing us with crucial medical evidence and an observation window for determining whether the abdomen was subjected to external forces."

"This point is the core that we cannot overlook."

As soon as he finished speaking, the previously rising tide of questioning noticeably subsided, and a whispering sound of exchanging words filled the venue.

Sitting in the front row, Zhang Biao and Director Lu both leaned forward slightly, exchanged a glance, and saw a hint of surprise and reconsideration in each other’s eyes.

This young man indeed seems to have some genuine insights.

Jiang An continued: "Alright, let’s look at the exploratory incision on the abdomen."

"Please note that the location of this transverse incision precisely spans the most prominent distribution area of the blood pooling."

As he spoke, he gestured on the diagram before him, "When finely observing the cut surface of the blood pooling area, we can clearly see that the fractured side of the skin presents a special pattern: scattered local cluster blood clots, distributed unevenly, but exhibiting a specific density pattern."

At that moment, the most senior police officer, who had previously voiced the strongest doubts, couldn’t hold back and interjected with a frown, "Is there anything unusual? When a person dies and blood settles forming blood pooling, when you cut into the area with apparent blood pooling, of course, you’re going to see clumps of gore! This is basic common sense."

Faced with this direct challenge, Jiang An did not show any displeasure.

"What you’re describing occurs if the time of death is already quite long, where blood is entirely settled and fixed, then much of your point is valid."

"What’s the relation to the time of death? Are you deliberately making it convoluted?"

The opposition spoke with skepticism, "Is there necessarily any connection between blood pooling and the time of death?"

With a slight crease in his brow, Jiang An replied in a deep voice, "In forensic practice, there is indeed a clear correspondence between blood pooling formation and the time of death."

"Especially for blood pooling formed within 12 hours post-mortem, there’s a critical feature—when we move the position of a corpse, the initially formed blood pooling will gradually fade and reappear in the new lower parts of the body. This phenomenon is more prominent within six hours after death."

"For instance, if we change a corpse in a prone position to a supine position within 6 hours post-death, then the blood pooling originally formed on the anterior side will completely disappear."

"Subsequently, new blood pooling will gradually form in lower regions like the back."

"Thus, by observing the distribution and the shape of blood pooling and whether it relocates with changes in position, we can make a relatively accurate preliminary estimation of the time of death."

Seeing the crowd’s faces still showing signs of confusion, Jiang An further elaborated: "Some of you might have noticed earlier that I emphasized the red patches on the abdomen side of this corpse are not typical blood pooling but pre-death bleeding."

"So, why draw such a conclusion?"

"The core judgment basis lies in the correspondence between time factors and corpse phenomena."

"Based on the room temperature data recorded by the forensic scene, combined with the early signs currently exhibited by the corpse—such as the degree of rigor, corneal cloudiness, and the temperature drop curve—we can preliminarily deduce that the time of death is approximately around five hours."

"If we take into account the time to transport the corpse from the scene to the autopsy center and perform preliminary handling, it should total no more than six hours."

"This involves an important forensic knowledge point: normally within six hours post-mortem, blood pooling is still in the settling phase."

"During this phase, blood deposits in the lower parts of the corpse due to gravity but is not completely fixed."

"Therefore, when the position of the corpse changes—from the initial prone position to a supine position—and is affected by vibrations and shifts during transportation, the blood originally deposited on the abdomen side could entirely flow again and re-accumulate in new lower regions like the back."

"Based on this principle, if during the autopsy we cut open the abdomen, under the dual influence of position change and the cutting operation, if the red patches in that area are caused by blood pooling, then the blood within should flow to the back side, and the redness in that position should visibly fade or even disappear."

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