Examination, postmortem

An autopsy. Also called a necropsy. Postmortem examinations have been done for more than 2,000 years but during most of this time they were rarely done, and then only for legal purposes. The Roman physician Antistius performed one of the earliest autopsies on record. In 44 B.C., he examined Julius Caesar and documented 23 wounds, including a final fatal stab to the chest. In 1410, the Catholic Church itself ordered an autopsy — on Pope Alexander V, to determine whether his successor had poisoned him. No evidence of this was found. By the turn of the 20th century, prominent physicians such as Rudolf Virchow in Berlin, Karl Rokitansky in Vienna, and William Osler in Baltimore won popular support for the practice. They defended it as a tool of discovery, one that was needed to identify the cause of tuberculosis, reveal how to treat appendicitis, and establish the existence of Alzheimer disease. They showed that autopsies prevented errors — that, without autopsies, doctors could not know when their diagnoses were incorrect. Most deaths were a mystery then, and perhaps what clinched the argument was the notion that autopsies could provide families with answers — give the story of a loved one's life a comprehensible ending. By the end of the Second World War, the autopsy was firmly established as a routine part of death in North America and Europe. For more information, see Autopsy (Postmortem Examination).