Jack the Ripper on Hanbury Street

[D.J.Adams]

So... Elizabeth Long's supposed sighting allows modern 'Ripperologists' to determine that the culprit was 5 feet 3 inches tall, that also being the height of the inscriber of the Goulston Street graffiti.
Amazing.
And based on the good Doctor, Bagster Phillips's, post mortem we know that Annie Chapman had advanced TB.

Yep.
Not that difficult actually.
Shorter than your favorite suspect?

[Gary Barnett]

Yep.
Not that difficult actually.
Shorter than your favorite suspect?

About the same as yours? ;-)

[Christer Holmgren]

Here is what I would like to add to the discussion about when Annie Chapman died.

When I wrote Cutting Point, I discussed some aspects of the case with two experts in forensic medicine, professors Jason Payne James and Ingemar Thiblin. I have since spoken to Ingemar Thiblin specifically about the issue of Chapmans time of death.

Thiblin initially took great care to point out that feeling for warmth by hand is a very uncertain method. He then added that the real problem with the method is that it failed to establish core temperatures. When I pointed out to him that Dr Phillips felt for warmth in the abdominal cavity, under the intestines, and discerned some little warmth there, Thiblin immeduately said "Then it is a very different matter. If Phillips felt a clear difference between surface and core, then it speaks for the option of a PMI of 3-4 hours instead of one of 1 hour only." He added that the other parameters mentioned were in line with such a timing too.

I thanked him for his help, but realized later that I had not been given any reason for Thiblins conclusion. So I approached him again and asked him if he could help me out. This is what he answered, in translation:

"Most of the knowledge of body temperature revolves around rectally measured temperatures or temperatures measured in inner organs. A rule of thumb is that body temperature drops 1 degree Celsius per hour. If we turn it around, one would speak of 1 hour per degree plus/minus 2 hours. Slightly slower in the beginning and towards the end (before the body has settled at the ambient temperature).

However, many studies show us that the central temperature kan remain around 37 degrees for several hours. There are even indications that the central temperature can rise slightly for some time after death. The reason for this is believed to be the work of micro-organisms.

Therefore, it is quite possible that inner organs can feel warm for several hours after death, something I have observed myself after several days of refrigerator storing of very obese individuals.

When it comes to the skin, I can find no study of post mortal temperature variations. I myself have observed warmish temperatures during examinations in situ around 4-5 hours after death. But this has taken place indoors. I can imagine that outdoors, unprotected skin will quickly take on the ambient temperature. There is no blood circulation warming from underneath in such a case. Wind and high humidity should quicken the process. Therefore, if it was raining and the clothing was damp, this should be taken into account. I can accordingly not rule out that the skin would feel cold already after some hour in a body that has been outside in September (unless it was unusually warm). The likelihood for the skin feeling cold is higher if the skin the doctor felt was exposed to the elements. If he felt the armpits and groins, it is another matter."

So this is what a renowned expert in forensic medicine tells us: SInce Phillips felt the core of the body and found it do differ from the skin temperature, a TOD around 3-4 hours before the examination is likelier than the suggestion that she had been dead for only an hour.

Thiblin sees no problem with how Chapmans body felt cold to the touch on the outside - that could well occur in an hour, depending on the elements. However, I find it interesting that Thiblin added that this only was the case for exposed skin - the armpits and groins would not feel cold after an hour only. So in that department, the question becomes one of whether Bagster Phillips felt these areas. And that question boils down to whether or not he was aware of how this was where the bodily warmth would remain longer. My own guess is that Phillips was perfectly aware of it.

To me, this leaves me in little doubt. Annie Chapman was not killed at 5.30. She died at a time that is roughly consistent with the TOD death in the Nichols case.

And no, I did not feed Ingemar Thiblin misleading material, nor did I bribe him.

I could not afford it.

[Mark J D]

... body temperature [etc]...

Would Chapman's living body temperature have been slightly higher than normal because of her diseased state?

M.

[Christer Holmgren]

Would Chapman's living body temperature have been slightly higher than normal because of her diseased state?

M.

Well, the thing is, when this issue is discussed, reports on various more or less exotic conditions causing temperatures to rise, fall or disappear entirely have been dug out and presented as evidence in the Chapman case. And yes, we should not loose sight of how people are different in many respects. Humankind offers a very wide variety of bodily behaviours in different situations, and it is true to say that each person is unique.

That, however, does not alter the fact that we are also very much alike, which is why we can produce for example medicines that will work in the same way on just about everybody. If we had differed wildly from person to person, that would not be possible.

In Cutting Point, I write about bleeding times in relation to Polly Nichols death.I asked Payne James and Thiblin about it, but I did not ask "for how long would Polly Nichols have bled after being cut?" because it is impossible to say about an individual about whom we do not know the personal conditions. Plus, of course, both doctors were aware that I write in the book that it seems she bled for at least around nine minutes. So what I did was to instead ask what kind they thought would have been the likeliest bleeding out time, given the circumstances involved. Which led to both doctors opting for a time of arund thre to five minutes.

And this is how I think we must approach these kinds of things. We will never be able to rule out factors that may have played a role, we will never be able to rule out incompetence on behalf of the medicos involved and we will never be able to rule out bias on behalf of the ones presenting something. So all we can do is to humbly ask about the likely outcome instead of trying to present any specific and exact determination.

Thiblin says that since there was a clearly discernable difference in temperature between core and surface in Chapmans case, this points more to a 3-4 hour time than to one hour only. And he also says that exposed skin could perhaps feel all cold after one hour only, especially if the weather was cold, wet and windy, but skin in places like armpits and groins, unexposed to the elements, would be a different story.

So when it comes to that factor, it boils down to whether or not Phillips felt for warmth in those areas, and given that he even tucked his hand into the abdominal cavity, under the intestines to feel for warmth, I´d say that it looks like a no-brainer to me. What Phillips says is recorded in the Daily Telegraph as "The body was cold, except that there was a certain remaining heat, under the intestines, in the body" and in the Morning Advertiser as "The left side of the body was cold, excepting a remaining heat under the intestines in the body". Both quotes lead me to think that Phillips checked the whole body, or at least one side of it, from the top and all the way down - and that would include armpits and groins.

[D.J.Adams]

Would Chapman's living body temperature have been slightly higher than normal because of her diseased state?

M.

Someone with tuberculous meningitis can experience temperatures as low as 32C.

[Christer Holmgren]

Someone with tuberculous meningitis can experience temperatures as low as 32C.

As I said, all sorts of speculation can be applied to the Chapman case. I find what counts is Thiblins words about how the discernable difference between core temperature and surface temperature points to a TOD 3-4 hours removed in time rather than just the one hour., plus how Phillips would have felt armpits and groins, only to feel that they were all cold - which they would not have been with a TOD just one hour away.

If Chapman started out from 32 degrees, her cold body in cold conditions would furthermore have been likely to develop rigor more slowly, not more quickly.

The Home Office described the testimony from the triumvirate of witnesses as ”doubtful” for very good reasons.

Me, I have fought this fight too many times already, so I am glad that a professor of forensic medicine has taken over now.

[D.J.Adams]

jnnpsyc00059-0075.pdf

That should remove much speculation.

[Christer Holmgren]

jnnpsyc00059-0075.pdf

That should remove much speculation.

I dont think anybody has claimed that people with tuberculosis meningitis cannot develop hypothermia. However, it seems that high, not low, temperatures is a typical symtom of the disease, just as is the case with all types of tuberculosis.

Again, with some effort, exceptions to rules can always be found. And that is what has always plagued the Chapman issue. Her rocket start rigor is much the same - generally, low temperatures will slow down rigor, but who wants ”generally” when three witnesses presenting doubtful evidence need to be squeezed in? No, lets look for exceptions instead!

Again, I am going with Thiblin.

[Christer Holmgren]

Just checked a clinical study of nigh on 200 patients with tuberculosis meningitis. One of the commonest symptoms was fever, 78,3 per cent developed it.

That should remove speculation too, one would hope.

If it had not been for Richardson (who gave different stories of his whereabouts in the back yard), Cadosch (who diluted his initial story beyond recognition) and Long (who didnt pay attention as per herself), nobody would dream of questioning Phillips. His verdict was consistent throughout with the respective parameters corroborating each other and establishing a timeline that was in line with the Nichols deed.

All it took for ripperology to show the simple truth on the door was three unreliable witnesses and a coroner who had a flair of stealing the show.

Ingemar Thiblin has told us why his medical colleague was the one who got it right.

[D.J.Adams]

Just checked a clinical study of nigh on 200 patients with tuberculosis meningitis. One of the commonest symptoms was fever, 78,3 per cent developed it.

Sounds like an interesting read.
Do you have a link or the authors of the clinical study?

[Christer Holmgren]

Sounds like an interesting read.
Do you have a link or the authors of the clinical study?

The link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122581/

The passage referred to, from the abstract: "A total of 89.9% patients illustrated symptoms of acute or sub-acute TBM. The most frequent symptoms and signs were fever (78.3%), headache (89.2%), decreased level of consciousness (48.1%), meningeal irritation (73%), impairment of cranial nerve function and increased intracranial pressure (60%)."

In the abstract, the numbers referred to are all describing patients that displayed symptoms that pointed them out as likely having T M, but since not all of them actually DID, it is of course vital to say that the fever number is linked to suspected cases, not identified ones. However, in the study, it also says that:

The clinical manifestations of TBM are non-characteristic, and common symptoms include headache (50–80%), fever (60–95%), loss of appetite and weight loss (60–80%), and vomiting (30–60%).

... so fever does seem to be a very common symptom.

I am not any medico, so I can only search the net for relevant material when these kind of questions arise. If you have the medical experience and insights, could you please answer these two questions:

1. Is it true, as it says on the net, that all types of tuberculosis have a connection to fever, and
2. Are you saying that hypothermia is something more than 50 per cent of those with Tuberculosis Meningitis will develop, or is it a case of there being a possibility that a fraction of the patients will develop it? If so, could you give a number for that fraction?

I read about body temperature on the net that the scope of temperatures that could be regarded as normal ranged from 33 something up to 38 something, and so that alone would provide Chapman with a possibility of having a body temperature close to the 32 something you mentioned for a T M patient - without even being sick! The question, however, is just how likely it would be that Chapman was a 33 something person. My own uneducated guess would be that perhaps ninety per cent plus of us range from 36,0 to 37,9, but as I said, I am no medico. Maybe you can confirm or dispell my belief in that department?

[Christer Holmgren]

jnnpsyc00059-0075.pdf

That should remove much speculation.

Having taken a look at this report, it seems the patients spoken of (the study is specifically about a single patient, but comparisons are made), who have a temperature fall for various reasons, tuberculosis meningitis being one such possible reason, enter into stages of intellectual impairment and possible personality changes. It seems no such factors are mentioned in the material concerning Annie Chapman, although we do of course not have any full evaluation about it. But overall, nobody seems to make any remarks about her having acted strangely or differently from a normal pattern.

If I am misunderstanding this, please let me know, but that is how it reads to me.

[Chris Phillips]

Here is what I would like to add to the discussion about when Annie Chapman died.

When I wrote Cutting Point, I discussed some aspects of the case with two experts in forensic medicine, professors Jason Payne James and Ingemar Thiblin. I have since spoken to Ingemar Thiblin specifically about the issue of Chapmans time of death.

Thiblin initially took great care to point out that feeling for warmth by hand is a very uncertain method. He then added that the real problem with the method is that it failed to establish core temperatures. When I pointed out to him that Dr Phillips felt for warmth in the abdominal cavity, under the intestines, and discerned some little warmth there, Thiblin immeduately said "Then it is a very different matter. If Phillips felt a clear difference between surface and core, then it speaks for the option of a PMI of 3-4 hours instead of one of 1 hour only." He added that the other parameters mentioned were in line with such a timing too.

I thanked him for his help, but realized later that I had not been given any reason for Thiblins conclusion. So I approached him again and asked him if he could help me out. This is what he answered, in translation:

"Most of the knowledge of body temperature revolves around rectally measured temperatures or temperatures measured in inner organs. A rule of thumb is that body temperature drops 1 degree Celsius per hour. If we turn it around, one would speak of 1 hour per degree plus/minus 2 hours. Slightly slower in the beginning and towards the end (before the body has settled at the ambient temperature).

However, many studies show us that the central temperature kan remain around 37 degrees for several hours. There are even indications that the central temperature can rise slightly for some time after death. The reason for this is believed to be the work of micro-organisms.

Therefore, it is quite possible that inner organs can feel warm for several hours after death, something I have observed myself after several days of refrigerator storing of very obese individuals.

When it comes to the skin, I can find no study of post mortal temperature variations. I myself have observed warmish temperatures during examinations in situ around 4-5 hours after death. But this has taken place indoors. I can imagine that outdoors, unprotected skin will quickly take on the ambient temperature. There is no blood circulation warming from underneath in such a case. Wind and high humidity should quicken the process. Therefore, if it was raining and the clothing was damp, this should be taken into account. I can accordingly not rule out that the skin would feel cold already after some hour in a body that has been outside in September (unless it was unusually warm). The likelihood for the skin feeling cold is higher if the skin the doctor felt was exposed to the elements. If he felt the armpits and groins, it is another matter."

So this is what a renowned expert in forensic medicine tells us: SInce Phillips felt the core of the body and found it do differ from the skin temperature, a TOD around 3-4 hours before the examination is likelier than the suggestion that she had been dead for only an hour.

Thiblin sees no problem with how Chapmans body felt cold to the touch on the outside - that could well occur in an hour, depending on the elements. However, I find it interesting that Thiblin added that this only was the case for exposed skin - the armpits and groins would not feel cold after an hour only. So in that department, the question becomes one of whether Bagster Phillips felt these areas. And that question boils down to whether or not he was aware of how this was where the bodily warmth would remain longer. My own guess is that Phillips was perfectly aware of it.

To me, this leaves me in little doubt. Annie Chapman was not killed at 5.30. She died at a time that is roughly consistent with the TOD death in the Nichols case.

And no, I did not feed Ingemar Thiblin misleading material, nor did I bribe him.

I could not afford it.

I find it difficult to understand how these comments would enable you to reach that conclusion.

You quote Ingemar Thiblin as saying the margin of error would be "plus/minus 2 hours" using a "rule of thumb" based on a measurement of temperature,

Thiblin indicated that he thought a time of death of 3-4 hours before examination was likelier than 1 hour. But even if the margin of error were only 2 hours, a central estimate of 3.5 hours would leave a range of 1.5-5.5 hours. And that rule of thumb is a calculation based on a measured temperature. Here there was no measured temperature, only an impression based on touch ("a certain remaining heat"). So the margin of error must be larger - perhaps considerably larger,.

Did Thiblin a margin of error for his own estimate, as opposed to the rule of thumb based on temperature measurement? If not, despite the fact that he thought 3-4 hours was the likeliest time, there would be nothing in his comments to rule out a time as short as 1 hour.

[D.J.Adams]

That study has 2.3% confirmed TBM.

Roughly half of PTB patients have a fever when presenting for treatment at hospitals.That's early days with the immune system reacting to the TB bacteria.

36 to 36.8 C is normal.

Very busy today and tomorrow,however shall get back to you.Thanks for your time.

I do find Elizabeth Long's evidence compelling.