Tattoos: Forensic Considerations and Human Identification Pt.1

In 2005, the U.N. General Assembly designated January 27th as the International Day of Commemoration in memory of victims of the Holocaust. It is well-known that each survivor has one number on their forearm. These numbers are all tattooed by the time of their arrival at the concentration camp.

(Taken at Miami Holocaust Memorial in 2014. If you zoomed in, you will see a number tattooed on the arm, half covered by the statues of people)

According to the United States Holocaust Memorial Museum, it states that originally the numbers were not marked on the forearm but across the chest with indelible ink. Yet, the serial number would be removed by the time they died (from whatever reason), as the clothes would be removed. This made them have no way to identify the bodies. Then they developed a metal stamp that holds interchangeable numbers (made up with needles of course), and punch on the upper chest of the prisoner at one blow, followed by rubbing in the ink. They then further modified the equipment with a single-needle device, and changed the tattooed site to the forearm instead. Since then, the tattooing was performed at the registration till the camp was dismissed. 

Tattooing does not only for identification for living cases, like the one mentioned above in the Holocaust (though it is a tragic example to use). It is also very significant in forensic applications. The gigantic and disastrous tsunami in Thailand in 2004 killed thousands of people. Water and the heat worsen the decomposition of bodies; they were hardly to be recognized. Some of the bodies were identified, or provided clues for further identification leads by tattoos.

Tattoo patterns, and locations in fact tell a lot about the deceased (if it is in a forensic autopsy, or decomposed bodies), or the person. And, in the old days, social status. According to Byard (2013), Gang and prison tattoos are more often “crude” with antisocial message, an emphasis on death, and violence (what if someone is a bone lover like us, forensic anthropologists? Hmmm…). Whereas in western countries, choices of tattoos often only have decorative purposes, or personal meaning instead of a cultural meanings like those in gangs, or in tribal people. Western countries’ tattoos usually use customized tattoos to record relationships—“birth of children, or death of a friend or family member.” (Byard 2013) For the latter, they are called “commemorative tattoos,” it put cremated ashes from the person being memorialized mixed in with the pigment or the ink. Tattoos used to identify slaves and criminals like abovementioned case with Holocaust, can actually trace back to the Romans. Of course, some people would make good use of the ink, and tattooed their medical info or background on the arms, like blood type, certain genetic diseases.

Skins with tattooed pigment would decompose in a much slower rate than those without. Thus, it is possible to find a section of the tattooed skin in pretty good conditions even the body was found few years after, “even with quite pronounced putrefactive changes and loss of superficial skin layer,” according to Byard (2013).

Style and design of tattoos may give a pretty good background idea (age, or cultural background of the decedent). Sometimes, if it is a customized piece of art, it may allow the investigators to find the artist as well. The archaeological discovery of the Siberian princess, Princess Ukok in 1993 has well demonstrated the great preservation of tattoo.

Altai Aborigines says the mummy of princess Ukok is their progenitor. The tattoo on her arm in fact has hidden some important message for mankind. They believe that she passed away voluntarily to protect the Earth from evil spirits. The tattoo covers from her shoulder to her hand, and only left arm tattoo was preserved. Left should was the canvas for a mythical animal, an antlered deer with the beak of a vulture. “The antlers are adorned with vulture heads; a similar head can be seen on the back of the animal, the body of which is twisted, followed by a sheep with its head thrown back. The mouth of a spotted panther with a long tail is seen at the legs of the sheep.” The clash between vultures and hoofed animals symbolize the conflict between the two worlds: a predator from the lower world against the middle world (symbolizes by a herbivorous animal).

(Source: Siberian Times)

(Source: Siberian Times)

Though researchers found later that the Siberian mummy was in fact died from breast cancer and self-meditated with cannabis, which crumbled the voluntary death speech from the aborigines, it supports the studies Byard quoted, saying tattoos in ancient times signifies the special social status of that tattooed person. And for Princess Ukok, she might not be a real princess, but was believed as a shaman because of the visions she saw after using cannabis.

** Recently, the face of Princess Ukok has been reconstructed. Thanks to the well developed facial reconstruction techniques. Click here to have a look of how she looked like.**


Byard, W. Roger. 2013. “Tattoos: forensic considerations.” Forensic Sci Med Pathol (2013) 9:534-542. 2011. “Tattoos of Princess of Altai conceal mankind’s biggest mysteries”

Siberian Times. 2012. “Siberian Princess Reveals Her 2500 Years Old Tattoos.”

United States Holocaust Memorial Museum. n.d. “ Tattoos and Numbers: The System of Identifying Prisoners at Auschwitz.” Holocaust Encyclopedia.

Trephination: Putting a hole on your head

Fig. 1: The Extraction of the Stone of Madness by Hieronymus Bosch del Prado. (Google image)

On August 23, 2010, a Hong Kong tour bus was being hijacked by a former Philippine police inspector, Mendoza in Manila. Mendoza claimed that he was dismissed from his job unjustly, and demanded a hearing for himself. Yet, the negotiation went downhill. He opened fire when he was acknowledged that the police had arrested his brother. Nine people on the bus, including Mendoza himself, were killed and some on the bus were severely injured. Among the injured, there was one young man from Hong Kong suffered from severe hematoma, and was sent back to Hong Kong for urgent treatment, namely trephination.

What sort of surgical treatment is trephination?

Trephination “is the oldest documented surgical procedure performed by man.” (Faria 2013) It basically is to drill a hole on a relatively safe spot on the skull to release the pressure inside the cranium, which possibly developed from hematoma. Though it is purely a medical trauma treatment today, trephination was also considered as a “magical”, religious and ritual treatment. Without a doubt, even with advanced medical techniques and knowledge today, “successful implementation of trepanation (Trephination) requires the serious knowledge and training and the procedure itself is not considered as absolutely harmless.” (Russon 2014)

Trephined skulls (i.e. skulls with a hole) are able to be found from the Old World of Europe and Asia, and also the New World, particularly Peru and South America. As above mentioned that trephination is such a high risk treatment, yet archeological findings from the pre-Inca, Peruvian civilization show the treatment of trephination and amazingly many of the treated patients of the prehistoric times survived from the surgery at least for a while, which supported by the bone healing and growth at the edges of drilled holes (Faria 2013). No scientific evidences to support any clinical symptoms improved after all of those prehistoric operations.

Yet, trephination back then was also used as a treatment for epilepsy, headache and various diseases that linked with demons. They believed that by making a hole on the scalp of one’s head would give the demons or the evil possessed a way to escape. In ancient Greece and Rome, instruments for trephination are also developed, which according to Faria, it set forth the engineering of the manual burr hole and electric drill neurosurgeons use for today’s craniotomy procedures. Later on in Renaissance, shape of the trephines had been modified. [Fig 1.]

Interestingly, scientists and anthropologists found that the trephination surgeries made by the Pazyryk surgeon in Siberia followed a strict recommended protocol of the Hippocratic Corpus from ancient Greek, which is believed that have been sat down around 5000 kilometers away (Liesowska 2014). The technique may varied but the care for the patient and the placing of the trephined hole show a similar ethical aim, according to Liesowska.

Then in 19th century, adapted from the past historic meaning, trephination is used in hospitals for mentally ill patients, as surgeons believed that the surgery would change the abnormal behaviors of patients, which in turns make institutions overcrowded. This view was celebrated after observing the famous American Crowbar Case in 1848. A construction foreman got severely injured while helping construct a railway line in 1848. A long bar measuring 3 feet 7 inches in length and 1.25 inch in diameter through Gage’s head. The 13.25 pound rod penetrated his left cheek, and exited the cranium just right of the midline near the intersection of the sagittal and coronal sutures [Fig 2.]. Gage survived but experienced a complete personality change—from being a responsible and energetic person to socially uninhibited individual.

 Fig. 2: American Crowbar Case (wikicommon)

The relationship between behavior change and the surgery is still understudy, especially the meaning of trephination carried out before prehistoric era, given that it may not related to any treatment of any kinds of diseases.

Trephination in a glance:

Ask Smithsonian: Do People Really Drill Holes in Their Heads? [Video]


Faria MA. Violence, Mental Illness, and the Brain- A Brief History of Psychosurgery: Part 1- From Trephination to Lobotomy. Surg Neurol Int. 2013:4-49.

Manila Hostage Crisis.

Liesowska, Anna.  17 September 2014. Scientists to recreate 2,300 Year Old Brain Surgery After Finding Evidence of Successful Operations. The Siberian Times.

Russon, Mary-Ann. 17 September 2014. Successful 2,300-Year-Old Brain Surgery Techniques Now Being Recreated in Siberia. International Business Times.