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Than a to Logy

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    Thanatology Thanatos=death Logos=science

    Is the branch of science that deals with the study of death.

    y Blacks law dictionary defines death ass Cessation of Life or Ceasing to exit.

    y Death is permanent and irreversible cessation of functions of three interrelated

    Vital Systems of the body. Nervous, Circulatory & Resp

    y If any of these 3 systems fail then the other 2 also fail as they are functionally

    interrelated to each other.[Tripod of Life]

    y Due to advancement of medical science it is possible to maintain resp. &

    circulation for long periods. However irreversible damage to the brain often

    occurs during the short period when breathing/circulation has been suspended.

    Due to irreversible brain damage body remains in vegetative form. Hence there

    appeared the concept of Brain Death.

    y Latest criteria for declaration of death is Brain Death.

    y The need for declaration of death is very important for cremation & ritual purpose

    and for transplantation purpose.

    Brain Death is diagnosed by testing following brain stem reflexes.

    1. Absence of corneal reflex.2. Dilated & fixed pupils not reacting to light.

    3. Absence of vestibule-ocular reflex.

    4. Absence of cranial motor nerve response to painful stimulus.

    5. Absence of cough reflex.

    6. Test withdrawal of ventilator should cause stoppage of resp.

    1 Somatic / Systemic / Clinical death.

    2 Cellular / molecular death.

    Somatic death-- The term death as commonly used means somatic death There is

    death of the body as a whole.

    Soma means body.

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    After somatic death tissues & cells survive for a varying period depending upon their O2

    requirement.

    When these individual tissues & cells die, it is termed as Molecular or Cellular death.

    It occurs in parts, eg. Nervous tissue dies with in 5 mts, while muscles survive up to

    about 3-4 hrs . blood cells & cornea may remain alive for > 5hrs. Organ which need

    more blood supply during life die early in the absence of circulation.

    Molecular death is generally complete within 3 to 4 hrs of somatic death.

    Diagnosis of Somatic / Clinical death is difficult in the following:

    1. Soon after death when the body is warm.

    2. Suspended animation.

    3. Coma due to excessive dose of sedatives/hypnotics.

    4. Hypothermia.

    5. Electrocution

    6. Drowning.

    MODES OF DEATH It refers to the abnormal physiological state that existed at the time

    of death.

    1. Coma 2.Syncope 3. Asphyxia

    Coma: death occurs due to failure of functions of the brain and irreversible damage to

    its vital centers.

    Coma may occur due to

    1. Raised intra cranial pressure.

    2. Poisons like opioids, alcohol.

    3. Metabolic disorders like uraemia.

    SYNCOPE: death occurs due to failure of functions of heart.

    It may occur due to.

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    1. Heart disease.

    2. Hemorrhage

    3. Pathological states of blood.

    4. Exhausting diseases.

    5. Poisoning due to digitalis, aconite or oleander.

    ASPHYXIA: death occurs due to failure of respiratory system

    It may occur due to

    1. Pathological cond of resp. system (pneumonia)

    2. Paralysis of resp. center (opium poisoning)

    3. Occlusion of air passages.

    4. Breathing of irrespirable gases.

    5. Traumatic asphyxia.

    MANNER OF DEATH

    It refers to the circumstances in which death occurs

    Natural

    Unnatural Accidental

    Homicidal

    Suicidal

    SIGNS OF DEATH/ CHANGES AFER DEATH

    IMMEDIATE SIGNS/ Signs of Somatic death

    1. INDRNDIBILITY & loss of EEG rhythm.

    2. Cessation of CIRCULATION

    3. Cessation of RESPIRTION

    EARLY SIGNS/ Signs of Molecular death

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    (occurs with in 12-24 hrs of death)

    1. Cooling of the body (ALGOR MORTIS)

    2. Changes in the eye.

    3. Changes in the skin.

    4. Post mortem lividity

    5. Changes in the muscles.

    LATE CHANGES (Occurs about 24 hrs after death)

    1. Decomposition

    2. Modification *Adipocere/ Saponification *mummification

    IMMEDIATE SIGNS (Signs of Somatic death)

    1. INSENSIBILITY & Loss of EEG rhythm.

    y Loss of sensation viz. perception of touch, pain, temp.

    y Less of Vountary power to move

    y Reflexes are lost.

    These signs are not conclusive of death as they may be present in condition as fainting

    attack, vagal inhibition, epilepsy, drowning , electrocution etc. These signs can betaken as conclusive only when associated with loss of rhythm for a continuous period of

    5 mts.

    2. Cessation of CIRCULATION

    y On careful auscultation heart sounds are not heard for a continuous period of

    5mts. Sometimes in living persons it is difficult to hear sounds(Feeble pulse,

    Thick chest wall Emphysema)

    y Flat ECG for a continuous period of 5mts.3. Cessation of RESPIRATION

    On careful auscultation complete absence of breath sounds for a continuous period of

    5mts.

    Resp. may stop for very short period without death in

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    1.Voluntary act 2. Drowning

    3. New Born Infant 4. Chyene-stokes breathing

    EARLY SIGNS (Signs of Molecular death)

    COOLING OF THE BODY/ ALGOR MORTIS

    Algor=Coldness Mortis=of death

    After death heat production stops and the body loses heat by conduction, convection &

    radiation till it is in equilibrium with the surrounding temp.

    Body temp. is recorded by chemical thermometer (THANTOMETER)25 cm long,

    graduated from 0-50 0C. It is inserted 8-10 cm in the rectum for 2-3 mts or by making a

    slit in the abdomen & inserting the thermometer under the lever.

    Isothermic Phase

    Body temp. is remain unchanged for a short period after death. When the body temp is

    normal at the time of death there is no fall in core temp for about 45 mts. As heat loss

    occurs only through body surface. It takes some time for the temp. gradient to be

    created b 100 the inner care & the surface of the body.

    If we plot a graph between temp (Y axis) & time since death ( X axis) we get a

    SIGMOID or INVERTED S shaped graph.

    In First 2 hrs

    Rate of fall of temp. = Half the diff. between body temp & the surroundings.

    In Next 2hrs temp falls at half of this rate.

    Thereafter temp falls slowly till the body is in equilibrium with the surroundings.

    In tropical countries like India avg. heat loss is 0.5 to 0.7 C per hour.

    Body attains Env Temp in about 16-20 hrs.

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    Time Since Death Normal body temp (37.2 C ) Rectal temp

    (in hrs ) = Avg. rate of fall of temp/hr (0.6 C)

    Temp estimates to find time since death applies mainly to countries with cold or

    temperate climate. In countries like India it is not possible to base any far reaching

    conclusions on the basis of this observation

    POST MORTEM CALORICITY

    Temp may increase in first few hrs after death

    1. Sun stroke , Pontine Hemorrhage mechanism of heat regulation is disturbed

    before death.

    2. Tetanus & Strychnine poisoning- increase in heat production in the muscles due

    to convulsions

    3. Acute Vital or Bacterial Infection: Lobar Pneumonia, Typhoid.

    Rate of Cooling of the body depends upon:

    1. Age- children and adults of small stature cool rapidly due to large body surface.

    2. Condition of the body- Lean bodies cool rapidly & fat bodies cool slowly since fat

    is a bad conductor of heat.

    3. Sex Females have mor e fat so body cools slowly.

    4. Mode of Death- Sudden death in a healthy person- body cools slowly. Deaths

    due to asphyxia, lightning, CO poisoning body cools slowly. Death s due to

    long illness & wasting disease body cools rapidly.

    5. Surroundings- Body cools rapidly in well ventilated rooms- movement of air

    accelerates cooling by convection. Also in water due to conduction. Body

    covered with clothing & lying in bed cools slowly.

    6. Env. Temp Body cools rapidly when temp difference between environment &

    body is more.

    CHANGES IN THE SKIN

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    After death skin assumes pale, ashy white appearance. It loses translucency. (Due to

    absence of circulation).

    POSTMORTEM STAINING/ LIVIDITY/ HYPOSTASIS/ SUGGILATION/ VIBICES/

    LIVOR MOTIS

    Means discoloration or staining of the skin & organs due to accumulation of fluid blood

    in the dependent parts of the body. It is due to blood gravitating & distending the

    tolneless capillaries and small veins in the depende t parts of the body.

    Its starts within an hour after death & presents as mottled patches on the dependent

    parts within 1-3 hrs.

    These patches coalesce in about 3-6 hrs.

    Fixation of lividity is due to stagnation of blood in the distended toneless capillaries &

    small veins and not due to coagulation of blood. Once the lividity get fixed, if the position

    of the body is changed pattern of lividity is not altered due to

    y Inability of blood to flow easily from the distended toneless capillaries and

    y Staining of tissues caused by diffusion of hemoglobin. From distribution & fixation

    of liviidity, it is possible to determine the position in which body was lying after

    death. Fixation of lividity indicates time since death is more than 8 hrs/

    Distribution & Pattern of lividity depends upon the position of the body after death.

    In HANGING it is present over the dependent lower limbs, external genitalia & lower

    parts of forearms and hands.

    In DROWNING as the body floats with face downwards, it is present on head & upper

    parts of the body is constantly changing position as in running water it may not develop.

    As lividity develops due to filling of Bld. Vessels it is not developed over areas of

    Contact Flattening (areas of body in actual contact with surface on which body is lying)

    because pressure of the body occlude toneless capillaries.

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    In supine position areas of contact flattening are back of shoulders, buttocks & back of

    calves.

    Pressure due to tight clothing prevents development of lividity in that area. White band

    on the neck due to tight collar or ornaments around neck may be mistaken as marks ofstrangulation.

    EXTENT of Lividity depends upon the vol. of bld in circulation & duration for which bld

    remains fluid after death.

    When total Bld. Vol. is decreased (massive hemorrhage ) the lividity is limited in extent.

    When total blood vol. is increased(CCF) extent of lividity is marked.

    COLOUR of lividity depends on color of blood & mode of death.

    Normally color of lividity is initially bluish pink & afterwards bluish purple.

    In deaths due to excessive hemorrhage & anemia- it is very faint.

    In deaths due to asphyxia ( bld is mainly venous &n do not coagulate readily)- Lividity is

    intensely developed & purple.

    In lobar pneumonia (bld. Coagulates rapidly)- Lividity is less obvious.

    CO Poisoning, Burns, Exposure to Cold-----------Bright cherry red

    KCN-------------Pink

    Phosphorus---------Dark Brown

    H2 S------------Bluish Green

    Nitrites--------------Reddish Brow

    Opium------------------Black

    Potasium Chlorate---------Chocolate Brown

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    Lividity of INTERNAL ORGANS develops in the same way as that on the skin. In supine

    position it appears over post. Part of cerebrum, cerebellum, left vent. Of heart, dorsal

    aspect of lungs, liver & kidney post. Wall of stomach, lowermost portion of intestines in

    the pelvic cavity

    LIVIDITY CONGESTION

    (due to disease)

    Cause Capillary & Small Vein

    distension with blood

    Due to some pathology in

    the organ

    Situation On dependent parts only Involve whole organ

    diffusely

    Cut

    Surface

    Oozing of blood from

    distended capillaries

    Exudation of fluid mixed

    with blood

    Swelling & Exudation Nil May be present

    Mucous membrane Normal Dull & lusterless due to

    inflammation

    Hollow organs when

    stretched

    Show alternate stained &

    unstained areas.

    Show uniform staining

    Nature of change postmortem Ante mortem

    LIVIDITY BRUISE

    Situation On dependent body parts Situated anywhere.

    Tissue

    level

    Epidermal Sub epidermal

    surface Not elevated Surface slightly elevated

    margins Clearly defined Diffuse

    Color Uniform in color Changes color with time

    Cause Distension of capillaries & veins

    with blood

    Extravasation of blood from

    capillaries

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    Nature of

    change

    Postmortem Ante mortem

    Effect if

    Pressure

    Pressed spot appears blanched if

    PMS not fixed

    No color change

    Cut

    Surface

    Oozing of blood from distended

    capillaries which can be easily

    washed away

    Extravasation of blood in the

    surrounding tissue which can not be

    washed away easily

    M/E Blood elements are found within

    the bld. Vessels.

    Blood elements are found outside the

    Bld. Vessels.

    MLI Suggest time since death &

    position of the dead body

    Suggest nature of injury & weapon

    used

    MEDICOLEGAL IMPORTANCE OF P.M. STAINING

    1. A reliable sign of death.

    2. It gives information about position of the body at the time of death & whether the

    position has been altered.

    3. It helps to estimate time since death.

    4. Its color may indicate cause of death.5. Its distribution may suggest manner of death.

    6. It may be mistaken as bruises or pathological conditions.

    CHANGES IN THE MUSCLES:

    1. Primary Relaxation- Immediately after death there is relaxation of muscle tone &

    lower jaw droops, intraocular tension falls, pupils dilate, muscles become soft &

    flabby, joints are flexible, sphincters relax (may lead to incontinence of urine &

    faeces). The muscles still react to external stimuli.

    2. RIGOR MORTIS (RIGOR=Rigidity MORTIS=Death)

    Shortening, Stiffening & Opacity of muscles which occurs after the period of primary

    relaxation.

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    Mechanism:

    The contractile element of the muscles consist of protein filaments Myosin & action.

    In relaxed state during life Actin inter digitate with Myosin only to a small extent and

    muscle fibers appear soft.

    This softness & extensibility of muscles is due to presence of ATP above a certain level.

    ATP above a certain level. ATP is converted to ADP & release of energy which causes

    contraction of muscle fibers and actin & myosin interdigitate with each other to greater

    extent.

    During life there is resynthesis of ATP but after death there is continuous breakdown of

    ATP and resynthesis of ATP occurs as long as glycogen is available. Once glycogen is

    exhausted synthesis of ATP stops and the muscle fibers loses normal softness,

    elasticity & extensibility. There is fusion of actin & myosin into a Dehydrated Gel

    resulting in Rigor Mortis.

    The extensibility of muscles begins to fall when ATP drops to 85% . During Rigor Mortis

    reaction of the muscle changes from slightly alkaline to distinctly acidic due to formation

    of lactic acid.

    ONSET OF RIGOR MORTIS

    Is tested by gently bending various joints of the body.

    Rigor Mortis occurs both in voluntary & involuntary muscles.

    It occurs earlier in Involuntary muscles than in Voluntary ms. It is not dependent upon

    the nerve supply of the muscles as it also appears in paralyzed muscles.

    In Involuntary muscles it appears in the heart within an hour after death. In Voluntary

    muscles it first appear in the

    Muscles of Eyelids----------------3-4 hrs

    Muscles of Face---------------4-5hrs

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    Neck & trunk-----------------------5-7hrs

    Muscles of upper limbs-----------7-9hrs

    Muscles of legs---------------------9-11hrs

    Small muscles of fingers & toes----------11-12hrs

    It passes off in the same order in which it appears. It passes off due to autolysis of

    muscle proteins. When erector pilae muscles of the skin are affected by RM skin

    presents a granular puckered appearance called GOOSE SKIN or CITIS ANSERINA

    (Cutis= Skin; Anser=Goose).

    The skin papillae stand out prominently with hair standing on end. Such a condition is

    also found when body is exposed to cold water (Drowning)

    PERIOD OF STAY OF RIGOR MORTIS:

    It starts in 2-3 hrs after death, takes about 12 hrs to develop (from head to toe) persist

    for another 12 hrs & takes about 12 hrs to pass off. ROLE OF 12

    FEATURES OBSERVED DURING RIGOR MORTIS

    Partial emptying of heart due to rigidity of heart muscles. Pupils are constricted (RM of

    Iris muscle)

    Postmortem delivery.

    FACTORS THAT INFLUENCE RIGOR MORTIS (1) AGE

    Rigor Mortis does not develop in a fetus < 7 months IUL. In a fetus> 7mnth IUL rigor

    mortis develops & passes off quickly. In Children & Old Age-RM develops & passes off

    quickly.

    (2) PHYSIQUE

    In a person of weak musculature- RM develops & passes off quickly and vice versa in a

    person of strong musculature

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    (3) TEMP

    It develops & passes off quickly at high atm temp & vice versa.

    (4) In death due to exhaustive diseases & convulsive disorders RM appears & passes

    off early.

    (5) In death due to drowning RM appears early due to muscular exhaustion but lasts

    longer due to coldness of water.

    (6) Rigor Mortis may be absent in septicemic conditions.

    MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS

    (1) It is a sure sign of death.

    (2) It helps to estimate time since death.

    (3) It may give information about the position of body at the time of death &

    whether it has been altered after rigor mortis has set in.

    (4) It may be confused with Cadaveric Spasm, Heat Stiffening, Cold Stiffening &

    Gas Stiffening

    CONDITIONS SIMULATING RIGOR MORTIS

    (1) Cold Stiffening: When body is exposed to extreme coldness for reasonable

    period stiffness occurs due to freezing of body fluids & synovial fluids &

    synovial fluids in the joints & hardening of S/C fatty tissue. Such a body

    becomes flaccid if kept at atm. temp. for sometime, after which RM

    reappears.

    (2) Heat Stiffening: When body is exposed to temp> 70 c, it coagulates the

    muscle proteins & causes stiffening & contraction of muscles. Body assumes

    pugilistic (boxer) attitude in which lower limbs & arms are semi flexed and

    hands clenched. RM does not develop in these cases & heat stiffening persist

    until the coagulate protein liquefies due to decomposition.

    (3) Gas Stiffening: It is due to accumulation of putrefactive gases in the tissues.

    Other putrefactive changes present in the body helps to identify the condition.

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    (4) Cadaveric Spasm/ Instantaneous Rigor: characterized by stiffening of

    muscles immediately after death without being preceded by primary

    relaxation.

    PRECONDITIONS FOR CADAVERIC SPASM

    y Somatic death must occur with Extreme Rapidity.

    y The person must be in Great Emotional Tension.

    y Muscles must be in a state of great physical activity at the time of death.

    Cadaveric spasm is a vital phenomenon as it starts immediately before death but due to

    obscure reason it persists after death without primary relaxation, while other muscles

    are undergoing pr. relaxation. It passes off when putrefaction in the muscles break the

    contraction.

    MEDICOLEGAL IMPORTANCE OF CADAVERIC SPASM

    (1) Indicates sudden death associated with great emotional tension.

    (2) Indicates that muscles were in physical activity at the time of death.

    (3) It may help to find the manner of death. In suicidal death weapon of light wt.

    (razor/knife) may be found tightly clenched in the hand of dead body.

    In some case of drowning grass weeds or other objects present in water may be found

    tightly clenched in deceaseds hand.

    In homicidal cases some part of clothing or hair of the assailant may be found in

    deceaseds hand.

    Secondary Relaxation

    With the disappearance of RM muscles once again become soft & flaccid. But they donot respond to mechanical or chemical stimuli. Muscle reaction again becomes alkaline.

    Secondary Relaxation coincides with onset of putrefaction.

    LATE SIGNS

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    1. PUTRERFACTION OR DECOMPOSITION

    is the last stage of resolution of body from organic to inorganic state. It is brought about

    by two main processes

    a) Auto = Self b) Bacterial Action

    Autolysis: Auto= Self Lysis= Destruction

    After death enzymes are released from the cells of the body. They soften and liquefy

    the tissues of the body. It starts 3-4 hrs after death and continues steadily for 2-3 days.

    Bacterial Action:

    Microorganisms responsible for putrefaction are both aerobes & anaerobes. Important

    bacteria responsible are Cl. Welchii Streptococci, E. Coli, B. proteus.

    Cl. Welchii produces lecithinase which hydrolysis lecithin present in cell membrane

    including RBCs.

    Thus initiates the process of putrefaction and haemolysis. Warmth, Moisture & Air

    which favors bacterial growth accelerates the onset & progress of putrefaction. During

    life these organisms are present in large intestine but after death they enter the blood

    vessels & spread rapidly throughout the body.

    FEATURES OF PUTREFACTION

    A) COLOR CHANGE

    First external sign of putrefaction is greenish discoloration of the skin over the caecum &

    flanks, and internally on the under surface of liver.

    Here the contents of the bowel are more fluid & full of bacteria. Discoloration is due to

    formation of sulphmethemoglobin. Due to bacterial action blood gets hemolysed & the

    liberated Hb is converted to sullphmetaemoglobin by the action of H2 S (formed by the

    microorganisms in large intestine). Color change over the caecum & flanks appears in

    12-24 hrs after death.

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    It appears earlier in summers and delayed in winters. Discoloration spreads over the

    front of abdomen & external genitals. Patches appear on the chest, neck, face, arms &

    legs which coalesce and the whole body is discolored in next 24 hrs.

    Marbling: The veins over the root of neck, shoulders & groins become visible as bluish

    or greenish lines forming a mosaic or arborescent pattern known as marbling. It occurs

    due to staining of the vessel wall by the pigments released from the decomposing bld.

    Marbling starts after about 24 hrs of death and is prominently seen in 36-48 hrs.

    B) DEVELOMENT OF FOUL SMELLING GASES

    Simultaneously with the color change body starts emitting foul smell due to production

    of gases of decomposition (H2S, ammonia, phosphorates hydrogen & methane). These

    gases form in the subcutaneous tissue, hollow viscera & eventually in the solid viscera.

    In 12-18 hrs abdomen gets distended due to collection of gases in the intestines. In 18-

    36 or 48 hrs gas formation is abundant & it collects in the tissues & hollow viscera

    leading to false rigidity of the cadaver.

    C) PRESSURE EFFECT OF PUTREFACTIVE GASES

    1. Bloating of Features

    In about 36 hrs face becomes so swollen & altered in color that identification

    becomes impossible. Eyes bulge out, Tongue becomes blackened out & protrudes

    out may be mistaken for strangulation. Breasts in females are enormously swollen.

    In 48-72 hrs rectum also protrudes.

    Due to excess pressure of gases body surface expands & may lead to splitting of the

    skin & impress pressure marks form previously well fitting clothes. Such a mark on

    the neck may be mistaken for strangulation.

    2. Shifting of areas of PM Staining: Due to decomposition blood clots liquefy &

    pressure of gases leads to displacement of PM staining in any direction. If PM

    staining extends to head, it may be mistaken for violence to the neck or

    smothering.

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    3. Changes in Skin, Hair & Wounds: Putrefactive blisters/ blebs appear on the skin

    in 36-48 hrs. they contain mainly gas & little reddish fluid. Vital Reaction is

    absent. When the blister breaks, patch of raw skin similar to scald is seen. Skin

    gets denuded and bruises & abrasions become unrecognizable. Skin of hand &

    feet may peel off like glove & stocking in 48-72 hrs. Such peeling off is also

    observed in burns & in drowning (when the body remains in water for 2-3 days).

    Hairs become loose & can be pulled out easily. Both Antemortem & Postmortem

    Wounds begin to ooze blood (Post mortem bleeding).

    4. Extrusion of fluid from Nose & Mouth: Due to pressure of gases in abdomen,

    diaphragm is forced upwards compressing the lungs & heart. Blood staines froth

    oozes out of nose & mouth. Stomach contents may be forced out & enter the

    larynx. If stomach contents may be forced out & enter the larynx. If stomach

    contents are beyond secondary bronchioles, it indicates that the inhaled food

    particles are antemortem in origin.

    5. Emptying of the heart: it occurs due to pressure of gases on the diaphragm

    leading to compression of chest cavity.

    6. Changes in the genitals: After 36 hrs of death penis & scrotum are enormously

    swollen. In females the genitals are swollen & oozing of blood tinged fluid. These

    changes may be mistaken as sexual assault. In about 48-72 hrs cervix & uterus

    protrudes. In a pregnant female fetus may be mistaken as sexual assault. In

    about 48-72 hrs cervix & uterus protrudes. In a pregnant female fetus may be

    expelled (Postmortem Delivery)

    D) APPEARANCE OF MAGGOTS:

    Flies are attracted to the putrefying body &

    Lay eggs in open wound & natural orificesin about 18-36 hrs.

    Eggs hatch in to maggots/Larvae------------in about 24 hrs

    Larvae develop in to pupae------------ in about 4-5 days

    Pupae develop in to adult flies --------in about 4-5 days

    Forensic Entomology is the study of insects infesting the dead body. It helps to

    find time since death.

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    E) OTHER CHANGES In about 3-7 days teeth become loose in their sockets &

    may fall out. Skull Sutures in children become loose & liquefied brain may run

    out. in about 5-12 days Colliquative Putrefaction begins. Tissues become soft,

    loose & get converted to semi fluid black mass.

    Abdomen bursts and stomach & intestines protrude.

    All these changes are not distinguishable in stages. If putrefaction still continues soft

    tissues separate from the bones. The body is skeletonized in about 1-3 months. In India

    bones start decomposing in a year in uncoffined bodies in 3-10 years in bodies laid in

    coffins. Decomposing bones loose wt. and become fragile due to loss of organic matter

    & may be totally destroyed in 10-25 years. Bodies lying exposed on the ground may be

    skeletonized in

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    BRAIN soft cysts appear, Swiss cheese pattern of these cavities distinguish them from

    encephalomalacia.

    FACTORS THAT MODIFY PUTREFACTION:

    External Factors:

    1. Temperature: At freezing point bacterial growth is inhibited & putrefaction will not

    occur. It starts at 10 C. ideal temp. is 37 C. A t high temperature putrefaction is

    retarded.

    2. Clothing: It initially hastens putrefaction by maintaining body temp. At later stage

    they slow down the process by protecting the body against flies and insects.

    3. Moisture: It helps the multiplication of organisms. Thus bodies recovered from

    water decompose early. Organs with high moisture putrefy faster. (brain)

    4. Air: Presence of air promotes decomposition & its absence retards the process.

    5. . Manner of Burial: In air tight coffins decomposition is retarded.

    Bodies buried without coffins decompose very fast,

    Bodies in deep grave putrefy slowly than those in shallow ones due to exclusion of air.

    In clayey water logged soils adipocere formation may occur,

    In sandy and porous soils mummification may occur.

    Internal Factors

    1. Age: New born or still born infants are sterile so putrefaction can occur only from

    invasion of the external organisms.

    In adults it starts from within outwards.

    2. Condition of the body: Fat & flabby body of children contain plenty of moisture

    thus putrefy rapidly. Parts of the body which are injured putrefy rapidly. Gravid &

    post partum uterus putrefy early.

    3. Sex: This has little influence but in females dying after child birth especially due

    to septicemia decompose rapidly.

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    4. Cause of death: In deaths due to septicemia organisms are in abundance thus

    decomposition occurs early.

    Putrefaction is retarded in wasting disease as anemia & malnutrion.

    Sudden death in apparently healthy person decompose slowly.

    In chronic poisoning by arsenic, antimony & other heavy metals the process of

    decomposition is retarded as they destroy bacteria & preserve the body.

    PUTREFACTION IN WATER

    As head is heavier tends to lie lower than rest of the body and due to gravitation of

    blood decomposition is more pronounced over the head.

    A body completely submerged in water putrefies slowly due to exclusion of air & low

    temperature.

    But water animals may destroy the body in a very short time.

    On removal from water such bodies putrefy rapidly due to increased moisture.

    Floatation of body occurs in 1 day in summers & 2-3 days in winters. It occurs due to

    accumulation of putrefactive gases. When body floats abdomen is above & spine is

    downwards.

    Time required for floatation depends on:

    Age: New born, mature infants float early than still born or immature infants.

    Sex: Females float sooner due to higher fat content.

    Condition of the body: Bodies with loose clothing floats sooner as air gets trapped in

    loose clothes. Obese bodies also float earlier.

    Season: Body floats quicker in summers because warm water favors putrefaction.

    Quality of water: Body floats earlier in sea water due to high Sp. Gravity.

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    Bodies immersed in pond float sooner due to warming affect of sun rays favor

    putrefaction.

    ADIPOCERE OR SAPONIFICATION:

    ADIPOS= Soft Fat CERA=Wax

    Its properties are in between Fat & Wax.

    It results from conversion of unsaturated liquid fats (Oleic Acid) to saturated solid fats

    (Hydroxystearic acid & Oxostearic acid) by bacterial fat splitting enzymes like

    clostridium from intestines & from environment.

    Moisture, Warmth & relative diminution of air are facilitating factors.

    Adipocere is yellowish white, greasy, wax-like substance with a rancid smell.

    It floats on water (Specific gravity is less than water).

    It cuts easily burns with a yellow flame & offensive odor due to ammonia & sulphur

    compounds.

    Fresh Adipocere is soft & moist but old samples are dry & brittle. The process involves

    hydrogenation & hydrolysis of body fats, it forms at sites where fatty areas of cheeks,

    breasts, buttocks & abdomen. The moisture required may be derived from the body

    tissue which thus becomes dry & dehydrated.


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