Thanatology

Deals with death in all its aspect.

 Death

1.Somatic/Systemic/Clinical

Complete & irreversible stoppage of :

Respiration (Bishop’s Triad of life)

Circulation (Death’s portal of entry)

Brain functions
 2.Molecular/Cellular

• Death of the cells & t/s individually in a varying

period of time according to their O2 requirements.

• Usually 1 – 2 hrs after the stoppage of vital

functions.
Mechanical excitability of skeletal muscle

1. Tendon reaction or Zasko’s phenomenon:

Strike lower third of quadriceps femoris
muscle, 10cm above patella upward
movement of patella (1-2 hrs of death)
2. Idiomuscular contraction or bulge: Strike
biceps brachii muscle, muscular bulge seen:
4-5 hrs may be seen upto 24 hrs.
 Resuscitation
Question of death is
important in:
Organ
transplantation
Time for removal of organs from dead body

• Cornea 6 hrs
• Skin  24 hrs
• Bone  48 hrs
• Blood vessels  72 hrs
• Kidneys, heart, lungs, pancreas, intestines and
liver must be obtained soon after the
circulation has stopped as they deteriorate
rapidly.
 BRAIN DEATH

The term brain death is defined as "irreversible

unconsciousness with complete loss of brain
function“.
 1. Cortical/ Cerebral death:

Vegetative state in which respiration continues, but there

is total loss of power of perception by the senses.

Produced by :
i. Cerebral hypoxia
ii. Widespread brain injuries
iii. Toxic conditions

• Living cadaver
 Brain-stem death:

• Loss of vital centres that control respiration

• Loss of ascending reticular-activation system

• Produced by:
i. Cerebral edema
ii. Increased intracranial pressure
iii. Intracranial haemorrhage
Whole brain death:

Combination of
Cortical
Brain-stem death
 Exclude
• Effect of drugs
• Temp. below 35 degree C
• Severe metabollic endocrine disturbances
 Harvard Criteria
1.Unreceptivity and unresponsivity
To most intense painful stimulu
2. No movements

3. Apnoea
Absence of spontaneous breathing for at least one hour
and
When patient is on ventillator, the total absence of
spontaneous breathing may be established by turning
off the respirator for 3 minutes and looking for effort.
4. Absence of elicitable reflexes
Pupils are fixed and dilated and do not respond to
direct source of bright light.
Ocular movement and blinking are absent
There is no evidence of postural activity
Corneal and pharyngeal reflexes are absent
Stretch tendon reflexes also cannot be elicited
5. Isoelectric EEG Confirmatory

All tests repeated after 24 hours with no change

 APPARENT DEATH

a state that mimics death, occurs in:

• Electrocution
• Hypothermia
• Sun stroke
• Drowning
• Drug over dose (barbiturates)
• Head injury
• Suspended animation
Human Organ Transplant Act, 2055 Guidelines for brain
death, 2073 NEPAL
• Exclude all causes of apparent death
• Check for cranial nerve reflexes
• (puppillary/corneal, occulocephalic, occulovestibular, pain, gag,
suction, cough, tendon reflexes)
• Apnea test While patient of ventilator maintain BP, Temp, Volume
and o2. Saturate blood with o2, disconnect ventilator, look for
spontaneous respiration 10 minutes Absence of spontaneous
respiratory effort shows inability of brainstem to respond to
hypercarbia i.e. apnea test positive Which proves brain stem death
• EEG, Cerebral angiography, Nuclear scan, Transcranial doppler, CT
A, MRI, MRA
 Manner of Death
• Suicidal
• Accidental
• Homicidal
• Undetermined
 Mode of Death
• Coma
• Asphyxia
• Syncope
 Cause of Death
Part I
• Immediate
• Antecedent
• Underlying

Part II
Contibutory/Secondary conditions
 Postmortem changes
Immediate:
◦ Loss of voluntary power
◦ Cessation of respiration and circulation
Early:
◦ Pallor and loss of skin elasticity
◦ Eye changes (tache noire)
◦ Primary flaccidity
◦ Rigor mortis
◦ Hypostasis
◦ Cooling of the body
Late (decomposition):
◦ Putrefaction
◦ Adipocere
◦ Mummification
Pallor and loss of elasticity of skin
Tache noir
 Primary Flaccidity
• Flaccid period starts immediately after death
• All the muscles begin to relax.
◦ Lower jaw begins to fall
◦ Eyelids loose tension
◦ Joints are flexible
• Extends 3-6 hours after death before stiffening
occurs
• Muscle irritability and response to electrical or
mechanical stimuli still persist
 Rigor Mortis
• Stiffening of muscles (voluntary and
involuntary muscles), sometimes slight
shortening of muscle fibres
• Appears first in involuntary muscle of heart
• It begins in the eyelids, neck and lower jaw
and passes upward to face, chest, upper limbs,
abdomen, lower limbs and lastly in the finger
and toes.
 Mechanism:
• Deathcessation of respirationdepletion of
oxygen used in the making of ATP ATP no longer
provided to operate the SERCA pumps in the
membrane of the sarcoplasmic reticulum, which
pump calcium ions into the terminal cisternae 
Calcium ions diffuse from the terminal cisternae
and extracellular fluid to the sarcomere  Ca
binds with troponin  crossbridging between
myosin and actin proteins.
Time of Onset :
• Temperate climates – 3-6 hours
• Tropical climates – 1-2 hours
 Duration

Temperate climate –
•  lasts for 2-3 days.
Tropical climate – 
• 24 – 48 hours in winter
• 18 – 36 hours in summer
In general – 
• 1-2 hours sets on
• for , 12 hours develop
• for  – 12 hours maintains
• and after 12 hours passes off
 Factors affecting Rigor Mortis
• Age
◦ Occurs rapidly in children and old age
• Nature of death
◦ Diseases causing exhaustion and wasting (eg: cholera,
cancer, TB) or violent death (eg: electrocution) onset
of rigor is early and duration is shorter.
◦ In asphyxial death, onset is delayed
◦ Widespread bacterial infection (eg sepsis) onset is very
rapid
• Muscular state
◦ When muscle is at reast and healthy prior to death,
onset is slow and duration is long.
◦ When muscle is exhausted (eg: exercise prior to
death) onset is more rapid.
• Atmospheric conditions
◦ Cold weather: onset slow and duration is longer
◦ Hot weather, on set is rapid due to increased
breakdown of ATP
• Heat stiffening
◦ When exposed to temperatutre >65celsius, rigidityis
produced (more than marked in rigor mortis)
• Cold stiffening
◦ Upon exposure to freezing temperature, tissues are
frozen and stiff, body fluids are freezing.
◦ Once replaced in a warm temperature, stiffness will
vanish, flaccidity occurs and not long after that rigor
mortis occurs
 Cadaveric Spasm
• In midst of intense emotional;/physical
activity, failure of normal relaxation occurs
• Affects only small number of group muscle
◦ Flexor of one arm
Eg. Fall from cliff into cold water, suicidal
gunshot to the head
Cadaveric spasm, an instantaneous form of
rigor, in the victim of a fall into water. grass
from the river bank firmly clutched in the
hand.
 Hypostasis
• Lividity, staining, liver mortis
• Occurs when circulation ceases  no arterial
propulsion or venous return  stagnant blood
• Gravity pulls the blood into its lowest
accessible area
• Visible at skin as bluish-purple or purplish-red
discoloration
• Hypostasis starts at 30mins – 4 hours after death,
and reaches maximum at 6-12 hours
• Pattern/distribution of hypostasis
◦ Depends on posture after death
◦ Supine: hypostasis over back area in exception of
shoulder, buttock, calves (pressed against surface
compressing vascular channel)
◦ Vertical: hypostasis over feet, leg, distal part of
hand and arm
 Colours of hypostasis
◦ Usually bluish-red
◦ CO2 poisoning: cherry red
◦ Cyanide poisoning: dark blue-pink
◦ Aniline, nitrite & chlorate poisoning: brownish
red
◦ Phosphorus poisoning: dark brown
◦ Anaerobic septicaemia: bronze
 Hypostasis in organs:

◦ Intestine: discontinuous marked discoloration of jejunum

and ileum
◦ Lung: dark blue in posterior edges, pale over anterior
edges
• Fluid/congestion/edema will be more apparent @
posterior part
◦ Myocardium: dark patches in posterior wall
◦ Esophagus: hemorrhage behind esophagus
• How to differentiate between hypostasis and contusion?
 Cooling of body (Algor Mortis)
• Cooling of body is a complex process. Therate
of cooling is not same in every different body
• Body cools more rapidly on the surface, and
slowly in the interiors
• Body heat loss is via conduction, convection
and radiation
 Factors affecting cooling of body
• Initial body temperature
• Body dimension
◦ Mass vs surface area
• Posture upon death
◦ Straight vs curled position
• Clothing and coverage
◦ Type of clothing, clothing material
• Ambient temperature
◦ Surrounding temperature
• Air movement and humidity
◦ Increased air movement increases heat
radiation
• Medium around body
◦ Water vs air
• Hemorrhage
◦ Blood loss reduces body mass and heat
LATE CHANGES:

i. Putrefaction / Decomposition

ii. Adipocere formation

iii. Mummification
 Putrefaction
• Decomposition is a natural process that occurs
for every organism that has died. Initially, the
degradation may not be visible to the naked
eye as the process starts at the cellular level.
Slowly the changes will progress to
macroscopic and form the post mortem
changes.
• In the end, the whole decomposition process
allows the recycling of energy flow and
nutrient into the surrounding ecosystem
(Fenoglio et al. 2010; Tibbett & Carter 2009).
 Putrefaction
Final stage of dissolution of the body t/s
from organic to inorganic state.
Two process contribute: Autolysis &
Bacterial action.

i. Autolysis: commences 3-4 hrs after

death & continues steadily for 2-3 days,
sometimes longer.

ii. Bacterial action:

-both aerobic & anaerobic.
-chiefly:- Clostridium welchii which
produces lecithinase
 4D's of decomposition
• Discoloration
• Distention
• Degradation
• Dissolution
Sequence of putrefactive changes:
Colour changes:
-1st external sign of putrefaction is Greenish discolouration of
skin over the caecum & flanks & internally on the
undersurface of liver.
-colour change is due to conversion of Hb into
Sulphmethaemoglobin ( due to H2S)
-colour appears : in summer–18 hrs &
in winter— 1 -2 days
-Marbled appearance of vein: veins stained greenish-brown or
reddish-brown in 36-48 hrs. (due to haemolysis of RBCs)
Development of foul smelling gases:
- proteins & carbohydrates undergo reduction into simple
compounds– amino acids, ammonia, CO, CO2, methane, H2S etc.
- these gases produce foul odour.
-PM luminescence: due to contamination of the body by
luminescent bacteria(Photobacterium fischerii) &
fungi(Armillaria mellea)
-PM PURGE

Liquefaction of t/s: colliquative putrefaction begins from

5-10 days or more after death.
Bloating of face and effusion of blood-tinged fluid from
the nostrils and mouth.
Conditions affecting the rate of putrefaction:
External:
i. Temperature – doesn’t occur < 0oc & > 48oc
-optimum between 210c to 38oc
-twice as rapid in summer than winter
ii. Moisture
iii. Air
iv. Clothing
v. Manner of burial CASPER DICTUM : air=2 water=8 earth
Internal:
i. Age / Sex
ii. Cause of death
iii. Mutilation
 Loss of all soft tissues of head and neck, in areas not
covered by clothing, by post-mortem animal predation
 Adipocere
Modification of putrefaction.
Fatty t/s of body change into substance similar to soaps.
Seen in bodies immersed in water/ damp environment.
Due to hydrolysis & hydrogenation of pre-existing fats.
Delayed by cold & hastened by heat.
Peculiar rancid/sweetish odour.
May persist for decades.
Shortest time for its formation:-
3wks.in summer.

Complete conversion of adult limb 3 to 6 months

Persits for years or decades.
MLA:
i. Features are well preserved, so helps in
identity.
ii. Cause of death can be determined, as injuries
can be recognised.
iii. Time since death can be estimated.
iv. Idea about place of disposal of body can be
formulated.
 Conversion of facial
and orbital fat into
adipocere
after several months
in water. There is also
a penetrating wound
on the forehead,
obviously ante-
mortem from the
healing margins.
Complete conversion of a body to adipocere. The body
was recovered from a deep lake 8 years after
disappearing in a boating accident during a heavy
storm.
Adipocere formation in
body left in dry sewer
tunnel for about 2
years. External water
is not necessary for
adipocere formation,
as body fluids may be
sufficient hydrolysis of
fat
 Mummification
Modification of putrefaction where drying & desiccation of the t/s
& viscera occurs instead of liquefaction.
Desiccation: due to losing of moisture by the body from
evaporation.
Ideal conditions for its formation:
-high atm. temp. devoid of moisture &
-free circulating air around the body.
Mummification in a man dead in a locked room for 10
weeks. The corpse is dry and leathery, with very little
moist putrefaction.
 The mummified body of an absconder from a
mental hospital who was found a year later in a
hay barn. The dry environment had inhibited wet
decomposition.
Body is shriveled, practically odorless,
often very dark & black in colour,
lost its weight & skins adheres to the
shrunken body.
Time required: 3 months – 1 year.

MLA:
i. Establishment of identity.
ii. Cause of death can be determined, as injuries can be
recognised.
iii. Time since death can be estimated.
iv. Idea about place of disposal of body can be formulated
 CASPER DICTUM
• air=2 water=8 earth
 Skeletonization
• In broad terms, a corpse outdoors in a temperate
climate is likely to be converted to a skeleton
carrying tendon tags within 12–18 months, and
to a ‘bare-bone’ skeleton within 3 years; there
are, of course, numerous exceptions, depending
mainly on the local environment.
• In closed conditions indoors, a body may never
skeletalize, often being converted to a dried,
partly putrefied, partly mummified shell.
• In India an uncoffined buried body is reduced
to a skeleton within about 1 to 2 years.
• Disarticualtion often occurs from head
downwards, central to periphery.
• Articulated bones are seen upto 3 weeks
• In about 5 weeks some bones are articulated
• Some bones are broken in 2-4 years
• Bone decay occurs after 10-12 years
• Neutral soil may not destroy skeleton at all
• Acidic soil may decay in about 25-100 yrs.
• In hot climate , bones on ground may decay in
5 to 10 years.
 Conditions preserving the body
1. Mummification
2. Adipocere formation
3. Freezing
4. Body in water/ soil containing antiseptic substances.
5. Injection of solution of Arsenic/ PbS & Potassium carbonate into
the femoral artery.
6. EMBALBING:
-T/t of body with antiseptics & preservatives to prevent
putrefaction.
-proteins are coagulated, t/s are fixed, organs are bleached &
hardened & blood is converted into brownish mass.
-should be done within 6 hrs of death.
-produces chemical rigidity which is permanent.
 ESTIMATION OF POST MORTEM INTERVAL

A precise estimation of the time of death

would be of great benefit in cases of
homicides, suicides or other unnatural deaths
where the time of death might impact the
course of a criminal investigation.
Methods of estimating the time since death are
based on two different approaches –

1. Antemortem events (either physiological or pathological along

with the history and other relevant investigation reports) –
e.g. Physiological – growth of facial hair, gastric contents.
Pathological -A wound in the healing stage.

2. Postmortem changes - Spectrum of progressive changes after

death.
 Chart showing the major changes to estimate
PM-interval

Rigor Decomposition
Temperature (oc)
37
30

Lividity
20

Cooling
10
0

0 6 12 18 24 30 36 42 48 54

Time after death (hrs)

 Entomology of cadaver
Flies (Musca domestica and M. vicinia) eggs
• 8 to 24 hrs in summer larva or maggots
• 3 to 6days  pupae
• 3 to 6 days  Adult flies
• Life cycle  5-6 days in summer, 8 -20 days in
winter
Lice usually remain alive for 3 to 6 days after
death of a person.
 Gastric Emptying
• Light Meal  1 to 2 hours
• Medium sized Meal  3 to 4 hours
• Heavy Meal  5 to 8 hours

If stomach is full containing undigested food ,

it can be said that death occurred within 2 to 4
hours of the eating of the last meal.
 Head of Meal reaches
• Hepatic flexure  6 hrs
• Splenic flexure  9-12 hrs
• Pelvic colon  12-18 hrs
Scene of crime
All these features are corroborative evidences for estimating PM-
interval.

It is only a collective application of different methods that is to be

used & no single method should be accepted as confirmatory.

It is preferable that the opinion is given on an approximate range

of time period rather than a specific date and time.
 Presumption of death
Sec 40 civil code

(1) If a person disappears without any notice for a period of

consecutive twelve years or if a person for whom it is natural
to have information about such disappeared person has not
received any information about him or her for the last twelve
years, such a person shall, except in cases where an evidence
establishing that he or she is alive is received, be deemed to be
dead.
• Provided that in the following circumstance, such a
person shall be deemed to have died after the
completion of the following period:
(1) In the case of a person having attained eighty years
of age, five years,
(2) In the case of a soldier deputed to war-field, four
years after the cessation of the war;
(3) In the case of a person traveling by an aircraft, ship
or other vehicle that met with an accident, three
years after the date of such accident.
 Presumption of survivorship
When two or more persons, natural heir of each other, die
almost simultaneously in conditions like air-crash, earthquake,
major accidents, battle etc. which render it uncertain which of
them survived the other/ others.

The person who died last i.e. the one who survived maximum
need to be found out— “Presumption of survivorship”

Decided by the facts & evidence available eg. Age, Sex, Body-
built, Nature & severity of injuries, Mode of death, PM changes.
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