Thanatology

1. Thanatology Dr. Cahyono Kaelan Sp.PA(K), PhD , DFM. Dept of Forensic Pathology Fac. of Medicine Unhas Makassar

2. Meaning and Definition • Thanatos = Death • Logos = Science • Thanatology = Science describing of the causes and changes after death.

3. Purposes of Thanatology 1. Diagnosis of death (Scene ) 2. Determine time of death (Alibi) 3. Predict the Cause of death 4. Predict the manner of death

4. DEATH • Definition : What is death? 1. Death = Soul separates with body 2. Brain death 3. Coma 4. Unconscious (decrease of consciousness) 5. Wake = Live

5. Definition of DEATH Human = 2 dimensions (individual and collection of cells Death • 1. Live is breathing and function of vital s(Lung, heart and brain)  Marked by Oxygen consumption • Death = Stop oxygen consumption. Permanent Stop function of vital organ (lung, heart and brain) do not need Oxygen anymore

6. Defines Death (cont) 2. Cellular death= lack of Oxygen cells die. In the brain cell only lasting of 7 minutes 3. Brain death = Stop of brain function, even other organ still working due to respirator) 4. Indonesian Doctors Association (IDI,1989), follows death when is brain death

7. How to define Death Stopping vital functions (H,L)  10 minutes Respirator (breathing apparatus) this criteria does not fit Now taken  “Brain death = is death” How to justify Brain death ? Taken from the most lasting part of the brain ( brain stem), other has gone

8. Methods? • No Response on command/ • Loss of stimuli • Reflexes of pupil, corneal, cough (-)) • Ice stimuli to inner ear disappear(-) • Stopping respirator  no spontaneous response • EEG flat • Need # 3 doctors (Anesthetist, Neurologist and other)  ICU

9. Simple Test on Death Scene • Auscultation (no heart beat)  need time + larynx • Winslow test: glass of water put on the top of belly ( moving  still alive) • Mirror Test : Mirror and spectacle damp / blurred  still alive • Feather Test : moving of Chicken feather or cotton on nostril –due to respiration alive

10. II. Changes after death • Face • Muscle relaxation • Eyes • Body temp • Livor Mortis • Rigor Mortis (Stiffness) • Putrefaction (Decay/Decomposition)

11. Skin Face • Face  Pale no blood running anymore, exception of CO intoxication  Cherry red

12. Muscle relaxation • Relaxation of muscle and muscle tone decrease  Yaw goes down, open mouth need to be tied up the yaw. • Relaxation of face muscles a younger looking than his real age. • Pupil (eye)  wider / dilatation • Relaxation of muscles start from heart , neck muscles, face than followed by upper extremity and the rest of the body weak toneless

13. Changes of Eye • No shine (damp sight) empty (death fish eye) • Light and corneal reflexes (-) • Retinal Vein damage in 10 seconds • Corneal  dry and blurred • Decrease of eyeball tone (softness of eye ball)

15. Body Temperature • Decrease of body temp • Except bacterial infection (sepsis  warm) • Depend on vicinity temperature • Location / Medium (Water > quicker than room temp) • Body constituent : Thin > Fat • Clothing : Thin > thick • Estimation only when death within <12 hrs

16. Livor Mortis • Due to gravity force • Blood pool into blood vessel on the lower surface • Occurred 1- 2hours after death • Potision lie on the back appear on the back of the body, back, buttock, and extremities and vice versa • > 4 hrs capillary and blood corpuscle damage  livor permanently • >12 hrs livor will not changes anymore • Color of Livor : Red (Cherry red  CO) Chlorate  Brown , Asphyxia  Black.

19. Rigor Mortis =Postmortem Rigidity • ATP ADP + LA • Small muscle first ( Face, palpebrae, Jaw) due to less of Glycogen • Heart, neck, face, extremity and upper part of body and other • Occur 6 hours after death • 12 hrs all part of the body stiff • 12- 36 hrs persistent stiff (rigorous)u • >48 hrs return of relaxation (Secondary)

22. Decay = Putrefaction = Decomposition • Autolysis=Mikrobacteria • Coecum region • Gas putrefection • 48 hrs • Change in color on right bottom region belly  Greenish • Gas H2S + Hb  Sulf-Met-Hb

24. Putrefaction signs • Greenish in color (Coecum region) • Superficial vein dilatation • Swelling of face • Abdominal distended (gases) • Scrotum / vulva Swelling • Skin blister • Fluid come up through mouth and nose • Tongue and eye ball protruded out • Belly and chest blast due to gas pressure • Hair and nail easy to pull or discharges • Internal organ decays and porridge like Uterus, brain, spleen , lung, kidneys. But a little lasting are prostate for male and uterus on female

25. Special Circumstances 1.Mummification: Dry of air , cool, low humidity no bacterial contamination after a few months • Corpus smaller / shrinkage • Dry • Blackish in color • Skin covered bones • Odorless • Anatomical composition intact 2. Adipocere (Saponifikation): occurred when

29. Saponifikation • Fat fatty acid  unsaturated fatty acid  saturated fatty acid+ alkali (base) • Reaction with alkaline forms  Salt (Salt not dissolve in water) • Occurred in part of the body contains fat (check, omentum) • White in color • Smell sting like decay of coconut oil • FAT + alkali  SALT (Soap)

31. Summary 1. Vital signs 2. Brain death 3. Changes after death 4. Postmortem changes (Early to late) 5. Purposes of Thanatology

33. Reference. • 1. Forensic Medicine • 2. Forensic Pathology

37. THANK YOU