Thanatology

Dr. Cahyono Kaelan Sp.PA(K), PhD , DFM.

Dept of Forensic PathologyFac. of Medicine Unhas

Makassar

Meaning and Definition

• Thanatos = Death• Logos = Science

• Thanatology = Science describing of the causes and changes after death.

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

DEATH • Definition : What is death?

1. Death = Soul separates with body 2. Brain death 3. Coma 4. Unconscious (decrease of consciousness) 5. Wake = Live

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

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

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

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

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

II. Changes after death

• Face• Muscle relaxation• Eyes• Body temp• Livor Mortis• Rigor Mortis (Stiffness)• Putrefaction

(Decay/Decomposition)

Skin Face

• Face Pale no blood running anymore, exception of CO intoxication Cherry red

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

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)

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

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.

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)

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

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

Special Circumstances1.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

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)

Summary

1. Vital signs2. Brain death3. Changes after death

4. Postmortem changes(Early to late)

5. Purposes of Thanatology

Reference.

• 1. Forensic Medicine • 2. Forensic Pathology

THANK YOU