Thanatology

Thanatos=death

Logos=science

Is the branch of science that deals with the study of death. y y Blacks law dictionary defines death ass Cessation of Life or Ceasing to exit. 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 y Latest criteria for declaration of death is Brain Death. 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.

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.

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 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 Accidental

(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 y y Loss of sensation viz. perception of touch, pain, temp. Less of Vountary power to move 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. 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. These signs can be

taken as conclusive only when associated with loss of rhythm for a continuous period of

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

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) 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. we get a

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

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

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 of strangulation. 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

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 Due to some pathology in the organ Involve diffusely whole organ

distension with blood Situation On dependent parts only

Cut Surface Swelling & Exudation Mucous membrane

Oozing

of

blood

from Exudation of fluid mixed with blood May be present Dull & lusterless due to inflammation

distended capillaries Nil Normal

Hollow stretched

organs

when Show alternate stained & Show uniform staining unstained areas. postmortem Ante mortem

Nature of change

LIVIDITY Situation Tissue level surface margins Color Cause Not elevated Clearly defined Uniform in color On dependent body parts Epidermal

BRUISE Situated anywhere. Sub epidermal

Surface slightly elevated Diffuse Changes color with time of blood from

Distension of capillaries & veins Extravasation with blood capillaries

Nature change Effect Pressure Cut Surface

of Postmortem

Ante mortem

if Pressed spot appears blanched if No color change PMS not fixed Oozing of blood from distended Extravasation of blood in the

capillaries which can be easily surrounding tissue which can not be washed away washed away easily

M/E

Blood elements are found within Blood elements are found outside the the bld. Vessels. Bld. Vessels. since death & Suggest nature of injury & weapon used

MLI

Suggest

time

position of the dead body

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.

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

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. 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 ROLE OF 12

(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) (2) (3) It is a sure sign of death. It helps to estimate time since death. 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.

(4)

Cadaveric Spasm/ Instantaneous Rigor: characterized by stiffening of muscles immediately after death without being preceded by primary relaxation.

PRECONDITIONS FOR CADAVERIC SPASM y y y Somatic death must occur with Extreme Rapidity. The person must be in Great Emotional Tension. 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) (2) (3) Indicates sudden death associated with great emotional tension. Indicates that muscles were in physical activity at the time of death. 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 do not respond to mechanical or chemical stimuli. Muscle reaction again becomes alkaline. Secondary Relaxation coincides with onset of putrefaction. LATE SIGNS

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.

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 1836 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.

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.

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 <24 hrs. Internally various organs decomposes different rates depending on their difference in structure , vascularitym access to air & bacteria. Organs which putrefy early (1-2 days) Organs which putrefy late (2-3 wks) STOMACH shows dark red irregular patches 1st on post.wall & then on ant. wall Perforation of stomach all may occur due to autolysis. Dark patches may be mistaken for the effects of irritant poisoning which are observed generally on the m.memb only. Decomposition involves the whole thickness of stomach wall. In autolysis perforation consists of area of discolored sloughing & is devoid of vital reaction. It mainly involves fundus. In corrosive acid perforation there is corrosion of the m.m softening of stomach wall & ragged irregular margins of perforation showing evidence of sloughing. In chronic ulcer perforation margins of the ulcers are visible & are indurated, regular & punched out. Scarring & adhesions to the surrounding structures may be present. LIVER becomes soft & flabby. Due to evolution of gases in liver subs. It becomes spongy and has honeycomb appearance (foamy or Swiss cheese liver) Greenish discoloration of liver ultimately turns black.

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.

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.

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.