A clear sign of biological death is. Signs of biological and clinical death

Biological or true death is the irreversible cessation of physiological processes in tissues and cells. However, the capabilities of medical technology are constantly increasing, so this irreversible cessation of body functions implies the modern level of medicine. Over time, the ability of doctors to resuscitate the dead is increasing, and the border of death is constantly being pushed into the future. There is also a large group of scientists, supporters of nanomedicine and cryonics, who argue that most of the currently dying people can be revived in the future if the structure of their brain is preserved in time.

Early symptoms of biological death include:

• to pressure or other irritation,
• clouding of the cornea occurs,
• Drying triangles appear, called Larchet spots.

Even later, cadaveric spots can be detected, which are located in sloping places of the body, after which rigor mortis, cadaveric relaxation and, finally, the highest stage of biological death begin - cadaveric decomposition. Rigidity and decomposition most often begin in the upper limbs and facial muscles. The time of appearance and duration of these symptoms is largely influenced by the initial background, humidity and ambient temperature, as well as the causes that led to death or irreversible changes in the body.

The body and signs of biological death

However, the biological death of a specific person does not lead to the simultaneous biological death of all organs and tissues of the body. The lifespan of body tissues depends on their ability to survive hypoxia and anoxia, and this time and ability are different for different tissues. The tissues of the brain that die first are the ones that tolerate anoxia the worst. The spinal cord and stem sections resist longer and have greater resistance to anoxia. The remaining tissues of the human body can resist lethal effects even more strongly. In particular, it persists for another one and a half to two hours after recording biological death.

A number of organs, for example, kidneys and liver, can “live” up to four hours, and skin, muscle tissue and some tissues are quite viable up to five to six hours after biological death is declared. The most inert tissue is one that is viable for several more days. This property of organs and tissues of the body is used in organ transplantation. The sooner after the onset of biological death organs are removed for transplantation, the more viable they are and the higher the likelihood of their successful engraftment in another organism.

Clinical death

Biological death follows clinical death and there is the so-called “brain or social death”, a similar diagnosis arose in medicine thanks to the successful development of resuscitation. In some cases, cases were recorded where, during resuscitation, it was possible to restore the function of the cardiovascular system in people who were in a state of clinical death for more than six minutes, but by this time in these patients irreversible changes in the brain had already occurred. Their breathing was supported by mechanical ventilation, but brain death meant the death of the individual and the person turned into only a “cardiopulmonary” biological mechanism.

Visual function is one of the most important for humans. With the help of vision, a person from birth learns about the world and establishes contact with people around him. Any pathologies of the visual organs, and especially congenital ones, bring inconvenience and affect not only his physical, but also his psycho-emotional state. One of these pathologies is the cat's pupil in humans.

The photo clearly shows the appearance of the “cat pupil” syndrome

Cat pupil syndrome belongs to a group of genetic congenital pathologies. This disease is caused by the presence in the karyoptosis of an additional chromosome consisting of particles of the 22nd chromosome. The disease received this name due to its main symptom – vertical coloboma of the eye. Therefore, it has an elongated shape, and such an eye resembles the eye of a cat.

Cat pupil syndrome is inherited. If at least one of the parents had this disease, the risk of its development in the intrauterine fetus is within 80%. Therefore, when carrying such a fetus, screening for chromosomal abnormalities is mandatory.

Symptoms of cat pupil in humans

The first signs of this pathology appear from the moment the child is born. These include: a narrow, elongated pupil, the absence of an anus, and the presence of dimples or protrusions near the auricle.

Additional symptoms of cat eye disease in humans may also appear during the first years of life. They appear as:

• Presence of hernias: inguinal, umbilical.
• Cryptorchidism.
• Abnormal development of female reproductive organs.
• Drooping corners of the eyes.
• Slantness and squint.
• Heart defects.
• Pathological development of the urinary system.
• Stunted growth.
• Changes in the structure and curvature of the spinal column.
• Dehiscence of palate and cleft lip.

Sometimes the presence of this disease is accompanied by mental retardation.

Diagnostic methods

Despite the fact that the pupil resembles a cat's, this does not improve night vision, nor the clarity of perception of distant objects

Most doctors can determine the presence of cat pupil syndrome by the appearance of the newborn. To establish an accurate diagnosis, it is recommended to carry out cytogenetic analysis and study of the child’s karyotype. These procedures are prescribed when planning pregnancy. These are the main methods for diagnosing cat pupil syndrome.

1. If necessary, the diagnostic complex is supplemented with:
2. Amniocentesis: specific analysis of amniotic fluid.
3. Chorionic villus biopsy: biomaterial is taken from the placenta.
4. Cordocentesis: examination of umbilical cord blood.

The presence of an extra chromosome confirms the development of pathology. It consists of two identical sections of chromosome 22. Normally, such a region in the genome is present in four copies. In cat pupil syndrome, three copies are detected.

Correct diagnosis is the key to successful treatment. Therefore, when identifying cat pupil syndrome, differential diagnosis is mandatory. Retinoblastoma has such a visual symptom as cat's eyes. This is a malignant neoplasm that affects the inside of the eyeball. This pathology is inherited and most often develops in children.

The disease is also differentiated from Rieger's syndrome. This pathology has very similar symptoms. But this disease occurs due to mutations of the 4th and 13th genes.

Treatment options

At the moment, methods for treating this pathology have not yet been developed.

In modern medicine there are no therapeutic methods for the treatment of genetic diseases. Therefore, there is no treatment for cat pupil syndrome. But there are medical recommendations for preventing the development of pathology and ways to help sick children. To do this you need:

• Take a test to determine the genetic compatibility of partners before conceiving a child.
• Consult a geneticist if there is a family history of this disease.
• It is mandatory to undergo perinatal diagnostics in the 1st, 2nd, 3rd trimester: ultrasound and blood tests.
• When a sick child is born, medical actions can only help improve his quality of life.
• A newborn with cat pupil syndrome must undergo proctoplasty in the first days.

In addition, such children must be examined by specialized specialists: a surgeon, nephrologist, cardiologist, endocrinologist, orthopedist.

If cat pupil syndrome is present, doctors cannot give any prognosis. No one knows how a child with a genetic disease will develop and how long he will live. This depends on the severity of the pathology and the extent of damage to internal organs.

With timely detection of the disease, provision of adequate medical care, advising care and rehabilitation, the quality of life of such people increases significantly.

Complications of the disease

It is possible to bring the condition of a child with cat pupil syndrome closer to satisfactory only with the help of systematic drug treatment. The lack of maintenance therapy leads to the development of severe diseases of all body systems. This condition often leads to death.

Genetic pathologies, including cat's eye syndrome, cannot be cured. Therefore, it is recommended to undergo a full examination and consult with a geneticist before pregnancy.

The cat's pupil is undoubtedly a very unusual pathology. Find out what other amazing facts our eyes hide:

Man, like every living organism on Earth, begins his journey with birth and inevitably ends with death. This is a normal biological process. This is the law of nature. You can extend life, but it is impossible to make it eternal. People dream, create a lot of theories, offer different ideas about eternal life. Unfortunately, so far they are unjustified. And it’s especially offensive when life is cut short not because of old age, but because of illness (see) or an accident. Clinical and biological death: what do they look like? And why doesn’t life always win?

The concept of clinical and biological death

When all the vital functions of the body cease to function, death occurs. But a person, as a rule, does not die immediately. He goes through several stages before completely saying goodbye to life. The dying process itself consists of 2 phases - clinical and biological death (see).

Signs of clinical and biological death give us the opportunity to consider how a person dies and, possibly, save him. Knowing the features and first symptoms of clinical death, as well as early signs of biological death, you can accurately determine the person’s condition and begin resuscitation.

Clinical death is considered a reversible process. This is the intermediate moment between a living organism and an already dead one. It is characterized by cessation of breathing and cardiac arrest and ends with physiological processes in the cerebral cortex, which are considered irreversible. The maximum duration of this period is 4-6 minutes. At low ambient temperatures, the time for reversible changes doubles.

Important! Having discovered that there is no pulse in the carotid artery, immediately begin resuscitation without wasting a minute. You need to remember how it is carried out. Sometimes situations arise when someone's life is in your hands.

Biological death is an irreversible process. Without access to oxygen and nutrients, cells of various organs die, and it is not possible to revive the body. He will no longer be able to function, the person can no longer be revived. This is the difference between clinical death and biological death. They are separated by a period of only 5 minutes.

Signs of clinical and biological death

When clinical death occurs, all manifestations of life are absent:

• no pulse;
• no breathing;
• the central nervous system is “disabled”;
• there is no muscle tone;
• skin color changes (pallor).

But unbeknownst to us, at a very low level, metabolic processes are still ongoing, the tissues are viable and can still be fully restored. The time period is determined by the work of the cerebral cortex. Once nerve cells die, there is no way to completely restore a person.

Not all organs die immediately; some retain the ability to live for some time. After a few hours, you can revive the heart and respiratory center. Blood retains its properties for several hours.

Biological death happens:

• physiological or natural, which occurs during the aging of the body;
• pathological or premature, associated with serious illness or non-life-threatening injuries.

In both cases, it is impossible to bring a person back to life. Signs of biological death in humans are expressed as follows:

• cessation of heart rhythm for up to 30 minutes;
• lack of breathing;
• dilated pupil that does not respond to light;
• the appearance of dark blue spots on the surface of the skin.

An early symptom of biological death is the “cat pupil sign.” When you press on the side of the eyeball, the pupil becomes narrow and oblong, like a cat's.

Since organs do not die immediately, they are used in transplantology for organ transplantation. Patients whose kidneys, hearts, and other organs are failing are waiting for their donor. In European countries, people obtain paperwork to allow their organs to be used if they die in an accident.

How to make sure a person is dead?

Diagnosis of clinical and biological death is important; it is carried out by doctors. But everyone should know how to determine it. Irreversible death of a person can be determined by the following signs:

1. "Symptom of a cat's pupil."
2. The cornea of ​​the eye dries out and becomes cloudy.
3. The formation of cadaveric spots due to decreased vascular tone. They usually occur several hours later, when a person has died.
4. Decreased body temperature.
5. Rigor mortis also sets in after a few hours. The muscles become hard and the body becomes inactive.

Doctors diagnose a reliable sign of biological death using data from medical equipment, which determines that electrical signals are no longer coming from the cerebral cortex.

In what cases can a person be saved?

Clinical death differs from biological death in that a person can still be saved. An accurate signal of clinical death is considered if the pulse in the carotid artery is not heard and there is no breathing (see). Then resuscitation actions are carried out: indirect cardiac massage, injection of adrenaline. In medical institutions with modern equipment, such measures are more effective.

If the person shows minimal signs of life, immediate revival is performed. If there is any doubt about biological death, resuscitation measures are taken to prevent the person’s death.

It is also worth paying attention to the harbingers of clinical death:

• reduction in blood pressure to critical levels (below 60 mm Hg);
• bradycardia (pulse below 40 beats per minute);
• increased heart rate and extrasystole.

Important! Establishing a diagnosis of clinical death should take no more than 10 seconds for the person providing assistance! Revival measures taken no later than two minutes after the first signs of clinical death appear are successful in 92% of cases.

Will the person be saved or not? At some stage, the body loses strength and stops fighting for life. Then the heart stops, breathing stops and death occurs.

Death is a phenomenon that once overtakes every person. In medicine, it is described as an irreversible loss of function of the respiratory, cardiovascular and central nervous systems. Various signs indicate the moment of its onset.

Manifestations of this condition can be studied in several directions:

• signs of biological death - early and late;
• immediate symptoms.

What is death?

Hypotheses about what constitutes death vary across cultures and historical periods.

In modern conditions, it is detected when cardiac, respiratory and circulatory arrest occurs.

Society's considerations regarding the death of a person are not only of theoretical interest. Progress in medicine makes it possible to quickly and correctly determine the cause of this process and prevent it, if possible.

Currently, there are a number of issues discussed by doctors and researchers regarding death:

• Is it possible to disconnect a person from artificial life support without the consent of relatives?
• Can a person die of his own free will if he personally asks not to take any measures aimed at preserving his life?
• Can relatives or legal representatives make decisions regarding death if a person is unconscious and treatment does not help?

People believe that death is the destruction of consciousness, and beyond its threshold the soul of the deceased passes into another world. But what is actually happening remains a mystery to society to this day. Therefore, today, as already mentioned, we will focus on the following questions:

• signs of biological death: early and late;
• psychological aspects;
• reasons.

When the cardiovascular system stops functioning, disrupting blood transportation, the brain, heart, liver, kidneys and other organs stop functioning. It doesn't happen all at once.

The brain is the first organ to lose its functions due to lack of blood supply. A few seconds after the oxygen supply stops, the person loses consciousness. Then the metabolic mechanism ends its activity. After 10 minutes of oxygen starvation, brain cells die.

Survival of various organs and cells, calculated in minutes:

• Brain: 8–10.
• Heart: 15–30.
• Liver: 30–35.
• Muscles: from 2 to 8 hours.
• Sperm: from 10 to 83 hours.

Statistics and reasons

The main factor in human death in developing countries is infectious diseases, in developed countries - atherosclerosis (heart disease, heart attack and stroke), cancer pathologies and others.

Of the 150 thousand people who die worldwide, approximately ⅔ die from aging. In developed countries this share is much higher and amounts to 90%.

Causes of biological death:

1. Smoking. In 1910, more than 100 million people died from it.
2. In developing countries, poor sanitation and lack of access to modern medical technologies increase mortality rates from infectious diseases. Most often, people die from tuberculosis, malaria, and AIDS.
3. Evolutionary cause of aging.
4. Suicide.
5. Car accident.

As you can see, the causes of death can be different. And this is not the entire list of reasons why people die.

In high-income countries, the majority of the population lives to age 70, mostly dying due to chronic diseases.

Signs of biological death (early and late) appear after the onset of clinical death. They occur immediately after the cessation of brain activity.

Precursor symptoms

Immediate signs indicating death:

1. Numbness (loss of movement and reflexes).
2. Loss of EEG rhythm.
3. Stopping breathing.
4. Heart failure.

But signs such as loss of sensitivity, movement, cessation of breathing, lack of pulse, etc. may appear due to fainting, inhibition of the vagus nerve, epilepsy, anesthesia, or electric shock. In other words, they can mean death only when associated with a complete loss of EEG rhythm over a long period of time (more than 5 minutes).

Most people often ask themselves the sacramental question: “How will this happen and will I feel the approach of death?” Today there is no clear answer to this question, since everyone has different symptoms, depending on the existing disease. But there are general signs by which one can determine that a person will die in the near future.

Symptoms that appear as death approaches:

• white tip of nose;
• cold sweat;
• pale hands;
• bad breath;
• intermittent breathing;
• irregular pulse;
• drowsiness.

General information about initial symptoms

The exact line between life and death is difficult to determine. The further from the line, the clearer the difference between them. That is, the closer death is, the more visually noticeable it will be.

Early signs indicate molecular or cellular death and last for 12–24 hours.

Physical changes are characterized by the following early symptoms:

• Drying of the cornea of ​​the eyes.
• When biological death occurs, metabolic processes stop. Consequently, all the heat in the human body is released into the environment, and the corpse begins to cool. Medical professionals say that cooling time depends on the temperature in the room where the body is located.
• Blueness of the skin begins within 30 minutes. It appears due to insufficient oxygen saturation of the blood.
• Cadaveric spots. Their location depends on the position of the person and the disease with which he was ill. They arise due to the redistribution of blood in the body. They appear on average after 30 minutes.
• Rigor mortis. It begins approximately two hours after death, proceeds from the upper extremities, slowly moving to the lower extremities. Fully expressed rigor mortis is achieved in a time interval of 6 to 8 hours.

Constriction of the pupil is one of the initial symptoms

Beloglazov's symptom is one of the very first and most reliable manifestations in a deceased person. It is thanks to this sign that biological death can be determined without unnecessary examinations.

Why is it also called cat's eye? Because as a result of squeezing the eyeball, the pupil turns from round to oval, like in cats. This phenomenon actually makes the dying human eye look like a cat's eye.

This sign is very reliable and appears due to any reasons that result in death. In a healthy person, the presence of such a phenomenon is impossible. Beloglazov's symptom appears due to cessation of blood circulation and intraocular pressure, as well as due to dysfunction of muscle fibers due to death.

Late manifestations

Late signs are tissue decomposition, or rotting of the body. It is marked by the appearance of a greenish-discolored color of the skin, which appears 12-24 hours after death.

Other manifestations of late signs:

• Marbling is a network of marks on the skin that occurs after 12 hours and becomes noticeable after 36 to 48 hours.
• Worms - begin to appear as a result of putrefactive processes.
• The so-called cadaveric spots become visible approximately 2-3 hours after cardiac arrest. They occur because blood is immobilized and therefore collects under the influence of gravity at certain points in the body. The formation of such spots can characterize signs of biological death (early and late).
• The muscles are relaxed at first; the process of muscle hardening takes three to four hours.

When exactly the stage of biological death will be reached is impossible to determine in practice.

Main stages

There are three stages that a person goes through during the dying process.

The Palliative Medicine Society divides the final stages of death as follows:

1. Predagonal phase. Despite the progression of the disease, the patient needs independence and an independent life, but he cannot afford it because he is between life and death. He needs good care. This phase refers to the last few months. It is at this moment that the patient feels some relief.
2. Terminal phase. The limitations caused by the disease cannot be stopped, the symptoms accumulate, the patient becomes weaker and his activity decreases. This stage may occur several weeks before death.
3. The final phase describes the process of dying. It lasts for a short period of time (the person either feels too good or very bad). A few days later the patient dies.

Terminal phase process

It is different for each person. In many people who have died, shortly before death, physical changes and signs are determined that indicate its approach. Others may not have these symptoms.

Many dying people want to eat something tasty in their last few days. Others, on the contrary, have a poor appetite. Both are normal. But you need to know that consuming calories and fluids makes the dying process more difficult. It is believed that the body reacts less sensitively to changes if no nutrients are supplied for a while.

It is very important to monitor the oral mucosa and ensure good and regular care to avoid dryness. Therefore, the dying person should be given a little water to drink, but often. Otherwise, problems such as inflammation, difficulty swallowing, pain and fungal infections may occur.

Many dying people become restless shortly before death. Others do not perceive the approaching death in any way, because they understand that nothing can be corrected. People are often half asleep and their eyes become dim.

Breathing may stop frequently or be rapid. Sometimes the breathing is very uneven and constantly changing.

And finally, changes in blood flow: the pulse is weak or fast, body temperature drops, hands and feet become cold. Shortly before death, the heart beats weakly, breathing is difficult, and brain activity decreases. A few minutes after the decline of the cardiovascular system, the brain stops functioning and biological death occurs.

How is a dying person examined?

The examination must be carried out quickly so that, if the person is alive, there is time to send the patient to the hospital and take appropriate measures. First you need to feel the pulse in your hand. If it cannot be felt, then you can try to feel the pulse on the carotid artery by lightly pressing on it. Then use a stethoscope to listen to your breathing. Again, no signs of life were found? Then the doctor will need to perform artificial respiration and cardiac massage.

If after the manipulations the patient does not have a pulse, then it is necessary to confirm the fact of death. To do this, open the eyelids and move the head of the deceased to the sides. If the eyeball is fixed and moves with the head, then death has occurred.

There are several ways to determine for sure whether a person is dead or not by looking at the eyes. For example, take a clinical flashlight and check your eyes for pupillary constriction. When a person dies, the pupils become narrow and clouding of the cornea appears. It loses its glossy appearance, but this process does not always happen immediately. Especially in those patients who have been diagnosed with diabetes or have vision-related diseases.

If in doubt, ECG and EEG monitoring can be done. An ECG will show within 5 minutes whether a person is alive or dead. The absence of waves on the EEG confirms death (asystole).

Diagnosing death is not easy. In some cases, difficulties arise due to suspended animation, excessive use of sedatives and hypnotics, hypothermia, alcohol intoxication, etc.

Psychological aspects

Thanatology is an interdisciplinary field of study dealing with the study of death. This is a relatively new discipline in the scientific world. In the 50s and 60s of the twentieth century, research opened the way to the psychological aspect of this problem, and programs began to be developed to help overcome deeply emotional problems.

Scientists have identified several stages through which a dying person goes:

1. Negation.
2. Fear.
3. Depression.
4. Acceptance.

According to most experts, these stages do not always occur in the order stated above. They can be mixed and complemented by a feeling of hope or horror. Fear is compression, oppression from the feeling of impending danger. A feature of fear is intense mental discomfort from the fact that the dying person cannot correct future events. The reaction to fear may be: nervous or dyspeptic disorder, dizziness, sleep disturbance, trembling, sudden loss of control over excretory functions.

Not only the dying person, but also his relatives and friends go through stages of denial and acceptance. The next stage is the grief that comes after death. As a rule, it is more difficult to tolerate if a person did not know about the condition of a relative. During this phase, there is sleep disturbance and loss of appetite. Sometimes there is a feeling of fear and anger due to the fact that nothing can be changed. Later, sadness turns into depression and loneliness. At some point, the pain subsides, vital energy returns, but psychological trauma can accompany a person for a long period.

The death of a person can be carried out at home, but in most cases such people are admitted to the hospital in the hope of providing help and saving.

All signs of death can be divided into two groups - probable and reliable.

Probable signs of death

Based on probable signs, death is expected. In everyday life, there are cases of a person developing a deep coma, fainting and other similar conditions that can be mistakenly accepted as death.

Possible signs of death:

1) body immobility;

2) pallor of the skin;

3) lack of response to sound, pain, thermal and other irritations;

4) maximum dilation of the pupils and their lack of reaction to light;

5) lack of reaction of the cornea of ​​the eyeball to mechanical impact;

6) absence of pulse in large arteries, especially in the carotid artery;

7) absence of heartbeat – according to auscultation or electrocardiography;

8) cessation of breathing - there is no visible excursion of the chest, a mirror brought to the victim’s nose does not fog up.

Reliable signs of death

The presence of reliable signs of death indicates the development of irreversible physical and biochemical changes that are not characteristic of a living organism, the onset of biological death. The severity of these changes determines the time of death. Reliable signs of death are divided into early and late according to the time of manifestation.

Early cadaveric changes develop during the first 24 hours after death. These include cadaveric cooling, rigor mortis, cadaveric spots, partial cadaveric desiccation, cadaveric autolysis.

Cadaveric cooling. A reliable sign of death is a drop in temperature in the rectum to 25 °C or lower.

Normally, a person’s body temperature is in the range of 36.4-36.9 °C when measured in the armpit. In the internal organs it is 0.5 °C higher, the temperature in the rectum is 37.0 °C. After death, thermoregulation processes stop and body temperature tends to equal the ambient temperature. At an ambient temperature of 20 °C, the cooling time lasts up to 24–30 hours, at 10 °C – up to 40 hours.

At the time of death, body temperature may be 2–3 °C higher than normal due to the development of infectious diseases, poisoning, overheating, or after physical work. The rate of cooling of a corpse is influenced by environmental humidity, wind speed, ventilation of rooms, the presence of contact of the body with massive cold (warm) objects, the presence and quality of clothing on the body, the severity of subcutaneous fatty tissue, etc.

A noticeable cooling of the hands and face to the touch is noted after 1.5–2 hours, the body under clothing remains warm for 6–8 hours.

With instrumental thermometry, the time of death is determined quite accurately. Body temperature decreases approximately by 1 °C per 1 hour in the first 7–9 hours, then it decreases by 1 °C in 1.5 hours. Body temperature should be measured twice with an interval of 1 hour, at the beginning and at the end of the examination of the corpse.

Rigor mortis. This is a peculiar condition of muscle tissue that causes limited movement in the joints. The expert tries with his own hands to make this or that movement in any part of the body, limb of the corpse. When encountering resistance, the expert determines the severity of muscle rigor by its strength and limited range of motion in the joints. To the touch, stiff muscles become dense.

Immediately after death, all muscles are usually relaxed and passive movements in all joints are fully possible. Rigor rigor is noticeable 2–4 hours after death and develops from top to bottom. The muscles of the face (it is difficult to open and close the mouth, the lateral displacement of the lower jaw is limited) and hands become numb faster, then the muscles of the neck (movements of the head and cervical spine are difficult), then the muscles of the limbs, etc. The corpse becomes completely numb in 14–24 hours When determining the degree of rigor, it is necessary to compare its severity in the right and left parts of the body.

Rigor mortis persists for 2–3 days, after which it resolves due to the activation of the process of decay of the actomyosin protein in the muscles. This protein causes muscle contraction. Resolution of rigor mortis also occurs from top to bottom.

Rigor mortis develops not only in skeletal muscles, but also in many internal organs (heart, gastrointestinal tract, bladder, etc.) that have smooth muscles. Their condition is judged during an autopsy.

The degree of rigor at the time of examination of the corpse depends on a number of reasons, which must be taken into account when determining the time of death. At low ambient temperatures, rigor mortis develops slowly and can last up to 7 days. On the contrary, at room temperature and higher, this process accelerates and complete rigor develops faster. Rigor rigor is severe if death was preceded by convulsions (tetanus, strychnine poisoning, etc.). Also, rigor develops more strongly in persons:

1) having well-developed muscles;

2) younger;

3) without diseases of the muscular system.

Muscle contraction is caused by the breakdown of ATP (adenosine triphosphate) in it. After death, some of the ATP is free from connection with carrier proteins, which is enough for complete relaxation of the muscles in the first 2–4 hours. Gradually, all ATP is utilized and rigor mortis develops. The period of complete utilization of ATP is approximately 10–12 hours. It is during this period that the state of the muscles can change under external influence; for example, you can straighten your hand and insert an object into it. After changing the position of a part of the body, rigor is restored, but to a lesser extent. The difference in the degree of rigor is established by comparing different parts of the body. The difference will be smaller the sooner after death the position of the corpse or its body part is changed. After 12 hours from the moment of death, ATP completely disappears. If the position of the limb is disturbed after this period, then rigor in this place is not restored.

The state of rigor is judged by the results of mechanical and electrical effects on the muscles. When a muscle is struck by a hard object (stick), an idiomuscular tumor forms at the site of the impact, which is determined visually in the first 6 hours after death. At a later date, such a reaction can only be determined by palpation. When a current of a certain strength is applied to the ends of the muscle, its contraction is observed, assessed on a three-point scale: strong contraction is observed in a period of up to 2–2.5 hours, medium – up to 2–4 hours, weak – up to 4–6 hours.

Cadaveric spots. The formation of cadaveric spots is based on the process of redistribution of blood in the vessels after death. During life, the muscle tone of the vascular walls and the contraction of the myocardium of the heart contribute to the movement of blood in a certain direction. After death, these regulatory factors disappear and the blood is redistributed to the underlying parts of the body and organs. For example, if a person lies on his back, blood flows into the back area. If the corpse is in an upright position (hanging, etc.), then the blood flows into the lower abdomen and lower limbs.

The color of the spots is most often bluish-purple. In carbon monoxide poisoning, carboxyhemoglobin is formed, and therefore the color of the stain is reddish-pink; in case of poisoning with certain poisons, the color is grayish-brown (formation of methemoglobin).

Blood is redistributed to areas that are not pressed. With severe blood loss, spots form slowly and are weakly expressed. With asphyxia, blood thins and the spots are abundant, diffuse and strongly pronounced.

In a living organism, the components of blood pass through the wall of blood vessels only in capillaries, the smallest vessels. In all other vessels (arteries and veins), blood does not pass through the wall. Only in certain diseases or after death does the vascular wall and its structure change and it becomes permeable to blood and interstitial fluid.

Cadaveric spots go through three stages in their development.

Stage I – hypostasis, develops after 2–4 hours. If you press on the spot at this stage, it completely disappears. In this case, the blood is squeezed out of the vessels, the wall of which is still impenetrable, that is, the components of the blood do not pass through it into the tissue. If the pressure is stopped, the spot is restored. Rapid restoration of the spot in 3-10 s corresponds to 2-4 hours after death, a time of 20-40 s corresponds to 6-12 hours. When the position of the corpse changes at this stage, the spots in the old place disappear, but other spots appear in the new place (“spot migration”).

Stage II – diffusion (stasis), develops after 14–20 hours. At this stage, the vascular wall becomes permeable to a certain extent; intercellular fluid diffuses through the wall into the vessels and dilutes the plasma; hemolysis (destruction) of red blood cells occurs. At the same time, blood and its breakdown products diffuse into the tissue. When pressed, the spot turns pale, but does not disappear completely. Recovery of the spot occurs slowly, within 5-30 minutes, which corresponds to 18-24 hours after death. When the position of the corpse changes, the old spots fade, but new ones appear in those places that are located below the locations of the previous spots.

Stage III – hypostatic imbibition, develops after 20–24 hours or more. The vessel wall is completely saturated with blood plasma and interstitial fluid. The blood as a liquid system is completely destroyed. Instead, in the vessels and surrounding tissues there is a liquid formed from the mixing of destroyed blood and interstitial fluid that has permeated the tissues. Therefore, when pressed, the spots do not fade, maintaining their color and shade. When the position of the corpse changes, they do not “migrate”.

All of the above changes are observed in the internal organs, more precisely, in those parts of them that are located below other areas. There is an accumulation of fluid in the cavities of the pleura, pericardium, and peritoneum. The walls of all vessels, especially large ones, are saturated with liquid.

Partial cadaveric desiccation. Drying is based on the process of evaporation of moisture from the surface of the skin, mucous membranes and other open areas of the body. In living people, the evaporated liquid is compensated by the newly received one. There is no compensation process after death. Drying begins immediately after death. But its first visually noticeable manifestations are observed after a few hours.

If the eyes are open or half-open, drying quickly manifests itself in the form of clouding of the cornea, which takes on a grayish tint. When the eyelids are pulled apart, triangular-shaped opacities are visible. The time it takes for these spots to appear is 4–6 hours.

Next, the lip border dries (6–8 hours); the surface of the lip becomes dense, wrinkled, red-brown in color (very similar to intravital deposition). If the mouth is slightly open or the tongue protrudes from the oral cavity (mechanical asphyxia), then its surface is dense and brown.

The same changes are observed on the genitals, especially if they are exposed. Thinner areas of the skin dry out faster: the glans penis, foreskin, and scrotum. The skin in these places becomes dense, brown-red, and wrinkled (similar to intravital trauma).

Drying occurs faster if the body is naked; in dry air. Skin areas with post-mortem abrasions dry out faster. Their color is brown-red (on the underlying parts of the corpse) or “waxy” (on the overlying parts of the corpse). These are “parchment spots”, the central area of ​​which is located below the edges. Abrasions are life-time. Their surface also dries quickly, the color is red-brown, but it protrudes slightly due to swelling of the tissue. Microscopic picture - full-blooded vessels, swelling, hemorrhages, leukocyte infiltration.

Cadaveric autolysis. In the human body, a number of glands produce chemically active secretions. After death, these secretions begin to destroy the tissue of the glands themselves, since the organ’s own defense mechanisms are absent. Self-destruction of the gland occurs. This is especially true for the pancreas and liver. At the same time, secretions leave the glands into other organs (the gastrointestinal tract) and change it. Organs become flabby and dull. The faster death occurs, the stronger the effect of enzymes on the structure of organs. The shorter the agony lasts, the less time the body has time to utilize enzymes and the faster cadaveric changes develop. All changes caused by autolysis can only be seen during an autopsy.

Pupil reaction. During the first day, the pupils retain the ability to respond to the effects of certain pharmacological substances introduced into the anterior chamber of the eye. The speed of pupillary reaction decreases with increasing time of death. After the administration of pilocarpine, pupil constriction after 3–5 s corresponds to 3–5 hours after death, after 6–15 s – 6–14 hours, 20–30 s – 14–24 hours.

The Beloglazov phenomenon. 15–20 minutes after death, intraocular pressure decreases in the eyeballs. Therefore, when the eyeball is compressed, the pupil takes an oval shape. Living people don't have this.

Late cadaveric changes dramatically change the appearance of the corpse. Their onset is noted during the period of manifestation of early cadaveric changes. But outwardly they appear later, some by the end of 3 days, others months and years later.

Depending on the preservation of individual characteristics of a person and damage to the corpse, late cadaveric changes are divided into types:

1) destructive - rotting;

2) preservatives: fat wax, mummification, peat tanning, freezing.

During conservation, the appearance changes, but to a certain extent, individual features and damage are preserved.

Rotting. Rotting is a complex process of decomposition of organic compounds under the influence of microorganisms and their enzymes. According to their living conditions, microorganisms are divided into aerobes and anaerobes (living with or without oxygen). Aerobes produce destruction more intensively. Anaerobes slowly destroy tissue, releasing unpleasant odors.

Microorganisms decompose protein into peptones and amino acids. Next, valeric, acetic, oxalic acids, creosol, phenol, methane, ammonia, nitrogen, hydrogen, carbon dioxide, hydrogen sulfide, methyl mercaptan, ethyl mercaptan are formed. The latter have an unpleasant odor. When rotting, unstable substances are formed - putrescine, cadaverine.

Optimal conditions for rotting are 30–40 °C. The rate of decay is highest in air. In water the process is slower, in soil even slower, in coffins very slow. At temperatures of 1 °C or less, 50 °C degrees or higher, the decay process slows down sharply and even stops. Decay accelerates if death was preceded by prolonged agony (rapid destruction of the tissue barrier of the colon), purulent infection, or sepsis.

After death, decay occurs immediately in the large intestine, where a living person has certain types of bacteria that are anaerobes, the vital activity of which continues after the person’s death. Microorganisms contribute to the formation of gases, especially hydrogen sulfide. It penetrates through the wall of the intestine and its vessels into the blood. In the blood, hydrogen sulfide combines with hemoglobin to form sulfohemoglobin, which has a greenish color. Spreading through the vessels, sulfohemoglobin penetrates the venous network of the skin and subcutaneous tissue of the anterior wall of the abdomen and its hypogastric region. All this explains the greenish coloration of the skin of the groin areas 36–48 hours after death. Further, the color intensifies due to an increase in the concentration of sulfohemoglobin and the formation of iron sulfide (greenish-gray color).

The accumulation of gases in the intestines leads to bloating of the intestines and the entire abdomen. This pressure is so strong that pregnant women experience miscarriage (so-called “post-mortem labor”) and uterine inversion. The gas penetrates the subcutaneous tissue of the entire body and causes swelling of the face, lips, mammary glands, neck, and scrotum. The tongue protrudes from the mouth. Gases press on the stomach, which leads to post-mortem vomiting.

Sulfohemoglobin and iron sulfide, spreading through the vessels, color them, which is noted in the form of a “putrid venous network” of a dirty green color after 3–5 days. After 8–12 days, the skin of the entire corpse has a dirty green color. The epidermis peels off, blisters with bloody contents form. Hair changes color after 3 years. Damage to the bones, gunshot marks on the skin and its pattern, and traces of cardiosclerosis persist for a relatively long time.

Fat wax. Synonyms: saponification, saponification of fats. Conditions for formation: a humid environment without access to air. This phenomenon is well expressed in people with significant subcutaneous fat.

Water penetrates the skin (maceration phenomenon), then penetrates the intestines and washes microorganisms out of it. Rotting sharply weakens and even stops. Fat under the influence of water decomposes into glycerol and fatty acids: oleic, palmitic, stearic, etc. These acids combine with alkali and alkaline earth metals, which are abundant in body tissues and in the water of reservoirs. A fat wax is formed, which has a gelatinous consistency of a dirty gray color (compounds of potassium and sodium), or a dense substance of gray-white color (compounds of calcium and magnesium). This process affects the subcutaneous tissue, fat accumulations in the chest and abdominal cavities, the brain, and the liver. However, individual features, the shape of organs, and traces of damage to tissues and organs are preserved.

The first signs of saponification of corpse tissue are observed from 25 days to 3 months. Complete saponification occurs no earlier than 6–12 months on the corpses of adults, and faster on the corpses of children.

Mummification. Natural mummification occurs at different ambient temperatures (usually high), lack of moisture, access and movement of dry air, and rapid release of fluid from the corpse. In the first days after death, rotting processes occur intensively in the corpse. Parenchymal organs (lungs, liver, kidneys and other organs) turn into a liquid mass that flows out through the disintegrated tissue. A decrease in the amount of liquid creates unfavorable conditions for the life of putrefactive microorganisms, as a result of which putrefaction gradually stops and the corpse begins to dry out quickly. Drying begins, as a rule, in areas devoid of epidermis, in macerated areas of the skin, with open eyes - in the area of ​​the cornea and conjunctiva, on the lips, fingertips, etc. Complete drying of the corpse is most often observed in a dry, loose, well-ventilated and suction room. soil moisture, in rooms with sufficient ventilation.

Corpses of thin and emaciated persons are easily mummified. On average, mummification of a corpse occurs after 6–12 months; in some cases, the corpse of an adult can be mummified in 2–3 months. The mass of the mummy is 1/10 of the original body mass. Skin color is parchment, yellowish-brown or dark brown. The internal organs dry out and take on a flat shape. The tissues become dense. During mummification, a person's appearance is preserved to varying degrees. You can determine gender, age, anatomical features. Traces of a shot, acute wounds, and a strangulation groove remain.

Peat tanning. The impregnation and tanning of tissues and organs with humic acids, which are products of the decay of dead plants, occurs in peat bogs. The skin becomes dark brown and dense. Internal organs are reduced. Mineral salts are washed out of the bones, so the shape of the bones changes. Bones look like cartilage. All damage is preserved. In this state, corpses can be preserved for a very long time, sometimes for centuries.

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