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

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

Early symptoms of biological death include:

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

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

Body and signs of biological death

However, the biological death of a particular person does not lead to the simultaneous biological death of all organs and tissues of the body. The lifetime of body tissues depends on their ability to survive hypoxia and anoxia, and this time and ability are different for different tissues. Worst of all tolerate anoxia brain tissue, which die first. The spinal cord and stem sections resist longer, they have a greater resistance to anoxia. The remaining tissues of the human body can resist deadly influences even more strongly. In particular, it persists for another one and a half to two hours after fixing biological death.

A number of organs, for example, the kidneys and liver, can “live” up to four hours, and the skin, muscle tissue and part of the tissues are quite viable up to five to six hours after biological death is declared. The most inert tissue is that which is viable for several more days. This property of organs and tissues of the body is used in organon transplantation. The sooner after the onset of biological death, organs are removed for transplantation, the more viable they are and the higher the probability 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 due to the successful development of resuscitation. In some cases, cases were recorded when, 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 irreversible changes in the brain had already occurred in these patients. Their breathing was supported by mechanical ventilation, but the death of the brain 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 a person. With the help of vision, a person from birth cognizes the world, and establishes contact with people around him. Any pathologies of the organs of vision, and especially congenital ones, bring inconvenience and affect not only his physical, but also his psycho-emotional state. One of these pathologies is the feline pupil in humans.

The photo clearly shows the appearance of the "cat's pupil" syndrome

Cat pupil syndrome belongs to the group of genetic congenital pathologies. This disease is caused by the presence in the karyo- rypt of an extra chromosome, consisting of particles of the 22nd chromosome. The name of the disease was due to the main feature - the vertical coloboma of the eye. Therefore, it has an elongated shape, and such an eye resembles a cat's eye.

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 a 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.

In the first years of life, additional symptoms of a cat's pupil in humans may also appear. They appear as:

• The presence of hernias: inguinal, umbilical.
• Cryptorchidism.
• Abnormal development of female reproductive organs.
• Downturned corners of the eyes.
• Squint and strabismus.
• Heart defects.
• Pathological development of the urinary system.
• growth retardation.
• Changes in the structure and curvature of the spinal column.
• Divergence of the 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, as well as the clarity of perception of distant objects.

Most doctors can determine the presence of feline pupil syndrome by the appearance of the newborn. To establish an accurate diagnosis, a cytogenetic analysis and a study of the child's karyotype are recommended. These procedures are prescribed when planning a pregnancy. These are the main methods for diagnosing feline pupil syndrome.

1. If necessary, the diagnostic complex is supplemented with:
2. Amniocentesis: specific analysis of the amniotic fluid.
3. Biopsy of the chorionic villi: biomaterial is taken from the placenta.
4. Cordocentesis: examination of 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 feline pupil syndrome, three copies are identified.

Correct diagnosis is the key to successful treatment. Therefore, when detecting feline 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.

Also, the disease is differentiated with Rieger's syndrome. This pathology has very similar symptoms. But this disease occurs when the 4th and 13th genes are mutated.

Methods of treatment

At the moment, no methods have been developed to treat this pathology.

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

• Undergo a study on the genetic compatibility of partners before conceiving a child.
• Consult a geneticist if there is a history of this disease in the family.
• Be sure to undergo perinatal diagnostics in the 1st, 2nd, 3rd trimester: ultrasound and blood tests.
• At the birth of a sick child, medical actions can only help improve his quality of life.
• A newborn with feline pupil syndrome must undergo proctoplasty in the first days.

In addition, such children are necessarily examined by narrow specialists: a surgeon, a nephrologist, a cardiologist, an endocrinologist, an orthopedist.

In the presence of feline pupil syndrome, doctors cannot give any prognosis. No one knows how a child with a genetic disease will develop and how long he will live. It 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 is significantly improved.

Complications of the disease

It is possible to bring the condition of a child with feline 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 is often fatal.

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

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

Man, like every living organism on Earth, begins his journey from birth and inevitably ends with his death. This is a normal biological process. This is the law of nature. It is possible to prolong 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 is especially insulting when life ends 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 process of dying itself consists of 2 phases - clinical and biological death (see).

Signs of clinical and biological death give us the opportunity to consider how the death of a person occurs and, possibly, save him. Knowing the features and first symptoms of clinical death, as well as early signs of biological death, it is possible to accurately determine the condition of a person and begin resuscitation.

Clinical death is considered a process that is reversible. This is an intermediate moment between a living organism and a 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 is doubled.

Important! Finding that there is no pulse on the carotid artery, immediately proceed to resuscitation without wasting a minute. You need to remember how it is done. Sometimes situations arise when someone's life is in your hands.

Biological death is an irreversible process. Without access to oxygen and nutrients, the cells of various organs die, and it is not possible to revive the body. He will no longer be able to function, it is no longer possible to revive a person. 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;
• "out of work" of the central nervous system;
• muscle tone is absent;
• skin color changes (pallor).

But imperceptibly for us, metabolic processes are still going on at a very low level, tissues are viable and can still fully recover. The time interval is determined by the work of the cerebral cortex. As soon as the 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, the respiratory center. For several hours, the blood retains its properties.

Biological death happens:

• physiological or natural, which occurs during the aging of the body;
• pathological or premature, associated with a serious illness or injury incompatible with life.

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 the heart rhythm up to 30 minutes;
• lack of breathing;
• pupil dilation 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 symptom.” When pressing from the side of the eyeball, the pupil becomes narrow and oblong, like a cat.

Since organs do not die immediately, they are used in transplantation for organ transplantation. Patients whose kidneys, heart, and other organs fail are waiting for their donor. In European countries, people draw up documents allowing the use of their organs in the event of their death as a result of an accident.

How can you be sure a person is dead?

The diagnosis of clinical and biological death is important, it is carried out by doctors. But everyone should know how to define it. The irreversible death of a person can be established by signs:

1. "Symptom of the cat's pupil."
2. The cornea of ​​the eye dries up and becomes cloudy.
3. The formation of cadaveric spots due to a decrease in vascular tone. Usually they occur after a few hours, when a person died.
4. Decrease in body temperature.
5. Rigor mortis also sets in after a few hours. Muscles become rigid, and the body becomes inactive.

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

How 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 on the carotid artery is not heard and there is no breathing (see). Then resuscitation actions are carried out: indirect heart massage, the introduction of adrenaline. In medical institutions with modern equipment, such measures are more effective.

If a person has minimal signs of life, proceed to immediate revival. If there are doubts about ascertaining biological death, resuscitation measures are taken to prevent the death of a person.

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

• lowering blood pressure to critical numbers (below 60 mm Hg);
• bradycardia (heart rate below 40 beats per minute);
• increased heart rate and extrasystoles.

Important! It should take no more than 10 seconds for a caregiver to establish a diagnosis of clinical death! Resuscitation measures taken no later than two minutes after the appearance of the first signs of clinical death 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 one day 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.

The 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 stated when there is a cardiac, respiratory and circulatory arrest.

Considerations of society regarding the death of a person are not only of theoretical interest. Progress in medicine allows you to quickly and correctly establish 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 the artificial life support apparatus 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 the person is unconscious and treatment is not helping?

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 is still a mystery to society. Therefore, today, as already mentioned, we will focus on the following questions:

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

When the cardiovascular system ceases to function, disrupting the transport of blood, the brain, heart, liver, kidneys and other organs cease to function. It doesn't happen at the same time.

The brain is the first organ to lose its function due to lack of blood supply. A few seconds after the oxygen supply stops, the person loses consciousness. Further, the mechanism of metabolism 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: 2 to 8 hours.
• Sperm: 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 150,000 people who die worldwide, about 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 the death rate from infectious diseases. Most often people die from tuberculosis, malaria, 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 whole list of reasons why people die.

In high-income countries, the majority of the population lives into their 70s, mostly dying from chronic diseases.

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

Symptoms-harbingers

Immediate signs indicating death:

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

But signs such as loss of sensation, movement, respiratory arrest, lack of pulse, etc. may appear due to fainting, inhibition of the vagus nerve, epilepsy, anesthesia, electric shock. In other words, they can mean death only when they are associated with a complete loss of the EEG rhythm for 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 single answer to this question, since each person has different symptoms, depending on the existing disease. But there are general signs by which you can determine that in the near future a person will die.

Symptoms that appear when death approaches:

• white tip of the 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 define. The farther from the boundary, the clearer the difference between them. That is, the closer death is, the more visually noticeable it will be.

Early signs denote molecular or cellular death and last 12 to 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 goes out into the environment, and the corpse is cooled down. Medical professionals claim that the cooling time depends on the temperature in the room where the body is located.
• Cyanosis of the skin begins within 30 minutes. It appears due to insufficient saturation of the blood with oxygen.
• Dead spots. Their localization depends on the position of the person and on 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 starts about two hours after death, goes from the upper limbs, slowly moving to the lower ones. Fully expressed rigor mortis is achieved in a time interval of 6 to 8 hours.

Pupil constriction 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 really makes a dying human eye look like a cat's eye.

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

Late manifestations

Late signs are the decomposition of tissues, or putrefaction of the body. It is marked by the appearance of a greenish discoloration 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 the blood is immobilized and therefore collects under the influence of gravity at certain points in the body. The formation of such spots can characterize the signs of biological death (early and late).
• The muscles are relaxed at first, the process of muscle hardening takes from 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 a person goes through in the process of dying.

The Society for Palliative Medicine 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 this 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 less active. This stage may begin several weeks before death.
3. The final phase describes the process of dying. It lasts a short period of time (a person either feels too good or very bad). A few days later the patient dies.

Terminal phase process

It is different for every person. Many of the dead shortly before death are determined by physical changes and signs that indicate its approach. Others may not have these symptoms.

Many dying people want to eat something tasty in the last few days. Others, on the contrary, have a poor appetite. Both of these are normal. But you need to know that the consumption of calories and fluid complicates the process of dying. It is believed that the body is less sensitive to changes if no nutrients are supplied for some time.

It is very important to monitor the oral mucosa, to ensure good and regular care so that there is no dryness. Therefore, a dying person should be given little water to drink, but often. Otherwise, problems such as inflammation, difficulty swallowing, pain and fungal infections can occur.

Many who die shortly before death become restless. Others do not perceive the impending death in any way, because they understand that there is nothing to fix. Often people are in a half-asleep state, their eyes dim.

Respiratory arrest may occur frequently, or it may be rapid. Sometimes breathing is very uneven, constantly changing.

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

How is the examination of a dying person carried out?

The examination should be carried out quickly so that, if the person is alive, the patient can be sent to the hospital and appropriate measures can be taken. First you need to feel the pulse on the arm. If it is not palpable, then you can try to feel the pulse on the carotid artery by slightly pressing on it. Then listen to your breath with a stethoscope. Again, no signs of life were found? Then the doctor will need to do artificial respiration and heart massage.

If after the manipulations the patient has no 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 along with the head, then death has occurred.

By the eyes, there are several ways to determine for sure whether a person has died or not. For example, take a clinical flashlight and check your eyes for pupillary constriction. When a person dies, the pupils become narrow, clouding of the cornea appears. It loses its glossy appearance, but such a process does not always occur immediately. Especially in those patients who have been diagnosed with diabetes mellitus or have diseases associated with vision.

In case of doubt, ECG and EEG monitoring can be done. An ECG within 5 minutes will show 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 1950s and 1960s, 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. Adoption.

According to most experts, these stages do not always occur in the same order as indicated above. They can be mixed and complemented by a sense of hope or horror. Fear is a contraction, oppression from a sense 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 can be: a nervous or dyspeptic disorder, dizziness, sleep disturbance, trembling, a 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 bear if the person did not know about the condition of the relative. In 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 departure of a person from life can be carried out at home, but in most cases such people are placed in a hospital in the hope of being helped and saved.

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

Likely signs of death

Probable signs suggest the onset of death. In everyday life, there are cases of a person developing a deep coma, fainting and other similar conditions that can be mistaken for death.

Possible signs of death:

1) immobility of the body;

2) pallor of the skin;

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

4) maximum expansion of the pupils and the absence of their reaction to light;

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

6) lack of pulse on large arteries, especially on the carotid artery;

7) lack of heartbeat - according to auscultation or electrocardiography;

8) cessation of breathing - there is no visible excursion of the chest, the mirror brought to the nose of the victim 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. By the severity of these changes, the time of death is determined. Reliable signs of death according to the time of manifestation are divided into early and late.

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

Corpse cooling. A reliable sign of death is a decrease in the temperature in the rectum to 25 ° C and below.

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, the processes of thermoregulation cease and the body temperature tends to catch up with 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, in case of poisoning, overheating, after physical work. The cooling rate of a corpse is influenced by the humidity of the environment, wind speed, ventilation of the premises, 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.

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

With instrumental thermometry, the time of death is determined quite accurately. Approximately, body temperature decreases by 1 °C in 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 kind of state of muscle tissue, which causes a restriction of movement in the joints. The expert with his own hands tries to make this or that movement in any part of the body, limbs of the corpse. Encountering resistance, an expert on its strength and limited range of motion in the joints determines the severity of muscle stiffness. To the touch, stiff muscles become dense.

Immediately after death, all muscles, as a rule, are relaxed and passive movements in all joints are possible in full. Rigor mortis is noticeable 2–4 hours after death and develops from top to bottom. The muscles of the face stiffen faster (opening and closing the mouth is difficult, lateral displacements of the lower jaw are limited) and hands, then the muscles of the neck (movements of the head and cervical spine are difficult), then the muscles of the limbs, etc. The corpse completely stiffens in 14–24 hours When determining the degree of stiffness, 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 actomyosin protein putrefaction process in the muscles. This protein causes muscle contraction. The resolution of rigor mortis also occurs from top to bottom.

Rigor mortis develops not only in the 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 mortis 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, stiffness develops slowly and can last up to 7 days. On the contrary, at room and higher temperatures, this process accelerates and complete rigor develops faster. Rigor is strongly pronounced if death was preceded by convulsions (tetanus, strychnine poisoning, etc.). Rigor mortis also develops more strongly in individuals:

1) having well-developed muscles;

2) younger;

3) who do not have diseases of the muscular apparatus.

Muscle contraction is due to the breakdown of ATP (adenosine triphosphate) in it. After death, some of the ATP is free from binding to carrier proteins, which is enough to completely relax 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 put some object into it. After a change in the position of a body part, stiffness is restored, but to a lesser extent. The difference in the degree of stiffness is established by comparing different parts of the body. The difference will be the smaller, the sooner after death the position of the corpse or its part of the body 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 stiffness in this place is not restored.

The state of stiffness is judged by the results of mechanical and electrical effects on the muscles. When hit with a hard object (stick) on the muscle, an idiomuscular tumor is formed at the site of 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: a strong contraction is observed in the period up to 2–2.5 hours, an average contraction is observed up to 2–4 hours, and a weak contraction is observed up to 4–6 hours.

Dead spots. The formation of cadaveric spots is based on the process of redistribution of blood in the vessels after death. During life, the tone of the muscles of the walls of the vessels 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 lower parts of the body and organs. For example, if a person lies on his back, then the blood flows into the back area. If the corpse is in a vertical position (hanging, etc.), then the blood flows into the lower parts of the abdomen, lower limbs.

The color of the spots is most often bluish-purple. In case of carbon monoxide poisoning, carboxyhemoglobin is formed, and therefore the color of the spot is reddish-pink; when poisoned by some poisons, the color is grayish-brown (formation of methemoglobin).

The blood is redistributed to areas that are not pressed. With severe blood loss, the spots form slowly and are poorly expressed. With asphyxia, blood thinning occurs and the spots are abundant, spilled 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, the vascular wall, its structure changes and it becomes permeable to blood and interstitial fluid.

Cadaverous spots in their development go through three stages.

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 impermeable, i.e., the components of the blood do not pass through it into the tissue. If the pressure is stopped, the stain is restored. Rapid recovery of the spot in 3–10 s corresponds to 2–4 hours ago of death, a time equal to 20–40 s corresponds to 6–12 h. 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 vessel 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 decay products diffuse into the tissue. When pressed, the stain fades, but does not disappear completely. Recovery of the spot occurs slowly, in 5-30 minutes, which corresponds to 18-24 hours ago of death. When the position of the corpse changes, the old spots turn pale, 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. Blood as a liquid system is completely destroyed. Instead, in the vessels and in the surrounding tissues there is a liquid formed from the mixing of destroyed blood and interstitial fluid that has soaked the tissues. Therefore, when pressed, the spots do not turn pale, retaining their color and shade. When the position of the corpse changes, they do not "migrate".

All of the above changes are also observed in the internal organs, more precisely, in those departments that are located below other areas. There is an accumulation of fluid in the cavities of the pleura, pericardium, 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 incoming one. There is no compensation process after death. Drying begins immediately after death. But the first visually noticeable manifestations of it 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 acquires a grayish tint. When pushing the eyelids, triangular opacities are visible. The time of appearance of these spots is 4-6 hours.

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

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

Drying is faster if the body is naked; with 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 section of which is located below the edges. Abrasions are lifetime. Their surface also dries quickly, the color is red-brown, but it slightly protrudes due to tissue edema. Microscopic picture - plethoric vessels, swelling, hemorrhage, leukocyte infiltration.

Cadaveric autolysis. In the human body, a number of glands produce chemically active secretions. After death, these secrets 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 to other organs (into the gastrointestinal tract) and change it. Organs become flabby, dull. The action of enzymes on the structure of organs is stronger, the faster death occurs. The shorter the agony lasts, the less time the body has time to utilize the enzymes and the faster the cadaveric changes develop. All changes caused by autolysis can be seen only at 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 reaction rate of the pupils decreases with increasing time of death. After the introduction of pilocarpine, pupillary constriction after 3–5 s corresponds to 3–5 h after death, after 6–15 s – 6–14 h, 20–30 s – 14–24 h.

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

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

Depending on the preservation of individual signs 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 individual features and damage are preserved to a certain extent.

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

Microorganisms decompose protein to peptones, amino acids. Further, 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. During decay, unstable substances are formed - putrescine, cadaverine.

The optimal conditions for decay are 30-40 ° C. The rate of decay is highest in air. The process is slower in water, even slower in soil, and very slowly in coffins. At temperatures of 1 °C and less, 50 °C and above, the process of decay slows down sharply and even stops. Decay is accelerated if death was preceded by prolonged agony (rapid destruction of the tissue barrier of the colon), purulent infection, sepsis.

After death, putrefaction 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 death of a person. Microorganisms contribute to the formation of gases, especially hydrogen sulfide. It penetrates through the intestinal wall and its vessels into the blood. In the blood, hydrogen sulfide combines with hemoglobin and forms sulfohemoglobin, which has a greenish color. Spreading through the vessels, sulfohemoglobin penetrates into the venous network of the skin and subcutaneous tissue of the anterior wall of the abdomen, its hypogastric region. All this explains the greenish coloration of the skin of the inguinal regions 36–48 hours after death. Further, the color is enhanced by 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, the entire abdomen. This pressure is so strong that pregnant women experience miscarriage of the fetus (the so-called "postmortem birth") and uterine inversion. Gas penetrates into the subcutaneous tissue of the entire body and causes swelling of the face, lips, mammary glands, neck, scrotum. The tongue protrudes from the mouth. Gas puts pressure on the stomach, which leads to post-mortem vomiting.

Sulfohemoglobin and iron sulfide, spreading through the vessels, stain 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 exfoliates, blisters with bloody contents form. Hair changes its color after 3 years. Damage to the bones, traces of a shot on the skin and its pattern, traces of cardiosclerosis persist for a relatively long time.

Zhirovovsk. Synonyms - saponification, saponification of fats. Formation conditions - a humid environment without air access. This phenomenon is well expressed in people with significant subcutaneous adipose tissue.

Water penetrates through the skin (the phenomenon of maceration), then penetrates into the intestines and washes out microorganisms from it. Decay sharply weakens and even stops. Under the action of water, fat 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 (potassium and sodium compounds), or a dense gray-white substance (calcium and magnesium compounds). This process is subjected to subcutaneous tissue, fat accumulations in the chest and abdominal cavities, the brain, and the liver. However, individual traits, the shape of organs, traces of damage to tissues and organs are preserved.

The first signs of saponification of the tissues of the corpse 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 (often at high temperatures), lack of moisture in it, access and movement of dry air, and rapid release of liquid from the corpse. In the first days after the onset of death, the processes of decay intensively occur in the corpse. Parenchymal organs (lungs, liver, kidneys and other organs) turn into a liquid mass, which flows out through decayed tissues. A decrease in the amount of liquid creates unfavorable conditions for the vital activity 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 the epidermis, in macerated areas of the skin, with open eyes - in the cornea and conjunctiva, on the lips, fingertips, etc. Complete drying of the corpse is most often observed in dry, loose, well-ventilated and suction moisture to the soil, in rooms with adequate ventilation.

The corpses of lean and emaciated individuals are easily mummified. On average, the mummification of a corpse occurs in 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 weight. Skin color - parchment, yellowish-brown or dark brown. The internal organs dry out and become flat. The tissues become dense. During mummification, the external appearance of a person is preserved to varying degrees. You can determine gender, age, anatomical features. There are traces of a shot, acute wounds, a strangulation furrow.

Peat tanning. Impregnation and tanning of tissues and organs with humic acids, which are decay products of dead plants, occurs in peat bogs. The skin becomes dark brown, dense. Internal organs are reduced. Mineral salts are washed out of the bones, so the shape of the latter 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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