1. thanatos- death; logos- science Assoc. Prof. Beatrice Ioan MD, PhD, MA
THANATOLOGY
thanatos- death; logos- science
Assoc. Prof. Beatrice Ioan
MD, PhD, MA

2. Death Irreversible loss of the properties of the living matter.
Cessation of life in a previously viable organism
Process - different rates of cellular death - internal organs have different functions with different cellular metabolic processes which cease to function at different rates

3. Stages of death 1. Agony (vita minima)
irreversible stage between life and death
mixture of vital and thanatologic processes
Decreased activity of cortical neurons
Bulbar centers are no longer controlled by cortical and sub-cortical centers- functioning of the organism is no longer unitary

4. Agony
Progressive disappearance of psychical functions- psychical chaos
Decreased contact with the environment
Complete immobility
Progressive disappearance of senses
Diminished vegetative functions

5. Agony Classification I. According to duration:
absence of agony- death occurs very rapidly
short agony (seconds, minutes)
long agony (hours)
II. According to the psychical condition:
conscious agony- no changes of consciousness;
unconscious agony;
alternation of conscious and delirious periods
Importance:
Validity of the documents signed during agony

6. Stages of death 2. Clinical death Short interval (about 5-10 minutes)
Cardiac activity and respiration are absent
Cortical neurons still function
The patient can be reanimated by medical means
3. False death
Very diminished respiration and heart activity
Cannot be detected by ordinary means
Loss of consciousness

8. Stages of death 4. Biological death (real death) irreversible
characterized by cessation of cellular metabolism
and structural changes of cells
Stages:
Somatic (systemic) death
complete and irreversible cessation of vital functions
life ceases in the body but still persists in some of its parts
b. Molecular (cellular) death
death of the tissues and cells individually
due to anoxia- different tissues die at different rates

9. Signs Of Death
I. Diagnosis of death in clinics- immediate signs of death
- Cerebral death
- Absence of cardiac activity and circulation
- Absence of respiration
Diagnosis of death in the autopsy room
II. Early signs of death
- Postmortem lividity (hypostasis)
- Rigor mortis
- Cooling
- Dehydration
- Autolysis
III. Late signs of death
- Putrefaction (postmortem decomposition)
- Conservatory processes

10. Postmortem lividity (hypostasis)
Mechanism
the circulation ceases ↓
accumulation and stagnation of blood in the capillaries and small veins of the skin and organs
the blood is pulled by gravity in the lowest areas of the body
Aspect
discoloration of the skin in lowest parts of the body
red-bluish/ compression areas

11. Postmortem lividity (hypostasis)
Stages:
Hypostasis hours
Stasis hours
Imbibition- after hours
Differentiation of the postmortem lividity from bruise
Forensic relevance
Diagnosis of death
Position of the body
Postmortem interval
Cause of death

14. Rigor mortis (cadaveric rigidity)
Mechanism
Decrease/ disappearance of ATP in the muscles - ATP concentration fails to 85 per cent of normal
Factors affecting the timing of rigor mortis
- temperature of the environment
- physical activity before death
- cause of death
Stages- Nisten rule
Installation- 3-6 hours
Generalization- 24 hours
Disappearance hours
Forensic importance
Diagnosis of death
Position of the body
Postmortem interval
Cause of death

16. Postmortem cooling (Algor mortis)
Mechanism
- Failure of heat production and thermo-regulation → the body is loosing heat (conduction, convection, radiation) → temperature of the body decreases progressively → equilibrium with the environmental temperature
Factors affecting postmortem cooling
Environmental temperature
Air moving and humidity
Clothing and coverings
Posture
Surroundings
Dimensions of the body
Hemorrhage
Particular: postmortem caloricity
18 degrees Celsius - 1 degree Celsius per hour
Forensic importance- diagnosis of death, postmortem interval

17. Dehydration Mechanism
Cessation of circulation and metabolic processes → the body looses water
Aspects
- pergamentation
- finger pads’ skin and lips-wrinkled
- opaque cornea
- soft eyes

19. Autolysis auto- self; lysis- destruction
enzymes released from the cells soften and liquefy the tissues of the body
internal examination
organs with a high content of enzymes (e.g. pancreas, stomach)
prepares the field for putrefaction
can be prevented by freezing the body/tissues

20. Putrefaction (postmortem decomposition)
The last stage in the resolution of the body from organic
to inorganic state → skeleton
Bacterial process
Factors affecting putrefaction
- environmental temperature
- concentration of oxygen
- concentration of water (brain)
- age- old age
cause of death

21. Putrefaction (postmortem decomposition)
Aspects
green spot of putrefaction- 2-3 days
all the skin - dark green or almost black
gases of putrefaction- increased volume
marbling
Particular situation
* New born

25. Forensic entomology Study of the insects that infest the corpses
Flies lay their eggs on the corpse- opened wounds and moist sheltered natural orifices- 18/36 hours (high temperature)
Maggots or larvae - 24 hours -inside the body- destroy soft tissues
Pupae days
Adult flies days
7 series - 3 months→ 3-4 years
One species at one time on one body fragment- different nutrients

26. Conservatory processes
Natural processes which, prevent putrefaction and preserve the corpses
Mummification
Very rapid dehydration - warm climate + good ventilation
- Bacterial activity stops- high temperature
months after death
Aspect
Skin- dry, shrunken, leathery, brown to dark skin adhering closely to the bones
Odorless
Preserved features
Reduced body volume
Internal organs - dried mass

28. Conservatory processes
II. Saponification (Adipocere)
- Fatty tissues are hydrolyzed - saturated fatty acids (stearic, palmitic acids) → calcium soaps
3-12 months
Aspect
yellowish- white greasy wax like substance
rancid smell
- floats on water
- can be easily cut
burns - yellow flame
Factors affecting saponification
Environment- moisture; warm temperature; absence of air
Lecithinase from Clostridium Welchii

32. Conservatory processes
III. Lignification
Environment with great concentration of tanic and humic acid (swamps, mines, volcanic lava)
Aspect
brownish, hard skin
soft bones (loosing of calcium);
good preservation for a long interval
Tolund Man- Denmark

34. Conservatory processes
IV. Refrigeration
Exposure of the corpse to low temperature
Aspect
whole body is stiffen;
perfect preservation for a long period of time;
when the body is bring into an warm environment putrefaction develops rapidly

35. Forensic Autopsy Mandatory in the following situations (Criminal Law):
Violent death
Sudden death
Suspect death
Medical malpractice allegation
Corpses with unknown identity
Rules:
performed in the base of the order of juridical authority
complete