Study Notes on Forensic Thanatology

AEMONTPELINA: Forensic Thanatology by Khalikov

General Information

  • Institution: Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University"

  • Department: Forensic Medicine of BSMU

  • Presenter: Ph.D., Professor Khalikov Airat Anvarovich

  • Relevant Artwork: Enrique Simonet Lombardo - "Anatomy of the heart" (1890)

  • Year of Presentation: 2022

Terminology

  • Death:
        - A cessation of activity in a biological structure aimed at preservation and reproduction.
        - Applicable to the organism as a whole and to its parts (e.g., necrosis of cells, brain death).

  • Thanatology:
        - A branch of pathology focused on studying various causes of death, mechanisms of onset, the dying process, and postmortem phenomena.

History of Thanatology

  • Earliest Document:
        - The Indian medical treatise Sushruta Samhita (early 1st century BC) details the autopsy procedure and is attributed to Sushruta, recognized as the founding father of Indian Medicine.

  • Significant Autopsy:
        - Antistius (44 BC) examined Gaius Julius Caesar's corpse and documented 23 stab wounds, with only one being fatal, depicted in Karl Theodor von Piloty's painting "The Murder of Caesar" (1865).

  • Chinese Contributions:
        - In 1247, Chinese scientist Song Ci published "Collected Cases of Injustice Rectified", which discusses crime-solving and autopsies. Song Ci is noted as China's first forensic medical expert.

  • Russian Legalization:
        - Autopsies became legal in Russia in 1716 under Peter I, mandating such examinations for violent deaths, per article 154 of The Military Regulations.

  • Pioneer Work:
        - Georgy Vladimirovich Shor authored the first domestic comprehensive work on thanatology, titled "About the Human's Death (Introduction to Thanatology)" in 1925.

Forensic Classification of Death

  • Medical and Biological Classification: Based on causes and mechanisms of death.

  • Social-Legal Classification: Based on the circumstances of death (e.g., homicide, suicide, accidental).

Types of Death (Forensic Context)

  • Non-Violent Death: Results from diseases, examined by pathologists, indicating sudden death should rule out external violence.

  • Violent Death: Classified as homicide, suicide, or accident. It is assessed by investigative bodies rather than medical professionals.

Mechanisms of Violent Death

  • Mechanical Injury: Caused by external forces.

  • Mechanical Asphyxia: Caused by obstruction of the airway.

  • Poisoning: Involves toxins affecting body functions.

  • Physical Factors: Extreme temperature, electricity, atmospheric pressure changes, and radiation can lead to death.

Registration of Death

  • Governed by regulations from the Russian Ministry of Health regarding recording the moment of death and establishing diagnostic criteria including brain death (Order No. 908N).

  • Criteria for Biological Death: Irreversible state with total brain death, confirmed by:
        - Cessation of heart activity and respiration exceeding 30 minutes.
        - Cessation of brain functions, particularly brainstem functions.

Indicators of Biological Death

  • EKG: Asystole presents as a straight baseline without cardiac complexes.

  • Physical Indicators:
        - No pulse in major arteries.
        - Absence of respiratory function and reactions from the central nervous system (CNS).

Signs of Death

  • Beloglazov Sign: The appearance of slit-like pupils 10-15 minutes post-death is an indication that CNS is not functioning.

  • True indicators include body temperature cooling, changes in color, and muscle rigidity (rigor mortis).

Postmortem Changes

  • Absolute Signs of Death: Include livor mortis, rigor mortis, autolysis, etc.

  • Immediate Causes of Death:
        - Destruction of vital organs (e.g., brain destruction, heart rupture).
        - Acute blood loss (2-2.5 liters) is critical for adults.
        - Shock from various origins, with classifications.

Various Causes of Death

  • Hemodynamic Disorders: Acute vascular failure leads to disrupted blood supply, hypoxia, and subsequent heart failure.

  • Blood Loss: Signs include organ anemia and varied occurrences of hemorrhages (e.g., Minakov spots information).

  • Shock: Resulting from different physiological failures affecting circulation (e.g., reflex cardiac arrest).

  • Blood Aspiration: Diagnosed by the presence of blood in respiratory pathways due to traumatic injuries.

Additional Causes and Impacts

  • Embolism: Defined as vessel obstruction due to air, gas, fat, tissue fragments, or thrombi; quick air entry (15-20 cm³) can lead to rapid death.

  • Traumatic Toxicosis and Acute Renal Failure: Microscopic signs support diagnosis alongside clinical observations.

Postmortem Change Classification

  • Early Changes (first 24 hours): Algor mortis, drying, livor mortis, rigor mortis, autolysis.

  • Late Changes: Include putrefaction and preservation processes such as mummification and adipocere formation.

Mummification and Adipocere Relevance

  • Mummification: Involves extensive drying due to a dry environment, while Adipocere forms in moist conditions, acting as a natural preservative.

Medicolegal Significance

  • Detailed importance for establishing death timing, causes, and juristic inquiries.

Conclusive Remarks

  • Thanatology provides critical insights into death investigation, facilitating legal and medical determinations. Understanding signs, classifications, and historical evolution is essential for professionals in this field.