What changes does the human body undergo after death?

After the onset of biological death, a number of cadaveric changes immediately appear. The rate of occurrence and development, their severity depend on the weight and sex of the corpse, the cause and rate of death, the environmental conditions in which the corpse was located, etc. Some of them appear during the first day and are calledearly, others, developing over a long period of time, received the namelater,(Table 6).

Table 6

Cadaveric changes

Early cadaveric changes include cooling of the body, partial drying of the corpse, cadaveric spots, rigor mortis and autolysis;

to the later ones - rotting, mummification, fat wax and peat tanning.

Early cadaveric changes make it possible to confidently decide about the fact of death; they are used to establish the duration of death, the position of the corpse and its movement, and sometimes they guide the expert in establishing the cause of death.

What causes the cooling of a corpse and what forensic significance does this cadaveric change have?

After death, due to the cessation of metabolic processes, the body, according to physical laws, gives off heat until its temperature is equal to the ambient temperature. Cooling begins from exposed parts of the body. The rate of temperature drop is influenced by temperature, humidity, air movement, as well as internal factors: fatness, individual characteristics, cause of death, presence and nature of clothing, etc.

Normal body temperature is considered to be 36.6-36.8°C, from which it is calculated. If it is known that the temperature of a sick person increases before death, an adjustment is made, as for other conditions. Body temperature should be measured (after establishing the ambient temperature) in the rectum, since here it is compared with the environment later than in the armpit. It is even better in this regard to measure the temperature in the liver using needle sensors. Last time
Instruments have been proposed that record air and body temperature, record and calculate the time elapsed after death.

The temperature of the corpse temporarily increases in case of death from tetanus, sepsis, or cooling slows down in case of sunstroke or carbon monoxide poisoning. When the air temperature is high, body temperature may also increase. This happens, for example, in Turkmenistan in the summer, which was the basis for local forensic doctors to prepare methodological recommendations for these conditions.

Where does desiccation appear on the corpse, what forensic significance does it have?

Partial drying occurs in the first minutes after death and depends on the evaporation of tissue moisture. It appears faster in places that are moisturized during life. These are the white membranes and corneas of the eyes, which is noticeable by clouding, loss of shine and the appearance of horizontal or triangular (with open eyes) spots at the corners of the eyes. These grayish-yellow spots appear after 2-3 hours and are called Larche spots. Drying is noticeable on the edges of the lips, in those places where the epidermis is thin: on the scrotum, as well as on the mucous membrane of the female genital organs and the head of the male penis. Post-mortem damage is exposed to drying out, forming parchment stains. Because of their dense yellowish-brown crust, they resemble abrasions.

Dried areas of skin on the scrotum, genitals, parchment spots in places of compression on the chest due to indirect heart massage or accidental blows, during manipulations with a corpse may be mistaken for intravital damage and lead to incorrect conclusions. To determine the origin of the stain, it is moistened with water, and a wet cloth, preferably soaked in an vinegar-alcohol solution, is applied to the surface. The parchment stain will completely disappear in 2-3 hours, but the abrasion will remain. To resolve the issue, you can also make an incision at the border of the spot with unchanged skin. The identification of the same color of the underlying tissues indicates a spot of cadaveric desiccation, because with intravital damage the underlying tissues will be dark red in color.

It is not possible to determine the age of death by desiccation.

What is rigor mortis and what forensic significance does it have?

Rigor mortis - This is a post-mortem muscle thickening that usually appears after 2-3 hours. Immediately after death, muscle relaxation occurs, which leads to sagging of the jaw, limbs, mobility in the joints, and the muscles become soft to the touch. But after some time, starting with the chewing muscles, neck, then the torso, upper and lower extremities, rigor develops, which ends after 18-20 hours. Over time, the intensity of the development of rigor mortis increases, reaching a maximum at the end of the day.

The timing and degree of development of rigor mortis depends on many factors. This is the degree of muscle development: in emaciated people, with acute anemia, in decrepit old people, rigor is weakly expressed, and in newborns it is absent.

High temperatures and dry air accelerate the development of rigor mortis. At low temperatures, rigor mortis develops more slowly in water. Rapid rigor is promoted by well-developed muscles, electric shock, poisoning with certain poisons, tetanus, epilepsy, and great physical activity before death, which lead to intravital convulsions.

The technique for studying rigor mortis involves feeling the muscles to determine the degree of density, as well as flexing or straightening the limbs at the joints. When describing rigor, the degree of its development should be noted: weak, moderate, strong. By the end of the second day and later, in a warm room, rigor mortis resolves, and at low temperatures, rigor mortis can persist for 6-7 days. Muscle relaxation occurs in the same order - from top to bottom and is associated with the development of autolysis and putrefactive processes. Rigor mortis is an unconditional sign of death; it allows us to judge the time of death and, to some extent, helps in resolving the issue of its cause. Rigor mortis records the post-mortem position of the deceased at the time of rigor rigor in this area and can be used to establish a possible change in position or any manipulation of the corpse. After artificial resolution of rigor mortis for 8-10 hours, it is restored again. This does not happen at a later date. This may be when removing his clothes or changing his position, or due to the deliberate insertion of a weapon in his hand for the purpose of simulating suicide.

Why do cadaveric spots form, what determine their characteristics and rate of development?

Cadaveric spots are formed due to the fact that after the cessation of blood circulation due to cardiac arrest and a drop in blood pressure, the blood, due to gravity, flows into the underlying sections. It is visible under the skin in the form of purple spots of varying degrees of severity. Sometimes various parts of clothing (collar, buttons) prevent the formation of cadaveric stains, leading to imprints of the corresponding shape. There are three stages of development of cadaveric spots:

1. Cadaveric influx (hypostasis), when blood descends in the vessels and changes color in the lower parts of the corpse. On average, this manifests itself after 2-4 hours. When pressed with a finger or a dynamometer, the blood is squeezed out of the vessels, this leads to the disappearance of the color, the color of which is quickly restored. If the position of the corpse is changed at this time, the cadaveric spots will move to a new underlying surface of the body. This is observed until 8-12 hours, when the development of the 1st stage of the cadaveric spot ends.

2. Cadaveric stasis (diffusion) is characterized by thickening and disintegration of blood, difficulty in its movement and the development of intense coloring. When onWhen pressed with a finger, the stain turns pale and slowly after a few minutes restores (after the pressure is removed) its original color. This stage lasts up to 20-24 hours. If at this time the corpse is turned over to the opposite surface, the cadaveric spots will move, but very slowly and only partially.

3. Corpse imbibition (imbibition) occurs within 20-24 hours. Due to blood hemolysis, i.e. the breakdown of its formed elements, the release of hemoglobin and plasma, the walls of blood vessels and the skin are saturated with blood. Therefore, when you press a finger on a cadaveric spot, its color does not change, and when the corpse is moved, it remains in the same place.

Simultaneously with the development of cadaveric spots, blood accumulates in the lower parts of the internal organs. For example, in the muscles of the occipital region, as a result of a leak, hemolyzed blood soaked the muscles and their color became dark red. This was mistaken by the doctor for injury caused by a blunt object from a blow or fall, which could lead to an investigative error. However, the gradual movement of blood and the absence of hemorrhage during microscopic examination of the muscles made it possible to correctly determine this cadaveric change.

The rate of appearance, degree of development, and intensity of cadaveric spots depend on a number of external and internal factors. High ambient temperatures accelerate the formation and development of cadaveric spots. Then they appear after 1.5-2 hours, and after 10 hours the stage of imbibition begins. With heavy blood loss, cadaveric spots may be completely absent or weakly expressed in color intensity, and in such cases they appear only in patches. With a quick death, the blood in the corpse is liquid, remains in the vessels and quickly forms abundant cadaveric spots. During a long agonal period, the blood coagulates, forming yellow and red clots and, due to the limited nature of its liquid part, the cadaveric spots are poorly expressed.

What is the forensic significance of cadaveric spots?

First of all, they reliably testify to the fact of death. Their study makes it possible to establish the duration of its onset, which will be noted below.

By the localization of cadaveric spots, one can judge the position of the corpse during the period of their formation, the change in the position of the body and the discrepancy with the circumstances of the incident. For example, cadaveric spots in the lower parts of the arms (on the hands) and legs (in the area of ​​​​the feet and ankle joints) indicate that the corpse was hanging during the period of formation of the spots. If, due to the circumstances of the case, the corpse was removed from the loop before the arrival of the investigator and forensic expert and examination of the corpse, and cadaveric spots were found on the back surface of the corpse lying on the bed, it should be concluded that the corpse was removed from the loop before the formation of cadaveric marks. spots and laid on his back. Or it was in the first 8-12 hours after death, during the period of hypostasis, when the cadaveric spots completely move to a new location.

The color of cadaveric spots depends on changes in blood hemoglobin and changes when it transitions to other states. For example, in case of carbon monoxide poisoning, when it combines with hemoglobin in the blood and forms carboxyhemoglobin, the blood and cadaveric spots turn bright red. When poisoned with cyanide compounds, cadaveric stains, like blood, acquire a cherry tint. The unusual color of cadaveric spots allows us to suspect the action of some poisons or dying conditions in order to plan further research.

Sometimes cadaveric spots resemble bruises, especially those that occur shortly before death. In such cases there should be no diagnostic error, because bruise - intravital injury from a blunt object. To resolve the issue, it should be taken into account that cadaveric spots are formed only in the underlying sections; they are usually diffuse. On the incision, protruding blood is easily removed, the color of the tissue is not changed. Bruising is often accompanied by rawness and swelling, has clear boundaries and is located anywhere. On the cut, the tissue is dark red in color, and blood clots are found. If in doubt, skin should be taken for histological examination.

Thus, cadaveric spots have great forensic medical significance: they are a reliable sign of death, can indicate the position of the corpse during the period of formation of the spots and a possible change in the position of the body, allow one to judge the duration of death, the conditions of the corpse, the rate of dying, and indicate the possibility of poisoning .

What What is autolysis and how is it expressed on a corpse?

Autolysis (cadaveric self-digestion), an early cadaveric change that occurs some time after death, because some tissues are affected by enzymes that continue to be formed after death. This leads to flabbiness of organs, loss of their characteristic structure, smoothing of the mucous membrane and their disintegration. Such organs become dull and become saturated with blood plasma. Autolysis is better expressed in the stomach. The significance of autolysis is that the post-mortem changes to which it leads, resembles painful intravital processes, which, if not known, can cause diagnostic errors.

Under what conditions does decay of a corpse develop and what significance does this have for forensic medical examination?

Rotting leads to the decomposition of proteins and other tissues, which occurs under the influence of various microbes that rapidly multiply in the body after the death of a person, when protective barriers cease to function. Rotting begins in the colon, where there are especially many microbes; the putrefactive process develops faster if there is an infectious disease in the body. The rate of decay is promoted by high temperatures, especially +20 - +40°C. It stops at temperatures of 0°C and below, as well as above +55°C. Therefore, in the warm season or in a warm room, corpses rot faster and can be stored for a long time in cold weather and especially in the refrigerator.

The first signs of rotting appear in the appearance of an unpleasant “putrid” odor caused by the formation of putrefactive gases:

hydrogen sulfide, methane, ammonia and others. They permeate all soft tissues, smoothing out wrinkles and swelling the face, turning out the lips and pushing the tongue out of the mouth. All this changes the appearance of a person beyond recognition even for people close to him, because all corpses take on the same appearance, which greatly complicates identification. A putrefactive venous network forms on the body, this is the translucency of tree-like branched blood vessels, putrefactive blisters, and skin tears. The skin of the corpse turns a dirty green color.

The internal organs also disintegrate: the brain acquires a mushy mass of a greenish color. Later, other organs, such as the spleen, liver, kidneys, and heart, also rot. The uterus, blood vessels, and cartilage remain unchanged longer. Gradually, the melting and destruction of the tissue occurs, the color of the hair changes, and skeletonization of the corpse occurs. Bones can be preserved for centuries. Sharp putrefactive changes and even skeletonization should not prevent the appointment of a forensic medical examination.

It is impossible to accurately determine the timing of decay, much less the duration of death, since many factors influence the rate of decomposition of a corpse. First of all, this is the optimal temperature for microflora from +25°C to +45°C with moderate humidity. At temperatures up to +10° and after +55°C, rotting slows down, as well as in cold rooms or cold rooms. Decay slows down somewhat in case of heavy blood loss, poisoning with cyanide compounds, sublimate, and after the use of antibiotics shortly before death. Emaciated corpses decompose more slowly than well-fed ones.

What late preservative changes in the corpse are known and under what conditions do they occur?

INthoseIn cases where the air is dry and there is good ventilation, corpses quickly lose moisture and dry out, which is called natural preservation of the corpse ormummification. This may occur when the corpse is in an open area or when it is buried in sandy, well-ventilated soil. The corpse loses up to 9/10 of its original mass, decreases by
volume, the skin becomes dense, acquires a brownish-brown color, internal organs decrease in volume and become dry. Such preservation of the corpse preserves the damage: strangulation groove, signs of disease, gunshot wounds, damage from blunt or sharp objects, but their features are masked and changed. To a certain extent, it is possible to restore damage in an acetic-alcohol solution with the addition of hydrogen peroxide. It is important that the general appearance of a person, his gender, height (albeit somewhat reduced), and individual anatomical features are preserved. You can determine the group, gender specificity. All this makes it possible to identify a person in cases of identification, although these possibilities should not be overestimated.

Complete mummification of an adult is achieved in 6-12 months, a child, especially a newborn, within a month or two.

In other conditions, when a corpse falls into water or is buried in clayey, moist soil, in the absence of air, rotting stops and the corpse turns intoadipose wax TThe tissue of a human corpse, which has turned into fat wax, thickens, loses its structure, acquires a cheesy appearance, a grayish-yellow color, with the smell of rancid cheese. Initially, this happens in places where there is the most fat: subcutaneous fat, cheeks, buttocks, and mammary glands. Like mummification, it can involve part of the body or the entire corpse. The transformation of an adult corpse into adipose wax requires 10-12 months, a newborn corpse - 2-4 weeks. Fat wax is similar in meaning to mummification. It is noted that chemical examination can reveal poisons, even alcohol, in its tissues.

Among other types of natural preservation of corpses, it should be notedpeat tanning, which

happens when it gets into peat bogs. The humic acids contained in them seem to tan the skin, it thickens and becomes dark brown. The bones become soft and can be cut with a knife.

Corpses are well preserved at low temperatures, for example, in glaciers, in water with a high salt content, in oil and other liquids.

What other than rotting can destroy a corpse?

The corpse is subject to destruction not only by the putrefactive process, but also by someanimals, birds, insects. This can be observed when the corpse is in an open area or indoors. Significant destruction is caused by flies and their larvae, which multiply at lightning speed. Within 15-24 hours, eggs are laid in all natural openings, which soon turn into larvae, and after a few days into pupae, then flies emerge from them. If the corpse is accessible to insects, the process of its destruction is divided into 4 periods, which makes it possible to determine the duration of death. The corpse is destroyed by ants, cockroaches, mites, and carrion beetles; they cause damage that disfigures the face of the corpse.

Damage is caused by rodents and predators, leaving wounds with scalloped edges from teeth. Parts of the corpse can be carried away by animals. Birds (crows, vultures) cause damage similar to puncture wounds. It is very important to correctly assess the damage and establish its post-mortem nature.

Normal skin color is due to the activity of the heart, which determines the intravital blood content in it. Soon after cardiac arrest, the arteries narrow and, from irritation of the vasomotor nerves by carbon dioxide accumulating in cadaveric blood, the muscle fibers of the artery walls begin to contract and move blood from small-caliber vessels - capillaries and precapillaries to venules and veins. Blood pressure drops to 0 mmHg. The displaced blood accumulates in the branches of the vascular network and overwhelms them. Due to the law of gravity, blood, lymph and interstitial fluid begin to passively move to the underlying areas of the body. After some time, plasma begins to leak from the vessels. The blood thickens and becomes less mobile. The number of red blood cells per 1 cm3 increases. After a while they begin to disintegrate. The blood in the heart and veins begins to clot, and the longer the agony, the more numerous the clots. The higher-lying areas of the body turn pale due to blood flowing down through the vessels, and the vessels of the lower ones become overfilled with blood and begin to show through under the skin, forming cadaveric spots. The blood in the venous system is poor in oxygen and rich in carbon dioxide, the amount of which causes the blue color.

Cadaveric spots are the translucency of blood that has posthumously descended into the underlying areas of the body.

The appearance of cadaveric spots is due to the post-mortem distribution of blood.

A number of works by domestic scientists - Kapatsinsky (1882), V.A. - are devoted to the study of cadaveric spots, the mechanism of their occurrence and features. Molchanov (1894) and others.

The color of cadaveric spots is determined by the amount and color of blood.

Normally, the color of blood is red. Oxygenated blood is bright red. After cardiac arrest, tissues continue to consume oxygen, and the blood becomes dark, resembling venous blood due to the disappearance of oxyhemoglobin and the formation of reduced hemoglobin, which has a dark red color.

The color of cadaveric spots essentially reflects the color of blood shining through the skin, its quantity, as well as the nature of the surface on which the corpse lay, the cause and rate of death, the effect of poisons, oxygen, cold, and humidity.

Cadaveric spots in persons who died suddenly from various types of asphyxia and injuries not accompanied by acute blood loss are blue-purple in color.

In cases of death from acute and chronic blood loss, some diseases, cadaveric spots are less intense, not abundant, poorly distinguishable, gray-violet.

In case of poisoning with barbituric acid, carbon monoxide, part 9 of the composition of stove, carbon monoxide and exhaust gases, oxyhemoglobin turns into carboxyhemoglobin. Its quantity determines the color of cadaveric spots, which will range from bright red to blue-purple in color.

Poisoning with methemoglobin-forming poisons - nitrites, salts of nitrous acid, berthollet salt, aniline - is manifested by cadaveric spots of gray-brown color and brown blood.

Corpse stains in persons poisoned with cyanide and hydrocyanic acid have a peculiar cherry tint, which is explained by the formation of cyanmethemoglobin.

In corpses removed from water, lying in a cold, damp place, in wet clothes, cadaveric spots acquire a pink-red color, due to the penetration of oxygen through the loosened epidermis with the formation of oxyhemoglobin in the superficial vessels of the skin. Blue-purple cadaveric spots on corpses located in damp rooms are surrounded by a pink-red border formed by the penetration of oxygen through moistened, loosened skin.

If a person was allowed to breathe oxygen, then the cadaveric spots will have a bright red color due to the formation of oxyhemoglobin.

Localization of cadaveric spots

The location of cadaveric spots is influenced by the initial and subsequent position of the corpse, which makes it possible to judge the change in the position and movement of the corpse, as well as the maximum gravity pressure of the body or items of clothing (belt, belt, elastic band, etc.).

The presence of cadaveric spots that fade and do not change color in the higher-lying areas indicates a change in the position of the corpse.

The localization of cadaveric spots is determined by the position of the corpse and the amount of liquid blood present in the corpse.

Cadaveric spots in corpses in a vertical position form below the lower third of the forearms, lowered arms and below the level of the pelvis, and in a horizontal position - on the posterolateral surfaces of the body, with the exception of places subject to pressure (scapular and gluteal regions, calves), into the vessels which blood cannot penetrate. Sometimes, against the background of cadaveric spots, areas with unchanged skin color stand out, displaying imprints of the relief of the surface on which the corpse lay. Such areas form compression of the vessels in places of greatest pressure, preventing the flow of blood.

In areas with even slight pressure, cadaveric spots do not appear, since the pressure compresses the capillaries and prevents them from filling with blood. In these places, the skin is not changed and sometimes conveys imprints of a pressing object, which make it possible to judge the geometric shape, size and other features of the pressing object. Most often, such prints are formed from folds of clothing, underwear and bed linen, belts, elastic bands, and a narrow tightly buttoned starched shirt collar. The imprint of a shirt collar can be mistaken by an inexperienced expert for the trace of a strangulation furrow. The brushwood, twigs, and branches lying under the corpse convey their characteristics and location by alternating dark and light, more or less depressed stripes.

To judge the post-mortem change in the position and posture of the corpse, the time of their change, a comparison of the posture of the corpse is carried out with the localization and change in color of cadaveric spots both during examination and pressure. Separate cadaveric spots when the corpse is positioned on the back can be in the face, neck, at the same time clavicles, anterior and lateral surfaces sti breasts These are local zones of stagnation that arise after death.

The appearance of cadaveric spots in the listed areas can be explained by irritation of the vasomotor centers with carbon dioxide from cadaveric blood, causing contraction of the muscle fibers of the artery walls, the special anatomical structure of individual groups of capillaries and precapillaries, which does not allow blood to flow down (spiral network of capillaries), as well as the fact that contractility the flow of individual blood vessels does not stop after death, but continues for some time in the dead body. This promotes, to some extent, the active movement of blood from one area of ​​the skin to another.

The abundance of cadaveric spots depends primarily on the amount of liquid plasma and the rate of blood clotting after death. In cases of death from asphyxia, when the blood remains liquid, they are abundant and appear first in the form of mottled blue, and then, merging, form extensive confluent blue-purple areas.

In cases of heavy blood loss, with an early and significant degree of blood clotting, cadaveric spots are not abundant.

The severity of cadaveric spots is determined by the amount of uncoagulated liquid blood in the corpse, its density, the rate of death, the mechanism of dying, the cause of death, the degree of muscle development, and age.

In the malnourished, elderly, children, persons with chronic diseases (tuberculosis, malignant neoplasms) and secondary anemia, accompanied by cachexia, acute blood loss, cadaveric spots are poorly expressed and can only be seen in the scapular and lumbar regions.

The absence of cadaveric spots without external damage to the body indicates an outpouring of blood in the body cavity.

Conditions conducive to the formation of cadaveric spots

The rate of formation of cadaveric spots depends on the nature of the injury, poisoning, disease, cause and genesis of death.

More rapid formation of cadaveric spots is promoted by: high ambient temperature, asphyxia, electrical trauma, poisoning (carbon monoxide), blood thinning, sudden death from cardiovascular diseases, when cadaveric spots appear by the end of the first hour.

The slow appearance of cadaveric spots is caused by low ambient temperature, blood loss, the duration of dying (agony), accompanied by blood clotting in the vessels and heart, and the thickness of the blood caused by dehydration of the body.

A sharp spasm of blood vessels under the influence of low temperature and freezing of the skin prevent the movement of blood into the vessels of the skin and subcutaneous tissue, which also slows down the appearance of cadaveric spots.

During prolonged dying, a significant amount of blood clots in the vessels, making it difficult for it to move to underlying areas of the body.

Depending on the amount of blood lost in cases of death caused by acute blood loss, cadaveric spots are delayed and become noticeable after 3-12 hours.

In seriously ill patients who died during prolonged agony, cadaveric spots may appear half an hour to an hour after death.

When there is no blood loss and the blood is liquid, cadaveric spots appear earlier.

Rapid death sometimes leaves pinpoint hemorrhages against the background of cadaveric spots, which are formed as a result of rupture of skin capillaries, excessively stretching their walls with blood, as well as increased vascular permeability and the rapid rate of development of cadaveric spots.

Over time, against the background of cadaveric spots in the stage of imbibition, post-mortem hemorrhages appear, sometimes increasing in size, which gradually turn into putrefactive blisters (Fig. 307). They arise as a result of rupture of putrefactive loosened vessels, and their painfully altered walls under the influence of a column of blood. The difference between such post-mortem hemorrhages and hemorrhages that occurred in the stage of hypostasis is hemorrhages in size exceeding those of large punctures.

Sometimes, against the background of abundant confluent blue-purple cadaveric spots, there are poorly visible bruises, which are mistakenly taken for cadaveric spots, which can mislead the expert and investigator and lead to an error. In these cases, it is necessary to differentiate a cadaveric spot from a bruise.

To objectively identify bruises against the background of cadaveric spots of putrefactively altered and mummified corpses, soak an area of ​​skin in running water followed by treating it in an alcohol-acetic solution or alkali.

Features of the appearance and development of cadaveric spots have long been used to determine the duration of death and the approximate determination of its cause.

The timing of the formation of cadaveric spots makes it possible to distinguish certain stages, the diagnosis of which is based on a temporary factor, which has its own morphological justification, allowing the process of formation of cadaveric spots to be divided into 3 stages.

First stage - the stage of leakage (hypostasis) consists of the flow and accumulation of blood in the underlying areas of the corpse. At this stage, the blood almost does not change its properties and is in the vessels, stretching them. The ratio between the solid and liquid parts of the blood is maintained. Towards the end of this stage, plasma diffusion through the walls of blood vessels into the interstitial spaces increases, but is still weakly expressed. The appearance of cadaveric spots is observed in the interval from 30 minutes to 2 hours.

After 3-6 hours, cadaveric spots increase in size and intensity, become diffuse, and in cases of sudden and asphyxic death acquire a blue-purple color. By pressing on the cadaveric spot in the projection of the bone, the blood is squeezed out from the skin vessels and the skin takes on its normal appearance for some time, that is, the cadaveric spot disappears. After the pressure stops, the blood returns through the vessels very quickly and the color of the cadaveric spot is restored. By 6-12 hours, in cases not accompanied by blood loss, they become abundant, confluent, of a rich blue-purple color in places not in contact with the bed of the corpse when it is positioned on the back. In places of contact with the bed of the corpse, the color of the skin is not changed and there are no cadaveric spots. On the lateral surfaces of the body, the color gradually disappears towards the front surface of the body. If the bed of the corpse is uneven, then the characteristic unevenness of the object is displayed on the skin of the back as constant areas of skin.

After changing the position of the corpse, cadaveric spots formed within 8-12 hours appear in other lower areas of the body.

From the surface of the cut cadaveric spot at this stage, blood flows out from the dilated venous blood vessels in drops, washed off with water, and quickly reappears.

Second stage - stage of leakage (stasis, diffusion, cadaveric edema). Sometimes it starts at 8-10 o’clock and can last up to two days. It is characterized by cessation of blood flow, diffusion of lymph and intercellular fluid from tissues through the vessel wall into its lumen, dilution of plasma, hemolysis of erythrocytes, diffusion of partially hemolyzed blood through the vessel wall into the interstitial space and saturation of surrounding tissues with it, their swelling, cessation of blood flow, from -due to its thickening due to sweating of the plasma, loss of the ability to move through the vessels, fixation in places of formation.

At this stage, cadaveric spots acquire a persistent color, the intensity of which is associated with the cause and genesis of death. When pressed, the cadaveric spot turns pale and slowly regains its color after some time. Sometimes, against the background of cadaveric spots, pinpoint hemorrhages are localized, resulting from stretching and rupture of capillaries by descending blood.

On a skin incision in the area of ​​the cadaveric spot, single small drops of blood appear, slowly appearing after washing off with water. A reddish watery liquid drains from the cut surface.

When the position of the corpse changes after 12 hours, the cadaveric spots may partially move to other areas and to other surfaces of the body, maintaining their less saturated color in the previously formed areas.

A skin incision reveals a little thick blood in the vessels.

Third stage - stage of corpse impregnation (imbibition). It occurs due to the death of the vascular endothelium, causing changes in the permeability of the vascular wall. Post-mortem loosening (essentially dying) of the vascular walls allows lymph and blood components to penetrate from the lumen of the vessels into the surrounding tissues. The beginning autolytic and putrefactive breakdown of red blood cells permeates and stains the walls of blood vessels and surrounding tissues with hemoglobin, which exits through the vascular walls along with the plasma. The tissues are completely saturated with lymph and interstitial fluid and stained with blood plasma, which has permanently changed its color.

Pressure on the cadaveric spot does not change its color and when the corpse is turned over, it no longer moves.

In the area of ​​the cadaveric spot, the cut vessels are empty, drops of blood do not protrude, and therefore its movement is completely excluded.

Simultaneously with the appearance of cadaveric spots on the skin, cadaveric stains appear in the soft tissues of the neck between the muscles and near the organs of the neck due to the leakage of blood from the jugular veins, in the internal organs - lungs, gastrointestinal tract, etc. In a corpse lying on its back, the posterior surfaces of the internal organs are saturated with blood, become denser than the surrounding tissues and acquire a darker color, which must be remembered when determining the degree of blood filling of the organs. The position of the corpse can be judged not only by the cadaveric spots, but also by the localization of the leakage and blood clots in the sinuses of the dura mater. The presence of a white part of the bundle in the longitudinal sinus and a red part in the occipital sinus indicates the position of the corpse on the back; their opposite localization is observed when the corpse is positioned on the stomach.

In the soft integument of the head, cadaveric spots are expressed by the juiciness and plethora of tissues, in the lungs - darker coloring of the posterior sections and gray-red coloring of the anterior sections. On the cut - wet and dry, respectively. Sometimes cadaveric spots in the lungs can be mistaken for hypostatic pneumonia.

During the development of hypostasis in the internal organs, part of the plasma leaves the vessels, seeps through the serous membranes, accumulating in the pleural and abdominal cavities, in the cavity of the pericardial sac. Initially, the transudate is yellow, then turns red with decaying red blood cells. By the end of 2-4 days. in the cavities you can find from 50 to 100 ml of transudate. These changes are postmortem and are not associated with disease.

The gastric mucosa takes on a dirty red color, more intensely expressed along the vessels.

Loops of intestines, especially those in the pelvis, quickly become dirty red.

The pancreas is soft, flabby, dirty red.

The wall of the gallbladder and adjacent organs is saturated with bile. The pattern of the liver lobules is indistinguishable. The cut fabric is dirty brown. The spleen becomes flabby. The pattern of the kidneys is blurred. There may be bloody contents in the uterine cavity.

The importance of cadaveric stains and stains for practice

Cadaveric spots are an undoubted sign of death, they are oriented towards the initial position of the corpse, they allow one to judge its movement, determine by localization the duration of the corpse’s presence in a certain position and resolve the issue of changing the position of the corpse, help to roughly establish the time and cause of death, and suspect poisoning with poisons that change the composition blood hemoglobin, the rate of death, indicate exposure to a humid environment and cold, can mask rashes in diseases, simulate and blur bruises, indicate the amount of blood in the corpse, provide grounds for judging the objects on which the corpse lay.

44. Early cadaveric changes. Mechanisms of occurrence. Forensic significance

Cooling of the body, cadaveric spots, rigor mortis, drying of tissues belong to early cadaveric phenomena.

When a corpse is cooled, the body temperature usually remains at the same level during the first tens of minutes after death. Sometimes, under the influence of microbes, it can rise to more than 40 °C.

The cooling of the corpse is caused by the cessation of metabolism and heat production. After 45–60 minutes, body temperature decreases uniformly by 1 °C per hour. The speed of the postmortem temperature drop is influenced by the ambient temperature, the location of the corpse, the presence of clothing, wind strength, weight and volume of the body, cause of death, etc.

Cadaveric spots. After cessation of blood circulation, blood and other body fluids move in accordance with physical laws: under the influence of gravity, they gradually descend to the underlying sections.

Blood seeps outside the vessels and accumulates in the tissues, giving them and the skin a dirty purple color with a predominance of various shades, depending on many reasons, including the cause of death.

In case of carbon monoxide poisoning, cadaveric spots have a bright red color (blood hemoglobin turns into carboxyhemoglobin); in case of poisoning with cyanide compounds, they have a peculiar cherry color.

In the cold, the color of cadaveric spots is bright pink (due to the oxidation of hemoglobin by air oxygen penetrating through microcracks in the skin that form when body fluids freeze).

When hanging, if the corpse has not been removed from the noose for a long time, the cadaveric spots are predominantly located on the forearms, legs, and feet.

Stages of formation of cadaveric spots:

1) the stage of hypostasis continues for 12 hours after death. The liquid part of the blood is in the vessels, and when pressure is applied to the spots, the blood is squeezed out of the vessels, and after the pressure stops, it quickly fills them again;

2) the stage of stasis (diffusion) is observed after 12 hours from the moment of death and lasts up to 24 hours. Cadaveric spots turn pale, but do not disappear when pressed;

3) the imbibition stage develops on the second day after death. Cadaveric spots are well fixed, do not move, and do not turn pale when pressed, since the soft tissues are saturated with blood.

Forensic significance of cadaveric spots:

1) are the earliest sign of death;

2) reflect the position of the body and its possible changes after death - approximately allow one to determine the time of death;

3) the degree of severity reflects the speed of death;

4) the color of cadaveric spots in some poisonings serves as a diagnostic sign or it indicates the conditions in which the corpse was located;

5) make it possible to judge the nature of the objects on which the corpse was located.

POSTHEATED CHANGES (cadaveric changes, cadaveric phenomena) - a set of changes that develop after death as a result of the cessation of the vital functions of the body.

P. and. appear at different times, so they are conventionally divided into early (cooling of the corpse, cadaveric spots, rigor mortis, drying out, autolysis) and late (transformative, or transformative), as a result of which the corpse is subjected to decomposition and destruction (autolysis, rotting) or natural preservation (mummification, saponification, peat tanning, freezing). P.'s development and. depends on the nature of clothing, environmental conditions, the degree of blood loss, the development of subcutaneous tissue, the cause of death, possible concomitant diseases and conditions of the body, and a number of other exogenous and endogenous factors.

Patterns of appearance and development, taking into account the dynamics of P. and. used in forensic medicine to diagnose the fact of death (see) and determine the period of limitation of its occurrence, establish the initial position of the corpse and its possible change in the postmortem period, for an approximate judgment about the cause of death and the resolution of certain other special issues. P. and. are also essential for studying the survival time of certain organs and tissues when determining their suitability for transplantation (see Transplantation). Knowledge of the characteristics of the decomposition of a corpse is necessary for differential diagnosis of putrefactive changes with intravital injuries or diseases. Thus, the protrusion of the tongue from the oral cavity under the pressure of accumulated gases imitates one of the signs of mechanical asphyxia; the formation of blisters on the skin of a corpse due to detachment of the epidermis and accumulation of fluid resembles a second degree burn; the greenish-colored putrefactive venous network is similar to the so-called. lightning figure; the flow of gastric contents into the respiratory tract imitates intravital aspiration of vomit; the release of bloody fluid formed during decay is similar to uterine, gastric or pulmonary bleeding. Putrefactive imbibition and hardening of the lungs should be differentiated from pneumonia, and changes in the gastric mucosa, its apparent swelling and red-brown color, should be differentiated from changes found in poisoning. Poisoning with caustic poisons can simulate rupture of the stomach wall under the influence of putrefactive gases. Putrefactive imbibition, compaction and red-brown color of the pancreas may resemble morphol, a picture of hemorrhagic pancreatitis. Foamy blood due to the penetration of putrefactive gases into the vessels is similar to blood during an air embolism (see). The deposition of crystals of hydroxyphenylammonium propionic acid salts on the fascia and serous membranes of internal organs should be distinguished from the deposition of crystals of poison taken during life.

Knowledge of the patterns of development of P. and. has significant atheistic significance, helping to expose superstitions associated with dying and death, burial of the so-called. supposedly dead. The movement and change in the position of the corpse in the coffin is explained by the non-simultaneity of the process of decay in different parts of the body, the varying degrees of severity of cadaveric emphysema in them. Posthumous birth, usually accompanied by uterine inversion, is caused by an increase in pressure inside the abdominal cavity due to the formation of putrefactive gases. Knowledge of the patterns of fat wax formation and mummification of corpses makes it possible to exclude the divine origin of holy relics used by clergy as an object of worship for believers.

Early postmortem changes

Cooling the corpse. After the cessation of cardiac activity, body temperature usually remains at the same level for the first tens of minutes, then begins to gradually decrease - on average by 1° per 1 hour at an ambient temperature of 16-18°. Over time, due to the evaporation of moisture from the surface of the skin, the temperature of the corpse reaches values ​​0.5-3° below the ambient air temperature; if it is less than -4°, cooling turns into freezing. The speed and degree of cooling are influenced by the ambient temperature, humidity and wind strength when the corpse is in the air, the nature of the environment, the posture of the corpse, the degree of fatness, and the cause of death. In case of death from tetanus, sepsis, typhus, or certain poisonings, the body temperature after cardiac arrest may rise for a short time to 40-41° or more. Cooling of newborn corpses occurs very quickly due to the tenderness and thinness of the epidermis, the larger surface of the skin in relation to the weight (mass) of the body. Registration of cooling of the corpse in forensic medicine. In practice, it is carried out by repeated rectal thermometry or deep electrothermometry of the liver. Body temperature less than 20° is a reliable sign of death. Taking into account the dynamics of cooling of the corpse in each specific case, the duration of the post-mortem period can be determined.

Cadaveric spots- a peculiar coloring of the skin due to the flow and accumulation of blood in the underlying areas of the body. They begin to form 2-4 hours after the cessation of cardiac activity. The degree of their severity depends on the rate of death of the organism; Thus, abundant diffuse saturated cadaveric spots are characteristic of rapid death (mechanical asphyxia, acute coronary insufficiency); scanty pale - for death from heavy blood loss, with prolonged agony, severe exhaustion of the body. Typically, cadaveric spots are blue-violet or purple-violet in color. Their scarlet, red color indicates poisoning with carbon monoxide, hydrogen sulfide, cyanide, death from hypothermia; grayish-brown - for poisoning with methemoglobin-forming poisons (Bertholometa salt, nitrites). It is customary to distinguish 3 stages of development of cadaveric spots: hypostasis (from their appearance until 12-14 hours after death), diffusion, or stasis (from 12-14 hours until the end of the first day), and imbibition (more than one day). Hypostasis is characterized by overflow of the veins with blood, stasis by hemolysis of red blood cells and diffusion of the liquid part of the blood through the wall of blood vessels, the beginning of staining of surrounding tissues with blood pigment; imbibition - the completion of tissue staining with blood. When you press a finger (dynamometer) on the cadaveric spot in the stage of hypostasis (see), it completely disappears and is restored again after the load is removed in a few seconds. When the corpse is turned over, the cadaveric spots at this stage completely disappear and reappear in the underlying areas of the body. In the stasis stage, cadaveric spots turn pale when pressed, but do not disappear completely; the original color is restored slowly (within several minutes). When a corpse is turned over, cadaveric spots remain both in the same places and are formed on new, underlying areas of the body (color book Fig. 4). In the stage of imbibition (see), cadaveric spots do not change color when pressed; when the corpse is turned over, they are preserved only in the places of their initial formation. Simultaneously with the appearance of cadaveric spots on the skin, the formation of the so-called. cadaveric hypostases in the underlying parts of the internal organs, which gives them a reddish-bluish tint due to accumulated blood. The presence of cadaveric spots is a reliable sign of cardiac arrest, and their nature allows us to judge how long ago death occurred, indicates a change in the initial position of the corpse, and provides guidance in the diagnosis of certain causes of death.

Rigor (muscular) mortis- a kind of compaction and shortening of skeletal muscles, creating an obstacle to passive movement in the joints, as well as the smooth muscles of internal organs and the muscles of the heart. Rigor mortis begins to manifest itself externally 2-4 hours after the heartbeat stops, reaches its maximum severity by the end of the 1st day of the post-mortem period and spontaneously resolves on the 3rd-4th day. It is based on a violation of ATP resynthesis and the accumulation of lactic acid. Complete breakdown of ATP in the muscles occurs only after 10-12 hours. after cardiac arrest, therefore rigor mortis, which was artificially disturbed before this time, is completely restored, which must be taken into account in forensic medicine. practice (the possibility of simulating lifetime actions for criminal purposes). Rigor mortis develops faster at a higher (but not higher than 50°) ambient temperature and low humidity, in persons with well-developed muscles, with vigorous muscular work preceding death, convulsions, poisoning with substances acting on the c. n. With. (strychnine, pilocarpine, etc.). Sepsis, severe debilitating diseases preceding death, some poisonings (chloral hydrate, toadstool) cause weak expression or complete absence of rigor mortis. In rare cases (destruction of the substance of the medulla oblongata, sharp convulsions preceding death), the so-called. cataleptic rigor mortis, which develops at the moment of cardiac arrest as a result of the direct transition of intravital contractures into rigor mortis and, thus, preserving the person’s posture at this moment. In forensic medicine, rigor mortis is determined by the presence of resistance to passive movements in the joints of the limbs, neck muscles and masticatory muscles. Rigor mortis is a reliable sign of death; it allows one to judge how long ago it occurred, the initial position, and in some cases the cause of death.

Drying due to uncompensated evaporation of moisture from the surface of the skin, it begins immediately after death, but visually it appears only after a few hours. The process begins in areas devoid of epidermis, i.e. on the mucous membranes of the eyes, lips, genitals, or in those places where the epidermis is thinnest - the scrotum, the terminal phalanges of the fingers. The first sign of drying out and, therefore, a reliable sign of death is the formation of dull yellowish-gray or brownish areas of drying of the sclera of the eyes in the form of isosceles triangles, the base facing the iris, the apex towards the corners of the eyes - Larcher spots. They appear especially clearly if the eyes remained open after death. Subsequently, the areas become denser, wrinkle, acquire a brownish, purple color and other drying areas. Drying also develops rapidly in those areas where the epidermis was damaged shortly after death; “parchment” spots form in these places - dense brownish-yellow sunken areas of the skin with translucent red vessels. The formation of parchment spots is also possible on intact skin in places that have been subjected to prolonged pressure. The drying process (see Mummification) is accelerated under conditions of high temperature and low humidity of the surrounding air. Usually it is limited to certain areas of the body, but under special environmental conditions, drying out can be total, which leads to mummification of the corpse (color fig. 7 and 8).

Autolysis- disintegration of body structures under the influence of hydrolytic enzymes due to the disorganization of enzyme systems occurring after death and a shift in pH to the acidic side. Externally, this process is characterized by a gradual softening and liquefaction of organs and tissues, the severity of which depends on the quantitative content of proteolytic enzymes in them. The high content of lysosomal enzymes in the pancreas, adrenal glands, spleen, and liver causes the appearance of initial signs of autolysis in these organs. Blood undergoes fairly rapid autolysis - post-mortem hemolysis is essentially a manifestation of autolysis. In the stomach and small intestine, digestive juices containing pepsin, trypsin and other enzymes are of leading importance. After death, their action is directed to their own mucous membrane, which has lost its protective barrier functions. Thus, self-digestion (see) of the mucous membrane occurs, the intensity of which is directly dependent on the stage of digestion that took place immediately before death. Self-digestion is most often limited to the mucous membrane, but in infants the walls of the stomach and intestines may be involved in the process of autolysis. Under certain conditions, gastric juice can enter the esophagus, pharynx, even trachea and cause esophagomalacia, “acid” softening of the lungs.

Late postmortem changes

Rotting - a complex biol, a process caused by numerous microorganisms that intensively multiply in the corpse and secrete a large number of proteolytic enzymes that decompose organic substances, primarily proteins, fats and carbohydrates. Putrefactive decomposition (transformation) of a corpse can occur in two forms. The first is observed when rotting occurs according to the type of reduction reactions, accompanied by the formation of simple volatile hydrogen compounds, which, as a rule, have an unpleasant odor. This process is considered to be rotting itself (see). The second form occurs when decomposition occurs by oxidation or combustion with the formation of a number of acid-containing compounds. This process is called smoldering. Typically, the putrefactive decomposition of a corpse consists of 3 stages: the formation of gases, softening of tissues followed by their imbibition and their complete liquefaction. Both aerobic and anaerobic saprophytes take part in the decay process; pathogenic microbes usually die quickly. Therefore, it is believed that infection inf. diseases during the autopsy of a corpse in the stage of decay is impossible. At the same time, during the process of decay, some toxic substances of the ptomaine group (putrescine, cadaverine) are formed, called cadaveric poison, which requires some caution when examining putrefactively altered corpses. The speed and characteristics of decay depend on a number of external and internal factors. High (approx. 40°) ambient temperature and high humidity contribute to the development of the rotting process. Rotting develops quickly in air, more slowly in water, and even more slowly in soil. At temperatures below 0° and above 50-60°, with a sufficient supply of dry air, rotting can slow down sharply and stop altogether. The process of decay is significantly accelerated during death from sepsis, purulent diseases or inf. diseases. Gender, age, and level of nutrition also matter. The corpses of newborns decompose faster, the corpses of old people - more slowly. The corpses of men decompose faster than the corpses of women, of obese people faster than of thin ones. In case of death from asphyxia, sun and heat stroke, or electrical injury, the process of decay develops quickly, in case of death from debilitating diseases associated with dehydration, in case of poisoning with alcohol, arsenic, quinine, cyanide, sublimate, etc., it develops slowly. The development of putrefaction is significantly delayed if a person consumes a large amount of antibiotics (tetracycline) and sulfonamide drugs shortly before death. In just 3-6 hours. after death, putrefaction begins to develop in the large intestine, where a large amount of putrefactive gases are formed, a number of which (hydrogen sulfide, methyl and ethyl mercaptan) have a specific unpleasant odor. Hydrogen sulfide, combining with hemoglobin in the blood, forms sulfohemoglobin and iron sulfide, which have a dirty green-brown color. Initially (days 1-2), a greenish color appears in the iliac regions, then along the course of large vessels, forming a putrefactive venous network (color. Fig. 6). On the 5-7th day, putrefactive gases, penetrating into the subcutaneous tissue, seem to swell it, leading to the development of cadaveric (putrefactive) emphysema, especially in the area of ​​the face, lips, mammary glands, abdomen, scrotum, and limbs. When touching the skin of such a corpse, a sharp crepitus is felt. On the 10-12th day, the entire skin takes on a dirty green color. Subsequently, the epidermis begins to peel off with the formation of blisters with serous-bloody contents, after rupture of which a moist brownish-red surface is exposed (tsvetn. Fig. 5). Of the internal organs, the stomach, intestines, lungs, liver, brain, pancreas, kidneys, adrenal glands, and heart are the most susceptible to rotting. The organs become as if “foamy”, acquire a brownish-red, and then a brownish-green or dirty green color (putrefactive imbibition), and liquefy. When gistol, examination in the tissue of these organs fails to identify parenchymal elements. Gradually, the process of decay spreads to other organs and tissues, with the non-pregnant uterus, prostate gland, ligaments, and cartilage surviving the longest.

Depending on the burial conditions (the nature of the soil, its pollution, humidity), after approximately 2 years the tissues and organs take on the appearance of a disintegrating homogeneous dirty-gray mass, the edges gradually dissolve and are washed away by soil water. Skeletal bones can be preserved indefinitely. Putrefactively altered corpses can be the object of forensic medicine. examination, while the degree of putrefactive decomposition is not an obstacle to forensic medicine. examination of the corpse (see Exhumation). Even with pronounced decomposition of the corpse, various damage can be detected, especially to bones, gunshot marks on the skin, etc., which is of important expert diagnostic value.

Preservative forms can determine the preservation of appearance (freezing) or individual characteristics, allowing for personal identification (see), identifying the characteristics of previously received injuries, etc. These types of P. and. include complete drying of the corpse or its parts (natural mummification), saponification of the corpse, or saponification (see Fatwax), peat tanning, etc. (color fig. 9).

Peat tanning occurs when a corpse gets into peat bogs and soils containing humus and other acidic, tannic and astringent substances. At the same time, the skin of the corpse thickens, acquires a dark brown color, and the internal organs decrease in size. Under the influence of humus compounds, mineral salts dissolve and are washed out of the corpse, so the bones acquire the consistency of cartilage and are easily cut with a knife. With histol. The study reveals complete preservation of the structure of the skin, muscles, and nervous tissue. In peat bogs, corpses persist indefinitely. At their court.-med. The study makes it possible to determine damage received during life. Corpses can also be preserved for a long time in water with a high salt content or in oil.

Other post-mortem changes

To P. and. The destruction of a corpse also includes its destruction by representatives of the plant (mold) and animal (insects, rodents, small and large predators, etc.) world. Molds and molds can grow on corpses or parts thereof if there is sufficient moisture. The participation of molds in the destruction of a corpse is insignificant, but some of their species can provide valuable indications about the place where the corpse was located and how long ago the death occurred. Of the insects, flies are the most important. Soon after death, they begin to lay large numbers of eggs in the form of white grains around natural openings, eyes, and wounds. After 1 day, larvae form from them, secreting a fast-acting proteolytic enzyme that melts the soft tissues of the corpse. Penetrating inside the corpse, they continue their development for 1.5-2 weeks, after which pupae are formed, and after another 2 weeks - flies. Thus, biol, the development cycle of flies is 3-4 weeks, but at elevated temperatures it can accelerate to 2 weeks. (at an ambient temperature of 30°), at low temperatures it lengthens significantly. Under favorable conditions (air temperature 15-20°), flies can completely destroy the soft tissues of the corpse of a newborn in 1.5-2 weeks, and an adult in 1-1.5 months. Other insects can also damage a corpse, in particular ants (they can skeletonize the corpse of an adult within 2 months), beetles, and mites. It is believed that the soft tissues and fat of corpses that are in the ground for 1-3 months are eaten by sarcophagi, by skin beetles for 2-4 months, and by sylphs for 8 months. Cartilage and ligaments are destroyed by mites.

Quite often, corpses are destroyed by rodents, especially rats, as well as wolves, jackals, and less often cats and dogs. Damage in these cases usually has an irregular shape with torn, scalloped, bloodless edges, on which tooth marks are clearly visible. In the aquatic environment, corpses are damaged by some types of predatory fish, crayfish, and leeches. Some birds, for example, crows, also destroy corpses. Damage to corpses by animals complicates the examination, but is not an obstacle for forensic medicine. corpse research.

Bibliography: Avdeev M.I. Forensic medical examination of a corpse, M., 1976; Lushnikov E. F. and Shapiro N. A. Autolysis, Morphology and mechanisms of development, M., 1974; Melnikov Yu. L. and Zharov V. V. Forensic medical determination of the time of death, M., 1978; Multi-volume manual on pathological anatomy, ed. A. I. Strukova, vol. 1, p. 636, M., 1963; Strukov A. I. and Serov V. V. Pathological anatomy, M., 1979; Forensic Medicine, ed. V. M. Smolyaninova, M., 1980.

I. V. Buromsky, M. N. Lanzman.

Early cadaveric phenomena include: cooling of the body, cadaveric spots, rigor mortis, drying of tissues.

Cooling the corpse

Body temperature usually remains at the same level during the first tens of minutes after death. Sometimes it can rise above 40 °C (the action of microbes).

The cooling of the corpse is explained by the cessation of metabolism and heat production. Meanwhile, heat transfer continues. After 45-60 minutes, body temperature decreases more or less uniformly by 1 °C per hour, with some fluctuations on the other side. A decrease in body temperature below 25 °C is an undoubted sign of death. The speed of the post-mortem temperature drop is influenced by the ambient temperature, wind strength, presence of clothing, location of the corpse, fatness and volume of the body, cause of death, etc.

Cadaveric spots

After the cessation of blood circulation, the movement of blood and other body fluids occurs according to physical laws: under the influence of gravity, they gradually move to the underlying sections. In this case, blood from the arterial vessels moves into the venous vessels, overflowing them. Due to the increased permeability of the vascular wall, blood seeps outside the vessels and accumulates in the tissues, giving them and the skin in these places a corresponding color. Typically, cadaveric spots have a dirty purple color with a predominance of various shades, depending on many reasons, including the cause of death.

For example, in case of carbon monoxide poisoning, cadaveric spots have a bright red color (blood hemoglobin turns into carboxyhemoglobin); in case of poisoning with cyanide compounds, they have a peculiar cherry color. In corpses exposed to the cold, the color of the cadaveric spots is bright pink (due to the oxidation of hemoglobin by air oxygen penetrating through microcracks in the skin that form when body fluids freeze).

Cadaveric spots are found in the underlying parts of the body. When the corpse is located on the back, they are located on the back surface of the body, on the stomach - they are located on the front surface. When hanging, if the corpse has not been removed from the noose for a long time, the cadaveric spots are predominantly located on the forearms and legs; feet

Stages of formation of cadaveric spots 1.

Hypostasis stage - lasts for 12 hours after death. The liquid part of the blood is in the vessels, and when pressure is applied to the spots, the blood is squeezed out of the vessels, and after the pressure stops, it quickly fills them again. This leads to the disappearance of cadaveric spots when pressure is applied, as well as to their movement to the underlying sections when the body position changes. 2.

Stage of stasis (diffusion) - observed after 12 hours from the moment of death and lasts up to 24 hours. Cadaveric spots turn pale, but do not disappear when pressed. This is due to the fact that the liquid part of the blood, stretching the wall of the vessel, begins to seep into the tissue. In parallel with this, hemolysis of red blood cells occurs. At this stage, the spots do not move when the position of the corpse changes, but somewhat reduce their intensity. 3.

The imbibition stage develops on the second day after death. Cadaveric spots are well fixed, do not move, and do not turn pale when pressed, since the soft tissues are saturated with blood.

The severity of cadaveric spots varies and depends on the cause of death, the nature of the disease and the mechanism of dying. For example, in cases of death with a long agonal period, as well as in cases of death from acute blood loss, the cadaveric spots are slightly expressed. On the contrary, in cases of rapid death (mechanical asphyxia, electrical trauma, etc.), the cadaveric spots are well defined. Forensic value: -

cadaveric spots are the undoubted, earliest sign of death; -

reflect the position of the body and its possible changes after death; -

allow you to approximately determine the time of death; -

the degree of severity reflects the speed of death; -

the color of cadaveric spots serves as a diagnostic sign for some poisonings or may indicate the conditions in which the corpse was located; -

allow us to talk about the nature of the objects on which the corpse was located (brushwood, folds of linen, etc.).

Rigor mortis

After death, the muscles of the body relax and become soft and pliable. After 2-4 hours (in some cases earlier), signs of rigor mortis appear. In this case, all the muscles become dense, hard, contract somewhat and fix the body in the position (pose) in which it was after death. To change this fixed position of the body in the rigor stage, considerable effort must be made. Rigor mortis manifests itself more quickly in the masticatory muscles and gradually spreads downward, i.e., to the muscles of the neck, chest, upper extremities, abdomen, and lower extremities. By the end of the day (sometimes after 12 hours), the entire corpse is in a state of rigor. This condition lasts 2-3 days, and then usually disappears in the same order in which it appeared.

Like other cadaveric phenomena, rigor mortis is influenced by a number of internal and external factors. For example, high temperature accelerates all chemical processes, including the development and resolution of rigor mortis. At low temperatures, these processes, on the contrary, slow down. With small muscle mass (children, thin people, old people), rigor is less pronounced and comes and disappears faster. In case of death from damage to the brain and spinal cord, poisoning with poisons affecting the central nervous system, epilepsy, tetanus, after heavy muscle load before death, rigor mortis occurs faster, lasts longer, and is more pronounced. Rigor mortis can sometimes develop instantly, immediately after death. This phenomenon is called cadaveric spasm, or cataleptic rigor. In this case, the position in which the deceased was at the time of death is recorded. The development of this type of rigor is associated with damage to the medulla oblongata, which causes convulsive muscle contracture. Forensic value: -

rigor mortis is an undoubted sign of death; -

rigor mortis records the posture that a person took after death; -

by the degree of spread of rigor mortis one can get an idea of ​​the time of death; -

the severity of rigor mortis provides some assistance in recognizing the cause of death. Drying corpse

The process of post-mortem drying depends on the evaporation of moisture from the skin and especially from the mucous membranes of the lips and eyes. The degree and speed of drying depend on the state of the external environment (temperature, air humidity, etc.), the nature of the clothing, the characteristics of the corpse itself, etc.

Drying occurs most quickly in areas of the conjunctiva of the eyes that are not covered by eyelids (4-5 hours after death). In this case, horizontal stripes or triangular-shaped brownish areas are formed on the sclera in the area of ​​​​the corners of the eyes (Larshe spots, 1868).

The mucous membrane of the lips, especially at the border with the transitional border, also undergoes drying. This sign is better expressed in the corpses of newborns and infants, since their mucous membranes are more delicate and dry out faster.

On the skin of the scrotum, the epidermis of which is very thin, dry spots also appear quite early, which can be confused with intravital abrasions caused by a blow to this area. This circumstance is especially important to take into account and record in the protocol, and subsequently in the expert’s opinion, in order to avoid conflict situations with relatives. When the drying spot is wetted with warm water, it disappears within 2-3 hours, while the abrasion remains.