[Calor, rigor, livor and supravitality--rational use for cadavers].
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Biomedical subjects
Publications and source records attributed to C Henssge.
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For the determination of the time since death, the distribution of the last meal in the stomach and small bowel may be of great importance. It may be even more difficult to estimate the time if there is a possibility that postmortem peristaltic emptying of the gastric content occurs, as has been claimed. Radiological control immediately after death by means of applying barium sulfate to the stomach, however, revealed no evidence of peristaltic emptying of the gastric content after death.
In accordance with Puppe's rule, the analysis of skull fractures may provide evidence on the sequence in which multiple blunt injuries of the skull occurred. In cases of multiple gunshot wounds of the skull determination of the sequence in which the gunshot wounds took place is much more difficult. In some cases, however, analysis of the skull fractures here can also allow the order in which gunshot wounds occurred to be established.
The criteria for estimating time of death, lividity and rigor mortis according to data worked out by Mallach, together with data concerning the mechanical excitability of skeletal muscles (Prokop), the electrical excitability of face muscles and pharmacologic excitability of the iris (Klein and Klein) were combined with a nomogram of the rectal/brain temperature at time of death to make a rational and practical method of estimating time of death that would be suitable for use at a scene of crime. In each actual case, only a few additional criteria can be used to verify the upper and lower limits of the nomogram readings and to reduce these defined limits. For this reason the outer data from Mallach's tables and Klein's results were separated into upper and lower limits, chronologically arranged and clearly presented. After rectal temperature measurement and corresponding nomogram reading, it is easy to recognize which further criteria must be examined. Analysis of the test results is extremely simple with the aid of the proposed chart.
The origins of the determination of the time of death are presented with special reference to the signs of death, rigor mortis and body cooling, as well as to the supravital electrical response of skeletal muscle. The systematic method for future research resulting from these old experiments is presented, with the aim of making a more precise estimation of the time of death by standardization of the influencing factors.
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In 28 cases of sudden death, the corpses were tested for the effect of different storage temperatures (5 degrees C, 14 degrees-15 degrees C, 25 degrees C) regarding the reaction of livor mortis to known pressure conditions (force and duration of pressure). The reaction is dependent on the storage temperature but there is no linear relationship. At certain storage temperatures the postmortem lividity reaction is dependent on the amount and duration of the pressure. In addition, at defined storage temperature and pressure conditions, there are large interindividual differences in the estimation of time of death.
Twenty-nine corpses were subdivided into three groups. Normally from the 3rd h post mortem on, they were suspended undressed in a tub holding 1,000 l in nearly still water of temperatures approximately 20 degrees, 10 degrees and 0 degrees C. The rectal temperature was measured, normally until the 33rd h post mortem. Time of death was calculated by means of the mathematical analytical two-exponential formula suggested by Marshall and Hoare (1962), in the version used by Brown and Marshall (1974). The adapting parameters of the formula were standardized according to the principle of Henssge (1979, 1981) and related to standardization by adjusting factors to body weight stated for standard values of cooling, i.e., undressed corpses in calm air. After termination of the post mortem temperature plateau, it was found that undressed corpses suspended in water of temperatures of approximately 20 degrees and 10 degrees C cool as quickly as undressed corpses of half the body mass in calm air of the same temperatures. As to the duration of the post mortem temperature plateau in water suspension time from the time of death, it may only be indirectly concluded that it is linked to the subsequent speed of cooling in the same way which is well known in the case of air cooling. Statistical standard values are given concerning the differences between the computed and the real times of death. Unexpectedly, the experiments in water at approximately 0 degrees C yielded distinctly slighter temperature which were especially marked at rectal temperatures up to approximately 11 degrees C in corpses of great body mass and small body surface in proportion to and equally, without regard to body mass. As an explanation of this, a decrease in the thermal conductivity of the subcutaneous adipose tissue in connection with a decrease in tissue temperature is discussed.
A new method of postmortem electrical stimulation of muscles, measuring the force of the reaction against time, is presented. Preliminary investigations have yielded the following results: The maximum force of reaction in response to a definitive stimulation, measured by a sensitive force transducer, decreases in proportion to the post mortem interval. Using this method, the mechanical reactions of muscles by electrical stimulation can be demonstrated over a much longer postmortem period as these movements are visible. The duration of postmortem reaction of different muscles seems to be much more uniform than was previously assumed. Occasionally, reactions of the M. orbicularis oculi can be seen for the longest time. The basal muscular tonus changes relative to time. The time course of a single force reaction also changes relative to the postmortal interval: the reaction becomes slower. It has been theoretically established that measurement of influencing factors such as temperature and pH in the tested muscle will enable the time of death to be more precisely estimated.
Analysis of the data on 21 corpses (brain and rectal temperatures which had been recorded simultaneously) yielded the following results and conclusions with regard to separate or combined computations of time of death: In the range of a standardized brain temperature (QH) 0.5 less than or equal to QH less than 1.0 (approx. up to 6.5 hpm), the most precise computations of time of death are achieved by exclusive application of brain temperature (standard deviation around dt = 0 "s0" = +/- 0.75; variation: 3.3 h). In the range of 0.3 less than or equal to QH less than 0.5 (approx. 6.5-10.5 hpm), combined computation of time of death balanced in the ratio of 6:4 (brain/rectum) is comparatively the most precise one (s0 = +/- 1.18; variation: 5 h). In the range of 0.07 less than or equal to QH less than 0.03 (beyond 10.5 hpm), the most precise computation of time of death (s0 = +/- 1.62; variation: 6.6 h) is achieved by exclusive application of rectal temperature. An "integrated" approach composed of both computation formulae, and thus possibly eliminating temperature in the occurrence of death, seems to be appropriate in the range of about 0.5 less than or equal to QH greater than 1.0 to avoid major errors in computing times of death, e.g., in cases involving fever in the occurrence of death (s0 = +/- 0.69; variation: 2.7 h).
The central brain temperature was recorded in 53 human corpses, stored at constant ambient temperatures between 10 degrees and 30 degrees C. The measurements were started on average 1.6 h post mortem and continued for 8-50 h. The sigmoidal shape of the temperature curves fitted the mathematical model of Marshall and Hoare (1962). This model provides a precise description of the temperature curves. For 44 corpses, studied at temperatures between 10 degrees and 25 degrees C, the time of death was calculated using fixed values for the adaptation parameters of the model. The margins of error for the 95% tolerance limit were +/- 1.5 h up to 6.5 h post mortem, +/- 2.5 h between 6.5 and 10.5 h post mortem and +/- 3.5 h between 10.5 and 13.5 h post mortem. For the recommended practical application a "brain temperature--time of death" nomogram is presented. We found that the rate of cooling was influenced by the amount of hair. Furthermore, it has been argued that the study method could be improved further. In consequence, we expect the central brain temperature to be even more accurate in the calculation of the time of death than has been discussed and shown on the basis of the present material.
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Cooling conditions differing from the chosen standard (naked-resting air) of storing of a dead body may be proportionally adjusted in computing of the time of death by data of the rectal body cooling by corrective factors of the body weight. These differing cooling conditions are: permanently moved air-clothing-covering-wet clothing. In our experiments the corrective factors of the body-weight range from 0.7 for totally wet clothing + permanently moved air to 2.4 for a covering similar to bed clothes. Temperature-time of death-relating nomogrammes, easily to handle, replace the computing without losing accuracy. The permissible variation of 95% resp. 99% in estimating the range of the time of death was found out.
A representative material of experimental rectal cooling curves proves the basic validity of the model described by Marshall et al. for the mathematical expression of body cooling. For defined conditions of cooling as a relating standard the values of the exponents needed for the solution of the formula closely correlate with the weight of body to be raised to the -0.625 power. For applying in forensic cases a prescription easily to be used for the chosen relating standard of cooling is given for the computing of the time of death with permissible variation. From the first experiments of different conditions of body cooling to be met in forensic cases the possibilities of extending the range of application are derived.
A 3 month old child was treated in hospital for "toxikosis and prolonged gastroenteritis". The child required a special diet. The parents picked up the child in hospital and brought it home against the device of the doctors. 26 hours later the child had died of severe exsikkosis (loss of 17% of body weight within one day). Using immunological methods (Ouchterlony test) we were able to demonstrate the child was fed with contraindicated food although the doctors had pointed out that the child needs a special diet. The parents were sentenced at court in two instances for manslaughter.