Somatic ,molecular and Sudden Death.

Introduction

• Thanatology  is  the  branch  of science  which  deals  with  study of death,  it  deals with death in all  aspects
• Death denotes  death  of human  being (46  IPC).  It is  defined  as cessation  of  life  or  cesation  to  exist.  Death is  of two  types

1. somatic  death  (systemic  death  or  clinical death)
2. molecular  death  (cellular  death).

Somatic death (svstemic  death  or  clinical death)

• It  is  the  complete  and irreversible  stoppage  of  the  circulation, respiration and  brain  functions (bishop’s  tripod  of life).
• Somatic  death  is  associated  with  immediate  signs  of  death  :-i)  Permanent  and  complete  cessation  of  function  of brain  and  flat  electric EEG(PGI03)  with no  response  to  external brain  death.
• Somatic  death  is  due  to  stopped  aerobic  processes.  However,  anaerobic  enzymatic  processes  are  still  continuing,  hence : Muscles still  respond  to  mechanical, elecfiical and  thermal  stimuli.
• Absent  of  brainstem  reflexes  :  Pupillary  reflex,  oculovestibular reflex, corneol  reflex, pharyngeal and tracheal  reflexes.

Molecular  death (cellular  death)

• It occurs  after  somatic  death.  lt  refers  to  death  of all  individual  cells.
• It occurs  when even  anaerobic  processes  stop, due to  non  availability  of  ATP.
• Early signs : Changes in  skin  and eye,  cooling  of  the  body, post-mortem  lividity,  changes  in muscles  (e.g. primary  relaxation,  rigor  mortis).

Suspended  animation  (sudden  death)

• It  is  apparent  death. i.e. signs  of life  are  not  found  as the  functions  are  interrupted  for  some time  or reduced  to  minimum.
• The person is  not dead, i.e.  there  is  no somatic  death, brain death or molecular  (cellular)  death.
• Life continues  and  resuscitation  is  successful  in such  cases
• The condition  lasts  from  few seconds  to  l/2  an hour  or more.
• It  may be  found  in  Electrocution, Drowning.
• Sudden death occurring after maxillary sinus irrigation is due to Air embolism

Hydrocution or immersion syndrome refers to sudden death in water due to vagal inhibition as a result of:

• cold water stimulating the nerve endings of the surface of the body
• horizontal entry into the water with a consequent strike on the epigastrium
• cold water entering eardrums, nasal passage, and the pharynx and larynx which cause mucosal nerve ending stimulation