Thanatology

Dr. Cahyono Kaelan

Sp.PA(K), Sp.S., PhD., DFM.
Dept of Forensic Pathology & Medicolegal
Fac. of Medicine Unhas
Makassar

Arti dan Definisi

Thanatos = Death
Logos = Science
Thanatology = Ilmu yang

mempelajari tentang penyebab dan

perubahan yang terjadi setelah
kematian.

Tujuan dari Tanatologi

1. Diagnosis kematian
(Scene )
2. Penentuan waktu
kematian
(Alibi)
3. Prediksi sebab kematian
4. Prediksi cara kematian

Kematian
Definisi : Apakah itu kematian?
1. Mati = Jiwa berpisah dengan
jasmani
2. Brain death = Mati batang otak
3. Coma = Tidak Sadar yang dalam
4. Unconscious = Kesadaran turun
/Pingsan
5. Wake = Live = Hidup /Sadar

Definisi Kematian
Human = 2 dimensions (individual and

collection of cells
Individual = Mati = roh berpisah dgn jasad
Kumpulan sel = kematian di tingkat selular
Hidup ditandai : Adanya tanda tanda vital (vital
signs) :Bernapas, Jantung berdetak/berdenyut
dan otak berfungsi sehat =bicara berfikir.yang
ditandai adanya kebutuhan akan oksigen.
Mati = Stop / berhentinya tanda tanda vital yang
permanen dan tidak ada lagi kebutuhan
oksigen Permanent Stop function of vital organ
(lung, heart and brain) do not need Oxygen
anymore

Defines Death (cont)

2. Cellular death= lack of Oxygen cells die.
In the brain cell only lasting of 7 minutes
3. Brain death = Stop of brain function, even
other organ still working due to respirator)
4. Indonesian Doctors Association (IDI,1989),
follows death when is brain death

Bagaimana menentukan
seseorang itu telah mati?

Berhenti tanda tanda vital : jantung dan

paru paru 10 menit
Adanya alat Respirator (breathing
apparatus) kriteria ini jadi tdk cocok lagi
Now taken Brain death = is death
How to justify Brain death ?
Diambil dari bagian otak yang paling
akhir hidup (batang otak) yang lain sdh
lewat

Bagaimana menentukan MBO

(Mati Batang Otak)?
No Response on command/
Loss of stimuli
Reflexes of pupil, corneal, cough (-)
Ice stimuli to inner ear disappear(-)
Stopping respirator no spontaneous
response
EEG flat (EEG = Rekam otak rata)
Diperlukan # 3 doctors (Anesthetist,
Neurologist and other) ICU

Simple Test on Death Scene

Tes penentuan kematian
1. Auskultasi (no breath and heart beat)
need time + place on larynx and chest
2. Winslow test: Gelas air diletakkan diatas
perut (bila goyang airnya = hidup)
3. Mirror Test : Mirror and spectacle damp /
blurred still alive
4. Feather Test : moving of Chicken feather
or cotton on nostril due to respiration
alive

II. Changes after death =

Perubahan setelah mati
Face
Muscle relaxation
Eyes
Body temp
Livor Mortis
Rigor Mortis (Stiffness)
Putrefaction (Decay/Decomposition)

Kulit Wajah
Face = Wajah Pucat karena tdk

ada darah yang mengalir lagi.

Kecuali pada kasus keracunan CO =
merah sperti buah cherry disebut
Cherry Red

Relaksasi Otot
Relaksasi otot dan penurunan tonus

otot, shg rahang menjadi turun, mulut

terbuka (perlu di ikat).
Relaksasi otot otot wajah a younger
looking than his real age.
Pupil (eye) melebar / dilatasi
Relaksasi otot-otot mulai dari :jantung,
otot leher, wajah ektremitas sup dan
bagian lain dari badan weak toneless

Perubahan pada mata

No shine (damp sight) empty

(death fish eye)

Light and corneal reflexes (-)
Retinal Vein damage in 10 seconds
Corneal = Selaput bening mata
dry and blurred
Decrease of eyeball tone (softness of
eye ball) = bola mata lembek /
kempes

Body Temperature = Suhu

Badan
Decrease of body temp (dingin)
Except =Kecuali pada keadaan bacterial

infection (sepsis warm)

Depend on vicinity temperature = temp
sekitar
Location / Medium (di Air > cepat dingin
dari di ruangan)
Body constituent /bentuk : Kurus > gemuk
Clothing /Pakaian : Thin > thick
Estimation only = berlaku bila mati dalam
< dari 12 jam

Livor Mortis = Lebam Mayat

Due to gravity force (gaya gravitasi)

Blood pool into blood vessel on the lower surface
Occurred 1- 2hours after death
Potision lie on the back appear on the back of the
body, back, buttock, and extremities and vice versa
> 4 hrs capillary and blood corpuscle damage
livor permanently (> 4 jam jadi permanen)
>12 hrs livor will not changes anymore (tdk
berubah)

Color of Livor : Red (Cherry red CO)

Coklat Chlorate /racun peptiside

Hitam Asphyxia

DEFINISI
Nama lain livor mortis ini antara lain
lebam mayat, post mortem lividity, post
mortem
hypostatic,
post
mortem
sugillation, dan vibices.
Livor mortis adalah suatu bercak besar
berwarna merah kebiruan atau merah
ungu (livide) pada lokasi terendah tubuh
mayat akibat penumpukan eritrosit atau
stagnasi darah karena terhentinya kerja
pembuluh darah dan dipengaruhi gaya
gravitasi bumi, bukan bagian tubuh mayat
yang tertekan oleh alas keras.

Dix J. Color Atlas of Forensic Pathology. USA: CRC Press. 2000.

Kaku Mayat = Rigor Mortis =Postmortem

Rigidity
ATP ADP + LA
Small muscle first ( Face, palpebrae, Jaw) due to

less of Glycogen
Heart, neck, face, extremity and upper part of
body and other seperti waktu relaksasi otot.

Occur / Terjadi :
6 hours after death
12 hrs all part of the body stiff
12- 36 hrs persistent stiff (rigorous)u
>48 hrs return of relaxation
(Secondary)

Gambar 3. Rigor mortis

Dix, J. Time of Death and Decomposition in : Color Atlas of Forensic Pathology. New York: CRC
Press: 2000. p. 10-27.

Gambar 4. Cadaveric Spasme

Shkrum, MJ., Ramsay, DA. Postmortem Changes The Great Pretenders in : Forensic Pathology of
Trauma Common Problems for The Pathologist. New Jersey: Humana Press: 2002. p. 23-47.

Decay = Putrefaction =
Decomposition
Pembusukan

Autolysis=Mikrobacteria
Coecum region
Gas putrefection
48 hrs = > 48 jam
Change in color on right bottom
region belly Greenish
Gas H2S + Hb Sulf-Met-Hb

Putrefaction signs = Tanda

Pembusukan.1

Greenish in color (Coecum region)

Superficial vein dilatation
Swelling of face
Abdominal distended (gases)
Scrotum / vulva Swelling
Skin blister

Putrefaction signs = Tanda

Pembusukan.2

Fluid come up through mouth and nose

Tongue and eye ball protruded out
Belly and chest blast due to gas pressure
Hair and nail easy to pull or discharges
Internal organ decays and porridge like
uterus, brain, spleen , lung, kidneys.
But a little lasting are prostate for male
and uterus on female

Putrefaction
Mulai timbul >24 jam post mortem
Warna kehijauan diperut
kanan bawah (dini)
Pelebaran p.darah superficial
Muka membengkak
Perut menggelembung (gas)
Skrotum / vulva membengkak
Kulit Melepuh
Keluar cairan darah dari mulut / hidung
Lidah dan bola mata menonjol keluar

Special Circumstances = Keadaan

khusus
1.Mummification: Mummy
Dry of air , cool, low humidity no bacterial
contamination after a few months
Corpus smaller / shrinkage
Dry
Blackish in color
Skin covered bones
Odorless
Anatomical composition intact
2. Adipocere (Saponifikation): occurred when

Mumifikasi
Mumifikasi terjadi pada lingkungan yang panas
dan kering dimana tubuh mengalami dehidrasi
dan proliferasi bakteri yang terjadi minimal.

Kulit berubah menjadi gelap,

kering dan keras

Mumifikasi dapat terjadi partial di mana bagian

tubuh lain sudah mengalami dekomposisi,
adiposera ataupun skeletonisasi

Saponification = Penyabunan
Fat or fatty acid (asam lemak). Dari

unsaturated fatty acid saturated fatty

acid (asam)
Reaction with alkaline /alkali dari tanah
forms Salt
(asam)+ alkali (base) Garam
(Salt not dissolve in water)

Occurred in part of the body contains fat

(check, omentum)
White in color, Smell sting /tengik like decay
of Coconut oil = minyak kelapa

FAT + alkali SALT (Soap)

Summary = Ringkasan
1. Thanatology and Purposes of
Thanatology
2. Vital signs and death
3. Brain death
4. Changes after death
5. Postmortem changes (Early to late)

Reference.
1. Forensic Medicine
2. Forensic Pathology

THANK YOU