Soon ripe Soon rotten Soon gone But not forgotten Epitaph on a Massachusetts tombstone Did you ever think when the hearse goes by, That some fine day you are going to die? They’ll put you in a wooden shirt And cover you over with gravel and dirt. The worms crawl in, the worms crawl out, They’re in your ears and out your snout. The worms crawl in, the worms crawl out, Eating your guts and spitting them out. A rhyme of unknown origin Chapter 4 Decomposition of the Body and Efforts to Slow Its Disintegration The first clue that the human body is highly degradable comes from ter- minology. The word “cadaver” is, at least according to court opinions, derived from the Latin words caro data vermibus, meaning flesh (or carri- on) given to worms. That derivation is sometimes contested. Some com- mentators connect the word “cadaver” to the Latin cadere, meaning to fall. Certainly, a cadaver has, in some sense, fallen. I still prefer the first derivation, caro data vermibus, not because I think it is the real source of the word “cadaver,” but because it contains an important truth. Depend- ing on its mode of disposal, a cadaver will sooner or later decompose. Cremation acts quickly to disintegrate the corpse. Burial preserves the corpse longer, depending on the conditions preceding and accompany- ing interment. Yet the “soon rotten” inscription on the quoted Massachu- setts tombstone is basically accurate as applied to burial. The questions become: How soon is soon? What, if anything, can be done to delay the rotting process? How long can the decomposition process be delayed? Copyright © 2010. Georgetown University Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 75 EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 2/8/2018 4:25 PM via BROWN UNIVERSITY AN: 353101 ; Cantor, Norman L..; After We Die : The Life and Times of the Human Cadaver Account: rock 76 | Decomposition of the Body Natural Deterioration Left on its own, a corpse will unfailingly putrefy and disintegrate. The process begins within minutes of death. The most immediate and obvi- ous transformation is in flesh color. A corpse promptly takes on the pal- lor of death. To quote Sherwin Nuland, “A man’s corpse looks as though his essence has left him, and it has.”1 Blood drains from the surface capil- laries and enters the deeper veins, leaving the skin paler than in life. However, not all of the skin surface remains pale. Within a couple of hours, gravity and deoxygenation come into play. Blood accumulates in the lower body parts, creating there a purple discoloration known as “livor mortis.” That lower flesh darkens to red “before progressing through shades of purple and blue” as oxygen disappears from the blood.2 By ten hours after death, that purple stain becomes fixed until the discoloration disappears in the embalming process when blood is drained from the corpse. (Livor mortis is discussed more fully in chapter 8 in the context of forensic analysis of the corpse.) Another color change occurs in an uncleansed corpse. Within forty-eight hours a greenish- black palette of bacteria growth appears on patches of skin. The consistency or rigidity of the body mass also changes upon death. Immediately upon death, most muscles become flaccid, as is often demonstrated by the lower jaw of the corpse falling open. The body then has the consistency of a cut of meat in a butcher’s display case. That sta- tus changes quickly. Within one to six hours after death the process of “rigor mortis,” that is, stiffening of the muscles, begins. The stiffening is caused by the disappearance of a chemical in the muscles that assisted muscle contraction. Over a period of four to ten hours after onset, rigor mortis spreads from the face downward to the legs. Full rigor occurs within twelve hours of onset and the body is then stiff (the obvious ori- gin of the nickname “stiff”).3 The temporary stiffness can be overcome with force, that is, massage and manipulation of extremities, but the muscles shortly begin to relax anyway.4 Within several more hours rigor mortis ends. The muscle relaxation rate depends on many variables, in- cluding temperature, but is often complete within twenty-four to thirty- six hours after death.5 The physiological change that compels artificial intervention and/or prompt disposal of a corpse is putrefaction. The precise rate of decay Copyright © 2010. Georgetown University Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 2/8/2018 4:25 PM via BROWN UNIVERSITY AN: 353101 ; Cantor, Norman L..; After We Die : The Life and Times of the Human Cadaver Account: rock Natural Deterioration | 77 depends on variables such as weight, temperature, moisture, and oxy- gen. Putrefaction—the dissolution of the corpse into liquids and gases— generally begins within minutes of death and becomes noticeable within two to three days.6 Cells within the body begin to break down and to disperse in liquid form proteins, carbohydrates, acids, and enzymes, among other things. Bacteria colonies present in the body, especially in the large intestine, multiply, break through internal walls into the abdo- men, and spread through the now passive circulatory system. “Blood is a fertile sea in which bacteria swarm and multiply.”7 The bacteria feast on the cells’ by-products. The microbial action of the bacteria, together with the destructive enzymes flowing from cell breakdown, gradually liquefies soft tissue.8 Organs are the first parts to liquefy, starting with the eyes and proceeding to the brain, stomach, and liver. Bacteria and enzymes continue to devour fatty tissue, muscle tissue, and connective tissue. The conversion of tissue to liquid starts by the seventh day after death and extends over weeks, months, or years, depending on the sur- rounding conditions. Temperature is an important variable. Higher tem- peratures speed up the decay process, while lower temperatures retard it. Artificial interventions such as chilling, freezing, or embalming delay decay. The bacteria that spread in the body have additional noticeable ef- fects. Within days, the bacteria-caused decay in tissue produces foul- smelling gases and liquids. The gases, including hydrogen sulfide, sulfur dioxide, methane, and ammonia, not only produce a stench but also cause the corpse to bloat. By the fourth or fifth day, gases have begun to inflate the trunk, tongue, eyes, breasts, and genitals.9 The foul odor of death has by now permeated surrounding rooms. In the second week, the gas pressure can make the abdomen, scrotum, breasts, and tongue swell and the eyes bulge.10 The gas pressure can also cause liquid to ooze from the nose, mouth, and other orifices and can make intestines pro- trude from the anus and vagina. Organs swollen by gases may begin to rupture and liquefy. Eventually gas pressure is capable of bursting the thoracic or abdominal cavities. Before embalming was common, sealed coffins sometimes exploded because of gas pressure. Decomposition of the corpse’s internal organs is paralleled by sur- face deterioration. By seven days after death, large blisters appear on a deteriorating corpse’s skin. These patches eventually loosen, and the top Copyright © 2010. Georgetown University Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 2/8/2018 4:25 PM via BROWN UNIVERSITY AN: 353101 ; Cantor, Norman L..; After We Die : The Life and Times of the Human Cadaver Account: rock 78 | Decomposition of the Body layer of skin detaches. After three or four weeks, hair and nails loosen as soft tissue decays and is converted to a semiliquid state.11 Because an unattended cadaver becomes repulsive within four or five days of death, steps are commonly taken to retard the putrefaction process and to make the body presentable to observers during the period between death and ultimate disposal of the cadaver. Those steps usually begin immediately upon discovery of death. At the outset, they include cleaning and possibly chilling the cadaver. Consider a hospital nurse’s duties after medical certification of death. The nurse must notify both hospital personnel and the patient’s family. The nurse draws the curtains, closes the corpse’s eyes and mouth, washes the body, withdraws invasive devices (unless an autopsy is like- ly), labels the body and lays it out, as if asleep, for viewing (when that is likely) or places the body in a mortuary bag and seals it. The corpse will be transported either to the hospital morgue to await pickup (or, in lim- ited circumstances, autopsy) or directly to a funeral home. The morgue is chilled to between 35 and 46 degrees Fahrenheit. If death occurs in a private dwelling, a representative of a hired funeral parlor customarily arrives within hours to bag the body and transport it to the funeral home. At the funeral home, the funeral director—formerly known as the “undertaker”—prepares the cadaver for ultimate disposal. As in the hospital, early tasks are cleaning and dis- infecting the surface; chilling will also occur if the body is to be preserved for disposition without embalming. At the funeral parlor, a common next step is embalming. The pri- mary object of embalming is to delay the putrefaction process long enough to facilitate the coming disposal steps by warding off odors, leakage, and other unpleasantness.12 Embalming involves infusing a liq- uid preservative into the corpse to inhibit decay.