Signs of drowning. Morphological signs of drowning Signs of intravital drowning

Signs of drowning:

Pronounced goose bumps over the entire surface of the body due to contraction of the muscles that lift the hair under the influence of cold water.

Persistent white finely bubbled foam, reminiscent of cotton wool, at the openings of the mouth and nose, as well as in the respiratory tract (S.V. Krushevsky’s sign).

The detection of foam at the openings of the nose, mouth and respiratory tract is a valuable sign indicating active respiratory movements during the process of drowning.

Acute bloating of the lungs - water presses on the air in the alveoli and bronchi, preventing the lungs from collapsing.

Rasskazov-Lukomsky spots (A. Paltauf) - light hemorrhages Red, up to 0.5 cm in diameter under the pulmonary pleura (not formed in sea water).

Presence of drowning fluid in the sinus of the sphenoid bone (V.A. Sveshnikov’s sign)

Lyphogeny is the reflux of red blood cells into the lymphatic thoracic duct.

Large volumes of fluid in the abdominal and chest cavities (Moro's sign).

The presence of a significant amount of liquid from the drowning environment mixed with sand, silt, and algae in the stomach and small intestine (Fegeerlund’s sign).

Hemorrhage into the eardrums, mastoid cells, mastoid caves, and into the middle ear cavity. Hemorrhages have the form of free accumulations of blood or abundantly permeate the mucous membrane, which in this case is swollen, full-blooded, dark red, bruising (K. Ullrich’s sign).

The presence of plankton in the blood and internal organs. Laboratory research on plankton is primarily carried out from rotten corpses.

Plankton (or diatoms) from the lungs of a living person are carried throughout the body through the bloodstream. A positive result will be if diatoms are found in bone tissue. It is necessary to remember that before collecting water, the dishes are washed with distilled water and for mandatory control, water is taken from the reservoir.

When examining a corpse removed from water, the question often arises about the duration of its stay in the water.

Typically, an expert will answer this question based on the degree of maceration (softening due to soaking in water) of the skin and the severity of decay processes.

In this case, the water temperature and other conditions of the corpse’s presence in the reservoir must be taken into account. Maceration develops in warm water faster than in cold. The hair on the head is easily pulled out from 10-20 days, and at a later date it falls out on its own.

While the corpse is under water, putrefactive decomposition proceeds slowly, but as soon as the corpse floats to the surface of the water, decay develops much faster. If this happens in the summer, then a few hours after surfacing the corpse turns into a giant one due to the rapid formation of putrefactive gases. Based on the signs of the corpse being in the water, one can presumably judge the time of death.

Signs of a corpse being in water:

Maceration of fingertips - 2-3 hours;

Maceration of palms and soles - 1-2 days;

Maceration of the dorsal surface - a week;

Shedding of the skin (gloves of death) - a week;

Algae on the body - a week;

Baldness - month;

The beginning of the formation of adipose wax is 3-4 months;

Transition of a corpse into adipose wax - 1 year;

Pink coloration of cadaveric spots (due to loosening of the epidermis and improved access of oxygen to cadaveric spots)

Peculiarities of external examination of a corpse in cases of death from closure of the respiratory tract with liquid (drowning)

The protocol notes where the corpse is located, in what liquid, at what depth, which parts of it are above the surface of the liquid, whether the corpse floats freely or is held by objects surrounding it, indicate which parts of the body come into contact with these objects and how the body is held.

This scheme should be followed if a corpse immersed in liquid is being examined.

Removing the corpse from the liquid must be done with great care, without causing additional damage.

If it was not possible to avoid such damage (when pulling out the body with hooks or crampons), the method of removing the corpse should be specified in the protocol and the cause of the damage should be indicated, as well as a thorough description should be made.

When examining the corpse’s clothing, the expert notes the degree of moisture, its suitability for the season (helps to establish the time when the drowning occurred), contamination, and the presence of any heavy objects in the pockets (stones, sand) that contribute to the rapid immersion of the body.

During examination, describe the presence or absence of white foam around the openings of the mouth and nose (indicate that the body has been exposed to liquid during life, usually persists for 3 days); the condition is noted skin(their pallor, the presence of “goose bumps”) when describing cadaveric spots, we pay attention to their color. produce a description of maceration phenomena that are important for establishing the length of stay of a corpse in water. In cases where the body is overgrown with algae, the degree of their distribution on the surface of the body (which parts of the corpse are covered) and the general appearance (length, thickness, strength of connection with the skin, etc.) are described.

The description of algae at the scene is important, along with signs of maceration.

When describing damage, it is necessary to pay attention to identifying signs indicating the possibility of causing this damage by aquatic inhabitants. If other damage is discovered, it should be borne in mind that they can be caused posthumously by steamship propellers and oars. The question of their intravital or posthumous origin is finally resolved during a forensic medical examination of the corpse.

Issues resolved by forensic medical examination in case of drowning:

Was death really due to drowning?

2.What liquid did the drowning occur in?

What circumstances contributed to the drowning?

How long was the corpse in the liquid?

When did death occur - while in the water or before entering the water?

If damage is found on the corpse, did it occur before it entered the water or could it have occurred while the corpse was in the water and how?

The main features from the monograph by V.A. Sundukov are given. "Forensic medical examination of drowning" see.

Signs characteristic of drowning in water (compendium) / Sundukov V.A. — 1986.

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Signs characteristic of drowning

Signs revealed during external examination of the corpse:

1. Persistent fine bubble foam around the openings of the nose and mouth (Kruszewski's sign) in the form of lumps resembling cotton wool (“foam cap”), is the most valuable diagnostic sign of drowning. At first, the foam is snow-white, then it takes on a pinkish tint due to the admixture of blood liquid. Foam is formed during drowning due to the mixing of mucus with water and air. It consists of a framework in the form of mucus, exfoliated epithelial cells and its own foam covering the framework. When the foam dries, traces of it remain around the openings of the nose and mouth. If there is no foam on a corpse removed from the water, then it is recommended to apply pressure to the chest, after which it may appear. Usually the foam disappears after 2-3 days, and only sanguineous fluid is released from the openings of the nose and mouth of the corpse due to the development of the processes of imbibition and hemolysis.

2. Due to an increase in lung volume (with the development of hyperhydroaeria), the circumference increases chest, as well as smoothing the supra- and subclavian fossae and reliefs of the clavicles.

3. The color and severity of cadaveric spots may vary depending on the type of drowning. Thus, Bystrov S.S. (1974) with the “true” type of drowning found the cadaveric spots paler, blue-purple in color with a pinkish or reddish tint, and with the asphyxial type they were abundant, dark blue, dark purple in color. Due to the loosening of the epidermis, oxygen penetrates into the blood of the superficial vessels of the skin, which leads to the formation of oxyhemoglobin (from reduced hemoglobin), so cadaveric spots quickly take on a pinkish color. When the corpse is partially immersed in water at the level of the boundary line, a bright red stripe with a bluish tint is observed, gradually turning into the color of the upper and lower areas of the corpse spots. Sometimes during drowning, cadaveric spots appear evenly over the entire surface of the corpse (and not just in the underlying sections as usual) due to the movement (turning over) of corpses by the flow of water.

4. The color of the skin of the face, neck and upper chest also changes depending on the type of drowning (S.S. Bystraya). With the “true” type, the skin of the named areas is pale blue or pinkish-blue in color, and with the asphyxial type, it is blue or dark blue.

5. Hemorrhages in the conjunctiva and sclera can be detected, as well as gelatinous swollen folds of the conjunctiva due to their edema.

6. Puffiness of the face is sometimes noted.

7. It is less common to see traces of defecation. Individual external signs: the nature and color of cadaveric spots, coloring of the skin of the face, neck, upper chest, hemorrhages (in the conjunctiva and sclera, puffiness of the face and traces of defecation - are not signs characteristic only of drowning, they are equally found in other types of mechanical asphyxia.

Signs revealed during internal examination (autopsy) of a corpse

1. In the lumen of the trachea and bronchi, fine-bubble persistent foam is found, which in the “true” type of drowning has a pinkish color, sometimes mixed with blood and water; priasphyktic type - this foam appears white (S. S., Bystrov).

2. Upon opening chest cavity The sharply increased volume of the lungs attracts attention. They completely fill the pleural cavities. Their anterior sections cover the cardiac shirt. Their edges are rounded, the surface has a variegated “marble” appearance: light gray areas alternate with light pink ones. Stripe-like imprints of ribs may be visible on the surfaces of the lungs. When discharged from the chest cavity, the lungs do not collapse. Lungs don't always look the same. In some cases (with the asphyxial type of drowning) we are dealing with the so-called “dry swelling of the lungs” (hyperaeria) - this is a condition of the lungs when they are sharply swollen, but on the cut they are dry or do not drain from the surfaces. a large number of liquids. Hyperaeria depends on the penetration of air into the tissue under the pressure of liquid. There is a strong degree of swelling of the alveoli. This is accompanied by stretching and rupture of the alveolar walls and elastic fibers, often expansion of the lumens of the small bronchi and, in some cases, the entry of air into the interstitial tissue. There are a small number of areas of tissue edema. The surface of the lungs is uneven and motley. The fabric feels spongy to the touch. It is dominated by small limited hemorrhages. The weight of the lungs is not increased compared to the norm. In other cases (with the “true” type of drowning), “wet swelling of the lungs” (hyperhydria) occurs - this is the name for the condition of the lungs of a drowned person, when a large amount of fluid flows from the surface of the cuts. watery liquid, the lungs are heavier than usual, but airy everywhere. Noted average degree swelling of the alveoli, the presence of a large number of foci of edema and large diffuse hemorrhages. The surface of the lungs is smoother, the tissue is less variegated, and has a doughy consistency to the touch. The weight of the lungs exceeds normal by 400 - 800 g. Hyperhydria is less common than hyperairia; It is believed that it occurs when a person falls under water after a deep exhalation. Depending on the state of the foci of bloating and edema, a third form of acute pulmonary bloating is distinguished - intermediate, which is also characterized by an increase in lung volume. When palpating, there is a feeling of crepitation in some places, and in some places the consistency of the lungs is doughy. Foci of swelling and edema alternate more evenly. The weight of the lungs increased slightly, by 200-400g. Microscopic examination of the lungs during drowning should look for areas of acute swelling and areas of edema. Acute bloating is recognized by a sharp expansion of the lumen of the alveoli; the interalveolar septa are torn, and “spurs” protrude into the lumen of the alveoli. Foci of edema are determined by the presence in the lumen of the alveoli and small bronchi of a homogeneous pale pink mass, sometimes with an admixture of a certain amount of red blood cells. Next, when studying the lungs, you need to pay attention to the blood filling of the vessels. When drowning, it is expressed unevenly. According to the air areas, the capillaries of the interalveolar septa are collapsed, the tissue appears anemic, in areas of edema, on the contrary, the capillaries are dilated and full of blood. Microscopic picture pulmonary tissue during drowning is supplemented by the presence of foci of atelectasis and the presence of hemorrhages in the interstitial tissue; the latter are limited and diffuse. In addition, plankton elements and mineral particles can be found in the small bronchi and alveoli, particles vegetable fiber etc.

3. Rasskazov-Lukomsky-Paltauf spots in case of drowning - important diagnostic sign- are large vague hemorrhages in the form of spots or stripes under the pleura of the lungs, having a pale pink, pale red color. However, this sign is not constant.

4. The presence of fluid in the stomach in which drowning occurred (Fegerlund’s sign); with the asphyxial type there is a lot of fluid, with the “true” type there is little. Water may also be present in the initial part of the intestine. The presence of impurities in the gastric contents of silt, sand, algae, etc. has a certain diagnostic significance. During lifetime ingestion, up to 500 ml of liquid can be detected in the stomach. Possibility of post-mortem penetration of fluid into the gastrointestinal tract intestinal tract most authors reject it (S. S. Bystrov, 1975; S. I. Didkovskaya, 1970, etc.).

5. In the sinus of the main bone, liquid (5.0 ml or more) is found, in which drowning occurred (V. A. Sveshnikov, 1961). When laryngospasm occurs (asphyxial type of drowning), the pressure in the nasopharynx cavity decreases, this leads to the entry of the drowning medium (water) into the sinus of the main bone through the pyriform slits. In the left half of the heart, blood is diluted with water and has a cherry-red color (I. L. Kasper, 1873). Hemorrhages in the muscles of the neck, chest and back (hemorrhages in the sternocleidomastoid muscle, Paltauf; hemorrhages in the muscles of the neck and back - Reuters, Wachholz) as a result of severe tension in the muscles of a drowning person while trying to escape.

6. Edema of the liver, bed and wall of the gallbladder and hepatoduodenal fold F. I. Shkaravsky, 1951; A.V. Rusakov, 1949). On microscopic examination, liver edema is expressed by expansion of the pericapillary spaces and the presence of protein masses in them. Swelling may be uneven. In those places where it is significant, intralobular capillaries and central veins are full of blood. In the crevices and lymphatic vessels of the interlobular connective tissue swelling reveals a homogeneous pale pink mass. Edema of the gallbladder is often diagnosed macroscopically. In some cases, it is found during microscopic examination - in this case, a characteristic state of the connective tissue of the bladder wall is revealed in the form of moving apart, loosening of collagen fibers, and the presence of pink liquid between them.

Signs detected in laboratory tests

These include signs associated with intravital penetration of the drowning environment (water) into the body and changes in the blood and internal organs caused by this environment (water):

1. Detection of diatom plankton and pseudoplankton in the blood, internal organs (except lungs) and in bone marrow.
2. Positive “oil test” by S. S. Bystrov - identifying traces of technical fluids (petroleum products).
3. Identification of quartz-containing mineral particles (B. S. Kasatkin, I. K. Klepche).
4. Difference between blood freezing points in the left and right heart (cryoscopy).
5. Establishing the fact and degree of blood dilution in arterial system and in the left heart (electrical conductivity study and refractometry).

Signs characteristic of drowning:

• fine-bubbly persistent foam at the openings of the mouth and nose (Krushevsky’s sign);
• increase in chest circumference;
• smoothing of the supra- and subclavian fossae;
• the presence of pinkish persistent fine bubble foam in the lumen of the trachea and bronchi;
• “wet swelling of the lungs” (hyperhydria) with rib marks;
• fluid in the stomach and upper small intestine mixed with silt, sand, algae (Fegerlund's sign);
• in the left half of the heart, blood diluted with water is cherry-red in color (I. L. Kasper);
• Rasskazov-Lukomsoky-Paltauf spots;
• fluid in the sinus of the main bone (V. A. Sveshnikov);
• swelling of the bed and wall of the gallbladder and hepatoduodenal fold (A. V. Rusakov and P. I. Shkaravsky);
• hemorrhages in the muscles of the neck, chest and back as a result of severe muscle tension (Paltauf, Reiter, Wahgolp);
• the visceral pleura is somewhat cloudy;
• air embolism of the left heart (V.A. Sveshnikov, Yu.S. Isaev);
• lymphohemia (V.A. Sveshnikov, Yu.S. Isaev);
• liver swelling;
• compression fracture of the cervical spine;
• ruptures of the gastric mucosa;
• detection of diatom plankton and pseudoplankton in the blood, internal organs (except lungs) and bone marrow;
• identification of traces of technical fluids - a positive “oil test” (S. S. Bystrov);
• identification of quartz-containing mineral particles (B. S. Kasatkin, I. K. Klepche);
• difference in blood freezing points in the left and right heart (cryoscopy);
• statement of the fact and degree of blood dilution in the arterial system, left heart (refractometry, electrical conductivity study).

Signs characteristic of a corpse being in water:

• "goose pimples";
• pale skin;
• nipples and scrotum wrinkled;
• hair loss;
• maceration of the skin (wrinkling, pallor, “washerwoman’s hand”, “gloves of death”);
• rapid cooling of the corpse;
• signs of rotting;
• presence of signs of fat wax;
• presence of signs of peat tanning;
• detection of traces of technical fluids (oil, fuel oil) on the clothing and skin of a corpse.

Common (“similar”) signs - general asphyxia and drowning:

• hemorrhage in the conjunctiva and white membrane of the eyes;
• cadaveric spots of dark blue or blue-purple color with a violet tint;
• the skin of the face, neck, upper chest is pale blue or dark blue in color with a pinkish tint;
• puffiness of the face;
• traces of defecation; “dry swelling of the lungs” (hyperaeria), subpleural ecchymosis (Tardier spots);
• liquid blood in the vessels and heart;
• overflow of blood in the right half of the heart;
• plethora of internal organs;
• congestion of the brain and its membranes;
• anemia of the spleen;
• emptying Bladder.

General (“similar”) signs of a corpse being in water and drowning:

• cadaveric spots are pale, blue-purple with a pinkish or reddish tint;
• swelling and swelling of the folds of the conjunctiva;
• swelling and maceration of the mucous membrane of the larynx and trachea;
• fluid in the middle ear cavity with a perforated eardrum;
• the presence of silt, sand, and algae in the upper respiratory tract;
• fluid in the abdominal cavity (Moro's sign) and pleural cavities.

Sign of Sveshnikov V.A. - the presence of fluid (drowning medium) in the sinus of the sphenoid bone. Having removed the pituitary gland, rinse the back of the sella turcica from a syringe with distilled water, use a small chisel to cut a small window into the sinus of the main bone, through which the liquid located there is extracted using a syringe needle (washed, like the chisel, with distilled water).

In case of drowning, its amount reaches 0.6-5 ml, which does not happen in other types of death. A drop of this liquid is applied to the slide either directly or after enrichment.

Under a microscope, you can find plankton, plant spores, microorganisms and even protozoa in it, which are found in 65-80% of deaths from drowning and are an indicator of the lifetime of drowning.

The trait was described in 1958(?).

Sources

Sveshnikov V.A. About a new sign in the diagnosis of drowning // Forensic medical examination and criminology in the service of investigation (collection of works). - Stavropol, 1965. - 4. - P. 348-350.

Drowning- this is the closure of the respiratory openings of the mouth and nose by immersing the face in a liquid or semi-liquid medium, causing closure of the airways or reflex closure (spasm) of the glottis, accompanied by disruption or cessation of external respiration and causing death by strangulation.

Drowning can occur while swimming in fresh and salt water, in various reservoirs, rivers, lakes, the sea, a bathtub, falling into a puddle, liquid mud, falling into various containers filled with technical or food liquids, semi-liquid masses, and sewage.

Drowning is promoted by intoxication, overwork, hypothermia, increased sweating, overheating of the body, overfilling of the stomach with food, a sharp change in blood circulation conditions in water, increased stress on the cardiovascular system, mental factors, diseases of the cardiovascular and nervous systems, injuries.

Swimming in cold water or prolonged exposure to relatively warm water can lead to convulsive contractions of certain muscle groups. This reaction occurs when swimming in one style for a long time, a feeling of fear, and panic. Occasionally, the so-called “immersion syndrome” (water, ice or cryogenic shock) occurs, which occurs due to a sharp temperature change that causes overirritation of skin thermoreceptors, vascular spasm, cerebral ischemia and reflex cardiac arrest.

Most often, drowning is caused by injuries caused by incompetent diving, diving in a shallow place, hitting objects on the water, in the water and at the bottom. Sometimes there is damage from parts of water transport. Damage caused by sharp tools and firearms is extremely rare.

The sudden and rapid immersion of a person in water, depending on the low temperature of the water compared to the body and the surrounding air, hydrostatic pressure changing with the depth of immersion, psycho-emotional stress, causes certain changes that determine the type of drowning and the genesis of death.

Drowning can occur in several types. Among them are: aspiration (true, wet drowning), spastic (asphyxial, dry drowning), reflex (syncope) and mixed types.

Death in water sometimes occurs due to diseases (myocardial infarction, non-traumatic cerebral hemorrhage), as well as injuries not related to drowning.

The pattern and duration of drowning is influenced by a number of conditions, such as the temperature of the water, fresh or salty, the speed of the current, waves, training in cold water, the will to live.

The aspiration type is characterized by filling of the respiratory tract and alveoli with fluid and a significant dilution of the blood by the absorbed fluid. This type of drowning occurs in several phases, just like mechanical asphyxia.

At the onset of true (wet) drowning, the person is conscious and fighting for his life. Trying to escape, thanks to the movements of his arms and legs, he either floats to the surface, then plunges into the water again, screams, calls for help, and grabs onto surrounding objects.

When immersed in water, a person instinctively holds his breath (pre-asphyxial period) for different times, due to the state of health and training (about 1 min), tries to surface.

On the surface it takes convulsive breaths and makes chaotic swimming movements. Due to the increasing lack of oxygen in the body, involuntary respiratory movements appear. The accelerated breathing rate during surfacing increases tissue oxygen consumption. Respiratory failure is aggravated by aspiration of even small amounts of water, coughing in response to irritation of the trachea, and bronchospasm. Then comes deep breath(inspiration), and water under pressure enters the mouth, nose, larynx, trachea and bronchi, causing irritation of the receptors of their mucous membranes, which is transmitted to the cerebral cortex, where the process of excitation occurs. Overirritation of the mucous membranes leads to the release of a large amount of mucus containing protein, which during breathing mixes with water and air, forming a persistent grayish-white or pinkish foam, colored in this color by an admixture of blood from the ruptured blood vessels of the alveoli (stage of inspiratory dyspnea).

Taking convulsive breaths while surfacing, a person can swallow water. A full stomach makes it difficult for the diaphragm to move. Physical stress and fear further increase oxygen deficiency, irritating the respiratory center. Involuntary respiratory movements occur under water (stage of expiratory dyspnea). Following this reflexively a deep exhalation occurs, expelling the air contained there along with the water from the respiratory tract. At 3-4 minutes, widespread protective inhibition of the cortex occurs. By this time, consciousness is usually lost, air bubbles appear on the surface of the water and the person sinks to the bottom. In the middle or end of the second minute after immersion in water, general convulsions occur due to the spread of overexcitation processes throughout the cortex and their capture of the motor zones of the cortex, and reflexes are lost. The person becomes motionless. Next, the waves of initial motor excitation begin to descend into lower departments central nervous system and, reaching the cervical part of the spinal cord, cause a series of deep, but rare breaths with wide open mouth(so-called terminal respiratory movements). Water, when swallowed, enters the stomach and the initial part of the small intestine. At the stage of terminal respirations, it enters in a wide stream airways under pressure that increases with the depth of the body's immersion, filling the bronchi and alveoli. Due to high pulmonary pressure, dilation of the alveoli develops - alveolar emphysema. Water enters the tissue of the interalveolar septa, breaks the walls of the alveoli, penetrates the lung tissue, displaces the air in the bronchi, and mixes with the air contained in the lungs (normally up to 2.5 liters). Through capillaries, water enters the vessels of the pulmonary circulation, significantly diluting the blood and hemolyzing it. Blood diluted with water penetrates the left half of the heart, and then into the systemic circulation. A final cessation of breathing occurs, soon the heart stops working, and after 5-6 minutes death occurs from lack of oxygen (Fig. 281).

When examining a corpse in cases of wet drowning, paleness of the skin is observed, resulting from spasm of the skin capillaries, goose bumps caused by contraction of the muscles that lift the hair, grayish-white or pink persistent fine bubble foam around the respiratory openings of the nose and mouth, described by the Russian scientist Krushevsky in 1870 It occurs as a result of mixing air with a large amount of mucus containing protein, released due to irritation of the mucous membrane of the respiratory tract with water. This foam lasts up to 2 days. after removing the corpse from the water, and then dries to form a film. Its formation is facilitated by the leaching of a surfactant (sulfactant) from the surface of the alveolar epithelium, which ensures the straightening of the alveoli during breathing, which was noted by the Ukrainian scientist Yu.P. Zinenko in 1970

The presence of foam indicates active respiratory movements during drowning. Due to the rupture of blood vessels in the alveoli, the released blood turns the foam pinkish.

The spastic type is caused by persistent reflex laryngospasm, which closes the entrance to the respiratory tract due to irritation of the respiratory tract receptors by water.

This type of drowning occurs when water with a temperature of about 20 ° C suddenly enters the upper respiratory tract. Water irritates the mucous membranes and endings of the superior laryngeal nerve, leading to spasm vocal cords and reflex cardiac arrest. Spasm of the vocal cords closes the glottis, which prevents water from entering the lungs during a dive and air from leaving the lungs when surfacing. A sharply increased intrapulmonary pressure causes acute asphyxia, accompanied by loss of consciousness. The phases of deep and atonal breathing are manifested by intense movements of the chest. Sometimes there may be no terminal pause. Due to the decline in cardiac activity, conditions are created for the development of pulmonary edema, a violation of the permeability of the alveolar-capillary membranes, which causes the entry of blood plasma into the air spaces of the final units of the lungs (alveoli), which, mixing with air, forms a persistent fine-bubble foam. Edema may be caused by mechanical damage membranes due to a drop in intrapulmonary pressure due to intense false inspiration with a closed glottis.

Sometimes a small amount of fluid enters the airways, which is quickly absorbed, especially in cases of drowning in fresh water, and does not cause blood thinning. On the cut, the lungs are dry, and therefore such drowning is called asphyxial, or dry, or drowning without aspiration of water.

The likelihood of laryngospasm depends on age, body reactivity, gender, water temperature, contamination with chemical impurities, chlorine, sand, shells and other suspended particles. Laryngospasm is most often observed in women and children.

When examining the corpse, pay attention to the blue-purple color of the skin, especially in upper sections body, abundant confluent cadaveric spots, hemorrhages in the skin of the face and mucous membrane of the eyelids, dilation of the vessels of the white membrane of the eyes. Occasionally, white fine-bubble foam is found around the openings of the nose and mouth.

An internal examination reveals severe emphysema of the lungs, their fluffiness, multiple pinpoint hemorrhages under the organ pleura, epicardium, in the mucous membrane of the respiratory and urinary tract, gastrointestinal tract against the background of dilated vessels. Rasskazov-Lukomsky-Paltauf spots are absent. The right ventricle of the heart is filled with blood. Blood in the heart may be in the form of clots, especially in the case of alcohol intoxication. The stomach usually contains a significant amount of watery contents, and the internal organs are filled with blood.

Sometimes drowning begins as an asphyxial type, and ends as a true drowning, when laryngospasm is resolved by water penetrating the respiratory tract and lungs. You can distinguish true insulation from false insulation by the signs given in table. 26.

Occasionally, signs of asphyxial and true drowning are absent. This kind of drowning is called reflex (syncope). This type is associated with rapid reflex cessation of breathing and primary cessation of cardiac activity as a response of the body to the aquatic environment in extreme conditions(water shock, allergic reaction for water, etc.).

It occurs from the action of cold water on the body, which increases spasm of blood vessels in the skin and lungs. Contraction of the respiratory muscles occurs, resulting in severe disturbances in breathing and cardiac activity, brain hypoxia, leading to the rapid onset of death even before the development of drowning itself. Syncopal type drowned contribute to: emotional shock immediately before immersion in water (shipwreck), hydroshock caused by exposure to very cold water on the skin, laryngopharyngeal shock from the action of water on the receptor fields of the upper respiratory tract, irritation of the vestibular apparatus by water in people with a perforated eardrum.

Death in the waterrarely occurs in expert practice. As a rule, it is observed in people suffering from diseases of cardio-vascular system(angina pectoris, post-infarction cardiosclerosis, acute coronary and respiratory failure), pulmonary tuberculosispneumosclerosis,diseases of the central nervous system (ethilepsy and mental disorders). The cause of death in water for divers can be barotrauma of the lungs, nitrogen narcosis, oxygen starvation, oxygen poisoning, subarachnoid hemorrhage due to diseases of the cerebral vessels, allergic shock to water associated with the effect of an allergen in the water on a sensitized organism, fainting followed by a reflex caused by irritation by water nasopharynx and larynx, leading to drowning, prolonged exposure to water at a temperature of +20 ° C, causing progressive heat loss, leading to hypothermia, damage to the tympanic membranes with subsequent irritation of the middle ear by water and reflex cardiac arrest or water entering the middle ear through a perforated eardrum due to a previous disease, irritation of the vestibular apparatus, leading to vomiting and drowning, loss of orientation in survivors, irritation of water entering the mouth, upper respiratory tract ways, aspiration of vomit upon the onset of unconsciousness.

An internal examination reveals fluid in the tympanic cavities of the middle ear. It penetrates through the Eustachian tubes or a damaged eardrum. The same fluid is revealed when opening the sinuses of the frontal and basal bones of the skull. It enters these sinuses due to laryngospasm, which causes a decrease in pressure in the nasopharynx and the flow of water into the pear-shaped slits. The volume of water in them can reach 5 ml, which was first noticed and described by V.A. Sveshnikov (1965).

Drowning may be accompanied by an outpouring of blood into the tympanic cavities, mastoid cells and caves. It can be in the form of loose accumulations or abundant soaking of the mucous membranes. Their occurrence is associated with increased pressure in the nasopharynx, circulatory vascular disorders, which, in combination with severe hypoxia, lead to increased permeability of the vascular walls and bleeding.

The tympanic cavity contains sand and other foreign particles from the reservoir. Blood effusions are detected in the middle ear and eardrum.

When examining the corpses of drowned people, bilateral, located parallel to the longitudinal fibers, blood dissections of the sternocleidomastial and large pectoral muscles(Paltauf), broad and scalene muscles, as well as neck muscles (Reuters). They occur as a result of severe muscle tension during an attempt to escape from drowning. Occasionally, vomit is found around the nose and mouth and in their openings, indicating vomiting in the agonal period.

The mucous membrane of the entrance to the upper respiratory tract is reddened, swollen, sometimes with pinpoint hemorrhages, which is explained by the irritating effect of water.

The same foam as in the circumference of the mouth and nose is also detected in the respiratory tract. Sometimes foreign inclusions are found in it (sand, algae, silt, small and large stones), indicating drowning in a shallow place.

Foreign particles can penetrate into the corpse when they are in or remain in the body for a long time. muddy water, containing them, in reservoirs with fast currents, and therefore their evidentiary value is small. Large stones and pebbles that have penetrated deeply into the trachea indicate active aspiration during the convulsive period of drowning. Sometimes gastric contents are found in the respiratory tract, penetrating to the small bronchi. In such cases, it is necessary to note whether it is squeezed out of the bronchi on the incision. Its presence indicates vomiting in the agonal period. Occasionally, mucus is found in the respiratory tract. Foam in the respiratory tract can form as a result of pulmonary edema, during vigorous artificial respiration, mechanical asphyxia from compression of the neck with a noose or hands and, as a result, prolonged agony. The mucous membrane of the trachea and bronchi is edematous, cloudy, the foam is usually unstable and large-bubbly.

Lungs - large, completely fill the pleural cavities and sometimes “bulge” out of them, cover the heart, emphysematously swollen, increased in volume and sometimes in weight, which is explained by the penetration of fluid during wet drowning. The edges of the lungs are rounded, overlap each other, and sometimes cover the heart sac. On the surface of the lungs you can see imprints of the ribs, appearing traps, between which lung tissue acts in the form of ridges - “the lung of a drowned man.” Similar imprints are found on the posterolateral surfaces of the lungs. Such changes are explained by the pressure of water penetrating through the respiratory tract into the lungs on the air present there, which breaks the walls of the alveoli and passes under the pulmonary pleura, causing emphysema. Water penetrates to replace the displaced air. As a result, the lungs significantly increase in volume, exerting pressure from the inside on the chest, as a result of which transverse grooves appear on them - traces of pressure from the ribs.

An increase in lung volume occurs during vigorous and prolonged artificial respiration, which must be remembered when examining a corpse. Upper lobes and adjacent ones root of the lung the edges are usually dry and air-stretched. The organ pleura is cloudy, under it there are rather large diffuse reddish-pink spots with indistinct blurry boundaries, described independently of each other by Rasskazov (1860), Lukomsky (1869), Paltauf (1880) and received in the literature the name Rasskazov-Lukomsky-Paltauf spots. Their color and size are determined by the amount of water that has entered the systemic circulation through the torn and gaping capillaries of the interalveolar septa, and by hemolysis of the blood, as a result of which the diluted and hemolyzed blood becomes lighter, its viscosity decreases, it thins out, and the hemorrhages blur, acquiring fuzzy contours. The lungs become “marbled” due to the alternation of protruding pink and receding red areas. Drowning in sea water does not cause hemolysis, and they retain their normal color.

It feels light and doughy to the touch, reminiscent of a sponge soaked in water. With wet drowning, the lungs are distinguished by their enormous volume, with dry areas alternating with watery ones, and take on a gelatinous appearance. A foamy liquid similar to that contained in the respiratory tract flows from the cut surface of such lungs. The lungs are heavy, full of blood, with hemorrhages under the pulmonary pleura.

In cases of dry drowning, the lungs are emphysematously swollen, dry, under the pulmonary pleura, mucous membrane of the gastrointestinal tract, renal pelvis, bladder - Tardieu spots, which form during the period of inspiratory dyspnea. In the initial parts of the respiratory tract there may be particles of sludge, etc. The venous system is congested with blood with a small amount of dark red clots.

Drowning in sea water, which is a hypertonic environment in relation to blood, results in the release of blood plasma into the alveoli, which leads to rapid emergence pulmonary edema and pulmonary failure. The blood does not thin, its viscosity increases, there is no hemolysis of red blood cells, and Rasskazov-Lukomsky-Paltauf spots are not observed. Areas of atelectasis are combined with foci of emphysema and uneven blood supply.

Thinning of the blood contained in the cavity of the left ventricle is a consequence of intravascular hemolysis and is a valuable sign that occurs only when true drowning in fresh water, which quickly permeates the endocardium of the left ventricle and the intima of the aorta.

Examining the corpses of drowned people, F.I. Shkaravsky drew attention to the swelling of the liver, bed and walls of the gallbladder of drowned people.

As a result of stagnation and an increase in the volume of fluid in the bloodstream, the volume and weight of the liver increase.

The sections are noticed by the large amount of liquid in the stomach, sometimes mixed with silt, sand, and aquatic plants, which penetrate the stomach when swallowed during drowning. The same fluid is found in the duodenum, where it passes only through the intravital open pylorus as a result of increased reflex peristalsis, which can be considered a sign of drowning.

Overfilling of the stomach with swallowed water, especially sea water and polluted water, causes vomiting. On the gastric mucosa there are striped hemorrhages, as well as ruptures in the area of ​​the lesser curvature, resulting from vomiting in the agonal period or hitting the stomach with water. Occasionally, pinpoint hemorrhages occur under the pancreatic capsule.

Signs of a corpse being in water, accompanying signs of drowning, include: wet clothes covered with silt, sand with the presence in its folds of shells, fish, crayfish, water beetles, algae and fungi characteristic of a given body of water, sticky hair, sharp pallor of the skin, raised vellus hair (“goose bumps”), wrinkling of the breast nipples, areola of the breast and mammary glands, scrotum, glans penis, pink color of the skin at the edges of cadaveric spots, rapid cooling of the corpse, skin maceration phenomena, “bath hand”, “skin” laundress", "glove of death", "groomed hand", post-mortem hair loss, rapid development of decay, fat wax, post-mortem damage.

Sharp pallor of the skin is formed when immersed in cold water - below body temperature, which causes contraction of the blood vessels of the skin and pallor of its integument.

The pink color of the skin at the edges of cadaveric spots occurs due to swelling and loosening of the epidermis under the influence of water. This facilitates the penetration of oxygen through the skin, which oxidizes hemoglobin and turns it into oxyhemoglobin.

The pink color of the skin is also observed on the surface of the skin, free from cadaveric spots, if the body is removed from cold water, which was noted by E. Hoffman and A.S. Ignatovsky.

“Goose bumps” are formed when the skin is exposed to cold water or cold alone, and in some disorders of the nervous system - due to contraction of smooth muscles.

The surface of the skin is covered with multiple tubercles, the formation of which is caused by the contraction of smooth muscle fibers connecting the surface layers of the skin with the hair follicles. As a result, they lift them to the free surface of the skin, forming small tubercles at the places where the hairs emerge.

Irritation of the skin by water leads to a contraction of the muscle fibers of the breast nipples, the areola of the breast, and the scrotum, as a result of which their contraction occurs 1 hour after being in the water.

Their development is significantly influenced by the temperature of the environment, air, depth of the reservoir, concentration of salts in the environment (fresh or salty), mobility of water (standing or flowing), flow speed, thermal conductivity of the environment, clothing, gloves and shoes.

Maceration is one of the signs of a corpse being in water. Maceration, or softening, is formed under the influence of water, as a result of which the epidermis becomes soaked, swells, wrinkles and gradually peels off on the palms and soles. Maceration is clearly visible in places where the skin is thick, rough, and calloused. It starts with the hands and feet. Initially, whitening and fine folding of the skin appear (weak maceration, “bath skin”), then a pearly white color and large folding of the skin (clear pronounced signs maceration - “washerwoman’s skin”. Gradually, complete separation of the epidermis occurs along with the nails (sharply expressed signs of maceration). The skin is removed along with the nails (the so-called “death glove”). After its departure, it remains devoid of epidermis, smooth skin(“sleek hand”).

Subsequently, maceration spreads to the entire body.

Warm running water accelerates maceration. Cold water, gloves and shoes hold it back. The degree of development of maceration allows us to roughly judge how long the corpse has been in the water. The literature presents different periods of appearance of initial and final signs of maceration without taking into account water temperature. The most complete terms of development of skin maceration depending on water temperature were studied by Ukrainian scientists E.L. Tunina (1950), S.P. Didkovskaya (1959), supplemented by I.A. Kontsevich (1988) and are presented in table. 27.

Due to loosening of the skin after about 2 weeks. hair loss begins and by the end of the month, especially in warm water, complete baldness occurs. In places where hair has fallen out, their holes are clearly visible.

The presence of vernix lubrication protects the skin of newborns from maceration. Its first signs appear by the end of 3-4 days, and complete separation of the epidermis - by the end of the 2nd months in summer and for 5-6 months. in winter.

A drowned person sinks to the bottom and at first, if there is no strong current, remains in place, but rot develops and the corpse floats to the surface.

Putrefactive changes begin to develop from the intestines, then the corpse floats up if there are no mechanical obstacles. The lifting force of putrefactive gases is so great that a load weighing 30 kg with a total weight of 60-70 kg is not an obstacle to ascent.

D.P. Kosorotov (1914) gives an example when a ship with 30 oxen in the hold sank in the ocean off the coast of India. All efforts to raise it from the water were in vain, but after a few days the ship floated to the surface due to the development of putrefactive gases in the corpses of the oxen.

In warm water, decay processes develop faster than in cold water. In small bodies of water with a water temperature of more than 22 °C, a corpse can float to the surface on the second day. IN middle lane In Russia, corpses float to the surface on the second or third day, depending on the water temperature. According to the Japanese researcher Furuno, from July to September, in cases of drowning at a depth of 1-2 m, the corpse floats up after 14-24 hours, at a depth of 4-5 m - after 1-2 days, at a depth of 30 m - after 3-4 days . In winter, corpses can remain in the water for up to several months. Rotting in water occurs more slowly than in air, but after removal from water, putrefactive processes proceed extremely rapidly. Within 1-2 hours after removing the corpse, the skin takes on a greenish color, cadaveric emphysema develops, the corpse begins to swell, the skin becomes dirty green, a putrefactive venous network and blisters appear. A foul odor emanates from the corpse. In corpses that are in water for 18 hours in summer and 24-48 hours in winter, along with whitening of the hands and feet, the light blue color of the skin turns into a brick-red color of the head and face to the ears and the upper part of the occipital region. The head, neck and chest acquire a dirty green color interspersed with dark red after 3-5 weeks in summer, after 2-3 in winter months In 5-6 weeks. in summer and winter more than 3 months the body is swollen with gases, the epidermis peels off everywhere, the entire surface takes on a gray or dark green color with a putrefactive venous network. The face becomes unrecognizable, the color of the eyes is indistinguishable. Determining the length of time a corpse spent in water becomes impossible in the summer after 7-10 weeks. and in winter after 4-6 months due to the development of putrefactive changes. If something prevents the ascent, then the rotting that has begun stops and the formation of adipose wax gradually occurs.

Occasionally, corpses removed from the water are covered with algae or fungi. In corpses in running water, vellus algae in the form of scattered shaggy areas are found on the 6th day, on the 11th day they are the size of a nut, on the 18th day the corpse is dressed as if in a fur coat of algae, which after 28- After 30 days they fall off, after which on the 8th day a new growth follows, which has the same course.

In addition to these algae, after 10-12 days, mucus-like fungi appear in the form of small red or blue circles with a diameter of 0.2-0.4 cm.

The presence of a corpse in water is judged by the presence of fluid in the tympanic cavity of the middle ear, in the sinuses of the main bone (V.A. Sveshnikov’s symptom), fluid in the respiratory tract, esophagus, stomach, small intestine, pleural (Krushevsky's symptom) and abdominal (Moro's symptom) cavities, plankton in the lungs when the skin is intact and in other organs in the presence of its damage.

Moro in the pleural and abdominal cavities discovered blood-colored liquid in an amount of up to 200 ml, which leaked into the pleural cavities from the lungs, and into the abdominal cavity from the stomach and intestines. How long the corpse has been in the water can be determined by the flow of fluid into the pleural cavities and the disappearance of signs of drowning. The presence of fluid in the pleural and abdominal cavities indicates that the corpse had been in water for 6-9 hours.

The enlargement of the lungs when the corpse is in water gradually disappears by the end of the week. Rasskazov-Lukomsky-Paltauf spots disappear after the corpse remains in water for 2 weeks. Tardieu spots are detected on the surface of the lungs and heart up to a month after drowning (Table 28).

Laboratory diagnostics for drowning

Many laboratory methods have been proposed for the diagnosis of drowning. Among them, the most widespread are microscopic research methods - the histological method of studying diatoms plankton and pseudoplankton.

Plankton- the smallest organisms of plant and animal origin found in tap water, water from various bodies of water, and in the air. They are characteristic of a given reservoir and have specific features. In the diagnosis of drowning, phytoplankton, and especially diatoms, are of greatest importance. Their shell consists of silicon, which can withstand high temperatures, strong acids and alkalis. The shape of the diatom is varied and typical for each body of water.

Plankton, along with water, enters the mouth, from there into the respiratory tract, lungs, from them through the vessels into left heart, the aorta and through the vessels spread throughout the body, lingering in the parenchymal organs and bone marrow ge long tubular bones(Fig. 282). Plankton persists for a long time in the sinuses of the main bone and can be found in scrapings from its walls. Along with water from the lungs, grains of sand and starch grains suspended in water, the so-called pseudoplankton, can also enter the bloodstream (Fig. 283). Until recently, methods for detecting plankton and pseudoplankton were considered the most convincing methods for diagnosing drowning. Their subsequent examination showed the possibility of post-mortem penetration of plankton elements into the lungs and other organs of the corpse with damage to the skin. Therefore, the detection of plankton and pseudoplankton has evidential value only if the skin is intact.

Currently, the histological method of studying internal organs has become widespread. The most characteristic changes are found in the lungs and liver. In the section of the lungs, foci of atelectasis and emphysema, multiple ruptures of the interalveolar septa with the formation of so-called spurs facing the inside of the alveoli, focal effusions of blood into the interstitial tissue, and swelling are revealed. In the lumen of the alveoli there are light pink masses with an admixture of a certain amount of erythrocytes.

In the liver, the phenomena of edema, expansion of precapillary spaces with the presence of protein masses in them. The wall of the gallbladder is swollen, collagen fibers are loosened.

A human corpse found or recovered from water may show a variety of injuries. Correct assessment their morphology and localization will allow you to correctly assess what happened and avoid wasting time searching for non-existent intruders. The main questions that an expert must answer are: by whom, during what, by what and how long ago the damage was caused.

The most common injuries occur during diving. They are formed when the jump technique is performed incorrectly, hitting objects on the path of the fall, objects in the water, hitting the water, hitting the bottom and objects on it and in it. Impacts on objects in the path of falling, located in water, and objects at the bottom cause extremely varied damage, reflecting the characteristics of the contacting surfaces and localized in any of the areas of the body, on any of its surfaces, sides, levels (Fig. 284).

When assessing them, it is necessary to take into account the position of the corpse in the water after death. The human body is somewhat heavier in specific gravity than water. The presence of small amounts of clothing and gases in the gastrointestinal tract allows the corpse to be known time at the bottom. A significant amount of gases in the gastrointestinal tract and developed during the process of decay quickly lifts the corpse from the bottom, and it begins to move under water and then floats to the surface. Persons in warm clothes sink to the bottom faster. The dressed corpses of men usually float face down, with their heads bowed, the corpses of women float face up, and their legs, weighed down by a dress, can be lowered below the head. This situation is explained by the anatomical structure of male and female bodies.

The impact of a stream of water at the moment of entering it sometimes causes ruptures of the eardrum. The entry of water into the middle ear cavity causes loss of orientation of movements in the water. Those who jump into the water experience ruptures of the eardrum, injuries in the lumbar region, contusions and dislocations of the spine in lumbar region due to bending of the body entering the water, spraining of ligaments and muscles, depression spinous processes of the vertebrae, spinal fractures from impact with water. If you fall into the water incorrectly, there may be bruises and ruptures of internal organs, shock, fractures of tubular bones, and dislocation of the shoulder joint.

Occasionally, the injuries found in victims are not fatal in themselves, but can cause a short-term loss of consciousness sufficient to cause drowning.

Hitting the water while entering it flat causes bruises, bruises and damage to internal organs, the severity of which is determined by the angle and height of the fall. A blow to the epigastric region of the abdomen or the external genital area sometimes causes shock, leading to death. An incorrectly performed “soldier” jump with legs spread apart causes bruises of the heels, scrotum, and testicles with the subsequent development of traumatic epididymitis. The “swallow” jump causes damage to the hands of one or both hands, any surface of the head, the chin, and at the handle of the sternum from a blow with the chin. Fractures of the base of the skull and spine are sometimes observed, accompanied by trauma to the brain and spinal cord, causing paralysis of the limbs due to the level of damage to the spinal cord.

Drowning in a shallow place is accompanied by the formation of abrasions on the limbs and torso from impacts on the bottom and objects located on it.

Parts of sea and river vessels cause a variety of damage, including body separation. The rotating propeller blades cause slash-like damage. The presence of several equally directed fan-shaped wounds indicates the action of propeller blades that have the same direction of rotation.

The significant time spent by a corpse under water in a stagnant body of water and developing putrefactive changes do not exclude the possibility of the corpse moving along the bottom and in various layers of water, dragging along the bottom with impact on various objects located in the water and on the surface. In bodies of water with running water, the listed damage can occur even before putrefactive changes develop. In mountain rivers and fast-flowing rivers, corpses sometimes travel a considerable distance. Depending on the topography of the bottom, objects on it and individual stones, rapids, driftwood, clothing and shoes are sometimes completely removed, and the remaining ones suffer from various damage caused by friction and snagging. Damage to a corpse caused by dragging and impact is localized on the skin, nails and even bones of any surface of the body. For water movement, transverse tears in the trouser legs are typical in the area knee joints, wear on the toes of shoes in men and heels in women, abrasions on the back of the hands. This localization and morphology of the damage is explained by the fact that the man’s corpse floats face down, and the woman’s – up. In these cases, cadaveric spots in men primarily form and are located on the face.

Damage caused by sharp objects can be caused by dragging along the bottom, but unlike sharp tools and weapons used to take life, these damages are isolated, superficial, localized in various areas bodies, including those inaccessible to one’s own hand.

Damage to corpses in water is sometimes caused by water rats, snakes, crayfish, fish, snails, stingrays, crabs, amphipods, birds, and leeches. Leeches cause typical damage, forming multiple T-shaped superficial wounds. Fish gnawing on a corpse leave funnel-shaped depressions on the skin. Crayfish and crustaceans can eat all soft tissues, penetrate cavities and eat all internal organs.

Atonal injuries occur in the final stages of drowning during convulsions. They manifest themselves as abrasions, broken nails, bruises on the forearms, abrasions on the anterolateral surfaces of the body, etc.

Attempts to provide assistance are accompanied by extensive abrasions on the lateral surfaces of the chest. Their presence indicates artificial respiration and chest compressions.

Damage from rough removal from the water with hooks, “crampons”, etc. are localized in any area of ​​the body and reflect the characteristics of their active part.

Inspection of the scene of a drowning incident

The investigator's protocol for examining the scene of the incident must reflect the temperature of the water and air, the mobility of the water, the speed of the current, the depth of the reservoir, the position of the corpse in the water - face up or down, and the method of removing the corpse from the water. The corpse is oriented in relation to the flow of the river, its turn or some other fixed landmark.

By examining the corpse, the presence or absence of objects holding the body on the surface of the water (life jacket, etc.) or contributing to its immersion (stones tied to the body, etc.) is noted.

Damage to clothing and shoes is described according to generally accepted schemes. Examining the skin, note its pallor or pinkish color, the presence or absence of goose bumps.

Particularly carefully at the scene of the incident are studied cadaveric phenomena, which, after removing the corpse from the water in the air, develop extremely quickly. The examination focuses on the color of the corpse's spots, which have a pinkish tint, indicating the presence of the corpse in water, their localization on the face and head, indicating the position of the corpse in the water, the degree of development of putrefactive changes, indicating where they are most pronounced, the presence or absence of hair, the degree of their retention by pulling the hair in different areas of the head. If there is no hair, the area and degree of expression of their holes is indicated.

When examining the face, note the presence or absence of pinpoint hemorrhages in the connective membranes of the eyes, dilation of their vessels, accumulations of fine bubble foam in the openings of the nose and mouth, the amount and color (white, gray-red), vomit, damage in protruding areas of the face.

When describing the body of a corpse, they focus on the wrinkling of the areola, nipples, scrotum and penis.

When recording signs of skin maceration, indicate: localization of areas (palm surface, nail phalanges, plantar and dorsal surfaces of the feet, etc.), severity of maceration - whitening, loosening, swelling of the epidermis, folding (shallow or deep), color, degree of retention of the epidermis by sipping , absence of epidermis on the extremities, swelling and separation in other areas of the body from the underlying layers of skin.

When examining the hands, they note the clenching of the fingers into a fist, the presence of sand or silt in it, abrasions with traces of sliding on the back surface of the hands, the presence of sand, silt under the nails of the fingers, etc.

It is not advisable to untie tied hands and feet at the scene of the incident, since it is better to carefully examine the knots and loops during the examination of the corpse in the autopsy room. At the scene of the incident, they describe the material from which the knots and loops are made, and their location on the limbs. The load tied to the corpse is not removed at the scene of the incident, indicating only the place of fixation, and is sent for examination along with the corpse.

Algae and fungi are described by indicating location, color, degree of distribution over surfaces and areas of the body, type, length, thickness, consistency, and strength of connection with the skin.

Before taking a water sample, it is necessary to rinse a liter glass twice with water from the given body of water in which the drowning occurred. Water is taken from the surface layer at a depth of 10-15 cm at the place of drowning or the place where the corpse was found. The container is closed and sealed by the investigator; the label indicates the date, time and place where the sample was taken, the name of the investigator who collected the water, and the case number for which the water was collected.

When corpses are found in puddles or containers (including bathtubs), their size, the depth of the container, what and how much they are filled with, and the temperature of the liquid are noted. If there is no water in the bath, this must be reflected in the protocol.

When describing the pose of a corpse, they indicate which areas of the body are immersed in liquid, which are above it, if the body is completely immersed in water, then at what depth it is and in what layer of water. If the corpse comes into contact with container parts, then the contacting area of ​​the body and parts are described. Diagnosis of drowning is based on a combination of morphological features of laboratory test results and the circumstances of the case, which can be decisive in establishing the type of drowning and death in water. Drowning - an accident - is evidenced by eyewitness testimony about the circumstances of immersion in water, alcohol consumption (confirmed by the results of laboratory tests), and the presence of diseases.

Suicide is supported by the failure to take rescue measures, tying up a load, tying up limbs, and the presence of non-lethal injuries that suicides inflict near water. In these cases, death occurs not from injuries, but from drowning. Criminal deprivation of life is indicated by the presence of injuries that the victim could not have caused to himself.

Information necessary for an expert to conduct an examination in case of drowning

In the establishing part of the resolution, the investigator must reflect: from which body of water the corpse was extracted, the place of its discovery - in the water or on the shore, full or partial immersion in water, whether there was a person in the water, the temperature of the water and air, the speed of the current, the mobility of the water, the depth of the reservoir , method of extraction from the water (with hooks, crampons, etc.), testimony of witnesses about the circumstances of the victim’s immersion in the water, an attempt to stay on the surface of the water, alternating immersion with appearing above the surface of the water, information about the previous fight, drinking alcohol, diving, participation in competitions on water, a shipwreck, first aid provided by a specialist or an outsider, diseases that the victim had at the time of drowning and had suffered previously.

The type of drowning (true or asphyxial) determines one or another morphological picture revealed by examination of the corpse.

External examination of a corpse in a dissection room differs from that at the scene of the incident in the particular thoroughness of the examination and recording of the identified features of nodes and loops, weighing of the load used to hold the corpse at the bottom, sketching and detailed photographing of the damage.

Internal examination uses a variety of sectional techniques and additional research methods aimed at detecting injuries, changes typical of drowning, and painful changes that contribute to death in water.

Hemorrhages are found in the soft coverings of the head, which may be the result of pulling the victim by the hair. It is necessary to open the cavities of the middle ear, the sinus of the main bone, with a description of their contents, its nature and quantity, the condition of the eardrums, the presence or absence of holes in them, examination of the muscles of the trunk, opening of the spine, examination of the spinal cord, especially in the cervical region. When examining the neck and its organs, they focus on the presence of soft tissue dissections with blood, fine bubble foam in the respiratory tract, its color, quantity, foreign fluid, sand, silt, pebbles (indicating their sizes), note the presence, nature and amount of free fluid in pleural and abdominal cavities. Carefully examining the lungs, record their size, traces of pressure from the ribs, describe their surface, shape and contours of hemorrhages, pay attention to gas bubbles under the pulmonary pleura, the consistency of the lungs, color on the section, the presence and amount of edematous fluid or dryness of the cut surface, reflect the blood supply of the lungs , heart and other organs, blood condition (liquid or with clots). To clarify the dilution of blood with water, a simple test is used, which is made by applying a drop of blood from the left ventricle to filter paper. Thinned blood forms a lighter ring, indicating hemolysis and blood thinning.

When examining the gastrointestinal tract, the presence of foreign bodies and fluid in the stomach and duodenum, its nature and quantity (free fluid, dilution of the contents) are noted. The stomach and duodenum are bandaged before being removed from the corpse, and then, above and below the ligatures, they are cut and placed in a glass vessel to settle the liquid. Dense particles will settle to the bottom, with a layer of liquid above them sometimes covered with foam. The presence of fluid in the duodenum is one of the most reliable signs of drowning, indicating increased peristalsis, but this sign has diagnostic value only on fresh corpses. Particular attention is paid to the lesser curvature of the stomach, where there may be ruptures of the mucous membrane. The diagnosis of drowning is confirmed by laboratory tests for the presence of diatom plankton elements in the internal organs. For the study, an unopened kidney is taken with a ligature placed on the pedicle in the hilum area, about 150 g of the liver, the wall of the left ventricle of the heart, brain, lung, fluid from the cavity of the middle ear or the sinus of the main bone. The femur or humerus is completely removed from putrefactively altered corpses. In addition to testing for diatom plankton, it is also necessary to carry out a histological study to determine changes caused by drowning and diseases that contribute to death in water.

Morphological signs of drowning quickly disappear under the influence of decay, so they can only be identified in cases where the corpse is in early dates removed from the water before putrefactive changes occur.
In case of aspiration drowning. the most valuable sign visible during external examination of a corpse is persistent white or pinkish fine-bubble foam at the openings of the mouth and nose. It is detected in 55-60% of drowning cases. Since foam is formed as a result of mixing air with water and mucus of the respiratory tract during active deep breathing movements(phase of shortness of breath), then its detection simultaneously indicates that the person fell into the water alive. The foam lasts 2-3 days, rarely longer. When it dries, a thin fine-meshed film remains on the skin.
Silt, sand, and algae are sometimes found under the nails in the clenched hand of a corpse. This sign is not directly related to drowning, but it indicates intravital exposure to water and active struggle or convulsive movements in the bottom layer (M.I. Raisky, 1953).
The formation of “goose bumps”, wrinkling of the nipples, scrotum, and penis, which are often detected on corpses removed from water, are considered signs of a corpse being in cold water.
Much more signs of drowning can be identified during internal examination of the corpse. The most characteristic is acute bloating of the lungs, which occurs in 90% of cases. Upon opening the chest, enlarged non-collapsed lungs become visible, almost completely filling the pleural cavities. Their anterior edges converge, partially or completely covering anterior mediastinum and pericardium. The surface of the lungs is motley, marbled (pale gray areas alternate with pinkish, red and violet-blue), often with impressions from the ribs. The surface of the cut (which is often accompanied by a crunch) also has a motley appearance: emphysematous anemic areas alternate with areas of atelectasis, plethora and hemorrhages.
The severity of emphysema and its saturation with water depend on the type and conditions of drowning. More pronounced pulmonary edema develops when drowning in cold and sea water, while a very large amount of foamy pinkish liquid drains from the cut surface of the lungs. The maximum severity of emphysema occurs during prolonged drowning in water at a temperature of +17-20° C.
During the process of rotting, the alveoli collapse and acute pulmonary emphysema, characteristic of drowning, ceases to be detected. Histological examination of the lungs during drowning is also characterized by a varied morphological picture: areas of emphysema alternate with foci of atelectasis, edema and hemorrhages; in the alveoli, bronchioles, small bronchi, foreign particles (grains of sand, particles of coal, wood, unicellular algae) and fine bubble foam are detected.
Fine-bubble foam, somewhat more often than at the openings of the nose and mouth, is detected macroscopically in the larynx, trachea, and bronchi. There may also be foreign particles: sand, algae, fragments of shells, etc. The mucous membrane of the respiratory tract is swollen, cyanotic, congested, sometimes with hemorrhages.
Other important signs of drowning are: Raskazov-Lukomsky-Paltauf spots; the presence of a drowning environment (water) in the sinus of the sphenoid bone, in the cavity of the middle ear and the cells of the mastoid process; swallowing liquid into the stomach; different condition blood in the right and left halves of the heart.
Rasskazov-Lukomsky-Paltauf spots are rounded hemorrhages under the visceral pleura of a pale red color with a diameter of up to 2 cm. They occur in 50-60% of drownings, are considered analogues of Tardieu spots, and their paler color and unclear contours are due to the hemolyzing and erosive effect of fresh water . When drowning in sea water, hemolysis does not occur, therefore subpleural hemorrhages retain their usual size for mechanical asphyxia, clear boundaries and dark red color.

color.
The fluid of the drowning environment in the sinus of the sphenoid bone (V.A. Sveshnikov’s sign) occurs in 70-80% of drownings. About the same often, fluid is detected in the cavity of the middle ear and in the cells of the mastoid process of the temporal bone. Sometimes hemorrhages are found in the tympanic cavity and mastoid cells.
Swallowing liquid into the stomach is a sign of drowning, since its postmortem penetration through the collapsed esophagus is excluded (Bystrov S.S., 1965; Didkovskaya S.P., 1970). For about
To detect this liquid, it is recommended to place the stirred stomach contents in a glass cylinder. When settling, solid particles sink to the bottom of the cylinder, and water remains on top. If the contents of the stomach were foamy (due to the ingestion of fine bubble foam released from the respiratory tract), then the contents of the cylinder become three-layered: solid particles at the bottom, water above and foam on top.
The different blood supply and state of the blood in the left and right halves of the heart are clearly visible in the first 1.5-2 days after drowning in fresh water (before the onset of rotting). Due to dilution by water, the blood in the left half of the heart appears lighter than in the right. If hemolysis has developed, then by the end of the first day one can see imbibition of the endocardium of the left ventricle and the intima of the aorta; the color of the endocardium of the right ventricle by this time has not yet changed. When drowning in sea water, blood thinning and hemolysis of red blood cells do not occur.
Many other signs described in the literature (pallor of the skin, hemorrhages in the conjunctiva, “goose bumps”, transudate in the abdominal and pleural cavities, swelling of the walls and bed of the gallbladder, etc.) are not related to drowning. They are either general asphyxia or signs of a corpse being in the water.
Asphyxial drowning. usually characterized by fairly pronounced general asphyxial symptoms. An internal examination of the corpse reveals severe swelling of the lungs with a significant increase in their volume and increased airiness. The acute development of such hyperaeria is accompanied by ruptures of the interalveolar septa and air can enter the left half of the heart through the pulmonary veins (Sveshnikov V.A., Isaev Yu.S., 1986; Procop O., 1960). Moreover, the volume of air entering the left ventricle of the heart reaches 5.0 cm3. There is usually a lot of fluid in the paranasal sinuses and in the sinus of the sphenoid bone.
V.A. Sveshnikov and Yu.S. Isaev (1986) note that asphyxial drowning is characterized by lymphohemia (reflux of red blood cells into the thoracic lymphatic duct), which is detected by microscopic examination of the contents of the thoracic lymphatic duct.
Due to the fact that many signs of both aspiration and asphyxial drowning are not constant, for diagnostic purposes a large number of different special research methods have long been proposed, which in some cases significantly facilitate the identification the real reason of death. Among them, histological examination, examination of diatom plankton and pseudoplankton, oil sample, and examination of the electrolyte composition of the blood are of particular importance.
The microscopic changes in the lungs during drowning, mentioned above, are quite characteristic. In cases of death in water, when no signs of drowning can be identified, histological examination can in most cases reveal pathological changes, usually of the cardiovascular system, which may explain the cause of death.
Great importance in the diagnosis of drowning on rotten corpses, there is a study for diatom plankton. Diatoms are widespread in nature. In water they are represented either by single cells or in clusters in the form of colonies. Their sizes range from 4-5 to 1500-2000 microns. More than 8,000 species and varieties of diatoms have been described. Their outer silica shell (shell) resists acids and high temperatures well and does not disintegrate when rotting.
The amount of phytoplankton in a reservoir depends on many factors (water composition, time of year, depth of the reservoir, etc.). In different bodies of water, in different areas and at different depths of the same body of water, in different time- meets different types and varying amounts of diatoms. Some water pollution, especially petroleum products, inhibit the development of phytoplankton. All these
The peculiarities of the biology of diatoms determine the different results of the studies - in some cases, a large number (hundreds and thousands) of diatom shells are detected in the blood and internal organs of drowned people, in others - the research results are negative. It has now been established that the detection of diatoms in the lungs of corpses extracted from water has no diagnostic value, since they, together with water, penetrate into the respiratory tract posthumously (Asafieva N.I., 1958; Berzins U.Ya., 1958; Didkovskaya S.P., 1970; Jncze Q., 1949, etc.). Therefore, the diagnosis of drowning can only be confirmed by the detection of diatoms in the blood, internal organs and bone marrow of long tubular bones. As a rule, for diatom analysis, one kidney in capsule, femur and humerus are removed from the corpse. The expert's tools, utensils and gloves must be repeatedly treated with distilled water. In order to establish the species characteristics of diatoms in the body of water in which the corpse was found, lung tissue can be removed.
According to many researchers, positive result Diatom analysis is found in 50-80% of drownings. Consequently, the absence of diatoms in the internal organs of a corpse does not exclude death from drowning. A negative result may be due to the absence of diatoms in this body of water.
The complexity of diatom analysis and the need to comply with strict rules of “diatom purity” when collecting material from a corpse and during its subsequent processing have led to the fact that research on diatom plankton is usually carried out only when there are putrefactive changes in the corpse.
As already noted, when drowning, along with water, not only plankton elements penetrate into the systemic circulation, but also other foreign particles (sand, coal, limestone, wood, etc.), which are called pseudoplankton.
Pseudoplankton elements, mainly quartz-containing particles (sand grains), are identified by the effect of birefringence under polarized light microscopy. Pseudoplankton can be found in the coronary arteries of the heart, on the intima of the aorta, in the choroid plexus of the lateral ventricles of the brain, and in fluid from the sinus of the sphenoid bone.
To prove the non-food origin of water in the gastrointestinal tract swallowed during drowning, S.S. Bystrov (1965) proposed conducting an oil sample. The test is based on the ability of oil and petroleum products to give a bright characteristic fluorescence in ultraviolet rays- from greenish-blue, blue to yellow-brown. Fluorescence is detected in the contents and on the mucous membrane of the stomach and 12 duodenum. It is very important that petroleum products can be found in the organs of highly decomposed corpses, since oil is not destroyed during the process of decay. A negative test result does not exclude death from drowning, since pollution of water bodies with petroleum products is not widespread and constant.
Other physicochemical research methods recommended for the diagnosis of drowning (determining the concentration of blood electrolytes, changes in electrical conductivity, specific gravity and viscosity of blood, etc.) have not become widespread in expert practice due to conflicting results.

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