Embalming

"Embalmer" redirects here. For the manga series, see The Embalmer. For the wrestling manager nicknamed "The Embalmer", see Percy Pringle. For the death metal band, see Embalmer (band).
Llullaillaco mummies (Embalming by Freeze-drying)

Embalming is the art and science of preserving human remains by treating them (in its modern form with chemicals) to forestall decomposition. The intention is to keep them suitable for public display at a funeral, for religious reasons, or for medical and scientific purposes such as their use as anatomical specimens.[1] The three goals of embalming are sanitization, presentation, and preservation (or restoration). Embalming has a very long and cross-cultural history, with many cultures giving the embalming processes a greater religious meaning.

Embalming is distinct from taxidermy. Embalming preserves the human body intact, whereas taxidermy is the recreation of an animal's form often using only the creature's skin mounted on an anatomical form.

History

Pottery, dishes, and other miscellaneous items from the embalming cache of Tutankhamen.

The Chinchorro culture in the Atacama desert of present-day Chile and Peru are among the earliest cultures known to have performed artificial mummification as early as 5000-6000 BC.[1] Perhaps the ancient culture that had developed embalming to the greatest extent was Egypt, where, as early as the first dynasty (3200 BC), specialized priests were in charge of embalming and mummification. The Ancient Egyptians believed that preservation of the mummy empowered the soul after death, the latter of which would return to the preserved corpse.

Other cultures known to have used embalming techniques in antiquity include the Ethiopeans, Guanches, Peruvians, Jivaro Indians, Aztecs, Toltecs, Mayans, and Tibetan and southern Nigerian tribes.[1]

The earliest known evidence of artificial preservation in Europe was found in Osorno (Spain) and are about 5000 years old human bones covered in cinnabar for preservation, but embalming remained unusual in Europe up to the time of the Roman empire.[1]

In China, artificially preserved remains have been recovered from the period of the Han dynasty (206 BC – 220 AD), the main examples being that of Xin Zhui and the Mawangdui archaeological site. While these remains have been extraordinarily well preserved, the embalming fluids and methods used are unknown.[1]

In Europe the knowledge and practice of artificial preservation had spread from these ancient cultures becoming widely spread by about 500 AD. The period of the Middle Ages and the Renaissance is known as the Anatomists period of embalming and is characterized by an increased influence of scientific developments in medicine and the need of bodies for dissection purposes. Early methods used are documented by contemporary physicians such as Peter Forestus (1522–1597) and Ambroise Pare (1510-1590). The first attempts to inject the vascular system were made by Alessandro Giliani of Persiceto, who died in 1326. Various attempts and procedures have been reported by Leonardo da Vinci (1452-1519), Jacobus Berengar (1470–1550), Bartholomeo Eustachius (1520–1574), Reinier de Graaf (1641–1673), Jan Swammerdam (1637–1680), and Frederik Ruysch (1638–1731).[1]

Modern methods

In the United States, the Civil War era sparked an interest in embalming and it became very common across the nation.[2]

William Hunter developed and popularized the modern technique of arterial embalming in the late 18th century.

The modern method of embalming involves the injection of various chemical solutions into the arterial network of the cadaver to prevent decomposition. William Harvey, the 17th century English physician who was the first to detail the system of blood circulation, made his discoveries by injecting coloured solutions into corpses.

The Scottish surgeon William Hunter was the first to apply these methods to the art of embalming as part of mortuary practice. He wrote a widely read report on the appropriate methods for arterial and cavity embalming in order to preserve bodies for burial. His brother, John Hunter, applied these methods and advertised his embalming services to the general public from the mid-18th century.

One of his more notorious customers was the dentist Martin Van Butchell. When his wife Mary died on January 14, 1775, he decided to have her embalmed and turn her into an attraction in order to draw more customers. Hunter injected the body with preservatives and color additives that gave a glow to the corpse's cheeks, replaced her eyes with glass eyes, and dressed her in a fine lace gown. The body was then embedded in a layer of plaster of Paris in a glass-topped coffin.[3]

Butchell put the body on display in the window of his home. Many Londoners came to see the body but Butchell also drew criticism on his gruesome display. A rumor, possibly started by Butchell himself, claimed that his wife's marriage certificate had specified that her husband would only have control over her estate after her death, for as long as her body was kept unburied.[4]

Interest in, and demand for, embalming grew steadily in the 19th century largely for sentimental reasons. People wished to be buried at far-off locations, and mourners wanted the chance to display the body for visitors to pay their last respects to. Another motive behind embalming at this time was to prevent the spread of disease while being able to prepare for burial without unseemly haste. After Lord Nelson was killed during the Battle of Trafalgar, his body was preserved in brandy and spirits of wine mixed with camphor and myrrh for over two months. At the time of his state funeral in 1805, his body was found to still be in excellent condition and completely plastic.[5]

Embalming fluids used in the early 20th century.

Alternative methods of preservation, such as ice packing or laying the body on so called 'cooling boards', gradually lost ground to the increasingly popular and effective methods of embalming. By the mid 19th century, the newly emerging profession of businessmen-undertakers - who provided funeral and burial services - began adopting embalming methods as standard.

Embalming caught on in the United States during the American Civil War, as a result of sentimental issues involving foreign officials and servicemen dying far from home, and the need for their remains to be returned home for local burial. This period starting at about 1861 is known as the Funeral period of embalming and is marked by a separation of the fields of embalming by funeral directors and embalming for medical and scientific purposes.[1] Dr. Thomas Holmes received a commission from the Army Medical Corps to embalm the corpses of dead Union officers to return to their families. Military authorities also permitted private embalmers to work in military-controlled areas. The passage of Abraham Lincoln's body home for burial was made possible by embalming, and it brought the possibilities and potential of embalming to a wider public notice.

Until the early 20th century, arsenic was frequently used as an embalming fluid, until it was supplanted by other more effective and less toxic chemicals. There was concern about the possibility of arsenic from embalmed bodies contaminating ground water supplies. There were also legal concerns because people suspected of murder by arsenic poisoning could claim that the levels of poison in the deceased's body were a result of post-mortem embalming rather than evidence of homicide.

In 1867, the German chemist August Wilhelm von Hofmann discovered formaldehyde, whose preservative properties were soon discovered, and which became the foundation for modern methods of embalming, replacing previous methods.

Today

Modern embalming is most often performed to ensure a better presentation of the deceased for viewing by friends and relatives.

A successful viewing of the cadaver is considered to be helpful in the grieving process.[6][7] Embalming has the potential to prevent mourners from having to deal with the rotting and eventual putrescence of the corpse.[8]

This view has been challenged, however, by authors such as Jessica Mitford, who point out that there is no general consensus that viewing an embalmed corpse is somehow "therapeutic" to the bereaved, and that terms such as "memory picture" were invented by the undertakers themselves, who have a financial interest in selling the costly process of embalming to the public. Mitford also points out that, in many countries, embalming is rare, and the populace of such countries are still able to grieve normally.[9]

Embalming is also a general legal requirement for international repatriation of human remains (although exceptions do occur) and by a variety of laws depending on locality, such as for extended time between death and final disposition or above-ground entombment.

In the United Kingdom, where open-coffin funerals are extremely rare, embalming is still used in many funeral homes.

Terms for embalmers

The roles of a funeral director and an embalmer are different. A funeral director arranges for the final disposition of the deceased, and may or may not prepare (including embalming) the deceased for viewing (or other legal requirements). An embalmer is someone who has been trained in the art and science of , and may or may not have any contact with the family, although many people fill both roles. The term mortician is becoming outdated, but may refer to a someone who is a funeral director, an embalmer, or both. Embalming training commonly involves formal study in anatomy, thanatology, chemistry, and specific embalming theory (to widely varying levels depending on the region of the world one lives in) combined with practical instruction in a mortuary with a resultant formal qualification granted after the passing of a final practical examination and acceptance into a recognized society of professional embalmers.

Legal requirements over who can practice vary geographically; some regions or countries have no specific requirements. Additionally, in many places, embalming is not done by trained embalmers, but rather by doctors who, while they have the required anatomical knowledge, are not trained specialists in this field. Today, embalming is common practice in North America and New Zealand while it is somewhat less frequent in Europe. In some countries, permits or licences are required; in others it is performed only by medical practitioners, and the costs can be relatively high.[10]

In the United States, the title of an embalmer is based largely on the state that they are licensed in. In Virginia and Maryland, a funeral director is someone who is licensed only to make arrangements and handle the business side of the funeral home, while a mortician is licensed to do these things as well as to embalm. As recently as 2015, Virginia has required that funeral directors also perform 25-50 embalmings as well as 25-50 arrangements during their apprenticeships as a requirement for their licensing, culminating in 3000 hours per apprenticeship.

Modern practices

Instruments used for embalming

As practiced in the funeral homes of the Western World (notably North America), embalming uses several steps. Modern embalming techniques are not the result of a single practitioner, but rather the accumulation of many decades, even centuries, of research, trial and error, and invention. A standardized version follows below, but variation on techniques is very common.

The deceased is placed on the mortuary table in the supine anatomical position with the head elevated by a head block. The first step in embalming is to check that the individual is in fact deceased (to avoid premature burial), and then verify the identity of the body (normally via wrist or leg tags). At this point, embalmers commonly perform basic tests for signs of death, noting things such as clouded-over corneas, lividity, and rigor mortis, or by simply attempting to palpate a pulse in the carotid or radial artery. In modern times, people awakening on the preparation table is largely the province of horror fiction and urban legend.

Any clothing on the corpse is removed and set aside, and any personal effects such as jewelry are inventoried. A modesty cloth is sometimes placed over the genitalia. The corpse is washed in disinfectant and germicidal solutions. During this process the embalmer bends, flexes, and massages the arms and legs to relieve rigor mortis. The eyes are posed using an eye cap that keeps them shut and in the proper expression. The mouth may be closed via suturing with a needle and ligature, using an adhesive, or by setting a wire into the maxilla and mandible with a needle injector, a specialized device most commonly used in North America and unique to mortuary practice. Care is taken to make the expression look as relaxed and natural as possible, and ideally a recent photograph of the deceased while still living is used as a reference. The process of closing the mouth and eyes, shaving, etc. is collectively known as setting the features.

Tank containing embalming fluid

The actual embalming process usually involves four parts:

  1. Arterial embalming, which involves the injection of embalming chemicals into the blood vessels, usually via the right common carotid artery. Blood and interstitial fluids are displaced by this injection and, along with excess arterial solution, are expelled from the right jugular vein and collectively referred to as drainage. The embalming solution is injected with a centrifugal pump, and the embalmer massages the body to break up circulatory clots as to ensure the proper distribution of the embalming fluid. This process of raising vessels with injection and drainage from a solitary location is known as a single-point injection. In cases of poor circulation of the arterial solution, additional injection points (commonly the axillary, brachial, or femoral arteries, with the ulnar, radial, and tibial vessels if necessary) are used. The corresponding veins are commonly also raised and utilized for drainage. Cases where more than one vessel is raised are referred to as multiple-point injection, with a reference to the number of vessels raised (i.e. a six-point injection or six-pointer). As a general rule, the more points needing to be raised, the greater the difficulty of the case. An injection utilizing both the left and right carotids is specifically referred to as a restricted cervical injection (RCI), while draining from a different site from injection (i.e. injecting arterial fluid into the right common carotid artery and draining from the right femoral vein) is referred to as a split (or sometimes cut) injection.
  2. Cavity embalming refers to the replacement of internal fluids inside body cavities with embalming chemicals via the use of an aspirator and trocar. The embalmer makes a small incision just above the navel (two inches superior and two inches to the right) and pushes the trocar into the chest and stomach cavities to puncture the hollow organs and aspirate their contents. He then fills the cavities with concentrated chemicals that contain formaldehyde. The incision is either sutured closed or a "trocar button" is secured into place.
  3. Hypodermic embalming is a supplemental method which refers to the injection of embalming chemicals into tissue with a hypodermic needle and syringe, which is generally used as needed on a case by case basis to treat areas where arterial fluid has not been successfully distributed during the main arterial injection.
  4. Surface embalming, another supplemental method, utilizes embalming chemicals to preserve and restore areas directly on the skin's surface and other superficial areas as well as areas of damage such as from accident, decomposition, cancerous growths, or skin donation.

A typical embalming takes several hours to complete. An embalming case that requires more attention or has unexpected complications could take substantially longer. The repair of an autopsy case or the restoration of a long-bone donor are two such examples.

Embalming is meant to temporarily preserve the body of a deceased person. Regardless of whether embalming is performed, the type of burial or entombment, and the materials used – such as wood or metal coffins and vaults – the body of the deceased will eventually decompose. Modern embalming is done to delay decomposition so that funeral services may take place or for the purpose of shipping the remains to a distant place for disposition.

A new method for embalming, developed in 1992 by Walter Thiel, uses a different set of chemicals and salts. This method produces bodies with no detectable odor and much better color preservation, as well as flexible limbs.[11][12]

Grooming

Restoration tools, Museum of Funeral Customs

After the body is rewashed and dried, a moisturizing cream is applied to the body. The body will usually sit for as long as possible for observation by the embalmer. After being dressed for visitation or funeral services, cosmetics are applied to make the body appear more lifelike and to create a "memory picture" for the deceased's friends and relatives. For babies who have died, the embalmer may apply a light cosmetic massage cream after embalming to provide a natural appearance; massage cream is also used on the face to prevent them from dehydrating, and the infant's mouth is often kept slightly open for a more natural expression. If possible, the funeral director uses a light, translucent cosmetic; sometimes, heavier, opaque cosmetics are used to hide bruises, cuts, or discolored areas. Makeup is applied to the lips to mimic their natural color. Sometimes a very pale or light pink lipstick is applied on males, while brighter colored lipstick is applied to females. Hair gels or baby oil is applied to style short hair; while hairspray is applied to style longer hair. Powders (especially baby powder) are applied to the body to eliminate odors, and it is also applied to the face to achieve a matte and fresh effect to prevent oiliness of the corpse. Mortuary cosmetizing is not done for the same reason as make-up for living people; rather, it is designed to add depth and dimension to a person's features that lack of blood circulation has removed. Warm areas – where blood vessels in living people are superficial, such as the cheeks, chin, and knuckles – have subtle reds added to recreate this effect, while browns are added to the palpabrae (eyelids) to add depth, especially important as viewing in a coffin creates an unusual perspective rarely seen in everyday life. During the viewing, pink-colored lighting is sometimes used near the body to lend a warmer tone to the deceased's complexion.

A photograph of the deceased in good health is often sought to guide the embalmer's hand in restoring the body to a more lifelike appearance. Blemishes and discolorations (such as bruises, in which the discoloration is not in the circulatory system, and cannot be removed by arterial injection) occasioned by the last illness, the settling of blood, or the embalming process itself are also dealt with at this time (although some embalmers utilize hypodermic bleaching agents, such as phenol-based cauterants, during injection to lighten discoloration and allow easier cosmetizing).

Clothing

In the Western world, men are typically buried in business attire, such as a suit or coat and tie, and women in semi-formal dresses or pant suits. In recent years, a change has occurred, and many individuals are now buried in less formal clothing, such as what they would have worn on a daily basis, or other favorite attire. The clothing used can also reflect the deceased person's profession or vocation: priests and ministers are often dressed in their liturgical vestments, and military and law enforcement personnel often wear their uniform. Underwear, singlets, bras, briefs, and hosiery are all used if the family so desires, and the deceased is dressed in them as they would be in life.

In certain instances a funeral director will request a specific style of clothing, such as a collared shirt or blouse, to cover traumatic marks or autopsy incisions. In other cases clothing may be cut down the back and placed on the deceased from the front to ensure a proper fit. This is done, for example, when the rigid state of the deceased makes it impossible to bend the arms to place them through the sleeves in clothing. In many areas of Asia and Europe, the custom of dressing the body in a specially designed shroud or funeral gown, rather than in clothing used by the living, is preferred.

After the deceased has been dressed, they are placed in the coffin or casket. In North American English, a coffin is anthropoid (a stretched hexagon) in form, whereas a casket is a rectangular box. It is common for photographs, notes, cards, and favorite personal items to be placed in the coffin with the deceased. Bulky and expensive items, such as electric guitars, are occasionally interred with a body. In some ways this mirrors the ancient practice of placing grave goods with a person for their use or enjoyment in the afterlife. In traditional Chinese culture, paper substitutes of the goods are buried or cremated with the deceased instead, as well as paper money specifically purchased for the occasion.

Chemicals

Main article: Embalming chemicals

Embalming chemicals are a variety of preservatives, sanitizers, disinfectant agents, and additives used in modern embalming to temporarily delay decomposition and restore a natural appearance for viewing a body after death. A mixture of these chemicals is known as embalming fluid, and is used to preserve deceased individuals, sometimes only until the funeral, other times indefinitely.

Typical embalming fluid contains a mixture of formaldehyde, glutaraldehyde, ethanol, humectants and wetting agents, and other solvents that can be used. The formaldehyde content generally ranges from 5 to 35 percent, and the ethanol content may range from 9 to 56 percent.

Specialist embalming

Badly decomposing bodies, trauma cases, frozen, or drowned bodies, and those to be transported over long distances also require special treatment beyond that for the "normal" case. The restoration of bodies and features damaged by accident or disease is commonly called restorative art or demi-surgery, and all qualified embalmers have some degree of training and practice in it. For such cases, the benefit of embalming is startlingly apparent. In contrast though, many people have unreasonable expectations of what a dead body should look like, due to the unrealistic portrayal of "dead" bodies (usually by live actors) in movies and television shows. Viewers generally have an unrealistic expectation that a body undergoing decomposition should look as it did before death. Ironically, the work of a skilled embalmer often results in the deceased appearing natural enough that the embalmer appears to have done nothing at all. Normally a better result can be achieved when a photograph and the decedent's regular make-up (if worn) are available to help make the deceased appear more as they did when alive.

Embalming autopsy cases differs from standard embalming because the nature of the post-mortem examination irrevocably disrupts the circulatory system, due to the removal of the organs and viscera. In these cases, a six-point injection is made through the two iliac or femoral arteries, subclavian or axillary vessels, and common carotids, with the viscera treated separately with cavity fluid or a special embalming powder in a viscera bag, "shake and bake". In many morgues in the United States and New Zealand, these necessary vessels are carefully preserved during the autopsy; in countries where embalming is less common, such as Australia and Japan, they are routinely excised.

Long-term preservation requires different techniques, such as using stronger preservatives and multiple injection sites to ensure thorough saturation of body tissues.

For anatomy education

A rather different process is used for cadavers embalmed for dissection by medical doctors and medical students. Here, the first priority is for long term preservation, not presentation. As such, medical embalmers use embalming fluids that contain concentrated formaldehyde (37–40%, known as formalin) or gluteraldehyde as well as phenol and are made without dyes or perfumes. Many embalming chemical companies make specialized anatomical embalming fluids.

Anatomical embalming is performed into a closed circulatory system. The fluid is usually injected with an embalming machine into an artery under high pressure and flow, and allowed to swell and saturate the tissues. After the deceased is left to sit for a number of hours, the venous system is generally opened and the fluid allowed to drain out, although many anatomical embalmers do not use any drainage technique.

Anatomical embalmers may choose to use gravity-feed embalming, where the container dispensing the embalming fluid is elevated above the body's level, and fluid is slowly introduced over an extended time, sometimes as long as several days. Unlike standard arterial embalming, no drainage occurs, and the body distends extensively with fluid. The distension eventually reduces, often under extended (up to six months) refrigeration, leaving a fairly normal appearance. There is no separate cavity treatment of the internal organs. Anatomically embalmed cadavers have a typically uniform grey colouration, due both to the high formaldehyde concentration mixed with the blood and to the lack of red colouration agents commonly added to standard, non-medical, embalming fluids. Formaldehyde mixed with blood causes the grey discoloration also known as "formaldehyde grey" or "embalmer's grey".

Religious practices

Embalming of the body of Christ from triptych, Netherlandish (Bruges), c. 1410-20

There is much difference of opinion among different faiths as to the permissibility of embalming. A brief overview of some of the larger faiths positions are examined below.

Notable embalmings

Abraham Lincoln, detail from a carte de visite (Photo caption from book: "Retouched post-mortem photograph by John B. Bachelder, Washington, D.C., April 16, 1865)

See also

Notes

  1. 1 2 3 4 5 6 7 Brenner, Erich (January 2014). "Human body preservation - old and new techniques". Journal of Anatomy: n/a–n/a. doi:10.1111/joa.12160.
  2. ↑ Chiappelli, Jermiah (December 2008). "The Problem of Embalming". Journal of Environmental Health 71 (5): 24.
  3. ↑ Tim Marshall (1995). Murdering to Dissect: Grave-robbing, Frankenstein, and the Anatomy Literature. Manchester University Press. p. 79.
  4. ↑ Christen, AG; Christen, JA (November 1999). "Martin Van Butchell (1735-1814): the eccentric, "kook" dentist of old London.". History of Dentistry 3 (47): 99–104. PMID 10726564.
  5. 1 2 Beatty, William (1807). Authentic narrative of the death of lord Nelson. pp. 72–73.
  6. ↑ http://www.amsocembalmers.org/docs/viewing.pdf
  7. ↑ "Access". Medscape. Retrieved 9 March 2012.
  8. ↑ 1991 Metcalf, Peter & Richard Huntington. Celebrations of Death: The Anthropology of Mortuary Ritual. Cambridge Press, New York. Print.
  9. ↑ "The American Way of Death Revisited Summary – Jessica Mitford – Magill Book Reviews". Enotes.com. Retrieved 9 March 2012.
  10. ↑ "embalming: Modern procedures. – Britannica Online Encyclopedia". Britannica.com. Retrieved 9 March 2012.
  11. ↑ https://www.researchgate.net/publication/45389997_Is_Thiel's_embalming_method_widely_known_A_world_survey_about_its_use
  12. ↑ http://www.fasebj.org/cgi/content/meeting_abstract/23/1_MeetingAbstracts/480.3
  13. ↑ "Let's Talk About Death". Orthodoxinfo.com. Retrieved 9 March 2012.
  14. ↑ Funerals
  15. ↑ scientificamerican.com 2015-04-22 Lenin's Body Improves with Age
  16. ↑ Mackey, Robert (2012-01-12). "North Korean television reports plan to embalm Kim's body". Thelede.blogs.nytimes.com. Retrieved 2013-10-05.

References

  • Abrams, J.L. Embalming. 2008.
  • Frederick, L.G.; Strub, Clarence G. [1959] (1989). The Principles and Practice of Embalming, 5th ed., Dallas, TX: Professional Training Schools Inc & Robertine Frederick. OCLC 20723376.
  • Mayer, Robert G. (2000-01-27). Embalming: History, Theory and Practice, 3rd ed., McGraw-Hill/Appleton & Lange. ISBN 978-0-8385-2187-8.

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