Principles of embalming

1. Dr. S. Prabhu
1st year PG
Anatomy
PIMS

2. Introduction
Embalming, one of humankind’s longest practiced arts,
is a means of artificially preserving the dead human
body.
Modern embalming is defined as the study & science of
treating a dead human body to achieve antiseptic
condition, a pre mortem appearance & preservation.

3. Esmond R Long M.D., a Medical Historian
‘Nothing gives a better perspective of the subject than an
appreciation of the steps by which it has reached its
present state’

4. Types of preservation
 Natural means.
 Artificial means.

5. Natural means of preservation
 Freezing – ice, snow, glaciers.
 Dry cold – cold dry air.
 Dry heat – dry warm air.
 Nature of the soil at the place of interment.

6. Freezing
Inca human sacrifice Snowcapping

7. Dry cold
Dry cold preservation of Bishop Peder Winstrup, 1605-1679,
church of Sweden.

8. Dry heat
Egyptian mummies

9. Nature of soil
 Long term burial in peat bogs.
 Soil impregnated with salt, aluminium or copper.

10. Artificial means of preservation
 Simple heat
 Powders
 Evisceration & immersion
 Evisceration, local incision & immersion
 Evisceration & drying
 Simple immersion
 Arterial injection
 Arterial injection & evisceration
 Cavity injection & immersion
 Arterial injection & cavity treatment
 Artificial cold

11. Simple heat
 Simple heat – slow drying in an oven that is heated
with mixture of slaked lime.

12. Powders
 Powders – sawdust + zinc sulphate or other
preservatives.

13. Evisceration & immersion
 Evisceration & immersion – used by Egyptians.

14.  Evisceration & drying – Guanche method.
 Evisceration, local incision & immersion – Europe
 Simple immersion – alcohol, brine or other liquid
preservatives.
 Arterial injection & evisceration – Hunter Brothers
 Cavity injection & immersion – Gabriel Clauderus
method.

15.  Arterial injection – mode of treatment of Gannal,
Sucquet.
 Arterial injection & cavity treatment – now a day’s
method.
 Artificial cold – refrigeration inhibits bacterial
activity.

16. Period of embalming history
1st period
 Originated in Egypt.
 3200 BC to 650 AC.
 Religious motive, believe in resurrection.
 Variation in techniques.

17. Continue..
2nd period
 650 AD to 1861
 Practiced in Europe.
 Period of Anatomists.
 Motive is to advance the development of
embalming.

18. Continue..
3rd period or modern period
 1861 till now.
 Europe to America.
 Funeral purpose, sentiments, public
transportations.
 Preserve for further study & research in anatomy.

19. Chemicals & fluids
 Preservatives
 Germicides
 Buffers
 Wetting agent
 Anticoagulants
 Dyes
 Vehicle
 Perfuming agent

20. Preservatives
 Formaldehyde
 Methanol
 Phenol

21. Formaldehyde
 Discovered in 1856, by british chemist, August
Wilheld Von Hofmann.
 Colourless
 Pungent odour
 Commercially available as formalin containing 37% of
formaldehyde in water.
 7% methyl alcohol, 37% formaldehyde remaining water.

22. Methanol
 Volatile, inflammable & poisonous.
 If consumed, causes blindness & death.
 Best preservative that precipitates proteins and kills
many organisms.
 Best useful dilution is 75% isopropyl alcohol.
 It is cheaper, toxic than ethanol.
 Stabilises formalin.
 Penetrates & diffuses easily.

23. Phenol
 Carbolic acid, Coal tar derivative, extremely
poisonous, colourless, Crystalline solid.
 Light exposure, turns dark(oxidation).
 Rapidly absorbed by protein contents of tissues.
 Non soluble in water, Soluble in ether, ethanol,
chloroform & glycerine.
 Powerful germicide & fungicide.
 Greying of tissues.

24. Germicides
 Surface disinfectants
 Kill microbes
 Eg: phenolic derivatives, zephiran chloride,
glutaraldehyde.

25. Buffers
 Weak acids or basic salts are used to stabilise the pH,
called buffers.
 Stability of the chemicals in embalming depends on
pH of the medium.
 Eg: sodium borate, sodium bicarbonate, magnesium
carbonate, sodium carbonate.

26. Wetting agent
 Lowers high surface tension of water & facilitates
penetration and distribution of embalming fluids.
 Eg: glycerine, glycol, sorbitol, sodium lauryl sulphate.

27. Anticoagulants
 Used to precipitate the calcium to non ionized state.
 They maintain blood in liquid state & facilitate
removal of blood and distribution of arterial fluids.
 Eg: sodium citrate, sodium oxalate

28. Dyes
 Produce an internal cosmetic effect that simulates
natural colouring of tissues.
 Eg: tetra bromo fluorescein(eosin), ponceau,
erythrosine, amaranth, acid fuchsin, toludine red &
rhodamine.

29. Vehicles
 Diluents or solvents or a mixture of solvents.
 Helps the ingredients in solution in a stable and
uniform state during transport through vascular
system to different parts of body.
 Eg: alcohols, glycerine, sorbitol, water

30. Perfumes
 Masking agents, water soluble or made water soluble
by surfactants.
 They are floral compounds.
 Eg: methyl salicylate(oil of winter green), clove oil,
cinnamon oil of peppermint(minthol) or lavender.

31. Muscle relaxants
 Relaxes smooth muscles in arterial wall & assist flow of
fluids in vascular system.
 Eg: magnesium chloride

32. Disinfection
Disinfectant - agent used to inanimate by destroying
microbial agent but not bacterial spores.
Germicide - agent used to inanimate by destroying
microbial agent but not bacterial spores.
Sterilization – effective decontaminates completely.

33. Embalming fluids
 Arterial fluids
 Cavity fluids
 Pre injection fluids

34. Arterial fluids
 Injected into vascular system.
 Dilution varies with types of bodies – dehydrated,
obese, oedematous.
 Also varies with special conditions like – refrigerated
bodies, burnt bodies, infants.

35. Arterial fluids for obese subject
1 Preservatives formalin
methanol
10 %
55%
2 Buffers Sodium borate 15 gm.
3 Anticoagulants Sodium citrate 15 gm.
4 Wetting agent Glycerine 15%
5 Germicide Phenol 5%
6 Vehicle Water 15%
7 Fungicide Thymol Few crystals
8 Dye 1% Eosin 5 ml.
9 Perfume Winter green oil 10 ml.

36. Arterial fluids for thin subjects
1 Preservatives formalin
methanol
10 %
55%
2 Buffers Sodium borate 15 gm.
3 Anticoagulants Sodium citrate 15 gm.
4 Wetting agent Glycerine 20%
5 Germicide Phenol 5%
6 Vehicle Water 10%
7 Fungicide Thymol Few crystals
8 Dye 1% Eosin 5 ml.
9 Perfume Winter green oil 10 ml.

37. Cavity fluids
 Fluids injected into body cavities i.e. thoracic,
abdominal and pelvic cavities with a trocar.
 For an average body, about 2 lts of cavity fluid is
injected.
 Preserves & disinfects the walls & parenchyma of
organs, contents of hollow viscera & space between
visceral organs.

38. Cavity fluid compositions
1 Formalin 60%
2 Methanol 25%
3 Glycerine 2.5%
4 Phenol 10%
5 Mercuric chloride 1%
5 Lavender 1%

39. Pre injection fluids
Death
Forces greater
volume of blood
to capillary bed &
venous system

40. Continues..
 Pre injection fluid is injected before injecting arterial
fluids.
 It allows to drain the blood from vascular system.
 4 to 5 litters injected, wait for 30min before injecting
arterial fluids.
 Loosens clots, improves drainage.
 Contains anticoagulants & buffers.

41. Fluids used in dissection laboratories
Paint mixture – for keeping moist.
1 Glycerine 75%
2 Alcohol 10%
3 Phenol 5%
4 Water 10%

42. Tank (immersion) fluid – for immersing cadavers
1 Formalin 15%
2 Glycerine 20%
3 Phenol 5%
4 Water 60%

43. Cloth fluid – prevent drying of area under dissection &
isolated dissected part.
1 Formalin 5%
2 Glycerine 50%
3 Phenol 5%
4 Water 40%

44. Methods of embalming
 Arterial embalming
 Cavity embalming
Supplemental method
 Hypodermic embalming
 Surface embalming

45. Hypodermic embalming
 To preserve small or large local body areas by
subcutaneous injection.
 May be arterial fluid or cavity fluid.
 Hypodermic syringe, 8 to 19 gauge of varying length.

46. Surface embalming
 Local body areas are preserved by applying suitable
chemicals to surface of the body.
 May be arterial or cavity fluid.
 Packs of cotton or gauge are soaked, applied to eternal
skin.
 Eg: burned tissues, bed sores, surface lesions

47. Embalming procedure
Factors determining the flow of fluids into tissues
 capillary resistance,
 chemical composition,
 injection pressure,
 osmosis, diffusion & gravity.

48. Gravity injection
 Traditional, safest, simplest & least expensive.
 Graduated glass bottle, 10 litters with an outlet.
 Outlet is corked through which the nozzle is passed,
connected to transparent rubber tube with screw
clamp to regulate rate of flow.
 Other end is attached to injecting needle or cannula.
 Bottled filled with arterial fluid is kept 4 to 6 feet from
embalming table.
 Raise of 1 foot gives fluid pressure of 0.43 pound.

49. Electric pump
 Simple device generates pressure to force fluid from
tank to vascular system.
 Provides steady & high pressure.
 Delivers 8 to 10 litres within 30 to 45 min.

51. Processes during embalming
 Injection
 Distribution
 Diffusion
 Drainage

52. Criteria for choosing artery
- Size/diameter of the artery
- Practicality of drainage form the accompanying vein
- Depth/location of the artery
- Branches of the artery
- Proximity to the Arch of the Aorta

53. Criteria for choosing vein
- Size/diameter of the vein
- Proximity to the Right Atrium of the Heart
- Depth of vein
- Ease of raising the vessel

54. Injection techniques
- One point injection
- Split injection/drainage
- Multipoint injection
- Restricted cervical injection
- Six point injection (sectional embalming)

55. One point injection
- One location is used for both injection & drainage
- The most common location is the RIGHT COMMON
CAROTID ARTERY & the accompanying JUGULAR
VEIN
- The FEMORAL artery & vein is the 2nd most popular
- The least common location is the
AXILLARY/BRACHIAL artery & vein

56. Split injection/drainage
- The injection of solution from one location & drainage
from another.
- This method may reduce short-circuiting of fluid.
- The most frequently used split injection/drainage sites
are:
1. The right FEMORAL artery for INJECTION
2. The right JUGULAR vein for drainage.

57. Multipoint Injection
- Injection from 2 or more arteries.
- Drainage may be from one or more locations
- A multipoint injection solves the problem of poor
distribution

58. Six point Injection (sectional embalming)
- Method is always used for bodies that have been
autopsied.
- Method may be used as a primary injection technique
for advanced decomposition.
- Drainage may be taken from one location but usually at
each injection point.

59. Identify, raise & ligate the following vessels
(6 point injection)
Right internal jugular vein (insert a drain tube toward
the heart)
1. Right common carotid artery (insert injection tube
toward the head/heart)
2. Left common carotid artery (insert injection tube
toward the head, tie off the proximal end)
3. Right axillary or brachial artery (insert injection tube
toward the right hand, ligate the proximal end)

60. 4. Left axillary or brachial artery (insert injection tube
toward the left hand, ligate the proximal end)
5. Right femoral artery (insert injection tube toward the
foot, ligate the proximal end)
6. Left femoral artery (Insert injection toward the foot,
ligate the proximal end)

61. Inject in the following order (6 point
Injection)
1. Right leg, left leg
2. Right arm, left arm
3. Trunk of body (using the right common carotid)
4. Left side of the head, right side of the head

62. Restricted cervical injection
- The head is embalmed separately from the body.

63. Raise the right common carotid artery & internal
jugular (restricted cervical injection)
- Insert an arterial tube toward the head, with stopcock
open.
- Insert an arterial tube toward the trunk.
- Insert a drain tube toward the heart.

64. Raise the left common carotid artery
(restricted cervical injection)
- Insert an arterial tube toward the head, with stopcock
open.
- Clamp or ligate the distal end of the artery.

65. Restricted cervical injection trunk
- Inject the trunk of the body, with drainage taken from
the jugular vein.
(solution entering the head by collateral circulation exits
from the open stopcocks)
- Inject the left side of the head, leaving the right
stopcock open.
- inject the right side of the head, leaving the left
stopcock open

66. Restricted Cervical Injection is
recommended in the following situations
- Bodies with general oedema
- Bodies that are likely to purge
- Poor distribution
- Bodies with facial or head trauma
- Cases of eye enucleation
- Delayed embalming

67. Drainage
Is brought about by displacement,
Arterial solution is injected into the circulatory system &
forces the blood to come out.

68. Drainage is composed of
- Blood & blood clots
- Interstitial fluid & lymphatic fluid
- Embalming fluid

69. Purpose of draining
 To make room for arterial fluids.
 Ensure even distribution.
 Avoid discoloration, odour, formation of gas.
 Prevents decomposition.
 Reduces microbial activity.

70. Drainage sites
 Internal jugular vein
 Femoral vein
 Right atrium of heart
 Inferior vena cava

71. Methods of drainage
 Alternate drainage
 Concurrent drainage
 Intermittent drainage

72. Cavity embalming
 Not a visible process.
 Two steps – aspiration & injection.
 Done after arterial embalming

73. Organs treated
 Pancreas
 Spleen
 Kidney
 Liver
 Lungs
 Heart
 Stomach
 Intestine
 Brain & brain stem

74. Instruments
 Scalpel
 Electric aspirator
 Hydro aspirator
 Pointed trocar
 Rubber tube

75.  Hand pump
 Nasal tube aspirator
 Autopsy aspirator
 Needle

76. Quadrants of abdomen

77. Trocar guides
 Trocar is inserted into abdominal wall, kept close to
ant. Abdominal wall until it reaches the specific organ.
 2 inches to left & 2 inches superior
to umbilicus.
Standard trocar point

78.  Right side of heart
move trocar along line of
left anterior iliac spine to
right ear lobule.
heart

79.  Stomach
direct towards intersection of 5th
intercostal space & left mid axillary
line.
Stomach

80.  Caecum
directed to ¾ of distance btw line
from pubic symphysis to right
anterior superior iliac spine.
when the point of trocar is 5cm
from line – point is depressed
then thrust forward to pierce
caecum.
Caecum

81.  Urinary bladder
directed towards pubic symphysis
in median plane until it touches
bone.
retract the trocar slightly, depress
the point gently & pierce into
the bladder.
Urinary bladder

82. Period for cavity embalming
 Immediately after arterial embalming.
 Several hours after arterial embalming.

83. Thoracic aspiration

84. Abdominal aspiration

86. Cranial aspiration
Inject the cavity fluid & pack the nostrils to
prevent leakage.
Aspirate the contents of viscera
Insert trocar into nostrils, to reach the
cribriform plate of ethmoid bone.

88.  After aspiration
 Cavity fluid is injected in all cavities & over the viscera.
 Concentrated fluid is injected because the residual
blood, lymph can dilute it.
 Cause decomposition.

89.  On an average, 70kg body needs 1 litter of cavity fluid
for each thorax & abdominal cavity.
 Injected either by 100ml syringe or lumbar puncture
needle.
 Trocar & cannula for aspiration.

90.  After completion of cavity treatment.
 Openings are closed using 2 sutures commonly.
 Nylon threads are used.

92. References
Ajmani, M.L (1998) 'Embalming: principles & legal
aspects', , (), pp. .
Andrew, L. Hodges (2006) 'Embalming explained',
Funeral Home, (), pp. .
Bajrachaya, S., Magar, A (2006) 'Embalming: an art of
preserving human body', Medical journal, 4(16), pp. 554-
557.
James, H. Bedino (2009) 'Modern embalming', Article #
20090206, (), pp. .
Natekar, P.E. (2012) 'A new embalming fluid for
preservation', JKISMU, 1(16), pp. 2231-4261.

93. Legal aspects

94. Historical background
 Mid 19th century, during civil war times.
 Mass causalities, military dead buried near battle field.
 Embalming was in demand.
 Increased interest among scientists for discovering
novel methods in performing embalming at its best.

96. Dr . Richard Burr (1865)

97. His embalming tent

98. Final military order 1865
 Hereafter no persons will be permitted to embalm
unless acting under licence of Marshall of army, dept.
or district.
 They will grant licence only to those who furnishes
proof of skill & ability as embalmer. Also establish
scale of prices.
 Applicants for licence will apply to Marshall of the
army.

99. Sir Jean Nicolas Gannal (1791-1852)
 Chemist in profession.
 Experiments on various chemical combinations.
 Arsenic as one of the component.

100.  Embalming should not be done prior to autopsy in
MLC.
 Heavy metals should be avoided in embalming
mixture.

101. Current situation in India
 Increasing medical institutes.
 Increase in demand for cadavers for teaching.

102. Anatomy Act (1949)
 An Act to provide for the supply of unclaimed bodies
of deceased persons to hospitals and medical and
teaching institutions for the purpose of anatomical
examination and dissection.
 Enacted by Medical Council of India in 1949.

103. In other words..
 ACT PROVIDES FOR THE COLLECTION OF DEAD BODY
FOR TEACHING PURPOSE ONLY IF THE DEATH
OCCURS IN STATE HOSPITAL OR IN A PUBLIC PLACE
WITHIN THE PRESCRIBED ZONE OF MEDICAL
INSTITUTE, PROVIDED THE POLICE HAVE DECLARED
AFTER LAPSE OF 48 HOURS THAT THERE ARE NO
CLAIMENTS, AND CAN BE USED FOR MEDICAL
EDUCATION.