Embalming

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Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for display at a funeral. The three goals of embalming are thus preservation, sanitization and presentation (or restoration) of a dead body to achieve this effect. Embalming has a very long and cross-cultural history, with many cultures giving the embalming processes a greater religious meaning.

History of embalming

Embalming has been practiced in many cultures and is one of the earliest surgical procedures humanity undertook. In classical antiquity, perhaps the Old World culture that had developed embalming to the greatest extent was that of ancient Egypt, who developed the process of mummification. They believed that preservation of the mummy empowered the soul after death, which would return to the preserved corpse.

Other cultures that had developed embalming processes include the Incas and other cultures of Peru, whose climate also favoured a form of mummification.

Embalming in Europe had a much more sporadic existence. It was attempted from time to time, especially during the Crusades, when crusading noblemen wished to have their bodies preserved for burial closer to home. Embalming began to come back into practice in parallel with the anatomists of the Renaissance who needed to be able to preserve their specimens.

Contemporary embalming methods advanced markedly during the American Civil War, which once again involved many servicemen dying far from home, and their family wishing them returned for local burial. 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.

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.

In the 19th and early 20th centuries arsenic was frequently used as an embalming fluid but has since been supplanted by other more effective and less toxic chemicals. There were questions about the possibility of arsenic from embalmed bodies later contaminating ground water supplies. There were also legal concerns as people suspected of murder by arsenic poisoning could claim that the levels of poison in the deceased's body were a result of embalming post mortem rather than evidence of homicide.

It is important to differentiate embalming from taxidermy. Embalming actually preserves the intact human body, while taxidermy is a recreation of an animal's form using only the creature's skin.

Who is an embalmer?

It is important to differentiate between a mortician and an embalmer. A mortician is a person who arranges for the final disposition of the deceased. An embalmer is someone who has been trained in the art and science of embalming. This 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 embalming body. Legal requirements over who can practice varies geographically.

It is important to note that some regions or countries have no specific requirements as to who may practice embalming. 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 and their results are not always suitable for funeral viewing.

Modern embalming

Embalming as practiced in the funeral homes of the Western World (notably North America) 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 first step in embalming is to check that the individual is in fact deceased, 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 myth. Any clothing on the corpse is removed and set aside and any personal effect such as jewelry is 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 utilized 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 template. The process of closing the mouth, eyes, shaving, etc is collectively known as setting the features.

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 is displaced from the right jugular vein. The embalming solution is injected through a mechanical pump and the embalmer massages the corpse to ensure a proper distribution of the embalming fluid. In case of poor circulation, other injection points are used.

2. Cavity embalming, the suction of the internal fluids of the corpse and the injection of embalming chemicals into body cavities, using an aspirator and trocar. The embalmer makes a small incision just above the navel and pushes the trocar in 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 screwed into place.

3. Hypodermic embalming, the injection of embalming chemicals under the skin as needed.

4. Surface embalming, which supplements the other methods,especially for visible, injured body parts.

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

Grooming

After the body is rewashed and dried, a moisturizing cream is applied to the face. The body will usually sit for as long as possible for observation by the embalmer. After being dressed for visitation/funeral services, cosmetics (like: Water/Oil Based Foundation, Baby Powder/Face Powder, Pink or Light Lipstick, are Make up used especially for Male Adolescent or Children) are applied to make it appear more lifelike and to create a "memory picture" for the deceased's friends and relatives. In the United States and Philippines baby powder or other deodorizers are sometimes used on the body for a pleasing fragrance and it is used for finishing effects for Make Up. 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 lips to prevent them from dehydrating, and the infant's mouth is often left open a bit 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 the hair, especially for deceased who are male. 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 the 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 casket 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 dead person in good health is often sought in order to guide the embalmer's hand in restoring the corpse 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 for easier cosmetizing).

Male Cosmetizing

Some of Male who Deceased, their Family Preferred a Simplier Make Up for their Loved Ones. After Embalming and Washing, a Baby Powder is applied to their body for deodorization and for Pleasing Fragrance. After Freshning the Embalmer applies Foundation on face to make the memory picture effect and lipstick is applied to cover the Dark Lips. Then the Corpse is Dressed. After Dressing The Embalmer Styles the Hair with Hair Gel, Pomade, Hair Wax or Baby Oil to make the desired style. The Embalmer Preferrs a Water-Based Foundation for Males for the Natural Effect, and Embalmer Applies Baby Powder or Face Powder for Smoothening or Powdery Effect of Face. The Male Cosmetizing is very Different from Women, because the Embalmer Prefers a Make Up for Women that is for Women only.

The foregoing describes the usual process for "cosmetic" embalming, wherein long-term preservation is not the goal; rather the natural appearance of the body is paramount. This kind of embalming is most often found in North America, whereas in Europe, body treatments after death are usually limited to washing and dressing the deceased - either in clothing used by the living or in a shroud. Cosmetics may still be used on occasion to conceal disfigurements by accident or disease, however.

Clothing

As for clothing the body, tradition has been for the deceased to wear semi-formal clothing (a suit jacket and tie for men (in Philippines a Barong Tagalog and Black Slacks is Preferred or sometimes for Male Adolescents an Polo shirt or White or Formal T-shirt and blue jeans ; a dress for women, commonly communion dresses, wedding dresses or bride's maid dresses and the less skin showing the better). In more recent years, the family often chooses to dress the decedent in more casual wear (such as a T-shirt and blue jeans), especially if the deceased was young. If a person is a member of the clergy of some religions, the person is often buried in religious vestments; as well, a member of the military, a police officer or firefighter is often dressed in his/her uniform. A military officer may also be dressed in a mess dress uniform that was never worn in life. Jewelry taken from the body prior to embalming is now returned if that is the family's wish.

As for undergarments, which are commonly chosen by the family or parents, panties and bras are generally simple and conservative but as with outer garments there are no requirements other than the next of kins' preferences, hopefully in accordance with the deceased's wishes. Depending on the height of the deceased, people are sometimes buried without their shoes on simply because shoes sometimes don't fit on swollen feet or will prevent the deceased fitting easily inside the coffin as feet often fail to sit perpendicular to the leg after death and can add several inches to a person's length lying down.

In many areas of Asia and Europe, the custom of dressing the body in a specially designed shroud, rather than in clothing used by the living, is preferred.

After the deceased has been dressed, they are placed in the casket (the term casket is derived from older usage to refer to a "jewel box", it is called a coffin when the container is anthropoid [a stretched hexagon] in form) for the various funeral rites. It is common for photographs, notes, cards and favorite personal items to be placed in the casket with the deceased. Even 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 the afterlife. In traditional Chinese culture, paper substitutes of the goods are cremated with the deceased instead, as well as Hell Bank Notes specifically purchased for the occasion.

Embalming chemicals

Main article: Embalming chemicals

Embalming chemicals are a variety of preservatives, sanitizers, disinfectant agents and additives used in modern embalming to temporarily prevent 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, methanol, ethanol, and other solvents. The formaldehyde content generally ranges from 5 to 35 percent and the ethanol content may range from 9 to 56 percent.

Specialist embalming

Decomposing bodies, trauma cases, frozen and drowned bodies, and those to be transported for long distances also require special treatment beyond that for the "normal" case. The recreation of bodies and features damaged by accident or disease is commonly called restorative art or demisurgery and is a sub-speciality inside embalming, although all qualified embalmers have some degree of training and practise in it. For such cases, the benefit of embalming is startlingly apparent. In contrast, though, many people have unreal expectation of what a dead body should look like due to seeing many "dead" bodies on television shows. Viewers unreasonably expect a body two weeks decomposed or having crashed in an airplane from 30,000 feet to look as it did in life. 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 embalmers are very happy when someone can bring in a picture and the decedent's regular makeups, if worn, to help make their loved one look more as they did when alive.

Embalming autopsy cases differs from standard embalming because the nature of the post mortem irrevocably disrupts the circulatory system with the removal of organs for examination. In these cases, a six-point injection is made through the two illiac 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. In many morgues in the United States (such as the Los Angeles County Coroners Office) and New Zealand, these necessary vessels are carefully preserved during the autopsy; in countries in which embalming has been less common, such as Australia and Japan, they are routinely excised. This inhibits the type of embalming that families prefer and is a common source of conflict between government pathologists and embalmers.

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

It should be remembered that embalming is only 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 caskets 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 of disposition.

Embalming for anatomy education

A rather different process is used for cadavers embalmed for dissection by medical and funeral service students. Here, the first priority is for long term preservation, not presentation. As such, medical embalmers use embalming fluids that are nearly pure formaldehyde (37–40%, known as formalin), made without dyes or perfumes. Many embalming chemical companies make specialized anatomical embalming fluids. Instead of using an embalming machine, anatomical embalmers may 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 funeral home embalming, no drainage occurs and the body distends with fluid that eventually reduces, leaving a 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 and to the lack of red colouration (added normally to standard, non-medical embalming fluids).

Embalming and different religions

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

• All of the major branches of the Christian faith, including Catholic rites, allow embalming, with the exception of Eastern Orthodoxy, which only allows embalming if required by law or other necessity.

• The Book of Mormon and The Church of Jesus Christ of Latter-day Saints do not profess against embalming. Often, due to the custom of church members dressing the deceased, embalming is given preference.

• Buddhism and Taoism beliefs accept embalming as a valid practice.

• Many authorities hold Hinduism does not accept embalming. In practice, this is not an adamant prohibition and embalmings for those of Hindu faith are known to happen, generally for repatriation to India or the South Pacific and for the purposes of viewing and funerary rites at the family home.

• People of Bahá'í Faith are not embalmed. The body is instead washed, and then placed in a shroud of white clothes (cotton, linen or silk). The body must be buried in a cemetery that is no more than one hour's travel from the place of death and within 24 hours of death. The body is interred facing Bahji (the final resting place of the founder of the Bahá'í Faith). Specific prayers for the dead are pronounced to support the progress of the soul.

• Zoroastrians traditionally hold a type of sky burial within structures known as Towers of Silence in which the body is exposed to weathering and predation to dispose of the remains, and thus embalming the body is contrary to their funeral designs. This is due to the Zoroastrian belief that the dead body is unclean and the pure elements of earth and fire should not be allowed to come into contact with it. This practice is not universally performed any more, and many Iranian Zoroastrians perform traditional cremations and burials instead.

• Muslims are required to be buried within 24 hours of death if possible. Embalming is forbidden. The body is still washed and prepared specifically for interment. This procedure is to be done according to the last will of the deceased, usually by a close relative of the deceased who is of the same gender. He or she is then dressed in a plain white burial shroud (for women, the hair, ears and neck are covered as they were in life, preserving her dignity before men who are not closely related; men are buried in their ihram, or pilgrim garb, as worn during the Hajj in Mecca). Muslims believe that the spirit remains with the body from death until after burial, which is the reason for same-day burial, as well as the aforementioned procedures; the body is treated with the same care and respect as in life so as to not cause undue stress to the deceased. For the same reason, cremation is also forbidden. Prayers and readings of the Qur'an are spoken aloud to give comfort to the deceased, and the body is not left alone even for a time following the burial, during which the deceased is buried (preferably without a casket) on his or her right side, facing Mecca.

• Traditional Jewish law generally forbids embalming, and burial is to be done as soon as possible - preferably within 24 hours. However, under certain circumstances, embalming may be permitted if it is impossible to bury a person immediately (such as a crime victim), or to permit the deceased to be buried in Israel. Guidance of a Rabbi or the local chevra kadisha (Jewish Burial Society) should be sought regarding any questions, as particular circumstances may justify leniencies. Notably the Biblical Joseph was embalmed (Genesis 50:26).

Embalming in popular culture

Fictional works tend to portray the fantastic, extraordinary and often dysfunctional aspects of any profession or activity with which the public has little contact, and to ignore the mundane or routine. Embalming is no exception.

• The film My Girl shows Dan Aykroyd as a funeral parlor owner, who throughout the movie is in the process of working on the deceased, usually embalming. In one instance when his daughter comes into his work area and begins to sing a song to his co-worker, he says "I'm embalming my high school teacher, don't sing".
• The television show Six Feet Under, set in a funeral home, has brought embalming and funeral practice back into the public eye and is noted for its reality and dark humour. The character Hector Federico "Rico" Diaz is a full-time embalmer employed by the funeral home in the show. Most of the fantastic restorations that Frederico performed were far beyond the scope or ability of most embalmers and do not reflect the true goings on in a preparation room.
• The reality TV show Family Plots, which was shown on the A&E Network often gave viewers a behind-the-scenes look into the embalming room. The embalmer working at the mortuary at the time, Shonna Wissmiller Smith, had become a minor celebrity.
• In the episode of the cartoon South Park entitled Pinkeye Kenny is transformed into a zombie when worcestershire sauce is used as embalming fluid.
• Many horror films dealing with animate mummies focus on gruesome aspect of Ancient Egyptian embalming practises, frequently having them embalmed alive as punishment for some transgression.
• In the end of the Vincent Price film The Abominable Dr. Phibes the central villain rather ludicrously embalms himself to be forever with his dead wife in the final sequence. This does not stop his resurrection for the sequel.
• There is a horror movie titled The Embalmer whose movie posters read "...beauty after beauty dragged to a sunken crypt...petrified play-captives of THE EMBALMER".
• In the film Kissed the lead female character is a necrophiliac who is training to become an embalmer.

Notable embalmings

• It was rumored that after her death Diana, Princess of Wales was hastily embalmed to cloud tests that she may have been pregnant. However if this were the case an autopsy would still have easily been able to determine such an obvious condition and the rumour is just urban myth.
• Contrary to media reports John Paul II (pope 1978-2005) was not embalmed before lying in state and photographs of him clearly show the blotchiness and discoloration that is characteristic of lividity and the early stages of decomposition.
• Having died in the summer when heat would hasten decomposition, Paul VI (pope 1963-1978) decomposed at his lying in state, prompting Vatican officials to install fans around the body to disperse the odor.
• Pius XII's (pope 1939-1958) botched embalming by a charlatan doctor -- which only sped up the rate of decomposition -- led to his body turning black and his nose falling off while lying in state, and the body disintegrated in the coffin. The Swiss Guards stationed around Pius XII's body were forced to change shifts every ten to fifteen minutes since the body's odor caused some guards to pass out. The doctor who performed the embalming had also taken photos of the Pontiff in his death throes and intended to sell them to tabloids. The Italian tabloids refused to buy the photos, and the doctor was banned from entering the Vatican City-State by John XXIII, who furthermore prohibited any photography of a deceased Pope until the body is properly vested and laid out.
• John XXIII's body is on display in an altar on the main floor of the Basilica of Saint Peter after having been exhumed from the grottoes beneath the main altar and has retained an extremely well-preserved state. If a body's remains do not decompose and this cannot be explained by science, it is often treated as a miracle. However, the case of John XXIII's body did not enjoy the same acclamation, as it may have merely been due to embalming and adipocere formation.
• Murdered civil rights activist Medgar Evers was so well embalmed it allowed for a viable autopsy to be performed on his corpse decades after his death and this helped secure the conviction of his killer.
• Perhaps the most famous embalmed body of the 20th century is that of Vladimir Lenin, which continues to draw crowds decades after his death.
• Eva Perón ("Evita") was embalmed at the request of her husband, Argentine President Juan Perón, in order to make a Lenin-like shrine to her memory. A coup d'état toppled Perón, and his plan did not come to fruition. Sixteen years after her death, Eva Perón's body was exhumed and found to be in perfect condition, leading some sectors of Argentine society to call for her canonization.
• When Abraham Lincoln's body was embalmed, the embalmer preserved it for the long term. At the turn of the century, it was disinterred for forensic study, revealing a perfectly preserved corpse.
• Rosalia Lombardo, who died at age two on 6 December 1920 and was one of the last corpses to make it to the Capuchin catacombs of Palermo, Sicily before the local authorities banned the practice. Nicknamed the 'Sleeping Beauty', Rosalia's body is still perfectly intact. Embalmed by a certain Alfredo Salafia, she is in a glass case, looking very much like a surreal doll.
• Arterial embalming began in the Netherlands in the 17th century. Embalming is no longer allowed in the Netherlands, except in the case of international transport of the corpse and in the case of members of the royal family, who choose individually for or against it.
• Plastination makes it possible to preserve individual tissues and organs that have been removed from the body of the deceased as well as the entire body itself. It is not achieved via arterial injection like embalming but by a much longer and more complicated process. Water and fat in tissue are replaced with silicone in a process which, for most specimens, takes about one month. Preserved tissue is first dissected and then dehydrated with acetone. It is immersed in a silicone bath under vacuum until the replacement of acetone is completed. After plastination, the resulting tissue is safe to handle (i.e., toxic fixatives are eliminated), the tissue has no odor, is extremely durable and intact even to the microscopic level. Thus, the anatomical specimens are safer to use, more pleasant to use, and are much more durable and have a much longer period of use. Plastination is not used for funerals due to time, cost and feasibility restraints.
• Benigno S. "Ninoy" Aquino, Jr. (1932-1983), popular opposition leader to Philippine strongman Ferdinand Marcos, was not embalmed after his assassination. His mother decided against it so that the Filipino people can see "what they did to my son." Mourners saw the fresh exit wound on Aquino's chin where the bullet made its exit after coming in from the back.

References

• 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 978-0838521878.

External links

• Videos,Gifts and Collectibles related to Death
• New England Institute at Mount Ida College (Embalming Program)
• Official Site of the Australian Institute of Embalming
• Official Site of the British Institute of Embalming
• Official Site of the American Society of Embalmers
• Official Site of the New Zealand Embalming Association
• video.google.co.uk – CGI Embalming using Aardbalmar:تحنيط

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .