Crushed Persons

CRUSHED PERSONS, i.e., those who died from the pressure of some heavy weight on the body. Cases of such death from bodily compression occur relatively frequently and in various settings. These include victims of urban and railway transport (being run over by tramcars and buses, railway trains, carriages, and carts); victims of collapses of earth, lime, bricks, and logs; victims also occur in panicked and fleeing crowds where people fall and others walk over their bodies (in Moscow in 1896, on the day of the coronation of Nicholas II, about 3,000 people died under such circumstances on the Khodynka Field). Injuries from crushing are diverse and numerous, expressed in the maceration and rupture of internal organs, fractures of the spine and shattering of bones, as well as the severance of the head and limbs (by a train); most frequently damaged are the liver, spleen, kidneys, and lungs, and less frequently the heart, gastrointestinal tract, pancreas, and urinary bladder. It should be noted that even with extensive destruction of internal organs and bone shattering, the skin may remain intact and only abraded in places or even show no signs of violence at all, which is explained by its high resistance and elasticity. Death usually occurs rapidly from hemorrhage, shock, and in cases of bone integrity disruption - sometimes from fat embolism, but there are cases when, despite significant injuries, life continues for some time (thus, one subject who suffered a rupture of the spleen and complete maceration of the left kidney from a falling log was still able to get up, walk 20 steps, and died 7¹/₂ hours later; another, pressed against a wall by a railcar, immediately fell unconscious, then came to after vinegar rubs and died only on the way to the hospital, upon autopsy revealing: complete rupture of the spleen and right kidney, multiple tears of the liver, fracture of the VI left rib with lung damage). It must also be pointed out that the immediate cause of death in a crowding mob and during collapses may depend on acute asphyxia due to compression of the chest and abdomen. However, even here in some cases adults and even children buried under a mass of earth or sand remained alive after many hours (thus, one mother, thinking her child was dead, buried it in the earth to a depth of 25 cm; after 8 hours it was dug up and brought back to life). Berenguier buried animals in flour and ash and found them alive after 15 hours. Thus, if respiratory movements are performed to a certain extent, those buried by a collapse can live the longer, the more porous the mass located above them and the thinner its layer, i.e., when a limited intake of atmospheric air into the respiratory tract is still possible. Finally, sometimes the collapsed mass merely blocks the exit, which can cause death from starvation after a longer period (a case is described where several miners buried by a collapse were dug out after 17 days, three of whom turned out to be still alive; they partly maintained their strength with water). Then the so-called "overlying" of children also leads to death from asphyxia both as a result of the closure of the respiratory orifices and from the compression of the child's chest by the mother's body; this happens for the most part if the mother falls asleep while breastfeeding. From a forensic medical point of view, it is important to remember that people do not always accidentally fall under heavy moving bodies: suicides not infrequently resort to this method (e.g., throwing themselves under a train).