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Diagnosis of death from drowning is often difficult, just a set of signs and laboratory methods of research helps to establish the cause of death.

Fig. 12. Foam around the mouth and nose holes when drowning.

At the external examination of a corpse have the value of the following characteristics, allowing to suspect drowning: the skin as a result of spasm of the capillaries of the skin paler than usual; cadaveric spots purple color with a grey tinge and pink colouring on their periphery. There is often so-called goose bumps, which is a consequence of the contraction of the muscle that raises hair. Around the holes of the mouth and nose, as a rule, is determined pinkish-white, persistent, fine bubble foam (Fig. 12). Foam around breathing holes remains until two days after removal of the corpse out of the water, then it dries on the skin can be seen mesh film dirty-gray color.
When internal study draws attention to a number of distinctive features. At the opening of the chest observed pronounced emphysema, last completely fill the chest cavity, covering the heart. On posterolateral surfaces of the lungs almost always visible fingerprints ribs. Light to the touch testovaty consistency due to the significant swelling of lung tissue. The increase in the volume of the lungs during the stay of the corpse in the water gradually disappears by the end of the week. Under the visceral pleura are observed spots of Lukomsky-Rasskazov. These spots are bleeding reddish-pink, considerably larger compared with spots of Tardieu, located just under the visceral pleura: Color and its value depends on the amount of water that got into the systemic circulation through broken and gaping capillaries millionarmy partitions. Diluted and hemolyzed blood becomes lighter, its viscosity is reduced, therefore hemorrhage become blurred. Spots of Lukomsky-Rasskazova disappear after a stay of a corpse in the water more than two weeks. Thus, no spots of Lukomsky-Rasskazova at long stay dead body in the water yet indicates that there was absolutely nothing.
Visceral pleura unclear. In the study of the respiratory tract in them is found grayish-pink, fine bubble foam, in which microscopic examination is often possible to detect foreign particles (sand, small algae and other). The mucous membrane of the trachea and bronchi swollen, unclear. From the surfaces of the cuts lung flows abundantly bloody frothy liquid. In the stomach usually contains a large amount of liquid. Capsule liver is also somewhat unclear. The bed of the gall bladder and its wall with severe edema. In serozhnykh cavities can see a significant number of specimens, which, according to some authors, formed after 6-9 hours after a stay of a corpse in the water and essentially refers to the signs indicating the presence of a dead body in the water. The same importance is the discovery of fluid in the tympanic cavity, middle ear. Due to laryngospasm reduced pressure in the nasopharynx, in this regard, the water through pear-shaped slit comes into the cavities of the main bone of the skull. The volume of water in the sinuses may reach 5 ml (sign Sveshnikov). When drowning find hemorrhage in the tympanic cavity, mastoid cells and mastoid caves that have the kind of free clusters of blood or rich of impregnation of mucous membranes. The emergence of this phenomenon is associated with an increased pressure in the nasopharynx, circulatory vascular disorders, which, combined with acute hypoxia lead to increased permeability of the vascular wall with the formation of these hemorrhages.
Important for the diagnosis of drowning are laboratory studies, especially the discovery of plankton. Plankton is the smallest organisms of plant and animal origin, living in lakes, rivers, seas, etc For each reservoir is characterized by certain types of plankton, which have specific differences. For the diagnosis of drowning the plankton of plant origin - the phytoplankton, especially diatoms. Diatoms have a shell consisting of inorganic compounds of silicon. This armour can withstand high temperatures, strong acids and alkalis. Diatom phytoplankton has a different shape and occurs in the form of sticks, stars, boats and other Diatoms up to 200 microns, together with water through a broken capillaries of the alveoli penetrate into the bed of a large circulation and blood flow are spread throughout the body, pausing in parenchymatous organs and bone marrow. The detection of this type of plankton in the internal organs and bone marrow is an objective method of proof of death from drowning.