Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for public display at a funeral. The three goals of embalming are thus sanitization, presentation and preservation (or restoration) of a corpse to achieve this effect. Embalming has a very long and cross-cultural history, with many cultures giving the embalming processes a greater religious meaning.
Embalming has been practiced in many cultures. In classical antiquity, perhaps the ancient culture that had developed embalming to the greatest extent was that of ancient Egypt, which 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.
However some of the best preserved bodies in the world are from Han dynasty China. It was thought that a special liquid in which the bodies were embedded (solutions containing mercury and antimony salts amongst others), may have been of a certain influence. The actual cause of the preservation—which started declining rapidly once the bodies were unearthed—was the very exceptional low temperature conditions obtained at the depths at which the tombs were located, under several layers of charcoal and clay, permitting ideal temperatures and humidity levels which were maintained throughout the seasons for centuries.
These mummies are nowadays stored in special refrigerated chambers which simulate the original conditions in which they were discovered to prevent further acceleration of putrefaction.
Embalming in Europe has become much more common in the more industrialized regions. 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. Arterial embalming is believed to have been first practiced in the Netherlands in the 17th century by Frederik Ruysch but his liquor balsamicum preservative was kept a secret to the grave and his methods were not widely copied.
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, replacing previous methods based on alcohol and the use of arsenical salts.
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.
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.
Modern embalming is most often performed to ensure a better presentation of the deceased for viewing by friends and relatives - as everything else being equal, an embalmed body will look better than one that is unembalmed and putrefying.[1][2] A successful viewing of the cadaver is considered by many credible authorities[3][4] to be helpful in the grieving process. It allows the mourners to form a memory picture of the deceased. Embalming has the potential to prevent mourners from having to deal with the rotting and eventual putrescence of the corpse, which is important due to the stress that Americans often place on hygiene.[5] 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. She also points out that in many countries, embalming is rare, and that the populace of such countries are still able to grieve normally.[6] 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.
The roles of a Funeral Director and an embalmer are different. A funeral director is a person who arranges for the final disposition of the deceased and who 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 embalming and may not have any contact with the family, although many people fill both roles. The term mortician is becoming out-dated, but may refer either to a funeral director or to 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.[7]
In the United States, the title of an embalmer is based largely on the state that they are licensed in. In Virginia, 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 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 obviously 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 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 the purpose of 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 to 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 in the chest and stomach cavities to puncture the hollow organs and aspirate their contents. He/she 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, utilises embalming chemical to preserve and restore areas directly on the skins surface and other superficial areas as well as areas of damage such as from accident, decomposition, cancerous growth 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 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 for disposition.
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 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 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 of males; while hairspray is applied to style the hair of females. 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 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 deceased in good health is often sought in order 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 for easier cosmetizing).
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. Clothing worn 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, in order 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. In many areas of Asia and Europe, the custom of dressing the body in a specially designed shroud/funeral gown, rather than in clothing used by the living, is preferred.
A lesser known procedure of dressing the deceased is that, in many cases, the upper body clothing is cut up the back and placed over the deceased, or "draped" on the front of the body with the arms straight out. This is since the rigid state of the deceased makes it impossible to bend the arms to place them through sleeves in clothing. Popular culture often ignores this, showing zombies raised from the grave wearing fully intact clothing. A notable exception is the film The Crow which accurately depicts a man raised from the grave having his coat and shirt cut up the back.
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 use/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.
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. The formaldehyde content generally ranges from 5 to 35 percent and the ethanol content may range from 9 to 56 percent.
Badly 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 restoration of bodies and features damaged by accident or disease is commonly called restorative art or demisurgery 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 going through 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 picture and the decedent's regular makeups (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 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 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 preservative chemicals and multiple injection sites to ensure thorough saturation of body tissues.
A rather different process is used for cadavers embalmed for dissection by 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)/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".
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.