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Occasionally the physician is called upon to determine whether a body supposed to be dead is really so, or only apparently so.
When the question does come, it brings with it a great responsibility, for the conscientious physician is compelled to admit that there is no single, certain sign of death, before putrefaction becomes apparent. It is upon this ground that the advocates of cremation have based some of their strongest arguments.
But while there is no single pathognomonic sign of death, a correct conclusion can hardly fail to be reached, in a given case, by the combination of conditions present.
The question usually arises because of some unusual condition about the corpse. The temperature of the body may remain high, rigor mortis may be absent, the lips may remain red, or some other unusual condition may be present.
The cessation of respiration and circulation must be regarded as proof
DETERMINATION OF DEATH.. JAMA. 1892;XVIII(7):207. doi:10.1001/jama.1892.02411110025011