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Embalming A to Z: Jaundice

      
Date Published: 
October, 2004
Original Author: 
Todd Van Beck
A S Turner and Sons, Decatur, Georgia
Original Publication: 
ICFM Magazine, October 2004

This condition, also called icterus, is not a disease, but is a symptom of a disease or condition. Jaundice is one of the most frequent challenges encountered by every embalmer.

Over the years, literally every conceivable concoction, formula, procedure and technique has been studied, developed and implemented to deal with it. There have been some successes and, as with all embalming processes, some cases where things did not work as planned, so embalmers always ask what to do in these cases.

In my own experience, I can remember following the instructions on "jaundice fluids" to the letter. When I was finished, I was pleased with the color, but as I left the preparation room I got that old embalmer's gut feeling that something was not right. Sure enough, by the day of the funeral I could detect some odor which ought not to have been present.

The next time, I put preservation first and used a trusted arterial fluid with predictable results in tissue preservation, yet I would again leave the preparation room with "that feeling." The next morning I would be pulling out the phantom cosmetics to cover over the dreaded green.

Jaundice is characterized by the yellow staining of the tissues of the body, including the blood volume, by bile from the liver. The bile's color is from the blood's hemoglobin that the liver has converted to bilirubin.

Every embalmer in the world knows this theory and knows that when bilirubin combines with HCHO (formaldehyde) the result is biliverdin and the dreaded green color.

I have found that massaging the face and hands with a quality massage cream and then wiping the cream away with a soft towel and applying more cream in a thick coating helps. A consistent massaging of the face and hands does contribute to removal of some stain and distribution of chemical.

Now the big question: What about chemical solution, jaundice fluids, dyes and the like? At my first job, I was taught by the embalmer at Heafey & Heafey to stimulate as much drainage as possible, and drain we did! We used water to make our solution and added drops of dye as we went. All in all, my memory of this approach was that it worked.

However, you have to consider the fact that in those days, funerals usually were held within a couple of days, so we did not keep the remains for an extended period of time. Since those early days of my career, I have encountered more and more instances where family members require several days to get together. Also, new medical drugs have altered the old embalming formulas.

Therefore, I have searched for an improved method of dealing with jaundice cases. Nathan Minnich, a former student of mine who has become a good friend and now teaches me things, has passed along the following method.

Instead of mixing consistent solutions of arterial fluid and dye, Nathan's approach is to use a great amount of dye (16-32 ounces) in the first gallon, and just a few ounces of preservative chemical. The rationale is that the jaundiced tissue gets dyed first before the HCHO can cause biliverdin.

Then, as additional half-gallon or gallon solutions are mixed, the formula is reversed, until, in the last gallon, just a few ounces of dye are used with a generous mixture of preservative chemical in order to thoroughly embalm the remains.

When I first heard this, I raised my eyebrows as all old embalmers do when a new idea comes to the floor. However, I have used the method on a dozen cases and the results are remarkable. It is much easier to cosmetize tissue that is pink rather than green, and much more pleasant to prepare well preserved remains.

If you have not tried this method of dealing with jaundice, I encourage you to give it a try. The results are truly remarkable and your families will be pleased.

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Code: 
A1479