Gettler's test is performed on heart blood recovered at autopsy from a body found submerged in a pond. The chloride concentration of blood from the LEFT side of the heart is markedly reduced compared with the right side. What does this indicate?

• A Fresh-water drowning ✓
• B Salt-water drowning
• C Post-mortem submersion without drowning
• D Death from electrocution prior to submersion

Explanation

Gettler's test compares chloride content of right and left heart blood. In fresh-water drowning, aspirated hypotonic water is absorbed through the alveoli into the pulmonary venous return, diluting left-sided blood and dropping its chloride below about 100 mg percent while right heart chloride remains near normal. In salt-water drowning the reverse occurs, with left heart chloride rising as hypertonic seawater draws plasma water into the lungs. B normal equal value suggests no vital drowning.

Reference: The Essentials of Forensic Medicine and Toxicology, 35th (Narayan Reddy) ed.

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