Philemon and Baucis syndrome: Three additional cases of double deaths of married couples

Philemon and Baucis death: a literature review

Double death, i.e., two bodies at a scene, is relatively rare. The double death from natural causes of two close persons is called Philemon and Baucis death in the medicolegal literature. Despite being mentioned for the first time more than 50 years ago, all detailed case reports on this case constellation are from the last 15 years. A comprehensive review of the literature on this phenomenon has not yet been published. In this article, we review the available literature on Philemon and Baucis death. Pathophysiologically, it can be assumed that this phenomenon is a sub-form of so-called psychogenic death. Therefore, we equally review the literature on sudden cardiac death due to acute psychological stress.

Philemon and Baucis deaths: A case of two siblings and state of the art

The simultaneous discovery of two corpses at the same scene obliges the forensic pathologist to consider many circumstances. First, the hypothesis of homicide/crime has to be investigated. However, when the circumstances, autopsy, histological data and toxicological and biochemical analyses suggest a natural cause of death, Philemon and Baucis syndrome should be considered. While a few cases of Philemon and Baucis deaths involving couples of spouses have been reported in the literature, only one paper describes the simultaneous deaths of two siblings. The case presented here concerns the death of two siblings who were found in an advanced stage of decomposition in their apartment, which had been allocated to them by social services. The victims were known to be living in conditions of social and economic deprivation and to be suffering from psychiatric disorders. The first suspected cause of death was malnutrition. However, this was excluded by complete autopsy, histological studies and, especially, biochemical investigations, which excluded starvation ketoacidosis. Moreover, no evidence of trauma or poisoning was found in either of the bodies. Despite the advanced stage of decomposition, one of the bodies presented with histological signs of myocardial sclerosis, left ventricular hypertrophy and contraction band necrosis, suggesting that the mechanism of death involved a fatal arrhythmia. The circumstances and the post-mortem findings were highly suggestive of Philemon and Baucis syndrome.

Philemon and Baucis, Diogenes and syllogomania, Wischnewski and hypothermia--gastric mucosal lesions in partially mummified bodies

We present a case of two brothers who died simultaneously, where their deaths could be considered to be a form of a Philemon and Baucis death; they also showed signs of Diogenes syndrome and syllogomania. The two brothers had been living in a socially isolated state and had not left their flat for months. They were found dead during the winter, in a flat with no heating. Taking the poor condition of the flat into consideration, it can be assumed that a draught existed and, therefore, the bodies were exposed to convection, that is, ventilation and low humidity, which is what caused partial mummification to the exposed areas of the body. The exact cause of death could not be determined due to the postmortem changes; however, there was very little to point to homicide or suicide as the manner of death. Despite these postmortem changes, the Wischnewski spots remained clearly visible, whose presence, in addition to the overall circumstances of the case, indicate that hypothermia could be a possible or at least contributing cause of death in both cases.