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The smell of death

Updated: Nov 1, 2023

This article was originally written in Romanian and published on

In about 4 hours—and if it's still roughly alive—a compromised immune system starts sending odoriferous signals.

Yes, we start to smell--not necessarily bad, but different; not necessarily loud, but detectable, it seems, to our reptilian brains—enough, at least, for lab tests to show that even the least sensitive among us can isolate the sick from the healthy in up to 9 out of 10 cases, by, yes, smelling their lived-in shirts.

To identify a state by a smell is not a new thing, although until now we have not explored it, as a bipedal civilization, except in the arts—smell of fear; smell of love; smell of safety.

Separately, even if we have forgotten how to isolate and listen to more than what is activated by disgust (exacerbated, in the last century, by hyper-sanitization), we are still able to correctly identify, by smell, the bad state of the others.

How? Well, in humans, body odor comes from the mixture between the bacteria on us and the secretions of the skin glands (the healthiest being, of course, the apocrine sweats in the armpits); the olfactory signature is therefore given by a complex and variable cocktail of compounds, from the most exotic ones such as E-tri-methyl-di-hexenoic acid, tri-methyl-tri-sulfanylhexanol up to sulfanylalkanols (to remember here: "sulf-" :)).

Once the body is attacked by pathogens, our bubble of volatile compounds begins to transform: first from the reaction/infection, then from the activation of histocompatibility complexes (which control the immune response, but also the emanation, it seems, of odoriferous substances ), and finally by changing the excretion rates of metabolic by-products from the endocrine or hormonal system. In other words, we become a smelly soup.

There are a lot of clinical studies that are currently taking place and that are closely following the way in which the smell can finally be measured and cataloged in specific symptoms; we train dogs to track epilepsy, and we develop electronic noses with wide applications, from the chromatography of perfume counterfeiters to the reconstruction of neural pathways in patients with degenerative diseases.

Until everyone wonders what and how, here is a short list of ailments that can be detected by smell:

  • Arsenic, among controversial substances, is a classic—so widespread, even, that it covers all intentions, from the noblest (as a drug used experimentally in some treatments for leukemia) to the most wretched (if you don't have enough individual poisonings in the literature, search more about Lewisite, chemical bomb). Fortunately, arsenic poisoning is no longer, since the discovery of rapid tests, a reason for panic among the objects of jealousies and misguided inheritances; but if it were, today we know that if we haven't eaten garlic, but our mouth smells, we need a doctor.

  • Cyanide (whatever it is, as alkali metals don't really like cyanide) is, from time immemorial, used for unorthodox purposes, because it kills quickly and often goes unnoticed because many people are genetically conditioned not to detect it olfactory. For the rest (those lucky ones), it smells like bitter almonds.

  • People with diabetes can sometimes have a breath with a fruity smell (of decaying apples, some say). This can signal diabetic ketosis/diabetes: when we don't have enough insulin or the body doesn't use it properly, we start burning fat. This can lead to diabetic ketoacidosis, a potentially fatal condition.

  • The Epstein-Barr virus affects approximately 90% of the world's population. Sometimes this leads to what we call infectious mononucleosis (mono). Bad breath is among the first signs of the disease for a large proportion of those affected.

  • Also known as fishy odor syndrome, trimethylaminuria is a rare metabolic disorder that occurs when a person cannot digest certain foods (eggs, liver, legumes, fish and some vegetables). As food remains undigested in the intestines, trimethylamine accumulates in the body, and is then eliminated in bodily fluids such as sweat and saliva. The smell is described as similar to rotting fish, urine, days-old garbage or rotten eggs. It is not a life-threatening condition, but bad breath can lead to social isolation, depression and emotional disturbances.

  • Maple syrup urine disease is a genetic disorder that affects the way the body processes certain amino acids. The name comes from the distinctive sweet smell of the urine of affected infants. The disease is accompanied by apathy in sucking, vomiting, lack of energy (lethargy), abnormal movements and delayed development. If left untreated, the condition can lead to seizures, coma, and death.

  • Scrofula is a condition in which the bacteria responsible for tuberculosis cause an infection outside the lungs. This usually manifests itself as inflammation in the lymph nodes, accompanied by an irritation in the throat. The scientific name is "cervical tubercular lymphadenitis", and patients often smell of stale beer.

  • Patients affected by typhoid fever often smell like freshly baked bread.

  • Patients with Parkinson's emit a woody-musky smell. This is known today, thanks to a wife with a sharp nose named Joy Milne, who reported the fact to her husband's medical team, insisting at the same time that it is a general characteristic of those affected. When subjected to vacuum testing, she correctly detected 6 out of 6 confirmed cases of Parkinson's, plus one more...diagnosed 6 months later.

  • Schizophrenia patients secrete an infinitely higher amount of trans-tri-methyl-di-hexenoic acid, which can lead them to smell very sweet, like overripe fruits.

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