Thanks for all of your great responses! Very interesting. @sonicnurse2b: I think we're read some similar articles regarding the decomposition process after life functions have ceased. I suspect that these processes are related, but as far as I'm aware gut bacteria are producing much of this smell, and I'm not sure if it can account for the smell we seem to be seeing before death. It might well be a component, though, as the bodily systems that suppress uncontrolled bacterial growth slow down. There have been a range of description of the smell, and quite a few are pointing at a hepatic link. The acidosis, acetone, fruity smells would tend to indicate an acetone smell on the breath. I think the acetone smell is related to a switch in bodily metabolism from glucose to fat, where excess acetone is produced via fat conversion and spills over into the blood stream....where it is then vented via the respiratory tract. Interesting given that glucose is produced in the liver. It would seem from various comments that acetone might well be a component of the smell, but perhaps not the entire story. Various people have described the sweet/fruity component along with some other component, variously described as "sour", "awful smelling". I've realised I've been making an assumption - namely that the smell is very faint. I've been assuming that because reputedly you need a keen sense of smell to detect it, and not all people can smell it. Is this actually the case, or is it more of a foreign smell that, once recognised, isn't very faint? Its quite interesting that its possible to evoke this particular smell via a memory - that would tend to imply that its quite distinct from, for example, just an acetone (nail polish remover) smell. Thanks very much again for the replies so far! Great food for thought. Actually on that note...a fair few responses have described the smell as coming from the breath, some from the skin - is it possible that both are involved? Perhaps the acetone smell coming from the breath (and providing the main component of the smell) and some other fainter odour coming from the skin? If a component were coming from the skin I would imagine that a patient's bedding would carry that component quite strongly. Cheers, F