"The Little Match Girl" depicts a little girl's body responding to a severe drop in temperature, which causes her to lose touch with reality and make choices that seem antithetical to what she ought to do if she wanted to preserve her life. The choices she makes and the visions she experiences can be explained as pathophysiological responses to the onset of death through hypothermia.
Without shoes on her feet, the girl's disordered physiological processes begin with her body attempting to conserve heat by squatting in the snow and drawing her legs under her body. The intense hunger she experiences is also a neurological response to a decrease of intracranial blood temperature, as the center of the brain devoted to thermoregulation is connected with hunger centers. Her cardiovascular system also reacts with blocked blood flow in her naked feet, causing them to turn red and blue. Her muscular system responds with shivering to increase thermogenesis to create body heat to replace that which she loses.
As her body temperature decreases further, her glucose levels become depleted and she loses energy—another reason for sitting in the snow. A lack of oxygen to the brain then causes random neuron activation, which leads to visuals of bright lights, increasing the sensory impression of her matches. At this point she experiences disordered consciousness and sensitivity and perception, resulting in delusion, hallucination, and delirium, bringing the intense visions she enjoys. When the body's thermoregulatory responses to severe cold fail to keep her alive, the girl's body succumbs to death and her blood, no longer moving, freezes her muscle tissue into stillness.
