Part 3

_Corrosive Sublimate._—By the action of boiling sulphuric acid on mercury, the hipersulphate is first formed. When this is heated with common salt mutual exchange takes place, and bichloride of mercury and sulphate of soda, the former of which sublimes are produced. Corrosive sublimate is in heavy, white crystalline masses, of a styptic and metallic taste, soluble in about 20 parts of cold water, much more so in alcohol. A solution of corrosive sublimate precipitates albumen and forms with it a definite insoluble compound, to which property its use as an antiseptic is due.

Corrosive sublimate has the property of retarding putrefaction. Animal matters immersed in its solution shrink, acquire firmness, assume a white color, and become imputrescible. On account of this property it is usefully employed in preserving anatomical preparations. We have seen a head prepared in this manner which had for seven years resisted the attacks of decay and insects, and been subjected to all changes of temperature.

_Hyposulphite of Soda._—This salt may be economically prepared by the following process: 16 ounces finely powdered carbonate of soda are mixed with 5 ounces flowers of sulphur, and heated in a porcelain dish with constant agitation until it takes fire and burns to sulphite of soda; this is dissolved in water and boiled with sulphur and thus forms hyposulphite acid; it is then evaporated to crystallization.

It is easily soluble in water; the solution gradually deposits sulphur; 1 to 4 ounces dissolved in the necessary quantity of water, and with the subsequent addition of 3 fluid ounces of sulphuric acid for each ounce of the salt, will liberate the hyposulphurous acid, which immediately decomposes into sulphur and sulphurous acid.

_Solution of Chloride of Zinc_.—Made in the proportion of 1 ounce of chloride of zinc dissolved in 1 pint of water. It is a powerful deodorizing and disinfecting agent in neutralizing noxious effluvia and in arresting animal and vegetable decomposition.

The concurrent testimony of a number of observers shows that it acts as an excellent disinfectant for hospitals, dissecting rooms, etc. When injected into the blood vessels, it preserves bodies for dissection without injuring their texture. The advantage is claimed for it, that while it destroys putrid odors, it has no smell of its own.

_Alumina._—Dissolve alum in six times its weight of boiling water, add solution of carbonate of soda in slight excess, agitate for a few minutes, filter, and wash the precipitate with distilled water; the product is hydrate of alumina.

_Acetate of Alumina._—A solution of this salt is obtained by saturating acetic acid with hydrated alumina and cannot be evaporated without the loss of acetic acid. It has a faint smell of acetic acid and a sweetish taste, and possesses strong antiseptic properties.

_Sulphate of Alumina._—Saturate diluted sulphuric acid with hydrated alumina, evaporate and crystallize; it is in thin, flexible plates, of a pearly lustre, sweet and astringent taste; soluble in twice its weight of cold water, but not in alcohol. Its chief use is as an antiseptic; a solution of 1 pound to a quart of water is used to preserve dead bodies; as a lotion it may be used in a somewhat less concentrated form.

The salts of alumina have been ascertained by Mr. Gannal to be powerful preservatives of animal matter. Among these the sulphate is to be preferred on account of its easy preparation and moderate price. Its aqueous solution was found by Mr. Gannal to be very effectual in preserving bodies, when injected into the blood vessels; in the summer season bodies were preserved for thirty days or more; in the winter for _three_ months.

For use in the winter, a quantity of the solution sufficient for injecting one body, may be made by adding a pound, avoirdupois, of the salt to a quart of water; for use in warm weather, the solution must be saturated.

POST MORTEM EXAMINATIONS.

Before commencing the work of embalming, and even while laying out a corpse, it is always necessary to make an inspection of the surface of the body. The minuteness of this inspection will depend upon the character of the case, and, in a great measure, dictate the course of treatment to be followed so as to insure success. It also behooves the operator, for his own safety, to look for evidences of skin diseases, ulcers, abscesses, etc.; the glands, penis and prepuce are to be carefully examined for syphilitic cicatrices.

It is customary to find certain changes in the external appearance of the body, which are due to the cessation of vitality in the tissues and the commencement of decomposition. I speak now of bodies which have not yet been buried, and which have been kept in the ordinary way, partly covered by a shroud, and lying on the back, in a loosely covered coffin.

If the bodies have been left in their ordinary clothes, the appearances are just the same. In such bodies, one of the first noticeable changes is the paleness of the skin and its mottling with irregular livid patches. After a short time the blood settles in the vessels of the more dependent portions of the body, and the skin which covers the back of the trunk and extremities becomes of a livid red color.

In many cases, if we cut through the skin, we find the tissues beneath congested and infiltrated with bloody scum; in bodies which have been kept for a number of days in cold weather, this red color is also seen on the anterior portions of the body, especially on the face and neck. In hot weather, the red color is very soon altered by decomposition; if the epidermis has been detached at any point, the skin beneath this is dry, hard and red. In warm weather, we may find, for a few hours after death, broad, bluish lines, corresponding to the cutaneous veins, ramifying in the skin of the neck and thorax. These lines are formed by the escape of the coloring matter of the blood from the vessels.

Within a few hours after death, even in cold weather, there is usually some escape of bloody froth and mucous from the mouth and nose. If the eyelids are not closed, the conjunctira and cornea soon become dry, brown and hard, the eyeballs also become flaccid. After a considerable time the skin of the abdomen becomes green; still later, decomposition fairly sets in. The entire body is of a dark green color; the tissues are infiltrated with serum, the abdomen is distended with gas, then the color changes from a green to a reddish brown; the epidermis is detached; the skin is covered with maggots; the entire body is swollen from the formation of gases; the face can hardly be recognized; the nails drop off, and the scalp becomes detached.

When a body is in this condition it can hardly be determined whether a month or five months have elapsed since death occurred. After this all the soft parts change into a formless, pustulent mass. The cavities are open, the viscera are indistinguishable, and the bones are left bare.

The rapidity with which these changes take place, varies under the influence of a great number of conditions. The bodies of infants usually decompose more rapidly than those of adults; fat bodies putrefy quicker than lean ones; the bodies of persons who die suddenly from violence, decompose less rapidly than the average, unless the body be considerably mangled. Exhausting diseases, fevers, and the puerperal condition, are followed by rapid decomposition, as is also death from suffocating gases. Poisoning by alcohol, by arsenic, and by sulphuric acid, may preserve the bodies for an unusual length of time. Atmospheric air, moisture, and warmth, quicken decomposition. At the same temperature, a body which has been for one week in the air, one which has been two weeks in the water, and one which has been eight weeks buried in the usual way, will all exhibit the same degree of decomposition.

THE RIGOR MORTIS.

It is proper to notice whether or not the body is in the condition of post mortem rigidity. More attention has, perhaps, been given to this post mortem condition than it well deserved. According to Kühne, the rigor mortis is produced by a change in the muscular fibres; the fibres first lose their contractibility, then there is coagulation of the myosine and loss of elasticity. When this acidity has reached its height, muscle becomes softer, and the rigor mortis gradually disappears; finally, the acid condition is succeeded by an alkaline fermentation, and decomposition ensues.

The rigor mortis generally begins in the muscles of the lower jaw and back of the neck; it then extends to those of the face, neck, thorax, arms, and finally, the legs; it usually disappears in the same order; it generally begins in from eight to twenty hours after death, but often much sooner. The bodies of persons killed on the field of battle, and of those who have been drowned, sometimes seem to be overtaken by the rigor mortis at the very instant of death; the bodies retain the same position, and the face the same expression, which they had in the last moments of life. The rigor mortis may continue for from one to ten days, generally, but not always; death from narcotic poisons is followed by a short and feeble rigidity. While death by lightning is followed by rapid and intense rigidity, in young children, it is feeble and of short duration. The degree and duration of rigor mortis after death from violence, from different diseases, etc., is stated so variedly and contradictorily by different observers, that no definite rules can be given concerning it.

The temperature of the normal living body is 98° to 99° F. In illness, the temperature may be increased several degrees. After death, the body generally cools to the same point as the surrounding air; this is said to take place in from fifteen to twenty hours.

Taylor, from the examination of one hundred bodies, states that the average heat of the skin of the abdomen, at a period of two to three hours after death, is 77°; at four to six hours, 74°; at six to eight hours, 70°; at twelve hours, 69°. The internal viscera retain their heat longer than the surface of the body.

It is said, that, after sudden death from accidents, apoplexy, acute disease and asphyxia, the body retains its heat for an unusually long period. It is both asserted and denied, that after death from hemorrhage the body cools rapidly; the body of an adult cools more slowly than that of a child or an old person; that of a fat person more slowly than that of a lean one.

In some cases there is an exceptional retention and even an increase of heat in the dead body. Dr. John Davy reports, that in case of death from rheumatism, after the viscera had been exposed for several minutes, the temperature of the left ventricle of the heart was 113°, and that of the liver 112°. In a second case, six hours after death, the temperature of the heart was 108°. It is stated that after death from yellow fever and cholera, the temperature increases for several hours after death. There are also recorded a number of instances in which the body retained its heat for several days, without known cause.

It will be seen from what has been said, that if we are called upon to pronounce upon the length of time that has elapsed since death, in a given case, this is only to be done approximately, and it is probably necessary to take into consideration the cause and manner of death, the condition of the individual, the state of the atmosphere, the manner in which the body has been kept after death; and even after making these allowances, we can only say that a person has probably been dead for such and such a time.

This chapter may prove tedious to some, but it is, however, an undeniable fact, that the preceding information (compiled from the Morbid Anatomy of F. Delafield, M. D.), is of the utmost importance to the professional undertaker. The external examination of the body, before handling, is a matter not to be neglected. Should any syphilitic sores or foul ulcers be present, the utmost caution must be used in handling the body, as the pus, which is a most virulent poison, might find its way into the system through some abrasion of the skin. The effects of this poison are such, that, should it not prove fatal, it will leave in the system traces that can never be completely eradicated. This chapter also contains information of such character as will be found needful to fully understand the subsequent chapters.

PRESERVATION OF BODIES.

The following process is intended to preserve bodies without the use of ice, merely until the time of the funeral may arrive. Sometimes, this ceremonial may be delayed for three or four days, or until some member of the family, who may be at some distance, can arrive. It is also intended to take the place of the cumbrous refrigerator, and substitute for the labor of removing ice, carrying the box to and from the residence, the more simple and less laborious process of injecting the abdominal viscera.

The first step to be taken upon arrival in the chamber of death, is to create a current of fresh air, by lowering the upper part of a window, or of a couple of them, if there be no transom light over the door.

Next, remove the body from the bed and place it on a cooling board; this board ought to be elevated about one foot at the head; also, the head of the body should be raised at an angle of about forty-five degrees; this disposition of the body will allow the fluids contained in the circulatory system to go down of their own gravitation, and leave the face, neck, and upper part of the body uncongested, and therefore free from the purple spots that gradually discolor the face and neck.

The head is raised on the cooling board at the proper elevation as directed above, by means of a head rest attached to the cooling board, and provided with a catch resting on a cog scale, which allows the rest to be raised or lowered at will.

The mouth must next be firmly closed by means of a ligature, tied firmly round the head and passed under the apex of the chin; this ligature should be kept in place until the rigor mortis has firmly set the jaws together.

A great improvement for the above purpose upon the old way of tying a cloth or a handkerchief round the head, is to use a band of some wide, elastic fabric, of which several sizes must be kept on hand, as when this ligature presses too tightly it leaves upon the face, especially on fat persons, unsightly wrinkles.

The eyes must next be attended to; the lids must be brought together firmly, avoiding at the same time interference with the lashes or the creation of wrinkles of the skin on the corners; then fold up neatly some small pieces of linen, well saturated in the following solution, which is also to be used to moisten the face with:

Alum, 8 ounces; Corrosive Sublimate, 2 ounces; Water, 1 gallon.

The linen pads should not exceed the size of a quarter dollar, and thoroughly saturated in the above solution before applying to the eyes. The face, after washing with soap and water, should be well moistened with the same solution, and a cloth laid carefully and evenly over the features, so as to come into direct contact with every part of them; this cloth must be kept moist with the above solution, and remain over the face until such time as the body is placed in the coffin, when the cloth may be removed previous to the lid being closed. This solution should be diluted with one-half water for use on children or persons whose skin is very fine. It must also be kept from a very strong light, in a glass bottle, and should, when used, never be mixed in a metallic vessel, but in a bowl, cup, or some dish of queens-ware or china.

The next step to be taken consists in preventing frothing or purging from the mouth and nostrils; also keeping down generation of gases, and swelling of the stomach and bowels.

For this purpose an incision about 4 or 5 inches in length is made in the abdomen, above the transverse arch of the colon; this incision will reveal the colon and upper part of the large intestines, also the stomach, a little to the left.

If the bowels are distended with gas, puncture first the colon and some of the smaller intestines, and, after expelling the air by firmly pressing on the abdomen, inject into the bowels about eight ounces of the following solution: Dissolve in one gallon of water as much alum as the water will take up, shaking at intervals; then pour off the clear liquor, and add to it two ounces chloride of zinc and two ounces corrosive sublimate. Keep this injecting solution in a cool, dark place.

The bowels being injected, the stomach must be emptied of its contents by puncturing its walls, and by pressing gently upon its outer surface in a downward direction; the matter contained in it will be forced out into the pleural cavity, and can then be either sponged or scooped out; the stomach is then to be injected in a similar manner as the bowels; some of the injecting fluid may be then poured between the interstices of the bowels, about (6 or 8 ounces), and some cotton batting be laid evenly over the bowels; this cotton should be well saturated with the solution after it is properly laid in its place. The lips of the wound may then be neatly brought together and sewed up.

It will be readily understood by the above described operation, that no gases can be generated in either the bowels or the stomach, as the injecting fluid in those parts of the viscera will effectually prevent their formation; and this being the case, the purging at the mouth and nostrils, which is the result of the escape of gas driving out the contents of the stomach, is avoided. The expansion of the abdominal viscera, or the bowels, is also prevented by the same cause.

In some instances, when the body is that of a stout, fleshy person, or especially when some length of time has elapsed from the time of death until the undertaker has been called in, and particularly if the body has been reclining in a horizontal position, the face, neck and shoulders, will be found highly congested with blood; the face, in fact, may be swelled and of a purple appearance, owing to the extravasation of blood into the capillary vessels under the skin.

In such cases, and after the body has been removed and placed into a proper position on the cooling board, if the blood is not carried to some lower part of the body by its own gravitation, it may be found necessary to cut into the jugular veins on either side of the neck, an incision about one quarter of an inch in length; through this opening the congested blood may be let out, and the face will soon recover its original color. This process, which occupies about twenty minutes, will be found preferable to the use of ice, especially when the corpse is at some distance from the undertaker’s place of business; or when it would be almost impracticable to carry a large and cumbrous ice box, besides the labor and bustle occasioned in the house of mourning by the carrying in and out of the box, ice, etc.

It is also well understood that this process can not be applied where the corpse is that of a person who has died of some contagious or infectious disease. Besides the danger to the operator in this case, it is not customary to retain for any length of time the remains of those who may have died from the effects of an epidemic.

To the solution for injecting, as given above, must be added one ounce of creosote to the gallon of liquid, when the preparation is to be used in warm weather.

STATE OF THE BODY AFTER DEATH.

As the object of this book is to give, not only the best modes of preserving and embalming bodies, but also to make comprehensive to our professionals the _modus operandi_, it is a most important matter to them that the different conditions of a body, as influenced by the cause of death, should be made a study of, and fully understood, before proceeding any farther. These different circumstances may so influence the state of the body, that the process of embalming, as given hereafter and as usually practiced, may not be successful.

I repeat an assertion already made, that one body having been treated successfully in a certain manner, yet the same method may fail in another case. Although the same chemicals may have been used in both instances, and given full satisfaction in the first, they failed to accomplish their object in the last.

It is a well known fact that the arterial system must be intact and without lesions, if the injecting fluid is to be carried in a thorough manner, and by the natural channels through the body—therefore any rupture in the arteries may cause the fluid to escape at that point, and fill the neighboring cavities. The result would certainly not in that case be satisfactory to the operator; for as the fluid would thus be arrested in its course, and fail to permeate the tissues through the arteries, veins and smaller vessels, the corpse would soon putrefy in consequence.

Destructive inflammation of the surrounding tissues may invade and destroy the walls of an artery. Thus, ulceration of the brachia, bronchial glands, and œsophagus, may perforate the aorta; gangrene of the lungs, the pulmonary arteries, ulcer of the stomach, the gastric arteries, etc.

Let us suppose that the operator chooses the femoral artery as a point of injection. The injecting fluid will fill the arteries of the abdomen and the thorax until it reaches a point where the walls of the arteries are ruptured, and then will lose itself into the surrounding cavities, thereby failing to reach the upper portion of the body. It will of course, in an instance of this kind, be found necessary to inject again at some other point situate in a higher part of the body, as for instance, the axillary artery. It is, therefore, easily understood that—

1st. The cause of death may so affect the arterial system that the point selected for injecting may not be the proper one.

2d. That it may be necessary to inject the body at different points.

3d. That, in many cases, the cause of failure does not lay in the lack of antiseptic properties of the chemicals used, but in the need of discrimination on the part of the embalmer, in choosing the proper place for injecting, and also in his ignorance of where that place should be.

It is, therefore, patent, that should the course of the arteries and veins be not readily understood by the operator, it will be a rather hard matter for him to discover the cause of his failure. This want, we will try to supply in the following chapters, by giving in detail the course of the blood vessels, also of the different positions of the several parts of the viscera, which it is necessary for the embalmer to be acquainted with, and which it is absolutely indispensable to know, so as to fully comprehend the instructions given further on in this book.

DEATH FROM POISONING.

_By Sulphuric Acid._—There does not seem to be any lesions of the arteries after death, as the stomach is the only part which might be perforated, as also the adjoining viscera might be blackened and softened by the action of the acid. The blood is thickened, sirupy acid, and the body may be partially preserved from decomposition.

_Nitric Acid._—In this case the stomach will be found to contain a viscous, sanguinolent yellow or greenish fluid, which must be got rid of before injecting. The lungs will also be found highly congested, and the blood must therefore be emptied out. The acid, Nitrate of Mercury, and Muriatic Acid, produce about the same changes after death as those of Nitric Acid.

_Oxalic Acid._—The stomach will be found to contain a dark, brown, mucous fluid, but in some cases of death from this poison there are no well marked lesions.

_Oxalate of Potash_ produces the same changes.