Part 4

_Potash-Soda._—These alkalies and their carbonates are rarely used as poisons. Cicatrices and strictures of the œsophagus and stomach may be produced.

_Ammonia._—The vapor of strong ammonia may cause death from inflammation of the larynx and air passages. But the strong solution of Ammonia produces corrosion of the mouth, œsophagus and stomach.

_Nitrate of Potash._—In some cases, there is intense congestion of the stomach, and sometimes perforation of that organ.

_Phosphorus._—The post mortem appearances vary with the length of time which lapses before death. If death takes place in a few hours, the only lesions are those produced by the direct action of the poison. The contents of the stomach, which must be evacuated, are often mixed with blood, and may have the peculiar smell of phosphorus. It is said that the mucous membrane of the stomach may emit a phosphorescent light in the dark. If death does not ensue until after several days, the lesions are more marked; the body is usually jaundiced, and there may be found a congestion of the liver, or there may be a small hemorrhage in the liver tissue.

_Arsenic._—The stomach may be empty, or contain mucous mixed with blood, and the intestines contain a white, rice-water fluid, which must be emptied out.

_Corrosive Sublimate._—The stomach is usually contracted; there are inflamed and congested, sometimes _gangrenous_, _patches_ of the mucous coat. The intestines may appear normal, or there may be patches of congestion. In both preceding cases it must be borne in mind that the poison may be absorbed by the skin, therefore the operator should use great care in manipulating the stomach and bowels.

_Vegetable Irritants._—Aloes, colocynth, jalap, gamboge, scammony, savin, croton oil, colchicum, veratria, turpentine; all these drugs produce congestion and inflammation of the stomach and bowels.

_Sulphate of Copper—Verdigris._—The post mortem appearances have only been observed in a moderate number of cases; the stomach may be unchanged, or there may be patches of gangrene and inflammation, and even perforation.

_Tartar Emetic._—In this instance the lesions are not constant, but the lungs may be engorged with blood.

_Opium._—The post mortem appearances of persons who have been killed by the preparations of opium, are negative. Intense congestion of the brain and lungs are spoken of by most authors, but they seem to depend chiefly on the way in which the patient dies, rather than on any specific action of the drug.

_Prussic Acid._—The skin is usually livid, and the muscles contracted; the stomach is congested, and the veinous system unusually full of blood. The most characteristic condition, when this acid is present, is the odor of bitter almonds exhaled from the stomach and tissues.

_Alcohol._—The different preparations of alcohol may, when taken in large quantities, produce sudden coma and death. The bodies are said to resist decomposition for an unusual length of time. There is congestion, and sometimes extravasation of the blood in the brain; the veins everywhere are full of blood, and the bladder distended with urine. Chronic alcoholic poisoning is of a different nature; in this latter case the brain appears normal, but the lungs are usually congested.

_Strychnia—Nux Vomica._—In cases of poisoning from these, the cramping and contraction of the muscles relax after death, but the brain is always congested with blood.

_Corium, Aconite, Belladona, Lobelia, Digitalis, Stramonium, Veratrum._—All these poisons produce congestion of the brain, lungs and stomach.

_Carbonic Oxide._—This gas is produced from burning charcoal, and forms the poisonous ingredient of illuminating gas. For post mortem appearances, see death from suffocation.

_Carbolic Acid._—A number of deaths from this poison have been reported in the last few years. In this case, the stomach, lungs and intestines are intensely congested.

_From Lightning._—In persons killed by lightning the internal viscera may be so lacerated and disorganized that the injection of the embalming fluid may be rendered impossible.

_Drowning._—Persons who have been drowned usually die from asphyxia. The lungs are generally congested, the stomach contains some of the fluid in which the person may have been drowned, and must be emptied. The abdominal viscera may also be congested, but the blood generally remains fluid throughout the body, and is easily removed.

_Strangulation._—In this instance the carotid arteries are generally ruptured; the heart, the lungs and the viscera, are usually congested. In death from suffocation the same symptoms are present. In cases of sunstroke, decomposition sets in very rapidly, and requires an immediate check; the lungs will frequently be found congested.

_Epidemic, Cerebro-Spinal Meningitis._—In many cases the skin of the body and face may show purpuric patches. The rigor mortis is pronounced and long continued, but decomposition sets in early. The intestines may be swollen, and even ulcerated, and the lungs congested.

The character of the disease almost precluded the idea of preserving the body after death. However, should the request be insisted upon, too many precautions cannot be taken, for the disease is of a virulent character.

EMBALMING BODIES.

The board generally employed to lay the body on while the operation of embalming is being performed resembles any ordinary cooling board with an adjustable head-rest, but it is also provided with a rim, extending all around, and raised about one inch above the level of the board; this rim stops at the foot, where the board remains open in all its width. There are also longitudinal grooves running the full length of the board.

The usefulness of this arrangement is obvious, as the liquids which are used during the washing and embalming of the body run down the grooves—the board being raised at the head about one foot during the operation—and can easily be collected in a pail placed under the foot of the board. This will do away with soiling the floor or carpet, as is often the case with the common board in use. The rim around the board will also prevent any liquid from dripping over the sides, and will save a great deal of annoyance and trouble.

The greatest precaution must be used by the operator. All useless and unnecessary talk must be avoided while at work; the mind must be concentrated upon the work in hand. The knives, needles and other instruments must be carefully laid away on a stand within easy reach of the operator, and not be left laying about the board, under sponges, towels, etc.; these might be grasped thoughtlessly, and in doing so a gash might be inflicted, which, if not fatal, at all events would certainly prove very serious.

Before commencing the operation, and after the body has been thoroughly cleansed with soap and water, let the operator anoint and rub his hands with either lard or sweet oil; not so much so as to soil any article used, but let a vigorous rubbing force the oil into the pores of the skin until the hands are almost dry.

The eyes and the mouth being carefully closed by the usual means, let the body be well saturated with the following solution:

Sulphate alumina, 2 lbs. Corrosive sublimate, 2 ounces. Water, 1 gallon.

A cloth moistened with this solution may be laid on the face, and remain while the operation is being performed. This solution should not be wiped off, but it should be allowed to dry on the body; the water will evaporate and leave behind it a thin coating of the salts, which by penetrating the pores of the skin will render it imputrescible.

Next, an incision about five or six inches in length is cut transversely from right to left in the abdominal region, over the stomach, about one inch in a line below the curvature of the lower ribs. Through this opening is revealed the stomach on the right, the liver and gall bladder on the left, the transverse arch of the colon in front, and below the smaller intestines.

If the stomach is distended with food or gas, it must in all cases be emptied of its contents and injected. For this purpose, puncture the walls of the stomach on the side exposed to view, and passing the left hand gently between that organ and the ribs, press down, so as to force the contents out and through the opening made. Then, after the stomach is completely emptied, inject with the following solution, which we shall designate, for the sake of avoiding mistakes, by the name of

EMBALMING FLUID.

Corrosive sublimate, 2 ounces. Chloride of zinc, 4 ” Creasote, 4 ” Alcohol, 1 gallon.

The chloride of zinc and corrosive sublimate must be first dissolved in the alcohol, and the creasote then added.

The small intestines must then be gently and carefully drawn out, and allowed to lay on the right side of the abdomen; this will reveal in the abdominal region a cavity, which may or may not be filled with serum, according to circumstances. At any rate, should there be any liquid, it must be carefully pumped out or sponged off until perfectly dry.

The cavity is then to be sprinkled heavily with tannic acid. The small intestines must then, and before being replaced, be next attended to. If inflated with nothing but gas, a simple puncture at different points, so as to favor the escape of the gas, and a moderate injection through the aperture, will suffice.

If, however, the intestine should be found congested with blood, or some other substance, the contents must be emptied by the following method: Seize firmly, between the two forefingers of the left hand, the intestine, at the lowest point you can reach, and with the right hand draw the intestine through the fingers of the left; this will have the effect of forcing the contents of the intestine forward in front of the fingers of the left hand. After the matter has so accumulated that the progress is impeded, the intestine must be cut, the matter extracted, the part which has thus been emptied, injected with the embalming fluid, and then tied up. This operation must be repeated until the whole of the intestines, small and large, have been emptied and injected, and then the whole is to be replaced into the cavity.

About four ounces of the embalming fluid must be poured over the intestines, and the wound neatly sewed together.

It may be found necessary before closing the opening to lay a thickness of cotton batting over the bowels and under the walls of the abdomen.

Should the lungs be congested with blood, they must be emptied. This object may be attained either by pressing upon the lower part of the thorax, which will have the effect of forcing the blood out through the nostrils and mouth; or else the diaphragm separating the thoracic cavity from the abdomen may be cut through, and the extravasated blood can therefore be got out through the opening. The injection of the thoracic cavity can also be performed through the same opening. The utmost caution must be used in perforating the diaphragm, as some of the arteries might be wounded by a careless use of the knife.

The above operation may be performed before closing the wound in the abdomen or replacing the intestine into the cavity, as it will then leave more room to collect the fluid which may escape from the lungs.

The lungs should in all cases be well injected, either through the trachea or by the process given above. The air passages must be carefully stopped with cotton. The mouth being closed, the nostrils are about the only air passages which require the attention of the operator. The eyes, after a few days, are liable to sink in the sockets, which gives the body an unnatural appearance. Mr. John C. Rulon, of Philadelphia, has invented a wax shell, which, after being introduced under the eyelids, prevents the sinking of the eyes.

The arterial system is to be injected, and next requires attention. Before commencing to inject the arteries, the jugular vein on the left side of the neck must be punctured so as to allow the blood to escape. In some subjects, the flow of blood will be very copious, in which instance the jugular veins must be opened on both sides of the neck; at other times the flow of blood will be very limited, and even the opening of the veins has sometimes been found quite unnecessary.

The femoral artery is the vessel generally chosen for injecting, at a point below the arch about eight inches from and below Poupart’s Ligament. After the artery has been raised, a small incision is punctured into the coat of the artery, large enough to admit the nozzle of the injector, and the canula is carefully pushed upwards into it as far as its length will allow; the artery is then safely and firmly fastened around it, and everything is then ready for injecting.

On the mode of injecting depends, in a great measure, the success of the operation. With some of the instruments now employed, the pressure of the injecting fluid is so strong and sudden as in some instances to rupture the walls of the arteries at some weak point, and fill the cavaties of the thorax and abdomen; sometimes even the liquid has been forced in with such force and in such quantities as to burst the arteries, and, after filling the chest, to pour out in a stream from the mouth and nostrils.

In the above instances, it stands to reason that neither the arterial nor venous systems have been properly injected.

The injection should be performed in a slow, regular manner. After a quart of the embalming fluid (the composition of which has been given above) has been injected, the operation should be suspended for about ten minutes, after which it should be renewed in the same manner, until a gallon and a half or two gallons have been injected. Sometimes the quantity injected need not be so great, as for instance in the case of a person much emaciated by long illness, or if the subject be a child.

The jugular veins must be kept open so long as the flow of blood continues, but they must be closed as soon as the embalming fluid makes its appearance. The best manner of closing the veins is by introducing into the jugulars a small pad of cotton, and neatly sewing up the opening.

It should be remembered that the cloth moistened with the solution for the face should be kept on, well saturated, while this operation is being performed, and even for a few hours after the body has been dressed.

A body prepared in this manner has been kept, in a wooden coffin, in a dark and moderately cool place, for the space of nine months without any perceptible change. After that time the shrinking of the tissues took place, and the body was slowly drying up and being desiccated without in the least decaying or putrefying.

THE ARTERIAL SYSTEM.

To understand thoroughly the process of embalming as described in the preceding chapter, it will be necessary to give here a brief explanation of the circulatory system; also to explain the position of the different parts of the viscera, to which reference has been made.

The arteries commence from the great arterial trunk, called the aorta, and their branches are distributed to all parts of the system; they are dense in structure, and preserve for the most part their cylindrical form when emptied of their blood, which is their condition after death.

The aorta arises from the left ventricle, at the middle of the root of the heart; it ascends at first forwards and to the right, then curves backwards and to the left, and descends on the left side of the vertebral column, to the fourth lumbar vertebra; here it is divided into the arch and descending aorta.

It should be here remembered that most of the branches, which spring from the great artery and vein, are double, that is, each right branch has a corresponding one on the left side—so that there are, for instance, the right and left carotid arteries, the right and left jugular veins, etc. From the arch of the aorta are sent off those arteries which are distributed to the head and arms; the principal ones among these are named as follows:

The carotid artery, which ascends in the side of the neck and divides into the temporal artery which is distributed in the temple, and the facial artery which supplies the face, and also sends a branch called the _internal carotid_ to the parts within the skull. The sub-clavian artery, lying beneath the clavicle, or collar bone—that part of the continuation of this artery which passes through the axilla or arm-pit, is called the axillary artery; its continuation in the upper part of the arm, the brachial artery; and in the fore-arm it divides into the radial and ulnar arteries, which are distributed to the hands and fingers.

The principal branches of the descending aorta are as follows:

The iliac artery, which on passing into the thigh becomes the femoral artery, and, in the leg divides into the tibial and peroneal arteries, which form numerous branches for the supply of the leg and foot.

Before dividing into the iliac arteries the descending aorta gives off several important branches, as the cœliac artery, from which the stomach and liver are supplied; the renal artery, which goes to the kidneys, and the mesenteric artery to the intestines; besides many other sub-divisions in various parts of its course.

THE VEINS.

The veins are the vessels which return the blood to the heart, after it has been circulated by the arteries through the different tissues of the body; they are much thinner in structure than the arteries, so that when emptied of their blood they become flattened and collapsed.

The veins of the trunk may be divided into, the superior vena cava, with its formative branches, and the inferior vena cava with its formative branches.

The superior vena cava is formed by the junction of the right and left vena innominata; it is a short trunk about three inches in length; it descends perpendicularly on the right side of the arch of the aorta, and terminates in the upper part of the right auricle of the heart. The right vena innominata receives the veins of the neck, which return the blood from the head as follows: The internal, external and anterior jugular veins—the external jugular vein being the one which is ordinarily open to let out the extravasated blood from the head—it will not be amiss to describe its course; it descends the neck in the direction of a line drawn from the angle of the lower jaw to the middle of the clavicle or collar bone, and terminates into the sub-clavian vein; it is variable in size, and replaced by two veins. The sub-clavian vein becomes the axillary vein near the arm-pit, and opens into the brachial veins down to the bend of the elbow, where it is divided into several branches which supply the fore-arm and the hand.

The inferior vena cava is formed by the union of the two common iliac veins; it ascends along the front of the vertebral column or back bone, and, passing through the fissure in the posterior border of the liver, terminates into the inferior part of the right auricle of the heart. Its branches are the lumbar veins, three or four in number, which collect the blood from the muscles and integuments of the loins and spinal veins; the renal veins, which return the blood from the kidneys, and the hepatic veins in the liver.

The common iliac veins, which, by their union form the inferior vena cava, are in turn formed by the union of the internal and external iliac veins; the external iliac vein passing into the thigh becomes the femoral vein, and is found in the same sheath with the femoral artery; further below it becomes the popliteal vein; about one inch and a half below Poupart’s ligament in the upper part of the thigh, the femoral vein receives the internal saphenous vein, which commences at the inner side of the foot and great toe; it ascends in front of the inner ankle and along the inner side of the leg; it then passes behind, and along the inner side of the thigh to the saphenous opening, where it pierces the sheath of the femoral vessels and terminates as above stated, in the femoral vein.

The above explanation of the circulatory blood vessels is given only for one side of the body—the right side. The other vessels branching off from the two great trunks, the aorta and the vena cava, on the left side are the same, with very slight modifications.

DIGESTIVE ORGANS.

The œsophagus is a slightly flexuous canal, inclining to the left in the neck, to the right in the upper part of the thorax; it commences at the termination of the pharynx, which is a musculo-membranous sac, about four inches in length, and communicating with the cavity of the nose and mouth; the œsophagus then passes behind the arch of the aorta to the œsophagal opening in the diaphragm, where it enters the abdomen, and terminates into the stomach.

The stomach in man is an oblong, membranous bag, placed obliquely across the abdomen and just below the diaphragm; its average capacity in the adult is about one quart; it has two openings, one towards the heart called the _cardiac orifice_, which receives the food from the œsophagus, and the other at the right or small end of the stomach, called the pyloric orifice, for the transmission of food to the small intestines.

The small intestines, about twenty-five feet in length, are coiled in various directions, and terminate into the large intestine, called the colon, which is about five feet in length, and resembles in appearance a long sac divided into numerous pouches.

The pancreas is a long narrow gland, situated partly behind the right side of the stomach, and within the first curve of the small intestine.

The liver is the largest gland in the body; it is situated on the right side, below, and in contact with the diaphragm, and is divided into several lobes. At its lower side is the gall bladder, into which the bile is poured after being secreted. Its duct opens into a duct leading direct from the liver, and forms with it the common bile duct, through which the bile is poured into the small intestine, at the same point with the duct from the pancreas, until, at length, it is carried with the food into the larger intestine or colon, from whence it is excreted from the system, through the rectum.

ORGANS OF RESPIRATION.

The lungs are supplied with air through the larynx and the trachea.

The larynx is an irregular cartilaginous tube, forming the upper part of the windpipe, as the whole tube is commonly called.

The larynx is situated immediately below the root of the tongue, and forms the protuberance in the front part of the neck, called Adam’s apple.

The trachea, which is a continuation of the larynx, is composed of about eighteen cartilaginous rings, connected together so as to form a tube, which is capable of maintaining a uniform size. On entering the chest, the trachea divides into two trunks, called bronchi, one of which goes to the right, and the other to the left, lung. As soon as the bronchi enters the lungs they branch off into numerous divisions and sub-divisions; their ultimate extremities terminate in air cells.

The lungs occupy the greater part of the chest, the heart being the only organ of much volume, which it includes in it.

The chest, or thorax, is a cavity closed on all sides from the entrance of air, and its bony walls afford an admirable protection to the delicate organs included within it. The walls of the thorax are formed by the breast-bone in front, by the ribs and spine on the sides and back, and by the diaphragm below.

The diaphragm, as has been stated in a previous part of this chapter, is a large muscular partition, which separates the chest from the abdomen.