Part 5

The explanations given in this chapter upon the arterial and venous circulation, also upon the names, places and relations of the abdominal and thoracic viscera, will be found of the utmost importance, to understand fully the process of embalming already given, and also the other methods which will be stated hereafter.

Although briefly enunciated, this review of the anatomy of the parts of the human body, which the embalmer must be conversant with, will be found quite sufficient for the purpose.

It will be seen, that even after the arterial and venous systems have been properly injected, there still remains a prolific source of putrefaction in the liquids contained in the intestines, and the thoracic viscera; for instance, the fecal matter contained in the intestines, and the undigested food in the stomach at the time of death, must all be evacuated, and the organs containing them properly cleaned and injected, and unless this be done fermentation will set in, and be followed by rapid decay of the surrounding tissues. It is true the arteries and veins extend their branches to all parts, and to every organ of the body, but it is also an undeniable fact that the contents of those organs which are prone to putrefy will carry the infection to the vessels containing them.

The stomach and bowels are emptied of their contents for the mere reason that these same contents are already undergoing a process of fermentation, which will generate into rapid decay and the emission of noxious gases.

In certain cases of consumption, the lungs are gangrenous and decayed long before death takes place; it will then be found necessary to introduce through the trachea some antiseptic fluid which will stop the progress of decay.

It is also necessary that the names of the different organs mentioned in this work should be explained, so as to make the use of technical words comprehensive to every undertaker who is not supposed to be familiar with the terms of the dissecting room or the human organism in general.

Besides the knowledge of the information given in the preceding pages will enable the embalmer to follow the workings of the embalming process in all its details, and enable him to discover the causes of failure in certain cases; also to use the proper means in the achievement of success.

ANIMAL MATTER.

PRESERVATION AND PUTREFACTION.

From the great complexity of the composition of animal substances, their decomposition is more rapid and its products more diverse than in the case of organic bodies of vegetable origin. While the carbon, hydrogen and oxygen give origin to the various kinds of ulmine and other substances of the same class, the nitrogen is generally valued as ammonia, and the sulphur as sulphurated hydrogen. It is the presence of these bodies that give to the putrefying substances the disagreeable odors by which that process is distinguished from mere mouldering and rotting.

Even during life, the constituent particles of the body are in a continual state of change, being absorbed and thrown out of the system, while others are assimilated in their place. Any part of our constituents, liquid or solid, which become unfitted for this vital function, is thereby killed, and must, if not got rid of, induce the death of the individual.

Hence, precisely the same means which give to the animal substances the fixity of constitution which belongs to true chemical compounds, and thus preserve them from decomposition by the disturbing action of their own elements (as when we coagulate albumen by an acid, by corrosive sublimate, or by sulphate of copper), produce if applied to the living body the death of the part or the whole being by depriving the blood or the tissue of the mutability of constitution, which is required for the functions of the animal frame.

It is thus that the generality of metallic poisons act in producing death. Being absorbed into the system, they unite with the albumen and fibrine of the blood, and converting them into the insoluble compounds which we form in the laboratory, unfit them for the continual absorption and secretive offices, which, as organs, while they live they must fulfill. If the injury be local and limited in extent, the part so coagulated may be thrown off, and after a certain time the functions return to their proper order. If the mass, or the importance of the affected parts be greater, the system cannot so get rid of the portions which have thus been removed from the agency of life, to submit to merely chemical laws; on the contrary, the vital powers of the remaining portions of the animal are so much weakened in the effort that general death is caused.

For putrefaction it is thus necessary: 1st. That the force of vitality which governs so completely the mere chemical tendencies of the elements of our tissues be removed.

2d. That there shall not be present any powerful chemical reagent with which the organized material matter may enter into combination and thus the divellent tendencies of the affinities of its elements be overcome.

3d. That water be present in order to give the necessary mobility.

4th. That oxygen be present, or at least some other gas, into the space occupied by which the gaseous products may be diffused; and lastly, that the temperature shall be within moderate limits, putrefaction being impossible below 32° or above 182°.

The agency of the first of these preventive powers need not be further noticed. The second is extensively employed for embalming purposes, and in the preparation of bodies for anatomical studies, by baths, or injections into the arteries of solutions of corrosive sublimate, acetate of alumina, sulphate of iron, tannin, wood vinegar, and creasote; this last body, however, does not appear to act by direct combination, but by the complete (catalytic) coagulation it produces in all the tissues of the body that have protein for their base.

The necessity for the presence of water is shown by the fact that by drying the animal substances they are completely preserved. It is thus that the bodies of those perishing in the Arabian deserts are recovered years subsequently, dried, but completely fresh.

Alcohol and common salt both act in the preservation of bodies by their affinity for water. If a piece of flesh is covered with salt, the water gradually passes from the pores of the flesh, and dissolving the salt forms a brine, which does not wet the flesh, but trickles off its surface; the water necessary for putrefaction is thus removed.

Fourth, by excluding oxygen, the putrefactive process is retarded, precisely as the fermentative action of the gluten in grape juice cannot begin until a certain quantity of oxygen be absorbed. It is thus that meat that is sealed up in close vessels and then boiled for a moment is preserved; the small quantity of oxygen of the air remaining then in the vessel is absorbed, and the produce of that minute change being coagulated by heat it cannot proceed farther.

A high temperature stops putrefaction by coagulating the azotized materials; a temperature below 32° by freezing the water acts as if the tissues had been dried; in both cases putrefaction is arrested.

During putrefaction, at a stage prior to any fetid gas being evolved, a peculiar organic substance is generated, _possessed of intensely poisonous properties, and the blood of persons who have died from its effects is found to be quite disorganized and irritating when applied to wounds_.

This and the blood of over-driven cattle are found to produce effects similar to those of venomous reptiles, and the wounds received in dissection are sometimes followed by similar fatal consequences. The communication of disease in this way has recently been very ingeniously ascribed by Liebig to the general principle of the communication of decomposition by contact.

The small quantity of diseased organic matter originally introduced into the system by absorption, acts as a ferment and reproduces itself in the mass of the blood, until this becomes unfitted for the performance of its functions and the animal is killed; the active principle being thus copiously present, is exuded from the skin and lungs and gives a contagious character to the disease, or it remains only in the blood, or is secreted in _pustules_, constituting infection, by which the disease may be communicated to some other person.

This brief enumeration of the process of putrefaction will, to a certain extent, elucidate the process of embalming given in this book; it shows that the different methods herein explained, fulfill the conditions necessary to stop the progress of decomposition.

A most important point, and one which ought not to be passed upon without serious consideration is, the communication of disease by contact and absorption.

In a former part of this work, it has been suggested that too much care cannot be used in handling the bodies of persons who have died of certain diseases, especially when their bodies are to be subjected to the embalming process, which operation is rendered extremely dangerous to the embalmer from the fact that the hands must, perforce, come into direct contact with the denuded tissues, the blood, or some vitiated secretion of the body.

We shall, in the following chapter, find instances when the decomposition of certain parts of the body has taken place even before death. It is obvious that in such cases the utmost caution is necessary to avoid serious results.

THROMBOSIS AND EMBOLISM.

Sometimes during life, some portion of the body is in a condition of gangrene, that is, the tissues are not only dead, but decomposing. With the evolution of gases, the softening and liquefaction of the solid parts, and the development of minute organisms, either animal or vegetable.

The bodies of persons who have died from such causes, _decompose with unusual rapidity_. The inner coats of the vessels are often stained with the coloring matter of the blood. The viscera are soft and flabby, the stomach may be swollen, and the kidneys congested and degenerated.

People who have suppurating wounds or abscesses may, without much change in the wounds or abscesses, be seized with rigors followed by fever, become jaundiced and die.

In such persons after death, the same tendency to rapid decomposition, and all the symptoms of the preceding cases are to be found.

There is no way of accounting for the rapid decay in the preceding cases, except by supposing that the pus from the original wound or abscess in some way infects the system, and renders the tissues prone to putrefy.

There is another modified condition of the body very different from the two preceding. Either in consequence of wounds, injuries, inflammations, abnormal conditions of the system, or changes in the venous walls, the blood may become coagulated during life and form thrombi in the veins.

These thrombi may become organized, or they may soften, break down, and their fragments be carried into the circulation; by their mechanical action in obstructing the vessels, they produce extravasation of blood.

By the irritative character of the thrombi themselves, they excite inflammatory action in the adjoining tissues; in this way are produced multiple abscesses. Therefore, we find in persons who die under such conditions, abscesses in the brain, heart, lungs, kidneys and intestines; further we may find purulent inflammation and abscesses in the connective tissues.

It is now necessary to explain the nature and composition of both the thrombus and embolus, and how, through their mechanical agency, the process of embalming may become seriously impaired, if not altogether arrested. A thrombus is a clot, composed principally of the fibrine of the blood, formed during life in the cavities of the heart, the arteries, the veins, or the capillaries.

An embolus is a solid body, usually a portion of a thrombus, carried by the blood current into some artery or capillary, and becomes fixed there. A thrombus may entirely fill the cavity of a vessel, or it may only form a layer on its wall, or it may project from a smaller vessel into a larger one.

An embolus may completely or only partly plug up a vessel; it may remain alone or a thrombus may be formed around it.

A thrombus may merely become harder and whiter in time, or it may become organized, or it may degenerate, soften, and change into a mass of puriform fluid and _gangrenous looking fibrine_, or it may calcify.

The production of thrombi is due to various causes.

(1.) Spontaneous thrombi are produced by any cause which seriously weakens the whole system, as old age and chronic exhaustive diseases. They are usually formed in the veins of the lower limbs and pelvis, and in the sinuses of the dura mater.

(2.) Compression of the vessels by ligatures, tumors, dislocated bones, and inflammatory exudation. _Pneumonia_ may produce _thrombosis_ of the _pulmonary veins_. _Phthisis_ may produce _thrombosis_ of the _pulmonary arteries_.

(3.) Thrombi may form into capillaries or small veins, and increase until they project into larger veins.

(4.) It may also form when there is inflammation, especially of a gangrenous and suppurative nature, in the parts around a vessel.

The causes of embolism are also various.

(1.) Fragments of thrombi in the veins are the most frequent material of emboli.

(2.) Thrombi of the heart, vegetations on the valves and on the walls of the aorta.

(3.) Portions of the inner-coat of the aorta may become detached and form an embolus; also portions of tumors which project in the veins, and fat may form emboli.

In a considerable number of cases, it is impossible to find any source for embolus. It must be remembered, however, in emboli, in connection with wounds, that not only the veins of the wounded region are to be examined, but also those of the pelvis.

The consequences of thrombosis vary with the situation of the clot; thrombi in the arteries produce either a lack of circulation in the region supplied by the artery, or else intense congestion from the collateral circulation. Later there may be inflammatory changes, softening, or gangrene. Thrombi in the veins produce inflammation in and around the vein, thickening of the skin and connective tissue, gangrene and hemorrhage.

The consequences of embolism vary with the character of the embolus and its situation. A simple plug of fibrine in a vessel only produces changes in the circulation, but a plug from a gangrenous thrombus has a tendency to excite suppurative inflammation wherever it lodges.

The size of the artery thus obstructed, and the character of its collateral circulation also lead to a variety of results. If a large artery is stopped, the part becomes empty; if a small one the part may become extravasated with blood from the collateral circulation. Thus, if the large arteries supplying the extremities are obstructed, paralysis of the muscles, and finally dry gangrene, ensue.

Emboli of the pulmonary arteries produce sudden death; of the coronary arteries, sudden death; of the cerebral arteries, softening of the brain; of the retina, sudden blindness; of the mesenteric arteries, congestion and gangrene of the intestines.

Abscesses are also produced. This takes place when the embolus is of an irritative and gangrenous nature. Large abscesses are only found in the lungs and liver, therefore the mechanical results of an embolus produce the following condition of affairs: A set of vessels are first emptied of their blood, and the nutrition of their walls thus impaired; after a time these vessels are filled up from the veins, their abnormal walls can no longer resist the blood pressure, and hemorrhage takes place.

After an hemorrhagic infraction is formed, the subsequent changes are of a degenerative character. The blood loses its coloring matter and breaks down into a mass of granules, forming a dry, yellow, wedge-shaped mass, or it may break down and form into a puriform fluid, or it may be surrounded by a zone of inflammation or of gangrene.

The above condition of the system will explain why and under the circumstances enumerated, the injection of a blood vessel may be brought to a sudden stop without any apparent cause, and the injecting fluid flow back towards the injecting point.

The various causes for such a result have been clearly demonstrated, but with the knowledge of these causes as previous stated, the remedy can be applied without much trouble. It can be estimated by the amount of fluid injected, about to what extent the vessel has been filled, and by following its course the point where the obstruction is, can be easily ascertained.

By reopening the vessel at a point above, the injection may still be carried on successfully, or the corresponding vessel on the other side of the body may be used for that purpose.

It is then that even a limited amount of knowledge of anatomy of the human body will be found of immense advantage to the operator, inasmuch as it will trace the cause of action, to be followed in this case, and will enable him to do so with success.

If, on the other hand, too great a pressure is brought to bear, so as to remove the obstruction by the mere weight of the fluid injected, the walls of the vessel may not be able to resist the strain, and the injecting fluid loses itself in the surrounding tissue and cavities, thereby failing to accomplish its mission.

PROCESS OF EMBALMING.

The following process is more laborious and requires more time than the one already given, but at the same time it is more complete and lasting, and when the operation is skillfully and properly performed, the body may be said to be embalmed for an indefinite period of time.

But to carry out this process to a successful issue, it will be found strictly necessary to study well, and bear in mind, all the details of the operation.

It would be impossible to omit any part of the process and still expect the same results, for, after repeated experiments and trials under favorable and adverse circumstances, the result has always proved to be the same. Still, this process is regulated by the same laws and governed by the same conditions which affect a body under all circumstances. An explanation of these conditions has already been given, and it will be found that a thorough knowledge of these will materially assist the operator in his work.

Let us suppose, for one moment, that a man entirely unacquainted with the causes which may affect the morbid conditions of the veins and arteries, goes recklessly on, and commences to inject some part of the circulating system; if that system is in a normal condition the injection will prove successful; if not, the worst consequences may follow. How is he then to remedy his mistake? His very limited knowledge, if he has any, will be of no avail to him. It is in the lack of a sufficient understanding of the human organism that the cause of many failures is to be found. When the proper antiseptics are used, the fault does not lie in the inefficiency, but in the manner in which they have been employed.

It is unnecessary to repeat here what we have before stated, that in order to understand thoroughly the process of embalming, the operator must make himself familiar with the explanations already given, and also with those which shall be found hereafter.

It will be seen in the following pages that the mode of treatment to which the body is subjected in this process, is entirely different from that which has already been given.

The completeness of this process will be readily understood after a careful study of its details, and if strictly followed in every particular, will be found not only satisfactory in its results, but also lasting for an indefinite period of time.

It is well enough to say here, that a metallic casket is not required to assist in keeping the body after it has been treated according to the following method. Quite the reverse, a wooden casket will answer the purpose much better, as the body is rendered perfectly inaccessible to the attacks of the ambient atmosphere by the external covering which encases the body, in its transparent and elastic coating, impervious alike to air and moisture.

The body should be placed on a table about four feet high, and elevated nearly six inches at the head; it must be here borne in mind that, to perform the following operation successfully, the operator should be left alone to his work, in a room free from intrusion, where idle questioning from standers by, or the talk of the usual routine of business, will not disturb him. And as it may require some time to complete the work, it were better that the remains were brought to the undertaker’s establishment, where there is generally, or ought to be, a room set apart for this branch of the business.

The body is first washed clean with soap and tepid water, so as to remove every particle of fat or greasy substance which might obstruct the pores of the skin, and thereby prevent the salts contained in the bathing lotion to penetrate the tissues and produce the desired effect.

The body must then be thoroughly dried by means of clean towels, and be well saturated with the following lotion:

Acetate of Alumina, 1 pound. Sulphate of Iron, 4 ounces. Corrosive Sublimate, 2 ounces. Water, 1 gallon.

The body is to be kept constantly moist with the aforesaid solution, and as soon as evaporation has dried up the surface of the skin, a new application of the solution becomes necessary; in fact, the process should come as near complete immersion as possible. The eyes must be well closed. To avoid the sinking, which after a certain time must inevitably take place, and which will disfigure the best prepared corpse, I would here suggest the use of the wax shells, to be inserted under the eyelids—these shells, as stated in a previous chapter, are manufactured by JOHN C. RULON, of Philadelphia, and can be had by the quantity on very moderate terms—to keep the eyelids in their place; the outside of the shell must be coated with white gum shellac, dissolved in alcohol.

After the insertion of the shells thus coated, the lids are brought together and held in place by the fingers. Shelac dries quick, and in about five minutes’ time it will be found that the gum has acquired enough of consistency to hold the lids together. As a matter of course it will get harder in time and prevent the lids from starting apart.

The operator will then cut a straight line through the skin with a scalpel, the line to extend from the superior part of the sternum to the umbilical region.

Another incision of the skin is to be made at right angles from the first, about six inches in length, and one inch below the lower bend of the last rib.

Then, with the thumb and forefinger of the left hand, seize the skin firmly at a point where the two lines intersect each other, and with the scalpel held in the right hand, carefully separate the skin from the fascia underneath. This operation is repeated on the four sides, and the flaps of the skin turned over the sides of the body. This will leave exposed to view a diamond shaped opening of the epidermis, with its apex reaching above to the superior portions of the sternum, and the lowest angle reaching to within two inches of the navel; the two lateral points extend on both sides of the body from the region of the stomach to the liver, and almost immediately above the transverse arch of the colon.