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faction; that the blood is in a fluid state; that hemorrhages are seen in various parts; that the stomach and intestines show sloughing without any inflammation. Some of these conditions may and probably do occur, but they are far from being invariable in their appearance. Experiments made by Orfila on animals with narcotic poisons prove the above statement. In conclusion, I would emphasize the fact that the narcotic poisons produce no characteristic changes in the stomach that can be detected.
The Liver.-The liver should be removed from the body and no attempt made to examine the organ in situ. After raising first one lobe and then the other, the diaphragm should be cut on either side and the suspensory and lateral ligaments divided, then the organ can easily be removed. The weight of the organ is ascertained, as also the measurements of its size recorded. The normal weight is from fifty to sixty ounces. The organ is normally about twelve inches in length by seven inches in depth by three and one-half inches in thickness.
The gall bladder is first examined to determine the character and amount of the bile and the presence or absence of gall stones, inflammatory lesions, and tumors.
At autopsies the surface of the liver, especially along the free border, is generally seen to be of a greenish or dark-brown color. This discoloration is due to the action of the gases developed by decomposition on the coloring matter of the blood, and has no pathological significance. The character of the surface of the liver is now noted, whether smooth or rough. The organ is opened by deep incisions in various directions, and the color, consistency, and blood supply of the liver tissue carefully recorded. The presence of new connective tissue, amyloid degeneration, abscesses, or tumors should not be overlooked. It should be remembered that, of all the poisons, phosphorus alone leaves characteristic appearances in the liver.
The Pancreas.- The pancreas is now easily removed, and its size and weight recorded. Normally it should weigh three ounces and measure eight inches in length by one and one-half inches in breadth by one inch in thickness. The organ should be opened by a longitudinal cut and examined for evidences of acute or chronic inflammation, fat-necrosis, tumors, calculi, and amyloid degeneration.
Genito-Urinary Organs.-It is very important in medicolegal cases that all the urine should be preserved and obtained uncontaminated; therefore before the bladder is opened a catheter should be introduced and the urine drawn off into a clean bottle which has previously been rinsed with distilled water. If more convenient the bladder itself can be punctured at its upper portion, a pipette introduced, and the urine drawn off in this manner.
The genito-urinary organs are removed together. This is done in the following manner. The body of the penis is pushed backward within the skin and cut off just behind the glans penis; the remaining portion of the rectum is raised. This with the prostate gland, bladder, and penis attached is removed by carrying the knife around the pelvis close to the bone and separating the pubic attachments. The organs are then laid on a clean board and the urethra is opened on a grooved director passed into the bladder, and the incision prolonged so that the internal surface of the bladder itself will be completely exposed. Examine the urethra for strictures, inflammatory lesions, and ulcers. Examine the bladder for congestion, hemorrhages, inflammation, and ulcers of its mucous surface, and note the thickness of its walls. Open the rectum and examine for ulcers, strictures, tumors, and the evidence of hemorrhage. The prostate gland is opened by a number of incisions into its substance. Examine for hypertrophies, tumors, and inflammatory lesions. Force the testicles through the inguinal canal, and cut them off. Weigh, open, and examine them for evidence of inflammation, tuberculosis, and tumors.
Female Organs.-Before removing these organs, any abnormalities such as adhesions, malpositions, and tumors should be noted. Dissect the organs away from the pelvic bones by carrying the point of the knife around the pelvis close to the bone. Cut through the vagina at its lower third, and the rectum just above the anus. The organs can now readily be removed. Examine the vulva for ulcers, hypertrophies, and tumors. Open and examine the bladder. Open the vagina along its anterior border and carefully examine its mucous surface for evidences of inflammation.
THE UTERUS.-Before opening the uterus, its size and shape should be recorded. The average normal weight of the organ is about one and one-quarter ounces; its length three inches, breadth two inches, and thickness one inch. Open the organ along its anterior surface by a blunt-pointed scissors passed through the cervix, and the incision carried as far as the fundus. Note the thickness of its walls and any abnormalities of its mucous membrane. During menstruation, the mucous membrane of the body is thickened, softened, and covered with blood and detritus. Retention cysts are found in the mucous membrane of the cervix and are not generally of pathological significance.
Remove, measure, and weigh the ovaries. Their normal weight is about one drachm each; their size, one and one-half, by three-quarters, by one-half inch. Open the organs by a single incision and examine for the evidences of acute and chronic inflammations, tumors, and cysts. The corpora lutea in various stages can be easily recognized in the substance of the organ. Open the Fallopian tubes and examine their contents and the condition of their membranes (see DISPUTED PREGNANCY AND DELIVERY, Vol. II.).
THE SPINAL CORD.
To remove the cord, the body should be placed on its face with a block beneath the thorax. An incision is made through the skin and muscles along the entire length of the vertebral column and the soft parts dissected away so as to expose the transverse. process of the vertebræ. The lamina are divided with a saw through the articulate process (a double-bladed saw specially adapted for this work can be obtained). lamina have been completely severed, these together with the spinous process can now be readily torn away with a stout hook and the cord exposed. A long chisel with a wooden mallet will often greatly facilitate this work. Great care should be exercised not to injure the cord. The roots of the spinal nerves are now severed, and the cord removed within its membrane. It should be remembered that serous fluid within the membranes of the cord, as also intense congestion, especially along its posterior aspect, is often seen as the result of post-mortem change. The cord is laid on a clean board and the dura mater opened with a blunt-pointed scissors along its anterior aspect, and an examination made for the presence of hemorrhage, inflammatory lesions, and tumors. Softening of the cord can generally be detected by the finger passed along it. This, however, is not a perfectly accurate test, especially if the body has been dead some time. The cord is now cut by transverse incisions about half an inch apart throughout its entire length, and the cut surface examined for the evidences of disease such as hemorrhages, softening, and inflammatory lesions.
After the cord has been removed, examine the vertebral column for the evidences of fractures and displacements.
Late autopsies are those performed after partial or complete destruction of the soft parts of the body, through the natural processes of decomposition, or the examination of bones exhumed long after interment. The term may be employed also to mean the inspection of an embalmed body, dead for some time.
The object of late autopsies is to determine identity, or to establish the guilt or innocence of suspected persons. · An examination of the skeleton even many years after death may give important information as to the manner in which the deceased came to his end. This cannot better be illustrated than by the citation of one or two cases.
In the celebrated case of “Eugene Aram," the bones of his victim were discovered thirteen years after the crime had been committed. A man who afterward proved to be Aram's accomplice was arrested on suspicion. He confessed the crime, and the opinion formed by the medical witnesses was confirmed by his statements. The skull presented evidence of fracture and indentation of a temporal bone. Aram argued the case in his own behalf, but the testimony was too strong against him: he was convicted and executed.
Taylor records the case of a man, Guerin, who was convicted of the murder of his brother from evidence obtained from an examination of the skeleton three years after interment. Here, again, blows upon the head were the cause of death, and the fractures were plainly perceptible upon the exhumed skull.
An autopsy upon a body before the soft parts have been entirely destroyed, or upon an embalmed body, should be conducted in much the same manner as ordinary autopsies. In these cases the method of burial should be noted. If it be a case of murder, and the body has been hurriedly put into the ground, it is not likely that the custom of Christian nations has been observed that of laying the body full length, with the head to the west.
In the case of partially destroyed bodies, the remaining soft parts will give little evidence of the mode of death unless the violence has been very extensive, and even then it may be impossible to determine whether a wound was inflicted prior to or after death. Recourse must be had to the skeleton, and the only evidence it can furnish is of fractures, unless, as happened in one case, a rope be found about the cervical vertebræ.
When the skeleton only is found, Taylor lays stress upon the following points:
(1) Whether the bones belong to a human being or one of the lower animals.
(2) If a human being, whether male or female.
(3) The length of time they have probably remained in the ground.
(4) The probable age of the individual to whom they belonged. If the maxillary bones be found, much information may be obtained from an examination of the teeth.
(5) The probable stature of the individual during life.
(6) The race to which he belonged. The conformation of the skull and thickness of the bones will give important information on this point.
(7) It should be determined whether solitary bones belong to the right or left side, and whether they form parts of one or more than one skeleton.
(8) Whether they have been fractured, and if so, whether it occurred during life, or by accident at the time of the exhumation. If it occurred during life, whether it be recent or of long standing
(9) The presence or absence of personal deformities, of supernumerary fingers or toes, of curvature of the spine, of ankylosis of one or more joints.
(10) Whether they have been calcined, as murderers sometimes try to make away with the bodies of their victims by