Chapter IV: Conclusion (2)

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.

_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.

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.

To cut through the abdominal fascia, carefully puncture it above the stomach, so the opening will be large enough to admit the forefinger of the right hand being introduced through the opening; then holding the scalpel with its edge upwards, the back resting along the extended forefinger, introduce both into opening, and cut from downward upwards into the fascia of the abdomen in a straight line across from the stomach to the liver in a similar way to that above described for cutting through the skin. This last incision is to follow the same course as the one cut in the epidermis, and will extend from one to the other lateral angles of the diamond shaped opening in the skin. This opening will reveal the stomach on the left, the liver on the right, and the transverse arch of the colon immediately beneath.

Then another cleaving of the fascia is to be performed, downwards and in a similar manner, from the middle of the transverse opening to within two inches of the navel; this last opening exposes the small intestines.

The reason why the cutting of the fascia of the abdomen should be performed in this manner, that is, with the scalpel being held edge upwards along the extended forefinger, is obvious; the forefinger in this case acts as a guide to the scalpel in dividing the tissues, and also protects the viscera from being wounded by the sharp point of the knife.

The abdominal viscera being thus exposed, the lungs, heart and other parts of the thoracic viscera must also be uncovered. For this purpose, and with the cartilage knife separate the ribs from the sternum about two inches on either side of the latter; commencing from the second rib down to the last one, and extending to the transverse opening made in the abdomen, it will be found that the ribs at that distance from the sternum are attached to it by a cartilage, which it is very easy to cut in children, harder in adults, and it may sometimes be indispensable to use a saw on old persons. This cutting through the ribs must be carefully performed, for fear of wounding some of the organs which lay immediately beneath and against the ribs.

The sternum being thus freed from the ribs, it can be turned back over and against the face, and will reveal through the opening thus made, the lungs, the heart, the arch of the aorta, etc.

The operator should use extreme caution whilst performing this operation, as the jagged and sharp edges of the ribs might cut through the skin and inflict a wound, should the hand be suddenly brought in contact with them. It is also necessary to enjoin again forcibly, the recommendation made before, of keeping the body well saturated with the lotion while the work is progressing.