POST MORTEM EXAMINATIONS.
Before commencing the work of embalming, and even while laying out a corpse, it is always necessary to make an inspection of the surface of the body. The minuteness of this inspection will depend upon the character of the case, and, in a great measure, dictate the course of treatment to be followed so as to insure success. It also behooves the operator, for his own safety, to look for evidences of skin diseases, ulcers, abscesses, etc.; the glands, penis and prepuce are to be carefully examined for syphilitic cicatrices.
It is customary to find certain changes in the external appearance of the body, which are due to the cessation of vitality in the tissues and the commencement of decomposition. I speak now of bodies which have not yet been buried, and which have been kept in the ordinary way, partly covered by a shroud, and lying on the back, in a loosely covered coffin.
If the bodies have been left in their ordinary clothes, the appearances are just the same. In such bodies, one of the first noticeable changes is the paleness of the skin and its mottling with irregular livid patches. After a short time the blood settles in the vessels of the more dependent portions of the body, and the skin which covers the back of the trunk and extremities becomes of a livid red color.
In many cases, if we cut through the skin, we find the tissues beneath congested and infiltrated with bloody scum; in bodies which have been kept for a number of days in cold weather, this red color is also seen on the anterior portions of the body, especially on the face and neck. In hot weather, the red color is very soon altered by decomposition; if the epidermis has been detached at any point, the skin beneath this is dry, hard and red. In warm weather, we may find, for a few hours after death, broad, bluish lines, corresponding to the cutaneous veins, ramifying in the skin of the neck and thorax. These lines are formed by the escape of the coloring matter of the blood from the vessels.
Within a few hours after death, even in cold weather, there is usually some escape of bloody froth and mucous from the mouth and nose. If the eyelids are not closed, the conjunctira and cornea soon become dry, brown and hard, the eyeballs also become flaccid. After a considerable time the skin of the abdomen becomes green; still later, decomposition fairly sets in. The entire body is of a dark green color; the tissues are infiltrated with serum, the abdomen is distended with gas, then the color changes from a green to a reddish brown; the epidermis is detached; the skin is covered with maggots; the entire body is swollen from the formation of gases; the face can hardly be recognized; the nails drop off, and the scalp becomes detached.
When a body is in this condition it can hardly be determined whether a month or five months have elapsed since death occurred. After this all the soft parts change into a formless, pustulent mass. The cavities are open, the viscera are indistinguishable, and the bones are left bare.
The rapidity with which these changes take place, varies under the influence of a great number of conditions. The bodies of infants usually decompose more rapidly than those of adults; fat bodies putrefy quicker than lean ones; the bodies of persons who die suddenly from violence, decompose less rapidly than the average, unless the body be considerably mangled. Exhausting diseases, fevers, and the puerperal condition, are followed by rapid decomposition, as is also death from suffocating gases. Poisoning by alcohol, by arsenic, and by sulphuric acid, may preserve the bodies for an unusual length of time. Atmospheric air, moisture, and warmth, quicken decomposition. At the same temperature, a body which has been for one week in the air, one which has been two weeks in the water, and one which has been eight weeks buried in the usual way, will all exhibit the same degree of decomposition.