Anatomy and Embalming / A Treatise on the Science and Art of Embalming, the Latest and Most Successful Methods of Treatment and the General Anatomy Relating to this Subject

by Albert John Nunnamaker; Charles Otto Dhonau

—The position of the body on the embalming board is regulated by the adjustment of the movable head end of the board.

After much experience with various classes of bodies, we find that the adjustment mentioned is a very valuable aid in securing the best results both as to completeness of the circulation and amount of blood drained.

In anemic, tubercular, cancer of the stomach and exhaustion cases, together with other conditions resulting in emaciation, the head end of the board should be raised to the height that seems suitable for the position of the upper part of the body when placed in the casket during the injection of the first bottle of fluid. When the first bottle of fluid has been injected, lower the head end of the board until the entire board is level, and leave it in that position until you have completed the injection, when you will again raise the end of the board until the position of the body is just as it will be in the casket.

When pneumonia and other non-emaciated bodies are to be injected, with drainage, use the same procedure as is stated above for the emaciated bodies.

In dropsical cases, raise the head end of the board only for the first bottle of the injection; then for the second bottle, lower the head end to about half of its first height, and set the foot end of the board on some object that will raise it five and six inches. In this way you will have a slight elevation at both ends of the body, and drainage can better be obtained from the center of the circulation. When the operation is complete, lower the foot end again and raise the head end so that the body occupies the proper position for the casket.

These adjustments are practical methods of overcoming gravity handicaps in the distribution of the fluid, and of accelerating the amount of drainage obtainable by keeping the level of the drainage tube below the blood level in the body, thus accomplishing a universal distribution of fluid, and securing a greater quantity of undiluted blood from the vein.

It is very important to remember when you are through injecting the body that you are to place the body in the exact position on the cooling board which you want it to have in the casket. After a little time the body will become more or less rigid due to the action of the preservative fluid used, and will set in the position you have placed it which condition will be hard to change later.

Selection of an Artery.

—Great care should be taken in the selection of an artery. Never make a practice of using the same artery on all cases. Acquaint yourself with the location of them all, and on different occasions, as different conditions arise, use the artery most likely to give the best results for the condition in hand.

Convenience usually governs the operator as to the artery he is to use. If blood is to be removed it is best to raise one of the larger blood vessels, such as the carotid artery and the internal jugular vein, or the femoral artery and femoral vein, or the axillary artery and axillary vein. If it is desired to draw the maximum amount of blood, the femoral artery and vein should be selected, as they are more dependent, and control more of the blood, when the body is placed on an incline. A drainage tube sufficiently long to reach above Poupart's ligament as far as the common iliac is all that is necessary as there are no valves intervening between the bifurcation of the common iliac and the right auricle. However if you can, extend the tube up through the ascending vena cava and eustachian valve into the right auricle. This will give you a chance to draw blood from the right auricle and is a much better procedure than tapping the right auricle with the trocar.