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 artery will now be seen lying next to the wind pipe and the internal jugular vein to the outside. In the lower third the artery will be about one-half inch deep, while in the upper third it will be about one to two inches deep, owing to the amount of fat in this region. In the upper third, the omohyoid muscle crosses over the artery, which must be either pushed aside or cut in two.

It is always advisable, to raise this artery in the lower third, as it is less apt to show in that third.

Loosen the artery well from the surrounding tissues with the aneurism hook, raise to the surface and place a bone separator beneath the artery.

Now remove the individual sheath, incise the artery and insert the arterial tube.

If it is desired to raise the internal jugular vein for the withdrawal of blood, it is best not to open up the common sheath, but to raise the artery and the vein both at the same time. Having raised them to the surface they can then be separated by the removal of the common sheath and dropping it back into the incision.

If it is desired only to raise the carotid, the hook should always be inserted between the artery and the vein, and directed toward the trachea. If it is directed around the artery in the other direction there is danger of rupturing the vein, and thus getting a bloody incision.

The Circular Incision.—In the circular incision as much of the skin as can be, is pushed above the clavical bone from off the chest wall. The cut is then made from one sterno-clavicular junction to the other following the supra-sternal notch. This method was devised for the use of the “Y” shaped tube, where both sides of the face could be injected at the same time. One precaution however should be noted, which is, that care should be taken that not more than the skin, be incised with the first cut. Just below the incision will be noticed a little branch vein which runs into the arch connecting the two external jugular veins. If the first cut is too deep this branch will be cut, and a flow of blood will result. However by cutting carefully this little branch can be noticed, tied off in two places and cut in between, and thus cause no further trouble. Remembering the linear guide, the artery can be reached by going down at either end of the incision. The tissues to go through will be the same as for the perpendicular incision, and the method of raising the artery will be the same, only, in the circular incision usually both carotids are raised, so as to inject both sides of the face at the same time.

The only advantages derived from the circular incision is that one can by the use of the “Y” shaped tube inject both sides of the face at the same time and get an equal distribution of fluid, and that after the injection is over, and the incision sewed up, the skin can be pulled back in place, making the incision appear much below the clavical, and where it is less liable to show than in the perpendicular incision.

For embalming female subjects, if the carotid is chosen as the artery to use, it will be best to use the circular incision. However for ordinary embalming it will perhaps be best to choose some other artery, which will be less apt to show, and not so deep.

We should be so skilled as to never make a mistake, but the best sometimes do make mistakes. If in raising another artery, a mistake should occur, the operator can raise either above or below the original cut, but with the carotid, the only advisable incision to make is in the lower third, and if a mistake is made the last chance is lost. For this reason then a great amount of care should be taken.