Etiology.—Predisposing causes are injuries or abrasions of the mucous surfaces of exposed parts, for the disease can originate in only one way, by inoculation.
Modes of Infection.—There are three modes of infection; illicit intercourse, heredity and accidental. Of these the embalmer need only consider the accidental form of infection.
Pathology.—The initial lesion is the chancre, the secondary lesions are ulceration of the mucous surfaces and cutaneous eruptions, and the tertiary lesions are inflammatory products known as gummata, and are found upon the bones and periosteum, or in the skin, muscles, liver, kidneys, lung, heart, brain; in fact in any of the viscera of the body.
Treatment.—Wash body thoroughly with 5% carbolic acid or 1 : 500 solution of bichloride of mercury. Work with rubber gloves. Inject half strength fluid for the first 64 ounces of fluid and follow that with normal fluid until disinfection and preservation are assured. Give the body a complete cavity injection with normal fluid. Drain blood from a large vein, and disinfect the blood before disposing of it. Close all openings of the body with absorbent cotton saturated with normal fluid. Bandage any large sores and saturate the bandage with normal fluid. When purpura (characterized by a blue spot on the face) exists, the discoloration cannot be removed. If anything is to be done at all for the discoloration, it must be of the nature of a covering for the spot, such as paint or other cosmetics. For transportation of the body, govern yourself according to the transportation rules.
Tetanus.
—Synonyms.—Lockjaw; Trismus.
Definition.—An acute infectious, non-contagious disease, characterized by painful spasmodic contraction of the voluntary muscles, most frequently those of the jaw, face, and neck; less frequently those of the trunk, the extensors of the spine and limbs.
Cause.—The cause is recognized as the bacillus tetanus.
Pathology.—The infection usually enters by way of a wound, especially of the hands and feet, and a punctured wound rather than an incised one. The post-mortem lesions are not constant.
Treatment.—The body should receive a complete arterial injection using half strength fluid for the first part of the injection, followed by sufficient normal fluid to secure preservation and disinfection. Blood should be drained from the veins and should be disinfected before being disposed of. Wash the wound with 1 : 500 solution of bichloride of mercury and bandage it to avoid infection from it. Inject the cavities of the body. Close the openings. For transportation, govern yourself according to the provisions of the transportation rules.