Pathology.—There is, in most cases rupture of the capillaries of the bronchial mucous membranes. If tubercular cavities are formed, a ruptured aneurism is sometimes seen, or large blood vessel eroded by ulceration. If pulmonary apoplexy has existed, the parenchyma may be lacerated.
Treatment.—Some operators wait until fluid passes from the mouth before taking steps to stop the hemorrhage due to the injection of fluid. We prefer to use plaster of paris and cotton, making a paste of them and forcing the paste down upon the epiglottis to prevent the waste of fluid from that source. When the cause of death is known, this operation must be done before the injection is begun or the throat will have to be dried out before the plaster of paris will set properly. Another treatment to prevent the leakage of fluid would be to tie off the trachea just above the upper border of the sternum.
The body is usually emaciated and should be injected arterially with comparatively mild fluid, in order to avoid drying or dessication of the features. Whenever fermentation exists in the abdomen, the cavity should be injected; otherwise it is not usually necessary. The amount of fluid for the injection should be based on the amount that will be taken by the vessels of a body the size of the one being injected. For transportation of these cases the provisions of the transportation rules should be your guide.
Pulmonary Abscess.
—Synonyms.—Abscess of the lungs; Suppurative pneumonitis.
Definition.—A collection of pus in the lung, accompanied by degeneration of tissue.
Pathology.—The abscess may involve one or more lobules, or engage almost the entire lobe, or the abscesses may be scattered throughout the whole lung.
Treatment.—Should hemorrhage occur, treat this case the same as for pulmonary hemorrhage. If no hemorrhage occurs, give the body a complete injection with a mild fluid and inject the pleural sacs from the first intercostal space or the apex of the cavity. For transportation, govern yourself according to the provisions of the transportation laws.
Pneumonia.
—This disease is divided into different subdivisions as follows: Lobar Pneumonia, broncho-pneumonia, and chronic interstitial pneumonia.