A small amount of bile is sufficient to tint the surface of the body. Bile is composed of salts, fats, organic matter, acids, and also coloring matter, called the bile pigments. Bilirubin is the principal coloring matter, and when dissolved in alkali, forms, when coming in contact with the air and also in the dead body, a green precipitate known as biliverdin. The bile pigments in the blood are carried with the serum from the capillaries to the tissues, being deposited in the internal coat or deep layer of the epidermis as well as the papillary of the dermis. The amount deposited regulates the extent of the pigmentation.
One of the most beneficial things to do, where pigmentation is present is to wash out the arterial system, draw blood from the veins, massage the exposed parts. Inject a diluted fluid at first, follow with a fluid of full strength, until complete disinfection and permeation of the tissues has taken place. Keep up constant massaging during the whole course of injection. This may bring fair results, with the addition of face tints and showing the body under artificial light.
Strong solutions of formaldehyde when used at first are deleterious, causing the skin to become green. This greenness is more pronounced when chemicals such as methylene blue have been administered by the attending physician before death. Bilirubin is a red yellow color, and alkalies precipitate the bilirubin and form biliverdin. Biliverdin is a greenish color.
All fluids contain alkalies, and are mostly alkali in reaction, and this may account for the greenish color of the skin after the injection of fluid. Acids do not precipitate the biliverdin and there is a tendency to dissolve it and keep it in solution.
Moadinger suggests that a weak solution of some acid be injected into the arterial system before the injection of embalming fluid. He prefers a two per cent. solution of oxalic acid.
Dhonau prefers the use of a one or two per cent. solution of borax, to be injected into the arterial system, followed by half strength fluid, and this followed by full strength fluid. Dhonau also applies full strength peroxide of hydrogen to the skin while massaging the face.
Eckels prefers the use of a fluid containing a peroxide.
If methylene blue has been administered by the attending physician and you have learned this fact before hand, it is then not advisable to use a formaldehyde fluid. There is a chemical action set up between the methylene blue and the formaldehyde which will give to the tissues a greenish color which is quite objectionable. In this case you would inject some fluid which does not contain formaldehyde. A benzoate of soda or borax, or peroxide solution would do.
A good formula to use, when you know methylene blue has been used by the attending physician is:
| Rx | Carbolic acid | 5 | oz. |
| Borax | 12 | oz. | |
| Glycerine | 1 | oz. | |
| Water, qs. | 1 | gal. |