Now turn the body over and hypodermic the back, then turn body over again. Fill the cranial cavity with sawdust, place the skull cap in position and sew up the scalp. Wash all the organs and place them back in the cavities in their proper positions or as nearly so as possible and as you do so fill in with hardening compound. Sew up the abdomen and wash the body with a disinfecting solution and apply outward cosmetics.
CHAPTER XXV. TREATMENT OF MISCELLANEOUS CASES.
Alcoholism.
—Definition.—An intoxication, acute or chronic, due to the injection of a sufficient quantity of alcohol to produce muscular inco-ordination, mental disturbances, and finally narcosis.
Pathology.—Where death is the result of acute alcoholism, the mucous membrane of the gastro-intestinal canal is engorged, injected, and dark red in color, and covered with a sticky, mucoid exudate. The brain and the kidneys show the same characteristic changes. In chronic alcoholism, changes of a more permanent character take place, depending somewhat upon the quantity, quality and kind of alcoholics consumed, and the length of time used. While all the bodily tissues are more or less impaired, the brain, kidneys, and digestive system suffer most. There may be connective tissue changes, fatty degeneration, sclerosed kidneys, liver or arteries, and a more or less dilatation of the stomach.
Treatment.—In acute alcoholism, the blood should be drained from a large vein, while fluid is being injected into a large artery. After draining a sufficient amount of blood from the body, the vein tube should be shut off and the arterial injection should continue until the capillaries have been filled to their utmost capacity. This strong treatment is advised on account of the early tendencies toward putrefaction, which is sometimes in an advanced state shortly after death. The cavities should receive a thorough treatment with normal or supernormal fluid. Myers advises the re-injection of the cavity in 6 or 8 hours after removing the fluid remaining in the cavity from the first injection. As a preventive treatment, this last is a wise precaution. While the cavity treatment is being given the stomach should be entered by the trocar, relieved of its contents and injected, thus preventing post-operative purging.
In chronic alcoholism, the greatest circulation difficulties will be encountered. The capillaries will not receive the fluid, the putrefactive processes causing the formation of tissue gas early in the case, which, when coupled to many natural impediments to the circulation in cases of this kind, virtually nullifies the circulation for fluid distribution. Inject as many arteries as possible, and if necessary the veins also. Use the hollow needle or trocar and give the unexposed portions of the body a heavy hypodermic injection. The fluid used in this case should be not less than normal in strength and in most cases should be at least ¼ over normal. Give the cavities a very heavy injection, paying special attention to the food passages. This is one of the cases coming to the attention of the embalmer where every emphasis must be laid upon the injection of a sufficient amount of fluid, through as many channels as possible. Do not count the cost of the fluid in this case, if you value the securing of satisfactory results. Cosmetic effect will be enhanced by injection of the carotids upward with drainage from the internal jugular veins. Finish the case with the use of good face powder, unless a discoloration is present, when this should be obliterated with one of the improved methods mentioned in the chapter on discolorations.
Morphinism.
—Definition.—A chronic intoxication due to the habitual use of opium, or some of its alkaloids, especially morphine.
Pathology.—There are no characteristic tissue changes, other than that due to indigestion and malnutrition. At death the patient is anemic, the skin dry, sallow and inelastic, the heart and blood vessels show the effects of poor nutrition, and the tissues generally present a starved appearance. The blood disintegrates, causing a discoloration of a brownish color, one or two days after death.