Order and cleanliness should characterize the autopsy. Abundance of water should be at hand, and after every incision the knife should be dipped into a vessel of water standing on the autopsy table. Practically all cuts should be made with a clean wet knife; only in the case of the chief-incisions of the large organs is it of advantage to cut with a clean dry knife, when it is desirable to obtain a judgment of the moistness or dryness of the cut surface. Never cut with a dirty knife, as the cut-surface may be obscured. A gentle scraping with the knife-blade often gives a more distinct picture of the cut surface. The water-stream should not be used too freely upon cut surfaces; it should be employed only when there is so much blood or fluid that the surfaces are obscured, or when it is desired to float up certain tissues or parts of organs. A better picture of the cut-surface can sometimes be obtained by blotting it with absorbent paper free from lint. Organs and tissues removed from the cadaver should not be allowed to dry. Nor should they be left in water. Both conditions will quickly ruin material in so far as its after-use for microscopic study is concerned. They should be kept covered with moist cloth or paper. As the organs are removed from the body they may be quickly dipped into water and quickly rinsed, but beyond this the use of water is not advisable.

Blood and fluids within the cavities of the body should be quickly removed as soon as their character is determined. Stomach and intestinal fluids in particular should not be allowed to escape within the body-cavities. They should not be washed out, but removed by the aid of beakers and sponges. Drops of blood or other fluids upon the surface of the cadaver should be removed before they become dry. All respect should be paid to the dead body. The face and hair should be covered after they have been examined; and great care should be taken to prevent any accidental cuts on the surface; and the entire field of operation as well as the autopsy-table must be kept clean. In private practice the external genitals should be kept covered except for their examination. An abundance of large sponges and a gently-flowing stream of water under low pressure permit a clean and orderly autopsy. The use of a hose with water under high pressure is dangerous because of the accidental spattering that is sure to occur. Blood and fluids from a dead body should not be spattered about because of the great danger of spreading infection. When accidents do happen prompt cleaning up and disinfection should be carried out. Particularly in private practice is it of the greatest importance that no blood-stains be left behind.

The time required for an autopsy varies with the conditions of the individual case. A complete and well-performed autopsy under ordinary circumstances requires at least one hour, usually an hour and a half. It is true that all the organs can be removed from the body in a much shorter time, but the removal and inspection require at least the time given above, if properly done. Some cases present great difficulties and may require 4-12 hours for a satisfactory and complete examination. For a medicolegal examination 2-3 hours is usually necessary. No prosector should make more than two autopsies in one day, and, if he is making them every day, one daily is quite sufficient. The intellectual and nervous energy required for a good autopsy is so great that it is impossible for anyone to do justice to a large number made in quick succession. In many German laboratories this fact is recognized and the autopsies are assigned proportionately to members of the pathologic staff.

At the close of the autopsy the cadaver must be thoroughly cleaned and restored, as far as possible, to its natural appearance. Directions for the restoration and closure of the autopsied body will be given in a later chapter.

CHAPTER II.
THE ORDER OF THE AUTOPSY.

ORDER OF THE AUTOPSY. In so complicated a piece of work as the complete autopsy it is absolutely necessary that a definite order of procedure be followed at every autopsy, altered when necessary to suit the requirements of individual cases. In medicolegal examinations a definite autopsy order should be prescribed by law. For the average case, in fact for nearly every autopsy, I believe the following order, as given in my protocol book, to be the best one. It is based upon topographic and anatomic relationships, preservation of blood-content, ease and convenience of method, etc. As the protocol should follow this order, it is given here in full.

Autopsy-Protocol No.

1. Name: 2. Sex: 3. Age:
4. Nationality: 5. Status: 6. Occupation:
7. Day and Hour of Death: 8. Time of Autopsy:
Clinical Diagnosis:
Pathologic Diagnosis:
Prosector:

A. External Examination. General.

 9. Build:27. Muscles:
10. General Nutrition:28. Rigor Mortis:
11. Head:29. Panniculus:
12. Facies:30. Oedema:
13. Eyes:31. Body Heat:
14. Neck:32. Hypostasis:
15. Thorax:33. Putrefaction:
16. Abdomen:34. Orifices:
17. Back:Mouth:
18. Anomalies:Nose:
19. Deformities:Ears:
20. Signs of Trauma:Genital:
21. Surgical Wounds:Anus:
22. Scars:35. Postmortem
23. Skin:Percussion:
24. Hair:
25. Teeth:
26. Mucous Membranes: