Prof. E. H. Crane's manual of instructions to undertakers

by Elliot H. Crane

Immediately after the gas has escaped, insert the point of the Syringe and inject one or two pints of the Excelsior Preservative into the cavity of the abdomen, which will pass all around the bowels and arrest any further decomposition or putrescence, and entirely prevent any further accumulation of gas or possibility of bloating. You can inject the Preservative through the Gas-trocar.

If you have found it necessary to make more than one incision with the Gas-trocar or knife, it is well to inject some of the Preservative into every opening made, even to the extent of three pints or more.

Whenever it is desirable for any reason to avoid leaving any external mark of the puncture, it should be made at the navel, first drawing the loose fold of skin at one side and puncturing through the navel; then, when the trocar is withdrawn the loose skin around the navel returns to its natural position. The trocar can be pointed downwards and to each side, injecting some of the Preservative in each place, thus accomplishing the thorough injection of the abdominal cavity from only one point of insertion.

In case it may be deemed necessary to inject the thorax (or cavity of the chest) raise or extend one of the arms and puncture and inject through the axilla or armpit.

The stomach may be reached from the point of insertion at the navel by pointing the Gas-trocar upwards at an acute angle, inclining it a little to the left in a line with the top of the left shoulder. The foregoing methods of injection have the advantage of leaving no visible trace of the operation.

It is also important (and not to be forgotten) to puncture the bladder with the Gas-trocar and draw off the urine. This is easily done by placing a washbowl or chamber in a chair and, after puncturing the bladder, turn the body on its side, and the urine will escape through the instrument at once, but if in some cases it might not escape through the Gas-trocar readily in this position it certainly will by raising the body to a sitting posture.

The point for the insertion of the Trocar to reach the bladder is just at the top of the os pubes or pubic bone (the bone uniting the hips in front at the bottom of the abdominal cavity), making the puncture in a line with the navel as near the top of the bone as you can and inclining the point of the Trocar a little downwards behind the bone.

Remember, always after the urine has been taken away, to inject at least half a pint of the Preservative into the bladder. It is important that this part of the work should be well done, for unless this precaution is taken, the urine is certain to escape more or less in the natural way on the second or third day.

And whenever the bladder is not thus attended to, you must never omit the simple precaution of putting on a good heavy diaper; say, double up a large sheet and use plenty of cotton well saturated with the Preservative, and do up the parts as snugly as a mother would her child, remembering to saturate these cloths again the second, third and fourth day, by pouring Preservative from the bottle on the diapers, thus deodorizing any escape that may have taken place, in order that there may be no disagreeable smell arising from this source on the day of the funeral.

This part of the practice is not new to those well up in the profession, but I have thought best to call your attention to these facts in order that no important point should be overlooked by any one.