49. In cases where the possibility of poisoning must be kept in view, and where matters may require to be procured for chemical analysis, it is essential to be sure that all instruments, vessels, and bladders used are scrupulously clean.
50. When any unusual odour is perceived, either in the blood in the course of making the dissection, or in the stomach when opened, it ought to be carefully observed, and if possible identified by all the medical men present. In this way alcohol, opium, prussic acid, oil of bitter almonds, and other odorous poisons may be recognised. The smell of the contents of the stomach ought always to be noted whenever it is opened, as the smell often alters rapidly.
51. The stomach and intestines should be taken out entire, and their contents emptied into separate bottles. If the stomach or part of the intestines present any remarkable appearance, examination may be reserved, if convenient, till a future opportunity; but in every circumstance it must be preserved and carried away, as it may itself be an important article for analysis. The throat and gullet may be examined at once, and preserved with their contents, which, if abundant, may be kept apart in a bottle. In addition to the alimentary canal and its various contents, portions of the solid organs of the body ought to be secured for analysis. The most important are the liver, spleen, and kidneys. A part of the liver, at least a fourth part, should be secured in every case of supposed poisoning; and in cases where the fatal illness has been of long duration, and therefore only traces of the poison may remain in the body, the whole of the liver, the spleen, and both kidneys should be secured. A portion of the blood, especially when the odour of any volatile poison is perceived, should be at once put into a bottle, closed by a good cork or stopper.
52. No person ought to undertake an analysis in a case of suspected poisoning unless he be either familiar with chemical researches, or have previously analysed with success a mixture of organic substances, containing a small proportion of the poison suspected.
53. All persons undertaking an analysis should bear in mind that the opinion of some other person practised in toxicological researches may be required; and they should therefore take care, when practicable, to use only a portion of the several articles preserved for analysis. The identity of the subjects for analysis must be secured by the [rules in Sect. 13].
VII. Examination in Cases
of Suffocation
54. In cases of suspected drowning, the inspectors will observe particularly whether grass, mud, or other objects be clutched by the hands, or contained under the nails; whether the tongue be protruded or not between the teeth; state of the penis; whether any fluid, froth, or foreign substances be contained in the mouth, nostrils, trachea, or bronchial ramifications; whether the stomach contains much water; whether the blood in the great vessels be fluid. Careful pressure should be made upon the lungs; any fluid contained in them in thus forced into the bronchial tubes and trachea, and its nature observed. When water with particles of vegetable matter or mud is found within the body, these must be compared with what may exist in the water in which the body was discovered, and should be preserved for further scientific investigation, if requisite. Marks of injuries must be compared diligently with objects both in the water and on the banks near it, and especial attention given to the question—whether any observed injuries had been sustained by the body before or after death.
55. In cases of suspected death by hanging, strangling, or smothering, it is important to attend particularly to the state of the face as to lividity, compared with the rest of the body; the state of the conjunctiva of the eyes as to vascularity; of the tongue as to position; of the throat, chin, and lips as to marks of the nails, scratches, ruffling of the scarf-skin, or small contusions; the state of the blood as to colour and fluidity; the state of the heart as regards the amount of blood in its several cavities; the state of the trunk and branches of the vena cava in the abdomen as regards distension with blood; and the state of the lungs as regards congestion, rupture of any of the air cells, and small ecchymoses under the pleura, or the pericardium. The mark of a cord or other ligature round the neck must be attentively examined; and here it requires to be mentioned that the mark is often not distinct till seven or eight hours after death, and that it is seldom a dark livid mark, as is very commonly supposed, but a pale greenish-brown streak, presenting no ecchymosis, but the thinnest possible line of bright redness at each edge, where it is conterminous with the sound skin. Nevertheless, effusions of blood and lacerations should be also looked for under and around the mark, in the skin, cellular tissue, muscles, cartilages, and lining membrane of the larynx and trachea. Accessory injuries on other parts of the body, more especially on the chest, back, and arms, must also be looked for, as likewise the appearance of blood having flowed from the nostrils or ears, and the discharge of fæces, urine or semen. In cases where death may be due to the emanations from burning fuel or other poisonous vapours, a small phial should be filled with the fresh blood, and securely corked for further investigation, if requisite.
VIII. Examination in Cases
of Burning
56. In supposed death by burning, the skin at the edge of the burns should be carefully examined for redness, or the appearance of vesicles containing fluids.