CHAPTER I. 



THE METHOD OF MAKING POST-MORTEM 

 EXAMINATIONS. 



General Considerations. 



THE object in making a post-niorteni examination may be to deter- 

 mine whether a person has died from violence or poisoning ; to account 

 for a sudden death ; or to study the lesions of disease. In any case the 

 examination should include all the important parts of the body, not 

 merely a suspected organ, and the results should be recorded at the time 

 the examination is made. 



Great care is necessary in endeavoring to ascertain the cause of death 

 when the clinical history is imperfect or unknown. Mechanical injuries, 

 ^rhich destroy life by abolishing the function of one of the important 

 viscera, are relatively infrequent. Most of the lesions found after death 

 are rather the marks of disease than the cause of death. We do not 

 know, for example, how great a degree of meningitis, or of pneumonia, 

 or of endocarditis, or of cirrhosis, or of nephritis necessarily leads to 

 death. On the contrary, one patient may recover with an extent of 

 lesion which is sufficient to destroy the life of another. So with acci- 

 dents ; there is often no evident reason why fractures of the skull or of 

 the pelvis should destroy life, yet they usually do. In some of the in- 

 fectious diseases, such as typhoid fever, the visible lesions cannot always 

 be called the cause of death. Sudden deaths of persons apparently in 

 good health are often particularly obscure. In many of them we have 

 to acknowledge that we can find no sufficient cause for the death. This 

 is of course due to our imperfect knowledge, but it is much better in 

 such cases to avow ignorance than to attribute the death to some trifling 

 lesion. The brain and the heart are the organs which are especially cap- 

 able of giving symptoms during life, without corresponding lesions after 

 death. Very well-marked cardiac or cerebral symptoms may continue 

 for days or months, and apparently destroy life, and yet after death 

 we find no corresponding anatomical changes. 1 But it Should be re- 

 membered that recent advances in our knowledge of the cell, which an 

 improved technique in hardening and preparation has greatly fostered, 

 have already shown that under various abnormal conditions the cells, 

 especially of the nervous system, may undergo morphological changes of 

 great significance, without perceptible alteration in the gross appearance 



1 See Sudden Death, page 48. 



