4 THE METHOD OF MAKING POST-MOKTEM EXAMINATIONS. 



of the affected part, changes which even the microscopical examinations 

 of the past have failed to disclose. So that while there often appears to 

 be a wide discrepancy between symptoms and lesions, with the increase 

 of knowledge the scope of this discrepancy is steadily narrowing. It is 

 the novice in post-mortem examinations who is particularly apt to mis- 

 take for lesions ordinary post-mortem alterations or the effects of em- 

 balming processes. 



External Inspection. 



Before commencing the examination of the internal viscera an inspec- 

 tion should be made of the external surface of the body. The minute- 

 ness of this inspection will depend upon the character of the case. In 

 the case of an unknown person, or of one suspected to have died from 

 unnatural causes, it is necessary to search for and record not only all 

 contusions, wounds, etc., their size, situation, and condition, but also 

 deformities from disease and any physical peculiarities of hair, ej'es, 

 teeth, moles, etc., by which the person may be identified. In such cases 

 it is well, if possible, to photograph, weigh, and measure the body. In 

 cases of doubtful identity it is sometimes wise to make a wax or plaster 

 cast of the outside of the teeth and jaws. In ordinary examinations we 

 note the general nutritive condition of the bod}*, and look for evidences 

 of external injury, for skin diseases, ulcers, osdema, gouty deposits, ab- 

 scesses, enlarged lymph nodes, etc. The external organs of generation 

 should be searched for syphilitic lesions. 



It is well to weigh the body, since the significance of the weight of 

 the individual organs is often closely dependent upon the relationship 

 of their weight to that of the entire body. 



Cadaveric Lividity. It is usual to find certain changes in the exter- 

 nal appearances of the body, which are due to the cessation of life and 

 the commencement of decomposition. We speak now of bodies which 

 have not been buried, but which have been kept in the ordinary way, 

 lying on the back, and loosely covered with a shroud or dressed with the 

 ordinary clothing. 



After life becomes extinct, and before the blood coagulates, it changes 

 its position chiefly in two ways : first, it is driven by their contraction 

 out of the arteries into the veins ; second, it settles in the veins and 

 capillaries of the more dependent parts of the body, inducing usually 

 within a few hours after death, a mottling of the surface with irregular 

 livid patches. These patches may coalesce, forming a uniform dusky- 

 red color over the back of the trunk, head, and extremities, and some- 

 times over the ears, face, and neck. The same effect is observed on the 

 anterior aspect of the body if it has lain on the face. At points of pres- 

 sure, from folds in the clothing, or from the weight of the body on the 

 table, the red color is absent or less marked. These changes occur be- 

 fore putrefaction sets in. This cadaveric lividity or hypostasis should 

 not be mistaken for aute-mortem ecchymosis, from which it may usually 



