26 THE METHOD OF MAKING POST-MORTEM EXAMINATIONS. 



Orth's fluid or formalin solution (5 : 100) is on the whole the best. If, however, the 

 lung is commencing to decay, strong alcohol will stop the process most quickly and 

 give as good results as are possible under the circumstances. Alcohol should be used 

 when the lungs are to be examined for bacteria. 



It is often desirable, and particularly in cases in which the topography of lesions is 

 to be studied, as in acute miliary tuberculosis, acute and chronic phthisis, infarctions, 

 etc., to inject the blood-vessels with colored gelatin. The lung should, after the injec- 

 tion, be hardened in alcohol. 



The Pharynx, Larynx, (Esophagus, and Thyroid Gland. For the re- 

 moval of these parts the incision through the skin should be carried 

 upward as far as practicable when permissible, to a point one inch be- 

 low the chin, the head being allowed to hang backward over the edge of 

 the table. 



The soft parts are dissected from the larynx, taking care not to cut 

 the thyroid body, and an incision is made through the floor of the 

 mouth, following the internal surface of the inferior maxilla. Through 

 this incision the fingers are introduced into the mouth, the tongue is drawn 

 down, the posterior wall of the pharynx is divided above the tonsils, and 

 the tongue, pharynx, and larynx are drawn out together. These organs 

 are then pulled downward, and with the aid of the knife the trachea and 

 ossophagus are removed entire, the oesophagus being cut just above the 

 stomach. If the contents of the stomach are to be preserved, as in cases 

 of suspected poisoning, a ligature is put around the oasophagus just be- 

 low the point at which it is to be cut off. 



With the euterotome the pharynx and oesophagus are now slit open 

 upon their posterior surfaces. The mucous membrane thus exposed is 

 examined for evidences of caustic poisons, of inflammation, tumors, 

 strictures, varices, etc. The enterotome is next introduced into the 

 larynx, and this organ and the trachea are laid open along the posterior 

 wall. Here we look for oedema of the aryteno-epiglottidean folds 

 (oedema of the glottis), for evidences of catarrhal, croupous, ulcerative, 

 and syphilitic inflammation, and for tumors and lesions of the laryugeal 

 cartilages. CEdema and redness of the larynx may result from post-mor- 

 tem changes, especially in bodies which have been kept for several days 

 in cold weather. A well-marked oedema glottidis during life may leave 

 no trace after death. Putrefactive changes usually commence early in 

 the larynx and trachea. 



The thyroid gland is dissected off and examined. Its weight varies 

 considerably, being, according to Krause, somewhat over 30 grams. 



PRESERVATION OP THE PHARYNX, LARYNX, TRACHEA, ETC. These structures are 

 freed from superfluous tissue and suspended entire by a thread in a large quantity of 

 Orth's fluid or Flemming's osmic-acid mixture, after which the hardening is completed 

 in the usual way. The oesophagus should be stretched loosely on sheet cork with pins, 

 and hardened in either of the above fluids. The thyroid may be cut into small pieces 

 and similarly hardened. 



