THE METHOD OF MAKING POST-MORTEM EXAMINATIONS. 27 



THE ABDOMEN. 



Eeturning now to the abdominal cavity, we first dissect off the omen- 

 turn. Tubercles of the peritoneum may be best seen in the ornentuni. 

 The colon is then raised and dissected free, to the caecum on one side and 

 to the rectum on the other. The colon and small intestines are then 

 drawn first to the right and then to the left side, so as to expose in turn 

 the right and left kidneys. As each kidney is brought into view an in- 

 cision is made through the peritoneum over the track of the ureter. The 

 ureter is followed through its entire length and its condition ascertained. 



Sometimes one, more rarely all, of the abdominal viscera are unusually 

 movable, owing to a relaxation of their ligamentous or other supports. 

 This condition euteroptosis is uncommon in the liver, more frequent 

 in the spleen, and especially so in the kidneys. It has been occasionally 

 described in the stomach and intestines. 



The Kidneys. These organs are now removed, the peritoneum and 

 fat being separated from them with the hand, and the vessels being di- 

 vided with the knife. The adrenals, at the upper end of each kidney, 

 are removed at the same time. The kidneys may be softened by putre- 

 faction, or the surface may have a greenish-gray color, caused by the 

 post-mortem action of putrefactive gases 011 the haemoglobin. 



An incision is made through the capsule, along the convex border of 

 the kidney, and the membrane stripped off. We notice the degree of 

 adherence of the capsule to the kidney, and also the surf ace of the latter, 

 whether smooth or roughened, palp, congested, or mottled ; an incision 

 is made along the convex surface down to the pelvis, so that the organ 

 is divided into halves. We observe the relative thickness of the cortical 

 and pyramidal portions, as well as the size of the entire organ. To as- 

 certain the latter point, it is well to weigh each kidney; the normal 

 weight is from 130 to 150 grams. The left kidney is, according to Orth, 

 from 5 to 7 grams heavier than the right. At from twenty to thirty-five 

 years of age, according to Thoma, the weight of the heart is to the 

 weight of both kidneys as 1 : 1.1. The weight of the kidneys of adults is 

 given by Vierordt in general as about 0.48 per cent of that of the entire 

 body. 



It is necessary to remember that in a kidney which is much atrophied 

 there may be an increase of fat in the pelvis, which gives the organ 

 nearly its normal size and weight, while the kidney tissue proper may 

 have in great measure disappeared. 



We now inspect the kidney tissue more closely, especially the cortical 

 portion. The pyramids consist largely of tubes running in nearly 

 straight lines from the apex to the base of each pyramid. These straight 

 tubes pass from the pyramids into the cortex in bundles, called medul- 

 lary rays, many of them retaining their straight course until they nearly 

 reach the surface of the kidney. These straight tubules send off branches 

 on all sides of the rays, which become convoluted, form Heule's loops, 



