34 THE METHOD OF MAKING POST-MORTEM EXAMINATIONS. 



THE GENITOURINARY ORGANS. 



The Male Organs. If the uriiie is to be examined it may be drawn off 

 with a catheter; or a vertical incision may be made into the bladder just 

 above the symphysis pubis, and some of the urine dipped out. The cut 

 end of the rectum should now be grasped with the left hand and raised 

 up, and this and the bladder, prostate gland, etc., dissected away from 

 the pelvis, the knife being carried close to the bone. The bladder is 

 now drawn backward and the loose tissue close under the symphysis 

 pubis cut. The body of the penis is then shoved backward within the 

 skin and dissected away from behind, beneath the symphysis, and finally 

 cut off just behind the glans penis. The penis and bladder are now 

 drawn backward and upward, and the pelvic organs removed together. 

 Or, the penis may be removed by sawing away the bones above the pubic 

 arch, and then dissecting away the penis, whose root is thus exposed. 



The pelvic organs are then laid on the table, the bladder uppermost ; 

 a long director is passed into the urethra, which is opened on its upper 

 surface through its entire length, and the bladder widely opened. In 

 the urethra the presence of strictures, diverticula, ulcers, inflammatory 

 lesions, is to be noticed ; in the bladder inflammatory lesions, hypertro- 

 phies, congestion and ecchymosis of the mucous membrane, hyperplasia 

 and ulcers of the lymph nodules, and tumors. The organs are now 

 turned over; the rectum is opened and examined for varicose veins, haem- 

 orrhages, ulcers, strictures, and tumors. The prostate gland is then cut 

 into and the presence of calculi, inflammatory lesions, hypertrophies, 

 and tumors sought for. Lastly, the vesiculce seminales are examined, in 

 which, though rarely, we may find evidences of tuberculous inflammation 

 and dilatation. 



The Testicles may be removed, when necessary, without cutting the 

 scrotum, by enlarging the inguinal canals from within and crowding the 

 glands through them and cutting them off. The average weight of the 

 adult testicle with its epididymis is, according to Krause, from 15 to 

 24.5 grams. Inflammatory lesions, tuberculosis, abscesses, and tumors 

 are the most frequent lesions. 



PRESERVATION. The urethral canal and bladder maybe pinned open and hardened 

 in Orth's fluid or in Flemming's osmic-acid mixture. The prostate, vesiculse seminales, 

 testicles, and tumors may be hardened in the same fluids. 



The Female Organs. The position and general condition of the pelvic 

 organs should first be determined by inspection. Abnormal adhesions 

 of the ovaries, broad ligaments, Fallopian tubes, and uterus ; malposi- 

 tions of the uterus ; subserous tumors of the uterus, and ovarian tumors, 

 are frequently observed. Haemorrhage into the posterior cul-de-sac is 

 sometimes found. The urine should be collected, if necessary, as above 

 directed ; the organs should be dissected away laterally, as in the male, 

 care being taken not to injure the ovaries and Fallopian tubes. The 



