A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomyThomas, A. R. (Amos Russell)
Science
A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomy
Thomas, A. R. (Amos Russell)
Anatomy, Pathological; Autopsy -- Handbooks, manuals, etc.
The body of a dead infant is found, and the physician may be called upon
to answer the following questions, one or all:—Was the child mature? Was
it born alive? If so, what was the cause of its death?
_Was the child mature?_ Among the various signs of fœtal maturity, such
as the firm, tense skin, of the usual pale corpse-color, the hair upon
the head, the weight and length of the body, the diameters of the head,
shoulders and hips, the horny nails reaching to the tips of the fingers,
the absence of the pupillary membrane, etc., the most infallible, is the
presence of the centre of ossification of the inferior femoral
epiphysis. “The easiest way to find this, is to make a horizontal
incision through the skin and superficial tissues over the knee-joint
down to the cartilages. The patella is then to be removed, and the end
of the femur made to protrude through the incision. Thin horizontal
sections are then to be removed from the cartilaginous epiphysis, at
first more boldly, but so soon as a colored point is observed in the
last section, then very carefully, layer by layer, till the greatest
diameter of the osseous nucleus is attained. This appears to the naked
eye as a more or less circular bright blood-red spot in the midst of the
milk white cartilage, in which vascular convolutions can be distinctly
recognized.” When there is no visible trace of this centre of
ossification, the fœtus can be no more than from thirty-six to
thirty-seven weeks old.
In still-born children, the commencement of this nucleus indicates a
fœtal age of thirty-seven to thirty-eight weeks; when it possesses a
diameter of from three-quarters to three lines, it shows the fœtus must
have attained a uterine age of forty weeks. When the osseous nucleus
measures more than three lines, we may conclude that the child has lived
after birth.
Isolated exceptions are occasionally met with, when, however,
concomitant appearances, such as, in the one case, defective
ossification of the skull, or in the other, peculiarly advanced
development, will guard us against mistakes.
_Was the child born alive?_ or, _Did it live during and after its
birth?_ and, _If so, how long?_
These questions are intimately connected, and in order to be able to
answer them, we must in our examination note the following points:
Public-domain text, read in full here on John Shaqi.
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