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 position of the diaphragm_, is a good diagnostic sign. The
diaphragm will necessarily be higher where there has been no
respiration, natural or artificial, than where the child has actually
breathed. “Its position is most easily ascertained by making a
longitudinal incision through the skin and superficial cellular tissue,
from the chin to the pubis, in the mesial line, dissecting these from
the thorax on both sides, next carefully opening the abdominal cavity,
introducing the finger of one hand into it, and pressing it up to the
highest point of the concavity of the diaphragm, and then with one
finger of the other hand reckoning off the intercostal spaces from above
downwards till both fingers correspond. The rule is, that the highest
point of the concavity of the diaphragm in children born dead, is
between the fourth and fifth ribs, and in those born alive, between the
fifth and sixth.” Where respiration has been but transitory, the
diaphragm will remain very nearly in its fœtal position.
_The lungs_, from lying quite posteriorly in the fœtus, come to fill the
cavity of the chest, the more perfectly respiration has been
established. In the fœtus, the left lung is never found even partially
covering the heart. Where respiration has been but transitory and
imperfect, the volume of the lungs will not be much increased.
The presence of dark bluish-red, insular patches in the lungs, no matter
what may be their ground color, proves that respiration has taken place.
The crepitant spongy consistence of the lungs of a live-born child, is
readily distinguished from the compact, resistent liver-like lungs of
one still-born.
The hydrostatic test for the presence of air in the lungs, is of all,
the surest for deciding whether respiration has taken place. The vessel
used should be at least one foot in depth, eight or ten inches in
diameter, and filled with pure cold water. The buoyancy of the lungs
depends upon the greater or less completeness with which the pulmonary
tissue is permeated by the air. Only one lung may float, generally the
right one, or only single lobes, or only a few pieces into which the
lung has been and must be divided, in order accurately to apply the
test. Artificially inflated fœtal lungs, may be distinguished from those
lungs which have respired, by the presence, in the case of the latter,
of the bluish-red mottling above referred to, and the escape of bloody
froth when the substance of the lungs is cut into, and slight pressure
applied.
The general appearance of putrescence in the lungs, will serve to
distinguish the buoyancy arising from the gaseous products of
putrefaction, from that due to respiration.
Careful attention to the foregoing points, will enable us to answer with
certainty whether the child was born alive.
_How long did the child live after its birth?_ The question can be
approximately answered with reference to the first few days, by
attention to the following points:
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