Medical Jurisprudence, Volume 3 (of 3)Paris, John Ayrton
Science
Medical Jurisprudence, Volume 3 (of 3)
Paris, John Ayrton
Medical laws and legislation -- Great Britain
After the observations which we have already offered upon the subject of
wounds, it can be scarcely necessary to urge the necessity of a speedy
examination of the more superficial lesions, which are likely to be
effaced, or changed in character by the progress of decomposition;
“_putredo mutat formam cadaveris et lesionem_.” The deeper wounds may at
the same time be inspected, but the greatest care should be taken that
they are not extended during the dissection, for unless they be
preserved, as far as it is possible, in their natural condition, we
shall not be able to establish a satisfactory connection between the
external injury, and the internal lesions with which it may be
complicated. Having complied with these injunctions, we are to proceed
to lay open the cavities. The order in which these operations are to be
performed is not of much moment; but let it be generally understood that
the discovery of what may appear sufficient to account for death in one
cavity, ought never to prevent our proceeding to the investigation of
the rest.
_Dissection of the brain and its membranes._—The body having been placed
on its breast, and the chin raised and supported by a block of wood, the
anatomist must proceed by making an incision over the top of the head,
from the root of one ear to that of the other; and then by dissecting
off the integuments, so as to invert one flap over the face, and the
other over the occiput, he will be able to discover whether the scalp
has sustained any injury, as indicated by the presence of abscesses,
sinuses, contusions, and extravasations; he will, at the same time,
ascertain whether any fissure or fracture exist, or any morbid change
has occurred in the bone, such as sponginess, exostosis, caries, or
exfoliation. In performing this part of his duty, we trust he will not
mistake, as _Hippocrates_[22] confesses he once did, a fracture for a
suture, and vice versa. It is not always easy, however, to determine
whether a fracture discovered in the cranium, was produced during life.
If it should have occurred immediately before the death of the person,
there will be found coagulated blood upon the bone and in the fissures;
if the individual has survived for some time, there will be marks of
inflammation, and perhaps the formation of pus in contact with the
skull; but if a fracture has been occasioned in making the dissection,
an accident which may occur in the most careful hands, the blood in the
fracture will not be coagulated, nor will there be any effusion around
the portions. The skull-cap may be now removed; for which purpose the
cranium is to be sawed in a circular direction, about a finger’s breadth
above the superciliary ridges, and lateral sinuses; the operation must
be conducted with great care, or we shall be in danger of wounding the
_dura mater_; the bone must be then divided by a few slight strokes with
the chissel and mallet. We shall always find a strong adhesion between
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