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
abdomen we should have reason to suspect the existence of any
perforations in the stomach or bowels, the anatomist must proceed with
great caution, so as not to enlarge their diameters, or alter their
appearance. In the case of _Miss Burns_, the medical report lost much of
its value, from the want of due precaution in this particular; _see our
account of the dissection_, _vol._ ii, _page_ 178. Should the contents
of the stomach or intestines have escaped into the general cavity, we
should be careful in collecting such matter, with a view to its future
analysis. The size and appearance of the stomach must be noted, and we
should observe whether any marks of inflammation, or gangrene, are
visible on its external surface; in tracing the intestinal tube through
its course, any appearance of inflammation, or phlogosis, should be
attentively examined; for which purpose a ligature may be passed at some
distance above and below the patch, and the portions of the intestine be
then removed. In many cases it will be essential to remove the stomach,
as where poisoning is suspected; for which purpose double ligatures,
about an inch asunder, must be placed above the _cardia_, and similar
ones in the _duodenum_; the division may then be made by the scalpel in
the space between them. The stomach should be examined without delay,
for no one who has not been engaged in such researches, can form an idea
of the rapidity with which this viscus loses its characteristic
appearances by exposure to air. The stomach is to be slit open with a
pair of scissars, care being taken that none of its contents are lost.
If the deceased had been found in the water, the quantity of that fluid,
found in this viscus, should be noted; and under such circumstances, the
presence of any weed, mud, or other extraneous matter, requires
particular notice. The quantity of alimentary matter will also afford an
object of remark, and it will be right to observe whether, by odour or
inflammability, the presence of any spirit can be detected. Having then
disposed of the contents of the stomach, and referred them to the
chemist for examination, we proceed to examine the viscus itself; in the
first place, we should be careful in ascertaining whether any white, or
shining particles adhere to its coats; if so, the substance must be
preserved for future analysis; the _cardia_ and whole interior of the
stomach is to be carefully inspected, and every indication of
inflammation, ulceration, gangrene, and schirrosity, is to be noted in
reference to its exact situation and appearance; with a view to deduce
an opinion as to the probability of its being the effect of poisonous
ingesta, or of recent, or remote disease. The mucous membrane of the
stomach should be squeezed between the fingers, and the nature of the
matter, if any should ooze out, must be noted, which on some occasions
will furnish a valuable diagnosis; where, for instance, the person had
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