The prosector then stands at the right side of the cadaver (if left-handed, on the left side), the body being brought as near as possible to the edge of the table. The cartilage-knife is then held in the palm of the right hand and with it an incision is made through the skin in the median line of the body, extending from just below the thyroid cartilage to the base of the penis in the male, and to the anterior commissure in the female, passing to the left of the umbilicus. If pathologic conditions (hernia, surgical wound, tumor, etc.) are present in the median line the main-incision should deviate to right or left as expedient. The incision in the suprasternal notch is made with the point of the knife, the thumb and fingers of the left hand being used to put the skin of the neck on a stretch. Over the sternum the knife is held horizontally and the tissues cut to the bone. As soon as the epigastrium is reached less force is used, and the cut should not be deeper than through the skin and subcutaneous tissue over the abdominal portion of the incision. At the end of the incision the knife is raised, vertically and the cut finished with the point of the knife. The incision is then carefully deepened in the epigastrium, just below the ensiform, until a small opening is made through the peritoneum into the abdominal cavity. To determine the presence of gas within the peritoneal cavity the peritoneum should first be nicked with the point of the knife to make a very small opening through which the escape of any free gas within the cavity can be easily noted. When bacteriologic examinations of the peritoneal fluid are to be made, the incision should be extended down to the peritoneum, which should then be seared, and the fluid secured by means of a sterile pipette forced through the seared portion. If it is more expedient to secure the fluid through an incision, the opening should be made with a sterilized knife and the fingers should not be put into the cavity, but are used to lift up the abdominal wall at the sides of the incision. In cutting through the peritoneum great care should be taken not to injure the stomach or intestines, which, often greatly distended, are pressed tightly against the peritoneum. If the opening is made just below the ensiform the knife, should it slip through unexpectedly, usually strikes the liver without causing any damage. [Illustration: FIG. 36.—The main incision completed. Lines show incisions through costal cartilages, and for disarticulation of sternoclavicular joints. (After Nauwerck.) The incision in the neck is begun higher than is usual in this country. ]