Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
25. The ordinary mode of examining the membranes of the brain, and the
brain itself, answers well in medico-legal dissections. Effusions of
fluid within the skull should always be measured. After the brain is
removed, the dura mater ought to be stripped from the base of the skull
to facilitate the search for fractures there, which will, of course,
indicate external violence. After the removal of the brain, the upper
part of the spinal canal should be examined through the foramen magnum
before any part of its course be laid open; and search should be
particularly made for dislocation or other injury in the region of
the atlas and dentata. In cases of fatal fractures of the head, the
strength of the bones should be attended to. In cases of extravasation
within the head, the state of the coats of the cerebral arteries should
be examined.
26. The best mode of opening the spine is, after having finished the
examination of the brain, to cut through the integuments from the
occiput to the coccyx--to lay the vertebræ thoroughly bare on each
side by cutting away the muscles--to make an incision with the saw
on each side of the skull, from the postero-inferior angle of the
parietal bones into the lateral edge of the occipital hole--to remove
the triangular portion of the occipital bone thus detached, and then
to cut the rings of the vertebræ on each side with the bone-nippers or
spine-knife, beginning with the atlas. In these cases preference should
be given to the saw, by which the operation is not only more easily
accomplished, but there is no risk of confounding previous fracture
with that made in dissecting. Where there is reason to think that the
bones are injured, the laying open of the canal should stop at the
distance of two or three vertebræ from the injury, and the injured
bones, with two or three adjacent vertebræ on each side, should be
removed entire before the examination is extended farther down the
spine.
27. The organs of the throat may be examined, either by dividing the
lower jaw-bone at the chin, cutting the soft parts close to the inner
surface of each half of the bone backwards, and then turning the two
segments outwards; or by freely reflecting the skin of the throat,
separating the soft parts from the inside of the lower jaw, the knife
being carried parallel with and close to the bone, drawing the tongue
out below the chin, and then continuing the dissection backwards.
28. The best mode of examining the organs situated in the throat is,
after detaching the soft parts from the lower jaw, as advised in Sect.
27, to dissect the soft palate from the bone, and proceeding backwards,
to detach the whole soft parts from the base of the skull and vertebræ
down to the sternum, leaving them connected with the organs in the
chest. Besides the ordinary points to be attended to in this part of
the examination, the presence of venereal or other ulcerations is a
matter requiring attention in some cases.
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