Charles Otto Dhonau

“ Just as surely as we are born, just so surely must we die, and just as it is the physician's duty to care for the living body, if possible to keep it in a strong and healthful condition, so it is the embalmer's duty to care for the body after death, not so much for the body itself, but from a sanitary standpoint, namely, to see that the body is well disinfected and embalmed so that there will be absolutely no chance for the spread of disease. ”

“ In answer to this let me say that the care and the embalming of the body is first importance because the law says so, because the education of the embalmer is paramount to other considerations and so regarded by the national association, because sanitary science demands it, because without a body properly embalmed and prepared for burial the funeral is a failure from whatever standpoint you wish to judge it. ”

“ Since death levels all distinctions—respecting neither love nor friendship—since the dearest and most sacred ties are relentlessly broken asunder, it is the natural attribute of affection, to seek to avoid in some degree, a painful separation, by preserving the remains of those they loved and by whom they were beloved. ”

“ Drainage or gravity consists in opening one of the principle arteries or veins of the body, inserting a blood drainage tube into the artery or vein as far as it seems practical, and then connecting the blood drainage tube to the blood bottle by means of rubber tubing. The blood bottle should be placed considerably lower than the body in order to have the blood drain successfully. If the femoral artery or vein is used, the body ought to be on a considerable incline, the head at least one foot higher than the feet in order to get the maximum amount of blood. ”

“ Just think of the possibility of having a body properly injected, and the preservation complete, and something along the line of a discoloration coming to the front and ruin the results of the work. If there is any condition possible in the dead body that can cause more trouble to the embalmer than discolorations in general, it has not as yet been discovered. You have only to realize what the appearance of a body would be in the casket, if any discolorations were present on an exposed surface, to know that too much can not be said on the subject. ”

“ The skin becomes diminished in thickness. When this occurs, it is easily seen why in old age there will follow, after the injection of fluid into the arterial system, greenish, brownish, and soft spots, in the different parts of the body, especially notable in the face, neck and hands. The products of degeneration may accumulate in the tissues and cause them to be thicker than they are in health, as is seen in the vessels, the walls of which are much thicker than normal. The blood contains fewer corpuscles and solid constituents, is more watery, and coagulates more readily ”

“ All the tissues of the body are very rich in these, so that all portions of the body are supplied with blood, which is essential for the nourishment and rebuilding of the tissues. The large vessels which convey blood from the heart are termed arteries, while the vessels which convey the blood back to the heart are termed veins.
For one to properly embalm the human body, it is necessary to understand the way the fluid will circulate through the body, and the only way we can do this is to study the circulation of the blood as it would occur in life. ”

“ The sternomastoid, is a large, thick muscle, which passes obliquely across the side of the neck, being inclosed between two layers of deep fascia. It has its origin at the sternum and clavicle and attaches to the mastoid process of the temporal bone. By making the perpendicular incision in the lower third, in as much as the muscle slightly covers the artery, it can either be cut or pushed to the outside of the incision. It is best to push the muscle to the outside with the thumb, and with the handle of the scalpel, work down deep through the areolar tissue. ”

“ Among the Jews, the Greeks, the Romans, and all modern nations, we see the honors of embalming accorded to Kings, Princes and men of distinction, but no tomb that has been opened, has rendered a single mummy so perfect, as those which we admire among the Egyptians. ”

“ The portal vein ends in capillaries in the liver, where certain important changes take place, namely, the taking out of the bile.
The portal vein and its tributaries are unlike the veins in the general circulation, as there are no valves. Their function in life is to gather up food or nutrition for the blood, and to the embalmer is of no special importance, only to know how this circulation is made up. The vessels that convey blood to the liver in life and the fluid in death are discussed under the liver. ”

“ Myology is that branch of anatomy which treats of the muscles. The muscles are formed of bundles of reddish fibres, endowed with the property of contractility. In the body we find two kinds of muscular tissue, called voluntary and involuntary muscle. ”

“ Ideal embalming would be a series of gravity injections at intervals of several hours. While the gravity injection such as the doctor describes will undoubtedly be a sure method of getting a perfect circulation, and while it is the process generally pursued in morgue work where the apparatus is convenient, it is in the majority of cases in the home impractical.
All bodies to be shipped must be thoroughly arterially embalmed, that is, to have introduced into the arterial system sufficient amount of disinfecting fluid to thoroughly sterilize every particle of matter in the dead body. ”

“ Then after the trocar has entered the abdomen the secret of removing gases successfully depends very largely upon the operator having a very correct idea of the location of all the abdominal organs. It is difficult to know when the trocar has pierced the interior of the stomach, or in fact even to make it pierce the stomach at all for the peritoneum which is a covering for all the organs of the abdominal cavity contains a serous fluid which makes the organs slippery, and even the sharp pointed trocar often does not take hold as it should. ”

“ Capillaries have one wall, which is the continuation of the inner wall of the artery, thus making the capillary so thin that fluid finds its way easily through it into the surrounding tissues.
Some parts of the body are more vascular than others and some tissues of the body, such as the cornea of the eye, the epidermis, cartilage, the substance of the brain, etc., are entirely destitute of capillaries. ”

“ It may be important to determine whether a bone was fractured before or after death. This point can not always be decided. Fractures inflicted during life are, as a rule, attended with more extravasation of blood and evidences of reaction in the surrounding tissues; but fractures produced within a few hours after death may resemble these very closely. Usually a greater degree of force is necessary to fracture bones in the dead than in the living body. ”

“ The medical man remembers that on occasions he has found it difficult, without applying some of the common and finer tests, to certify death in a patient dying of a lingering disease, but his knowledge forbids him believing that such difficulties as he may have experienced in his own practice can ever have caused his fellow practitioner to make so grievous a mistake in a similar case. ”

“ Any one who is familiar with hospital work must know that all do not die in the same way. For some it is the long lingering disease, chronic in form, which after a long and tedious course the thread of life is finally broken, and we hardly know the instant at which the change was completed. ”

“ The only way the fluid which is in the minute capillary circulation of the stomach and intestines, is able to reach the inside of those organs and come in contact with the undigested food and the fecal matter is by soaking through the mucous wall. No doubt a certain quantity of the fluid does soak through, and when it does, if there is not much undigested food or fecal matter in these parts, disinfection will be accomplished and it is in these cases that we do not have any trouble with distentions of the abdomen. ”

“ The chief visceral lesion is that of the intestinal canal. The intestines contain a more or less quantity of rice-water, fluid rich in the comma bacillus. The blood is very dark, but slightly coagulable and robbed of its salts and fluids.
Treatment.—Arterial and cavity embalming, closing all orifices of the body. Any discharges from the bowels should be disinfected before being disposed of. In epidemics, cosmetic effect is a non-essential and in that case the most thorough treatment must be given without regard to appearances. ”

“ While all the bodily tissues are more or less impaired, the brain, kidneys, and digestive system suffer most. There may be connective tissue changes, fatty degeneration, sclerosed kidneys, liver or arteries, and a more or less dilatation of the stomach.
Treatment.—In acute alcoholism, the blood should be drained from a large vein, while fluid is being injected into a large artery. After draining a sufficient amount of blood from the body, the vein tube should be shut off [355] and the arterial injection should continue until the capillaries have been filled to their utmost capacity. ”

“ Feverish Conditions in the Body Before Death.—Fever is the name usually given to the rise of temperature that goes with inflammation. In severe inflammatory [200] diseases, the tissues lose much of their moisture through the arrest of the saturating power of the blood stream and the disturbance of circulation. The skin contains a sub-normal amount of moisture when the embalmer reaches these cases, which may be further reduced by outward evaporation and the dehydrating power of the embalming fluid. ”

“ The hair grows from its roots and as it grows it pushes itself out from the skin and owes its growth to the small capillary circulation, carrying pure arterial blood to each and every hair, and for this reason you can understand for yourself the erroneous idea of what is termed the “post-mortem growth of hair.” ”

“ A severe contusion during life may present, at first, no mark or only a general redness. After a short time the injured part becomes swollen and of a red color, this color may be succeeded by a dark blue, and this in turn fade into a greenish yellow or yellow; these later appearances are due to an escape of blood from the vessels and to a subsequent decomposition of the hemoglobin. If, therefore, we cut into such an ecchymosis after death, we find extravasated blood or the coloring matter of the blood, in the form of pigment [193] granules, free in the tissues. ”

“ The habit of inquiring about the sex, and age of the person, as well as the cause of death, should be cultivated. The importance of knowing the sex of the person lies in the fact that in some communities different styles of door badges or decorations are more appropriate for one sex than for the other. When the ruling decoration is some form of fresh flowers, this should be ordered before the embalmer leaves for the house of mourning if possible, unless the call should be received at night or in the early hours of the morning, when this item is usually left until the earliest business hour. ”

“ If for any reason the heart does not get this proper nourishment, say the coronary arteries should become clogged, or a fatty infiltration, or a lack of red blood corpuscles, we would have a condition in the body known as anemia.
The heart must also have a proper nerve supply from the brain, and if because of any disease, the vaso-motor or the vaso-constrictor fibers should become affected, the heart would cease to contract and expand, and hence the complete stoppage of the heart. A condition of this kind is known as asthenia. ”

“ The lesion of the skin consists of an acute hyperemia with exudation in the vascular papillae of the corium, the sebaceous and sweat glands.
Treatment.—Bodies rarely die from this cause; the usual immediate cause of death is exhaustion. An injection of half strength fluid for the first part of the injection followed by normal fluid for the balance of the injection, with full cavity injection, closing the orifices is all that is necessary. For transportation, govern yourself according to the provisions of the transportation rules. ”

“ In accident cases the seat of injury will determine the artery to be raised, using the one through which you can give the body the greatest supply of fluid to all parts. Often it will be necessary to raise several arteries to complete the injection.
There is no necessity for undue exposure in either sex, however it is hardly ever advisable to inject the femoral in the female, as some mischief-maker might without any real cause influence others in the community against your methods. ”

“ To inject the body, the four principle arteries to be tied are the two common carotids and the two vertebrals, besides numerous veins and small vessels. If it is impossible to tie all the severed vessels plaster of paris may be used, and then by injecting either through the brachial, axillary or femoral a thorough injection may be obtained. The stub end of the carotid might also be used for injection, but would not advise it as in most cases we find that it would be hard to get especially if the head were cut off close to the shoulders. ”

“ The artery might appear to be a solid mass when the dissecting knife is passed through. We have seen the anterior and posterior tibial, the popliteal, radial, ulnar, the aorta arteries, and especially the arch of the aorta thus affected. Calcification may be present at many places. These cases are frequently met with in old age.
A body of this kind, where there is fatty degeneration of the arteries, is sometimes hard to embalm. The walls of the artery will be very much weakened, and too much pressure must not be made on them while injecting fluid. ”

“ After life becomes extinct, and before the blood coagulates, it changes its position chiefly in two ways: First, it is driven by their contraction out of the arteries and into the veins; second, it settles in the veins and the capillaries of the more dependent parts of the body, inducing, usually within a few hours after death, a mottling of the surface with irregular livid patches. These patches may coalesce, forming a uniform dusky red color over the back of the trunk, head and extremities, and sometimes over the ears, face and neck. ”

“ However for ordinary embalming it will perhaps be best to choose some other artery, which will be less apt to show, and not so deep.
We should be so skilled as to never make a mistake, but the best sometimes do make mistakes. If in raising another artery, a mistake should occur, the operator [231] can raise either above or below the original cut, but with the carotid, the only advisable incision to make is in the lower third, and if a mistake is made the last chance is lost. ”

“ Should an insufficient circulation be encountered when embalming a body, the part which does not receive the fluid, being unprotected, may be affected by the color producing germ mentioned above. The most likely to be affected by an insufficient circulation will be located somewhere in the extremities of the circulation, that is to say, in the skin. We can place the affected part more definitely in the skin of the face, particularly the nose, which has a rather poor circulation. ”

“ It not quite as large as the common carotid, but as a rule large enough to admit the large size arterial tube. It has become a favorite with many because it is quite easy to locate and to raise, and because of its proximity to the axillary vein, a vein which is large enough to admit a drainage tube for the withdrawal of blood. Again the axillary artery is in a secluded place, being as it is in the axillary space (arm pit) . The artery [232] does not lie very deep, and is not covered by any muscles as you operate, there being practically nothing to hinder the progress of the operation. ”