—Definition.—An intoxication, acute or chronic, due to the injection of a sufficient quantity of alcohol to produce muscular inco-ordination, mental disturbances, and finally narcosis.
Pathology.—Where death is the result of acute alcoholism, the mucous membrane of the gastro-intestinal canal is engorged, injected, and dark red in color, and covered with a sticky, mucoid exudate. The brain and the kidneys show the same characteristic changes. In chronic alcoholism, changes of a more permanent character take place, depending somewhat upon the quantity, quality and kind of alcoholics consumed, and the length of time used. 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 and the arterial injection should continue until the capillaries have been filled to their utmost capacity. This strong treatment is advised on account of the early tendencies toward putrefaction, which is sometimes in an advanced state shortly after death. The cavities should receive a thorough treatment with normal or supernormal fluid. Myers advises the re-injection of the cavity in 6 or 8 hours after removing the fluid remaining in the cavity from the first injection. As a preventive treatment, this last is a wise precaution. While the cavity treatment is being given the stomach should be entered by the trocar, relieved of its contents and injected, thus preventing post-operative purging.
In chronic alcoholism, the greatest circulation difficulties will be encountered. The capillaries will not receive the fluid, the putrefactive processes causing the formation of tissue gas early in the case, which, when coupled to many natural impediments to the circulation in cases of this kind, virtually nullifies the circulation for fluid distribution. Inject as many arteries as possible, and if necessary the veins also. Use the hollow needle or trocar and give the unexposed portions of the body a heavy hypodermic injection. The fluid used in this case should be not less than normal in strength and in most cases should be at least ¼ over normal. Give the cavities a very heavy injection, paying special attention to the food passages. This is one of the cases coming to the attention of the embalmer where every emphasis must be laid upon the injection of a sufficient amount of fluid, through as many channels as possible. Do not count the cost of the fluid in this case, if you value the securing of satisfactory results. Cosmetic effect will be enhanced by injection of the carotids upward with drainage from the internal jugular veins. Finish the case with the use of good face powder, unless a discoloration is present, when this should be obliterated with one of the improved methods mentioned in the chapter on discolorations.
—Definition.—A chronic intoxication due to the habitual use of opium, or some of its alkaloids, especially morphine.
Pathology.—There are no characteristic tissue changes, other than that due to indigestion and malnutrition. At death the patient is anemic, the skin dry, sallow and inelastic, the heart and blood vessels show the effects of poor nutrition, and the tissues generally present a starved appearance. The blood disintegrates, causing a discoloration of a brownish color, one or two days after death.
Treatment.—Drain blood from these cases using half strength fluid for the first part of the injection. The more blood obtained, the less the danger of discoloration will be. Give the body a thorough cavity injection in addition to the arterial injection. If your treatment does not eliminate the blood as a factor, the discoloration will occur and then it cannot possibly be removed. In this case the use of cosmetics, if in the hands of a patient operator, will overcome the color.
—Synonyms.—Lead-poisoning.
Definition.—A chronic intoxication due to absorption of lead.
Pathology.—The muscles are atrophied and pale in color. Arteriosclerosis of the cerebral blood vessels is found. There may be softening of the brain and hemorrhage.
Treatment.—Drain blood from the veins while injecting fluid in the arteries. The fluid should be used half strength for the first bottle of the injection. Massage the face downward to help eliminate any discoloration of blood origin from cerebral hemorrhage. Give the body a thorough injection both as to arteries and cavities. If the face is unduly pale from this treatment, carmine rouge, judiciously applied will lessen the paleness.
—Definition.—A chronic intoxication caused by the continued absorption of arsenic.
Treatment.—Same as for plumbism.
—Definition.—A chronic mercurial poisoning, caused, either by ingestion of the drug, or by inhalation and absorption of the mineral in the industrial pursuits.
Pathology.—There is an acute inflammation of the mouth, stomach, and intestines. The kidneys are inflamed and the liver is degenerated.
Treatment.—Drain blood from a large vein while the injection is going on. The first bottle of fluid for the injection should be half strength. The cavities should be injected, as intense inflammation takes place in the alimentary tract.
—Synonyms.—Sunstroke.
Definition.—Heat-stroke is the result of exposure to intense heat, either from the direct rays of the sun, or the radiation of blasts or furnaces, or to an overheated atmosphere.
Pathology.—Owing to the excessive heat of the body, putrefactive changes occur very early. If a post-mortem examination is made very soon after death, the left heart will be found contracted, while the right heart will be engorged, and the venous trunks filled with dark semi-fluid blood. There is also venous engorgement of the brain, spinal cord, and lungs. Ecchymoses and extravasations of blood are found in the skin and mucous membranes.
Treatment.—Drain blood from a large vein during the injection. The first two bottles of the injection should be of half strength fluid. The face should be massaged to assist in the securing of capillary circulation and in the elimination of the blood discoloration. The body should be treated as soon as possible after death, as putrefaction begins early. The cavities should have a very thorough treatment, eliminating the gases and injecting normal fluid therein. Should ecchymosis occur, obliterate the color by an application of cosmetics.
—Definition.—An excessive accumulation of fat, impairing the bodily functions, or rendering one uncomfortable.
Treatment.—Drain blood from these cases, injecting the first bottle of fluid half strength followed by normal fluid for the balance of the injection. Massage the face downward during the injection. Inject the cavities, with special attention to the stomach and intestines. For transportation of these cases, govern yourself according to the provisions of the transportation laws.
—Definition.—A chronic disease caused by inflammation and obstruction of lymphatics and marked by great thickening of the skin.
Treatment.—Drain blood from these cases and inject normal fluid sufficient enough in quantity to secure preservation. For long time preservation, supplement the foregoing treatment by a special injection into the thickened extremity, either through an artery leading directly to the part or by trocar or hollow needle inserted under the skin. Give the body a thorough cavity treatment, using normal fluid throughout. For transportation, govern yourself according to the provisions of the transportation laws.
—Treatment.—Inject fluid into the lungs by inserting a child's trocar into the windpipe at the upper border of the sternum, making the injection sufficient in strength and amount to fill the lungs. If this is not done, a bloody purging will take place several hours after death. Tap the stomach through the epigastric region, aspirate the contents and inject strong fluid before removing the instrument. Drain blood from the body during the injection, which should be quite heavy and of normal fluid. The last bottle should be made 1¼ strength or ¼ over normal.
—Definition.—A body that has been floating on the water.
Treatment.—The body is distended with gases in the cavities, tissues and capillaries, putrefaction is in an advanced state, and a vile odor will be present. If body is to be shipped, aspirate all the gas possible from the tissues with the hollow needle, injecting strong fluid in the same openings. Open the body from the base of the neck to the pubic bone, relieve the gases in the alimentary tract and lungs, and fill cavity thoroughly with hardening compound, after which it should be sewed up. Inject as many arteries as possible with very strong fluid. Dress the body and place it in a metallic casket. Pour the contents of two pound bottles of Platt's chlorides on the underclothing to assist in deodorizing the body. Do not open the casket after it is once sealed.
If the body is not to be shipped, it will be advisable to deodorize it as much as possible and bury it without delay.
—Mother and Foetus in Utero.—Treatment.—Before pregnancy has reached the three months stage, the child will receive fluid directly from the circulation connected with the mother.
After the three months stage, the circulation, by direct flow, is stopped and fluid could only reach the foetus by absorption from the placenta. This is naturally insufficient to preserve the child, which by this time is immersed in the liquor amnii (water of the womb) and which is subject to early putrefaction in that situation. The trocar should be directed to the uterus or womb from a point on the median line, half way from the umbilicus to the pubic arch, care being taken to reach the water which surrounds the foetus. Withdraw the water, and inject as much strong fluid as possible so that the foetus will be surrounded with fluid, and in that way preserved. If the trocar enters the body of the child, this will not occur, so the instrument should be carefully manipulated to reach the space between the child and the uterine wall. The mother should receive a very heavy arterial and cavity injection, with full drainage of blood. The vulva should be closed with absorbent cotton. The face should be massaged thoroughly toward the heart.
—Synonyms.—Old age.
Definition.—A state of decline in an aged person characterized by progressive atrophy of all the tissues and organs.
Pathology.—Excessive shrinking and obliteration takes place among the capillaries. 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; also the total quantity is less. The pericardium, endocardium, and the capsules of the liver and spleen are opaque and toughened. Degeneration of the cardiac substance may lead to a state of asthenia, which generally produces death. Dilatation of the orifices of the heart may be the prominent lesion, or they may be contracted by atheroma, or by thickening of the vales or rings. The lungs are changed more or less, increasing the bronchial secretions, which during life have been attended by severe paroxysms of coughing.
Treatment.—Inject half strength fluid for the first bottle, following that with ¾ strength for the second and normal for the third and all thereafter if more be necessary. Blood may be drained from the vein if the operator thinks it advisable. The commercial face solution or water should be used on the face while massaging in order that the skin may be kept moist and to prevent dessication from the action of the fluid. The cavity should be injected as a matter of precaution.
—Synonyms.—Senile gangrene; mortification.
Definition.—Putrefactive fermentation of dead tissue, from various causes.
Treatment.—The extremities are affected in senile gangrene. They should be wrapped with absorbent cotton which should then be saturated with fluid. The body itself should receive the same treatment accorded in the paragraph on senility.
1. NOTE—Many embalmers get along, some way, with much less in their outfit than enumerated here. The authors believe that the embalmer should have all the material needed to properly carry out his work, and anything of necessity left from the outfit only reduces the efficiency of the embalmer, and leaves him, at times, without the proper assortment of material.
2. The quantity to be injected of course varies, but a fair estimate would be that the quantity should be three-fourths of the capacity of the blood vessels of the body. This would require approximately one and one-eighth gallons of fluid to every 150 pounds of tissue. The latest transportation rules demand the injection of an amount of fluid equal to 10% of the body weight into the arteries.
3. Extracts from a paper written by F. W. Alexander, Conrad, Iowa.