(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "Medical Jurisprudence And Toxicology"

INTERNAL EXAMINATION

63

14.    In the case of the body of a newly-born infant it is necessary to
examine the lower epiphysis of the femur for the centre of ossification to

prove its maturity. For this purpose the knee
joint should be opened by making an incision
across its front and the lower end of the femur
should be pushed through the wound. The epi-
physial cartilage should now be sliced off in thin
sections until a central pink spot is seen. The
slicing of the cartilage should be continued till
the greatest diameter of the ossified point is
reached.

INTERNAL EXAMINATION

If there be a fatal wound leading to one of
the cavities, that cavity should be opened first,
or the head should be opened first, and then the
thorax and the abdomen. Professor Harvey
Little John 4 recommends the examination of the
head first in cases of alleged infanticide so that
the examiner may have an opportunity of in-
specting the contents of the skull before the
blood can possibly drain away during the exami-
nation of the thorax and trunk and also because
he will be better able to interpret appearances in
the lungs when they are examined. Every organ
contained in the cavities must always be examin-
ed, but the spinal cord need not ordinarily be
examined unless there is suspicion of some in-
jury to the vertebral column or the alleged cause
of death is due to some spinal poison or some
such disease as tetanus. In that case it should be
examined last of all.

Fig.   18.—Section   through

the    lower     epiphysis    of

the femur showing centre

of ossification.

HEAD

A transverse incision across the vertex should be made from ear to ear,
and after reflecting the flaps anteriorly upto the orbits and posteriorly upto
the occipital protuberance the inner surface of the scalp should be examined
for extravasation of blood and the skull bones should be examined for
evidence of any fracture or separation of sutures after the periosteum is
denuded and the temporal muscles have been dissected off. In a doubtful
case the skull should be tapped with a hammer; it would elicit a ringing
note if there is no fracture. To remove the skull cap a circular cut is then
made with a saw round the cranium keeping close to the reflected flaps.
Its inner surface should then be examined for fracture of the inner plate,
or effusion of blood, which may be found on the durajxtater. The longitudinal
venous sinuses should be examined for evidence of laceration or thrombosis.
The dura mater should be removed by cutting longitu3Inalry along both the
sides of its middle line noting any effusion of blood or serum or the presence
of pus. It would not be out of place to note here the distinction between
meningitis and mere effusion of blood in the meninges. In the former the
surface of the brain looks greasy and dull, but not so in the latter. The
brain should now be removed by raising the anterior lobes with the fingers
of the left hand and cutting through the various nerves at its base and the
medulla as low down as possible. The brain should be placed in a large

4.   Trans. Medico-Legal Soc.s Vol. XVI, p, 88.