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.