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Full text of "Medical Jurisprudence And Toxicology"

ABDOMEX                                                                 65

or  purulent  fluid.   Now   the   abdominal   organs   should  be   removed   and
examined separately as below ; —

Stomach.—In ordinary circumstances the stomach, is examined by
making a cut while in situ for the contents as regards their quantity and
quality and the degree of then* digestibility. But in suspected poisoning
the stomach should be removed after tying a double ligature at both ends.
It should then be opened in a thoroughly clean plate; after emptying the
contents its mucous surface should be carefully examined noting its appear-
ance, and any suspicious particles found adherent thereto should be picked
off with a pair of forceps and placed in a separate small phial for chemical
analysis. The contents of the stomach should also be examined as regards
their smell, colour and character and for the presence of any foreign particles
or lumps ; these, if present, should be felt between the thumb and index
finger as to their roughness or smoothness.

Intestines.—The intestines should be removed after ligaturing at both
ends and should be cut longitudinally to examine the inner surface for the
presence of congestion, inflammation, erosions, ulcers, perforation or any
other lesion. In cases of suspected poisoning the contents should be pre-
served and sent for chemical analysis wherever possible, as they may some-
times give valuable clues as to the nature of the poison.5

Liver.—The surface of the liver should be examined as regards its
smoothness or roughness. If there is any injury to the liver, its nature and
dimensions should be noted as well as the size and weight of the liver.
Normally the liver measures 12" X 7" X 3J". The organ should be cut
open by deep incisions in several places, and the colour, consistence and
blood supply of its tissue should be carefully marked ; at the same time the
presence of an abscess, new growth or amyloid degeneration should be
observed.

The gall bladder should be opened and the presence or absence of bile
stones and the character and quantity of the bile should be noted.

Spleen.—The size, colour and consistence of the organ should be noted
as well as the condition of its capsule. In the case of a rupture of the spleen,
its size and position should be described, as well as the size and weight of
the spleen. The normal spleen in the adult measures 5" X 3" X !"•

Kidneys.—The size, colour and weight of the kidneys should be noted.
Normally the size of a kidney is 4" X2// X 1". Its capsule should be
examined as to whether it is adherent or strips off easily. The kidneys
should be cut open and the internal cut surfaces should be examined for
the presence of Brighfs disease or amyloid degeneration ; the pelves should
be examined for calculi and evidence of inflammation.

Bladder.—The bladder should be examined for congestion, haemorrhage,
inflammation and ulceration of its mucous membrane. It may be opened
in situ and its contents noted, but in a suspected case of poisoning the urine
should be removed and preserved for chemical analysis, as it may some-
times give a valuable clue as to the nature of the poison. Dr. Gopi Ballabh
Sahay, late Lecturer in Forensic Medicine at the Prince of Wales Medical
College at Patna suggests the following method for drawing urine un-
contaminated with blood or other extraneous matter from the bladder of a
dead body : —

Squeeze the penis and mop out the external meatus. Put the glans in
the mouth of a small glass jar or a wide-mouthed glass "bottle and press the
bladder in situ after opening the abdominal cavity. Urine will pour out in
the jar or bottle, unless there was a very bad stricture of the urethra or an

5.   The UP. IkTedL Manual, 1934, p. 225, amended para No. 793.
5