Method of Post-Mortem Examinations: With Especial Reference to Medico-Legal Practice

A review from the "Saint Louis Courier of Medicine and Collateral Sciences," Volume 4: "THE present generation is conversant with pathological anatomy, only as a supplement of the clinic. As a rule, the clinical teacher determined while the patient was alive, which organ was to be the object of investigation; and the autopsy, likewise, was usually confined to that organ, or at least with all the others only in a secondary manner. The clinical anamnesis, consequently, determined the course of the anatomical examination. We all know what was the result. The fact is, that we can further the advance of medical science in the most essential manner, by acquiring the habit of submitting all the other organs of the body to a minute examination; for it is obvious that we can do as much by anatomical as by clinical examination." This exposition by Virchow, in 1859, gives the key to the method of post-mortem examination, stated and explained in the book* before us, a method which has received the official sanction of the German government, and is imposed upon all medical officers who may be concerned. The regulations governing the conduct of the post-mortem, establish the order in which the different steps of the examination are to proceed, the order and method of opening the three cavities of the body, and of examining the contained viscera. Minute directions are given for the proper dissection of each organ. The delightful thoroughness of the whole, will carry the reader back to those celebrated pathological halls, from whose abundantly stored records so much of our knowledge of morbid anatomy has come. A complete post-mortem, made at the order of medico-jurisprudence, is a serious piece of business, involving, at times issues that touch human life. This book, with its concise; definite and comprehensive directions, will prove invaluable in the hands of the medical expert. It also is of great value to the general practitioner, saving him much time by lending a directness to his work and distinctness to the results, while he may not find it necessary to follow out the whole scheme of dissection, but will confine himself to a single organ, or group. The reader should especially note the explanations beginning on page 40, of the method of laying open different organs with the view of retaining the parts in such a connection that they may be returned to their proper position as occasion demands. Dissection of the brain and heart is minutely dwelt upon. On page 16 begins the explanation of the order of the opening of the cavities, and the reasons for this order; e. g., the abdomen should be opened before the thorax, that the arch of the diaphragm may not be disturbed before examination; the thoracic organs should be removed before the abdominal, that the heart may not lose its contents, etc., etc. To give further emphasis to the regulations, Virchow adds four reports of his own, of interesting post-mortems performed according to the rubric, which illustrates sufficiently their value. No mention appears of the method of opening the spinal column after complete evisceration, by cutting away the vertebral bodies, which is a speedier procedure than that through the back. The profession is much indebted to the translator as well as to the author for this manual, which may be well regarded as a final authority.