Post-Mortem Examinations

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1891 edition. Excerpt: ... one point in conducting an autopsy, and that is the method of opening the thorax. It is evident to me that not a few young practioners, in common with the majority of students, sometimes experience great difficulties in this part of the examination, simply because they do not clearly appreciate the anatomical conditions. In opening the wall of the thorax, the division of the cartilages should be made at a point as distant as possible from the sternum. As a matter of course, this direction applies only to non-ossified cartilages. If, however, the cartilages are even only partially ossified, the bone forceps must generally be substituted for the knife, and under these circumstances we may with advantage go further outward, and divide the bones of the ribs, in order to obtain free access to the viscera of the thorax. It may be observed that the sterno-clavicular joint is, as a rule, not ossified unless it has been the seat of severe disease. This joint is, therefore, always to be cut through; and inasmuch as it is crescentic in form, and its surfaces are separated by an inter-articular cartilage (see Fig. 4), separation is to be effected by means of steady strokes of the knife, directed in a crescentic curve round the sternal end of the clavicle. The cartilage of the first rib, on the other hand, is very frequently ossified, even in cases where the other co.-tal cartilages are free from bony deposit. As a rule, what we meet with here, as in the other costal cartilages, is a supra-cartilaginous, i. e., a perichondrial ossification, of great hardness, always enough to spoil the knife. If there be no ossification, we first cut through the costal cartilages on each side, close to their union with the ribs, the knife being held horizontally, so...