for injuries incurred before death. The importance of this fact to the medical jurist cannot be overrated.

The incision for exposing the cavities of the thorax and abdomen, as usually made, commences at the episternal notch and terminates at the symphysis. It should be firm, deep, and pass to the left of the umbilicus to avoid the round ligament of the liver. In extending the incision through the peritoneum, the recti muscles may be severed at their pubic attachments. This will be found convenient, especially if rigor mortis is well developed and the muscles large. As in medico-legal autopsies it frequently becomes necessary to examine the trachea, pharynx, and oesophagus, it is better to commence the incision at the chin and complete it as usual. This is the present German method. It exposes the region of the neck, and renders it possible to remove the larynx, trachea, and œsophagus. The two former structures will always require examination in cases bearing marks of violence in the neck, as from strangulation or suspension. Sometimes, in cases where the body has been found face downward in a shallow pool of water, an examination of the pharynx and trachea will show, by the presence of water, sand, or weeds, that efforts at respiration had taken place after immersion of the mouth; and such evidence would tend to the conclusion that the deceased met death by drowning, or at least that when he fell into the pool he was alive. Where there is reason to expect fracture of the trachea or larynx, it has been advised that the structures should be opened from behind, and examined after removal. In those instances where corrosive poisons have been taken, the examination of the oesophagus will show the action of the drug. If the examination of the trachea and larynx reveal reddening and oedema, it should not be forgotten that these structures are almost the first to undergo putrefaction, of which the reddening and œdema may be but signs. In the somewhat rare cases where a foreign body has lodged in the oesophagus, and, as in a case seen some years ago by the writer, caused ulceration into the aorta and sudden death from rapid hemorrhage, an examination of the oesophagus will be necessary in order to show the cause of death; also in death from corrosive poisons.

In order to expose the thorax, it is, of course, necessary to reflect the soft parts to a point beyond the cartilages of the ribs. This may be most conveniently done with the short, broad knife. In the abdominal region, the primary incision may extend quite down to the peritoneum; but as such a tour de force can only be accomplished after much practice, it is better to make several incisions through the abdominal wall, than by one ill-judged slash of the knife to wound the intestines. When the peritoneum is reached, it may be opened by passing two fingers into a narrow opening made for the purpose, and then slitting it up between the fingers as a guide. The abdomen is to be opened and inspected first, but the contained viscera must not be dissected or removed until after the examination of the thorax, because the division of the large vessels of the abdominal viscera would certainly drain the blood from the cavities of the heart, and render it impossible to state with precision their condition with regard to contained blood. So too, if, on the other hand, the thorax be opened first, it will be impossible to determine the position of the diaphragm-a point of some importance in autopsies on the bodies of newborn infants. The inspection of the abdomen should therefore be made with a view to determining the position of the diaphragm with regard to

the ribs, the color of the contained parts, and, where this can be ascertained without dissection, the presence and position of any foreign body. With regard to the latter consideration, it may be observed that the search for a missile in the abdominal cavity is always a matter of difficulty, as witness the autopsy in the Garfield case, where the bullet was not found in the abdomen at all, although most careful search was made for it, but was afterward discovered in the vessel which had been made the receptacle of the removed viscera. It will therefore be necessary in these cases to defer the search for the foreign body until the dissection of the abdomen. The presence of fecal matter from wounds of the intestine, of clotted blood or of serum, may be ascertained at this point. Blood-clots should be transferred to a graduated vessel and thus measured, so that an exact statement of the amount of clot may be made in the report in place of the usual inaccurate wording, "a large amount of clot," etc. The quantity of blood-clots or other fluids in the cavities of the body may also be determined by weight. Serum may best be measured by sopping it up with a large moist sponge and expressing it into a suitable vessel, until the cavity is dry. The color of the abdominal contents ought to be ascertained soon after opening the cavity, as, owing to absorption of oxygen, they quickly change from a dusky red to a deep red, which may and often is mistaken for the signs of an inflammation. It may be further remarked that bright red arterial blood is never found in the dead body. (Virchow.) The more dependent parts of the abdominal viscera always assume a deeper red than those which are uppermost, and this fact will assist the examiner in determining whether the color is due to inflammation or not. If confined to the dependent parts, it is certainly the result of the gravitation of the blood; whereas if uniform, particularly if the peritoneum have lost its gloss, it is probably due to irritation or inflammation. Old adhesions, thickenings of peritoneum, and other signs of past inflammation are to be noted.

The preliminary inspection of the abdominal cavity having been completed, the thorax may now be opened. One precaution is to be observed in this connection. After the costal cartilages have been divided close to the ribs, in disarticulating the sternum from the clavicle particular care is to be taken not to wound the great veins beneath, as is often done. Where this happens, it is impossible to determine whether the blood which is certain to be found in the chest is the result of the wounding of the veins, or, if there is a wound of the chest, to determine what proportion of the effused blood is due to the previous injury and what to the divided veins. If the crescentic shape of the sterno-clavicular articulation be borne in mind, the separation of the articular surfaces will be facilitated if the examiner direct the knife in such a manner as to follow the curve. The cartilage of the first rib is frequently ossified, and it is here that the greatest care must be exercised, else the knife or costotome will wound the vessels beneath. In the first place, it is to be remembered that the cartilage of the first rib extends about half an inch further outward than that of the second, consequently the incision must be made. with this in mind, else the knife will come in contact with the manubrium. If the knife is placed under the rib and the cut is made in a forward direction, the vessels will be avoided. After dividing the sternal attachments of the diaphragm, the entire sternum may be removed or reflected and the pleural cavities examined. Any fluid, as serum or blood, is care

fully to be removed with the sponge and expressed into a vessel, and measured or weighed. The presence of adhesions is to be noted, and other evidences of recent or chronic disease which appear on the surface of the lungs. The mediastinum is also to be inspected. The pericardium is then to be opened carefully so as to prevent the escape of any fluid therein contained, which is to be measured as before directed. Both its visceral and parietal surfaces are to be inspected for pathological changes. With regard to the external appearance of the heart, an important point is the condition of the coronary arteries. After the removal of the heart, their caliber should be tested, after which they should be slit and their interior examined for atheroma, etc. Many a case of sudden death may be explained by an inspection of the coronary arteries, one of which may be found to be almost or quite occluded by a thrombus, which has rapidly formed about an atheromatous plate stripped up by the blood current. If the heart be now removed from the thorax, much of the blood in the auricles may escape, and an exact estimate of the blood in the heart rendered impossible. It may be objected that such exactitude is unnecessary. In a medico-legal inquiry it is impossible to be too exact, as the result of many a trial has shown, to the mortification of the too confident medical witness. The auricles and ventricles are therefore to be opened in the manner about to be described, and their contents examined both with regard to color, quantity, and general appearance. Ante-mortem clots will be evidenced by their extreme pallor and toughness, also the fact that their centers are disintegrated. Pale yellow and succulent clots are of no significance, as they may be formed in the last moments of life, whatever the cause of death. (Delafield.) The heart should be opened in such a manner as to expose the cavities and valves without injuring the latter. The dissection of the heart consists of two stages. The first stage includes the opening of the auricles and ventricles, the heart being in situ, and the subsequent estimation of the clots and the measurement of the auriculo-ventricular openings. The second stage consists in the removal of the heart and the examination of its valves and interior. The right auricle should be opened first. The incision should commence between the two venæ cava and end in front of the base. (Fig. 2.) The clot should then be turned out into the pericardium, from whence it may be removed for estimation by weight or measure. If measured, an ordinary glass graduate may be used. The approximated index or middle fingers of the left hand may then be introduced through the tricuspid valve into the right ventricle, the walls of which must be gently separated. If the auriculo-ventricular opening permits the introduction of these fingers, especially if the fingers be thick, the lumen of the valve may be considered normal. In the case of slender fingers, it is possible to introduce between the index and middle fingers of the left hand the index finger of the right. After the size of the opening has been ascertained the incision into the right ventricle should be made. This should commence close to the base, pass into the ventricle, and end just short of the apex. The septum must be avoided. In the case of each cavity, the clot is to be turned out as before directed and measured. The incision for the left auricle commences at the left pulmonary vein and ends in front of the base, avoiding the coronary veins. The incision into the left ventricle begins behind the base and is carried down toward the apex, which it must not quite reach. The measurement of the valves and clot is con