Directions to Observe in a still More Obstinate and Difficult Case.
Where the body is badly bloated, when you are first called, it is best,
immediately after attending to the stomach (as before instructed) to let
off the gas from the cavities of the body. This is best done with the
Gas-trocar, if you have one, as with this instrument, and having a small
rubber pipe attached to it, you can puncture the abdomen or cavity of
the body with the point of the Gas-trocar, and by extending the rubber
pipe out of the window, the gas (which has a very offensive odor), will
pass out of the window through the pipe, thus saving any disagreeable
smell, for the time being, in the room. Many however, puncture the
abdomen in several places and let the gas off in the room, as the
Preservative will soon deodorize and purify the room.
It is sometimes necessary to puncture the body in two or three places,
in order to get rid of all the gasses, but seldom more than once, as in
nine cases out of ten the gas will all escape in less than two minutes
from one opening.
Immediately after the gas has escaped, insert the point of the Syringe
and inject one or two pints of the Excelsior Preservative into the
cavity of the abdomen, which will pass all around the bowels and arrest
any further decomposition or putrescence, and entirely prevent any
further accumulation of gas or possibility of bloating. You can inject
the Preservative through the Gas-trocar.
If you have found it necessary to make more than one incision with the
Gas-trocar or knife, it is well to inject some of the Preservative into
every opening made, even to the extent of three pints or more.
Whenever it is desirable for any reason to avoid leaving any external
mark of the puncture, it should be made at the navel, first drawing the
loose fold of skin at one side and puncturing through the navel; then,
when the trocar is withdrawn the loose skin around the navel returns to
its natural position. The trocar can be pointed downwards and to each
side, injecting some of the Preservative in each place, thus
accomplishing the thorough injection of the abdominal cavity from only
one point of insertion.
In case it may be deemed necessary to inject the thorax (or cavity of
the chest) raise or extend one of the arms and puncture and inject
through the axilla or armpit.
The stomach may be reached from the point of insertion at the navel by
pointing the Gas-trocar upwards at an acute angle, inclining it a little
to the left in a line with the top of the left shoulder. The foregoing
methods of injection have the advantage of leaving no visible trace of
the operation.
It is also _important_ (and _not to be forgotten_) to puncture the
bladder with the Gas-trocar and draw off the urine. This is easily done
by placing a washbowl or chamber in a chair and, after puncturing the
bladder, turn the body on its side, and the urine will escape through
the instrument at once, but if in some cases it might not escape through
the Gas-trocar readily in this position it certainly _will_ by raising
the body to a sitting posture.
The point for the insertion of the Trocar to reach the bladder is just
at the top of the _os pubes_ or pubic bone (the bone uniting the hips in
front at the bottom of the abdominal cavity), making the puncture in a
line with the navel as near the top of the bone as you can and inclining
the point of the Trocar a little downwards behind the bone.
Remember, always after the urine has been taken away, to inject _at
least_ half a pint of the Preservative into the bladder. It is important
that this part of the work should be well done, for unless this
precaution is taken, the urine is certain to escape more or less in the
natural way on the second or third day.
And whenever the bladder is _not_ thus attended to, you must _never_
omit the simple precaution of putting on a good heavy diaper; say,
double up a large sheet and use plenty of cotton well saturated with the
Preservative, and do up the parts as snugly as a mother would her child,
remembering to saturate these cloths again the second, third and fourth
day, by pouring Preservative from the bottle on the diapers, thus
deodorizing any escape that may have taken place, in order that there
may be no disagreeable smell arising from this source on the day of the
funeral.
This part of the practice is not new to those well up in the profession,
but I have thought best to call your attention to these facts in order
that no important point should be overlooked by any one.
This done, in addition to the treatment according to the foregoing
instructions, I term partial embalming, and the entire time consumed in
thus taking care of a body will not exceed one hour. And if the
Preservative _is used freely_ and my instructions are carried out in
this process of treating a case, there will _never be a failure_, and
the body in _every instance_ will be as effectually preserved for ten,
twenty or thirty days, as it would under a treatment of full embalming
for all time.
[Illustration: [Fleuron]]