DISCOLORATIONS.—Continued.
=Discolorations Occurring After death.=—Those discolorations occurring
after death would be as follows:
(a) Desiccation.
(b) Greenish tinge of putrefaction.
(c) Chemical action.
(d) Postmortem discoloration.
(e) Postmortem staining.
(f) Capillary or venous congestion.
=Desiccation.=—This is a brownish color caused by the drying of the
skin. Various conditions might cause this color of which a few are
considered here:
Natural evaporation, the drying action of formaldehyde, freezing the
skin, feverish conditions of the body before death, absence of a normal
amount of moisture in the skin of the dead body.
_Natural Evaporation._—The passage of moisture from the skin into a dry
atmosphere reduces the normal amount of moisture in the skin, thereby
producing an altered color. The extent of the moisture reduction
governs the color produced. When evaporation begins, the skin loses its
softness and becomes slightly yellow in color. As evaporation continues
the skin becomes more hard and the color changes from yellow to brown.
At this time nothing can be done to restore the original color as in
the absence of the blood circulation, the pigment of the skin will not
take up moisture, nor will moisture penetrate the skin itself.
_Treatment._—The only treatment for a condition of this kind is
necessarily a preventive one. While embalming a body, the operator
should apply either water or one of the commercial face solutions to
the skin of all the exposed portions of the body. If the condition
within the skin is one in which there is a predisposition toward
dryness, the face solution or the water by being present on the skin
will reduce evaporation from the skin itself; in this way maintaining
the natural degree of moisture. Should a hard, dry spot appear in the
absence of any preventive treatment, the operator can only coat the
spot with grease paint and thereby hide it.
_The Drying Action of Formaldehyde._—Formaldehyde is derived from
methyl spirits, which in itself has an active affinity for water. The
amount of water ordinarily mixed in formalin in the compounding of a
formaldehyde fluid is not sufficient to satisfy the appetite of the
formaldehyde for more water. When a formaldehyde fluid comes in contact
with moisture laden skin, there will be a movement of moisture from
the skin toward the formaldehyde fluid, thereby reducing the degree
of moisture in the skin and in that way causing it to become dry.
When the skin becomes dry, it changes in color the same as in natural
evaporation.
_Treatment._—There are three conditions in the skin met by the
operator. The first is where there is a predisposition toward dryness
and this is where the skin does not contain a normal amount of moisture
to begin with. In old age cases, tubercular, and anemic bodies, the
ordinary embalming fluid should be diluted at least one half for the
first part of the injection, thus reducing the appetite for moisture on
the part of the fluid. In addition to this, water or a face solution
should be used externally to prevent outward evaporation from further
reducing the moisture in the skin. The fluid exhibits a tendency to
draw water into the pores, thus maintaining to a large degree, the
normal moisture percentage.
The second condition met with is one in which the skin contains a
normal amount of moisture. In this case it would not be necessary
to reduce the strength of the standard fluid at any time during the
injection, but it is necessary to apply water or a face solution
externally to limit outward evaporation and to provide a source
whereby moisture could be drawn into the pores by the appetite of the
formaldehyde, thus again maintaining the normal percentage of moisture
in the skin.
The third condition is one in which the skin along with the balance
of the body, will contain more than a normal percentage of moisture.
This condition may be looked for in edematous or dropsical cases. The
injection in these cases should be normal in strength unless the dropsy
is very pronounced, when an overnormal injection can be given without
reducing the moisture percentage in the skin below the normal point.
Should the above precautions not be used and the skin be dried through
the appetite of formaldehyde for water, no treatment can be given which
will restore the moisture to the skin. When moisture is drawn from the
skin and the percentage is below normal, the skin will shrink and will
draw tight against the bones and subcutaneous tissue. This frequently
gives rise to the sharp nose and to the drawn appearance so common in
those cases. Prevention is the only remedy.
_Freezing the Skin._—When the body is subjected to a temperature of 32
degrees Fahrenheit, the moisture in the skin freezes, thereby removing
it from its usual consideration, as the element that is responsible for
the usual softness and flexibility of the skin.
In the cold months, bodies are sometimes left in cold rooms with
the windows open. The embalmer did this in the past, thinking that
subjecting the body to the influence of a cold atmosphere would
simplify preservation.
From the standpoint of preservation alone, this theory is correct,
but in accomplishing the above result the moisture of the skin may be
frozen. The resulting color is light yellow. The texture of the skin is
changed from soft to a slightly hardened condition.
_Treatment._—Never allow the room temperature to approach the freezing
point. Should the above treatment be disregarded, and the yellow
color become present, have the room warmed, and the color will slowly
disappear.
_Feverish Conditions in the Body Before Death._—Fever is the name
usually given to the rise of temperature that goes with inflammation.
In severe inflammatory diseases, the tissues lose much of their
moisture through the arrest of the saturating power of the blood stream
and the disturbance of circulation. The skin contains a sub-normal
amount of moisture when the embalmer reaches these cases, which may be
further reduced by outward evaporation and the dehydrating power of the
embalming fluid. Small brown spots resembling the fever blister in the
living body may be present around the mouth.
_Treatment._—Use half strength fluid for the first part of the
injection, followed by normal fluid for the second, third and fourth
parts. Apply water or a commercial skin or face solution while the
injection is going on.
_Absence of a Normal Amount of Moisture in the Skin of the Body._—The
normal amount of moisture in the skin has been determined to be an
amount equal to seventy-five per cent. of the weight of the skin. Any
percentage less than seventy-five per cent. is considered subnormal.
This condition can be expected in all fever cases, in anemics, and in
old age.
_Treatment._—When the skin appears rather dry, the injection of fluid
should be half strength for the first and second parts, normal for
the third and fourth. The skin of the exposed parts of the body should
be dampened with an application of water or a commercial face or skin
solution, while the injection is being made.
=Greenish Tinge of Putrefaction.=—Putrefaction discolorations are those
which are produced when putrefactive bacteria become active in the skin
or subcutaneous tissue.
This discoloration appears generally about the second day, unless
preservative fluids have been applied to prevent it. It first begins in
the ileocaecal region or lower part of the abdomen. The skin covering
these parts assumes a brownish color which shades to yellow, yellowish
green, and finally a green color. This green discoloration will in a
few days spread all over the surface of the body.
Among the putrefactive bacteria is the bacillus fluorescens, a
chromogenic germ, which produces a greenish color when it becomes
active in the tissues. One of the first external evidences of
putrefaction is the production of a greenish color in the abdominal
wall. This, of course, could not occur when embalming had been done
with any degree of completeness. Should an insufficient circulation
be encountered when embalming a body, the part which does not receive
the fluid, being unprotected, may be affected by the color producing
germ mentioned above. The most likely to be affected by an insufficient
circulation will be located somewhere in the extremities of the
circulation, that is to say, in the skin. We can place the affected
part more definitely in the skin of the face, particularly the nose,
which has a rather poor circulation. This condition will not make
its presence known until three or four days after embalming has been
done, making it almost entirely absent in bodies embalmed in ordinary
practice. Should several days elapse between the time the body died
and embalming, allowing the discoloration to appear, the following
treatment would be advisable:
_Treatment._—Inject a very small portion of the following solution just
under the skin, using a hypodermic needle.
Alum 10 gr.
Corrosive Subl. 10 gr.
Zinc Chloride 5 gr.
Grain Alcohol 4 fl. oz.
Formaldehyde 2 fl. oz.
Just a small portion of the above solution is all that will be
necessary, working it under the skin with the finger tip, so as to
avoid destroying the features by swelling the tissues.
This treatment being a chemical one, it is necessarily slow in its
action of bleaching the green color. Should haste be necessary, inject
a very small quantity of embalming fluid to arrest the putrefactive
process and then cover the spot with theatrical grease of the proper
color to match the surrounding skin.
=Chemical Action.=—Chemical action is any discoloration of the skin
or tissues of the body which may be caused by the action of opposing
chemicals. There is only one known discoloration occurring in the
body after death as a result of the presence of a chemical in the
body, which, when coming in contact with formaldehyde, produces a
discoloration. This particular discoloration, greenish in color, is
the result of the work of the drug methylene blue in contact with
formaldehyde.
Often, in cases of chronic malaria, or diseases of the liver, or again
as a general antiseptic, methylene blue will be administered by the
attending physician, and you should learn this fact beforehand, for
if methylene blue has been administered it is advisable not to use
a formaldehyde fluid. There is a chemical action set up between the
formaldehyde and the methylene blue, which gives the tissues a greenish
color, which is quite objectionable.
In this case you would use some fluid which does not contain
formaldehyde, benzoate of soda, or borax, or peroxide solution should
be used.
Another good formula to use is the following:
Rx
Carbolic acid 5 oz.
Borax 12 oz.
Glycerine 1 oz.
Water, sufficient to make 1 gall
or
Rx
Carbolic acid 5 oz.
Oxalic acid 12 oz.
Boracic acid 2 oz.
Water, sufficient to make 1 gall
=Postmortem Discoloration.=—This is a general expression, and refers to
any discoloration which might occur on the body after death.
What is usually meant, though, when this term is used is _the settling
of the blood to the dependent parts of the body after death_. If the
body is lying on the back, the blood will naturally gravitate toward
the back, into the azygos system and cause a bluish discoloration, or
the same condition will result, if the body is found lying on the face
and stomach, in which case the discoloration will be in the face and
the anterior chest and abdominal walls.
=Postmortem Staining.=—This condition is caused by changes in the
blood while in the veins. The blood becomes more fluid in character
and the red blood corpuscles become granular and give off their oxygen
which escapes through the walls of the veins and carrying with it the
haemoglobin or coloring matter of the blood, stains the tissues over
the superficial veins a purplish red color. This discoloration only
appears on the ventral surface of the body and along the course of the
large superficial veins. An excellent example of this discoloration
is seen in the drowned subject where almost always all the superficial
veins can be easily traced by this discoloration.
=Capillary or Venous Congestion.=—This term includes those
discolorations either caused by gas distension or by the unskillful
injection of fluid into the vascular system. Gas forming in the
abdominal or thoracic cavities will so press upon the heart as to empty
it of its blood, which will be forced upwards into the large venous
trunks of the head, neck and axilla. All embalmers are familiar with
the flushed face which often appears when the arterial system has been
injected in a too hasty manner. It causes the veins and capillaries of
the face and neck to become congested the same as that caused by the
formation of gases in the cavities.