The intestines are removed next. The omentum may either be removed when the abdominal cavity is inspected or left till later. It is freed from the transverse colon by dividing it close to the gut with a knife.

The most convenient way to dispose of the intestines is by freeing the sigmoid flexure from the mesocolon and dividing just above the rectum. The transverse colon is freed by dividing the two folds of the lesser omentum, the ascending by dividing the mesocolon.

To remove the small intestine it should be grasped with the left hand and sufficient force exerted to keep the mesentery in a state of tension. The blade of the knife is held parallel to the intestine and the mesentery is cut at its attachment by means of to-and-fro motions. As the intestines are set free they should be received into a pan. When the duodenum is reached it is ligated and cut on the distal side. The mesentery is then removed. The gut is then opened, the large intestine along one of its longitudinal muscular bands, the small along its mesenteric attachment, as opposite to that side the most important lesions involving the lymph-nodes and Peyer's patches are found.

In order to determine whether or not there is any obstruction of the hepatic or common bile-ducts the duodenum should be opened in situ. The incision should be along the anterior wall and extend from the pylorus to where the duodenum passes beneath the mesentery. The opening of the bile-duct is usually marked by a small papilla. Pressure is first made on the common duct, and the opening watched to see if any obstruction prevents the escape of bile. Pressure should then be made upon the gall-bladder to see if its contents can escape.

The kidneys may be removed along with the adrenals by making an incision to the inner side and then above the adrenal, then cutting along the outer convex border of the kidney through the peritoneum and the perirenal fat. The kidney is shelled out by using the left hand and the vessels are cut from above downward and as near to the aorta as possible. When they are divided the organ is raised and the tissues loosened with the fingers until the ureter is disclosed, when it is severed.

When the entire urinary apparatus is diseased all the organs may be removed together by first dissecting the ureters till the bladder is reached, then turning the kidneys downward, after which the pelvic organs can be taken out.

Sometimes the kidneys may be removed without the adrenals, in which case the latter are either opened in situ or removed separately. The right adrenal is attached to the under surface of the liver and must be dissected free.

The left kidney is generally removed first.

In examining the kidney it is held between the thumb and fingers with the convex surface upward. A deep longitudinal incision is then made down to the hilum. The capsule can then be stripped by getting hold of it with the thumb-nail.

The size, color, condition of the surface, and density should be noted. Portions of the kidney substance may be removed with the capsule. The presence of cysts or of infarcts should be determined. On section the relative proportion between cortex and medulla, the color of the cut surface, the presence of abnormal substances, amount of connective tissue, the normal markings of the kidneys, the blood-vessels, glomeruli, the tubules of the cortex and of the medulla should be carefully noted. The pelvic mucous membrane should also be examined. Weight, right kidney 131, left 150 gm.

The liver is removed by raising up the right lobe and freeing it from all attachments, then the left lobe. If adherent to the diaphragm, remove it with the liver. The portal vein and the common bile-duct should be examined.

The tissue is exposed by one or more long cuts on the anterior surface across both lobes. Should note the amount of congestion, the degree of fatty changes, the amount of connective tissue present, and the degree of bile staining. Weight 1612 gm.

In removing the stomach a portion of the duodenum is cut through and lifted up and the stomach, together with the pancreas, freed by incisions from below upward. The stomach is dissected free from the pancreas and opened along its greater curvature. If any marked lesions are noticed from the outside, the incision should be so made as not to damage them.

The pancreas is examined by making numerous transverse incisions. Should be on the lookout for fat necrosis. The duct may be slit open along its course.

In removing the organs of the neck it is best, if allowed, to continue the skin incision up to the symphysis of the jaw. The skin is dissected free as far as the hyoid bone and upward to the chin. The tissues are loosened by passing the knife around inside the clavicles. The head should be allowed to drop back and a long thin knife is inserted at the symphysis beneath the tip of the tongue. By means of a sawing motion the muscles are divided first on one side and then on the other as far as the vertebral column. The esophagus and the trachea are lifted up and the dissection continued till the posterior wall of the pharynx is divided. The tongue is drawn downward and an incision made on either side, well out, so as to divide the lateral pillars of the fauces without wounding the tonsils. The soft palate is separated and the structures removed.

The esophagus is opened by being cut along its median line posteriorly from the pharynx down. It is then pulled to one side, when the larynx and trachea are divided along the posterior wall.

The lobes of the thyroid gland should be cut in their long diameters.

The pelvic organs are removed by dividing the peritoneum along the brim of the pelvis and dissecting it with the ringers till the posterior surface of the rectum is freed. The cut end of the rectum is drawn upward and toward the pubes while the attachments posteriorly are dissected away. The pelvic organs are now attached only at the external openings. These are divided anteriorly close to the pubes and posteriorly along the outlet of the pelvis.

The rectum is opened along its posterior wall and cleaned.

In opening the bladder a slight incision is made in the anterior wall of the fundus and with a pair of scissors the cut is continued along the anterior wall through the urethra.

The uterus is opened by making an incision along the anterior wall from the fundus to the cervix. Two secondary incisions extend from the upper end of the first cut to the openings of the Fallopian tubes. The vagina is opened by carrying the incision downward. It should be done from this direction so that the operator may be sure that any foreign substance found in the uterus was not conveyed there on the point of his scissors, an important consideration in medicolegal cases. The ovaries are opened along their greatest diameter.

The testicles can be drawn up through the internal ring and examined without any injury to the scrotum. The greater portion of the penis can be removed by incising the skin as far as the middle of the dorsum and dividing just behind the corona. Is then dissected free and withdrawn underneath the arch of the pubes.

The structures now left for examination are the inferior vena cava, the thoracic and abdominal aorta, the iliacs and the thoracic duct. They should be slit open.