ILLUSTRATIVE CASES.
Homicide.
1. Cullingworth: Lancet, May 1st, 1875, p. 608.—Woman. Believed to have been intoxicated. Face, especially right side, swollen and livid; a little blood had oozed from mouth, nose, and inner angle of each eye. Immediately over (in front of?) larynx and on each side of middle line were marks of irregular outline such as might be caused by pressure of thumb and fingers. Several dark, bruise-like discolorations on flexor surface of each forearm. Hands clinched. Elbows flexed. Discharge of fæces by rectum. Necroscopy: Brain and membranes normal. Hyoid bone and laryngeal cartilages uninjured. Mucous membrane of larynx and trachea congested and covered with frothy mucus. Lungs intensely congested. Several hemorrhages; masses of tissue of each lung, chiefly toward base, were solidified by effused blood. All the heart cavities empty. Stomach normal, empty. No congestion of abdominal viscera.
2. Taylor: “Med. Jur.,” Am. Ed., 1892, p. 412.—Man and woman. Strangled by cord, tied so tightly that there was hemorrhage from mouth and nose.
3. Harvey: Indian Med. Gaz., December 1st, 1875, p. 312.—Hindoo woman, age 45. Strangled with the right hand. Necroscopy: Two contusions and abrasions on temple. Neck discolored from right to left jugulars; marks of thumb on right side and three fingers on left, extending from jugulars to windpipe. Eyes half protruded. Tongue discolored. Blood-vessels full of clots. Brain congested (?) and showed external hemorrhages (?). Lungs normal. Heart empty. Liver ruptured to the extent of four inches, with adherent blood-clot. Spleen, stomach, and intestines normal. Muscles of chest, both sides, congested, discolored, and there were clots of blood over and under them. First six ribs of left side and first three of right fractured.
4. Harris: Ibid., p. 313.—Boy, age 10. Abrasions over front of neck, especially near left ear, probably from ligature; also abrasion on upper part of chest, probably from forcible pressure. Underneath these marks the veins were much distended. Trachea minutely congested; contained much frothy fluid. Lungs showed rupture of some of the air-vesicles; entire tissues distended with blood and frothy fluid. Dark fluid blood in both sides of heart. Large quantity of fluid in pericardium. Brain much congested. Eyes congested. Tip of tongue between teeth. Other organs normal.
5. Mackenzie: Ibid., February, 1889, p. 44.—Hindoo woman, age not given, strangled by another, stronger woman. Necroscopy: Abrasion on front and lower part of neck just above sternum and clavicles; four inches long, three broad; five superficial lacerated wounds on sides of neck, four on left, one on right, apparently nail scratches. Two contusions below and behind lower jaw. Also contusions on thighs. No spots of ecchymosis on neck. Contusion under skin of lower part of neck and upper part of chest, eight inches long, four broad. Left greater cornu of hyoid bone fractured. Both upper cornua of thyroid cartilage fractured; cricoid fractured on each side. Larynx, trachea, and bronchi contained pink frothy mucus; mucous membrane congested. Lungs much congested; pink frothy mucus in bronchi; no emphysema nor apoplexies. Right side of heart full of dark blood; left side empty. Liver, spleen, and kidneys congested. Stomach and intestines normal. Bladder empty. Internal genitals normal. Brain congested.
6. Mackenzie: Ibid., August, 1888, p. 232.—Hindoo man, age about 30. Strangled by soft cloth cord. Necroscopy: Circular mark of cord, one-fourth inch diameter around lower part of neck; indistinct in front, but distinct at sides and back. Superficial abrasions of lips and right cheek as from a gag. Faint marks of blisters on temples. Fingers not clinched. Face livid, swollen. Eyes closed; conjunctivæ congested; corneæ hazy; pupils normal. Tongue protruding and bitten; not swollen. Fluid blood oozing from mouth and nose. Clotted blood under scalp of left temple. Skin beneath cord had the color and consistence of parchment. Muscles not torn. Hyoid, thyroid, and cricoid not injured. Larynx, trachea, and bronchi empty; congested. Lungs much congested. Some dark fluid blood in right side of heart; left side empty. Liver, spleen, and kidneys congested. Small patch of congestion in stomach. Intestines normal. Bladder normal, contained some urine. Brain congested.
7. Ibid., p. 234.—Hindoo woman, age about 40. Broad, circular, depressed “parchment” mark, one inch broad, around the neck, between hyoid bone and thyroid cartilage; made by two pieces of cloth, each three feet seven inches long and one inch broad, twisted into a single cord and tied tightly by three ordinary knots on right side of neck. Superficial wound on left side of head above ear. Face turgid, swollen. Eyes closed. Tongue between teeth and bitten; not swollen. Muscles of neck uninjured. Trachea uninjured. Lungs congested. Right side of heart full of dark fluid blood; left side empty. Liver and spleen congested. Other organs, including brain, normal.
8. Ibid., p. 235.—Hindoo woman, age about 25. Piece of cloth twisted tightly twice around mouth. Double cord made of two twists of thin coir rope tied tightly around middle of neck just below thyroid cartilage; beneath the cord the skin was “parchment” like. No injury to muscles of neck nor windpipe. Eyes closed. Face not flushed. Tongue not ruptured nor bitten. Hands not clinched. Larynx, trachea, and lungs congested. Right side of heart full of dark fluid blood; a little fluid blood in left. Liver, spleen, and kidneys congested. Other organs, including brain, normal. Dr. Mackenzie considered death to be due to “asphyxia or suffocation.”
9. Harvey: Ibid., January 1st, 1876, p. 2.—Hindoo woman, age 12 or 13. Faint mark on front of neck; none at back. Severe bruise on top of head, under which was much clotted blood, but no fracture. Lungs congested. Clots in right ventricle; left empty. Brain, larynx, and trachea congested. The examiner believed that she had been stunned and then suffocated by pressure of some soft substance against the neck.
10. Ibid.—Hindoo man, age 20. Dead seven days; much decomposition and discoloration. Wrists and ankles were bound. The two corners at one end of a cotton lungi (turban) were passed one on each side of the neck and fastened in a knot under left angle of jaw. The lungi was then passed around the body under the arms, etc., so as to draw upon the neck and be buried deeply in the swollen flesh. Under the bands the skin was blanched; the tissues above the bands were black and much swollen. Lungs, larynx, and trachea much congested. Heart empty.
11. Ibid.—Cases of strangulation by sticks and other hard substances. Boy, age 7 or 8. No external marks of violence. There was hemorrhage from mouth and nose. Face swollen and crepitant. Congestion of subcutaneous tissues and bruising of muscles of right side of neck. Mucous membrane of larynx and trachea covered with blood. Lungs much congested; blood in both pleural cavities. Heart empty; bloody serum in pericardium. Brain congested; slight hemorrhage on surface. Abdominal organs normal. Dr. Harvey states that the boy was no doubt strangled by pressure of a lathi on his neck.
12. Ibid.—In another subject two sticks were tightly tied together, one pressing on the front, the other on the back of the neck, flattening larynx and other soft parts. In the following case some hard substance, like a brick, had been wrapped in a cloth and used for compression. Boy, age 15. Necroscopy: Large dark ecchymosis in subcutaneous tissue of front of neck and upper part of chest. Also marks of violence on chest and left side of face. Dissection of neck showed blood-clot and also laceration of muscles. Trachea folded on itself, showing that compression had lasted several minutes. Tongue protruding and bitten. Eyes closed. Features calm. Trachea much congested. Lungs congested. Great veins of heart and neck full of fluid blood. Heart, dark fluid blood in both sides, mostly in right. Brain and membranes much congested.
13. Pemberton: Lancet, May 22d, 1869, p. 707.—Woman, age 60. Found dead. Nose partly displaced and cartilages injured. Lips pale. Mouth closed. Lividity of front of neck from jaw to sternum. Cricoid cartilage ossified (cretified?) and broken on left side; hemorrhage in surrounding tissues. Lungs and heart as usual in suffocation.
14. Cullingworth: Med. Chron., Manchester, 1884-85, i., p. 577.—Woman, married, found dead. Bruise and ecchymosis beneath the ear; effusion of blood in underlying tissue. Other bruises on face, etc. Several bruises in mouth, on lips and tongue. Blood dark and fluid. Brain and membranes much congested. No marks of injury on throat. Lungs congested; surfaces emphysematous. Heart contained dark fluid blood. Urine and fæces had been discharged.
15. The Gouffé Case.—Murdered by Eyraud and Bompard in 1889. Archiv anthropologie criminelle, Paris, 1890, v., pp. 642-716; vi., 1891, pp. 17 and 179. Reports by Bernard, Lacassagne, and others. Gouffé was decoyed into a room and strangled; afterward his body was tied up, placed in a trunk, and taken some distance away. The murderers fled to America; but eventually Bompard returned to France and Eyraud was captured; both confessed. When found, the body was well advanced in putrefaction; after a very careful examination was identified. He was strangled by the pressure of fingers; the head was afterward wrapped in a cloth which was held in place by five turns of a cord around the neck; traces of the furrows made by these cords were found. Heart empty; no blood in muscles of neck; hyoid bone intact but superior thyroid cornua fractured at base.
16. Horteloup: Ann. d’Hygiène, 1873, xxxix., pp. 408-416.—Man found dead on some leaves in a fountain at bottom of staircase; skull and spine fractured. The murderers stated that they had struck him on the head with a crutch; then, believing him to be dead, carried him and threw him into the fountain. When examined, his face was livid, tongue between teeth and bitten nearly in two; and three parallel abrasions on left side of neck and one on right; slight wounds about the face in addition to the fractures mentioned. No report of examination of lungs or larynx. Horteloup concluded that the man had been strangled to death, and that when thrown into the fountain, alighting on his head, the jaws were brought together and tongue bitten.
17. Laennec: Journ. de med. l’ouest, 1878, xii., pp. 68-71.—Woman, age 53; attempted strangulation by her husband. There were slight ecchymoses on each side of neck under angle of jaw, most marked on left side; when seen, she complained of lassitude and lively pain in hypochondria and region of lower ribs antero-laterally; no sign of lesion. She stated that she was awakened from sleep by pressure on neck and chest and feeling of suffocation; she soon lost consciousness and so remained for some hours. Her statements were corroborated by other testimony. Laennec considered the case one of prolonged syncope from pressure on carotids.
18. Lancet, ii., 1841-42, p. 129.—Woman, found dead, her clothing on fire and lower part of her body burnt. Necroscopy showed face and neck swollen as low as thyroid cartilage, and purple; eyes prominent and congested; mouth closed; tongue not noticed; front of neck below swollen part showed two dark-brown hard marks and slight marks also of pressure; on incision the vessels were engorged. Blood, fluid; brain, congested. There were no vesications from the burns and no sign of inflammation.
19. Alguie: “Étude méd. and exp. de l’homicide réel ou simulé par strangulation, relativement aux attentats dont Maurice Roux a été l’objet,” Montpellier, 1864, p. 121.—This essay contains the reports of many interesting experiments on animals and the cadaver. His conclusions in this case were that the victim had first been struck on the neck by a club; then a ligature was placed on the neck, with many turns, tied tightly, but the knots did not remain tight. [The marks were visible four months afterward.] The assailant then tied the limbs. The victim recovered with temporary loss of voice, memory, etc.
20. Gatscher: Mittheil. d. Wien. med. Doct. Colleg., 1878, iv., p. 45.—A man found hanging. The examiner declared that he had hung himself. Eight years afterward, suspicion of violence. A commission appointed. The protocol had shown the blood fluid; a red-brown dry furrow around the neck; ecchymoses in connective tissues of same; the entire back and posterior parts of limbs showed post-mortem suggillation. The commission declared that the man had been strangled, had lain for at least three hours on his back, and then been hung up. The murderer confessed.
21. Ibid., p. 46.—Woman, age 50, found dead in bed. Blood fluid; two ecchymoses size of beans in crico-thyroid muscles of each side; patch of hepatization size of fist, in lung; injury of body. The examiner declared that she had been strangled by compression of larynx with two fingers, but he could not say how long the pressure had continued, that is, whether she had died of the strangulation or of the pneumonia. The assailant stated that he had choked her and when she seemed to be dead, had left her. The woman lived alone.
22. Waidele: Memorabilien, 1873, xviii., pp. 161-167.—Husband and wife quarrelled and fought; he stated that he choked her with her neck handkerchief, and as she turned round toward him, then choked her with his hand until she died. The examiner declared that she died of asphyxia; there was a brownish-red dry streak on each side of the neck in the laryngeal region corresponding to the handkerchief, and also two small abrasions of skin which might have been made by the hands; he concluded, however, that she had been choked to death by the handkerchief, because there were no ecchymoses.
23. Rehm: Friedreich’s Blätter f. ger. Med., 1883, xxxiv., pp. 325-332.—Woman, age 37. Choked by the hand on the neck, and at the same time assailant’s knee pressed against her abdomen, pressing her against a wall, causing hemorrhage around the pancreas. Death stated as due to asphyxia.
24. Schüppel: Vier. ger. öff. Med., xiii., 1870, pp. 140-156.—Woman, just delivered of child, and boy ten years old, were burnt to death in a fire which consumed their house. Examination of the bodies showed upon the neck of the boy a groove, and his tongue protruded. The husband was charged with murder, was imprisoned, and committed suicide.
25. Weiss: Ibid., xxvii., 1877, pp. 239-244.—Woman strangulated by the bands of her nightcap.
26. Isnard and Dieu: Rev. cas jud., Paris, 1841, p. 101.—Man, age 65. Marks of fingers on face and neck. Opinion that he had been assaulted by two men. The two murderers confessed.
27. Friedberg: Gericht. gutacht., 1875, pp. 211-224.—Woman found hanging to branch of tree, but in half-lying position, feet on ground. Opinion given that she had been strangled and then hung.
26. Tardieu: “Pendaison,” p. 223.—New-born infant. Question whether its death was due to asphyxia from compression of neck by the mother with her hand to hasten delivery. He doubted the possibility of the mother thus assisting her child. But the direction of the seven excoriations on its face contradicted the mother’s statement. The traces of finger-nails were distinct. The lungs and alimentary canal showed that the child had lived. Opinion given, infanticide.
29. Ibid., p. 219.—Woman, advanced in years, habits dissipated; found strangled. Four excoriations on left side of larynx, one on right; blood in subcutaneous tissue. Marks of nails and long scratches on wrist. Injuries on face and left breast. She had been strangled by one hand on her neck while the other was over her mouth and nose. Face livid; eyes congested; frothy bloody liquid flowing from mouth and nose; tongue behind teeth; bloody froth in larynx and trachea; lungs large, much congested, splenized in places, surface emphysematous, looking like white spots; black fluid blood in heart; brain somewhat congested.
30. Ibid., p. 216.—Wife of the celebrated painter Gurneray; found dead in bed, where a fire had been placed and slowly burnt and charred her lower limbs, belly, chest, and right hand. A running noose around her neck. Injuries of head; face livid; tongue between teeth; brain normal; mark of cord slight; subcutaneous tissue infiltrated with blood. Marks of pressure on chest; bloody froth in trachea; lungs congested; heart contained fluid blood. Opinion given that she had been struck on head, causing unconsciousness; then partly stranded and partly suffocated by pressure on neck and chest. Body afterward burnt to cover up the crime.
31. Ibid., p. 211.—Three murders by one man. All women. All injured about the head and then strangled by both hand and ligature. Two died; one had an odor of alcohol and had apparently not resisted. The third was resuscitated. She was strong and stout, and resisted. Marks of fingers and nails on neck. Afterward she had headaches and giddiness for a long time.
Suicide.
32. Francis: Med. Times and Gaz., December 2d, 1876, p. 634.—Hindoo lunatic, a giant, strangled himself. He passed two or three coils of stout thread around his neck, attached the ends securely to his wrists, and then extended his arms to their utmost limit. This occurred during a ten-minute absence of his attendant, who, returning, found the man had fallen to one side from a kneeling position, with his back against a wall, quite dead. No reason to suspect homicide.
33. Badahur: Indian Med. Gaz., December, 1882, p. 330.—Hindoo woman, age about 17, strangled herself with the border of her saree. Necroscopy: Circular depressed mark caused by the border of a band of cloth, which she had passed in three coils around her neck, the coils tightly overlapping each other; the short ends had been knotted together with a “granny” knot at the back of the neck, like the native women tie up their hair. The coils were so tight that they had to be cut off. Face swollen, dark purple; conjunctivæ congested. Tongue between the shut teeth; bloody froth issuing from mouth and nostrils [the examination was in September, thirty hours after death]. Skin of neck reddened in nearly a continuous line all around, both above and below the band, about three-fourths inch wide, evidently caused by the pressure of the three folds. Considerable ecchymosis above and below the coils; the neck underneath the folds was swollen and red. Brain and membranes much congested. Trachea, pharynx, and œsophagus congested. Lungs congested. Right cavity (auricle?) of heart full, left empty. Liver, spleen, and kidneys congested. Intestinal peritoneum congested. Stomach contained half-digested food. Small intestines empty; fæces in large intestine. Bladder empty. Uterus and appendages congested; no evidence of catamenia.
34. Harris: Ibid.—Woman; made a loop of her hair around her neck, knelt down so as to put it on the stretch; when found, was nearly dead.
35. Geoghegan: Taylor’s “Med. Jur.,” Am. Ed., 1892, p. 413.—Informed Dr. Taylor of a suicidal strangulation by a ribbon. The mark on the neck nearly disappeared after removing the ligature. There was bleeding from one ear, from rupture of tympanic membrane. No froth from mouth or nostrils; but little lividity or swelling of face.
36. Taylor: “Med. Jur.,” Am. Ed., 1892, p. 418.—Boy: found dead with handle of pitchfork under necktie; marks of strangulation on larynx; eyes and tongue protruded; tongue livid and marked by teeth; brain congested. Also man found dead with handkerchief tied around neck and twisted by razor strop. Taylor considered both as suicides. Also a third case (Amer. edit., 1880, p. 465). A man of unsound mind twisted a fishing-net firmly around his neck several times; it remained secure without the aid of a knot.
37. Fargues: Rec. de mém. de méd., etc., Paris, 1869, xxii., pp. 443, 444.—Soldier, age 32, while drunk, strangled himself with his handkerchief, wrapping many folds around his neck, making a deep furrow without ecchymosis; face pale, eyes closed, lips partly closed.
38. Borchard: Jour. de méd. de Bordeaux, 1860, v., p. 349 et seq.—Collation of cases of suicide by strangulation: First, an officer who placed his sabre scabbard under his cravat. Second, a woman strangled herself with a silk cravat, tightly tied. Third, a man tied the sleeve of his jacket around his neck and fastened the end to a window, so that the strangulation was partly due to suspension. Fourth, a woman strangled by a cord.
39. Hofmann: Wien med. Presse, 1879, xx., p. 16, et seq. Also Lehrbuch, p. 559.—Woman, age 20, found dead in bath-room, with a thick thread passed three times around the neck, and tied tightly in front at the second and third turns; so tightly that even after cutting the cords the pressure continued. No signs of violence. (Illustration.)
40. Zillner: Wien med. Woch., 1880, xxx., pp. 969, 999.—Woman, age 33; found dead on the floor; a neck-handkerchief tied in a firm knot in front of the neck; and underneath, a cord passed twice around the neck and knotted in front in the middle line between the larynx and hyoid bone. Blood was flowing from the ears. No sign of violence or struggle.
41. Bollinger: Friedreich’s Blätter f. ger. Med., 1889, xl., p. 3.—Man, age 48; melancholic; found dead. Had torn up part of a sheet, fastened it around his neck and the ends around a bed-post, then placed his feet against the farther post and pressed, tightening the ligature. (Illustration.)
42. Roth: Ibid., p. 9.—Man, age 68; melancholic; found dead in bed. Had made loose ligature of cravat, tied into it a piece of wood; the ligature lay in front of larynx. Had attempted suicide once before.
43. Ibid.—Son-in-law at 36 years of age had committed suicide in the same way.
44. Ibid.—Man, age 63; found dead in his bed; cord around neck inclosing piece of wood.
45. Maschka: Vier. ger. öff. Med., 1883, xxxviii., pp. 71-77.—Woman, age 45. A cloth was found wound tightly three times around her neck in front of larynx, and tied in a simple knot. There were also injuries of the head. At first it was thought that she had been murdered, but Maschka concluded that she had committed suicide.
46. Ibid.—Woman; supposed to have been murdered by her son. There were marks on the neck and other injuries, and hemorrhage into the brain. Maschka concluded that the marks on the neck were not due to strangulation.
47. Hackel: Dorpat Diss., 1891, p. 34.—Man, age 48; strangled himself with part of a mattress. Was found lying on his back, dead, holding the ends in his hand. There was a double mark of ligature.
48. Binner: Zeitsch. f. Med-beamte, 1888, i., pp. 364-368.—Woman; suicided by choking herself with her hands.
For other cases, see Tidy, “Med. Jur.,” Cases 20 to 65; Maschka, “Handbuch,” p. 625.
Accident.
49. Bédié: Rec. de mém. de Méd., etc., Paris, 1866, xvi., pp. 482-484.—Soldier, age 39, found dying, lying on his bed; had returned to his room drunk and lay down in his uniform. Face much congested; lips cyanosed; eyes closed. Skin of neck below thyroid cartilage showed deep mark from pressure of collar of uniform where the collar was fastened; had passed urine into his clothing. When examined after death his face was pale yellow, lips cyanosed, eyes closed; large hypostatic patches; traces of pressure on neck still visible; lungs congested; larynx, above level of pressure, congested; below was normal. Fibrin clots in both ventricles of heart. Liver, spleen, stomach, and intestines congested. Brain somewhat congested. Bladder contained urine.
50. Liégey: Jour. de Méd. chir. et pharm., Brussels, 1868, xlvi., pp. 339-342.—Infant, age 8 months, accidentally strangled; it had been placed in its cradle; coverlet over it and held in place by a cord passed across. Some time afterward it was found dead beside the cradle, its head hanging with the right side pressing on the cord. Liégey had the mother replace everything as it had been and satisfied himself that the above statement was correct. When found, the face was pale, eyes and mouth closed; transverse furrow on right side of neck, level of larynx, 3.5 cm. long, one deep; muscles in vicinity congested. Lungs congested. Right side of heart contained clotted blood; left side nearly empty. He concluded that the case was one of accidental strangulation.
51. Friedberg: Gericht. gutacht., p. 240.—New-born child found dead in closet. Mother stated that she had taken the child by the neck and drew it into the world. Opinion given that the child had been accidentally choked to death by the hand.
For other cases, see Tidy, “Med. Jur.,” Cases 15 to 19, 59, and 62; Maschka, “Handbuch,” p. 623.