Text-book of forensic medicine and toxicology

by R. J. M. Buchanan

HANGING

Death by hanging is caused by the more or less perfect suspension of the body by a cord applied around the neck, the weight of the body acting as the constricting force.

The body need not hang completely, partial suspension is sufficient to cause death. The ligature surrounds the neck above the thyroid cartilage, the epiglottis is pushed against the back of the pharynx, the base of the tongue and the soft parts are pressed into the cavity of the pharynx, so that the obliteration of the naso-pharyngeal and the laryngeal passages is complete. Death is due to asphyxia and pressure on the cervical blood-vessels, even if the air-passages be not completely occluded; stoppage of the cerebral circulation being sufficient to cause death; in such a case the signs of asphyxia are absent.

Consciousness is quickly lost, due to pressure on the vessels, and, for this reason, in accidental or suicidal hanging the person is prevented from making any effort to save himself.

Post-mortem Appearances.—The external appearances are more or less those described under “Death from suffocation.” In the greater number of cases the face bears a quiet, placid expression, no turgidity or lividity being noticeable. The eyes are usually half open, but not protruded, and the condition of the pupils variable. The tongue may be protruded, but just as often not. The face may be pale or livid, and a bluish colour present on the free border of the lips. Cyanosis and swelling of the face are only present when the death agony has been long; they soon disappear.

Ecchymosis of the conjunctiva, and on the outer surfaces of the lids may be present. The escape of urine, fæces, and semen may take place, but are not characteristic, and are extremely rare.

Casper states that in not one of the many cases he had examined of persons hanged has he ever “found an erection of the male organ,” and he also asserts that the emission of semen is extremely rare. Seminal emissions take place more frequently in persons who have been shot, and also in those who have been poisoned by irrespirable gases or by hydrocyanic acid. As a test of strangulation, it is therefore worthless. Tardieu, however, only noticed the escape of urine and fæces in two out of forty-one cases; it is by no means a test of hanging, as it may occur after death if the body is shaken in a cart, or roughly used when first found. A fat person dying of apoplexy may have a mark round the neck as if strangled. Injury to the spinal cord due to fracture or dislocation of the cervical vertebræ is rare in suicidal hanging. Fracture of the spinal ligaments and of the hyoid bone is also rare. Rupture of the internal and middle coats of the carotid arteries sometimes occurs. But it appears that considerable damage is done to the soft parts of the neck by the present judicial mode of hanging with the “long drop.”

Dr. Dyer has recorded (New York Medical Journal, vol. iii., 1866) some experiments he made on the eyes of a man and some dogs killed by hanging. He found certain transverse fissures across the lens, which he is inclined to think are characteristic of this mode of death. Dr. R. F. Hutchinson states that an invariable sign of death from hanging is the flow of saliva out of the mouth, down the chin, and straight down the chest. The appearance is unmistakable and invariable, and could not occur in a body hung up after death, the secretion of saliva being a living act (Chevers). Death from hanging may take place although the toes or other parts of the body rest on the ground. Death is complete in four or five minutes.

Marks of the Cord, &c.—The mark of the cord is nearly always present. It varies with the breadth and hardness of the ligature, but is often interrupted. Its irregularities are reproduced on the skin. It is sometimes only seen on one side. In strangling, the mark is low down, most frequently encircling the neck; in hanging, the mark is generally above or on the thyroid cartilage, and carried obliquely upwards. The mark of the cord may be of a dirty yellowish-brown colour, and, when cut into, feels more or less hard and leathery. In general appearance it is not unlike the mark left by mustard-plasters or blisters applied within a short time of death. This effect is probably produced by the rubbing off of the epidermis, and subsequent drying up of the cutis on exposure to the air. At other times the mark may be of a dirty reddish or bright blue colour; or, lastly, there may be little or no mark present, or the edges may assume a livid red coloration, being nothing more or less than a post-mortem stain.

May the mark of the cord be produced after death?—On this point Casper says: “That any ligature with which any body may be suspended or strangled, not only within a few hours, but even days after death, especially if the body be forcibly pulled downwards, may produce a mark precisely similar to that which is observed in most of those hanged while alive.” And the same authority also adds that “the mark of the cord is a purely cadaveric phenomenon.”

Accidental hanging is rare, and generally happens with children while playing at hanging, or by accidentally becoming entangled in a window-blind cord or swing rope, or by the neck-band of an article of clothing by which they may become accidentally suspended from the spike of a railing.

Homicidal hanging is rare, but the body may be suspended after death from violence, to simulate suicide; and it may have to be decided whether the hanging took place during life or after death.

The mark of the cord is of no assistance, rents in the carotids with extravasation into the coats of the vessels indicate ante-mortem suspension. The flow of saliva down the chin to the body indicates suspension before death. It is important to examine the body for injuries which could not be self-inflicted, and to remember the possibility of poison having been administered with suspension after death.

Suicidal hanging is the most common, as it is a favourite mode of death with suicides. The absence of marks of injury on the body found suspended, and the want of evidence as to a previous struggle having taken place, all point to suicide. The fact that the feet are found in contact with the ground does not militate against the probability of suicidal hanging; and it appears that in India the natives seldom hang themselves from any height, and are most frequently found with their feet on the ground. A person may take poison first, and hang himself before the poison has had time to prove fatal.