In a small proportion of cases of hanging, homicidal and judicial, death occurs by dislocation of the spine. This is said to have been first noticed by the celebrated Louis, who states that the Paris executioner was in the habit of giving a violent rotary movement to the body of the convict as the trap was sprung, causing a dislocation of the odontoid process and compression of the cord and almost instant death. Taylor[816] says that for dislocation the body must be heavy and the fall long and sudden. Devergie[817] found this to occur in about two per cent of cases. It is said that the Paris hangman placed the slip-knot under the chin in front, which is as Dr. Haughton suggests.
Death may occur from secondary causes after apparent recovery; from congestion of brain and other lesions of the nervous system; these may prove fatal at remote periods.
Fracture of the odontoid process according to M. de Fosse is more common than dislocation, and the giving away of the intervertebral substance more likely than either of the others. The phrenic and other respiratory nerves are likely to be paralyzed; the vertebral and carotid arteries may be ruptured. The medulla oblongata is also likely to be fatally injured. Death may also occur from hemorrhage upon the cord, causing pressure.
Besides the ropes used as ligatures in judicial hanging, almost every conceivable article that could be made into the semblance of a cord has been used by suicides; usually, however, some portion of the bedding or clothing. When one resolves on suicide, all the precautions of the managers of prisons and asylums fail to prevent.
The secondary effects in those who recover involve the respiratory organs—dyspnœa, cough, bloody sputa, bronchial râles, and fever; or the nervous system—aphonia, dysphagia, numbness, chilliness, spasms, pains in neck, face, or shoulder; sometimes paralysis of bladder and rectum, and loss of memory. The marks on the neck slowly disappear.[818] Verse[819] collated a number of cases in which the hanging was not completed and the subjects lived for varying periods afterward. Wagner and Möbius[820] discuss the spasmodic seizures and amnesia, which often appear after the restoration from hanging.
Symptoms in Hanging.
Obviously these will be in some respects identical with those of strangulation. In considering the latter, some of the similarities and dissimilarities of symptoms and post-mortem appearances of strangulation and hanging were mentioned.
Death may be immediate and without symptoms.
There is, of course, no preliminary or “waiting” stage, as in strangulation, except in those rare cases of suicide where the subject inclines his body forward with his neck against the ligature, his body being near the floor or ground. The absence of a drop makes this condition very similar to ordinary strangulation. The body of a victim of homicide might be similarly placed for the purpose of deception, and also that of a subject previously made unconscious; in these cases the symptoms and appearances would resemble those of strangulation.