The following cases illustrate what may be done to resuscitate one who has been hanged: A man, age 35, in good health, weight one hundred and sixty pounds, was executed with a drop of over six feet; the rope slipped behind the mastoid process. After three minutes his struggles ceased; the radial beat ceased at six and one-half minutes; all signs of life at ten and one-half minutes, and the body was blue. Fourteen and one-half minutes, body let down; mark about one-fourth inch deep on neck; swelling above and below; no fracture of vertebræ. Strong galvanism of the pneumogastrics after sixteen or seventeen minutes at intervals of four seconds caused marked respiratory efforts; sixty-six minutes, galvanism renewed; heart-beat and radial pulse recognized; epiglottis swollen, requiring the tongue to be drawn forward; a few ounces of blood removed; pupils contracted. One hundred and four minutes, galvanism renewed; subject swallowed a little brandy-and-water. One hundred and thirteen minutes, slight muscular action; cornea sensible. One hundred and eighty-six minutes, feet warm, carotid pulsation. Signs of life now increased till six hours after drop, when pupils began to dilate again. Twelve to fifteen ounces of blood were taken and pupils again contracted and pulse beat strong and steady; breathing easy, more regular; eyes followed movements of persons around the room. Died nine hours later, fifteen hours after drop. The experiments were repeatedly interrupted by the sheriff.[830] Taylor[831] reports a case of recovery. Woman, age 44; found hanging from a clothes-line, thrown over a door and fastened to a handle on the other side; her knees on the floor; white froth around the mouth; tongue protruding and swollen; face dusky and swollen; lips dark blue; brown parchment mark on neck; skin abraded over larynx; conjunctiva insensible; pupils dilated and fixed; fingers clinched; limbs flaccid; no reaction from tickling feet; no respiration; faint heart-beat and fine thready pulse. Sylvester’s artificial respiration method used at once and continued for four and one-half hours; tongue held forward by forceps. One hundred and fifteen minutes after body was first seen there was spontaneous movement of legs. One hundred and forty-five minutes, conjunctivæ sensible. One hundred and seventy-five minutes, retching. Two hundred and five minutes, free vomiting. She recovered but remembered nothing of the hanging. Keen[832] reports the results of experiments upon a criminal who was executed by hanging. He was cut down about half an hour after the drop. Faradization and galvanization of pneumogastric and recurrent laryngeal nerves caused movements of left vocal cord, but not the right; there was no reflex motion in the larynx. The left phrenic nerve made no response to stimulus. The internal intercostal nerves caused the raising of the cartilage below them (inspiratory), the external intercostals depressed the upper seven ribs (expiratory), and raised the eighth. The other four not examined. The muscles of the face retained their contractility.
Very few, comparatively, however, have been restored after hanging. For cases of recovery see Medical Times and Gazette, London, 1871, Vol. I., p. 669 (Cases 12, 13, 42, 44, 47, 49, 66).
Post-Mortem Appearances.
The post-mortem appearances are external and internal.
The external appearances are those due to the action of the ligature on the neck and to other violence, if any has been done, and those due to asphyxia or syncope.
The MARKS of the ligature. If the suspension be very brief and the ligature soft and supple, and the body instantly cut down after death, there may be no mark. Allison[833] questions the value of the mark, contending that it is post mortem, and reports cases; says it is present only if the drop be considerable or the suspension continue after death. Tidy says that the mark is, in a measure, independent of the ligature and duration of suspension, and does not usually acquire its color for some hours after death; sometimes, however, it has occurred in a much shorter time. It may be slight because the ligature has been placed over the clothing. The longer a body hangs after death, the more the mark shows. It can be produced upon the cadaver.
Harvey[834] says: “The characteristic mark is sometimes found in non-fatal cases.... In eight instances in the present returns (of nearly 1,500 cases of hanging) there was a distinct mark.”
Coutagne,[835] in twenty-four necroscopies on subjects hung, found only slight or doubtful lesions in five cases; but of these, one was in a condition of advanced putrefaction, another was apparently weakened by loss of blood from wounds, and in the other three there were marks of violence. In seventeen cases the lesions of the neck were plain; hemorrhage in connective tissue or muscle.
The direction of the mark is usually oblique, following the line of the lower jaw upward and backward behind the mastoid processes; it may, however, be horizontal. If the ligature encircles the neck more than once, one mark may be circular, the other oblique. If a running noose is used the mark may be circular, and be seen all the way around the neck, looking like the mark of a strangulation. Taylor[836] states that if the noose should be in front, the mark may be circular, the jaw preventing the ligature from rising upward in front as much as it does behind. If it encircles the neck but once, its continuity is apt to be broken by the prominence of the hyoid bone, thyroid cartilage, sterno-mastoid muscles, etc.
In four-fifths of the cases (117 out of 143, Tardieu) the mark is found between the chin and larynx; in nearly all the remaining fifth, over the larynx; in a very few below the larynx; the last position is due to the protection of the neck by a handkerchief or beard, or where there is some anatomical or pathological peculiarity which prevents the ligature from going higher.