Hofmann[837] had seen two cases of tumor of neck; one in a woman, where the cord was below the larynx; and in a man where it was over the larynx. He quotes[838] as follows: Remer, above larynx, 38; over larynx, 7; below larynx, 2. Devergie, above larynx, 20; over larynx, 7; below larynx, 1. Casper, above larynx, 59; over larynx, 9. Roth[839] in 49 cases found the ligature mark above the hyoid bone in 5; between the bone and the larynx, 31; over the larynx, 8; below the larynx, 1. Hackel found the ligature in forty per cent of cases between hyoid bone and larynx; in sixty per cent lower down. The ligature always appears lower after the body is laid down than it was in suspension. Maschka found the furrow 147 times in 153 cases above the larynx.
The mark will vary in character according to the kind of ligature used, its mode of application, the vitality of the tissues, and the period that has elapsed since death. The result is different according as the knot or loop is single or double, a running or slip knot.
The mark may differ in character in one part of the neck from another. The same furrow may be soft in one part and dry in another. The width of the mark does not necessarily correspond to the diameter of the ligature. A double mark usually means that the ligature has been twice passed around the neck, although the marks may not be continuous or parallel. Tardieu states that a large single leather thong pressing on the neck only by its borders may make a double mark. The mark is usually depressed. The depth of the depression, groove, or furrow, as it is called, is greater the narrower and firmer the ligature, the longer the suspension, and the greater the weight of the body. The mark may be merely a slight depression, without color, or only a red blush, if the subject is young, tissues healthy, and suspension brief. Roth,[840] in 49 cases of hanging, found the furrow of the ligature was brown in 40, red-brown in 6, and 3 times bluish.
In about two-thirds of the cases the bottom of the furrow, the place of greatest pressure, is white, especially so where the knot is tied; while the edges of the furrow are usually slightly raised and red or livid. If the subject is very fat, there may be only a slight depression. Harvey[841] says that this hard, white, shining, translucent band from compression of the connective tissue is the first stage of the parchment or vellum skin, and is chiefly noticed in fresh bodies. The borders are swollen and œdematous, called by Lacassagne “bourrelet de sillon.”
The skin beyond the furrow is usually violet. Authors differ as to whether this is due to congestion or hemorrhage. Roth[842] in 49 cases found swelling below the furrow 27 times. Hackel found ecchymoses above the mark in thirty-five per cent of the cases of hanging. Hofmann thinks that the lividity of the upper border of the furrow is due to the stopping of the venous blood descending from the head.
The dry, hard, yellowish-brown, or reddish-brown “parchment” furrow, described by writers, is said to be common. Ogston[843] found it in one-third of his cases. It is found only when the body has remained suspended for several hours after death; indeed, may be produced by applying the ligature to the cadaver; is not at all, therefore, a proof of suspension during life. Liman states that constriction by a ligature even for some time does not necessarily cause a mummified or excoriated furrow. He saw cases in which the mark was soft, flat, scarcely colored, but little interrupted, and not parchmenty. The parchment skin seems to depend very much upon a previous excoriation of the skin. Its appearance can be prevented or delayed by examining a body soon after death or by rehanging it; and after it has appeared it will disappear on the application of some liquid. Taylor[844] compares this parchment mark to the cutis from which the cuticle has been removed for two or three days.
Slight abrasions and ecchymoses are sometimes found in the furrow. Ecchymoses alone do not indicate whether suspension has been before or after death; but abrasions with hemorrhage strongly suggest suspension during life. Devergie regards ecchymoses of the neck as strongly suggestive of homicide. Neyding[845] says that suggillation in the groove is oftener found in strangulation than hanging. And Bremme[846] that there is no hemorrhage in the subcutaneous tissue of the mark if death occurs at once and the cord is removed at once after death; but if the cord remains for some time after death there may be hemorrhage, or if death does not occur at once, whether the ligature be removed or not.
Roth[847] found ecchymoses or small bladders at the lower margin of the furrow, 9 times in 49 cases. Riechke found only once in 30 cases a hemorrhage beneath and on both sides of the mark. Chevers did not find ecchymoses of the skin of the mark in cases of hanging. Casper found no ecchymoses in 50 of 71 cases. Maschka has seen two cases where burns on the neck resembled mark of ligature.
The furrow, when once distinct, remains constant for a long time after death, even in putrefaction. Marks from soft substances, however, disappear sooner than those from strong and uniform compression.
The NECK nearly always appears stretched. According to Roth the mobility of the head is increased by this stretching. The HEAD is always inclined to the opposite side to that of the knot. In suicides the head is usually bent forward on the chest. The HANDS are often clinched so tightly that the nails are driven into the palms. This occurs more especially when the hanging has been done with violence. When the feet touch the ground, as often occurs in suicide, the hands may be stretched out. Roth found the hands and feet flexed in 44 of 49 cases. Taylor says that we may expect to find the hands clinched when constriction of the neck is sudden and violent. The LEGS are usually livid.