Taylor says that “that which is difficult to a conscientious medical jurist in confining himself to the medical facts is often easily decided by a jury from these as well as the general evidence afforded to them.”
The limbs may be secured by the suicide before hanging himself. Persons even with some disability of the hand have suicided by hanging. Blindness is no obstacle, nor age; a boy as young as nine and a man as old as ninety-seven.
Burger[877] fully discusses the question whether the hanging is before or after death.
Hanging—Suicidal, Homicidal, or Accidental?
Hanging is usually suicidal. Lesser[878] states that for three years, 1876-79, there were admitted to the Berlin morgue 274 bodies of “hanged,” of which 272 were suicidal; 2 infants of three and eighteen months, homicidal. One man had first tried to kill himself with sulphate of copper; another by cutting his throat; a woman by cutting her arm. The other cases were uncomplicated. Pellier states that the number of suicides in France from 1876-1880 was 13,445, and nearly all were by hanging. Taylor[879] states that 2,570 persons committed suicide by hanging in England in five years, 1863-67; four-fifths of these were males. Harvey[880] reports for three years 1,412 cases of hanging in India, of which 2 were accidental, in 3 there was presumption of homicide, the rest probably all suicidal.
Feebleness of body does not preclude subjects taking their lives in this way. They sometimes also wound or poison themselves first and hang themselves afterward. A subject being found suspended in a room fastened on the inside, would be suggestive of suicide. The absence of signs of struggling or of any marks of injury also favors the idea of suicide.
The possibility of a suicide breaking a rope, being injured by the fall, and rehanging himself successfully, must be admitted (Cases 57, 58). The possibility of blood flowing after death must not be forgotten.
It is worthy of note that after beating or other violence children and women may commit suicide from shame. Again, as Tardieu says, many have hung themselves while partially intoxicated, and it is likely that some such have just previous to the suicide met with falls or other accidents which have left marks like those of violence. He also records the case of a woman who fastened a cord to a bed-post, put her head in a noose while kneeling on the bed, and made a deep wound in her arm with a razor. She closed the razor, laid it aside, and fainted from loss of blood. She must then have fallen forward and died from the pressure of the cord on her neck.[881]
Homicidal hanging is rare but does occur. Where the hands are tied together; where the injuries produced by the cord are severe; where there are contusions and well-marked ecchymoses; where the laryngeal cartilages and hyoid bone are fractured or the cervical vertebræ dislocated or fractured; or where the carotids are injured or there is hemorrhage into their walls; where there are severe wounds, the hemorrhage from which would be sufficient to threaten syncope; where there are many marks of violence on the body; where there is evidence of a severe struggle—in all these cases murder may be reasonably suspected. The number, situation, extent, and direction of must be carefully noted and weighed. If these are out of proportion to the ligature, the suspension, etc., they strongly suggest homicide, although they may occur in suicide (see Cases 4, 11, 18, 20, 28, 29, 44, 52, 55, 59, 66).
Homicidal hanging may be committed by an assailant who is strong on a subject who is weak, on a child, a woman, an old person; on one stupefied by liquor or narcotic poison; or by many combined against one person.