The mucous membrane of the cheeks may be found lacerated. Where the victim is thrown to the ground and knelt upon, fracture of the ribs and ecchymosis of the chest wall may occur.
In a case examined by me of combined strangling and throttling, marks of the ligature and fingers were both present, and on the clavicles separate marks produced by the knuckles while tying the cord. These knuckle marks did not show up till some time after death. Effusions of blood were present in the tissues of the neck on each side of the larynx, and amongst the muscles on both sides, and in the sheath of the left carotid artery.
The hyoid bone was fractured in two places in its left half. The thyroid cartilage was fractured vertically on each side of the middle line into three pieces, the central portion having fallen behind the other two into the cavity of the larynx. The right wing of the thyroid was comminuted. The cornua were fractured. The cricoid cartilage was also fractured posteriorly, and into three pieces in front. Effusions of blood in the fractured areas had formed beneath the mucous membrane. Effusion of blood was present on the front wall of the pharynx and the upper part of the œsophagus. The right carotid artery was atheromatous, and linear and star-shaped fissures were present, the latter surrounded by a ring of sub-intimal effusion of blood.
On the right side of the thorax the fifth rib was fractured at the junction with its cartilage, and on the left side the second, third, fourth, fifth, and sixth ribs were fractured close to their cartilages, and again from three to five inches further back. Blood effusions in the tissues of the chest wall and under the pleuræ were present in the region of the fractures.
A handkerchief was found tight on the neck and tied with two knots both fastened securely. It was probable that the handkerchief had been tied on after the throttling, as the knot ends were too short to allow a sufficient pull on them to cause the injuries. Throttling may be regarded as a homicidal act; although one or two instances of suicidal throttling have been recorded in the insane.
Judicial Hanging.—In judicial hanging the prisoner is suspended by a rope with a running noose around the neck, after a sudden drop of from six to eight feet according to the weight of the body. The noose may be arranged with the knot or slip-ring fixed at the side below the ear, or in front so as to jerk the head backwards. The sudden and severe strain upon the neck produces fracture or dislocation of the spinal column at the second or third cervical vertebra, with rupture of the spinal cord. Other local injuries occur, such as rupture of cervical muscles, fracture of the larynx, and even lacerated wounds of the neck. The head has even been severed completely from the body, and the deep structures of the neck have even been so lacerated that the body has hung by skin only, stretched to the thickness of two or three fingers. Death is said to take place from shock, pressure on the vagi, and asphyxia, probably also cerebral apoplexy. When death is instantaneous, the body hangs motionless, the head fallen over the side opposite the knot, and the neck stretched.
The heart may, however, continue to beat for a varying period after apparent death—in some cases even as long as 14½ minutes. The following interesting series of pulse tracings were taken by Dr. Llewellyn Morgan, of Liverpool, and kindly placed at my disposal. In No. 1 the heart beats could be recorded at the wrist for 14½ minutes after the drop; in No. 2 for 12½ minutes; and in No. 3 for 12 minutes. The frequency and character of the beat is variable, but in each case shows a practically normal rate towards the end. (See [Figs. 16], [17], [18].)
Apart from the local injuries to the neck, the external appearances in judicial hanging are similar to those in other forms.