2. That severe pressure applied from before backwards, so as strongly to compress the larynx against the vertebral column, or violent blows inflicted over the larynx by means of a heavy body, are sufficient to cause fractures of the larynx. Fractures so produced, however, will be most discernible on the internal surface, and generally in or near the mesial line.

3. Violent compression applied to the sides of the larynx (as in ordinary manual throttling or strangulation by grasping), is, of all applied forces, the most likely to produce fractures of the alæ of the thyroid cartilage, or even of the cricoid cartilage, and fractures so produced are most perceptible, as well as most extensive, on the external surface of the larynx. By this lateral mode of applying force, the hyoid bone is almost most readily broken.

4. That the condition of the larynx in regard to the absence or presence of ossific deposit materially influences its liability to fracture from external violence. If altogether cartilaginous, partial slits or splittings may be produced. If partly ossified, fractures may be produced by a comparatively moderate degree of applied violence, and if extensively or entirely ossified, extreme violence will generally be required to produce laryngeal fracture (Edinburgh Medical Journal, 1855-56).

Homicidal suffocation may be due to forcibly introducing foreign bodies into the air-passages, especially in children; adults suffocated thus are generally under the influence of alcohol or drugs, or enfeebled from disease. Suicidal suffocation by these means is generally limited to lunatics.

Fig. 16.—The pulse in this case became slower than normal. Five minutes after the drop the type reached that of bradycardia, then recovered itself, and even 14½ minutes after the drop was beating with normal frequency, but in the meantime had become very feeble.

Fig. 17.—The pulse in this case became accelerated and then fell again, but was feeble throughout.