XVII.—DEATH BY HANGING
In hanging, death occurs by asphyxia, as in drowning. Sensibility is soon lost, and death takes place in four or five minutes. The eyes in some cases are brilliant and staring, tongue swollen and livid, blood or bloody froth is found about the mouth and nostrils, and the hands are clenched. In other cases the countenance is placid, with an almost entire absence of the signs just given. The mark on the neck, which may be more or less interrupted by the beard, shows the course of the cord, which in hanging is obliquely round the neck following the line of the jaw, but straight round in strangulation. In judicial hanging, death is not due to asphyxiation, but, owing to the long drop, the cervical vertebræ are dislocated, and the spinal cord injured so high up that almost instant death takes place. On dissection the muscles and ligaments of the windpipe may be found stretched, bruised, or torn, and the inner coats of the carotid arteries are sometimes found divided. In ordinary suicidal hanging there may be entire absence of injury to the soft parts about the neck, the length of the drop modifying these appearances. The mark of the cord is not a sign of hanging, is a purely cadaveric phenomenon, and may be produced some hours after death.
XVIII.—DEATH BY STRANGULATION
This differs from hanging in that the body is not suspended. It may be effected by a ligature round the neck, or by direct pressure on the windpipe with the hand, in which case death is said to be caused by throttling. Strangulation is frequently suicidal, but may be accidental. When homicidal, much injury is done to the neck, owing to the force with which the ligature is drawn. In throttling, the marks of the finger-nails are found on the neck.
XIX.—DEATH BY DROWNING
Death by drowning occurs when breathing is arrested by watery or semi-fluid substances—blood, urine, etc. The fluid acts mechanically by entering the air-cells of the lung and preventing the due oxidation of the blood. The post-mortem appearances include those usually present in death by asphyxia, together with the following, peculiar to death by drowning: Excoriations of the fingers, with sand or mud under the nails; fragments of plants grasped in the hand; water in the stomach (this is a vital act, and shows that the person fell into the water alive); fine froth at the mouth and nostrils; cutis anserina; retraction of penis and scrotum. On post-mortem examination, the lungs are found to be increased in size ('ballooned'); on section, froth, water mud, sand, in air-tubes. The presence of this fine (often blood-stained) froth is the most characteristic sign of drowning. Froth like that of soap-suds in the trachea is an indication of a vital act, and must not be mistaken for the tenacious mucus of bronchitis. The presence of vomited matters in the trachea and bronchi is a valuable sign of drowning. The blood collects in the venous system, and is dark and fluid. Tardieu's spots are not so frequently met with in cases of drowning as in other forms of asphyxia. The other signs of death by asphyxia are present. Wounds may be present on the body, due to falling on stakes, injuries from passing vessels, etc.
The methods of performing artificial respiration in the case of the apparently drowned are the following (the best and most easily performed is Schäfer's prone pressure method):