too, will depend upon the material of which the cord is made,-the smooth surface of one leaving much less excoriation on the skin than the rough surface of another. If the cord is placed several times around the neck the mark may show the number of grooves and ridges, corresponding to the number of turns, and in between the grooves there may be a line of blisters, filled with serum or blood, where the skin was pinched between the several coils as the cord was tightened. Casper, however, describes a case of suicidal strangulation in which the ligature consisted of packthread wound three times around the neck, and tied fast over the larynx. The mark was but slightly depressed, and consisted of only a single line, broad and white, with here and there a tinge of blue.

The color of these marks of the cord may be either dusky red or purplish, or may show without any discoloration; or, as in the cases of hanging, though less often, the epidermis may be denuded, and the skin, after drying, show a parchment-like stiffening and color.5

349. General internal appearances.-The general internal examination may show the signs of asphyxia if the death has been associated with suffocation; but more often the lungs and other viscera are not congested, the right side of the heart is empty, and the taches de Tardieu are more often absent. The lungs more often show, especially in infants, many small areas of intervesicular emphysema, and apoplectic nodes in place of the sharply circumscribed small ecchymoses of suffocation. The brain is usually congested, and there may be ecchymotic spots; but an actual extravasation of blood on the surface of the brain is very rare if it ever appears as a direct result of the strangulation. This fact is of considerable importance in many cases, since in death by apoplexy the turgor and discoloration of the face may occasionally lead to a suspicion of homicidal strangulation, especially if any questionable traces of constriction be found on the neck.

350. Deep tissues of the neck.-The most important internal lesions are in deep tissues of the neck. Tardieu considered the superficial and the deeper hemorrhages in the neck as more common in strangulation than in hanging, and very significant. There are ef fusions of blood between the muscles, around and into the larynx and the trachea, and in the sheath of the great vessels of the neck. So,

Casper, Ger. Leichenöffn., 2tes Hund., tion of the collar or some band. These Fall 59, 1854. are, as a rule, easily identified by their Lines around the neck of a corpse, character and location, and the finding especially where the body is water of the constricting band in place when soaked or bloated, are not infrequently the body is discovered. found, due to the post-mortem constric

too, fractures of the larynx, trachea, and hyoid bone are more common even than in hanging. The interior of the larynx is often congested or violet in color, and the trachea may contain blood-stained, frothy mucus. Rupture of the intima of the carotids is rare. The condition of the more deeply seated organs of the neck cannot at all be inferred from the state of the skin which covers them. Tardieu. has shown that even when no external bruise exists, effusions of blood may be discovered beneath the skin, among the more deeply seated muscles, and even upon the larynx and the trachea; or, if the hand has been used to effect the compression, the effusion may extend to the upper part of the neck and chest.

Where the body has lain a considerable time in the ground, and is advanced in putrefaction, the marks of strangulation, if this has been forcible, will occasionally be recognized. An instructive case is upon record, in which, after a lapse of thirty-eight days from the interment, a corpse was, by order of the authorities, disinterred. The body was already greatly decomposed, but the evidence of strangulation was obtained chiefly from the fact of the striking contrast of the integuments of the neck with those of the rest of the body. There was observed a white and shriveled space over the larynx, half an inch in breadth, and extending back on each side of the sterno-cleidomastoid muscles, from which, also, to the nape of the neck over the second vertebra, there ran a groove of a blackish-brown color, and parchment-like appearance. It was very difficult to cut through this condensed skin, which, upon incision, gave the sensation of old, dry leather, and its section was yellowish-white, and perfectly dry. Another remarkable case occurred in Paris, where, after the body of a female had lain several years in the ground, and was reduced to an almost perfect skeleton, an examination made by MM. Boys de Loury, Orfila, and other medical jurists, proved that the woman had perished by strangulation. The third, fourth, fifth, and sixth cervical vertebræ, as well as the right clavicle, were held together by a blackish mass, in the composition of which there could not be recognized any tissue. This mass was surrounded at its lower point by several twists of a cord, two lines in diameter; the cord was in a very decayed condition, and no knot could be found upon it; its direction was exactly horizontal.

351. Diagnosis. The distinction of the signs of apoplexy from those of strangulation consists essentially in this: that in the former none of the derangements which have been described of the parts beneath the skin can be detected.

The proofs of strangulation are also different from those of hanging. This distinction is important chiefly when a dead body is found suspended; for it must be remembered that this position generally denotes suicide, while strangulation ordinarily indicates death by homicidal violence. The cases most apt to be confounded are those in which strangulation has been effected by a cord or similar constricting band. The obliquity of the mark has been generally insisted upon as proving death by suspension. But, when the whole weight of the body has not exercised its traction, this sign may fail, and, on the other hand, the complete circular mark is often wanting, even where strangling has been the cause of death. In the latter case, also, the constricting band or cord leaves a comparatively slight impression, while in the former a deep furrow is produced. But in strangulation the injuries to the soft parts beneath the skin are very marked, while in hanging they are comparatively slight, as a general rule. The discharge of feces, urine, and semen, which has been regarded as peculiarly the effect of death by hanging, may result from almost any form of violent death, and occurs in many forms of natural death when the bodily vigor is not greatly impaired.

The signs of death by strangulation differ from those of death by suffocation, in this: that the skin markings in the latter are observed about the nostrils and the mouth, and not upon the neck; but in many cases the evidence of both forms of violence will be found combined.

352. Ante-mortem versus post-mortem strangulation.-The question as to whether the strangulation was produced before or after death is not one that would be likely to come up. The object of any one, in applying a ligature around the neck after death, would be, of course, to convey the idea that the person had committed suicide. As, however, this mode for self-destruction is extremely uncommon, and usually attended with circumstances which betray it, the presumption, in the case of a person found strangled, is that the deed was committed by another. Hence, the probability of suicide, which obtains in hanging, from the frequency with which this mode of selfdestruction is chosen, is, in cases of strangulation, not to be entertained, unless direct or circumstantial evidence supports it. Moreover, the cases in which it may be possible to admit the suspicion of suicide are not those in which any doubt can be entertained, because, if the cord has been placed upon the neck merely for the purpose of concealing the fact of murder, the means by which life really has been taken will not fail to be revealed. Thus, marks of fatal violence will be found upon some part of the body, or traces of poison in the stom

ach. Yet, if any doubt should still remain of the truth of these considerations, it also remains that the signs of death by strangulation cannot be closely imitated after death. We have seen above, that, when death has resulted from this cause, not only will the marks of the fingers or of the constricting band be found of various depths and of different degrees of discoloration, but also that the aspect of the countenance, taken in connection therewith, as well as the internal signs of death by asphyxia, will indicate the mode of death. Although the experiments made upon dead bodies by Dr. Casper show that if the attempt to imitate the mark of strangulation were made six hours after death, it would be unsuccessful, yet, as the attempt would most probably be made immediately after death, and even before life was quite extinct, it is evident that any satisfactory conclusion can be drawn only from an examination of the mark, in connection with the other signs of asphyxia. These cannot be produced after death, and we may, therefore, be certain where we find a mark indicating strangulation, and, at the same time, the face purple and congested, the tongue protruded, the eyes prominent, and the other indications of death by asphyxia, that the individual has been strangled during life.

353. Cases; accidental strangulation.- The majority of instances of strangulation are homicidal; a few cases of accidental origin are on record; and suicide by this method is very rare.

Dr. Taylor relates that a girl was accidentally strangled in the following way: "She was employed in carrying fish in a basket at her back, supported by a leathern strap passing round the forepart of her neck, above her shoulders in front. She was found dead, sitting on a stone wall; the basket had slipped off, probably, while she was resting, and had thus raised the strap, which firmly compressed the trachea. A similar case is reported by Watson (Homicide)." Should the body not have been removed from the position it occupied at the time of death, and if the evidence of veracious and disinterested witnesses relative to this fact can be obtained, there will seldom be any hesitation in admitting the possibility of the accident.

The allegation may, however, be made for the purpose of concealing crime. A person who, in a state of helplessness from intoxication or other cause, has fallen into a position in which his throat becomes compressed by a tight cravat, may possibly thus die accidentally of strangulation. But if marks of constriction be found upon the neck, it is much more probable that they were caused by criminal violence than that they were due to accident. As in courts of law un

due stress, medically speaking, may be laid upon the possibility of strangulation marks being accidentally produced, the medical witness will do well to compare closely the impressions upon the neck with the ligature supposed to have produced it, as in many cases an important and conclusive discrepancy will be found.

353a. Suicidal strangulation.- Were there not a sufficient number of well-attested cases of suicide by strangulation upon record, it might fairly be doubted whether it would be possible for persons voluntarily to destroy themselves in this manner. But the annals of legal medicine abound with examples of the most determined tenacity of purpose, and the most singular choice of modes of death upon the part of suicides. Without dwelling upon this fact, it may be stated that in this mode of death an infirmity of purpose is less likely than in many others to frustrate the intentions of the suicide. Unconsciousness steals in such an insidious but rapid manner over the senses, that the will and power to escape are speedily lost.

The ligature used by those who thus destroy themselves is generally chosen from those articles of dress which lie nearest at hand; as cravats, garters, and the like. The knot will most probably be found in front, or a little to the side, and the mark left will convey the idea of less violence than will that made in homicidal cases, where no other injury has been inflicted. The question often arises, says Casper, whether the mark upon the neck has been caused by a certain instrument which is supposed to have been used. This question it is not always easy to answer. It is true that hard, rough substances, cords, etc., usually produce excoriations, which is seldom the case with softer ones. It is also true, as a general rule, that the breadth or diameter of the mark upon the neck corresponds to that of the instrument used. But many exceptions occur to these rules. The instrument may be of a soft texture, and yet have rough edges; it may be twisted, and the sides press against the neck, etc.

Some light may often be thrown upon cases of murder or suicide by hanging, by observing what kind of a knot is tied in the ligature, as it is known that different classes of tradesmen are in the habit of tying knots in a way peculiar to themselves.

Complicated knots and more than one coil of rope around the neck, suggest suicide. Arrangements which allow of slackening of the rope, so relieving the constriction after the victim loses consciousness, exclude suicide.

A remarkable instance, showing the rapidity and ease with which self-strangulation may be effected, is the following: A gentleman was