ing to tighten a cord by drawing it to the left while in a recumbent posture, whether prone or supine. This hypothe sis would, besides, leave wholly unexplained the flattening of the nose (obviously from direct pressure, not from a fall), and the fact that the deceased had bled in two places, one spot being a foot from the other. "3. The cord must have been pulled with excessive violence in a horizontal direction by one end only, as the mark was circular around the neck. The other end of the cord formed a noose or loop, and was tightly fixed at the back of the neck. Thus, then, all the force of traction must have been exerted to the left, in which direction the right hand of a right-handed person could not act horizontally, so as to produce the amount of violence found on the soft parts of the neck. "4. That the fact of there being three coils and a half of rope round the neck, formed an obstacle to the tightening of the cord, by pulling one end to the left so as to imbed the two inner coils in the skin, and to leave the outer, or third coil, loose. On the supposition that the deceased produced the constriction by her own act, it follows that the three coils must have been round the neck at one time, and the two inner coils sufficiently loose to allow of respiration before traction was commenced. "5. The double indentation found on the trachea could not have been produced by the two inner coils (on the supposition of suicide), except by the great tightening of the outer coil. "6. As insensibility and loss of power must have immediately followed the complete compression and obliteration of the trachea by the two inner coils, the outer coil ought not to have been found loose or unconnected with the object by which the force of the contraction had been produced. "To suppose that the deceased could have produced the intense constriction by the first coil, and afterwards retained sufficient power to pass a second coil from right to left around her neck, indenting the skin and flattening the trachea as much by the second as by the first coil, involves, in my judgment, a physiological impossibility. There was, therefore, on the suicidal hypothesis, no explanation to resort to but that all three had been placed at once round the neck loosely; that one end only of the cord had then been so pulled to the left as to produce the great amount of violence found, and to tighten equally the two inner coils; while the outer coil and extremity of the cord, by which this immense force must have been ap plied to the two inner coils, was found lying loosely, without any attachment either to the hand of the deceased or to any other fixed point. "7. To have indented the neck, compressed and bruised the trachea in two distinct places, to have caused effusion of blood to the amount of a cupful from mouth, nose, and ears-this effusion being found in two distinct places, a foot distant from each other-would have required a very considerable tension of the outer coil, and, at the same time, a continued tension, lasting sufficiently long for the head to move a foot after a cupful of blood had been lost as a mechanical result of the first constric tion. "8. Admitting such conditions of the body and cord to be compatible with suicide, the act could only be conceived to be possible in this case, by the fact of the end of the cord being found tightly wound round the left hand of the deceased. "9. On the suicidal hypothesis, it would undoubtedly have required a very firm grasp of a rope to produce such effects as were here observed; and from the rapid production of unconsciousness by the compression of the trachea and the arrest of respiration, it would have been impossible on the part of the deceased, to relax the grasp. Hence the cord should have been found, either firmly held in the hand in the rigidity of death, or wound round it in a state of tension. Unless we adopt this view, we must suppose that, after having used an enormous amount of violence by a rope in the left hand, the dead body had the power of relaxing the grasp, of loosening the outer coil of cord, and so moving the hand that the end of the cord should be found lying between the finger and thumb, and barely touching the palm. Such a condition is not only physiologically, but, in this case, as it will be presently shown from the length of the cord, physically impossible.” 10. (This refers to the absence of any marks of the cord upon the hands, such as would have been there, if forcible traction had been made by them.) "11. The length of the cord renders it impossible to suppose that such a force could have been exerted by the deceased herself. The length of the cord was 59 inches. The three coils and a strangulation may be simulated by persons who have an interest in pretending to be victims of violence.19 When this mode of violence has really been attempted without a fatal result, the signs of it are evident in the discoloration and swelling of the neck, along with a marked difficulty in swallowing, and often a very great alteration of the voice. An intelligent and respectable young woman, who desired to excite an interest in her behalf, gave out that she was the victim of political conspirators, whose secrets she had discovered. One evening she was found at the door of her chamber in a state of great excitement and, apparently, alarm. She did not speak, but at first made signs, and after a time wrote that she had been attacked by a man who attempted to strangle her with his hand, and at the same time stabbed her twice in the breast. These blows had only injured her clothing, and her corset was not pierced at the same place as her dress, and the alleged throttling had not altered the character of the voice, but suppressed it entirely! No external sign of violence could be found upon her, and ultimately she confessed her trick. whole length of the cord up to the last half coil, and left no portion whatever to give a purchase for pulling with so much violence. Either condition is a physical impossibility; and no theory will suit the facts, or explain them, excepting that which admits that the act was not the result of suicide, but of manual violence applied by another person.' half must have consumed at least 52 ceive that such violence to the neck inches leaving only 7 inches for could have been produced by the act of the traction. "This,' says Dr. Tay- the deceased; and if one coil had thus lor, 'was barely enough to reach the been spontaneously wound round the finger and thumb of the raised left hand, it would have consumed the hand, and not enough to allow of such a firm grasp by the hand as would be necessary to the production of so much violence to the soft parts of the neck. I find, by measurement, that the circumference of a small female hand in the adult is rather more than seven inches. This measurement includes only the palm of the hand without the thumb, and embraces the part of the hand around which a coil would be placed, when the object of a person was to produce firm traction. Hence, then, the hypothesis of suicide involves one of these physical conditions. Without a firm hold of the cord, which could not have been had with less than one coil round the hand, it is impossible to con "The evidence by which the crime was fixed upon the prisoner, Drory, it is not necessary here to relate. The chain of evidence was complete and irresisti ble, and, as has been stated in the text, the criminal made a confession previous to his execution." 19 See case of Roux, § 353a, supra. CHAPTER IX. HANGING. 354. Definition. 355. Cause of death. 356. Symptoms. 357. Post-mortem signs; external examination. 358. Examination of neck. 359. Internal appearances. 360. Deep tissues of the neck. 361. Associated lesions. 362. Ante-mortem versus post-mortem suspension. 363. Suicidal versus homicidal hanging. 364. Cases; accidental hanging. 364a. Homicidal hanging. 364b. Suicidal hanging. 354. Definition.- Hanging consists in the suspension of a person by a cord, or other means of constriction, around the neck. The weight of the body does the active pulling on the cord. Two general types of hanging may be considered: the one, where the person is elevated from his support, and the other, where the support is removed from under the person. In the execution of criminals in the United States and in England the support is removed from under the person, and the body drops, to be brought up suddenly by the rope. But the cases that come up for consideration before the courts are more frequently ones where the body has been pulled up, or where the fall has been so slight that there is an absence of the signs of sudden tension on the structures of the neck. 355. Cause of death.-The cause of death may be either suffocation, due to cutting off the supply of air to the air passages, or to disturbance of circulation in the brain, as in the cases of strangulation, where the compression of the vessels of the neck is the more important factor; or, in the cases where the drop is sufficient, the death may be due to destruction of the spinal cord by dislocation or fracture of the cervical vertebræ.1 This last method is the most In cases where the rope used for sult from the injuries accompanying the suspension breaks under the strain of fall. Here, however, death can scarcely the weight of the body, death may re- be said to be due to the hanging. prompt, and is the aim of the judicial hangman, but it is far less common in the cases of suicide.2 That death may be due simply to the interference with circulation, or, at least, be independent of any respiratory embarrassment, is shown by the case recited by Reineboth, where a man upon whom a tracheotomy had been performed committed suicide by hanging, and the rope was around the neck, above the level of the canula, which was in place at the time of the man's death. The post-mortem examination showed no signs of asphyxia, but engorgement of the vessels of the brain. 4 Hofmann considers compression of the great vessels of the neck one of the most important factors in the cause of death. He was unable to force liquids through the corotid arteries while the body was hanging. The jugular veins were also compressed, as the vagus nerves must have been. Hofmann also found the rope, in cases of suicide by hanging, to be almost invariably between the larynx and the hyoid bone, and therefore he states that death by hanging (also in some cases of suffocation), is due not to the compression of the larynx, but to an obstruction of the pharynx from a pushing back of the base of the tongue against the vertebral column. The larynx is flattened or pushed back, with its horns between the spine and the great vessels, which causes prominence of the thyroid cartilage. 356. Symptoms.-The symptoms of carotid compression, as given by Hofmann, are cyanosis of the face, dizziness, fainting, and unconsciousness; these are followed by spasmodic contractions of the muscles, an increase of blood pressure, and an increase in the frequency of the pulse. They come on promptly, with early unconsciousness. The rapidity of onset depends upon the location of the constricting noose. That in some cases, at least, unconsciousness comes on immediately, is shown by a case cited by Hofmann of a suicide who was found hanging with a revolver in his hand: he had not had time to shoot himself. And also by another case, cited by Tardieu, where a woman was found dead under a broken noose, with the marks of the cord and of fingers on her neck. In other cases it is evident that death does not occur for some time after loss of consciousness. Taylor cites a cases of a woman forty-four years See Hammond, N. Y. Med. Record, 1882, p. 426; and Calcins, Reports of the N. Y. Med. Leg. Soc., 1882, p. 254. Reineboth, Viertljrschr. f. ger. Med., 1895, IX., 265. See, also, the corroborating experiments of Ignatowski, Viertljrschr. f. ger. Med., 1893, VI., 250; and Haberda and 5 Reiner, ibid., 1894, VIII., suppl. 126. R Taylor, Glasgow Med. Journ., 1880, Vol. II., p. 387. of age, who was found hanging. When discovered she was comatose, there was froth at her mouth, her tongue was swollen and protruding, her face bloated, her lips cyanotic. The epidermis was abraded from the larynx, where the rope had been. Her conjunctivæ were insensible, the pupils of her eyes did not respond to the action of light, her plantar reflexes were gone, there was no respiratory movement, but there was a slight cardiac impulse. She eventually recovered. Just how long she had been hanging was not determined. One old instance records a recovery after being suspended for nineteen minutes. According to Glaister,10 five or six minutes after the act of suspension is usually the limit of time up to which resuscitation is possible. 357. Post-mortem signs; external examination. The post-mortem examination, except for the local conditions of the neck, is rarely characteristic. If death has been due in large part to asphyxia, the lividity and the facial expression may be that of suffocation in general; but more often the face is not congested nor the eyes prominent nor the tongue protruding beyond the teeth, though it may be forward in the mouth. The amount of infiltration of serum into the legs and lower portion of the body is dependent upon the length of time that the body has been hanging before it is found. Erection of the penis, with an emission of semen, cannot be considered characteristic of this mode of death, as it is found in other modes,11 and not at all constantly in this mode; and may even occur in postmortem suspension.12 Dr. Dyer made some very interesting observations13 on the condition of the eyes in a man executed for murder. An examination before death showed nothing unusual. The post-mortem examination, thirty-five minutes after the drop fell, showed the eyeballs not more prominent than before death, the lids closed and not discolored, 'Berlinische Sammlungen z. Beförderung der Arzeneywissensch. etc., Berlin, 1779, X., 242. 13 Orfila cites two cases of erection of the penis in the bodies of men that were hung, three and five hours, respectively, 10 Glaister, Med. Jurispr., 1902, p. 138. after death. (Bull. de l'Acad. Roy. de "Klein observed the penis in a state Méd., 1839.) On the other hand, Casof erection in a man who had commit- per says that he never saw erection of ted suicide by shooting; Schlegel ob- the penis in a man who had died from served freshly effused semen in a youth hanging, and in a very small proportion who had thrown himself from a church of the cases only a slight degree of tower and fallen upon his head; and a turgescence. In seventy-seven cases colcase of poisoning with Prussic acid is lected by Casper the seminal discharge related by Merzdorf, in which the penis was noted in nineteen. (Brit. and For. was found in a state of semierection, Med. Rev., Vol. V., p. 615.) with the spermatic fluid effused. Vide 13 Dyer, New York Med. Journ., Vol. Siebold, Handbuch der ger. Med., § 343. III., 1866, p. 416. |