23475424 violent asphyxial deaths
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Violent asphyxialViolent asphyxial
deathsdeathsDefinition: In violent
asphyxial deaths, the process ofrespiration i.e., the exchange of
air between the atmosphere andthe lungs beds is prevented bysome violent mechanical means.
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Types of violent asphyxiaTypes of violent asphyxia
1. Hanging
2. Strangulations3. Drowning
4. Suffocations
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HangingHanging
Definition :
Hanging is a process in which the body issuspended with a ligature around the neck
which causes constriction of the airpassage preventing exchange of airbetween the atmosphere and the alveoliof lungs, leading to asphyxia and death.
The constricting force is either the weightof the whole body or the weight of thehead alone.
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Types of hangingTypes of hanging((on the basis ofon the basis ofthe position of the knot used)the position of the knot used)
1. Typical hanging. In a typicalhanging, the knot of the ligature
should be at the nape of the neck
on the back. Typical hanging is notvery common in occurrence.
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2. Atypical hanging. In atypical
hanging, the knot of the ligaturemay be at any site other than the
nape of the neck. It may be near
one angle of the mandible, near themastoid, or below the chin.
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Hence in case of typical hanging,
maximum pressure is exerted in the
front of the neck, on the midline, i.e.,over the wind pipe. The pressure over
the jugular veins and the carotid
arteries are comparatively less butequal on both sides.
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In atypical hanging, the
commonest site for the knot is nearone side mastoid process or near
the angle of mandible.
Occasionally, it may be below the
chin.
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When a knot is on one side, the pressure
over the vessels on both side is not equal
and it also takes more time for total
occlusion of the wind pipe. When the knot
is blow the chin, there may not be much
evidence of asphyxiation as the respiratorytract is not directly compressed.
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Types of hangingTypes of hanging (according to(according to
the degree of suspension)the degree of suspension)
1. Complete hanging. In this
variety, the body is fully suspended
and no part of the body touches the
ground. The constricting force hereis the weight of the whole body.
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2
. Incomplete or partial hanging. In
this variety the lower part of the body
is in touch with the ground. Sometimes
only the toes, sometimes the whole
foot or feet, sometimes the
knees(hanging in kneeling position),
sometimes the buttock(hanging in
sitting position),may be in touch with
the ground.
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Partial hanging is taken
to be diagnostic of beingsuicidal in nature.
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The ligature materials in casesThe ligature materials in cases
of hangingof hangingThe ligature material may be anything
which may be tied around the neckwith some additional length for fixing
it to the point of suspension. It can be
a rope, electric wire, belt, neck tie,
bedsheet, scarf, cycle chain or any such
thing.
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The knotThe knotThe knot may be a fixed
one(double or more), or itmay be a slipping knot or a
running noose.
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Precise causes of deathPrecise causes of death
due to hangingdue to hangingThough a form of violent
asphyxia, not in all cases ofhanging death occurs due toasphyxia. Any of the
followings may be the actualcause of death.
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1. Asphyxia along with apoplexy
due to simultaneous pressure over
larynx and jugular veins. Thecombined effect of asphyxia and
apoplexy is the cause of death in
most cases.
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2. Asphyxia alone.
3. Apoplexy alone.
4. Cerebral anaemia or
ischaemia due to pressure over
carotid and vertebral arteries.
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5. Vagal shock. This may
occur due to inhibition ofthe heart due to irritation
of the carotid sinus.
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6. Fracture dislocation of the
second and third cervicalvertebrae, which causes injury
to the medulla and the upper
part of the spinal cord, as in
case of judicial hanging.
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Postmortem
appearance of hanging
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A.External findings
A.External findings
1. The ligature mark.
In most cases of death due tohanging, the ligature mark
around the neck is very muchconspicuous.
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The ligature mark in case of
hanging is oblique, non-continuous, placed high up
around the neck, grooved,
parchmentised and abraded at
places.
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The ligature mark is non-
continuous because of a gap atthe nape of neck due to hairintervening between the ligature
material and the skinunderneath. There may also besome gap near the site of the
knot due to the pull on the knotfrom the point of suspensionabove
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The upper margin of the ligature
mark has a line of postmortemstaining, all around above the
ligature mark. This is due tosettling of blood, from head and
neck above the level of
constriction, caused by the
ligature material.
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When the knot is in contact
with the skin, it is usuallyinverted V shaped, due toextension of ligature materialdownward on both sides fromthe knot above. The point of
contact of the skin with the knotmay leave a deep parchmentisedabraded impression.
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Factor which influence theFactor which influence the
appearance of the ligatureappearance of the ligaturemarkmark
A. The ligature material.
B. Period of suspension.
C. Degree of suspension.
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D. If something, say, the collar of
the shirt intervenes between theligature material and the skin of the
neck then the ligature mark will
not be prominent.
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E. The weight of the body of
the deceased.F. Tightness of the ligature.
G. Slipping of the ligaturematerial.
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H. When the ligature is
applied in multiple turns,then there will be
multiple,parallel, groovedligature marks.
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I. Design of a ligature
material, e.g. of a rope ora cord may get imprinted
on the ligature mark.
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J. The ligature material may
be in situ around the neck ormay be sent along with the
dead body or may be absentaltogether.
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2.The dimensions of the neck
2.The dimensions of the neck
Due to prolonged suspension, the
neck becomes slender andincreases in length. This will not be
seen in suspension for a short
period.
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3.Bending of the neck
3.Bending of the neck
The neck gets flexed to the side,
opposite the side of the knot. Thestate of bending will continue until
the onset of decomposition.
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4. The face may be pale
or flushed or congested.
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5. Tardieus spots may be
present on the forehead, overthe eyelids, under the
conjunctiva and sometimesnear the temple.
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6. Tongue may be partly
protruded out in between thelips and during the stage of
rigor mortis may also be bitten
in between the jaws.
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7.7. Dribbling of salivaDribbling of saliva..
Dribbling of saliva is a
very constant andimportant finding in a
case of death due tohanging.
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Dribbling of saliva occurs from the
angle of the mouth which is at alower level i.e., from the angle
opposite the side of the knot. When
the knot is on the nape of the neck
it occurs across the middle of the
lower lip. When the knot is underthe chin, then it occurs through
either or both angles of the mouth.
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The saliva drops down in
front of the chest when thebody is bare or it stains theclothes in front, when thedeceased is dressed. Whendried or partly dried, it
becomes quite fixed andcannot be easily removedor rubbed out.
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Dribbling of the saliva is considered
a very important phenomenon insupport of death due to antemortemhanging, as because, excessive
salivation is an antemortem reactionwhich occurs due to irritation of thesubmandibular salivary glands
during life, due to the pressure andfriction caused by the ligaturematerial.
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8.P
eculiar distribution of the8.
P
eculiar distribution of thepostmortem stainingpostmortem staining
As the body remains suspended in
the upright position after death, the
postmortem staining will be present
over the lower limbs, lower parts ofthe upper limbs and the upper
margin of the ligature mark.
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Occasionally, in the lower limbs,
there may be multiplehaemorrhagic spots due to rupture
of the capillaries, due to being
over-distended by blood.
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This distribution of the
postmortem staining is howevernot confirmatory of the death
being due to hanging. It onlyspeaks that the body was in a
state of suspension in upright
position for a considerable
period after death.
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Thus, if a dead body is placed
after death, in upright positionin a state of suspension with aligature around the neck, then
similar distribution ofpostmortem staining will bethere, provided that sufficienttime has been allowed to pass, inthat position of the body.
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9. The hands are usually
clenched. Sometimes the
hands may show
presence of fibers, like
that of jute when a jute
rope has been used.
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10. Fingertips,
nailbeds, and lips show
sign of cyanosis.
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11. In males there may be
involuntary discharge ofsemen.
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12. In both sexes there
may be involuntarydischarge of fecal matter
and urine.
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13. In addition, there may
be some abrasions at placeslike lateral aspects ofshoulder, due to friction
with a wall or a post or apillar, which occurs during
suspension, particularlyduring the last phase of lifewhen there is convulsion.
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14. In some cases, the right
side eye remains open with
more dilatation of the rt.
pupil, whereas the left eyeremains closed and left pupil
less dilated.Th
is is known asLe facie Sympathique.
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B. Internal findingsB. Internal findings--
1. In some cases, the
tongue is slightlyprotruded out and in
others the tongue ispushed back.
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2. Larynx and trachea
are congested. There
may be Tardieus spots
under the mucus
membrane of the
trachea and larynx.
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3. Lungs are congested.
There will be presence of
Tardieus spots on the
undersurface of the pleura
which are particularly
abundant at the interfaces
of the lobes.
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4. Brain is congested,
oedematous with presence ofhaemorrhagic spots. Similar
findings are present in thelayers of meninges.
5. All the organs arecongested.
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6. Maximum findings are available
in the TISSUE
OF THE
NE
CK.
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(a). The subcutaneous
tissue underneath theligature mark is dry,white, firm and glistening.
The platysma and thesternomastoid muscle
may sh
owh
aemorrh
agesand are even occasionallyruptured.
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(b). The hyoid bone
may be fractured inpersons, more
commonly above the ageof40 years. Fracture of
thyroid in hanging casesseems to be a rarity.
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. There may be transverse
tear of the intima of thecarotid arteries.
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(d). Larynx are congested.
There may be Tardieus spotsunder the mucus membrane
of the larynx.
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(e). In case of JUDICIAL
HANGING or where there isa drop from a reasonableheight, the ligature around
the neck causes a forcefuljerky impact on the neck atthe end of the fall. In such
cases there will be fracturedislocation of the C2 and C3or C3 and C4 vertebrae.
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In case of fracture of C2
and C3 the fractured pieceof the odontoid process ofthe C2 vertebra causes
damage to the medulla. Inother cases there is
corresponding injury to themeninges and the spinalcord.
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(f) In a few cases,posterior wall of theoesophagus may showcongestion due tocompression againstthe cervical vertebrae.
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MEDICOLEGAL ASPECTSMEDICOLEGAL ASPECTS
OFHANGINGOFHANGING
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A. Suicide hangingA. Suicide hanging
Hanging in its face value goes in
favor of being suicidal in nature. The
place of occurrence is secluded. The
point of suspension remains
approachable to the suicide. Partial
hangings are almost always suicidal
in nature. There may be a suicidal
note left behind.
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There should be a motive for
committing suicide. Often asuicide failing in othermethods to end life. May
lastly adapt this methodsuccessfully. In these casesevidence of some other
adapted methods may bepresent on the body.
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B. Homicide hangingB. Homicide hanging
1. Homicedal hanging is rare.It is not ordinarily possiblewith an adult victim, ifhe is
not intoxicated or not madeuncinscious by some othermeans, like head injury.Alternatively, the victim iseither a child or a very
deilitated person.
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2. Usually the rope is first
fastened around th
e neck andthen it is pulled over a high pointof suspension. Hence, there will
be presence of evidence ofpulling or dragging of the victimon the ground as also presence ofevidence of friction at the pointof suspension , with the ligaturematerial.
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3. The hand of the victim may
show presence of foreignmaterial like foreign hair or
button. The hands, feet and
the mouth of the victim may
be tied. Signs of struggle may
be present on the body of thevictim and at the place.
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C. ACCIDENTAL HANGINGC. ACCIDENTAL HANGING
The following circumstances ofaccidental hanging may beencountered:-
In factories, a worker working ata height if falls accidentally, mayget hanged on a sling or rope.
Similarly, if during such a fall thenecktie gets fixed at some point,then the victim may die due to the
effect ofhan in .
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2. Similar deaths may occur
in case of a trapeze playerwhen his grips slip and his
chin gets entangled on theswinging sling.
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3. When a person on the
top of a ladder suddenlymisses a step, in course of
falling down,h
ish
eadmay get fixed in between
two steps and he may die
due to constriction of the
neck in suspension.
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4. Infants while
accidentally slippingdown in between the
side grills of the crib,may die due to
constriction of th
e neckwith the body being ina suspended position.
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5. Children while
playfully acting judicialhanging, may actually
be hanged to death.
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6. In course of
masochistic practice the
victim may accidentally
die due to hanging.
Such person gets sexual
gratification by partial
asphyxiation.
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He arranges the
situation by placing anoose around his neckand creates a state ofpartial asphyxiation inhimself by pulling the
other end of the rope,across a pulley type
arran ement.
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After getting sexual
orgasm he releases thepull on the rope. In course
off such practices thevictim may fail to release
the pull and die due to
hanging.
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Males are the exclusive victims.The circumstance in such a
case is sufficient to indicate theactual nature and mode ofdeath. The victim is found
either naked or female dresswith pornographic pictures atthe place of occurrence. Often,
some soft cloth is placedaround, in between the ropeand the neck.
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D.Postmortem hangingD.Postmortem hanging
Often a victim is killed
by some other means andthen hanged to simulate a
suicidal death.
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As in case ofhomicidal hanging,
there will be evidence ofdragging of the body on the
ground and friction at the point
of suspension of the ligaturematerial, as the ligature is first
tied around the neck of the dead
body and then the body is
hanged.
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The unapproachability of the
point of suspension by thevictim, the signs of
disturbance and the evidence
of the actual cause of death,
present on the dead body, are
the other features which makethe fact (post mortem
hanging)clear.
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StrangulationsStrangulationsDefinition in strangulation, the
exchange of air between theatmosphere and the lungs is
prevented by way of constriction ofthe neck by means of a ligaturematerial or by some other means,without suspending the body, wherethe force of constriction is appliedfrom outside and is not the weight ofthe body or the head of the victim.
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Types of strangulationsTypes of strangulations
According to the mode of
causation,strangulations are
of the following types-
1. Strangulation by ligature.
2. Manual strangulation or
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2. Manual strangulation orthrottling. In this form of violent
asphyxiation, the neck iscompressed with fingers. Theupper part of the neck is mostly
affected and th
e pressure isexerted there, against themandible. The neck may be
compressed from th
e front, backor from any side and one or bothhands may be used.
3. Strangulation by means other than a
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3. Strangulation by means other than a
ligature material or hand or limbs.
Strangulation may be caused bycompressing the neck in between two
sticks or rods, by compressing the neck
against the ground or wall by a stick infront, or by pressing the neck on the
ground by foot.
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4. Garrotting . In garrotting, a loop
of a th
in string is th
rown aroundthe neck of the unaware victimfrom his back. Then this ligaturematerial is rapidly twisted with thehelp of two sticks tied at the freeends of the string, so as to constrictthe neck strongly. The unawarevictim is very rapidly asphyxiatedand dies. This is just a variety ofstrangulation by ligature.
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BANSDOLLA is a form
of strangulation in whichthe neck is compressed in
between two bamboo
sticks, one in front and
another on the back, or
with one bamboo stick
against the ground.
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5. Mugging. Strangulation
of the neck by compressing it in
the knee bent or elbow bent.
Table. Difference in postmortemTable. Difference in postmortem
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pp
appearance between hanging andappearance between hanging and
strangulation by ligaturestrangulation by ligatureHanging strangulation by ligature
(1)Ligature
mark
(2)Abrasions
and
ecchymosis
(3) Bruising
oblique, encircling the
neck uncompletely, high up
the neck,between the chin
and larynx. The base is
pale, hard and parchment-like.
About the edges of ligature
mark not common.
Of the neck muscles less
common.
transverse, encircle the neck
completely, below the
thyroid cartilage. The base
is soft and reddish.
About the edges of ligature
mark are common.
Of the neck muscles more
common.
Table Difference in postmortemTable Difference in postmortem
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Table. Difference in postmortemTable. Difference in postmortem
appearance between hanging andappearance between hanging and
strangulation by ligaturestrangulation by ligatureHanging Strangulation by ligature
(4) Neck
(5)Subcutaneo
us tissues
(6) Hyoid bone
(7) Thyroid
cartilage
(8) Larynx
and trachea
Stretched and elongated.
White, hard and glistening
under the mark..
Fracture may occur
Fracture is less common.
Fracture rare
Not stretched and elongated.
Ecchymosed under the mark.
Fracture is uncommon
Fracture is more common
Fracture may be found
Table Difference in postmortemTable Difference in postmortem
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Table. Difference in postmortemTable. Difference in postmortem
appearance between hanging andappearance between hanging and
strangulation by ligaturestrangulation by ligatureHanging Strangulation by ligature
(9)
Emphysematou
s bullae
(10) Carotid
arteries
(11) Face
Not present on the
surface of the lungs.
Horizontal intimal tear
may be seen
Usually pale and
petechiae are notcommon.
Very common on the surface of
the lungs.
Horizontal intimal tear is rare
Congested, livid and marked
with petechiae.
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Table. Difference in postmortemTable. Difference in postmortem
appearance between hanging andappearance between hanging and
strangulation by ligaturestrangulation by ligature
Hanging Strangulation by
ligature
(12) Signs of
asphyxia
(13) Tongue
(14) Saliva
External signs less
marked.
Protrusion is less
marked.
Often runs out of mouth
External signs well-marked.
Protrusion is more marked.
Absent
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Medicolegal aspects ofMedicolegal aspects of
strangulationsstrangulations
Strangulations in their facevalue are homicidal in nature.
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Inh
omicidal strangulationby ligatures, anything
which can be twisted, may
be used as ligature material.
The knot may be a half
knot or a full knot or adouble or tripple knot.
Th ill b k f
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There will be marks of
violence, at different otherplaces of the body. The site
will be approachable to
others and there will be
marks of disturbance at the
site.
If the hands of the deceased
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If the hands of the deceased
are in a state of cadavericapasm, then the grip may
show the presence of
foreign scalp hair of torn
fibers of a cloth or a button.
There may be homicidalwounds on the body.
When a person after being
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When a person after being
strangled, is pulled headward
with the free end of the rope,
then the ligature mark, instead
of being circular and continuous,will be like that ofhanging being
oblique and non-continuous.
Suicidal and accidentalstrangulations are not common.
Th ttli f ll ti l
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Throttling, for all practical
purposes, are alwayshomicidal. It is claimedthat accidental throttling
death may occur due tovagal inhibition when one
playfully manipulates orpresses the neck ofhisfriend.
Strangulation caused by other
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Strangulation caused by othermaterials, palmar
strangulation,garrotting andmugging, if diagnosed properly,then must be taken as homicidal
in nature, except in some cases ofhouse collapse and similarcircumstances when a beam like
structure if falls on the neck of alying person, may strangle himto death.
Strang lation like marks ma be
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Strangulation-like marks may befound caused by a necklace or acord round the neck, when theneck swells during the state ofdecomposition. In case of
decomposition, even withoutthese materials around the neck,strangulation may be doubted
due to the fold of the skin at theupper part of the neck caused byswelling of the neck.
DROWNINGDROWNING
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DROWNINGDROWNING
Definition . Drowning is a form ofviolent asphyxiation where therespiratory passage is occupied byfluid i.e., water, due to submersionunder water and inhalation of water.To be drowned, it is not necessarythat the whole body should be under
water. Submersion of mouth andnasal openings by any means issufficient for that purpose.
Types of drowningTypes of drowning
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Types of drowningTypes of drowning
Depending on differentcircumstances, effects andfactors, we get the following
types of drowning 1. Dry drowning
2. Wet drowning
(a). Fresh water drowning
(b). Salt water drowning
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3. Shallow water drowning
4. Immersion syndrome
5. Secondary drowning
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1. Dry drowning1. Dry drowning
In about 10% to 20% of deathsdue to drowning no water isfound in the lungs during the
postmortem examination. Theseare the circumstances wheredeath actually occurs due to
submersion or drowning, yet thelungs remain dry or water-free.
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Dry drowning may occur in two
ways.1. During first inhalation of
water, there is severe laryngealspasm which does not allow anywater to enter the lungs though
death
occurs due to asph
yxia dueto laryngeal spasm in acircumstance of drowning.
2 Wh d th
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2. When death occurs
due to vagal inhibitionofheart before
complete submersionof the body under thewater, as it happens incase of immersionsyndrome.
Wet drowning
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Wet drowning
In this variety, the waterenters the lungs. The effects of
water entering th
e lungsdepend on, whether
submersion has occurred in
freshwater or it has occurred
in salt water.
3 Shallow water drowning
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3. Shallow water drowning
alcoholics, epileptics,infants and children and
unconscious persons maydie due to drowning in
shallow water, in a shallow
pit or a drain.
I h ll d i
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In shallow water drowning,
the whole body need not besubmerged. Submersion of
face alone is sufficient tocause drowning if the
mouth and the nose
remains under the water.
4 Immersion syndrome4 Immersion syndrome
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4. Immersion syndrome4. Immersion syndrome
This is a condition which is found intemperate and cold zones. Usually
the young swimmers are the victim.
When they drive in very cold water,they may suffer from vagal
inhibition of the heart and die
sudden death in water, even thoughthey may be good swimmers
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5.Secondary drowning5.Secondary drowning
This is not drowning in the truest sense,but a complication or sequelae ofdrowning. After a few days of recovery
from drowning, the victim may sufferfrom pulmonary infection and edema.Ultimately the person may die due toasphyxia of pulmonary origin. Due to its
etiological background, such adevelopment is termed as secondarydrowning.
Signs of submersion in a dead
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Signs of submersion in a dead
body removed from water 1. When freshly removed from water,
the body and the clothes will be wet.
Irrespective of the time passed afterrecovery of the body from the water,
there will be sand and mud stain on
the body, hair and clothes. Thisfinding is not specific of antemortem
drowning or death due to drowning.
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2. Development of cutis
anserina (goose skin likeappearance of the surface of
the body) is another non-
specific finding which also
does not tell about the
antemortem or post-mortemnature of drowning.
Cutis anserina develops due to
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Cutis anserina develops due tocontraction of the erector pilaemuscles of the skin occuring dueto contract of the body with thecold water. It also occurs in alldead bodies during the state ofrigor mortis of the muscle of theskin. Cutis anserina is not
appreciable when decompositionof the dead body starts.
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3. Retraction of the
scrotum and penis in
males is another non-
specific finding, which
occurs due to
submersion, whether
before or after death.
4.changes in the skin of the palm
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4.changes in the skin of the palmand sole, like that which occurs
in a washer-women is yetanother non-specific sign ofsubmersion of a body under
water for some hours whichhasno relationship specifically withantemortem or postmortem
drowning. The skin of the palmsand soles are bleached,sodden,corrugated and thickened.
5. Presence of mud, sand , gravel
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and weed in the hand, in a state
of cadaveric spasm is one of theconfirmatory signs of death due
to drowning, because th
ecadaveric spasm of the hands
indicate the last work of the
person whichhe performedduring the process ofhis death.
Presence of sand weed etc
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Presence of sand, weed etc.
in the hand in that state,indicates that, just before
deathhe tried to grab the
soil at the bottom of the
water. This means that at
the time of deathhe wassubmerged under the water.
6. Presence of copious fine white
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6. Presence of copious fine white
froth near the mouth and the nasal
opening is another vital finding in
a case of death due to drowning. It
occurs due to th
e ch
urning effectof the air in the alveoli the water
inhaled and the mucus secretion
from the respiratory tract wall.The churning effect results from
the violent effort for respiration.
Another feature of this frothing is
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Another feature of this frothing is
th
at, it continues to come out for aconsiderable period, even if wipedout again and again. Continuousfrothing is a very very strongfinding in support of death due todrowning but is not absolutelyconfirmatory, as it may occur inthose cases where death is precededby pulmonary edema.
7. Presence of sand and mud
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7. Presence of sand and mudin the nail beds, though not inthe tight grip of cadavericspasm, is another important
finding in support ofantemortem drowning andbears weight in this respect,
though not as forceful as thecadaveric spasm.
8 Suffused and congested
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8. Suffused and congested
conjunctiva is anotherexternal finding of
antemortem drowning
which also carry
reasonable weight towards
antemortem phenomenonof the drowning.
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9. Distribution ofpostmortem staining in abody removed from water
is somewhat differentthan in other dead bodies
and is usually found overthe head, face and neck.
10 S d d d
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10. Sand and mud
may be present inside
the mouth cavity and
the nose.
11 A dead body
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11. A dead body
recovered from a pondor river may bear post
mortem injury due toeating by fish or otheraquatic animals or dueto impact with someprojecting substances.
I t l fi diI t l fi di
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Internal findingsInternal findings--
1. The mouth cavity
will show presence ofsand, mud etc.which are
not of much significance.
2 Sand mud or weed
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2. Sand, mud or weed
may be present in theesophagus which is also
not very muchsignificant in support of
death due to drowning.
3 The lumen of the larynx
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3. The lumen of the larynx,
trachea, bronchus andbronchioles show presence
of fine forth mixed with
sand and mud. This is a
very important sign of
death due to drowning.
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4.Presence of sand and
mud in the lower
respiratory tract is more
important than their
presence in the upper
respiratory tract.
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5. The lungs are voluminous,
edematous, have balloon likeappearance with marks ofindentation over the surface
by ribs. The lungs pit onpressure. When incised, thecut surfaces ooze frothy thinfluid blood.(aqueousemphysema)
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5. The stomach may show
presence of water, sand, mudand weed.
6. Presence of water, sand etc.
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,in the upper part of the
intestine is diagnostic of deathdue to drowning, becausepassing of these substancesthrough the pylorus needsantemortem process of
peristaltic movement andopening of the pyloricsphincter.
7 The blood is thick in
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7. The blood is thick in
case of death due todrowning in salt water,
and is thin due tohaemolysis in case of
drowning in fresh water.
8. Laboratory findings8. Laboratory findings--
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(a). Detection of diatoms in
some remote organs and
tissues including brain andbone marrow. This is one of
the most dependable signs of
death due to drowning but
there are fallacies.
(b). Blood chemistry: According
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( ) y g
to Gettler, in case of fresh water
drowning, haemodilution occurs
in the right side chambers of the
heart early and for t
his t
he
chloride value of the blood on the
right side chambers may come
down to the 50% of the normalvalue.
Conversely, in salt water
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drowning, there is
haemoconcentration whichaffects the left side chambersof the heart first and as aresult there is increase in thelevel of chloride in the blood
of th
e left side ch
ambers ofthe heart by 30% to 40%.
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. Microscopic changes in
the blood: In fresh waterdrowning there is both
haemodilution andhaemolysis which leads toboth absolute and relative
low count of the R.B.C.
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In salt water drowning,
there is
haemoconcentration which
causes relative increase inthe R.B.C. count. The
R.B.C.s shrink and appearcrenated.
O SO S
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DIATOMSDIATOMS--
These are unicellular algae
whichhave inert silicon coating
around them. These are presentin all natural water sources,
more abundantly in pond water
or in a lagoon, or where thewater is stagnant.
Th l f t i
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They are less frequent in
streams or in rivers where
the water is frequently
polluted by chemicals andindustrial refuse.
When a drowning person inhales
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water and when the alveoli get
distended with water and air, thealveolar walls may get rupturedexposing the capillaries which
are also ruptured along with.The water from the alveolar sacsalong with diatoms it contains,
enters the circulation and arecarried to distant organs andtissues.
Hence, in a body removed from
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water, if diatoms can be
demonstrated in the tissues of somedistant organs(distant from the lungs
and the body surface, to exclude the
chance of contamination of the tissueby surface diatoms), then it goes
strongly in support of death due to
drowning. There are of coursecertain fallacies of the presence of
diatoms in the tissue.
Test for presence ofTest for presence of
didi
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diatomsdiatoms
1. By histological examinationdiatoms can be demonstrated in
th
e lungs or rarely in some oth
ertissue, provide that plenty ofdiatoms were present in the
submerging water and a goodnumber of them entered in thecirculation.
2. Diatoms can be
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demonstrated,alternatively andcomparatively moreeasily, by acid digestionof the bone marrow,
brain or tissue fromother organs.
Value and fallacy of diatom
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y
testAlong with test of tissue
for diatoms, a sample of th
ewater from which the body
has been recovered, should
be subjected to control test.
If similar type of diatoms are not
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ypavailable in both the test sampleof the tissue and the sample ofwater for control test or ifdiatom is only present in thetissue then it can be concludethat diatom entered the bodytissue of the victim during theusual process of drinking waterwhich contained diatoms.
On the other hand
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On the other hand,
diatoms may not be
observed in the tissue,
even if drowning wasantemortem and the
water contained diatom.
If diatoms are present in
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both test sample of tissueand control sample ofwater, then it is strongly
presumed that drowningwas antemortem in natureand occurred in that water.But still it is not conclusivein all cases.
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Even if the drowning was not
antemortem in nature, similar
diatom may be present in both
the test sample and the controlsample, if the victim was
habituated to drink water from
the same source during his/herlife.
This is because when a person
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This is because when a person
drinks water a little of thewater may trickle down the
larynx and trachea etc. and
may reach the lungs bed and
enter the circulation through
some weak point of thealveolar walls.
In spite of chances of
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fallacy, if similardiatoms are available,both in the tissue andthe water then, that actsas a strong evidence of
death due to drowning.
Medicolegal aspects of
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g p f
drowning or submersion of abody in water or questions
which arise after removal ofa dead body from water. The
following medicolegal
questions may arise in
connection with such a case:
1. Whether drowning wasantemortem or postmortem
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antemortem or postmortem.
2. If drowning was antemortemwhat was the precise cause ofdeath?
3. What was the nature ofdrowning, suicidal, homicidal oraccidental?
4. What is the time of death andwhen did the submersion occur?
5. Was any other offenceinvolved in the case?
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involved in the case?
6. If the body is unidentified thenestablishment of the identitybecomes an important step of
investigation.7. If the body has been recovered
from a river, then it is necessary
to know the actual place ofdrowning.
1.Whether drowning was
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antemortem or postmortem
Of all the postmortemfindings available in a dead body
recovered from water, only someexternal and internal findingsand some laboratory findingsfocus light on whether drowningwas antemortem or postmortem.These are-
(a). Cadaveric spasm of theh d i h f
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hands with presence ofsand,mud,weed etc.in the grip.
(B). Copious, white fine froth
through the nose and mouth.( c). Presence of similar froth
along with sand, mud etc., in
the lumen of the whole of therespiratory tract.
(d). Voluminous lungs, like
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balloons, with indentation
or presence of marks of
ribs on the surface;
discharge of copious frothy
fluide blood from the cut
surface; emphysemaaquosum change;
presence of thin haemolysed
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p y
fluid blood in the spaces at theundersurface of the pleura on the
lower lobes and at the interfaces
of the lobes and absence oftardieus spots are the important
feature of antemortem drowning
deaths.
(e). Presence of water, sand, mud
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(e). Presence of water, sand, mud
and weed in the stomach and theupper part of the small intestine.
(f). Presence of diatoms in the
distant organs or tissue, similar
to those present in the water
wh
ere th
e body of th
e victim wassubmerged.
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(g). Difference in the chloride levels in the
blood of both side chambers of the heart.
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(h). Changes in the blood in addition to
the above, like haemoconcentration,
increased plasma magnesium level,relative increase in the R.B.C. count,
about 40% decrease in the blood volume,
crenated appearance of the R.B.C.s
under the microscope in case of saltwater drowning
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Increase blood volume(even up to
70%)due to haemodilution, haemolysis
with
absolute and relative decrease inR.B.C.count, increased potassium level in
the plasma in case of fresh water
drowning.
In case of dry drowning, it is verydifficult to say if death occurred due
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difficult to say if death occurred due
to drowning, because almost all thereliable signs of death due todrowning including the laboratorytests are those of wet drowning.Hence,in dry drowning,circumstancial evidences becomeimportant to come to the conclusion
whether death was due tosubmersion under water.
Suffocation deathsSuffocation deaths
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Definition :
Suffocation means a group of
conditions of violent asph
yxiation,where passage of air between the
atmosphere and the lungs is
prevented by mech
anical waysother than constriction of neck or
drowning.
Types of suffocationsTypes of suffocations
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Types of suffocationsTypes of suffocations
According to the frequency of
occurrence, suffocations are of the
following types-
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(1). Smothering
Definition - in smothering
respiration is prevented by
the closure of the mouth and
th
e nasal opening.
(2). Traumatic asphyxia
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Definition - in traumaticasphyxia, there is forcefulcompression of the chest
which preventsrespiratory movements ofthe chest wall and also
causes injury to the chestwall.
(3). Choking
D fi iti i h ki
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Definition in chokingthe air passage isoccluded either by some
foreign materials or dueto some pathology orforeign substance in theneighboring structure(e.g.esophagus).
(4). Gagging
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Definition in this type ofviolent asphyxiation, cloth
is pressed inside the
mouth cavity which also
creates pressure over the
posterior wall of thefauces.
Overlying
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Definition in this condition
young individuals (usually
infants or very young children)
die due to asphyxia, when theyget compressed under the body
of an intoxicated adult bed
partner. This is purely