Valor pico a pico

carefully by cutting, preserving the knot and both cut ends should be tied with a thread. It should be inspected and its dimensions should be noted. It should be sealed and then handed over to the police.

The ligature mark is usually situated above the thyroid cartilage and is found to be going obliquely upwards following the line of mandible and may be interrupted due to presence of knot. In some cases, ligature mark may be present at thyroid cartilage level or below.

The character of the mark varies according to the nature of the ligature used. The pattern of ligature

56 Concise Textbook of Forensic Medicine and Toxicology

Table 9.1 Differences between ante-mortem and post-mortem hanging

Features Ante-mortem hanging Post-mortem hanging

1. Motive Usually suicidal. Homicidal Motive to disguise as suicide. only in cases of lynching.

2. Ligature mark Ligature mark well developed, No such features seen. base is parchment-like and is

yellow or brown.

3. Saliva Dribbling of saliva may be seen. Absent.

4. Injuries No other injuries may be seen. Other injuries which caused death may be seen.

5. Asphyxial features Will be seen in the body. No asphyxia signs present. 6. Circumstantial evidence Closed room. No signs Signs of struggle may be seen.

of struggle may be seen.

7. Drag marks on the body Not present. May be seen. 8. Suicide note May or may not be present. Never present. 9. Rope fibres Maybe seen in the hands. Not seen.

may be present on the neck skin. The ligature mark is like a groove, its base is pale, hard, leathery and parchment-like. The ligature mark is the deepest at the knot. The colour of the ligature mark is reddish brown if the body has been suspended for a long time. Sometimes in a fat person, a pseudo mark may be seen due to presence of skin folds of the neck. In these cases no characteristic marks like parchmentisation would be seen.

The neck is found elongated and stretched. Petechial haemorrhages may be seen on face, neck and under the conjunctiva. The tongue may be seen protruded in some cases. Dribbling of saliva may be seen from the angle of mandible. This is considered as the surest sign of ante-mortem hanging as this is a vital phenomenon and cannot be produced after death, although in a dark skinned person, this sign may be difficult to detect.

Turgescence may be observed in genital organs. Semen may be found at the urethral opening. Due to relaxation of sphincters, urine and faeces may be seen in clothes. If the body has been suspended for a long time, post-mortem staining may be seen in the arms and legs (lower part; Table 9.1). 2. Internal Examination: A curved incision from behind the right mastoid process to the left, extending down up to sternum is useful for careful dissection of neck layer-by-layer

for the best results. A dry, white and glistening subcutaneous tissue is seen underneath the ligature mark. This is typical in death from hanging. The carotid arteries may be found lacerated. The muscles of neck may be found ruptured especially in cases where great force has been used in hanging. The fracture of cervical vertebrae along with rupture of spinal cord may be seen in judicial hanging. Usually, thyroid and cricoid cartilages escape fracture. They may be found fractured if somehow ligature passes on the neck—may be in atypical hanging. Fracture of hyoid bone may be seen in some cases. The epiglottis and mucous membrane of mouth may be ruptured. The lungs may be congested, oedematous and exude blood mixed serum. The right side of the heart is filled with dark fluid and, due to haemorrhages the left side is empty. The abdominal organs are congested. The brain may show congestion. Petechial haemorrhages may be seen in lungs, heart and abdominal organs.

Medico-legal Importance

The questions normally asked of a doctor in a hanging case are:

Asphyxial Deaths 57

1. Whether a person has died of hanging or not?

2. Whether hanging is accidental, suicidal, or homicidal? Sometimes, a person may be killed by other methods like strangulation, fire-arm or stabbing. This body may be put in hanging position so as to create an impression that the person had hanged himself. In such cases doctor should carefully examine the dead body and look for other causes of death. Careful dissection of neck would reveal that the person had died of hanging or strangulation.

Hanging is mostly suicidal in nature. No age bar is there for suicide. Males commit more suicide as compared to females. Major reasons for committing suicide in males are unemployment, family tensions, drinking, etc. The major reasons for females committing suicide are family maladjustment, failure in exams, failure in love life, dowry, etc.

Homicidal hanging is very rare. It is possible that one person is overpowered by a group of persons and forcibly hanged. In such cases, injuries may be seen on the victim who tries to defend himself. Lynching is a form of homicidal hanging which was quite prevalent in old times where a mob used to hang a condemned person by a tree.

Accidental hanging is common among children who may accidentally die because of slippage of stripes of school bag on the neck.

Auto-erotic hanging or sexual asphyxia is a

form of accidental hanging. It has been reported that by producing asphyxia with a ligature on neck, sexual stimulation is enhanced in a sexually charged atmosphere. The victims are mostly males. Some soft material like handkerchief or wire may be used by the victim and its pressure is increased by hands or remotely by legs. The victim is usually found naked with pornographic material around him. If he has taken alcohol, asphyxia is rapidly produced. Sometimes, he may not be able to remove pressure

in time and may die. In all such cases, examination of scene of crime is very useful.

Strangulation

Strangulation is a violent form of death which occurs from constriction of the neck by means of ligature or by other means without suspending the body:

1. Throttling: It is defined when constriction