Chirag Goyal
I.
Table
of Contents
II. Introduction:
Handing & Strangulation
B. Causes of death in
hanging –
II.
Introduction:
Hanging & Strangulation
In
the year 2019, 1,39,231 cases of suicide were reported in India and rate of
suicide was 10.4[1],
however it’s still suspicious how many cases out of these were actually of
strangulation.
A. Hanging
Hanging
is defined as a method of violent asphyxial death in which the body is
suspended completely or partially by a rope knotted around the neck and the weight
of the person hanging is applied to the neck, resulting in complete or partial
asphyxial death.[2]
On
the basis of suspension, there are mainly two types of hanging[3] –
Complete
hanging - The
body is totally hanged from the ceiling, with no portion of the body contacting
the ground at any point.
Partial
hanging - The
body is partially suspended, with the toes or feet contacting the ground, or
the body is sitting, kneeling, lying down, prone, or in any other position with
only the head and chest touching the ground, or the body is partially suspended
with the toes or feet touching the ground. The constricting force is exerted by
the weight of the head (5 to 6 kg), the chest, and the arms. Although it is not
essential to use the entire body weight, even a very small force is sufficient
to bring about death.
On
the basis of the types of knots, there are mainly two types of hanging[4] –
Typical
hanging: The
ligature extends from the midline above the thyroid cartilage on both sides of
the neck symmetrically upward to the occipital region, and the knot is over the
centre section of the back of neck.
Atypical hanging: It refers to a situation in which the knot is not on the occiput, for example, on the right or left side of the neck or at the front of the neck.
B. Causes of death in hanging –
·
As
a result of the compressive force of the ligature, the laryngeal and tracheal
lumens become narrowed, resulting in hypoxia and death.
·
The
ligature causes the jugular veins to get clogged, resulting in the cessation of
cerebral circulation, it is called venous congestion
·
Reflex
vagal inhibition can lead to sudden cardiac arrest.
·
Fracture
of cervical vertebrae
C. Types of Hanging
Hanging
can be divided into suicidal, homicidal and postmortem
Suicidal
hanging: In many
countries, hanging is a common method of committing asphyxial suicide. Males
are more likely than females to be between the ages of 10 and 80 years old. The
victim is able to approach the point of suspension because it is still
accessible. In nature, partial hanging is almost always considered suicidal. It
is possible that a previous attempt has occurred, and the crime is generally
committed in a secluded location (the victim's home is the most common
location). It is possible that a suicide note has been left behind. There
should be a compelling reason for someone to commit suicide. It is possible
that fibres of ligature material are present in the clenched hand.[5]
Homicidal
hanging: This is
extremely rare. Unless the victim is intoxicated or rendered unconscious, or
unless the victim is either a child or a disabled person, this is not normally
possible in an adult victim. In the following situations, homicide should be
suspected: a. There are signs of violence or disarray in the furniture b. Injuries,
whether offensive or defensive.[6]
Accidental
hanging: Hanging
deaths in children under the age of six are almost always unintentional. It has
been observed in children while "playing hanging" (e.g., pretending
to be a cowboy) or "Lassoing" (getting suspended from playground
equipment), and in adults (e.g., autoerotic hanging) in a variety of settings.
When workers fall from scaffolding, they may become entangled in the ropes,
which can cause them to be hanged. Keeping the neck from being jerked around by
the steering wheel Falls from great heights or from trees, as well as slipping
from a ladder, can result in being suspended from the neck to an object in
between.[7]
III. Difference
between strangulation and hanging
1.
Ligature mark is most important factor used in differentiating. At the
site of ligature, there is a pressure mark on the neck that is visible. “A typical ligature mark is present in the
upper half of the neck, above the thyroid, and is oblique bilaterally
symmetrical, extending to the angles of the mandible, then to the mastoid, and
finally to the occipital protruberance..”[8]
When
the knot is tied on the posterior part of the neck, it is possible to hang
completely from the knot. “There will be
no mark if the ligature is soft and it is cut down immediately after death, but
there will be a slight mark if the ligature is intervened by a thick and long
beard or clothing around the neck.[9]
Abrasions and bruises of the skin may be visible at the site of the knot as
well as in the groove's bottom bed. There may be areas of hyperaemia and, on
rare occasions, a few ecchymoses along the edges of the wound.” It is
possible to find fibres from the ligature adhering to the skin. For fixed
knots, the ligature mark is formed as an inverted "V" shaped
impression, with the apex of the V corresponding to the location of the knot.
When using a slip knot, the running noose may tighten around the neck, leaving
a mark all over the neck except where the knot is.[10]
When
distinguishing between hanging and strangulation by a ligature, it is also
important to consider the level at which the ligature mark is placed on the
body. Strangulation is a type of death that occurs when the neck is constricted
by something other than one's own body weight. When people die by hanging or
strangulation, asphyxia is the most common cause of death. However, it is
possible that it is caused by venous congestion, cerebral ischemia, shock, or a
combination of more than two of these factors. It is possible to sustain a
fracture-dislocation of the cervical vertebrae during a judicial hanging[11]
Some
of the factors which may affect ligature are as follows –
·
Ligature
composition: If a hard or thick and rough ligature is used, the mark may be
more pronounced than usual. Use of soft materials may result in a barely
visible mark on the surface of the skin.
·
Material
width: Broad ligature material may leave a broad mark with less grooving,
whereas thin ligature material may leave a deep, narrow grooved impression,
depending on its thickness.
·
Weight
of the body: The greater the weight of the body, the more prominent the mark
will be.
·
Rescue
hanging: If the person survives the hanging, the ligature mark becomes less
visible and heals, eventually becoming a pale scar-like mark.
2.
External appearance - The neck has been elongated. The head is tilted to
the side, in the opposite direction of the knot. In most cases, the face is
cyanosed, and cyanosis can be found on the lips, tongue, nose, ears, and nails.[12]
Because of congestion, the eyes appear prominent, and the pupils are dilated.[13]
The term for the eye that can remain open on the same side as the other is le
facie sympathique. When the tongue is drawn in or protruded and bitten, this is
referred to as.[14]
It is typically swollen and blue in colour. Bloody froth may be seen at the
corners of the mouth and around the nostrils, with saliva dripping from the
angle of the mouth. Hands are clenched, especially in the case of a severe
hanging. Due to the excessive congestion, it is possible to experience haemorrhage
into the middle ears on occasion.[15]
Hypostasis
causes engorgement of the penis with blood, which may be semierect and with
semen at the tip of the penis. Because of the relaxation of the sphincter,
urine and faeces may be released. It is common for post-mortem hypostasis to
occur in the legs, feet, hands, and forearms after a body has been suspended
for an extended period of time. The upper part of the body will appear pale
after the body has been suspended for an extended period of time. Petechial haemorrhages
can be discovered in the skin of the legs within two to four hours of the onset
of the symptoms. It has been shown that if the body is removed from the scene
within four hours of death and placed in the supine position, postmortem
hypostasis in the limbs will fade and new areas of lividity will develop along
the back and buttocks.[16]
3.
Internal Appearance: The subcutaneous tissue beneath the ligature mark
is dry, white, firm, and glistening, indicating that it has been ligated.
Hemorrhages and ruptures of the platysma and sternomastoid are common in these
structures. Hyoid bone fractures can occur in anyone, but they are more common
in people over the age of 40.
The
fracture is usually caused by a ligature pulling the hyoid bone backwards,
resulting in increased divergence of the greater horns (anteroposterior
compression fracture), but it can also be caused by traction pulling the hyoid
bone backwards. Transverse carotid intimal tears, long drops, and posteriorly
placed knots (Amussat's sign) are all signs of carotid artery disease in obese
patients. It is possible to have a ruptured vertebral artery, an intimal tear,
and subintimal haemorrhage (which is the most common). Congestion has developed
in the larynx and trachea. It is possible to have a fracture of the superior
horn of the larynx.[17]
It is possible that the tracheal rings, thyroid cartilages, and costal
cartilages will be fractured.
When
the cut section is squeezed, bloody froth comes out of the congested lungs. The
mucus in the respiratory passages is bloody froth. The right chamber of the
heart and the pulmonary vena cava are both full of blood, while the left
chambers are empty. The viscera of the abdomen are suffocating. The brain is
usually pale and congested, but not always. The pleura, pericardium, meninges,
brain, and abdominal viscera are all possible sites for petechial haemorrhages
to occur.[18]
IV.
Steps
of identification
Following
the identification of the body, a thorough examination is performed to look for
any external injuries, dribbling of saliva, signs of asphyxia such as bluish
discoloration of fingernails, petechial haemorrhages, signs of sphincter
relaxation, pattern and also any distribution of hypostasis, the extent of
rigour mortis that has developed, and other factors. A thorough investigation
of the Ligature mark is carried out. Last but not least, step-by-step
dissection of the neck was performed in order to observe the neck tissues
structures beneath the ligature mark after the thoracic organs and brain had
been removed from the body. This allowed the blood in the neck to drain away,
resulting in a cleaner dissection field and a more comfortable procedure.
In
the case of Amar Iqbal Singh vs State Of Punjab[19]
(2009), the court gave 10 differences between hanging and strangulation which
were based on above-mentioned criteria
In
the case of Sunil Duggal & Ors. v. State, Delhi High Court[20]
held that hanging and strangulation are two very different causes of death and
it should be differentiated on different medical factors.
V.
Hanging
v. Strangulation: Judicial probe
One of the
most recent case of Mavjibhai Ramjibhai Taviyad v. State of Gujrat[21],
the court was faced with the issue
of differentiating between Hanging and Strangulation. The Court noted that the
medical evidence is sure that death occurs by strangling. It can be suicidal,
murderous or unintentional. There is a single curve around the neck with one or
more knots in homicidal strangling. The same is true of the position in this
scenario. There may, or may not be, signs of struggle depending on the facts,
circumstances, and prior conditions of crime. It can therefore only be
determined that the form of death was not homicidal because there is no injury
and no acts of struggle by the deceased indicated.
The bench also
refers to Modi's "Medical Jurisprudence and Toxicology (23rd edition of
Lexis Nexis Butterworths),' where the difference in suspension and
strangulation is explained by the medical emphasis on particular differences.
Hanging differs in the following terms from strangulation:
1.
“Mostly homicidal;
2.
Face-Congested, livid and marked with
petechiae;
3.
Saliva-No dribbling out of the mouth down on
the chin and chest;
4.
Neck-not stretched and elongated in fresh bodies;
5.
external signs of asphyxia, very well marked
(minimal if death due to vasovagal and carotid sinus effect);
6.
Bleeding from the nose, mouth and ears may be
found;
7.
Ligature mark-Horizontal or transverse
continuous, round the neck, low down in the neck below the thyroid, the base of
the groove or furrow being soft and reddish;
8.
Abrasions and ecchymoses round about the
edged of the ligature mark, common;
9.
Subcutaneous tissues under the mark-
Ecchymosed;
10. Injury
to the muscles of the neck-Common;
11. Carotid
arteries, internal coats ordinarily ruptured;
12. Fracture
of the larynx and trachea-Often found also hyoid bone;
13. Fracture-dislocation
of the cervical vertebrae-Rare;
14. Scratches,
abrasions fingernail marks and bruises on the face, neck and other parts of the
body-Usually present;
15. Sometimes
evidence of sexual assault;
16. Emphysematous
bullae on the surface of the lungs-May be present”.
The above
characteristics would not ordinarily be acquired where it is hanging. If the
medical evidence discussed above is assessed on the basis of the above expert
criteria for medical jurisprudence, it can be apparently observed that symptoms
like congested face, ear bleeding, horizontal ligature in continuous circle,
neck abrasions around ligature mark, hyoid bone fracture, cervical vertebrae
dislocation, etc. have been detected. They prove that dying is a thorny act. As
said, wound scars demonstrating struggle cannot always be present because it
could happen that the deceased was not in a position to resist or throw was so
brutal that the deceased was never able to demonstrate any resistance.
The position was
similar to what was observed by the court in the case of Muniammal vs The
Superintendent Of Police[22].
In this case, the court relied
significantly on the medical reports of the forensic department. It observed
that a conscientious assessment of the authorities in the field of 'medical
jurisprudence' would indicate that there should be as many data as possible on
the post-mortem certificate collected at the time of such an inspection. If the
post mortem certificate lacks details or does not contain sufficient results,
then it will cause the decision-making authority so many complications. The
doctor cannot assume that any deceased's kith and family will come out with a
version that suspects that the deceased will die. However, as advertised, the
doctor must provide possible results in the post-mortem certificate in order to
support the administration of criminal justice.
*Student of 5th Semester , B.A. LL.B.(Hons) Jindal Global Law School , OP Jindal Global University, Sonipat
[2] Nageshkumar G Rao, Textbook of
Forensic Medicine and Toxicology, 2nd edition 2010, Jaypee brothers Medical
Publisher, page no-195
[3] K.S. Narayan Reddy, The
Essentials of Forensic Medicine and Toxicology, 34th edition -2017, jaypee
Brothers Medical Publisher (P) Ltd New Delhi-110002, page no-315
[4] Id.
[5] Gautam Biswas , Review of
Forensic Medicine and Toxicology, 2nd edition, Jaypee Brothers Medical
Publisher(P) Ltd New Delhi-110002, page no-190.
[6] Id.
[7] .K.Singhal, Forensic medicine
& jurisprudence, 5th edition2018, published by The National book depot Mumbai,
page no-125.
[8] S.K.Singhal, Forensic medicine
& jurisprudence, 5th edition2018, published by The National book depot
Mumbai, page no-121.
[9] Ajay Kumar, Text Book of
Forensic medicine (Medical Jurisprudence and Toxicology), 2nd edition-2016,
Avichal Publishing company (P) Ltd New Delhi-110002, page no-159
[10] Parikh’s Textbook of Medical
Jurisprudence, Forensic Medicine and Toxicology, 17th reprint edition -2017,
CBS pulisher & Distributors P. Ltd New Delhi-110002, page no172.
[11] K.S. Narayan Reddy, The
Essentials of Forensic Medicine and Toxicology, 34th edition -2017, jaypee
Brothers Medical Publisher (P) Ltd New Delhi-110002, page no-321
[12] S.K.Singhal, Forensic medicine
& jurisprudence, 5th edition 2018, published by The National book depot
Mumbai400012, page no-12.
[13] Parikh’s Textbook of Medical
Jurisprudence, Forensic Medicine and Toxicology, 17th reprint edition -2017,
CBS pulisher & Distributors P. Ltd New Delhi-110002, page no 171.
[14] K.S. Narayan Reddy, The
Essentials of Forensic Medicine and Toxicology, 34th edition -2017, Jaypee
Brothers Medical Publisher (P) Ltd New Delhi-110002, page no-321.
[15] Ajay Kumar, Text Book of
Forensic medicine (Medical Jurisprudence and Toxicology), 2nd edition-2016,
Avichal Publishing company (P) Ltd New Delhi-110002, page no-161.
[16] K.S.
Narayan Reddy, The Essentials of Forensic Medicine and Toxicology, 34th edition
-2017, Jaypee Brothers Medical Publisher (P) Ltd New Delhi-110002, page no-321.
[17] Gautam Biswas, Review of
Forensic Medicine and Toxicology, 2nd edition, Jaypee Brothers Medical
Publisher(P) Ltd New Delhi-110002, page no-183.
[18] S.K.Singhal, Forensic medicine
& jurisprudence, 5th edition2018, published by The National book depot
Mumbai400012, page no-124.
[19] Amar Iqbal Singh v. State Of Punjab,
Criminal Misc. No. M-30471 of 2009.
[20] Sunil Duggal & Ors. v. State,
Delhi High Court, 2019.
[21] Mavjibhai
Ramjibhai Taviyad v. State Of Gujrat.
[22]
Muniammal v. The Superintendent Of Police, Criminal Original Petition No.12582
OF 2007.
Extremy Insightful,Great work!!
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