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148                                              MEDICAL  JURISPRUDENCE

2.   Apoplexy or Cerebral Congestion.  This is due to congestion of the
venous blood in the brain from compression of the large   (jugular)  veins
completely blocked by the ligature passed round the neck.

3.    Combined Asphyxia and Apoplexy. This is supposed to be the com-
monest cause of death, as in most cases the air passages are not completely
blocked by the ligature passed round the neck.

4.    Syncope.  This results from pressure on the large arteries of the
neck which prevents blood from going to the brain thus causing anaemia.

5.    Shock. This occurs from pressure on the pneumogastric nerves.

6.    Fracture   or   Dislocation   of   the   Cerviccd^Vertebrce.  In   judicial
hanging, a sudden drop of five to seven feet according to the weight of the
condemned person produces fracture or dislocation of the upper cervical
vertebrse which, compressing or lacerating the spinal cord, causes instanta-
neous death.   Usually the first and second vertebrae are injured, but in a few
cases the third"an9Tl&urth vertebrae may be found fractured or dislocated.

: Fatal Period.  Death is almost instantaneous, if the cervical vertebrse
jare fractured as in judicial hanging. It may occur instantaneously or ra-
!pidly in cases of asphyxia, but usually in five to eight or ten minutes if the
{blocking of the air passages is partial only. Death is, as a rule, slow in
cases of apoplexy.

Treatoent.-^^e^&rst and the most important thing to do is to let^the
individual dowri^and to remove constriction of the neck by cutting -"the
ligature. Artificial respiration should then be used after pulling out the
tongue, aSn^wiping the froth from the nfouth and nostrils. Jhis may be
supplemented by ammonia vapour to the nose and tickling the fauces. CoM
affusion may be applied to the head, and the galvanic battery may be used
if the body is warm but if the body is cold warmth should be restpred Tby
friction and mustard plaster on the chest, abdomen and calyes. If tife
patient is able to swallow, stimulants should be given by the mouth, other-
wise they should be given Ey*podermically or per rectum. It may be necefr
sary to perform venesection to relieve distension of the right side of the
heart and pulmonary circulation or cerebral congestion. The patient should
be watched for some time after respiration has been established, as death;
may occur from a relapse of the symptoms.                                                 "*"';'

r     .IQie. secondary effects of hanging in subjects who have recovered, are>
sometimes hemiplegia,  epileptiform convulsions,  amnesia,  dementia, broa\;
chitis, haemoptysis, cervical cellulitis, parotitis and retropharvngeal abscess.

In August 1919, a Hindu woman, aged thirty, who hanged herself while under the >]]
influence of opium was cut down.   On the 3rd day she died of meningitis.    On posfc
mortem examination the brain and its meninges were congested and the lungs were
congested and oedematous.

Appearances.  These are external and internal.

External  Appearances.  External  appearances   are  those   due imfjte
ligature on the neck and those peculiar to the mode of death.              /      \

^gatore-Mark-^Iliis depends on the nature of the ligature usecl, amc|
the Time 'of suspension of the body after death. If the ligature be soft, am!
the body be cut down immediately after death, there may be no
Again, the intervention of a thick and long beard or clothes on the
may lead to the formation of a slight mark only.

 5^e mark is usually situated above the
and the chin, and is directed obliquely


ward following "theiMe~drihfe mandible ffower jaw) and interrupted at tfifj
back, reaching the mastoid processes behind the ears. TE^g,. mark majrb*-
found on or below ttte thyroid cartilage, especially in cases of partial "