158 MEDICAL JURISPRUDENCE Fig. 50.—Throttling: Finger marks on the neck and face. In a case of strangulation, which occurred on the 16th September 1915, I found a frac- tured dislocation of the first and second cervical vertebrae toge- ther with the usual cord-mark. In addition to these injuries, the right humerus, the left femur, and the first and second ribs of both sides were fractured. The fracture-dislocation of the spine was either caused by forcibly twisting the neck during the act of strangulation, or by a violent blow with a blunt weapon across the nape of the neck. In another case in which a man was murdered by pressure on his neck with a stout lathi the hyoid bone was fractured and the first and second cervical vertebrae were fractured and dislocated.8 The larynx and trachea are"'congested, and contain frothy mucus. TJxe cartilages of the larynx or the rings of the trachea may be frac- tured, when considerable force is used. It should be noted here that the hyoid bone is not, as a rule, fractured by any other means than by strangulation, although the larynx and trachea may, in rare cases, be frac- tured by a fall. Jungmichel 9 reports the case of a labourer who fell from a roof and sustained a longitudinal fracture of the thyroid cartilage, a frac- ture of the left ramus of the mandible and a compound fracture of the left humerus. Chatter ji 10 relates the case of a boy, aged 10 years, who fell from a «chair, striking his neck against the back of the chair, and sustained a small rupture at the posterolateral aspect of the trachea on the left side at its junction with the cricoid cartilage. The lungs are usually congested, showing the appearance of red hepati- zation and exuding dark fluid blood on section. They may show emphyse- matous patches on their surface due to the rupture of the air-vesicles. The bronchial tubes usually contain frothy, bloody mucus. The right side of the heart is full of dark fluid blood, and the left empty. The right ventricle is found contracted and empty like the left, if the heart has continued to beat after the stoppage of respiration. Sometimes, both the cavities are found full, if the heart stopped during diastole. The abdominal organs are darkly congested. The brain is also congested. Medico-Legal Questions.-*U3^ questions that are raised in a court of law in connection with strangulation are — death was caused by strangulation. 2. Whether the strangulation was suicidal, homicidal or accidental. 8. All. High Court Criminal Appeal No. 281 of 1923. 9. Medizimsche Klinik, Feb. 8, 1929, p. 219 ; Jour. Amer. Med. Assoc., May 4, 1929, p. 1,565. 10. Calcutta Med. Jour., Sept. 1925, p. 66.