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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

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.