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1. Smothering or Closure of the Mouth and Nostrils.—Infants are
often accidentally smothered by being overlaid by their mothers when they
are drunk. This is more common among the lower classes of women in
England. In India, such cases are rare, as infants are generally not allowed
to sleep in the same bed with their mothers, but are placed in separate
cradles; however, they are sometimes smothered by inexperienced girl
mothers who press them too closely to the breast when suckling. A com-
mon method of killing infants and children is to close the mouth and nos-
trils by means of the hand, bed clothes, soft pillows or mud.
Cases have been recorded of adults being accidentally smothered by
plaster of Paris at the time of taking a cast or mould, or by falling face
downwards into vomited matter, flour, cement, sand or mud, especially
when drunk or during an epileptic fit.
2. Obstruction of the Air-passages from within.—This may be due to—
(a) The presence of foreign bodies, such as a piece of meat, potato
skin, fruit-stone, corn, button, coin, cork, rag, India-rubber teat, live fish,
round-worm, loose artificial teeth, mud, cotton, leaves, etc.
It is not necessary that a foreign body should be of such a size as to
block the air-passages completely. Even a small object blocking the lumen
partially may cause death by spasm.
On the 26th September 1912, a Mahomedan girl, about 10 years old, was standing in
a street in Agra with her infant sister, one year old, in her arms, when a boy playfully
gave her a push from behind. The infant girl fell and died immediately. On post-
mortem examination a split gram (chaneki dal) was found to be obstructing the lumen
of the larynx. It appears that the infant girl had a parched gram in her mouth at the
time of the fall, and it got into the larynx during the involuntary inspiratory movement.
Dr. G. B. Sahay, Police Surgeon, Patna, described to me a similar case which occur-
red to him on the 12th September 1939. A male child, one year old, was playing alone
on a veranda, while his mother was busy with her work in the house. All of a sudden
the child shrieked, became blue in the face and died in a few moments. The mother
accused her neighbour of having practised witchcraft on the child, but post-martem
examination showed that the upper part of the windpipe was found clogged by a whole
parched gram with marks of teeth bite.
On the 10th April 1929, a Hindu male, aged 60 to 65 years, died all of a sudden
while trying to hire an ekka, for proceeding to his house. At the post-mortem examina-
tion I found a carious tooth lying in the glottis and death was caused by suffocation
due to spasm of the glottis brought on by the tooth lying there.
Vomited matter may regurgitate into the larynx, and by inspiratory
efforts may be aspirated into the smaller bronchi and may cause suffocation.
This is especially common in acute alcoholism, and occasionally occurs during
a fit of epilepsy or in a case of badly administered anaesthesia. It must be
remembered that the contents of the stomach fall into the larynx and tra-
chea after death owing to pressure of the gases of decomposition, but they
cannot reach the smaller bronchi.
(b) Diseases, such as tumours pressing on some portion of the air-
passages, or a false membrane a%in diphtheria or cedema of the glottis, or
effusion of blood from haemoptysis^ epistaxis and wounds of the throat, or
pus from an abscess in the tonsils or caseating glands ulcerating into the
trachea. A foreign body in the pharynx or oesophagus may cause obstruct
tion pressing on the windpipe from behind.
3. Pressure on the Chest—This may occur accidentally through the
chest being pressed violently in crowds at big fairs, or by being ixampfecl
upon in the rush of such crowds. Pressure on the chest may also occur ia
railway > inotor-car or other vehicular accidents or "by burial under the <&$**
ris oŁ a falling wall or roof. Cases of compression of the chest homicidal!^
are also met with in India.