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SUFFOCATION                                                       167

Medico-Legal Questions.—These are—

1.    Whether death was caused by suffocation.

2.    Whether the suffocation was suicidal, homicidal or accidental

1.    Whether Death was  caused by Suffocation.—Sometimes it is not
easy to state whether death is due to suffocation, inasmuch as the signs of
asphyxia may be altogether absent, or these signs may be present in deaths
from  epilepsy,  tetanus,  or  strychnine  poisoning.   To   come  to  a definite
conclusion it is, therefore, very essential to look for evidences of violence in
the shape of external marks surrounding the mouth and nostrils, or on the
chest, or the presence of foreign bodies in the throat.   Again, it cannot be
positively affirmed from the presence of Tardieu's spots that death occurred
from suffocation, since they are found in deaths from apoplexy, heart disease,
pneumonia, etc.

Circumstantial evidence should always be taken into consideration to
establish the proof of death from suffocation.

2.    Whether the Suffocation was Suicidal, Homicidal or Accidental,—

Suicidal suffocation is very rare, though a few cases of suicide among
prisoners and insane persons have been recorded. They are said to have
stuffed their throats with rags, pieces of blankets, hay, etc.

Homicidal suffocation is common, and is usually resorted to in murder-
ing infants and children by forcing mud, etc. down their throats, or by
smothering them by the hands, clothes, etc. In adults it is only possible
if the victim is weak and feeble, or is unable to resist, having been pre-
viously stupefied by intoxicating or narcotic drugs. Homicidal suffocation
by pressure on the chest is sometimes resorted to in India, but in the case
of adults it is often combined with smothering or throttling, and it is usually
an act of more than one person. "Burking" is a method of suffocation
adopted by Burke and his associate, Hare, for killing their victims. They
used to throw their victims down on the ground, and kneeling on the chest,
used to close the mouth and nostrils with one hand, and firmly hold the
lower and upper jaws together with the other hand, thus effectually blocking
the air-passages.

A form of homicidal suffocation practised in Northern India is known
as " Bans-dola", although it is not so common now as it used to be
formerly. In this form the victim's chest is squeezed so forcibly between
two strong wooden planks or bamboos, one being placed across the upper
part of the chest and the other across the back of the shoulders, that the
respiratory act is interfered with, the muscles are lacerated and the ribs
are fractured. If the force applied is very severe, the lungs may be crushed
and lacerated*

Burying alive used to be resorted to in India as a form of punishment,
and lepers used to be sometimes buried alive.

In the case of infants dying under suspicious circumstances and after-
wards exhumed, a question may arise as to whether they had been buried
alive. The presence of fine dust in the oesophagus and stomach is a con-
vincing proof of the infant having been buried alive. In a burial after death
fine dust may be f ound in the upper air-passages, but not in the oesophagus
or stomach.

Accidental suffocation is frequent and is produced as described above.


Suicide.—A middle-aged man was brought to the workhouse by the police with a
history of delusions. On examination, no definite signs of insanity were found, tat it
was thought desirable to keep him under observation. On the evening of Hie same
day he suddenly became excited and violent and was, therefore, placed la a padded