STRANGULATION, an act of violence in which constriction is applied directly to the neck, either around it or in the forepart, in such a way as to destroy life. This definition obviously includes hang ing which differs from other forms of strangulation, only in that the body is suspended. The direct cause of death in the great majority of cases is arrest of the respiration owing to pressure on the windpipe—i. e., asphyxia. If much violence is used, death may be produced by direct injury to the upper part of the spinal cord from fracture or dislocation of the cervical vertebra; (as is now the rule in execution by hanging), or by syncope from shock, and in such cases must be almost instantaneous; on the other hand, if the constriction is so ap plied as to compress the great vessels in the neck and not the windpipe, as may happen in "garotting," it is due to coma, and is somewhat slower than in cases of asphyxia. Or if both vessels and wind pipe are compressed, coma and asphyxia may both contribute to cause death.
When suspension of the body has not continued for much more than five min utes, and the parts about the neck have not suffered violence, there is a proba bility that resuscitation may be estab lished; though many cases are recorded when after only a few minutes' suspen sion it has been found impossible to re store life. Moreover, if a person who
has hanged himself has been cut down sufficiently soon to allow of the respira tory process being restored, he is by no means safe: death often taking place from secondary effects at various pe riods after the accident.
The treatment to be adopted after the patient has been cut down may be briefly summed up as follows: Exposure to a free current of air, cold allusion if the skin is warm, the application of ammo nia to the nostrils, of mustard poultices to the chest and legs, and of hot water to the feet, and the subsequent abstrac tion of blood if there should be much cerebral congestion; above all, artificial respiration should be used if natural breathing do not at once commence. In manual strangulation the external marks of injury will be in front of the neck, about and below the larynx; and if death has been caused by a ligature the mark round the neck will be circular, whereas in hanging it is usually oblique. The internal appearances are much the same as in the case of hanging. See AS