STRANGULATION, violent constriction of the neck, involving such compression of the windpipe as to close the air-passages, prevent respiration, and finally cause death. In hang ing, which sometimes produces strangulation, if much violence is used, death may be caused by direct injury to the upper part of the spinal cord (q.v.) from fracture or dislocation of the cervical vertebra;, or by syncope from shock; in such cases death must be almost instantaneous. If the constriction is so applied as to compress the great vessels in the neck and not the wind pipe, death is due to coma, and is somewhat slower than in cases of asphyxia. If both ves sels and windpipe are compressed, coma and asphyxia may both contribute to cause death. When suspension of the body has not contin ued for much more than five minutes, and the parts about the neck have not suffered violence, thire is a probability that resuscitation may be established; though many cases are recorded when after only a few minutes' suspension it has been found impossible to restore life. Moreover, if a person who has hanged himself has been cut down sufficiently soon to allow of the respiratory process being restored. he is by no means safe, death often taking place from secondary effects. It is believed that uncon sciousness comes on very rapidly, and death takes place without causing any suffering; the violent convulsions that are so often observed being similar to those which occur in epilepsy. Ex
posure to a free current of air, cold allusion, if the skin is warm, the application of ammonia to the nostrils, of mustard poultices to the chest and legs, and of hot water to the feet, and the subsequent abstvaction of blood if there should be much cerebral congestion, are good measures for the treatment of partial strangulation. They should be used if natural breathing is not at once resumed. From the post-mortem appear ances together with circumstantial evidence, the medical practitioner is not unfrequently called upon to answer such medico-legal ques tions as: Was death caused by hanging, or was the body, suspended after death? Was the strangulation the result of accident, homicide or suicide? In case of strangulation from other causes than that of hanging the post-mortem symptoms are similar, but the injury done to the parts about the neck is commonly greater. In manual strangulation the external marks of in jury will be in front of the neck, about and be low the larynx; and if death has been caused by a ligature the mark around the neck will be cir cular, whereas in hanging it is usually oblique. The internal appearances are much the same as in the case of hanging.