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Violent asphyxial deaths

By Dr. Naveen
Violent asphyxial death

1. Definition: In violent


asphyxial deaths, the process
of respiration i.e., the exchange
of air between the atmosphere
and the lungs beds is prevented
by some violent mechanical
means.
 Violent asphyxia can be caused by -
 (1). Constriction of the neck.
 (2). By closure of nose and mouth.
 (3). By occlusion of the lumen of the air
passage by some materials .
 (4). By restricting the movement of the
respiratory muscles.
2. Types of violent asphyxia

 1). Hanging
 2). Strangulations
 3). Drowning
 4). Suffocations
Hanging
 1.Definition :
– Hanging is a process in which the
body is suspended with a ligature
around the neck which causes
constriction of the air passage
preventing exchange of air
between the atmosphere and the
alveoli of lungs, leading to
asphyxia and death.
In hanging, the constricting
force is either the weight of
the whole body or the weight
of the head alone.
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2.Types of hanging
1). Typical hanging.
In a typical hanging, the knot
of the ligature should be at the
nape of the neck on the back.
Typical hanging is not very
common in occurrence.
 2).Atypical hanging. In atypical
hanging, the knot of the ligature
may be at any site other than
the nape of the neck. It may be
near one angle of the mandible,
near the mastoid, or below the
chin.
 Hence in case of typical
hanging, maximum pressure
is exerted in the front of the
neck, on the midline, i.e.,
over the wind pipe. The
pressure over the jugular
veins and the carotid
arteries are comparatively
less but equal on both
sides.
In atypical hanging, the
commonest site for the
knot is near one side
mastoid process or near
the angle of mandible.
Occasionally, it may be
below the chin.
When a knot is on one
side, the pressure over the
vessels on both side is not
equal and it also takes
more time for total
occlusion of the wind pipe.
When the knot is blow the
chin, there may not be much
evidence of asphyxiation as
the respiratory tract is not
directly compressed.
Types of hanging
 1.Complete hanging. In this
variety, the body is fully
suspended and no part of the
body touches the ground.
The constricting force here is
the weight of the whole body.
 2.
Incomplete or partial
hanging.
The lower part of the body is in
touch with the ground.
Sometimes only the toes,
sometimes the whole foot or
feet, sometimes the knees,
sometimes the buttock,may be in
touch with the ground.
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Partial hanging is
taken to be diagnostic
of being suicidal in
nature.
The ligature materials in
cases of hanging
 Theligature material may be
anything which may be tied
around the neck with some
additional length for fixing it to
the point of suspension. It can
be a rope, electric wire, belt,
neck tie, bed sheet, scarf, cycle
chain or any such thing.
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The knot
The knot may be a fixed
one(double or more), or it
may be a slipping knot or
a running knot.
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Precise causes of death due
to hanging
Though a form of violent
asphyxia, not in all cases
of hanging death occurs
due to asphyxia. Any of
the followings may be the
actual cause of death.
Asphyxia along with
 1.
apoplexy due to
simultaneous pressure
over larynx and jugular
veins. The combined
effect of asphyxia and
apoplexy is the cause of
death in most cases.
2. Asphyxia alone.
3. Apoplexy alone.
4. Cerebral anaemia or
ischaemia due to pressure
over carotid and vertebral
arteries.
5. Vagal shock. This
may occur due to
inhibition of the heart
due to irritation of the
carotid sinus.
6. Fracture dislocation of
the second and third
cervical vertebrae, which
causes injury to the
medulla and the upper
part of the spinal cord, as
in case of judicial hanging.
Postmortem
appearance of
hanging
A. External findings
1.The ligature mark.
–In most cases of death due
to hanging, the ligature
mark around the neck is
very much conspicuous.
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–The ligature mark in case
of hanging is oblique, non-
continuous, placed high up
around the neck, grooved,
parchmentised and
abraded at places.
 The ligature mark is non-
continuous because of a gap at the
nape of neck due to hair
intervening between the ligature
material and the skin underneath.
There may also be some gap near
the site of the knot due to the pull
on the knot from the point of
suspension above.
 The upper margin of the ligature
mark has a line of postmortem
staining, all around above the
ligature mark. This is due to
settling of blood, from head and
neck above the level of
constriction, caused by the
ligature material.
 When the knot is in contact with
the skin, it is usually inverted “V”
shaped, due to extension of
ligature material downward on
both sides from the knot above.
The point of contact of the skin
with the knot may leave a deep
parchmentised abraded
impression.
Factor which influence the
appearance of the ligature mark

 A. The ligature material.


 B. Period of suspension.
 C. Degree of suspension.
 D. If something, say, the collar
of the shirt intervenes between
the ligature material and the
skin of the neck then the
ligature mark will not be
prominent.
E. The weight of the body of
the deceased.
F. Tightness of the ligature.
G. Slipping of the ligature
material.
H. When the ligature is
applied in multiple turns,
then there will be
multiple,parallel, grooved
ligature marks.
I. Design of a ligature
material, e.g. of a rope
or a cord may get
imprinted on the
ligature mark.
J. The ligature material
may be in situ around the
neck or may be sent along
with the dead body or may
be absent altogether.
2. The dimensions of the neck

 Due to prolonged suspension,


the neck becomes slender and
increases in length. This will not
be seen in suspension for a
short period.
3. Bending of the neck
 The neck gets flexed to the
side, opposite the side of the
knot. The state of bending will
continue until the onset of
decomposition.
4.The face may be
pale or flushed or
congested.
5.Tardieu’s spots may be
present on the forehead,
over the eyelids, under the
conjunctiva and
sometimes near the
temple.
6. Tongue may be partly
protruded out in between the
lips and during the stage of
rigor mortis may also be
bitten in between the jaws.
7. Dribbling of saliva.
 Dribbling of saliva is a
very constant and
important finding in a
case of death due to
hanging.
 Dribbling of saliva occurs from the
angle of the mouth which is at a lower
level i.e., from the angle opposite the
side of the knot. When the knot is on
the nape of the neck it occurs across
the middle of the lower lip. When the
knot is under the chin, then it occurs
through either or both angles of the
mouth.
 The saliva drops down in front of
the chest when the body is bare or
it stains the clothes in front, when
the deceased is dressed. When
dried or partly dried, it becomes
quite fixed and cannot be easily
removed or rubbed out.
 Dribbling of the saliva is considered
a very important phenomenon in
support of death due to antemortem
hanging, as because, excessive
salivation is an antemortem reaction
which occurs due to irritation of the
submandibular salivary glands
during life, due to the pressure and
friction caused by the ligature
material.
8. Peculiar distribution of the
postmortem staining
 As the body remains suspended
in the upright position after
death, the postmortem staining
will be present over the lower
limbs, lower parts of the upper
limbs and the upper margin of
the ligature mark.
 Occasionally, in the lower limbs,
there may be multiple
haemorrhagic spots
 due to rupture of the
capillaries, due to being over-
distended by blood.
 Thisdistribution of the
postmortem staining is however
not confirmatory of the death
being due to hanging. It only
speaks that the body was in a
state of suspension in upright
position for a considerable
period after death.
 Thus, if a dead body is placed
after death, in upright position in
a state of suspension with a
ligature around the neck, then
similar distribution of
postmortem staining will be
there, provided that sufficient
time has been allowed to pass,
in that position of the body.
9. The hands are usually
clenched. Sometimes the
hands may show presence
of fibers, like that of jute
when a jute rope has been
used.
10.Fingertips,
nailbeds, and lips
show sign of
cyanosis.
11.In males there may
be involuntary
discharge of semen.
12.In both sexes there
may be involuntary
discharge of fecal
matter and urine.
 13. In addition, there may be
some abrasions at places like
lateral aspects of shoulder, due
to friction with a wall or a post
or a pillar, which occurs during
suspension, particularly during
the last phase of life when there
is convulsion.
 14.In some cases, the right
side eye remains open with
more dilatation of the rt. pupil,
whereas the left eye remains
closed and left pupil less
dilated. This is known as “Le
facie Sympathique”.
B. Internal findings-
1. In some cases, the
tongue is slightly
protruded out and in
others the tongue is
pushed back.
2. Larynx and trachea are
congested. There may be
Tardieu’s spots under the
mucus membrane of the
trachea and larynx.
 3.Lungs are congested. There
will be presence of Tardieu’s
spots on the undersurface of
the pleura which are particularly
abundant at the interfaces of
the lobes.
 4. Brain is congested,
oedematous with presence of
haemorrhagic spots. Similar
findings are present in the
layers of meninges.
 5. All the organs are congested.
 6.
Maximum findings are
available in the TISSUE OF
THE NECK.
– (a). The subcutaneous tissue
underneath the ligature mark is
dry, white, firm and glistening.
The platysma and the
sternomastoid muscle may show
haemorrhages and are even
occasionally ruptured.
 (b). The hyoid bone may be
fractured in persons, more
commonly above the age of 40
years. Fracture of thyroid in
hanging cases seems to be a
rarity.
©. There may be
transverse tear of the
intima of the carotid
arteries.
(d). Larynx are
congested. There may be
Tardieu’s spots under the
mucus membrane of the
larynx.
 (e). In case of JUDICIAL
HANGING or where there is a
drop from a reasonable height,
the ligature around the neck
causes a forceful jerky impact on
the neck at the end of the fall. In
such cases there will be fracture
dislocation of the C2 and C3 or
C3 and C4 vertebrae.
 In case of fracture of C2 and C3
the fractured piece of the odontoid
process of the C2 vertebra causes
damage to the medulla. In other
cases there is corresponding injury
to the meninges and the spinal
cord.
(f)In a few cases,
posterior wall of the
oesophagus may show
congestion due to
compression against the
cervical vertebrae.
MEDICOLEGAL ASPECTS OF
HANGING
A. Suicide hanging
 Hanging in its face value goes
in favor of being suicidal in
nature. The place of occurrence
is secluded. The point of
suspension remains
approachable to the suicide.
Partial hangings are almost
always suicidal in nature.
 There may be a suicidal note
left behind. There should be a
motive for committing suicide.
Often a suicide failing in other
methods to end life. May lastly
adapt this method successfully.
In these cases evidence of
some other adapted methods
may be present on the body.
B. Homicide hanging
 1.Homicidal hanging is rare. It is
not ordinarily possible with an adult
victim, if he is not intoxicated or not
made unconscious by some other
means, like head injury.
Alternatively, the victim is either a
child or a very debilitated person.
 2.Usually the rope is first fastened
around the neck and then it is
pulled over a high point of
suspension. Hence, there will be
presence of evidence of pulling or
dragging of the victim on the
ground as also presence of
evidence of friction at the point of
suspension , with the ligature
material.
 3.The hand of the victim may
show presence of foreign
material like foreign hair or
button. The hands, feet and the
mouth of the victim may be tied.
Signs of struggle may be
present on the body of the
victim and at the place.
C. ACCIDENTAL HANGING
 The following circumstances of
accidental hanging may be
encountered:-
– In factories, a worker working at a
height if falls accidentally, may
get hanged on a sling or rope.
Similarly, if during such a fall the
necktie gets fixed at some point,
then the victim may die due to the
effect of hanging.
–2. When a person on the top
of a ladder suddenly misses a
step, in course of falling down,
his head may get fixed in
between two steps and he
may die due to constriction of
the neck in suspension.
–3. Infants while accidentally
slipping down in between
the side grills of the crib,
may die due to constriction
of the neck with the body
being in a suspended
position.
–4. Children while
playfully acting judicial
hanging, may actually
be hanged to death.
–5. In course of masochistic
practice the victim may
accidentally die due to
hanging. Such person gets
sexual gratification by
partial asphyxiation.
–He arranges the situation by
placing a noose around his
neck and creates a state of
partial asphyxiation in himself
by pulling the other end of the
rope, across a pulley type
arrangement.
– After getting sexual
orgasm he releases the
pull on the rope. In course
off such practices the
victim may fail to release
the pull and die due to
hanging.
– Males are the exclusive victims.
The circumstance in such a case
is sufficient to indicate the actual
nature and mode of death. The
victim is found naked at the
place of occurrence. Often, some
soft cloth is placed around, in
between the rope and the neck.
D. Postmortem hanging

Often a victim is killed


by some other means
and then hanged to
simulate a suicidal
death.
 As in case of homicidal
hanging, there will be evidence
of dragging of the body on the
ground and friction at the point
of suspension of the ligature
material, as the ligature is first
tied around the neck of the
dead body and then the body is
hanged.
 The unapproachability of the
point of suspension by the
victim, the signs of disturbance
and the evidence of the actual
cause of death, present on the
dead body, are the other
features which make the fact
(post mortem hanging)clear.
Strangulations
 Definition – in strangulation, the
exchange of air between the
atmosphere and the lungs is prevented
by way of constriction of the neck by
means of a ligature material or by some
other means, without suspending the
body, where the force of constriction is
applied from outside and is not the
weight of the body or the head of the
victim.
Types of
strangulations
 According to the mode of
causation,strangulations are
of the following types-
–1. Strangulation by ligature.
– 2. Manual strangulation or
throttling . In this form of violent
asphyxiation, the neck is
compressed with fingers. The
upper part of the neck is mostly
affected and the pressure is
exerted there, against the
mandible. The neck may be
compressed from the front, back
or from any side and one or both
hands may be used.
– 3. Strangulation by means other than
a ligature material or hand or limbs.
Strangulation may be caused by
compressing the neck in between two
sticks or rods, by compressing the
neck against the ground or wall by a
stick in front, or by pressing the neck
on the ground by foot. BANSDOLLA
is a form of strangulation in which the
neck is compressed in between two
bamboo sticks, one in front and
another on the back, or with one
bamboo stick against the ground.
– 4. Garrotting . In garrotting, a loop of
a thin string is thrown around the
neck of the unaware victim from his
back. Then this ligature material is
rapidly twisted with the help of two
sticks tied at the free ends of the
string, so as to constrict the neck
strongly. The unaware victim is very
rapidly asphyxiated and dies. This is
just a variety of strangulation by
ligature.
–5. Mugging. Strangulation
of the neck by compressing it
in the knee bent or elbow
bent.
Table. Difference in postmortem appearance
between hanging and strangulation by ligature
Hanging strangulation by ligature
(1)Ligature oblique, encircling the transverse, encircle the
mark neck uncompletely, high neck completely, below
up the neck,between the the thyroid cartilage.
chin and larynx.

(2)Abrasions
About the edges of
and About the edges of
ecchymosis ligature mark not ligature mark are
common. common.
Of the neck muscles
(3) Bruising
Of the neck muscles more common.
less common.
Table. Difference in postmortem appearance
between hanging and strangulation by ligature
Hanging Strangulation by ligature
(4) Neck Stretched and Not stretched and elongated.
elongated.

(5) Hyoid Fracture is uncommon


bone Fracture may occur

(6) Thyroid Fracture is more common


cartilage Fracture is less
common.
(7) Larynx Fracture may be found
and trachea
Fracture rare
Table. Difference in postmortem appearance
between hanging and strangulation by ligature
Hanging Strangulation by ligature

(8) Not present on Very common on the surface


Emphysematous the surface of of the lungs.
bullae the lungs.

(9) Carotid arteries Horizontal Horizontal intimal tear is rare


intimal tear
may be seen

Congested, livid and marked


Usually pale with petechiae.
(10) Face and petechiae
are not
common.
Table. Difference in postmortem appearance
between hanging and strangulation by ligature

Hanging Strangulation by
ligature

(11) Signs of External signs less External signs well-marked.


asphyxia marked.

(12) Tongue Protrusion is less Protrusion is more marked.


marked.

(13) Saliva Often runs out of Absent


mouth
Medicolegal aspects of
strangulations
 Strangulations in their face value are
homicidal in nature.
 In homicidal strangulation by ligatures,
anything which can be twisted, may be
used as ligature material. The knot may
be a half knot or a full knot or a double
or tripple knot.
 There will be marks of violence, at different
other places of the body. The site will be
approachable to others and there will be
marks of disturbance at the site. If the hands
of the deceased are in a state of cadaveric
spasm, then the grip may show the presence
of foreign scalp hair, of torn fibers of a cloth
or a button. There may be homicidal wounds
on the body.
 When a person after being strangled, is
pulled headward with the free end of the
rope, then the ligature mark, instead of
being circular and continuous, will be
like that of hanging being oblique and
non-continuous.
 Suicidal and accidental strangulations
are not common.
 Throttling,for all practical purposes, are
always homicidal. It is claimed that
accidental throttling death may occur
due to vagal inhibition when one
playfully manipulates or presses the
neck of his friend.
 Strangulation caused by other
materials, palmar
strangulation,garrotting and mugging, if
diagnosed properly, then must be taken
as homicidal in nature, except in some
cases of house collapse and similar
circumstances when a beam like
structure if falls on the neck of a lying
person, may strangle him to death.
 Strangulation-like marks may be found
caused by a necklace or a cord round
the neck, when the neck swells during
the state of decomposition. In case of
decomposition, even without these
materials around the neck,
strangulation may be doubted due to
the fold of the skin at the upper part of
the neck caused by swelling of the
neck.
DROWNING

Definition . Drowning is a form of violent


asphyxiation where the respiratory
passage is occupied by fluid i.e., water,
due to submersion under water and
inhalation of water. To be drowned, it is
not necessary that the whole body
should be under water. Submersion of
mouth and nasal openings by any
means is sufficient for that purpose.
Types of drowning
 Depending on different circumstances, effects
and factors, we get the following types of
drowning –
– 1. Dry drowning
– 2. Wet drowning
• (a). Fresh water drowning
• (b). Salt water drowning
– 3. Shallow water drowning
– 4. Immersion syndrome
– 5. Secondary drowning
1. Dry drowning

 In about 10% to 20% of deaths due to


drowning no water is found in the lungs
during the postmortem examination.
These are the circumstances where
death actually occurs due to
submersion or drowning, yet the lungs
remain dry or water-free.
 Dry drowning may occur in two ways.
– (1). During first inhalation of water, there is severe
laryngeal spasm which does not allow any water
to enter the lungs though death occurs due to
asphyxia due to laryngeal spasm in a
circumstance of drowning.
– (2). When death occurs due to vagal inhibition of
heart before complete submersion of the body
under the water, as it happens in case of
immersion syndrome.
Wet drowning
 In this variety, the water enters the
lungs. The effects of water entering the
lungs depend on, whether submersion
has occurred in freshwater or it has
occurred in salt water.
3. Shallow water drowning

alcoholics, epileptics, infants and children


and unconscious persons may die due
to drowning in shallow water, in a
shallow pit or a drain. In shallow water
drowning, the whole body need not be
submerged. Submersion of face alone
is sufficient to cause drowning if the
mouth and the nose remains under the
water.
4. Immersion syndrome

 Thisis a condition which is found in


temperate and cold zones. Usually the
young swimmers are the victim. When
they drive in very cold water, they may
suffer from vagal inhibition of the heart
and die sudden death in water, even
though they may be good swimmers.
5. Secondary drowning

 This is not drowning in the truest sense, but a


complication or sequelae of drowning. After a
few days of recovery from drowning, the
victim may suffer from pulmonary infection
and edema. Ultimately the person may die
due to asphyxia of pulmonary origin. Due to
its etiological background, such a
development is termed as secondary
drowning.
Signs of submersion in a dead
body removed from water
 1. When freshly removed from water,
the body and the clothes will be wet.
Irrespective of the time passed after
recovery of the body from the water,
there will be sand and mud stain on the
body, hair and clothes. This finding is
not specific of antemortem drowning or
death due to drowning.
 2.Development of cutis anserina
(goose skin like appearance of the
surface of the body) is another non-
specific finding which also does not tell
about the antemortem or post-mortem
nature of drowning.
 Cutis anserina develops due to
contraction of the erector pilae muscles
of the skin occuring due to contract of
the body with the cold water. It also
occurs in all dead bodies during the
state of rigor mortis of the muscle of the
skin. Cutis anserina is not appreciable
when decomposition of the dead body
starts.
 3. Retraction of the scrotum and penis
in males is another non-specific finding,
which occurs due to submersion,
whether before or after death.
 4.changes in the skin of the palm and
sole, like that which occurs in a washer-
women is yet another non-specific sign
of submersion of a body under water for
some hours which has no relationship
specifically with antemortem or
postmortem drowning. The skin of the
palms and soles are bleached,
corrugated and thickened.
 5. Presence of mud, sand , gravel and weed
in the hand, in a state of cadaveric spasm is
one of the confirmatory signs of death due to
drowning, because the cadaveric spasm of
the hands indicate the last work of the person
which he performed during the process of his
death. Presence of sand, weed etc. in the
hand in that state, indicates that, just before
death he tried to grab the soil at the bottom of
the water. This means that at the time of
death he was submerged under the water.
 6. Presence of copious fine white froth
near the mouth and the nasal opening
is another vital finding in a case of
death due to drowning. It occurs due to
the churning effect of the air in the
alveoli the water inhaled and the mucus
secretion from the respiratory tract wall.
The churning effect results from the
violent effort for respiration.
 Another feature of this frothing is that, it
continues to come out for a
considerable period, even if wiped out
again and again. Continuous frothing is
a very very strong finding in support of
death due to drowning but is not
absolutely confirmatory, as it may occur
in those cases where death is preceded
by pulmonary edema.
 7. Presence of sand and mud in the nail
beds, though not in the tight grip of
cadaveric spasm, is another important
finding in support of antemortem
drowning and bears weight in this
respect, though not as forceful as the
cadaveric spasm.
 8. Suffused and congested conjunctiva
is another external finding of
antemortem drowning which also carry
reasonable weight towards antemortem
phenomenon of the drowning.
 9.Distribution of postmortem staining in
a body removed from water is
somewhat different than in other dead
bodies and is usually found over the
head, face and neck.
 10.Sand and mud may be present
inside the mouth cavity and the nose.
 11. A dead body recovered from a pond
or river may bear post mortem injury
due to eating by fish or other aquatic
animals or due to impact with some
projecting substances.
Internal findings-
 1. The mouth cavity will show presence
of sand, mud etc.which are not of much
significance.
 2. Sand, mud or weed may be present
in the esophagus which is also not very
much significant in support of death due
to drowning.
 3. The lumen of the larynx, trachea,
bronchus and bronchioles show
presence of fine forth mixed with sand
and mud. This is a very important sign
of death due to drowning. Presence of
sand and mud in the lower respiratory
tract is more important than their
presence in the upper respiratory tract.
 4.The lungs are voluminous,
edematous, have balloon like
appearance with marks of indentation
over the surface by ribs. The lungs pit
on pressure. When incised, the cut
surfaces ooze frothy thin fluid blood.
 5.
The stomach may show
presence of water, sand, mud
and weed.
 6. Presence of water, sand etc. in the
upper part of the intestine is diagnostic
of death due to drowning, because
passing of these substances through
the pylorus needs antemortem process
of peristaltic movement and opening of
the pyloric sphincter.
 7. The blood is thick in case of death
due to drowning in salt water, and is
thin due to haemolysis in case of
drowning in fresh water.

 (a). Detection of diatoms in some


remote organs and tissues including
brain and bone marrow. This is one of
the most dependable signs of death
8. Laboratory findings-
 (b).Blood chemistry: According to
Gettler,in case of fresh water drowning,
haemodilution occurs in the right side
chambers of the heart early and for this
the chloride value of the blood on the
right side chambers may come down to
the 50% of the normal value.
 Conversely,in salt water drowning, there
is haemoconcentration which affects
the left side chambers of the heart first
and as a result there is increase in the
level of chloride in the blood of the left
side chambers of the heart by 30% to
40%.
 ©.Microscopic changes in the blood: In
fresh water drowning there is both
haemodilution and haemolysis which
leads to both absolute and relative low
count of the R.B.C.. In salt water
drowning, there is haemoconcentration
which causes relative increase in the
R.B.C. count. The R.B.C.s shrink and
appear crenated.
DIATOMS-
 These are unicellular algae which have
inert silicon coating around them. These
are present in all natural water sources,
more abundantly in pond water or in a
lagoon, or where the water is stagnant.
They are less frequent in streams or in
rivers where the water is frequently
polluted by chemicals and industrial
refuse.
 When a drowning person inhales water and
when the alveoli get distended with water and
air, the alveolar walls may get ruptured
exposing the capillaries which are also
ruptured along with. The water from the
alveolar sacs along with diatoms it contains,
enters the circulation and are carried to
distant organs and tissues.
 Hence, in a body removed from water, if
diatoms can be demonstrated in the tissues
of some distant organs(distant from the lungs
and the body surface, to exclude the chance
of contamination of the tissue by surface
diatoms), then it goes strongly in support of
death due to drowning. There are of course
certain fallacies of the presence of diatoms in
the tissue.
Test for presence of diatoms

 1. By histological examination diatoms


can be demonstrated in the lungs or
rarely in some other tissue, provide that
plenty of diatoms were present in the
submerging water and a good number
of them entered in the circulation.
 2. Diatoms can be demonstrated,
alternatively and comparatively more
easily, by acid digestion of the bone
marrow, brain or tissue from other
organs.
Value and fallacy of diatom test

 Along with test of tissue for diatoms, a


sample of the water from which the body has
been recovered, should be subjected to
control test. If similar type of diatoms are not
available in both the test sample of the tissue
and the sample of water for control test or if
diatom is only present in the tissue then it can
be conclude that diatom entered the body
tissue of the victim during the usual process
of drinking water which contained diatoms.
 Onthe other hand, diatoms may not be
observed in the tissue, even if drowning
was antemortem and the water
contained diatom.
 Ifdiatoms are present in both test
sample of tissue and control sample of
water, then it is strongly presumed that
drowning was antemortem in nature
and occurred in that water. But still it is
not conclusive in all cases.
 Even if the drowning was not antemortem in
nature, similar diatom may be present in both
the test sample and the control sample, if the
victim was habituated to drink water from the
same source during his/her life. This is
because when a person drinks water a little of
the water may trickle down the larynx and
trachea etc. and may reach the lungs bed
and enter the circulation through some weak
point of the alveolar walls.
 In spite of chances of fallacy, if similar
diatoms are available, both in the tissue
and the water then, that acts as a
strong evidence of death due to
drowning.
 Medicolegal aspects of drowning or
submersion of a body in water or
questions which arise after removal
of a dead body from water. The
following medicolegal questions
may arise in connection with such a
case:
 1. Whether drowning was antemortem
or postmortem.
 2. If drowning was antemortem what
was the precise cause of death?
 3. What was the nature of drowning,
suicidal, homicidal or accidental?
 4. What is the time of death and when
did the submersion occur?
 5. Was any other offence involved in the
case?
 6. If the body is unidentified then
establishment of the identity becomes
an important step of investigation.
 7. If the body has been recovered from
a river, then it is necessary to know the
actual place of drowning.
1.Whether drowning was
antemortem or postmortem

 Ofall the postmortem findings available


in a dead body recovered from water,
only some external and internal findings
and some laboratory findings focus light
on whether drowning was antemortem
or postmortem. These are-
 (a). Cadaveric spasm of the hands with
presence of sand,mud,weed etc.in the
grip.
 (B). Copious, white fine froth through
the nose and mouth.
 ( c). Presence of similar froth along with
sand, mud etc., in the lumen of the
whole of the respiratory tract.
 (d). Voluminous lungs, like balloons, with
indentation or presence of marks of ribs on
the surface; discharge of copious frothy fluide
blood from the cut surface; emphysema
aquosum change; presence of thin
haemolysed fluid blood in the spaces at the
undersurface of the pleura on the lower lobes
and at the interfaces of the lobes and
absence of tardieu’s spots are the important
feature of antemortem drowning deaths.
 (e). Presence of water, sand, mud and
weed in the stomach and the upper part
of the small intestine.
 (f). Presence of diatoms in the distant
organs or tissue, similar to those
present in the water where the body of
the victim was submerged.
 (g).Difference in the chloride levels in
the blood of both side chambers of the
heart.
 (h).Changes in the blood in addition to
the above, like haemoconcentration,
increased plasma magnesium level,
relative increase in the R.B.C. count,
about 40% decrease in the blood
volume, crenated appearance of the
R.B.C.s under the microscope in case
of salt water drowning
 Increase blood volume(even up to
70%)due to haemodilution, haemolysis
with absolute and relative decrease in
R.B.C.count, increase potassium level
in plasma in case of fresh water
drowning.
 In case of dry drowning, it is very difficult to
say if death occurred due to drowning,
because almost all the reliable signs of death
due to drowning including the laboratory tests
are those of wet drowning. Hence,in dry
drowning, circumstancial evidences become
important to come to the conclusion whether
death was due to submersion under water.
Suffocation deaths

 Definition :
– Suffocation means a group of conditions of
violent asphyxiation, where passage of air
between the atmosphere and the lungs is
prevented by mechanical ways other than
constriction of neck or drowning.
Types of suffocations

 According to the frequency of


occurrence, suffocations are of
the following types-
–(1). Smothering –
• Definition - in smothering
respiration is prevented by
the closure of the mouth and
the nasal opening.
– (2). Traumatic asphyxia –
• Definition - in traumatic asphyxia,
there is forceful compression of the
chest which prevents respiratory
movements of the chest wall and
also causes injury to the chest wall.
 (3). Choking –
– Definition – in choking the air passage is
occluded either by some foreign materials
or due to some pathology or foreign
substance in the neighboring structure(e.g.
esophagus).
 (4). Gagging –
– Definition –in this type of violent
asphyxiation, cloth is pressed inside the
mouth cavity which also creates pressure
over the posterior wall of the fauces.
 Overlying –
– Definition – in this condition young
individuals (usually infants or very young
children) die due to asphyxia, when they
get compressed under the body of an
intoxicated adult bed partner. This is purely
accidental in nature.
 Aspiration of large quantities of water results
in overdistension of the
 pulmonary alveoli (emphysema aquosum) the
alveolar septae are thinned and
 stretched with narrowing and compression of
the capillaries. The appearances
 resemble pulmonary emphysema.