LECTURE IX: DEATH BY ASPHYXIA

- is the general term applied to all forms of violent death which results primarily
from the interference with the process of respiration or the condition in which the supply of
oxygen to the respiration or the condition in which the supply of oxygen to the blood or to the
tissues or both has been reduced below normal level.

Types:

1. Anoxic Death – associated with the failure of the arterial blood to become normally saturated
with oxygen. Due to:
a. Breathing in an atmosphere without or with insufficient oxygen, as in high altitude
b. Obstruction of the air passage due to pressure from outside, as in traumatic crush
asphyxia
c. Paralysis of the respiratory center due to poisoning, injury or anesthesia, etc.
d. Mechanical interference with the passage of air into or down the respiratory tract due
to:
 closure of the external repiratory orifice, like in smothering and overlaying
 obstruction of the air passage, as in drowning, choking with foreign body
impact, etc.
 repiratory abnormalities, like pneumonia, asthma, emphysema and
pulmonary edema
2. Anemic Anoxic Death – due to a decreased capacity of the blood to carry oxygen. Due to:
a. Severe hemorrhage
b. Poisoning like carbon monoxide
c. Low hemoglobin level in the blood
3. Stagnant Anoxic death – brought by the failure of circulation. Due to
a. heart failure
b. shock
c. arterial and venous obstruction, incident to embolism, vacular spasm, varicose vains,
or the use of tourniquet
4. Histotoxic Anoxic death – due to the failure of the cellular oxidative process, although the
oxygen is delivered to the tissues, it cannot be utilized properly.

CLASIFFICATION OF ASPHYXIA:
1. Hanging
2. Strangulations:
a. strangulation by ligature
b. manual strangulation or trottling
c. Special forms of strangulations:
- palmar
- garroting
- mugging or yoking
- compression of the neck with stick
3. Suffocation
a. smothering or closing of the mouth and nostrils by solid objects
 b. choking or closing of the air passage by obstruction of its lumen
4. Asphyxia by submersion or drowning
5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gases.

CAUSES OF DEATH IF HANGING;

1. Simple asphyxia by blocking the air passage
2. Congestion of venous blood vessels in the brain
3. Lack of arterial blood in brain due to pressure on the caretid arteries
4. Syncope due to pressure on the vagus and carotid sinus which leads to reflex
irritation and paralysis of the medullary autonomic.
5. Injury on the spinal column and spinal cord.
6. It may be any be combination of the above-mentioned causes.

Time Required in the process of Death:

1. Severity of constricting force:
If constricting force is only sufficient to occlude the windpipe/trachea, death is delayed;
If pressure is sufficient to occlude the carotid art., jugular viens and vagles nerve, then
unconsciousness develops immediately and death is accelerated.
2. Point of application of the Ligature.
Below larynx-death instantaneous
Above larynx - > 3-5 min. – death
Hust side of neck – delay death
Hust below the jaw – delay death

Determination whether hanging is ante-mortem or post-mortem:

Hanging Strangulation with Ligatures
1. Hyoid bone – injured - spared
2. direction of ligature mark is inverted - ligature mark horizontal
v- w/ apex as the site of knot
3. ligature usually at the level of hyoid bone - lig. Usually below larynx
4. ligature groove deepest opposite/ - lig. Groove is uniform in depth in its
site of the knot whole course
5. vert. Is present - vert. Injuries not present

Asphyxia by Submersion or Drowning

Mechanism of drowning:
Person- (does not know ho to swim) falls into a deep body of water – body sinks bec. Of
momentum of fall – and sp. Grav. Of body > than H2O
- body will be buoyed yp – because of instinctive movement of individual
and air under clothings
- while under H2O – breath is held – but upon reading surface – there is
an attempt to breath – air and H2O gets into mouth and nostrils
- subj. will raise his hard – will cause him to sink
- subj. alt. Appears and disappears on surface – everytime he attempts to
breath H2o and air gets in
 - violent coughing occurs – which will expel air in the lungs – greater
desire to breath – more H2o is drawn in lungs and stomach
- H2O files bronchicoles – push residual air – surface of lungs –
ballooning soggy and edeenatom.
- Death 2-5 minutes (average time)

If dead body recovered in H2O – physician must answer the ff. questions:
2. Did death occur prior to entry in H2O? If so what was the cause of death?
3. Did drowning cause death? If so is it fresh/salty H2O pool?
4. Any ante-mortem injuries? If so did they play any part in the death
5. Any post-mortem injuries?
6. was there any natural disease? Poisoning? Contribution to death?

Post-Mortem;
Internal Findings:
a. Respiratory System:
1. “Emphysema aquosum”- remedial air - balloons
2. “Edema Aquosum” - H2O is air sacs
3. “Champignon d’ocume” – whitish foam – nostrils mouth

Gettler’s Test – quantitative determination of the chlorise content of the blood in the right
and left ventricle of the heart.
- difference if of at least 25 mcg. Proves that death occurred in fresh salt
H2O and drowning is the cause of the death
- salt H2O – Cl content of right side vert is less than lt. = fresh H2O – CL-
lt of right side less than lt.

Findings Conclusive that the Person Died of Drowning:

2. presence of materials or foreign bodies in hands of victim
3. Emphysema auosum and edema of the lungs
4. H2O in stomach similar to medium where body was fd. Submerged
5. champignon d’ocume and foreign bodies
6. presence of H2O in the middle ear.

Burling – invented by Burks and Hare – murdering people to be sold to medical schools
Death by Crucifixion – interested on the how Jesus Christ dies?
- when person is nailed on the cross the wt. Is supported by the nailed ft.
In order to breath – person has to raise his body and throne his weight on
his feet.
- When on the corss- intercostals number are stretched – chest cage is
fixed. Alternative lowering and raising of the body lead to exhaustion –
unconsciosness – death by classification as traumatic Asphyxia
Assignment: Medico –legal Aspects of Sex Crimes:
b. Heart
c. Stomach
d. Brain
 e. Blood
f. Other organs

E. Compression Asphyxia (Traumatic Asphyxia or crush Asphyxia)

e.g. death by cruxifixion; death by burking
- rarely attempted is suicide
F. Asphyxia by Breathing Irrespirable Gases
a. CO “silent killer”
CO + Hg – carbohemoglobin – 250x more stable than Oxyhemoglobin
Main action is O2 deprivation
Accidental and suicidal death by CO common
b. CO2 – prod. of human resp., decomp. Of org. matter and fermentation
c. H2S – hydrogen sulfide
d. Hydrogen Cyanide – bamboo shoots

DEATH O PHYSICAL INJURIES DUE TO AUTOMOTIVE CRASH OR ACCIDENT

DEATH OR PHYSICAL INJURIES DUE TO ATHLETIC SPORTS
CHILD ABUSE OR NEGLECTED CHILD