11. Champouillon: Same journal, 1876, xlvi., p. 129.—Man, age 62; first tried to suffocate himself with charcoal smoke and then hung himself, but the rope broke and the body fell. He lived two days.

12. Pellier: Lyon thesis, 1883, No. 188, p. 72.—Boy, age 16, hung himself; rope broke; he was resuscitated; reddish circular furrow on neck, not like parchment; he had erection and ejaculation; buzzing in his ears and flashes before his eyes.

13. Lacassagne: Pellier thesis (supra), p. 71.—Man; hung himself; was cut down and sent to hospital; was aphonic for four days; then a severe bronchitis set in, and at the end of a week a gangrenous expectoration. The mark of the cord lasted fifteen days.

14. Maschka: Archiv. de l’anthrop. crim., Paris, 1886, i., pp. 351-356.—Man, age about 60, found dead under a tree in the woods near Prague. No sign of violence. A cord thick as a sugar-loaf around the neck; another cord attached to a branch of the tree. There was at first a strong suspicion of violence, but the conclusion reached was that he had hung himself and that the body had fallen from breaking of the cord; that death was due to asphyxia was shown by the furrow on the neck, the dark liquid blood, and the congested lungs. There was no infiltration below the furrow in the neck, and no lesion of larynx. The man had shown signs of melancholy.

15. Friedberg: Virchow’s Archiv, 1878, lxxiv., p. 401.—Suicidal hanging. Examination twenty-eight weeks after death. The front of the neck showed a groove above the larynx, firm and of gray color; ecchymosis in subcutaneous tissue.

16. Bollinger: Friedreich’s Blätt. f. ger. Med., 1889, xl., p. 7.—Man, age 48; found dead. Had made a ligature out of a night-gown and tied it around his neck, the other end around top of a low bed-post; his neck hung by the ligature placed below the larynx. Illustrated.

17. Med. Times and Gaz., London, 1860, ii., p. 39.—Woman; had collected accounts of celebrated persons who had been hanged; finally hanged herself.

18. E. Hoffman: Mitt. d. Wien. Med. Doct. Colleg., 1878, iv., pp. 97-112.—1st. Woman, age about 25; found dead sitting in bed, a handkerchief around her neck fastened to the bed-curtain. The police thought she had been killed and then hung, but the physician concluded that she had committed suicide. An examination of the stomach showed that she had previously tried to poison herself with arsenic.

19. 2d. Woman, age 51; found hanging in half-lying position.

20. 3d. Man, age 50. First tried to kill himself with phosphorus, then sulphuric acid; finally hung himself in a half-kneeling position.

21. Müller-Beninga: Berlin. klin. Woch., 1877, xiv., p. 481.—Man, age 40; hung himself. There was no swelling of genitals and no soiling of clothing. Necroscopy showed death from asphyxia, and in urethra near meatus quite a quantity of seminal fluid, as shown by microscopical examination.

22. Tardieu: Op. cit., p. 18.—The Prince of Condé was found hanging in his room, August 27th, 1830. He was suspended by two handkerchiefs to a window fastening, his feet, however, touching the floor. The knot was at the back of the neck (as shown by the illustration), the face turned slightly to the left, the tongue protruding; face discolored; mucus at the mouth and nose; arms hanging and stiff; fists shut; heels raised; knees half bent. The text says that the knot was nearly under the right ear, but the illustration shows a different position (see Fig. 22, p. 743).

23. Allison: Lancet, 1869, i., p. 636.—Three cases of suicide by hanging, in which there was no mark: 1st. Woman, hung herself with a piece of sheep-net band; cut down before death. 2d. Man, hung with plough-string; cut down in about six minutes. 3d. A heavy man.

24. Tardieu: Op. cit., pp. 93-105.—Woman, died of coma and asphyxia from suicidal hanging, according to report of Drs. Costan and Facieu. Tardieu approved their report. It was at first thought a case of homicide with subsequent hanging, more especially because of the kind of knot used, nœud d’artificier. But Tardieu showed that it was also a nœud de batalier. Her feet touched a chair, and her knees were bent. There was a neckcloth in front of her mouth, but it did not seem to have interfered with respiration.

25. Ibid., pp. 67-72.—The famous case of Marc-Antoine Calas, who committed suicide by hanging (see Voltaire, “Traité sur le tolérance,” etc., in Nouv. Philos. Histor., 1772, xxxii., p. 30). He hung himself to a door. No sign of violence. The city hangman said it was impossible for a man to commit suicide in that way. The father was accused and convicted of homicide. Tardieu shows that the act was a suicide.

26. Ibid., p. 72.—Another famous case. A woman, age 30, hung herself to the key of her bedroom door. Her husband cut her down. He was accused and convicted of the crime and condemned to prison, where he died. Tardieu showed that the case was one of suicide.

27. Hofmann: Wien. med. Presse, 1880, xxi., p. 201.—Man, age 68, suicide by hanging. There was profuse hemorrhage from both ears.

28. Ibid.: 1878, xix., pp. 489-493.—Woman, found dead sitting in bed. She first tried to poison herself with arsenic, then hung herself.

29. Ibid.—Man, tried to poison himself with phosphorus and sulphuric acid, then hung himself. There was a transverse rupture of the sterno-cleido mastoid muscle and suffusion in its sheath.

30. Maschka: Wien. med. Woch., 1880, xxx., pp. 714, 747, 1075.—Man, age 63. It was at first a question of suicide by hanging or homicide by strangling. He concluded that it was the former.

31. Ibid.—Also man, age 58. Similar case. Same opinion.

32. Ibid. 1883, xxxiii., pp. 1118-1120.—Woman. age 23. Question whether she committed suicide by hanging or was strangled and then hung. Opinion, that it was a case of suicide.

33. Hofmann: Allg. Wien. med. Zeit., 1870, xv., pp. 192-214.—Man, age 60. Suicide by hanging or homicide; opinion, that it was the former.

34. Van Haumeder: Wien. med. Woch., 1882, xxxii., pp. 531-533.—Suicide by hanging or homicide. There were many wounds in the head; these occurred during the delirium of typhus.

35. Maschka: “Sammlung gericht. Gutacht.,” etc. (Prag), Leipzig, 1873, p. 137.—Boy, age 9; found dead in sitting position. Injuries on neck and elsewhere. Question, had he hung himself or been choked? Were the injuries inflicted before or after death? Opinion, suicide.

36. Ibid., p. 144.—Boy, age 13. Found hanging in sitting position. Question whether murder, suicide, or accident. Opinion, suicide.

37. Ibid., p. 149.—Woman, age 60; found hanging, sitting position. Suicide or homicide. Opinion, suicide.

38. Ibid., p. 156.—Woman, age 30; found hanging. Opinion, suicide.

39. Ibid., p. 165.—Man, age 63. Suicide by hanging, or homicide by strangling? Opinion, suicide.

40. Berliner: Viert. f. ger. Med. und öff. San., 1874, xx., pp. 245-253.—Woman, age 30; found hanging. Opinion, suicide.

41. Deininger: Friedreich’s Blät. ger. Med., 1884, xxxv., pp. 47-59.—Woman, age 61; found hanging. Opinion given, suicide.

42. Mader: Bericht d. k. k. Rud. Stift., Wien. (1875), 1876, p. 378.—Woman, age 43; tried to hang herself. She was at once cut down, bled, and taken to hospital unconscious. Next day, face red; pulse and temperature normal. Third day, conscious and could speak, but not aloud; tongue twisted and turned to right; paralysis of right hypoglossal nerve. Uvula drawn to left. Skin of right limb felt “furry.” Applied electricity and gave strychnine; phonation was more distinct during the use of the battery. Two months later she was still aphonic, but the vocal cords were in better action. The right hemiparesis was lessened.

43. Grant: Lancet, 1889, ii., p. 265.—Man, age 48; found sitting against a door, hung to the knob by a handkerchief.

44. White: Lancet, 1884, ii., p. 401.—Woman, age 53, insane. Made several attempts at suicide; once with a stocking around her neck, once with an apron; the last time by fastening a portion of her dress to a ladder. She was quickly cut down, cold affusion applied, and artificial respiration (Sylvester). The eyes were prominent and glassy, pupils widely dilated, no reaction to light; conjunctivæ insensitive; lips livid; tongue swollen and pale; face pale; oblique depressed mark on neck, most marked on left side; skin cold; no pulse; no heart-beat recognizable; no respiration; no reflex action. Galvanism failed to arouse any muscular action. The details are too numerous to give all of them. There was reduplication of heart-sounds for several days, due to interference with pulmonary circulation. She recovered both bodily and mental health.

45. Richards: Indian Med. Gaz., 1886, xxi., p. 78.—Man, age 20; suicide; was cut down and lived for four days.

46. Kite: Univ. Med. Mag., 1888-89, i., p. 475.—Man, age 69; suicide.

47. Terrier: Prog. Méd., 1887, vi., pp. 211-214.—Two men, age 29 and 25, insane. Attempted suicide by hanging. Both resuscitated.

48. Nobeling: Aertz. Intellig.-bl., 1884, xxxi., p. 213.—Two suicides by hanging; men, ages 24 and 40.

49. Ritter: Allg. Wien,. med. Zeit., 1886, xxxi., p. 375.—Soldier, found hanging. Cut down in ten minutes. Artificial respiration applied; fifteen minutes later, an effort at respiration; face changing from blue to white and then to red; pulse small, irregular; still unconscious; mark of ligature distinct; a few hours later had a maniacal seizure; gave morphia hypodermically and he slept; was also aphonic. Gradually recovered and returned to duty.

50. Strassmann: Viert. f. ger. Med., 1888, xlviii., pp. 379-381.—Three cases of suicidal hanging in men, ages 27, 37, and 40. The last was found kneeling.

51. Balta: Pest. Med. Chir. Presse, 1892, xxviii., p. 1244.—Man, age 45-50; hanging; suicide. Thyroid cartilage and hyoid bone broken.

52. Hackel: Op. cit., p. 35.—Man, found hanging to a beam by a sheet. Had previously tried to choke himself with his hands.

53. Ibid.—Two cases of suicidal hanging where the cord made no mark. In the first the body hung free; in the second the body was partly supported. In the first there was no rubbing of the skin; in the second the body was soon cut down.

54. Freund: Wien. klin. Woch., 1893, vi., pp. 118-121.—Man, found hanging; cut down, but could not be resuscitated. Ligature between hyoid bone and larynx, then crossed over itself about middle line of neck, passed up along each side of face, knotted above the head, then thrown over a beam, and on the other side the loop was caught between his legs.

55. Hoffman: Op. cit., p. 525, illustrated.—Case communicated by Dr. Rosen, of Odessa. Man, age 21, and woman, age 17, hung themselves by same ligature thrown over an open door, one of them on each side. They had previously tried other means of suicide without success (see Fig. 24).

56. Ibid., p. 530.—Man found hanging by handkerchief to branch of tree but sitting on the ground. Mark of handkerchief superficial and pale. When the necroscopy was made the mark had disappeared. Also a similar suicide where there was no mark at all.

57. Ibid., p. 541.—Man found hanging to a window. Another man cut the cord and the suspended one fell into a cellar, fracturing his skull.

58. Ibid.—Man found hanging; cut down; the fall caused rupture of liver.

59. Ibid., p. 539.—Drunkard hung himself; there was evidence that he had previously injured himself during his drunkenness.

60. Ibid.—Boy hung himself because he had been punished by the schoolmaster. There were marks on his back and lower limbs from the punishment.

See also Taylor, “Medical Jurisprudence,” pp. 451-452; Tidy, “Medical Jurisprudence,” incomplete hanging, Cases 33 to 36 and 62; Hofmann, “Lehrbuch,” p. 538.

Homicide.

61. Harvey: Indian Med. Gaz., 1876, xi., p. 3.—Woman, age 20, feeble. Her mother-in-law had kicked her; she probably had fainted; supposing her to be dead, the husband hanged her to a tree within half an hour after the supposed death. Autopsy: No marks of injury; oblique mark of cord on right side of neck; tip of tongue between the teeth; face somewhat livid; right side of heart full of dark blood; lungs congested posteriorly.

62. Ibid., p. 4.—Woman, age 38. Rope close under the chin passed upward behind the ears. Head bent on chest. Large wound above clavicle. Under the rope was a depression (made after death) but no hemorrhage. Much blood in abdomen and a hole in the liver. Kidney bruised and blackened. Right lung torn through; blood in pleuræ. Wounds were supposed to be gunshot, but the husband confessed that he had thrust a sharp solid bamboo into her body and afterward hung it up. She died of hemorrhage.

63. Rehm: Friedreich’s Blät. f. ger. Med., 1883, xxxiv., pp. 332-362.—Man, age 73; first roughly maltreated; afterward hung.

64. Tardieu: Op. cit., p. 125.—Woman found hanging in her room. Circumstances indicated homicidal strangulation and that the hanging was done to avert suspicion. Post-mortem examination showed the base of the tongue ecchymosed, and ecchymosis extending up to the soft palate; mucous membrane of pharynx congested; connective tissue and mucous membrane between hyoid bone and larynx congested posteriorly; epiglottis showed slight ecchymosis, mucous membrane red. These ecchymoses were not caused by the cord, for the latter was placed below the hyoid bone and this bone was not broken. There were also marks on the collar-bone like the mark of two hands.

65. Ibid., p. 124.—Girl, 15 years old. Body found hanging. Post mortem showed beyond doubt that she had been violated, then strangled, then hung. Her head showed many ecchymoses from either the fist or the foot; blood flowing from left ear. Brain slightly congested. Tongue between teeth, bitten and bloody. On front of neck were two marks: the lower were impressions of fingers close together, nearly uninterrupted, and which had bruised, flattened, and tanned the skin, which here was dry, hard, and horny. This lesion was above the intraclavicular notch and extended toward the sides of the neck with regularity of curve and neatness of imprint, evidently made with the right hand. Above the first furrow under the skin was a kind of track, less extended, more regular, a bruising of the same nature as the preceding, but continued, due to the pressure of the index finger and thumb of left hand. A little below the jaw was a livid place on the skin, which was otherwise unaffected by the ligature. There was nothing to indicate a circular action of the ligature. Froth in larynx and bronchi. Lungs apparently normal. Food had passed from stomach into œsophagus and air-passages.

66. Ibid., p. 122.—Woman found hanging in her room, and was resuscitated. She stated that the man who lived with her had tried to strangle her and then hung her. Tardieu saw her in hospital. Respiration short and embarrassed; pains in neck and jaw. Found narrow, circular, sinuous, horizontal, uninterrupted line around the neck below thyroid cartilage; line everywhere equal, deep, and three to four mm. wide; the skin excoriated and covered with thick crust. Below this were several superficial excoriations. There were many contusions on other parts of the body. Tardieu concluded that the mark on the neck was from attempt to strangle; the wounds elsewhere to prevent resistance. She had at the time pulmonary consumption. She died of this disease aggravated by the assault.

67. Ibid., p. 106.—The Duroulle affair. Woman found hanging. Presumption of homicide; arrest of husband; acquitted. She was found with her face to the floor, one end of a cord around her neck; another similar cord attached seven feet above to a rafter, over which it passed three times. Bidault and Boulard reported it a suicide. The results of the post mortem were as follows: Skin of a red-violet color; face swollen; eyes prominent and congested; conjunctivæ a vinous red; lips violet; tongue swollen, tip between teeth; froth in air-passages; lungs congested; brain congested; blood fluid. Circular depression around neck with congestion of skin above and below; ecchymosis in subcutaneous tissue on level of angle of jaw and about one centimetre in size, supposed to correspond to the knot. Tardieu reported that the marks rather resembled those of strangulation than hanging; the ecchymoses were more like those produced by the hand over the mouth. The marks on the face supposed to have been made by a supposed fall of the body were by him considered to have been caused by violence. He believed the woman had been strangled and then hung.

68. Ibid., p. 130.—The Daugats affair. Man found hanging, sitting on the ground, head and trunk somewhat inclined to the left; legs stretched out; clothing not disordered; the part of the cord which was around the neck was applied to the neck of the waistcoat and shirt; on his head a woollen cap. The ground had been recently swept. Necroscopy twenty-four hours afterward. Face pale; right eye open and prominent, left closed; mouth closed, contained food apparently from the stomach; tongue retracted; slight mark on neck under which the tissue was normal: atlas dislocated on axis, but tissues around were normal; no lesion in spinal canal; penis not erect; moisture having the odor of urine on the shirt; large ecchymosis and infiltration of left cheek; extensive contusions on scrotum, with hemorrhagic infiltration, especially around right testicle. Veins of head engorged with black fluid blood. Brain normal. Some black fluid blood in right cavities of heart, left side empty. Lungs black. Other organs normal. Causse and Orfila concluded that the man had been suffocated and then hung. The wife and son confessed that they had injured the testicle through the pantaloons; he then fainted; they then suffocated him with the woollen cap placed over the mouth and nose; the son kneeled on the man’s belly, the body was then hung up and the head violently twisted.

69. Passauer: Viert. f. ger. Med. und öff. San., 1876, xxiv., pp. 26-49.—Woman found hanging in a kneeling position. The ligature on the neck was loose. The necroscopy showed the following: Tongue between the teeth; eyelids swollen and livid; livid spots on face and left ear; lower lip torn; a number of marks on neck; one red stripe not sharply limited; skin not parchmenty and no ecchymosis; ecchymoses of scalp; periosteum of skull reddened; hemorrhage in temporal muscle; brain and pia mater congested; much fluid in ventricle. Larynx and trachea dirty red-brown; right side of heart empty; a little dark fluid blood in left; great vessels, including aorta, containing much dark fluid blood. Lungs congested and œdematous. Liver, spleen, and kidneys congested. Opinion given that she died of asphyxia and was either choked or hanged. Reference to Royal College of Medicine, Königsberg, where the opinion was given that she died of injuries on head and neck and was afterward hanged.

70. Becker: Same journal, 1877, xxvii., pp. 463-473.—Woman, age 52; found hanging. Death caused by shock and incipient asphyxia from strangulation and probably the wounds on head and limbs.

71. Maschka: “Samm. gericht. Gutacht.,” etc. (Prag), Leipzig, 1873, published a number of interesting cases, in each of which there was a question raised as to the cause of death.

72. Ibid., p. 127.—Man found dead. Had he been strangled or hung, or had he died some other way? Opinion, death from paralysis of the brain.

73. Ibid., p. 133.—Woman, age 42; found hanging; a mark around her neck. Did she hang herself or die of other injuries? Opinion, died of other injuries.

74. Rehm: Friedreich’s Blätt., 1883, xxxiv., pp. 322-362.—Man, age 73; found hanging. Opinion, while weak, sick, and suffering from wounds inflicted by his own son, he was hanged by his daughter-in-law.

75. Hofmann: “Lehrbuch,” p. 538.—A father hung his five children, the eldest 9 years. Another man hung two children, the eldest 13 years.

See also Tidy, “Med. Juris.,” Cases 40, 48, 51, 57(?), 58(?); “Hanging after Death,” Case 50.

Judicial Hanging.

76. MacLaren: Indian Med. Gaz., 1873, viii., p. 234.—Three cases of judicial hanging; hung at the same time and cut down and necroscopy begun forty minutes afterward; drop twelve inches. In the first and third there were reflex movements for a few minutes after drop fell. First man, age 40; pupils slightly dilated; no protrusion of tongue or eyeballs; mark of cord above thyroid cartilage; no discharge of semen or fæces; ecchymosis under cord, left side; dislocation of atlas from axis; odontoid ligaments ruptured; transverse ligament uninjured. Brain and membranes much congested; clear fluid in lateral ventricles. Lungs collapsed, anæmic; one ounce straw-colored serum (measured) in pericardium; dark fluid blood in both ventricles of heart; liver much congested.

77. Second man, age 16; pupils widely dilated; eyeballs protruding. Marks of cord same as in preceding case. No discharge of fæces or semen. No ecchymosis under cord; dislocation and rupture of ligaments between axis and third vertebra. Brain did not show well-marked congestion. Lungs collapsed and anæmic. One and one-quarter ounces serum (measured) in pericardium. Heart normal; dark blood in both ventricles; liver normal.

78. Third man, age 20; pupils slightly dilated; eyeballs and tongue not protruded. Marks of cord as in preceding. No discharge of fæces or semen. Slight ecchymosis under cord; mark in front of neck. Dislocation of occipital bone from atlas. Brain and membranes much congested. Lungs collapsed and anæmic. Half ounce serum in pericardium. Heart normal; dark fluid blood in both ventricles; liver normal.

79. Cayley: Ibid., p. 122.—Man, age 35; executed by hanging. Scarcely any convulsive movements after drop fell. Necroscopy two hours afterward. No congestion or protrusion or swelling of the tongue; no muscular rigidity or contractions. About half-way around the neck was indentation of cord, obliquely directed; hardly perceptible in front; its surface appeared rubbed and compressed; no discoloration; no ecchymosis under skin. Cord lay across upper part of thyroid cartilage. Larynx and trachea not injured. Fracture and dislocation of upper cervical vertebræ. Lungs collapsed, not congested. Pericardium empty; heart distended, left side with red blood just beginning to clot; right side with fluid black blood. Liver and other abdominal organs much congested. No discharge of fæces or semen.

80. Garden: Same journal, 1880, xv., p. 12.—Man, age 40, weight about one hundred and twenty pounds; drop two feet; was in a fainting condition, and had to be supported; was not probably fully conscious when platform fell. There were spasmodic retractions of arms and legs for about two minutes; forty seconds after the drop his jungeas fell off; his penis was in strong erection, and the ejaculatory movements were seen. Necroscopy one and one-quarter hours after drop fell. Head and limbs cold; eyes open, natural; tongue not protruding; fingers clinched; superficial veins contained fluid black blood. Mark of cord extended from just below left mastoid process, where the knot was applied, across the thyro-hyoid membranes to a place on right side about two inches below ear. There was scarcely a trace of it behind. Skin dark and ecchymosed, but no ecchymosis of subcutaneous connective tissues. No discoloration nor fracture in neck. Subarachnoidal fluid in excess; puncta vasculosa unusually numerous. Under surface of epiglottis reddened and showed two small dark red ecchymoses; mucous membrane of larynx and trachea pale. Lungs showed venous congestion; no infarctions or small ecchymoses; right lung emphysematous; the left showed old firm adhesions throughout. Heart large, flabby, pale, a very little blood in each ventricle; subpericardial ecchymosis one-fourth inch square anteriorly, another larger one posteriorly; extensive pericardial adhesions. Liver and kidneys congested.

81. See two cases of judicial hanging by Wilkie, same journal, 1881, xvi., p. 275.

82. Porter: Archiv. Laryngol., New York, 1880, i., p. 142.—Redemier hung. Drop five feet. Pulse beat rapidly a few minutes, then lessened in frequency and stopped beating in fifteen minutes. During this time there was violent spasm of muscles of thorax and upper limbs. Necroscopy, dark groove around neck crossing larynx just below pomum Adami. Brain congested. Lungs emphysematous. Cricoid cartilage fractured diagonally. Laryngeal mucous membrane showed ecchymosis and œdema. Vertebræ neither fractured nor dislocated.

83. Another criminal hung at the same time had dislocation of cervical vertebræ.

84. Fenwick: Canada Med. Jour., 1867, iii., p. 195.—Man executed; drop six feet; second cervical vertebra torn from attachment to third; medulla torn across; hyoid bone and tongue torn from thyroid cartilage; general congestion of viscera; lenses normal; eyes congested; clot between sclerotic and choroid coats left eye.

85. Dyer: Trans. Amer. Ophthal. Soc., 1866, p. 13.—Man, age 24; weight one hundred and seventy-four and a half pounds; drop three feet; knot under left ear; for two minutes at intervals, slight motion of abdomen, like effort at respiration, and at same time knees drawn up a little. Death speedy and quiet. Cut down at end of thirty minutes. Necroscopy thirty-five minutes after drop. Body and head moist and warm; emission of semen; face livid; upper lid discolored; abrasion of skin under right ear; deep red mark around neck. Eyeballs not prominent; eyelids closed; corneæ dull; pupils a little dilated. Both lenses fractured. Brain normal; spinal cord normal. Heart empty.

86. Dyer: Same Trans., 1869, pp. 72-75.—Man hung. One eye showed fracture of lens, the other lens showed fine lines. A second case showed dislocation of a cataractous lens. A third showed fissure of lens.

87. Green: Same Trans., 1876, p. 354.—Man hung; drop seven or eight feet. Died quietly and without struggle. One-half to one hour after drop fell, eyes were examined. No lesion of capsule or lens.

88. Keen: Amer. Jour. Med. Sci., 1870, lix., p. 417.—Two criminals hung; drop five feet. Hyoid bone fractured in one; no fracture of vertebræ in other.

89. Clark: Boston Med. and Surg. Jour., 1858, lviii., p. 480.—Execution of Magee. Man, age 28; weight 130 pounds. Drop seven to eight feet. No struggle nor convulsion. Urine discharged at once. Seven minutes after drop fell, heart-beat one hundred; nine minutes, ninety-eight; twelve minutes, sixty and fainter; fourteen minutes, not audible; twenty-five minutes, body lowered. Face purple; pupils dilated; eyes and tongue did not protrude. Mark of cord just above thyroid cartilage, a deep oblique furrow except a small space under left ear; knot over mastoid process. Forty minutes, cord and strap removed; body, especially face, became paler. Necroscopy a little over an hour after drop fell. Body pale; skin mottled; small ecchymosis just above line of cord right side. Right sterno-mastoid muscle torn. Hyoid bone fractured; spine not injured. No seminal discharge. Ninety minutes, pulsation in right subclavian vein; heart-beat, eighty per minute; thorax opened, heart exposed; right auricle showed full and regular contractions and dilatations. The spinal cord was then divided. One hundred and twenty minutes, heart-beats forty per minute. These pulsations of right auricle continued at intervals for three and a half hours longer; readily excited by point of scalpel. Heart normal; left ventricle contracted; right ventricle not so; no coagulation. Brain normal; lungs collapsed; liver and spleen congested; mucous membrane of small intestine pinkish; other organs normal. In the discussion, Dr. Gay thought the absence of cerebral congestion was due to the circulation continuing in the left carotid.

90. Hofmann: Wien. med. Woch., 1880, xxx., pp. 477-480.—Man, a criminal, hung; after hanging ten minutes, the body was cut down. Examination half-hour after drop fell. He was resuscitated and partly regained consciousness, but died three days afterward of œdema of lungs after repeated severe convulsions. He had tumors of the neck which probably interfered with the compression of the trachea. See also Allg. Wien. med. Zeit., 1880, xxv., p. 161, and Wien. med. Blät., 1880, i., pp. 423-430; translated in Ann. Mal. Oreill. and Larynx, Paris, 1880, vi., pp. 99-112.

91. Kinkhead: Lancet, and 701-703.—Cases of hanging. In one, the body of the third cervical vertebra was broken across and the two pieces separated; in another case dislocation of second and third cervical vertebræ.

92. Nelson: Southern Clinic, 1885, viii., pp. 198-202.—Two colored men hung; drop five feet. In one there was atlo-axoid dislocation.

93. Dercum: Phila. Med. Times, 1886-87, xvii., p. 368.—Description of the brain of a man executed by hanging.

94. Kirtikar: Trans. M. and P. Soc., Bombay, 1885, vi., pp. 104-107.—Man, age 25, and woman, age 35. Both hanged. Drop nine feet. Knot tied over cricoid cartilage, a little to left side. In falling, the knots slipped to below the ear. There was fracture of the body of third cervical vertebra and rupture of ligaments. The cord was ruptured in each; in the woman in two places—once at the third cervical, the other at the dorso-lumbar junction.

95. Lamb: Med. News, Philadelphia, 1882, xli., pp. 42-45.—Execution of Guiteau. Drop six feet; knot placed under left ear, but slipped to back of head. Yellowish furrow a few lines wide around the neck, directed downward and forward. Sterno-mastoid muscles torn transversely about midway of their length. Thyro-hyoid ligament ruptured; hyoid bone and thyroid cartilage widely separated. Large blood-vessels not injured. No fracture or dislocation of vertebræ.

96. Thomson and Allen: Catalog. Surg. Sec. Army Med. Mus.; specimens 298 to 302.—Execution of Wirtz. Rope one-half inch diameter; drop five feet; knot under left ear. Several slight shrugs of shoulders, after which body was quiet; let down in fifteen minutes. No involuntary evacuation. Face pale, placid. Eyes partly open; pupils dilated; slight injection of conjunctivæ. Mouth open; tongue not protruding. Just above thyroid cartilage extending on right side from median line in front to spinous process was a dirty brown deep furrow with congested walls; on left side a line of discoloration due to direct action of rope. Soft parts above and below the line much swollen, particularly on right side. Larynx and hyoid bone unnaturally mobile. Right trapezius muscle torn; sterno-mastoid divided transversely, leaving an interval of two inches. Slight ecchymoses between muscle and larynx. Ecchymoses on ligamentum nuchæ. Hyoid bone, both greater cornua fractured and dislocated from body; lesions more marked on right side. Several small ecchymoses in vicinity. Larynx not injured. Brain normal. No bloody or frothy mucus in air-passages. Lungs not congested. One drachm of straw-colored serum in pericardium. Heart empty. Abdominal organs normal. Bladder somewhat distended with urine.

See also Tidy, “Med. Juris.,” Cases 1 to 4 and 60.

Accident.

97. Harvey: Indian Med. Gaz., 1876, xi., p. 3.—Boy, age 1½ years; was swinging by two ropes attached to two posts; the ropes became twisted around his neck. Necroscopy showed mark of very small rope in front of neck from ear to ear; mucous membrane of larynx dark; lungs much congested.

98. Hackel: Op. cit., p. 35.—Man, age 19, sitting on a load of wood, with the lines around his neck, fell and was hung by the lines.

99. Biggs and Jenkins: New York Med. Jour., 1890, lii., p. 30.—Case 16; child, 6 months old, sitting on a high chair, fell between the chair guard and seat and was asphyxiated by compression of neck.

See also Tidy (op. cit.), Cases 53 and 54.

SUFFOCATION.

The term suffocation is applied in a special sense to the act and condition of preventing access of air in other ways than by pressure on the neck, as by pressure on the chest, by obstruction at the mouth or nose, by obstruction in the air-passages or on them from neighboring organs, by irrespirable gases, etc.

This article will consider all of these except drowning and irrespirable gases, which are treated of elsewhere by other writers.

Smothering is generally understood to mean the act and effect of stopping the mouth and nose.

Causes.

External Causes.—Overlaying is a frequent cause of suffocation in infants, which in such cases have usually occupied the same bed with one or both parents. In some cases the parents have been drunk or otherwise unable to prevent the injury, and the infant may also be partly stupefied with the alcohol derived from its mother’s milk. Infants are also sometimes overlaid by domestic animals. Again, they have been suffocated by being pressed too closely to the mother’s breast, or by covering with bedclothes, shawls, etc. Noble[883] attributes some cases of asphyxia in the new-born to anæmia of the brain from pressure on the skull by forceps, etc., and recommends as treatment for this condition hanging the child head downward, so that the blood may gravitate to the brain (Cases 12 and 30).

Infants are sometimes smothered for mercenary purposes.

Persons have been suffocated by the pressure of a crowd. Pressure on the chest combined with forcible closure of the mouth and nose was the method of Burke and Williams, in the notorious burking murders (Case 58). The close application of a hand, cloth, or plaster over nose and mouth is of itself sufficient to cause suffocation, especially in children and feeble persons. Pressure on the abdomen crowds up the diaphragm and interferes with breathing. It is very likely that no external mark will be found in cases of pressure on the chest and abdomen, but the lungs will be marbled and emphysematous.

Taking plaster casts of the face and neck without inserting tubes in the nostrils has caused death in some cases. Suffocation often follows the falling of walls, houses, banks of earth, piles of coal or corn or wheat. One may fall into and be imbedded in some mobile substance as coal, wheat, corn, quicksand, or nightsoil, and be suffocated. Infants have been destroyed[884] by burying them in manure, ashes, bran, etc. In these cases there is not only the entrance of the foreign body into the air-passages, but the pressure of the mass against the chest and abdomen.

Internal Causes.—The air-passages may be closed up by foreign bodies within them, or within adjoining organs, especially the œsophagus. A great variety of substances in one of these two ways has caused suffocation: mud, cotton, rags, corn, meat, beans, pepper, potato skins, the fang of a tooth, artificial teeth, buckles, shells, flint, buttons, screws, crusts of bread, bones, fruit, stones, heads of grass, coins, slate pencils, nuts, nut-shells, shot, penholders, worms, fish, etc. (see Cases 6 and 55). Taylor[885] states that there were eighty-one deaths in one year in England and Wales from food in the air-passages.

Should an inspiration occur in the act of vomiting, the vomitus may pass into the air-passages; a similar accident may occur in a person who attempts to swallow and speak at the same time. Infants have been suffocated by inspiring vomited milk. Fitz[886] states that food may pass from the digestive tube to the air-passages after death.

A case of suffocation in an infant by retraction of the base of the tongue is recorded. It has been stated that negroes have committed suicide by doubling back the tongue into the throat, or, as it is called, swallowing the tongue.[887] In giving anæsthetics, the subject being supine, and the head and neck somewhat flexed, the tongue, epiglottis, and soft palate may fall backward and suffocation may follow. Howard[888] states that pulling the tongue forward under such circumstances may reopen the pharynx, but will not lift the epiglottis. The thorax should be raised and head and neck extended backward. He believes that in giving anæsthetics the head should be lower than the shoulders. In order to avoid vomiting no food should be taken for some hours before the anæsthetic.

Cases are recorded of artificial teeth having fallen from the mouth into the air-passages during anæsthesia and sleep, and in epileptic and puerperal convulsions. It would appear advisable that these teeth should be worn only while eating (Case 13).

Hemorrhage from the lungs, from rupture of an aneurism or from injury of the mouth or throat, may make its way into the air-passages and cause suffocation. So also the bursting of an abscess of the tonsils or other part near the air-passages (Case 7).

Œdema of the glottis from scalding or other irritation of the fauces or glottis, or from disease of the kidneys; tumors pressing on some portion of the air-passages; rapid, profuse bronchial secretion in infants; acute double pleuritic effusion; cheesy glands ulcerating into trachea; simultaneous œdema of both lungs—all of these may cause suffocation (Cases 18 and 49). [For cases of enlarged thymus gland, see Hofmann, op. cit., pp. 587, 588.]

Paralysis of the muscles of swallowing, from diphtheria or other cause, predisposes to suffocation. Progressive asthenia in which the muscles are exhausted; injury of spinal cord or pneumogastrics; paralysis of muscles of respiration from the use of curare; the spasms of tetanus and strychnia poisoning; the entrance of air into the pleural cavities with collapse of the lungs—all tend to cause mechanical suffocation either by pressure or by paralysis (for deaths in epileptics, see Cases 1, 10, 11, 33, and 40).

It is not necessary that the air-passages should be absolutely closed to cause suffocation.

The cause of death is more likely to be pure asphyxia, because of the absence of the complicating pressure of the hand or ligature on the vessels and nerves of the neck, and of fracture of larynx or vertebræ.

Symptoms.—Foreign bodies[889] entering the trachea naturally fall toward the right bronchial tube instead of the left because of the size and position of the entrance of the right tube. If then but one tube is involved, the signs will usually be on the right side; whereas if the foreign body stop in the larynx or trachea, both sides will be affected. The latter condition is much more dangerous. The symptoms would be resonance over the lung with the respiratory murmur partly or wholly absent; less mobility; puerile breathing on the unaffected side. In either case there may at first be little disturbance, especially if the shape of the foreign body is such as not to greatly interfere with the access of air; otherwise there may be at once, and almost always will be after a time, more or less urgent dyspnœa. Diminution of the necessary oxygen may cause convulsions, apoplexy, and other brain symptoms. Acute emphysema of the portion of lung not obstructed may follow its forcible distention. The local effect of the foreign body is an irritation which causes spasm and cough. It may be carried upward by the expirations and downward again by each inspiration. Inflammation is likely to appear eventually and may involve the lung. If the obstruction is not complete there may follow periods of alternation of good and bad health, ending perhaps in recovery. The foreign body may be expelled after a greater or lesser interval. On the other hand death may result from secondary causes. In the absence of correct history the symptoms may lead to a wrong diagnosis and inappropriate treatment; as where a patient whose symptoms resulted from the presence of a piece of bone in the larynx, was treated for syphilis. A foreign body may be coughed up from the lung into the trachea and fall backward into the opposite lung.

Partial closure of the larynx, most likely caused by a flat or irregular substance, rather than globular, may cause gradual asphyxia with symptoms of apoplexy, making the diagnosis difficult.

When a foreign body remains a long time in the larynx, spasmodic cough and croupy breathing usually ensue, expectoration tinged with blood, hoarseness, or complete aphonia, pain, dyspnœa, possibly crepitation and dulness over the lungs. The case may end suddenly in death from closure of the glottis, or the foreign body may pass into the trachea and set up a new train of symptoms, or it may be expelled.

The frequency with which foreign bodies in the pharynx or œsophagus obstruct respiration, and the facility with which they may usually be removed, suggest a careful examination. Otherwise the patient may be treated indefinitely for supposed obstruction in the air-passages. Foreign bodies in the œsophagus have perforated into the trachea, and even the lungs, heart, and aorta.

Treatment.

The obvious indication is to search for and remove the obstruction. The means and methods of treatment are fully treated of in surgical works, but may be briefly mentioned here.

Laryngoscopical examination may be necessary. A curved forceps is usually the best instrument for removing the foreign body. A tallow candle may serve to push it into the stomach if there is no bougie at hand. Suction may be used. Sneezing may be brought on by tickling the nostrils; coughing by tickling the glottis; vomiting by irritating the fauces, or by emetic; the body of the subject may be inverted and in this position the fauces may be tickled, or fingers may be passed back into the pharynx. Johnson[892] says that at the moment of inversion the patient should try to take a deep inspiration; this opens the glottis and facilitates the expulsion of the foreign body. The inspiratory current has no appreciable effect in retarding the movement of the foreign body in the direction of gravity.

Noble recommends inversion of the body in new-born infants in which asphyxia may be supposed to be due to anæmia of the brain. Tracheotomy or laryngotomy may be necessary. It may be necessary to administer oxygen. Foreign bodies like beards of grass and fish-heads can be withdrawn only with difficulty because of their sharp projections. Intense suffering and dyspnœa in a robust subject may necessitate venesection. Generally speaking it is better to bring up the foreign body than to push it down into the stomach. Beveridge suggests to blow into the ear, to induce a reflex action and cause expulsion of the foreign body. Cold affusions, artificial respiration, galvanism, frictions of the limbs, artificial heat, stimulants by mouth and rectum, may one or all be needed.

Hamilton[893] says that it is useless to expect good results from electricity if five minutes have elapsed since life appeared to be extinct; Althaus,[894] that three hours after death the muscles will cease to respond to faradization; and Richardson,[895] that a low temperature prolongs the sensitiveness of the muscle.

With regard to insufflation, Le Bon[896] objects to it in asphyxia as being hurtful and not useful. Colin[897] tamponed the trachea of a horse; in four minutes fifty seconds it was apparently dead; the tampon was removed and insufflation practised for fifteen to twenty minutes without effect. He claims that artificial respiration is useless after the circulation ceases.

Fell[898] and O’Dwyer[899] recommend forced inspiration. McEwen[900] uses a tracheal tube by the mouth.

Dew[901] offers a new method of artificial respiration in asphyxia of the new-born; Lusk[902] considers the subject of life-saving in still-births; Forest,[903] artificial respiration in the same; Read[904] discusses Schultze’s method with approval; Duke[905] plunges the infant into hot water; Richardson[906] recommends artificial circulation by injection of vessels, or electric excitation; Jennings[907] recommends the same; Richardson[908] also considers fully the subject of artificial respiration and electrical excitation; Woillez[909] has described and recommended what he calls a spirophore.

After the removal of a foreign body the irritation remaining may cause a sensation as if the body was still lodged.

Death may occur from hemorrhage after its removal.

Post-Mortem Appearances.

These are mainly those of asphyxia. There may also be evidences of external violence, homicidal or accidental, as of pressure on the chest. Persistent deformity, flattening of the nose and lips, and excoriation of these parts may result from forcible closure of mouth and nose.

The SKIN AND CONJUNCTIVA usually show patches of lividity and punctiform ecchymoses; especially lividity on the lips and limbs. The face may be pale or violet; it is often placid, especially if the suffocation is accidental. Tardieu[910] admits that infiltration of the conjunctiva and punctiform ecchymoses of the face, neck, and chest may also be found sometimes in women after severe labor, and in epileptics. He records the result of the examination of those who died from suffocation at the Pont de la Concorde, 1866. The face and upper parts of the trunk were generally light red to a deep violet or black color, with punctated blackish ecchymoses on the face, neck, and upper part of chest.

The EYES are usually congested. Mucus and sometimes bloody froth are found about the NOSE and MOUTH. The TONGUE may or may not protrude.

The BLOOD is usually dark and very fluid. Wounds after death may bleed. According to Tardieu[911] fluidity of the blood is most constant in compression of the chest and abdomen, as also its accumulation in the vessels and right side of heart. Its color varies from red to black.

The BRAIN and pia mater are generally congested. This is said to be invariable if the eyes are congested. Mackenzie in thirteen cases found the brain congested in all.

The HEART varies much in appearance and condition. The right side is often full of blood; occasionally empty. Sometimes subpericardial ecchymoses are found, usually along the coronary vessels. The blood in the heart may be partly coagulated if the agony has been prolonged and there has been a partial access of air, which is gradually diminished. Mackenzie[912] found the right cavities full and the left empty in nine out of thirteen cases. Johnson[913] as a result of experiment on animals claims that when access of air is prevented there is a rise in pressure in the arteries, the right side of the heart fills, the pulmonary capillaries become empty, and therefore the left side of the heart becomes empty. As a result of further experiments[914] he verified his former conclusion, and added that in the last stage of asphyxia there is increased pressure on the pulmonary artery and lessened pressure in the systemic vessels. He thinks[915] that when both sides of the heart contain blood, there is paralysis of vaso-motor nerves and the arteries.

The TRACHEA is usually bright red and often contains bloody froth. The LARYNX or trachea as well as PHARYNX or ŒSOPHAGUS may contain a foreign body. If the latter has been removed the resulting irritation may be seen. The LUNGS are sometimes congested, at others normal; color red or pale. Sometimes one lung only is affected. They may be emphysematous. Mackenzie found them congested in all of thirteen cases examined by him. The lungs of young persons may be found comparatively small, almost bloodless, and emphysematous. Tardieu, Albi, and others believed that the punctiform subpleural ecchymoses indicated suffocation, and were due to small hemorrhages from engorged vessels which ruptured in the efforts at expiration. These spots are usually round, dark, from the size of a pin-head to a small lentil, and well defined. They are not like the petechiæ in the lungs and heart after purpura, cholera, eruptive fevers, etc., nor like the hemorrhages under the scalp after tedious labor, all of which are variable in size. These punctiform spots are usually seen at the root, base, and lower margin of the lungs. Hofmann states (“Lehrbuch”) that they are found in the posterior part of the lungs and in the fissures between the lobes. They are indisputably frequent after death from suffocation, and if well marked either in adults or infants that have breathed, they indicate suffocation, unless some other cause of death is clear. Simon, Ogston, and Tidy, however, have shown that they are sometimes absent in fatal suffocation, and are sometimes present in the absence of suffocation, as after hanging and drowning; in fœtuses before labor has begun; often in still-births, although some of these are probably due to suffocation from inhaling fluid or from pressure. Also in death from scarlet fever, heart disease, apoplexy, pneumonia, and pulmonary œdema. Grosclaude[916] quotes from Pinard, who declares that these ecchymoses are found in fœtuses which die from arrest of circulation. Grosclaude himself made a large number of experiments on animals by drowning, hanging, and strangling, and fracturing the skull. The ecchymoses were found in nearly all the cases.

The ecchymoses are partly the result of venous stasis, which overcomes the resistance of some capillaries; and the latter rupture, partly from the aspirating action of the thoracic wall, the lung being unable to fill itself with air, but mainly[917] from vaso-motor contraction and lateral pressure at the maximum of the asphyxia, the time of tetanic expiration. If the asphyxia is interrupted before this stage, the spots do not appear. Similar ecchymoses may be found under the scalp, in the tympanum, retina, nose, epiglottis, larynx, trachea, thymus, pericardium, in the parietal pleura, along the intercostal vessels, rarely the peritoneum, in the stomach, and sometimes the intestines; and in other parts of the body, especially the face, base of neck, and front of chest; in convulsive affections, as eclampsia and epilepsy, and in the convulsions of strychnia and prussic acid poisoning there may be suffusion and congestion of the lungs though not the punctated spots.

Mackenzie, in thirteen cases of suffocation from various causes, failed to find the Tardieu spots either externally or internally. Briand and Chaudé[918] state that they are less constant and characteristic in those who have been buried in pulverulent substances.

Ogston[919] holds that in infants that are smothered the ecchymoses are found in greater number in the thymus gland; while in adults dying from other forms of asphyxia they were found only once in that gland. The spots are found in clusters in infants that are smothered, but only single and scattered in adults who die from drowning, hanging or disease. They were wanting in the lungs of but one infant.

They may be recognized as long as the lung tissue is unchanged. The apoplectic spots in the lungs seen in strangulation are not found in suffocation.

Tardieu[920] from experiments on animals and examination of twenty-three new-born infants who showed traces of violence around the mouth, found the lungs rather pale and anæmic, subpleural ecchymoses well marked. All the deaths were rapid. In cases of compression of chest and abdomen[921] the congestion of the lungs was extensive, and pulmonary apoplexy frequent; more so than in other forms of suffocation. He gave strychnia to animals which died in convulsions, and found very irregular and partial congestions, generally not marked because death was so prompt; blood always fluid; no subpleural ecchymoses.

The LIVER, SPLEEN, and KIDNEYS are generally congested; the kidney more than the other organs named. The spleen is said to be often anæmic. Semen has sometimes been found, unexpelled, in the urethra.

Page[922] experimented on three kittens, suffocating them in cinders. The post-mortem examinations showed the veins engorged, left side of heart empty, right side full of dark, half-clotted blood. Lungs distended, much congested, color violet; many small fluid hemorrhages in substance; no subpleural ecchymoses. Frothy mucus tinged with blood in trachea and bronchi; bronchi congested. Brain and abdominal organs normal.

Proof of Death by Suffocation.

It is sometimes difficult in a given case to state WHETHER DEATH IS DUE TO SUFFOCATION. There is no lesion which of itself could be accepted as proof. But a collation of the lesions found taken in connection with the surroundings of the body will in many if not in most cases lead to a definite conclusion.

Infants have been found alive four and five hours after having been buried in the earth.[923] If the pulverulent material has penetrated into the œsophagus and stomach, the burial has occurred during life. Exceptionally when burial has occurred after death and traces of the material are found in the air-passages, they are not found in the œsophagus or stomach.

The committee on “Suffocation,” of the New York Med. Leg. Soc., reported[924] the following group of appearances as evidences of death by suffocation: The general venous character of the blood, the turgidity of the larger veins, the congestion of the parenchymatous organs, especially at the base of the brain, the lungs congested in a variable degree and œdematous, frothy mucus in the bronchi, the right side of the heart always fuller than the left. Fitz[925] holds that suffocation is a condition composed of a group of symptoms and appearances due most probably to accumulation of carbon dioxide in the blood and a deficiency of oxygen. The appearances are: The blood dark and fluid (though in gradual suffocation there may be clots in the right side of the heart), the right side of the heart full, venous congestion of the lungs (not constant), interstitial emphysema of the lungs, and venous congestion of the liver, kidneys, and brain. He prefers the word engorgement to congestion in this connection.

Tardieu[926] holds that when in infants buried in pulverulent substances we find emphysema of the lungs in high degree, bloody froth in the air-passages, abundant subpleural and subpericardial ecchymoses and the blood fluid, the burial has occurred during life. The same lesions are found in small animals similarly treated.

It must not be forgotten that an intoxicated person or one in an epileptic spasm is practically helpless, and can, therefore, be suffocated, accidentally or otherwise, under circumstances in which one in possession of his senses would be able to escape.

Accidental, Homicidal, and Suicidal Suffocation.

Accidental suffocation is frequent, as has already appeared. Suicidal suffocation is very rare. Homicidal suffocation occurs. Foreign bodies have been forced into the air-passages. Smothering has been done by holding the face in various materials to prevent access of air; by pressure on the chest; by forcible closure of the mouth and nose as in burking; by laying compresses over the face, as in the case of King Benhadad,[927] whom Hazael killed. “And it came to pass on the morrow that he took a thick cloth and dipped it in water, and spread it over his face so that he died; and Hazael reigned in his stead.” Benhadad was already quite ill and not expected to live.

Death by suffocation[928] may be considered as presumptive of homicide unless the facts are already referable to accident.

In infants, suffocation is, of course, either accidental or homicidal; in adults usually accidental. The absence of signs of a struggle in adults suggests accident; unless there is cause of suspicion of previous stupefying with narcotics.

Taylor[929] calls attention to a dangerous practice among some attendants upon infants, of putting into the mouth of the child to quiet it a bag containing sugar; and instances a case in which the child would have died of suffocation but for the fortunate discovery of a part of the bag protruding from the mouth.

In ten years, 3,612 deaths were reported in the city of London, of infants smothered by being overlaid.[930]

Infants may be born into a mass of blood and fæces, from which the unattended mother in her weakness may be unable to remove them.

Page[931] shows by experiment that the inspiratory effort when violently exerted is sufficient to convey small objects into the air-passages. Cinders passed thus into the trachea and œsophagus of kittens and rabbits. Berenguier[932] experimented on new-born pups, placing them in ashes, plaster, and starch. In ashes they lived fifteen hours; these found their way into the middle of the œsophagus, but were stopped at the glottis. Plaster and starch formed a paste with the oral mucus and the movement of the mass was not so great as the ashes. In no case did either of the materials pass beyond the glottis. Tardieu[933] examined three infants which had been buried during life. One was in ashes: the nose was obstructed, mouth full: ashes also in the œsophagus and stomach, but none in larynx or bronchi. The second infant was in manure; a greenish stuff was found in the mouth and stomach. The third in bran (confessed to by the mother); the nose and mouth were full, but there was none in the throat; a few grains in the trachea. Tardieu experimented on rabbits and Guinea pigs by burying them in bran, sand, and gravel, some of them being alive and the others dead. In those buried alive he found the substance filling the mouth and nose to the base of the tongue; in most of the cases the œsophagus and trachea were not penetrated. In the animals first killed and then buried, the substance had not passed into the mouth or nose. In one case only he found ashes in the larynx and trachea of a rabbit which had been buried many hours after death in a box of ashes. Matthyssen[934] held a Guinea pig, head downward, with its nose under mercury; the lungs were full of globules of mercury (which has a specific gravity of 13.5). A dog was plunged head first into liquid plaster-of-Paris; the plaster was found in the bronchial tubes.