Violent asphyxial

deaths
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.
 Types of violent asphyxia

1. Hanging
2. Strangulations
3. Drowning
4. Suffocations
 Hanging
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.
The constricting force is either the weight
of the whole body or the weight of the
head alone.
Types of hanging(on the basis of
the position of the knot used)

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 (according to
the degree of suspension)

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. In
this variety 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(hanging in kneeling position),
sometimes the buttock(hanging in
sitting position),may be in touch with
the ground.
 Partial hanging is taken
to be diagnostic of being
suicidal in nature.
 The ligature materials in
cases of hanging
The ligature 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,
bedsheet, scarf, cycle chain or any such
thing.
 The knot
The knot may be a fixed
one(double or more), or it
may be a slipping knot or a
running noose.
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.
1. Asphyxia along with 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.
– 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.
This distribution 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. Homicedal hanging is rare.
It is not ordinarily possible
with an adult victim, if he is not
intoxicated or not made
uncinscious by some other
means, like head injury.
Alternatively, the victim is
either a child or a very
deilitated 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. Similar deaths may occur
in case of a trapeze player
when his grips slip and his
chin gets entangled on the
swinging sling.
–3. 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.
–4. 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.
–5. Children while
playfully acting judicial
hanging, may actually
be hanged to death.
–6. 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
either naked or female dress
with pornographic pictures 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.
– 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.
–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.
– 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
Hanging by ligature
strangulation by ligature
(1)Ligature oblique, encircling the neck transverse, encircle the neck
mark uncompletely, high up the completely, below the thyroid
neck,between the chin and cartilage. The base is soft and
larynx. The base is pale, reddish.
hard and parchment-like.

About the edges of ligature

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

(6) Hyoid bone Fracture may occur Fracture is uncommon

(7) Thyroid Fracture is less common. Fracture is more common

cartilage

(8) Larynx and Fracture rare Fracture may be found

trachea
 Table. Difference in postmortem
appearance between hanging and
strangulation
Hanging
by Strangulation
ligature by ligature
(9) Not present on the Very common on the surface of
Emphysematous surface of the lungs. the lungs.
bullae

(10) Carotid Horizontal intimal tear Horizontal intimal tear is rare

arteries may be seen

(11) Face Usually pale and Congested, livid and marked with
petechiae are not petechiae.
common.
 Table. Difference in postmortem
appearance between hanging and
strangulation by ligature
Hanging Strangulation by
ligature

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

asphyxia marked.

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

Often runs out of mouth

(14) Saliva Absent
 Medicolegal aspects of
strangulations

 Strangulations in their face

value are homicidal in
nature.
Inhomicidal 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
apasm, 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
This is 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,sodden,
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.
4.Presence of sand and
mud in the lower
respiratory tract is more
important than their
presence in the upper
respiratory tract.
5. 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.(aqueous
emphysema)
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.
8. Laboratory findings-
(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 due to drowning but
there are fallacies.
(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.
On the other hand,
diatoms may not be
observed in the tissue,
even if drowning was
antemortem and the
water contained diatom.
If diatoms 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
Of all 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
 Increaseblood volume(even up to
70%)due to haemodilution, haemolysis
with absolute and relative decrease in
R.B.C.count, increased potassium level in
the 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.