Mechanism of Death in Hanging: A Historical Review of the Evolution of Pathophysiological Hypotheses

Abstract

In cases of hanging, the exact mechanism leading to death has yet to be elucidated. Most of our contemporary knowledge is still based on writings from the end of the 19th and the beginning of the 20th century. This article reviews the historic experiments that shaped our current theories. Medico-legal textbooks written in English and French from 1870 to 1930 were reviewed. Various animals, such as rabbits, mice, and dogs, have been used to develop animal models of hanging. Limited human studies on cadavers and judicial hangings have provided some additional insight into the pathophysiology of death by hanging. The main pathophysiological theories described were respiratory asphyxia, interruption to cerebral blood flow because of occlusion of vessels in the neck, and cardiac inhibition secondary to nerve stimulation. The relative contributions of each of these theories to death in cases of hanging is still debated today.

Agonal Sequences in 14 Filmed Hangings With Comments on the Role of the Type of Suspension, Ischemic Habituation, and Ethanol Intoxication on the Timing of Agonal Responses

“…2Y4 This explanation of the mechanism of death is largely based on old writings and experimentation from the end of the 19th century and beginning of the 20th. 5 Apart from a few animal studies that gave very limited information on the pathophysiology of hanging in human, 6 there was slight new development on this issue until the recent studies on filmed hangings by the Working Group on Human Asphyxia. 7,8 In a series of 8 filmed hanging, it was demonstrated that all cases demonstrated deep rhythmic abdominal respiratory movements.…”

An overview of the mechanical asphyxia with the main emphasis on hanging

“…Sudska medicina, pogotovo forenzična patologija, stoljećima se doživljavala više kao umjetnost nego kao znanost. Međutim, dio našeg znanja još uvijek dolazi iz tog doba 16 .…”

“…Većina današnjeg poznavanja patofiziologije vješanja i gušenja temelji se na europskim istraživanjima s kraja 19. i početka 20. stoljeća. U Francuskoj je 1870. g. Tardieu otkrio da je asfiksija mehanizam smrti kod vješanja 16 . Bio je uvjeren da je asfiksija uzrokovana začepljenjem traheje, a ne krvnih žila vrata.…”

Three Nonlethal Ligature Strangulations Filmed by an Autoerotic Practitioner

“…1 In ligature strangulation, the pressure on the neck is applied by a constricting band tightened by a force other than the body weight, whereas in hanging, the constricting band is tightened by the gravitational weight of the body or part of the body. 2 Since then, judo-related studies have given some insight into the pathophysiology of manual strangulation. If a strangulation case cannot be subclassified in any of these 3 types, it should be categorized as strangulation NOS (not otherwise specified).…”