Hanging (self-suspension) is a type of asphyxia in which the body is suspended by a ligature encircling the neck and the constricting force is the body’s weight.

Types of Hanging

According to degree of suspension:

1. Complete Hanging: The body is completely suspended in air, with no part of it touching the ground.

2. Partial Hanging: The body is partially suspended, with only head and chest off the ground with the toes or feet or other body parts contacting the ground. Head (5 to 6 kg), chest and arm weights act as constrictors in such circumstances.

Depending on position of the knot:

1. Typical Hanging: The ligature runs above the thyroid cartilage symmetrically and go upward on both sides of the neck to the occipital region and the knot is behind the central region of the neck.

2. Atypical Hanging: The knot is anywhere other than previous position. i.e. on the right side, left side, front side, back side of the neck.

In the cases of hanging body is hung by rope, cord, dhoti, chunri, saree, scarf, wire, or any other material which can be used as ligature material . The occurrence of such cases can be indoor or outdoor.

Hanging may be suicidal, accidental, homicidal. Suicidal Hanging is most preferred method for suicide.

Causes of Death

  1. Asphyxia.
  2. Venous congestion.
  3. Combined asphyxia and venous congestion is the
    most common cause of death.
  4. Cerebral anemia.
  5. Reflex vagal inhibition.
  6. Fracture or dislocation of the cervical vertebrae

Fatality Time

• The usual period is 3 to 5 minutes.
• Fatal hypoxia takes place when O2 level fall below 20% of normal.

Postmortem Appearance

External Features

• The ligature mark in the neck is the most important and specific sign of death from hanging. The ligature mark is situated above the level of thyroid cartilage between the larynx and the chin in 80 % cases, it is obliquely placed; does not completely encircles the neck.

• Usual signs are pale or congested face;

• Open, closed or partially open-eye which is typical symptom of hanging (la facie Sympthaquie);

(‘La Facies Sympathique’ with right eye remaining open with dilated pupil and the left eye closed with small pupil (Lopes C, 1945, Portugal Medical, 29, 361). This may be due to pressure upon the cervical sympathetic, the eye on the same side remaining open and pupil dilated.)

• Tongue protruded or between the teeth;

• Elongated neck;

• Urine or faecal may be passed;

• Seminal traces from male genitals and blood mixed fluid in case of female genitals.

• Post-mortem lividity;

• V shaped ligature mark or incomplete ligature mark going upward;

• Minor periligature injuries;

• Parchment like skin present below the ligature mark and impression of ligature itself on skin etc.

• Skin present just below the ligature mark becomes parchment like or dried and impression of ligature may also present in neck confirming the ligature material.

• In true suicidal hanging the rope moves from above downwards.

Internal Features

• Hyoid bone is fractured in 15-20% cases and seen in persons above 40 years.

• Most common site of fracture of hyoid bone in hanging is at the junction of the inner two third and outer third of greater cornu (cf. Inward compression fracture or Adduction fracture seen in case of throttling).

Judicial Hanging

• Legal death sentence is carried out by hanging the criminal in India.

• The cause of death in judicial is (Brainstem Damage).

• The knot is placed below chin (most efficient method), the length of rope from the point of suspension is equal to the height of individual. There is a sudden drop, resulting in fracture and dislocation of Upper Cervical Vertebrae (Fracture of C2 from C3, rarely C3 and C4).

Crime Scene Investigation In Case of Hanging

During crime scene investigation an investigators should look for following points in hanging cases:

• Investigator should check to see if the victim is dead or alive, and if they are, take them to a hospital right away.

• If the victim is deceased, photograph the victim and the crime scene before lowering the body by cutting the ligature without disturbing the neck knot or the knot at the point of anchor.

• It is important to make a note of the type of knot. It is a slippery knot, a simple loop knot, or a non-slipping knot.

• Investigator also should take note of the body position, appearance, and other distinguishing features, as well as the search for a support used to reach the point of anchor used for hanging.

• Investigator should note of the height of the person, the support, and the point of anchor to determine whether or not the point of anchor is within the victim’s reach.

• Investigator should note the victim’s or deceased’s finger and foot prints near the place of anchor and over the support, respectively.

• Look for a suicide note and other corroborating evidence.

• Send the body to further examination.


A Textbook of Medical Jurisprudence And Toxicology By Rai Bahadur Jaising P. Modi

Review of Forensic Medicine and Toxicology by Gautam Biswas

Review of Forensic Medicine Seventh Edition by Dr. Sumit Seth

The Essentials Of Forensic Medicine And Toxicology By Dr. K.S. Narayan Reddy

Clinical Forensic Medicine Edited By Margaret M. Stark