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

Authors

  • Renaud Clément M.D., M.Sc.,

    1. Laboratoire de sciences judiciaires et de médecine légale, Edifice Wilfrid-Derome, 1701, Parthenais street, 12th floor, Montreal, QC H2K 3S7, Canada.
    2. Laboratoire de médecine légale, Faculty of Medicine, Nantes, 1 Gaston Veil street, 44035 Nantes Cedex 1 France.
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  • Margaret Redpath M.D.,

    1. Laboratoire de sciences judiciaires et de médecine légale, Edifice Wilfrid-Derome, 1701, Parthenais street, 12th floor, Montreal, QC H2K 3S7, Canada.
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  • Anny Sauvageau M.D., M.Sc.

    1. Laboratoire de sciences judiciaires et de médecine légale, Edifice Wilfrid-Derome, 1701, Parthenais street, 12th floor, Montreal, QC H2K 3S7, Canada.
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Additional information and reprint requests:
Anny Sauvageau, M.D., M.Sc.
Office of the Chief Medical Examiner
7007, 116 Street
Edmonton, AB T6H 5R8
Canada
E-mail: anny.sauvageau@gmail.com

Abstract

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.

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