Q: I’ve got a couple of questions about hanging. I have a 140-pound man of slight build who has been hanged. His neck is not broken and thus he is strangling. His hands are bound. How long might he survive before death? Would he lose consciousness well before or shortly before death? If he is taken down before death, we would certainly see abrasion of the neck. What else would we see? If unconscious, would he revive quickly? Could his injuries be life-threatening? (I’m thinking of throat swelling here) I am looking at pre-modern society here. No ER or modern medicine.
A: In hangings, death results from asphyxia, which is the reduction of oxygen to the brain. Asphyxia in hangings results from the compression of the airways and the carotid arteries (the arteries on either side of the neck that carry blood to the brain) by a noose or other ligature that is pulled tight by the body weight. Thus, the victim must be completely or partially suspended.
Though the airway can be compressed and breathing can be interrupted, the real cause of loss of consciousness and death in most hangings is compression of the carotid arteries, which blocks blood flow to the brain. Except for judicial (legally directed) hangings, fractures of the cervical vertebrae (spinal bones of the neck) are uncommon. The reason is that these fractures require that the body drop a sufficient distance to break them. How far is this? The answer depends upon several factors. Individuals who are obese, have small neck musculature, or who have arthritis of the cervical spine may suffer neck fractures quite easily. Just the opposite is true for muscular, thick-necked persons. In judicial hangings, these factors are considered in gauging the distance of the drop. Too little drop and the condemned person is strangled to death, too far and he could be decapitated.
The neck markings seen after hanging depends mainly on the nature of the noose used. Soft nooses such as sheets may leave little of no markings. Bruises and abrasions are not common with softer devices. In fact, if the victim uses a soft noose and if the body is discovered fairly quickly and cut down, the ME may not be able to find any marks at all. A rope or cord may leave a very deep, distinct furrow in the victim’s neck. The longer the body hangs, the deeper the furrow. Abrasions and contusions are more common with these types of nooses. Occasionally the furrow and any associated bruising may reveal the braid pattern of a rope or the link configuration of a chain.
In hangings, the furrow and the bruising will follow a typical course. The pattern is that of an inverted V. The furrow tends to be diagonal across the neck with its high end where the knot is located. The knot is usually to one side. This means that if the knot is to the victim’s left side, the furrow will be lower on the neck and much deeper on the right side and will angle upward toward the left ear. Near the knot, the furrow may shallow and disappear. This pattern is due to the body hanging by the “bottom” of the nose.
Okay, enough about hangings, let’s get to your situation. Since the asphyxia is due to compression of the arteries and not the prevention of breathing, loss of consciousness occurs very quickly, usually in a minute or less and maybe as short as 20 seconds. The brain needs a continuous supply of blood and when this is interrupted, consciousness is lost quickly. Death may take from 1 to 5 or 6 minutes.
If your victim is found within 2 to 3 minutes, he would be unconscious but could wake up fairly quickly—a couple of minutes. Or not. Some people die in a minute while others can take many minutes. Go with a couple of minutes but not longer and you’ll be OK. He would probably have the typical V-shaped bruises on his neck and a furrow that would resolve over a half hour or so.
He could return completely to normal or be left with brain damage or even remain in a coma for hours, days, weeks, months, years, or forever. It all depends upon how long the brain was deprived of blood and luck. This varies from person to person.