A State in which
 Body Lacks O2
or
 Defective Aeration of Blood
Most important cause –
Mechanical Interference with Respiration
Deficient
Oxygenation
ASPHYXIA
1
Reduced
Pulmonary
Blood Flow
Vicious Circle
of
Asphyxia
Reduced Venous
Return To Heart
Pooling
of Blood
Capillary
Dilatation
(A)Non- Specific – Parenchymal Degeneration of Tissues
(B) Specific
1) Cyanosis (Bluish Discoloration)
Due to · Decreased O2 tension in bld &
· Increased reduced Hb
Becomes apparent when at least 5 gm of red. Hb is present
Blood is Purple / Dark in color.
Bluish color is Marked over: areas of PM Staining, Lips,
organs with abundant capillary & venous bld (Lungs, Liver,
spleen, kidneys)
2.
Increased Capillary Permeability

Blood transudes into tissue spaces - Gelatinous
Moistening of Organs.

Excess Fluid in Serous Cavities (Pleura & Pericardium)

Tissue Edema (Mediastinum & Lungs)
3)
Petechial Hemorrhage / Tardieu Spots
French Police Surgeon described them in 1866
Mechanism:
Anoxia – Blood Stasis - Increased Capillary Permeability
& Raised Intracapillary Pressure
Dark Red,
Well defined,
Round,
Pin-head sized
3)
Petechial Hemorrhage / Tardieu Spots
Present at sites where capillaries are least supported
[Face, Conjunctiva, Meninges, Serous Surface of Heart
& Lungs]
Pronounced in areas where Intracapillary pressure Rises rapidly
- Above the Level of Neck Constriction
Better appreciated in
- Fair Skinned Persons &
- Fresh Dead Bodies
Presence of Tardieu spots - Not diagnostic of asphyxia
May be found in:

Bleeding Disorders,

Coronary Thrombosis, Electrocution, Poisoning,

Anticoagulant Therapy, Thrombocytopenia.
But in these cases - Distribution is Generalized.
Absence of Tardieu spots - Does NOT Exclude Asphyxia
If Dead Body is suspended for Long time - Gravitation of
blood in dependant body parts – Over distension - Rupture of
Capillaries.
Present on Hands & Legs
Features:
1.
Larger
2.
Less Circumscribed
3.
Does NOT appear on - Serous Surface of Heart & Lungs
Cessation of Respiration due to Mechanical Force (violence)
1.
Hanging
2.
Strangulation
a. Ligature - Strangulation
b. Manual - Throttling
3.
Suffocation
4.
Drowning
Type of Violent Asphyxial Death in which
body is suspended with Ligature around Neck
resulting in Constriction of Air passages
preventing Exchange of air between Lungs & Atmosphere
Based on Position of Knot
1. Typical
Knot - At the Nape
2. Atypical
Knot - At any site other than Nape
Commonest site Angle of mandible or
Mastoid Process
Complete Hanging
Body is - Fully Suspended
NO Body part touches the ground.
Constricting force - Weight of body
Incomplete / Partial Hanging
Body is - NOT Fully suspended
some Body part touches the ground.
Some Body weight is transmitted to ground
through the part touching the ground
Depends on - Effect of Neck Compression
If Pressure on Larynx is prominent
Symptoms of Asphyxia Predominate.
Respiratory Distress, Cyanosis,
Convulsions, Confusion,
Ringing in the ears.
Pressure on Jugular Vein
Severe Pain on the side opposite the knot
Pt. Hemorrhages on Forehead, Eyelids & Conjunctiva
Pressure on Carotid Artery
Immediate Unconsciousness
Failure of Resp. Center (reduced blood supply to brain)
Asphyxia & Apoplexy - simultaneous pressure on Larynx &
Jugular Vein
Asphyxia alone
Apoplexy alone
Cerebral ischemia (pressure over carotid & vertebral A
Vagal shock: Inhibition of heart due to vagal stimulation.
Injury to medulla (Fracture dislocation of C2-C3 Vertebrae)
Force of constriction required to occlude:
Jugular Vein ------------2Kg.
Carotid Artery -----------3.5 Kg.
Trachea -------------------15 Kg.
Vertebral Artery ---------16.5 Kg.
Fatal Period
About 3-5 minutes
Instantaneous - Fracture dislocation C.Vertebrae – medulla injured
Occlusion of Carotid & Vertebral A - Fatal Period is shorter
Death due to Asphyxia
- Fatal Period is longer
Post Mortem Changes
External Findings
Face - Pale, Congested, Swollen, Pt. hm.
Eyeballs - Prominent due to congestion.
Tongue - Protrude – due to Pressure at its base
Exposed part of Tongue - Dark Brown / Black
Salivary stains at Angle of Mouth opposite to the Side of Knot
(due to Dribbling of Saliva)
Neck – Stretched,
Head - Inclined opposite to the side of knot
PM staining –
Circumferentially on dependant parts of Arms & Legs,
Face & Neck above the ligature.
Bluish discoloration of Hands, Nail Beds & Lips.
Tardieu Spots on Forehead, Eyelids & Conjunctiva.
Involuntary Discharge of Semen & Fecal matter.
Pressure Mark around the Neck.
Abraded Contusion
Immediately after Death - Appears as Pale Groove.
Later - Yellowish Brown, Dry, Hard, Parchment like.
Edges of Groove - Hyperemia & Pt. hm.
Situated - Above the level of thyroid cartilage &
directed obliquely upwards along the line of mandible &
Reaches Mastoid Process behind the ears.
Non-continuous (Incomplete)
May be absent at - Back of Neck or Below the Knot.
1.
Ligature Material
Tough & Narrow – Prominent Mark
Soft & Broad – Faint Mark
2.
Period of Suspension:
Longer Period - Deep & prominent mark
3.
Degree of Suspension:
Complete Hanging – Mark is Prominent
4.
Body Weight :
Heavy Body: Mark is Prominent.
5.
If something intervenes between L. material & Neck -
LM is Less Prominent.
4.
LM also depends on Number of turns around the Neck
Larynx & Trachea - Congested.
Larynx, Trachea, Pleura - Petechial Hm
Internal Organs - Congested.
S/C tissue underneath L. Mark - Dry, Pale, Firm & Glistening
Platysma & Sternomastoid Ms - Injured
HANGING
Ligature
Strangulation
Fracture Hyoid Bone
Less common in Hanging than Throttling

Hyoid bone m/b fractured in persons > 40 yrs

# Greater Cornua – at Junction of Inner 2/3rd & outer 1/3rd

Fractured Ends - Displaced Outwards.

Carotid Arteries - Transverse Tear in Tunica Intima.

Lymph Nodes Above & Below LM - Congested.

Judicial Hanging - # Dislocation of C2-C3 / C3-C4
Ante-mortem or Post-Mortem ?
Ante-mortem Hanging
1. Dribbling of Saliva (Angle of Mouth)
2. Pt. Hm. & Ecchymosis underneath LM
3. Carotid A. - Tear in Tunica Intima,
- Extravasation of bld. within the vessel wall
4. Congestion & Hm of Lymph Nodes - Above & below LM
Suicidal, Homicidal or Accidental
Hanging - Most commonly Suicidal
Partial hanging - Almost always Suicidal
Signs of Struggle – Absent, However self Inflicted injury/due to
convulsions may be present
Homicidal – Rare
Lynching - Mob kills a person by hanging him publicly.
Accidental Hanging – Rare
Fall from Height – Victim get hanged on a Rope / Neck-tie
Children - while playing (imitate Judicial Hanging)
Sexual Asphyxia / Auto-Erotic Hanging
Sexual perverts get Sexual gratification by Partial Asphyxiation
Place a Noose around his Neck &
Pulls other end of rope across a pulley (create Partial Asphyxia).

After gratification - releases the pull.

May become semi conscious and unable to release the pull
- Dies due to Asphyxia.

Victim - Naked / Dressed in Female dress
pornographic literature lying along.
Violent Asphyxial death caused by
constriction of Neck by means other than body weight
Strangulation
Ligature
Throttling /
Manual Strangulation
Hand
Mugging
Elbow / Knee bent
Bansdola
Stick
Cause of Death - Same as Hanging.
Postmortem Appearance
Asphyxia, Face - Congested & Cyanosed.
Eye balls - Prominent.
Tongue – Protrudes, may be Bruised & Bitten.
Tardieu Spots – Abundant
Sub Cunjunctival Hemorrhage.
PM staining - Dark & Prominent.
Injuries on other Body Parts - Due to Struggle
Neck injuries
L Mark - At or Below Thyroid level
Horizontal, Encircles the Neck Completely.
May be Absent at Back (due to hair / cloth)
May be Oblique – If victim is Dragged with Ligature or
Strangulated in Recumbent Position.
S/C Tissues under LM – Ecchymosis
Neck Ms, Laryngeal Cartilages, Trachea, Carotid A. - Injured
(injury more extensive than Hanging)
Superior Horn of Thyroid Cartilage – Commonly Fractured
Hyoid Bone Fracture: Rare (Level of constriction is Below Hyoid)
Hyoid Bone Fracture may be present if
1. Excessive force is used
2. Age more than 40 yrs
Broken Fragments are displaced outwards.
Homicidal - Most Common
Knot – At Back of Neck.
Mouth – Gagged; Limbs – Tied
Signs of Struggle – Present
In Females – Signs of Sexual Assault
Infanticide - by passing Umbilical Cord around the Neck.
Suicidal – Rare
Knot – usually at Front
Using such a Method - that ligature remains Tight without
any victim’s effort.
Accidental – Rare
Neck tie / Scarf - Caught in moving machinery
Strap placed on Head may slip
and compress the Neck
During Birth – Umbilical Cord gets twisted
around the Neck
PM Findings
Signs of Asphyxia - Petechial Hemorrhages
Asphyxial Signs are minimal in Cardiac inhibition due to
Pressure on Carotid Sinus / Vagus N.
Tongue – Protrude; may be Bitten
Eye Balls Prominent.
Signs of Struggle
Neck- Bruises - Oval & Larger (thumb)
- Multiple & Smaller (Fingers)
Neck - Scratch marks (Multiple, Crescent shaped)
Internal Findings
S/C Tissues underneath Bruises & Nail Marks – Hemorrhage
Superior Horns of Thyroid Cartilage Fracture - More common
than Hyoid Bone Fracture.
Hyoid Bone Fracture common in persons > 40 yrs.
Internal Organs – Congested.
Homicidal - Almost Always
Accidental - Rare - Sudden holding of neck - Vagal Inhibition
Suicidal - Extremely rare
- Self Throttling is Impossible - as victims becomes
Unconscious - Hands Relax and Grip is released
Ante-mortem Throttling
1.
Bruises on the Neck
2.
Swelling of Tissues at and above the level of Compression
3.
Bruises of Larynx, Trachea, Surrounding Muscles of Neck
4.
Fracture - Thyroid cartilage & Hyoid Bone - Hemorrhage at
the Fractured ends.
5.
General Signs of Asphyxia
Mugging / Choke Hold
Strangulation by Compressing Neck with Elbow / Knee Bent
Garroting
Victim is Strangled by throwing a
Ligature over the Neck from back and Tightening it quickly.
Loss of consciousness – Rapid.
It can kill a Strong man without any Sign of Struggle
Bansdola
Neck is Compressed between 2 bamboo sticks (one
placed in front & other behind the neck).
Sticks are tied at one end & a rope is passed at the other
end to bring the sticks together
Neck can also be compressed with one stick against the
ground.
Exchange of Air between Atm. & Lungs is prevented
by means other than Neck Constriction &
Drowning
Types:
1. Smothering
2. Choking
3. Gagging
4. Burking
5. Traumatic asphyxia
Smothering
Air exchange is prevented by - closure of Mouth & Nostrils
PM Findings
homicide - Nail Marks & Contusions around mouth & nose
(Absent if a cloth is used)
Inner side of Lips & Gums- Abrasion, Contusion, Laceration
Fracture Nasal Cartilage. Bleeding from nose.
Fracture dislocation of teeth.
Signs of Struggle on other body parts
Accidental Smothering
Abrasion, Contusion, Laceration around mouth & nose and
Injury on inner side of Lips & Gums - May be present
Fracture Dislocation of Teeth.
Signs of Struggle - ABSENT
In epilepsy - Tongue bitten & injury to other body parts
Fall on Dust / Flour – Traces of these materials present in
Mouth & Nose

Smothering due to masochistic activity
circumstances :-
Pornographic Literature,
Exposed Private Parts,
Wearing Dress of opposite sex
Method used for Self Smothering
Suicidal Smothering
Pillow tied around Mouth & Nose
Plastic Bag around Head
Local effect of pressure but NO remarkable injuries.
Medicolegal Aspects of Smothering…
Accidental (Most Common)
Alcoholics / Epileptics –
Fall on Bed - Burry their Face in Bed - Fail to revert
to favorable posture (Postural / Positional Asphyxia)
Accidental Smothering
Child Birth - Placental Memb. adhere Mouth & Nose
Overlaying - Mother rolls over the baby during sleep.
Children - while playing with Plastic Bags.
Accidental Smothering
Sexual perverts - Cover their head with plastic bags.
Glue Sniffing (Solvent Abuse)
Victim re-breathes plastic bag contents (glue)
Glue solvents (Xylene) induce drowsiness
Moisture accumulates in plastic bag –
Bag adheres to mouth & nose – Breathing is blocked.
Cause of Death – Asphyxia or
Arrhythmias (Halogenated hydrocarbons in solvent)
Trauma to Chest, Abdomen / Back - Prevent Resp. movement
E.g
House Collapse, Stampede,
Run over by Vehicle,
Fall of Earth on Trench workers
PM Findings
Signs of Asphyxia.
Deep Cyanosis of face, Numerous petechiae
Demarcation Line b/w discolored Upper Body and
Normal Lower Body.
Chest Compression–Back pressure-Displace blood in opp.
Direction (From SVC to Head & Neck Veins - No valves in SVC)
Valves in Subclavian Veins – Prevents blood to enter Veins of
Upper Limbs.
Pressure on ChestBlood Flows in Opposite Direction
Blood unable to cross the Valve
Blood cannot cross the Valves
Gets pooled in Head & Neck, Upper part of Chest
Face & Neck – deeply Cyanosed
Eyes – Blood Shot
Petechiae – Scalp, Face, Neck & Shoulders
Heart & Lung – Injured
Ribs – Fractured (Bilaterally at the angles)
Other Body parts - Injuried (depending on cause of Trauma)
Most Commonly Accidental
Mothers – Roll over a baby - Traumatic Asphyxia
Can be Homicidal (Burking Phenomenon)
Lumen of Air Passage occluded by :Foreign Material / Pathology in Resp. Tract or Esophagus.
Size of Object – NOT Important
Object smaller than lumen may cause spasm of Air passage
Cause of Death
Asphyxia, Vagal Inhibition,
Laryngeal Spasm / Bronchospasm
PM Findings:
Asphyxial signs.
On Autopsy - Cause of Choking may be found.
Chocking is most commonly Accidental
May occur due to Foreign material in Air Passages
Inhalation of Vomitus –
due to Drunkenness, Anesthetic agent, Epilepsy or Coma.
Regurgitation of Milk (Infants)
Bleeding into Resp. Passages
(Cut Throat Injuries, Tonsillectomy / Tooth Extraction)
GAGGING
Cloth is pressed inside the mouth
Gag blocks the mouth – Blocks passage of Air coming
from Nostrils to pass through Back of Throat.
Gag become moist due to Saliva - Obstruct cloth Pores –
Leads to complete Obstruction of Air Passage.
Autopsy findings:
Lips, Soft palate & Pharynx - Abrasion, bruise & lacerations.
Medicolegal aspects:
Mostly Homicidal (in Infants / children)
Adult - Gagged to prevent shouting (Death is Accidental)
Choking - Obstruction of larynx due to Food Bolus
Occurs in Cafe / Restaurant
Sudden Collapse mimics Coronary Heart Attack.
common in suppressed Gag Reflex- (Intoxication, Sedation)
Cause of Death
Asphyxia or
Reflex Cardiac Arrest (Stimulation of Laryngeal N.)
Food bolus impacted in Larynx.
Death is Accidental (Relatives can claim Insurance benefits)
Timely treatment can save the person.
Blow on Back / Sternum or pressure on Abdomen
(Heimlich Maneuver) Violent Coughing - Expels foreign body
Combination of Smothering & Traumatic Asphyxia.
Burke & Hare used to kill the Victims and sell their body to
Edinburgh Medical School for dissection.
Burke used to Sit on Chest of inebriated Victim and
Cover Mouth & Nose with one Hand &
Push the Jaw Upwards with other hand,
Hare pulled the Victim by holding the feet.
Passage of Air between Atmosphere & Lungs is prevented by
Submersion of Body in Water / Fluid.
Types : - 1) Typical
2) Atypical.
Typical drowning (Wet Drowning)
Typical Signs of drowning are present
Exchange of Air is blocked by :- Inhalation of Fluid
It may be Fresh Water or Salt Water Drowning.
Water moves from Lungs to Bld Vessels
Hyper-volemia & Hemodilution.
RBCs Burst & Hemolysis occurs - Liberation of K++
Decrease in Na++ & Cl -
Vent. Fibrillation due to:
Anoxia, Hypervolemia, Hyperkalemia & Na ++ deficit
Fatal Period:
4 - 5 mts (Five)
Due to Hypertonicity of water -
Water moves from Bld Vessels to Lungs (Pulmonary Edema)
HypoVolemia, HemoConcentration, Crenated RBCs, Hypoxia
Circulatory Shock - Cardiac Standstill
Fatal Period - 8-12 mts.
Very little or NO inhalation of water into Air passages.
1. Dry Drowning
20% cases of drowning are due to Dry Drowning.
Water enters Larynx - Sustained Laryngeal Spasm.
Very less Water enter Lungs
Cause of Death - Asphyxia.
2. Immersion Syndrome (Vagal Inhibition)
It may occur in:

Sudden Impact with very Cold Water.

Falling or diving in Water with Feet first.

Horizontal Entry into Water (Impact on Epigastrium)
Cause of Death: Vagal Inhibition
3. Submersion of Unconscious
Victim is Semiconscious / Unconscious during fall in water
(Epilepsy, Drunk, Head Injury or Dizzy due to HT,)
Typical findings drowning – Absent
4. Near Drowning / Sec. Drowning Syndrome
Complications or Sequelae of Drowning in victims who survive.
Hypoxic encephalopathy & Secondary changes in lungs
(fibrosing alveolitis) due to infection from inhaled water
Lungs - Rigid, Stiff & heavy but are NOT edematous.
Microscopically lungs show ARDS
Death occurs after some hours or days.
Cause of Death: Combination of
Cerebral Hypoxia,
Pulmonary Edema,
Aspiration Pneumonitis,
Electrolyte Imbalance & Metabolic Acidosis.
Mechanism of Drowning
Non-Swimmer Falls in Water –

Sinks due to
(1) Body Weight (2) Force of Fall

Rises to the Surface due to
(1) Buoyancy of Body (2) Struggling Movements.

Shouts for Help & Tries to Breath -
Water is Swallowed & Aspirated - cause Violent Coughing –
Air expels & its space is filled by water - Sp. Gravity of Body Increases –
Victim Sinks - Struggling Movements - Comes to Surface –
Again Sinks (due to inhalation of more water)
This continues several times till he finally sinks
Sign / Symptoms
Auditory & Visual Hallucinations
Return of Memory of Past Events.
Confusion
CAUSE OF DEATH:
Asphyxia
Vent. Fibrillation
In Fresh water drowning.
Cardiac Standstill In Salt water drowning
Other causes of death:
1.
Vagal inhibition
2.
Hypothermia,
3.
Sec. Drowning Syndrome,
4.
Injury to Head / other Vital organs during fall,
5.
Cardiac failure,
6.
Rupture of Cerebral Aneurysm.
Cause of Death can be
(1) Drowning alone or
(2) Combination of Drowning + Disease / Trauma
POSTMORTEM CHANGES:
External Changes
Body & Clothes: Wet (if body is recently recovered from water)
Skin - Wet, Cold & Pale (contraction of blood vessels)
Face - Cyanotic
Conjunctiva - Congested.
PM Staining may be Absent (body constantly moving)
When present it is confined to - Head & Neck, Front of Chest
Rigor Mortis
Appears Early (muscular exhaustion)
Passes off Late (cold water)
Fine Froth from Mouth & Nostrils
White, rarely Blood Tinged, Lather like
Abundant & Increases with Compression of Chest,
Reappears on applying Pressure.
Mechanism of Froth Formation
Water in Resp. passage – acts as irritant – Stimulates secretion
of mucus –
Air & Mucus Churned up (due to Violent Respiratory efforts)
Fine Froth is produced
Froth is also Present in Poisoning –
Opium, Cocaine, OPC & Barbiturates.
In poisoning, froth is Neither so Fine,
Nor so Copious & Persistent and
Typical signs of Drowning are Absent.
Froth may be Absent in death due to Laryngeal Spasm.
Cadaveric Spasm
may be present in localized group of Muscles (Hands)
Weeds / Mud may be found tightly clenched in the Hands.
Cuties Anserina / Goose skin –
Skin appears Granular & Puckered with
Hair standing on the end.
Due to spasm of Erector Pillae muscles (due to Cold).
Not diagnostic of Drowning. (also occurs due to Rigor Mortis)
Skin of Hand & Feet - Wrinkled, Bleached & Sodden.
Due to Immersion in Water.
Not Diagnostic of Drowning
Indicates that Body remained in Water for some time.
Emphysema Aquosum (Ballooning of Lungs)
Lungs - Voluminous, Water Logged,
Bulge out on Opening Chest Cavity.
Impression of Ribs on its surface &
Surface: Pale, Pitting Edema.
On Cut Section - Blood stained Fluid Oozes out.
Tardieu Spots - Scanty
- Bld Vessels get Compressed by Water filled Alveoli
Microscopic,
Unicellular Algae,
Present in Natural water (single or in colonies).
Size varies from 10-80 µ
Sillicacious Cell Wall - Resist Acid, Heat & Putrefaction
Drowning - Victim inhales water –
Alveoli distend - Alveolar wall rupture –
Water along with diatoms moves from Alveoli into Circulation
and carried to Distant Organs (Brain, bones etc)
- Detected Microscopically
- Indicate Antemortem Drowning
1. Deceased did NOT drink this water just before drowning
2. All the species present in Test sample are
also present in Control sample.
3. Different Species of diatoms in Test sample & Control
sample are in similar proportion.
Diatom test:
5-10 gm of Bone marrow kept in
10 ml conc. HNO3 + 0.5 ml conc. H2SO4 for 12 hrs
Fluid is washed with DW and Centrifuged Repeatedly
Final residue - Examined under Phase contrast Microscope
Diatoms resist Putrefaction - Test is valid in decomposed bodies
Diatom Test is Negative in

Postmortem Drowning &

Dry Drowning.
Signs of Ante mortem Drowning
1. Persistent, Copious, Fine Froth - from Mouth & Nose.
2. Fine froth in Air passages.
3. Diatom Test - Positive.
4. Edematous Lungs.
5. Cadaveric spasm - Hands Tightly Clenched containing
material present under water
Suicidal Drowning Signs of Struggle Absent.
common in Indian females (Dowry death).
Victim may tie her hands / legs & attach weight before jumping
She may take Poison, Cut her throat before drowning
Dead body may be injured by sea animals –
Injuries will be postmortem NO Vital Reaction.
Homicidal drowning Common
- Body remains concealed for some time
-
It is carried to distant place.
PM Findings of drowning - Almost similar in Suicidal,
homicidal or accidental death
Circumstances of the Case helps to find the manner of death
Anoxic - Prevention of O2 from reaching Lungs
Stagnant - Impaired Blood Flow resulting in Lack of
oxygenated Bld transport to Tissues
Anemic - Low Hb - Inability of Blood to carry O2
Histo-toxic Tissues Destruction – Tissues cannot use O2
Cause of Death
Vagal Inhibition
Signs
No Asphyxial signs
Death instantaneous
Slight Vagal Effect
Slight Asphyxial Signs
&
Cyanosed face; Suffused Eyes
Some Venous Constriction
Occasional Petechial Hm.
Moderate Venous
Moderate Asphyxial Signs
Constriction
Cyanosed Face, Bulging Eyes,
&
Conjunctival Ecchymosis &
Some Resp. Obstruction
Few petechiae
Pronounced Venous &
Well marked Asphyxial Signs
Resp. obstruction
Deeply Cyanosed face, Blood Shot Eyes,
Bitten Tongue, many petechiae in Scalp,
Slight Arterial Constriction
Conjunctivae & Face.
Rope & knot may form
Fixed Noose
Two Limbs of Rope near Knot
are Pulled upwards
Inverted V shaped Mark
At apex of V - Mark is Absent
(Head tilts away from the knot)
Running noose:
End of Rope is passed through the loop (slip knot)
Noose tightens in Horizontal plane
LM - Horizontal.
- additional Vertical mark (due to suspending ligature)
Gettler Test
In a living person
Cl level of Bld. In Left & Right chambers of Heart - Equal
According to Gettler
In Fresh Water Drowning
Hemo-Dilution of Right side Chambers - occur Early
Cl level of blood in Right side is 50% of Normal value
(Normal Value = 600mg/100ml)
In Salt Water Drowning
Hemo-Concentration occurs on Left side First
30-40% increase in Cl level in Left Chambers of Heart
Gettler Test is NOT Significant if:
1. Victim had Patent Foramen Ovale, or VSD or
2. Drowning in Water with Saline Conc = Blood
3. Advanced Stage of Decomposition