Strangling orstrangulation is compression of the neck that may lead tounconsciousness ordeath by causing an increasinglyhypoxic state in the brain by restricting the flow ofoxygen through thetrachea.[1] Fatal strangulation typically occurs in cases of violence, accidents, and is one of two main ways thathanging causes death (alongside breaking the victim's neck).
Strangling does not have to be fatal; limited or interrupted strangling is practised inerotic asphyxia, in thechoking game, and is an important technique in manycombat sports andself-defense systems. Strangling can be divided into three general types according to the mechanism used:[2]
Strangling involves one or several mechanisms that interfere with the normal flow ofoxygen into the brain:[3][4]
Depending on the particular method of strangulation, one or several of these typically occur in combination;vascular obstruction is usually the main mechanism.[5] Complete obstruction of blood flow to the brain is associated with irreversibleneurological damage anddeath,[6] but during strangulation there is still unimpeded blood flow in thevertebral arteries.[7] Estimates have been made that significant occlusion of thecarotid arteries andjugular veins occurs with a pressure of around 3.4 N/cm2 (4.9 psi), while thetrachea demands six times more at approximately 22 N/cm2 (32 psi).[8]
As in all cases of strangulation, the rapidity of death can be affected by the susceptibility tocarotid sinus stimulation.[5]Carotid sinus reflex death is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed.[3][9] The reported time from application tounconsciousness varies from 7-14 seconds if effectively applied[10] to one minute in other cases, with death occurring minutes after unconsciousness.[3]
Manual strangulation (also known as "throttling") is strangling with the hands, fingers, or other extremities and sometimes also with blunt objects, such asbatons. Depending on how the strangling is performed, it may compress theairway, interfere with the flow of blood in the neck, or work as a combination of the two. Consequently, manual strangulation may damage the larynx[3] and fracture thehyoid or other bones in the neck.[5] In cases of airway compression, manual strangling leads to the frightening sensation ofair hunger and may induce violent struggling.[3]
Manual strangulation iscommon in situations of domestic violence,[11] and is regarded by experts as an especially severe form ofdomestic violence, due to its extremely frightening and potentially lethal nature, and an observed correlation between non-fatal strangulation in domestic violence and future homicide.[12]
Manual strangulation also has a history as a form of capital punishment, during the 18th century, a sentence of "Death by Throttling" would be passed upon the verdict of acourt martial for the crime of desertion from the British Army.[13]
More technical variants of manual strangulation are referred to as strangleholds,[14] orchokeholds (despite the term "choke" more technically referring to internal airway restriction), and are extensively practised and used in variousmartial arts,combat sports,self-defense systems, and in militaryhand-to-hand combat application. In some martial arts likejudo,Brazilian jiu-jitsu, andjujutsu, when applied correctly and released promptly after loss of consciousness, strangleholds that constrict blood flow are regarded as a safer[15] means to render an opponent unconscious, when compared to other methods, especially strikes to the head, the latter of which can cause potentiallycatastrophic or fatal and irreversiblebrain injuries much more quickly and unpredictably.[16]
Ligature strangulation or garroting is strangling with some form of cord such as rope, wire, chain, or shoelaces (agarrote) either partially or fully circumferencing the neck.[17] Even though the mechanism of strangulation is similar, it is usually distinguished fromhanging by the strangling force being something other than the person's own body weight.[5] Incomplete occlusion of thecarotid arteries is expected and, in cases ofhomicide, the victim may struggle for a period of time,[5] with unconsciousness typically occurring in 10 to 15 seconds.[17] Cases of ligature strangulation generally involve homicides of women, children, and the elderly.[5] Compared to hanging, the ligature mark will most likely be located lower on the neck of the victim.
During theSpanish Inquisition, victims who admitted their alleged sins and recanted were killed via ligature strangulation (i.e. the garrote) before their bodies were burnt during theauto-da-fé.[18] Throughout much of the 20th and 21st centuries, theAmerican Mafia used ligature strangulation as a means of murdering their victims. Confessed Americanserial killerAltemio Sanchez used ligature strangulation in the rapes and/or murders of his victims, as didGary Ridgway (the Green River Killer) and British serial killerDennis Nilsen.[19]
Incaprettamento is a method of strangulation in which the victims neck is tied to their legs bent behind their back (similar tohogtie), so that the victim effectively strangle themselves. This method was common throughoutNeolithic Europe, and occurred for over two thousands years in northern and southern Europe, as evidenced by skeleton remains. It is uncertain why it was so common, but researchers speculate a person bound in this way might be considered to have strangled themselves, versus being killed by someone else. Victims may have been part of a ritual sacrifice. Rock art in Addaura Cave, in Sicily, made between 16,000 and 13,000BP, depict two human figures bound in the incaprettamento manner. Today, it is a method of homicide mostly associated with theItalian Mafia, who have used it as a ritual warning or reprimand.[20][21][22]
