ABSTRACT
The lack of understanding of asphyxia was the reason why causes of death which had nothing to do with asphyxia were attributed to asphyxia while others which were asphyxial were excluded. Long before oxygen and circulation were detected, people knew that strangulation would cause death. The main mechanisms of mechanical asphyxia are hanging, ligature strangulation and manual strangulation, or through obstruction of the airways, for instance by a soft covering such as a pillow, and thoracic compression. Death by thoracic compression may occur accidentally but also occurs in homicides. The main mechanisms leading to death in strangulation are compression of the neck arteries, airway obstruction. In cases of homicidal smothering with a pillow, the diagnosis of death by smothering may be difficult since external evidence of violence is scarce or even missing. In such cases, it may be important to search also for evidence of the aspiration of fabric fibres.
