Traumatic asphyxia combined with smothering is a combination of both these entities. It can be accidental or homicidal. An accidental form is overlay, where an infant is placed in bed for the night with either an adult or a larger child. Subsequently, the infant is found dead. During the night, the other individual rolled onto the infant, killing it by a combination of
smothering and traumatic asphyxia. If the circumstances surrounding the child's death are not known, such a case is often ascribed to SIDS. In fact, an autopsy cannot differentiate between the two. Other deaths in this category are individuals buried in cave-ins, grain, or sand, etc. The physical findings at autopsy are generally nil. Rarely, a few fine petechiae of the facial skin, but not of the sclerae or conjunctivae, will be found.
Burking is a combination of suffocation and traumatic asphyxia developed (or at least perfected) by the "resurrectionists" Burke and Hare in the early 19th century.11 These men made their living by digging up bodies from graveyards and supplying them to medical schools for dissection. They
decided, however, to eliminate the chore of digging up bodies and go straight to the source. Victims, usually intoxicated, were brought to the ground, whereupon Burke knelt or sat on their chests, expelling the air and interfering with inspiratory efforts. He then put one hand over the victim's nose and mouth and used the other hand to press the lower jaw towards the upper. Visible injuries were virtually nonexistent. The two now had a fresh body for the schools.
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