Thinking the perp or his/her master/mistress, received or had the medical knowledge to know that strangulation coupled with subsequent hanging, would complicate initial LE investigation and autopsies. rbbm. imo, speculation. WARNING GRAPHIC PICS AT BOTTOM OF LINK. http://medind.nic.in/jbc/t13/i2/jbct13i2p93.pdf "Death due to constriction of neck may broadly result due to hanging, strangulation with ligature material or manual strangulation i.e. throttling. Sometimes due to external postmortem appearance of the ligature marks on neck, it becomes difficult for the autopsy surgeon to clearly state whether the constriction of neck is homicidal or suicidal in nature." "Hanging in its face value goes in favour of being suicidal in nature. In manual strangulation or throttling, a form of violent asphyxiation, the neck is compressed with fingers. The upper part of the neck is mostly affected and the pressure is exerted there against the mandible. The neck may be compressed from the front, back or from any side and one or both hands may be used. Throttling for all practical purposes is always homicidal. In postmortem hanging, often a victim is killed by some other means and then hanged to simulate a suicidal death but there will be evidence of dragging of the body on the ground and friction at the point of suspension of the ligature material, as the ligature is first tied around the neck of the dead body and then the body is hanged but the actual cause of death and other circumstantial evidence will make the fact (post mortem hanging) clear.  Deaths resulting from asphyxia consequent upon manual strangulation raise the suspicion of homicide." "Conclusion In cases of death due to violent asphyxia, whether it was a suicidal death from hanging or homicidal killing from ligature or manual strangulation, sometimes there are fabricated or supposed allegations by the relatives of the deceased or, the investigating agencies register criminal case under pressure or on mere statement without prior investigation or, due to atypical nature and appearance of the ligature marks on the dead body, the autopsy surgeon is not in a state to clearly give opinion on postmortem examination. Under such situations, the autopsy surgeons need not act in haste and must give ample time to the investigating agencies for complete and thorough investigation of the case and then only a final opinion should be given about the nature, mode and cause of death".