What is the surest sign of antemortem hanging?

The surest sign of antemortem hanging is dribbling of saliva. This phenomenon occurs due to the positioning and contortion of the victim's body during hanging, which can affect their ability to swallow and control saliva. Dribbling indicates that the individual was alive during the hanging, as it reflects the physiological responses and reflexes present in a living person.

In contrast, features such as paltauf hemorrhages, skin lacerations, and rigor mortis provide different insights. Paltauf hemorrhages, which result from the rupture of small blood vessels due to asphyxia or pressure, can occur postmortem as well and may not reliably indicate the time of death. Skin lacerations can occur either antemortem or postmortem due to various factors, including the conditions of hanging or manipulation after death. Rigor mortis develops in deceased individuals and signifies the onset of death rather than conditions surrounding how the person died, making it a less reliable marker for determining antemortem status compared to physiological responses like dribbling of saliva.