Voodoo death

Voodoo death, a term coined by Walter Cannon in 1942 also known as psychogenic death or psychosomatic death, is the phenomenon of sudden death as brought about by a strong emotional shock, such as fear. The anomaly is recognized as "psychosomatic" in that death is caused by an emotional response—often fear—to some suggested outside force. Voodoo death is particularly noted in native societies, and concentration- or prisoner of war camps, but the condition is not specific to any particular culture.[1]

Walter Cannon and his work

In 1942, Walter Bradford Cannon, MD, now looked to as a forerunner in modern physiological psychology, published a work wherein he postulated the idea that fear could affect a person to the point that their physical condition would deteriorate in response to psychological distress.[2] Citing examples of extraordinary deaths (and their extraneous circumstances) in aboriginal societies, Cannon posited the idea that fear of supernatural consequences to broken societal taboos caused the deaths witnessed in the natives.

What Cannon describes has since been termed "bone-pointing syndrome," wherein an individual receives some sort of shock—often the breaking of some social/religious taboo—that he interprets as an ill omen for himself; his physical condition then deteriorates at a rapid rate, and he dies within a period as short as 24 hours after the initial shock.[2]

Cannon discusses the example of a Maori woman who learned that the fruit she had eaten came from a tapu (tabooed) place; less than 24 hours later she was dead. Conversely, Cannon also shares the example of a young man who had fallen ill when the local witch doctor had pointed a bone at him, a societal taboo that meant a curse of death; however, when the perpetrator explained to the young man that the whole thing had been a mistake, and that no bone had been pointed at him at all, the young man's health returned instantly.[2]

Cannon notes the similarities in each case: the individuals were both members of a society where beliefs in the supernatural are fiercely upheld, and both had suffered what they both believed to be some form of a curse as dictated within their personal beliefs; also, the individuals shared similar physical symptoms. And yet, in the case of the young man, once the cause for the psychological distress was removed, his mysterious illness disappeared. Cannon attributes these rather drastic physical repercussions as the workings of the emotion fear upon the mind which then leads to destruction of the physical condition.[2]

Causes

Cannon's explanation

According to Cannon, the emotion of fear working on the mind, which he terms the "sympathetic" or "sympathico-adrenal" division of the nervous system, causes a fall in blood pressure as brought on by "a reduction of the volume of circulating blood".[2] Cannon explains the loss of blood volume by the constant injection of adrenaline into the small arterioles which constrict, preventing a proper flow of blood within the body and causing a drop in blood pressure. From there, the weak blood pressure prevents the sufficient circulation of the blood by damaging the heart and nerves responsible for the maintenance of the vessels which transport blood, thus making it harder for circulation to continue since the very organs necessary to maintain proper blood circulation are deteriorating. An accelerated heart rate then ensues, followed by rapid breathing. Added to these symptoms are the effects of no food or drink in the person experiencing psychological distress: Cannon suggests that true shock, in the medical sense, could be the cause of death as a result of little food or drink. States Cannon: "The combination of lack of food and water, anxiety, very rapid pulse and respiration, associated with a shocking experience having persistent effects, would fit well with fatal conditions reported from primitive tribes."[2]

Modern explanations

Since 1942, scientists have discovered many more of the processes involved in the effect of stress upon the body, such as the region of the brain called the amygdala. The series of events by which a sensory stimulus is introduced to the mind, and the amygdala processes the emotion of fear which follows is called the "vision-to-fear pathway", or the "auditory-to-fear pathway", depending on the stimulus.

The generally recognized sequence of events, as enumerated by Esther M. Sternberg, MD, in 2002, stands as follows: various chemicals and electrical impulses are released that are transmitted by nerve fibers. Simultaneously, hormones are excreted from the brain, adrenal and pituitary glands in response to stress on the system. Cardiac arrhythmias are often the result of an overabundance of these hormones on the system.[3]

In 1981, Wylie Vale, PhD, discovered corticotrophin, the brain's hypothalamic stress hormone, or CRH: this hormone secreted by the hypothalamus coordinates with "the brain stem adrenaline centers involved in initiation of the sympathetic response ... to cause a massive release of both adrenaline-like nerve chemicals and stress hormones. Together these might well cause illness, including loss of appetite, weakness, cardiac arrhythmias, and even vascular collapse that could result in death."[3]

Martin A. Samuels, MD, elaborates further on still another process of death, stating that with the release of adrenaline and an increased heart rate, sometimes catecholamines, stress hormones, will build up, leading to calcium channels opening and remaining open, resulting in an overflow of calcium into the system, killing off cells.[4]

Parasympathetic over-activation

Cannon believed that extreme emotional stress could be explained in terms of degree of sympathetic-adrenal excitation. However, an experiment performed by Curt Richter (1957) responded to Cannon's challenge with an animal model. Richter placed pre-stressed rats in a closed turbulent water. the latency to drowning was recorded. Most domestic lab rats lasted for hours while unexpectedly all of the wild rats died within 15 minutes. Richter monitored heart rate and determined whether the heart was in systole or diastole after death. He found out that heart rate slowed down prior to death and the heart was engaged with blood reflecting a state of diastole. This contradicted Cannons proposal that sympathetic adrenal over-activation is the result of death since a sympathetic over-arousal would increase both heart rate and blood pressure to severe degrees. Richter interpreted this that the rats died as a result of over-stimulation of the parasympathetic nervous system, specifically the vagus nerve which regulates heartbeat. The lethal vagal effect was the psychological state of hopelessness.[5]

Sudden prolonged immobility or faked death is an adaptive response exhibited by many mammalian species. Hofer(1970) demonstrated that several rodent species when threatened exhibited an immobility that was accompanied by a very low heart rate. For some of the rodents that heart rate reached below 50% of the baseline. Hofer distinguished between prolonged immobility and faked death phenomenon. Unlike the behavior of "hopelessness" described by Richter, the death-faking occurred with a sudden motor collapse during active struggling. Hofer interpreted the fear-inducing slowing of heart rate as a vagal phenomenon.[6]

These data suggest that vagus contributes to severe emotional states and may be related to emotional states of immobilization, such as extreme terror. Unfortunately, this immobilization technique is potentially life-threatening for mammals (but not for reptiles). Mammals would undergo states of bradycardia or hypoxia as an over-activation of parasympathetic vagus system. The organs of the oxygen-hungry mammal are deprived of oxygen due to lack of blood flow, and the animal dies.

Critical evaluation

Despite Cannon's general ignorance on the particulars of physiological breakdown, scientists in the intervening years since the publication of Cannon's work, have generally agreed with his fundamental hypotheses concerning voodoo death. Criticisms that generally come against Cannon's work are directed at the hearsay nature of Cannon's case studies, but recent studies have discovered numerous examples of voodoo death in various societies.[7] To those who allege difficulty in the experimental process of validating Cannon's theory, Barbara W. Lex, in her 1974 article titled, "Voodoo Death: New Thoughts on an Old Explanation", states that "Voodoo death" can easily be observed without complicated experiments:

"Pupillary constriction, easily observable and indicative of parasympathetic activation ... the amount of saliva, of perspiration, degree of muscle tonicity and skin pallor in an individual are also discernible without complicated instruments."[8]

However, there are those who contest the theories involving psychologically-induced body failure. David Lester, PhD, in 1972, contends that Cannon's evidence, particularly the evidence concerning animals, is anecdotal and irrelevant, and instead sets forth the concept of "death by suggestion", and supports "giving up-given up" complex set forth by George L. Engel, thus attributing the cause of death entirely to the psychological state of the individual in question rather than a psychological–physiological connection adduced by Cannon.[9] Going even further, Harry D. Eastwell, MD in his 1982 article, "Voodoo Death and the Mechanism for Dispatch of the Dying in East Arnhem, Australia", rejects entirely the concept of "Voodoo death", stating that the deaths in cases reported by Cannon et al. were more likely due to dehydration rather than to any psychological response.[10]

Influence of this theory on modern science

Fight or flight

Deeply related to these cases of sudden death is what Cannon termed the "fight-or-flight response", what has been classified as a "neurophysiological-behavioral" response pattern. "Fight or flight" is a phrase used to describe the instinctual and physiological responses to strong emotion within animals as well as humans. Cannon associates the two emotions of rage and fear because of the similar effects the emotions will have upon the mind and body—rage will encourage the response to "fight", while fear will encourage "flight". The mind, when faced with one or both of these emotions in response to a perceived threat, will emit adrenaline, and heart rate will increase; however, sometimes the system is overwhelmed by the responses, and collapse ensues as brought about by the workings of stress hormones.[4]

In the case of voodoo death, the "flight" response overpowers the system, but there is little to no possibility for action in the mind of the individual suffering from the perceived threat—considering the state of aboriginal tribes, the victims believe themselves to be suffering from a curse in which they are condemned to die, and so they believe themselves to be unable to act to save themselves.[11]

New fields

Cannon's theory concerning voodoo death opened research into various fields of psychological studies; since the publication of Cannon's work, scientists have discovered many disorders and the like related to psychosomatic responses to situations. Because of Cannon's postulation that the mind could bring about death, scientists have become open to the idea of the mind working on the body in a greater number of ways, leading to the development of psychosomatic medicine.[12]

The advent of theories concerning voodoo death within the scientific field has also led to the development of a branch of psychology termed psychophysiology.[12]

Notable cases

Though cases within aboriginal societies are the most commonly cited when researchers such as Cannon set forth examples, similar cases of psychosomatic death have also been reported in other cultures.

In his 1964 article, James L. Mathis, MD, describes a case of a previously healthy man who died from asthmatic attacks when his mother "cursed" him for going against her wishes. Mathis proposes that "fatal psychosomatic conditions" were the cause of this man's death, and thus a form of voodoo death.[13]

Another scientist—Clifton K. Meador, MD—in 1992 discussed the case of a man diagnosed with cancer who, along with his physicians and family, believed he was dying of cancer. In the autopsy after his death, however, the doctors discovered that his cancer was not at all the cause of his death. Meador deduces that the man's belief in his imminent death was the cause of his death itself.[14]

See also

References

  1. ^ Stumpfe, K.D. "The psychogenic death of Mr. J. A case report." pp. 263–73.
  2. ^ a b c d e f Cannon, Walter. "Voodoo Death." pp. 169–181.
  3. ^ a b Sternberg, Esther. "Walter B. Cannon and 'Voodoo' Death: A Perspective From 60 Years On." pp. 1564–1566.
  4. ^ a b Kirn, Timothy. "Voodoo death is brain's lethal response to fear."
  5. ^ Richter, C.P. (1957). "On the phenomenon of sudden death in animals and man". Psychosom. Med. 19 (3): 191–8. CiteSeerX 10.1.1.536.1405. doi:10.1097/00006842-195705000-00004. PMID 13432092.
  6. ^ Hofer, M.A. (1970). "Cardiac respiratory function during sudden prolonged immobility in wild rodents". Psychosom. Med. 32 (6): 633–47. doi:10.1097/00006842-197011000-00008. PMID 5530023.
  7. ^ Lester, David. "Voodoo Death." pp. 1–18.
  8. ^ Lex, Barbara. "Voodoo Death: New Thoughts on an Old Explanation." pp. 818–823.
  9. ^ Lester, David. "Voodoo Death: Some New Thoughts on an Old Phenomenon." pp. 386–390.
  10. ^ Eastwell, Harry D. "Voodoo Death and the Mechanism for Dispatch of the Dying in East Arnhem, Australia." pp. 5–18.
  11. ^ Gomez, E.A. "Voodoo and sudden death: the effects of expectations on health." pp. 75–91.
  12. ^ a b Lane, R.D., Waldstein, S.R., Chesney, M.A, et al. "The Rebirth of Neuroscience in Psychosomatic Medicine, Part I: Historical Context, Methods, and Relevant Basic Science." pp. 117–134.
  13. ^ Mathis, James L. "Sophisticated Version of Voodoo Death." pp. 104–107.
  14. ^ Meador, CK (1992). "Hex death: voodoo magic or persuasion?". South Med J. 85 (3): 244–7. doi:10.1097/00007611-199203000-00004. PMID 1546347.

Sources

  • Cannon, Walter. "Voodoo Death." American Anthropologist, 44. 1942. 169–181.
  • Eastwell, Harry D. "Voodoo Death and the Mechanism for Dispatch of the Dying in East Arnhem, Australia." American Anthropologist, 84.1. 1982. 5–18.
  • Gomez, E.A. "Voodoo and sudden death: the effects of expectations on health." Transcultural Psychiatric Research Review, 19. 1982. 75–91.
  • Lane, R.D., Waldstein, S.R., Chesney, M.A, et al. "The Rebirth of Neuroscience in Psychosomatic Medicine, Part I: Historical Context, Methods, and Relevant Basic Science." Psychosom Medicine, 71.2. 1 Feb 2009. 117–134.
  • Lester, David. "Voodoo Death: Some New Thoughts on an Old Phenomenon." American Anthropologist, 74.3. 1972. 386–390.
  • Lester, David. "Voodoo Death." Omega, 59.1. 2009. 1–18.
  • Lex, Barbara W. "Voodoo Death: New Thoughts on an Old Explanation." American Anthropologist, 76.4. 1974. 818–823.
  • Kirn, Timothy F. "Voodoo death is brain's lethal response to fear." Clinical Psychiatry Jan 2004. Web. 15 Nov 2009. <http://findarticles.com/p/articles/mi_hb4345/is_1_32/ai_n29068809/?tag=content;col1>.
  • Mathis, James L. "Sophisticated Version of Voodoo Death." American Psychosomatic Society, 26. 1964. 104–107.
  • Meador, Clifton K. "Hex Death: Voodoo Death or Persuasion." Southern Medical Journal, 85.3. 1992. 244–247.
  • Sternberg, Esther. "Walter B. Cannon and 'Voodoo' Death: A Perspective From 60 Years On." Am J Public Health, 92.10. 2002. 1564–1566.
  • Stumpfe, K.D. "The psychogenic death of Mr. J. A case report." Z Psychosom Med Psychoanal, 25.3. 1979. 263–273.

Further reading

Algor mortis

Algor mortis (Latin: algor—coldness; mortis—of death), the second stage of death, is the change in body temperature post mortem, until the ambient temperature is matched. This is generally a steady decline, although if the ambient temperature is above the body temperature (such as in a hot desert), the change in temperature will be positive, as the (relatively) cooler body acclimates to the warmer environment. External factors can have a significant influence.

The term was first used by Dowler in 1849. The first published measurements of the intervals of temperature after death were done by Dr John Davey in 1839.

Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), indicates that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police.

In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

Death hoax

A death hoax is a deliberate or confused report of someone's death that turns out to be incorrect and murder rumors. In some cases it might be because the person has intentionally faked death.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Death rattle

Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest. Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. Usually, two or three days earlier, the symptoms of approaching death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement. While death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex, such as brain injuries.It is sometimes misinterpreted as the sound of the person choking to death, or alternatively, that they are gargling.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Dysthanasia

In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine.Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive. The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.

Fan death

Fan death is a well-known superstition in Korean culture, where it is thought that running an electric fan in a closed room with unopened or no windows will prove fatal. Despite no concrete evidence to support the concept, belief in fan death persists to this day in Korea, and also to a lesser extent in Japan.

Funeral director

A funeral director, also known as an undertaker (British English) or mortician (American English), is a professional involved in the business of funeral rites. These tasks often entail the embalming and burial or cremation of the dead, as well as the arrangements for the funeral ceremony (although not the directing and conducting of the funeral itself unless clergy are not present). Funeral directors may at times be asked to perform tasks such as dressing (in garments usually suitable for daily wear), casketing (placing the human body in the coffin), and cossetting (applying any sort of cosmetic or substance to the best viewable areas of the corpse for the purpose of enhancing its appearance). A funeral director may work at a funeral home or be an independent employee.

Kurdaitcha

Kurdaitcha (or kurdaitcha man) is a type of sorcerer amongst the Arrernte people, an Aboriginal group in Central Australia. The kurdaitcha may be brought in to punish a guilty party by death. The word may also relate to the ritual in which the death is willed by the kurdaitcha man, known also as bone-pointing. The word may also be used by Europeans to refer to the shoes worn by the Kurdaitcha, which are woven of feathers and human hair and treated with blood. Other spellings of kurdaitcha are gadaidja, cadiche and kadaitcha.

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus raised from the dead in the Gospel of John.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Necronym

A necronym (from the Greek words νεκρός, nekros, "dead" and ὄνομα ónoma, "name") is a reference to, or name of, a person who has died. Many cultures have taboos and traditions associated with referring to such a person. These vary from the extreme of never again speaking the person's real name, often using some circumlocution instead, to the opposite extreme of commemorating it incessantly by naming other things or people after the deceased.

For instance, in some cultures it is common for a newborn child to receive the name (a necronym) of a relative who has recently died, while in others to reuse such a name would be considered extremely inappropriate or even forbidden. While this varies from culture to culture, the use of necronyms is quite common.

Necrophobia

Necrophobia is a specific phobia which is the irrational fear of dead things (e.g., corpses) as well as things associated with death (e.g., coffins, tombstones, funerals, cemeteries). With all types of emotions, obsession with death becomes evident in both fascination and objectification. In a cultural sense, necrophobia may also be used to mean a fear of the dead by a cultural group, e.g., a belief that the spirits of the dead will return to haunt the living.Symptoms include: shortness of breath, rapid breathing, irregular heartbeat, sweating, dry mouth and shaking, feeling sick and uneasy, psychological instability, and an altogether feeling of dread and trepidation. The sufferer may feel this phobia all the time. The sufferer may also experience this sensation when something triggers the fear, like a close encounter with a dead animal or the funeral of a loved one or friend. The fear may have developed when a person witnessed a death, or was forced to attend a funeral as a child. Some people experience this after viewing frightening media.The fear can manifest itself as a serious condition. Treatment options include medication and therapy.The word necrophobia is derived from the Greek nekros (νεκρός) for "corpse" and the Greek phobos (φόβος) for "fear".

Nocebo

A nocebo effect is said to occur when negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have. For example, when a patient anticipates a side effect of a medication, they can suffer that effect even if the "medication" is actually an inert substance. The complementary concept, the placebo effect, is said to occur when positive expectations improve an outcome. Both placebo and nocebo effects are presumably psychogenic, but they can induce measurable changes in the body. One article that reviewed 31 studies on nocebo effects reported a wide range of symptoms that could manifest as nocebo effects including nausea, stomach pains, itching, bloating, depression, sleep problems, loss of appetite, sexual dysfunction and severe hypotension. Mental states such as beliefs and expectations can strongly influence the outcome of disease, the experience of pain, and even success of surgery.

Obituary

An obituary (obit for short) is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant. In local newspapers, an obituary may be published for any local resident upon death. A necrology is a register or list of records of the deaths of people related to a particular organization, group or field, which may only contain the sparsest details, or small obituaries. Historical necrologies can be important sources of information.

Two types of paid advertisements are related to obituaries. One, known as a death notice, omits most biographical details and may be a legally required public notice under some circumstances. The other type, a paid memorial advertisement, is usually written by family members or friends, perhaps with assistance from a funeral home. Both types of paid advertisements are usually run as classified advertisements.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

Post-mortem interval

Post-mortem interval (PMI) is the time that has elapsed since a person has died. If the time in question is not known, a number of medical/scientific techniques are used to determine it. This also can refer to the stage of decomposition of the body.

Rigor mortis

Rigor mortis (Latin: rigor "stiffness", mortis "of death"), or postmortem rigidity, is the third stage of death. It is one of the recognizable signs of death, characterized by stiffening of the limbs of the corpse caused by chemical changes in the muscles postmortem. In humans, rigor mortis can occur as soon as four hours after death.

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