Some Breath Play Literature Citations
What's below is a repost I made in the Jay Wiseman's Fetlife Group on Fetlife.com circa December, 2008.
What's below is an admittedly quick and dirty survey of the online literature I put up in response to a thread a while back on tribe.net about "how I knew" that vagal inhibition could cause cardiac arrest due to only a few seconds of choking. While my more official, on-the-record statements will be a bit more polished, I thought I would repost this from my profile to here because I believe making it at least a bit more readily available would be A Good Thing. I'll be posting more info later, but below are a few snacks for thought.
Best,
Jay
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Hi all,
While we're on this general topic, and for those who would like a few more literature citations, especially regarding cardiac arrest from only a few seconds of strangulation or choking due to vagal-induced arrest secondary to stimulation of the carotid sinus bodies in the neck, I provide the following. (It was originally posted in a thread on tribe.net regarding this topic.)
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1. Deaths Occurring Following the Application of Choke or Carotid Holds, published in the textbook "Forensic Pathology" by Dominick J. Di Maio and Vincent J. M. Di Maio, New York 1989
In theory, the carotid sleeper hold will cause rapid unconsciousness without injury to the individual. Unfortunately, in violently struggling individuals, a carotid sleeper hold can easily and unintentionally be converted into a choke hold as the individual twists and turns to break the hold.
A properly applied carotid sleeper can also cause death. One would not expect any trauma to the structures of the neck, however. The compression of the carotid arteries, with resultant decreased cerebral blood flow, can theoretically precipitate a stroke in an individual with atherosclerotic disease of the carotid and/or cerebral vasculature. The pressure may cause dislodgement of atherosclerotic material with a stroke due to an embolus. Blood flow to the brain is from both the carotid and the vertebral arteries. If the vertebral arteries have impaired blood flow due to atherosclerosis then occlusion of the carotid arteries may compromise an already compromised circulation with resultant thrombosis and/or stroke.
Compression of the neck by a carotid sleeper hold may also cause stimulation of the carotid sinus with bradycardia. Application of the hold to an individual who is agitated and struggling may increase the struggling, with increased release of catecholamines. The catecholamines working with the carotid sinus stimulation may produce a cardiac arrest. In addition, if the individual has intrinsic heart disease, he may be even more sensitive to bradycardia and the arrhythmogenic activity of the catecholamines
Next resource:
Death of Douglas Scott
(URL above is: http://campaigns.ahrchk.net/douglasscott/mainfile.php/reconstruction/9/)
Based on the research and study, in general, the following mechanisms of death can occur in hangings:
a. Obstruction of the airways, commonly due to the tongue being raised and forced against the back of the palate and pharynx, and occlusion of the veins carrying blood back from the head to the heart. These two mechanisms, often in combination, will produce obvious physical signs including catechize haemorrhages into the face and eyes from capillary bleeding and obvious signs of congestion and discolouration resulting from venous engorgement.
b. Sufficient pressure to cause blockage of the arteries may cause death sooner but, in practice, pressure on the carotid arteries is more likely to cause death as a result of reflex cardiac arrest due to distension off the carotid sinus. The rapidity of this mechanism, which can occur in both manual strangulation and hanging, commonly results in death with a pale face and no petechial haemorrhages or signs of congestion.
c. Sudden death without asphyxial signs is a well recognized occurrence in hanging resulting from reflex cardiac arrest, particularly if there is more of a drop or free-swinging likely to cause sudden pressure or traction on the carotid arteries. It is also well recognized, however, to occur as a likely consequence of manual strangulation or throttling, as the fingers can easily be placed in a position where they may inflict deeper and more direct pressure on the carotid sinus than can be achieved with the more diffuse pressure of a broad ligature.
From “Sudden In-Custody Death Syndrome” www.charlydmiller.com/LIB06/2005JanSuddenInCustodyDeathSyndrome.pdf
Essay on Sudden In-Custody Death Syndrome
(URL above is: www.charlydmiller.com/LIB06/2005JanSuddenInCustodyDeathSyndrome.pdf)
“Pressure applied to the carotid artery area impedes blood flow, which can produce carotid sinus stimulation and result in bradycardia and cardiac arrest.” His journal cites in support of this are #'s 14 & 15
From an online forensic pathology textbook
http://www.ghsl.org/index.php?option=com_docman&task=doc_view&gid=376. (Unfortunately, as of 12/09 this link seems to no longer be working.)
Strangulation - External Pressure of Neck 1. Manual Strangulation (throttling) 2. Strangulation by Ligature 3. Hanging (self suspension) 4. Sexual Asphyxia
Death from pressure on the neck may be: slow (minutes)
classic signs of cyanosis pressure needs to be applied for at least 15-30seconds
instantaneous due to cardiac arrest
pale face with no classic signs
When pressure is applied to the neck, there may be:
1. Obstruction of the airway is difficult since the cartilages are rigid; it occurs only if extreme pressure is applied.
2. Obstruction of the jugular veins with impaired venous return of blood from the head to the heart gives rise to the classic signs of asphyxia.
3. Obstruction of the carotid arteries is much less common as the arteries are deep. If severe and bilateral, the result may be cerebral ischaemia.
4. Stimulation of the baroreceptor nerve endings in the carotid body, at the bifurcation of the common carotid artery, leads to bradycardia (lowering of the heart rate) or to total cardiac arrest. This reflex action works through stimulation of nerves in the carotid body with a response via the vagus nerve that supplies the heart. Commando punches to the neck stimulate the carotid sinus and may cause cardiac arrest.
Manual Strangulation (throttling )
Manual strangulation is commonly homicidal, the victim often being a woman strangled by a man, often associated with a sexual attack. The victims may also be infants, children and the elderly. Robust individuals can be throttled if under the influence of drink or drugs. It is extremely rare for a woman to strangle someone unless it is a child, such as in infanticide.
Suicide by strangulation is virtually impossible since as one loses consciousness, the hands are removed.
[Note from Jay: Dr. Knight reports that cases of suicide by manual strangulation have in fact occurred.]
Accidental strangulation may occur during horseplay, usually of a sexual nature. Death is due to vagal inhibition.
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