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On the Phenomenon of Sudden Death in Animals and Man

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On the Phenomenon of Sudden Death in Animals and Man On the Phenomenon of Sudden Death in Animals and Man CURT P. RICHTER, Ph.D. VOODOO" DEATH-that is the title of a his eyes become glassy, and the expression of paper published in 1942 by Walter Cannon.1 his face becomes horribly distorted. He attempts It contains many instances of mysterious, sud- to shriek but usually the sound chokes in his den, apparently psychogenic death, from all throat, and all that one might see is froth at his parts of the world. A Brazilian Indian con- mouth. His body begins to tremble and his mus- demned and sentenced by a so-called medicine cles twitch involuntarily. He sways backward and falls to the ground, and after a short time man, is helpless against his own emotional appears to be in a swoon. He finally composes response to this pronouncement—and dies himself, goes to his hut and there frets to death. within hours. In Africa a young Negro un- knowingly eats the inviolably banned wild Cannon made a thorough search of reports hen. On discovery of his "crime" he trembles, from many primitive societies before he con- is overcome by fear, and dies in 24 hours. In vinced himself of the existence of voodoo New Zealand a Maori woman eats fruit that deaths. He concluded: she only later learns has come from a tabooed . the phenomenon is characteristically place. Her chief has been profaned. By noon noted among aborigines—among human beings of the next day she is dead. In Australia a so primitive, so superstitious, so ignorant, that witch doctor points a bone at a man. Believing they feel themselves bewildered strangers in a that nothing can save him, the man rapidly hostile world. Instead of knowledge, they have sinks in spirits and prepares to die. He is fertile and unrestricted imaginations which fill saved only at the last moment when the witch their environment with all manner of evil spirits doctor is forced to remove the charm. R. Her- capable of affecting their lives disastrously . bert Basedow in his book The Australian Aboriginal2 wrote in 1925: Having, after a painstaking search of the literature, convinced himself of the reality of The man who discovers that he is being boned this phenomenon, Cannon next addressed by an enemy is, indeed, a pitiable sight. He himself to the question "How can an ominous stands aghast with his eyes staring at the treach- and persistent state of fear end the life of erous pointer, and with his hands lifted to ward man?" To answer this question he had re- off the lethal medium, which he imagines is course to his experimental observations on pouring into his body. His cheeks blanch, and rage and fear in cats. He believed that while rage is associated with the instinct to attack From the Psychobiological Laboratory, Johns Hopkins Medical School, Baltimore, Md. and fear with the instinct to flee, these two Presented at the American Psychosomatic So- emotions have similar effects on the body. ciety 1956 Annual Meeting, March 25, r956, Bos- Thus, when either of these instincts is aroused ton, Mass. the same elemental parts of the nervous sys- This work was carried on under contracts with tem and endocrine apparatus are brought into the Office of the Surgeon-General and the Office of action, the sympathicoadrenal system. Naval Research. Received for publication February 18, 1957. If these powerful emotions prevail, and the VOL. Xix, NO. 3, 1957 192 SUDDEN.DEATH PHENOMENON bodily forces are fully mobilized for action, and having the opportunity to observe an indi- if this state of extreme perturbation continues vidual in the throes of voodoo influence would in uncontrolled possession of the organism for make observations on respiratory and pulse any considerable period, without the occurrence rates, concentration of the blood, etc., to test of action, dire results may ensue. this theory. Thus, according to Cannon, death would I bring this up here not because I have result as a consequence of the state of shock had opportunity to examine human victims— produced by the continuous outpouring of I have not—but because I have observed what adrenalin. Voodooed individuals would, there- may be a similar phenomenon in rats and fore, be expected to breathe very rapidly, have because our studies may throw light on the a rapid pulse, and show a hemoconcentration underlying mechanisms of sudden unexplained resulting from loss of fluids from the blood to death in man, not only in voodoo cultures. the tissues. The heart would beat faster and We are still actively at work on the problem faster, gradually leading to a state of constant and consequently this communication must contraction and, ultimately, to death in systole. be considered simply as a report of work in Cannon expressed the hope that anyone progress. Fig. 1. Glass swimming jars, water jets, cold and hot water faucets, pressure gauge, and pressure regulator. PSYCHOSOMATIC MEDICINE RICHTER 193 As so often happens, this phenomenon was temperature playing into the center of each discovered accidentally, as it were, during the cylinder precluded the animals' floating, while course of other experiments. The first obser- the collar of the cylinder itself prevented vation was made with Dr. Gordon Kennedy escape. The study was started with observa- in 1953 while studying the sodium metal> tions on our domesticated rats. Figure 2 shows olism of rats on very high salt diets. To deter- the relationship between swimming time mine the amount of sodium excreted, three (drowning) and water temperature. The or- animals on a diet containing 35 per cent NaCl dinates show average (7 rats at each point) were kept in metabolism cages over large glass swimming time in hours, and the abscissas funnels. The urine was collected in a cylinder. water temperature in degrees Fahrenheit. As To prevent contamination of the urine with can be seen, the average survival times were this salt-rich food, the food-cup in each cage directly related to the temperature of the was placed at the end of a passageway, as far water: thus, the swimming times ranged from as possible from the neck of the funnel; how- 10-15 minutes at 63-73 ° F-> t0 6° hours at ever, despite our precautions, food was still 950 F., to 20 minutes at 1050. dragged over the funnel, apparently on the The significance of this average curve was whiskers or hair of the snout. In a further greatly reduced by the marked variations in attempt to prevent this contamination the individual swimming times. At all tempera- whiskers and hair were trimmed away with tures, a small number of rats died within 5-10 electric clippers. One of the three rats at once minutes after immersion, while in some in- began to behave in a very peculiar manner, stances others apparently no more healthy, incessantly pushing its snout into the corners swam as long as 81 hours. The elimination of of the cage or into the food-cup with a cork- these large variations presented a real prob- screw motion. Although before the clipping lem, which for some time we could not solve. procedure it had seemed entirely normal, eight Then the solution came from an unexpected hours afterwards it was dead. source—the finding of the phenomenon of This observation was recalled a year or two sudden death, which constitutes the main later, while we were studying differences in topic of this communication. On one occasion the response to stress of wild and domesticated while I was watching rats swim it occurred to Norway rats. For these studies we measured me to investigate the effect of trimming the endurance by means of swimming survival rat's whiskers on its performance in water. times, using specially designed tanks—glass Would a rat swimming without whiskers show cylinders 36 inches deep, standing inside glass the peculiar behavior of the original rat in the jars 8 inches in diameter and 30 inches in metabolism cage:1 depth (Fig- O- A jet of water of any desired Our observations were started with twelve, Fig. 2. Curve showing average swimming time (end point, drowning) of unconditioned tame domesticated Norway rats with relation to water temperature. Averages for 7 rats at each point. VOL. xrx, NO. 3, 1957 194 SUDDEN-DEATH PHENOMENON tame, domesticated rats. Using electric clip- without the use of any anesthetic, it became pers, the whiskers and hair o£ the facial area obvious that a number of other factors had were trimmed before the animals were placed to be taken into account. To evaluate the in water at 95 ° F., a temperature at which relative importance of these factors, it became most intact, control rats swim 60 to 80 hours. necessary to follow the rats from the time they The first rat swam around excitedly on the left their cages until they finally died at the surface for a very short time, then dove to bottom of the swimming jars. the bottom, where it began to swim around Figure 3A shows the type of metal cage nosing its way along the glass wall. Without used for the wild rats. The bevelled end con- coming to the surface a single time, it died tains a hinged door, the flat end a sliding door. 2 minutes after entering the tank. Two more Figure 3B shows the black opaque bag used of the twelve domesticated rats tested died in for catching and holding the rat. The open much the same way; however, the remaining 9 end is held over the sliding door at the flat swam 40 to 60 hours. end of the cage.
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