Hi, this is a copy of Walter Cannon's article on voodoo death. The

first puplication can be found in American Anthropologist, 44,

169-181.

Title: 'VOODOO' Death , By: Cannon, Walter Bradford, American

Journal of Public Health, 00900036, Oct2002, Vol. 92, Issue 10

'VOODOO' Death

In records of anthropologists and others who have lived with

primitive people in widely scattered parts of the world is the

testimony that when subjected to spells or sorcery or the use of

"black magic" men may be brought to death. Among the natives of

South America and Africa, Australia, New Zealand, and the islands of

the Pacific, as well as among the negroes of nearby Haiti, "voodoo"

death has been reported by apparently competent observers. The

phenomenon is so extraordinary and so foreign to the experience of

civilized people that it seems incredible; certainly if it is

authentic it deserves careful consideration. I propose to recite

instances of this mode of death, to inquire whether reports of the

phenomenon are trustworthy, and to examine a possible explanation of

it if it should prove to be real.

First, with regard to South America. Apparently Soares de Sousa was

first to observe instances of death among the Tupinambás Indians,

death induced by fright when men were condemned and sentenced by a

so-called "medicine man."... Thus the chief or medicine man gains

the reputation of exercising supernatural power And by intimidation

or by terrifying augury or prediction he may cause death from

fear....

Also in New Zealand there are tales of death induced by ghostly

power.

In Brown's New Zealand and Its Aborigines there is an account of a

Maori woman who, having eaten some fruit, was told that it had been

taken from a tabooed place; she exclaimed that the sanctity of the

chief had been profaned and that his spirit would kill her This

incident occurred in the afternoon; the next day about 12 o'clock

she was dead. According to Tregear the tapu (taboo) among the Maoris

of New Zealand is an awful weapon. "I have seen a strong young man

die," he declares, "the same day he was tapued; the victims die

under it as though their strength man out as water...."

Dr. S. M. Lambert of the Western Pacific Health Service of the

Rockefeller Foundation wrote to me that on several occasions he had

seen evidence of death from fear. In one case there was a startling

recovery. At a Mission at Mona Mona in North Queensland were many

native converts, but on the outskirts of the Mission was a group of

non-converts including one Nebo, a famous witch doctor. The chief

helper of the missionary was Rob, a native who had been converted.

When Dr. Lambert arrived at the Mission he learned that Rob was in

distress and that the missionary wanted him examined. Dr. Lambert

made the examination, and found no fever, no complaint of pain, no

symptoms or signs of disease. He was impressed, however, by the

obvious indications that Rob was seriously ill and extremely weak.

From the missionary he learned that Rob had had a bone pointed at

him by Nebo and was convinced that in consequence he must die.

Thereupon Dr. Lambert and the missionary went for Nebo, threatened

him sharply that his supply of food would be shut off if anything

happened to Rob and that he and his people would be driven away from

the Mission. At once Nebo agreed to go with them to see Rob. He

leaned over Rob's bed and told the sick man that it was all a

mistake, a mere joke--indeed, that he had not pointed a bone at him

at all. The relief, Dr. Lambert testifies, was almost instantaneous;

that evening Rob was back at work, quite happy again, and in full

possession of his physical strength....

Obviously, the possible use of poisons must be excluded before

"voodoo" death can be accepted as an actual consequence of sorcery

or witchcraft.

Also it is essential to rule out instances of bold claims of

supernatural power when in fact death resulted from natural causes;

this precaution is particularly important because of the common

belief among aborigines that illness is due to malevolence. I have

en deavored to learn definitely whether poisoning and spurious

claims can quite certainly be excluded from instances of death,

attributed to magic power, by addressing enquiries to medically

trained observers....

Dr. J. B. Cleland, Professor of Pathology at the University of

Adelaide, has written to me that he has no doubt that from time to

time the natives of the Australian bush do die as a result of a bone

being pointed at them, and that such death may not be associated

with any of the ordinary lethal injuries. In an article which

included a section on death from malignant psychic influences, Dr.

Cleland mentions a fine, robust tribesman in central Australia who

was injured in the fleshy part of the thigh by a spear that had been

enchanted. The man slowly pined away and died, without any surgical

complication which could be detected. Dr. Cleland cites a number of

physicians who have referred to the fatal effects of bone pointing

and other terrifying acts. In his letter to me he wrote, "Poisoning

is, I think, entirely ruled out in such cases among our Australian

natives. There are very few poisonous plants available and l doubt

whether it has ever entered the mind of the central Australian

natives that such might be used on human beings."...

Before denying that "voodoo" death is within the realm of

possibility, let us consider the general features of the specimen

reports mentioned in foregoing paragraphs. First... is the fixed

assurance that because of certain conditions, such as being subject

to bone pointing or other magic, or failing to observe sacred tribal

regulations, death is sure to supervene. This is a belief so firmly

held by all members of the tribe that the individual not only has

that conviction himself but is obsessed by the knowledge that all

his fellows likewise hold it. Thereby he becomes a pariah, wholly

deprived of the confidence and social support of the tribe. In his

isolation the malicious spirits which he believes are all about him

and capable of irresistibly and calamitously maltreating him, exert

supremely their evil power....

In his terror he refuses both food and drink, a fact which many

observers have noted and which, as we shall see later, is highly

significant for a possible understanding of the slow onset of

weakness. The victim "pines away"; his strength runs out like water,

to paraphrase words already quoted from one graphic account: and in

the course of a day or two he succumbs.

The question which now arises is whether an ominous and persistent

state of fear can end the life of a man. Fear, as is well known, is

one of the most deeply rooted and dominant of the emotions. Often,

only with difficulty can it be eradicated. Associated with it are

profound physiological disturbances, widespread throughout the

organism. There is evidence that some of these disturbances, if they

are lasting, can work harmfully. In order to elucidate that evidence

I must first indicate that great fear and great rage have similar

effects in the body. Each of these powerful emotions is associated

with ingrained instincts--the instinct to attack, if rage is

present, the instruct to run away or escape, if fear is present.

Throughout the long history of human beings and lower animals these

two emotions and their related instincts have served effectively in

the struggle for existence. When they are roused they bring into

action an elemental division of the nervous system, the so-called

sympathetic or sympathico-adrenal division, which exercises a

control over internal organs, and also over the blood vessels. As a

rule the sympathetic division acts to maintain a relatively constant

state in the flowing blood and lymph, i.e., the "internal

environment" of our living parts. It acts thus in strenuous muscular

effort; for example, liberating sugar from the liver, accelerating

the heart, contracting certain blood vessels, discharging adrenaline

and dilating the bronchioles. All these changes render the animal

more efficient in physical struggle, for they supply essential

conditions for continuous action of laboring muscles. Since they

occur in association with the strong emotions, rage and fear, they

can reasonably be interpreted as preparatory for the intense

struggle which the instincts to attack or to escape may involve. If

these powerful emotions prevail, and the bodily forces are fully

mobilized for action, and if this state of extreme perturbation

continues in uncontrolled possession of the organism for a

considerable period, without the occurrence of action, dire results

may ensue....

What effect on the organism is produced by a lasting and intense

action of the sympathico-adrenal system? In observations by Bard, he

found that a prominent and significant change... was a gradual fall

of blood pressure... from the high levels of the early stages to the

low level seen in fatal wound shock. In Freeman's research he

produced evidence that this fall of pressure was due to a reduction

of the volume of circulating blood.

This is the condition which during World War I was found to be the

reason for the low blood pressure observed in badly wounded men--the

blood volume is reduced until it becomes insufficient for the

maintenance of an adequate circulation. Thereupon deterioration

occurs in the heart, and also in the nerve centers which hold the

blood vessels in moderate contraction. A vicious circle is then

established; the low blood pressure damages the very organs which

are necessary for the maintenance of an adequate circulation, and as

they are damaged they are less and less able to keep the blood

circulating to an effective degree. In ... wound shock, death can be

explained as due to a failure of essential organs to receive a

sufficient supply of blood or, specifically, a sufficient supply of

oxygen, to maintain their functions.

The gradual reduction of blood volume ... can be explained by the

action of the sympathico-adrenal system in causing a persistent

constriction of the small arterioles in certain parts of the body.

If adrenaline, which constricts the blood vessels precisely as nerve

impulses constrict them, is continuously injected at a rate which

produces the vasoconstriction of strong emotional states, the blood

volume is reduced....

The foregoing paragraphs have revealed how a persistent and profound

emotional state may induce a disastrous fall of blood pressure,

ending in death. Lack of food and drink would collaborate with the

damaging emotional effects, to induce the fatal outcome. These are

the conditions which, as we have seen, are prevalent in persons who

have been reported as dying as a consequence of sorcery. They go

without food or water as they, in their isolation, wait in fear for

their impending death. In these circumstances they might well die

from a true state of shock, in the surgical sense--a shock induced

by prolonged and tense emotion....

[E]vidence of the possibility of a fatal outcome from profound

emotional strain was reported by Mira in recounting his experiences

as a psychiatrist in the Spanish War of 1936--39. In patients who

suffered from what he called "malignant anxiety," he observed signs

of anguish and perplexity, accompanied by a permanently rapid pulse

(more than 120 beats per minute) and a very rapid respiration (about

three times the normal resting rate). These conditions indicated a

perturbed state deeply involving the sympathico-adrenal complex. As

predisposing conditions Mira mentioned "a previous labiality of the

sympathetic system" and "a severe mental shock experienced in

conditions of physical exhaustion due to lack of food, fatigue,

sleeplessness, etc." The lack of food appears to have attended lack

of water, for the urine was concentrated and extremely acid. Towards

the end the anguish still remained, but inactivity changed to

restlessness. No focal symptoms were observed. In fatal cases death

occurred in three or four days. Postmortem examination revealed

brain hemorrhages in some cases, but, excepting an increased

pressure, the cerebrospinal fluid showed a normal state. 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.

The suggestion which I offer, therefore, is that "voodoo death" may

be real, and that it may be explained as due to shocking emotional

stress--to obvious or repressed terror. A satisfactory hypothesis is

one which allows observations to be made which may determine whether

or not it is correct.

Fortunately, tests of a relatively simple type can be used to learn

whether the suggestion as to the nature of "voodoo death" is

justifiable. The pulse towards the end would be rapid and "thready."

The skin would be cool and moist. A count of the red blood

corpuscles, or even simpler, a determination by means of a

hematocrit of the ratio of corpuscles to plasma in a small sample of

blood from skin vessels would help to tell whether shock is present;

for the "red count" would be high and the hematocrit also would

reveal "hemoconcentration." The blood pressure would be low. The

blood sugar would be increased, but the measure of it might be too

difficult in the field. If in the future, however, any observer has

opportunity to see an instance of "voodoo death," it is to be hoped

that he will conduct the simpler tests before the victim's last

gasp.