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Forensic Pathology, State Health Laboratory Services, Queen Elizabeth H Medical Centre,
Nedlands, Western Australia
Summary
We describe the circumstances and post mortem medical
findings of 4 unusual fatalities where death occurred during
autoerotic practice. Three cases occurred in young to middleaged men - - hanging, electrocution and inhalation of a zucchini.
The manner of death in each was accidental. The fourth case
was an elderly man who died of ischemic heart disease,
apparently whilst masturbating with a vacuum cleaner and a hair
dryer.
The body was dressed in female clothing, including panties, a brassiere, camisole, suspenderbelt and black stockings, and was partly seated
on a chair (Fig. 1). Suspension was from a roof rafter, with a petticoat
extendingfrom the neck of the deceased to a wire which was tied around
the rafter. The left leg was also suspended from the rafter, by a separate
ligatureof further femaleclothing. The penis and scrotum were exposed,
with a belt and 6 elasticized bands tied around the scrotum. Alongside
the body were ladies' underwear, hair wigs and 2 pornographic magazines, one depicting sexual activity.
The autopsy showed the body of a middle-agedman of normal build.
The facial skin was suffused. There were numerous petechiae, around
and on the eyes. A ligature mark encircled the neck. The penis was
engorged and semi-erect.
Internal examination showed mild pulmonary congestion but no
further abnormality. There was no injury to the neck tissues. There
were no epicardial or visceral pleural petechiae.
Toxicological study showed a blood alcohol level of 0.131 g%;
common drugs were not detected.
Further enquiry revealed that the deceased was born the youngest
of 3 children, and had suffered from enuresis until his early teens. He
had been married for '18 yrs: The year prior to his death his wife had
found female clothing and pornographic magazines amongst his
belongings, which she had disposed of by burning. The basement of
the house where his body was found was freely accessible from the
outside. Although the house was owned by the local church and used
as a child care centre during the day, the basement was apparently a
well-known evening haunt of the local homosexual community.
CASE REPORTS
Case t: Hanging
The body of a 48 yr-old man was found suspended by the neck in the
cellar of a suburban house. He had been last seen alive5 days previously.
Fig. 1 Accidental asphyxiation due to hanging. There is a crossdressing of the male victim.
Figs. 2a and 2b
Patterned, superficial electric burn marks on the skin of the abdomen (2a: magnification 0.5) and penis (2b: magnification x 1.5).
Case 2: Electrocution
The body of a 32 yr old man was found lying supine on the bed in his
quarters, in a country mining town. He had been last seen alive 3 days
previously, when he had been drinking in the bar.
The body was naked, showing changes of decomposition. A braided
flexible electric cord extended from a wall-mounted electric plug
(switched " o n " ) to the left side of the chest. The cord had been taken
from an electrical appliance; the appliance plug had been removed from
the cord, bare wires being thus exposed. Attached to one of the live
wires of the electric cord was a 45 cm long metal neck chain, extending
down the left side of the abdomen to a single loop wrapped around
the base of the penis. The negative wire of the electric cord was in contact
with the chest of the deceased; the earth wire was tucked into the
rubber/fabric shroud of the cord. At the site of contact with the negative
wire on the chest was an electric burn to the skin extending into
subcutaneous fat. A further, patterned, superficial electric burn mark
extended down the left side of the abdomen and around the base of
the penis, the pattern corresponding to that of the neck chain (Figs.
2a and 2b).
Autopsy examination showed changes of decomposition, but was
otherwise unremarkable. Identification was established by fingerprint
comparison.
Toxicological study demonstrated the presence of alcohol in the blood
(0.229 g%) and bile (0.205 g%). It is unlikely that all of this is explained
by post mortem generation due to decomposition.
The electrical apparatus was assessed by professional inspectors. The
metal chain had an electrical resistance of about 100 megohms, greater
when the chain was slack but less when straightened and taut; skin
contact with either the bared wires or more proximal part of the chain
was expected to be particularly dangerous.
Further enquiry revealed the man to be separated from his wife; he
lived in single-mens quarters of a mining company. He had recently
travelled overseas where it is believed he learnt of the autoerotic use
of electricity. The electric voltage overseas was less than half that of
the mining town (110 V as compared with 240 V throughout Australia).
Case 3: Choking
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The naked body of this 77 yr old widower was found in the bathroom
of his home (Fig. 4). Adjacent to the body, and switched on and
working, were a vacuum cleaner and a hair dryer. A pair of men's underpants was impacted in the hose of the vacuum cleaner.
Autopsy examination showed the body of an elderly man o f normal
build. There was no evident injury; in particular there were no apparent
marks of electrical injury.
Internal examination showed enlargement of the heart with extensive ischemic fibrous scarring of the thickened left ventricular
myocardium. Extensive calcified coronary arteriosclerosis was present,
with no thrombosis. There was no significant valvular disease. The lungs
were mildly congested and there was benign hypertensive nephrosclerosis.
Toxicological analysis was unremarkable.
The vacuum cleaner and hair dryer, together with the electric circuitry
of the house, were assessed by an electrical inspector and cleared of
malfunction.
The cause of death was therefore believed to be combined arteriosclerotic and hypertensive heart disease. The scene examination suggested
the likelihood that the electrical appliances were being used
autoerotically.
DISCUSSION
Autoerotic deaths are typically unwitnessed, the death
usually occurring in a discrete or isolated setting,
reflecting the secretive nature of this type of sexual
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the thrill-seeking being associated with arousal and exhilaration. 39 Others have suggested an association between
autoerotic behaviour and strict, punitive parenting,
leading to the suggestion that an association between
cruelty and sexuality is formed, the former manifested
as sadomasochism with self-directed pain and humiliation. 12 Alternatively, is there eroticization of helplessness
and risk-taking, victory and a sense of success resulting
from survival? 14As indicated by Sheenan and Garfinke112
"male and female, punishing conscience and guilty
sinner, sadist and masochist, pain and pleasure, victim
and voyeur all seem to converge in a single act".
ACKNOWLEDGEMENTS Thanks are offered to Mr D. A.
McCann, Perth City Coroner, and Professor J. M. N.
Hilton. Mrs Lorraine Kinsey kindly typed the manuscript.
Address for correspondence: C.T.C., Chief Forensic Pathologist, Forensic
Pathology, State Health Laboratory Services, QEII Medical Centre,
Nedlands, WA 6009.
References
1. Resnik HLP. Erotized repetitive hangings: a form of self-destructive
behavior. Am J Psychother 1972; 26: 4-21.
2. Sass FA. Sexual asphyxia in the female. J For Sci 1975; 20: 181-5.
3. Scott B. Sexual asphyxia. Aust Pol J 1975 (Apr); 85-90.
4. Walsh FM, Stahl C J, Unger HT et al. Autoerotic asphyxial deaths:
a medicolegal analysis of forty-three cases. In: Wecht CH, ed. Leg
Man Ann. New York, NY: Appleton-Century Crofts, 1977; 157-82.
5. Knight B. Fatal masochism - - accident or suicide? Med Sci Law
1979; 19: 118-20.
6. Hazelwood RR, Dietz PE, Burgess AW. The investigation of
autoerotic fatalities. J Pol Sci Admin 1981; 9: 404-11.
7. Hazelwood RR, Burgess AW, Groth AN. Death during dangerous
autoerotic practice. Soc Sci med 1981; 15E: 129-33.
8. Emson HE. Accidental hanging in autoeroticism. An unusual case
occurring outdoors. Am J For Med Path 1983; 4: 337-40.
9. Wesselius CL, Bully R. A male with autoerofic asphyxia syndrome.
Am J For Med Path 1983; 4: 341-5.
10. Hiss J, Rosenberg SB, Adelson L. "Swinging in the park"; an investigation of an autoerotic death. Am J For Med Path 1985; 6: 250-5.
11. O'Halloran RL, Lovell FW. Autoerotic asphyxial death following
television broadcast. J For Sci 1988; 33: 1491-2.
12. Sheehan W, Garfinkel BD. Adolescent autoerofic deaths. J Am
Acad Chil Adolesc Psychiatry 1988; 27: 367-70.
13. Garza-Leal JA, Landron FJ. Autoerotic asphyxial death initially
misinterpreted as suicide and a review of the literature. J For Sci
1991; 36: 1753-9.
14. Bell MD, Tate LG, Wright RK. Sexual asphyxia in siblings. Am
J For Med Path 1991, 12: 77-9.
15. Byard RW, Bramwell NH. Autoerotic death: a definition. Am J
For Med Path 1991; 12: 74-6.
16. Boglioli LR, Tuff ML, Stephens PJ et al. A case of autoerotic
asphyxia associated with multiplex paraphilia. Am J For Med Path
1991; 12: 64-73.
17. Hazelwood RR, Dietz PE, Burgess AW. Autoerotic fatalities.
Lexington Books. DC Health and Company, 1983.
18. Byard RW, Hucker SJ, Hazelwood RR. A comparison of typical
death scene features in cases of fatal male and female autoerotic
asphyxia with a review of the literature. For Sci Intl 1990; 48:
113-21.
19. Byard RW, Bramwell NH. Autoerotic death in females: an underdiagnosed syndrome? Am J For Meal Path 1988; 9: 252-4.
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