File this under truth is very much stranger than fiction. In this month’s issue of The Forensic Examiner, there was a report of an extremely unusual case of autoerotic asphyxia. It seems that the victim, as part of his masturbatory fantasy, filled a large tub with joint compound, a substance similar to Plaster of Paris. Erotic posters lined the walls of the room and he had a pornographic VHS tape playing. Apparently his plan was to immerse himself in the plaster as part of his self-gratification scenario. Though his choice of materials was odd, this is not an unknown practice. Typically, the person will use a mud bath for this scenario. Apparently, the pressure of the mud restricts chest expansion, causes shortness of breath, and heightens the sexual release.
Unfortunately, as the scene of this man’s death was reconstructed, after he stepped into the tub he lost his balance and slipped under the surface, immediately inhaling some of the plaster. This is not something that is easily expelled from the airways and he died in short order from asphyxia. This type of asphyxia would be deemed mechanical asphyxia, since a mechanical obstruction, in this case the plaster, prevented air exchange and he died from this.
Erotic asphyxia is classified as a paraphilia and is employed during certain sexual practices. If it is employed with a partner, it would be called erotic asphyxia, while if used during a solo session, it would be termed autoerotic asphyxia. Apparently the goal is to deprive the brain of oxygen during the sexual act since many feel that this heightens the intensity of the event. A partner might use a pillow, a plastic bag, or strangulation, either manual or by use of some literature, to cause the oxygen deprivation in the other partner. This practice was featured in the movie Rising Sun. Unfortunately, these things can go wrong in a hurry. More about that in a minute.
In the case of autoerotic asphyxia, the victim usually sets up some mechanism for saving himself. If he puts a plastic bag over his head and secures it with tape around his neck, he must have some way of getting oxygen when the deprivation becomes severe. Usually he will have a knife or some other sharp object to cut the plastic so he can breathe. If he uses a noose or ligature of some type, then he will set up some way of releasing the obstruction. He might hang the rope over a door or from some other fixture and then tie it around his neck in such a fashion as to produce strangulation during the sex act. He might have a loose end that, in case of an emergency, he can pull and release the ligature, allowing himself to breathe. Unfortunately, a lack of understanding of the physiology involved in this scenario leads to tragedies more often than you might think.
Most people believe that during strangulation or hanging the victim dies because he cannot breathe. In some cases this might indeed be the cause, but that’s not the dangerous part. Most of us can hold our breath for one or two or three minutes if necessary, but then we must breathe. We know that we are becoming oxygen deprived and we know that we need to breathe. The sensation comes on gradually and increases in intensity as time goes along. But we have time to take that breath. Unfortunately when any form of obstructing ligature is wrapped around the neck, inability to take in air is not the most dangerous problem. It is the compression of the carotid arteries, the two arteries that lie on either side of the windpipe and that conduct over 90% of the blood supply from the heart to the brain, that is the culprit. When these arteries are compressed to the point that blood flow to the brain is severely restricted, loss of consciousness can occur very quickly, sometimes in 20 seconds or so. The person has very little warning. It’s not like the gradual onset of the need to breathe. The victim here suddenly loses consciousness. As you can see, if the victim is unconscious, he cannot employ his safety mechanism and therefore is found dead from strangulation. The same thing happens in people who are clowning around with ropes and similar devices and acting like they’re going to hang themselves often as part of some childhood or adolescent stunt. The victim can fall unconscious, suffer brain damage, and even die before anyone around him realizes what’s going on. It can happen fairly quickly.
The autopsy in this case showed that the victim had widespread petechial hemorrhaging in his eyes. Petechial hemorrhages are reddish dots of blood found in the sclera (white part of the eyeball) and conjunctivae (the pink tissues that surround the eyeball), and are due to the seepage of blood from the small capillaries in those areas. They indicate increased pressure in the venous system at the time of death. They can be seen in hangings, strangulations, and sometimes in drownings. When an individual in any of these circumstances struggles to draw air into his lungs, the pressure inside the chest is transmitted to the venous system and when the pressure within the vessels rises high enough, blood leaks out of the capillaries and into the tissues in and around the eyes. Sometimes the back of the throat and the airways also. In this victim’s case the pressure rose because he was trying to breathe through plaster. In addition the autopsy showed that he had large amounts plaster in his esophagus, suggesting that he not only inhaled but swallowed the plaster. Must’ve been a terrible way to die.
It you want to know more about sexual asphyxia, and I know that being the inquisitive and voyeuristic soul that you are, you do, check out these links: