An elderly, naked man, hands and genitals tied up, hanged. Autoerotic fatalities entered medical literature when the German doctor Bernt took interest in this case in his paper on suicides (1821). It took another century before attention was paid to the sexual aspects of these deaths: again a German forensic, Ziemke, in 1926 identified and consistently described these cases as accidental deaths caused by strangulation as a means to sexual arousal.

In the days of public hangings it was common knowledge that they caused erection and ejaculation. That reflex is caused by the snapping of the spine, and can be seen as a sign of sexual pleasure. (Recently experts have attributed it to the body's final instinctive attempt to shed its seed in hopes of impregnating a waiting receptor.) There are a number of references in 18th century literature, the most prominent in Marquis de Sade's "Justine" (1791), where Thirhse helps Roland achieve an orgasm by hanging him briefly. Afterwards, he exclaims: "Oh, Thirhse! Oh, these feelings are indescribable! They exceed everything!" A few months after "Justine" was published, the first documented death by sexual strangulation occurred in London: Franz Kotzwara, composer and celebrated double-bass player, and a great libertine, paid a visit on September 2, 1791, to the prostitute Susannah Hill on Vine Street no. 5; he gave her 2 shillings to buy ham, beef, porter and brandy, and after their dinner he asked her to cut off his genitals; she refused, but agreed to satisfy him by strangulation; kneeling, he hung himself with a rope tied to the doorknob. Five minutes later he was dead. Susannah Hill was charged with murder, but was acquitted after testimony proved her innocence. The court records were destroyed to prevent the scandalous case from going public. A secret copy was made, now kept in the Francis Countway Library of Medicine in Boston. But the story did get out, and was hinted at in the newspapers. The year after, it was discussed in an anonymous pamphlet "Modern propensities; or, An Essay on the Art of Strangeling, & c. Illustrated with Several Anecdotes. With Memoirs of Susannah Hill, and a Summary of her Trial at the Old Bailey on Friday, September 16, 1791, on the Charge of Hanging Francis Kotzwara, at her Lodgings in Vine Street, on September 2" (J. Dowson, London 1791). In 46 pages, it discusses the putative effects of hanging on the body, the Kotzwara and Susannah Hill case, and an earlier incident concerning a Reverend Manacle, who was working in the Newgate prison, who had contracted a veneral desease that rendered him impotent. Observing the effects of hanging, he approached a female prisoner, Mrs. Birdlime, who was sentenced to death for shoplifting; he pretended he wanted to demonstrate with his own body how painless it was to be hanged; persuaded, she assisted him in the act. When he was cut down and regained consciousness with the expected erection, she agreed to have sex with him as a reward for his sacrifice. Manacle repeated this hanging act with other women prisoners, and ended up killing himself in the process. The pamphlet also cited the example of General S. who suffered from "a certain corporeal debility, which prevented him from regular enjoyments." And it discloses that it was the notorious Jonathan Wild who first discovered, while searching the pockets of hanged felons, that "They evinced certain emotions and commotions, which ... proved that all flesh must die to live again." From then on, the pamphlet describes in detail "the sublime science of strangulation" and the "lively sensations" it provokes. It suggests ways to lessen the visible physical marks and permit greater security and control, referring to "the celebrated Patent Inventor of Spring Bands, on Mount Street, who, from his wonderful improvements in surgery and mechanics, could very probably invent not only a safe but an agreeable and graceful mode of suspension," and promoting the use of "elastic garters" for self-hanging and a product from the same inventor called "Vanbutchell's Balsam of Life". It is assumed that the eccentric quack Martin Vanbutchell himself wrote the pamphlet. At that time he placed advertisements in the papers that praised hanging and strangulation as a means to sexual satisfaction.

It might also be Vanbutchell who is the author of some articles on strangeling in "The Bon Ton Magazine"(1793). The first one explores "The Origin of Amorous Strangulation", while the other discusses "The Effects of Temporary Strangulation on the Human Body". The tragic end of Kotzwara is told once more, illustrated in a print that depicts a smiling Susannah Hill in the process of placing a noose around Kotzwara's neck. He sits in front of the fatal doorknob with a glas and a suggestive bottle in his hand that leaves no doubt about the sexual aspects of the act. Thanks mainly to Vanbutchell and his twisted interests in propagating the case, sexual strangulation has since then also been referred to as "kotzwarism" in the proud tradition that christens sexual specialities after their prime exponent.

Scientific research viewed bodily pleasures and sexuality from the perspective of the "civil" bourgeois norms, which society as a whole was subjected to throughout the 19th century. The morals condemned sexual activity as irrational and "deviating" except for the quick procreational back and forth in the matrimonial bed. The whole spectrum of sexuality was thereby turned into a medical issue, being dealt with in terms of disease, diagnostics and classifications, with matching etiologies and normalizing treatments in psychiatry (sex as insanity) and legal medicine (sex as crime). If masturbation was associated with sickness, insanity and death, autoerotic satisfaction by strangulation was studied in connection with mental disorders and sexual pathologies. The pioneering work was done in Vienna, the breeding ground for psychoanalysis, as well as sexology in the Institute for Sex Research. Their dissertations on sexual practices and preferences reflected the uneasy sexuality of the times as much as the "perverse" nature of the subjects. There are discussions of sexual strangulation in works by Eulenburg (1895), Stekel (1929), Ellis (1936), and the first recent mentioning of Kotzwara's story occurred in Hirschfeld's "Sexual Anomalies: The Origins, Nature and Treatment of Sexual Disorders" (1948). It was partly due to these and other sexological descriptions that forensics, by and by, was able to identify and explain certain deaths as accidents in the process of sexual self-strangulation. It was isolated at last and defined as a clinical entity by the german Schwarz in 1952, and later given the scientific name "sexual asphyxia" by Brittain in 1968.

                   THE POPULARITY OF THE BREATHLESS ORGASM

The central element of the "syndrome" is the pursuit of the physiological effects of insufficient oxygen supply to the brain via: hanging and strangulation, suffocation (with plastic bags and the like), blocking the respiratory organs, compressing the chest, and chemically through the use of narcotics. The stimulation of the "high" might be enjoyed for its own sake, but is often accompanied by masturbation. It also frequently goes hand in hand with other "perversions", or "paraphilia": a high frequency of cordophilia (the pleasure of being bound and sometimes hung in ropes and chains); sexual bondage in the form of tight dresses and hoods (latex, rubber, leather), rain boots, blindfolds and gags; clips in the nipples, body-piercings, branding of the genitals and other self-tortures; fetishism (stimulation by the sight and touch of certain materials and objects like pieces of clothing); transvestism; voyeuristic usage of S&M pornography; and narcissistic mirroring or self-portrayal with cameras or video which has resulted in recordings of fatal accidents.

Generally the cause of death is asphyxiation due to strangulation, and similar accidents involving deficient oxygen supply. It can occur in connection with other forms of autoerotic stimulation, i.e. heart failure, due to high blood pressure, perforation of the bowel wall, broken necks as a result of falling from self-bindings, or hypothermia occurring when the person is unable to free himself from intricate knots in natural settings. Schackwitz describes a case in 1931, where a 37-year-old shop assistant was found dead in his bed. He was lying under the covers, gagged with handkerchiefs, the head tightly wrapped in a towel. His legs were tied with towels, the hands tied up behind his back. He was clutching a nail scissors in his left hand to free himself, but the arteries were cut up by the tight laces around the wrists, and he bled to death. Many deaths occur during sexual stimulations with electricity, putting the genitals into a bowl of water together with both ends of a live wire, or touching the penis wrapped in tinfoil with one end of a wire, while the other end is held in the hand. Putzmann describes the death of a 15-year-old electrician’s apprentice utilizing a complicated installation that connected the mains with a teaspoon in his anus and an aluminum cord around the penis via a glim lamp in his mouth. Perhaps the most unique of all autoerotic fatalities, "The Love Bug", was published by Rupp in 1973, actually involving an "auto". In this case, a 40 year old pilot from the U.S. Air Force had put on a self-manufactured harness, and let himself be drawn naked in chains behind his Volkswagen sedan, set to circle in the first gear in a deserted parking lot. On one occasion, though, the chains got tangled with the back wheel, and he ended up being squeezed to death against the car. This behavior could very well be seen as an answer to Jean Rosenbaum’s book, published the same year, "Is Your Volkswagen A Sex Symbol?"

Sexual asphyxia is the most fascinating, when it appears together with the secondary "paraphilia" in intricate autoerotic rituals displaying the excessive inventiveness of desire. They sometimes suggest torture machines from the Middle Ages, constructed for the production of intense polymorphic pleasures through self-bindings, hangings, torments, oral, anal, and genital stimulations of every conceivable kind. For the same reason, autoerotic practices were referred to as "bachelor machines" by Michel Carrouge in his influential book on sexual politics and esthetics "Les machines celibataires" (1954). This term is a very appropriate one, in so far as the actual practitioners might be anything between 8 and 80 years old, but on average they are in their mid twenties, and almost exclusively men.

In continuation with the sexual liberation and the critique of bourgeois morals and gender roles in the sixties and seventies, Carrouge's book formed the basis for an exhibition under the same name in Venice in 1975. It showed sculptures like the bicycle inspired "bachelor machines" by Marcel Duchamp ("Mariee ...") and Robert M|ller ("La Veuve du coureur"), side by side with documentary photographs of autoerotic practices, for instance a naked man strapped on an oversize bicycle wheel ("Masturbation with complicated machinery"), taken from the forensic textbook by Weiman and Prokop,"Atlas der gerichtlichen Medizin" (1963). The same textbook furnished the materials for a series of paintings by Heike Ruschmeyer, "Artists" and "Acrobats", exhibited in Berlin in 1983. She uses photos of autoerotic fatalities, presenting the human body as dead, physical matter, deprived of emotional and symbolic content. She counteracts the public's rejection, and brings the dead bodies as well as the spectators "back to life" by stimulating emotional investments and identification through iconographical enlargements of the pictures, painted over in the brilliant colours appropriate for the polymorphous sexuality. She states in the catalogue: "I have long since left the cult of the death drive behind me, and revived Prokop's corpses in flying cadmium-red angles and lemon-coloured androids" By doing so, she takes the practitioners of sexual asphyxia away from the realm of medicine, criminology, pathology and social taboo, and recontextualizes them as artists belonging in galleries and circuses to be viewed, acknowledged, even admired by the public.

This use of forensic photos might provoke and shock by confronting the spectators with realistic representations of the body, sexual practices and death transgressing esthetic and behavioral norms. Beyond the shock value lies the intention to transform these conventions themselves, bringing about a social recognition of hitherto unacceptable and excluded subjects. For the last two hundred years, art was supposed to transcend carnality and low sensual desires that tie human beings to the physical world. On the contrary, modern art and especially the avant-garde movement has focused on the body and the mental moldings of its desires as the source of art and symbolic systems. First and foremost, this has been the domain of performance and body art, involving the artists themselves in sensual explorations that sometimes come indistinguishable close to autoerotic rituals.

Again, Vienna was in the forefront in the early sixties, when Hermann Nitsch presented a series of outrageous performances that would later be turned into the OM (Orgies Mysteries) Theatre. They expressed the desire to constitute something like an animistic or Dionysian oneness with nature within a "desensitized" and "alienated" civilization, as the slogans of the times went. In 1965 he formed the "Wiener Aktionismus" group together with Otto Mohl, Rudolf Schwarzkogler, and G|nter Brus. Much in the same vein, their work was devoted to catharsis and liberation through the performance of taboo acts that were extremely violent and abject. For instance, Brus would appear dressed in a woman's black stockings, brassiere, and garter belt, slash himself with scissors till he ran with blood, vomit, defecate, eat his own excrement, and so on. Within the licensed context of art, they tested the limits of their own and the public's tolerance in "Aktionen" that more often than not were received with shock and disgust, occasionally even shut down by the police.

In the following decade, the acts of self-mutilation and taboo breaking in body art were met with the same reaction, whether it was Linda Montano inserting needles around her eyes ("Mitchel's Death", 1978), Kim Jones cutting himself with a razor blade twenty-seven times in a pattern suggesting the body's circulatory system, or Paul McCarthy, who showed up in a wino hotel wearing a blond wig, black lace panties smeared with blood, and proceeded to fornicate with piles of red meat and ground hamburger with his penis painted red, a hot dog shoved up his rectum ("Sailo's Meat", 1975). The performances were committed to a social and esthetical emancipation and redefinition of sensuality within frames of reference that spanned ancient bacchanalia and sacramental rites, shamanic magic, Hindu ascetics and on to the notion of the artist as the artwork himself in Romantic or Abstract Expressionist art. From an alternate viewpoint, though, many of these acts only differ from autoerotic, masochistic and other polymorphously perverse sexual practices in context and intent. This even goes for a case as special as "The Love Bug", which got its artistic counterpart, when Chris Burden had himself shot in the arm and crucified to the roof of a Volkswagen in 1971 and 1974.

The resemblance is perhaps most striking in the works of body artist Fakir Musafar. He is a part of the sado-masochistical subculture, an early advocate of body piercings with Gauntlet Enterprizes, and a practitioner of torturous trials and body modifications as an artform. In the act "Suspension" (1964), for instance, he was placed naked in front of a mirror, hanging from a rack, suspended in his own skin, the wires hooked through the breasts, clips in the nibbles, the penis tied up with a string, and tight belts around the legs, the waist, the arms. Down to the domestic setting, and the little, improvised step-ladder of books, the act presents a picture so close to the scenery of some autoerotic fatalities that it is distinguished only through secondary information.

The literary history of sexual asphyxia followed much the same development as the visual arts. In the 19th century, the subject is absent save for a few instances. A hanging scene, similar to the one in "Justine", takes place in "Gamiani, ou Deux Nuits d'Exces" (1833), a novel filled with sadism and bestiality, often attributed to Alfred de Musset. Further, death by sexual hanging occurs in a mainstream novel by Karl Ferdinand Gutzkow, "Der Zauberer von Rom" (1859-61). With the advent of modernism, realistic representations of sexuality found their way into high literature, including erotic hanging, and it is fittingly present in "Ulysses" (1922), where James Joyce describes the aftermath of the hanging of the Croppy Boy: "He gives up the ghost. A violent erection of the hanged sends gouts of sperm spouting through his dead clothes on to the cobblestones. Mrs. Bellingham, Mrs. Yelverton Barry, and the Honorable Mrs. Mervyn Talboys rush forward with their handkerchiefs to sop it up."

The most consistent and enthusiastic poet of sexual asphyxia must be William Burroughs. "Cities of the Red Night" (1981) is practically dedicated to Ix Tab, goddess of the hanged in Mayan culture, so much so the review in New York Times was entitled "Pleasures of Hanging". Nevertheless, he is only serving leftovers from "Naked Lunch" (1951), where hanging is a regular on the menu. With a great deal of empathy he describes the sensations of a boy who is stimulated sexually while being hanged: "Green sparks explode behind his eyes and sweet toothache pain shoots through his neck down the spine to the groin, contracting the body in spasms of delight."

Burroughs envisioned the human being as a "soft machine": an uncentered sensitivity with completely unbound and liquid catheter-like energies that could take on all shapes and forms and always be ready for new pleasures. This fantasy was seized upon by Gilles Deleuze and Felix Guattari and used in the famous book "Anti-Oedipus" (1972), an academic outgrowth of the French students’ revolt in the sixties. They celebrate the triumph of the pleasure principle and partial drives over the determination of gender, genitals and social reality through "bachelor machines". The concept of the human subject as a "machine" for the production of unrestricted satisfaction implicated a psychotic suspension of repressions and the objective world. Highly inspired by anti-psychiatry and especially Laing, this hymn to psychosis and eternal flux might be attractive on paper. In real life, though, it is a questionable thing, as was experienced by Kurt Vonnegut's oldest son, Mark. Having spend considerate time in mental institutions, being diagnosed as a schizophrenic after "three major breakdowns and a few minor ones", he wrote with some irritation about Laing's and his disciples' exalted view on the condition in "Why I want to bite R. D. Laing" (Harper's, April 1974):

"He said so many nice things about us: we're the only sane members of an insane society, our insights are profound and right on, we're prophetic, courageous explorers of inner space and so forth. But what I felt when I found myself staring out of the little hole in the padded cell was betrayal: I did everything just like you said, and look where I am now, you bastard."

If not to the point of psychosis, the emotional and cognitive models that were tried out as transgressions within the context of art have nonetheless been accepted to some degree by society. The stance towards the body, its functions and desires has become less rigid, and the repertoire of social and gender roles is much broader than it used to be. The arbitrariness of the signifiers of sexual difference (haircut, clothes, gestures, etc) is not restricted to the realm of the "deviant" or avant-garde, and there is considerable cross-over to mainstream culture even from sexual undergrounds like sadomasochism.

By and by, even the extremes of body art have become less offensive and out of bounds through sheer repetition, conditioning of the audience, critical acclaim, institutional acceptance, and because of the widespread change in attitudes and modes of reception that the artists themselves participated in bringing about. A few years ago, a crane suspended Stelarc from fishhooks in his skin and lifted him above (of all things) The Royal Theatre in Copenhagen. Likewise, sexual asphyxia is a regular in crime novels, since P. D. James described the alteration of a death scene to make it appear like an autoerotic fatality in "An Unsuitable Job for a Woman" (1972), and it is the subject of an entire sexual thriller by J. Money, G. Wainwright and D. Hinsberger, "The Breathless Orgasm".

                        THE MECHANICS OF ASPHYXIATINGLY GOOD SEX

Sexual asphyxia is now being discussed in popular Sexual Advice Literature, and the normative attitude in scientific sex research has been replaced by a more neutral and descriptive approach to sexual states and mechanisms. Nonetheless, it is still expelled to the realm of the pathological as a "paraphilia", and largely dealt with in medical terms oriented towards the diagnosis and the treatment of a "deviance" from norms of behavior considered to be natural and universal.

These standards of behavior imply a high degree of repression and sublimation. The individual's experience of his own body and sensual pleasure is displaced and transformed into the experience of the surroundings and the desire for other persons and objects, or even channeled totally into symbolic, mental activities. The opposite takes places in autoerotics, where the active and out-turned projections and emotional investments temporarily are withdrawn from the environment and reinvested in the body. That is why these practices are so taboo, they go against the demand to repress the affective body and express the emotions via something else in an objectified and socially mediated way, whether it is an interest in clothes, the partner, the internet, whatever is approved by the surroundings.

The autoerotic gadgets and techniques attract a lot of attention. Spectacular as they may be, from an economical viewpoint they are only means to a goal, the emotional charging and resensitizing of the body to increase arousal. In that respect, they don't differ from roller coasters and other devices in amusement parks. Many of them are instruments to break down the individual's control of himself and his surroundings in a paralyzed and helpless position. Reducing voluntary control and the ability to act produces an intense feeling of being an other-directed, passive body, where the consciousness of the body and it's sensations reaches a climax. Furthermore, self-bindings and bondage causes a blocking and a withdrawal of all projections to the body, because the blocking of the motor and perceptual systems (blindfolds, etc.) implicates the disappearence of an outer world to invest with emotions and act upon as an object. Finally, the possibility to regulate sensations and levels of arousal by motor outlets, modification of the sensed objects or flight is suspended. Therefore, the arousal can escalate uncontrollable to the point of panic (like having a nightmare, being buried alive), culminating with the orgasmic release and brief blackout of the objective world, even unconsciousness.

While often being stimulated by masturbation, orgasm also occurs all by itself. There are many indications that voluntary control disappears at very high levels of arousal connected with lacking possibilities (or enactive models) to reduce the level, triggering instead arousal-reducing autonomic impulses and response-patterns of relaxation. This orgasm-like somatic reaction might be one of the desired effects in sexual hanging besides the "high" of asphyxiation. In addition, the strong arousal by fear and high sexual arousal have the arousal itself and the increased bodily experience in common: dizziness, shivering, gooseflesh, palpitation, breathlessness, and so forth. It is only the subjective evaluation of the arousal as a negative state (pain and fear) or a positive state (pleasure and sex) that determines its quality. The same ambiguity of pain and pleasure goes for the passive masochistic passion. Again, the connection is that both passion and pain are results of a strong arousal superseding the voluntary control, while their difference is determined only by the cognitive-hedonic evaluation. Fear and pain seem to be a degree better at producing the objectless state of arousal that is being cultivated by autoerotics.

The active desires directed at objects are established much later in life than the passive pleasures, erasing the distinctions between Object and perceiving Subject in a boundless sensuality. This polymorphous sensuality goes back to a time, when the individual was helpless and dependent on the care of the nursing person, that is, the mother. Therefore, it is not unlikely to see the reactivation of early, passive-incestuous fascinations between pleasure and fear in autoerotic practices, as might well be the case in transvestism also. The rituals could be understood in terms of problems with a positive evaluation of high levels of (incestuous, or otherwise prohibited) sexual arousal, being relabeled and dealt with as fear, pain, and punishment. There is a high incidence of boys in puberty who practice sexual hanging in connection with transvestism in their mother's clothes and narcissistic identification with themselves as other in a mirror. In the end, though, the subjective motives and biographical causes for the "misinterpretation" of sexuality and gender identity by masochist and transvestite asphyxiophiliacs remain unknown, because it is always to late: they are dead.

In 1972, Litman and Swearingen reported a fatal case of autoerotic asphyxia encompassing bondage, cross-dressing, masochism and extreme risk-taking. The clinical picture cannot be reduced to pathology, it shows burning desire and wild aesthetics, transgression, body art, even literature in the same blinding flash. The young man was dressed in women’s underwear, brassieres, panties and garter belts, wearing a blond wig, full makeup, jewelry, and a taffeta dress. There was a pair of panties in his mouth, and he had two false rubber breast pads placed wet over the nose and the mouth. A stocking was pulled down over his head, secured around the neck with a choker. Bound in chains with padlocks at the knees, the wrists, the neck, he hung himself. His body was charred, because he had set himself on fire in the act. He left a suicide note, addressed, "To whom it may concern - please be tender when you cut me down". Anticipating his last minutes in a thrilling piece of terminal prose, he describes the terror and sexual excitement of the autoerotic ritual, culminating with orgasm and death:

"I know what I'm going to do next. I'm really terrified by sadistic thrill. It is 9:35 Sunday night and in three minutes I will be dead. I strike the match, reach down and set fire to the gossamer edge of the black nylon slip. Quickly I wrap the chain around my wrists and snap the padlock firmly. In a frenzy of passion, I kick the chair over and my body is spasming at the end of the chain noose. I come wildly, madly. The pain is intense as my clothes start burning my legs. My eyes bulge and I try and reach the keys, knowing I have finally found the courage to end a horrible nightmare life dangerously."

                                        MEDICAL WARNINGS AND FACTS

Most suffocation and/or strangulation done in an erotic context (known as breath control play, or asphyxiophilia) puts the recipient/practitioner at risk of cardiac arrest. Often the first detectable sign that an arrest is approaching is the arrest itself. If the recipient arrests, the probability of resuscitating them, even with CPR, is small; the recipient is dead and their partner is in a tough legal position, since police treat such deaths as first-degree murders until proven otherwise by the defendant, whose best witness is dead. There's also the surviving partner's remorse to having caused such a death, and the trauma to the friends and family members of both parties. Breath control fans say that what they do is acceptably safe because they don't take it to the point of unconsciousness. But no one really knows when a person is about to go unconscious, and unconsciousness is a symptom, not a condition, that has numerous underlying causes ranging from simple fainting to cardiac arrest. In fact, so far no physician, nurse, paramedic, or other person with training in how a human body works has advocated a form of breath control play that does not put the recipient at risk of dying.

Most people (from urban teenage boys to aging farmers on their tractors) die from autoerotic strangulation (solo play). The stats are unclear, since family members often "sanitize" such scenes before calling 911. The American Psychiatric Association estimates a death rate of one person per year per million of population -- thus about 250 deaths last year in the U.S. Law enforcement estimates go as much as four times higher.

Oxygen runs the human body, so hypoxia (becoming dangerously low on oxygen) can shut it down. One minute of asphyxiation can kill. There are many documented cases of as little as five seconds of choking causing a vagal-outlfow-induced cardiac arrest. Even hooking the bottom up to both a pulse oximeter and a cardiac monitor; if you ease up at first sign of PVCs, the PVCs could stop almost at once, or they could continue for hours. In some cases the recipient appeared to fully recover but was found dead several hours later. CPR can only increase the chance of survival by 10%. 

When the heart gets low on oxygen, it starts to fire off "extra" pacemaker sites. These usually appear in the ventricles and are thus called premature ventricular contractions -- PVC's for short. If a PVC happens to fire off during the electrical repolarization phase of cardiac contraction, it can kick the heart over into ventricular fibrillation--cardiac arrest. The lower the heart gets on oxygen, the more PVC's it generates, and the more vulnerable it becomes. When breathing is restricted, the body can't eliminate carbon dioxide, and the amount of carbon dioxide in the blood increases. Carbon dioxide (CO2) and water (H2O) exist in equilibrium with what's called carbonic acid (H2CO3) in a reaction catalyzed by an enzyme called carbonic anhydrase. A molecule of carbonic acid dissociates on its own into a molecule of what's called bicarbonate (HCO3-) and an (acidic) hydrogen ion. (H+) If breathing is restricted, CO2 builds up and the reaction shifts to the right in an attempt to balance things out, making the blood more acidic and decreasing its pH. This is respiratory acidosis. (If the patient hyperventilates, they "blow off CO2" and the reaction shifts to the left, thus increasing the pH. This is respiratory alkalosis.) Finally, if breathing is restricted, oxygen has a hard time getting in. A molecule of glucose (C6H12O6) breaks down within the cell by a process called glycolysis into two molecules of pyruvate, creating a small amount of ATP for the body to use as energy. If there's not enough oxygen to metabolize the pyruvate, it is converted to lactic acid and produces a metabolic acidosis, causing the pH of the blood to fall to life-threatening levels. The pH of normal blood is in the 7.35 to 7.45 range (slightly alkaline). A pH falling to 6.9 (or raising to 7.8) is "incompatible with life."

There is also risk of cumulative brain damage if the practice is repeated often. Lab studies of repeated brief interruption of blood flow to the brains of animals, and studies of people with what's called "sleep apnea syndrome" (in which they stop breathing for up to two minutes while sleeping) show cumulative brain damage. Other documented dangers: rupture of the windpipe, fracture of the larynx, damage to the blood vessels in the neck, dislodging a fatty plaque in a neck artery which then travels to the brain and causes a stroke, damage to the cervical spine, seizures, airway obstruction by the tongue, and aspiration of vomitus.

                                                THE FUN OF NEARLY DYING

Excerpts from a description by Michael Decker:

Visions of elbows pulled sharply back and taped together. Of wrists and hands squeezed tight, useless, cocooned in silver tape. Of a fine wire noose sinking, biting into a defenseless throat, the hog tie pulled taut from ankles bowed painfully. These beloved time tested images exhilarate my fight. I smell my own pungent fear. The sweat seeping from armpits and crotch forms cold pools on wrinkled latex. Fantasies of death, fear, vulnerability electrify me, my crotch involuntarily rocks, metronome like.

I am alone, hog-tied, ankles cinched back, clipped to the leather harness constricting my waist. Lying naked on my side the latex sheeting mutates from fire to ice as I squirm, repositioning myself, searching for the freedom I do not want. Rope tightly wrapped just under both knees and around both ankles binds my legs as one. My engorged, dark veined cock is separated from my balls and thrust out by 3 rings of welded surgical steel. The waist harness connects to the rings, and there's a carabineer welded to an aluminum plate, riveted to the harness just behind the butt plug. When I wriggle my double shock cord looped wrists, secured in the carabineer, the plug moves and twists, refocusing my attention to my very sore and sensitive portal. My elbows are also bound together by twin loops of heavy shock cord.

A long rubber belt wrapped around my thighs captures an industrial size vibrator. It's set on a low frequency, and I experience heavy pounding vibration through my balls, pulsing all the way up my shaft. Flexing my crotch increases my need to come, but it's still just out of reach. In earnest I renew my struggle, needing to reaffirm the illusion of my helplessness, "that my bondage is inescapable".

A rigid, searing cock betrays my feigned terror. My mouth is dry, tongue curled under and forced back from struggling with the red lacquered ball. The taut multi-strap muzzle digging into my temples tightly grips my head, leaving me exposed and vulnerable. A thick layer of tape covers the gag, sealing screams in and air out.

I want the delicious nipple pain to stop, because the feelings are too intense. Small, wide plastic spring clips mash the sensitive tips. The nipples spasm and twitch, their metal rings wired to an automated shock box set uncomfortably high. Pain competes with pain.

Breathing is tenuous. The two-inch rubber belt, snug around my neck allows little room for error, flexing the neck-muscles constricts blood flow, relaxing almost restores it. The danger sharpens my consciousness. The vibration quickens my pace. There's one last device: a small rectangle of latex rubber cut from an old medium weight garment and taped in place just below my nostrils. The flap partially covers my only source of air, breathing must be slow and controlled. As fear overtakes me and panic begins, I fight for air and the flap seals my nostrils, breathing stops, and forces me to focus on control.

Getting close to panic and death excites me. At ages 5, 7, & 12, I experienced near drownings and became fascinated with pre-panic breath deprivation. My mother was a religious zealot, and when she caught me masturbating at an early age, told me "God kills masturbators". Self-gratification equals death. I negotiated with God nightly, "I promise this will be the last time I beat off if you'll just will let me live...no, really". If you fear something enough, and tease it often without penalty, you may become an expert at chasing it. Do I want to die? No. I want to live so I can keep pursuing the pleasures I get from stalking death's intensity. I'm as insane as any other danger seeker, but my motives are easier to understand, self-gratification.

When death seems inevitable, quickly approaching, when we know escape has been taken away, we fight with commitment and unsuspected strength, for in that fight we find our reward. We are never more awake, more alert than in the battle with death. Panic awakens us to all that is life. In panic we blossom, there is no monotony or routine. "Embrace fear" is our mantra. Each time we win the fight, we wait, anxiously anticipating the next battle. If we're defeated, and die, we have no regrets, we've reaped the rewards of our bravery, and we've savored the extreme passions and intensities of our being. Life is not safe! Life is not benevolent! Life is not consensual!

BIBLIOGRAPHY

Hazelwood, Robert R., Autoerotic Fatalities, Lexington, Mass.: Lexington Books, c1983.

Money, John, The Breathless Orgasm: a Lovemap Biography of Asphyxiophilia, Buffalo, N.Y. : Prometheus Books, c1991.