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December 20, 2001
Media Contact: Dolores Davies, (858) 534-5994
TO DEATH,” MORE THAN JUST AN EXPRESSION
In the legendary Sherlock Holmes story “The Hound of the Baskervilles,” by Arthur Conan Doyle, Sir Charles Baskerville dies from a heart attack brought on by extreme psychological stress. Findings from a new medical article by University of California, San Diego Sociologist David Phillips suggest that people can indeed be scared to death, both in fact as well as fiction.
Phillips’ research, published in the December 2001 issue of the British Medical Journal, may provide the most persuasive evidence to date linking extreme psychological stress and fatal heart attacks. In the study, Phillips, a well-known authority on mortality trends and the social and psychological factors affecting them, collaborated with UCSD Mathematics Professor Ian Abramson and UCSD students George Liu, Kennon Kwok, Jason Jarvinen, Wei Zhang.
“I have often wondered if people could indeed die by fright,” said Phillips, “and if so, how this could be investigated quantitatively. I recalled that in ‘The Hound of the Baskervilles,’ Sir Charles Baskerville dies of a fatal heart attack, apparently because he is frightened to death by the hound. Since Arthur Conan Doyle was a physician as well as an author, I wondered if his story was based on medical intuition or literary license, i.e. were fatal heart attacks and stress linked in fact as well as fiction?”
numerous laboratory studies have shown cardiovascular changes following
psychological stress, for ethical reasons only non-fatal stressors can be
studied in the laboratory and one may not be able to generalize beyond these
mild stressors to determine if, in the real world, fatal heart attacks are
precipitated by extreme stress.
“The challenge was to find a way of testing this hypothesis that would circumvent the ethical problems of the laboratory experiment and yet retain some of its vigor,” explained Phillips. “The best solution seemed to be to use a natural experiment – a real life event that met certain criteria. First, this real life event had to have distressing psychological effects on one segment of the population but not on others. In addition, it shouldn’t actually be a dangerous event – it should only be perceived as such. Lastly, this event should not be linked to any changes in the quality of medical services.”
It was not easy for Phillips and his collaborators to find such an event that met these criteria, but they did. The real life event they choose is connected to a Chinese and Japanese superstition. In Mandarin, Cantonese, and Japanese, the words “death” and “four” are pronounced nearly identically, and consequently the number “four” evokes discomfort and apprehension in many Chinese and Japanese people. Because of this, the number “four” is avoided and omitted in some Chinese and Japanese floor and room numberings, restaurants, and telephone numbers. In addition, the mainland Chinese air force avoids the number “four” in designating its military aircraft, apparently because of the superstitious association between “four” and “death.”
study by Phillips and his co-authors finds that cardiac deaths peak on the
fourth of the month for Americans of Chinese and Japanese descent, and that
this pattern is not seen among whites. The study used computerized U.S.
death certificates to examine more than 200,000 Chinese and Japanese deaths,
and 47,000,000 white deaths, from 1973 to 1998.
Doyle suggests that Sir Charles Baskerville was particularly susceptible to a
stress-induced heart attack because he had a chronic heart condition,” said
Phillips. “If Doyle's medical intuition was correct, deaths from
chronic heart disease should display a particularly large fourth-day peak.
Sir Charles Baskerville's superstitious fear of an avenging spectral hound was
shared and reinforced by his neighbors. Similarly, Chinese and Japanese
superstitious fears are likely to be stronger where they are reinforced by
large Chinese and Japanese populations.”
evidence supports both of these expectations. For U.S. Chinese and Japanese,
there are 13% more cardiac deaths than expected on the fourth of the month.
This fourth-day increase is still larger (27% above expected) in California,
where Chinese and Japanese populations are concentrated.
and his co-authors tested nine, alternative, non-psychosomatic explanations
for their findings, including the possibility that, on the fourth, Chinese and
Japanese might change diets, increase alcohol consumption, refuse medicines,
or overstrain themselves. The researchers concluded that their data
suggest a link between psychological stress and heart attacks.
findings are consistent with the existence of psychosomatic processes, with
the scientific literature, and with a famous non-scientific story. The
‘Baskerville effect’ seems to exist both in fact and in fiction, and
suggests that Conan Doyle was not only a great writer, but a remarkably
intuitive physician as well.”
has published extensively on the role that psychosomatic factors can play in
precipitating and delaying death among certain groups. He has studied
the effects of gambling and medical errors on mortality rates as well as the
ability of some people to prolong their lives for a significant event.
For more information on Phillips’ work visit his web site at: http://weber.ucsd.edu/~dphillip/
To view the British Medical Journal paper in its entirety please go to: http://weber.ucsd.edu/~dphillip/baskerville.html
David Phillips can be contacted directly at 858.534.0482 or email@example.com
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