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Dr J C Barker  MD, MRCP, DPM – Scared to Death – An examination of fear, its cause and effects

Fear is one of the most deep-rooted and dominant of all the emotions. Furthermore intense fear and great rage have similar effects on the body. Thus when either of these instincts is invoked, the effects are mediated through the same elemental parts of the nervous system and endocrine apparatus-the so-called "sympathetic" or "sympathetico-adrenal system". The changes produced thereby are directed to preserve the homeostasis or constancy of the body’s internal environment and to enhance the organism's efficiency in dealing with the oncoming physical struggle.

But as Cannon remarks, "If these powerful emotions prevail and the bodily forces are fully mobilised 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."

Thus, according to this hypothesis, death would appear to result from a state of shock due to persistent over activity of the srmpathetico-adrenal system, with continuous outpouring of adrenaline and rapid depletion of the adrenal corticosteroid hormones. The latter would lead to failure of Seyle's general adaptative reaction to stress.

A persistent and profound state of fear could thereby induce a disastrous reduction in blood pressure resulting in death. Starvation and falure to drink which are usually prevalent in those reported to be dying as a consequence of voodoo agencies, would only serve to aggravate the situation. Under these circumstances Cannon postulated that death might well result from a true state of shock in the surgical sense, induced by prolonged and tense emotion.