Letter: Bizarre but common

Sir: As Monique Roffey rightly suggests ('When masturbation can be fatal', 13 July), auto-erotic asphyxia may be more common than generally supposed and its details revealed only in specialist forensic journals (such as Medicine, Science and the Law and others). Modern authors have referred to the condition; for example hanging and ejaculation are referred to by the characters Estragon and Vladimir in Waiting for Godot. The condition is sometimes known eponymously as the Kotzwarra Syndrome after an 18th-century musician who, like some of the sad cases described by Ms Roffey, died during the course of his activities.

Reports of these activities have been published from many parts of the world. The behaviour is perhaps best understood as part of sado-masochistic activity - as I show in my book Bizarre Behaviours, Tavistock/Routledge, 1990.

Yours faithfully,

H. PRINS

Midlands Centre for

Criminology and Criminal Justice

Department of Social Sciences

Loughborough University

Loughborough, Leicestershire