[Bolus death and drowning--expression of central nervous system dysregulation?].

According to the author's own investigations and to findings reported in the literature, almost all bolus deaths and highly numerous accidental deaths by drowning occur to adults and adolescents under the impact of alcohol. An attempt was made to elucidate the mechanism by which alcohol actually play its role in bolus or drowning death. These two causes of death have in common complete or partial obstruction of respiratory tract. Yet, safety against that life-threatening condition were devised by evolution very early in phylogenesis (respiratory block, cough reflex, circulatory centralisation). They are reflex-triggered for immediate effect and take that effect through the vegetative nervous system. These findings have been secured by animal experiments. However, on account of considerable interference of alcohol with vegetative activity, via action on transmitter metabolism (transmitter synthesis, storage, release, rebonding and bonding by means of products of alcohol metabolism), symptoms of extreme vagotomia may develop, such as bradycardia with circulatory centralisation and apnoea of alcohol-related irreversibility, finally resulting in cardiac arrest. The "reflex-related" process of bolus death has often been described, with reference being regulatory made to individuals staying in water and drowning without any self-rescue attempt.