The phenomenon has been attributed to pressure on the cerebellum created by the noose. Spinal cord injuries are known to be associated with priapism. Injuries to the cerebellum or spinal cord are often associated with priapism in living patients.
Death by hanging, whether an execution or a suicide, has been observed to affect the genitals of both men and women.
In women, the labia will become engorged and there may be a discharge of blood from the vagina. In men, "a more or less complete state of erection of the penis, with discharge of urine, of mucus, or of the prostatic fluid, is a frequent occurrence ... present in one case in three." Other causes of death may also result in these effects, including fatal gunshot wounds to the brain, major blood vessels, or violent death by poisoning, and forensically, a postmortem priapism is an indicator that death was likely swift and violent.
Samuel Beckett's Waiting for Godot includes a passage in Act I:
Estragon: What about hanging ourselves?
Vladimir: Hmm. It'd give us an erection.
Estragon: (highly excited). An erection!
Vladimir: With all that follows. Where it falls mandrakes grow. That's why they shriek when you pull them up. Did you not know that?
The 2003 Channel 4 documentary on the Jack Sheppard case, The Georgian Underworld, Part 4: Invitation to a Hanging noted that his hanging caused an erection.
Referred to numerous times in Naked Lunch.
The "Cyclops" section of James Joyce's Ulysses makes multiple use of the terminal erection as a motif.
The Michael Moore documentary Fahrenheit 9/11 includes found footage of United States troops "jocularly prodding the post-mortem erection of a fallen Iraqi".
In The Decline and Fall of the Roman Empire, Edward Gibbon relates an anecdote attributed to Abulfeda that Ali, on the death of Mohammed, exclaimed, O propheta, certe penis tuus cælum versus erectus est (O prophet, thy penis is erect unto the sky).
At the end of Herman Melville's short novel Billy Budd, Billy's unusual moral purity is suggested by the fact that, contrary to the general rule, he does not get an erection after being hanged. On the other hand, in Thomas Pynchon's novel Mason & Dixon, Charles Mason says to himself that "In my experience, 'tis usually the Innocent who get [terminal erections], and the Guilty who fail to."
In Thomas Harris's third Hannibal Lecter novel, Hannibal, the hanging of Inspector Pazzi by Dr. Fell causes a death erection.
In Six Feet Under one of the people who dies has "angel lust" - Season 1 (Episode 2).
In Zardoz there is a reference to death erections.
In Reno 911!, the officers are amused to see that a recently deceased civilian still has an erection.
In Hanns Heinz Ewers's novel Alraune, a woman is artificially created using the fluids from the post-mortem erection of a hanged man.
In Boris Vian's 1946 novel J'irai cracher sur vos tombes (I Shall Spit on Your Graves), the final sentence mentions a lynching victim's "ridiculous" erection.
^ Helen Singer Kaplan & Melvin Horwith (1983). The Evaluation of Sexual Disorders: Psychological and Medical Aspects. United Kingdom: Brunner Routledge. Retrieved on 2007-01-26. "Men subjected to capital punishment by hanging and laboratory animals sacrificed with cervical dislocation have terminal erections. The implication is that either central inhibition of erection is released and erection created or that a sudden massive spinal cord stimulus generates an erectile response. There is ample experimental and clinical evidence to support the former supposition."
^ ab Willis Webster Grube (1897). A Compendium of practical medicine for the use of students and practitioners of medicine. Hadley Co.. Retrieved on 2007-01-26. "Erection has long been observed to follow injuries to the cerebellum and spinal cord. Out of eleven cases of cerebellar hemorrhage, erection of the penis was noted six times by Serres. Death by hanging is often accompanied by partial erection."
^ George M. Gould and Walter L. Pyle (1900). Anomalies and Curiosities of Medicine. Retrieved on 2007-01-26. "Priapism is sometimes seen as a curious symptom of lesion of the spinal cord. In such cases it is totally unconnected with any voluptuous sensation, and is only found accompanied by motor paralysis. It may occur spontaneously immediately after accident involving the cord, and is then probably due to undue excitement of the portion of the cord below the lesion, which is deprived of the regulating influence of the brain... Pressure on the cerebellum is supposed to account for cases of priapism observed in executions and suicides by hanging. There is an instance recorded of an Italian castrata who said he provoked sexual pleasure by partially hanging himself."
^ David Levy, DO. Neck trauma. eMedicine.com. Retrieved on 2007-01-26.
^ William Augustus Guy (1861). Principles of Forensic Medicine. Henry Renshaw. Retrieved on 2007-01-26.
^ Samuel Beckett. Waiting for Godot, Part I. Retrieved on 2007-01-26.
^ Thomas Sutcliffe. "Lock, Stock and Two Yards of Hemp", The Independent, April 25, 2003. Retrieved on 2007-01-26.
^ Yann Tholoniat. Joyce's Cyclops. Retrieved on 2007-01-26. Tholoniat is a Senior Lecturer at the Marc Bloch University.
^ Thomas Peyser. "Burning Down the House", June 30 2004. Retrieved on 2007-01-26.
^ Edward Gibbon. The Decline and Fall of the Roman Empire. Retrieved on 2007-01-26.