VOL. 1, No. 2 / 3, July 2004

D. T. Mage and E. M. Donner [2004] Med Hypotheses Res 1: 131-137.

Is SIDS at “Borkmann’s Point?”

David T. Mage* and E. Maria Donner

Institute for Survey Research, Temple University, Philadelphia, PA 19122 (D.T.M.), and
DuPont Haskell Laboratory for Environmental Health and Science, Newark, DE, USA (E.

Abstract.  Aim: To test whether Sudden Infant Death Syndrome (SIDS) is at
“Borkmann’s Point”. “In every investigation, he [Borkmann] insisted, there is a point
beyond which we actually don’t need more information. When we reach it we know
enough to solve the case with help of only mental effort.” (Authors’ translation from
Borkmanns punkt, Håkan Nesser, 1994). Methods: We examine five universal clues to
solving the mystery of SIDS that determine its gestalt and must be explained
simultaneously by any causation mechanism. They are: (i) Absence of evidence for cause
of death at forensic autopsy; (ii) Male excess of 50%; (iii) Lognormal-type distribution of
ages; (iv) Seasonal variation with a winter maximum and summer minimum; (v) Increase
in rate with parity. We survey the literature to determine whether any published
hypothesis for the cause of SIDS can meet these five criteria. Results: The five universal
characteristics of SIDS appear to be satisfied by an absence of an X-linked ability to
withstand cerebral anoxia that is related to seasonal respiratory infections and age-
dependent risk factors such as neurological prematurity and physiological anemia leading
to cerebral anoxia. Conclusion: SIDS is now at ‘Borkmann’s point’ because there is
sufficient published information in the medical literature to show that SIDS must be an X-
linked cerebral-anoxic condition.

*Address all correspondence to: David T. Mage, Institute for Survey Research, Temple
University, 1601 N. Broad St., Philadelphia, PA 19122-6099, USA. Phone: 215-204-7578.
Fax: 215-204-4416. E-MAIL:

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