BODILY DISEASES; INSOMNIA, SPIRITUALISM, HEREDITY, AND ALCOHOLISM.
Incurable bodily diseases, and the accompanying pain of some other
disorders, are not uncommon causes of a voluntary death. It has been
estimated that incurable diseases are even more powerful as a cause
than very painful ones.
The heavy voluntary death rate of persons afflicted with pellagra has
been already noticed, as has the dictum of Pliny that the presence of
stone in the bladder constitutes a fair reason for self-destruction.
Not long ago I held an inquest on the body of a medical man who
hung himself to avoid the pain and worry of an apparently incurable
stricture of the urethra.
Continental statisticians have calculated that bodily disease causes 8
per cent. of Italian suicides, 13 per cent. of French, 10 per cent. of
Norwegian, and 12 per cent. of Prussian suicides. These are voluntary
deaths, not deaths during delirium accompanying disease.
Loss of sight, and loss of hearing, are both causes of increased
suicide rate; in Prussia it has been estimated that persons having
suffered such deprivation contribute a rate almost double that of
persons not so afflicted.
INSOMNIA.
Closely connected with mental and bodily disorders as a cause of
suicide is sleeplessness, apart from organic disease. There is, I
suppose, nothing more trying to the sensations, and nothing more
exhausting to the nervous system, than this symptom. Its tendency
to become habitual, and to become more and more complete, are its
harassing qualities. I have held inquests on cases distinctly referable
to the misery caused by want of sleep.
That sleeplessness is an important factor in producing suicide is
pointed out very forcibly by Dr. Jos. Williams in an article in the
“Lancet” of 1850. “Business men especially apply to their doctors
for this ailment, and their request is often answered by a little
anti-dyspeptic mixture, whereas a powerful sedative for a few nights,
until rest and change can be arranged for, would be the means of
preserving life.”
The “Medical Times and Gazette,” 1872, in referring to two similar
deaths from suicide, those of Mr. Justice Willes and Hugh Miller the
Geologist, insisted also on the necessity of procuring sleep and rest
for worried men, and so did good service.
ALCOHOL.
Without doubt the habitual use of alcohol to excess is a very fertile
suicide prompter, and it is found that the stronger the form of alcohol
used, the more often crime and suicide are produced; such are as rare
when the light wines are drunk, as they are frequent among spirit
drinkers.
Lunier, Ann. Med. Psychol., 1872, calculating the results in 79
departments, states that the amount of crime in France is in direct
proportion to the consumption of alcohol, and so are the rates of
lunacy and suicide. As a mean of the estimates of many observers,
about one-eighth of all suicides are _directly_ caused by alcohol.
It produces suicide in several ways; in a fit of drunkenness, during
delirium tremens, by causing mania or melancholia, or by leading to
complete imbecility.
Suicides due to alcoholic poisoning, and alcoholic mind failure, are
indeed seen among those who are too rich to require to work at all,
or to be regularly at work; but the greatest amount of disease and
death due to alcohol exists among the poor, and especially among the
poor of our great cities; a very large number of these spend almost
the whole of their small earnings in poisonous drinks. The radical
remedy for suicide caused by this form of indulgence is doubtless the
improvement of the intellectual and moral status, the cultivation of
habits of thrift, economy, and foresight. If the humble mechanic could
only be led to the conviction of the paramount necessity of assuring
himself against accidents, disease, and old age, and of avoiding the
degradation of becoming chargeable during such misfortunes to the means
of others who have provided such store, he would neglect the gross
indulgences of the sot, for the self-esteem and honour arising from a
consciousness of having worked while it was yet day, and laid up a
store for the evil hours which do so surely come.
The drink question is one, however, which is now so frequently brought
to our notice, by our worthy teetotal and temperance friends, that
I am sure I need not occupy much space in discussing the amount of
self-destruction caused by alcohol, directly or indirectly, through
debauchery, loss of money, position, or self-respect.
HEREDITY.
The influence of Hereditary Predisposition is one of surpassing
interest, but is also another of those causes of which it is very
difficult to procure accurate statistics; and very few countries have
as yet given any data in connection with it.
Relations of suicides are apt to be very reticent of confessing to
lunacy in their families, and it is hereditary mental failure, lunacy,
epilepsy, dipsomania, &c., which are the forerunners of a future death
by suicide.
In Bavaria alone has an effort been made to estimate hereditary
influence; from 1857-66, we are told it was shewn to exist in 13 per
cent. of all voluntary deaths, since then in 18 per cent.
Voltaire narrates that he knew a professional man, his brother, and the
father of both, who all killed themselves at the same age, in the same
manner.
Bucknill and Tuke give examples of suicide from hereditary insanity,
and remark, “that they abound;” similar cases will be found described
in almost all works treating of insanity.
Falret gives several cases, for example:─In one, a grandmother, mother,
and grandchild, killed themselves. In another, five sons and one
daughter, of a questionably sane father, all committed the act.
Griesinger gives us an example:─A man and his wife became insane, he
hung himself and she drowned herself; one daughter poisoned herself, a
son strangled himself, and another daughter threw herself off a house
top.
In Lisle, on “Suicide,” ten marked cases are given.
Burrows narrates, at full length, the case of one family, as
follows:─The grandfather hanged himself; he left four sons, one hanged
himself, one cut his throat, one drowned himself, and one died a
natural death. Two of these sons had large families; of the third,
two children became insane, one died a natural death, the other made
several attempts on his life, and two others drowned themselves,
apparently sane.
The effect of mental agitation in a person knowing that he is
the descendant of insane persons or of suicides, is worthy of
consideration; to a well-educated man, what a “skeleton in the closet”
to live with, must be the constant recollection of the risk to which
hereditary transmission exposes him. Such a spectre may well refuse
to be laid, and must be a fertile cause in the production of another
generation of suicides.
SPIRITUALISM.
There is yet another mental cause which is credited both with causing
insanity and with causing suicide, especially in the United States.
I refer to Spiritualism, in the modern acceptation of the title. It
has been seriously discussed in America, whether or not a believer in
spiritualism is not ipso facto mad (Buckham) but without going to that
extreme point of view, it is most wise to bear in mind that many cases
of lunacy and many suicides have been assigned to this cause.
The combined effects of a belief in the doctrine that it is possible in
our bodies to hold communication with the departed, and of attempts to
practise this system of intercourse, conjoined with the corollary that
what spirits reveal is true, and so to say, inspired, has frequently
had a most fatal effect on minds of a dreamy sort. I knew, myself, a
most sane and sensible young medical man, who became imbued, through
a spiritualistic father, with a faith in the possibility of obtaining
information of a mystic and occult character by means of somewhat
mesmeric proceedings; sad to relate, he very soon became mentally upset
with a religious terror, and took his life, without having previously
evinced any tendency to self-destruction.