Any irregularity in the action of the uterine organ may give rise to the same inclination. Under such circumstances, emmenagogues will do much good.
German writers dwell much upon the connexion between suicide and derangement of the cutaneous secretion. That this function should also be attended to there cannot be a doubt, although we cannot call to mind any cases of suicide which could be directly traced to suppressed perspiration.
In some cases, a blister applied and kept open in the neighbourhood of the head has effected much good. In other instances, issues have been beneficial, particularly in persons subject to cerebral congestion. There is, however, a condition of brain accompanying the suicidal disposition which may be denominated a state of cerebral irritation, in which bleeding or depletion would be injurious. In such cases, friction on the spine, and the administration of anti-spasmodics, gentle aperients, and alteratives, will be serviceable.
Sufficient attention is not paid to those precursory symptoms which indicate the existence of a disposition to suicide. In two-thirds of the cases that occur, the act is preceded by premonitory signs, which, if attended to, will prevent the developement of the propensity.
With very few exceptions, the mental symptoms are those which are principally manifested in these cases. Lowness of spirits, a love of solitude, an indisposition to follow any occupation which requires exercise of the mind, are generally exhibited. The person’s suspicions become roused; he fancies his dearest friends are regardless of his interests, or are plotting against his life. He takes no pleasure in the family circle. He may be suffering from some evident physical malady, acting through sympathy on the brain, and deranging its functions; and then he will often refer to his disease, and express his utter hopelessness of ever being cured. There is an expression of countenance generally present in a person who meditates suicide, which, if once seen, cannot easily be forgotten. Suicidal mania is easily recognised by the experienced physician. The surgeon of a large establishment in the environs of the metropolis informed me, that in six cases out of ten he could detect, by the appearance of the eye, the existence of the desire to commit self-destruction. A young gentleman, a few days previously, had been admitted into the house as a patient. The surgeon, after examining and prescribing for the lunatic, said to one of the keepers, “You must watch Mr. —— carefully, for I feel assured he will attempt his life.” Everything with which he might injure himself, were he so disposed, was taken from him; but it appears that he had resolved to make away with himself, and had carefully concealed a pen-knife in his boot. On the evening of the day on which he was admitted he made a dreadful gash in his throat, but failed in injuring any large vessel. He confessed that he had determined to sacrifice his life; he said, “It has been pre-ordained that I should fall by my own hands, and I am only fulfilling my destiny by cutting my throat!” Shortly after this he was removed; and as we have been subsequently informed, sufficient care not being taken of him, he eventually succeeded in killing himself.
How difficult it is for the medical man to persuade the friends of a person who has evinced a disposition to suicide, of the absolute necessity of his being confined and carefully watched! A physician, dining with a friend, met by accident a young lady who had exhibited, for a few days previously, a shrewdness of manner that attracted the notice of those with whom she associated. He also observed a wildness and incoherence about her ideas; but what particularly struck his attention was, the peculiar expression of countenance which so often denotes the presence of suicidal mania.59 He felt convinced in his own mind that the lady meditated self-destruction; and so firmly persuaded was he of the fact, that he seriously spoke to the gentleman at whose table he was dining on the subject, and urged him, as he was intimately acquainted with the young lady’s family, to suggest the propriety of having medical advice, and of carefully watching the movements of the lady. This suggestion was treated with ridicule, and of course the subject was not broached again. Two days after the conversation took place, intelligence was brought that the lady had taken a large dose of laudanum, and had died from its effects! A little prudent caution might have saved the life of this poor unfortunate being.
In cases in which the disposition to suicide has been evinced, the patient ought to be carefully watched, and, under some circumstances, placed under restraint. Men who talk loudly of the effects of moral coercion, and who repudiate the idea of strait-waistcoats &c., have had but little practical experience of the treatment of the insane. Moral discipline has done much good. Deeply should we regret to see the system which has been in force within our own recollection again introduced into our lunatic asylums. In endeavouring to avoid Scylla we have fallen into Charybdis. How many lives are lost in consequence of the patients not being properly secured when they have exhibited a desire to commit self-destruction.
A lady who had attempted to destroy herself was very properly sent to an asylum. Having expressed a determination to avail herself of the first opportunity for carrying her intentions into execution, she was most carefully guarded. She was never allowed to be out of sight; a trustworthy nurse always kept by her side; and in the course of time she was pronounced recovered. But as it was not considered prudent to send her home at once, she was separated from the other inmates of the house, and allowed to reside with the surgeon and matron of the establishment. Even under these circumstances it was thought better not to allow her to be wholly by herself, fearful that the disposition might again suddenly develope itself. She resided with the surgeon for some weeks, and appeared completely well. She expressed much astonishment when told that she had attempted her own life; she was apparently horrified at the idea. She was sitting with the matron one morning after breakfast; the surgeon was going round the asylum, when a child was heard to cry up stairs, as if it had received some injury. The matron immediately left the room; she was not absent three minutes, and when she returned she was astonished to find the young lady had vanished. Immediate search was made for her, but she was not to be found, when, looking behind the curtain in the parlour, the lady was discovered hanging to the cornice! In that short space of time she had succeeded in suspending herself, and was quite dead. Of course we cannot determine whether she had recovered, and this was but a sudden recurrence of the suicidal mania, or whether she had cunningly concealed her ailment for the purpose of throwing her attendant off her guard, and thus being enabled to effect her dreadful purpose. We should be more disposed to accede to the latter solution of the question, knowing the extreme cunning of such lunatics, and the ingenious stratagems they often have recourse to in order to accomplish any mischievous object they have in view.
A person who manifested indications of mental aberration was found in the act of hanging himself. Upon being detected, he promised most solemnly to abandon his rash resolution. He attempted a second time to kill himself by cutting his throat, but the wound was not fatal. He was now placed under the care of a gentleman who had devoted much attention to the treatment of insanity; and, knowing his propensity, the keeper received strict injunctions to watch his movements carefully. Everything by which he could injure himself was removed from his room, he was shaved every day by a barber, and no instrument of any kind was allowed to be in his possession. He was confined for nine months; and it appeared, from what afterwards occurred, that he had, during the whole of this period, been absorbed in the one idea of how he should contrive to commit suicide. He was discovered one morning hanging by the neck from the bedstead, quite dead. How he got possession of the cord which suspended him, puzzled everybody acquainted with the history of the case. At last the enigma was solved. It appears that parcels of books and newspapers had occasionally been sent to him by his family, tied with twine; and he had carefully, and unknown to the keeper, concealed each piece, until he had collected a quantity to constitute a cord sufficiently strong with which to hang himself. For nine months this idea had exclusive possession of his mind; and although he exhibited no apparent symptoms of insanity, he had evidently been contemplating suicide for the period already specified.
A female had made repeated attempts, during her residence in the asylum at Wakefield, to hang herself, but had been so watched that she had not succeeded. One evening, the servant, on going to remove all her clothes out of her bed-room, thought she saw something bright on the top of one of her under garments; upon examination, this was found to be a pin. She had contrived just before bed-time to take off her garter; and, knowing that her pockets as well as her clothes would all be removed, she contrived to pin it within her dress, so high up that it would not easily be perceived. Very providentially, the brightness of the metal discovered it, and she was again prevented from accomplishing her purpose. By degrees the propensity wore off; and after a residence of eighteen years in the Hanwell Asylum, Sir W. Ellis found her a few years ago, living, though upwards of eighty years of age, in a comparatively tranquil state, waiting her removal in the ordinary course of nature.
When persons determined on suicide find that they are unceasingly watched, and so carefully secured that they have no opportunity of executing their design, they will assume a most cheerful manner for days and weeks together, in order to lull suspicion; and when a favourable opportunity offers, it is never neglected.
A man who had long been in a state of despondency, and had made many attempts to hang himself, but had always been prevented, very suddenly appeared much better. He became apparently cheerful, and being desirous of employment, was sent out with a large party into the hay-field. He continued in this and other out-door occupations for some time, gradually improving. One evening, on returning from the field, when the rest of the party went in to tea, (which they were allowed when hay-making,) he told the farming man that he did not feel thirsty, and as it was very warm he would rather remain at the door. He was left there. A short time afterwards his keeper came down to inquire for him, and being told where he had been left, immediately exclaimed, “Then he has hung himself!” It was also singularly impressed upon his mind, that it was in one particular out-house that he had done it. There he went, and found him suspended and dead, as he expected.
“A noble lord,” (says Dr. Rowley,) “whose family I had the honour to attend, had received, it is said, some little reproof from a great personage, concerning a military omission. It seized his lordship’s mind so seriously, that on examination it was evident to me that suicide was intended. All weapons and dangerous means whatever were removed. It being a circumstance of delicacy, I sent for his lordship’s son, then about eighteen, from Westminster school, communicated my apprehensions, and requested his constant attendance on his noble parent. This the young man executed for several days, and prevented the commission of the crime apprehended. In my absence a few hours in the country, a very eminent, learned, and indeed remarkably sagacious physician, but my mortal and vindictive enemy, was called in. I had, contrary to medical etiquette, enforced the necessity of promptly bleeding a most noble lady in an apoplexy, which saved life, but brought down invectives, hatred, and vengeance on me. Whether out of opposition to my vigilance, or from malicious motives, it would be difficult to determine, but the noble lord was liberated from all restraint, and my apprehensions treated by injurious insinuations and with contempt. Thirty-six hours had scarcely elapsed before the noble lord put a period to his existence, by a sword he had concealed, which had been a present from Prince Ferdinand: he wounded his breast in two places, but the third thrust pierced his heart. Thus perished a nobleman, whose liberality, feelings, and many virtues, did honour to human nature, and who might, in all probability, have been now living, had not medical arrogance and illiberality, merely from personal ambition, dictated error, at the risk of human destruction! Horridum! valde horridum!”
The physician should constantly bear in mind this important fact connected with the suicidal disposition—viz., that those determined upon self-destruction often resolve to kill themselves in a particular manner, and however anxious they may be to quit life, they have been known to wait for months and years, until they have had an opportunity of effecting their purpose according to their own preconceived notions. A man who has attempted to drown himself will not readily be induced to cut his throat, and vice versa. A morbid idea is frequently associated in the maniac’s mind with a particular kind of death, and if he be removed from all objects likely to awaken this notion, the inclination to suicide may be removed.
An old man, upwards of seventy years of age, who had a market garden, near the asylum at Wakefield, consulted the late Sir W. Ellis as to the best mode of destroying himself, as he had made up his mind not to live any longer. He said he had thought of hanging himself, if Sir William could not recommend an easier death. The physician talked to him some time upon the heinousness of the crime he contemplated, and endeavoured to shew him that hanging was a most horrible death, from the suffocation that must be felt. His conversation was attended with little success. Finding that the chylopoietic viscera were a good deal disordered, he prescribed for him, and sent to inform his wife that he ought never to be left alone. The medicine had the effect of restoring the secretions to a healthy action, and he got better. Sir William heard no more of him for some time, when he was at length informed that he was discovered dead in a little shed in his garden, where he used to keep his tools. But so fixed was the mode in his mind, by which he was determined to accomplish his death, that, though the place was so low he could not stand upright in it, and he had not a rope or a string with which he could suspend himself, he contrived to effect his purpose by getting a willow twig, and making it into a noose, which he fastened to one of the rafters. He stooped to put his head through it, and then pushing his feet from under him, suspended himself until he died. Now, if he had not made up his mind to destroy himself in this particular way, he might have accomplished it with much greater ease by drowning himself in the pond in his garden, or by cutting his throat with his garden knife, which he always had about him; but neither of these was the mode he previously intended.
It may be practically useful to all who have the immediate care of suicidal patients to bear this in mind; and if the medical man can find out that any particular plan is contemplated, he ought to be especially careful to remove the means of accomplishing it out of the patient’s reach, and to prevent him having an opportunity of carrying it into execution.60
“A medical friend,” says Dr. Burrows, “who had much enjoyed life, and never met with any circumstances to occasion him particular disquietude, when at the age of forty-five became very dyspeptic, low-spirited, and restless. He gradually shunned society; but still, though with great reluctance, pursued his professional avocations. This depression increased so much that he often told his wife that he should consult me. (He knew very well that both his father and grandfather had destroyed themselves.)
“One morning he kept in bed much longer than usual, and a relation calling, went up, without being announced, to see him. He seemed composed, at length complained of being very faint, and upon raising him up, blood was perceived on his hands. Upon examination it was discovered, at the moment his friend entered the chamber, he was employed in opening the femoral artery; that there had been considerable hemorrhage from the small vessels he had divided. I saw him within an hour afterwards. He had recovered from the syncope, and expressed great sorrow for what he had done; described with minuteness his case; lamented he had not seen me sooner, but that he could not muster sufficient resolution; consented to place himself under my superintendence; and, in fact, to follow all my directions.
“I placed him in charge of a careful keeper. It was agreed that he should be removed into lodgings in the environs of town; and he therefore submitted to the necessary medical treatment.
“He remained two days at home, till lodgings could be procured, during which he was calm and rational; but there existed the suicidal eye, which sufficiently denoted that he was not to be trusted.
“On the third morning, his keeper, having a violent attack of rheumatism in his right arm, could not shave him, and another person was obliged to be trusted. This person, unfortunately, laid the razor on the dressing-table; and, while his face was turned away, and the keeper was heating some water a few feet from the table, the patient suddenly jumped up, seized the razor, and in a moment applied it to his throat, and effectually divided the carotid artery.”
A case somewhat similar we find recorded by the same authority. Major—— had been wounded at the battle of Waterloo. He had since recovered his health, but a great depression of spirits followed. The maniacal diathesis was hereditary. By degrees he became more desponding, his ideas wandered, and at length a suicidal propensity was evident. On visiting him, Dr. Burrows strongly urged the necessity of placing him under the supervision of an experienced keeper; but here, as in too many cases, his family opposed this advice, and would not permit proper restraint, but put him under the care of a nurse only. In the evening, he retired early to bed. The nurse went to tea in his chamber, supposing her charge to be asleep. The patient watched the opportunity, jumped out of bed, seized a knife on the table, wounded, and would have effectually cut his throat, had not the nurse interposed.
“A clergyman in Warwickshire told me,” says Dr. Conolly, “that he was requested, some years ago, to interfere respecting certain measures proper for securing a neighbour who had exhibited unquestionable symptoms of insanity. His neighbour, however, was not to be met with on the day when it was intended to remove him, and when he reappeared, which was either the next day or in a day or two afterwards, he was quite in a sound state, in which condition he has lived with great comfort up to the present time. On the other hand, an instance came under my own observation in which a gentleman had shewn many proofs of disordered mind for the space of three or four months, and his actions becoming dangerous, it was resolved to remove him. About two hours before I was to call for him, he was so quiet and orderly in a conversation with the old family-apothecary, that the latter gentleman rode off to the relations of the patient, relenting all the way concerning the proposed restraint, and purposing to solicit its postponement; in which attempt he was only prevented by being overtaken by a messenger before he had ridden half a mile, who came to inform him that his apparently tranquil patient had nearly blown up his house and his whole family with gunpowder, having for that purpose thrown a pound and a half of it into the fire, sitting by to see it explode. In another case, a gentleman had made repeated attempts at self-destruction, but seemed to have got well, and was no longer much looked after; yet after living comfortably at home for a little while, and having passed a cheerful evening in reading to his wife, he concluded it, when she had retired, by hanging himself in the parlour.
“These lamentable accidents are, of course, always productive of disagreeable feelings in the mind of a practitioner; but never more so than when he has been too confident of the absence of danger. It is questionable, perhaps, whether there are not, in all these cases, certain means of which prudence might avail itself, for the purpose of ascertaining the exact state of the supposed convalescent’s mind, as well as the existence of such intentions in a lunatic as are inconsistent with the safety of other persons, or with the preservation of his own existence. The lunatic may maintain a very guarded silence on these matters so long as they remain quite unsuspected, but is not very well able, in general, to prevent his intentions becoming visible to those who have begun to suspect him. These intentions, too, are generally associated with certain recollections, or certain topics, or certain antipathies or prepossessions, which may be found out and brought into the conversation; in which case, the lunatic can seldom conceal his agitation, his superstitious belief, his anger, or his inly-cherished hope of full revenge. Indeed, he is often in no degree solicitous to conceal his feelings. There cannot be anywhere a more harmless person than Jonathan Martin; his manners are mild, his occupations are of the most peaceful description, his language is strikingly simple and unassuming; but take up the Bible, and you have touched the chord of his insanity; you find that, to destroy the noblest monuments of ancient piety and munificence seems to him a work to which God has especially called him. The effect of possessing a key to the excited feelings of a lunatic is, indeed, always surprising to those unaccustomed to their peculiarities. You walk with a man who seems to delight in the simplest pleasures of a state of innocence; he admires the flowers of the field and the beauty of the sky, or he dwells with satisfaction on the contemplation of whatever is generous and good; nothing can exceed the mildness of his manner: but a single word calculated to rouse a morbid train of ideas, a name, the reminiscence of a place, or any trifling inadvertency, will convert this placid being into a demon; the tones of his voice, his gestures, his countenance, his language, assume, in a moment, the expression of a fiend; and you discover that opportunity alone is wanting to effect some dreadful crime. The discovery of such a design is certainly not always so easy, but wherever suspicion exists, strict superintendence is warranted, or various degrees of restraint must be determined upon, and steadily adhered to.”61
The following cases will shew the necessity of guarding a person by the strictest surveillance from the moment that he evinces the slightest symptom of mental alienation, when it manifests itself by incongruous expressions or attempts at self-destruction. This precept should be engraven on the mind of every medical man, and no feeling of false delicacy should prevent his communicating his suspicions and wishes the moment he considers measures of precaution necessary. In these cases, the loss of an hour may make all the difference between life and death.
M. Piorry was called to the Hôtel de Bibliothèque, where he found a man of athletic form and military appearance in a state of complete insensibility. He manifested all the indications of apoplexy or epilepsy. Some time elapsed before the physician could ascertain what was the matter; he could not obtain any satisfactory answers to his repeated questions. At last the patient made Piorry understand that he had swallowed a key. Professor Roux was sent for, who, after considerable difficulty, succeeded in extracting the foreign body from the œsophagus, along with an oblong piece of copper attached by a chain to the handle of the instrument. On the succeeding night he made fresh attempts to destroy himself; first by hanging with the bed-clothes, and, on that mode not proving successful, he endeavoured to strangle himself by squeezing two chairs against his neck. Thwarted in effecting his design, he again swallowed the key, and he was nearly dead when he was discovered, and the key extracted from his throat. He was now confined in a strait-waistcoat, and was subjected to proper medical treatment. In the course of a short period, all disposition to suicide was removed, and his mind was restored to perfect integrity.62
A soldier, who was greatly beloved in his regiment for his exemplary conduct and amiable qualities, became affected with suicidal melancholy, and fired a pistol into his mouth. The havoc made was dreadful; but by great exertions on the part of M. Petit, who attended the case, his life was preserved. During his confinement, he manifested great anxiety for his recovery, and expressed himself horrified that he should ever have attempted to commit self-destruction. The surgeon and his friends entertained every hope that all suicidal tendency was dissipated. The result, however, proved that the whole was a manœuvre on the part of the patient to lull suspicion to rest, and when he had succeeded by this dissimulation in throwing his friends off their guard, he put an effectual period to his existence whilst in the wards of the hospital.
The following case exhibits some practical points exceedingly worthy of record, and displays besides, in a remarkable degree, the control a lunatic disposed to suicide acquires over himself, his conversation, and conduct, when he wishes to lull suspicion to sleep. In this instance, says Dr. Burrows, who relates the particulars of the case, a most judicious physician, and those in whom he had confidence, all experienced in the phases of this wonderful malady, insanity, and its no less wonderful concomitant, suicide, were completely deceived.
A medical friend of the Doctor’s, travelling over Shooter’s Hill, observed a gentleman walking up it, his carriage following him. When opposite to each other, the stranger suddenly fell on his knees in the dirt, and lifted up his hands, as if in earnest prayer. The friend stopped his post-chaise at so extraordinary a sight, and soon found by his looks and manners that the poor gentleman was insane. He immediately accompanied him back to London, and placed him under Dr. B.’s care till his relations were informed of his state.
The history of the case was this:—The patient was a cavalry officer of rank, aged thirty-five, and had particularly distinguished himself at the recent battle of Waterloo. On that occasion he had two horses killed under him, and was himself wounded in four places. He was first struck on the crown of his helmet by the splinter of a shell, which wounded the scalp and stunned him; he was next shot through the fleshy part of the thigh by a grape shot, which at the same time killed his first horse; from these two wounds he lost much blood. Whilst lying under his second horse, he was pierced in the groin by a lance; and in this helpless condition he received from a French drummer, who was rifling the dead and dying, a violent blow on the temple from the butt-end of a musket, from the effects of which, he remained some time insensible. He was afterwards conveyed in a most deplorable state as a prisoner within the French lines, and though released the same evening by the victorious allies, a long while elapsed before his wounds and exhausted condition received any attention.
He inherited a predisposition to insanity, and was naturally reserved, diffident, and taciturn, but affectionate and generous.
When he recovered from his wounds, he often complained of pains in his head; and it was observed that his temper became fretful and suspicious; that he slept ill, was depressed in spirits, and courted solitude. These symptoms increased latterly. At length he imagined himself the sport of his brother officers, and many other delusions arose.
There was a moral cause likewise operating which, on a constitution that had recently received so severe a shock, no doubt greatly influenced his disorder. He had applied for promotion in consequence of his sufferings in the service. This was withheld, as he thought, ungraciously, and too long; and when he was raised a step, his mind was already too much disturbed duly to appreciate it. The anniversary of the glorious battle of Waterloo was just passed, and the recollection of it was painful to him. In this state he came to town.
He was exceedingly sober and temperate by habit; but during the day before, with a brother officer, he was persuaded to commit an unusual excess in wine, with the hope of raising his spirits.
This proved a match to the mine. It exploded, and his intellects became completely deranged.
Dr. Burrows found him with his countenance very wild, the eyes injected and pupils contracted, pulse quick and weak, tongue white, and great thirst. He had had no sleep for five nights. Sometimes exalted, violent, and loquacious; sometimes depressed and taciturn. He was rather languid, which was imputed to his having lost full twenty ounces of blood from the rupture of an hæmorrhoidal vessel.
It is not necessary to detail the medical treatment adopted, but we will proceed to those points in the case which are relevant.
He was placed in lodgings with a careful attendant. In about three weeks he was nearly well, when unluckily a whitlow formed on his finger, and as one of his delusions was that he was rotten in every part, it was the cause, besides pain, of considerable irritation, and it broke his rest; other delusions returned, but subsided with the pain of the whitlow, and he again greatly improved.
In six weeks he was so well that the Doctor took his leave, advising him to travel during the remainder of the autumn. The next day some domestic occurrence occasioned violent irritation, and he again relapsed into despondency, unattended by paroxysms of violence; but he shortly recovered.
However, instead of going into the country and varying the scene, his lady brought him into town and permitted unrestricted intercourse with his relations, &c. He grew quarrelsome, suspicious, and very low-spirited, and began to abuse his wife. It was then earnestly recommended that he should be completely separated from all intercourse with her and his connexions, but the advice was disregarded.
A boil now formed on his body. This irritated him more than the whitlow, and his delusions about his rottenness were more prominent than ever; but when the boil suppurated and discharged, his mind again improved.
No persuasion could induce his friends to give him exercise or diversion, or change the scene. He therefore sat all day brooding over his fantasies, and reading religious books; for now there was added to his delusions an impression that he was very wicked, and had neglected his religious duties. His face, too, assumed the suicidal expression.
A month afterwards, a consultation with two eminent physicians confirmed Dr. Burrows’ opinion of the treatment to be pursued. But, notwithstanding this consultation, all remedial aid was neglected, and he was allowed to follow his own inclinations, both in religious matters and in totally secluding himself. In about three weeks all the symptoms were so much increased that he was sent to a private asylum. A few days afterwards, while walking out, he tried to drown himself, but was rescued by his keeper. He continued in this desponding state some months, when, rather suddenly, he appeared much better; and continuing to improve, his physician thought him well, and he returned home. Two days only had passed, when he called on the same physician, acknowledged that he was as bad as ever, and entreated earnestly that he might again be received into his house. He was so on that day. The next day he poisoned himself and died.
It proved, that he had never abandoned the desire of committing suicide; but he so well concealed it, and otherwise conducted himself, as to lead to the conclusion that he had recovered. It was, in fact, a scheme, the sole object of which was to get out and buy laudanum. Having procured a sufficient quantity, but anxious to save his wife the agony of witnessing the act he meditated, he preferred returning to the asylum to execute it.
A few general principles have been laid down in this chapter to direct the practitioner in the management of certain cases of suicidal insanity. The success of the treatment will in a great measure be dependent on the physician making himself acquainted with the minute history of each case submitted to his professional care. No particular rules can be adduced that will be applicable to all cases of this description; much must be left to the judgment of the medical man. The physician should, however, never forget that whatever apparently may be the physical disturbance going on in the system, the brain, and the brain alone, is the seat of the disease in all cases of suicide, and to the condition of that organ most particular attention ought to be paid.
The instinct of self-preservation—The love of life—Dr. Wolcott’s death-bed—Anecdote of the Duke de Montebello—Louis XI. of France—Singular death of a celebrated lawyer—Dr. Johnson’s horror of dying—The organ of destruction universal—Illustrations of its influence—Sir W. Scott, on the motives that influence men in battle—Have we any test of insanity?—Mental derangement not a specific disease—Importance of keeping this in view—Insanity not always easily detected—Is lowness of spirits an evidence of derangement?—The cunning of lunatics—Esquirol’s opinion that insanity is always present—Moral insanity—The remarkable case of Frederick of Prussia—Suicide often the first symptom of insanity—Cases in which persons have been restored to reason from loss of blood, after attempting suicide—The cases of Cato, Sir Samuel Romilly, Lord Castlereagh, Colton, and Chatterton examined—Concluding remarks.
Nature has ordained no law more universal in its influence than the desire which all animated beings display, and which is indeed the governing principle in the greater part of their actions, to preserve their existence, and to secure themselves from the influence of circumstances that bring it into danger. That “no man ever yet hated his own flesh, but nourisheth it and cherisheth it,” is an axiom laid down in scripture, and one founded on reason and observation.63
One of our poets, in alluding to this subject, after declaring life to be the dream of a shadow, “a weak-built isthmus between two eternities, so frail that it can neither sustain wind nor wave,” yet avers his preference of a few days’, nay, a few hours’ longer residence upon earth to all the fame that wealth and honour could bestow—
“Is there anything on earth I can do for you?” said Taylor to Wolcott, as he lay on his death-bed. The passion for life dictated the answer, “Give me back my youth?” These were the last words of the celebrated Peter Pindar.
Dr. Johnson had a superstitious fear of death. Boswell asked him whether we might not fortify the mind for the approach of death. Johnson answered in a passion, “No, Sir, let it alone! It matters not how a man dies, but how he lives. The act of dying is not of importance; it lasts so short a time.” But when Boswell persisted in the conversation, Johnson was thrown into such a state of agitation that he thundered out, “Give us no more of this;” and turning to Boswell, he said, with great earnestness, “Don’t let us meet to-morrow!”
There is an anecdote recorded of one of the favourite marshals of Napoleon, the Duke de Montebello, which finely illustrates the strength of this instinctive principle. During a battle in the south of Germany, the duke was struck by a cannon-ball, and so severely wounded that there was no hope of his surviving. Summoning the surgeon to his side, he ordered the wounds to be dressed; and when help was declared to be unavailing, the dying officer, excited into frenzy by the love of life, burned with vindictive anger against the medical attendant, threatening the heaviest penalties if his art should bring no relief. The dying marshal demanded that Napoleon should be sent for, as one who had power to save, whose words could stop the effusion of blood from the wounds, and awe nature itself into submission. Napoleon arrived in time to witness the last fearful struggle of expiring nature, and to hear his favourite marshal exclaim, as the lamp of life was just being extinguished, “Save me, Napoleon!”
The following case, which occurred in humble life, illustrates the same principle:—A man on the point of death vowed he would not die, cursing his physician, who announced the near termination of his life, and insisted that he would live in defiance of the laws of nature.
It is recorded of Louis XI. of France, that so desperately did he cling to life when everything warned him to prepare for death, that he, in accordance with the barbarous physiology of that age, had the veins of children opened, and greedily drank their blood, hoping in that way to fan the dying embers of life into a flame!
A once celebrated member of the English bar, whose strong original powers of mind had been obscured and enfeebled by the gross sensuality of his habits, in the extremity of his last illness, when the shadows of death were fast coming over him, with a blasphemous audacity, swore by his Creator that he would not die. In this state of morbid and impious rage he struggled out of his bed, tottered down the stairs, and fell lifeless in the passage. From the exclamation of this unfortunate man, it would seem as if he fancied that he held the reins of life in his hands, and could arrest at will the rapidity of its descending career.
Spence says, that “Salvini was an odd sort of man, subject to gross absences, and a very great sloven. His behaviour in his last hour was as odd as any of his behaviour in all his lifetime before could have been. Just as he was departing, he cried out in great passion, “Je ne veux pas mourir, absolument!”
It is not our intention to consider this subject phrenologically. That we have all certain good and evil propensities inherent in our nature, developed in various degrees in different individuals, is admitted by the anti-phrenologist, as well as by the most zealous advocate of that science. We need no phrenology to tell us, that “the heart of man is deceitful above all things, and desperately wicked:” scripture makes us acquainted with this fact. It is useful to look at the dark as well as the bright side of human nature. Without, then, using terms which might be considered objectionable, there can be no doubt of the existence in the human mind of a propensity to destroy, varying in degree from the simple pleasure of viewing the destruction of human life, to the most impassioned desire to kill others or oneself. This is a natural propensity, and, when not subdued by the higher faculties of the mind, it exhibits itself in the form of unequivocal insanity. This feeling to destroy may exist in conjunction with a consciousness on the part of the individual that he is about to commit a crime opposed to the laws of God and man. Dr. Gall relates many particulars of cases in which this natural propensity became morbidly developed. A student shocked his fellow-pupils by the extreme pleasure he took in tormenting insects, birds, and brutes. It was to gratify this inclination, he confessed, that he studied surgery. A man had so strong an inclination to kill that he became an executioner; and a Dutchman paid his butcher, who furnished ships with extensive supplies of meat, for being allowed to slaughter the oxen. In these cases we see this natural feeling inordinately developed. Subject such persons to the operation of causes likely to excite this extra-developed propensity, and they will murder others or themselves.
Gall mentions the case of a person at Vienna who, after witnessing an execution, was seized with a propensity to kill; at the same time, he had a clear consciousness of his situation. He wept bitterly, struck his head, wrung his hands, and cried to his friends to take care and get out of his way. Pinel mentions the case of a man, exhibiting no apparent unsoundness of intellect, who confessed that he had a propensity to kill. He nearly murdered his wife, and then attempted several times to destroy himself.
In 1805, a man was tried at Norwich for wounding his wife and cutting his child’s throat. He had been known to tie himself with ropes for a week to prevent his doing mischief to others and to himself. A man exposed to a sudden reverse of fortune was heard to exclaim, “Do, for God’s sake, get me confined; for if I am at liberty I shall destroy myself and wife! I shall do it, unless all means of destruction are removed; and therefore do have me put under restraint. Something above tells me I shall do it; and I shall!”
Whenever the mind is exposed to the influence of excited feeling, and the operation of the reasoning powers are suspended, we see the faculty alluded to developed according to the constitution of the individual. On the field of battle, striking examples occur of the various energies of this inclination. One soldier at the appearance of blood experiences the intoxication of carnage; another will swoon at the same sight. Sir Walter Scott, in the poem in which he has referred to the battle of Bannockburn, alludes to the various feelings that influence the mind in the heat of an engagement; and it will be perceived that he directs particular attention to those who are influenced by no other motive than the pleasure they derive from sacrificing human life:—
What conclusion are we justified in drawing from the facts just related? Certainly, that there is in us all a disposition to destroy, which is in some wisely and providentially restrained. If this view of the matter be correct, we do not think that we should be wrong in concluding that by far the great majority of cases of suicide result from a morbid development of this natural feeling, consequent upon a primary or secondary affection of the brain. This subject is of great interest in a medico-legal point of view, and is well deserving of serious consideration.
Is the act of suicide an evidence of mental derangement? Before this question can be satisfactorily answered, it would be necessary for us to consider that vexata questio—what is insanity? Have we an unfailing standard to which to appeal; an infallible test by which we can ascertain, with anything like a proximity to truth, the sanity of any mind? Perhaps, if we were to assert that we considered it impossible to point out the line of demarcation which separates the confines of a sane and insane condition of the mind, we might lay ourselves open to an attack. Again, were we bold enough to proclaim our non-adherence to what is considered as the orthodox faith in this matter, and assert that we viewed every departure from a healthy tone of mind, whether in its intellectual or moral manifestations, as an evidence of insanity, we might still more expose ourselves to the merciless lash of the critic; yet these are the opinions to which we should feel most disposed to give our assent. We must make a marked distinction between insanity considered as a legal and as a medical question; and it is greatly owing to our not keeping this essential difference in mind that so much useless reasoning and vituperation has arisen. The man who is daily exposed to the kind and cheering influence of friendship, and who fancies himself alone in the world, without one human being to sympathize with him in his afflictions, is as essentially mad as he is who imagines himself to be made of glass, and is fearful of sitting down lest he should injure his brittle glutei muscles. A poet of antiquity wrote a book describing the miseries of the world, and destroyed himself at the conclusion of the task.
“No man who is oppressed with grief,” Crichton justly observes, “and who is constantly preyed on by mental and bodily pain, can be supposed capable of exercising his judgment at all times correctly; a fresh misfortune, imaginary or real, excites an irresistible desire of relief. Tired out, hopeless, dismayed by the threatening aspect of many a bursting cloud; discerning nothing, whichever way he looks, but a dreary and comfortless life, how can he be supposed capable of taking a clear, calm, and comprehensive view of the obligations he owes to his Creator or society, or of reflecting on the sudden vicissitudes which daily occur in human life, and on which every man may safely form some hope, even in the most distressed situation? The wretchedness of life is the only picture present to the mind of one in whom grief has terminated in such a state of deep melancholy; the only objects of comparison are the misery of existence on the one hand, and the relief he can obtain by withdrawing himself from it on the other.”
Insanity results from a disease of the brain. Although after death, in many cases, no appreciable structural lesion can be detected in the cerebral mass, it would be illogical for us to conclude that the sentient organ has not been physically affected. Derangement of mind is but the effect of physical disease, and, like all other diseases, it has an early as well as an advanced stage. Medical men have not paid sufficient attention to the premonitory indications of mental alienation. Having erected an arbitrary standard of derangement in their own minds, they have been disposed to consider no deviation from mental soundness as insanity, unless it exhibited the symptoms which their preconceived ideas had led them to suppose necessary, in order to constitute that disease. They have argued as if insanity were a specific disease invariably manifesting the same phenomena, and in this way definitions have been framed, by which the soundness of the intellect has been tested. It is hardly necessary to say how fallacious all such tests must be. The brain, like every other organ, is liable to a variety of diseases, in all of which the mental faculties are more or less affected. The danger of attempting to erect an arbitrary standard of insanity is this: it induces us to overlook the incipient symptoms of mental derangement, and to consider no deviation from soundness of intellect as insanity which does not come within the scope of our definition. The early symptoms of mental aberration are as much an evidence of the presence of insanity, as when the disease is more advanced, and the indications become so apparent that no one hesitates in pronouncing the individual mad. Medical men who have maintained that the act of suicide is not invariably the result of insanity have argued as if the mental ailment was always self-evident and easily detected; whereas, those who have had any experience in the matter know full well, that occasionally there are no diseases more difficult of detection than those which relate to a morbid condition of the mind. If an act of suicide has been committed, and the individual at the moment of perpetrating it did not manifest evident symptoms of insanity, the conclusion drawn is, that he was perfectly sane at the time. That the facts of the case do not warrant this inference must be apparent to those who consider the subject in an enlarged point of view. If we examine attentively the majority of cases of suicide, we shall find that the unfortunate persons have laboured, either for some time previously or at the very moment, under depression of spirits, anxiety of mind, and other symptoms of cerebral derangement. Very few cases of suicide take place in which you cannot trace the existence of previous mental depression, produced either by physical or moral agents. It may be said that lowness of spirits is not insanity; certainly not, according to the legal definition of the term; but we may always be assured, that if mental anxiety or perturbation be more than commensurate with the exciting cause, it may be presumed that the individual is labouring under the incipient indications of insanity.64 This view of the case is strengthened if an hereditary predisposition to the disease should also be present.
“It will be said,” says Esquirol, “that there are individuals who, in the midst of affluence, grandeur, and pleasures, and in the full enjoyment of reason, have suddenly put an end to their existence, immediately after parting with their friends in good spirits, or after having written letters on business with perfect correctness. Can these be said to be insane when they commit suicide? Yes; most undoubtedly. Do not monomaniacs appear perfectly sane on all other subjects, till the particular idea is started which forms the burden of their hallucination? Are they not capable of curbing the expression of their delirium, and dissembling their aberration of intellect? It is the same with sane individuals, over whom the suicidal idea tyrannizes. A physical pain, an unexpected impression, a moral affection, a recollection, an indiscreet proposition, the perusal of a passage in writing, will occasionally revive the thought and provoke the act of suicide, although the individual the instant before should be in perfect integrity of mind and body.”
In general, most persons actually insane wish not only to be esteemed free from the malady, but to be considered as possessing considerable intellectual endowments; hence, real lunatics seldom allow the existence of their lunacy; but are always endeavouring to conceal from observation those lapses of thought, memory, and expression, which are tending every moment to betray them, and of the presence of which they are much oftener conscious than is generally apprehended or believed. Alexander Cruden, when suffering under his second and last attack of mental aberration, upon being asked whether he ever was mad, replied: “I am as mad now as I was formerly, and as mad then as I am now, that is to say, not mad at any time.”
Again, medical men who have reasoned against this opinion have forgotten entirely one peculiar, and a very remarkable feature of insanity—viz., the singular cunning of lunatics; how extremely difficult it is in many cases where we know the individual to be unquestionably mad, to make his delusion apparent. The case of the lunatic who indicted Dr. Monro for confining him in his asylum has often been cited. He brought an action against the Doctor at Westminster; and, although the man was subjected to a most severe examination and cross-examination, his insanity could not be detected. The trial was on the eve of being concluded, when Dr. Sims entered the court, and knowing the man’s peculiar delusion, he was requested to ask him a question. He did so, and his insanity instantly became apparent. He brought another action against Dr. Monro in the city of London, and, knowing that he had failed before by acknowledging his love for an imaginary princess, so remarkable a degree of cunning did he exhibit that one of the severest examinations to which a man was ever subjected in a court of justice could not induce the lunatic to disclose the delusion under which he was known to labour. This curious feature of insanity must be taken into consideration in forming an estimate of the presence of derangement in cases of suicide, and we must not hastily conclude, because insanity is not self-evident, that it does not exist.
A merchant, fifty-five years of age, of a strong constitution, although of a lymphatic temperament, mild and gentle in his disposition, the father of a numerous family, and who had acquired a considerable fortune in business, experienced some domestic troubles, not sufficiently serious, however, to affect any one of a resolute character. About a year ago, he formed a large establishment for one of his sons, and shortly afterwards became very active, and expressed, contrary to his usual habits, the delight which he felt at his increasing prosperity. He was also more frequently absent from his warehouse and business than usual. But notwithstanding these trifling changes, neither his family, nor any of his friends or neighbours, suspected any disorder of his reason. One day, whilst he was from home, a travelling merchant brought to his house two pictures, and asked fifty louis for them, which he said was the price agreed on by a very respectable gentleman who had given his name and address. His son sent away both the pictures and the seller. On his return, the father did not mention his purchase; but the children began the conversation, alluding to the roguery of the merchant, and their refusal to pay him. The father became very angry, asserting that the pictures were very beautiful, that they were not dear, and that he was determined to purchase them. In the evening, the dispute became warmer, the patient flew into a passion, uttered threats, and at last became delirious. On the next day, he was confided to Esquirol’s care. His children, frightened at their father’s illness, and alarmed at the purchase which he had made, looked through their accounts; and great was their astonishment at seeing the bad state of their books, the numerous blanks which they presented, and the immense deficiency of cash. This irregularity had existed for more than six months. Had this discussion not taken place, one of the most honourable mercantile houses would have been compromised in a few days; for a bill of exchange of a considerable amount had become due, and no means had been taken to provide for it.
A patient has been known to weep, and affect the deepest contrition for attempting suicide, when it has been proved that all the time he was meditating on the means of accomplishing his design. A workman was admitted into a French hospital, having a third time attempted his life. He appeared deeply mortified and broken-hearted that he should have suffered a relapse, and was much affected by the remonstrances of his physician. He promised faithfully, in tears, to abandon his rash resolve. Ten minutes afterwards, whilst on his road home, he perceived a piece of cord; he seized it, made a noose, put his head into it, and suspended himself from the branch of a tree, where he was found dead! Cases illustrative of the same fact are mentioned in another part of this work.
Again, we must bear in mind that insanity is often as much a disease of the moral as of the intellectual faculties, and that it is possible for the intellect to be perfectly sound, and yet for insanity to be present. Moral derangement has not met with that consideration from the profession which its importance demands. Insanity often consists in a vitiated condition of the moral principle, independently of any delusion of the intellect; and in many cases of suicide, if we investigate their history, we shall find that the alienation has been of this character. A man, whose disposition naturally disposed him to vice, fancied that he had been guilty of committing a nameless offence, and, whilst labouring under this idea, blew out his brains. In this case, the intellect was unaffected; the derangement consisted in a perversion of the moral powers. Senile insanity, which has been recognised in our courts of law, is a derangement of the moral constitution. In cases of this description, it is possible for the person to be conscious of his infirmity, and to confess, with great apparent regret, his inability to control his feelings. “I am impotent, and not fit to live,” said a man, and accordingly cut his throat. If we admit the existence of an insanity which consists solely in a perversion of the moral powers, then we should hesitate in pronouncing ex cathedrâ that insanity is not present because no derangement of the intellectual faculties can be perceived.
Dr. T. Mayo observes, that “no intellectual delusion need be present when self-destruction is coveted. But there must be an extinction of that moral sense which revolts from it on grounds independent of fear. Owing, however, to the systematic neglect of moral symptoms, the suicide is seldom recognised as possessing this destructive tendency until he has made an attempt upon his life; often, therefore, until all measures must be too late.”
A very common feature of moral mania is a deep perversion of the social affections, whereby the feelings of kindness and attachment that flow from the relations of father, husband, and child, are replaced by a perpetual inclination to tease, worry, and embitter the existence of others. The ordinary scene of its manifestations is the patient’s own domestic circle, the peace and happiness of which are effectually destroyed by the outbreakings of his ungovernable temper, and even by acts of brutal ferocity. Frederic William of Prussia, father of Frederic the Great, undoubtedly laboured under this form of moral mania; and it furnishes a satisfactory explanation of his brutal treatment of his son, and his utter disregard of the feelings or comfort of any other member of his family. About a dozen years before his death, his health gave way under his constant debauches in drunkenness; he became hypochondriacal, and redoubled his usual religious austerities. He forbade his family to talk of any subject but religion, read them daily sermons, and compelled them to sing, punishing with the utmost severity any inattention to these exercises. The prince and his elder sister soon began to attract a proportionate share of his hostility. He obliged them to eat and drink unwholesome or nauseous articles, and would even spit in their dishes, addressing them only in the language of invective, and at times endeavouring to strike them with his crutch. About this time he attempted to strangle himself, and would have accomplished his design had not the queen come to his rescue. His brutality towards the prince arrived to such a pitch that he one morning seized him by the collar as he entered his bed-chamber, and began to beat him with a cane in the most cruel manner, till obliged to desist from pure exhaustion. On another occasion, shortly after, he seized his son by the hair, and threw him on the ground, beating him till he was tired, when he dragged him to a window, apparently for the purpose of throwing him out. A servant hearing the cries of the prince, came to his assistance, and delivered him from his hands. Not satisfied with treating him in this barbarous manner, he connived at the prince’s attempts to escape from his tyranny, in order that he might procure from a court-martial a sentence of death; and this even he was anxious to anticipate by endeavouring to run him through the body with his sword. Not succeeding in procuring his death by judicial proceedings, he kept him in confinement, and turned all his thoughts towards converting him to Christianity. At this time, we first find mention of any delusion connected with his son, though it probably existed before. In his correspondence with the chaplain to whom he had entrusted the charge of converting the prince, he speaks of him as one who had committed many and heinous sins against God and the king, as having a hardened heart, and being in the fangs of Satan. Even after he became satisfied with the repentance of the prince, he shewed no disposition to relax the severities of his confinement. He was kept in a miserable room, deprived of all the comforts and many of the necessaries of life, denied the use of pens, ink, and paper, and allowed scarcely food enough to prevent starvation. His treatment of the princess was no less barbarous. She was also confined, and every effort used to make her situation thoroughly wretched, and though, after a few years, he relaxed his persecution of his children, the general tenour of his conduct towards his family and others evinced little improvement in his disorder, till the day of his death.65
In considering this point it is important to remember that the attempt at self-destruction is OFTEN the FIRST distinct overt act of insanity. A young lady of delicate constitution, but previously in apparent health, started up one day from the tea-table, rushed to the window, and endeavoured to throw herself out. It required several persons to restrain her until a strait-waistcoat could be procured. She remained insane from that time until the day of her death, with very partial glimmerings of reason. “Fortunately,” says Mr. Chevalier, who relates the case, “her life was not long protracted.”
It has been inferred, that when an unsuccessful act of suicide has been committed, and the person expresses his regret for what he has been guilty of, that we are justified in concluding that the mind was sane when the suicide was attempted. The effort which Sir Samuel Romilly is said to have made to stop the hemorrhage after having cut his throat, has been cited by a celebrated living authority as an evidence of his previous sanity.66 We must bear in mind that many cases of suicide result from derangement of mind dependent on cerebral congestion.
In such cases, we can imagine a person insane when the act of self-destruction is attempted, and sane immediately afterwards. The loss of blood which a person would sustain from an extensive wound of the throat, particularly when, as is often the case, some large vessel is wounded, would instantly relieve the brain of the superabundant blood which had been oppressing it, and deranging its manifestations, and thus producing a return of sanity. That this was the fact in Sir Samuel Romilly’s case is evident from its history. There cannot be a shadow of doubt that he was insane when he cut his throat; and his apparent desire to live after the act was committed, may be attributed to the relief which he had derived from the loss of blood.
Mr. T. Miller, of Spalding, in a fit of delirium, cut his throat so dreadfully that after languishing three days, he died. He manifested during this interval the utmost contrition for his offence, declaring he knew not what he had done until he found the blood streaming from his wound. He dictated his will, and talked rationally with his friends till his dissolution.67
A merchant in the city, not many months back, met with some losses in business. His mind became affected to a certain extent; he felt a strong desire to kill himself; but being a man of education and enlarged capacity, he fought most resolutely against this inclination. He had been exposed during one day to the influence of circumstances which caused great mental depression. He said to his head-clerk, previously to his leaving his counting-house, that his head felt heavy and oppressed, and he had a presentiment that something would happen before the morning. The clerk suggested the propriety of his having medical advice, but he did not think proper to do so. In this state he went to bed. In the middle of the night he awoke in a state of extreme agitation; no language could convey an adequate idea of his feelings, and suicide was the only act which held out the hope of relief. In this state he rose from his bed, called up the servants, and commanded them to run for the surgeon. A professional gentleman who lived close by was soon in attendance, and the moment he entered the room the patient exclaimed, “Bleed me, or I shall cut my throat!” The operation was instantly performed, and as the blood flowed from the vein the patient exclaimed, “Thank God! I have been saved from committing self-murder.” Every disposition to suicide was immediately removed.
The following is an extract of a letter found in the pocket of Captain Aitkins, of the Pembroke Fusileers, who committed suicide:—“As some inquiry may be instituted as to the cause of my death, I think it necessary to state that it was inflicted by my own hand, partly from pecuniary embarrassment, and partly from the effect of strong nervous malady, which has fixed itself on my spirits so as to render life insupportable.” In this case we have no hesitation in asserting, that if the brain could have been relieved of the unnatural weight which oppressed it, this poor man would not have stained his hand with his own blood.
In many cases the delusion of the intellect is so self-evident that no one questions the existence of insanity. A respectable Scotch merchant, near Pimlico, committed suicide by cutting his throat. He fancied the devil was in him; he asserted he could feel him in his throat. On examining his room after his death, two wills were discovered, in one of which he desires his executors to employ a surgeon to open his body, that the devil might be found, secured, and destroyed; and in this way, he says, he will be prevented from injuring any one else.
Many other cases could be cited in which the act of suicide was clearly traceable to mental derangement, were it considered necessary further to illustrate this point. Much evil has resulted from the opinions which the profession have entertained relative to the absence of insanity in cases of those who have exhibited a disposition to destroy themselves. In this matter, the principle which the great Edmund Burke applied to politics is equally applicable to medicine—“We had better be blamed for too anxious apprehension, than be ruined by too confident a security.”
It is a safe doctrine always to presume the presence of insanity in those who have exhibited a desire to commit suicide. A person who has once attempted to take away his life cannot be trusted, notwithstanding he manifest the usual evidences of a sane intellect. It is astonishing to consider the ingenious tricks and stratagems to which a person whose mind is bent on self-destruction will have recourse in order to effect his purpose. We find recorded the case of a woman who was tried for her life, and who, in order that she might escape from the hands of the executioner, applied a hundred leeches to her body, hoping to bleed to death. Another female exposed herself to a swarm of bees; and we read of an apothecary who endeavoured to beat out his brains with his own pestle.
A builder, who had been found fault with by his employer, became melancholy, and finally determined upon self-destruction. He hurried to a steep part of the high road, where vehicles of all descriptions were compelled to put on the drag in the descent. Here he waited until a heavily loaded wagon reached the spot, when he seized hold of one of the wheels that was not locked, and applying his body to the circumference, was instantly crushed.
A woman cut her throat severely, but not fatally. Her friends could not be prevailed on to believe that she was insane. She recovered, but shewed such evidences of that unhappy condition, through the whole progress of her cure, as were sufficiently unambiguous to every competent judge. She had speculated unsuccessfully in the lottery, and it was insisted that the rash act was solely to be ascribed to her disappointment in this venture. Soon after her recovery, and when her affairs had assumed a more comfortable train, she went up one day into her bed-room, and being thought to stay longer than was necessary, a person went to see after her, and found her sitting before a dressing-glass, with a basin under her chin, and a knife in her hand, cutting her throat again, as deliberately as a surgeon would have performed an operation. She recovered this time also, and afterwards made a third and successful attempt.
A maniac who was extremely turbulent, and had evinced a strong propensity to destroy himself, was confined, and everything taken from him which could be imagined in any way capable of being instrumental for such a purpose. He was remarked on one occasion to be unusually quiet, and on his keeper looking through an aperture in his apartment, he discovered him scooping out his eyes with a bit of broken china found by him in the mattress, which he had torn to pieces; and with his face full in the glare of the sun, he had completely accomplished this horrid act before the door could be opened to secure him.
A gentleman of some political consequence in France had an attack of apoplexy, from which he recovered by copious bloodletting. Some years afterwards, he had a fall from his horse, and was wounded severely in his head, the injury occasioning fever and delirium of some weeks’ duration. After this accident, he evinced some marks of mental aberration. He threw up his post under government, and retired to his chateau in the country, for the purpose of concocting, as he said, a scheme for uniting the people of all nations. To prepare a suitable edifice for this philanthropic union, he began to pull down his chateau; but being interrupted by his friends, he came to Paris, and one day jumped off the Pont-Neuf into the middle of the Seine. He swam manfully, and reached the shore in safety. He was so proud of this exploit that he considered himself invulnerable, and began next day to run in the way of carriages or fiacres he met in the street, calling to the drivers that they need not mind him, as he could not be injured! He was seized and carried home, but in a day or two jumped out of the chamber window into the street. He was then placed in M. Esquirol’s establishment, and considered as an incurable maniac.
During the French revolution, a case of mania without delirium gave rise to an extraordinary scene at the Asylum de Bicêtre. The mob, after the massacre of the prisons, broke like madmen into the above hospital, under pretence of emancipating certain victims of the old tyranny, whom it had endeavoured to confound with the maniacal residents of that house. They proceeded in arms from cell to cell, interrogating the prisoners, and passing such of them as were manifestly insane. A maniac, bound in chains, arrested their attention by the most bitter complaints which he preferred, with apparent justice and rationality. “Is it not shameful,” said he, “that I should be bound in chains, and confounded with madmen.” He defied them to accuse him of any act of impropriety or extravagance. “It is an instance of the most flagrant injustice!” He conjured the strangers to put an end to such oppression, and to become his liberators. His complaints excited amongst the armed mob loud murmurs and imprecations against the governor of the hospital. They immediately sent for that gentleman, and, with their sabres at his breast, demanded an explanation of his conduct. When he attempted to justify himself, they imposed silence upon him. To no purpose did he adduce, from his own experience, similar instances of maniacs who were free from delirium, but at the same time extremely dangerous from their outrageous passions. They answered him only with abuse; and had it not been for the courage of his wife, who protected him with her own person, he would have been sacrificed to their fury. They commanded him to release the maniac, whom they led in triumph with reiterated shouts of “Vive la République!” The sight of so many armed men, their loud and confused shouts, and their faces flushed with wine, roused the madman’s fury. He seized with a vigorous grasp the sabre of his next neighbour, brandished it about with great violence, and wounded several of his liberators. Had he not been promptly mastered, he would soon have made them repent their ill-timed humanity. The savage mob then thought proper to lead him back to his cell, and, with shame and reluctance, yielded to the voice of justice and experience.