The Anatomy of Suicide

by Forbes Winslow

Like Metastasio, he would not, if he could help it, permit the word death to be pronounced in his presence. Boswell once introduced the topic in the course of conversation, which made Johnson highly indignant. He observed, that he never had a moment in which it was not terrible to him.

Three or four days before he died, he declared that he would give one of his legs for a year more of life. The ruling passion was exhibited strong in death. At Dr. Johnson’s own suggestion, the surgeon was making slight punctures in the legs, with the hope of relieving his dropsical affection, when he cried out, “Deeper! deeper! I want length of life, and you are afraid of giving me pain, which I do not value.” If we had not a thorough conviction that this fear of death was but the result of physical disease, which no moral and religious principles could subdue, Dr. Johnson’s conduct towards the end of his life would excite a feeling in our mind towards him very opposite to that of respect.

With reference to suicide, there is no fact that has been more clearly established than that of its hereditary character. Of all diseases to which the various organs are subject, there are none more generally transmitted from one generation to another than affections of the brain. It is not necessary that the disposition to suicide should manifest itself in every generation; it often passes over one, and appears in the next, like insanity unattended with this propensity. But if the members of the family so predisposed are carefully examined, it will be found that the various shades and gradations of the malady will be easily perceptible. Some are distinguished for their flightiness of manner, others for their strange eccentricity, likings and dislikings, irregularity of their passions, capricious and excitable temperament, hypochondriasis and melancholia. These are often but the minute shades and variations of an hereditary disposition to suicidal madness. A gentleman suddenly, and without any apparent reason, cut his throat. The father had always been a man of strong passions, easily roused, and when so, was extremely violent. The brother was a man of impulse; he always acted by fits and starts, and therefore never could be depended upon. The sister had a strange, unnatural, and superstitious horror of particular colours and odours. A yellow dress caused a feeling approaching to syncope, and the smell of hay produced great nervous excitement. The grandfather had been convicted of homicide, and had been confined for two years in a mad-house.

Andral relates the case of a father who died from the effects of disease of the brain; the mother died sane. They had six children, three boys and three girls. Of the boys, the eldest was a man of original mind; the second was very extravagant in his habits, and was ultimately confined in a mad-house; the third was extremely violent in his temper. Of the girls, one had fits of apoplexy, and became insane; the other died at her accouchement, with symptoms of derangement; the third died of cholera, not, however, until she exhibited indications of mental aberration.

A case more singular than the last is recorded. All the members of a particular family, being hereditarily disposed, exhibited, when they arrived at a certain age, a desire to commit self-destruction. It required no exciting cause to develope the fatal disposition. No wish was expressed, or attempt made, to overpower the suicidal inclination, and the greatest industry and ingenuity were exercised by the parties in order to effect their purpose. In two cases, the propensity was subdued by proper medical and moral treatment; but, just in proportion to its being suppressed, did the idea of suicide appear to fix itself resolutely in the mind. The desire came upon the individuals like the attacks of intermittent fever.

A. K., a man aged 57, was twice married. He was a shoe-maker by trade; but not having received any education, his wife was compelled to attend to all his accounts. He had experienced, when young, a blow on the head, which occasionally gave him pain. He became very intemperate in his habits, and at particular intervals he exhibited an uncontrollable temper, quarrelled with everybody, neglected his business, abused his wife, and became extravagant and melancholy. During the paroxysm he would exclaim—“Oh, my unlucky head! I am again a lost man!” When the attack subsided, he returned to his business, was affectionate to his wife and family, most humbly begged her pardon for having ill-treated her, and expressed the greatest contrition for his conduct. These attacks came on at regular intervals. He procured a piece of rope for the purpose of hanging himself, and for some months carried it about with him in his pocket for that purpose. During one of his fits he effected his object. His grandfather had strangled himself, and his brother and sister had attempted suicide.

Dr. Gall knew several families in which the suicidal propensity prevailed through several generations. Among the cases he mentions is the following very remarkable one:—“The Sieur Ganthier, the owner of various houses built without the barriers of Paris, to be used as entrepôts of goods, left seven children, and a fortune of about two millions of francs to be divided among them. All remained at Paris, or in the neighbourhood, and preserved their patrimony; some even increased it by commercial speculations. None of them met with any real misfortunes, but all enjoyed good health, a competency, and general esteem. All, however, were possessed with a rage for suicide, and all seven succumbed to it within the space of thirty or forty years. Some hanged, some drowned themselves, and others blew out their brains. One of the first two had invited sixteen persons to dine with him one Sunday. The company collected, the dinner was served, and the guests were at the table. The master of the house was called, but did not answer; he was found hanging in the garret. Scarcely an hour before, he was quietly giving orders to the servants, and chattering with his friends. The last, the owner of a house in the Rue de Richelieu, having raised his house two stories, became frightened at the expense, imagined himself ruined, and was anxious to kill himself. Thrice they prevented him; but soon after, he was found dead, having shot himself. The estate, after all the debts were paid, amounted to three hundred thousand francs, and he might have been forty-five years old at the time of his death.”

Falret, whose researches have thrown much light on this affection, believes that it is more disposed to be hereditary than any other kind of insanity. He saw a mother and her daughter attacked with suicidal melancholy, and the grandmother of the latter was at Charenton for the same cause. An individual, he says, committed suicide in Paris. His brother, who came to attend the funeral, cried out on seeing the body—“What fatality! My father and uncle both destroyed themselves; my brother has imitated their example; and twenty times during my journey hither I thought of throwing myself into the Seine!”

Gall also relates the case of a dyer, of a very taciturn humour, who had five sons and a daughter. The eldest son, after being settled in a prosperous business with a family around him, succeeded, after many attempts, in killing himself by jumping from the third story of his house. The second son, who was rather taciturn, had some domestic troubles, lost part of his fortune at play, and strangled himself at the age of thirty-five. The third threw himself from the window into his garden, but did not hurt himself; he pretended he was trying to fly. The fourth tried one day to fire a pistol down his throat, but was prevented. The fifth was of a bilious, melancholic temperament, quiet, and devoted to business; he and his sister shewed no signs of being affected with their brothers’ malady. One of their cousins committed suicide.

Among the physical causes of self-destruction, insidious affections of the brain must stand prominently forward. It is not often that the physician is permitted to examine after death the state of this organ; but there can be no doubt that, in the great majority of instances, the brain will be found to have undergone a serious structural alteration. “During the last twenty-five years,” says Dr. G. Mantell, “many cases of suicide have come under my notice in which the mental hallucination which led to self-destruction has depended on lesions of the brain, occasioned by slight or neglected injuries of the head, to which neither the patient nor his friends attached any importance. In several instances of self-destruction, without any assignable moral cause, and in which no previous signs of fatuity or insanity were manifested, I have found, upon a post mortem examination, either circumscribed induration or softening of the brain, or thickening and adhesions of some portions of its membranes. The conviction was forced upon my mind that very many of the so called nervous or hypochondriacal affections, which are generally considered as imaginary and dependent on mental emotions, are ascribable to physical causes, and frequently originate from slight lesions of the brain.”