CHAPTER X.
PHYSICAL TREATMENT OF THE SUICIDAL DISPOSITION.
On the dependence of irritability of temper on physical disease—Voltaire and an Englishman agree to commit suicide—The reasons that induced Voltaire to change his mind—The ferocity of Robespierre accounted for—The state of his body after death—The petulance of Pope dependent on physical causes—Suicide from cerebral congestion, treatment of—Advantages of bloodletting, with cases—Damien insane—Cold applied to the head, of benefit—Good effects of purgation—Suicide caused by a tape-worm—Early indications of the disposition to suicide—The suicidal eye—Of the importance of carefully watching persons disposed to suicide—Cunning of such patients—Numerous illustrations—The fondness for a particular mode of death—Dr. Burrows’ extraordinary case—Dr. Conolly on the treatment of suicide—Cases shewing the advantage of confinement.
Medical men have not considered with that degree of attention commensurate with its importance the relationship between physical derangement and those apparently trifling mental ailments which so often, if not subdued, lead to the commission of suicide. The origin of self-destruction is more frequently dependent upon derangement of the primæ viæ than is generally imagined. Every one must, in his own person, be aware of the influence of indigestion, and what is termed bilious disorder, upon the spirits. An inactive condition of the bowels is a common cause of mental disquietude. Voltaire, who was a man of great observation, appears to have paid considerable attention to this connexion. He advises a person who intends to ask a favour of a prime minister, or a minister’s secretary, or a secretary’s mistress, to be careful to approach them after they have had a comfortable evacuation from the bowels. Dryden invariably dosed himself before sitting down to compose. He says—“If you wish to have fairy flights of fancy, you must purge the belly.” Carneades, the celebrated disputant of antiquity, was in the habit of taking white helebore, (a purgative,) preparatory to his refuting the dogmas of the Stoics. Lord Byron says, in one of his letters, “I am suffering from what my physician terms ‘gastric irritation,’ and my spirits are sadly depressed. I have taken a brisk cathartic, and to-morrow ‘Richard will be himself again.’” The following anecdote is recorded of Voltaire:—“An English gentleman of fortune had been sitting many hours with this great wit and censurer of human character. Their discourse related chiefly to the depravity of human nature, tyranny and oppression of kings, poverty, wretchedness, and misfortune, the pain of disease, particularly the gravel, gout, and stone. They worked themselves up to such a pitch of imaginary evils that they proposed next morning to commit suicide together. The Englishman, firm to his resolution, rose, and expected Voltaire to perform his promise, to whom the genius replied, “Ah! monsieur, pardonnez moi, j’ai bien dormi, mon lavement a bien operé, et le soleil est tout-à-fait clair aujourd’hui.”
We knew a gentleman whose temper was not controllable if he allowed himself to pass a day without his accustomed evacuation from the bowels. Pinel records the particulars of the case of a man who had fits of mental derangement whenever the action of the bowels became irregular.
The blood-thirsty miscreant Robespierre is said to have been of a “costive habit, and to have been much subjected to derangement of the liver.” After death, it is said that “his bowels were found one adherent mass.” It is indeed interesting to consider, both morally and medically, how far these morbid ailments influenced this monster in the bloody career in which he was engaged.
There can be no question but that the morbid irritability which many of our men of genius have manifested was but the effect of a derangement of the physical frame acting upon a mind naturally sensitive to such impressions.
Much of the petulance, personality, and malignity of Pope was dependent upon causes over which he had no control—viz., disease of the stomach and liver, producing hypochondriasis. It has been well observed by Madden, “Who knows under what paroxysms of mental irritation caused by that disease (indigestion), which more than any other domineers over the feelings of the sufferer, he might have written those bitter sarcasms which he levelled against his literary opponents? Who knows in what moment of bodily pain his irascibility might have taken the form of unjustifiable satire, or his morbid sensibility assumed the sickly shape of petulance and peevishness? Who knows how the strength of the strong mind might have been cast down by his sufferings, when ‘he descended to the artifice’ of imposing on a bookseller, and of ‘writing those letters for effect which he published by subterfuge?’ Who that has observed how the vacillating conduct of the dyspeptic invalid imitates the vagaries of this proteiform malady can wonder at his capriciousness, or be surprised at the anomaly of bitterness on the tongue, and benevolence in the heart, of the same individual?”[56]
That Pope was a severe sufferer from bodily disease will appear evident from the following account given by Dr. Johnson of the poet. He says, “Pope’s constitution, which was originally feeble, became so debilitated that he stood in perpetual need of female attendance; and so great was his sensibility of cold that he wore a fur doublet under a shirt of very coarse warm linen. When he rose, he invested himself in a bodice made of stiff canvass, being scarcely able to hold himself erect till it was laced; and he then put on a flannel waistcoat. His legs were so slender that he enlarged their bulk with three pairs of stockings, which were drawn off and on by the maid, for he was not able to dress or undress himself, and he neither went to bed nor rose without help.”