The Anatomy of Suicide

by Forbes Winslow

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.