And again, the existence of insanity cannot be affirmed in those suicides, which have taken place in every age of the world, and are not quite obsolete even now,─those cases of voluntary death among natives of uncivilized countries, which form a part of either their political, social, or religious institutions.
“Just as madness may exist, without any idea of suicide, so suicide may take place, the effect of a full and free determination, formed by a healthy mind, and executed with the coolness and complete system of precautions of the most perfect logic,” says Maudsley, and he carries with him the greater part of higher class medical opinion.
All our necessities, our desires, and our passions, produce a mental and bodily struggle; every want of man, though necessary to his perfection, involves victims to mental failure, and consequently either to crime or suicide. Even religion is frequently found to lead to disorder of intellect, from too great abstraction of thought from our earthly duties; while, on the other hand, mental failure is often shewn by religion becoming so absorbing a theme that it causes a patient to forget his worldly responsibilities.
The following authorities, who have specially studied the state of mind in cases of voluntary death, inclined to the doctrine that all suicides are insane: Esquirol, Falret, Bourdin, Winslow, Chevrey, Foderé, and Davey.
Forbes Winslow especially was the champion of this opinion; he distinctly wrote, no healthy mind ever permitted the act; but then in his time a wave of special tenderness to all criminals overshadowed the country; and exists even now, for our paupers are far less well cared for than our gaol birds.
M. Foderé, Professor of Medical Jurisprudence at Strasburg, used to say of voluntary death, “a suicide must be insane;” but this was a colloquial remark, rather than a medical dogma.
M. Falret, in his treatise on “Suicide and Hypochondriasis,” says, “suicide is necessarily an act of delirium;” perhaps it is to a medical man who considers hypochondriasis and hysteria to be insanity.
In the year 1777 this question of the coincidence of suicide with insanity was gravely argued before the Parliament at Paris, but the decision was put aside on a question of form, and never settled by them.
Dr. J. G. Davey read an essay before the Bath and Bristol Branch of the British Medical Association a few years back, in which he proved to his own satisfaction that “suicide is at all times, and under all circumstances, the effect of a positive brain disease;” but his arguments fail to explain the cases where two persons commit the act together; are we to suppose such disease of brain to be contagious? He mentions such a case, but without explanation. See Asylum Journal of Mental Science, vol. vii. 108, and xvi. 406.
It may be only a coincidence, but it is a fact, that almost without exception the supporters of the theory that all suicides are insane have been medical attendants in asylums.