Among the preventable deaths which every year carry off more of our citizens than the most savage war, Suicide ought to be attended to with strenuous and patient care.
“Do you call suicide a preventible cause of death?” a hundred voices will probably ask. They will say that the self-destroyer usually does his last deed when nobody is thinking of such a thing; and that it would be cruel to blame his family and friends for a calamity which they have at the moment no reason to apprehend. May be so: but still we may be justified in treating of suicide as a preventible kind of mortality. Let us look at some of the leading facts.
According to the coroners’ returns, the cases of suicide inquired into in England and Wales were, in 1850, 1314. In 1857, they were 1349. In 1858, they were 1275.
The first remark of some readers will be that they thought there had been more: and of others, that they had no idea there had been so many. But all will probably go on to remark on the uniformity of the proportion of suicides to other deaths in three consecutive years. The proportion would be found no less regular in thirteen years, or in thirty. This circumstance ought to set us thinking whether so regular a phenomenon must not have some steady cause. Men in society always end by obtaining control over steadily-operating influences; and therefore we may hope to get the mastery over the causes of suicide, and nearly put an end to that mode of dying.
In order to do this, we must rouse ourselves into a mood of common sense, such as few persons but physicians and managers of lunatic asylums are accustomed to entertain in the presence of this tragic subject. There are many reasons why we should feel awe-struck and overwhelmed with some kind of delicate feeling or other when cases of suicide occur or are discussed.
The old Romish belief that the viaticum was necessary to save the departing soul, caused the death of the most innocent suicide to be regarded with horror and dismay: and far worse was the thought of the eternal destiny of the conscious self-murderer. His burial in unhallowed earth, with a stake driven through his body, was a shock to society, and a bitter disgrace to his family: and the anguish of those past times has been so far perpetuated as that every countenance still becomes grave, and every voice sinks into solemnity when there is mention of any one who has raised his hand against his own life.
Again, there is still a prevalent reluctance in society to advert to the subject of insanity. There is still an inability among the great majority of people to regard insanity as disease, in the same way as the maladies which affect other organs than the brain; and in almost every case of suicide the coroner’s jury declare the act to have been done in a state of insanity.
The insanity is considered a milder imputation than a design to perpetrate the act: but it is still felt as a grievous imputation, and one which induces awe-struck silence, and a desire of oblivion, rather than any practical study of such cases with a view to putting a stop to the practice of self-murder. Thus we go on in ignorance: and while we indulge in old prejudices and ill grounded sensibility, a thousand lives will be thrown away every year which a more reasonable and healthy habit of mind in ourselves might save. This seems to me a very serious consideration.
Young people always set out with supposing that self-destroyers are persons of acute feelings, who cannot endure the hardness of the world, or bear the misfortunes which have befallen them, by their own fault or otherwise. This view is so constantly confirmed by works of fiction, and by the traditions which have come down from ancient times, that we cannot wonder at it: but it would be a great blessing if the rude and disgusting truth were thoroughly known and appreciated that, in the great majority of cases, the self destroyer has injured his brain by drink or other excess; that, in others, the sufferer is a coward, or the mere victim of passion, or crazed by selfishness.
Most people would be exceedingly surprised to learn how many of the thirteen hundred self destroyers in any year were profligates, blackguards, cowards, and miserable egotists, who had brought their brains into such a state that they could not control their actions, nor bear pain of body or mind.
So many emotions of awe and tenderness are naturally and necessarily roused by any tale of wilful death that it seems to be harsh, coarse, and light-minded to say what I have said. While quite understanding, and even sympathising with, this kind of recoil, I must say that the truest reverence for human life, and the highest order of sensibility, will be that which shall go the straightest way to work to diminish the practice of suicide.
The true story of any coroner’s register, told in full, would bring us all into a mood of common sense, with no little danger of the most exalted sentiment being turned into strong indignation against the victims who had spoiled the happiness of so many people besides their own. Let us take any such register, in any district in the kingdom, and see what we shall find between any two dates. Here is a specimen of what is always going on, though it is not everywhere that so many self-murders happen in a single neighbourhood within a very few years.
A. was an agricultural labourer of a very superior kind. He was a model of physical strength, and might earn large wages from the quantity of excellent work he could do. He had a wife somewhat his superior in station and cultivation. No children. A comfortable dwelling; a kind landlord. No disease or misfortune, nothing amiss, till he and his wife took to drinking. On his landlord’s death he was excused long arrears of rent, but received notice to quit — altogether inevitable under the circumstances. His wife being absent, in a temporary service, the dwelling was observed to be closed one day. A. was found hanging in a closet.
B. kept an inn, with good command of custom; took to drinking, and threw everything into disorder; at one time hanged himself, and was cut down in time; at another time cut his throat, but not quite fatally: on which a lady was overheard to comment, “Dear me! that is a pity!” her sympathies being with his wife.
C. was a farmer and grazier: had good land, and enough of it, good stock, sufficient capital. In short, was free from pecuniary care, as far as the world could see. He was an eager angler, and sufficiently provided with amusement. He took to drinking. His sheep strayed, and were the pest of fields and gardens in the early spring before the grass grew.
He became ashamed to meet the complaints of his neighbours, and to show his cankered face among them. He slunk away to the meadows with his rod and line, or shut himself up with his bottle. He became occasionally wild with the horrors of delirium tremens, and then permanently despondent. He was watched and nursed very carefully: but one day blood was seen oozing out from under his chamber-door — he had cut his throat with his penknife.
D. was an active, cheerful – tempered young woman, affectionately treated by her family. She became variable in spirits, and was believed to dread desertion by her lover. She went out one day, without any remark or act which could excite particular notice, and was next seen dead in the water — her umbrella being on the bank: “Found drowned,” as the compassionate verdict declared.
E. was not without a vigorous and absorbing pursuit. He was, besides being a farmer, a poultry-fancier. But he took to drinking, and one day his body was seen floating, under circumstances which left no doubt as to how it came into the water.
F. was an old gardener, who had enough — by such work as he could yet do, together with his wife’s property — for comfort at home, if the home had been an amiable one. He might still have earned fair pay: but he was lazy and pleasure loving. He was trying to keep upon his feet in the road when he should have been prying his scythe or pruning-knife.
After a time, it became understood among the neighbours, when utensils were missed from back-yards and sheds, and when fruit disappeared from gardens in the night, that the pilferer might be pretty well guessed at; and, when the talk became more open, he was found one day to have gone away. He had not gone many miles. At a town where he went occasionally on business — perhaps to sell vanished billhooks, blacking-brushes, or rare strawberries — he was found hanging in a closet. His most intimate friend and drinking companion was
G., a postillion, so clever and full of local knowledge that he could make almost any amount of money during the travelling season of the year. Yet he could not pay the rent he had guaranteed for his daughter, or any other debt; and he, like C., was at last ashamed to show his blotched face in the place where every one had been well-disposed towards him. He drank all night after hearing of F.’s suicide, and in the early morning went to the stables. A little time after some one saw a pair of legs in an odd position, and went to see. G. had hanged himself.
H. was pitied, and let alone by the men on the farm on which he lived. He was considered weak; he had never married; and his father was well to do; so he went out as much as he liked with the stock, and no more. Whether he would have been weak as a sober man, there is no saying. He was not sober; and a feeble despondency took possession of him.
He was perpetually saying that he would not be seen any more, and bidding people good-bye; so that at last every one called it “his way,” and paid no attention to it. For once, however, it was said in earnest: he was not seen any more alive, and he had bid some of them good bye when he went out with some cattle. He was found lying at length in a brook, too shallow to have drowned him, if ho had not turned his face resolutely under water.
Is this enough, from one neighbourhood, within a few brief seasons? It is enough for my purpose, whether this coroner’s register relates to the north, south, east, or west of England. Of all these cases, there is only one which in any degree answers to the sentimental view of suicide: that of the young woman. The others all subjected themselves to disgusting and tormenting disease of brain, liver, and skin by a habit of intoxication.
This may remind us, that the thirteen hundred deaths in a year are those only in which the verdict of the coroner’s jury declares the case to be one of suicide. Coroners, physicians, and registrars are of opinion that a large amount of self murder passes unrecognised, and is called illness or accident.
Another noticeable circumstance is, that wherever there are suicides from drink, there is a large mortality from the same cause, so wilfully incurred that it is virtual suicide, though no coroner’s court may sit over the corpse. If the number of men and women who died intemperate — died of intemperance persevered in in spite of all imaginable warnings — in the locality of these suicides, and while they were going on, were added to the avowed self-murders, the disgust of inquirers would be almost lost in horror: so many innkeepers in five years; so many shopkeepers, so many artisans, so many labourers, till the churchyard is so crowded that the wonder is where the next series of suicides will find room — the verdict of insanity entitling them to a grave in consecrated ground.
Thus does a minute study of any district discourage every romantic association with suicide, and point to preventible causes. So do all the general facts of the case. For instance, nearly three men commit suicide to one woman. As there is no such disproportion in the subjects of what we may call natural insanity, we may attribute the majority of male suicides to the habit of men to incur the artificial insanity caused by intemperance.
It is too true, that many women are intemperate: but custom and opinion restrain the vice to a very small proportion of the sex; and it is observable, that the sort of women who so drink — the low population of our cellars and rookeries, and the outcast class — are precisely those who commit nearly all the suicides on the list.
Another general fact is, that the proportion of suicides regularly corresponds with the seasons of the year. The greatest number is in the early part of summer; next, in the opening of spring; and the smallest is at the end of autumn. So far is the popular association of suicide with foggy November from being well founded!
Again: suicides are (with the exception of some peculiar localities) more common in towns than in the country; and in one sort of occupation than another. There are districts which seem to be actually infested by the notion and the practice, while in others it is extremely rare. For instance, while the average of suicide for England and Wales is 68 in a million of the population in the three years 1856-7-8, the county of Pembroke afforded a proportion of only 10 suicides, while Westmoreland exhibited a proportion of 111.
These are the two extremities of the list of counties.
Every one would suppose that Middlesex would be at the top, and far above every other, unless, perhaps, its populous neighbour Surrey; but rural Westmoreland is worse than even the seat of the metropolis. Middlesex shows a proportion of 105, and Surrey of 104, to the 111 of Westmoreland. Such an act indicates constant and ascertainable causes; and the causes are not difficult to find among an antiquated population like that of our mountain districts, where natural instincts and passions are strong and comparatively unchecked, and where society is in a transition state from an ancient to a modern economy.
The change in the fortunes and method of life of the “statesmen” of the Lake District, caused by the agricultural improvement and the manufactures of the neighbouring counties to the south, has broken the fortunes and the spirit of many a rural family, and induced debt, despair, and drunkenness in many a homestead where all was prosperous a century or two ago. Here we trace causes of suicide, which, as the returns show, work only too surely; and such causes as these are preventible, and will assuredly be obviated by a further advance in civilisation — the first step of which should be, in the special case, an improved management in land and stock.
Another general fact is, the operation of the imitative faculty in propagating the practice of suicide. The case is too low to justify the use of the word sympathy. It might answer well to call it mimickry at once. People who commit deliberate suicide have generally a weak faculty of imagination, together with a strong egotism.
They cannot conceive of anything outside of their immediate trouble; they have not the serenity and fortitude which accompany a comprehensive capacity and excursive habit of mind; they think of nothing but an escape from present anguish; and they seize upon any suggestion afforded by the conduct of others. Hence a run of suicides when a new or fantastic method is exhibited.
The particular propensity is met for the occasion by some mechanical device: such as raising the balustrades of London bridges at one time, and covering over the gallery of the Monument at another. In their grosser forms of egotism, these imitative suicides are remediable by ridicule, neglect, or the punishment of such offenders as are rescued from death.
During the reign of Louis Philippe there was a suicidal epidemic in France, which would have been simply ridiculous but for the perdition of many young people who might have lived to be wiser. A pair of impatient lovers, who could not wait to be happy, shot or drowned themselves (I forget which), tied together with pink ribbons. As soon as the story had gone the round of the papers, another pair of lovers shot themselves with pistols, which were tied together with blue ribbons; and then others poisoned themselves, united by red ribbons; and others precipitated themselves from a balcony, bound together by some other coloured ribbons.
By this time, something must be done. The thing done was to suppress all public notice of such suicides for a time; and they soon ceased. In 1841 there was a rage for jumping into the Thames from the bridges. When there was a case almost every night, the survivors of the experiment, and those caught in the attempt, were sentenced by the magistrates to short terms of imprisonment. As soon as it was found that the real disgrace of conviction for an offence was sure to be incurred in case of failure, the number of suicides immediately sank to the average.
As to the permanent causes of that average amount —they are the influences (whatever they may be) which excite the destructive propensities. A maniac tears his clothes to pieces, if he can do nothing else; a man at large knocks down his neighbour, murders his wife, or cuts his own throat, according to the degree of excitement, or kind of passion that he is under.
The same propensity, disciplined by good training, superior powers, and habitual self-control, enables a higher order of man to preserve his health of mind, and occupy that particular faculty in conflict with his difficulties. He conquers fortune, instead of taking up the razor against himself or somebody else.
It is a very large and arduous remedy to obtain: but the true preventive of suicide would be a full and equable development of the human faculties, by which imagination would modify the present by the future; ameliorating sensations by ideas, and rendering despair impossible; and by which also all distracting selfishness would be precluded, like any other monomania.
In speaking of such an equable development, I of course include such exercise and regulation of the physical faculties as is indispensable to the health of the system. As a warrant for this view, I may cite one more general fact, indicated by the official returns; that, so far from the spread of education (random and partial as that education is) occasioning an increase of suicide, the amount diminishes (other things being equal) according to the superior quality of education, and increases among the uneducated classes, in proportion to their ignorance. In fact, the passions and propensities of the rudest people are the strongest.
Do we want something more within compass, more immediately practical than the grand method of preserving the balance of the faculties, and the health of the mind? Well, then, there are some very plain practical truths which we might attend to much better than we do.
I say no more about the artificial insanity which comes of excess in drink and other vicious indulgences. Nobody needs convincing of the mischief of intemperance, or the horrors of delirium tremens; and it is enough to fix attention upon the connexion of this artificial insanity and suicide. If we turn to what is commonly considered natural insanity — the insanity to which coroners’ juries attribute nearly every suicide that occurs — we shall find that some powerful preventive duties lie directly in our way.
It is an old complaint on the part of physicians, and of sensible people outside the medical profession, that families and friends, and sufferers themselves, conceal the symptoms of maladies of the brain till they can be concealed no longer. The further practice of making a secret of the existence or condition of an insane relative is mischievous in the same direction, by keeping up the notion that there is some sort of disgrace or insurmountable horror in insanity.
The notion is a relic of ignorance and superstition, as we see by the fact that nobody is ashamed of having been delirious in a fever. In that case, the simple physical origin of the brain disorder is completely established; and the delirium is regarded, when it is over, like the other symptoms of the fever.
In the case of the insane there is still some lingering of the ancient notion of possession by demons; or of the malady being a signal case of branding by the wrath of Heaven. No men or women would now admit that any such conception influences their minds; but yet they might find it a difficult matter to explain clearly why they feel disposed to conceal the fact of the insanity of any relative.
It is not my business here to go into any inquiry of that kind. My present point is, that a vast amount of curable brain-disease becomes incurable, and that a large proportion of suicides is occasioned by this practice of concealment of early symptoms. A man who would complain to wife or brother, and to his physician, of disorder in any other organ of his frame, will not speak about his brain. He would be explicit about disordered functions and local pains, and treacherous weakness of limb or sense, but he is gloomily silent about an impaired memory, irritable moods, depressed spirits, haunting fancies, and the long train of forerunners of uneoncealable brain-disease.
He goes on as long as he can, and tells only when he feels he is not to be trusted with razors, or the laudanum bottle. Then his family conceal it, trying insufficient remedies, and letting him go about till he assaults some eminent personage, or kills a child, or hangs himself. Such patients often, if not usually, pass through a stage (well known to convalescents from a “nervous fever,” as it is called), when the suffering from a sensation of tension in the head is such that the impulse to “let it out “is almost — sometimes quite — uncontrollable.
The patient may be as fond of life as anybody; he may have every reason, this illness apart, for valuing and enjoying life; his reason and conscience may be quite clear as to the duty and privilege of brave living and unselfish dying; and yet he snatches at the first knife within his reach, to relieve the intolerable sensation in his head. Hence the suicides, not only of convalescents from severe illness, but of many sufferers from incipient, or still manageable brain-disease.
Here, then, we see that a rational, honest, cheerful attention to the health of the head — just as if it were the chest or the abdomen — is one preventive of suicide. There is more behind, however. We must go still one step further back. The duty will not be fulfilled till the prevention of insanity itself is taken in hand.
To a great extent it may be said that the same improvement in education and morals which would preclude much suicide, would preclude a far larger amount of insanity. This is true; and it narrows the ground of special consideration. If we all lived so as to enjoy the best health, and if we were all good and reasonable, very few people would kill themselves, and insanity would be very rare. Taking that much for granted, there are special considerations belonging to the case.
Insanity, and particular forms of insanity, are hereditary. The practice of suicide goes down through successive generations, as we all know familiarly by the evidence given at coroners’ inquests. Out of this fact arises a clear and stringent duty in the matter of forming a marriage connection. But there is one point especially on which the evidence is so plain, and the consequences of transgression are so fearful to the parties concerned, and so injurious to society, that nothing but ignorance can excuse the commonness of the offence.
The intermarriage of blood-relations will hereafter be regarded as a barbaric crime, like some of the gross practices which we read of in ancient and in foreign countries far behind us in civilisation. We recoil from Spanish and Portuguese marriages between uncles and nieces; but we see marriages of cousins take place before our eyes, with no more effectual condemnation than a shake of the head, and a prophecy of future mischief. And this goes on while marriage with a deceased wife’s sister — an union which no natural law forbids, and some strong ones prescribe — is resisted by ecclesiastical opposition which makes no difficulty about the marriage of cousins.
One single testimony of fact will here be worth more than anything else that can be set down. The Commonwealth of Massachusetts desired, a few years since, to ascertain the number of idiots in the State, with a view to arrangements for their welfare, as well as to establish the statistics of the case.
The legislature sent out a Commission of Inquiry; and the Report of that Commission (written by the Dr. Howe so well known as the educator of Laura Bridgman, and as the Principal of the great Blind School at Boston, U.S.) lies before me. One passage [page 90] gives “the statistics of the seventeen families, the heads of which, being blood-relatives, intermarried,” which he had occasion to inquire about in the discharge of his commission. Ninety-five children were the issue of these seventeen marriages. Of the ninety-five children, one was a dwarf, one was deaf, twelve others were scrofulous and puny, and forty-four were idiots. Forty-four were idiots! Nature speaks plainly enough here; and no considerations of sentiment, custom, or prejudice should drown her voice.
We found asylums for idiots: we reform our lunatic asylums: we reason with our hypochondriacs, and soothe our sufferers under morbid melancholy, and try to divert and occupy the monomaniac. This is all very well: but it would be better to have no idiots and lunatics, and to know the practice of suicide only by tradition. We may aim at this from this day forward; and if we do not aim at it, socially and individually, it will concern us very closely to consider what share we have in the thirteen hundred yearly deaths in England to which we give the name of self-murder.